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574 KNOWELL PL - Building Permits
� ,. Aov��cant to fill in all spaces except those within heavy Doraer lines anC sign all apprapriate tleclarations. � OF COSTa MESA • /CON'S/T.R'UCTION PERM T roject Address ��Y L_L_/� 8 Wt'« ��GE� c�--�-T—Q . Applicant'sMailingAddress �!•��%X /7�• Owner's Name �S,F///L7LD �//��/�� Phone � -�78a Address � ..�:''�%X-- /{� D / ��_�L.'9/�E� ' Arch/Eng. _� �/�.�7 License No. � Address / _ � C.A ..S% � Contractor's Name o one � Addresslmailing) .D Qj%y /�� City License No. ,� 4" S% 3 LICENSED CONTRACTOR OECLARATION I hereby aftirm that I am Ilcensetl untle� p�ovi5iOn5 of Charte� 9(mmmencing with seclion 7000) of Division 3'of the usines ntl Protessions Cotle, antl my license is in tull rce and ettect. Dd LicenS I]55 iLi ens o. � Date �� • Signature �I WORKERS' COMPENSATION D RATION � nereby aitirm that 1 have a certi i te of consent to selt-insure or a certificate � of Wo�kers' Compen5ation Ins � ce,.o� a ce�tifietl copy the�eof ($ection 3000, Lab. C.) � �O iCv No. G S3 o13 como v� i9v G Certifietl copy is hereby fumi5hetl. • LJ Certit"etl wpy's filetl with the city B' tli pivis' n. Date���� � Applicant / �i EXEMPTION FROM WORKERS' CO ENSATION DECLARATION (Thissection neetl not be completetl i e permit Is tov One huntlretl (5300) or less). I certify [ha[ in the performan<e Ot hE work for whi<h thi5 pe�m�t is i55uetl, I . shalL not employ any person in any manner so as [o become subject to the Worker5' Compensation Laws of Califomia. oate Si9nature NOTICE: If, atter makinq thiz tleclaration, you shoultl become subject to the Worker5' COmp¢nsation provisions ot th¢ Ldbor Cotle, y0u must forthwith compty with such provisions -or this permit shall be tleemetl revoketl. CONSTRUCTION I.ENDING AGENCV� 1 hereby atfirm that th¢re is a ns[ructlon lentling agency for th¢ perfo�mance of the work tor whic� permit/is issuetl (SecHon 3097 Civ. CJ Lentler's Name � �� Lenaer's Aatlress � OWNER BUILDER DECLARATION 1 hereby affirm Lhat I am exemp[ irom the Contracfor's License L.aw for the foilowing reason (Section ]031.5 Business antl Professional Cotle: Any city or county which �equires a permit to cOnSt�uCt, alt¢�, improve, Eemoli5b or �epai� any structure, prior to i[s issuance, also requires the applicant for such permit to file a siqnetl statement that he/she is licensetl pu�suant to the provisions ot the Con[racroYs License l.aw (Chapter 9(commencin9 with Section 7000) ot Division 3 of Me Business antl Pro(¢ssions Cotle) or that he/she is. exempt thereirom antl the basis for the alle9etl exemption. Any vlolation o( Sectlon 7031.5 by any appli<ant for a permit subjects the aoP�icant to a civil . �enally ot not more than five M1untlred tlollars ($500). I, as owner of the property or my employee5 with wages as their Sol¢ compensation, will tlo tne work, ana the structure is not Intentletl or�o(teretl for sale (Sec[ion 7044, Business antl Professional Cotle:�The Contractor's - License Law tloes not apply to an owner ot a prooerty who builtls or improves . thereon, antl who tloes such work him5elf/herself or throU9h nls or her own employees, provitletl that such improvements a�e not Intentletl or ofTeretl t0/ � sale. If, however, the building or Improvement is soltl within one year of com- plet' n, the owner will have the burtlen oi provin9 he/she tlitl not bulltl or im- e Por the purpose ot sale). r m ezclusivel contractin with licensetl ton- wner of the ro e t a Y 9 I as o P P Y. ' n] 44 usiness antl Professions Cotle: Vatto�st0 consttuct the project ISecLo 0 , B TM1e Con[ractoYs License Law does m[ apply fo an owner o( property wM10 builtls or'improves tpe�eon. antl who cont�acts for Such oroieCts w�th a r.on- tractor(5) l�cense pursuant to me Con(ractor•5 License L.aw). I am aware that proof of tneir Worker's Compensation insurance shoultl be provitletl to me. ❑ I am eaempt un0er Section 8. & P. C. for this reason 0 I hereb certif that/1�have read t is application antl state that tne above iniormation is orrectJ 1�agree to comply with all city antl county ortllnances and state law relatinA to builtling consbuctlon, and hereby authorize repre- , sentatives of h}�s city�t0 enter upon tne above-mentionetl proper - tor inspectionp .q'6es. � U_.�.an �..dL Drivers' Lif nse or 55 � ]865-46,�r v. 5/BB white - guiltling; Canary - App ;�,.,35433 � ....._. TYPE OF CONSTRUCTION � tve ❑ GONVERSION ❑ DEMOLISH DESCRIPTION OF WORK/USE OF, ADD �ALTERATION� OTHER' �%D✓EOL/ TYPE OF PEHMIT LI GRA�ING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑,MECHANICAL � �OTHER . � ' PROJECT DESCRIPTION 5� FT •L' �� oCCUVANCv � CONSTRUCT�ONTVGF_�N� vniunTintig�%MJD---- ZONE GRADING CV. VDS. AC EK 5 Remarks: / q,Q n y,i. i(!/q .� ' Bar Sink Backflow Preventer Backflow Irrigation Bathtubs rinking Fountains loor Drains loor Sinks 25 $2fVIC2 �Uf�CiS Kitchen Sink Lavatories P—Trap Roof Drains - Reinspection Fee � $75 Boiler Duct- Under.Ground Duct - Structural Duct�- Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. iCBO �k Heating System & Ducting ❑ 0.100,000 BTU O 7 00,000 Reinspection Fee nk - Accounting; Goltlenrotl - Assessar $15 Showers Service Sink - Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Close[ Water Heater Water Service Auto-Wash laue Fee IANICAL Hood or Typel ❑ Canopy Typell ❑ Refri r tion e a S stem 9 Y ❑0-t00,0006TU ❑100, System Repair/Alteration Fire Dampers � Registers Issue fee A.P. # ' � S Main Building: A R E �' T Front' �W IB Rear - - A — � C Right-, S . Left � Ping.�Ref. # , ' — Planning Notes:,� � c Automatic Washer - Construction Pole Sub. Cooking Unit � Dishwasher Dryers ❑Gas �Electric � Fan . . �, � t -. : _. Zone � . Accessory�g6ilding:, ~ Z , ' O . . ..- . , .. ... N: � - _ _ N, G: R• Parking Req./Provided �� ' E' Q M _ T S. ELECTRICAL Trensformer ❑ 15-50 KW ❑ 50+KW F.A.U. Fixtures � Device Boxes OUtIetS Switches ' Garbage Disposal •• Generator 00.5 KW �5-15 KW - e- - I Reinspection Fee s $�3� �:: DEVELOPMENTSER � 2oning APProved BY_ FEES ! : �tBuilding ApO�oved By $15 Meter LJup to 100 amps Mecer ❑over100amps ' Sub Panel Mato�s�ai HPO1�-8 Inc. Solar 09-15HP�016-15+ Microwave f , Pole Light - Range Sign � Standing Sections � Trash Compactor ' - � Issue Fee . ; ,. VICESREQUIREMENTS: ' , FEES $ 3 3tion Issued.By ��� Date �i��-i� �J'.i � SUMMARV OF FEES � BUILDINGPERMIT $ ���d�! �SMIP - .� $ , �'rD PLAN CHECK $ PERMIT � ISSUANCE.•� PLUMBING $ $ PLANCHECK 25°k $ ENERGVP.C.� $'� ' ELECTRICAL $ GRADING � ��^ $ PLAN CHECK 50% $ MICROFILM � $ p� �1� MECHANICAL , $ � TOTALFEE:�� $ � /O.J � PLAN CHECK 25% $ ' _ , , : o.i oaoisaia-e�eisaia ..a':a�r . _ .. ilo.s� DATE: �9/23/3� TIi9E. 14:2I t� � --\ ...� j? CONSTRUCTIONANDPLANNING �4 �- POOL&SPA �,�- � . APPROVALS Permit# �Date Inspector AppROVALS Peimit# f Date Inspector 1 . i. Temporary Electrical Service or Po�e ' 0 52. � Pool & Equipment Location . . • 2. Soil Fi�e-Uind�grnd. �� :� 53. Steel Reinforcement 3.'Electiical Conduit Utility-Undrgrnd. % � 54. Forms � ' � � 4.'Elecirical Conduit-Undrgrnd. � �� 55. 'Electrical Bonding � 5. Steel �Rejnforcement• �,` 56.`Rough Plumbing & Pressure Test - 6:: Elecvical UFER�Grndl r" ' 57. APRROVAL TO COVER-GUNITE � � .7. Footings � � :,�. � . ' ; �� - 58. Electrical Conduit•Undrgmd. � 8� Foundat�on i ��C � __ - r � 59. Gas Pipe, O Undrgmd., Test 9� Watei�'Pipe-Undrgrnd. ��� 60. Backwash Lines, P-Trap, O Undrgrnd. i 10� StGuctural Floor�ystem �� ' - 67. APPROVAL TO DECK � f 11. Propert� Sewer Line & House Conriection � 62. Backwash & Receptor-Final ' � 1�2� Sewer Cap� , j . 63. Heater & VenrFinal . i • 131, Roof Drains � �, ' 64. Plumbing SYstem - Final � 74. Rough Plumbing'' . � 65. Electrical-Final 15. Rough Electrical Conduit 66. Solar System-Final . 4�6� Rough Electric Wiring . �67. Fencing & Access Approval T9�. Rough Wiring Sign . 68. APPROVED FOR PLASTERING � 18.� Rough ElectricabT Bar Ceiling 69. POOUSPA SYSTEMS FINAL � .1.. 1�9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT v �20. RoughFactory �ireplace j; , APPROVALS Permit# � � ' 21. Ducts, in Structure . ' 70. Underground Hydro 22. Ducts, Ventilating j� ' 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Jest '' 72. Underground Flush 24. Roof Framing . 73. Undergrnd.Storege Tank O Gas ❑ Oil 25. Roof Sheathing � � 74. Overhead Hydro � . 26. T-Bar,Ceiling (Structural) & Monocoat ' 75. Dry Chemical 27. Fra'me�and Flashing 76. Dry Standpipe . � 28. Lathiriga& Siding 77. FIXED SYSTEM FINAL � 29. Insulaiion ' � 78. FIRE PREV. FINAL , 30. Drywall'Nailing . , , 'HEALTH DEPT. REQUIREMENT � 37. Plaste� Brown Coat � � - - � 79. FINAL INSP,ECTION - `"'--- " � ' 32. Electrical Power Meter-Final ' �80. FOOD C RTIFICATE ISS ED 33. Final Electric Notes: �-9 34. Pinal Heating & Air Conditioning �- ti 35. Final Gas Pipe-Test - � � � 36. Hood or Canopy ' � � , 37. Final Factory Fireplace � � 38. Final Plumbing � ' ' , , . 39. Water Service-Final � 40. Gas Service-Final � 41. Solar pomestic-Final - 42. Backflow Preventer � � j 43. Backflow Irrigation ' � ' � . c 44. Landscape Irrigation System � � _ 45. Sound Attenuation � ' � � ' 46. Handicap Regulations � �,O �b 8 ',� < 47.FINALSTRUCTURE&BUILDING c1 Q,' '�j�o3 XU 48. Special Requirements Completed � � � e�� � 49. Electric Release to Edison �- - ;% n,.- 50. Gas Release to Southern California Gas Co � :.�, N °l 51. CERTIFICATE OF OCCUPANCY ' _ . � . •' ' �� _ No, Date � OWNER ROGERS i{. K. . ... " ` DATE. 9�2 . . 5 7 / JOBADDRESS -j-'� � j,�e]_ Place BUILDINGPERMITNO. rj(�� GENERALCONTRACTOR Owner VALUE $ 9 zO.00 : L. �.%� BLOCK TRACT 2]_(�8 Dwellin� � GROUP I TVPE V ZONE RIl FIRE DISTRIGT y%], I PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER FootingTrench �/ 9 �8-, Foundation Forms and Grade to Garaae Plumbing, Rough to Slab Plumbing. Rough Comple Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer � � u� S� Tank or Cesspool L, d Plastering Plumbin9, Fimal, Fixtures Plumbing, Final Gas Test� Wiring, Final Occupancy Form 210 G-H 1M 1&68 . Co�ta Mesa Building Department APPLICATION FOR PERMIT ' �. � COSTA MESA20CALI OERNIA v�l r U • D � G �� FORM 204 �-H ZM 5-54_ . � . .. . � , - .. " �. .. _ . .� . ... ._. . . `, . . . ' . . . _ . . � .. . , , � : . : . _ _ _ _ ' ` . . . � . � , � � . . . . " ". o � � . .. _ ' _ ' ' � . , � .' ' ' ' _ ' ' ."' _ ' ' _ ' _ • � _ . ',._ ��.. .. ; ;i ' '. . _. , . . • ..i ' ,• � . . ` _ •� '�r,� ,: . ' � ...>� . . � .., . _ � � � ' .-.�.�'•� i . .: 'i' ' - � !• :a. � - - ', ri.: �. r ,��T yy � .n�. �. � ' j r '� S�bPL�.PLt�l� . . . � ' . .. . � .. , � .. . . :1� n ��1. � . Show loeatlon and distances from � - � • ' � •� � � _�� � �i -, property line and between bufidinga - , ., - ' __ � :y�, ' . • �� __.. ' — - - -- - --- - - --- - - ••��-� t; � a •,:, .. ' � ,_. . ?� ._ ',' , _r: ' � . , , . -, ., — ---. . .-,� . — -.-_ " � �.-..: = . . ... . � � �'n7'C ... ,.LS ' i ... . ...'•'?� _ .i. .� . .r_'.' _' _. _ '_'_"_' ',_ .'. __'..._ . � - .r .. .,i . - , . ' . . :r � , � . � . , , ..��. . . � � . � i. �..'1 - - � � ' __ � : � 'n'r � . . . � , . . ._ . . . .. . . � _.'. , . � ` . , . , _, �.... � Q _'t_�' _ _' � •.��� �. ' �a C C� S . � :r - - - -- �� --- � ----- �- - --�-- -------- -----" .----- ---- � - F . . . . . . _ - i: OWNER .. . Rnr SF��.S��K � K- . ` DATE 9-22-5� JOBADDRESS —��- $ylOW81]. Place BUILDING PERMIT NO. rj(�2 GENERALCONTRACTOR Owner VA WEa 9.520.00 LOT 13 BLOCK TRACT 2168 . Dwelling � GROUP I TVPE �7 ZONE RI_I FIRE DISTRICT �%n � PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR I DATE NUMBER Footing Trench 9 "�-4-- �! Foundation Forms and Grade to Garaae i+lumbing, Rough to Slab Plumbing, Rough Comple Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewerf y�� Septic Tank or Cesspool Lathing Plastering Plumbing, Final, Fixtures Plumhin9� Fin,al Gas Testl Wiring, Final Occupancy Form 21J G-H 1M 12-68 �� ^20- �. . C.osta Mesa Building Department APPI.ICATION FOR PERMIT ,� , COSTA MESA,OCAL FORNIA �• � B U 1 L D�.l N G � �77� ' FOYt O++ CE USE ONLI� '`- ' �'0 �Ci -if'�.'+•IN � -- I � ecei� o. . � P,Grg�i�No, Building . _ " ; 7 ,_.��. � � -�� �''� � t� . Add�ess : � . � r . _ _ osta Me�a� a�1fOPll18, Received by Date Rec d. r Q= � y ecJ,� Nearest I y� ' _ CrossStiYx ,� Building 57ft /ud w� � �. �� Address o`""e i� f � Costa Mesa, California �. nrohitector '�- ' Engineer Address Contractor / �j.7."",r. � Address Legal Lot Description No. (Attach Metes and Size of Lot Use of Exterfor Covering Use o1 N Buildina ; I hereby aelcnowled and state that the with all City Ot�i building cronst ettE Signatureof � � Permittee Authorized Agt. Valu,ation $ � �� iORM 204 G-H ZM 5-54 . �s- City LiC. No. Bloek I Tract���,� ( No. of Bldgs � Now on Lot No.of No.of Famiiles Rooms Rear Yard 2 J Side Yard , S� � i OF WORH + I I naa�c�o� I II Demolish I Rooms Roaf Cove Date � �� ��d�� � ._ APPROVALS 'Foundatfon Location Inspector � �..D Forms, Materfals, , �/ � Under-Pinning _ 7-- Frame: Fire Stops, , Bracin9, BOlts that have read this Application �e ' rnrrectiand agree to rnmply es and�.4t�s regulating Plan Check Total Fee FINAL O � � Z D r .. .._... ' . - - - •- - � , . _ . . '- _ ' ,;t--� ,__ ;2,,..�.s�. i: ' • � .. :,t', • ...�i.a, ._...,r . , - ,r_ ..d" _ ,��� 3� . ; ,:, .., j + - . � Street " --. � - � .� . �.., - - -- - - -- - - - , . �. F _ _ - - - �� - � ' - ------- --- -- - ,-_--_, , :; '::�.... � -. ., •��� - ... �e . :-., ._. _,,.. _ ,.i� ,.. : .�_� ., . ; 1.,.�r - -- -- - ,, � rrT:r^'i ...... . , �.i: � :z_ I: . �fi��'�. F� ; ��J'. - � L_� .�`__.—_ �.!"';-'Ir,-_. _�_ �_'� _ � _-___�.�_.__'� � — r!.'-.. -,{�A;r - •� 1 � PLOT PI.AN ' --. ''� ',.._. _ _. . _:. . . 3 �:' � , : ,jF�ilt; :�,,�: s . . : �.' , � Show IocaUon and' di�nces%from , _ •�=' •':� r °i+• �•:!.; . . � property line and between buildinga : �., ,•: . ., ,. , , .. - � . . . . o'J �'r Ol:.:': - .io'r . ,. �y. . --- — • - -- — — r - . i � ' f.+ '�. �h :. . . _. �_ - � , , . . . . �- i ... . � •�^:op•i f.�'— -- —.�— ' -- :�! -�lo i _ .. : ,i i) . . 'I.ia . '. .'1 . . i if1:. . . 1 ' . . . , � . '. �' � i . - ' � ^. r • ' � � ..fi..,f1. .u.:�9 . ' " _ ' ' . '_' ' ' '_ '. —'_ _«__ . . _ . ._. _ � � . . — ;� ,�. .. i.,�:�.' , . i ;, • • <'� .. ;!i i . . ' ' ' . ' .....i ./' . ' - . - . . � . . . �- i� ' _ ' . . . . ..... `'J" i .. .b. ..� — . .. '� . . .. . . . _ ♦C.'u:::1. � _ . . ... . .. ' i � ^f' . .{ . �_ _ _ __� �.T��. _ _ . ' y__ _ _ � ...a - . . _ � ' � �.� � —�, - �-'c . � � `' ;i �. ,G t : ___` . � _ � _� . .. - .� . 1 :.]i