The URL can be used to link to this page

Home My WebLink About203 LA COSTA CT - Building Permits • vF CITY OF COSTA MESA BUILDING DIVISION > N •,,,' �i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t Pk. PERMIT /B05-00140 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT • Job Address: 203 LA COSTA CT Status: ISSUED Suite: Applied: 01/25/2005 Vicinity: Issued: 01/25/2005 Parcel Number: 42620265 Zoning: Applicant: JANOSIK,STEPHEN ISSUED BY: Address: 1621 E ST ANDREW PL Phone: (714)259-5120 SANTA ANA,CA Zip: 92705 Owner: ZELL, DONALD H Address 18818 TELLER AVE STE 140 Phone: 949-548-6441 IRVINE,CA Zip: 92612-1679 Contractor: ALUMINUM ROOFING SPECIALISTS/DIAL ONE WINDOW REP Address: 1621 E ST ANDREW PL Phone: (714)259-5120 SANTA ANA,CA Zip: 92705 License: 523043 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT REPLACE ALUMINUM WINDIOW KITCHEN WITH A BAY WINDOW OF THE SAME SIZE SIZE AND AT THE SAME LOCATION FEE SUMMARY Plan Check: $63.21 Calc Valuation: $3,300.00 Permit: $97.25 Claim Valuation: $3,300.00 SMIP Res: $0.50 SMIP Cont: $0.00 Other: $0.00 - Inspection: $0.00 Total: $160.96 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446.46(6/00) DECLARATIONS o WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one 01 the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ave and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. workers'compensation Insurance carrier and policy number are: [� Ca �T �• ft, Q - Policy Nu bar: 73 tT7 9---2, r- is section need not be completed if the permit is valued of one hundred dollars($100)or less.) O I certify that in the performance of the work for which this permit is issued,I shall not employ any y manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation pro ' ns of Section 3700 of the Labor Code,I shall forthwith these ProviptOps. _ Appli - iqn: re: Fiy/� ' lJP COete: I L�.1 -Or W ;, , . •(LURE TO SECU WORKERS' MP NSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($100,000),IN ADDITION I E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 here eMmmlllat-f•am licensed under provisions of Chapter 9(commencing with Section 7000)of Divlsio 3 of the 'nessad Professions Code,and my license is In lull f f-0flect..Liatt Z ss# �"lure: - bete: \ZS-A'�- CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). • O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). o I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature end pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a,permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. l ig orture1IOfo- swner(s) II, /- J `-C) 'n. n.�.ifpplicant / '-Date CODE 0 INSPECTION TYPE OATS INTITIALS CODE( INSPECTION TYPE ` J gdTE INTRIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy6"GS 'may',\E\�� Oci tub a� '7SEE �_ OFEE S V Headboard fastened into bender 1/i4µ QCK through entire width • NA40ce Jambe fattened to Hinman ,`I top fo bottom both sides �,f' i N w' ff wi `/ J/y Yl.IoLAC 4d'Oat �arayao Yb Seatboard fastened yr•ge, 414.1 into sub sill •.' N„_ Via'/cd N.v<J 2r..44;,),) wimC Support Corbels To bet x stock finish I Wy SE Arsoa at wrapped in alumi inum i tC or 3#y Limo ul I �f LR.0 per.O_/ Yl/.lJ,i ,/,//A •////________ IN'CR'°R Tf•I — _ I ....�. — wfl4 $rvPJ [pyo [g}�� FrERfe4 l l�il P t,�OVED i•t _ su 1f ACE - —• CITY OF COSTA MESA I ll PLANNING DIVISION - 6281t DErq,L — SUBJECT TO BLDG. DEPT. REG. t/Sf /6c/ Nm/as TrIni ,O,No✓P' NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. 5o5CQt4J :PP !' DATE: . ....5_45 DIVISION OF BUILDING SAFETY CITY OF COSTA MESA • PPROVED • • WDaleNs set of plans gpecgdions MUST be kept antis is lob et all t' :, and it is lnlawh4 to make mrydrerges or alterations at sa ne wilaU written permission . •the Division of BtMi9 and Safety,Cay of Costa Mesa. The'forcing of[Ms plan awl speci iorsSHALLNOTbeheldtopanneortobeanapproval of the violation of any provisions of any co of Costa Mesa Ordinance and/or Slate law. These play and panne she&expire by rattan and becane nue end void it the budding or wale k rid Toed and flahfened alive per UBC 1303(d)wahh 180 days of canoe. 0, 03 La_ Cosdt. LA COSTA I' • • \1 J(1) I I I I I I I I I I I I - -_- IDSA / �•� 1 -STORY SFD I ' 1 1 1 1 i 1 1 1 1 ; I 1 1 SITE PLAN i I 1 i I I i PROPERTY LINE Applicant to fill in all spaces except those within heavy border lines and sign I appropriate declarations. CITY F COSTA MESA CONSTRUCTION PERMITRMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address �S L" ®COSZ9 coy.- I) a70 c. 5 /a 1�`l `� 0. 1203 1/27/87 557,91 It •j Ov6 � ' e TYPE OF CONSTRUCTION NEW LJ ADD H ALTE RATI•N Uf REPAIRApplicant's Mailing Address F9/ :0 /� Pest/704r ti // S• 6(�` 7/9/3 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.# �`�Ca — (QQa - Q0 O I Zone /v1 Owner's Name A/ �'•.l Phone. J _ I ?PI! 6K00f/G DESCRIPTION OF WOR•/USE OF :LOG. Address /Z7'V e� NL-�• �•4R� t •' ••i G I S Main Building: Accessory Building: ' E / 2 Arch/Eng. License No. .TVPE OF PERMI GRADING �+ FOUNDATION STRUCTURAL T Front ' p( . 0 Address ^ - QQ ,,//�� J ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL N B Rear 5a Contractor's Name N� "TJNL(f•'JPhone 0YSS/4/1/3 ❑ OTHER - C Right a�•� / - N //�)/)I� o�es� PROJECT DESCRIPTION at:.` 12 a SF OCCUPI,NC R-3 v • Address(mailing) 9 "�"1""�,O/~ • /me ' :N� CONSTRUCTION TVPf� VALUATION $/.1 �-6�� $ Left /(�/ R City License No. �TO7 �. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION ---G �•s Ping. Ref.#' a. i5 Parking Req,/Provide• / E 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: pc* 13'/1 _g641 �S� Planning Note' • • • ,_Y� 1 L'♦♦Il s • O (� with section 7000) of Division 3 of the Business and Professions Code,p nd I -( ^ � �/."., / ,,,/� ,, ,, • N, \ my license is in full force anryFllect. 'i/�./, ••r _ug /,(�,/7 %/y`L.CA• �.V��C(.[1'/Lt.O S License C s 0� __- ' ' 7 `� Date Signature —I1 _- PLUMBING I FEES \ '^YORKE S'C PENSATION DEC • .4r1► Bar Sink Showers ELECTRICAL FEES ereby affirm that I have a certificate of consent to sell-insurg or a certificate- /f Workers' Compensation Insurance, or a certified copy.tnereo( (Section Backflow Preventer Service Sink / °°°111Automatic Washer Transformer 0 15-50 KW / Labt) C DD��""3(y0-�. _I •��,I Policy No:-.-- y i C�7 C//Company l/fir'"/�� Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW Certified co y is hereby turnishetl. rtketertifie Is I ith the cit Buil n. Bathtubs Sewer Connection Cooking Unit Meter El up to 100 amps Date Applicant EXEMPTIO FR M CO PEN CLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amp (This section need not be completed if e per ' s for one hjrndred ($100)or less). e, Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that In the performance of the work for which this permit-Is issued, I shall not employ any person in any manner so as to become subject to the - Drinking Fountains Solar TaA--- Motors❑O- P ❑1h-8 Fan Workers' Compensation Laws California. Date Signature Floor Drains SW ming Pool w/Spa F.A.U. Inc.Sol. ■9-15 HP 016-15+ NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks final Fixtures Mi •wave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY . Gas Service Outlets Water Closet Device Boxes 1 hereby affirm that there is a construction lending agency for the performance `ole Light - of the work for whl • hi, per is' is i. d e 3097 Civ. C.) Lender's Name f C i• a �../ C-Y/'y Interceptors , • Water Heater Outlets ;i Range Lender's Address .% A _ w. i"iii s ...t Kitchen Sink Water Service Switches OWNER BUILDER OECLARATI•N Sign • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - • - Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap - Laundry Trays Generator ❑o- ❑$-1$KW any structure, prieClO Its issuance, also requires the applicant for such permit Tri_. Compactor to file a signed statement [hdt he/she is licensed pursuant to the provisions of Roof Dr ns - •he Contractor's License Law(Chapter 9 (commencing with Section 7000) of - {/// J- ,i- i vision 3 of the Business and Professions Code) or that he/she is exempt erefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil LJmalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Foe $ 3 - . compensation, will do the work,and the structure is not intended or offered • - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 1' FEES . License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own Boiler DEVELOPMENT SERVICES REO . 11employees, provided that such Improvements are not Intended or offered for r '1 L sale. If, however, the building or improvement is sold within ono year of com- Zoning Approved By Date D� plellon, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground rove for the purpose of sale). Building Approved By Date - . U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Application Issued By s �tial Dat: ,a tractors to construct the project (Section 7044, Business and Professions Code: /J The Contractor's License Law does not apply to an owner of property who Duct- Ventilating ,L96 .flI r•• : SUMMARY OF FEE builds or improves thereon, and who contracts for such projects with a con- // p tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ '-•. BUILDING PERMIT $ 4173•a7 SMIP $ D` 05— proof S proof of their Worker's Compensation insurance should be provided to me. _ �r� �1� PLAN CHECK $ 7G .Or PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIL ICBG# pv- •ampers PLUMBING $ ISSUANCE $ Date owner Heating System& Ducting 'Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,001 : L ELECTRICAL $ GRADING $ information •rrect. I agree to comply with all city and county ordinances • and state • t• construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives +•' n the above-mentioned pr•perty or inspection � _ o ��s1 MECHANICAL $ . pppp Signature sate .S TOTAL FEE $ �7 ' Drivers' Licen "W - ' � Reinsp•• on Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor . • CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. . 9/3 l Co 57. APPROVAL TO COVER-GUNITE 7. Footings yI31e7 58. Electrical Conduit-Undrgrnd. 8. Foundation . . 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • ./qk 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final i. 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING J 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT V 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro • -- 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 00ir 25. Roof Sheathing ef`li7 (0!f4 74. Overhead Hydro U 26. T-Bar Ceiling (Structural) & Monocoat 11/� -J 75. Dry Chemical 27. Frame and Flashing �f/iY7 G/- 76. Dry Standpipe ,, ;, fv - J 28. Lathing & Siding S 's4 G' 77. FIXED SYSTEM FINAL 29. Insulation , /gi Cr 78. FIRE PREV. FINAL H 30. Drywall Nailing c/r,t ' 4rel HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: Fire.?tacit Tbreirs 2.47 T2 / 7ig.7 GAS 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test it8 Lt-FtJR SPSt • - 1Z1U1XE•MtNTS / 76* 36. Hood or Canopy LtsiO �VOVb • -14 37•. Final Factory Fireplace • ^Q _.y 38. Final Plumbing ' � w','"Y i - ratUatt 97 / 7-e,dYFoy ^-AZ '6N7 39. Water Service-Final - 40. Gas Service-Final ! - + t 41. Solar Domestic-Final ' r `;,42. Backflow Preventer - • - • , 43. Backflow Irrigation , 44. Landscape Irrigation System ' 45. Sound Attenuation • 46. Handicap Regulations . 7/ 47. FINAL STRUCTURE & BUILDING 71 /1_� i 7 �� "/ �CTq 48. Special Requirements Completed 23 ' i/ft 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co r 4 51. CERTIFICATE OF OCCUPANCY No. Date • 1 . . . THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE • WITH THE CURRENT ENERGY REGULATIONS , CALIFORNIA ADMINISTRATIVE CODE , TITLE 25 , STATE OF CALIFORNIA , IN THE BUILDING LOCATED AT : TRACT/PHASE : LOT NUMBER : . 11 T SITE ADDRESS : �(o�p dR ri .) T (la)- /0E99Number Stet City EXTERIOR WALLS : Manufacturer cS /0Thickness/Type : 3 � R/Value : rg// CEILINGS : Blown (circle one ) le- 30 --- � � ' f ►e-aa 7 /M, i'n^nn Manufacturer : Yvl Thickness : g_-19 R/Value : 4o41/i1 GENERAL CONTRACTOR : kw(4290Mehl? 6/ 4LICENSE # : BY : TITLE : DATE : INSULATION CONTRACTOR : WESTERN INSULATION LICENSE�� ' / # : yg/a77 BY : .lTITLE : S'� �C//��V/ DATE : 702. _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY Of COSTA MESA`'3 CQN$TRUGTIO PERMIT PE�2-MIT N9.� TRACT NO. LOT NO. UNIT NO. Project Address 21 i.17.�1s,1fc /V'J2-. Applicant's MailingNew/obi-ft Address I /kg eMtn;5;i� Pi`[t/,,a� TYPE OF:CONSTRUCTION It)NEw U ADD U ALTERATION U REPAIR 359 �29�07 49ee8 TL Owner's Name /1!!wp»tY` /k1fY OU4l'(/!�J Phone !P'tt 7 ,a ❑ CONVERSION ❑ DEMOLISH ❑ OTHER v A.P.# _ / DESCRIPTION OF WORK/USE OF BLDG. -Q r( Address S Main Building: • Accessory Building: E • Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING rs❑ UNDATION 111 STRUCTURAL T Front • O k. Address . . El TENANT El ELECTRICAL LSYPLUMBING ❑ MECHANICAL B RearN f ❑ OTHER A I Contractor's Name Pi rerCAfY G•yr- Phone .303 Merrill PROJECT,DESCRIPTION SQ. FT. OCCUPANCY C Right • N Address(mailing/ fit Merrill r• K G y9) CONSTRUCTION TYPE VALUATIONS S Left City License No. Z- ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION /� r - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: C3 - 2„ /� h..f�riy- 24J( .-20"7-9 Planning Notes: Q (w with section 7000) of Division 3 of the Business and Professions Code, and 6J,/ 111 rrt/// --6 _ -�s•'G) " my license is in ful for d effect. ,•y r /1jl„ „—� T License ass icense No Q• V S Date r� ' Signature -�s.. - • PLUMBING FEES . WORK RS' OMPENSATION DE LARATION Bar Sink Showers hereby affirm that I have a certificate of consent to self-insure or a certificateELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy) thereofeoT (Section Backflow Preventer Service Sink V 3800, tab.f.)� R19�h3 6R _/Ce♦GU.br'C. J-h0eazi , Automatic.Washer Transformer 0 15-50 KW Policy No. f / Company "� / Backflow Irrigation Sewer Cap - Construction Pole Sub. 0 50+ KW Cpfltified copy is hereby furnished. - ' S/Crerti ie co y i filed with the city B I Dyyl n/J, a 3 Bathtubs I Sewer Connection /7 °J Cooking Unit • Meter Duo to 100 amps Date Applicant .✓f /C - ' - EXEMP ION RO WORKERS'CO ENSATION DECLARATION • Clarifiers Solar Collectors Dishwasher Meter Dover,100 amps - • - (This se ion n ed not be completed if the permit is for one hundred ($100)or r - less). t Dishwasher Solar Piping .Z -jam ' Dryers,❑Gas ❑Electric . Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors❑B-1 HP ❑1'/x-8 • Workers' Compensation Laws of California. - - Date Signature Floor Drains Swimming Pool w/Spa �_ F.A.U. •• ' - NOTICE: If,after making this declaration,you should become subject to the . Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service outlets 3 Water Closet G DeviceBoxeS I hereby affirm that there Is a construction lending agency for the performance O Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors j Water Heater 00 Outlets- - Ran Lender's Name �/ 91' • - Lender's Address - ' Kitchen Sink / Water Service - / ck? - Switches Si n - OWNER BUILDER DECLARATION - g I hereby affirm that I am exempt from the Contractor's License Law for the 9 Lavatories ( Auto-Wash e� Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or a7 • county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays ( , Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor .. to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of _ •__ •_ _ _ J { Division 3 of the Business and Professions Code) or that-he/she is exempt - __- - - ' therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil - _ _ _ • , penalty of not more than five hundred dollars($500). • 1, as owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee _ $ 3 • compensation, will do the work,and the structure is not intended or offered - Reinspection Fee ' I $15 Issue Fee $ 3 - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES ' License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENTSERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 . sale. If, however, the building or improvement is sold within one year of com- — Canopy Type II ❑ Zoning Approved By - Date p , the owner will have the burden of proving he/she did not build or in- Duct- Under Ground - prove for the purpose of sale). {{{{��'� - Building Approved By Date ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System 'Application Issued By - - Dat: tractors to construct the project(Section 7044,Business and Professions Code: , The Contractor's License Law does not apply to an owner of property who • Duct-Ventilating ❑O.100,000 BTU 0100,000 BTU SUMMARY OF.FEES builds or improves thereon,and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $- SMIP S. ' proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ _ PERMIT ❑ am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ - , Date owner Heating System & Ducting Registers PLAN CHECK 25% $ `'7, ENERGY P.C. $ I hereby certify that I have read this application ate that the above ❑Q100,000 BTU 0100,000 BTL GRADING $ information is co - t. I a- e- to comply with .1 d county ordinances ELECTRICAL $ and state laws ;tat g tie. (ding construe '%•- f ereby authorize re•re- MICROFILM $' sentatives of s •ity, nt>/upon t -14 ~- entioned pro•erty for • PLAN CHECK 50% $ inspection au?+•ses I /�� st _ - - - MECHANICAL $ • SiTOTAL FEE $ /7- /b ' Drivers' Date Drivers' License or SS# ♦ - CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor t CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date ,Inspector APPROVALS Permit# Date Inspector 1.. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd.. 1-3o-'17 LLD 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. j-30 / j 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection y/1u/17 ,Q7f' 62. Backwash & Receptor-Final 12. Sewer Cap / ///, 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 00, Mgt' 65. Electrical-Final 15. Rough Electrical-Conduit �� 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • - 24. Roof Framing • 73. Undergrnd.Storage Tank EGas 00iI ' 25. Roof Sheathing , - - - 74. Overhead Hydro • I , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing • o , C; 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL ` 4" „ 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - v- 79. FINAL INSPECTION /i' , 32. Electrical Power Meter-Final ) 80. FOOD CERTIFICATE ISSUED - 33. Final Electric Notes: f/1 f/p•74/ �/ DK- Aec., 34. Final Heating & Air Conditioning / {' '` 35. Final Gas Pipe-Test 77' 9,- rel •'" !t' 36. Hood or Canopy . ' . 1. 37. Final Factory Fireplace ,, t f 1 38.-Final Plumbing it jy, .//% ' , ' -. • 39. Water Service-Final �o i •' 40. Gas Service-Final 7/4/ G • 4' • - - . X41. Solar'Domestic-Final ',� V• '42. Backflow Preventer - .. ,J -. 43..Backf low Irrigation -- .. " I ' 44. Landscape Irrigation System C , .y - 45. Sound Attenuation - 46?gandicap Regulations - , r 47. FINAL STRUCTURE & BUILDING : • co - 48. Special Requirements Completed 1a le' •49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co -:,a 51. CERTIFICATE OF OCCUPANCY / • No. Date • i .-r_Tc.-.: -, • --••\ COSTA MESA SANITARY DISTRICT PERMIT VALIDATION t I P. O. BOX 1200 7 COSTA MESA, CALIFORNIA 92626 PERMIT NO. /6. v APPLICATION FOR SEWERAGE.FACILITIES USE AND CONNECTION PERMIT Date /-2(3.-- D 7 Ordinance No.6 Effective 9-29-69 ///�/�� ' 9 n Czaofz.. C a' CONNECTION CHARGES Applicant to fill In this ares only Building Address?M go 70 O41zd'e- A1/cr NUMBER FIXTURE FEE/FIX. FEE ( 03i roesei, os Jek al Bathtub $ 15.00 3a5, Tract No. 2VD Lot No . 1/� �- 7 '/ Shu Shower Tub or Washer 15.00 15.00 ' O05:-# Owner nek.121ar// �",-.V< 'Sink,bar 7.50 M a /I Applicant 7 Sink, Kitchen 15.00 I 05- as Wash Basin 7.50 ;10 - Address I,/ S'i ' v fL. NE74Wr2/1T , -�e7/ 0'. Wash Basin(Set) 15.00 IP i Water Closet(Toilet) 45.00 C14..5I • Telephone Number eVS Q9/3 Bidet 16.00 Dental Units 7.50 PROCESSED BY Drinking Fountains 7.50 --\ Floor Drains 15.00 INDUSTRIAL USE CHARGES Interceptors for Grease,Oil,Solids, Etc. 22.50 Cu. Ft. per month per acre in excess of 15,000. Interceptors for Sand,Auto Wash,Etc. 45.00 Rate is$0.50 per 1,000 cu. ft. per month per acre or any Laundry Tub or Washer(Self Service) 22.50 fraction thereof. Receptors 22.50 (non ad valorem user-double above) $ Shower,Gang- Per Head 7.50 Sinks,Bar-Commercial 15.00 SPECIAL CONDITIONS Sinks,Commercial or Industrial 22.50 Sinks, Floor '7.50 Sinks, Flushing Rim 45.00 Sinks,Service 22.50 TOTAL CHARGES Swimming Pool 46.00 Urinals,Pedestal 45.00 Connection Charge $ Urinals,Stall 16.00 Use Charge Urinals,Wall 15,00 Total Permit Charge $ Urinals,Wall Trough 22.50 Penalties • e I, /jN - •� Total Du e $ , atod /i L �olYtection Charge $ vt.t '(, 4 S 2•SO?Penalties: Charges are double if connection is made prior to _-..„\ NOTE' A sewer permit Is required at th ims5n�f Sp obtaining permit, plus$5.00 a day. ($25.00 a day for a Sewer Hook-up. /JS 11 / / public corporation). 16a kfvb - /5-- CMF 0708-68 Rev.7-78 ONatE = i u 1t-isc S lib /S - Was A.6Ga1N 7•51) I -!'O;t a •iiSc----- 891 Production Place , NewportBeach, CA 92663 Newport Harbor Builders, Inc. July 23, 1987 TO: Mr. George Edmunston Mechanical Inspector CITY OF COSTA MESA P.O. BOX 1200 Costa Mesa, CA. 92626 RE: 203 LA COSTA COURT Costa Mesa, CA. In consideration for the issuance of Temporary Occupancy authorization and a release of all utility meters on the residence mentioned above, the undersigned does understand and agree that final occupancy on this property, as well as on 201, 205, and 206 LA COSTA COURT, will be witheld by the City until each of these four homes have met the relevant Title-24 requirements pertaining to fireplace openings. :leal771."- 77207 7 John . Pe -r a Date President Construction Management • General Contracting • Development • License#412984 • (714) 645-4913 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION/ PERMIIT+f� — PE IT NO. TRACT NO. LOT NO. UNIT NO. 5685 4/08/87 3�p50 Tl Project Address 2-03 L.4 ( 1v r,4- esw"e . ..8:06 , i" L/ C i TYPE OF CONSTRUCTION ❑ NEW L I ADD H ALTERATION U REPAIR Applicant's Mailing A,ddr/fess n A /f 7��'r Owner's Name,„...... •u�•//L .� / • 'p9/�1rt�+.Pho e // ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P-# Zone l, ( f��i4-.7 /y7 g DESCRIPTION OF WORK/USE OF BLDG. Address rr77 LL J�L,r� ��c'/-+' S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION E Z CI T Front O Address y� // �/ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING CI MECHANICAL B Rear N Contractor's Name A .4.4,l S/` Phone�76 V-/ ❑ OTHER A 1 2 �^ A1-4.f3 �/ PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right G/4";9 'l./"� Address(mailing) � �� fenny ' . 7!71cY�. K G • CON STRUCTION TYPE VALUATION $ s Left City License No. 32' /�� ZONE GRADING CU.YDS. ACRES R • LICENSED CONTRACTOR DECLARATION _ Ping, Ref.# Parking Req,/Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: 0 ," V'� Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code,and l!U my license is in full f•.ce and - feet. , •7 ' T ` rLicense Cla s . — cense� [ I S 1 Date - Signature • til �Jw PLUMBING - FEES • 1 WORKERS' COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES v of Workers' Compensation Insuran , or a certif.-d c py thereof (Section ' 3800, Lab. C.) yJ- /p/f, tD Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. J4-(ov "Company ' -1/ Backflow Irrigation Sewer Cap0 50+ KW Construction Pole Sub. Certified copy is hereby furnished. / i -- Certified co y is file lth the city B tl •• Di Moo: i /, • Bathtubs Sewer Connection P�..r�� Cooking Unit Meter ❑up to 100 amps Date '7- Applicant - • -. .L_ ' EXEMPTION FROM WORKERS'COMPENSATION •ECLARATION Clarifiers - Solar Collectors - Dishwasher • Meter ❑over 100amps (This section need not be completed if the permit Is for one hundred ($100) or less). Dishwasher Solar Piping • Dryers ❑Gas ❑Electric Sub Panel . I certify that in the performance of the work for which this permit is issued, I . shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors DOT HP.01%-8 • Workers' Compensation Laws of California. - Date Signature Floor Drains Swimming Pool w/Spa — - NOTICE:If,after making this declaration,you should become Subject to the F.A.U.- Inc.Solar 09-15 HP 01845+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures • Microwave CONSTRUCTION LENDING AGENCY • Gas Service Outlets Water Closet •'tr: Device Boxes I hereby affirm that there is a construction lending agency for the performance i Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors Water Heater Lender's Name Outlets r Range • Lender's Address - Kitchen Sink Water Service SwitchesSign ' OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays any structure, prior to Its issuance,also requires the applicant for such permit Y Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt - • therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil " penalty of not more than five hundred dollars($500). 3 L.1 I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ compensation, will do the work, and the structure is not intended or offered - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee $ 3 erese Law does not apply to owner if a property who builds or improves FEES thereon, and who does such work himself/heaself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees,lf, hprovided that such improvements eves aie not intended or year o f dc m- Boiler Hood or Type I 0 sale. If, hehowever,wthe will havent the burdendof pro i sold within one yeui of rim- Canopy Type 0 • Zoning Approved By Date tette n, the owner of proving he/she did not build or im- Duct-Under Ground PBuilding Approved By Date prove for the purpose of sale). e ❑ t as owner tr the property,rojectam 7exclusively contracting ing with licensed con- Duct-Structural Refrigeration System -Application Issued By Dat T • he ars t construct the project (Section 7044,Business and Professionsfproperty Code: T The Contractor's License law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU V - SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK . $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepi/Fact.Blt. ICBO# Fire Dampers ISSUANCE $ , ,` PLUMBING $ • Date Owner Heating System 8.t Ducting Registers V PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above • ' 10-100,000 BTU ❑100,000 BT information is correct. I agree to comply all city and county ordinancesNoELECTRICAL $ GRADING $ and state laws relating to bui •ing con , and authorize repre- sentatives MICROFILM $ . r •�lPLAN CHECK 50% $ inspection of this�c'ly to ,,ter p.. a ,6novo- herebyed property. for �� inspection purpos , . 4 0lP"t ' MECHANICAL $ TOTAL FEE $ 30. Signature !`' J - - Date 77 Drivers' License or SS# _ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ .L_7 CMF 0865.46,rev.10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod -Assessor • CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring • 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 5 $/y2 ,Ser FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ��( APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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 i 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' 34. Final.'Heating & Air Conditioning 7/x//17 7 •- 35. Final Gas Pipe-Test z 36.,Hood or Canopy 37. Final Factory Fireplace _ 38. Final Plumbing t • - 39. Water Service-Final . '40. Gas Service-Final 41.,Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation • ' 44. Landscape Irrigation System •- 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING . 48. Special Requirements Completed . C , • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY t No. Date O7 S ' ' ''a/ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OFF COSTA MESA/ CONST UCTION PERMIT " PER T NO. E T- LOT�NO. UNIDT yo, Mar% ��L 2450 2/18/27 58eEJ;' TI. Project Addyess J P)"- T 9piicant's Mailing Address TYPE OF CONSTRUCTION LJ NEW LA AOD LJ ALTERATION U REPAR2 Owner's Name L / /�tfffi=? -J b -�- (}ch om 59. -- 7/3- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Address •1 �✓.biva y .... /ice / DESCRIPTION OF WORK/USE OF BLDG. • S Main Building: Accessory Building: lZ Arch/Eng. 1 License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL T Front O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • N A Rear Address N Contractor's Name ` Phone%P- •• 33,76 ❑ OTHER C Right' G i _��/ / PROJECT DESCRIPTION SQ. FT. OCCUPANCY_. K Address(mailing) �• / � Y- '-��%=� ,O� �,n e CONSTRUCTION TYPE VALUATION$ S Left • R City License No. •7`rr��[[ ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION //p - I hereby affirm that I am licensed under pr. Ions of Charter 9 (commencing Remarks: K ��Q� - - Planning Notes: G with section 7000) of Olvisiony 3 of the I and Pr• - sions Code,and CCJJ 49 I M my license is in full forcPF�nd Act. yy��''/ �/ A/�`pf $ Date License .ss t,�� ((Siigggnature �+�1a"`/.p ' �J ad PLUMBING FEES , WORKERS'COMPENSATION DECLARATIO Bar Sink Showers - hereby affirm that I have a certificate of cons- -to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or . certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) fAutomatic Washer Transformer 0 15-50 KW , • Policy No. Company Backflow Irrigation Sewer Cap ❑ 50+KW 8 Certified copy is hereby furnished. Construction Pole Sub. �/ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection 1I Cooking Unit Meter 10up to 100 amps /is (1) Date Applicant 4 — / • r/w�/ EXEMPTION FROM WORKERS'COMPENS• ON •ECLAR• ION Clarifiers Solar Collectors • I Dishwasher Meter Dover 100 amps 1, t.{./ (Thissection need riot be completed if the p- t is • one h •e r'• ($100)or ^T less). Dishwasher Solar Piping ii Dryers ❑Gas iectric / Sub Panel I0- W I certify that in the performance of the • fo 140 •- mit is Issued I shall no employ an person in any o e Drinking Fountains Solar Tank • Fan ^/,„,r '" - Motors❑0-1 HP ❑1 h-8 Worker o F5{(. Laws of CalifCalif• s.C �ia�= Date Signature .� Floor Drains SwimmingPool w/S a 7- • P / F.A.U. Inc.Solar ❑0-15 HP ❑16-15+ x '5 NOTI It,a emir ma ing this o the you s••ul• become subject to the Workers' Compensation provisions of the La••r Cade, you must forthwith Floor Sinks Urinal Fixtures / comply with such provisions or this per' it shall be deemed revoketl. Microwave l,� CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes -si I hereby affirm that there is a construction lending agency for the performance __y Pole Light I.of the work for which this permit is issued (Section 3097 CIV. CJ Interceptors Water HeaterOutlets Lender's Name Range 9, DO • Lender's Address Kitchen Sink Water Service OWNER BUILDER DECLARATION ' Switches - Sign SCJ D I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections • county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00.5 KW❑5.15 KW • / any structure, prior to its issuance, also requires the applicant for such permit - / Trash Compactor \ to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains - the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section • ' 7031.5 by any applicant for a permit subjects the applicant to a civil . enalty of-not more than five hundred dollars($500). • I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, • will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Secion 7044, Business and Professional Code: The Contractor's MECHANICAL . FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own _ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of tom. Canopy Type II ❑ Zoning Approved By Date ptetlon,the owner will have the burden of proving he/she did not build or im- Duct- Under Ground prove for the purpose of sale). Building Approved By Date O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By tractors to construct the project (Section 7044.Business and Professions Code: Dat The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ ISSUANCE $ Date Owne Heating System& Ducting Registers • - ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify h. I r ! I application and state that the above ❑0-100,000 BTU 0100,000 BTL GRADING $ information is c. re• agr e•• ,p with all city and county ordinances ELECTRICAL $ and state laws r lat a b }',4I ons ruction,and hereby authorize repre- MICROFILM $ sentatives of t is 1 to 1'/'upo the above-mentioned property or PLAN CHECK 50% $ •inspection purp f MECHANICAL $ SS r� �� Signature `i� i Date / TOTAL FEE $ •s u- l� Drivers' License or SS# I Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865.46,rev.10/94 W,ite - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&SPA . APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring ( '';� 67. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# • 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe -a 28. Lathing & Siding 77. FIXED SYSTEM FINAL u 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT • 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 7 9-1_S 7 J C. Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final l: 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer ' 43. Backflow Irrigation • • 44. Landscape Irrigation System •� 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48.:Special Requirements Completed r 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Ha CITY OF COSTA MESA -sr-` • 3.'. F ^.al Power Meter-Final ��0 BUILDING SAFETY DIVISION If a '33. f. ilectric Q POST IN CONSPICUOUS P►of F-- „-- ..Final Heating1181 Air Conditioning Y ON THE JOB fattSj t3Fi:EisialGasPipi-Test Wilt 0°, e 6 NOTICE n . Hood or CanbPy . You must furnish PERMIT NUMBER and th JOB ADDRESSi.IL FOR EACH RESPECTIVE INSPECTION. ALL 754-5627. '• -FFiina`l Factory fireplace ' APPROVED PLANS SHALL BE ON JOB T rt�(FIM �3H Fjna lu bin9 .V07 %/r OAT ISSV..W.;i.V -gprztia ef�ice-9inal r vim - ova -C)grf / TN 7 40-Ga Tv GROUP PER IT NO. -40.-Gas Service-Flnal V T rP-3 B o6'� 41. Solar Domestic-Final . BUILDING ADDRESS / ��-�� CPC-1,14- /_1 aU 3 Lek Co;154 CPC/ 42. Backflow Preventer TRACT LOT BLOCK ` / -431/5- 43. Backflow Irrigation iNEW ADO ALTER REPAIR MOVING DEMOLISH 44. Landscape Irrigation System 45. Sound Attenuation OWNER // 46. Handicap Regulations 44 Lt. O117/0/•40/- VICr 47. FINAL STRUCTURE&BUILDING USE Vet.'/ p S F!l 48. Special Requirements Completed POOL&SPA SETBACKS APPROVALS Permit# Front Yd. Side Yd. L R_._Rear 49. Pool&Equipment Location Side Yd. L R Rear ,50. Steel Reinforcement - CONSTRUCTION AND PLANNING 51. Forms ' APPROVALS Permit## Date Inspector 52. Electrical Bonding 1. Temporary Electrical Service or Pole 53. Rough Plumbing&Pressure Test 2. Soil Pipe-Undrgrnd. I-34,-V 1...0) 54. APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. 7.yc.ri Jia<IA 55. Electrical Conduit-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 56. Gas Pipe,0 Undrgrnd.,Test 5. Steel Reinforcement 57. Backwash Lines,P-Trap,0 Undrgrnd. 6. Electrical UFER Grnd. /"'AP!, C.f/ 58. APPROVAL TO DECK 7. Footings , la f3Ir'J [i 59. Backwash&Receptor.Final 8. Foundation 60. Heater&Vent-Final 9. Water Pipe-Undrgrnd. k 7 I-AA � 61. Plumbing System-Final 10. Structural Floor System 3„)f V 62. Electrical-Final 11. Property Sewer Line&House Connection 2//) n //fl( 63. Solar System-Final • I 12. Sewer Cap /� 64. Fencing&Access Approval 13. Roof Drains 65. APPROVED FOR PLASTERING 14. Rough Plumbing rim/0/�,e, 66. POOL/SPA SYSTEMS FINAL 15. Rough Electrical-Conduit /r�� FIRE DEPT.REQUIREMENT 16. Rough Electric Wiring My\04(/�V 1 APPROVALS Permit#i I 17. Rough Wiring Sign �`(\� `vQV 67. Underground Hydro 18. Rough Electrical-T Bar Ceiling 68. Product Piping OGas ❑Oil • 19. Rough Heating&Air Conditioning 7J/n/p 69. Underground Flush 20. Rough Factory Fireplace H L C 70. Undergrnd.Storage Tank 0 Gas 0 Oil 21. Ducts,in Structure 71. Overhead Hydro 22. Ducts,Ventilating 72. Dry Chemical 23. Gas Pipe-Rough&Test 73. Dry Standpipe 24. Roof Framing 74. FIXED SYSTEM FINAL 25. Roof Sheathing 4 IS) � 75. FIRE R EV.FINAL I 26. T-Bar Ceiling(Structural)&Monocoat Notes 2/17'!/7 Fat`.Lata- FriC..r' 27. Frame and Flashing e//I?? 6..i./ 28. Lathing&Siding ✓S14`slL•.1 29. Insulation ' 3-let o' 30. Drywall Nailing shilr 6-9' 31. Plaster Brown Coat C'f 641 CiP3 Isee reverse for additional notes/ CMF 0559-46.rat 1202 / Y I 0 - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. — , CITY OF COSTA MESA CONSTRUCTION PERMIT PE MId NO. TRACT NO. LOT. NO. UNIT NO. _ Project Address 2!I r ?nil? c r'orIA Al SQ ar �a�� o� ��A ��7r� 2504 4/04/66 Applicant's Mailing Address .S'4 N/P- �� a..V!= TYPE OF CONSTRUCTION NEW ADD ALTERATION U REPAIR - 9 r ❑ CONVERSION ❑ DEMOLISH ❑ OTHER , Owner's Name ✓ 'i/i"Al ,m�� Phone La I—217.r d FJ j _ VN R r A.P.yW L*?62 — a 3 —0(p Zone it) D CRIPTION OF WOR S. •F B. e 7 Address • i - • i - [00.1\/i (. 6.% !/ - C. - s Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING II FOUNDATION LI' STRUCTURAL T Front aid' O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BB Rear 5g / - N / Contractor's Name OAyN/ ...a-Pei�" . L//L pert hone ❑ OTHER V - - — - 5 C Right ia I GI h/ N Address(mailings PROJECT DESCRIPTION SQ. FT. OCCUPANCqvy„s CON ST RUCTION TYPEArV VALUATION$ O A V $ Left )0f R City License No. ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION Ping. Ref. Parking Req./Provided �(y� 1 _ Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I{� �5��(J S Planning Notes: Y/A I / In /1�A / / m/ M with section 7000) of Division 3 of the Business and Professions Code, and V ��---IYY'�� s��s l�'.1+"�`�- T my license Is in full force and effect. S License class License No. Date Signature PLUMBING FEES A - WORKERS'COMPENSATION DECLARATION • Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of consent to self-insure or a certificate A Workers' Compensation Insurance,,or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) '� Transformer 0 15-50 KW - er Policy No. Company ' Backflow Irrigation Sewer Cap k• Construction Pole Sub. 0 50+KW 8 Certified copy is hereby furnished. - Certified cop Y'is filed with the city Building Division. Bathtubs Sewer Connection _ Cooking Unit Meter Duo to 100 amps Date Applicant ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - Solar CollectorsDishwasher - Meter Cover 100 amps •1 / e.:94•13 (Thissection need not be completed if the permit Is for one hundred ($100)or : s less). Dishwasher Solar Piping ✓ Dryers CNGas Electric Sub Panel - 5—. r ^ I certify that in the performance of the work for which this permit is issued, I — . - J shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1'h-8 Workers' Coa s�1ti n Laws of Calif ni . _ —_ - , — Date J y'�� Signature Floor Drains Swimming Pool w/Spa F.A.U. //� 7Inc.Solar ❑9-15 HP ❑16-15+ 'NOTICE:It,afper making this declar ion, you should become subject to the _ - Workers' Compensation provisions f the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. • CONSTRUCTION LENDING AGENCY / Gas Service Outlets 1 Water Closet 2 Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - of the work for which this'permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 2 Outlets Range t 140, Lender's Name - 9 , Lender's Address Kitchen Sink - ( Water Service 2 (X)J Switches OWNER BUILDER DECLARATION — Sign pli I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories / Auto-Wash • following reason (Section 7031.5 Business and Professional Code:-Any city or / 2 Garbage Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—Trap - - Laundry Trays ' Generator 0.5 KW ❑5-15 KW any structure, prior to its issuance,also requires the applicant for such permit ❑ Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains 'he Contractor's License Law(Chapter 9(commencing with Section 7000) of r ivision' 3 of the Business and Professions Codey or that he/she is exempt ' ierefrom and the basis for the alleged exemption. Any violation of Section - 1031.5 by any applicant for a permit subjects the applicant to a civil ` ;malty of not more than five hundred dollars ($500). 80 I, as owner of the property - - - - - Reinspection Fee $15 Issue Fee $ 3 ,. ran p.ncatinp, will do the Work,and the structure Is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 a0 JA,for sale (Section 7044, Butioness and Professional Code The Contractor's MECHANICAL FEES - D License Law does not apply an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS�/� ' /�� / �� employees. provided that such improvements are not intended or offered forZoning Approved By /�-' ' ate _7 `Y sale. If, however, the building or improvement Is sold within one year of com- - Canopy Type II ❑ pletion, the owner will have.the burden of proving he/she did not build or Im- Duct- Under Ground • /u—� G{ 4 LA/, rove for the purpose of sale). _ Building Approved By y • Date O I,'as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System r• Application Issued By C& Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • - ' 00-100,000 BTU ❑100,000 BTU - Z' ` SUM .A'V OF FEES builds or Improves thereon, and who contracts for such projects with aeon- - - �s • tractor(il license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration I ' BUILDING PERMIT $ .• ... •�r� SMIP $ ♦✓O proof of their worker's Compensation insurance should be provided to me. — _ L^ PLAN CHECK $ J7 PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers • ++ PLUMBING • $ I.• O I ISSUANCE $ Date `(////2/7 Owner (!Q'?t.t'L Heating System&Ducting Registers .1 `,', PLAN CHECK 25% $ • I ENERGY P.C. $ I hereby certify that I have re this application and state that the above 00-100,000 BTU 0100,000 BTL • -ELECTRICAL $ v , 0 GRADING $ information Is correct. I agree t comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection aurosy5• •- 'PLAN CHECK 50% $ MICROFILM $pMECHANICAL $ (I 5". z Signature yG -Li en Date i//t//S!/� TOTAL FEE $ Drivers' Li se or SS t — Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0065-46,rev. 10/84 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POG .SPA ' APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole ��/ �. 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. y44/Fl %0 `^ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. / 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Eledtrical UFER Grid. 57. APPROVAL TO COVER-GUNITE 7. Footings �f,ZfQ , 58. Electrical Conduit-Undrgrnd. L7. 8. Foundation � 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. y/.21/p1 _sir 60. Backwash Lines, P-Trap;O Undrgrnd. 10. Structural-Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final. 14. Rough Plumbing 7-3-o Q La 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71..- Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing I 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing.& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT r 31. Plaster Brown Coat` 79. FINAL INSPECTION 32. Electrical Power Meter:Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric ' 7-1T 0 &?r- Notes: 7443-- Ne COLS M&Tiig IZl1L.l2t7T 34. Final Heating & Air Conditioning 7"/7�/l'6 Ok `2 .-sem Cyt„ 35. Final Gas Pipe-Test 7-,3-8L (..i/� Pito/a �c4 /,007 to ••• 0t� ( 36. Hood or Canopy // �`�'�F� 37. Final Factory Fireplace 38. Final Plumbing 7/ r 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation . ' • • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 7/27/17 Or- 48. Special Requirements Completed • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - _ Date I !.• No. Applicant to fill in all spaces except those within heavy border lines and_sign all appropriate declarations. PERM NO. TRACT NO. LOT NO. UNIT NO. 5485 I 0/2O/B6 CfFY OF COSTA MESA CONSTRUCTION-PERMIT 66' it Project Address 2// E' 26 i-A Si-. .Go.f%i t� /1✓JE,Sq a��3 ON N � ADD . . a• .�4 TYPE OF CONSTRUCTION NEW U ADD LJ ALTERATION ❑ REPAIR r ' Applicant's Mailing Address/ sA AT-5 ' f �JZ7aVGr ss'' Owner's Name �/a HA/ ,UOA/ERPhone%.�l-3f7 01 CONVERSION ❑ DEMOLISH CI OTHER A.P. �� _ '�73'- V � • Zone •/'/� .•�• ,( DESCRIPTI NOF WOF C/US OF BLDG. . . Address oils • 20 74 .571 COS//Q /fir s.•( nJO Cf{l� Cj/�rvts.ya, / S Main Building: Accessory Building:Ej44 KA,i'c Z Arch/Eng, License No. • TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION STRUCTURAL T Front cit, /�_6 �' Q Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear /—de/y N �`�,/ ❑ OTHER — _ Contractor's Name�QyNS�"r nu,r• Phone [1 p - - - C Right �— ry N Address(mailing) PROJECT DESCRIPTION Sq. F7•,�� OCCUPANCY� - K / N G CON ST RUCTION TYPE ✓ VALUATION$ JU — S Left a 5 .�0 R City License No. 'ZONE G RADI NG CU.YDS. ACRES G 0/fR Ping. Ref.# • Parking Req./Provided E LICENSED CONTRACTOR DECLARATION - / !'1 p I I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: s' Cr f-sg 3s•73 pL. 4"/Z43/cc Planning Notes: M ' with section 7000) of Division 3 of the Business and Professions Code, and !p / 6 /��.n .� (lP_,��,,mss,.-,�rgAA'e/]/+,/��/'�o�- ��4.,�er�,q�-I�/s,�__,/nn/ �� my license is in full force and effect. T ! .C. S69- ec s - `{/t_+•/�f/ o//✓n 'eA a trir y ff12 17•t*- $ License Class ' License.No. S�[•J U a Date Signature ' •- . PLUMBING - FEES, WORKERS'COMPENSATION DECLARATION Bar Sink. .- Showers I hereby affirm that I have a certificate of consent to self-insure or a certificateELECTRICAL FEES 7f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) - - Automatic Washer Transformer 0 15-50 KW • Policy No. Company Backflow Irrigation - Sewer Cap - • - Construction Pole Sub. 0 504 KW- . ' 8 Certified copy is hereby furnished. ' Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps! Date Applicant ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - Solar Collectors - Dishwasher ' Meter :lover 100 amps (This section need not be completed if the permit is for one hundred($100) or , less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • - Fan ' - Motors Do-1 HP 01'/x-8 Workers' C pen ti n Laws of Califor a. • Date (/i/enP9j Signature �iI?1.L.1� Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:4f,aft making this declar n,you should become subject to the - Inc.Solar 09-15 HP 016-15+ - Workers' Compensation provisions the Labor Code, you must forthwith Floor Sinks Urinal - Fixtures I comply with such provisions or his permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes • I hereby affirm that there is a construction lending agency for the performance Pole Light 1 of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors Water Heater , Outlets Lender's Name • -- Range, Lender's Address . • Kitchen Sink - Water Service' - Switches - Sign - OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section,7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains - - the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt - - - - ' therefrom and the basis for the alleged exemption. Any violation of Section I 7031.5 by any applicant for a permit subjects the applicant to a civil • ' p ity of nat,more than five hundred dollars($500). ^Q 3 Ld' Reinspection Fee $ I, as owner of the property the structures_ tr.offeole Pe $15 Issue Fee dor sail (Sect will do the work,and the structure is not The red Reinspection Fee I $15 Issue Fee • $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's �� License Law does not apply to an owner of a property who builds or Improves MECHANICAL FEES thereon, and who does such work himself/herself or through his or her own r DEVELOPMENT SERVICES REQUIREMENT employees, ever, the-building d that such improvements are not intended Or ear tl for •• C � (g'a� .� sd I¢. If, the own ve or improvement is gsold within one year of im- 0 Zoning Approved BY '� Date o ' plq}�fon, the owner will'have the burden of proving he/she did not build or im- Duct-Under Ground guild ing Approved By / Date /pp/// ti Ob for the r of purpose o • `Tp 7 �jRG tractors 1,as owner of the property, Se exclusively contracting with con- Duct-Structural Refrigeration •I Application Issued By �� - Date /!,1 f tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating00-100,000 Ito ( 11 111 : builds or improves thereon, and who contracts for such projects with aeon- • SUMMARV`OF FEES . e'/�/ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple I: System •• BUILDING PERMIT $ 62'34) SMIP $ f V`� proof of their Worker's Compensation insurance should be provided to me. L, PLAN CHECK $ 3,4'9 PERMIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# , Fire Dampers PLUMBING $ ISSUANCE $ Date //p/2a/�'( - Owne ..@�1�(Q1 Heating System 8.: Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby ertify that I have rea is application and state that the above ❑o-100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree t omply with all-city and county ordinances - ELECTRICAL $ and state laws relating ti.o building construction, and hereby authorize repre- sentatives PLAN CHECK 50% $ MICROFILM $ inspection of this city to enter upon the above-mentioned property for - inspection pu o ' Signature - i tip c- Date_/D 16/22 _ MECHANICAL $ TOTAL FEE $ Drivers' l'� nse or SS# - - - • / Reinspection Fee $15 Issue Fee -$ 3 PLAN CHECK 25% $ - ,/-�/y// CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor (•Q. ..6 /, 9// J D CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical•Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. //8 0� 57. APPROVAL TO COVER-GUNITE 7. Footings - 4 s r7// of,Da 58. Electrical Conduit-Undrgrnd. . FtC 8. Foundation I (� 59. Gas Pipe, ❑.Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System £'taa, SJs/87 DM- 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test • 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas. 0 Oil 25. Roof Sheathing Of/ ,p4- 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat / ( 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 55Jsi/87 Occry cA)tC-g'f ¢4 34. Final Heating & Air Conditioning V 35. Final Gas Pipe-Test 36. Hood or Canopy '� 37. Final Factory Fireplace 38. Final Plumbing i. 39. Water Service-Final - - 40. Gas Service-Final • 41. Solar Domestic-Final 42. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 7 Ate78s • • 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate beclarations. 312•-' . 19/19/77 CITY OF COSTA MESA Cn ONSTR CTI ON qPERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO, Project Address 3Z4 C- l ite).0\ . Applicant's Mailing Address i." dr,20L11 //114 "I' • /0.6. • TYPE OF CONSTRUCTION , Ell NEW Li ADD LI ALTERATION LI REPAIR f Owner's Name g✓/7 &,kC drjPhone&VSy/3 7O CONVERSION CI DEMOLISH ❑ OTHER A•P•# Zone • p� "DESCRIPTION OF WORK/USE OF BLDG. Address 89/ Ov� / C • �.8• S Main Building: Accessory Building: ' Arch/Eng. /License No. -TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front o AddressoQ '' // // Ell TENANT ❑ ELECTRICAL 01 PLUMBING CI MECHANICAL B Rear N Contractor's Name T A/AM 2NdaYfPhonel/C•97/3 ' , ❑ OTHER Address(mailing) SQA Ri ht • - N ;PROJECT DESCRIPTION SQ. FT. OCCUPANCY g G 4ur%io�l " , A1.8' K �/� I CONSTRUCTION TYPE VALUATION S Left • R City License No. 2� +� -ZONE' GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req,/Provided E • I hereby affirm that I am licensed under provisions of Charter 9(commencingRemarks 8 27 ' 0// Planning Notes: -~ 0 with section 7000) of Division 3 of the Business and Professions Code, and - 43' my license is in full for and effect. _ • _- -- - - T License Classy ,, -cans' a 1 S Date 4 /T eS-.7 Signature � F ` • ' i 'PLUMBING - FEES - WORKERS'COM ENSATION DECL • • I 1irkzi 'iereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink • Showers ELECTRICAL FEES Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink . _400, Lab.* 374.4 23 G�2 ,� Automatic Washer' Transformer 0 15-50 KW f( Policy No. Company Backflow Irrigation ' • Sewer Cap Construction Pole Sub. 0 50+ KW. `•', _, Certified copy is hereby furnished. • V Certif' cop 15111 with the city Buildi iv Ion. _ • Bathtubs -, - • Sewer Connection , - _ Cooking Unit Meter ❑up to 100 amps I Date �'(7-� Applicant - — - is EXEMPTION FROM WORKERS'COM CLARATION Clarifiers Solar Collectors Dishwasher . - • . Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I • ' shall not employ any person in any manner so as to become subject to the i Drinking Fountains Solar TankFan Motors❑0-1 HP ❑1%-$ Workers' Compensation Laws of California. Z_ - Date Signature Floor Drains Swimming Pool w/Spa F.A.U. - NOTICE: If,after making this declaration, you should become subject to the _ _ Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performanceg of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Name ut ets Range • Lender's Address - - - Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code; Any city or Garbage Disposal • Standing Sections county which requires a permit to construct,alter,improve,demolish or repair Pr Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of - `Ivision 3 of the Business and Professions'Code) or that he/she is exempt ' - I erefrom and the basis for the alleged exemption. Any violation of Section •131.5 by any applicant for a permit subjects the applicant to a civil eenalty of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee $ 3 • compensation, will do the work, and the structure is not intended or offered • - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner Of a property who builds or improves _ I thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler 4 Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved ByDate / pletion, tion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By _ Date rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 7/11 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTUSUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License Law). I am aware that yxhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP '$ proof of their Worker's Compensation insurance should be provided to me. `!^J.K`` �'.II' .�A.I.'��yPLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Mt. ICBG 'Y"F00 Fire Dampers I - ISSUANCE $ HeatingSystemPLUMBING $ Date Owner & Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. ,$ I hereby certify th. -.ve read Kis application and state that the above 0o-100,000 BTU Di 00,000 BTL - - GRADING $ information i - •ct. I a•.ree •' amply with all city and county ordinances ELECTRICAL $ and state .• s dating q constru>'•n, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives .f i is ci e• er upon t• above-mentioned property for inspection •o ' / o �j' B2 MECHANICAL $i ••,erste - lar Signature .LJ/./A.L// Dace(1 // Y/. TOTAL FEE . $. •"'�--E++a—. Drivers' L' en dor ' ' fil�r/ - Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $a, ��ct) CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE-. 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9 Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68: APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL i 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush - ' , 24. Roof Framing 73. Undergrnd.Storage Tank D Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL ;. 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31, Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: '/271, re Leg 1 . A - 4/ _ . C4' L r • 34. Final Heating & Air Conditioning HI'S I LEQ ' - ,a 35. Final Gas Pipe-Test / f- • 36._Hood or Canopy RC i 37PFinal Factory Fireplace ' -j' "- 38. Final Plumbing \, ` • 39`.'Water Service-Final - 1 ' ' . 40. Gas Service-Final 41. Solar Domestic-Final 'f 42. Backf low Preventer , ' i 43. Backflow Irrigation + ,i ; 44. Landscape Irrigation System - 45. Sound Attenuation L." , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - "+ 48. Special Requirements Completed , 49. Electric Release to Edison -- C:- - 50. Gas Release to Southern California Gas Co i L. 51. CERTIFICATE OF OCCUPANCY • No. Date • • 891 Production Place Newport Beach, CA 92663 Newport Harbor Builders, Inc. Mr. Geo. Eudmonson City of Costa Mesa P.O. BOX 1200 Costa Mesa, CA. 92626 RE: LA COSTA COURT We respectfully request a temporary occupancy on the above address. We are unable to complete the requirement at this time for the glass fireplace doors. They are being custom made to fit our rched openings and are due approximately six weeks from now. B.Zc . 87 Thank you for your consideration. Sincerely, Age i Liam F. Willoughby Newport Harbor Builders Building Permit #B27065 Factory Fireplace MIM-29872 Bldg. Address 203 La Costa Court y4. -m/%q Construction Management • General Contracting • Development • License#412984 • (714)645-4913