HomeMy WebLinkAbout617 SHASTA LN - Building Permits City of Costa Mesa Planning Department
Post Office Box 1200
77 Fair Drive
GIj�F 0 q Costa(714) M556-esa,5245California 92626
SI!I I
REQUEST FOR OCCUPANCY
(Single Family Residential or
Condominium Units)
Tract No. Otal7 / - 2� Date // / 9 77
Lot No. I 73
Address 1/ 7
The developer of the above entitled tract desires to sell the above
set forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he, she, they) 4P/ (was or were) /f,44—ladvised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the
City at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless
from any claim resulting in damage or personal injury to the undersigned by
reason of the aforementioned uncompleted condition.
RECEIVED By
CITY OF COSTA MESA S Purchaser
p1 /
I
SEP 1 h 1977 By. � X1(1 •
eveloper : • !Au ham-.71819110111112111213141516 PM D
91ll121Represe :ti
X181 IO► I I 1213141516 /
1111 IRVINE BOULEVARD, SUITE 210
CMF 0569-26 TUSTIN, CALIFORNIA 92680
PROJEG AODRES,•, 617 SHASTA LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 063348
OWNER'S NAME: BROOKVIEW CONDOS
ADDRESS: HOMEOWNERS ASSOCIATION PERMIT NO: B 063348 PLAN CHECK NO: N GOVT: N SUPP : N
630 PAULARINO
COSTA MESA CA CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
587-0399
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF RESHT REROOF W/TIMBERLINE 30YR COM SQ FT: 8, 645
ADDRESS: UNIT:
CLAIM VALUE: 8, 645 , 00 CALC—VALUE; 8, 645 . 00 GROUP OCC; R-3 /
PERMITTEE: MESA ROOFING ( 714 ) 548-3012
ADDRESS: 843 W 17TH COMMENTS; PERMIT INCLUDE 617, 619, 621 SHASTA LANE
CM CA 92627 *******iEiE****#�H*�E�L*****###�r�LTei<*#x+E* 3E*>Eit****##****+r ##*## **it#+E*#*#*#***4*#*#**
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQUIREMENTS
70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect.
SETH ACK S
CITYLIC.:03568q1 STATEuc.:56415• -
,---Male: 8-6,— /3 Signature: /
_au. MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have 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
POLICYND.:pWC. 24167500 EXP.DATE: 07/01 /94
COMPANY:GOLDEN EAGLE PARKING REQ: PROV: PARCEL: 93405181 ZNE: REF NO:
.fl Certified copy is hereby furnished. 0 Certified copy' '" ' - - ' 8uildin. Division, PLANNINGNOTES>
p L� >
� •
'—W /-1e: UCL—/ '� ADDlicanf:w_ i' *************************************#***********###*****iF*********#0 G****7E#***
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). D E V E' L O P M E N T SERVICES R E Q U I R E M E Nit S
I certify that in the penormance of the work for which this permit is issued,I shall not employ any person in any manner so as to become i'
subject to the Workers'Compensation Laws of California. ZONING APPROVED'BY •
•
DATE:
Date: Signature:
NOTICE:IL 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. r. ' / 5� •r
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: - A if DATE. U `� 73
which this permit is issued(Section 3097.Civ.C). *************is'3H**********#** -******. *K- -************X--***************###ic********
LENDER: *****##***#**#*#*********#*******aE***-n+4*##***#*********************iF******#****
ADDRESS: 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 1 0 8 , Cl D $6
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
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($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 offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 108 . 86 0 , 00 0 . 00 108 , 86 108 . 86 . 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
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 108 . 86 OVER/SHORT• 00
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 108 . 00 , 86
❑ 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 theContractors'State License Law),l am aware *,**.**************************************************************************le*
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that I am'aware of and understand the requirements of California Health and Satety Code Sections 25505,25533,and SFR 8645 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 8, 645 . 00
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 END OF FEES
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 stale laws relating to building construction and hereb authorize representatives of this city to enter upon the above-mentioned
property for inspection/ purposes.��rpj /—� l
,pate: 8—(—n Signature --/�._ _ i/
0100144443-00144444 TOT 108.86
Driver's License or Social Security#: DATE: 07/06/93 TIME: 15:03
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue: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
',Of 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnc. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grnd 57. APPROVAL TO COVER.GL PdITE - '
7. Footings 58. Electrical Conduit-Undrgrnd. •
8. Foundation 59. Gas Pipe, 0 Unurgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lanes, P-Trap. ❑ Undrgrnd.
10. Structural Floor System I, 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 j
16. Rough Electric Wiring 67. Fencing & Access Approi„ai �l
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica6T 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 Hydio ~
22. Ducts, Ventilating 71. Product Piping `:Gas -i Oil
23. Gas Pipe-Rough & Test 72. Underground Flusir _7
24. Roof Framing '/ jr 73. Undergrnd.Storage Tank 0 Gas J•'
25. Roof Sheathing ''tp%3l- 74. Overhead Hymn
26. T-Bar Ceiling (Structural) & Monocoat ♦7 ' 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding I 77. FIXED SYSTEM FINAL
29. Insulation _ 78. FIRE PREV. FINAL
30. Drywall Nailing I . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat i 79. FINAL INSPECTION ;
32. Electrical Paver 'icterFina! i + 80. FOG() 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
I I
41. Solar Domestic-Final I I.
42. Backflow Preventer l -�
43. Backflow Irrigation I -,
I a
44. Landscape irrigation System
45. Sound Attenuation •
46. Handicap Regulations =�/�
47. FINAL STRUCTURE & BUILDING
48. ANAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY -I
No. Date
- ..uuauuil u.,yu.0♦�i..Y v^'- V LV /U
.
JOB ADDRESS 617-621 Shasta Lane BUILDING PERMIT NO. 42524
GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK 3 Unit Condo
AP No.418-071-01 LOT TRACT FIRE ZONE VALUES 117,000.00 •
INSPECTIONS Si nature Date TYPE V GROUP I & T ZONE R?—CP
SOIL ,/,c e.TL PERMITS ISS ED
GAS %� /� SUBCONTRACTOR
Date Number Signature
WATER ( C Z•P fl ar creire Plumbin
ROUGH PLUMBING 3.ag .7)6.4 ,t,,_ /o-i9 X- 7_O/�.1G`.---
PROP. SWR. LINE ❑ HOUSE CON. [rte]' /L�� 3. f3.77 A-4.76 70-1.7
SPRINKLING SYSTEM �"S
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING t s.2.3 70 •
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER ❑
ROUGH WIRING , TieD 257E/7 ii,,�/ Heating and Vent. •
TRENCHES FORMS 2 STEEL REINF. y� _."7„,i, ��7,4- /..3r 2C I3C/r'
FLOOR SYSTEM II/GS .1/6'n /71aiay�„lie ]idU /-3/-77 / 3s-en'•`.......---
BOND BEAM n STEEL REINFORCE n
SHEATHING O 7.to--,$)
FRAME AND FLASHIN "- 3�l_23. 27
LATHING — IN [-K- OUT ✓� o T._ '77
PLASTER. BROWN COAT VGi 7i
STRUCTURAL. FINAL /� Abe<
/34/ �� (1
HEATING, VENT.. REFRIG. AND A.C., FINAL
7/ pe<° f[0µ,0, (� 7L Lin/Qry�
PLUMBING. FINAL AND GAS TEST l F;24-0._ Mit Sz /7- G (,4l y`/11
' ELECTRIC. FINAL C d -33'// rat • //--/G VP/99
BUILDING, FINAL
SPECIAL REOIIIREMENTS a»7
21i � �
/� a C* IL `tom - , : q 19/77
//0/0/77"
/7
4252 f PAIL
, ^ 2n-76r7-177.001529'.) ***523.P2
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
b. / APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely'— Use Ink Only
ADDRESS/6610 bpi 442/G /� ,�/tycN`lfp///�,ZAAI RECEIVED BY /Y�1Qi - 0 -DATF4.
OWNER/4020A Ei rtgpQ�aa_e_Ba ollt/l ct /P- 07/- sO/Vi PERMIT NO.
/ A.P. NO.
ADDRESS /�y"(/ /Y / G/7 D/ILIP BUILDING &21,�/} � j Liu
- .
MAIL / /� /J ADDRESS(() / (y ` I� (�/(J
CITY Lag, facie- NO. TRACT L / LOT L BLOCK
CONSTRUCTION /J NEW ADO ALTER REPAIR MOVING 0E100115H
LENDER iB
BRANCH /1,4 Mei /lee r.&.2„
OWNER
ARCHESS
ITE S(/�Ii ap�UVALU$�/^./4a0
ARCHITECT TEL. USE �! �'1IKK// JJ gl.°
OR ENGINEER NO
FIRE
ADDRESS ZONE TYPEr GROUP
/AQ'^ n
APPROVED /n� �1 /1/
CONTRACTOR 6eoi same-- BY Il`" DATE (�f/ X
ADDRESS
TEL. E /rl/M IPANS G NO.OF �S USE OF NEW 3(���
CITY NO. •f` BUILDING CO)JDO
F STATE 270J9S VARDAPPROVED
MA NS BUILDING YARDS APPROVED
ACCESSORY BUILDING
LIC.NO.
LIC. NO. J
W SIZE INO.OF BLDGS. (FROM C/L STREET)
B. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
ca EXISTING BLDG. , R,SIDE ,T, FT.
U) (/I
FSeparate permits are required for L.SIOES'bifi.k� FT.
electrici. ,plumbing and heating work.
CREAR FT. FT.
(.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
C _MAIN BLDGS. ACCESS.BLDGS.
..1 3 VAI' 4M/DO VAR.# 73 77 DATE
C.V.P.#'- APPROVED
a ^
7 APPROVED/-' ` I ) DATE F-1174.
ce OLD FOR SPECIAL REQUIREfv►ENTS
144
0 I hereby acknowledge that I have read this application and state
N
b.
(Y that the above Information is correct and agree to comply with
m
Co all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of o
Sthe State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. n
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business
VALUATION PERMIT FEE $ 3/�a co
and Professions Code,Division 3,Chapter 9.
,/ rn
PLAN CHECK f 20 3, /3 o
Signature of / //�L It2 rn /9 i(/ ,J
Permittpa f� f� OHYY t'S'Gr �!/'P $ //7000 TAX f GJ�i9 u.
2
17 U
U
Authorized Agent TOTAL PAID $ 5�.9 Do pt