Loading...
HomeMy WebLinkAbout1023 SEA BREEZE DR - Building Permits � CITY OF COSTA MESA 4 BUILDING DIVISION F • ,i DEVELOPMENT SERVICES DEPARTMENT PERMIVNUMBER �• PERMIT v1305-01636 gilbbommo(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.BtfLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1023 SEA BREEZE DR Status: ISSUED Suite: Applied: 09/19/2005 Vicinity: Issued: 09/19/2005 Primary Occ: R1 Type of Construction: V-N Parcel Number 93529012 Zoning: Applicant: YRIBE,MARTHA Address: 1023 SEA BREEZE DR Phone x 714-292-3576 ISSUED BY: I COSTA MESA,CA __ Y-Zip 92627 Owner: YRIBE,MARTHA Address 1023 SEA BREEZE DR Phone. ' 714-292-3576 COSTA MESA,CA - Zip' 92627 Co • ntractorOWNER BUILDER • Address:' Phone: License: 000000 s - Arch :- - Eng: Address: Address: Phone: Zip - -License. _ License: • SCOPE OF PERMIT CAHNGE AT THE SAME LOCATION AND SAME SIZE TWO SLIDONG DOORS AND 2 BEDROOM WINDOWS.BEDROOM WINDOWSSHALL ;i';'COMPLY WITH UBC SEC.310A A COP`hWAS GIVEN TO THE APPLICANT �'ra 'FEE SUMMARY Plan Check:' _$0;00 . `` ( " Calc Valuation: ,. $4,800.00 Permit $111'25 ` ClaimValuation r: •$4;800:00 ' SMIP Res: $0.50ii. Other: ;- $0.00 Inspection - $0.00 { Total ($111.75 PLANNING & ZONING • • SETBACKS MAIN STRUCTURE Front 00 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 - ` d 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 U U 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: Carrier: 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 of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shalLforthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPEINSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),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 force and effect.Lic.# Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: _ A � I hereby affirm that under penalty of perju ;em EXE )3 THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any citydr:cdunty whi he:quires Alpe-:tip constrr U mprove,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signlilat9glent that he.or she Is'Iice e�pursuer; t rovisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ancrPlebfd'silons Coddj°or that hairs '' is exerdjit'het from and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applica to a civil'ptiialty of is more than five hundred dollars($500).): ❑ I,as owner of t e 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.). ' acI,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.). ❑� . v e .t un.er sec. Business and Professions a for this reason: _0111111L�, // :.Ignature: 1 A C.•, & •PO /[,J A t 0 `' • - •verified by drivers icons: Si - ❑No Od -- - L. - tD 6]O. 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: I 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 Jully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Ts the subject of this a plication a_permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end 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 a e-de cbpd property for i pecti•I purposes.I agree t to occupy or allow occupancy of any building authorized by this•:rmit until tip i tin pIction. {h— 6} Si•naure Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE I INSPECTIONTYPF DATE INTMALS CODE INSPECTION TYPE PETE WEALS 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 ! Z47 NC__ FROM : FAX NO. ' yep. 13 2005 01: 15PM. P2 • /pevkc 7m Ma/l679eme nt Ca /roc ,1000.144 La Palma Avenue L ` Anaheim, G4 91801-3650 • July 22, 2005 • Ms. M. Untie 1023 Seabreeze Drive Costa.Mesa,CA 92627 Re: Installation of sliding glass doors,windows - Pacific Terrace HOA ' Dear Homeowners: • As managing agents for the Board of Directors of Pacific Terrace HOA, we have been Instructed to advise'you that your request to install new vinyl sliding glass doors and windows at your unit located at 1023 Seabreeze Drive, Costa Mesa, CA has been approved: with the following • stipulations: • Installation to be done by a qualified licensed and insured contractor. • Permits — if required by the City of Costa Mesa a copy of the sign-off permit to be •submitted to the Association upon completion. • Construction debris to be cleaned up each day from the common areas prior to 5:00 P.M. • Theunit owner will be responsible for the curb area of Installation: Any problems associated with the sliding glass doors and windows including'but not limited to leakage, structure damage, and any collateral damage to other units as a result of any problem associated with the window or its installation is the. unit owner's responsibility. If the installation is required to be removed, the unit owner will be responsible for all damages and restoration costs of said installation area. The approved specification if for retro fit vinyl. Windows/Doors - Color: White. vinyl; panes double plain (no grids). Any modification to such specification must be approved prior to installation. • •: This installation and maintenance to be disclosedin all pending andfuture.esaows of this unit. The Board of Directors.appreciates that you have followed the'necessary procedures in order to .' have a.homeownermodification approved. Enjoy! • Sincerely.yours, FOR THE BOAF'.D OF DIRECTORS Pacific Terr- HOA • • . ianiels.` Perkcam Management Company, Inc. • . BOD: pmc • • • 7715PHONE.• 714-.956-2012 FAX 714-956-5720 • • • 09/13/2005 TUE 13: 10 [TX/RX NO 66541 21002 LOST 'Fs9 CITY OF COSTA MESA p, t��t1ra, P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 // a: t;l rli DEVELOPMENT SERVICES DEPARTMENT �C9gPORRTE0:94a Transaction Receipt • Date: 09-19-2005 ACTIVITY NUMBER: B05-01636 TYPE: SITE ADDRESS: 1023 SEA BREEZE DR Unit/Suite APPLICANT: YRIBE,MARTHA CONTR: OWNER-BUILDER 1023 SEA BREEZE DR COSTA MESA,CA 92627 714-292-3576 OWNER: YRIBE,MARTHA STATE LICENSE 000000 714-292-3576 CITY LICENSE TOTAL FEES: $111.75 TRANSACT.AMOUNT: $111.75 8000005326 R • R A . _ . Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)7544856 • TDD(714)754-5244 • www.ci.costa-mesa.ca.us '419_14-4. CITY OF COSTA MESA 4 _ �� P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 cipot00.00 ' DEVELOPMENT SERVICES DEPARTMENT PAY9q�ogP u. Cash NOTATION: TRANSACTION RECEIPT DETAIL INFORMATION FOR TREASURY: CAC 2000 Building Permit Fee 0300 $111.25 2100 Building SMIP Fee 0340 $0.50 • B000005326 • Ip Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)754-4856 • TDD(714)754-5244 • vnvw.ci.costa-mesa.ca.us APN a4 4,,,,.„,,,;,,- , Owners"r ° d ra . . .�.' �- ^�w. -, r.P,roperty.Address. _ ,_.. C 0 (1 935-29-001 TOLENTINO ROMEO _ EA BREEZE DR 1 2 935-29-002 KOSCIUCZYK ELISABETH A 1040 SEA BREEZE DR 2 at✓935-29-003 LO RICHARD HSIEN-TA Car6EA BREEZE DR 3 4 935-29-004 HEARNE MICHAEL N 1036 SEA BREEZE DR 4 5 935-29-005 RICHARDS CAROLE LEE 1035 SEA BREEZE DR 5 6 935-29-006 CONTINO MARCIA A 1033 SEA BREEZE DR 6 7 935-29-007 COPPER DOUGLAS A 1034 SEA BREEZE DR 7 8 ✓935-29-008 JEWETT BARBARA A 1032 SEA BREEZE DR 8 C Y 935-29-009 TORRE DE FUGET MARTHA E 02 EA BREEZE DR 9 10 935-29-010 STEEL MASON TUCKER&SHARON LYNNE 1027 SEA BREEZE DR 10 11 935-29-011 FRICKER NORMAN C 1025 SEA BREEZE DR 11 12 ✓935-29-012 SMITH STEVEN L&CAY 1023 SEA BREEZE DR 12 13 935-29-013 DEVINE JACK M & DOROTHY E 102GJEA BREEZE DR 13 14 935-29-014 LIEFFERS HENRY J 1024 SEA BREEZE DR 14 t n P¢rrr fS Plus �mk � t„ .... 11C�Uti3 VtS"cII?Lel) esf lc 15 -�� NJtAtne- --\-D rYte Vc, P' Nv be AG Paani7 tol(9 Copyright©1996-97 Experian Page: 1 of 1 4 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • PERMIT NO TRACT NO. LOT NO. UNIT NO. t CITY OF COSTA MESA CONSTRICTION PERM? p��a •7a qb� 9• �' l' I / I ;Protect Address 102.,3 ack (�p0r�0�/�..� �D 7 �rT - , -2146 2%I I/87 125 Applicant's Mailing Addres 10Z3 S24--OH.ZGZC. vt . • TYPE OF CONSTRUCTION NEW L i ADD U ALTERATION U REPAIR ' i e 78 TI �9\ 1 p� ❑'CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name' Q-W•' `�.P lwJt..�i - - Phone�z�Dti`1 . . .-_ y� A.P.# L}a a �' 13 r __ Z_ane ��, pr. p DESCRIPTION OF 0 R K SE 4 BLDG. lgZ•ri SUL-gt •TjC� 0-.. �^pS IN V.isAS�Pe ' me S. la - , y• - S Main Building: Accessory Building: Address - - ,'� 1—' • Arch/Eng. ' LicenseTNo. TYPE OF PERMIT U GRADING U OUND I[O-Nl C STRUCTU-AL T Front , S/ GI /t�.i 0 Address ❑ OTHERI El T e+ ELECTRICAL C PLUMBING Ll MECHANICAL '13 Rear /3/ • N • Contractor's Name d f-$ Phone / - N - PROJECT DESCRIPTION tS-p. FT. OCCUPANCY OCCUPANCY R3/I�ji C • Right �5/ G Address(mailing) CONSTRUCTION TYPE a+�+z VALUATION Chf�l u�•S *I100f City License NO. • ZONE ' GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION ' Ping. Ref.# Parking Req./Provided E hereby affirm that am licensed under provisions of Charter 9 (commencing • Remarks: •�! - Planning Notes' e�•1/� - M with section 7000).of Division 3 of the Business and Professions Code, and / �-^'- - T my license is in full force and effect. _ - , . License Class License No ' - - /���� _ S • Date Signature ' PLUMBING FEES 4 3 02-thr C.4,A Troc1— 94674' tett. nQh>� WORKERS'COMPENSATION DECLARATION Bar Sink' - Showers �/j.�)�LV�l�I�� ' I hereby affirm that I have acorn/icate of consent to self-insure or a certificate _ 7 'r ELECTRICAL • FEES ,r,.Workers' Compensation Insurance, br a certified copy thereof (Section -. 0, Lab. C.) I Backflow Preveriter Service Sink ; Automatic Washer Transformer's❑ 15.50 KW • i;cy No. • Company Backflow Irri anon -❑ 50+ KW u Certified copy is hereby turn fished. - g - Sewer Cap _ Construction Pole Sub. _• , - LJ • Certified copy is filed with the city Building Division. : Bathtubs, - ' Sewer Connection - Cooking Unit - Meter Duo to 100 amps , Date - Applicant - - - ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers' Solar Collectors r Dishwasher Meter Dover 100.amps• - - • (This section need not be completed if the permit is for one hundred ($100)or • 1 less). . • ; Dishwasher-, Solar Piping •_ . • Dryers ❑Gas DElectric Sub Panel • •, I certify that in the performance of the work for which this permit I issued, I - . . - , shall not employpany person,in any manner so as become to te Drinking Fountains Solar Tank' • _ ' Fan Motors❑0.1 HP ❑1'/2-8 Workers' e n Laws of Cali rni /l as to e ' Dates . Signature Floor Drains - Swimming•Pool w/Spa . ' F.A.U. ' Inc.Solar ❑9-15 HP 016-15+ ' NOTICE:.I after making This'declaration,.you should become.sub)e to the - . _ - - - Workers' Compensation provisions of the Labor Code, you must forthwith - Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shallbedeemed revoked. • • CONSTRUCTION LENDING AGENCY l 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 Outlets Lender's Name • - Range Lender's Address • Kitchen Sink t Water Service. .. - - •' .- OWNER BUILDER DECLARATION Switches - Sign I hereby affirm that I am exempt from.the Contractor's License Law,for the Lavatories , Auto-Wash Garbage Disposal Standing Sections • • • 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 Generator ❑0-5 KW❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains • • ,SPA. (hQ, the Contractor's License Law(Chapter 9(commencing with Section 7000) of SPA- '7 �.G 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 ' 11.5 by any applicant for a permit subjects the applicant to a civil ' • - - alty of not more than five hundred dollars($500). • •I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - ' Reinspection Fee 'I $15 Issue Fee I , . . $ 3 or sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL . . FEES - License Law does not apply to an owner of a property who builds or improves __ �-m thereon, and who does such work himself/herself or through his or her own % • DEVELOPMENT SERVICES REQUIRE )N : - �Jt-/r employees, provided that such improvements are not intended or offered for ' Boiler Hood or Type I 0 M sale, If, however,,-the building or improvement is sold within one year of cam- Cana Type II ❑'/ // '2.00Ing Approved By Date - pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • ' py yp - ,v/aeir ove for the purpose of sale). Building Approved By .._. Date ,1P�(.,�� as owner of the property, am exclusively contracting with licensed con- t on- Duct-Structural Refrigeration Syat6 'Application Issued By ' -- - -•��r� 1-- Dat. .... tfact ors to construct the project (Section 7044,Business and Professions Code: - / U The Contractor's License Law does not apply to an owner of-property who Duct-Ventilating ❑0-10 000 BTU ❑100,000 BTU . . ' MARY a" F' builds-or improves thereon,and who contracts for such projects with a con- - J� 7 r tractor(s) license pursuant to the Contractor's License Law). I am aware thato N� BUILDING PERMIT $�c�fiY"JZ7" SMTP - $ V proof of their Worker's Compensation insurance should be provided to me. Exhaust System-❑ Multiple 0 yst¢m Repair/Alteration • • PLAN CHECK $ �S•U3 PERMIT" ❑ I are exempt under Section B.8. P.C.for this reason Fire I/Fact.Bit. ICBG# / Fire,Dam ors ' - p p - - PLUMBING $ 6 'OD ISSUANCE :$ Date n._( IL in Owner ����� Heating System& Dycting - Registers - .; a 73 ENERGY P.C. $ ' PLAN CHECK 25% $• I hereby certify that I have read this application and state t-the above ❑0-100,000 BSU�❑100,000 BTL— - - /21 00 GRADING - .$ information is correct:I agree to comply with all city and county ordinances / ELECTRICAL $., - - and state laws relating to building construction,and hereby authorize repre-, -t , - - - (,� 'U MICROFILM • .$ ' sentatives of this city, to; enter u n the above-mentioned-property for; • • • ' PLAN CHECK 50% :$ 'I' • inspection purppse$, ' • - Signature' 1LW• Reinspection Fee • Issue Fee PLAN CHECK 25% $ ' 25--` 7p • ,CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting;Goldenrod - Assessor - _ - - _ a II . I,, CONSTRUCTION:ANIS' ..PLANNING <`t POOL& SPA . AP• PROVALS Permits# Date Inspector APPROVALS Permit# Date Inspector 1 Temporary Electrical Service or Pole 52. Pool & Equipment Location '2. Soil Pipe-Undrgrnd. " •• • 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms , 4. Electrical Conduit-Undrgrnd. • 55.. Electrical Bonding • • 5. Steel Reinforcement j • 56. Rough Plumbing & Pressure Test - 6. ElectricaLUFER Grnd: • 57. APPROVAL TO COVER-GUNITE' - i ' 7. Footings" e ?• '• c • 1. t 58. Electrical Conduit-Undrgrnd. .-/ ' ' 8. Foundation• , - 59: Gas Pipe, 0 Undrgrnd,,Test • . 9. Water Pipe-Undrgrnd`:; - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • 11. Property Sewer Line &.House Connection 62. Backwash & Receptor-Final 12. Sewer Cap _ • 63. Heater & Vent-Final • , ' 13. Roof'Drains - 64. Plumbing System - Final 14. Rough Plumbing •- 65. Electrical-Final • 15. Rough Electrical-Conduit • ' - 66. Solar System-Final • 16. Rough Electric Wiring ' • 67. Fencing & Access Approval I 17. RoUgh Wiring Sibn 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T bar Ceiling_ 69. POOL/SPA SYSTEMS FINAL , :, )11/10 19.- Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT I. , 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure ' ' 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil r• 23. Gas Pipe-Rough & Test- ' 72. Underground Flush • ' ,. 24.- Roof Framing- ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil _ 25. Roof Sheathing74. Overhead Hydro - , 26.,T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27.. Frame and Flashing - 76. Dry Standpipe • I - 28., Lathing& Siding77. FIXED SYSTEM FINAL ` ' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 3,1. Plaster Brown Coat 79. FINAL'INSPECTIONi '77 • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • ' `•I 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 • - 9 1 • • 39. Water:Service-Final � .. 40. Gas Service-Final 41. Solar Domestic-Final • - 42. Backflow.Preventer - I ' ,43. Backflow Irrigation • - L • • • :44- Landscape Irrigation System I-1 • 45. Sound Attenuation • r 46. Handicap Regulations . . - ,' 47. FINAL STRUCTURE & BUILDING - ,1 48..cSpecial Requirements Completed ''= 49..Electric Release to Edison • ' 50. Gas Release to Southern California Gas Co - '51,.-CERTIFICATE OF OCCUPANCY - ' ' h No. Date •i >. oveR NE>.D 19oAEQ 4 Lit-kw; ... .. , . K .fit -- Q 15� 1tt .{� 6XiSTiT-1G • CO 0-'‘., , )1 or � 0I I _.. ENCE �' r'1_Y�'" yQ� ' \ 2 ' 14./ APPROVED ,� , • _ OTY OF COSTA MESA (7::-yElectnCal Section 3•l ., [_`��4echanical Section 01A. /i'Iun1b Ecctiorr \,, 4GAL. /J/ li i." ��I f CONCRETES -� 1 ;•ed Date..... 76 I _ 7 l IH, cc..p NC, F A PERMIT BASED UPON P NS AND EC:i.G.1.y25 SJ!AL NOi PREVENT THE BUILDING OFFICIAL i.nc.FiER R QUIRINGTHE CORRECTION OF ERROR I . :" SAID PLANS AND S ECIFICATIONS OR FROM PREVENTING 5 ;JILD.NG OPERATIONS EING CARRIED ON TIIEREUNDER WHEN I N VIOLATION OF THIS$ ODE ORW6•AtIVINER ORDINANCE • 'F THE CITY. R NFCRMATIOTf CALL 7545273 I ( 0 Poa,R3i :::.,,CaVrr $- - -- 3-Z } SLlOihLG CcLAS9 OooR.HOt�E ---P- ! ecow). xt o . i • ( �qui PM£!ST A' --°- - - GAS LNE ir ?An %' x5J �. Em ods©� �" 15 RUr1� F\.-NCNETi CDA'C / PLANNING DW -- - _ — —4 '� /� i*i Ruc. DEPT. . II I / APPROVE: EX1S^c:, I I��DA7F t ' -7c i-El.... 1 l DIRECTOR OP PLANNING 41fII I / EQU1 PT.n6NT I i I t.AS M,T4R --/ / P\1M4 111 8 NA �� ld / Rog NE-WEAL Eu_ IV .. 1023 SE.A FR.EFZ.r 1150000 %tU E1EA7EFZ t --- ---"- ,,,Y..-- CO9t A, k'4W ' , CA, / 1t ... PROFOSEG Tc t ,r_.‘�1 Ji ` 1... • 144S- Sa a GPS E, 4 I I / . • )ii.___________________________._ _ . __ . .. . . . APPROVE® City of Costa Mesa Building g Dept. THESE PLANS — FATE ry MUST BGp/y� 19 STRUCTURAL APPROVAL ONLY NO CHANCES WITHOUTOO A7 PRIOR APPROVAL All TIMES MAKE iHEI ISSUANCEPROVAL OF DEPT. PLANS AND OR cRA"T,:,, SEPARATE PERMITS ARE REQUIRED BEA PERMIT FOR SPECIFICATION'S ,Ha Cr�^t'r•^^T ORFOR ELECTRICAL. PLUMBING, PERMITTHE FOR, OR Alc APsROVA; OF, .>.: .ONSTRIOF AN APPROVAL OF HEATING, VENTILATING AND AUTHORITY TO V O THIS OR :f.eJ0 F.,c..-.;I D';:.e " ANDY OF CODE SHALL Br. .,ti"OF REFRIGERATION WORK WHICH H AUTHORIZES EXCEPT G(yL J''r pfr.THE WORK C GIVE . ORIZES IS 1AWi UI.`' +:z AS THE y/�KOF THIS Q THE ISS; .µA ca ISSUANCE OF OR USE ,p P SPECIFICATIONS A PEP/"7 penult 9 it Y(r FRCM THEREAFTER HALL "'T P�cVE�7`}`'C U'';`" PIANS /ED ON THEREUNDER WHEN SAID PANS ANDREOUI41.� � THE COR,�y" i IIDING OFFICIAL THIS NUMDER MUS ACCO 14PANY VENTING BUILDING SPEQpCATp;, ECT/ON CF ERRORS IN IN VIOLATIpH OPERATIONS BEING w OR Faorn ALL INSPE;TION REQUESTS THE CITY. OF THIS CODE OR OF4ANY OTHER ORDINANCE OF ' FOR OUILOWGS WRE�;E PERSUh'S AAE TO OE EMPLOYED,WE "H"" STAT THE STATE OF CALIFORNIA DIVISION Of INOUSTAIAL SAFETY BE CONSULTED FOR ADDITIONAL REQUIREMENTS. i • N I ,' „ i I I 1 i i ' ' ?�\ '\ ,l j I / - I /7 ►_Ii - H+fHELE , V f, ! . 0.eca�JooC Oe-ck. , , . II __ . i I i) .Ex\s-<\'-s) F.a..Ce - i 'IrThQTc T Q- IOfe&-t—>/AY.arab, b PMIM aanr n—Cairn n1•94 a• Oa CIOVOSSAMP/StIONIUI aW.P DMON w9 •, . - ..NLY Of,T. /.e• as r ry ins n _ �..11•1 .. IMIMMIEMM M.�tir.+c.iv -_ ' wrn'taN w+�. ylranWln K ..waU.✓.errr TYP/CAL ow.va way sertION -tea c •.wW•V OM TWr+w owe ��_ .— «w1. s iw .w < a•'Z vwWW waw ). Irma."owe - v w war.. a.ww.all man LOW fooar,came Aro M:aN r.-.r. .Tf.r - lam -i . �..� : il. .t .y • T' -" I. q`\ flP/CAL isFC7/CN mane Ave '�• yrci t..n . .tt • T ti � ( �..�\ roves ;v. a. r..ww sea: w•w.. 2t`. ` • "6&; S. roe.. .w: •�• w... ... `a .',i W r.. N se err � . ter. • .•w. +. Iw+J Yd •w.w- r..r.. .w+rwr/ 1.,:t it ' • T .. 0 1=7 ".- .Z ( I w a.a..r.aio norm ow no 0 r.'yY rarse —. Mr. ea eabab or T111~•••••••‘•' I ..•.w••••• w win'moat W.) n • ._ t --1, . g. O r� 1 (�,� ' ,•iii .#40. I11— . . ( • ,) 1 • • ,..,.. ., 1 , ..„...,. r , (........,, 00,,e. IF . --REVISED � t% ' 'Y OF CI STA MESA aPCALIFORNIAG92626 .O. BOX t200 I. J� •Ole- .47 FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY °'pPa,nnEo Project Address KfrL3 S.36,-6 Permit # `t / /7 6 Project Name Al/E7J S)84- Wre � , Owners Name 1 /gee-lett Owners Address 7.67 Z-3r City Use Caly Owners Telephone ///teC YT -55--55-72-Z7 I (l/�"''e� �i'%e6 as Owner, Contractor, Agent (strike out all except one) do hereby attest that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In the event that any person, or persons, are employed under the provisions of this permit, I shall innediately cause a valid Certificate of Workmen Compensation to be filed with the Costa Mesa Building Division. I agree to defend at my own cost, and to indemnify and hold harmless, the City, its officers, agents and/or employees, frau and against, any and all liability, damage, costs, losses, claims and expenses, howsoever caused, resulting directly or indirectly from, or connected with the improvement under this permit. I further state that I have read and fully understand the implications and re- sponsibilities of the above statements, and will comply with all provisions of the Contractors State License Law found under the Business and Professions Code, Division 3, Chapter 9, of the State of California. S-7-5 A/ 244:- Print Name dr • -Al Signature Date / is ' CMF 0777-46 .ll/\p o ell/m :1 `-"..J1 L+7.1.L-N'A \'c+ J', 1 \-.irYV r 0l2 ( ,91 �' 2b2S -SV0) ---- --- i '7 \4''S-aW `cyitoo i i Z13�d3H Yl14> 000`SZ1 I 3Z3�a`� cBS �Zo\ j' 113M31V 0021 LI SaWV 8'\1 ` av d 'S 2 �/ ' a�iaw 5�9 i --v.' j/ 3JN914 cl 1V0"J '1:13H01314 VI �N�'6 5\ „1 i' j� S X ,4 bbd J �til-1 S`d'9 is \ ,-------- 4 y — ► .Ltv3wa1nb3 " -31,,,1Of{ -8-a1-3N+" -1:5'3 .L Dna 21000 WI-VD 9C1‘0 \5 >,..z.,,,,,z )(q�j T of 14-1"1-)1:14% % O h ' d\c Ss ��H9n tt7nod / '. Vara 1:a61.21 '1'd�?3�"�13 6\0 3soN is - I -"(ray of Costa Mesa Building Dept. 2 `(y� ,3 I 7 - I {Ya '. ' , DATE 3='R.-+ 1MESE PUNS MUST JOB ALL TIMES Y 'a: MAKE NO CHANGES WBEITHOUTON PRIORAT APPROVAL r OF WT. Yl� 0IlVa d� SZj (------4-:-. ., . DI$o'D '9\+ 1ks-- �i9i THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL 1 \ "7 - OF FLAWS ANO SPECIFICATIONS SHALL NOT BE CONSTRUED _\ V-J 0017 - TO BE A PERMIT FOR; OR AN APPROVAL OF, ANY VIOLATION OF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- b�0 A. ,�-- �- - BONING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE rte__.- PROVISIONS OF THIS CODE SHALL BE VALID, EXCEPT IN SO - o �— 7r�J ai /l /(p FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL �\ ddS (� /�/CEJ��f7 �•j ( / ''r`T THE ISSUANCE OF A PERMIT BASED UPON PLANS AND I \\ �Y(ta1S�g'T " " •1i•PA�1 THE SHALL NOT PREVENT THE BUILDING OFFICIAL Z IPP.UcT - t FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS 1 '‘N........_. ��_ it ���A NU�'�'�� ,+ ST�� NTING BUILD ii O PLANS PERAT OPERATIONS CARRED ON THEREUNDEPECIACATIONS OR FROM R WHEN I IN VIOLATII IF THIS CODE OR OF ANY OTHER ORDINANCE OF THE CIN. �_,,.L,• C- 30N3 j I I �` hTy\•iSIX3 Ii1 ,SI 3x111. A-1:)b)(3doaa __ _ / Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT"- """ PERMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address iOtS Seo-% .. t.Zz L. O`�� Jo2I ° � LJ I - ' : 1429• : 1/30/87 38093 TL •Applicant's Mailing Address ' fol (i./.. . egenaL )2.G M - TYPE OF CONSTRUCTION NEW ❑ ADD IJ ALTERATION 1i REPAIR f' ' • t , ,` CI CONVERSION ❑ DEMOLISH ❑ OTHER J,•�ia a Owner's Name R'W•W2.i.JL�� Phone •�•Z-Qa,\ A.P.# QS/-/a_ ,. - , Zone R•.� p♦ ESCRIP ION OF),NO K/ E OF BL G. ' Address ,iO7J. r>2'U- 7t•C.e7.i Ot- , COs1'q LA, SL 1 �4��) 7LJ /I- -crtlJ"$�/C,e //Pto zv r �V•� S Main Building: Accessory Building:4 ' Arch/Eng. ' License No. TYPE BFP MIT i GRADING �F OUNDAT ON C TRUCTURAL T Front '• '�'�/ O Address ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I B Rear / a / N Contractor's Name Phone '• ❑ OTHER C Righ / G Address(Mailing) PROJECT DESCRIPTION S F -_ OCCUPANCY 4 / I ' - — 927 .K CONSTRUCTION TYPE l� � VALUATION$ 7 Z$ - • -� $ ' eft (✓t75 2 I R City License No. ZONE - GRADING CU.YDS. ACRES • LICENSED CONTRACTOR DECLARATION Ping. Ref.# , Parking Req./Provided E Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: PeAt-- °3' — a7 _ .. Planning Notes: IQ met, patio— � M with section 7000) of Division"3 of the Business and Professions Code, and Li W 7 O ' T my license is in full force and:effect..} , I License Class ' _C License No. / - S ' Date Signature PLUMBING FEES. z -7- .6//sci �,(,O A IT1'1 -Ti (tc. YV/L/ /w' OW...Jr WORKERS'COMPENSATION DECLARATION Bar Sink • D`"_ " I hereby affirm that I have a cer tificate'of consent to self-insure or:a certificate Showers / - ELECTRICAL - FEES Workers' Compensation Insurance`,;Or a certified copy thereof (Section Backflow Preventer Service Sink ' 10, Lab. C.) - • Automatic Washer " Transformer 0 15-50 KW ' ulicy No. ' '�- Company Backflow Irrigation - Sewer Cap- "_ • • ❑ 50+ KW ® - 8 Certified copy is hereby'furnished. . - COnstfuctiO POIe Sub. Certified copy Is filed with-the city,Building Division. Bathtubs • ' Sewer Connection t Cooking Unit Meter Dui)to 100 amps Date Applicant '� - - - - EXEMPTION FROM WO RKERS'COM PE NSATION DECLARATION Clarifiers ` • Solar Collectors Dishwasher Meter ❑_over 100 amps (This section need not be.completed if the permit Is for one hundred ($100) or less). _-- Dishwasher • Solar Piping ' Dryers ❑Gas '❑Electric - , Sub Panel - I certify that in the performance of the work for which this permit is Issued,I _- ' . - • i • shall not employ any person-in any so manneras to beco object to the Drinking Fountains ' Solar T.' Fan Motors 00-1 • ❑1'G-8 ' Workers' gp 5ation Laws of Califbn _ . Date tI' 7 -Signature V- l,C/ /t,([l�.]f Floor Drains - Swi• ing Pool w/Spa' Ina Solar 49-15 HP 016-15+ .NOTICE:.If,after making this declaration, you should become subject to.the - — - - • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • rinal Fixtures Mic , ave comply with such provisions or this Permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY Gas Service Outlets • Water Closet Device Boxes I hereby affirm that there is a Construction lending agency for the performance •ole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name 9 Lender's Address Kitchen.Sink . Water Service . .. Switches . - Sign - - OWNER BUILDER DECLARATION - - - --- I hereby affirm that I am exempt from the Contractor's License Law for the • , Lavatories Auto-Wash • Garbage Disposal Standing Sections following reason (Section 703].5 Business and Professional Code: Any city or - county which requires a permit to construct,alter,improve„demolish or repair P-Trap ' • Laundry Trays • Generator ❑0-5 ❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit _ P to file a signed statement that he/she is licensed pursuant to the provisions'of . Roof DL- s • ” the Contractor's License Law(Chapter 9(commencing with Section 7000)of ' Division 3 of the Business and Professions Code) ord .that he/she is exempt• - .- - - - , - - r¢ am anthe'basis for the allegetl.e xem ption. Any violation of Section • • ]�p$ by any applicant for a permit subjects the applicant to a civil j/lty of not more than five hundred dollars ($500). I - . - 3 as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee• $ compensation, will do the work,and the structure is not intended or offered III - Reinspection Fee f $15 Issue Fee $ 3 • for sale (Secion 7044, Business•and Professional Code: The Contractor's I MECHANICAL 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 - DEVELOPMENT SERVICES REQUIREMENTS: . employees, provided that such improvements are not intended or offered for Boiler • Hood or Type I 0 • •i sale. If, however, the building or improvement is sold within one.year of corn- Canopy - Type II 0 Zoning Approved By �� mate pletion,'t he owner will have the burden of proving he/she did not build or im- Duct-Under-Ground • Building Approved By Date__! s 3 d v¢for the purpose of sale). - t /, SO ^ I; as owner of the property, am ekd usively contracting with licensed con- Duct-Structural Refrigeration S Application Issued By •! �' -%--Date ...J✓ ra rs 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 I:I BTU ❑100,000 BTU i/ �/Or SUMMARY OF FEES builds or improves,thereon,and who contracts for such projects with a con- - - - O"t� 00 rS O tra tors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ . Multiple 0 •stem Re.air/Alteration I71‘111 - / BUI DING PERMIT $ _ SMTP $ pr of of.their worker's Compensation insurance should be provided to me. E,x 1R L J PLAN CHECK $ LCL PERMIT' ��/��m exempt under Section B.& P.C.for this reason Rirepl/Fact.Blt. ICBG# Fire Dampers • PLUMBING $ ISSUANCE $ ' Date t_1.___01:2_Ird1 owner �W .Lw T•tt� - Heating System& Duc • - Registers 1l(,Omple tiIbPCCtIC PS - ENERGY P.C. •$ I hereby certify that-i have read this application and state that the above 00-100,000 BT :01100,000 BT PLAN CHECK 25% $ ELECTRICAL $ - - GRADING $ ' • Information is correct: I agree to comply with all city and county ordinances _ _ • • and state(laws relating to building construction,and hereby authorize repre- I • - - Dote . �IS - - `PLAN CHECK 50% $ MICROFILM' $ - fives of this city to-enter upon the above-mentioned. roperty for - _ inspection purposes. „ ( MECHANICAL $ TOTAL FEE $ 0•443 Signature K�. • . - - . - I - Date I - - $ Drivers"License or 55# ._ . Reinspection Fee 1 $15 ssue Fee $ 3 PLA 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 ' 3. Electrical Conduit Utility-Undrgrnd. . 54. Forms - • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , - 5. Steel Reinforcement ,' - , 56. Rough Plumbing & Pressure Test r • . I ; 6. Electrical UFER Grrid._ 57. APPROVAL TO COVER-GUNITEI . . . 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation ' . , ' ' i - 59. Gas Pipe, 0 Undrgrnd.,Test _ r 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 , L • 13. Roof Drains • S64. Plumbing System - Final ' - . ;...t4. Rough Plumbing... . 65. Electrical-Final ' 15. Rough Electrical-Conduit - 66. Solar System-Final a. 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,,inSttucture - 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil _ 23. Gar Pipe-Rough &Test 72. Underground Flush , 4,4. Roof Framing ^ ; ' 73. Undergrnd,Storage Tank 0 Gas 0 Oil ' • 25. Roof Sheathing . - 74. OverheedHydro 26. T-Bar Ceiling (Structural) & Monocoat . . 75. Dry Chemical , . 27. Frame and Flashing 76. Dry Standpipe . - 28., Lathing & Siding - 77. FIXED SYSTEM FINAL . h' _ . 29. Insulation 78. FIRE PREY. FINAL • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat79. FINAL INSPECTION 32: Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I 33. Final Electric ' Notes' 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy . i- / 37.IFinal Factory Fireplace - , 38. Final Plumbing - i. ' si 39. Water Service-Final • - 40. Gas Servide-Final - - . 41. Solar Domestic-Final . 42. Backflow Preventer - q !43. Backflow,Irrigation 1! i O • 44. Landscape Irrigation System ° `' E X R E • Incomplete Inspections 145. Sound Attenuation 1.441/ !n ' 46. Handicap Regulations Oate i 47. FINAL STRUCTURE & BUILDING . , 48. Special skequirements Completed 43: Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY, - r• • - No. ' Date _ • •' . ,00RESS: 1023 SEA BREEZE DR .UNIT CITY OF COSTA MESA — BUILDING PERMIT PERM NO': B 054091 NAME: PACIFIC TERRACE H.O.A. DRESS: ,1500 ADAMS AV PERMIT NO: B 054091 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA- 92626 • f, • CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT ARCM/ENGINEER: HEG.NO.: JOB DESCRIPTION : REROOF DUPLEX W/3—TAB ASPHALT SHINGLES SQFT: - 2, 156. ADDRESS: UNIT: CLAIM VALUE; 2, 156 . 00 CALC—VALUE: 2, 156. 00 GROUP OCC: R-3 / . PERMITTEE: ELLIOTT ROOF MAINTENANCE ( 714 ) 997-4938 ^A ADDRESS: 324 S EARLHAM• COMMENTS: INCLUDES OF "1025 SEA BREEZE" ALSO F§ Q �1c-rT�p ORANGE CA 92669 ***************TE*x*************** *+E%r�E*�E�ERE**%E*****�E�E**+E' ra" f�114 �BiE/H 6E P F LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS !REQUIRED Date LIC.: Q]Q96 5 Flay ELIC.: 5 3 4 4 cuss: C-39 s _� Dale: Y//{�- SignaWre: 7��— /�' MAIN BRIARING ACCESSORY EAILDING WORKERS'COMPENSAT"—Flay I hereby affirm that I have a certificate of consent to self-insure or a certificate of Work rs' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT ' IN . LEFT: FT IN lIGHT: FT IN POLICYNO.: 571785 EXP. DATE: 07/01 /92 COMPANY: STATE furnished. mfiedcopyis eawimthepyepilamgDivision. PARKING REQ: PROV: PARCEL; 93529006 INE; REF NO: ID Certified copy is hereby PLANNING NOTES> .�' It gale'. /f! Applicant: h- lyz- 8,ec ****************************** .********* *********)E***** ****** **** ********* 7 EXEMPTION FB1OM WORKERS'COMPENSATION DECLARATION:, This section need not be completed if the permit is for one hundred(41170)or less). DEVELOPMENT . SERVICES R E Q U I R E M E N.,;T S , 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. ZONING APPROVED BY DATE: ''fir Date: Signature: NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : i DATE: El • Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• 5-N DATE• Z' which this permit is issued(Section 3097,Civ.C)., ************************************************ ****************** ** LENDER: "DUPLEX" STRUCTURE ******************************************************************************* ADDRESS: "DUPLEX" STRUCTURE _ LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 . 00 • . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed • SMIP/NON—RES pursuant to the provisions of the Contractors'State 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 PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or of fered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS=--->, 54 . 50 0 . 00 ' 0 .00 . 54 . 50 - 54 . 50 . 00 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 employees,provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTALS-->. COLLECTED: 54 . 50 OVER/SHORT'• 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ' for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 0 0 • . 50 - . ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ********************************0***************!E*************************0**** that proof of their worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ' ❑ I an,exempt under Section: B.S P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST , TOTAL COST Dam: Owner: SFR 2156 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 156 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: "• I hereby certify that I have read this applicant 'and slate that the above information is correct.I agree to comply with all city and county' ordinances and slate taws relating to buildin r onslruction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. /rAic— Date: f Signature /i+r w Li �° .Cp 01 00092061-0009E087. TOT Drivels License m Social Security>: DATE: 09/25/91 TIRE: 13:13 1641-46 while—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 1 CTION AND PLANNING: . . POOL ?A ' Date Inspector Date Inspector LS Permit# APPROVALS Permit # vary Electrical Service or Pole 52, .Pool & Equipment Location . • 2. Soil`gipe-Undrgrnd. y _ 53.•Steel Reinforcement '3. Electrical Conduit Utility•Undrgrnd. ' - 54. Forms - ' '_rU4,'ElectricalConduit_ 'ndrgrnd. .5 - 55. Electrical Bonding • •,.•-: 5. tel Reinforcement - - - 56. Rough Plumbing.81 Pressure Test 5 > :d 6.,ElectricaI UFER Grnd. ,o ,..57, APPROVAL TO COVER-GUNITE 'R. footings Ix[ , - 1.158. Electrical Conduit-Undrgrnd. -. r • B Foundation •'' • 59. Gas Pipe, 0 Undrgrnd., Test .9. Water Pipe-Undrgrnd. - : "60. Backwash Lines, P-Trap, 0 Undrgrnd. , •, rn' .::. 10. Structural Floo}.SYste , 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 r•r• - - .. APPROVALS: L^Permit # 21,'Ducts,in Stryctute.; 4 1 ` `70. dndeig7ouni3 Hydro ' •22. Ducts, Ventilating . ' -- . ' 71. ProductrPiping DIGes Oil 23-Gas Pipe-Rough& Test .ti _ ,L t " .72. Underground Flush_ ; - = 24. Roof Framing •-,..- I - - - .. .. C;73.r Under rnd.Storage-Tank L7 Gasr❑Oil 25. Roof Sheathing - • t ' '74._Overheadi Hydro 26. T-Bar Ceiling (Structural) & Monocoat + • J '',t t 75.D_ry Chemical 27:;-Frame and Flashing • > , , 76. Dry Standpipe C ' • 28. •Lathing-& Sidings - _ t..' Y - 77:r FIXED SYSTEM FINAL- •29. Insulationr , ; 78-;FIRE PREV. FIN4L , _ ;' 30. Drywall Nailing = -. HEALTHIDEPT REQUIREMENT .31. Plaster Blown coat : Y •,79::FINAL INSPECTION = 132.. Electrical Power Meter-Final: , .... ,80.,-FOOD CEIRTIFIGe,TE ISSUED `'• = 33:tFinal Electric �' ; - 4,; ' ''Notes: 1'5- 4 ,. 34.-Final Heating1& C.Ir;Conditioningc 4' LI - _ "35.;Final Gas Pipe-Test• .1' - : :* •• ': .,••• : ,36.`Hoofl or,Canopy f: - x ,q .- v 37..Final Factory Fireplace 5.^ t• * ? r. I. -38. Final Plumbing I . ; .L • .39. Water Service-Finals ' , ' . .r ;40. Gas Service-Final r • d; ,.,, , , • -4' .r . >41. Solar Domestic-Final,-, - • - •6 + - .-, - • _ t , II. - 1 • 42.-Backflovdt Preventer.'s` - `; ! - • 43. Backflow Irrigation+ ' .. -s L.- _ i• 4 - s ,„44. Landscape lrrig * n Sem, -.`.1 c - - ; ...4 71.2 _C 1.8, ^ >45.;Sound Atte luatir7n; ' I i - t i. '_ .. .. .. IIS -s r••. .. :46. Handicap Regulatj c s -} • • c o . 7.t. 47:,FINAL STRUCTURE /170 /1 `s ,+`:,: •` 48Y-FINAL PLANNING? F1• ' ' - '• ', ;; : -49=Electric Release to Edison ,1 t >< ,_50. GasReleaseto Sou tern California Gas Co • j 'I• 1.41vt _,i tC J.^ ' 51. CERTIFICATE OE OCCUPANCY - „ -, • No. Date