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HomeMy WebLinkAbout1809 TANAGER DR - Building Permits IIIIlb .__ Ys' CITY OF COSTA MESA :rat' BUILDING DIVISION ,. PERMIT NUMBER t DEVELOPMENT SERVICES DEPARTMENT ',y"���; PERMIT '°�o,mw - E99-00676 (714)754-5273 • Fax(714)754-4856 77 FAIR DRIVE,COSTA MESA,CA 92626 • ELECTRICAL PERMIT Job Address: 1809 TANAGER DR Status: ISSUED Suite No Applied: 07/21/1999 Vicinity: Issued: 07/21/1999 Parcel Nunmber: 13963110 Applicant: WILSON ELECTRIC ISSUED BY: Address: 1138 PAULARINO AV • - Phone: (714)556-2821 COSTA MESA,CA Zip: 92626 , Owner: 'MITCHELL, LEONARD J 01C) Address ,.1809 TANAGER DR , • - Phone: - ii- ' COSTA MESA;CA Zip: 92626 9 Contractor: WILSON ELECTRIC Address: 1138 PAULARINO AV Phone: (714)556-2821 COSTA MESA,CA - Zip: 92626 - License: 693150 SCOPE OF PERMIT UPGRADE EXISTING 100 AMP ELECTRICAL METER TO NEW 200 AMP METER IN SAME LOCATION. FEE SUMMARY Quantity Quantity ISSUE FEE $22.00 Temp Dist System/Lighting $0.00 0 . ,Temp service test , $0.00 Busway/100 ft $0,00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 ,Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200e. $27.25 1 Misc.Conduit $0.00 0 • Service to 1000a. $0.00 0 Misc.Conductor $0.00 0 Service over 1000a, $0.00 0 Circus(gen or ride) $0.00 0 Motors to lhp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp . $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits 50.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $49.25 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 DECLARATIONS ) f �I 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 Is issued. My workers'compensation Insurance carder and policy number are: Carrier: Policy Number: (This section need not be completed/f the permit is valued at one hundred dollars(S 100)or less.) ❑ I certify that in the p rfo ante of the work for • this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws Ca mia,and agree that ould become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pr ' I Q� Applicant Signature: _ Date: —Z I— ( WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(5100.000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am lice se under prorviisi s of Chapter 9(commencing with Section 7000)of Division 3 of the Busty ss and fa`ofessions Code,and my license Is in full force and effect.Lic.s ?) Ise Class 4 1.1:—1 v Contractors Signature' Date: —Z 1-49 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 D/15C LAR ATIO N S: h\ I hereby affirm thelunderpenalty 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 courity-whlch.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 Cede)or,ttiat 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 toe civil penaltyat not more than five hundred dollars($500).): ort mplo ❑ 7 4 ,owner of the property,res io s employees with wages c their sole not apply WILL DOn r THE WORK,and the s or ime is not thereon, or offered for sale(Sec. 7044,Business and Professions-Codes 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 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: ❑ 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(38)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: 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? ❑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 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 end Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application asermit 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 LJ NO (Section 65850.2 of the Califomia Government Cale 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 ❑No (If'yes the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Catifomia Health and Safety Code Section 42303 been made? 0 Yes ❑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-describ pr¢pOrly for inspection purposes.1 pgr e not to occupy or allow occupancy of any building authorized by this permit until final inspection. Ignatur Legal Ow r(s) Date-4 _2 — et cc And/Or Authorized Applicant Date CODE 4 INSPECTION TYPE 1NImALS POPE( INSPECTION TYPE PAIS PIMA 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 20B Final Plumbing _ 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupancy 2448-46 �t_E�yr CITY OF COSTA MESA ).spr ,I BUILDING DIVISION C� ti "'^' ' DEVELOPMENT SERVICES DEPARTMENT �V/ o. PERMIT PERMIT NUMBER • M98-00440 (/ (714)754-5273 • Fax(714)754-4856 • 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT • Job Address: 1809 TANAGER DR Status: ISSUED Suite No Applied: 09/25/1998 Issued: 09/25/1998 Vicinity: Parcel Nunmber: 13963110 Applicant: RICHARD LEWIS Address: Phone: ./' Zip: /. Owner MITCHELL,LEONARD J Address: MITCHELL, BONNIE M - _ _ - - COSTA MESA,CA Phone: 714-545-6325 . . 1809 TANAGER DR • Zip: 92626 , , ; Contractor: . GEORGE BRAZIL PLUMBING, HTG. Address: 3801 LENAWEE AV . Phone:' 714-541-9753 CULVER CITY,CA - Zip:"90232. . . • License: 679898. , Arch/Eng: _ - . Address: • Phone: Zip: • License: • - SCOPE OF PERMIT .. . . ' 4TON NC UNIT REPLACMENT. FEE SUMMARY Quantity ./- . % / Quantity ISSUE FEE $22.00 Repair./Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 Repair,Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 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 $13.25 1 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 $0.00 0 15 To 30 hp/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< 10000cfm $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 $35.25 • COMMENTS/SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or 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 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. 0, 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 is issued. My workers'compensation Insurance carrier and policy number ere: //' Gp Carrier: 'i ' R Sin--r£ !, b Policy Number T�7-2Vo/ �/ O (This section need not be completed it the permit Is valued at one hundred dollars($100)or less.) ❑ 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, a eq thgt if I should become subject to the wprkers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. / (/ g /' Applicant Signature: �( Date: 1d N WARNING:FAILURE TO SECURE WORKERS SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRI INAL PE ES AND CML FINES UP TO ONE HUNDRED THOUSAND• LORE($100,000),IN ADDf110N TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licens@O under ejpro plonns of Chapter 9(commencing with Sept(n 7000)of Division 3 of the Business and Prpfesslons Code,and my license is inforfull s C ne and effect. e 6- 29 trr1 - l/ Dates: M 2z0/4 Contractor's Signature: • Date: 2r- 94 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: 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(commenting 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(5500).): ❑ 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.). ❑ 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. 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,Califomia Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the DMsion 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 at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature 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 Califomia 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 aaermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 101 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? 0 Yes 0 No (If yes-,the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by Califomia 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,end 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. .:suture Of Legal Owner(s) / Dat- rAnd/Or Authorized Applicant ' '? •ate CODE L IN2PEETIC TYPE RAM EMU CODE! INcPFCTInN TYPE RAIL 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1 O-1 -95k 1266 Pool Spa Final _ 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign _ 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446.48 . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. r /7t0.5g.�$/ /OO CITY OF COSTA MESA CONSTRUCTION P RrMIT I r�Tue- I`) TRACT NO. LOT NO. UNIT-NO, l/i • dS Project Address /80 Q T7zna aer o7 • II O V RU j r / ' , • , '✓ TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION REPAIR Applicant's Applicant's Mailing//,,ppyydIddrrrress //// CI CONVERSION C7 DEMOLISH ❑ OTHER A.P.# Zone Owner's Name Phone? 79�G/f� DESCRIPTION OF WORK/USE OF BLDG. Address / S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT El GRADING ❑ - •UNDATION LI STRUCTURAL E Fronto Address ,,. ❑ TENANT ❑ ELECTRICAL 13 PLUMBING ❑ MECHANICAL B 'Rear N Contractor's Name 411 S✓//fill// Phon-i%LPM°C ❑ 'OTHER ` C Right N ,—,/ - PROJECT DESCRIPTION SQ. FT. -_ OCCUPANCY Address(mailing) • �y CONSTRUCTION TYPE VALUATION$ K Left • R Ref.y City License No. L.)0 5 ZONE GRADING CU.YDS. ACRES ping. # - Parking Req./Provided E LICENSED CONTRACTOR DECLARATION (,i 7 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: v Planning Notes: RFCEIVEQ V`aL ` 1985 M with section 7000) of Division 3 of the Business and Professions Code, and � k my license is in f r and effect. -�[� T T License Cies a I e e No. I C tf' , S r 'e • Signature S��✓ / %Vr/y ' PLUMBING FEES _ RKERS'COMPENSATION DEC ARA I•N Bar Sink Showers ELECTRICAL FEES ,'ereby affirm that I have a certificate of consent to self-insure or a certificate _ , • of Workers' Compensation Insurance, or a certifie copy thereof (Section Backflow Preventer Service Sink 3800, Lab. '/ ///��,/ ./ys/ Automatic Washer Transformer 0 15-50 KW I Policy No. • ! -• C Company r(1[.L.L LC.L•ri Backflow Irrigation Sewer Cap0 50+KW / Construction Pole Sub. bfie• copy is hereby furnished. .,_ iirCer 'tie p (ilea with the city } o er Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date �s" Applicant ��/I � � -✓ll • EXEMPTIO FROM WORKERS'COMPENSATION D CLARATION Clarifiers - Solar Collectors Dishwasher Meter ❑over 100 amps (This section need not be completed if the permit Is for one hundred ($100) or ' less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank . Fan Motors❑0-1 HP ❑1'F,-8 Workers' Compensation Laws of California. - _ Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ 'NOTICE:If,after making this declaration, you should become subject to the - - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures ' comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service . Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performancePole Light , of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors j Water Heater n Outlets Lender's Name J sr-. Range Lender's Address __ - Kitchen Sink Water Service OWNER BUILDER DECLARATION • - Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash - following reason (Section 7031.5 Business and Professional Code: Any city or - Garbage Disposal !Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0.5 KW❑5.15 KW any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor a file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains • ne Contractor's License Law(Chapter 9(commencing with Section 7000) of • Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section - , 7031.5 by any applicant for a permit subjects the applicant-to a civil - _ _ penalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered _ - Reinspection Fee , I $15 Issue Fee • $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's • MECHANICAL FEES . - . - License Law does not apply to an owner of a property who builds or improves ' _ thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or Improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By Date ' pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). -3 './^ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By . � ! Date P-1-P tractors to construct the project (Section 7044,Business and Professions Code: ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • 00-100,000 BTU 0100,000 BTU • SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant'to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o// their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ _� w PERMIT ISSUANCE $ Date Owner • Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000 BT GRADING $ ELECTRICAL information is correct. I agree to comply with all city and county ordinances $ and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of is city to erste upon the bove-mentioned prop rty for inspection p s • S'O(•, Signature ate MECHANICAL $ ._ TOTAL FEE $ i Drivers' Lice or SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ ( CMF 0865-46,rev.10/84 - Accounting;Goldenrod -Assessor r 4 _& SPA CONSTRUCTION AND PLANNING 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 OF ER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O 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 ❑Gas ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 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 Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 9'.Z]-Jt L,EG 39. Water Service-Final s fn 40. Gas Service-Final (.t 41. Solar Domestic-Final • 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System_-, 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No• _ Date NA CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT NO. eres-63 DATE r/ gill LOT NO. 9 / ADDRESS 'Sop 70A 449CPC ZO2 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 (was or ere 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. BYC t1.4-ha �r�-CilL /,�JjPurcha r /� ���/ BY �iVc�N C:D. e .2i 7��i�� Developer and/ authorized / Q representative G. BY /Waitc « �< '�Z%'� Lender 9428 7/15/86 18.00 TL Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -' •- CITY OF COSTA ME$Q,.(�PONS� TION PERMIT P i/yt O �C�� TRACT NO. LOT NO. UNIT NO. Project Address /rJt/ lQ,�p'//7 /'1 l-1 J I Applicant's Mailpg Address^f1t-J p (�I�1WN\\ n(� /S. -1 TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION REPAIR �• Owner's Nam 11V71FVL�yR Phone 6�xsf / ❑ CONVERSION ❑ DEMOLISH ❑ OTH A.P.# Zone / DDD'�CR P K O'F1 ER K/USE OF BLDG. Address - ev&l a) S Main Building: Accessory Building: Arch/Eng. License No. T OF PER IT„�/ GRADING ❑ FOUNDATIOON,/LJ STRUCTURAL E Front 0 Address • ❑ TENANT IQ ELECTRICAL ❑ PLUMBING l6MECHANICALB Rear N Contractor's Nam' i�'.- I . k Phon ❑ OTHER A i ay ``11 `` 1111 PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) i ��ACIAL E LTN K G 3p O/� CONSTRUCTION TYPE VALUATION$ s Left R City License No. ll I ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.`{� Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and - my license is in 1 for ' . d effect. .��s 1�� T License r . s —at..BS Licen e o- sv+�•fl - S �ci nate / i£� Signature 21��i7 -- •„ r PLUMBING _ FEES !, R RS' OMPENSATION DECLARATIO / Bar Sink Showers VQ meby affirm that I have a certificate of cons n to elf-Ins a or a certificate ( ELECTRICAL FEES 1 of Workers' Com ensation Ins ante; or a c- ifie• copy ther f (Section ` Backflow Preventer Service Sink /s7 ' r //, ` Automatic Washer Transformer 0 15.50 KW 3800, Ldb. C.) G Policy No. Dl4lI Company Atli -�:- Backflow irrigation Sewer Ca ❑ 50+KW Certified copy is hereby furnished. p Construction Pole Sub. • Certyds_ed 9y l lea with the city - Ieiv'sion. '_ 1 / Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps Date 60 �U—Ov Applicant is fA.� .mow ' EXEMPTION FROM WORKERS'COMP SATION 21 CLARA ON - Clarifiers r Solar Collectors - - Dishwasher Meter Dover 100 amps - - (Thissection need not be completed If the permit Is f•ra.ne'hundr.• ($100) or less). Dishwasher • Solar Piping Dryers ❑Gas DElectric -Sub Panel I certify that in the performance of the work forwhich this permit is issued,I - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan / ' Workers' Compensation Laws of California. Motors❑0.1 HP 15.8 Date Signature Floor Drains Swimming Pool w/Spa F.A.U. NOTICE: It,after making this declaration,you should become Subject to the / Inc.Solar ❑B-15 HP ❑76-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes ' 1 hereby affirm that there Is a construction lending agency for the performance Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors • Water Heater - Lender's Name - Range Lender's Address Kitchen Sink ' Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories _ - Auto-Wash - Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P ,Standing Sections • county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5.15 KW Trash Compactor any structure, prior to its Issuance, also requires the applicant for such permit 'n file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains - e Contractor's License Law(Chapter 9 (commencing with Section 7000) of vision 3 of the Business and Professions Code) or that he/she is exempt .nerefrom and the basis for the alleged exemption. Any violation of Section \ 7031. 7031.5 by any applicant for a permit subjects the applicant to a civil ----. 0 penalty of not more than five hundred dollars ($500). �— I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee ' $ 3 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee , $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES - . . License Law does not apply to an owner of a property who builds or improves _ - , thereon, and who does such work himself/herself or through his or her own - - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for • Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- , Canopy Type 11 ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- . Duct- Under Ground Building Approved By Date prove for the purpose of sale). - ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural . Ref( eration System Application Issued By a Date '7-is /Y./. tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply-to an owner of property who - Duct-Ventilating 00,000 BTU 0100,000 BTU �6 SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors license pursuant'to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP. $ ' proof of' their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers - PLUMBING $ ISSUANCE $ Date - Owner - Hea)mg System& Ducting Registers PLAN CHECK 25% $ ` ENERGY P.C. $ I hereby certify that I have read this application and state that the above ;0-100,000 BTU 0100,000 BT �//1 06 GRADING $ informatio s correct. I agree to comply with all city and county ordinances ' ELECTRICAL $ // and state la relating to buil• ng constru '•n, and hereby authorize repre- • MICROFILM l $ sentatives of is city t• e• upon t e .•ove-mentioned pr•.erty or PLAN CHECK 50% $ inspection p r.:.sC51 �.(j" ��7 (.1 �7� Signature Lvu W •0, - _ Reinspection Fee $15 • Issue Fee $ 3 PLAN CHECK 25% $ , CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ,,CONSTRUCTION AND PLANNING Pt &SPA • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 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://aclr'Y402472 . ✓� 34. Final Heating & Air Conditioning ,4 �D1 /V / i/ . /J .gl 35. Final Gas Pipe-Test L <C/s( � U ii/ 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation to 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations o 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 4.1 c 51. CERTIFICATE OF OCCUPANCY No. Date I ADDRESSOPSMLIKNc 1809 TANAGER 'DR MT: CITY OF COSTA MESA — BUILDING PERMIT owiesf MEIPKNOW+MITCHELL, LEONARD J PERM NO: B 086387 `\ Aomass:MITCHELL, BONNIE M 1809 TANAGER DR PERMIT NO: B 086387 PLAN CHECK NO: N GOVT: N SUPP : N :OSTA MESA,CA 92626545-6375 p. APPL.MAAR3ADORESS CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC.NM: JOB DESCRIPTION : REROOF W/DECRA LITE ICB0#3409 SQ FT: 5, 000 ARCH.OR ENO'S ADDRESS: UNIT: CLAIM VALUE: 5, 000 .00 CALC—VALUE: 5, 000 . 00 GROUP OCC : R-3 /U-1 wNuciorstweCAL—PAC ROOFING ( 714 ) 761-1550 CWIRACTORS MOUND 2130 ORANGEWOOD COMMENTS : REROOF 2800SF RESIDENCE W/METAL ROOFING ADORES&ANAHEIM CA ue.m.: 719716 ******************************ter**it*****ease***sate**+ERE*******RE************+E*+r**+E*iE-* 90630 WIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby elfin under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division a of the Business and Professions Code,and my license is in fin force and effect. CITyUC.No.:067317 uc.Cuss: C39 uc.NO.: 19716 EXP: 06/98 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Data / J/c'Y contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN NNER B ILDER DECLARATION:I hereby affirm under penalty of perjury am exempt from the Contractors License Law for the bang reason(Sedion TDDl.s Brims and Professions Code:Any city.calmly whim requires a name lo context alter.improve, PARKING REQ: PROV: PARCEL : 13963110 ZNE: REF NO: she iofpe t .°OAea also requires ( to Mthat e caed pish.or ursuant to re prowthe Contractors trsLkweLaw(Chapter a conmedngwitSeas, 7i*Med0o)of vision the PLANNING NOTES>- - Busvness and Professions Code)a that he or she Is exempt therefrom end the basis fon the alleged exemption.Amy violation Of Sedb 'I.,' t 7031.5 by and applicant for a permit tutted*the applicant to a chi penalty of not more than foe hundred dollars(SSODB. ***************4*************************se stint*******st***************se****at se**** O off�ialprogeny Bployees dPwages sair sok Co° ctn� do and lyoaure anot intended D E V E ,L OP MENT SERVICES R E Q U I R E M E N T Soreorse(Section 7044, usn anrofnCode:ThenaouLa appinbweoofpropry who bunds or inproves thereon.and Ma does such work himself or heel or through his of her own empb/ece.provided that such impm..mensremlwemedoroneedfasale.If. a within r .however.thebuidingorimprovement addwoneyeelcompletion,the ZONING APPROVED`'BY DATE: �` owner-udder will have the burden proving he or she did not build or improve for the purpose of sale). ❑ I.as owner d the proven.am exdumvely oawadiro wan Sors.d cono-acten a mrmw"Praise' ,e wand(SedOf rola.Buin.a.nd • Professions Code:The Codradars License Law does and apply to an owner of property who builds or improves thereon and who BUILDING APPROVED BY DATE: contracts for Mil projede with a oomradods)licensed percent le the Cookson License Law). 1 • ❑ Ianexempt underSection: B.AP.C..for this reason: APPLICATION ISSUED BY: DATE: ***it**********ie to tE tE tt ie iE tE it iE is if it if it iF**it******if it tE******** it to iF*ter if.**st***1E*it reit Dat Owner. "°° LEGALIZATION:N F E E SUMMARY - STRUCTURAL 'SEGMENT: Y I do hereby candy the I em aware of end understand the requirements of Canine Health end Safety Code Sedios MOS,p55T1,and ap�emitfoCOOMIuthat I clio ormodi onfrmrbuilding°occupant yMananpmwntoistrA°°ofto d.Reesid°°ertwo"hohdudinap ionncodes n°ereerepti fromnts MeseBLDG PMT PLUMBING ELECTRIC MECHANIC FIRr E- SMIP/RES GRADING provisme. PERMIT 99 . 75 . 50 Dale: Amount: SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby Winn der penalty of pend perjury one the'dietary dedrre:atioPLAN ^ ISSUE FEE J. o in./ear maimenacertificate dconsent tosetinsuraarworkers'comieradion.asprovidedforbySedian37WdleLabor BUILDING—DIV—> PERMIT ISSUE PLAN CHECK TOTAL Code,falhperfmnanceoftheworkforwhichthispensisissued. ..;Y PAID DUE ❑ ihave end tvil aintai,wodncam,p«,.etmn ninda,oe.esrequiredbySecine,3TmoftheLaborCode,fortepermd performance TOTALS— — > 100 . 25 0 . 00 0 . 00 100. 25 100 . 25 . 00 a' work for whim this permit Is awed.My woken'compensation insrrwe censer and policy number we: -i Carrie: AMERICAN PATRIO EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 100 . 25 OVER/SHORT: . 00 Policy Number. WC10298544 08/01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This season need not be completed/rhe perm*is for one hundred doers WOO/a ion.) 99 .75 ,'50 ❑ I certify that in the performance of the work for with this pemnh is issued.I that not employ any person in any manner so an to become eubnd to the workers'corpersatipn laws d CNtlomtie,end pre n mould sabred to the workers' stili(-iE'il*************itteiL•sEstsettiesestsesesestttitietttt*********se***ieitsese***nesse****sestitsesesesese******* cons of Section 3700 d the Labor Code.I shallshallfforthwithyeahM I I N D I V I D U A L F E E BREAKDOWN y Data i7 2 t Appkcem Warning:Failure to secure workers comwensadon coverage la unlawful„and subject an employ.to criminal penalties and TYPE QTY DESCRIPTIO N UNIT;)COST TOTAL COST civil fines up to one hundred thousand dollars(sloga0L hi addition to tis cost of compensation.damages as provided for In i section 3706 s, sofUeLaborCodInt«nt and attorney's ten SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE L. 00 5, 000 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally d perjury the there is a construction lending agency for the END OF FEES performance of the work fa which this penia is issued(Sedan 3097.CN.C). LENDER'S NAME: LENDER'S ADDRESS: • I codify that I have read this application end see that the above information is corned.I agree to comply with an city and county ordinances and stare laws relating to building construction end hereby authorize representatives el this cin to enter upon the ebove-mentioned property for inspection purposes. /,1 SCOTT JOHNSON 61—C3-1536L;5:49 k::/C::J.ci Pent Name /� 1;(•rr'T '1' ._��Jl. . Data: r' /:• "r�O(')yT�C�S 'J IJ� -� Sip /Agent/AppecanVConnada (5151-46.WP) White-Building A Safety:Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING PuOL & SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pdle 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd.c. 53. Steel Reinforcement - S.:Electrical Conduit iMility-Undrgrnd. 54. Forms - :4, Electrical ConduifUhdrgrnd. 55. Electrical Bonding • '•' 5.-Steel Reinforcement' 56. Rough Plumbing & Pressure Test - 6-..Electrical UF ER Grnd. 57. APPROVAL TO COVE R-GUNITE . ,7. Footings 58. Electrical Conduit-Undrgrnd. 2 1 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 TODECK 11. Property Sewer Line& House!Connection 62. Backwash & Receptor-Final - I 12. Sewer Cap - 63. Heater& Vent-Final 13. Roof Drains _ 64. Plumbing System • Final 14. Rough Plumbigg I 65. Electrical-Final • 15. Rough Electrical-Conduit I 66. Solar System-Final . 16. Rough Electric Wiring 67. Fencing & Accesi 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 a , -' RIRE.DEPT.REOUIREMENT .. .. ., -. . - i - , J - 20.;Rotigh Factory FicePlace ; C _ APPROV,_ALS2 ; Permit# = - 21. Ducts, in=Structuce,• : - r i,, -_ • • ; 70.-Undergrotirid Hydro = 22. Ducts, Ventilating ' -- ' 4' 71. Prod --'ot•Pib in Gas „ .. ..Ar _ U P 9Q Oil :r 23, "Gas Pipe;Rough &Test er• -a. , 72, Underground Flush 24. Roof Framing °'t ;� - �• -�', 73.. UndergrRd.Storage.Tank 0 Gas 0 Oil 25.;fodISheathing c 'F 1� e Q 74:Overhead Hydro. 26. T•Bar Ceiling (Structural) & Monocoat = i 75; Dry Chemical - 27.-Frame and F(ashiagw - _. a 76. Dry Standpipe :, Y 1 • 28. Lathing&Siding:T '' 7.7�. FIXED`SYSTEMFINALS • t^ 29. Insulation - - _ YB. FIRE PR EV. FINAL 30. Drywall Mailing ',„,7 . > - ' $'' - 'HEALTH DEPT. BEOUIREMENT r • 31. Plaster Bilwn Cog, 1 iX 79. FINAL INSPECTION .. '•j Th 32. Electrical Power Merer-Final _ i. - 80. FOOD CERTIF)CATE ISSUED' - 33. Final•Electric ._ r Notes: =.i ') 'RC1 34.:Final Heating& Air Conditioning - - t .. , 35.:Final GasPipe-Test' - . - ; •fi Hood or Canopy .. -i : I _ •i 37. FinarFactory Fireplace.'' - - ,. •-• J 38. Final Plumbing : -, r 39. Water Service-Final' -r - • - . r 40. Gas Service-Final .- - - 41. Solar Domestic-Final ,; - . 42. Backflow Preventer, _ _ /- .-q9=,w� Ye'_0 / �r` c�vetL . - 43. Backflow Irrigation. - eirtif 44.:Landscape Irrigation System . . - t y. - _ g., - • 45. Sound Attenuation' - - 96. Handicap Regulations ;•., t47. FINAL STRUCTURE & BUILDING /"Z':1 f a y dy< _ i. 48.FINAL PLANNING' • , - 49. Electiic Release to Edison - ' _ - '50. 'Gas Release to Southern CalifordiaGasCo 51. CERTIFICATE OF OCCUPANCY - No. Date PLAN NO. 7BR 3425 LOT NO. 9 P? , AID ?'&7400 880* ***142.86 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely r RECEIL DATE RE VED BUILDING cG / OyC �D ADDRESS /fof Tanager Drive -hoty PERMITTD 25, OWNER 1st Los Angeles Corporation A.P.NO. [� MAIL ADIDRESS NG O Z ADDRESS#1 Wilshire @ Grand r �� 97 r- ,e.- 'OQ/vE w L11 0. 0 CITY Los Angeles NOTEL.625-7341 TRACT 6;(615 LOT 7 BLOCK ZZ C CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOIISH OI- LENDER 1st Los Angeles Corporation ✓ am _JO BRANCH Z. /r/ /� _J inOWNER 4r C-• • C A#' m ADDRESS#1 Wilshire Q Grand V LUE -CO ARCHITECT TEL. 46 S14 $ UN OR ENGINEER FArl G. Kaltenbach NO. 547-80 FIRE ,r� W CE ¢ ADDRESI823 E. 17th, Santa Ana ZONE TYPe 4 GROUP tSt7‹: - 1 w APPROVED W O CONTRACTOR The Buccola Company BY DATE ma J cc ADORESS4501 Birch Street W IIJ ZONE NO.OF y_ BVILDINGUSE OF NEW/err.W/nTT Z= CITY Newport Beach TEL K-� PLANS0,2_ �rAK G4�, _ H O STATE CITY YARDS APPROVED YARDS APPROVED U1 ¢ LIC.NO, 146423 LIC.NO. 2104 MAIN BUILDING ACCESSORY BUILDING D O (FROM C/L STREET) SIZENO.OF BLDGS. OF LOT 6o. x low I NOW ON LOT 0 FRONT Sot- FT. FT. USE OF r EXISTING BLDG. R SIDE J FT. FT. I— SIZE OFoo NO.OF Z NEW BLOGl,850 sq ft ROOMS 9 STORIES 1 L.SIDE r FT. FT. Q EXTERIOR WALL ROOF . V_ COVERING COVERING Shingle REAR .2-7 FT. FT. J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 1a MAIN BLDGS. ACCESS.BLDGS. VAR.* DATE O41,. Gig / CUP,* APPROVED I— $PPR to _ OV/ tbOLV679J,yDATE to2 '/ /O/,- h. NOL . • .PECIA REQUIREMENTSo � rE VI hereby acknowledge that I have read this application and state -41,/ ,'8s0 that the above information is correct and agree to comply with nn CC /all laws regulating building construction, and I shall not employ e 8 t / /�D D F any person in violation of the workman's compensation laws of (/f < N the State of California. rAX m zI hereby certify that I am properly licensed as a contractor under -.• FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses are in full force and etfect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: ¢s am exempt from the provisions of the State of California Business VALUATION and Professions Code,Division 3, Chapter 9. Cf 5 co �, PERMIT FEE $ , .� N Signature of [ may,\ J\ D co Permittee $ G, ��- PLAN CHECK $ ��� E 0 a Authorised Agent /(/f TOTAL FEE $ / — OWNER 1ST LOS Angeles Corp- "ion DATE '-13-72 JOB ADDRESS 1809 Tanager Dri. _ BUILD.... PERMIT NO. 3�i258 ' GENERAL CONTRACTOR The Buccola Co. DESCRIPTION of WORK Res.v/att.gar. AP No. LOT 9 TRACT 6663 FIRE ZONE VALUE $26,500.00 INSPECTIONS Syii nature Date GROUP I&J TYPE V ZONE R-1 SOIL /V1,c3-N1-72_, PERMITS ISSUED GAS SUBCONTRACTOR Date I Number Signature WATEntrigmCW. 9 7L •lu bine ROUGH PLUMBING 'q/-7�'j 'Tr6 -72 i„ / PROP. SWR. LINE Q HOUSE CON. 0 "v7,(c.7Zi t , .4. %--2,-72 C/3‘ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING tle (N jr7y TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER ❑ ROUGH WIRING --!--) eating and Vent. J/ TRENCHES E FORMS n STEEL REINF. 75.7 7 v I, 0 7-4,,--7..g90"7 FLOOR SYSTEM /�/���L e / 1-� 77'47 �f/- BOND BEAM n STEEL REINFORCE n SHEATHING .N. �I /J FRAME AND FLAS HIN �(�+- L� �� LATHING — IN OUT/ C- PLASTER, BROWN COAT '` �X STRUCTURAL, FINAL JJ '/y'yn',� �/ (/ HEATING, VENT., REFRIG. AND A.C., FINAL Ir� ff � % y/t,. L-wits Ci0 1Ir' PLUMBING, FINAL AND GAS TEST n '' /� ��L ELECTRIC, FINAL ff /7).