HomeMy WebLinkAbout3421 TIMBER LAKE - Building PermitsPNOJEC7 ADOflE55: 3 q z S T IMB ER LAKE
OWNEH'SNAME: VILLAGE CREEK� HOMEOWNERS
nooxEss: ASSOCIATION
3929 TIMHER LAKE
CM VA 92626
UNIT:
C
AFCHIENCINEEfl: CHESTER CARVILLE NEG.NO.:CS$�OS
aoonEss: 7922 ARMOUR ST N'
PEHMITTEE:'$,D. CA 92111�
aouaess: FHOENTX ENTERPRISES INC. (.213 ) 690-9559
411 COMERCIAL WAY
LA HABRA CA 90631
IICENSEO CONTPACTOB OECLABATION: I �ere�y affirm Ihat I am licensetl un� isio s o1 Chapter 9(com � cing wit� Section
7000) o� Division 3 0� Ihe Buslness anU Prolessions Code. and my license i5 � ul om d eflec�.
c�,vuc.: �Q s ,euc.:376639 /
Da�e: "� � � Signa�ure: _ _ _ _ _ /4 _ _
WOBREHS' COMPENSPTION OECLl�FA710N: I �ereby affirm ihat ave a cenificate o consent to seli�insure or a certilic f Workers'
Compensation Insurance or a cer�ifietl copy Ihereoi (Seclion 3800, Lab C�. ,
'OLICY NO.: W% O O 3 S Q E%P. OpTE: O% � � 1
comraer: CA COMP 6 FIRE
� Cenifie copy is here6y furnish ❑ Certified copy is filetl wi Bui ' g vision. -
s �
Oate: ApDlicani:
E%EMPTION FBOM WOPKENS' COMPENSRTION �ECLPHATION: Q�is seciian neM nol be campleleA if the permit is fo� ane AuMreO �S ess�.
I ce�ily I�a� in ihe petlarmance of �he work for which Ihis permii is i55ue0. I shall no� employ any person in any manner so a become
I sublect Io Ihe VJorkers Compensalion Laws ol California.
� Oa�e: - � - Signalure'.
NOTICE: II, af�er making this tleclara�ion. you should become suDlect to IAe WOBerS' Compensa�ion pwvisions oi Ihe Labor
CoOe. you must fonhwi�h comply wit� such pmvisions or ihis permit shall be deemea revoked. .
CONSTFUCTION LENOING FGENCY: I hereby attirm tAat ��ere is a cons�mc�ion lending agency for ihe pedormance o� �he work �or
which thls oermit Is issued (Section 3097. Civ. GI.
LENOEP:
FODNE55: - �
oWNEB BUILOEP OECIAHRTION: I nereby allirm ihat I am exempt imm the ConVactors' State License Law for ihe following reason
(SeClion 7031.5 Bu5ine55 and Pmfessional Cotle: Any tity of t0unly whith requires a permit �o constmc�, al�er, impmve, Aemoli5h, or .
re0air any 51mcWre. prior Io i�s issuance, a150 requires the applican� tor such permii Io file a signed�s�alemenl thal he/she is 6cen5e0
pur5uani lothe provisions of�he Contractors' Stale License Law(Chapter 9(cammencing wi�h Section 7000�of0ivision 3 o�ihe Business
antl Pm�essions Cotle) or Iha� �e/she is exempl ��ere�mm and Ihe basi5 lOr Ihe allege0 exemp�ion. Nny viola�ion of SeCiion 7031.5 by
any applicant for a permi� sublects the applican� Io a civil penalry at nol more �han five Auntlred tlollars ($500).
I, �as owner af the pmpetly or. my employees wi�� wages as their sole compensa�ion, will do Ihe work, and �he
7 simclure is not inientlee or o��ered for sale (Sec�ion 7044, Business antl Prolessional Code:. The ConVaclors' Slaie License Law
does not apply to an owner of a property who huilds or improves ihereon, antl who tloes such woB himselflherself or ihmugh
nis or her own employees. pwvitlee Inat sucn �mpmvemenis are not intenOeU or offere0 for sale. I( nowever ihe �uiltling or
impmvemeni is sold within one year of completion, �he owner will have �he EurOen ol pmving he/she ditl no� builtl ar improve
lar ih¢ Durpose o� sale�. �
I,as ownerolthe propetly,am exclusively contrac�ing wi�hlicensed conlraciorsto cons�mc�lhe prole��l,Section 7044, Business
❑ antl Pmlessions COAe: The Conlraclors' State License Law does no� apply �o an owner of pmperty who bmltls or impmves �hereon
antl who conlrac�s for suc� prole��s with a contrac�or(5) I¢ense pursuan� to Ihe ConVac�ors' Sia�e License Law). I am aware
Ihat proo� oi I�eir Worker'S Compensa�ion insurance shoultl �e provided �o me.
� I am e�empl untler Section'. B. 8 P. C. '
lor this reason'. � ,
�a�e: � Owner
I tlo �ere�y cenily Iha� I am aware of and understantl the requirements o� Calitomia Health antl Sa�ery CoOe Sec�ions 25505. 25533, and
2553A anA Ihal I ar any WNre building occupanl willfwill noi (circle one) neetl �o comply wiih said state cotles antl ��e reQuiremen�s �or a
Oermi� for constmction or modifica�ion imm Ihe Air Oualiry Managemen� OisVicl. Fesitleniial constmction apDlica�ions are exempt Irom
Ihese pmvisions.
�aie: Applicam�. _
I hereby cerlitythat I have reatl�his appliwlion antl slate ihzi the
ortlinances and sla�elawsrelatinglo �uiltling conslmction ane herel
pwperly I mspection purpose
Da�e: � SignaWre'. �
Oriver's License or Social Searily x:
I agreeJo ply wi�� all ci�y anA
Ihisci nt upon�heabove-me
t64L46 Whne—Builamg-, Green—CoEe Enlor<emenL Canarv—Appllcanl; Pink—Revenue: Goldenro�—Assessor
_ CITY OF COSTA MESA — BUILDING PERMIT FERM NO: B p50539
PERMIT NO: B 050534 PLAN CHECK NO: 00154-91 A GOVT: N SUPP: N
CONSTRUCTIUN TYPE: V-N PERMIT TYPE: STR PURFUSE: REP
JOB DESCRIPTION : REPAIR SETTLEMEN.T DAMAGE ., � SQ FT; 193
_ �. .. .
CLAIM VALUE: 14,300.00 CALC—VAL[JE: 14,300,00 GROUP OCC: R-3 /•
COMMENTS: HUILDING SETTLEMENT REPAZR/FOUNDATION "
;�*��*�r**�********�rx*��r�*�*****x**�r********�r*��tx**�*���c�**�+�*�*************�****
Z O N I N G R E Q U I R E M E N T 5
' S E T B A C K S -
------------ MAIN BUILDIIJG ---------- ---------- ACCESSORY BUILDING --�------
FRNT: FT IN REAR; FT �IN FRNT; � FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
FARKING REO• PROV: PARCEL: 93506124 ZNE; R2 REF NO;
�ANNING Nf3TES> FOUNDATION REPAIR, _
>
3f ik iF k fk aE �iF 1E �1E if iE3E if if 3E k iE iE iF ik if if iF iF 3F if �1f dF iF 1E iE iF 3E iE fF 3E iE iE if 3E iF iE 3E �E iE �1E iE iF if iE �E )E �E 1F 14 iE 1F iE if 3E IE iE 3E iE iE iE iF iE iF 3f iE 3E� If If iE 1k iF if �f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � �� � DATE; p1 I.l `1 I
HUILDING APPROVED �HY' : l.-� I� 17,��� DATE: �
APPLICATION ISSUED B . DATE:
iE if iF if ih iF if 9F iF �k if jE 3F 3F 3E fE iF iE �f if F3F4 £1E IE 1E IE aF 3E?43E if iE�'�F'�j�iE iE
fF3EiEihiEiEiE�IFiE�7F�lE�1F3F1FiF3fifif7E-0flfiElF�Eififlf�lElF�lEiF1E�1f�lEi(��lE�lfiFifi EiFifiEif�lf#IEIFif�7fifiEif�*ifff�lfiFif3EfF�1F3f�E1E�E3Ei61EifiEiEiF3E3FiF1EiF
LEGALIZATION:N F E E S M M A R Y�' STRUCTURAL' SEGMENT;Y
BLDG PMT PLUMHING ELECT IC MECHANIC FIRE SMIP/RES GRADING
PERMIT 162.00 ' 1,00
' SMIP/NON—RES
PLAN 26..33 '
ISSUE FEE �
HUILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS---->.; 163.00 0:00 26.33 189.33 189.33 .00
REVENUE DIVISION TOTALS--> COLLECTED: 189,33 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
162.00 . ' 1.00 26.33
-lE # iF�IE #!E iE 3ElE if lf 3F iF iE iE iE iE �f iF �E �IE IE 1E iF �1E� iF 3F 3E �E �If IE �F iF if �)f lElElE 3E if if �f iF iE 3F 1E �lE 3E if iE iF 3F 1E 3E If iF iE iE 1E if iE iF iF �1F iE if 3E iE iE ab �1f� if IE�7F iE iE iF 3F if
I N D I V I�D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N � UNIT COST TOTAL COST
SFR 143 STRUCTURAL BY VALUE PER 5100,00 100.00 19,300,00
END,OF FEES .
ax oaoxGsaz_r�a����� �b��'
, c�rE: �va.3,%�� 'r�n�: i;�. zt+
' �
CONSTRUCTION AND PLANNING � �& SPA � � '
Date Inspector Date Inspector
APPROVALS Perm�t # ^ j. . APPROVALS Permit #
� .e
1. Temporary Electrical Service or Pole. '% � - 52. Pool & Equipment Location �
i
2. Soil Pipe-Undrgrnd. �� ' �� ' 53. Steel Reinfo�cement �-
' -3.'Electrical Conduit�Ui��ity-Undrgrnd.''. 54. Forms 1
- 4S.Electiical Conduit-UndrgrnB? ;., ;:� 55. Electrical Bonding �
5.;Steel Reinforcement - � 56. Rough Plumbing & Pressure Test ''�
6. ;Electrical.UFER Gmd. � .. 57. APPROVAL TO COVER�GUNITE
7. Footings ` , � 58. Electrical Conduit-Undrgrnd.
�8. Foundation � • � - � 59. Gas Pipe, O Undrgmd., Test �'� �
9. Water Pipe-Undrgrnd. , R� .�`�, 60. Backwash Lines, P-Trap, 0 Undrgrnd. �'�_,�
10�. Structural Flooi SysCem :,'�f� ;�� �� 67. APPROVAL TO DECK i" � �,
11. Property Sewer Line &�Hou� 1Connestion_ �„ 62. Backwash & Receptor-Final '' � �
12: Sewer Cap _ _ �� j� %� f ' 63. Heater & Vent-Final `7
73. Roof Drains � �- ��� � 64. Plumbing SYstem - Final „i�'
14. Rou h Plumbin � �
g g � iy� � 65. Electrical-Final � /f �
15. Rough Electriwl�Conduii '� ' /, 66. Solar SYstem-Final �_
4
76. Rou9h Electric'Wiring:'� jr' , �" �`1.�; 67. Fencing & Access ApProval ��✓
17. Rough Wiring Sign ��� �j � t 68, APPROVED FOR PLASTERING �
18. Rough Electrical-T Bar�Ceiling v� 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ��
20. Rough FSctory F�eplace . . �, � ti > �APPROVALS .���Permit # ,�
21. �Ducts, in_Structure , �.. �' � � �, - < • 7Q, Underground.Hydro �-
22. Ducts, Ventilating_'* +%; '- ' 71. Product,Piping O�Gas O�OiI
23.'Gas Pipe-Rough &'T,ast '�" ' . - � �'� v :
, , .�_ �� '72. Underground Flush- ,
24. Roof Framing � � � - _ - >�73.=UndergrndiStorageTank OGas ❑Oil �
� ; �.
25. Roof,Sheathing ' ' '. ' ' '� v �74.'Overhead HYdro � 'f` .�
26. T-Bar Ceiling (Structurall & Monocoat ! � � �� ' � 75.-Ory Chemical •
27. Frame and Flashing, '- - ' . . 76. Dry Stand'pipe ' = ;, �
28. Lathing & Siding . �- .� � �•�, = 77.. FIXED SYSTEM;FINAL�'
29. Insulation ' . �� � . . ' _ � I f, ,; 78.:FIRE PREV. FINA�L � �
30. Drywall.Nailing � ` � � .-i " j � HEALTH DEPT`REQUIREIVIENT
31. Plaster Brown Coat; . _ ' � I �� ,.79. FINAL INSPECTION '
32..Electrical�Power Meter;Final ' . ,. ; � . �80. �FOOD CERTIFICATE ISSUED .
33. � inal Electric; `"' . ' . ' I '; , � Notes: - � ' " • '
�34. �Final Heating & Air Conditioning � �� � �{ ' ` , ' , '
I I. /
35. Final Gas�Pipe-Tes't` - ' ' � � ' � � `; : .� _ �-�
.- ��... . . .
36. Hood or'Canopy _ � . . .,
37. �Final�Factory Fireplace � ' � � i ! (' �
38. Final.Plumbing ' ( � ..,
"39. Water Service-Final • • ' ( � • - ' �
I ��
40. Gas Service-Final � . . I I � - - .
t�
�41. Solar pomestic-Final � k � .
42.`Backflow Preventer� " .. _ � � 1� , _�j � . � ' ..
.43. Backflow Irrigation- � � ,; ' � = -
i -
44. Landscape I�ripation System,. " _ , - - . - � . ' �_
'45. Sound Attenuation ' � • ' ' � ' - - x� '. �
46. Handicap Regulations ,' . ' _� ' - .
47. FINAL STRUCTURE & BUILD(NG ��� �J/ . - . �
48.-FINAL PLANNING� � - i �' . ', - "
. 49. �Elec[ric Release to Edison . i i•:
„
�50.,Gas Release to Southern Califomia Gas Co �. � � I �; .- `> ,` .
51. CERTIFICATE OF OCCUPANCY ; : - , _ . . , ,
No. Date
October 24, 1994
CITY OF COSTA MESA
CALIFORNIA 92628-1200 P.O. BOX 1200
DEVELOPMENT SERVICES DEPAfirMENT
Dear Costa Mesa Property Owner:
In reviewing past permits, we find that work has been done on your
property located at 3421 Timber Lake, Permit No. B63398, for a
roofing permit. The permit is valid for 180 days from issuance or
your last inspection, per Section 303 (d) of the 1991 Uniform
Building Code. Should we not hear from you within 10 days, your
permit will expire as stated herein and additional fees will be
required to finalize the permit. Failure to final a Building
Permit cauld possibly impact the future sale of your property.
To activate the above permit, please follow these steps:
1. Telephone (714) 754-5626 or 754-5627.
2. Request an inspection; state address, permit number, and type
of inspection.
3. Be sure to have working smoke detector's as required per
Section 1210(a) of the 1991 Uniform Building Code.
4. Have an adult present at the property at the time of
inspection to provide us access.
Should you have any questions regarding this process, please
contact 1ne at (714) 754-5273.
Thank you for your cooperation.
Sincerely,
���Vl� � �
o anda Huapaya
e it Processing Speci list
77 FAIR DRIVE
Builtling Division p14) 754-5273 • Code Emorcement (71d) 754-5623 • Planning Division (714) 754�5245
Fq% p74) 556�7508 • TDD (714) 754-5244
�fl0.1ECTR0�HE5S: 3425 TIMBER LAKE
� OWNEfl'SNpME: VILLAGE CREEK H.O,A,
aooaess: 3929 TIMBER LAKE
COSTA MESA, CA 92626
, (� RflCMIENGINEEB: S S 3— S B 7 6
aoonEss:
flEG.NO.:
UNIT:
uxiT:
PE"minEE: PETERSON ROOFING ( 714 ) 979-7111
aooRess: 3006 ENTERPRISE
C�OSTA MESA CA.92�i�8
UCENSED CONTPRCTO �ECLABATION: I hereby a��irm Iha� I am Iicense0 unaer pmvisions o C apler 9 �commencing wil� Sec�ion
' 70W) of DiNsion 3 of I�e Business and Pmlessions CoOe. and my license is in full torce anG enec�.
CITY LIC.: c STRTE LIC.: CIASS:
4�445 607872
� Dale: � -� �? Signamre: �
WOBKEflS' COMPENSATION DECLAPATION: I Aereby aflirm thaU havi cenificate of consent to sell-insure or a cetlificate af Workers'
Compensalian Insurance. or a cerUfieO copy Ihereoi (Seclion 3800, laD. C�.
PoucvNo.:1021355-93 exv.oaTe: p4/01/94
coMraxr: STATE FUNP
❑ Cenitie� copy is hereby tumishetl. 4 Cetlified copY is Iiietl with the ciry Building Oivision.
�a�e: Zf � � � � 3 ppplicant: ��.c.sy��
E%EMPTIONFBOMWOBKEP$'COMPENSRTIONOECIAMTION: (T�i55 onneetlnotbecompleteUil�hepermitistaronehuntlretl�$10D�orless).
I ce�ity tha� m ihe pedormance ol the work br which ��is permi� is issuetl, I shall nol emplay any pe�son in any manner so as to become
suble�� �o t�e Workers' Com0en5alion Laws ol Califomia.
Dale: SignaNre:
NO710E: If, aller making this OeclaraUon, you shoultl become sublect to tAe Workers' Compensation provisions of ihe labor
fAtle. you must fonnwith comply witn such pmvisions or ihis permit shall Ue Oeemetl revoketl.
CON5T8UCTION LENDING AGENLY: i hereby aflirm t�at Ihere is a constmction lentling agency for ihe pedormance ol tAe woAe for
wAich �his oermit is issue0 (Seaion 3097, Civ. C).
LENOEfl:
FODPESS:
CITY UF COSYA HESA —:Uie.�iNG PEAMIT
PERMIT NO: H 063398 PLAN CIiECK NO: N
CONSTRUCTION TYPE: V—N PERM=T TYPE: STR
JOB DESCRIPTION ; T/OFF SHEATH REROOF W/COMP SHiNGLES
CLAIM VALUE: 4,b00.00 CALC—VALUE: 4,600,00
#�*M�*****����*�*�****��R*i�**�%****+Mr�*******D��****w�t****
Z O N I N GS ERTE Q U I R E M E N T
PERM NO: B 063348
GOVT; N SUPP: i�1
PURPOSE: ALT
SQ FT: 4,600
GROUP OCC: R-1 /
5 6 3427 TiMBER LA
��'������'('���R
sAcxs R�(
------------ ,��iEIIN HUILDING ---------- --------- ACCESSORY BU ,���IRED___ .._,�
YL�TI'4�-----
FRN2: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
P RKING REp: PROV: PARCEL: 93506042 ZNE: REF NO:
PL NING N6TES,;>�•
� '
if1F##' iEiEiE3ciEiEiE?F.Y�ixdE?f{E�siEiEY�iE�EiF%aE3fiE3FiEaflEiEiEiEiEltiflEiE34jfiEiFiE�lEjEiE� #tiFiFlElPiEif�ElElfiEiEif3EiE#!PlFiEiEiFiEif�E�EiEi4
D E V EiL O P M E N T S E R V I C E S R=E� Q U I R E M E N T S
ZONING
BUILDING
APPLICATIO�
?4i�iFic?4ic?ciciFiEi4 "iF
#f iF 3E #F iF # i# iE � iFlE iE
Lr�GALIZAiION:
OWNEfl BUILOEfl DECLAflRTION: I herehy at�irm �hat I am e�emp� imm Ihe ConVactors' S�ate License Law �or (he �ollowine reason B��
�Sec�ion 7031.5 Business and Pmlessional Code: Any city ot couniy which requires a permii lo con5�mci, alter, improve, tlemolish, or p ERM I T
repair any simc�ure, prior ta i�s issuance. al5o reQuires Ihe apDlicani lor suc� Dermit �o �ile a signed slalemeni Ihai �e/she i5 licensed
pursuant lo Ihe provisions of Ne Contraclors' State License Law (Chapter 9(commencing wiih Section 7000) oi Oivision 3 of IAe Business
antl Prolessions Code) or �ha� hels�e is eKemp� �herefmm ana �he basis for �he allegea exemption Nny violation oi Sec�ian 7031.5 by pLAN
any applicani br a permit sublec�s the apDlicani �o a civil penalty o� nol more tAan five hunEred dollars �5500). T SS UE F EE
i, as owner oi me pmpeny or my empioyees wim wages as meir soie compensation, will ao me work, ana ine BUZLDING—DIV—>
❑ s�mcWre is not inlen0e0 or offere0 far sale (Sec�ion 704a, Business antl Pmiessional Cade: The Caniracrors' State License Law 'j'O'1 AL.�i --- —>
Ooes no� apply to an owner o� a D�openy who builUs or impmves �hereon, antl who aoes such work himseltlhersel� or Ihmugh
his or her own employees, pmvideA Ihat such impmvemems are not inlendetl or ofleretl �ar sale. I�, however the building or
. _
BY '%: DATE:
7 $Y : y LIATE: ]�
ED BY: i DATE: �� L J
fE?E iE 3F iE 3FTFY3EiF �lF3F �3F a'F3F iFlFiFiF3FiFiF3t-3FiFiF�i-3F ��lE"ftif iF{F,�r3F {rIF�E ff IF iE it iE iF ic� iF 1E r ir r i i r� it iE
3E #E iE 1E iE iF iE iE i4±E iFlFlE iF iE 1F iF fE if iE �E iE iE # iE�IE 3E �ff ?E�lt iEi41F 3ElE if iF?E jE'7f iE 1E ih iE !E iE i! iE if itlE iE 3E iF df il�lF iF iE if iE iE #
F E E S U M M A R Y � STRi1CTUAAL SEGMENT:Y
"�;
�rNpT ?LUMBING ELECTRSC MECHANIC � FIRE SMIP/RES GRADSNG
\� SMIP/NON—RES
PER.ZT ISSUE PLAN—CHECK iOTAL PAZD DUE
72. 0 0.00 0.00 72.50 72.50 .00
impmvemeni is soltl wiihin one year o� completion, Ihe owner will have ��e burUen o� proving he/she ditl not huild or impmve �EVENUE D I V I S ION TOTALS� —> COLL ECTED • 7 2. 50 OVER / SHORT : 0 0
mrieevurposeo�sa�e�. BLDG PMT PLUMBING �LECTR"1C MECFIANIC FIRE SM1P/TOT GRADING PLF1N—CHECR
I, as owner ol ihe pmpetly, am excWsively conVacling with licensea contractors �o cons�mct ihe pmlec� (Sec�ion 709d, Bu5ine55 7 2, 0 0 "� , 50
❑ anU Professions Code: The Coniractors' Stale License Law aoes not aoPly m an owner oi pmperty who bmlds or impmves ihereon `�
andwhocomrac�s�orsuchproleclswithacoNraclor�s�license0ursuant�o��eConlraclors'S�a�eLicenseLaw�.lamaware *�**************�************************�*�********************.*#*******�,*****
Iha� pmo� ol Iheir Worker's Compensatian insurance should be'pmviUeO �o me.
� I am exem0� untler Sec�ion: B. 8 P. C. I N D i V I D��U A L F E E B R E A K D O W N
lOr Ihis reason: �
Oa�e: Ownec
I ao here�y ceeity iha� I am aware of and untlerstantl ��e requiremems of Cali�omia Heallh antl Safeiy CaAe Sec�ions 25505, 25533, an0
25534 ana I�at I or any �Nure huilAing occupanl willlwill noi (circle one) nee0 �o compty wi�h saitl s�ate cotles and Ihe requiremen�s �or a
permi� �or consimclion or modilica�ion �mm Ihe Air �uality Management DisUic�. Fesitlen�ial cons�ruc�ion applications aie exemp� from
ihese omvisions. ,
Dale'. qpplicant: �'i�
I hereby cetlify�hat I have read I�is appbcation and stale I�al �he a0ove in�orma�ionis correcL I agree�o compty wi�h all ci�y and coun�y
ortlinance5 antl s�atelawsrelalinglo building cons�mction antl �ereby aulhonzereDreSenlaiive5 o�this cilylo enter upon��e above-men�ionea
pmpeny lor inspection purposes.
Daie: V �'% � �� Signa�ure�U_��_+
Canarv—AoolmanL Pink—Revenue�. Goltlenmtl—Assas or
rYPE Q�Y D E S C R I P T IyO; N UNIT COST TOTAL C05T
SFR 4600 REROOF BY VALUE RESIDENTIAL N020NE 1.00 4,600,00
E x'' � �: ;'% END OF FEES •
' ��Op�@LC 7f. �x..,,l:�l(f.
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NSTRUCTION AND PL�ANNING POOL & SPA � � ��
- Date Inspector - �Date Inspector
APPROVALS Permit # . . APPROVALS Permit # ,
�1. TemporarY Electricai Service or Pole � - 52. Pool & Equipmen[ Locdtion
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. Electrital UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7., Footings ' 58. Electrical Conduit-Undrgrnd.
8. Foundati0n " 59. Gas Pipe, � Undrgrnd., Tesi
9. Water Pipe•Undrgrnd. ' . . 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connectio� . 62.- 8ackwash & AeceptorFinal �
72. SewerCap , , - _ 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. Pencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough H¢ating & Air Conditioning - fIRE-DEPT, REQUIREMENT
20. Rough Factory Firepiace ' ' APPROVALS � ;Permit # , �
21. Dutts, in Structure .. . � 70. Underground Hydro
22. DuMs,Ventilating - ' 71, Produc['Pipin9�G,as �Oil
23. Gas Pipe-Pough & Test , . � � � , 72. Underground�Flush , •� �
24. Roof Framing � • ' � � 73. Undergrnd.Storage'Tank OGas ❑Oii _.. Y
25. Roof Sheathing � q..l �Q,t.t/�i 74. Overhead 1-lydro .:_ 1
.�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -'
27.,Frameand Flashing � . . � 76. DryStandpipe � �f'
28. Lathing & Siding -� � ' �' •', 77.' FIXED SYSTEM FINAL �1�`
29. Ins�lat(on '. . �. 78. FIPE PREV. FINAI �
i
30. Drywall Nailing ' � � � HEALTH DEPT. REQUIREMENT , .
� 37. Plaster Brown Coat j � 79.' FINAL INSPECTION � ��'
i -
32. Electrical Power Meter-Finai � � 80. POOD CERTIFICATE ISSUED •
33. P.inal EleCtric� ' , � ' � � � � ' . ,
i Notes:
34. Final Heating & Air Conditioning ' ' ' � � �
i i
35. �Final Gas Pipe-Test � '• ' ' � - . . '
�
36. Hood or�Canopy ' • i 1 � �
�
37. Final Factory fireplace ' �
� ,
38. Final Plumbing E�'� � ' �
39. Water Service�Final ��� . � � 1 � • '
jr��ti
40. Gas Service-Pinal �
41. Solai Domestic-Final �f i
42. Backflow Preventer ' ; � �
43. Backflow Irrigation . � � ,; •
44. Landscape �rrigation SYstem , � . •
45. Sound Attenuation � � ' , � .
46. Handicap Regulations' •
d7. FiNAL STRUCTURE & BUILDING ' i� ' ^
48. FINALP�ANNING „ - • � ' � � -
49. Electric Release to Edison � � �
50. Gas Release to Southern California Gas Co � �� •
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER STATE-W'_f�F DevelopQrs, Znc. DATE 4-28-76
JOB ADDRESS q1t21. Tiinhnr T.akn BUILDING PERMIT N0. 41770
AP No.i40-0.'
INSPECTIONS
SOIL
GAS
WATER
ROUGH PlUM91NG
PROP. SWR. LINE
SPRINNLING SVSI
MISCELLANEOUS
ROUGH HEATING <
M
p AIR CONOITIONING
:E OR POLE
UNOERGROUND �� POWER I�
ROUGH wIRING
TRENCHES � FORM
FLOOR SYSTEM
BON� BEAM � ST
SHEAiHING
FRAME AND FLASHING
LATHING - IN
PlASTER. 6ROWN COA
ELECTRIC, FINAL
BUIl01NG, FINAL
J STEEL REINF.
REINFORCE r I
�.EFRIG. AND A.C., FIN4L
ANO GAS TEST (� � �
FIRE ZONE
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicani to Fip in CompJetely
BUILDING
AooRess�a�qTimber Lake
OWNER State-Wide Developers, Inc.
MAIL _"_. „ . �. ..
CITV
BRANCH
ADDflESS
ARCHITEI
oio.`' 826-4550
ADORESS17848 SkvPark Blvd Irvine
con,TRncTORState-Wide Developers. In
ADDRESS(.�Qf'j� Cjt"�n(��a1�
TEL.
c�T� CvPress No.826-
uc Tivo. 224710 �ic�No.
SIZE NO.OF BLDGS.
OF LOT � 2, 093 acres NOW ON LOT
USE OF
EXISTING BLDG.
SIZE OF NO. OF
NEW BIDG. ROOMS STORIE'
C VE R�INGA`L�ib��ter COV�ERING Shake
USE OF BUILDING AND WORK TO BE PERFORMED
ums
I �ereby acknowletlge that I have raatl this application and stete
that the above into�maHon is correct antl agree xo comply with
all laws regulating builtling construction, and I shell not amploy
any persoo in violetlan of the warkman'a compenmtia� laws af
the State ot Calitornia.
I hereby certity thaT I am proparly licensetl es a cOntractor untler
Me State of Calitornla eusiness antl Professions Cotle, Dlvisicn 3,
Chepter 9, antl thet such licenses ara In tull force entl affect, or I
em ezampt trom the provisions of ffie S2ata of Cafifor ia Businen
antl Prolessions Cotla, Division 3, Chapter 9.
SIB^atureaState-Wide Develope s, c.
Permittee
AuthorizedABent Vice President
ra*o
�#i�Y 13-ib�.;�.�Q 694� �*�214_67
APPLICATION FOR BUILDING PERMIT
RECEIVED BV DATE RECEIVED D TE ISS ED
. —
/2-2//-O/�oZ �PEP I N
A.P. NO. O —OS�%-O I � ��,i
ADDRE S ��JZ� �OO[ Lf✓/CL,
TRACT p g�� LOT BLOCK.
W AD� P
X
OWNER (i(/�
VALUE �
S $
FIRE
ZONE TVPE GROUP
APPROVED
ZONE
MAIN BUILDII
FROM Ul STj1EE
DISTANCE BET
EIOLD FOR
THEAMOUNTS
THE PUFPOSE OF
VALUATION
33,Soo'0
S.� � '!��
2
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0
VALUATION IS FOR '
A PERMIT FEE ONLY: �
¢
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