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ADDRESS OF BUILDING: 2519 VASSAR PL DMT: CITY OF COSTA MESA — BUILDING PERMIT
'"t CWNEWSHOE IFMOWN: FORD, LYDIA
ADDRESS 2519 VASSAR PL PERM NO: B 076302
rt� COOSTA7MESA, CA 92626 PERMIT NO: B 076302 PLAN CHECK NO: N GOVT: N SUPP: N
APPL.MMUNO ADORES& CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : T/OFF & RE—ROOF W/COMP SHINGLES SQ FT: 4 , 000
ARCH.OR ENG.'S ADDRESS: UfIT:
CLAIM VALUE: 4, 000 . 00 CALC—VALUE: 4 ,000 . 00 GROUP OCC : R-3 /
CONTRACTOR'SNAKE: LEE ROOFING OF COSTA MESA ( 714 ) 642-7223
CONTRACTORSMNUNO 1653 SUPERIOR COMMENTS : REROOF RESIDENCE W/COMP SHINGLES
ADDRESS: COSTA MESA CA uc.NO.: 349686 *********+t********* stat ***it+E+t+ESE+ *x****rt**+E********N+t+E*+E+E**+I *****************
92627 wit Z ON ING R EQUIREMEN TS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Dhvisbn 3 of the Business and Professions Cade,and my license is In lull lea and anted.
CITY LIG.NO.: 028751 LIG.CLASS: C-39 Lt.NO.: 349686 EXP: 03/96 MAIN BUILDING ACCESSORY BUILDING
Date: i��0/Qtv Contractor: (I. I,L FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the
fofbw'eg reason(Section 7031.5 Business end Professions Code:Any city or aunty which requires peri to construct,alter,Improve, PARKING REQ: PROV: PARCEL : 00000000 ZNE: REF NO:
vmolbh,or repo any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she
licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> IC
.usiness and Professions Code]or that he or she is exempt therefrom end the basis for the alleged exemption.My violation of Section >
7031.5 by any applicant for a permit subjects the applicant toacivil penalty of not more than tNe hundred doftan IS5001). *******************************************************************************
❑ I.as owneroftMpopenyormyempbyeeswithwagesastheielecompensation,willdothework,andthe'wcturebnotintended D E V E;1L OP MENT SERVICES R EQUIR E M E N ,T S
or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property
who Wads or improves thereon,end who does such work Nmself 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 S sold within one yew of completion,the ZONING APPROVED BY DATE :
owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale).
❑ I,a owner d the property.am exclusively contracting with licensed contractors to construct the project(Section 7044.Business and
Professions Code:The Contractors License Law does napply to an owner of property who builds or improves thereon and who BUILDING APPROVED B Y DATE: -
not
for such projects with a contractor(s)licensed pursuant to the Contractors License Law).
❑ I am exempt under Section: B.A P.C..for this reason: APPLICATION ISSUED BY: �— DATE: -2— ':0 'H
.
Date: Owner: ********************************************* ****************** **
LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that I am aware of end understand the requirements of California Health end Safety Code Saviors 25505,p5rn3,and
25534.and that I or any More building occupant will/wit not(circb one)need to corn*with said state codes and the requirements for
.,e permit or modification from the Ai-O y anagement District.Residential construction applications are exemptmm Uwe
tifBLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. consPERMIT 63 . 00 . 50
Date: Applicant: S M I P/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: I SSU 'T
IUILE FEE
❑ ghave end wiAmaintain ccertificate dconahtmseBpennarsmsuedicompensation,eprovided labySed'wn3)OOdthe Labor BUILDING—DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Code,la the performance of the work for which this permit is issued.
❑ Ihave and wilSection aof
performance TOTALS > 63 . 50 0 . 00 0'. 00 63 . 50 63 . 50 . 00
work for which this permit is issued.My workers'compensation insurance canter and policy number are:
Carrier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 63 . 50 OVER/SHORT: .00
Policy Number: 1300948-95 06/30/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
,This section need not be completed i the permit is for one hundred dollars(Sf001 or less.) 63 . 00 . 50
❑ I certify the,in the performance d the work for which this permit is issued.I shall not employ any person in any manner so es to rt
become subject to the workers'compensation laws of California, and agree that B I should become subject to the workers' *******************************************************************************
compensation provisions of Section 3700 of the Labor Code.I shall f hwnh comply with tit provisions
y Date: a �I9� Applicaci �c (Q I N D I V I D U A L F E E B R E A K D O W N
Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to edMnal penalties and TYPE QTY D E S C R I P T I O N, _ UNIT COST TOTAL COST
civil Anes up to one hundred thousand dollars(5v040001 In addition to the cost of compensation,damage as provided for In
Section 3706 of the Labor Code,Interest,and afoomey'slees SFR 4000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 4 , 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally or perjury that there is a construction lending agency for the END OF FEES
performance of the work for which IM permit is issued(Section 3097,Civ.C). -
,{
LENDER'S NAME: .
LENDER'S ADDRESS:
I certify that I have read this application end date that the above information is correct.I agree to comply with all city and county ordinances
and stale laws relating to buildup construction and hereby authorize representatives of this city to enter upon the above-mentioned property s_I
for inspection purposes.
Sm2INft r1181;1D71SaM€R af}PtS R V° .
0a:::41.-->k
1 Prm e
c z/2. C U Date. al mf 9l0 01 0019 95I_c[1,gy54 TOT b: SJ
Signature of Owner/Agent/Applicant/Contractor 04TE: 02/O6/Cr TIME.
C3:3L
(5151.46,WP) White-Building&Safety:Green-Fle:Canary-Appldun:Pink-Revenue;Goldenrod-Assessor
•
I t. __ 1. ,
0 , -f .. -.
• . CONSTRUCTION AND PLANNING POO. .;PA
APPROVALS Permit# Date Inspector APPROVALS Permit# DateI�spector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ti- !
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement
3: Electrical Conduit.Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd:
8: Foundation • - - 59. Gas Pipe, 0 Undrgrnd.,Test _
• 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Ur drgrnd.
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. POOUSPA SYSTEMS FINAL •
19. Rough Heating & Air Conditioning _ FIRE DEPT-,REOUIREMENT
20. Rough Factory.Fireplace - 'APPROVALS . _ Permit#
21. Ducts, in Structure = 70. Underground Hydro -
22. Ducts, Ventilating s - , ` 71. Product Piping OGas 0Oil
23. Gas Pipe-Rough & Test Y _ _ 72. Underground Flush . - _
.:
24. Roof Framing : " 73.. Undergrnd.Storage Tank 0 Gas 0 Oil
25. RoofSheathing 2^7-cC2 6ei 747- Overhead Hydro _ •
26. T-Bar Ceiling (Structurals & Mon6coat 75, Dry Chemical -. -
27. Frame and Flashing i - - 76. Dry Standpipe
28. Lathing & Siding = . ' ' - _ • 77.- FIXED SYSTEM.FINAL .
29. Insulation - e _ •• 781 FIRE PREY. FINAL
30. Drywall Nailing - , -. HEALTH,DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION.
32. Electrical Power Meter-Final • • '80.,FOOD CERTIFICATE ISSUED. -
33. Final Electrics Notes: -c_ - . - J
34. Final Heating& FIJI. Conditioning ' /IP73//?j . =- �.d•� 2. 7 ' ca.A 4G.^
35. Final Gas Pipe-Test, /o%1/(i'/�4 =- / -" e
36. Hood or Canopy v; ' - . .- ` • -
37. Final Factory Fireplace - . _ . ..
38. Final Plumbing -
39. Water Service-Final , .,. •. -
40. Gas Service-Final i. _.
41. Solar Domestic-Final - -
42. Backflow Preventer -
43. Backflow Irrigation ' - " .
44. Landscape Irrigation System •_ `
r _
45. Sound Attenuation - y
•
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /47./7., ' u//( _ _
48. FINAL PLANNING - - - -
•
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
Si. CERTIFICATE OF OCCUPANCY r .
No Date
- - _ _ _- _Applicant to fill in all spaces except Those within heavy border lines and sign all appropriate declarations. - - _ •
-
CITY OFSOSTAIME�$A /�CONS�T�R•U�CTI N,PERMIT P/E�RMIT NO.q _ TRACT NO. LOT NO. :UNIT NO. •
• ProiectAddress 4�] 1 -1 VN�it F—. R 3► ► / s' • .
Applicant's Mallin Addre TYPE OF CONSTRUCTION U NEW U ADD H ALTERATION XI REPAIR • -- IL
n s15 • ❑ CONVERSION El DEMOLISH El OTHER A.P.# - • -'- . Zone - va•..a
• Owner's Name FO K.I.'1 Phone DESCRIPTION OF WORK/USE OF BLDG. •
Address Q.S•1 C UASS 2g— S Main Building: 'Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT . ElGRADING ❑ FOUNDATION ❑ STRUCTURAL -T Front 0
Address ❑ OTHERT ❑ ELECTRICAL PLUMBING CI MECHANICAL B Rear I N
• Contractor's Nam' o 1k S rPhoneb�a' � C Right N
ll rs 1� A`` PROJECT DESCRIPTION SQ. FT. • OCCUPANCY K Left '
Address(mailing) I1 �+�/YlS AVS �`—P^'�Q CON STRUCTION TYPE VALUATION $ S R
City License No. •Il ZONE GRADING CU.YDS. ACRES Ping. Ref.# , Parking Req./Provided . • E
LICENSED CONTRACTOR DECLARATION - _ Q
• 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
-
mYlicensei SII f•.ce pntl effect. • '�+7' ., T
. :. _ S
Licen Cies I`i ig `'e� =n_se_Na-f�1 6 U PLUMBING " FEES
a, Date �t, Signature
WORKERS'COMPENSATION DEQ' ARATION Bar Sink. Showers -
I hereby affirm that.1 have a certificate of consent to self-insure or a certificate - - ELECTRICAL - FEES
if Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink •
3800, Lab. C-) Automatic Washer Transformer 0 15-50 KW' - •
Policy No. Company I Backflow Irrigation Sewer.Ca - • -
❑ 50+ KW
P Construction Pole Sub.
Certified copy is hereby furnished. '
— Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps•
Date • Applicant
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps
(This section need not be completed If the permit is for one hundred ($100) or •
r. less). Dishwasher Solar Piping Dryers ❑Gas DElectric - • Sub Panel
I certify that in the performance of the work or which this permit is issued, I - .
snail not Co employ anyperson in any m�sRer as to come subject to the Drinking Fountains Solar Tank - - _. Fan —
Workers Com nsat' ws of Califor(I\i/#J- Motors❑0-1 HP ❑1'h-8
Date Signature Floor Drains SwimmingPool w/Spa
NOTICE: If,after making this declaration you should become subject to the — _ p F.A.U. Inc.Solar ❑9-15 HP 016-15+
• Workers' Compensation provisions of the Labor-Code, you must forthwith Floor Sinks
comply with such provisions or this permit shall be deemed revoked. • Urinal Fixtures •
Microwave
CONSTRUCTION LENDING AGENCY .:- •"1 Gas Service Outlets Water Closet r
I hereby affirm that there is a construction lending agency for the performance d5 Device Boxes Pole Light
of the work for which this permit is issued (Section 3097. Civ. C.)
Interceptors Water Heater Outlets Range
Lender's Name 9
•
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 L.5 Lavatories Auto-Wash Garbage Disposal Standing Sections '
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,Improve,demolish or repair 4,, P—Trap Laundry Trays Generator ❑0-5 KW ❑5'15 KW
any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor
to file a signed statement that he/she is licensed pursuant to the-provisions of .----; Drains
the Contractor's License Law (Chapter 9(commencing with,Section 7000) of _ • -
Division 3 of the Business and Professions Code) or that he/she is exempt
floret rem and the basis for the alleged exemption. Any violation of Section .
031.5 by any applicant for a permit subjects the applicant to a civil - '
enalty of not more than five hundred dollars($500).as owner of the property or my employees with wages as their sole Reinspection Fee I $15 . Issue Fee $ 3
compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 •
for sale (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 '
prove for the purpose of sale). Building Approved By ••
/,/Qj,1�� Date If Ci1
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By y- — Date !Q
tractors to construct the project (Section 7044,Business and Professions Code: '
The Contractor's License Law does not apply.to an owner of property who Duct-Ventilating - 00-100,000 BTU ❑100,000 BTU 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 thatBUILDING PERMIT •$ SMIP $
proof of their Worker's Compensation insurance should be.provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ _ PERMIT
'❑ am exempt under Section ,B.& P.•C.for this reason Firepl/Fact.BIt. ICBG# . Fire Dampers - PLUMBING $ S ISSUANCE $
-.
Date owo-r - Heating System& Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. $ -
I hereby certify .t I a .-r ad this application and state that the above 0o-100;000 BTU ❑100,000 BTL . ELECTRICAL - $ GRADING $ -
information Is co ed. I •gr-e .• .mply.with all city and county ordinances •
and state). .s re -ti g o b II.i.g construction, and hereby authorize repr - PLAN CHECK 50% $ MICROFILM $
sentatives •f thi- n I h pon the above-mentioned pert •
�•
inspection . r..U: MECHANICAL $ • TOTAL FEE $ , U
Signature �! 1 tr. Date �u Reinspection Fee $15 Issue Fee • $ 3' PLAN CHECK 25% $
r i^Drivers' Licens: or SS . /)` —_ '
CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND:PLANNING POOL & SPA - .
APPROVALS Permit# Date Inspector APPROVALS • Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location l
i
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. Footings58. Electrical Conduit-Undrgrnd.
8. Foundation J 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 Drains64. 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 & Siding77. 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 /(.(q-y7 tf O -
36. Hood or Canopy
37.;Final Factory Fireplace t .
. 38. Final Plumbing I(-(t 4'7 L44p -
39. Water Service-Final
40. Gas Service-Final - • - .
.
I41. Solar Domestic-Final _
.
, 42. Backflow Preventer •
43. Backflow Irrigation ; . r -
.-=-04. .Landscape Irrigation System •- � , -
. 45. Sound Attenuation - --
46. Handicap Regulations I •
47. FINAL STRUCTURE & BUILDING - - ' • ,
48;.Special Requirements Completed '
49.. Electric Release to Edison
50. Gas Release to Southern California Gas Co -- f
J
51. CERTIFICATE OF OCCUPANCY . - +-�
No. Date
JOC q 9 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' r
CITY OF COSTA MESA . ,CONSTRUCTION PERMIT FRIT O. TRACT NO. LOT NO. UNIT NO. •
- Project Address '�'tq IL /� - - -
TYPE OF CONSTRUCTION ❑ NEW U ADD Li ALTERATION LJ REPAIR - nag/. In/P' /OE _ n nn L
Applicant's Mailing Address -?•-1 ' ��/ ❑ CONVERSION' ❑ DEMOLISH '❑ OTHER- _
A.P.# - I Zone
Q owner's Name l�e-da�(¢�',',7p - Phone •' ""/�' DESCRIPTION OF WORK/USE OF BLDG.
v Address 7�z q tfAc.=�Y�L_FL, _ - - S Main Building: ' • Accessory Building: -
OQ Arch/Eng.' ' License No. TYPE OF PERMIT ❑ GRADING- DI FOUNDATION(, ❑ STRUCTURAL T Front ZO
1 •
Address �•� .- �❑ TENANT '❑ ELECTRICAL ❑ PLUMBING ,VAI MECHANICAL B •
Rear ' N
-
Contractor's Name 47A 46 �j/1pS , Phone -i-!o•3 ❑ OTHER - •
C Right - N
PROJECT DESCRIPTION SQ. FT. OCCUPANCY
(W Address(mailing) 7c1�1.- C.�✓{. yt*?-`'� �Ft., CONST RUCTION TYPE - ,VALUATION K Left ' G
City License-No. 59(,3• 1' ZONE GRADING CU.YDS. -ACRES Ping. Ref. # Par king•Req./Provided E'
LICENSEO.CONTRACTOR DECLARATION Q
•
•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 - • - - " T
my license is in full force and effect. .
License lass Lipe� N • -
Date Signature �f .C/� ' PLUMBING FEES •
WORK R COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL • FEES'
I hereby affirm that I have a certificate of consent to self-insure or a certificate
,f Workers' ComAlitiensation Insurance„ or a certified copy thereof (Section Backflow Preventer Service$ink
1800, Lab-- - - - - - - . .. - - • Automatic•Washer : - - • •Transformer ❑'15-50-KW- : -•
Policy No. O7r1/37F Company • ' J •- L, 9—ti. Backflow Irrigation •
Sewer Cap0 50+KW
iCertified copy is hereby furnished- - - Construction Pole Sub.
Certi/ned io is filed with the city Bu4dln/Div -. I Bathtubs Sewer Connection �- Cooking Unit Meter Cup to 100 amps
• Databa./7/a- ' APplican ti/ , _ —.
EXEMPTION FROM WORKERS'COM-ENSATION DEC LA'1^ Clarifiers Soler Collectors Dishwasher - Meter 'Cover 100 amps .•
(Thissection need not be completed if the permit is for one hundred ($100).or - -
less). Dishwasher : Solar Piping - -, Dryers ❑Gas DElectric Sub Panel '
I certify that in the performance of the work for which this permit is issued, I - - - - - -- - • --- - - -
shall not employ any person in any manner so as to become subject to the Drinking Fountains , Solar Tank Fan - 1
Motors❑0-1 HP ❑1%-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 - a
Workers' Compensation provisions of the Labor Code, you must forthwith (Floor Sinks Urinal - '
comply-'with such provisions or this permit shall be deemed revoked. - . . . . - - - Fixtures Microwave - - - -
CONSTRUCTION LENDING AGENCY Gas Service Outlets - • Water Closet - Device Boxes Pole I
I hereby affirm that ttiere is a construction lending agency for-the performance - - Light
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors _ Water Heater - - Outlets •
Lender's Name - .. Range ,
Lender's1Address - - - Kitchen.Sink. . -Water Service • Switches Sign - j
OWNER BUILDER DECLARATION
I hereby affirm that I am.exempt from the Contractor's License Law for the Lavatories Auto-WashGarbage Disposal • ;Standing Sections .
following reason (Section 7031.5 Business and Professional Code: Any city or - • ' ' . - . _.
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 - P
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains .
the Contractor's License Law(Chapter 9 (commencing with Section 7000) of - . -
.Division 3 of the Business and Professions Code) or that he/she is exempt _ - ,
'therefrom-and the basis for-the alleged exemption. Any violation of Section • - - , ' . I '
'031.5 by.any applicant for a. permit subjects the applicant..to a civil . _ -
LIenalty of not more than five hundred dollars ($500). ' I - '
I, as owner of the property'or my employees with wages as their sole Reinspection Fee 1 $15 Issue Fee- - $'3 ,
compensation, will do the work, and the structure isnot intended or offered III - 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, piovided that such improvements are not intended or ottered'for Boiler _ Hood or Type I ❑ ,
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date
pletion, the owner.will have the burden of proving he/she did not build orim- ' Duct-Under GroundBuilding Approved BY Date
prove-for the purpose of sale). — - -
o I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' Refrigeration System • Application Issued By --le,rf
Date A/-t�
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 - ❑0-100,000 BTU ❑100,000 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 ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ ' •
proof of their Worker,s Compensation insurance should be provided to me.' - - PLAN CHECK $ PERMIT
rsgi
❑ 'I a in exempt under Section B. & P.C.for this reason Firepl/Fact.Bt. ICBG# Fire Dampers, PLUMBING $ -ISSUANCE $
Date • •
- Owner - - Heating System& Ducting Registers 44_a PLAN CHECK 25%•
$ ENERGY P.C. $ • I '
I hereby certify that I have read this application•arid state that the above I_ K0-100,000 BTU 0100,000 BTL ELECTRICAL GRADING . $ '
information is correct. I agree to comply with all city and county ordinances - - $
and state laws relating to building onstruction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city t -nter '(pon the above-mentioned pr per y for pa ,
inspection purpoSCS' /A/ / - •
Signature ... .• �.. y/f Date/0 7 MECHANICAL $ 7�
�OTAL FEE ' $ r
Drivers' License or'SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25%' $ _
a
CMF 0865-46,rev.10/84 White = Building: Canary --Applicant; Pink--Accounting; Goldenrod - Assessor . -
.CONSTRUCTION AND PLANNING POG" SPA
APPROVALS - Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
'2. -Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3.,Electrical Conduit.Utility-Undrgrnd. 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE .
•
7. Footings - 58. Electrical Conduit-Undrgrnd. .
•
8: Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System . 61. APPROVAL TO DECK
11. Property sewer Line & House Connection 62. Backwash & Receptor-Final
.12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains - 64. Plumbing System - Final •
14. Rough Plumbing - 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final . .
16: Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
• 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
• 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 •
l
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 /( �5 79
35. Final Gas Pipe-Test �L •
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 t
44. _Landscape Irrigation System i 1,
45. Sound Attenuation - I , •
46. Handicap Regulations
•
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
l
49. Electric Release to Edison -
50. Gas Release to Southern California GasOo •
1 .
51. CERTIFICATE OF OCCUPANCY
No. Date -
:A •
9029 iiEE RECEIVED
COSTA MESA BUILDING DEPARTMENT vC�ytn,APR 21 1959
P.O. BOX 317 FINANCE DEPT.
COSTA MESA. CALIFORNIA
OF
FOR APPLICANT TO FILL IN APPLICATIONOSTA FORFSA PERMIT
ADDRESS 2519 Vassar Place . BUILDING •
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO.
OWNER Brown Homes, Inc. ?e19 9
MAIL RECEIVED_BY-' / DATE RECEIVED , DATE ISSUED
ADDRESS 1555 P)acenti a i""l 0—/SL JY
7 ' 2.).-.3
CITY Newport Beach, Cal. TEL. MI 6-3227 BUILDIN
ARC
JEER Same N
ORO. COSTA MESA. CALIFORNIA
FIRE
ADDRESS same ZONE
R W Koll Const. Co. CITY LIC 1217 >ONG.� NO.LNS TYPE GROUP
CON rRAC?OR NO. K7� ex
ADDRESS same TNO. sameEL. BVPROVED DATE
LEGAL LOTCORRECTIONS
DESCRIPTION NO. 16 BLOCK TRACT 2882
A.P.NO.
SIZE X 102 NO.OF BLOCS. O
OF LOT 60 NOW ON LOT
USE OF C
EXISTING BLDG. '
SETBACK LINE FROM _
CENTER OF STREET 50 REAR YARD 27
SIDE YARD RIGHT 5 LEFT 5 •
DESCRIPTION OF WORK -
NE X ALTERATION ADDITION
REPAIR MOVING DEMOLISH '
SIZIE DING1Gr/I—T30 ROOMS 6 STORIES 1
•
EXTERIOR WAL 4 ROOF t
COVERING SR.11CCO COVERING hot—mopned
USE OF NEW
BUILDING residence and att. garage
Plan 2—BR
The Amount shown under valuation Is for the
I HEREBY ACKNOWLEDGE.THAT I'HAVE READ THIS APPLICATION AND •
STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL purpose of establishing a permit fee only.
CITY ORDINANCES D STATE LAWS REGULATING BUILDING CONSTRUG
noN. `i�%J29_�-'/G VALUATION PERMIT FEE $ 35.00
SIGNATURE OF
PERMITTEE 50
$ 515,622.00 PLAN CHECK 17.50
AUTHORIZED GENT (TOTAL FEE $ 52.50 NB
.-,
OWNER Thu glas McHniget DATE 9/1) 9
JOB ADDRESS 2519 Vassar Pl - BUILDING PERMIT NO. 10371
GENERAL CONTRACTOR Admiral-Bilt Construction VALUE $ 232.00
AP. No. LOT 16 TRACT 2882 FIRE ZONE DESCRIPTION OF WORK Blockwall
I' 'ECTIONS DATE GROUP TYPE ZONE Rl
i-ground Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED
Underground Gas DATE NUMBER
Overhead Water and Gas
Rough Heating
Rough Plumbing
Miscellaneous
Prop. Swr. Line House Con. St. Swr,
Sprinkling System
Heating, Final
Plumbing Fixtures
Final Gas Test
Construction Pole _
Underground Power
Rough Wiring
Trenches( Forms Steelfl'1311-
Floor System
Steel Reinforce Chimney Re-Rod _
Bond Beam
Shonthing
and Flashing
L .,g, In Out
Plaster, brown coat —
Plumbing Fixtures, Final
Electric Fixtures, Final -
Building, Final
OCCUPANCY }/amu GGlsL LLo Pte/ J'%/!_, A/1�etN
Form 210-3M-4-59 4, Com' 10371
r 1®371 FE
RECE1�E®
COSTA MESA BUILDING-SAFETY DEPARTMENT GG(. y "1 )7
P.O.BOX 317 COSTA MESA. CALIFORNIA ` kata �E�•
FOR APPLICANT TO FILL IN*COMPLETELY APPLICAI'IiION FORT PERMIT
TYPE OR PRINT BUILDING
BUILDING cj V CS e e 'PL. •
ADDRESS a. 51 �//i J '1 F- 1'
COSTA MESA, CALIFORNIA FOR OFF/CE USE ONLY
OWNERRECEIPT NO. I PERMIT NO.
�OV Gi.AS Ni� j�N , Gr+r (fThnI-.Y7
MAIL -Si1 /'ASS A(t '�L. ,•. RECEIVF.p.BY DATFyN^���E.O J�GATE/I-SUED
ADDRESS 1 {� A �jr/� /—// T`.�I{ 9-,y,,57
EL.
CITY L=CS IA ME-Sq NO. ADDRESSe-AV�
S/9 lJcssti
A&,'�'g"aiECT LIG..
NO. 'COSTA MESA. CALIFORNIA
On'o"`="INFER
FIRE
ADDRESS
��� .� ZONE TYPE GROUP
•CONTRACTOR iRA 1.-- Bi LT CO NJFRIC.NO. ( 573W APPROVED DATE
ADDRESS I'iIµ W - 5 ST- SAAIr`A LAA A ^ ZONING •
LEGAL I LOT la - O V 1 ZONE ,f ' I NO.OF �I USE OF NEW A ,
DESCRIPTION NO. ' BLOCK TRACT r, PLAN/E7 BUILDING �/JJ- W/ L//�//'
A.P.NO. • APP { i// . !c/
BY i f/' DATE / �J�
E /`6 i-f i
SIZNO.OF BLDGS. YARDS •y EVES
OF LOT 1` Q NOW ON LOT REQUIRED ALLOWED
USE OF (CENTER LINE ST.)
EXISTING BLDG. FRONT JZF7r. IN,
SETBACK LINE FROM
CENTER OF STREET REAR YARD R.SIDE FT, /O S�IN.
SIDE YARD I LEFT I RIGHT L.SIDE FT, L/IN.
DESCRIPTION OF WORK REAR FT. IN.
1‘
N / , I ALTERATION I II ADDITION
REPAIR I I MOVING - I DEMOLISH I
BUILDING NO.OF
SIZE . ROOMS STORIES
EXTERIOR WALL 1 I ROOF
COVERING COVERING
USE F BUI AND WORK TOB F
X S%L f'8 Ai'
8/.t.01 FC&CC .
,tN X jr4X S %,. ii , -6' M.
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION
AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. THE AMOUNT SHOWN UNDER VALUATION IS FOR THE
PLY WITH ALL CITY ORDINANCES A D STATE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
BUILDING CONSTR(}C�TION. VALUATION n
SIGNATURE OF 1 ilfl ll. 1 30v-
5
PERMIT FEE $ pC
PERM ITTEE V �1 '��
c o✓(�
$ PLAN CHECK $
AUTHORIZED AGENT TOTAL FEE $ e"----