HomeMy WebLinkAbout1993 SANTA ANA AVE - Building Permits WCITY OF COSTA MESA
ta. BUILDING DIVISION
>t ,• a DEVELOPMENT SERVICES DEPARTMENT PiER NUMBER
t j4 • PERMIT 06-01246
k e
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca®%1ILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 1993 SANTA ANA AV Status: ISSUED
Suite: Applied: 07/26/2006
Vicinity: EXTERIOR OF HOUSE Issued: 07/26/2006
Primary Occ: R3 Type of Construction: V-N
Parcel Number: 42628411 Zoning:
Applicant: GORINA, JOSE
Address: 10395 SLUSHER DR
Phone: 800-807-9889 ISSUED BY:
SANTA FE SPRINGS,CA Zip: 90670
Owner: MALMQUIST,JOHN C 2ND
Address 1993 SANTA ANA AVE -
Phone: 949-646-5612
COSTA MESA,CA Zip: . 92627
Contractor:? -SEARS HOME IMPROVEMENT PRODUCTS INC _ - � - % A,
Address: .=10395 SLUSHER DR - - - - -
Phone: 800-807-9889
SANTA FE SPRINGS,CA ,
• Zip: 90670 License: 721379
Arch : Eng:
Address: - Address:
Phone: Phone:
Zip: License: - License:
SCOPE OF PERMIT
INSTALL VINYL SIDING OVER EXISTING WALLS OF SFD(ER 1478). •
\ , ' - - A
FEE SUMMARY -
Plan Check: $0.00 Calc Valuation: $12,000.00
Permit: $209.25 Claim Valuation: 912,000.00
SMIP Res: $1.20
SMIP Com: $0.00
Other: $0.00 -
Inspection: $0.00
Total: $210.45
•
PLANNING &ZONING
SETBACKS
MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 ,. Right 0-9, "
ACCESSORY - Front 0-0 - . Rear 0-0 Left 0-0 Right 0.9-
PARKING Existinq: 0 -Required: 0 Proposed: 0 - -
i
- /.
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 resutt in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(& )
DECLARATIONS 1I -
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.
--CT:
workers'compensation Insurance carrier and policy number are: / _
Carier.7 >4(/C/ L Policy Number. > (yl Lel 4 't 3`'tW t(O C7
(This section need not be completed if the permit is valued at one hundred dollars($100)or less.)
❑ I certify that In the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of alifomia . d agree that If I should become subject to the workers'compensation provisions of Section 3700 of he Labor Code,I shall forthwith
comply with these pr ' ions. ` -
Applica t Signature: A A/t-`_ Date:. -- &-CO D Ca
WARNING:FAILURE TO SESWORKE COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLSARE($f00,..$ IN ADDIT•. TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 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.It. 7-2-1-5-7LClass# --s 13
S Contractors Signature: Date:— ' `7th 0 c'
CONSTRUCTION LEND AGENCY: -
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement Is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). '
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more 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 e
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health end Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this 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 L-)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 and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If'yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penally 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 slate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
Signature Of Legal Owner(s) Dat
AA . 11t 4 -' 'O -2-Cp___ . t9
�' nd/ar Authorized Applicant ( Da _
yODE tI .- ' I '' x'' ' PATE 1tf�L5 DDDE! INSPECTION TYPE DAM Itf AU
1616 FI'WSystem , Ire Prevention 206 Final Mechanical
1268 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 "
If
ADDRESS OF4L0IP 1993 SANTA ANA AV DMT' CITY OF COSTA MESA - BUILDING PERMIT
owNE"SNMIEIPIcmt MALMQUIST, JOHN C 2ND PERM NO: B 083731
• ADDRESS: 1993 SANTA ANA AVE
COSTA MESA,CA 92627 PERMIT NO: B 083731 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MMLRID ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
ApcHRECTORE, MER: LIC NO.: JOB DESCRIPTION : T/OFF REROOF W/COMP. & FLAT SIDE W/BUR SQ FT: 4 , 500
ARCH.OR ENG.'S ADDRESS: UMT:
CLAIM VALUE: 4 , 500 . 00 CALC-VALUE: 4, 500 . 00 GROUP OCC : R-3 /U-1
CONTRACTORSNAYE LEE ROOFING ( 714 ) 642-7223
COGRACTOp5MM1g10 1653 SUPERIOR COMMENTS: RESIDENTIAL REROOF
ADDRESS: COSTA MESA CA UCNC: 349686 >E****aE aEaEtt*ataEjt;rpt,E;t*+r*x** *tt*iE**********M>t*atxREaERtac******* ***at RE****n*xataE***x+ERE**+t
92627 um: ZONING REQUIR EMENTS
LICENSED CONTRACTORS DECLARATION;I hereby affirm under penally of perjury that I am licensed under provision of Chapter 0 SETBACK S
(commencing wish Section 7000)of Division 3 d the Business and Professions Code,and my license is in full face and end.
069337 uc.cuss: C 39 ucNO34°i XP: 02/98 MAIN BUILDING ACCESSORY BUILDING
' Date: ..1'-'" T-I'�1 Contractor: `19•, ear FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
I R BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
..wing reason(Section 7031.5 Business and Profession Code:Any city or county which requires a panne tommaud,alter.improve, PARKING REQ: PROV: PARCEL : 42628411 ZNE: REF NO: .
demolish.or repel any structure.prior to in
s issuance also requires the applicant for such pet to file a signed statement that he or she
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(oornmendng with Section 7000)d Division 3 d 144 PLANNING NOTE 'S '
Business aril Professions Code)or that he or she is exempt therefrom and the basis for the eloped exemption.My violation of Swath �.
7031.5 by any applicant for a permit subjects the applicant to a 641 penaltyd not more than Ewe hundred dollars poop. **********************fir****!E**iE7f***********iE************************1f‘Sk****lE***
O I,as owner of the properly or my employees with wages as her sole compensation,will do the work,end the endure is na intended
or offered for sale(Section 7044.Business and Professions Code:The Contmdon License Law does not apply to an owner of properly DEVELOP M EN T SER VICES R E Q U I R E M E N 'T S
who bunds or knproves theism,and who does such work Nmsell or herself or through his or her own employees,provided that such - -
improvements are not intended or offered for sale.ff.however,the building or improvement is sold within one year of completion the ZONING APPROVED BY DATE: h.'
ownerbuilder will have the burden d proving he or she did not build or improve for the purpose of sale). -
E Les owner of the propend.am exclusively contradkp with licensed contractors to comaruct the project(Section 7044.Business and
Professions Coda:The Contractors License Law does rot apply to an owner of property who builds or improves thereon end yds BUILDING APPROVED BY : DATE.
contracts for such projects with a contrador(s)licensed pursuant to the Contractors License Law). .
❑ I am exempt under Section: B.8 P.C..for this reason: APPLICATION ISSUED BY: DATE: i .
Dale: owner: **************************************** * *********************** r * T**
1 do hereby certify that I em aware of and understand the requirements of California Health end Safety Code Sections 25505,25533,and LEGALIZATION;N F E E SUMMARY STRUCTURAL `. EGM EN t:Y
25514.and that I or any Mere building occupant will/wit not(rims one)need to oomph/wih said state codes and the requirement for
a peri forconstmctlon or modification from the Ak ehiy enagement Diann.Resin/Mist mntmdanappireticneare exemP from three BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 99 . 75 . 50
Date: Applicant: SM I P/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarator: PLAN
El Ihave and veil maintanacertificate of consenttosal--insure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE FEE
Code.forthepedormenceoftheworkforwhichthispermitisissued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
'� o I have andwih maintain w«kers'compensation insuranceo t
as required by Section 3700 o Labor Code,for the performance of the
TOTALS----> lUU l5 0 . 00 0 . 00 100 . 25 100 . 25 . 00
C work for which is permit s issued.My waken'compensation insurance carrier end policy number are:
Carder C'TItTr. t'TThin EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 100 . 25 OVER/SHORT: . 00
Policy Number. 1nnnn A0 _ o-7 06/30/98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This section need not be completed/the pemmf is for-on;hundred dopers($IOO1 or less.) 99 . 75 . 50
El I certify that in the performance o the work la which this permit Is issued,1 shall v. any person In any manner so es to
robed to the workers'compensation laws of Geld I shoo, .v • subject to the workers'
hon pro�vi=/'wardSact//��bn 3700 d the Labor Code.I shall
with NoesA��.:. ... *************************************************************************iE*****
Date: '1—1 `Y —c� App'rat' �,()• � /!_ IND I V IDUAL F E E BR EAK DOWN
amine:Failure to secure workers'compensation coverage Is unlawful,and shell subject en employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
\ civil fines up to one hundred thousand dollars($100,000),In addition to the coat of compensation,damages as provided for In
Section 3708 of the Labor cods,Miner, sa
end enomeya7s . SFR 4500 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 500 . 00
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury gnat there is constructionwor
a ding agency for
nthe END OF FEES
pedoance d the w r
work which the peri s (Section 3097.Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify Incl I have read this application and stale that the above information is correct. city
.I agree l0 comply with aand county ordinances
end state laws rewire to construction constion and hereby authorize representatives of this city to to enter uptedbovem
a -meoned property
87-14-1997/82:12 P71/f188.25
moWg4MmaTy" '^9ERTS
e PERMITPT8.81-8889889
f/1.1/T� Date:/44 5t.. 983731
ignature of• Agan 115t3 t/Cont••or
)5151.45,WP) Whhe-Duildkp 8 Safety:Green- e:Canary-Appkcant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNINL _.l & 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 ,
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 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
77. 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, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing R 1 a_'Zc'� 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat b6 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating& Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace .,
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
- 43. Backflow Irrigation
1
44. Landscape Irrigation System
45. Sound Attenuation
46, Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING `I
.
49,. Electric Release to Edison ^ '
50. Gat Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA I PERMIT NO. c� TRACT NO. LOT NO. BLDG'. NO.- -- - '- -- -
CONSTRUCTION
PERMIT /A r. -// ZJ 9753 12/21/81 ' • "
Project Address A ,,qA a• \ i - • _ 7a 00 T�
1 Igg3 SAItry- An RYE . e•q� • TYPE OF CONSTRUCTION - , I
Owner N\ ' rt1MAL1MOuic-r Phone JI-0574 0 NEW 0 ADD 0 ALTERATION - - - - -
Address pa) 4t'- a - - - --- 0 REPAIR 0 CONVERSION ❑DEMOLISH - ZONING REGULATIONS
Arch/Eng. - - License-No. 0 OTHER. _q P _ _ _
DESCRIPTION OF WORK ' ' '
Address "
- - I - ZONE - - PLNG. REF.le, -
Contractor Vyl-) , -- - Phone TYPE OF PERMIT ' BUILDING - Tp gt�ILDING . - �, -
SETBACK C/L ST. PROPERTY LINE '
Address . - - - • - ❑ GRADING 0-FOUNDATION' 0 STRUCTURAL
SIDE VARD - - '
LICENSED CONTRACTOR DECLARATION 0 TENANT ❑ ELECTRICAL CIPLUMBING• ❑MECHANICSIDE YARD -- - - - -
I hereby affirm that I am licensed under provisions of Charter 9(com-
mencing'.
RIGHT ,
•
mencing',with section 7000) of Division 3 of the Business and ❑ OTHER _ _ -
Professions Code, and my license is in full force and effect. '\ REAR YAKS(TO P/L)
PROJECT DESCRIPTION _
License Class License No. PKG.SPACE REQ. - PROVIDED
Date Signature. - _ _ _
WORKERS'COMPENSATION DECLARATION .�- c OCCUPANCV_CONSTRUCTION TYPE STREET WIDTH 1 - PARK FEE $.
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION- ZONE ZONING-A PPROVED;BY _ DATE" '
certificate of Workers' Compensation Insurance, or a certified copy - SPECIAL CONDITIONS: • .
thereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES
Policy No. - Company - - - -- "- - - - - - - . . -
❑ Certified copy is hereby furnished. - . . ' REMARKS: --_ - . . _,. - - - ' I '- .
❑ Certified copy is filed with the city Building Division. . _ - -
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ . - ' ' - --'
(This section need not be completed.if the,permit-is for one hundred - - _ _ - •
($100) or less). . 1 - , . - _. _. _ _ _ _ -
-l_certity that In the performance of the work for which this permit i5 _ _ _ _
issued, I shall not employ any person In any manner so as to become y PLUMBING J _PLAN CHECK - ELECTRICAL-' PLAN CHECK ._ .- -
subjecttothe.Workers'Compensation Laws ot.California. - UW tLLIN(o --- -- - (.A HA&L
Date Signature' BATHTUBS SHOWERS e SO FT - 1
NOTICE: If after;making this declaration, you should become subject TOILETS., r- URINALS . ' . - ' -, GENERATOR - 0:1 KW—1-10 KW -
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS- - -APPLIANCE 10-50 KW -50+ KW - -
revoked. _ _-.
CONSTRUCTION LENDING AGENCY KIT.SINKS- ' - 'DISHWASHERS" --' " "' -- MOTORS "0-1 HP.=1-10 HP - - ,
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - - -- • -(INC.SOLAR) 10-50-HP 50+HP-
formance of the work for which'this.permit Is issued (Section 3097 - • , -
Civ. C.). - FLOOR SINKS - - FLOOR DRAINS - - , ' FIXTURES . - OUTLETS SWITCHES - ,
Lender's Name _ _
Lender's Address DRINKING FOUNTAINS .- -' - , GAS TUBE SIGNS - - ' - - - - -
OWNER BUILDER DECLARATION "" - INTERCEPTORS - - CLARIFIERS - - POLE LIGHTS - - - - - --
I hereby affirm that I am exempt from the Contractor's License Law for -
the following reason (Section-7034.5 Business and Professions Cotler SWIMMING POOL ` - P TRAP - - -LOINS I NUL I ION - -
Any city or county which requires a permit to construct, alter, 1. POLES METERED
' improve;demolish-or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION - -' --PANELS MAIN - SUB -
quires the ap1licant for such permit to file a signed statement that he
'is licensed pursuant to the provlsions'of the Contractor's License law' GAS SERVICE OUTLETS SERVICE- AMP -
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and'Professions Code) or that he Is exempt'therefrom and-the WATER HEATERS - " BTU OUTPUT ,- -- - - - - - - ' __
basis for the alleged exemption. Any violation of Section 7031.5 by - - - -• ' , ' •
any 'applicant for-a-permit subjects the applicant-to a-civil penalty 'SEWER CONNECTIONS - - " - -- .- - - - - ' ---- - '--- '
at nyt more than five hundred dollars ($500). - -
µf, as owner of theproperty, or my employees with wages as their -SOLAR TANK" - • ' COLLECTORS-- " -- - � ' --- '-- - -
sole compensation,will-do the work, and the structure is not intended_ _ _ _ -
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. i - ISSUE FEE "-- --- _ . _ -
Contractor's License Law does not apply to an owner of a property, - --- -
-- qpp LIGATION APPROVED BV - DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE
through his own employees,-provided that such improvements are not., - _
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
.is sold within one year of completion, the.owner will have the burden ,
of proving he did not build or improve for the purpose of sale). -
.fl Iq as owner of the property, am-exclusively contracting with HEATING SYSTEM 0-100,000 BTU - • PERMIT �$ .SMTP' -,$ •
licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 +BTUPLAN CHECK $ PERMIT :
CONSTRUCTION AND PLANNING 11 IIPOOL&SPA \ ' -
APPROVALS Permit I I MI ' Y11 Date Inspector • pppROVALSPermit# - Date Inspector
•
1. Temporary Electrical Service or Pole - 43.. Pool & Equipment Location ' - - - -
2. Soil.Pipe-Undrgrn • 44. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrn _,. 45. Forms • - •
4. Electrical Conduit-Undrgrn 46. Electrical Bonding - - - • • •
5. Steel Reinforce _ _ 47. Rough Plumbing & Pressure Test
6._ Electrical UFER Grn . _ - 48. APPROVAL TO COVER-GUNITE - -
7. Footings 49. Electrical Conduit-Undrqrn
8. Foundation . 50. . Gas Pipe, ❑Undrgrn,Test
9. Water Pi pe,Undrg[n_- 51.• Backwash Lines.P-Trap. ❑ Undrgrn
10. Structural Floor System 52. APPROVALTO DECK . '
11. Property Sewer Line & House Connection . 53. Backwash & Receptor-Final '
12. Street Sewer Connection .. - . - 54. Heater- & Vent-Final
13. Rough Plumbing -, 55. Plumbing System - Final .
14. Rough Electric-Conduit - •56. Electrical-Final
15. Rough Electric-Wiring - • - 57. Solar System-Final . . -
16. Rough Heating & Air Conditioning- . 58. Fencing&Access Approval .
17. Ducts, in Structure. _ - 59. APPROVED FOR PLASTERING
16. Ducts, Ventilating - . -
19. Gas Pipe-Rough &Test ' : ' 60. POOL/SPA SYSTEMS FINAL ' -
20. Roof-Framing - -
21. Roof Sheathing ' - . - NOTES: Mole- etl ' � ' /__ 15.-E-2--22. Frame and Fla
shing - /
23. Insulation .. - _
24. Lathing &Siding - - - - -
25. Drywall Nailing - ..
26. Plaster Brown Coat - - - -.- . -
27. Electrical Power Meter-Final , - - ,- , '
28. Final Electric - . - - - - -.
29. Final Heating & Air-Conditioning [4h 1-2---16 F .
30. Final Gas Pipe-Test - -
31. Final Plumbing -
32. Water Service-Final _ - . - '
33. Gas Service-Final
34. Solar Domestic-Final - • .
35. Landscape Sprinkling System •
• 36. Sound Attenuation
37. Handicap Regulations • -
38. FINAL STRUCTURE & BUILDING -
39. Special Requirements Completed -
40. Electric Release to Edison -
41. Gas Release to Southern California Gas Co. •
42. CERTIFICATE OF OCCUPANCY -
No Date - - - '
I' ."-\/ • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY Cf COSTA MESA PERMIT NO. TRACT NO. LOT NO. -BLDG.NO.
4-ONSTRUCT1ON PERMIT a. `/3 L. 112- I
Project Address ,%13 Mai Mt* P '4E '. , "•••IE OF CON UCTION •
COI1! '/ /
Owned WV(AM NALM GUISr Phone631A-O� SR`V 0 NEW ADD O ALTERATION .
Address IctQ3 SRNVA Anlq AVS C . -'I• 0 REPAIR 0 CONVERSION ODEMOLISH ZONING REGULATIONS
•
Arch/Eng. License No. 0 OTHER ,4 /��
U�Es CRIPT N ALP' gstip OF WORK e, — ten-11
Address Yy4M. QM. 2 SQ. P . ZONE R-'/ PLNG. REF.
• ContractorCOone BUILDING ,�.�/. TOBUILDING
/(l TYPE OF PERMIT SETBACK C/L ST. Att. • PROPERTYLINEAddress 0 GRADING�FOUNDATIO STRUCTURAL s LFT IDEYARD [-8 .ow
LICENSED CONTRACTOR DECLARATION 0 TENANT ELECTRICAL PLUMBING OMECHANICAL SIDE YARD /�
I hereby affirm that I am licensed under provisions of Charter 9 (com- - RIGHT /0 L
mencing with section 7000) of Division 3 of the Business and 0 OTHER -
Professions Code, and_ my license is in full force and effect. REAR YARD(TO P/L) s3 '(y
PROJECT D CRIPTION
License Class License No. - �� v
SO FT - PKG.SPACE REQ. PROVIDED
Date -- Signature
, c STREET WIDTH PARK FEE $ —
' WORKERS'COMPENSATION DECLARATION OCCUPANCY C5ATerICTION TYPE
I hereby affirm that I have a certificate of consent to self-insure or a VALUATION • `^d ZONE7
ZONING APPROVED BY OIKi•/I,�/yl DATE L/Lf[/e1
certificate of Workers' Compensation Insurance, or a certified copy I-�r .l A
thereof(Se/ccttio�n//3800 Lab.C.). ��y��"./y GRADING Cu.YDS. ACRES SPECIAL CONDITIONS: '
policy No.l�QpS77-R/Company S *Th rU,uG ,
Certified copy Is hereby furnished. REMARKS:
Certified copy is filed with the city Building Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION .. . k . '
(This section need not be completed if the permit is for one hundred - • .. - _ - . •
($100) or less).
I certify that in the performance of the work for which this permit is -
Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers Compensation Laws of California. - UWELLIN1a --airyry (aA HA(aE 10 �s
Date - __Signature BATHTUBS SHOWERS SO FT / f� SO FT s/6
NOTICE: If after making this declaration, you should become subject -TOILETS • URINALS GENERATOR 0-1 KW_1-10 KW
to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW - '
revoked. -
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS 'MOTORS 0-1 HP 1-10 HP
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS • - (INC.SOLAR) 10-50 HP 50 + HP
formance-of the work for which'this permit is issued (Section 3097 -t - _
Civ. C.). - FLOOR SINKS FLOOR DRAINS-, .\_1 ,> ‘, FIXTURES OUTLETS SWITCHES
Lender's Name -
Lender's Address DRINKING FOUNTAINS r„__ ,I',� S r\ .GAS TUBE SIGNS
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS': POLE LIGHTS
I hereby affirm that I am exempt from the Contractor's License Law for 'r �'
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP _ cons HUt IIUN
Any city or county which requires a permit to construct, alter, - -1 c, POLES METE��$�A SUB
improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION l ' •2 PANELS MAIN jf SUB ,S co
quires the applicant for such permit to file a signed statement that he
is licensed pursuant to the provisions of the Contractor's License Law ' n +: SERVICE AMP
(Chapter 9 (commencing with Section 7000)-of Division 3 of the GAS SERVICE / OUTLETS •.-j -'i " P S
Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS(� BTU OUTPUT 2 co . '
basis for the alleged exemption. Any violation of Section 7031.5 by • ' '
any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS amen_ 3 es es -
•
of not more than five hundred dollars ($500).
O I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS - 4\-
•
sole compensation, will do the work, and the structure is not intended - ' - . .
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE 3 O
Contractor's License Law does not apply to an owher a propertyifor � APPLICATION APPROVED BY /118 t
who builds or improves thereon, and who does suchmwork himself or ISSUE FEE , DAT E'9
through his own employees, provided that such Improvements are not YY
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK S MMARV OF FEES
is sold within one year of completion,the owner will-have the burden -
ofproving he did not build or improve for the purpose of sale). BUILDING • Cy
SYSTEM 0-100,000 BTU • PERMIT $ a SMTP . ' $ 4O I, as owner of the property, am exclusively contracting with AND DUCTING
•
licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ 22• 2- PERMIT
and Professions Code: The Contractor's License Law does not apply to ` 00 ISSUANCE $
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU _ PLUMBING $
tracts from such projects with a contractor(s) licesned pursuant to SYSTEMGRADING $
the Contractor's License Law). 100,000+BTU • _ PLAN CHECK $ 's p
1:1I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $ /t• Ci $
reason MICROFILM $
Date Owner - SYSTEM REPAIR,ALTERATION PLAN CHECK $ TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ -
information is correct. I agree to comply with all cityand countyPLAN CHECK LESSANEP
9 P $ VANCE PC $
representatives
and state laws relating to terst upon ,and hereby authorize •
representatives of rthis city to enter upon the above mentioned IJ!/lsO9
property for.y79 o`s'�e�tl n pup rApses. /y J s/A^i/
Signature -_ ,` --
ISSUE FEE -
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
. \
CONSTRUCTION AND PLANWIG POOL&SPA
'- . ' "
APPROVALS Permit el.i13a Date Inspector
APPROVALS Permit - Date Inspectu�-
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location •
2. Soil Pipe-Undrgrn 9/ 5't -elTzJ 44. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn .46._ Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing & Pressure Test
-
6. Electrical UFER Grn 9/-,.8t p 48. APPROVAL TO COVER-GUNITE
el/7. Footings /a 9 � p 49. Electrical Conduit-Undrgrn '
8. Foundation 50. Gas Pipe, ❑Undrgrn,Test
9. Water Pipe-Undrgrn .1/1Q'Y �/?C 51. Backwash Lines.P-Trap. ❑ Undrqrn -
-10. Structural Floor System 70.9-5/ 52.- APPROVAL TO DECK
•
11. Property Sewer Line& House Connection 53. ..Backwash& Receptor-Final
' 12. Street Sewer Connection n 54. Heater & Vent-Final -
13. Rough Plumbing / o - lye f S N ( 55. • Plumbing System -Final - -- - ' ' - - •
14. - Rough Electric-Conduit -56. Electrical-Final - '
15. Rough Electric-Wiring - - ,/t,_Li-S'( - e 57. Solar System-Final • .
16. Rough Heating & Air Conditioning 58. Fencing & Access Approval
17. Ducts, in Structure . 59. APPROVED FOR PLASTERING •
18. Ducts, Ventilating - -
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • .
•
20. Roof Framing •
21. Roof Sheathing -
22. Frame and Flashing re // 43- gi NOTES: teat 0c1 . A) c ZS /m/3�
• 23. Insulation /24&f/ r43' • .. IUn{- Y c( o l'I-5L 7
24. Lathing & Siding 2,fj, / ,a-- _ . •
25. Drywall Nailing ,f2 4--1 i '
26. Plaster.Brown Coat _��" � •/�2 c ,8/ _ - • . ...
. 27. Electrical Power Meter';1.nal - _ - ..
28. Final:Electric • /•-g.7-tom C! e_ ` ' '
29. Final•Heating & Air Conditioning - .
30. Final Gas Pipe-Test - - .. ` -
31: Final•Plumbing //J--7f 2 /%,2 -
32. Water Service-Final ����l�
33:' .Gas Service-Final , .
34. Solar Domestic-Final • . -
35. . Landscape Sprinkling System : - .. .
36. Sound Attenuation _ •
37. Handicap Regulations -- • . .
38. FINAL STRUCTURE & BUILDING 2-q, 82 >dt:
39. Special Requirements Completed
40. Electric Release to Edison .4--7-x'.1, -. '//I -
41. Gas Release to Southern California Gas Co. - '
42. CERTIFICATE OF OCCUPANCY '
- • No Date - .
APR 2 1 1960
OWNER GUTLFORD1 LESLIE V. DATE ll- -K9
JOB ADDRESS 1993 Santa Ana Avenue BUILDING PERMIT NO. 10791
GENERAL CONTRACTOR ocaner/builder VALUE $ 200.00
sets
AP. No. 118-13h-09 LOT 1 & 2 TRACT 712 FIRE ZONE DESCRIPTION OF WORK ats fax II/&xt.orgs
bathroom f>.�t�tr�s
INSPECTIONS DATE_I GROUP I&J TYPE V ZONE Tt
Underground Soil U.G. Water PERMITS ISSUED
Underground Gas SUBCONTRACTOR DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr.
Sprinkling System
Heating, Final
Plumbing Fixtures t� �1
Final ct Test
P / /
Construction Pole
Underground Power
Rough Wiring �i
Trenches Forms Steel �` _ i
G"(i
FloorSystem
Steel
Reinforce Chimney Re-Rod
Bond Beam r� 6 �J
Sheathing
Frame
�r �� —17
/
atmand n Flashing '
v'�,
Lathing,. In Out /i1-
Plaster, brown coat
Plumbing Fixtures, Final C-" - „
Electric Fixtures, Final
Building, Final
OCCUPANCY
Form 210-3M-4-59 1 A701
10991 isEE RECEIV}: J
E �at/ //— lv v/�7
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT,
P.O.BOX 317 COSTA MESA. CALIFORNIA •
CITY OF COSTA MESA
rFOR APPLICANT TO FILL /N COMPLETELY APPLICATION FOR PERMIT
TYPE OR PRINT
t1 n/ BUILDING
ADIDRESSG /,,// q3 Sc ///UQ �Ve-
COSTA MESA, CALIFORNIA FOR OFFICE USE ONLY
/! c ((• /�/ / RECEIPT NO. I II E1Yem)4aISO.Ai
OWNER LeS He 111/! ) }61 ci .IL Y
MAIL /7 f- 'J' y, { l REED BY DAT/a EC IVED DATE ISSUED
ADDRESS ! %ty1/Q '!�J Il/P/(^ LA +1 /l/� ch-- I i/- f-J f'
/(1 7� TEL. / �I/ / /
CITY S' (��-i4 NO. ADILDING
ADDRESS
ARCHITECT LIC. COSTAMESA. CALIFORNIA
OR ENGINEER NO. / (J1�
FIRE
A
CONTRA
ZONE TYPE ROUP �/
STATE APPROVED -�/ [ /J
CONTRACTOR Q�h,.,' LIC.NO. BY C� l DATE'l/p/,j
ADDRESS 9$04 ZIONING o
LEGALI LOT 4 I pNLOA.,405F 01
_
DESCRIPTION NO. / BLOCK TRACT 1
/ APPROVED it/L-/)
/
A.P.NO. I�'�t I / 3 -/a y BY W {^/l) DATE i /--Y -A
OF LOT �. 1 U y. I�1� Ir/IC' NNow oN LOTS YARDS
YADS
REQUIRED AWED
USE OF (CENTER�s y (CENTER LINE ST.)
EXISTING BLDG. l/ /,vt(JtC>rYL_ FRONT IN.
SETBACK LINE FROM
CENTER OF STREET REAR YARD R.SIDE , FT. IN.
} SIDE YARD I LEFT I RIGHT L.SIDE / FT. IN.
DESCRIPTION OF WORK
,/1 REAR �1 FT. IN.
NEW II ALTERATION I / II ADDITION
• REPAIR I I MOVING I II DEMOLISH I
BUILDING NO.OF l''
SIZE ROOMS N STORIES I
ROOF
.- COVERING EXTERIORWALL I COVERINGCCs In",SIA...., f_
• USE OF BUILDINGAND WORK TO BE PERFORMED /
&C�i-.a144 , Neto f/y Tv re s ;e, ETM.
1T , I . _
CV-007A e/ES;T
I HEREBY ACKNOWLEDGE--THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
AND STATE THAT THE BOVE IS CORRECT SNO AGREE TO COM.
PLY WITH ALL CITY D ANCES AND ST TE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING corvsiau / _ �/J VALUATION
PERM ITTEE OF, // /�+� // /}��') PERMIT FEE $� ,
���(((di, CCC �-O f/// ON PLAN CHECK $ -�
AUTHORIZED AGENT I 0. J
a .r-a TOTAL FEE $