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Home My WebLink About1795 TANAGER DR - Building Permits 7� -� CITY OF COSTA MESA pC BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PE MIT NUMBER PERMIT B06-01887 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.gBIALDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1795 TANAGER DR Status: ISSUED Suite: Applied: 11/09/2006 Vicinity: KITCHEN AND BATHROOM(2ND STORY) • Issued: 11/20/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 13963117 Zoning: R1 Applicant: THETFORD, DEWAYNE Address: 2450 MARINO DR Phone: 714-715-8043 ISSUE Y: NEWPORT BEACH,CA Zip: 92663 Owner MILLER, CHARLES R Address 1795 TANAGER DR Phone: COSTA MESA,CA Zip: 92626;, Contractor: COASTAL BUILDING CONTRACTORS I Address: 2450 MARINO DR i>s Phone: 949-646-0400 NEWPORT BEACH,CA Zip: 92663 License: 773298 Arch : - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT INTERIOR REMODEL OF EXISTING KITCHEN AND 2ND FLOOR BATHROOM.WORK INCLUDES:REPLACE FIXTURES AND WINDOWS IN KITCHEN/BATHROOM,NEW LIGHTING,AND RELOCATE KITCHEN HOOD. FEE SUMMARY ' Plan Check: $163.31 Calc Valuation: 515,000.00 Permit: $251.25 Claim Valuation: 515,000.00 SMIP Res: $1.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $416.06 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 • • 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 wit e pit bl�d all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result i e expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) - ' DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of 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. r ❑�.l have 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. My,work:-:'compensation Insurance carder and policy number are: rtier FPicyNu '1,,� section need not be completed if the permit is valued at one hundred dollars($100)or less.) / ` I certify that in the performance of the work for which this permittied,I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California .ould r subject to the workers'compensation provisions of Section 3700 of th bor e,I shall forthwith comply with these provisions _me Applicant Signature:-• '� {Date' (/ 2-f dl WARNINO:FAILURE.TO SECURE W- -4 COMPENSATION••:r E IS U • Ft1L AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTI S AND L FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE•••- •.• PENSA '• ,• GES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. L LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed und �' • s of Chapter 9( •- mencing with Section 7000)of Division 3 of the Busine .nd Professions C.•e,and my license is in full force.and.effecl-Lio:A� L t £ Class'n Contractor's Signature:� Date: I1ner 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 Cade: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.). ❑ 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 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 8,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: I Mt 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 0 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 builtling occupant need to file a registration form for acutely hazardous materials? 0 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 and 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? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes [J No (Section 65850.2 of the California Government 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? ❑Yes 0 No (if yes",the facility must meet the requirement of Sections 25534 end 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 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 end 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. fair. °- ne4s4 '/Ar. Date ' • A _,/ul `nr..•'•.•plioent-- ---- Date-` CODE T. PATE R LS CODE! INSPECTION TYPE gdIE emnAU 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 Wail 212 Final Fire Prevention 202 Final Factory Fire Place , • 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy *444101a ' ,.� CITY OF COSTA MESA BUILDING DIVISION F no pm. . DEVELOPMENT SERVICES DEPARTMENT /PERMIT NUMBER PERMIT V M06-00704 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1795 TANAGER DR Status: ISSUED Suite No Applied: 11/09/2006 Issued: 11/20/2006 Vicinity: SECOND FLOOR Parcel Number: 13963117 s/+ ISSUED awn Applicant THETFORD, DEWAYNE Address: 2450 MARNIO DR Phone: 714-715-8043 NEWPORT BEACH,CA Zip: 92663 Owner: MILLER, CHARLES R Address: 1795 TANAGER DR Fe' ;,;, Phone:, 2 COSTA MESA,CA Zip: ; 2' Contractor: COASTAL BUILDING CONTRACTORS Address: 2450 MARINO DR Phone: 949-646-0400 NEWPORT BEACH,CA Zip: 92663 License:773298 SCOPE OF PERMIT MECHANICAL PERMIT FOR INTERIOR REMODEL OF EXISTING KITCHEN AND 2ND FLOOR BATHROOM.WORK INCLUDES:REPLACE FIXTURES AND WINDOWS IN KITCHEN/BATHROOM,NEW LIGHTING,AND RELOCATE KITCHEN HOOD. REF#B06-01887 WORK TO INCLUDE: 1 HOOD W/MECH EXHAUST. FEE SUMMARY • Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorption Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $10.65 1 15 To 30hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp - , $0.00 0 Air Handlers< 10000dm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee - $0.00 Reinspection Fee- $0.00 - - TOTAL CALCULATED FEES $34.15 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 co re ll applicable codes, and all required Inspections end 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 2448-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of 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. - ❑ I have 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 laic-cried. My workers'compensation Insurance comer and policy number are: Cartier: Policy Number: (This, section need not be completed if the permit is valued at one hundred dollars($100)or less.) /kp I certify that in the performance•Lihework.for, hick this pe ued,I shall not employ any person In any manner so as to become bject the workers' compensation laws of C: • n a,anape' should'' • •: subject to the workers'compensation provisions of Section 3700 o e La r Code,I shall forthwith comply with these pro Ions. Applicant Signature: i Date: ,/,2 Z/ r). WARNING:FAILURETO( SECU0). •ODIT1O COMPENSATIONT • •s ERENS TION.;D GL AND SPRNIDED FOR I AN SECTION EMPLOYER TO THECRIMINALLABOR PENALTIES ANDFINES rUPO NEYS HUNDRED THOUSAND COLLATE(5100,000),IN ADDITION TO THE COST• COMPENSATION,D AGES AS PROVIDED FOR IN SECTION 3]08 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licens:• I nearer previsi• •1 Char + commencing with Section 7000)of Division 3 of the Business and Professions C..e,and my license Is in full force and effect.Lic.a I -. Class# Contractor's Signature: /t_ Date: aPv 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). Lenders Name: Lenders 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 then five hundred dollars($500).): O 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 appty 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,I.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: O 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 B,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 0 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 al 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? 0 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 and pressure). 3 Does or will the applicant or present or future building occupant need to prepare en RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑Ne (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 Flre apartment 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 ❑No 5 Does or will the applicant Or present or future building occupant require for the work which is the subject of this application agermil for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? DI Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 0 No (If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _...__.._ ___... ._ agency _. 7 a a patron from mtl South Coast res Desy eby CaliforniaDistrictHor other airpollution 4l district3 is required Yfor the work which is the subject of this application,have all of the disclosures prescribed by CelloHealth and Safety Code Section 42303 been made? ❑Yes 0 No _._......_....__..f_ _ .._ _._....___.._......._..._._ 8 (If yes•,enrich 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 end 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. Signatur; •J$ • ner(s�_ Da i1. /i 2/ nry 411.1111111."—And/Or uY•riz•• •piker? ate CODE r IWSPECTION TYPE (/ PAIl gllmdLS SiDDE.! INSPECTION TYPE g1�¢..✓f 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical G' 4 .a f 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof _ 210 Final Electrical 201 Final Block/Retaining Wall _ 212 Final Flre Prevention 202 Final Factory Fire Place -220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ' v; CITY OF COSTA MESA 442-a BUILDING DIVISION >:� ,i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER t.' AS 11 �; PERMIT Vis; '/P06-00911 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ftslMBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1795 TANAGER DR Status: ISSUED Suite No Applied: 11/09/2006 Issued: 11/20/2006 Vicinity: SECOND FLOOR Parcel Nunmber: 13963117 Applicant THETFORD, DEWAYNE Address: 2450 MARINO DR ISSUED BY: Phone: 714-715-8043 NEWPORT BEACH,CA Zip: 92663 Owner: MILLER, CHARLES R Address /1795 TANAGER DR , _ . , COSTA MESA,CA - Zip: 92626 'Ir. royvdy, Ji �,$,,ee, y�r'" Contractor COASTAL BUILDING CONTRACTORSwA. Address: 2450 MARINO DR - Phone: - 949-646-0400 NEWPORT BEACH,CA Zip: 92663 License: 773298 . ' SCOPE OF PERMIT PLUMBING PERMIT FOR INTERIOR REMODEL OF EXISTING KITCHEN AND 2ND FLOOR BATHROOM. WORK INCLUDES:REPLACE FIXTURES AND WINDOWS IN KITCHEN/BATHROOM,NEW LIGHTING,AND RELOCATE KITCHEN HOOD. REF#:B06-01887 • - WORK TO INCLUDE:'1'BATHTUB, 1 DISHWASHER;1 GAS(1-4 OUTLETS),1 KITCHEN SINK AND 1 WASH BASIN. - FEE SUMMARY AMT QTY•: AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub • $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System , $0.00 0 Process Piping(pe00 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors_,- -• " , $0.00 0 Vacuum Brkr Bkflow(5.) $0.00 0 Dental Units - $0.00 0 Septic Tank $0:00 0 Wash Basin $9.80 1 Dishwasher $9.80 1 - Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor $0.00 0 i ' Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 . . 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0 Drain,Roof $0.00 0 Shower - $0.00 0 Water Heater/vent $0.00 0 _ Drinking Fountain . , $0.00 , 0 . . Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank , . $0.00 . - 0 •.. Sink,commercial $0.00 0 _ Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 , 0 Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 ' Sink,kitchen- $9.80 1 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 - 0 Sink,service/mop • $0.00 0 OTHER $0.00 Gas Repipe I$0.00 0 ' Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 . 0 - Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 .-0 - , REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0- c . . TOTAL CALCULATED FEES: $68.85 •ITC /COC/'IAI r e-munITI(IIJC 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 suspendedr abandoned fora 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 -" 244646(6/00) . DECLARATIONS • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: o 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. o I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cede,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) Ir.? I certify that in the performance of the vgo ILc for which this permit is issued,I shall not employ any person in any manner so as to beco subj ct to the workers' compensation laws of Calif•' -,and agree_ if I shout. :-.•me subject to the workers'compensation provisions of Section 370 f the bor Code,I shall forthwith comply with these provisi••s. Applicant Signature: 4111 Date: // 2y ('7 WARNING:FAILURE TO SECURE WORKERS'COMPENSATIt'� •eVE••� IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINALANALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE.S- OF COMPEN nk ON,DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed •:r provlsio`nsuf_Chapter/9(cam• Vr ening with Section 7000)of Division 3 of the Business L,Pr•fessio's Code,and my license Is in full force and effect.Lic.# 7 32 "VA - __ Class It Contractors Signature: =��'\ Date: 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 end 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.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 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,Gm 2,Art 2,Sec. 341,Title 8,California Administrative Code). O 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 0 No (Section 25505 of the Califomia 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? 0 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 and 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? 0 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 aEermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? u Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 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 prescnbed by California Health and Safety Code Section 42303 been made? 0 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. Signature Of ga=s _ Date And/Or Autho'. lice ate YODEL INSPECTION TYPE PATE jMRIALS CODE INSPECTION TYPE PATE 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 6--/•09 ( ' 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/Occupancy • • PROJ'+CT AODRESS: 1795 TANAGER DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 068697 OWNH1'J NAME: MILLER, CHARLES R e ADDRESS: MILLER LESLIE V PERMIT NO: B 068697 PLAN CHECK NO: 03146-94 A GOVT: N SUPP ; N 1795 TANAGER DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ADD 714 ) 549-2200 AflCH/ENGINEER: REG.NO.: ADDRESS: MILAGRA DESIGN ( 009A0 JOB DESCRIPTION ; ADD 1ST 6 2ND FLOOR BEDRM 6 BATHROOM SQ FT; 798 2900 BRISTOL ST A202 C .M CA 92627 CLAIM VALUE: 30, 000 . 00 CALC—VALUE: 59, 052 . 00 GROUP OCC: R-3 / PERMITTEE: NEW WEST BUILDERS ( 714 ) 640-8218 ADDRESS: 2796 HARBOR BLVD • COMMENTS : ADD 2 BEDROOMS & 2ND STRORY BATHROOM C.M. CA 92626 ******itis***trx****+C***sE*ar**** +E****** **********aE+Ed6xaE*iE******i ****+6*+E**er*******kr LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under prgvisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 at the Business and Professions Co and my license is in lull three and effect. SETBACKS ("482 STATE LIC.: 46 41 Cuss: B 71 EXP; 04 /94 _ 7a K Signawr • I MAIN BUILDING ACCESSORY BUILDING i41.111(ERcCtIMPENSATION DECLARATION: I here y a firm thall have acenificate al ionsent to sell-insure or a certificate of Workers' FRNT: 21 FT IN REAR; 26 FT 4 IN FRNT: FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab,C). LEFT; 5 FT IN RGHT: 5 FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV; PARCEL: 13963117 ZNE: R1 REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> ONE AND TWO—STORY ADDITION TO EXITING RESIDENTIAL PROPERTY, > Dale: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($tip)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the perforpipance of the work for which this palit is issued.I shall not employ any person in any manner so as to become n p tto a rorkers'Gampensauon Laws of California.( ZONING APPROVED BY .• G J " �o he /�. C�'— DATE: SPY �e. , `r �o ��'h� Signal `, NDTICE: I.alter making this declaration,you h,,,.W U� me subject to me workers'Compensation provisions of,be Labor BUILDING APPROVED BY p55 DATE; •cP— Z — l Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction Ientling agency for the performance of the work for APPLICATION ISS UED 'BY: DATE; .3a . 1`f which this permit is issued)Section 3097„Civ.CI ******************aF******.*********** ****************.*.*.*.******** ********it LENDER: • ******************************************************************************* ADDRESS: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby Mirth that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 459 , 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed5 . 91 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7001)of Division 3 of the Business r SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 74 . 67 any applicant for a permit subjects the applicant to a civil penalty of not mare than five hundred dollars($500). ISSUE FEE —i I. as owner o1 the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ 1 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 4 6 5 , 41 0 , 0 0 7 4 , 6 7 5 tip Q$, 540 , 08 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through • • P Vf t his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or N d improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 540 , 08 O / 0 0 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP+2;[' tG$�p � 'P�fi—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 459 , 50 t' r$b�� ((,,JJ((f''L 74 . 67 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner at properly who builds or improves thereon and who contracts for such projects with a cantractar(s)license pursuant to the Contractors'State License Law). I am aware *********************************.*%,*,*,*********.*,**********,*,*,**,********,•* ***** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E .E BREAKDOWN o I am exempt under Sectinn: B.8 P.C. lor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: Owner: SFR 798 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 59, 052 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and •END• OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. • , Dale: Applicant: _. I hereby certity that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction hereby authorize representatives of this city to enter upon the above mentioned )Warty I inspecti,n purposes.eC> l 01 00155959-00146971 TOT 540.0`& y� —X 0 c(Y CC Sign • /' DATE: OS/31/94 TINE: 16:46 altgLe P�.�-� Driver's License or Social Security Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING PO. -v 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'Condult•Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55, Electrical Bonding 5. Steel Reinforcement oke- l y&465 56. Rough Plumbing & Pressure Test 6- Electrical UF ER Grnd. at,/„qct 6,6„ 57. APPROVAL TO COVER-GUNITE 7. Fobtings 9.-/_.(y ea.... 58. Electrical Conduit-Undrgrnd. 8. Foundation 54aP �p g�i_gq ewes,- 59. Gas Pipe, 0 Undrgrnd-, Test 9. Water Pipe-Undrgrnd.ndPPPP t 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 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Undergrdund.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 14d-14/ &C✓/' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat �wr 75. Dry Chemical 27. Frame and Flashing Je_tt_ 76. Dry Standpipe 28. Lathing & Siding - .• 77. FIXED SYSTEM FINAL lain" 29. Insulation Trig 4. to /" 78. FIRE PREV. FINAL 30. Drywall Nailing !� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final , 80. FOOD CERTIFICATE ISSUED . 33. Final Electric Notes: 87-3L-�p/LY' 7 s 34. Final-Heating & Air Conditioning - • / -#- 35. Final Gas Pipe-Test wv • 36. Hood or Canopy 6- 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41, Solar Domestic-Final c. 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation - L• 46. handicap Regulations 47. FINAL STRUCTURE & BUILDING /...25-.9 5-, 4(,4.W 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date NEWPORT-MESA UNIFIED SCHOOL DISTRICT 13 2 4 CERTIFICATE OF COMPLIANCE OF DEVELOP, 4T FEES %_ PURSUANT TO AB 1600 AND AB 181 t TO: / ( ) City of Costa Mesa District Receipt No. �� r ( ) City of Newport Beach Cj C�p �Z / ` ( )) County of Orange Plan Check No. Applicant: 1��r 6 / cnj g 9 r .15 u( v0 (Pt S —t Address: -AVL 2-7 c C 1114 oVt r (a 5714 Wll:57 p , rA 9' zG t(, Telephone Number SS-) '2-Li ttY Tract/Parcel and Lot Number(s): Location of Project: V?"1 5 illton Elr / Co S 7I 44,564 l c 1- , Number of Square Feet of sIP Residential Space 17 S-7x $ 1.72 Total Residential/ Sr. Citizen Space x $ .28 Total Commercial and Industrial Space x $ .28 Total Warehouse Space x $ .2235 Total Commercial/Industrial Project is: (Check One) Warehouses Motel Preschool R & D Bank Auto Repair Movie Theater Neighborhood Shops Hospital Mini-storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. Regional ShopsMedical Office Restaurant . Light Industrial Office Park Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid schooacility fees in compliance with Government Code Sections 53080 and 65995. The Building Permits for this s., eta•e in this proposed development may now be issued by your jurisdiction. W Checks are to be made payable to Newport-Mesa Unified School 1/riot / By: Morized Rap native M The above representation as to square footage is true. Applicant agrees at if it is later determined that such representations are not true then this certificate shall automatically terminate :nd the appropriate City/County shall be notified. . / Date: D75,0 b €14y � --k0 Mpil_.„ I n"- kl tontitcf PROJECT ADDRESS: 1795 TANAGER DR UNIT. CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 068696 OWNER'S NAME: MILLER, CHARLES R ADDRESS: MILLER, LESLIE V PERMIT NO: B 068696 PLAN CHECK NO: 03147-94 A GOVT: N SUPP : N 1795 TANAGER DR COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: CON ARCH/ENGINEER: MILAGRA DESIGN REG.NO.: 008900 JOB DESCRIPTION CONST. 94LF RET, BLOCK WALL SQ FT; 84 ADDRESS: 2900 BRISTOL ST A202 C.M. CA 92627 CLAIM VALUE; 3, 000 .00 CALC—VALUE: 5, 040 .00 GROUP OCC ; R-3 / PERMITTEE: NEW WEST BUILDERS ( 714 ) 640-8218 ADDRESS: 2796 HARBOR BLVD COMMENTS : 84LF RETAINING WALL C .M. CA 92626 ******iF+r******FF****F6*+r+ex**FFFr*"F****d6frFF+Ei6+F*x****+r********+t*x**********kE***iEir*+t*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU I R EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. S E T B A C K S YLIC.: 482` 3 STTELItat.: 469cuss: B-1 E. • ; 04 /94 D e: I Signatures _a— MAIN BUILDING ACCESSORY BUILDING ERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT : FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV; PARCEL; 13963117 ZNE; R1 REF NO:. Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> CONSTRUCT 6 ' HIGH CONCERETE BLOCK WALL AT REAR PROPERTY LINE > Date' Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N T S I certify that in the performance of the work for which t ' permit is issued.1 shall not employ any person in any manner so as to become n m�othe .rke�s'Compensation Laws of Calif iia. ZONING APPROVED BY ,Lf�g� DATE; ` Q4 a. / _'OTICE:II.after making this declaration.y d become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY A S� DATE: r '� 6/ /4 Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ' 71 DATE: i. "� cet which this permit is issued(Section 3097,Civ.CI' *****************************************.y� .*y * ******************** .. **� LENDER: ********************************************************************* ********* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT 81 , 0 0 . 50 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 13 . 16 -L'—'\ any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE ./~ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 8 1 . 5 0 0 , 0 0 13 . 16 94 . 66 94 , 66 . 00 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 employees. provided that such improvements are not intended or offered for sale.If, however the building or improvement is sold within one year 01 completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: — 94 . 66 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 , 50 13 . 16 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *.****.*,**.*,.K,*. *.*,****,*,**,****,***.***,************************************************ that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.&P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date. Owner: SFR 84 RES—RETAIN WALLS UP TO 6 FT / FT. 60 , 00 5, 040 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit far construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. ' Date' Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ' ordinances and state laws relating to building construction hereby authorize representatives of this city to enter upon the above'mentioned • 01 OOIbb4bb-OO16b968 -11-674-61— ordinances OT 94.66 property for pinypechon rposes. / ( DATE: 66966-00 6968 15:46 dil F/70 170 �ay Signal H/ Driver's License or Social Security Applicant:Pink—Revenue:Goldenrod—Assessor ' CONSTRUCTION AND PLANNING PO. J SPA • - ' APPROVALS Permit# Date -Inspector APPROVALS Permit 4 Date . Inspector I 1. TemporaryElectrical 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 7=(4( .t1 Gc.61 56. Rough Plumbing & Pressure Test 6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE :7.' Footings 4344-q2( &r 58. Electrical Conduct-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. r 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 Wiling Sign 68. APPROVED FOR PLASTERING i 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i 20. Rough Factory Fireplace , APPROVALS Permit 21. Ducts,in Structure 70. Urderyround Hydro 22. Ducts, Ventilating - ' 71. Product Piping 0 Gas E Od 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oi. 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 - i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric. Notes: f--27-IV- 6A- ',4' 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Testl�-5 _t e • ,,0 2.;:i, g aC da- 36. Hood,or Canopy . 1--a-?‹1--a-?‹ . LG _ tee:4r 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 (Z5"tc7S 4641 48. FINAL PLANNING - a. 49. Electric Release to Edison 'J. 50- Gas Release to Southern California Gas Co ' - 51. CERTIFICATE OF OCCUPANCY - No. _ Date - i , 4. PROJECT ADDRESS: 1795 TANAGER DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 068698 OWNER'S NAME: MILLER, CHARLES R ADDRESS: MILLER LESLIE V PERMIT NO: E 068698 PLAN CHECK NO: N GOVT: N SUPP : N 1795 TANAGER DR COSTA MESA CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE; ADD ARCHIENGINEER: 714 ) 549-2200 NO . flEG .: MILAGRA DESIGN 009,90 JOB DESCRIPTION : ADD 1ST & 2ND FLOOR BEDRM & BATHROOM SQ FT: ADDRESS: 2900 BRISTOL ST A202 PERMITTEE: C,M CA 92627 CLAIM VALUE; CALC—VALUE: GROUP OCC : R-3 / PERMI : ADDRESS: NEW WEST BUILDERS ( 714 ) 640-8218 2796 HARBOR BLVD COMMENTS: REF: B-68697 C .M. CA 92626 *srsr*SF+t****** +6x•+r+eE6yr*+r+ ****yr**x********x•x**** *yr****+E+t*sE**** *************ye***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CI LIG.: Q._48 2 3 STATE LIC.: 4694 ss: B 1 EXP• n e 7 a a r.Og( ) GCC Sign= `%L�— MAIN BUILDING ACCESSORY BUILDING ' RKERs'COMPE ATIONDECLARATION: Thereby affirmthatIhaveacertilicateofconsenttoself-insureoracertificateofWorkers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL; 13963117 ZNE; REF NO; Certified copy is hereby furnished. ❑ Certified copy is filed with the city Budding Division. PLANNING NOT ES> > Date: Ap0licant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this p is issued.I shall not employ any person in any manner so as to become subject toto�ym 'a the Qorkers' coDATE pensation Laws of California. ZONING APPROVED BY __ _ : _A / Signator �-t./ NOTICE:It.alter king tht eclaration.you shoo become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : _ DATE Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �/ `\ /// A(�.E NSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: { DATE: ( 1 `V/ l which this permit is issued(Section 3097.Civ.C). ************************************ * *** ************************ie fF to it It*),/. FJJEE** LENDER: ***********************************************************************. ******* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the blowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 5075 , repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0 2 SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 15 . 00 I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 50 . 75 15 , 00 0 . 00 65 , 75 65 . 75 , 00 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: --- 65 . 75 OVER/SHORT; . 00 lor the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 65 . 75 ❑ and Professions Cork: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and whn contracts for such projects with a contractors)license pursuant to theContractors'State License Law).l am aware **,*.***.**,*.*.**,*,****,***.*.*,*********,*.**,*,***,*,*.****,**,*,*,N,**************************,)f**,* that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.8 P.C. Z N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 10 FIXTURESLIGHTING 1 ST 20 EA, . 75 7 , 50 25534 and that I or any future building occupantwiNwitl not(circle one)need t0 conicity with said state codes and the requirements for a ELE 20 RECEPT/O�)TLET 1 ST 20 EA, , 75 15 , 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ELE 10 RECEPT/OUTLET ADDITIONAL EA, . 45 4 , 50 these provisions. ELE 7 RECEPT/SWITCH 1 ST 20 EA. . 75 5 , 25 ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 , 50 Date: Applicant: END OF FEES I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws re:ring to building construc' nand hereby authorize repr sentatives of this city to enter upon the above-mentioned property for ins.'ction put mses. 01 00166972-00166971 TOT 65.75 ti . _ �l Signator ' DATE: 08/31/94 TTtIE: 16:47 I •iver's License or Social Security I; • 1641-46 While—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor '11. CONSTRUCTION AND PLANNING PG S 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, C 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 • / g/j a 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 -?j= 21. Ducts, in Strudture 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping CGas 0011 • 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 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-Finalj�// 80. FOOD CERTIFICATE ISSUED 33. Final Electric /Cl Notes: 34. Final Heating& Air Conditioning / • �t 35. Final Gas Pipe-Test 36. Hood or Canopy '. Y 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final I 41. Solar Domestic-Final 42. Backf low Preventer 43. Backf low Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY _ No. Date gi Qowt h\RS NoO\Tr) ONE r'45M - Z WZ rz_A 2 'Z 1 1 ` ARii L___ 1 '., iivokce- , sis 9 4, ,I,„_______ .-7-_-, 1\ ,_ 42 • '- ‘- LkGHT c;p.cv Cr - Au_. NE-us Oowt 15'�i i-S d r`' " 3- Pk-\-)G c1tR-.(_i\- - 'i' NEW ov--rUI 4) 3 - a- CA cE oco$- c.iRcuvis Z n u 9 s P\1 QE Pi\ 1Tj I Q IN I 2 • '446- _cc I 2 FioUdZ LicNTCi12cvLLD*u-N_ ss 2- PLUG cite, i-{�L�NEtt) smecuaw- '7" 3—F.A.v. ?,0 Qs RsAr t i S IC\5 LL_ i £..1 YQCG N Ni! C7-20 -5'o 1. - _aco _NG te I_ $3 / I^ \s r'11�G PRDJECTADDRESS: 1795 TANAGER DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05106 / _QWNER'SNAME: KING, BERNARD P ADDRESS: KING, BARBARA L PERMIT NO: P 051067 PLAN CHECK NO: N GOVT: N S(JPP: N 1795 TANAGER DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH 662-1431 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : CHANGE OUT DISHWASHER SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: NOCK PLUMBING ( 714 ) 895-1246 nuns: 11610 SEABOARD CIR COMMENTS: CHANGE OUT OF DISHWASHER STANTON CA 90680 *************:E*****:E**sE*SE************+ESE*************:E****************:E:E******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC' 0 0 B STATE LIC.:511971 a 36 �. ZZ MAIN BUILDING . ACCESSORY BUILDING le: Signature: j FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN dORXERS'COMPENSATION DECLARATION: I hereby affirm lh I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN CompensationsWa Q�6c�{t}d�ye6copy thereof(Section 3 00.Lab. POLICY NO.: 1,1.0 1 L 7 U EXP. DATE: v 3/01/91 COMPANY: STATE PARKING REQ1 PROV: PARCEL: 13963117 ZNE: REF NO: .❑ certified copy is hereby furnished. Certified copy is filed w`h the cit riding Division, PLANNING N TES> /j (/t(j 1 j > Date: (/IZC1 I—E Applicant: ******************************************************************************* / EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if permit is for one hundred($100)or less). DEVELOPMENT SERVICES' REQUIREMENTS 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 Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: ouSignature: BUILDING APPROVED BY : DATE: NOTICE:II,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Civ.C) *************************** ****Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.W //. / �-1° /'� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: /iF([�'/ c DATE. �'9lFJ which this permit is issued(Section ** * ************************************ * * LENDER: ************************************ **************************************** ADDRESS: LEGALIZATION:N F• E E SUMMAR Y STRUCTURAL SEGMENT:N • OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 703t.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2!,00 L repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 25t SMIP/NON—RES •irsuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN I Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3,00 • I , I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING PERMIT 13.00 PLAN—CHECK TOTAL 5P,00 . 00 ID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State 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 employees, provided that such improvements are not intended or offered for sale. It,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 5. 00 OVER/SHORT: 00 improvementd of sold lt.within one year of completion,the owner will have the burden of proving he/she did not build or improve ithe enis BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT GRADING PLAN—CHECK 00 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.S P.C. for his reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date. Owner: PLU 1 DISHWASHER 2.00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements fora V permit for construction or modification Dom the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county • ordinances and state laws relating to building construction and hereby authorize presentativ of this city to enter upon the above-mentioned property IIcr 1inspectio purposes. `' Date• Zia Ct( Signature. 0i 00022403-300.2,24U5 .170:- • i.CO Drivers License or Social Security DATE: 03/12/21 HIT: 1.4:35 1641-46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor - ‘ , CONSTRUCTION AND PLA. AG • PC Si SPA APPROVALS Permit# Date Inspector APPROVALS Permit# -_ _ Date Inspector 1. Temporary Electrical Servile or Pole -- 52. Pool & Equipment Location . 2. Soil Pipe-Undr trnd. 2.2 53. Steel Reinforcement r ._,n lr-- M .. 3'-Electrical Conduit'Utility-Undrgm T` 54. Forms 4. Electrical ConduiuUndrgrnd. 55. Electrical Bonding tit' t ttr'u5teghReinforce-4i: 56. Rough Plumbing & Pressure Test v �t AElectrical UFEB,Grnd. 57. APPROVAL TO COVER-GUNITE (a.: 1t.Z?-Fooiings S-= 58. Electrical Conduit-Undrgrnd. 1" d u -o8:- ,6.undation ., 59. Gas Pipe, C Undrgrnd., Test .. 9. Water Pipe-Undrgpid. 60. Backwash Lines, P-Trap, C Undrgrnd. 10. Structural Floor System - w 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • re .t 12. See& r Cap LI r✓ re i 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final .Y 14. Rough Plumbiho •-" 65. Electrical-Final 15. Rough ElectricTI-Conduit 66. Solar System-Final 16. Rough Electric'•Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricjl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20r•Rough Eactocy Fireplace , tc,q q-; w C O •r4: :i rAPPROVACSCCPerMit # J - : '^ cr c: rr cc >,:. : 'SSr tt.•4 x t rl Zrx . x cu e , - -r* ; L� {'•: :.''.. :A !-i 1.Y Z o, ,S72,-:.<1* L1 2L_Du'c{s, in.Straict e;;� -;S w S C ,-,... .: -go. Undergnopnd. Hydro * -c - 22. Ducts, Ventilating i a a: _ S +-C$ 't 91. Product`'P1ping l3 Gas CIO iI 23t Ga`s_Pipe,Rough & est ttiS '= tyl •7' .-4 Cx M -'72• Underground FlusJt 4. 24:-Roof Framing .t-r. I F-;- ..f t > 0 7 ? 5•731-UndergrnB'.StoragaTankt Gas C Oil • 25. Roof Sheathing .s. t >2 ;;' • '.., ; • tc ; .J;- . s 74:=-Overheadciydro-,-+'. 26.. -Bar Ceiling (Structural) &sMlonocoat - c: t7 to • x . S _ 75•-Dry Chemical ., 27f„Fra,tne and Flashin l '� is ^' ' 76' Dry Stant'ipe �' ` s Ca Cr `_,28`.--Lathin Siding.-:; ri 1,t •= u: _; > .. : 2• . ME. , ,. " ' a C 9: - tl . •• ••I I 77Y FIXED SYSTEM 6r, . ,� ,t• 29. InsulaYron 71 "' t" x 78jFIRE PR EV. FINAL ,. tr. r 3:30. Drywall:Nailing r'sv 4 ( :* a w : •.HEALTHrDEPT. REQUIREMENT 7:31. Plaster Brown, Co ! ' V F 79''F1NAL9Nr✓QECTIN ' - c v. ' r,- ' r•�T� .� 2,32.rElectrical Pmwer:Meter-Final; = � • t' l` r. r80::,FOOD C.1,c....----=---.• RTIFICATE ISSUED ^ :3 7 � .L : r , -f -. 334Fin I Electric � "' r •.-.- • "' -i t" . "Niles: c' �7 `' t j34rFiria"i Heatin` & Ai.Coridition �^ ' - 1• -• 5 r,;. i F 2 Ill s _F N C ' 35!TFinai Gas Pipe-Test• -� ' I r``c r` vas -, t*' C m ;r r --4 .. :. .-s I h.: ai J ..::C 0.- T P. • t 11- - t' ,,„36. Hobd or R ^ ! mh r. �: . aR - = ! -379:Final Factory Fireplacet CV' a, nt k . , -i - .r • ,38. Final Plumbing Wit„ , -. ysleg ! 5 •. n c;39. Water Service-Finalr - i t. a. i f' ' Ct - ., u; 40. Gas Service-Final ',,k ..,„ {{' "' cc wog ,S , 'n P ; .- • ? t41. Solar DomesticFinel5 tl •• ,, _ ¢o - -. :t. .r :.. _ i f . .t.• 'it" r xI - 42 sBackf low Prevente ` Su ,- " I I i; 'e u; j{-_ '? 43. Backf low Irrlgatiorr ' x q� - - - ir.r a- G Lt �, z Jr " - 5. X44. Landscape irrigation System...,c, u• > ," - ti '',7:e .. U _ 't7; . - td . - 545.=Sound Attenuation .tc;- tr m S - ti r. • _i w .c t 46. Handicap Regulations -I + .r• rr 5 :rC S 47sFOAL STRUCTURE & BUILDING ._ .> f ! t. r - .c n. 48.E INAL PLANNING �'�"r -. l s 01 K . 049 Ele`ctric Release to Edison a ; I 4 r• - - -i ; -. .. .. k . :- .r .-50. Gas-Release to Southern California Gas Co I �' ' C • 0 t '' 3 -. ;`51. CERTIFICATEOF:000UP4NCY - ,-_ ; 1.7; rc - _ - No Date CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. 6p 6.3 DATE //—/.7i 72.- LOT NO. ADDRESS / 79,5 73j t j0C6 e ,D2 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she- 0 (was or .in advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. BY j moi- a-zz-Zeef /7 �'L, Purchaser E C f I {- BY go.ee� ./M Cpd CITY O, Of COSTA MESA D Developer and/or �dthorized o ^'n- representative c�J �� AM NOVII 1 ' 1972 BY t #4• eC�.c re/Q��E ice`<„* e8�9�iiJ�iili7,7'2fV'4'J s Lender A r r/i PROJL ADDRESS: % UNIT: 1 D ER'SNAME: 1795 TANAGER DR � 3 CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 068700 C ADDRESS: MILLER, CHARLtS' R MILLER, LESLIE ,V" PERMIT NO: P 068700 PLAN CHECK NO: N GOVT: N SUPP : N 1795 TANAGER DR COSTA MESA CA 92626 CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU PURPOSE: ADD 714 ) 549-2200 ARCH/ENGINEER: MILAGRA DESIGN REc.xD.: 006149.0 JOB DESCRIPTION : ADD 1ST & 2ND FLOOR BEDRM & BATHROOM SQ FT: ADDRESS: 2900 BRISSTOL ST A202 PERMITTEE: C,M CA 92627 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ADDRESS: NEW WEST BUILDERS ( 714 ) 640-8218 2796 HARBOR BLVD COMMENTS : REF: 8-68697 C.M. CA 92626 *************iEEr+EEE*** *****s6****ErxEExsr+E****yt*********Er** **+E*y6*+E+6**x*x+E+E***+e+E**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T S 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. CITY Llc.: 482 3 STATE LIC.: 96. , CLASS: B—i EXP; 04 /94 SETBACKS to � ' CT—. signature:. Ate_i MAIN BUILDING ACCESSORY BUILDING KERS'COMPENS TION DECLARATION: I hereb• . '• that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY; PARKING REQ• PROV: PARCEL : 13963117 ZNE: REF NO: Certified copy is hereby famished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES> > Date: Applicant: * ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if We perm)is for one hundred(5700)or less). D EVEL OPMEN T SERVICES REQUIREMENTS I certify that in 1 re perlorma a of the work for which this It is issued.I shall not employ any person in any manner so as to become subject to the rockers'Co pensation Laws of Californi ZONING APPROVED BY ' ate i d • Signatu • � DATE: NOTICE:U.after making this dee aration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. . , DATE: CONSTRUCTION LENDING AGENCY; I hereby affirm that there is a construction lending agency for the.pedormance of the work for !^/(" �— • which this permit is issued(Section 3097.Civ.C). , . APPLICATION ISSUED B Y: tiEfM)F DATE: ' tri LENDER: ********************************************************************** ***.:**** ADDRESS: LEGALIZATION:N F E E S 'UMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 33 . 00 repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 70¢0)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 20, 00 ❑ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD INGD 1V > PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 33 . 00 20 . 00 0 . 00 53 .00 53 . 00 . 00 does not apply to an owner al a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. It,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: — 53 . 00 OVER/SHORT: . 00 mrthe purpose olsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 53 . 00 ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner f property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ***********,***************************************, ***************************** Mat proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: R.a P.C. INDIVIDUAL F E E BREAKDOWN mrthis reason: TYPE QTY DESCRIPTIO N - UNIT COST TOTAL COST Cate: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 SHOWER � • 7 , 00 7 , 00 25534 and that I or any future building occupant wL vill not(circle one)need to comply with said state codes and the requirements for a PLU 1 WASH BASIN ( SET) 7 .00 7 . 00 permit for construction or modification from the Air Dually Management District.Residential construction applications are exempt from PLU 1 WATER CLOSET (TOILET) -- 7 , 00 7. 00 these provisions. PLU 1 WATER HEATER AND/OR VENT — 7 . 00 7 , 00 Dale: Applicant - PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5 . 00 END OF FEES I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county ordinances and s to laws re ting to building construction dhereby authorize representatives of this city to enter upon the above'menlioned property for in ection put rises _ zi T Da Zr b C� signal 01 0ATE: 08/31/94 TIME:00166974-00166974 16:47 53.00 Driver's License or Social Security. 1641.46 White—Building;Green—Code Enforcement;Canary—ApplicanC Pink—Revenue;Goldenrod—Assessor rrCONSTRUCTION AND PLANNINGfra. PC & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole �I 52. Pool 8., Equipment Location 2. Soil Pipe-Undrgrnd. 111,4 -- piJ ) 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) Egotings 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 104_ 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing M.rA 6& K� 65. Electrical-Final 15. Rough Electrical-Conduit L!/'�-L 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 _,, onditioning FIRE DEPT. REQUIREMENT ,44.s 20. Rough Factory Fireplace • . APPROVALS - Permit# 21. Ducts,in Structure 70. Underground Hyclro 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 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation . ' 78. FIRE PREV. FINAL ( 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 7,9. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning i . 35. Final Gas Pipe-Test MJ, cl/') a-//'7� !�4 36. Hood or Canopy U-ZZ��' vv�` ; 7i3-c-- a 11... 37. Final Factory Fireplace a^ 38. Final Plumbing l/Z-c.-ft/,n .-1, - 3(� �a--tr7Vie -�I/� 39. Water Service-Final �e�� 40. Gas Service-Final I _/S 41. Solar Domestic-Final I 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation - - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date PROJECT ADDRESS: 1795 TANAGER DR UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 069292 OWNER'S NAME: MILLER, CHARLES R ADDRESS: MILLER LESLIE V PERMIT NO: P 069292 PLAN CHECK NO: N GOVT ; N SUPP : Y 1795 TANAGER DR COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ADD 714 ) 549-2200 ARCH/ENGINEER: MILAGRA DESIGN REG.NO.: 00000 JOB DESCRIPTION ; ADD 1ST & 2ND FLOOR BEDRM & BATHROOM SQ FT: ADDRESS: 2900 BRISTOL ST 0117: A202 C,M CA 92627 CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 / PERMITTEE: NEW WEST BUILDERS ( 714 ) 640-8218 ADDREss: 2796 HARBOR BLVD COMMENTS: REF; B-68697, REPLACE FIXTURES RE: #P68700 C .M. CA 92626 ***********************Or***+k******OE***sr****+E******irk*OE**OE**************** ***** LICENSED CONTRACTOR DECLARATION: I hereby of' that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS 7000)of Division 3 of the Business and Professions ode.and my license is in full force and effect. SETBACKS CITYL l048i/2({ sTATELlC.:469 :' s: B-1 EXP: 07/95 Date: C.1( `., l ,•. , MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION OECLARATIO'. 're.y affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800. Lab. C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REp• PROV; PARCEL : 13963117 ZNE: REF NO: 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > - Date: Applicant' ***********************************************4t******************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less) DEVELOPMENT SERVICESREQUIREMENTS I certify that in he per ormance of the work for which this p it is issued.I shall not employ any person in any manner so as to become subject to the orke Compensation Laws of California/ ZONING APPROVED $Y 'DDATE: aL Date'. 10 `vgtd S;gnatore: BUILDING APPROVED BY NOTICE:If after making this declaration .me• elect o the Workers'Compensation provisions of the Labor DATE; Code.you must forthwith comply =n. .. . mons or l .-rmit shall be deemed revoked. Q CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE; ID 1. ( 6 which this permit is issued(Section 3097.Civ.C). *************-******************************r x************************* ***5!** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION; N FEE - SUMMARY STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,atter,improve,demolish,or PERMIT 21 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 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). ISSUE FEE 10 . 00 I. as owner of the propen or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 21 . 00 10 , 00 0 . 00 3 1 00 31 . 00 , 00 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 employees.provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED; 31 , 0 OVER/SHORT: . 00 improvement ose of sold le). one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK for the purpose of sale). I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 31 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts far such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *************************************8(***************************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL FEE BREAKDOWN ❑ I am exempt under Section: B.8 P. C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date'. Owner. PLO 2 WASH BASIN 7 . 00 14 , 00 I do hereby certify That I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLO 1 WATER CLOSET (TO I L ET) f 7 . 00 7 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date Applicant: • l hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereb uthorrze representatives of this city to enter upon the above-mentioned J property for in5pection nooses. 1 01 00169579-00159579 1—C)1' 31..010 ' Date: I p—t 6 4(- et Signature'. DATE: 10/14/94 TIME: 10:38 Driver's License or Social Security 1641_46 White—Building:Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING PG & 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 r..!Oil 25, Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final GM Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing l2 ja- 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1795 TANAGER, DR • UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 068699 GOVT; N SUPP : N OWNER'S NAME: MILLER, CHARLES R ADDRESS: MILLER LESLIE• V PERMIT NO; M 068699 PLAN CHECK NO: N 1795 TANAGER DR COSTA MESA, CA 92626 CONSTRUCTION TYPE; V—N PERMIT TYPE: MEC PURPOSE; ADD 714 ) 549-2200 ARCH/ENCINEER: MILAGRA DESIGN REG.NO.: OOg�OSQ JOB DESCRIPTION ; ADD 1ST 6 2ND FLOOR BEDRM 6 BATHROOM FT: ADDRESS: 2900 BRISTOL ST " ' A202 C,M CA 92627 CLAIM VALUE: CALL—VALUE: GROUP OCC : R-3 / PERMITTEE: NEW WEST BUILDERS ( 714 ) 640-8218 I ADDRESS: 2796 HARBOR BLVD COMMENTS: REF: 8-68697 C.M. CA 92626 *****+r******+Erkr*********+FrF*****************************************kr***+Ex•*****+E LICENSED CONTRACTOR DECLARATION:•I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ON INC R EQU IR EMENTS 7000)of Division 3 of the Business and Professions Cod nd my license is in lull force and effect. SETH ACK S c0T 822 STATELIC.: 4694e /Cuss: A 1 EXP : 04 /94 K �_ J4.� Signatu � MAIN BUILDING ACCESSORY BUILDING � Rs•C PENSATIO DECLARATION: I herebyaffirm that I have a certificate of consent to self-insure or a certificate of Workers' FRN T; • FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV; PARCEL;, 13963117 ZNE; REF NO: a Certified copy is hereby furnished. 0 Certified copy is fled with the city Building Division. PLANNING NOTES> > . Date: AODlicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the perm)is for one hundred 15700)or less(. DEVELOPMENT SERVICES REQUIREMENTS I certify that in the p'normanc•of the work for which this a net is issued,I shall not employ any person in any manner so as to become sue ectmo• a ers'Com •nsation Laws of California. ZONING APPROVED BY •,• at -a - Sign DATE: NOTICE:II.after making his declaration,you should become subject to the Workers'Compensation provisionhe Labor BUILDING APPROVED BY DATE: ' Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. Yo CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: which this pelmet is issued(Section 3097.Civ.CI. **********************.***.******.****SA"*.fEk iE •***************************v' 1* LENDER: ********************************************************************* - ********* ADDRESS: LEGALIZATION:N F E E S U M M A . R Y STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT • 12 .00 repair 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 the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 252 SMIP/NON—RES and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred donors(5500). ISSUE FEE 15 . 00,: I. as owner of the progeny or my em loyees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTAL S----> 12 . 00 15 . 00 0 . 00 27 . 00 27 , 00 . 00 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 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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; '2 , 00 OVER/SHORT: , 00 for the purposeof sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 27 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware that proof of their Worker's Compensation insurance should be provided to me. *.X.* .** ,**,**,x,",*,** ,***** ,*,*, ,**,*,*,***,*,*,*,**,*********x, , *****,************************ I:1I am exempt under Section: B.8 P.C. IND I V IDUAL F E E B R E A K DO W N forthis reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and MEC 1 I NS T FORC—AIR/GRAN FURN <=, 100 K BTU 9 . 00 9 . 0 0 MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 , 0 0 3 , 0 0 25534 and that I or any future building occupant wituwill not(circle one)need to comply with said state codes and the requirements fora permit for construction or modification from the AU Duality Management District.Residential construction applications are exempt from END OF FEES mese provisions. • Date: Applicant: • I hereby certify that I have read this application and state that the above information is correct,I agree to comply with all city and county • , . ordinances and state laws Feta'ng to boating construction d hereby authorize representatives of this city to enter upon the above-mentioned 0 01 0Ql66973-0016697; TOT 27,00 for inspe ion pug. ses. 'J� DATE: 03/31/94 TIDE: 16:47 'ora C Signal �F"'� - I river's ense or Social"curtly 1641-46 White—Budding;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING - PL & 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 p 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER G•nd. 57. APPROVAL TO COVER-GUNITE 7: Footings 58. Electrical Conduit•Undrgrnd. 1 8, Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P?rap, 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 U Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑01. • 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter•Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning • CS--- 41- a R f--4 ,ar nay `j 35. Final Gas Pipe-Test ./ e7 �¢ ' 1 l Gt 36. Hood or Canopy 10 /n-(f -q _ __ _ays I � 37. Final Factory Fireplace ,/,.._ !- t /l 38. Final Plumbing 39. Water Service-Final Q �C �. 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. FINAL PLANNING -" 'l 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date OniiER 1ST IAS Angeles Corporation DATE 3-13-12 JOB ADDRESS 1795 Tanager Drive BUILDING PERMIT NO. 34251 GENERAL CONTRACTOR The Buccola Co. DESCRIPTION of WORK Res.w/att.gar. AP No. LOT 2 TRACT 6663 FIRE ZONE VALUE $ 42,500.00 INSPECTIONS • Signature Date GROUP T&J TYPE l/ ZONE R-1 SOIL /` I4 ;-2-1—?Z SUBCONTRACTOR PERMITS ISS ED GAS Date Number Signature WATERI4g A4Qtq)L lum ing n ROUGH PLUMBING P�fli7 f'r 61,7L 4/^7ee 3-/37� /0/73 ...--- PROP. PROP. SWR. LINE ❑ HOUSE CON. ❑ 4t 7r(/ 7� 7 ,t. LY 7-22-72. Cp is✓7 SPRINKLING SYSTEM / MISCELLANEOUS JA ROUGH HEATING AND AIR CONDITIONING /V/ S2.-?y TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING ��>//`//f� / *tt.cj q and Vent. c7 TRENCHES FORMS STEEL REINF. [ ' �� !( `� • / z /O�-/7 /O4LD F' ` SYSTEM o-_7 /1a /r- 7-/V-72i 7/7gI E ;EAM n STEEL REINFORCE In / SHEATHING / 0�']CJjFRAME AND FLArSyH�INB IppktC.--# 7l" // �iLATHING — IN II OUT/ Lab- �PLASTER, BROWN COAT //-�/*te_' STRUCTURAL, FINAL Act ,e _ yq q�/ HEATING, VENT., REFRIG. AND A.C., FINAL M s/ —j-2-7L '< ActJ _//// . �7,4-7 . ,, /it/- of b-7.� PLUMBING, FINAL AND GAS TEST n ( /7l) � *-72 ELECTRIC, FINAL . /l�i',Z- FLAN NO. 11A 3425 LOT NO. 2 F ,_PAW 22-7c-E6s,00 873* **t203.98 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely REC E fiY DATE RE5.51_VED DAAjE IS U D BUADIDRESS �� Tanager Drive ! .��i✓ - 7 .�J 7 ?- PERMI3$25 OWNER 1st Los Angeles Corporation A.P. NO. ��JJ``ff MAIL BUILDING N ay me Z ADDRESS #1 Wilshire @ Grand ADDRESS /775 fA/ /6E'Q rC/ LUIll 0- 0 CITY Los Angeles NO`$25-7341 TRACT 46'61? I LOT BLOCK ZZ < CONSTRUCTION I- NEW IADO ALTER REPAIR.j MOVING OFMO(JSH O LENDER 1st Los Angeles Corporation III am _ID BRANCH /J J N OWNER /T Z.49,, &g,O. m ADDRESS #1 Wilshire @ Grand `��, �/C v,At1 7�� m ARCHITECT TEL USE /et(/- LCCl/• 0,/�• $Lft'�i♦ Q OR ENGINEER Earl G. Kaltenbach NO.547-8046 ///��I� U N '1p FIRE (_/` {/ WCC ADDRESgH23 E. 17th, Santa Ana, Ca. ZONE T E GROUP /UIl fL w APPROVED LU J Z CONTRACTOR The Buccola Com an BY GATE 03 4501 Birch Street W W ADDRESS ZONE NO.OF USE OF NEWIeern "1/417 O= TEL 40-80 PLANS BUILDING Z F- CITY Newport Beach No. S V 33 R / �- 2 e/v c 6 >P STATE CITY YARDS APPROVED YARDS APPROVED NEE LIC. NO. 146423 LIC. NO. 2104 MAIN BUILDING ACCESSORY BUILDING 0 0 I (FROM C/L STREET) SIZENO.OF BLDG& OF LOT 634 X 100' I NOW ON LOT 0 FRONT CO FT. FT. USE OF EXISTING BLDG. R,SIDE— FT. FT. I— SIZE OF NO.OF Z NEW BLDG. 2,966 SC;.ftfOOMS 12 STORIES 2 L.SIDE r FT. FT. Q EXTERIOR WALLROOF U COVERING I COVERING Shingle _REARS, 5 FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& d0 MAIN BLDGS. ACCESS. BLDGS. Q *7.4.. / UC.U.P.# APPROVED APPROVED/ LID — /iDATE —a y ?a- o z f, I hereby acknowledge that I have read this application and state STATE HOLD "cLUAL RLOU.r.EMENT D that the above information is correct and agree to comply with // / CC all laws regulating building construction, and I shall not employ as a 76/_ r any person in violation of the workman's compensation laws of 7GQ(J _ //��"F s 4v 6 47 fn the State of California. co a) Z I hereby certify that I am properly licensed as a contractor under TSO. FT. O the State of California Business and Professions Code, Division 3, THE �Ll HOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e rt am exempt from the provisions of the State of California Business and Professions Code, Divi on 3,Chapter 9. VALUATION i�� m PERMIT FEE $ N Signature of I ! _ ] B Permittee $ ��/7 ��' PLAN CHECK $ E �)+ 8 Authorized Agent ` TOTAL FEE $ 014:21-- LL/I