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HomeMy WebLinkAbout266 15TH ST - Building PermitsCITY OF COSTA MESA ' 9 E BUILDING DIVISION F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. 608-00122 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93780028 DATE ISSUED: 04/14/2008 ISSUED BY: RMD JOB ADDRESS: 366 E 15TH ST CM Suite/Unit: Vicinity: HOUSE AND GARGE Squares: 5000 Valuation: $8,800.00 SCOPE OF WORK: TEAR OFF (E) ROOF MATERIALS, INSTALL A MINIMUM OF 1 LAYER OF 30# FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 30 YEAR TIMBERLINE COMP SHINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 50 SQUARES. REPAIR AND REPLACE SHEATING AS NEEDED. - OWNER: MELUM, TONY Address: P O BOX858Unit: PHONE: City/State/Zip: BALBOA, CA APPLICANT: LEHMAN, JEFF PHONE: 949-646-3571.,; . CONTRACTOR: J S L ROOFING INC Address: 2415 MARGARET DRUnit: City/Slate/Zip: NEWPORT BEACH, CA 92663 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: TOTALFEES $0.00 $167.25 $0.00 $167.25 Address: 2415 MARGARET DR. Unit: City/State/Zip: NEWPORT BEACH CA : A, = License No. 747706 , PHONE: 949-646-3671 CELL: License No. PHONE: License No. PHONE: 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE 1. INSPECTION TYPE PRENITMALS ODE/ INSPECTION 7YPE DATE INTmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof Z 3—gyp Z—k14/210 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 WORKERS' COMPENSATION DECLARATIO. 1 herepy 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 theperformanceof the work for which this numb is issued.My workers' comp tion durance Cartier and policy number are: T/7/N 7/`/C Car err. (Tea sedan needrwr De canpleled/foe ptrrrM u rdhied of one evndred cu6ars (5100) a fess) Policy Number ❑ 1 hat inin terformance of the work for which this permit is issued, I sha not empl any person in any manner so as to become subject to the rs' tom salion laws of Califomia, antl agree that if I should be lett to a workers' compensation provisions of Section 3700 of the Ld O moo/ , 1,6pfall forthwith comply wrath these provisions. ,�/%J io/el /i%, -- O 2� TT /T'! hra _nTs Signature Dale ftl0#43: FBtiLURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS 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 ffectt.. -Lica# B D Class #� 71 Trac is Signature Y CO;T 9bya NDING AGENCY: ❑ I hemirm 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 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, 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.). ❑ 1, 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 contactor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature 305716 (3/071 Date Owner ID verified by di Driver's License No. tics ❑ Yes ❑ No Expires: 41 Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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. vrill be mom than thirty -silt (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Appliparfs Signature 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 ❑ No (Section 25505 of the California Health and Safely 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 ❑ No (Section 25533 of the California Health and Safety Code. with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of this application a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? []Yes ❑ No (if 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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. CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and slate that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not occupy or allow occupancy of any building authorized by this pe, it until fi inspection. 17 Si j of Legal n s) Date f �^ AppLcant Date < Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CON T UCTION P RMIT Z Xroject Address (0 6 � h f Applicant's Mail i-ngQAddress s.sv9%''fQi Owner's Name +�r% "�GW-� Phone �dtlress 2-6(. St I Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) City License No. LI NSED CONTRACTOR DECLARATION I hereb at I am licensed under provislons of Charter 9 (commencing With n f the Business d P -ane my license Is In full force and effect License Class -� I Date � Signature WORKERS' COMPENSATION DECLARATION 0bey affirm that I have a certificate of consent to self -insure or a certificate orkers' Compensation Insurance, or a certified copy thereof (Section , Lab. C.) Policy No. Company ' eCertified copy is hereby furnished. . S Certified copy is filed with the city Building Division. Dale 'Applicant - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if 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�O as to become suWect to the WOr kers' o Tel n -Laws of CallfOrniay Date Signature �� S Oa9^`� NOTICE: f, mpe making this ions f the you should becomeustfsubject to the Workers' Compensation ipro provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a is permit s issue agency for the performance Of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of 'the Contractor's License Law (Chapter 9 (commencing with Section 7000) of on 3 of the Business and Professions Code) or that he/she is exempt '� rom and the basis for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil malty of not more than five hundred dollars ($500). 1, as owner of the property or my employees With wages as their sole cont pensali0n, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who tloes 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 com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of Sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such omiects with acon- tractor(S1 license pursuant to the Contractor's License Law),I am aware that proof of! their Worker's Compensation insurance should be providetl to me. ISI,�ram exempt under Section 7 O y� B. & P. C. for this reason 'ate Owner I hereby erti/y that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize repre- sentatives of this cty to enter upO the above-mentioned Prot for Inspection purpos 7 �i !1' Sionature `0865-46, rev. 5/88 White - Building; Canary - Applicant: Pink - ACCO tin O.v. rsi v TYPE OF CONSTRUCTION INNEW LJ ADD LJ ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIP NOF WORK/USE BLDG. _4'4 oVe-I—!OKv ca &- G e Ira- s 0 TYPE OF PERMIT IJ GRADING LJ FoUNDATIOX LX5Th4JCT ❑ TENANT ❑ ELECTRI ❑ -OTHER G14r• 110 PROJECT DESCRIPTION SO. CONSTRUCTION TYPE— ZONE— Remarks: YPE_ZONERemarks: Bar Sink Backflow Preventer Backflow Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee LwN VALUATIOk$ GRADINGCU.YDS. AC $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting 110100,000 BTU ❑ 100,000 BT Reinspection Fee 1 $15 Goldenrod - Assessor Showers Service Sink. Sewer Cap �• Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater 1V A.P. q� U l/ci - I % I ^ Zone 'KL 1 $15 1 1 Issue Fee S Main Building: Accessory Building: /� 37 net Date Dat - Issue Fee REPAIR E` T Front 10, Q d-wx-p_ Z O ('✓ A Rear I $ Re 9D $ $ $ $ $ � G Refrigeration System ❑0-100,00013TU 0100,000BT System Repair/Alteration N Fire Dampers C Right / Registers 'f N RAL K Left CJ G R E Ping. Ref. # Parking Reg./Provided o Planning Notes: P�— — g $ 3 O ^1 /ZVA T � E TS 38 ELECTRICAL FEES ' FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100amps Dryers ❑Ga ❑Electric Sub Panel Fan Motors E10-1 HP ❑ 1'h - B F.A.U. Inc.Solar 09-15 HP ❑16-15+ Fixtures Microwave Device Boxes - "Pole light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 00-5 KW ❑5-15 KW Trash Compactor Reinspection Fee 1 $15 1 1 Issue Fee $ 3 DEVELOPMENT SERVICES REOUIREM TEDI S.:/L Zoning Approved By-l~"x:- Building Approved By Application Issued By / /� 37 net Date Dat - Issue Fee $ 3 AANICAL FEES Hood or Type I El Canopy Type 11 ❑ BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY F FEE $ 7.37• SD $ $ $ $ $ $ $ SMTP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $ Re 9D $ $ $ $ $ � G Refrigeration System ❑0-100,00013TU 0100,000BT System Repair/Alteration nII , Fire Dampers Registers 'f " - Issue Fee $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PO SPA APPROVALS it # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-U6drgrnd. `4, 54. Forms Electrical/Conduit-Undrgrnd. 755. Electrical Bonding 5. Steel R@inforcement 56, Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7•. Foozings 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 /1 !o �% ,Q' 61. APPROVAL TO DECK 11. Property Sewer Line & House,Con necti on 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. ,Flectrical-T Bar Ceiling, , 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Condition ng FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 2.1.: Ducts, in Struct6re 70. Underground Hydro 22.D,ucts, Ventilafing 71. Product Piping O Gas ❑Oil 23.' Gas Pipe=Rough,&Test ' 72. Underground Flush 24: Roof Foaming• 73. Undergrnd.�� Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing• �+ .0 74. Over IeacFAydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flasking 76. DryStandpipe 28. Lathirig'&;Siding_ .. �� 77. FJP IX7ED SYSTEM FINAL 29. Insulation, 'f• ---- 78. FIH+E PR€V. FINAL 30. Drywall Nailing ,7, 3 RLt � - .HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coaj ` �.• 79. FINAL INSPECTION 32. Elecirical Power -Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Note 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy �%�p- �f 2�(/C� �jr�ywo 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service -Final 4O. Gas Service -Final '41. Solar Domestic -Final - 42. Backflow Preventer 43.' Backflow Irrigation 440 Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . 47. FINALSTRUCTURE & BUILDING 48. Special Requirements Completed 49: Electric Release to Edison , 50. Gas Release to Southern California Gas Co �- 51. CERTIFICATE OF OCCUPANCY No Date •. `a CERTIFICATE OF COMPLIANCE - PAYMENT OF SCHOOL FACILITY FEES NEWPORT -MESA UNIFIED SCHOOL- DISTRICT Developer/Applicant: �f�2ry% �.I: ! TZ e) Address: �( 6 �c� �S ��ti ✓� Telephone Number: t2,3 JZ7�� Tract/Farcel=and_L o_t-Number(s):. Location of Project: .2.66 Number of Square Feet of /� Residential Space /(/_ x $1.50 Total > Number of Square Feet of / O 8' Commercial and Industrial Space x $0.25 Total Commercial/Industrial Project is: (Check One) Mini -storage Movie Theater Racquet/Health Warehouses Heavy Industrial Regional Shops Light Industrial Motel Bank Neighborhood Shops R & D Hotel Medical Office Office Park 1 "r 4/ .2 7, '67'b Preschool Auto Repair Hospital Large Office Office Bldg. Restaurant Fast Food The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995. Checks are to be made payable to Ne ort -Mesa Unified School District. 17,1 %' buWness Manager Newport -Mesa Unified School District The above representation as to square footage is true. Developer/ Applicant agrees that if it is later determined that such representa- tions are not true then this certificate shall automatically terminate and the appropriate City/County shall be notified. Date: 2 !1 d' / t/LfiL ( - � Develope /Applicant jut 19 1989 PROJECT ADDRESS: 266 E 15TH ST OWNER'S NAME: BARRY LOWE ADDRESS: 266 15TH ST #A CM. CA, 92627, ARCHIENGINEER: ADDRESS: REG.NO.: UNIT: A UNIT: PERMITTEE: BARRY LOWE (714)631-8711 ADDRESS: 266 E 15TH ST A CM. CA 92627 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 farce and effect. CITY LIC.: STATE LIC.: CLASS: date'. Signature: PORKERS' COMPENSATION DECLARATION: I ready affirm that I have a certificate of concern to sell -insure or a cendicale of Workers ,ompensation Insuranceor a certified copy in erect (Section 3800, Lab, CL POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is tiled with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is lot one hundred ($100) or less). I county that in the Performance of the work for which INIS permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signalure: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate 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 me applicant for such permit to tile a signed statement that ne/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 Cade) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ly 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 emloyees with wages as their sole compensation, will do the work, and the • `� structure is not intended or offered for sale (SPection 7044, Business and Professional Code: The Contractors' Stale 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. IL however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she dict not build of 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' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). 1 am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ Iexempt under Section: B. 8 P. C. forr this reason. Date: 2'�"' 9/ Owner: I do hereby certify that I am aware of and understand toe requirements of California Health and B ty Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with sat 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. Dale. Applicant: I hereby certify that I have read this application and slate that the above ggginnff��Aormation is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and her ebyaulh representatives of this ciryto er upon the above mentioned property far ins_pecll^o'n�pur�poses. d/ a/✓S/ Date: ��� Signature: Drivers License or Social Security x: 164646 While—Building: Green—Code Enforcement; Canary—Applicant. Pink—Revenue: Goldenrod—Assessor CITY OF'A MESA — BUILDING PERMIT PERM NO: E 05109 PERMIT NO: E 051094 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION RELOCATE ELEC, METER TO BACK OF UNIT "B"/ SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: RE: B49054 PRIMARY BLDG. PERMIT. iE 9E BE Bt Bt 9F Be 1ERE iE * al• BE * * * 9E• iE iE iE iE iE BE RE BE BF BE RE iP PE IP iE iE 9t Bt BE * * iEiE it is * 1E iE it iF * * B6 iE 9f 9F iE BP BE 1f 9F It BE 9t BE Bf iF 9E ie >F BE BF 9F * * iE * aF * iE iE 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 REQ' PROV: PARCEL: 42516104 ZNE: REF NO: PLANNING N TES> > iF iF IF BE iE Rf iE 9t iE BP it Bt iE * IE ie * BE IE iE it * BE * * * iE iE * BE 9f iP * iE Bt * * iE iE iE it IE * * iE if iE BE BE 9E k 3E BE iEiP iE 9E 9F eE 1E Bt iE 1E Bt it iE iE 9t 1E iE iE iE * BE * * BP 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: v DATE, REBFlFBFBEiEiFi(iE9EiEiFiEiE9EiEiEREBE*iEiE iE9E±fiE9FiEkiF*9E i FikHE 3E iFRF 9K RF 9FiE 3F iF Bk BE iE BP BP*iP BE IE ft iERP iE REiE BE 9P**ItiE BP iE 9E iE EE BF lE iE Bt kit BE**BE iE iEBE 9f k9F BE Bt Bf 9f 9K IPBL•iEit It BF kiE *BFil BE B6 iE iE*iF FE 9Ek 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 18,50 503 SMIP/NON—RES ISSUE FEE 4.50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 18,50 4,50 !',"' 0.00 23.00 23.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 23.00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 23.00 Bf * iE if iE il} iE * iE iF if IF 8P k it iE 9E iE iE * BE iE 9t Bf iP iE 9F it if iE BE 8F it iE iE * * iF iE it• 9t * iE BE if * * 9E BE it if Bf 9E IF 9E IE iE iP 4E iE it aP 9P it If BE * * * BE BE iE 3t 3F 9E iE 9f iE I N D I V I D U A I; 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 ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18.50 END OF FEES EXPIRE D DATE�b CONSTRUCTION AND PLANN1imG b SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2.` Soil Pipe-Undrggrnd,_ 53. Steel Reinforcement _3.. Electrical Conduit Utility-Undrgrnd. 54. Forms c 4.Electrical Cond'uiYUndrgrnd. 55. Electrical Bonding &.y$teel Reinforcement 56. Rough Plumbing & Pressure Test _ ' .8. •.Elictrical UFER'Grnd. 57. APPROVAL TO COVER-GUNITE t ` 7._ c.oti ngs 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 Lin ef& House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 'i 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit rP 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:�:t•-Permit #"- 20.,Rough Factory Fireplace ' t+:W .{ -- x 21._Ducis,in-Str'uctuce j70. Underground: Hydro 22. Ducts, Ventilating` -•1!5 _ 'L'•- f s71. ProducirPiping 10Gas 010il 1, 23.,Gas:Piper_ ough &•Test ' n'<` x - w y 72, Underground Flush;. " .r . 24: -Roof Framing -. t? x 573��Undergrna.Storage--.Tank 0Gas 0Oil 25. Roof Sheathing 74,?Overhead Hydro;J- p'... .. .. .r. 26r T -Bar Ceiling (Struotural) & Monocoat " RJ _ n 75 =Dry Chemical n 27 Frame qdl Flashings ° . ,... ,-0`, r 76" Dry Standpipe s.� :_28. Lathing'& Siding; > :. _ c > }. 77G FIXED SYSTEM FINAL x'29. Insulation ,-* •- "' tr I �:. 78sFIRE PREV. FINAL - •> ..{ -� �.} 1 .30. Drywall.Vailing HEALTH DEPT-REQUIREME�(T> •..31. Plaster Brown Coat4, ! • ;� -FINAL INSPECTION a i,.,,, .'��', r79: 32. Electrical Power Mater -Final, ` Y :80:rFOOD CERTIFLCAT.E ISSUED - Electric - ! • r'f' 4-N es: -Chs' -'hocv 533_yFinjl 34. -Final Conditioning.. r 35.=Final Ga's Pipe -Test' �' `` ��^ •- • '• = Hood or -Canopy -37. Final Factory Fireplaces" -38. Final PI uinbing c, 1 '39. Water S&vice-Final. - •• 1 !� '- �!.^• • '= t AO. Gas Service -Final , .. ,r;: _ .r :r• J'� X41. Solar Domestic -Final_' "' 'r = ! '•-Ce 42.`Backflow Preventers - "' R' I 'I• - r - 43. Backflow Irrigation J' :. jS7 A :.44. Landscape Irrigation System, -j: n• - �, _ �.: c' r ^� - ''45__ -Sound Attenuation •-�`.-• ,r r': - - °=�: a 346 .Handicap Regulations •;- : J. •47. -FINAL STRUCTURE &BUILDING 48r FINAL PLANNING LA - 49.:Electric Release to -Edison - `,50._ Gas.Release to Sou4hern California Gas Co I I .f` _ !'• 's . l� '.51. CERTIFICATE OF;OCCUPANCY� No. Date r PROJECT ADDRESS: 266 E 15TH ST UNIT: B OWNER'S NAME: BARRY LOWE ADDRESS: 266 15TH ST 4A CM. CA. 92627 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE:—BARRY LOWE (714)631-8711 ADDRESS: 266 E 15TH ST A CM. CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby alum that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codeand my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: ,XDRHE RS' COMPENSATION DECLARATION: I hereby affirm that I have a cenilicale of consent to sell -insure or a carbonate of Workers' aiompensatmn Insurance, or a certified copy thereof (Section 3800. Lab C). POLICY ND.: EXP. DATE: COMPANY: L7 Cennied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1D0) or less), I eerily 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 became subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3D97, Clv. C). LENDER: ADDRESS: IOWNER 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 Cade: Any city of county which requires a permit to construct, alter, improve, demolish, of 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 Cade) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by my applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the a LJ^ 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 at 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 helshe did not build or improve for the purpose of sale). I, as owner of the properly, am exclusive] yy contracting with licensed contractors to construct the project (Section 7044, Business Eland 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 contractors) 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. -)L- — ''�—� Owner: I do hereby certify that I am aware of and understand the requirements of California, Health and 'Vvy Code Sections 25505, 25533, and 25534 and that I or any future budding occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date. Applicant: I hereby certify that l have read this application and state that the above information is correct- I agree to comply with all City and county ordinances and state laws relating to building construction and hereby authorize representatives o is city to enter upon the above-mentioned property for inspection purposes. Date: Signature'. Driver's License Cr Social Secunly w: 164146 White–Building: Green–Code Enforcement: Canary–Applicant: Pink–Revenue: Goldenrod–Assessor CITY OF COSTA IESA — BUILDING PERMIT PERMIT NO: E 051095 _PL CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE JOB DESCRIPTION : ELECTRICAL METER PERMIT , PERM NO: E 05109 /Z GOVT: N SU P: SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B39407 PRIMARY BLDG. PERMIT. RP*Rf9P9F���*****iERr�P*9E IEiEiPRriEiEiEiPaEiPiPafiPiPiEiPREiPiEiHaE�E*iP9E�EIERPiFikiE*�P�PEE�t+r�E�t�E*�PT6EE�P�*�E�P***�P�r��6*�P+t** 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 PURPOSE: OTH ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN 4,50 0.00 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN BLDG PMT PARKING REQ• PROV: PARCEL: 42516104 ZNE: REF NO: PLANNING N TES> iE iFiP 1E 9f iE 9F aE RFiE iE RP RP jE 1F RE * iP iE * 9P 9EiE 9f * iP iH * RE �P 9E 9i;P RE IE * RP * RP 9E 9P * * BPiP RP 9P 9P 9P jH it iP 1P iE RE 3E iE 9P * iP aE 9F 9P iE K 9P 9E IE It 9F 9E RP iE FP * IF RE iF iP 9F M 3P if 1E Hf iP iP * RE 9t 9PiP * tP iE * 9f 9E RE RkiF lF 9E iF * * RP * iE 9t *>E k k 9E * k 9t RE * * iPiF 9E iE iE 9E9f iP 9t iE 9E * Rt * 1E 9t iPiP 9E * iE iP 9f k RE iE DF iP * 9E tE 9E * BF 3F lP Rt 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 BELOW 600 V & BELOW 201 AMP 18,50 18.50 DATE: BUILDING APPROVED BY APPLICATION ISSUED BY: Of Rf if Ht if 9P RP RE 9P IPiP *BE RF iE 9P IE iP IP IPiPBt . Rf*1E**iP RE if iF iF Rf*iFlFlE iF iF iE 9f iF 3F 1F RE iE 9E iP IF***SF 1E ik iFM 9E iE k 9P *RE ik 9E RE*IF LEGALIZATION:N F E E S U M M A R Y PERMIT BLDG PMT PLUMBING ELECTTRICC MECHANIC 50 . to% PLAN DATE: DATE: Dpi iP iFiE 9E RF 1E IE k if 9E * aF 9P RE 9E iE M 9P k iF iP iE 9E * 9E 9F iF STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES ISSUE FEE 1.4.50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 18.50 4,50 0.00 23.00 23.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 23,00 OVER/SHORT;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 23.00 iE iFiP 1E 9f iE 9F aE RFiE iE RP RP jE 1F RE * iP iE * 9P 9EiE 9f * iP iH * RE �P 9E 9i;P RE IE * RP * RP 9E 9P * * BPiP RP 9P 9P 9P jH it iP 1P iE RE 3E iE 9P * iP aE 9F 9P iE K 9P 9E IE It 9F 9E RP iE FP * IF RE iF iP 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 ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18,50 18.50 END OF FEES EXPIRED DATE% 7� n &SPA CONSTRUCTION AND PL_A_ NNlrviJ 7C APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Uncirgrnd.. 53. Steel Reinforcement - E(ectrical'Cond_uit Utility-Undrgrnd. 54. Forms �t4.-Elrectrical Conduit-Undrgrnd. 55. Electrical Bonding • I' ,5:LSteel Reinforcement 56. Rough Plumbing & Pressure Test _- v,,`_ lectriealUFER-Grnd. 57. APPROVAL TO COVER-GUNITE- .- '= 7. Footings 58. Electrical Conduit-Undrgrnd. a' 8"Foundation " 59. Gas Pipe, O Undrgmd., 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 n, 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 ElectricWiring 67. Fencing & Access Approval 17. Rough Wiring Sidn 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT rAPPROVA'�S -----Permit # >' 20., Rough Factory Fireplace u: T• t; - :, 21 �'Duci's, irrStr',u'ctu�e, ' '`� -- ;-. a ;70. Underground Hydro r. .... 22. Ducts, Ventilating,= r71. ProduritTPiping OG'as COiI 23' Gas Pipe Rough &Test `' l" •t - Underground Flus, :� s -172. 24?8oot Framing ty Ir73LUndergrnd'.Storagiajank-0Gas C1 Oil 25. Roof SheathingWy r `�. " � `.�k" ' 74?,0verhead'Hydro_-- i 26, T -Bar Ceiling (Str,uctural) &;Monocoat - p: 75:7Dry Chemical •% a �^'s� i - Y '-S v% T !�- I 27==Frame and Flashn IT _u `" 76' Dry Standpipe �' L J ., v, „ -.u;u, .r ,cr : r-_ _28. Lathing:& Siding3 ? Q;c z >' •• 77,- FIXED SYSTEM -FINAL x'29. Insulation C •.. pt , 78p FIRE PREV. FINAL u,•� 30. Drywall -Nailing `JCS - -- " '- HEA LTFkDEPT+: REQUIREMENT r _ '. 31, laster Brown Coat' .,791 -FINAL INSPECTION; :r - - _ „ z I - ',Ix.' - 32:=electrical Power�Mete[-Final; l':f i= ?.; :80r. -FOOD CERTIFICATE ISSUED 2 -in'el Elgctr ic• s ��.�; "Notes:z -g''lS B©-�� t^ .?7 34rFinal Heating'&Ai'4ec nditiomng; - 35 :.Final Gas Pipe-T6itx -.36.r'Hooil oi,CanopYua. •y ,,. " , t t c^� .e Y -Final Factory Fireplace1 F-' yi ' y ' y37; 38. Final Plumbing .'39. Water Service -Final- - I r + 1 '�'sv<.f ✓T' ' 's' m40. Gas Service -Final zAl. Solar Domestic -Final`> a •• _ v;�=� rr -; -42 ?Backflow Preventer rro - 43. Backflow Irlgatiom �: - t' = _ cc r i ' 44. Landscape Iriigatign System..". -'. t� r -_ _ nJ 00 45: Sound Attenuation ' I ^` t '46._Handicap Regulations- � ••47 -FINAL STRUCTURE & BUILDING 48`:' -FINAL PLANNING. f' > :L / if, 3 " U. ' v 49.-, Eleciric Release to�Edison -50. Gas Release to Southern California Gas Cn7 I Co .'51. CERTIFICATE OF, OCCUPANCY _• f - - No. Date CITY OF COSTA MESA BUILDING SAFETY DIVISION POST IN CONSPICUOUS PLACE ON THE JOB NOTICE You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 754-5627. APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. A. P. NO. -/2,S 161- G BUILDING//A�D//D C. ESS, {� 2 N t �r O. 14m.s S NEW ADD ALTER REPAIR MOVING DEMOLISH OWNER ccrry Lot Al *0 USE fl SETBACKS Front Yd. Side Yd. L R Rear Side Yd.,__L ._"--R' -'-'Rear--- CONSTRUCTION AND PLpNlllikd I W r i 1 e APPROVALS Permit # ! DatInspector 32. Electrical Power Meter -Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39, Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed POOL & SPA APPROVALS Permit# 49. Pool & Equipment Location 56. Steel Reinforcement 1. Temporary Electrical Serf or Pole 7 - . Rough Plumbing & Pressure Test 2. Soil Pipe-Undrgrnd. 1J C41W 5 . APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. / G�"Q 5 . Electrical Conduit-Undrgrnd. - 4r-- Electrical Conduit-Undr - - Gas Pipe, ❑ Undrgrnd., Test 5. Steel Reinforcement 57. Backwash Lines, P -Trap, OUndrgrnd. 6. Electrical LIFER Grnd. (OtO58. APPROVAL TO DECK 7. Footings 59. Backwash & Receptor -Final 8. Foundation 60. Heater & Vent -Final 9. Water Pipe-Undrgrnd. AO/Z74f &AV9 61. Plumbing System - Final 10. Structural Floor System ((� y( 62. Electrical -Final 11. Property Sewer Line & House Connection 63. Solar System -Final 12. Sewer Cap 64. Fencing & Access Approval 13. Roof Drains 65. APPROVED FOR PLASTERING 14. Rough Plumbing 66. POOL/SPA SYSTEMS FINAL 15. Rough Electrical -Conduit FIRE DEPT. REQUIREMENT APPROVALS Permit # 16. Rough Electric Wiring 17. Rough Wiring Sign 67. Underground Hydro 18. Rough Electrical -T Bar Ceiling 68. Product Piping 0Gas 0Oil 19. Rough Heating & Air Conditioning n CAP 69. Underground Flush 20. Rough Factory Fireplace qo L OD 70. Undergrnd. Storage Tank 0 Gas 0 Oil 21. Ducts, in Structure 71. Overhead Hydro 22. Ducts, Ventilating n 3 4Q 72. Dry Chemical 23. Gas Pipe -Rough & Test 73. Dry Standpipe 24. Roof Framing 74. FIXED SYSTEM FINAL 25. Roof Sheathing p 75. FIRE PREY. FINAL 26. T -Bar Ceiling (Structural) & Monocoat Notes: 0"�- 27. Frame anct Flashing 01 �6. (i 60 !"'t 28. Lathin iding 30 Z 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat (see reverse for add' al notes) CMF 0559-46, rev. 12/92 Notes Continued) PROJECT ADDRESS: 266 E 15TH ST UNIT: DWNER'SNAME: BARRY LOWE ADDRESS: 266 15TH ST #A, CM. CA. 92627 ARCH/ENGINEER: REG.NO.: . ADDRESS: UNIT: PERMITTEE' BARRY LOWE (714)631-8711 ADDRESS: 266 E 15TH ST A CM. CA 92627 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 UC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure or a cenificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C). POUCY NO.: EXP. DATE: • ''OMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTIDN FROM WORKERS' COMPENSATION DECLARATION: (This socron need not be completed it the permit is lot one hundred ($100) or less). 1 ubNty that in the pedor race pl the work for which this permit is issued, shall not employ any pers it manner so as to become subject to the w rkers' o pensation Laws of Calitomi. (r Date: Signature NOtICF1If, site making this declaration, you should become subject// the Workers' ompensation provisions of the Labor Code, you mus fonhwith comply with such provisions or this pen shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction tending 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' State License Law for the following reason (Section 7031.5 Business and Professional Cade: Arty, 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 permR subjects the applicant to a ciW penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation; will do the work, and the ® structure is not intended or offered for sale (Section 7044, Busioess 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 hlmselNherise or through L CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 044676 PERMIT NO: E 044676 PLAN CHECK NO: N GOVT: N SUPP- N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION METER FOR PROPERTY SPRINKLERS SQ FT: CLAIM VALUE: 300.00 CALC—VALUE: GROUP OCC: / COMMENTS: METER FOR PROPERTY SPRINKLER 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 -- -- --- 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 REQUIRED: PARKING PROVIDED: PARCEL: 42516104 ZONE? PLANNING NOTES>. 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: LEGALIZATION:N F E E S M M A R.Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING 'EI,ECTR C MECHANIC FIRE SMIP/RES GRADING PERMIT 18.50 PIAN 50% SMIP/NON—RES' ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS- --- > 18.50 15.00 0.00 33.50 33.50 .00 his of her own empbYees, provided That such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED • 33.50 OVER/SHORT: 00 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 sae). BLDG PMT PLUMBING ELECTRIC• MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of the property actor am exclusive contracting with licensed contractors to mnsuuct the project (Section 7044, Business 33.50- ' ❑ and Professions Code: The Contrs' State License Law does not apply to an owner of properrtyry wen bolds or improves thereon ' and who contracts for such projects with a contractoris) license pursuant to the Contractors State License Law). I am aware•##T4###################*######################################################## that proof of then Worker's Compensation insurance should be provided to me. I N D I V I D U A L: F E E B R E A K D O W N ❑ I am exempt under Section: B. S P. C. for this ea xxi: Date:ffilu Ownat* 1 do hereby fly that am aware of and understand the requirements of California Health and afety Code Sections 25505, 25533. and 25534 and th I or any future building occupant willNnll not (circle one) need to comply with sa state cedes and the requirements for a permit for construction or modification from the Airmlity Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that Me above information is correct. I agree to comply with all city and county ordinances and s ate laws relating to building construction and hereby authorize representatives I this city to enter upon the above-mentioned property for,i/ns ction p Date: 77 Signature: Driver's Lice se or Soci I Security x: 1641.48 White—Builtlino; Green—Coda Enforcement; Cenary—Ap liwm; Plnk—Revenue; Doldenrod—Aaaessor TYPE QTY D E S C R I P T• I OIN ELE 1 SERVICES BELOW 600 V 6 BELOW 200 AMP END OF FEES i; s EXT ED DATE ro %� }: UNIT COST 18.50 TOTAL COST 18.50 ` CONSTRUCTION AND PLANNING APPROVALS Permit # Data Inspector PC 9 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. 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 Electricel•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 'FIRE DEPT. REQUIREMENT APPROVALS _.Permit # Y70. 20: Rough Factory Fireplace - - - 21; Ducts, in,Structure Underground Hydro 22. Ducts, Ventilating • 71. Product Piping OGas 0Oil 23. Gas -Pipe -Rough & Test 72. Underground Flush . 24. Roof Framing _ - 73. Undergrnd. Storage Tank OGas 00 i 25. Roof Sheathing - - _ .r 74. Overhead Hydro 26'T -Bar Ceiling (Structural) &`Monocoat 75. Dry Chemical r 27'. Frame and Flashing _ 76. Dry Standpipe `+ 28. Lathing & Siding t 77. FIXED SYSTEM FINAL -, 29. Insulation _r5 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: �r 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test -36. Hood or Canopy •37. Final Factory Fireplace ; 738. Final Plumbing 39. Water Service -Final - I 40. Gas Service -Final - 41. Solar Domestic -Final - 42. Backflow Preventer 43. Backflow Irrigation - - 44. Landscape Irrigation System- ,- 45. Sound Attenuation 46. Handicap Regulations -. - - 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING moi' 49. Electric Release to Edison --50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date L August 8, 1994 Mr. Barry Lowe 266 15th Street Costa Mesa, CA CITY OF COSTA MESA CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT 92626 RE: 266 15th Street Dear Mr. Lowe: P.O. BOX 1200 You have requested an extension on permits B39407, EP44675, E51095, E51094, EMP44674 and E44676 for the above property. An extension has been granted for 180 days to commence from the date of this letter. This is a one time only extension and no further extension will be granted. Should you have any questions please feel free to contact me at (714) 754-5615 Monday through Friday between the hours of 8:00 a.m. and 4:00 p.m. Sincerely, BURT MORGAN Chief Plan Check Examiner BM: mm 77 FAIR DRIVE Building Division (714) 7545273 Code Enforcement (714) 7545623 Planning Division (714) 754.524S FAX (714) 5567508 TDD (714) 754-5244 PROJECT AD?RESS: UNIT: OWNEWMNAME: 266 E 15TH ST B -BARRY LOWS ADDRESS: 266 15TH ST #A CM. CA. .92,6-2.7. ARCIUENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: BARRY Lb WE (714)631-8711 ADDRESS: 266 E 15TH ST A CM. CA 92627 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.: STATE LIC.: CLASS: - Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a cre ified Copy thereof (Section 3B00, Lab. C), POLICY NO.: EXP. OAT@: COMPANY: `] Certified copy is hereby furnished. ❑ Certified copy is filed with the tidy Buffing Drvision. Date: Applicant: f� EXEMPTION FROM WORKERS- COMPENSATION DECLARATION: (This section need net be Completed a the pernN is for one hundred ($100) w less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any airier so as to become subject to the Workers' Compe�tipop Lars of California. /�v Date: to Tz , r7 Signature: 'L•'�- NOTICE: If, after making this declaration, you should become subject to IIT Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit she De 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, CN. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby allirm 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 civil penalty of felt more than five hundred dollars (5500). I, as owner of the property or my employees with elopes as their sole compensation, will do the work, and the structure it not Intended of 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 Nn15elf/herseU 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). 1, as owner of the property, am exclusively contracting with licensed contractors to Construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Stale License Law dots net apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware 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: le- Z b �`F� Owner: Ido hereby certify that l 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 Ouality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby cerlity that 1 have read this application and state that the above information is correct. I agree to Comply with all city and county ordinances and state laws relating to building constrocti ul and hereby authorize representatives of this ci to enter upon the above-mentioned Property for inspection purposes.p Date: /101 LG �p f Signature: Driver's License or Social Security A: ! 164145 White -Building; Green -Code EnforcemenC Canary -Applicant; Pink -Revenue: Gobenmd-Assessor CITY OF, COSTA MESA - BUILDING PERMIT PERM NO: EMP 044674 PERMIT NO: EMP 044674 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC PLU PURPOSE: NEW JOB DESCRIPTION E.M.P FOR B39407 / NEW SFD. 2ND UNIT SQ FT: CLAIM VALUE: 3,500.00 CALL-VALUE:-•=-GROUPrOCQr• COMMENTS: SANITARY SANITARY DIST FEES PAID 072789 4" # it ie it it M it.)t ♦E it iF ♦F iE it iF iE if iE it N-it)E iE i( -if !(iF if # if IF 1E if� 3e �(� iF if iE lE i(iE )E if ih i@ if iF iE if iE ie ii itNie )f lf if i(IE iE 3E iF ik lE iE iE jF iE !k N� # f! 1E iF 1f If if if Z 0 N I N G R E Q U I R F. M 1E N T S S E T B A C K 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 IDI PARKING REQpUIRED: PARKING PROVIDED: PARCEL: 42516104 ZONE: PLANNING NOTES> it iE it 9t 3f iE iE iE iF%i< at k ii it iF it iE iF K iE iE iE iE it iE ie iE iE is itis N it Bt it iF iF it iE it iF iE iE it iE iE iE iE it iE iE it iE iE iE it iE it iE iE it it iE iE iF i<iE it iE iE aE iE iE iE * * x iF 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: 10 'z6- ititiEititatit.�at***it itiEititititititit�t i x - - i it it it it itiEititit*iF'ftiFiF'7FI;:i: ititititititititititititit�**ititititicititititiEitititic•itititititinti- iEatx-��•IE->Fae��yr�E*xN:L+e+E***�•>E**�L�r*�EN�r�**yE���c�x LEGALIZATION:N F E E U M M A'R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE .SMIP/RES GRADING PERMIT 14.50 83.60 11.50 PLAN 25: 50% 25% SMIP/NON-RES ' ISSUE FEE .3.00 15.00 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN --CHECK TOTAL PAID DUE TOTALS ---- > 1.11.60 33.00 - 0.00 144.60 144.60 .00 REVENUE DIVISION TOTALS -7-> COLLECTED- 144.60 OVER/SHORT: 00 BL G ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECJ< jE�5 98.60 28.50 iEitieitititiEitL7jy�iE if iF 1EiEiEiEiEitiFiE�ititiEiEifif#iEiEiEiEihiFlFiF#iFitififiEifiFiEiEihitiElEiEiE9EifiEiEiElEitifi(itiEiEiEitit A rL✓¢�[2-fj�A L F E E B R E A K D O W N TYPE QTY D S C R I P T I O N UNIT COST TOTAL COST ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. .75 15.00 ELE 9 FIXTURES, LIGHTING ADDITIONAL EA. .45 4.05 ELE 2.0 RECEPT/OUTLET 1. ST 20 EA. .7.5 15.00 ELE 22 RECEPT/OUTLET ADDITIONAL EA. .45 9.90 ELE 20 RECEPT/SWITCH 1 ST 20 EA. .75 15.00 ELE 7 RECEPT/SWITC11 ADDITIONAL EA. .45 3.15 ELE. 1. RES APPLIANCE NOT'OVER 1.0 HP 3.00 3.00 MEC 1 INST/RELOC RECESSED WALL HEATER 9.00 9.00 MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4.5.0 4.50 PLU 1 BATHTUB 2.00 2.00 PLU 1 DISHWASHER 0.1121-00 2.00 eA i CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PO SPA APPROVALS Permit # Date Inspector 1. Terr#brary 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. Foptings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, D 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 -..r. - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Elecirica [-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 - Permit # - 20. Rough Factory Fireplace ._. - 21. Ducts, in Structure - - • 70. Underground Hydro 22. Ducts, Ventilating - 71. ProductPipingOGas OOil 23. Gas Pipe -Rough & Test 772. Underground Flush?' -J' 24. Roof Framing -' 73:'Undergrnd. Storageank O'Gas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75, Dry Chemical t 27. Frame and Flashing 76. Dry Standpipe 4 28. Lathing & Siding... - r 77: FIXED SYSTEM FINAL " 29. Insulation - ^I 78. FIRE PREY. FINAL - 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT - - 31. Plaster Brown Coat _ 79. FINAL INSPECTION 32. Electrical Power'Meter-Final !/�. 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' i'1 Notes: 34. Final Heating & Air Conditioning- t� - 35. Final Gas Pipe -Test`• i/ - 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 - '44. Landscape Irriqation System 45. Sound Attenuation - - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING F, 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co `,.. 51. CERTIFICATE OF OCCUPANCY No. Date • PROJECT /DRESS: LAUNDRY TUB OR WASHER 2.00 OWWS S NAME: PLO 1 ADDRESS: 2.00 2.00 PLO 1 REG.NO.: UNIT: UNIT: LICENSED CONTRACTOR ECIARATION: I hereby amrm that I am Amnsed under provisi of Chapter 9 (commencing with Section 7000) of Division 3 of the eu and Professions Cade, and my liana Is in lull fart ntl effect. CITY UC.: STATE UC.: cuss: Date: Signature: WORKERS' COMPENSATION DEC RATION: I hereby affirm that l have a ter ifi of consent to self -insure or a certificate of Workers' Compensation Insurance, or a cera copy thereof (Section 3800; lab. CI POLICY NO.: EXP. DATE: �SOMPANY: p Cenilled copy is hereby furnished. Certified copy is filed with a city Building Division. Date: Applies EXEMPTION FROM WORKERS' COMPENSATION O 1 1 certify that in the performance of the work for ich t subject to the Workers, Compensation Laws of tifo Date: Sign NOTICE: If, after making this declaration, you s¢ Code, you must forthwith comply with such firm CONSTRUCTION LENDING AGENCY: 1 hereby affirm which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: / OWNER BUILDER DECLARATION: I (Section 7031.5 Business and Proles; I: (Thisse n need not be completed it the pemiil6 Our one hundred (51 DO) a leu). permit is' sued, I shall not employ any person in any manner so as to become f�ome subject to the Workers' Compensation provisions of the Labor in or this permit shall be deemed revoked. there is a construction lending agency for the performance of the work for the and Professions Code) or that he/she is exe t therefrom and the b is for the any applicant for a permit subjects the app t 1p a civil penalty of t more I, as owner of the propeM my employees whh wage as in ❑ structure is not intended ar offer for sale (Section 7044, Busmen and F does not apply to an owner of properry who builds or improves\e,,echis or her own employees. p 'tled roar such Improvements areimprovement u sold within a year of completion, the owner wilfor the Duryose of Sale).,asowneroftheprope , am exclusive)y contrectlnA with license ❑ a d Professions Dede: a Contractors' State License Law does not apph and who contracts to arch projects with a contractor(s) license pursue that proof of their rker's Compensation insurance should be provides ❑ I am exempt undo Smdon: B. 8 P. C. lar this reason: Dale: Owner: I do hereby certify t am aware of and understand the requirements of California Health ntl Solely Code Sections 25505, 25533, and 25534 and that I r any future bulldmil occupant wllgwill not Icicle one) need to comply wit Id state codes and the requirements for a permit for con ction or modification from the Air Duality Management Dina. Residentia onstruction applications are exempt from these provi5 S. Dale: Applicant actors' Stale License Law for the following reason a permit to construct, alter, improve, demolish, or 1 to file a signed statement that he/she is licensed ing with Section 7000) of Division 3 of me Business led exemption. Any violation of Section 7031.5 by five hundred dollars ($500). sole compensation, will do the work, and the ssional Code: The Contractors' State License Law no who does such work Nmsell/herself or through ed or offered for sale. If, however the building or burden of proving he/she did not build or improve ars to construct the project (Section 7044, Business in owner of property who builds or improves thereon the Contractors' State License Law). I am aware me. I here certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ortlin les and state laws relating to building construction and hereby authorize representatives of this cry to enter upon the above-mentioned property for inspection purposes. Date: Driver's License or Social Security M: Signature: 1641-46 White—Buildina: Green—Cada Enforcement: Canarv—AppticanC Pink—Revenue: Goldenrod—Aveeaor `` PERMIT NO: EMP 044674 PLAN CHECK NO: 01158-89 N PAGE: 2 TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLO 1 LAUNDRY TUB OR WASHER 2.00 2.00 PLO 1 SINK, KITCHEN 2.00 2.00 PLO 1 WASH BASIN 2.00 2,00 PLO 1 WATER CLOSET (TOILET) 2.00 2,00 PLO 1 WATER HEATER AND/OR VENT 2.00 2.00 PLO 1 GAS PIPING SYS 54• OUTL—PER OUTLET .50 .50 ELE 1 SERVICES BELOW 600 V S BELOW 200 AMP 18.50 18.50 END OF FEES 'l. a .3 :l CONSTRUCTION AND PLANNING - APPROVALS ' Permit #- _ Date Inspector PdW SPA APPROVALS Permit # Date ..Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. w 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 i 6. 'E�trical UFER Grnd. 57. -APPROVAL TO-COVER-GUNITE 7._Notings i� 58. Electrical Conduit-Undrgrnd. 8. Foundation �59,Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe=Undrgrnd. �� 60. Backwash nes, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK_ 17. Property Sewer Line & Houseto`nnection i 62. Backwash & Receptor -Finale 12. Sewer Cap f - 63. Heater &Vent -Final 73. Roof Drains :: ,''r 64. Plumbing System - Final 14. Rough Plumbing tJ [.i0 65. Electrical -Final 15. Rough bectr'ical-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 q CAWS FIRE DEPT. REQUIREMENT APPROVALS Permit # 20: Rough Factory,Fireplace- 21`Duots, in Structure 70, Underground Hydro 22. -Ducts, Ventilating 2 (rlGO 71. Product Piping 0 Gas 00il 23. Gas'Pipe-Rough &Test 72. Underground Flush 24. -Roof Framing :+ 73. Undergrnd. Storage Tank ED Gas- 0 Oil 25. Roof Sheathmg<j ' 74. Overhead Hydro , 26.,T -Bar Ceiling,) Structu_ral)_& MonocoaU 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 31' Final Electric I- - Notes: 34. ,Final Heating & Air Conditioning 35 -.!Final Gas Pipe -Test ,: - 36. Hood or Canopy - 3V'Final Factory Fireplace - + i 38.,Final Plumbing 39. Water Service -Final -.;. 40'. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation -. 44. Landscape Irrigation•System 45. Sound Attenuation 46. Handicap Regulations 47--FINAL.STAUCTURE & BUILDING - 48. FINAL PLANNING 49: Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date sk Mesa Building Department 111 EAST 20th STREET COSTA MEF :ALIFORNIA ' PFOR APPLICANT TO FILL IN No.of qv Families ilding Address zir6 "F— /j— Line from Street Costa Mesa, California OF WORN Nearest �1 MB1dg.q.-,0S0'C Alteration . Cross St. -.f.'4 Alr4 A�,z1�4 Addition Owner Moving I Mail Demolish Address �� /�" Wall Tel. ^ City f O.YTiC [�C S,ll No. Architect or Lic. Engineer No. Address /+ City Lic. Contractor ,y,y/,y L�gy�A�>pq�� No. Address JS— Legal Lot J¢/� Description I No. % Block I�l'rec�A APPLICATION FOR PERMIT 492 sUILDING FOS.. OFFICE USE ONLY Receipt No. Permit No. 2C> Rees' ed by Date Recd. 1 Date Issued Build' g Address Costa Mesa, California Lot j 6 �1' /z,r Now on Lot g Bldg. No.of qv Families No. of ? Roomak Line from Street / Rear Yard fj"'of Side YardDESCRIPTION OF WORN II MB1dg.q.-,0S0'C Alteration I Addition II Moving I I Demolish Builof g e'oo �, No. mRooms !� Storiesr Wall I Roof 7 APPROVALS Foundation LocationI Inspector I Date Forms, Materials, I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building construe 'on. Signature of Plaster, Int. Permittee ValuationPermit Fee $ D e 47 Plan Check $ 07. o O Bond Beam $ f,�QOO Total o O v Fee $ / (o. FINAL PLOT PLAN Show location and distances from property line and between buildings. coS7^ '1V 1 uEsn "�-�- f •-c u J � J 6 0 6 � a o ' a Street PLOT PLAN Show location and distances from property line and between buildings. coS7^ '1V 1 uEsn "�-�- r.. f r.. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address Z(06 /7/� A Sr Applicant's Mailing Address _x66 2Sd'A .Si Owner's Name Phone Address 266 /fi 151T Arch/Eng. License No. Address Contractor's Nam Phone Address(mailing) ql City License No LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions Of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. nate Signature 'RKERS' COMPENSATION DECLARATION ,reby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company BCertified copy is hereby furnished. Certified copy Is filed with the city Building Division. O,te Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or less). I certify that in the performance of the work for which this permit Is Issued I Woo not empl y any person in any man r].gr 5o as to be oma se ubiect to lite Workers' ws of CalifOny$( Date Signature Air NOTICE: If, iter eking this declaration, yo should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be tleemed 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's Name Lender's Address OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit Subjects the applicant to a civil o�eynalty of no a than five hundred dollars ($500). W I. ce¢teemefielf gOrk. and [he structure is not Ipteptletl or offered 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 com- pletion, the owner will have the burden of proving he/She did not build or Im- prove for the purpose of sale). ❑ I, as owner Of the property, am exclusively contracting with licensed con- tractors to construct the project(Section 7044, Business and Professions Code: The Contractor's License Law Aes not apply to an owner of property who builds or improves thereon. and who contracts for Such projects with a con. tractor(s) license pursuant to in, Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. &,P. C. for this reason Date Owner I hereby ertif that have read this appy anon and state that the above information i5 orrect. I agree to comply wish all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this yily to enter 4pon the above-mentioned propejty }br Signature Ir wlylt-W, Drivers' License Or 55 D s� SMIP A.P.# S Main Building: Accessory Building: TYPE OF CONSTRUCTIOtl NEW ADD El CONVERSION DEMOLISH ❑ OTHER ffi DESCRIPTION OF WORK/USE OF SLOG. ALTERATION REPAIR E T Front A Rear TYPE OF PERMIT GRADING 11 FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER C Right $ Left Ping. Ref. # Parking Req./Provided PROJECT DESCRIPTION SQ. FT. OCCUPAN Y CONSTRUCTION TYPE VALUATION$ p� ZONE GRADINGCU.YDS. ACRES Planning Notes: $ Remarks: inn MA /IAir/o _ Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories Roof Drains Reinspection Fee $15 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0.100,000 BTU ❑ 1 oo,000 BTI Reinspection Fee 1 $15 0865-46, rev. 5/88 White+ Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Laundry Trays Issue Fee Hood or Type ❑ Canopy Type II ❑ Refrigeration System ❑0.100,000BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee ELECTRICAL Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter Dover 100amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00.1 HP 01IS-8 F.A.U. Inc.Solar 09-15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Garbage Disposal Generator 00-5 KW 05.15 KW Zone Standing Sections Trash Compactor Reinspection Fee $15 1 1 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES I Building Approved By $ 3 BUILDING PERMIT $ MW Clu $ PLRLCHECK`2',}tb�� {�;at' /p ISS � $ \ �'�..PLAN CH2ER pp$ ,,,4167�AL $ O N N G R E Q M T S. FEES $ 3 FEES s� SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ CONSTRUCTION AND PLANNING Permit # DateAPPROVALS TispectorAPPROVALSPROVALS POv� & SPA: Permit #' Date Inspector li 1. Temporary Electrical Service or Pole C i 52. Pool &Equipment Location 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 1. 6.. Electrical UFER'Grrid. 57. APPROVAL TO COVER-GUNITE 7. Footings ,: 58. Electrical Conduit-Undrgrnd. '8. Foundation '•' .1 59. Gas Pipe, 0 Undrgrnd., Test '9. Water Pipe-UndrgrAd. 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 .r 67. Fencing & Access Approval 'Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.,Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19,jRough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20:7'Rough Factory Fireplace 21r 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 OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric I Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test j,•'' 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 "- 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 ice:• :� . " :i ` Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COcTA MESA CONSTRUCTION PERMIT Project,tilddre s 266 8 /JW1- Applicant's Mailing Address .2b6 If S %� Owner's Name AAA Ld ag Phone 6 -7( -,?7 � Address 2J Arch/Eng License No. Address Contractor's Nam' Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature �RKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C-) Policy No. Company BCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if 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 become subject to the Workers' Compensation 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 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil 'a"Ity of not more than five hundred dollars ($500). 41, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, a$ owner of the property, am exclusively contracting with licensed con- 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 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 proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner 1 hereb c "til, I have read this apphca on and state that the above information is correct. I agree to comply with all city and county ordinances and stale laws relating to building construction, and hereby authorize repre- sentatives of this city enter upon th onetl bove-mentipro er y for inspection purposes.K Signature � Date 7 4, Drivers' License or SS of TYPE OF CONSTRUCTION J NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WOJ1K/USE OF BLQG, TYPE OF PERMIT LJ GRADING LJ FOUNDATION IJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY CON STRUCTION TYPE :Kr�" VALUATION$ ZONE GRADINGCU.YDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ o-100,000 BTU Ell 00,000 BT Reinspection Fee I $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Issue Fee Hood or Type I ❑ Canopy Type II ❑ Refrigeration System ❑o-100,000BTU 13100,000 System Repair/Alteration Fire Dampers Registers Issue Fee A.P. # S Main Building: Accessory Building: E T Front B Rear A C Right K S - Left Ping. Ref. # Parking Req./Provided Planning Notes: Zone ELECTRICAL Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑50+KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors E10-1 HP Ell %-8 F.A.U. Inc.Solar 09-15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 00-5 KW 05-15 KW Trash Compactor FEES T N G R E Q M T S. I I Reinspection Fee 1 $15 1 1 Issue Fee I• •5-8�1 I $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES Building Approved By ter_ Application Issued By $ 3 SMIP SUMMARY OF BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ 30 • Q7 PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ 30 t OU 0100042178-00042178 T07 ;.1. DATE: 09/11/87 TIfiE: 13:44 CONSTRUCTION AND PLANNING APPROVALS Permit 4h Date Inspector POLL & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole & 2. Pool & Equipment Location 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, ❑ 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 i6. Rough Electric Wiring 67. Fencing & Access Approval 1.7. 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 Permit # 20. Rough Factory Fireplace 21. Duots,*'in Structure 70. Underground Hydro 22. Ducts, Ventilating _ 71. Product Piping ElGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O 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 FOOD CERTIFICATE ISSUED 33. Final Electric tes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39, Water Service-Final /y 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer .. 43. Backflow Irrigation - 44. Landscape Irrigation System /. 1 45. Sound Attenuation 46. Handicap Regulations L 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co f / - 51. CERTIFICATE OF OCCUPANCY^ ( No. Date r CITY OF COSTA MES�A/ CONSST8UCTIONPERMIT � Project Address �D Applicant's Mailin Address 266 ��f11 S% Owner's Name Phone Address 26(o /!�/yL S;i— Arch/Eng. License No. Address Contractor's Nam Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (comment, l'; with section 7000) of Division 3 of the Business and Professions Code, anc my license is in full force and effect. License Class License No. ^-te Signature RKERS'COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sectior 3800, Lab. C.) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PET NO. �6�� TRACT NO. LOT NO. UNIT NO. P. zoi TYPE OF CONSTRUCTION NEW ADD El1.8 CONVERSION DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. — Policy No. Company eCe rtif letl copy i hereby furnished. / Cert, with the city But Divisi Date Applicant EXEMPTI N F OM WORKERS' COMPENSATI DECLARATION (This section need not be completed if 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 emy Y pLato erson in an mance o as to beco a bp'ect to the Workers' o?nV Laws of Californl O' Date Signature L comply with such provisions or this permit snap oe aeemea revoxea. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit i; issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or ctor's License Law (Chapter 9 (pummencing will' aecrwu .ow) of of the Business and Professions Code) or that he/she is exempt and the basis for the alleged e%emption. Any violation of Section any applicant for a permit subjects the applicant ty pivil not more than five hundred dollars ($500). z C�— ( License LBW does not apply to an owner of a property wno burros 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. I1, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she old not build or im. Eve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon. and who contracts for such protects with a con- tractor(s) license pursuant to me Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner hereby cer y that I have read this app cation and state that the above information , correct. agree to comply with all city and county ordinances and Stale laws relating to building construction, and hereby authorize repre. SentativeS of I y.� city to enter u on a above-mentioned prop rty r Inspection pury65e Signature jjDate Drivers' LI ALTERATION LJ REPAIR TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY— CONSTRUCTION CCUPAN YCONSTRUCTION TYPE VALUATION $ _If ZONE GRADII�N��G CwU..YDS. ACRES— Remarks: Remarks: / !�Y/n Gyr_//, 49 � nk Preventer Irrigation ,king Fountains tr Drains tr Sinks Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash S Main Builth E T Front B Rear A C Right K SLeft ' Ping. Ref. # Planning Notes: FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 130-5 KW ❑5-1 I I Reinspection Fee 1 $151 I Issue Fee I $ 3 I I Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBG # Heating System & Ducting ❑Q100,000 BTU ❑100,000 Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type II ❑ Refrigeration System ❑0-100,000 BTU ❑10o,8o8 System Repair/Alteration Fire Dampers Registers Issue Fee FEES $ 3 Zone Bu ELECTRICAL Transformer El15-50KW 1150+KW Meter LJup to 100 amps Meter ❑over 100amps Sub Panel Motors ❑0.1 HP E)1% - 8 Inc.Solar 119-15 HP 016-15+ Microwave Pole Light Sign Standing Sections Trash Compactor I Reinspection Fee I $15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By�lLl_ PPP LLLUUMIBINTIJ_. ECK E L -E i5A ¢9�2f�5% CHECK 'BB% CITY !%E efJAN SUNT ')Q.RYa(1 S FEES $ p���� �((fJ LL77 SMIP $ PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTALFEE N G R E Q M T S. FEES $ 3 CONSTRUCTION AND PLANNING 'APPROVALS Permit# Date I Inspector POvL & SP! -A: APPROVALSPermit#; Date Inspector 1. Temporary Electrical Service or Pole =! , " "��' 52. Pool & Equipment Location 2. Soil Pipe'Undrgrnd. !i 53. Steel Reinforcement - 31 Electrical Conduit;Utility-Undrgrnd. 54. Forms 4. Electrical-Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grind. 57. APPROVAL TO COVER-GUNITE 7. Footings % 58. Electrical Conduit-Undrgrnd. 8. Foundation `9. l 59. Gas Pipe, O Undrgrnd.; Test 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 -F i'nal 12. Sewer Cap .',r ,1 63. Heater & Vent -Final 13. Roof Drains `- 64. Plumbing System - FirSal, 14. Rough Plumbing - 65. Electrical -Final - 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring . i 67. Fencing & Access Approval Rough Wiring Sign 68. APPROVED FOR PLASTERING 18"'Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1�-,; Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 201 Rough Factory Fireplace 21 - Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing _ 73. Undergrnd. Storage Tank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & 6onocoat 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. E=lectrical Power Met&. -Final 80. FOOD CERTIFICATE ISSUED a` 33. 'Final Electric Notes:` - 34. Final Heating & Air Conditioning F,cu 35. Final Gas Pipe -Test ' 36. Hood or Canopy - f: 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final s ., �C(_ _3 40. Gas Service -Final V .r- 41. Solar Domestic -Final 42. Backflow Preventer / 43. Backflow Irrigation 44. Landscape Irrigation System-� 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING Z� 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ' f' -I ., - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA C//O//NSTRU TION PERMIT Project Address � 66 xo/4t- Applicant'sMailin Address Owner's Name 2� Phone-!P_I��/ Address Arch/Eng. License No. Address Contractor's Name __Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Divition 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature 'vORKERS' COMPENSATION DECLARATION ereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company eCertified copy Is hereby furnished. - Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permIt'is issued I shall not em toy ny person in any nri so as to beco s jest to tNe Worker o t' Ws of Califor El Date "ignature NOTICE: ,aft making this declaration, you s uld become subjec to the Workers' Compensation prbvisions of the Lobo Cotle, 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 is issued (Section 3097 Civ. C.) Under's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt 'therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant.AP �a civil Aepalty of not more than five hundred dollars ($500). h lr `( License Law does not apply to an owner of a property woo quads 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 com- pletion, the owner will have the burden of proving he/she did not build or Im- Srove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereoh. and who contracts for such Projects with a ran- tractor(s) license pursuant to the Contractor's License Law), I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am ex e)n pt u/Ider Section B. & P. C. far this reason 1 1 / A -J Date Owner I hereby emit that 1 have reap information Is c rrect. 1 agree to and state laws relating to buildir sentatives of this ity to enter inspection purpo Signature Drivers' License or S above TYPE OF CONSTRUCTIIOV LJ NEW U ADD ❑ CONVERSION X DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TYPE OF PERMIT U GRADING ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT._ ALTERATION IJ REPAIR J FOUNDATION LJ STRUCTURAL PLUMBING ❑ MECHANICAL CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.YDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG * Heating System & Ducting ❑0-100,000 BTU ❑l 00,000 BT Reinspection Fee 1 $15 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Issue Fee Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System ❑0-100,000 BTU ❑100,000BTU System Repair/Alteration Fire Dampers Registers Issue Fee FEES A.P. # I Zone S Main Building: Accessory Building: E T Front B Rear A C Right K S Left Ping. Ret. # Parking Req,/Provided Planning Notes: ELECTRICAL FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter Dover 100 amps Dryers ❑Gas C]Electric Sub Panel Fan Motors 110-1 HP ❑1'/h-8 F.A.U. Inc. Solar 09-15 HP Ell 6-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator ❑0-5 KW ❑5-15 KW Trash Compactor i N G R E Q M T S. I I Reinspectian Fee 1 $15 1 1 Issue Fee 1 $ 3 1 1 $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By FEES Building Approved By Application Issued By - $ 3 SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUA E PLAN CHECK 25% $ C. ELECTRICAL $ - h R:e''f $ PLAN CHECK 50% $ MIC�R1OF14411����{{11 $ MECHANICAL $ �EZTi5F 88$ ' a PLAN CHECK 25% $ 1 . CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole i. " 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement i ' 3. Electrical Conduit Utility-Undrgrnd. -'.� 54. Forms ; 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test i 6. Electrical UFER 57. APPROVAL TOCOVER-GUNITE 7. Footings 1 ��� 58. Electrical Conduit-Undrgrnd. Si 'Foundation 59. Gas Pipe, D Undrgrnd.,'Test �r 9- Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, D Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK'. 11 .Property Sewer Line & House Connectionv 62. Backwash & Receptor!Final 12'. Sewer Cap ' S �q• L am• 63. Heater & Vent -Final,,; 13. Roof Drains� , 64. Plumbing System -Final: - 14. Rough Plumbing 65. Electrical -Final t i , 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING J6. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ;v FIRE DEPT. REQUIREMENT APPROVALS Permit # 20: Rough Factory Fireplace 21.. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping D Gas D Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank D Gas D Oil 25, Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final ), 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing =21V(.� I 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 4' 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation C i 46. Handicap Regulations fry' 1 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - ••Fy"""" 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date " ..� PRDJECT ADDRESS: 266 E 15TH ST OWNER'S NAME: BARRY LOWE ADDRESS: 266 15TH ST #A CM. CA. 92627 631-8711 ARCH/ENGINEER: ADDRESS: UNIT: A REG.ND.: UNIT: PERNUTTEE: BARRY LOWE (714)631-8711 ADDRESS: 266 E 15TIl ST A CM. CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Uniizism 3 of the Business am) Prolessions Code, and my NUTcul is m IWI force and effect. CITY LIC.: i STATE LIC.: CUSS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certi0wte of consent to self -insure or a certificate of Workers' Compensation Insurance, or a Certified copy thereof (Section 3800, Lab. Q. IDLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the pemut is forms hundred ($100) or less). I Candy that in the performance of the work for which this perm% is issued, I shall not employ any person in any manner so as to become subject to the Workers' COm enationny' s of California. Date: /_ Signature: NOTICE: If, after making this declaration, you should become subject to the orkers' Compensation provisions of the Labor Code, you must Ionfimb comply with such provisions of IMS 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 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 Profession 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 propend or my empployees with wages as their sole compensation, will do the work, and the E] structure is not intended or offered for salelsection 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 Eland Professions Code: The Contractors' State License Law does not apply to an met of prop¢who builds or improves thereon and who contracts for such projects with a contractors) 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 P 7 0 4 4 B. S P C. formisreaon:LALL �WORK BY OWNER �f Date � wV Owner: I do hereby certify 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 wilOwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification front the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws reading to building construction and hereby authorize representatives of this city to enter upon the above-mentioned plop" fm ' spec/Sion purposes. Date: �(� Signature: d � Orjyer's Licens& or Social Security #: 16419 White—Building; Green—Code Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 049054 PERMIT NO: B 049054 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : T/OFF REROOF W/ COMP SQ FT: 1,100 CLAIM VALUE: 1,100.00 CALC-VALUE: 1,100.00 GROUP OCC: R-3 / COMMENTS: T/OFF REROOF W/ COMP Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: I'T IN LEFT: FT IN RGHT: FT IN LEFT: FT 1N RGHT: FT IN PARKING REQ: PROV: PARCEL: 42516104 ZNE: REF NO: PLANNING NOTES> 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: LEGALIZATION:N F E E S U K M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 27.00 .50 PLAN SMIP/NUN-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS-----> 27.50 0,00 0.00 27,50 27.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27,50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 27.00 .50 I N D I V I D U A L F E E B_R—E K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1100 REROOF BY VALUE RESIDENIAL NOZONE 1.00 1,100.00 END OF FEES (31 (1066"n8?-p00b4883 'T ICY ' _ , fl8IE2 00/1.9/00 IDLE: 15'02 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PONW SPA APPROVALS Permit # A Date a Inspector' A+ 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location + 1 2. Soil Pipe-Undrgrnd. + 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. t 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. 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 r; 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final I 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 Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 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 i.i;�, 78. FIRE PREV. FINAL 30. Drywall Nailing l� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric _. I Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test t ' 36. Hood or Canopy 37. Final Factory Fireplace r " ' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �IL 48. FINAL PLANNING " 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 266 E 15TH ST OWNER'S NAME: BARRY LOWE ADDRESS: 266 1ST11 ST BA CM. CA. 92627 ARCHIENGINEER: ADDRESS: REG.1i UNI7:A CITYOF COSTA MESA — BUILDING PERMIT' PERMIT' NO: EP 044675 // PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE. ELE PLU UNIT: PERMHTEE: BARRY LOWE (714)631--8711 ADDRESS: 266 E 15TH ST A CM, CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby off him that I am licensed under provisons 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.: l STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that] have a certificate of consent to self -insure ora certificate of Workers Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C). I NO.:* EXP. GATE: Certified copy is hereby furnished. ❑ Certified copyis filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKEgs' COMPENSATION DECLARATION: (This section freed not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued: Is a not employ an erson in any manner so as to become subject to the W ers' Co person Ion Laws of California. Date:- Signature: !7 NOTICE: If, aftermakm6 this decimation. you should become subject to a Workers' Compensation provisions of the Labor Code. you must fortriw'ith comply with such provisions or thus permit II be deemed revoked. CONS7gUCTION TENDING AGENCY: I hereby affirm that them is ac`oostruction lending agency for the performance of the work lot 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 71%11.5 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 hefohe 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 Ave hundred dollars (5500). I, as owner of the property or my aInvolve with wages as their sole compensation, will do the work, and the ❑C structure is not intended m a0ered for sale(Section 7044, Business and Professional Code: The Contractors' State License Law - does not apply to an owner of property who builds or improves (hereon, and who does such work himself/herself or through ' his or her awn 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 propeM. am exclusive contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: Au Cantmctors' State License Law does not appy to an met of property who builds or improves thereon and who contracts lot such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of thelf Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. A P. C. for this leas n: Date:Owner: I do hereby cetify that I am aware of and understand the requirements of California Health a Safety Code SOctiorts 25505, 25533, and 25534 and that I or any future building Occupant YAIVW ll not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air uglily Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have Mad this application and stale that the above information ordinances and state laws relating to building com uction and hereby repres[ property for�innsp °Jionn OUTPos . Date: V Signature: Dover's Licnee or Soc' Security M: 7 White—Building: Green—Code E_ torcoment:.Canary�Applicant; with all city and county on the above-mentioned Goldenrod—Assessor PERM NO: EP 044675 GOVT: N SUPP: N PURPOSE: ALT JOB DESCRIPTION MOVE WTR HTR / UPGRADE SERVICE SQ FT: CLAIM VALUE: 300.00 CALC—VALUE: GROUP OCC: / COMMENTS: MOVE WTR HEATER / UPGRADE SERVICE TO 100 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 —'------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN.RGHT: FT IN LETT: FT IN RGHT: FT IN PARKING REQUIRED: PARKING PROVIDED: PARCEL: 4251.6104 ZONE: PLANNING'NOTES> > iF il-eE iE 9E 9E TE 3E 3f aE iE-%ie IE lE iE le iE iE if 1f iF iE iE iE iE iE ik ifiF iE'fE iE%iE if iE 1(- N -ie fE iE fF 1(-i(- iE if iE if I(d(-!f iE of iF iEdE iCiE fE if 3F 9E if iE i4 iE aE lE 1E TE if IE iE iE If ie ik k 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: APPLICATI LEGALIZATION:N F E E S U M M A BLDG PMT PLUMBING ELECTRIC ME PERMIT 2.00 18.50 25% 508 PLAN ' s ISSUE FEE 3.00 15.00 BUILDING—DIV—> PERMIT ISSUE PLTAN—CHECK TOTALS-----> 20.50 18.00 0.00 REVENUE DIVISION TOTALS--->. COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 5.00 33.50 E*� DA�TtiEt-*�3�FiF��ii 9E ie ♦E iE iFdE N' 9f 1E.)E 3E iE iE if if Bt # iE ie ie.M 9E STRUCTURAL SEGMENT:N C FIRE SMIP/RES GRADING SMTP/NON—RES TOTAL PAID DUE 38.50 38.50 .00 38.50 OVER/SHORT: .00 FIRE SMIP/TOT GRADING PLAN --CHECK Bf-9E Te 3f aE ff-af iF * 3E 9E 3E iE aF iE * i4 jE if ie % aE i6 4f.)F * * ale lE # iF if if iEDk aE IE # 1E 3E of iE 3E 9( 9f 1( -if- 3E if if dk 3(-lE iF iFif iE if 3E iE lE k iE iF iE j(- %1E 1f lf i( -i(• -0F �(-1E iE iE if jf 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 ELE i SERVICES BELOW 600 V G BELOW 200 AMP 18.50/18.50 PLU I WATER HEATER AND/OR',VENT 2.00 2.00 END OF FEES t 1 I CONSTRUCTION AND PLANNING APPROVALS Permit # APPROVALS Date Inspector P(. & SPA APPROVALS Permit # Date Ins 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �p�j�•j (�,� 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54: Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation "' 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. , 10. Structural Floor System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final _ - 13. Roof Drains I 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final ` 15. Rough Electrical -Conduit 66. Solar System -Final 1 16. Rough Electric Wiring - 67. Fencing & Access Approval I 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 Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure - r ,.70. Underground Hydro 22. Ducts, Ventilating .71. Product Piping 0 Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73:- Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing _ 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and, Flashing - - 76. Dry Standpipe 0 28. Lathing & Siding '� 77:- FIXED SYSTEM FINAL / Insulation _ q- 78: FIRE PREY. FINAL :30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat f 79. FINAL INSPECTION_ 32.�Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED. tric ' Notes: Z^ -Cts" Lp P ting &Air Conditioning r^ Pipe -Test EHood - Canopy.tory Fireplace 1% 38. Final Plumbing UPI. - 39. Water Service -Final i 40. Gas Service -Final - 41. Solar Domestic -Final r - 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation System' - 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING `- 48. FINAL PLANNING f: 49. Electric Release to Edison r• 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date i OWNER JOBADDRESS 266 E. 15th St 1.7Si.1 BUILDING PERMIT NO. GE..cRAL CONTRACTOR Jack Cornair VALUE $ 11800.00 LOT AP 117-181-5 BLOCK TRACT Residence GROUP I TYPEy ZONE R), FIRE DISTRICT 7092 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench zj,D Foundation Forms and Grade to Garage Rough Framing t"4 ��.'�0-� Plumbing, Rough to Sla O.d , WP / - - p Plumbing, Rough Complete � 6/ • Temporary Pole Wiring, Rough/ ��. �9 ��S �(/L�/ l'%�'li/yyd .� �o? /6 J 1 / ] '- Heating, Rough/1, ��7` �o�, // a g •SS �/ 32 H,fing, Final S , House /Sewer, St.�— Septic Tank or Cesspool _ Lathing, In Out Plastering „? Plumbing, Final, Fixtures Com lete Plumbing, Final Gas Test S uk y -16—,f Wiring, Final Occunancv A'nrm 210 C -H 1 nnn 177, Project Addre A.P. Number Building Perm CITY OF COSTA MESA PARK FEES Fee %yment Receipt 001202 Owner's Name Mailing Address _ FEE: Single Family 2 -Bedrooms or Less 3 -Bedrooms 4 -Bedrooms 5 -Bedrooms + Multiple Family " Bachelor or Studio 1 -Bed room 2 -Bedrooms 3 -Bedrooms + Number of Units @ $ 861.76 = @ 1,205.67 = @ 1,545.62 = @ 1,810.50 = @ 474.37 = L4 74, 31 @ 573.18 = @ 881.51 = @ 1,229.38 = f, //'''' ZZ Uq Total Fee •" 4 14. I Planning Department Approval Date I y Applicant's Signature i • City Grciinance 72.44 " City Orolnance 7 -45 •*• City Resolution 78.116 CMF 0174-30, rev. 7/85 White—Planning; Canary—Planning; Pink—Finance; Goldenrod—Applicant c�oisGa arcs