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Home My WebLink About2774 MALLARD DR - Building Permits ' M CITY OF COSTA MESA q BUILDING DIVISION F DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER PERMIT 00411 .4. men 03-00668 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2774 MALLARD DR Status: ISSUED Suite No - Applied: 12/19/2003 Issued: 12/19/2003 Vmbey: Y - Parcel Number: 13954202 ISSUED BY: Applicant: MOUNIR NOUJAIM Address: 1411 N BATAVIA SUITE 112 Phone: 714-744-2715 ORANGE,CA - Zip: 92867 Owner: ROZAR, RANDY L Address: 2774 MALLARD DR Phone: COSTA MESA,CA Zip: 92626 Contractor AMERICAN EAGLE PLUMBING, HEATING &AIR INC Address: 1411 N BATAVIA SUITE 112 - Phone: 714-744-2715 ORANGE,CA Zip: 92867 License:770254 SCOPE OF PERMIT CHANGE OUT FURNACE LESS THAN 100K BTU FEE SUMMARY Quantity Quantity ISSUE.FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 - - Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 , ' 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 . 30 To 50 hp/1,750 k BTU - $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 . Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 ` 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 ' Over 50 hp $0.00 0 Floor Fumace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $38.30 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 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 2446-49(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm.under penalty of perjury one of the following declarations: O 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 ork for which this permit is Issued. 1 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 carder and policy number are: Carrier: C f`^�1( (�(/7V n Policy Number: / '-''7 7 /t/ \L>'_O (This section ne ddhot be completed if the permit is valued at one hundred dollars($100)or less.) • O 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 become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 370of the Labor Coda,I shall forthwith comply with these provisions. �— / 1 , 0 ` !z ig Applicant Signature: r� Date: / WARNING:FAILURE TO SECURE bi - .,. •VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO ' ✓OST 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 Professions Code,and my license is In full force and effect.Lic.# `77 0 2 SL{ Class# C-70—C-'3 C Contractor's Signature: — Date: /7/irk) 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). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and 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 properly 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.). • O I,as owner of the property,am 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.). O I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 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 ❑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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes ❑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? 0 Yes ❑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? ❑Yes 0 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 and 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. Signature Of Legal Owner(s) a� ��' d1OF�Sutpaized Applica�� Da � ate CODE if INSPECTION TYPE PATE INTITIALSS WOE II INSPECTION TYPE gdlf 1616 Fixed System Final Fire Prevention 206 Final Mechanical )9- 0-0S 1266 Pool Spa Final 208 Final Plumbing 200 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 • • CITY OF COSTA MESA 4 BUILDING DIVISION F - ,l DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 111,11 PERMIT 602-00725 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDIJob Address: 2774 MALLARD DR Status: ISSUED Suite: Applied: 05/28/2002 Vicinity: ROOF Issued: 05/28/2002 Parcel Number: 13954202 Zoning: R1 R1 Applicant: SHULMAN, JOE ISSUED BY: Address: 7821 SEAGLEN DR Phone: (714)536-5116 HUNINGTON BEACH,CA • Zip: 92648 Owner: ROZAR,RANDY L Address 2774 MALLARD DR Phone: COSTA MESA,CA Zip: 92626 , Contractor: SHULMAN ROOFING Address: 7821 SEAGLEN DR Phone: (714)536-5116 HUNINGTON BEACH,CA Zip: 92648 License: 690617 Arch : Eng: Address: Address: . Phone: Phone: , Zip: License: License: SCOPE OF PERMIT_ TEAR OFF WOOD SHAKES,7/16 O.S.B.,304 FELT,NEW FLASHINGS,EAGLELITE PONDEROSA TILE,ICBG#4660, 7.2 LBS.3000 S.F.WITH ATTACHED GARAGE. FEE SUMMARY Plan Check: $145.11 - - Calc Valuation: $12,115.00 Permit: $223.25 Claim Valuation: $12,115.00 SMIP Res: $1.21 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 : ' Total: $369.57 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 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 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 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. .0:7_71'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'co ¶Its lion Insurra�ce carer and policy number are: ('� CCardeir J a 1 it. Policy.N�umber: 2--tj —0( (This section need not be completed it the permit is valued at one hundred dollars($100)or less.) ❑l I certify that in the performance of the work for whi h this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Californ' ,and agree th t If should ecome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provision. 'ApplicantSignature: ffi----( bate:—) 5-,2_2--.-0.-0 ?— WARNING:FAILURE TO SECURE ORICERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(6100,000), N ADDITION TO THE(xlT OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37CC OF THE LABOR CODE.INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed ander p .vis'ons of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full forcevnWLenect:Lic-sem 4. I IGasaN--C'''''.Thg Co�to�nature:-7 Date:—Cc�L$..-O'g- C -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). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and 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 properly 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,am 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 tor 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 drivers license. 0 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 ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U 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? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the Califomia 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 Califomia Health and Safety Code Section 42303 been made? ❑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 and 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. Date 5- -f7Z And/Or Authonzetl Applicant \ Date CODE 6 INSPECTION TYPE PAL 1NTTAI5 CODE 1 1NSPECTIONTYPE DAIS INIITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing - 200 Final Re-Roof 6'i(-OZ 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 4R:lIECT ZDDRESS: 2774 MALLARD DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 066751E L/ '-01/MER'SNAME: BECKER, STEPHEN ROY ADDRESs: BECKER DONNA C PERMIT NO: B 066753 PLAN CHECK NO; 01132-94 L GOVT: N SUPP ; N 2774 MALLARD DR COSTA MESA CA 92626 CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE; NEW 714 ) 545-4514 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL POOL 6 SPA SQ FT: 18 , 150 ADDRESS: UNIT: CLAIM VALUE: 18, 150 . 00 CALC—VALUE: 18, 150. 00 GROUP OCC : R-3 / PERMITTEE: SEIKO POOLS ( 714 )731-3177 ADDRESS: 285 E MAIN ST 12 COMMENTS : CONSTRUCT NEW SWIMMING POOL 6 SPA / SHALL COMPLY WITH ORD#93-12 TUSTIN CA 92680 *4itiriFiF+FiFftyE+F+ ****iFyFx****itie*****fix*****3Fy *******+t**+tit+Eyr*** Tt*fETryr+t+t+F*yr*T6********** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R EQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. S E T B A C K S CITY in.: 017532 STATE LIC.: 398790 CLASS: ,. . ! — y' Signature: r 3 MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FT IN REAR: FT IN FRNT: 8 FT 3 IN REAR: 5 FT IN Compensation Insurance.or a certified copy thereof(Section 38110.Lab.C). FRNT;LEFT: FT IN RGHT: FT IN LEFT: 13 FT IN RGHT: 12 FT IN POLICY ND.: WC 112 5 8 5 4 7 6 ED EXP.DATE: 11 /01 /94 I COMPANY: CNA INS PARKING REQ: PROV; PARCEL : 13954202 ZNE : R1 REF NO: ❑ Certdied copy is hereby furnished. LX Cerlihed copy is f/ed with the city Bufding Division PLANNING NOTES> INSTALL POOL/SPA COMBINATION TO THE REAR OF AN EXISTING > SINGLE FAMILY RESIDENCE, Date: 'Y— y - `l 1/ Applicant: /�Le. *************************************************** *************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). D E V E L 0 P M E N T SERVICES REQUIREMENTS 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 become Q y� subject to the Workers'Compensation Laws of California. ZONING APPROVED BY ,J SNI— DATE: yjls'lS�/ Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : % DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. C CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y- h ;A % �� DATE- I/ • which this permit is issued(Section 3W7.Civ.C). *********************4** *** *`t' *** ** ** **** **************** ** LENDER: ***4**************************************** ********************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 198 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3a1 the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 128 . 70 3 . 81 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 201 . 81 0 , 00 128 . 70 330 . 51 330 . 51 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through • his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 201 . 81 OVER/SHORT: . 00 forptheepurposeofsde)hin one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 198 . 00 3 81 ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(S)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************.N. that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN O I am exempt under Section: B.8 P.C. for this TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFC 18150 POOL 6 SPA . 00 Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 1 Q 0 18, 15 0 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEE$ permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Dale: Applicant e I hereby certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned 01 00158682-00158683 TCET property for inspection purposes. DATE: 04/11/94 TIME: 201.81 Signature: 11 Iver's License or Social Security b: 1641.46 While—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor l c a i[ -CON SIB.UGGf.ON AND PLANNING PL /L & SPA "ems Date Inspector .. Date Inspector ' .APPROVALS Pemi dr',':_.4.1. APPROVALS Permit gk 2: 1 L J 1. Temporary Electrical Service or Pole• 52. Pool & Equipment Location �L 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement /` 3. Electrical Conduit•Litility-Undrgrnd. 54. Forms . 4-.Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5' Steel Reinforcement -, 56. Rough Plumbing & Pressure Test 6..,Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE V i (f (. 1 ,'7.•Footings 58, Electrical Conduit•Undrgrnd. f 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof 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 rT s/7 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace -APPROVALS Permit # - • 21. Ducts, in,StructuFS.! ,� 70. Undergrbund.Hydro 22. Ducts, Ventilating , _ •- ' - ; 71. Product-Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test ._ - ' 72. Underground FIus6 24. :Roof Framing, . � `73.'Undergrnd:StorageTank OGas 0011 25. Roof Sheathing . , , '74.:Overhead Hydro 26.-.T-Bar Ceiling (Structural) & Monocoat 1 ' 75..Dry Chemical • ' 27.. Frame and Flashing' 76. Dry Standpipe - .-ii. 28. 'Lathing& Siding: ' ' •• 77. FIXED SYSTEM-FINAL 29. Insulation ' , - . . 76. FIRE PREV. FINAL 30. Drywall Nailing - - ' - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' .I 79. FINAL INSPECTION 32. Electrical Power Meter-Final , $0. FOOD CERTIFICATE ISSUED +I 33. Final,Electric, , Notes: -. . 34. Final Heating& Air 'Conditioning_ I - 35. Final Gas Pipe-Test l _ , 36. Hood or Canopy , . - • - 37. Final-Factory Fireplace - 38. Final Plumbing - •• r 39. Water Service-Final • t. 40. Gas Service-Final - i 41. Solar Domestic-Final 42. Backflow Prevente'r - - 43. Backflow Irrigation - 44. Landscape Irrigation System , ; - - , - • - j 45. Sound Attenuation I - •_ 46. Handicap,Regulations - .. . - 47. FINAL STRUCTURE & BUILDING • - - 46. FINAL PLANNING , • 49. Electric Release to Edison . ' 50. Gas Release to Southern California Gas Co n 51. CERTIFICATE OF OCCUPANCY No.� Date • ost-_ens_oned _:ncret_ 4k SZPCRT OF ZNSPr--"N ON Masonry ` ) Fireproofing jj Cunite � ; Reinforcing Steel • TO: CC7SA • Address: OWNER: 2c3Citj7 f • PROJECT: Swlmm?iiS DtbSoa Report No. Address: 3.0 C}, (nc,u_n "icl sf: Permit No. $(„(r"]S3 Architect: 5eiLm PII S Contractor: S4t,5(c1'IZ:JS Address: Address : Engineer: 1- :,rSCW Subcontractor: \ iltrp. rA\vfiht»y}� (Gun Itel Address: Masonry cr Concrete) M Inspector: 1 , \rt cit-m, Address: 0e, 1. 3-15`{ ti.Aier..5kut I Mix Used: y,)_j Slump, inches:-13 Admixture: --6;;.- Designed S-Designed Strength, PS12 � J0 Cu.Yds . No. of DATE: Placed Cvls. Remarks iz W1C(4, S 3 waltri i)tk2Ct<• Roto 71,r\t nrzigci,�) -ft47v ncc-)\kS :obies of Reports to: (Indicate which Bldg. Dept . L furnish address of any not listed) Los Angeles ab oratories r"�71 Testing CONSULTING, TESTING, AND INSPECTIONS COMPRESSION TEST REPORT TEST MADE FOR: Max Sitter P. 0. Box 3454 Fullerton, CA 92631 JOB IDENTIFICATION : 2774 Mallard Street, Costa Mesa LOCATION IN STRUCTURE : Swimming pool & spa - deep end. FIELD DATA • Mix Designation : 4-2-1 Specified PSI @ 28 Days : 2000 Admixture : NI Slump : NI Concrete Plant : Vern Anthony Samples Made By : Gary Cement Type : II Date Samples Delivered : 4-28-94 Date Cast : 4-18-94 LABORATORY DATA Gunite + + + +- - - - ---+- -- - - -----+ +.. .- -+ ; LAB . NO . ; MARK DATE AGE AREA COMPRESSIVE ; REMARKS ; TESTED ; DAYS : I STRENGTH PSI + + + + + + t t +---18-06---+--C_---+--5=2_94-*_-WI __+ 15.21 + 3120 + + , + +----7/.41,-- ... +,\ -. (i' --+ + + + Respectfully {1lamiti<;eci - - ` ., ',t)tis I II 1/Li � � •i seckas , P . r\T2 <' '� ,�. . �( ' ` . 7950 Garfield Ave., Bell Gardena, CA 90201 • Tel. (310) 827-2816 927-2617 N SFS f It, 'Is CITY OF COSTA MESA BUILDING & SAFETY DIVISION 77 Fair Drive, POB 1200, Costa Mesa, CA 92628-1200 Tel (714) 754-5273 Fax (714) 754-4856 FACSIMILE TRANSMITTAL To: Dennis Gaikerna. From: Irene Hash;end t Of: Seiko Pools Tel: 714. 75'!. 5659 Fax: 7/4. 731 . 083 Date: /2./17/14 Re: 0777,4 !l a,!(arej Dv Tnclotalcov#er pages 5 i notes: See affarchul. Peen'h;45 P 66 756 B 66 753 Both Teals passed . Ont eats en -Plc . PIs To-rMiard copy -tis e-wners ( Beckers). ,2/s eenc;rem rec Iof. If you experience transmission problems or have any questions, please do not hesitate to contact the sender at the telephone number indicated above. ADDRESS CC BUi0030: 2774 MALLARD DR UMT: CITY OF COSTA MESA — BUILDING PERMIT AU IVKNDWN:BECKER, STEPHEN ROY FLOOD: AE 46 PERM NO: B 066753 ADDRESS:RECKER, DONNA C • 2774 MALLARD DR PERMIT NO: B 066753 PLAN CHECK NO: 01132-94 L GOVT: N SUPP: N COSTA MESA, CA 92626714 ) 545-4914 APa,MNLga ADDRESS CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE: NEW ARCHITECT DR ENGINEER: uc.No. JOB DESCRIPTION : INSTALL POOL & SPA SQ FT: 18 , 150 ARCH.OR EHG'S ADDRESS UMT: CLAIM VALUE: 18, 150 . 00 CALC—VALUE: 18, 150 .00 GROUP OCC: R-3 / CONTRACTORS NAME SE I KO POOLS ( 714 ) 731-3177 CONTRACTORS MAILING 285 E MAIN ST COMMENTS : CONSTRUCT NEW SWIMMING POOL & SPA / SHALL COMPLY WITH ORD493-12 ADOREss:TUSTIN CA uc.N°_ 388790 *****************************IE**iE**BEBEIE*BE*RE*****lErt****+E+ ******+E**********aE***+E*It 92680 mo: 12 ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby edim under penalty of pethat ury I am licensed under poWsons d Chants 9 SETBACKS (commencing with Section 7000)of°Makin 3 of the Business and Professions Code.and my license is in full forte and effect. clnuc.No.C17532 uc.cuss:C53 uc.No.: 388790 EXP: . 00/00 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: 8 FT 3 IN REAR: 5 FT IN Dae: Contrador. - LEFT: FT IN RGHT: FT IN LEFT: 13 FT IN RGHT: 12 FT IN OWNER BUILDER DECLARATION:I hereby affirm under pensly of Perjury that I am exempt from the Connecters License Law fa the Imownp reason(Yadkin 7031.5 Business and Professions Code:Anycry a county which requires a perms to mnsbud,easy improve, PARKING REQ: PROV: PARCEL : 13954202 ZNE: R1 REF NO: demolish,or MOS any'HUMUe.Prior toes issuance.also requiresthe appbmntfora.Ch perms to fie a signed statement that he orshe PLANNING NOTES> INSTALL POOL/SPA COMBINATION TO THE REAR OF AN EXISTING is Icensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Melon 3 d the Business and Professions Code)or that he or she is exempt therefrom and the base fa the alleged exemption.Any vi laton of Section > SINGLE FAMILY RESIDENCE. 1031.5 by any applicant for a permit subless the apd'vant to a m{penal,d nue mos then&e hundred dollars IS-533D. **********3********1E*********************************3F*******.0k***************** ❑ 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 DEVELOPMENT SERVICES REQUIREMENTS or offered for sae(Section 7044,Business and Professions Code:The Contractors license Law does not apply to an owner of progeny who bifida or improves thereon.and wto does such h work Nmsed or hese/or through M or her own employees.provided that such improvements ere not intended or altered for sale 11.however.the building or itprwemene S sold within One yeero ooenpetoe.the ZONING APPROVED BY DATE: ownereuhlder will have the burden of proving he or she did not build or improve for the purpose of safe). ❑ I.as owner&IhepropeY,amesdaaielywnrecigwMkanmdconusdmtomnaWTr"Projes(Sectic°JOa,aesinessand BUILDING APPROVED BY Professions Cods:The Contractors License Law does t apply to an owner of properly who builds« who improves thereon and wDATE: convects for sudh projects with a contredor(s)licensed pursuant to the Contractor,License Law). ❑ tern exempt under Section: B.ARC..for this mem APPLICATION ISSUED BY: DATE: ******************************* ******************************************* Dela Owner. LEGALIZATION:N F E SUMMARY STRUCTURAL SEGMENT: Y I do hereby certify that I ern ewers of end understand the requirements d CW/oma Heath and Sermy Code Sections 25505,25533,end . 25534,end that I a any haute building occupant will/wil not(alMs one)need to comply web said sate codes end the requirements for BLDG PMT PLUMBI ECTRIC MECHANIC FIRE SMIP/RES GRADING •plane t«construoticn or modhficetionham the Ai uaby uhyeman District Residential oongniabnappErmian an exempt from these pmwssione. PERMIT 198 . 00 • • Dae` Applicant: PLAN 128 . 70 O SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of the(dewing declaration: ISSUE FEE 3 . 81 ❑ Ihave and wAmaintain acertificate dconsent tosetinsunbWatticanpanauion,espWm ovidedfeebaS3200&iMLabor BUILDING—DIV—> PERMIT S E PLAN—CHECK TOTAL PAID DUE Code,for panorm.nqe of the work which this permit issued. TOTALS----> 201 . 81 00 128 . 70 330. 51 330 , 51 . 00 ❑ I have end MMI maintain workers'compensetcn insuran�cee,as requiredn� by Sect on 3700 of the Labor Code,for the performance d the w«k lot which this panic,:issued.Myw«ke workers' compensation Snenea purist end policy number eels' EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 201 . 81 OVER/SHORT: . 00 carrier: Policy Number WC1LL5b74 /bED 11 /01 /94 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This sacion need n«be completed y the permi is for ono hundred dollars($1001or lea) 198 . 00 3 . 81 • ❑ I oenyy that in the performance&the work for which this permit a issued,I shed nea smoky any person in any mane so as to become subject to the workers'compensation lawsofCelanmia,end agree the dl Mould become subjectto the workers' ******************************************************************************* compensation provisions d Seaion 3700 d the Labs Code,I Mall forthwith camel/with those provisions. - INDIVIDUAL F E E BREAKDOWN Oae: enplicant: Waning:Failuretosecure workers'compenaion coverage Is unlawful.and shall subject an employee to crimhMl penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST chdl fines up to one hundred thousand dollars(5104000).In add/don to the root of compensation,damages es provided for In . Section 3706 of the Labor Cod,Interest.and attoomeyiIna SFC 18150 POOL & SPA • 1 . 00 18, 150 , 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under gamy d perjury that there ice condndioh lading agency for the END OF FEES performance d the work for which the panne is issued(Seam 3097,Cs.C). LENDER'S NAME: LENDER'S ADDRESS: • I certify that l loos mad this application and state that the above information is coned.I agree to comply with all city end county ordinances �E v I and Ree Jews tN&ng to Mildip construction NI hereby authorize repr.,eraatlYes d this ant enter upon iM.bow.mamcned property, L)C for inspection purposes. - teAj. �� -' I Print Herm. DAT �q� '6 oil/ Date: Signature el Owner/AgenVAppiant/Contrector __ __ POOL & SPA ION AND PLANNING Date Inspector APPROVALS Perurit , Date Ins-actor ALS Permit emporary Electrical Service or Pole 52. Pool & Equipment Location _ 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Unclrgrnd. I} _ 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash tines. P-Trap, 0 Un,lrgu:d. 10. Structural Floor System 61. APPROVAL_ TO DECK - - 11. Property Sewer Line & Houw (:onnection ---- - - 62. Backwash & Rcceplor•F inal _ -�- - - - _--_- 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 1 16. Rough Electric Wiring 67. Fencing & Access Approval I 17. Rough Wiring Sign 68: APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL .7/ G V' `„ • 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT 12/17/j' 20. •Rough Factory Fireplace APPROVALS Permit '#` ' _ 21. Due s, in Structure 70. Underground Hydro (--_ - -_ _ 22. Ducts, Ventilating - 71. Product I'ipir�y,1.7Gas ❑OSI _ - 23. Gas Pipe-Rough & Test • • , 72. Underground Flush 24. Roof Framing . .' 73. Undergrnd.StorageTank 0Gas Id al , 25. Roof.Sheathing . . 74. Overhead Hydro.___._. _ --- __._._. 26. T-Bar Ceiling (Structural) & l/onocoet 75. Dry Chemical --_--_--`_--_�- • 27. Frame and Flashing ! _ 76. Dry Standpipe -i -_-_ " - -• - - 28. Lathing & Siding 77. FIXED SYSTEM FINAL : 29. Insulation - ' • 78. FIP V. FINAL. 30. Drywall Nailing I ALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . (/-J Cie 1 INSPECTION 32. Electrical Power Meter-Final SOD CERTIFICATE ISSUED 4> 33. Final Electric - Notes: - _ n// 34. Final Heating & Air Conditioning �0 �� 96 �� lJn i y1Q� /'pp7 o 35. Final Gas Pi peTesti / Alt t./ i,Q 36. Hood or Canopy .. • ,vL//6 /c�.E f-c-c r `Ey .(" ^ '---- ----- i 111 +aFt� 37. Final'Factory Fireplace. -^ - , - - V 38. Final Plumbing - - -- 39. Water Service-Final - - 40. Gas Service-Final - - . - . 41. Solar Domestit-Final ' - 42. Backflow Proven tar ~-____.--- _____-- 43. Backflow Irrigation - 44. Landscape Irrigation System : 45. Sound Attenuation . 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING _ 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY -----_________"" No. Date • PROJECT ADDRESS: 2774 MALLARD DR ( UNIT • CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 066756 •6oo ss: BECKER, STEPHEN ROY a9oRESs: BECKER, DONNA .C_ PERMIT NO: P 066756 PLAN CHECK NO: N GOVT; N SUPP : N 2774 MALLARD. DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V-5 PERMIT TYPE: PLU PURPOSE: OTH 714 ) 545-4914 AACNIENGINEER: REG.NO.: JOB DESCRIPTION INSTALL POOL & SPA ADDRESS: UNIT: SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / PERMITTEE: SEIKO POOLS ( 714 ) 731-3177 ADDRESS: 285 E MAIN ST 12 COMMENTS : RE: B66753 TUSTIN CA 92680 *****************+e+tar***BETr********dr***+r+rir******udtirrAron*********+P***************+r LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S CITY LIC.: 017532 STATE LIC.: 388790 cuss: effect. MAIN BUILDING ACCESSORY BUILDING we: y % G/ Signature: FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: thereby aflir that l have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation,5 pc gr, cni�yof(Section 3800.Lab !. POLICY NO.: W"1 I L 1bi 7 EXP.DATE: 11 /0 1 /94 COMPANY: CNA INS ,vv PARKING REQ: PROV: PARCEL: 13954202 ZNE: REF NO: I: Certified copy is hereby furnished. L? Certified copy is filed with the city Building Division .7 PLANNING N T ES> • ' J .- // > ale: 7 S — *IL/ Applicant:, sir irar*lrir*lrararirlrfrlr*irfrir*lrarlrltariratiritititirir7r*arltfrir*ltititar*****aril*ir*ftirfrirfrirfrir#ar#Iritlrar*atat3tir*irararir3rir EXEMPTION FROM WORKERS'COMPENSATION OECLARATION: (This section need not be completed it the;emit is for one hundred(5101)or less). DEVELOPMENT SERVICES REQUIREMENTS 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 become subject to me Workers'Compensation Laws of California. ZONING APPROVED BY DATE; Date: Signature: BUILDING APPROVED BY NOTICE:y:II.after making this epy with s,you should become this pert the Workers' revoked. eCompensation provisions of the Labor DATE Code.you must forthwith comply with such provisions or permit shall be deemed rvo CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: dr A -- DATE: which this permit is issued(Section 3097,Civ.C). ************************arlririr irit it it **it ifirirarit it#iritfrirititit3rlhir#af*.ir .1t.M. .k ** LENDER: ********************************* ***** *** e• ********************************* ADDRESS: LEGALIZATION:14 F E E S U M • R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7,00 • repair any structure.prior to its issuance,also requires the applicant for such permit to tile a signed statement that he/she is licensed 25% pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON-RES and Professions Code)or that he/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). ISSUE FEE 20 . 00 ' I. as owner of the property or my employees with wages as their sole compensation, will do the woo, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK . TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 7. 00 20 .00 0 .00 27.00 27. 00 • 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• , '27.00 OVER/SHORT• 00 forme purpose off sale). improvement e sold one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN-CHECK pr I.aofesr of the eTh.amCo etr osis'Stately contractingLicnwithw lioes ednot contractorsnto owner op to thert project hbuilds ov, thereosn 27 , 00 ❑ and ProfessionsoCode:oThe projects aLicense Law does not apply to annheoof property ahskeor improves thereon and who contracts for such pralects Litho tontracmr(s)license pursuant to the StateContractors' License Law).l am aware *************************************************M***************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B REAKDOWN ❑ I am exempt under Section: 8.8 P.C. tor this TYPE QTY DESCRIPTION ' UNIT COST TOTAL COST Date: Owner: PLU 1 SWIMMING POOL 7.00 7 • 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouabty Management District.Residential construction applications are exempt from these provisions. Date: Applicant: E X P I . I hereby certify that I have read this application and state that re above information is correct.I agree to comply with all city and county L Si11V wiz ordinancesand inspection spurose to building LWSW[Ii00and herebyauthorize representativescel upon above-mentioned 1/� �/ Iw/1L/9� properly for purposes. DATE r �+' v/ v 01 101.`,?<_e4_!1n 1 gb54 TOT 27.00 sc /j/ CA7L: 04/11/94 Ti! c: 1b 07 ey— .T % / Signature: Drivers License or Social Security a: • CTION AND PLANNING -___ -__- -. ..---___POOL .,r'A Date Inspector ! Dote ( inspector ROVALS Permit# AI PROVALS Permit # I c. 1. Temporary Electrical Ser vied or Poi_ - -- 52. Pool & Equipment Location- -_ f - � 2. Soi; Pipe•Undrgrnd. :. . 53. Steel Reinforcement • 3.• Electrical Conduit Utility-Uncryrnc. 54. Forms - - • � 4..Electrical Conduit-Undrg:nci. • I 55. Electrical Bonding _ 5. Steel Reinforcement 66. Rough Plumbing & Pressor e _117T----- ----1Z);-1 t f�+ ' 6. Electrical LIFER Grnd.-- __--�- 1 --- 57. APPROVAL TO COVER-GUNITE • 7SFootings 58 Electrical Co; do I[-U c r p nd. • B.:Feundalio', 59. GasPipe,01 Undrgind., test .__ 4-.2.i •q� 0. -'wr Pi r U; n r i - �j� -- 60 B.aekeraeh Lines, P•Trap• Li UiJrgrnti 1 10,•Strocturrti Floor Ss n, Ul APPROVAL .O DECK 11 Property Sewer Line & ?T./LOC C01111.elatiCal t ' ; d I rtiB.crtwash : Neu_pm .Fr . 4 12_ Sewer CoP__._ 53. Nectar & Vennt•Fina: i41�1 13. Root Drains • 64. Plu;nbny Sbslem - P incl ._.___. i _.. 14. Rough - 1 Plumbing _ _"- y 65. Electrical-Final 1 15. Rough Electrical-Conduit 66. Solar System•Final 1 r `-' 16. Rough Electr ic'Wiring -_ 67. Fencing & Access Approval ,.__{-. _ _ 17. Rough Wiring Saga 6S, APPROVED FOR PLASTERING I ---1.- - ! 18, Rough Electrical-I Car Ceilingr r ,11 69. PUOL(SNAaa .�7 Pi,1;' FINAL ! I 19. Hough Heating & Air Conoitioning FIRE DEPT. REQUIREMENT •1 20.-Rough Factoby F(ruplaca -APPRO•VALS • Permit 21. Ducts, m•S r.uc a c' 70. Uuda-:rgreund I tYcro ( 1 ter_ _ 22. Ducts, Ventilating. . H ' ' ':71. Product;Pimng 0Gas O'Oii 1 23..Gas P,prlf Rough S'Test �i 72. Underground Flush. r 24.:Root Frerning --�.�. ' '73: ;Undurgrnd.StorayaTink 0Gas ❑Oil -- _ . 25. Roof Sheathing . ''74.•Oyer head Hydro. . • i }�{.-r I - I • 26. T•Ba1 Ceiling (Structural: &•Monocoa: 1 - . u - . 27. Frame and Flashing' •_ Illi _ _ 76: Dry Standpipe 28. Lathing & Sidiin977::' FIXED SYSTEM FINAL" '29. Insulation' -- 78.TFIRE PREV. FINAL 30. Drywall Nailing • ( • • •HEALTH DEPT. REQUIREMENT ^. 31. Plaster Brown ::oat'.___---_ '.�,. 79: FINAL INSPECTION----'-'_ -'-"-- 1 • [ • 32_:Electnc-al Power Meter-Final i S• :80. •FOOD CERTIFICATE ISSUED i 33. rinai EiectrcI '.I� Notes: I-r _ 134. Final Heating& Air Corcition uig.: _ 7 ._54- "�s12 e • �•!�' 11�(T/ 35.'Finat Gas Pipe-Test _ : - 4_ 7 3>Y1-1‘v ` . i 6-12 r-/ / --- 36. Hood or Canopy __ �. L, f 13.- 2. _:_ acs L ee--7 cArto 37. Final''Factory Fireplace - - - l i 38. Final Plumbing ::/:// ( ��` e. -"---"---- 39. Water Service•Final' _ _ •(L/76 / L Fri - ---" .- •40. Gas Service-Final . . . / / '41. Solar Domestic-Final : • .' 1 '42, •Backflow Preventers r L ' _ ._ __ • . 43. Backflow Irrigation- - 44. Landscape Irrigat_�on System, - '45. Sound Attenuation, = ••'' I 46. Handicap Regulations • ' H 47. FINAL STRUCTURE & BUILDING • . • 46. FINAL PLANNING. . 49. Electric Release to Edison • • 50. Gas Release to Southern California Gas Co " , 51. CERTIFICATE OF:OCCUPANCY • ' No. Date DEC-16-'96 MON 09:44 1D: KO POOL COMPANY 1EL NO:714-731-'^'R93 #051 P01 v ( -- -.-==---- FROM: ,__ _� •• SEIKO POOL CO. • 285 EAST MAIN #12 ▪ TUSTIN CA. 92780 To: /,E'S/VS COMPANY: C/'T V d Jr 4'�.)�. .? %1-. FAX NUMBER: 7/'/ 7 C# - BUSINESS FROM FAX NUMBER: 714-731-0893 BUSINESS PHONE: 714-731.3177 BATE. PAGES: RE: 2n - i'7- 0 ZKC) / (NOTE} .frnm ennis &a.nkern a_ DEC-15-'96 MON 09.45 ' 'EIKO POOL COMPANY TEL NO:714-731 's tt n _ 1 SEP-13-'94 09:14 III:CITh; or CCGTA NEA TEL ICr:714-556==cr3 V.-11A Pni 54 "r' REFUND REQUEST FORM : BOX -16. e90179y cony%tMESA, CA 92628-1200 From: Li Finance Permit # __0_ d i. ✓ O Building Safety O Planning Amount S 3S0. " f Public ServicesAccount # hi , isurc Services o Police - Attn. Chief of P.tiice /� Attach Copy of receipt __. ' `'d""< �_ — - 9 -1 atkp Had Signature Dart Name and address of applicant' _11Lc_ /js"4Irv/_______._,--_-.—__ (Please Print) Z ., -) 4 ti -__A-__ _ 6205/.et__Air t Zr/•/F_-.-- Z*-Q- ..--`1.-.°L�1-1. ._-- — _f 7 - Tr-9y_ Appliv's Sig�yturC Dale Ste"%/c 6'.-4-'/t. -.RECOMMENDED ACTION Approved Disapproved Finance Director _ PAr6-1 (�j 0Siynatlut a !- tJ City Manager ___—_._ ❑ 0 Sienuurt Pau O City Council -- 0 C Signature DIM REMARKS: a+42:re,wo u'a,,rrimarmw C..' Dep.nnt. cc._-_ 4LT.a :2-. t C.::_t". .^::- [. 14c'o� __5'__--..__ GJ._ F}r VENDOR NAME ACCOUNT DISTRIBUTION VENDOR NO DATE CHECK NC MR 1181144.11•11811441181144.11•JL „ U 008749 08-19-94 1017. FWD - kCOUM AMOUNT - \ :- C 1.--_ __ , "\ROMA' -..�.;+�TUND ACCOUNT AMGUNf-- — ____ 81 17203000 350.00 ` 3 REMITTANCE ADVICE _ _ PP/ DATE I IWO:KEN0.1 PQ 1 GROSS AMOUNT IDISCOUNT I NET AMOUNT u REMARKS_ _—_ D8-16-943;012801 }012801 350.00 .00 350.00 I V I I TOTAL I 350.00 ii 350. ii PLEASE DETACN BEFORE DEPOSITING +•v ____._ .vvrn :des.w�.pl�p..woes.e„�.-t".uS.,:.y::et�9R'Ja9.n�az.:.. r,ta�a39sn.,,.rga�mm.-v_:,:,r,.pux•x..v,rNx..rtv.vJ..Ba=_ . .,.x.bq.�a•k' - Di \d'i, • 1666 VE _ 1017365122' SC al.mmu. CITY OF COSTA MESA NQ. 3233A1Onnvr ‘011141- A.C* 2 it \1: WARRANT NO DATE ----- --- 1011365 08-19-94 - - __ $ ;350.0[ PAY , TO THE MR'BEtt ER ORDER 2714 MLS,ARP AR DF COSTA 'VESA CA 92626 NOT NEGOTIABLE '•6, h� ':-intgn4'4G::m :Gta b.Go.d.:.VKa GGGtip:,CL4Gfi G'8\icu0. HBHfi44\�V. � Its i01716Sn' t: i2200066it: i4e� �4Yii586n' 20420 £0d T50U £680-TEL-VTL:ON 131 ANddWOD 100d ONI3S:GI 9P:60 NOW 96.-9T-730 v ADDRESS O..NUM: 2774 MALLARD DR Wit CITY OF COSTA MESA — BUILDING PERMIT v;`11ENSN4AI(Plearm:BECKER, STEPHEN ROY FLOOD : AE-46 PERM NO: B 066753 ADDRESS:BECKER, DONNA C 2774 MALLARD DR PERMIT NO: B 066753 PLAN CHECK NO: 01132-94 L GOVT: N SUPP : N • OSTA MESA, CA 92626714 ) 545-4914 APDL.YAWNS ADDRESS: CONSTRUCTION TYPE: V—S PERMIT TYPE: STR PURPOSE: NEW ARCHDECT OREJIONEER: uc NO.: JOB DESCRIPTION : INSTALL POOL & SPA SQ FT: 18 , 150 ARCH OR ENG.'S ADDRESS: WIT: CLAIM VALUE: 18, 150 . 00 CALC—VALUE: 18, 150 . 00 GROUP OCC : R-3 / CONTRACTORS NAME:SEIKO POOLS ( 714 ) 731-3177 cion owsumm 285 E MAIN ST COMMENTS : CONSTRUCT NEW SWIMMING POOL & SPA / SHALL COMPLY WITH 0RD1t93-12 ADDRESS:TUST IN CA UC No.: 388790 **************iEfE3FiFif3EiEiElEiE+E3f*iF***7E1E1fif#iEdE#IE+EifiElEfEiE+EIE)EIEIE****+E1hlEiE+EfE***x-1EiE#iE***lEiEiEiF1ESc-6E 92680 gist 12 Z O N I N G R E Q U I R E M E N T S LICENSED CONTRACTORS DECLARATION:I hereby anion under penalty a perjury that I am licensed under provisions d Chapter 9 S E T B A C K S (commencing with anion 7000)d Division 3 of the Business and Professions Code.and my license is in full force and effect. Cmuc.NO.017532 uc.cuss:C53 uc.N0.: 388790 EXP: 00/00 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FTIN REAR: 5 FT IN sale. Contractor: LEFT: FT IN RGHT: FT IN LEFT: 13 FT 3 IN RGHT: 12 FT IN WNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law for the fdlowng reason(Section 7031.5 Basilan trod Pttesaiom Code:Any coy or rnuny which requires a perms to construct,alter,improve. PARKING REQ: P RO V: PARCEL: 13954202 Z N E: R1 REF NO: demolish, Or any structure.prier to its issuance,also requireslhe applicant for suchpemtil to ale a signed statement that he or she PLANNING NOTES> INSTALL POOL/SPA COMBINATION TO THE REAR OF AN EXISTING is licensed pursuant to the provisions of the Contredors License Law(Chapter 9(commencing with Sectbn 7000)of Division 3 of the Business and Professions Code]of that he or she is exempt therefrom and the basis fads alleged exemption.Any violation cl Sadiron > SINGLE FAMILY RESIDENCE. 7031.5 by any applicant for a permit subjects the applicant to a chi penalty of rat more than(e hundred dollen PPSOOU. ******************************************************************************* ❑ I,as owner of the property or my empbyees with wages as thei sole eampensetion,will do the work.and the structure is no intended 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 or offered for sale(Section 70ee.Business and Professions Code:The Contrados License Law does not apply to en owner of popery who brads or improves thereon.end who does such work himself or herself or through his or her own employees,provided that such improvements ere not intended ooffered for sale.If.however,the builingorim oproveeniSsobwithinoneyewofcomplthe ZONING APPROVED BY DATE: owner•buiber will have the burden of proving he or she did not build or improve for the purpose Of sale). ❑ I.as owner d the property,em exdusiwly contracting with licensed contractors to construct the project(Section 7043.Business and BUILDING APPROVED B Y Professions Code:The Contractors License Law does not apo y to an owner of popery who builds athereon improves and who DATE: contracts for such projects with a conisdocs)licensed pursuant to the Contractors License Law). ❑ lamexempt under Section: B.AP.C.,for this reason: APPLICATION ISSUED BY: DATE: ******************************* ******************************************* Des: Owner LEGALIZATION:N F E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and 25534,and the)any tenure building occupant will/will not(sada one)need to amply with eels stela man and the requirements for BLDG PMT PLUMBI ECTRIC MECHANIC FIRE SMIP/RES GRADING a permit forcostructionor moddiulion from the Ar Duality Management District.ResidedW construction appicatbre are exempt from these PERMIT 198 . 00 provisions. CCa Dale: Applicant: PLAN 128 . 70 SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE (/(�� 3 . 81 ❑ Ihavaend wiimaintain acertificate dconsent toseffinsurfor workers'oxnpenlion,sprovided fobySedion3700dthe Labor BUILDING—DIV—> PERMIT \�IS�ITE PLAN—CHECK TOTAL PAID DUE Code.tor performance d et»wakfwwNchuIssued. TOTALS----> 201 . 81 ��(00 128 . 70 330 . 51 330 . 51 . 00 d d 3 I have and wit maintain workers'compensation insurance,as required by Section 3700 e Labor Code,for the performance of the work for which this permit is issued.My workers'tom bn'n s rencarrier er er end policy number e: Career: CNA�I[�S EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 201 . 81 OVER/SHORT: 00 Policy Number: WC.1115t354 /bt.0 11 /01 /94 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (Dr's section need not be completed l the penal is for one hundred dollars(fico)or less.) 198 . 00 3 . 81 ❑ I way tont in the performance of the work for which the permit is issued.I shall not employ any person in any manner so as to become subject to the waders'compervation laws of Cal6ontia,and agree that rub 6I should become erbled to the'mockers' ******************************************************************************* eompenalien provisions d gd Sedn 3700 the Labor Cede'I shag comply oven then prwisds' I N D I V I D U A L F E E B R E A K D O W N Dale: Applicant: Warning:Failure to stout.worn's'compensation coverage Is unlawful,end shell subject an employer to criminal penalties andTYPE QTY DESCRIPTION UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100.000).In addition to the cost of compensation,damages es prov/ded for In n Secti3706oftheLaborCode,Interest,andattorney'sfees. SFC 18150 POOL & SPA • 1 . 00 18, 150 . 00 CONSTRUCTION LENDING AGENCY:I hereby atfinn under penalty of perjury that there is a construction wiling agency for the END OF FEES performance of the work for which this panne is issued(Section 3007.Cit.C). LENDER'S NAME: LENDER'S ADDRESS: . I certify their have read this application end date that the above information is correct.I agree to comply with SI city and county ordinances E V T , , and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentloned properly, LAlP for inspection purposes. �� M1,�.�' / a itrAdijiLa Print Name t , DAT _said q b Date: l' I 1 6 . Signature of Owner/Agent/AppfcantContrador (5151 46.WP) White-BuMna A Safety;Green-tile:Canary-Applcant;pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNINL, . -,OL & SPA APPROVALS 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 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60, Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof 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 �p 17`i� � 7_ 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT /,2/! 7.4 tLR 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping,0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush . t ` 24. Roof Framing -- - - ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil h. 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. Flp�/��\,V. FINAL 30. Drywall Nailing F)EALTH DEPT. REQUIREMENT 31. Plaster Brown Coat INSPECTION 32. Electrical Power Meter-Final OD CERTIFICATE ISSUED 33. Final Electric • Notes: '/^ 34. Final Heating & Air Conditioning (d/�6 96 y4 L Pa:1s 35. Final Gas Pipe-Test Gf iO/`�f; tw, 0�¢,-7 36. Hood or Canopy - /}//E j,t r,/_c,e-N_.c-rt,t c(y '(( 37. Final Factory Fireplace G 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No Date 04-15-1996 07:09RM FROM SEIKO POOL CO. Tustin CR TO 7544856 P.02 • ♦- _ t ^ Corr or tO TA IMSA T. EleetnetNNW&-FngI I BUILDING SAFETY DIVISION 33. Final E Iectlic POST IN CONSPICUOUS PLACE 34. Final Heating 3 Air Conditioning ON THE JOB 36. final GasPipe-Test NOTICE 36. HoodorCanopy You must furnish PERMIT NUMBER and the JOB ADDRESS FOR 37. Final Factory Fireplace EACH RESPECTIVE INSPECTION. CALL 754.5627. APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. 38. Final Plumbing A.p,NO. DATE ISSUED 39. Water Service-Final i 3 9 c..-4/2 GI .+--. 1 / c 1911 TYPO UNVUP PIMA r w. 40. Gas Service-Final •Z13 - -►I-3 .'- 1 4I. Solar Bomestk•final tVIL[IINQ AnnRFSS 4F is• ar E77t (' tJ r:.f �?.•. TRACT LO aaz S. ,. _ .. NEW ADO ALTER REPAIR , MOVING_ 1) ISR _.- 44_-12t1512PeWPM°*Om FA"Aealldion ,,. _. OWNER 46. Handicap RegulaSas ,,.(__, .f t.c'.t-- USE' 47. FINAL STRUCTURE d BUILDING "' C w,•N PK re J /. 5 '&L.;&L.; ( 48. FINAL SPECIAL REQUIREMENT'S t .L.:...-• .p et. POOL 6 SPA J SETBACKS APPROVALS Permit# Front Yd Side Yd. L. .— R Rear 49. Pool&Equipment locationr /‘ all' dr Side Yd. L, R pear 50. Steel Reinforcement CONSTRUCTION AND PUNNING , 51. Forms - APPROVALS Permit P • Data52. Sepltcl PrOti III1T1. Temporary Elul . 1:' Dili 53. Rough Plumbing d Pressure Test 1A a Soil Pipe•Undergrould . . cat ,54. APPflDVAL TO COVER•OUraTE S,' Li 3. Electrical Conduit Utility- nderglolmd 75 2A 56. Tindal Conduit•.Undegoimd 4. Electrical • - � .. -Urtde 1 1 rid • ears. -e a — _... —. 5. SteelRZ;;;;WinTh- . .. .7546637 57. Backwash rites,PInv, r:unci bout I. 1111r711 6. EItetr ea!LIFER GIS. 58. APPROVAL TO DECK 7, Footings 59_ Backwash ii R ,-i or•Final •Le, B. Foundations 60. Heater&Vent final liFf4' M1 1.1_•_•11:__ 1.-J_�-_.._J _. .•. . . _ -. ... -• ___ to. riumoing.bystqm -i-mal_ 4.10. Structural Floor System 62. Electrical•Final bite* Y�^ 11. Property Sewer Line&Nouse Connection 63. Solar System -Final 12. Sewer Cap 64. Fencing&Access Approval 1/St/ / ' 13. Moot Drains fig. APPROVED FOR PLASTERING j7Ay, /dr lr l � 14. Rough Plumbing 66. POOUSPA SYSTEMS FINAL /f 15. Rough Electrical-Conduit FIRE DEPT.REQUIREMENT 16. Rough Elecrnc Wring APPROVALS Permit;iE 17. Rough WSry 5591 7 i, ,; 1.1 _11..4:.4 - deare f14 'et ,,.,., .. . . _,., '. .ri 1 t' .. ,• "A�Y ,�� dY11�1 .� �likdlimw +. .ou;, ', I. 171/. Underground Staa4e Tank❑Gas❑oi! !i.Ducts,in Stmctto , 71. Overhead Hydro - !2. Ducts,VentiMlirtg 72. Dry Chemical _ 3, Gas PO•Rough&Test 73. ON Standpipe 1. Root Framing ..- 74. FIXED SYSTEM FINAL 15. Rous Sheathing 75. ARE PREY.FINAL W. T-bar Ceiling(Structural)&Monocoat Notes Se—��l av Niro_ !7. Frame and Flashing V-19,-* M. /9.- - !8. Lathing&Siding !9. Insulation — 30. Drywall Nailing - ro ass ravorse for atfl0nal notes) TOTAL P.02 04-15-1996 07:09PM FROM SEIKO POOL CO. Tustin CA TO 7544856 P.01 • 7T/v : ' /A-r/1le/ A rx , ; r; 15 :it 1y1'q a _ _ _ _ C"--777.11,\ I • . a. V,. i :�, 754. 4 856 rtd 3 SEIKO POOL CO. Dawn 445196 Fax #; 1-714-731-0893 OFC. 1-714-731-3177 ES INCLUDING COVER: DARYL GAMKEMA / DEMMIS GAMKEMA / TOM OUELLET -PD.IECkADDRESS: 2774 MALLARD DR • UNIT: IflomifR•S NAME: BECKER, STEPHEN ROY CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 066756 moms: BECKER, DONNA .C.‘ PERMIT NO: P 066756 PLAN CHECK NO: N GOVT: N SUPP : N 2774 MALLARD. DR" ' COSTA MESA,CA I 92626 CONSTRUCTION TYPE: V-5 PERMIT TYPE: PLU PURPOSE: OTH 714 ) 545-4914 ' ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL POOL & SPA SQ FT; • ADDRESS: j UNIT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: SEIKO POOLS (714 )731-3177 ADDRESS: 285 E MAIN ST 12 COMMENTS : RE: B66753 TUSTIN CA 92680 ************************* *+raH*+PSE**+eek******aP*+ex*>E** aal+Erik****aEx*xa6T6**+r**a ******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: 017532 _STATEm:_388790 cuss: 53 Dae: / G' Signature:0 �/ 3 MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATIONIp�gWppk DECLARATION:p� ea�PRhereby affu that l have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Wl.lA tcatlUed.cttkrsof(Section 3BOO.Lab.C)1 /01 /94 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: W MIA C]9 /b tM:11]] EXP. DATE: 1 COMPANY: CNA INS ,,ii!C PARKING REQ: PROV: PARCEL: 13954202 ZNE: REF NO; 1:1Certilietl copy is hereby furnished. L•J Certified copy is filed with city Building Division PLANNING NOTES> x rate: „ L Applicant:� r ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less), DEVELOPMENT SERVICES REQUIREMENTS 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 become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE; Date: Signature' BUILDING APPROVED BY : ode.NOTICE:If.afterstmaking thiscdeclaration,wihu should become or sprt the Workers' rempensation provisions of the Labor DATE Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: /" ///y , ; DATE: C which this permit is issued(Section 3097.Civ.C). ************************ ****** * * ***I ***** *************** ^� •* *.•** LENDER: *************************************** *** ********************************* ADDRESS: LEGALIZATION:N F E E S U M • R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC_ FIRE SMIP/RES GRADING (Section 7031,5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 .00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25* pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN SMIP/NON—RES and Professions Code)or that he/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). ISSUE FEE 20 . 00 . • BUILDING DIV > PERMIT ISSUE PLAN—CHECK .TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS 7 , 00 20 , 00 0 , 00 27,00 27 , 00 , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner Of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 27. 00 OVER/SHORT: • 00 improvementisBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose se ools within one year of completion,the owner will have the burden of proving he/she did not build or improve of sale). 27 . 00 I.as rof sr of s the depe h, Com tractsis'S ate License withw licensednot contractors toconstructof oertht project hbuilds ov. thereon • ❑ and who contra tsdt The projects State License Law does not apply to on ownerer property Salic or improvesI thereon and who contracts for such protects withacontractor(a)license pursuant to the Contractors' late License Lawl. lam aware *************************************jE**iE*iE******;1F***************************** that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL F E E B R EAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Date: Owner: PLU 1 SWIMMING POOL • 7 .00 7 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant vrill/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: EXPI • 1 hereby certify that I have read this application and state that the above rction is correct.I agree to comply with all city and county ,i I ordinances and state laws relating to building construction and hereby authorize ize rerepresentatives of this city to e er upon he above-mentioned r 1 /IL/94 property for inspection purposes. i / / '�. v 01 (s'Oi`3684—QIJl`36$4 TOT 27.00 property DATE _41119P DATE: 04!11/94 TIME: 16:07 d' N— t —�L/ Signature; V✓ / / I Driver's License or Social Security a: ' - ' "-N 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • I if CONSTRUCTION AND PLANNING rUOL & SPA Date Inspector Date Inspector APPROVALS Permit ,-• APPROVALS Permit# -. 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 - 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test -4--2.5' t iq.� ' ' 6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE ` ' . 7.'Footings " 58. Electrical Conduit'Undrgrnd- 8, Foundation - 59. Gas Piper Undrgrnd.,Test 4-�Lij'g4i�`s T 9. 'Tater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10...Structural Floor System 61. APPROVAL TO DECK 11. P aperty 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 67. Fencing & Access Approval 17. Rough Wiring Sigi 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20.•Rough Factory Fireplace - - - 'APPROVA'LS.' . .Permit #. 21. Ducts,in Structure.' ' ., -; -' :70. Underground'.9c-0und.H. 22. Ducts, Ventilating " "•'r ']1. Product:Piping 0Csas 0 Oil 23:'Gas Pipe'--Rough &'Test ; • • . • 72 . Underground Flush_ .1t n.: + 24.-Roof Framing . - _ - ' '73.'Undergrnd:Storage:ank 0 Gas 0 Oil ,� .r c 25. Roof Sheathing 74.'Overhead Hydro; 'Ti 26. T-Bar Ceiling (Structural) &:Monocoat - ' ' 75. -Dry Chemical ' -_ B • 27. Frame and Flashing :: �. _ 76: Dry Standpipe y -- 28. Lathing& Siding , _--,, _ • •• 777 FIXEDSYSTEMIFINAL" '29. Insulatidn - ` " I '' �• 78:'FIRE PREY. FINAL - • 30. Drywall Nailing ( -. I- •HEALTH.DEPT. REQUIREMENT 31. Piaster Brown Coat; s ,_ 79' F1NAL1NSPECTION - 32.•Electrical Power Meter.Final - I :80. FOOD CERTIFICATE ISSUED - 33. Final Electric . . Notes: 34. Final Heating-& Air'Conditioning,: ' - I ! 35. Final Gas Pipe-Test j--- ? .3M-C)..12_ . /�!�a;J 36. Hood or Canopy 1, n - - "" I' 3-'2.6)-g6=moo s -T `j 37. Final'Factory Fireplace - 7--.... ' i • , ' f i/-1. �/p/ a,„ _ - 38. Final Plumbing - • _ _ 1 lll�/6/76 � /� 1 39. Water Service-Final- t /L//6/4.6 f i ,E -; er i -40. Gas Service-Final .• - - n '41. Solar Domestic-Final - I -42. Backflow Preventers - ` - - . - 43. Backflow Irrigation• - .- 1 44. Landscape Irrigation System - • - ' •45. Sound Attenuation • n - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING I i it - - - I 48. FINAL PLANNING • I • 49. Electric Release to Edison r , 50. Gas Release to Southern California Gas Co • - 51. CERTIFICATE OF-OCCUPANCY . - No. Date I DEC-16-96 02 :24 PM >91 Real Estate< P. 01 A sem.-. - - STA TE. FAX - 968-2979 FAX 1NFORMATTON SHEET TO; ./t-Z"..�- FROM: DATE h 'TIME: .Z /1/29 Atee, /L--,,t.)-.5L NUMBER OF PAGES ( [NCLUDES 'PH IS SHEET) It 1F' ALL PAGE.5 ARE NOT HECE[VEl1 PLEASE CALL (714) 968-4456 eJ.-, ,x. Z7 - /lWecMCP -at- 4'75ii, (1 'Oto Exte1(en.:e CJCVIt:@PSU/ls- 20c'S 1(4Vo$hmsl,Sl. AwVMglon Pour A,CA 926.16 lecp?.one 714/9(4 4,00 Fox 71d/OnS /9 BEC-]6-96 02:24 PM WAR Real Est at e< + P-02 HUILUIIJG SAFETY DIVISION 33. Final Electric __ _ =1"-L�4 POST IN CONSPICUOUS PLACE 34. Final Heating&Air Conditioning ON THE JOB 35. Mal Gas Pipe•Test NOTICE 36. Hood or Canopy You must lumish PERMIT NUMBER and the JOB ADDRESS FOR 37. Final FactoI fireplace EACH RESPECTIVE INSPECTION. CALL 754 5627. APPROVED - - - -- PLANS SI TALL HF ON JOO AT ALL TIMES. 38. final Plumbing A r•,Nye DAT ri°E' 39. Water Service Final tree I DAMP PERMIT NO QD. Gas Service Filial 9 L... 41. Solar Domestic-Final eUtONG ADORFAS . ---' -'- . 2.7 7 r -" /r.iV. f , 1, 42. BaddlowPreventer TRACT Jim BLOCK L 41 Backllow Irrigation NEW ADD ALTER ntrAin I MOVING DEMOII;r, 44. Landscape Irrigation System r -.. __. ..._ _ 45. Sound Attenuation -. . owNcn ; `, 46. Hanka Regulations -�--- - -" USER a 47. FINAL STRUCTURE&BUILDING .-_ .._ .. 48. FINAL SPECIAL REOUIREMENTS POOL&SPA ._ -- SETBACKS APPROVALS Permit 1_•_ Front Yd----_Side Yd. L----- . H Rear- 49. Pool&Equipment Locationy//, V (41.412- Side Yd. L - R. Rear 50. Steel Reinforcement V CONSTRUCTION AND PLANNING 51. Forms DPT-.L,.otaa APPROVALS Perm11 -- 52. Electrical Bonding - 1. Temporary Electrical Se (cepOR INSPECZI,.�`. 53. Rough Plumbng A Pressure Test _ -a4 -7 i_e4- 2. Soil Pipe-Underground CAA It--- 54. APPROVAL TO COVER-GUNITE -., 94IeiEr 3. Elecllical Conduit Ufilily- nderground I 55. Electrical Conduit-Underground - 954.0626 J 4.Electrical Conduit-Under round 56 Gas Pipe V Underground Test 7h,,- - 5. Steel Reinforcement --754•562Z. 57, Backwash Lines.P-Trap,rya Unrkyround 4-2S , 6. Electrical UfCR Gmd. 58. APPROVAL TO DECK p 7. Footings - _ __ - - 59. Backwash&Receptor-Final _- 4- `.C• 8. Foundations 60. Heater a Vent-Final j-n c Cr 9. Water Pipe-Underground - 61. Plumbing System •Final {,i9 4 10. Structural Floor System - _ 62. Electrical-:Final _-_ 4*-9f air I I. Property Sewer Line&House Connection 63. Solar System •Final 12. Sewer Cap _ 64, Fencing&Access Approval _ I Vat. 1- 13 Root Drains _ 65. APPROVED FOR PLASTERING 7 ,J y_�/ ^ 14. Rough Plumbing 60. POOL/SPA SYSTEMS FINAL '//f/$.e 4- 15. Rough Electrical-Conduit _ _ FIRE DEPT-REQUIREMENT •`` • 16. Rough Electric Wring__ -..-- APPROVALS Permit I •_ 17. Rough Wring Sign 4?. Underground Hydro 18. Rough Electrical-T Bar Ceiling _ 68. Product Piping ❑Gas ❑Oil 19. Rough Heating&Air Conditioning 69. Unde_rground Flush •• • 20. Rough FactoryFn --I Fireplace -�. _ 1 ._ 70. Underground Storage Tank[]Gas Elgt •_ 21.Ducts,in Structure 71. Overhead Hydro 22. Ducts.Ventilating _ -.- 72. Dry Chemical - l 23. Gal Pipe-Rough&Test _ --_ 73. Dry Standpipe 24, Roof Framing _ - - _,._ 74. FIXED SYSTEM FINAL _ 25. Roof Sheathing _H 75. FIRE PREV.FINAL 26.1-Bar Ceiling(Structural)&Monocoal _ Notes; 1- S -- ell re gy full(/Cy - 27. Frame end Flashing 26. Lathing 8 Skiing _. �` J _.. (_ .-. • . 29. Insulation 30. Drywall Nailing^.. _ . 31.Plaster Brown Coat --___ . - ,_ (sea reverse lot additional notes) mala 9,M to.,503 weal Estate< P. 03 Mvx7 /YI A4et ra o n c rty r �xsh. /1es1,�{ A CL-etc4,c4) 1 s "f'R kic,lc CAR .P CP tl� VACJECTADDRESS: 2774 MALLARD DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 066754 OWNER'sNAME: BECKER, STEPHEN ROY ADDRESS: BECKER DONNA C PERMIT NO: E 066754 PLAN CHECK NO: N GOVT; N SUPP : N 2774 MALLARD DR COSTA MESA CA 92626 CONSTRUCTION TYPE: V-5 PERMIT TYPE: ELE PURPOSE: 0TH 714 ) 545-4914 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL POOL & SPA SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: SEIKO POOLS (714 ) 731-3177 ADDRESS: 285 E MAIN ST 12 COMMENTS: RE: B66753 TUSTIN CA 92680 **aEHy6t **EE**et*RE**tE**tEEEEE****tE*+E**-x**x**EH*N-N-***1r****Rr**a6*ac-+taERk**yH**tE**R6EHtE****tE***+ctE LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONI NG REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SE TB ACK S CITY LIC.: 017532 STATE LIC.: 388790 CLASS: C53 / oat - Y" 9`f Signature:-�el-leze MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ampensahI� Lel on w w, ettilied.?Ott of(Section 3800.Lab.c)). /0 1 /9 4 COMYNO.: CNA INS /C�.1J EXP. DATE: PARKING REQ: PROV: PARCEL : 13954202 ZNE: REF NO: COMPANY: ,,yy O ❑ Certified copy is hereby furnished. L'_T Certified copy is filed /withh the_ city/Building Division. PLANNING N TES> .�/ - L� ii ��i-, > Oa '� ^ Applicant:�� ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMEN TS 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 become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY : DATE; Date: Signature: BUILDING APPROVED BY NOTICE:y:If,afterstmaking this dpy ts,you shouldo become subjectoto the Workers' rempensation provisions of the Labor DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; [�,1� 1��,/�h�'L DATE: which this permit is issued(Section 3097,Civ.C). ************************* **** lE**** ** ******************** © ** LENDER: ********************************************* ******************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 30 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN JFM I P/NON—RES and Professions Code)or that he/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). ISSUE FEE 15„..—CHECK 5 , 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044 ,Business and Professional Code: The Contractors'State License Law TOTALS----> 30 . 00 15 , 00 0 . 00 45 , 00 45 . 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale. If. however the building or REVENUE DIVISION TOTALS--> COLLECTED• 45 , 00 OVER/SHORT; . 00 improvement is sold within one year of completion,the owner will have the burden o7 proving he/she did not build or improve iroe purpose of ). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK sale). I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me, IND I VIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner. ELE 1 SWIMMING POOL — IN GROUND — NEW EA, 30 , 00 30 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a - permit for construction or modification from the Air Ouality Management District.Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have read this application and state that the above intormation is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of thiscity to enter u n the ve mentioned 01 00158680-00158680 TOT 45.00 property for inspection purposes. OATEs 04/11/94 ! �yL / TIME: 16:05 Date: Y l D/ '7 / Signature: / r I ricer's License or Social Security x: 1641-45 While—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor 1 CONSTRUCTION AND PLANNIL_ . JOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1 1. Temporary Electrical Service or Pole„ 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. v ` • 53. Steel Reinforcement • 3._Eleetrical Conduit Utility-Undrgrnd.'• 54. Forms •4:'Electrical Conduit-Undrgrnd. _ 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Etegtrical UFER'Grnd. 57. APPROVAL TO COVER-GUNITE _ •• 7. Footings I 58. Electrical Conduit-Undrgrnd. _ •8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final {� 12. Sewer Cap 63. Heater & Vent-Final 13. Roof 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 I 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace i s;% c' ^ + •• .APPROVALS" :Permit# ' _ r< _ 21.:pug:s,in•Structure: .. • -- • ;70, Linderr-giound Hydro -' 22 Ducts, Ventilating - 71. Product_Piping GGas 0Oil 23. Gas-Pipe'Rough &'Test • _ . r_ ` . , _472. Undergrotincl Flash, 24. Roof Framing %„ - , -•- 73.• Undergrnd.Storage'Tank 0 Gas ❑Oil 25. Roof Sheathing - - , 74. Overhead Hydro'• 26. T-Bar Ceiling (Structural) & Monocoat - 75.-Dry Chemical ` -+ - - 27. Frame and Flashing; '• _ , 76. Dry ' �I :Yr T. _ _ Standpipe . 28. Lathing& Siding •• ••_ Y 77: FIXED SYSTEM' 29. Insulation , ` . •' '' t i, •• 78.:-FIRE PREY. FINAL . . • .30. Drywall Nailing . -' _ - HEALTH DEPTt REQUIREMENT 31. Plaster Brown Coat' , ii. , .29. 'FINAL INSPECTION, , 32. Electrical Po.ver Meter-Final ' ii/ 1 n3...FOOD CERTIFICAT.E ISSUED . 33, Final Electric • 1 -A oil Notes:. -17- ; --at R Iy/ . Irl--/� �1 n ! (F�" 12,34. Finai Heating'& Air_Coriditioniiig_ - _ 35. Final Gas Pipe-Test I' ' - 36. Hood or Canopy . • Iti . - ' . 37. -Final Factory Fireplace _ s • 38. Final Plumbing . 39. Water Service-Final f - . 40. Gas Service-Final _ t - t ,,, I f • _41. Solar Domestic-Final ' • •• _a ' I f . •42. Backflow Preventer -- - - 43. Backf low Irrigation- • I' -. - r 44. Landscape Irrigation System- -r v _ - 45 .:Sound Attenuation .. 46. Handicap Regulations •. ' •• 47. FINAL STRUCTURE & BUILDING ' 48.1FINAL PLANNING' • .49. Electric Release to Edison - ' 50. Gas Release to Southern California Gas Co • : : . - 51. CERTIFICATEOFOCCUPANCY - • No._ Date Ii s W el /`t1Asi_E?tan ) 7 f4clim ,.e. PRDJECTADoRESS: 2774 MALLARD DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06491 : OWNER'sNAME: BECKER, STEPHEN ROY ADDRESS: BECKER DONNA C PERMIT NO: P 064913 PLAN CHECK NO: N GOVT: N SUPP : N 2774 MALLARD DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: 0TH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REMOVE 6 REPLACE W/NEW WASHER SQ FT: ADDRESS: PERMITTEE: G N R INSTALLATIONUNIT: (714 ) 505-9441 CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / II ADDRESS: 716 N VALLEY D COMMENTS : NO OTHER WORK IS PERMITED . ANA. CA 92801 ;'r*****yr******iex**************QEµ****>E*a6ar*****prow*7r****at**+t******** war*r;.*****a* I LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIREMENTS 7000)of Division 3 of the Business and Processions Code.and my license is in lull force and effect. SETBACKS cITYLIC.: 058868 STATE LIC.: 622456 LASS: C-36 / Date: ti 1 6_S Signature:_ MAIN BUILDING ACCESSORY BUILDING /......-- WORKERS'COMPENSATION DECLARATION: hereby affirm That have a certificate of consent to self insure or a certificate of Workers' FRNT: FT I N REAR: FT I N FRNT: FT I N REAR: FT I N compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL : 42612130 ZNE: REF NO; 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NUTES> • LLEE�� Dale: Applicant: N EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). 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 certify that in the performance of the work for which this permit is l shall not employ any person in any manner so as to become subject to the Workers' Coo�pensation Laws of California. ZONING APPROVED BY DATE Date: /l aftD °(�) Signature: BUILDING APPROVED BY �� ode.NOTICE:It.after making this dpy with s,you should become or subjectemithe a Workers'mrevoked. ---i- 1 vo Compensation provisions of the Labor : DATE: Code.you must forthwith comply with such provisions or this permit shall he deemed revoked. � CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: �� DATE: I I l � which this permit is issued(Section 3097,Civ.Cl• *'******'**'************************r :'3i1*Yr* ***************************** ri'*3F'*Fx H-*, LENDER: ******************************************************************************* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or 1.. repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 254 SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/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 live hundred dollars($500). ISSUE FEE 20 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS—---> 7 . 00 20 , 00 0 . 00 27 . 00 27 . 00 00, does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. Il,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 27 . 00 OVER/SHORT: . 00 improvement is oomose of sale).within one year of completion,the owner will have the burden of proving he/she did not build or improve or the purpose BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such Projects with a contractor(sl license pursuant to theContractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN O I am exempt under Section: B.14 P.C. tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 DISHWASHER I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 7 . 00 7 , 0 0 25534 and that I or any future building occupant will/will not(circle one)need to compty with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property fore inspection purposes. /'» Date: /�rP'� Signature: L/—_/(/, 01 00150732-001507n TOT 27.00 Driver's License or Social Security P: 558- 11/16/93 TIME: 09:00 164146 white—Building:Green—Code Entorcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNINu POOL & SPA APPROVALS 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 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit•Undrgrnd. • 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64, Plumbing System S Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 9 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. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure , 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing , / T / ---_--- • 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING _-- 49. 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 2774 MALLARD DR ( ZE UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 066755 OWNER's NAME: BECKER, STEPHEN ROY ADDRESS: BECKER DONNA C. PERMIT NO: M 066755 PLAN CHECK NO: N GOVT: N SUPP : N 2774 MALLARD DR COSTA MESA CA 92626 CONSTRUCTION TYPE: V-5 PERMIT TYPE: MEC PURPOSE; OTH 714 ) 545-4914 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL POOL 6 SPA SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: SEIKO POOLS (714 )731-3177 ADDRESS: 285 E MAIN ST 12 COMMENTS: RE: B66753 TUSTIN CA 92680 *+t***BF+r+6*****x***x*****aFatal***aret*-x*sl-***kl**arkrkEar*******1t**+FBE-*****Br*****k6**kt****BrkrB6 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: 017532 STATE LIC.: 388790 SS: 3 Date: f/.� 5 — yL-/ Signature: t �� MAIN BUILDING ACCESSORY BUILDING GRUBS'COMPENSATION DECLARATION: I hereby alfirFi that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR• FT IN .ompensation Insurance,or a certified coy thereof(Section 3800, Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY No.: WC 112 5 8 5 4 76 ED EXP.DATE: 11 /01 /9 4 COMPANY: CNA INS PARKING REQ: PROV: PARCEL : 13954202 ZNE: REF NO: ❑ Certified copy is hereby furnished. EX Certified copy is filed with the city Bu Division. PLANNING NOTES> —� 7 — /// > • Dale: Applicant: / �r ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TICs section need not be completed if the permit is for one hundred MOO)or less). DEVELOPMENT S E R V ,I C E S. REQUIREMENTS 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 become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • • DATE: Date: Signature' DATE: NOTICE:U.after making this with you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY —- Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / /J�lp CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance o1 the work for APPLICATION ISSUED B Y: C/`�, DATE• sF +firTr*br which this permit is issued(Section 3097.Civ.Cl. ************************ **** * **** ** a** ** *************{l.** *. .*.* LENDER: **************************************** *** ********************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 ,50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 25% SMIP/NON—RES and Professions Code)or that he/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). ISSUE FEE 15 . 00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 9 . 50 15 . 00 0 .00 24 . 50. 24 . 50 . 00 does not apply man owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 2 4 . 50 OVER/SHORT improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improveO O for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to owner of property who builds or improves thereon and who contracts tot such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware ***************************************************.**.******+**.************.****** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I em exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date; Owner: MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 . 003. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 EACH APP L NOT IN OTHER CAT UNDER FEE 6 . 50 6 . 50 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to budding construction and hereby authorize representatives of this c to enter upon the above-mentionede 01 OO1.r8681 001e3631 TOT 24.50 property tor inspection purposes. DATE: 04/11/94 TIME: 16:06 el' Signature: "/ C 1 a linker's License or Social Security x: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNIhni• POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Servtte or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _, • 53. Steel Reinforcement 3. .Electrical Conduit Utility-Undrgrnd., ' 54. Forms ,i - 4'. Electrical Conduit-Undrgrnd: . - 55. Electrical Bonding 5: Steel Reinforcement _ 56. Rough Plumbing & Pressure Test - 6.'Electrical UF ER Grnd. - 57. APPROVAL TO COVER-GUNITE 7.'Footings - 58. Electrical Conduit-Undrgrnd. ______,..c----- _ 6. .. 59. Gas Pipe,?/drgrnd.,Test / 2s. 9:. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10, 'Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final 12.'Sewer Cap 63. Heater & Vent-Final 13. Roof Drains64. 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. REQUIREMENT • - 20. -Rough Factory Fireplace .i _ - - 'APPROVAL'S' Permit # .. _ . . 21. Duch,is Structure • _ y,-, -i70. Underground Hydra 22. Duets, Ventilating- .., _ -71. ProductPTping , Gas OOiI 23. Gas-Pipe:Rough & Test 4'4]- • 72. Underground Flush 24. Roof Framing _ 73. •Undergrnd:Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - , • 1I 74. Overhead Hydro ' • 26. T-Bir Ceiling (Structural) & Monocoat '' . - 75: Dry Chemical 27. Frame and Flashing _ .. - 76. Dry Standpipe 28. Lathing•& Siding •• •• • 77. FIXED SYSTEM FINAL '29. Insulation , -' ' 7B. FIRE PREY. FINAL 30. Drywall Nailing - t HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat _ .,.79. -FINAL INSPECTION - �! 32. Electrical Power Meter:Final _ .2- 180. FOOD CERTIFICATE ISSUED 33. Final Electric • - ; rotes: i-- ) i - zi- 'l/tt erre t�:rtc ' ,�� '34. Final Heating& Air,Conditioning 35. -F.inal•Gas Pipe-Test* ,/_15 ` _ 36. Hood or Canopy '� J ^37. Fina! Factory Fireplace - _ ' i . • _'' i 38. Final Plumbing 6--pp -A• It" i-11 39. Water Service-Final _ i I • r 40. Gas Service-Final _ �Ic"I .1.1. . 41. Solar Domestic-Final - . f 42. Backflow Preventer, r 1 . .. t 43. Backflow Irrigation ' 44. Landscape Irrigation System ,• '' • - _ . -, A5. •Sound Attenuation ^ :. - i- ` ' 46. Handicap Regulations •- , ' •. 47. FINAL STRUCTURE& BUILDING - . 48. FINAL PLANNING - r . , • 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co y' 51. CERTIFICATE OF OCCUPANCY- . No. Date OWNER TURNER, ROBERT DATE 9-19-77 JOB ADDRESS 2774 Mallard Drive BUILDING PERMIT NO. 44671 GENERAL CONTRACTOR Owner-Builder DESCRIPTION of WORK Add Bay window to dining area AP No.139-542-02 LOT TRACT FIRE ZONE VALUE $ $00,00 INSPECTIONS Signature Date TYPE ry GROUP T ZONE R—1 SOIL ' SUBCONTRACTOR PERMITS ISSI(ED GAS Date I Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER O q ROUGH WIRING C ` /a-f 'V) Heating and Vent. . . TRENCHES p FORMS I] STEEL REINF. FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING A FRAME AND FLASHING C /0.13-77 LATHING - IN ✓ OUT n C,C PLASTER. BROWN COAT STRUCTURAL, FINAL Electric, '/'�y7�/ � HEATING, VENT., REFRIG. AND A,C., FINAL �-(d$77 ti� Ottc • 91-19-17 '7�`'941-- PLUMBING, FINAL AND GAS TEST n 7 ELECTRIC, FINAL et, 11• f-71 BUILDING, FINAL a fe. g• ,/ • PAID r 4 4 6 71 SEP 19-77crus400 856# *****8.50 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only A �t/,/t /J RECEIV DATE RECEIVED (D3aTTEJ}S ED7 BUILDING ADDRESS �a e•or/// // H� L L Z .�!L A.ed L�• GQCt 7R A /3 9' sem, 2.QcR PERMIT NO. OWNERre A.P.NO. S `� ��f ,Os86Y7 l/J2AlL"�l' BUILDING ADDRESS �a774 4&Ls.ao '/j,MAIL ADDRESS 2//?�y �«R� mR -n TEL. TRACT4S2S7 LOT./ BLOCK CITY Cp,(T/a /0675 Al NO.5.41?3C3 9 CONSTRUCTION /� NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER /i• A . - / BRANCH v p T OWNER rag 9 • /(//2ti/e ADDRESS ADD a fT �y,/t�ALUE ops/ S• ARCHITECT //�� TEL. SASE Iv 1R.�e'� $ 9g �_ OR ENGINEER (/G/.Vt?P, NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR O(,,iare_ BY DATE ADDRESS TEL. ZONL, NO,OF USE OF NEW4 P V / CITY NO. /� �/ PLANS 2 /i BUILDING k. ►DoW f^" STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 61,1 SIZE NO.OF BLOCS. (FROM C/ S 13E EIS Cr OF LOT NOW ON LOT FRONT ip F C FT. Q USE OF , rn EXISTING BLDG. 'asia eider R.SInF /"5y FT. FT, Separate permits are required for L.SIDE.2, / FT. FT. electric,plumbing and heating work. , ...,,w REAR ft/ FT. Al USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& Qj(1•ID,�F7'� MAIN BLOCS. ACCESS.BLOCS. ..1VAR.* DATE Q Atn7-/o41 eI Roc)L{//,VDPW 'TC C.U.P.# APPROVED bb APPROVEDQ/ � T 7-19-77 - ('Ra7ecr 4/'PLov6 ce ha N PL�CO7/e,✓ of W O I/f'P'C PC-1M i r /tom yo733 APP,Csvd' to I hereby acknowledge that I have read this application and state n X that the above Information Is correct and agree to comply with m gi• all laws regulating building construction, and I shall not employ OA/ /o-/G-7S' Z any person In violation of the workman's compensation laws of la a the State of California. X I hereby certify that I am properly licensed as a contractor under SO. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business `tet ^ v and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE S /{ i f:/� V 00 PLAN CHECK $ 0o Signature Of.�J� �. '7� U. Permittee F V+.`s 'f' s.wti`w/ $ 8©O ^_ U. TAX $ • 5.-0 f /yU Authorized Agent TOTAL PAID $ .I�. co? LIwitrm MESA VERDE BUILDERS, INC. UAlri 4-19-b7 JOB ADDRESS 2774 Mallard Drive BUILDING PERMIT NO. 26916 GENERAL CONTRACTOR Mesa Verde Builders, InCDESCRIPTION OF WORK Res. W/Att. Garage AP No. LOT RC) TRACT 6237 FIRE ZONE VALUE $ 32,495.00 INSPECTIONS Signature Date GROUP I & J TYPE V ZONE R-1 soil /�j� di� SUBCONTRACTOR S-O7 I PERMITS ISSUED Gas YcY 6_(S Date i Number I Signature Water 4-tcc7 Plumbing Rough Plumbing 4-rlr7 .t.t t� ' - ,4�-2/0/7�h Prop. Swr. Line pi-louse Con.(n"----- 7_ c is,/ is/, A . .../.0 /'. /p;9-(o Sprinkling System Miscellaneous Rough Heating and Air Conditioning . Ja f`7 Temporary Service or Pole Underground 0 Power L] Rough Wiring (x-14-&7 / Heating a d Vet. Trenches ® Forms El Steel Reinf. p ,f--/—&7 `I ivif Ai-4YLLI°i, -4"--,2-„7 -Thor Floor System I'll- F7 Bond Beam 0 Steel Reinforce 0 -,� � Sheathing M-�(a 5' 6n Frame and Flashing /0114 6-/y_67 Lathing— In eJ Out El .en) 7-4-e.,67 Plaster, Brown Coat /Oa- I_„ -Gy Structural, Final .,, ectri Heating, Vent., Ref rig. and A.C. F'•al, a� /y�/iintf _, 4:Eb, . 17220 Plumbing, Final and Gas Test rir Sr Electric, Final A' - q-i"1_6 Building, Final a- j4 1r 269 --I/COSTA MESA BUILDING-SAFETY DEPARTMENT APR ZS 67Cff5aCO7244'Y e--**.147.00 FF,O.BOX 917 COSTA MESA,CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT Lot 39 TYPE OR PRINT'L'ract 6237 BUILDING BUILDING /J �J �7'�/ /^/,/,�1 ,/ T �j For Office Use Only ADDRESS 2 / / J //(Ti/ita De RECEIPT NO. COSTA MESA. CALIFORNIA '�"' - REV Bq ' RF sIVrp DAT ISSUED OWNER Mesa Verde BuilderInc. /d_ 7-�-- 7 Z-/-/9-‘7 PiatabaXgkrboCINXbdeMPOOMCC MAIL O BUILDING ADDRESS 2850 Mesa Verde Drive ADDRESS Cr- TEL. ipFIRE �J 'M`COSta Mesa TEL ZONE TYPE GROUP \\d /APPROVED AF.OR...GIENEER Kaltenbach NO' BY DATE ADDRESS 1823 E. 17th Stanta And ZONING ��{{ 'Inc .LZO E NO. ^ USE OF NEW (kL Mesa Verde Builders I ��/ i PLANS I BUILDING CONTRACTOR 711104R1X9uQi¢i�XFC}OC LEGAR //w.T3 /—T, / �7. ADDRESS 2850 Mesa Verde Drive DESCRIPTION �Y/�"� /l CITY Costa Mesa, A.P.NO. NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIC..NO. 187318 ATE TEL 549-0395 SO'TO SIDE BREAR P.L, ( EAVES SIZE G y x I O J NO.OF BLOCS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW on LOT 0 USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET/ SETBACK LINE FROM FRONT ,2.137. FT. CENTER OF STREET REAR YARD 5 SIDE YARD LEFT I RIGHT R.HIDE FT. FT. DESCRIPTION OF WORK L.SIDE 5 FT. FT. NEW X ALTERATION ADDITION REAR fli(/ FT. - FT. DISTANCE BET. BET.MAIN 2 MAIN BLDGS. ACCESS.BLDGS. REPAIR MOVING DEMOLISH VAR.# DATE BUILDING NO.OF SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALLf,,, ROOF Shake "P797414.14,17,� '//p/� COVERING otUC COI COVERING Shinwle BY DATE 7 �0 (/! USE OF HU'LOINS AND WORK TO BE PERFORMED New Residence I H N 4/4"24.2 ya70.Fr G ,4 I HEREBY ACKNOWL GE TREAD THIS APPLICATION THE AMOUNT SMO UNDER VALUATION IS FOR TH8 AND STATE THAT THE ABOVECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. p PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION m BUILDING CONST UCTION.SIGNATV� PERMIT FEE $ '� N N PERMIT}U'eP OF „�• �� .�I p' y�/7� CO s 3_/ �/ ECK $ / O ,y7_ L AUTHORIZED AGENT i TOTAL FEE 4OWNER TURNER, Robert R. DATE 10-16-75 JOB ADDRESS 2774 Mallard Drive BUILDING PERMIT NO. !►0733 GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Ftg. to extend Dn. Eta, eacl.Pati AP No.139-542-02 LOT TRACT FIRE ZONE VALUE E 1,100.00 INSPECTIONS Signature Dote TYPE V GROUP I ZONE R-1 SOIL GAS SUBCONTRACTOR PERMITS ISSpIED Date I Number I Signature WATER Plumbing ROUGH PLUMBING I I PROP. SWR. LINE ❑ HOUSE CON. 0 SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND 0 POWER 0 ROUGH WIRING farm AL C, 11/3-95 Heating and Vent. TRENCHES !j - FORMS STEEL REINF. 0 .Qtc_ ,/Z/ FLOOR SYSTEM BOND BEAM n STEEL REINFORCE n SHEATHING FRAME AND FLASHING figt c_ /f-i3-7 LATHING — IN OUT rf 4 .C- /2.4S-i6 PLASTER, BROWN COAT STRUCTURAL, FINAL RLL /]1 7n, Ele[ ri HEATING, VENT., REFRIG. AND A.C., FINAL rtl . 44 / r /e - 91316,a-i PLUMBING, FINAL AND GAS TEST H v _-/ ELECTRIC, FINAL f,t/4gP�4 v#414,t/.-%.25 RIIII nING FIN Al r -U__. . J e.. .a �S_'e. A/ /21:5', , . PA. 46733 "CT 16-75-a .O3 689-r -- .:*'17 n C COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP LI AT N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only R Ell DATE RECEIVED DATE ISSUED �//BUILDING /J ,/ j� �/f (Or //�fADDRESS iG 77'l .QARD jJ . tTA// f9 2 ,1 U /5 77.4-72AP NO/99y5JERffftttAAAIT NO. KOWNER IRp8�2.T /C• NeYL MAILq ,"0� BUILDING n9yz/ /t/t� n p�• ADDRESS .(774 /Y/I�LL,q/dp ADDRESS ,/(F //f{I/,/ 1J //'' /"�/�� TEL. TRACT/n LOT BLOCK CITY [.C7srm /• /ESA NO. 549-363 9 Io73 CONSTRUCTION (� NEW ADD{ALTER REPAIR MOVING OFMOI ISH I LENDER ONe IX BRANCH L � "L //JJ c r OWNS {{,��,/!J�[7 IC• /CAJF—�i' ADDRESS F7i(�VC:W_Fent Op ` ALOE // •V ARCHITECT TEL. USE Ca�SSP . O S �yY �' OR ENGINE R NO GROUPFIRE T ZONE TYPE ADDRESS // // _ )(CONTRACTOROA BYAPPROVE C DATE /b•�(p -7C ADDRESS 1llyyy��s /) It / • TEL. _ ZOP/ j (PLANS / BUILDINCOLV e 10'77„ CITY NO. '` r /t � 'z F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING SIZEACCESSORY BUILDING • NO.OF BLOTS. 0. (FROM C/L STI ET) /�� 0. LOT 60 '/ / O Q NOW ON LOT / FRONT ( FT. a USE OF cn., EXISTING BLDG. reseOesic6R &A.SIDE_ f '�Ct-A/p FT. rn E Separate permits are required for L,SIDE ..‹.-T FT. electric,plumbing and heating work. REAR g�r. FT. '-, US OF BUILDING WORK TO BE PERFORMED < O{�/ DISTANCE BET. BET.MAIN& "V"'-' /Q s-A TFi 40 DAL MAIN BLOCS. ACCESS,SLOGS. a1 r VAR.#Y+ DATE )( CNC L CSG PAT/0 'TO BNLARGF rA^'+eLy C.U.P.# APPROVED J /��7 n RPPROVED �//J DATE/D�/6 =75- -4 /.5— /CQQ/✓1 .4-..NLS [a+,V/sJ F_ JPS OM RV (�- cg V W7-4 0..Liar I hereby acknowledge that I have read this application and state i N N (Y that the above Information Is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ m i Z any person in violation of the workman's compensation laws of m the State of California, fat,I hereby certify that I am properly licensed as a contractor under SO. FT. '14- g6 Orxit ' ry the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses aro in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; m am exempt from the provisions of the State of California Business e VALUATION PERMIT FEE $ // d and Professions Code,Division 3,Chapter 9. N 57 co �..- PLAN CHECK E c Signature ofWhat 'J/�� T� /9 a Permitted)/ ^ r'�`r�/'�`•� $ //`'Q TAX $ SZ f U Authorized Agent .. TOTAL PAID E/ Da