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HomeMy WebLinkAbout2647 WESTMINSTER PL - Building Permits CITY OF COSTA MESA aUs BUILDING DIVISION A Fµ yl 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us e. FOR INSPECTIONS CALL: (714)754.5626 0. 0 PERMIT NUMBER: BX09-00271 PERMIT TYPE B_MISC STATUS: ISSUED APN: 43920110 DATE ISSUED: 12/10/2009 Zoning: ISSUED BY: RMD JOB ADDRESS: 2647 WESTMINSTER PL CM Suite/Unit: Vicinity: REAR OF PROPERTY Primary Occ: Const Type :?? SQ. FT: 0 Valuation: 51,800.00 SCOPE OF WORK: CONSTRUCTION OF 73 LF OF 6'HIGH CMU PERIMETER BLOCK WALL WITH STUCCO FOR A SFD. BLOCK WALL TO BE BUILT PER CITY STANDARDS. OWNER: HUBBARD, MARTIN Address:: 2647 WESTMINSTER PL Unit City/State: COSTA MESA, CA Zip Code: 92627 Phone: APPLICANT: TORRES, MARTIN Address: 213 E VALENCIA DR Unit: City/State: FULLERTON, CA Zip Code: 92832 Phone: 714-675-8977 CONTRACTOR: MARTORCOR LANDSCAPE DESIGN License No. 640603 Address: 213 E VALENCIA DR Unit: City/State: FULLERTON, CA Zip Code: 92832 Phone 714-675-8977 Cell: 951-490-4798 ARCHITECT: License No. Phone ENGINEER: License No. Phone FEE SUMMARY Building Plan Check: $0.00 Building Permit: $63.15 Electrical Permit: $0.00 SMIP Residential $0.50 SMIP Commercial $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $64.65 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODED INSPECTION TYPE DATE, INnTIAL1 CODE INSPECTION TYPE DATE /4111 77RL5 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 WORKEtRS'COMPENSATION DECLARATION: Owner ID verified by drivel s license. 0 Yes 0 No • I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized (Carrier:- irr by this permit,and that no building structure,scaffolding.falsework,Cr demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Tors seaun need • be.. leeimp• a vxuea or arra nuMrea mwrs(sloo)nkuJ 2,Arta Sec.341,Title 8.California Administrative Code). Policy Number: 13)7 5 / t ` 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above.unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of AVWwm's Signature Date the Labor Code,I shall forthwith comply with these provisions. *A& ]•,einY /�_C /..5 Division of Industrial Safety Permit Number: A 7A.m A5.gnart.re / + DateHAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and and effect. a registration form for acutely hazardous materials? 0 Yes 0 No CCic.#-- -/ 6 0 (Section 25533 of the California Health and Safety Code, with some ♦ exceptions. requires registration with the Costa Mesa Fire Department by A. a y c . - _ — a --!' 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the Califomia Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property. or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. 951. 111r1Signature of Legal Owner(s) Date ��yy Signature Date /� ^ �� �/- 941duln nzea.Appacapl-. W City of Costa Mesa CITY OF COSTA MESA - [Created: 12/10/2009 11:14:32 AM] [Scale:46.57] [Page: 8.5 x 11 /Portrait] i ••• i Overview Map Legend APPROVED AddIllAku Large a dintsss CITY O sfA MESS, No..Por BLVD PL/�N ' ' VISi0 �,y - :It etg?yg3ECTT0iIts t. . DEPT. poi, r NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE I APPROVED BY THE PLANNING DIV. BY. OCA 1 1DM E: i___1 / Map Display '73 lin ••. I� �—V vY-. rf �a�l"`rI•��� �f .a 'r \ \ . �\ ,%,.1+ `Lr ' + i"t y 'u aRs:', ' %\\ ,- - - \ c',y 7% * 1 I .,. . i ` N\ • ' .y.4.! + „ t -L • ..tri -� l,•i •l ' �' ! +r S Kt i ?• a i. .~•r • JU ?CAC / rte. * 4 ` ? c t ,, � 404'7' 4 r.� ,e ' ',• 1. kf.1 i. G i II. 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J,(rf } . 1, 1• l .tab J1 T < 2 4 i, f 4Ct 2002.9v.*.t aor,: er Y.4"-:$11:y:'� cy \i:ads. °X�' `'i`:.T [tisk+ (C)2002-9 GeoPrlee.net(GeoVec,Inc.)-(866)422-2606 _------- - ) POOL AND SPA W/SL-t1D-E /Ay CONTRACTOR INFO: MR. CARLOS & / k ,j__ \_, , ASSOCIATES ( . \\\ 336 E. FRONT ST. COVINA, CA. 91723 +12" RBB C PR H_PROLS-EirE.Q. LIC-232130 \ "COCATION 626-332-8731 73 r---- , • k \ 1 — scg;T:ica__ co \ Trl . .., . 4. -cri , . . \ . .r T 7" 711" • • ....•:k • •Ii • in .,.• IS A It•• 6_ }.ti,i- 28' alkilk _5'-6" HIGH .......... a Kbj *** is„,,, Ipail-r- ROCK SLIDE V aye ijilra \ r- ....at\....a IA 1 r I e•? x111411 3' on Ma \ -,. 'CHILD-SAFE DOUBLE MAID DRAIN \ // \ , 1-1/2" GAS LINE EXISTING FOR POOL RESIDENCE HEATER AND SPA \ \ FIRE PIT RAISED \ 12" MARTIN4HUBBARD 2647 WESTMINSTER PL. P/L 6' HIGH COSTA MESA Th- 60-9--7 FENCE 949-500-4180 / I- ,.._ TYPICAL 611 CONCRETE BLOCK FENCE alkCement Coping Optional I 1 GENERAL- NOTES Channel Block With 1.3/8 ��. ■, _ _H I 1 Horizontal Top of all ep , �� I I MORTAR' Fences 16C, One Part Plastic Cement, and Three Parts Sand I a BUM II 1 It GROUT: One Port Cement Three and For F 5'or Leu c� One Half Ports sand Vert.Bars 3/B"O at 4' .o"O.C. o COPING: One Part Cement, Three 19 a : ' _� I Pails Sond For Fences Higher Than 5' fy(�, .+ CONCRETE: Well Mised 1:2-1/2: 3-1/2 Vert. Bars 3/13"54 at 32" D.C. a u - if' < z „ Mae of 7- I/2 Gallons of Fill Cells Solid With Grout I > Z Water Per Sack of Cement Where Steel Occurs e Reinforcingsteel Shall • GROUT MAV BE POURED FROM THE TOP �I 3 OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A,15.39 w o OCCURS. A.S.T.M. I��i ZONTAL REIN u n II '_, I l2 FOR EMENT SHALL OF CLEAR.CLEAN IS All Steel to Lapped IN 4 ' - � FREE OF ALL MORTAR DEBRIS,ETC. 24"or to Code H � NATURAL GRADE '� '.�." ,o wit `fi Vii, IT li _ TWO 3/B"O BARS MEI • ,� CONTINUOUS TOP 1 I—.--- `,�C &BOTTOM F-.—NIDTH Ibl TO IS. O C MAX SEE CHART HOOZBELOWt STEEL MUST BE TIED IN DC PT11 Cr CARTHTCOTH PLACE AT TIME OF TRENCN 1 I , 1/3 THE HEIGTH or FENCE INSPECTION. JJ L j -9C-LOW SOT TOM OF FOOTING 2'-4142" SCALE: I/2" o I' , , FOOTING REQUIREMENTS CHART • WALL HEIGHT 6 ' 51------71r 3' WIDTH 14" . 14" . 12" . 12" THICKNESSIO" 10" 8 " 8 " DEPTH OF EARTHTOOTH 24" 20" 16" 12" SPACING OF EARTHTOOTH 12' 14' . 16' 16' a t* BUILDING DIVISION J •THE SKETCH IS FOR INFORMATIONAL PURPOSES •SOLID WALLS/FENCES BETWEEN 216•&6'IN HEIGHT SHALL ONLY. APPLICANT IS RESPONSIBLE FOR PROVIDING BE SETBACK AT LEAST 10' FROM FRONT PROPERTY LINE AN ACCURATE REPRESENTATION OF THEIR PROPERTY T•L NOT EXCEED 7 6•IN HEIGHT IN CASE THE SHAPE AND SIZE DO NOT CORRESPOND •9011D WAILS/FEIN WITH WE INFORMATION PROVIDED ON ME SHEET. WITHIN lO OF ME FRONT PROPERTY UNE(Nat CURB LINE). •VERIFY DISTANCE FROM CURB TO PROPERTY LINE AND SHOW ON PLAN. VERIFICATION FROM THE CfIYS ENGINEERING DIVISION 5 REQUIRED. CALL(714)7563311 POR INFORMATION. Val Val 1 v 1�1 Q6a IS9 ® la G01a 1O 1 � 1 t � 1 e .yT 1 1 1 1 1 1 1 1 1 • ra t . • yE • S • 1 a RESaIta REsaNa R9opa REs10ENa 1 • W 1 � 1 1 W .* r 1 ,''• • lel loot tNA ¢r mot t _ _ _ 4 STREET BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION • ADDRSS0F BUILDING: 2647 WESTMINSTER PL UNE CITY OF COSTA MESA — BUILDING PERMIT or;" •.EIFKNOWN: CHAMBERLAIN, CRAIG SPERM NO: M 073237 v ADDRESS' CHAMBERLAIN, JULIE ' 2647 WESTMINSTER PL PERMIT NO: M 073237 PLAN CHECK NO: N GOVT; N SUPP: N COSTA MESA,CA 92627 APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: ADD ARCHITECT OR ENGINEER; JULIE CHAMBERLAIN 'rm., C22330 JOB DESCRIPTION : 420SF 1ST FL, 555SF 2ND FL RESID ADDITIO SQ FT: ZR OR ENG.'S ADDRESS: 2647 WESTMINSTER PL INT: C.M. CA 92627 CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / • CONTRACTOR'S NAME: Cp4IRACTOR'SMMUNG COMMENTS: REF: B-72931 " GARBAGE DISPOSAL 4 BATHROOM VENTS ADDRESS: UC.NO.: ******************************************************************************* .. UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. CITY LIC.NO.: LIC.CLASS: LIC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dae: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT : FT IN OWNER BUILDER DECLARATION:I hereby affirm under penaky of perjury That I am exempt from the Contractors License Law for the following reason(Sedion 7031.5 Business and Professions Code:Any cityor county which requires a permit to construct,aver,improve, PARKING REQ: PROV: PARCEL : 43920110 ZNE: REF NO: 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 D'v'ion 3 of the PLANNING NOTES> Business and Professions Cade)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031,5 by any applicant faepermit subjects the applioant to scivil penalty of not more than five hundred dollars t550gD. ******************************************************************************* ❑ I,seems,'d the propel),or mY employees with wages as their sole compensation,will do the work,and the structure is not intended DEV V E L O P M E N T S E R`V I C E S R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contradore License Law does not apply loan owner of property Q who buids or improves thereon,and who does such work Nmsett or herself or through he or her own employees,provided that such improvements axe rot intended or offered for sale.f,however,the buiding or improvement is sold within one year of completion,Me ZONING APPROVED BY r owner-builder will have the burden of proving he or she did not build or improve for the purpose of•.e). DATE: '0 I,as owner of theproperty.am exclusively eoLtwdoe with licensed contractors of constructlthe• •ld•(Sections7044,he Business end Professions Code:The Contractorstha License Law does not apply to ownercense who uida ire• • es thereon and who BUILDING APPROVED BY err DATE: contracts for such protects with a contractor(s)licensed pursuant to the Contr.. Illoense ;w). F t+ /" • am exempt under Section; B.a P.O.,f• this reason: • APPLICATION ISSUED BY: - DATE: O : 1.`3 •Ci • ,• qillita_A A ' J ' *********************47r %WWW********** ** ♦ LEGALIZATION:N F E E SUMMARY STRUCTURAL S GMENT : N I do hereby certify That I am aware of end understand the .• : : -• California Health and Safety Code Sections 25505,25533,and 25534,and that I or any future building occupant will I will not(a - ., need to comply with said staleand codes athe requirements for a permit for construction ormodifrcationhomtheAktanagement. -•..Raid«nalconmruaionappErationaare exemptfrom these BLDG PMT PLUMBING ELECTRIC • MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 43 . 00 •Dale: Applicant: 25% SM I P/NON—RES WORKER'S COMPENSATION DECLARATION:I hero affirm under penalty d PLAN by Da v perjury one following declarations: ISSUE FEE • 15 . 00 ❑ I have and will maintain a certificate of consent to seffiinsure for workers'compensation.as provided for by Section 37C0 of ihe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the performance of the work for which this permit is issued. o I have and will maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the TOTALS > 4 3 . 0 0 1 5 . 0 0 0 . 0 0` 5 8 . 0 0 58 . 00 00 work for which this permit is issued.My workers'compensation insurance carrier and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 58 . 00 OVER/SHORT: 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This sea/on need net be completed it the permit is for one hundred dollars/stool or len.) .5 8 . 0 0 ❑ I artily that in the pedamence of the work for which this permit is issued.I shall nd employ any person in any manner so as to become subject to the workers compensation laws of California. end agree that R I should become subject to the workers' ***********************************IE*****************if************************* compensation provisions of Section 3700 of the Labor Coda,I shall forthwith complywith those provisions. INDIVIDUAL F E E BREAKDOWN Date: Applicant: j Warning:Failure to secure workers'compensation coverage s unlawful,end shall subject an employer to criminal penalties and TYPE QTY D E S C R I P T I 0 'N •. UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(3104000),In addldon to the cost of compensation,damages as provided for In ort Section 37osprthe LaborCode,Inroc esandafomey'shw. MEC 1 INST FORC—AIR/GRAV ,FURN <= 100 K BTU 9 . 00 9 . 00 • CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of penury that there is a construction lending agency for the MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 . 00 3 . 00 pedormawe of the work tor which this pemmsa issued(Section 3097,Civ.C). MEC 1 FACTORY FIREPLACE 6 . 50 6 . 50 LENDER'S NAME: MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAUST 6 . 50 6 . 50 LENDER'S ADDRESS: MEC 4 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 18 . 00 . I certify that I have reed this application and state that the above information is correct.I agree to comply with all city end county ordinances END OF FEES and state laws relating to building construction and her.by authorize representatives of the city to enter upon the abwedmenfwned property for inspection Purposes. JULIE H`•t IERLAIN Name 0• +_ 0013 22 30'15512? L8� 58.00.cif.1,I Date: _I I -cis • 07/14/95 TINE: 75:!u sign .e ppliamVComractor (5151-46.WP) Whde-Building&Safely:Green-Fle;Canary-ApplcanL Pink-Revenue;Goldenrod-Assessor ,. t:ONSTRUCTION AND PLANNING POOL« SPA Date InspectorDate Inspector �- GPPROVALt Permit # APPROVALS Permit # • • 1. Temporary Electrical Service oriole • -al 52. Pool & Equipment Location .. 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. / 54. Forms . 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UF ER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. _® 8. Foundation _ 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. - � 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection _ 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains .- 64. Plumbing System - Final 14. Rough Plumbing • 65. Electrical-Final 15. Rough Electrical-Conduit " -f 66. Solar System-Final - 16. Rough Electric Wiring I 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING _ 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. R.u• H--ti • & Ai C. .rti. i • i►� FIRE DEPT. REQUIREMENT .gam. 20. Rough Factory Fireplace SW APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T"Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREV. FINAL 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: / �7,00y-- 34. Final Heating & Air Conditioning -i G - , 35. Final Gas Pipe-Test 36. Hood or Canopy ,P---G04-447-- 37. G447--37. Final Factory Fireplace 38. Final Plumbing -----..-. • 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer -_ 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING _ 48. FINAL PLANNING 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co_ .. 51. CERTIFICATE OF OCCUPANCY • No Date . .. A0t Esss0FBWLaxD: 2647 WESTMINSTER PL UM1 CITY OF COSTA MESA — BUILDING PERMIT .0 NERS(R.IEIFlc*1: CHAMBERLAIN, CRAIG � ' ,. /PERM NO: P 073238 ' -A-' ADORES& CHAMBERLAIN, JULIE 2647 WESTMINSTER PL I . PERMIT NO: P 073238 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA,CA 926. 7 PPI. A .KAIUNO ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE : PLU PURPOSE: ADD ARCHITECT OR ENGINEER: JULIE CHAMBERLAIN /.' uC.N: C22330 JOB DESCRIPTION : 420SF 1ST FL, 555SF 2ND FL RESID ADDITIO SQ FT: . ARCH.OREIC's ADDRESS: 2647 WESTMINSTER PL. .' UMT: C.M. CA 92627 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / CONTRACTORS NAME COMRACTOWS'UJUNG COMMENTS : REF: B-72931 " GARBAGE DISPOSAL ADDRESS UC.NO.: **************************************sESE•+ ********sE******************sESE*st**sESF** - MTl Z O N I N G REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby aflkm under penally of perjury that I am licensed under provisions of Chapter 9 ETB ACK S (commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force end effect - CRT LIC.NO.: LIC.CLASS: LIC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dale: ContractorFRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby am,under Penalty of perjury that I em exempt fon the Centred=License Law for the following reason(Swine 7031.5 Banes and Prof mims Code:Any cly or county whid requires a perms to commie.Mer.improve, PARKING REQ: P RO V: PARCEL : 43920110 Z N E: REF NO: demolish,or repair any structure.Prior to IC issuance.also requires the appkanl f«such permit to file a signed statement that he or she ' is licensed pursuant to the provisions of the Contractors License Law IChepler 9(commencing with Section 7000)of Dinbion 3 of the PLANNING NOTES> Business and Professions Code)or that he or she is exempt therefrom end the basis for the alleged exempicn.My violation of Section > 7031.5 by any applicant fix apenal eubjeds the applicant toecivil penallydnot mus than hie hundred dollars l$5001). ******************************************************************************* ❑ las owner of the property or my employees wlh wages as their sole compensation,will do the work,and the stmdure is not intended DEV EL OPMENT SERVICES R V I C E S R E U I R E M E N T S or offered ler sale(Section 7044.Business and Professions Code:The Contractors License Law does not appy to en owner d properly Q who builds or improves thereon,and who does such work Mmself or herself or through his or her own employees,provided that such improvements are not intended o ofbred for sale.If,however,the building or inpromenent is sok within one year of completion,the ZONING APPROVED B Y a �' ownerbuilder will have the burden a proving he or she did not build or improve for the purpose of sale). DATE: 'y3 I,as owner of the properly.am exaluh*ly contracting with licensed contractors to construct the project(. ' 7044.Business and --_-- Professions Coati.The Contractors teens,Law does not apply to an owner of progwy who brei i es thereon and who BUILDING APPROVED BY : • �.' DATE: contracts I«such paws with a codradods)licensed. -uant to the tractors License • axonal se under B.SP.c. rormbreme: / APPLICATION ISSUED BY: tLEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT: N hereby candy that 1 am aware o and understand the reqs . Caliomia Health and Safety Code Sections 25505,25533,and , 531,and thator any fauna building occupant will/will not(circle• - to comply with said state codes and the requirements ler a permit forconstrudim ormodifiatonfromMeAir Duality Management Dist -.Residential construction appliatonsare exempt from Mese se BLDG PMT PLUMBING ELECTRIC ' MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 106,00 i..- Date: ..-Date: Apdkent: 25% ,.ti SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: PLAN : • , t ❑ Ihave and ail mantannXself-insure mewSections' ISSUE FEE 20 . 00 r,i code,for the performance a me work f«,w:ch this permit is issued. BUILDING—DIV > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE o Ihays end mil maintain workers'ampemmmnitsirang,a required bySettee 3700ofthe Labor Code.for tieperformance othe TOTALS----> 106 , 00 20 . 00 0 . 00 126 . 00 126 . 00 . 00 work for whim this permit is issued.MY workers'compensation insurance arrir and Policy number are: Carrier REVENUE 'DIVISION TOTALS--> COLLECTED . . • • 126 . 00 OVER/SHORT; 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANICF ;IRE SMPP/TOT GRADING PLAN—CHECK (This setups need s0(beconp/etedi the permit isl«one hundred dollars($1001 or less.) 126 . 00 /. ) El candy mmat in the performance o the work for which this permit is issued,I shall not parsone e employ any in any manner to •.'y /' , become subject to the workers'compensation laws of Californias and agree Ihm Cl should become subject to *********************************** to the worker ***************1(,*'1E************************** compensation provisions of Section 5700 of the Labor Code.I shall forthwith comply with those provisio s. _ INDIVIDUAL F E E . BREAKDOWN Date: Applicant: edam/ng:FaNun to secure waren'compensation coverage Is unfawM,and shell subject en employer rocriminal penalties and TYPE QTY DESCRIPTIO N - fines • UNIT COST TOTAL COST civil up b one kinked thousand dollars($100,000A M addition to the cost o/compensation,damages as provided for In Section 3706 of the Labor Code,Interest and attorney's fees • PLU 2 BATHTUB 7 . 00 14 . 00 ' CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a construction lending agency ler the PLU 1 DISHWASHER . 7 ,00 7 . 00 performance o the work for whimmb permit is issued(Sedioe 3097.Cir.C). PLU 1 SINK, KITCHEN A 7. 00 7 . 00 LENDER'SNAME: PLU 3 WASH BASIN . ' /: 7 . 00 21 , 00 LENDER'SWS ADDRESS: PLU 3 WATER CLOSET ( TOILET) ,J-, 7 , 00 21 . 00 I codify lhatl have readthis application and mmethat the .• :information is Med.I agree to compywilh allmy edcoumy ordinances PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 and slate laws relating to building conavud We,. horde representm'xes of this Sy to enter upon the above-mentioned propend foriepedlon pmpme. PLU 1 SEWER, CONNECTION TO BUILDING•` EACH 15 , 00 15 . 00 JULIE CH 1 i5LAIN PLU 1 FIXTURE SET/TRAP W/PIPING & BACKFLOW 7. 00 7 . 00 \ ' n ion, /� PLU 1 WATER RE—PIPE END OF FEES 7 .00 7 . 00 sQ: /�X oma �• � � -4� - _ Signature of. , r-pot : rect.:. . u. t i.013 (5151-46.WP) While-Building 8 Safely:Gran-file;canary-Applicant:Pink-Revenue:Golenr«HAsseseor • 711Mir POOL SPA -1 ' 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. 978/71f `/1C7. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. !-�! 54. Forms 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P-Trap, ❑ Undrgrnd, 10. Structural Floor System - ; 61. APPROVAL TO DECK 11. Property pwer Line & House Connectiona.S..5 62. Backwash & Receptor-Final 12. Sewer Cap LL 63. Heater & Vent-Final 33. Roof Drains . - 64. Plumbing System - Final 14. Rough Plumbing ! el 65. Electrical-Final 15. Rough Electrical-Conduit I - 66. Solar System-Final 16. Rough Electric Wiring -"I 67. Fencing & Access Approval 17. Rough Wiring Sign 1. 68. APPROVED FOR PLASTERING _t. 18. - 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - ,. a ' yrs) 34. Finaf Heating & Air Conditioning 0 -27 ?c- acs Pm 35. Final Gas Pipe-Test D12.-"ert_ 36. Hood or Canopy '-. / '(S� 37. Final Factory Fireplace • ' e � A7 -et, e--cibti7 1 Lim CRY[ 38. Final Plumbingf�1 X9-24 As. 39. Water Service-Final ¢ . AIMISIII 40. Gas Service-Final 41. Solar Domestic-Final b - 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation 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 Co 51. CERTIFICATE OF OCCUPANCY ' No. Date 41111 sSORBMLOPR 2647 WESTMINSTER PL 1.111T: CITY OF COSTA MESA - BUILDING PERMIT 1 OMNEWSMYEIFI0IONN: CHAMBERLAIN, CRAIG PERM NO: E 073236 i . ADosssx CHAMBERLAIN, JULIE 2647 WESTMINSTER PL PERMIT NO: E 0736 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA, CA 92627 ANaA CONSTRUCTION TYPE32: PERMIT TYPE: ELE PURPOSE: ADD ARCKIrECTOREJOEER:JUL IE CHAMBERLAIN SND- C22330 JOB DESCRIPTION . 420SF 1ST FL, 555SF 2ND FL RESID ADDITIO SQ FT: ARCH.OR ENG.'S ADDRESS: 2647 WESTMINSTER PL uMr: � communes NAMEC.M. CA 92627 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTORS MALMO COMMENTS : REF: B-72931 ADORE$& MC NO.: 344E34*363E46464646*3636*363646*4644*3636443634463E343436*46*4E46*1E34343434***36463646***3434343634143436*444636443446363636444436*#36463644 UNIT: ZONING REQUIREMENTS I LICENSED CONTRACTORS DECLARATION:I hereby slim under penally of Perjury Na I em licensed ander prwoions Of Chapter 9 S E T B ACK S (commenting with Section 7003)of Division 3 d the Business end Profession Code,and my license is in full force end effect. Cm LIC.NO.: LIC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING Dale: Contractor: FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjxy Mall em exempt from the Contractors License Law for the , following reason(Sedon 7031s Busies,and Professions Code:Pm ciy Or County which requires a Perms to oonawa,alter.improve. PARKING REQ P RO V: PARCEL : 43920110 Z N E: REF NO: ,, emdoh,or repair any structure,prior to its issuance,also requires the applicanl tar such Permit to file a signed statement that he or she ;`".:;h5 licensed Pursuant to the provisions of the Connectors License law[Chapter 9(commencing with Section TOW)d Division 3 d the PLANNING NOTES> ' Business and Preteseons Code)or Thal he or she is exempt therefrom and the be®for the alleged exemption.My violation of Region > 7031.5 by and applicant for a permit subjects the apploanl to a civil penally of riot more than nee hundred dollars IS 501). 4E 46 dE 1E 1E**1E iE 1E 141(-*1E**iE*iE lE iE*3E 1E*3E 1E*****1E 4****dE*1E fE 1f lE*lE 1E lE*iE*lE 3E**3E*3E if*3E IE dE**1E aE 1E 3446 iE if*1E 1E 1E iE 3F lE ❑ orffeof lemtor 4Bdosisodsole CtrmemdOaof °nde oeredfor salSemon77044. us�anPro.eionCe The ontradofLimLawd rapplyyloano erpropyD EV EL OPMEN T SERVICES REQUIREMENTS who Wilds a improves thereon, and who does such work himself or herself or through his or her own employees,provided that such impoveneaa wend intended or dfeeedlorsate.ithowma.the building ainpmvemea'n'cid Milli"oneYs"mmpYon,the ZONING APPROVED BY _ DATE: _ owner-0ulda will haved provingthe burden he or she did not build or improve forthe purposed sale). Y❑ I.as owner of the popery.am exclusively contracting with honed contractors to construct • (Section 7041,Business and Pntrol:.faCode:The c withaat;canesLawdoesratappy10anowr L�orimpmestneeonanewho BUILDING APPROVED BY DATE: _ convects for such Section: with a contractor(s)licensedB.&P. maul to the Co,\A��/rls`�trYal law • exempt under Sectors: B.AP.C.. this APPLICATION ISSUED BY: DATE: t ligi '�' '0 - 9 ********36363636363646**364E*3646*46343E*3E 3f 343E 463E 36364E 4E 4E 464E 3E 4E*4E*♦E 3E iE 343E♦E 3E* 3446 herebyc«nymelataw.reof and udmatadthe regarem term.w.enwsafeyCode s.aias25506.nsu.end LEGALIZATION: N F £ E S U M M A R Y STRUCTURAL SEGMENT:N 25534,and Ila I or any have building om1penl will/veil not facie one)need to comply wish said male codes and the reguhemam ler • a pemafor ooreamhor modifmionfrornlhe Ai�G3�y anepmera District.Raddeaelconmrudon appimonsaeesamm from therm BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 1 19 . 3 5 Date: Applicant: 5 0% SMIP/NON-RES WORKERS COMPENSATION OECLARATION:I hereby Mian under penally of Perkily one of the following dedarmom: PLAN ❑ Ihave and wamaintain acertificate aconsent m sen am -insure ler as provided Section ISSUE FEE 15 . 00 Code.forthepedonnanceoftheworktorwhichthispermitielesued. : BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ I have and MI meintan workers'compemation insurance.as required by Sedion 3700 of the Labor Code,for the performance of the TOTALS----> 119 . 35 15 . 00 0 . 00 134 . 35 134 . 35 . 00 work for which this permit S issued.My woken'compensation insurance coder and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 134 . 35 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (This section need not be completed I the panne is for one hundred dollars f$100/or lees) 134 . 35 ❑ I certify the in the performance of the work for which this pennb IS issued,I Modl not employ any penin in any manner so as to become eubjea to the warkere'compeaeion lave of Celomu,and sores the d I'MUM became subjed to the mt.' 4646463446k###34464646464644343434343E344434k363444463636364646343E3E36343436363E46444436#34343636463646463434444E#463634343E34363434364E443E3434463644 Dal.:compensation provisions a Section 9700 a the Labe,I shall Ionnwnn Cpnpty with thosepmvoions. INDIVIDUAL F E E BREAKDOWN A Warning:Fetes to secure worken•compensation coverage Is unlawful,and shall subject an emPloYof h,criminal Penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($104000),In addition to the cost of compensation,damages as provided ler In Seddon 9R6odthe Labor Labor Code,lntegnf and attorney.is... ELE 20 FIXTURES, LIGHTING - 1 ST 20 EA. . 75 15 . 00 CONSTRUCTION LENDING AGENCY: I hereby effinn under pmeM d WOW Ihm Iden is a canetrudon lending agency for the ELE 20 R EC EP T/OUTLET 1 ST 20 EA. . 75 15 . 00 perforrnancealnewok br which twPemiloaa.d($eaon309T.cn.c). ELE 34 RECEPT/OUTLET ADDITIONAL EA. . 45 15 . 30 LENDER'S ELE 20 RECEPT/SWITCH 1 ST 20 EA. . 75 15 . 00 LENDER'S ADDRESS: ELE 12 RECEPT/SWITCH ADDITIONAL EA. . 45 5 . 40 I certifylhat I have read thisappl'raion and sate that theabovew°nnm'oniscorrect Iagrea to comply with as oily and counyordnan® ELE 4 RES APPLIANCE NOT OVER 1 . 0 HP 3 . 00 12 . 00 and state tan relatip to Wadi g cuaion and .. . authorize representatives this dyenterm enter upon the aboveesoned propertyfurinspecionprposes. mwELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 JULIE CAMB 11 AIN ELE 1 SUB-PANEL 11 . 00 11 . 00 PrintELE 27 FIXTURES, LIGHTING ADDITIONAL EA. 45 12 . 15 1 1 . t 16:21-x00186121 TOT 134.35 \ Date: DATE: 07/1'r/45 TIi1E 15:18 ipneare. r. .nlredar I\'5151d6.WP) White-Building A Safely:OreemFle;CenW-ApPicam;Pink-Revenue:OoMemodAaaeaaor --- - -- - -- --- • ' CONSTRUCTION AND PLANNING POOH . SPA - �1 APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location _ 2. Soil Pipe-Undrgrnd. -' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. - 8. Foundation • . 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System H 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - • . 65. Electrical-Final 15. Rough Electrical-Conduit -Ir 66. Solar System-Final • 16. Rough Electric Wiring ?As I /l/ll 67. Fencing &Access Approval 17. Rough Wiring Sign (�' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts. Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof.Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling {Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric -a- _� _ Notes: 3 -!8 Yd /ockriee` 34. Final Heating & Air Conditioning �'` 35. Final Gas Pipe-Test . . 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING --• 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date ,r .4 F r— —I It-I I i.-e. n'-.VLA• j C 1! 1 I J I I BB.N BATH 1 1 1 i HI 0 IP . • • C.-•'-'-'‘- B II API BED OM 1 �" I i1/41* eifr , ? f�lr(-'1,�= i tR A TI FLOOR PLAN NOTES SE£ I !-9' /: _ {. _- ! I. µL GLASS SHOWER.NO tm 1 FOP rl iJ� I ' YfCtY ENCLOSURES SHALL BE Of L"/ 11NA WW �� 1 A 0 O _ryI 2. FEE WINIIOW F ON INC WINDOW - J CI 'oalrn umca.rrrc y E ♦ SOOTrstoRmCuSNt. B FOR SOUGHT — 4. ACCESS IN CIL. O p F. FIREPLACE SHALL BET'TEDDY _ /� �/�J�I /% 1 -'t� NCORS/iK-]B,w/&AIROLO. /SC ^ fY��%\ � II to I15'A R DOORS t COMBUSTION P8041 AIP ARA R 1 II �S6 HIGH , REPORT ESIBS. PROVIDE SPARK LASS OA C II 41 .. WIN. F Y-C CLEUR IN FROM . L� yr GUIROPAIL \ tl BAl - I Oi _ L OF W./ER CIDFI]BOWL y, ! INE'-x]!: ^6W x•-0• - ` S.CAUL,A.JOINTS wxERE ,plt, ! ' FLUBBING nnuREF CONTACT WALLS OR MOORS. • Y I,r I w.wArER HEATERS RAMC xoN-RIGID • L Att+CONNECT.AND ova . IN CLOS. l _ ��(‘ NCMM SN.LL BE ANCHORED OR n O 5 O Y — / _1 I SIRAMFO. t V-5 1!3 T 5'-s I!x' Y-L 1!C• 1.1 / I,1„ Z'-9 v: Q � WALKIN ' c C _I 040(• r I • r � C�S. n©I STER /b pp p BEDROOM 2 BEDROOM V o . I I o I } n=c PIACE CNIWNEY r T a r 1 11e I) V now FiPsi FLooP �i#tY I rf I6F7 — J Qc ® ! IT WALL LEGEND SC REIc WALL TO eF PFWa O RE BM w1µTO //I_ NCWIJN I e eilmiWINM, Nom WLL i ; r'r i. 0 0' ' I I A 12_61 2 H ; o-U y 31'-10 jr1 %1`°'r Y-01 b /- E) TWI ; j 2R'-ro yr(ERSnNC) :m'-r IEE16nm) 1 7.c ,/ Ex Ex 0 O DEN GARAGE BEDROOM SUB OUT CAS. O, NTME L ECT.UNDRYOR I QA ATN -- u Alla;NEW WNL WTI CASTING • -J Ex =t1" Z OI 1q, �` 0 �IP;__ l F.6 1 c.wmT a.,q_I :M11 0 & STMN r/ j. ../ t V 1 0�. 1 ' 1 1 'ex. {"NMA '( ". 2 LES 4+.h� QR. . – 0� LIBRARY i[El' -. -� _Olt I 1 R« 1, brmr-7 r'�4t ,-1 Q S." �I It,M I.—Fi (1.4/ 6r E4CW. C.IA. VI �p WDR('� ', �° �KITCHF J lrR R 7 t<(a-CAA c.. („Shi - D sl v 69Ss6on 2-11 — IVB La i I:. __— y/ — i— sss I' $E 9 GnitDcyDIIC) K•�cbw Go w ion • Oi S,- I I is=. R — —r) -VP I ( 1_• Ok _co 1 � eve_ .-5c o�o I ( Y Sec W R« �I 13 s+s C. M • ] •dG y` 3'-6 }-6 I I T-9 6 I ✓ L`r m A Ir � 12'-:a _. _. lS „psi.wdas L.JtifJ1 L 344-�Er,^ J CDO e DINING, 00 ( 7 Bsft.r* G P( 1r FA FAMILY ROOM 2b1'( Ge.yv4 '' ?,O GO ♦ firA ' s . fi-fi WLN PARTITION Y I 0111.1M 4- 41 FEAfld �j PR. r--T EIRE PLACE 11111 -1 A I '(1� T a (.1 I— 6 .o E / (1011 10 p 1 scr i I 8 0 (M - - 1 e 1 m- 8 Ir-6:/S j S-C' JI-:G I/2 I • AODRESS OF BUILDING: 2647 WESTMINSTER PL Wit CITY OF COSTA MESA — BUILDING PERMIT i'tFSNAMEIFKNan7I: CHAMBERLAIN, CRAIG PERM NO: B 072931 ADDRESS CHAMBERLAIN, JULIE i2647 WESTMINSTER PL PERMIT NO: B 072931 PLAN CHECK NO: 02072-95 A GOVT: N SUPP : N COSTA MESA,CA 92627 APPL.MMUNCADDREss' CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD ARCHITECT ORE/ MEER: JULIE CHAMBERLAIN UCNo.: C22330 JOB DESCRIPTION : 420SF 1ST FL, 555SF 2ND FL RESID ADDITIO SQ FT: 3, 975 ARCH.OR ENG.'S ADDRESS: 2647 WESTMINSTER PL WIT: C.M. CA 92627 CLAIM VALUE: 80, 000 . 00 CALC—VALUE: 75, 150 . 00 GROUP OCC : R-3 / CONTRACTOR'SNAME: CaITRACTORSMNUNO COMMENTS : REMODEL KITCHEN—FAMILY—DINING ROOMS ADDRESS: UG NO.: ******************************************************************************* WHIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions or Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. - CRY Lt.NO.: LIG.CLASS: LIC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: 21 FT 10 IN REAR: 18 FT IN FRNT: FT IN REAR: FT IN Dale: Contractor: LEFT: 30 FT 8 IN RGHT: 3 FT IN LEFT: FT IN RGHT: FT IN OWNER BUILOER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Cerement License Law for the folkway reason(Secrion 7031.5 Business and Professions Code:Any city or county which requires a permit to COOSITUCt,alter,improve, PARKING REQ: PROV: PARCEL : 43920110 ZNE: R1 REF NO: demolish.or repair any structure,pen I0 is issuance.So requires the applicant for such penal to file a signed statement thai he or she a licensed pursuanl lo the provisions of the Contraders License Law(Chapler 9(commencing with Soden 7000)of Dbision 3 of the PLANNING NOTES> 420 SQ. FT. FIRST STORY AND 555 SQ. FT. SECOND STORY ADDITIO Business and Professions Code]or that he or she is exemptlhereh«n and the basis for the alleged exemption.Any violation of Sethon > - (-975 SQ. FT. TOTAL TO EXISTING SINGLE—FAMILY RESIDENCE. 7031.5 by any applicant or a permit subjects the applicant l0acivil penalty ofnot more than In hundred dollars l$500)). *****************,x*******#**„**„************* 4341E********IE I****I**********.* ****** ❑ I,as owner of the property or my employees with wages as their sole compensation,will do the work,and the endure is ndinlnded or offered ler sale(Section 7044,Business end Professions Code:The Contractors License Law don not apply to an bonier of propend D E V E 2, 0 P M' E N T S E R V I C E S R E Q U I R E M E N T S who bulds or improves thereon.and who does such work Nmseff or herself or through he or her own employees,provided that such - �/ vY I improvements areml intended or offered for sale.R,however,the building or improvement a sold within one year d complelin.the ZONING APPROVED BY ______r DATE: _ G }}�� ownerbuilder will have the burden d proving he or she did not build or improve for the purpose d sale). e'- en I.as owner of the property,am exclusively contractile with licensed coniacl«s to wWud the Aged(Sedan 7044,Business and l -- / Professions Code:The Contractors License Law don not apply to an ower d progeny wife builds or improves thereat and who BUILDING APPROVED BY . ,/</ j 1 1 DATE: (O / et- 1 I contracts for such projects with a concretion)licensed remnant to th Contractors . ossa '= of t exempt under Section: B.$P.C.,brihe APPLICATION ISSUED BY: • i# '*3F3 DATE: W - - •23,'S ************************* �� * *************** ** 4�rebycertify that Iamawaredand understand the requireme deomiaMeaehand Safety Code Section25505,PSraa,and LEGALIZATION:N F E E S U M M A R Y STRUCTURA SEGMEN :Y and thal I«any Mute building occupant will/all nor(circle one)need to comply win said state codes and the requirements for a permit for construction Cr modification from the Aa y anagament Didrid.Reekn «mn coe Residential construction are neon in these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ..- proviaiow. PERMIT 531 . 50 7 . 52 Date: Applicant . SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dederetions: PLAN 86 . 37 ISSUE FEE oI have Code,'ndwwmaintaanceofrnel.aconsent toself.maurel«workerscompensatin.as provided l«bySmin3700of the Labor BUILD ING—DIv—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE code,I«1n.penerman.adwwMf«wNchtniepemlteiasaed. TOTALS----> 539 . 02 0 . 00 . 86 . 37 625 . 39 625 . 39 . 00 ❑ I have and wil maintainworkers'c«npeaaton insurance,n required by Section 3700 d performanced the Labor Code,for the the work for which the permit is issued.My workers'compensation insurance canier and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED• 539 . 02 OVER/SHORT• . 00 Policy Number; BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK `(This section need not be completed y the pennu is for one hundred dollars($lO0/«ess) 531 . 50 - 7 . 52 o I certify that in the pedonnnce o the work for which this permk is issued,I shall not employ any person in any manner ea as to become subjed Io the workers'compensation laws d California,and agree that a I should become subject to the workers' ******************************************************************************* compensation provisions of Section 3700 of the Labor Code,I Mak fomwith oomphy with those provisions. INDIVIDUAL =F E E BREAKDOWN Dale: applicant • Warning:Failure to secure workers'coniaemafon coverage Is unlawful,and shall staffer an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000A In addlion to the cost of compensation,damages a provided for In Section 37C6ofMeLabor Code,interest,and aromeyflees, SFR 975 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 72, 150 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the SFR 3000 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 000 . 00 performance of the work for which the permit is issued(Seaton 3087,Cb.C). LENDER'S NAME: END OF FEES LENDER'S ADDRESS: I certify that I have read this applcmion and stale that the above information is coned.I agree lo comply with all ply county uny ordinances a and state laws Sating to building construction and hereby authorize representatives of the ply Io enter upon the above-mentioned propend - for inspection purposes. V SU IlC j' BERLAIN , i• . \ r _ Date: 1023 q5 arc : i ,:. Sgreture� - ApeNAppicanVContrect« (5151.4e.WP) While-Building&Safety:Green-File;Conary-Apptcant;Pink-Revenue;Goldenrod-Assessor V CONSTRUCTION AND PLANNING POOL _ SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1 Temporary Electrical Service or Pole 52. Pool & Equipment Location 1 Z. Soil Pipe-Undrgrnd. .`.• 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. -7 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5'. Steei Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UFER Grnd. �L 57. APPROVAL TO COVER-GUNITE 7. Footings • $'/ y6- /T58. Electrical Conduit-Undrgrnd. 8. Foundation /7('f ! / 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. s�60. Backwash Lines, P-Trap, 11.. Undrgrnd. 10. Structural Floor System 1 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap / 63. Heater & Vent-Final 13. Roof Drains - ')) 64. Plumbing System - Final 14. Rough Plumbing • . 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # • 21, Ducts,in Structure 70. Underground Hydro 22, Ducts, Ventilating • 71. Product;Piping 0 Gas ❑Oil 23. Gas Pipe-Rough& Test • 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 1/20- � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ! I� 75. Dry Chemical , 27. Frame and Flashing / 7e7`� 76. Dry Standpipe 28. Lathing& Siding '• t Y 77. FIXED.SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing io1k7/fr'Adr HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: •7 y) Ccw v/'/ 34. Final Heating & Air Conditioning //7�,2 • et e,/ /. /Oil 35. 35. Final Gas Pipe-Test • cel d� 36. Hood or Canopy - _ • 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final • 41. Solar Domestic-Final • 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations r • 47. FINAL STRUCTURE & BUILDING e /�3/ - 48. FINAL PLANNING - •49. Electric Release to Edison ; 50. •Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY _ No. Date NEWPORT-MESA UNIFIED SCHOOL DISTRICT 15 !7 .6ICATE OF COMPLIANCE OF DEVELOI-...cNT FEES PURSUANT TO AB 1600 AND AB 181 TO: ( k.--rCity of Costa Mesa District Receipt No. z2V/ ( ) City of Newport Beach c/ ( ) County of Orange Plan Check No. 9 F O ?W l x Applicant: s\ l •I a �1 � t�°''��`dr-�"+–J�I. �p Address: 2�-K"T1 kr(-1 �1 i 4�i� ' , t �i•M(, Telephone Number: (1 L+) o't - q-c 72 TracUP d Lot umbers) -- — Location of Project: Ial– Number of Square Feet of /� �q�/ Residential Space / / x $ 1.72 Total /'O / /, Residential/ Sr. Citizen Space • x $ .28 Total Commercial and Industrial Space x $ .28 Total • Warehouse Space _ x $ .2235 Total Commercial/Industrial Project is: (Check One) Warehouses Motel Preschool R & D Bank Auto Repair Movie Theater Neighborhood Shops Hospital Mini-storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park Fast Food • This project is exempt because 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 Sc ool District. By: . Aulhoriz.•%¢presentative j 2 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 a • - -• ropriate City/County shall be notified. Date: /�+ �- 9S Applica CITY OF COSTA MESA BUILDING DIVISION CERTIFICATION OF SKYLIGHT INSTALLATION Permit No. 411n7.3 Property Address 1 tc l r`ra �R r Owner 4tio UC.ta rA-1.444teeptimo Contractor State Contractor License Number Classification I hereby certify that I have installed, or caused to be installed, an approved listed skylight I.C.B.O. # SIE P.- 21 (.P on the roof of above subject address.That I have re-fabricated the roof to the standards of the industry and'in accordance with Chapter 32,34,52 Appendix 32, and Section 1704 of the latest adopted edition of the Uniform Building Code as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer.The integrity of the area worked on is as good or better than the rest of the existing roof. CIKI further certify that I am the owner of the property. (Owner-Builder permittee only). 0 I further certify that I am: O Owner of sole proprietorship company O Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Company or Corporate Name 474649 l0 -n-11 tSP- •.dreaa Received by Building Division a t=as_ Sar. — • 4". 2X02 By: Signature w Date InnI Date Printed or typed na e • 1029-46 White-City;Canary.Owner;Pink-Contractor ERLIg FINAL GRAbING CERTIFICATION ORIGINAL Project Address: 'O- 7 v1aien-111?feP-- PC' ' C- . Lot Number: Permit Number: 1 129 By Civil Engineer: I certify to the satisfactory completion of grading in accordance with the approved plans, specifications, local and state codes. All drainage devices required by the grading permit, grading plan and grading ordinance have been installed. Adequate provisions have been made for drainage of surface water from each building site. The minimums are: • 2%Fall from structures within 5 feet from exterior walls. 1% Fall for asphalt surfaces and landscaped areas. 0.5% Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded tract map were set. All final grading eleva- tions are within ± 1/10 of the designekelevati. . ' • Supervising _..re` t A /l— Reg. No. ignamrc q Date V ' B �LQ • AltedrA Trilitb:4) * `UP. a •1 * NO.C22332 U�ql a�cc OF cAU' 33 • STAB and SIGN 1591.46 . . FINAL GRATING CERTIFICATION Project Address: 2-04-7 6.50-eiMt/,\% - int-/ • Lot Number: Permit Number: 151c7--sit Al I cern to the satisfactory completion of grading in accordance with the approved pl. - specificatio local and state codes. All drainage devices required by the grading permit, grading plan and _ •ding ordinance have been installed. Adequate provisions have been made for drainage of surface ater from each building site. The minimums are: .-/------- 2% 2% Fall from structures within 5 - = from exterriior walls. I% Fall for asphalt surfaces and Iandsca. areas. 0.5% Fall for concrete surfaces o-approved . .osal areas. The final monuments as she on the recorded tract map were s- All final grading eleva- tions are within ± U t of the designed elevations. Supervi . g Civil Engineer Reg. No. (Signature) Date Tl-+ � aP/. ala kb •9 � ptS co 1 /ks -��rJ C N A ccs , k. , � crE; Th PPP rxJg , C=42,11.{74C., 'p L,A. , C to Ni tc_-N- t S Pic eA(ZT 6f T clrr_ r CA.9----. _y:: � * -Ittr \v . / No 332 u...,, tet- r--t rNt r2t�‘til P�- E-C-1 A.1 t C,T s'ltOF CALO. C, ` -.-Q- 0- --‘‘.F. -KP. 5i9 i STAMP and SIGN u199136 • tAi°`EOU arie- `2-10 `i6 PROJECT ADDRESS: UNIT: OWNER'S NAME: 2647 WESTMINSTER PL g CITY OF COSTA MESA — BUILDING PERMIT DCo1.A Mn. 0 nCt71QC ADDRESS: CHAMBERLAIN, CRAIG w.. . CHAMBERLAIN, JULIE PERMIT NO: P 067385 PLAN CHECK NO: N GOVT: N SUPP: N 2647 WESTMINSTER_ ar'. COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE : PLU PURPOSE: NEW ARCH/ENGINEER: REG.NO.: ADDRESS: JULIE CHAMBERLAIN C21119:32 JOB DESCRIPTION : DEMOLISH CARPORT CONST NEW 478SF GARAGE SQ FT: 2647 WESTMINSTER PL PERMITTEE: C,M, CA 92626 CLAIM VALUE: CALC—VALUE: GROUP OCC: M-1 / ADDRESS: SEAN C GRATTAN ( 714 ) 240-1222 33671 BAYPORT WY COMMENTS : REF: B-67383 7000)SW CONTRACTOWIQECI,MTIQN;0Q(tp¢93 affirm that I am licensed untleci visi*2NChptjr9 • m.•s.gwith Section i6+eitik*ititnFttir*it+ts6ieitr*it46taa6atitx-iritic*it-ieitit#ir[-iteE4EieiFatafic•i!.y.if*.it•�E4EietEieiEie.tEit- .i6.tt.tEit.itis.x.x.ic.aE***.*.>(..>(..>Eet.�Ey. of vision 3 al the Business and Professions Code.and my license is in fullforce and effect. ZONING REQUIREMENTS CITY LIC.: STATE LIC.: CUSS: �/ SETBACKS Date: 5-7 q _ clgnat`drP20 B i Adir WOR%EAS'C MPE ATION DECLARATION: I hereby affirm that l have a senificate of cone to self-insure or a cervi mate of Workers' MAIN BUILDING ACCESSORY BUILDING Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN POLICY NO.: EXP.DATE: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN COMPANY: ❑ Certified copy is hereby furnished. 0 Certified copy is filed ecity : g0' m. PARKING REQ• PROV: PARCEL : 43920110 ZNE: REF NO: PLANNING NOTES> Date: rs . _�-c�1/a-_ > EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thi tion need notb t'�tetl it the. tis for one honored 15100)ar less). ******************************************************************************* I cenify that in the performance of the work far which this permit is issued. sr ?plo an ••in any manner so as to become D E V EL OP MEN T SERV ICES REQUIREMENTS sod' r the Workers'Cr pensation Laws of California. Air • Date: Signature: // / ZONING APPROVED BY DATE: NOTICE: '.atm making this declaration,you should become Cec1 to the Worker r•rensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deem yoked. BUILDING APPROVED BY : 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(Section 3097,Civ.CI. APPLICATION ISSUED BY: '�• DATE: S LENDER: *********************4***********ic ****************************** ' ADDRESS: ************************************************************************** **** LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 12 , 00 pursuant to the provisions of the Contractors'State 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 25% SM I P/NON—RES any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). PLAN I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ISSUE FEE 20 . 00 ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through TOTALS----> 12 . 00 2 0 , 0 0 0 . 00 32 . 00 32 . 00 , 00 his or her own employees.provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). REVENUE DIVISION TOTALS--> COLLECTED : 32 . 00 OVER/SHORT: 00 I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon - . 32 . 00 7' - and who contracts for Such protects with a contractor(s)license pursuant to the Contractors State License Law).I am aware • that Proof of their Worker's Compensation insurance should be provided to me. it********.It•*-1(if,N,•*,*********,*.***** *.N,.1(,.k,*,***,ft*7t*****,**,***44*************************** ❑ I am exempt under Section: B.a P.C. INDIVIDUAL' F E E BREAKDOWN for this reason: TYPE QTY D E S C R" I P T ION UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and pLU '1 LAUNDRY TUB OR WASHER' 7 , 00 7 • 00 25534 and that I or any future building occupant wiluwitl not(circle one)need to comply with said state codes and the requirements for a pLU1 GAS PIPING SYS OF 1. TO 4 OUTLETS 5 . 00 5 , 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • these provisions. . END OF FEES Date: Applicant: I hereby certify that I have read this application and state that the above information is co . .gr'-to co r,with all city and county • ordinances and stater g building construction and hereby authorizeArr '•rt•- ter upon the above-mentioned . properly for ins tat Ton pug es. Date Signature: / 01 00161391-00161391 T+J T 32.00 Drivers- cen a or Social Security a: DATE: 06/01/94 TIME: 15:32 16416 White—Building:Green—Ca_e cnlp2ement Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL .,PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 4._G. j4.. /jy/QJ) 53. Steel Reinforcement 11 l.Lll��-``1t�=-%% 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrr,d.,Test 9. Wat ; Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Struttural Floor System I 61. APPROVAL TO DECK 11.�°-roperty Sewer Line & House Connection 7.1a 62. Backwash & Receptor-Final - 1 12. Viewer Cap 63. Heater & Vent-Final 13. Roof Drains _ '` 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 OSI 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning � ��j G'-(9Y_LCLt�L-T'COrs_/�TiL �.Z1� 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 'j_tZMI 1 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: 2647 WESTMINSTER PL CITY OF COSTA MESA — BUILDING PERMIT nrn_ x4 ran/ n ncnio -. ADDRESS: CHAMBERLAIN, CRAIG CHAMBERLAIN, JULIE PERMIT NO: B 067383 PLAN CHECK NO: 01094-94 L GOVT: N SUP P : N 2647 WESTMINSTER PL COSTA MESA,CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: NEW ARCH/ENGINEER: REG.NO.: ADDRESS: JULIE CHAMBERLAIN C2"732 JOB DESCRIPTION : DEMOLISH CARPORT CONST NEW 478SF GARAGE SQ FT: 478 2647 WESTMINSTER PL PERMITTEE: C ,M. CA 92626 CLAIM VALUE: 6, 000 . 00 CALC—VALUE: 8, 890 . 80 GROUP OCC : M-1 / ADDRESS: SEAN C GRATTAN ( 714 ) 240-1222 33671 BAYPORT WY COMMENTS: X LICENSED CONTRACTOBIDtCLARATIOND jIIniUy affirm that I am licensed underTLoyisiou3s2teRjptir 9(c men • th Section ****iEiEiEiEifiEiF***)G***lEiFiFififaEifiEiEiEificif#******1FlE{(.*.{c{I-.)E*at.{{7FYEB{.*a(..)F.R.)ESE***{e.*{t..)(.*a[..**..IE.xc{k. 33.3x.)S.x.{F*. 7000)of Division 3 of the Business and Professions Code.and my license is in full force and eflecl. ZONING R EQU IR EMENTS CcI,C.: STATE LIC.: CLASS: SETBACKS Da ->// y/ 6r4 ¢SagdrP 20 B WORKERS'COM PEN TION DECLARATION: I hereby affirm that I have a certificate of co nt to self-insure or a certificate of Workers' MAIN BUILDING ACCESSORY BUILDING Compensation lnsurace.or a certified copy thereof(Section 3800. Lab.C). FRNT: 61 FT IN REAR: 14 FT 6 IN FRNT: FT IN REAR: FT IN POLICY NO.: EXP.DATE: LEFT: FT IN RGHT: 3 FT IN LEFT: FT IN RGHT: FT IN COMPANY: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PARKING REQ: 2 PRO V: 2 PARCEL: 43920110 Z N E: R1 REF NO •PA9 4 0 6 PLANNING NOTES> REPLACE (DEMO) 2—CAR CARPORT WITH 2—CAR ATTACHED GARAGE AT Date: Applicant ' • > EX., ' SF RESIDENCE. (VARIANCE FROM SIDE SETBACK REQS . ) EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be oomph e permil i .r.r ndred(5100)or less). *************************tE***************************************************** I certify that in the performance of the work for which this permit is issued,II shall ' p••any s.nI. anner so as to become DEVELOPMENT SERVICES REQUIREMENT S s leg to the W -kers'C pensation Laws of California. 5-131 -Ti- h.— oat 3/ C7 signature. /L ZONING APPROVED BY ' Art41 " DATE: NOTICE.If.afte making this declaration.you should b• .me ...` to the Workers'Co . r..ion provisions o1 the Labor r 9 Code,you mus forthwith comply with such provisions or this permit shall be deemed revo ed. BUILDING APPROVED BY 14 A. DATE: 7 3 1 — �- 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(Section 3097.Civ:c). APPLICATION ISSUED -BY : • a DATE: — 11 1 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 (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING repair any structure.prior 10 its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 10 8 . 00 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 8 9 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by SMIP/NON—RES any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). PLAN 70 . 20 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ISSUE FEE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through TOTALS----> 108 . 89 0 . 00 70 . 20 179 . 09 179 . 09 . 00 his or her own employees.provided that such improvements are not intended or offered for sale. If. however the building or improvement purpose of saleinin one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 108 . 89 OVER/SHORT• . 00 Las owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon 108 . 00 . 89 and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. *****************,******,***,IE****.)E**,**1E*,****,***af*,*******,***df********************* O I am exempt under Section: B.S P.C. INDIVIDUAL F E E BREAKDOWN for this reason: Date: owner TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 25534 and that 1 or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a SFR 478 R E...S_ GARAGES TYPE V 1 8 . 60 8 , 890 . 80 permit for construction or modification from the Air Quality Management District,Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is cor agr•- . - . city and county ordinances and stale laws relali :to building construction and hereby authorize repre of trh r.0 upon the above-mentioned prgAgrty for inspecli purpr.es. (/"/,aI Ir/ cSignature' yr'I1 01 00161389-00161390 TOT 108.89 Driver's Lice 'e or .tial Security a: Canary—Applicant:Pink—Revenue',Goldenrod—Assessor / , CONSTRUCTION AND PLANNING POOL APPROVALS Permit# - Date Inspector APPROVALS Permits Date Inspector 1. Temporary Electrical Service'or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �j 5. Steel Reinforcement 6�-8 �1p9 1ji 56. Rough Plumbing & Pressure Test 4 6. Electrical UF ER Grnd. i 40- [� 6.4.1 57. APPROVAL TO COVER-GUNITE 7. Footings 614-W a(/[7 58. Electrical Conduit-Undrgrnd. 8. Foundation S« ph gyp..-7 a4"M' 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. / 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # {I 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 9 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 6-2.2-IN 60.4 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & hAonocoat 75. Dry Chemical 27. Frame and Flashing 7-1q-94( ec.. S-. 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing 7-17-7( 64/41- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING f 'i5 c - 48. FINAL PLANNING 4.1 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ECT ADDRESS: UNIT: OWNEWSNAME: 2647 WESTMINSTER PL CITY OF COSTA MESA — BUILDING PERMIT _nro as ton_ r nC7DQA . ADDRESS: CHAMBERLAIN, CRAIG CHAMBERLAIN, JULIE PERMIT NO; E 067384 PLAN CHECK NO: N GOVT; N SUP P : N 2647 WESTMINSTER PL COSTA MESA, CA 92627 CONSTRUCTION TYPE: PERMIT TYPE: ELE " PURPOSE: NEW ARCHIENGINEER: REG.NO.: , ADDRESS: JULIE CHAMBERLAIN C2P732 JOB DESCRIPTION : DEMOLISH CARPORT CONST NEW 478SF GARAGE SQ FT: 2647 WESTMINSTER PL PERMITTEE: C,M, CA 92626 CLAIM VALUE: CALL—VALUE: GROUP OCC: M-1 / ADDRESS: SEAN C GRATTAN ( 714 ) 240-1222 t3�+3�6�71 BAYPORT WY n COMMENTS: REF: B-67383 LICENSED CONTRACTOR'DE6t'ARATIO)PITrQ)eTyallirm that I am licensed undei-prvisiMiswf.Clalpr9 •mm'• with tion **********#'*#'*****######x-#x•ir.•#####ir##w#######iF#dt*****########################if## 70001 of Division 3 of the Business and Professions Code.and my license is in lull force and effect. w Z ONING REQUIREMENT S . LIC.: STATE LIC.: CLASS: ' / SETBACKS n 01 / sioa�rg20 B — MAIN BUILDING ACCESSORY BUILDING alit.: Co PEN •TION DECLARATION: I hereby affirm that I have a certificate of co Ito self-•: re or a certificate orkers' FRNT; FT IN REAR: FT IN FRNT• FT IN REAR: FT IN Compensation fdsur. ce,or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN COMPANY: 7 Certified copy'shereb furnished. ❑ Certified copy is filed with he cif Div PARKING REQ: PROV: PARCEL: 43920110 ZNE: REF NO: ►, PLANNING NOTES> rate. — � Z d Applicant:_ > ******************************************************************************* Ex ION F M WO ERS'COMPENSATION DECLARATION: (This sent need not be completed it the permit i5 for one hundred(5100)or less). edify that in the p ce of the work for which this permit is issued.I shall not employ any person in any manner so as to become D EVEL OP M EN T S ERV ICES REQUIREMENTS I subject to the Workers'rs'Compensation Laws of California. Date: Signature: ZONING APPROVED BY DATE: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. BUILDING APPROVED BY : I— 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(Section 3097,Cie.C). APPLICATION ISSUED BY: • CJUA�� DATE: S)-- LENDER: ###***#####**#############*#####***###*xi(fEleaf#*Tt###iEt#i'sF####iR#########*x#####i( 3!-# ADDRESS: ######**************#********ih*##'###**** E##if-###9E###!n########!f-#*#iE###**** E#i(**** LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 6 , 75 pursuant to the provisions of the Contractors'State 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 5 C.,* SMIP/NON—RES any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5503). PLAN I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ISSUE FEE 15 . 00 ❑ structure is not intended or offered for sate(section 7044,Business and Professional Code: The Contractors'State License Law BUILDING—DIV—) PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herseu or through TOTALS----> 6 . 75 15 . 00 0 . 00 21 , 75 21 . 75 • 00 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 com0letion,the owner will have the burden of proving he/she did not build or improve for the purpose 01 sale). REVENUE DIVISION TOTALS--> COLLECTED : 21 , 75 OVER/SHORT• . 00 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon 21 . 75 and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware thatproof of their Worker's Compensation insurance should be provided to me. *******************************i(*##-##7r-*7F{L#*1f##*i(.*{F#T{.*##.7(-*-*#*i(##***TE#****-lf##**** ❑ I am exempt under Section: B.a P.C. INDIVIDUAL F E E BREAKDOWN for this reason: Date'. owner. TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST I do hereby teddy that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 4 FIXTURES, LIGHTING 1 S T 2 0 EA. 7 5 3 . 00 25534 and that I Or any future buiidmg occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 3 RECEPT/OUTLET 1 ST 20 EA, , 75 2 , 25 permit for construction Or modification from Inc Air ualuy Management District.Residential construction applications are exempt from ELE 2 RECEPT/SWITCH 1 ST 20 EA, . 75 1 . 50 these provisions. END OF FEES 1 Date, Applicant: I hereby certify that I have read this application and state that the above information` oner omply with an city and county ordinances and statelaws elating to building construction and hereby authori�s7^ Main.•a filer upon the above-mentioned ropertY for ins /Qection urposes 01 00161392-00161392 TOT 21.75 Dal : 3y 54— Signature: DATE: 06/01/94 TIME; 15:33 Ori e's License r Social Security?: — — 1641-46 Whio.Buedmg:Green— trforcernentl Canary—Applicant:Pink—Revenue;Goldenrod—Assessor 111 CONSTRUCTION AND PLANNING POOL ..SPA ` APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector'� 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, C Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final , 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring /7/ / e 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date VWNCK en. +i++uv L, nuuA_Leun Li. DATE JOB ADDRESS 26147 Westminster Pl. BUILDING PERMIT NO. 39280 jGENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Carport t.—,... /�i-tm. •- • - • LOT TRACT FIRE ZONE VALUE E 1, 40.00 I r ECTIONS Signature Date TYPE VN GROUP J ZONE R1 SOIL SUBCONTRACTOR PESMITS ISSMED GAS Date I Number W ATER - Signature Plumbing - ROUGH PLUMBING ;7113. s), LINE HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE^ OR POLE LJ UNDERGROUND POWER 0 ROUGH WIRINGHeating and Vent. C TRENCHES U FORMS 0 STEEL REINF. d Ci/e.../2-5-.... �/9 T FLOOR SYSTEM BOND BEAM ri STEEL REINFORCE in • SHEATHING FRAME AND FLASHING r-� LATHING — IN fl OUT I I PL"`TER, BROWN COAT SURAL, FINAL. Electric HEA'ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC. FINAL BUILDING, FINAL *JEW 7-23.)? ' 1 A ' ' e 3928.0 .,iv 75-74P�Rp0 6734s*u•*�2i.50 ?5-114-',PAILTiv COSTA MESA BUILDINM•SAFETY DEPARTMENT �'/ 75'7L'Cgc•OO 873?o*n'*t.-2' (� P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 1' t A For Applicant to Fill in Completely APP (CATION FOR BUILDING PERMIT 4 RE I V D DATE RECEIVED /D1AT`F�/,ISSSSUE''D') BUILDING /7 / //^] 1 .\ �tn., Ct' �`, 11.–.7 � 1 , ADDRESS /mob `7 7 W �/ OWNER `I I 1 t..•� I u C, t\ -[ J A.P.NO. • —1 .:3— Q PERM•IT:O.• a BUILDING n(col , n I�St MAIL ADDRESS ` 1 �I\( ADDRESS meq,rex. to • Z -y+-- 37C, fir, d_ W CITY Cc., 1-a MGscct TEL. o_ TRACT OT BLOCK 1 Z CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH OZ cn LENDER J co BRANCH C to aADDRESS OWN/EER7�WIL<L/IAr WI �vALI 1 ` re L • ARCHITECT TEL. USE a R.Pn& S UE 1400'i J Q OR ENGINEER NO, ZQ I, FIRE A/ W CC ADDRESS ZONE 3 TYPE L" GROUP f W LLA APPROVED/// /J/� ry ([ J O CONTRACTOR 0WN\Cx I^ BY /`� DATE �V 7I co Z JCC ADDRESS W w TEL. ZON NO.OF USE OF NEW O= CITY NO. �, PLANS 2 BUILDING � ;dFL I ZF W O STATE CITY YARDS APPROVED YARDS APPROVED NIL LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 0 0 (FROM C/L STREET) SIZE NO.OF BLDGS. OF LOT NOW ON LOT ReNT FT. FT.t USE OF EXISTING BLDG. R•SJDE FT. LFT. I— SIZE OF NO.OF z/ U Z NEW BLDG. • ROOMS STORIES L.SIDE FT. T FT. I0 Cr EXTERIOR WALL I ROOF / r COVERING f COVERING 'REAR FT. (� FT. 2. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& /� MAIN BLOGS. ACCESS.BLOCS. VAR.+ DATE O /Fx/a 1/ /�.An/OD/Gr//'� C U.P,# 1`'�y ` �� ( APPROVED Z �Y ROVEDGv/�y^qk&N DATE 11"2"5/7� O \ r pI hereby acknowledge that i have read this application and state UCC all tl the egula ng b u ildinn is strrcctti antl adree ao cnot a ploy L..) ell laws regulating builtling construction, end I shall not employ any person in violation of the workman's compensation laws ofthe State of California. to a Z I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR • Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT ONLY: [[ am exempt from the provisions of the State of California Business (% 6• and Professions Code,Division 3,Chapter 9. VALUATION to �{.,\. PERMIT FEE $ er Signature of ( J p II nC\1\/,� 4 /J �� m Permittee s-"`^-1` //��'�` )L1[/L/VJ�\` $ AI PLAN CHECK $ / E f I — LL Authorized Agent TOTAL FEE $ ' OWNER LAMP, G. F. DATE 4-16-59 JOB ADDRESS 2647 Westminster BUILDING PERMIT NO. 9066 7G�EgNE L CONTRACTOR Owner — Builder VALUE $ 1,400.00 A4" 1-23 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Carport & Patio 1 UP J TYPE V ZONE R4 PLAN NO. 9066 INSPECTIONS DATE PERMITS ISSUED SUBCONTRACTOR DATE NUMBER Trenches Forms Steel 4 4*-ZY-sr Floor System Steel Reinforce Chimney Re-Rod Bond Beam - Frame and Flashing Lathing, In Out Plaster, brown coat %)?13 / /(i9ii� /4 -u-sy Underground soil W/G Pipe Test Top Out . Furnace Gas Vents Rough Plumbing /VW5 P-3-'T/ s Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System • ;H 1-' 'ng Final `' Iging Fixtures, Final Final Gas Test . Construction Pole • .Underground Power Rough Wiring Fixtures, Final tf./y-.f. .'j_:-Q-j 9 OCCUPANCY Form 210-5M--1-57 QnAA 9066• • �uhh RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT LII/(,,/ ci c% P.O.BOX 317 COSTA MESA, CALIFORNIA FINANCE DEPT. SA TOR APPLICANT TO flit IN COMPLETELY APPLICATION�FOR PERMIT TYPElOR PRINT BUILDING BUILDADD EING iSS (! Y/ M//ltiK.yG(.( S7 ,y/CO{STTAA ME A. CALIFORNIA FOR OFF/CE USE ONLY A(/ L or I RECEIPT NO. I PERMI�OT NO. OWNER __�/`�i� T ,,,/// ` MAIL ♦ RECEIVED BY DATE RECEIVED D TE I UED Q ADDRESSS 67 r,�rJ..0....f p�J�fJ / ,6 s7I y-ori �JJ/� CITY [ //!�( � TNO. (J(/J/� ADDRESS • ARCHITECT LIC. COSTA MESA. CALIFORNIA OR ,INFER NO.O. ADDRESS ZONE typi V' O?OU�7 '�+ CONTRACTOR,....4,7 STATE L C NO. BPPROV-ear ��L�) pp''.�J_ BY GI'"T! ATE ADDRESS/L� IC-, / ZONING LEGAL __�I LOT ' I ,7J/_ ZONR // I NO.OF i'7 I BUI OF NEW i�- DESCRIPTION NO. o/ /BLOCK TR /IICC((LLl�� ,//•�I //PLAN9 T// BUILDING' / A.P.NO. / q- /(J ( - d BYAPAt/ `.D DATE /L' I SIZE LOT �o7 f A 7s / I NO.OF NOW ON LOTB YARDS 614-nLL9 / REQUIRED ALLOWED USE OF = (CENTER LINE ST.) - �i EXISTING BLDG. FRONT ��/ FT. IN. SETBACK LINE FROM /12 I CENTER OF STREET , ,C/ • REAR YARD R.SIDE -- I- FT. IN. 11 SIDE YARD i LEFT 1.-5- 7- 1 RIGHT ' S / L.SIDE 6FT. IN. DESCRIPTION OF WORK REAR 4,9' FT. IN. NEV 1 II ALTERATION I II ADDITION I/ti ' REPAIei I II MOVING 1 II DEMOLISH I S ZIE DING lO Y1411 NO.OF ROOMS STORIESJ/ EXTERIOR WALL IROOF 3 )/% COVERING COVERING n` -/ USE OF BUILDING AND WORK TO BE PE F ED 701.77 1 'II HHHEERRREEB'BYY ACKNOWLEDGEACNOV /W EDTHAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- pV RPOSE OF ESTABLISHING A PERMIT FEE ONLY, PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCT N. ///�///J VALUATION SIGNATURE O //l/ PERMIT FEE $ l PERMITTEE e/t� V ��LLiT $ PLAN CHECK $ AUTHORIZED AGENT / i TOTAL FEE S iA OWNER HAMSACH ., RICHARD A. •\ DATE 3-10-55 (% JOB ADDRESS 2647 Westrginister BUILDING PERMIT NO. 995 G—'ERAL CONTRACTOR Moore Construction VALUE $ 595.00 LOT BLOCK TRACT - Reside upper walls with J. M. Asbestos Siding GROUP J TYPE V ZONE R4 FIRE DISTRICT 1013 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench Foundation Forms and Grade to Garage . Rough Framing ' :A'Plumbing, Rough to Slab APWi- Plumbing,Rough Complete AI4/'/ Temporary Pole a / l�����(J ' ..(/ ' 4 Wiring, Rough ' i `)-A OW Heating, Rough W L • /_ , Heating, Final \ I' ),%,;3 �, v' gSewer, House p . \Sewer,St. C ` I )yPi 1 F :Tank or Cesspool P S(-A) L.._..ing, In Outet! 99���� dy''v Plastering -C plumbing,Final,Fixtures Complete Plumbing,Final Gas Test Wiring,Final _ Occupancy Form 210 G-H 1500 1-55 Costa Mesa Building Department l APPLICATION FOR PERMIT- • x . 111 EAST 20th STREET 1313 BUILDING I■� COSTA MESA, CALIFORNIA . FOR APPLICANT TO,ILL IN FOR OFFICE USE ONLY el No. Permit No. Building A , Address l�i N�-� ,lyfuL(_P� c) Costa Mesa, California Received by 1 Da ?Zs:. Date Issued Nearest 3 _f0 -� S Cross St. , Building ��/�J9 Address Own er/1,1�1,�/�4,� 1.44,74,4._ Costa Mesa, California Mail U, t '7_ / _(/- _ -Address (a`f/ lU,�,/' Nearest J ` �� Tel. Cross St. City i.#a r/, No. wen Zone ,/ I No.of I-Type I Group J.. Architect or Lip. w Plans Engineer No. Approved by Date Address vow City uo. CORR g4 i 7.. .tractor No. ! r`���.�I,, Address /5;, -!4 4,e+t i� ai LegalLot }r r 1 0 1955 Description I No. I Block I Tract (Attach Metes and Bounds) Size of Lot I Now. on Lot CITY OF COSTA MEStA Use of No.of No.of - 9 1.."4_,-1.Existing Bldg. 4,e_f I Families I Rooms Setback Line from Rear Yard -y Center of Street Side Yard D DESCRIPTION OF WORK r Now I I Alteration I I Addition I Repair I Moving I I Demolish I Building No.of Size Rooms Stories Fvterior Wall �I Roof tring Covering APPROVALS of New Building Foundation Location Inspector Date Forms,Materials, Under-Pinning _ • / l / ' Frame: Fire Stops, Bracing,Bolts ¢•7i, .R�B,t,r vR_ 4, ;, ,/ h hereby acknowledge that I have read MA Application Lath. Int. and state that the above is correct and agree to comply Lath.Ext. with all City Ordinances and State Laws regulating • building construction. Signature of Plaster, Int Permittee ? A-448kCELI E /' Plaster,Ext. Authorized Agt. Masonry Reinforced Valu.ation Permit Fee $ lr-e,� -,3 — Plan Check $ Bond Beam $5,3 Total (IOC OO Fee $ ---- FINAL FORM 204 G-N 2M 5-54 :. - • C - m ' o o 0 0 a L , • • -Street . . r - . ,-(.•.,' p. PLOT PLAN _ ' Show location and distances from - - — property line and between buildings. _ , OWNER DATE L1`25), G'. tALD F. 2-13-59 JOB ADDRESS . _ „• , _ . . . BUILDING PERMIT NO. 8668 GENERAL CONTRACTOR Own Pr-Builder VALUE $ 560.00 A N6123 ol LOT 68 ma 376 FIRE ZONE DESCRIPTION OP WORK Porch addition ,UP J TYPE V ZONE WI ,/ PLAN NO. 8668 INSPECTIONS DATE e PERMITS ISSUED SUBCONTRACTOR DATE NUMBER Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing f-' F Lathing, In Out Plaster, brown coat Underground soil WIG Pipe Test Top Out Furnace Gas Vents Rough Plumbing Cesspool Septic Tank Prop. Swr. Line House Con. St. Swr. Sprinkling System V 'ng Final I .binq Fixtures, Final Final Gas Test Construction Pole Underground Power Rough Wiring Fixtures, Final OCCUPANCY &./� 1 3 Form 210-5M-1-57 u66tf • 8668 ' " Vi L G E 1 U I COSTA MESA BUILDING DEPARTMENT fl�J;j1iCE UE�'i X19$9 R O. BOX 317 • COSTA MESA, CALIFORNIA Gm Of GOSTA r.�E1$a FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING / 47 �_ BUILDING ADDRESS W �srmJ/vsTt/z ��- - COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PERMIT N (/,/ OWNER [-/�A L /) F. L �a PI /? G � e• MAIL //, WI.," I RECEIVED BY DATE RECEIVED WE SU/Ep, ADDRESSaL% 4.FJ GvG STiJ7 /n� S re- �'_ --//—1/4.17 I(/i�'�/%� /�"� TEL. (r�' p BUILDING JJ��V��/ �{/_ CITY(Q%T A f //L- S �} NO. Lr DVu9� ADDRESS 2G 77 //els .n////I % / OROS -ECT ,it LIC. OR NEER . NO. COSTA MESA. CALIFORNIA v FIRE C ADDRESS ZONE Iy' G ZONE /// O.OF s ITVPE V GROUT ' � CITY LIC. // PLAN CONTRACTOR NO. 0 I//'� TEL. APPROVED . ' IF 1 ADDRESS P - NO. BY ( DATE - 5 ` LEGAL LOT 6) V - 3 CORRECTI NS DescalPnoN NO./ BLOCK TRACT A.P.NO. j nn play ',p}�■. SIZE yf / /7 (f / NO.OF BLDGS. 1 ILO I :+' OV }'S ■ p OF LOT O p / /r Q Now oN LOT / It hA V 1 1J EXISTING SLOG. /` t S/ 4 e JI! C E' CITY OF C STA MESA LINE FROM IIT� I \ PL-.r4Iyj11� 1JC.v 1'. SETBACK �4 CENTER OF STREET L REAR YARD �}`j SUBJECT TO 6 OG. DEPT. REG. pp SIDE YARD ' RIGHT ��It,LEFT / RKz1 ,(n/ DESCRIPTION OF WORK "� By_piAt'1 ) DATE �"/A'S - I AN TACH.e'rrf NEVALTERATION ADDITION 1�[ ' 7-- (i e cx� 2-'3-1/47 REPAIR MOVING DEMOLISH \ IC BUILDING �/ NO.OF SIZE J/-J ROOMS / STORIES EXTERIOR WALL R /1 COVERING COOVEOF RING 1/'�V. \ USE OF NEWj �/ � BUILDING 0 -0•2 The Amount shown under valuation is for the I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND purpose of establishing a permit fee only. i STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND ST T LAWS RE / TING BUILDING CONSTRUC- TION. VALUATION SIGNATURE OF 6 PERMIT FEE S PERMITTEE --#.4"1'//` :11/ � / !At 6 /D PLAN CHECK g S AUTHORIZED AGENT TOTAL FEE $ 0-0 Jib • s • i3®6FEE RyECEAIIE� COSTA MESA BUILDING-SAFETY DEPARTMENT �)CS� .-►� P. O. BOX 317 COSTA MESA. CALIFORNIA FINANCE DEPT, For Applicant to Fill In Completely APPLICACTION�FOR PERMITSA TYPE OR PRINT '// y �s BUILDING ADD a1S""s 2 09 X/�`/in,e4Y COSTA MESA. CALIFORNIA For Office Use Only / RECEIPT NO. PERMIT NO. • ���((( ,..../ ♦ �i"//�/lam" �/ n /'Iy/�/ J� /�_/ MAIL Sj..//yy / lI Jv/ /q� RECEIVES B I 074 /% J I �72 (E _v 6 CITY( /�j fir TNO<.IIV Dfij BUILDING �` ADDRESS AROR T ENTER 4 No.L.ICOSTA�MESA. CALIFORNIA ADDRESS • FIRE N� I✓ TYPEZONE GROUP / I- CONTRACTOR APPRO p) ,C1 BY�/�''/)� `C�G/`CCf//..'"'�Itt^A DATE ADDRESS t lI V ZONING 0.-'.-.77-.02.2/21744.4._ ny''1 111 ZO / NO.OF USE OP NEW I �� n�//- CITY -�� I PLANS �/' I BUILDING /L V STATE TEL. LEGAL 1 h l f & 'V•Y, ^ 396 9 / SIC.SIZE O. DESCRIPTION t PK F+ OF LOT 11 4 I NO. OF awes. NOW ON LOT A.P.NO. USE OF YARDS ` EVESt EXISTING BLDG._ -/7/41--221t _ APPROVED ALLOWED SETBACK UNE FROM / (CENTER UNE ST.) CENTER OF STREET REAR YARD /- FRONT 6 q0 FT. t IN. SIDE ARD I LEFT e-jam I RIGHT .2. R.SIDE �.5 FT. IN. . DESCRIPTION OF WORK L.SIDE 3 3 FT. IN. NE . I II ALTERATION I II ADDITION I X REAR r( J!/ FP'Q -G'�/// IN. REPAIR I LOVING DEMOLISH I APPROVED t Li U9 DA/- (0-0 -6? D It) _6" BUILDING%� (�31� RNO. OF OOMS STORI S \ /1-'1 ' TT / ICS SIZE /�W EXTERIOR WALL ROOF COVERING I COVERING - ./ C('/"/A�,"�� USE OF BUILDING AND WORK TO BE PERFORMED ,_-_ - ./ � 61 /I HERESY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT ANO/AAGGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL CITY INA' ATE YNG /�D / BUILDING CONSTRU VALUATION �( SIGNATURE OF PERMIT FEE $ (X�/ PERMITTEE /- u tit $ PLAN CHECK $ AUTHORIZED AGENTS G TOTAL FEE $ 0 CITY OF COSTA MESA o p"'F4:6 BUILDING DIVISION ... • j(+,-.,.,n„�i 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: BC09-00492 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: POOLSPA DATE ISSUED: 12/03/2009 ISSUED BY: BJK JOB ADDRESS: 2647 WESTMINSTER PL CM Suite/Unit: APN: 43920110 Zoning: , , Vicinity: POOL AND SPA Primary Occ: Const Type: SQ. FT: 350 Valuation: $35,000.00 SCOPE OF WORK: INSTALLATION OF A 350SF IN-GROUND GUNITE POOUSPA AT LEFT-REAR OF AN EXISTING SFD. ELEC: 1 POOUSPA ELEC; MECH: 1 FAU < 100K BTU; PLUMBING: 1 SWIM POOL AND SPA, 1-4 GAS OUTLETS, 1 P-TRAP. OWNER: HUBBARD,MARTIN Address: 2647 WESTMINSTER PL Unit: Phone: 949-500-4180 City/State/Zip: COSTA MESA,CA APPLICANT: ELLISON, PAUL Address: Unit: : Phone: 626-332-8731 City/State/zZip: CONTRACTOR: MR CARLOS AND ASSOCIATES License No. 232130 Phone: 626-332-8731 Address: 336 E FRONT STUnit: Cell: City/State: COVINA,CA ZipCode 91723 ARCHITECT: License No. PHONE: ENGINEER: TODD L LACHER License No.67656 PHONE:714-630-6100 COMBINATION PERMIT FEE SUMMARY Building Plan Check: $320.29 Building Fees: $492.75 Electrical Fees: $73.00 Mechanical Fees: $41.50 Plumbing Fees: $130.45 SMIP Residential: $3.50 SMIP Commercial: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES: $1,063.49 "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S INSPECTION TYPE DATE INITAL$ CODES INSPECTION TYPEINTmALs 1616 FixedSystem Final Fire Prevention 208 Final Mechanical LifiDA 1U 1266 PoollSpa Final H 17 /d � 208 Final Plumbing 200 Final Re-Root 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drivers license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. q I have and will maintain workers'compensation insurance,as required by DIVISION.OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: 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 ❑ I hereby certify that no excavation free(5)or more feel in depth into which a number are: 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 tCamerte or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thissecthn need not be completed the gonad is valued al one hundred dollars($1001aless.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Number: ❑ As owner-builder, I will not employ anyone to do work which would I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless ue~d, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division, to the workers' compensation laws of California, and agree that if I should becom- ubject to the work- - compensation provisions of Section 3700 of Applicant's Signature Date t Irr''o. • th comply with these provisions l/I Li /z 3/0 Division of Industrial Safety Permit Number: Apptl is Signature �t L„2 HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to tile and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No (5100.000). IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safely Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST.AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds.or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. _ a registration form for acutely hazardous materials? ❑Yes 0 No ;Gni,, 2321 /.. - C53 (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by 72_/3/0each business which at any one time has on hand a quantity of acutely (..--contractor's SignatureDate _ 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). 0 I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code), prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑ No 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 8. (If"yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Slgnalure Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. Si. re of +:1 /! Signature Date Cr' / / 7Z / aq 3057-16 par) - !f / •nerorA5thor zed Applicant Dale