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Home My WebLink About3498 WIMBLEDON WAY - Building PermitsAOP��cant to fill in a1l spaces exeeot those within heavr porCer Iines antl sign a11 apDropriate tleclantions. CITY OF C�OSTA ME(Sp/_ QC�O7NSTRUCTION PEHMI I ocanniT nin TanrT n�n i nT nin - ��'—P�ectAddress �T /6 �l��E�� 'q�%� Applicant's Mailing Address /�� Owner's Name N N ��0 phone.�.Z6� Addreu s�� Arch/Eng. Licenu No. Address / ` Contracror's Nam N Phone Address (mailing) Ciry License No. LICENSED CONTRACTOR DECLARATION I hereby affi�m thal I am licensetl untler provi5ions ot CharlGr 9(commencing wit� section ]000) of Division 3 of the Busines antl Professions Cotle, antl my Iicense is in full force antl effect. License Class � n e o. Date Si9nature WORKERS'COMPENSATION DECLARATION , ' here0y atfirm that I nave a certifltate ot mnsent to selbinsure or a certiflcate Workers' Compensation Insurance, or a certitletl copY thereof (Sectlon .00, Lab. C.) . Poliq No. Company eCertifietl copY is hereby turnlsneE. Certifietl copy is tiletl with the city Builtlin9 Dlvislon. �ate AOPlicant ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neeG not be completetl if the permit Is for one huntlretl (5100) or less). I certity that in the pertormance oi the work for w�lch this oermk is ea, I shall no[ employ any person in any �a nner So a5 o Come Subj¢ t t he XWork o pe [i ws of CaliL6tniata4QC(� , Date Signa[ur�l�A ��f 'NOTICE: If, aiter iakin this tleclaration, you sM LL bec me subicct to the Workers' Compen5ation provisions of [he Labor Cotle, you must torthwith comply with such p�ovisions or tltis permit shall be tleemetl revoketl. CONSTRUCTION LENDiNG AGENCV 1 nereby affirm that there is a wnstruction Ientling agency for the performance oi tne work for which this permit is issued (Section 309] Clv. C.) Lentler's Name Lentler'S Adtlress OWNER BUILDER �ECLARATION � I hereby affirm that I am exempt from the Contrac[ot's License Law (or Ihe followinq reason (Section ]031.5 Business antl Professlonal Cotle: Any ciry or ' county which requires a permi[ lo consl�uct, alt¢r, Improve, tlemollzh o� �epai� any structure, prior to itsissuance, also requires the appllcant for such permit \ ,Olv6ion 3 oi Ine•tlus�nes5 ano Yroresslons loaeJ or ma[ ne/sne �s exempl 'St`��erefrom and Ihe basis for.the allegetl exemptiOn. Any vlotaHon oi Section "�'^131 5 by any applicant fo� a p¢rmit subjec[s ltle ap0licanl l0 a civil �� ty of not more than five huntlretl tlollars (y500). I, az owner of the. property or my emo�oyeet with wa9es as lheir sole Oenzation, will tlo the work, antl t�e structure Is not intentletl or oiferetl o ule (Section 7044, Business antl Professional Cotle: The Contractor'S License Law tloe5 not appty to an ownlr o( a prOpe�ry who bulltls or Improves thereon, antl who aoes such work himself/herself or through his or her own employees, provitletl Nat such improvements are nOt Intentl¢tl O� oiteretl for sdle. It, however, Ihe builtling o� Improvement is soltl within one y¢a� ot wm- pletion, the own¢r will have the bu�tlen Of proving he/she tlitl not buflC or Im- �1rove for Ne pu�0ose of sale). u 1, as own¢r ot tM1e property, am ezclusively mnlractinq wilh lic¢nsetl con- t�actors to constru[t the project ($ection ]044, Buslness antl Profes5lon5 Cotle: The Contractor'S License Law tloes not apply [o an ownGr of properly who builtls or improves thereon, antl who contracts tor such projects wllM1 a com Matlor(sl license pursuant to the Cont�actor'S LlcenSe Law). 1 am aware lhat prooi of [heir Worker's Compensation insurance zhoultl be provltle0 to me. ❑ I.am exempc untler Sec[ion B. & P. C. for thls rea5on Date - Owner I hereby rertify that I have reatl tnis application antl state that the above Information is correcL I a9ree to comOry with all city antl county O/tllnance5 antl state laws rela[ing to builtlinq consbu �ion, antl nereby authorize r¢O�e- sen[atives o�,tnis city to entyr upon jrteT[�ove-mentlonetl_property jor �' Slgnature `l-�'[� x Drivers' License or 55 CMF 0865-46. rev. 10/04 B- /� 2s5 I�0��5 I 63 I-.... .._. TYPE OFCONSTRUCTION NEW ADD ALTERATION REPHIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/ SE OF BLDG /oisTs' 0'��2 Livr�� ocK-t TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL ❑ TENANT '❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ.FT. OCCUPANCV CONSTRUCTION TVPE JL VALUATION $ �{ O�O 20NE GRADING CU. VOS. ACRES Remarks: G,7-�"h- Bar Sink Backflow Preventer Backflow Irrigation Bathtubs (�.�dflflEfS Dishevasher Drinking Fountains Floor Drains � Floor Sinks GasService OuNets (itchen Sink Lavatories '—Trap Roof Orains Reinspaction Fee $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blc IC80 # Heating System & Ducting ' ❑ o-i oo,000 aTu � i oo,000 sr ReinspeRian Fea White - Builtling; Canary - AppllGant; Plnk - ACCounting; Goltlenrotl - Asse55or $75 Showers Service Sink Sewer Cap � Sewer Connection. Solar Collectors Solar Piping Solar Tank � Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash LaundryTrays ' Issue Fee Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System , ❑0.100,OOOBTU ❑100,OOOBTU System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 53 A.P. � �o,(„— S Main Buildin9: E T Front ARear C Right K Left S '� Ping. Ref. # Planning Notes: � T Auromatic Washer Construction Pale Sub. Cooking Unit Dishwasher . Dryers OGas ❑Elec Fan F.A.U. � Fixtures Device Boxes Outlets Switches Garbage Disposal Generetor �0.5 KW C 2365 II/16/84 �� I Accesso� B 'Id: , e3.37 T` Zone ��•1 n i Parking Req./Provided �� ELECTRICAL Transformer ❑ 75�50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps • Sub Panel Morors �61 HP �1 N,'- 8 Inc.Solat 09�15 HP �16-15+ Microwave Pole Light Range � Standing Sections 5 KW Trash Compactor Fee �$15 � � luue Fee DEVELOPMENT SERVIuCE�S R Zaning Approved By DIG! _ Building Approved By — 0 FEES $ 3 2 O N I N G R E � M T S SUMMARV OF FEES - BUILDING PERMIT $ I%/� Sa SMIP $ �'r� PLAN CHECK $ � � � 37 . pERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ � GRADING $ PLANCHECK 50°� $ MICROFILM $ MECHANICAL $ TOTAL FEE s 2. 37 PLAN CHECK ZS% $ . �. .CONSTRUCTION ANDPLANNING ��APPROVALS - Permit# ,. 1. Temporary Electrical Service or Pole r � �"_ 2. -Soil Pipe-Undrgrnd. - 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Coniluit-Undrgrnd. - � � . 5.�Steel�Reinforcement - 6. Electrical UFER�Grnd. . 7. Footings . . - � 8J Foundation � 9. Water Pipe-Undrgrnd. . 10. Structural Floor System 11. Property Sewer Line & House Connectiqn � 12. SeweF Cap 1 73. Roof Drains 14. Rough Plumbing � � 15. Rough Electriral-Conduit 16. Rough Electric Wiring , 17. Rough Wiring Sign , � � 78. Rough Electriral-T Bar Ceiling � 19. Rough Heating & Air Conditioning - 20. Rough Factory Fireplace ' 21. Ducts, in Structure � 22. Ducts, Ventilating i - 23. Gas Pipe-Rough & Test � 24. Roof Framing , 25. Roof Sheathing 26. T-Bar Ceiling (S[ructural) & Monocoat - 27.� Frame and Flashing � 28. Lathing & Siding , 29. Insulation 30. Drywall Nailing � . 31 . Plaster Brown Coat 32. Electrical Power Mete'r-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood'o� Canopy 37. Final Factory Fireplace 38. FinalPlumbing, • � � I 39. Water Service-Final; ' � , 40. Gas Service-Final i 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigaiion � � 44. Landscape Irrigetion System � 45. Sound Attenuation � ' � i 46. HandicaP Regulations; � 47. FINALSTRUCTURE&BUILDING �� 4�. Special Requirements Completed i 49. Electric Release to Edison - � �- , 50. Gas Release to Southern California Gas Co , � � 51. CERTIFICATE OF OCCUPANCY Date � -. POC SPA Inspector qppROVALS Permit# :� i � . ,52. Pool & Equipment �ocation ; 53. Steel Reinforcement � � _ 54. Forms . ' •55. Electrical Bonding 56. Rough Plumbing & Pressure Test � 57. APPROVALTOCOVER-GUNITE � � � 58. Electrical Conduif-Undrgmd. . 59. Gas Pipe, O Undrgrnd., Test � 60., Backwash Liries, P-Trep, � Undrgrnd. 61. APPROVAL TO DECK , 62. Backwash & Receptor-Final . 63. Heater & Vent�Final � - � 64. Plumbing System - Final 65. Electrical-Final • � 66. Solar System�Final _ � ' 67. Fencing & Access Approval � 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT � �APPROVALS. Permit # 70. Underground HYdro 71. Product Piping O Gas ❑ Oil 72. Underground Flush , 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION � 80. FOOD CERTIFICATE ISSUED Notes: Date I I . I- .: . . I 1 P m a Date I Inspector 0 Aoolicant to till in all soaees ezceot tnase witnin heavY eortler Iines antl sign all avProoriate aeclarations. , CITY OF COSTA� ME�S�jA CO�NST�RUCTION P/ERMIT P T NO TRACT NO. LOT NO. UNIT NO • Project Address �i•..� "' Y�i.v��t.l.'�: ""�� • A-pljcant's Mailin9 AddrfpJs s j��'�.�ew' 4%�'j' /ana �'G 5524'j��•p j��j?� Owner's Name f��r (��/� ��3< ahone Address Arch/Eng. License No. �`/.$�� Q �� Address � � Convactor's Nam O• ' ' �✓ - Phone �j2 /,� /i`3 Addreu (mailinglr'��%'vv� RS�a`� Ari� . •Ci9 Y•2Y/J•. `J's�:� �' City License No. �t' �— LICENSE� CONTRACTOR DECI,qRAT10N I hereby affi�m tha[ I am litensetl unClt provi5ioni ot Cnarter 9(commencipq with section 7000) ot Divlslon 3 of Ihc Busine5s antl Protessions CoOe, antl my license is in tull torce antl e/iect. License Class �'�U �j,J�e�se No. �� Datc 'N'%'Sti Si9nature SdG : ��.1 i� WORKERS' COMPENSATION D��LARA ION % M1ereby affirm that I have a certi(icate ot mnsent to seH-insure or a certificate ' ( Workers' Compen5a[ion Insurdnce, or a cerHfletl copy tnereof (Section l800, Lab. CJ .{�N PolicY No.�U J�i.��-`�(9 ComPanY�••'"^•'��✓•.�Cu<� �Certitietl copy is hereby furnispetl. Cer�tif-ietl ncopy is filetl with the �ity B I Iv' ' n Dat¢� �'r� AppliCdnt�.9',� �� EXEMPTION FROM WORKERS' COMPENSA O DECIARATION (Thissection neetl nol be completetl If the permit is fo� one huntlretl (5100) ar less). �I certiry that In the pCrformance Of the work for which thls pe�mlt I5 issuetl, I snall not employ any person in any manner so as to become subject to the �Workers' Compensation LawS ol Califomla. Date Signalure I NOTICE: If, aiter making this tleclaratlon, you shoultl become subject to tAe Workers' Compensation provisions of Ihe Labor Cotle, You must forthwith comply with such p�ovisions or this permit Shall be tleemetl �evoketl. CONSTRUCTION IENDING, AGENCV _\ I he�eby af9rm lhat there i5 a consk/uction lentling a9ency for [he perfo�manCe N of th¢ work fov which this permit is issuetl (Sectlon 3097 Civ. C.) I LPnUer's Name Lenaer'S AdOreis � OWNER BUIL�EH UECIARATION I he�eby atfirm that I am exemOt trom the Contractor'S Ucense Law for tne following reason (Section ]031.5 BuSiness antl Protessional Cotle: Any ciry or county which �equires a pe�mll t0 <onSVuc[, alt¢r, Im0/ove, tlemOlish or r¢pair any st�ucture, priOr lo Ils is5uance, also �¢quires lhe appli<ant fo� Such pertbit LO iIIC d SIgOCtl SIdLCffICOI Shdl hC�5I1C IS IICPfISBG pU151ldf1l LO Lb8 PlOVISIOf15 Of the ContraclorY LicenSe Law (Chdp[er 9(commencin9 �'�N Sec[ion 7000) of Division 3 ot the Business antl Protessions Cotle) or that he/she is exempt :here/rom anA lhe basis tor the alle9ed exemption. Any violation of Sec[ion 7031.5 Cy any applicant for a pe�mit zubjects the applicant to a civil pendlry of not more tnan tive huntlred tlolla�s (E500). ❑ I, as owner of tne properly or my emo�oyees with wages as their sole comoensation, wi11 Oo the work, antl the structure is not Intenaetl or ofteretl (O! Shc2 ($CC�IOl1 7044, BUSiOCSE dOd PlOi25510f1d1 Cotle: The COI1IfdCIOI'S ' LicenSe Law Ooes nol apply lo an owner ot d property wlio Guiltls or improve5 thereon, antl who tloes such work nlmself/herseli or tnrough his or her own em0loyee5, prOvitletl that Such Irt�provemenis are not in[entletl o� otferetl fo� sdl¢. H, however, the bulltling or improvement Is soltl wlthin one year of com- pletiOn, the owner will have the burtlen of proving h¢/sne tlitl not builtl or im- �rOve for tne purpose ot sale). I, as owner of Ihe p�operty, am exclusively conVacting with Iicense0 cOn- t�actorsto constructlh¢ prOject ($ectlon 7044, Business antl Profeszions Cotle: The Contractor's License Law tlpes not apply to an owner of property who builtlz or improves th¢reon, antl who contracts (or such orojects witn a con- (ractor(s) i¢ense pursuani to tne Contractor's License L.aw). I am aware that prooi of their WorkeYs Compensatlon Insurance shoultl be provltletl to me. ❑ I am exemp[ untle� Section 8. & P. C. fo� this reason Oate Owner I hereby certity thal I have reatl this application antl state that the above informafion Is correcL I agree lo comply with all city antl county ordinances antl Slate laws rela[ing to bulltliq9 COnSGuction, antl hereby authoriie �e0r¢- sentativez of lM1is city to e Cc� upon the abOve-menlionetl property fo� inspection pu 5 { � `� Signature �� ^^'�'.I� Date� Orivers' License or �� %•� ��3 22 TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ OEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLOG. TVPE OF PERMIT LI GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT �ELECTRICAL ❑ PLUMBING ❑ MEGHANICAL ❑ OTHER PROJECTDESCRIPTION Sc2.FT. oCCVaANCY_ CONSTRUCTION TYGE VALVATION S ZONE GRADINGCU.VDS. ACRES, Remarks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceprors Kitchen Sink Lavatories P-Trap Roof Orains Reinspection Fee � $15 Duct - Under Ground Duct - SVuctural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact Blc ICBO # Heating System & Ducting ❑ ai oo,000 sru O i oo,000 peinspeaion Fee � $15 CMF 0865�46, rev. ]0/B4 White - Builtling; Canary - Applitanh Pink - Accountin9; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connectian Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service A uto-W esh laue Fae Hoodor TYPeI ❑ Canopy Type I I ❑ Refrigeration System ❑o�ioo,000aTu ❑ioo,00a System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 $ 3 A.P. # S Main Building: E T Front g Rear A C Ri9ht K Left $ Ping. Ref. # Planning Notes: Automatic Washer Construction PoleSub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elea Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Oisposal Generator �0.5 KW [ Fee 0236 5/10/r^ 013�71DJ�:: Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up ro 100 amps �� Meter pover100a s Sub Panel Motors � 0-7 H P O t Y, - 6 Ina Solar 09-75 HP �76-15+ Microwave Pole Light Range Sign Standing Sections 5 KW TraSh Compactor $15 � � Issue Fee FEES $ 3 Z O N I N G R E Q M T S DEVELOVMENT SERVICES REQUIREMENTS: Zoning Approv¢d By DatB Building Approvad ey Date Appliwtion luued By �'h Data �� "�8 /'� SUMMARV OF FEES BUILDING PE,B��fl� SMIP $ PLAN ECK $ � PERMIT PLUMBI $ ISSUANCE $ PLAN CHEC 25% S A�_.— ENERGV P.C. $ ELECTRICAL $ �� /[��±} �G�RADING $ PLANCHECK 50% $ � C'"'ICROFILM 5 � MECHANICAL 5 TOTAL FEE $ PIAN CHECK 25% $ ' / CONSTRUCTION AND PLANNING POOL & SPA �.APPROVALS Permii# Date Inspector AppROVALS Permit# Date Inspector 1. Temporary Electr�cal Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgmd. 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. Fodtings . 58. Electrical Conduit�Undrgrnd. �8. Foundation: ; 59. Gas Pipe, � Undrgrnd., Test 9. Water'Pipe-Undrgmd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor 5Vstem 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 i 6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-7 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. U�derground Flush 24. Roof Framing ' , 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL ." 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT Ir 31. Plaster Brown Coat 79. FINAL INSPECTION " � 32. Electrical Power Meter-Final .�1.�� 0. FOOD CERTIFICATE ISSUED „ 33. Final Electric .� ' Notes: 34. Final Heating & A�r Conditioning . i :, 35. Final Gas Pipe-Test "' 36. Hood or Canopy � � � 37. Final Factory FirePlace 38. Final Plumbing ' . . i 39. Water Service-Final ' � ' 40. Gas Service-Final �, . 41. Solarpomestic-Final � , �� 42. BackflowPreventer �, .43. Backflow Irrigation ' " � • 44. Landscape Irrigation SYstem ' , • • 1 45. Sound Attenuation . . � �46. Handicap Regulations �. . 1 47: FINALSTRUCTURE&BUILDING � • � � 48:' Special Requirements Completed . � . ' � 49' Electric Release to Edison . �� :�' 50. Gas Release to Southern California Gas Co , � 51. CERTIFICATE OF OCCUPANCY �- No. Date Applicant lo fil� i� all spaces within �«TY Q� COSTA MESA PERMIT NO. � CONSTRUCTION PERMIT L= .�5�% Arch/Eng. License No. Address Contractor ,( qT}Y//i'i7/ _ / Phoi LICENSED CONTRACTOR DECLARATION � / I hereby atfirm tha[ I am Iicensetl untler provisions of Charter 9(com- mencing with section ]000) of Division 3 p( the Busines5 antl Professions C(t�e, a tl�y 114ente is in tull form V antlret ept. License Class �— y �� 'y F se Mo. � �� r� Date Si9nature �"��'�� /� WORKERS' COMPENSATION DECLARATION � I her¢by aifirm that I have a certificate Of COnsen[ to selt-in5ura or a celtifiCatC ot Worker5' Compensation InSuran�e, oI a celtifietl Copy th¢reof (Section 3800, Lab. CJ. P^"ty No. Company ' �rtifietl copy is hereby furnishetl. .ertifietl copy is filetl with the city Builtlin9 Divislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl If the pe�mit i5 (or one huntlretl ($1�0) OY 1255�. I ce�tity that in the performante of Ihe wo�k fo� wM1ich thi5 permit is Issuetl, 1 shall not employ any Oe�son In any manner so as to become sublect to the Worker5' Compensation l.aws o( Cy��fornia. Dd[¢ Signature NOTIGE: If after making [his tletlaration, you shoultl become subject [o th¢ WOrkers' Compensation provlsion5 0� Ih@ �bor Cotle, you must for[hwith comply with such provisions or tM1is p¢rmit sM1all be tleemetl revoketl. - . . CONSTRUCTION LENDING FGENCV I h¢r¢by df(irm [hat there I5 a Constructlon lentling agency for the per- tormance O( tM1e wo�k fo� which tM1ls permit i5 i55uetl (Section 3097 Civ. CJ. Lender's Name � Lentler'S Atltlress OWNER BUILDER OECLARATION I her¢by affirm that I am exempt from tbE Contrat[or'S License Law for the followinq reason ($ec[lon ]031.5 Business antl Professions Cotle: Any city or county whith requires a perrqit [o const�uct, alter, Ifi1pIOVE. tl2rt10115h OY repair any zt�ucture, prior to It5155UdIlCE. d150 fE- quires the applicant for such permit to file a signetl statement tbat M1e is licensetl pur5uant to th¢ provision5 of the C4ntraclor'S CicenSe Law (Chapter 9(Commencing with Se<tiOn 7000) oi Division 3 of the BuSinesS antl P�ofessions Cotle) o� that he i5 ex¢mpt Iherefrom dntl the baais tor tite alleged exemption. Any violatioq ot $ecHon ]031.5 by applicant for a permit subjetts [he applicant to a civil p¢nalty rt more than five hundretl tlollars ($500). �., as owner ot the property, o� my employee5 wilh wages as their sole compensation, will tlo the work, antl the structure is not Intentletl Or oHeretl for sale. (Section 'l046, Bu5ine55 anU Prote55ions Cotle: The Conlracfor's License Law tloes not apply to an owner of a property wh0 builGs o� imp�oves thereon, anG who tlo@5 zuch work hims¢It or (hrough his own employees, provitletl Iha[ such iTprovements ar¢ not Intentletl or offeretl for sal¢. If, howeveq [he builtling or improvement Is soltl witM1in one year of completion, the owner will M1ave tM1e burtlen of proving he tlitl nat bulltl or improve Por [h¢ purpose of sale). ❑ I, as owner of the Pvoperty, am excluAiv¢ly contracting with licensetl contractors to consVuct the project (Section ]044, Business dntl Professions Cotle: TM1e'Contractor's Llcensp �yw dpEs not apply to an owner of property who builtls o� improves thereon, antl wM10 com Va<Is f�om such projeCts with a conlydctar(S) licesnetl pu�suanl to the Contractor's License taw�. ❑ I am exempt untler Section - B. & P. C. for this reason Date Owner - I hereby certity Ihat 1 have reatl thls application antl State Ihat Ihe above Information is corretL I a9ree to comply with all City antl county ortlinances antl state laws relating to cOnstruction, antl hereby authoiize rep�esePtatives of this city to e�ter upon Ihe above mentionetl bartle� lines antl si9n all apOropriate Eeclarations. ��/�- / 1(/ ' TRAs,� flg, LOT NO. BLDG. NO. � (� �`-�� ' �2/ `� (�'-� I�l 1,�/�� r" -. TVPE OF CONSTRUCTION . 930 �I I SIBI [� �NEW ❑ ADD ❑ ALTERATION � ��REPAIR ❑CONVERSION ❑DEMOLISH ❑ oTHER ZONING REGULATIONS DESCRIPTION OF WORK P"P' � TVPE OF PERMIT ❑ GRADIN��G--yy� __❑ FOUNDATION ❑ STRUCTURAL ❑TENANI`qs.CLECTRICAL OPLUMBING ❑MECHAI ❑ OTHER � PROJECT DESCRIPTION 54. FT. OCCUPANCV—CONSTRVCTION TVPE VA�UATION ZONE GRADING CU. VDS. ACRES PLUMBING . � PLAN CHECK BATHTUBS SHOWERS TOILETS �URINALS �' LAVATORIES DOUBLELAVS KIT.SINKS DISHWASHERS SERVICESINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS � INTERCEPTORS CI.ARIFIERS SWIMMINGPOOL - PTRAP � WATERSERVICE ALTERATION GASSERVICE OVTLETS �' VJATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SVS. ISSUE FEE � MECHANICAL PLANCHECK HEATING SVSTEM 0-100,000 BTU_ ANODUCTING 100,000+BTU_ REFRIGERATION 0-300,000 BTU_ SVSTEM ' 100,000+BTU_ BOILERS BTU SYSTEM REPAIR, AI.TERATION EXHAVSTSYSTEM MULTIPLE Drivers' License or 55 � `�� --� �� —' �SSUE FEE CMF 0865-46 White-Bulltlin9: �nary-AppliGant; Pink-Accountin9; Goltlenrotl-Assessor 0 � ZONE REAR VARD (TO PKG.SPACE REQ. ZONING APPROVED BV SPECIAL CONDITIONS: ELECTRICAL PLNG.REF. PARK FEE PLAN CHECK GENERATOR 0-1 KW_ 1-30 KW _ TRANSFORMER APPLIANCE 30-50 KW_50 + KW _ MOTORS 0-1 HP_1-30 HP'"_ (INC. SOLAR) 30-50 HP 50 + HP _ FIX7URES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS MAIN SUB SERVICE ' AMP � ISSUE FEE - � ` HPPLICATION APPROVED BY ' DATE 8950 TL SUMMARV OF FEES BUILDING ' -' PERMIT $ SMIP , $ . PLAN CHECK E PERMIT ISSUANCE $ � PLUMBING $ - ' GRADING S PLAN CHECK $ ELECTRICAL $� $ PLAN CHECK $ MICROFILM $ MECHANICAL $ - TOTAI FEE $ PLANCHECK $ - VANCEPC $_ � FINAL FEE § � ��/ CONSTRUCTION AND PLANNING � . POOL & SPA � - � ,_ APPROVALS Permit # Date Inspector pppROVALS . Permit # Date Inspector 1. Temporary Electrical Service or Pole . 43. Pool & Equipment Location � 2. Soil ipe-Undrgrn . 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms � 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn ' 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn .8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn � 51. Backwash Lines P-Tra ❑ Undr rn � 10. Structural Floor System � 52. APPROVAL TO DECK� 17. Property Sewer Line & House Connection i' 53. Backwash & Rece tor-Final 12. Street Sewer Connection � 54. Heater & Vent-Final 13. Rough Plumbing ' � 14. Rough Electric-Conduit - �56. Electrical-Final 15. Rough Electric-Wring � -- 57. - SolarSystem-Final_ � -- 16. Rough Heating & Air Conditioning � encing & Access Approval 17. Ducts, in Structure � APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing ' 21. Roof Sheathin - 22. Frame and Flashin NOTES: � 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 32. Water Service-Final 33. Gas Service-Final 34. Solar pomestic-Final ' 35. Landsca e S rinklin S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison •� -8 41. Gas Release to Southern California Gas Co. 42. CERTIFICATEOFOCCUPANCY • No Date , . w COSTA MESA BUILDING-SAFETV DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 F�+ 7. W 0. Q h H i F� G Lr] F Q a > � � � w a. � � a z Li7 x 3 For Applicant to Fill in Completely - Use Ink Only ADIDRESS 3498 Wimbledon Way OWNEROR Wimbledon �iSSOC. TENANT ADDRESS 1470 Jamboree Rd c�Tv Newport Beach T�,�90-6800 coNsraucrion,imperial Savings & Loan LENDER BRANCH Pasadena ADDFESS 61 S. Lake Ave ORENGINEEaCoYbin/Yamafuji N�'49-7124 nooRess 17992 Mitchell So.,Irvine CONTRACTOR McLain Dev. Co. aooRess 1470 Jamboree Rd cirv Newport Beach No�640-6800 LC NO. 273875 LICVNO. 1HH%.3 SIZE NO.OF BLDGS. O OF lOT NOW ON LOT USE OF Separate permits are required for electric, plumbing and heating work. OF BUILDING AND WOFK TO BE PERFORMED PRD — New Construction Single—family dwelling I hereby acknOwletlga thet I have reed ihls epplicntion end state that the abova information is cOrrect antl agrBe to comply with all laws ragulatinB builtling consttuction, entl I s�ell not employ any person in violation of the workman's compensation lews ot the State of Celifornia. I hereby certity that I am properly licansetl as a conttectar untler the State of California B�sinass antl Profassions Cotle, Divizion 3, Chapter 9, and that such licenses are in full force enA etfect, or I am exampt from the O�a�isions of the S[eSa of CelitOrnia Business antl Professions Cotle, ivision 3, apt� 9. SiBneture of Petmittee or Autho�hetl ABant Date APPLICATION FOR STRUCTURAL PERMIT RECEIVE BV P�� I� O�B ^ �,. � _ . _I�- .� l 4 7 ! %� A.P. NO. . �I %-� 8 UI LDI NG ADDRE55 3498 Wl1 UNIT OR SPACENO, i.d R.NO. LOT 10275 64 NEW ADD AITER REPAIR MOVI X OWNER Wimbledon �iSSOC. PRD VAWE USE E APPROVED APPROVEDSETBACKS PLANNING ACTION VALUATION DATE BLK. L '�!� 7 �o dN UNDER VALUATION IS FOR ABLISHING A PERMIT FEE ONLV: PERMIT FEE b � l a ' PLAN CHECK S TAX S �� TOTALPAID $ �/ .C% OWENS•CORNING Fiberglas.. �lanket 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: �� /,t/;„�biF�/;,� G�J� �t C / i«�S Street Lot Number Tract Number � Exterior Walls � f � �� Owens-Corninq Fiberglas Blanket Insulation � Thickness R-Value Ceilings Owens-Corning Fiberglas Blanket Insulation � Floors Owens-Corning Fiberglas Blanket Insulation . Faundation Walls Manufacturer Type General Contrecto G� � � Thickness R-Value Thickness "' R-Value Thickness R-Value _ License No. By � �• " Title � Date (Signamre/� � e Insulatio ntractor—�'i/��"�4iJ��i'-�LI�L�'LicenseNa �Q i /� � By —�� Title �N Date �C/��_ �Sig aWre) ' Homeowner Copy (White) State Copy (Yellow) Builder Copy (Pink) Gu�. No. lfi-BL-699ST Gi�o in U.S.A.. July 19]i OWENS-COHNING FIBERGLAS CORP. Insulation Operating Division Fiberglas Tower. Toledo, Ohio 43659