HomeMy WebLinkAbout3392 WIMBLEDON WAY - Building PermitsC-OS
CITY OF COSTA MESA
CONSTRUCTION PERMIT
Project Address —
Applicant's Mailing
Owner's Name —
Addreu � 3 i
Arch/Eng. —� n
Aop���ant to tilt in all spaces
those wilhin heavY �ortle� lines anE si9n al� approp�iate tlecla�ations.
ri
W(1J11/5CL-7/C7L]' TYPEOFCONSTRUCTION ,I�NEW LJADD LIALTERATION LJREPAIR
��i%�/O 4�F CA{%�sGLt ❑ CONVERSION ❑ DEMOLISH ❑ OTHER s� ('�
�%�' PhOne DESCRIPTION OF WORK !� X�� �U�c/�✓��
No.
....��, e�...� � �.a �� '.i..=�..—�
Address(mailingll�'� ------ �4BQn
City License No.
�YiYv <A cA$F4.r �'r Ao¢ Y
UCENSED CONTRACTOR DECLARATION '
1 hereby a(tirm that I am licensetl untler provislons oi Charter 9(tommencing
witn section 7000) of Division 3 oi tne Business antl ProfgSqon;FyypS}pA
my Iicense is in full force a ffec[� ' � i 7 7�� /
License Cla} s LicenSe N�"'-""'—"
Date �/ tz 14� Signature � �� �/yH��`7
WOHKERS' COMPENSATION DECLARATION
1 hereby atfirm that I have a certiticate of consent to self-insure or a tertiticata
i Workers' Compensatlon Insurance, or a certltietl copy the�eot (Sectlon
d00, Lab. CJ ' '
Poiicy fVo. Company ' �
eCertifietl capy is hereby fumishetl. ' .
Certitietl copy 6(iletl with the city Builtling Dlvision. .
Date AOPllcant
EXEMPTION FROM WORKERS' COMVENSATION�DECLARATION
(This section neetl not be completetl if the permit i5 (or one huntlretl ($300) or
less). '
I certlty that in the pertormance ot the work tor which this perm�t ivissuetl I
shall not employ any persOn in any manner so as to beCome Subject to t�e
Worker5�'. .C9�!�pensat�l Laws ot Califnc��( � y� ,
Date �Y'�Si9nature �,� � �}� � �
NOTICE:If,'after making thls tleclaration, you shoultl Cecome subject to,tne
Workers' Compen5ation provisions of the Labor Cotle, you must forthwlth
comply'with such provisions or��thls permit, shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV . '
I hereby aftirm Ihat there Is a construct1'on lentling agency tor the performanca
of the work tOr whiCh Ih15 .pertiYt IS IsSu¢tl ($ectlan".3097 Civ. CJ
Lentler's Name � �� w
L¢ntler'S AtltlreSs -
OWNER BUILDER DECLARATION ' .
1 hereby afTi[m that I am exempt fmm the Contractor's License Law for the
an0 the basis for the :
^ any applicant tor a
not more than five hun
TVPE OF PERMIT LJ GRADING LJ FOVNDATION CJ STRUCTVRAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
; � ❑ �OTHER '
PR0.IECT DESCRIPTION Sci. F7. - OCCUPArv v_
CONSTRUCTION TVPE � VALVATION $ �'
Remarks:
Sink
Backflo'w Irrigation
Bathtubs .
rinking Fountains
loor Drains
laor Sinks
as Service Outlets
Sink
Roof Drains
! � �-Reinspection Pee
u I, as owner ot the propertypr my employees with wages as theii sole
COrtlpensation, will tlo the wOrk, antl the StrpCture is not Intentletl Or Oft¢r¢tl
for sale (Section 7044, Business antl Protessional Cotle: The Contractor's
License Law tloes not apply to an owner of a property who builtls or improves
thereon, antl who.tloe5 such work�nimself/herself or through his or her own �
employees, provltletl that such impmvements are not Intentlea or otteretl for
sale. It, however, [ne Euiltlin9 or improvement is soltl wlthin one year of com-
pletion, the owner wlll have the burtlen of provinq he/she Eitl not builtl or Im-
�rove for the purpose of sale). .
LJ I, as owner oi the property, am exclusively contractin9 with Iicensetl con-
tractors to construct the project (Sectlon 7044, Businesz antl Professions Cotle: .
The �Contractor's License Law tloes-not apply to an owner ot property who
builtls or improves thereon, antl who conVacts (or such projects wlth a con-
tracto�(s) Iicense pur5uant to ihe Contrdctor'S License Law). ' ,
❑ I am exempt untl¢r Section B. & P. C. for th75 red5on
�
Date Owner '
I hereby certify that I have reatl this aoolicatlon antl state that the above
information is correct. I
antl'state laws relatin9 t
sentatives of this dty
Inspection purp�-� �
S�9nature Cs�/
Driverz' License or 55 �
CMF OB65-46 rev. 7/63 '
all dty a
i. antl he
enter
GRAOINGCU.VDS: ACR
.. O � r'_.,f\�Cln .
� Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping - �
Solar Tank -
Swimming Pool w/Spa
Urinal
.Water Closet
Water Heater
� Water Service �
$25.
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO # '
Heating System & Ducting ,
00.100,000 BTU 0100,000
Reinspection Fee
White - Builtling; Canary - APplicanh, Pink - Accounting; Goltlenrotl�- Assessor
I�
�
Issue Fee
Hood or Typel. ❑
Canopy Type II ❑
Refrigeration System
❑0.100,0008TU ❑100,000
System Repair/Alteretion
laue Fae
FEES
A.P. #
S Main Bu
E
T Front ,
B Rear C�
A
c a�snc3
K l.eft
S
Ping. Ref. #
Use of Building:
Planning Notes:
Automatic Washer
Cooking Unit�
�ISfIW35fIQf
Dryers ❑Gas
Fan
F,A,U.
Fixtures
Device eoxes
OUtletS
52aa 9ia�ia�
Zone
Park.Fees $
17,C^ TL
Z
O
� N
. I
N
, G
R
E
U
U
R
M
E .
ELECTRICAL
Transformer ❑ 15-50 KW �
❑50+KW �
- Meter �up to 100'amps "
' Meter �over 100 amps
.SubPanel �
'Motors�P7 HP �1'fe-8
Inc.Solar 09-'15 HP 076-15+
� Microwave �
Pole Light
Garbage Disposal
Generatoi �a5 KW 05-15 KW
$ .3 .
Reinspection Fee
FEES
PUBLIC SERVICES HnEO�
Zonin9 APProved BY SdL�
APPliwtion APProved By
$ 3
BUILDING PERMIT
' PLAN CHECK
PLUMBING
. P�AN CHECK ;
ELECTRICAL
PIAN CHECK
MECHANICAL
PLAN CHECK
Sign
Standing�Sections
Trash Compactor
$25
$ 3
i�
SUMMARV OF FEES
$ __Q .lLL SMIP $ O.SO
$ � � PERMIT � �
$ � 'ISSUANCE $ ,
$ ' ENERGV P.C. $
$ GRADING � $
$ MICROFILM � $ �
$ TOTALFEE $ I . �O
$
' CONSTRUCTION AND PLANNING POOL �A
' APPROVA�S Permit # � Date Inspector p�ppROVALS Permit # Date Inspector
r'
1. Temporary Electrical Service or Pole' � 52. Pool & Equipment Location
Y. Soil Pip"e-Undrg�nd. 53. Steel Reinforcement � �
, 3:. Electrical ConduitrUtility-Undrgrnd' 54. Forms
4. �Electrical Conduit�Undrgrnd. , 55. Electrical Bonding
-5, Steel Reinforcement 4, � 56. Ro `gh Plumbing.& Pressure Test
6. ElectiicafUFERGrnii. 57. APPROVALTOCOVER-GUNITE
7: Footings ,� i �� ' 58. Ele�frical Conduit-Undrgrnd.
8. �Foundation ' %� �� �� , 59. Gas Pipe, � Undrgrnd., Test '
9.! Water Pipe-Und"rgrnd�. �, . 60. Backwash Lines, P-Trap, �- Undrgrnd.
10. Structural Floor System = 61. APPROVAL TO DECK
17. P�operty Sewer Line & House Connection . _� 62. Backwash & ReceptorFinal
12. Sewer Cap - ' ' 63. Heater & Vent-Final �
� �_ 1 � t
13. Roof Draihs� "` ,: 64. Plumbing System - Final �
;.
14. Rough Plumbing ;' ..� .'� 65. Electrical-Final '
15. Rough Electrical-Conduit � � 66. Solar System-Final
b6' Rough Electric Wiring 67�. Fencing & Access Approval
77. 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. Dugts, in Structure ' 70. Underground Hydro ,
22. Ducts, Ventilating ,-" � 71. Product Piping � Gas ❑ Oil
,23.�Gas Pipe-Rough & Test ` -r �` - 72. Underground Flush
i.
24. Roof-Framin ��
„ 9.4 . � � 73. Undergrnd. Storage Tank O Gas ❑ Oil
�25. Roof Sheathing I, - � 74. Overhead Hydro .
26. T-Ba� Ceiting (Sfructural) & Monocoat , 75. Dry Chemical
27. Frame anq Flashing 76. Dry Standpipe
28. Lathing & Siding i� 77. FIXED SYSTEM FINAL
29. Insulation 7S. FIRE PREV. FINAL
t� HEALTH DEPT. REQUIREMENT
30. Drywall Nailing ��
31. Plaster 8rown Coat+� 79. FINAL INSPECTION
32. Electrical Power'Me'tervFinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric - � ? . Notes:
34. Final Heating & Air Conditioning � �
35. Final Gas pipe-Test � �
36. Hood or Canopy . .
37. Final Factory-Fireplice �
38. Final Plumbing �
39. Water Service-Final . � � " �
40. Gas ServiCe-Final '
41. Solar porr�estio-Final , , -
42. Backflow PrevenFer�, ' � . � �
r
43. Backflow Irrigation ' . . �
44. ,Landscape Irrigation System , � '
45. Sound Attenuztion , � � � � , ' �
46. Handicap Regulations ' �
47. FINALS7RUCTURE&BUILDING �
48. Special Requirements Completed -
49. Electric Release to Edison � - ;• .
50. Gas Release to Southern California Gas Co ' ' '
51. CERTIFICATE OF OCCUPANCY � , � , ' . , ,
No, Date
�39a �M��
�- ^ � a,��� P CD
AYPRO�ED
CRY OF COSTA MESA
PU+NNING DEPT.
wweer ro ewa. o¢vr. ncc
I6Y QKC��. DATE 71��/ ��--
DItERW Of KANNINO
J
�-
♦ '(�S % � i
� ?'� �,'�. �i� '
♦ �
.
�'' � � � i
Dote 19_
�� 1 � � �1 : ' • Figured By
• r �
Checked By
' HARDWARE
6586 BEACH BLVD. • BUENA PARK. CALIFORNIA 90621 • PHONE: 522-2864
Estimate To Owner
Street Street
City Phone City Phone
LIN. R. PIECES SRE LENGiH DESCkIPTION FEfi lOinl fEEi RnIE niv,OUNI
X
X
X
X
X
X
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
We Agree To Furnish The Above Items For The Sum Of 3 F. O. B.
Provided This Estimale Is Accepted wthin 10 Days from This Data 1S
PlEASE EXAMINE TMIS ESTIMATE CAREfULLY AS WE AGREE TO
FURNISH ONLY THE ARTIClES NAMED AND DESCRIBED HEREON.
AlL AGREEMENTS CONTINGENT UPON STRIKES, ACCIDENTS OR
OTHER CAUSES OF DELAY 6EYOND OUR CONTROL.
{w� '�•A
ESTIMATE '
�� �
. I PATIO COVER DETAIL — 12/9/81 — NOT TO BE USED FOR SUNDECK, ETC. I
, �/E (�-(�AL
J �STATE-���, �
tv/ ax3 G" r�r SPACING SPAN ^
�, �il S�ZE - � .
OVERHANG ' O � /C�- 12
RAFTERS: "
-�2� FOR DRAIN Min. 114�
..�.tc � cNGTH w� SLOPED
A
4' ^/c
`BEAM
2"■��
STATE S12
3�16x2�"T'
POST-BEAM
CONNECTION
3/g K S�Lags 32% —�
Predrill Ledger '-�
Pred�ill Exiatinq '/�-3 Deep
JOIS7 MANGER
Or other approved methods
of suppurt � tie.
ALL LUMBfR OOUGLAS F/R
CONSTRUCTION GRADE FOR
TABLEN0.1
# 2 OR BETTER FOR TABLE NO. 2
y `. y " l�= Ze "
SHOW SIZE SHOW SPACING
SHOW LOCATION ON REVERSE SIDE,
I�I DROP PATIO FLOOR
� -+— SLOPE TO DRAIN— 2"max.@door ,
' ' °'� ��3 ' � THICK SLAB �� �
' ^ �'� � PUDDLED SAND FILL�
�
�- � Remove G.oss And Weeda Down To Notura� Grade
���.. .:� ��
CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT
--POST-ANCMOR—�I -.�.-.. � 7t-GALLONS-PER-SACK-CEMENT.
� For Pipe Posf, Embed r1z� Provide 26 Ga G.I. Flashing At Wood Floor Const.
Pipe in Footing to within 3" of Bottom, and
Provide detail of Flange or Weld Plate Screwed or Bolted to Frame.
CMF 0012-46 (BU 40) rev. 12/BI
CON71 NUOU
LEDGER
TYPICAL JOIST ANCHOR
NOTE � USE REVERSE SIDE FOR PLOT PLAN.
No. 1 No. 2
UBC S'YD. TABLE UBC STD. TABLE
25-21-J-6 25-21-R-1
For open egg crate alumi- For wlid sheathing.
num or plastic roof Shingles or built up
covering. roofing.
MAXIMUM SPAN SIZE SPACING MAXIMUM SPAN
17' 2" 2„ x 6" @ 12 a.c. 12, 0•,
75' 7" 2" x 6" @ 16 o.c. 10' 5"
13, 8,• 2„ x 6" @ 24 a.c. 8, 6„
10' 11" 2" x 4" @ 12 o.c. -
9' .11•• 2„ x 4" @ 16 o.c. -
$. $.. 2., x a•� @ za o.�. —
NOTE: FOR PROPOSED OR FUTURE ROOM, OR WHERE PATIO WALLS
ARE TO BE BUILT. USE N0.2 CHART ONLY.
FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO WALLS
ARE TO BE BUILT SUBMIT COMPLETE HOUSE AND ADDITION
PLANS FOR APPROVAL.
COSTA MESA BUILDING DEPT.
77 FAIR DRIVE
I NSPECTI ONS: 754-5627
��L�R��� `��
City of Costa Mesa Building Dept.
BY.` � _._._-.DAFEJ�7 19_�
TFiESE PIANS MUST BE ON J08 AT ALL TfMES
MAKE NO CHANGES WITHOUT PNIOR APPROVAL
OF DEPT.
7HE ISSUFYCE OR GFANTING OF A PEflMR 03 FPPR�VAL
OF PlANS AtJD SPECIFILATIOMS SHRiI N07 2E CONSiRUED
TO BE A PEF�MIT fOR, OR AN FPPRO'!PL OF, ANY VIOLATtON
CF ANY OF THE FR01'GION� OF fHl, CODE NO PERMIi PRE�
SUiHI@G TO GIVE AUiHORITY TO VIULfQE OR CANCEL THE
PROVI�ICNS CF 1HIS CODE SHALL BE VALI6, ECCEPT IN SO
fAR AS THE WORH OR USE WN1CH li AlliHORIZFS �S IAWFUL
THE ISSUANCE OF A PERMIi BASEO liPO�� PIANS AND
SPEC�fICRTI0M15 SHALL NOf PnEVENT THE BUILqfNG OFFICIAL
fG017 THEfiEAfTCR REQUIRING THE CORRECTION OF ERRORS
L'� :qID FIANS AND $P[CIFICATI0�1 OR PROM PREVENIING
FUILDINC OPERATIONS BEING CARRIED ON THEREUNDER WHFN
�Y VIpL4T1C'! OF TN1S CODE OR OF ANY 07HfR ORD(Ngh�6
c= THe c�n.
. �:
;..
STRUCTURAL APPROVAL ONLY
SEPARATE PERMITS ARE REQUIRED
FOR ELEC7RICAL, PL�Ji'98(MG,
HEATING, V�P;TlL^7tyG A?!D
REFRfGERATIQN WOR�
�Ef(i�Eo� � � `'�6 �O
THI� i�J�'3'"�� °7 r^CO��n�AUY
y ALL INSPECiiJ.: i;:Q'1.F.STS_... I
; FOZ Ctc;:LD..': S .'.,;,!3 P.RE TO
BE E���P! p' v� „?Nf,T THE
SiATE Gfi b' r. plViSiON OF
INDUSIRIAL S:.F�!S' BE �,u7��ULTED FOR
AD�IiIONAL REQUIRENiENTS.
1
a
J. e N CITY OF COSTA MESA �
, _ � BDILDING DIVISION
� DEVELOPMENT SERVICES DEPARTMENT
��. �- .. PERMIT
(714)754-5273 •�Fax(714)754-4856
Parcel
�
Arch :
Address:
Zip:
Plan C
Pi
SMIP
SMIP
NOTES:
BUILDING PERMIT
s: 3392 WIMBLEDON WY
e:
:y: HOUSE & GAR4GE
;r: 41207171 Zoning: R1 R1
it: RON SELL ,
�,s: 17W2 ROSEBUD
� Phone: 7'14-993-3328,
YORBA LINDA CA ,. � Zip: 92666 " _. -
i
:r: MONDRAGON; GELACIO 8 MARIA L
ss 3392 WIMBLEDON WY . � - � � �
,� �
, - � ' Phone; - „ � �
�, COSTA MESA, CA - - - � ' Zipi 92628-1200�'.�+,� -
,.� ,�' � -� �. _
�r:� � SELL ROOF,ING COMPANY
��s: ' , 77072 ROSEBUD"�
, � ' " � � Phone: 714-993-3328
%�
YORBA LINDA CA �
p: 92686 �" License�: 323842
�
r'
-, Phone:
O
,� � License:
� Eng:
Address:
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 09/14/1999
Issued: 09/14/1999
ISSUED BY: �
,
Phone:
�'� License:
SCOPE OF PERMIT
- T/0, INSTALL 1/2" OSB BOARD, 2 LAYERS OF 30# FELT & ICBO #4660 EAGLELITE LIGHT WEIGHT TILE
$0.00
$167.25
$0.89
' $0.00
$0.00
$0.00
$168.14
Front 0- 0
Front 0- 0
Existinq: 0
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
_ _ ; � .
PLANNING 8 ZONING
Left 0- 0
� � Left � �0-0
Proposed: 0
Calc Valuation:
Claim Valuation:
�
Right 0- 0
Right 0- 0
$a,soo.00
$8,900.00
�
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or'abandoned
(or a period of 180�days.
INSPECTIONS: II order for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectiona and tinel epproval must ba obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
I
FOR INSPECTIONS CALL: (714) 7545626
h.
WQRKERS' COMPENSATION DECLARATION:
I hereby aHirm untler penalry of perlury one of the followinq dedarations:
❑ I have end will maintain a certificate ot consent to seH-Insure tor workers' compensetion, as provitled for by section 3700 of the Labor Code, for the pertormance oi the
work for which ihis permit is issued.
❑ I have and will maintain workers' compensation insurance, es required by seMion 3700 of ihe Labor Code, tor the peAormance of the work for which this permit is issuetl.
My workers' compensation Insurance carrier end policy number are:
Carner: Policy Numher:
(This secfion need nof be completea il the permit is valued at ane huntlred dollars ($100) ar less.)
❑ I cerilfy that in ihe pertormance of ihe work for which ihis permit is issued, 1 shell not employ any peroon in any manner so as to become suhject to lhe workers'
compensation laws of Califom and agree t if I s Itl become subjea to the workers' compensation provisions of Section 3700 ot the Labor Code, 1 shall fonhwith
comply with these pravisio //� Gj
Applicam Signawre: .%%� Date: � —! 7 �/
WARNING: FAILURE TO SECURE WOfiKERS' WMPENSATION COVERAGE IS UNL4WFUl AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUN�RED
THOUSAND DOLLARE ($100,000�, IN ADDITION TO THE COST OF �MPENSATION, DAMAGES AS PROVI�ED FOR IN SECTION 3�O60F THE LABOR CODE, IMEREST, AND ATfOPNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby attirm ihat I em licensed under provisia
force and aflecL Lic. N %-, ?
ContracroYs SignaEure: � /.
CONSTRUCTION LENDING AGENCV:
with Section 7000) of Division 3 of the Business and Prof iq� Code, antl my license is in full
_ qassq /� —� 7
_ Data: �(9 ^
❑ I hareby aHirm that there is a consiruction landing agency for Ihe peAormance of Ihe work tor which ihis permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's Adtlress:
Signature:
OWNER•BUILDER DECLARATIONS:
Date:
I hereby a%irm that untler penalry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such permit
to file e signetl statement that he or she is licensetl pursuant m the provisions of ihe Coniractors License Lew (Chapter 9(commencing with Section 7000) oi Division 3 of ihe
Business antl Professions Code) or that he or she is exempt �hereirom and the basis tor Ihe elleged exemption. Any violation of Section 1031.5 by any epplicant for a permit
sub�ects Ihe applicant to a civil penalry ot not more ihan five huntlretl tlollars ($500).):
❑ I, as owner oi the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the siructure is not intentled or ottered for sale (Sec.
7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property who builtls or improves ihereon, and who tloes such work
himself or �ersalf or through his or her own employees, providad that such improvemenis ere not intended or offered for sale. It, however, the building or improvement is
sold within one year ot completion, the owner-builder will have Ihe burtlen of proving ihat he or s�e did not build or improve for purpose of sale.).
❑ I, as owner of Ihe property, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to consiruct Ihe projeci (Sec. 7044, Business antl Professions
Code: The comractors License Law does not appry to an owner of property who builds or improves thereon, and who contracts for such prolect with a coniractor(s)
license pureuant to Ihe Contractors License Laws.).
❑ I am exempt under sec.
Signature:
Owner ID venfietl Dy tlriver's ticense. ❑ Yes ❑ No
Business antl Professions Cotle tor t�is reason:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
Driver's License No.
Date:
Expiras:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity that no eacavation five (5) or more feet in depih into which a person is required to descend, will be made in connec�ion wl�h work euthorized by Ihis
permit, and �hat no builtling structure, scaHolding, talsework, or tlemolition or tlismantling thereoi, wiil �e more than �hirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, Celitornie Adminisirative Code).
❑ As owner-builtler, I wili not employ anyone to do work which would require e permit Gom Ihe Division of Indusirial Safety, as notetl above, unless such person has a
permit to do such work from the division.
Signature: oata:
Division oi Intlustrial Safety Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTAV: I certi(y under penalry of perjury that I have read this application and state that the information given is
correct I agree to comply with all state laws and ciry ordinances relating m builtling construc�ion, antl authorize represantatives of the Ciry of Costa Mesa to emer upon the
above-descnbetl property for inspection purposes. I agree not to occupy or allow occupancy oi any building authorized by this permit until final inspection.
gnaWre L wner(s) � �// p� �jG�
!� 1 �� l �
—� Antl/OrAuthonz App6cant Date
COpE A, INSPECTIONTYPE
7616 Fixetl System Finel Fire Prevention
7266 Pool Spe Final
200 Final Re-Root
201 Final Block/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2416-6fi
DATE INTRIRL
�� �
COOEI'� INSPECTIONTYPE
206 Final Mechanical
208
210
212
220
222
250
Final Plumbing
Final Electncal
Final Fire Prevention
Final Planning Approval
Final Site
Final Builtling/Occupancy
DRTE INTRIALS
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant Co Fill in Completely - Use Ink Only
BUILDING
ADORESS Tract_10277, Lot 37
OWNER McLain Development Co.
CITV
1470 Jamboree Road
NewPort Beach No 640-6800
BRANCH
ADORESS
ARCNITECT Cozbin/Yamafu 1 TEL.�Si—SS6%
OR ENGINEER J NO.
ADDRESS 3661 Spruce St., Newport Beach
CONTRACTOR McLain Development Co.
ADDRESS 1470 Jamboree Road
TEL.
cirv Newport Beach No. 640-6800
uc No. 273875 uc�No.
OIF LOT 48 X u0 I NOW ON LOTS
USE OF
Separa[e permits are required for
electric, plumbing and heating work.
USE OF BUIL�ING AND WORK TO BE PERFOR�
Single fami.ly residence
NeW House
1 �oreby ncknowlatlpe that I �sre reatl thts application antl suta
that the ebove Infolmatian ia carract antl epree co comply wfth
ell lawe repuletlnp bulltlinp conrtruetlon, antl 1 ahall noi amploy
enV Po�son �n violat�on of the workman's compensation lawe ot
Mo Stam of Celitorn�e.
I �areby eanify thec � am propeNy Ilcansetl es e eonbector under
tho Smta of Calitorn�a Buaineu antl Proteuions Cotle, Dlvision 3,
Chaptar 9, entl t�at such licenus ere In tuli forca antl aHx<, or 1
em exampt from thB P�ovislans of the Stete of Californle Businep
nntl PrOtBaSIOnS COtlO. DlvisiOn 3, Chapte
Slpnoturaot 4`A � `(� i1,�'J [� , /
Parmlttae 1 �"�' 1 S C nJ�.B�
Authorizetl A�e� U `
3796 2/21/79 342.31 Tl
379b �2%21`L19 342.31CKT0
I�h3796 0000447497 ' IA"" "
TION �bR STRUCTURAL PERMIT
'/ PERMIT NO.
A.P. N O. 7I ��O %I' ��
ADDRE S '339�Z ,
TRACT ZOZ%% LOT 3% BLOCK
ROM
�
DATE
NO.OF USE OF NEW
��J]O PLAPS BUILDING R�
%
VAR.� DATE
C.U.P.ye Z — ..3 APPR(
APPROVED �.�_�p� _.�
N
n
m
�� 2190 a
sQ.FT. �a4e 585 �
THE AMOUNTSHOWN UNDER VALUATION IS fOR m
THE PURP06E OF ESTABLISHING A PERMR FEE ONLY: �
VALUATION PERMIT FEE E Z5 �0 Q
u�
PLAN CHECK E � �fO o
$ �� �� TAX E • �/ . V
TOTALPAID S 3 �r3