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PflOJECT F�OPESS: � Z U 2 li ERMONT �1�r
OWNEH'S NAME: CAN/EIiON KEI TA A
aooeess:13105 DrAOPHINE ST
STLVER SPkIiVG,MD 2Q906
pPCH/ENGINEEfl:
aooxEss:
NEG.NO.:
uxiT:
uxiT:
PEflMITTEE: HEST ROOFING ( 714 ) 557-4040
ADUPESS: E%O w 1% TH $ T i%
COSTA MESA CA 97.627
LICENSEO CONiXRCTON OECIAHAiION: I hereDy a��irm tha� I am 6censetl waer Dmvisions o� C�apter 9(commencing wiih Sec�ion
7000� o� �iv� n o he Business and Professons Cotle, anU my license is in full torce antl eflec�.
ciTv uc.: ���7 STRTE LIC.:J'� O�I Z O,, ,� �`SS' C— 3 9
�ate:�.�•C.� SignaWre' y�"b7'Y�
WOflHEBS' COMPENSATION OECLANATION: I here6y allirm�ha� I have a certifica�e oi consen� to sel4insure or a certilicate of Workers'
Compensa�ion Inmrance. or a ceridietl cnoY �hereo� (Semion 3800. Lab. C�.
POLICY NO.: 1]. 3�] S S Z' y� EEP. UATE: O 6 I O S. I�J' A
comeaxv:STATE FUND
❑ C¢ni�retl topy is hereby lUmished. jC] C¢ni�ieA Copy is h ed with he ciry Building Division.
Dale: D �✓ � �� NpplicanL `l�Q
E%EMPTION FBOM WOPHEBS'COMPENSRTION OELIABATION: (i�issec�ion neetl no�Gecampleletlifthepermiiislorane hunOreO($11p�orle55�.
I ceNty Ihat in �he petlormance ol �he work lor which Ihis permit is issuea, I shall no� employ any person in any manner so as lo �ecome
su�lec� lo Ihe Workers' Compensation LawS ol Calilornia.
�a�e: Signa�ure:
NOTICE: II, alier making Ihis tleclara�ion, you should become subleci to Ihe Worker5' Compensa�ion provisions ot the La�or
Cotle. you mu9 fo�hwith comply with such O�ovisions or lhis permit shall be AeemeU revokeU.
CONSTPUCTIDN LENOING AGENCY: I hereby aflirm tha� ��ere is a consimction lentling agency for t�e peAormance of the wark for
which ihis permil is issuetl (Semion 3097. Civ. C�.
LENOEP:
AD�flESS:
OWNEB BUIL�EB OECIABATION: I hereby a�hrm ��at I am exempl imm Ihe Conirac�ors' S�aie License Law for �he following reason
�Seclion 703L5 Business anU Pmtessional Code'. My ci�y ol counry which reQuires a permit �o cons�mc[, al�er, impmve, demolis�, or
reoair any stmciure. prior �o i�s issuance, also reQmres Ihe applicanl for such permit ta fiie a signed s�aiemen� �hat he/she is licensetl
pursuaN m �he O�ovisions ol lhe Comraclors' Slate License Law (Chapler 9(commencing wilh Sectian 7000) o� Division 3 0l ��e Business
and Prolessions Cotle) or I�al helshe is exempt thereimm an0 ihe basis �or �he alleged exemplion. Any viola�ion of Section 7031.5 by
any applicanl for a permit sublecis ihe aDPlicant to a civil penally of not more tAan Iive hunOreO Uollars (55001.
I. as owner of ihe proveny or my emDloyees wilh wages as ineir sole compensation, will Ao the work, antl ihe
❑ simcWre is na� intenaetl or otlerea �or sale (Seclion 704a, Business and Pm�essional Coae'. The Conlrac�ors' S�a�e License Law
does noi apply �a an owner ol a propeny who �uiles or impmves ihereon, antl who tloes suc� work himselAhersel� or thmugh
�is or her own employees, provi0ea Ihai such impmvemen�s are nol intendetl or olferetl Ior sale. tl. however the building or
improvemeni is Soltl wi�hin one year oi COmDleiion, Ihe owner will have Ihe burUen o� pwving �e/She tlitl not builtl Or impmve
lor the purpase al sale�.
I, as owner ol Ihe propehy, am exclusively coniracting with licensea conVactors to conslmcl ihe pmiect (Section 7044, Business
❑ antl Prole55ion5 CoOe: T�e COntratb5' Sia�e Litense Law Ooes nol appty t0 an owner oi D�oDertY who �utlds Or imOmveS �here0n
antl who cantracls lor such pmle��s wii� a contraclor�s� license pursuant�o �he Contractors' State license Law�, I am aware
Ihat pmo� o� their Worker's Compensation insuronce shoWd be pmwaetl to me.
� I am e�empt wder Section: B. 8 P. C.
CITY OF COSTA MESA — BUILUING' PERMI'1' F'EkM NO; B 063286
PERMIT NO; B 063286 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRIJCTION TYPE; 5—N AERMIT TYPE: 5TR •' PURPUSE: ALT
JOB DESCRIPTION ; T'/O ROCK REROOF COMP SHINGLcS SQ FT; 2,B33
CLAIM VALUE; 2,II33,00 CALC—VAI,UE; 2,833,00 GROUP OCC; R-3 /M-1
COMMENTS; SMOKE DETECTORS RE�UIRED PER THE 1991 r,AITION �:��,K�`DE��CTOR
iE1E3E�1E3EiE#)F3FiEiEiE�Flti(��763Eif�lfiElEikiElEiEiflEif 1E�FdfiEiEfF3EiFi(-�%�1hiFlE�F�i(�%�ii�?FiElEaf1E3ElE%�i(�-lE i # iE h � 3f'f f�'
Z O N Z�1 GS ERTEB�AUCIKRSE M E N T 5 REQUIRED
------------ ,�iAIN BUILDTNG ---------- -------- ACCESSORY BUILD:C�?G --------
FRNT: FT IN REAR; FT IN FRN1'; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REp• PROV; PARCEL: 13910301 7.NE: REF NO;
PLANNING N(STES,>� f�
� Y
iI' k-Ik )( lf i(' iE i(' 1E'J(' ih 3E'lc'lE IElF if K' i(' if if' lE iF 3E iF iP X� if -1F if ik if if IE iE iE 3f i(� if )f')F iF iE' if'J(�!F if i(' �E if'% it 1F!E!E 3E i( K� 3f iF iE i(' �lE 1F'1F'1(' 1f 3f'!E i't.iE 1E iE it if� 3�' if i(-3E
D E V E'I, O P N E N T S E R V I C E S R E Q U I R E M E N �2� 5
f '
2.ONING APPROVED; FtY 17ATE; °�"`
a"
BUILDING APPROVED HY ; DATE; ..�
APPLICATION ISSUED $Y: � UA7'c: � '2- �
%if7FiEifiElFiFit�EiEiF3FiF3fi3FlEiEiEififlF . . . fe. . .. . . . . . +rx�x �itiE3Fit�#%x�iEiEdEx. i� cx� iFlE
1f if iE IE�7k iE IE if 1E )f if iF if iE if �%� 3F rt 3k # iP iF iF X� iE it x� iE i! iE 1E jE if iE if X-iF �� iE N�-](� %� fE i(� k� 1F if iE 7E �f� 3t if K� ik iE �E 3E !E if iE iF iE aE 1( %• ib fF N� 3f`�it iE iFit � iE if 1F 3F �E
LEGALI7,ATION;N F E E S U M M A R Y S1'RUCTURAL SEGMENT;Y
-t. ' �'
BLDG P�'�iT PLU,`;BING ELECTRIC MECHANIC PIRE�, SMIP/RES GR;� ING
PER,�IT �4,00 ;r '
�- SMIP/NON�RES
PLAN ' � ��� � (,, `
ISSUE FEE �,. ' � ' ,. �
BUILDING—DIV—> PERMIT I5SUE' PLAN—CH$CK TOTAL PAIP �•% .,�DUE
TOTALS----> 54.50 0,00 0.00 59,50 '�� 54.50� .QO
1
REVENUE DIVISION TOTALS--> COLLECTED; 54,50 OVER/SHORT:/\�ii 00
BLDG PNT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOTn GRAI7INCp P,3,AN-4HcOK
S4 . �� . J���, .. i J� !
n !
}t !E ik M� %�]E !E iE iE �lf iF k iE iE ##!f iE if �lE� fE �%1F lE IE � iE !f !F iE if if IF 1E i!')f 3E 1E # it iF?E 9E i( iE M� ftif }E #E %� if iE ?E ik if X� if �7ElF-ik M k-N� if k� fF-%� iE K^ K!E iE iE'�4 iE !F ii-
I N D I V I D[7 A L F E E H R E A K D O W N f(i ��,
rorimsreasan. TYPE QTY D E S C R I P T I q N ONTT COST � I%OTAL CUST
Oaie'. Owner. '^ �
i ao ne�eby cemry mai � am aware o� ane unaersiane ine requiremenis o� Ca�i�ornia Heatlh antl 5a�ety Cotle Sections 25505, 25533, ana S FR 2 R 3 3 REkOOF B Y VALUE RES ID ENT I AL N020NE 1;;0 0� �� � i� � B���,3 . � �
25534 antl Ihal I ar any �uWre building occupent willlwill nol (circle one) neetl to comply with saitl s�ale codes anOlhe requi�emen�s for a END �F FEES ,� R G t d��
permit loi consimction or mo0ilica�ion trom Ihe Nir �uali�y Managemeni Disinct. Pesi�enlial consimction ap0lication5 are eKemp[ �mm ' '� / +—
Ih¢s¢ p�Ovi5i0n5. �% ,� , � F � } ^
• 3•'
�ale: ApplicanC r ,, ,
1 hereby cer�tly Ihat I have reatl I�is applicaiion antl 51aie Ihal �he a�ove in�ormalion is wrrect. I agree to comply wiN all cily antl coun�y t ��� � '
orainancesandLalelawsrela�ingloDwltlingcons�mctionan��ere0yaulharirereDres Ia�ivesa�lhiscirytoen�erupon��eabove�mentianetl n ,r�
pmpeny �or inspection purposes. i �
oT�e. �'ti'�� si9namrc. O1 0�14�995—Q0143996�) T� �T� ��¢,Sl
'� DATE� OEl02/93 TIt1E: 11:45_. �'
�riverS License or Social Securi�y M: � �
16a1-46 Wlute—Building; Green—Cotle EnbrcemenL Canary—Applicanl;IPink—Revenue: Goltlenrod—Assessar
T .
:-.__
CONSTRUCTIOIV ANO P��ANNING ` POOL & SPA ^
APPROVALS Permit #� Date Inspector �PRQVALS Permit # Date lnspector
7. Temporary Electrical Sev�`ye�c� Po�e. .��; ,� � 52. Pooi & Equipment Location
2. Soil Pipe-Undrgrnd. -� (� 53. Stee� Reinforcement
3. Electrical Conduit Utility•Undrgrnd. . 54. Forms �`
4. Electrical Conduit-Undrgrnd. _ 55. Electrical Bondino
5. Steel Reinforcement - 56. Rouqh Plumbing & Pressure Tesi
6. Electrical UFER Grnd. 57. APPRQVftL TO COVER�GUNITE
7. Footings 58. Elecirica� Conduit�Undrgrnd.
8. foundation � _}i'� - 59. Gas Pipe, O Undrgrnd., Test L� .
9. Water Pipe-Undrgmd. � 60. Backwash lines, RTrap, L Undrgrnd. --"- ��
,. �
70. Structural Floor System �� -'r �" 61. APPROVAL TO DECK .
i i. Property Sewe� Line & House Connection ' 62. Backwa5h & Receptor-Final '
12. Sewer Cap � . . 63. Heater & Ven[-Final �
73. Roof Drains � 64. Plumbing Svstem � Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical•Conduit 66. Solar SYstem-Pinal " .
16. Rough Electric Wiring 67. Fencing & Access Appruval �
17. Rough Wiring Sign 68. APPROVED FOR PLAS7ERING
J
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVqLS Permit # � � I
i
21. Dutt:, in Structure 70. Underground Hydro '
I
22. Ducts, �/entilating _ . ., 77. Product Pipin9 �Gas O-Oil �
23. Gas Pipe-Rough & Test • . 72. Underground Flush � �
24. Roof Framing 73. Undergmd.StorageTank uGas ❑Oii
25. Roof Sheathing - �- j'-q3 �' (���7q. Overhead Hydro �
:
26. T�Bar Ceding (Structural) & Monocoat �5. Dry Chemical �
i
27. Frame and Flashing - 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL �
29. Insulation I ; � 76. FIRE PREV. FINAL
30. Drywal� Naiting '" ` � � HEAITH DEPT. REQUIREfV1ENT
i
37. Plaster Brown Coat � � � •79. FINAL INSPECTION
32. Electrical Power MeterFinai � S0. FOOD CERTIFiCAiE ISSUED '
i
33. Finai Electric ' I � Notes:
34. Finai Heating & Air Conditioning � ; �
35. Final Gas Pipe-Tert � � �
36. Hood or Canopy � � -�
37. Pinal Factory Fireplace ! , •
i ' ---
38. Final Pl�mbing j �
39. Water Service-Final I .
40. Gas Service-Finai ; i �
41. Solar pomestioFinal � i
42. Backf�ow Preventryr�� � �
.
43. Backflow Irrigatio�%' !�=la�[7 � _ ��� ���� � �
t) ! �
44. Landscape Irripati��Sy:iem (��v�
45. Sound Attenuatia�t- �
�:.
46. Hardicap Regulatan = � , -----�
47. FiNALSTRUCT4RE8r8UILDING � � � �3 �'��G ��r �
�/? q� 6� �� � ���� � �� �
as. FirvaL PLANNIPIC�'? _�iM _ . � - _-- -
49. ElectricReleasetaE'dis'on- �f_/z�3=��'-9' /� /e % m��
� l rit l-s
50. Gas Release to SoUtH�rn California Gas Co ��/�
qs.
51. CERTIFICATE OF�OCCUPANCY
No. Oate
OtvNER �LION EiVTERPRISLS DATE 1-17-61
JOB ADDRFSS �rmO • 13UILDING PERMIT NO.
AP. No.
INSPECTIONS
TE
VALUE $lUl.uu
ZONE DESCRIPTION OF WORK
OUP TYPE ZOND`�l
SUBCONTRACTOR I _ PERMITSISSUED__
OCCUPANCY �{'��„���/I �`��'lr� �^v I I
Form 210—SM-11-59 S-B P " ,, lg6,rp..
`" �3��0
, ... _ .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFORNIA
For Applicanf io Fill In Completely
TYPE OR PRINT
AODRESS ��� 2- e z o '
COSTA MESA CALIFORNIA
owravwlC�Il�n�l Fh�.-pnPR�JP�'
MAII .? (�00
ADDRE55 V/ R � / O
cin
(�? u� t � T No:
ARCHITEGT TEL.
uJ
■ SIZE I NO. OF BLOG9.
� 96fBACK LINE FROM
DESCRIPTION OF WORK
NO. OF
EXTERIOR WALL ROC
COVERING COv
USE OF BUIL�ING AND WORK TC
U��1 L � ,c u_{"..
r' p- �+ P. �- • ,
i'�L I��e;�-�'��`h�
`�JAN 17 S�ot
fINA�!CE DEPT.
CIiY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
HECEIPT NO. I�- Pgq T O.
� :� � .5
BY DATE FELEI EO OATE ISSUEO
/�— /7— r/J/ � /— / 7,L
COSTA MESA. CALIFORNIA
FIRE
ZOPIING
NO. OF '� / U6E OF NEW
PLAN6 y BIIILOING
LEGAL
YARDS
APPROVED
(ceNrew uNe er.�
II
EVES
I
0
� HEREBY AGKNOWLEOGQ THAT 1 HAVB ReAD THIB APPLICATION }ME AMOUNT SHOWN UNDER VALUATION IB FOR TXE
M!O BTATE THAT THE ABOVE 19 COqRECT AND AORE¢ TO COM- pUPP088 OF HBTAOLIBHING A PEpMiT FEE ONLY.
PLY WITH ALL CIiY ORD�NANCEB AND BTATE lAW6 RE6UUTINO
Bu1LDINo CONBTRUGTIo • - VALVATION ��
PERMATURE OF ���� K�� � 2 Ey �j �� PERMIT FEE .$ a
� $ `/�� PLAN CHECK $ n
AUTHORI ED A �� � �
K
TO7AL FEE �� o
LL
.;� .
:� 12��0
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 8f7 COBTA MEBA. GLIRORNIA
Fo� Applican+ fio Fill In Complefely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
'�,SOri
SIZE
OF LOT � X � � i
U6E OF
EXISTING BLDG
6G.TBACK LIN6 FROM
CEMER OV STREET
SIOE YARD LEFT �
DESCRIF
NEW I X II AI
REPAIR I II Mi
BUILDING
SIZE 1 � SQ �
EXTERIOR WALL
COVERING
USE OF BUILOING AND
NO, OP BLD6B.
0
%S� REAR YARD
� � I RIGHT �i
�ION OF WORK
NO. OF �
FOOMS
TO BE
BUILDING
ADDRESS
FIRE
ZONE
APPROVED
BY
ZONE _
_I� �
IEGAL
��E R�.������
c��- �u� 1 i »so
fiNANG� ��P�':
� ciTv n� �a��A M��A
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
PECEIPT NO. P@RMIT NO.
'y� �7pp-r-�w�&(-1��
BY I DATE qEG81VEO �—DAT 18E 8U£D
COSTA MESA. CALIFORNIA
ZOIdING
NO. OF 6E OF N
PLAN9 BU�LDING
uHe er.�
APPROVED
EVES
1 HEP¢BY ACKNOWLEDGE'MAT 1 XAV6 ReAD THIB APPLIWTION THE RMOUNT BHOWN UNDER VALUATIDN �B FOR TXE
AND BTATE.THAT THE AB�VE 19 CORPECT ANO AGREE TO COM-
PURPOBE OF, EBTABLIBHING A PERMIT FEE ONLY.
PLY WITM ALL CIN OpDiNANCE9 AN� BTAT¢ I.�W9 RBOULATIN6
emimxG coNeTRurnoN� ,�, VALUATION
81GNATURE OF -
� PERMIT FEE $ 3S•
PERMI7TE
$15, 045 • PLAN CHECK $ 1� �50
AUTHORIZED AGENT �.ke & C egrove� InC. _ �,� ��
c: