HomeMy WebLinkAbout664 WILSON ST - Building Permits�
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�poxrssoveuim�c 664 W WILSON ST
pNx¢RSfUYEIFppWN: SERRA, CARMALENE
�� 664 W. WILSON ST
COSTA MESA,CA 92627
957-5213
�oo.. �,mmo wowEss:
�q�y1RECT OR ENfIIiEER:
I�CN.OH ENO.'8 ADDPE55:
uc. xa:
UNT:
UNT;
caim�crarswu� LEE ROOFING OF COSTA MESA ( 714 ) 642-7223
�pyiNACTORSY41➢1G 1 6 5 3 SUP ER IOR
�nor�ss COSTA MESA CA ucNo: 349686
92627 uHr:
110EM8ED COMRACTOFS DECLARATION: 1 MMy dlim uMw qnMy d parjury ihm I em licenwd uMw pwiume at Clupw B
(cd��ercin0 wil� Section ]000) d Oivuion � d Ne Bueiron ud PMmeio�n Cade. aM mY licame e in hY lau ud elleq.
cmuc.no.:028751 uc.cuss: C-39 uc.n/o.:�� 3496/f86 � EXP: 03/95
Dde: �^�3 ^ Q� Cwmma: LN[.� /(�/ /'/ LQ
pWNEF BUILOEH DECLINRTION: I hereby elrum uMer perely d prN�Y �hm I em sRemq Imm iM Conlretlors Licenaa l.aw la �M
bIW��O ree�on (Sadion ]0�1.5 Buai�ase arM Prdeveione COEe: R�ry ciY a counly wM1itli repuiree e pe�mn to mneVuct, eller, im0�%+.
'emoloh, or rapei eny evucwro. pior W ee uvuenca, dao reQuires iM eppliraN lor vuc� peimil lo fib e sgmd etmemenl ihel hs or �M
. I��d Wnuent ia tha povieion� d iM Comrmws limnse Law �Choqm 9(cammend�q v.ilh SeUion ]000) d Oi+ebn 3 d tM
dul�sd end PraieaW Cadel a iAm he a tlie M uanq �herahvm arW tM be.iv 1a tla dbYed mamqbn. MY voinun d Sepim
raf1.5 by erry xppGrnN �a e pmmil wbjeGa 1M applkW lo e dW penetly d nol mm Ihen Ms IwMad doAan �SSOOp.
p i.m�«airoww«�v«mr«�o�w».�n.�mme:.w.�,o«��.•;omm..�n.�ene.wn�.e�w.m.a
a all«ed la vb (SeeYon )Ou. eumm ud Pmlpdan CaCe: TM Cw4eepon Lieanfa LewEma nal eWN �oen arnwra pape'ry
who Wid� or inpove+�Mrean. end Ma dam �uM hak IimWl a Mne� ar Maqh h"v v har ovm emOpr�. G�'� �hm wcA
impovement� are nd iruwded a afle'eE la �eb, tl, howe`er. iM W ikinp ar inpuvemaM o edd xilhin w Yeer d mmplMon. Ns
owm�-0uJdx witl ha w lM bu�tle� M V�'�^Y he n ehe did nal buJd a impm+la IM WNae d aelal.
� I. n ovmx W �M V�WNV, em sscWwNY mnirmfq �dh Yunsed canhecias b mw�W Me V�9� (Setlion'lOM. Biv'viws end
Pmleucns Code: Ths Convadwe liaw lew doee mi WpIY b en oM.r d PW�Y xM Wdds a impw'a �Mraon eM xM
wnlrecro far wch Wqetl� wKh e mqrepa(e) licansed Wnueru w iM Caqrodm L'csue lew).
� I em axemq urder Sadion: B. 8 P.C., tor thw raewn:
I Ap Mrepy cerliy Ihq I em ewera d eM urdenWd ihe repuiremsxe d Cellmde HaeAh erd Sda�Y Gode Setliam 25505.255at. end
25�.11. xd Mm I n ury Mun Wikiiq ompeni, vnll / wil m� (acb ona) ��o camply wi� eek etme oodu md �M iepu'vemaib lor
eD�4lacanWNbnamadifWionhomlMM�ly enepemeNDiqf�C.ReeNwtl�OdulruquneGV�ipueneumqhomYwa
pa.{fbm.
ode: �cd�cam:
W ORKER'S COMGENS�TION DKLMATION: 1 Mreby atfvm uMr priMY d pajwy ar d ihe b0oxirq dsdvCiom:
� I heva W Mil me"vaen e wMr�s d m�uw �o eapnwne b xorken' mmpaeuao�, m pvridod ta by Saeion 3lODtl iM leba
COM, la �he pMmmnca d Ur wk la wHc� Nu pxmu u mwtl.
p in.�ww�.�.m�«.•w�w�..���,,.�..,�a���.ewsw�arooam.�.n«cae..wm.c.��+.�K.ain.
.an�,.waa,iM.w�na."ae.Mvw«�,�••S1�ATEMFUND eeea�v�n.��e�. EXPIRES
Cerrier.
Pakyrv�me«: — 06/30/95
is esction neeG�rofW cmnabred I ths W�] is /a me hundnd Gdkre l3faol a lev.)
;ly� I m�M ihq in Ne pManwica d Rw waM b wh'rA thu permil is ifeueE. 1 MeA m empb/ erry p n ury memer ro n to
,� Wmns wbj«f �a tM xaMsa' mmDm�mian lewe d CeGlmae. eM pr Ne1 ! I e �wdjen to tM xa�Mn'
cpnp/eJnaeibn pwisbm d Swion 9'!00 d �M lebar Code, 1 wa
Ode: �J�/� '��� Appfrant:
W�mlrp: FWun b/ecun woiltwi compw'wtlon coYsiap� Is unl�wh( Mt/sIWI uO/�c! �n �np/q�r ro ralml�W pm�ltlu �M
Gv�l Mnu W ro arr hWrM flauuMWlbn (t1�4000A N tlYltlon h!M ewf ol ronpru�tloR ��AP� u pnvMW br In
s.caon arz6 or m. t.eo. caM �m...t .�a •mmer'• r«..
CONSTqUCf10N LENUINO �QENCY: I Mnby elfiim wder peruXy of parjury Ihn iMre u e m�miuGon bMinp epancy br tM
p,��. a ma .o� i« .nw� �w w�+„:wee ts«�o� aos�. ca. ct.
LENDEH'S NAME:
LENUEP'S RDDFE55:
1 c!�*Y �Mo 4 heva reedtho eGV�+�elion W mm�hm llx abwa iNametion m conxi.l ap�aetomndY with W a�l ud ownry ad�enas
yd �Ida lexe iele�iq b Wildip edeV Wian ud Mreby aulhvca repeaeM�e�nea d Ihu tiry b eN> upon IM 6Eova�meeYionaE papenY
i« �re �rtw,,..
/ 20 lo
ir Nems
ns � o�.. .� —/ 3� 4<
un d Or,m/IpeWAppiceM�Gmlreun
(5�S1�M.WP) WM1�e-BuikiqdSebry:O�een-Fb:Ceneey-qOP��:Rnk-Rsvenw:0akemo�Aewev
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; B 071443 PLAN CHECK NO: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: STR
•7' �• �
•• � �• �
PURPOSE: OTH
JOB DESCRIPTION ; T/OFF REROOF W/3 TAB SHINGLES SQ FT; 3,000
CLAIM VALUE; 3,000,00 CALC—VALUE; 3,000,00 GAOUP OCC; R-3 /M-1
COMMENTS: REROOF 2500SF RESIDENCE, SMOKE DETCTORS REQUIRED PER 91UHC
1i K ft M M 1f M%if M M M M M 1f 7F M if K M 1f M 1f 1f M M 1F M if 14lf M 1F!! M M K 1F �f 1f M IF 1f it if M K 1f iF IF M M it M M 1F � �]F {f jl-�/f�iFif� /1�{�f-IFdi �-I����y
Z O N I N G R E Q U I R E M E N T I'dlVi'<<_ UC ;�� �:
------------ MAIN HUILDING _____S_E—T B A_C—K_S__— ACCESSORY e����� R E D____ �
FRNT; ET IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT It3 RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 42215320 2NE; REF NO;
PLANNING Ni5'PES>
�
M1F1F1F7F1k1kiklMM1F1F�FfF1f kMff 74ikikKlFMMa1K1FMiFikitilMiFilatMlFMiF1FiF1FiFikiFiFikilMiFiFiFMMiFiFiFiFaF�FY3FiFMiFatMlFilitMlF3FatiFitjF
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:
1 •
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED HY: DATE: 3 ���
ikMMiFMihit�hifllMitiflhlFifNifih�kifM ifMitMkMitifMiF !4k
if if 1F 1f M 1h 1t M M M if if M M 1f 1f M M 1h 1t 1FM k k 1f if M M M!F 1f if iflFlFlt 1f 1F if if 1f 1t if fF M 1f 1f M if �F M M%1f M M if i! 41F k iF 1E 1f 1f M iF 1F 1f 1F 1f M 1t 1f 1f 1f 1t M 1f
LEGALZ2ATION;N ' F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING &LECTRIC MECHANIC FIRE SMZP/RES GRADING
PERMIT 54.00 .50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
YOTALS----> 54.50 0,00 0.00 54,50 54.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 59.50 OVER/SHORT; ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54.00 ,50
if1FkM1tkltlfkkMMlfMifff�FMlFfklF1FMMMMMIfM1kfFlflfl!lfiflfMM�hlfltkitMMMlf1k#tMklfMlt#!k*kffkk1t7f1kMkiFlt7lif4ifkkkikikif
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
SER 3000 REAOOF BY VALUE RESIDENTIAL N020N£ 1.00 3,000.00
END OF FEES
01 Q0177996-C4117997 7 r� 7 54.SD
DATE: 03/13/SS TIP1E: 1�:21
CONSTRUCTION ANDPLANNING POG�'A
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspecmr
7. Temporary Electrical Service or'Pole 52. Pool & Equipment Location
i �
2. Soil Pipe�Undrgrnd. a,' , 53. Steel Reinforcement ' � �
.�$iiElectrical Condpjt-UtilitY-Undrgmd. 54. Forms �
'��.4; �E'i�ctrical Cond�jf•U,drgmd. � 55. Electrieal Bonding 1
c.r_��
,�5. Steel Reinforceitjent� 56. Rough Plumbing & Pressure Tesi '
•= � lectrical UFER;6YPSi. 57. APPROVAL TO COVER-GUNtTE �
';!r^. r.it '
i i.'j�iKootinqs '��; `� 58. Electrical Cond'�jii Undrgmd.
i
�^;8� �Foundacion ;+�c.^, �. ... 59. Gas Pipe, O Undr.grnd„ Test
-m i,
`"n'J' Water Pipe-Un�md.�� 6Q. Backwash Line15�1''�Trap, C7 Uh�Jrymd.
10. Strucmral Fioo'rSystem 61. APPROVAL Tfl mECK ; -
17.'firoperty SewerVGine_& HouseConnection 62. Backwash & Receptor�Finai •
or �
72. �ewer Cap �j " cc 63. Heater & Vent�Final -
73. Roof Drains . 64. Plumbing System - Final,
14. Rough Plumbing, �; 65. Electrical-Final '�
15. Rough Electricai-Co�duic !r 66. Solar System-Fj��i '
76. Rough ElectricV}�iri�9 �, 67. Fencing & AccC�sflpP�oval I
77. Rough Wiring Sign 68. APPROVED FF3(i'P�ASTERING
�� .. �
78. Rough Electtic��'f;T Bar Ceiling 69. POOL/SPA SY�F�MS PINAL '
19. Rough Heating & Ait CondiYianing P{ftE DEPT, REQUIREMEN7
.i � .r � W r p. : Ht1JE+ h' y :�7
2Q? R�ugk�ac43, ry!Fi}epiace �,.:�; Q,i r �� r r� Y;` APP�OV��3^;� � P�mit #¢ ��•
2• � DUtts, in SSuctUre ��-•• t-+�: S', :� �+ 70.`Undef-t,Ye�(rd Fd+/dro x
� i�� 4 `- O. t
27�. Oqcts,rl/ent,ilat`t'Utg�` `'�S �' � r ij r;.�, r` 71. Prod St7iRinc��as �70i1
23: Gas Pipa-Rou9h &:Test i n;;: . M C �l: z 72. UndergrdUnd F+Us�r � � '��-�- o
2�? Roof F�aming [� �� t" 1� � ��> �'; �� � q 7� Undergri�ii. Stc�r,�Qe,7an� � Gas �?Oil
25. Roof Sheathing„ :r v v'-- ` �+�j 7ti�r�.pverhead HydrHc � a
y'-� �� �
26: T�Har Ceiling (St�dcturaq &lyjQpocoat ; �� �� ;�# � ' �s { 45 •� r,
79.`Qry Chemical , .�� r c_�
n:.t o...' _. . Y ` . �' � i , t. .. : ,
2T Fra.me.and,Fiashigg _�:;c; . r� r���: � �6.4Dry Standpipercq n v '_i
i 28. L�ihing'&$�din�} " �:�zE; �.� �, �- � � t; � 77. FIXED;SkSTEW1-'FINAi�._; �t `
E
"� 29. Insulafion �� r,;+ 'l -{ : .. � �� �; � 7& PIRE PREV. FII�AL � :' !�: .
�' 30. Drywa,11!Nailing�'� ^ ! � �' s t; ,�}i�AlTjk1 DEP�.`'PiEQt11R�MENT
� j 37. PlasterBroevn Coes g, i t,-n• r � �, s �: 79� PINAL t1VSPECYtilN ,`� � _
�; 3�' Electrital P'Qwe�i'IeEe�F�n�i� �% � �; Y•^ 8�7' FOOD CERTIF�J�CaTE I��JED ,s
-' �� -x i c' a cn s,• :+; .�.. t
- 33= Fii,npl �leciqc ni . �, T ( ,� Nqtes: �;�� i. �i :�,h
� 34: FiY61 Meatitnj &�ir Conditiob5iig : i � 1 � � t u7 = i�= e ._ CSE�
H . l .`l z I%' Rt M � � S� H 1• H �� t T•
3�FinalGesPipe��r zt ��� �j r � - .. � " ; ��`�
� t=7. �,; � ra � 4�. y:' :Cc+ C;.� . Fp'
`� � t ;7 1 P' `7 s t: 1 �f d 2 5' ('1+i--' t i �:. ��
' 36. Hood at Canopy. _ ( � -�
... .,•, � . i x � .,n ::c� • cc �itn
� y ') •�" -• �f � � I '� R' '-.t � :�1 I ` � � � -T�- �
3T Fiqal F�ctory Fir,�p�cE• � F.p. ... � � F x� N
38. Pittai P.1�mbingQ' '� �' '� : �� -` � '.a ` , �
�� Y n, �. � . � .- r. � Y :�
° 39. 4V�4er Service�F�n�l ,�- � '� � ., i � � •. � :�:'`' d , ;i
; 40. Gas ServiceeFinata ;:� Si^-� _' r tu � ; kr. ? C.:. r.�c� .+ - -�
i��
r, c. c.. � i x 1-� p F -�•�
�• 41. Solar pomesvc�fi;�a�- �� '- "-: � � ` ��' �. '
_, .� . ?7 r r t r� . - v + '; �
� 42. Backflow Prevenier � N r y , i �� C; � F • � � f+
• t # ni n_� f
43. Backflow I�i `r:"_. , i. -.o F �� :
..l9atinn s, F , � .�
� :, _ .� _
. 44. Landscepe�rriqation System�ii'� �: ..n ^. c'?r .� n: sv '�::� +^ �: �:>
.+' ' k Y T T p,l C1C. +�-
j '� . ..�rrc. � � 2: F E•, + � ry �-i C',... u;�� �
'- 45:, Sound,�Atte�ua'tlqri �� :.. . ,,7 r•; • t' r. r t• F-�::�
��-, . . .. v . . . ,
:: 4�• Handicap f�eguiations ii r e c er; �• [?o ^
i � . . � nio�n .
i, s n1 O_: ' r
47- FINAL STRUCTI�RE & BFALD�NG ' I �
, - 6 _�i; ��✓ , � . 4.
V 48;i FI�NA� PLANNING i i-�� .._ , _. r•t �. �• -
�'� K' \�
� 49.' El�tri� Aei.Pase to`Edison � � i �' ' �jj .^ x �-: o
_ � � o
� 50: Gas. Refease to Southern Caiiforwia Gas Cn i � �- -� ��:-'*� �` �J ��•
� -� �: a
51. C RTIPICATE OF DCCUPANCY > - .. �*!,� . - ��
No. Date
Pp0.1ECT ROOBESS: ((� q W W I LSON S T
,OWNEN'SrYpME: SF.RRA, SANiTNA
' doueess: gERRA� CARN!AI,ENE
?.509 KTNCASll Dk APT 208
COSTA ;�IESA,CA 92626
ANCHIENGINEEfl:
nooecss:
NEG.ND.:
UNIT:
UNIT:
PEHMITTEE: ar 4 S AEATIiJG tr ji:l� C�IVn ( 714 ) 837-2000
aooAess: z�jpq CAMINOR CAPiSTRANO 157
LAGIJNA NIGUEL CA 92677
LICFNSED CONTNACTON OECIABATION: I here�y allirm �Aat I am IicenSeA unaer pmvisions ol C�apter 9(commencinA wiih Seciion
7000� of Division 3 0� Ne Business an0 Prolessions Cotle. an0 my license is in lull force antl etleci.
cinuc.:07_77G58 sT"TEuc.:3938lR cuss: �-ZO
' ?�y� / Z Signalure: _�_��
WOflREflS' COMPENSRTION OECIABRTION: I hereby a��irm �ha� I haue a certi�ica�e ol cansent In sel4insure or a certi�icale o� Workers'
Compensaiion Insurance, or a cenilieC cop thereo� (Section 3800, la�. C).
aoucrxo.: WC10127339�3 E%P.DRTE: OI IOI ��3
COMPRNY: CNP.
� ❑ Cenitiee copy is �er¢Dy fumishe0. � Certilietl coOY � �ile0 wit� I�e city ilOmg Oiv¢ion.
�
—�i�i �4�. Z AODlican�� �� �^-n-a�
E%EMPTIUNFNOMWOBREBS'COMPENSIITIONOECLAflRTION: Qhis5eclionneetlnolbecompletetli��hepermi�is�oronehuntlreA�$100�orless).
I Certify �ha� in �he petlormante ol �he woB lar whic� �his permii is i55ueJ, I Shall not employ any per5on in any manner 5o a5 �o heCome
sublet� lo the Workers' fAmpensation LawS ol Califomia.
Dale: Signature:
NO7ICE: Ii, atter maNinp iNs aeclaration. yau shoul0 bemme su0iect Io ihe workers Compensation provi5ions of the LaGor
Cotle. you musl �onAwilll comON v^�� suc� pmvl5ians or Ik5 permit shall Ge EeemeO revokeA.
CONSTNUCTI�N LENOING RGENCY: I �ereDy aflirm Ihai �here is a cans�mc�ion IenUing agency for Ihe p¢dormance ol I�e work tor
which Ihis permil is i55uM (Seclion 3097. Civ. C).
LENOEfl:
aoosess:
OWNEB BW�OEB OECLANRTION: I here�y aifirm IAat I am exempt Imm ihe Caniractors' State License Law for Ihe lollowing reason
�Section 703t.5 Business antl Pmlessional Cotle: Nny ciry ol counry w�ic� repuires a Oermit ta consimct, alter, impmve, Jemalish, or
repair any stmcture, prior to iis issuance, alm requires Ihe applican� lor such permit �o file a signetl statemenl t�a� he/s�e is licensetl
pursuam �o ��e provisions ol Ihe Comrac�ors' S�ate license Law (C�ap�er 9(commencinA wi�h Sec�ion 7000) oi Division 3 oi Ihe Business
ana Pro�essions Cotle� or Ihai he/she is eremD� Ihereimm an0 Ihe �asis br Ihe allegetl exempiion. Any violaiion ol Section 703L5 by
any applicani for a permil suble��s Ihe ap0licanl lo a civil penalry o� not more �han �ive hwAreA tlollars (8500�.
I, as Owner of Ine pmperty ar rtry employees with wayes as their Sole cOmpenSation, wJl Co tne work, ana the
❑ sirucmre is not inten0etl ar oHereOlor sale (Sectbn 7044, Buvneu an0 Professional CoCe: T�e Coniractors' State License law
aou not aoD�Y to an owner ol a om0eny wlw buil�s or imo�oves iher¢on, an0 wlro does such vrork hims¢II/herself or ihmugh
his ar her Ovm emDloyees. pmviAeO tAdt such impmvemenis are not intende0 or oflere0 lar Sale. If, Mw¢v¢r the �uiWing or
impmvemem is m10 within one year ol completion, tAe owner vnll �ave I�e hurden al DmvinA he/s�e tli0 nol 6uilU ar impmve
for the purpose ol sale).
I, as owner ol Ihe orooeny, am e�clusively contracting wi�A licensetl cantrac[ors to conslmct [he pmleq (Section 7044, Business
❑ antl Prolessions CoOe: The ConUaclors' State License law tloes no� apply Io an owner oi properiy who Duilds or improves Ihereon
antl who contracis for such D�ojecls witA a conlractoqs) license pursuant to t�e Contractors' S�ate License Law�. I am aware
�hal pmol ol t�eir WOBer'S COmDensalion insuranC¢ ShoWU be D�a��a� �o me.
� I am edempt under Sectian: B. 8 P. C.
br �his reason:
Daie: Owner:
I Co nereby cenily Inal I am aware ol an0 untlerslane ihe reQuirements a1 Catitomia Health antl Safety CoOe Sections 25505, 25533, anJ
2553a an0 ��ai I or any lumre Uuilding acupant wilVwiA not (cirUe one) neeE b compty with saiG state codes anU ��e repuiremenis for a
permii for consimction or mOGdicalion �mm I�e Air QuaOy Manaqemenl OislricL RevGen�ial conslrupian apD�iwiions are exempt imm
inese o�ovisions.
Dale: Applicant:
I hereUy ceriify Ihal I Aave reatl Ihis application antl s�ale tha� Ihe ahove Inlormalion is correct. I agr¢e �o comOty with al� ciry antl counry
ortlinances ane slalelawsrelatingto builtling conslmclion antl hereby aut�oriiereD�esen�alives o�ihis cityto enteruponthe above�men�ioned
prOpBriy �Or in5peclion purp05¢5.
'L2f� �� � '�/ Z Signalure: ,�.�+5�
Oriver's license or Social Seari�y a:
t6a�-C6 White—Bmltlind; Green—Cotle Enlorcemenl: Canary—Aooliwnt; Pink—Revenue: GOldenro0—Axsnzsnr
Cii'Y OF COSTA NESA - BU�LDING PERMIT PEkM NO; M. 05648f
PERNIT NO; M 056488 PLAN CHECK N0: N GnVT; N SUPP: N
CONSTRUCTION TYPE: V-N PERMI'Z TYPE: McC PURPOSF.: OiH
JOH DESCRIPiIUN , iNS:'Ai,L N�'rT A/C i7i�1IT E REPi,ACE :fEATER S� FT:
CLAIN. C�ALUE; 3,000.00 CALC-VAi.UE; GROliP OCC: R-3 /
COMMENT5• SMOKE D^TECTOR RE�UIRED IN 1HF. HOME
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7. O 1� 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 BU�LDING ---------
F'RNT: FT iN REAR; FT IN tRNT; rT IN REAR; FT iN
LEFT; FT TN RGHT; FT IN LEFT; FT ZN RGHT: F'T TN
PARKING REG: PROV; PARCEL: 427_15320 7.NE; REF NO:
PLANNING NZSTES>
�
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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'P S
ZONING APPROVED HY DATE;
BUILDING APPROVED BY : DATE:
APPLICATIOh ISSUED lY; � -' DATE:� �%�r���
iF ff �1F �# iF le IE #%� #E ii�% iE i( 1c iF iE if # if if .�'� iciiiFR'�'?i�7iTF3t "�i: ��iF#�£'&'&ir'�ft �IE iF if� 7E if� ## 1i� k ic �`&'% u�%�Tc ?i� #
if 3f-iE �IF if ?e k 1E if fE If i! iF iF # ie # i6 # if ## ic N-} 1f iE if 3E # 3!� iF ## k if ### k iE ih?f ic ii iE ii� iE 1f # ie iE !F ii } 3E t�E 1E } IE iF #�f ir N� iE 3E iE iE # il k# 3'r±(� 3r A� if
LEGALIZATION;N F E E S U M M A R Y STRUCTliRAL SEGt,EN':':N
BLDG PMT PLUN.BZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
FERMI'i 18 00
l58 SMIP/NON-RES
PLAN
ISSTiE FEE 15.00
BUILDIhG-DIV-> FERMIT ISSUE PLA1�-CAECK TOTAL PAID DUE
TOTALS-----> 18.00 15,00 0.00 33.00 33.00 ,00
RF.VENUE DIVISION TOTALS--> COLi.ECTED: 33.00 OVER/SAORi• 00
HLDG F�M3 PLUMBING cLECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
33.00
# �F ik �1F # lf 3F 3i� ih if �%# 3F% If 3F iE 14 fE 3E # iF iE iE iF iE if ii if �)f �fe ## f( ## lE iE # ie # 1f 3f �f� # iF #� ii� i!� ib N# Ik iE 3f =4 ic # lE i( le iF iF iE # 3F 3F # 3f!'r �E # 1E iE # if #� M� 3E
I N D I V I D U A L F E E H R E A?C D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
MEC 1 INST FORC-AIR/GRAV FTJRN [= 100 K BTU 9,00 9,00
N,EC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9,00 9,00
END OF FEES
R1 a.'ii���,.� �;i _:;i - -.-- . .
::�TE' ��: �.�.' . '.,,_ , 1.
' CONSTRUCTION AND PLAN(�1�NG 1 POOL .PA ;
APPROVALS Permit #�- �Date Inspector AppROVALS Permit # Date Inspector
^. Temporary Electrical Service or Pole � 52. Pool & Equipme�t 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
5. Efectrical UFER Grnd. 57. APPROVAL TO COV£R-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test --
9. Water Pipe-Undrgmd. ' 60. Backwash Lines, P-Trap, O Undrgmd. �
10. Structural Floor System � 67. APPROVAL TO DECK
11. Property Sewer Line & HouSeGonnection 1 62. Backwash & Receptor�Final �'
12. Sewer Cap � 63. Heater & Vent•Final �
73. Roof Drains � � 64. Plumbing System � Final �
14. Ro�gh Plumbing � � 65. Electrical�Final
15. Rough Etectrica4-Conduit 66. Sotar System-Final
i 6. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign b 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Faaory firepiace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergmd. Storage Tank D Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 76. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal � 80. FO00 CERTIFICATE ISSUED
33. Final Electric " Notes:
34. Fina� Heating & Air Conditi0ning 3//O/Q L�i�
35. Final Gas Pipe-Test �•
36. Hood or Canopy �
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
4/. Solar pomestic-Final
42. Backftow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAISTRUCTURE&BUILDING '
48. FINALP�ANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co i�
57. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECTAD09,F55: 66q W :dILSOtv ST
GWNEP'SNAME: SGRRA, SANTINA
noosess: SERRA CARN.'A:,ENE
2509 �iINCAID DR APT 208
COS'�'A McSA,CA 92526
RNCXIENGINEEN:
RO�flESS:
XEG.NO.:
UNIT:
UNR:
PFflMITTEF: S & S HEAiING F. AiR COND ( 714 ) 837-2000
aooness � /329 CAMINOR CAPISiRA1@G 157
LAGUNA NIGUb:� CA 9267"/
LICENSEO CONTBACTOH OECIANATION: t �ereGy atlirm thal I am licensed untler pmvisions ot Chapter 9(cammencing wi�� Sec�ion
7000� ol Oivision 3 al Ihe Business ana Professians COAe, anA my license is in lull force antl elfecl.
ciTruc.:027758 sTarEuc.:3938iA�C-.�'0
I"�1p-��4—�i2 siqnamre:_ �(,�yy —i.rS-
WONNEPS'COMPENSRTIONOECLANATION: Ihere6yaffirm ha� �aveaceniliwteoicansemroseli-insureoracenificareofWorkers'
, Compensaiion Insurance. o� a cenifietl copy t�ereoi (Section 3800. Lab. C1.
�'POLICYNO.:WCSU:2733903 E%P.DRTE: OZIOSI93
LOMPANY: C�ja
❑ CenifieE copy is hereEy lurnishea. � CeM1ifietl copY is fileE wit� tAe ury Build g Division.
. �,=(� � �% Z Applicanl ��� --"'-+ +�
E%EMPiION FPOM WOBMEPS' COMPENSRTION UELUNPTION: Rhis seciion neeU not be comDleteO if the permil is lor oire �uMreO (5700) w less�.
I ce�ity Ihat in Ihe Oer�ormance ol I�e �+ork for w�ich Ihis petmil is i55ue0, I s�all no� em0loy any person in any manner so as to become
suble�� �o Ihe Workers' Campensalion Laws o� Calitomia.
Dale: Signa�ure:
NOTICE: Ii, atter making t�is declaration, you shouitl become SUDlect to ihe Workers' ComDensation pmvisions ol the Lahor
Cotle. you musl farlhwiN comDly wil� such provisions or �his permii 5hall he deeme0 revoketl.
COKSTNUCTION LEN�ING AGENCY: I hereby affirm t�at Ihere is a conslmction lentlmg agency lor I�e peAormance of the work tOr
whic� this permil is i55ue0 (Seclion 3097. Civ. C�.
LENOEfl:
ROOflESS:
OwNEB BUILOEB �EClABA710N: I here6y aflirm Ihat I am eMemD� �mm Ihe Coniracbrs' State License Law lor the lollovnng reason
(Seclian 7037.5 Business anJ Pmlessional Catle: Any city of coun�y which repuires a permit m constmct, alter, Imprme, demolish, or
repair any StmcWre. prior lo its issuance. also requires t�e apDlicanl for such De�mit Io file a 5igne0 5laiemen� ��at �e/she is licensetl
pursuanl lo I�e pmvisions oi �Ae Contracmrs' S�a�e License Law (Chapter 9(commencing wi�h Seciion 7000) ol Oivision 3 0� the BuSinesS
antl Pmfessions Code) or Ihai he/she is exempt Iherelmm and Ihe basis lar ihe alleged exemption. Any violatian ol Sectian 703L5 by
any applicani �ar a permii 5u�lecis �he applicani to a civil penalry ol no� more ��an five hundretl tlollars �5500).
I, as avmer ol ihe O�openy or my emyloyees witn wapes as Iheir wIe campensalion, vnn tlo Ne work, ana the
❑ stmcWre is no1 imenOeA or o1�ereA �or sale (Section 704d. Business and Professional Cotle: The Coniractors' State License Law
does not apply to an owner o� a pmpenY wtro EuilGs Or impmve5 �h¢reon, and who Joes wch wOrk �im5elf/heRelf or thmugh
his ar her own em0�oyee5, provi0e0 iha� suc� improvemenls are noi intended ar ofler¢G for sale. If, Aowev¢r Ihe GuilGing or
im0�ovemenl is 5a10 wi��in one year oi completian, ihe ownei vnll have Ihe burtlen o� Oroving he/she Citl not builtl or impmve
lar ihe Durpou al sale�.
I, as owner oi Ihe pmpeny, am excNsively conlraciinp wilA licensed tontraclors to conslmci Ihe prolecl (Sec�ion 7044, Business
❑ antl Prafe55iatS CaOe: iA¢ Contracmrs' State License Law Op¢s not appry ro an owner of Ompe�1y wM hmlEs or im0�oves Nerean
and who canVacts lar such prole��s vnt� a conVatlor(s�license pursuanl b �he Contraciors' Stalp LiCenSe �aw),I am awart
��at O�oo� of I�eir Worker's Compensation insurance s�aultl be Orovidetl to me.
� I am ezem0� untlei Setlion: B. 8 P. C.
. lor ihis reason:
Oa�e'. Owner
I Uo nere�y cendy that I am aware o1 ana untlerstana tAe repuiremenls of Calilomia Healt� ana Safety Ca4e Sections 25505, 25533, and
2559a anU Ihat I or any Iuiure builtling occupani wilVwill nol �circle one� nee0 to romply wii� said 5�ale coaes ana Ihe reQuiremen�s tor a
perm�t lar con5lNclion or moGJiWtian Imm Ihe Air �ualily Managemen� OiSirict. FeSidential conS�Ncibn apDlications are exempt imm
I�ese provisions.
Dale: Applicanl:
I hereby cetldy IOaI I have reatl Ihis appliw�ion antl s�a�e ��ai ��e ahov¢ iniormation is wrreci. I aAr¢e Io comply with all ciiy anG couniy
ortlinances ana slate laws reW�ing �o UuilOing ton5lruclipl and her¢P/ aulhorrze repr¢sen�ativ¢5 of �NS ciry Io enler upon Ihe ahOve�men�ione0
pwperly lor inspection purposes.
f7ale!� ��7�� Signalure'. �'� -1 �
�T
oriver's ucense m Sociai Security a:
t6abA6 W�i�e—Builtling; Green—Coae Entorcement; Canary—ApplicanC Pink—Revenue: GOlaenroC—Assessor
—�
CITY OF COSTA MESA - BUILDTNG PERt!I5' PEkN. NO; = 05648;
PER:!I'f NO: E 056487 PLAN CHECK NO; N GOVT; N SUPP; N
CONS'iRUCTIbN TYFE: V-N FERN.IT TYPE: EiE F'URFOSE; OTit
JOB DESCRSFTZON : cLECTRICAL PERN.I'l rOR A/C iINZT SQ FT:
CLAIM VALUE: 3,000,00 CALC-VALOE: GROUP OCC: R-3 /
COMN.ENTS; Si�!OKE DETECTOR RE�UIRED IN THE HON,E
itfE3Eif�iFlkiFi(iE�l(�leiEiE3E>iFiiff#i4iEki!#### ick#ic#3EiF%�3't�lEifiF##iF�kikiliF+(�E1t-k�#i'rik�kii�#iEie3Eif+E�lEifih�lF#F3fk1'r�lfii�i'ri5#kiF�#
Z O N I N G R E Q D � A E M E N T S
S E T B A C F: S
------------ MAI\' BUILDING ---------- --------- ACCESSORY RUILD�iNC ---------
FRN1: FT IN REAR; FT IN =RNT; FT IN REAR; FT TN
LEFT: FT IN RGH'l; FT Ih LEFT; FT IN RGIiT: FT TN
PARKING REq • PROV; PARCEi; 422153?0 ZAIE; REF NO;
PLANNIhG NGTES>
7
iF i: if �k ii� K• IE #!F �lE iE * IE ii- 3i� 1't ii if� ii� %!f 1!� # if )k ie iF iE �lk ik #�1E iF #-le if iE � if 1f #+E #: If iE �k # if iE if� i( iE?E ih # IF #f #ii� iF fE if lE ii- # it� 1f� if 1F iE iF ## if if� 1f iF 1F ib
D E V E L U P M E N T S� R V I C E 5 R E Q U; R E N. E N T S
7.ONING APPROVED BY '"' DATE;
BUILDING APPROVED BY ; � _ DATE;
APPLICATION ISSUED BY; 3—�'�— %c Z
- `7'h°'� nATE:
iE1EiF#%�#kiF?e�)fiFlf�If-3(�ih�ii3Fii•iEiEf4iE��,;iiir'£iFiFiF7�i3F'T.T3t , . x� .iEiFiEd'r)f#iFlfiFif?exiFT.t£7F'�F�##
�.�`:�ii�Y;.'y'..�.?:}{-.i#i;�:.}109�4474#�i�%X:ya;l:}:i?:iFV#a:.tia:;� cu 7: ): a,. y. .
_. .} #!� ir%izie.:A�/:.'ir+rtF�Ca:�Y,C�:.1-*iEfEif-iE#k#iEkiciiit�:
�EtlA:,,r%:�rri�+�stv F s� � a!k'. r? ,� x Y 5;�ac*�_'�c��:?� 3���;En�r:ro
BLDG PMT PLUN.BI,'VG ELECTRIC MECHANIC FZRE SMIP/RES CRADIIvG
PERN:3T �50� gMIP/NON-RES
PLAN
ISSUE FEE 15,00
BDILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL FATD DUE
TOTALS----> 7,50 15,00 0,00 22,50 22.50 ,00
RcVENUE DIVISION TOTALS--> COLLECIED• 22,50 OVER/SHOR1• 00
BLDG PMT PLUM3ING �LECTRIC MECHANIC FIRE SN,IP/TOY GAADING PLAN-CHECK
7.2.50
## 7f It % if ff iF %�1e # iF 3E ii� i'e tE iE }. # iE k 1f iE # if # if # iF iF k iE iF d: # aE iE ff� #?E iF ii� # iE-1E ii i(� i(� 1E iFiE # iF ii 3E 3f #?F iF if iF #')i- # iE ii�lF ##jE } je ie # iF aF i 1f }
I N D I V I D U A L F � E B R E A I( D O W td
TYPE QTY D E S C R I P T I O N Jt�'IT COST TOTAL COST
ELE 1 MOTOR/POWR APPARATUS 1,1 - 10,0 AP 7,SU 7.50
Et3D OF FEES
^: u�iil�+..'- ' , i�,�.' _
.aT� �_ .. :_ _ ._ ..
�
. � ,
, CONSTRUCTION AND PLANNING ' POOL ,PA �
APPROVALS - Permit # Date Inspector pppROVAIS Permit # Date Inspector
1. Temporary Electrical Service•or Pole .• 52. Pool & Equipment Location _
2. Soil Pipe�Undrgrnd. . - �' , 53. Steel Reinforcement
3. Electrical Condoit Utility-Undrgrnd. ' 54. Forms ��
4. Electrical Conduit�Undrgmd. 55. Elect�icel Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrital UFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footinqs 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgmd., Test j
9. Water Pipe-Undrgmd. • 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structural Floor System � � 61. APPROVAL TO DECK .
i i. Property Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sewer Cap �� �i 63. Heater & Vent-Final
13. Roof Drains , 64. Plumbing System • Final �
14. Rough Plumbing ' 65. Electrical�Final
15. Rough Electrical-Conduit 66. Solar SYstem-Finat
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rou9h Factory Fireplace APPROVALS Permit #
21. Dutts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O 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 MeterFinal r� 80. FOOD CERTIFICATE ISSUED
33. Final Electric 1j-� �� %i� Notes:
34. Final Heating & Air Conditioni�g �•� ,
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 pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING :-1
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co .'
51. CERTIF�CATE OF QCCUPANCY
No. Date
� . - . � � ����� ��� R���IVED
COSTA MESA BUILDING DEPARTMENT ��{� ��/1�� �w■�'���
P.O. BOX 31"I .��n{� q� .�
COSTA MESA. CALIFORNIA IlrfV A[ Af1M� �!'�
�+1� W C:3)1 �#
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
BUILDING 66y, w. I�lson St. BUILDING
ADDRE55
COSTA MESA. CAIIFORNIA FOR OFFICE USE ONLY
MAIL
ADDRE55
TEL.
NO.
LIC.
rv o.
AODRE55 Garden Vl"�Qe
� T�, CITY LIC. �
CONTRACTOR O egTOPB� 113C• NO.
ADDRE55 4�9 E. 17th St. T�o:Li• 8-i159
LEGRI LOT I� ^r�
DESCRIPTION NO. �G BLOCK TRACT 1GG�S
A.P. NO.
S��E 61 x 100
OF LOT
USE OF
EXISTING BLDG.
No. or e�ocs. II0116
now orv �or
SETBRCK LINE FPOM ��1
cervr[A oF siaeei . 4'Z� REAR YARD
NEW
REPAIR
BUILOING
PbY'Z�1�JXf/
RIGHT bi IEFT ��
DESGRIPTION OF WORK
A ALTERATION ADOITION
MOVING DEMOLISH
NO.OF
�i5 sd; � ROOMS �j STORIES
LL IAOOF
wi.th attached garage.
aE�E��irzD-�yl 9-,30E�„�I S��,E3�o�
l
6UILDING
ADDRE55
COSTA MESA. CALIFORNIA
Plan 110BR
I HERE6Y ACKrvOWLEOGE THPT I MPVE REf�D TMIS �1PPLICATION AND
$TFTE THFT THE ABOVE IS CORRE<T LNO tGftEE TO COMPLY W!TH 4Ll
<ITY OFOINPNCES /�NO STATE WS REGUIPTING BUILDING CONSTFUC�
norv. VALUATION
SIGNATURE OF
PERMITTEE
PLPNS
_ " I�13,919.00
IZED AGENT �.ke & Colegrove, InC.
OATE
CORRECTIONS
PERMIT FEE rDJ2�V�1
PLAN CHECK 516�00
TOTAL FEE 54g�OO
VBMi
CP
AOP���ant to fill in all ipaees exeept those wit�in heavy boraer lines ane sign all aDD�ooNale aeclarations.
CITYOFCOS7a M/ES CONSTRUCTION RMIT
� Project Address �[' ��� ° LL�� �SO/1 i
Applicant'sMailingA dress —�QQ���(JYL "d� `
.
Owner's Name/� si��"�'1 � /1 - Phone
Address - �/�%�
Arch/Eng. License No.
Address J _
Contracmr's Name ./ __PhAone ' d0
Addresslm��l'ngl ��[�d/En �tM��7 /'Uiti,�la. Q�7[y
City License No. � d�% �S
LICENSEO CONTRACTOR DECLARATION
I hereby affirm that I am licensetl untler provislon5 of Charter 9(commencing
with section ]000) of Division 3 of the Business antl Professlons Cotle, antl
my license is in f I for e antl efiect. �
Licens CI 5 ' ens No.
Date �-�-g� Si9nature � � -
WORKERS' COMPENSATION DECLARATION
1 nereby aftirm chat I have a certificate ot ronsent to self-insure or a certiticate
' Workers' Compenwtion InSurance, or a certifi¢tl co y thereot (Section
��. "°. `.'�CS�! q! o �
volicy No. company '
Certifietl mpy is he�eby tumished.
Ce ifietl c� is filetl with the city B ing rv�j ion. '
ate��.— APPlicant �� {J
EXEMPTION FROM WORKERS' COMPENSATION DECLAqAT10N
(Thizsection neetl not be com0leteE if Ihe permi[ is for one hund�etl ($300) o�
less).
I certify that in the pe�fo�mance o/ Ih¢ work for which this pe�mR is issuetl, 1
shall not employ any pe�son in any manne� so as to ecome� ubjec[ ta the
Workers'_ mp tion Laws of Califor/ye�� //`
Date Signa[ure �t� �C
�NOTI E: If, atter making tnis tleclaration, you s oultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
compty with such provisions or this permlt shall b¢ tleemetl revoketl.
CONSTRUCTION LENDING AGENCV �
I hereby aftirm that there is a construction lentling agency for the perPormance
of the work tor whicM1 tn's rmit is issuetl (Section 3097 Civ. CJ
Lender's Name'
Lentler's Atltlress �
OWNER BUILOER �ECLARATION -
I hereby attirm that I am exempt trom the Contracto�4 License �aw to� the
following reason (Section �031.5 Business antl Professional Cotle: Any ciry or
county which requires a permit.to const�uct, alter, improve, tlemolish or repair
any structure, prior to its issuance, also require5 the applicant for such permit
to fiie a siqnetl statement that he/she is licensetl pursuant to the provisions of
the Contractor's License Law (Cbapter 9(commencing with Section 7000) of
Division 3 ot the Business antl Professions Cotle) o� that he/she is exempt
'herefrom antl the ba5i5 for the alleged exemption. Any violation ot Section
031.5 by any applicant fo� a� permit subjects the applicant to a civil
xnalty of not more tnan tive huntlretl tlollars ($500). '
❑ 1, a5 owne� of the property or my employee5 wi[h wa9E5 as tM1ei� sole
mmpensation, wi11 tlo the work, antl the structure is not intentletl or otteretl
tor sale (Sec[ion ]044, Busine55 antl P�ofessional Cotle: The Cont�acto�'s
License 12w tloes not appty [o an owner of a O�operty who builtls or improves
thereon, antl who does sucn work himself/herseli or through his or her own
employees, provitletl that such improvements are not Intentletl o� offe�etl tor �
sale. If, howeveq the builtlin9 or improvement is soltl within one year ot mm-
ple[ion, [he owner will have the burtlen of proving he/sM1e tlitl not builA or im-
p�ove for the purpose ot sale).
❑ I, as owner of the property, am exclu5ively contractinq with IicenSetl wn-
tractors to mnstruct the project (Section ]044, Business antl Protessions Cotle:
The ConVactor's License Law does not apply to an owner of property who
builtls or imp�oves thereon, antl who cont�acis for such projecfi with a con-
tractor(51 license pursuant�to the Con[racror'S License Law). I am aware tbat
proot of their Worker'S Compensation insurance shoultl be P/ovitletl to me.
❑ I am exempt untler Seciion—M� 8. & P. C. for t�is reason
niia
Date
� I hereby certify tha�
information is correr
antl state laws relati�
sentatives of this ci
inspe�tion purposes.
' $ignature �
Drivers' Licen
1F 0865-46,rev.10/84
owner'—
have reatl this
tafe tM1at the above
tl county ortlinances
:by authorize repre-
ionetl O�operty to�
Oate / 3-�S
TVPE OF CONSTRUCTION LI NEW I-J ADO LI ALTERAT�ION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT GRA�ING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL��PLUMBING ❑ MECHANICAL
❑ OTHER
PROJEC7 DESCRIPTION SCZ. FT. oCCUaANCv-
CONSTRUCTION TVPE VAIUATION $
ZONE GRADINGCU.VOS. ACRES
Remarks:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service DU[I2t5
Interceptors
Kitchen Sink �
Lavatories -
Drains '
=Reinspectian Fee � $15
Boiler
Duct - Under Ground
Duct - Sttuctural
Duct-Ventilating �
Exhaust System ❑ Multiple
Firepl/PactBICICBO# '
Heating System & Ducting �
❑ o-i oo,000 aTu � i oo,000
peinspectian Fee � $15
White - Builtling; Canary - Applicant; Pink - Accountin9; Goltlenrotl - Assessor
PLUMBING
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimmin9 Pool w/Spa
Urinal
Water Cloret
Water Heater .
Water Service
Auto-Wash
Laundry Trays , .
Issue Fee
Hoodor Typel ❑
Canopy Type I I ❑
Retrigeration System
❑aioo,000sTu �ioo,000
System Repair/Alteration
F ire Dampers
Registers �
laue Fee
$ 3
$ 3
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Fan
F.A,U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW
Fee
5045 1/07/85
Zone
Accessary Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+KW
Meter ❑up Lo 100 amps
Meter ❑over100amps
Sub Panel
Motors �0-1 HP 01 h- B
Inc.Solar �9-75 HP �16-15+
Microwave
Pole Light
Range
; Standing Section
5-15 KW Trash Compactor
$15 Issue Fee
DEVELOPMENTSERVICES
Zoning Approved By
Building Approved By _
SUMMARVOF
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $ S�b'
PLAN CHECK 25% $
ELECTRICAL $ �
PLAN CHECK 50% $ �
MECHANICAL $
PLAN CHECK 25% $ .
5e9'1 TL
FEES
$ 3
SMIP � $
PERMIT
ISSUANCE $ �
ENERGV P.C. $
GRADING $
MICROFILM $
TOTALFEE $ Od
Z
O
N
I
N
G
R
E
Q
M
T
5
CONSTRUCTION AND PLANNING � � POOL �PA I
APPROVALS Permit# DateY Inspector AppROVALS Permit# Date Inspec,2nr �
� 1� Temporary ElecVical Service or Pole ' . 52. Pool & Equipment Location
2. � Soil Pipe-Undrgrnd. . � ' 53. Steel Reinforcement
3. Electrical ConduitUtility-Undrgrnd. . 54. Forms
�4. Electrical Coriduif-Undrgrnd. . -" 55. Electrical Bonding '
5. Steel Reinforcement I � 56.- Rough Plumbing & Pressure Test '
6. Electricai UFER�Grnd. ' 57. APPROVAL TO COVER-GUNITE -
7.- Footings • . . _ � � 58. Electrical Conduit-Undrgrnd. �
8� Foundation - . _ • 59. Gas Pipe, O Undrgrnd., Test �
n 9.=Wa'ter 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 Electriral-Conduit � 66. Solar System-Final -
16. Rough Electric Wiring � 67. Fencing &�Access Approval
17. Rough Wiririg Sign 68. APPROVED FOR PLASTERING
18. 'Rough Elect'rical-T Bar Ceilin9 69. POOUSPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. flough.FactoryFireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating " 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
�24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil .
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Strucwral) & 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. DFywall Nailing HEALTH DEPT. REQUIREMENT
37. 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 . �
ss. F��ai Pi�mb��y % q 35- �c%D
39. Water Service-Final ��
40. Gas Service-Final ,
41. Solar pomestic-Final . .
42. Backflow Preventer . . , '
43. Backflow Irrigation � �
44. Landscape Irrigation SYstem � '
45. Sound,Attenuation .
46. Handicap Regulations � , � �
47. FINALSTRUCTURE&BUILDING
48. Special Requirerrients Completed � . - -
49. Electric Release to Edison � � � � - - �
.,
50. Gas Release to Southern California Gas Co � � ,
51. CERTIF.ICATE OF OCCUPANCY � . � �
� Nn. _ Date ' I � � I _
OWNER
'OB ADDRESS i
DATE
BIIILDING PERM/T NO.
GENERAL CONTRACTOR Dike & COlEp'Pove VALIIE $ Zj,919.00
AP. No. LOT 2. TRACI' 2215 P� ZONE DFSCRIPTION OF WORR Single £amily Res.
G' �IP I& J 7'7fPE V �� R11 PLAN NO. �
INSPECTIONS I DATE I SUBCONTRACTOR
coat
P" inq Pixtu
Pi�._. Gas Test