HomeMy WebLinkAbout469 LENWOOD CIR - Building PermitsPea��'�ooxess: 46y -LENWOOD C1
MOORE, HAROLD W
x�ME: 469 LENWOOD CIR
) � �nooness: COSTA MESA, CA 92627
642-4942
�HCHIENCINEEH: .
nooxess: .
HAROLD MOORE
� PENMITTEE: 4C��j LENWOOD CI
�oneess: � . M .
uNrt:
flE0.X0.:
uxrt:
(714)642-4942
CA 92626
LICENSEO CONTMC70R DECLAHIITION: I here6y amrm Ihat I am Iicense0 under pmvisions ot CAaDter 9(commencinB'��� Section
7000� of Division 3 of tAe Businew an0 Pmfessians COUe, ana rtry Ilcense is in full foru anE eHed.
iLTY IJC.: ST�TE LIC.: C1A53:
x: SignaWre:
1(EBS' COMPENSRTION UECUIIATION: I �ereby attirm that I have a carlificata oi consent ro seli-insure ar a certifcate o1 Workers'
a0ensatian Insufante, a! a C¢rtifietl coOY ��ereof (Section 3800, Lab. C).
POUCY NO.: E%P. O�TE:
COMPRNY:
n CeNfieO copY is hereDy fumiSheE. ❑ Cetlified copy is filed wRh the ciry BuilAinB Division.
,z; qpplicant: -
IXEMPfION FBOM V/OHI(EHS' LOMPEMSA710N OEpAWI710N: (Ihis sectlon nreU not be complete0 ii Ihe permit is fa one AuMreE (E100) a less�.
I certity that in the peAormance oi iha work far whic� Nis De�mit is issy�tl, I shalt not employ any person in any manner so as to become
subject ta iheyNorker' Compensation Laws f Cali/omia. �/ ,/j�_ /
�� 30 4d ii. �r i �
Date: d Signature: L LU �LU� t
NOTICE: Ii, atler makinq Ihis tleclaration, you shoul0 hecome su6ject to ihe Workers' ComDensation pmvisions of tAe Labor
Catle, you must forthmth comply wit� such pmvisians or ihis permit shall he UeemeO revake0.
fANSTHUCTION 1FN01NG RGENLY: I herehy affirm Ihat Ihere is a consimetion lendinp apenq tor Ihe pedormance ot ihe work tor
whicti ihis permitis issuetl (Sectian 3097, Civ. C). ,
LENOFR:
'" _ RUOBES3: . . .
OWNFB�BUILOEN DECIAMTION: I hereby atfirm that I am exem0� �mm Ihe Coniractors State License Law far the lollowinq reason
(Section 7031.5 Business and Protessional COUe: My ciry of counry which requires a Dermit [o rqnstmct, alter, impmve, Uemolish, or
air any stmcture, D�or to its issuance, aiso requi2s Ne aDP�icant for such De�mR ta file a si0ne0 sta[ement Ihai �e/she is IicenseE
�ant ro tha pmnsions of the Contractors' Sta[e license Law (Chapter 9(commencinp wilh Section 7000) oi Divlsion 3 of Ne Business
Professions Cotle) or ihat he/she is exempt thereirom antl ihe �asis for the alleAed exemD��on. Any Nolation al Sectian 7031.5 Oy
- apDlicant lar a permit suEl�s ihe aDPlicant to a civil penalry af not more Ihan five hunOreO tlollars (5500).
I, as owner ol the D�aDeM or my' employees wi[h wayes as their wle compensation, will tlo t�e work, anE the
O stmciu2 is not intenOeA or offereA for sale (SecOon 7044, Business an0 Pmiessional Cade: The Conirapors' State Liunse Law
� tloes notapDN�o an owner oi a pmperty wAo 6uiltls orimD�avesihereon, and who tloes such work �imself/hers¢If or thmupA
� �is ar her own employees, provideC that such impmvements are not intendetl or ofiereA for sale. 1/, however Iha Ouildinp or
, imDravement is mIA within one year oi completion, the owner will have the hurden of provinq Ae/she Uitl not bui10 or imprave
for IAe purpose oi�sale). ,
I, as owner of IAe pro0erty, am eeclusivety contradinA ��h IicenseU con[ractors [o consiruct tAe O�olep (Section 7044, Business
❑ and Pmfessions Cotle: Tha Con[actors'. SWie License Law does not apDly to an owner ot proOertY who �ml0s ar impmves Ihereon
antl w�o coniracts for such pmjecis cith a coniractor(s) license pursuant ro the Contactors' State Licenu Law). I am aware
that Drooi oi iheirWorker's ComDensxUon insurance s�oultl be OrovideA to me.
� I am exempt under Section: B. 8 P. C.
lar t�is reason: /
Date: d��U (Owner: ����/�
I Oo here6y certi that I am aware of and unUersund the requiremenes of Califamia Healih an0 Salery Catle Sections 25505, 25533, anE
'25534 and that I or any fuNre builEinO occuDant wiltlwill not (circle one) need ro compy with said state cotles anE tha requirements for a
permit tor consimction or mo0itiwtion Irom I�e Nr Uuality Manapement Oisinct. HesiOential construction aDUliwtions are exempt trom
Ih¢Se Dmvisions.
Date:
I hereby certlty that I have read ihis ap
ortlinances and state lavrs relatinp to Oui
propeliy lor inspecti n purposes.
oa�e: � 30 �J
Onver's License ar Social Secunry N:
ApDlicant
n and Sue
�°�
is correcL I apree to comDly wRh all ciry an0 counry
�WINes of [his city to entar upon the abovamentbnetl
1601-68 W�iie—BuilOiig; GroBn—Cotla Enforcemenp Canary—ppplicanl; Pink—Revenue; GWEenroC—qssgswr
CITY OF COSTA MESA - BUILDIrIG PERMIT
PERMIT N0: IB 098812 PLAN CHECK NO: N
CONSTRUCTION TYPE; PERMIT TYPE: OTH STR
JOB DESCRIPTION ; FINALIZE EXPIRED PEkMIT #G8283
CLAIM VALUE:
CALC-VALUE: ,
PERM NO: IB 098812
`•, GOVT: N SUPP: Y
� ..
PURPOSE: OTH
�
SQ FT:
�GROUP OCC:' R-3 /
COMMENTS: X � � -
****�*���*�r+���*��**��r***��x*x�**��x�*x**�r*******�*�*��***+�*x��********�+r**�*��***
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S -
______'_____ _____'_'
LEFT: FT IN RGHT; FT IN LEFT: FT IN RBUILDING ---------
MA HUILDING ----- ACCESSORY
EAR; , FT IN
GHT; FT IN
PARKING RE4� PROV; PARCEL: 42515226 ZN£; REF NO:
PLANNING NtSTES>
>
iE iE 3E iE jE dE # if iF iE �lE 3t if� iE 3k dE iE iE iF iE dE 1F it iE iE iE iE ik iF it iE if if iE jE iE iE iE �)E 3E iE iE if dE iE iE iE iE �lE iF �1F iF �1E if iE iE iE i6 if iF 3E �1E �f iE �)E iF iE * iF 7E iE if iF �lE if iF iE iE iF
D E V E L O P M E N T S E R V I C E S R E Q U I k E M E N T"S�
ZONING APPROVED BY DATE: �- �
BUILDING APPROVED BY ;
DATE:
APPLICATION ISSUEU BY; �� DATE: ���
jFiEiEiEiEiEiEitiElfiEiEltiEitjEitik3lif�kjk iF' 3F�j�F��k'�F3f��F�ikiE3EiEiFiF3EdFiEiE vi(�if
#t i! 1f iF jE jE iE it i� it 3E ik iE iE �E iE it iE if it iE iE �E %iP il� �t dk jE 9E iE �E iE iE ik iE iE iE iF ik if iE iE �1E iF iE iF it it iE if iE iE iE 3E i(� 3f ik jf iP iE if iF 1f iE iF iF iF if iE 3E 3F 3E 3E it �F i! * if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE- SMIP/RES GRADZNG
PERMIT 30.00
PLAN ' SMIP/NON-R�ES �
ISSUE FEE
BUILDING-DIV-> PEkMIT �ISSUE PLAN-CHECR TOTAL PAID DUE
TOTALS----> 30,00 0.00 0.00 30,00 30.00 ,00
kEVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECR
30,00 ,
iE 3E iE if� 3E iE �lE 3E iE if it iE iF � iE iE iE iE iE iF ih iE iE iE if iF #�1E jE iE if iE iE i! iF jE i! iE i(� iF �)E if iP iE it dk 9t iE iE 34 �E IE iE 9f iE jF dE iE i! iE i(� i(-iE iE iE iE if dE iF �JF iE IF dk dE i(� �1F iF 3E 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
INS 1 BUILDING RE-INSP£CTION FEE
END OF FEES
30.00 30.00
0
�l? D�G68685-OOOb968` T i: T
D'a7E�.OE/3L�/?� 'TFiic: �1E=5q
i
:0. �C
0
��ONSTRUCTION AND PL� � POOL 'A , � .
PPROVALS Permit #� - Date Inspector p�ppROVALS Permit # Date Inspector
1. TemporarY Electrical Service or Pole � 52. Pool & Equipment Locatio� �•� �+'
2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement . � .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms - �
4. Electrical Condui[-Undrgrnd. - ' 55. Electrical Bonding �
5. Steel Reinforcement � � � 56. Rough P,lumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd. -
8. Foundation 59. Gas Pipe, O Undrgrnd., Test ..
9. Water PipB-Undrgmd. - ��'> 60. �Backwash Lines, P�TraP, O Undrgrnd.�� �,
10. Structurel Floor System - � �; . ` � � . �61. `APPROVAL TO DECK � � �
_ /
1,1. Property Sewer Line & House Connection 62. Backwash & Receptor•Final %".
12. Sewer Ca � � ��
D � 63. Neater & Vent-Final -% �
13. Roof Orains . 64. Plumbing System � Final �
�14. Rough Plumbing . 65. Electrical-Final
15: Rough Electrical-Conduit 66. Solar System-Final
- 76. Rough EI¢ctric Wiring _ 67. Fencing & Access Approval -
17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING
18. Rough Electriwl-T Bar.Ceiling � 69. POOUSPA SYSTEMS FINAL -
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. U�derground Hydro
22. Ducts, Ventilating 71. Product Pipin9 O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing - 74. Overhead Hydro -. �� � � �
26.,i�Bar Ceifing (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing _ 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. F�RE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMEN7
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED �
33. Final Eleciric Notes:
34. Final Heating & Air Conditioning
35. Final Gas P�Pe-Test
36. Hood or Canopy �
37. Final Factory Fireplace .-
38. Final Plumbing
39. Water Service-Final
40. Gas ServiGe�Final -
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations -
47. PINAL SYRUCTURE & BUILDING � �� ,
48. FINAL P4ANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cn �
51. CERTIFIGATE OF OCCUPANCY.
No. Date
�
1 l� " __ ' ' . . . � ' ...
y � m H W {L ' -. 1 > . �, . _ . .
'p w yj�: ,N � .-�i 4 'P .r � �p ri ��w �ioiot teer wmm� novy eorear Ilnas antl �i9n all aoDrooriata Geela�atlons. ... ' . . '" ' '_' . , , ' y .
i/1 -^'}� . '� �` ! J:^.':J
, �':n j'�py+'� s- ' TRACT NCC � pOT N �- _
-�-y�. .-• ,8a��'3�� <3� a�; �,� :, -. . . _. -
r _Y_ A :; " ' " .. ,. � • ' " . .
. - ,. ;. ._,-. . : . . . �_- : �, _ ' .
: rr ' - ' ' •. � .
y,,' '- - - � TYPEOFCONSTflUCT�ON � NEW ADD' '14CTERATION.. REPAIR� �' . ' .. . � ' ' ' ; �
PrajectAOdrasy�A�� U-'��' � o . ld�Or1VERSION ❑DEMAOLISH OTHER, , . .
ro �c p Fo��~�LY2Y44, ; oEs IPTION OF WORK rTl%v L/V/N( °,P �,p/' . . ��. � IN E U T N
Owner'c Name ' ' .r ' . �'. i ,, � '" . �: � �, . i.
Addrea WO CI'Pr'- C��': Z.:��� ' . . . . . . . ' `_ ' � . . . .
TVPE OF PERMIT GRADING � FOUNDATI N STRUCTURAL A.� P.'d� S ' ZONE � .
❑ TENANT �ELEGTRICAL PIUMBING �MECHANICAL ' - PWG. REF. �W �- BUILDING �
Arch/Eng. License No. : � � _ ..
Address ' ^x� O.OTHER . . . ' ' - : '.. � : . ' � � ` Tq B EILD�NG E � // . . �,.�.�_�� . g
� --REAR VARD ITO P/U a:C-(oWL
Contfe[tOf'SNam _ � hOnB PROJECTDESCRIPTION S�:FT. 'OCCUPANCY� LEFTSIDEYAR� � �� :��GHTSiDE�'ARD /� ��
� CONSTRUCTIONTYPF � ' VAWATION$ GJ�SL50 � S`O `V
Addre55�meilingl � � ' -� ' PKG.SPACEREQ.�- PPOVIDED —
, _ - 20N€ GRADINGCV.VDS. � 'ACRE� � �
4cense No. . .
ICENSED CONTRACTOR DECLARATION ' , �
ereDy afilrm t�at 1 am IlcenseC un0er provi5�ons oi'Charter 9(commenGng .
'th sectlon 7000) 01 Dlvlzion 3 ot t�e Business anE %ofesslons Cotle, sn0 '
• Iltens6 Is In fulllorce ana eHdt. : . , -
canse CHss ll<ense No. ,
Date St9nature � ' �
W00.KER5' GOMVENSATIOM DECLARATION � .
' �eraGy�affirm that I �ave a Cerilflcate of consent to seHaniure or a certlfiwte •
WorkerP Compensatlon Insurenca, or a urtlfieE' coDY L�erEof (SecUon ""
]0, Lab. Gy�
-olitY No. �1S 3' O 3 i S. . ComPanY 5��T�10' ��.:
Certltiotl mpY �f �ereby fYrnlz�e0. �
CeJ1J 1 tl J2Y�S tilatl with t�e CI[ � �� Dlvlsion. '
Date Yj.�/��iL—AOVIIwnt�J�fR� ���
-E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thls section neeE not be comGletetl If tha permit is for one huntlreU (5300) or
lessl: : . , . : ; ,
1 certlty t�at In t�e Dertorms�te of t�e work for which Mli parm�t Is IiSueG I-
{hall nOt Bmploy �ny plr50n In any 1lldnne! so �dS�to EecOT! Su�2tt t0 t�le �
Wo�kers' Compensdilon Laws ot C21NOSnta.� 'j � � �`�-), '
Pata �i9naWra�(—aa�a,Ed'+Z+� /�--/,�=-��
NOTICE: 1�, after makin9 ��Is tleclarallon; you i�outd DCcome subject to [ha
Workers' Compen5ation provisions of Ne Labor Coae, you must forthwlth
�omply with tuc� Drovisions or this permit shail be tleemetl revoketl. -
GONSTRUCTION LENDING AGENCV
1 �enby affirm t�at t�ere Is a construction lantlin9 agency �or the parformance -
Of t�e work for. wl�ic� tNs perm�t is � issuetl �5ecilon � 309�, Civ. C.J .
4enGer's Name'
�naer•s Atlareis � ' ' � �
NER BUILDER OECLARATION - - . , � � � ,
ereDy atflrm Mat I am e�mpt lrom Me Contractor's Ucense Lnw for t�e
lowing reason (Sectlan 7031.5 Businass antl Pro(assional Cotle: Any city or .
nb w�lcn reaulres a xrmlt t6 constru<t. alter. imoreve demulish or renalr �
1.0 Dy-any dpPncam i�r a ptrmii suo�¢c[5 IOe 2pplicant to a Uvil '
tlty ut nol mot! than five �unGrotl G011drs (5500). ' �-
. I,.as ownGr oi the propCfty ol�my eTp1oY¢GS wltll wages a5 [Iloir SO�e '
�ompensatlon wlll tlo t�e work, anU the ttruc[ure Is not inlentled or offeretl :
for sale (Sec�lon 7044, Buslness antl Protessional Cotle: The Contractor's
4�cense L.aw Ooes nOt apply t0 dn owner of a O�op¢rty who builtls or Improves
(hereon, antl who tloes such work blmself/h¢r5elf or �hrough bi5 0� her own
employees, provltled tnat zuch Improvements are not Inlentletl or offerea for
zaie. if �owever, t�e Euiltling or ImOrovement is soltl within one year of com-
pletion, t�e owner �will have [ho Durtlen o1 provin9 n!/s�e tlitl not Duiltl or IT-
&r.,ova torthe purpo5e otsale).
�J I, as owner of tbe pmperty, am exclusively contracting wit�'liunsee mn-
vacroreto conzvuct l�e projeci ISectlon 7044, Business antl Protessions Gotle: �
y'ne Contrattor's LJcense Lnw dces �not apply to an owner of praperty who -
builGs or Improves thereon, a�tl who <on[racts Tor suc� projects wlt� a con-
t�actor(s) Ilcense pursuant to the Co ��or' Litanse IaviJ,
[�'I am exempt untlar 5e�t� '�_` � 6. & P. C. tor tNs reason �
CYY
Date Owner
�.re reatl Ihis
-��c�•�ua:�.Qu
x Registers �� i
Canary . qpp���nt; Pi�k = Accountlng; Goltlenrotl - Assessor � - "�- �� --- -' '�"
=1
. . • laue Fee ��� . � -
iANICAL
Refrigeration System
❑0.700,ppOBTU ❑700,OOOBTU
System Repair/Alteration �
STqEET WIDTH C� � �
.J
SPECIAL CONDITIONS: �
Automatic Washer '
Construction Pole : '
Cooking Unit
DishWdsher � � '
Dryers ❑Gas, dHectric �
Fan -
F.A.U.
'pARK FEE S ��
ELECTRICAL �
�Meter ❑over]OOamps. �
Sub Panel
Sub Pole �. ; ' ' . �
Motors O04 HP O1Y.-8 � �� �
InaSolar �9-15 HP� �16-15+
�Microweve .
Pole Light . � �
Range . �
Device Boxes Sign �
Outlets � � . ' � StandingSettions �
Switches . � � '� " � Tresh Compactor .,
Garbage Dispoml �
. Generator �0-5 KW �545KW �
� Transformer .015-50 KW � - '
� �SU r KW , � � �.Reinspection Fea
E75
Mete� ❑up to iDOamps � Iszue Fee
S 3 ZoninB Approved 8Y T- � Date yyy��/
Applit�ation Approved By l �«�r � '� ' Date �[.
ApW�ration laued By ' � / � Date
�
+ .: . ....- _ �_ . . .
Reinspec[ion Fea� � �,t75
� " Iswa Fee : � ' �S 3
�,
S15
- . SUMMARV OF FEES .
�BUILDINGPERMIT S� SMIP . $ �J-
:PLAN CHECK � �Jig____ PERMIT � •
:PLUMBING �, •,✓S �3,•�'U ,. ��UANCE . S
PLANCHECK �/ s� `��= �. GRADING _ � S
�ELECTRI,CAL .' S � ' ' _-
.P.LAN CHECK � ='� � MICflOFILM E �.
;MECHANICAL ,$ � "� TOTAIFEE � $
PLAN CHECK $ D LESS � ��" '�
� , . " ADVANCE� PC , $ � � �+�/ '.� ��%]
' - � �- �, �. ' ' ' .. . '' FINAL FEE �: $ ��.Ly1_.�`'
� �'.,. \ ��Spe�to` N .._..t & E�1��Pm��. „/�. �.+Y�.:; . .• ,� s
:,
. . _... _ . �- , ^�"� , `
- .. .� '-��ti;
• _,:�
,.,,ru�� _ ... POOI&SPA�, ,. �.;t, ;:°?i�:'�'�A.Yw.��•
- CONSTRUCTlON AND PLANNING _ . � . � . " _ ,. .y �°,;:�DB�„ [ ��
<Date� � Inspector � t
APPROVALS .� 'Permit # - APPROVALS Permii �1`-" � ' _ � � . ��, .���.
. Temporary Electrical Service or Pole � � 52. Pool & Equipment Location�,� ��=,.� �.��� T' x.l"' •c'�;:`.�'
; SoilPipe•Undrgmd'. : /1�1(�J � 53. SteefReinforcament�� �, ' •�,��;:_ �ri`�j'.z
54. _Forms =�' '. `� ' •- �'1 - " �.I
., Hectrical Condu�t Utilitv-Undrgrnd. : _ _ : o,,, F -
�'���� . . . i � ' : .� M Cy; • ro ' ��e��al� �.��
� 4.�ElectricalConduibUndrgrnd. .. • > ��; 55. ElectriqlBonding , c :;, � � a.�' � ,.,, :
er'���HI Fi�e�pku 56. Rough�Plumbing&PressurdTOst. - � �� ����;��J•;
. Steel Reinforcerrient . f=�3,-$3', „d.� � . - ' -
� 57. APPROVAL7000VER-GUNITE ' � iy�- 'y ^�i;`�; ;
�6. Electiical UFER Grnd. � �. �L 5 '. � i'ai� -',� �. . - . "..� ..:
7. Footin95.� �a �l 8�`�T ' � �^�(p.+ 59.'.Electrical Conduif•Undrornd:" - - ;•' .i y� �
�8. Foundatlon - , - 59. Gas Pipe, O Undrgrnd:,;Tel4� �. �. � "�,�, 'a ,i'•'' ,n,. • i"�
�9.;4Vater Pipe-Undvgrnd. � 60. _8ackwash Lines;P-Tr[p,`O'Undrprndi,� : - '2•:" ir. (-S� ;
` . 'i, _ . :, ��� � �.y.
� iO,Struan �'Flodr.'Svstein - � ' .j 61. APPROVALTODECK�.'i�',• _ ;,. ��,? .t�,;, ,. ,�
r. : -
' 1: ProPertY �wer'Lirie & House Connection� it. �' ( , �. 62. Backwash & Re6eptOr•Flnel - ..' . � ^ .' � *5 ° � " t �
�,y, . .. ' . : c . y,.� �? �.,.:
� '� ,� `
� ��� 12.�'Sewer.CaD. . , Q��,fr�p,�' �,o; 63. Heater &.Yent•Finel1��p , � . ,,�
! "�`� }ains � . . , � .;�,FI''N�'� °" `���' % ' • f �;' '
� ' � 13' Roof D ��� . -, 64. �Plumbing�SYStam ... .r.;A�c., � 9 � . �
- ��" v).
q;. � . . ' �
� : 65. Electrical-Finei„�: .;�'�''*�` : t"' . , '•.,�
� ,� ' < : �14.�Rou9h Plumbing ' D �.� � ,
'�.�`�-�` � � f6. Rou9h Electrical-Conduit . .. ►0-20-$Y G � �l 66.'Solar'SYs2em•Finel. �� , � �'� .; 7_. �.� _ _.. - ---:
"'Ff y'�.4 . ' ' -
.:'�;,.r Is.,"s�„ghElectriCWiring�-��a� ccai�Y. . . `.f_._'.,'- _.'�-.
67:"Fe'ricinp'&AoceiiMF��I�'^' � �.
' 17. Rough Wir`f�g Sign gg. :APPROVED'�bp PLA�TER�NG . I _ .� . _. ; , ' '- `I '
_ 18.' Aough Elect.iral-T Bar Ceiling • gg; ppp�l,7SPA�SYS7EMS FINAL .. ' �� + r-,
19. RougB Heating & Air Conditioning �� ,� �7 ''� j FIRE DEFT: RE�UIREMENT � _ ,
. i'
j� �, i' � .
0.! Rough Factory Firep�ace . � APPAOVALS ' Pirmlt � ' , .' .
,
i00: t� • Ducts, in Structure � . 7p, Undellyrpund Hydro' ` :� � �
� '.f2., Ducts, Ventilating �, . � 7�; prpdue( pfpGq;OGsi , t10i1
., Gas Pipe-Rough & Test : ' �' ' 7�; vnddrW't�urM, Fluth ;, a - �
_ ?:, ;,
4.�RoofPramin9- '. ::,' , � ''�`.��,�,'+!:y'�,'i�.'d�� rs` : � 173;�Unddryrnd.StaeqeTen�t�t]Gei 00(I . �
'
" � o. Roof Shmt6fha `..;..' ... , L ��' �
- � v�:1 •
r:'.:.) ?"i I
, 6. T-Bar Ceiling (Structuraq R Mpnpcoat
/� -,�
`,"'��^`') 7..FrameandFlashing Ni��'4 Co.d
1�
28. Lathing & Siding ' .
� 29. Insulation , �+ +9
W -
30.�Drywall Nailing '
�31:,,Plasfer Brown Coat . � �
32.. Electricai Power Meter-Final , i
33. Finai Eiectric
34. Final Heating & Air Conditioning
35, Final Gas Pipe-Test "
36. Hood;or Canopy �� �
37. Final Factoiy Fireplace�
; 38. Final Plumbing
39. Water��Serwce-Final . , ; .-� .rr. ..;, -�-i• :,�
r
40. Gas SerJice-Final ' . - . //IlS.'��;'7 . J
41. $olar�Domestic-Final . ' �
. .. w!.. .. . ..
42. Backflow Preventer � . -
43. Backflow Iriigation . , ', . � �; �
44. Landscape Irrigafion System � �
('Y� 45. Sound Attenuation
�� 46. Handiwp qegulations �
t 47. FINAL STRUCTUR6& BUILDING
48. Special Requirements Completed
49. Electric Releaseto�Edison .
50. Gas Release to Southern California Gas
51. CERTIFICATEOF OCCUP Y �
No. ' bate
m
75. Dry Chemfeel , 'i 4
78. Dry Stantlpipe '�;
77: fIXED SVSTEM FINAL
78. FIRE PREV. FINAI c
Notes .,�Q� �D�`
��I
��
•
���
r
i . ' � � �1
� � i
,'`L -� � IUe i f PA cl v..t°� '�ra.n;
dA35
�18-53 Fi�rnla�. �oa'�InT Di
-Y-�y P.�t��l F�a„n �
_[ �IX 11 STRAI�INs'� W/�ZL
�-o-a� T�.
' 1 EvL 1
E u- �
NF_WdE'XIS
�b �ud o�
�i
� -Z 7
�
� .' I
, � ,,
�-iMsv�AtE,
r
967 L�NWU
Pfl0.1ECT ROUflE33: MOORE , � HARO
OWNEN'S N�ME: 4 6 t� LENWOOD
nooness: COSTA MESA,
642-4942
92627
uxn:
AflCHIENGINEEH: � BEC.NO.:
AO�RESS: � ' UNIT: ' `
� HAROLD MOORE (714)642-4942
- PEHMRTEE: 4(j9 LENWOOD CI
,, nooxess: C,M. CA 92626
110EN5EU CONTMCTOB OECLAMTION: I hereEy affirm that I am licensetl unJer provisions ol C�aD�e� 9(�mmencinp with Section
'9) ai3Oivision 3 oi tha Business and Protessions Code, an0 my license is in full lorce anA etlecl.
, LIC.: STRTE �C.: CUSS:
I-'4: � SipnaWre: ' .
REH8' COMPENSRTION OELIAWI7ION: I ne2by attirm ihat I Ilave a tertifitate of Consent ta 5¢I1-insure ar a certifita[e of WOMefs'
,pensation Insurance, or a cetlitie0 copy t�ereoi (Section 38U0, La�. q.
IPoUCY NO.: E%P. DRTE: - �
^.OMPRNY:
Cenilie0 copY is herehy fumishe0. ❑ Certified coDY is tile0 wilh Ihe ciry BuiltlinA Division.
' Date:� � Ap0licant:
' E%EMPTION FBOM WOBNEBS' fAMPEN311TI0N DEQAMTION: Qhis sectian nee0 not Ue complete0 tt Ne pertdl b far ane hunOretl (5100) or kn�.
I cetlity Ihat in t3A�edormance af Ne woM /a�which ihis Oermit is issue�h no� elqpioy any� n any manner so as to �ecoma
subjecl �o �Ae Worker Compensation Laws f Calitornia. ' ��� �
Oate: � SiAnaNa:
HOTICE: II, a er making �AiS Aetla2tlon, you ShoulE Eecome 5ubjeci l0 the Work¢rs' Compensation pmvisions of the Labor
Cotle, yuu must forthwith comply wit� such provisions or ihis permit shall De OeemeA revake0.
CONSTHUCTION LENOIXG RCENCY: I herehy affirm ihat them is a construction IenEinO a0ency for t�e pedormance of the work for
which this Dermit is issue0 (Section 3097, Civ. C�.
LENDER;
aoosess:
� OWNEH BUILOEB OECIAMTION: I �ereEy aflirm ��a� 1 am ¢aempt imm the Contratmrs' State License Law for the tallowing reason
'Section 7037.5 Busineu an0 Profeuianal Cotle: My ciry of counry w�ich requires a Dermit ro consimct, alter, imDrove, OemolisA, or
:pair zny simcture, prior to its issuance, also requires the applicant for suc� permit to file a siqneJ statement that �e/she is IicenseE
pursuani to the pmHsions a� lhe Con�2c�ors' Slaie License law (Chep�er 9(cammencinA wii� Seclion 7000) oi Division 3 af I�e Business
�'�0 Pmlessions Cotle) or that he/sAe is exemD� �hereimm and ihe �asis lar Ne allepea exemDtion. Any violation ai Section 7031.5 hy
`�'<';;,applicant lor a permit su6jects t�e apDlicant ro a dNl penalry ai not more than five huntlmA Aollars (5500).
,����� I, as owner at Ihe D�aDenY or my employees with'waAes as tAeir sole comDensation, will do Ne work, an0 t�e
L� stmcture is not imenAeA oi aflereA for sale (Section 7044, Business anA Pmfessional CoAe: The Contraclors' Stah License Law
Eoes not appty ro an owner oi a pmperry who builds or impmves thereon, anE who does such work himself/hersell or IAmuOh
his or �er own.employees, provided I�at such imprwemen[s are not intenUeO ar aRereO for sale. If, hawever t�e buil0ing ar
improvement is sotd within one year of completion, the owner will �ave t�e hur0en of Omvinp he/sAe Oitl not huiltl or improve
/or ihe Duryose ol Sale�. ,
I, as owner ai the O�oDertY. am exclusively coniractinp with IicenseE contnctors to constmct the D�oject (Section 7044, Business
❑ anA Pmfessions CqOe: Tha Contractors' Sta�e Licensa Law does not apply ro an owner ot property wAo 6utlds or improves tAereon
anU who coniracis far such D�alecis with a contractaqs)license pursuant to Ihe Cont2ctors' State License'Law),I am awara
that O�oof of iheir Worker's Compensation insurance sAoultl be Drovitle0 ta me. ' ,
.� I am exemD� untler Sectian: 8. d P C.
for this 2 n: � /J � _ /J,._� '/
�t�. /(i�//
Date: �a� �� Owner. liM-f�l/ r/!
I Oo nereUy iertiry that l am aware at anU untlerstana the requiremen6 0l Calibmia Health antl Safery CoOe Sections 2550.5, 25533, and
25534 anA tAat I or any fuwre EuilEinq occupant vnlVwill not (circle one) nre01a camply witA sai0 state cotles antl ihe requiremenls far a
permit lor conslmction or moCification from the Air Oualiry ManaAement District. Hesidential constmction applications are exemD� irom
these Omvisions.
Dale: ApplicanC
I hereGy certiry that I have reaA Ihis applicatian an0 state Ilwt IAe a6ove information is conect. I aqrre ro comply with all ciry an wun�
ortlinances an0 sute laws relating to Uuiltlinq c�stmction and here0y autharize reD�sentatives of Ihis ciry lo enter uDon Ihe a0ove-m tione
properiy tor ins eciion fp0us.
Date: 3V /����
Oriver.'S License or Social Securiry k:
1891-GB wMte—BuilEing: Graen—Cotle En�orcemenl; Cenary—Appliwnt; Pink—Revenue: Goltlenrotl-0.axssor
- CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IP 048815
PERMIT NO; ZP 048815 • PLAN CHECK NO:. N GOVT: N SUPP: Y
CONSTRUCTION TYPE; PERMIT TYPE: OTH PLU PURPOSE: OTH
JOB DESCRIPTZON : FINALI2E EXPIRED PERMIT #G8283 SQ FT:
�. �
CLAIM VALUE; CALC—VPLDE: GROUP OCC: R-3 /
COMMENTS : X � �q �� �Y`3C3 � Z �
�**�*�r�*�***** ** ***� x �*��*�r*+r�*�*�r�**+�*�**�r��****;�+�**�**���r��r**���r***�r***
Z t_7 N I N G$ ER.TEg�?AtICIKRSE M E N T 5
------------ MAIN BUILUING ---------- --------- ACCESSr�RY�BUILDING -------
FRNT: FT IN REAR: FT • IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHTc FT IN LEFT: FT IN RGHT; FT IN
YARKING RE • PROV: PARCEL: 92515226 ZNE: REF NO:
PLANNING N�TES> . .
�
iE iF ik iE �lE iFlk it iE it iE iE iE iE iE iE iE i! #'�E iE it iE iF iF ik iE iE i!� iE it jE it iF iF iF �)E!E'k iE 3E 1f-1F # iF iF iF #.�)E 3E if il� iE',E if iE iF 3f iP iE 3(-3E jE fE it it it iE iE �1E iE,it if �lf dE �k ik i6 iE
D E V E L O P M E N T S E R V I C E S.;1 R E Q U I R E M E N T S
�, �
ZONING APPRO�'ED BY �
HUILDING APPROVED BY ;
DATE:
DATE;
APPLZCATION ISSUED BY: ���
**�r*�r*�t�r�e+���*�r�**��r*�* x * �,r * �a * * , �**xD*****�� —�JD— *x�
it it if it it it it d! 1E i6 it i! iE �E''.P j!'lE it iE iE i6 jE iE iE jE ik iE jF �E iElt iP i! iE 1(� ff 3E iF ik �F *�E if if dt it iE iF if jt iE iF it 3k iE iF iE iE iE 3E 1E iE iE �f !E �)F �E iE i� if iE 3f iE iE dF iF �E iF it
LEGALIZATION;N . F E E S U M M A R Y STRUCTURAL SEGMENT;N
' bLDG PMT .PLUMBING ELECTRIC MECHANI6 FIRE SMIP/RES GRADING
PERMIT , 30.00
' 258 SMIP/NON—RES
PLAN �
ISSU£ FEE '
BUILDING—DIV—> PERMIT. ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 30.00 - 0.00 0,00 30,00 . 30.00 ' ,00
i
REVENUE DIVISION TOTALS--> COLLECTED: � 30.00 OVER/SHORT: ,00
BLDG PMT PLUMBING.ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
30,00
iE iF iC� iE iE 7k iE it iE iF iF i6 it iE iE iE iE iE �)E!E if iF ik iE fE jE iE 1E jk iElE iF it jE iF if if iE �E iE iF iE iE jE iE iF iE iElE ib iE iE iE iE iE jE jE 3E if if jE it iE iE dE iE jE iF iE iE iE AE iFlE iF iF iE iE 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
PLU 1 PLUMBING RE—INSPECTION FEE 30,00 � 30,00
END OF FEES
m
0
D': OLi068bSa"—OODd8683 �-Cf �'
DATE: OS/30f9� ?It1E: 0&:4w
i
N
CONSTRUCTION AND . ..N,, _o � �OOL & SPA � -
APPROVALS Permit # Date Inspector qppROVALS� Permit-# Date Inspector
1. Temporary Electrical Service or Pole � 52. Pool & Eq�ipment Location =r. '�
,. .
w
2. Soil Pipe-Undrgmd. � - - 53.. Steel Reinforcement � �� ,!
�� _
3. Electrical Conduit Utility-Undrgmd. � _. 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-Undrgrnd.
8. Foundatian . -' 59. Gas Pipe, O Undrgrnd., Test -',-'
9. Water Pip¢-Undrgrnd. _ . n� 60. Backwash Lines, P-Trap, � Undrgrnd. ��
10. Structural Floor System .� " 67.-ARPROVAL TO DECK �`�
11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final '�" ' �
12. Sewer Cap '� �. 63. Heater & Vent�Final . � J
13. Roof Drains � 64. Plumbing System - Final i' �
14. RoughPlumbing 65.-Electrical�Final , �i
15. Rough Electrical�Conduit 66. Solar System-Final • �
16. Rough Electric Wiring , . 67. Fencing & Access Approval -
17. Rough Wiring $ign - . 68. APPROVED FOfl�PLASTERING �
18. Rough Electrica�-T Bar Ceiling - 69. POOL{SPA'SYSTEMS F�NAL �
79. 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 �Gas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Shedthing �� � � 74, Overhead Hydro
26. T-Bar Ceiling IStructurai) & Monocoat � 75. Dry Chemical
27. Frame and F�ashing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAi
29. Insulation ' 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Platter Brown Coat , 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning � .
35. Final Gas Pipe-Test �
36. Hood or Ganopy
37. Final FactorV Fireplace
38. Final Plumbing ` u d(�fJ
39. Water Service-Finai
40. Gas ServiGe-Final
41. Solar pomestic�Final �
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System �
45. Sound Atteauation
46. Handicap Regulations
47. FINAL S7RUCTURE & BUILDING
46. FINAL P4ANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ,
51. CERTIFIGATE OF OCCUPANCY -
No. Date
907 LtNWVVU C
Pfl0.1ECT ADONESS: MOORE , HAROLD W
OWNEH'SNpME: 469 •LEI��WOOD CI�i
aoosess: COSTA MESA, CA ,
642-4942
92627
uxrt:
RflCNIENGINEER: � flE0.N0.:
RUGHESB: � UNR:
• PENMITTEE: HAROLD MOORE ( 714 ) 6 4 2— 4 9 4 2
nooxess: 469 LENWOOD CI
C,M. , CA 92626
LICENSEO CONTMCTOB OECUM710N: I hereby affirm ihat I am IicenseU wder pmvAsions of Chapter 9(commencinA with Section
7000) of Division 3 of the Business anA Pmiessions CoOe, and my license is in full force anE effect. .
cm uc.: srnre uc.: cuss:
'e: SlqnaNre:
AKEPS' COMPENSATION OECUIM710N: I heraby affirm ihat I have a certificate oi consent ro sell-insure or a cetliticata aI WoMers'
.,mpensation Insurance, or a cerlifiea coDY Ihereof (Section 3800, Lab. C).
POLICY NO.: E%P. DATE:
COMP�NY:
❑ Certifie0 coOY is �ereby fumished. ❑ Cenified coDY is fled wiih [�e ciry Builtling Division. �
9aie: � Appliwnt
IXEMPfION FflOM VIONKFPS' COMPENSRTION OECIAMTION: (ihis secfion ntt4 not E8 completeE tl Ne p¢rmii is lor one huMreE (E700) or less�.
I certity Nat in t�a pedormance oi the work for which this perm0 is iss A, sha�l not employ any person in any manner sa as ro 6ecome
� suhject to � oBers ampensation Laws oi Calitomia. (�/y/��� �
•'Oate:— � �V �� SiqnaNre: •• • �� �
NOTICE: If, aller makinq this Oeclarztion, you should become su6jec� to the Warkers' Compensation pmdsions oi tAe LaEor
Cotle, yrou mwi forthmN comply with SucA provisions or Ws permit SAall ha EeemeO avokeC.
CONSTBUCTION 1FN01NG RGENCY: I herehy aKrm t�at ihe2 is a canstmction lentlinp agency for the pertarmanc�oi Ne wark for
wAic� �his permii is issueU (Section 3097, Civ. C�.
�xoea:
i RODflFSS: ' . ' -
OWNEH BUILOER UELIAHRTION: I here�y aifirm t�at I am exemD� �rom the Cantractors' State Licensa Law for [he lollowinp reason
(Section 7037.5 Busin¢ss an0 Pmfessional Code: My ciry oi counry which reQuires a permit to con5tmci, alter, impmve, AertwliSA, or
reDair any strucWre, D�or to ils issuance, alm requires the applicant lor such Dermit ta file a siAneO statement that he/she is IicenseA
pursuant ro[he D�ovisions of Ihe Con[racrors' State License Law (ChaD�er 9(commendnq with Section 7000) of DNision 3 of Ne Business
�d Prohssions CoOe) or t�at Ae/she is exempt iherelrom an0 t�e hasis for the alleAed exemD��on. My nolation oi Section 7IXi1.5 Ey
y applicant for a permit suGleCs Ne apDlicant to a civil penalry oi not more ihan Me huntlreA tlollars (E500).
'� 1, as owner oi �he Ompehy or my employees with wa�es as �heir sole compansa�ion, will tlo t�a work, anE Ihe
❑ structure is not intenAeO or ottered for sale (Section 7044, Business antl Pmfessional Coda: The Con[ractors' Stata License Law
I Oces not apDly to an owner of a propetly who huiltls or improves tAereon, antl wha Ooes such work himself/herself or �hrou0h
his or her own emD�oyees, Drovi4eA ihat such improvemenis are not intended or otteretl for sale. It, however ihe builOinB ar
impmvement is mltl wit�in one year otcompletion, the owner will have tAe 6urJen af provin0 Ae/she Oi0 not builU or imD�ove
(ar Ne Duryase oi sale).'
I, az owner ol I�e pmperry, am exclusively contractlng wit� licensetl contractors to construct t�e D�olect (Section 704C, Business
, anE Pmfessions CaOe: The Coniraclors' State License Law Oces not appty ta an awner of Droper1y wAa bwltls or im0� �ereon
anA who coniracts tor such prolects wit� a contracror�s) license pursuant �o the Contactors' State License Law�. I am awam
that Dmof oi t�eir Worker's Compensation insurance s�ould he pmvi0e4 ro me. "
� I am exempl under Seciion: � B. 8 P. C.
fOr �his f¢aso 4 Cf '
Date: , �`� � L � (Owner: �n'L
I Ao �ereby cerliry Na� I am aware oi an0 unAerstanA t�e requiremenis of Calitomia Heatth anU Salery CoGe Sections 25505, 25533, an0
25534 antl t�at I or any luture building oaupant will/vnll nat (circle ane) ne¢E to camDly xii� said state coEes and the requirements tar a
permit tar canstrudion or moAitication trom the Fir �ualiry ManaAement OisMct. HesiOential constmction applications are exemD� �rom
these Drovisians.
Daie.'� ' � qpplicant
I here0y certiry that I Aave reatl ihis aOD�iwtion antl state that the a�ove intormation is correct. I apree to comply wi[h all ciry an0 wunry
or0inances anG state laws relatlnp to huil0in0 croswction anE �ereby authorize represenfatrves oi Nis ciry to enter upan the ahovo- ntloneA
pmperty fnor in petlion urposes. �/y1,y,��
Date: J 3O f 4 �
Dnver's Lic¢nsa or SOcial Secumy M: ,
184id6 W�ite—BuilEinB: Green-COCe Enlo¢emenq Canary—qpplicant; Pink—Revenue; GolOanrotl—Assesaor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: ZE 048813
PERMIT NO: IE 0q8g13 PLAN CHECK NO: N GOVT: N'SUPP; Y
CONSTRUCTION TYPE: PERMIT TYPE; H PURPOSE:�OTH
JOB DESCRIPTION : FINALIZE EXPIkED PERMI #Gi1283 � SQ FT:,_
CLAIM VALUE; CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: }t '[�y-e� � �'�y�g 1� �
�*�***�r�t-��t**�t�r�t�f*�r #��t*�t�t*�riri�*k� �-*�t�-x��r*�r*it*+r***�r**�+r**�-�r+r�-�tx�*�t+t***�**�t+r**�t*�t*�t*
Z O N I N GS ERTEBQAUc2xRSE M E N T S , � •
------------ MAIN BUILDING -�-------- �--------- ACCESSORY BUILDING ---------
FRNT; FT IN kEAR: FT IN FkNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT' IN RGHT: 'FT IN
I�ARKING REQ; PROV; , PARCEL: 42515226 ZNE: REF NO: ''�
PLANNING NGTES> .
>
iF �k 9E iF iE it iE if iE jE iE if iE iE i! iE iE �1E if iE iE iE �lt iE iE iE iE �E # iE iE iE iE?E il.iE �)E iE iE iE iF 3E iE iF iE jF iE 3E iE if if 7E if if iF i4 �IE if iE �)t if IE ih iF iE iE 3F iE �1E iE dE �lE if jh iF if if 3E i(-
D E V E L O F M E N T S E'-R V I C E S R E Q U I R E M E N T S
.^i � .
,ZONING APPROC�ED HY �" DATE:
bUILDING APPROVED BY ; • r DATE:'
APPLICATION ISSUED BY; �''
DATE: �-30—Rc�
iE iF iE iE iE it iE if 1E �)E 3F 3E iE iE jE iE 3E jF 3F �F it iF 3E 3F ik iE iE iE IE IE jF dE���F{E iF
jE if iE iE jf 3k if if if iE 1E iE iE 1E 3F iF dF 3E jf iE iE 3E iE if if jE iE if if �f iE iF �t �! if Af �f if iE iE iE iE iF �E iE iF iF �E iF iF ik if !! iF if 1E iE jE 3E iE iE rt iE iE iE if iE iE aE iF iF iF �E jE 3E 3k iE �E �1(�
LEGALIZATION:N , F E�E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE �SMIP/RES GRADING
PERMIT 30,00
� 508 SMIP/NON-RES
PLAN �
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 30,00 0.00 0,00 30.00 30.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: � UO
, HLDG PMT PLUMBING ELECTRIC.MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
30.00
if iE iE 3E it it if it?f iE it �E iE iF iE if iE iE iE iE iF iE iE �E iE if iE iE iF iE jE �1c iE iE it iE iE jF iF # jt ik iE iP jE iE �F if iE iE iF iF iE if iE �E if iE fE iE iE iE iE iE i4 iE iE iE iE iE if 3f iE iE �E it *�F iF
I N D Z 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 ELECTRICAL RE-INSPENDIOF FEES 30,00 30.00
Ot n�06$486-Oltpb,'•,E:?b '1-��'�
C!ATE: OS/3�/90 7I!1E,. �a:SD
0
a 7' L'-
CONSTRUC710N AND PLAfv�..,uG- � � POOL & .. .. �
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
_ _ �
1. Temporary Electrical Service or Pole -� �' 52. Pool & Equipment Location �;,� ' '.,�
2. Soil Pipe•Undrgrnd. � 53. Steel Reinforcement � ��
�
3. Electrical Conduit Utility-Undrgmd. 54. Forms - �- '�
:y
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-Undrgrnd.
8. Foundation � � 59. Gas Pipe, O Undrgmd., Tett � �
.
9. Water Pipe-Undrgrnd. "'� 60. Backwash Lines, P-Trap, O Undrgmd. ..
i
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 Dreins ' 1= 64. Plumbing SYstem � Final f �
74. fiough Plumbing 65. Electrical-Finai _
.`
15. Rough Electrical-Conduit 66.� Solar System-Final
16. Rough Elett�ic Wiring _ � 67.�,Fencing & Access=Approval � �
17. Rough Wiring Sign - - 68.-APPROVED FOR PLASTERING
18. Rough Elettrical�T Bar Ceiling 69.� POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditio�ing - FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #�
21. Ducis, in Struc[ure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing . 73. Undergmd.SmrageTank �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 Brow� Coat 79, FINAL INSPECTION
32. Electrical Po'�`ier Meter�Final 60. FOOD CERTIFICATE ISSUED
33. Final Electric • e 9Q� Notes:
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test
36. Hood or CanopY .
37. Final Factor4 Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final .
41 . Solar pomestic-Final
42. Backflow Preventer .
43. Backflow Irr�gation
44. Landscape Irripation System •
45. Sound Attenuation �
46. Handicap Regulations -
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Editon
50. Gas fielease to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Pq0.1ECT RODflESS: � 4 6 y L ENWOOD C I .
OWNEP'SNRME: MOORE, HAROLD W
aooness: 469 LENWOOD CIR
COSTA MESA,CA , 92627
= 642-4942 .
UNIT:
'RHCHIENGINEFR: flE0.N0.:
nooness: uxR:
HAROLD MOORE (714)642-4'942
PERMITTEE: 4Ejg LENWOOD CI
: pDONES3: C, M, CA 9 2 6 2 6
� UCENSEU CONTMCTOB OEIXAMTION: I hereby aRirm ihat I am IicenSeC under pmvisions al ChaOter 9(cammancinp wit� Section
� of��ivision 3 of tha Business antl Pmfessions Code, antl my license is in full torce an0 eflect.
LIL.: , STATE UC.: ClABS: ' '
e: SiAnature:
NKEHS' COMPENSFTION OFCIAMTION: I hereby attirm tAat I have a certificate of consent to selFinsure or a certificate af Warkers'
m0ensatian Insu2nce, or a cetlitie0 coDY thereof (Section 3800, Lab. C�.
PoLICY NO.: � EXP. ORTE:
COMPRNY:
� Certifie0 capy is Aereby fumishetl. ❑ Certife0 coDY is file0 with ihe ciry BuilOinA OiNsion.
Oate: - AppliwnC
� E%EMPfIOX FBOM W08NEB3' COMPENSPTION OECWUTION: Rhis seNon neetl not be wmpleteA B ihe permit is for one hunOreO ($100) or lew).
. I cetliTy Ihat in the performance af [he work for whicA t�is Dermit is issued, I shall not employ any person in any manner so as to become
suhlect �o Ih Work Compensation Law of Califomia�� p�,�Q /
i
Oate: ' 34 ' SipnaNre: �
NOTICE: I/, a er maNinp tAis Ueclaration, you shoultl become sublect ta [he Workers' ComOensatian O�ovisians oi [he La6or
Cotle, yrou must fortAwitA compry vnih such Dmvisions nr tAis Oermi[ s�all be tleemed revoked.
CONSTPUCTION 1EN01NG �GENCY: I here6ypffirm tAat tAere is a canstruction lenaing agency for tAe pedormance of ihe work for
which Ihis permR is issue0 (Section 3097, Civ. C�.
� LENDEfl:
' " RDDflESS: '
�, OWNEP BUILOEB OEClAN1TI0N: I hereGy affirm thatlam axemptimm tAe Contractors' State License Lawfar Ihe fallavnng reason
'Section 7031.5 Businass antl Pmfessional CaUe: Any ciry af county whic� requires a Dermit to constmct, alter, imOmve, Uemolish, or
pair any stmcNre, prior to its issuance, also repuires I�e aDPliwnt for such permit ro file a signed statament that Ae/she is IicenseA
.�rsuant to ihe D�ovisions ol the Coniractors' State License Law (CAaD�e� 9lcommencing with Section 7000) at �ivision 3 of Ihe Business
��A Professions CoUej or that he/sha is exempt therefrom and tha hasis tor ihe alleAed exemptian. Fny violation of Section 7031.5 �y
y apPlicant ior a permit sublects iha applicant ro a civil penalry of not moa ihan five hundred Aollars (5500).
'� I; as awner ot the pmDertY or my employees witA wapes as iheir wle com0ensatian, will tlo [he work, antl the
I❑ stmcture is nol intended ar aifereA for sale (Section 7044. Business antl Pmiessional CaUe: TAe Coniractors' State License Law
tloes not aDPly to an owner ot a pmDeny who builOs or improves thereon, anU who Oaes suc� wo�k Aimult/Aerself or ihrouAh
� his or her awn employees. provitleU tlw[ suc� improvements are not intenaeE or oflereA br sale. It, however the huiltling or
improvement is wld mt�in one year oi completioq Ihe owner will hava the 6urden of pmNnp he/she EiE not huiltl or impmve
tor the purposa ol ule).
I, as awner of the DroperN. am exclusNely wn[ractinp with IicenSeE contractors to construct t�e D�olect (Section 7064, Business'
� and Professions Cotla: Tha Comractors' sUte License Law Ooes not apply to an awner of properry who Ewl0.s or impmves theredn
� an0 who wntracis lar such Dmlecis cith a contractoqs) licenu Dursuant ro Ihe Coniractors' State License Law). I am aware
ihat pmof ol Iheir Worker's ComOe�stF�on insurance shoul0 be pmvided to me. �
� I am exemOt un0ar Section: . B. 8 P. C. .
for ihis reazon� ' � �/ ^
� / �+v ��vp/� �
. Date: '�3U�gU Owner:
� I Oo here6y cenity t�at I am aware oi ana untlerstantl ihe requirements oi Califomia Health anU Safery CoOe Sections 25505, 25533, antl
�' 25534 anE thai I or any Iuiure CuilUing accupan� wilVwill not (Cifcle an¢) neeU lo Camply wit� saiA Sta�e COCeS antl Ih¢ requiremen�s �of a
permit tor constmctwn or madiliwtion trom [he ar Oualiry ManaOement Oistnct Hesitlential wnstrudian apDliwtions are exempt tmm
, these Omvisions.
Oate: � ' pppliwnl:
• I �e20y cerliry that 1 Aave reaOl�is aOD�ication an0 state iha[ t�e above infarmation is correcL I a0ae ro compy with all ciry an0 counry
oNinances antl state lavrs relatin0 ro builEinp c siruction anA hereby auth nm re0��en[aUves ol this ciry to enter upon the aEove-mentionetl
' proDenY �o�inspection purposes. �,, 2
� Oa�e: �. G V ., uvr _
' Oriver's License or Social Seariry M:
18a136 W�i�e—BuilEing; Groon—CoOe Enio¢emem; Canary—Appliwnt; Pink—Revenue; GolEenroE—Asnesaor
CITY OF COSTA MESA — SUILDING PERMIT FERM NO: IM 048819
PERMIT NO: IM 048819 PLAN CHECR NO; N . GOVT: N SUPP: Y
CONSTRUCTION TYFE: PERMIT TYPE; MEC OTH � PORPOSE: OTH
SOB DESCRIyTZON : FINALIZE EXPIRED PERMIT itG8283 SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC:,R-3 /
COMMENTS: X hs-�2,� '� �� �{ B'BI L '
�ljEifititifitififiE3tiE?EiFif '�iflfiliFlFiEiEifiEiEildEiFikilifiE3Eil�EiflEiEiflFitikiriE�lifiEiEiE3P3FiEjF3EiEiEiEit�AiEiElfiEjEitiEiEiEiFititiF�EiEifj(-jEif
Z O N I N G R E Q U I R E M E N�T S ,
S E T B A C R S �
------------ MAIN BUILDING --------- --------- ACCESSORY BUILDING --------- �
FRNT; F'T 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: 42515226 ZNE: REF NO:
PLANNING NOTES>
�
iE iE iE!(� 1E 1k iF iF df iE 3E jE 9f iE if 3F ik iE iE iE iE iE iE 3t iF iF it dF iF if if iE iF iE �E �E jf jE 3ElE if iF iE iF iF it iF if jE iE iE 3E ik jE iE 9F 1t if iE IE iE iE iE 9F iE 3E 3E jF IE iE jF �E iE 3E 3E 7E if� jE if�
D E V E L O P M E N T S E R V�•I C E�S R E Q U I R E M E N T S�
ZONING APPROVED BY ,r-' �" DATE;
BUILDING APPROVED BY ; ` DATE:
APPLICATION ISSOED BY: 1;, - DATE: r,
jE iE �E �)E iE 3! i! iE 1E iE if 3E iE 1E iE iF jf iE iE iF iE iE 3E i(� ih ih iE i(� iE iE if dE����iF�`�3E iE
�f ik jE it i! iE 3E iE iE iE iE ih �E it iE jE if iE iE iE iE iE i' jf iE iE jE 3E aE iE iE iE if iF ik iE �E it iF iF i(� iF 3E iE iE �t 3f iE iE jE 3E iE iE iF iE i(� it it iE iE iE �E �1t iE iE iE �)E iF iE iF 3E it iE iE iF 3E it iE jE
LEGALIZATION:N F E E S U M M A R Y_ STRUCTURAL SEGMENT:.N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIitE SMIP/RES GRADING
PERMIT 30.00
, 25R SMIP/NON—RES
PLAN ' "
ISSUE FEE . '
bUILDING—DIV—> PERMIT� ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> � 30.00 0,00 0.00 30,00 , 30.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 30.00' OVER/SHORT; .00 '
BLDG PMT PLUMHING ELEGTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30,00 '
iE iE if iE if iE if if �F iE iE 3E iE iF iE iE �t iE ik ik jE iE iF iE iE jF iE iE iE iE if ik iE if iF it iF if iE dE jE iE it iE if iE iE dE jf iE if iF iE jE if 3E iF jf it it iE iE iF iE iF it * if iE iE it if 1f iF 3E iE iF iF �E
' 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
MEC 1 MECHANICAL RE—INSPECTION FEE 30.00 30,00
END OF FEES
0
OI DilOb8634-�0�63684 'FC�'�'
vATE: 6�/3D/90 TFC4e: OE:49
3D.C:'
CONSTRUCTION AND �I G ' POOL a'SPA � -
Date .Inspector Date .Inspector
APPROVALS Permit # � � 4 - � . APPROVALS � Permit # i
1. Temporary Electrical Service or�Pole 52. Pool & Equipment Location i- � �
, �
2. Soil Pipe�Undrgrnd. _ 53. Steel Reinforcemen( ! ��
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit�Undrgmd. - 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-Undrgrnd.
8. Founda[ion - - � -' 59. Gas Pipe, O Undrgrnd., Test w/
� . -
9. Water Pipe�Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. ��
10. Structural Ploor System � �- 61. APPROVALTO DECK � �-!�
11. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal �_ _ � .
12. Sewer Cap . 63. Heater & VenbPinal -_� �
73. Roof Drains 64. Plumbing System-� Final �? �
14. Rough Plumbing 65. Electrical-Final �
75. Rough Electriw6Conduii 66. Solar SVste�m-Finel
16. Rough Electric Wiring � 67. Fencing & Access ApProval
77. Rough Wiring Sign - 68. -APPROVED�FOR-PLASTERING
18. Rough Eiectrital-T BarCeiling Y � 69. POOUSPA 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 77. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Shsathing 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 MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final He2ting & Air Conditioni�g t p(�f�
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
43. Backflow Irrigation
44. Landscape Irriqation System . ,
45. Sound Attenuation
46. Handicap Reg��a[ions
47. FINAL STRUCTURE & BUILDING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
` ?' AVDlicanl lo fill in all spaees except those within �eavY DorEer lines antl sign all aOGroDriate tleclara[ions. - �'�
9EJ� � � �c���?:. � �e .
-�:CITY OF COSTA MESA� - - ' ' � � - PERMIT NO. � � � � TRACT NO. LOT NO. - BLDG. N . - - - - - - - - - � - -
�,S:Ol�lSa4ilICTION PERMIL �. _ � . ,.-;. � ._� 4 i . • � ' ; • ' ' . � . . ':n `: ' ' :
Pioj¢ctAddres5 -� � -_� 1 � • TVPEOFCONSTflUCTION NEW ADo ALTERATION �REPAIR
Applicant'S Mailin Addrett' e✓�' W OOCJ � ° 7 � ❑ CONVERSION �❑ DEMOL(SH ❑ OTHER A-p, # � • ; Zpne ' - ' ' �
OWner'SName' ,AA�e����l�' �) � Phone• Z- �"Z' 'DESCRIPTIONOF�WORK � - _ . � � . , _ _ -
�� � � S Main Building: � Accessory Building: . ! O
addieu • 4(,9 Lenwoo�l-_ , i '. e, . , . . ' •
TYPEOF,PEFMIT '� GRr�DIrvG= FOUrvoATiON S7RUCTURaL T Pront _ � � N�
Arch/En .'. .� Q-� YD D �l � � ." ', � � License No. � ' � , . , . � - u - 1
9 �� }� _ ; ❑ TENANT �❑_ ELECTRICAL ❑ PLUMBING O�MECMANICAL . . B Rear � ' � - -
Address. ' i2M p US V r' -� IV ��/ �� . ���OTHER I�' ' S' 'Q .. - , . G
Contractor's Nam OlLY��P"I' �� U PGA P/' -� Phone � PROJECT DESCRIPTION 50. FT. � � OCCUPANCY � C Right -� _
Addre55lmailing) � 4�� C�NWOO.C� �CONSTRUCTIONTVPE VALUATION$ S Left ' � � � � • E
' ��� ZONE ' , GRADINGCU.YDS. ACRES Ping. Ref.# � ' Park:Fees Q� �'
City License No. ' �
. ' . ` ' U
LICENSEO CONTRACTOR DECLARAT.ION ' � � � � Remarks: �_���g� ' . � � Pafking Req./ProVided � ' ' ' - �
�:hereby atfirm that 1 am licensetl untler provisions o( Charter 9(commencing . p
'th section 70o0) ot Division 3 ot the Buslness antl Professions Cotle, antl � ' � � � Use of Building: ' - � E
,y iicense iz in full force antl e/fecL - , � � Planning Notes: ' '. M
ILicense Class � License No. ' � i PLUMBING �� FEES � E
Date � ' � ' S19nature �. - . � . - - . . . ' ! ' . . N
W00.KER5' COMPENSATION DECLARATION Baf Sink Showers i i T
I h¢reby affirm that I hav¢ a certifi[ate ot COnSent to Sel/-insure O/ a certifiCdt¢ � �
of-Workers' Compensation -Insurance,' or a certifietl copy-thereot-(Section � Backflow Preventer i Service Sink' i �� S
900, �5b. CJ � ' 7 i � " . � Backflow Irrigation Sewer Cap ' ' ' � ELECTRICAL '. � � FEES
Ilcy No. ' ' I ' Company = ' . ' � '
I Certifietl co is hereb fuTishetl. � ' � Bathtubs �-' Sewer Connection • � �
�y- pv v Automatic Washer Transformer ❑ 15-50 KW
OC'Certitietl copy is tiletl with the city Builtlinq �ivision. ' � -. . � 0 50�+ KW �
Clarifiers � � �
Date Appli<ant � Solar Collectors i ' �Construction Pole Sub. ' i �
-EXEMPTIONFROMWORKERS'-�COMPENSATION�DECLARATION.� � - Di5hwa5her ' • -" " 'Solar'Piping'� ' - - � ' .Cooking'Unit'.- ' - Met¢r'Dupto�100ampr^�' '---
(This section neetl nat be mmpletetl if tne permit is for one huntlretl (§100) or . . �� , , ,
less). � •4 � ' Drinkin Fountairis � � �
I certify'[hat in tM1e Oerto�mance�.ot the wo�k fo� which this Oe�m�t is'i55ueU, I; 9 ' -$Old� Tdnk ' 'DiShwdShE� ,M2t¢� ❑Ov¢f 100 drt1p5 ; � �
shall not employ any �p¢r5on in 5ny manne� so.as to bewme Subject to lhe � . � ' � , j
Workers' Compensation' Laws of Calitornia. , FIOor Drains' ; � Swimming Pool w/Spa' � Dryers �Gas ❑Electric � � Sub Panel � �
Date � � Signature � '� ' ' ' " — - �
NOTICE: If,'atter making this tleclaration, you shoultl become subject to the � FloorSinkS � U�inal � Fan, ' i . Motors �0-1 HP �7'/a-8 �
Workers' Compensation provisions oNtne Labor Cotle, you must torthwith -r ; . , - - - - - � -
comply'with'such-p�ovi5lons or�,this-permi[;Shall be:tleemetl revokea. GasService � �Outlets'. WaterCloset� , F.A:U. • � 'IncSolar�9-15HPO16-15+ � ' �
CONSTRUCTION LENDING�<AGENCY. - � � - ' � ' ' �• ' ' ' ' '
I hereby aifirm tM1at there is a construction lentling agenry'for the performance � Intercept0�5, � Water-Heater � ' . - 'Fixtures � � `Microwave � ' �
of the wark (or ;which�� this permit-.is issuetl- (Sectiom_ 309� Civ. �CJ - - � ' •
Lenaer's Name _ _ ; n ` � KitchenSink - ' WaterService '� � - ' � ' DeviceBoxes � • �Pole!Light
Lentler's Atltlress ' ' ' - � ' ' Lavatories ' - ' �0 Outlets , � � Range �
z �;p`/NER BUILDER DECLARATION .' � � ' ` ' ' ' - � � ' ' � . � 1
:a.ereby, affirm Shat I am exempt frBm the Cbniractor's. License Law for the . - ' . . ,
< '9lowing reason'(Sectlon 7031.5 Business antl PwfessionaliCotle: Any city or • P-Trap� ` � � ^ � - . .� � I � Switches ' � ' Si n '
county which requires a pErmit'to construct, alt¢r, improve, tlemolish o� repav ' _ � � � . , - . . ,z, _ � 9 � , � � �
any structure, orior to its issuance, also requires tne applicant for such permit " Roof D�ains; = � ' ' Garbage Disposal ' . � Standing Sections , . �
[O file a'Signetl Statement that he/she is licensetl pu�suant tdthe provi5ior15 ot
[he Contractor's License L'aw (Chapter 9 (commencin9 with'Section 7000) of � - ` ' - - - � �� � � � ' '
•Division� 3 of the Business antl Professions Cotle) or that he/she is exempt . - r a. .�- �- - �� Generamr �0.5 KW 05-15 KW �Tresh Compactor ,
theretrom antl the basis for the allegetl exemptian. Any{violation of Section � ' � 'o � '�" ` - ' � �
'031.5 by any' applicant for aa permit. subjectr tne,applicant to'a civil � � Reins ction�Fee ' � ' Issue Fee -� � ''� -$�3 � � ' � � �
�alty ot not more than tive huntlretl tlollars ($500). � '- � � , . , �
1, as� owner ot tne' property br:my employees' with' wa9es as their sole i ' Reinspeetian Fee . $25 ' luue F¢B - �$' 3 �
_.impensation, will tlo the work, antl the structure is not intentletl or offeretl � - !MECHANICAL . - FEES
for sale. (Section a044, Business antl' Professional Cotle: The- Contractor's ..„ , PUBLIC SERVICES REOUIREMENTS: ' � :
LicenSe Law tloes not apply to an.owner OT a property who builtl5 or improves � BOil2� ' - " '' � HOOd O� Type I ❑� � I , ' '
the�eon! antl who tloes sucli work.himself/herselt or througM1 his or her own �- � Za���g qpproved By D2te
amployees, provitletl that such improvements are not�intentletl or offeretl.for �, � , Canopy Type II- ❑ � ,
• sale. If, however, the builtlin or improvement is soltl within one ear of com- ; Duct ,- Under Ground � ' � ' A lication A �
9 v PP PProved BY Date ' / �/
Oletion, the owner� wlll.have.the burtlen of proving he/She tlitl no[ builtl or im- . � ' ' � I ' '
�rove tor the purpose of sale). � c , j Duct - Structurel ; � Refrigeration System . - � . Appliption Issued�By � ' - ' ' Data_L'L�
I, as owner of the pioperty, am ezclusively contractin9� witti Ilcensetl con- i i ❑p-100,000 BTU ❑100,000 BTU '
tractorsto construct the pro�ect (Section 7044, Business antl Professions Cotle: � Duct - Ventilating � ' � � � � � � : ' { �SUMMARV OF FEES � � • :
The.Contracmr's License Law does not apply.to an owner ot. property who BUILDING�PERMIT $ ' SMIP �$
builtls or impwves thereon,'antl who cont�acts for Such projeCtS with a con- Exhaust System ❑ MultiPl¢ 0• $yS[2rtt R¢pdif/Alt¢�dtiOn -• ' � � �
, tractor(s) license pursuant to ine Contracfor�s License Law). � � � , . pLAN CHECK i i$' / 1 PERMIT• � � � '
❑ I.am exempt untler Section � e. & P. C. tor this reason � Firepl/Fact. BIL ICBO�# � � ' ' LUMBING �$��7� 'ISSUANCE $ � .
� � N CHECK �' � $ '� I ENERGY•P.C. � $ �
Date ' Owner. � � � Heating System & Ducting ; . �
I hereby certify that 1 have reatl this application antl state that the above ❑0.100,000 BTU �100,0008T � I� GRADING .$
information is�correct:�l�agree to compry with all city antl,county orainances - - - - - - -! - ' - • ELECTRICAL $ ' ' � + - �
antl;.state laws relating,to builtling construttion; antl hereby authorize repre- , � ' � � PLAN CHECK � � 1 MICROFI LM �$ �
sentatives of, this! city� o' entar upb the above-mentionetl property �tor � M � . � � . . !$� �
inspection purpos S.� � � ` p. �' 1 ' � ` ' MECHANICAC ; � $ ' � , TOTAL FEE ` $ �S'��
' Signature Date . � . . ' � � , .
Drivers' License or 55 � !' Z o . Heinspection Pea ;$25� ' IsSue Fee $ 3 � PLAN CHECK ; f$ ,
. . : . . •, t . . �
'CMF0865-46rev.]/83'-White--Builtling;Canary�-Applicanh,Pink�Accountin9;.Goltlenrotl-Assessor ` '. � ' . � � „� � � ..,. ._' i � _ ,______ ______ ___',,,,� _ , �
. "-_ . - . _ .. . .. _ - .. _ ., � . -. . ..- . _ . i»
�� � CONSTRUCTION AND PLAh...NG� � ' � � � FOOL & . �
ti
� A�� - " � Date Inspector - �' � � . Date Inspector
� `,��APPROVALS Permit # � _ . - APPROVALS Permit #� _ . .
- '�1. Temporary Electrical Service or Pole . 52.- Pool. & Equipment Location . ,
� 2. Soil Pipe-Undrgrnd. ; ' .. . 53. Steel Reinforcement ' � . .
'3. Electrical Conduit Utility-Undrgrnd. ' ' 54. Forms � �- - � �
.4: Electrical Conduit-Undrgmd. � _ -� 55.� Electrical Bonding - .� . � ,
5. Steel Reinforcement e�f���° Ok '� � w �_ 3' �. 56 � Rough Plumbing & Pressure Test �. � � _
�&: Electrical,UFER Grnd. - - 57. APPROVAL TO COVER-GUNITE
.`�� 7. Footings .Fi�r f��ce fao'F1nysOk , . � 58.� Electrical ConduirUndrgrnd.� �
. 8: Foundation � � , - , 59. Gas Pipe, O Undrgrnd., Test.., ' � � ,
,9. Water Pipe-Undrgrnd. ' • � 60: Backwash Lines, P-Trap, O Und�rgrnd. �
10. Structural Floor System ' , 61. APPROVAL TO'DECK �,
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � .
12. Sewer Cap . 63. Heater & Vent-Final ._
13. Roof Drains , � • . � 64: Plumbing�System - Final - ' � ; ,
14. Rough Plumbing � 65. Electrical-Final � � -
15. Rough Electrical�-Conduit ' " 66. Solar System-Final '- ,
� 16. Rough Electric Wiring � � ' � 67. Fencing & Access Approval � �
17. Rough Wiring Sign • . - ': . 68. APPROVED FOR PCASTERING �
18. Rough Electrical-T Bar Ceiling � � . 69. POOUSPA SYSTEMS FINAL � .� �
19. Rough Heating &;Air Conditioning `' FIRE DEPT. REQUIREMENT. �
i
20. Rough Factory Fireplace � . � APPROVALS • Permit# � •�
. 21. Ducts, in Structure � , ' �70. Underground Hydro I ' � �
' 22. Ducts, Ventilating • �' � � ' 71, Product Piping OGas •OOiI
_ 23: Gas Pipe-fiough�&�Test ' ' 72. Underground Flush � � �
�Q Roof Framing � � � ' . _ 73. Undergrnd.StorageTank �Gas ❑Oil � � • �
.;25. Roof Sheathing ' � � � 74.'Overhead Hydro .
6. T-Bar Ceiling (Structuraq & Monocoat '� . 75. Dry Chemical � '
27. Frameand 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 CERTIFICD,TE ISSUED •
33. Final Electric � ' ' Notes: , ' ,
34. Fina� Heating & Air Conditioning ' ,%
35. Final Gas�Pipe-Test ' ' � � ' � � . � �`^'
, �
36. Hood or Canopy � � . � , . � ' , � r + �.
i
37. Final Factory Fireplace . � - . . ' i
i
38. Final Plumbing � � �� � • . • �:.1
39. Water Service-Final ' , • � .
� -
40. Gas Service-Final � . . � '
41. Solar pomestic-Final . ;, � � �
- --- - -- - � � : �
42. Backflow Preventer � ' � , %' � � �
43. Backflow Irrigation • ' � . .i � � � � � � � , '� � �
44. �Landscape Irrigation System � ' _ �, �
45. Sound. Attenuation • . � , . � '
46. Handicap Regulations , �. , , � _ -
47. FINAL STRUCTURE & BUILDING � � � � '
� � �
48. Special Requirements-Completed , . � � � � . - �
49. Electrie Release to Edison - -t ��' � ' � "
50. Gas Release to' Southern Califomia Gas Co � ' • ,
51. CERTIF.ICATE OF OCCUPANCY , _ . __ , � . . , ,
', � No. � �Date ' - ' ' � � ' '. • . . .
. . . �� ' an•Mc.. .
' ' • Appliwnt to till in all spaees exeept thoze with�n �eavy EorGer Iinas and sign all aoVrooriate Eaebntions. - � .
.'`GITI F'COSTA'MESA' , .ti' -, .i _. .. . . . ... . , -- .� . - .._. _ _961.5. 8/I�71-+?� ��, ,34a�T-:<'` rT
� �- ; PER NO TRACT NC`� , �OT N , . BLD . , � . J
'CONSTRUCT.ION FERMIi . ' . �� � � .. .�'B�=�S��' 3l �'�'� • S ` ' " - ' , . ` , � ! . . � , � , � . .
. ., . ' . . � ,
�Applicent s Mading Addrett • � ���� u% • �' �' TVPpE('OF CONSTRUCTION, " , NEw P.DU' ALTERATION� REVAIR ` � � � � - ^� �� . � � � _ '� .
COQOC�-' C�� r� - ' ,ld, CONVERSION ; ❑ DEMOLISH OTHER �; ' �" � ' . + � �- + ' n' ^ I =� 1 ' � ' �, � •
ProlectAddrea: . p . . . - - 7 =� f . .' ' . z: ' . -,- :: .
OWnefiNamBl" �'�' .2iro '� -t p ry' n�n'P�4'ZY4�/, . DES IPTIONOF�WORK A/�/� '.L/✓/N� =iP�oniY(' ' -
, � � � . : : � � ; 1 ' � . : .. .. . -: i . . .n ,.. _ � . � s ' O I G' ` ULAT `N 1 t :
naa:ess . uio' . 'Grr�T� G'�Ef�. 'aG2 : � ' • ,> . � /� � , ,
' TYPE�OPPERMIT • 'GRADING FOUNDATION� �STRUCTURAL A.P.vIE. S = � (� ZONE . : I'T .
Afch/Eng ' • � Lit6�KN0. ' �O�TENANT� �ELECT,RICAL' 'PCUMBIN6 '�MECHANICAL � � � � , ' � '� � � ..BUILDING.
Addressi `-� � � � '� � .. � +x _ _ . � ; ' - : ,PWG. REF 9F;.'�'_ � . � . I
� O;�OTHER � ; � ` .TO BUILDING /� // „ ' � j
CAntIeCtOI'S Nem � � �' hone i ; PRQIECT DESCRIPTION 5�: FT. � OCCUVANCV � � � R E V LI E : C/ �- •REAR VAfiD'(TO P/L) .
` � � - ' ' � • ' " - ' � iLEFT SIDE YARD � �� - RIGHT�SIDE VARD �� � �
. t � , ' � : „ . ' GONSTRVCTION TVPE ' � VALVATION $- Gl� SCSO . . S 'O ` 1 . YQ 1.
Address'Imailin9) ' I , � . . . —�— , '
' � I P �'. .} � ' �- i ;"'ZON� t GRADINGCU.VDS. � " .ACRE� PKG.SPACE'REQ.�- � � ' PROV.IDED � � , � � .f` �;
License No. - '
'CENSED CONTRACTOR DECLARATION ! f � � � . ' Remarks: ( ' S"� . � ' • � %k� I ' I ST'REET WIDTH � �� i �PARK FEE,$ �-4 ' �
�.reby atilrm that,l� am Ilcensetl untler provislons of,Charter 9 (commencing I � ~ �- � ' , � � � - _ ,.
a settlon 7000) of DIvI5Itir1'3 Of the Business an0 Pfol8551on1 Cotle, antl � .1 ; � C , � ' �j. , ' ' "�SPECIAL CONDITIONS: � ' ' ' � ' � c: ; � '-
...Y Ilcense.ls In full folte an0 effet[. � � �. • ' . : � . . . � ' � _ ` � t
iJcense class t :. i , ' ! ' License No � � �� ; � t � � � ' PLUMBING ' � � � . , � . � : I : � I � ; ; � � � � � 1 �� 1 �
Date' • ' SI9naWre � � ' � � � � � �~ � '
I WORKEHS' COMPENSATION DECLARATION � . - �'� � BBr Siak , � � i � $eN�e� Cap�• � , � � ; . � I ' ; I � ; ELECTRICAL � " i I : S ,
• _ �
:! hareby'atflrm that I nave a Certlflcata of consent to se��-Iniuie or a certltiWte %__. g�kflowPr2Venter .,�:. ' ,_.,,. _' , �_ .___ Automabc W85her � A � 1 }MetEf �over 10a amps � ;+ �!
��• Workers Compeusatlon Insurance or a certiited; topy'thereoT (Section � - ���-Conn¢tLon:_ _ . . .Y... __. _ � _ . .. . _
"�i0 Lab C}��: • s . � r � f . • . . i ..- � �r Construction Pole ' 'Sub Panel � " ,
�' ^'"' S3 -O 3 YSt '' ri�d�C C6n•�p.T1Ip.Eiwc�% . Backf�owirriqation 1 ; SolarCollectors � ="�� � � , LL ��
r II<Y No %! ComOanY y • . . . - �`y i� i• 1 I
E � � � � r • , - _ � - Cooking Unit - $ub Pole � I i
CertHlad-copy'is nereby turnisnea. � , ; - 1 . � .� �� Bathtubi `.j/� � Solar Piping j � ..- i � � �. . } . I , i � (
�Cor 1 tl c� 2�Y� s fileG wlth the cit • Ivision. � , . � . . �.. Dish��+asher � ' ' � ' �
P �-� Clarifiers � f I SoiarTank � * - " ' ' � � ,Momrs �0-1 HP� ❑7X$ - � -�
Date ���1; 'Yo '� APPll�ant i , � .i , . ' . � � f . i :` , ��i � ' -
'EXEMVTION�FROM'WORKERS'�COMPENSATION'OECLARATION" "'� ' J' - - ' Df ers OG85"OElec[nC` ^'-' ' '� �
(Thls section neetl�no[ �e comD�etetl'If tha�permit is for one huntlretl•(5300) or ,j i Dishwasher � � i Swimming Pool w/Spa _' r. � Y- `Inc:Solar'��9?75�HP`076-15+ �
iess)- e : �� i . .� � � 1 .. . � �; . . - � : _ � ,�. '" � � Fani 1 • �Microwave �
1 certify,that �Imthe perto�manGa'of the work for,whlch this perm�Yls Issuetl .I" � �J, Drinking Fountains . Urinal,� , p-m� - 1 . ' . . . • � ; , �
. shall;no[ employ,any person In any rtlanner so,a4 �a �ecome sub'ecGto t{�e •� � , _- F.A.U. 1 ' .,, 1 1 ,Pole'Li ht � ' �
' Workers'� ComDensatlam Laws of Glifo� Snia. � � �,, _• � : Floor D�ains� ', E �. Water Clomt' � � � 9 . � 1 � �
:
Data I ` , 519nature'!X ��'�7�""ss+�'F+'1 � .' v . . . . ', �
' rvOTICE: li, after makirig this tleclaretlori;.you should become suoJedt to tha � � Floor Sinks_�:, ,' _�, " ' _ Water Heater .I Fixtures �� ! �'Range � � �
Workers' Compensatlon OroviSions oi .the.labor CoGe, you must torthwi[� '- �� " � ' ' - ' � � � � � .
romD�Y�N'�th;such�provlsionsaor'�this'�permH�s�all be aeemea�ravoeea. � i" Ga'sSerJice;j :Outlets� WsterSernce•_ ,`I '5�9�! _ � ! C'�
CONSTRUCTIONiLENDING�'AGENCV'-' � , , , ,. ' i _ �,' - ~ r � � � �'- , '
i ., axES
� Device B � '
I nereby attirm lhat there Is alconstruction Ien0in9 a9ency for t0e periormanca ` Interceptors _�_ � � ,r / Outlets : � �-(' Standing Sections�, i�, -� � � G^ �
of [he �work for wNch'this� permR�is;i55ue0 �(5eabon��3097- Civ. C.)� { �O � - ' � �. � . : .. ,
Lentler's' Name';' � � " � � � � ' ! - ' Suvitches�, '�' •� � , � ( �.
� 1 :. � .a .. � r ' t r�- 1. � _ ' i Kitclien�Smk� � � � � 1 �_ : - _ ".. . �. . ` �.Trash ComPacror g
„ er s Atltlress ^ , ' r. ' '' ' Garbage Disposal , y� � � � � T� � '� �
NER'BUILDER UECLARATION' - �, � F i ' ", �- � - j ; LeVetofles � ' � y "p • � _� r �' �� � ' . ' ' 7 . �
'r ;'ieby:affirm that I am.exempt Trom tha Contra«or'sUcensa L'aw tor the �- . � Generator� �0-5 KW �545'KW � ' � � �
, i�llowing reason'(Section 7W3-.5 �Businessantl P�ofessianal,Cotle:'Any city or P �T�ap� �v ' � - � � . ( � ` � �', � t..,l � �' � ' � �� ;'/.{ t
' � I anu�truc u're; feqorrto itsls uenc2�alzotre�oires tl�eapro cxnt to�such r�ermitr � ' � " � M° ' - .� Transformer..O15r50 KW j ; 1!j �.: {'- -:r � .
. Y G q � PP P `, � Roo1�D�ainS� V- + , , �• .�. � . , �I (
� to-flle a signeC itatemenLthat�he/s�e Is Iicenzetl OWsuant to theiprovi5ion5 of - " - � ; 05U+ KW.. �' � � ��
i the Cont�actor'S License l'aw�(Cnaptar 9 (commendnq�with75ection,7000) of � � j � }.' 4 ; +y: ' � , 1 �• i � ' - ' '' j 7�: � t!� , .�,jReinspeCtion Fee . i � $15' 1
pi,vl5ion 3,.of the.Business antl,Profession5 COCe);Or<thaYha/she�isexempt � '? � ShOwe�S �: pi - � � � � � � ReinSpection` ea � $75° ° � ` � � � - � � -
�.etrom xn0 theibasis for the allege0 axemption/Any•,violatiomat,Section ,�' _� i: " � - M2ter ❑up to 700ampi .'1 iluue Fee �? `$�'3
y ^.'S Ey:any"applicant for2a permiL'su��ects.the;appli<ant to a civil ' ^• - � � � ' I �a ' � .
� "41ty oi not moro than five, huntlretl tlollars (E500i'. ' ^ � , ' ; ;. SeivicE Sink � � .;y� � � � __ � ; �y5ue Fee �r� { , $ 3L � � 7A��ng P.ppro4ed By �� ' ' �' Oata � � �
u -1,;,as�owner ofithe!pro0erty Of:my employae5_ `�'_�t� wa9es�,as t�eir sole � , � � � �. .^ -� s� �M1 1 � { )) � '
. mmpensatlon willitlo the work; antl the'structure is not Intentletl or o7feretl � �� '� � - ' j { r' MECHANICAL j � �,$ qpp�ifation Approved By -' ��'� t � J'�Date /��/ � 3 �
for salel(Sec4lon 7044, Busine55;antl�Professional'Cotle: ThalContractor't : , � , " � ' ' ' ' ' � , . . ����
V License Law Ooes not apPly to,an owner of a DropeftY wno builtls or improves j BOi10� � y � ;={ Refrigerotion System � ' -� '� �'� ,'�� � �t' � t ~ �'� �3�
' themon,�anC w�o Ooes:sucn,wo�k hlTselt/he�self or th�ou9h his O� h0/ own : � •-� �'�• {•�• �� " � ' 1 I � ,�. APP��mtion ISSUBd By"" �'�. DetB �
' employees,-provitletl Mat such improvementz are;not Intentlea or offeretl for ' '' � ❑0-100 OOBTU ❑100,0008TU' � '
i sale. Ii, �owever, the bulltlin or Im rovemant Is sold within one ear ot com- � � Duci : UnderiGround � i A ; � . -' :1 ' ,� ii . j� i
9 P Y . . r- . , � �;' � - � � SUMMARV.OFFEES � �
', pletion, the owner;will have tha burtlen of proving he/she d10 not builC or im- � -. - i. �� :� �
;�rovetortnepurpozaof,sale)l � { ^, � i t , � � Duct-Structural SystemRepair/Alteration � �'� ! . .BUILDINGPEFMIT �$, �� �� SMIP��� 1 $ � '•3�
� U I, as owner oi c�a pioperty, am axUuSivety contraciing�with�licensetl cbn- i � � , � � � . ' � i - � , ,: -� • r
� tractorsto construct the`project ISecUon 7044, Business ana Protessionz Cotla: . j� Duct- Ventilating ! p� � � �' � .+PLAN CHECK�' •=-$� ."� T�' pERMIT ~t �' ' ;'
� The•Contractor's� Litense' Law�does��nobapply�to ?n�owner oYproperty who-'Z' . � - � , � , ; - . � �t'- ' " ISSUANCE�� - - $'L
builtls or Improves thereon, antl who contracts for such projects with a con- � � Exhaust,SyStem ❑�Multiple 0� � i � j ! ' :PLUMBING = ✓$ -./3, �.
'' tractor(s) ilcensa oursuant to the Co ��r' .Litense Law). t - � - ' � GRADING � . $ � � �' '
i �'I am exempt un8er Se�tl� � � ` ��. & P. C. Tor this reaion ; Firepl/FaCt. Blt. ICBO # � � � + � � 'n ,� �PLAN CHECK� ^' $ ��1���n �r; . � i .
p( � Date � O"v+ner: � t Heating�System & Ducting � � , � J . }lELECTRICAL`:- ,.J/$, �+ �y �~' '�, �, .. $i,! � ,,•:. ,
' � I � , �' �f '�' • i i�' g '� MICROFILM $,^ � �
�I.hereby cerHfy that_I;,have read_tnis'applicaUon.anC state.that.the.above_, __. ❑0.100,000'BTU.�700,0008T�, PL/aNCHECK' $� !
. i IMormaUon is corract. 1 agree�to comply with all G�tY�antl county ortlinances ' . i. � �i ' - � � '✓ J' . i� TOTAL!FEE, �$'� ��
, antl�stata laws relatlng to builtling construcUon,'antl hereby authorize repra- ' Hood oi . r � , ; �MECHANICAC $, ��� ,� , .l . `
sentatives otithis- Ity�to enter.upon the abovB-mantlonetl property tor , Typ=I �' 1 qeinspeetionFee; �$15 � t "`{ � LESS:' y � 4 Nj
- Inspecuon o tps � i . • � � "/„'a/C.7 � Cano � T e II ❑� � / i � . `, �PLAN CHECK $ � ' qDVANCED PC ) $ ,• `
� Signa[ure - � ' Date�c=� � , r � 6 � j� �'�] � (�
�.J , �rlvers' Llcenie oc55 � - � � ' + � � � Register5 �� + - _ � Issue Foe ; i $ 3 F i �" .." ' ' p�NAL FEE' � $ '�V�
: i , � - r�
. �
`--�865-06'rev. 12/82 '- White = BUIItlin9: Canary` "- Applicanf; Pink -`Accounting; Goltlenrotl - Assesior"'"- - -" '- �- �� ' ' ' - - - -^' ` ' --' - '�'^' -'^�-_. , . -- . .. ^ - -. . �. „ ..^ . .
��\ ' . ' _ .. '
,. . . . . _
, � -- =----- -- .�_. .. ,.
� ? �+ CONSTRUCTION AND P.L�, ,NG 4 S -� � �-- - '- � --= �r .POOL _ r, n ; � , ,, .,;- �
' � �APPROVALS,i Permit # " ^ � cOate � � F�spector . I�APPROVALS Perm�t.$' -�Date� _Inspecmr
. r: � � .� � � - - • - •
" � F1.jTempoiary Elect,ric`al Service;o� Pole ' y,%�. q i� -=� _-,:52: �Pool &�Equipmeht,L:ocation-�-;•� �` .. '
,'� .� �: N �� - � -� -
� (2:� Soil'Pipe-Undrgrnd, � , r ;`� � � yz , yJ, � v � � 53: Steel.'Reinforcement ' _ � - � ' � _ -'
����_ `�: , r-1
-:3.1Elec'tricafConduitUtilitv�Undrgmd.i-�,rj ��- :n �� 554:�F.orms• - - = c�� `" '
� � 4.1 Electrical Conduit Undrgmd - ✓ � � % � � � � ' c ' ry ~ °' ' ' �
y . _ N �, � � r . � _. � 55. �Electrical.Bonding _ _
erY cal-: tt� k - •. . , . � . n " _ , . . � ' f'
.5.rSteel Reinforcement � : _ _ - F� P�, j� '�� Sj - �„� � "56. �Rough Plu'mbing &�Pressure Test " _ , '
�6.! Electiical UFER Grnd. ' G' °� ' ; a a `''� ��' 57'.tAPPROVAL70 COyER-GUNITE � � - : -; • � �
,��5� Fac�;� .
` 7.�Footings �- ; a'L�1 E+53; c� � ; c,;' � - '�.��`; - - `58._Ele'aricai Conduit-Undromd:" • � _ � ,.. -
8. � Foundation �-�' � � � � ' � `� ^ ' `�'= - ` �59. _Gas Pipe� ❑ Undrg�nd oTes4�r , �"��'
` 9.� Water Pipe� Undrgm�d. � � � � � �i ' - %��� � ��t ; , < ��'' _ _ 'gp. .Backwash�Lines; P.Trap; O'UndrgmdC� � � � - ' , �
`� . �. .i�r . t" i � i i �` ; ` � .' .c .' . :t' . . .
10.'� Structural Floor.'System a a � ' � ; ., s z ,, '. �61.'APPROVAL TO.DECK `•. ._. , , - � , �
� 11.�Properfy Sewer!Lirie & House Connectiom - �;� �:', `; ; �;: _62.:Backwash�& Receptor-Final'�`_ ' . - �
, � .
. 12. f Sewer; CaP; � :,� ' � r n � i c $� j�IO� � �i�t p i ' 63. Heater &`. Vent Final. .. . , , -, , , � :
•, . - . .� . . . . _ .
13.�,Roof D�ains ! �, ; _ - t i _ , �,� � � -64..PIu�mbingSystem; Fi�al � -. "_ - -� �
� 14., Rough Pluinbing � ' • � � � � � �� • "65. Electrical-Final ' - � � � � • - �J �
, �o-
l5.'Rough��Electrical=ConduiY�-"-, "' . ---/0_Zp_�C � j�; '�66.�SolarSYste,m`-Final� -- ��-"---` '.- - -•- - - --
- cotrrct ci b - -tr o
c 16.!� Rough, Eiectric Wiring �, . , im ai'� , w ,� � -" ' �• t; • �f r67: �Fericing & AcceSi�Approval-�� �� - � - -.
_ .'17.' Rough,Wir.ing Sign: • " ,i`� � , f - � �`' _ � ' `gg: �APPROVED FOR PLASTERING ' ' `
u... i_ �1 6 'ci- , 'a� - I.
' �18 �; Rough Elearical,-T'Bar Ceiling �. �, ' � �- � � � i'. � ^ . ; 69'. :POOUSPA�SYSTEMS FINAL , . � .,�
' 19.�Rougli Heating & Air�Contlitjoniri�g ' � � %/!lG��3 , L; � � FIRE�DEPT: REQUIREMENT ' < `
; , - , '.
° 20.� Rough Factory Fireplace � � !! �. �� � � �� � � � � � ' APPROVALS � Permit # � _ � , - , . �
✓ 21. Ducts in�Sfructure "' ; ; �i ;� ? � ± I � ! � '70. Underground Hydro ' � �
- 22.;;Ducts�,iVeritilatingr _ � . , i� . �, � 1 : � . ;71. Product;PiPing.�Gas OOiI , . , .
_�2 .rGas.PiPe-Rough&Teet` � � i„i � � -.��'� �- -.---� �--i72; UndergroundFlush-�-i�;;--� � �-- � � �; - - .
�
� ��,2 .��Roof Framing � , � � � . ' � .�„r �!�� }:; ? :, I °j j'_ ' � - � .- � ;73: Undergrnd.�StorageTank OGas. OOii I �
� ' Roof Sheathing ; } � ; �.r� ;� ; . - �a_r/ _�3 : 74: Overhead Hydro - ,i . ' ,
�*26.j�T.Bar Ceiling (Structuralli,& Monocoai � . 4 � � �t ' ' ^' I75. Dry Chemical ' •- . - ' • �.
� .� ��.�. tl I'i�, j.. .i i
! �-27.+Frame.and°Fleshing- NZ;�ub C4�d i � 2-21-ff� f t �76�; Dry StandPipe . � ^ - � � I �� ,; �
� �28.�` Lathing & Siding ;, - ' � i( ' � -Jl�_ I � i 77! FIXED SYSTEM FINAL. � ' . � � i
� . � - ; � a�y ��..8.�
29'� Insulation-' °" + � � R � . � , � ' '
� - , ; � I ;y ,� i. 2--�8'; �� , ; 78. FIRE PREV. F.INAL
� -:30.�Drywall Nailing - I � . il J �4 �� � � Notes: \�liO� � " , �
� � s � � n � �f--�--- r- � -'- : I - - � - --� . . . - -- � --�. ._ .
r �31:�Plaster Brown Coat, .. � � . ,� 1 ,y9. : � � ^ ( ' . � - ' .a
i
n ,�32.Electrical Power Metei-Final � �� {� y' � . �. �� � j . � �� _L �:`�Q . � � �
33.�Final Electric � � i _ ,� ��_;j,__� ..;� �._._�..... � � . ��=,�t%..- _l�v � l^t '1i-,.' ,� '"}� � • � �
� 34. Final'Heating &�AirConditioning N �, � ";/ {�' � � �. ^ '
- � i .r_. . c � �_ : v a. . � C. � i '%' � !� t' %:y� '' ��"
35. Final�Gas Pi�pe�-Test ,� " ^I �� i• '�.' o i� �'� i .U: " . " _ ' - °, '; � `�
_ ,,_
�
36. Hood�oriCanoPY'• ,� � � i' ��i � f } �' � � - � , _ ` . - ' � .
a: n i
37. FinaliFactory FirePlace: �.� i c� �. 1�. i� „` ��!' i I� I'`L-�.l�e�1 fPAciy o�� .�'rq,nJn � ..
� n � ,;4ti0 � ��
38. Final �Plumbing � , � ^ � � � � '
i ' , '_'
r�, � 'i •=� §'�` � �. i � i�e:d +Siro s�dj4 JS.:-ge t laihiti e�ei;or
39. Water7Ser,vice-Final � � � v � ! � � � ' � � ' � � � r
, ;�. �, + i �,: i , 12 163, 0 1 h P
40. Gas Service 1Final �� i � ' i .� � '�d/ji,�7 � � � ' . � ' �. � • t. �
���� �� Of f m�N iNS�� P h.�,
41. Solar�Domestic`•Firial � . � j j �,; �_T - _� - �2`?8.-��.�ir � l ��' � '
42. Backflouv Preventer � � � � .�m�_ � ,� !_ _ � __� . , � : .�
z,- -p�y'_ '� � ,; � {� . -TO' IAfS�i.ATE .
. �q � - - ,. .. _, . . �
43. Backflowlriigation: � �; � =t;_ �::{_ -_� S'���;yX 12 S7R�P/N6 a lvqll e7W
� �, "_, ,� . .... � ' i � . � -. j'u I = ' - = � � t 1 ' . . •
44. Landscape Ir�igation,System, ; � +- ' • , � .` � •''+ A� � �- -
._ o, r.^.�_:1- `I . .
� 45. Sound`Attenuetion;�'- �<� � �-'�>! '� ' � , ' I - `� � -� - ' ' _. � _
,�, , . �-: - f � . - r � i z-.8�-8'+ ri;4L ui ��� "� �
46. Handicap Regulationii ' � � � � 1° � � �'' �� ' � , . � � � � , . - �� .
I� I � 1 =t �, I Ev` J. ' � G ro w .d'.
47.�FINA'LSTRUCTURE�&BUfLDING� ;_ i ` ' ; ! � � � �5 -
a � � 1. I'I :� E� I.� �L G 6 L _q
48. Special RequirementsCompieted • � i � �w ��'I � � d' �
u ,• , �. Nr-_ w Exls �� � o �-z �- y
49. Etectric Releaseto�Edison � ; :,� � _ �,.+�...�} ...��.;._ � 'b- �Cu d' - oH �1 � " '
50. Gas Release to Southein California Gas Co ; � � � t � � � l '' ' �
t � � A i ( I i -9 1 ' I /
51. CERTIFICATEOPOCCUPANGY ' � � � � ' ' ' �__�".` . �' y
� ; , � � .j`[ - �- -i - -r-� -7--�"�-•1- , . - : - , . , ' ' � � Ls�
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owNEx K, W, KOLL CONST, C0. INC. nATE 6-F,-57
JOB ADDRESS �, T cnxinnA Ci r�rle BUILDING PERMIT NO. 5261
GENERAL CONTRACTOR gamP VAL[IE $ 13�000.00 _
AP. No. LOT ],5 TRACT 3137 FIRE ZONE DESCRIPTION OF WORK R,25, w/att �ar. _
GROUP I& J T7fPE V ZONE Rli PLAN NO. �t�
INSPECTIONS � DATE I SUBCONTRACTOR I PERMITSISSUED
DATE I NUMBER
Final Gas Test / S n/.(, '( .�% 2� 2 7�iw i%�D� �M.�. «�� oZ �
Costa Mesa Bailrling Department APPLICATION FOR PERbII�
��� -�. P. O. Bor � 7 5293 p
��� y COSTA MESA, 1 ,FORNIA D , � �' � �
FOR OFFICE USE ONLY
FOR APPLICANT TO FILL IN Receipt No. Permit No.
naare5s 469 Lern;ood Circle S`ZE�i�
Costa Mesa, California Received by Date Rec'd. Date Issued
Nearest CO — S
CrossSt. `�1S'tlri Builtling
Address
owne� K, Z�1, Koll Construction Co. Inc. Costa Mesa, CalifoTnia,
Mail
Address 2826 ldevroo: � Rl vri __ NPa�a�t
wrcnrcector �
Engineer T^jl].
Address 2�25
Contractor
Center of
2ch Cal. No.
� Lic.
� ��a No.
�t�rport, Costa IQ
c�c,
�f No.
Block
H A
Traet
�J.z� Nowon Lot ?`�one
INo.of No.of
F,amilles Rooms
� . Rear Vard 22
�:.,e...,_. ��r
New I � I Alteretion I I Addition I
Repair I I Moving I I Demolish I
Bullding No. of
Size 157_5 Raoms 5 Stories j_
ExteNor Wall � Roof �
Covering ��m� & Sittecly�Covering Sh;�i�P
Use of New
Building Siurin I'aniiy Ihaeliing
�F�taio
.�,0 �?c`
I her y acknowledge that I have read this Application
and state that the abwe is correct and agree to comply
with all City Ordinances and State Iaws regulating
building construction.
Signatureof , ,
Permittee
Aulhorized Agt�
Valu,ation �� PermitFee
$ /�` .Q O O � Plan Check
ToSal
Fee
RM 209 10�55 . D. P. d 5.
30 —"
/S_ _
.��
Type
Dale
CORRECTIONS
APPROVALS
Foundation Location Inspector
Forms, Materials,
Under-Pinning
Frame: Fire Stops,
plaster, Int.
Plaster, Ext.
Masonry Reinforced
Bond Beam
O
A
�
z
D
r
Date + I
J�
o�
,,
ri.vl� ri.rir
6how Iocatlon and distances from
— property Iine and between buildinga
� .
4
r✓
Gh.-
:�1
�
G
G
,,..:,- _-.. ..
�
:� -. :::�,'� .
,
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— ' _ � '
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,\
DEC 31 1957
�OWNEIi HjTCHES. Charles R. DATE 9-6-57 �
JOB ADDRESS 1�69 LenUrood Circle BIIILDING PERMIT NO. 5(�]_
GGNERAL CONTRACTOR �gr-Ri�ildar VALIIE $ 1,280.00
AP. No. LOT 15 TuacT 3137 PIRE ZONE DESCR[PTION OF WORK Rtlmpus room add. to �1.
GROUP I TYPE V ZONE RIt PLAN NO. riFi77 e5,
INSPECTIONS
0
Pinal G�s
SUBCONTRACTOR
�, undergmunU rower -
, Rough W^ring ;� � � _ / G_�
=/
P
J- .-�� E
� � '+ 56 i �i
,COSTA� MESA BUILDING DEPARTMENT
P.O. 60X 31� ��
COSTA MESA. CA�IFORNIA " ��
FOR APPLICANT TO FILL IN
aui�oiNc �� �/ .��P � ( liSw�i(P '
A�DRE55 e /Iq//
1 MAI
CITV �
ARCHITECT
OR ENGINE
I CH PY�:L[�1C L-i
LEGAL L�
OESCRIPTION ry(
A.P. NO. _ �.�'�
COSTA MESA, CALIFORN
FEEyR�(EIVED =��
FINANCE DEPT. ,
CITY�OF COSTA MESA
APPLIC,4TION FOR PERMIT
BUILDWG .:: •
FOR OFFICE USE ONLY �._-
TEL. � IJILDII
NO. ADORE'
LIC.
NO.
FIRE
ZONE
TY LIG �ONE�
� O,
TEL. APPROb
NO. BV
TRACT�,�
1' , �
NO.OF BLDGS. /
NOW ON LOT
USE OF /°C.�'�/{,_
EXISTING 6LDG-.{f,L� •
SETBACK LINE FPOM ��
c[rvr[a oF sTaEEr ��� REAR YARO
SIDE VAR� ' RIGHT r� LEFT C�'
DESCRIPTION OF WORK
NEW ALTERATION AODITION '
REPAIfl MOVING DEMOLISH
BUILDING�/ �y NO.OF
SIZE (� ✓�-O ROOMS STORIES I
E%TERIOR WALI� L+,p b ROOF ^ a�' �
cnvcAiNr. a��..ixv'tl COVERING ����•
COSTA MESA. �CALIFORNIA
CORRECTIONS
PLAnNItdG DEPT.
/
I HENEBY f�CKNOWLE�GE TM.�T I MAVE REA� THIS APPIICnTION wND
$TATE TXPT THE ABOVE IS COFRECT PND /�GREE TO COMPLV WITH AL�
CITY OROINTNCES AND STATE LA�NS REGULPTING BVILUING CONSTFUC�
iioN. VALUATION � .
LG � PERMIT FEE S
P RMnITTEE ,�'L t
/ 'J �O PLAN CHECK S � —
g uG V
AUTHORIZED AGENT / TOTAL FEE S /a -- �err