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HomeMy WebLinkAbout2020 SWAN DR - Building Permits 4 , CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 1004 . -`efti mrc 401-01810 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 2020 SWAN DR Status: ISSUED Suite: Applied: 11/13/2001 Vicinity: HOUSE&ATTACHED GARAGE Issued: 11/13/2001 Parcel Number: 13953214 Zoning: R1 R1 Applicant: DAVILA, ELIAS ISSUED BY: • Address: 19651 EDUCATION LN. Phone: (714)968-6135 HUNTINGTON BEACH,CA Zip: 92646 Owner: ELLIOTT, ROBERT J Address 2020 SWAN DR Phone: COSTA MESA, CA Zip: 92626 Contractor E D ROOFING SYSTEMS CO Address: 19651 EDUCATION LN. Phone: (714)968-6135 HUNTINGTON BEACH, CA Zip: 92646 License: 672009 Arch : Eng: Address: � Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF EXISTING SINGLE FAMILY RESIDENCE&ATTACHED GARAGE(32 SO).TEAR OFF EXISTING ROOFING& RESHEATH WITH 1/2"OSB. INSTALL 30#ASTM FELT UNDERLAYMENT&REROOF WITH 40 YEAR PRESIDENTIAL. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,300.00 Permit: $125.25 Claim Valuation: $5,300.00 SMIP Res: $0.53 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.78 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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(8100) DECLARATIONS 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. o 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 olicy number are: Cartier: Policy Number: 1 '3 C Jl -(This section need not be completed if be perinit is valued of one hundred dollars($100)or less.) - _a l ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with thesT ns. Applicant Signature: Thi./1 mete: . )00 16"0 7 WARNING:-FAILURE-TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(St W,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am flood under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Pr f§'ons Code,and my license is in full force end effecttic: -�� ZOOq , (Class q i �'( Contractor's Signature: -O�—,±"rt—T •'- .• •-L� Date:---- IJ&'J, i -a i • 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: Lender's 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 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).): ❑ 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 sale(Sec. 7044,Business end 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,the 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 properly 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. ❑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? 0 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 a plication a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 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 ❑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 at of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑Yes 0 No B (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: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,end authorize representatives of 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 egad Owner(s) Date -`YAL • ,ham _ iJed( 13 --Si � And/Or Authonzed.Appllwnt r -Dale CODE F INSPECTION TYPE PAH INTRIAL$ CODF I INSPECTION TYPE PATE. INIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof ')"1 O`C) 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 Bullding/Occupancy _ F CRESS OF eMLIKNO: tvcv bvitari inc °M, CITY OF COSTA MESA - BUILDING PERMIT OWNERS NAME IF MOWNELLIOTT, ROBERT J FLOOD : AE-46 PERM NO: B 083703 ADDREsa ELLIOTT, SALLY R .00,-..-- 2020 SWAN DR PERMIT NO: B 083703 PLAN CHECK NO: 02745-97 L GOVT: N SUPP : N Fr ' COSTA MESA,CA 92626 APPL � CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: CON .MAILINGRES& ARcxRECT OR pNGNEER: UC.NO: JOB DESCRIPTION : CONST. 190SF DECK SQ FT: 190 ARcx OR MG'S ADDRESS: °NT` CLAIM VALUE: 1 , 200. 00 CALC-VALUE: 3, 062 . 80 GROUP OCC: R-3 / C0"""CTOASN"'E` COMMENTS: X CONDIACTORS WANG ******************************************************************************* AD°"cam G`NO: ZONING REQUIREMENTS Wit SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby Slim under panty of perjury that I em licensed under pro.ta d Chapter 9 (dmmencing with Section 7000)of Division 3 of the Business end Professions Code,and my keno Is in lug harpa and effect. C UC. LIC.CLASS: UC. tate, MAIN BUILDING ACCESSORY BUILDING Mt FRNT: FT IN REAR: 25 FT IN FRNT: FT IN REAR: FT IN .e:P)/, It �? Contractor: LEFT: 28 FT 6 IN RGHT: 17 FT 6 IN LEFT: FT IN RGHT: FT IN OW UILOE DE RATION:I hereby«firm under penalty d perjury that I am exempt from the Contractors License Law la the I.,,..C.. u .reason(Section 7031.5 Business n as and Professions Code:Any city«county which requires a permit to connive.,alar.improve, PARKING REQ: 2 PROV: 2 PARCEL: 13953214 ZNE: R1 REF NO: •:'dish,orrapalanysrduruga,misbssummaborenaeatheapp«emr«wchpWnutafileedpmeddaumnmtMtheor.M PLANNING NOTES> CONSTRUCT 190 SQ. FT. RAISED DECK ( 3 ' HIGH) , ATTACHEDTO is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)d Division 0 of he > REAR OF EX, SFRESIDENCE. Business and Professions Cadet or that hesShea exempt therehoeand the Mus It the alleged exemption.Any yidetion 01 Section *********************************************11.***************************ii***ff* 2 7031.5 by any applicant 1«a permit he o the applicant exam to a civi penalty d nae mate then free hundred dollen 1550010. ❑ L es owner d the property or my employees with wages es Mei sole compensation.will do the work,and the sbuatre a nes intended DEVELOPMENT SERVICES R E Q U I R E M E N `I' r• or offered for sale(Section 7044.Business and Professions Code:The C««rJon License Law does not apply to an owner d property /- who butch or improves thereon,and who does such work himself or herself cc through he at her own employees.provided that such Czr DATE: h _ improvements ere not intended or offered for sale.5.however.the bidding or improvement is sold within one year d compleeion.the ZONING APPROVED BY 1 ows burtler all have the he d proving he a she old nal build a improve la the purp e el.sale). i ——I -Pmlessims �\ ❑ Lesownrdthepopety.am atknMty camrmkq win kcenadoMrecrosmmhauct the peoed(Sed ]W4,Busvweard BUILDING APPROVED BY DATE: contracts for o de:projects with ora License Lawd�Oca�I itheowner d property wM bits a leronoyes t and wise — -r n$ ( ( n LD APPLICATION ISSUED BY: DATE: 1] lam event undd Section13 roc ibis � **** ±E* *** ** ********?F************* sE****�f*********?f 3F******* **-4:71-1--- * 3 *****£'** Date: 7 I( q-7anter: `. / LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y do hereby ca that tem aware dand understand the requirements Caneed to nand Safety Code Sections 25505,n5nt and BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2553.and Net I or any haunt building azaerem_will/veil cwt(circle an)reed m nom with aid slate cedes and the requirements ler a permit for mmwctionor modification Iran the Ae eyc anaoemera District. el mutrafion appicalts are exempt from these PERMIT 87. 25 50 provisions. SMIP/NON-RES Date: Applicant: PLAN 56. 71 WORKER'S COMPENSATION DECLARATION:I hereby affirm under prubyd perjury one of the blowing dedaratlons: ISSUE FEE ❑ Ihave and wiamaintain a certificate dmnseMtoselfinsurefor workers'compenWprovided Section d n3700theLWar BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code.for thepad«mancedmeworkfawfichthiapermnbissued. TOTALS----> 87. 75 0 . 00 56 . 71 144 . 46 144 . 46 . 00 ❑ I have and nil maintain workers compensator.insurance.as reamed by 000001137C°d the Labor Code,ler the performance of the wok for which the permit leissued.My waked'campensation inertrencCe mmler and poky number are: REVENUE DIVISION TOTALS--> COLLECTED: 144 . 46 OVER/SHORT: . 00 Garr"` BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK Pofiry Number: 87. 25 . 50 56 . 71 (this section need not be completed 1 the permit is b aro hundred dollars($10)or fess) ,a,❑ to becomthetjethepedmarrms, oMwakblawnhepemn.,andd.lehall 11C4 matdmpoyanyperson oomestaymemw eors. ***********************************************************)f*************?4***** become subject to int workers'compensation laws d Cardonie,end agree that i„maid become subled m IM morrows. compensation prrnean d Section 0700 tithe Labor Code,I dull forthwith compo with those provision. INDIVIDUAL F E E B R E A K D O W N • As: A" TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Warning:Callum to secure',mean'compensation coverage la unlawful,and shill subject an riployer to criminal penalties and Seecctoon3706o the oneLabor Cods Interees�ndrealomaayee tee.ad°lti°nt°°ucost of compensation,damages as provided for In SFR 190 RES-BALCONY, EXTERIOR STAIRWAY 16 . 12 3, 062 . 80 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty dthere e perjury that a construction lending agency for the END OF FEES performance of the work for which the permi is issued(Seaton 5097.Cb.C). LENDERS NAME: LENDERS ADDRESS: I cedity that I have read this agitation end store that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize represenlateee of this city to enter upon the above-mentioned property I«ins•... p'nposea SALLY ELLIOTT iA� A rte • 67-11-1997/09:85 pN/f144.46 -,n`'��� .V l 7( C PERMIT:083703RC �/ /_ ♦ l,tes�. Date: t Signal Owner,.enVA., .. VCanfrad« (5151'45.W P) White-Suildi g A Safety;Green-File;Cavy-Applcs t;Pink-Revenue;Goldenrod-Assessor INSTRUCTION AND PLANNING - - POOL & SPA • sPROVALS 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. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings _ 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection a 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 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 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: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service•Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING �"0 _ y 2_-' 48. FINAL PLANNING � 62 ' 49,.•Electric Release to Edison • • 50,'Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date . - A• pplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ',l '� 822 2/05/87 7;00 Tl CITY OF'COST_A (') �} (J;�J /,U'CTgION PERMIT PERM T NO. TRACT NO. LOT NO. UNIT NO. Project Address OGLI�--V 0(�(////�/ •/// �l '7a D9 . . Applicant's Mailing dre5y /V /l{/�C/.(_,(//� TYPE OF CONSTRUCTION ❑ NEW ❑ ADD H ALTERATION ❑ REPAIR • ' /J/J C//f•,.ilT'/ rl//✓J�/ LI CONVERSION ❑ DEMOLISH El OTHER • , : 21� • Owner's Name �Y' (/77 Phonn4X(O'/ t(� - SIT r .. Zone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building; olL`eSs01y-Building: Arch/Eng. - License No. TYPE OF PERMIT LI GRADING ❑ FOUNDATION STRUCTURAL T Front - �l e a ., 0 Address /j I /� �/ �7(�L LI TENANT LI ELECTRICAL El PLUMBING �CHANIGAL B Rear - RE-CAM ,/ t.rr N r/// /'1IT)gPI `7Y Y [J3 ❑ OTHER _ A t I Contractor's Name I Can Phone •%- "Y-14- /:�t /✓ PROJECT DESCRIPTION SQ. FT. OCCUPANCY • C Right N Address lmailing) n)- HQQQSIG� S:FR, CA. Q43,.f]d 1p .I( ��� 4 y �� • GnCZ ! l G �j�//� CONSTRUCTION TYPE • VALUATION $ S Left • f R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Parking Req./Provided E la I I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • M with section 7000) of Division 3 of the Business and Professions Code, and Tmy license is in f or a•..effect . _ LI CenS- Class aICS• '; n AS/ • • - • `S -bo j Date .....L Signatureer.nt/ -: /L_O•'� - PLUMBING • FEES • .. ' . - Do WORKERS'COMPENSATION DE�/ ARATION ELECTRICAL FEES I hereby affirm that I have a certiO 'te of consent to self-insure or a certificate Bar Sink Showers , of Workers' Compensation Insu ance, or a certified copy thereof (Section 3800, Lab. r7-/�/�� n� /j/� — i / Backflow Preventer Service Sink • - Automatic Washer ' • ' Transformer 0 15-50 KW olicy No. (` �(D(X r,�(7 Com pony ,S Backflow Irrigation • Sewer Cap - -❑ 50+KW t B Certified copy is hereby furnish-• // Construction Pole Sub. , Dateer ifl ygpy i$.iflpd with th: city a ice. ��vis�n�/ / Bathtubs Sewer- Connection /`�// rCooking Unit Meter ❑up to 100 amps Applica EXEMPTION FROM WORKERS'CO •'ENSATION DECLARATIONClarifiers • Solar Collectors Dishwasher - Meter Dover 100 amps , (This section need not be completed the permit is for one hundred ($100) or • _ , less). - Dishwasher - Solar Piping Dryers ❑Gas ❑Electric - Sub Panel • I certify that in the performance of the work for which this permit is issued, I . - 1 shall not employ any person•in any manner so as to become subject to the Drinking Fountains Solar Tank . Motors❑0-1 HP 01v2-8 Workers' Compensation Laws of California. - Date Signature Floor Drains Swimming Pool w/Spa . F.A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE: If,after making this declaration, you should become subject to the - . . Workers' Compensation provisions of the Labor Code, you must forthwith ' comply with such Floor Sinks Urinal Fixtures Microwave' • provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water ClosetI ' I hereby affirm that there is a construction lending agency for the performance • Device Boxes Pole Light , of the work ' for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater • Outlets Range • Lender's Name -' --Lender's Address Kitchen Sink • - Water Service - - - - -- OWNER BUILDER DECLARATION • Switches Sign • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal Standing Sections ' 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 Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ; .Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000) of . • • Division 3 of the Business and Professions Code) or that he/she is exempt . . - , "- . "" therefrom and the basis for the alleged exemption. Any violation of Section . 7,031.5 by any applicant for a permit subjects the applicant to a civil 1,13toalty of not more than five hundred dollars($500). I 3 ' 1, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ - ompensation, will'do the work, and the structure is not intended or offered - • Reinspection Fee ! $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL I FEES License Law does not apply to an owner of a property who builds or improves thereon; and who does such work himself/herself or through his or her own SERVICES REQUIREMENTS: i employees, provided that such Improvements are not intended or offered for . Boiler - Hood or Type I ❑ , sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground _ • BuildingApproved prove for the purpose of sale). PP By ��-� Date 2 ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 1'.m, Dat 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 ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- __ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMTP $ • proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • PERMIT - ❑ I am exempt under Section B. &P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ - ISSUANCE -- $ Date Owner . - / Heating System&Ducting • Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above / '❑0-100,000 BTU 0100,000 BTL / /f GRADING $ • information is correct. I agree to c ply with all city and county ordinances f ?' Cl ELECTRICAL $ and sta ws relating to b ildi onstruction, and hereby authorize repre- MICROFILM $ may_ • sentat' • ♦f his city� t nt pon the above-mentioned property for PLAN CHECK 50% /L//✓�/ inspe•gnat - i�.1//liT� .A/ gl Signat Dat• MECHANICAL Z V F TOTAL FEE- $ Driver'icense or SS# / Reinspection Fee $15 Issue Fee - $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 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. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. �. 8. Foundation 59. Gas Pipe, O-Undrgrnd., Test ^l 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 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 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: 34. Final Heating & Air Conditioning 430'7 Gto 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date OWNER PEMBA SUBDIVIDERS, INC. DATE 2-4-66 JOB ADDRESS 2020 Swan Drive BUILDING PERMIT NO. 25210 GENERAL CONTRACTOR Same DESCRIPTION OF WORK Res. w/att. garage AT' No. LOT 40 TRACT 5493 FIRE ZONE VALUE $ 31,456.00 1 ECTIONS I Sign e. Date GROUP I&J TYPE V ZONE B-1 Sou L - • - - 5I PERMITS ISSUED Gas SUBCONTRACTOR Date I Number I Signature Water ag !lam '� - - Plumb''g Rough Plumbing i rS_fr4 ' j%fl!�. Sr- ..,�. 1y:. Prop. Swr. Line 3 House Con. ID- ar`i"/ �Tir%ixr7 Z7j1 _ 41 _, _ •. ASO 74 Sprinkling System Miscellaneous Rough Heating and Air Conditioning 9,41-7-37-1,S• Temporary , 4' ,- Temporary Service or Pole Underground 0 Power LI Rough Wiring /9ii/3 q/5-q-c i Heating and Vent. Trenches rt Forms ® Steel ReinL El ,j'4W j/,/6,; AerytntAy( 4;, (/- 0_„_J es//6 -66-.44/ l Floor System; , M. ' / -3 6 E I'd 3/5'-4.6- Bond E6Bond Beam 0 Steel Reinforce 0 L. Sheathing 41 y/r746 Frame and Flashing , �� y/e p/a< Lathing— Inn Out® 9h-7/6-c Plaster, Brown Coat ' 4 r09/66 I lural, Final El 1.__.ing, Vent., Refrig. and AC., Final /, • /y.,�,? A f4/ �/, 4-,7.-(0(l,. X57?8 Plumbing, Final and Gas Test©- Q :J " G/3 / Electric, Final L-_ €/6 Building, Final._. e-Z•`-ice • ._ 3 Lot 40 25210 COSTA MESA BUILDING-SAFETY DEPARTMENT I CITY OF COSTA MESA P.O.BOX 317 COSTA MESA,CALIFORNIA r[[[ 1199 For Applicant to Fill In Completely APPLi&pp O?J FOR66RMIT TYPE OR PRINT BUILD ' Ff Ee 3 my BUILDING ADDRESS 2020 Swan /��'++''�� Drive RECEIPT NO, COSTA MESA, CALIFORNIA 215710 RECD ED BY DATE RECEIv D DATE ISSUED OWNER Pemba Subdividers, Inc. /�/a6-6,-6I,.l-B'4�//�1�19966 BUILDING MAIL ADDRESS <V 0�0 �J�(/(lM �(,Y�(/ ' ADDRESS 2850 Mesa Verde Drive FIRE cm Costa Mesa, Calif. No.549-039; ZONE TYPE V GROUP tfly- APPROVED OR ARCHITECT GEN ER Kaltenbach Ta547-804E BY DATE EN 1823 E. 17th St. SantaAna ZONING ADDRESS 1,C ZONE NO.OP BUILD". DI NEW)O(i21fMLI PLANE BUILDING CONTRACTOR Pemba Subdividers, Inc, ��/ I °Z �-frid 2850 Mesa Verde Drive LEGAL DESCRIPTION L ADDRESS DHSCRIPTION ��Ll.[, /// i/G 1, CITY Costa Mesa, Calif. A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE 187318 NO. 549-0395 3O•TO SIDE B REAR P.L. LIC.NO. EAVES SIZE 1 NO.OF BLDGE. ALLOWED (U.B.C.REQUIREMENT) OF LOT 70 x 105 NOW ON LOT 0 USE OF Single FamilyResidence YARDS APPROVED YARDS APPROVED EXISTING BLDG. gwith attched garage MAIN BUILDING ACCESSORY BUILDING (FROMC/L STREET)( SCENTER OF SNE TREETM SO REAR YARD 28 FRONT CO1T. \ SIDE YARDI LEFT 7 I RIGHT 13 R.SIDE i? . ` FT. DESCRIPTION OF WORK L.SIDI( �I}Aµ� FT. FT. NEW ALTERATION ADDITION REAR ��J FT. FT. DISTANCE BET. BET.MAIN REPAIR MOVING DEMOLISH MAIN BLDQS. ACCESS.BLDGS. BUILDING NO.OP VAR.# DATE .SIZE 2393 ROOMS 13 STORIES 2 C.U.P.# APPROVED EXTERIORWAµ, ROOF Shingles & APPROVES" COVERING btuCCO I COVERING. shakes BY /WV``�``1�DATE 1.-.#1.6-.-C , USE OF BUILDING AND WORK TO BE PERFORMED rte, - ,a. w/ . 6-7 �/ 239OHQ.FT. Sf D .1- 19 I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AN TT LAWS REGULATING VALUATION �`0 BUILDING CONSTRUCTION. CY $ 9 SIGNATURE OF I �1 ) PERMIT FEE I PERMITTEE .1Ald � M - 3 / 6 /I7 YIi7 S $ l I- T-�CVVVJ PLAN CHECK $ ^,,,I{{{'.-f ` AUTHORIZED A A ` .3.J I` TOTAL FEE $ t 1\--)