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HomeMy WebLinkAbout151 23RD ST - Building PermitsPT PROJECT ADDRESS: 151 23RD ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 051036 OWNER'S NAME: V N E. DEVELOPEMENT ADDRESS: 4'3519 VON KARMEN *100 PERMIT NO: M 051036 PLAN CHECK NO: N GOVT: N SUPP: N NB CA 92660 CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: OTH ARCNIENGINEER: REG.ND.: JOB DESCRIPTION : NEW SFD ( INSTALL 75000 BTU FAU) SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 ' - PERMITTEE: BEACH AIR CONDITIONING ( 714 )848-4977 ADDRESS: 6131 NORBROOK DR COMMENTS: RE: B50516 PRIMARY BLDG• PERMIT. HUNTINGTON BEACH CA 92648 ****************************+tat***aP�rs6***+FSF*********+Fat+tSPat+e+esFa6s *****S6**FHa *******SF* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and ellecl. SETBACKS CITY LIC.: 050062 sTATELIC.:603499 cuss: C-20 Dale:_— s '7 Signature: � MAIN BUILDING ACCESSORY BUILDING w FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN %RKERS'COMPENSATION DECLARATION: I hereby aOir r veal ni e n msel6inslueor a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN compensation Insurance.or a certified copy thereol(Se o N.Lab. ). POLICY NO.: EXP.DATE: COMPANY: PARKING REQ" PROV; PARCEL: 42606402 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant' ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed if the perm(is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is d.I shall not employ arty persornin any manner so as to become sublect to the Workers'Compensation Laws al California. ��/��'q _ _ Q� ZONING APPROVED BY DATE: Date: —I -5---- Signature: BUILDING APPROVED BY NOTICE:If,after making this declaration,you should become subje to the Workers'Compensation provisions of the Labor : / DATE: 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 APPLICATION ISSUED BY: ►nom ��' --sig...: DATE; 7- which this permit is issued(Section 3097.Civ.C1. ********************** ' ' ' ' ' ' ************ **724** LENDER: ***************************************** .x ** Tr******************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 0 0 repair any structure.prior to its issuance,also requires the applicant for such permit to Ide a signed statement that he/she Is licensed '15 Y SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN nd Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ty applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500), ISSUE FEE 15.00 I. as owner of the progeny or my employees with wages as their sale compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE pTOTALS----> 9. 00 15 .00 0 .00 24 .00 24 . 00 . 00 I. structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'Slate 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 REVENUE DIVISION TOTALS--> COLLECTED• 24 . 00 OVER/SHORT• 00 orimprovementthe a soldf le)Mn one year of wmpletgn.the owner von have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK for Ind purpose of sale). I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 .00 ❑ and Professions Code: The Contractors'ectswiitit License Law does not apply to anowner1 property who hoods or improves thereon re ******************************************************************************* and who contracts for such protects with a State Lone contractor(s)license pursuant to the Contractors'Slate License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDO 14 N ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 I do hereby Wily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/ in not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from theAir uality Management District.Residential construction applications are exempt from mese 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 relating to building construction and hereby trhor¢e representatives of this city to err upon the above-mentioned property for inspection purposes. 01 0O0E0725-C00$07TF.�T :;.•r;, Date: Pe— I 5- y�. Signature: .�DATE: 02/15/91 TIME: 13:01 Drivels License or Social Security e: 1641-46 White—Building:Green—Code Enforcement Canarv—Applicant:Pink—Revenue:Goldenrod—Assessor I CONSTRUCTION AND PLAN(v...G 'DOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service dr Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. a . . 53. Steel Reinforcement _It:Electrical Condli�'.litility-Undrgrnd. 54. Forms m14.Electrical Conduit-Undrgrnd. 55. Electrical Bonding L 5CSteel Reinforcemen. 56. Rough Plumbing & Pressure Test r '-'�6;rc6F6 . j Electrical UFERd57. APPROVAL TO COVER-GUNITE cc ro/1-1.Footings S=x -1 58. Electrical Conduit-Undrgrnd. '8.4-Foundation :�,� . • 59. Gas Pipe, 0 Undrgrnd., Test :9?Water Pipe-UndrSnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. • {0_Structural Flog System r r 61. APPROVAL TO DECK 11. Property Sewer-Lint& House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap a O 63. Heater & Vent-Final 13. Roof Drains t 64. Plumbing System • Final 14. Rough Plumbing x 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electriry"Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS ANAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT - - - •T -tn:- .X n .F. 20*•Rough Eattocy Eheplace I 'Xtf1 a 0 C 3"•- + rAPPROVA CQPetmit # ' ry "' '• •C n- •I i SIT tr.! a .S - 1 Y -. U: Nr.1.- '' r C C ). 1t �.:• i -.Fu SCS . H J „ 22.. • + 21,,;Ducts,i`.5t uctse . .. .. ..iS x S p •-,S .e -170. Unde gtiou d Hydro s. to 22. Ducts, Ventilating.: , C'S x c(:l' t 171. Produci'Piping El Gas O'Oil 23.=GasPipe.C.:Rough&'Test mS .', m " ct 0A a .,72. Underground FIGsh' ,-- - S., T - - 247Roof Framing nM •- ••.n . C C 'r '' 73tUndergrna'.$toragiTanktGas t'❑ell - 25. Roof Sheathing n N,. • c > 0.1* t X74 Overheadliydroj x 2erT-Bar Ceiling (Structural) &,Monocoat x - m C .tiv 't 75TDry Chemical 7 r - C h 27�=Franre and Flashipd' LW "r ~' " 76`Dr r ' '�- "' '� 'n ca L.:1 Xtr 1. _ >- tax Y Stanc�p e i.."-Z3 o , 'I• .� apt.J IT x >14 • r. • •y. .r ~ 28. Lat�,ingjr Sidings. . '1-( I .4: X7 .. .• ..* t 77,r FIXED SYSTEM FINAL: J ,� .t. , i+ 1-.1. . •. •• r tn I i it w D tX 29. Insulation 5•.{ 1, I, ; 78x FIRE PREY. FINAL n :> x i' 30. •Drywall Nailing k• • - �_ - I .1.1. * A- HEALTItOEPT. REQUIREMENT .31. Plaster Brown Coat: , ' I• ,, r I 4. T79:"FINAL l(,..s ON - " ' -. 32.,-Electrical Power:plleter-Final r c ,,• r r r80;r,FOOD CERTIFICATE ISSUED s; 33:1:Fin`el Electric ". .n r tr i • s ` Ndies: 7 'T n V_ n >•z, ;j34-Final Heating;&Ai;Conditiorxng; C; 43)2/y '/ r kd:z a w. s 35^1Final Gas Pipe-Test • C. tea • 1. IT SO y. -1: S •. p e1 . ,J r. •Iq ?. >36. Hood o Canopy r" .A. a fl i [h s: _%, :t." i 't-f37::-Final Factory Fireplaces I :St* n: 1 - a. 38. Final Plumbing `r a { Iv } i 74W 1 P � u 39. Water Service-Finalx ., a I ; {t T cu _ .. n. '- -C '.40. Gas Service-Final u. t i rit t. ' " r ?_41. Solar Domestic-Finals n ! _•• I I hy, •20 C.• 42.SBackflow Preventers • (U r_ i 1 ft 1 ;: it' 43. Backflow (rtlgatiorr SS t. r 1 t 'X 4 = u..• 44. Landscape irrigation SYsterp�1 r n ` ow. t F p, :IL . _ r- 0 ... - >45.:Sound Atteduation .4.:- a z: - l-o -• `7 I- T.1. .5,:••••4 • r-. - , .. .. 3 .1! m al r •, - Tr rr.^ .1: • t-•'J A •546:;Handicap Regulations C " •' '• '•.`; y '" t �c. •"r ' • 475FINAL STRUCTURE & BLAID!NG z 1 .;f -4 :L7 FY ' • 4e.FINAL PLANNING i :1_ a Ii• v 'U n• y .:.493 Electric Release to Edison . v sj i. - 7 . - . ,. - S 1 . 1: .-r ] ,50._Gas.Release to Southern California Gas Co t I • i; -' TCrl- - J • t51. CERTIFICATEOF;OCCUPANCYf s I may f - - No Date • r • PROJECr ADDRESS: 151 23RD ST UNIT' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: D 049104 OWNER'S NAME: VNE INVESTMENTS I ADORERS: 4350 VON KARMAN #100 PERMIT NO: B 049104 PLAN CHECK NO: 05848-90 A GOVT; N SUPP : N NEWPORT BEACH CA 92660 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH (714 ) 250 -7830 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : PL WALL/6 ' HIGH/PARTIALLY RETAINING SQ FT : 67 ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: 1 , 340 . 00 GROUP OCC : R--3 /M-1 PERMITTEE: VNE INVESTMENTS I ( 714 ) 250- 7830 ADDRESS: 4350 VON KARMAN 100 COMMENTS : $$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$$ NEWPORT BEACH CA 92660 ************** *****u********'firs*eriE*********+tit *****************************u. LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQU I R EMEN T S 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACK S CITY UC.: STATE UC.: CLASS: Date Signature: MAIN BUILDING ACCESSORY BUILDING -- s0-`'.. G.OMPENSATION DECLARATION: I here affirm that)have a certificate at consent to self-Insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: T IN REAR: FT IN .d"^'.,.—.mnlnsurance,or a certified copy thereof(Section 3800,Lab.C). LEFT : FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN `'W ND.: EXP.DATE: MPANY: PARKING REQ: PROV: PARCEL: 42606402 ZNE: R2 REF NO: ❑ Certified copy is hereby famished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> 68 LINEAR FEET OF 6 FOOT HIGH CONCRETE BLOCK WALL— TO BE LO • , > CATED INSIDE OF PROPERTY LINE, Date: • Applicant: **********************eE*********************************************-*ik'********i£ E(EMPTION FROM YORKERS'COMPENSATION DECLARATION: (This sedan need not be completed if the pemit is for one hundred(51 W)or less). DEVELOPMENT S E R V I C E S R E Q U I R E M E N �'. S I certify that in the performance of the work fur which this permit is issued.I shall not employ any person in any manner so as to become des G��> subject to the Workers'Compensation Laws of California.' ZONING APPROVED BY DATE: /Si/ft7 Date: Signature: - NOTICE:If.after making this declaration.'you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : 85.04-- _ _ DATE: _9_//:d Code,you must forthwith comply with such provisions or this permit shag be deemed revoked. �� �� CONSTRUCTION LENDING AGENCY: I hereby affirm that Mere is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: �—f which this permit is issued(Section 3097.Civ.C). ************************** r*3tiF*}'*"*.. **lsfFse—.;.sf* .**';F'*z****************TF*p *xx** ** UNDER: ****************************************A***#' **********************4 ********* ADDRESS: LEGALIZATION: N F E E SUMMAR Y., STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Gide: My city of county which requires a permit to construct,alter,Improve,demolish,or PERMIT 33 . 00 r 5 0 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensedSMIP/,_50 ON—A E S 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 PLAN 5 , 36 ('i , any applicant far a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE • I, as owner of the property or my employees with woods as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK • TOTAL PAID DUE structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S————> 33 . 50 0 . 00 + 5. 36 38 :8'6` 38 . 86 . 00 '\ does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ;, his roher mnt is employees,hin provided tal t completion.the nle are notofferedteedbd udefor she/ Ieihowever notird or IImprvre REVENUE DIVISION TOTALS--> COLLECZED:' 38':8.6: 'OVER/SHORT: . 00 forptheepurpose of sae)hin one year al cempledon.Me owner wit have the burden of proving he/she did not build or Improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE , SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 33 . 00 , 50 5 . 36 © and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or Improves thereon .1 and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware *************************************************i5**ifi***********************T;** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL r F E E B R E A' K D 0 W N ❑ I am exempt under Section: B.S P.C. ,. // ) for this reason: TYPE QTY DESCRIPTIO N' i UNIT COST TOTAL COST Date: 9 -ZI-?D Owner: /u/11I Q 131/1/ 4 SFR 67 RES CONCRETE BLOCK WALL / Ft: 20 , 00 1 , 340 . 00 I do hereby certify that I am aware of and understand the requirements of California Health a Safety Code Sections 25505,25533,and END- O F FEES - 25534 and that I or any future building occupant will/will not(cirde 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 F. fl these provisions. I , 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 relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. O1 OD0703��/—D00703Jb �'[9 i E i .. Date: g`./.- 7U signature: AfrrYl /YJLIyu lj DATE: 09/25190 TIn:: 1.1!43Driver's license or Social Security A: VV _\1641 48 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor — — _' CONSTRUCTION ANP PLANN _ .19L & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement Y"/Lq/ de s/6' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 71-1/ 6Ci,i41-- 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16, Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat t" - 79. FINAL INSPECTION 32. Electrical Power Meter-Final / 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning - • 3 -8r t'(- e9fr 04) 35. Final Gas Pipe-Test 9v / 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final p/_ c�5,, jee,`,* 40. Gas Service-Final ! YYC y ege-- 41. Solar Domestic-Final C `StaW _ a ever 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 42 2C-q(' atb 48. FINAL PLANNING 49. Electric Release to Edison • , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PIPP.0 ECT ADDRESS: 151 23RD ST UNIT: - CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BP 048701 t OWNER'S NAME: V.N. E. DEVELOPMENT ADDRESS: 4350 VON KARMAN PERMIT NO: BP 048701 PLAN CHECK NO: N GOVT: N SUPP : N SUITE 100 NEWPORT BEACH, CA 92660 CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE : OTH 714 /250-7830 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; DEMO SFD & SEWER CAP SQ FT: 1 , 000 ADDRESS: UNIT: CLAIM VALUE: 1 , 000 , 00 CALC—VALUE: 1 ,000 , 00 GROUP OCC: R-3 / PERMITTEE: V.N. E. DEVELOPMENT ( 714 ) 250-7830 ADDRESS: 4350 VON KARMON 100 COMMENTS: DEMO SFD & SEWER CAP NEWPORT BEACH CA 92660 **************** ** *********x************ ** **** ************ ******>F** **** UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY UC.: STATE UC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN .` POLICY NO.: EXP.DATE: • IIMPANY: PARKING REQ: PROV: PARCEL: 42606402 ZNE: REF NO: J Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > • Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Tits On need not be completed if the permit is for one hundred(5100)or leu). DEVELOPMENT SERVICES R E Q U I R E M E N T S I certify that in the performance of the work for which this permit is sued,I shall not ploy any person in any manner so as to become subject to the Woncw(s'Co�ption Laws of California. ZONING APPROVED ROV EU B Y , �{ LA DATE: 7 Date: Signature: /I'L, NOTICE:If,after making this declaration,you should be a bject tote Workers'Compensation provisions of the Labor BUILDING APPROVED BY t DATE: Code,you must forthwith comply with such provisions his 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 APPLICATION ISSUED B Y: DATE: 4 which this permit is issued(Section 3097,Civ.C). *********************4- • • - yF' iEO LENDER: ******************************************************************************* ADDRESS: LEGALIZATION ;N F E E SUMMARY STRUCTURAL SEGMENT:Y _ OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 25 , 00 2 , 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed2 5$ 5 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3, 00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 27 . 50 3 , 00 0 . 00 30 . 50 - '- 30 . 50 _ - . 00 ' does not apply to an owner of a property who builds or improves thereon,and who does such cork 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 REVENUE DIVISION TOTALS——> COLLECTED • 30 . 50 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25 . 00 5 , 00 . 50 ® and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware ****************************************************************.yX*.*.**.*.*.*.**.*.***..* that proof of their Worker's Compensation insurance should be provided to me.70/1 I N D I V I D U A L F E E B R E A K D O W N p I am exempt under Section: 8.&P.C. for this reason: — TYPE QTY DESCRIPTION TOTAL COST Date: p ,1�7 owner: yUNIT COST SFR 1000 ALTER BY VALUE RESIDENTIAL NOZONE 1 .00 1 , 000 . 00 I do hereby certify that I am aware of and understand the requirements of Calif nia Health and Safety Code Sections 25505,25533,and PLU 1 SEWER CAP / DEMOLITION EACH • 2 , 00 2 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is c t:I agree to comply with all city and county ordinances and state taws relating to building construction and hereby au rize atives of this city to enter upon the above-mentioned property for inspection purposes. Date: ...3' Z 3 Signature: / 1b 01 CDD68167-04063169 TCaT 30.5i' Driver's License or Social Security N: DATE: 08/23/90 TIME: 09:07 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor -� CONSTRUCTION AND PLANNING Pt & SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' 10. Structural Floor System � . 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final - 12. Sewer Cap Its-Z-10 L.ED 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy J 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 /O/E/9d L.ED 48. FINAL PLANNING 49. Electric Release to Edison :v 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 1 1 Wilda ADDRESS: r`. 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 048700 A. ' -OWNER'S4IAME: V•� DEVELOPMENT must 43_ VON KARMAN PERMIT NO: E 048700 PLAN CHECK NO: N GOVT: N SUPP : N d`UII & 100 NEWPORT BEACH, CA 92660 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH 714 /250-7830 • ARCH/ENGINEER: REO.NO.: JOB DESCRIPTION : CONSTRUCTION POLE FOR NEW CONSTRUCTION SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE; GROUP OCC: / PERMITTEE: V.N.E. DEVELOPMENT (714 ) 250-7830 • ADDRESS: 4350 VON KARMON 100 COMMENTS: TEMP POWER POLE NEWPORT BEACH CA 92660 *****************************+r *******>F* ***** ******st****** **** ****DE******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7030)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACK S CITY UC.: STATE UC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRN T: FT IN REAR: FT IN FRN T; FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: ''IMPANY: PARKING REQ: PROV: PARCEL : 42606402 ZNE: REF NO: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Tis section creed not be competed if the pent is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I I not employ any person in any manner so as to become., subject to the orkers'Compensation Laws of California. fr ZONING APPROVED BY DATE: Date: —�� signature: " BUILDING APPROVED BY _NOTICE:If,after making this declaration,you should beco suhe Workers'Compensation provisions of the Labor DATE Code,you must forthwith comply with such provisions or ' permit shall be deemed revoked. �/ p� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency fo the performance nce of the work for APPLICATION ISSUED B Y ; DATE: jJ --i- CONSTRUCTION which this permit is issued(Section 3097,Civ.C). ***************************************** x************************ ** *>i:'*** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Cede: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 1 5 , 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed 5 10% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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). ISSUE FEE 15,00 I, owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ as structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS--——> 15 , 00 15 . 00 0 . 00 30 . 00 30 , 00 , 00 does not apply to an owner of a properly 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 REVENUE DIVISION TOTALS--> COLLECTED• 30 , 00 OVER/SHORT: 00 improvementiswit. offs e)Ain one year of completion,the owner will have the burden of proving he/she did not build or improve fororthe purpose of d BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK FAI,as owner of the propertyam exclusively contracting with licensed contractors to construct the project(Section 7044,Business 30 , 00 LJ and Professions Cade: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects vsth a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* that proof of their Worker's Compens¢fion Insurance should be provided to me. ' INDIVIDUAL F E E BR EAKDOWN I am exempt under Section: B.8 P.C. for this r n: �J TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: .4'27owner: `/ ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15 ,00 15 , 00 I do hereby ce that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant willvri0 not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: 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 relating to building construction and hereby authorize representatives o his ci pon the above-mentioned C property for i ctlon pia Date: Ai iv ��Z gar0100065170-0C368170 TOT 2 Driver's License or Social Security a: . DATE: 08/23/40 TIME: 09:07 C, 164146 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor 4 CONSTRUCTION AND PLANNING • PC _Si SPA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector '1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement Electrical Conduit Utility-Undrgrnd. 54. Forms Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 1 65. Electrical-Final 15. Rough Electrical-Conduit , 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric /7$ aid. Notes: 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co .•''' 51. CERTIFICATE OF OCCUPANCY No. Date ^ PROJECT ADDRESS: 151 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 050511 OWNER'S NAME: V.N. E. DEVELOPEMENT ADOFSS: 4350 VON KARMEN #100 PERMIT NO: B 050511 PLAN CHECK NO: 00179-91 A GOVT: N SUPP; N NB CA 92660 • CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE:INEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW SFD SQ FT: 2, 815 ADDRESS: UNIT: CLAIM VALUE: 100, 000 . 00 CALL—VALUE: 171, 487 , 00 GROUP OCC: R-3 / PERMITTEE: V.N.F.. DEVELOPEMENT ( 714 ) 250-7830 ADDRESS: 4350 VON KARMEN 100 COMMENTS; NEW SFD NB CA 92660 *>E* ****4************** ************ *>E+E**+E+E>E*FE*****AE-x****** F*** x************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACK S CITY LIC.: STATE LIC.: CLASS: Date: Signature' MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 20 FT IN REAR: 14 FT IN FRNT: FT IN REAR: FT IN `* compensation Insurance.or a certified copy thereof(Section 3800,Lab.Cl. LEFT: 5 FT IN RGHT: 12 FT 6 IN LEFT: FT IN RGHT: IN 1LICY NO.: EXP.DATE: COMPANY: PARKING REQ: 2 PROV: 2 PARCEL: 42606402 ZNE: R2 REF O• —90-24A • O Certified copy is hereby furnished. ❑ Certified copy isfiled with the city Building Division. PLANNING NOTES> ONE OF A TWO UNIT CONDOMINIUM PROJECT. 2ND UNIT ADDRESSE . > AT 2292 ELDEN AV. ONE GUEST PKING SPACE ALSO PROV. F/ BOTH Date: Applicant: - • *****************************************Ie******************lE**•***!E******IF***** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIR EMENTS 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 p � / Sublet)m the Workers'Compensation Laws of California. - ZONING APPROVED BY 4/V ifs• 1 C , DATE: co O6 Date: Signature: BUILDING APPROVED BY L. DATE: NOTICE:IL 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 shag be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• `� DATE: which this permit is issued(Section 3097,Civ.C). ., ********************** i3.i3.^is�- _4a.s:iy4,4.a ********4*- - -** LENDER: - *****************************Q�•s- -:.* ..IE**************9E*****************4E**.s*** ADDRESS: LEGALIZATION:N F E E ' U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors State License Law for the Ionowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 891 . 50 12 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit Co Ire a signed statement that he/she Is licensed SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 144 . 87 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044•Business and Professional Code: The Contractors'State License Law TOTALS---—> 903 . 50 0 . 00 144 . 87 1048 . 37 1048 . 37 . 00 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 REVENUE DIVISION TOTAL S--> COLLECTED: 10 4 8 . 3 7 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 sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 891 . 50 12 ' 00 144 . 87 ni and Professions Code: The Contractors State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractoi(s)license pursuant to the Contractors'State License Law).lam aware *******************************************************3e*********************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. • for this reason: A r, TYPE QTY DESCRIPTION UNIT COST TOTAL COST --- Date: / 9--`/ Owner /!// ' OV SFR 2375 DWE—TYPE V—WOOD FRAME —GOOD 69 . 00 - F63, 875. 00 Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 440 RES—GARAGES TYPE V 17. 30 7, 612 . 00 25534 and that or any future building occupant vhttNhll not(circle one)need to comply with said state codes and the requirements lora END OF FEES • permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from , , these provisions. �� . r., • •� , Date: Applicant: - • \y 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 •1te ff ] ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned `'I Y{ v property for inspectionpurposes /iSr _ — � ). Date' /— / Signature: .. `• r •• .. Driver'sSecurity License or Social : ' 1641-46 White—Budoing:Green—Code Enforcement:Canary—Apoticant:Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNINL A APPROVALS Permit# Date �l nspector APPROVALS Permit# Date Inspector 1.iTemporary 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 /-/e_ ct.„..r;'r• 56. Rough Plumbing & Pressure Test • 6. Electrical UF ER Grnd. _ (,-(Q- 4 6.441 57. APPROVAL TO COVER-GUNITE • 7. Footings f g'1p... 6°49 58. Electrical Conduit-Undrgrnd. '8. Foundation (-0-.4.1 (a tat 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash-Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains ' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • 20. Rough Factory Fireplace - -APPROVALS Permit# 21. Ducts, in Structure. 70. Underground Hydro 22. Ducts, Ventilating - - 71. Product Piping 0 Gas 0 Oil 23: Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing -73. Undergrnd.Storage Tank ❑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 i 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat; ' i l'. 79. FINAL INSPECTION 32. Electrical Power Meter-Final I .},, • 80. FOOD CERTIFICATE ISSUED • 33. Final Electric. -al H'-(. Notes: • 34. Final Heating & Air Conditioning I 1 f •%j . 1 / a` 1/4)z/7/ 1/,,[J�/ 35. Final Gas Pipe-Test' - I$ •' , • - lTi� `R� D� is '? 36. Hood or Canopy . •; - 37. Final Factory Fireplace • - • 38. Final Plumbing - -t I - - '39. Water Service-Final - - 40:Gas Service-Final / .- 41. Solar Domestic-Final i • 42. Backflow Preventer j. - -- 43. Backflow Irrigation - 44. Landscape Irrigation System 45.-Sound Attenuation • -46. Handicap Regulations .. 47. FINAL STRUCTURE & BUILDINGS-1 -��` @Jy/Chef"1- a':`7-Z'_ (,'� L/ � Ail 48--PIPI t' ..L-ANN}NGsP _ o6la? 1 49. Electric Release to Edison ' - - 50. Gas Release to Southern California Gas ' - . • 51. CERTIFICATE OF OCCUPANCY No_ - Date CITY OF COSTA MESA PARK FEES 001231 Fee Payment Receipt r ct Address 1 2-4 iz-eI cYy,L� h.. .Number 400/ — aro 4' —072— Building Permit Number Mt€avl ---r-1120-1-4 `, M€ V Lam, �l� Owner's Name 11,,,�..}} �'� � � _ 1� Mailing Address 49 O Voh_k- 'ecvw In 4*'1OC 1J M (�, ar2/0(OP FEE: Single Family * Number of Units 2-Bedrooms or Less @ $ 861.76 = • 3-Bedrooms @ 1,205.67 = 4-Bedrooms @ 1,545.62 = r." ' " 5-Bedrooms+ @ 1,810.50 = t ' tiple Family ** it DEC 28 1990 "F Bachelor or Studio @ 474.37 = 1-Bedroom @ 573.18 = 'Y OF COSTA MESA 2-Bedrooms @ 881.51 = 3-Bedrooms+ 2i @ 1,229.38 = 245$•7(O I�, Total Fee *** 24515'74' Planning Department Appro to .f'"4'l go/�q aBy Applicant's Signature 7\( * City Ordinance 72-44 ** City Ordinance 72-45 *City Resolution 78-116 i 'q1 �} I� �nn�II CMF 0174-30,rev.7/85 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant J��V�1➢.��U - TTY OF COSTA ME;' j; • • CALIFORNIA 92628-1200 P.O.BOX 1200 Insulation Certificate -7 151 23rd Street, • SoS( \ Costa Mesa, CA ' Number and Street City Orange County Subdivision Lot Number Description of Installation ROOF Material R-30 FIBERGLASS BATTS Brand Name CERTAINTEED Thickness(inches) 10" Thermal Resistance(R-Value)R-30 EXTERIOR WALL Material FIBERGLASS BAnS Brand Name CERTAINTEED Thickness(inches) • 31/2" _ 1'nem al Resistance(R-Valuc) R-13 • CEILING Batt or Blanket Type Brand Name Thickness(inches) Thermal Resistance(R-Value) Loose Fill Type Brand Name Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) • RAISED FLOOR • Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) FOUNDATION WALL Material Brand Name _ i niceness(inches) Thermal Resistance(R-Value) • POLYSEAS, CAULKING PER TITLE 24. Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. General Contractor(Builder) License Number Signature and Title Date SUN WEST INSULATION,INC. Contractor Lic.#449316 Costa Mesa 4t 049010 S onvactor(G suulatiiomn(Installer) License Number r Signature and Title Vice-President • Dale SASCE ADDRESS: 151 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; EMP 05051E OWNER'S NAME: V,N E, DEVELOPEMENT ADDRESS: 4356 VON KARMEN #100 PERMIT NO: EMP 050516 PLAN CHECK NO: N GOVT: N SUPP: N NB CA 92660 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE MEC PLU PURPOSE; NEW ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : NEW SFD SQ FT: ADDRESS: UNIT: CLAIM VALUE: / CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: V,N, E. DEVELOPEMENT ( 714 ) 250-7830 ADDRESS: 4350 VON KARMEN 100 COMMENTS: REF B50511 NB CA 92660 ***>E* IEEEx*SESE x*St*****SE><SE*tE>ETETE****m+E>F********* **SE>E">F***I6*x***>E+ESL*x*****+E+E*SE>E>E+E*"x LICENSED CONTRACTOR DECLARATION: I hereby atfirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 01 the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN ' ^.ompensation Insurance.or a certified copy thereol(Section 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN OUCY NO.: EXP.DATE: COMPANY: PARKING REQ' PROV: ,P,�.RCEL: 42606402 ZNE; REF NO: E F] Certified copy is hereby famished. ❑ Certified copy is filed with the city Building Division. PLANNING N TES> T > Date: Applicant- EXEMPTION FROM WORKERS'COMPENSATIONDECLARATION: (int section need not becompleted it the permit is fa one hundred($100)or less( DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work or which this permit is issued.I shall not empty any person in any manner so as to become sublem to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE Date: Signature: BUILDING APPROVED BY NOTICE:If.alter making this declaration,you should become subject to the WOrkRrs'Compensation provisions of ine Labor DATE: 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 APPLICATION ISSUED B Y, '' DATE• a/08 which this permit is issued(Section 3097.Civ.C). **************************** ',,,e' �. . . --a— ******************* ****2h*** LENDER: *****0*********************if***********ler ger ****************************Xi****** ADDRESS: LEGALIZATION:N FEE SU MARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTR MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 40,50 8 3 3 47 JA,25 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she Is licensed 25% 0 Z L 5% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 700)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3,00 1 5 „00 15. 00 I. as owner of the property or my employees with wages as hair sole compensation, will d0 Inc work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS——--> 170 . 88 33. 00 0 , 00 203 . 88 203 , 88 . 00 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 REVENUE DIVISION TOTALS--> COLLECTED • 203. 88 OVER/SHORT• 00 improvement is sold within one year of completion.the owner wig have the burden of proving he/she did not build or improve mrthe purpose olsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK L as owner of the property am exclusively contracting with licensed contractors to construct the project(Section 704a,Business 43 . 50 9 8 13 62 . 25 IN and Professions Code: The Contractors'State License Law does not apply to an owner of propely who builds or improves thereon and who contracts for such Oratetls with a conlrattor(s)license pursuant to the Contractors'State License Law),l am aware *****'***************************************'*********************************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. for thisrea�son✓q ' TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: I DwnEr G ELE 2375 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ ET . 03 83 . 13 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 , 00 25534 and that I or any future building occupant wiIVwit not(circle one)need to comply with said slate codes and the requirements for a MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 . 00 3 . 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from NEC 3 GAS PIPING SYS 5+ OUTLETS PER OUTLET0007'715-600T1642; 2 , 2,-°i- r these provisions. NEC 3 FACTORY FIREPLACE OI 6`_ O jF 7'g 19 . 50''0` Date: Applicant: NEC 3 VENTILATION FAN CONN TO SINGLE DUCT PATE' m / 0 91 TINE: 16:14 13 . 50 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 PLU 2 BATHTUB 2 , 00 4 00 ordinances and state laws relating to building construction and hereby authorize representatives this city to enter upon the above mentioned PLU 1 DISHWASHER 2 , 00 2 , 00 property for it .pectin,'purposes ALU 1 SHOWER 2 . 00 2 . 00 -----•Date �� ( Signature: PLU 1 SINK, BAR 2 ,00 2 , 00 PLU 1 SINK, KITCHEN 2 , 00 2 , 00 Driver's License Or Social Security te: 1641,46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING t..UL PA ,1 APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector l::Te:porary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10..Structural Floor System 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • - APPROVALS- Permit# 21. Duct's,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 0 Gas ❑Oil 25. Roof Sheathing - 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing _ 76. Dry Standpipe • - 28. Lathing& Siding _ I 77. FIXED SYSTEM!FINAL 29. Insulation I . 78. FIRE PREV. FINAL 30. Drywall Nailing I ' I� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat, •. " 79. FINAL INSPECTION 32. Electrical Power Meter-Final fry! •- . 80. FOOD CERTIFICATE ISSUED 33. Final Electric I 1• '. +l Notes: 34. Final Heating & Air Conditioning `� I I' Vii. •- 35. Final Gas Pipe-Test -J(0(11 I P . 36. Hood or Canopy 37. Final Factory Fireplace / 1 4 38. Final Plumbing digit /1-/rpi 39. Water Service-Final ' j • ' 40. Gas Service-Final . - . I 41. Solar Domestic-Final 42. Backflow Preventer I 43. Backflow Irrigation • - • 44. Landscape Irrigation System . ' -45. Sound Attenuation • 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING I %j" 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - • No. Date Ili ji PROftT ADDRESS; UNIT: ' OWNER'S NAME: . • ADCAESS: PERMIT NO: EMP 050516 PLAN CHECK NO; 00184-91 N PAGE; 2 ****** ******************iFiE9EiE*********************ill *********S6**iF*If****l ***1E**IE • ARCHIENGINEER: REG.NO.: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ADDRESS: UNIT: PLU 5 WASH BASIN 2 , 00 10 , 00 PERMITTEE: PLU 2 WATER CLOSET (TOILET) 2 . 00 4 . 00 ADDRESS: PLU 1 WATER HEATER AND/OR VENT 2. 00 2 . 00 PLU 1 WATER SERVICE 2 . 00 2 . 00 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 . 00 2 . 00 7000)of Division 3 of the Business and Professions Code.and my license is in IUB lerce and client. PLU 3 GAS PIPING SYS 5+ OUTL-PER OUTLET . 50 1 . 50 CITYLIC.: STATE LIC.: CUSS: PLU 1 GAS SERVICE 2 . 00 2 . 00 Date: Signature: PLU 1 SEWER, BUILDING / TRAILER 5 , 00 5 . 00 WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' END OF FEES 4 'ompensation Insurance,or a certified copy thereof(Section 3800,Lab.CI. OLICY NO.: EXP.DATE: COMPANY: `J Certified copy is hereby furnished. 0 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:It.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'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,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 not more than five hundred dollars(5500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the .1 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property wry builds or improves thereon,and who does such work himself/herself or through • his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve Mr 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'State License Law does not 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 at their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. lor this reason: *DUPL $CATF REC(fl?'e'* Dale: owner: 01 00077640-CO077642 TCT _J+.2`: I do hereby certify that I am aware of and understand the requirements al California Health and Safety Code Sections 25505.25533.and GATE 01/09/91 T InE ..i:14 25534 and that I or any future building occupant wiluwill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification Iron 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 relating to building construction and hereby authorise representatives of this city to enter upon the above-mentioned property for inspection purposes. Dale: Signature: • Driver's License or Social Security f: 1641.46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • • 6ONSTRUCTION AND PLANNIN.. al. .PA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector :Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21.TDucts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough Si Test 72. Underground Flush 24. Roof Framing, 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27: Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation - , 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 6 .134# ��480. FOOD CERTIFICATE ISSUED 33. Final Electric 6-et Notes: 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. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date • PROJECT ADDRESS: 151 23RD ST UNIT: CITY OF COSTA MESA – BUILDING PERMIT PERM NO: M 051035' OWNER'S NAME: V.N.E. DEVELOPEMENT ADDRESS: 4350 VON KARMEN #100 PERMIT NO: M 051035 PLAN CHECK NO: N GOVT: N -SUPP: N NB CA 92660 CONSTRUCTION TYPE: V–N PERMIT TYPE: MEC PURPOSE: OTH • ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW SFD ( INSTALL 75000 BTU FAU) SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC–VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: BEACH AIR CONDITIONING (714 ) 848-4977 ADDRESS: 6131 NORBROOK DR COMMENTS: RE: B50511 PRIMARY BLDG, PERMIT, HUNTINGTON BEACH CA 92648 *+E***�r**4*�E*********�P*�E*�P� ****�E�E�E**********************+ESP********************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS ' 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. SETH ACK S CITY LIC.: 050062 sun uc.:603499 Lass; C-20 Date.• Z—/ 5=9( signature'. �� FRNT: FT MAIINN BREARING FT IN FRNT: FATCESSINYREAR: LDING FT IN 'WORKERS'COMPENSATION DECLARATION: I hereby affirm that have acertl to of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42606402 ZNE: REF NO: 'T Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT S E R''V I C E S REQUIREMENTS 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. ZONING APPROVED BY DATE: Date.• ri---( S^ 9( Signature: W.Gva WI! jt." BUILDING APPROVED BY NOTICE:II.after making this dee ration.you should eco a subject the Workers'Compensation provisions of the Labor : DATE: 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 APPLICATION ISSUED B Y; • DATE: n..,/S which this permit is issued(Section 3097.Civ.C). ************************* ** * .14'4E * * * ***************** ** * * LENDER: ******************************* ********** ** ******************************** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5% SMIP/NON–RES 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 PLAN 'ny applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 15.00 1. as owner of the property or my employees with wages as their sole compensation, win do the work, and the BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTAL PAID DUE L❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 9 . 00 15. 00 0.00 24 .00 24 .00 . 00 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 REVENUE DIVISION TOTALS--> COLLECTED• 24. 00 OVER/SHORT: 00 ithe purpose sold o s d withint. is w)hin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING 'ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN–CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 .00 ❑ and Professions Code: The Contractors'State 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. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: Owner: MEC 1 INST FORC–AIR/GRAV FURN <= 100 K BTU .9. 00 . 9 . 00 I do hereby certify that lam aware of and understand the requirements of California,Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: 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 relating to building construction and hereby uthorize representatives of this city to enter upon the above-mentioned property for inspection purposes. _ r• 1 O0080726-00080726 TOT :4.00 DATE: 02/15/91 TIne: : Date.12_�—/ 91/ Signature' ri4.� 1J'0_ Orivei s License or Social Security e: 1641-46 white—Building:Green—Code Enforcement:Canary—ApplicanC Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING .I0OL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1.:Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. SoilT Pipe-Undr�rnd.i o 53. Steel Reinforcement . .3:,Electrical Conduitaijility-Undrgrnd. 54. Forms 4', Eidctrical ConddiYUndrgrnd. - 55. Electrical Bonding • K ;,, 5.• yS{e,el Reinforce'IT! - 56. Rough Plumbing & Pressure Test : • ,6..Electrical UFER'Grnd. 0 57. APPROVAL TO COVER-GUNITE .tea -r r. r.rr _ [U' 'Footings G=m C. 58. Electrical Conduit-Undrgrnd. E--r...:'. c ,8.;yfoundation _ •a 59. Gas Pipe, 0 Undrgrnd., Test '' 'g:Water Pipe-Undr4Fnd. - - 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10.cStructural Flo • o_System - 61. APPROVAL TO DECK 11. Property Sewer:Line.& House Connection 62. Backwash & Receptor-Final t 12. Sewer Cap v o . 63. Heater & Vent-Final 13. Roof Drains ra 64. Plumbing System - Final 14. Rough Plumbing . 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.rRough Eactony FAAplace its;Pi L -. •r J L A APPROVA S1lCPermiiit # ' ' r"t Q < ,D •r :s.-..a. 1 1St:- '1 -+ v.! :r CWr >J tr. ' :• V • c •_� r 4 6: 21..Ducts, in--Strt4ctu€ba , .. u S ! S R :r .70. Underground:Hydro ,,, 22. Ducts, Ventiiating.:r t YS . .5' !' • t '171. ProducTPFpipg EV is 00il er •-• 1, ' 'J •Z e1 - - n-.' . > 23�1"ias,_Pipe Rough 811'.est in,, - to 7 ,r •' ` X72. Underground Flust+- .- 24:>:Aoof Framing kJ-Lc i .-.-• ••••r 0 - -Y 'R S73_undergrni:P.Stora�q rank-0 Gas 008 Sheathin s^ •- r .11 .n r .0 i t S 7 25. Ro 4f 9 iv! S v j cur: 7 74_;•Overhead Tlydr !y 26 JT-Bar Ceiling (Stcuatural) 8v`Menocoat ' ^ u+ C 75*Dry Chemical ", t - a „- 275--Frameand Flash` to t - ="- ,,, a ,;t;a: �• n. y; 76: Dry Standpipe �c�rr E- i ,. .. ..:: .-. r-. _ :-28.. Latbingac Sid ingr.+. .: 7Q1t c: ' E . t 77P' FIXED SYSTEMIFINAL* v vs x'29. Insulativ i-.:� 0 1-1 •• •• 7• to I [r t :.t :Pt u: Qrt X-1, S .. j j1. 78gFIRE PREV. FINAL t ^ r *'30. Drywall Nailing ':{ { ,� A :-i HEALTH:DEPT4 REQUIREMENT 31. Plaster down Cgat x ,,,n' T.79.'FINAL INSP-ECTI N .. 5 i ` . S • .--32.7EIectricaPoyer!MeterFinalCu 4.:x .030:,rfOOD CERTIFI.CAATUED- r .,'33'rFirir Ele�tr- ' r i c In I'• .- "t - IN ke •• c' -$ .7 .. VI x Irl i ..L / ( I ,. , 'i34i Firra'I Heating;& !?,irtConditigmng; ,1 4, �y �K S Ct:e.1- . S cre �35;1E4-cal Ga{ Pipe-Test; fir'' •• -1 ! ?_ C: C1ry ITIS • t Ir' -so 1 . t 1 - ; ,, r t•t - 36. 'Hood oPCano PY 1 �r,- • . • n '�... .I: t E F.. ..0 ?: i,r ,37LFinal Factory Firedlate jrS 'L- + ''r3 1 itr a 8 2 ..._,1 t Jr; i+ .: ._, =38. Final Plumbing .r cu t .l s r. tic P: ..Si _ �: .r r ".39. Water Seivice-Finals s• i 1 1 /�_< -! - (1 11^+ 0 :/t'1 a It a . 1 f+ 7 > 4. .n ,D .-40. Gas Service-Final "' • r 0 et . `T 541. Solar Domestic-Finals •• Y ^i t �o •-i r _ :r Is) :t I 4 :r r -O IY x rC 42.-Backflow Preventers t1 _ . x at ^Y- a 43. Backflow Irrjgationt -CS.S t0:: w v is r 0 • , • s. .t N. s J 0.44. Landscape Igigation Systems ja _� : i1. Co _ 0lr -! x cu 7-1::.) A: 0 ?45.4_Sound Attenuation tc.- ,rt X -. -' fl - '" s-` u:`t • „• .-� :. . .. '. •n i, 1171:f - •- c ' . -,C x u6., andicap Regulations D 'D :, '`t •• • .e , -C . po c 47.!FINAL STRUCTURE & BUCLDING ( ..[t : = N S 'r• _ A Y 485c1N.L PLANNING` j t-l- ': �• 1 i .t •L ;49.,=Electric Release to Edison i r f I r r `rt 50.<Gas Release.to Southern California Gas Co S o" 51. CERTIFICATEOF;OCCUPANCY ; s 5U No. Date PROJECT ADDRESS: 151 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 051041 OWNER'S NAME: V N.E. DEVELOPEMENT a . AOBRESS: 4250 VON KARMEN #100 PERMIT NO: M 051041 PLAN CHECK NO: N GOVT: N SUPP: N . * NB CA 92660 • CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: NEW ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : PREFAB FIREPLACE ICB0#1581, NER244 SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: SIERRA FIREPLACE ( 714 ) 837-7008 ADDRESS: 31 ARGONAU COMMENTS: REFER TO #B50511 ALISO VIEJO CA 92656 ***ar**:ETH:E:E** **aE:t:t*r*:E*** ESE:Ex:E*:E******:E*******aE*:ESE********+Ear*** *****:L:E******** LICENSED CONTRACTOR DECLARATION: I hereby affirm t I am licensed under provisions Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code, . my license is ince an a ect. SETBACKS Garlic.: 42 95 STATE LIC.:44025 n . CLAS : Gate: 7. 4 signature:_ (� MAIN BUILDING ACCESSORY BUILDING ( pgOflKER 'COM NS�IONDECIAflATION�lherebya '�Ih.flhavearenilitaleolcOns no ell ins acennicateofworkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance or a certified copymer f(5 ( u Lab.Ci. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN IPOLICYNO.: 73W00389700 xP r TE: 04/11 /91 COMPANY: NATIONWIDE PARKING REQ: PROV: PARCEL: 42606402 ZNE: REF NO: ❑ Cenified opy ishe by furnished. enif.•, copy a with the city : ding r-'.io . PLANNING NOTES> L IY//G� / > EXEMPTIo ROM KERS'COMPENSATION DECLARATION: tenon need not becompleted if •-per isfor o' (red(s1W)orfess). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this. issued.I shall not employ an un in any manner so as to become sublectto the Workers'Compensation Laws of Calitomi ZONING APPROVED BY DATE: Date: Signatur: NOTICE:II.atter making this declaration,you silo I become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shah be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE: -,— which this permit is issued(Section 3O97.Crv.C). ******************************************* *********************** * * ** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E S U M MAR Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I herebyalfirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,Improve,demolish,or PERMIT 19 50 repair any structure.prior to its issuance,also requires the applicant for such permit to lite a signed statement that he/she Is licensed 25% SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN Ind Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by iy applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S5W). ISSUE FEE 15.00 I _ I, as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered lot sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 19 . 50 15. 00 0. 00 34 . 50 34 . 50 . 00 I 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 REVENUE DIVISION TOTALS--> COLLECTED: 34 . 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 sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business A34 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.I.P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: MEC 3 FACTORY FIREPLACE 6 . 50 19 . 50 Ida hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that l of any future building occupant wilwel not(drde one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date'. pplicant: I hereby cenity that I have read this applica on and state that� e above informatio rect.I a ee to comply with all city and co ty ordinances and [tate laws relating to building onstruction and i relay authorize rep sen aY of tM city to enter upon the above-menf' ned • property for n,pectin/p'//�'�_nses. / • IIIII Date: e I t _ Signature: e. .• iil - x 764 �. Driver's License or 5/oral Security>: / DATE01 066-0 15/ 910aIIi1: 15:14 34—'50 t641.46 mine—Building:Green—Code Enforce 'it:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor OONSTRUCTION AND PLANNING /COL ,PA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1.=Temporary Electrical Service or Pole 52. Pool & Equipment Location ry . 2. Soil Pipe-Undrgrndr, _ 53. Steel Reinforcement _ 3:Electrical Conduit U�ility-UndrgrndfS 54. Forms - 4.Electrical Condltltr •1.7hdrgrnd. �- 55. Electrical Bonding . `:.5.,3teel Reinforcem'R O tri 56. Rough Plumbing & Pressure Test _ 3;6.=Electrical OF ERffGrid. c_ I. 57. APPROVAL TO COVER-GUNITE p..• 1 _i 7.1...Footings 7J t` , 58. Electrical Conduit-Undrgrnd. -c ,®;;<Foundation i J 59. Gas Pipe, 0 Undrgrnd., Test '' n _ 9;:Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. J 10..:Structural Floor System a 61. APPROVAL TO DECK 11. Property Sewer Lin€•& Hduse Connection 62. Backwash & Receptor-Final 12. Sewer Cap ..---y 63. Heater & Vent-Final 13. Roof Drains .^ 'L 64. Plumbing System - Final 14. Rough Plumbing r 65. Electrical-Final 15. Rough Electrical-Conduit • 66. Solar System-Final 16. Rough Electricfiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20..rRough Factory Fireplace I :„C Ir. <*,� 0 _l :r TAPPROVAt6 3CPethiit # v •>' in Fr 'XI c- >1 r I ttr' X< \ i .•. X J .c < cu. > F Q' . . -r ar Ir:• :cs > a- . 4 >_ saga. P u SYS 21 _Ducts, in•Structuc-e* . .. :-,5- * _ j .-n * ,70. Underground.Hydro t 22. Duct's, VdntiWting}._ • Gs .r 'S K= a -171. Product`iping DUs f?Oil 23:;Gas PiPeFough &'fest .. ° r. - - : I Oma. .if •1, n 4 in 4 GIF -72. Underground Flush) n i- 245Roof Framing "I"-or - .r > O > a .` r573a1Undergrnd'Stor S'Tankp Gas 0 Oil 25. Rodf Sheathin '" >. v W 7 •T1 to -, ' 9 r- •c v . j Loi e. 5746Overhead 1iydroD ; 26._T. -Ba_r Ceiling (Structural) &:Monocoat . _ 10 0 -- 1 :> 75, ,Dry Chemical �-1 '--i G tr 4 • 27`Frame and Flashi g` to tri a x. n77-+ F2,13: .S �.: ^n;u; . r �•, an: x 76: Dry Standf!tPe :� - 128. •Lathing&Siding�tia r ;<I.0 u; - S •• • -ti + 77?'FIXED SYr$TEM•FINAL' '•r; rLI>29. Insulatiof4. S I I ( Ik ,r 78?-„ i S F IR r 30. Drywalk.IVailing + s " !. ....Z. S a :-t HEALTH'DEPT= REQUIREMENT : !iow,n 31. Plaster ,Coat:r s ; intr. r. I �; 'i r79.'"FINAL I44$P_ECTIIN v G' tr 32..,Electriral Power Meter,•FinaIi r [U I, . 1:80.yF00D CERTIFICATE ISSUED 33 fFin�l Etactric T. 2 , n k •, "No`{es: C. _ * = C ,r; to r. .. , r+ . ✓, . .. I . .e L- ir. - S ••n , ..N x34 -Fngf Heating;& Air-Coryditionxtg� fl c i.,' S S i,l>:W a S G 35:1Final Ga's Pipe-Test, n ( y. 7 r1 tns •• " :r - • tit •• i r :t I:0 OI-.'t. •r _a - p. .. ,.I . ..r .a ... 0. 0_36: Hood,oc_CanoPY _ I tr•-, a. ; -a s_ lr CC) u- '37..FInatFactory Fireplace: 1 Vit1" o Y' yy "air r n .' t'; ti y ft: in <38. a1 Plumbing :' •. n I �? 7 i S I•u ^ k D . t39. Water Service-Final' t -• I .+ '' "O+, o WtT1 * o: •r F I I v >+ CI. .e. TAO. Gas Service-Final _ °t ° M ' •r - l , r.• .. <(Ir r a. r. I e a. 0., vN 541. Solar Domestic-Final S n• . • _• I `[_r = ,S -)' -' = 42:Backflow Preventer,- Cu I ' I.• cc 7� ,- 43. Backflow Irrrf9ation< rxSS . T , u:. 'o "Il-, i r It l: T J C. • S t-74,37. -a :. lu .T y <. -U 144. Landscape litigation Systemnm-; x .. :r - • 0+ 4 .v ..1..r.. .r _ Z: 0 t45._Sound Attenuation •ter{-- r a %- •4 Fdt • - n m •• .• pt III MS _ t:• • I_.',-, r. J46-,Handir cap,Regulatiops '-J ' •' ; r c; 's _ 47.:FINAL STRUCTURE & BUILDING . I 'r' y of 'S 48'. .., L PLANNING . �.:r r. ' f• . P I. 't49.;Electric Release to Edison I is r r. i : 5D ,.Gas.Release to Sout}tern California Gas Co ; I { • 1r : � • _f+ • s 51. CERTIFICATE OF.00CUPANCY • 5 l :,r• - • No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: 151 23RD ST CITY OF COSTA MESA - BUILDING PERMIT PERil NO: B 0700fl ADDRESS: THOMAS & LINDA MC CHURCH 151 23RD ST PERMIT NO; B 070019 PLAN CHECK NO; N GOVT: N SUPP : N C.M 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ARCM/ENGINEER: flEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : DEMOLITION DUE TO FIRE DAMAGE SQ FT: 2, 000 PERMITTEE: CLAIM VALUE; 2 , 000 , 00 CALC-VALUE; 2, 000 , 00 GROUP OCC : R-3 / aoofllss: SOUTH COAST CONTRACTORS ( 714 ) 496-0697 30251 GOLDEN LAN RN E COMMENTS : DEMOLITION PERMIT LAGUNA: NIGUEL CA .92f677 ********4*** N***************** ******* ***************** **** ***� **********R LICENSED CONTRACTOR DECLARATION: hereby al um that)a licensed er provisions of hooter 9(commencing with Section 7000)of Orvisio 3 of the usiness d Professions Code.and m licens s' full force and effect. Z ON I N GS EREQUIREMENTSCITY LI T f LIC.: C it.3: / n' / 651003 B EHP ; Y vl � - MAIN BUILDING ACCESSORY BUILDING Date:✓ Signature:_ r ER C MENSAT ON DECLARATION: Iherebyaffirml Ih.ve e�. •of.,nsent to self-insure or acerfdicateof Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN . pensation Inurance.or a certified copy thereof(Section .La .C). LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN POLICYNO.: 1OWBRC39300E EXP.DAT 03/ . /95 COCernWe H•RTF -D FIRE PARKING REQ• PROV: PARCEL ; 42606424 ZNE: REF NO: C}d Certified copy s hereby fu nni;ed Certified copy is file with the y •adding Division. PLANNING NOTES> G > illApplicant: / *********************************************************************af********* PTIDN FROM ORKERS' 1M' SATIN DECLARATION: (This section need not be completed it the p•mit is for one hundred($100)or less). DEVEL OP MEN T SERVICES REQUIREMEN TS I certify that in the performance of the work for which this permit is issued.I shall not employ any pe on in any manner so as to become subiect to the Wdrkers'Compensation Laws of California. ZONING APPROVED BY DATE; Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. q CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y : DATE c / which this permit is issued(Section 3097.Civ.C). ************************************ * *************************** IF • e'SF** LENDER: ************************************************************************** **** aoDREss: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 4 5 . 0 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed , 50 pursuant to the provisions of the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). I S SUE FEE ❑ I, as owner if the pro ertyretl employeesfamyall70th, wages their esolenclmpesation,C wiilador the work, and the BUILD ING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 45 , 50 0 . 00 0 . 00 45 . 50 45 . 50 . 00 does not apply to an owner of a property who builds or improves(hereon,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 REVENUE DIVISION TOTALS--> COLLECTED: 45 . 50 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45 , 00 , 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner al 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 .x.**.N.***********.N{f..N..M.***.*****..If*******.*.N.*****.if.lf**.******************,If************** that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.&P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY DESCR IP T ION UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 20 FIRE DAMAGE / $100 RES NOZONE 100 . 00 2, 000 . 00 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 END OF FEES permit for construction or modification from the Air Quality Management Di trict.Residential construction applications are exempt from these provisions. //' I her Applicant: herebycertify that have Latin this i' mg and statenthat the i we int -.1 on ist correct.!agree to complyter with all cityoand county ,V/ ordinances and slat .ws relating to qui' Ing msVuction and he aulhory� presenlatives of this pay to enter upon the above-mentioned Lr inspec on• -�; y ! / 01 00172221-00172322 T1?T 4550 x / ,' —_ DATE: 11/22/94Stay • : Signatwe: 11E: 01-31:1501- 3:;0 river's License n Social S•curity A: 1641-45 White-Building:Green-Code Enforcement:Canary-Applicant;Pink-Revenue: oldenrod-Assessor CONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Und-grna.. Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, 0 Undrgrnd. 10. Structural Floor System C 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash& Receptor Final 12. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains _ 64. Plumbing System - Final _ 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Undergrourd Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas D Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE 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 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 1-m2-Staff 671-4111-748. FINAL PLANNING W 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ' No. Date C • PROJECT ADDRESS: UNIT: OWNER'S NAME: 151 23RD ST CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 070405 ADDRESS:THOMAS & LINDA MC CHURCH 151 23RD ST PERMIT NO: B 070405 PLAN CHECK NO: 04979-94 L GOVT: N SUPP: N C.M 92626 • CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ARCH/ENGINEER: H C HANSON REC.NO.;53�`�7 JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: 20.000 ADDRESS IRVINE BL T. 120 PERMITTELTUSTIN CA 92680 CLAIM VALUE: 20,000. 00 CALC-VALUE: 20,000.00 GROUP OCC: R-3 / ADDREss:SOUTH COAST CONTRACTORS ( 714 ) 496-0697 TT3�0�2T5�N1177A GOLDEN LANTERN E COMMENTS : REPAIR FIRE DAMAGED ROOF S FIREPLACE YIIItD AAA, NIGUFrtL ' A 92E� 7 **Xif'*****X'IE')E**'l(**1E'M')E'I **********'lE****'l ***X'lE'1F*'lE'******'****-X****************'IE'X*M** LICENSED CONTRAC N: I ereb a em that I am license. • der provisions o C aster 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of Ih Business .nd Professions Code.and my li e•-.- is', orce and effect. S E T B A C K S CITY LIC.: : p C :. 651003 EXP: -Tate- — Signature:— _ MAIN BUILDING —'— ACCESSORY BUILDING WORKERS'CO PENSATION DECLARATION: I hereby elfin hLe.401.1cate of cone• o self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section n I.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.GATE: nCOMPANY: PARKING REQ: PROV, PARCEL: 42606424 ZNE: REF NO: YJ Certified copy is hereby furnished. ❑ Certified copy is fited with the city Building Division. PLANNING NOTES> >. • . rttab Applicant: iE 7f*****-**-******3f iE*jf (*'*iE1E*'******iE*x3E*1E**1E1E'IE**-********-X*1f****BE X***********if****'** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section .ompleted if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the pedo mance• the work for which this permit i i u, i0t employ any person in any manner so as to become sub lot-Worker) •mr• 'o La sof California.e = _ ZONING APPROVED BY 7 /_._. DATE: 446#/# �1# e. Signamre: ,�i�i� �� OTICE: .a ler aking IM ieclaration,you sho.M7ome sublet(to the Workers' • pensation provisions of the Labor BUILDING APPROVED BY _ ____ D ATE:CC I Cade.you must fonhwith comply with such provision-or this permit shall be deem•• revoked. ,, (,'� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction len.' g agency for the performance of the work for APPLICATION ISSUED BY- • �� /. • DATE: !. / / Z! which lois permit is issued(Section 3097.Civ.C). jE.X.XjE.k,lFiE.IEjE.X.1E3fjE3EjEjf3E3EjE.X.I 4r- .-.. . .IF.XiF3FBF3FgE.gE3F3F3F�F;F.XBE.X.X.X{E{E3E.XdE EBF�E�F�$$33FF'1F3F1f')E ADLENDER: DRESS: ****M**X********'X**SE***********************4 '1E'IE*X'X9E'IE'X**'IE'lE'I **********1E'IE***.X***'*1E'* LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 207. 00 2 . 00 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 SMI P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 134 , 55 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE ' I, as owner of the progeny or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN'—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Cade: The Contractors'State License Law TOTALS----> 209 .00 0 .00 134 . 55 343 . 55 343 . 55 . 00 . .. 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 REVENUE DIVISION TOTALS--> COLLECTED: 343. 55 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 207. 00 2 . 00 134 . 55 ❑ and Professions Code: The Contractors'State License Law does not 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).l am aware ,X,)E,X,fE,)E,)f,XX,XjE,)fjE'XjE,XjE,*,X*,*,X,X,X,X*,IE,)E,fEjE,X,)EX,)E,X,fE,)E,X,X,fE,)E,fE**jE,)E,X,)E,)f,)f,LE,)E,X,fE,K)E,1E, ,fE,X,X,X'X,)E,)(X,kE,)(X.)E,X,)f'X,Njf,X,X,X,)f,)F That proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.&P.C. I N D I V I D U A L F 'E E B R E A K D O 14 N for this reason- TYPE QTY DESCRIPTIO NI UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 20000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 .00 20,000.00 25534 and that I or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit lot construction or modification from 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 info• •ion is correct.I agree to comply with all city and county ordinances and state laws r•.ting to building construction and hereby aut • e rep^ ' e rives of this city to enter upon the above-mentioned property for inspection p pses. 01 00173554-00173556 TOT 3433.55 Date: _ /, Signature: DATE: 12/16/94 TIME: 14:24 ver's License or Social Security 1641-46 white—Building:Green—Code Enforcement;Canary—Applicant;P —Revenue;Goldenrod—Assessor • • CONSTRUCTION AND PLANNING r-. POOL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Sail Pipe-UntirgrO. 53. Steel Reinforcement ,l 3. Electrical Conduit-Ufility-Undrgrnd. 54. Forms 4.-Electrical Cortiduit-U¢drgrnd. 55. Electrical Bonding 5.- Steel Reinforcement ' 56. Rough Plumbing & Pressure Test '6. Electrical k_IEER Gind. 57. APPROVAL TO COVER-GUNITE 7..Footings 7 58. Electrical Conduit•Undrgrnd. • 8. Foundation. `'i 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. Rod Drains :. 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .,20. Rough •Factory Fireplace _ - APPROVALS'-"Perm?t# 21. Ducts, in Structure • I •- - -- - "70. UndergroUhd Hydro 22. Ducts; Ventilating.' " , 71. Product Piping OGas D Oil ,. 23. Gas Pipe-Rough & Test ;:; r y . .72, Underground Flush 24. Roof Framing " - - • -, '33. -Undergrnd.'Storage Tank 0Gas OOP' 25. Roof Sheathing I-S v➢ (,:e.4.4" ' -74. Oterhead Hydro .• 26. T-BatCeiling (Structural) & M'onocoat - .. 75.-Dry Chemical ' -. T. 27. Frame and Flashing _• , : 1---20.7-75.‘,4/t(..- 76. Dry Standpipe ... ' 28. Lathing & Siding • • r. . ' ' 77. FIXED SYStEMaiNAL • - 29. Insulation - _. •/-26-yr VS4 78. MIRE PREY. FINAt • - - 30. Drywall Nailing _ -30`9 (a'c -- - HEALTH DEPT. REQUIREMENT 31. Plaster Brbmm Coat ,-- ,79.'FINAL INSPECTION 32. Electrical Power Meter-Final ' !. • • 180. FOOD CERTIFICATE ISSUED 33. Final,.Electric-. I _ . Notes: _ . • 34. Final Heating & Air Conditioning k-1 r �c�✓ �_! q�fly S �_! 35. Final Gas PipeiTesf, . , ' ' ,--eadz-._ iDa 1ki _ 36. Hood.or Canopy - i �s I 37. Final Factory Fireplace' - -0t77_44-44 : • 38. Final•Plumbing a . . _ - -. 39. Water-Service-Final - 40. Gas Service-Final - - - .. . 41. Solar Domestic-Final 42. Backflow Preventer ' - , - - i • 43. Backflow Irrigation - • w -- • '44. Landscape Irrigation System.- - - . - -.- A5. Sound Attenuation 46. Handicap,Regulations - - /�11,, �/.' - - • . 47. FINAL STRUCTURE & BUILDING 3 Z•3-99140/ " ' - 48. FINAL PLANNING - - ...• = 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY - •••_. • - •• No. Date City of Costa Mesa California 92628-1200 'P.O.Box 1200 Insulation Certificate �7 24 6/ 1 r Permit Number (//} / 61 --Wr . /17 7? cd also AA Number and Street City ��� Subdivision Lot Number Description of Installation ROOF Material Brand Name Thickness (inches) Thermal Resistance (R-Value) EXTERIOR WALL r, / /11 /11/ Material1/ Brand Name Thickness (inches) /? Thermal Resistance (R-Value)_A' —/S CEILING //� Batt or Blanket Type_ Brand Name_/`'� 1/0/% Thickness (inches)_ _ 3-D Thermal Resistance (R-Value) .[C-221) Loose Fill Type Brand Name Contractor's minimum installed weightlff2____ lb. Minimum thickness inches , Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) L�S • RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above.insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the Califor is Adminstrative Code. ter-sw- 6 r/rr°' eneral Contractor(Builder) ice se Number igndture and Title Date _ 1_Lt, ._ _ac t/es VSY 7 ?E/ 2 .ub:Contractor solation Installer) LLicen umber . nature and Title Date 1907-46 AliPROJECT ADDRESS: •• UNIT: OWNER'S NAME:. 1S1 23 - CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 070408 ADDREss: THOMAS S L A MC CHURCH " tbrf 151 23RD ST 1-- SCC - G PERMIT NO: P 070408 PLAN CHECK NO: N GOVT: N SUPP: N C ,M 92626 ; �jC CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: H C HANSON REG.ND.:S30gw JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT : ADDRE55:17371 IRVINE BL I '120 PERMITTEE:TUSTIN CA 92680 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / ADoMess:SOUTH COAST CONTRACTORS (714 ) 496-0697 30251 GOLDEN LANTERN E COMMENTS : RE: 870405 / COVERS LISTED ITEMS AND GAS TESTING LAGUNA NIGUEL A 92677 ***l **iflfiEiE***lE1ElE-IEIE*****lEiElfiEiEiEiEjEiEiE-1 **lEiEiE***IEI **lE-x**iEiEiEiE***IEIE***lEiEiEiEiE***IEiE"1EiEiEiE*** LICENSED CONTRACTOR DECLARATION: I I. reby affirm that I am licen ..i rovisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of 1 •• Business and P•essions Code.and my li e • ull force and effect. SETBACKS CiTYLIC' , A uc.651003 '�" t: EXP : Date:/.4, .4 Signature:_ _rd MAIN BUILDING ACCESSORY BUILDING RXERS'CO 'ENS TION DECLARATION: thereby affir t I have.certificate of co ••ntto selfinsure or a certificate of Workers' FR NT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 00.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42606424 ZNE: REF NO: -D Certified copy is hereby furnished. ❑ Certified copy is filed with the city B'sing Division. PLANNING NOTES> > ' Date: Apogean!: *************************************.***************1f****************4E.*****4*** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This secti:: •Completed it the permit is for one hundred($100)or less). DEVELOPMENT S E R.V I C E S REQUIREMENTS I certify that i the pedor ance of e work Is which this permit is 44• 4, ot employ any person in any manner so as to become su•'cttao I•rke /) L. sofCalifornia. / a ZONING APPROVED BY DATE: rate: / Signature: , % — ----- -- _________ OTICE: .alter making is declaration,you should b Ar subject to the Workers' :mpensation provisions of the Labor BUILDING APPROVED 'BY :_ — — ,__ DATE: Code.you must forthwith comply with such provisions or t s permit shall be deem:: revoked. ���y�� ..—— —fia(�—,—�/—'(—� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: Ap ,1111 /�.. DATE: f' 9F iF • which this permit is issued(Section 3097.Civ.CI *****.)F*.)E.K..K.. .)F.****.)E.)F.)E.)F** • �+ . > - .X..�.�.K..)E,)E.)F .. .)E' .e. LENDER: *****4************************************* 4 ****.******•**.*********iE************ ADDRESS: LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 21 ,00 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 25% SMI P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 20. 00 } I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or altered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 21 . 00 20 .00 0. 00 41 . 00 41 . 00 . 00 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 REVENUE DIVISION TOTALS--> COLLECTED': 41 . 00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/'TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 41 .00 , - ❑ and Professions Code: The Contractors'State License Law does not 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 ******************.. . . . *. . .K..*. .*.K..*.K..**. .*. .*.K..*. .x..*. .x.. . .*.*. . . .K..K.. . . .*. . .K.. • " . .*. . .*.*fig.. . .*. . .**. that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.8 P.C. I N D I V I D U A L F "E E B R E A K D O W N for this reason: TYPE QTY DESCRIPTIO N m • UNIT COST TOTAL COST Date: Owner' Ido hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLO 1 BATHTUB 1 7. 00 7. 00 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 PLU 1 SHOWER 7. 00 7. 00 permit for construction or modification Irom the Air Quality Management District.Residential construction applications are exempt from P LU 1 GAS SERVICE 7. 00 7. 00 mese provisions. END,OF FEES Date: Applicant: ./ I hereby certify that I have '.d this application and state that the above' for• on is .rect.I agree to comply with all city and county ' ordinances an sta claw elating o building construction and hereby aulho .rep> olives of this city to enter upon the above.mentioned property for r L -pu po • //r • / 01 001715:?-110173`:9 TOT 41.0D Dale: Signature: r vers License or Social Security 4: DATE: 17/1e/94. TIME: 14:26 164646 While—Building,Green—Code Enforcement;Canary—Applicant:Pink—Revenue Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe.Undrgrnd. . 53. Steel Reinforcement 3. Electrical Conduit-Utility-Undrgrnd. 54. Forms h.e 4. Electricai'C5ndui't-Undrgrrd. 55. Electrical Bonding - G- 5. Steel Reinfotcement- 56. Rough Plumbing & Pressure Test Electrical LIFER Grad.111 57. APPROVAL TO COVER-GUNITE 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. Sewrer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing • • G-ti' C .) 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace -. - t. APPROVALS„ :'Permit # " _ 21. Ducts, in Structure • • • _ - 70. Undergrb'urld Hydro • 22. Ducts, Ventilating : ' • ^11. Product Piping 0 Gas 0 Oil 23. 'Gas Pipe-Rough& Test . -72. Underground Flush 24. Roof Framing - . 73. Undergrnd:Storage Tank O Gas 0 Oil • - 25. RoofSheathing • - ` -' ; �74.-Overhead Hydro 26. T-Bar Ceiling (Structural) & Monotoat ' ' 1 75. Dry Chemical - 27. Frame and Flashing, - • - 76.`Dry Standpipe .. r 28. Lathing& Siding '-'• ': - . 77. ;FIXED SYSTEfiFINAL - 29. Insulation - - 78.' FIRE PREV. FINAL 30. Drywall Nailing . . HEALTH•QEPT:REQUIREMENT 31. Plaster Browq Coat C :. .79. FINAL INSPECTION • 32. Electrical Power Meter-Final • " -80.,FOOD CERTIFICATE ISSUED 33. Final Electric , • • .. Notes: (_if-1S_PAnti.LL- //tepen- Ca 34. Final.Heating & Air Conditioning �Ji�7 • _ L/-,, � a �� -P� D 35. Final Gas Pipe-Tes;tl;;, r u � ' 7. ^"T • s-mss rf�l - 36. Hood or Canopy 1.19, -7S--- . =7S", . 37. Final Factory Firepljnde �,r-` 38. Final Plumbing r!cis- \: [ 1 -7c-- ' 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' ' T ) 46. Handicap Regulations .. 47. FINAL STRUCTURE & BUILDING _ 48, FINAL PLANNING - _ . - - .49. Electric Release to Edison ' - o . 50. Gas Release to Southern California Gas Co , - - 51. CERTIFICATE OF OCCUPANCY - • No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: 151 23RD ST • CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 070407 ADDREss:THOMAS S LINDA MC CHURCH 151 23RD ST PERMIT NO: M 070407 PLAN CHECK NO: N GOVT: N SUPP: N ' C .M 92626 , CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: OTH ARCMIENRESS: ADDH-C HANSON REG.NO.:S3��IT'7 JOB DESCRIPTION : FIRE DAMAGE REPAIR SQ FT: REss: 17371 IRVINE BL 120 PERMITTEE: lUSTIN CA 92680 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / aoDREss:SOUTH COAST CONTRACTORS (714 ) 496-0697 30251 GOLDEN LANTERN E COMMENTS : RE: B70405 PRIMARY BUILDING PERMIT bi4NIGUEL A .92627 �E�E�Ek>E�E�E*�E�F�E�E�EfESESE�EiE�E�E�E�E�E�E*x�E�ESEIEiE�E�E�E�E�E�E�E�E�F�E�E�ESE�E�E�E�E�E�EitsE�E�EiEiE** �t�EiEiEiESE#�E•sF�E�EiEaE�E�E�E�E*** LICENSED CONTRAc N: ereby affirm that t am license er ions o C apter 9(commencing with Section Z O N I N G REQUIREMENTS 7000)01 Division 3 of a Business andProfessions Code.and my lic is in . I. e and ellect. SETBACKS CITY LIC. 7 ) T LIC.B 5100 3 CLASS;, E , WO / Signature:_ _ ._.410 ———•- MAIN BUILDING ACCESSORY BUILDING WORKERS' OMPEN ATION ECLARATION: I hereby affirm t haYre a certificate of consent to self-insure• a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 38 .Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ.; PROV: PARCEL: 42606424 ZNE: REF NO: %a Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Divisio PLANNING NOES> > • Date: Applicant: ********'1E****************************.**********************')E************')f****** EXEMPTION FROM WORKERS' I MPENSATION DECLARATION: (This sear i mpleted if the permit is for one hundred(5100)or less). -• DEVELOPMENT S E R .V I C E S REQUIREMENTS I certify that in the perlorma •of the v irk for ich this permit is is • employ any person in any manner so as to become subject to the 4 ensati• California. ��'�,� ZONING APPROVED BY • _, DATE: 4 �� Signature: Ai as. —� --- _ • -—---——— NOT IC :If.aft r aking his d•cfaration,you should 'cc, e subject to the Workers'Co•sensation provisions of the Labor BUILDING APPROVED BY : _ _ DATE: Code.you must forthwith comply with such provisions o this permit shall be deemed eked. "'---'--- CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending .gency for the performance of the work for r - i APPLICATION ISSUED BY: AC i DATE: ‘.47410,4% which this permit is issued(Section 3097.Civ.C). �. . . . . . , . • . . *********************** * • 3FIF '. .. '3C*�*3F3F"£3F•IF*********** ** LENDER: ***X*************3E******************** *** e*'If*****************dE**7E************ ADDRESS: LEGALIZATION:N F E E 'S U M" A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/R ES GRADING (Section 7031.5 Business and Professional Code: Any city Of county which requires a permit to construct,alter,improve,demolish,or PERMIT 15 ,50 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 1 25% SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 15 . 50 15 . 00 . 0 . 00 30. 50 30 . 50 . 00 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 REVENUE DIVISION TOTALS > COLLECTED: 30. 50 OVER/SHORT: .00 tor the purpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC • FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business . 30. 50 ❑ and Professions Code: The Contractors'State License Law does not 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).l am aware , *, ,**, ,x,***,********************************************************************* that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN for reason: TYPE QTY DESCRIPTIO N. - UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and MEC 1 INST FORC-AIR/GR A V FURN <= 1100 K BTU 9 . 00 9 . 00 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 MEC 1 FACTORY FIREPLACE 6 . 50 6 . 50 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF' FEES these provisions. Date: Applicant: I hereby certify that I have read this application and stale that the above in. rtrecl.I agree to comply with all city and county ordinances and stale law elating to buittlmg nnslruction and herebya - / novas of this city to enter upon the above-mentioned pmOerlY'/• echo ose• �/ . / Signature: o• Ee 12/16/94 ap353a 111¢4:::2151- IP DRTEt 12/16/94 iINE: $0s0 t river's License or Social Scour ty x: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pmk--avenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL SPA • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.-Electrical Conduit Utility-Undrgrnd. 54. Forms 4'.iElectricel-Conduit-Updrgrnd. 55. Electrical Bonding 1 5.-Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6.;Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 77- Footings ' - 58. Electrical Conduit-Undrgrnd. -8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test '3. Water Pipe-Undtgrnd. 60. Backwash Lines, P•Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOLJSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace 2. ' I;tiO;, : APPROVALS' .,Permit # ; 21. nets, in Structure 70. Urttfergrbund Hyt}ao 22. Ducts; Veirtilating' - r;‘, F71. Product?lining QGas 0 GO 23. Gas Pipe1Rough & Test - - 72. UndergroUnd Flush 24. F(oof Framing • F • 73.TUndergrnd--.Storage Tank 0 Gas 0 Oil 4. 25. Roof.Sheathing - 74. Overhead Hydro t 26. T-BarCeiling (Structural) & Monocoat - :Tim, ' 75. Dry Chemical - ., 27. F-jame and Flashing'. -- - 76. Dry Standpipe 28. Lathing & Siding, - • ,' 77., FIXED SYSxEM FINAL i 29. Insulation - - 78..1IRE PR EV. FINAL 30. Drywall Nailing " - HEALTH DEPT. REQUIREMENT 31. Plaster Brown-Coati; . -79. FINAL INSPECTION 32. Electrical Power MeterFinal '80. FOOD CERTIFICATE ISSJUED� g-===-� - 3. Final Electric • .4 dotes: (-((-QS 4 • :34. Final:Heating& Air Conditioning • • ^Ifs�s (-l rs�S _ -m di/6: ice•; 0 C�- 35. Final Gas Pipe-Test` •,': ' p r.r.a.�P vee ea vZzg_r,on, !tJ 36. Hood or Canopy • • r t 37, Final Factory Fireplace' - - ' 3 _ 2 ZYLZ. 38. Final-Plumbing ^ ' 7_j,.s i /�J�..-,""` 39. Water Service-Final - .r - A� - 40. Gas Service-Final , -.• ' - - 41. Solar Domestic-Final • is - - "' 4' 2. Backflow Preventer . - - • 1 43. Backflow irrigation ' . _ - • ; 44. Landscape Irrigation System - ..� r y 45. Sound Attenuation - . "` 46. Handicap Regulations - ,. ; - - - • 47. FINAL STRUCTURE &BUILDING • . 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - -'- - 51. CERTIFICATE OF OCCUPANCY ' c No. Date • PACT ADDRESS: • , UNIT: OWNER'S NAME:, 151 23RD ST - CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 070406 ADDRESS: THOMAS & LINDA MC CHURCH 151 23RD ST PERMIT NO: E 070406 PLAN CHECK NO: N GOVT: N SUPP: N , C .M 92626 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH --— AflLH/ENGINEER:H C HANSON REG,N0,:S3 JOB DESCRIPTION FIRE DAMAGE REPAIR SQ FT: ADDRESS: 17371 IRVINE BL • '120 PERMITTEE: TUSTIN CA 92680 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ADDRESS: SOUTH COAST CONTRACTORS (714 )496-0697 30251 GOLDEN LANTERN E COMMENTS : RE: B70405 PRIMARY BUILDING PERMIT LAGUNA NIGUEL A 92677 ***************iEIEI ***iE*iESESEtEiE*aE**iE****iENiE*iEiEiEiEIEiEiEiEiE*iEiEiEiEiEiE****iE***iE**iEiEiE*:EifiEiE*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licen '. u .. • 'visions of Chapter 9(commencing with Section ZO N I N G REQUIREMENTS 7000)Ot Division 3 of the B siness and Professions Code,and my tic: e i in I orce and elect. SETBACK S CITY LIC: ST yfc.., 51003 Cf. EXP: tea. I_ L // Signature' .` dfifte MAIN BUILDING ACCESSORY BUILDING —I RKEp�i SATIO'DELLA'ATIDN: Ihereby affir I have. 'rtihcate of consen .sen-insure or a certificate of Workers' FR NT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance,or a certified copy thereof(Section (00,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42606424 ZNE: REF NO: C Certified copy is hereby furnished, 0 Certified copy is tiled with the city Building 'ivision. PLANNING NOTES> Date: Applicant: *******'7E**********7E************X**K'*************1E******!E***********-7E********7E** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section. .m .'h. pleted if the permit is for one hundred($100)or less), DEVELOPMENT SERVICES REQUIR EMENTS I certify that in the perform nce of he work I.r which this permit is iss 'I sh. omploy ally person in any manner so as to become sue Itmp o the orkers' -, en i. ay.of California. ZONING APPROVED BY DATE; 4 Date' i _ / Signature: ata .__ ._. _._. --.-._..-— NOTICE:If. .ter m. ng this' (oration.you should becom:subject to the Workers'Compels ion provisions of the Labor BUILDING APPROVED BY : __ DATE: _(fir_ __ Code,you ust forthwith comply with such provisions or t s permit shall be deemed revoke•. --- //��{ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agen or the performance of the work fpr APPLICATION ISSUED BY:-Z� :V. . • , /e!! % � . . . . . . . DATE: Z lbiF3F�iF which this permit is issued Section 3097.Civ.C). ,**,*,***,****,**,***,*, *,***,** 7,! T,******,***_* *7* ** LENDER: ************************************** ***- *.****x***********************3E***** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the blowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve.demolish,or PERMIT 11 , 00 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 5 0% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 . 00 I. as owner 01 the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 11 .00 15 . 00 0, 00 26 , 00 26 . 00 . 00 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 REVENUE DIVISION TOTALS--> COLLECTED: 26. 00 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 26 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to theContractors'State License Law).l am aware .*.**..*.*.*.*,*.*..*.*.*.*.*.*.*.*.*.*.*.*,*.**.-*.*-*.*-*-*-*.*-*.*-*.*.*-*-**.*.*.*.*,*-*.*.*.**,**********.*************,****** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: owner: ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT 11 . 00 11 . 00 I do hereby certify that I ant aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES 25534 and that I or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification Iron the Air Ouality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: / ' I hereby certify that I har ead this pollution and state that the above' o correct.I agree to comply with all city and county ordinances and state lav' elating I..uilding construction and hereby or sentatiues of th6 city to enter upon the above-mentioned property fpr in recti. purpose '. Signature: v 01 00173557-00173557 TOT DATE: T 26.00 12/16/44 TIM! t4:?S Driver's Lice se or S...I Security ' 1641-46 white—mudding:Green—Code Enforcement:Canary—Applicant:Pink— slue:Goldenrod—Assessor , r I. CONSTRUCTION AND PLANNING POOL _. SPA • APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Eltctrical Coad Pit•Undrgrnd. 55. Electrical Bonding . 5. Steel Reia'forcetnent- 56. Rough Plumbing& Pressure Test 6. Electricat't1FER 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 t 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT . REQUIREMENT 20, Rough Factory Fireplace APPROVALS .,_Permit # - , : 21. Ducts, in Structure ', 70. Underground'Hydro 22. Ducts, Venti 'tiny' .71. Product-Piping 0 Gas 0 Oil 23. Gas Ape-Rough & Test :, .' - -72. Underground Flush ' 24. Roof,Fr3tning' -- . . - .73. Undergrnd.Storage Tank O Gas 0oil 25, Roof Sheathing : -• '74. Overhead Hydro 26. .7-Bat Ceiling (Structural) & Moho?:oat ,,M ` 75. Dry Chemical -• ' 27. Frame and Flashing; _ • 76. Dry Standpipe - i ` 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 Potyer Meter•Final 4 • •80.,FOOD CERTIFICATE ISSUED ._ -33. Final Electric ----THSrleli- Notes: ,.._.4 ��_ SGS 34. Final Heating-& Air Conditioning-'• ' 35. 'Final Gas Pipe-Test-- .- 1 .- _ - - 36. Hood or Canopy ':` > .. . • - 37. Final Factory Fireplace y - . ' i "' 38. Final Plumbing i.r •- • u . • 39. Water Service-Final - • •40. Gas Service-Final - -- ' : c , 41. Solar Domestic-Final : 42, 6ackf low Preventer, • 43. Backflow Irrigation' 44. Landscape Irrigations System -- .. . 45. Sound Attenuation` '' 46. Handicap Regulations _ _ - 47. FINAL STRUCTURE & BUILDING ' 48. FINAL PLANNING - • 49. Electric Release to Edison . . 50. Gas Release to Southern California Gas Co ' , . - 51. CERTIFICATE OF OCCUPANCY . No. Date I:51 23 rd St COSTA MESA CA . a rill.1191 r .. n u1 n I `I r .ta 1 7 ` . Dining I . . _! Garage Family 115T• FLOOR • ii Ri}chen (c_, U C 4 Ga 5PA -Nt Amor -1:7111 ED 9 CD 1 told kW-cf. 1 lH T145 GPt nrilliMIS: 41,1 YFLO UR_ BATH- sNowER M• BED- 1 1.x;4:,3 J 2ND FLOOR D `x51 p0 tqcc CITY OF COSTA MESA ,^E CALIFORNIA 92626.1200 P.O.BOX 1200 v6 DEVELOPMENT SERVICES DEPARTMENT 40;;;;;,--—, P �ORPORann August 6, 1990 To: Building Safety Division Newport-Mesa Un. School Dst. (2) Code Enforcement Pacific Bell (2) Communications Police Dept. - Ping. & Research Copley-Colony of Costa Mesa Santa Ana Heights Water Company County Administration Office Sanitary District Engineer County Clerk/Bd. of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Fire Administration U.S. Post Office - AIS Fire Prevention U.S. Post Office, Adams Avenue Manager, MIS File (2) Mesa Consolidated Water Dist. The City of Costa Mesa wishes to advise you that the following addresses have been changed or added: OLD ADDRESS NEW ADDRESS A. P. NO. 151 23rd Street 151 23rd Street 426-064-02 2292 Elden Avenue For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. Your cooperation in this matter is appreciated. Sincerely, RICHARD WELMERS Planning Intern RW:jl (ADDCHNGE. 100) 77 FAIR DRIVE Building Division(714)754-5626 • Code Enforcement/Business License(714)754-5234 • Planning Division(714)754-5245 I f r I 2292 W ELDEN W r Q Z o W 151 23RD 23RD STREET LO<inits„ CITY OF COSTA MESA O .�F CAL.-JRNIA 02626 P.O. SOX 1200 Ali - '-':.i ° F , ,, . 4. -4.4„ FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY • Project Address ,-- /,.7/ or, 02° ,.a,zf . E 7/7 . Permit f 78E49 Project Name p Type AV V Owners Name „ �v c ey% / Owners Address /0-7 72 „'-ca - c21y, 72‘27 City Use Qily Owners Telephone ryt- 02//S I .czctr .z. c, - as Owner, (strike out all except one) do hereby attest that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In the event that any person, or persons, are employed under the provisions of this permit, I shall immediately cause a valid Certificate of Workmen Corriensation to be filed with the Costa Mesa Building Division. I agree to defend at my own cost, and to indemnify and hold harmless, the City, its officers, agents and/or employees, from and against, any and all liability, damage, costs, losses, claims and expenses, howsoever caused, resulting directly or indirectly from, or connected with the improvement under this permit. I further state that I have read and fully understand the implications and re- sponsibilities of the above statements, and will e'anply with all provisions of the Contractors State License Law found under the Business and Professions Code, Division 3, Chapter 9, of the State of California. SR_,7// Lt-/G,4, c5-i/Au/ 'til.--79-74t.., //Print Name / 2rn ai 7+�.�lca—� �cc e, 7 77 Signature v ate CMF 077746 OWNER SHAW, ELLIS P. DATE 7_5_61 JOB ADDRESS 157. East 23rd Street BUILDING PERMIT NO. ' 111801 GENERAL CONTRACTOR Ne)son & Dye Construction, The. VALUE $ 1 ,250 00 AP.No. 118-08h-16 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Det 2—car gar. INSPECTIONS DATE I GROUP J TYPE V ZONE R— i Underground Soil U.G. Water SUBCONTRACTOR PERMITS ISSUED lagroundGas DATE NUMBER G`>3caned Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring zaG ' 5g.-(-4( rm./ r _1-ar-41 Isy84' Trenchese0 - Forms/?444Steel Floor System Steel Reinforce Chimney Re-Rod Bond Beam Egli fi /i 7 -.LC. —C SiFrame and Flashing y •24 .- (,1 Lathing, InRIYI4P Out 'COWL- 8 t—lol F tr, brown coat -(4--G/ _ .bing Fixtures, Final Electric Fixtures, Final ' (p/1 py Building, Final 1 J OCCUPANCY I 1 Form 210-5M-11-59 S-B P 1µA01 . 14801 FEE RECEIVED \j-FI JUL 3 173f COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT �+ �L TYPE OR7PRINT BUILDING ADD EISS .�.7/ ,E. 3 1"/ Alia MESA. CALIFORNIA For Office Use Only p�MEMIT 7 OWNER f l`/� /` • JAVA L✓ I RECEIPT NO. I 1 ] ROI MAILCEIVED BY DATE allonym DATE ISSUED ADDRESS /5/ C. 2301 REit,..... 7-.f-6I CITY G b (�E O/A- TEL. NO. BUILDING s �^'� �/ ADDRESS .S'I `• �" ARCHITECT //!! TEL./0/4. COSTA MESA. CALIFORNIA OR ENGINEER A/eZ OA/ gyre /NO. ..�(,/jb -- ADDRESS 2/2 j/l/r'.CI✓C�L/C,//LEA- "O - FIRE ZONE TYPE 7 GROUP ,j''0.-- ..." ' CONTRACTOR /X�`/GAP �° VZ l w'/ A✓ BYPR DATE�.% / ADDRESS x(2/2 /VA ildgt//te fo - �g�( tip ZONING CITY .f'�ilia /jet�/ CALL///A�f/ C}� SON1` I PLL�ANS / / I BUILDING I �.5.�� �'CY LIC.TNO.CO-9 (� D /3 NO. �T ' YO/J(J LEGAL DESCRIPTION 7-I{ / ` �•'Whir SIZE OF LOT CvO-I X /is U( I NO. OP BIROS. d /1 _ I NOW ON LOT A.P.NO. t I Sj •w lS R�' `, USE OP GQ /t 4 60 YARDS EVES EXISTING BLDG. _ _ APPROVED ALLOWED SETBACK LINE PROM / (CENTER LINE ST.) ,( Agit CENTER OP STREET / REAR YARDSsgq .y FRONT /bQ `FT. r/'Ijj',I//1 IN. SIDE YARD I LEFT I RIGHT 973.Si_ R.SIDE (/q//T. E LQ&LIN. DESCRIPTION OF WORK L.SIDE r FT. IN. NEW Y I II ALTERATION I II ADDITION I REAR ir FT. ./y IN. REPAIR I MOVING I II DEMOLISH I BYPRO\ I'V'Y1� DATE ! -c/B -. SIZE DING 22'x25" ROOMS i STORIES' i �/•/ EXTERIOR WALL I ROOF CC'//--{{/PC COVERING WALL CO' COVERING l//`/. Q USE OF BUILDING AND WORK TO BE PERFORMED Soo a -en.. NM.. 3RPA5Q- r. • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO CAM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. . PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTIOl. VALUATION SIGNATURE OFCu - PERMIT PEE $ O r PERM ITTEF ?� (/ od a $ Ia,SQ- PLAN CHECK $ 7 AUTHORIZED AGENT - 1 vu TOTAL FEE $ I�• 0