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PROJECT ADDRESS: 1032 SEA BREEZE DR 0NIT - CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 054089
I OWNERS NAME: PACIFIC TERRACE H.O.A. '
ADDRESS: 1500 ADAMS AV PERMIT NO: B 054089 PLAN CHECK NO: N GOVT: N 'SUPP: N •
,II COSTA MESA,CA 92626
• • • CONSTRUCTION TYPE: 5-N ' PERMIT TYPE: STR PURPOSE: ALT
ARCH/ENGINEER: • REG.NO.: JOB DESCRIPTION : REROOF DUPLEX W/3-TAB ASPHALT SHINGLES SQ FT: 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
ADDRESS: 324 S EARLHAM • COMMENTS; INCLUDES OF "1034 ' SEA BREEZE" ALSO �+p }�RE E (+¢+E�0
ORANGE CA 92669 ***********�E**+ESE**�E***+E�E�6�E*TE*�P�P************�E***�E*ic*�P***** *JIVIV C li ! `/�
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section' ' ZONING R E U I R E M E N T S
7000)at Division 3 of the Business and Prole ions Code,and my license is in full force and effect. (// S E T B ACK S
CITY LIG.: 03.' 965 STATE LIC. 465344 ' /CLASS: C-39 Cn !RF
, Date: i — Signature: ��. y1•,— - �iLQ-ems - MAIN BUILDING ACCESSORY BUL ��'i1�U1�1%--D--
WORKERS'Cr PENS. ION DECLARATION: I hereby affirm t Ihave a certificate of consent to self-insure or a certificate of Workers' 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 RGHT: 'FT IN
POLICYNO.: 571785 EXP.DATE: 07/01 /92
COMPANY: STATE FUNDPARKING REQ: PROV: . PARCEL: 93529006 ZNE: REF NO:
7 Certified copy is hereby furnished. EX Certified copy is filed with the city Building Division. /PLANNING NOTES>
��9/ — /a— e / >
Date: Applicant: *****************************************************************•**************
EXEMPTION OM WORKS S'COMPENSATID DECLARAT (Thissectionneednotbecompletedifthepermitisforonehundred($100)orless). 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:
Date: - •Signature: - - —
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - DATE: .•
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked, q
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for - APPLICATION ISSUED BY: 7 DATE• WiFF �
which this permit is issued(Section 3097,Cw.C). *. *{p
LENDER: "DUPLEX" STRUCTURE *******************************************************************************
ADDRESS: "DUPLEX" STRUCTURE • LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
•
•
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE. SMIP/RES GRADING
(Section 7931.5 Business and Professional Code: Any city of county which requires a perm&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 tile a signed statement that he/she is licensed SMIP/NON-RES •
•
pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 70110)of Division 3 of the Business r
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 five hundred dollars(8500). , 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 offered for sale(Section]044,Business and Professional Code: The Contractors'State License Law j 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,tie owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING- ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 4 , 00 , 5O
❑ and Professions Code: The Contractors'Stale 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 *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
0 I am exempt Bober Section: B.&P. C. - -
for this • TYPE QTY DESCRIPTIO N UNIT COST TOTAL 'COST
Date: 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 Quality Management District.Residential construction applications are exempt from
these provisions.
Date: ppAppppplicanB '
I hereby certify that I have read this applicat n and state that the above information is correct.I agree to comply with all city and count •
ordinances and state laws relating to building onsiructlon and hereby authorize representatives of this city to enter upon the above-mention
property for inspection purposes.
/n 01 00098065-0009806E 'T'C11' . 1,4,55
Date: /7-4/9/ Signature y DATE: 09/25/91 TIME: 13: t4
Driver's L cense or social Security a:
1641.46 Whhe—Building.Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
_ '• -- POI SPA
- CONSTRUCTION AND PLANNING
APPROVALS Permit.4 - _ _ Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole • -. 52. Pool & Equipment Location- .
2. Soil Pipe-Undrgrnd. 1 - - 53.:Steel Reinforcement .
_ 3. Electrical Conduit Utility-Undrgrnd: ' - - c. -54. Forms - • - -
' ,%,4. Electrical Conduit-Undrgrnd. - - _"55. Electrical Bonding
'\t 5..Sieel Reinforcement - _ r56. sough Plumbing & Presiure Test
"6.;£1ectrical UFER• rnd. -i- - � : ,57. APPROVAL TO COVER-GUNITE L
%�J-€ootings i•'- . 'i,x58. Electrical Conduit-Undrgrnd. -t
' -8. Foundation T.> ' : 59. Gas Pipe, 0 Undrgrnd.;Test
9. Water Pipe•Undcgrnd. - >.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 i ,r., • 63. Heater & Vent-Final
13. Roof Drains c 64. Plumbing System.- Final
14. Rough Plumbing .1 65. Electrical-Final
15. Rough Electricaj-Conduit . 66. Solar System-Final •
- 16. Rough ElectricWiring 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 .•-i - - _ - - . tAPPROVALS--- Permit # e
21: Duets, ip,Structure'; ,, .. - y `70. Clnderground Hydro
22. Ducts Ventilating o c< {71, Product-Piping OlGas ❑.Oil
23.2Gas Pipe=Rough &'Test : _ - -72. Underground Flush. '.•
24.cRoof Framing . .- -• _ .'
.73Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - J. , ., '- ' 74. -' C:
.
26.T-Bar Ceiling (Structural) & Monocoat ` ..i.. 75.-Dry Chemical I' • • •n
27:_Frame and Flashings T. - 76' D'ry Standpipe Sr '
28.' Lathing& Siding` r . - ti 4c 77.7 FIXED SYSTEM F.INALe _ '
'29. Insulation - •, ; ' 78., FIRE PREV. FINAL r „. *-.>-;
i30. Drywallj'Jailing ,i - HEALTH:DEPT,. REQUIREMENT
31. Plaster Blown Coot: - i rr Y ‘,79:7F INA L IN$PECT1.2N -- '
. 32. Electrical Power Meter-Final: : } - a. , 780:, FOOD CE'RTIFICAfTE ISSUED r''
33.tFinal Electric _�• " - '•Notes: -" ^'S: - .x - -
6.1
1-.. 4 . •c . r rf n,�'
34.-Final Heating'& Rir,Conditioning w C. 5 ..:.y, I, ti _
351Final Gas Pipe-Test i •" 1 , W. l: 1
_36. Hogd otyCanopy'r r - t : . - -o
• 37:=Final Factory Fireplace .....1. - - - . . 4.
-- '_»
i. = -•
:38. Final Plumbing " -. u
;39. Water Service-Finals c . h ' - r . * .1.
ii - ' .z -. l
-40. Gas Service-Final ''' - - - " `''
;41. Solar Dornestic-Final : i", tT r
4 .; .C.-. r . .
' 42.`Backflow'Preventers F -
- s
43. Backflow Irr.igationr 'T, � - t t 1 'u,: n * r`, •--
• i t..
- _stem„ i , , ? f•i r - ; .3 i_ 7
t_44. Landscape Icrigatiop Sy .)_ _ s - i -
45 Sound Attenuation J s ,`- ' ' `„ - `-' '1 •T`• _ _
;_46rHandicap Regulatior•, �, _ • w - ",r, ;C SL',;-� 1
' •^47..-F14AL STRUCTURE-& B IDlNG /007 ROT : 't ;,;.>', •
4Br�pINAL PLANNING.'e- It`s - , •
Y I �:^ '- -
c-49.-:Eleciric:Releaseto Edison-- ;:-. -: i ,i -
50. Gas.Release to Southern ...,.. ornia Gas Co - i - • `
_. ; . -, Cit
r51. CERTIFICATE OF:OCCUPANCY - ;
No._ - I Date