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Home My WebLink About2785 WAXWING CT - Building Permits O r - CITY OF COSTA MESA BUILDING DIVISION 1. 1r.„r : i DEVELOPMENT SERVICES DEPARTMENT P IT NUMBER T PERMIT B05-02019 itba,„,sno r' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.86.WLDING PtRMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2785 WAXWING CI • Status: ISSUED Suite: Applied: 11/09/2005 Vicinity: FRONT OF HOUSE Issued: 12/08/2005 Primary Occ: R3 Type of Construction: V-N Parcel Number: 13962131 Zoning: R1 Applicant: DAVID MYHRE / Address: 2785 WAXWING Cl ,� / Phone: 714.662.5952 -► COSTA MESA,CA Zip: 92626-4850 ISSUED BY: Owner: MYHRE, DAVID W TR • Address 2785 WAXWING CIR Phone: 714-662-5952 • COSTA MESA,CA Zip: 92626-4850 Contractor: Address: Phone: Zip: License: Arch : _ Eng: Address: Address: Phone: Phone: Zip: . License: License: SCOPE OF PERMIT - 03/15/07 REVISED:SKYLIGHTS WERE NOT INSTALLED AND 10”SOLATURE REPLACED THE INITIAL 14". FRONT FACADE ALTERATIONS TO SFD.WORK TO INLCUDE:REMOVAL OF 1 (E)WALL AND REPLACE W/A SEAT WALL AND POST,CHANGE OUT FRONT WINDOWS(6), 1 EXTERIOR DOOR(NO CHANGE IN SIZE FOR WINDOWS OR DOOR)AND INSTALL 2 SKYLIGHTS(ICBG#NER 216) AND 2 SOLARTUBES. FEE SUMMARY Plan Check: $99.61 Calc Valuation: $7,500.00 Permit: $153.25 - Claim Valuation: $7,500.00 SMIP Res: $0.75 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • Total: $253.61 • • • 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: 0v_ Required: 0 • Proposed: 0 • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR'INSPECTIONS CALL: (714)754-5626 2448.48(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: • 1 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. ❑ 1 have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be complete. ' he peril is valued at one hundred dollars($100)or less.) u t fy that in the p:••rmance o the work for ich this permit is iss •d,I shall not employ any person in any manner so as to become subject to the workers' • compensation la of fomi- and agree t t III shout•become- bject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the a .ry '••-: ,"IX:LL alSlf...gDa yr.. ._ - �— `i A /I 'cl'1 r•'T'LAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI FINES UP TO ONE HUNDRED A• ING7FAILURE TO S'�WO•'ERS'COMPENSATIIXJ COV •q. THOUSAND DOLLARE(S100,000),IN ADDrtION TO THE COST OF,e• DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in lull force and effect.Lic.11 Class a Contractors Signature: Date: 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 1 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 and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,es 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:n owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license,•rsuant tot r Contractor icense Laws.). -.exe y1 •.er.ec. I - . Business and Professions Code for this reason: • _ tire/ o - I C^U _ •verif drivers license. >❑No • ve s License No. xpGes:- r� Verification of Ownership by(type of d• • ant,i.e.-property tax bill or deed) r r _ 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: I 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 application apermlt for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? LL]]Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes-,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERT •• • OMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penally of perjury that I have read this application and state that the information given is corr. . I .:ree to•amply with all .ate I.ws and 7 ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the •ove •esc bed.p'•perty yr ins/-'60"AA.• e ' agree not to occupy or allow occupancy of any building authorized by this ormit until final inspection. 1�, /�: . 3 S /T or atStei :.- :t er(s) '1' An• •r Authorized Applicant Date P00E A INSPECTION TYPE PAIS INTRIALS gODE1 INSPECTON TYPE PATE MBA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 3 -lG -07 7� - CITY OF COSTA MESA 4 BUD DING DIVISION . % DECLARATIONS 1 1 ' 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. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) I] t"l certi fy that in the performance of the work for which this permit is Issued,I shell not employ any person in any manner so as to become subject to the workers' :-•----ddmpensation laws).GaMomia,and agrea.dtat if I shouldbecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these,.provisions. / y/� TApplicant Signature 1...-- ��""� r.--Date.--/C2 ' tU a WARMNG.:FAILURE TO SECURE WORKERS'COMPENSAU 1, ERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE 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 licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force end effect.Lac.R Class a Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors Ucense 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).): 1- -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 and Professions Code:The Contractors Ucense 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 tractors Ucense 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 rsuanfty the ContractO;s Ucense ws.). ❑ I a xe pt u r sec. 7 /„ Business and Professions Code for this reason: > \Sdgnature_s- — �� Date: 7.2_ ---6 -d� Owner ID verified by driver's license -0-Yes 0 No Drlver's.Ucense No. C- _�•� Expires: 6-T-10 Verification of Ownership by(type of document,i.e.-properly 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: I Wit 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 ❑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 Ilan 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 application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 W III any pad of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have at of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (if"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws end 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 corr rI agree to cold y.with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the ve-described pr rty for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. .Signature Of Legal Owner(s)=-' - Date' !S. And/Or Authorized Applicant Date CODE s INSPECTION TYPE ns RUIDEk$ CODE( INSPECTION TYPE C gaIE ___ _ 1616 Fixed Sys Final Fire Preventio - .• Final M- --. .: - / 1266 Pool Spa Final 08 Final Plu •ing 200 Final Re-Roof 210 ' al Eie rical 201 Final BtocWReta g We 212 Final 're -reventlon 202 Final Factory Fire Place 20 Final -am _ • at 203 Final Sign I 222 al Site 204 Final Demolition 250 Final Building/Occupancy w December 11, 2006 Mr. Ed Petros Chief of Inspections City of Costa Mesa Development Services Department Reference Permit Number 1305-02019 Dear Mr. Petros: I am requesting a 90 day extension of the above permit from the expiration of December 28, 2006. 1 will be unable to complete all tasks in time for a final inspection before this date. Several vacations and other personal matters have prevented us from completing our project. Thank you for your consideration. 273Y, Dave Myhre -41111111111. 2785 Waxwing Cir. Costa Mesa, CA 92626 (714) 557-7839 4� • CITY OF COSTA MESA F w! °�"•l BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT ririth PERMIT PERMIT NUMBER ./ b"`°"" °� 698-01898 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 • BUILDING PERMIT Job Address: 2785 WAXWING CI Status: ISSUED Suite: Applied: 10/20/1998 Vicinity: Issued: 10/20/1998 Parcel Nunmber: 13962131 Zoning: R1 R1 Applicant: HERMAN, RICHARD - Address: Phone: Zip: Owner: MYHRE, DAVID W Address 2785 WAXWING CIR Phone: COSTA MESA,CA Zip: 92626 Contractor: HERMAN ROOFING Address: 4050 1/2 BROTHERTON Phone: 714 736-5677 CORONA,CA Zip: 91719 License: 348265 Arch/Eng : Address: Phone: Zip: License: SCOPE OF PERMIT T/O EXISTING ADN REROOF THE HOUSE AND GARAGE WITH COMP.SHINGLE, ROOF CERT ATTACHED TO PERMIT. FEE SUMMARY Plan Check: $0.00 Cab Valuation: $5,320.00 Permit: $112.25 Claim Valuation: $5,320.00 SMIP Res: $0.53 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $112.78 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 Existihq: 0 Required: 0 Proposed: 0 NOTES: • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned far 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 DECLARATIONS 1 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. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars(5/00)or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions.. '/ Applicant Signature: V {"r %� Date: V /O — 2.0 . �9 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($100,000),IN ADDMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full e force and effect.Lic.B r . n Class q / C—3 5 Contractor's Signature: // Date:4/0 —2-0—95 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 t0 a civ,l penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly,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 and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,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 property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification o1 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,The 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 Yea 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 Califomia 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 application apermit for Such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? OO Yes O No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safely Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 6 (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,and 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. J Signature Of Legal Owner(s) /0/202 v/20/ Date And/Or Authorized Applicant Date CODE I INSPECTION TYPE DAM IIIMIALS COOEF RLSPFf'TInN TYPE PAIL PMIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa FinalLj_ 208 Final Plumbing 200 Final Re-Roof /"Iy q` L i6' '4 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final Building/Occupancy 2446-46 PROJECT ADDRESS: 2785 WAXWING CI UNIT: • CITY OF COSTA MESA — BUILDING PERMIT PERM NO; ZB 054240 OWNER'S NAME: MYHRE DAVID W \ ADDRESS: 2785 WAXWING CIR PERMIT NO: IB 054240 PLAN CHECK NO: N GOVT: N SUPP: Y COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: OTH STR PURPOSE: ADD (714 ) 557-7839 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; RENEW ' FAMILY ROOM' ADD• PERMIT 50198 SQ FT; ADDRESS: UNIT: CLAIM VALUE: 18, 330 .00 CALC—VALUE: GROUP OCC: R-3 / i) PERMITTEE: DAVID MYHRE ( 714 ) 557-7839 ADDRESS: 2785 WAXWING CI COMMENTS: SMOKE DETECTOR(S) REQUIRED IN HOME. ;r COSTA MESA CA 92626 ** ****+ESE**+t;,P***Sr************* **+E*************EP******rpt*********************** . — LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chaplet 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Prolessions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date' _ _ Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate 01 Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: 'COMPANY: PARKING RE • PROV: PARCEL: 13962131 ZNE: REF NO: Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division, PLANNING N TES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(51001 or less). DEVELOPMENT SERVICES REQUIREMENTS • 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. ZONING APPROVED BY DATE: ' Date: Signature' BUILDING APPROVED BY : DATE: NOTICE:If.after making this declaration.you should become subject the Workers'Compensation provisions of the Labor ,-- Code,you ID must forthwith G comply with such mprovisions a this permit shall be ending deemed revoked.f [' (• CONSTRUCTION LENDING AGENCY: .hereby C). that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: � which this permit is issued(Section 3097.Civ.C). ************************* ***** {� * **** ********************* *` ***. LENDER: *************************************** * *********************************** ADDRESS: ' LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I 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 30. 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 SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of DMsion 3 of the Business PLAN 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 penalty of not more than five hundred dollars(S500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or of fered for safe(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS ----> 30. 00 0.00 0. 00 30. 00 30 . 00 . 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.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 30. 00 OVER/SHORT• 00 imto thepurpo a olsale). one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK rryy I.as owner of the property,am exclusivefy contracting with licensed contractors to construct the project(Section 7044,Business 3 ,00 LX and Professions Code: The Contractors'State License Law does not a i . • '•'r of property who builds or improves thereon • and who contracts forsuch projects with acontractor(s)licen • .(r5uant to the Co tactors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance sho • •e provided to me. INDIVIDUAL F E E B R E A K D O W N • o I am exempt under Section: B. : '.C. • ler this reason: TYPE QTY DESCRIPTIO N UNIT COST • TOTAL COST ---- Date: /O— a -9/ Owner C- INS 1 BUILDING RE—INSPECTION FEE 30. 00 30 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Salety Code Se '•n I ,25533,and END OF FEES 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state cod,.•. e requirements or a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date. Applicant: 4 I hereby certify that I have read this application and slat' -t the above information is correct.I agree to comply with. city and county . _ ordinances and stale laws relating to building construct' and hereb authorize representatives of this city to enter upon e above-mentioned J''- •5"..—_u.`•a .L _ .. properly for inspection purposes. [.^TE: j,•r;•ij/) Tri-,7: t..'r • w Dale:/ 7� �l Signature: 4 e: • \ � - Driver's License or Social Security a: 1641.46 While—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor / CONSTRUCTION AND PLANNING PO . 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 • t. LERctrieal Condlil tt'UFility'Undrgrnd. 54. Forms '.:: ;. 4; teptrical Condtlitlaldrgrnd. 55. Electrical Bonding 15.;1el fLeinforce- jun 56. Rough Plumbing & Pressure Test 1J ^ zP ftlectgical UFE8 gr d. 57. APPROVAL TO COVER-GUNITE `` 7?CFo6otings ' S 't 58. Electrical Conduit-Undrgrnd. ro C. rr r4; 0 E-,ff.rFoundat ion i', 59. Gas Pipe, 0 Undrgrnd., Test S' 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 en rr 12. Seo er Cap 63. Heater & Vent-Final 13. Roof Drains iv 64. Plumbing System - Final 14. Rough Plumbing '0 65. Electrical-Final 15. Rough Electricjj-Conduit 66. Solar.System-Final 16. Rough ElectriclWiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electri l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL cia19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ - - S.. -. - -.a. .mac. rX [ . .--120nftou h Factory Fjyeplace : ct 0 0 sx aPPR@VAtSiDcPermit # * y _ ,r it- - tut .. T • , crr trkr - - i -1 '', Le rem '� n• 21.FDuctt,irLStr9uctL e., , - S j *. x 570- Modest ta±i' H Igro * tri 1�, F S ... ra < 9f? Y, �' 22. Al Ducts, Ventilating CJS * S it t * Cc71. ProducrP.,Ling Q:Q.'is D'Oil 23.CGas Pipe�ftough &" est i rS f !n j, y J' * E-72. Underg ofln�l Fl , Y 24.-Roo3 Framing E A 1 i " - a 7 ^ s 4 S737UndergrntltStorage-Tank E7Gas 0041 rr ••• •Y� Y 25. Root Sheathing i,,-,..„,"- S ^J r ;q art O :V.Y A 574.cOverhead'I4 dro5 ° 26-_T-Har CeilingIStru ural) &rNlonocoat i r Ir. in r r "Jy .e.2 qt a torr 75�Dr Chemical Y .� 7 to 27*-Frame and Plashing" i r -e t17 -:i r. 76:'D7y Stant i1.5e 02'. ti: S nt + 1 C O t :.R TtJ T > >•'r7 2. • 71,1-1 a '.. ?l _ _28. Ladling: Siding..* ,.• _.._;:,; tr.: i �; ..1 ••* * 77:, FIXED SYSTEM:61NALr -+ >29. Insulatidn 6 'r C " " to I I �. + 781'FIRE PREV. FI1UAb y 7 ex, '" N.rs r .� • ':30. Drywall;Nailmg --. p w .. HEALI/H;DEPT REQUIRtMENT S ^)C C31. Plaster eYow¢CgStp is - 1 r :•. 79reFUNAL ItIP_ECTIgiN a' C Ir.Y \' t rt-in 'A •o .' d: r v _32,oElectricgLPoer Meter-Final; iJ 1 F .r80.rFOOD CER IFI.6¢-TE ISSUED4rJ• y x33."7, *r, Electric in tr• ` !`1 I " " 'Notts: 7 ,-,F1/1 ° - rr y ♦ u: u; 1 I' .% I- J.; .0 viz-) 5 -'S „34.-Fin�ai Heating.& Al Conditionin i•. �, ,•,� a' .r,_ S rim S J 7 '2 35.ifinai Gas Pipe-Td t' I � ` 'r ins lc er �0 �.- rt- i . a4 .. +: .- r ] :Z0 a.-: t tr tr „36."Hon. oranopy j . ,7s 1 O. .. . t ^ +} r ? .1C [' Erg7rr- {17.CFina1 Factory Fif.G'3lace v St' a• :r .n ' 4. t ',£ ' tr - n .. .. r •v ;r 1 f-.F- rp 1 , Y. F I. - rn .t IC I •• .• :.a .i !V 1 j :/ 8 r S Q tr is 38. Final PI[Knbing r t' I •-4 , I 1 . x * S :-4 -r W t;39. Water Service-Finalr i I r. v t-ri 5 '-L: Y' 'i i r t.:[ b 'K Y O .i -40. Gaeter vice-Final r' 1 t 'r "O• • t `'t o: 1' M •1;'r in . r pi I rA y 00 ao3 •i 141. Solar Domestic-Final S •• •1 I • is '..t0 -7.•1 -i - n. 14 'A It '10 "' x :r 0 42`Backflo a Preventer" 44a A Oi X 5 43. Backflow Irr-iiationr u,SS #- S cc . * G 0 `. .. K ,T. . X yi i �" ''44. Landscape IF2igatiop System; ��. r "r `' .Y 1 'o * 3 0 rr .9 P X 'k Irl _ '7 7 A i L. co tV ;L;J _ :J r7 X45 Sound Attenuation zttr 7 F. - r_ 1_* c -, ;r _ < - c0'. it X46 Handica[T Reyulatio s 0 , * y n o: :S np S . t 47. INArt. L STR41CTU4iE & BU;�DING l e 1j (I � a i j T [y ''18!*11\ ALPLANNING: � • I o"y `0 " x .J 1 I '„t .1 n 7 * t-1 li • I 0. • . ; 1 ' c49nEleptric Release to E 1'Edison ; I r a: . u .:. 7 I ••5- t0. • n .n 'r -r50 Gas Release to Southern California Gas Co ' I ' - e ' 0 "•Lr. 0 0 a51. CERTIFICATE OF. OCCUPANCY r * ;, G t*+� 3 No. Date :. _ .. .( tctre0aA.. CITY OF COSTA MESA I )IN, SA r- .Y DEPARTMENT POST IN CONSPi"�JOUS PLACE ON THE JOB DATE IIfri•UElie ♦♦ PERMI-,- .. ..� _ ;...tl. .{ • BUILQINd5WpRE55 r Ta.Ac,t 11 LOT iJ BLOCK 7 NEW ADD ALTER REPAIR MOVING DLMOLISH OWNER !•r �t • USE ?an:- . ��..- 'r:.t . r�. 'ir..c../ . • FIREZONE TYPE' GRQUe s • �' ..... SETBACKS Front Yd li.`f • Side Yd. R L___ Rear Side Yd. R L. _ Rear • t!i i•.:: :iii. . .. . .',.i i'i I.L.�:'v i'i . . .. .i.i7l!V;.i , ::ITh n1.. . ,t.1L�, F':Oki< P;iu ., L.. .. . .:1i. Gt. CAVE ..,. i-i I:GtlP!'iE 11`.1Sk':_CI IONS AT . ."U ."‘A {L-h:: n`T: ;? LIN l IL GOND': i. i:El). _ STRUCTURAL INSP. DATE Trenches Dr Forms O' r Floor System Steil Reinf - ` r •eathing-a• • • ''yt�� Frame and Flashing. ))c LO-22-Sri? Insulation - Lathing Dry Wall Nailing .<G Plass e,;Brown Coat — � � Sound Att.,nuation I iandicap R sgulation FINAL PLUMBING Sr Underground Water Rough Plumbing — f)'_o. (0.-24—.44 Prop.Sewer Line and House Conn — Street Sewer Conn. Water Service Sprinkling Sys•nm — Gas Test FINAL HEATING,AIR-COND.AND REFRIGERATION Refr. Lines,Pressure Test Ducts, Underground Ducts,in Structure Ducts, Ventilating y�s Rough Heating and Air-Cond. ,$d, /127re FINAL ELECTRICAL Tempo.'ry Service or Pole Under'.rou nd Pow-r Meter qq Rough Wiring l.. -t. ef04.6 FINAL Do ni t occuuy this project until final inspection has br en made and occupancy has been approved Building Final Special Re,r irements Occupancy NOTICE 24-hr. notification required when the job is ready for inspection. You moist 'furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 556-5273. Sal -- ir713 APPROVED PLANS SHALL BE ON JOB AT ALL TIMES ' .9.16 .. u.. PROJECT ADDRESS: 2785 WAXWING CI UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: IP 054241 OWNEWS NAME: MYHRE DAVID W ADDRESS: 2785 WAXWING CIR PERMIT NO: IP 054241 PLAN CHECK NO: N GOVT: N SUPP: Y COSTA MESA,CA 92626 ` CONSTRUCTION TYPE: 5-N PERMIT TYPE: OTH PLU PURPOSE: OTH :a �I ARCH/ENGINEER: ( 714 ) 557-7839 1 REG.NO.: JOB DESCRIPTION : RENEW ' FAMILY ROOM' ADD. PERMIT 78154 SQ FT: t ADDRESS: UNIT: iv PERMITTEE: DAVID MYHRE ( 714 ) 557-7839 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / ADDRESS: 2785 WAXWING CI COMMENTS; RE• IB54240 PRIMARY BLDG. PERMIT, COSTA MESA CA 92626 ************+e�E*�e�E�e�r�L****yr�E�E�E�E�E�e**ye**** *�E�r�r;e**********seTE*****rRr*********err*TE*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-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.Lab. C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: . •COMPANY: PARKING REQ. PROV; PARCEL: 13962131 ZNE: REF NO: I Cedltied copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES . REQUIREMENTS 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. ZONING APPROVED BY DATE: Date: Signature: NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : "- DATE: Code.you must lorlhwith 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 BY: 3 <r/ which this permit is issued(Section 3097.Civ.C). ************************ 'w** . .1'I �. ..* *, * *** ******************* ** * */*** LENDER: ******************************** ' ********* ************************************ ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 30.00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 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.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($500). ISSUE FEE • I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> 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----> 30. 00 0.00 0 ,00 30 . 00 30 . 00 . 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 ro herm owntisemployees.provided of that mpl ion,the owner me ori note the btl de offeredofprfor she/.Inot b ild oipve REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: .00 Imp or hof smtl yeei.pro year oft such limp oveentwell have the burdenr proving he/sheldid not build or gimprove lot thepurposeolsafe). 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 30. 00 and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon license r ••Contractors'Stale License Law).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be prey• • o me. I N D I V I D U A L F E E BREAKDOWN ❑ f .. exempt under Section: B.8 P.C. this reason' C forr TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: ra - 3-9, owner'. / PLU 1 PLUMBING RE-INSPECTION FEE 30.00 30 . 00 Code do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Section,41.1.11128533.and END OF FEES 25534 and that I at any future building occupant will/will not(circle one)need to comply with said state codes an. e requirements for a permit for construction or modification from theAir D Duality Management District.Residential construction app cations are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and s •that the above intormation is correct.I agree to comply .11 city and county ordinances and state laws relating to building const• i ion and hereby authoriz•representaliv'..f this city to enter .on the above-mentioned property for inspection purposes. /' Date_P o.- 3—9/ Sig . . . _ Driver's License or Social Security x: ./ 4 '^Cr _ - --7,-.--- 1641.46 White—Budding:Green—Code Entorcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor :ATE: r ti/L? ' 7.r,;E' 7,;:::: I. .� CONSTIiPJ-CTION AND PLANNING POC 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 i,Elactrt&al Condu(tj.k ity-Undrgrnd. 54. Forms • v4 Electrical Condutt•Unklrgrnd. 55. Electrical Bonding _5` I Fieinforcejc 56. Rough Plumbing & Pressure Test c 3614lektrical UFEF}cb1 I. 57. APPROVAL TO COVER-GUNITE ti • • ,S F.•'Rinf.gs s 58. Electrical Conduit-Undrgrnd. rc L-�8":F,oundation n 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 Capa. 63. Heater & Vent-Final 13. Roof Drains cc 64. Plumbing System - Final • 14. Rough Plumbiri•A r" 65. Electrical-Final 15. Rough Electrical;Conduit 66. Solar System-Final 16. Rough Electric'Wiring 67. Fencing & Access Approval 17. Rough Wiring Sion 68. APPROVED FOR PLASTERING r 18. Rough ElectricawT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ _ _ _ : :•-'• - 7 7 r -OZ.:- tK * 20.t4.iou'h Factory Fiieplace i .Ctrl �t 7 ..- 0 'D t^a- t_ AAPPROVACS%:ZPerinit # t '• '' tz et S-a• 1 Srr r.c.f 7: S ^'x * . LC ��•],N!-t;^ 7 7 a' 0 L' r- 3" I t--f-• 'C`S- *' '7* •F ,yvF+� r*1 a 'r] 21. uc�ts, in-Structurg r i •• •• i=S # S 1-+M r' - 0. l derg o,to :Hyr�o 3 - p 22. Duca, Ventilating-t OS 't. S .iv. M '• 1. Produc-`Pi ibg OrgEs ODiI 23.`,Gas-Pipe`rRoug'h &•l sti tcs t Ih t- S *C v 4-72. Underground Flu` sf(C,+ --,- 24..-Root Framing• rq n i c-(-' ••rr x > -D e yt :s .t73.'XUndergrnd'Storer ank 8 Gas 0 Ott 25. Roo heaihing .t'*" S. '-vu ;*"n i >G N;* r.:• r/4.?Thverhead �lYdroIOH :ar , p6 n .e 26T-BarCeiling (Struc+tural) &,:FDortocoat I. ko - CC:* :* 75PDry Chemical .--j . I� 0 _ - .. .. -c•c: n s. r-/* k 't- m. r..,fl n 27.`• ra eand Flashi,g* to a 'D * * ( d OZw :ItS m r �r �., ,^t[tx * a > Is:< :t 76. bry Stan ,�I�e Ftoo :! r: J r - tOta L x .Hca - '1-. . .* v 11/4.. u .28. Lattijng`ttt Siding lrt c r * s ••r y 771rFIXED S1`!STENI'lIN1c L:« V >29. lnsulatioT y* C s ' r b] I w PR t > u; (` a80. Drywall Nailing ft--; a c I V, 't --- 13EALT 4-4EPTCREQUIREMENT . ., 5+ Don ,- •t 31. Plaster &own Coil• Y s 1 Cr I.1" 4 ' r_.r.79 LTY^}�A,L I1�3PP.ECTICN a ' .i �, r,:a I ;ter A 4 -4.I ntr x. .. r✓ Li. ;-32.CEIectrical-Power MEtet;final i l t N r+r * t'80.t*OOD CERTIFI^ATE ISSUED tr 33`Fina/1 Eljctrir' •. I a .% tdI /''t a t'itlotes: IT tib F ,7. . :fit• C' = 4 r 'c. 01I • a a 34.-Fin`gF Heating Air,¢onditiom 'gc. • :r. I - it: S t^^ *7 S Ot7 .S ..t ... r, .r 35.t inat GassPiP&-TeJ* C * I c * n n ITIS 't tr 0 • .• 4 i- I '- -/ :k u =0 01- a Cr tr. -r F �* t a -I VI .t. V] 1n ,za6. Floofl orrtanopy�-.r s 1 try * r. I -I-.S a E k-ti ... ,^.,[r .« rr,.• r 4 rn `r!. K m rr 7.' inaT Fa ory FirepFacE,r 1 Str ?,' -. m I ;i1":,': E n % to 38. Fina Plt]inbing * "rzN I ja � 14�9� L 'a. S H :r. ti., . i . rr r F39. Watt Service-Final'r: i -+ * I . * n „An a h F- k 3_: I b: 'F A. :t 1. 0 7 ;,40. Gas Service-Final t n <tt'tt- * t*] I _ I .. tk* Oo ON' •-it t 1 ' a - YZ1. Solar Domestic-Final S •• -t Cs ' pp * "Co •-4 x i-42.:-Backf I oa Preventer*fr- to * I ,t * ,., 7F .r p 1-, 43. Backflow Irrigation • cc.5;S r a u:; * 0 • * >. .:. r„^ yaN x C. • * CC's *. a *'F Ill 4 U c- ;44. Landscape lii-igatiog System=,trn is; * to c c O-c -* tt co co :r.CJ * co 8 15.CSound Attenuation 1-t'xr tr r S . '�. :-.i, 'n I-4 ,t1 tro tc.= a •� m '1 s . .. :% tr1 i:1 tr. A * 1 T C • ._,t7 a '.16.FHandicap,Regulatio`s 'j a a: to •• •• ••* * :c -- - Co -. 7..EINAL STRUCTURE & BUILDING 4. 4DING * ti :% t Cu S u48 11J51/4L P A K i tr(r .a ., c .a tru i, r ,. L NTVING, I t•, r N I a to in ‘• c49.cElectric Release to Edison 1 * r ,^1K .e i I * 1 * i / "t,. . to Q -r• t: 4, . 50. Gas Release to Southern Calit'ocgjaGas Co * I Aq. 1:. it U qtr' r :51. CE Fig'IFICATE OF::000UPANC'r ;k S r -6 No. Date • 4a.. CITY OF COSTA MESA E OIN a SAFEs'iY DEPARTMENT )• POST IN CONSPtic dOUS PLACE ON THE JOB DATE Ip:`ED' ✓✓ / Si' _fe.I A.P. ry0. _ PERMI',- N�J- -J' -7. ‘•••• .- `-/ 1,1 : • Bu!LOINS ijppRESS i.. 1 TMC1t•4, y(t LOT V BLOCK Cnt NEW ADD ALTER REPAIR 'MOVING DLMOLISH OWNER ± •r USE j' FIRF3ONE TYPE GR9Ue 9 SETBACKS Front Yd `>''j`¢ • Side Yd. R L___ Rear Side Yd. R 1. Rear . . ,(rUs..LI P::FTvi; ... '.. It;, y!;:;!;1\ IViI.., c.c CONI I. E: , T ,,', I. ri-I '.GU ,I'!E IreSPEC IIUrJS AT I . •.TLt ri . .,, _],a ... „ftH. r.Fl r! UN:l I_COMP! i'TELI. _ STRUCTURAL INSP. DATE Trenches E1 Forms 0- r • ' / -/ ' t Floor System • Ste-I Reinf £ •eathings• • • t TT Frame and Flashing- /y ta•22'rip Insulation y /7"71-LIJ Lathing �C J - Dry Wall Nailing IOC Plasty;Brown Coat < . - MAIL- ••• • Sound Att.tnuation I•andicap Regulation FINAL PLUMBING s Underground Water Rough Plumbing _ f, to 74-* Prop.Sewer Line and House Conn - Street Sewer Conn. Water Service — -- SprinklingSys•em --- Gas Test FINAL HEATING, AIR-COND.AND REFRIGERATION Ref r. Lines,Pressure Test Ducts, Underground Ducts, in Structure Ducts,Ventilating �+- Rough Heating and Air-Cond. 7 477riv FINAL ELECTRICAL Tempo'an/Service or Pole Under'round , Poo.,r Meter _ Rough Wiring C .L• le•tie FINAL Do nI t occuuy this project until final inspection has bt en made and occupancy has been approved Building Final Special Re,I•irements Occupancy NOTICE 24-hr. notification required when the job is ready for inspection. You -nun furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RLSPFCTIVE INSPECTION. CALL 556-5273. 75-ci •- ! APPROVED PLANS SHALL BE ON JOB AT ALL TIMES • PROJECT ADDRESS: 2785 WAXWING CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IM 054242 OWNER'S NAME: MYHRE DAVID W 111111 ADDRESS: 2785 4AXWING CIR PERMIT NO: IM 054242 PLAN CHECK NO: N GOVT: N SUPP: Y COSTA MESA,CA 92626 CONSTRUCTION TYPE: 5—N PERMIT TYPE: MEC OTH PURPOSE: 0TH ( 714 ) 557-7839 ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION RENEW ' FAMILY ROOM' ADD. PERMIT 17768 SQ FT: •, ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / PERMITTEE: DAVID MYHRE ( 714 ) 557-7839 ADDRESS: 2785 WAXWING CI COMMENTS• RE; IB54240 PRIMARY BLDG. PERMIT. COSTA MESA CA 92626 ******�r;t*;E**;k*********�E*Ar;r****;k***�E;E*;r;r**:E4 ****rRk*;r;E+E**;E*;r;E*********;r********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-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.Lab.C). LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 'ILICY ND.: EXP.DATE: . • x OMPANY: PARKING REQ: PROV: PARCEL: 13962131 ZNE: REF NO: J Certified copy is hereby furnished. 0 Certified copy is filed wish the city Building Division. PLANNING NOTES> > Date: Applicant: ******IE*****************************,lf********Ik********************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(51%)or less). DEVELOPMENT SERTVICES REQUIREMENTS I really 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 APPROVED BY : - DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. lent: CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work far APPLICATION ISSUED BY; ` � DATE: which this permit is issued(Section 3097, Civ.C). ************************* **** x 444. i * * * ************** * **** LENDER: *********************************** ****** '** ' ****************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby af firm that I am exempt from theContractors'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 30 00 repair any structure,prier to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed L 5 t SMIP/NON—RES pursuant to the provisions of the Contractors'Stale 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 PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Ti structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 30. 00 0. 00 0.00 30. 00 30. 00 . 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.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 30. 00 OVER/SHORT; 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for me purpose of sale). 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 30. 00 IX and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts lot such projects with a contractor(5)license pursuant to r' Contractors'State License Law). I am aware ***********************************************{t************{F*.********{R****.*.)E*{(. that proof of their Worker's Compensation insurance should be provii INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.Z.P.C. for this reason: - TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: to ' 3'9/ owner: f/ MEC 1 MECHANICAL RE—INSPECTION FEE 30. 00 30 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Secli 3. 14,25533.and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes a e requirements for a permit for construction or modification from the Air Quality Management District.Residential construction (cations are exempt from these provisions. Date: Applicant. I hereby certify that I have read this application and stat at the above information is coir y.I agree to comply ' i. city and county ordinances and state laws relating to building construct' and hereby autho se representah s dl this city to enter a. n e above-mentioned property for inspection purposes, i'- - _ _ Date: �U' 3 -9/ Signature: ifr.7,_ 1..i'i'y. T:i:2: Driver's License or Social Security or /� 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant Pink—Revei1 :Goldenrod—Assessor F & SPA CONSTRUCTION AND PLANNING 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 `'• I-Elitrical Cond41t'U ility-Undrgrnd. 54. Forms F nqi.r 4i Elgctrical Cond:AlJ�drgrnd. 55. Electrical Bonding S; '5 `CCLe_ el ReinforceTh nr, 56. Rough Plumbing & Pressure Test gp:_c nt lgctn• cal UFE',grrtid. 57. APPROVAL TO COVE R-GUNITE a - V, . W :S Q7.;CF.00tings S 58. Electrical Conduit-Undrgrnd. 't .10oundation ,. 59. Gas Pipe, 0 Undrgrnd.,Test 1- 9.Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Linf;& House Connection 62. Backwash & Receptor-Final Qt 12. Sewer Cap 63. Heater & Vent-Final c a 13. Roof Drains rp 64. Plumbing System - Final 14. Rough Plumbi g rc 65. Electrical-Final 15. Rough Electrica`J-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 a: • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT x 20.iiRoLigh F ctory Fireplace ur <i C ES 7• . z . PPRSVArSJm CPermit 4 .r c .r of T• • ST tr..* * S 1•1 rri - r•3 Ttnryr-. - -. li 21. Duci'f, inStr ctu .,: 570. U de�•E uiigN ro ' -iJ its 22. Ducts, Ventilating,* i tis r s rya: * '471. Productiling O&3as CrOil 23. a , oy{ph &?est n *. t 72 •Undergron FI F -- , S tr J* x l • i--11..; », t[* r- 'A p 4 * J 24. .Rooj Framing. (Tyr LFt-• - > O it .. S730:UndergrnhStora>vankiO Gas- 0 0+1 7 25. RogYShhathing a'. s- Ni „x71 v• CJS N-x * 5749,0verheadiAlydro8f 26.-rf-Bar Ceiling (Stiugtural) &4gonocoat * '7 kr O tan x x 75:7'Dry Chemical s� •• .7 T. "` -- t F -7 27_Frame alp Flash{ritj, •s .r. m V ` r: 76!-Dry Standee ?S t s :n --•-• a.� 'pit tC v: r7' Y mr * - �. :. ..n ^i i 0. r•n Cv T X >' K r I t(EJ s: ,.0 C F-28. La;ping a Siding01 -. ^,y;i, 'x S ••I ••:t e 77:1 FIXED . .- 51NACR - S K >29. Insulation ^' •J !^ •'••' t' to t 78 FIRE PREV. FI{j1!}L '2 C., - I:* S : .. CITY OF COSTA MESA BC 1N, SA F6.,Y DEPARTMENT ' • • POST IN CONSP tWOUS PLACE ON THE JOB DATE IGLUE9• ? / N% / Z : 'I" 0 A.P. ry0. PERMI-, = ' BUIL9 ---.*IN4� ADDRESSf ^ 0&?'. 'o_ -- f"!4 G•A:,., :.J`� '.. ^.�.. a':r• TRACat LOT ~El BLOCK S' -= -j NEW ADD ALTER REPAIR :MOVING OLMOLISH OWNER , +' • • USE .• ..t ;, 4' •. . ...:i;L•L • eti-•. �;:•i.s /Ir'�:. FIRE,3ONE TYRE. GRDUe SETBACKS Front Yd _'-'`gip • Side Yd.R L___ Rear Side Yd. R L. Rear , ' ..: .OiJ itECainC. . ..• !l ni .-L,•�. i. L!ti 1/20 RIC 1lit.., . COM- L. _ , !:!IN h:E 10.' S Al' .1 .'UL.A .. ,;.E2. ,.l-T i: UI'JI ICI.Y:.IYI i.• ii.-ti. _ STRUCTURAL INSP. DATE ` Trenches 0orms 0- 'F � • ' Floor System Ste^I Reinf £ •eathing-•• • I Frame and Flashing- io-22-Y Insulation OC Lathing Dry Wall Nailing OS a f..2.4 - Plasiet;Brown Coat Sound Attenuation • t•andicap Regulation — - FINAL PLUMBING Underground Water 1-1°' Rough Plumbing _ f (0-24.-* Prop.Sewer Line and House Conn - Street Sewer Conn. Water Service -- ' Sprinkling Sys•em Gas Test FINAL HEATING, AIR-COND.AND REFRIGERATION Ref r. Lines,Pressure Test _ Ducts,Underground Ducts,in Structure Ducts,Ventilating Rough Heating and Air-Cond. r(�(/J icre/z3rjt71) FINAL • ELECTRICAL Tempo/ivy Service or Pole —� Underr,round _ Pow'r Meter a Rough Wiring C .L. i/'0 •/CjSrn' FINAL Do n, t occuuy this project until final inspection has lar en made and occupancy has been approved Building Final Special Re,!•irements Occupancy NOTICE 24-hr. notification required when the job is ready for inspection. You mist 4urnish PERMIT NUMBER and the JOB ApDRESS FOR EACH RLSPFCTIVE INSPECTION. CALL 556-5273. 75-41 x-7-73 APPROVED PLANS SHALL BE ON JOB AT ALL TIMES fiLfl ' 6946 PROJECT ADDRESS: 2785 WAXWING CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IE 054243 OWNER'S NAME: MYHRE DAVID W • ADDRESS: 2785 WAXWING CIR PERMIT NO: IE 054243 PLAN CHECK NO: N GOVT: N SUPP: Y COSTA MESA,CA 92626 • CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE OTH PURPOSE: OTH (714 ) 557-7839 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : RENEW ' FAMILY ROOM' ADD. PERMIT 47674 SQ FT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ADDRESS: DAVID MYHRE ( 714 ) 557-7839 2785 WAXWING CI COMMENTS: RE: IB54240 PRIMARY BLDG. PERMIT. COSTA MESA CA 92626 ********+r***4************ **+e*****************************+ ******************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE Lit.: ClASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selhinsure 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,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING REQ. PROV: PARCEL: 13962131 ZNE: REF NO: 3 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NVTES> > - Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION OECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S 'E,R V I C E S REQUIREMENTS 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. ZONING APPROVED BY t DATE; Date: Signature: NOTICE: If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ( /�t• jF/�^J// / %/�/jJ� DATE: '/ Code.U TIO must fortDING G comply with such provisions this permit shall beendingdeemed rency fo. i iri**gi{'i!#,�F`%iE iVF.IF� dF *** CONSTRUCTION this permit LENDING AGENCY: Civ.affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: / DATE: /O which this permit is issued(Section 3097.Civ.C). ************************ * 4* 'tip t g******************* ALENDER:DER: *****************************************A * i ******************************** LEGALIZATION:N F E E - S U M M ' R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I 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 -30 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 }} pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7090)of Division 3 of the Business J 0% SMIP/NON—RES and Professions Code)or that he/she is exernpt 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($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> 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----> 30.00 0. 00 0.00 3 0. 00 30. 00 . 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 roro herm owntisemployees.iin provided that sumph improvements me are not intendedhor of for she/. ainothowever d rbuildingmr or REVENUE DIVISION TOTALS--> COLLECTED: 30. 00 OVER/SHORT: . 00 improvement rptheepurpoof sale). one year of compleeon,the owner will have the burden of proving he/she aid not build or improve 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 30.00 1X 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 pursua 'Contractors'State License Law).I am aware {F***********.X.*******************.***************************.*******.***********.** that proof of their Worker's Compensation insurance should be pr. •. to me. am exempt under Section: B.a P.C • I N D I V I D UAL F E E BREAKDOWN forthis reason: / j TYPE QTY DESCRIPTION UNIT COST TOTAL COST Dale: �� ' 3 owner: _ _ . . _ _ ELE 1 ELECTRICAL RE—INSPECTION FEE 30. 00 30. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sectio r ,25533.and END OF FEES Ar Duality 25534 and that I or any future building occupant ill not(circle one)need to comply with said state codes e requirements for a permit for construction or modification from the Air DManagement District.Residential construction (cations are exempt from these provisions. Dale: Applicant: I hereby certify that I have read this application and state e above intoimatien is correct.I agree to comply with a ity and county ordinances and state laws relating to building constructi.- .nd hereby.uthcrize r'presentatives ci this city to enter upon ove.mentioned property for inspection purposes. / Date./O •' 3 Y / Signature: . -_ / I,;59J :!,r-C{S:77L _r Driver's License or Social Security a: DATE: li7{ilia♦ �Ij;F; py ` 1641-46 Wbiie—Building,Green—Code Enforcement.Canary—Applicant,Pink—Revs .e:Goldenrod—Assessor CONSTRUCTION AND PLANNING POL . 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 113; Eltetri£al Condigf�fU{ility-Undrgrnd. 54. Forms 14:_Electrical CondttitUrtdrgrnd. 55. Electrical Bonding :1/415j,_51).-el Reinforceiiiel 56. Rough Plumbing & Pressure Test _ •gq. lectrjcal OF Ef?':($n(t. 57. APPROVAL TO COVER-GUNITE rU � 7?IF gtirigs 58. Electrical Conduit-Undrgrnd. ,c r87;Eoundation 59. Gas Pipe, 0 Undrgrnd.,Test r'' • x 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 r••] kt 12. Se ger Cap iv 63. Heater & Vent-Final 13. Roof Drains ro 64. Plumbing System - Final • 14. Rough Plumbirig; 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 .e17 Cr .1-:c E- IT. * En 20.�.rRough Factory Fireplace I Is;ir1 K-= r 0 r"* x tAPPRO▪ VNtSUCCPermit # r > ""_ .L: S rA t 57-T. 1 'Srr t.l< * S f� T•* I. : ix <CU:-(-- .'� t 7' tit s 1 (-t- ::S - �x * . , s`-,¢ , m to 21.,,bucts, inStrilctut.* S * ,s p ,yM * 4 0. Undergeestaid-HY o .S. c. a D 22. Ducts, Ventilating-* t ar - _ K S a�: x GJ-' 1. Product`-T�)•§ing,RT4s ❑Oil 23.3as`Pipe-Rough &• est i 'X '"` :-"lt :` E-,, m 1 OC if r.. RIS k tri < 0* * r--!2• Underground Flys); I, ,�.,, ].� 1. . S .- i -� , r. 24.F-R000'Framing• •nw I -F• •'r- rx 0 is * - ..3!XEJndergrnd?Stora ems-,'Tank ©Gas ❑oir 25. Roof *0 CO*Shathingz• [ll x to in . isi� •.• •-4" s'-t. it v Y* O ▪ 03* * ., 574 `Uverhead Hydrocs • _ 267T-Bar Ceiling (Structural) & REonocoat * to t7 rnr s 75.'ry Chemical r. x -i C •n 27.frameald Flashing" m -x in': .14; 76.'"bry Stance (2 '# _. rn ";-.1 i-28.`Lathjng,3 Siding :t :24`.-i'..,. r:: * S_- ..x •r. 77. FIXED SYSTEMiliNALlc iC X29. Insulation ,, k S - I I it: .* 78.11•FIRE PREY. FIN) y > ,S e00. Drywall[Nailing et': * t* s I-. NEALTvRe EPTTREQUIREMENT . ... l 4i,.1(y S .lir, r,. -r ,. :C31. Plaster B'iown-C• o&P li ,s 1 tr(r * I 1 rlt. .wt. rr79 C'FINAL IIlgBECTI� * c) t `r •-32.7EIectricaLPower MeteaFinalCO I i4* tr80.tif00D CERTIFIC*Tt ISSUED , 1S 7. 3. ina3,Eltricl Com* r � i �% y: 1. t ,/�-'1� yT t • t o l -r I t I� "� Kiri R -7 MIT! tr S v * f i1. - LL / E" T &- •'y int, ! n34.-Fin�f He tingt�i Ars.- -- tioni.r}gs c� .- R r,. /a .�J S ;�= l' „ .E :. .. .J •_ w •� It,: nt ten.• i r-,.‹ 35."FinatGas Pip€Te�"t` •r A 't: t :Ica, i s wS :x Er - O 1 d •• ...c•^., + ar Fi I It: -t .^.o 0i-I * S?' 1-4* ke F. F 7 s_ .'1In •i 1 :N11 u36.'T Ho41 or`Canopy•- 0 , try ` -" * r , ,•k_t S 0 * rr Er - - :•t' t, ' nil . , . 2' .r -r •tri 1 .n trI,11 x-37.` inat!Fa ory Fireptvacti, l F_Eit u' .141. 01 •Ir, *. :x : Ct t Mtn'n * it. 1 vl n -V s -...F•.c•V. •3 it .. - 7-4 .=38. Final.Pl Uunbing t co : -+ * 'I • 4-' J S - . "1t C,39. Water S rvice-Final* s' I * ir, I /: i1 r z Ci i tam 0 x Q 3. ] r --W • •I in t�jto. Ga;`Servi6e-Final y.tit .Strtr n 5 * to :z I '&. Co cru * :r 111. Solar Dotnestic-Final S Cli' •• Ct I [t :z 'CO 1.--i t: 1.- .: ;n .t !i. x A ;r E42`Sackf low a, .z ;-+ !U * 7 i ,t i�i ai S Preventers of * i t z :* tr >E- -t a i-' 43. Backflow Irri'gationK SS : * w :t a::: :* C o i ,.CSF r. Y x t� i,J :.. 3 i U `,44. Landscape I..r . oq S'Istemxt t� ir• 4 r. - rJ O:* ti !x in •U VJ CJ ti. OI ca F45.:Sound Atteriiiationr i-+tUE in >n g: i•-• N f-r * CI r, ,-4 7 tr< :t n 1, 1 .. .. z in •n int Y. E tT C •2 • t-,a W r ( t a S. *. p, .. .. ••J: :x :J - . t-,0 "I-: * 6.:Fiandica'p,Regulatio¢s 0, Y :r * rx =C :s :7c .s t 47.;-FINAL STRUCTURE & BUItDING 4 i it �r '7 ru S . it k .i: r- , f, r. :e I v :v. F. it 0' a , LT'Cr x k x i , iC, ' J it •� 48.._�INF,L PLANNING;; , r-.(-. :x tU I I t; ;•Z m to i2 H c49.!Electric Release to Edison i :�; i o_ ,t, .. ?. - .4:: * .S O 0:1. .T. t 1 0 •,50.�,Gas Release to Southern California,Gas Co , I It :* E-4 ,. __• cin * n • • 4.51_,CERTIFICATEOF,OCCUPANCY' xH. ,z FZ:ic y. i, o No. Date CITY OF COSTA MESA E )IN, SPF&7 Y DEPARTMENT POST IN CONSP elJOUS PLACE • ON THE JOB DATE II UUED' A.P. t$O. P N IVO. '"r `✓'.-i ♦i• • C it BUILQINd,F'PDRESS f �— TRAC/it £ LOT (% BLOCK it NEW ADD ALTER REPAIR 'MOVING DL.MOLISH OWNER r{•' ' . USE ! 1 .� FIREZONE TYPE GRQUQ SETBACKS Front Yd ,: .•h'¢ . Side Yd. R L—__ Rear Side Yd. R L. Rear .. _... it) Edi.RIC .. CGI`:1- . - ! :+i:. u L,,. . .. .., 1, hOLITINE INS!-.: :IONS AT ..I .. ?n'.. It l Ed.::: n.1 r. L{:i!I I_CORit"._, Tcii. _ STRUCTURAL INSP. DATE Trenches I]'-Forms 0 � • ' -1 Floor System Ste'l Reinf. • £ •eathing-•• ' • r Frame and Flashing- J) x'22-'$7 Insulation j/7/-a � Lathing �� a i Dry Wall Nulling .ft 2�- 2' Plasm;Brown Coat rp Sound Att muation I,and icap R egulation FINAL PLUMBING 5rr Underground Water Rough Plumbing _ <O 24 Prop.Sewer Line and House Conn — Street Sewer Conn. Water Service --- Sprinkling System --- Gas Test FINAL HEATING, AIR-COND.AND REFRIGERATION Refr. Lines,Pressure Test Ducts, Underground Ducts,in Structure Ducts. Ventilating Rough Heating and Air-Cond. -1121 /D/ /�1L% FINAL ELECTRICAL Tempo)'ry Service or Pole Under,round Pow'r Meter ,t �� Rough Wiring EL -C—. ��0•04—'��++YI FINAL Do Ili t occupy this project until final inspection has br en made and occupancy has been approved Building Final Special Re,rirements Occupancy NOTICE 24-hr. notification required when the job is ready for inspection. You must furnish PERMIT NUMBER and the JOB A2DRESS FOR EACH RLSPFCTIVE INSPECTION. CALL 556-5273. 75-4 -- r713 �pAPPROVED PLANS SHALL BE ON JOB AT ALL TIMES X05" "'FS,y L TY OF COSTA MES, e4"' a CAIJFORNIA 92626 P.O. BOX 1200 h iretaid I . O FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY • Project Address 2 7 C� w szn{ (CO`^ , Permit # /9.1 Project Name /Z Zarid. nen-- Type Owners Name ;atiU ;it - / "'( "‘"k\2 7l� S� �d9:�C..�.-c. � Owners Address KQ . Q1 ( City Use 1y .5 Owners Telephone • yG - i- S // -- 5;- - ;7-5 7J .3 > I at.firii du . !44-y cQ.7 as Owner, &4ntractor, Agent- (strike out all except one) do hereby/attest that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In the event that any person, or persons, are employed under the provisions of this permit, I shall immediately cause a valid Certificate of Workmen Compensation to be filed with the Costa Mesa Building Division. I agree to defend at my own oast, and to indemnify and hold harmless, the City, its officers, agents and/or employees, from and against, any and all liability, damage, costs, losses, claims and expenses, hcwsoever caused, resulting directly or indirectly frau, or connected with the improvement under this permit. I further state that I have read and fully understand the implications and re- sponsibilities of the above statements, and will comply with all provisions of the Contractors State License Law found under the Business and Professions Code, Division 3, Chapter 9, of the State of California. • �,r>//o. �-• 7%1n/ Print Nine 6 -zs'S" o Signa`tiif Date CMF 0777-46 `01""ts9 CITY OF COSTA MESA 0 R A, CALJFORNIA 92626 F.O. BOX 1200 F1 • 1) FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY Project Address ,a27825"82s ( 4k(,i/J(�, (ike�e Permit 41 SCS 1478 Project Name `NFe'l/L y ,71 r si A.n/7" IYFe Owners.Name ( i¢ ✓ i CO- /At y c�2 Fz Owners Address Q76S —JAkn.L C(cC City Use only Owners Telephone 7/y- _6-5- ? - 7cY'3 I 04� i io (r. {'icy /.2F as owner, (strike out all except one) do hereby attest that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In theevent that any person, or persons, are employed under the provisions of this permit, I shall immediately cause a valid Certificate of Workmen Compensation to be filed with the Costa Mesa Building Division. I agree to defend at my own cost, and to indemnify and hold harmless, the City, its officers, agents and/or employees, frau and against, any and all liability, damage, costs, losses, claims and expenses, howsoever caused, resulting directly or indirectly frau, or connected with the improvement under this permit. I further state that I have read and fully understand the implications and re- sponsibilities of the above statements, and will comply with all provisions of the Contractors State License Law found under the Business and Professions Code, Division 3, Chapter 9, of the State of California. t 1 u (-v • P1 y N2/t Print Name / & - � 6 - 5 - 8O Signature !/ Date `iVmvLIC MYHRE David W. URIC 5-29-73 l'IJOB ADDRESS 2785 Waxwing Circle BUILDING PERMIT NO. 36714 �GENCRAL CONTRACTOR owner-builder DESCRIPTION of WORK Patio Cover JAI 139-621-31 LOT 29 TRACT 6758 FIRE ZONE VALUES 1,000.00 -INSPECTIONS Signature Date GROUP T TYPE V ZONE R1- SOIL 1SOIL PERMITS ISSUED •CGA5 SUBCONTRACTOR Date I Number I Signature WATER Plumbing &ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIN CONDITIONING TEMPORARY SERVICE ON POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES FORMS STEEL REINF. 43.t. FLOOR SYS EM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n PLO 9, BROWN COAT STE. JRAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL _.. . _..._ _..... N ACJ d/9 7Th • 36714 . COSTA MESA BUILDING-SAFETY DEPARTMENT .t.., S PAI P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 O-TF' n�1 57-1 ` •• .d+ 1 ridC APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVE rrr�� BY DATE RECEIVED ^ DATE t ISSUED D BUILDING 85. ik / ve C,� ,ADDRES 2b__P�73 say-7-3 OWNER .1 ! V I + , i A.P.NO. / •� / _ .- BUILDING //9 c 1 /^ ✓' 07 I r. MAIL `_ ADDRESS / (J 5. &4*J D Ztit Lil ADDRESS �•V ey+�+,,Ln,, �757 :4 G - U CITY CO`,/ it iii e /9 NO, S7-7k37 TRACT LOT ,$/LOCK Z< CONSTRUCTION NEW ADD .ALTER REPAIR MOVING DEMOLISH O—N LENDER i(/ZJw"G— V/ d m JV) BRANCH atv1d W• y� Let_ J to OWNER Li /,( Q ADDRESS �' _ /_-/n/ VAL /J/�7�/� o_� 4 ARCHITECT �. TEL. USE /.(�f !U ! /I1y G/ $ !UU// to OR ENGINEER NO Z CC --� ZONE TYPE �GRO UP Z 2 ADDRESS //a Ly �{�{JJ ) J O CONTRACTOR ------ �� g,.APPROV ED DATE S—o29 73 m Z J cc ADDRESS -----, W W O= TEL. ZONEA /IPLANS NO.OF USEBUILDING OFNEW �QT/0 /j CITY NO. 1 —0STATE __ CITY YARDS APPROVED YARDS APPROVED to CC LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING DO (FROM C/L ST EET) OF LOT 53X NSXinri� NOW ON LOT //�� / FRONTFT. FT. EXISTING BLDG. S(.•.G A C Fxv.••.t•—ry eel R.SIDE sr FT. FT. I— SIZE OF NO.OF / C Z NEW BLDG. ROOMS STORIES L.SIDE /✓ FT. FT. VEXTERIOR WALL ROOF s[9 _ COVERING COVERING _REAR Ci, FT. FT. J ` USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& / IN BLOCS. ACCESS. BLOCS. O !aj 77 0 CuC_Oe.L C3,anl %rf/4'/I1 C U.P.#'• APPROVED 1— V) //j/'�,, ��•y� APPROVED%�z�/��/jam//�/q rA (...1, ✓4J �- AY :/u V //ten OAT O UI hereby acknowledge that I have read this application and state a. D that the above Information Is correct end agree to comply with CC all laws regulating building construction, and I shall not employ 10' I— any person in violation of the workman's compensation laws of CO the State of California. cov) z 50. FT. 6 I hereby certify that I am pperfy :ICCnx ., u a.a L ,,.. ..,.Osr te State ,a,.a,TG'P.ute•siuns tuoe,-Bivisien�S. THE AMOUNT SHOWN UNDER VALUATION IS FOR • • ,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: so CC am exempt fr•.• • provisions of the State of Califo Business VALUATION /� 00 ao and Profo '• _I Division 3,Cha ter 9. PERMIT FEE $ /(/ N Signet 0) Permittee �'� Val ii PLAN CHECK $ E / p[J/ LL Authorized Agent TOTAL FEE $ /(/ OWNER FIRST Los Angeles Corp. DATE 12-14-71 tc�JOB ADDRESS 2785 Waxwing Circle BUILDING PERMIT NO. 33963 �GFNERAL CONTRACTOR Euccola Co. DESCRIPTION of WORK Add closet o. LOT 29" TRACT 6758 FIRE ZONE VALUE $ 1,450.00 INSPECTIONS Signature Dote GROUP I TYPE V ZONE R-1 SOIL PERMITS ISSUED GAS1/4‘.; SUBCONTRACTOR - - Date Number Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. El SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING Floating and Vent. TRENCHES ❑ FORMS ❑ STEEL REINF. U FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN f] OUT n PI TR, BROWN COAT Si (URAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C.,�FINAL r PLUMBING, FINAL AND GAS TEST l l ELECTRIC, FINAL s]] BUILDING. FINAL t3. 1,0T LC PAIii n . - 33963 DEC 14-71rn --OO 57c "• ;.r.'' `7/ ._, COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY ADATE REC IVED DATE ISSU O BUILD Do ESS 2785 WAXWING CIRUL.F G Al"_ L.--) a Z 7� W PERMIT NO. OWNER FIRST LOS ANGELES CORPORATION A.P. NO.BUILDING (�9 I/ MAIL41 WILSHIRE Q GRAND ADDRESS ' / 0 S # (�[-/� ADDRESS �t ui aU CITY LOS ANGFU,FS TEL TRACT �� as-11 LOT Ci BLOCK I- Z 2 Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH O-I- LENDER CO 0- 03 J D BRANCH J to OWN ERrs W / r ✓ ADDRESS r VALU / h -1 < OR ENGINEER ARCHITECT E•G• KALTENBACH No`810-5152 --/''�-+ $ t7 (/r O Q FIRE W 0 ADDRESS 2545 E. CHAPMAN, FULLERTON ZONE TYPE GROUP I APPROVEDJ 7 J O CONTRACTOR BUCCOLA COMPANY BY DATE/"// ^/ Z J x ADDRESS 4 01 BIRCH STREET w W W ZO NO.OF USE OF NEW,/,,,t, Z F CITY NEWPORT BEACH No�j40-8833 PLANS =UILOING r W-O STATE CITY YARIA APPROVED YARDS APPROVED N 2 LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING D 0 (FROM C/L STREET) SIZE NO.OF BLDGS. OF LOT 8 000 B•. ft. NOW ON LOT 1 :•NT FT. FT. USE OF EXISTING BLDG. -- p • F . FT, I— SIZE OFo s I NO.OF Z NEW BLDG. 18 X 0 ROOMS 1 STORIES -- L.SIDE T. FT. Q EXTERIOR WALL ROOF _V COVERING STUCCO OVERING SHAKES REAR FT. FT. E —I USE OF BUILDING AND WO TO BE PERFORMED DISTANCE t . BET.MAIN& MAIN BL••., ACCESS. BLOCS. ADD ONE ADDITIONAL CLOSET TO HOUSE C.U.P.# APPROVED I— v) UNDER CONSTRUCTION APPROVED �(� DATE I l((i/.7I (v� VI hereby acknowledge that I have read this application and state % \ D that the above information Is correct and agree to comply with ccall laws regulating building construction, and I shall not employ1. F any person in violation of the workman's compensation laws of CO the State of California. a t� ZI hereby certify that I am properly licensed as a contractor under / 0 SO. FT. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 0 Chapter 9, and that such licenses ere in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: cc am exempt from the provisions of the State of California Business VALUATION S-� and Professions C wis 3,Cha r 9. m PERMIT FEE $ / • '" 7 Signature47) m Permittee { ef $ PLAN CHECK $ s E LL Authorized Agent .. SDl 0 OWNER DALE MyHRE DATE 6/5/80 JOB ADDRESS 2785 Waxwing Circle BUILDING PERMIT NO. 50198 GENERAL CONTRACTOR owner-bili]der DESCRIPTION of WORK Family Roan Addition 7 D. 139-621-31 LOT 29 TRACT §758 FIRE ZONE VALUES 18.330.00 IN.rr'ECTIONS Signature Date TYPE GROUP ZONE SOIL SUBCONTRACTOR I PERMITS ISSgED — GAS Date Number I Si lure WATER Plumbing ROUGH PLUMBING its I6-214 D/} G 54-0 MS PROP. SWR. LINE Q HOUSE CON. El SPRINKLING SYSTEM MISCELLANEOUS J ROUGH HEATING AND AIR CONDITIONING ) /Uf//�//fO TEMPORARY SERVICE^ OR POLE Ll UNDERGROUND POWER n ROUGH WIRING C, /0-/y-Sp. /Heating and Vent. /_q -V q TRENCHES FORMS STEEL REINF. . £-1S-co #/O 6-X---1,0 1 710 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n EXPIRED SHEATHING �S 7-,Orf-Cz Irx'Olpplete • FRAME A FLASHING >S 10f-23-Sa (� Inspections -...SPS - IN OUT :71 ...f // _/+� ' Cancel Date 1-L S'�S1 Sii. kit PL"TER, BROWN COAT a la-ug S RIRAL. FINAL I� Electric ( EAI inc. VENT., REFRIG. AND P.C., FINAL 10 b---f x'`247$1 LUMBING, FINAL AND GAS TEST n IfY� ELECTRIC. FINAL BUILDING, FINAL / 2 '2 ' Gam'/c PM"a / y , y- f-� -7r- r‘ V 7---.. 9230 6/05/80 COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT133e28 TL P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 REC ,s�PERMIT L< /d (n For Applicant ptoo Fill in Completely —Use Ink Only /�• / VX BUILDING 7 35 (/gy/N// G//� . A.P. NO. r�/_o r �/ ADDRESS TENANTOR O�/� /yl //`f j= ADDRESS 27s et Aryl 4/: vY/ L�,/ Y/�c�G UNIT OR MAILING rjp7c & a'// c'/'' SPACE NO. ADDRESS / Tj2.N0. LOT BLK. TEL. 127CITY (-47 NO. CONSTRUCTION NEW ADD ALTER ? EPAIR ?MOVING DEMOLISH LENDER BRANCH OWNER ADDRESS // /' n_ s a` ALOE /D OARCHITECTR ENGINEER .7AAA SI/IAY/ffEJOL VSE 1JIaJ^w^_ \ s S(Q 3� ADDRESS 474 !V• oyf/ if /5 ZONE TYPE e GROUP/rAP // CONTRACTOR �(�"t(�C BVPROVED VV DATE / / �� ADDRESS (((••• 1 TEL. CITY NO. -Sy STATE CITY APPROVED SETBACKS W NO. LIC.NO. SIZEIR NO.OF BLOCS. (FROM C/L TRE T) /J a. OF LOT 55X NOW ON LOT -oN �/f-i707 4 7el hUSE OF EXISTING BLDG. S//' Ze, A.SIDE G— FT. f FZ• Separate permits are required for L.SIDE l/O FT. ( / e/ C electric,plumbing and heating work. REAR /S—FT. f l/ EW.. USB OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a GI DATE 4 A tag q 00.697 7C? 4k/-q. APPROVED /J {��/� / H APPR ED /' ` >•• (G�% /��IC �C , .. 2" 6 RV DATF(7 -3=a CL (((�j�(((///✓✓✓ lel a. • 0 I hereby acknowledge that I have reed this application end state r• X that the above Information Is correct and agree to comply with a• all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 2 44 the State of California, en m I artily that I am properly licensed as a con�Apso�under SO. FT. N the State of . . . : s and • •Saeaio r?L de, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Nm Chapter 9, and that sue •.. .s : . . full force end a act,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE_ ONLY: m am aXBmpt fr•.• . : ...u,. of the St t. • . ?for ea Business QQS'♦�— and Pr• • o u,D^tion 9. VALUATION PERMIT FEE E n E Signature of f PLAN CHECK $ s ^ 0 PermitteeS a 3 30 1. z8 Autflorized •g. t .te_ c2-7-, 7 / TAX E F . TOTAL PAID E 3IC • 33857 ;0`J 12-71c„c•OO 599” ..�;t17y,5,^. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 r ' d For Applicant to Fill in Completely /0/3 APPLICATION FOR BUILDING PERMIT J RECEIVED BY DATE RECEIVED DATE ISSUED E D BUILDING e?...., BDDRENSeJif s / VIny<Ji r <J <•J1t ..e., ( � p4 /n R5 A.P. NO. OWNER j_ rfiDX% atr 47 MAIL BUILDING S� - r ADDRESS 103-o ^O n�- ADDRESS ! Z w w /` /r/y� �Z CITY a Nj! Oa �7Q 0/7NO`�1C 73(u� TRACT/r51 CD/d s� LOT s BLOCK Z < CONSTRUCTION ^r\-I4 r6 NEW ADD AL4ER REPAIR MOV s DFMOI ISH O— N LENDER h� Q-2�„ a_ a m V J D BRANCH ^ a J N OWNER 1 a gW ADDRESS yygy0000 (� (�/1 el <�/ ,7 r ARCHITECT ra y/ A TEL.p USE.C..!"b•W/ < -ThUE y/(OrJ 1 / a N OR ENGINEER NO, 87o'S IS2-• G� /// Q FIRE V,9u W w ADDRESS as�sg eAn hat, ZONE TYPE / GROUP )~ IL Z C/�^ - /./�'�� APPROVED ILO CONTRACTOR l 'u. . act.„ , „ Q BY DATE mZ ' / ,. J cr ADDRESS 4 O � f W w ZO NO.OF USE OF NE .{:Ji77/• zF TEL ny PIANS BUILDIN ) y./. >L/�� CITY NO.5C1Q,E J3 �/ .�//!I/r(. /CMr'•I• w O STATE CITY �p YARDS APPROVED YARDS APPR VED tom LIC.NO. 146 LI a- 3 LIC. NO. a W MAIN BUILDING ACCESSORY BUILDING D O YJ (FROM C/LST-EET) SIZE / / 'NO.OF BLDGS. OF LOT 5 / _ NOW ON LOT O RONT _ FT. FT. USE OF / ",y/' EXISTING BLDG. R SIDE ✓ FT. FT. I— SIZE OF c2445 " r NO.OF . J7 STORIES L.SIDE 6 FT. FT. VEXTERIOR WAL ROOF _ COVERING _e COVERING REAR yf1< FT.4, FT. J USE OL-Fr�BUILDING AN WORK�{T,.{O..BE PERFORMED DISTANCE B//ET. BET.MAIN& / "' 4 • II r' & ac Cr--- MAIN BLDGS. ACCESS.BLOCS. T VAR.* DATE OC.U.P.# APPROVED I— APPROVED P)/{/ �I UiJ1Y /rDATE //-- /d �_7/ 0 UI hereby acknowledge that I have read this application and state D that the above information is correct and agree to comply with I-lULU tut{ SPtCJ1AL REQUIREMENTS cc all laws regulating building construction, and I shall not employ I I— any person in violation of the workman's compensation laws of it/FT. HVg the State of California. /�� / / to !/f- (-Q/ Ill Inz I hereby certify that I am properly licensed as a contractor under o the State of California Business a - -rofessions Code, Divisicn 3, THE AUNT SHOWN U ER VALUATION IS FOR Chapter 9, and that such license are in full force and effect,or I THE PURPOSE OF ESTABL ING A PERMIT FEE ONLY: u cg am exempt from the provi ions • th.State of Cal x nia Business VALUATION and Professio •de,Di Ion 3,Ch.pter 9. `/Q s�� n PERMIT FEE $ Signature of © /f �.+ �� m Permittee :%�/ i/ '/r lP /1. / $_/(/ 0/-I/1 . — PLAN CHECK $ �O E V/LO1 ✓C• lie �—�<� o Authoriz:tl •gent / /7.?5 v u. TOTAL FEE $ /,1