HomeMy WebLinkAbout859 SONORA RD - Building Permits� . s �
CITY OF COSTA MESA
BUILDING DIVIS/ON
77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR fNSPECTIONS CALL (714) 754•5626 _
RERMIT TYpE MECH
APN: 14154305
JOB ADDRESS: 859 SONORA RD CM
Viciniry:
SQ. FT: 0
; ,
PERMIT NUMBER: M09-00125
STATUS: ISSUED
DATE ISSUED: 12/23/2009
ISSUED BY: CAC
Suite/Unit:
SCOPE OF WORK: REPLACE�EXISTING FAU WITH <100K BTU AT THE SAME LOCATION
OWNER: RIVERA, VICTORIA � Address: 9532 DUMBRECK DR Unit:
PHONE: 714-756-2962 City/State/Zip: HUNTINGTON BEACH, CA
APPLICANT: RIVERA, VICTORIA Address: 9532 DUMBRECK DR Unit:
PHONE: 714-756-2962 � City/Stale/zZip: . HUNTINGTON BEACH, CA
CONTRACTOR: OW NER-BUILDER
Address: Unit PHONE:
. Ciry/State: � ZipCode:
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: $38.30
PLAN CHECK FEE: $0.00
lNVESTIGATION FEE: $0.00
REINSPECTION FEE: $0.00
TOTAL FEES: $38.30
License No. 000000
CELL:
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Qrd. No. 92-28, § 1, 12-27-92)
EXPIRATION; PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. -
INSPECTIONS: In order for �he work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all
required inspections and £nal approval must be obtained. Failure lo obtain inspections and final approval will result in the expiration of this permit.
CODEO. INSPECiIONTVPE DATE INTITIAlS COOEt INSPECTIONTYPE UAiE IN�
161fi Fixed System Final Fire Prevention 206 Final Mechanicai
1266 Pool Spa Finai 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
s�� t:,��<��`�_'
203 Final Sign 222 Final Site -,_� �:
204 Final Demolition 250 Final Building/Occupancy
� �. � � .�'.
WORKERS' COMPENSATION DECLARATION:
I hereby aRrm under penalry of perjury one of the following declaralions:
❑ I have and will maintain a certifcate of consenl to self-Insure for workers'
compensation, as provided (or by section 3700 of the Labor Cotle, for the
performance o( the vrork for which Ihis permil is issued.
❑ I have and will mainlain wnrkers' compensation insu2nce, as required by
5ectbn 3700 of the Labor Code, for Ihe peRortnance o( the work for which this
pertnit is issuetl. My vrorkers' compensation Insurance carrier and policy
number are:
Carrier.
(Tnrs seGun need ml Ee rompletetl Atne peimrt is valued at one hundmtl dollars (St00) oi less )
Policy Num6er:
❑ I certify that in lhe pertormance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation lavrs of Califomia, and agree thal if I should
become subject to the vrorkers' compensation provisions o( Seclion 3700 of
the Labor Code. I shall forthwith comply with these provisions.
Appliwnl's SignaWre
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERP.GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions o( Chap[er 9(commencing
with Section 7000) o( Division 3 0( the Business and Professions Code, antl
my license is in full force and eRect.
Lic. # Class #
GonVactor's 9gnaWre Da�e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a constructbn lending agency tor the
peAortnance ot the v.nrk fa which this permit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Address: __
oa�e
OW NER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the (ollowing reason (Sec. 7037.5,
Business and Professions Cotle: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any strucWre, prior to its
issuance, also requires the applicant for 5uch permit to fle a signed statement
Ihat he or she is licensed pursuant [o ihe provisions of the Coniracrors
License Law (Chap[er 9(commencing with Section 7000) of Division 3 of Ihe
Business and Pro(essions Code) or thal he or she is exempt therefrom and
the basis (or the alleged exemption. Any violation of Section 7031.5 by any
applicanl for a permit subjects lhe applicant to a civil penalty of not more than
five hundretl dollars ($500).):
❑ I, as owner ot the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the StmCture is not intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of property who builds or impmves
lhereon, and who does such work himself or herself or through his or her ovm
employees, provitled lhat such improvements are nol intendetl or offered for
sale. If, hovrever, the building or improvement is sold within one year of
completion, the owner-builder vrill have the burden of proving that he or she
tlitl not build or improve for purpose of sale.).
I, as ovmer of Ihe property, am EXCLUSIVELY CONTRACTING WITH
LI ENSED CONTR4C70RS to construct the project (Sea 7044, Business and
Professions Code: The coniractors License Law dces no[ apply to an ovmer of
; property who.builas or improves Ihereon, antl vfio contracts for sUCh project wilh
a contracta(s) license pursuant to the Cont2ctas License Laws.).
❑ I am exempt under sec.
Business and Professions Code for ihis reason:
�3-/a3/o 9 "
ignaWr Dale
3051-46(3i01� �
r �
Owner ied b tlriver s license. �j Yes ❑��—
D� r's Li e No. / l Eunires: O a d o/o
Venfication of Ownership by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INUUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certify that no excavation frve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection with v.ork auttwrized
by this pertnit, and that no building structure, scafidtling, falsework, a demolition
or tlismantling thereof, will he more than thirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Califomia Adminis[rative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from the Division of Industrial Safery, as noted above, unless
such person has a pertnit lo do such work from the tlivision.
ApO���nfs SiB�aWre
Division ot Industrial Sa(ety Pertni[ Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to fle and
certify a Business Plan for emergency response to release or threatenetl
release o( a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health antl Safety Cotle requires, with some
exceptions, Ihat a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time tlunng a reportetl
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 teet of compressed gas
at standard temperaNre and pressure).
2. Does or will the applicant or present or fuWre building occupant neetl to file
a registration tortn for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safe[y Code, wi�h some
exceptions, requires registration with me Costa Mesa Fire Department by
each business which at any one [ime has on hand a quanti[y of acutely
hazardous materials equal to or greater Ihan a wzighl of 500 pountls, or a
volume of 55 gallons, or 200 cubic teet of compressetl gas at standard
temperature antl pressure).
3. Does or will Ihe applican[ or present or fuNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program (or acu[ely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Health and Safety Code provides tha[ Ihe
Costa MeSa Fire Department may require the preparation, Certification and
filing with ihe Fire Department of an RMPP by businesses which are requiretl
to register awtely hazardous ma[erials with ihe Fire Departmen[.
4. If an RMPP is presently required, has Section 25534 of the California
Health antl Safety Code been fully complied wim7 ❑ ves ❑ No
5. Does or will the applicant or preseni or (uture building occupant require for
the work which is the subject of Nis applica[ion a permit for such constmction
or modifcation from the South Coast Air ouality Management District or (rom
any other air pollution control Oistrict or agency? ❑ Yes ❑ No
(Sec�ion 65850.2 of the Califomia Govemment Code requires Ihat the requested
infortnation �e fumished on applications for non-residential builtling permits).
6. Will any part of ihe Faciliry to be consWctetl un0er this permit be within
1000 feet from the outer boundanes of a school? ❑ Yes ❑ No
(If "yes", Ihe facility mus[ meet Ihe requirement of Sections 25534 and 42303
of lhe Califomia Health and Sa(ery Cotle).
7. If a permit from the South Coas[ Air Qualiry ManagemeM DisMc[ or o[her
air polWtion control district or agency is requiretl for the vrork which is the
subject of this applicatioq have all of [he disclosures prescribed by Cali(ornia
Health and Safety Code Section 42303 Deen made? ❑ Yes ❑ No
8. (If "yes", attach certificate of wmpliance fmm Ihe appmpriate air polWtion
control oKcer).
CER7IFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is cortect I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre �ate
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury �hat I have read �his application antl state that
the information given is correcL I agree to comply vnM all state laws and ciry
ordinances relating to building consWc[ion, and authorize representatives of
the City of Cos[a Mesa ro enter upon the above-descrihetl pmperty for
inspection purposes. I agree not to occupy or allow occupancy o( any builtling
autho ized y tl's permit until fina pectiop.
� .��,�../� /a-/a-s/S
SlgnaWre o� Legdl Owner(s) Daie
AnalO� P.uNo�ixetl ApPlicanl Dale
. 1 . • _ �. . �
,.'��"`��
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Costa Mesa
City of Costa JVlesa �uiCding 1�ivision
77 Fair Drive, Costa Mesa, CA 92626
714-754-5273/Fax 714-754-4856
OWNER BUILDER VERIFICATION
Permit # � ��— O � � Z �
Disclosures & Forms for Owner- Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as fhe builder of the
propsrty improvements specified at
We are providing you with an Owner-Builder Acknowledgment and Information Verification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner-Builder. We wili not issue a building permit until you have read, initialed your understanding of
each provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting
authority.
OWNER'S ACKNOWLEDGMENT AND VERIFICATION OF INFORMATION
DIRECTIONS: Read and initial each statement below to signify you understand or verify this information.
�� 1. I understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
(�� 2. I understand building permits are not required to be signed by property owners unless they are
responsible for the construction and are not hiring a licensed Contractor to assume this responsibility.
j�� 3. I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that
I may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his
or her name instead of my own.
�R- 4. I understand Contractors are required by law to be licensed and bonded in California and to list their
license numbers on permits and contracts.
l�� 5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors,
and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may
be cqnsidered an "employer" under state and federal law.
��6. I understand if I am considered an "employer" under state and federal law, I must register with the state
and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and
contribute to unemployment compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
�7. I understand under California Contractors' State License Law, an Owner-Builder who builds single-family
residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building Contractor.
3148-30 CALBO Jan 1, 2009 OB Packet template '� Of 2
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�'� 8. I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable
for any financial or personal injuries sustained by any subsequent owner(s) that result from any latent
construction defects in the workmanship or materials.
l�� 9. I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information
about licensed contractors.
ul�, 10. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
�i 11. I agree that, as the party legally and financially responsible for this proposed construction activity, I will
abide by all applicable laws and requirements that govern Owner-Builders as well as employers.
� 12. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
information i have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors' State License Board may be
unable to assist you with any fnancial loss you may sustain as a result of a complaint. Your only remedy against
unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed
Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property ownei
and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's
driver's license, form notarization, or other verification acceptable to the agency is required to be
presented when the pe�mit is issued to verify the property owner's signature.
Signature of property owner (/�%�i�C�c-e� Date: _/a-�3� /�
Note: The following Authorization Form is required to be completed by the property owner only when
designating an agent of the property owner to apply for a construction permit for the Owner-Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I
hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents
necessary to obtain an Owner-Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally fillec
out the above information and certify its accuracy. Note: A copy of the owner's driver's /icense, form
notarization, or other verification acceptable to the agency is required to be presented when the permit is issued
to verify !he propeRy owner's signature.
Property Owner's Signature:
3148-30 CALBO Jan t, 2009 OB Packet template
Date:
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. ��� ��c�iv�a
•� I8665 , � c�nR � tss2 Lot 67 - Tract lt260
COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. Plan 3oo-�t
P. o. aox s,� COBTA MEBA. CALIPORNIA' ^�TY OF COSTA MESA �
For Appliean+ to Fill In Complefely qpp��CATION FOR PERMIT
TYPE OR PRINT .
BUILDING 859 Sonora Road BUILDING
ADDRESS
COSTA MESA: CALIFORNIA For Off7ee Use Onl y
RlCEIPT NO. P¢RMIT NO.
liF? Olsten c.:
-"aiue pppROVED
t10ri _.,
c,n, Corona Del 1�Tar,Calif.
�C.TNO. SSOB-SB-1 No: OR 3-l�220
OF LOT 698l� S.�'. � I NO. OP BLDOS�O�a
NOW ON bT �
USE OF ���
EXISTING BLDG.
B6iBACK LINB PROM C1� � __ r���
I LEFf 6t I RIGNT 6�
DESCRIPTION OF WORK-.
1 v Kn�
1 HEREOY AC�cNOWLEDGC TXAT 1 HAVE RBAD TH18 MPLIWTION
AND BTATE TNAi TXE ABOVe IS CORRECT ANO AGRH6 TO�COM•
PLV WITH ALL CIiY ORDINANCEB AND BTATB LAW! R[6UTATIN6
BUILDINO CONBTRUCTION. -
SIGNATURE OF p i��erit li0
PERMI7TE /yJ
$Jr � _ . �//i i � /i O /.//
�
CASTA MESA. CALIFORNIA
ZONING
ZONE� _/ I PUNe � I US8 OP N��^9 �
emtnma Q � ,
LlOAL Lo� 6'7 i.P Y z6�
DEBCRIPTION
�eeemn uMe st.l j'i�
FRONT
R. 61DE �
L. SIDE �
awsw z.3
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-"� IN.
rF Z.�Z/��. L
�overed Porch 3� S.r•
TXE AMOUM BXOWN UNDER VALUATION 19 POR TNH
PYIiP08E OP E9TABL18HINp G PgqMIT pEE ONLY.
s 17,333.00
e
PflQIECT AODflESS: 8 S 9 SONORA AD .
OWNEH'SNPME: RIVERA ALFRED V
nooeess: g�37. DGMBRECK DR
� , HUNTINGTON BEACH,CA 92696
AflCH/ENGINEEfl: �714�965-1�62
AOOBESS: . .
UNIT:
NEG.NO.:
UNIT:
PEflMITTEE: MESA PACIFIC ROOFING ( 714 ) 645-7552
aonnEss: 1127 BAKER ST
COSTA MESA CA 92626
UCENSEO CON7PNCTOP �ECNBFTION: I nere0y affirm that I am licensed untler pmvisions of ChaD�er 9(commencing with Section
7000) oi �ivision 3 0l Ihe Business and Professions Code, antl my license is in tull lorce and eftecl.
c�Tvuc:.030729 sTarEuc.:43074 cuss: t�����
' �--�
Daie'. — �' Signature: _ _ _
WOflNENS'�WMPENSRTONOECLABATION: I�ere�yaffirm�ha�lhave ertificaeo�co ntmselFinsureoracetli�ica�eolWorkers'
Compensalion Insurance, or a ceriilietl copy thereot (Section 3800, Lab. C).
eaucrno.: 653447-99 EXP.DATE: O%IOSI91
carnraNv: STATE FUND
❑ Certifie0 capY is hereby fumishetl. [� Cehi�ietl copY is hle/tl�v��j� e city Build�ing Oiv/isio .
�ale:��� ��� AOPlicant /�/n� /
E%EMPTIONFPOMWONNEflS'COMPENSpTIONOECIABATION: (hi55et�i0nne o�beCom0let '�Ihepermiti5�oronehUnOretl�5100�or1e55�.
I ce�ify I�ai in Ihe pedormance o� the work �or whi�h �his permit is issued. I s�all no� employ any person in any manner so as �0 6ecome
sublect �o Ihe Workers Gompensa�ion Laws of Califomia.
Daie: Signa�ure: ' '
NO710E: II, alier making Ihis Ueclaration, you shoultl become sublect to ihe Workers' Compensation pmvisions of the Lahor
Code. you must foMwilh comply wiN such provisions or ��is permit shall be tleemetl revoked.
CONSTHUCTION LENOING AGENCV: I hereby alfirm that Ihere is a constmction IenAing agency for lhe pedormance of ihe work for
whic� this oermii is issuea (Section 3097. Civ. C�. � ,
_ LENOEF: � �
ADOflESS:
OWNEP BWLUEB OECLABATION: I hereby aflirm Iha� I am exemp� �mm the ConVactors' Slaie License Law �or �he following reason
(Sec�ion 7031.5 Business antl Prolessional Code: Any ciiy oi coun�y which �equire5 a pe�mii to constmc�, al�er, improve, tlemolish, or
repair any slmqure. prior to'its issuance, also requires the appiican� for such permi� lo file a 5igneE statemenl that helshe is licensed
pursuam m Ihe provisions al Ihe Comracmrs' S�a�e License Law (Chapter 9(commencing wi�h Section 7000) ol Division 3 of the Business
anA Protessions Cotle) or Ihat h¢Ishe is exempl �herelwm antl Ne basis br �he allegetl exemp�ion. Fny violation o� $ec�ion 7031.5 �y
any applicanl lor a permit sub�ec�s Ihe applican� Io a civil penally af no� more ihan five hunaretl tlollars (5500).
I, as owner o� �Ae pmpetly ar my employees wi�� wages as Iheir sole compensalion, will do �he work, antl ihe
❑ sVuc�ure Is not intendetl or ofleretl tor sale (Sec�ion 7044, Business ana Pmtessional Cotle: The Conlradms' S�a�e License Law
. aoes wt apply Io an owner of a pmDeey who 6uilds or improves �hereon, antl who does such work himsel�/hersel� or �hmugh
his or her own employees. Orovi0e0 t�at such impmvements are no� inteneetl�or oiferetl for sale. If, �owever Ihe huilding or
impmvemeni is 5014 wi�hin one year 0� completion. Ihe Owner will have Ihe �UfUen o� proving �e/She aitl n0� buiitl Or impmve
lor Ihe purpo5e of sale�.
I, as dwner o� Ihe O�oPe�y, am exclusively conlracling with licensetl conVac�ors m cons�mm the pmlec� (Sec�ion 704d; Business
❑ an0 Professions CoOe: T�e Coniractors' SIaIe License law tloes not apply lo an owner oi pmperty who 6uilds or impmves iherean
ane who comrac�s lor such prblec�s wiU a coniractor(s�license pursuan� to �he Contracmrs' S�ate License Law),I am aware
Ihal pmo� o� �Aeir Worker's Campereation Insurance 5houlA be pmvide0 to me. , �
� I am eeemp� under Sec�ion: B. 8 P. C. � . �
lor I�is reason'. � ,
�a�e: Ownec
I tlo hereby ceruly I�at I am aware of antl unAerstantl �he requirements of Caldornia Healih antl $afety Cotle Sections 255�5, 25533, and
25534 and ihal I or any fuiure builtling occupani willlwill nol (circte one) need Ia comply with 5ai0 sta�e codes and �he requiremen�s for a
permil for consimc�ion o� modifica�ian imm Ihe Air �ualiry Managemen� OislricL Residenlial consimction applicaiians are exempt Irom
Ihese pmvisions. •
Oaie'. ApplicaN:
I hereby rerlity �nal I have read this applicaiion and s1a�e ihat the above inlormation is correcL I agree b comply wi�h all ciry and counry
or0inancesanasialelawsrela�ingto�utldingcons�mctionantl�erebyau�h erepresenlativesofthis ityloeNeruDonNeabove-men�ion¢tl
propehy IOrin50etli0n pu�pOs�e.jS.�, ' ,
�ale: �� S _ � Signamre: ! �
odw�'s�icenseo�sodaisecumyx:
i6<La6 Whi�e—Builtling; Green—Cotle Enlorcement Canary—Applicant; Pink—Revenue: Goltlenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 049T5 .
PERMIT NO: B; 099757 PLAN CAECK NO: ,, N., GOVT: N SUPP: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR �' PURPOSE: ALT
JOB DESCRIPTTON ; PARTIAL RESHEATH/FULL.REROOF W/FIB.GLAS. SQ FT: 2,80�
CLAIM VALUE: - 2,800,00, CALC—VALUE: 2,800.00 GROUP OCC: R-3 /M-1
COMMENTS• SMOKE DETECTOR(S) RE�UIRED IN HOME. '` .
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Z O N I N GS ERTEH�AUCIKRSE M E N T S
------------ MAIN BUILDING �--------- ---`----- ACCESSORY HUZLDING ---------
FRNT: FT IN REAR: . FT IN FRNT: FT IN REAR:, FT IN
LEF,T: FT IN RGHT; FT IN LEFT; . FT IN RGHT; ,. FT IN
PARKING REQ• PROV; PARCEL: 14154305 ZNE; � REF NO; "
PLANNING NCSTES> � '
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� ' 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
ZONING APPROVED BY , ' DATE; �
BUILDING APPROVED,BY : DATE: `
APPLICATION ISSUED BY; ' DATE• ������Fk�
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LEGALI2ATION;N F E E S U�M A R Y STRIICTURAL SEGMENT;Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP./RES GRADING
PERMIT 54,00 � 50
� ' � SMIP/NON—RES
PLAN , ' ,
ISSUE FEE � � ' '
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ' PAID DUE
TOTALS----> 59,50 . 0.00 � 0.00 54.50 54.50' ,00
REVENUE DIVISION T'OTAI.S--> COLLECTED: 54,50 OVER/SHORT; ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECFt
54,0� � .5� .
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� I N D I V I D U A L F E E- B R E A R D'O W N
TYPE QTY D E S C R I P T I'O N UNIT COST TOTAL COST
SFR 2800 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 2,800,00
�END OF FEES
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CONSTRUCTION AND PLANNING ' - POOL & SPA . �
APPROVALS Permit # " Date Inspector ppPROVALS Pe.mit # Date Inspector �
1.� Temporary Electriwl Service or Pole_ � ' 52. Pool & Equipment Location '
2. Soil Pipe-Undrgcnd. . � �-t 53. Steel Reinforcement � _
�
� 3:,Electric'al ConduifUtility-Und�gmd."`` ;� � 54. Forms �
:.4i�Electrical Cond�it:Undrgrnd. - ` , 55. Electrical Bonding �'�
T��
��5:;Steel Reinforcemeni�. ''�Y 56. Rough Plumbing & Pressure Test S
^8�_iElectrical UFER Grod. - 57. APPROVA� TO COVER�GUNITE r'
''�7:�Footin`gs � 58. Electrical Conduit-Undrgrnd. 4'
�.. �..
��8.�_Foundation _ '�' . :.�>'' - 59. Gas Pipe, O Undrgrnd., Test ,�'''�
9. Water Pipe-Undrgrnd. '.: .; , f Z 60. Backwash Lines, P�Trap, O��Undrgmd. j� ;�
10. Structural Flooi System �� � `; r 61. APPROVAL TO DECK '
11. Property $ewer Line & Hopse Connection ' 62. Backwash & Receptor�Final ', �
•r «
12. Sewer CaP �� ' �l: 1 ,� . ,
., ,,,-: 63. Heacer & Vent�Final � `� ��
13. Roof Drains T, � ' f' - 64. Plumbing System - Final '� �'
��,
14. flough Plumbing: '" 65. Electrical-Final � "
15. Rough Electricaj.Conduit `' �" 66. Solar System-Final �1
16. Rough Electri �Wiring i ' 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 ' � FIRE DEPT. REQUIREMENT
- - - - "! c* iJ'r-+tvE-� u; r. [- N
20 :-Rough Facto .ry Fi�eplace � a:!-t .6 �: :- U � �-'�s x. -i4pPRO,VAL'S�;�CPermit # '`� '��
r.� - :r x _ ir y� � %] a' v�. ^� r:
21 �Ducis, in�Structure' , �'t ;'�'� \' � ��>. � ' s'����J '.. !" .
. x ... -.c, �� ;� n -]0. llndergroundjHydro 0
22.� DuRs, Ventilating•�=: f S .;. � t � �a; ;� :_ �7�, product°Piping O'Gas O'Oil
23�Gas Pipe_Rough & Test ; ��;,�. �; ,� - �y x =�7z. Undergiound FlSsli',,. ;' "_'' "
24.iRoof.Framing� '..�� � -- - � 7 ���•?. S73!iUndergrndtStorage>Tenk�]Gas�OOil �
_y
25. Roo ,f Sheaching :�;y: 'T •ti� ;�` � , " �'74 `Oyerhead �Hydrof� -� .
26.eT�Bar Ceiling (Structuraq & Monocoat � G �x r 75.`Dry Chemical �" � _ y
27:-Frameand Flashing^ ~^ �. - u: , x � „-� �;; ::; �:, �~
, =��� �r, 76.-Dry Standpipe �� �
[�
�28."Latt1in9,& Siding'�� ;. -�y �� .,.. ;r .. • '� � 777FIXED SYSTENLFJNALx y ^ Y,
'29. Insulation "�T•`'n �"" � ht`' I �;', 7grFIREPREV.FINFqL a� �
�.: tu:, � „ ' � 1' : � ;, y ,_� HEALTH:bEPT.: R-EQUIREMENT
�?30. Drywall Nailing .: w �
'� +�:
�31. Plaster BF;own CoaC,- � �,�„n, 'y i � ,�� y, �79: �fINAL INSP.ECTION r�- � ':��
'. _ _ ., , _ r I �s '.(. ir: ; J' .
'�32:;Electrical;Power MeterFinal, ' ��. p, � r-.f, s: �,SO;:FOOD CER�IFI,EATE ISSUED'
`33�Final Electric ��,;. � -� `� �'; � iVotes: - �O �' �`
a. . r � .il t �-'!/f ^ '�� 77 �
`� � ,. ��. . � ... , , -. . .
`�.34..-Final Heatingi& fCiraC"onditioning"� s�'' � f `f;, ;_ � r � �}� ��!/ .
' - Q!`�
' � �. .. : t,..
35:.�Final Gas'Pipe-Te"stx� J . :+ { ,��. f� _ �S � ��
r � � -' t,-
i ` . .. y ' Y. � � 1.' �?v ^ {Zl . � r _:] ,y
�36.'Hood or„CanopV.- � x ; �7 'i; ., r : �;� �e .e;•�
' ' i •�:
�-37.�Final Fabtory FirePlabe` ` =�'" ` n � � •��• r "t' � �. '.`�
� i � i: %.•-k 2i
_ . .. .- . Y. - � .. .. ._ .. S` 1 � '-L �l m
�38. Final PlUmbing ���,i , i I � �;;� ' '" '- �' `
:-39. Water Secvice-Final>� � � ' j .}�- a C• •�+ r �: Ci
1 � lR +l y �,1,
��40. Gas Servlce-Final ; ,�� K., : � r,' � ' �, �,a �`!c� �� ���
=47. Solar pomesticFinal:� � -� ( � * * �:��� -
'.. - I !r - - L� - � -
42 �Backflow Preventer` '" " ' - � �;� ;� ' .� '�
.� • r- - . ,
43. Backflow� Irrigation� ��. S ;' '-' - _ �r � -�
i �. _ � �• i a: � (1
1 ' .
C44. Landscape Iriigatio� Systern:7t i:�; ,A L ti �,� .�,: ia �.0 �i::' t�� ;� c
=A5 �Sound Attenuation � "%� `r '.: ;_ - E- � . � ��' Tn � .. � � �
�t �n r� �i* : r' t7' :.0 .�.
-46^Handicap,RegulatioPs ;_' `� �'� � � ' ' l ,� -�O� "` r
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�47.�PINqL STRUCTURE & BUhLDING y �_(6 O � ', p W ; �c � " .
a8;_FINAL PLANNWG`' � ����`+ ` � ;/ " ' � ` ~ � , '
� L...�_ x r.: � ��. '�; :! �: ..� . _..
cA9 jElec[ric Release to.Edison ' • ; � ,'� +. >, ri� � i Y :v
❑ rY •r'\
-�'50.,_Gas Release to Southem Califo�nia Gas Co � ���)�' `, ,;; '� ;< `
� •
. 51. CERTIFICATEOF.yOCCUPANCY .(. ;� :{ � i., ��_: �, �.,: F, ,_,
No. Date