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Home My WebLink About3486 WIMBLEDON WAY - Building Permits(��a) �sa-sz�3 • Fax (»a� �sa-aess CITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT JobAddress: 3486 WIMBLEDON WY Suite: Vicinity: RESIDENCE & ATTACHED GARAGE. Parcel Nunmber: 47204308 Applicant: PITMAN, J VERNON Address: 7522 SLATER AV 108 , HUNTINGTON BEACH,CA Owner: PROULX,CECIL M TR Address 3486 WIMBLEDON WY ' � = COSTA MESA; CA � Contractor: ., SOUTHCAND �ROOFING INC. 'Address: 7522 SLATER AV ..i i/:-� ' � 108 : '_ % , � ' HUNTINGTON BEACH,CA - Zip: 92647 Arch : Address: � � Phone: .. � i Zoning: R1 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 R1 ISSUED BY: Phone: 714375-9500 Zip: 92647 Phone: Zip: 92626 Phone:- 714375-9500 License: 750442 � Eng: Address: Status: ISSUED Applied: O6/03/1999 Issued: O6/03/1999 Phone: � \ Zip � ' . � , License: Zip: License: � ' SCOPE OF PERMIT , � REROOF: T/O WOOD SHAKE; APPLY 2 LAYERS OF 30# FELT; REROOF WITH "NATURE GUARD" SHAKES (ICBO #5121). 30 SQUARES. - � ` � Plan Check: $0.00 � Permit: $162.25 SMIP Res: $0.99 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $163.24 SETBACKS�. MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Exlstina: 0 NOTES: Rear 0-0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING 8 ZONING Lek 0- 0 Left 0- 0 Proposed: 0 EXPIRED � aa.i oi Calc Valuation: Claim Valuation: Right 0. 0 Right 0-0 $9,860.00 $9,860.00 I NOTICE: The work authorized by this permit shall comply with ell applicable handicap access requiremenis under Calitomie statutes and related � regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned for a period of 180 deys. INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with ell applicable codes, and all . requlred Inepectlone and flnal approval must be obtained. Failure to obtain inspections antl final approval will result in the expiration of this permit. i FOR INSPECTIONS CALL: (714) 7545626 r • WORKERS'COMPENSATON DECLARATION: 1 hereby ettirtn under penalry of perjury one oi Ihe following tleclaretlon5 �'. �� _.� . . ❑ I have entl wlll malntein a certiilcate of consent to seli-Insure br workers' compensetlon, as pmvided tor by sectlon 3700 of the Lebor Cotle, tor the pertormance of Ihe work for which this permit is issued. � I have and will maintaln workers' compensatlon insurance, as required by sectlon 3700 ot Ne Labor Cotle, tor Ne pertortnance ot I�e work for which this permit is issuetl. My workers' compenseiion Insurance cartier antl pplicy number are: Cartier: Policy NumDec (This sectlon need nof be comp/eted tl(he permit is velued et ane huntlred tlollers ($100) or less.) � � " ❑ I certify that in the pertormance of Ihe work tor which ihis ermit is Issue4 I shell not employ any person in eny manner so as to become subject to the workers' compensellon lews of Celifomie, and g iha � I sh ul e me sublect to ihe workers' compensation provisions of Sedion 3700 of Ihe Labor Code, I shall forthwith comply wlth these provisions. Applicant Signa�ure: Date: l(� � — � � WARNINGFAILURETOSECUREWORKERS'C ENSATIONppVEPAOEISUNUWFULANDSHALLSUBJECTANEMPLOYERTOCRIMINALPENALTIESANDGVILFIN UPTOONEHUNDRED TFqUSAND DOLLARE (5100,000), IN AODITION TO THE W5T OF COMPENSATION, DANAGES AS PROVIDED FOR IN SEGTION 3]O6 OF THE LABOF CODE, IMERESi, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I here�y aMirtn Ihat I em licensed under provisions ot Chapter 9 force antl eHect. Lic. a '— Contrectors Signa[ure: 7000) of Division 3 at ihe Business end Professians Cade, and my license is in full Class a Dete: / � � _ CONSTRUCTION LENDING AGENCV: ❑ I hereby eHirtn thel there is a consWction lendinq aqency tor the peAormance of Ihe work tor which this permit is issuetl. (Sec. 3097, Cidl Code). Lender s Name: Lendels Address: Signature: Date: OWNER•BUILDER DECLARA710NS: I hereby ettirm �hat under penelty of perjury iha� I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe Following reeson (Sec. 7031.5, Business antl Professions Code: Any ciry or county which requires a permit to consWct alter, improve, demolish, or repair eny simcture, prior to its issuance, elso requlres the epplicant tor such permit to file e signed stetement ihat ha or she is licer,sed Dursuent m the provislons of Ihe Contrectors Licensa Lew (Ghapter 9(commencing wlth Sectlon 7000) of Division 3 oi t�e Business end Protessions Code) or thet he or she Is exempt thereirom entl the basis tor the alleged exemption. Any vlolation of Sectlon 7031.5 by eny appiicant tor a permit subJects the epplicant to e civll penalry of not more then five hundred dollers ($500).): ❑ I, es ownar of ihe property, or my employees with weges es their sole compensation, WILL DO TME WORK, antl the structure Is not intended or oflered for sale (Sec. 7044, Buslness entl Professians Catle: The Contrgctors License Lew tloes not apply to an owner of property who 6uiltls or improves thereon, entl wha does such work himsetl or hersalt ar through his or her own employees, provided ihat such Improvemenis ere not intended ar aHered lar sale. If, however, Ihe bullding or improvement is sold within one year of completlon, Ne owner-builder will have �he burtlen of proving Ihat he or she did not build or improve for purpose of sale.). ❑ I, es owner of t�e property, am EXCLUSIVELV CON7RAC71NG WI7M LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cotle: TTe wntrectors License Ww does not appy m en owner at propeny who builds or imprwes thereon, and who comrects br such project with a coniracbr(s) license pursueM to Iha Contractore License Lews.). ❑ I em e:empt under sec. Business end Professions Code for this reason: Signature: Date: Ownar ID verilied by drivers Ilcense. ❑ Yes ❑ No Driver's License No. Ezpires: Verification of Ownershlp by (type ot document, i.e. - pmperry tax bill or deed): DIVISION OF INDUSTRIAL SAFETY VEHMIT CER7IFICATION: ❑ I hereby certly Ihat no ezcavation five (5) or more teet in tlepih Into whlch a person Is required to descend, will he made In connectlon with work euthonzetl hy this permlt, en0 Net no builtling structure, scattoltling, talsework, or demolition or dismanlling t�ereot, will be more then ihlrty-six (38) feet �ig�. (Chap. 32, Grp 2, Art 2, Sac. 341, Title 8, Gallfomie AtlmiNs�retive Code). ❑ As owner�builder, I will not employ anyone to tlo work which would requlre a pertnit irom the Division of Industnel Safery, as no�etl ebove, unless such parson has a permil to do such work irom the division. Signature: Date: Division ot Induslnal Setety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CER7IFICATION: 1 Will Ihe epplican� or prasant or future builtling occupant need to tile anA certlty a 8usiness Plan for emergency response lo release or threatened release of a hazardous matenal? ❑ Yes ❑ No (Section 25505 oi the Celifomia Health end Salery Code requlres, wit� soma exceptlons, that a Business Plan ba lilad wl�h the Cas�a Mesa Fire Departmam by every business which hes at any one time dunng a reported year a quantiry of hazardous matenals equal to or greater Ihen e weight of 500 pounds, or a volume of 55 gallons, or 200 cubic laet of compreued gas at standard temperaWre end pressure). 2 Does or will the apP�icant or present or future 6uilding occupanl need lo tile e registretion fortn for acutely hezartlous matenels7 ❑ Ves ❑ No (Section 25533 of the Califomia Healih and Satery Cotle, with some excepilons, requires registration with �he Caste Mesa Fire Depanment by each business w�ich at any one tlme has on hand a quantiry of acutety hezartlous meledals equel to or graeter than a welght of 500 pountls, or e voluma of 55 gallons, or 200 cubic feet oi 33 of Will �hB OppliCaN of presen� Of tu�ure bulltl�ng OtCupent n9etl IO prBp9r0 an RMPP (Hlsk ManagBmBnt �� Ves ❑ No �clion 25534 of the Calitornia Healih and Safery Code provides thet the Costa Mesa Fire Department mey i �ertment of en RMPP by businesses which are requlretl to register ecutety hazaMous metenals with the Fire 4 If en RMPP is presenlly requiretl, has SecClon 25534 of the Celtlornla Haaltll entl Setety GOtle oeen tully com 5 Does or will Ihe epplicem or present or future building occupant requlre tor the work which is ihe subjec� ot Irom the South Coest Air Oualiry Management Dlstrict or trom eny other air pollution conirol tlisirict or egenc� (Section 65850.2 of the Califomla Govemment Code requires ihat Ihe requestetl information be tumishetl on 8 W III eny pan of the feclliry to be wnswaetl untler Ihis permll be wlthin 1000 Iee1 tmm t�e outer bountlanes � (II'yes", Ihe tacility must meet Ihe requirement oi Sections 25534 end 42303 oi Ihe Califomla Healt� antl Se1 ihe preparetlon. certification antl filing with the Fire Iment. .._.__...__._..... .. _..__.—_—._._.____...._. 7 ❑ Yes ❑ Na ation a Permit for such construction or moditication �s lJ No ins lor non-residentlal huilding parmits). 7 tl a Dertnil Imm the South Coast Air Oualiry Managemeni Disirid or other eir polNtion control district or egency is required tor ihe work which is the sub�ect of this epplication, heve ell of the tlisclosures prescnbed by Celifomla Heell� entl Sefery Cotle Section 42303 been matle7 ❑ Ves ❑ No 8 Qf yes', ettech ceniticate of compliance from Ihe appropriate eir polluti coNml otticer). CERTIFICATE OF COMPLIANCE: I certify thet penelt ury ie Infortnation given above is correct. I egreb to compry with ell stete laws entl ciry ortlinances regeNing Hezardous Metedals and Emissi� _�,, �.-,� �� G - /, \ IlL Signeture: � 1� '� `�. b�.R�j{ Date: C(f% ;' CERTIFICA7E OF COMPLIANCE AND AUiHORVATON OF ENTRV: 1 certily under penelry of pei�ury that I have read Ihfs application and siate that the information given is correct. I egree to comply wlth all stete laws antl ciry ordinances relating lo buiiding consiructlon, and euthodze representatives of the City of Casta Mesa to enter upon Ihe ebove-descnbed D�aPerry tor ir�sppction puryoses. I agree not to wcupy or allow occupancy o1 any building authodzed by tNs partnit umll Nnel inspection. COOE t. INSVECTIONttPE � � 1616 Fixed System Final Fire Preveniion 1266 Pool Spa Flnal 200 Finel Ra-Raof 201 Finel BIocWReleining Wall 202 Finel Fectory Fire Plece . 203 Final Sign 204 Final Demoli�ion Y6a8d8 �INMIALS $�QQEd�-' MSPECTIONTYPE � 206 � Final Mechanicel 208 Final Plumbing 270 Finel Elactncal 212 220 222 250 Final Flre Praventlon Final Plenning Approvel Final Site Final BuiltlinglOccupancy PB._E INTRIRLS ' . ADV�� to fill In all spaces exce0< <�ose vu�t�in �lavy Oo�Etr Iines anC sign all apOroD�iate tlecla�ations. � ' CIT.iul��F COSTA MESM CONSTRUCTION PERMIT ApplicanYsMailingAddrea '��Z L/ GOLnJ CYP' FrojectAddreu �3_Y�(p CCl/�+'�iiFLdbni �Owner'sName ��U�� Phone Addreu 3`ff3�^ W� M.c�L00 nJ Arch/Eng. ' License No. Addrea Contractor's Nema �'9� '�'''� ' W�S�'�"� ohone 8�� Z7� Addreulmailing) Sy`/Z .L�waoL.J C �,P � License No. (� Z�/ / u 7 ' LICENSED CONTRACTOR DECLARATION I here0y affirm 4hat 1 am Ilcensetl under proWslons of Gharter 9(commencing � with sactlon 7000) ot Divlslon 3 of the Business antl Profasslons CoGe, anC my Ilcanse Is In /ull force anG eifect. / � iJcense C�ais l.icsnu No�Z-�� u" ' Data� -/S'� z 519natura -5��- WORKERS'COMPENSATION DECLARATION� ' �reDy afflrm that I have a certifirate ot conunt to self-Insure or a ce�tlllcata Norkers' Compensation Insurance, or a tertifieE copy thereof (Sectlon _�JO. LaG. CJ ,p r � Policy No. y�� Company Sii�TR Certifle0 <oDY I5 hereby furniihatl. , tbpy Is (Iletl with tha tlty Bgiltl�g � Isio�1 � ril Da ' AOPlitant •6F EXEMPTI • ROM W00.KER5' COMVENSATION DECLARATION ,(This sactlon neetl not ba com0�etotl If the permit h for one huntlretl (5100) or . less). � . � � . I certify that In the perPormance of tne work for which Ihis Oerm�t I5 isiuetl I snall.not employ any perwn�in any manner so as to become suDject to t�e � Workers• Compensatlon Laws o/ Callforni /J • Date�-�S'-RZ Si9natura ��L�L�-� NOTICE: I(, aftar making-this tleclaration, you 5lioultl become SUE�ect to tha Workert' Compensatlon provislons ot t�e Labor CoUe, you.must torthwilh comply wft� such provlsions or thts permit shall ba'deametl revokeG. .CONSTRVCTION LENDING AGENCV ' � � ' I hereby afTlrm thal there Is a conslruction ientling a9ancy for t�e performanca oi the work for whi<h- t Is' p mit is � izsuetl �(Section � 3097 Civ. CJ� Lentlar'i Name �� IsnOer'S AOEress � � � OWNER BVIIDER UECLARATION � - � � � I heraby afTirm that t am exempt from tha Conlractor's-Licensa Law for the followlnu reason (Settion 7031.5 Husiness ane Professlonal Cotle: Anv citv or }i:� oy any aOP��cant Tor a permit'suDjects tM1e.aDP��nt to a clvil -�Yhalty of not more than five �untlraE'tlollars ($500). • I, as oWner o/ the properry or my employee5 with wages.as Iheir sole compensatlon will tlo the work, antl theatructure� is not IntentleG or offeretl for sale (Sec�lon 7044, Business antl � ProfesSional Cotle: � The' Con(ractar's ' LI<ense Law Aoes not apPly co an owner of a property who bulltls or improves tnereon, antl who tloes such work hlmselt/�erselt or Ihrough nls or har own emplo ees, provltleA that such �Improvements are�not Intentle0 or offeretl for sale. IY �owever, the GUIltling or improvemant is 5oltl wit�in ono yeai o/ com- pletlon, Iha owner wlll have the burtlen of proving he/she tlltl not bulltl or Im- �rave for tha purpose of, sale). .' � � I, ai owne� o/ thB property, am exclusively tontractln9 '�+��h�llcensetl con- trac[ors to construct.t�e pro)ect (Sectlon 7044, Bu5ina55 antl Profe55iont Cotle: The Contractor'S LI<anse law does not apply to an owner ot property who bulltls or Improves thereon, antl who contracSs tor such proJects with a con- tractor(5) Iicense pursuant to ihe Contractor'S License Law): � ❑ I.am exempt unEer Sec[lon . B. & P. C. for this reason ' TVPE OF CONSTRUCTION LJ NEW QS1 ADD U ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK A!�O �O�'�-��1,%Cr' N 0 �7 TVPEOFPERMIT LIGRAOING L�.FOUNDATION �Y.$TRUCTURAL ❑ TENANT �LECTRICAL ❑ PLVMBINO ❑ MECHANICAI ❑ �OTHER PRQIECTDESCRIPTION. Sq.FT. ,�� oCCUPANCY �--/ GONSTRUCTIONTVPE 4 VALUATION$ 'SOC�O. �� ZON� GRA�ING CU.YDS. ACRFS Remarks: Sef Sink 3ackfiow Preventer • 3ackflow Irrigation 3athtubs Clarifiers Dishwdsher Drinking Fountein5 Floor Drains FloorSinks � uas Service ' Ou'. Inlerceptors ' Kitchen Sink Lavatories , � P-Trap Roof Dreins Showers , Service Sink � • � Boiler ', . � DuCt- Under Ground Soler Piping ` � ' , SOlar Tank � ' Swimining Poal w/Spa• � �,. �.- Urinel .+ Water,Giout � . S- - - Water Heater � - , " Water Service � Duct-.Ventilating __ � Exhaust System ❑ Multiple Firepl/Fact.8lt. ICBO # Date Owner � Heating System & Duttinq i I �ereby certlfy that P hare� reaE this applicatbn antl� stata that� the a�ove � ❑4100,000 BTU 0700,000 Information Is correct. I agree to comply witn all city antl tounty ortllnances ana state laws relating to bulltling conitru<tion, antl hareby authorize reDre- ' Hood Or T e 1 ❑ sentativas o/ t�is clty ta enter upon the above-mentlonetl property for YP � Inzpec[IOn Du�pose5 Cano T e II ❑ Slgnature GZ'��c�l_. � oate7—�S-83 Drivers' Licensa or 55 � / Register5 CMF 0865-46 rev. 12/82 White - Builtling; Canary - Appllcant; Pink - Accountin9: Galtlenrotl - Assessor i Reinspection, Fee ' Issue Fee , IANICAL Refrigeration System ❑0.100,OOOBTU ❑100,OOI PLNG. fiEF.4h TO BUILDING /' PFOPERTV LINE � LEFT SIDE VARD PKG. SPACE FEQ. STREET WIDTH SPECIAL CONDITIO Automatic Washer Dishwasher - Dryers ❑Ga�. Fan ' F.A.U. ' Device Boxes Outlets � Generator�0-SKW05-15KW TransFormer �15-50KW ❑SU+KW. $15 Meter ❑upto100ampa $ 3 Zoning APProved By ApPlication APOroved By —[�� APPliration laued Bv �" � � Rei�upec[ion Fee $15 • Iswe Fee S 3 BUILDING PERMIT 'PLAN CHECK PLUMBING PLAN CHECK• ELECTRICAL PLAN CHECK MECHANICAI PLAN CHECK c.i� REAR VARD (TO P/U RIGHTSIDE YAflD PROVIDED , _�RK FEE $ Sub Panel � . Sub Pole •Motors O04 HP ❑1�'r5$ � .Inc.Solar �9-15HP �16-15+ Microwave . •�'�'� Pole�Light � � Fiange , . Standing Sections '�Trash Companor Reinspection Fee �laue Fee' ' �—Date SUMMARV OF FEES $ ��.,, s,,.� � SMIP $ � � PERMIT � $ � . ISSUANCE� $ GRADING $ N a p $ .i� MICROFILM $ ' TOTAL'FEE $ LESS � . ADVANCEDPC ' FINAI FEE 0 $� ,so $• $ �Z — _ � 1 1 L' �CONSTRUCTION AND;PL�A ING �' - - -' �----'-�-- �. -� �--- �'�-��' �, POOL A . , . . '. •, " - �' �C -:Aate' � Inspectoi ' '" � ' - � ',Date �� Inspector '. ��j iAPPROVALS ; Permi£#�L� , ��APPROVALS' -- Permit�#, • � t� � � � � " `�_: I emporary Electrical Service or`.Pole ` . � o � � .� "52:� Pool &�Equipment Location � -- • - . ' e •i. - .v Z• �Spil Pipe-UndrgrndF - ' : - . � �53' Steel Reinforcement � � _ � � , ^- 3% Electrical ConduiT Utilitv-Undrgrnd � ' � - - - . ,54.I Forms ' � � - ' � � � v• ' '4. Electcical Conduit-Undrgrnd. � � � �_ ' �' � 55. �Etectrical Bonding . � . �, i �5; Steel'Reinforcement � � .= � ' �. � L2 �y �� 56.� Rough Plumbing & Pressure Tesf - ' �- . _/- - = �6: Electrical UFER Gmd.' G;` ��- ��: 57:; APPROVAL TO COVER-GUNITE . 7. Footings : ' ' � - . � � /�'��.� +58� Electrical:�pnduit=Undrarnd. � : _ � 8. Founda�ion � , - � ' � ' ' 59. Gas Pipe, O �Undrgrnd., Test� .. - - - . 9. N/ater Pfpe-UndrgrnA. �� "_ � "- _ '60. Backwash. Lines, P-Trap, O Undrgrnd.� � - 10. $tivaural Floor System - c 61. APPROVAL TO-DECK ' - 11. �Property Sewer Line &•HouseConnection�, � � _ � . 62. Backwash & ReceptorFinal � � 12. Sewer Cap , � I , 63. Heater & Vent-Final � . � - - . �' t - 13. �ioof.Drains ' ` ' � � . 64. Plumbing System %Final .: � - 14. Rough Plumbing �� . • ' ' �- � 65. Electrical-Final � � • a = �5i RougR Electric8l=Conduit' j -,'� --" ,��-3 -'�^j� .' � 66. �Solar System-Final � � '� - � ' �,. r�16. Rough Electric Wiring•, . � �,-� `-�?-, ; - ;:; i :. ; r • 67t�F.encing�&�AccesS-Approval i . . - = •`1•7.:Rough,�Wiring�Sign;. ;, ' � ' � '. • ! �, �gg,� APPpOVED FOR PLASTERING � � , � - - -i: , iB.,,Rough�Electrical-T�,BanCeiling �� '� � - , � � ; �- �69. POOL/SPASYSTEMSFINAL � . _ � � i� 3 . _, 19. Rou'gti Heating & Air,C�nditioning + �_ � i ' � FIRE DEPT. REQUIREMENT � �, ' _ 20. Rough Fa�Kory Fireplace , � � o � , APPROVALS Permit# � � , � �: � f � � i � � 21. �Ducts; in Structure,�, '' ' � �, j � � , .' �70. Underground Hydro . � , ,22�. �pucts, Uenfilating �.' � . i � � { , � � i • '�71.� Product Piping �Gas ❑ Oil � ' � � - �2�. Gas Pipe-Rough & Test : � ��_ ! � ' 72. Underground Flush. � �i � ',`�z4'.'ROofFraming. �, � '� � '" i� i�l; �73�Undergrnd.StoiageTankOGas,DOil ; � � � 25. Roof Sheathing ; , - � �,T� � �� D � � _ '74. Oyerhead Hydro � - ' ' ' 26. �'f-Bar Ceiling (Structuraq. & Monocoat' � � ; � .� '"'j i _ � � '75. Dry Chemical . � � � � � .27: Frame and Flashing � � ' � 'r� . g' � !�_ ,76. Dry Standpipe . . ' 28. �Lathing & Siding, � i- ; � i ; � ' ' '77: FiXED SYSTEM�FINAL _ ' � �� rf.��j � 29.Ijlnsulation2 ' , ' �, . � � ` � I , 76. FIRE PREV. FINAL -� '30. Drywall Nailing ,` •' � ' ' � ' � � � � 'Notes: ' , ,� �'31. �Plaster Brown Coat : � � �. , ,�:5' -- •��! � .- , - - . . .. . � 32. ,Electrical'Power Meter-Final ' . � � ' � � � - �' 33.'Final Electric ' ' 9 �j � � 34. Final Heating &.Air COnditioning ' ' � . � . � 35. Final Gas Pipe-Test , � � . ; �1 • - . � s � - . ' . , 36. Hood or!CanoPY � � � � ' - . _ , ' � - � . , ' ' , , � . i , 37. Final Fac[o ,ry Fireplace�• � ' { " ; • ' , � . �� _ ` - . � r i i � i � 38. Final Blumbing � � �• � � . . , . - , I 39. Water'Ser4ice-Final J j� � ' ' � � , � . 40. Gas Service-Final . � ' � ' � �� . � 41. Solar DOmesticFi�al �' � . �- � - • - _ - _ _� � ' , . y.; 42. Backflow PFeventer , ' , � � ' � � , � , � � ' - � - - --' --_ . _ . + 43. Backflow Irrigation = � � ,�, � .� �' ' � _ ' �� ' �. . . � � � � . . I � � .., �. i 44. Landscape Irrigetion�$ystem� � � �' - . � ' � .i ' . • , - - � � 45. Sound �Aftenuation � , ! � ".. , ( .. � ;;' � ' � � � ; . � : ' : : � �, 46. HandicapRegulations` ' '�� _ ' �r ,•� • � '� � ' _ �� . . � , 47. FINAL STGjUCTURE'& BUILDING� ,9 �f - , I � • � 48. Special RequiremenfrCompleted � � , � _ " � , � , , � � . 49. Electnc Release'to �Edison; • '. � ' - � , -_ - - . - _- - _-� - ,`. ' . . 50. Gas Rele�ase to Souihe�n Califomia Gas Co ' � � � � ' ' • " � ' � .. � . -�-�-+--`--� .i . . , . , . 51. CERT,IFICATE.OF 06CUPANCV' , : __ .. ' � ,' - _ _ . . No � � Date -f � � , AOV�icant <a fi11 in all spaces except those witnin heavY GorAer lines antl sign all aoo�e0riate tleclarations. PEFMIT N TflACT NO. LOT N UNIT NO. Ci7Y oF COSTA mESA CONSTRUCTION PERMIT —7 Q A.P. # — LO 7 /]� JQJ�' /� CJ p� —� Zone � 3�(o wiMB��o�1 w�y _ .—� �� mject Address r . S Main Building: Accessory Building: S�-n�i TVPEOFCONSTRUCTION NEW A�� ALTERATION REPAIR E FrOnt Z ApplicanYS MailingAdd�eSs �,� �p� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' T O Owner's Name c�GFG�L � L� PhoneV-7J21N DES IP ION OF�ORK/USE OF,� LIDG. �� B Rear N Address 3�a�p WIH SiEDOnJ � ��(f�� Hf�/•.1�K�F/L. (L/h.�' �� A I Arch/Eng. License No. TYPE OF PERMIT GRADING F UNDATIOrv STRUCTURAL I K Right G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Left ' R Convactor's Nam< �WN�. Phone ��oTHER Ping. Ref. # r' g Req. i E PROJECT DESCRIPTION 5�. FT oCGVPAN V n Address (mailingl .�j. O Planning Notes: M CONSTRUCTIONTYPE V VALUATION$ G F� T CityLic¢nseNo. 20NE GRADINGCU.VDS. ACRES IICENSED CONTRACTOR DECLARATION . S' I he�eby atfirm that I am licensetl untle� p�ovi5ion5 ot Charte� 9([ommenGing Remarks: with Section ]000) Of DiviSion 3 Of Ihe Business and Pro(es5ions Cotle, antl my Ilcense is in full (orce antl eftecL ELECTRICAL FEES License Clazs License No. Date Si9nature PLUMBING FEES �+utomatic Washer Transformer ❑ 15-50 KW WORKERS' COMPENSATION DECLARATION COnSLfuCtiOn POIeSUb. ❑ SO+ KW I hereby affirm thai 1 bave a certificate of consent to self-insure o� a certificate Ba� $ink ShOw¢�5 Workers' Compensation Insurance, or a certifietl copy thereof (Section Backflow Preventer ServiceSink Cooking Unit Meter �up to 100amps 0. l.ab. C.) iicy No. company Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps_ eCertifietl copy i5 hereby (urnlshetl. Dry2f5 ❑Gas ❑EI¢CtriC Sub Panel "� Cer[ifietl copy is tiletl with Ihe city Builtlin9 Division. BathtUbS Sewef ConneCtion Date Applicant . Fan Motors DO-1 HP �1 %- 8 EXEMPTION FROM WORKERS' COMPENSATION DEC�ARATION CldriFi¢r5 SOlar C0112cLOf5 (Thi55ection neetl not be completetl if the Oermit is for one huntl�etl ($300) or F.A.U. Iess). Oishwasher Solar Piping Inc.Solar �9-75 HP �16-15+ I certi}y Ihat in the performance of [ne work tor which this permk is issuetl, I Fixtur¢5 shall not empioy any person in any m nn; e� so as to be ome subje t to the Drinking Fountains Solar Tank Microwave • Worke ' p pg ation Laws of Califorr�a. . Date��,� d�_—Si9nature u�n.., A� �l C3nil __. Floor Dreins Swimming Pool w/SPa Device Boxes Pole Light .. NOTIC . If, �te� making this tletlaration, you shOultl beGome Subje t to the �uL12[5 Workers' Compensation provision5 Ot the Ldbo� Cotle, y0u must farthwith FI00� SinkS U�ipol Flange compty with such provisions or tnis permit shall �e tleemetl revoketl. CONSTRUCTION LENDING AGENCV Switches Si n Gas Service Outlets Water Closet 9 I hereby affirm that there is a construction lentlinq aqency for the performance oi tne work tor wnicn tnis permit is issuetl (Sectlon 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections L.entler's Name Lentlers ntltlrezs Kitchen Sink Water Service Generator �65 KW �5-15 KW Trash Compactor � OWNER BUILDER �ECLARATION I hereby atfirm Ihat I am exemp[ from the Contrac[or's License Law for the Lavatofies Auto-Wash following reason (Section �031.5 Business antl Professional Cotle: Any aty or . county which requires a permit to constru<t, alteq imorove, tlemolish or repair P—Trap �,yundry Trays any struclure, pnor [o its issuance, also reqaires the applicant for such permit to file a siqnetl statement that he/she is licensetl pursuan[ to the provisions ot Roof Orains the Contractor's License Law (Chap[er 9(commencing with Section 7000) of �ivision 3 0( the Business antl Professions Cotle) or tM1at be/she is ezempt � ' '-.3refrom antl the basis for the allegetl exemption. Any violation oi Section � Rainspection Fee $15 luue F0e $ 3 `�1.5 by any applicant for a petmit Subjects the applicant to a civil -�+��"*Yalty of not more tnan tive hundred tlo��ars (5500). 3 DEVELOPMENT SERVICES REQUIREMENTS:��(�/ /��/� � (((�� I, as owner af the property or my employees with wages as their sole ReinspeMion Fee $15 Issue FeB $ `� "'�^"� � � c�pensalion, will tlo the work, antl Ihe structure is mt Intentletl or offeretl , Zoning Approved By Date for sale (Section 7044, eusiness antl Protessional Code: The Contractor's MECHANICAL FEES Building Approved By � Date� LiGenu I.aw tloe5 not apply to an owner of a property who builtls or improves thereOn, antl who tloes Such work himselt/herself ot th�ough his or her own AppliCdti00 ISSUBd By_ Dat�� employeei, prOvidetl that such improvemen[5 are not intentletl O/ otferetl tor BOIIE� HOOd O� Typ¢ I ❑ saie. It, however, the builtlin9 or Improvement is soltl within one year of com- Canopy Type II ❑ SUMMARV OF FEES • pletion, the owner will have the bu�tlen of proving Ite/Sbe tlld nOt bulltl or im- DUGI - Unde� G�ound prove tor the purpose ot saie). ��,BUI LDING PERMIT $ O: Ofl SMIP ,' $ �..r� ❑ I, as owner ot the property, am exclusivety contracting with licensetl con- Duc[ -Strucmral Refrigeration System pLAN CHECK 9 ZS traCtorsto construct Ihe pvoject (Section 7044, Business antl Protessions Cotle: $ PERMIT ;i Tne Contractor's License Law tloes not applY to an owner of property who Duct - Ventilating ❑0.100,000 BTU ❑100,000 BTU ISSUANCE builtls or improves thereon. antl who contracts tor such oroiects witn a con- PLUMBING $ $ tractor(s1 hcense pursuanc m me Contractors License Law). I am aware tnat Exhaust System ❑ Multiple ❑ System Repair/AI[eration PLAN CHECK 25% $ ENERGV P.C. $ proof of their Worker's Compensation insurance shoultl be provitletl to me, ELECTRICAL $ GRADING i. $ ❑ I am exempt untler Section B. & P. C. im this reason �FirepVFact. Blt. ICBO # Fire Dampers MICROFILM� $ PLAN CHECK 50% $ Date Owner ' Heating System & Ducting Registers � MECHANICAL I hereby ce tify that 1 have reatl 4his application antl state t al the abave �P700,000 BTU 0100,OOOBT $ TOTAL FEE $ � • 7 intormation is correct. I a9ree to comply with all city antl county ortlinances PLAN CHECK 25% $ antl zta[e lawz relating to builtlin9 �onst�uction, antl he�eby authoriie rep�e- senta[Ives of ihis city [o enter upon t above-mentionetl pr per y for � inspec[lon pu oses. � � Signature � ^ Date Reinspectian Fee $15 Issue Fee $ 3 01 00027692-�DD2i694 �''!_l� � :,j,�.i,�i Drivers' License or 55 � - �AlS�7 (I.ilf�l,l�_q TTMCe -ir•'7L ' 0865-46, rev. 5/88 WM1ite - Builtling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor `CONSTRUCTION AND PLANNING �� P'4 APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector � Y. 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. ElectricalUFER�Grnd. 57. APFROVALTOCOVER-GUNITE . 7. F.00tings � 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 Drafns � 64. Plumbing System - Final 14. Rough Plumbing 65. Elecirical-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 EI'ectrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL '19. Rough'F'�eating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough�FactoryFireplacs APPROVALS Permit# c21. Ducts, in Structure 70. Underground Hydro 22. Ducts, V"entilating 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe Rough & Tesi 72. Underground Flush ' 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical• 27.�Frarr�� and Flashing 76. Dry Standpipe 28. LatFiing,&'Siding 77. FIXED SYSTEM FINAL :� 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing i�, HEALTH DEPT. REQUIREMENT 31. Plaste� Brown Coat � 79. FINAL INSPECTION 32. Electrical Power M�ier-Final 80. FOOD CERTIFICATE ISSUED � 33. Final'Electric - Notes: 34. Final Heating & Air Conditioning 35. Final Gas-Pipe-Tesi 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final ' 40. Gas Service-Final 41. Solar pomestic-Final 42. BackflowPreventer , •'�?�� 43. Backflow Irrigation � 44. Landscape Irrigation SYstem 45. Sound Attenuation � ' 46. Handirap Regulations ' 47. FINAL STRUCTURE & BUILDING -3 S'j/�/O G �� o� � 48. Special Requirements Completed 49. Electric Release to Edisqn ''� 50. Gas Release to Southern �lifomia Gas Co , ",, �' `% 51. CERTIFICATE OF OCCUPANCY • i-. No. Date . ; F � a a y y S F G w F Q � �- ..7 a W a � C a z W S 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADIDRESS 3486 Wimbledon Way OWNER�OR WlII1b�.2C1O1] ASSOC. TENANT MAILING ].4%� Jamboree RCl ADDRE55 Newport Beac Te - CITV NO. i�NOER`T1ON Imperial Savinqs & Loan BRANCH Pasadena ADDRESS F)1 S_ Ld�CE ADDRESS 6081 I/21!8� �89.81 TU APPLICATION FOR STRUC'fURAL PERMIT Cfl/p1BV PERMIT `-Q ��I �� N A.P. NO. / / � Oya. —C� � ADDRE55 3486 Wimbledon Way UNIT OR SPACE NO. 58 TR.NOZ-15 LOT 58 E lv NEW AD� LTER REPAIR�MOVING OEMO OWNER USE -7124 rvine Z�NE�Oi�- APPROVED � ADORESS 1470 Jamboree Rd aTv Newport Beach No`.640-680 LIC.NO. 2%38%.�J LICVNO. ZHH�J3 SIZE NO.OF BLOGS. OF LOT NOW ON LOT O VSE OF EXISTNG BLDG. Separate permits are required for elec[ric, plumbing and heating work. USE OF BUILDING AND WOFK TO BE PERFORMED PRD — New Construction - Single Family Dwelling I hereby acknowled8e thet I have reed this epplicattan end state that the above intormation is corract antl agrea to comply with all laws regulating builtling conrtrucUon, antl I shell not employ any Oarson in violation of the workman's eompenaaHon lews oi Ma State of California. I hereby certity that I am proparly licensed as e contrector untler the State of California Buslness antl Protauions Cotle, Divislon 3, Chaptar 9, antl that such licenses ara In full force antl affect, or I am exempt trom the provlsions of the Stoi of California Busine�s and Professions Cotle, Division 3, ha ter . Signature of Permittee or Auihorizetl Agent Date APPROVEDSETBAGKS PLANNING ACTION - / O � O`7 APPRf nPr� ne�� Fa� sP�cw, �� VALUATION g9��3� VALVE $ m � > u 5 N VN UNDER VALUATION IS FOR m � 'ABLISHING A PEfiMR FEE ONLV: � v� PERMIT FEE .5 /� � ./ m � PLAN CHECK § "� � 0 LL � TAX E f U TOTALPAID $ S) �` OWENS•CORNING Fiberglas Blanket Insulation The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is. in- stalled in conformance with current energy conservation regulations, California Administrative Code, Title 25, State of California, in the building located at: 7�%Q�i. • 1/(/i n1 ��//�,I LY/d � 1 0 /%�—��S � Street ' Lot Number Tract Number � - erior Walls � � r � � ns-Corning Fiberglas Blanket Insulation � // ' Thickness R-Value Ceilings � �� G Owens-Corning Fiberglas Blanket Insulation /' i/ � Thickness R-Value Floors Owens-Corning Fiberglas Blanket Insulation Thickness R-Value Foundation Walls Manufacturer Type Thickness R-Value General Contractor License No.. By Title Date (Signaturej� Insula£ ontr ctor _��✓ �� ^�� ri✓�ii7License No. � �� f��,% r � 1/s0 c% /�� By_ _��2dc�a�� Title Date ( �gnamrel " � ... ' Homeowner Copy (White) . '-� S[ate Copy (Yellow) . OWENS-CORNING FIBERGLAS CORP. Builder Copy (Pink) . Insulation Operating Division Pu�. No. 16-BL-699SP - L�Iho in U 5 A.. July 19)) - FIb2f(J�85 TOW21, TO�BdO, �h10 4$[)$J