HomeMy WebLinkAbout2780 WAXWING CT - Building Permits PROJECT ADDRESS: 2780 WAXWING CI UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 068991
OWNER'S NAME: SHEF, RONALD D
ADDRESS: 2780 WAXWING CIR PERMIT NO; B 068991 PLAN CHECK NO: 03585-94 S GOVT; N SUPP: N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT
( 714 ) 754-0640
ARCM/ENRESS: flEG.NO.:
ADDRESS: UNIT: SQ
JOB DESCRIPTION INSTALL THREE NEW SKYLIGHTS ( ICBO#4063) FT: 1 , 200
CLAIM VALUE; 1 , 200 . 00 CALL-VALUE; 1 , 200 . 00 GROUP OCC: R-3 /
PERMITTEE: HORIZON SKYLIGHTS ( 714 ) 586-7246
ADDRESS: 25162 MADEIRA DR COMMENTS : NO CUT RAFTERS / DOES INCLUDE NEW SHAFTS
LAGUNA ISp92653
653 **********************************************************x*****r****`t„******
LICENSED CONTRACTOR DEhereby thatla •nsed underrovxUsop1er 91commencing with Section ZONING R EQU I R EMENTV \C E LV1Lf fl7000)of Division 3 of the Business and Professions Code,and • li nse is in lull force and effect.
SETBACKS
CITYLIC.: 052177 STATE LIC.: 412084 C e EXP; 05/95 EQ (�
Dale _ C2-3'9' Signature:_ . — MAIN BUILDING ACCESSORY BJ2bEJ`Y!�iJIRE''•T----
ORKERSCOMPENSATIONDECLARATION: I hereby affirm that I hav• ificate of consent to sell insure or a certificate of Workers' FRNT' FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800.y• C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: 0625551-93 EXP.D' '. 09 /01 /95
Comm STATE FUND PARKING REQ: PROV: PARCEL: 13962123 ZNE; REF NO:
❑ Certified
copy is hereby furnished. 13( Certified copy` filed ith the cit : •••• r'lion. PLANNING NOTES>
date / 3 9y Appikant: AI� iFiEifitit**********3eiEil****iEiEfElEiEi¢ifil****itis*it3tiEiEitieitft***********ifltiE3(****** *iFiEifiEiF****i4*
PTION FROM WORKERS'COMPENSATION DECIARATIO '(T or nil be competed R W pant O for one hundred(stop)or less). DEVELOPMENT SERV ICES R E Q U I R E M E N ,1 S
I certify that in the performance of the work for which this permit.:'lied.I shag not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. ZONING APPROVED BY '
Date: Signature: n DATE:
NOTICE:II.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : C/�+e i DATE: �1�3Z
Code.you must forthwith comply with such provisions or tfds permit shag be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:_____ •
/i+ i
DATE; _9/�J 7lyy�
which this permit is issued(Section 3097.Civ.C). **********************. * �• ' . • • yam****.****it* 'it-'r_,,1z3 Fsr
LENDER: ******************************************'.*****�*****************************
ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT;Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 29 , 00
repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed . 5
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON-RES
and Professions Code(or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN 16 . 85
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE
I, as owner of the property or my employees with wapes as their sole compensation, wit do the work, and the BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 29 . 50 0 , 00 18 . 85 48 , 35 48 . 35 . 00
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTAL S--> COLLECTED ; 48 , 35 OVER/SHORT: . 00
forthe purposeofsate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
' I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 29 , 00 . 50 18 . 85
❑ and Professions Code: The Contractors'State License Law does not appty to an owner of property who builds or improves thereon
and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware **.***.N.****.**************** N.***,N,**,N,*********,IF***********************************
that proof of their Worker's Compensation insurance should be provided to me.
I am exempt under Section; B,8 P.C. • IND I V IDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: Owner:
I do hereby certify that l am aware of and understand the requirements 01 California Health and Safety Code Sections 25505,25533,and SFR 1200 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 200 . 00
25534 and that I or any future building occupant willwit not(circle one)need to comply with said state codes and the requirements for a END OF FEES
permit or construction or modification from the Air Duality Management District.Residential construction applications are exempt from
these provisions.
Date: Applicant:
I hereby certify that I have read this application and state that I a•die information' correct.I agree to comply with all city and county
ordinances and state laws relating tobuilding construction and by e• .uthorize i( •• atives of dty to enter upon the above-mentioned
properly for inspection purposes. ' 01 00168312-00168314. TOT 43.35
Date; fc4)'3' eeril1. Signature: DATE: 09/26/94 TIKE: 15:51
Giver's License or Social y N: /
1641.46 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
CONSTRUCTION AND PLANNING POOL 'A
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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, 0 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 Connectiorf 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 t7"z?_gC( ac..* 76. Dry Standpipe
28. Lathing & Siding t 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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 (aq ,f�cy 64
48. FINAL PLANNING CC
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Date
HORIZON SKYLIGHTS
/• � * LAGU51 25162
MADEIRA
ILLS, CA 92653 o�,�x S (.ti/ /TSS Qt,7t 77- /�el".
�r�UL 714586-7248SKYL/TFSYS;��5l /G' 1�: r'. . 'r `
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X 6t� �A`iG'/t4fl?y' o SG . G,.. sed .
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DIVISION OF BW-,D ' G SAFETY ✓,' ,
CITY OF COSTA dESA
APPROVEi►Ttos
MUST • kept on this Its, at ail times :WOKEDETECTOR ����fif
and set of plans andmake
specificationses or abr ration on same vtthout written 1. K —
and K fs ping t to make arty specs ate City of C 1 REQUIRED{t R E
perm)ssron from the Division of Building and`ably. �..f t 3{fl ���j �, f
The stamping of this otan and specifications el any
'.2 w0 .e 1 ,Pe • _ /r ��``
m to be an approval of the violation of any J4'.P •G. U -
Mesa
Thes plans
andlor State law. „- and become I ult and void if (, i
These Plans and permit shoe expire by limb .
I.
„� `Cryo er USC§303 f r�
11
the building or work is not commenced and __ `i_ .,.,ZZ r2 z—c t d, _
td)within 180 days of issuance. — — _ I'
. .. . . ..
C i,L L L /
754-5626 •
- A. SLe a'C/ IVF Jl dr :Id �.G i - _ 754 56"e7 , �Oi✓-�tf� -
IP'e»tr #168:9-9—/� FI>>04c- s - ???d ;........11111ThiA/74/a.
THIS NUMBER MUST ACCOMPANY
HORIZON SKYLIGHTS
25162 MADEIRA a•�x l' .'1%• .14.../r..)- �l'`%/tz <<`"�_
2:744 jC LAGUNA HILLS, GA 92E53 " ��
( ✓Tit/ ^ 714-586-7246
•
4/ 6n FQl LT 72.4 -024/0: 0 '
. V / r 2X
��,rot-
APPROVED
/AL1
DIVISION OF BUILDING SAFETY 4-2, T � �7i7� 1 rfri�L 1 --
CITY OF COSI A MESA j/
APPROVED _„� U
__� 2 oate_t.-ice ,/,, 37 ' 404 -.4,4-e ( ..
W ./ L/N.9�7c, \
This set of plans and make.
any c ans MUST be kept n thi; lob at all trines \—T�
and it is untawtul to make any changes or alteration on sane without written
perms from the Division of Building a rd Safety,City of:ossa Mesa
The stamping of this plan and specifiaatfc ns SHALL NOT 'e held to permit — ti
or to be an approval of the violation of y provisions oft ny City of Costa I nr L s� 4-
(d)within
Ordinance andlor State taw. �,. A fi�
These plans and permit shall exp,re by lir dation and hecor�e null and void p ' ___ _- ���
the building or work s not commenced ai U m?" • ^ '"" ""'9 j'�— I
--
(d)within 786 days al issuance
(� SMOKE DETEgaci, ��; ; j
� �... .. ... ---r REQUIRED
/� (
v {
--"--------...„.<
•
C.) .?�j�'6 SGC/4.//zv 7o/si-
C 1
FOR INSPECTIONS•
ax 6 e c(,- /.✓ -.7-1.41r :� c CALL
754-5626 MMI--- c24/ 1-p�
penult # �6�! f/. 754 5627 11/�f��LC�S - 7�1� GJ /�G✓� ilq Ct,e
• TH{S.NUMBER MUST ACCOMPANY , , /!/J
HORIZON SKYLIGHTS /«; Dem
G/"• ?•
LAGUNA HILLS,E AR 92653•
��` ?�� ''6.0,i/L.7,-c•—r.
� � / r 61(i et
•A drill-WO 4¢ " 714-586-7246
I-41 -5/4k2.47---,&-- SYS, 7S ,z/��• 1-� 7
X 6n�,�fGrc�/W ozy�,o E' SG • gU rL Vas.
r-z1 / 4
1.—. l��,r,c- / .
G SAFETY e f L77�L ��95/fJ/T� ��' 1/ �//
DIVISION OF PRILDIN.. 1�y,
CITY OF COSTA IAESA L .t MLS ( ._
APPROVE) 3/14 37 " --Ce""P j
Date 414 ✓� \ • . 7ty/i/l eiti t�
SM E DETECTOftfi' �`� \T.
ltbli est m plans and specifications MUSH) kept on this lot at ail limes / REQUIRED
ydp}etadavrtulw make any
changes or d l atety.Ci same osa Mesa nen
fa psion horn the Divisionlad Building and,atery,City �,�
,�damping 0l this plan and Specifications ?HALL NOT be t ald to permit
•
.,.astons of any )ty of Costa ----1
._ � ��
!nobs 8n approval of the violation of any ----1-,� -
v macule and,or State law. • I --- -
Mesa ^ ' '
These plans and permit shall expire by limit rd h^come'1141.
the building or work is not commecceo anu. ,r, •+e^ /,ive /et USC§303 .-I
td3wdhn180days otissuance. / �' •
,2zz -C--Z1,_
• N T •I
•
1}��a66P •
. 21- n —
7
\ -_ '-- -,�F0� INSPECTIONS Le- ` l'i2_0
„SAID KY �1f� �D�f771��f12- /��T�
or /UAn9n L47 _
1
Permit #= 9/ 7sa-sb27 40p415 _ ait° GuffCGuJJAG t,g
THIS NUMBER MUST ACCOMPANY
-. ..... ocnn:'CTR
PRO.-11T ADDRESS: 2780 WAXWING CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06902C
DwIER'sxaME: SHEF, RONALD D
• ADDRESS: 2780 WAXWING CIR PERMIT NO; B 069020 PLAN CHECK NO: N GOVT: N SUPP : N
COSTA MESA, CA 92626
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE; ALT
714 ) 754-0640
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT: JOB DESCRIPTION ; T/OFF RESTH & REROOF W/COMP , SHINGLES SQFT: 5, 600
CLAIM VALUE ; 5, 600 , 00 CALL—VALUE; 5, 600. 00 GROUP OCC; R-3 /M-1
PERMITTEE: COASTAL ROOFING ( 714 ) 921-9451
ADDRESS: 5354 E WESTRIDGE COMMENTS ; SMOKE DETECTOR( S) REQUIRED IN HOME,
ANA CA 92407 ****x"**xx•+6+E+tEEx**E6araE***SEx-E6aEarx-E6*s6x-***********,Ex*jr-x***EE+6*aE+r*********ar+Ea6***EE*******
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of uhapter 9(commencing with Section ZONING N I N G R E Q U I R E M E N T S
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect SETBACKS
{CITYCITY LIC.: n54535 STATE LIC.: 5875 . LASS' —39m09
{ q—Z7—Py Signatur - MAIN BUILDING ACCESSORY BUILDING
NORIIEAS'COMPENSATION DECLARATION: herebtInav acenircateofconsenor a certificate of Workers' FRNT: FT I N REAR: FT I N FRNT; FT I N REAR; FT I N
C � pensation insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
POLICYNO.: 1222027-94 EXP.CATE: 09/01 /95
COMPANY: STATE PARKING REQ: PROV: PARCEL; 13962123 ZNE; REF NO: .
❑ Certified copy is hereby furnished. cfr,Certified copy is '-: e city : ilding Divisi. PLANNING NOTES>
2 7 >
PTIDN FROM WORKERS'COMPENSATION DECLARATI' . (This section need not be completed if the permit is for one hundred($103)or less). DEVELOP MEN T SERVICES REQUIREMENTS
locally 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.
ZONING APPROVED BY DATE; -
Date: Signature:
NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APP ROVED BY DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; y El this permit is issued(Section 3097.Civ.Cl. **********************. . . . . .. . . . . . . . . F . . **#.*D******* *�
LENDER: ************************************************************************ ****3 **
ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT; Y
OWNER BUILDER DEessandON: I Professional
Ahauamexemptounty hichreom the CPntraolors'State oconsenseLawforthe prove,owing molish,on
r PERMIT BLDGG1PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed . 56
Pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7030)of Division 3 of the Business SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($503). ISSUE FEE
I. as owner of the property or my employees Wim wages as their sole compensation, win tlo the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
o
stiucmre is not intended or offered for sale(Section 7D44,easiness and Professional Cotle: The Contractors'State License Law TOTALS——--> 81 , 56 0 . 00 0 . 00 81 , 56 81 . 56 . 00
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 employees, provided that such improvements are not intended or offered for sale. II,however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED ; 81 , 56 OVER/SHORT: , 00
for the purpose of sale) BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I.as owner of the property.am exclusive) contracting with licensed contractors to construct the project(Section 7044,Business 81 , 00 , 56
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). l am aware *******************************************************************************
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B.&P.C. IND I VIDUAL F E E BREAKDOWN
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOT L COST
Date: Owner:
I do hereby cenily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 5600 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5 600 , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a END OF FEES
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from
these provisions. p
Dale'. Applicant- V b,-
I hereby certify that I have read this application and state that the above information is correct I agree comply with all city and county qj Q
ordinances and stale laws relating to building construction and hereby authoriz presentatives of thi y enter apo a above-mentioned SEP 2 ( 19,/4 —'
pro.'ny for inspection purposes.
1111 iir 9`7 signatu CITY OF COSTA MESA
•r's License or Social Security n:
\ 1641-46 White—Building:Green—Code Enlorcemenl:Canary—Applicant:Pink—Revenue: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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, 0 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
r
15. Rough Electrical-Conduit • 66. Solar System-Final
16. Rough Electric Wiring '4 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 ❑Oil
25. Roof Sheathing "f5! "! 4 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat ���I!!!! 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 I i
' 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 I
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING th -5 iq, 470-
48. FINAL PLANNING '5 1 (!GN/`
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co -_
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA REQUEST FOR OCCUPANCY �
TRACT NO. 6-71.5-A9 DATE 27;2 //��F 7 Z
LOT NO. 2/
ADDRESS 2780 .tom/• cC. ,i0 Ce.eecr
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreement, acknowledges that
(he-she a (was orj advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditions of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agrees to indemnify and hold the City harmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition.
BYSk II '
•urchaser
)
BY SaCcec.,p ��'iL/ / - ,... li
Developer and/o Authorized
representative
7.
BY ,2�j . �t'nFa L% : � i '
Lender
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PER T NO. TRACT NO. LOT NO. UNIT NO.
9175 P/1-1/135 •
c�710 wax• 4)/n ui ' 0;.707 .
Project Address I
Applicant's Mailing d3/JreguL /� p TYPE OF CONSTRUCTION U NEW ❑ ADD U ALTERATION 1J REPAIR • ,
Owner's Name C-)ne / Phone 5y�SQno ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone
\50/in DESCRIPTION OF WORK/USE OF BLDG.
Address f S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT U GRADING FOUNDATION U STRUCTURAL E Front Q
Address ,,/J� 7 ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N
Contractor's Nam- 1112(�I .Sfn / 4'i Phone /4t t'�� ❑ 'OTHER A
II n / / /y PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N
Address(mailing) 4 / K G
/�!'��� CONSTRUCTION TYPE VALUATION S Left
City License No: £0 ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 0
with section 7000) of Division 3 of the Business and Professions Code, and
Planning Notes: M
my license is in fu f, •. and effect. _, KEGEIVED FEB 8 1986 T
License las ic• p ed • — S
Date - ai I Signature _/.��PSI - //S/�� PLUMBING FEES
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation insurance, or a certified copy thereof (Section
3800, Lab. y.l C//_n/cD0 / Backflow Preventer Service Sink 0 15-50 KW
( U !C�/'� rt 1//' Automatic Washer Transformer
Policy No. V Company Ya Backflow Irrigation
yCertified copy is hereby furnished. / g Sewer Cap Construction Pole Sub. 0 50+ KW
Cert' ie filed with the city B i I v" io i_ Bathtubs Sewer Connection
�- / -Ei yS yg'�j}j j).//,per Cooking Unit Meter ❑up to 100 amps
Date OC Applicant /I /(lA Y•�(���
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed If 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
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 0o-1 HP ❑1'h-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/SpaF.A.U. Inc.Solar ❑9-15 HP ❑16-15+
'NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave
comply with such provisions or this permit Shall be deemed revoked.
CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet •
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 HeaterOutlets
Lender's Name / Range
Lender's Address Kitchen Sink Water Service ® Switches Sign
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 Garbage Disposal ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5.15 KW
any era signed
prior tom nt issuance, also requires the tCto applicant for such permit Trash Compactor
to file a 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
7031.5 by any applicant for a permit subjects the applicant to a civil
a�nally of not more than five hundred dollars($500).
U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 • •
compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 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 - - - - - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I El
sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ ,Zoning Approved By nate
procto n, the owner will have the burden of proving hC/sho did not build or Im- Duct-Under Ground Building Approved By Date _aes
prove for the purpose of sato). /��,(+/s/f
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 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 00.100,000 BTU ❑100,000 BTU - IRY OF FEES
builds or Improves thereon, and who contracts for such projects with a con-
tractors) license pursuant'to the'Contractor's License Law). I am aware that
System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof of their Worker's Compensation Insurance should be provided to me. ff PERMIT
7
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLAN CHECK $PLUMBING $ 0 o 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 00.100,000 BTU 0100,000 BT GRADING $
information is correct. I agree to comply with all city and county ordinances s ELECTRICAL $ -
and state laws relating to building construction,and hereby authorize reprePLAN CHECK 50% MICROFILM $
sentatives of this city to - ter upon t e above-mentioned property f r - $' /}-/
Inspection p os.-4/
s / / / f-// 5S MECHANICAL $ TOTAL FEE $ 57 L)
Signature y ift..-4/ / ��_ �_at. Date -D
Drivers' License or SS# _ Cla $15 . Issue Fee $ 3 II PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building: Canary -Applicant; Plnk -Accounting; Goldenrod - Assessor
• CONSTRUCTION AND PLANNING POOL .'A
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, 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
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: S'-' -tf , - tien-c tec . LED
34. Final Heating& Air Conditioning 5:147 CA4Mtc(.. 45 nut 2a3 Va, LEn
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
33856
':01' 12-71N,,...
00 5c3,1- **° 1 ]PSC
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
A APPLICATION FOR BUILDING PERMIT
/U ' For Applicant to Fill in Completely /0 (°
RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING • rt - —4?-7/
ADDRESS ..- v t0 ��_ .
_ / PERMIT flA
OWNERrift A.P.NO. mac}} jj
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MAIL I BUILDING (�0 //✓ t �L�
ADDRESS ADDRESS d Ll./L
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TEL (o7rj.) J
0 0 CITY V.0.4 /tALKIA0 900x7 NO./0 t73ri. TRACT & LOT BLOCK
Z CONSTRUCTION r NEW ADD A TER REPAIR MOVING DFMOI H
ZO N LS
LENDER �.(i1�Q i
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J O BRANCH / /J
JN OWNER 0,Q on
W ADDRESS /�{[� Q Q p (,//1p� ��/j� ��,r, �ryf'm Q OR ENGINEEf // /��-�Lc+aNti!.LF NOLO7O'S/S�. USE/L_G`r• r,✓/r^ W/� VUSN�ti.
Nr (,p� A,W Q .2 S_ Jto a" /YILA�[.aI /Ai(CA��'- FIRE
Z Q ADDRESS G ZONE TV EV GROUP
d W APPROVED
W Z CONTRACTOR (_ yy� ,rs� BY DATE
J Q tV/. __I//lj-
mZ I g0 �
J z ADDRESS
u.1w TEL. ZONA NO.OF USE OF NEW Ann-
.i
I- CITY )ti ' (- ND-54f0-p33 PLANS BUILDINGQ `
APPROVED YARDS
NCC LTC. NO. _U /IL as .. LIC. NO.01083 CITY YARDS
BUILDING ACCESSORY BUILDING
r O (FROM C/L ST EET)
SIZE / ////''', r' NO.OF BLOT.
OF LOT �R K 13 6 / Q n,-\ I NOW ON LOT FRONT FT. FT.
USE OF ` J
EXISTING BLDG. H.
R.SIDE FT. FT.
H SIZE OF !1 c/ / - ROOMS NO.OF / STORIES L.SIDE 6 FT.I— FT.
Z NEW BLDG.dl [-G
✓ EXTERIOR WALK- ROOF
COVERING �] COVERING REAR _66 FT. FT.
J USE OF BI/�) I,NG AND WORK TO BE PEV1FORMED DISTANCE BET. BET.MAIN&
a
a l VC�1 Lir' R-/Y is i J?.. r A T
MAIN BLOCS. ACCESS. BLOCS.
Q VAR.* DATE
0
C.U.P.sls APPROVED
I— APPROVED/44 /� 77
C/3 �SY DATE 1/--/d' //
z
0
0 I hereby acknowledge that I have read this application and state HOLD FOR SPECI 1L REQUIREMENTS
D that the above information is correct and agree to comply with
CC all laws regulating building construction, and I shall not employ
F any person in violation of the workman's compensation laws of _ i
the State of California. ,s�/y/Jr / �(� y
Z I hereby certify that I am properly licensed as a contractor under 9s/ 76 O. FT. C4 d O
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UND R VALUATION IS FOR
Chapter 9, and that such license in full fort: d effect,or I THE PURPCBE OF ESTABLISHING A PERMIT FEE ONLY: a
am exempt • the prow' Tone State ofornia Business
and Proles ode,Di sion cip
VALUATION (,` pl
Ater 9. PERMIT FEE S P 0� c'
D
Signature o / CO
Permittee Age $�O -r- PLAN CHECK S 6'9 CO E
, • bbb���ttt000 000��� 7 Gia
Authors ly Agent' TOTAL FEE S // f��V '