HomeMy WebLinkAbout354 LA PERLE PL - Building PermitsADonE55 oF BUIIqNc: � 7 4 LH Y tl( L
-'j, owr�ew3ruMeiFiuiavr�: WILDMAN, HELE
dDOflE55: P O BOX 1 2 5
` SEVERANCE NY
518) 532—`1734
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ARCH. OX ENG.'S ADDXESS:
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12872
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uN,: CITY OF COSTA MESA — BUILUING PERMIT
PERMIT NO: E 078096 PLAN CHECK NO: N
CONSTRUCTION TYPE: �'—N PERMIT TYPE: ELE
UNT:
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LICENSED CDNfPACTOqS UECLRNPTION: I hareby eflim uMer panely d pa�ury Ihm I em IkenseE uMu ywiaona d Cheqx 9
(romme�np wilh SaMion ]000) M Division 3 d the Buainev end Prdessions COEe, eM my licenee is in lull farce end eflect.
cm uc. No.: uc. cuss: uc. no.: EXP ;
oe�e. comreaor.
OWNEN BIIILOEN DECLANATION: I hereby elfiim under penety ot perN�Y �� I em uemq hwn iM Comreaon lironce law la ihe
bllowinp reeaon (Sedion )0.At S Busiiwss end Pro�asvona Coda: Any eily a munty whieh requiree e permil lo mnsleuM, ellar, imprwe.
amolsh, w repei any st�uc�ure, p'v �o ns eauerce, e6o requiree iM epd�� �a euch parme to file e aqrwd aletemani Met he a ehe
. i��a w�� m�n� a��� a �n. c��,aa«e �ma �. icnaae, s ��ma�� .vn saaA� �000) d a.A�, a d�n�
Businaea eM PrWembna Cade� or �hel he or aha is eaemq ihereirom end ihe basis for tha elbped exemqbn. My vbleton d Setlian
1031.5 by anY aDW�� I« a permil wbpaa �M epd�� �o a civil penelly ol nd more Ihen five �uMreC Adlen �5.5001).
ID I. es owner d �he MW?M a mY amdWeee x'vh weBae es �M1e'r ede mmVametion;will Eo Ne wak. enA IM stiuclure ie nM in�enEeE
imp�wemenls are nd intenEeC a ollereE lot eele. n. M1owever. IM bwMirq m inpwemenl ie odd wilnin pn yeer d wmqMqn, Ilro
owner-buiMer vnll heva iha buMen N provinB he ar nhe did nd Wild or improve la iM W�e M eele).
❑ I. m oww M ihe YW�Y, em �duvrelY ooniredM wtl� IicmaeE mnVenwe to cmmua �hs D�W� (5eaion )OII. Bwi�e eM
Prolemione CoEe: The Coniredwe licenae Lew Eom ml epqy to en owmr ot qopeny wM10 buiNa or impovee iha1eon end who
conlracb la suM Wo'e nlretlar(e) Icanaed punuent m �he Conlreqon Liceme Lew�.
� I P erSection: 8.8 P.G..Mihn�eewn:
D Owner:
I Eo,h cMity Ihet I em ewere G eM uManiend tha repuiremenn M CelAwnie Heellh uM Sdary Cade Saqiona 255p5, 25533, and
end thet I or eny imure buildi�q oaupent will / will nd (dmh one� naeC lo cwnply wRh xiE elele mEee enC �M requiremenb lo�
epe�mGlacwqbw,YionwmodifimtianhwntMA'r a�arapementDisiritl.Peaidantielmnstivaioneppl�bmueatempfmmlheae
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WORKEP'S COMPENSATION UECLRPATION: I hereby e/firm urdx pend�y d perjury om d �he idlowirq dadaraliom:
❑ I M1ew eiM xi1 mein�en e canifrate d mnxnl to eaMinwra Iw xorkers compenmlion, as prwideE la by Setlian �)00 d IM Lebor
Cade.la iM paAormarwe d tlre xak ta wlich Ilue permil ie iesueE.
❑ I luve arM vnl meinten workers oompemetion insurence, es required by Seaim 3]00 d tha lebar Code, M tM perlormance d Ihe
wak la whrh thia permn ia isaueE. MY wor4nra' mmpeeue�nn iiuurenee eernm vd pdiry number are:
c�a�:
Pd'cy Number:
(This seaion nsed nn W mmpbrod % iM qrmR u M om �undrei dollen (SiOV/ a bss./
❑ I cenfy Rut in �M ce�lormence d ina wwk lor vfikn tnia va�mn ia iasued, I nhdl mi emdM' eny vamn in eny mariner ao ea io
bemim eubptl to IM wwkers' wmqneUion lewe d Celifanie. eM epree Ihe� tl 1 ehouk bacoma wbjeq Io IM xoMeis'
compansmion pmrisuns d Saean 3]00 0l Iha IaEor Code. I shell lorl�wnh wmpy wnh Uroes qoviemns.
om,: nod�,e
Wern/np: Fe/lun fo �wuro woAsri rompxuetlon eovereps b unlswNl, entl �hell �ubJwt en Hrrp/oyx ro etlMnsl pavltl�� entl
clN/ Ilroi up m one hunCred fho�nntl Gollan (5100,000), ln �daltlan N M� caf ol comp�nufbM1 Jem�pu ai povlGeJ br /n
Sxtlon 3� ol Ns LeDo� Cod, /nhn�4 and ettomW'i Iw.
CONSTPUCTION LENOIN4 ROENCY: I hereby ellirtn unEx penelly M parN�Y �� �� c e canslrud'an lemting eperu.y br �M
�nom,� w ma � iw.nw� ino v�,�v o a�ed tseea, xc�. c:. cl.
� LENDEN'S NAME:
LENDER'S RDOHE55:
I canity ihet I heve read ihis epplcelbn end stme �he� the ebova inlwmelion ie wrteU. I epree io comply wn� all ctily eiM munry adinerwes
uM ste�e levn mlmig lo build'vp con�rud'wn erd hereby eu�horrza repewme�ivea d ihis dly io entar upon ihe abwe-mentionad pmparry
�«inapetlq�0"`0°�°' ROHERT DAVIS
(StSt<B WP) While-Build'vq 8 Sefery; GreeeFFk: Canery-Appl ant: Pink-Ravenue: (ialEenrod-Asseawr
PERM NO: E 078096
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : LEGALIZE ILLEGALLY HOILT STORAGE 6 BATHR SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: U-1 /
COMMENTS: REF: B-76802
**�****x�*�*�**+�*it*****�+�*�*x****��tx��***�***xie*atit�+�+��*it*�atat��*��*+�*ie***�**��*��;*
7. O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGAT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: FARCEL: 42531121 ZNE: REF NO:
PLANNING NOTES>
> — 1
fE iE 1k iE 1E iElE iE iE 1E iE iE iElf iF if if-if if iE 1f �)f 1E 7E i!� iE 1E ff 1E iE 1E iE iE fE"if.iE iF iE if 1E iE �E iE if iE 1E fE 1E iE iE fE fE iE iE iE �lE IE �fE �1(-fE fE i't �1E �YE 1E 1ElElE �IE iE iE iE iF �IE # iF 1E iElE
D E V E L O P M E N T_� S_E R V I C E S R E Q 0 I R E M E N T S
ZONING APPROVED BY
HUILDING APPROVED BY :
i .. .!
APPLICATION ISSUED BY: ' '"
1klE1E1ElEififiEiElfiE'lE'lElE1E1EiE9EiE'IE'IEiE�lFiFiF3fiF��F��F��F�iFiF�FiF iF iFiE�
LEGALIZATION:N F' E� E' S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 43.50
50�
PLAN
ISSOE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 43,50 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRZC MECHANIC
65.50
DATE:
DATE; /
DATE: O II Q v
iE3ElEfEfEiF1EiE jkiE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON—RES �
TOTAL PAID DUE
65.50 65.50 .00
65,50 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
iE iE 3ElE fE iE iE 1k iE iE 1E 3E if jF 3E if iElE 1E 1E �E �Elf ib 1E 1E iE iE �E 1E IE �E iE fF �E fE iE 3E fE 3E 1E �E �E 1F �E 1E 1E fE iE iE if * iE 1f 1E df 1E iE if iE iE 1E iF �E iE iF iElE iE ik iE iE �E 1f if iE 1E 9E 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R 2 P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V& BELOW 201 AMP 27.25 27.25
ELE 1 SUB—PANEL 16.25 16.25
END OF FEES
�
�
C0�ISTRUCTION AND P�ANNING � ^ PO� . SPA , (
Date Inspect Date lnspeitor �
SlPpSiOVALS Permit # �' APPROVAIS Permit #
7. Temporary Electrical Service or Pole ,��'ti, 52. Pool & Equipment Location .
2, gpii Pipe-Undrgrnd. � 53. Steel Reinforcement
F�3.�"ElectricalConduitUtility•Undrgmd. ! 54. Forms
-^�rr.
-- 4. Ele'ctricai Conduit�Undrgmd. ' 55. Electrical Bonding ��
�.
i�'.S���Steel Reinforcament �� 56. Roagh Piumbing & Pressure Test �' � �
.. .6. �ectrical UFER Gmd. 57. APPROVAL TO COVEft-GUNITE �
i`µ:h Y
'+'`-=.'7�.;Fnotings 58. E�ectrical ConduiT-Undrgmd. �
=`<8. Foundation 59. Gas,Pipe, l7. Undrgrnd., Test
'g�"9. Water Pipe-Undrgrnd. 6Q. Backwash Li�es,P�Trap, O Undrgrnd. �
10. Structural floor SYstem 67. APPROVAL TO DECK
7 7. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final
�2. �SQ'^�e� CaP 63. Heaier & Vent-Final
73. Roof Drains 6A. Plumbing System � Finai
14. Rvugh Plumbing �5 65. ElecCrical-Final
15. Rough Electricai-Conduic -_ 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval !
77. Raugh Wlring Sign 68. APPROVED FOR PLASTERING �
18. Rtlugh EleMrical�T Bar Ceiling 69. PQOL/5PA SYSTEh4S FINAL
19. Rouc�h Heatir7g&q ir Conditioninq Fl� EPT REQUIREMENT
� � t 1� C, 'l':: i L"7 b' Q' '; G: Cu' Y': C Y�' -�CA� G
20. �S?ou23h ��cto� Feteplace j r`a i� c� z: ti H�;; ^ APP�j01�.�1�`5��.-`�: P`yrmit # �
. � - �-� �-, ,
27.FDucts.iR�truCtuFe.;: � •••• �'�=� '` � `y ._'.. 70.�.JndeYgc�'µ(jdC�dro �
.a: i S'r� Tc fS r. �7::: i
22..9ucts, Venti(a ing,:y: � i;:� - .-�.� �u� 71. ProducCAipin�_C]Gas �Oil
23.vGas�Pipe�Rough & Test _ �y: <' �� � `� = ' 72. Undergrdund F�ush
r�n r 6 5� .
24_ qoof�Framing' " �`-`! �� �" " � �� � 7� Undergrnd.StaeageTank OGas COiI
25. Roof Sheathing � � � `� 's � ? �n 7b�. Overhead Hydcn
'1�t :t'-� i7 ,^-.`c
26. T�9ar Ceiling {Structural! & Monocoat ;c `-'�'
�>+ C7': 7k. Dry Cha,7nical F,
27.cFrameartd Plashing:� •��;�7 � �• � �ri 76. Dry Staf'idpipe�'
r, r� 9i'
` 28.'Lathing &Siding''.''. '' �:��,: j st �' ��� ' ' 7� FIXED`�SYSTEM FINAI
29. Insulation %;� ` � ^ ?� � � �' 7�. FIRE PREV. F�INAL �
30. Drywall Nailing =': ;_, � ;` �.-, rt g p�k��ALTH DEPT. REQUIREMENT �,_�____�
,�.31.Plaster8rownCoat��`+ ��T'v �� � � ' 79.FINAL��NSPECTIQN s
32. Electrical Power Meter-Final '���„/, �� $0. F000 CERTiFICATE ISSU'eD
r�:
33. Fi��al Electric W Notes:
34. Finai Heatirtg & Air Conditioning � I
35. Final Gas Pipe�Test
36. Hood or Canopy �
�~
37. Flnaf Factory Fireptace �
---- �
3$. Pinai Plumbing �
39. tNater Service-Final
40. Gas Service-Final '
41. Solar pomeStic�Final '
42. Backflow Preventer ,
43. Backflow Irrigation
44. landscape Irriqation System �
45. Sound Atienuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING -
r
48. FINAI P�ANNING
49. Elsctric Release to Edison ---
50. Gas Release to SouThern Calitornia Gas Co �
51. CERTIFICATE OF QCCUPANCY �.�
No Date
.00�sso�Ba��: 354 LA PERLE PL urar:
oxNexsxnxeir�vn:WILDMAN, HELEN D
� �,ow+Ess:p O BOX 125
" SEVERANCE NY 12872
518) 532—`1734
�vtt.uuiwcwo�ss:353 LAPERLE LN
C.M. 92627
�XCXRECT OX ENIiNHfI: 11C. Np.:
UICX.ON ENO.'S �DOAE55: UNT:
CONfXAttORS N�ME:
cartn�croxs�uiwc
ADONFSS uc.ra.:
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LICENSED CONTHACTONS DECU1p1TI0N: I Mreby ell�m uMx parely d perjury �het I em Icenaetl uMm pwisione M Cheqa 9
(mmmenarp xi�h Seciion )000) ol Drviaion 3 0l the Buainem eM PrWeauom Code, eM my lioenea ia in lull br<e anA eHad.
cm uc. No.: uc. cuss: uc. No.: EXP ;
ome: commao.:
OWNEN BUILDEH DECLqPATION: I Mreby etfiim undar penely d per'ryry Ihel I em exemq Irom tM Comraqon Licenee Lew Ia �ha
'dbwvq reamn (Seuion ]031.5 Busi�e�e aiW Prdmabna Cale: Any ciy a county x1iiM rtQui�as e partnil to caulrucl, elier, improva,
amd'oh, a repei any sVuc�ure. prior b Ia eavice, abo reQui�ee iM eppl'vsm Iv euch pom�il to fib e aipmE sbtemeM tlel he a eM
�e licemed W�� �a Ihe paviaiom W Na Conlradae Liceroe Law �Cheqar 9(canmemiip xil� $ed'pn )000) d ONebn 3 d iM
Busineas eM VrWeaions Cotle� w ihei he a nhe is eaemq �hxelrom arM Ihe bew fa Na elbped examqun. My viole�on d Sedion
)031.5 by enY aCd�� lor a partnn subpd� IM epplicenl b e wil perely d ml mare IMn INe huMred Edlen �SSWj).
�] I. m ovmer olihe propeny a my empbyeea wYh wepes av �hei sob mmpenulbn, will Ao IM xrork. eM ihe nuunure e na immded
«mia,ed i«.da ts«uon mu. e�� e„a a,«<.ao�a c�: rne canveaas u�v. �. ma. �a accW �e � a�, d wawm
wlw Wida a mpro+es �Mraon. eM wM10 doea s lh xak timeetl or henatl a WapM1 M a Mr own smpbyees. pwiEeE Ihm euch
imD�'emanls are nd imeMeE a oHared fa eab. X, howa�er, tM p�iNirp or'unprmwmam u vald wnhin are yw d cpnpletion, ihe
ow�wr-0uikbr will heve �he burden d provirp ha or eM Ek iwl Wild a improve /w IM Wmoae d eele�.
� I. ea owrcr d tM pW�Y. em mdurcNY mntredN wnh licaaed conVaclas ro camue Na pMw (5aevn )041. &airoea utl
Vrolaviom Coh: The Contreeae Licenae lew does iat epply io en owner d pmpeM � d+ilde a impwu �hareon arM who
wnvazvs lor swli prqetle xith e mnlr�or�s) Icenaed WnueM �o �M Contmaon liafue lew�.
�TSQ examp undx Seaion: 8. 8 P.C.. br Nia raemn:
I do by cMity �hel I em ewere a! ark u�Meniaid me �aquiremenb d Celfomie HeeXh vd Sdery Cotle Sedione Y5505, 255�3, eM
. eM the� 1 a eny Mure W iNi�q owpeni will / wil nd (c'ucb me) need b comply wIh aek atate codn ud the rpuiremenn M
eGe�InmmvuciianamoClfiu�ionham�Mlir u�a 1iy.arew���0'ntriC.FeeidemielcormruaioneVP�iomusezsmqlmmNeaa
Data: Appli�a�t:
WOqKEH'S COMPEN4ITION DECL�fl�T10N: I hereby effirm vMer penelry d perjury pr d Hro Mlovnrq deWralbna:
❑ 1 heva erd W meinten a untl"raie W misenl to sepiroun lar v.wkera' wmpenselion, n prwided ia by Seaion 3]W d �M labar
Gotle. far ihe W�amence d Na v.ak (or wldch �Na D�Y u is9ueA.
❑ in�re�ew���m��xen•�v�����.m�n��eaMsae�a�aoain.im«cme.ro,m.va�ro.�.am.
wak t«.hidi uw w�n ie iesued. Mv wvkan comue��ion vnurarice umer vd c�v �wmber u.:
c�a.:
. PdicyNumbar
�This seclian neM mt be rompbfeC / �M parmt is M aro hvnE�eC Edlan /SIOJI w Nxa,1
❑ I eertdy WI in IM pe�amenee d IM wak /a whch thb pmmA ie baued. I Mdl nd empby erry pucn in vry menew eo n to
w�» .�q� �o ma .«k,�,• ��.m�, e.. a c�rn�. �a .o�e, uw n i.n�d e,�om, wq,a to tM Mo'Mie'
�w��vion ww+aon. a seaia, moo w me Ld,« cme. �.n,n �ann.nn oomW wnn moee o�ow.ian..
Deta: Appli�am:
WeminO� FeYun ro��cvro wailron' eompxwtlon rovarep� l+unMwNl, entl L�sll NdJxf en smploysr to erlMiW pxuMN en0
aM nnu w�� nuwree �noua.w aaYn (sfatowA �n .ee�rkn ro m. co.t or mmyruatan d+m.w u povww ror �n
Sxtlon 9]OS ol Ms LMor Cod�, Intrruf, anL �ttomryl I�u.
CON4TNUCTION LENDIN4 AOENCY: I hereby effirtn uMer perialry d per'�uy Ihet IM�e u e eon�eWbn MMiep xpem,y lor �he
oenameze a ine wax i« � mm v��'v m.�d Iseeo� xei. cx. cl.
LENDEN'S NRME:
l.Q1DEN'S ADDXE55:
I cerlily ihel I heve reetl �his appliraiion eM ate�a ihet the above informetion is conea. I qiee to cwnpty wil� ell tly enE oounry ardinancea
end s�ele lews relet'rq lo Wikvq eanstrWion eM hereby eNlqrce repreaentairves d Ihc aryto en�u upan IM ebwe.menlunad peopeM
IpN9(NCOIIp11f�OHERT nn.vTc
� � /7— �Y�
Dme.�
(5151de.WP) Whna-BUJd'vp 8 Sefay: Green-FJa: Cenvy-Appirent: Pink-Pewnue:OOWen�oo-A+ae�sv
CITY OF COSTA MESA — BUILDING PERMIT
" ' PERM NO: E 077726
PERMIT NO: E 077726 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : LEGALIZE ILLEGALLY BUILT STORAGE 6 BATHR SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: U-1 /
COMMENTS: REF: B-76802
�at*at�x�*it*��***��r*� ***it�t��r****x **ieit**x�itatit**iex ***it*atx �t*it**�it�tx�**�ritititat***at**� *�itft*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42531121 ZNE: REF NO:
PLANNING N6TES>
�
1E 1E 1E 1E dE 1f 1E 1E 1E 1f 1f iE 1f IE 7E 1FlE 1E 1E iE 1E if 1E 1f if 7ElElf IE iE 1E 1E iE 1E fE fl�iE fE f! M iE iE 1E 1E 1f 1f 1E 1E 1E iF 1f 1f 1f iE iE 1E 1E 1E 1f 1F 1f 1E 1F if 1E 1f 1E 1E 1E fE 1E 1E IE 1E 1E iE 1E 1klE
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
V'
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : t�'"� DATE:
APPLICATION ISSUED HY: .�� DATE: S I, / V
I(�1E1kiE1EiElf1E1f1I�fEiEfEfEiElE1E1E1E1EfE1E 1E1E1E1E1('1E1(�1EfE1F 1E1E
LEGALIZATION:Y F E El S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 6.00
50$
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 6.00 15.00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
2 1 , � �
SMIP/NON—RES
TOTAL PAID DUE
21.00 21.00 .00
21.00 OVER/SHORT; .00
FIRE SMIP/TOT GRADING PLAN—CHECK
*ititit�itet�r�r��***�at�*�t**�+t�**itft*et�trtit**atrt*if*itit**at**�*�**it�*�it*��*at**�t�r��x �it�it�**iE*it
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 FIXTURES LIGHTING 1 ST 20 EA. .75 75
ELE 3 RECEPT/OUTLET 1 ST 20 EA. .75 2.25
END OF FEES
/ (�
_ I CONSTRUCTION AND PLANNING �� ' PO� � SPA
�� ,^,PPROVAIS Permit # Date Inspector pppROVALS Permit # Date tnspector
1. Temporery Electrical Service or Pole �' 52. Pool & Equipment Location r
2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement
.. 3. ��lectrical Condu�t Utility•Undrgrnd. � 54. Forms '
'4: Electfical Conduit�Undrgrnd. 55. Electrical Bonding i'' ,
�� 5. Steel. fleinforcement � 56. Rough Plumbing & Pressure Test
-;..6. Electdieal UFEfl Grnd. 57. APPROVAL TO COVER�GUNITE
"�,7. �Footings 58. Elearical Conduit�Undrgrnd.
`8. Foundation 59. Gas Pipe, O Undrgrnd., 7est '
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, Q Undrgrnd. "
70. Structural Floor System 67. APPROVAL TO DECK
11. Property Sewei L�ne & House Connection 62. Backwash & Receptor-Finat
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains 64. Plumbing System - Finat
14. Rough P�umbinq ' 65. Electrical�Final
15. Rough Electrical-Conduit •• 66. Solar Sys[em-Final '
16. Rough Electric W�ring 67. Fencing & Access Approval
77. Rough Wiring Sign 66. APPROVED FOR PLAS7ERING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough H�ating &�A�� Condrtioning .� � v� ^ pIREDEPT. AEQUIREMENT .
- - - � . ' ,,, . . -i -
20. Ziough Pactory Ft(.G�lace = : ,J � ' � - �: K •, APPR.OV.�1"$_ ` P � mi2 # � : � •r -
.� < � �^_
21.flucts,in.Ejtructur¢�z �� �• , �- i�.�K 70.t-tJndergrtrtMd6fydro '
�
22. Oucts. VETqtila"tin9� _ ��`. � .. � 77. Product�Piping L1Ga: �70i1
23. �as P�pe�ough &�Test - - - x � . , _ 72. Undergraund Ftush - ��
; 4. Roof Framing -' _ _ �: x,_ � ' �. "� 73: Undergr�d. Sto��ge Tanl� O Gas C Oil
25. �RooS.She�thing � � ..� v ` �r -, - - `��. 74 Overhead HYdm-- �
26. �T�Bar Ceiling (St�ucturaq & M&�d"coat , - -� ;. 75. Dry ChG{nical " r'_ , _ '"
- 27. Erame and Flashing . , . . * � 76. Dry Staudpipe•Z.-� � � � - -
28. Lathing&Siding �-� � y i ,� 7� FIXEOS`(ST�M-FINA�.'�" ' '
*- 6 78�. fIRE PREV. FINAL �
� 29. Insulatiop. z c - !: - '
30. Drywali Nailing '" % ' i � " -' -HEALTH DEP7_.REQUIREfYENT
37. Plaster Browr�.COat �'" � c� r � �F � 79. FINAL RVSPEC1:IQfV ._ ,- �
.' �
32. Electrical'Power MeterFinal � '� � 8�f.� FOOD C.�qTIFICATE I�SS�JE6' .
. �. . ��/�l��i _ .
.' 33. finaf Electricr K .�' �. _ c" ��7`'��i�_^ ,: Notes: _ _ :-� .
34. ,E,inal��Heatiny& Air Gooditioning � tT. � � [ - _ - ' � �� •- �
rt• � � t'1 �r �
K _ . ...
35. Final Gas-Pipe-Test . " ' ��. ' � '. ,- . , .
, _ • • �- _
36. Hood or CanoPY " � � ' `�' �''� '^ ' , ^ , : _ ?e _ :.r
•ro ���
- 37. Final Factory Fireplace� � : F;`; _, ; ', � -' � �
' 38. Final Plumbing � " � ' ' ` - _
h
39. Water $ervice-Final `- ' ,�, -. - ` .
- . - �' : �
40. Gas Service-Final + � � � - �� � � � � � �
41. �olar pomestic•Final . : - , ;
.� _
42. Backflow:Preventer - �.� .- w r, .". -
43. Backflow Irrigat�on • y_ n' ` F : � x- , �
44. Landscape IrriQation�System'. �: x < � ' - - , � = - .
,� , 1
45. Sound Attenuation, ;_, " . � ', ,;' r _
46. Handicap Regulations _ -• � ' � � ".
47. FINALSTRUC7UR"E&BUILDIrN�i ' -. �
46. PINAL PLANNING- � " • -
49. Electric Release to Edison � � � '
- - r
50. Gas Release to Southem CaliforD�a Gas Co . . _ � � ��
51. CERTIFICATE OF OCCUPANCY
No. Date +
DECLARATION OF ._�THORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
� �
�819�r-Permit N ��.
This Permit #
AP Number
t. I(we), H e 1'���. W t��m �—n , declare that I am the Owner of Title
of the above referenced real property, and that I(we) hereby authorize:
'�obert �Dc�uis
Name
3S
(�"1 e
_(�i�� 63►-aa�sr
Telephone No.
to obtain permits in my behalf, as owner/builder, for C.6f11��_fZt6C� � 6 0.iOSi�
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I(we) shali im-
mediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws.
3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation.
4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties as a result of work authorized
by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct.
Executed this 9� day of � 19� �p_, at ������ ��.
I�QYOGt✓e,7 �' �NDoo� .��bi�i6
Printed Name MARG-�aE: �.. <,,;;,o Date
NOtery PubliC. Smte ot New Yotk
^ � � � Essex County. No. 4841103 �
� � / n �/ea.o e � �-,�. MyCommiuionEaV���'�u1y31,19
�ignamre
NOTE: This authorization does not grant authorization to perform the work as owner, it solely provides
for limited power of attorney to secure this permit in any behalf.
NOTARIZATION REQUIRED
an9-as (Rev. 7/911
�OONESSOiBUILqNO: 3SA LA PERLE PL
°"�Rs""�E�`�w"' WILDMAN, HELEN D
�0°"E"' P O BOX 1Z5
SEVERANCE,NY 12872
�vr�. �uia+c.no�ss:
urcxrzEcr on u+m+vn:
u+cx on eaas �oox�ss:
uc w:
UNT:
J
�s
uNr:
`°"`""`t°"5""'�' JOE CARLOS PLUMBING ( 714 ) 548-5558
CONffl1Ci0RSYNINO 1675 SUPERIOR
"0DPE54i COSTA MESA CA �NO= 385443
92627 u"T:
110EN5EO COHfNACTOR4 DELIM�TON: I M1ceby dfim ivWx pene�y d peepey Nei 1 am IicmmE ivdw porinan� d Gheqr 9
(eommaewiiq rnh Seeiian )000) d Dnivion 9 al the Bueimm eM Pmfeseima Cotle. enE mY �� � in IWI Iaea md eHsq.
c.no.: 025793 uc.cuss: C-36 uc.wo.: 385443 EXP; 12/97
ete� CaMratlar.
NER 8 ILDEH DECIAN�TION: I hneby effirtn uMer pendy d perjiry Ihel I em uemq Imm �M Conlreuon licanee Lew la Ihe
Wbwiq �sefm (SeUion 1W 15 &niroe� vM Rdemiona Cadl: �my cYY o mumY whitli nVuim e Oe�p lo aoroluY. Mx. impow.
smolah, a repv eny nruciure, pna b nn uwvKe, eho requiree tha eppli�anl lor auc� permil lo fib e eipned eletemeM Ow M a sM
� licenfed W��t la tM provitims d IM Contretlas L'xeme lew �Cheqel 9(oommenenp Milh Setlon ]000) d Dw'vbn 3 d Ihs
B�ninav eM VrMeaeione Codel m �hm he n+he ie naemp ��sehvm eM �M Easo fa Me dbpod ezemqion. MY vidmion W SeUion
]0�1.5 by eny epplicen� fw e permil oubjeda Ihe apW'rani ia a ovil peneXy of mt m«e Ihen IMe huMmE tlollan �fSW�.
� I. m oxmr al llw pope�Y a my empbyeee wih wepes m thei ede wmpanution. xill do Ne waM. vM IM NiucNn e rol impMed
or oRered la veb (Section 1Wa, Bueinev end PMeeaiona Cotle: The ConVedon Licama Lew doee m�epply�oen ownerd propMy
who WIM w inwo'�� �Mreon. end who eoes � A xaele NenseM a Mnell rc Waqh hu a her own �mpkpee�. pwidad thet weh
imqwemenle ue M imeMed n dlemE la veb. tl. Aowever. tM buiNirp or inpwemmi n�dtl wnhin a�Yw d mmple�ion. Ns
oxmer-Wilder Mill hera Ihe W Nen d pioviip he ar eha diE nd WiW a imqwa la �he WNae d veb�.
❑ �. es own« a �n. wwsm. � aauv+Nr �,����o �n �iron.a convma. m mn.ma m. wa� (swion ]o... an:�... w
Prdevbna Code�. TM Cantredae License lew Eoee iwl apply lo en owiwr d qvpe�y who buJda « Lnpovw Iheraon enE x1n
Cq1VYU Ia Wil pOqlda wilh e fpY2tl01'e) WMld WA�� lo IM COn�retlOn LGMG 19w�.
� I un uamp undx Seclian: B. 8 PF., la Nis reavm:
Dme: Owner:
I do MiaEl' �M Nel I em awvs d rd u�daaW W iM �W��M«m d CaOarva IWlA md CaelaiY COEe SWion 25505. 2553�. ad
25Ua, vd thm I or ury Muro buiNirp omryeni xill / wil M(dfcb ane) med to compy wih eaid &eta mds� W iM nQuimnwN� Oor
a0�lamuWtlbnamod(mionhanlMAi�iui�y enepmru0inria.Retidraielav�tlrutlioneppfulbmena'anqhomtlrea
pwbions.
Dme: �oDkeN:
WOflKEN'S COYGEH4�TION DECWi�TON: I heretry alfvm uMv penMy d paij�y ons d tM blbwLq Aetlumbru:
❑ � neve ene »il meim.n. eanrm. a om+.n �o..n;mu. ror Moekero• eoinpammion. o pwided �w b swion sroo a �n.l.e«
coe.. �« �ne wmm�ancs a ua w�k �«.N:cn mis o� a a.�e.
❑ in..<d,a.um.w.:,.ona.•�v.��++m:M���..,�wo.aers�e�a�aoam.�e«coa..�«m.o.�a.am.
}( waF fa x/i'rh IM1ie permn u iuued. MY ��n �De�� inwra�ce mmer eM pdiry numbar ere:
c.m..:
aatiyr+�mt«:
(Th'v wion nsM ria 6s cwndmeC / Ns Oe^�� h b aro hu�eA da0ars R10J1 a Im.)
� I ceMAy ihe� in Ihs pMamence d the wak la whch ihia parmil ie eeuetl. I Mell ml mm ury pamn a eny men�wr o n to
bacwm wbpa io iM wYan' oompemation laxe d CeNomu. enE epres IIW p I k bxmr wEjtl lo tM xaAw�'
� naelion pmvie/ions d Sodion �)OD M �M Lebor , hwi�h mm xit qwi ' s.
tla: ^ �\��'�.� Appl' :
W� Inp: FNun ro��cun workn�'rompinutlon cwerep� li �nla l, enJ Nsll wE/�cf �n w'plo n/Mnl pxuNu mA
� nrr. �y ro a,. n�nerw rnou..m dd�en �sio0.000A M�� n ro Ms ewt ol rompxwtbM1 mep� �� povWM br In
Swtlon 9]O6 0l Ms LWoi COM, lnNn�t, an0 eMrnsy'� Iwa.
CONSTNUCIION LENDINO �OENCY: I Mreby ��m uMer panalry d perpiry Rat iMre b a wnslrudion bMirp porcy far Ne
peAormerce d Ihe xwk M which the pvml ia uaed (�� ��. C'v. C).
LENOEH'S NAME:
LENDEH'S �DDPE49:
I cenM �� I heva reaE ihia epplkMim uM ada tMl iM ebv+e iMormmbn u mrtm. I epna lo mmply wilh M tllyenE oouMy adinaiws
eM e�eta lewa �slm�q io buikiq cmwudion vd heraby eNlar¢e npeaenle6wa d thie ray m amx upon 1M abwe�meNuned piapa'ry
la irepxtian puryme�.
JIM HOI;GES
(5151d6.WP) � Whna-BuildiqBSdery;
Nnk-pmaiue: GclEenmE-As�w�a
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 083899 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMZT TYPE: PLU
JOB DESCRIPTION : REPIPE FROM GAS MERTER & SEWER REPAIR
CLAIM VALUE:
CALC—VALUE:
PEAM N�: P 4�3389
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: X
�r�e�***�r���r��e���x�r���r�r+r�*�r�e�r�r�r*+r*��**�e�e**�r*�*+t*�r***�**�r��+r�r��*�r�r*�r�r**�e*�r:�**�*�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN AGHT: FT IN LEFT; FT IN RGHT: FT IN
PARICING REQ: PROV: PARCEL: 42531121 ZNE: REF NO:
PLANNING NOTES>
% i; A
1k iF ik if iF 1f if 1f 1f dF 1F it ik it 1f if �f iF ik iF ik ik iF if ik 3F if * ft iF if �F it k 1k �)f %iklF iF it 3k iF'!f �f' if M it iF �E iF iF 1F 1f If' M if'k ik 1E M 1f if if if iE iE iF iE if'1F iF iF')f iE �E iF if 3E
D E V E L O P M E N T S E R V I C E S, R E Q U Z R E M E N T 5
ZONING APPROVED BY DATE:
HUZLDING APPROVED HY : DATE: I 1
DATE
LEGALIZATION:N F E E S U NT M A R Y STRUCTURAL BEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 30Z5=
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 30.75 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
52.75
SMIP/NON—RES
TOTAL PAID DUE
52.75 52.75 .00
52.75 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
M it if if iF ik iF �)k 3F it ik %ik if'lE'1F if 3! if if iF iF if 1F iF iF if if iF if if if if 1E'If iE if �If ik it iE'k if'k �h i("1F iE if 1E IF M iE %iE k it 1E 1E ik il� iF ii' iF if ib iF iF 1E iE iF iF if iE iE iE if'lE if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 GAS RE—PIPE 8.75 8.75
PLU 1 SEWER, CONNECTION TO HUILDING EACH 22.00 22,00
END OF FEES
e�-es-i99�iii:iz atisse,�s
kCPT�:61-0fi89693
REkMIT:083899
CONSTHUCTION AND PIANNING P�� SPA
APPROVA6S Permit # Date Inspector - APPROVAIS Permit �k Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipmeni Location '
2. Soil Pipe-U�drgrnd. - 53. Steet Reinforcement ,
��
� . .
�3.' Electrical Conduii� U,t7{jiy-Unc��rnd. 54. Forms
v c4 Eiecvical ConduirUndrgrnd. 55. Electrical Bonding . �
`.5nSteel Reinforcement � 56. Rough Piumbing & Pressure T.est :
` 6. Electrical tJFER "Grnd, 57. APPROVAL TO COVER•GUNITE , i '
F�7„Eootings '�~ � � 58. EtectricalCo�duit-Undrgmd.
�`$. Foundation =� c 59. Gas Pipe, O Undrgrnd., Test
";J. Wa[er Pipe-Undrg,nd. � 60. Backwash Lines, P�Trap, � Undrgmd.
10. Siructural Floor,System 61. APPROVAL TO DECK
11. Property Sewer Line & 4ouse�Connection 62. Backwash & Receptor-Final
��
12. Sewer Cap ` _„ 63. Heater & VentFinal -•
13. Roof Drains � 64. Plum6ing System • Ffnal '
14. Rough Plumbing_; _ 65. Electricai�Final
� 75. Rough Electrical�Conduit �Y - 66. Solar Svstem-Final
16. Rough Elettric W7rinf' 67. Pencing & Access ApProval
17. Rough Wiring Sign � .� 68. APPROVED.FOR PLASTERING �
18. Rough EleCtriwl-T Bar Ceiling'" � -69. POOUSPA SYSTEMS FINAL -
79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
' ' ' _ r• �, m •_� � �..n
20. Rbuql? FactorqjFir"eplace � " ^ °C' K J _' �' ' %APPFj9VAL$=„� Perinit # �
< i S'T' ::c ti ^r ; r.
21.OLcti,in�Struciure:ir .. , - _ ��. � _ �-+.p 770. �lndergrn7rttlH�.dro a
22. OuMs; Ve'y�'tilazng _. K �' � �S �:Y :r71. Produ�Rping CT3�as CyOil
23. Gas Pipe-RpugYj & 1'e,�st .:� � � �, � <f, ��x � � 72. Underground Ftus1T � -
24. RbofSFraming•• �; �-'-� ���r � � _ - y�•;7�+Undergrnd.Stora�,,e.Tank�OGas �OV"
25. Roo y§heaihin ' �- . ', '� ` : �� . -_ .
9 t �, �� v� '7 ? �� 74'_+ Overhead Hydrq� �
Z6. T-Bar•Ceiling (Strucc�raq & Monocoat � � ' �7 '' 75:: Dry Che�jcal { - ; ''" - �'.,*;,
27. Erame,and.Flashing " ? - '� , �' � `" '-'' ' • -
x .-; � 76. Dry Standp'rPe - , c � �,
+28. Lathing &'Siding � - _ � T �' .• _k 77;y FIXED SY.�TEM`f. �NAI:� ^ �
'29. Insulation� i `� 5 � .' `� � � 7�.EIRE EREV. FINAL � : . .
^30. Drywail N3iling � + ' � � - ' � _• HEALTH�DEPT. REQUIREN(ENT
.- 37. Plaster Brown.Coat � S , ., : f. ^ � � � 79.� FINAL1INS$ECTION �. .
� 32. Electrical:Bowet Meter�Finai �� " � �, �•S0� FOOD CERTIF'�LFtTE 15SUED �
I• 33. Einah,Electric � '' �' ' rti p:_ i - r 1'
ti 4 r F t No1es: t-t
c34. Fina�Heattng & Air GondLtioning•y c� �� l� �' ���� .
._ , .. , ,-, ^ r /� , �.: - ' `r i - J
35. F.inal�Gas�Pipe;fest '� ,_, . �„ � j�/ � i ,'' `: _ ":�.. ;'' �. '
t ��
�36. Hood>or C'anoPY �' -�� � � * -; a +" � � <<� .. �' '� � _'
� �-. . � �.� i. � �-,
_'37. F'�naF;Factory Flrepla���,� � .. r., } :t � :' ! � .. .
' ' .. _ r - -' -: - '*'- i -----
-�38. FinaFPlupibing > � -� � �'? :i -� c ^'
� . �
`� 39. Water Service�Final ' ' �+� � �" � �"% ` ^ ;
t i - -+.
'- 40. Gas Service•Pinal �� -, ;+p, � n� � ' �� .� �^,, � �
}
T41. Solar pomestic�Final' -, . - .. 1' =` • - <r, � -i .
} - . I �:' � . V I�'
42. 3"ackflow Preventer ,. -' - : -�� - � _
. r i
43. Backflow Irrigaaion � _. - Y � t . ~ .t , . .
' �
44. Landscape Irripation�System z �� 2 -. + c•1 = " r�t � .. - _
,% � .
a5. Sound Atteniiation �' "-J r' �- �-x r, ��� sS
- F T T c ' "( " '�
46. Handicap$egulations .:� _ a � � • ; ,5 . �v ,
i
47. F7NA-L STRU6TURE & BU�LDING � �'� ' - ' � � = "
o. � < " • - + -
48. FINAL PLANNING ;. � - % ^t ' .� -. � -+. � -
r
49; Electric Release to Edison • � - T'
.
50. 6as Releasa to Southem California Gas Co . '� �. -� - �
_ < .
fit'. CERj}FICATE OF OCCUPANCY." " � _ ' -
No. Date
�pppES50FBNLOWG: 354 LA PERLE PL
�pa�+u�Ei°.�arrc WILDMAN, HELEN D
, �+� P O BOX 125
�, SEVERANCE NY
� 518 ) ,532—`]734
,vvi:'uuxo�uo�ss: �
%EAh1NY :
APCXIfECT ON fN(iNFFA:
ANCIL OF EN�.'91DURE55:
CONfP�CTqf9 WI�:
CCMPACi01f8 YA'IAIO
ADDNESS
IINT:
12872
11G NO.:
UNf:
uc. xo.:
uxr:
LICENSEO COMRRCTOPS DECUH�TION: I Mreby ellim uMx psrely d qr�vry Ntl I am 1'remotl uMer pw'vim+ d Cheqv 9
(oomme�np v.ilh Sepion ]000) d p�yip� � d Na Buairow eM Pmla�ima CaE�. xd mY �Ne u in IW Mw vd aXep.
em uc. No.: uc. cuss: uc. No.: E X P:
� om.: commam:
OWNER BUIL�EH OECLARATIOry; I MnW eifirm under pendy d per'ryry Ihel I 4n uemq /rom iM Conlraaae licenae lew la iM
fdloxinp reewn (�� )�1.5 &��i�na erd Prolmaion� Cada: AnY cYY a muntY �itli rtyuiree e perm� to mrotruct. ellx. imprw�.
demd'e�, a rapv ury svuuun, pfpe W es ewenca. eho nQuiree tM eppl'xsnl la pch pamu to fib e epmE Hnlement tlW M u eM
o ticeneW pu�went to �he yovubm d Ur Cmlredm Ixanee lew IChepx B(mmmanmp wdh Seabn ]oW) tl Diveion 9 d IM
Bua'viw en0 Rdea'an CoEe� a Ihn he a ehs u a�emp theMmm enE iM be�61a Ns eEaped awempion. My vialetion d Saqion
�mi.s M�r evdvzm i« e w�mn wqea+ma eod�sm io e dw ro�aM d �a mae ine� rxe nund�ea donan IssaoU.
�] I, ee owner dthe pope�y a my employaea wYh wepas d Ihei vde compeneelpn, will do �he wak, erd IM eVucNro a rot intenEeE
a ollered for eele I��ion )01a, Buaneav enC Profineiane Cada: The Conireaan Limnee Lew droe rwt eppy lo en owrwrol poPoM
wM buldn a inprovea Ihemon, eM v.1w tlaee euch work Nmeett or henetl w ihrouph he a her own emDloyeec, povNed thet wch
imparomenu era ml iMerMad or dimeE Iw aeb. X, howavar, iM buiNieq w'unqwemeM is sotl vnihin wr yeer d comWmion. Ne
o..�«�w�a« mu n.� me w�d.� a aw�ro n. «.ne eb �a w�w «�mww. ia in. wmona d.w�.
� I. n ovme� d ine MaWM. am eadareN oonlraa�q xvA 4cenaeA cano-ec�on m cmp�ue Ma G�ol� (Seabn 1ou. BwiMee aM
Prolaseiona Goda: The Canhdon liceme law doee m� eVWY ro en owris d pW�Y xfw buitle or impw'm Ihe�eon eM who
comrecro la wA pqeds wiU e mntreqor(s) IicemeE W��^� to the Convmors licertse lawl.
� I�q u r Senian: B. d P.0 .1 Nn ieeaon:
�D owner.�� 1 l 1��AA l l lQl%.
i n.,eey �enM mm i,m ewme a e�a u�eers�enn ino �a�+.ame�n a ceuamie H„nn o�d sday cme s«Jiam zssos, zssx�. ,,,d
SSSa, end Ow I a a�ry iNun W iltlinp omryeni will / wil nd (orcb me) need to romply wp� seM ¢leb cadea xM �M requiremenls br
epermnlormnevuciionw�mEifiraiionhomlMA'e e�iy enepemenlDisirid.ReeiEenlidmnmruaoneppYralioneareezemptimmtheee
povisbne.
Dme: App���
WOPKER'S COMVFNS�TION DE�upAT10N: I hareby eH uedx penMy d pr'ryry one d Ne /dbwiiq detlerm"vn:
❑ I M1eva vM xip meinlen e wn��e d mneant �o sell-ineuro lor xaken' wmpenution, m povideA Ia by Sedian �)00 d the lepor
�iOdl��OflhO p91�01111BfICB O���q Nqk�pf M'�IlChlhl9 PBT11119189YBd.
'�] I I�m vM Hil meinlen xorlw�i mmpemPobn inwrerce. m iapu'veC by Setlqn �)00 d iM LeEar Cade. br iM paAormenm al tM
. wak la x1i'rh �M1ia pemiN o bsusd. MY wnFen' eanpemmion imurerce fueier end pdi�.y number era:
c�«:
� ad:.y rmmeer:
�mr:.,saro., ��e,�m ea �Waad r me v�e z ro, o� n��e�e ed�lsiool w i.,..�
� I mnry ihet in Uw perlomier�� W iha w«k i« v.fich ihis pa�mn b iaeuad, I ehell ml emplq eny pe�von in eiry menner ao n to
Eacoma w4� to tM xaAen' comoanaeiion lewe a celi�amie, uM earee inm il I ahouk Dxmm. subjea m iM Mvhan'
como�svion wa+.�a d Eeaian a�ao d ine ten« caee. � enen �onnwnn om�oh �mn �ro.. v��au.
ova: �va�:
Waminv' F�uun ro�cun wrortw�'romp�nutlon eowrg� l� vnbwN( �ntlWll rtlJs[t an wryrloyx ro cilMml v�bu �ne
clvll flrros �q ro ons h�ndre0 tlquunC Oo1Nr� (Jlaqoo0). In edtlltlon ro tlrs ro�r ol rompxuetlon, demeps aa provllM br In
Sxtlon J)P6 0l tlre Lebor Lod�, Interos( ens attomsy'� /w.
CONSTNUCTON LENDINU RG@NCY: I hereby eifum uMer pereAy d perj.iry �het Ihem u e mu�ivaion bMi'q epercy Iv iM
yenomieiwn d �n. v.wk �« wnkn me wmi� ia'n.u.d (seaon ws1. civ. cl.
LENDEN'S
i�,nu� mv i na� rem mq
eM stale le�n reletna w W
WILD
IN
.m ��n o�e��.
y� �
(StSf-16.WV� W�ae-Buiknp 8 Selery: GreerFJe: Cenery-Appfrav: Pink-Revenue: GalEmio�As�amr
CITY OF COSTA MESA — BUILDING PERM
PERM NO: B 076802
PERMIT NO: B 076802 PLAN CHECK NO: 00997-96 , ; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : LEGALIZE ILLEGALLY BUILT STORAGE 6 BATHR SQ FT: 2,100
CLAIM VALUE: 2,100.00 CALC—VALUE: 2,100.00 GROUP OCC: U-1 /
COMMENTS: GARAGE DOOA. LEGALIZE BUILT BATHROOM 6 SHOWER , COUNTER & STORAGE
1E fE IE fE 1E fE 1E �F 1E iE iE iF 1E 1E 1E iE Ik ih ik jE ik 1E 1E 1E iE 1f 1E 1E 1E 1E 1E IE 1E iE iE df iE iE 1E 1F fElE iF 1E 1F iF 1E �f 1E 1E 1f 1E 1E 1F 1E 3E 1E �E iFlE 1E iE 1ElE fF 1E If iE iE k 1F iE iE 3E IE iE IF iE iE
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 42531121 ZNE: R2 REF NO:�,
PLANNING NOTES> INTERIOR ALTERATION TO TO LEGALZZE WATER HEATER, TOIL,ET,
> SINK 5 SHOWER IN DET GARAGE. LUR REQUIR£D.
if� 1F 1E iE �E iE iE 1E iF if if 161f if 1E 1E IE iE if iE if if if 1F IE 1E 1E 1E iE fE 1E 1E 1ElE 1ElE iE �E iE 1E ik iE if 1E iE 1E 1E if 1E 1E iE 1E IE fElE 1E �E 1E IE iE IE 3E iE iE 1f IE fE iE 1E.1E 1E �E iE iF iE iE iE ik 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N,.T S
ZONING APPROVED BY ��J\ DATE: ' /
BUILDING APPROVED BY : DATE: U
APPLICATION ISSUED BY: DATE:
��t�ieatieiF�+���at***�ieiE*+eat� * ���**at**** ie*
LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 108,00 50
SMIP/NON—RES
PLAN 70.20
IISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 108.50 0.00 35.10 143.60 143.60 .00
REVENUE DIVISION TOTALS--> COLLECTED: 143.60 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
108.00 .50 35.10
1f iE iE if if 1E 1E 1E iE fE 9ElE 9E �E IE 1E if if iE IE 1E iF iE IE iE IE if 1f iE iE 1E 1E iE 1E 1F 1E �ElE 1E iE iE iE IE 9E IE 1f IE iE iE jf IE If 1E ik iE if if i! ik if if iE 1ElE �E �E 1E iE �E 1f iE �E fE 1E fE 1E iE 1E IE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2100 ALTER HY VALUE RESIDENTIAL NOZONE 1.00 2,100.00
END OF FEES
�; - .`-<-
CONSfRUCT10N ANO PLANNINO � � ._JL & SPA
.!:f'R�+JALS Permit # Date Inspector �� APPROVALS Permit # Date �nspecror
�t. 7emporary Electric2l Service or Pole , _ 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. '` 53. Steel Reinforcement �
- 3. E�ectrical Conduit Utility•Undrgrnd. .� 54. Forms �
4. Electrical Conduit-Undrgmd. 55. Electrical Bonding -
5. �Sceel', Reinforcement 56. Rough Plumbing & Pressure Test � -
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
). Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation :`' 59. Gas Pipe, � Undrgrnd., Tesi �
9. Water Pipe�Undrgrnd. - gQ, gackwash Lines, P-Trap, O Undrgmd. �
10. Svucwral Floo� SYstem - 61. APPROVAL TO DECK
}�, p�opercy Setver Line & HouseConnection � ' 62. Backwash & Receptor-Fina1
12. $ewer Cap • 63. Heater & Vent•Fina�
� 13. Rooi Drains ' 64. Plumbing System � Final
74. Rough Plumbing � 65. Electrical-Finai �
15. Rou9h Elecerica6Conduit 66. Solar SYstem�Final
i6. Rough Electric LViring • 67. Fencing & Access Approval -"
77, Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIijE DEPT. REQUIREMENT
20. Rough Fattory Fireplace APPROVALS Permit #
27. Ducis, in Structure� 70. Underground Hydro
, 22. Duccs, Ventilari�g � 7i. Product Piping OGas ❑Oi1
�',23. Gas Pipe•Rough & Test � 72. Underground Flush
. 24. Roof Framin9 73, Undergmd. Storage Tank �0 Gas ❑ Oil
25. Root Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Fiashing 76. Dry Standpipe
28. L9thing & Siding � " � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. DtY�vall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Elect�ical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final E�ectric Nates: --
34. Fi�al Heatin9 & Air Conditioning l� '' �
35. Final Gas Pipe-Test r"� �
,i
36. Hoodor CanopY � .
37. Final Factory Fireplace -
38. Final Plumbing � ' -
39. Water Service-Final - �
40. Ges Service-Final ' . . ' _
41. Solar Oomestic�Finai � . � � . .
42. Backflow Preventer �
43. Backflow Irrigation
q4, l.andscape Irripation SYstem � �
45. Sound Attenua[ion
46. H2ndicap Regulations
47. FINAL STRUCTURE & BUILDWG �'-�(i��� �� �
48. FINAL PIANNING - �'
49. Electric Release to Edison •- .
50. G8s Release to Southern California Gas Co �
51. CERTIFICATE OP OCCUPANCV
No. Date
. --- .--- -
,..� .. •_. .. ,. ,_...... _�.. __� .._, �.. ". -.:��
E--- 23 � �{ ' --�!
20� �!�
. — � 6 g � 2 _.—____—r
IDIVISION OF BUILDING SAFETY
CITY OF COSTA t�AESA
ji j APPROVED
�'� � 3 1�' 6
� set oi ptaris and sA�lkxlrons MUST be an pds p2�@� itpt
nd it is unlxMuf to make a�ry cAanges a alte ation on }itliaA�ltq � ')
A
rtnission from lhe oivsan ot Buildm8 and ry.�1'�C� I�t
� �i �}T
�tamP�n9 Ot thi5 P� �d ' SFi�1CLyQT �pe l� b I '
or to be an approvat of the vio{ation M a prov�ioro�qF'a�y C4y d .
esa Or!=�ance amUor SUte law.
nese P;.rs aid Oermit �all exphe by Mtita + and vdd f
I I e buiid�ig oT work is not commenced antl maintained adhre par UBC §303
,,.) wit�in , &o aays or issuaxe.
� - - - - - . -
�
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' L - - - - - - -- ' dk..lt,�
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S.nk G�.y.l,�f1'�t:� Hw �
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y Gra,9 e 3S 4 �..o_ P�le. PI �.e., , C.�, 9-ka� cYl e so..
,
%y = � -��+-
1 1';: I �';
�
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DELETIOivS, OR rn;�r^.ECTI!DNSiSH V
,AAi'i1Q � --•
BE APPf �(ED 6Y -i i!E PtA:���±'"�� P,4E117 _,
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eoon�ssweuaaxc: 354 LA PERLE PL
oxmcxsxweiFp+oww: WILDMAN, HELEN D
., �_ ��+� P O HOX•, 125
- SEVERAN2'E NY 12872
518 )'r5?!;'—„1734
APPL.M/JIlNGR00PE55: �'
AXCXRECT OXENtlNEEN:
ARCN.ON ENG'S �DURE55:
uc. xo:
CONIFACiOR'S NA1�:
cwm�cTans xuiwc
woness: uc. ra.:
UNi:
UNT:
UNT:
UCENSEU COMRACTOHS OECL�PATION: I Mroby eXim uMer penehy d perjury tM1el I em IiunroE uMx panaiona d Cheqw B
(mmme�wip wilh Sectbn )OW) d Orviaion 3 d Ne Bu9nea uM Pmleasiona Coda, eM my liceree n in lull 1«ce eM eXed.
cmuc.No.: uc.cuss: uc.No.: EXP:
Dete: Conlretla:
OW NEfl 6NlDEfl DECIAN�TION: I Mreby eifirm wMer peneYy d perFN�Y �het I em ezemq Imm iha Canveaon Liceme Lew for IM
lollowinp reeaon (Seaion 1a31.5 Buevrens enA Prolenione Code: Rny ciry a coun�y whirh requirea e peimX Io mnalrucM, eller. improve,
demofoh, or repeir any s�mclure, qior b ils reauenca, eho requires Ihe epplirent br euch perm0 to file a sipned eietement thm he or ahe
ia licenaed W 9uent lo iM provieiom d ihe Conlreqan license lew [Cheptx 9(commeiang wilh Sedion 1000) d Divaion 3 W ib
Buaiiwas anE Prdeaiona Cada� or Ihel he « ahe ia exemq Ihaehom enE IM baw la ihe elbged exemqun. My videtion of SeUion
]W 1.5 by eny epplirent la e permn wbptls iM epplican� to e avJ penelry d rwt m«e ihen iNe hwMreE Eollen �f500�).
�] i.e.o�„a.dmawooam«mv.mda�wm�.sina:�mmo�w�+.wnaoubwon�.�eine:����soa�m�d
«on«ea ror seie cs«iiw, �oa. eumrea ena a,weseions coae: rne conuei.ron ucen.e �..does �a =aWr me� o.mera popany
wM W ids a inpoves Inerean. ard who doea euch xv�k himaell a Mrmell a IMouph �b a �m ovm empbyeac, prv+ided ihet euch
improvementa era M imeMad a diereC lor eele. X, however, tM WiMiip a'rnpwamem ia eoN wi�hin ona yav ol cwn0letion, tM
owrer-buiNer will heve the Eurdan d provinp he or eha did nm build or improvs fa Ihe W�e W veb).
� I ea ovmer d �ha pmpeM� ��C�ivety caniredinB ��h liceneatl conVmlon �o conalrud �he prqetl (Sedion )044. Busi�wss eM
PrMassione Code: TM Conlredon License lew Eoea nd epph/ to en ovmer d papeity xfio buiNe a impov» Ihereon enC who
irecis la wM projxie wi�h e oonlredm�s) lienaed OursueM to the Conlredae License Lew�.
I amq u er �bn: B. d PA , l t � �
oa.: ow���� 1`+Z��Q � �t l(1}�
i na�nv �nM �nm i em e.�.a a ene unae��e me .eaw,emams d cvaom� H.enn ene sme�r coae s«am. uws. zssaa, d,d
2551a, enE thet I or eny Mure WilCi�p aocvpent will / will nm (arcb ma) neetl b crompy w[h aeid ewe mAee eM Ihe reyuiromaMe la
eroimnlormnsVuctionwmodifi'elionhantheRi ue�lily�epameniDisind.ReuEenlielmnslrudionepp4raioneereexemptiromlheae
oe�e: acviK�:
WOPKEN'S COMPEHS�TION DECIAPATION: 1 hereW elfi�m uMer perel�y d p«jury an d IM Idbwi�p Ex�eretiona:
� IMwvdwilmeinieneceNlkdedmnseniioeallimunbrx«kaiiwmpeiva�bn,e+praidedlaEySedion3]OUdiMleCa
Cotle, f« tM paNameMe o/ �M xwk la wkc� Inis permn ia iaued.
] i ne...�a �;� �m.:� �,on�en• mmre�..��, ������. � roa��roa M s«r�m a�ao d me i.an« coea i« m. wnom,e�,ce a in.
woA lor wliicM1 ihia pemin ie iaeueE. My wakere' mmpan�bn insurenca famar eM poliq numEer ere:
ce„�a.:
Policy Number:
ion neeC rrot be compbleC f tM pemid'a Iw one hundred ddlera /5�001 w bu.)
centy Ihet in IM parlormarce d ihe work Iw wfich t�ia peimn o eaueE. I Mell ml employ erty penon in ury menner eo m to
become aubjec to tM worke�a' canpenseiion kws d Celilomie, vM apree Nm il I ahouk bacome wbjatl to �ho xwMn'
compensa�ion pmvinione d Seaion 9100 W the Labar Code. I Mell forl�xilh canpy wiM tlme pmviwme.
Deie: Applicent:
Warnlnp: Fsll✓n ro�rouro woMea'romperuetlon rowrep� b unlewNl, entl �MII subf�ct en employN fo [tlMntl psns/Hw erM
e/vll flrns up ro om hunOrM fhouulM tloll�r� (5100,000J, In eddltlon ro fh� ro�t ol rompsns+t/on, J�m�q� �a prov/tlW br In
9xtlon 3106 0l Ms Le6or Cotiv, /nNnsf, end ettomsy i Iw.
CONSTRUCTION LENDINO AOENCY: I hareby ��m uMer penelry d parjury �hm �Mn o e camiudion bMiiq epa�wy for iM
paAamarKe d iM wak la wfiicM1 tho peimi o aweE (Sequn 309]. Cir. CI.
LENDEH'S N�1NE:
LENDEN'S ADDflE35:
I canity thet I heva read i�is epdKetion end mme Ihet ihe ebove iMormmion ia rortaa. I eprea lo compy wilh ell aly eM rouMy orEinencee
enE slele levn mla�ing to builEinO cansvudion aM hereEy euihorrze reprasen�elivea W ihie dry io enter upon �he above�mentoned popeiy
�����eP����v����WN WILDMAN
c� � � ^-. I, b
l S..L4.�A Dae
SipneNrea RpenVAPW�✓�o�lreda
(6t51d6.WP) W�iisBuildinp 8 Sefety. GreemFle; Cenery-AppFrant; Pink-Revenue: GOldanro�Aeueaor
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: H 076801
PERMIT NO: B 076801 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: DEM
JOB DESCRIPTION : DEMOLISH ILLEGALLY BUILT " WALLS 6 COUNT SQ FT:
CLAIM VALUE; 200.00 CALC—VALUE: 1,000.00 GROUP OCC: U-1 /
COMMENTS: DEMOLISH ILLEGALLY BUILT COUNTER & SECTIONOF WALLS"
*� ie*+�****� *�******x �**�***�***itit**�***��at�+e*�**+r�+�**+�*�**�*�**+e�**+�*iE**iciF�****it
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAA: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 42531121 ZNE: REF NO:
PLANNING NOTES> ",
i
1E iE iE 1E aE �E 9E iE if� 3E if 1E ik iF 1Elf !E!E iElE iE jE fE 1E 1E'lE �E 3ElE iE iE iE iE iE fE 1E iE �E �E �E fE 9E �E 1E IE iE iE �E iElE �E iE 1E 3E �E iElE �E 3E 1E iF 1E 1E 3E 3E 1E aE 1E iFiF if 1E aE iE iE iF if iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY � DATE:
BUILDING APPROVED BY : �/� DATE: _�_'�_�_,�(_� I'�
- I�Z�+T
APPLICATION ISSUED BY: DATE: �
��*�**��+�****�+��******* � **�* �* � * � ** � ** �******�******��r�� *���+�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25,00
SMIP/NON—RES
PLAN .50
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 25.50 0.00 0.00 25.50 25.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 25.50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CIIECK
25.00 .50
iE 3E 3E 1E iE iE iE 1f 3E 1E 3ElE iE iE iE if iE �F iE 9E iE IE IE iE iE 1E 1E iE iE jE 1ElE 1E 1E iE IE IE 1E iE iF iElE 1E ff 16 iE iE 1E iE 3E IF 1E 3E iElE ik 1E iE 1E 1f 1F iE 1E iE iE iE �E fE iE aF iE 1E IE aE iE if iE iF 1f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
. .. . .. �.
�\
'CONSTRUCTION AND PLANNING � � �OL & SPk�� `' "_� .._ _� _
' ` Date tnspector �� "- Date fnsPector
APPROVAlS Permit # � APPROVALS Perm'it # , �
1, Temporary Electrical Service or Pole ,: � 52. Pooi & Equipment Location �
2, Soil Pipe-Undrgrnd. -; 53. Steel Reinforcement !'
3. Electrical Conduit Utility-Undrgrnd. � ' 54. forms
4. EleYtrical Conduit-Undrgmd. �~ 55. Electrical Bonding �
5. St�Re�nforcement 56. fiough Plumbing & Pressure Test - I
6. Elec:rical UFER Grnd. ' S7. APPROVAL TO COVER�GUNITE �
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation -. 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. � 60. 9ackwash Lines, RTrap, O Undrgmd.
10. Structurai Floor System I 67. APPROVAL TO DECK
11, Property Sewer Line & House Connection � . � 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Final
13. Roof �rains . � 64. Piumbing SYstem - Finai
14. Rough Plumbing ---�_7 65. Electrical�Final ;
15, Rough ElectricabConduit . 66. Solar System-Final �
76. ftough Electric Wiring � 67. Fencing & Access ApA�oval � ' �
17. Rough Wiring Sign 68. APPROVEp FOR PLASTERING
7$. Rough Electrical�T Bar Ceiling 69. POO�ISPA SYSTEMS FINAL
ty, Rough Heating & Air Cor.ditioning FIRE DEPT. REQUIfjEMENT
20. Rough Factory Fireplace � , APPROVALS . Permit #
21. DuCts, in $tructure � � 70. Unde�9round Hydro ` �
22. Dutts; Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test " 72. Underground Flush
24. Roof Framing� - 73. Undergmd.StorageT�nk OGas ❑Oil
25. Roof Sheathing 74. pverhead Hydro
26. T-Bar Ceiling (Structureil & Monocoat 75. Dry Chemicat
27. Frame and Flashing . 76. Dry Standpipe
28. Lathing&Siding � 77. FIXEOSYSTEMFINAL
29. Insulation 78. FIRE PREV. FINAL �
30. Oryavall Nailing �HEALTH DEPf. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION �-
32. Electricai Powei Meter-Final 80. FOOD CERTIFICATE IS5UED
33. Final Eiectric Notes: �
34. Final �Heating & Air Conditioning �� ,
.
35. Pina1 Gas Pipe•Test � }"' `-
36. Hood or Canopy . ��
37. Final factory Fireplace
38. Final Plumbing , -
39. Water Service�Final
40. Gas Service-Final
41. Solar pomesticFinai ' .
42. Backflow Preventer.
43. Backfiow irrigation
44. Landscape Irriqation System . ,
45. Sound Attenuatio�
46. Handicap Regulations � �
d7. FINALS7RUCTURE&BUII.DfNG �..��.���L-L_
ar
48. FINAI PI.ANNING
49. Eiectrie Release to Edison _
50. Gas Release to Southem Calitornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
ADDPESSOFBNIqNG: �jS4 LA PERLE PL
avxcxsNu.�e�ca�wn+: WILDMAN, HELEN d
� woxEss: P O B OX 12 5
, SEVERANCE NY 12872
� 518)�532-'1734
�vv�. wuuxc �oo�ss: �
ARCNRECT Ofl FlIf�NEFA:
4iCN. OR ENO: S ADDPESS:
uc. ra:
camuaars tun:
cartxncroxsMuuxc
�ooness: uc. xo.:
u�*: y CZTY OF COSTA MESA — HUILDING PERMIT '
• � (;(. / PERM NO: P 075803
PERMIT NO: P 076803 PLAN CHECK NO; N GOVT: N SOPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : LEGALIZE ILLEGALLY BUILT STORAGE 6 BATfiR SQ FT;
UNT:
UNT:
UCENSEU COMHACTOHS DECLANRTION: I hereby ellim u�dar peneAY m parjury ihel I am liceneed uMer pranaiona ot Chepier 9
(commena�q wnh Semm� ]W0) ��� 3 d Ne &ninen eM Prdesaima CoEe. enE mY lioensa u in full lace arM ellee.
cm uc. r+o.: uc. cuss: uc. r+o.: EXP :
ova: c�i�a«:
OWNEF BUIL�EP DECLAHAiION: I hemby elfi�m under penepy d psrlury Ihet I em ssemq Irom tM Comreaae Licenae Lew lor tlie
lolbx'vp reeaon (�1ion 1031.5 Buaiiaee vM Prdeobna Coda: �nY uY a�+ntY �� �Vuim e permil to canbun. ellx. impova.
demol'uh, a repei eny evucture, qior lo ils 6auerca, ebo reQuins IM ePWium tp wch permn to fib e aqned slelament ihet he a eM
u liceneed puieuentlatha pranaione diM Conlredon LiceneelewjCheqn 9(canmenarq xilh Sed'an ]000) d DHbion 3 W ihe
Busineaa enE PrWeaebm Code� or Ihel M w ehs ia ezemq �hmehom eoE ihe bene lor Iha ellped exemplion. My volmbn d Seabn
1031.5 by enY Wd�� iw e permn eubpe� �he epd�t to e rivil pereM d �wl more then live huMred dollen �550011.
�r I, m ownar ol lhe prope�y or my ampbywe wih we0� ��ha'r eds canpenee�ion, will do IM woA, eM Ihe �Iruc1ure re nd Imended
ar oXered lar eela (Section )00<. Busineee and Proleaeiane Code: The CoMrenon L'wenea Lew don nm epply toen ownerd pmpeM
wM buida or inD�� Ihereon, uM who Eaes auch waM NmeNt ar henetl «ihrouph he a Mr own empbysae, povkeE ihet auch
impwaneme ve ml inieMed a dlared la eele. ll, lawever, lha buikiep a inprwemam p eoN wnhin aa yaer W wmplNun, �M
owiwr�buiNer will heve Iha buNen oi D�'��9 ha or ehe diE iwl W iM or improve la Ue WN�e W aele).
� I. a� ovmer d iM YWeM. em e�dwNeN oon�reqiq xilh liwnald conVaalon to mne4utl Ihe Ppl� (Sauion )014. Buairase ud
Prolmuom Code: TM Conlredae Lironee Law doee riq appy b en ovmer W prtpeny who WiHe or impovw theraon W who
comnrn Iw wrh prol�a wuh e mnlredor(e) Iceneed punuenl lo Ihe Conveaora Limnaa Lew�.
em mamq uMer Sedian: B. 8 P.C. �M \thine � �a�n: � �(\�\ ��
Det � i� � �� Ownar: �T�C�CJ�.YI�`i�i �.�1 �
I o Mreby cmNy Ow I em eware d erd undenlerM IM requirementa d CNLomie Heellh ud bdery Cade Swfiana 25505, 253�, antl
553a, uN �he1 I a vry Mun Wilduq om�peni wiil / wll na (arcb aw) nsed to comply wilh uid tlete ooE» eM IM roquirom�nb M
apeimilfamneWclionormoEifiralionlromt�eAi uaTenyT.%nepementDielnd.ReelEmtialooneliutlioneppiceliomarauempitmm�hees
Dele: APWicam:
WORKEN'8 COMGENS�TION DECURATION: I Mraby elfiim uMx ro�Y d pajury ais d Ihe bAowi�p Eedueloru:
� IheveeMxilmeinleneaeNRctladwnrmto�aMinwnforw�sn'compsnWion,mPrwk�dlaby&aaian3)OUdthelebor
Code, lor iM pe�iwmance d tha vaA lor whi<h Ihia peimn le iauad.
] I hew eM xie meiman xaken' mmpemetion Imurarce, u rp�ired by SaGbn �)00 d IM Lebor COEe, la the peNamuica d tM
woric la whch Ihie permil ia iwued. My wvkere' cpnpenaelion iNurerwe mmm ud pdiry number aze:
Cemac
PdiryNumber.
(This sMion need not bs complele.f /!he parml is la one hundreL dJ�� R�OOf w hea.l
❑ I cenily Itul in Ihe peAormence d IM work br wfich Ihie pertnii ia ieeuad, I ehell na emqoy eny pemn in enY menner ro d m
Exome eubjea to tM v.oikeri canpaneetbn levn d Gelibmb. vM apres Nm il I ahauk becoms wbjaq �o Ihe v.vAnn'
wmpenution pmvieions ol5adion 3]00 0l lha Lebor Cotle. I ehdl loMhxilh mmpM �h thoee provieiwa.
ome: �ppicenc
WiminD: Fallun ro��cun woilr�r�' corrp�nutlan cowrp� l� unN�l, �ntl �NII suDHcl m�mplorir ro crlml�ul P�IHu �rM
nvn nMa w ro on. nunar.d maus.r�a ewrm fsioa,000l, �n .anron ro m. co.� or mmw�,..rron, am.a.... nrova.d ror �n
9�ctlon 3laG o/ N� LaDor Carb, /nfaea4 +�4 ettomq's Iw.
CONSTRUCTON LENDINO AOENCY: I Mreby elfirm unEar peneXY � pe�NrY Ihtl �hen ie e eonet�udion bMiep eper�ey la tM
peAormerim d the work Iw which �hb qrmt le bs�ad (Sedion 309], Cn. C�.
LENOEX'S NAME:
LEN�EWS AODFESS:
1 ceMity �hm I heve reeE Iho epd�� eM mua Ihel iha aEova inlamAion ie mrtsp. I apisa io compN �h ell dry arM munry oMinencee
uM etate lav.a nle�eq W Wikrp canetruGion ud Mreby eu�hor¢e mpeb��e�ivu d Ihis tlty lo enler upon iha ebova-menlbned properry
br inepedion purpoue.
t^'L��N WILDMAN
�\(\''�\ \ r_Pnnl Ne e
�{ O Q Q 1'C�J��'�7�1� �L-ii�l_� Oeb:�
Sipnazurac O�narApen ppplunVConlretla ��•
(S151de.WP) WhXsBuiIE'rq 8 Stlery; Greeo-Fle; Genery-+�VV«C Pink-Ravanw; add�nroQNMuor
��
CLAIM VALUE:
CALC-VALUE:
GROUP OCC: U-1 /
COMMENTS: REF: B-76802
�iF**+�**�*********�*� **iE**�*x�**�*���*iE� *�iF*��*�*�**etx at�*�� **��**+��� *at*�**ic it�**�t*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42531121 ZNE: REF NO;
PLANNING NOTES>
�
aE �E 1E 1E IE iE iE iE iE 1E i6 iE 1E iF ik iE iE iE aE jE iE iE 3E �E IE 3E 1E IE iE iE if iE iE iF 3F iE 3k fE �E �E 1E 1E iE iE if if iE ik9E 1E �E �E 1E 1E iE 1f 161E iE iE 9E iE iE 1E iF iF iF jE �E IE iE iE 1f if �E iE iE iE if
D E V E L O P M E N T S E R V I C E 5--� R E Q U I R E M E N T S
V
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : � DATE: !
APPLICATION ISSUED BY: /'/J�— DATE: , 6
1E9EiEiEiEiEaEiEiEiEiEaEiEiEiEiEifiFiEaflEiEiElfifiEifiE3EiElEiE1f 1E �i�iFiElEiEiEiEiElfif iFifl(�3EfElElElElEiEiFiFifiFiEif �E iE 1E iE ifiE1E
LEGALIZATION:Y F E E _S U M M A R Y STRUCTURAL SEGMENT:N
��'/ .
BLDG PMT PLUMBING ELECT�2IC� M�ECHANIC FIRE SMIP/RES GRADING
PERMIT 100.00 ' ' � � .
PL� 258 L � � � SMIP/NON-RES
ISSUE FEE 20.00 � � �
BUILDING-DIV-> PERMIT ISSUE PLAN-CI-IECK TOTAL PAID DUE
TOTALS----> 100,00 20.00 .^ ' 0�.00 � 120.00 120.00 ,00
REVENUE DIVISION TOTALS--> COLliECT-ED: ��� 120.00 OVER/SAORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC �. .FIRE SMIP/TOT GRADING PLAN-CHECK
iio,00 �
�E IE IE iE iE 1E ff if aE if 1E iF * iElF �E i(� iE IE 3E iE iElE IE iE 1E 3f iE fE iF 1E if 1E if iE iE iE iE ** 1E iE iE iE 3P1F if !E 3E �E k 9E iE �E �E iE iE iE 1E �E 1ElE aE 9E iE iE IE iE if iE iE if 1f iE ik1E iE 1E if
I N D I V I D U A L. *,F E E �.'H R E A K D O W N
�
TYPE '�QTY D E S G R I P T I O^N+� , � UNIT COST TOTAL COST
PLU 1 HATHTUH ^ `' x 7 00 7 0
PLU
PLU
PLU
PLU
PLU
1 SHOWER .� ^, �,�
1 SINK, BAR - y �
1 WASH BASIN �
1 WATER CLOSET (TOILET) �. �
i SEWER, CONNECTION TO HUILDIN
END OF FEE
i � j
i
' 7.00
r. %.��
. 7.00
% , � �
G EACA 15.00
S
r
, �
%,��
7,00
7.00
7.00
15.00
�CONSTRUCTION AND PIANNING . • �OL & SPA
� qPPROVAIS Permit # Date Inspector AppROVALS Permit # Date 'Inspector
.
1.`Temporary Electrical Service or Pole 52. Pooi & Equipment Location
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit UtilitY-Urtdrgcnd. 54. Forms ��
4. Elec,trical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Stee�Reintorcemeni 56. Rough Piumbing & Pressure Test .� �
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER•GUNITE
7. Footings � 58. Elearical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgmd. . 60. Backwash Lines, P�Trap, � Undrgrnd.
10. StruMural Floor System 67. APPROVAL TO DECK
7 i. ProPerty Sewer Line & House Connection . 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Finai
73. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrica!-Finai
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sig� 68. APPROVED FOR PLAS7ERING
78. Rough Electrical�T Bar Cailing 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace APPROVALS Permit #�
21. Duccs, in Structure ' 70. Underground Hydro
22. Duccs, Ventilating 71 . Product Piping � Gas ❑ Oil
23. Gas PiPe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-6ar Ceiliog (Structuraq & 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�Finai ' 80. FOOD CERTIFICATE ISSUED
33. Final Etectric � � Notes:
L{--�� 46- �a�/_z�zz�az�s -
34. Final Heating & Air Conditioning .,� v �
�LL�EL�L fi��t✓� �'D_��4' !JO_`L_t
35. Final Gas Pipe•Test � /,/t/� ��_��)
(/-��`s!/-� .
36. Hood or Canopy _
� 1�iJ_. ._.-4Z�-��� �L�7c cd�.�-(
37. Final Factory Fireplace
�a'f�llJ ��{_L7 bS'C%f.tY✓�u�G- / /,�16 � _
38. Final Piumbi�g eJ
� -
39. Water Service-Final ,
.40. Gas Service-Final
41. Solar pomesticFinal , � � -
42. BaCkflow Preventer �
43. BaGkflow Irriqation
44. Landscape Irriqation System
45. Sound Attenuation �
46. Ha��dicap Reguiations
47. FIMAL STRUCTURE & BUILDING .
48. FINAL PLANNING
A9. Electric Release to Edison
50. Gas Release to Southern California Gas Co , �
51. CERTIFICATE OP OCCUPANCY -
No Date
�
OWNER _ (�TF'jAQRN�� FT.l1YT1 I, DATE 2_l_�7
JOBADDRES8 3�fy j,a Perle Dr BUILDINGPERMITNO. //��y_
GENERALCONTRACTOROy,mep $],d7-. VAWE a 9(Q_00
APll�-263-01
Li.�- zl BLOCK TRACT 1],%5 Pvt Garage
GROUP
INSPECTIONS
Footing Trench
Foundation Forms dnd Grade to
Rough Framing _
Plum6ina. Rouph to Slab
Heating, Rough
Heating, Final
Sewer, House Sewer, St.
S 'c Tank or Cesspool
L �ng, In Out �
Plumbing, Final, Fix
P�umbing, Final Gas
Wiring, Final
Occupancy
FOflM 210 3M lO�vS
DATE
3 19 7
CS�L`I�
SUBCONTRACTOR
PERMITSISSUED
I NUMBER
426l�
• _` 4343
COSTA MESA BUILDING DEPARTMENT
P.O.80X 31]
COSTq MESA. CALIFORNIA
BUILDING
ADDRE55
—OWNER�
MAIL /
ADORE55
CITV C
ARC CT
OR 1 JE
FOR APPL►CANT TO FILL IN
3� ,�2.r�� 1�
COSYA M SA. CALIFORNIA
�cc.� I�or -) /
oescniPnorv �NO./j
A.P. NO. I I � �
SETBwCN LINE FROM
CENTEN OF STREET
SI�E YARD
iE4.
NO.
TE�.
NO
I TRAC
� o. or�ocs.
NOW ON LOT
`
DESCF2IPTION OF WORK
NEW �/' ALTERATION ADOITION
�ftEPA�R MOVING DEMOLISH
OUILDING NO.OF �
SIZE ,ZD X � FOOMS � STORIES
EXTERIOR WALL
ROOF
,COVERING S��r'�'� COVERING ° Q.'�_
USE OF NEW �
BUILDING ��R.'�"%
J
FEB -1 '" ' 6.0 0? 3`0�9'0 0 0
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
�yV��� —� � � �
BUILDlNG
ADDRE55
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZONE NO.OF TYpE GF
� PL�N6 : /
Y
APPROVED
BV DATE _
SUBJECT TO
I HEREBY wCKNOWLEOGQ THwT I M�VE FEI.O THIS APPIICATION �rvO
STRTE TMAT THE �BOVE I$ CORNECT .�NO �GREE TO COMPLY WITM ALL
CITY ORDINRNCES FND STRTE L�WS REGUL.�TING BUILDING CONSTRUC�
T�Orv. VALUATION
SIGNATURE OF PERMiT FEE S
PERMITTEE
// / 0 � PLAN CHECK S
s 7 ��
AUTHORIZED AGENT TOTAL FEE $
� YW {