HomeMy WebLinkAbout164 TERRAZA CT - Building PermitsPROJECT ADDRESS: UNIT: J
OWNER'S NAME: BRIGGS DEVELOPEMENT CO.
ADDRESS: 23046 CARLOTTA AV #315
LAGUNA HILLS CA
380-0685
ARCHIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: BRIGGS DEVELOPMENT (714)380-0686
ADDRESS: 23046 CARLOTTA AV 315
LAGUNA HILLS CA 92653
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Diiision 3 of the Business and Professions Code. and my license Is in full force and effect.
CITY UC.: STATE LIC.: CLASS:
Date: Signature:
IVORKERS' COMPENSATION DECLARA71ON: I hereby affirm that I have a Certificate of consent to selbin tem or a certificate of Workers'
implantation Insurance, or a certified copy thereof (Section 3800. Lab. Q.
OLICY NO.: EXP. DATE:
F COMPANY:
' Confided copy is hereby fumkshed. ❑ Certified copy is filed with the city Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Dia section need not be completed it the pemrl is la we hundred ($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 Califomla. '
Date: - Signature:
NOTICE: It, after making this declaration, you should become subject to the Workers Compensation provisions of the Labor
Cade, 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
. which this permit i5 issued (Section 3097, Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(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
pursuant to the provisions of the Contractors' State 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 CMI penalty of not more than five hundred dollars ($500).
I, as owner of the property or my amployees with wages as their sole compensation, will do the work, and the
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. 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
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
and Professions Code: The Contractors' Stare License Law dors not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractogs) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date: 70/19 Q O Avner.
I do hereby certify that I am aware of and understand the requirements at Califf nia Hes hand Safety 44ictions 25505, 25533, and
25534 and that I or any future building occupant wilitwill not (circle one) need to comply with said state c y5.apit the requirements for a
permit for construction or modification from the Am Oualiry Management Dis I. Residential cgnstmc'e aD cations exempt from
these provisions.
Date: Applicant:
I hereby certify that have read this application and state that thea ve info alion I5 correc spree o y 'th all cry and county
ordinances and state laws re g to building construction and hereby au01o' representatives of this ci enter a th a -mentioned
Property for impe ' ph es.
Date: !� L Signature:
Driver's License or Social Security
1641/6 White -Building; Green -Code Enforcement: Canary-Applicanh Pink -Revenue: Goldenrod -Assessor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO:'G 049366
PERMIT NO: G 049366 PLAN CHECK NO: 04403-90 L GOVT: N SUPP: N
CONSTRUUIITION TYPE: V -N PERMIT TYPE: ELE MEC PLU STR PURPOISE: NEW
JO$�DgSCRIPTION :,NEW APARTMENT 1 OF 12UNITS SQ FT: 12,073
CLAIM VALUE: CALC-VALUE: 122,357.00 GROUP OCC: R-1 ! /R --
COMMENTS: APARTMENT 1 OF 12 UNITS
Z O N I N G �R E Q U I R E M E N T S
S E T B A C K S
i
------------ MAIN BUILDING ------------------ ACCESSORY BUILDING--=------
FRNT: 17 FT IN REAR:' 13 FT IN FRNT: FT IN REAR: FTx, IN
LEFT: 10 FT IN RGHTtt• 25 FT IN LEFT: FT IN RGHT: FT., IN
PARKING REQ: 24 PRO.V: 24 PARCEL: 43929107 ZNE: R2 REF NO: DR9015
PLANNING NOTES> ONE, 2 -STORY DETACHED APT. UNIT (ONE OF A 12 -UNIT PROJECT)
>
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DEVELOPMENT rrSERVI"CES R.EQUIREMEN•-T'S'
ZONING APPROVED BY hL:•. ' fib(/"I >' DATE:
BUILDING APPROVED BY :S if^DATE: S Iro
APPLICATION ISSUED BY: DATE: IDIS 9 v
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if*1E BE 1E iflE is 3e iE*ia ik 3P 3t*eE eE ie 3F ie*3k*iE ie 3u 35 4t*1E. 3t Et iP iPiE*et*15 et 3F**4t**aP*at lP at 3F iP 4F iE it iE eP iF aP iP iP*4F iP iP iP TE iesiP iE iE
LEGALIZATION:N F.0 E'r S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 720.00 27.00 58.56 15.50 8.56
pptt���yy
25% 50% 25% SMIP/NON-RES
YWE FEE �lStlLF�i� 3,00 15,00 15,00
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 829.62 33.00 468,.00 1330,62 1330.62 .00
REVENUE DIVISION TOTALS--> COLLECTED; 862.62 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
720.00 30,00 73.56 30,50 8.56
ie lP lfie**#fE eE ee 3F 1E eE****it****it ie*ie it i!*ie iP*iS iE iek3e*iP*ie**3f***iE aPk*1E*eE aE eE*****fE4P*iE*4E at ii aE iE 4E*iE aE iE*1E ala
I N D I V I D U AL F E.E• B R E A K D O W N
TYPE
QTY
D E S C R I P T I O N
6,920.00
SFR
1673
DWE-TYPE V -WOOD FRAME
-GOOD
SFR
400
RES -GARAGES TYPE V.,
2.00
ELE
1673
NEW RES BLDG FOR 1'.OR 2 UNITS/
SQ FT
MEC
1
INST FORC-AIR/GRAV.FURN <= 100
K BTU
MEC
1
FACTORY FIREPLACE '
PLU
1
BATHTUB
PLU
1
DISHWASHER
PLU
1
GAS SERVICE
PLU
1
SINK KITCHEN
PLU
1
SEWER CONNECTION TO BUILDING
EACH
PLU
1
SHOWER
UNIT COST TOTAL COST
69,00
115,437.00
17.30
6,920.00
.03
58.56
6.50
6.50
2.00
2.00
2,00
.
200',
2.00
2. 00
2.00
2.00
5,00
5.00
�t c�ti oo.-aLa
,:- ,,1 ; 2.00:
,».� _.
ORTS:
CONSTRUCTION AND PLANNINu
APPROVALS Permit # Date
Inspector
, Jc SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
-
-2..Soil Pipe-Undrgrnd.,
D
�j
53. Steel Reinforcement
• -3. Electrical Conduit Utility-Undrgrnd.
54. Forms
',4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
_ 5s;Zteel-Reinforcement.
��=�,j'
�/�`�
56. Rough Plumbing & Pressure Test
.::,6.:6ectricalUFERGrnd.
57. APPROVAL TO COVER-GUNITE
t-
17: Footings
58. Electrical Conduit-Undrgrnd.
--
;8.rFoundation `ga-x �,..
Q-Z`(�
�(,v
59. Gas Pipe, ❑ Undrgrnd., Test
v -
-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
20`:'=Rough Facto'Y Fireplace -
..
.,,FIR�i.E REQUIREMENT
.1.1 OVA-F 1 Permit
2i:'Ducts, in Structure
.;70. Ufpdergroupa Hydro
22. -Ducts, Ventilating: -•. _
-, ,*
•�:xx
f71, Product'Piping OGas 0DII
23` Gas Pipe�Rough &Test
4 c�
? s,
,72, Underground FI➢_sh,,.�
24:"Roof Framing(•,
73.:Unergrn. StoraETnk�O Gas+OOil
'741'6yerhead
25. Roof Sheathing ;��
y ,
"-'� �,
HydreP
26_,T-Bar Ceiling (Structural) & Monocoat
I. c,
^'+- x
75^6ry Chemical c.j-
27; Frame and Flashing
?!
76. Dry Stand..
-
'28. Lathin -& Sidin "
9 9',.: i . ; •
'
.� :,
--
_n -1.':J :y ..•
77.: FIXED SYSTEMi,[NAL to cr-
'C',
:R �.- ti;
i0' •'-ars!:'
29. Insular on
78 FIRE PREY. FINAL *' ^
°`t'"
q•
30. Drywall Nailing . _
_ _.
--�, ,: a..v
7
•cq„ •; FL EA LTH•D_.EPi. REQUI R_EM E_Nrr.; r.:
31. Plaster Brown Coat - .?
v
a
°7 FINAL INSPECTION
•32.,Electrica•I Power`Meter'-Final'1F00D.CERTIFICATE
ISSUED. try'
•W41LILUMMIZI
33: Final Electric 1,n -
T W T
_
es: "OPLD FOR SPF�IAL
_ i,h-"`.
X134:. Final Heating &Air Conditioning' i- '
v35:
�y
0
'�''
!Final Gas Pipe-Test
a/�Qj
v n
x r
,36.-Hood o'r Canopy
-
-737.--Final Factory Fireplace- •-- - -
�s3( Qf
(�O"
-- r
~38'FinP
,am
(
-1
39. Water Service -Final -
H RI
likb .
40. Ga's ServiceFinal-
'41: Solar Domesiic-Final -
~<
,. -
i• ; __ ..
42JBa6kflow Pre venter' ,
��•' -'
43. Backflow lrrigation .•
- -•--•
'44. Landscape Irrigation System'
t
't
s x `''- "- •' '"
45`�Sound •Attenuation-
•:n
�46."Handicap Regulations -' _
'� %=' •= '
-47.-FINAL STRUCTURE & BUI'LDING
.49..Electric Release toEdison,
--
.50. -Gas Release to Southern California Gas Co
- �' ' ' ' ' - ' ' ' ' '
- 51. CERTIFICATE OVOCCUPANCY
No. Date
• ' -' _
PROJECT ADDRESS: UNIT:
OWNER'S NAME:
ADDRESS:
ARCHIENGINEER: REO.NO.:
ADDRESS: UNIT:
PERMITTEE:
ADDRESS:
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed urger provisions al Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, and my license is in full forte and etfecl.
CITY LIC.: STATE LIC.: CLASS:
Date: Signature:
FRXERS' COMPENSATION DECLARATION: I hereby affirm that ns
t I have a certificate of consent to sett nt-insure or a cetate of Workers'
nPensation Insurance, or a certified copy Defend (Section 3BOO, Lab. Q.
LICY NO.: EXP. DATE:
COMPANY:
[] Certified copy is hereby furnished. ❑ Cued copy is filed with the dry Building Division.
Date: Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Ih's serum reed not be ow#eled'd UN Wmh b fW Oe hunored (5100) a less).
I early trial in the Performance of the work far which this permit is issued, I shag not employ any person in any manner so as to became
subject to the Workers' Compensation Laws of California.
Date: Signature:
NOTICE: If, atter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or Ittis 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
which this permit is issued (SacOon 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to constmct, alter, Improve, demolish, or
repair any structure. pilot to Its issuance. also requires De applicant for such permit to file a signed statement that helshe is licensed
pursuant to the provisions of the Contractors' State 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 (5500).
I, As owner of the property or my emyleyes wi
eth wages as Deb sole compensation, will do De work, and the
.� structure is not intended or offered for sale (Section 7071, 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 far sale. If, however the building or
Improvement is sold wl0In one year of completion, the owner wig have the burden of proving he/she did not bulld or improve
for the purpose of sate).
I, as owner of the property, Am exclusively contracting with Ocensld contractors to construct the project (Section 7074, Business
❑ and Professions Code: The Contractors' State License law does rot apply to an owner at property who bac lds or Improves thereon
and who contracts tot such projects r(D a waractor(s) license pursuant to the Contractors' trite License Law). I am aware
that proof of their Worker's Compenstbron insurance should be provided to me.
❑ 1 am exempt under Section: B. S P. C.
for gds reason:
Date: Owner.
I do hereby cenity that I am aware of and understand the requirements of Cafifamla HeaXh and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant MR)WO not (Circle one) need to comply with said state Odes and the requirements for a
permit for construction or rrodificatbn from the Air Oualily Management District. Residential construction applicants are exempt from
these provisions.
Date: Applicant:
I hereby certify that I lave read this application and state that the above information is correct. I agree to limply with all city and county
ordinances and state laws retailing to building construction and hereby authorize representatives of this city to enter upon the abwa-mentioned
property for inspection purposes.
Date: Signature:
Driver's License or Serial Security N:
I
END OF FEES
D� TOP. 77=
01 03071"C —C 771`.71 Tel
DATEC 10/03'40
PERMIT
NO; G
049366
PLAN CHECK NO:
04403-90 L
PAGE; 2
3ei!*Mit*iE*iE**iE 9E****it*it****iE**Bt**ie itiE**9E iE**ie**iE if*kTe 9t**M9e st**iE eF 9E it BE**BF Cie*iE 9E et**ie*9e tett***ik
TYPE
QTY
D E S
C R I P T I O N
UNIT COST
TOTAL COST
PLU
3
WATER
CLOSET (TOILET)
2.00
6.00
PLU
1
LAUNDRY TUB OR WASHER
2.00
2.00
PLU
1
WATER
HEATER AND/OR VENT
2.00
2.00
PLU
1
WATER
SERVICE
2.00
2.00
I
END OF FEES
D� TOP. 77=
01 03071"C —C 771`.71 Tel
DATEC 10/03'40
FMF
CONSTRUCTION AND PLANNI ..
APPROVALS Permit 46
Date
Inspector
WM & SPA
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 LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
B. 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 1.r Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
20.-RoughFactoiy.Fireplace
2.1. 'Ducts, in Structure
70. Underground Hydro
22; -Ducts, Ventilating
71. Product Piping 0Gas 00il
't3.••Gas.Pipe- Rough & Test
72. Underground Flush
24:`Robf Framing
73. Undergrnd. Storage Tank 0 Gas ❑ Oil
25. Roof Sheathing
74. Overhead Hydro
26: -T -Bar Ceiling:(Suucturap & Monocoat
75. Dry Chemical
27. Frame and Flashing.
76. Dr Standpipe
Y
28 Lahing
77. FIXED SYSTEM FINAL
29. Ins'ulatIdn '^`=="
r
78. FIRE PREY. FINAL
30. Drywall
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL INSPECTION
32..Electrical PoQu Meter -Final
80. FOOD CERTIFICATE ISSUED
33.EFirtal Electrte =: ':
Notes:
34.'Fir' I Heating & Air Conditioning
35, -Final Gas Pipe -Test =
36 Hood or Canopy
7.
37. Final Factory Fireplace
38._Fi yl Plumbing
39 +Water Service -Final
40:- Gad Service -Final
41.;Solar Domestic -Final
42: Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Haridicap Regulations
47',FII AL.STRUCTURE & BUILDING
48"FINAL'PLANNING
49. Electric Release to Edison
50: Gas Release to -Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
FINAL GRADING CERTIFICATION
Project Address: 164 Terraza Court
Lot Number:
Permit Number:
By Civil Engineer:
I certify to the satisfactory completion of grading in accordance with the approved plans,
specifications, local and state codes. All drainage devices required by the grading permit,
grading plan and grading ordinance have been installed. Adequate provisions have been made
for.drainage of surface water from each building site.
The minimums are:
2% Fall from structures within 5 feet from exterior Nulls.
1% Fall for asphalt surfaces and landscaped areas.
0.5% Fall for concrete surfaces to approved disposal areas.
The final monuments as shown on the recorded tract map were set. All final grading eleva-
tions are within + 1/10 of the designed elevations.
Supervising Civil Engineer n Reg. No. RC? it 7m—
(Signature) 6/11/91
Date
2O`9
c'Au, G�\
Z
rn
m
� E 192 �
32AMP and SYN
'Wo s
vJTY Of CHSTA MEF I
--� .;ALrn(?nN,A 92628.1//2//00 /7r0..��OOX IznO ^�A
InsuEatian Ccrtitira[e "
._... __....
2468 ELDEN AVENUg " mistmet City
ORANGE------------.__ UNIT J
County sulrlivivi,m Lat Nwnber
ROOF
htatcrial
ThicknessOnclrs) ._._.._.....
I'j!CI'EiR10R 1VA1..1_
Material _BAT c;
111ickncss(inctics) ;.._...._._._.__. _.
Ctan_iN�
Description of his4lllation
IArand Namc
'fhcmtal Resistant (R -Value)
Ilr:md Name-.WV_ILLE.......
"Ibermal Rcsisianct (R-Valuc) R-11
Lett or ULvt't:ct "i'; pc BATT -'.---'--.. _.._--.---...._.._ ..... Drand Name MANVILLE
'Ihicknesv(irdrs)_ .—'IhermalResistance (R-Value)_R_14 and__R_30
Loci Fi)l T rBrand Namc.
ConlracwF's 1114611113111 iMudlul wcihhUfC, , _ lb Nlinimum thickness _ inches
Marto facture r' : installed weight per.squam loci Resistance (R- Value)
RAISED FLOOR
Material
ISl:md N:nnc _
-Ihcrmel kcsistance (R -Value)
SI_A13 FI-OOR
Nfatcrial 13r.wd Name
Thickness (inches) .. __......._..._.... _ ._. ___.._.._.._...._.._..—_ lherrnal Resisumce. (R -Value)
N'idrh (incfus)
FOUNDATION .VA l..1.
h1welialIlrind Nnmr..
_.......... ..... .. ..................... ,..,..,.........
................._.......
"Ihicl:ncss(inclrs) ,,,,,,,,,,,,,, 'Ilr,.rmalRcsi."Anc't(R-VWuc)
I)CrCI,Ir:AI iqp
I hereby certify that Ihc: atxwc insulation was installed in the huilding at the atxrve I(x:.ntion in wnlonuance with
the current Buildinp, Energy EfliciCOCY Standar(ts for new residential buildings contained in 1'illc 2.1 of the
(::difornia Administ- ativc
Gn�c; nl (antra',u4 (Nuilr: t 1 .....�
\�.. _.. ....
S ..; --'-"___....._._...._........ __ .. .__.._— __........._..._._.... .............
___._..._._..._I
l ;nnnur. er.l llllc
l_(......WESTERN ....INSULATION.,.__INC.._..._..._.........._.......... `.'x,..481278..._ —__._....._._.__.....___......
t\ ioh 'vna ren f L,aafati:m brrnllcr ......
t1 .... .. I.icc,l)n Nurntx.T._ .................__........... ....
Authorized Agent >' 6-4-91
PROJECT ADDRESS: 2464 ELDEN AV UNIT: J
OWNER'S NAME: BRIGGS DEVELOPEMENT CO.
ADDRESS: 23046 CARLOTTA AV 4315
LAGUNA HILLS CA
380-0685
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: SANTIAGO AIR CONDITIONING (714)998-1600
ADDRESS: 231 BLUERIDGE
ORANGE CA 92665
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect.
CITY LIC.: 015264 STATE LIC.:269496 CLASS: C-20
Date: IZ ZC) Signature:. _ _
WORKERS' COMPENSATION DECLARATION: I hereby affirm at I have a cenificate oo =nsca or cenificate of Workers'
Compensation`ura}�' c6{ a copy thereof (Section 3000. Lab.
POLICY NO.: 0— EXP. EXP. DATE: 7/01/91
COMPANY: PACIFIC STATES
�a
,T
Certified copy is hereby furnished L'] Cedilied copy is filed with the city Building Division.
Date: 42 —�;zo-1 U Applicant:
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (T s section need not be complefedn the permit is for one hundred ($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 became
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: II, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forfor 11- 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
which this permit is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Stale License Law for the following reason
(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
pursuant to the provisions of the Contractors' Slate 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 (M).
I. as owner of the property or my employees wiIn wages as their sole compensation, will do the work, and the
tru
❑ scture is not intended or ollered 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. II, 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
for the purpose of sale).
I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7144, Business
❑
am Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a aonlaclor(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.
❑ I am exempt under Section: B. S P. C.
for this reason:
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M Ut)03811
PERMIT NO: M 050386 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
JOB DESCRIPTION : NEW APARTMENT 1 OF 12UNITS SQ FT:
CLAIM VALUE: CALL—VALUE: GROUP OCC: R-1 /
COMMENTS: RE: G49366 PRIMARY BLDG. PERMIT.
��r�F*XF�E*EFTFTE*ifXH�FTtitXF�r�E fE��+t**�**XF�F*�pTF**SETFRF**XFTETc�+�+��E*>F�F*�ETr�E�F*�F�H�*RF TE TF**�E�FTF�F TF TF***�F*�Fkk
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REO• PROV: PARCEL: 43929107 ZNE: REF NO:
PLANNING N TES>
>
IF if44 ie )F iF * iF 9f iF )K aE iF iE iF N-iF 9P iE 1F 1F iH JE iE iE )F iF )t 9f * 3F IF iE iE iE iE 1F )F iE iE iE * * aF iE 3F N 3E iE 3E iF iE IP )E 3f aE * * IF iF IE 9E iF iF lE iE iE iF !E 1E iF XF iE * IF ae )F!f #
D E V E L O P M E N T S E R;V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :_ _ DATE:
APPLICATION ISSUED BY: DATE:
3f 1F IE*iF )E iF ft lF iE ie aF ie iF iFk**)E NiF 9P >tik*#1E kik iE iE iE aE "i(7fPt iF lE
)f iFRF Af>E*iE jF ieiP)F 3e IE AF iE iF lF ieiE iE iF 9E aF 3F )E RF AF iE *lE iE iE TF iF 3F RE Df***JF9F 1f fP)kBf iE IE IP 3E iE 9F Tf 3FRFk KiF)F iE 9f IE *1F IF%IE ft•1F 1E iF JE%*if TE il�
LEGALIZATION:N F E E S U MARY STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9,00
25% SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 9.00 15.00 0.00 24.00 24.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
iF4E if iF ieiF * iF IF iE Bt * * k * iF M if it * 9E iF * iP 9F tF iF iF iF iP iE �E tE * * it It )FIE 4F iE Te * iF * iE9E iFRF IFiE iE RE ie iE * iE iP iF iP iE iF 3( * X * iF * iF iE }F * iE i6 iF iE 3E iE IE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date: Owner: I MEC
I do hereby caro y that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant viij not (circle one)need to comply win said state codes and the requirements for a
permit for construction or modification from the Air Guality Management District. Residential construction applications are exempt from
these provisions. �/
Dale: eA& X70 Applicant _
I hereby certify that I have read this application and stale that above information is correct. I agree to comply with all city and county
ordinances and state laws relating to building Construction and hereby authmite representatives of this city to enter upon the above mentioned
property for inspection purposes.
Date�� tv 0 Signature,
Driver's License or Social Security
Applicant: Pink—Revenue: Goldenrod—Assessor
1 REFRIGERATION SYSTEM <= 100 K BTU/H 9,00 9.00
END OF FEES
AL
IMF
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
PO�PA
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. -t r,
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8. Foundation - •;
59. Gas Pipe, ❑ Undrgrnd., Test
-
9: Water Pipe-Undrgrnd.
60. Backwash Lines,P-Trap, O Undrgrnd.
10: Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
12. Sewer Cap •-
63. Heater & Vent -Final
13. Roof Drains -
64. Plumbing System -Final
14. Rough Plumbing
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 ElectricakT Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
--APPROVALS -•_ Permit #
20.: Rough Factory Fireplace
i
21Duets, in Structure' ..
_
.70. Unde7 round Hydro -.
22. Ducts, Ventilating ?
'-
'71. Product` Piping O Gas ❑Oil
23�Gas Pipe -Rough &Test
72. Underground Flush
24. Roof Framing
73.- Undergrnd. Storage Tank O Gases ❑ 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
j 1
78• FIRE PREV. FINAL
30. Drywall Nailing -
�,�• -
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat'
1 h
79. FINAL INSPECTION -
32. Electrical Power Meter -Final
-,
��: •:
80. FOOD CERTIFICATE ISSUED
33.`FinalElectric
Notes:
34: Final Heating
35: Final Gas Pipe -Test,
36: Hood of Canopy
37 `Final Factory Fireplace
-
38. Final Plumbing
-
39. Water Service -Final
i
- - -
40. Gas Service -Final
I
'
.41. Solar Domestic -Final-
42. Backflow Preventer
I
'
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:1L �A RTrn17A1 ATS UNIT: J
OWNER'S NAME: BRIGGS DEVELOPEMENT CO.
ADDRESS: 23046 CARLOTTA AV #315
LAGUNA HILLS CA
380-0685
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: CALTA PLUMBING INC (714)540-2914
ADDRESS: 31030 W CENTRAL
S.A. CA 04
LICENSED CONTRACTOR DECLARATION: hereby affirm that4M,e
sed under or cion f Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code, ande is in lull rce deffect.
cITY LIc.: O $TATE LI 233re:uss;
� Signature:v _ _• _ _ — /
WORMERS' MPE SAT ION DECLARATION: I hereby affirm that I have a rtificale of consent If -insure or a certificate of Workers'
Compensation sy�jc°p �0.jj h ed "Whereof (Section 3800. Lab
:Y NO.: �I��Ll��-7V JDAT 4/O1/ 1
,APANy: REPUBLIC
U Demigod cop Is here refurnished. Certified coph the city join vision.
Date: 7 Q Applicant:
EXEMPTION BMW KERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less).
I Certily 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 WorkersCompensation Laws Of California.
Date: Signature:
NOTICE: If, after making this declaration. you should become subject to the Workers Compensation provisions of the Labor
Code. you must foMwath 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
which this permit is issued (Section 3097. Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(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 helshe is licensed
pursuant to the provisions of the Contractors' Slate 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 (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 (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 himsell/herself or through
his or her own employees, provided that such improvements are not intentletl or offered tar sale. II, 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
for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business
❑ and Prolessime Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects won 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.
❑ 1 am exempt under Section: B. 8 P. C.
for this reason.
Dale: Owner:
I do hereby fenny that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
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 Duality Management District. Residential construction applications are exempt from
these provisions.
Date: Ariolhv,rot:
I hereby certify that l have read this applicali a and state that the nformation is most I ,ee to comply with all City d county
ordmancVrwsrel mglobuilding destruction and here a role repre. fiver scity to enter upon the abov mentioned
pmpenyn our pass.
Signature:tial Security
11\41-46 White—Bottling: Green—Code Enforcement Canarv—Applicant: Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 05020
PERMIT NO: F 050205 PLAN CHECK NO: 06807-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: FIR PURPOSE: NEW
JOB DESCRIPTION ; NEW APARTMENT 1 OF 12UNITS SQ FT:
CLAIM VALUE: CALL—VALUE: GROUP OCC: R-1 /
COMMENTS: APARTMENT 1 OF 12 UNITS
NE * 9E 3f iE 9f 9E iE BE iF iE lE iE iE iF+E+E 9E * x RE * iEif RE NEjEiE iE Bt iFjE if iE iE iE * iE iE iE iE iE * iE 4f 9E BE JE 9f * * iFif REiEiE JE RE * iE * 9t * REiE dF iE iE iE iE iE 9F if iE 1EiE RF
Z O N I N G S E T B A C K S R E Q U I R E M E N T S
'
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 43929107 ZNE: REF NO:
PLANNING NOTES>
>
if 9F iF iE 9E iE 9E BE M iE * )E RE iE 9E JE JE iF iE BE iE * * * iE it * k k Bt 9E iE iE 9E * RE RE k IF 1E iE it JE k iE aF * RE iE iE iE JF k 9E * iE 9E iE JE 9E 9E 3E JE�E iE tE iE iE it IE k IE iE * iF k �E 9E iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:
JF BFif TE k9h**kif it 9E 9Ek NRE kiF**iE 3E iF
BETE 11, tiE4E; lir* �F if
iF ifM***LEk**it*REk**LE*iE RE REkk*MBE OF it kE****9E REiEiE LE if iE 9E fE**IF iE BE iE iE*RE 9E iE iE JE 9E 9FlE it 9E*TEk IE XE iE LtiE 9E fE lE iE k1E JE IE 9E iE iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00
65% SMIP/NON—RES
PLAN 35.10
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS ---- > 54.00 0.00 35,10 89.10 89.10 •00
REVENUE DIVISION TOTALS--> COLLECTED: 54.00 OVER/SHORT•00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00
* * * iE M iE 9E Jf if iE if * * iE iEiE iE iE * iE iE 9F Jf TEiE * 9E iEif * * iERE iE iE iE 9E iEiE iE 1E 9f iE * 4E iE * * iE iE 9E iE iE 9E iEiF Jf * iE * aE if iE iE * * dE 9f if DFiE iE iE iE iE iF iE * iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIR 54 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 54.00
END OF FEES
01 00075732—OL075772 _rODT `.. 0
DATE: 12/06/90 TINE: 1`:10
CONSTRUCTION AND PLANNING
F '_ & SPA
APPROVALS Permit #
Date
Inspector
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole;.,1
52. Pool &Equipment Location
2. Soil Pipe-Undrgrncl. -
53. Steel Reinforcement
`3.�Electrical Conduit-Utility-UridrgrnJ.:k'
54. Forms
-
4:"Electrical Conduif-Undrgrnd. rr
55. Electrical Bonding
n•
5.'.Steel Reinforcement
56. Rough Plumbing & Pressure Test
B.�_Electrical UFER.Grnd.
57. APPROVAL TO COVER-GUNITE
T.: 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 & HoDse 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
_
[APPROVALS:-•CPermit#
20trRoughF.actoryFireplace 'r':
~.r
_
-r \ - K ..• rpt
`:
-
fJ
21. Ducts, inStructu�,e:' ,. c
�. ,a
= _
-70. Underground Hydro
,9
22. Ducts, Ventilating - -
- `"f •
Prod ucTP�ing O'Gas 00il
X71.
23.Gas_PiperRough &'Test i;
72. Underground Flush;
-16,
24.rRoof Framing - ^_r
`173:LUndergrnd:StoragEFTank:OGas �0Oil
25. Roof Sheathing :_"' --
_ . .,
- �
-
_ -
`74'Overhead •Hydro-
26__T-Bir Ceiling (Structural) &•Monocoat
a tt
% -
75, Dry Chemical
_
27 _Frame and Flashing'
_
76y Dry Standpipe `s - r r
28. Lating`&Siding :•.. Lc-
77,-F IXED SYSTEM, FINAL'
(.,Ip.ct
'29. Insulation 77g.,;
FIRE PREV. FINAL
.30. Drywall.Nailing r w r.
- '
I ,•
HEALTWOEPT=REQUIREMENT
•-31. Plaster Brown Coat; .\
!:
791 FINAL INSPECTION
,� ^.
,
-32.-Electrical Power Mater-Final -
Y
�. =
r80.1 FOOD CERTIFICATE ISSUED
33.,Fingl Electric ' -
a <
O
I- '
"Nofes:
34,--Final Heating;& Air', Cond i tion ing.
a:
;-,
I
35:'Final Gas Pipe-Test -
� �- `-• " T : --
,36.'Hooa or�Canopy _ rr _ n
i •
I N
Y •-_
37.ZFinal Factory Fireplace "' -�
•"
-`„°
r
_
-38.-Final Plumbing •-
3
.'.39?Water Service-Final--
te.- x -• ^-'
40. Gas Service-Final r r l=
z41.,Solar Domestic-Final�•-
'42. Backflow Preventer';
43. Backflow Irrigations N
ti
�.
X44. Landscape Ir.rigatio`p Systems = x
- _
- ' '`
r_,
45. ;,Sound Attenuation sr .r
s -
- r S•
,46. Handicap, Regulations
J
47 ,FINAL STRUCTURE & BUILDING
..: ti
-
48:'FINAL PLANNING:
'
'
�
Release toEdison
--
i- •i
z49.=Eleciric
i I
50.,Gas Release to Southern California Gas Cu
.; f
`
-51. CERTIFICATE OF OCCUPANCY
--
- -
No. Date
Pro)act Address: gall:
Owner's Name:�2
Address:
Arch.UEn0lasa: Reg. Na:
Address: unit:
ParmlNa: Q-I(.(ft
Address:
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am kemN ander Ixaysion; at Chapter 9 (commencing
with Section MR of Division 3 or the Business and RWe59pns Coda and my erase b in M1A force and effect.
QTY UC:' SLATE LIC.: CLASS:
Date: Signature:
'A'9BNERS' COMPENSATION DECLAIRION: I hereby affirm that I have a artilirale m consem to seg -insure
certificate of Workers Compensation Insurance, or a cenihed copy thereof (Section 3800, Lab. Q.
Y NO.: EXP- DATE:
�MPANY:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the dry Building Division.
Date: Applicant:
EXEMPTION FROM WORKERS' COMPENWION DECLARATION: (This section need not be completed if the permit
is for one hundred ($100 or less). I rerdty that in the performance of the work for which this permit is Issued.
I shag rot empty any person n ay rmorer w es to become eub)ed a the Wbftm Compensation laws of Wfomda.
Dale: Signature:
NOTICE: If, after making ata decardbn, you shade become subject to the Winters- Compensation provF
sae of the labor Does. you mW Mtwdh comply with Rich peasants or this; perm shoe be dttne0 reveled.
CONSTRUCTION LENDING AGENCY: T hereby affirm that there is a construction lending agency for the pecor-
mance of the work for w ich this pentyl is Issued (Section 3047, Ov. C).
LENDER:
ADDRESS:
OWNER WILDER DECLARATION: I hereby affirm that I am exempt from the Comramors' Sate License law
far the follawing reams (Section 70.115 Business and Pmf World Code: AM. city of count' wlNca required, a
permit to construct, after, improve, demolish, or repair any structures prior to is ssuanca also requires the spoil-
card
poLLram for such permit to file a signed astement that he/she is Ttcem a =W. . to the provisions of the Cdrtnc-
tore Stat License law (Chapter 9lcamm erdng with Section 7oD0 m Ois%ion 3 m fro Bavaess and Professions
Code) or that he/she is exempt therefrom and the bass for the afieped exemption. Any violation of Section 70315
by arty apponm far a permit suojem the applicam to a dull penalty at M more than OW hundred guests ($500.
❑ I, as owner of the ordinary m ptmy, emplayees with wages es their sale compensation, WAS do ds work, and
the mer
is not intended or offered for sae (Section 7044, Business and Professional Code: The Con -
fracture' Sate License Law does not apply to an owner of a property who builds or imprmdes thereon, and
who does such work himselOhemelf or through Ns or her awn employees, provided [bar such improvements
are not intended or offered for sale. IL however the gNldmg or Improvement is sold within one year of com-
pletion, the owner will have the burden of proving helshe Cid nm build or Improve for the purpose of sale).
I, as sumer of the propend, am exclusively wmrectin0 with licensed WntadM to copaact the project
(Section 7044, Business and Professions Co Oe: The Contadori State License Lax does not apply to an
owner of property who builds or improves thereon and who contain fon such projects with a conlador(s)
license purevam to the Contactors Sate License Law), I am aware that proof of their Worker's Compensa.
tion Insurance should be provided to me.
❑ I am exempt under Section: B A P. C. /
for this reason: I/ �/-
Oise: Meer.
UNI—
MODEL
do hereby cert that I m Mesa Ol and understand the requi
is of Can ma Heart
nil ev Coda Sec.
tions 255M 25533. and 25534 and that I or any future bdldm
-pant edDitall a (o
le one) need to comply
win said state Was and Oro requirements far a pe rill far comb-
run a modfca frormob
Air Quality Manage -
m Dlsiricton
met. Resident I Wnsiractbn applications are ext mp
va r�
mm these pe72
Water Heater
Date. Applicam:
'
Left
1 hereby ertify t I have read IIs affirZ. mi and a tet are above kilo n is conW.
' -
i agree to comply
with all city and county ordinanees and saner laws nI to
D castrocton and
am apresen-
[at Nes of this dty to e r upon the above-memlonW Drops
for inspection pis
Rear
$30 Issue Fee S15
Aill
Ping. Ref, N Parking Req./Provided
Sfpat-re:
O
Planning Notes:—
APPLICANT: DO NOT FILL IN SHADED AREAS
PERMIT NO.!
/V—
UNI—
MODEL
A.P. N
Zone
Swimming Pool w/Spe
S
Main Building Accessory Building
DEVELOPMENT SERVICES REQUIREMENTS::
Zoning Approved By
Building Approved By
Application Issued By
Z
PURPOSE: El NEW ❑ ADDITION�ALT ATION El REPAIR
❑ CONVERSION ❑ DEMOLITION OTHER
DESCRIPTION OF WORK/USE OF BLDG. 5 U 1 L 1'O Ou7— SRA-[sC
/�Qr�g/L� /�7V / ���� C // ,� y� \
/7 /� `
7
Front
Washing Machine
Water Heater
N
B
A
Left
$30 Issue Fee S 3
I
C
Right
tiple ❑ Refrigeration System
❑ 0100,000 BTU . ❑ ioO000 BTU ♦
G
K
S
Rear
$30 Issue Fee S15
R
Ping. Ref, N Parking Req./Provided
O
Planning Notes:—
M
IG
TYPE OF PERMIT: ❑ GRADING ElFIRE 11STRUCTURAL ❑ SIGN
,�/
00 ELECTRICAL El PLUMBING 11 MECHANICAL ❑ REINSPECTION
n
JOB DESCRIPTION: ❑ SO. FT. OCCUPANCY GROUP
0C,
CONSTRUCTION TYPE VALUATION $ 8UD " CU. YOS.
CATEGORY: ❑ MINOR CONSTRUCTION ❑ MAJOR CONSTRUCTION (Under 200,000 sq.ft.)
❑ MAJORMIGH RISE (Over 200,000 sq. ft.)
Remarks:���1.%�"• f �'L-�5 ��PIG.�
T
S.
ELECTRICAL
FEES
Automatic Washer Motor ❑ 0-1 HP ❑ 1-10 HP
Christmas Tree Lot ❑ 10-50 HP 50.100 HP
11GRADING
Construction Pole ❑ over 100
Sub Pole Outlet .
Cooking Unit Pole Light
Dishwasher Sign Outlet-
-y i
Dryer ❑ Gas ❑ Electric
Square Footage
' PLUMBING FEES
F.A.U.
I Standin coon '
Backflow Prevention Repipe,
Fireworks Stand
'Panel
Backflow Irrigation Roof.Drain
Fixture -
Swimming PooVSpa -
Bar Sink Service Sink
Garbage Disposal
Switch
Bathtub Sewer Cap
Generator: Size
Temporary Work With t
Clarifier Sewer Co ion
Meter ❑ up 200 amps
Meter veer 200 amps
Tansformer
Size
Dishwasher S
- prinking Fountain lar Collector
mig4mve
Trash Compactor
-I Floor Drain Solar Maine
Gas Service
Gas System
ZS.rny
Reinspection Fee
Boiler
putt—Undergrounc
Duct—Structural
Duct—Ventilating
Exhaust System ❑
Fan
Fire Damper
IDriver a License or Social Security N: I I Reinspection Fee
-,� 086548 rev 101119 White - Building; Gran - Code Enf vVemnent; Canary - Apptimm;,p; .-.o----_., -awn.avpg ; Assessor -_
Solar Tank
Reinspection Fee
1 $30 1 Icaue Fee
1 $15
Swimming Pool w/Spe
at Toilet
DEVELOPMENT SERVICES REQUIREMENTS::
Zoning Approved By
Building Approved By
Application Issued By
11�
Date
Date
Date
Urinal(/s-�-r
r
Wash Basin
Washing Machine
Water Heater
Water Service
SUMMARY OF FEES
&
BUILDING PERMIT $ Z I MECHANICAL $
PLAN CHECK $ PLAN CHECK 25%•S
PLUMBING $ SMTP $ J V
PLAN CHECK 25% $ I •-'�� GRADING $
ELECTRICAL _
PLAN C TOTAL FEE
o—S $ V
CITY OF COSTA MESA —
$30 Issue Fee S 3
MECHANICAL - FEES
Heating System & Ducting
❑ 0-100000 BTU 100,000 SRU a
Hoodo YPI 1 116,S
py Types 11 ❑
tiple ❑ Refrigeration System
❑ 0100,000 BTU . ❑ ioO000 BTU ♦
System Repair/Alteration
N
$30 Issue Fee S15
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CONSTRUCTION AND PLANNI,
APPROVALS Permit #
Date
Inspector
WL & SPA
APPROVALS Permit #
Date
Inspector
t. Temporary Electrical Service or Pole
52. Pool & Equipment Location
2., Soii'Pipe-Undrgrnd.
53. Steel Reinforcement
�
l-
3, Electrical Conduit Utility-Undrgrnd.
54. Forms '
4 'Electr�cal Conduit-Undrgrnd.
55. Electrical Bonding '
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Elec)rical LIFER Grnd.
57. APPROVAL TO COVE R-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
r;%r
l 8. Foundation
t
59. Gas Pipe, 0 Undrgrnd., Test
. Water,Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0 Undrg�nd.
%
�A'
10. Structural Floor System
61. APPROVAL TO DECK ••'�
i
11. Property Sewer Line &House Connection
62. Backwash & ,leceptor-Final
12. Sewer Cap
63. Heater & Vent -Final ✓'
'-r
- 13.,Roof/Drains
64. Plumbing System - Final
114. Rough Plumbing
65. Electrical -Final
15. Rjugh 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
'j
FIRE DEPT: REQUIREMENT
APPROVALS ifPermit#
f,
i
20. RoughFactoryiFireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping El Gas 00i1
23. Gas Pipe-Rougli & Test
• j7'
72. Underground Flush
-24. RoofFraming4
73: Undergrnd. Storage Tank 0 Gas 0Oil
-25'. Roof Sheathing
0
.14. Overhead Hydro
26. T -Bar CeilingflStructural) & Monocoat
' /
75. Dry Chemical
27. Frame and Flashing
`�'
76. Dry Standpipe
28. Lathing &.Siding
77. FIXED SYSTEM FINAL
29. Insulation,
1.r
78. FIRE PREV. FINAL
30. Drywall Nailirig'
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat .�,%
79. FINAL INSPECTION
32. Electrical Powei7Meter-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
i
38. Final Plumbing
r
- -
39. Water Service -Final
40. Gas Service -Final
41. Solar Domestic-Finalr
•� `'
r
42. BackflowPreventer�l
r
'f
43. Backflow Irrigation
,•
.. �r�' '
44. Landscape Irrigation System
r
,
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
'