HomeMy WebLinkAbout2330 VANGUARD WAY - Building Permits (E204) •
CITY OF COSTA MESA
`y' •,� BUILDING DIVISION
3/4. 1 '�•" ' DEVELOPMENT SERVICES DEPARTMENT P98-00325
T.$ triCalt
• PERMIT PERMIT NUMBER
``
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(714)7'"54---5273 • Fax(714)754-4856 PLUMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626
Job Address: 2330 VANGUARD WY Status: ISSUED
Suite No Applied: 04/29/1998
Issued: 05/05/1998
Vicinity: CONDO UNIT E204
Parcel Nunmber: 93865132
Applicant: PONCHER, SCOTT
Address:
Phone:
Zip:
Owner: PONCHER, SCOTT
Address UNIT A-101 . . . . . •
COSTA MESA,CA Phone:
2330 VANGUARD WAY Zip: 92626
Contractor NOCK PLUMBING
Address: 11612 KNOTT ST
Phone:-714 8951246
GARDEN GROVE,CA .Zip: - 92841
- License:707775
Arch/Eng:
Address:
Phone:
Zip:
License:
• SCOPE OF PERMIT
INSTALL WATER HEATER.
FEE SUMMARY
AMT QTY AMT' QTY AMT QTY ' ,
ISSUE FEE $22.00 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation • $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $11.00 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink,Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop • $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) • $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $33.00
COMMENTS/SPECIAL CONDITIONS
•
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
DECLARATIONS •(j
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are:
Cartier: Policy Number
(This section need not be completed if the permit is valued at one hundred dollars($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 come subject to the workers'
compensation laws of Califon!: and agree that if I should become subject to the workers'compensation provisions of Section 3 0 0 e Labor Code,I shall forthwith
comply with these provisions.
Applicant Signature: Date:
WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE($100.000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Profession]Code,and my license is in full
force and effect.Lic.A Class A �
Contractor's Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or 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 five hundred dollars($500).):
❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or Improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑Yes 0 No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? 0 Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a..ppernit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? i�Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes El No
(If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials end Emissions.
•
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty 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 city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
aiglature Of Legal Ow : ) .././C14
• if Or Authorized Applicant Date
LOBE I INSPECTI0N TPE DAIS =ALS CODE E INSPECTIONTYEE BATE EMU
1616 Fixed System Final Fire Prevention 206 Final Mechanical
fry.
1266 Pool Spa Final 208 Final Plumbing .200 Final Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2446.6
Applicant to fill In all spaces except those within heavy border lines and sign all approoriate declarations.
CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. • I 7.'.'-2 ;Till—
CONSTRUCTION PERMIT I 4 /0 3 OS �y$( I � p'�G
Applicant's Mailing Address P-O-Rf1X 10844�9�1t RPV H111 C 90213 TWE OF CONSTRUCTION NEW U ADD L] ALTERATION REPAIR
Project Address•/ 330 VAN6-u AK() WAY P' a3/ ❑ CONVERSION ❑ DEMALISH ❑ OTHER
Owner's Name Nawaoer LANDINs L1'D, Phone�T/-Oq$3 DESCRIPTION OF WORK C'C NAI]MI N I U M TYPE, 13
t� rt n�,. / `1 �• Ell
t� /,� ZONING REGULATIONSg
Address P.c1•(',Ax I08N3 OR V�kL( ITILLS CA ]Q^1-/-3 TYPE OF PERMIT • CS GRADING ICF FOUNDATION IN STRUCTURAL A.P.#/"]`r q -/5 ---O&' ZONE R,3
Arch/En . CLACK IFI DIQtr15 Thr License No. C---c2,-C7
9El TENANT r. . ELECTRICAL "PLUMBING �.i MECHANICAL PLNG-REF.46 '/10 U UILDING
A ,1 7rf1 -8,5-110T-))4,51
Arch/Eng.
Cr
Address 11469 SA(>I^�VIC�f{T'li_ �L/�, �/ LA.QQOYR ❑OTHER TO BUILDING REAR YARD(TO P/L) �'ln/I
/ PROJECT DESCRIPTION SQ. FT. SIO PROPERTY LINE
Contractor's Name Z ^+ � Phone OCCUPA7CV R- Icw LEFT SIDE YARD / IGHT SIDE YARD L'' / n h- Imo./
✓Address(mailing) CONST gpUCTON TYPE V--- I H2 - VAAL'U.,A�TION$ IG /)SOO. C.1 �/,/✓' "7� {� �[,J(/
ZONE K -. GRADING CU.YDS.SITS ACRFS PKG.SPACE REQ. G' PROVIDED 02.5
L./License No. )
LICENSED CONTRACTOR DECLARATION Remarks: B L0G- F _ LI N O TYPE_ STREET WIDTH •. •`v PARK FEE$ �;l
I hereby affirm that I am licensed under provisions of Charter 9(commencing + If I. EOR SPECIAL
with section 7000) of Division 3 of the Business and Professions Code,and SPECIAL CONDITIONS.0 REQUIREMENTS l. (' I Of •
•
my license Is In full force and effect.
License Class License No. PLUMBING �I'±,,�y�" Mb t z t''t �.; 7 1 f _
Date Signature - "`�' x-"- l'i t'�+^-^�`ECTR/f /1.CA-L, � I ../}V
'PORKERS'COMPENSATION DECLARATION J Bar Sink Sewer Cap ELECTRICAL a d � i a
lereby affirm that I hive a certificate of.consent to self-insure or a certificate / Automatic Washer Meter ■over 1 PI amps A In . v ,.J .,r
I Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Sewer Connection fS.f1�sU
3800, Lab. C.) Backf low Irrigation Solar_Collectors Construction Pole / Sub Panel
Policy No. Company - - - _- / Cooking Unit Sub Pole
8 Certified copy Is hereby furnished. Bathtubs Solar Piping ,
Certified copy Is filed with the city Building Division. Dishwasher her ! Motors X10-1 HP ❑11/2-8 •
Date Applicant Clarifiers Solar Tank
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Swimming Pool w/Spa / Dryers Ib Gas ❑Electric
(This section need not be completed If the permit Is for one hundred($100)or _ y Ino.Solar ❑g-15 HP ❑16-15+
less).. • 4( Fan Microwave i
I certify that in the performance of the work for which this permit is issued I Drinking Fountains Urinal
shall not employ any person In any manner so as to become subject to the - / F.A.U. — Pole Light A•S'
Workers' Compensation-Laws of California. Floor Drains Water Go - /
Date - Signature pu Fixtures
NOTICE:If,after making this declaration,you should become subject to the Floor Sinks / it ..r � p - / - J Range .
Workers' Compensation provisions of the Labor Code, you must forthwith �1�,��; PPP �t Device Boxes
comply with such provisions or this, permit shall be deemetl revoked. 6 Gas Service / Outlets ervice -y Sign .
' CONSTRUCTION LENDING AGENCY • Outlets
I hereby affirm that there Is a construction lending agency for the performance Interceptors ` Standing Sections
' of the work for which this permit is issued (Section 3097. Civ. C,) rs Switches
Lender's Name - / Kitchen Sink , �� Trash Compactor
Lender'
reason Address •
- ,.,O I(� / � / Garbage Disposal
OWNER BUILDER DECLARATION Lavatories 1� �`'\ '] "/J
I hereby affirm that I am exempt from the Contractor's.License Law for the P-Trap
Generator ❑0.5 KW 05-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or p rs/`.
county which requires a permit to construct,alter improve,demolish or repair �ryy``'' V Transformer ❑15.50 KW
•
any structure, prior to its issuance, also requires the applicant for such permit Roof Drains \7��1/'" -
to file a signed statement that he/she Is licensed pursuant to the provisions of 050+KW
lF Contractor's License Law(Chapter 9(commencing:with Section 7000)of Reinspection Fee $15
..['vision 3 of the Business and Professions Code) or that he/she,is exempt Showers Lit' - Reinspection Fee $15
Reinspection
and the basis for the alleged exemption. Any violation of Section - 1=E up to 100 ampsIssue Fee ' '$,3.
`131,5 by any applicant for.a,permit subjects the applicant to a civil _
penalty of not more than five hundred dollars($500). Service Sink Issue Fee $ 3 Zoning Approved By �fliWSlfl1` - Date fl#E/hea
LJ I, as owner of the property or my employees with wages as their sole " i
compensation', will do the work,and the.structure is not intended or offered MECHANICAL `
for sale-(Section 7044, Business and Professional Code: The Contractor's --- -- -- - - -- -= - - -- _—- Application Approved By Pr - '" ' � � aaTe 1,4-So
License Law does not apply to an owner of a property who builds or improves . Boiler - Refrigeration System
Application Issued By //.2 -30 -(�3
thereon, and who does such work himself/herself or through his or her own PP Al� Date
employees, provided that such Improvements are not intended or offered for - ❑0-100,000 BTU ❑100,000 BTU .
sate. If, however,the building or improvement Is sold within one year of com- Duct-Under Ground SUMMARY OF FEES
le On, the Owner will have the burden of proving he/she did not build or im- -
e for the purpose of sale).,as owner of the property, am exclusively contracting with licensed cop-
•
Duct-Structural • System Repair/Alteration •£'S '3 I
BUILDING PERMIT $ �' (q $ '`I"'
I
ra ors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating • PLAN CHECK $ PERMIT
The Contractor's License Law does not apply to an owner of property who - SMTP
I
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple❑. PLUMBING •$ ISSUANCE ' $
tractor(s)license pursuant to the Contractor's License Law). GRADING $
❑ I am exempt under Section - B,& P.C.for this reason Firepl/Fact.BIL ICBG# PLAN CHECK $
•
ELECTRICAL $ $ '
Date / �� owner' • eras' Al .a.. - >-..w" , / H ting System&Ducting MICROFILM $
•
I hereby tfrtiiyt ah t"1'have read t s application and-state the j the above ' / J0-100,000 BTU 0100,000 BT - PLAN CHECK $
Information Is correct. I agree to comply with all city and count ordinances MECHANICAL TOTAL FEE. $
and state laws relating to building constructl•n,and hereby authorize repre- rof - $
sentatives of-this ty to enter up. • the above-mentioned ro erty, for Hood or Type I 1�` '
inspection itur•oo�L? -' /p Cano• T •e II ❑ Reinspection Fee $15 pLAN CHECK $ LESS
Signature t/,A_ a - ia._ sate/� 30 ADVANCED PC $
Drivers' Llc:nse or SS# Registers . • Issue Fee $ 3 $I
_. • FINAL FEE $ eZ.3'
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
c? nCONSTRUCTION,AND.PL'ANNING' . rt. 14",:- - -s :. S=- , POOI .PA _ : :.
APPROVALS ` Per'ritit.#! " :. . - '=Date - r Inspector ', ''APPROVALS Permit# - Date ;Inspector
r'r t: Temporary Electrical Service or'Pole - _ ; .1452F' Pool &•Equipment Location • .,
' 24. ? Soil Pipe-Undrgrnd:.- 1. " .o 7 ' `. r . . X53., Steel Reinforcement - -
3? Electrical Conduit Utility-Undrgrnd: 4.. 5Forms,' - '
4' Electrical Conduit-Undrgrnd. L 55, Electrical Bonding - -
5, Steel Reinforcement " ' -'
' ; n`,' _ 56.• Rour. gh Plumbing & Pressure`Test •
! ` '57-APPROVAL TO COVER-GUNITE
6: Electrical LIFER Grnd.. - •
-
7. Footings ' . - -• ` - ''- # 58Electrical!Conduit-Undrernd.
8. Foundation '• f 1 ' ` C. _ ' 59. Gas Pipe,;0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. ' _ `60. Backwash,Lines,P-Trap, 0.Undrgrnd.
10. Structural Floor System .` i 3 n` ' 61. APPROV'AL.TO DECK - - - -
11. Property Sewer Line& House Connection , <- ' - - 62. Backwash& Receptor-Final- _ . _ . -
12. Sewer. Cap sf 4 j F - o , - --1. -"63. Heater& Vent-Final
13. Roof Drains Y. - : 64. Plumbing System - Final - "
14. Rough Plumbing ;.; 65. Electrical-Final •
si .f 15i'Rough Electrical-Conduit'--' - - �, 66.."Solar System-Final ' _
16. 'Rough Eleciric Wiring, N ' :i I- f - , •i i
• • r I i ,I r, - I _ C: 67. Fencing & Access Approval
" "17. Rough Wiring Sign:; ,-= 1 • - _ 4. 68.1 APPROVED FOR-PLASTERING . - ' . .
•
18. Rough Electrical;T Bar Ceiling, , : , - I - • 1 69. POOL/SPA SYSTEMS FINAL
19. RoughHeating& Air Conditioning • 1 - - .- 1•FIRE DEPT. REQUIREMENT
20.'?Rough Factory Fireplace' 11 n i " i I I APPROVf9Ls.-y Permit,# -
1.
_, 21. Ducts,:in Structure • • I i t t 70.rUnderground Hydro i
.•".22-.. Ducts•, Ventilating ' i 1 I ! 1 i . i p11i duct'Pi ping 0`Gas 0Oil
_ ,•.23. Gas Pipe-Rough&_Test ; ! :i• r . I I 1 1'• 1 •72.. s't Underground Flu ' -
i-24. ;Roof Framing - j0 1 ,. ' I • s i 1 ; • 1 1473.rU,ndeigrnd.Storage Tank O.Gas 0 Oil
c : ho
Of Sheathing i .;• ' .. ,
, ' , ' , I ' ! • I �74. Oveihead Hydro '
f .26. T-Bar Ceiling (Structural) & Monocoat' 1 ' 2t 75. Dry Chemica' -
'-27. Frame and Flashing I 4 I I . 1 /k.X76_.1 Dry Standpipe
28 lathing 82-Siding ;� i.eI ! I ! -. I . 77_ FIXED SYSTEM FINAL• , •
29 Insulation - f 1 I, ! I 1 I v'�°''+78. FIRE PR£V. FINAL '
v
,30. ,Drywall Nailing • I ! '' I ;`',�f Notes:! /I, ; . - •
- , � -T .
-- ti 31. 'Plaster Brown Coat- -t, ;,
II .,..,
, f
!t 32.;Electrical;Power Meter-Finil 1 11 1 l i I ! . I I '
t. 1 33. Final Electric r i 1 ' 1
34. Final Heating &'A i�Conditioning 14 -'' .--',/I /'1 , ; ' 12 . •• / .
35. Final GasPipe-T.esf; '- i
36. Hood or Canlo5Y Ir I , I ' •- ; -' I' ' , I ! . -
37. Final Factory Fireplace ' I i " ' -
38. Final Plumbing ; ,. , , 1 ! I;' , v i I 1 , '
39. Water Service-Final E.
E,r1 i _ 1 ! !
40. Gas Service-Final ' i
41. Solar Domestic-Final I - :L t .1 '- • _1 __ _- -_w _
42. Backflow Preventer , : ; I1' ,'_ -- .
43. Backflo"WIrrigation' ,,f i v I, I r , • -t r t ,
•
44. Landscape Irrigatilin$ystm I' = , _ : I , .• ; -
45. Sound;Attenuation ' " f
46. Handicap Regulations . = it ` . I,: '
47. FINAL STRUCTURE & BUILDING. - I . � ' I '
48. Special Requirements Completed ^ .
1
49. Electric Release•to Edison, I . . ' __j.._. ._ _ l _" _ 1_ i.- ; .. _- . .._- •
•
50. Gas Release to Southern California Gas Co ; I I 1
n l I 1 ,
51. CERTIFICATE OF:OCCUPANCY „ i .i . -i- - ,_ . _- _ i- t - "_ - ! `
No ') II 1 '_ Date ' 1 I I I ; ' ,
City of Costa Mesa _
Development Services Department CERTIFICATE OF OCCUPANCY No. 001 061
Building Safety Division
P.O.Box 1200
Costa Mesa,California
The Building located at o�on s7 .,,..,.,a Tom., r_7n47
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group R-1 Occupancy.
Use of Building rnnAnmin11,m
Legal Description dln_1 c1_f1f,
(See reverse side for Metes and Bounds)
Building Permit No '71 cq:o Electrical Permit No. rico;') Plumbing Permit No. cicogo
Mechanical Permit No. _I CDS_ Number of apartments - and/or guest rooms
ISSUED TO: Building Official • '
Nrawnort. Tam-lira T.imi f pri
• P O Box 10843 by
llpvprly Ai11g. ra cirri'1
Date (' / ,. /C. 1
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C.
CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File
. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 5605 I /14/855 57708 IL
CITY-OF COSTA MESA • - - -
. PERMIT NO. TRACT O.. LOT NO. BLDG.NO. '/
CONSTRUCTION PERMIT G 11�43SZ /�/zVa/r ' a20) •
Project Address - • i• L j.' C 1.0 sr1 -•. t TYPE OF CONSTRUCTION 1115 NEW L.J ADD ALTERATION Li REPAIR - ,
e• S. S r. a: 3. Q a • - 0 CONVERSION 0 DEMO ISH ❑ OTHER T A.P.#IS O Zone
Applicant's Mailing Address �' - /...47 '- �j
Owner's Name L - raP' : L L : e --ho j3 • - e DESCRIPTION OF WORK *4 S� et.. . r.e-L.� v
. 2 _ / o S Main Building: Accessory Building: Z
• Address P.O LPX InS43.) REUERI4JI S1 CA.9'0,113 / / 0
p r-� `, L( TYPE OF PERMIT GRADING FOUNDATION P. STRUCTURAL T Front J}71'""R-rn PC N
Arch/Eng. CLARK- Went: 1Ca License No. C'SR4 • CS I
'\ 7 0TENANT ® ELECTRICAL �'PLUMBING Ip MECHANICAL B Rear
CO Address 11969 SAN UICONTF_ ea.., 1.k., �9�t0099g ❑ OTHER • A (�� 7°- nr'A�`'rsr, N` "
I Contractor's Name PAUL TtTRIPK - Phone MO-0771f PROJECT DESCRIPTION SQ. FT. Ia6) OCCUPANCY R-I/M_I C Right 5/ 7n pi R
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1 Address(mailing) A A t : L it dike . CONSTRUCTION TYPE T VALUATION$ 69(74 '23 S Left 39' /O 4eAr-sTrii' �'s E
M City License No. t ISA-7g ZONE GRADING CU.YDS. /� ACRESJPing. Ref.+ �,,U- _g0/_ 6g Park.Fees $ /�Z g 3c U
LICENSED CONTRACTOR DECLARATION Remarks: ���` S / }9 e/ Parking Req./Provided 2' -z® I
P hereby affirm that I am licensed under provisions of Charter 9 (commencing C ^ [)_- ,J
with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: �J ann ,er—, • E
my license is in full force an. effect ����--'CCC
License Cl.s C. - c> - N....".; . X57 - PLUMBING FEES Planning Notes: - ' 'M
E
Date - e' a Signature ' air./F /fe//�..,. HOLD FOP ^ OP IT T)t'F• NN
WORKERS' COMPENSATION DECLARATION Bar Sink ShowersSPFCTA1, r Ir_MTS.
'hereby affirm that I have a certificate of consent to self-insure or a certificate • Backflow Preventer Service Sink • S
of Workers'- Compensation Insurance, or d'certified copy thereof (Section - - - -
3800, Lab. C.) -�• - -/. i .
�7I3A p4-" S��FTF �I�P TnIS. 1Nf Backflowlrrigation Sewer-Cap ELECTRICAL FEES ,
Policy No. Cl Company ^
® Certified copy Is hereby fuinlihed, Bathtubs Sewer Connection;" - - I 1 I , 0 15-50 KW • ( OG
Cer�if lei�opy,I filed with the city B % D" i 4' Automatic Washer Transformer
Date 11- -yl Applicant B �G� A!0• Clarifiers Solar Collectors'- c. 'r: Construction Pole Sub. 0 50*KIN '
EXEMPTION FROM WORKERS(COMPENSATION DECLARATIO - -
Dishwasher Solar Piping �J
(This section need not be Completed if the-permit is for one hundred ( 100) or '7 P 9 .POd6// OA/Ly Jh Cooking Unit Meter,�up to 100 amps' s all
less). I .
I certify that in the performance of the work for which this permit is Issued I Drinking Fountains Solar Tank _ •
( Dishwasher Meter Cloverover 100 amps 1 DO
shall not employ any person In any manner so as to become Subject to the
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Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa 1 Dryers iNGas ❑Electric 1 Sub Panel x 6 00
Date Signature •
NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal3 Fan ;( Motors 00-1 HP 01%-8 CO
Workers' Compensation provisions of the Labor Code, you must forthwith ' " - -
comply with such provisions or this permit shall be deemed revoked. - / Gas Service S Outlets Dai Water Closet • (o I I . F.A.U. Inc.Solar 09-15 HP 016-15+ 1 al
CONSTRUCTION LENDING AGENCY �1
I hereby affirm that there is a construction lending agency for the performance ' Interceptors -- / Water Heater -2.0b 1.2 Fixtures •Microwave ,,11
of the work for wh�1_ftti er il- is i�sye (5�tyo9, 09 Iv. C.) Z T
Lender's Name t&)E FKHA(j5L4 C'IFN�TL�H&E j / Kitchen Sink - / Water Service ' '4 QC)
9 Ste SOI Device Boxes Pole Light
Lender's Address 9 I LIA)fALtJ UILLRGE .'t)R-) - '
OWNER BUILDER DECLARATION Lavatories - f4 ^
SaCRANEN's License.,'Law / lv¢S� MifLN/tJ�. (� p� lA Outlets Range CN
I hereby affirm that I am exempt from the and Contractor's License Law i t e P-Trap ``3'
followingutwhich re (Sectionirpermit
to5 Business , Professional Code: Any or city or (l Switches Sign 'Uj •I
county requires o a its issuance,
c ,conrequiresstruct,alter,improve,demolish repair
taoy lstructure,Siprior that he/, also icesthesuant to the r such permit - Roof Drains I Garbage Disposal Standing SectionsOQ
to file a rictotl statement Law(Chapter
is licensed pursuant to ice prov7isions of ' - - •
(
;�'{te Contractor's the Licensei and rife 9 Professions(commencing with Section is exemptxt)of - Generator ❑0.5 KW ❑5-15 KW Trash Compactor
s., retro 3 of sis for dexemption.Code) or that he/she f a . p
21131.5 bym and the basiscthe alleged jets. Athe
applicant'
toa Section • 1
''pe 31.5 •any applicant for a permit ss($5 s.the appllcant'to a civil 3 • �7j -R�. ' fes` 2- O•
eenalty of not more than five hundred dollars($500). Reinspection Fee ' , $25 Issue Fee • $ !1,
LI I, as owner of the property or my employees with wages as their sole ' ' r Reinspection Fee $25 .Issue Fee $ 3
Compensation, will do the work, and the structure is not intended or offered MECHANICAL FEES _ -
for sale (Section 7044, Business and Professional Code: The Contractor's - - - - - PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or Improves Boiler • Hood or Type I ❑ - -
•
thereon, and who does such work-hhnself/herself or through his or her own Zoning Approved By Date
employees, provided that such Improvements are not intended or offered for Canopy Type H ❑ �//
sale. If, however, the building or improvement Is sold within one year of com- Duct-Under Ground Application Approved By Date / 54 8•S
Diction, the owner will have the burden Of proving he/she did not build or im- �O
move for the purpose of sale). Duct-Structural Refrigeration System Application Issued By Date I� CC1t
•
LJ I, as owner of the property, am exclusively contracting with licensed con-
00-100.000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: -A Duct-Ventilating (.O -SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who ' 7j.00 ' / p
builds or Improves thereon,and who contracts for such projects with a con- BUILDING PERMIT $ ill' SMIP $ .4.S2
tractor(s) license pursuant to the Contractor's License Law). Exhaust System 0 Multiple 0. System Repair/Alteration PLAN CHECK $ • 2'ZZ.QS PERMIT •
0 1 am exempt under Section B.& P.C.for this reason • Firepl/Fact.Bat.ICBG#13o( U
I ` PLUMBING $ SG•O0_, ISSUANCE $
Date ' Owner Heating System&Ducting I • k
PLAN CHECK . $ ' .'j-7ENERGY P.C. $
I hereby certify that I have read this application and state that the above I ®4100,000 BTU ❑100,000BT 2-C3GRADING $ '
information is correct. I agree to comply with all city and county ordinances - - t(- ^,A ELECTRICAL $ �•
and state laws rel 'ng to building construction,and hereby authorize repro- PLAN CHECK $ I S .(n(Z MICROFILM $
sentitives Of city to fifer u on the above-mentioned property for -
inspection p es.
Signature Date /"ate MECHANICAL $ I1,� . TOTAL FEE $ (e�7'eS
Drivers' License or 55+ y . Reinspection Fee $25 1 - Issue Fee • $ 3 PLAN CHECK $ Zi•SO
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor' - - - .-
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CONSTRUCTION AND PLANNING . • POC SPA
-APPROS;ALS 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 `'
. Steel Reinforcement _ 3�/GY 1.1____. 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. / (� 57. APPROVAL TO COVER-GUNITE
7. Footings . . 3free ' 58. Electrical Conduit-Undrgrnd. •,
8. Foundation , . . 59. Gas Pipe, 0 Undrgrnd.,Test e '
9. Water Pipe-Undrgrnd. i . ire60. Backwash Lines, P-Trap, 0 Undrgrnd. • 0,
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 /a 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 g AieAr C,p - 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 Pipa=Rough &Test 72. Underground Flush
24. Roof,Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing ' �a` VC- 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat /%r, 75. Dry Chemical
27. Frame and Flashing '105„/er at- 76. Dry Standpipe
28. Lathing.&'Siding r //�I9" 77. FIXED SYSTEM FINAL
29. Insulation ‘00/5"-- j/(__ 78. FIRE PREV. FINAL
30. Drywall Nailing ,0/0" 't./C- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter-Final / g 80. FOOD CERTIFICATE ISSUED
33. Final:Electric -- / - Notes: 97.1ld6-lasire :q�veer Oe LEO
34. Final Heating & Air Conditioning 40. Of `,> ..4 i e. J. � lei _ Q _
35. Final Gas Pipe-Test / ritAr
! ` w.L[�C�-fLL �r�
36. Hood or Canopy
37. Final Factory Fireplace - / ' �'� 9 '
38. Final Plumbing '/z /P,
39. Water Service-Final 'Y
40. Gas Service-Final
41. Solar Domestic-Final .
42. Backflow Preventer
43. Backflow Irrigation
44. .Landscape Irrigation System
45. Sound Attenuation a
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING / 3i/S4 i/...,,����ttt
48. Special Requirements Completed -gG Ca
49. Electric Release to Edison - - - I .. -
50.,Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY w ' t •
No. -//C / Date ,14/ 6-Y, C
Pat_