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HomeMy WebLinkAbout629 SHASTA LN - Building Permits PROJECT ADDRESS: 629 SHASTA LN UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 061501 OWNER'S NAME:PASCO, INC (MGMT• CO. ) ADDRESS: P P .O. BOX 2968 PERMIT NO: M 061501 PLAN CHECK NO: N GOVT: N SUPP ; N COSTA MESA CA 92628 CONSTRUCTION TYPE: S-N PERMIT TYPE: MEC PURPOSE: REP ARCH/ENGINEER: ( 714 ) 641-0593 flEG.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR SQFT: ADDRESS: UNIT: • CLAIM VALUE: CALC-VALUE: GROUP OCC: R-1 / PERMITTEE:ORION CONSTRUCTION ( 714 ) 363-0727 ADDRESS: 28 OAKCLIFF DR COMMENTS: RE• B61499 / WORK INCLUDES "627 & 631 SHASTA LN" ALSO! ! ! LAGUNA NIGUEL CA 92677 ************4**x******** *******x *********** -********* *#x*x ****x#k6*#**T6****x LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. 5 E 1. B A C K S CITY LIC.:040100 /—STATELIC.:4854! 99...,..? CLASS: r Date: 'S�os745 Signature: a � —= - MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENS TION DECLARATION: I hereby affit't l have a cervi. ate of consen .sell-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 POLICY NO.:046-93UNIT03554 EXP.DATE: 01 /01 /94 CDMPANY:STATE FUND PARKING REQ: PROV: PARCEL: 93405177 ZNE: REF NO: ❑ Certified copy is hereby furnished. © Certified copy is ftl with the city Buildin Division. PLANNING NOTES> �_jCf// > •�' Date: 4. ' Applicant: / 4.I`•.-- *******1l**xx***fE*74*#!Fx*x!(*************iE*!E**x***ih*************x xll•****1(***3F****** EXEMPTIO EN' BOM WORKERS'COMPENSATION DECLARATION: his section need not b completed ft permit is for one hundred(5100)orless). • DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ a y person in any manner so as to become subtect to the Workers'Compensation Laws of California. 'ZONING APPROVED BY DATE: Date: Signature: _.— NOTICE:II.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. x CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for -APPLICATION ISSUED B Y: /J • /%/ Lc� DATE: 7-`3-/_ ** which this permit is issued(Section 3097,Civ.C). *************** *******Y///A$******• Y.*./.}S�{ •** *** •ct**ft*****fixli*********x ** u..It%}e** LENDER: ************************************* E***** ********************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N 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 - 34 00 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 _ 1 ,, 2 5% SMIP/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 , ' 15 . 00 I, as owner of the property or my employees with wages as their sole compensation, win 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----> 34 , 00 15 . 00 0 , 00 49, 00 49 , 00 .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 • 49 , 00 OVER/SHORT; 00 for he purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANI foC 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 _ 49 . 06 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contractsfor such projects with acontractor(s)license pursuant to the Contractors'Slate License Law).I am aware *****************x**********?E*****************************************.*******,y.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUA L F E E B R E A K D O W N ❑ I am exempt under Section: B. 8 P.C. • tor this reason: TYPE QTY D E S C R I P T I O N.' UNIT COST TOTAL COST Date: Owner: - MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 Ido hereby cenity that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and MEC 1 REPAIR/ALT COOLING' UNIT/SYS W/CNTLS 9 • 00 9 .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 9 . 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from NEC 1 GAS PIPING SYS 1 - 4 OUTLETS 3 . 00 3 , 00 these provisions. MEC 2 VENTILATION SYS NOT UNDER PERMIT, EA, 6 , 50 13 . 00 Date: Applicant: _ END OF FEES I hereby certify that I have read this application and slate 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 inspection purposes. i ....i Date: .31/224.5. Signature: %a�-..- '- Driver's License or Social Security Applicant;Pink—Revenue:Goldenrod—Assessor - • CONSTRUCTION AND PLANNING POOL`& SPA APPROVALS Permit ,'"r- 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 Uunty•Undrgrnd. 54. Forms 4. Electrical Conduit-Undr7rnd. I 55. Electrical Bonding 5. Stee; Reinforcement J 56. Rough Plumbirg & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE r 7. Footings 58. Electrical Conduit•Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undigrnd., Test -J{I 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap. Cl Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Recaptor-Final . 12. Sewer Cap 63. Heater & Vent-Final 4I - v 13. Roof Drains 64. Plumbing System • Final ' 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning �/srtJ 4/ FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ! APPROVALS Permit 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Rping [I Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush ' I 24. Roof Framing 73. Undergrnd.Storage Link 0 Gas Oil 25. Roof Sheathing 74. Overhead Hyoro 26. T-Bar Ceiling (Structural) & Monocoat 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 1 33. Final Electric Notes:44,Dets itxr4Ari oto 1tq ‘JMts (n 27 f{ 34. Final Heating & Ai��0dKent- z�/Aj � // 35. Final Gas Pipe-Test ' G 3c ,CCP 36. Hood or Canopy 1, 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 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING .; 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY No. Date I C CTAtris'�: 629 SHASTA LN UNIT: ' CITY OF COSTA MESA — BUILDii'JG PERMIT PERM NO; B 0',: 4'. 9 Dw; EWslr_PASCO INC. (MGM"', CO. ) ADDRESS:•••• O. BOX 2968 PERMIT NO: B 061499 PLAN CHECK NO: N GOVT; N SUPP : i COSTA MESA CA 92628 (714 ) 641-0593 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STA PURPOSE: REP ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : FIRE DAMAGE REPAIR ' SQ FT; 14i, 000 ADDRESS: UNIT: CLAIM VALUE: 145, 000 . 00 CALC—VALUE; 145, 000 . 00 GROUP OCC ; R-1 / PERMITTEE:ORION CONSTRUCTION ( 71 4 ) 363-0727 ADDRESS: 28 OAKCLIFF DR COMMENTS- FIRE DAMAGE REPAIR INCLUDES X1627 & 631 SHASTA LN" ALSO! ! ! LAGUNA NIGUEL CA 92677 ####xx##4>ExxTc##xxxx#######>ErF##x•*##x>E)E>t##7Ex###xxxux*tx##*x#aEx#xx##xxxxxxxxxxxx#4y LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 71001 0l Division 3 of the Business and Professions Code,and my license is in lull force and effect. SE TB ACKS — ' CITY LIC.:04 100 STATE LIC.:18545 CLASS: • Dale: /'a signawre: MAIN BUILDING ACCESSORY BUILDING --- WORXERS'CMPENSATIONDECLARATION: Ihereby afli t I have a certili••te of consent sell-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified coy thereof(Section 3800,Lab C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.:046-93UNIT03554 EXP.DATE: 01 /01 /94 COMPANY:STATE FUND PARKING RE • PROV: PARCEL: 93405177 ZNE; REF NO; 0 Cemlled copy is hereby furnished. ® Certified copy is file ith the city Building Div'' n. PLANNING N TES> Date: 9/'r 1/7' Applicant: z /16�✓�./']�. #####x##xfEk#7f#xlf#lE7PiF.#xx, ffif # ##-#1t•x####i(Ifx##if•###jE#iP-x#if#x###3E########xlE{(x;Ex###xxi4;(tFx?E EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: I his ion need not be comp) ea if the a per r1Y15 for one hundred(5100)or less). D E V E L O P.' ..F •E N T SERVICES REQUIREMENTS I certify that in the performance of the work for which this per 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: Dale: 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. . ' //pw CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED ,B Y• �/ j~ /, /F//`'/`, DATE: . 34-57/;& 4-57/;& which this permit is issued(Section 3097,Civ.C). ###xkt#############Rx#xxj 7r# fest, #a. *it iti -. *- it 7rx•4tt#x##x!e#######x'fx###hitt fr l<it-f..,x st x,?f LENDER: x*K####x*****####x#*IE#**###BL•4****#x##### .*****************************x****x-* ADDRESS: LEGALIZATION:N F E E SU — MARY STRUCTURAL SEGMENT;Y pfollowing BLDG PMT PLUMBING ELECTIIIC M'EC`H• ANIC .'FIRE • SMTP/R•ES GRADING OWNER BUILDER DECLARATION: I herebyaffirm that 1 am exempt from the Contractors'State License Law for the reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 797, 00 _ / /; 4 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 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business , SMI /NON.—R ES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by P LAN _ -' any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE r •i ▪ ', I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT .SSUE PLAN2CHECK' • >'''OTA1, ' • PAID DUE - ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 811 . 50 0 . 00 • 0 . 00 811 • 50 811-I,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 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; { '. 11 , 50 'OVER/SH6R7' '' •' 00 forme purpose of sale), BLDG PMT PLUMBING ELECTR MECHANIC 7' .F1,,SE • SMIP/TIOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 797, 00 14 . 50 i, ❑ 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). I am aware #xx'#xx###x#LE*#x%#x#x###.x x##x##x###kEx '0(lf x iE###x#x,-R.. ' #)49(.1`..x :Nihric x'X.K.it:#x•x x-)F#x X-it Et-X that proof of their worker's Compensation insurance should be provided to me. I N D I V I D U A Ti• E h s D ❑ I am exempt under Section: B.&P.C. t �R. $ A 17 D' 0 '•W N • . for this reason. TYPE QTY DESCR IP T I O- N, - •• UNIT --"Si'iTOTA3 COST Date: Owner: SFR 145000 FIRE DAMAGE/VAL RESIDENT' iLES ]. . 00 • 445, 000 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and k `or Y 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 g END OFA —P66 /���, permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from [ - p ' ,�/rAw r Date: Applicant: 44 E D '1 �. , -' 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 ) •• E• �p� ' • ' • , ' ordinances and slate laws relating to building construction and hereb ulhurize representatives of this city to enter upon the above-mentioned oak-pec • ' 6 r \ properly for inspection purposes. 7 //,A4 Date: ,/ /4S Signature: i s• �� FF��� u 2:1,7 Driver's License or Social Security=: } , • 1 ,' • 164646 White—Building:Green—Cade Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor v� . .N 3 VTRUCONANDLANNING POOL& SPA ,APPROVALS Permits Date Inspector APPROVALS Permit# Date Inspector 1111 1 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 1 z. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - H 3. Electrical Conduit Uti my•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. � ~i 8. Foundation 59. Gas Pipe, ❑ Unurgr.nd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK j 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final I I 12. Sewer Cap . - 63. Heater & Vent-Final 1 H 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 1 4 15. Rough Electrical-Conduit 66. Solar System-Fin:.! 16. Rough Electric Wiring 67. Fencing & Access Approval 1 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I 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 "_l Oil , r ' 25. Roof Sheathing 74. Overhead Hydro - , 26. T-Bar Ceiling (Structural! & Monocoat 75. Dry Chemical ' :es' = / I/ >� 27 Frame and Flashingi/ /9, /Y s�/y` ii„(((/// 76. Dry Standpipe ----vs:-.--, 28. Lathing & SidingI Z1 Re-'. 77. FIXED SYSTEM FINAL 29. Insulation /4 f'3 41 78. FIRE PREY. FINAL ] -:` �'i I 30. Drywall Nailing 6/41 HEALTH DEPT. REQUIREMENT ' I y/ J 31. Plaster Brown Coat PIIMP f' i. 79. FINAL INSPECTION 4 1 32. Electrical Power Meter-Final '' 80. FOOD CERTIFICATE ISSUED v i• j 33. Final Electric Notes: 3 d/s 4/10 p 1 34. Final Heating & Air Condrtionin � ,//1p ,/`/ / g • _bfL�ND��L(N 1) S t { 35. Final Gas Pipe-Test 1 y 36. Hood or Canopy I / ' 37. Final Factory Fireplace • t , 38. Final Plumbing 6 Zy, ir r / -i 39. Water Service-Final /"Lcr _ /J rIii e:dr//�'� 1 40. Gas Service-Final ' P / 41. Solar Domestic-Final 4/60V-- i211Deb, 42. Backflow Preventer �eetnb. 43. Backflow Irrigation ± 44. Landscape Irrigation System L O, _/fGo.!L_WJv G ,--i j • 45. Sound Attenuation ,f/2'/r3egr? • I 46. Handicap Regulations / K 47. FINAL STRUCTURE & BUILDING 1 dt1-- f,--411% 444•e/C a` 1 48. FINAL PLANNING I0 (Mt- //et_ T/z'/� lL ff% � 49. Electric Release to Edison i^� 1 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY No. Date 1 i:: FRED FfSCHER,JR.C.E. frja 4. 04---1// �D� � 0 . 128 E.KATELLA,nun 19 CT 7o 7—v ORANGE,CA 52637 • \ (714)997-S$23 67/,,-7 litV ( C(1 m !� x/9-1 do,S • /id b`5/ l/d-,R! .. 0�7i oN �NSy/Z. c2 pr. ; C.o ftpv M ,fir- Zv,ti-vv _ � Pe ST - PI f,YSG 1, 'P.4-.4-' 4; 4- ini E,w , BoT i ::: :.. / z.0 95 li •...). li• ;,• ; Pli • -_ • Q�p t°ti f ESSIpN� ,fit on/• tix". .J� �'� i • w _ •-• No. I 50 rte-, a z O SG/-LE 7 �' ,ry: l� Exp.- 7/ S flP Vi V t'' 1\A\"g) r` GsG`iatfr-c --N___ o 32:y ! cy . 4K . /45co- . cam- . 6* (4I- o . 3 1 . City of Costa Mesa California 92628-1200 P.O.Box 1200 Insulation Certificate • Permit Number )7(0 14 !q 1 62-e? S'gnSra ('nn pv_s_A Number and Street City County Subdivision Lot Number Description of Installation ROOF Material r OJ - ' -• Brand Name 3 --u'r1(5. • Thickness (inches) I Thermal Resistance (R-Value) EXTERIOR WALL - Material 2 X `(- Brand Name a M,as Go-Q-ra..az Thickness (inches) 3 Thermal Resistance (R-Value) - 13 CEILING • Batt or Blanket Type '1-s- Brand Name -t- Thickness (inches) S i Thermal Resistance (R-Value) (L- 19 Loose Fill Type Brand Name Contractor's minimum installed weight/ft2 lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR Material (14.3 _E—rs. Brand Name Thickness (inches) '- Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adminstrative Code. O P-r cia.) <(-05-7t1/4-1 General Contractor(Builder) ) 2/«/i Licenseic /Number _ F1C✓c2�J O / t t / Cl 3 .ignature a' Title [[[ date • Sub-Contractor(Insulation Installer) License Number Signature and Title Date 1907-46 PROJECT ADDRESS: tUNIT: OWNER'S NAME:P, F�79 S!ASTA LN CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 061500 - ADDREss: A.SCO INC, (MGMT, CO, ) , P,0 hOX 2968 PERMIT NO; E 061500 PLAN CHECK NO: N GOVT: N SU.PP; N COSTA MESA CA 92628 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: REP ARCH/ENGINEER: ( 714 ) 641-0593 flEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: TEE: CLAIM VALUE: CALC—VALUE; GROUP OCC; R-1 / PERMITORION CONSTRUCTION ( 714 ) 363-0727 ADDRESS:TEE 28 OAKCLIFF DR COMMENTS; RE; 861499 / WORK INCLUDES 627 & 631 SHASTA LN" ALSO! ! ! LAGUNA NIGUEL CA 92677 *********>E*rk4*x***** *sE***** ***>E** * **!t**> ****K** N* * *****u***K***** -3E*#*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY 110:040100 STATELIC.:48545• _ CLAss:B Date: 3 ''4,4S Signature: / _ _ MAIN BUILDING ACCESSORY BUILDING WORKERS'C MPENSATIONDECLARATION: Ihereby affirt,�mIhave acertificate.fconsent tI�II-insureoracertificateofWorkers' 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 POLICY NO.:046-93UNIT03554 EXP.DATE: 01 /01 /94 COMPANY:STATE FUND PARKING REQ: PROV: PARCEL: 93405177 ZNE: REF NO: ❑ Certified copy is hereby furnished. © Certified copy is file with the city Building Division. •. PLANNING NOTES> > r Dale- 3 ,'-a�j Applicant: '--u **************-1F*********is**********-%*lE**d(******1F**dt**!S*******i(-%**74**?F****IE**1f#* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: ( I n need not be comple d if the perm i for one hundred(5100)or less). DEVELOPMENT S E R V I C E S REQUIREMENTS I certify That in the performance of the work for which this permit is issued,I shall not employ any person any manner so as to become subiect 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. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• • t 41 , DATE: #S— /1-1 which this permit is issued(Section 3097.Civ.C). *****.***-**********.******, ** **n****• *.. * x. :**** *AX*** ** • ***********BE A-A-******-A• * LENDER: ***************************************** ®:***************************** ***** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: I hereby affirm that 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 5 7 15 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 50% SMIP/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 far a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 0-0 -. ' 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----> 57 . 15 15. 00 . 0-, 00 ./2 . 15 72 . 15 . 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 ; '72 . 15 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 2 . 15 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon ^ and who contractslor such projects with acontractor(s)license pursuant to theContractors'State License Law). l am aware ***.***************.**************.***3! IF-!E**********iF****************************** that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.s P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY D E S C R I P T I O•, N. ' - UNIT COST TOTAL COST Date: Owner: ' I do hereby cenily that lam aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and ELE 12 FIXTURES LIGHTING - 1 ST 2 0 EA, 75 9 , 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 ELE 20 RECEPT'/0f.7TL ET 1• ST 20 EA, . 75 15 , 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ELE 22 RECEPT/OUTLET ` ADDITIONAL EA. . 45 9 . 90 these provisions. ELE 20 RECEPT/SWITCH : • 1 ST 2.0 EA. . 75 15 , 00 ELE 5 RECEPT/SWITCH • ADVITIONAL EA. . 45 2 . 25 Date: Applicant: ELE 2 RES APPLIANCE NOT OVER ,. 1 .0 HP 3 . 00 6 , 00 I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county -END OF FEES 1- ordinances and state laws relating to building construction and hereby authorize representati of this city to enter upon the above-mentioned property for inspection purposes. 7 Date: �" Signature: '' �x— Driver's License or Social Security a: - 1641.46 Whie—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor ' CONSTRUCTION AND PLANNING POOL & SPA ( I 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 43. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding l V 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER 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. - Ii 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 Al -celj(e u4, f y.. ,M ��,< 67. Fencing & Access Approval i 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, 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 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28, Lathing & Siding . i 77. FIXED SYSTEM FINAL 29. Insulation i- 1- 78. FIRE PREY. FINAL 30, Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION I 32. Electrical Power Meter-Final '` 80. FOOD CERTIFICATE ISSUED _--y/ 33. Final Electric 7-113 Notes: 3; -9_,!Q IStimet A Yo/ 34. Final Heating& Air Conditioning #40.11- arm f 35. Final Gas Pipe-Test 36. Hood or Canopy , ' I 1,=ZI_9.3,__'®yyt/ 477(q45/_ _ _� 37. Final Factory Fireplace i/ -- �o--- 38. Final Plumbing .�. / / - - i- 39. Water Service-Final • / /�' - 40. Gas Service-Finalerr 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System I 45. Sound Attenuation 46. Handicap Regulations • 1 i 47, FINAL STRUCTURE & BUILDING . 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY ' No. Date 0 • PROJECT ADDRESS: 629 SHASTA LN UNIT: 1 OWNER'S NAME: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 061502 ADDRESS: PASCO INC, (MGMT. CO. ) P,O. BOX 2968 PERMIT NO: P 061502 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA CA 92628 CONSTRUCTION TYPE: 5—N PERMIT TYPE; PLU PURPOSE: REP ARCH/ENGINEER: (714 ) 641-0593 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: PERMITTEE: CLAIM VAI/UE; CALL—VALUE; GROUP OCC; R-1 / ADDRESS: 28 CONSTRUCTION ( 714 ) 363-0727 28 OAKCLIFF DR COMMENTS; RE; 861499 / WORK INCLUDES "627 627 & 631 SHASTA LN" ALSO! ! ! LAGUNA NIGUEL CA 92677 ********* **4*****###************######*************WWN *M***#*x•#####3E###*#x#BE*M LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NG R EQU IR SMEN TS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect SETBACKS* CITY LIC,:04 100 STATE LIC.:485459 CLASS: . -- Dale: 3�%c,#' Signature: /. .— ./a—_ ._ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm�j.ve a(entie.). iI consent .selbinsure 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 Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY ND.:046-93UNIT03554 EXP.DATE: 01 /01 /94 COMPANY:STATE FUND PARKING RE • PROV: PARCEL: 93405177 ZNE; REF NO: O Certified copy is hereby furnished. gJ Certified copy is fil with the city Building Division. PLANNING N TES> x > —.-- Date: 'a/'y'si 9-3 Applicant: 4.40,----'174---1-4.--€.7„.... #fF###iFiE##iE##iEiE#if-##########1E##iF##ifiE%###It iE#iE#iE3f4#######iEit3fiF###iE3f##i(##iE##iF3f BEiE##* EXEMPTION FROM WOR FRS'COMPENSATION DECLARATION: (Thi lion need not pleted if the join is for one hundred(atop)or less). D E V E L O P M E N TS ER V C E S' < 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: • o • NOTICE:If.aper making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APP ROVED BY : . , DATE: 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 thelperformance of the work for APPLICATION ISSUED B Y ; / 3L� ��� DATE: 3/�9 ��I which this permit is issued(Section 3097.Civ.C). — iE#•#*####iF 1E##if iE*########xi #z##RRzie fe...r A'#RF k#R'1t'.':3F�ER ,x kie ye R'RiE#1E##*'iE iE 3('###: %xRR-R'IeA R## LENDER: (Elk#IF#########iEitiF##if##-1E****iE1E####iEiF#it#7f####!Ei irkif****##iEiE3E#leiEJtiE****iE#jF#lE3E#iii(#1E### ADDRESS: LEGALIZATION;N F E E ,S tT VIM A R Y STRUCTURAL SEGMENT;N 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 8 4 00 repair any structure,prior to its issuance.also requires the applicant for such permit to life a signed statement that he/she is licensed .- pursuant to the provisions of the Contractors'State License Law(Chapter 9l commencing with Section 7000)of Division 3 of the Business 2 5% x ,r 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($SW), ISSUE FEE 20 . 00 I. as owner oI 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 TOTAL S----> 84 . 00 20 . 00 ' 0 , 00. 104 . 00 104 . 00 .00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through }. t, 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--> COLLECTTED; • 104 , 00 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 104 , 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon f ' and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *.*.**.K.#.1(.M..1E.#%..M.iE.lEil-i(-#N-.#.1(-#.if-#IE#####iE##iEiEIEiE#i(-!E#ih#iE###iE#le#iE##iEiFiEIE#####iEiP###iEiE#EiE#iE#iE34#)Ek that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.a P.C. INDIVIDUAL' : F E E BREAKDOWN -I for this reason: TYPE QTY D E S C R I P T I OvNa UNIT COST TOTAL COST Date: Owner: PLU 1 BATHTUB :4 7, 00 7 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU1 DISHWASHER . 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 a7. 00 7 . 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from PLU 1 LAUNDRY TUB OR WASHER 7 , 00 7 , 00 these provisions. PLU 1 SHOWER 7 , 00 7 , 00 Date: Applicant: PLU 1 SINK, KITCHEN 7 . 00 7 , 00 PLU 3 WASH BASIN . 7 . 00 21 . 00 I hereby certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county PLU 3 WATER CLOSET (TOI L ET) 7 . 00 21 , 00 ordinances and state laws relating to building construction and hereby authorize representatives of thin city to enter upon the above•mentioned pLTJ 1 WATER HEATER AND/OR VENT •"' 7, 00 7 , 00 property for inspection purposes. /� Gi END OF FIEES Date. " S'-5a Signature: Driver's License or Social Security a: t / / 1641-46 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor f - - • CONSTRUCTION AND PLANNING POOL & SPA �I I Date Inspector �. Date I Inspector APPROVALS Permit-r-4/, APPROVALS Permit ,F 1. Temporary Electrical Sarvice or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3 Er ctrica'. Conduit Utility-Undrgrnd. 54. Forms 4 Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. St a. Rcin'ofcement 56. Rough Plumbing & Pressure Test r--6-.- EL.ctr.ca LIFER Grnd 57. APPROVAL TO COVER.GUNITE 1 7. Footing-, 58. Electrical Conduit•Undrgrnd. ,I 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 & Rcceptur-Fir.al 12. S*.:er C:'p 63. Heater& Vent-Finan t-- y 13. Roof Dra.ns 64. Plumbing System . Fuel 14. Rough Plumbing � 9 9 r /4511$ /EQ 65, Electrical-Final I 15 Rough Electrical-Condut 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17 Rou h!71rin SignPLASTERING 9 68. APPROVED FOR 18. Rough Elcetrical-T Bar Ceiling g 69. SYSTEMS FINAL I, 19 Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit 4 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping D Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas C Oil 25. Root Sheathing 74. Overhead Hydro 26. -i-Bar Ceitng (Structural) & Gionocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding I r 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREY. FINAL I . 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. raster Rrown Coat 79. FINAL INSPECTION I 32 Electrical Power Meter-Final _ 80. FOOD CERTIFICATE ISSUED 33. Final Electric i Notes3ho/cz to eact, of tK J44Ft 4,t7 p' 34. Find Heating& Air Conditioning G 1( (ridea L - q-z -vg Fpt,4 K, 0r_ ibins ) !I 35. Final Gas Pipe-Test eyle ��� e "7 4 6 a( . GED_ q� 36. Hood or Canopy / G_;ZL=F7 ZTr_'7 •-t- Agit- 37. Final Factory Fireplace - 38. Final Plumbing figt /Kph 39. Water Service-Final ..r 40. Gas Service-Final 41. Solar Domestic-Final I 42, Backflow Preventer • 43. Backflow Irrigation ` , 44. Landscape Irrigation System I 45. Sound Attenuation 1 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING f 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date -\