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HomeMy WebLinkAbout2868 TABAGO PL - Building Permits • CITY OF COSTA MESA BUILDING DIVISION F . 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B08-00100 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 13933202 DATE ISSUED: 03124/2008 ISSUED BY: KJB JOB ADDRESS: 2868 TABAGO PL CM Suite/Unit: Vicinity: RESIDENCE AND ATTACHED GARAGE - Squares: 3100 Valuation: $16,500.00 SCOPE OF WORK: TEAR OFF ROOF.RE-SHEATH WITH 1/2"PLYWOOD.COVER WITH 1 LAYER 30/t FELT AND 50 YEAR CELOTEX COMP SHINGLES. INCLUDES RESIDENCE AND ATTACHED GARAGE. OWNER: COOK,GARTH E Address: 2868 TABAGO PL Unit: PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: STEVE'S ROOFING Address: 711 WEELO DR Unit: : • PHONE: 949-548-2965 City/State/Zip: COSTA MESA,CA , CONTRACTOR: STEVE'S ROOFING , - License No. ,3021S7 Address: 711 WEELO DRUnit: PHONE: 949-548-2965 City/State/Zip: COSTA MESA,CA 92627 - CELL: ' ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $279.25 Reinspection Fee: $0.00 TOTAL FEES $279.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE O. INSPECTION TYPE DATE INITIALS CODES INSPECTION TYPE, DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 41-7-0-fN ` 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy I WORKERS'COMPENSATION DECLARATION.. Owner ID verified by dri...,, s lice.._.,. ❑Yes ❑AJo' I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the perform ce of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by Ilion 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My rkers' compensation Insurce carrier and policy ❑ I hereby certify that no excavation free(5)or more feet in depth into which a number are: is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffdding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thissectfin need not be completedif the perml is valued et one hundred dollars($100)a fess) 2,Art 2Sec.341,Title 8,Califomia Administrative Code). Policy Number: O 3 o U `I" Th ❑ As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subjec to the ' compensation provisions of Section 3700 of the La r C ,I sha f t comply with these provist ns. / Applicant's Signature Z�/O V Division of Industrial Safety Permit Number: Date nt's Signature Dat/` 000 HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file �m'y license isinfull force and effect. —� a registration form for acutely hazardous materials? 0 Yes 0 No Cc.'t-4- ,r' oty ? 'Class# . (Section 25533 of the California Health and Safety Code, with some 'C7/�A1"`,'.—'_, exceptions, requires registration with the Costa Mesa Fire Department by • each business which at any one time has on hand a quantity of acutely onvr gnature t ate hazardous materials equal to or greater than a weight of 500 pounds, or a ' volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If.yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date properly who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a conlractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. atuR o1 Lune) Date -/ Signature Date / /a<WD V 3057-46(3I07) ` v, 000 And/or AuthOr¢e App iwm ,Date • CITY OF COSTA MESA BUILDING DIVISION Fktl 77 FAIR DRIVE,COSTA MESA, CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesas .us FOR INSPECTIONS CALL: (714)754-5626 • Rb.^onnd PERMIT NUMBER. P08-00042 PERMIT TYPE PLUM STATUS: ISSUED APN: 13933202 DATE ISSUED: 02/05/2008 ISSUED BY: BJK • • JOB ADDRESS: 2868 TABAGO PL CM . Suite/Unit:- Vicinity: uite/Unit:Vicinity: - - - SCOPE OF WORK: COPPER REPIPE OF SFD AND WATER LINE TO METER. NO OTHER WORK AUTHORIZED WITH THIS PERMIT. OWNER: COOK, GARTH E Address: 2868 TABAGO PL PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: LARRY HORTON - Address: 560 LIBRARY ST : PHONE: 800-806-7374 City/State/zZip: -SAN FERNANDO,CA CONTRACTOR: MASTERSERV INC License No. 580017 Address: 560 LIBRARY ST PHONE: 800-806-7374 City/State: SAN FERNANDO, CA ZipCode: 91340 CELL: 818-408-4100 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: • PLUMBING PERMIT FEE SUMMARY • PLAN CHECK FEE: $0.00 PERMIT FEE: $43.10 TOTAL FEES: $43.10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No. 92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE DATE INIIIIALS CODES INSPECTION TYPE DATE INIRIALS 1616 Fixed System Final Fire Prevention • 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing "0--N-03 200 -W—o$200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's lice.. . ❑Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: /� 7 person is required to descend,will be made in connection with work authorized Carrier: J/y/� (/ Z; //7-"lee- (6/1- by this permit,and that no building structure,scaffolding,falsework,or demolition (This section need not be completed tlmepermrtls valued at one hundred tlonas($100)or less) or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp [[��n/,rte 2,Art 2,Sec.341,Title 8,Califomia Administrative Code). ©/ /[ Policy Number: 1r /1960 '7� El As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,I hall for hwith come y with these provisions. Applicants Signature Date / ta:25:05-' Division of Industrial Safety Permit Number Appl ra signature Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. / a registration form for acutely hazardous materials? 0 Yes 0 No Lice# 29/'.7 Class# C-5 6 (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by i Air pZ `42 -- --fria each business which at any one time has on hand a quantity of acutely Contractor's Signature Dale hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Dale 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑ No thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of egal•..e-(s) Date _!�y/ Signature Date -1" - - �'-F'r—���---"` !l/�������5: 3057-46(3/07) 01111.. An:/or Authonzed Applicant Date • CITY OF COSTA MESA 4 AI BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 I P . . PERMIT d# ✓P02-00753 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 2868 TABAGO PL Status: ISSUED Suite No Applied: 12/20/2002 Issued: 12/20/2002 Vicinity: Cgerli Parcel Nunmber: 13933202 ISSUED BY: Applicant: PAUL KAMINSKY • Address: 11612 KNOTT ST Phone: (714)895-1246- GARDEN GROVE,CA Zip: 92841 Owner: COOK, GARTH E Address 2868 TABAGO PL Phone: COSTA MESA,CA Zip: 92626 • Contractor: NOCK PLUMBING - Address: 11612 KNOTT ST Phone: (714)895-1246 GARDEN GROVE,CA Zip: 92841 License: 707775 Arch / Eng : - . 1 Address: Phone: Zip: License: - SCOPE OF PERMIT INSTALL NEW WATER HEATER FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 - Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer ,$0.00 0 . . P-Trap - " $0.00 0 .-Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) /$0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 / Wash Basin $0.00 0 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 Sewer Private Line . $0.00 0 Water Closet(Toilet) $0.00 0 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(6/00) DECLARATIONS I • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. /�•IC I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. —My-workers'compensation Insurance carrier and policy number are: ...---- Carrier: Carrier: ` i..o . Cie A? O/`- N, II. Policy Number: '70777 S (This section need not be completed if the permit is valued et one hundred dollars(5100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation-laws-Of Cel d agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr• ' I. Applicant Signature: / Date: .2 -2 a “7.2---- WARNING: aZ---WARNING:FAILURE TO SECURE WORKE 5'COMP SAI1ON COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITI T E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Us. , --0 S Class a 14' 6 Nig Contractors Signature: . Date: /i• 20 • oe.___ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec..3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom end the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not Intended or offered for sate(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,tho owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: • HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes No (Section 65850,2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: C FICATEO3F COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is rrect. I agree o co ••ly with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-describe• era. y for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date / , • 2-Q - OZ_ And/Or Authorized Applicant Date CODS F, EVE NTYPF DALE LNn9L5 CODE I INSPECTION TYP( QAU MALE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 0..213-0,3 � 1266 Pool Spa Final 208 Final Plumbing 'J• 200 Final Re-Root 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 649 8/19/01 41 ,175 CI�t' OF COSTA MESA PETIT N� �� TRACT NO. LOT N BLDG.NO. 3 - .. IL CONSTRUCTION PERMIT L�/G 460a 4.� _ Project Address 2'��8 G1'g T•6�A.h, rf L TYPE OF CQNSTRUCTION Owner 1 ryCp. ~ 1�'J�•�1�Phone ZS,�R 0 NEW ADD 0 ALTERATION ^+ Address 2P6C TINSficip PUN-GE ❑ REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. License No. 0 OTHER �q�.ss.. — • DESCRIPTION OF WO COL.+s-.I267�. /APO A.P.t / a—02..... Address 1 COVO WO• t• ZONE - PLNG. REF.# Contractor a _ Phone TYPE OF PERMIT B • "S• tuL�ILpi I NG �.,/' SETBACK C/L ST. v.l?PERTY LINE Address 0 GRADING 0 FOUNDATION LCSTRUCTVRAL SIDE YARD /O•/ LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICA SSIIDEE YARD // I hereby affirm that I am licensed'under provisions of Charter 9 (com- - • - RIGHT. mencing with section 7000) of Division 3 of the Business and 0 OTHER / T Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) J CO • License Class License No.• -�/ O PKG.SPACE REQ. PROVIDED Date Signature SQ.FT. �' I••-- •'' ^� WORKERS'COMPENSATION DECLARATION • OCCUPANC` I CONSTRUCTION TYPE ' STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VALUATION t ZONE ZONING APPROVED By dae9/2 ••c`9d• DATEQ J 78/ certificate of Workers' Compensation Insurance, or a certified copy •���" ��I CJ / •---reof (Section 3800, Lab.C.). SPECIAL CONDITIONS: GRADING CU.YDS. ACRES Y No. - Company , ..ertified copy is hereby furnished. REMARKS: ❑ Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section need not be completed if the permit Is for one hundred - - . ($100) or less). (cert fy that In the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK ' subject to the Workers'Compensation Laws of California. DWELLING GARAGE, Date Signature BATHTUBS SHOWERS SO FT SO FT ' NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+ HP formance of the work for which this permit is Issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name - Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP CLANS ALA.I IDN Any city or county which requires a permit to construct, -alter, POLES METERED SUB Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the 'siness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT s for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ... not more than five hundred dollars ($500). - ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation,will do the work, and the structure Is not Intended - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY el.. DATE ••� through his own employees, provided that such Improvements are not • intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion,the owner will have the burden f proving he did not build or improve for the purpose of sale). BUILDING SMTP $ O•`+O I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ 2 00 AND DUCTING PLAN CHECK $ �•ZS PERMIT censetl contractors to construct the project (Section 7044, Business 100,000+gTU and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM . GRADING $ . the Contractor's License Law). 100,000 +BTU -, - PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this .BOILERS BTU ELECTRICAL $ S reasonMICROFILM $ -- Date Owner SYSTEM REPAIR,ALTERATION PLAN CHECK $ TOTAL FEE$ - I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ information is c• rect. I agree to comply with all cityand countyPLAN CHECK $. LESSANE PC VANCE PC $ ordinances and s -te laws relati g to construction,and hereby authorize representatives city o enter upon the above stion d W.property for f' : : • f•oses. [jam• ''l �/ Signature APS -dr • - ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL& SPA - APPROVALS Permit# Date Inspector APPROVALS Permit/4# - Date Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location 2. Soil Pipe-Undrgrn -• 44. Steel Reinforcement • - • • 3. Electrical Conduit Utility-Undrgrn -� . 45. Forms 4. Electrical Conduit-Undrgrn . . 46.• Electrical.Bonding • 5. Steel Reinforce r • ' 47. Rough Plumbing & Pressure Test _ 6. Electrical UFER Grn ` - - 48. APPROVAL TO COVER-GUNITE 7. Footings s . . Q. 2o.* , S3,,, 49. Electrical Conduit-Undrgrn 8. Foundation `' - 50. Gas Pipe, ❑Undrqrn,Test 9. Water Pipe-Undrgrn - - • 51. Backwash Lines, P-Trap, ❑Undrgrn 10. Structural Floor System . - • - 4 20,$/ .-7 #t-„14 52. APPVIOVALTO DECK 'd1, •. Property Sewer Line&A-louse Connection 53. ,Backwash & Receptor-Final • 12. Street Sewer Connection 54. Heater & Vent-Final - 13. Rough Plumbing 55. Plumbing System -Final - ' 14. Rough Electric-Conduit - .56. Electrical-Final 15. Rough Electric-Wiring 57, Solar System-Final - • 16. Rough Heating & Air Conditioning t. b8. Fencing &Access Approval 17. Ducts, in Structure • - 59, APPROVED FOR PLASTERING 18. Ducts, Ventilating - 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing - • 21. Roof Sheathing i - 22. Frame and Flashing I • NOTES: - • 23. Insulation 24. Lathing & Siding 25. Drywall Nailing . • 26. Plaster Brown Coat . • 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 1 32. Water Service-Final .:: 133. ' Gas Service-Final 34. Solar Domestic-Final • 35. . Landscape Sprinkling System. - 36. Sound Attenuation - • • 37. Handicap Regulations - - 38. FINAL STRUCTURE & BUILDING 9. /el. -yam - . 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. • 42. CERTIFICATE OF OCCUPANCY . _ - • 1"No Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PE MIT NO. TRACT`D O. LOT NO. UNIT NO. A P # I �o? _()a Zone /Z� project Address !-Pl�rl � 0 Ce-' 3 " ' D �='TTM I 1 _ S Main Building: Accessory Building: %pplicant's Mailing Address ZIo Na T e_'0. c)—,A TYPE OF CONSTRUCTION LI NEW ii ADD LLL���JJJnr�aALTERATION LI REPAIR E •n�� f Z On ❑ CONVERSION ❑ DEMOLISH ❑ OTHE W T Front Ze Zi-, O . Owner's Name �` 0�e c Pc-- rrt�^ DD SCR)Pi` N Oty RK�US�E�O ,DG �(�-� a p I A Rear . 0 f N •Eddress •-•K�� F3 11--^c ^' t OGr�/•1 pN�i"/'� 1'�I (,�(•� ( I C Right 't 7b1 N Arch/Eng. License No. - - TYPE OF PERMIT GRADING FOUNDATION LJ STRUCTURAL ' K G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S L 0 1 ',t� ❑ -OTHER R Contractor's Nam (M )311'1 LTS Phone $)(Z f Ping. Ref.# Parking Req./Provided E c�� �� PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ Address(mailing) 7 l�i a%./re-7 WO C �S- / Si r Planning Notes: �a LE hA/g1a b,(AC(1L `(,()(,L,�.� M CONSTRUCTION TYPE_ "V N VALUATION$ p O ^ Cf.'�1"`� T City License No. ZONE GRADING CU.YDS. ACRES rfl LICENSED CONTRACTOR DECLARATION e� L/�• /t 17 K. I' 1y //�� S' I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 4L 1 1 • e4 l M Loa,' I\• salt { ? & _ph with section 7000) of Division 3 of e Bu 'ness and Professions Code, and 19 my license is in full for rhe f/ .(- s ELECTRICAL FEES ^ Lice ns• .ss L .� / Li ,a��Gr . • L...0 ra ct01^ refer J•12-� iit\Sr e'cI-� _a•1 ltr2y rl — `U Date 's•1%Li%s Signature : . 1 Sera PLUMBING FEES Automatic Washer Transformer 0 15.50 KW -OR ER''COMPENSATION DECLA-ATION Construction Pole Sub050+KW reby affirm that I have a certificate of consent to self-insure or . certificate Bar Sink Showers Workers' Compensation Ins rance, or a ce/ified copy there-f (Sectio - Cooking Unit Meter ❑up to 100 amps 3600, Lab,q),., Backflow Preventer Service Sink ' W(� 2,36,.., " I - ' /��."� Dishwasher Meter Dover 100 amps Policy No. "•mp. yap. ... Backflow Irrigation • Sewer Cap _ \ C hied copy is reby furnish,•. Dryers ❑Gas ❑Electric Sub Panel art ified I with the it y Buil • ��• / Bathtubs Sewer Connection 119 Date /,ff Applica t ���-.6.-- Fan Motors 00-1 HP ❑1'h-8 EXEMPT ON M W RKERS'C. • - SATION DECLARATION Clarifiers Solar Collectors (This sec ion nee not be completed If the permit is for one hundred ($100)or Dishwasher — F.A.U. Inc. ar 09-15 HP ❑16-15+ less). Solar Piping I certify that in the performance of the work for which this permit Is Issued I Fixtures shall not employ any person in any manner/so as to become subject to the Drinking Fountains Solar Tank Icrowave Workers' Compensation Laws of California.' Date Signature _ Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If,after making this declaration,you should become subject to the e Outlets Ran Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Ur' al 9 comply with such provisions or this permit shall be deemed revoked. Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets ater Closet Sign I hereby affirm that there is a construction lending agency for the performance Garbage Disposal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION ' - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays 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 Roof Drains 'he Contractor's License Law(Chapter 9(commencing with Section 7000)of ivision 3 of the Business and Professions Code) or that he/she is exempt ,erefrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee $15 Issue Fee $ 3 /031.5 by any applicant for a permit subjects the applicant to a civil ,enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REOUIREMEN7$: ' ,/3.. • I, as owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee $ 3 L�'f�'C� -g7 89 compensation, will do the work,and the structure Is not intended or offered Zoning Approved By __����`�v Date for sale (Section 7044, Business and Professional Code: The Contractor's' MECHANICAL _FEES Building Approved By ad 1166... ii License Law does not apply to an owner of a property who builds or improves - ��,� Date thereon, and who does such work himself/herself or through his or her own Hood or Type 0 Application Issued By LJ %/�i���_ - Dat: employees, provided that such improvements are not Intended or offered for Boiler :a— sale. If, however, the building or Improvement is sold within one year of Com- Canopy Type II 0 SUMMARY OF FEE pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale). - • BUILDING PERMIT $ a 3 • ACo SMTP $ s .5—D ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Re Igeration System _ PLAN CHECK $ ! ' [.S_ tractors to construct the project (Section 7044,Business and Professions Code: PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0.100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- __ tractor(s) license pursuant to tne Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration • PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B.&P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $ PLAN CHECK 50% $ P Date a awner Heating System& Ducting Registers MECHANICAL $ pa I here• certify that ave rep ' application and state that the above 00-100,000 BTU 0100,000 BTU--'' TOTAL FEE $ infor ation is correct agree yo all city and county ordina ces PLAN CHECK 25% $ and tate laws rated•• to b •ction,and hereby authors-e r pre- sem••tives of this • to dr •/ e alga/-mentioned ro•.rtier Ins• coon purposes. �, r Sign. re _ / ��- �'� nate y^I /9 ".DUPLICAT Drivers' License or .5 - - /. Reinspection Fee $15 Issue Fee $ 3 (J /� I •".r 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor• i DD�f�D 07/ D03D 19D TIOT ,7.v••.:1 DA TE• 04/07/889 TIDE: 15:39 ' CriNSTRDCTION AND PLANNING ' _ PO Y SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. 'Electrical Conduit-Undrgrnd. - 55. Electrical Bonding . 5. Steel Reinforcement - • 56. Rough Plumbing & Pressure Test I 6., Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - - 7. Footings - . + 040Og 58. Electrical Conduit-Undrgrnd. 8. Foundation . - ) 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. . • 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final ' 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - ' 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing& Access Approval 17: Rough Wiring Sign 68. APPROVED FOR PLASTERING 1.8. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1). Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace • " APPROVALS Permit# 21. Ducts, in+Structure - 70. Underground Hydro 22. Ducts, Ventilating : -- • 7.1. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test -c- 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) 81:Monocoat 75. Dry Chemical 27. Frame•and Flashing 76. Dry Standpipe 28. Lathing & Siding ^' 77. FIXED SYSTEM FINAL 29. Insulation .i ;' 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coate . 79. FINAL INSPECTION • 32. Electrical Power Meter-Fin•al 80. FOOD CERTIFICATE ISSUED 33. Final Electric _1 Notes: 34. Final Heating & Air Conditioning P/L,r U 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ' 39. Water Service-Final 40. Gas Service-Final •- 4 41. Solar Domestic-Final 42. Backflow Preventer ' 43. Backflow Irrigation , +• ,i 44. Landscape Irrigation System t 45. Sound Attenuation ') • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 89-0-D 48. Special Requirements Completed - 49. Electric Release to Edison ✓ ,. 50. Gas Release to Southern California Gas Co " -i 51. CERTIFICATE OF OCCUPANCY No. Date i - - . _ PARTY WALL AGREEMITI. inns AGREEMENT, -made and entered into this Z ( day of 114f19 0 , s, by and between C( 67, 6itoIC hereinafter referred to as "LAND CEEER", and - , P hereinafter referred to as "ADJACENT PRCPER.1 CWNER". It is hereby agreed that a party wall will be constructed co the property line between 7_8627-1411154-0 PLIC G 2 j (Address of Adjoining Properties) 1-Pr( hat) RACE , (o flof- (926,2 in the City of Costa Mesa, County of Orange, State of California, as per nap recorded in Book " , Page_ of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroath1 Otis A- L'Ltc3SA&! , ons 1)-1.6C oiL r3o77-1 PeoPstl7E5 IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. IAND " i • ADJACENT PROPERTY OWNER (Signature) (Signatur E. C2oK Name (Typed or Printed) Name (Typed or'Printed) %q (F3 T 'z P( 6,2- n �� (Ad•dress) cocp9,t ccs 029 �/2e2g (Address) • 10 Pei • EHROVEDUR -Go .,C..iuil.` APLT A MES 1. ETID? CQR COP ECTIO.V $HLL � �] fl� Vr���DEPT. QE A° „UI'ED QY THE PL ;;igl.JGDEPHRTMET DEPT. REO.E4- '7-3 City of Costa Mesa Building Dept. G BY ,4 C7, DATE 9/7 19 THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE NO CHANGES WITHOUT PRIOR APPROVAL OF DEPT. THEI ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL OF PLANS AND SPECIFICATIONS SHALL NOT BE CONSTRUED TO BE A ��O� PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION OF ANY OF NO# /✓ THE PROVISIONS OF THIS CODE. O PERMIT PRESUMING TO GIVE AUTHORITY TC VIOLATE OR CANCEL THE PROVISIONS OF THIS THIS NUMBER MUST ACCOMPANY CODE SHALL BE VALD,EXCEPT IN SO FAR AS THE WORK OR USE WHICH IT AUTHORIZES 5 LAWFUL. ALL INSPECTION REQUESTS THE ISSUANCE OF A PERMIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT PREVENT THE BUILDING OFFICIAL FROM THEREAFTER REQUIRING THE CORRECTION OP ERRORS IN SAID PLANS AND SPECIFICATIONS OR FROM PREVENTING BUILDING O?ERATIONS 6EGNCi CARRIED ON THEREUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE OF THE CITY. - RESIDENCE RESIDENCE RESIDENCE RESIDENCE hWl 7.065 )TI 1062-CC Ct W . CO I \ '40 ' FC-- 11.05A6(0 Pc� STREET _ TYPICAL 611 CONCRETE BLOCK FENCE a •_ • I. Cement Coping Optional :moi GENERAL— NOTES i'i Channel Block With 1-3/80 Horizontal Top of all • MORTAR: One part Plastic Cement, and Fencesiff Three Parts Sand 0 GROUT: One Part Cement Three and For Fences 5'or Less s One Half Parts Stand Vert. Bars 3/8"¢at 4' -0"O.C. ad o S Sri 1 COPING: One Part Cement, Three For Fences Higher Than S' Tiluu CONCRETE: WellParts Sand Mixed 1:2-I/2: 3-I/2 Vert. Bars 3/8"¢ at 32" O.C. > w, cc _ Max. of 7- 1/2 Gallons of Fill Cells Solid With Grout 1, > Z Water Per Sack Of Cement Where Steel Occurs 555111111 > —Reinforcing Steel Shall tlif -' GROUT MAY BE POURED FROM THE TOP Conform to Sec.A-15-39 IIIYYY��� w O - OF THE FENCE IN CELLS WHERE STEEL O F OCCURS. A.S.T.M. CELLS AND AREAS OF HORIZONTAL REIN- All Steel to be Lapped e��' Wu. n ' FORCEMENT SHALL BE CLEAR,CLEAN& 24"or to Code Ili FREE OF ALL MORTAR DEBRIS,ETC. NATURAL GRADE I s.,11/4V/A., - "/ Mill Be l' v I mi . 4J: TWO 3/8"0BARS ....al BARS 4rr.A.0 - D^ o• e s CONTINUOUS TOP & BOTTOM WIDTH - TO 16' O. C. MAX, SEE CHART -' - _ HOR7ZSTEEL MUST BE TIED IN BELOW DEPTH OF EARTHTCOTH PLACE AT TIME OF TRENCH a ° 1/3 THE HEIGTH OF FENCE INSPECTION. q L i , • _ L BELOW BOTTOM OF FOOTING. � o^ l o" j 2..__jj_ SCALE: 1/2" : 1' DOTING REQUIREMENTS CHART i WALL HEIGHT 6 ' 5' 4' 3' WIDTH 14" 14" _12" .- . . . . . . . . 12" THICKNESS 10" 10" 8 8 " DEPTH OF EARTHTOOTH . . 24" . . . . . . . .20" 16" . . . . . 12" SPACING OF EARTHTOOTH. . 12' 14' 16'. . . . . . . 16' City of Costa Mesa California Ca``- 7 &_,e 7�t3AL o Qc bce Building Department c Ecl-� N.,,,\ �-x. + ' _. I?.EVfsEP NoV.82. - _. pc ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTAMn/Ep$9 CO /1(/(.1TR(�U_CTION P/ERMIT PER NO. TRACT NO. . LOT NO. UNIT NOA.P.# I Zone Project Address d awry Wp1I /0(-' - &? Building: Accessory Building: /Oen, -#g TYPE OF CONSTRUCTION LI NEW Li ADD U ALTERATIOry S Main ' Applicant's Mailing Address i �- 1J REPAIR Front E Z /' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T 0 Owner's Name IVa Phone al-101( / DESCRIPTION OF WORK/USE OF BLDG. I A Rear N Address ���irr I N Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑FOUNDATION U STRUCTURAL I C Right - G Address ❑ TENANT ❑ ELECTRICAL ''.-. ❑ MECHANICAL S Left R Contractor's Nam .l�Phon04 J 7YflJr ❑ OTHER Ping. Ref.# Parking Req./Provided E #.7r 1 ////���/jj///}}} p /,- ��/U PROJECT DESCRIPTION SQ. FT. OCCUPANCY r� Q O Address(mailin 1 3 . r ero isv ' / • Planning Notes: RECEIVED t-(� y CI ry1 g `/''1_67 ✓/ CON STRUCTION TYPE VALVATION $ DEC 1 3vT City License No. ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: with section 7000) of Division 3 of the Business and Professions Code,pand my license is In full • - nd effect. / ,,,5„0 7 ELECTRICAL FEES Licens- la e•.e No 0 Date '•L Signature Stilt 2 i -,_ PLUMBING FEES Automatic Washer Transformer 0 15-50 KW '•IORKERS' COMPENSATION DECLARATION Conatruction Po le Sub. 0 50+ KW ereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter pup to 100 amps 3800, Lab. Backflow Preventer Service Sink I Dishwasher - - Meter Dover 100 amps Policy No.�opy'/heY-Q 7l Company S�/(�/7�� �'/.l Backflow Irrigation Sewer Cap — _ -�I-certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel D Cer j3{ed$l7py- Jsled with the ntY P I' Bathtubs Sewer Connection Date //9S-(/(J '�A Applicant Fan Motors 00-1 HP ❑1h-B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit Is for one hundred (5100) or Dishwasher Solar Piping F.A.U. less). Inc.Solar 09-15 HP 016-15+ I certify that in the performance of the work for which this permit is issued, I Fixtures Microwave shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light - NOTICE:II,after making this declaration, you should become subject to the Outlets Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) interceptors Water Heater a - Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service • Generator 00-5 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - following reason (Section 7031.5 Business and Professional Code: Any city or • county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays - 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 Roof Drains •he Contractor's License Law (Chapter 9(commencing with Section 7000) of )ivision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 nerefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zoning Approved By compensation, will do the work, and the structure is not intended or offered - - • Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES' Building Approved By Date License Law does not apply to an owner of a property who builds or improvesthereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 Application Issued By - Dat employees, provided that such improvements are not intended or offered for • sale. 11, however, the building or improvement is sold within one year of corn- Canopy Type II 0 SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground - Prove for the purpose of sale). BUILDING PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PER MIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU / PLUMBING $ 5•ti'-'1 ISSUANCE $ ac- builds or improves thereon. and who contracts for such oroiects with a con- ENERGY P.C. $ tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration I • PLAN CHECK 25% $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ 17 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt.ICBO# Fire Dampers MICROFILM $ _ Heatin System&DuctingRe Isters PLAN CHECK 50% $ Date Owner 9 v I g MECHANICAL $ cJC °0 I hereby certify that I have read this application and state that the above ID O-100,000 BTU 0100,000 BTL TOTAL FEE $ Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction,and hereby authorize repre- sentatives of this cit to a ter o the above-mentioned property for iSignaturetion pu s Date �/tO -O orp Drivers' License or SS# /, Reinspection Fee $15 Issue Fee $ 3 01 00023000-00023000 TOT 5.00 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 12/21/83 TIME: 09:59 • • • CONSTRUCTION AND PLANNING POS ' SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement ~ 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4-'Electrical Conduit•-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement• 56. Rough Plumbing & Pressure Test .6. ElectricalUFER'GrrSd.� 57. APPROVAL TO COVER-GUNITE • • 7. Footings E58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line,& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap / 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final •• 14. Rough Plumbing?' 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval -'17. Rough Wiring Sign 68. APPROVED FOR PLASTERING r 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 ❑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 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 12-27-bt ZAP,-Gant- [„CD 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing /04/S L5/) 39. Water Service-Final i 40. Gas Service-Final 1 • 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. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ��// 51. CERTIFICATE OF OCCUPANCY No. Date • aa.d. cam- ' - ' -� Lret 41 1 Zan . '., jr"//P. FEE RECEI�IE�� COSTA MESA BUILDING-SAFETY DEPARTMENT MAR 6 1961 P. 0. BOX 317 COSTA MESA. CALIFORNIA ��// FINANCE DEPT. For Applicant to Fill In Completely APPLICATION FOBIIRERMICOSTA MESA tel/ �'PE OR PRINT r' BUILDING BUILDING ADDRESS �jj''�s s� -\010 TAS t� \. COSTA MESA. CALIFORNIA For Office Use Only Investors Marine Inc. RECEIPT NO. PERMIT NO. OWNER �[(�� MAIL RECEI`yED BY D RECEIVED DAT ISS ADDRESS _•l1. I •: . ' li 'az ✓ .., -- — '/ ^•.1u R 4.9/4,1 CITY Newport Beach,Calif. NEL-Mid;" BUILDINGDDR -i 6 . �, ARCHITECT Same TEL. /8- COSTA MESA. CALIFO•IA OR ENGINEER NO. ((fin ADDRESS FIRE '14 (�_ ZONE TYPE GROUPJ 1�(/Jf' CONTRACTOR Mesa Verde Builders, Inc. APPROVED BY DATE ADDRESS 1653 Minorca Drive ZONING ZONE I PANO.OFNS BUILDIUSE OFN� • •NE 9-7 CITY . ] 11 lam[ STATE TC E 181269 Tao NO. 9-0395 LEGAL DESCRIPTION \:- • - SIZE 721X10/4 I I NO. OF BLOCS.0 OF LOT I NOW ON LOT A.P.NO. USE OF YARDS EVES EXISTING BLDG45, _ APPROVED ALLOWED SETBCENTEECK R rI LINEFM REAR YAR& _611 AcENTEFRONT •"4147T. LINE eT.I 7 . IN. SIDE YARD I LEFT 61 RIGHT 51 • R.SIDE f..5.--FT. IN. DESCRIPTION OF WORK 6J FT. IN. L.SIDE /`_ NEW I X V ALTERATION I II ADDITION I REAR 1rp�' (jam FT. {7 IN./ APPROVE PROVEgIj \/ ��_!� ATE - -�j/ REPAIR I V MOVING I V DEMOLISH I LLL 6�`- ,t�f__ _ ) D SIZE Bu'ING1500 Sq.Ft.ROOMS 6 DRIES 1 (\�;/f EXTERIOR WA,pLLsiding ROOF SZ'HsiIngle 1 O� COVERING St stUCCO (COVERING i'J^af . USE OF BUILDING AND WORK TO BE PERFORMED n ,/Qi single family residence and gang v — 57 Model No. 550-C Attached garage 462 Sq.Ft. I HERESY ACKNOWLRlGE T T I HAVE READ THI APP CATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT TH ABO IS CORR AND A•RE• TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY _ IN CES AND ST T8 LAW OULATINO BUILDING CONSTRUCYIO VALUATION �/ SIGNATURE OF ' A I MA ` 'I i(t�` /, ^/Q OD PERMIT FEE $ J'(o�� N PERMITTEP i $ /X 1 / (- PLAN CHECK $ /r' `I' AUTHORIZED AGENT 6-4/._ ¢ - - TOTAL FEE u