HomeMy WebLinkAbout855 MAGELLAN ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FA1R DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job nddress: 855 MAGELLAN ST
Suite:
Viciniry:
Parcel Number: 14132211
Applicant: COLLAZO, FERNANDO
Address: 2220 E ORANGEWOOD
ANAHEIM, CA
Owner. SMITH, KENNETH R TR
Address 1121 SALVADOR
COSTA MESA, CA
Contractor; WIN-DOR INC
Address; 2220 E ORANGEWOOD
ANAHEIM,CA
Zip; 92806
Arch :
Address:
Zoning: R1 R1
Phone: 714-385-1202
Zip: 92806
Phone:
Zip: 92626
Phone: 714-3851202
License: 545553
Eng:
Address:
Status: ISSUED
Applied: 08/102004
Issued: OB/10/2004
ISSUED BY: _____ e_����
� Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
CHANGE OUT g WINDOWS AND 1 PATIO SLIDER THROUGHOUT S.F.D. TO MEET 1997 U.B.C. EGRESS REQUIREMENTS. HEADERS ARE TO
REMAIN THE SAME.
Plan Check; $0.00
Permit; $111.25
SMIP Res; $0.50
SMIP Com; $0.00
Other; $0.00
Inspection; $0.00
Total; $111.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existlnq: o
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING 8 ZONING
Left . 0- 0
Left 0- 0
Proposed: 0
Calc Vafuation:
Claim Valuation
Right 0- 0
Right 0-;0 " �
sa,soo.00
sa,soo.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No, 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or it work is suspended or abandoned
tor a period ot 1 BO days.
INSPECTIONS: In order for the work authorized under ihis permit to be consideretl legal, such work must compy with all applicable codes, and all
required inepectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration o( this permit.
FOR INSPECTIONS CALL: (714) 7545626
�aau�ae �tiw�
WORKERS'COMPENSAnON DECLAHAnON:
I hereby ettirm under Oenalry of perjury ona of the tollowing declarations: .
❑ I heve and witl maintein a certificate of consent to self-Insure for workers' compensetion, es providetl tor by sectlon 3700 0l the Lebor Cotle, tor the pertormance of the
work for whlch this permit Is issued.
�'I have and will meintain workers' compensaLon insurance, es required by secUon 3700 oi the lahor Code, for Ne peAormance oi Ne work for which this pertnit is issuetl.
My wor/k�p/r�/ mpensatio Insure e cerrie ntl policy number are:
Cartier:% A, r�H%� �� S� ��7i ✓( �5 Pdicy Number: ` D�S ���v S��
(71ds sectlon need not be cromplefed i! (he permit is va/uetl at one hundred dollers (S 100) or /essJ
❑ I ceniry t�at in the peAormence ot Ne work for which this pertnit is Issue4 I shall not employ eny person In any manner so as to become suD�ect ta Ihe workers'
compensetion lews of Calitornia that if I should become sub�ect to the workers' compensatlon proNsions oi Sec lon 3700 ot t�e Lebor Cotle, I shall forthwith
comply with these provisio ! . ��iD/�
ApplicentSigneWre: ` _ lDete.^. C
WARNINO:-PPIWRETOS �5'COMPENSATIONCAVERAOEISUNUWFl/LANDSNALLSUflIECTANEMPLOVERTOCRIMINALPE TIESANDCNILFlNESUPTOONEHUNDRED
YFIOUSANDDOLURE� ADDITIONTOTHECQSTOFCOMPENSATIdJ,DAMAGESASPROVIDEDFORINSECTION3](IBOFTHELABORCO�E,IMEREST,ANDATTOFNEY'SFEES.
LICENSED CONTRAC70RS DECLARATION:
and
CONSTRUCTION LENDING/
� I here�y eHirtn that there
Lenders Neme;
Signetura:
OWNER-BUILDER DECLARATIONS:
9(commencing with Section 7000) ol
ofessions Cotla, antl my license is in full
G Gc7
lending agency for t�e pertormance ot Ue work for which t�is permit is issued. (Sec. 3097, Civil Code).
Lendets Address:
Dete:
1 hereby eKrm t�at untler penalry ot per�ury thet I em E7(EMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe lollowing reason (Sec. 7031.5, Business entl Professlons
Cotle: Any ciry or counry which requires e pertnit to construct, eltar, Impmve, tlemolish, or repair eny sirucWre, pdor to its issuance, elso redulres the aDPlicant tor suc� pertnit
to lile a signed statement ihat he or she Is Ilcensed pursuani to ihe proNsions ol the Coniradors LJcense Lew (Chepter 9(commendng with SecUon 7000) ot Division 3 01 [he
Business and Pmfessions Code) or ihet he or she Is exempt tharefrom and the besis for the ellegatl exemption. Any violetion o1 Section 7031.5 by eny epPlicant for a pertnit
suD�ects the epplicant to a clvil penalry ol not more than tive hundred dollers (5500).):
❑ I, es owner of the propeny, or my employees with weges es Ihel� sole compensa�lon, WILL DO THE WORK, end tha structure is not intended or oMered for sale (Sec.
7044, Business end Professions Code: The Contractors License Law does not apply to an owner o1 property who builds or improves Ihereon, and who does such work
himself or herself or ihrough his or her own employees, provided ihat such improvements are not Intended or oNered br sele. II, however, ihe building or improvement is
sold wilhin one year of completion, ihe owner�builder will heve the burden of proving that he or she did nol6uild or improve for purpose ol sale.). '
❑ I, es owner ot the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to Construct the project (Sec. 7044, Buslne5s end Profe55ions
Cotle: The contrectors Licensa Lew does not epply to an owner of propeny who bullds or Improves ihereon, antl who coniracts tor such prolect with e contractor(s)
license pursuant to the Contradors License Lews.).
❑ I em exempt under sec. Businass end Prolessions Code for this reeson:
Signeiure: Date:
Owner ID verilietl by drivers license. ❑ Ves ❑ No Orivef5 Licen50 No. Expires:
Vadflcation ol Ownership by (type oi tlaument, i.e. � property tez bill or deedJ:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no excavetion five (5) or more teet in depth imo which e person is requireG to descend, will be made in connection with work authonzed by this
permit, and that no building strudure, scattolding, falsework, or demolition or dismentling thereof, will be more ihen ihlrty-six (36) taet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomle Adminls�retive Catle).
❑ As owner-builder, 1 will not employ anyone to tlo work which would require e pertnit from the Division ol Industnal Safery, as noted ebove, unless such person hes a
permii Io do such wark trom tha division.
SignaNra: Date:
Divislon ol InOustrial Satery Pertnit Number:
CERTIFlCA7E OP COMPLIANCE AND AU7HORIZA710N OF ENfTiV: I cetlily under penalty ot perjury Ihat I have read this application and state thet the infortnation given is
correcL I agree to comply with ell state laws en0 ciry ordinances relating to bullding constmction, end euthodze reprasentatives of the qty of Costa Mesa to enter upon the
ebove-tlescnbed property tor inspection purposes. I egree not to occupy or allow occupancy ol any building euthonzod by t�is permit until finel ins0ection.
COOE t. �pE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Finel Re-Roaf
207 Final Block/Reteining Wall
202
203
204
Final Faaory Fire Place
Final Sign
Final �emolition
ui:
COOE I INSPECTION TYPE
206 Final Mec�anical
208 Finel Plumbing
210 Final Eleciricel
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building�Occupency
I I\1�1:11111dF7
,;FNff�CTA'�PE55: SSS MAGELLRN ST uNir: CITY OF COSTA MESA — HUILDING PERMIT P O:
� OWNEP',NpME: SMITH, KENNETH R TR
i aoopess: 1121 SALVADOR PERMIT NO: B 068670 PLAN CHECK NO: N
COSTA MESA,CA 92626 ' '
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE; ALT
714) 641-9818
AHCNIENGINEEF: FlEG.NO.:
AOOHESS: UNIT:
PEHMITTEE: WINEGARD ENTERPRISES ( 714 ) 673-2535
noonEss: ZQ33 SEVILLE
BALBOA CA 92661
LICENSEO CONTFPCTOB DECIANNTION: I hereby aifirm thai I am licensed un�er D�o�isions o� Chapter 9(commencinp wi�� $ection ,
1000) ot Divi o t g/�siness antl Pmie i 5 Cp7Qe a 0 my license is in �ull lorce an0 eflecL '�,
cirv,uc.: ��� TATELIC.:��9"A� ���. C39 EXP; 06/95
� : �`'� Signa�ur '
0 PENSPTION OECIAflATION: I hereby alfirm al have a cetlificate ol consenl to selFinsure or a certilicate ol Workers'
Compens ion su���$aFg�IiheQ�r�py �hereo� (Secii 38� Lab. �.4 � O 1/ 9 S
raucrxo.: STATE FUND TE:
COMPAN7: �(
�] S{p,�tifietl copy is hereby �umished. L.� Ceni�ied coOY is liletl with the city BuilOing Division.
,jJ4F1�T10N BO WONIEPS'COMPENSA710NOELLAPA710N: ( issetianneednotbecampletetlilthepermitisforonehunOreO(510�)orless�.
1 cetldy iha� �etlormance oi ��e work �or which t�is per rt is i ued. I s�all not employ any person in any manner so as ta became
su0lec� to tAe Warkers' Compensation Laws ol Cab�ornia.
Dale: Sigwmre:
NOTICE: I�, alter making Ihis tleclara�ion, you shoultl become suble�� �o the Workers' Compensation pmvisions o� IAe Labor
Code. you musi larthwi�h comply with such pmvisions or this permit s�all be OeemeO revoketl.
CONSTBOCiION LENOING AGENCY: I hereby af6rm tha� there is a cons�mction lending agency for ihe petlormance ot Ihe work tor
whic� t�is permi� iSlssuea (Section 3097. Civ. C�.
LENOEfl:
FODHESS:
OWNEfl BUILUEN UECLAPATION: I hereby afiirm that I am exemD� �rom Ihe Contracmrs' State License Law far Ihe followinA �eason
�Seclion 7�31.5 Business an� Protessiana� Code: Any ci�y ol counry whic� requires a DQ�mii �o consimct, alier, impmve, tlemolish, or
repair any s�ruclure. prior to its issuance. also requires Ihe aOP�ican� for such permi� �o file a 5igneU statemenl that he/she is licensed
pursuam lo �he pmvisions oi ihe Comracmrs' Sta�e License Law (Chaprer 9(commencinq wi�� Section 7000� oi Division 3 al Ihe Business
� and Pmiessions Coae) or �hal he/s�e is exemp� Iheretrom and Ihe �asis �ar �he alleBea exemp�ion. Nny viola�ion o� Sec�ion 7031.5 �y
� any applicanl �or a Dermi� sublects �he apDlicani �o a civil penalry o� not more Ihan live hundred dollars (5500).
I, as owner ol ihe pmpeny ar my employees with wages as ineir sole compensation, will tlo ine work, antl the
❑ slmcWre is not inlentletl or o��ereA for sale (Seclion 7094, Business anU Pmfessional Cotle: The ConVactors' State License Law
tloes noi apply �a an owner ot a pmperty who Uuilds orimpmves thefeon. and who Ooes such work AimSelVherself or�hrough
Ais or her mvn employees. pwvitletl ��at such improvements are not inientle0 or ollered /or sale. tl, hawever �he building or
improvement is soltl wiihin one year o� compleiion, Ihe owner will have the 6urAen of proving �e/she Ditl nol builA or improue
lor �he purpose ol sale).
I, as owner of �he pmpeny, am exclusively coniracting wi�h Iicense0 con�rac�ars to constmct �he prolec� (Secfion 7044, Business
❑ anA Pmfessions Code: TAe Con[raclors' SIaIe license law aoes noi aDON �o an owner of pmpeM who Uuilas or improves �hereon
and who conUacis for such pmlects wi�h a conlracbqs)license pursuan��o Ihe ConVactors' ��ate License Law�. I am aware
��ai pmol af their WoBer's Compensalion insurance S�aWE be pmvi0ed [o me-
U I am exemD� untler Sec�ian�. B. 8 P. C.
lor inis reason.
oaie� Ownec
I do �ere�y certiiy iha� I am aware ol an0 unders�and Me repuiremenis oi Calitarnia Health anA Safery CoOe Setlions 255Q5, 25533, and
25534 and Ihai I or any INure �widing occupanl willlwill noi (circle one) need to comply wiN saitl state codes antl �he requirements tor a
Dermi� lor con5imction ar modilicalion imm the Air Oualiry Management �istrict. Fesitleniial constmc�ion aDD�ica�ions are exemp� fmm
Ihese Orovision5.
�ace: ADDlicam:
I �ereby certilythat I have reatll�is apPlicalion antl stale tha��he above inlorma�ion is correci. tagree b comply wilh all ci�y anA pounty
oramances antl sta�elawsrelatingto �uiltling con5imc�ion and hereby aulhorizerepresen�aiives of�his ciryio enteruponthe abave�men�ioned
�prafperiy lar inspectian pwposes.
ya,e� �` Signamre: `�
�
�riveiS �icense or Social Seariiy A:
t6aba6 White—Builaing: Green—Coae Enb¢emem, Canary— O�licant; Plnk—Revenu , nrotl—Assessor _.
JOB DESCRIPTION ; T/OFF RESHTH & REROOF W/COMP. SHINGLES SQ FT: 4,200
CLAIM VALUE; 4,200,00 CALC—VALUE; 4,200,00 GAOUP OCC; R-3 /M-1
COMMENTS; SMOKE DETECTORS REQUIRED , I,C.H2O 4660
*�*�u*�r+r���*+��+r�r*�x�*x�*rt*�****�**+r*�r*+��r�*�+�+�*�*��**��********�r�r**�*�*x*��r*�*;��*
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY 6UILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN AGAT; FT IN
PARKING REQ • PROV; PARCEL; 14132211 ZNE; REF NO:
PLANNING NbTES>
,� .
iE 1F if iF if iE fE iE 1E fElt 1! 1! ft ftlE if IE fE if iE if it if ik iE iE it 1F ff !k!f iF if iP i! iE fE df it iF iE 1f !E!E if 1! if !h ik 1E 1E iF fE iE if 1E 1E i! 1! 1E iE iE!! 1f !f !F fE iF iElE iE 1! 3E iE iE iF iE it
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 APPROVED BY DATE;
BUILDING APPAOVED BY ; DATE:
APPLICATION ISSUED BY; QQ1
f��rir�r�r*�r*iri�irx�irx�x�**u�ir**�t�r��t����i�3FiFlF'��3F�r��F�r3Fir�iF4±F3F��rx�fr+rDiAr**�rx �� �r*�
iEiElEififlEffiEiElEitifititiFiEitiElEk1E1E�lkifiEititiFitiEifiEiEiEiEiEititiEiE%iFiEiEiPitlEltifiEiEiFiEfE9EitiEititlFiEiEitifitiEiEiEki1 iFiEitiFiEitit
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC ,MECHANIC FIRE SMZP/RES GRADING
PERMIT 7z.00 , SMOKE D�TE� 50
�y-,�MIP /NON—RES
PLAN � «
ISSUE FEE REV(Vl��y
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK PAID DUE
TOTALS----> 72,50 0,00 � 0,00 72,50— 72.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 72,50� OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
�2.�� � ' .5�
k fF iF iE iF it t! iE iF if 1t i! 4 iE k iE itlE iE k 1E if iE if iE 1E #k i! fE iE fElE iE k if 1E�1k it if'iE if iE it aE iF ft iE it iF i! iE k It if it if 1E it iE it �E iE iF fI� if 1f i! 1E iE iE 1! iE i! iE if iflE it it
I N D I V I D 0 A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O,N '. UNIT COST TOTAL COST
SFR 4200 REROOF BY VALUE RESIDENTIAL, NOZONE 1,00 4,200,00
END OF FEES
fl2 QOid6841-OD166842 T�� T 72,50
�A7E: GSl29/94 iF�IE: 14:`b
� ! ..:.ONSTRUCTION AND PLANNING POO. oPA
. ,APPROVAIS Permit #- Daie lospecior qppROVAIS Permit ?k Date Inspectar
a
Li. Temporary Electrical Service w Poie ' � 52. Pooi & Equipment Location
2. Soil Pipe�Und�grnd. 53, Steel Relnforceme,nt
3. Electrical Cor�duit Utility-Undrgrnd.'� - 54. Forms
4. Elecirical Conduil-Undrgrnd. � 55. Electrical 6onding
- 5.�Steei Re�nforcemen: � 56. Rough Plumbing & Pressure Tzst
6. Electrical UFfiR Gmd. 57. APPROVAL T6 COVER�GUNITE
. �. Footings 5$. Electrical C,onduit-Undrgmd.
8. Foundation , ' 59. Gas Pipe, [_! Undrgrnd., Tesc
9. Water Pipe-U�drgrrd. ' 60. Backwash Linea, P�Trap, O Undryrnd.
10. Structural Floor System " 67. APPROVAL TO DGCK
77. Property Sewer Line & House Conneciion 62. Backwash & Receptor�Finat
i2. Sewer Cap " 63. Heater & Vent�Final
i 3. Roof Dreins � . 64. Piumbing SYstem - Finat
24. flough Plumbing 65. Electrical�Final
15. Rough Electrica!�Conduit 66. Solar System-Final
16. Rough Electtic Wiring 67. Feneing & Aecess Approva!
17. Rough Wiring S�yn 68. APPROVED FOR P�ASTERING
78. Rough Electncal�T Bar Ceiling 69. POOI/SPA SYSTEP,15 FINAL
-}
19. Rouyh Heatin9 & Air Canditioni�g FIRE DEPT. REQUIREMENT
--: --•--- i �
20. Rough PactoYY Fireplace � �APPROVALS � Permit #�
21. Duc.s, in Stri�ctuje ..� � - 70. Undergiound Hydro
22 �uc!s, Ventila2ing . � � 77. Product Piping fl Gas O Ol
23. Gas'Pipe�Rough & Ten ' . � - � . 72. Under9round FlusYi
24. Roof Framing � � � 73.' Undergrnd.�torayeTank DGas OOiI
25, floot Shzathino X/3//�%��� 74. Overhead Hydro�
7
26. T�Bar Ceiling (Structural) &,A4onocoat � 75. Dry Chemical
27. Frame and Flashing , . _ 76. �ry Standpipe � '
28. Lathing & Siding - - 77. FIXED SYSTEA-0 fINA�
29. Insulation ' i ,. 78. FIRE PREV. FINAL
30. Drywall Nailing ' � � . HEALTH�OEPT. REQUIREMENT
31. Plaster Brow.n Coat , i � J9. FINAL IN'SPECTION '
i
32. Electrical Power MeterFinal � i � 80. FOOD CER7IFICATE ISSUED
33. �ina7 Elec:ric - � '� � Notes: 0� �! ��cf� ,�d �
34. Final Heating & Air Conditioniog � ^ _. _/ $ /3 /O /1 j� �
Grl«' ! 1�7�r �
35. F�nal Gas Pipe�Test ' ', . I :
36. Hood or CanOPY , � � ' �
K� �,� 5�.�. `I,Yj��y��
37. Finai Faciory Firepldce ' � ' ' � � R� .�_ � ' �P�
38. Final Plumbing , - ' � / �� .. �
Y �l
39. VJater Service�Finai ' ' • , X`
40. Gas Service�Final � ' "': . �
47. Solar pomest�cPinal � , .� "� -
42. Backflow Preventer ' ; � � -- � - •
43. Backflow Irrigation ' �,
44. Landscape Irrigation System �- � • � �
C5.�Sound Aitenuation �
46. Handicap Regutations �
47. FINAL STRUCTURE & BUILDING L%��'� .��
b
48. �FINAL PLANNiNG . --�--� -
49. £lectric Release to Edison � ��
50. Gas fletease to Southem Caiifornia Gas Co �'-"'',
51. CERTIFICA'fE OF OCCUPANCY _` -'
No. Date '
1
PNOJECT FODHESS: 8 S S MAGELLAN S T
OWNEN'SNAME: SMITH, KENNETH A
aoonEss: 1121 SALVADOR ST
COSTA MESA,CA 92626
545-6740
AflCN/ENGINEEH; HEG.NO.:
ROORESS:
UNIT:
UNIT:
PEXMIiiEE: �EE PLUMHZNG 6 HEATING (213)759-9101
aooness: 5457 CRENSAAW BL
LOS ANGELES CA 90043
LICENSEO CONTFACTOB DECIAflPiION: I �¢reGy aflirm I�al I am licensed unCei provisions ol Chapter 9(commenr'ng wilh Sec�ion
7000) ol Division 3 01 �OC Busineu ana Prolessions COGw an0 m� en5e �' tlCl �Ort¢ e�leCi
cirr uc.': 0 3 0 `2 0 3p STATE LIC.: Z 4 O S 8 � ss: —� �
oate: �.�7—/_� Sigwmre — � �
)PREBS' COMPENSATION OEClAM710N: I here0y atlirm �liat I bave a ceniliwte ol con5ent to sel4insure ar a cenificate al Workers'
mDensa�ion 1 a �p �j endied taoY �heBol (Seclion 38p1. LaU.
/OLICY NO.: �� � J�+� E%P. DRTE: S� O S I 9 S
comrnr+r: STATE FUNDR ///
❑ Certilietl copy is here�y fumishea. LT Cenilie0 cooY u��' • w"' �� y Buil� , rvis^ �IL� , �
/_
�+ / �
�ale: � •• � � 7� AOufiuni: �+_�(
�''� EXEMPTIONFFOMWOHIIEPS'fAMPEN5p7I0N0EClAf1AT10 . �inssenunneMrolEecompkteUillhepermnbfamehwtlreG�5100�orles5�.
I renify that in �ne petlormance oi tne vrork br wNcn ihis permit is is5ue0.1 5ha11 not empby any person in airy manner so as to betome
suble�� �o Ihe Workers' Compensa�ion LawS ol Cali�amia.
Oale: Signaiure:
NOTILE: It, aiter making ihis Eeclaration. yau s�ou10 become su0ject to t�e Warkers' Compenutqn prwisions of i�e �aUor
CoOe. yau must lanhvnt� comO�Y "^�� such prwisions or tNs Dermii shall Oe tleemeE r¢vokeG.
CONSTflUCTION LENOING RGENCY: I �ere0y allum that t�e�e i5 a fAnsimclion lendinq a9ency br ��e peAormante ol IAe work lor
w�ich Ihis permi� i5 issuM (Seciion 3097. Civ. C�.
LENDEP:
AOOflESS:
OWNEB BUILOEP OECtANATION: I here0y atlirm t�at I am exemD� ��am t�e Contractors' State License Law lor ��e I011awin0 �eason
�Section 7Q31.5 Business an0 Ptof¢SSiOnal Cotle: Any city al county whGll rGQui25 a ptmti� lo fARSINct. alter. improva, Eem0lis�, or
fPpoll dfly S�fINWfE. PdOf 10ii5155�dI1CC. d150 ICQIIIfCS IIIP d00fILdfli 10f Sllth pCfrttii IO ��IE d SIQfIEG Sldl2rtlC0i IIIdi IIPl5h0 IS IICEIISCQ
pursuanllolhe provisions ollne ConVactors'Slale License law�thapter9l�mmentin0 vn�� Section 7000�o10ivision 3 ofine Business
ana Pmfessians Coae) o� rtut �e/s�e is eKempt tnerzimm an0 tne basa lor ine aDepetl e.emotian. My vioWtian al Section 7031.5 Oy
any aDoliWnt for a permil suei��s ine aoolicanl to a civil penatty ot nOt mo2 thdn five hunEretl Oollars (5500).
�I, as owner ol ihe proDertY a� mY emWoyees witn wapes az �neir mle compensa�ion, vriu Oo the vrork, anA Iha
� s�mcwm is not intenaeA ar olhreC lor sale (Seclmn 70aa, Business anG Pmlessianal Catle: The Coniraclors' State License Law
does rwl applY �0 an owner 01 a O�OOelly wln pri165 ot improves t�¢r¢On, and who Gce5 Sutli wofk �imSelV�ersel� or �hwuph
�is or ner ovm empl0yees. pmvi0e0 Itwl sucn imprwemenis are n0t inteMeC or altereU lor sate. If, however Ihe OuilOing Or
impmvemem is sola xit�in one year al rompletion. iAe wmer v.i0 Iwve tne OurOen of O��nO ��e 4� not OuiW or improve
Ior Ine ourpose al salel.
I, as awner ol t�e O�oVeny. am exclusively cwirac6np wit� Iicense0 camracmrs �o canslmc� tAe D�ojecl (Section 70aa, Business
❑ and Pmlessrons CaGe: T�e Contacmrs Slaie L'amu law Eoes no1 appry ta an owner o� properry who WilOs or impmves Ihereon
ana wha comraqs loi such orqecis wi�n a coniracmqs) license pursuant to ine Coniracmr5' State L¢ense Law�. I am aware
t�at D�ool ol iheir WOrk¢r'S CompCnWiqn in5urance shoultl Oe proviGed 10 m0.
� I am eeempl undEr Settion: B. 8 P. C.
tori�5 rea50n:
Dale: Q«ner.
I ao nere�y cenily Inal l am aware oi ane unaersland ine reQuiremen6 0l Califorma Healih an0 Satery Cqae Sections 25505. 25533, anA
2553d anA IAaI I or any lulme Euibing occupant vrilVwiO noi (GrUe ane) nee0 t0 Comply vnth 5ai0 S�ate w0e5 antl Ilie repuir¢men15 b� a
permil for conslmtlion ar moGiiica�ion imm Ihe Air Ouatily Manaq¢ment OiSlrict. fle5ideniial con5imclion applicaiions are e�empt �mm
inese pmtisions.
Oa�e: Np0licanl
I �¢reEy ce�idythatl have reaa I�is application an0 statei�all�e a0oveinlo�malionis corr¢ci. Ia9�eeio cam0ly with allciiy an0 coun�y
orainances and sta�e laws reW�ing to Dudtlmg crosimction ana nere0y autMrue representatives of INs ary io enter upon �he aGwe-mentioneE
piopetly forinspeclwn ourpases.
�ate: Signamre:
Oriver's License or Saul Secunly ,:
16aFa6 Whne—Bmiamg�, Green—CoOe Enlorcemem: Canary—AppLtant: Pink—Revenue; GobenroC—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M
PERMIT NO; M 050912 PLAN CHECK NO: N GOVT: N SU P:
CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH
JOB DESCRZPTION ; REPLACE FAU SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: B-2 /
COMMENTS: REPLACE FAU C.E.C. APPROVED
�r*�**�*��*�r�*�r�+r�r*�r****�t�r********�***�r��r��*�r*+��r+r�t*x���r*�c�t*�r-z���rx� x�x�r�r�*�**�t�r**x�
Z O N I N G$ ERTEHQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARRING REQ• PROV: PARCEL: 14132211 ZNE: REF NO:
PLANNING NOI'ES>
i
iE if 1E iE iF if iE fE iE if if iE iE iE iE if �E iflf iP iE fE iF if if iE iE ff if iE iF if iE �f fE if iF iF 1F �E iE 3F iEib if iE if if iE iF IE ik iE if iE if iF if �f iE fE �E !E iE 3E 1E ff 3f 9F if #?F iE 3f iF iF �F?f if
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 APPROVED BY � DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE; ��F����S�
iEiElEiflflEiFiflE�lfififlEN�iEfEiFlFiElE-0E1E rac r��iFiElE�EiEif-7E�EiEiEiE iEif
�kifiElflfiEiflfitiElFifiE1E1lIFlFififiklh1f1f1EikfEiEifikltiFfEiFfFlflElklflklfif FiEiEiFIF7EIElflfi(�iElfiFfEifiElkifiE#iE1FfFlFiEiF1E#IElEififlElEiEiFiE
LEGALIZATION:N F E E S' M M A R Y STRUCTt3RAL SEGMENT;N
BLDG PMT PLUMBING ELECT IC MECHANIC FIRE SMZP/RES GRADING
PERMIT 9'�SY SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15.00 - 0.00 24.00 24.00 .00
REVENUE DIVISION TOTALS--> COI:LECTED: 24,00 OVER/SHORT: 00
BLDG PMT PLOMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN—CHECR
24.00
if k# ik iE if if !f !f 1E 1ElE itlE �t iF IE if iElE 1E 1f iElE iF * ff iE iE if fk 1E 1f 7flf �E iE if if lE iE if if k if iE if iE if %iF iE iE 1E iF If if if iF iF 1F iE k fE if �F if fE iF M jF iE if if iE if ik if 1f
I N D Z V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
MEC 1 INST FORC—AIR/GRAV�FURN <= 100 K BTU 9.00 9,00
END OF FEES
\Q��
: C,�� � 9356—0007i5SE 'e i±Y
` �r�E: OZ/0�/9i 7I�fE: 1?:`•�
V
ta.�:
� � i
CONSTRUCTION AND PLANNi..� OL & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # �Date Inspector
i
i. Temporary Electrical Service oi Pole , 52. Pool & Equipment Location
2. Sail Pipe-Undrgrnd. ',% � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd.% j 55. Electrical E3onding
5. Steel Reinforcement 56. flough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings � �- . � 58. Electrical Conduit-Undrgrnd.
8. Foundation i i � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. '� �� •� ����: 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floo� System � �! �' � 67. APPROVAL TO DECK
11. Property Sewer Line & Houie�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 � �� 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 FIRE DEPT. REnU1REMENT
20. Rough Factory Fireplace . - ' • APPROVAL'S � Permic #
21. Ducts, in�Structure . � 70. Underground Hydro � �
22. Ducts, Ventilating � . 71. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough &'Test , 72. Underground Flush � '
24. Roof Framing � • � 73. Undergrnd: Storage Tank O Gas O Oil
25. Roof SReathing . 74. Overhead Hydro ��
26. T�Bar Ceiling (Structural) & Monocoat 75. �rY Chemical
27. Frame and Flashing 76. Dry Standpipe
� 28. Lathing & Siding • � •' � 77. FIXED SYSTEM FINAL
29. Insulation '. � 76. FIRE PREV. FINAL
30. Drywall Nailing ' . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai ' ' 79. FINAL INSPECTION
� 32. Electrical Powsr Meter�Final � . � �� I•� 80. FOOD CERTIFIGATE ISSUED .
33. Final Electric - - � ( ., i� ' 'Notes: Lf.�-� r �n pHE�pmE ���F3�CdiRm"'�/�
34. Final Heating & Air Conditioning �r / �, � � �
35. Final Gas Pipe-Test � ' i �I � ' � , '
36. Hood or CanopY i li +� �' �
37. Final Factory Fireplace .��,�: �' �
38. Final Plumbing � � �� � . •
� ", :
39. Water Service-FinaP � � q ��! � -'
40. Gas Service-Final , �1; I � .
47. Solar pomesticFinal . � .
' 42. Backflow Preventer � �
43. Backflow Irrigetion
44. landscape Irripation System ,
45. Sound Attenuation -
46. Handicap Regulations - �
47. fINAL STRUCTURE & BUILDING I�. � .
48. FINAL PLANNING � ��? I
49. Electric Release to Edison 4:: I
50. Gas Release to Southern California Gas Cn I�; �
51. CERTIFICATE OF OCCUPANCY
No Date
.; �
- � �-�� - � � `'. �,� k..
. . �-`3��� � DEC 9 1360
COSTA MESA BUILDINGSAFETY DEPARTMENT � I'II��/II';CE/� I)nC?({j[,r
P. O. 60X 917 COSTA MEBA. CALIFORNIA �'� �� (l� i�lJsT/'1 �41{„�)`�
Lo t� So. PL/�N y� BW
For Applicanf io Fill In Complefely APPLICATION FOR PERMIT
TYPE OR PRINT BUILDING
BUILDING
ADDRE68
COSTA MESh CALIFORNIA For Offite Use Only
fl6L[IIT NO. ��RNI,�g10.
OWNER Mese Del Mar Develo mept Co. ��c-��
M/�I(. R6Ctl [D GY OATH N6C81V8/D DAT6 Il6UCD
ADDRESS %�/ I ,� �- t� O/1'2� n/1 9Rii'1
GITY CiOLOIl9 a81 HaY ' TNp�OB J�ZGO BUILDING
ADDRE86 855 i'�8 81�,8L Street
ARCH�TBCT THL
..-..,.____ ..______..__ .�hn v.00n COSTA MESA. CACIFORNIA
del Mar
_ _ . TEL.
6IZE p� / p-f / NO. OP BGD69.
OF LOT de X/�'f Now oN Lor
U6E OF
EXISTING BL
BLTBACN LINB pROM / ��
CBMCR OR BTRGHT D� REAf2 YARD
/
SIDE YARD I 4EFT ' I RIGHT
DESCRIPTION OF WORK
BUILDING
S12E
E%TERIOR
COVERING
U�E OF BI
NO. OF
APPROVED
ZONING
2QM E NO. OP /� UH6 OF �
jj-1 �LANO G BUILDINO
L60AL 1O�J� ✓ _ �/
YARDS
APPROVED
/ ICENTHR LINt !T.)
I HEP89Y ACKNOWLEDO[ THAT I HAV6 R[AD TNIO AIILIGTIOH
ANO 8TAT8 THAT TH8 ABOV! Ie COPFER ANO A,�O COM•
PLY WITX ALL CITY O INANCE6 AND BTATH {a IIEOUL11TN0
BUILDINO CONB�UGTI 1.
81GNATURE OP a�
PERMI'RE
AUTMORIZED AGQN7
APPROVED
gy W
none
EVES
�
�
���
i2-8-60
TX6 AMOUM LXOWN UNO6p VALUATION IB IOR TN¢
PUItP098 OP 89TABLIOHINO A PHpMIT F!E ONLY.
$J�, 08q.0o