HomeMy WebLinkAbout2412 SARATOGA WAY - Building Permits lb
CITY OF COSTA MESA
BUILDING DIVISION
). •a�` ''�• 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa .us
/,".r'# . FOR INSPECTIONS CALL: (714)754-5$2€RMII NUMIit 08-00010
oso F
PERMIT TYPE MECH STATUS: ISSUED '
APN: 41916281 DATE ISSUED: 01/17/2008
ISSUED BY: CAC
JOB ADDRESS: 2412 SARATOGA WY CM- Suite/Unit:
Vicinity:
SQ. FT: 0 - - - __ .
. - ` -- - .
SCOPE OF WORK: REMOVE ANP REPLACE FAU 5100 K BTU
OWNER: MAKI,ELLIDA K' Address: 2412 SARATOGA'Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: JAMES PELKEY ' _ Address: 5733 E SANTA ANA CYN UNIT G Unit:
PHONE: 714-307-0491 '` -. City/State/zZip: , ANAHEIM HILLS •
CONTRACTOR: ADALANTE AIR COMPANY - - License No: 862879 .
Address: 5733 E SANTA ANA CYN UNIT.GUnit: . - ` - . _ ._PHONE: 714-307-0491
City/State: ANAHEIM HILLS-°. ..ZipCode: 92807 CELL: ":`
MECHANICAL-PERMIT FEE SUMMARY •
MECH ITEM FEE: r $38.30 . - -- „
PLAN CHECK FEE $0.00
INVESTIGATION FEE:: $0.00 - -
REINSPECTION FEE: $0.00
TOTAL FEES: $38:30
•
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OFLASTINSPECTION.
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.
601E S. INSPECTION
TYPDATE INTITRlS 206 Final ec TYPE ^ DATE ,r INTIM.
'
1616 Fixed System Final Fire Prevention 206 Final Mechanical et/
1266 Pool Spa Final _ 208 Final Plumbing Y
200 Final Re-Root _ 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
WORKERS'COMPENSATION DECLARATION Owner ID verified by drib ,;e... .. ❑Yes ❑ No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: 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
Carder. or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp
(This sector need not be completed the permit is valued al one hundred dollars($100)or less.)
2,Art 2,Sec.341,Title 8,California Administrative Code).
Policy Number:
❑ As owner-builder, I will not employ anyone to do work which would
Q certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the - -r ' i pensation provisions of Section 3700 of
Applicant's Signature Dale
the bor Code,I shal forth 4 , j. r. • I th these provisions.
1 - _Aladin , /,� Division of Industrial Safety Permit Number:
��_SS-7777@@!t���JQQ•�L�� alwre ( Dale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
W G: FAILURE TO SECURE WOR 'S'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my licedse.is in full force and effect. J� O
' a registration form for acutely hazardous materials? 0 Yes 0 No
L .# P--a49 ,a7 • C: s# C (Section 25533 of the California Health and Safety Code, with some
.w arap, exceptions, requires registration with the Costa Mesa Fire Department by
I I/ d ' ' r�� each business which at any one time has on hand a quantity of acutely
ffillirc.. - ,i: ature a hazardous materials equal to or greater than a weight of 500 pounds, or a
Ila volume of 55 gallons, or 200 cubic feet of compressed gas at standard
CON -UCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued. (Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
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 (Section 65850.2 of the California Government Code requires that the requested
License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building perils).
Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑No
applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
O I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No
thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution
employees, provided that such improvements are not intended or offered for
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
property,
❑ I, as owner of the
LICENSED CONTRACTORS to construct the project(Sec.7044, Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Sate
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. _ _ the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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 .- 411,0
finalyinspection.
144-
Sign. . • 41,10:44 aDate
Signature Date 1 / I A ;MSSD g
30 57-4 6 131071 And/or Autv!
•• CITY OF COSTA MESA
• "' BUILDING DIVISION
F(re_ AI
77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
4. Ira . FOR INSPECTIONS CALL: (714)754-5626
411.ePoe
PERMIT NUMBER. 08-00001
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 41237153 DATE ISSUED: 01/02/2008
ISSUED BY: SOK
JOB ADDRESS: 1002 SECRETARIAT CI CM Suite/Unit:.
Vicinity: - - _
Squares: 2500 - - - - Valuations - "$5,000.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. INSTALL 1 LAYER 30#FELT, 50 YEAR METRO SHINGLES, REPLACE/REPAIR
SHEATHING AS NEEDED.4:12 PITCH.25 SQUARES INCLUDES ATTACHED GARAGE.
OWNER: HUNTER,PATRICIA Address: 1002 SECRETARIAT CIR Unit:
PHONE: - • ."City/State/Zip: COSTA MESA,CA-
APPLICANT: POPA ROOFING.INC.- - - - Address: 13672 ONKAYHA Unit: :
PHONE: 714-778-6294 - .� - City/State/Zip: IRVINE, CA - .
CONTRACTOR: POPA ROOFING INC. • LicenseNo. 675902
Address: 13672 ONKAYHAUnit: • . PHONE: 714-778-6294 -
City/State/Zip: IRVINE, CA 92720 - CELL:
•
ARCHITECT: - � License No. PHONE:
ENGINEER: - License No. - - PHONE
FEE SUMMARY
Reroof Plan Check: $0.00 -
Reroof Permit Fee:
Reinspection Fee: •
TOTAL FEES $111.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord. No.92-28,§1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE S. INSPECTION TYPE DATE IwnnAL$ CODE JI INSPECTION TYPE DATE INTITIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final /��,_�//�, 208 Final Plumbing
200 Final Re-Roof /-23-4 (�' 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
WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive.'" ❑Yes ❑No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
e ormance of the work for which this permit is issued.
ti
I H370 and will bCoworkers' oae insurance,ths required which
echo 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
permit is issued. My workers' ompen tion Insurance carrier and policy ❑ I hereby certify that no excavation fate(5)or more feet in depth into which a
number are: �1 4 person is required to descend,will be made in connection with work authorized
�,. Com. / 0 by this permit,and that no building structure,scaffdding,falsework,or demolition
Carrier. -.--) �c or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp
rnu seCwr need
not
meted if
permit is valued at one mired dollars($100)orless.) 2 Art 2Sec.341.Title B,California Administrative Code).
Poficy Num rub:-� beb(cf0 / D
( `� • 0 As owner-builder, I will not employ anyone to do work which would
❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject tr the workers' compensation provisions of Section 3700 of - -
the Labor Cod-,� fonh,fir comply with these provision
, Applicant's Signature Date
Z Division of Industrial Safety Permit Number:
Appli; s Signature' —� � HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION'COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No
(3100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires, with some
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire
ATTORNEYS FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. �7 a registration form for acutely hazardous materials? ❑Yes ❑ No
Lid;#`v"' ^- - '0V relies#—eZ (Section 25533 of the California Health and Safety Code, with some
L -• // -•�.�.%a-�'-• exceptions, requires registration with the Costa Mesa Fire Department by
S �� ( -2----/-4.--11-' each business which at any one time has on hand a quantity of acutely
1 centromere wr - 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
CONSTRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? ❑Yes CINo
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date
4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑ No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No
applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property. or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application.have all of the disclosures prescribed by Califomia
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
thereon,and who does such work himself or herself or through his or her own 8 (If• ",attach certificate of compliance from the
employees, provided that such improvements are not intended or offered for "yes", P appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044,Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
Business and Professions Code for this reason: 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.
Signature Owner(s) to
Signature Dale / /1�
3057-46(3/07)
r--------
AnmAuthor) m—�� (Date
•
1
Fire Incident # STA MESA FIRE DEPARTMENT .
Police Incident# P.O. BOX 1200
COSTA MESA,CA 92628-1200
(714) 549-1113
RELEASE OF PROPERTY AFTER EMERGENCY INCIDENT
The Costa Mesa Fire Department, in the interest of the safety and welfare of the community at I4 37, (time)5/12,/r,7 (date),
assumed control of the property located at stag 7e iAJAel /10A it 7s.
The necessity for assuming control of the property was because of tri 2 tr
Pursuant to the conditions contained herein, as ofU 7/7 (time) ;,m/ct7 (date), the subject property is released
to, and is to be under the control and the responsibility of ___/,,, ,a S 4�cr5c 1 An El (name),
who is the owner(y),owner's representative( ),tenant( ).
YOU ARE HEREBY PLACED ON NOTICE OF THE FOLLOWING CONDITIONS (Check applicable conditions):
(A) A rekindle or an additional fire from a hot spot is possible. The Fire Department recommends that a fire watch, with a
means to extinguish hot spots, should be posted for 24 hours.
) The following utilities: electricity(y ), gas( ), water(-c), serving the property have been shut off. It is advisable to
contact the appropriate utility company before restoring the service.
( y) The structure may have been weakened by the incident. Until a structural survey can be made, it is advisable to keep all
unnecessary people out of and away from the building.
(„) Buildings that cannot be locked or secured by normal means must be secured by alternative means. Barricades and/or
fencing are required to prevent unauthorized entry. It may be necessary to provide a security guard.
( ) Rebuilding and/or repairing the damage will require permits(e.g.,building,electrical,etc.)from the City of Costa Mesa's
Development Services Department, Building Safety Division. They may be contacted Monday through Friday between
the hours of 8:00 a.m. and 5:00 p.m. by calling(714)754-5273.
( ) The Costa Mesa Fire Department and the Costa Mesa Police Department retain the right to re-enter the property
at reasonable hours, should their investigation of this incident require such re-entry.
( ) Other precautions/conditions (specify): km).i Air 0: - A Ar. 72< ,.rv,vc c) _
The conditions listed above are not all inclusive. They arc intended as guidelines for the City's Fire Department in exercising their
discretion in providing emergency assistance advice.
Information concerning a copy of the report for this incident can be obtained by calling the Fire Department Business Office at(714)
754-5106, Monday through Friday,between the hours of 8:00 a.m. and 5:00 p.m.
You may be entitled to a reassessment and subsequent reduction of your property tax as a result of this incident. For further information
contact the Orange County Assessor's Office at(714) 834-2727,Monday through Friday, between the hours of 8:00 a.m. and 4:45 p.m.
The OWNER,OWNER'S REPRESENTATIVE, and/or TENANT shall protect,defend, indemnify and hold harmless CITY and its
elected and appointed boards officers,and employees from any and all claims, liabilities, expenses, or damages of any nature,
including attorney fees, fo inju 'to or death of any person,and for injury to any property, including consequential damages of
any nature resultigqg\th/eiefrom, . ising out of or in any way connected with the negligent performance of this Release by act or
omission,by or or:bdhalf o 0 E OWNER'S REPRESENTATIVE, and/or TENANT, or resulting from any violation by
OWNER, OWNE"STREP'_ . •N TIVE, and/or TENANT of any statute, law, regulation, or other legal requirement.
Signed: -* Dates VP//1)7 Time Dc17n
ON r(d,) Owner's Representative ( ) Tenant( )
Costa Mesa-Lire Department
Signed: J�r>1 7 - Assignment /Aii/�':C7.11 ATilt
/ Officer in Charge
•
•
WHITE-FIRE ADMINISTRATION YELLOW--OANE/OWNER'S REPRESENTATIVE/TENANT PINK--DEVELOPMENT SERVICES/BUILDING SAFETY
1PROJECTADDREsS:
2412 SARATOGA WY UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 069630
1 OWNER'S NAME: MAK I , ELL IDA K
ADDRESS: 2412 SARATOGA PERMIT NO; B 069630 PLAN CHECK NO: N GOVT; N SUP? : N
COSTA MESA,CA 92626
CONSTRUCTION TYPE: V—N PERMIT TYPE: STA PURPOSE: ALT
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; T/O RESTH & REROOF W/C-A+1 & HOT MOP SQ FT: 2,508
ADDRESS: UNIT: /nll�
CLAIM VALUE: 2, 508 , 00 CALC—VALUE:&if' 2, 508 . 00 GROUP OCC; R-1 /
' PERMITTEE: STOUT ROOFING INC ( 310 ) 923-6775
ADDRESS: P 0 BOX 4309 COMMENTS; REROOF SLOPE SIDE W/COMP FLAT SIDE BUR SMOKE DETE. REQUIRED
DOWNEY CA 90241 ***************************+E***kkx****aE************ac******1E*********yE******* ***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC�.7:'�05937 STArELIC.: 40236 , um: C 39 EXP: 10/95
DateIl„1 signature:-- _— _— MAIN BUILDING ACCESSORY BUILDING
WORKERS' OMPENSATION DECLARATION: hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT I N REAR: FT I N FRNT; FT I N REAR: FT I N
Compensation 1pttyare2oviegtified copy thereof(Section 3800.Lab.91.5/19/95 LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
POLICY NO.: J 6 EXP.DATE:
COMPANY: AIG ,,--;;(( PARKING REQ• PROV; PARCEL ; 41916281 ZNE; REF NO;
o Certified copy is hereby furnished. Ll Certified copy i bled with the city Building Division. PLANNING NOTES>
> •
n *** ************************************************************************
Date. ��� �� Applicant. `�� ****D E V E'.L OPMENT SERVICES R E U I R E M E N- .T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(4100)or less). Q
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: BUILDING APPROVED BY ; DATE;
NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor
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 B Y ; Y DATE:
3097.issued(Section *************************** lO **** ** *.
LENDER: ***************************+J3{'**************************************** **** ****
ADDRESS: LEGALIZATION;N `iF 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 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 PLAN
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the . 00
❑
—
TOTALS--structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'Slate License Law —> 54 . 50 0 . 0 0 0 , 0 0 5 4 , 5 0 S 4 . 5 0
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
improvementois sold le)hin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDGPLAN—CHH E'
iprthe ens of dale). PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING ECK
I.as owner of the property,am exclusively contracting with licensed contractors to construct the protect(Section 7044,Business
54 , 00 , 5 0
O and Professions Code: The Contractors'state 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). lam aware **************************************************************************il.*.x.*.*
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D - U A L F E E BREAKDOWN
❑ I am exempt under Section: B.&P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner: SFR 2508 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 503 , 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: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property for inspect'. purposes. ,fJ M(/��
Date: .� •—, _ Signature'. �/ / I. 01 00170640-00170641 TOT 54 513
Driver's License or ocial Security 4: DATE: 10/28/94 TIME: 13:17
164146 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL ,PA
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.-Sieel Reinforcement 56. Rough Plumbing & Pressure Test
6. -Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -
.7.-.Footings . . 58. Electrical Conduit-Undrgrnd.
' 8. Foundation ' - 59. Gas Pipe, ❑ 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 Cap63. 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
r
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1
_ !
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- „x ,V
20.-Rough Factory Fireplace ., -; _ r :APPROVALS^•:.Permit # •
21.'Duccs,in Structure' - . e -,70. U'ndergeound Hydro •
22. Ducts, Ventilating . , • • '71. Product:Piping OGSs D'Oil
23. Gas-Pipe-Rough & Test :, `„ -i i y72. Underground Flush .,
24.,Roof Framing . • ' 73.r�Undergrnd.StorageTank 0 Gas 0oil
r n
25. Roof Sheathing -• 4.4.4-lc( 6 tilt .-74;Overhead Hydro ,-
26.:T-Bar Ceiling (Structural) & Monocoat 'r 75t.. Dry Chemical - 11 ;r,
27. Frame and Flashing - 76"Dry Standpipe -,,_ ' - ,'t
•
28.- Lathing & Siding. . ... •• • • t 77.: FIXED SYSTEM FINALi.
r29. Insulation '' „ - '' 1 1 „ ; 7872FIRE PREV. FINAL r
130. Drywall•Nailing i• -I: HEALTH.OEPT,REQUIREMENT
31. Plaster Brown Coat. , . I fi i', - _79nFINAL INSPECTION
32.,Electrical Power Meter-Final -,- r ; ..-�• • :80. FOOD CERTIFICATE ISSUED
.
33. Final Electric •I 'r Notes: _ - -r
34. Final Heating,& Air Conditioning - ' I I, . .
4.
35. Final Gas Pipe-Test- .r '
36. Hood or1Canopy . - 1 I I '
37. Final factory Fireplace • - '' i J` : t i
38. Final Plumbing - . I. ,
39. Water Service-Final , I 1 : i'
',40. Gas Service-Final.. _.
41. Solar Domestic-Final .' - • ' - -
- - i A .t' Ir. r 1
42. Backflow Preventer ' I; '. '
43. Backflow Irrigation : . = .. -
44. Landscape Irrigation System - . • t; _
. a
45. Sound Attenuation - ; -
aa
46. Handicap,RegUlations - - . , -
47. FINAL STRUCTURE& BUILDING 6.4‘.45-644....9 ' .
48. FINAL PLANNING •• - '- .
.49. Electric Release to Edison _ } ^
,50. Gas Release to Southern California Gas Co I•-'�� .
51. CERTIFICATE OF OCCUPANCY-
No. Date
OWNER SAN Vista Building-Co. DATE ..(-21-b'( -
JOB ADDRESS 2412 Saratoga Way BI^TJDING PERMIT NO. 27325
GENERAL CONTRACTOR San Vis nag. Co. DESCRIPTION OF WOE Res.watt.gar.
AP No, 930-03-255 LOT 255 TRACT 5160 FIRE ZONE VtwUE $ 18,114.00
INSPECTIONS Signature Date GROUPI & J TYPE V ZONE R-3
Sod 7-2-3---4 7 PERMITS ISSUED
Gas ?rrrt -7 SUBCONTRACTOR I Date I Number I Signature
Water i c 2.-C7 [f Yr'7 f^G7 Pjiimbing //�o_
Rough Ptubing gyfz7 , u et-IPI/� 707/1i7'�.7.�Z
Prop. Swr. Line 0 House Con. g4-- /f.9-/S7. 2--7-C7 99
Sprinkling System
Miscellaneous
Rough Heating and Air Conditioning TIC, Y-(Ce67
Temporary Service or Pole
Underground 0 Power O .
Rou_h Wirin• . eafin d V t.
Trenches Jai Forms t Steel Reinf. 1 I Q- 7/3N._ co7 at- P. . ` . 91//.7 -da
Floor System � ///
Bond Beam 0 Steel Reinforce 0 �—
Sheathing R3 'Ad
Frame and Flashin Gr. @ . C
Lathing— In Out AF,. t,
Plaster, Brown Coat t-ir. •7
Structural, Final er ,gje. . 7 ft? .yec
Heating, Vent., Refrig. and A.C., '•.1 w ta. r oggyi y l. 1 t'
Plumbing, Final and Gas Test •r ift* at _ "Mar / ,
Electric, Final - urn -,-c
Building, Final I/Ai t _1
-y D
( -3'25
2IJUL 25- ,SA001681<` ,+.*:'=':9C.CC
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 9282E
For Applicant to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
For Office Use Only
BUILDING �J //�� COK
BUILDING
D O'.. I IV Q JL.CI� / RECEIPT NO. (^ ERMIT#4,05.
(/��C�O^S�TA MESA.. CALIFORNIA /n�_ y '7-?/-67
PATE
^ 7
OWNER (O Cgi.U(,.vz.tieHritatta
C�, -t lit-U-0-04-111 e° R[e[Ivs Y/� DATE c[//-4 /"?/u6/
ADDRESS /'�-rau) BUILDING
�`f ^'' (} / /'�tAFIRE
DDRESS ) (f/� �(/�/�CITY 0 �vmNO.LR32iM' ZONE TYPE //GROUP �Y )f
ARCHITECT {�,,'� APPROVED (///
OR ENGINEER O r -Q NO.%�1'-/ 221 BY DATE
GJ �j- ZONING
ADDRESS / 0.2171�L '41.291-1/)pLL.Q
nc R3 PLANS n
I BUILDI:firSing Res.
CONTRACTOR -nc a..l.ka
/� LESCR LI2S. 1 ,ta.G�-s20
ADDRESS .. 1 1 Ci.w....g DESCRIPTION
930-03-255
CITY n\ C?I-c.4--4-AA^ A.P.NO.
STATE \ TEL NOTE: NO DAVE OVERHANG SHALL BE LESS THAN
EO'TO HIDE O REAR P.L
LIC.NO. NO.
VES
SIZE ^�A ,,// NO.OFSLDGS. ALLOWED (U.B.C.REQUIREMENT) _
OF LOT �I/ /� -7� I NOW ON(.0y C7
USE OF -A._ YARDS APPROVED YARDS APPROVED
EXISTING BLDG. - MAIN BUILDING ACCESSORY BUILDING
(FROM C/L STREET)
SETBACKLINE'FROMFRONT 0 FT. PT.
CENTER OF nen REAR YARD
SIDE YARD LEFT RIGHT R.HIDE 0 FT. FT.
DESCRIPTION✓y/ OF WORK L slot 0 PT. PT.
NEW I ALTERATION ADDITIVN -REAR 0 PT. FT.
DISTANCE BET. BET.MAIN&
REPAIR MOVING DEMOLISH MAIN 131-DGS. ACCESS.BLDGS.
BUILDING 'J NO.OF �J VAR.* DATE
SIZE (� ROOMS St RI //' _ C.U.P.# APPROVED
EXTERIOR W�}"{�"/,' ROOF A- APPROVED //���/y�(/� p C
COVERING !/JF•(/ I COVERING ( X BY Weak.
DATE 7-1 -V7
USE OF BUILDING DWORK BE plc/FORM lll..���
-lG LI Ina ii a
f� %�/ Low
__e;3y° SQ.FT. Vya
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE j
AND STATE THAT ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. R1
PLY WITH ALL C •-DINANCES AND STATE LAWS REGULATING VALUATION
BUILDING CONE - •N. /R0 PERMIT FEE $
SIGNATURE OF )' y E
i4(.•412- ---
PERMITTfiFB/ /// PLAN CHECK S a 0 - 12
AUTHORIZED A EN• ��,,
.. .. r. ., ... TOTAL FEE $