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Home My WebLink About263 23RD ST - Building Permits PROJECT ADDRESS: 263 23RD ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 054248 , (NEWS NAME: SCHOCK, S JAY ADDRESS: SCHOCK . CATHERINE PERMIT NO: P 054248 PLAN CHECK NO: N GOVT: N SUPP: N 263 E 23RD ST COSTA MESA CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU PURPOSE: ADD / J (714 )645-17176 14 ARCH/ENGINEER: ALEC OSACHOFF REc.ND.: NOJ: JOB DESCRIPTION : 1ST & 2ND FLOOR ADDITIONS, RE:#B54245 SQ FT: ADDRESS: 42 MIRADOR IRVINE CA 92715 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 • / . PERMITTEE: JAY SCHOCK (714 )645-1276 ADDRESS: 263 23RD ST COMMENTS: INCLUDES FAM RM DINING & LAUNDRY, COSTA MESA CA 92627 �E�Eit�L****�E�ERE�E�r�r�r�ESr*****�E*�FfE****�E*�E*****�E***+r SERE* **+r*** Eye**********Rt*****:r*****Sr* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 0l Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: 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: 42608404 ZNE: REF NO: 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> It Applicant' ******************************************************************************* .EMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES.: REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as 10 become ' subject to the Workers'Compensation Laws of California. ZONING APPROVED BY . • DATE: Date: Signature: ' NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. d-, CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• A DATE. 0 Q et which this permit is issued(Section 3097.Civ.C). ******************************************* * ******************** • ** LENDER: INCLUDES 2 BD RMS, 1 MAST **************************************9F******4fii******************************** ADDRESS: BD RM & HATH,KITCHEN LEGALIZATION:N F E E S U M MAR Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law fdr 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 34 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 5 g 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 live hundred dollars($500). ISSUE FEE 300 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----> 34 . 50 3. 00 0. 00 37. 50 37. 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his roro herm owntisemployees.witin provided of that pithe o me are note the bd or offeredofrfor sale.Ieinothowever d rbuildingmr or REVENUE DIVISION TOTALS--> COLLECTED: 37. 50 OVER/SHORT: . 00 improvement purposold ale)hin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the p•ject : tion 7044,Business 37. 50 . and Professions Code: The Contractors'Slate License Law does not apply to an owner o . •ieny'ho' • or improves thereon • and who contracts for such projects with a contractor(s)license pursuant to the Co AAA '•rs' ate w). l am aware {(.**jE**{(.********************************************{E**.*******.****.x.************* that proof of their Worker's Compensation insurance should be provided to me. // VII o I am exempt under Section: B.&P / I N D I V I D U A L F. E E BREAKDOWN for this reason. e7/�y1r ' TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date:__2..j2"--/ 7/ owner: ► (IL PLU 2 BATHTUB • I do hereby certify that I am aware of and understand the requirements ofk C darns Healtl End Safely Code Sections 25505,25533,and PLU 1 DISHWASHER 2 . 00 4 . 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 2. 00 2. 00 permit for construction or modification from the Air(Malay Management District,Residential construction applications are exempt from PLU 2 LAUNDRY TUB OR WASHER 2. 00 4. 00 these provisions. PLU 2 SHOWER 2. 00 - - • ' _4; 00 Dale: Applicant' / I PLU 1 SINK, BAR ki2"00',.''-•. `�- ''. `. 2 . 00 PLU 1 SINK, KITCHEN "2:, 00' ' 2 . 00 I hereby certify that I have read this application an tate that the above /. al on 5 corr: 'a.ree to c'mply with all city and county PLU 1 WASH BASIN 2 , 00 2 . 00 ordinances and state laws relating lc building cons action and hereby au/ •repro?ntativ�y..- ••n the above-mentisr d PLU 2 WASH BASIN (SET) 2.00 4 . 00 properly fo/r/i/ns/petyli"pit prposes. • ( J / PLU 3 WATER CLOSET (TOILET) 2.00 • 6 . 00 Calm_Z6t ignature: / .': `ff.�- PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 . 00 2 . 00 Driver's License or Social ecurity p: 1641-46 White-Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor ' ONSTtiNtCTION AND PLANNING POOL & ' ROVALS 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'.-...,ri.- J•z r , 3.�Elyciv(cal'Fo9uttU? lity-Undrgrnd. _ 54. Forms <` ;Blecirical ConduhSl;drgrnd. i65. Electrical Bonding - - .yT .n!1 •.1 15.*S2ieSiFr' ft5rcer5itntc t' 16. Rough Plumbing & Pressure Test S L'-'6 .J.tl I ', V.11' rr: 6.• Isot,..,-.4J Ei? Gr 7. APPROVAL TO COVER-GUNITE S'J7 Fdoi gf* QJ 358. Electrical Conduit-Undrgrnd. 8.foundation ' •i59. Gas Pipe, 0 Undrgrnd.,Test 9.IWater Pipe-Undrgrnd. =60. Backwash Lines, P-Trap, 0 Undrgrnd. . n . 10. Structural Floor System _t'i61. APPROVAL TO DECK ` - - .i' 11. Prop-artye Sewer Liner& House Connection 62. Backwash & Receptor-Final .- .. J1 12. Sewtei• Cap a .,� _` 63. Heater & Vent-Final ' 13. Roof Drains:__ f / 64. PlumbingSystem - Fina(-' _ - 14. Rough Plum6irj, - Q3/�1((n, , >Ara5. Electrical-Final 15. Rough Ehctricii•Conduit e( fid/ 66. Solar System-Final I 16. Rough Electricrlyiring 67. Fencing & Access Approval , 17. Rough Wiring Sign 68. APPROVED FOR PLASTERfNG t 18. Rough Electrical T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air ConditioningFIRE DEPT. REQUIREMENT - _ ,J -C • S T -co E- IA :t'. 7'^.-J .77 :GT^' 20.'Roti�h Factors/ Fiieplace I 'z n 4 t r. '7 10 Tt 3 tAPPROVA91.CPertflit # t > = 1 .�• : --- F .,j '.e .S :_.a. : yS-,r cc< Y •S -1T:% r !; 'X '- i�-,.- 1 :K -7 r^-. -,�.::7 7,7._ ,5;v ! ,--.- r•5 x '- 7 =x ,L �:" '7 r( r .x to 21..>Dudts, inStr9cturp.t .. .. ;- t t c ` _y *" y0. Undergrogpd:Hycjro t 22. Ducts, Ventilating-.:3 �:S * _ ^'fr S :-.4."(-.. .,Ji, •71, Producr'Piibing CGes OFil 23.•{)as`Pipe tough 8/1,st i ns :n Q ,Q r:. 1 �`2. Underground Flu`'sI j ; ., .-1 - , Le #0. . .. S f. h 3 --. 1 , T 24.:Roof:Framing. St I s-E- ••`r a. .. Q t yK 4 s73.1}Jndergrnd?Storag Jank f7 Gas 0Cif ")J'•.-+-"' 14 -•--• 25. Roo SHeathing `� r s o� ', -q p !vx a _ c' F-; y �• 'i ;:x S •, , i7 rJy 5/4:!Overhead �iydroD y 26.r T-bar, Ceiling (Structural) &;A1ocno - .coat a tq C Ills i 75.=pry Chemical t.; t -4 C 'r07 - 1s-uLu;x:.t3: . > c..•', s .r -,r-- �.rlr.F -r,-r 27. raa andFlashi2gfi > ch76r Dry StandQ�e22-.; .;: S :r •-rJ 7:'S itit - nJ Js. _, T ^ .r.;s,..i=r.:c ...n,a _;_28.1ltyI ng& SidingsY r: -71•LLJt .,Jz ,:4": S . . ,• * • 77.LFIXED S'L ''.-NAL?� _ V .%',-.1- `1za 'voA ... r ••*, I 1 rr H -r-, cq -1n _ r. 10•' N ,Lrs-f •. r> ''29. Insulation £ C .- ,. .. t to i n* 78. LRE PREV. FI 't •t Sr-ro 2:- : 1,I 1 �hL :> Q :n: cr . : .Cd. :330. Drywall:Nailing '+ .x t x w• •HEALTFteEPTrREQUIREMENT .g 't,tn ♦ r_ I W C.,' ^I stili.. ^ r) -. - r n. I I 79.t'FiN7LINLC 'T S �L31. Plaster Brown-Cog; strtr * nr < _, , , r. ,�5 70 :-32.aElectricabPower Meter7Fin aI ; * COCU � X . o80.hRTIATSUE f000 CEFICE ISD~ .3 --:<'.. r•• I 1 p: J x t'7 . t Y m T 7>_ * ..1•3 Z.33.` in t ElEttric, .gyp t d y Notes: _ a 7 y !t __, C 34,Fina Heating A ryConditionigq t Ix o S ^.^ S 35.' inatGasPipE-Tei IT''O •- p I r , tr , s I.- 06.6 riootl or nopy rzx ! tr'i 4. r C1 p k .£ >. c. x 7.ZFina1.Faatory Fireo.. ce: I St" •3 x T I It. x S_ . t .-38. Fink+Plumbin i �-' t a u i � '-. t 7 '.39. Water Service-Finals J i ''' i. . r n 'wn .i 1::: ,n S. x : x- U; I i ,r * Y t- 7• in F 1.1' A # t,, 'l t,40. Gas Service-Final s to KvM I s * at fr 01.- ^-).,J a 241. Solar Domestic-Final S n •' 4 =` k .t. r `L U --t 1 ;� J . a ti. g_ -i. * 1- pJ x. ;:O I is-. 1 . Ji "r s. '42.=Backflow Preventers, CV * I tx :P M - ~t G , :J -" t 43. Backflow Irri¢ationy: `SSS * :3.. x 'J::' :CO ........:.`v.!n:.y".t... >4 t tl: • :. r4 JZ At (-1 O' 1 't• ).Ca. a .1 .1 r• „ ,, ,y •�c...�:JurJ...v,....... ,op. Landscape lrngatiou System"Dl)70 X 1: C,1 7 7 a* -t ;:c V Cu Xi.; 1. PJ 00000000000 545. and Attenuatiori' .-+xr• 'r . > F - t a %. rr t-- , m (-1 Y C .. .. s tri :n �)t:t :7,1-• -- - Q • :--- * S t- F ra : 1J .* �6. �Iandicap,Regtllatiot?s y. t, a, rz m ;S 70 .S .F 47..FINAL STRICTURE & BUIIlDING *. I t :e 7 c. s * I rt• rr .Y as- I `,t * 1 T t t- 48i_FINALPLANNING; 1 �. otv 1 i is in 'n .r t i- . 49i:Eleixric Release to Edison i s 1 ! it > S ii; ,50. Gas.Release to Southern California Gas Co x (} x ,.• - . 0;n a p _^ ^1 x51. CERTIFICATE OF;OCCUPANCY .:t. ._ •,,. :> 5 .r "G - ... - 000007G0=J00 No. _ Date j `\ • PROJECT ADDRESS: UNIT: TUNER'S NAME: ADDRESS: PERMIT NO; P 054248 • PLAN CHECK NO: 03899-91 N PAGE: 2 *****************qtr*+ *************************se*shat**r*********sr+r****+e********* 'A ARCH/ENGINEER: REG.NO.: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ADDRESS: UNIT: PLU 1 GAS PIPING SYS 5+ OUTL-PER OUTLET . 50 . 50 PERMITTEE: END OF FEES ADDRESS: LICENSED CONTRACTOR DECLARATION; I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 70001 of Division 3 of the Business and Professions Code.and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate 01 consent to self-insure or a certificate of Workers' Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EAP.DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Cem0ed copy is fled with the city Building Division. • le: Applicant: .EMPTION FROM WORKERS'COMPENSATION OECLARATION: (itis section need not be completed if the perm)is for one hundred($100)or less). I cemty 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 sublet to the Workers'Compensation Laws of California. • Date: Signature: NOTICE:II.alter making this declaration,you should become subject to Om Workers'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097.Civ.C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law foe the following reason (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or repair any structure.prior to its issuance.also requires the applicant far such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis foe the alleged exemption.My violation of Section 7031,5 by , any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). I, as owner of the property Or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve for the purpose of sale). I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business • -] and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts lot such projects with a coneractor(s)license pursuant to the Contractors'State License Law).I am aware that proal of(heir Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.6 P.C. for this reason: Date: Owner: I do hereby certify that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and - , 25534 and that I or any future building occupant widAvitl not(drde one)need to comply with said slate codes and the requirements for a -" ' ' permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date. Applicant; I hereby cerlity that I have read this application and state that the above information is correct.I agree to comply with an city and county ordinances and state laws relating to budding construction and hereby authorize representatives of this city to enter upon the ahove.mentioned properly for inspection purposes. Date: Signature: Dover's License of Social Security#: I6an.46 white—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor . CONSTF15CTION AND PLANNING POOL & �A!'ROVALS Permit# Date Inspector APPROVALS Permit# _ Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, ,7/jglf'I��"`%/f 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 74 97 /!ki k 62. Backwash & Receptor-Final 12. Sewer Cap !�i/ 63. Heater & Vent-Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20.(rRough Eactory Fireplace APPROVALS Permit# f T ^ '" 21.pu4s,irStructure 70. Underground Hydro 22'Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23! as'ipe-Rough & Test 72. Underground Flush 24.r.,Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Rodi Sheathing 74. Overhead Hydro 26.1,7-Bar CeingJStructural) & Monocoat 75. Dry Chemical t 27 Frame&Ad Flashing 76. Dry Standpipe 28.'-Laf' ing 6r Siding 77. FIXED SYSTEM FINAL 29. Insdlaticf 78. FIRE PREV. FINAL 30. Drywall;Nailing HEALTH DEPT. REQUIREMENT 31. Plaler BrowwCoat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33.7inal Electrieh Notes: 34 Final Heating-e:Air Conditioning 35.tZFinal Gas Pipe:Iest 4.d or Canopy 37.'x-Final FactorPireplace 38. •Final Plumbing 39.,.Water Service'Final - r 40%as,Service-Final 41.nSolar Domestic-Final 42. Bact flo`wy Preventer 43. Backflow Irrigation 44. Laridsc4Qe I? igation System 45. Sound Attenuation 46. Har4dicap Regulations 47cfIntAL STRUCTURE & BUILDING T Y 48.«FINriAL PLANNING 49. Electric pelease to Edison 50.�Gaselease tq Southern California Gas Co 51. CERTIF1'CAXE OF OCCUPANCY No. Date _ _ _ • Applicant to fill in all Spaces except those within heavy border lines and sign all appropriate declarations. /'7 1 ` PERMIT NO. ACT O. LO NO UNIT NO. }EiISti' F COSTA MEM t(t�ON�cj UCTIO5. .PER CM 31 q ftU • Project Address -�•�✓ 'SAME- `Au1� .Lf• CM-, B + • 1 O I��"ryr v�� Applicant's Mailing Address SAf- I. •/ • - A� TYPE OF CONSTRUCTION Yat NEW a ADD U ALTERATION U REPAIR 'Own. 's Name ME-tMg.s' J•J.SC fbCFC Phone (04. "1274, - ❑ CONVERSION ❑ DEMOLI H ❑ OTHERt'c1�J C'ARiI(v� A.P.# 426-O8�/— 05e _ Zone /2/ j-) DESCRIPTION OF WORK/USE OF BLDG. n '� > Address SAME -'- OCT4es1BD S Main Building: Accessory Building:C�4�•e P-ocle-e. iN•r7AFjLln1 3..:075 . ' 2� B' E 6o� L �/' /'_J Z Arch/Eng. License No. .-TTYPE OF PERMIT ❑ GRADING FOUNDATION STRUCTURAL T Front /� r e.l am G1 O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MF_CJ+ANICAL "tat �j A Rear 5 , N �A 'i Gc 44 .0 . ❑ OTHER CARA{eg 'L a^-a� J/ti 1'��WJ Contractor's Name 'K'r"v"r•'�=• -Phone �Y5��2�1° Fid _ 2 • 3 ,L . . . t '",PROJECT DESCRIPTION SQ. FT. 3? aCCfUPA Y • C Right 3 / G Address(mailing) 7 7�,�s - T • V J/ 5 City License No. - JY3:.l-i-L_. - CONSTRUCTION TYPE VALUATION�S Left r'w / /(p. JR LICENSED CONTRACTOS1 DECLARATI•N . • , 7 ZONE GRADING CU.YDS. ACRE �/) �2b E Ing. Ref.# V r , gift- Parking Req./Provided I hereby affirm that I am•licensed under provisions of charter 9 (commencing Remarks: ,/QI f S7 C PlanningNotes: /'� Q with section 7000) of Division 3 of the Business and Professions'Code,and �^ 7• G• `� "�`J t�'+'jQ!LV/ �(JD 41� OF'/OAI� S �f J M T my license is in full force and effect. PC-�.f• 60 b t7L �IS G/4 1•...5.1 h V-O, IQf 4-5 P.Is S - °+y,hse Class • License No. 4+ PLUMBINGOBIFEES '� HOLD FOR SPECIAL REQUIREMENTS e Signature '- - RKERS' COMPENSATION DECLARATION ' ; Bar Sink Showers ELECTRICAL FEES .iereby affirm that I have-a certificate of consent toself-Insure or a certificate -of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) ,,, .- Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW — Policy No: Company - .- Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW 6 Certified•copy is hereby furnisheg. - . Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Dap to 100 amps Date Y Applicant EXEMPTION FROM WORKERS'COMPENSATION-DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred,($100)or - less). .� Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is issued 1 shall not employ any person in any mu so s to becgmesull�ect t the Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑1'/-8 Date zS/Cotr� roe,n Cowie of Cantorrda/,� y� / / Date /`U V Signature I`• t%-C+/ - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE:If,after making this declaration,you should become subject to the -- Workers'.Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole-Light I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heater Outlets Ran e Lender's -Name . 9 Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION . • I hereby affirm that I,am exempt from the Contractor's License Law for the Lavatories - Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code:Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW 05.15 KW Trash Compactor V structure, prior td its issuance, also requires the applicant for such permit ' file a Signed Statement that he/she is licensed pursuant to the provisions Of Roof Drains - - Contractor's License Law (Chapter 9 (commencing with Section 7000) of - .viiton 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil malty of not more than five hundred dollars($500). $ 3 LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee compensation, will do the work, and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and rwho does such work himself/herself or through his or her own 1Hood- Type DEVELOPMENT SERVICES REQUIREMENTS: 3'2l \ \ employees, provided that such improvements are not Intended or offered for Boiler Canopy Type II D Zoning Approved By Date y / sale. if, however, the building or improvement Is sold within one year of com- pletion the owner will have the burden of proving he/she did not build or In- Duct-Under Ground Building Approved By Date pr a for the purpose of sale). �,�p ) .1 ^p� `J, f,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By &- t' Data 1 '[• �ir'yl t/ ract_ors td construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU ❑100,000 BTU SUMAAAJiY OF FEES (•8 builds or improves thereon, and who contracts for such projects with a con- - (!%�I J tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ W SMTP $ proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple ❑ System Repair/Alteration PLAN CHECK $ _ PERMIT 0 I am exempt under section B.ICP.C. ort is red n Firepl/Fact.Bit. ICBG# Fire Dampers E p Y 1 ISSUANCE $ Date 3_�1 Owner Heating System&Ducting Registers InCUnI(J�eitl 61S�C flops PLUMBING $ ENERGY P.C. $ PLAN CHECK 25% $ hereby certify that have read this application and state that the above 00-100,000 BTU 0100,000Bit (' +h•-. ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances ''1, -��S� _ v MICROFILM $ aced state laws relating to building constri tion,and hereby authorize repro- Dalt: -- seatatives of s city ;. enter upon r e •ove- entioned prqperty for /• - - PLAN CHECK 50% $ (' Ce inspection p po a ��t/Y J i / �1 {gyp / MECHANICAL $ TOTAL FEE $ 2•'3 , .-- Signature ,a/. -/ is- _nL / Date 3-21-89/ Drivers' License or SS# - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Aonlirant. oink -Accounting;Goldenrod - Assessor - - - - .y0_ .fes- 2?/ /993 V CONSTRUCTION AND PL•A OOL &SPA APPROVALS ' Permit# t'• Date Inspector APPROVALS Permit:# L Date Inspector 1: Temporary Electrical Service.or Pole 52. Pool & Equipment Location III -. 2. Soil Pipe-Undrgrnd, ' 53. Steel Reinforcement . ' r 3. Electrical Conduit Utility-Undrgrnd. 54. Forms •_ 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding i 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd.s // 57. APPROVAL TO COVER-GUNITE • . - 7. Footings ` _ 4_(- Cf d pie- 58. Electrical Conduit-Undrgrnd: 8. Foundation • `/ 59. Gas Pipe, 0 Undrgrnd`.Test' 9. Water Pipe-Undrgrnd. _ /+ 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System ',°3/�/Qa Ot 61. APPROVAL TO DECK -, ' • 11. Property Sewer Line & House Connection / ( 62. Backwash & Receptor-Final; 12. Sewer Cap 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final . - 15. Rough Electrical-Conduit 66. Solar System-Final -. ` .16,,Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING' • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ., ' r 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT?: I:.• • 20. Rough Factory Fireplace APPROVALS Permit# ' 21. Ducts, in Structure 70. Underground Hydro . , ' 22: Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil i 23. Gas Pipe-Rough &Test 72. Underground Flush " 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil _ ' 25. Roof Sheathing q/s/ p Aa_ 74. Overhead Hydro 26. T-ear Ceiling (Structural) & Monocoat ti 75. Dry Chemical ' 27. Frame and Flashing �jvO� 76. Dry Standpipe - 28. Lathing& Siding �fp fJW 77. FIXED SYSTEM FINAL nl 29. Insulation I� tO Qi 78. FIRE PREV. FINAL 30. Drywall Nailing tB 0 P� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 2- io pe- 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED £Final Final Electric Notes: c^^ - ua y��L Heating & Air Conditioning npp,��y] • 35. Final Gas Pipe-Test `(,L.b'e(i4" OK 3'g-BR P/ 36. Hood or Canopy b r N^ 37: Final Factory Fireplace `�f�//IIII`aS � �_ 8.' Final Plumbing 7 L ke- 1.b /was- tj� , 39. Water Service-Final ( 3 O �d T�,(�•O n 40. Gas Service-Final � � ! Ld PO- c. / _ /' 41. Solar Domestic-Final 34/ca f t,, ,, i e, - - 42. Backflow Preventer W3/�'a a V , , � r J ers_p cad r / f� 7 �.r try 43. Backflow Irrigation Landsape Irrigation Systeml :sus,ace 45. Sound Attenuation ^^^"'99®AA SSS"��"""' 46. Handicap Regulations - /� y r• \ -1 47 FINAL STRUCTURE & BUILDING / 0/4...- p�- / • � S, G K L- I"7 /{---. 48:_Special Requirements Completed /!"' Inc; it/ /ist 49."Electric Release to Edison . i��`,..�//�e" / .f• 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY It l • No `Date A 1 . , 'j - CIT'- OF COSTA MESA (-- CALIFORNIA 92628.1200 P.O.BOX 1200 Insulation Certificate 5T/.��ia�T,4Qcl ko �,{,sa%% F �efi4i�leC/i/ ( '7 2C.3 T ,TT ( f� Number and Street City Co ty Subdivision Lot Number Description of Installation ROOF / J / Material CCG o,4c --x'4j Q' Brand Name Cs o/1e/ _ Thickness(inches) .7" Thermal Resistance(R-Value) k-oz. 5 EXTERIOR WALL Material --.//9 ' Brand Name /titi0,// Thickness(inches) " Thermal Resistance(1k-Value) ,-,/' CEILING Batt or Blanket Type Brand Name Thickness(inches) Thermal Resistance(R-Value) Loose Fill Type Brand Name Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material T Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR /12A- ) Material I Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) FOUNDATION WALL Material T T Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adm'rristra e - --1� trsic- .tor (Buiiii ilder) R iVQ/7:3/ clrcenseNumber Si. azure and Title Date Sub Sub-Contractor(Insulation Installer) License Number sere s,7#6 Signature and Tide Date City of Costa Mesa MEASURE "G" EXEMPTION Plan Check it 460-88L Exemption # 89-10 Permit # Case # PA - 37— I2C0 Address: 263 E. 23rd Street Unit: Applicant: Mr. & Mrs. Schock FACTS: D Residential ❑ Commercial/Industrial ❑ Other ❑ Existing Lot ❑ Not Part of Larger Project Project Description: Garage with_second floor studio including toilet and sink. No. of Dwelling Units. " 1 Gross Floor Area NA Square Feet F.A.R. NA Estimated Traffic Generation: NA Avg. Trips/day FINDINGS: The above described project is exempt from compliance with Measure "G" for the following reasons: n 1. Project is a commercial/industrial development which meets all of the following criteria: gross floor area is equal to or less than 10,000 square feet or has an average daily trip generation or less than 130 daily trips, has buildable floor area ratio of less than 0.5, on an existing lot, and is not part of a larger project. in 2. Project is a residential project of four dwellings or less on an existing lot. n 3. Project is residential construction that does not increase the number of permanent housing units on the parcel where the construction takes place, such as remodeling or rebuilding of an existing house. ❑ 4. Project is commercial/industrial construction that does not increase the footprint or square footage or change the use on the parcel where the construction takes place, such as remodel- ing or rebuilding an existing structure. ❑ 5. Project is a public benefit facility, which is defined as public libraries, public administration facilities, public parks, public utilities, and religious facilities. ❑ 6. Project is a facility serving the health and safety of the people, which is defined as hospitals, police, fire and safety facilities, and schools. Exemption ratified by: • Planning Commission Date January 9, 1989 ❑ City Council Date 1 co &LM 1648-30 • .1 PNaSDDRESS: 263 - 23RD ST UNIT' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054246 —OWNER'S NAME; SCHOCK, S JAY — ADDRESS: SCHOCKCATHERINE PERMIT NO: E 054246 PLAN CHECK NO: N GOVT: N SUPP: N 263 E `23RD ST COSTA MESA CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: ADD (714 ) 645-1 `176 ARCH/ENGINEER: ALEC OSACHOFF REG.NO.: NO? F. JOB DESCRIPTION : 1ST & 2ND FLOOR ADDITIONS, RE: #854245 SQ FT: ADDRESS; 42 MIRADOR Wry• IRVINE CA 92715 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: JAY SCHOCK (714 )645-1276 ADDRESS: 263 23RD ST COMMENTS: INCLUDES FAM RM DINING & LAUNDRY• COSTA MESA CA 92627 ****** P;L?,E******** PS ***** Pft*****�E* PSE*�E�t*** P*4* *******3E**************+t***:e Sr***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I 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 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.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 42608404 ZNE: REF NO: El Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> Dile: Applicant: ******************************************************************************* .EMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(S1D0)or less), DEVELOPMENT S''E:R 'V I C E S REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become vp. subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: • Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : • DATE: Code,you must forthwith comely with such provisions or this permit shall be deemed revoked. ' Se CONSTRUCTION LENDING AGENCY:. I hereby affirm that there is a construction lending agency for the performance,of the work for APPLICATION ISSUED BY: �'S DATE• fj 2 which this permit is issued(Section 3097.Civ.C). i ****.****.*.*******.*.*************.*************4#$***************.****{�.** .{E*.*.l)E *}*.* LENDER: INCLUDES 2 BD RMS,1 MAST *********************************�e********************************************* ADDRESS: BD RM & HATH, KITCHEN LEGALIZATION:N FEE SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law f or 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 86 10" repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . ' S(:)%t,•- $M I P/NON—RE$ 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(5500). ISSUE FEE ' 15,OO.� 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----> 86, 10 15, 00 0.00 101 . 10 101 , 10 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through 1. his or her own employees. provided that such improvements are not intended or offered for sale. If.however the building or TOTALS—_ improvement purrpose oflsate)hin one year of completion,the owner will have the burden of proving he/she and not build or improve REVENUE LDGDIVISION PLUMB NG ELECTRIC MECHANIC FIRE1 SMIPO/TOT/SHORTi GRADING PLAN—000 HECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the proj ct(Sectir 7044,Business 101 , 10 ' K ,01 and Professions Code: The Contractors'State License Law does not apply to an owner of property w r build r improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contrac/s'St. Lic s: — am aware *********************.*************.)f**************************.****************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN I am exempt under Section: B.8 P.C. / ❑ for this reason / / �I // TYPE QTY DESCRIPTI O N - r' UNIT COST TOTAL COST I do 20 i/ wof Health Safet Code Sections 25505,25533,and ELE 33 FIXTURES LIGHTING' ADDITIONAL EA. . 45 14 85 25534 and that I or any future building occupant win/win not(circle one)need to comply withh said state codes and the requirements for a ELE 20 RECEPT/OUTLET 1' ST 20 EA• •75 15,00 permit for construction or modification Imm the Air Duality Management District.Residential construction applications are exempt from mese provisions. ELE 43 RECEPT/OUTLET 'ADDITIONAL EA, . 45 19 . 35 ELE 20 RECEPT/SWITCH ' 1 ST 20 EA. .75 15. 00 Dale: Applicant: ( ELE 2 RECEPT/SWITCH •ADDITIONAL EA. . 45 . 90 l hereby certify that I have read this application an state that the at / dorm r 1 rrW.Iqree r comply with all city and county , ELE 2 RES APPLIANCE NOT OVER 1 .0 HP 3.00 6. 00 ordinances and state laws relating to building co ruction and hereb 1j14__ tto enter upon the above-mentioned 'END OF FEES property for inspection put es es Date: �0 cFfature: I/ 4 • cOuS. G_'rirrlY i7�A 1-1:: r ,• - Driver's License or Social Security u: ' - DATE: ' ' '92 T'i47 —. 1641.46 While—Building;Green—code EnlorcemenC Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & t. Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # _r • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location t/ 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement l:2r^:-'^ h t^ - _tbeccimaliCon�({UUTility-Undrgrnd. 5 orms ,-I • •u4:(Electrieel Cobiluit•U4drgrnd. 7 g 5. Electrical Bonding • •S-n T.-t :Yr 1; • :5: Sia'aVRePre&ce'r`te�n -1 56. Rough Plumbing & Pressure Test S w., .+..•. ti• 86.:El/etiicAt:UfERG(Ri. <57. APPROVAL TO COVER-GUNITE a dr$1110 ;-.4--9�2 N 2't58. Electrical Conduit-Undrgrnd. , er- 8.�toundation -;. 9. Gas Pipe, 0 Undrgrnd., Test 4. 9.'Water Pipe-Undrgrnd. .1-60. Backwash Lines, P-Trap, 0 Undrgrnd. - - 10. Structural Floor System _1:61. APPROVAL TO DECK ` 11. Property Sewer Line'& House Connection I 62. Backwash & Receptor-Final ft < v- ..t - 12. Sewe{ Cap ti o. r- 63. Heater & Vent-Final 13. Roof Drains L.- rO 64. Plumbing System - Final , - f 14. Rough Plumb-it1i, • 65. Electrical-Final t 15. Rough EI'ectrical-Conduit 66. Solar System-Final ��""""'��"""- ` A 16. Rough Efectric;Wiring - 9/(/1 eepti 67. Fencing & Access Approval ,,' ) 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica,CT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - .. ^., '- - __ • r 4:-: -T -J rJ'.-+w:-• 13 * i-. :osn:r7t:::rtritc 20. rHoi h Faactor�y Fi?e7'�lace i ixir rt"! * " 7 7* t 'APPROVAU9JDCPerifiit# " s- • '-••-1.-"' - tT. S '31 S tK i 'sty U.t.1 t S N 'TX. Yc 0 .1: tVt-+E-+ t ;,.Tl(rin rrri > CJ `-- X:R. r- Y' < t-: _' tt S Si�i =a rr * .Y. ... 2L;-Ducts,in_Strpcturpr , •. .- t-IS a t 1-�:x * ^70. tJndergro(tpd;Hyt{ro a 22- Ducft V9ntilating•* ^:S' * ,. 'S �t* 'x Vy1. Produc}PRiA EF Es O it 'C rl !Th w OY t rt z CI K a, r_t: r Q! }11 1 g r 23.`;Gas_ ipe'_Rou h &lest (^ -! Cr .-I* ''' ` ' � .� k t_7S r. ti 7 •y 0:t t( t-72. Undergfoeyl9c1 Fluilp Y. -y. .- •S-r .r. 24.t'Roof.Framing. Si I r--E^ ••r s > 0 •? ., * S/3,tRJndergrnc7?Stora dank E Gas 0 QBLJ o:^" .y :l•x •n :t '� tt Hv: s '� I x 25. Rogi•_Shiathing C• �' rt t' t,:j 2, N'*r 574,9Overhead ydro5'- 26.tT-Bar Ceiling (Structural) &{iclonocoat 1; . -tn i ttfl T 75.•=Dry Chemical �LI-' 0 tr"trtc2sr;'-;n. .. .. �.ir • •••c- .1( .'1 4 �*- 'Y. > ._..,_-i -Ir-.:i-tirntyrf In 27._yFra a and Flashi g:: In * * :k 76:^Dr n'� `" 's -' ti '�'<'l!'C1^ru !� ,4.r. 01.11: :1. Cr :>- :n:t .e Y Stand 4pe [gym .r: t-r-t lrt rq lr: -i w '-..,:. ‘4,:, r .. .n f k ' y "4 X28. Lathing:& Siding;:-'; ra t s, 1. t 77.CrFIXED SYrSTEM eTh -* tm-n -• �I l c a ,^. < I � M r •'-1 f-<'-: r,1(� 'g r-' ^' t r9 rn/.^/ , 9 X* •° .5 •• •• 7 *(r] I f* * 0 :r Nloty,-ttr0•^. '29. Insulation r* S I ft; •r 78tFIRE PREV. FI :4:(1:, K > x - •., 733 - rrr- r30. Drywall,Nai ling * y a .' :t I I '-t HEA LTH- EPT*REQ U1R EWE NT:h'-S C.31. Plaster Srnwn,Coaf t 1 'r * 9'FINAL II FECTIk��lry•� ' `�' `'• 'c�'(-`xx'-''t r----13. :� i '1 ry.K 1 -r-+ rl� ,.� r r.-•r-- _ F32.cElectricaDPower MetetaFinal: /1"t ffiHHiQh4ieS I ** t80:rFOOD CERTIFICATE:. ISSUED •-.N C '/-_ s33.SFin�1 Eltrfctri� „„ 1.1 i 'L Arr:;Conditionila 'il!, �/� '` •^ steal' 35.'2`(;incl Gas'Pi -Telt tt /� o '• r i'- * n * ��0 1079254416-:(1 �/Ci �.y U H Iti Y-. 't' 1 36. Hood or�CanoPv e[:+ ;. : LT•� a. x t'' I fe. > g r tlo _ I-i_ (r S ^w , C i r n t-F Y . .a'r+ ,, r 7. inaY Fa tory FireNac`e ^ I, 'S`n a v tri * r i' I .�SOStiS LI 38. Final]Plumbing i ' i i tl. r S .- N % -a n .^ r ;r -- G39. Ware Service-Final* 4- is I k *. ;1 Ctrl * S c t: 1 't. 'X * * >• .t tri VI CI II MIX! +r cp :t v. k t r rU • c ,.I '.t+.ti+:ti. -•-tr. f10. Gas Serv1ce-Final -r U7 'Slr'tc .`^. :n w I I Ft t P" •-:t7 L - - •c 41. Solar Domestic-Final S f i 4. :Ds r _ -. 1-' a: .42.8ackf lows Preventert`-. a x; "' I* * I >r `4 1-r T t:. :'r.. O r, 43. Backflow Irr}gationT 2552 :p r * rX:- J!: 'J w ,:,44. Landscape Iriigatiog Systempnl;u tc :r rt t , 17r. ;: lit; PJ OJ - 1:t f. co. nJ;J^J^.;^.1vo :,,,. % t + - - '745.CSound Attenuation` -'Ii^ IT' :r S E-- -4*; * n v-- t.t. w ti m -1 :r: -i •• .- x Irl to to r * 1•- L^ ' • t-it, t c a. - S .. .. ?36.',F,iandicap,Rdg1 ulatid`-ps .`4 0 :s ••* t c,K tt S Oo ••;S a -47..-IFINAL STRUCTURE & BUILDING a I I h' * 3 JJ S -t Ir 7 1 r *a ;-• I to :r T -- DK 1 (r Er :K ! .x to U. '. r.-• i 48..FINAL PLANNING•, F: w a i * tr _ CTI S t i, _49.cEleccric Release to Edison i .F (a .P Y 1 * 7 .. .- .. t * j !- tz :x In .t .rte t _.�(�...,-i X50. Gas„Release to Southern California Gas Co ;;, I • I'. *l. . :-_4 7 - atm - :1 _• -n r. 51. CERTIFICATE OF:;OCCUPANCY - y r o; o r151. No. Date Applicant to fill in all spaces except those Iwthr„� �'ortler lines and sign all appropriate declarations. PERMIT NO. TRACY NO. LOT NO. UNIT NO. 42Cd -o �if - OA `7 ' CITY OF COSTA MES.:'•, C STR UCTION PERMIT 324 A.P.# .y- y- Zone 1'L '4V2_ EP3$ t If N ,sf', k-TS Project Address - (WJ $ Main Building: Accessory Building:e4teaL��"� �y� TYPE OF CONSTRUCTION LI-KNEW U ADD Li ALTERATION U REPAIR 1'-`�'- Applicant's Miijing Address v'"s RIG E Front //__ 1_ ��I��'L� Z Nl2 MRS.JrY .t0 El CONVERSION El DEMOLISH ❑ OTHER T fob -�c 0 Owner'£•Nam4 � Phone DESCRIPTION OF WORK/USE OF BLDG. A Rear 5 I N Addr Arch/Eng. License No. TYPE OF PERMIT GRADING LJfOUNDATION IJ SARUCAU RAL C Right �I G ❑ TENANT ELECTRICAL PLUMBING ❑ M CCH-A,NICAL $ • Left I6.5 1 CoAdnt aktor's Name__ 0/0 - Phone ❑ OTHER �nt�rctia /2AJO Or�Js7 Ping. Ref.# PA- 2,.. 124 Parking Req./Provided E 0 Address(mailing/ PROJECT DESCRIPTION SQ. FT. - OCCUPANCY_____1S ' C {� g Planning Notes: C i4°i% E k acc:0dU') FLOb2 M CONSTRUCTION TYPE VALUATION$ �+ y• q{� City License No. ZONE GRADING CU.YDS. ACRES 21 VO 10 ; 1 Al GL_U 1 N�-7 1'olLi r S LICENSED CONTRACTOR DECLARATION r� a�1�I/ I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /t 3 �� / �J 1�� with section 7000) of Division 3 of the Business and Professions Code,and .cs my,license is in full force and effect. ELECTRICAL FEES ',};•,znse Class License No. — jr "_e Signature _._ PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS' COMPENSATION DECLARATION ❑ 50+ KW Bar Sink Showers Construction Pole Sub. 1 hereby affirm that 1 have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (SectionCooking Unit Meter Ouip to 100 amps 3800, Lab. C.) ,o —Backflow Preventer Service Sink • Policy No. - . company Backflow Irrigation Sewer Cap • Dishwasher t Meter over 1Ovammps 1 8 Certified copy is hereby furnished: Dryers ❑Gas ❑Electric Sub Panel es"`� Certified copy is filed with the city Building Division. Bathtubs Sewer Connection I 1 ( O O nate -_ Applicarit- -• Fan Motors 00-1 HP 01%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors - (This section need not be completed if the permit is for One hundred ($100) or F.A.U. Inc.Solar 09-15 HP 016-15+ less). "+ .' I Dishwasher Solar Piping I crtify that in the performance of the work for which this permit is Issued, 1 /�� Fixtures Microwave if shall not employ any person in any.mer so s to become subject t the Drinking Fountains Solar Tank • �✓ Dae r4 Cop-costal'''. Laws Califo( AZ /�� Date rs; ofSignatureCn1. Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE:if,after making this declaration,you should become subject to the Outlets Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal g 2— tar comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - I Switches Sign [J TO Gas Service Outlets Water Closet Z-OG .l I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097 Civ. C.) Int¢rc¢ptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the I Lavatories Auto-Wash 017 rowing reason (Section 7031.5 Business and Professional Code: Any city or -:',owing which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays ;`'-S'structure, prior to its issuance, also requires the applicant for such permit 3 4- )'tie a signed statement that he/she is licensed pursuant to the provisions of • the Contractor's License Law(Chapter 9 (commencing with Section 7000)of Roof Drains /r Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $.3.- 4.a 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). I $ 3 DEVELOPMENT SERVICES REQUIREMENTS: C I, as owner of the property or my employees with wages as theirsoleReinspection Fee 1 $15 Issue Fee 1 Zoning Approved By Date compensation, will do the work,and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Al //• Date License Law does not apply to an owner of a property who builds or improves ._ ______ ) �/ thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 • Application Issued By ? /.S�, L-.. - . Dat: � 4,- employees, provided that such improvements are not intended or offered for BoilerL sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEE`" pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground pr ve for the purpose of sale). PERMIT $ SMIP $ _ jgI as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT ractors to construct the project (Section 7044,Business and Professions Code: ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU , PLUMBING $ 7 . Oh ISSUANCE $ builds or improves thereon.and who contracts for such oroiects with a con- - ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ proof of theirWorker's Compensation insurance should be provided to me. ELECTRICAL $ 5---s-.75— GRADING $ ❑ I am exempt under Section B. F. P.C.for is reason Firepl/Fact.Blt. IC80# Fire Dampers MICROFILM $ ��gq / PLAN CHECK 50% $ Date 4�' -k=1� {— Owner Heating System& Ducting Registers MECHANICAL $ TOTAL FEE $ (.O Z r7 S— I I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,0008 information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of t 's city o enter up,n he ab• e-mentioned property for inspection pun• - r ` / s_1q-se/ ._. Signature .//F /,.. . .1- _�.. Date 4 O I • Drivers' License or,S5 $ -4L 04f19/S9 TIDE: Jt'130 0865-46.rev. 5/88 white - Building: Canary -Applicant; Pinky Accounting; Goldenrod - Assessor - f ' CONSTRUCTION AND PLANKL )OL&SPA ., APPROVFIZLS ...eermit# Date Inspector APPROVALS • Permit# s Date Inspector . .n - N ' i 1. Temporary Electrical Service or Pole r 52. Pool & Equipment Location 2. l Pipe-Undrgrnd. 53. Steel Reinforcement ' Sa !��'3.i Electrical Conduit Utility-Undrgrnd. �1 JI . Forms - ' ` • Electrical Conduit-Undrgrnd. C 55. Electrical Bonding 5. "teel Reinforcement 56. Rough Plumbing & Pressure Test 6.klectrical UF ER Grnd. 6-i58 0 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. I , 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test , 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 Undrgrnd. ' 10. Structural Floor System 61. APPROVAL TO DECK • ' 11;,.Property Sewer Line & House Connection 62. Backwash & Receptor-Final - 1 12. Sewer Cap '� • 63. Heater & Vent-Final 13. Roo(Drains - 64. Plumbing System - Final 14. Rough Plumbing 4 f`Q(to 60 65. Electrical-Final 15. Rough Electrical-Conduit �J/� 66. Solar stem-Final 16: Rough Electric Wiring I///qo Vf:467. Fencing & Access Approval 17. Sign7. 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 Factdry Fireplace APPROVALS Permit# 21. Ducts, in Structure (AI 70. Underground Hydro 22. Ducts, Ventilating {-) 71. Product Piping 0 Gas 0 Oil 23._Gas Pipe-Rough& Test L' 72 Underground Flush �/ I24'. Roof Framing ' 'el' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25'. Roof Sheathing ,/J 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 ��f 79. FINAL INSPECTION 32. Electrical Power Meter-Final s? �YdrIO& 80, FOOD CERTIFICATE ISSUED Q ^� 33. Final Electric 7 -,..5---9/ Svc( Notes:3�/ tiA st_Z odtl e 34. Final Heating & Air Conditioning .( ;1 35. Final Gas Pipe-Test ` •' 36. Hood or Canopy 37. Final Factory Fireplace- :- ,M 38. Final Plumbing I 612$191 lie- .39. Water Service-Final ,-/ / 40. Gas Service-Final- .- t-t? 41. Solar Domestic-Einal' , y • �) 42. Backflow Preventer ---- - j s-. . 43. Backflow Irrigation v" 44. Larndscape Irrigation System - ' / i 45. Sound Attenuation „,.. i' 46. Handicap Regulations- - U 47. FINAL STRUCTURE & BUI LDI NG . i r 48. Special Requirements Completed I 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co _- - 51. CERTIFICATE OF OCCUPANCY I' , r r, No. Date I� : •... r , r PAM"! W.LL AGREDOTT 'IIS AGREEMENT, made and entered into this • day of �jffgc/j fifU , 11110, by and between ± ,/ ScZct hereinafter referred to as •LAPID O WR", and A ,u, ASO eO hereinafter referred to as •PATACENT PROPER.1 CNfl'. } It is hereby agreed that a party wall will be constructed on the property line betb+een 2 63 2 3 Ed .ST 273 23R1 S' (Address of Ad ining Properties) in the City of Costa Mesa, County of Orange, State of California, as per nap recorded in Bodc "/ , Pa ee 3 of Miscellaneous Maps, in the office of the :aunty Recorder of said County. The party wall shall be permitted to encroach Pc) /� we /�/1ifN j/yle vet)el o/ %%e IN WITNESS WiE EOF, the parties have entered into this Agreenent the lay are year first above written. AND • ia- / /41. AAZACENT PRCPERTY OWNER _A A ,Si-na.A. ew (Signature) / / � is ,e or Printed) Nane ( or Printed) 263 lac 2,3 '`� (% I Z 75 p. 25'1 ST �sf/;%s :Address) (Address) PARTY FALL AGR.M.22NT 497/ THIS AOREEKEt.'T, .made and entered into this i d 1/ -- day of A/r / /910 , Ipm, by and between —110/ ocie // hereinafter referred to as Sao CRIER', and & ace SX-' hereinafter referred to as 94:CAC:2.S '?RPE.R- OWNER'. i It is hereby agreed that a party wall will be constructed on the property line between Z63 23Rd 57- j 2.53 , 23 , Sl (Address of Joining Properties) in the City of Costa Mesa, County of Orange, State of California, as per map cecorded in Bodc , Page of Miscellaneous Maps, in the office of .the :oanty Recorder of said County. The party wall shall be/Ipernfitted to encroach Rolle `Lu f doss a} /A a IN WITNESS WHEREOF, the parties have entered into this Agreeaent the !ay and year first above written. MDAt/ i Ap3- *I) •-a-ERIY 'FR i /. (Si•nt tur- ) (Signature) / ScL / ,U/7vc e AA? iarre ( ,eo' or Printed) Nave (Typed or Prin ) L 26 3 f Z3 ��/�sf�� is c 23g� (/ 7154 :Address) (Address) crAooREss' 263 23RD ST �. UNIT: CITY OF COSTA' MESA - BUILDIN.G PERMIT PERM NO:, B 046717 x NAM' SCHOCK • - DORilSAME PERMIT NO: B 046717 PLAN CHECK NO: 03362-90 S GOVT : N SUPP : N • le. CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE- : OTH -ARCH/ENM : 645 1276 Amos: UNIT: UNIT: JOB DESCRIPTION : STD BLOCK WALL & RETAINING WALL ' SQ -FT: 142 CLAIM VALUE: -800 . 00 CALC--VALUE: 4 , 320 . 00 GROUP OCC: R-3 / PRMITTEE: SCHOCK ( 714 ) 645-1276 (ADDRESS: 263 23 RD ST COMMENTS ; 105 LF STD BLK WALL/37 LF RETAINING WALL 3�]qt / CM CA 92627 • *###############*******#************************•*** ## ** * ************* LICEMED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000'of Division 3 of the Business and Professions Code,and my license is in lull force and effect. • SETBACKS CITT'LIC.: STATE UC.: CUSS: . Dae: Signature: • ---'--- MAIN BUILDING • -- ACCESSORY BUILDING ----- ------- OOR(ERS'COMPENSATION DECLARATION: I hereby affirm that l have acertificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT • IN FRNT: 10 FT IN REAR: 80 FT . IN Compensation Insurance,or a certified copy thereof(Section MOO,Lab.C). LEFT: FT . IN RGHT: FT IN. LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: • , • COMPANY: PARKING REQ: PROV: PARCEL: 42608404 ZNE: Ri REF NO: ❑ Certified copy is hereby furnished. ❑ Certifiedcopy rsfiled with the dtyBuilding Division. PLANNING NOTES> BLOCK WALL BUILT AT THE 10 ' FRONT SETBACK AND ALONG PORTIONS • > OF BOTH SIDE PROPERTY LINES. RET. -PLANTER WALL AT FTCOF SITE Applicant: *******************#*******##********* **3E**##******#***********)4 lE*#4c*** ****** EXEMPTION FROM WORKERS'COMPENSATION'DECLAJWTION: (Dissection ot be the permit is for one hundred($100)or less). r DEVELOPMENT SERVICES Ft E Q U I R E M E N.:.T S I certify that in the performance of the work for which Nis permit is issue Ino emp n in any manner so as to become ': r' subject to ih Workers'or- o nation Laws,ot California. ZONING APPROVED 'BY :- �.Z-. ___ DATE:� a�,:.Z6 �t� • --, Date: Z O Jo Signature: • - — '— . NOTICE:It,after making this declaration,you should become bje o the Workers pensation provisions of the Labor BUILDING APPROVED BY : DATE: r. Code,you must forthwith comply with such provisions or Pis perm shall be deemed revoked. - —i==-�-'-' -- CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: - �rr�� DATE: V. ^/7,Cai which this permit s issued(Section 3097,Civ.C). ************#*********" a4 .-T_-77-7C •*3FTWq********#**" —*.3E• ADDRESS: LEGALIZATION: N F E E S U ' M A R .Y,. STRUCTURAL SEGMENT:Y - OWNER BUILDER DECLARATION: Ihereby 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: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT• 7 2 . 0 0 , 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she Is•licensed ' pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing lith Section 7000)of Division 3 of the Business - SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ' ' PLAN 46 . 80 any applicant for a permit subjects the applicant to a dull penalty of not more than five hundred dollars(5500). ISSUE F E E , 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 7644,Business and Professional Code: The Contractors'State License Law TOTALS----> 72 . 50 0 . 00 46 . 80 119 . 30 119 . 30 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or " improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve REVENUE. DIVISION TOTALS--> COLLECTED : - 119.. 30 OVER/SHORT : . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC , FIRE ', SMIP/TOT GRADING PLAN-CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 72 . 00 . 50 4 6 - 8 0 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of.roperly who builds or improves thereon ' and who contracts for such projects with a contractor(s)license pursuant to the Con r to State License Law).lam aware *********#*#*************************4*#*********#****#****#********#********** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D O W N 0 I am exempt under Section:7 0 4 4 B.A alb_P.C. _ for this reason: OWNER DOING WORK A / TYPE QTY DESCRIPTI O N ' UNIT COST TOTAL COSI' Date: 4fie gU (Avner: . (1 I `' . � ,.' ' I do hereby certify that l am aware of and understand the requirements of Catitorm.Heal i and Safety Code Sections 25505.25533,and SFR 105 RES-CONCRETE BLOCK WALL • / FT 20 . 00 2, 100 . 00 -25534 and that I or any future building occupantwilt/will not(circle one)need to comply Th said state codes and the requirements for a SFR 37 RES-RETAIDI WALLS UP TO 6 FT / FT`.' 60 . 00 2, 220 . 00 permit for construction or modification from the Air Ouality Management District.Residen ial construction applications are exempt from END OF FEES 01 00057237-00057238 T O T 72.50 these provisions. DATE: 03/28/90 TIME: 11:43 Date: Applicant: ' I hereby certify that I have read this application and state that the above inf a n is.• ed.I e oT with all city and county • ordinances and state laws relating to budding construction and hereby a re oral of ` to en F..••.the above-mentioned .p ; • 1 property for inspection purposes. Date:7,ry t !ii Signature: / 0100057239-00057239 TOT 46.80 Driver's License or Social Security x: DATE: 03/28/90 TIME: 11:45 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue:Goldenrod—Assessor ' I7 . ! i NG-l POOL A CONSTRUCTION AND PLAN Date Inspector Date Inspector PPROVALS ie"''r# - Lr APPROVALS Permit # -j 1, Tem^-- ' Electrical Service or Pole ' - •_ 52. Pool & Equipment Location r At ` ! . Soil Pipe-Undrgrnd. 'i. 53. Steel Reinforcement i 3. Electrical Conduit Utility-Undrgrnd. 54. Forms y" 4. Electrical Conduit-Undrgrnd. 55. Elecirical Bonding • 5. Steel Reinforcement 3j[q.L{D &W H 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 3-.14-RO ow-bi-' 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test i f 9. Water Pipe-Undrgrnd. •%�� 60. Backwash Lines, P-Trap, 0 Undrgrnd. - 10. Structural Floor System -l 61. APPROVAL TO DECK - ..... '43. Property Sewer Line & House Connection _- ' .62. Backwash & ReceptoFinal r'� %v 4 , • 12, Sewer Cap - \ 63. Heater & Vent-Final .x' -- :T 13. Roof Drains t ,,, 64. Plumbing System - Final - -'`-7 , t 14. Rough Plumbing j ' 65. Electrical-Final / ' , 15. Rough Electrical-Conduit 66. Solar System-Final 't _ 16. Rough Electric Wiring 67. Fencing & Access Approval ; 1 ' 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. 3--Bar Ceiling (Structural) & Monocoat # 75. Dry Chemical • 27. Frame and Flashing 76. Dry Standpipe 2B. Lathing & Siding • -.r77. FIXED SYSTEM FINAL 29. Insulation i _ : �� 78. FIRE PREV. FINAL • 30. Drywall Nailing : , I' ' - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ..j 1' LP;5®cc, s, 5A eat o*t 35. Final Gas Pipe-Test • Ti . ! -4-06 cycK'e G�4 ; ' -- 36. Hood or Canopy ' . . ` I - 37. Final Factory Fireplace - • 1r _ Y_ Y-q, "- ®K i � T 9it _1 6��- -LL _ • 38. Final Plumbing . - - _/V 39. Water Service-Final! c-'724/-ye ,a-us/C,2 PtifeA.g,t 4etA4L 40. Gas Service-Final;r • , 41. Solar Domestic-Figal 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigaltion System • ' '45, Sound Attenuation - • 46.-Handicap Regulations n - 47. FI NAL STRUCTURE & BUILDING 5-*'- , Gcy,j/- ' 48. FINAL PLANNING �' f 49. Electric Release to Edison ' ' 50. Gas Release to Southern California Gas Co ' '1 �t ' 51. CERTIFICATE OF'OCCUPANCY No. Date - ---1 PROJECT ADDRESS: 263 23RD ST • 0N1Tc • CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 054245 MINER'S NAME: SCHOCK, S JAY ADDRESS: SCHOCKCATHERINE PERMIT NO: B 054245 PLAN CHECK NO: 02364-91 A GOVT; N SUPP: N • 263 E 23RD ST lbr. • ' COSTA MESA,CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ADD ARCHIENGINEER: (714 )64 5-1276 flEC.NO,: ALEC OSACHOFF Nom F.. JOB DESCRIPTION : 1ST 6 2ND FLOOR ADDITIONS SQ FT: 2,077 ADDRESS: 42 MIRADOR • IRVINE CA 92715 CLAIM VALUE: CALC—VALUE: 143, 313 .00 GROUP OCC: R-3 / PERMITTEE: JAY SCHOCK ( 714 )645-1276 ADDRESS: 263 23RD ST COMMENTS. INCLUDES FAM RM DINING 6 LAUNDRY, COSTA MESA CA 92627 ********R� •****�r�E�t****�F�t�t�tlt�E+r�Pr�E�t�r+Esr** trot+E�t�r4+t**+t***+E*******+e******************* LICENSED CONTRACTOR DECLARATION: I hereby attirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIREMENTS 700010/Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby atlirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT: 23 FT 6 IN REAR: 5 FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: 5 FT IN RGHT: 15 FT 10 IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• 2 PROV; 3 PARCEL : 42608404 ZNE: R1 REF NO: ❑ Certified copy ishereby turnished, ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> PROPOSED 1 , 566Sp FT, ADDITION TO EXISTING FIRST AND SECOND li > FLOOR OF AN EXISTING S, F, INCLUDING T. I . rte. - Applicant:'- ******************************************************************************* EMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section emit be completed it the perm:is lou one hundred(5100)or less). D E V E 'L O P_ M E N T SERVICES R E Q U I R E M E N -T S certify that in the performance of the work for which this permit is issued.I shalt not employ any person in any manner so as to become - sublect to the workers Compensation Laws al California. ZONING APPROVED BY 1 DATE: 10. �—I`1 \ Date: Signature: NOTICE:If,atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; .•' DATE: Code.you must fonhwith comply with such provisions or this permit shag be deemed revoked. - q� CONSTRUCTION LENDING AGENCY: I hereby atlirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED .B Y ' - . \/•A p - �J H DATE• O Z which this permit is issued(Section 3097.Gist.C). ***************************************** * *********************** * ** al*** LENDER: INCLUDES 2 BD RMS, 1 MAST ******************************************************************************* ADDRESS: BD RM 6 BATH, KITCHEN LEGALIZATION:N F E E -S U M M A. R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the 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 79 3 , 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 14 . 33 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)nl Division 3 of the Business • SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 128 . 95 any applicant for a permit subjects the applicant to a CMI penalty of not more than live hundred dollars($500). ISSUE FEE • - I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 807. 83 0, 00 • 12 8 , 9 5936 .78 936 . 78 . 00 does not apply to an owner of a property who builds or improves thereon,and who does suchwork himselUhersell or through - - .. •M ,� his or her own employees,provided that such improvements are not intended or offered for sale.II,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 807 . 83 OVER/SHORT: . 00 8 for the purpose ol 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(S•Mien 7044.Business 793. 50 14 33 and Professions Code: The Contractors'State License Law does not apply to an owner of property •• or improves(hereon and who contracts for such projects With acontractor(s)license pursuant to the CO r or5'Sl f e•se Law).l am aware *******{E***************************'************************************.*{E****** that proof of their Worker's Compensation insurance should be provided to me. " J INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B. E.P.C. -- tor hreason: / /TYPE QTY DESCRIPTIO Nf , UNIT COST TOTAL COST Date: Zp Gpt C / owner: '/ / I I Ido hereby certify that I am aware of and understand the requirementsof Cablorns Heal, and Safety Code Sections 25505,25533,and SFR 2077 DWE—TYPE. V—WOOD FRAME -GOOD 69 . 00 143, 313 ,00 25534 and that I or any future building occupant wi:Owi7 not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the An uality Management District.Residential construction applications are exempt from • these prowsiMls . Date Applicant: ' } I hereby certify that I have read this application acid state that the above inlor i i5 r real f 4'ar comply with au city and coo ty - ordinancesand state laws relating to building rng6tnuction and hereby auOprim to res rf city r.�u•u the above-menti ed l•` Date. fo7�sspe�iui',/pur ll// ' • ._ 1nsper • / _ Date. Signature: Driver's License or Social Security ii: - ' . . 16at.46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor . -f CONT.TRUCTION AND PLANNING 4110 POOL Fig. i 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 �4'I Electrh&l,'Coi uyt Utility-Undrgrnd. `_ `54. Forms • • L.." (Elleetticel Condrt uit•Udrgrnd. i: :-$5. Electrical Bonding :5: Stee ROle&cerEieni 7/30 2, 0 ie Z 56. Rough Plumbing & Pressure Test. ?6 e.EIHcUieal_UF• ER:Grntf. ( [7 ..". 7. APPROVAL TO COVER-GUNITE _• _ ``7S Fdotqs= i 7 il�9a.D(¢ r 18. Electrical Conduit-Undrgrnd. 8. Foundation ' 69. Gas Pipe, 0 Undrgrnd.,Test 9.'Water Pipe-Undrgrnd. ? .60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System -1/30/12,- e e _n-61. APPROVAL TO DECK 11. Property Sewer Linr& House Connection rl x 62. Backwash & Receptor-Final • G at S 1 12. Sewer Cap `,. , y ,• 63. Heater & Vent-Final -13. Roof Drains% ' 64. Plumbing System - Final 14. Rough Plumbing, 65. Electrical-Final - 15. Rough EI ctricat-Conduit 66. Solar System-Final c 16. Rough Eactric'Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING e 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - .r --+UJ art l; I 20.�`Rou-h Facto Fireplace I '-t.1-1 2 i• 0 :J _aa k .APPROVAt:SJ:%7erhnit # * r r it. G7 �' : tr u:e a .t -, r:, r , x U:-'- y z ,- ,y r . re , a s d ?_ n t rn 21..Duts s, in_Str cture '.. .. ,S t 5 7 ,- 70. Underground_Hyaio r. l : • 22.•Ducte, Ventil Cting; "•'-.1`5, r D �, s .; y .71. Product ;`ping �s ❑Oil L r�. `23.i'%asFipellough &Test n T ` 'J2. Under Ln .T S •. 'r ground Fluih�� . ,•; - _ t 5 - _ 24.'Root Framing- �. Y .r ,S JY f< 73:4Jndergrnd'.Storage?lank ®Gas 0 Oil 25. Rooj,Shq,athing '.t. + , IL 'U• -r 74. Qverhlgad liydro;' r 26.fT-Bar Ceilin (Structural) &.Monocoat c r rI. v t'1't -* 75. ry Chemical - * - 27. ragje arid Flashing', »,r -'r 4.t/,/C7L jOG ; 76.(-9y Sfancjpte W ,� 'n ra 7 .28 l// !! 1 Letting Siding'= �:t'r ua/ �• 1.2- &C4 _i 77..._"FIXED SYS'EM�F1NALr " -� 54; . , .Thr9 syr 1 .� 29. Insulation S ., ( t" gyp1 i, a 78,>fIRE PREY. FIffjA,� .. .r, t!.30. DrywallNailing - - . /-q 4, T 4, 6 -c. HEALTHOEPT.R-EQUIREMENT •_31. Plaster Bfown.Coatw_ , t rr = w 70.(013jLf�' t. . ,79." INAL INS! v 7- J CTIQN - 1 tI ,32 .cElectricarPov er MetenFinal , • ._ �, •T L' I e . ?80.?FOOD CERT LATE ISSUED 33.`1 incl Ele�tri , c J,r r ,-, . •_- n r /� /y S. :.5,' S .t ' Y I tit . Nos: to ll.; .t..4-..M.t.! :'r Fpi.r.a l�v.m_0151- z134.,-Final Hewing& Ak'd rtditionjgg5 % /^, r;/ rn I. n , 1 r •• l •_ �. � O1/ s �35.(Tina! Gas1PiPE-Test� fzJ :Et • v t't �� 06.• Hood oreanopy z. t n -_ a - ffl / ,/ / ( rT 14 37.'.Fina1'Factory Firepacez 1 :sr'. 'camr a: r38.eEinahPlumbing 7 •�v a. \ . • { - . --or « �CJ� 3 e39.=Watdi Service-Final• a b. c I b - 0 D v ,r, -, 0.•Gas Service-Final .rr. --•;n 41/4 •_, � r , .r - ''41.-Solar Domestic-Final S •tt- - 42.`Backflow Preventer, - 1,.:,:), �S re - I • p r z ?-~ • O •- 43. Backflow Irrigation:. . T.SS ^ ♦ ! t . rte = - • • r Y u• r rr .t s .0 i ;,44. Landscape Irrigation System -r ) •,g,c; ,r 1) ;� C?• +: ,r N v a i:,. +' ,& -0 7r45.Sound Attenuation's .g,- ' - ' .. •r -r X t'I 1-+ ,r•G 174'5 7 1 rr a - . „ t to it n.. i .. C"-Cr at • t - .t 'S46.•.Handicap,Regplations '� tiDS y n • 4- -.- - - > 472fINALSTRUCTURE & BUILDING / ;49e-L :r• ' . ill.-a _ ms:: 48: 1N4 PLANNING j r,_ 1Q ', „ W. , "q 1 y it c c49.cEle tric Release to Edison , S I k s' x 1 •-. ,t. 50.,Gas release to Southern California Gas Co .;'. i I 1 LI r ; S ,. y - o r, .0 751. CERTIFICATEOF'OCCUPANCY - no ?C + No. Date 4110 410 CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT Developer/Applicant : l Je J A /�G/o Cie Address : Z6i U/ /�ZJ)2� ✓ t c, 711 Telephone Number : % 1)C /z70 Tract/Parcel and Lot Number(s) : / �L Location of Project : 2c3 2 �J ne/ 57/ ( OS%�� Number of Square Feet of // /��` Residential Space �. 6 x $1 . 50 Total' o2/,5 /7 7, 0 0 Number of Square Feet of Commercial and Industrial Space x $0. 25 Total Commercial/Industrial Project is : (Check One) Mini-storage Motel Preschool Movie Theater Bank Auto Repair Racquet/Health Neighborhood Shops Hospital . Warehouses R & D Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office _ Restaurant Light Industrial Office Park Fast Food The provisions of Government Code Section 53080 are not applicable . This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be made payable to Newport-Mesa Unified School District . Business Manager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/ Applicant agrees that if it is later determines th. t such representa- tions are not true then this certificate sf: ll au /omatically terminate and the appropriate City/County shall be Vti ' iea Date : 20c-/ 97 ke Dev: oll• r/Appl ' ant J FINAL GRADING CERTIFICATION . Project Address: Y�f2 6 3 2 3 .14-. Lot Number: (iti 3Ly 1.YI k g 4 trot. k )4,5JJf Permit Number: 0 -5—("/ 2-Lit 3 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 shown on the recorded tract map were set. All final grading eleva- tions are within ± 1/10 of th designed elevations. Supervising Civil Enginee i.-^- `�--- Reg. No. (Signature) • Date ' r 'at? BOURSOMMia SN‘ CD use cc No. 31 i`3 J\CIVIL Q/ 9lfOfCikitc STAMP and SIGN 1691-46 • • • INSULATION CERTIFICATION This is to certify that, in conformance with the current energy regulations (California Administrative Code, Title 25, Statr of California') and approved plans, insulation has been installed in the building located at: • Citycounty • Nn. (1/{lvailaUla) Sunni Lot Number • Tract No. DESCRIPTION OF INSTALLATION ROOFS Type of Material __ Manulacturer Thickness R Value'• • EXTERIOR WALK �� %%////�� //////// / e of Material /9 type Manufacturer "2(4 �2 �G_E2-i Thickness O/R Value" / fyp . ��___�_ / (Or Trade Name) CEILINGS }IATTS: Type of Material Manufacturer Thickness R Value•• _ (Or Trade Name) Sq. Ft.Covered • BLOWN: • Type of Material Manufacturer Thickness _ _ No. Begs (Or Trade Name) Wt./Bag __._.. __--_ Sq. it.Covered _ It Valle" __ f•LOORS Type of Material Manufacturer Thickness R Value'• _ (Or Trade Nemo) SLAB ON GRADE Typo al Material _._.__"..._.....Manufacturer Thickness R Value'' (Os Trade Nemo) • Width of Insulation Inches FOUNDATION WALLS (if requires)) Typo of Material _ _ Manufacturer Thickness R Value" —War J liffee Name) �/ REMARKS (if desired) ��ar al. —.C2,,y2S (tonere' Contractor (Builder) " • License Number — Title Dale gub-Contractor(Insulation Applicator) }3 V RGY CONTROL INSULATION INC. License Number 409822 Insulation, Masonry, Etc.) (State"SAME" If same as General Contractor) 9v N,idaanL_FL._5 llivan Title President Date 9- 77-Q,� California Administrative Code, Energy Insulation Standards, declares: EXCERPT from Sec. 19876 of the Health and Safety Code of the ornpllance. Upon comoleslon of the Installation of Insulation, a card of California: rtilying that the Insulation has been installed In conformance with the • quframe nu of these regulations shall be completed and executed by . "No certificate of occupancy or similar certification that a .e insulation applicator end by the builder. This insulation compliance strutted hotel, motel, apartment house, home or other resit ud shall be posted at a conspicuous location within the dwelling.') dwelling Is habitable shall be issued by such a building depar unless the structure at least satisfies the minimum energy insu •'R Value is the measure of the resistance of a material or building standards established pursuant to this chapter." lmponent to the passage of heat. The resistance value (R) of mess type ssulatlons shelf-Trot Include any value for reflective facing.) e9 CITY OF COSTA MESA , CAUFORNIA 92620 P.O. BOX 1200 J• F 41' DEVELOPMENT SERVICES DEPARTMENT ejalte lAugust 19, 1983 Re: 263 East 23rd Street To Whom It May Concern: I visited the above address to determine if any illegal additions or conversions were done since the original construction of a single family residence. The original permi.t, 'number 31671 issued under jurisdiction of the County of Orange in 1950, showed a 789 square foot dwelling. The total area of the dwelling at the present time matches that shown on the permit application. No additions or conversions appear to have been made since the dwelling was originally constructed. If I can be of further assistance, feel free to call at 754-5293. Sincerely, 4(1.14k. Cloud Chief Inspector - Structural WEC:ld • • Code Enforcement/Business License (714) 754-5234 Building Division (714) 754-5626 Planning Division (714) 754-5245 77 FAIR DRIVE :9 CITY OFpCOSTA MESA *IX CAUPORNIA 920P.O. BOX 1200 FI • ..A V•41._ DEVELOPMENT SERVICES DEPARTMENT o • db August 19, 1983 Re:\, 263 Fast 23rd Street 'lb Mau It May Concern: I visited the above address to determine if any illegal additions or conversions were done since the original construction of a single family residence. The original permit, 'nlmlber 31671 issued under jurisdiction of the County of Orange in 1950, showed a 789 square foot dwelling. The total area of the dwelling at the present time matches that shown on the permit application. No additions or conversions appear to have been made since the dwelling was originally constructed. If I can be of further assistance, feel free to call at 754-5293. Sincerely, • • �Ja17.ace Cl Chief Inspector - Structural WEC:ld • • Code Enforcement/Business License (714) 754-5234 Building Division (714) 754-5626 Planning Division (714) 754-5245 77 FAIR DRIVE . COUNTY OF ORANGE --- BUILDING DEPT. ...>„ „............<.....e.e— Permit No..3.2410...i/._ 636 No. Broadway Application for Building Permit . Santa Ana, California Phone: KI 2-6211 AND FOR A Certificate of Use and Occupancy Date..O.C.M.0 1e 1 0.„153__S-0 I. OWNER'S NAME Pitt 1.--5.-/-1/4 t-3„0 C. 15 0 -c it, PHONE: Ba 6.6484 MAILING ADDRESS Sot i,e,,%/..1 t•-)a _Atic. CITY hiEkta_Po R-1-- 15 Ca C-,H Name . 11/4-3.0.1s4.C... Name______NA.1 t-,-.3,-_,MR_O_____C So"-C CD (Architect or Engineer) (Contractor) Address Address - CityCity ."-- State State Lic. No. Phone t/ Lic. No..10.0_ _ c. / Phone Se_ (..age...1 PROPOSED USE: 1:::).W C.- 1.-t-I hi C.- 2. JOB LOCATION.- 2-G 47 - E . 23 €1? --i--; Ca.5--t-a. 1"-1 (House No.) (Name of Stre (Town or School District) 3. LEGAL DESCRIPTION: Lot (Metes and Bounds Description—Use reserse side of form) .....-•••••www.......w.... -- 4. CORNER LOT ( ) INTERIOR LOT ( 71.., ) THROUGH LOT ( ) SLOPE OF LOT ( ) Lav Ei... 5. SIZE OF BLDG.:4,s- Zs AREA:_78 9._s).!__ __SIZE OF LOT:.57.5:X_I-3 S- AREA: .7.4-2..C.0 6. 'HEIGHT OF BLDG.: ..1______________.7......________.CEILING HEIGHT: e --3- I-1 ,.0. AV-NO OF STORIES otos,. 7. NO. FAMILIES- 0"a Size of Smallest Bedroom- ----1 1..• a' Size of Kitchen: 1 0 t cs• 8. EXTERIOR WALL CONSTRUCTION: ERA rti.C. INTERIOR WALL COVERING ..0f3.‘•(-- WA L(— (Frame, Stucco, Etc.) (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard from Center Line of Street •r-S-14-•... Nearest Side Yard 5 4 Rear Yard am ' Distance in Feet Between Bldgs. on Same Lot W. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 11. For (a) Footing: Width Depth in Ground Width of Wall Accessory Bldgs. and (b) Size of Studs:. Spacing lilf _ i4 - ' • loor Similar Si. Structures: (c) Size of Floor Joists: 'pacing "CC (d) Size of Rafter Spacing "CC 12. VALUATION OF PROPOSED WORK: Including alll00 ab r, plumbing, electrical wiring, heating, fire sprinklers, paint- ing and sewage disposal 13. I HEREBY CERTIFY THAT TO THE BEST. OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. o -...°:,..-- Signed: .0-.-. % irl=ry.se Plans Filed- ../.__ 5--C) (Owner) By. • \ (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: CHE I G BY Bldg. Permit $ /0 00 GROUP ,....t"..6...2,..1 -- APPLICATIO EALTH / - E.= TYPE ZONINGSeckilIRE Plan Check - $ ...‘ Total - - - $ on .....,,C-4g DIST. &re/ SHAL --••• MAP PLANS Ay (1)......---MAR Receipt No. - - SPECS .. STATE Paid to - - SHEET NO 4%r CORRECTIONS ENGINEER Date VERIFIED CAL PERMIT ISSUED BY: DATE /0 ... / 3 '" V a I C. W. 10 OHUE COUNTYSBUILDIN ING= t PECTOR $ti•z.,.., 5M-7-50 I ter ' .0.1 DEPUTY k( ....—_,, . d _.., M$TES AND BOUNDS DESCRIPTlI._ ,: uF A1oin-iau'I=STF'(e . SST F r-t orn-Is. - Sou-rHPA5TFR1 "-1 4-&o.3 Fre-1M of I- oT 324-. of NEW PofT NF 1roHT5AS YE2 MHP 7-1-4Ee S.OF RM-o le 0 a A f.) F=5 001c ¢ I P/-\eE. 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