HomeMy WebLinkAbout247 23RD ST - Building Permits r
CITY OF COSTA MESA
"Its:•. BUILDING DIVISION
> Y r-,,,. . : DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
PERMIT
G. 1101411 P03-00683
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 247 23RD ST Status: ISSUED
Suite No Applied: 10/16/2003
Issued: 10/16/2003
Vicinity:
Parcel Nunmber: 42607410
ISSUED BY:
Applicant: KEVIN SZABO
Address: 2737 S CRODDY
STE D Phone: (714)241-1414
SANTA ANA,CA Zip: 92704
Owner: KNIPP, DONALD A TR
Address 247 E 23RD ST
Phone:
COSTA MESA,CA Zip: 92627
Contractor: COAST ROOTER PLUMBING HEATING &AIR CONDITIONING
Address: 2737 S CRODDY
STE D Phone: (714)241-1414
SANTA ANA,CA Zip: 92704
License: 529127
Arch / Eng:
Address:
Phone:
Zip:
License:
SCOPE OF PERMIT
C/O OF WATER HEATER.
FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 . Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain,Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain,Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord.No.92-28,§1,12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
244646(8100)
DECLARATIONS
WORKERS'COMPENSATION DECLARATION: •
-
I hereby affirm under penalty of perjury one of the following declarations:
O I h and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
rk for which this permit Is issued.
I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workscompensation Insurance carrier and policy number are:
Carder: •T 'F 4 .4.)r)Zi Policy Number: , 1 7--.3)D _ O
(This section need not be completed i/the permit is valued at one hundred dollars($100)or less.)
❑ I certify that in the performan of the work for which t is permit is issued,I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Car or la,and agree sh Id become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisi _.—
Applicant Signature: Date: 1 0 ' lam' 0 3
WARNING:FAILURE TO SECURE WOR ERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(4100,000),IN A ITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of enter 9(commenc' g with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full
force and effect.Lic.# S'20 12, / Class# C %6 N7 (--
Contractors
Contractors Signature: r /L Date: /0 -/7-03
CONSTRUCTION LENDING AGENCY:
O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code).
Lenders Name: Lenders Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its Issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
O I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). •
O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. 0 Yes to No Drivers License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Ttle 8,California Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes 0 No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
._ t.........._.ardour materials?
— _._ _ _
2 Does or will the applicant or present or future building occupant need to file a registration form for acutey hazardous 0 Yes 0 No
(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes ❑No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No
(If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No
8 (If yes',attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection'urposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
F TfllapLI Legal Owner(s) Date
And'r Authorized Applicant Date
MIS , ' 'II-, I' PAIS EMU CODE! INSPECTION TYPE PALE REMALS
1616 Fixed System Final Fire Prevention _ 206 Final Mechanical /�
1266 Pool Spa Final 208 Final Plumbing )O-ca7-03 Bev
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final BuildinglOccupancy
p S . CITY OF COSTA MESA
4
BUILDING DIVISION
Y :j�,,,rr , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER
t � • PERMIT P05-00319
(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626
PLUMBING PERMIT
Job Address: 247 23RD ST Status: ISSUED
Suite No Applied: 04/29/2005
Issued: 04/29/2005
Vicinity:
Parcel Nunmber: 42607410 ISSUED BY: r' -
Applicant: SZABO, KEVIN
Address: 1730 MT.CLIFFWOOD
Phone: 714.241.1414
17390 FOUNTAIN VALLEY,CA Zip: 92708
Owner: KNIPP, DONALD A TR
Address 247 E 23RD ST
Phone:
COSTA MESA,CA Zip: 92627
Contractor: COAST ROOTER PLUMBING HTG & A/C
Address: 17390 MT CLIFFWOOD
Phone: (714)241-1414
FOUNTAIN VALLEY . Zip: 92708
License: 529127
SCOPE OF PERMIT
WATER HEATER CHANGE OUT
- FEE SUMMARY
AMT QTY AMT QTY AMT QTY
ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0
Backflow irrigation $0.00 0 Landscape Irrigation ,$0.00 0 Swimming Pool $0.00 0
Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0
Bathtub $0.00 0 Pressure Regulator - $0.00 0 Urinal $0.00 0
Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0
Connect(Ice,Soda,etc) '$0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0
Dental Units $0.00 0 Septic Tank ' $0.00 0 Wash Basin $0.00 0
Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0
Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0
Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $0.00 0
Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $12.30 1
Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0
Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0
Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0
Gas(1-4 outlets) $0.00 0 Sink,kitchen $0.00 0 Water Softener $0.00 0
Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00
Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00
Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00
Interceptors(Grease,Oil) $0.00 0 - REINSPECTION $0.00 0
Interceptors(Sand Auto) $0.00 0
TOTAL CALCULATED FEES: $35.80
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714)754-5626
2446-46(6/00)
DECLARATIONS -
•
WORKERS'COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the
work for which this permit is issued.
t have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued.
My workers'compensation Insurance carrier and policy number are: / (�
elrtei:"S, Sir fr,`,n Poticy,Number:—{ 7 bQSSS
(ThidsCctlon need not be completed I p it is valued at one hundred dollars($100)or less.) C' `- Y
❑ 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 Califorpin,and e I t If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith
comply with these provisi
11p`plicaMSgna ure: /-Date:,...J /y``//(/y, i/--
WARNING:FAILURE TO SECUR WORKERS' PENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EM 'ERPttTD CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE(5100,1x0).IN ADDI TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full
[ an ffo t.:Le, 529/2 _ cJa 1 C-3 6
QI cntractor-s-Signe _ _ / �tal--,,. of/2-97(7 S
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.(Sec.3097,Civil Code).
Lender's Name: _ Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions
Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit
to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the
Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars($500).):
o I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec.
7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work
himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is
sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions
Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires:
Verification of Ownership by(type of document,i.e.-property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
o I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this
permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.
341,Title 8,California Administrative Code).
O As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑Yes ❑No
(Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No
(Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)?
❑Yes []No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑No
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aparmit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No
(If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this
application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No
8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances
regarding Hazardous Materials and Emissions.
Signature: Date:
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is
correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the
above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
QQSignature Wag Owner(s) q/ ,/ Data
} hd/ rA_Szetl AppliC$nt / Date
;ODE I INSPECTION TYPE DATE INTITIAIS CODES INSPECTION TYPE Mt INTRIALQ
1616 Fixed System Final Fire Prevention 206 Final Mechanical .c
1266 Pool Spa Final 208 Final Plumbing -1 r+-(H •o5 B IY
200 Final Re-Roof 210 Final Electrical
201 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
PROJECT ADDRESS: UNIT:
OWNER•SNAME: 247 23RD ST CITY OF COSTA MESA – BUILDING PERMIT PERM NO: P 061688
ADDREss: 23RD ST PERMIT NO:BRUCE FREEMAN TR P 061688 PLAN CHECK NO: N GOVT: N SJPP: N
247 23
247
COSTA MESA
o CA 92627 CONSTRUCTION TYPE; 5–N PERMIT TYPE: PLU PURPOSE: OTH
ARCH/ENGINEER: REG.NO.:
ADDRESS:RICHARD DODD C25uxlt1 JOB DESCRIPTION : ADD 560SF 1ST FL, 38SF 2ND FL RESID ADDI SQ FT:
201 SHIPYARD WAY, BERTH A F
PERMITTEE:N,B , CA 92663 CLAIM VALUE: CALC–VALUE: GROUP OCC; 'R-3 /
ADDRESS:SYDNEY BERG ( 619 ) 598-3490
2_634 COVE CT 1 COMMENTS: RE: B61613 PRIMARY BUILDING PERMIT,
LICENSED CONTflACTOR�OECLARATION: thereby affirm lhatlam licensed under'ProvisarnonlGfia1pter9(cpmmencing with Section ****************** **' *************lFjeifif******4****3E3f1ElFi ***lEjE9F3EiF#i("***** 1 ********
7000)of Division 3 al me Business and Professions Code,and my license is in ma torte an•'effec,, ZONING REQUIREMENTS
CITY LIG.: /q / STATE LIC.:29 2 9 3 5 CLASS:
B SETBACKS
Date:—t-1 l ( c/3 Signature. ►!1iI�iW__ .—IL MAIN BUIILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of c. to self sue or a certificat orkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FY IN
Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). ,
LEFT:T: ; FT IN RGHT' FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP. DATE:
COMPANY: PARKING REQ: PROV: PARCEL: 42607410 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES>ES>
> –
Date: Applicant: ***********************"****************kt***********thee***Sete 16********************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Thissection 't not be completed it the p•rmit i5 'one hundred($100)or less). T J
D E C E L O P M E N T S E R V 'I. C E S K E Q U I R E M F. N T S
I certify that ithe performance of the work for which this permit is issu:,.1 shall ,1 employ any peon i� ny manner so as to become .1•••subject to the
orker'Compensation Laws of California. , •
Date 'JJ I93 Signature: i(, ' ZONING APPROVED BY . " b� DATE;
NOFIC :I ter making this declaration,you shout, Become t to the r orker.'Compensation pr. ons of the Labor BUILDING APPROVED BY : •'% d'
Code.you must forthwith comply with such provisions or chi 'it shall de. ed revoked. /j� DATE:
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction •eding agency for the performance of the work for -'' I/\
which this permit is issued(Section 3097.Civ.C). APPLICATION ISSUED B Y: �� v PATE: �'�f/�3
LENDER: '�^ *****I **********ItlE****i ******?f if it IL-it le *it- *7 * • it®t**kit *******#******is ntt k.cit***It*"*
ADDRESS: *****!E*iEdfiE******•*)f* k****3E***3t9F*•1F*?f**-16**it#1*iE*iE. ****0E3t*******iF-k"3Eit**i(•*"**3(**3E*iE***
LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N •
OWNER BUILDER Bsiess and
hereby daffirm manym exempt frhic theContractors'a StateLicenseLaw for the fel,odeireasonr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING
(Section 7031.5 structure.
tc Business and its issuance.
also Any city f county which requires a permit to construct,nalent,improve,demolish,cor
sany 5thecprov.prior to Contracts alsorequires the wapplicant for such menti g fileta signed 7000)0of Division thio h3/oho a lsnesd PERMIT 61 5 0
pursuantrs ion pro eor of h /she is exe' ptState erefr m and the bass 9(rommeneied wish Sectionnyvla i oa ti the Business12 5 SN1I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for Inc alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty o1 not more than five hundred dollars($500). ISSUE FEE 20,00 .y r'
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DI V—> PERMIT ISSUE PITA' CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS––––> 61 . 00 20 , 00 0 , 0 0 81 . 00 81 . 00 0 0
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--> COLL ECtrED: 81 , 00 OVER/SHORT: , 00
for purpose of sale).4 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 81 . 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 lo)such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware
that proof of their Worker's Compensation insurance should be provided to me. *****************'k'********:*******if;**?E,********"**)E*************************in*ke*if
❑ I am exempt under Section: B.8 P.C. INDIVIDUAL . FEE BREAKDOWN
for this reason: i •
'
TYPE QTY D E S C R I P T I O. 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. PLU 1 BATHTUB :, 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 i: 7. 00 7 . 00
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from _
PLU 3 WASH BASIN 7. 00 21 , 00
these provisions. \PLU 2 WATER CLOSET ( TOILET) i 7, 00 19 :0 0
.00
Dale: Applicant.
'LU 1 WATER HEATER AND/OR VENT 7, 00 700
I hereby certify that I have read this application and state that the Moorinformation is correct.I agree to omply with all city and county {1L U 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 . 00 5, 00
ordinances and state laws relating to builtling construction and hereby/or¢e representatives of thi city ,•nter upon the above-mentioned \6 END OF FEES
property for in pection purposes.
(//jq /'
Date: /ce se 7, 3 Signature: y��// .� 01 00137038-00137038 -r EJ T 21.00
Driver's License or Social Security h: _ DATE: 04/12/93 T.IfE: 15:54
-\ 1641.46 White—Building:Green—Code Enforcement:Canary—Applicant, ' k—Revenue:Goldenro.-Assessor
t
CONSTRUC I SON AND PLANNING POOL °' SPA
APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector
1 1. Temporary Electrical Service or Pole52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. • 'j-/2ft3'_[rc,O 53, Steel Reinforcement ,
3. Electrical Conduit Utility-Undrgrnd. 54, Forms I
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test t
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd.
8. Foundation J 59. Gas Pipe, 0 Undrgrnd.,Test
} 9. Water Pipe-Undrgrnd.
wore,ii „yn�1 60. Backwash Lines, P-Trap, 0 Undrgrnd. -
10. Structural Floor System ����« ` v %� 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection - - 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final • I
13. Roof Drains - 64. Plumbing System - Final
14. Rough Plumbing G1/1h4'5 CFO 65, Electrical-Final
15. Rough Electrical-Conduit _ 66. Solar System-Final _
i.
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
I18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit # .
a
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating / 71. Product Piping 0 Gas 0 Oil23. Gas Pipe-Rough 8, Test
#!het`Lr 72. Underground Flush
24. Roof Framing ���TTT 7G 73. Undergrnd.Storage Tank C Gas 0 Oil
25. Root 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
I 29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing . - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
I
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric • - Notes: - j10ly:__-.a.7
_I S-/t. Iy rro tv
34. Final Heating& Air Conditioning a.fil ,3 s-J rs _Dd /set-
! / srkGF•H 2r Yum /"`
35. Final Gas Pipe-Test f/f/t7 2Vir
36. Hood or Canopy : .
37. Final Factory Fireplace II
38, Final Plumbing fret
39. Water Service-Final {\ -- .1
40, Gas Service-Final
41. Solar Domestic-Final •
--- I
42. Backflow Preventer . • I
I
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING i -
48. FINAL PLANNING I I
49. Electric Release to Edison j
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY ,
No. Date
I_
PROJECT ADDRESS: UNIT:
OWNER'S NAME: 247 23RD ST CITY OF COSTA MESA - BUILDING PERMIT ^^" "^ .. ^c ' °^c
ADDRESS:KNIPP, BRUCE FREEMAN TR
#B PERMIT NO: M 061805 PLAN CHECK NO: N GOVT; N SUPP; N
8842 ARCEL CIR
ARCH/ENGINEER:HUNTINGTON BEACH,CA 92646 REG.Na: CONSTRUCTION TYPE: PERMIT TYPE: NEC PURPOSE: ADD
ADDREss: 213 263-7391 OJNIT,
RICHARD DODD C2S.,v JOB DESCRIPTION : ADD 560SF 1ST FL, 38SF 2ND FL RESID ADDI SQ FT:
201 SHIPYARD WAY, BERTH A F
PERMITTEE:N.B, CA 92663 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
ADDRESS:J,L, REID HTG & AIR ( 619 ) 598-3490
27130 PASEO ESPADA A1406 COMMENTS: REF B61613
LICENSEDCONTRACTORUECLARATION: h•reby affirm that I am licensed undfr pfovisibnd01,Rapter 9(commencing with Section ******************************************************************fl-**********
70001 of Division 3 ofThe R-sines rd P de•.ions C de,�p d yJ4cense is in fol force-arid eltect. Z ONING REQUIREMENTS
.a � g( CLASS: SETBACKS
Alli .4\d" flii 5Yyretal8 C-20
WOR ERSI MPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' MAIN BUILDING ACCESSORY BUILDING
Comrensalion nsurance,or a certified copy thereof(Section 3800.Lab.C). FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
POLIC 0.: EXP.DATE: LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
COM PA
❑ Certified copy is hereby lurnished. ❑ Certified copy is filed with the city Building Division. PARKING REQ: PROV: PARCEL : 42607410 ZNE; REF NO:
.PLANNING NOTES>
Date: Applicant: >
EXEMPTION FROM WOR%EflS'COMPENSAT`.N DECLARATION: (This section need not be completed if the permit is for one hundred(Stpl)pr less). *******##********* '********** ***** ************* ** ************************
'data: That in the perlormay e of the w, for which this permit is issued,I shall not employ any person in any manner so as to become -fir DEVELOPMENT S E R--V ICES REQUIREMENTS
Rgg k19 t • orkers'Cin-'. on Lr sol Getout i J/
1 l_ --��� ZONING APPROVED BY
Da e. J�4►�— ti Signature
DATE: •
ROTI :If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor4
:,- ou must forthwith comply with such provisions or this permit shall be deemed revoked. . BUILDING APPROVED BY : `- DATE:
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for _
which this perms is issued(Section 3097.Civ.C).
',APPLICATION ISSUED B Y• /� ��— DATE: hi/0)0)3
LENDER: 74
********************** 'x • �;�'i;�:ss�'�-'.tae to x' - xxxxx**#*****#** . xxxxx*#
ADDRESS: • *************************-SE********* .***************************************
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
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or BLDG PMT PLUMBING ELECTR' C MECHANIC FIRE SMIP/RES GRADING
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 13 , 50
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 2 5 t SNIP/NON-RES
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). PLAN
I, as owner of the property or my employees with wages as their sole compensation, wilt do the work, and the ISSUE FEE 15. 00
❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law BUILDING-D IV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through TOTALS----> 13 . 50 15 . 00 0 . 00 28 , 50 28 . 50 , 00
his or her own employees, provided that such improvements are not intended or offered for sale. If. however the building or
Improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). REVENUE DIVISION TOTALS--> COLLECTED; 28 . 50 OVER/SHORT: 00
I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon 28 . 50
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. ***********#**********#***************#**************3e*******************#*****
❑ lam exempt unser Section: B.s P.C. INDIVIDUAL F E E BREAKDOWN
for this reason:
Date. Owner: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
I do hereby certify that lam aware of and understand the requirements of California,Health and Safety Code Sections 25505,25533,and NEC 1 REPAIR/ALT COOLING UNIT/SYS W/CRTC S 9 . 00 9 , 0 0
2e534 and that or any orfuturemifcamg lrom occupanttAir Quality
Myrna¢one)needri comply with saidstate icodes and the eirexempt farm NEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 4 . 50
permit for construction building
the Air Duality Management District.Residential construction applications are exempt from
these provisions. END OF FEES
Dale: Applicant:
I hereby certify that I have read this application and state that the above information is correct.I agree to corm h all city and county
ordinances and state laws relating to building constructir and hereby authorize representatives of thi •enter the above-mentioned
/Date:property inspection\--1 CS, i �1, •
\/ Date: 1J') Signature: :r A i-c-
•
Driver's License or Social Security a: 01 00137522-00137522 TOT 28.50
1641-46 White-Building;Green-( . $-Applicant:Pink-Revenue:Goldenrod-Assessor DATE: 04/28/93 TIME: 15:39
CONSTRUCTION AND PLANNING ' iiT POOL - „PA - i -
# • - - - _ Date Inspector• Date inspector
APPROVALS Permit
APPROVALS Permit ;
1. TemporaryElectrical Ser-yjce or Pole t - I I
1 52. Pool & Equ:Ument Loca at
r i2. Soil Pipe.Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Ut:hty•Undrgrnd. I 54. Form.- I ( I
4. Electrical Conduit•Undryrr... 55. Electrical Bond rg
I
5. Ste& Reinforcement _ 56. Rough Plur-.h rg & Pressure Test
6. Electr•cai Ur ER Gird 57. APPROVAL TO COVER-GUNITF i
7. Footings 58. Electrical Conduit-LPndi2iI nd _ 1
8. Foundation 59. Gas Pipe, ill Ur.Ui or id., Test I i.
e-Undr mr! --� ----- 1-
9. Water Pi
P g 60. Beelswash 1 rE,. P Trap .� red
1
10. Structural Floor System 61. APPROV i__t-u.rCK __
.
11. °rope.ty Sower Line & House Connection 62. Backwssn & Hecerrrc, F: ai
12. Sever Cap 63. I Iueter & Vent-Enc. - •
13 Root Drams 64. P.umbing System FP'31 I -
,. ._ .
14. Rout Piumding 65. Dent'ice i•F ra.
15. Rough Electrical-Conduit . I 66. Solar System•Fm0•
16. Rough Electric Wiring 67. Fencing &Access Adoreva I I
17. Rough W:rirg Sign (-- 68. APPROVED FOR PLI.ST ERING ---
18. Rough Electrical.T Sar Geeing 9 1 69. POOL'SPA SVSTE'::S FINAL
IS. Rough lteattng & A.,- Co-.3,tienrig AI S
FIRE DEPT. REQUIREN.,ERT --- r-- - -
20- Rough Factory r-;rec'o r I I APPROV^-LS Rormn -_____TI _I -
21. Ducts, in Structure --- 70. U : hyrira
t - -
----- --- -- -- -
22. Dors, Venti!at ng 71. Product Prnc ' :Gen. �'0,,
23. Gas Pipe-Rough & Test 72. Undurgrou-ir ^!user
24 Rpof Framing /3. Undergrnd.4n.✓ - r-i; Gs -
25. ?cod Shea:n ."12 I 1 74. O-crnead Hyr „ I
26. T-Bar Cea,ng (Structural & Morocoat l 75. Dry Ch:nucul
t 27. F;erne and Flashier ---1
1 76. Dry Stene:,-..n._
23. Lathny & n:rl n9 77. F,XED SYSTc • r ii:AL
29. Insulation II 78. DIRE PRE\i. FAA!
33. Drvv.a!I I\a ling 1 HEALTH DEPT. REDUIREME eT
_ _ .._
31 3,dstr Bvwn Coat -_- ! 79. F1'eALID:'t.'ECTiO^,i
32. Electrical Rowel 'deter•Frndl f 80. FCOD CFRTiFIC,\-E IS-SLED
33. Final E!ectr.c • Nate,: _
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy �-----I--- ---- - ---`-- -
- --- - - --- -- --- ,
37. Final Factory Fireplace - - •
38. Final Plumbing
39. Water Service-Final
i -�-- - ------.-. - s
40. Gas Service-Final I
41. Solar Domestic-Final
-
42. Backflow Preventer -
43, Backflow Irrigation - - `__�__-__-_---!_
44:. Landscape Irrigation System
49. Sound Attenuation
46. Handicap Regulations
47.. FINAL STRUCTURE & BUILDING , -r,
48. FINAL PLANNING 1
48. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51'- CERTIFICATE OF OCCUPANCY 1
No. Date . - -
PROJECT ADDRESS: 247 23RD ST - UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 061844
OWNER'SNAME:KNIPP, BRUCE FREEMAN TR
ADDRESS:#B PERMIT NO: E 061844 PLAN CHECK NO: N GOVT: N SUPP: N
8842 ARCEL CIR
HUNTINGTON BEACH,CA 92646 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
213-263-7391
ARCHIENGINEER:RICHARD DODD REG.ND.:C2950 JOB DESCRIPTION : ADD 560SF 1ST FL, 38SF 2ND FL RESID ADDI SQ FT:
ADDRESS: 201 SHIPYARD WAY, BERTH A UNIT:F
N.B . CA 92663 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE:ARTHUR E. SONS ELECTRIC ( 714 ) 859-8976
ADDRESS:28238 SHORE COMMENTS; RE: B61613 PRIMARY BUILDING PERMIT.
MISSION VIEJO CA 92692 *+E****** ****x**�R+6�r+r�E*********** �5�6,ETr*S6�E �E *4 * ******#;E:6********* #:6**********
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NG REQUIREMENTS
7000)of Dmsion 3 of the Business ane Professions Code.and m license is in full force and effect. SETBACKS
CITY LIc.:030600 STATE LIG38185 . - CLASS-C .1fQ
— Date: a f— 73 Signature: _ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that l 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 RGH T: FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL : 42607410 ZNE: REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NO T ES>
> -
Date: Applicant: *************3E********************0********************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S E. R V I C E S REQUIREMENTS
I certify that in the performance of the work for which this per ' iss ed.I shall +I emplf .ny p in any anner so as to become •
subject14"d-to the Workers'Compensation Laws of California / 4, ar u ZONING APPROVED BY DATE:
Dale: - /� om .4 _
Signatu _i/ %�
NOTICE:D.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : a A 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: a"-
x - - DATE:
which this permit is issued(Section 3097,Civ.C). **********************'wr —�x, x. x'** : " '®***********x*********** . xtr***
LENDER: **********************************#E******** *****% 1!******3f**iE*****************
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 70. 85
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 0% 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 -
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----> 70, 85 15 . 00 0. 00 85. 85 85 . 85 . 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: 85. 85 OVER/SHORT: . 00
forme 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 85 . 85
❑ 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 of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E £ BREAKDOWN
❑ I am exempt under Section: 0.8 P.C.
for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date Owner: ELE 18 FIXTURES LIGHTING 1 ST 20 EA. , 75 13 . 50
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 20 RECEP T/O�JTL£T 1 ST 20 EA. . 75 1S , 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 ELE 1 1 RECEP T/OUTLET ADDITIONAL EA, , 45 9 . 9 5
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from
mese provisions. ELE 20 RECEPT/SWITCH 1 ST 20 EA. . 75 15 . 00
ELE 2 RECEPT/SWITCH ADDITIONAL EA. . 45 . 90
Date: Applicant: ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 , 50 18 . 50
I hereby certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county ELE 1 MOTOR/POWR APPARATUS 0 . 0 — 1 .0 HP 3. 00 3 . 00
ordinances and state lava relating to budding construction and f .ya horize representatives of t,1 ity to enter upon the above-mentioned END OF FEES
property/for/' inspection purposes.os ��
Date: "7--�1- ( .�S Signal : // iI e �`a___ -
• 01 00137672-00137672 TOT 85.85
Driver's License or Social Security a: DATE: 04/22/93 TIME: 15:57
164446 White-Building:Green-Code Enforcement,Canary-Applicant;Pink-Revenue;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL ,PA - I
APPROVALS Permit,-u,- Date Inspector APPROVALS Permit - Date Inspector i
I
1. Temporary Electrical Service or Pole 52. Pool & Equipment Locat on
a
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Ut:hty•Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test l
6. Electrical UFER Grd 57. APPROVAL 10 COVER•GUNITF 1
,
7. Footings 58. Electrical Corduit•Undrgind. i --i
8.
8. Foundation 59. Gas Pipe, ❑ Ur•Jrgrnd.,Test l
9. Water Pipe-Undrgrnd. 60. Backwash Lae:. P•Trap, Ei Uraroma t-
10. Structural Floor System 61. APPROVAL TO DECK (j �
11. Property Sewer Line & House Connection 62. Back..ash & Receptor Final
I
12. Sewer Cap
63. Heater & VenFFina �
13. Roof Drains 64. Plumbing System - Finalfit
lv
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit - 66. Solar System-Final
16. Rough Electric Wiring I /R7. Fencing & Access Ai-Prov
4143 i� _ •
17. Rough Wiring Sign y 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & A 1 Conditioning FIRE DEFT. REQUIRE•. ENT
20. Rough Factory Fireplace - APPROVALS Purina --)--
21.
21. Ducts, in Structure 70. Undargrounu Hy,.ro
22. Ducts, Ventilating _I 71. Product Pip:ny_ Gas _`a •
l
-I.
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Unaergrnd.Storni--- I G,s 17. O. I --
25. Roo' Sheathing 74. O'crhead Hyorr _
26. T-Bar Ceiling (Structural) & Monocoat 75 Dry Chemical
27. Frame and Flashing 76. Dry Stancp.rac -- -- --�--- -- - - -
28. Lathing & Siding77. FIXED SYSTEM FINAL
29. Insulation _ : 78. FIRE PREV. FINAL
30. Drywall Nailing i HEALTH DEPT. REOUIREnIEN
31. Piaster Brown Coat FINAL INSPECTION
1 32. Electrical Power i, cier•Fina, 4A. a0 FOOD OFR-, :AT: 'c=;'rp
p D - '-___ - -t /�/J
33. Final Electric 8_gLg3_, D Notes. (Fi, 3 �J,04'_ wo n hi/I 8-3-93 I Qb
34. Final Heating& Au CorJition.n2 /-
35. Final Gas Pipe-Test _I\ - - - - •
36. Hood or Canopy - - --- --- --- -
37. Final Factory Fireplace i -- --- _ - --
38. Final Plumbing
39. Water Service-Final
-i40. Gas Serv.ce-Final
41. Solar DOmestic-Final i
42. Backflow Preventer -
I43. Backflow Irrigation _--_ _-
I 44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations - - -- - - ---_- --
I 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: 247 23RD ST UNIT: CITY OF COSTA MESA - BUILDING PERN. _'i Pit- N, No: R 05:6 . 3
OWNEfl's NAME:Kti IPP, BRUCE FREEMAN YR
ADDREss: B PERMIT NO: B 061613 PLAN CHECK NO: 007 19-93 L GOV'. ; N S,;PP; X
8842 ARCE4L, CIR
HUNTINGTON BEACH, CA 92646 CONSTRUCTION TYPE: PERMIT TYPE; STR 'JRPOSE: ADD
213-263-7391
• ARCH/ENGINEER:R [CHARD DODD SQ
REQ.NQ.'C2950 JOB DESCRIPTION : ADD 560SF 1ST FL, 38SF 2ND FL RESID ADDI FT; 2, j98
ADDRESS: 201 SHIPYARD WAY, HEATH A UNIT:F
N,B , CA 92663 CLAIM VALUE: 60, 000. 00 CALC—VALUE: 56, 252. 00 GROUP OCC ; R-3 /
PERMITTEE:SYDNEY BERG ( 619 ) 598-3490
ADDRESS: 2634 COVE CT 1 COMMENTS; MISC RESIDENTIAL ALTERATIONS
VISTA CA 92083 x*##,E*x"####>E*****x*"**x"#*******x*x#N"###**#>Ex*#*#x"x***********x*x**xxlax:'tx**xfl3*TEN.
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 . in full rce and effect. S E T B A C K
.: ATE LIC.:292935 /de,SS:/ J
CITY LIC
Date: Signature:_ I ! •
MAIN BUILDING ACCESSORY BUILDING
WORKER 'COMPENSATION D C ION: Ihereby elfin)) to of con t oself-insure r`cenit Workers' FRNT: 24 FT IN REAR: 15 FT IN FRNT: FT IN REAR : FT i�
Compensation Insurance.or a certified copy thereof(Section 3800. r.C) LEFT: 6 FT IN RGHT: 6 FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ' 2 PROV: 2 PARCEL ' 42607410 ZNE: R1 REF NO:
❑ Certified copy is hereby furnished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES> ADD IT/REMODEL OF SFD. 61* OPEN SPACE. 250 SF REAR YD COVER
>• OK-87 . 5 ''F PROP, CONNECT GARAGE TO DU; EXPAND 2ND FLR
Date: Applicant: *************3t$t****************4*********** ******x#3:****x***TE**MXXXX-****).**#.:*
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for• e hu , i $100)or less). D E V E .a 0 P 11/41--E.14 T S E R V I C E S R E Q U I R E M E N T - "'
I certify that in the performance of the work for which this permit is issued.I s II not a!ploy any person in a many .as to become - y
subject to tthe orkers'Compe scion Laws of California, / 7 - ZONING APPROVED BY '1+' , • SCC_ DATE: Z
Date 2... Signature: / ` / i'
NOTICE:If,after making this4eclaration,you should bac e a Workers'C•,y�psalion pro !ns of " alio! BUILDING APPROVED B Y.:� .� DATE: : '
Code.you must forthwith comply with such provisions o this per all be deemed Ci
d. - ;•
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a co ruction lending agency for the performanc: , the work for APPLICATION ISSUED BY:, ' y DATE,:.lel
r)if.etiI(.-L/1 3
which this permit is issued(Section 3097.Civ.Cl. ************************,***** ******* icif xzii•w**f **x***�e**1T5****"**v s":t"�rtxrexxx**
LENDER: ********************"***B%**TE*****#x-***************#********)(44#*x"** *1iti(-}:-'{.**aK*)e*
ADDRESS: •
LEGALIZATION; N F E E S U M.,M A R Y •• STRUCTURAL S€GMENT ; Y
_
OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC ,KECH'AN IC 'FIRE SMI1'1R'ES 11 GRAD \G
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 446 , 00 , J;Yj 3.: a•
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed -
pursuanl to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • - �^ _ SM I P i maty O S'S
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 289 . 90 .. �'— •J I'+—
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE . • / " 7 i --. �-'a'¢t )
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-iCHWK 'f. '� TOTAL"' PAID ��� Dom
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS—---> 451 , 63 0 . 00 ' 2'8 9'. 9b y/_, 741 . 53Z:-%. 741 , 51 '• :W . 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; ),-•• 451 , 63 ""OVER/SHORT; 0 0
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC "FIRE S �/` -JT GRAUING PLAN—CHECK
996 00
I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business �I 73
❑ 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 *de************.> ***x.****#**********x"**#****j(***••`}i•� .. * X**3E*!S�*#'**Xt X**:f x#%*
that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A Li. F E ! A,� —
❑ I am exempt under Section: B.&P.C. r ``�•`W N
IOr this reason'. t
TYPE QTY DESCRIPTION UNIT COST TOTAL COST
Date'. Owner: (Rj 1
I do hereby certify that am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 598 DWE—TYPE V—WOOD FRAME vl )D. ' 74 . 00 4 4 252 . 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 SFR 12000 ALTER BY VALUE REENDEOFIFTw , 'O�IE 1 . 00 12, U00 , 0U
/.'
permit for construction or medication 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 alien is correct.I agree to comply with all city and county .
ordinances and state laws relating to building construction and hereby aut ,' o.alives of this city to en r upon bove.mentioned r.
properly for ins ctian purposes.
•
Date: 2 ,9 3 Signature. / /
Driver's License or Social Security p: —
1641"46 white—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor
%rIONANDPLANNING POOL A
.. Permit Date Inspector APPROVALS Permit # Date Inspector
1. temporary Electrical Service or Pole 52. Pool & Equipment Location • '
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
i
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56, Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 56 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Uncirgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. •
!
10. Structural Floor System' . ' , --- 61. APPROVAL TO DECK r - !I
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 ' . •
9 65. Electrical-Final
15. Rough Electrical-Conduit I 66. Solar System-Final
16. Rough Electric Wiring - .' 67. Fencing& Access Approval .- i
i
17. Rough Wiring Sign " .. 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
-
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
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. Undersrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing S�Gi3 Q 74. Overhead Hydro
~
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing
Cif 3(/1 76. Dry Standpipe
28. Lathing & Siding I If 3c"0 77. FIXED SYSTEM FINAL I
29. Insulation Gl if 78. FIRE PREY. FINAL j
30. Drywall Nailing 0 ) HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION I
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: 4/14::_tt? o /
34. Final Heating& Air Conditioning
i I ?tie. ._ f2ertaT2140/-
35. Final Gas Pipe-Test ' /, / �
36. Hood or Canopy r i N¢/ inAil Caney/t S✓e 4 .0-1:
37. Final Factory Fireplace w�
9-/63, 1v,t
38. Final Plumbing '1'2 t•
Y Y _
'1-
. .,
39. Water Service-Final
I - - a - 0
. 4 4r
40. Gas Service-Final I �C r. ' Q� "7
_ nl -i _
41. Solar Domestic-Final 1 \\s s• �sr'$' 'F;
42. Backf low Preventer ,Di" �1 - wry! 6r" U
43. Backflow Irrigation I.,; �"' t
44. Landscape Irrigation System f
-1
45. Sound Attenuation 1
E-X P-1-R-E-D
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING 1I r,fii (�,,,/I ir' .-. ,
48. FINAL PLANNING 1 4,i -*IAA -
49. Electric Release to Edison -
-
.
50. Gas Release to Southern California Gas Co ''
51. CERTIFICATE OF OCCUPANCY
No. Date
'
lir r '
' TORT-MESA UNIFIED SCHOOL ‘r
STRICT
CERTI}�CATE OF COMPLIANCE OF DEVELOPMENT FEES j 1
PURSUANT TO AB 1600 AND AB 181 7 �^'c p
To: (Xf City of Costa Mesa Plan Check No. ( �s / - ( 3
( ) City of Newport Beach
( ) County of Orange 7 District Receipt No. Z L//
Applicant: 7DAP4ct9 //4 {� Amoia
Address: „247 5 023.e_a_ 577 c°0S779' /4614/ o 9��7
Telephone Number: (7/4) 6-4-€.— 7
J
Tract/Parcel and Lot Number(s) :
Location of Project: 2'4'7 to Z3 11---- 5r— Ci‘-(
Number of Square Feet of
Residential Space x $1. 65 Total
Residential/ 14.Sr. Citizen Space 3` 71 x $ .27 Total 57 /6. .
Commercial and
Industrial Space x $ . 27 Total
R&D Space x $ .2652 Total
Warehouse Space x $ .2653 Total
Commercial/Industrial Project is: (Check One)
Warehouses Motel Preschool
- R & D Bank Auto Repair
Movie Theater Neighborhood Shops Hospital
- Mini-storage - Racquet/Health Large Office
Heavy Industrial Hotel Office Bldg.
Regional Shops Medical Office Restaurant
- Light Industrial - Office Park Fast Food
This project is exempt because .
This certifies that the above-named Developer/Applicant has paid school
facility fees in compliance with Government Code Sections 53080 and 65995 .
The Building Permits for this square footage in this proposed development
may now be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified School District.
By:
������� % J�eaS
Authorized Representative
The above representation as to square footage is true. Applicant agrees
that if it is later determined that such representations are not true then '
this certificate shall automatically terminate and the appropriate
City/County
� shall
//be notified. �
Date: -3 :273 ,, l/�/n/1
Q ''C-4
Applicant
,• "
A23456)
,9
N S'0
my AQ ,,a
N F,v . ,i., CJ
.44
mac;
�eete'Lzoze,Vb
.
1\
FINAL GRACING CERTIFICATION
•
Project Address: 241 E• 23�D �T GoC7A Mrs\
Lot Number: t 323 N1;t.ALto'PT 14EIGHTS
•
Permit Number: t3 06,16 13
By Civil Engineer: •
I certify to the satisfactory completion of grading in accordance with the approved plans,
specifications, local and state codes.. All drainage devices required by the grading permit,
grading plan and grading ordinance have been installed. Adequate provisions have been made
for drainage of surface water from each building site.
•
The minimums are:
•
2% Fall from structures within 5 feet from exterior walls.
1% Fall for asphalt surfaces and landscaped areas.
0.5% Fall for concrete surfaces to approved disposal areas.
The final monuments as : .w . • the recorded tract map were set. All final grading eleva-
tions are within ± 1/l6 of he des gned elevaf,ons.
Supervising Civil Engin- `S ss0 ";.. i$ LJ eg. No.C— 241,50
(Signal ur ) e/
• Date 9/02 8/7
-3
•
stia Mob/
V-- co H. #
40t
WI se
• * No. C2951
RENS //9S
• STAMP and SIGN
,69116
PROJECT ADDRESS: 247 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 062466
OWNER'S NAME:KNIPP, BRUCE FREEMAN TR
ADDRESS:#B PERMIT NO: B 062466 PLAN CHECK NO: 01979-93 S GOVT: N SUPP; N
8842 ARCEL CIR _-
HUNTINGTON BEACH,CA 92646 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
' ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION : 8LF CITY STANDARD BLOCK WALL SQ FT: 8
ADDRESS: UNIT:
CLAIM VALUE; 200 . 00 CALL—VALUE: 160. 00 GROUP OCC; R-3 /
PERMITTEE:BERG CONSTRUCTION ( 619) 598-3490
ADDRESS: 2634 COVE CT • 1 COMMENTS; X
VISTA CA 92083 *****+E**4 ter*****yP***RE*rEkRr******r*RPRP*********+E***RERP*******RE***+t************AERP***
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licen 'd under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS
70001 of Division 3 of the Business and Prolessions Code,and my tic +'is in full force and elect. SETBACKS
CITY LIL.906281 rum.292935 Cu '.B
Date:_((/� 3` signature:_ G, , _ _ _ _ /_ MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: (hereby• gm that acertilicme of sent to sell insure oracert ate of workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3811ab.C). / LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP. DATE:
COMPANY: PARKING RE • PROV: PARCEL: 42607410 ZNE: R1 REF NO:
. .❑ Certified copy is hereby furnished. 0 Certified copy is fled with the city Budding Division, PLANNING N TES> 8 LINEAL FT. OF 5' HIGH BLOCK WALL ALONG SIDE PROP• LINE AND
> SETBACK 20 FT, FROM FRONT PROP, LINE, -
Jate: Applicant: _ , ********************************** **************** ***************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION:-(This section need'it be completed it the permit is for ne hurt d(4100)or less). 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 issued,/all not moldy any person in ma so as to becomep
subject to the Waaer Compe adLaws o
an f CalilDmia. ZONING APPROVED BY r, DATE: \O'l'fb tp l 3
/ Date: 4 — 93 Signature: ..' / •x1
NOTICE:It.after making this declaration.you should became sue• to the Worker/rmpensation provi ns of ih bor BUILDING APPROVED BY DATE:
Code.you must forthwith comply with such provisions or this p• •t shall be dee�• evoked. p PI /�
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a onstruction lending agency for the performance of the work for APPLICATION ISSUED BY• DATE; �
which this permit is issued(Section 3097,Civ,C). ********************************************* *********************DE,**********
LENDER: *******************************************************************************
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby alfirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES-'r GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve.demolish,or PERMIT 15. 00 50:1
repair any structure,prior to its issuance,also requires the applicant for such permit to file 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 9. 75
and Prolessions 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 live hundred dollars($5001. ISSUE FEE ,
I. as owner of Inc property or my em loyees with wages as their sole compensation, will do the work, and the BUILDING 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----> 15. 50 0 . 00 9 , 75 25. 25 25 . 25 ,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• 2 5, 25 OVER/SHORT: 00
improvement is sold within one year or completion,the owner will have the burden of proving he/she did not build or improve
for 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 15. 00 . 50 ,- 9 .75
❑ 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 *******************************************************'Jp***********************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL- FEE B R E A K D ,O W N
❑ I am exempt under Section: B.8 P.C. i
for-this reason: TYPE QTY D • E S C R I P T I O N UNIT-COST TOTAL COST
•
Date.• Owner: SFR 8 RES—CONCRETE BLOCK WALL / FT. 20,.00 , ,f 160. 00
I do 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 I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a J r- �Y
permit far construction or modification from the Air Duality Management District.Residential construction applications are exempt from (•
these provisions. •
Date'. Applicant: 1 44.
I hereby certify that I have read this application and state that the above;"irmation is correct.I agree to co ly wi . city and county
ordinances and state laws relating to building construction and hereby a�.,ice repro/natives of this city to e r u7' e above'mentioned , _
properly for inspection purposes. / , ; •
•
.9 Date:_/-3- (1 Signature: 4' /. ma 01 0014Q400-00240402 TOT25.25
7
Driver's License or Social security x: / . DAT't a 06/03/93 TIME: 15:05 —
1641-46 Whoa—Building:Green—Code Enlorcomont:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor __
. - r ' -- - - `
CONSTRUCTION AND PLANNING POOL 'A 1
APPROVALS Permit e= Date Inspector APPROVALS Permit sk Date Inspector
1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location .
e•
r•4.S9i Pipe-Undrgrnd- G e . 53. Steel Reinforcement
---..--rc.• - .,- 1
3. Electrical Conc'giip Uti!ity•Undrgrnd. 54. Forms
4. Electrical Conduit4Undrernd. 55. Electrical Bonding
i
- 5. Stal Reinforcement 56. Rough Plumbing & Pressure Test
6. Eractrical OF EA Grnd - 57. APPROVAL TO COVER-GUNITE f -
/ I j
7 fopt!ngs s ��Q /1r�1,�Qa ,/y 58. Electrical Conduit Undrgr cd. /•_
6 'Xa a c L v coif__
B. Foundation59. Gas Pipe, 0 Undigrnd., Test t- l
c
F.
�. Water Pipe-Undrgrnd. •
60. Backwash Linea, P-Trap, !7 Undrgrnd.
__ I
T_
10. Structural Floor System • • 61. APPROVAL TO DECK j
ti. Property Sewer Lira& Hoose Connection . - 62. Backr:ash & Recepto•-F inei I
-
12. Sewer Cap - ` - I
63. Haatci & Vent-Final
13 Roof Drains - 64. Plumbing System - Final -I'
14. Rough Plumbing - 65. Electrical-Final
•
15. Rough Electrical-Conduit ., 66. Solar System-Final I i
16. Rough ElectriQ.Virine • 67. Fencing & Access Approval
17. Rough Wiring-Sign 68. AP?ROVED FOR PLASTERING
18 Rough Electrical-T Bar Ceiling 69. POOL/SPA SYS-E.JS FINAL
19. Rough Heating & Air Corditioning -rja. FIRE D{,PT.REQUIREMENT
20: Rough Factiy ctryplace I ;fr r•r ',4, (,:". -'I ,g, F. APPR VF%,i,',,•�_Pe nrit ;� 7 --
--'f--n.• r moI t tc- 7 ?'- S -7, -•+-y -- • _ __I
21 t•+Dd ts,is Sti cture •• • -C •• .i. I • ` -70. tilndergrei iA H fro x
22,,Duds, yenttlatinj f i cr.= y 7,1 . 5 4. : 171. Pruduc8."Tping :14)s 10 1
23. Gas Pi e-Ron h & West i �. . r --"i-t �r- - -
F 9 _ .` jy - c -'. .�72. UadergreM-AiFk^!:v- -
24-Reo�f Framing : - ' I- : - - -' _ ,• : t ,73x UndergrnJ.s oreg-r,y:.rk`C Ga: 'C'
25. Roof Sheathing - • • > 74.:Overread Frvero=__ I
26.,T-S5r Ceiling (Strutturall &tv onocoat' '1.' .. r :' > 755 Cry C,Juara,cal •_,:.:7: ; - '
27. Frame avid Flashing _ C r - - A 76. Dry Stan6T71-e "-..o I
128. Lath•ng-& Sting 7 .-, -.is D<t ' . 1 •• .�, ' 77. FIXED SXEt.1 I1'A(Z _ t.
IV 29- Insulation - _ s _ - 7 -.4. t' + - 7� FIRE PREY. FR, L s
IC _ -
30. Dryr.aiI Nat ng . - < ` HEALTH-0EP7- REQUIREMENT
t`31. Plaster grown Cosi, •e rp- r I c ,c -79. FINAL ILSnECTION -
I' r 4--1s- _ -s ,� •
-;.32•-Electrical Power MYt(*_Ana: `• ; •- �-80,TFOOD CERTIFICIATE lt, kED,-
33 .Fiiv! Eact ris 4 ,r, t s 5 :4 Nates:
I-- An
34: Fina! Heating&' Cord tibr.k - (I - ," s.
35r:F!ral Geis PitaTes{ rzo- - 1 .x I % -
• -. -cc_- - --‘77- - -- --
LL
Q36. Hood or-Canopy • , - -7- -a • r C •
`•
_ _
" - -- ca - _ _ , r - ------ - ---
•37.:Fircal Fyrtory Fueplace Oy > -y
qrs. ,a i_-..C_-+' _ -_ _--- - ,
-38--Final Plumbing - - I - - - •
[33:'lVater Service-Final .. - x I I .:II ' -----1
.40.• Gas Service sinal r: r --r:
, I 1 I - - -
•
-1
'41. Solar Domestic-Final 'j . I . - _ -
r -
42. Backflow Preventer •, _•,-,;•
, - f-0-17- 'ma yT"triti
43. Backflow Irr'igatiork �,
f.44. Landscape [ideation System r ' 1
= •• • - - - =� -
- .c r t I , f - x J " -C
I -45YSound attenuation . I r - -r` e.
e. - -- ----
: � '
_46:.Ha_dicap Regulations _ ( I . -4 c • ; C. v -
,47.=FII;AL STRUCTURE & BUILDING 1/_36_17 4414.i-
T
48: FINIAL PLANNING -- - .- 1, �- --'
S u
49.- EIearic Release to Edison
,�-1
50:;Gas Retease to Southern California Gas Cv r I
- - _ . •.
A r. . .L_ 4
:51. CERTIFICATE OF OCCUPANCY I. +. +. v- r- - -
No. Date I
e
t.
t.
_ ADDITIONS, DELETIONS, 0� CORRECTIONS SHALL
'1' Jr a ® BE APPROVED DY COTE
THE PLANNING DEPARTMENT
1/2
ay — 5- :..f. s q APPR
OYg
' -:....:1106E A
:: 4""crrY °P- eletATEt%e. /44±0
_\ TRr
t PEF:: ' s`!S TO GIVE l ____ ��.
P`F:, :13OiJS OF THIS �1/L'[EO YDO. DIL !b.
Tin- e _ (^u WORK CA USE
(�U9 h.�; :;t I SSV � � � �
ccrpg sa ,Li,L ��oC Of'WAS _
qt el l i AU, L\`.°D oRCN PLANS AND
.e'l, . 6UY.D'87G OFFICIAL
WHE "n."t : ' -t°i 1_,\� ;•. 1H=
IrIG"TA :11'`,a .� zGAA<Cnosi OpnEvoi t IN
SP€� r:p'.N`'• 1.=� PREVENTING
SAIDS Pt
t'lSAFA,:I C:wl tC1'C-A VON THEREUNDER WHEN
RIJILDING OPER, :ION13F,1h±,. :.11‘-':1)r _._Inimp Att10E OF
1 VIOiTY. Ci TI us C3DE
DIE CI?�. � 1111 .
it
b 1i r et
RESIDENC[ R[[IO[NCE IDCRCC RESIDENCE in av ✓ W
w \
I
et
IA yI N
W
STREET 6
TYPICAL e CONCRETE BLOCK FENCE
Cement Coping Optional '-1; • • GENERAL— NOTES
Channel Block With 1-3/80 IF St _�
Horizontal Top of.all
Fences H Him -1 p MORTAR: One Part Plastic Cement, and
Three Parts Sand
For Fences 5'or Less a� a, —,� GROUT: One Half CementrtsThree and
Vert.Bars 3/8" at 4' -o"O.C. d One Half Parts Sand
s
¢ o = COPING: One Part Cement, Three
For Fences Higher Than 5' t LL u I S :ii
''� I I CONCRETE• parts Sand
Vert. Bars 3/8"O at 32" O.C. > w — Well Mixed 1:2-I/2: 3-I/2
R _ • Max. of 7- 1/2 Gallons of
Fill Cells Solid With Grou[ 1eI • > Z Water Per Sack of Cement
Where Steel Occurs SSi111��� > -Reinforcing Steel Shall i is
2 tD ism GROUT MAY BE POURED FROM THE TOP
-- OF THE FENCE IN CELLS WHERE STEEL
Conform to Sec.A-15-39 ` u o OCCURS.
A.S.T.M. I CELLSANDAREASOFHORIZONTALREIN-
I w re) �'_ FORCEMENT SHALL BE CLEAR,CLEAN&
All Steel to be Lapped Ie■ I'PlI
FREE OF ALL MORTAR DEBRIS,ETC.
24"artoCode HHNATURAL GRADE �I� V — A
TWO 3/8"0 BARS '�� I" D .. 1
CONTINUOUS TOP
& BOTTOM -4.--II----••—WIDTH TO IS. O.C. MAX,
0
SEE CHART �♦ . . • •
BELOW
HORIZSTEELMUST BETIED INDEPTH or E ARTHTCOTH
PLACE AT TIME OF TRENCH p r
. 1/3 THE HEIGTH OF FENCE
INSPECTION. t. II -SLOW BOTTOM OF FOOTING.
k—°'-1 o" Z..�� • SCALE: 1/2" = I'
FOOTING REQUIREMENTS CHART
WALL HEIGHT 6 ' 5 4' 3'
WIDTH 14" 14" 12",., . . . . . . 12"
THICKNESS . . . . . . . . . .10" 10" • 6 " . e "
DEPTH OF EARTHTOOTH . . . 24" . . . . . . .20" 16" . . . . . . . 12"
SPACING OF EARTHTOOTH. . 12' 14' . . . . _ . . . . . 16'. . . . . . 16'
•
City of Costa Mesa, California •
Building Department .
• • k?Ev/tEP Nov.82
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this „f r day of
M Y_f l q'g 3 , by and between [/01 /c i''P
hereinafter referred to as "LANDOWNER," and 4 � _.R,•_ _
hereinafter referred to as "ADJACENT PROPERTY OWNER?'
It is hereby agreed that a party wall will be constructed on the property line
between Er 2-3''4 S-r
(Address of Adjoining Properties)
t 25/ r 923 40/
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
`r of said County. The party wall shall be permitted to encroach
• IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER ADJACENT PROPERTY OWNER
/
(Signature) Si.-atur-
ame (typed or Printed) fame(T (A)
dr �. 23,-4 Sr)
(Address) (A res—?&' 3-4
s
NOTARIZATION REQUIRED
1906-46
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT No.5193
State of "AI ... I OPTIONAL SECTION
I • n CAPACITY CLAIMED BY SIGNER
�It County of b S kl\ D/� Though a statute
beowotlt o require
may prove
G . I ('�� ( 1 , invaluable to persons retying on the document.
On 51aci h3 before me, tot`7E R. a,ccQ�.\l,1 , ®INDIVIDUAL
DATE NAME,TITLE OF OFFICER-E.G..'JANE DOE,NOTARY PUBLIC'
J `
El CORPORATE OFFICER(S)
y//
P personally appeared N_ TIO \CO IV. U7 D V C-)�'G ICi 10,1 pp ,
,f NAM S)OF SIGNER(S) TITLE(S)
PARTNER(S) LIMITED
,psatisfactory ersonally known to me-OR -ti proved to me on the basis of satisfactoevidence 9 9 GENERAL
GJ to be the person(s) whose name(s) is/are 9
/// subscribed to the within instrument and ac- ❑ATTORNEY-IN-FACT
y knowledged to me that he/she/they executed 9 TRUSTEE(S)
�/ the same in his/her/their authorized ❑ GUARDIAN/CONSERVATOR
capacity(ies), and that by his/her/their 0OTHER:
OFFICIAL SEAL signature(s) on the instrument the person(s),
ryf/ JOANNE M. CHICCARELLI or the entity upon behalf of which the
( `�0 1 '�^ NOTARY PUBLIC -CALIFORNIA person(s) acted, executed the instrument.
' i';,k', ' LOS ANGELES COUNTY SIGNER IS REPRESENTING:
Y I ^` My coma esplrc3 APR 22, 1994 NAME OF PERSON(S)OR ENTITY(IES)
ITNESS my hand and official seal.
fl� . _ # e `Ai .
illi SIG •TU' OFNOTA-Y _
/
OPTIONAL SECTIONLI
LAI
/ THIS CERTIFICATE MUST BE ATTACHED TO TITLE OR TYPE OF DOCUMENT 41Cli+ r �Q I 1 1 Pt r is rn C',SJ+
6.f THE DOCUMENT DESCRIBED AT RIGHT: NUMBER OF PAGES I DATE OF DOCUMENT S/@CI 193
Though the data requested here is not required by law,
jV it could prevent fraudulent reattachment of this form. SIGNER(S)OTHER THAN NAMED ABOVE
C1992 NATIONAL NOTARY ASSOCIATION•8236 Remmet Ave.,P.O.Box 7184•Canoga Park,CA 91309-7184
PROJECT ADDRESS: 247 23RD ST Y UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 061073
OWNER'S NAME:KNIPP, DONALD A.
ADDRESS:_ea... PERMIT NO: B 061073 PLAN CHECK NO: 00553-93 S GOVT: N SUPP: N
rit8-84 z A FEEL C li
rT „ . - . CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 100LF CITY STANDARD BLOCK WALL SQ FT:
100
ADDRESS: UNIT:
CLAIM VALUE: 2, 000 . 00 CALC-VALUE: 2, 000 . 00 GROUP OCC: R-3 /
PERMITTEE:DONALD KNIPP: ( 714 ) 548-2878
ADDRESS: 247 23RD ST COMMENTS: X �p �,, p
C.M. CA 92627 -)* �E
*********** ******�k�6�r*****�r*�k*�6*�E>t�r�r�r******�r�6�6� *********8MM® *®'EFEt TOR
LICENSED CONTRACTOR DECLARATION: I hereby affirm that l am licensed under provisions of Chapter 9(commencing with Section •
ZONING REQUIREMENTS
7000)al Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS REQUIRED
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
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:
COMPANY: PARKING REQ' PROV: PARCEL: 42607410 ZNE: R1 REF NO'
❑ Ceniliedcopy ishereby furnished. E Ceniliedcopy mfiled with the city Building Division. PLANNING NOTES> 100 LF OF 6 ' HIGH BLOCK WALL INSIDE THE REAR PROPERTY LINE.
>
' Gate: Applicant: *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION.: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES R E Q U I R E N E. N T S
I certify that in the performance of the work for which this permit' sued,I shall not employ any person in any m ner so as to become
subject to the
.Work Com cation Laws of California 1 ZONING APPROVED BY WcS� DATE: - 72-11%/41
'
9 Date: /-7 t J Signature: 0
NOTICE:If,fitter make g this declaration,you should become subject to the Worh Co pensalion °visions of the L bar BUILDING APPROVED BY : DATE:
Code, you must lcrlhwith comply with such provisions or this permit shall be deemed revoked. t
CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: yeDATE: ',J ( #
which this permit is issued(Section 3097.Civ.C). ****************************************** * *****************{E** * t.9* ***
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 4S , 00 , 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 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 violatione[ of Section 7031.5 by PLAN 29 . 25
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 d0 the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
rrf structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law TOTALS----> 45 . 50 0 . 00 29 . 25 74 . 75 74 . 75 . 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 ' 74 . 75 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 purposeof 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 29 . 25
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon r
and who contracts for such projects with a contractor(s)license pursuant to the ContractorsState License Law).l am aware *******************************************************************************
that proal of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN
❑ I am exempt under Section: O.&P.C. .
for this reaso \�S�JL� n n TYPE QTY D E S C R I P T I O' N UNIT COST TOTAL COST
Dale: tSAO D«ner:iYat°0 SFR 100 RES-CONCRETE BLOCK WALL / FT. 20 . 00 2, 000 . 00
I do 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 I or any Allure building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification tram the Air Quality Management District.Residential construction applications are exempt from
(hese provisions.
r
Dale: 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 constfuclion and h by authorize representatives of this city to enter upon the above-mentioned
property for mspe on ses.
Dale: � �`�(� Signature'. -
Driver's License or Social Security n:
1641.46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor ,
CJ..STRUCTION 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. Pacifica' Conduit-Undrgrnd. 55. Electrical Bonding
( 5. Stte: Reinforcement - 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
)3(I - V
7. Footings 7I3 �_p. 58. Electrical Conduit-Undrgrnd.
�_SP�EL
B. Foundation s 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 i 62. Backwash & Receptor-Final
12. Sewer Cap '
63. Heater & Vent-Final
i 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 CERT"ICACT^E IS�SUEDD
33. Final Electric Notes: 3I ? X� //
34. Final Heating& Air Conditioning /
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace , I .;
,
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final i
•
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation "
46. Handicap Regulations LI;
i
47. FINAL STRUCTURE &$UILDING ((ribsir.
48. FINAL PLANNING -
49. Electric Release to Edison •
50. Gas Release to Southern California Gas Co I
51. CERTIFICATE OF OCCUPANCY
No. Date
A
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA P MIT NO. TRACT NO. LOT NO. BLDG.NO. - - - -
CONSTRUCTION PERMIT S— 3 2 ef 2 1
44_94 4/12/8.2 16_.00 TU
Project Addr s .2"41,4-7:/„,,,j,?/ st' e• VPE OF CONSTRUCTION ! t
Owner nr••D/_/ /-j71 - Phone ' _ ANEW 0 ADD 0 ALTERATION -
Addr , yT �rrrGGG///1 / f- .. 0 REPAIR 0 CONVERSION ❑DEMOLISH -
ZONING REGULATIONS
Arch/Eng. 4 License No. 0 OTHER • A P * - - - - -
- DISC IPTION OWO K . • .
Address - fJ,...n e-r 2 /+/'•r-is •.. • ZONE -- PLNG. REF. - •
Contractor - - '- Phone TYPE OF PERMIT- - BUILDING - �BPt�i LDING -
'SETBACKC/LST. O RTV LINE
Address - SI 8-et - - 0 GRADING '0 FOUNDATION STRUCTURAL LSIDFF}YARO- - - •-- - - - - - •
LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ •
ELECTRICAL ❑PLUMBING ❑MECHANICAL- S IEDET YA RD
I hereby affirm thst I am licensed under provisions of Charter 9 (corn- , .. 1 RIGHT
mencing with section 7000) of.Division- 3 of the Business and 0 OTHER ,_ •
Professions Code, i and my license is in full force and effect. REAR YARD(TO P/L)-
-• PROJECT DESCRIPTION _ • _
License Class License No. , - - P PKG.SPACE REQ. PROVIDED e -
Date •. Signature - "-_ - _- . 'SQ. FT. _ '••••7.7• ^
WORKERS'COMPENSATION DECLARATION OCCUPANCY�CONSTRUCTION TYPE STREET WIDTH PARK"FEE $.
I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ZONE ' ZONING APPROVED BY DATE
certificate-of Workers' Compensation-Insurance,-or a certified copy _
thereof(Section 3800, Lab.C.). ,GRADING CU.YDS. ACRES SPECIAL CONDITIONS: r _
Policy No. Company - - -- .. • - -
Certified copy is hereby furnished. REMARKS: - _ —. _ .. • _ -
Certified copy is filed with the city Building Division. / •�r �y �y�.�.�/��/�
•EXEMPTION-FROM WORKERS' COMPENSATION DECLARATION L/UI/e�/ [o#,_ -• U-w/o�P1L^ea+:/�✓f 1
(This section need not be completed if the,permit.is.for one hundred . •
,Je-to (�/"1�r Com- - - - -
($100) or less). - P T / fee)
I certify that In the performance of the work for which this permit is
issued, I shall not employ any person in ny manner so as to become PLUMBING PLAN CHECK - ELECTRICAL - - PLAN CHECK '
subject to the Workers Compensatio 5 0 h i - - DWELLING GAHAGE. -
Q Signature BATHTUBS - -SHOWERS
Date 4-y>- i - 'SQ FT SO FT -
NOTICE: If after making this declaration. yo should bet a subject -.TOILETS. a URINALS --- ' - GENERATOR 0=1'KW_1-10 KW -
to the Workers' Compensation provisions of the Labor Co e,you must - (TRANSFORMER
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS- - - ' — 'APPLIANCE • - 10-50 KW=50+-KW •- - - - '
revoked. - _ - -- - - • • -KIT.SINKS' -DISHWASHERS ' - -MOTORS - -
CONSTRUCTION LENDING AGENCY - -0-1 HP1-SO-HP- -
_
•
I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - t- —^ (INC..SOLAR) _ 10-50-HP_-50+-HPC-1� .-^
formance of the work for which this permit is issued (Section 3097 •' - - -- - 1
(Civ. C.). - - ' - ' '•'- - - ' - - -- "" ' ' ' FLOOR SINKS - FLOOR DRAINS - -. -- FIXTURES - OUTLETS' SWITCHES - -- - . -
Lender's Name _ _ -
'
Lend. Address DRINKING FOUNTAINS - - -- , - - -- - 4GAS TUBE-SIGNS- - - - -- -
OWNER BUILDER DECLARATION - _ '- -_ "' INTERCEPTORS -- CLARIFIERS -. "POLE LIGHTS • .- - -- -- - - - 4
I hereby affirm that I am exempt from the Contractor's License Law for - • '
the following'reason-(Section 7031-,5 Business-and Professions-Code: LUNSI Hut.I ION _ _ •
'Any city or county which requires a permit to construct, alter, SWIMMING POOL • P TRAP - 1
.POLES METERED SUB -
Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ' - ALTERATION 4,PANELS" MAIN SUB - - - '
quires the apt.licant for such permit to file a signed statement that he - --
is licensed pursuant to-the provisions of the Contractor's License Law GAS'SERVICEOUTLETS- - - ' • '- ' "- jSERVICE -- - - - -AMP. - - -
(Chapter 9 (commencing with Section 7000) of Division 3 of the - '
Business and•Professions-Code) or that-he is exempt therefrom and the WATER HEATERS BTU OUTPUT-- - ' --- - - -- - - - - -- -
basis for the alleged exemption. Any violation of Section 7031.5 by - •
,applicanb•for a permit subjects the-applicant to-a-civil penalty SEWER CONNECTIONS- " • - - - - • - ---- _- -- --- - - - - _ -,••••1/;applicant-for
more than live hundred dollars ($500).
-as owner of the property, or-my employees'with wages as their- SOLAR TANK - COLLECTORS' -.
sole compensation, will do the work,and the structure is not Intended -ISSUE FEE' a
or offered for sale. (Section-7044, Business and Professions Code:The SOLAR PIPING SYS. •!c" _ - - - - - ' - _7 - - - - . /��
Contractor's ,License-Law.does not apply to an owner of a property APPLICATION APPROVED BV DATE •�
who builds or improves thereon, and who does-such'work himself or ISSUE FEE --- - - - - — -
through,his own,employees,,provided that such improvements are not — _ _ y
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK - - re ^ - -' -- -
of proving he-did not build or improve for the purpose of sale). ' . " - BUILDING `/ - -- - .-
HEATING SYSTEM 0-100,000 BTU iPERMIT s /O.Oo • SMTP s $ C.,
0-1,- as 'owner-of -the property, am exclusively contracting with AND DUCTING - --- I— - - - -• --- - - - -
licensed contractors to construct the project (Section 7044, Business 100,000+BTU I PLAN CHECK $ -PERMIT
and-Professions Code:-The Contractor's License Law.tloes not apply to - ISSUANCE t ...--„ye
S� ''1[''
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ rr
tracts-from-such•projects-with-a-contractor(s)_licesned_pursuant to SYSTEM - - I - -- - . GRADING._$
the Contractor's License Law). 100,000•+BTU • iPLAN CHECK ,$ _
-D I'am exem t'under Section- ' — " '- - " B.8r14.-C.for this - - ' - - -$ •
p - BOILERS BTU - 'S ELECTRICAL -$ '
reason - -- •- - .- -_ -MICROFIL $
SYSTEM REPAIR,ALTERATION 'PLAN CHECK -$ M - _ _
Date Owner 1 -
I _ TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLEMEC HANICHL $-
,
Ihformation is correct. I agree to comply with all'city'and county' ,PLAN CHECK- $ - - - VANCE PC $- ' ' '
ordinances and state laws relating to construction,and hereby authorize See • . -
representatives o this ' y t e er up n -the above mentioned -i
property fo ecti a r1J/,/p _ 1 P s/, p/ /� FINAL FEE $_1/
Signature 1 � ` 1 J/ ' Date y-/..-rcL ' _ 1 it <P6/7 h r ' /(O.
O
>� - -CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION PLA
AND NNING POOL& SPA . . I •
" I - \- Date - Inspector - Date 1 Inspector
APPROVALS Permitrmit# APPROVALS • •
Permit# '
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location - - - • • .• -- - - -
2. Soil Pipe-Undrgrn' _ 44. Steel Reinforcement -•- - - -
. 3. Electrical Conduit Utility-Undrgrn _ _ _ , 45. Forms -
4. .Electrical Conduit-Undrgrn . 46. Electrical Bonding - - - -
5. Steel Reinforce__ - - - - - _. 47. Rough Plumbing & Pressure Test -
6. Electrical UFER Grn - _ 48. APPROVAL TO COVER-GUNITE - - '
7. Footings . _ /a-_ M.o f3-S- 94 49. Electrical Conduit-Undrgrn
8.. Foundation . . 50. Gas Pipe, ❑Undrgrn,Test
9. Water-Pipe-Undrgrn . . - - 51. Backwash Lines, P-Trap. ❑Undrgrn -
10.. Structural Floor System . _ •A-)S - ,2,,,7cf.-a-f 52. ,APPROVAL TO DECK .
-.11. . Property Sewer Line & House Connection _ . 53... Backwash & Receptor-Final
12. Street.Sewer Connection . . _ - - - 54.- Heater & Vent-Final
13. Rough Plumbing - _ -55. Plumbina System - Final -
14. Rough Electric-Conduit - - -, 56.---Electrical-Final-- • •
15. Rough Electric-Wiring - - - 57- Solar System-Final - •
16. Rough Heating & Air Conditioning' - - ' -- . 58. Fencing &Access Approval
17. Ducts, in Structure. - - : . . -. _. 59. APPROVED FOR PLASTERING . • , , •
18: Duct& Ventilating -4 - - - _. - - - ._ _ •
19. Gas Pipe--Rough &Test . - - - - - - 60. .POOL/SPA SYSTEMS FINAL -, - - • '
20. Roof Framing - • - -• - - _ -
21. Roof Sheathing . _ - -- - - • -
22: Frame and Flashing - r L :{..21. ?1 _ NOTES: -
23. Insulation - - Z•. - - - - - - • - - - _ _
24: Lathing & Siding • t , _ . - - - - - - - -
25. Drywall Nailing - ',4. L_ 4_1p .Sr% -
26. Plaster Brown Coat - - •
27. Electrical Power Meter-Final - - - •
28. -Final Electric - - -- - •- - - '
•
29. Final-Heating & Air Conditioning -- - - - --
30. Final Gas Pipe-Test • • •
31. Final Plumbing - - _. -
_
• '32: Water Service-Final - .- - - - -- .
33.-` Gas Service-Final --_ - - - •
34. Solar Domestic-Final -
- 35-- Landscape Sprinkling System-1 - , '
36. Sound Attenuation - - • - '
37. Handicap Regulations - - - - -
38. FINAL STRUCTURE & BUILDING - 1 �cj.-- 4.-jg14--- - --
39. Special Requirements Completed . - - _
40. Electric Release to Edison - • • - ' -
41, Gas Release to Southern California Gas Co. - - - - ,
42. CERTIFICATE OF OCCUPANCY - � -
- No. . Date • - - -
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PER IT NO``S�// TRACT •
NO. LOT NO. BLDG.NO.
CONSTRUCTION PERMIT JI /7Y-�o •
Project Address a I ,,. 3 ` TYPE OF CONSTRUCTION
j 8301 II /17/8I 10.50 TL
Owner /la rola J� Phone dYX'-�671'❑ NEW ❑ ADD ❑ ALTERATION Q "' "" " "
Address ? 97 2� , ��r.M, 0 REPAIR 0 CONVERSION DEMOLISH 1� ZONING REGULATIONS
46
Arch/Eng. License No. 0 OTHER �� /Qf,(
DESCRIPTION OF WORK %/ l/ A.P.
Address 1. ZONE PLNG. REF.
Contractor 5laMV ' Phone TYPE OF PERMIT BUILDING TO BVE�t_DING
SETBACK C/L ST. OP R V LINE
Address 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDEE
E VA RD -
LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING ❑MECHANICAL LS.I
I EYARD
I hereby affirm that I am licensed under provisions of Charter 9 (tom- RIGHT
mencing with section 7000) of Division 3 of the Business and 0 OTHER
Professions Code, and my license is In full force and effect. REAR YARD(TO P/L)
PROJECT DESCRIPTION
License Class License No. PKG.SPACE REQ. PROVIDED
Date Signature _ SQ. FT. _
WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE E
I hereby affirm that I have a certificate of consent to self-insure or a
VALUATION -S/fQ-� ZONE ZONING APPROVED BY DATE
certificate of Workers' Compensation Insurance, or a certified copy
thereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS:
Policy No. Company - --
'.ertlfied copy is hereby furnished. REMARKS:
:ertified copy is filed with the city Building Division.
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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK
subject to the Workers Compensation Laws of California. uwtl_u rv(a [aA HHtat
Date Signature BATHTUBS SHOWERS SQ.FT 50.FT
NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW -
to the Workers' Compensation provisions of the Labor Code,you mustTRANSFORMER •
forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW_50+KW
revoked.
CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP
I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS . (INC.SOLAR) 10-50 HP 50+HP
formance of theworkfor which this permit is Issued (Section 3097
Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES
Lender's Name
Lender's Address - DRINKING FOUNTAINS GAS TUBE SIGNS
OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS .
I hereby affirm that I am exempt from the Contractor's License Law for
the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSi KULl ION
Any city or county which requires a permit to construct, alter, POLES METERED SUB
Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS - MAIN SUB
quires the applicant for such permit to file a signed statement that he
is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE - AMP
(Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT
basis for the alleged exemption. Any violation of Section 7031.5 by
z applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS
t more than five hundred dollars ($500).
, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS
sole compensation, will do the work, and the structure is not intended
or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING 5Y5. ISSUE FEE '
Contractor's License Law does not apply to an owner of a property APPLICATION'APPROV ED BY DATE
who builds or improves thereon, and who does such work himself or ISSUE FEE
through his own employees, provided that such Improvements are not
intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES
is sold within one year of completion, the owner will have the burden
of proving he did not build or improve for the purpose of sale). BUILDING
y��r.I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ /0-- SMTP $
licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000+BTU
and Professions Code: The Contractor's License Law does not apply to \'. PLAN CHECK $ PERMIT
ISSUANCE S
tracts
sowner of propertych who builds c improves thereon, and whoacon- REFRIGERATION 0-100,000 BTU PLUMBING $
Vac C from such projects with a tooted C[or(s) Iicesnetl pursuant to SYSTEM GRADING $
(1... the Contractor's License Law). 100,000 +BTU PLAN CHECK S
0 I am exempt under Section B.8, P.C.for this $
r� BOILERS BTU ELECTRICAL S
!,,,. reason PLAN CHECK $ MICROFILM $
Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$
I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $
PLAN CHECK LESS AD-
information is correct. I agree to comply with all city and county $ VANCE PC $_
Y\ ordinances and state laws relating to construction,and hereby authorize �
representatives f this Joan -r pon the above menti9ned 56property fo pito u p /d�-
Signature 7" i Date//- /7—E/ •
FINAL FEE E
Drivers' License or SS ISSUE FEE
CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL&SPA
APPROVALS 1 Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
2. Soil Pipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
5. Steel Reinforce 47. Rough Plumbing & Pressure Test
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undrgrn
8. Foundation 50. Gas Pipe, 0 Undrqrn,Test
-Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑ Undrgrn
10. Structural Floor System 52. APPROVAL TO DECK
11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing 55. Plumbing System - Final
14. Rough Electric-Conduit .56. Electrical-Final
15. Rough Electric-Wiring 57. Solar System-Final
16. Rough Heating &Air Conditioning bB. Fencing &Access Approval
17. Ducts, in Structure 59. APPROVED FOR PLASTERING
18. Ducts, Ventilating
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathing .
22. Frame and Flashing NOTES:
23. Insulation •
24. Lathing & Siding
25. Drywall Nailing
26. Plaster Brown Coat
27. Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Final
34. Solar Domestic-Final
35. Landscape Sprinkling System
36. -Seond#teauaFlon v `)e nt? �0-i- }t 1
37. Handicap Regulations
38. FINAL STRUCTURE & BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATE OF OCCUPANCY
No Date
CITY OF COSTA MESA N° 272
PAh. ;EES
Fee Payment Receipt 1
Project Address 02.5/7Q-8 -�7-r Park Area
A. P. No. //8 — 42y— 8a /
Building Permit No. 437,1
Owner's Name Min071 Pt fcitil i
Mailing Address 47197 a 3 V •
FEE 11✓�.Ad
Single Family * No. of Units � @ $455.20 =
Multiple Family ** No. of Units @ $321.32 =
/ �1 Total/FeeliSS�0
/
Planning Department Approval Date 7 /1 ' / 7 By tiGOe96-
Applicant's Signature nrily
•
City Ordinance 7244
•• City Ordinance 7245
••• City Resolution 74-124 cot
White-Planning;Canary-Planning;Plnk-Finance;Goldenrod-Applicant CMF 0174-26 UU
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
s 1 P.O.B0X 1200 COSTA MESA,CALIFORNIA 92626 Fl riph4 n ,i - ,'e- 50 TL
REC BY PERMIT
For Applicant to Fill in Completely — Use Ink Only p. �s N� 48 61'7
BUILDING ise -S Lam, . i 57' A.P.NO. IIp <�-3 y
ADDRESS �(7 J 1 r
BUILDING
OWNER OR ADDRESS a' 4 7 ,F ,2-3 St, C/i,
TENANT OeA.0 4 Cr I"'
UNIT OR
MAILING SPACE NO.
52 M,L'
ADDRESS — M S4
CITY e06 a. Ale,S2 NO. T
TEL NEW ADD ALTER REPAIR MOVING DEMOLISH
CONSTRUCTION t.
LENDER /V ilio C.
BRANCH / PP(/bb
OWNER are/ r/lc;„fit NE
ADDRESS ARCHITECT ��',�//yy y //�_�-�
OR ENGINEER
/A? 1 NO. USE a(�� Q, {' . t E -
JADDRESS ZONE TYPE �- GROUP J
APPROVEDey_
p/��/
CONTRACTOR aQ,r- BY DATE Q♦/ n
ADDRESS
TEL.
CITY NO.
F STATE CITY APPROVED SETBACKS
LIC. NO. LIC.NO.
-(y SIZE NO.OF BLDG (FROM CA.S �iE ET)
S
A. OF LOT NOW ON LOT FRONT SrL FT. 0
a USE OF /
� EXISTING BLDG. R.SIRE S FT. V
to
FSeparate permits are required for L,SIDE i9 F 8
electric,plumbing and heating work. REAR FT.
mo., USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
2 C,6(r ;�
DATE
al
tofrl
"'I APPROVED
'C
1. ROVED dui DATE 8/13 1!7
C T CA N sC
W
QI hereby acknowledge that I have read this application and state c'
a that the above Information is correct and agree to comply with C
Qs all laws regulating building construction, and I shall not employ i
Z any person in violation of the workman's compensation laws of o
14 S the State of California. ro
I hereby certify that I am properly licensed as a contractor under SQ. FT. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E Y
and Professions Code, D'vision 3,Chapter 9. SE,t 0 n
' „ PLAN CHECK E
idS
Signature o / 00 • OO
Permittee rte. at, / , $ X6001 LL
TAX E • So V
or
Authorized Agent Date TOTAL PAID E CM s .'0
`4* f 742
�all
j , •.bR 18-77x„_ on 889 it%:,it i AV!C
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APL ATI N FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
//�� RE D DATE RECEIVED DA E ISS ED n
BUILDING /2E9725 /e0 9,— i ./ 7,
ADDRESS G J ,
/ c /cj/�� P RMIT NO.
/LV�i I�'lll'Ac.s./•
OWNER A.P. NO.
MAIL BUILDING
ADDRESS ADDRESS
TEL. TRACT I LOT BLOCK
CITY NO.
CONSTRUCTION NEW (ADD(ALTER(REPAIR (MOVING DEMOLISH
LENDER
`'Y`' L[[ ��/ •
/jam
BRANCH OWNER A! ra"/ tart
ADDRESS /`//►�•7- VAL
TEL. USE `}• $
OR ENGINEER NO.
FIRE
ADDRESS ZONE TYPEelr-4-GROUP
APPROVED
CONTRACTOR BY DATE
ADDRESS ZONE INO.OF USE OF NEW
TEL. PLANS BUILDING
CITY NO.
f STATE CITY YARDS APPROVED YARDS APPROVED
ZLIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLDGS. (FROM C/L STREET)
A. OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
WI EXISTING BLDG. R..IDE FT. FT,
rn
F Separate permits are required for L.SIDE FT. FT.
electric,plumbing and heating work.
C _REAR FT. FT. I
[W., USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& --
Q4 MAIN BLDGS. ACCESS.BLOCS.
VAR.# DATE
C.U.P.# APPROVED
a
7 APPROVED
, BY DATE
C4
w
Q I hereby acknowledge that I have read this application and state N
In
IX that the above Information is correct and agree to comply with m
L all laws regulating building construction, end I shall not employ i
Z any person In violation of the workman's compensation laws of o
Sthe State of California.
I hereby certify that I om properly licensed as a contractor under SQ. FT. a
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses ere in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ / �� v
and Professions Code,Division 3,Chapter 9. / n
m
PLAN CHECK $ m
Signature of _ 0
Permittee $� TAX $ 2
u
III
U
Authorized Agent TOTAL PAID $ I
1
dfe•
43742 i 3O-77 om,7s'l... _. : ..(;:i.si
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely— Use Ink Only
„V7 4 RECEIVED BY DgT RECEIVED' DgT�E�I,t.-
BUILDING
V�i'( //TT//�, CC(f�7
ADDRESS o‘
�t rn4�, F.- �/I BUILDIN/' — 162L-/-3
/ -J PERMIT NO.
OWNER ////�'��III '' // �'Y��' 1/
MAIL 1 ADDR ESS '' 7 -a s-/
ADDRESS /.�wvCT
TEL fi o 4-ka TRACT f ct�� ��LOTT 0,4 LOCK
CITY (1:0,51,1���a NO. J /O'a(Ip
CONSTRUCTION , EW ADD ALTER (REPAIR (MOVING DEMOLISH
LENDER
BRANCH ^0� 0 {: NirP
OWNER /C I \
ADDRESS nL^'y� 1A '/
ARCHITECT TEL. USE r1/4111W/ V LUES "Oo
OR ENGINEER NO
FIRE
ADDRESS I�J/ / ZONEGROUP �/ 7
CONTRACTOR ! 'aea/el r Kr) APPROVED iitt
TE4// 7/ADDRESS a G�7 1C'. 2 3 jf 1(y,
TEL. S �( ZO NO.OF USE OF NEW
CITY Can: Ain Sa NO.5-6-.20Q / PLAN( BUILDING ^ n4z1.4.774�I
ISTATE CITY YARDS APPROVED YARDS APPROVED
LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING _
W SIZE // NO.OF BLOCS.
0.. (FROM C/LS - T) �� I
OF LOT IS D X S QE¢/ NOW ON LOT PONT 1T. I/a (pQ,F(r./ /,/
Q USE OF //r/�l-
4., EXISTING BLDG. _R-SIDE5V!FT. FT.
cncn
FSeparate permits are required for L.SIDE L��� FT. FT.
electric,plumbing and heating work. REAR c2L.JFT. FT.
L. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
CMAIN BLDGS. ACCESS SLOGS.
.� r / VAR.,ft DATE �j �/_77
�U/1 �(r 2(J re Se (r. GyCP. C.U.P.s7 /� APPROVEQ� �
'EC
iii /y /r
APPROVED///. l� "" re
>-' RV t/f iy�A�'/ DATE . 1.-711.2_.-79.___ /•,
w ,wel n FOR SPECIAL REQUIREMENTC Artill
0 I hereby acknowledge that I have read this application and state
Cd that the above information is correct and agree to comply with 0:3:3.
.' all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of ��/ o
the State of California. (�,�/.0
I hereby certify that I am properly licensed as a contractor under / / 1 SQ. FT. w In
V I
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o v'
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business 'a
end Professions Code,
Dtv)sion 3,Chapter 9.
VALUATION PERMIT FEE $ n
Signature of W r/� S ,� / L, /I/1'/PLAN CHECK S �3i JV u.
J L/t/ u.
o
Permittee y TAX $ .li 5
rf' �
U
Authorized Agent TOTAL PAID 5
, is 7
1 • Pr
�
COMPLAINT INVESTIGATION
C.,6Received by C.,1� Date /1.--a.-- s
Made by: Address d a 7 I eat .- ` _Ph.No
Against-
/ Address am7 e'G7M6,- _
Directions: l n Q �� // ,/�
Nature of Complaint: / e ` /-C'(/ v- C fl� /`t�� `t7TLZ/"^
d-+f V ' L� -tet_ wy—9.L�� 7'jtef LLC/
/ l / /
•
Actio taken: _ �--4" A.6/ _ / s_.-s . _ is. i .�� it..-L n_,ii. a- S. _
Complete: Yea Complainant Yeo By: 011. M
c �
Interviewed: , - ',
No _ ,A ^ No � Date: �� �
"La lJ r"'
OWNER KNIPP, HAROLD F: DATE 8-12-79
JOB ADDRESS 247 E. 23rd St. BUILDING PERMIT NO. 48618
GENERAL CONTRACTOR Owner/Builder DESCRIPTION of WORK Demo residence
AP Na. 118-124-34 LOPM 59-13 TRACT FIRE ZONE VALUES 500.00
IA'"ECTIONS Signature Date TYPE GROUP ZONE
SUBCONTRACTOR PERMITS ISSUED
G^'_ Date I Number I Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE rl HOUSE CON.
SPRINKI-ING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING •
TEMPORARY SERVICE OR POLE
UNDERGROUND ❑ POWER EI
ROUGH WIRING • Heating and Vent. CC
TRENCHES I] FORMS ❑ STEEL REINF. p\R`O''\Ot$
FLOOR SYSTEM S.
`\\[�Ue
BOND BEAM Li STEEL REINFORCE p] 4��!(��eA`�e,�_,t\
SHEATHING \P�' ( i:;‘,4
FRAME
FRAME AND FLASHING u
LATHING — INE OUT
PLASTER. BROWN COAT Date
STRUCTURAL. FINAL Electric
Hr 'N6. VENT., REFRIG. AND A.C ,I FINAL
.,
P .ING. FINAL AND GAS TEST I -
_
ELECTRIC. FINAL
BUILDING. FINAL
I
--COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
c-•-•---,,- P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 n..'� -
RE I E Y ]PERMIT N2 48618 ,s50 TI
For Applicant to Fill in Completely —Use Ink Only 'A
ADIDRESS.yet 6 Z3 574 C. Ali A.P.NO. in �I� '( �3q
BUILDING
OWNER OR ADDRESS 1 4,7 e .23 5/
TENANT el t./ If Gr Y
UNIT OR
MAILING SPACE NO.
ADDRESS Sa nT O
_7/�' /}� TR.NO. Lyp]T `Cy BLK.
�AJ /fit I ejA
TEL. T IY1 .J i -�
CITY NO.
NEW ADD ALTER REPAIR MOVING DEMOLISH
CONSTRUCTION /�
LENDER /V Cn,sR /X\
BRANCH //) J,,t J
OWNER
y,I,y Jlr !Y rC�AUVF Lam' OO
ADDRESS 1 USE TJC I . E kJ�XJ "l
ARCHITECT TEL.
OR ENGINEER NO.
ADDRESS ZONE TYPE GROUP
APPROVED D
CONTRACTOR ,eul tier BY DATE F tJ 7
ADDRESS
TEL.
CITY NO.
F STATE CITY APPROVED SETBACKS
LIC. NO. LIC.NO.
itj SIZE NO.OF BLDGS (FROM C/L STREET)
L OF LOT NOW ON LOT FRONT FT.
a USE OF
,c5, EXISTING BLDG. R 41RE FTaft-AMP
rn
FSeparate permits are required for L,SIDE FT.
electric,plumbing and heating work. REAR FT.
(W,., USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
G
DATE
`� - APPROVED
APPROVED p/'3 /�O
>-. By DATE 4 7
a 10
bir fs-47--Cr J<AAAkeM.R.,
m
SCtiI hereby acknowledge that I haread this application and state °'
haw,that the above information is correct and agree to comply with C
L all laws regulating building construction, and I shall not employ >:
Z any person in violation of the workman's compensation laws of o
Sthe State of California. m
I hereby certify that I am properly licensed as a contractor under SO. FT. w
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR B
Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business VALUATION
and Professions Code, Division 3,Che ter 9. PERMIT FEE E s O0 1
u.
Signature o PLAN CHECK E �� o
Parmoftiea $ OO TAX $ . CO V
Authorized Agent Date / 7 V TOTAL PAID E ra
•
OWNER KNIPP Harold ?• DATE 8-23-62
JOB ADDRESS 2 7 E. 3rd. St. BUILDING PERMIT NO. 13017
GENERAL CONTRACTOR OWner_Bi�. VALUE $ 212.00
AP No.n8_324_13 LOT TRACT FIRE ZONE DESCRIPTION OF WORKNeroof etefi Q•
INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE 11-1
SUBCONTRACTOR PERMITS ISSUED
G, DATE NUMBER
Water
Rough Corn. Refrig. 0 Air Cond. 0
Rough Heating
Rough Plumbing
Miscellaneous •
Prop.Swr.Line 0 House Con. [J St.Swr. ❑
Sprinkling System
Constructio?ole
Underground 0 Power ❑
Rough Wiring
't Tenches 0 Forms 0 Steel Reinf. 0
Floor System
Bond Beam ❑ Steel Reinforce 0
Sheathing / /b "-i•-t:
Frame and Flashing .4r. 1 U-'7. 4.g.
Lathing — In 0 Out ❑
Plaster, brown coat
Refrig. 0 Air Cond. ❑ Final
I ng, Final
Plumbing Fixtures, Final
Final Gas Test
Electric Fixtures, Final
Building, Final t4-F y-?..r' sY
OCCUPANCY
FORM BU4•5M — 7-61 t 17701
�. ,•1114
17701 FEE R kaEaki a
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COSTA MESA. CALIFORNIA
For Applicant to Fill In Completely APPL T'IMNIMWMt T •
TYPE OR PRINT /
BUILDING 2y ?
7 t, , 3 BUILDING
ADDRESS
COSTA MESA. CALIFORNIA For Office Use Only
-- // 1}-.-' J I RECEIPT NO. P MIT
OWNER .7 roil/ / ` / 1 I �7 0
MAIL 111111 RECEIVED BY DATF�/�$ECEIVED DATE UJp
ADDRESS . 7 Rap Ir I v „ D 3D / /o/,�' .7
TEL. BUILDING
CITY CDs €5.sz NO. ADDRESS _
ARCHITECT TEL. COSTA MESA. CALIFORNIA
OR ENGINEER /14)n 09 NO. /
ADDRESS ------ F
- Z N V f 1 I
IRE TYPE GROUP I
CONTRACTOR /11,44) ,.QV //34/// 4 ✓ APPROVEDk/
DATE 6
- 23 -
BY
ADDRESS - ihNING ..0
• ZONE / NO.OF USE OF NEW4 Pet..
CITY {, — I PLANS Z BUILDING
STATE TEL. LEGAL eel `0`T y.. J(_3 /4-1.71-'9%7' ?
/ ,
LIC.NO. NO. DESCRIPTION
SIZE
OF LOT , /� NO. OF SLOGS. A P NO. �� [J
!/O 27.5 I NOW ON LOT l — / Z / — /3
USE OF YARDS EVES
EXISTING BLDG. Fa4/ - GH C,6 APPROVED ALLOWED
SETBACK LINE FROM (CENTER LINE ST./
CENTER OP STREET REAR YARD FRONT /3 K1 4-1)-'4. IN.
SIDE YARD I LEFT I RIGHT R.SIDE F --S //_(
FT. IN.
DESCRIPTION OF WORK L.SIDE r `V4f 7,4-pc. IN.
NEW I II ALTERATION I XII ADDITION REAR a S ,( FT. IN. (
�(' ,..../
REPAIR I II MOVING I II DEMOLISH I BYPROVED, /���� /�-1
--
DATE /Z'�
BUILDING NO. OF �vv
SIZE ROOMS STORIES
EXTERIOR WALL I ROOF
COVERING COVERING
USE OF BUILD jyG A WORK TO BE PERFO 1 E•
?q nn
a
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 COM- - PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
PLY WITH ALL CITY ORD( CES AND STATE LAWS REGULATING
BUILDING DGNeTRUrnu// ��II VALUATION
SIGNATURE OF �/!/ /J/ "LJ PERMIT FEE $
PERMITTEE
/ $ 7) I/ PLAN CHECK $
/ I
AUTHORIZED AGENT TOTAL FEE .— O
n