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Home My WebLink About3115 KILLARNEY LN - Building Permits. 1 Applicant ta fill in all SDaces exceot t�ose within heavY bor0er Ilnes anC sian all anorooriate tlecla�ations. I L3P L/ I R/RF 1 I.�i] TI p CI� OF COSTA2�yj E'S'A CO /�TRUCTION PE/RMIT � PEFMIT NO. TRACT NO. LOT NO. UNIT N6. � . ' . .� , . Prolect�.V.i,dress '�� /� /LC ��-F!��1 ! /"' ' ��r I � � ApplicanYs Mailing A d�2M55 �� yT�� •� t�f��"4CY G�` ��O j.J�� / TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Owner's Name � ��,r,� `�u��G C� Phone^�"7'�/�/ � CONVERSION � DEMOLISH ❑ OTHER qp # ' � ' Zone � � - -� � �y DESCRIPTION OF WORK/USE OF BL�G. � . ' Address ] �� f�/��C�/Y�/��' � �.G � (,:C$� //7✓S/:� ' S MainBuilding: Accessory.Building: .- - ' E - � 2 Arch/Eng. License No. � � TVPE OF PERMI7 ❑ GRADING ❑ FOUNoaTiorv STRUCTURAL � T Front ' � -'' p AddresS ' �❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANIGAL g Reaf N Contractor's Name ' Phone ��O7tiER, � A . , � PROJECT DESCRIPTION SQ. FT. � OCCUPANCV C Ri9ht � N Address (mailing) � � , K . G .. - f CONSTRUCTIONTYPE VALUATION$ S Left R CitYLiCen5eN0. ' ZONE GRADINGCU.YDS. .ACRES - UCENSED CONTRqCTOH DEGLARATI N Plny. REf. # Pa�king R2q./ProvidCd ' ' E� 1 hereby at(irm that I'am licensetl untler provisions of CM1arter 9(commencinq Remarks: • � Planning Notes: � - � witM1 section 7000) ot Division 3 of the Busin is d Pro(essions Cotle, antl M my license'is in full force antl effect. � . S License Class Li ens No. , oate - Signature PIUMBING FEES WORKERS' COMPENSATION DECLARATION Bd�Sink . Show2�5 I hereby afiirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL � ' FEES of Workers' Compensation Insurance,�or a certifietl copy thereof (Section gackflowPreventer - � ServiceSink ' - - ' - ' ' ' ' " - "" 3Boo, Lao. c.) " � - Aummatic Washer Transformer �❑ 15-50 KW Poli<y No. ' Company � Backflow Irrigation � Sewer Ca �� 50+ KW . P Construction Pole Sub. B Certifietl copy is heteby fumishetl. � Certifietl mpy is filetl with the city Builtling Division. Bathtubs Sewer Connection Cooking Unit 'Meter ❑up to 100'amps . Date ' APplicant � . EXEMPTION FqOM WORKERS' COMPENSATION DECLARATION Clarifiers Solar Colleciors Dishwa5he� Meter ❑over 100 amp5 ' (Thissection neetl not be completetl if the permit Is tor,one huntlretl ($300) or . . ' ' " Iess�. Dishwasher ' Solar Piping � Dryers ❑Gas ❑ElecVic Sub Panel I certify that in the pe�totmance ot tne�4D�k fo� whi h tM1is m�t is iss"u�e I shall not employ any per5on in any ITa ner so as olbecome subject �p `�le Ofinking FOUnLainS $Oldf Tdnk Fdn � � Workers�'� Com satiDn Laws of Caliid ' e� Motors 00.1 NP �1'/: - 8 . . Dare �✓ -��Signature � � �� Floor Drains Swimming Pool w/Spa F A,U. 'NOTIC�: If, atter makinq tbis tlecl ra ' n, you shoultl become subject to the Inc. Solar 09-75 HP �i6-15+ Workero' Compensation provisions the Labor Cotle, you must forthwith FI00lSinks -. � U/indl- � ' ' 'Fixtu�e5 ` ' - -" - "- "' complY �+�lh zuch provisions or [nis permit� shall be tleemetl remketl. MiC�owav¢ CONSTRUCTION LENDiNG AGENCV. � GasServiCe ` Outlet5 WaterClOset � ' - 1 M1ereby aftirm that tM1ere is a mnstruction lentlin9 agency for the pertormance � �� Device BoxeS � Pole'Liqht of Ne work for whicb this permit is issuetl (Section 3097 Civ. C.) Interceptor5 . 'Water�Heater " ' " Outlets Ran e ' lentler's Name. 9 ' ' � Lender'sAtltlress � - Kitchen5ink " Water'Service - ' Switches Sign � � OWNE(i BUILDER OECLARATION � � I hereby, aftirm that I am ezempt from the Contractot'S License Law for the LavatO�i¢5 ' ' AUtO-WdSh � , following reason (Section 7031.5 Business anC Professlonal Cotle:'Any ciry or Garbage Disposal ; Standin9 Sections county which requirez a permit to cOnstruct, alter, improve, tlemolish o� �epair P-Tldp - LauOd� T�a s � ' - any structur¢', prior to its issuance, also reqUires the applicant for such permit Y Y Gen¢retOf �0-5 KW �5-15 KW TrdSh Compactor to tile a Signetl statement [hat he/she is licensetl Oursuant tolhe provisions of ROOf D�ains ' � tne Contractor's License Law (Chapter 9(wmmencinq with�Section 7000) of ' Division' 3 of the Business antl Profes5ion5 Cotle) or that he/She is exempt tM1erefrom-antl t�e basis (o� the alle9etl eKemptiOn. Any violation of Se[tion ' ' , . 703L5 by any applicant for a' Permi[ subjects the aOP�icanf to a civil "- ��enalty of not more than tive huntlretl tlollars ($500). ' - ' I; as owner of the' property o�- my employees with waqes, as their sole ,RQ��Sp¢Mion Fe¢ $15, � ISsue FeB ' $ 3 � � compensation, will tlo the work, 5ntl the structure is not intentletl or ofteretl � Reinspection Fee $15 luue Fee $ 3 for sale (Section ]044, Business ana' Professional Cotle: The. Contractor's , MECHANICAL FEES License Law Goes not appry to an ownev of a property'who builtls or improves �' ' thereon, and who tloes such work'himself/herzelf or through his or ner own . • DEVELOPMENT SERVICES REQUIREMENTS: empioyces, p.ovidea tnat such improvements are not intentleC or ottered'tor Boiler Hood or Type I ❑ � � sale. If, however, the builtling or improvement is soltl within one year of com- - Cdnopy Typ211' ❑� ZOning Approved By Ddt¢ pletion, the owner will have the burtlen of proving he/she tlitl not builtl o� im- DuCt - UndE� GiOu�tl - Building Approved By DatB �rOve fof the purpose ot sale). I, as owner of tne property, am exclusiv¢ty contracting with licensed con- Duct - Structural . Refrigeration System Appliption Issued By Dat^ ' � Q� t�actorsto consVuct the project (Section 7044, Business antl Professions Cotle: - The Contractor's License Law tloes not apply to an owner ot property who Duct - Ventilating ' 0-100,000 BTU ❑100,000 BTU p� � SUMMARV OF FEES ' � builds or improves thereon, antl who contracts for such projects wltn a con- - �- ; traclor(s1 license pursuant to the Contractor's License Law�. I am aware tnat Exhaust System ❑ MWtiple ❑ System Repair/Alteration . BUILDING PERMIT �$ � SMIP $ proof of their Worker's CompensdF n insurafce shoultl be provitletl to me. / � PLAN CHECK $ PERMIT � ` ❑ I am exempt under Section & P. C or this reason Firepl/Fact.6lt. ICBO # Fire Dampers ' ' � ISSUANCE $ � X^ . / ii�� .,� PLUMBING 5 p t �� /_,' 1:/ !6 � Heating System & Ducting Registers ENERGV P.C. $ rs PLAN CHECK 25% $ i hereby certity that i have�d this appiication and state Ihat the above I�0.100,000 BTU �100,0006T ' '" ELECTRICAL GRADING '$ info�mation is corr¢cL I agree o comply with all tity antl county ortlinances $ anastate laws relating ro,builtlin construction antl hereby authorize repre- ' PLAN CHECK 50% $ MICROFILM $ sentatives ot his city o ente� pon the 'above-mentionetl pt erty for inspectionpur oses, � �� yj� � MECHANICAL $ I I.� �Signatur��J ��,�/ Datel� _'" � . TOTAL FEE $ ��.DO Orivers' nse or � Reinspec[ion Fee $75 Issue Fee $ 3 PLAN CHECK 25% •$ CMF 0865-a6, rev, l0/84 WM1Ite - BWltling; Canary - Applicant; Plnk - Accountinq; Goldenrotl � Assessor f � ,f � CONSTRUCTION AND PLANNING -' POOL & SPA ��APPROVALS Permit# Date Inspector .`p�ppROVALS Permit# Date Insp"ector ' i:�emporary Electrical Service or Pole � � 52. Pool & Equipment Location 2. Soil Pipe-Undrgmd. , � �� 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 UFER Grnd� 57. APPROVAL TO COVER-GUNITE � . ,�7.-•Footings � 58. ElectricalConduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgmd. " 60�. Backwash Lines, P-Trap, O 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 SysYem - Final - 74. Rough Plumbing 65. Electrical-Final . � 15. Rough Electrical-Conduit � 66. Solar SYstem-Final - 16. Rough Electric Wiring - 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS F�INAL � 19. Rough Heating & Air Gonditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil - 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Roof Framing . � � 73. Undergmd. Storage Tank O Gas ❑ Oil . ' 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ' _ 75. Dry Chemical � 27. Frame and Flashing 76. DrY Standpipe � 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric N�tPS: G�y �S LEi"rC.a2r� [.��J 34. Final Heating & Air Conditioning � 2 _ C� 35. Final Gas Pipe-Test . 36. Hood or Canopy - _ 37. Final Factory Fireplace . 3S. Final F'lumbing ` � " 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final .. . . 42. Backflow Preventer 43. Backflow Irrigation � . 44. .Landscape Irripation SYstem • � 45. Sound Attenuation � � , 46. Handicap Regulations - ' � . • � 47. FINAL STRUCTURE & B1�11LDING � 48. Special Requirements Gompleted � ' � 49. Electric Releaseto Edison - -- - �• - ' 50. Gas Release to Southern California Gas Co � , � ` 51. CERTIFICATE OF OCCUPANCY ' _ . ' ' . N�. pate ' � - AVDlleant to fill in all spaces exceot those wit neavy Go.tler Iines ana sign all aDoroDriate aeclaratians. CITV OF COSTA MESA C'r�STRUCTIO'nN PERMIT PERMIT NO, /� TRACT NO. LOT NO. UNIT NO. 6638 I I/04%Bfi B�QO TL Project Address .�//.� /�- La� �ZPL/ �-N�17.4� , ^ 2(j + � Applican�'S Mail�ng Add e5 /�L /'LP�G/ /��7P . TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR _ L ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, �b ZonB Owner's Name �� H� �Tlf�G% PhnneJ�4�_u�0% DESCRIPTION OF WORKNSE OF BLDG. - Address �� -L��u ��' S Main Building: Accessory Building: � E z Arch/Eng. License No. TVPE OF PERMIT�V GRADING FOUNDATION STRVCTURAL T Front p , Address ❑ TENANT b! ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Reaf '' � �� a N Contracwr'sNam� po� �/ ❑�OTHEF Ed`. %. �q �.� C Fight I I�vo�� re. � G //�,,��,,,n PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address (mailing) �� `n�ar�� `�-u�"�-�""�r�'� K Left t�` •�� n� . � �T CONSTRUCTIONTYPE VAIUATIONS S �J , � � _ City License No. � �� R ZONE GRADING CV.YDS. ACRES Ping. Ref. # P 'n R./ ' e. E LICENSED CONTRACTOR DECLARATION Q I he�eby aifirm t�at I am lic¢nsetl untler Orovisions of Charter 9(commencing Rema�ks: PldOning NOL¢s: M with section ]000) of Dlvislon 3 ot the BUSiness antl Professionz Cotle, antl my license is in full to ce antl effect. �//^ _ T �jc ' icen5e No � S. ate ' ' Signature PLUMBING FEES ' DECLAftFTION . ' Ba� Sink ShOw¢f5 I hereby aitirm Ihat I have a cerL ica e i icate FEE$ of Worke�s' CompensaEon Insurance,� ar a certifie� copy tnereof (Section gackfloW Preventer $C�Vice Sink � - � - -- 3800, l.ab. �) p Q � Automatic Washer Transformer ❑ 15-50 KW Policy No. �✓'rJ.J �.�31/O� Company ��% �� Backflow Irrigation Sewer Ca ❑ SO+KW . P Construction Pole Su6. Certifietl mpy is M1e�eby fumishetl. - ith the city Builtlin9 Division. L q ' Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date � APPlicdnt ' ' L d•�. , . RKERS' COMPENSATION DECLARATION Cld�ifiE�S . SOId� CAII¢C[O�5 Dishw25he� Meter Oover 10� amp5 (This section neetl not be completetl it the permi[ is fo� one huntl�etl (5300) or Iess). Dishwasher Solar Pipin9 Dryers ❑Gas ❑Electric Sub Panel I certify tM1at in the Oertormance of [ne work for which thiz permk I5 issuetl, I � shall not employ any person in any manner so as m become subject to the Drinking Fountains Solar Tank Pan Momrs �0.1 HP O1'h- 8 Workers' Compensation Laws ot California. Date Si9nature � � Floor Drains Swimming Pool w/Spa F.A.U. Ina Solar �9-15 HP �16-15+ NOTICE: If, after making t�is tletlaratiOn, you shoultl become Subject to the , Workers' Compensation provisionz of the L3bor Cotle, you must -tortltwith Floor Sinks Urinal - - Fixtures -- � camply with suc� p�ovi5ions or tbis permit Shall be tleemetl revoketl. MiCttov.2vC CONSTRUCTION LENDING AGENCV ' GdSServiCe OULIetS Wat¢fC105¢t ' ' I hereby a/flrm that there Is a construction lentlln9 agency for the perlormance Device Boxes Pole Light ot the work tor whicn thi5 permit Is' Issuetl (Section 3097 Civ. C.) Inlerceptors Water Heeter - • Outlets Range Lentler's Name - Lentler's Aatlress . Kitchen Sink Water Service Swilches g{y� OWNER BUILOER DECI.ARATION� . . . I hereby affirm that 1 am exempt trom lhe ConVactor's License Law for the Lavatories � Garbage Disposal g following reason (Sectian 7031.5 BuSiness antl Prolessional Cotle: Any city or Standin Sections counly wnich requires a permit [o construct, alter, ImOrove, tlemolish or repalr P—Trap any Tlructu�e, priOr to it5 i55udnce, also requires Ne applicant 1or SUGh pe�mi[ Generator �0-5 KW �5-15 KW T�35h COfI1p2Ct0� to tile a signetl statement that he/she is I7censeC pursuant to the provis�ons ot� Roof Drains the Contractor's License Law (Chapter 9(commencin9 wlth Section 7000) of � (,�j� �J � Division 3 of the Busina55 antl ProteSsions Cotle) Or [ha[ he/ShC is exempl . . therefrom antl the basis for the alle9etl exemptlon. Any violation of Sectlon 7031.5 by any applicant for a permit subjec[5 tha applicant to a civll eenalty of not more than live huntlretl tlollars (5500). LJ I, as owncr ot the prooerty or my employees witn wagas as iheir sole Reinspection Fee $15 ISSue Fea $ 3 compensation, will ao the work, ana tne structure Is not intentletl or oNeretl qeinspection Fee $15 Iwue Fee $ 3 tor sale (Section �044, Business antl Professional Cotle: The Contractor's MECHANICAL FEES LiCense �Law tloes nol apply to en owner Ot a O�oO¢rty who builtls o� improves thereon, antl wh� tloes sucn work himseli/her5elf Or throuqh nls or her own DEVELOPMENT SERVICES RE�UIREMENTS: ¢mployees, provitletl lhat sucll improvements ar0 nOt intentletl or offeretl Por BOiI¢I HOOd Of Typ21 ❑ � sale. I/, however, the builtling or improvement Is soltl within ona year of com- Canopy Type I I ❑ . Zoning Approved By Date pl¢tlOn, [M1e Owne� will have lhe buttlen of proving he/she tlItl not bulltl or im- Dutt - Under Ground Bpilding App�Oved By Date �rove lor the purpose o/ sale). I, as owner oi the property, am ezclusively contracting with licensea mn- Duct � Structural Refrigeration System Application laued By Dat ttactors to consirutt the proj¢ct ($ection ]044, Business antl Professions Code: Tne Contracmr's License Law tloes not appty lo an owner oi property who Duct �.Ventilating ❑0-100,000 BTU ❑700,000 8TU SUMMARV OF FEES builtls o� improves the�eon, antl wno contracts tor such projec[5 with a con- ' tractor(s) Ilcense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ MWtiple ❑ System Repair/AI(eretion BUILDING PERMIT $ SMIP $ proof Of their Worker's Compensation inzurance shoultl be pwvitletl to me. _ PLAN CHECK $ PERMIT ❑ 1 am exempt untler Section B. & P. C. tor tnis reason Firepl/Fact. Blt. IC80 �k PLUMBING $ ISSUANCE $ Date owner Heating System & Ducting PLAN CHECK 25% $ ENERGY P.C. S I hereby certiry that i have read this application ana state that tne above ❑6100,000 BTU O100,0008T EIECTRICAL $� GRADING S information is correct. I agree to como�Y w��h a11 tlty antl county ortlinances antl state laws relatin9 to bulltling consiruction, antl hereDy authorize repre- PLAN CHECK 50% $ MICROFI LM $� 5¢ntdtives of this cit o enter upon the above-me0tionetl Property for � v� i on . MECHANICAL $ TOTAL FEE $ ure Date 0" Drivers' License or SS $ — iieinspection Fee .$15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0 - . . . anary - Appliwnt; Pink - Attounting: Goltlenrotl - ASsessor � CONSTRUCTION qND PLANNING . POOL & SPA APPROVALS Permit # Date Inspector AppROVqLS Permit # Date Inspector i. l�emporary Electricyl 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 Reinfarcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. - � 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 6. Foundation • 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,,P-Trap, O 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-Cpnduit 66. Solar System-Final 76. 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 APPROVALS Permit # 21. Ducts, in Structure 70.- Underground Hydro 22. Ducts, Ventilating - 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & 7est 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil ' 25. Roof Sheathing 74. Oyerhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe ; 28. Latfiing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Dryevall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Mater-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 � ' 39. Water Service-Final �; _ 40. Gas Service-Final [7 � tY 41. Solar pomestic-Finall 1 (:1 42. Backflow Prevente �( ;' � j-�j ., � �� 43. Backflow,lrrigation'�'1: , �? : (iq � ;� 44. .Landscape Irri�ation Syste`m � ... 45. Sound Attenu�ation `« � `•'� � t-- .46. Handicap Regulations - �.at 47. FINALSTRUCTURE&'BUILDING' ; 48. Special Requirements.Completed ro - :c 49. Electric Relea� to Edison 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY No. Date PflOJECT ADUBESS: 3 I 1 J K I LI�ARN EV L N UNIT: OWNEP'S NAME: DUl L' I.'�'.LD, JA.MES N. y aooaess: 3115 XIL' ARhEY i,N COSTA 'r:£SA, CA 92626 ��ENGINEEH: S �} 9—' 3 9 O 7 flEG.NO.: ADDNE55: UNIT: �'I PEflMITTEE: ORANG� CUIiNTY ROOFING INC ( 714 ) 77i-0781 aooeess: 179�2 STEARNS DR G A CA 9i705 LICENSED CONTFACTOAtlECIAAATION: I �ere6y ailirm ��a� I am licensetl untler pmvisions of Chap�er 9(commencing wi�h Section 7000) of �ivision 3 of Ihe Business and Pro�essiqns Code, antl my IicenSe i5 in full �o�ce antl el(ect. cirv uc.: �: �� 6 � sTnrE u/c,l5 2 8 4 3�orss. �� / Oa�e: �L Sqnalure: _ T WOHREHS' COMP—�CLFPATION: I harebY aifirm ��a� I have a certificate of conse t[o selt�insure or a cehificate ol Workers' Compensalion Inmrance. or a cenifiea copY ��er¢of �Seclion 3800, Lab. C). POLICVNO.: 4OLZOO�—�.L E%P.UpTE: O9�OI�9Z COMPANY: � TA 1 E � Cenihe0 copY is hereby Wmishetl. ❑ nilietl cop he city E;��i� C / Oa�e: � pPplicant� � � E%EMPiION ROMW BNENS'COMPENSATIONOECIpqpTION: (iAi55ectionneetlno�becomple�e�ilNepermi�is�aronehunOre0�3100�orless�. I cetlily t�ai in Ihe per�ormance ol the work �or which Ihis permit is issue4 I sAall not emplay any person in any manner so as to become Subleci lo Ihe Workers' Compensa�ian Laws ol Cablomia. Oate'. Siqnalure: NOTICE: Ii. ai�er makmg IhiS tleclara�ian, yau should Uecome SUEIed �o �he Workers' Compensation pwvisions o� Ihe Labor Code, you must �otlhwilh comply wi�� such p�p�isions ar �his permi� shall be deemed revoke0. CONSTflUCTION LENOING ACENCY: I hereby a�firm �ha� �here is a constmc�ion lentling agency to� Ihe peAormance of Ihe work �or which Ihis Oermi� is i=.suetl (Sec�ion 3097. Civ. C). LENOEN: RDOflE55: OWNEH BUILDEB oECLANFTION: I hereby atfirm �hat I am exempt Imm �he Coniracmrs' State License Law for ihe following reason (Seclion 703L5 Business an� Pmtessional Coae: Any ciiy ol counry which requires a permit �o cons�mc�, al�er, improve, demolish, or repair any Slmcture. priar ro ils issuance. also require5 ihe aDDlicanl for such permit to file a signed 5[a�emeni Ihal he/she is licensetl Oursuant m ��e omvisions o� the Contracmrs' S�a�e License Law (ChaO�er 9(commencing with Section 7000) of Oivision 3 0l lhe Business and Pmiessions Cotle) or �hai he/s�e is exemp� Ihereimm and Ihe basis lor Ihe allegetl exemptioa Any violaiion ai Seclion 703L5 by any aD�licantlar a permil suble��s the apPlican� �o a civil penalry ol noi more ��an �ive hundred Jollars (5500�. I. as owner of ihe pmoeny or my employees wiN wages as �heir sole compensation, will tlo ine work, an0 tAe ❑ s�mcWre is noi inlen0e0 or offered lor saie (Seclion 7044, Business antl Professional CoOe: TAe ConVactors' Slate License Law tloes not apply to an owner ol a pmperly who builtls or impmves Ihereon, antl who tloes sucA wo�k �imseli/herselt or ihmugh his or her own employees. Droviaea ihal such impwvemenis are not inten0ea or offered for sale. If, however ihe builtling or 'mprovemen� is saltl within one year ot campleiion. Ihe owner will have �he burden of pmving he/she ditl nol builtl o� impmve lor �he purpose af sale�. I, as owner ot �he pmDerty, am eKclusivel� conlracling wi�h licensed conVac�ors �o constmc� �he pmjec� (Section 7044, Business ❑ antl Pmfessions Code: T�e ConVactors Iaie License Law does not apply �o an owner of propetly who builds o� impmves �hereon and who coniracis for such pmlecis with a coniractm�s)Ilcense pursuam m ihe Contractors' State License Lew), I am aware , Iha� pmoi of ��eir WOBer's CompensatiUn insurance shoultl be pmvitletl to me. I� I am exeinD� undei SecUon. �. & P. C. br Ihis reason: Oale: Ownec I tlo he�eby ceNty �ha� I am aware oi an0 undersland Ihe reQuirements o� Cali�omia Healih an0 Sa�ery Cotle Sec�ions 25505. 25533, antl 2553A ana ��a� I or any IuWre �uildinq occupant will/will no� (circle one) neeA Io comply wi�h 5ai0 sla�e cotles antl �he reQuiremenis �or a permii lor conslmc�ion or motliticaiion imm Ihe 4i� Ouality Managemenl DisVict. FeSlden�ial con5ime�ion apPli�a�ions are exempt �mm Ihese D�ovisions. Oale: AP�Iicani: I �ere�y wtlify Ihal I have read Ihis applicali�aqd slale thal ihe above inbrmation is correci. lagree�o mply wilA allcily antl tounly ordinances and slate laws rela�ing Io bmlding ns��uction an hor' arepf¢SFIIf3D0E5ahh o Ier upon Ihe ahove-mentioned pmper�y lor inspecuon purposes. Daie: �� ig i Drivur's License or Social Secun�y p: � ��„ �,� t64Ln6 Wlule—Builtling; Green—Cade Eniorcemen��, Canary—ApplicanC Pink—Revenue; Goltlenmtl—Assessor CITY OF C057'A MF.SA — BGILDL'VC; PERMI2' PER�! NO: 3 0'i359E PF.RMIT NO; H 053596 PLA(� CHF_.CK NO: N GOVT; N SUPP: N CONS�;RUC'PION TYPB: V—iv PERM.IT TYPE: STR PJRPOSE: Ai,1 JOB DtSCRIPTIUN : T/OFF REF.00F W/COMP, 2700SF RESID S GARA SQ FT: 6,500 CLAIM VALIIE: 6,500.00 CALC—VALUE: 6,500.00 GROUP OCC: R-3 /N—i COMN.ENTS: T/ UFP REROOF W/ COMP 5MC�F�.�. DETECTOR �%i5?iifiEyiE##ic#IF9fdfYi�1(�%ifif�k�}E�Y<�if)i�fE�#iE#df�ic�lf�9F)t#i(��1E4E�IEie14###-kiE9fk4E#7f�lE�lFif�3tlh��iE�kicrFl�ic'rE� ic�ir�rFirYciE#�3fYr�lf�lEdE i, O N I N G R E Q[J I R B Ni E N T,S ��.i'S( {IRED 5 L T B A C K S wsw ----------- MAIN BUILD�NG ---------- --------- ACCE550RY .dU3LD�NG -------- F'RNT: FT IN REAR; FT IN =RNT; FT IN REAR: FT 1'n LaFT; FT IN RGHT: FT ZN LEFT: FT IN RGAT; =T �N ,PARKING kE�i• PROV: PARCEL; 13S0910� 7.NB: RE; NO; PLAI�NING NiST'ES> ..) 7'r # iF ii� � iF �1F #!f -1'r iF #�F'#!if iF iE if �7'r � je ie # iF iE ie �F jE if lEiE �le IE 3F ii� 3f !f �F iE �!F i41f dF 3f iE # ii� 3'r 3!� if �E�e# if k if ii� 3E k}�IE 3f ii� 3E 3E 9i� # 1E 3i iF ie #�E k�16 #� iE ��N. D E V c: L O P N. E 1� T S E R V I C E 5 R E Q U S R E M E N.'. S ZONING APPROVED BY DATE.: B(7ILDING AFPRC)S1ED BY ; DATE; AFPLSCATION ISSC7c.D HY• � DATE:�lZ� �] � ie#};1e3F#ikK�iF3ElE3(�#i(�1FiE�1ElE#34:k?f .. � �t.ft�x. x. . .. . t. � s��k�ieif�If�1F!'tiE1ElE#it,�3�.5't�xxrr�i',-�.:+.1F#F iE if 3f 3E iF j(� �7F jE iP?E iE iE K K� �E IE 1f IE fE �!'r 4E lE � If # iF # Y iF #% iE iE i(� ii� lE 9e ��74 �# �)k iE ik �% 7f aF# aF* 1E iE # N� i6 N� #�%• k lf 1E #F?F �14'.e� Y.� ir 3E iE�e ie at it ii� iF �Y� ?i� Y-±E 34 LEGALI'lATION:N F E E S i7 N, M A R Y STkTJCT:1rZAL 5EGMENT;Y BLDG FMT PliUMBING ELECTRTC; MECriANIC FIRE SMIPlRES CRAD'SNG PERMIT 90,00 � 65 SMIP/NON—RES Pi.AN , IS5ilE FEE BUILDING—DIV—> PERMIT ISStJE PLAN—EH�CK TOi'AL PAZD DT]F. TOTALS----> 90.65 0,00 U,00 90.65 90.65 .00 REVENilE DZVISION TOiALS--> COLLECTED; U0.65 OVER/SHORT: .00 Bi,DG PMT PLUMBII�G cLECTkIC MECHANyC cIRa SN.IP/TOT GcZADING PLAN—CHr.CK 90.00 y ,65 �' it 3t' �' )t' R'X"'*.' i�:' �i' �(' 1l' .'K' �{' it jF i�' �' il- i�' �' �' i�: iF * �t ii jC �' iE"� }%')l' {%i!'�' i�"l�' k' � i�: i! l(' ii �! il' �l' �' �' it if iC �' �("� {E )t i�"x' Y.i(" il' i�' i[ ii' 1t �i' I! # if # i(' i{' i�' {(� j( ji j�. } I N I) T V.i D U A L r� E E B R E A K D O W N TYP: QiY D c S C R I F T Y l� N UNIT COST TOTAL COSt SFR 6500 R£ROU= BY CrALliE RESZDENTIAL NOZONE 1,U0 6,�OO.pO t.�v ,�F FL�.c, � ' . O1 OOD9��.^;-C�U9;i;,'?5 ". e_:•r DtiiE: 0�127%9! TF11E: ;?;�., ' ��C� 'JCT� N AND PLANNING � POOL & SPA APPR� LS�� Permit�k Date Inspector pppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Locatlon ' 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 UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgmd. 8. Foundation . . 59. Gas Pipe, O Undrgmd., Test 9. Water Pipe-Undrgrnd. . • p 60. Backwath Lines, P�7rap, O Undrgrnd. 10. Structural Floor SYstem ' ,- ' 61. APPROVAL TO DECK 1 t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final . 12. Sewer Cap , 63. Heater & Vent�Final 13. Roof Drains . 64. Plumbing System - Final 14. Rou h Plumbin - � 9 g , 65. Electrical-Final 15. Rough Electrical�Conduit . 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access ApP�oval 77. 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. Duc[s, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. RoofFraming 73. Undergrnd.StorageTankOGas ❑Oil 25. Roof Sheathing �-�Gt� �'�,,/� 74. Overhead Hydro 26. T-Bar Ceiling (Structura�) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQU�REMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Eiectrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test S�-G�'�� C�y,�,d�t, ��G -- / 36. Hood or. Canopy & c.�� 37. Final Factory Fireplace 38. Final Plumbing ' 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer . 43. Backflow Irrigatipf� 44. Landscape Irriga�an System 45. Sound AttenuatjFn F 46. Handicap Regul�gn�'"$ 47. FINALSTRUCF�bR '� UILDING �..�-�� ,(N� 48. FINALPLANNI(VG -^ � - 49. Electric Release to E n _. �� 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. ' Date OWN�R AP No. INSPLCI'IONS e F LOT 39 7'RACT 4356 RIRE 7.ONE �Signaturel DA'CP] GROUP �J flOV 2 9 7962 BUILDING PERMPP NO. VALUP $ ' DliSCRiPTION OF TYPP: V SUBCONTRACTOR 7,ONE Gar. COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MESA. CALIPORNIA For Applicani to Fill In Complefely TYPE OR PRINT BUILDING 3�/.� � ��q rhr �ay e� AOORESS - COSTA MESA. CALIFORNIA OWNER �rbor Hall of Fyme Homes Inc. MAIL P�Q• ��( 2066 ADDRESS an Santa Ana No:KI 9-22 .A.RGHI^ECf e �T8If115Or1 TE,�,��rQ�4 Lot 39, Tract � ,�P2��609�1��"D - flDV201962 FINANCE DEPT. APPLICATION � FQ�it�$TA MESA BUILDING For Office Use Only xeceirr xo. r�gyq xp,� �LL ��D„ Sti• �13tS7! ZONE LifeLime Residential ffidw Cnr !�PPROVED BY OATB COSTA MESA. CALIFORNIA ADDRESS zl 1 SO• Artesia SL. ZONING CITY Santa Ana ZONE � NO. OF � I BUIIDINO u/ �� PLANB LIrC.TNO. LOVV�O No: KI 9�204 LeOAL 3 2. B.>`� DEeCRIPTION BIZE 6000 � I NO. OP BLDGB. O OF L07 rvow oN �oT p, p, NO. USE OF None YARDS EVES EXISTING BLDG. APPROVED ALLOWED CeNIEARKOPNBTitEETM ��' REAR YARD��22� IC6M8R UN6 BT.1 ��_ _. FRONT > I ci �u � I LEtT � � I RIGHT DESCRIPTIOtd OF WORK � coveR�i°rr�"��g`�ster I COVERING Shake U6�QF BS11LD�jiG AND WORK TO BE PERFORMED I XEREBY ACKNOWLEDOE THAT 1 H�VE PCAD TXI6 APPLIGTION PND 9TATE THAT THE A9 VE 18 COIiABCT /�ND AGR6H TO GOM- PLY WITH ALL QiY O NCE6 AND BTATH LAWB GULATINa BWlDINO CONSiRUC //��j/�\[} SIGNATURE O . 1 VI ' h\. � �Al1THORIZED AGENT APPROVHD CY FT. I7' FT. �— / 9. Z ZF�_ — r� �� - �'3°Q'�_ y�o4, TNE �MOUNT BHOWN UNOEP VALUATION IB POq TNE PURP08E OF ¢eTABLIBH�NG A PERMIT FEE ONLY. VALUATION PEftM1T FEE S S�—"' $ � �i� PLAN CHECK $ ��S � � � y�/1� �l, L• T 1 VV aos�nnnxEss __ 3115 Killarnev Lane BUILDING PF.RI�iIT NO. 25536 Final or Date GROUP J TYPE SUBCONTRACTOR � 25536 � COSTA MESA BUILDING-SAFE7Y DEPARTMEIYT G.O. BOX 1200 � COSTA ME8A. CALIFORNIAYP82! For Appllcanf to Fill In Completaly TYPE OR PRINT eui��No " �4 ADDRESS � G��` � COSTA ME3A. CALIFOR IA ewwew �r� n'l� ✓N � 2 U. � a 1'i C.S MAIL � '�' L S^ AOORHHID L[ow� CITY i�f CaS��i M�SA APR 1 1966 R[C[II� 110. HO.O� UYiOIH[W ruH� �%. eWtolxa - ( 3.3 -�� HAN68HALL88Ll88THAN 61ZE ��J �-%- �'1 NO. oI �LDot�/ ALLOWHD .( U. B. C. RCQUIRHMENT7 OF LOT / t l� now N YARDBMPROVBD VAROSMPROVBD U6EOF �± MAINBUILDINO AGCHi80RY8U1LDIN6 EXI6TINO BLDO. C-- YLTeACR un[ fROY �� '� PROM C/L IIT 617) CHtrt¢rt or m�[aT �� RUR YA D PR�NT Pf. ��l � p}. SID6YA DI UiPT 'f�. RIOFTT !�/ A.OIDi D F(. DESCRIP710N OF WORIC �. ni rr. rr. � S Z E'N� Q XZ� ROOMB D EXTERIOR WALL � � _ . .� ROOP GQF CC 1 H6R8lY ACKNOWL6p0[ TXAT � MI1V6 RfAD TNIB AYVL�CATION I�HD BT�T6 TNAT TH6 AOOV6 �� CORRtGT�AND AORH6 TO COY• PLY WITX ALL CITY ORDINAXC�I Al1D RATi LAWi RtOYLATINO BUILOINO CONBTRUClION. � SIGNATUR60P ; ) I PERMITTE wuTxonizeo �airtr vwn. iF err. Mw�n e wccasa.e� DA76 V ' w � 0.1`� S � e i 6 �. �,. � 0 TN[ /�YOUIf� 6MOWN UNDBR V�LUATON IB FOP TNB i �YpPO![ OP [BTAGLIBXINO A PCflMIT F6H ONLY. j VALUATION m('j � PERMITFEH � p 3�d _.. � i