HomeMy WebLinkAbout742 WEELO DR - Building PermitsPqOJECT RUONE55: {-74 2, rrEELO DR uNi^ C�
�� OWNEfl'S NAME: TANAKA, ISAMU 5 \
aooeess: �aNAKA, YOSHIKO.,K
1846 WALLACE AVc
'' COS�A MESAp.CA 92627
PflCN/ENGINEEfl:�7C4AJ48—z722 , ���\ BEG.NO.:NOP'r
aooaess: zd351 IRVINE AVE 1 uwiT:
PENMITTEE: SANTA ANA HEIGHTS 92707
aoosess:DENNI5 CHERRY { 714 ) 641-1505
211 WAL�UT 5�T �
UCENSEO CONTflACT PbECI}�RATION: I herehy ailirm Ihal 13m licen5�e -une r p�roviso � o C pter 9lcommencing wi�n Seciion
7000) of Oivision 9 0l Ue Business ana Pmfessions Cotle, antl my license is in t�ll foree and eHect.
CITY UG.: STRTE LIt.: \\ GLASS:
�aie: Signa�ure:
WONNEBS' COMPENSFTION OEClAHR710N: I hn�eDy afiirm Iha� I have a cetli�icate ot to sell-insure or a certitica�e ol Workers'
Compensalion Insurance, or a ceniiiea copy thereol (Sec�ion 3800, Lab. C�.
POIICY NO.: EXP. DFTE:
� . COMPpNY:
� Ceritlied copy is hereby �umishetl. ❑ Cepifietl capy is file0 wilh the ciry Builtling �ivision.
I � I
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Daie'. PPplicanl:
E%EMPTION iBOM WOflNEflS' COMPENSFTION OECLpqATION: (This sect eetl no� 6e comple 0 i� ermii is for one �untlred ($1W) or less�.
I cetlify thai in Ne pedormance o� �he work lor w�ich Ihis permit is u, I shall not e o y p n in any manner so as to become
sublec� �o 1 e Worker ' Compen5aiion Laws of Calilomia.
Daie' SignaWre'.
ICE:IL ter making ihis tleclara�ion, you shoultl become sublec� ta the rkers' Compensation visions o��he Labor
Code. yau mu5i totlhwith comply wi�h suc� pmvisions or lhis permi� sha e deemetl revokeA.
CONSTBUCTION LENDING AGENCY: I here6y aryirm Ihal �here is a constmction IenNng agency tor t e pertormance o� the wo�k for
which Ihis permii is issued (Seciian 3097. Qv. C�.
LENOEH:
AUDNESS:
OWNEfl BWLOEN OECIAflFTION: I hereby affirm Ihat I am exempi Imm ihe Contractors' Slaie License Law �or lhe following reason
(Seclion 7031.5 Business anG Pmiessional Cotle: Any cily ol county which requires a permi� to constmci, aller, impmve. demolish, or
repair any s�mc�ure. prior lo ils issuance, alm �eduires ��e apDlicanl for such permit Io file a signee statemen� ��at �e/she is Iicen5e0
pursuan� Io Ihe provisions oi Ihe Conlracbrs' S�aip License Law (C�apler 9(commencing wi�� Section 7000) at Division 3 of lhe Business
an0 Prolessions Cotle) or Ihal he/5he is exem0� �heretmm antl Ihe basis�lar ihe allegee exemp�ion. Any viotation ot Seciion 7031.5 �y
any applicanlior a permi� subjecis Ihe applican� lo a civil penal�y ol noi more Ihan tive hunOreO dollars (5500).
I, as owner ol ine pmpeny oi my pmployees witn wages as ineir sole com0ensation, will tlo the work, an0 ihe
al7 s�mcmre is not imenaea or ollere0 br sale (Seclion 7044, Business and Pro�essional CoOe- The Contractors' Sia�e License Law
does nal apDly lo an owner ol a pmperiy who buila5 ar impwves thereon, an0 who daes such work himsel�/hersel� or thmugh
�is ar her own emD�oyees, pmvide0 ��al such impmvemenis are noi intentle0 or oflered �or sale. I�, however t�e builAing o�
improvement is 5010 wilhin one year of compietion. �he owner will have Ihe bur0en ot pmving he/she tlitl nol �uiltl or impmve
forine purpose of salel.
I, as owner ol �he pmperty, am excNsivelk conlrac�ing wi�� licensetl conVactors �o cons�mct the projec� (Section 7044. Business
❑ ana Professions Cotle: The Conirac�ors' ��ate License Law does nol apply to an owner of pmpe�y who �uAtls or impmves lhereon
antl who coniracis �ar such pmle��s wilq a conimcloqs) license Dursuant to the Contracmrs' S�ale LiCense Law�. I am aware
��ai pmoi ol Iheir Worker'S Compensali4n insurance shaultl be pmvi0etl lo me.
� I am exempt under Section: B. 8 P. C.
for s ieaso :
Datey�� _ Owner
I tlo reby ce ty Ihal I am aware of antl unaers�antl Ihe requiremems o� Cali�omia Health an afery CoOe Seqions O5, 25533, antl
2553a antl tha� I or any �uture �uiltling occupanl willlwill nol (circle one) neetl ta comply wi� aitl state catles antl � requiremen�s �or a
permit for cansimc�ion or moOAicaUon �mm Ine Air �uahty Managemeni �i5iricL Besiaential conSUuc�ion appl¢a�ions are exempt Imm
lhese provisions.
�aie'. APplicanC _
I hereby ceriily Ihal I have reatl Ihis apDlicalion aptl state I�at
ortlinanws antl stalelawsrelating�o builaing con5imclion anaY
pmperiy lar s�ecti n purpases.
Dale'. Si9naturedL
�river L¢ense or Social Securily M:
is corr ydgree mply with all ciiy antl couniy
ma �.ain�5 lo �erupon�heabove�meniioned
� � d t�
t6GL46 Whne—Builtlmg'.Green— y— ppi � �
, Code Enlorcemenl: Canar A I canit Pink—Revenue; GOltlenro0—qssessor
CITY OF COSTA MESA - BUILDING PERMIT PE3.;:--N`, B 061458
PERMIT NO; B 061458 PLAN CHECK A30; 04881-92 I, GOVT; � SUPP; N
CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR P�POSE; NEvJ
JOB DESCkIPTION ;;+iEW ONE STORY SFD F TWO CAR GARAGE SQ FT; 3,235
CLAZM VALL3E: CALC-VAI�UE: 114,967.30 GROIIP OCC; R-3 /M-1
COMMENTS: EXISTZNG SFD & GARAGE TO HE DEMOLISHED ON SEPARATE FERMIT.
�!E if !E lE iE iE iE if 7E iF #!E iE �)E iE iE 3E iF it ik iE 3E 3E 3F if R� %iE # 1(� *?f 3f if 3t iE �)f iE �IE iE 3f �lE N� #� it iE 3F 3E 1F !(� if� 3f i(� # iFib-iE % iF iE iF 3E if 3F 1E iF � 1E #�lE *# iFlf Y ff 3f # iE
Z O N I N G k E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BCI2LDING ---------
FRNT; 20 FT IN REAR; 10 FT IN FRNT; FT ZN REAR; FT IN
LEF'f: 10 FT IN RGHT; S FT IN LEFT; F7' IN RGHT; F'T IN
PARKING REQ • 3 PItOi�; 3 PARCEL: 92417301 ZtJE; R2 REF NO: DR-92-2&
PLANtdING NtSTES> DEMO EXISTING,�3,E5 & REPLACE WITH NEW DETACHED RESIDENCE, 7
+> BEUROORM$. REp,�j STBR I5 SEPAkATION,P,E F T H
*x*�*�*�*xx**.�xx�****.�r*'*�r�t�rx'�tx�t�****�t*+��x�x�x��-x�*?axxx*��c*kxxx�x�-�rx�.�.��x�x�**xxx-*
D E V E.L O F M�E. N"T � S E R V I C E S R E Q U I R E M E N3�. S
ZONING APPROVED BY �. �' �` DATE; 3I Z2/q'1
HUZLDING APPRO�F�D� HY` : � � � DATE;, � '•'
APPLICATION ZSSUED �Y; � , 4'v �� GFj �� DATE• %.�� 2L
ic-1FitfF#ifkltk#it3kifi6�EifX-iEiFlEiF�fEx"f�Tr��FiSTriF3F3Ffr5fitx�t'F-irx�#�ir xx� i'F3fx�-x��tx�ir�rFx�iE#iE%�3E�tE�rti(N�iEx,.x� frxiEm:�.�iF
iF IE �lf ik ik ii if iF iE 3f iE if �iElF if� %� 3E iF 1f� M� If !! it iE 1E iE-IN�7ElE # iE iE ii� if it K� iF k 1E N�'!f !! iF i(�!F 7't iElf ih iF iF IE *iE iF fE if� 3E iF if i4 �F 7F if iE iF1't dF if" K# iEif 1F iE �E #'E
LEGALIZATION:N F E E S U M M,:A R•Y _ ..• 3TRUCTURA�' SEGMENT;Y
HLDG PMT PI�UMBING ELECTRIC.��M�CHANIC_ TM' FIR� �, SMIP/kE5 GRADING
PEkMIT 692.00 � 11,10
PLAN 449.80 ,! / � , �. .� 't SMIP/N�03-RES
ISSUE FEE: � % � r '•
i:;
HUZLDING-DIV-> PERNIT ISSUE RLAN-CHECK : 'TOTAL %� PAID DUE
TOTALS----> 703,93 0.00.--�" 4q', � ]153,73 !•1153,73 ,UO
�r li' . � . :�
REVENUE DIVISION TO'tAL5--> COLLECT.$D,; '� 703,93 OVER/�SHOR'P: 00
BLDG PMT PLUMBING ELECTRIC MECHAN�iC FIAE-;SMZP/TOT't'GRADING PLAN-CHECK
692.00 � • y, -- 11,•�3n/,.
*�***��x*���*xx*x�x•�*****�c��r**��*� ***�xxx�xx����***�,�*x�x�+��`"�x*� *�x�-�r�x*��x*�
ik �E '�' iF (F it
I N D I V I D tJ A-7.r F E!E ". Bj.R E� A R D Q"'W� N
TYPE QTY D E� C k I P T I O N. �, �. �,� J,_ .; UNIT �CC)�T TOTAL CO3?
5FR 1382 DWE-TYPE V-WOOD FRA,YiE�� � ' yCpOD ,c ='74' �DO 102, 263.00
5FC 1387. EC�iJ-RESIPENTIAL AIR COND %-;AVEA �J,t,85 3,938.70
SFR 471 ftfi5-GARAGES TYPE VEND-OF F,EES'�,-' ^ 1:�3,60 8,760,FU
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CONS7RUCTION AND PLANNiNG
APPROVALS Permit #
i. Temporary Elec[sical5ervice or Pote
2. Soil Pipe-Undrgrnd.
� 3. Electrical Conduit UtititY�Undrgrnd.
4. Electrical Conduit�Undrymd.
a
5. Steei Reinforcemenc
6� Eleciricai UFER Gmd.
7. Foot�ngs
8. Foundation
9. Water Pipe-Undrgrnd.
70. Structural Floor System
17. Properry Sewer Line & House Connection
12. Sewer Cap
73. Roof Orains
14. Rough Plumbing
15. Rouyh Electrical•Conduit
16. Rough EleCtric Wiring
77. Rough Wiring Sign
18. Rough Electrical-T Bar Ceilin9
19. Rough Heating & Air Condit�oning
20. Rough Factory Fireplace
27. Ducts,in Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof 5heathing '
26. T•8ar Ceiling (Structurall & Nonocoai
27. Frame and Fiashing
2$. Lathing & Siding
29. Insulation
30. Drywail Nailing
31. Plaster Brown Coat G
32. Electncal ?ower Meter�Finai �
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Ges Pipe-Test
36. Hood Or Canopy
37. Final �actory Firepiace
38. Pinal Plvmbing
39. Water Service�Final
40. Gas Service-Final T
41. Solar bomesticFinal
42. Backflpw Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuatio�
46. fiandicap Regulations
47. FINAI. STRUCTURE & BUILDING �
48. FINALPLANNING
49. Electric Release to Ed(son
50. Gas Re�ease to Southern Califomia Gas C<
51. CERTIFICATE OF OCCUPANCY
No. Date
Date
Pp(, . SPA
I,nspector AppROVALS Permit #
' 52. Poo4 & Equipment l.ocation ' ,
� 53. Steel Reinforcemeni �
• 54. Forms '
55. Electrical Bonding
56. Rough Plumbing & Pressure Tzst
57. APPROVALTOCOVER�GUNITE
58. Electncal Condu;t�Undrgrnd.
;
59. Gas Pipe, O U�drgrnd., Test
. 60. Backwash Lines, P-Trap, � Undrgrnd.
' 61. APPROVAL TO DECK ,- �
- 62. Backwash & Receptor-F�nal �
' 63. Heater & Vent-Fina� � /'
. 64. Plumb�ng SYstem - F�nal
' 65, Electricai�Final . . 'i
� 66. Solar SYstem-Final � � ,
67. Fencinq & Access AnProvai
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
� 70. Underground Hytlro
71. Product Piping O Ges U O�i
72. Underground Fiush
,/2� _ A 73. Undergrnd. Storage Tank � Gas ❑ Oi{
;y'/ 74, Overhead Hydro
7
75. DrY Chemical
�.��- 76. G� Y Standpipe
e-� 7''. FIXEp SYS7EM FIN,9L
� 78. FIRE PREV. FINAL
i -
� NEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
��
I No�e=: �,�: d,e. D...�./� . .
Date I Inspec,tor
� ��i � si� _ .
IZa C.ecl .cM 11..» P- S.�lvG .
�J/zZt/P3 i
6K
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Project Address:
F'INAL GRA�ING CERTIFICATION
742 �Veelo Drive, Costa Mesa
Lot Number• P�rtion of Lot 603, Newport Mesa Tract
Permit 1Vumber: � ��0 1�i- 5 8
By Civil Engineer:
1 certify to the satisfactur}• completion of grading in accordance H•ith the approved plans,
specifications, local and state codes. All drainage de��ices required by the grading permit,
grading plan and grading ordinance ha��e been installed. Adequate provisions ha�•e been made
for drainage of surface water from each building site.
'I�he minimumx are:
2% Fall from structures within 5 feet from exterior walls.
1°% Fal) for asphalt surfaces and landscaped areas.
0.5°� Fall fnr concrete surfaccs to approved disposal areas.
The final monuments as shown on the recorded tract map were set. All final grading eleva-
tions are within t 1/10 of the designcd elevations.
5upervising Civil Engineer �y. Reg. No. 35715
� , ign�t re)
Datc 9-23-93
�
; ESSIpNq�
M F • v F�
a��,cZ
�
35715. �
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P
Alpine�ConsultantM nc.
230'11 Moulton Parkwey, Suiee J-12 Tele: (7'14J BSSBOSB
Laguna Hills. CA 92653
September 23, 1993
Grading Inspector
City of Costa Mesa
Engineering llepartment
77 Fair Drive
Costa Mesa, CA 92626
Reference Project Address: 742 Weelo Drive Costa Mesa
Legal; Portion of Lot 603, Newport Mesa Tract
Owner: Tanaka
I certi£y to the satisfactory completion of grading in
accordancw with the approved grading plans, the speci£ications,
local and state codes. All drainage devices required by the
grading permit, qrading plan and grading ordinance have been
installed. Adequate provisions have been made for drainage
of surface water from the building site.
The minimums are:
2$ fall for structures within 5 feet from exterior walls.
1� fall for asphalt surfaces and landscape areas.
0.58 fall £or conc. surfaces, approved disposal areas.
��!/,Lk:Y-C�H^// ��
William F. Young.
R.C.E. 35715
Q�pEESSIONq� F
��O v`PM F Y�G 'Lcy
� ` 6' m
� 3 35�15 �
� �
Q�\♦c _ CIV1�- n2
CITY OF C05TA MESA .; �:'°
CA 1RNIA 92628•1Z00 � P. O. BOX 1200 . �
Insulation Certificate
;:7.
' '..�;'.:�' .;,,,�,
l/f0��7,'��J.,. � ,..
.. �`�� Gl/EEL o G�OS�'�Y /./�%s'A- � . � .
NW„� �,a s�« ctry , . . , .
��I./��✓G� - � .
- Counry Subdivision � ' � , � LatNumbu• � , . �
c _ I.
Description of Installation
ROOF �P � f �.t/Y�?C� .Ff/��'
Ma�crial
71�idrness (inches) , �-5 „
EXTERIOR WALL
Material �- � !/NGraGE�4 ,QfIT�s'
Thick+iess(inches) • 6"
HrandName /r%i�l�/Gr� .
7hermal Resistance (R-Velue) —�
Btand Narne /✓%/�r✓�/�G�' . .i ,. � :.� .
'Riecmal Resistance (R-Yffiue) —1%5 ' `-' '
CEILING • ; � -
Bau or Blanket Type B�TT Brand Narne /1iA.✓U,i'(� ' . ,
7hickness (inches) // " 7hermal Resistance (R-V�!'ue) ' � ' '
Loose Fill Type Brand Name � '
Contre�tor's minimum installed weighUft • Ib Minimum thiclrness' inches � •
Manufacuver's installed weight per square foot to acheive Thermal Resistance (R-Value) ' • '''' •
RAISED FLOOR
Macerial
'Ihickness (inches)
� SLAB FLOOR �
Material
'It�icl�ess (inches) '
Width (inches)
I . FOUNDATION WALL
� Matedal
'Ihickness (inches) '
; ,�� . �:::;' ��,r'',',a � ..
BrandNeme . ,�,a .. �'
'Ihertnal Resistance (R-Velue) `
� � '..�
' . ..
Brand Narne -
'ltiermal Resistance (R-Value) � �
. ^" , , -.
Brand Name � , �
'Ihertnal Resistance (R-Value)
Declaration '' ' `' � � �
I hereby cerafy that,the above insuladon was installed in the building at the above locadon in confotmance.wi4h "
the cwrent Building Energy Efficiency Standards fornew residenpal buildings contained in Tide24 of the�A "`. �r '
Califomia Administradve Code. . •
, ,' .
, ,'; � , _
GenernlContr�tor(Builder) � (jeenseNumber ' •� �
�� / Signp� and TiAe , .. . .
!.!/�L/..P /id�s'�/�Riio.�/ �O �.+/C ���ib �� •
Sub on tnrc� ion_ L^utaller) Lia e Number
.,� J /,r �!"����� �-�3��3 ,
Signenue�TiUe Date .
0
m
To:
.
-.
N. .'ORT-]S6SA UNIFIBD SCHOOL �;,"°�PRICT
CBRTIFICATB OF COZSPLIANCE OF DEVSLOPMSNT FBES
PIIRSDl�IT TO AB 1600 AND AB 181
�� City of Costa Mesa Plan Check No. �.L'��— 9�L
( ) City of Newport Beach
() County of Orange District Receipt No.
Applicant: � StSi'v� � T1�,.J,��c A
Address: "yj Q-'Z ���t-�C
Telephone Number: �7( Q- 5¢� Z.�1 ZZ-
Tract/Parcel and Lot Number(s): �
Location of Project:
Number of Sguare Feet of
Residential Space
Residential/
Sr. Citizen Space
Commercial and
Industrial Space
R&D Space
Warehouse Space
/ 38a
i � o o d�r,�v
/ ga, x $1.65 Total
x $ .27 Total
x $ .27 Total
x $ .2652 Total
x $ .2a,53 Total
Commercial/Industrial Project is:
Warehouses
R & D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
(Check One)
Motel
Bank
Neighborhood Shops
Racquet/Health
Hotel
Medical Office
Office Park
� � �
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
J/ This project is exempt because �-�� �70U ;D-9 -�•
This certifies that the above-named Developer/Applicant has paid school
facility fees in compliance with Government Code Sections 53080 and 65995.
The Building Permits for this square footage in this proposed development
may now be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified School District.
gy: ���a��' �"'�����
Authorize Representative
The above representation as to square footage is true. Applicant agrees
that if it is later determined that such representations are not true then
this certificate shall automatically terminate and the appropriate
City/County shall be notified. /� /.��� \
Date: 2 1Z �,�
ljcnf.��s ✓. c i�r� �...�/
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LIMITED STATEMENT Uf RESPONSIBILITY � etdg. Permit #
TO WHOM IT MAY CONCERN:
This Permit #
� �i- 2 V\� =.E � o �1��' "
� �-i 2�-I t� 3 � 1
Street Address AP Number
�, ' SAM U ��1�A�C,Q , as Owner in Title of the above referenced
property, do hereby authorize:
\, /� Alv.(IS �)• i�i�—���11ci1 �% ( � � �1 � � �7C� CJ
Name Telephone No.
9. i ) �vaLN UT s�-.
Street Address
'Z
to obtain permits in my behalf, as owner/builder, for dv � �`� ��C� P�-��'Y� ��T"5
at the above referenced property.
Should a^v� erson become an p.p�p�pyEg engaged in the improvement of. the property, I shall
immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
� claim resulting in damage or personal injury to myself or any other parties.
�S^N�A TANAKA
�zci�aic.w�?� �.-eG • � 3 . 43
Printed Name Date
�d=tL��c/ /I!.«-�1
� Signature
NOTARIZATION
REQUIRED
on�,,�.�a,
�
�
i�
PFOJECTRDOflESS: ' �42'WEELO DR
OWNEfl'SNAME: TANAFCA, ISAMU S
aoosess: TANAKA, YOSHIKO K
1846 WALLACE AVE
COSTA MESA CA
APCHIENGINEEH: � 7 1 4� 5 4 8— z� Z z
D.C.A.
aooaess: 20351 IRVINE AVE
PEqminEE: SANTA ANA HEIGHTS
anoness: DENNIS CHERRY
211 WALNUT ST
92627
flEG.NO.: NO
�:
CA 92707
(714)641-1505
C,M, CA 92626
❑CENSEO CONTFACTOfl DECLl�flATION: I hereby aflirm �ha� I am licensed unde� pmvisions oi ChaD�er 9 �commencing wiih Seclion
7000) ol Uivision 3 oi Ihe Busines3 antl Pmfessions Catle. antl my license is in fu�l force ana ellect.
CITY LIC.: SYpTE LIC.: C1A55:
�ate: — Signature:
WONREPS' COMPENSpTION OECLARp7�ON: I Aere�y aflirm that I have a certiticaie o� consent �a sell�insure or a certitica�e oi Workers'
Compensa�ion Insurance. or a cenihee copy thereol (Section 3800. La�. CI.
POLICY NO.: E%P. OATE:
COMFpNY:
❑ Cetlilietl capy is hereby fumi5he0. ❑ Ce�ified coDY �5 �iled wi�h �he city Building �ivision.
�a�e'. ADPlicam:
E%EMPYI�NFflOMWOPREBS'COMPENSFiIONOECIAPRTION: (Thisse�'.t�ee0na�b¢w IN4i��he�Y i SlaYnehUndr¢A�$1INl�orless�.
I certi� that in the perlormance o� lhe wa[k lo[ wM1ich I[tis pe�m[t 1 Ssu t sttall no� plo .rs in an manner so as �o became
sublecl Io Ihe orker ' Compensa�ion Laws ol Calilomia.
�ale: Signature:
NOTI : If. a ter making @is declaration, you should become subject lo ih orker5' Compensationp avisions of ihe Labor
Coae. you mus� lorihwi�h can�Ply wilh such provisions or Ihis Oarmit 5 �e tleemetl revoked. �
CONSTflUCTION LENOING AGENCY: I here6y allirm Iha� I�ere is a tOnstmttion 1¢nding agenty br e peeormance of tAe work Ior
wAich ihis Oermil is issued (Sectian 3097. Civ. C�.
LENOEfl:
AOOflE55:
OWNEB BUILOEF OECIABBTION: I hereby atlirm Ihat I am exempt �mm the Coniractors' Siate License Law �or �he �ollowing reason
�Seclion 7031.5 Business antl Prof¢ssional CoOe: Any city of cowry which requir¢s a permit �o coretrucL alter, impmve. Oemolish, or
repair any s�mcWre, prior �o iis is5uanre. also requires Ihe applicant �or such permi� Io file a signed slatement Ihai helshe is licensed
pursuanl to Ihe pmvisans of Ihe ConVactars' S�a�e License Law (Chapter 9(commencing wi�� Section 7000) o� Oivision 3 0� �he Business
ana Protessions Code� or Ihat he/she is exempl lherelmm and ihe basis for the allege0 exemplion. Any violation of Section 7031.5 by
any applicant Ior a permii subiectSlhe applican� Io a civil penatly of not more than five huntlretl Oollars (5500).
� I. as owner ot the DroOeny or my employees with wages as iheir sole campensation, will tlo the wark, an0 ihe
slruclure is not inlen0e0 or offeretl lor sale (Section 704a. Business an0 Pm�essional Cotle: The Conlractors' State License Law
Ooes not apply to an owner of a pmpeny who huilds or impmves thereon, ana who Aoes such work himselflherseli or through
his or her own employees. PmviOea Ihal such im0�a�emems are not imended or o��erea �or 5ale. II. however the huilding or
impmvemen� is soitl within one year pi comple�ion. Ihe owner will have Ihe burden o� proving he/S�e tlia not builtl or im0�ove
lor �he purpose of sale).
I. as owner a� ��e pmpetly, am e�clusively contraming wi�� licensed conirat�ors to cons�mc� �he prolec� (Section 7044. Business
❑ antl Pmlessions Code: ThF. Caniractors' Sta�e License Law aoes no� apply to an owner of pmDehY who 6uilU5 ar improves �h¢reon
and who coniracls for SucP Projects witA a conirat�ar�s�license pursuanito anVactor5' Siale License Law),I am aware
�hat D�ooi of Iheir Worker'S Compensa�ion insurance shoNd �e pmvitled me.
� I am exemp� under Sec�ion' B. 8 P. C.
Im Riis iees n:
�ale'. G Own :
I Ao herebY �e �y tha I am aware ol and un4er51an01�e repuirements o� Califomia Heal�h tl$afeiy Code Sec�ions O5, 25533, antl
2553a and tha� I or any IUWre 6uildmg occupam willlwill no� (circle one) nee0lo compry saiA sia�e cotles antl � eQuirements ior a
permit �or con5imction or mo0dicaiion irom Ihe Air �uality Managemen� DislricL Pesiden�ial constmc�ion applicat ns a�e exempi �mm
mese pmvisions.
Oaie: aDPlicam:
Ihe�eby cer�ilyihat I have reatllhi5 applicalion antl s�a�e�hal �he a e' lormation is rrecl. ee compty with all ciiy and c0unty
o�tlinancesanastalelavrsrelatingloDwldingconslmaionand0ere au rizerepres alives t' ci�ytoen�eru0oniheahove-memioned
pmpetly lor ms ecuon urposes.
Daie: Signalure:
' �river's L wnse o� N:
1641�C6 Whl�e—Building; Green—Code Enlorcement: Canary—Applicanf, Pink—Revenue', Goltlenmd—Assassor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IB 069356
PERMIT NO: IB 064356 PLAN CAECK NO: N GOVT: N SUPP; Y
CONSTRUCTION TYPE: 5—N PERMIT TYPE: OTH STR PURPOSE: NEW
JOH DESCRZPTZON : NEW ONE STORY SFD 6 TWO CAR GARAGE SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS: RE—INSPECTION PERMIT, RE: H-61958
�***�***�r**�r*****ir*x�rx�**ir*+�*�**i�****�****+r******�x�*�ae*+�***************�c*r+�+�f�*+r+r
2 O N Z N G A E Q U T A E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: PT IN REAA: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42417301 ZNE; REF NO:
PLANNING NOTES>
> =-%
�r**�t�rirx+t+c�itir*i�ir*rt*�r**�***+�x��r*x��r****+�*x-*�r**�x�t�tie*�***�r+t�**�*+�*+t*+r�r�rr*****+t+t*******
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E�.NyT S
y�.
ZONING APPROVED BY DATE:
BUILDING APPROVED BY ; DATE: �/�.
APPLICATION ISSUED BY: DATE: :-�IO
�*��*,«,«*�****�**����*�����������-�������.���,�������*�**�**�* 3
i! iE iE if if it if iE if iE i! iE 1E fk 1! 1E iElE iElf i! 1f i! i! fE �F k if 3f k 1E 1E �E ik iE 1F �E if it iF if k if 1E �f ik �f if 1E if 1! if iE if K 1f if iF f! iE fElf if if 1flE if 3E 1f !f fE 1f if if iE %aE if M
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 30,00
PLAN
ISSUE FEE
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 30.00 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBZNG ELECTRIC MECHANIC
30.00
SMIP/NON—RES
TOTAL PAID DUE
30.00 30.00 ,00
30.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
it i! iF it k k 7k iF if if iF ff 1E iF i! if !f iF k if if if k if k if iE iE ik if iE iE iE 1F iF iE it k iElf if !F %i! it if iF M iE if iE 1f fElf if !f if if iE ie 4 i! if 1f if ik if k iE 1f iE if fElf ik if if 1! iF
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I 0 N UNIT COST TOTAL COST
INS 1 BUILDIAIG AE—INSFECTION FEE 30,00 30.00
END OF FEES
Di II014345�4—GG14$4�4 T���'
rHT�: 10/07/93 Tit1E: 15:25
�
�
�
CONSTRUGTION AND PLANNWG POO� & SPA
APPROVAIS Permit # aate Inspector APPROVALS Permit # Date Inspector
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location r
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' �
3. Electrical Conduit Utility�Undrgmd. 54. Porms �
4. Electr4aa{ Conduit�Undrgrnd. 55. Electrical Bonding
- 5. Stee1 fteinfbrcement 56. Rough Plumbing & Pressure Test i
6. Etectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgmd.
6. Foendatfon � 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgmd. " 60. Backwash �ines, P-Trap, � Undrgrnd. �
70. Structural Floor System i 61. APPROVAL TO DECK '� � .
11. Property Sewer Line & House Connection , 62. Backovash & ReceptorFinai' '
72. Sewer Cap � . • � 63. Heater & VenFFinal � " � �
13. Roof Drains . 64. PSumbing SYstem - Final �
r�
14. Rough Plumbing � ./ 65. Electrical-Final ,
75. Rough Etectriral-Conduit 66. Solar SyStem-Final
16. Rough Etactric Wiring 67. Fencin & Access AnProval �
9 %% I
77. Rough Wiring Sign 68. APPftOVED FOR PLASTERING '
18. Rough ElectricaP-T Bar Ceiling 69. POOL(SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditionin4 FIRE DEPT, REQUIREMENT '
20. Ro�gh Fac:ory Firoplace _ �APPROVALS Permit # �
21. Ducts, in Structure . ' 70. Underground Hydro �
22. Ducts, Ventilatin9 ' 77. Product Pipin9 QGas OOii
23. Gas Pipa-Rough & Test - 72. Underground Flush
24. floofFraming • 73. Undergmd'.StorageTank OGas ❑Oii
25. Roof Sheathing 74. Overhead Hydro � �
26. T�Bar Ceili�g {Strucwrall & Monocoat 75. Dry Chemical ' �
27. Frame and Fiashing � _ , . 76. � Dry S.andpipe ,. �
(
� 28. Lathing & Sid�ng . � 7Z FIXED SYSTEM FINAL �
29. Insulation � �' 78. .FIRE PREV. FINP,L �
30. �rywall Naiiing � NEALTH �EPT. REQUIREti7ENT
31. Piaster Brown Coai 79. FINAI INSPECTION
32. -Eiearical ?ower MeterFinal �60. FOOD CERTIFICATE ISSUED
33. Finai, Electric � � Notes: . '
�34. Finai Heating & Air Conditioning � �
35. Final Gas Pipe-Te"st ` - . ' ., �
36. Nood or Canopy' _ . �
37. FinaYPactory Fireplace _
38. Finei Plumbing
39. LVater Service-Final -
40. Gas Service-Final . , . �
41. Solar pomestic-Final - .
42. 8ackflow Preve�ter ' �
43. Backflow irngation �
44. Landscape lrrigation System . � .
45. Sound Atienuation
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING ����� _ _
46. EINAL PLANNING. -
49. Electric Release to Edison
50. Gas Release to Southern Caiifornia Gas CA • .
51. CERTINCATE OF OCCUPANCY •
No pate
\ �
�
�
�
�
Pfl0.1EtT R6DflESS: •74 �� WEEL'O DR 7o t r , UNIT:
OWNEfl'SNRME:TaNAKA, ISAMU Jr
nooRcss: � ANAKA YOSHIFCO K
f 1846 WbLLACE AVE
COSTA MESAqCA 92627
lAflCHIENGINEEH: � 714 � •%4a-277z flEG.NO.:
aooecss: D , C ._A , NOAuNiT:
203�1 SRVINE AVE
PEBMITTEE: SANTA ANA HEIGHTS CA 92707
nooxess: DE211SWALVUTYST ( � �14 ) 641-1505
UCENSEU LON1flFLTOH U CIABATION: I hereby a�lirm t�a� I am Iitense0 und2r'p7ovisonS �LYiabiei 9(commencing m�A Seciion
7000� ol Drvision 3 oi tAe Business ane Pmlessions Cotle. ana my license is in lull force antl e�fecl.
CITY UC.: STATE IIC.: CLASS:
Oate: Signalure:
WOflNEBS' COMPENSATION OEUAPaTION: I nereoy aflum inat I have a cenilicale af cansent lo setbinsure or a cehificate o1 warkers'
Compensalion Insurance. or a cetlifieU coOY �hereol (Section 9800. Lab. C).
POLICY NO.: E%P. UATE:
COMPANY:
� Cenilied copY �s hereby fumishetl. ❑ Ceriified mpy is liled wilh �he tiiy BUiltling �ivision.
Oale: Applicant:
ESEMPfIONFflOMWOBKEPS'COMPENSATIONOfLIABATION: Qhiss¢ innee�not0ecomle�e0il ¢pe iti5toron¢hundreE�5100�oNess�.
I ceriily �nat in I�e petlormance ol Ihe wo�k for whic� �his permil i 5�etl. I shall no � D ny 5 � in Any manner so a5 io become
suEiect to .e Wor rs' CAmpensation Laws ol Califomia. / •
Da�e: Signa�ure: �
N ILE: t., atler mawng IAis tleclara�ion, you s�oulG Gecome suDlect to orkers' Compen o mdsions of the labor
CoEe. you musi lanhw�th comply with such pmvisions or ihis Dermit s i be�eeemee revokee.
CONSTBUCTION LENOING AGENCY: I hereby alfirm t�al there is a consimclion'IenOinp agency for I�e pedormance ol itle work lor
w�ich I�is permi� is issued �Stttion J097. Civ. C�. .
LENOEN:
AOOflESS:
OWNEB BUILOEH OECLAflATION: I her¢�y allirm Ihai I am exempt Iram �he CanVacmri Slate License Law �or the �allowing reason
(Seclian 7031.5 Business and Pmiessional Code: Any ciiy al counry w�ic� reQuires a permi� lo cons�NCL aller, improve, Oemoiish, or
repair any SVuc�ure. priar Io iis issuance, also re0uire5 I�e applicant �or such permii �o file a 5igneU slatement Ihat he/s�e is licensetl
Oursuam �o Ihe D�ovisions o� the Comracmrs' Sia�e Litense Law �ChaD�ar 9(commencinp vn�� Section 7000) of Oivision 3 al Ihe Busineu
and Pmfessions Cotle) or Ihal ne/she is exempllnerelrom ane ihe basis for IAe allegea ecemption. Any violation of Section 7031.5 oy
any a0�licant �ar a permii subjects ��e ap0liwnt lo a civil penaliy of no� mo�e Ihan live hun4re0 tlollars (5500�.
�I. as owner of i�e DmDany or my employees with wages as tAeir sole compensation, vnll Oo Ihe woA. anA I�e
stmcmre is noi imenAeO or oflered for sale (Secuon 70aa. Busmess anA Pmlessional Cotle: T�e Coniractors' State License Law
does not apply lo an awner al a D�operty wlp Guiltls or impmv¢5 t�ere0n, and w�o do¢5 Suc� work himtel�/hersell or I�mugh
�is or �er own employees. D�ovi0e0 ihal such improvements are nol imendeC or o��ereG lor 5ale. It, however I�e 6uBding or
impwvement is solC wil�in one y¢ar ol complelion, ��e owner vnll have Ihe burtlen ol O�oving �e/s�e tlitl noi builC or impwve
lor the Durpose ol Salel.
I. as ownerollhe OmDerly,am eMclusively coniracting wilhlicensed conlractorsto consimctlhe prolecl�5ection 7Ma, Business
❑ antl Pmlessions COAe: IDe Canlrac�ors' Siale License Law does not apply Io an own¢r ol pmpeM � builGs ar impmves Ihereon
antl who conlra[Is �m such pmjecls wii� a coniractor�s�license OurSuan�io I�e ConVaciors' $lale License Law�.l am aware
Ihat pwol o� I�cir Warker'S Compensalion insurance s�oultl be provitled �o me.
� 1 am esempl under Section: B. 8 P. C.
lo,�r i/his reason�
Oate: _��JY ZL/ � 3 Owne
t e
I tlo hereby cetli�y �ha� I am aware of antl untlerstand Ihe requiremen�s ol Cali�omia Health an aleiy Code Seciion 505. 25533, and
2553d and i�al I ar any fuWre Ouilding occupam wilVwill noi (circle one) need �o comply wii iU slate cotles an reQuiremems lor a
permil lor conSlmciion or moddication �mm �he Nii Ouabry Managemeni DiSVici. qe5iaen�ial conslmction a0 ions are exempt �mm
�Aese D�ovisions.
Oale: NpplicanL _
IhereGy certily�pa�l�ave reaG I�is appli[alion and stale lhal�Ae
or0inances anU 9ate laws reta�ing �o �wlding conslmnion and heret
pmperiy � in50ection purposes.
Daic3 SignaWra �
Oiiv .'S Litense or Sotial Secmily x:
is carr 1. I agree 1 mDN ��h all Lrty an� county
n�a ' S o � o r ler upon the above-mentione0
�6at-a6 Whne—Bmleing', Grem—Coee Enlorcemenl; Canary—AOOlicam; Pink—Revenue: Goltlenrotl—qssessor
CITY Or COSTA M�SA - BUILilSNG PER,�1iT PERM NO: P 061,F1
PERMIT NO; P 061461 PLAN CHfiCK NO; N GOVT: ,C SJPP; N
CONSTRUCTIflN TYPE: �-N PERMIT TYPE; PLU PJRPUSE: tit.W
JOB DESCRIPTION ; NEW ONE STORY SFD S'tW0 CAR GARAGE SQ Fi;
CLAZM VALOE: CALC-VALUE; GROUP OCC: R-3 /N,-�
COMMENTS; kE;#B61458
if # k# It iE if iE il±E # If iE ### iE iF iE # iE it if if # iE�lt# i(� it if 1E iF !h#1(� ik iE fE It it #lbif iE if iF # it ik iE iE if%iE it # iP i! #!h iE ih 3F ii ## fF �1f %1F it ±f iE ####?h
Z O N I N G ti E�i U I R E M E N T S
S E T B A C K S
------------ MA1N BUILDING ---------- --------- ACCESSORY BUILDING — ------
FRNT: FT TN REAR; FT IN FRNT; FT IN REAR; FT TN
LEFT; FT IN RGHT; ET' IN LEFT; FT IN RGHT; FT iN
PARKING ftEp � PROV; PARC�:L: 42417301 ZNE; kEF NO;
PLANNING Nt5TE5>
i "
ik it IE if 14 iF 3F iF 3EiE il� IF ##�lE it i(� iE iE iE 3E %k k IE ### iElE 1E 3E iE iF �lE if k�lE it9Eif iF if� iE ik jF #.�Fi(� iP if iE iE iF iE 3! IE �1F �Ik lE 3F N�# i( 3E i6 �E # IFiE If� iF i( N• iE # If !E if
D E V E L O P M E N T S E R V�'C E 5��, R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED HY ; � � DATE;
APPLICATION ISSUED BY; '"£� DAT'E: �I�-r � �
iFiFkikifiEiFifif9FlEiE1E7FiElEiE3fiElFif�iE�iF7F�iifii3�%�iF�iFiriti'tTe�£ ir if�Tc"iT%irititik�lEikit�ll7F#iFiE�(� fFiF��xn x %k
�lE iE iE # it if if # iE iF 1E If 1E ih-]f if iE-lE �7(� It iE iF iE if� N� iE %# jF�Jf if-�)E lF iE i(� �ff �lE :�f #!F if iE �1E iE?f iFif !E ik ## IF%# ib # iE iE if # K N� if lf� if #" 7E iF #�f iF 1E'1( iE iE :l� # 3E;f
LEGALI7,ATION:N F E E S U M M A R Y STRUCTfIRAL SEGMEUT;N
BLDG PMT PLUMHING ELECTRIC MECFIANIC FIRE SMIP/RES GRADING
PERMIT 98,00
25� SMTP/NON--RES
PLAN
ISSUE FEE 20,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 98,00 20,00 0,00 118.00 118.00 .00
REVENUE DZVISION TOTALS--> COLLECTED; 118,00 OVER/SHORT: 00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADIi�G PLAN-CHECK
118,00
-lf if lE it itlF lE i(-!F �IE * iF iE iF jf iC IE 3l� it 1f %iE k 7F iF 3E iE 1E iE �ltlF 3E jF �1f iE iE ik ik k iE iE %� � 1(� ih If�-%�IF iE iE if 3E ih �%3t 3(� M� iE K� K� % k� 3f 3F * iE-1F i(- 3k it 7t 3F iE 3F if �7f� K- ih �rt
I N D I V I D U A L F E E B R E A K D O W N
'TYPE QTY D E S C k I P T I O N UNIT' COST T'OTAL COSY'
PLU 2 BATHTUB '7,OU 14.00
PLU 1 DISHWASHER 7,00 7,00
PLU 2 SHOWER 7,00 14.OU
PLU i SINK, KIT'CHEN 7,00 7,00
PLU 3 WASH BASIN 7,00 21.00
PLU 2 WATER CLOSET (TOILET) 7,00 14.00
PL[J 1 WATER HEATER AND/OR VENT 7,00 "7,00
PLU 1 WATER SEkVICE 7,00 '7.OG
PLU 1 GAS SERVICE 7,00 "7.00
END OF FEES
�
. C� ST('+JCTION AND PLANNING
APPROVALS Permit #
7. Temporary E�ectncal Service or Pole
2. So�,l Pioe-Undrgrnd.
3. E!cctric3l Conduit UtilitY�Undrgrnd.
� 4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
� G E'�ctnca! UFEF Gmd.
7 Foot ngs
3. FuurcaUon
9. F:ater P�pe�Untlrgmd.
�. 10. SVuct�.rel Puor System
i i. Propc�ty S�v�er �ine & House Connection
1� 12. S��wer Cap
� 73. Roof Dtains
� 14. Fouah P1unu�nr�
15 Ro�gh Eiectrical•Condwt
; i6. RoughElectricWiring
17. Rough W�ring Sign
18. Rough Electrica6T Bar Ceiling
79. Rough Heating & Air Conditioning
10. Rough Factory Fireplace
21. Ducts, in Structure
22. Duas, Ventilating
23. Gas Pipe•Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Cedmg (Structurall & Monocoat
27. Frame and f-Iash�r.g
28. Lath:rtg 3i Siding
29. Insulation
30. Orymali Nadmg
37. Plaster Broivn Coat
32. Electrical Power Meter�Final
33. Finai Electric
34. Final Heaung & 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 pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape liripation System �
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING
49. Eiectric Release to Edison
50. Gas Release to Southern California Gas
51. CERTIFICATE OF OCCUPANCY
Date
Date
POt,_ & SPA
lnspector APpROVALS Permit ;�
_ 52. Pool & Equipment Locaunn
/
53. Steel Reinforcement
54. Forms •
55. Electrical Bond�ng
56. Rough Plumbing � Pressure Test
57. APPROVALTOCOVER�GUNiTE
56. Electncai Condu�,t�Undrgmtl.
' 59. Gas P.pc, rJ Undrgrnd., Test
�� , 60. S�ck�vash �ines, P�Trap_'"-' Urdrgmd.
� 61. A?PROVAL TO DECK �
� '_�� 62. Baekevash & Rceeptor�Final
63. Heatar & Vent-Final ',
64. Plumb(ng System - Final -�
(�L(J 65. Electrica�-Final � �
i
66. Solar System�Fina! _ ,
67. Fencing & Atcess APproval � �
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENY
APPROVALS Permit ;r�
70. Underground hlydro
77. Product P'p�rg ;7 Gas �70i1
72. Undcrt�rowid Flus'i
i3. Undergmd. Storag�.: Tank C� Gas '� C�
74. Overhead Hydro
75. Dry Chemical
76. Dry Standp�.pe
77. FIXED SYSTE'r1 FiNAL
78. FIRE PREV. F�NAL
HEALTH DEP7. REQUIREAiENT
79. FINAL INSPECTIC^! _ I
80. FOOD CERTIFiCATE ISSUED I
��
0
Notes:
Date I inspector
: ii
�li
�
�
PNOJECiAOOflESS: a742 NEELO DR IlNli:
OWNEfl'S NPME: TANAKA. ISAMU S
anoness: TANAKA YOSHIKO K
1846 WAI�LACE AVE
. COSTA MESA CA 92627
FflCH/ENGINEEF: � 7 1 4� S 4 8— Z� 2 2 NEG.NO.:
nooncss: D C, A. NOIy�NiT:
2d351 IRVINE AVE
PEXMITTEE: SANTA ANA HEIGHTS CA 92707
aooness:DENNIS CHERRY ( 714 ) 641-1505
21] WALNUT ST {�%
LILENSEU CONTBACTOHbECI}�FATION: I hereEy a��irm �ha� I am Iicen5e0 unECAmi5mn,25 0/ GFapier 9(commencinp wi�� Sec�ion
70110� oi �insion 3 0l Ihe Business a� Pw�essions Catle, and my license is in �ull lorce an0 etletl.
GTY LIC.: STATE LIC.: CLASS:
Dale: SignaWre:
WOBKEflS' COMPENSATION OECLABATION: I here�y aflirm ihat I �ave a cetlificate o� consent to sell�insure or a cetlilicaie ol Workers'
Compensation Insurance. or a certilietl copY �hereof (Section 3800. Lab. q.
POLICY NO.: EXP. DATE:
COMPRNY:
❑ cenmea coov �s nereey mr��snea. ❑ CeNfied copY is liletl vnt� the ciry BuilJing Oivision.
Dale: ADPlicant
EXEMPTION FflOM WONNEPS' COMPENSATIDN OECLAPpTION: (T�is el on need noi Ue co B� �'�he Dermit is for one hwdreG ($1W� or less�.
I cetlily Ihal in Ihe Oerbrmante ol Ihe work lor which I�is permi ' is ed. I Shall n� m I an� p son in any manner so as lo Oecome
' suhleciy�o /�ye _Wo/r¢ers' Compensation Laws ol Calitornia.
Oaie:��C.4�� 3 SignaWre: '
NDfICF: If al�er making IhiS 4eclaraiion, you shoultl become suGjeci 1 e Workers' Compensaf mvisions o� Ihe Labor
Code. you musl Iorlhwii� comply wilh suc� pmvisions or ihis permit all 6e deemed revoked.
CONSTflOCTION LENOING AGENCY: I here�y aliirm ��at �here i5 a ConS�mCiion lending agenCy lOr �he perbrmance oi t�e work fOr
whicA Ihis permi� is issuetl (Section 3097. Civ. C).
LENOEfl:
A�ONESS:
OWNEfl BUILUEP OECIAfl�TION: I �ereUy aifirm Itwi I am ¢xem0� ��om �Ae Cantracbrs' State License Law lor I�e lollawing reasan
�Seclion 7U31.5 Business an0 Pwiessianal Cotle: Fny ci�y of counry which reQuires a De�mit Ia con5imc�, aller, impmve, Eemolish, or
reoair any simcture. prior to its issuance, also reQuires the applicant lor sucn permit to lile a sipnea stalement inat he/she is licensed
pursuanl io Ihe pmvisions ol lhe ConVacmrs' Slate License �aw (C�apler 9(commencing with Section 7000) o� Divisian 3 0l Ihe Business
an0 Prolessians CaOe� or Ihal M1e/she is exempt there�mm ana ihe basis tor �he allegetl exemplion. Any violation o� Section 703L5 by
any apP�icantlor a Dermil SuUjeclS �he applicantlo a civil penal�y o� noi more �han �ive Auntlre0 dollars �E500�.
� I, as owner ol 0e D�operty a� my employees vnih wages as �heir sole compenu�ion, will GO Ihe work, anG I�e
simctureis nolinlenAeO arollereClar sale�Section 70Cd.8usine55 an0 ProfesSionalCotle: The Coniractors' Slale License Law
" eoes noi apoN to an owner o� a prooenY who buiias ar imD�oves ihereon, antl wno tices such work himsetuheruu or tnmuAn
�is or �e� own empl0yees. pmvidee ihat such impmvemenis are not inten0e0 or oflered lar Sale. If. Iqwever itle OuilOing or
fmowvemenl is sol� wii�in one year ol completion. t�e owner will �ave ihe hur0en ol O�ovinA he/stle did not Oui10 or impmve
lor 1�¢ purpo5e ol Saie).
I, as owner o� Ihe pmpetly, am evClusively conirac�ing wi1� licensetl mmracmrs to constmcl ��e prole�� (Section 704a. Business
❑ an0 Pmiessions CoOe: The Coniractors' Slaie License Law Uoes nol appty to an ovmer ol 0�apertp wAo builas or im0�ove5lAereon
and w�o conlracis lor such pmjects vni� a coniractor(s�licen5e pursuant�o ihe Contraclors' Stat¢ LiCense Law�.l am aware
t�ai prool ol I�eir Worker'S Compen5ali0n insurance s�oNE Ee pmvitletl to me.
� I am ecempi un0er Section: 8. 8 P. C.
�Of illi �Ed50�:
Oale: Owner
I tlo her y cetlily t�a� I am aware ol antl understantl Ihe requiremen�s ol Cali�omia Heali� ana ely Cotle $ections 5, 25533, antl
255� an0 t�a� I or any Iuiure UuilOing occuDant will/will not (circle one) neea �o compty with iA sla�e cades anU 1 puiremenis for a
permii foi consimclion or moailicalion Irom Ihe Air Oualiiy Management Uisirict. FesiEen�ia con5lmciion aDPlicat ns are ezempi irom
Ihese pwvisians.
�ale: FpDlican�:
I �ereby cerlAythat I havereatl Ihis aDPlicalion antl slate��atihe a e in�armation is c rre agfeq �o comply wilh all cily and counry
orAinances antl slaie IawS relating Io builtlmg conSlNction and �er a horize represe 1 0l I 5c y �o enier upan Ihe a0ove�menlione0
prope^ity lor nspeclion purposes.
Date�j��{.l�3 SignaWre. M1
L
Oriver�Lrtense m Social Securiiy n:
i6aLa6 Whuo—BUJdmg�, Green—Catle Enlorcement; Canary—Applicant Pmk—Revenuo; Goltlenrod—Fssossor
CITY OF COSTA MESA - AUILDING PERMIT PERM NO; M 061460
PERMIT NO; M 061460 PI,AN CHECIC NO; N GOV1'; N SLIPP; N
CONSTRUCTION TYPE: 5-N PERMIT TYPE: MEC PURPOSE: NEW
JOB DESCAIPTION ; NEW ONE STORY SFD 6 TWO CAR GARAGE SQ FT:
CLAIM VALOE: CALC-VALUE; GROUP OCC: R-3 /M-1
COMMENTS: RE�#B61458
�#�r�r**� �r*�*�**�ru*x*�**��*x�#x�x+t*�t�e#�r�r*� �x���#�t�*��*�t�#�*�*�r��**#x��#x*�xx#��*�r*
Z O N I N G R E Q U Z R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY Bi7ILDING ---------
FRNT; FT IN REAR; FT ZN FRNT: FT IN REAR: F'I' IN
LEFT; FT TN RGHT; cT IN LEFT; FT IN RGHT; FT TN
PARKING REO• PROV; PARCEL; 42417301 ZNE; REF NO;
PLANNING NGTES>
> -
• �t#�**it*x�*�x�itir-x��t*�t�trx-x��t***#iti��r#�tir���rx**#it�it�t�t�-�t#�rit-x�tt-�t�#*#x��#****tt#x�**��xx�3rx��tit#*#*�t�f�i�
D E V E L O F M E N T S E R;V I C E•$ R E Q U I R E M E N T S
20NING APPHOVED BY % • DATE;
BUILDING APPROVED HY ; DATE:,. __�1
�APPLICATION ISSUED BY• �� � DATE:�I2't-I
�1hiEiFlhkiEiPiEiEiFikiE�lFiEifik3E%�iElf��lF . . : ' .� . ' .n.. . iflF�Jff't-I4iEi(�iF�X�k�3'F�x. . . -ux- �%-�li
iflf%iflf�lEN�kiFlFitif�i(�iE�ltiEiF3kiE�1E1f1E1fiEiFifM�1E3f1Ei('lEiliflf%� iEiEjE36N�iEii�IFl6ifM�3Fif�!(�iEiEl6ikiflE7f�H•7FflfPlFN��lki61f1f�1biF3f�if�)h'ltlEN�N-Itdt
LEGALIZATION;N F E E S U M M A ft Y STRUCTURAL SHGMEiVT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 18,50
25F SMIP/NON-RES
PLAN
ISSUE FEE 15,00
BUILDING-DZV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 18,50 15,00 0,00 33.50 33.50 .00
ftEVENUE DIVISION TOTALS--> COLLECTED; 33,50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTkIC MECHANIC FIRE SMIP/TOT GRADING FLAN-CHECK
33.50
M if # 1f if i!• if if ik 1f ih i4'1f'lf if f! if if 1f if if' IE if ii ik iF il' i!!F iE ff 1! 1FlE �f 1("!E �1E iPif # tf 1E # ff iE'X' iE lFiE if �f if if i%iP 1%if if iF 1f if i!!f iklf±P �F 1i I(' i[' iP iE if iE {f iF #!f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P 1' I O N UNIT COST TOTAL COST
MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9,00 � 9,00
MEC 1 GAS PIPING SYS 1- 4 OUTLETS 3.00 'S3,OU
MEC 1 FACTORY FIREPLACE 6,50 6,50
END OF FEES
CONSTRUCTION AND PIANNING
APPROVALS Permit i'r
i. Temporary Electncal Service or Pole '�
2. Soil Pipe�Undrgrnd.
3. Electncal Conduit Utdiry•Undrgrnd.
4. Electric3l CondwbUndrgrnd.
5. Steel Reinfo�cement
6. Electrical UFER Grnd
7. Footings
8. Foundation
9. 4Vater Pipe-Undrgmd.
10. Structural Floor Svstem
it. Property Sewer Line & HouseConnection
12. Se�.ver Cap
73. Roof Dra�ns
14. Raugh Piumbmg
75. Rough Electriwl�Conduit
16. Rough Electric 6Viring
17. Rou9h 4"Jiring Sign
18. Rough Electrica6T Bar Ceiling
19. Rough Heating & Av Cond�Loning
20. Rough Factory Fireplace
21. Duttt, in $tructure
22. Ducts. VentilaUng
23. Gas Pipe�Rough & Test
24. Roof Framicq
25. Roof Sheathing
26. T-Bar Ceihng (Structurall & 1lonocoat
27. Frame ar.d Flashing
28. Lathing & Siding
29. Insulation
30. Dry�•�all Nailing
37. Plaster Brown Coat
32. Electrical ?ower MeterFinal
33. Final Electric
34. Final Heaung & Air Condrtioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. final Factorv F�replace
38. Final Plumbing
39. Water Service�Final
40. Gas Servi�e-Fina�
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape irnpation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Souihern California Gas Co
No. Dare
Date
PO(,.. & SPA
Inspeccor APPROVALS Permic,-� Date
52. Pool & Equipment Location '
53. Steel Reinforcement .
54. Forms � �
55. Electrical Bonding
56. Rough Plumb�ng & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Elactncai Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Oacic�vash L�n�s, P�Trap, O Undrp�nd.
' � - 61. APPROVAL TO DECK :
62. Backtvash & Receptor-Final � . •
� 63. Heater & Vent-F,rai '
i� -
� 64. Plumbir.g Sys'em � Fi�al •
G5. ElectricabFl�al .
66. Soiar SYstem-Finai ' '
67. Fencing & Access Approoal �
68. APPROVED FOR PLASTEqING
69. POOUSPASYSTEP:7SFINAL
[�7 FIRE DEPT. REQUIREMENT
APPROVALS Permrt �
70. Underground Hynro
71. P.oduct Pipin9 �Gas ❑Oil
72. Underground FI z�i
73. Undergrnd.StorcgeTank ��Gas �0�1
74. Overhead Hydro
75. Dry Chem�cai
76. Dry Standp�Ge
, 77. FIXED SYSTEM FINAL
� 78. FIRE PREV. FItJAL
HEALTH DEPT. REQUIREMENT
' 79. F�NAL INSPECTION
� 80. FOOD CERTIFICATE ISSUED
Notes:
Insp2qmr �
,Y
�
�I
�I
� PpOJECi AOOflESS: � � UNIT:
OWNEH'SNPME: �4z WEELO DR
aooeess: tANAKA� YOSHIKO K
1846 WALLACE AVE
COSTA MESApCA 92627
PflCH/ENGINEEH: � 7 S 4! S 4 8— � 7 z 2 pEG.NO.:
aooaess: D, C. A, NOPuNiT:
20351 ZRVINE AVE
reeminee: SANTA ANA HEIGHTS CA 92707
aooeess:DENNIS CHERRY (714)Fi91-1505
211 WALNUT ST 9
LICENSEO CONTRACTQ OECtABA710N: I �ere6y allirm iAa� 1 am Iicense0 un0�p �ison�ol C�apter 9(commencing wit� Sec�ian
7000) o� Division 3 al I�e Business ane Pmfessions CODe, and my license is in full lorce an0 eifeci.
GTY LIC.: ST�TE LIC.: CUSS:
Dale: Signature:
WOHI(EflS' COMPENSFTION UECLAflATION: I AereDy allirm t�al I �ave a cenificate ol consent lo seli-insure or a certificate oI Workers'
Compensatmn Insurance, ar a[endiea copy Ihereol (Seclion 3800, La�. C�.
POLICY NO.: E%P. DFTE:
COMPANY:
❑ Cer�ifietl copy is hereby IumiSheU. ❑ CetlilieU coDY is liletl wit� the city Builtlinp Oivision.
Date: AODlicam:
EXEMPTIONFAOMWOBKEflS'COMPENSRTIDNUECIAflPT10N: Qhis ¢ neeEnotbeco e� Ihe ermi�i5bronehwMreE�$t00�orless�.
I cetlity Ihal in Ihe pedorman[e a� the work �or whi[� t�is permi�' iss ed, I shall no m any pe in any mannecso a510 �ecame
subl�� �o e Wa� ert' CAmpensaiion Laws ol Calitomia. -
Daie: SignaWre:
ICE: I, alier makmg I�is Oeclara�ion, you s�oul0 become suDle�� �0 1 orkers' Compensalion pryyi ions o� �he La6or
Code. you mus� lohhwilh comO�Y w��h such provisions or this permit 5 be deemetl revokeA. f'
CONSTHUL710N LENUING RGENCY: I �ereUy affirm inat t�ere is a canstmction IendinA aAency lor ihe peAormance of t�e work br
wnich this Oe�mi� is issued (Section 3097. Civ. CI.
LENOEP: ^
PODNESS: '
OWNEfl BUILDFfl OELLAflATION: I hereby afiirm Ihai I am exempl tmm Ihe Contraclors' State License Law �or t�e followinp ieason
�Seclion 7031.5 Business anC Pro�essianal Code: Any ciiy ai counly w�ich re0uires a pe�mi� Io constmci. alter, improve. Aemolish. o�
cepair any 5lmcture. prior lo i�s i5suance, also repuires llle applicant for su[II permil Io lile a sign¢E siatement Itui he/sh¢ i5 Iicen5e0
pursuanl io Ihe piovisions a� ��e Gantraclors' Sta�e license Law (ChaO�e� 9lcommencing wit� Section 7000) of Oivision 3 oi ihe Business
anG Pmlessions Code� or Ihal he/she is exempt I�erelrom an0 Ilie Dasis for Ihe alleged exempiion. Any violaiion of Seciion 7031.5 �y
any apPlicanl lor a Dermit suhlecis t�e aD�licant to a civil penally of not more itWn five �undretl Oollars (5500�.
� 1, as awner of Ille pmpeny or my employees vnN waget as iheir sole comDensdtion, vnll Eo t�e work, an0 t�e
slmcmre is not inrenaed or of7ereU for sale (Semion 70aa. Business and Pmfessional Cade: TAe Coniractors' State License Law
tloes not apply �o an owner o� a pmpetly who builtls or impmves Ihereon, ana who tloes such work himself/hersell or IhrouAh
his ar her own employees. pmvitlea t�at such impmvemen�s are nol inlenaetl or otleretl �or sale. It, howeve� �he �uilUing o�
im0�ovemenl is soltl wit�in one year ol com0lelion. Ihe owner will �ave Ihe Ourden ol pwving he/she tliA noi builU or improve
�or ��e purpo5e o� sale�.
I, as awner ol Ihe proper�y, am exclusivelp conlmcling wiih licensed cantracmrs m consimci Ihe pmlec� (Sec�ion 7044, Business
❑ and ProleStions CoOe: The Conlractars' State License Law tloes nol apDly to an owner ol provenpwho builes or impmves Iher¢on
anC who comrans lor such pmjecis vui� a caniracmr(s� license pursuam ro t�e ConVadors' Slate License Law�. I am aware
t�at O�oof of their Warker's Compensation insurance 5�ou10 6e D�aviQeE to m
� I am exemD� under $eclion: 8. 8 P. C.
forl ' reaso :
oaie: L P�vne
I tlo her y cetlil hd� I dm dwa�e o� d�0 und¢�SId04 I�¢ r¢qUi�¢m¢n15 0� CalilOmia H¢dllh dn Ie�y Cotle Seciions 255 , 25533, antl
2553< and Ihal I or any �Wure builtling occupam will/will nm (ci¢le one) neetl Io comply wit ai0 stale wEes ana Ihe re vemenls lor a
permil lor wnstmction or mo0iticalion Imm I�e Air Oualiiy Managemen� Disiricl. Resitlenlial con5lmciion applications are e�emD� ��om
I�ese pmvisions.
Uale: AO�licanl: _
I heie�y ceitilyi�al I haverea0 Ihis appli[ation ana slatet�a�
a�Omances ane s�ate laws �elaung �o bwlding cons�mciion anC 1
pmpeny lar ISOQ��iO pYlQOSCS-
Date: � Signawre�
�river'S License m Social $ecuri�y #: � �
16aFa6 Whnv-6wltling; Green—CoOe Enlorcemenl: C
in�ormation is corre . �omply wiih ail city an0 couniy
uizerepresentat I�rs lo nleruponlhe above�menlioneC
Pink—Revenue: GOIGenroe—Auessor
� .., ,
CYTY OF COSTA MESA — BUILDIi�iG PE;AMI'1' PEkN, NO; E 067459
PERMIT NO: E 061459 PLAN CHECK NO; N C,OVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PQRPOSE: NEW
JOB DESCRZPTION : NEW ONE STORY SFD & TWO CAR GARAGE Sft FT;
CLAIM VALUE; '� ` CALC—VALUE; GROUP OCC; R-3 /M-1
COMMENTS; RE;#B61458
#iEkifiFiE#K-IEftkX�lFkiEiEltikiE#iFi(-iE#iE#kiE#iEiF�IE#iE1E1EiEikiF#!E##iEiEiEx�it}f#ftikfElEffifitiElEiFiElE#ih1t1F#%fEi6*M�%�#ikif�h#iE
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ------
FkNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN kGFIT; FT 1N
PARKING REQ• PkOV: PARCEL; 42417301 2NE: REF NO;
PLANNING Nt5TE5>
> � i
1F iE # iE �lF jP iE if ik ik i! # 1! iE if !E 3E iE iF if 1E ik ft it il� # it iE # M# if iF ifdf k iE it it ik fE iElElF �lE �JE if iclf iE df iF %� if if if� i(� fE iE it if ib iF i(� if� tE iE iE !F iE if if iF iE if if i(� )f �lf
D E V E L O P M E N T S E A"V I C E S R E Q iJ I R E M E N T 5
20NING APPROVED BY ' • DATE:
BUILDING APPROVED BY ; DATE;
APPLZCATZON ISSUED BY; C�--�l'V��� DATE; 1L(
K�iF3EitiEif�N�ifiElfK�1F1f�7faklFiFitiEititir3C7F7i�3Fii�iFiFlF7F7F7FiF�iF3F?FiFiT-irx��ti'F- fi�'T�xti3Fi2�irir7Fie�ki6ikiF#jti(�7E#iFxtr]�x�rl it�ri �iFM�
lE 3F iF 1F # if if if it iEif ih k iE iE 16lF �% ft )h 1f �IF )F IE% if K� iE ih 1E * iE iE'+k if 1! if 1E # iFiFlf 1E 1E �M-ik iF �If if #!E iE ik ih IE %IEif iF �% N- iE # M� ib 94 # iF # 1E !f ik %�ik 7E #!k i4 i't
LEGALIZATION;N F E E S U M M A R Y STRUC'PURAL SEGMENT:t�I
BLDG PMT PLUMBING ELECTkIC MECHANIC
PERMZT 61,65
508 '
FIRE SMIP/FtES GRADING
SN,IP/NON—RES
PI,AN
ISSUE F�E 15,00
BUZLDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAZD DUE
TOTALS----> 61.65 15,00 0,00 76.65 76.65 � ,00
REVENUE DIVISZON TOTALS--> COLLECTED: 76,65 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC•' FIRE 5MIP/TOT GkADING PLAN—CHECK
76,65
IE iE 7E iE if if iE If 3f if if iE if 3E iE 3E it iF IE iE iE iE iE �1F iE # iE if iE iE IE lE �f # it-k # iE # i% iF iF iF lf iE i(� #�lE iF i(� iE iF H• # iE if iE iE I(� # iF if iE !f # if !E �7f iE iE iE �E iF# 1f+F K� iE if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O.N ' UNIT COST TOTAL COST
ELE 20 FIX7'URES, LIGHTING i S.T �0 EA, ,75 15,00
ELE 9 FIXTURES LIGHTING ADDITIONAL EA, ,45 1,80
ELE 20 RECbPT/OGTLET 1 ST 20 EA. ,75 15.00
ELE 28 RECEPT'/UUTLST ADDITIONAL EA, ,45 12,60
ELE 20 RECEPT/SWI1'CH 1 ST 20 EA, ,75 15,00
ELE 5 RECEPT/SWITCH F�DDITIONAL EA. ,45 2.?.5
END OF FcE5
)'�`
J � CONSTRUCTION AND PLANNING
''< < Date lnspector
i APPROVALS Permit �� ,
t. Temporary Elecvical Service or Pole
2. Sod Pipe-Undrgrnd.
3. 'clectrical CorduR Ut��ity�Undrgmd.
4. E!ectrical Condu4-Undrgrnd.
5. Stee� Reinfo.czment
6. Electrica: UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe�Undrgrnd.
70. Structural Floor System
9
11, Prop=rty Sewer Line & House Connection , �
; 12. Sewer Cup
73. Foof Ore �s
14. Rough P;;,mbinq
15. Rou�h Eiectrlwl•Conduit
76. RoughElectricWiring
77. Rough!^dirmgSiyn
18. Rough Electrica6T Bar Ceiling
19. Rouyh Heating & Air Conditioning
20. Rough Faaory Fireplac2 �
2L �ucts, in Structure
22. Ducts, Vent�iac�Rg
23. Gas Pipe-Rough & Test
24. Poof Frami�g
25. Roof Sheathing
26. T-Bar Ce,ling (Structurall & Monocoai
27. Frame ard Flashing
28. Lathing & Siding
29. �nsulatio�
30. Drywall Nailing
37. Piaster Bro�vn Coat -
32. Electncal Power Mete��Firal
33. Final Eletttic
34. Pinal Heating & Air Cond�tioning
35. Finai Gas Pipe-Test
36. Hood or Canopy
37. Final Fattory Fireplace
38. Final Plumbing
39. 1Vater Service�Final
40. Gas Service�Final
41. Solar OomeeticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape I�rigation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas
51. CERTIFICATE OF OCCUPANCY
Date
u
J
A
POOL & SPA
APPROVALS Permit �
52. Pool & Eqwpment LocaGon �
53. Steel Re�nforcement -
54. Forms
55. Electrical Bonding
56. Rouyh Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas P�pe, � Undrgrnd., Test
60. Backwash Lines, P-Trap, �1 Undrgrnd.
61. APPROVAL TO DECK •
62. Backvrash & Receptor-Final ��
i
63. Heatcr & Vant-Fina� �
64. Plumb��g System - F�ne;
65. Electrical-Final
i�6. Solar System�Finai ;
67. Fencing & Access Approvai � i ,
68. APPROVED FOR PLASTERING �
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product P:ping O Gas C Oil
72. Underground Flush
73. Undcrgmd.StoragcTankOGas ❑Oil
74. Ovenc�ad Hytlro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINA�
78. F�RE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERT.IFICA7E ISSUED
Date � Inspector
i
I'
��
�
�
PPOJECT p00PESS: 7 4 z WEELO DR UNIT;
OWNEH'SNRME:TANAKA� IJ�I�i"iU S
AOOPESS: TANAKA YOSHIHO K
1846 WP�.LLACE AVz
COSTA MESApCA 9262�
APCN/ENGINEEfl: � 7 1 4! 5 9 8— z 7 Z Z NEG.NO.: �
aooaess:DOj51�IRVIhE AVE NOty��T,
eeammee:SANTA ANA HEIGHTS CA 92707
AODflE55:UENNIS CHERRY ( 714 ) 641-1505
211 WALNUT ST �9
LICENSED CONTBqCTOpb CIABRTION: I herehy allirm tAat I am Iicense0 una¢Cr p�roviso �oYChdD�er 9(commentinA wilh Seciion
70001 oi Division 9 0� Ihe eusiness and Pmlessions Catle. and my I¢ense is in NII lorce anA eifeci.
CITV LIC.: $TRTE LIC.: CIASS: ,
Daie: Signamre:
wOPNEflS' COMPENSATION DECLABA7IOx: I nereey aflirm inat I have a cenificate af consent to sell�insurt or a certilica�e of workers'
fqmpen5aiion Insurance. ot a ceNfied copY �h¢reol (SecOon 3800. 1a0. C�.
POLICY NO.: EXP. OATE:
LOMPANY:
❑ Cenifieu cooY �s hereby tumisnea. ❑ Cenifie0 copy is litea vulA Ihe cily BuilEing OiNsian.
Date: Apvlicant
E%EMPTION FROM WOXKEflS' LOMPENSATIDN OECLAPRTION: (TAis cl n nee0 nol 0e complp}e er - Is lor one huMreU �5700) or less�.
I certily ��at in ihe pedormance oi IM1e work lor w�ich this permi is e0, I Shall n01 'I�lo' y on h any manner 50 as �a betome
SUUject lo Ih Worker ' Compensation Laws al Calilomia.
�
Da1e: ` Signaiure'
NO tE: tl. [er malting ��is declaraiion. you s�ould Oewme SUGject Io 1 arkers' Compen5aiion,� dsions o� l�e LaGor
COOe. you mu51 �orthvni� cOm01y wilA SutA provi5i0n5 ar I�6 p¢rmii 5 il pe 0¢¢metl r¢vOkeA. V
CONSTflUCTION LENOING RGENCY: I hereGy atfirm tha� Nere is a canStmCiiOn I¢naing agency far t�¢ petlarmanCe o� Ihe wnrk for
whit� Ihis permi� is i=suetl (Stttion 3097. Civ. C�.
LENOEfl:
ADOHESS:
OWNEB BUILOEfl DECLABATION: I hereby allirm Iha� I am exemp� imm the Conlrac�ors' State License Law lor �Ae lollowing reason
ISection 703t.5 Business and Pmfessional Cotle: Any city of county which Bquires a permil to constmct, alter, improve, aemolisA. or
repair any slmcWre, pnor to i�s issuance. also requires the applicani lor suc� Oe�mit to lile a signetl s�atemenl Iha� �elshe is licens¢tl
pursuam Io IAe pmvisions ol Ihe CanUa[lors' S�a�e license Law (Chapter 9(commencinA with S¢c�ion 7000) ol Division J oi the Business
ane Pw�essions Cotle) or Uul he/s�e is exempllAerelmm an0 i11e hasis lor I�e alleged e�emption. Any Nolation ol Section 70.iL5 by
any apP�icant lor a permit suble�ts t�e ap0���ni lo a civil penalry ol nol more ltun liv¢ hundretl Oallars (5500�.
� I. a5 owner o� Ihe pmpetly ar my emyloyees vnlA wages as Iheir sale compensalion, vnll Oo Ihe work, antl Ihe
S�NCIOf¢ IS f10� IItlCOECtl Of O��CfCtl �Of SdIE (Sec�ion 70a4, Busines5 an0 Pm�essional Cotle: The Conlrac�ars' Sta�e License Law
eoes no� apply lo an owner of a pmpeny who builtls or impmves ihereon, and who doe5 such wark AimSelllAerself or ihrough
his or �er own em0loyees, pmvitled ihat suc� impwvemen�s are nol inlentlea or ollereG lor sale. II, however Ihe huilJinA or
im0�ovemen� is so10 wil�in one year of completioq the owner will �ave t�e burden o� pmving hels�e tlid not Ouild or impmve
lor Ihe purpose of sale�.
I, as owner o� the pmpetly, am eKclusivel9 conlrac�ing wi�h licensetl conlraclors b cons�mcl lhe D�olec� (Section 7044, Business
❑ and Pwlessi0n5 Cade: T�e Conlraciors' Siale litense Law tloes no� apply �0 an Owner o� D�oDehY wh0 �uilds ol improveSlhere0n
antl who tOnlmtls lor Suth pwlec�s with a ConlraClor(5) litense Dursuan� Io Ihe ConlraCiors' S�aie LiCenSe Law�. I am aware
ihal proo� ol Iheir Worker'S Compen5aiion in5urance ShoulU 6e OroviUetl lo me.
� I am ezempt untler Section: B. 8 P. C.
br Ni5 reason:
�aie: ?i/ZL/q 3 Ownec
I Oo he cenify t t I am aware of antl untlerstand t�e reQuiremenis ol Calilomia Healih an0 S y CoUe Sections 2550 , 25533, antl
25534 antl Ihal I or any IUWre builtling occupanl wilVwill no� (circle one) neea �o comply with s 5�aie cotles ana Ihe r iremenls lor a
oe�mii �or consimctian or moaihcaiian imm Ihe Air Ouality Management �islricl. flesitlential conslmclion apPlicati are eKempl irom
IhCSC pfOV1510f15.
Oate: ApPhcanl: _
I h¢reby terlirytha� I have rea0 I�iS apDlita�i0n an0 5tale Iha�
or0inance5 and s�a�e laws reWling �o builtling constmnion and M1
prapetiY �orin5petlion purp05¢5.
Oale:�/. " � Signaiure:�
�rivefs L¢ense ar Social Secun�y a:
is wrrecl la�gfr� Io comply wi�� allci�y antl caunty
nlalive�}j'SC1lyjut}�IerupOnl�ea�Ov&menlione0
�bai�aa wnne—emioing: tireen—coae tnmrcemem; canary—nOP�iwn1; rmx—qevenue; uoiaenroo—nsseswi
CITY Or COSTA MESA — BUILDING PERN,.IT PERM NO: GRA 06145%
PERMIT NU; GHA 061457 PLAN CHECK NO: 04882-92 L GOVT; N SUPP; N
CONSTRUCTION TYPE; 5—N PERMIT TYPE; GRA PURPOSE; 0'['H
JOB DESCRIPTION : GRADING PERMZT FOR NEW SFD/ATT GAR PROJ. SQ F"f:
CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 /M-1
COMMENTS: EXISTING SFD 6 GAR:9GE TO BE DEMOLISHED ON SEPARATE PERMIT,
iF 3E k�76 k it ik if if �E if ik ik if iE # i! iE iE iE iE rt iF X� i(� iE iE iE iE i! if �f if iF iF iE iE iE�k 1F iF 7t # it �1k iE i(�!f !E !t if ik il� # i(� %� #!f #!f ## i6 N• if� �1F 1F # N-#!E If i4%jF i(� k#?i�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUZLDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; F'T IN LEFT; FT IN RGHT; FT IN
PARKING RE • PROV; PARCEL; 42417301 2NE; REF NO;
PLANNING N TES>
>
�t�tx-�x��t�ti��ti�i�i�*i�f��i�ft�t**-�*�t#�t�t�t�tit*it�t#��t�ir�tx-�tft�tu�x��t**i�*�titx-it#x�irx�irit��ir�t-it*#�t-�tu�x�x�.k#�-�x��x�#;riti�
D E V E L O P M E N T S E R V I C E S R E Q U I k E M E N.�`'. S
ZONING APPROVED BY DATE; �
BUILDING APPROVED BY ; DATE;'i �a
APPLICATZON ISSUED BY; � Lh �� DATE; �'1 �7
ItitilikkiEiEiEiEiti'riEifiPiFkiEiFiEiE1EiER�t1�F�FiF3F3F�F3F3F3FiFiFiZ�'£3f3F3F3F�iF {F�&3fR�7F�3F7F3FiEiEiElkkiF#3E#�k xiE�
iE iElh 1E iE iE 3F if iE 1E if 1ElE iE iFif It iF IE 3E IF if iF ik if 3t !E i(� iE iF iF if iF iE N� �7E iE 3E iE 1(� iF if iF k�l! 1E 3F If !t 3E 3f fb ik 1F �f �lE iE iF IF iE 1k 1F�)f if if� iFiE # 1f # iE iE iF )F } iE IF iE !f
LEGALIZ:4TION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLDMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 33.00
SMIP/t30N—RES
ISSUE FEE z3.00
BUILDING—I)IV—> PERMIT ISSUE PLAN—CHECK T01'A1� PATll DUE
T01'AiS----> 33,00 3,00 22.50 58.50 58.50 ,00
REVENUE llIVISIUN 'I'OTALS--> COLLECTED: 58.50 OVER/SHORT: .00
DLDG PMT PLUMBING ELECTRTC MF.CHANIC fiTRF, SMIP/TOT GRAbTNG PI,AN—CHECK
35.00 7.2.50
iE iE i4 iE M iF 1EiF if� �IF 1h ik 1f iE iE iElf ik%if �%�lE- �!E iE IF �%"� 1f iE dF f[ 9k iE �%�lf it �7E �%iP-1E!(��)F �%i!� ii-9EiE 9E iE�%� iF �lf �If �� �1F if i(..7f..k.K..1f i( �7( if �% 1F i(� i(� df 3F �7f #�7! #�X� 9E if �1(
I N U I V I U U A L F E E B R E A H D O W N
TYPE QTY D E S C R I P T I O N UNIT COST
NO FEES WERE SELECTEU FOR THIS PERMI7'
l � .
TOTAL COST
' CONSTRUCTION qND PLANNING I
� APPROVALS Permit # Date Inspector
r-
1, Temporary Electri,al Serviceor Pole
2. Soil Pipe-Undr9rntl.
3. Electrical Conduit Ut��ity�Undrgmd.
4. E:'ectr�cal Conduit-Undrgrnd.
5. Steel Reinfo�cement
6. Eleetritat UfER Grnd
7 Fooungs
8. Foundation
9. Water P�pe-Undrgrnd.
10. St�uctural Floor System
71 . P�opvty Sewer Line & House Connect�on
12. Se�ver Cap . ... .-
13. Roof Drains
74. Rough Plumbinq
15 Rough Etectricai�Condwt
16. Rough Electric �Viring
17, Rough Wiring Sign
18. Rough Electrical-T Bar Ceil�ng
19. Rough Heating & Air Cor.dilioning
20. Rou�n Factory Firep!ace
21. DuMs, in St�ucture
22. Ductt, VentilaLng �
23. Gas Pipe-Rough & Test
24. Roof Framing �
25. Roof Sheaxhinq
26. T-Ba� Ced�ng (Structurall & fvionocoat
p7, Frame and Flashinq
28. Lathing & Siding
29. Insulation
30. Dry�•.ail Nadmg
31. P:aster Bro�vn Codt
32. Electriwl Power Meter�F�nal
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final FactorY Fireplace
38. Final Plumbing
39. �Nater Service-Final
40. Gas Service�Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. �andscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUIIDING
46. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Sputhern California Gas
51. CERTIFICATE OF OCCUPANCY
No. Date
a
u
s
0
POOL & SPA
APPROVAIS Permit � Oate Inspector
52. Pool & Eq�ipment Location
53. Steel Reinforcement ' -
54, Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAI TO COVER�GUNiTE
58. Electrical Condult�Undrgmd.
59. Gas P�pe, C' Undrgmd., Test
60. Backwash Lines, P�Trap, C7 Undrgrnd.
67. APPROVAL TO DECK '
62. Backtvaih & Recap!or�F,nat .
63. Heater & Vent-Final '
64. Plumbing SVstem � Final ,
65. Electrical-Finai
66. Snlar Svstem-Fina� -
67. Fencing & Access APpr�val .
68. APPROVED FOR PLASTERIh�, .�
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit,F
70. Underground Hydro
71. Product Pipin9 � Gas L' Oil
72. Undergiound Flush
73. Under9rnd. Storage 7ank O Gas ❑ Oii
74. Overhead Hydro
75. Dry ChemiCal
76. Dry Standpipe
77. FIXED SYSTEM FINAI
78. FIPE PREV. FINAL
HEALTH �EPT. REQUtREP.IENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
/�
i
�
�
PH0.IECT AOOflESS: '�q `� WEELO DR �
OWNEP'SNAME: �ANAKA, ZSAMU J
aooness:TANAKA YOSHIKO K
1846 W�P.LLACE AVE
COSTA MESA(� CA 92627
AflCH/ENGINEEN: ( 71 4� S 4 8— z 7 Z Z qEG.NO.:
aooRess:
UNIT:
uxiT:
PENMITTEE:DENNIS CHERRY (714)641-1505
, aooaess: zll WALNUT ST
C,M. CA 92627
LICENSEU CONTflACTOfl OECIAflATION: I here0y affirm Ihai I am licensed unUer pwvisions o� ChaD�er 9(commencing with Seclion
7000� o� �ivision 3 0� I�e Business ancl Pm�essions Cotle, ana my license is in lull force and efleci.
' LITY LIL.: SiATE LIC.: CUSS:
I Date: Signatu�e:
I WOflNEBS' LOMPENSATION �ECLABATION: I here0y alfirm that I have a cenilicale of conseni to selhinsure or a ceniliWte oI Workers'
CAmoensation Insurance. or a ceridiea coDY �hereoll�clion 3800, LaG. C�.
POIILY NO.: E%P. OpTE:
COMPANY:
❑ Cendiea copY ¢ �eceby fumis�e0. ❑ Certilie0 copY is IileG vnt� t�e ciry BuilGing ONision.
Oa�e: ADDlicanC
i
E%EMPTIONFHOMWONNEflS'LOMPENSRTIONOECLRflRTION: �T�ii neeanolDecom I�IfIl�permilisfoionehunOreA�3f00�orless).
I ceriity Nal in I�e pedormance ol the work lor wnicn Nis permii' iss tl. I s�all n 16 ny.berson in any manner so as �o become
subletl �o �� Vor4er5' omDensa�ion Laws ol Calilomia.
Dale: � � SiBnature '�
NO E: It, alrer making �his Oeclaration, you s�oWG Gecome subject t WOrkers' Camp ion pmvisions oi lhe Laho�
Cade. you musl lo�hwith comply wilh suc� provi5ion5 or Ihis permit I G¢ Ueemed.rev .
CONSTflUCTION 1EN01NG AGENCY: I Aere�y ailirm Itui ��ere is a cons�mtlion IenOing agency tor t�e pedormance o� �he work lor
wnicA inis oermi� is i<suetl ISeclion 3097, Civ. C1.
LENOEH:
FOOflE55: �
OWNEB BUILUEfl UECIAflRTION: I hereby aifirm �M1aI I am exempl Irom Ihe Coniracbrs' S�ate License Law br Ihe following reason
(Section 7031.5 Business antl Pro�essional Cotle: Pny ci�y o� coun�y which requires a permi� �o cons�mcl, alier, impmve, demolish, or
repair any slmciure. prior to iis issuance. also reQuires �he applicant lor such permit �o lile a signed staiement that he/she i5licenseJ
pursuant io Ihe piovisions of the Comrac�ors' State License Law (ChaO�er 9(commencinA with Section 7000) of oivision 3 of ihe Business
anU Pmiessions Code� or tha� he/5�e is exempt iherefrom antl ��e Dasis br the allegeE exemp�ion. Any viola�ion o� Seciion 7031.5 hy
any apDlicani lor a Dermii subl��5 i�e applicant �o a civil penalry o� nol more �han �ive hundred dollars �E500�.
I, as owner o� Ihe D�openy or my employees vnN waqes as Iheir saie compensa�ion, will Oo I�e wark, an0 ihe
❑ simc�ure is not intenaed or ollereU lor saie (Seclian 7044, Business antl Pmiessional Code: The ContractOrs' Slate License Law
eoes not appty to an owner ol a pmpeny wAo �uilds or improves Inerean, and who tloes suth woM1 himself/hersell or througn
his or Aer Own employ¢e5. provitl¢E l�a� Suth impmvemenis are noi intenaeJ Or offere0 Por Sal¢. It, �owevef �he �UilAing or
im0�ovemenl is soltl within one year ol completion, the owner will have Ine buraen of pmvinA he/she Uitl not �uilU or impmve
for Ihe purpose ol sale�.
I, as owner ol me pmpeny. am exclusivety ConlraCling wilh liCensetl COnhaCiors �o tonSVut� ��e prolet� (Set�ion 7044, BU5ine55
� anU Prolessions Coae: T�e Conlraclor5' Staie License Law Uoes not apDly io an owner o1 pmDeny who builUs or impmves �hereon
and who conirat�s br such pwjetls wi�h a conlraciar�s) license pur5uanl Io Ihe ConiractoR' Slaie License Law). I am aware
I�al pmof al ihen Worker'S Campen5aiion insurance 5�ou10 be proui0ea lo me.
� I am exempt under Seciion: B. 8 P. C.
for Ini teaso ' /
oa�e: Z�zs�93 �„ -
I tlo �ereDy cendy iha� I am aware ol antl untlerstanG �he r¢puiremenis al CaL�ornia Heallh a�ery Coae 5¢ctio 5505. 2553J, an0
25534 an0l�at 1 or any imure 6uilaing occupam willlwill no� �circle one) neetl m comDty w' saitl state coaes ana t�e requiremenis for a
permil lor conslmclion or modilicaiion Imm Ihe Air �ualily Management DiSVict. ReSiEen�ial constmc�ion aOP�ications are eKempt �wm
I�ese pmvisions.
Date: Fpplicani:
I nereoy cetlify Inat I have reaathis ao0l¢ation antl s1at1
or0inance5 and staie laws relating to DuilOinp con5imction
pmpetly Iar ins ction p rposes.
Daie: Zr Signamr�
o�i�ers uce�se o� sodai seaaiy x: �
in�ormation is correcL I e to camply wii� all cily and couniy
o�izereo�esemati is ' emeruoon��eabove�memionetl
i64L46 W�i�e-6utltling; Gieen—Codo Enbrcemenf, Canary—ApPlicant: Pink—Revenue; Goltlenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: HP 061153 PLAN CHECH NO: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE; PLU STR
JOB DESCRIPTION : DEMOLISH SINGLE FAMILY RESIDENCE
CLAIM VALUE; 1,000.00 CALC—VALUE; 1,000,00
PERM NO: BF 061153
GOVT; N SUPP: N
PURPOSE: DEM
SQ FT:
GROUP OCC; R-3 /M-1
COMMENTS: X
�r�r�r�r*��r�r+��r*x��rx �rx�r�r****x*�rx�t*+rx**�t*�t�t�xrt*�rx�r���-��*�t�*��r�rx��r**�r**��*�xx***�r**x��*�r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ • PROV; PARCEL; 42417301 ZNE: REF NO;
PLANNING NOT'ES>
>
i!�!E i! iE if if iE iE if if if iflk 1E 1E �lE ik iE if iElElE �lE iE iF iE iF iE iE iE ik iE �E 1E i! iF!(� iE 1E 1E iF iE If iF 1E iE 3Elf 3F �1Elf iF%1E iF iE IFiF if� iE 3F fk iF iE iF it M� iF 1F i(- iE �f if 1E 3E #!(� If if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE; �C
ifififilifitikilkiFiFiEifkiFiEiFifiEiEiEiE iE3kif1FiE3EiElEiEil� �r ifif
k if if ik i! i! i! ik k ik iF ik iF ik ff !t i! k ik �E iE 1E iE i! 3E iE if !f if !E j! if i! k 3f lkiF if iE k if fk 1t �k it f!i! iEiE iE iF it iE iE iF �lf if it if iF fE jk �E 1E iE fE 3F iE if iE ik iF iF � �F lE iF iE iE
LEGALI7,ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25,00 7,00
PLAN z5k SMIP/NON�—RES
ISSUE FEE 20,00
BUZLDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 32.50 20.00 0,00 52.50 52,50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 52,50 OVER/SHORT; ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
25.00 7.7,00 .50
If if IE 1f iF if iE ib ik if if 1E iF if !t if %1E 1FlE if-1ElF 3ElE iE iE if iF iE iF iE iE 1f if aF 1E iE if �1f 3Eif iflk IE if iflFlt 9f IE if �E iE iE �EiE ff it 3F iE iE iF if if !E iFlE !E ik ih N� i( ff 1E iE �1E iE if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 SEWER CAP / DEMOLITION
END OF FEES
EACH 7,00 7,00
� �
1993
;sA MEsa
�
� CONSTRUCTION AND PLANNING
IAPPROVALS Permit �.
i. Temporary Electriwl Service or Poie
2. Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility�Undrgrnd.
4. ElecVical Conduit�Undrgmd.
5. Steel Reinforcement
6. Electr�cai UFER Grnd.
7. Footinqs
( 8. Foundation
� 9. Water Pipe-Undrgmd.
� 10. Structural Floor System
� 11. Property Sewer Line & House Connection
� 72. Sewer Cap
13. Roof Drains
� 14. Rough Plumbing
75. Rough Electrical�Conduit
�-
� 16. Rough Electric4Viring
17. Rough 4Viring Sign
18. Rough Electrical-T Bar Ce�ling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace _
27. Ducts,in Structure
22. Ducts, Ventilating
23. �Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T•8ar Cedir,g IStractural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Orywall Naihng
31. Plaster Bro�vn Coat
32. Electriqi Po�ver Meter�Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test ,
36. Hood or Canopy
37. Final FactorY Fireplace
38. Final Plumbing
39. \Nater Service-Finai
40. Gas Service-Final
41. So�ar pomescic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. fINAL STRUCTURE & BUILDING
48. fINAIPLANNING
49. Electric Ralease to Edison
50. Gas Reiease to Southern Califomia Gas
51. CERTIFICATE OF OCCUPANCY
No. Date
.�
Date I Inspector
n
,
POOL & SPA
APPROVAtS Permit � Date Inspector
52. Pool & Equipment Locat�on �
53. Steel Reinforcement �
54. Forms
55. Electrical Bonding
56. Rough Pfumbing & Pressure Test
57. APPROVAL TO COVER GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, C7 Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor-Pinal �
-83" Heater & VenFFinal
64. Plumbing System � Final �-
65. Electrical-Final ,
66. Solar System�Final � . �
67. Fencing & Access Appruvai �
68. APPftOVED FOR PLASTERING
69. POOLlSPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Pipin9 O Gas ❑ Oil
72. Under9round Flush
73. Undergmd. Srorage Tank O Gas ❑ O�'
74. Overhead Hydro
75. Dry Chemical
76. Ory Standpipe
77. FIXED SYSTEM FINA�
78. FIflE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION �
60. FOOD CERTIFICATE ISSUED
Notes:
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County of Orangg
Building Deparfinent APPLICATION FOR
Room 322
Courf House Anne:
$anta Ana, California
Phone: KI 2-6211
PERMIT
P&RMIT NO.�� 3 � �
(1LG/i C", � �� , 19�31
1. OWNER'S NAME� '! �� �� ������ -- PHONE: �C�c �/'�/ ��d�
MAILING ADDRESS � � ..� �✓ vc..r
� I %(�S�r<eo or P. O. Bax No.)
NAME 1'�
(AerLi[ece qor �EnQinear)
ADDRESS � ��`7 �
CITY
Stacc Lic. N
Phone
� �I��D S7� N��.��
NAME ����
�co��ao. o. eu�m«>
CITY.
Statc Lia N
2. JOB LOCATION— � �� (/'�v `–�� `� � ' ` ��'U�"-� �%*� '�'
(Hou�a No.) (N.me of Sneee) (Town or School Disrice)
3. LEGAL DESCRIPTION: Lot � 6 �� Blod� TraccZ r' �T ���� l�' � �/� �
4. Mects and Bounds Dcscription — Use Reverse Side of�This Form.
5. CORNER LOT () INTERIOR LOT (� THROUGH LOT () SLOPE OF LOT
THIS AFPLICATION CANNOT BE PROCESSED UNLESS LEGAL
IS ACCURATE AND COMPLETE.
6. PROPOSED. WORK: New Building (�(')
7. PROPOSED
New Stzucture ( ) Addicion ( ) Repair ( )
Move ( ) Demolish ( ) Convcrsion ( )
8. SIZE OF BUILDING �� X 30 AREA�t2S��_ SIZE OF LOT��D�S� AREA ��wDB �
�'/ /
9. CEILING HEIGHT� TOTAL BUILDING HEIGHT� NO. OF STORIES�
10. NO. LIVING UNITS �� SIZE OF SMALLFST BEDROOM SIZE OF KITCHEN
11. EXTERIOR WALL CONSTRUC'I'ION: Brick O Concrete Tile O Monolithic Concrere O
Wood Frame (x) Steel Frame ( ) Concrete Frame ( )
12. WALL COVERING: Wood O Me�al ,( ) Stucco (}�) Other_
13. FRONT YARD SETBACK FROM CENTERLINE OF STREET •`- ��
�j h�i /
14. DISTANCE TO PROPERTY LINE: Side Yard >^J/� Rear Yard �� _
I5. SHOW ON PLOT PLAN EXISTING BUILDINGS NOW ON LOT, STATE USE OF EACH. `�
/�
16. DISTANCE I[V FEET, FROM PROPOSED BUILDING TO NEAREST EXISTING BLDG.: �
17. VALUATION OF PROPOSED W RK: In� ing All Labor, Plumbing, Electrical Wiring, Heating, Fire Sprink-
krs, Painting, Sewage Disposal $_
t8. I HEREBY CERTIFY THAT TO THE BEST OF M.Y KNOWLEDGE AND BELIEF THE INFORMATION
IN THIS APPLICATION IS CORRECI' AND THAT THE CONSTRUCT70N WORK WILL CONFORM
TO ALL LAWS OF THE COUNTY OF ORANGE AND TH�j STATE OF CALIFORNIA APPLICABLE
THERETO. �/ � �
Plan Filed. �
BY.
Owner or A�uhorised Aeene
FOR DEPARTMENTAL USE ONL]L
0� � c;if��
t9. GROUP o T'YPE nISTRICT MAP NO.
PERMIT FEE $ � �� RECEIPT N0.�1— PAID TO �� DATE � ' �, � --�"Z�
CHECKING FEE $ R�E7CEIPT NO. PAID TO ATE
PERMIT GRANTED_ �P �/� i0 19�, l"i����
PLANS CHECKED BY.
APPROVED BY:
HEALTH DEPT.
STATE FIRE MARSHAL
STATE DIV. OF HOUSING—
OM-13��9
SHEET ATTACHED
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y(�/oa� �Y. i�s f,,, �� v�� T ,
A
a
COUNT'Y OF ORANGE
BUII.DING DEPT.
636 No. Broadway
Santa Ma, Califomia
Phone: KI 2-6211
1. OWNER'S
MAILING
Name ...._.,...
Address ......
City .-------�--
State
Lic. No.......
Application for Building Permit
AND FOR A
CertiFicate of Use and Occupancy
(Architect or Engineer)
Permit No... .Tyo��..-�J._Q
� ��� i% ..
� .., r- � ,-
Name .._�!�'_.Y�".��..
� (Contractor)
Address -- ,-/��Q.' -�d� --'il/--- -----...------� ---
City .-----Lt�.���...-------,�!'."�..PS�'_.- �--�-----------'--.....
SCate
Lic. 7
Phone.� ��f`s` �
- - ...._--........----
PROPOSED USE:... --{���Gf./ �,Y---...---�--lY...N..r. -����---� � ---------�----- ------------ --� -.....---�------- ...------.... ��--
/- �n
`L' /�� �P P D � CO S'l3"' . -��-/�-�.t��-- -- �-----�--
2. JOB LOCATION - - --�-f-�- - --�- ----------(�51....-----� -... - ------- ----- ---�� -------- -- - - --- . .. �'
(House No.) (Name oE Screec) Tovm or School Distritt) �
NAME OF AND DIRECTION FROM NEAREST CROSS STREET ............._ .._.Q.'1.Y.7._o �� +�___r...._(L.Q�iPG'/�. E?r .
3. LEGAL AESCRIPTION: Lot.:......---- --..��..�.lC-.C_...Block .. .......................... ` - - '---- Tract... -- ----- `- - - ...
(Metes and Bounds Description—Use reverse side of form�)�
4. CO1tNER LOT ( ) INTERIOR LOT ( l! ) THROUGH LOT ( ) SLOPE OF LOT ( )
i. SIZE OF BLDG.:..L��. °� �--.----AREA:.......:�.�P..�._...-----SIZE OF LOT:---_/ O 0 X/ 3S---AREA:..I�. �--_�- �-----„--
�' � p� /
6. HEIGHT OF BLDG.:--------t .................................CEILING HEIGHT:....------_0..---.-----_-__NO. OF STORIES.......__-.---_----; _----._
7. NO. PAMILIES---.--_---_---_._�-_-_----...--_Size of Smallest Bedroom---------------------------------------_ Size of Kitchen---------------..-----_.-----_....
8. EXTERIOR WALL CONSTRUCTION:.._..J._��!. CC_o.___________INTERIOR WALL COVERING....._C./��T.P!�..c._,..
(Frame, Stuccq E�tpe.) /' (Plaster-Drywall, Ete.)
ROOFING COV�RING...----(_,_Q'r✓!-.� S�..L�l�.�_./.� -- ---- - - - - --�-...
J. STATE HOW MANY BUiLDIIti�GS NO�V ON LOT AND GNE USE OF EACH..........,lY� u_S_!_ __ 9�..._�A�'.R4 ��
]0. SETBACKS: Fro��t Yard From Center Line of Street-------------=-�-U----.-------------------"----------'------.....--------------'--'----------...--------._.-,--
�, f 1
Nearest Side Yard......._7..�.....Rear Yard......._._��._.Distance in Feet Between Bldgs. on Same Lot.........�..8 ...........................
(Property Line) (Proper:y Line)
11. A COMHLETE PLOT PLAN IS RLQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH.
12.
1 i.
14.
(a) Footing: Width------"---"1-�--1-\--------Depth in Ground-------' �--�c----1 �-----Width of Wall----------------------------,-
i
(b) Size of Studs:__......%�?�.�......_.Spacing._....,�.�:.._I_...._._."CC Material of Floor....__.. L?N4'.i�.E.f�......
c Size of Floor oists :..............��� y � "
� ) ) , - - -- -Spacing....------�- .. ....................... CC
�
} it �
- �d) Size of Rafters:..-----....3i. �.�2..--------------......Spacing....-----'�---------�-----------.:'CC
VALUATION OF PROPOSED WORK Including all labor, plumbing, electrical wiriog, hcating, fire sprinklers, painting and
sewage disposal $___...�..00 G
....------------'-"-------
I HEREEY CLRTIFY THAT TO THE BEST OF MY KNOWI.EDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
Plans
Bldg. Peimit
Plan Check
Total • -
Receipt No.
Paid to -
Date _._........
�� — / — �7 �,
FOR
GROUP.. �---------------
TYPE__.......�.-----�--- -------
DIST. � �� `�
Mnr.................... -- -----�---
SHEET NO.___,� . ................
-� -�'('Owner)
� �,,/
.
' , �
�_.r:..-:.--'__._..-r ._:
� (Authorized Agent)
Y
CcH��E,�C�KING BY
APPLICATION...../N:!_.'% HEALTH ............................
ZONING............�....__ FIRE
PLANS AND MARSHAL .........................
SPEC'S. - - ---- .:. �.... STATE - ---- -- -- -...--- ---�
CORRECTIONS ENGINEER
;� , r��zvviri-iaauciL .i-i INSP_'�TOR
.
, q��� ..
DAT$ 1� I �� '' ' l.X/ 6�-��--� ,
- -. �-----�- --------� -�---�--------.... - : ;`
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