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Home My WebLink About208 WELLESLEY LN - Building Permits PROJECT ADDRESS: 208 WELLESLEY LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06638: OWNER'S NAME: FORRESTER, PAUL R • ADORESS: 208 WELLESLEY DR PERMIT NO: E 066383 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: REP 546-2385 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REWIRE SFO, ADD MISCELLANEOUS APPARATUS SQ FT : ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / PERMITTEE: PAUL 6 NANCY FORRESTER ( 714 ) 546-2385 ADDRESS: 208A WELLESLEYALANE *******_***************************** :*******a,****fl**, ************>E* ********** COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETH AC K S LTY LID.: STATE LIC.: CLASS: ale, Signature: MAIN BUILDING ACCESSORY BUILDING ORKERS'COMPENSATION DECLARATION: hereby affirm that have a certificate of consent to selhinsure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRN T: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE; • PARKING REQ: COMPANY: PROV: PARCEL : 14139527 ZNE: REF NO: ' —I Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant- ********iter********************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENT S certify that ine the ece of the work for which this permit i ed,I Shall not employ any person in any manner 5o as to become subject to the Workers'Compensation Laws of CaliforniZONING APPROVED BY • DATE: Date' Signature: BUILDING APPROVED BY _ _ NOTICE:It.after making this declaration.you should become reit to Workers'Compensation provisions of the Labor _/ DATE: Code.you must forthwith comply with such provisions or this permit s II be deemed revoked. // CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: — DATE: ..31 �'�y/� which this permit is issued(Section 3097.Civ.C). **************************ax******'" * . . " " " " " ******************aF***x etetelt** LENDER: *********************************************** .****************************** 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 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRAD ING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 4 3 . 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed es 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 15 . 00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the properly or my employees with wages as their sole compensation, will do the work. and the TOTALS----> 43 . 00 15 . 00 0 . 00 58 . 00 58 . 00 , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds Or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If.however the building or REVENUE DIVISION TOTALS--> COLLECTED• 58 . 00 OVER/SHORT: 00 improvement pose soldf le). one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 58 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contractsfor such projects With a contractrr(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. IND IV IDUAL F E E BR E AK D OWN ti I am exempt under Section:B P 7 0 4 4 B.&P.C. for this reason: ALL WORK BY OWNEP TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date ,7-441-.�,ea— ',7-441- ffl Come ELE 14 FIXTURES, LIGHTING 1 ST 20 EA. . 75 10 . 50 do hereby certify that I am aware of and understand the requirements of California Health a Safety Code Sections 25505,25533,and ELE 10 RECEPT/OUTLET 1 ST 20 EA, . 75 7 . 50 25534 and that l or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 4 R EC EP T/SWITCH 1 ST 20 EA. , 75 3 , 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ELE 1 SUB—PANEL 11 , 00 11 , 00 these provisions. ELE 1 MISC CONDUCTOR NOT LISTED REQ PERMIT 11 . 00 11 . 00 Date: Applicant: END OF FEES I hereby wily that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and bet'r . thothe representatives of this city to enter upon the above.mentioned properly for inspection purposes.y� S Date: 'Is Signature: _ W IP.AirlaK '.Ar _SOP 01 00157073-00157073 TOT 58.00 Driver's License or Social Security to: DATE: 03/14/94 TIME: 10:53 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor �• •CONSTRUCTION AND PLANPOO WA n�NI 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 r- 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 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final / 80. FOOD CERTIFICATE ISSUED 33. Final Electric 1�;b6. e�c�-y`_//!)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 r 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: 208 WELLESLEY LN UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 067457 OWNER'S NAME: MCFARLANE, PETER ADDRESS: 208 WELLESLEY DR PERMIT NO; B 067457 PLAN CHECK NO; 02009-94 L GOVT: N SUPP : N COSTA MESA,CA 92626 CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ALT 752-1212 mu/ENGINEER: REG.NO.: JOB DESCRIPTION REPLACE CRACKED SLAB IN GARAGE SQ FT: 1 , 500 '.5 ADDRESS: UNIT: CLAIM VALUE: 1 , 500 . 00 CALC-VALUE; 1, 500 . 00 GROUP OCC : M-1 / PERMITTEE: PETER MCFARLANE (714 ) 752-1212 ADDRESS: 208 WELLESLEY LN *OM*E**S*#R*P****#2#SMA***R**ARA*E*DOOR*x********x##x*#***********************x C.M. CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING R EQU IR EMEN T S 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. S E T B AC K S CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING Date: S'COMPENSATIONDECLARATION: Ihereby affirm Nallhave acenificateofconsent roself.insuraoracertificate ofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT ; FT IN LEFT: FT I N RGHT; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: 2 PROV; 2 PARCEL : 14139527 ZNE: R1 REF NO: ❑ Cemhedcopy ishereby furnished. 0 Cerlifiedcopy isfiled with the citBuilding Division. PLANNING NOTES> REPLACE DOUBLE "SWING OR BARN" DOORS ON GARAGE WITH A > SECTIONAL GARAGE DOOR ate: Applicant: x****************************************************************************** • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R EQU IR EMENTS I certify that in the performance of the work for which this permit is issued.I shall rat e dry any person in any manner so as to become subject to the Workers'Compensation Laws of California. / ZONING APPROVED BY � Z • DATE: � Date: 6 /219y Signature: ` BUILDING APPROVED BY NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. f q 1l CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: .. DATE: 1p ' a� 1 clfri which this permit is issued(Section3097.Civ.C). ***********************• • • • x �'4Ta� ix#ir'*+f LENDER: ************************#*******x*****#*************x****************#+h******** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 35 . 00 . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 22 . 75 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I] structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 35 . 50 0 , 0 0 22 . 75 5 8 , 2 S 58 . 25 , 0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale,If,however the building or REVENUE DIVIS ION TOTALS--> COLLECTED• 58 . 25 OVER/SHORT: 00 improvement lesols within one year of completion.the owner will have the burden of proving he/she did not build or improve farorthe purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 35 . 00 , S0 22 . 75 L7 and wo Professions stlo The Coprojects rs'vdhState c0ntraselawdoespursuant to theownertfctors'rywhohui4sor improves I asthereon ******************************************************************************* and who contractsCo Ie: such Contract with a eumrecterLawlicense not apply t to the Contractors'State wh builds imp' em aware that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason` �^� TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: GPZI/y Owner: ,'/-7C-Ivinde SFR 1500 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 1 , 500 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wilt/ill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby aut 'e represen rives o his city to enter upon the above-mentioned property for inspection purposes. Date:—41 -17e/ Signature: /1/I 01 00161588-00161590 TOT 58.25 Driver's License or Social Security C:: DATE: 06/02/94 TIME: 11:15 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL 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 p•�.y�//� �� l q'Y � 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. r 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # • 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing o_,2.(_4c1. Gam( 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 u `IL„L,In`n , 35. Final Gas Pipe-Test 'rr_ 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 4. 0 C CONN:E1 NOPEGRASS o t ZI KOREAN 0 N ii CNE!NE1 -. ,• KA WWiY.6.A®AV..m jIl BRICK WALKWAY .— C+O1 wE5 r - s•Eu I • Y Øa I �OVTORAGE 1�J p �4 11 {1N9 iv _ w .— �.t fttF.�i F- II Q -Wed 40 o CC • O I Y /� 2oCisfi n5 'i x9 pest z - - _ 3 a v ;n\ • zO art/ s 3i / �' ( & Yx'Y ?est' �(� I I GARAGE --- _.I m i/ 1 ® itY/" P:,,,-.01,',-) (J eyl v' I " 1 IIPi le CO ugh �Wa�l , . v ' —�—t + I / i--� � 1.!q�a;'!- @ Ntw Lta.d« • CDLIQ' s `p lO I i / IS\ �IG,Xy i a —4— _4.__ ,...I.1 99 C. s rJp Prom:nS g.S" � ' \ y lixy o-. Fop nt w ksad er } [�1 / $v( orfs Mo:.. • F roof A*adt+ l ` ) Ie ',r7 in Sao./id 9o23a i (bn t (WALKWAY . —-0. 9er gc door Fe,. i. �, Ems- 6 2 �s� Z GeOD2o 14.1P B I ! t I '1, .:. _: i �. o p.c ,r 0. OF , - AML.:A ( OP•nr-.r or' 4PFRU , D .1 — ;tf; c.c ;f. CONCRETE j2IVEWAY 7' i.'✓• rrr)A�se e,. fh. 1 -L4 e -)2•1-12, rifg� to(1 q CRY OF C• n'1M 1 —1 ��__ •:I: . ' G(rc�i f ) . PLANNING =•T. is�UDansred tplE�t tOANsMai/Oulu C re/�i"�e� eorcre RC1 ro •.. OMNI�nbmdf on same ttltgtsal Li,;tit, Nett re6ar- DATE 6"-x-951 CdYdCahlMid to e�n's>< 27 �xt ,a �IlireiNir nelalwo ...+ dilIMIS �k�s NOT ta atria 1111111111111Vetions 01 ant/teflon* �9s t c�rr� t 1 _ willitagratt NOTES TAL HOME AREA 2,122 sq. ...- .., ,..n.in ea: .37.•a •• mar• .- I .... - . nail RESIDENCE OF OerlsalAgtgawmtisnot ••r • ••°.•�'A:Pmaeuatneda perLIBCp& NANCY & PAUL FOR) TOTAL H()AIE L11NCAREA 1,821 s9. t�� UCED P`RONT 208 WELLESLEY LANE I EXCLUDING ATTACHED(2)CAR GARAGE I DO MO II UUPULt TOTAL CARPETED AHR 1os.a2 sq.yds COSTA MESA L DDITIOI IS, DEI'E%CLUDING(Z)BA HROOMS l- r., ORANGE COUNTY,CALIFOI BE APPNinti t THE PLr'tli,'.iNG DEPARTMENT O ...-COUNTER J •`— KOREAN GRASS O / #1 = ".".> ssa a ccGOZr= CAB NTI ill- - _ Pr._.. - BRICK WALKWAY CVLASHUI Oi-- r....-- � �' .I I 11 1 (ii8_ 0501.<5 DRYER --- g 8a LJ 1!i a 3 — OVERHEAD StORAGE win 03 O- 5 11 ! H / rlXy Po5 t 0- Co^cret- Y 00 ' Q ° :,� 3 r U Y l' /� IAQEd 0 r II GARAGE `_—__TI m 6r) C.>r r-0.,, Gal art I H i' z Q/6 8 x 2 x4. l V 1 I I O nee/5 e v\/ ,i I.Y�:>l :- o., st, --I 3 9x4 Pas fS . — I / C..—.). Plo.r to —.\ I �= 1.w. .... -' 1.endef • E _ EI�'sI. E. © %/ O Crock i Gar•'t Floo/ E cif 1'41 - P t:ft rail: 7P gora5c O.6ropcn,^l BRICK WALKWAY ,` Sfa 6 IS •J. 6e (eP lac<� w;}h sfc./‘ar k'C6)•c..% I CONCRETE DRIVEWAY �,/ R _.— 2/ 3 >) ►Jots : cwt.+t r04 swAvl res4s ov, A HXY — e.si likt-rh NOTES TOTAL HOME AREA 2,122 sq.II. RESIDENCE Of I INCLUDING ATTACHED(2)CAR GARAGE I .0 v(1.4 s'n\t PRINT NANCY & PAUL FORT T}��. TOTAL HOME LIVING AREA 1,627 sq.n. REDUCED CALI''T Y�( I EXCLUDING ATTACHED(2)CAR GARAGE I Ip o NIOS7 SCALE 308 WELLESLEY LANE / \ TOTAL CARPETED AREA 105.42 sq.yas `40 `1d COSTA MESA _ `\ (EXCLUDING(2)BATHROOMS I ORANGE COUNTY,CAUF01 // HR'�/ - l'Joac n— 216 • PROJECT ADDRESS: 208 WELLESLEY LN / '✓`y UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 056691 OWNER'S NAME:. FORRESTER, PAUL R ADDRESS: 20 WELLELEY DR PERMIT NO; P 056691 PLAN CHECK NO: N GOVT; N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP 546-2385 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPLACE BATHTUB, SHOWER AND REPIPE SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERmITTEe: PAUL & NANCY FORRESTER ( 714 ) 546-2385 ADDRESS: 208 WELLESLEY LANE COMMENTS: REF: B55641 COSTA MESA CA 92626 *********************SE**************EE*EE**SEAE**********+E****+E+E* *****EE*********EE* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: SETBACKS Due: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: IherebyaffirmthatIhaveacertificateofconsenttoself-insureoracertificateofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800, Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 14139527 ZNE: REF NO: ❑ Certified copy isis� herebyre/��fumiissheed�. 0 Certified copy iso filed with the city Building g Division. PLANNING NOTES> Date: LS/MeV/772 Applicant: / /Le e / ".�4QGS ie_ ****************lE*************************************************************iF ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1100)or less). DEVELOPMENT SERVICE S REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become . subject to the Workers Compensation Laws 01 Gaffomia. ZONING APPROVED BY : DATE: Date' Signature: NOTICE:If,alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. _ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• �/ ' ' DATE: 3-3s C Z which this permit i5 issued(Section 3097.Civ.C). ************************ * *,* ** ' **** *,***,**,**************** LENDER: ************************************* . ** :************************************ ADDRESS: LEGALIZATION;N F E E SUNFMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby at firm That are exempt from the Contractors'State License Law forthe'following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 6. 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3. 00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 6 . 00 3. 00 0 .00 9. 00 9 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or altered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 9. 00 OVER/SHORT: 00 for the purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 9 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ix I am exempt under Section:0/37044 8.8 P.C. for this reason: ALL WORK BY OWNER TYPE TYPE QTY DESCRIPTIO1 N UNIT COST TOTAL COST Date:._a_ 142.922._ ___7GOwner://cow+ "Meter 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 BATHTUB 2. 00 1 00 25534 and that I or any future building occupant will/will not(circle one)need to complyenth said state codes and the requirements fora PI 1 1 SHOWER 2 .00 2 , 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from PL • 1 WATER RE—PIPE 2. 00 2 . 00 these provisions. /��. @y�j X P I R E D END OF FEES I Date: 3-2.9 92 Applicant: k`, e �70.e zsr2/L 10 npl:te I - ' ' t.• I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county /� �: ordinances and stare taws relating to building construction and hereb authorize representatives of this city to enter upon the above-mentioned •[��] , /�� property lar inspection purposes. ,, < / r Sty 1�^ �� Qp f � L'' _ 'Date:. .2s!Z Signature. aC !ii_,i `J ? Driver's License Of Socul Security•: .. , . _. y- I 1 .. 1641-46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor (g 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. .i, 53. Steel Reinforcement ij •/ 3.- ctriial Conduit Utility-Undrgrnd. •:? 54. Forms r L�R , 4: fslectrical Conduit•Undrgrnd. 55. Electrical Bonding Y.: , 5: Stiel RBinforcemeht,• !,' 56. Rough Plumbing & Pressure Test`' -6:. Et€ctrical UF ER Grad. 57. APPROVAL TO COVER-GUN4TE 7. Footings 58. Electrical Conduit-Undrgrnd. . . 8,'Foundation - 59. Gas Pipe, 0 Undrgrnd., Test - • -9. Water Pipe-Undrgrnd. 'i 60. Backwash Lines,P-Trap, 0 Undrgrnd. ' i 10. Structural FIoo7.S'stem , 61. APPROVAL TO DECK 11. Property Sewer line& House Connection 62. Backwash & Receptor-Final . • t r 12. Sewer Cap 63. Heater & Vent-Final ,` 13. Roof Drains 64. Plumbing System - Final / ." ' 14. Rough Plumbing ' 1 65. Electrical-Final -, J 15. Rough Electrical-Conduit 66. Solar System-Final f;• 16. Rough Electri0Niring 67. Fencing & Access Approval ,' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �" I 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. ,Roth Factory Fireplace - _ - `* v $1PPROVAL�S Permit# t. • 21. Ducts, inStructurg- • - - *• 70. Underground-Hydro • , 22. Ducts, Ventilating_.. .5 r ' ,71, Product'Ptping OGas OOit -� Ventilating:), 23.;Gas Pipe_Rough &Test "-,; - ' 72, Underground Flush^ . 24.'Roth Framing - i ?73.-:UndergrnaP.Storag iTank 0 Gas 0 Oil - • • 25. Roof Sheathing ' _ = . , '74`Overhead Hydro ; 26.,.T-Bar Ceiling (Structural) & Monocoat - _ r ' 75.yDry Chemical , 27.:Frame and Flashing. - - - 76: Dry Standpipe ., t,-, , • • 28. Lathing& Siding .•.:, , •• • •- 77. FIXED SYSTEM-' YS EM-F_INAL. ;' - 29. Insulation - • - ` - l 78. FIRE PREV. FINAL • ., `•30. Drywall Nailing HEALTH'DEPT. REQUIREMENT 31. Plaster BFown Coat , 79: FINAL`INSP@CTION ; • I `I - 32.-Electrical Povuer Meter-Final 1 � •SO.rFOOD CERTIFICATE ISSUED {I 1 •33.4inal Electric, - , . Notes: - , 34. Final Heating-& Air-Conditioning, - ' r _ i 35. Final Gas Pipe-Test _ -- t' _ ' ,36. Hood or:Canopy . r • ',ti • .3: Cr • • - r • 37.-;Final Factory Fireplace - • ,_ �,� r 38. Final Plumbing r, - 1 �2j- �'� � .�//` Y 1 -`39. Water Service-Final,' IL, 40. Gas Service-Final _ ,T . - , , - ^ - -41. Solar Domestic-Final - •• - 42. Backflow Preventer , C c 1 43. Backflow Irrigation , i ,44. Landscape Irrigation System : - z A. , - - • • . , ' 45. Sound Attenuation , s . . - - A . .t r 46.,Handicap Regulations _ _• , _ :• - . 47. FINAL STRUCTURE & BUILDING * _ - 48. FINAL PLANNING - �. 49.:Elehlric Release to Edison - - 1 . 50..Gas Release to Southern California Gas Co : I -( _ 51. CERTIFICATE OF OCCUPANCY . - No. Date 'A-PROJECT ADDRESS: 208 WELLESLEY LN UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 055642 OWNER'S NAME: 'FORRESTER PAUL R ADDRESS: 208 WELLESLEY DR PERMIT NO: E 055642 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: REP ARCH/ENGINEER: 546-2385 REG.ND.: JOB DESCRIPTION : REPAIR AND UPGRADE BATHROOM SQFT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC=VALUE: GROUP OCC; R-3 / ADDRESS: PAUL & NANCY FORRESTER ( 714 ) 546-2385 208 WELLESLEY LANE COMMENTS: REF: B55641 COSTA MESA CA 92626 ***RL*;,E**4**********+E***********RR*RETE****************+ESR**+L+e*********+E*******+r+E**+E LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7. ON INC R EQUIR EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: SETBACKS Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: QPROV: PARCEL; 14139527 ZNE: REF NO: CertifiedEDm thePARKING REQ: copy is hereby furnished. Certified copy is filed with city Building Division. PLANNING NOTES> Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less), DEVELOPMENT S E% 12 VI CES REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner.so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY : DATE: Date: Signature: NOTICE:It,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. r CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the penormance of the work for APPLICATION ISSUED BY• sir DATE• b)----.3a , which this permit is issued)Section 3097.Civ.q. ********************* **** * *** ** ************************************* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E S U M MAR Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,atter,improve,demolish,or PERMIT 6 • 7 5 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0* SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 1500 00 I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 6, 75 15 . 00 0.00 21 . 75 21 , 75 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himsetf/hersell or through his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or tipimprovement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 21 . 75 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 21 . 75 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License law).l am aware *****************-*.******.********.*.************.*.*.*.*.****.**.**.*********.************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN 51 I am exempt under Section: B P 704 4 B.8 P.C. for this reason: ALL WORK BY OWNER TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: JO 4Wi /9.71 Owner exit. �ae/ e ree ELE 3 FIXTURES LI�HTING 1 ST 20 EA, , 75 2 . 25 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and ELE 3 RECEP T/OUTLET 1 ST 20 EA. . 75 2 . 25 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from ELEt 3 RE�CEEgEND OF FEES T/SWITCH 1 ST 20 EA. . 75 2 . 25 these provisions. E �( P Dale: Applicant: • l omPlet61E5sP�f5o55 S I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county }, ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned /a -.4 oity property for inspection purp / _'f� t D26C /?7/ Signature ; ��JJ� 1- wain: - ' • Driver's License or Social Security a: k - .:1:)!:: I t641d6 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor 01 jl9CONSTRUCTION AND PLANNING POG 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. 4lectrical Conduit-Undrgrnd. 55. Electrical Bonding `.. 5. Steel Reinforcement" 56. Rough Plumbing & Pressure Test ` ,- 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE + 7. Footings 58. Electrical Conduit-Undrgrnd. . 8. Foundation - r. 59. Gas Pipe, 0 Undrgrnd.,Test _ 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 9 Undrgrnd. ' 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - e. 12. Sewer Cap 63..Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final • 15. Rough Electrical-Conduit Solar System-Final VI 16. Rough Electric Wiring 4//kg- 4 4, Fencing & Access Approval •- 17. Rough Wiring Sign {�'7 Y/' 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ er 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 Flashir{ •r 76. Dry Standpipe . 28. Lathing & Siding t r • 77. -FIXED SYSTEM FINAL" 29. Insulation ' " r 78. FIRE PREV. FINAL - 30. Drywall Nailing HEALTHOEPTAREQUIREMENT 31. Plaster Brown-Coat , i ; - _ 39. FINAL INSRECTIOW - 32. Electrical Power Meter-Final , I x -; '80. FOOD CERTIFICATE ISSUED 33. Final Electric' - /...2 pi, I 41, . - 'Notes: '34. Final Heating& Air Conditioning , - I - 35. Final Gas Pipe-Test • • - 36. Hood or Canopy - . 37. Final Factory Fireplace T IS - 38. Final Plumbing - - - 39. Water Service-Final - - -40. Gas Service-Final ' _ 41. Solar Domestic-Final - 42. Backflow Preventer , 43. Backflow Irrigation 7 _ _ 1 - - 44. Landscape Irrigation System. -. - . - - 45. Sound Attenuation r - , - - • . i '46. Handicap Regulations - - - •- 47-. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison i •" .� > - - 5d. Gas Release to Southern California Gas CD I I , 51. CERTIFICATE OF OCCUPANCY - \ No" Date PROJECT ADDRESS: 208 WELLESLEY LN UNIT: - CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 056691 OWNERS NAME: FORRESTER PAUL R ADDRESS: 208 kELLE§LEY DR PERMIT NO: M 056690 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: REP 546-2385 ARCH/ENGINEER: REG.HO.: JOB DESCRIPTION : REPLACE WALL HEATER SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / PERMITTEE PAUL & NANCY FORRESTER ( 714 ) 546-2385 ADDRESS: 208 WELLESLEY LANE COMMENTS: REF: B55641 COSTA MESA CA 92626 ********+E****4r+ESE********************************+F+E************+E*****+E********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY ND.: EXP.DATE: COMPANY: PARKING REQ- PROV: PARCEL: 14139527 ZNE: REF NO: D Certified copy is hereby furnished. 0 Certified copy is feed with the city Building Division. PLANNING NOTES> pp' �s Ta > Date:—I-25 9J Applicant;S/IL ,c , eseeSn ******************************************************************************* r EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(1100)or less). D E V EL 0 P M E N T S ER V I C E S REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE:It.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED B Y : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. kr/�y^1 ��` C CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance 01 the work for APPLICATION ISSUED BY• , ` . 1 Sr Id DATE• ;��/ which this permit is issued(Section 3097.Civ.Cl. *********************{E****** *** ******* ***- *******************4E****** *** LENDER: ******************************************** ****************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 0 0 repair any structure.prior to its issuance,also requires the applicant for such permit to rile a signed statement that he/she is licensed 5= SMIP/NON-RES 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 PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15.00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15. 00 0.00 24 . 00 24 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If, however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 24 .00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 .00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts lm such projects with a contractor(s)license pursuant to the Contractors'Slate license Law).I am aware *************************************************************************.******, that proof of their Worker's Compensation insurance should be provided to me. u I am exempt under Section: B P 7044 B.&P. ,BuI N D I V I D UAL F E E BREAKDOWN forthisreason: ALL WORK BY OWNER TYPE QTY D E S C R I P T I ON UNIT COST TOTAL COST ------ Date: 3-241 92 Owneraft 2 ,etceeS7250. I do hereby certify that am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and MEC til I NST^/RELOC RECESSED `• ALL HEATER 9. 00 9 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from E X • I R • D (hese provisions. ; is ��JJ /J,/O� n,2,2E57G`T2. I a P e l ,. Date J'ZS-92 Applicant;f/F�� r dL�• I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county f2)« ii,*sig ;�I� —`ordinances and state laws relating to building construction and hereb nhorire representatives of this city to enter upon the above-mentioned7. properly far inspection purposes. • 4 `Date: .? —ZrS'•/ Signature: � � ��O1 ,: `?rT_: .- .• _ -- _ •, Driver's License or Social Securityx: "p. ,,AT'-• 'J orf' T!, -.• JO, 1641.46 White—Building;Green—Code Enforcement:Canary_Apolic0nt;Pink—Revenue:Goldenrod—Assessor I (•i J- ' CONSTRUCTION AND PLANNING POOL .$PA . • APPROVALS Permit# .Date Inspector APPROVALS Permit # Data 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 Reinforceme)nt 56. Rough Plumbing & Pressure Test 6: 'Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. •i _ 8- -Foundation '•f 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrtrnd. • II 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 - --I 64. Plumbing System - Final • ' 14. Rough Plumbing • �• 65. Electrical-Final - •,' 15. Rough Electrical-Conduit 66. Solar System-Final •. r 16. Rough Electric Wiring 67. Fencing & Access Approval '° c i 17. Rough Wiring Sign - + 68. APPROVED FOR PLASTERING,;, ' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I",- 18. 19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT 20.'Rough Factory F replace r v ' APPRQVALS• Permit# - 21: Ducts,in Structure• .. . ` ' Underground t - '.70. .Hydro • 22. Ducts, Ventilating - .: r . .71. Product,Piping C Gas Boil • 23. 'Gas Pipe-Rough & test - r „ • -> • _72. Underground Flush r G 24. Roof Framing ' '73.-Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - , '- 74• ;-Overhead Hydra; .. 26. T-Bar Ceiling (Structural) &(Monocoat -. 7 75,.Dry Chemical _ - - .` 27. Frame and Flashing. - �, 76. Dry Standpipe �,- - • ' 28. Lathing & Siding ••• r.- } ' •r' 77.: FIXED SYSTEM FINAL` - - "29. Insulation , 78:-:FIRE PREY. FINAL r 30. Drywall Nailing HEALTH DEPT•. REQUIREMENT . r 31. Plaster Brown Coat, ---•___!,1, 79. FINAL INSPECTION - - . 32. Electrical Power Meter-Final • • .80. FOOD CERTIFICATE ISSUED . .33....-F inal Electric 7 _ ' ' i. ' • ` ' Notes: 34. Final Heating& Air Conditioning _ ZS-q4,_ '- . ) ., _ G r • 35..Final Gas Pipe-Test - - ;Kr • , `-•' . - . - r� _. -.L.) • r t i36. Hood or Canopy H s rr. _ 37._Final Factory Fireplace 38. Final Plumbing L 39. Water Service-Final _ . ' - r ,40. Gas Service-Final - ., _ ' 41. Solar Domestic-Final - I 1 L 42. Backflow Preventer . I - I • • 43. Backflow Irrigation - i ,44. Landscape Irrigation System ,- = r _ , - - , t - 45: Sound Attenuation - - • •r . .. II 46.,Handicap Regulations 47. FINAL STRUCTURE & BUFLDING ' r .. . • • 48. FINAL PLANNING ; •49. Electric Release to Edison e i 50. Gas Release to Southern California Gas Co 1 . -51. CERTIFICATE OF-OCCUPANCY . .- -. No. Date nIOJcCT ADDRESS: 208 WELLESLEY LN 0N1T' . CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 056774 • Ot ER's NAME: .FORRESTER, PAUL R AODRESS:, 208 'WELLESLEY DR PERMIT NO: B 056774 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP 546-2385 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 4 SKYLIGHTS 6 NEW WALLS AT FAU SQ FT: 2, 500 ADDRESS: UNIT: CLAIM VALUE: 2, 500 . 00 CALC—VALUE: 2, 500. 00 GROUP OCC: R-3 / PERMITTEE: PAUL 6 NANCY FORRESTER ( 714 ) 546-2385 n ADDRESS: 208 WELLESLEY LANE COMMENTS: MISC DRYWALL 6 STUCCO "FIELD VARIFY! " Re-SP '. 6 551O'// COSTA MESA CA 92626 ****************************+ +E***************+e**********+E***yE*****+E*****yr***+E** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 711001 of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: . FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL : 14139527 ZNE: REF NO: • 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> . > !1i Dale: AODlicant: ********************* t-****Rt**************************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed if the permit is for one hundred($10X5)or less). D E V E L O P;M E N'-T SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become _ subject to the Workers'Compensation Laws of California. ZONING APPROVED BY :7 'tr DATE: PT; • :9!92 Signature: is NOTICE:II.after making this declaration,you should become subject t�rW kerCompensation provisions of the Labor BUILDING APPROVED BY -.. DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. _ A CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• /1♦_/' P� DATE• a'' / ` which this permit¢issued(Section 3097.Civ.C). **iE*** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5 4 . 0 0 repair any structure,prior to lis issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 50 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SNIP —RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 . 00 0. 00 54 . 50 54 . 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED• 54 . 50 OVER/SHORT: 00 for the purpose of sale). BLDG 4PMT MT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOOT GRADING PLAN—CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware **.*.*.*..************************************************************************** that proof of their Worker's Compensation insurance should be provided to me. 6] lam exempt under Section: B P 70 4 4 B.8 P.C. INDIVIDUAL F E E BREAKDOWN `N for this reason: ALL WORK BY OWNE [�� TYPE QTY D E S C R I P T I\O N UNIT COST • TOTAL COST ,.te:�-3i- 92 Owner: ' I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and SFR 2500 ALTERBY" VALUE RESIDENTIAL NOZONE 1 . 00 2, 500. 00 25534 and that I or any future building occupantwill not(circle one)need to comply with said state codes and the requirements for a 1 G D END OF FEES permit for construction or modification from the occupant(? Duality Mafia meet District.Residential construction ap licalions are exempt from R G (hese provisions. P 1 S X , ti —•.rgale:.7'r�� 92 Applicant t 1�' 1� __ �/ I hereby certify that I have read this application and stale that the above informs on is correct.I agree to comply with all city and county f, T ; 41401� - ordinances and state laws relating to building construction and hereb authorize representatives of this city to enter upon the above mentioned I,� /// property for inspection purposes. /• �Y: g',9/ 9 Signature: .11 et'1' 71'- -1 Ll_ Th •„ . • Driver's License or Soria!Security a: l 1641-46 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor S • CONSTRUCTION AND PLANNING - POOL _ SPA • R 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 j 9. Water Pipe-Und'rgrnd. 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 Cap63. Heater & Vent-Final ' 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 4 - 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final k • 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 # . - a 21. Ducts, in-Structure .. . _ 70. Underground Hydro 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0Oil - 23. Gas Pipe-Rough& Test 72. Undergroupd 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 Flashingr 76. Dry Standpipe • 28. Lathing & Siding L442_ 77. FIXED SYSTEM FINAL _ ,. •29. Insulation ! 1 , -,�./' 78. FIRE PREV. FINAL j 30. Drywall Nailing f-t3 A.. j(ty- HEALTH DEPT. REQUIREMENT ,/ 31. Plaster Brown Coat' I - 79. FINAL INSPECTION - . 32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED ' 33.'Firiel Electric • . `Notes: - • 34. Final Heating& Air Conditioning. 35.:Final Gas Pipe-Test - S .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. Backf low Irrigation - - 44. Landscape Irrigation System . , _ _ 45: Sound Attenuatit n - 46. Handicap Regulations - - .- - 47. FI NAL STRUCTURE & BUILDING 2-2-1e? &ire--- 9��G� _U/_� tter/ oiG /',./ , •�-- 48. FINAL PLANNING .. . 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ( - 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. I's •CITY OF COSTA MESA PER NO. ,� TRACT NO. LOT NO. BLDG.- NO. 3048 PTB/07/81 5000 TL CONSTRUCTION PERMIT —5 / • Project Address .208 a.. le•-•177' ` TYPE OF CONSTRUCTION / /1 , Owner i J Phonete/aa_0,2_3(2,50NEW 0 ADD 0 ALTERATION �S'% - • Address , of zokp ee eta-a, ,_ye.., 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. License No. r 0 OTHER DESCRIPTION OF WORK A.P.# Address ' ZONE PLNG. REF.// Contractor ., - . -/. cy�/.6, Phoneu7�j TYPE OF PERMIT BUILDING Tp g�1I t,DING Address r'" yy�� SETBACK C/LST. PROPERTV LINE `T V,/ artetin,��• _4te r4K/ a.e.1- _ 0 GRADING ❑ FOUNDATION 0 STRUCTURAL SIDE YARD LICENSED CONTRACTOR DECLAR4*ION ❑ TENANT 0 ELECTRICAL (PLUMBING ['MECHANICAL/ 5I E YAM.) I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license is In full force and et. • REAR YARD (TO P/L) PROJECT DESCRIPTION Licenyay as Lic nso No. PKG.SPACE REQ, PROVIDED Date V3 AP/ Slgnat fifeX - SQ. FT. WORKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY DATE • certificate of Workers' Compensation Insurance, or a certified copy _ thereof(Ser,(lon 8D0y Lab C.). ,/� GRADING CU. YOS. - ACRES SPECIAL CONDITIONS: Plicy No.eexxCCOO 3'14 1� Company//wa. L`-�l - ;Pricy copy is hereby furnished. !/ REMARKS: tertlfied copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section need not be completed if the permit Is for one hundred • ' ($100) or less). - I certify that In the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK - subject to the Workers'Compensation Laws of California. .. - uWtLLINL. c,AKAGE y\pr BATHTUBS SHOWERS Date Signature SO FT SO FT NOTICE: If after making this declaration, you should become subject 'TOILETS : r URINALS GENERATOR 0-1 KW_1-10 KW - to the Workers' Compensation provisions of the Labor Code,you must - • TRANSFORMER . , forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50'KW_50+KW • revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50+HP - formance of the work for which this permit is issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP - LUNSI HUL I FUN Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) Orthat he Is exempt therefrom and the WATER HEATERS BTU OUTPUT / ee - - • basis for the alleged exemption. Any violation of Section 7031.5 by c-•• applicant for a permit-subjects the applicant to a civil penalty SEWER CONNECTIONS st more than five hundred dollars ($500). . , as owner of the property,or my employees with wages as their SOLAR TANK COLLECT9R5 - sole compensation, will do the work,and the structure is not intended \ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE . -6e APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement rO G MECHANICAL PLAN CHECK is sold within one year of completion, the owner will have the burden SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). BUILDING - - AND G SYSTEM 0-100,000 BTU PERMIT $ SMIP. $ ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING - licensed contractors to Construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to 4-OO • ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ Cl tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+BTU_ PLAN CHECK $ ❑ I am exempt under Section - -- B. & P.C.for this BOILERS BTU ELECTRICAL $ $ reason MICROFILM $ Date - Owner SYSTEM REPAIR,ALTERATION PLAN CHECK -$ TOTAL FEE$ MECHANICAL $ _ • I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- Information is correct. I agree to comply with all city and county - PLAN CHECK $ VANCE PC $_ ordinances and state laws relating to construction,and hereby authorize representatives of this city tentupon the above mentioned c_ property for p tion purp ¢s• er. yi�d p� J Signature u^--'— Date/3�J _- FINAL FEE $ Drivers'License or SS(' _ ISSUE FEE • CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING • POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1 • 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn • • 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 53. Backwash & Receptor-Final 12. Street Sewer Connection - 54. Heater & Vent-Final 13. Rough Plumbing 55. Plumbing System -Final 14. Rough Electric-Conduit ••56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning - 58. Fencing &Access Approval 17. Ducts, in Structure _ 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation - - ' 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final - 28. Final Electric 29. Final Heating &Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing ¶<-e S' /0-49 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed • 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date _,` • _7f AI 02 Twining Laboratories 01 ai'utILn d E%. 'Ch.c. Po BO' • 1 - ::e:- .:..- . .C•:e £E_C.. eq_.:. cue: . 3. 42b.335S . 2,3: e3ea,so . '714) 8?7.b432 ?PF:;. .P%Cis TESTING s .: .. -. .. -D-'•'- .A „ -C , Pei • -e I x• [,::)'= Examination: 5 074-2612 COMPRESSION TESTS ON GUNITE CYLINDERS Mr. L, E. Sprague 5041 Ooanoke Avn. Permit #38315 Irvine, California 92705 PROJECT SWIMMING POOL FOR PAUL FORRESTER' gel/ar ADDRESS 203 Wellesley Lane, Costa Mesa SAMPLE FROM Bond, Shallow End, Deep End ARCHITECT CONTRACTOR Automation Pools ENGINEER SUBCONTRACTOR Gunite Unlimited SPECIFIED MIX Pre-Mix Gunite Mals STRENGTH 2,000 psi DATE CAST 5-14-74 DATE TESTED 5-21-74 5-21-74 5-21-74 CYLINDER NO. 1 II III IV "HOLD" V "HOLD" COMPRESSION 7 Days 7 Days 7 Days VI "HOLD" TOTAL LOAD, LBS. 51 ,500 52,000 51 ,000 POUNDS PER SQ. IN. 2,053 2,093 2,053 Size: 5-5/8" x 12-1/2" 5-5/8" x 12-1/2" 5-5/8" x 12-1/2" COMPLIANCE 7 Day test couplies with specifications. MADE AY DELIVERED BY RECEIVED ON • CYLINDERS L.E. Sprague Dave 5-14-74 DISTRIBUTION: LL�� Automation Pools „Ji�LU��r SAFETY DE:• tbsLa Mesa Bldg. Dept. Gunite Unlimited u ft- 1A • Attn: Dan Mills j L.E. Sprague •.LL RI POLIS ARE SUbRITTLD AS THE CONzIOENTIAL PROPERT, OF CLIENTS. AUTHORIZATION VOR PUBLICATION 01 OUR REPORTS CONCLUSIONS. OR EX- TRACTS EROR OR REGARDING TRIM IS RESERVED PENDING OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLIENTS. THE PUBLIC AND OURSELVES. 330-12 .RalicT ADDRESS: 208 WELLESLEY LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05638;1 I OWNER'S NAME: FORRESTER PAUL R • ADORESs: 2,0&1WELLESLEY DR PERMIT NO: E 056382 PLAN CHECK NO; N GOVT: N SUPP: Y - COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: REP 546-2385 ARCMIENGINEER: REG.NO.: JOB DESCRIPTION : REPAIR AND UPGRADE BATHROOM SQFT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC ; R-3 / ra ! PAUL, & NANCY FORRESTER ( 714 ) 546-2385 ADDRESS: 208 WELLESLEY LANE COMMENTS: REF: B55641 COSTA MESA CA 92626 *X***X ..Ki-**.X :#X#Kdi3(iLXX***kIFdF******** E****K*X.X#Mi lfkleiEM*N3ikXi!#XXi *.X****** E******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Coder and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: SETBACKS Date; Signature: ---- MAIN BUILDING '- ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to sell-insure or acenificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGH T; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ; PROV; PARCEL ; 14139527 ZNE: REF NO: 1 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division, PLANNING NOTES> > Date: Applicant: - ***********X-*******K******iF#XiFit#iEifiF****#ieiEiE********X-EKKli************ i#3fie X3fieiFX?E}; EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the paint is for one hundred(5700)or less). DEVELOPMENT S S. R V I C E S REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'CompensationLawsof California. 0� ZONING APPROVED BY �• DATE; 27iZ�I3/1?�2 youshoul I I/�J NOTICE:If.after making this declaration. should become subject to ars'Compensation provisions of the Labor BUILDING APPROVED BY ; FL— • DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /�� G CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• F _ �5� DATE• °yl Y7 r�— whichthispermitisissued(Section 3097.Civ.C). X.X.Xif..):********iF.X*.XX.ii.K.if.{p7FX k.X..ky,.i(.**{(.K. ix ** F.7FiE*****if#X#itit* ****i:Yifi6ifiF**38T xR- X conk#X LENDER: 'I ********** a#iei4X************iEitiEiE-)EiE 1F**#if#ieiFiliF#X-i%iEi*****ii***lficiFklci4if Y.X#?fiTXiF#iciiiiii*** • ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N DINNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 8 6. 30 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0 t SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 4 . 50 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 86 , 30 4 , 50 0 , 00 90. 80 90 , 80 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 90. 80 OVER/SHORT: . 00 • los the purpose otsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 90 , 80 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who bmlds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).I am aware *.*******X..XXiF*.X.**X..X*K.X.*X*X..XXiE************1F**XiE*IE****X*******-X#****if**X********** that proof of their Worker's Compensation insurance should be provided to me. am exempt under Section:BP 70 9 4 B.8 P.C. INDIVIDUAL F E E BREAKDOWN for this mason: ALL WORK BY OWTYPE QTY DES UNIT COST TOTAL COST • DateQ7 F8 /972 owne� 1. ELE FIXTURES, LIGHTING 1 ST 20 EA. . 75 15. 00 I do hereby cenify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELI.- - FIXTURES, LIGHTING ADDITIONAL EA, . 45 9 , 4 5 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a LT permit for construction or modification from the Air Ouabty Management District.Residential construction applications are exempt from ELI ;:- • C EP T/OTLET 1 ST 20 EA. . 75 15, 00 Mese provisions. E7 1 , KECEPT/OUTLET ADDITIONAL EA, , 45 . 45 ` RECEP /SWITCH 1 ST 20 EA, . 75 1500 Date' Applicant: s, /� L 2 P-/SWITCH ADDITIONAL EA. . 45 . 90 I hereby certify that l have read this application and state that the above information is correct.I agree to comply with all city and county ELE 4 ," ' RES APPLIANCE NOT OVER 1 ,0 HP 3 , 00 12, 00 ordinances and state laws relating to budding construction and hereb authorize representatives of this city to enter upon the above-mento d ELE 1 SERVIC( S BELOW 600 V IS BELOW 201 AMP 18 , 50 18, 50 property lot inspection purposes. �..� Date 27�'/7e Signature- �� •p+ END OF FEES Driver's License of Social Security p: ,'j ll.';. ,/ ' ' ' 1641-46 White—Building:Green—Code Entorcemem:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor -:1 CONSTRUCTION AND PLANNING POC SPA APPROVALS Permit# Date Inspector APPROVALS Permit # ' Date Inspector • 1. Temporary Electrical Service or Pole '52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms µ 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit Solar System-Final 16. Rough Electric Wiring I,71/,�eZ C 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 .f� ,.i ) 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil X 23. Gas Pipe-Rough & Test 72. Underground Flush j. Y'' 24. Roof Framing 1 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro , �ti', 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 FOOD CERTIFICATE ISSUED 33. Final Electric 412• tes: - 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 PROJECT ADDRESS: 208 WELLESLEY LN UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 055641 - AYNER•S NAME: FORRESTER PAUL R ADDRESS: 208- WELLESLEY DR PERMIT NO: B 055641 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: REP ARCH/ENGINEER: 546-2385 REG.NO.: JOB DESCRIPTION ; REPAIR AND UPGRADE BATHROOM SQ FT: 3, 000 ADDRESS: UNIT: CLAIM VALUE; 3, 000 . 00 CALC—VALUE: 3,000. 00 GROUP OCC: R-3 / PERMITTEE: PAUL & NANCY FORRESTER ( 714 ) 546-2385 ADDRESS: 208 WELLESLEY LANE COMMENTS: ADD 1 REPLACEMENT WINDOW COSTA MESA CA 92626 *;ESE**********************•*********************-********************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect SETBACKS CITY LIC.: STATE LIC.: CUSS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.on a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 14139527 ZNE: REF NO: 7 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: _._ _ -_ ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - ' t DATE; Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - DATE: Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - �• �` CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED -BY: - DATE• ).a"3D- el which this permit is issued(Section 3097.Civ.C). ***************************************** ******************************-****** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E t SUMMARY STRUCTURAL SEGMENT:Y `1,3 OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the followingreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 54 .00 5 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensedQ. w pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN -' - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($501). ISSUE FEE Y• I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 54 . 50 0 , 0 0 0 . 00 00 5 4 , 50 54 . 50 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through , his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED• 54 . 50 OVER/SHORT• 00 for the purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING" PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 . 00 ? • 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contfacts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************.************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E. E BREAKDOWN ig I am exempt under Section: B P 704 4 B.&P.C. for this reason: ALL WORK BY OWNER TYPE iTY DESCRIPTIO N. UNIT COST TOTAL COST --Date: SO LaG /79/ D«ner: P/XK ie •teteeark7e SFR 000 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 3, 000, 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and - — ND OF -FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a • permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from X, these provisions. P I R E D r .• Date: Applicant: . >.@ II:S�tE?Ctlp(Eg P. 4- I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county j l f .�.., ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon theabove-mentioned I tp. ), r� ,properly for inspection proposes. SE _,:f..,,, . .3_o1. G /Fr/ Signature: 4 _, -/ / . d {� Driver's License or Social Security x:: k 1641.46 White—Buildmo:Green—Code Enforcement;Canary—Aoolicant:Pink—Revenue;Goldenrod—Assessor L 4 r CONSTRUCTION AND PLANNING POC SPA i i Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # - 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. &lectrical Conduit-Uridrgrnd. 55. Electrical Bonding - 5. Steel R'einforcemeht. 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -- 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. , 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line:& House Connection 62. Backwash & Receptor-Final " r 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains c 64. Plumbing System - Final - t 14. Rough Plumbing 65. Electrical-Final .1--- 15. Rough Electrical-Conduit 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing & Access Approval r . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •'!r 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 r - . 72. Underground Flush- - s 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 L(:/e._CtZ aw4 . 76. Dry Standpipe : • •. 28. Lathing,& Siding - • - _ - -' •• 77. FIXED SYSTEM-FINAL' 29. Insulation • G,6!7 9� 78. FIRE PREV. FINAL I .30. Drywall Nailing -- HEALTH DEPT. REQUIREMENT -31. Plaster Brown Cost, , 4e Irly� ,79. FINAL INSPECTION - ,rr • 32. Electrical-PowerMeter•Final _ - 80.-FOOD CERTIFICATE ISSUED 33. Final Electric • ' Notes: '34.. Final Heating& Air.Conditionings - < s : 3-:2-5"--412,-- Cow S�L� �_ w 35. -Final Gas Pipe-Test• - _ , 36.-Hood or Canopy _ _ i , ZS-g2 - per. 04 di 37. Final Factory Fireplace . •W 38. Final Plumbing , 39. Water Service-Final r . - - 40. Gas Service-Final t r _ • - • 41. Solar Domestic-Final - . • - 42. Backflow Preventers - 43. Backf low Irrigation. • - , • • 44. Landscape Irrigation System. - _ • 45. _Sound Attenuation - _ - - 46. Handicap Regulations , , 47. FINAL STRUCTURE & BUILDING • zi-2--gg 6411- ; c'-,jt; �./J 48. FINAL PLANNING (/��`4 di.--A- a_ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I ' -- I - 51. CERTIFICATE OF OCCUPANCY' No. Date 1 OWNER FORRESTER, PAUL DATE 4-23-74 JOB ADDRESS 208 Wellesley Lane BUILDING PERMIT NO. j8j15 GENERAL CONTRACTOR Automation Pools DESCRIPTION of WORK Pvt.Swim Pool / '0.141-395-27 LOT TRACT FIRE ZONE VALUE $ 3,100.00 I. ECTIONS /14Th Date GROUP J TYPE III ZONE RI ' Pool Location L4m Mr-7l SUBCONTRACTOR PERMITS ISSUED Date 1 Number Signature Forms Main Drain • 5Steel Reinforce 1 ( (Elec. Bond Electric Approval to Cover YGk) 5^'1-7/ e. 1 a�-7y 97337/ /, ��,,�,� // Underground Electric irt) 5-2..�j➢tt erkeniv /a'SIGGC� Ciso- .7q 7376 '! Plumbing Gas Piping Test /�,, Filtering System Lines rY" J 5-14.°Y k �' F 4 6.5`"32 / ` Backwash Lines and Recep. 1V9 S SV /yL176.02S-7940.,pp, , sz-30L79 6.5- 9?....--- Electrical S90//Electrical Final Heater and Vent Final `M 5 1-47(7/F. System Final / ,�) Backwash and Recep. Final 'Vigo 5 1'fly Fencing Final 44s) Pi kit/ (et. j u_ Z0 fir/' • _ 38315 eR ?1-7I�P7I°OO 875 ****3^.5C - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 • •P (CATION FOR BUILDING PERMIT For Applicant to Fill in Completely R V • BY DATE RECEIVEDE BUILDING ow (t,�',LIre, .C.e f' 14/ I d f D -2E7� ADIL ESS ?� [/ ?//}} OWNER r A.P.NO./q/- 3%s= .7 P-E?R,?r NO.5 BUILDING908 gLEY ADD m� ADDRESS fes( Z ADDRESS +) �•� CLO CITY NEQ51eaza r TRACT�IF� LOTIR BLOCK z Z CONSTRUCTION NEW ADD AkTER REPAIR MOVING f)FM(H ISH 1-• LENDER ✓ O co - J D BRANCH ‘2,4441 /�nom. J(n OWNER o1e,e ��P m J LU ADDRESSLVALUE Oa -CO ARCHITECT TEL S ) Y $ 0 N OR ENGINEER —`t s . • At_ •. WZ < , FIRE cc ADDRESS il ^ A �,_ q ,/AI _ ZONE MEW GROUP d w CONTRACTORn�l// 27 /is// I APPROVE Wig DATE ��I J • Z .Q3?e,/ cJ /aP,o /2v J ADDRESS Lu tu TEL. / / ZONA NO.OF USE OF NEW 0= CITY �� U NG,... /7�7/) A / PLANS BUILDING ars 5'�tm !7•r�. Z / O STATE CITY YARDS APPROVED YARDS APPROVED jO LIC.NOQ(a9'R 70 LIC. NO3�9� MAIN BUILDING ACCESSORY BUILDING SIZE INO.OF BLDGS. (FROM C/L STREET) 7-46e1USE 'J //� OF LOT /t�� NOW ONB LOT FRONT FT. /FTUe� EXISTING BLDG. y� /J L R.SIDE FT. //J FT. I— SIZE OF NO.OF "``PPPP /r FT. 2 NEW BLDG. ROOMS STORIES L.SIDE FT. UEXTERIOR WALL ROOF _ COVERING COVERING _REAR FT. 6FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d O MAIN BLDGS. ACCESS. BLDGS. O 7 �7Z.1 T NA4 ]pQ(1� C U.P# APPROVED/ F- APPROVED J�D�G DATE T �' ,� U) AY 0 Z O I- I hereby acknowledge that I have read this application and state cel Dthat the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ '1Fany person in violation of the workman's compensation laws of (n the State of California. m r N ? I hereby certify shot I am properly licensed as a contractor under SQ. FT. t) the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • am exempt from 0 e provisions of the State of California Business and Professions Curie. Division 3, Chapte VALUATION ��, m ke PERMIT FEE $ ste (v D Signature of� ^^ �,wr C-�J' �/j � J m Permittee en s-(�C�(/�L ( • K�J$ Wo-- PLAN CHECK $ /✓t !� E o A Authorized Agent TOTAL FEE $ `/C-zri OWNER FORRESTER PAUL R. DATE 11-14-78 JOB ADDRESS 208__ Wellesley Lane BUILDING PERMIT NO. 47053 ,\ ENERAL CONTRACTOR Bldr. DESCRIPTION of WORK Change Garage door 1neat Ion 141-395-27 LOT TRACT FIRE ZONE VALUE S . IN '-' TIONS Signature Date TYPE v GROUP _T ZONE R-1 SOIL M 11j iSSUBCONTRACTOR y^^}� Oaixe- ... NumbD.Tyn^�'`ry$5i naru.eATER UGH PLUMBING ( �. fl 1v ? may. A.J D ,, . PROP. SWR. LINE O HOUSE CON. 0 JII �.' SPRINKLING SYSTEM ,.- ¢j R �) MISCELLANEOUS In A" b ,i U % 4J — l �a71 ROUGH HEATING AND AIR CONDITIONING 0 $l., 1 .,‘AYI a1 A�.� TEMPORARY SERVICE OR POLE 1 r �`'t•Y�] UNDERGROUND 0 POWER ❑ L IINnFR DII<LL(!)11 ROUGH WIRING Hi.da,pn3yikri lNG till-Joni TRENCHES LI FORMS Li STEEL REINF. LI O FLOOR SYSTEM /' ,. Lt J BOND BEAM n STEEL REINFORCE n �r L • SHEATHING D C C FRAME AND FLASHING �� it-27- y�V Y LATHING — IN n OUT In PLASTER, BROWN COAT 5' URAL, FINAL Electric REFPIG. AND A.C.. FINAL PLUMBING, FINAL AND GAS TEST n ELECTRIC, FINAL BUILDING, FINAL 047053 77�l1 COSTA MESA BUILDING-SAFETY DEPARTMENT 8903 11/14/78 6�50CAF0 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 8903 I'll 1'4/78 APP ICA ON OfiMtU&IJRkaerza1lT A For Applicant to Fill in Completely — Use Ink Only y / REC V D V ATE RECEIVED D E I SUE BUILDING ADDRESS//�� Op /,/J/�'10//e/0y L—f/, A-Le / , p RMI13•••• OWNER /-/0.fL./ r \ . / �tJ/^ES/r/- A.P.NO./T/,3 5-27 MAIL T� // , / // BUILDING ADDRESS .2drT LCJ e/( sie z/ Lia. Ke ;'ADDRESS R0�7 �ei/e5 /E One / TEL. U ' BLOCK eril CITY Cos Q !VJ( C=SQ NO..�J�1i:2�� TRA i LO CONSTRUCTION NEW ADD ALTS- REPAIR MOVING DFMOLISH LENDER , BRANCHki/Vh '{�.() C /y- ADDRESS J / l:a _ f '54t ` / . ARCHITECT TEL. U ¢a Q /l/�1�'`/WArf/rRV'.4CfR�szX(.l�I`i F.,.I 6 OR ENGINEER NOFIRE '17 �/7� ADDRESS ZONE TA'PE, J'/'rs(//y--ss GROUP �° /,/A(�I/ '7[ APPROVED - EgAc• �I I3 . �.'ONTRACTOR ��JAi FIYI-BS/e /� BY TE n ADDRESS (n�((�/L ZONR / NO.O� USE OF NEW CITY '�V NO. • TEPLANS BUILDING /`B S/ F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE 'NO.OF BLDGS. (FROM C/L STR/E�ET) /] / 04 OF LOT NOW ON LOT ;ONi /qi. //t FT. 6 USE OF �/ EXISTING BLDG. R.SIDFT, CA J FSeparate permits are required for L.SIDE F� electric,plumbing and heating work. ' WREAR FT. i� FT. [.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 'C MAIN BLDGS. ACCESS BLDGS. .tVAR.# DATE Q (77- ✓4l 5 6 ! O [. a,..„It C.U.P.#2[y APPROVED �Y / /�IP.I14 DATE P-75-7 • .4 V� 04 W CI hereby acknowledge that I have read this application and state n 94 that the above information is correct and agree to comply with m 6, all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of 2 S the State of California. m I hereby certify that I am properly licensed as a contractor under SQ.FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F E ONLY: am exempt from the provisions of the State of California Business (}'{/ e and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE $ .. m en Signature of /I / `7T�.tee. +�I/ PLAN CHECK $ o ✓/// o Permittee S �� TAX $ o �•.sz) U Authorized Agent TOTAL PAID $ Mk- --, . FEE RECEIVED 5X53 SEP 1 3 1957 ' COSTA MESA BUILDING DEPARTMENT FINANCE DEPT. P. BOX 317COSTA MESA, CACITY OF COSTA MESA CALIFORNIAL FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT BUILDING BU I LD I N G ADDRESS 208 WELLESLEY LANE COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY II� RECEIPT NO. Pr ��..��ii 2 OWNER COL LEGE PARK No . ll MAINRECEIVED BY DATE RECEIVED��MAIL ff SU) riS`�E�Cy ADDRESS 2116So . ST. / 7i,_7_` / EU) 2 b J TEL. BUILDING NO. 1< 1 5R577 ADDRESS '�f - ary SANTA ANA . CALIF , ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA '\ _ FIRE ADDRESS ZONE //J CI IC �,�.��' ZONE�/y�, \ PLO.OF AN$ TYPE GROUP CONTRACTORI�/ / .NO. IYt"ITG� �] \ 1 �1�.., TEL. APPROVED ADDRESS NO. RY DATE LEGAL LOT CORRECTIONS DESCRIPTION NO. 38 BLOCK TRACT 3187 A.P.NO. SIZE NO.OF BLOCS. OF LOT 60 X 115 NOW ON LOT USE OF EXISTING BLDG. SETBACK LINE FROM CENTER OF STREET .� SV REAR YARD 34. 1. SIDE YARD RIGHT 5 LEFT -5 DESCRIPTION OF WORK NEW X ALTERATION ADDITION . REPAIR MOVING H DEMOLISH BUILDING �1 NO.OF SIZE 152)1 ROOMS STORIES EXTERIOR WALL ROOF • _COVERING COVERING USE OF BUILDING RESIDENCE & ATTACHED GARAGE ' I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH,ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC- TION. VALUATION SIGNAT ERMITTEURE OF COLLEGE PARK NO . L PERMIT FEE $ 30 P al PLAN CHECK S lS $ 12,400. / AUTH.-QED A EN TOTAL FEES yS_1 4AA A OWNER COLLEGE PARK NO. 4 DATE 9-26-57 JOB ADDRESS 208 Wellesley Lane BUILDING PERMIT NO: 5772 GENERAL CONTRACTOR Harbor Construction VALUE $ 121400.00 AP. No. LOT 38 TRACT 3187 FIRE ZONE DESCRIPTION OF WORK . Res. w/att. gar. GROUP I & J TYPE V ZONE Rl PLAN NO. 5753 I, /ECTIONS DATE SUBCONTRACTOR PERMITS ISSUED 7f DATE NUMBER Trench Forms Steel 4;1 7e' /C-' a 4 Floor System Steel Reinforce Chimney Re-Rod Bond Beam Frame and Flashing 4-E/F /�-/2-S I Lathing, In Out j.—--f r—3`�Y Plaster, brown coot/7,.....) g-/-4,---4 2-/O-fl' Underground soil Ne S /G Pipe Tejyl P„c/D'S.I.S1 Top Out Furnace M(t.S /7-16-57 ,f ilto e & je-//-Sr //4440 ,.—' 7. Gas Vents Rough Plumbing M//5 /1 -1/-S) 5.1-11:1,-- Nnt-71 /A- 2. -CI 1.1201 Scptic,sµ-ptic Tank Prop. Swr. LineiA-House Coat/C St./Swi:S,J 7.J /.,,u t ..&a.44.60 /0-. r S7 //7,'}J Heating System ./ . /R Heating Final /K/{j H'//" ,5 J Ptcr ing Fixtures, Final /(7y-{ 14-t/'"CT/ /./R b ?'-;?;Gas Test /3-- /M i+S /-e,—sd'I I C'o truction Pole . 0-3V 6 / / L 4 Underground Power :/ ,/ Rough Wiring ? 4.-/Y-1i R€14..--n . f'-ee-t. -/z-9-S7 1-r4q' ,y �I . Fixtures, Final f Li�y'J3/ VVVI�I OCCUPANCY (i_Ty-tni Form 210-5M-1-57 38373 7i.; oo 368 : t:*5.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT _ REC IV O BY DATE RE IV DATE ISSUE BUILDING / ',s 5-9- t C 7 ADDRESS Lar//�54� c�/1/n ss7� �j� ��/ V{ _ PER...Y i•1,�a OWNER a %�/ „ .P.OE<rn A.P. NO. t4l�S Zr/ MAIL ��'��/"'"�� •••p I / // BUILDING of e / Z ADDRESS . 2t /4.4-Zi 's,// JAA/E ADDRESS_ �./ JAW W W y �y/y / TEL. L� TRACT Si • / LOT / BLOCK Z 0 CITY �7 S7j4' //7G S/Q NOS/*07 S 4CONSTRUCTION NEW ADD ALTER REPAIR MOVING fIFMOI LSH O N LENDER .j J D BRANCH //n / JN OWN ER/ �/'/.0 /////g/trfyf� .. CO J ADDRESS //JJ�� L / VALUE ,/'� m ARCHITECT TEL. USE toefe,pp/� 471, $ % / J N OR ENGINEER N . U Q FIRE J/�/ji T w t[ ADDRESS ZONE TY E ((,(/GROUP J d W //J �• p APPROVED /� Q-�� J O CONTRACTOR /J,2 �OF/r v C.��^�<-/ • 4'.p• BY DATE C— m 2 ADDRESS e je, 7 en-n.4 - 4' W w TEL J ZONtE 1 NO.OF USE OF NEW �I..-0C Z 1- CITY S.o vry _�yA NO,_j7j'/791c/ ` PLANS BUILDING` ( 1rvAL - 0 STATE � CITY YARDS APPROVED YARDS APPROVED ill Ln CC LIC. NO. ,,,7 //e/-y?/ LIC. NO. MAIN BUILDING ACCESSORY BUILDING _0 f SIZE / NO.OF SLOGS. (FROM C/L STREET) OF LOT GjQ x ../490 NOW ON LOT _FRONT FT. Ip FT. USE OF EXISTING BLDG. R.SIDE FT. FT. I- SIZE OF NO. OF / Z NEW BLDG. ROOMS STORIES L.SIDE FT. Sr_ FT. Q EXTERIOR WALL ROOF ^ _V COVERING COVERING REAR FT. ---e- FT. AND J USZo4�NG/"p�ZK TO 8�`�/./S ED DISTANCE BET. BET.MAIN& MAIN BLDGS. ACCESS.BLDGS. CL !N 0- a y,(7);//.7" / Q / '/n// (/ VAR.# DATE O J 4 CUP.,yE APPROVED I- APPROVE V) RV V DATE ZO17- SlAi U I hereby acknowledge that I have read this application and state Cr!e-b Dthat the above information is correct and agree to comply withCC all laws regulating building construction, and I shall not employ AX F any person In violation of the workman's compensation laws of H the State of California. �� 9 ZI hereby certify that I am properly licensed as a contractor under SQ. FT. >C 0 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOP /i Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: • IC I am exempt from the provisions of the State of California Business VALUATION and Professions Code,Division 3,Chapter 9. m PERMIT FEE $ r ' �� N7� ) Se of / ��!/•�� //� � m Permignaturlttea. iA-O�/ I (•t/LQifti� g3Q Or W �/PLAN CHECK $ / — E Authorized Agent Ste'-e) I TOTAL FEE $ V CUKKCs'LKKj, rain UMIL y �4 JOB ADDRESS 208 Wellesley Lane BUILDING PERMIT NO. 38373 GENERAL CONTRACTOR Modern Construction Co. DESCRIPTION of WORK Blockwall AP N0.141-395-27 LOT TRACT FIRE ZONE VALUE $ 380.00 II 'CTIONS Signature Date TYPE j GROUP III ZONE R-1 3so._ PERMITS ISSUED t3 GAS SUBCONTRACTOR Dote I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER [J ROUGH WIRING . Heatin• and Vent. TRENCHES .2 FORMS • STEEL REINF. D - FLOOR SYSTEM • BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING — IN n OUT n PLASTER, BROWN COAT STRICT URAL, FINAL Electric HI G, VENT., REFRIG. AND A.C., FINAL PLL,...dING. FINAL AND GAS TEST n ELECTRIC, FINAL �(/ BUILDING, FINAL ,Litt 7-/v-7)