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HomeMy WebLinkAbout979 SPRINGFIELD ST - Building Permits�v OJECTROOPESS: 9%J SPRINGFIELD ST � OWNEB'S NAME: NAKASHIMA MICHAEL G � AOOPESS: 9`19 SPRINf'iFIELD ST � COSTA MESA,CA 92626 540-3466 ANCHIENGINEEH: NEG.NO.: RODBESS: ' - � w� u"�T: CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: H 060009 PLAN CHECK NO: N CONSTRUCTION TYPE; V—N. PERMIT TYPE; STR , UNIT: PEHMITTEE: MIKE 6 SHERYL NAKASHIMA ( 714 ) 540-3466 nooness: 979 SPRINGFIELD ' COSTA MESA CA 92626 LICENSEO CONTHRCTOB OECIABATION: I hereby afiirm Ihat I am IicenSeU untler pmvisions af Chapler 9(commencing with Seciion 7000� ol Oivision J oi Ihe �usiness and Pmiessions Cutle. and my license is in full lorce an� eflect. CITY LIL.: STATE IIC.: CL4SS: � Dale: Signamre: WOfl1IEFS' COMPENSATION OECIAflATION: I hereby aflirm Ihat I have a certificate ai consent to sel4insure or a cenilicate oi Workers' Compensation Insurance, or a certtlietl copy thereot (Sec�ion 3A00. Lab. C). , POLICY NO.: � ' E%P. UATE: � COMPANY: ❑ Certifietl copy is here�y lumished. ❑ CertitieA coDY is filetl with ihe city BuilOing �ivision. . Oa�e: ApplicanP. E%EMPTION FNOM WOBREBS'COMPENSATION OECLAflATION: (ihisseclian neeU notbecomDleleOiitAe permlis�oronehuMred�5100)orless). I ceNty ihat in Ihe pedormance of Ihe work �or which �his permil is i55ue0, I s�all no� employ any person in any mannef so as �o become subject Io Ne Workers Compensatmn Laws ol Cali�omia. � oaie: � Signamre�. NOTICE: II, aM1er making ihis tleclara�ion.'you s�oultl become subjecl �o �Ae Warke�s' Compensa�ion pmvisions ai ihe labor Cotle. you must fart�wi�� campry wi�h such pmvisions or Ihis permi� shall be deemed revoke0. CONSTBUCTION LENOING AGENCY: I hereby a�hrm iha� Ihere is a consimc�ion lending agency fol Ihe pertormance o� the woB lor which �his permil is i=suea (Section 3097. Civ. C�. IENDEN: aooRess: � . OWNEB BUILOEfl OECIABpTION: I hereby affirm �ha� I am exemp� �mm �he Contrac�ors' $ta�e License Law tor �h¢ following reason (Sec�ion 7031.5 Business ana Pmlessional Code: Any cily ol county which requires a p¢rmit �o con5imcl, al�er, impwve, tlemolish, or repair any s�mtlure. prior lo ils issuance, also requires �Oe applican� �o� such Oermil �o lile a 5igne0 s�a�ement lhal he/she is licensetl pUrsuam Io ihe provi5lon5 Ot Ihe Contratmrs Sia�e Litense Law (Chap�er 9(tommencing wiih SectiOn 7000) Of Divisi0n 3 Of the BUsiness' antl Pmiessions Catle) or Ihai helshe is eKemp� �heretmm and Ihe basis-lor Ihe allegetl exem0�ian. Nny viola�ion o� Sec�ion 7031.5 by any apPlicani �or a D¢�mii suhlects �he applican� to a civil penalry oi noI more ihan �ive hundred tlollars ($500�. . ❑' I. as owner ot ihe OroDeny or my employees wilh wages as iheir sole campensation, will Oo ine work, antl ihe stmcmre is not inteneeJ or offereA for sale (Section 7044, Business anA Pmtessional Coae: The Contmctors' Slate License Law Ooes no� apply to an owner at a pmpeny who builOs or improves Ihereon, antl who tloes such work himsel�/herself or �IlmuAh ' his or her own employees, provitletl Ihat such impmvemenls are nol inten0ed or oiferetl for sale. Ii, however ihe building or impmvemen� i5 SOIA wil�in One year ol comple�ion. Ihe owner will have Ihe huf0en ol proving he/She tlid no� build or impmve for Ine purpose of sale�. ' I, as owner o� ��e property, am ¢�clUsively contraCling wiih liCensed Contfadors to tons�md Ihe pmlect (Section 7044, BuSine55 ❑ antl Pm�ession5 CoOe', T�e Contractors' S�ate LicenSe Law Ooes noi apDly lo an owner of pmperty who builtls or impmves therean antl who conlrocts lor such pmjecis wi�h a con�racior(s) license pursuan� to the ConUac�ofs' State Litense Law),I am aware ihai pmol ol their Worker's Compensa(ion insumnce s�aultl be pmvided m me. � i am exemp� unaer Secuon: BP7 Q ej ij B. 8 P. C. mr mis reason: ALL WORK BY OWNER /�J,/J�)� 1 oate'. ��/�p ' Owner. _�.�%"� � ��"�'�"� . I Oo here�y cetlily �hai I am aware ol an0 understane Ihe reQuirements o� Cahiomia Heal�h antl Safe�y CoOe Sec�ions 25505. 25533. and 25574 an4lhai I or any fulure builtlmg occupant wiil/will no1 (circle one eeA to compty wilh saitl state coaes antl �he requiremen�s lor a permii for consimc�ian or mo0ifica�ion�iwm t�e Air Oualiiy Manageme �istnct Residen�ial construclion applica�ions are exempi �rom Ihese pmvi5ion5 - , � ����� Date: Applicam: � v�- I heieby cetli�y I�al I have reatllhis applicalian antl slate�hal Ihe a�ove informa�ion is correcl. I agree�o comply wiih all cily antl counly ortlinances and Slalelaws relaiingto butltling consimclian and her aulhorizerepre5enii�ives otihis cilylo enter upanthe above-mentionetl pmpetly for inspepion purposes. �Date: � p� � Signalure: ,1��Ji^R-� or Social Secunty p: 16di�a6 W�i�e—Bmltling: Green—Code Enlorcemenl', Canary—Applican�; Pink—Revenue: Goltlenrotl—Assessor JOB DESCRIPTION ; T/OFF RESHT. REROOF 2000SQ W/COMP CLAIM VALUE: 5,000.00 CALC—VALUE: 5,000,00 PERM NO; B , 060009 GOVT: N.SUPP: N PURPOSE: ALT SQ FT: 5,000 GROUP OCC; R-3 / COMMENTS• SMORE DETECTOR RE�UIRED IN THE HOME **�ex�r+r�r�r�r�r*�e�r�r�r�*�*+t*�t�***� �r�t�r�t�t�r**+t�r�t�t*�t�t�t�r�r��+t�r*�r���r*�rx*�r�r�**�r�t�r*�r�r*�r*�t*�*+t* Z O N I N G R E Q U I R E M E N T S � S E T B A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; 'FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL; 14172126 2NE; REF NO; PLANNING NlST'ES> > �f �f �t iE iE iF if iF iF iE �F iE if !E iE iE iE M i! if if iF if 1k 1k iE iF 1F Ik iE iE iF 1E 1f iE �E 1k �kiE 1F if iE 1E if 1F 1! �E k!E if ik iFiE if 1kiE 1kiE iF k 1E �F fE iE if iF iElf 1F'iF �f iE iE iF iP 1E iE iEif D E V E-�L O P M E N T S E R V I C E S R E Q U I R E M E N'T� S 20NZNG APPROVED"HY DATE; � BOILDING APPAOVED BY DATE; � APPLICATION ISSUED BY:� � DATE; �.'� it�FifiFiFiEiEitiEiFiE141EiEiEiE1FiElFiFiiiE7E7F7F7EiF{F{E7FiFiEifif3F3F3F7F�•i 3FiFiFifif�iF7F�F'iF7F'�FiFiF7FaFlfifiFifiFifMiflF�iFiEiE if iF �F iE ik�f iE iE 3f 1E iE iE iE if IElf ik iE iF 1E IE 1f �FIE �f 3E iE if iF if it 3F ikiE iE iE 1f 1k if if iF 1E iE 1E k�F �F if 1t iF* iE iE iF M!F iE iFiE ik 16 iF iF ik 1f �E Ik iE iE 1E if iF iF iF�! ik 3E 3k k LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y' BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 50 PLAN SMIP/NON—RES ISSUE FEE " - BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL _ `PAID DUE TOTALS----> 72.50 0,00 ;f. 0,00 72,50 -145,00 —72,50 REVENUE DII7ISION TOTALS--> COLLECTED; 72.50 OVER/SHORT: 00 BLD7zPM�T� PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT� GRADING PLAN—CHECK J. if ik 1klFiF iF ik 1F iF if if iklFlFiF iF if k iE 3F iF aFiF if k iFif it if iFif if if If if �FiE if it �f if �Fif iFiF if iE iF if 1f if iElE if if ik iE iF if i! iF iE iE it iF ik iE iF ik IE if iE iF iE iE �f iF iF k I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O�N � UNIT COST TOTAL COST SFR 5000 REROOF BY VALUE RESIDENTIAL N020NE 1.00 5;000,00 END OF FEES � . ' F : t i ; . � . _ �' / , I . ,. . .- . � . POOL & SPP. CONSTRUCTION AND�PLANNING - . - :< � ' . . , � APPROVALS Permit # Date Inspector � � Date Inspector APPROVALS Permit # i " 1. Temporary Electrical Service or Pole - , -� 52. Pool & Equipment Location _ �� f �" � Z.�y$o,il Pipe-Undrg[nd._, . 53. Steel Reinforcement . � � "' ... .: : , r ., n,•:�aEt"¢ctrjsal Conduiy��ility-Undrgrnd. � . 54. Forms. � - � � �'•4:��E}`actrieal'ConduiY-Undrgrnd, 55. Electrical6onding � � • ' � �" � J r S ;:'-�• T,�eel Reinforcementj ' 56. Rough Plumbing & Pressure T,�s� � q *-' 6:yE{�ectrical UFER Grrid. . 57. APPROVAlTO COVER�GUOiIT.f _ - �„�';�otings ' `;r � 58. Eiectrical ConduirUndrgmd. � �� (�., � ?7�.tFoundation � � 59. Gas Pipe, O Undrgrnd., Test C � �.. -�.r �:: ��;�.�t'Nater Pipe-Un�grnd. � � 60. Backwash Lines, P�Trap, O Undr�rnd, __l� `� � '�� 1-4A.StructuralflodcSystem . 61. APPROVALTODECK ' � 11. Pr6perty Sewe2Li ti&' House Connection � 62. Backwash & Receptor-Final y� _ ' 12. Sower Cap y, � 63. Heater & Vent-Final ,, " 13. Roof Drains '= 64.' Plumbing System - final „ � � 14. Rough PlumbiFlg �U 65. Electrical-Final ' • � � 15. Rough Electrica{�Conduit - 66. So1ar System-Finat � h � 76. Rough ElectriC_Wiring � _ 67. Fencing & Access Approval � 17. Reugh Wiring Sjgn � -� 68. APPROVED FOR PLASTERING 18. Rough Electric;�]-T Bar Ceiling 69. POOLESPA SYSTEMS FINAL 79. Rouqh'Heating & Air Conditioning FIRE DEPT. REQUIREMENT .,, . _. . . � 4'r=,T,=- s � �- ti 20; Roi+yh �actoFy F+'1� lace -� i!'`� � � ' J = � * * PPF%i�Vf1��� =Pera7�it # � >' �`' F S e ,i 5_ � ! S T' z¢ 'x S r, � ac +c : -, ''_� - J �-�� 21,-Du�:s,iq�Str,gcturex I r� r,� � S G r:� �,70. Fhidergr��o6idHyCro x S 22�Du�s. Qenti�tirfg y i ��� % C � `.4v x`71. ProducLP,`�ii�g C��s C�OiI 23�"Ga ip0.-,Ro' h & �est � S � , � '- "' "X ' -',� � '' :� +_ `� i-p ,�y i taS **! e' G Oh x 72. Undergiound Fldcft�. s� r-- c -� ._ . . . . _ _ 24�Rob7 FFaming =� �'-�-' '•�' Y� r C� � x x �73�Under rr�'.Siork,� �nk'[3Gas ❑l`�il - x K; .K J 7. F�i}c'K i- 9 � ay . ~ ;� x ,c 25. Roaf SltEathing �x a,"-, '� �' M,,�� 74c0+.�erhead Nydr� � * i �9- =,� . 26:'�T-Hflf' Ceilin9 (St„ubtural) &`.Nrortocoat � � � �x x 757giy Chem,ical . "" A �' _ � 27�Fr e nd F,I sh." '�' * '� w'� ` O> x S i9 ce .� �?P �_ .p Yi� .:; x M .� } tex x� 76`.-8ry Stan��ipe � �p ,; ;-; �y28. Lai4ing"�it Sidin��.1: v ^%:� � % S_ ^x X 77� FIXED ' TE�'{� ,INA ?` � . •"' ?� 'r C .T. x :� -�T •- � x .Tl !t .'> t s.' � " ¢7 29. Insulation . R ;� .. .K ;�c 78gFIRE PREV. FIN{eL x� C� ?- �30.DrywaIlTJaiiing"�K ��" HEALTFhDEPI'.:REQtiIREMENT r �. :"5Jc i^ .x cf y31. Plaster �'{ovyq Coat� S j ;c.,- ��; � _ ; � „79�'FINAL IM1�ECTIQN ;. `'� " � �V 1 a . a -32uElectrical PowerMexeZ-FinaU �r :�1 � * !80?;FOOD CERTIFtCICTE 195UED ,� � r- - �• , .. < r r r� r Q n � r: I 7 x"r '' . X. i / ��- --+ F rr r33�Firial El�ctric �-� :,, � ¢ � . x 'Nq�,esl"�//rvY ,�_ - � � ' ;� . y-., �� R734��Finej H�dting&' ii:Co�ditiar?'8�$: C1 x f: r u( " ("t'-^__�;` i' S �:_ < K K '1 1 .�C X Zl 35nFirial G� Pi{%-TGSt`. '.r � � � (l ^. ;ns a •� SU ..y �� �!: H :c x-� T C G h x� " n+ [�36. �Horpd ucCanoPYz+� ,.y �-, r: �'. K ^ 2 C'�� .c � � .tr If �37:=Firi�1 Fa�tory Fi��laceX i 5�., y ���' Y" r �� x r �m ; . ... � :� �� -�38. Fina1 Plttmbing x�n� � W� 5'+ S t-; Y.a +j . v � �39. Wat'er Setirvice=FinaF T � '�' � * k Y: (`, �;R x x ^� t z?_ I KQ KX ✓. # S :t .i. v x . _ ... . ✓ .. . . . .�40. Gas Ser��ce-�Kinal �� „ �Yr,� � x rn .: x per; �vn; .s ' �-- - `r >�41. Solar pomesiic•Finals <�� •' * (-$ ` x Q�'� * O i: F# :�` - i� K Z ti � 42'"Backflow Prevente'� r t,, � x j;.= •;�-, � „ 43. Backflow Ir � atiorF 'ySS �� � � r y :c:-c � � � w i �,�j44. LandscaDe Iiripation Systertn?�n .� :�, C - G�s x~ .^•� ia �- tcCJ �: "� rn c - ' ^'- - � �45%Sound Atteauation "' ^ Y +: ` -+ l �Y :� �"' � �r� �q '� > .r f l f. '' ;,e rn rz� m K!c tT V <:. � F.. t: - x :+ _ C46�.Handica�A R�gulations ` � r .. .. -•-� .: J �.; .S iro 'S � � 47.SFIMFiL STRVCTUftE & BUrLDING � I -- 0.'CS - 2i T # l� ; j <' 1 :r. .� 48:^=F1f;}AL PI.AIVNING i�r:r t::o ; x ic �n � _. _ �v - i- :- c49V Elec[ric Release to-Edison � . " . �� � � i t , - � M S i :l � ^ 7 i: t.� V rJ J.^ Y ` � p50�Ga�Rel_ease to Southern Califorpia Gas Co x '<�s � C, . pr-, .� � � - - „ y55. CEflTIF1CATE OF,�OCCISPAP3 V �: .,: �: � p !-Jo yc , c.- �. No. Date � ' •. � \� ti DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS ��9s���,'cF��c� ST. Slreet Address Bldg. Permit # This Permit # AP Number 1. I(we), ����.� S�l /�A"�Si���/Y , declare that I am the Owner of Title of the above referenced real property, and that I(we) hereby authorize: � c�7'T /7� I S.�" i.o a o'-2s 7 7 O Name � Telephone No. �nf0� ��//L�C,{� S/• � Street Address C�sT State Zip to obtain permits in my behalf, as owner/builder, for `%��� i�'��%L �r�-,�-s��rnR. at the above referenced property. �� 2. Should any person become an employee engaged in the improvement of the property, I(we) shall im- metliately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the�City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. 4. I agree to indemnify and hold the City of Mesa and its employees or officers harmless from any claim resulting in damage or per ur to � yself or any other parties as a result of work authorized by the permits from t � �ly E Pnc-cc����j'm�' 5. I declare u de%!���f��E�Sn�,r¢�@h'�'�'�ibe f egoing is true and correct. Executed this �� day of NG 1� 19�2 , at COST/� MESQ} , California. iYl ll�E �vA-,�A-s�{jn'!,q l �9 �9Z Printed Name Date NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attorney to secure this permit in any behalf. ons�ne �ae�. vsil OFiiCV1L SEILL : SAl1.Y E ARMSii20NG NOTARIZATION REQUIRED ' ^ ���bffc-Calffom(o ORANGECOUNiY MyComrtds9on� Uef A'�3 i� 29.1Sv^-0 " NAKA�rilMA, M1Ch8El li. �"' � 25-1`1-/b JOB ADDRESS 979 Snrinefield Street BUILDING PERMIT N0. 42501 NSPECTI OIL AS IATEF SWR. LINE U HOUSE CON. :LING SYSiEM ROUGH HEATING ANO AIR CONDITIONING UNOERGROLINO �J POWER ROUGH WIRING TRENCHES FORMS BON� BEAM FAAME ANO Flp5MIN6 LATHING - IN n ( PLASTER,BROWN COnT HEATING, VENT., REFRIG. ANO A.C., F PLUM6ING. FINAL FN� GAS TEST rI BUILDING, FINi SPECIAL REOW SUBCONTRACTOR �� a25oi COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant ro Fill in Completely — Use Ink Only BUILDING ADOFESS q79 ��iF/NCp F/�I D S/- O W N E R//l�NLfAFL �. /1. SII��� /f . ��HSN CITV (�ms'/� CANSTRUCTION BFANCH ADOflESS TEL. CONTRACTOR—�C�l[.(JXfj(/ - /`L-CLC ADDRESS TEL. CITV NO. STATE � ' CITY � LIC. NO. 'LIC. NO. SI2E � � NO.OF BLDGS: OFLOT (j� x(Q� ' NOWONLOT USE OF EXI5fINGBLDG:'SINGLE FqMrLY DwE�C(A Separate permits are required for electric, plumbing and heating work. USE OF BUIIDING AND WORK TO BE PERFORMED I hareby ecknowlad9a that I have �eatl this application and stfte that the above infolmation is corract end a8ree to comply with all laws regulatin9 builtling construction, and I shell not employ any parsOn in violaT�an o£ Me workman's cOmpensatiOn laws of the State of California. 1 eby certlfy that I am properly Ilcensetl as a convacc�or�� � the SWte g^ 'e Business antl Professio 6aC�6ivision 3, Chapter 9, d that suc h�+i rcirt� u!1 /orce and effecS, or I hn+ am exem t f�o �he'O��5ion5 of the fornia eusinass In�nf�Code, Divislan 3, Chaptar 9. � 9 ^A///jjj r Signature ot7A/��_��" Y/.� � Permlttea `�� �� � ��Ay A/1f1�( Authorized ABent !;IG 14-75����Ot�7485:'- ::u„n-.�„j.SG FORSTRUCTURALPERMIT A.P. NO. � � �� BUILDING l� ADDRESS � TRACT��S� � LOT OWNER / /. USE � FIRE ZONE APPROVE . 1 ev � ZONE NO.OF � �I PLANS VAqOS APPROVED MAIN BUILDING (FROMC/LST EET) FRONT SI I L. SIDE FT. � /J� � flEAR /%�J FT. D DISTANCE BET. MAIN BLOGS. VAR. #- THEAMOUNTSI �THE PURPp$E OF VA�VATION $ �� / SN�m �+ VAWE /. .�y, USE OF N BUILDING DATE n m i : m N ✓N UNDER VA�UATION IS FOR m 'ABLISHING A PERMIT FEE ON V: � PERMIT FEE $ � N PLAN CHECK $ 0 TAX g /71 LL �v � S. U TOTALPAID $ � 27614 COSTA MESA BUILDING-SAFETY DEPARTMEIYT P.O. BOX 1200 GOSTA MESA� CALIFORNIA 926i6 � ? PkID r ti� �': i�'_ � SEP �_5-61�t,,,,GO 71 �'•;� )9.J0