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Home My WebLink About875 VILLAGE CREEK - Building Permits(714) 754-5273 • Fax (714) 754-4856 • Www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber. Applicant: Address: Owner: Address ConUactor. 875 VILLAGE CREEK 93506054 STEVEN SCHNIERER 2057 MANDARIN DR COSTA MESA, CA ELECTRICAL PERMIT Phone: 714-779-1689 Zip: 92626 PHILLIP, ELIZABETH J %DANDAN, MOUNIRA R COSTA MESA, CA Phone: 875 VILLAGE CREEK Zip: WEST COAS7 HEATING AND A/C Address: B FALLBROOK ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 7000a Service over t000a Motors to 1 hp Motors l0 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication tlrops Sub panel to 200a Pole Light Pkg Sign Circuits IRVINE, CA Phone: 949-552-5612 Zip: 92604 License: 814471 Status: ISSUED Applied: 06/02/2004 Issued: O6/02/2004 �xy g�� DA�� SCOPE OF PERMIT REPLACE FURNACE WITH 75,000 BTU, INSTALL NEW A/C UNIT IN REAR OF PROPERTY. $23.50 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 Quantiry FEE SUMMARY Temp Dist System / Lighting Busway I100 ft Sfanding Section Misc ElecVical Equipment Transformers up to 7 kva/kw ......:.........up to 10 kva/kw ........."........up to 50 kva/kw .................up to 100 kva/kw ..................over 700 kva/kw Low Vollage Equipment Low Volt Wiring System / Ckt Misa Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for �he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446-46�fl�00) WORKERS' COMPENSATION DECLARATION: � I hereby alfirtn untler penelty oi perjury one oi the follawing declaratians: ❑ I �eve entl will melntain e certiilcate oi consent to setl-Insure lor workers' compensation, as provided lor by section 3700 oi the Lebor Cotl , for the pndormance ot the work tor w�ich t�is pertnit is issuetl. �1 I have antl will mflintein workers' compensetion insurance, es requiretl by section 3700 oi the LeOor Code, for ihe peAortnance of Ihe work for which Ihis pertnit I5 issued. My wo ers' compens on Insurence cerner end p011cy num6er ere: Carrier:T�fia�e �UY� PolicyNumber. �.I %�'I �7SZ— z��3 (This sectiar need not be canp/eted /l fhe pemtifl5 va/ued ef one hundred dollars ($f 00) or Iess.J - ❑ I certity Ihat in ihe peAortnance oi the work tor which this pertnit is issued, I shall not employ any person in any menner so es to become sub�ect to the workers' wmpensation I� , elifomia, en should become subject to the workers wmpensetion provisions ol Sectlan 3700 of the Labor Code, I shell forthwith comply with ih AppNcant5lanawr rDete;� �O�Z' WARNING: FAILUR O SECURE WO ' WAIPENSATION GUVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIhLNAL PENALTIES AND GVIL FlNES UP TO dJE HUNDRE� T1K%15AND E(5100.000). IN AD ON TO THE COST OF COMPENSATIIXJ, OMMGES AS PROVIDED FOR IN SECTIIXJ 31O80F iHE LABOR CODE, IMEREST, PND FTTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: Chepter 9(commencing with Section 7000) of Division 3 oi the 8usiness end Professions Cotle, end my Ilcense Is in tull CONSTRUCTON LENDING AGENCV: ❑ I hereby aHirtn that t�ere is a construction lending egency for ihe peAormance ot ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). LentleYs Name: Lendels Atldress: Signature: OWNER-BUIIOER OECLARATIONS: Dete: I hereby eMirtn that under penelry ot per�ury t�et I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Buslness entl Professions Code: Any ciry or county whic� requires e permit to consiruct, alter, improve, demolish, or repair any stmcture, prior to its issuance, also requires ihe epplicant tor such permit to file e signetl stetement ihel he or she Is IICenSed pur5uent b lhe provislons of tha Contrectors License Law (Chapter B(commencing with Sectlon 7000) of Divislon 3 ot the Business end Professions Code) or thet he or she Is exempt therefrom and the basis for ihe alleged e:emption. Any violation af Section 7031.5 by eny applicent lor a pertnit subjects the epplicant ro a civil penelry ol not more than tive hundretl dollars ($500).): ❑ I, as owner of Ihe proparry, or my employees wlth weges es their sole compensetlon, WILL DO 711E WORK, entl the structure Is not InlentleC or otteretl for sele (Sec. 7044, Business and Professions Code: The Contractors License Lew does not apply to an owner ot properry who huilds or improves thereon, end who does such work himself or herseli or Ihrough'his or her own employees, pravided Ihet such improvemenis ere not Intended or oHered tor sale. If, howaver, the bulltling or improvement is sold within one year ol completion, tha owner-builder will heve ihe burden of proving that he or she did not build or improve for puryose ol sale.). ' ❑ I, as owner of lhe property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the projacl (Soc. 7044, Business antl Prolessions Code: The contreciors License Law does rwt apply to an owner ol property who Cullds or impmves thereon, end who con�rects lor such pro�ect wlt� a wniractor(s) license pursuant to the Coniractors tJcense Laws.). ❑ I am e:empt under sec. Business and Professions Code for lhis reason: Signature: Date: Owner I� verifiatl by tlnvefs license. ❑ Ves ❑ NO OrivetS License No. Expires: Veritication of Ownerehip by (rype ot document, Le. - properry taz bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certify that no excavation tive (5) or more feet in Aept� into which a person is required to descend, will be made in connection with work euthorized by this pertnit, end ihat no building siructure, scaHoltling, lalsawork, or demolition or dismantling ihereof, will be more than thirry-six (36) feet hig�. (Chap. 32, Grp 2, Art 2, Sec. 347, Title 8, Calitomia Atlministrative CodeJ. ❑ As ownerbuiltler, I will not employ enyone to do work which woulA require a pertnit from the Division of Intlusirial Safery, es notetl ebove, unless such person has e pertnit to do such work fram the division. Signature: Date: Division ot Industnal Safery Pertnit Number: CERTIFlCA7E OF COMPLIANCE PND AUfHORIZA710N OF ENfSiV: I certify untler penalry of perjury that I have read this application and state that t�e Informatlon given is correcc I agree to compy with all stete laws end city ordinances releting to building construction, antl authonze representatives ol t�e Ciry ol Coste Mesa to enter upon the ebove-descnbed properry tor inspection purposes. I egree not to acupy or ellow occupency of eny buildinq authonzed by this permil until fnel inspection. CQ�E t. INSVECTION TYYE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rool 201 Final BlocklRetalning Wall 202 Final Factory Fira Placa 203 Finel Sign 204 Final Demolition Q�jf, INTRIALS CODE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Pinel Electrical 212 Final Fire Prevention 220 final Planning Approval 222 FinalSite 250 Final Builtling/Occupancy PdIE INTITIALS P� � 75 v i �� o�5c C�reck- �r . �L r (714) 754-5273 • F� (774) 754-4856 • www.ci.cosla-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No viciniry: Parcel Number. Applicant: Address: Ownec Address: Contrector Address: 875 VILLAGE CREEK 93506054 STEVEN SCHNIERER 2057 MANDARIN DR COSTA MESA, CA PHILLIP, ELIZABETH J °hDANDAN, MOUNIRA R COSTA MESA, CA 875 VILLAGE CREEK MECHANICAL PERMIT Status: ISSUED Applied: 06/02/2004 Issued: 06/02/2004 ISSUED BY: Phone: 714-719-1689 Zip: 92626 ��Y Phone: � � .1. Y z�P: g'i"£ 0 WEST COAST HEATING AND A/C 8 FALLBROOK IRVINE, CA Phone: 949-552-5612 Zip: 92604 "3 3 Z � License: 814477 SCOPE OF PERMIT REPLACE FURNACE WITH 75,000 BTU, INSTALL NEW A/C UNIT IN REAR OF PROPERTY. , - .ISSUE FEE Inst FAU <700 k BTU Insl FAU >100 k BTU < Repair/Alt Cooling/Heat Inst / Rep. Recess W211 Htr Refrig Sys <100 k BTU Refng Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers c 10000cfm AirHandlers> t0000cfm Floor Furnace Floor or Suspend Healer $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair! Alt Refrigeration Unit " - Ventillation System Evaporative Cooler Commercia l I n cinerator Domestic Incinerator Compressors / Absorption Systems . Upto3hp/100kBTU , � � 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp I 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upta3hp 3To15hp 15to30hp 30 to 50 hp � � Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee � , ReinsOection Fee TOTAL CALCULATED FEES Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $14.70 1 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 $0.00 $0.00 $53.00 � NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inepeetione and tinal approval must ba obtained. Feilure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaawa �eroo� WORKERS' COMPENSATION DECLARATION: I hereby ettirtn under penelty of perjury one of the following tleclarations: ❑ I heve antl will meintain a ceniticete oi consent to selt-Insure Por warkers' compensation, es provitletl tor by section 3700 of the Lebor Code, tor lhe peAortnancs oi Ihe work tor which t�is pertnit is issued. ��4 �ave end will maintaln workers' compensation insurance, as raquiretl by section 3700 ot Ihe Lehor Code, for Ne pertortnance of �he work for which Nis pertnit Is issued. My wo compensa n Insurance wrner end pollcy numbar ere: �s M Carn'er: 1�0.�e �V `(�� j'Pollcy NumDer. �%� �/SZ^ Z W 3 (This3ecHon need not be completed i/ the permit is ve/ued et one huntlre0 tlallers ($100) ar /ess.) �-J ❑ I certily that in the peAortnance oi Ihe work for whiCh thi5 permil is iuued, I shall not employ eny person in any manner so es Io 6ecoma subjecl to lhe workers' wmDensation laws oi�lifomla, enC egree that tl I should become sub�ect to the workers' compensation provisions oi Secilon 3700 of the Lebor Coda, I shall forthwith T/qUSAND - rDete =��- XJMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED TO THE C0.ST OF COMPENSNTION, OMV GES AS PROVIDED FOR IN SECTION 3]O60F THE IABOR CO�E, INTEREST, AND AiTORNEI^5 FEES. LICENSED CONTRACTORS DECLARATION: of Chapter 9(commencing with SecNon 7000) of Division 3 ot t�e Business e�tl Pr�lessions Code, end my license is in full torce and eMect. Lic. x Contractofs Signature: CONSTRUCTION LENDING AGENCY: ❑ I �ere6y ettirm that there is a construction lentling egency for ihe peAormance oi Ihe work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lander's Neme: Lendar's Address: Signeture: Dale: OWNER•BUILDER DECLARATIONS: I hereby ettirtn that unCer penalry of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness end Professions Code: Any ciry or counry which requires e permit to construct, alter, imprave, tlemolish, or repair eny slructure, prior to its issuance, elso requires the applicant lor such permit b file e signed stetement ihat he or she is Ilcansetl pursuent to Ihe provlslons of �he Contracrors License Law (Chapter 9(commencing with Section 7000) oi Divlsion 3 of Ihe Business end Professions Code) or that he or she is a:empt therefrom entl the basis lor the alleged exemption. Any violetion of Section 7031.5 by eny epplicant for e permit sub)ects the epplicant lo a civil penalry ot not more than live hundred dollars ($500)J: ❑ I, es owner oi the pmperty, or my employees with wages as t�eir sole compensatlon, WILL DO THE WORK, end the s[rucWre is not intentletl or oHeretl tor sele (Sec. 7044, Business and Profeuions Code: The Contractors License Lew does not apply to an owner of property who builds or improves Iheraon, end who does such work himseli or hereeN or ihrough his or her own employees, provided ihat such imprwements are no� Intended or ottered for sale. II, however, 1he building or improvement is soltl wit�in one year of completion, ihe owner-6uilder will have the burden of proving ihat he or she tlid not build or improve lor purpose of sale.). ' ❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Protessions Code: The contrecrors License Lew doe5 not epply to en owner ot pmperty who bulids or Improves thereon, and who con(rect5 br such pro�eci wlih a cantractor(s) licensa pursuant to the Coniractore License Laws.). ❑ I am exempt under sec. Business antl Protessions Code for Ihis reason: Signature: Date: Owner ID verifietl by tlrivefs license. ❑ Yes ❑ No Driver's License No. Verification of Ownerehip by (rype of document, i.e. - pmperry tax DIII or deed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certify �hat no ezcavation five (5) or more fee� in depth inm which a person Is required to descend, will be made in connection with work euthotlzed by Ihis permit, and that no building sWdure, stallolding, falsework, or demolition or dismentlinq thereof, will be more than thirry-six (3fi) feet hiqh. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Califomia Atlministretive Code). ❑ As owner-buiidar, I will not empioy enyone to tlo work which would require a permit from the Division of Intlustrial Satery, as noted ebove, unless such person hes e permit to do such work from the division. SignaNre: Date: Division ot Industnal Sefery Pertnit Numbar: CERTIFlCATE OF COMPLIANCE ANU AlITT10RPA710N OF ENTRV: I cenify under penelty ot perjury t�at I have read this application and state Ihet the intortnation given is correct. I egree to comply with all state laws and ciry ordinences relating to building construc�ion, antl euthorize representatives oi tha Ciry of Costa Mesa to enter upon the ebove-described propeAy for inspection purposes. I agree no� to occupy or ellow occupancy of any building authonzed by ihis pertnit until finel inspection. [�rr�r,Ei��arz.r.� 1616 1266 200 201 202 203 204 Fixed System Final Fire Pravention Pool Spa Final Finel Ra-fioof FIne181ocWRataining Wall Finel Factory Fire Place Finel Sign Finel Demolition PajE � � INTRI�LS CO�E I INSPEC710N TYPE 2os Finai Mechanicei 208 Final Plumbing 210 Final Electncal 272 Flnal Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Building/Occupancy P� 1t�9Li � PflOJECTR00flE5S: 8'�S VZLLAGE CREEK owNeesname: VILLAGE CREEK HOMEOWNERS aooRess: ASSOCIATION 3429 TIMHER LAKE CM VA 92626 UNIT: AFCNIENGINEEH: CHESTER CARVILI,E REG.NO.: CS$�OS aoosess: 79z2 p.RMOUR ST PEHMITTEE: S. D, CI� 9 Z 1 1 1 aooness: PHOENIX ENTERPRISES INC, ( 21 3) 690-9559 411 CON.ERCIAL WAY LA HABRA CA 90631 UCENSED CONTflACTOB OECIANATION: I hereEy allirm tha� I am licen5e der pr sions oi ChaD�e� 91c mencing wrth Sec�ion 7000� of Diuision 9 at�he Business and Pmfessions Cotle, antl my lice i n lull ce an Ifecl. ciTvuc.: 5078 s/TyjT�/j�c 376639 Date: —�"�./— SignaWre: — _ . _ '��/^�;%� NOPNENS' CO�fEN5ATI0N OECLAHATION: I hereby allirm ��at I have a cerli�icate ot consent Io SelFinsure or a ceNii le ol Workers' Lompen5alion Insurance, or a certiliea cooY �hereol (Sectian �800. Lab. CI. POLICYNO.:W%003S4 EXP.OATE: O% SI S COMPFNY: CA COMP �IRE }� Cenilietl coOY is hereby lumis�etl CenilieJ copy is liled wi e. Buil �i 'sion. � �a�e: — _�� Applicant: EXEMPTI N FBOM WOBKEPS' COMPENSATI N UECUBATION: (ihis seclian neetl no� be complete0 i� IAe permil it for one h red (4100) or lest�. I ceNty Ihat in Ihe petlormance of Ihe work for w�ich this Dermrt is issuetl. I shall no� employ any De�son in any manner so as �o become sublecl lo Ihe Workers' Compen5aiion Laws ol Calilomia. Date: Signamre: NOTICE: II, afier making Inis tleclaration. you shoWA Oecome subject �o I�e Workers' Compensation pmvisions o� the La�ar CoOe. }rou must larthvnt� mmply wi�h such pmvisions o� t�is permit shall Ge Eeemea revakea. CONSTqUCTION LENOING BGENCY: I here�y allirm ihal ihere is a conslruciion lentling agenry lor ��e pedormance a� the work �or w�ich Ihis permit is issue0 �Seclion 3W7. Civ. C). LENOEP: ADOHESS: OWNEB BUILOEB OECLABATION: I Aereby afiirm ttut I am exempt imm t�e Contracmrs' Stare L'uense Law lor t�e tollovnng reason (Seclion 7031.5 Business antl Professional Code: Any tiry oi coun�y which r¢quires a permi� Io constmct, alter, improve, tlemolish, or repair any 5lmcture. prior to iis issuance. also cepuires I�e applican� tar Suc� permit Io �ile a 5igneA statemen� ��a� �e/she is Iicen5e0 i Dursuant lo I�e pmvisions al ihe Comracmrs' State License Law (Chapter 9(commencing with Section 7000) ol0ivision 3 0� the Business I ana Pmfessions CoOe) or �hat he/ihe is exemp� �herelmm antl ��e basi5lor Ihe allege0 exemption. My vialalion ol Sec�ion 7031.5 by any aDPlitan� lOt a permii SUbl��s �he applicani lo a[ivil penalry of nol mOre Ihan five huntlre0 U011ars (5500). I. as owner of Il�e pmpeny ar my employees vntA wages as iheir sole compensation, wiil tlo the work, antl tne � 0 51mcWre is no� intenGeC or allered for sal¢ (S¢Cuon 70aa. Buvness ana Professional Cotle: T�e Contractors' State License Law Uoes not apDly to an owner ol a D�openy who buil�s or imprwes tller¢on, and wha daes such xrotk himselV�ersell or t�roug� nis or ner own employees. D�a��Oed t�al such im0�ovements are not intended ar ollered lar sale. If, however ihe building or impmvemenl is sold within one year of camolelion, ihe owner will have ine OurJen of D�a'/�ng IIe/she Oitl nol build or improve for ihe purpose o� sale). I, as awner of Ihe pmperty, am exclusively contracting vrith licensea coniractors to consimcl the pmiect (Sectbn 7044, Business ❑ an0 Pmlessuns CoOe: The Comractors' State License �aw aoes noi aDPN �o an mmer oi DmpeM �o bWtls or imryoves Nereon ana w�a coniracls far suc� pmjecis vnth a contracbr�s) license pursuant to the Canlractor5' State License Law�. I am awdre IAaI D�ool ol Iheir Worker'S Campensa�ion insurance shaNa Ge pmhdetl �o me. � I am edempt untler Section: B. 8 P. C. lor t�i5 reason: Daie: Owner. I Go �ereby cenity ��at I am aware ol anG un4ersiana I�e repuiremenis ai Cahbmia Heai�� antl Sale�y Cotle Sectqn5 25505, 25533, anG 25534 and ihal I or any fulure DuilOing ocapant wilVwill not (circle ane) nee0 to compty vntA 5aitl state codes anU Ihe requirements lor a permil lo� consimction or motlilicaiion Imm Ihe Air Ouali�y Managemenl OistricL Fesiaential conslmciion apDlicaiions are exempi imm I�ese O�ovisions. Date: Applicam: I hereGy [¢Nly I�a� I �ave rea01�i5 ap0litatiUn and 51aie Ihai I�e abOv¢ inio� a�i is rect. I agree to �� mpy wi�� all ciry antl county � ordinance5anE5�atelavrsrelatingtobuilQingconslmctionan4�ere0yaultp/ :re esen' .rves^Iihisci � er_rupon��eaDove-ment� � O�opertylor nspetu� r'DurpO:,(�� '\// /Y oa�e ��,�� SignaWre:_ _ — Otiv¢[S Litense Or Social Secunry d: ��"'----�^KJtraiCP.iO Fevenue; Golaenratl—Assessor �� _ � CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05054 PERMIT NO; B 050546 PLAN CHECK NO: 00146-91 A GOVT: N SUPP: N CONSTRUCTTON TYFE; V—N PERMIT TYFE: STR PURPOSE: REI' SOB DESCRIPTION ; REPAIR SETTLEMENT DAMAGE SQ FT; 143 CLAIM VALUE: 19,300.00 CALC—VALUE: 14,300.00 GROUP OCC: R-3 / COMMENTS: HUILDING SETTLEMENT REPAIR/FOUNDATION ***��*x*;�**�r��**x*�r�*�**�x�*�r****�r+rx�t***��r��t*�t**�x��***u*x�*��+�*+�****� x*�e�*��t+r�* Z O N I N GS ERTEBQ�UCIKRSE N E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT ZN LEFT: FT IN RGHT; FT IN 'PARKING REQ• PROV: PARCEL; 93506124 ZNE; R2 REF NO: PLANNING NZ7TE5> FOUNDATION REPAIR. i **�x��****�**��*�***xxu**�r**�*��**x�x*�*��**+�***�**x��***��****+�****+��*****x D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APFROVED BY ��.p � �� DATE: 0) 1 S� 1 HUILDING APPROVED BY : �-✓1 L i7 ite�� DATE; �F iE 1E 3f if 9FiF 3f iF �f if iP ik jF if i!� iE 3t iE IE iFlF 3E iF 16 i(� jf % 14 iE *�7F i2- iF �k LEGALIZATION;N F E E S BLDG PMT PLUMBING ELEC IC PERMIT 162.00 � DATE• � �Fit�F�— if7f-7FiF3F'ie7F7F��f1EiElEiEiEiFitM�f�{FiF1fiE iF if iF iF if i(� it IE iE K iF if if it IE lf # iF if 3F iE if IE iE�IE iE if iE IE iE 1E iE 3f iE ih If iE * M M A R Y STRUCTURAL SEGMENT;Y MECHANIC FIRE SMIP/RES GRADING 1,00 PLAN 26.33 . SMIP/NON—RES ISSUE FEE BUILDZNG—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE TOTALS----> 163.00 0.00 26.33 189.33 189.33 ,00 REVaNUE DIVISION TOTALS--> COLLECTED: 189,33 OVER/SHURT; ,00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SN,IP/TOT GRADING PLAN—CHECK 162.00 1.00 26.33 �E iE if jE iE �f if if 1E If jF �E �F iE !F if if aE iF 3F iE �lE �E iF 1F if iE if if iF 3f IE3f if IE It i6 iE iF iFjElE 1Pif 3F iE 3E if fE iF If 3f �lE �E IF IF �F 3f iF iF 3F iE if ff iE IE iE 3f IF 3E if ik lF if iP iF if if �F I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R Z P T I O N UNZT COST TOTAL COST SFR 143 STRUCTURAL BY VALUE PER 5100.00 100,00 19,300,00 END OF FEES 01 aRD7E697-0007E699 To,"; 1f+9:?s oaT€: �l/s3/91 rirE: i,::4 CONSTRUCTION AND PLANNING POOL & SPA I APPROVALS Permit # Date Inspector AppRO�/ALS Permit # Date Inspector . i 1. Temporary Electriwl Service or Pole . ; 52. Pool & Equipment Location '� R 2. Soil Pipe-Undrgrnd. '� �� 53. Steel Reinforcement �. -� 3. Electrical Conduit Utility-Undrgrnd. � �� 54. Forms 4: Electriwl Conduit-Undrgrnd.r- 55. Electrical Bonding �' 5. Steel Reinforcement � ' �%- 56. Rough Plumbing & Pressure Test .6. �Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings � � 58. Electrical Conduit-Undrgrnd. 8. Foundation . . �,. 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrrid. �'�,- �%i 60. Backwash Lines, P-Trap, O Undrgrnd. ,� 10. Structural Floor System �� '�i;�r 67. APPROVAL TO DECK !;� i t. Property Sewer Line & I�- ouse Connection �„_ 62. Backwash & ReceptorFinal `� 12. Sewer Cap . ' � /7 63. Heater & Vent-Final � .'� ^ 13. Roof Drains � ' '�^ 64. Plumbing System � Final ;!� � 14. Rough Plumbing ��` �� ,� 65. Electrical-Final � r-�4� 15. Rough Electrical-Cond�t 'J^ ,; ��j; 66. Solar System-Final ��' 76. Rough Electric Wiring � C � �; '' 67. Fencing & Access Approval ' ;�. . 17. Rough Wiring Sign �' ,� �• 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT 20. Rou9h Factory Fireplace - APPROVALS Permit # 21. Ducts, in Struct�re . -. 70. Under9ro�nd Hydro 22. Ducts, Ventilating _ ' 71. Product Pipirig OGas ❑Oil 23. Gas Pipe-Rough & Test . , 72. Underground Flush' 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing . . �4, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monowat � 75. -0ry Chemical 27. Frame and Flashing , 76. Dry Standpipe 28. Lathing & Siding � � i i �. 77. FIXED $YSTEM FINAL 29. Insulation � � � I 78. FIRE PREV. FINAL i I 30. Drywall Nailing � �. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � 79. FINAL INSPECTION �32. Elecirical Power Meter�Final � � �. 80. FOOD CERTIFICATE ISSUED �� 33. Final Electric' I � I Notes: � , 34. Final�Heatinq & Air Conditioning � j �. i 35. Final Gas�Pipe-Test � '� �; _ z I i I � 36. Hood or Canopy - �• - 37.�FinaPFactory Fireplace . � I � �, i 38. Final Plumbing � � I � .. I 39. Water Service-Final � � i � i �40. Gas Service-Final ( � . � � 41. Solar pomestic-Final � � � I 42. Backflow Preventer i �, . 43. Backflow Irrigation - - ' 44. Landscape Irrigation SYstem � _ 45. Sound Attenuation � - 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILOING Z��-q'� 48. PINAL PLANNING. � � � 49. �Electric Release to Edison � I I • 50. Gas Release to Southern California Gas Co � � j� - . 51. CERTIFICATE OF OCCUPANCY , . , , No. Date COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant ro Fill in Completely BUIIDING..�� ...�� ,. . OWNER State-Wide Developers, Inc. MAII 9461 Grindla ADDRESS y CITV Cypress NQ�ZE CONSTRUCTION BRANCH ADORESS � OHFOIG1p166FL �,phrharh�Pi�lacki No�556-fifil ADDRESS »$48 SkyPark Blvd Irvine CONTRACTORSLaLe�W�dE DeVe�OPei�S� Inc. ADOFE55 9461 Grindlay TEL. c�T� �press No• 826-455 LIC.NO. 224J�O LICVNO. 01F LOT 12, 093 dCT'ES NOW ON LO 0 VSE OF EXISTING BLOG. SIZE OF NO. OF WALL �ia�zerIROOF OO COVERI JII,DING AND WORK TO BE ums 1 Residence w/att gar I heraby acknowletlpe ffiat I have reetl this appliceNon antl smm that the ebovo Information Is eorrect and aprae to eomply with oll laws reBulaLnp builtlinp eon4Vuction, entl I�hnll nOi amploy nny perzon io vlolallon ot Me workman's compenvHon lawi ot t�e State of Celifornla. I I+areby canify Met I am properly Iicensetl as e contracror untler Me State of Collfornia Business entl Professlonf Cotle, D��Isicn 3, Chapter 9, and thet such Iicenses era In full force entl af}ect, or I 0m azemp[ irom [he provlsione of t�e $[ete of Cali rnie Businecs antl Proiessi C tla, yi on Cho er 9. �'�a$�__ e-�Ji��peqs nc. — s�ene:�,e oi�%"^ ,Q Permlttea AuthorizeOApont llira DMPl1lIPpf �av t�s-76�;�-0D 62 23�1.%3 I n-• �,: � APPLICATION FOR BUILDING PERMIT '�EIVEDBV DATEFECEIVED nntc�ceiu BUILDING �j,s j�I� ADDRESS p � TRACT �SB 4 1Res FIRE 20NE APPROVED VALU«�Q � ZONE NO.OF USE OF NEW K Z C�� P�� Z BVILDING G VARDSAPPROVED VARDSAF MAIN BUILDING ACCESSOfl' (FROM C/L STREET) DSTANCEBET MAIN BLDGS. VAR. �` C.U.P.�WZ� APPROVED /, BEf. MAIN �� 0 1480 Sp.FT. J•645 ; THE AMOUNTSHOWN UNDER VALUATION IS FOR a hIE PURPOSE OF ESTABLISNING A PEFMIT FEE ON�V: Q VALVATION r. �,w � 7A �'/a � PERMIT FEE $ / �'C/ j �� z r� y 50 m 5�y �fj PIAN CNECK $ �� E `o u TOTAL FEE $ I