HomeMy WebLinkAbout723 WILSON ST - Building Permits(714) 754-5273 • Faz (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
JobAddress: 723 W WILSON ST
Suite:
Vicinity: WHOLE HOUSE
Parcel Number: 422a0102
npplicant: CORNELL, ROBERT
Address: 135 W SANTA FE AVE.
FUL4ERTON,CA
ownec TERICH, MICHAEL F SR
Address 17398 SANTA LUCIA
FOUNTAIN VALLEY, CA
Contracror ROYAL ROOFWG
Address: 135 W SANTA FE AVE.
PULLERTON,CA
Zip: 92632
Arch :
Address:
Zoning:
ISSUED BY:
Phone: (800) 400-7692
Zip: 92632
Status: ISSUED
Applied� 05/16/2000
Issued: 05/1 fi/2000
Phone: ���
ZiP: 92��8 ��4
g�o
Op''SF'
Phone: (800) 400-7692
License: 432352
Eng.
Address:
Phone:
Phone:
Zip: License: License: .
SCOPE OF PERMIT
REROOF EXISTING SINGLE FAMILY RESIDENCE (10 SQ). TEAR OFF EXISTING ROOFING, INSTALL 1 LAYER OF 30#
FELT UNDERLAYMENT, & REROOF WITH 20 YR. FIBERGLASS SHINGLES.
Plan Check: $0.00
Permit: $47.90
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $48.40
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Existin : 0
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEESUMMARY
PLANNING & ZONING
Lek 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuatio�:
Right 0- 0
Right 0- 0
$1,250.00
$1,250.00
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or i( 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 Inspectione and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION:
I hereby alfirm untler penalry oi perjury one oi the toliowing tleclarations:
❑ I have end will mainlain a certificate ot conseN to selt-Insura for workers' compensa�ion, es providetl for by section 3700 of ihe Lebor Code, for the pedormance of the
work tor which this Dermit is issuetl. �
� I hava and will maintain workers' compensation insurance, as required by section 3700 of Ihe Labor Code, for the peAoimance of the work for which this permit is issued.
My workers(' c`om�ens�a�ion/ Insurencre carner end policy number ere: 'I1 /
Cerrier. �' —" „"'� V � �Ns � � � Policy Number W G �� S 3 �GZ %S
(This sectlon need not be comp/efed q fhe permit Is velued et one hundred dollers ($100) or less.)
❑ I cetlify ihal in lhe peAormance of lhe worJc,for which ihis permit is issued, I shall nol employ any person in eny manner so as to become sublect to Ihe workers'
compansation laws of Califo� , a�gr 4 fiat it I shoultl become subject ro the workers' compensation provisions of Section 3700 of ihe Labor Cotle, I shall forthwith
comply with Ihese provisi ds.
ApplicaN Signature: Date: S � �6 "�b
WARNING FAILURE TO SECU W KERS' COMPENSATION COVERNGE IS UNLAWFUL AND SHALL SUBJECi AN EMPLOVER TO CRIMINAL PENqLTIES ANO CIVIL FWES UP TOONE HUNDRED
THOUSANDDOLLARE(5100, ),IN DDITIONTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEDFORINSECTION3]060FTHELABORCADE,INTEFiEST,ANDATTORNEV'SFEES.
LICENSEO CONTRACTORS DECLARATION:
I here6y attirm ihat I am license under provisic
force end eHect. Lia k �
Comractor's Signature:
CONSTRUCTION LENDING AGENCV:
oi Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business antl Professions Code, and my license is in full
Class a G-'37
//ol , Date: S %G^O�
❑ I hereby attirm that there is a constmction lentling egency for iha pertormance of ihe work for which this permit is issued. (Sec. 3097, Civii Cotle).
Lentler's Neme: Lentler's Atltlress:
Signature:
Date:
I here6y attirm thef�unBer penelry ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Businass and Protessions
Code: Any ciry or coun'ry whicti.requires a permit ro conswct, alter, improve, demolish, or repair any strucNre, prior to its issuance, also requires ihe applicant for such permit
ro file a signed stetemen� ihat he�or.she is licensetl pursuani to the provisions ot ihe Coniracrors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe
Business ana Professions Cotla) br ihat tia or she is exempt lherefrom end Ihe basis tor Ihe ellegetl exemption. Any vlolation oi Section 7031.5 by eny applicant for a permii
subjects the applicant to e civll penalry oi not more than Nve hundred dollare ($500).): ,
❑ I, as owner ot the property, �or �my amployees with wages as iheir sole compensation, WILL DO TME WORK, antl the stmcture is not intended or oHered for sale (Sec.
7044, Business and Professions Cotle: The Contrectors License Law tloes not apply to an owner of property who builds or improves ihereon, and who does such work
himseli or herself or Ihrough his or her own employees, provided ihat such improvemenis are not iniendetl or oHered tor sale. If, however, the huilding or improvament is
soltl within one year ot comple�ion, the owner-builtler will have the burden of proving that he or she tlitl not build or improve tor purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The contrectors License Law tloes not app�y to en owner of property who builds or improves ihereon, end who contracts for such project with a contrador(s)
license pursuant to ihe Coniractors License Laws.).
❑ I am exempt under sec. Business and Professions Cotle for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Ezpires:
Venfication of Ownership by (type of dxument, i.e. - pmperty tax bill or deetl):
DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIiICAT10N:
❑ I hereby certify thet no excavation tive (5) or more feet in tlepth into which e person is requiretl to tlescentl, will be matle in connection with work authonzetl by ihis
pertnit, antl that no building strucNre, scatloldinq, falsework, or tlemolition or tlismantling thereof, wiil �e more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
347, Title 8, California Administrative Code).
❑ As owner�builtler, I wili not employ anyone to do work which would require a permit trom the Division of Industrial Safety, as no[etl above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safery Permit Number:
CERTFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENiAV: I cenify under penalry of perjury that I have read this application and state that the information givan is
correcL 1 agree to comply wit� all state laws and ciry ordinances relating to building consWction, and authorize representatives of the Ciry of Costa Mesa to amer upon ihe
above-tlescribed property tor inspection purposes. I agree not to occupy or allow occupancy ot any building authorized by ihis permit until iinal inspection.
0 t.
1616
7266
200
Fixed System Final Fire Prevention
Pool Spa Final
Final Re-Roof
201 Final BIxWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
2448-06
pgTE IN7
COOE� INSPELTIONTYGE
206 Final Mechanical
208 Final Plum6ing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Siie
250 Final Builtling/Occupancy
s-P�-�o
Date
ATE MTRIaLS
�
�
PHOJECT AUDflE55: % 2 3 W W I LSON 5 T
OWNEH'SNRME: TERZCH, MICHAEL
aooaess: TERICH, MELINDA
SAME
APCHIENGINEEfl:
AOOXESS:
PFG.NO.:
UNIT: B
UNIT:
PEXMITTEE: L.M. SCHUETZ PLUMBIP7G (719)761-5347
aooxess: 5 7 71 ORANG E
CYPRESS CA 90630
UCENSEO CONTPRCTOP OECLAflATION: I hereby affirm that I am IicenSeA untler pmvisions of Chap�er 9(commencing wilh Sec�ion
7000) oi Oivision 3 0l ��e Business antl Prolessions Cotle. and my license is in tull torce anA e��eci.
CITYLIC.: 1S[TATEUC.:S7�IS9% c �s:C036 E-P�, e�
Da�e'. �� � � � � T Signai re: �n���� �L
wOXNEHS' COMPENSATION oEClA8FTI0N: I hereby afhrm that I have a cenificate oi consent m self-insure or a c n icare ol Workers'
Compensation Insurance, or a certilietl coDY �hereol (Section 3800. Lab. C�.
POLICY NO.: E%P. �ATE:
COMPANY:
S] Cetli�iea coDY is �ereby �umi5he0. ❑ Ceni�ietl copY is filetl with �he ciry BuilAing Division.
Da�e: Applicant:
E%EMPTION FBOM WOHREflS' COMPENSATION DECLAflFTION: (This section need not he campleletl il ihe permit is for one hunAred ($100) or less).
I cetlify �hal m the pedormance o� Ihe wark lor which this permit i sued. I shall no� employ any person in any manner so 5 �0 6ecome
su�iea� �o t�e Workers' Compe ation Laws of Califomi • R' ��^ /
oaie ►� ��— 9� ix ` e:'� l.�
Signat J �-L L,—,
NOTICE: If. afler making Ihis Ueclaration, you should Oe ome sub�ec� m �he Workers' ComOansation pmvisions of abor
Code. you must lotlhwi�h comply with suc� Dmvisions or ��is permi� shall he Oeemetl revaketl.
CONSTFUC710N 1EN01NG pGENCV: I hereby atfum ihat there is a constmction lending agency for t�e pedormance ol the work for
w�ich Ihis permii is issuetl (Seciion 3097, Civ. C�.
LENUEfl:
nooness:
OWNEfl BUILDEB UECLAXR710N: I hereby aifirm ihat I am exempt from the Cantracmrs' State License law lor the I011awinA �eason
(Seclion 70.11.5 BuSiness and Pwlessional Code: Any city o� cowry w�ich reQuires a Dermit to constmci. alier, improve, tlemolish, or
'. repair any Slmtlure. prior to iis i55uante. also reQuireS Ihe apDlitan� for such permi� t0 �ile a Signed Slaiement �hai helshe i5 Iiten5e0
pursuant to ihe D�ovisions ol Ihe Comracmrs' S�ale License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the Business
and Pmfessions Cotle) o� �hal he/s�e is exemp� �herelmm antl ��e basis lor the allegeU exemp�ion. Fny violaiion o� Section 7031.5 Dy
any applican� for a Oermii subjects the applican� to a civil penalry o� not more Ihan five huntlretl aollars (E500�.
I. as owner ol Ihe property or my employees wi�h wages as their sole compensa�ion, will do �Ae waM, antl lhe
❑ simcmre is noi intentlea or oilered for sale (Seclion 7044. Business and Pmiessional CoOe: T�e Coniracmrs' State License Law
tloes no� apply �o an owner ol a propetly who 6w1d5 or impmves Ihereon, and wha Ooes such work �imsell/her5el� o� �hrough
his or Aer own employees. D�ovidetl that such impmvements are not intentletl or oflere0 for sale. If, however the builAing or
improvemenl is soltl wit�in one year o� comple�ion. �he owner will have �he burtlen af pmvinA he/she tlitl nol builtl or impmve
� for Ihe purpose ol sale).
� I, as owner of ihe propeny, am exclusively conVac�ing wiih Iicen5e0 con�mctors to cons�mc� �he pmjec� (Section 7044, Business
❑ antl Pmfessions CoOe: The ConVacmrs' Siale License Law tlaes not apply to an owner ot property who builUs or improves �hereon
and w�a conirac�s for such prolecis with a conlractor(5) license pursuant to Ihe Conlrac�ors' S�a�e License Law�. I am aware
Iha� pmo� oi Iheir WOBer'S Compensation insuronce shauld be pmvided �o me
� I am exemp� untler Seciion�, B. 6 P. C.
for Ihis reason'.
Oale'. Ownec
I tlo hereby retlify Ihat I am aware oi an0 untlerstana Ihe requiremen�s of Califomia Health and Satery Code Sec�ions 25505, 25533, and
2553C antl thal I or any lu�ure builtling occupant will/will noi (circle one) nee0 �o comD�Y wi�h SaiA s�a�e cotles and the repuiremenis lo� a
permit lor conslmction or mo0ilicaiion Imm �he Fir Oualily Management Dis�rim. Residential consimdion apDlica�ions are e�empi imm
I�ese prOvisions.
Oate: ApplicanL
I nereby ceridy Ihai i have reaA t�is apPlicalion anA s�a�etha� Ihe aboveintorma�ionis correcl. lagreeto camply wilh all ciiy an0
artlinance5antl5�alelawSBlalingtobuildingcons�mctionantlherebya or@erepreSenlative5otihiscirytoen ruDontheabove-me
pmperly lor inspect�ionj pu�Doses. �
�a�e: / D '� `'i — � � Signatur .
Driver�s ticense or Socia� Securiiy a: �
�6<n46 Whne—Builtling: Green—CoCe Enlorcemen�; Canary—Applicant; Pink—Revenue; GalEenrotl—Assessor
CITY OF COSTA MESA — HUILBING PERMIT PERM NO: P 069115
PERMIT NO: P 069115 PLAN CHECFC NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; PLU PURPOSE: REP
JOB DESCRIPTION ; WATER REPIPE & NEW idATER SERL�ICE SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP QCC; /
COMMENTS: NO OTHER WORK AUTHORIZED BY TFIIS PERMIT
**��r**+�***+�**+�+�*�r*�*�***�x�***+����rx**�r���*��+�***r�**�**�*+�*�****�***��***���*���
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN bUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAA; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REt�; PROV; PARCEL: 42240102 ZNE: REF NC�;
PLANNING NOTES>
i
�r�r�r**�r*�rx*��r��rx�**+�xx�*�rx�r*��r�r**xx*�r�*�**��*��*x��r+r�r�r�*�r�r��r*�***x*+���r�r*�**+�**ux�**
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROC�ED BY DATE;
BUILDING APPROVED BY : pATE:
APPLICATION I5SUE➢ BY; �S� DATE: `0��1 �a�
jEiF�E1Eil3FifiEiE3fiEiE�F3EifiEiEiFiEIFiFitititiFifiElEififitiEiEifiFiFiEiFiFiFiP�EY.-4 Eii�iE iFif�itiElEiEitifiFiF#�iEitiFifiE#EaFiEifiEiFkjE?fiE
if if iE iE iE if iE iE iE iE iE it-iE iE iE fE iE 1F i! iE iE !E!E iE fF 1E if 1Elf if if �It if i(� if ff 1f ff !E iE iE 3E ic iF iF 3E iE ic 3E iE iE it iE iE ik if iF if iE if �1F if fE iE iE if ik �lE iE ih jE iE iE IE iE jE if if iE
LEGALIZATION;N F E E S U M M A R Y STRUCTUAAL SEGMENT:N
.�
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 14.00
252 SMIP/NON—RES
PLAN
ISSUE FEE 20,00
BUILDING—DIV—> PERMIT ISSUE PLAN-CHECX TOTAL PAID DUE
TOTALS----> 14,00 20.00 0.00 34.0/0 34.00 .00
REVENUE DIVISION O A --> `
T T L5 COLLECTED; 34,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
34.00
1E iE if if iF iE iE iE iE iE iE 1E iE iE iF iE iF �)E iE iF i6 iE iE iE if i! iF iE iE iE iE if iE it iE iE i' iE if 3f 3E if �E iE iE �E jE it if iE iP 9F 1t �f iE if �f iE iF iE iE iE if dE it if if ie if iE 9f iE iE 9E aE iE iF �f 3E
I N D I V I D U A L ' F E E B R E A K D t� W N
TYPE QTY D E S C R I P T I O N ONIT COST TOTAL COST
PLU 1 WATER SERVICE 7,00 7,00
PLU 1 WATER RE—PIPE 7,00 7,00
END OF FEES
34.00
at aoiEss??-uoibsse2 rr� T
DATE: 10/Q�/94 TIi?E: 11:37
CONSTRUCTION ANDPLANNING POOL ?A
APPROVALS Permit #�_ Date i inspector qppROVAIS Permit # Date Inspector
L Temporary Electricai Service or Po1e 52. Pool & Equipment �ocation -
Z. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Elactrical Conduit Utility-Undrgmd. 54. Forms
4. Elecirical COndait-Undrg; nd . 55. Electrical 8onding !
5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Test �
6. E�ectrical UFER Gmd. 57. APPROVAI TQ COVER�GUNITE �
7. Footings � 58. Electrical ConduiFUndrgrnd. - i
8. Foundation 59. Gas Pipe, Q Undrgmd., Test i
9. Vdater Pipe-Undrgmd. 60. Backwash Lines, P�Trap, O Undryrnd. ,
I
70. Svuc:ural Kloor System 67. APPROVAL TO DECK ;
7 t. Prope�ty Sewer Line & House Connection 62. Backwash & Receptor-Final
�
12. Sewer Cap 63. Heater & Vent-Final
i 3. Roof Drains 64. Plumbing System - Finai !
74. Rough Piumbing � � 65. Electrical�Final
15. Rough Electrica6Conduit ' 66. Solar SYstem�Final
76. Rough E�ectric Wiring 67. Fenein9 & Access Approval I
17. Rough Wiring Siyn 68. APPROVED POR PLASTERING i
,
18. Rough Eleczrical�T Bar Ceilin9 69. POOUSPA SYSTEPoiS FINAI '
19. Rouyh Neat�ng & Air Conditioning FIRE DEPT. REQU�REMENT
i
20. RouynFac:ory'rirep!ace APPROVALS Permit# �
27. Duc,s,in Sttucture 70. Underground Hydra �
22. Ducts, Ver,tilating 71. Product Piping O G�s ❑ Oii
23. Gas Pipe�Rdugh & Test 72. Underground Flush
2A. Roof Framing 73. Underyrnd. Storaye Tank O Gas ❑ Oi;
25. Roo` Sheathing 74. Overhead Hydro I
26. 7�8ar Ceiling IStructural} & Monocoat 75. Dry Chemical �
27. Frame and Flashing 76. Dry Standpipe �
28. La.hing & 5iding 77. FIXED SYSTEM FINAL
29. Insu(ation 78. FIRE PREV. FINAI
30. 6rytvall Nailing . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coa: 79. PINAL INSPECTION
i
32. Electrical P�wer Meter-Finai 80. FOOD CERTIFICATE ISSUED
33. Finai Electr�c Notes �
34. Finai Heatir�g & Air Conditioning �O ^�
-14..-1-`�--�'�.�+.�-- - -
35_ Pinal Gas Pipe�Test
36. Hood or Gnopv � �
37. Final FactorY Fireplace . i
38. Final Plumb��g
39. Water Service-Final
40. Gas Service-Pinal
47. Soiar pomestic-Final
i
42. Backfiow P�eventer
43. Backflow Irrigation �
4A. Landscape irrigation System
45. Sound Aitsnuation
46. Handicap Re4ulations !
d7. FINAL STFIUC7URE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern Califomia Gas Co
57. CERTIFICATE OF OCCUPANCY
No. Date
�
�
PHOJECTAUUflESS: %23 T^1 WILSON jT
OWNEX'SNAME: TERICH, MICHAEL
aooxess: TEAICH, MELINDA
SAME
FflCHIENGINEEfl:
AOOPE55:
HEG.NO.:
uxiT: A
UNIT:
PENMITTEE: L,M, SCHUETZ PLUMBING (714)761-5347
aooeess: 5 7 71 ORAN G E
CYPRESS CA 90630
UCENSEO CONTflRCTOfl DECNBATION: I �ereCy aflirm �Aal I am Iicense0 un0er pmvisions o� Chapter 9(commencing with Section
7000� ol �ivision 3 0l the Business antl Pmtessions CoOe, ana my license is in lull force antl etlect.
cirv uc.: qTATE LIC.: S9 4 5 9� ��C 0� X�; .�[
oaie: ! F� ' y— Q�� Si naNre: �"� 1 � � � ���
WONREHS' COMPENSRTION OECLABATION: I hereby aliirm Ihat I �ave a cenificate of consen� to sel4insure or a cehific o� Workers'
Compensalion Insurance, or a certilietl copy t�ereol �Seciion 3800. Lab. C).
POLICY NO.: EXP. UATE:
COMPANY:
❑ Ceni�iea coDY is hereby fumishe0. ❑ Cehi�ietl copy is liled wi�h the ciry Building Division.
Date� ADPlicant.
E%EMPTION fROM WOXREPS'LOMPENSATION OECLANPTION: (7hissection neeA not�ecampletetliithe permitisfaronehunare4�E100�arless�.
I cetlify Ihat in Ihe petlormance oi Ihe woB for which ihis permit is issued, I shall not employ any person in a y manne� 5� as �o become
Subleci Io Ihe 'Wa/rkers' Compansaiion Laws ol Calltomla � �
�ate� "N � 9 � SignaWre: -D�e— L
NOTICE: Ii. alter making Ihis tleclara�ion, y0u ShoUld ecome SubleCt Io ��e Workers' Compen5a[ion O�o�isions ¢ Labor
Code. you musl �anhwi�h com0ly wi�h suc� pmvisions or �his Dermit shall be tleemed revoke0.
� CONSTflOCTION LENOING pGENCY: I here6y alfirm that there is a cons�mction lending agency for �he pedormance oi Ihe work br
which Ihis permii is issuetl (Seclion 3097. Civ. C�.
LENUEfl:
pDONE55:
OWNEfl BUILOEP DECNNATION: I �erehy aifirm �ha� I am exemp� �mm lhe Con�ractors' State License Law fot the lollowinp reason
(Settion 7031.5 Busin¢SS and Pmfessional Code: Nny cily ol counry whith requires a permi� t0 COnSVutC alfer, impmve, Oemolish, Of
repair any 5lmciure, prior Io ils issuance. also reQuires the aOPlicani for such permi� to file a signed slalemeni �ha� �e/she is IicenSeC
pursuant lo ��e provisions of Ihe Canlraclors' S�ate License Law (Chapter 9 gommencing wit� Section 7W0� ot Division 3 oi Ihe Business
ana Pmiessions CoOe) or ihal he/sne is exemp� iherefrom ane ihe basis Ior �he allegee exemption. Any violation o1 Section 7031.5 by
any apDlicani br a Oermil sublecls I�e apDlican�la a civil penaliy ai nol more ihan tive hundre0 Jollars (E500�.
I. as owner ol Ihe propeny or my employees with wages as their sole compensation, will Oo the work, ana ihe
❑ simcmre is not intenaea ar olierea for sale 15ecuon 70ad: Busness an0 Professional Catle: The Contrac�ors' Sla�e License Law
tloes n0� aD01y IO an own¢r o� a D�ope�y who bUi105 or impmve5lhere0n. antl who tlo¢5 SUch woAc himseli/hef5eif Of IArough
his or her own emptoyees. pmviaeU ��ai such impwvements are not inten0e0 or offere0 for sale. If, however the huil0ing or
impmvemenl is so10 wii�in one year ol comDielion, Ihe owner vnll have the hur0en ol Omving he/she Gid no� bui10 or impmve
lor Ihe purpose of sale�.
I. as owner oi t�e pmDeny. am exclusively comrac�ing wi�h Iicense0 contractors �o cons�mci Ihe pmlect (Seclion 7044, Business
❑ antl Pmfessions COAe: The Comraclars' S�a�e litense Law Aoes no� aDPty to an owner o� OropeM who bml0s or improves thereon
an0 who wnlrac�s br SucA pmlecis wilh a contrac�or(5) Iicense pursuant to the Cantrac�ors' State License Law). I am aware
Ihal prool ol l�eir Worker'S Compensa�ion insurance s�oulE �e pmvi4e0 to me.
� I am exem0� untler Section: B. 8 P. C.
. for Ihis reason:
�a�e. Owner.
I Oo hereby ceni�y �hai I am aware of and understana the reQuiremems ot Calilomia Health and Safery Cotle Sections 25505, 25533, and
2553A an0 �hai I or any Iuiure builtling occupaniwlll wlll not (circle one) neeU�o comply with seid slaie co0e5 en0 Ihe reqW�emen�slora
permil lor conslmc�ion or moUilicaiion �rom Ihe Air Ouali�y Managemeni OislricL Resitlential cons�mc�ion applications are exemp� hom
these provisians.
oate: Apvlicam:
I hereby cerlify I�ai I have reatl Ihis applicalion antl siale �hat Ihe above information is correcL I agree to comply with all ciry and counly
ortlinances and sialelaws relaling�o builtling cons�mclion antl hereby Nhorize representatives af�his ciry�a en�erupon�he ahove�men�ioneU
pmpehy Iorinspeciion urposes. � ' V
�ate: " '� � � Signalur '.
oriver's �icense or socia� security a;
16a1-46 W�ile—Builtling�, Green—Cotle EntorcemenC Canary—Applican�; Plnk—Revenue; Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 069114
FERMIT NO: P 069114 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: PLU FURPOSE: REP
JOH DESCRIPTION ; WATER REPIPE S NEW WATER SERVICE SQ FT;
CLAIM VALUE; CALC—VALUE; GROUF OCC; /
�OMMENTS; NO OTHER WORK AUTEIORI2E➢ BY THIS PERMIT
i��*�t�r**x�x�x��r�r�r#xx�r�x��r�t�i�x��ri��r*+rx-*>r*�r�rt��r*�r�r�r***u�+�*��r*�r�r*��r+rt��t�x�x��*t�****�+�x�!it�*�rx+tf�+E
Z O N I P1 G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BOILDING ---------- --------- ACCESSORY BUILL�ING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN AGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKZNG RE • PROV; FARCEL; 42240102 ZNE; REF NO:
PLANNING N TES>
1 ^
k i! iE iE iF iE iE iE iE it it it iE 1E ie� iE iE iF i€ iE #: iE if # it jE i6 iF fE i! i! iE it� it iF iE iE iF if it iE iE iF iE iE iP # iE?E it # it jE 1E iE iE R' iE! iG iE iF?E iE iE i! i(� iE iE ic iE iE k ir it 1E if iElE
D E V E L t7 P M E N T S E R l7 I C E S R E Q U I R E M E N T S
ZONING APPROVED HY PATE:
HUILDING APPROVED BY : DATE:
t f
APFLICATION ISSUED BY: SS� DATE:
ie**if**��-*i��t�r*x��*�*�r�r*����riF�r�r�x� �F"iF�r�*�rx�iFTt�r��! �r �r �r x*�r****�tx�**+�x �.� l �,�_�t*
if iF if if 1E iE i! iF if iE iE if !E ik iE iF 3E iE 3c iE if 9E iF iE iE jE iE ik it if if 7f 3E i! jE iE iE iE iF iF iE if iE iF 3E if iF �E iE iE iE iE iE 3F IE iE 3E iE if iE 1E iF it iE 3E jE iE 1E i� iE iE iE 1�-iF iF iE iF jf if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 14.00
25& SMIP/NON—RES
PLAN
ISSUE FEE 20,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 14,00 20.00 0.00 34,00/ 34.00 ,00
r r __� / r
RE�ENUE DICISION TOTALS COLLECTED: 34.00 OCER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CAECK
34.00
iE iE iE iE iE k iE iE 9F M iE it iF ic it if iE iF iE if if i' ## iE iE # iF if iE iE iE if if iE iE 1E 7f if iE it if iF ff it iE iE iE iE it iE ik iE 1E i! # iE it iE it iE # iE 3E iE it iE iE i: iE iE iE i! it jt it iE iE i4
I N D I V I D U A L ' F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER SERVICE 7.00 7,00
PLU 1 WATER RE—PIPE 7,00 7,00
ENP OF FEES
aa.00
�1 �ii:e°u$yi'�(r'�Ev�dii Yi.l�j'
GRTE: 14/QQf94 iZ��E: 21:r6
� CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit # Dat�r APPROVALS Permit # Date ' inspector
I
1. Tempora�Y Electrical Service or Pole 52, Pool & Equlpment Location
2. Soil Pipe�Undrgrnd. 53. Steei Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. 55. Eiectrtcal Bondin9
5. Steel Rei�forcemenc 56. Rough Piumbing & Pressure Test I
6� Electrica� UFER Gmd. 57. APPRQVA�TO COVER�GUNITE
7. Footin9s 58. Eiectricai ConQuit�Undigrnd.
8. Foundation 59. Gas Pipe, Q Undrgrntl., Test
9. VVater Pipe-Undrgrnd. 60. Backwash Lines. P�Trap, C7 Undrgrnd.
i�. Structura� Floor Svs�em 61. APPRoVA� TO OECK �
t t. Property Sewer �ine & House Connectioo 62. Backwash & Recepmr�Final �
12. Sewer CaP _ 63. Heater & Vent-Final
73. Roof Dre�ns � 64. Plumbing System - Final
74. Rough Pi�mbing 65. Electrica6Finai .
i
15. Rough Electricai-Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Siyn ' 6$. APPROVED FOR PLASTERING
18. Rou�h Electrical�T Bar Ceiling 69. POOLlSPA SYSTEM5 FINAL
19. Rough Heating & Air Conditioning FIRE DEP7. REQll1REMENT �
20. flough FOctory Fireplace APPROVALS Permit �= �
21. Ducts, in Sttucture 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping rJ Gas ❑ Oil '
23. Gas Pipe�Rough & Test 72. Underqround Flush
24. Aoof Framing 73. Undergmd. Storage Tank � Gas ❑ Oil i
25. Roo` Sheathing 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemica� �
27. Frame and Flashing 76. Dry Standpipe
I
28. Lathing & Siding 77. FIXED SYSTEAI FINAL
29. Insulation 78, FIRE PREV. FINAL I
30. Dry�vall Naifing HEALTH OEPT. REQUtREMENT
31. Piaster Brown Coat 79. PINA� INSPECTION I
32. Elzctrical Power Meter�F�nai 80. F000 CERl-iFICATE ISSUED i
33. Pinal Electric Notes: � i
_ I
34. Final He2ting & Air Conditioning Q^r� .,L- �-.�` � �
� _[i 7/l � Hr.r� a..- _�
35. Final Gas P�Pe�Test
36. Hood or Canopy �
1
-- ----+
37. Final Factory Pirepiace ' i
38. Final Plum6in9 �
39. Water Service-Final -�
40. Gas Service-Final
41. Soiar pomesticFinal �
42, Backflow Preventer '
1
43. Backflow Irrigation '
44. Landscape Irrigation System
45. Sound Aitenuation
�
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL P�ANNING
49. Etectric Releate m Editon
50. Gas Release to Southern California Gas Co
5L CERTIFICATE OF OCCUPANCY
No. Date
COUNTY OFORANGE
BUILDING DEPT.
,636 No. Broadway
Santa Ma, Califomia
Phone: KI 2-6211
1. OWNER'S
,_ Application for Building Perm�c'
AND FOR A
Certificate of Use and Occupancy
MAILING ADDRESS._.../...-S•1_Jt'.....__ �L`.:�:.... �.....-..
Nam�Q..��%�-�Y.-!��-�..� �X.�.�G���..._�
(Architect or Engineer)
w • � . . !�_ _ e .� . � . _�. _ _ 1 i _ r
iba
/' .
�,
Permit No....� /.��1%..�..�.,
/7 �9s �-
Date--�4/.��.......---....-----�- .. ..............
-- - PHONE:------------....._...- --�
r✓p
��TY..../1/e_w/�d s�7''
--- �---- ----------
� -- -- - ---�D �.N. �- 3Z � - � ........---�-- ... - -�
(Con[racror)
. Address
� °� i
c�tY ��S- .1.. ---� �-?`l.P�'s° � .......,� t..�..� �f''s� °°�....... - - � ... �-- �- -...... --------- --- �- ---�- - -- � ---�--
�-
State State
Lic. No.. -- - --- ........--- Phone.-- -- ----........ -- .... ` Lic. No ..................................- -...---. Phone - --- --� - ----................
� C
PROPOSED USE:......--1. �.--.----- �.... v--E ..:...........i_AI.---....�.1�1Y.E' l - -/1.�L el - - ------------....--...- - ��- --� --- ---�----
2. JOB LOCA
3.
4.
i.
6.
7.
8.
BS� �st,�e1
,r
(House �) (Name of 5[ree[) (Town or School Distritt) �
NAME OF AND DIRECTION FROM NEAREST CROSS STREET.���!.�.�...�t�F�..,t�_4� .............�� S�
/-- - - - --- -
LEGAL DESCRIPTION: Lot.----��---���------ �-------...---.Block -----...------------'- -� - � - - - Tract��.'. � v `.'-C- F�S
(Meres and Bounds Description—Use reverse s�de o( form) /r/�1 �
CORNER LOT ( ) INTERIOR LOT (� )' THROUGH LOT ( ) SLOPE OF LOT ( )
SIZE OF BLDG.: cc� �--.�.�.`-,�-�--AREA:.�e,..�..Q..�.��..�SIZE OF LOT:.G..� 4� /56-- AREA: ------ -- --- ......-- �--
1 Q�
HEIGHT OF BLDG .:............�.2......._._..___........CEILING HEIGH'i':..........CJ.........._...........NO. OF STORIES....�.Ne.-...........
ii
i �
NO. FAMILIES-'-----Q..fy'� ..............Size of Smallest Bedroom:-Q.--_.C�.'---'-----�1---_.�f.-- Size of Kitchen.-_.........-------'-----------....
' aR,/�ri<l�/
EXTERIOR WALL CONSTRUCTION:..L'1Q .N.....M.. _'5... ...............INTERIOR WALL COVERING...._..._....T......................__....
(Frame, Stucco, Ett.) / ,o (PlasterDrywall, EtcJ
ROOFING COVERING - -....�...H... � /✓S.T.lS�we.. - . _ - - - - - ..................._... - - -
9. STATE HOW MANY BUILbINGS NOW ON LOT AND GIVE USE OF EACH..........�a.�.�.
10. SETBACKS: Front Yard From Cencer Line of
�� /G 1
Nearest Side Yard ........................Rear Yard.....f,� ..-1........Distance in Feet Between Bldgs. on Same Lot..........................
(Property Line) (Yroper[y Line)
11. A COMPLETE PLOT PLAN IS REQUIRED, SHOWINC ALL STRUCTURES AND USE OF EACH.
�L_
12. (a) Footing: Width---------------�.._................----Depth in Ground..........�..�...--------.Width of Wall-_-.,-�---_---------.----..
I� , � N
(b) Size of Studs:.�:!�_a....._.....Spacing.._�� ....................'CC Material of Floor..:�.._.�._.___�S).�!.C.i........
(c) Size of Floor Joisfs:-� -�=��..�:?._r. � ........Spacing ...................--- -............:'CC
I�
(d) Size of Rafters:....._...2 -n 4-..........--- ---.Spacing.---�4-- -� - ....- .:'CC
13. VALUATION OF � POS�D WORK: Including all labor, plumbing, electrictl wiring, heati�g, fire sprinklers, painting and
sewage disposal $--..��m �......_=--------------
t4. 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.
Plans Filed
Bldg. Permit
Plan Check
Total - �
Receipt Na.
Paid to •
Date ........._.
(Authorized Agent)
FOR DEPARTMENTAL USE ONLY
GROUP....
TYPE-------� '�--� -- .............
DIST.
- MAP- ---L... �. �... - -
.. SHEET NO...-�s----------.--
9'- �/�� - S"�
DATE -- - - � -7- ------ -•---- - ........
s000--�-s: n,���
Ci�`�f
CH CKING BY
APPLICATION�� HEALTH ............................
/.�— FIRE
ZONING ...............-... --..
PLANS AND MARSHAL .........................
SPEC'S...- . ...................... STATE....---.........--------......
CORRECTIONS ENGINEER
VERIFIED........- -�� - - CAL .......... .....-�- - ......----
unrvtrc �
JOB ADDRESS
SOIL
�GAS
W AT
ROU(
PROf
SPRI
�.�� _ LOT T
,:TIONS _ . '
P1u1-1
ING AN� A�R
UNDERGROUNO � POWER U
ROUGH WIRING
TRENCHES � FONMS Q STEELI
FLOOR SVSTEM
BON� BEAM ❑ STEEL REINFORCE
SHEATXING
FRAME ANO FLASHING
LATNING - IN OUT
PLPSTER.BPOWN CPAT G
Ht �G
PLIIMBII
ELECTRI
Bt11LDIN
VENT.,
, FINAL
FINAI
FINAL
UAIt
BUILDING PERMIT N0.
SUBCONTRACTOR
i� ?,.'-��,c,�
�v. l)
C05fA MESA BUILDING-SAfEfY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA BZ628
For AppllcaM ro F(11 In. Compftldy
TYPE OR PRINT
i��oino �%Z.� �%. %��fG S07�1
�oa�
COSTA MESA, CALIFORNIA
xNeR .'S ,. N/. % lJ �1
enaeu / %��vOPvPP..O✓f�
�ARCHITEGT
�- �Na1N61
>Z/7�
Ho. or e�.00�. i
aerowcK uH¢ �noM
eeemaopeineei z. ' RRAR
WDBYAR LlRT ��� RIONT
DESCRIPTION AF WORK
RE
BU
1 N!RlsY ACNNOWL�W
AND BTATB THAT TM[
PLY WITH ALL CIiY OR
GUILOINO CONHTRY
H16NATURB O
PBRM17T6
AUTXORIZW AGRN'C
GiP�
XAV6 PYG T�i� A��
66RR[CT ANO AOp6[
Ary0 RAi[ LAWI Ri�
' !�/ / d2_ .
r
P:'.t6 r 7 i.i::: �,: `�'
JUL 31-67��;5,;0..21 , 5'� ' 6 S I„
A►PLICATION FOR PERMR
lUIIDING
f01' OHIC� UH OIIIY
R[C[I'T NO. �I
� _ )i
L[GAL
YARDB MPROV HD
MAIN BUILDINa
VAR• #
ZONIN(i
I "/ _1
BNALL DB L688 THAN
l-td�
�r� ,1� �1c�'.�'
(U. B. C. QOIRF�AHNT�
YARDBAPPROVHD
ACC6DBORY BUILDIN6
`� �. ��
�
CAT6
�
7
7 � � /1 ��DAT[ � " �_
HOLD FOR SPECIAL REQUIREMENTS �
,D � Qlt,�![.Ga^- ') Ol-'I �(/,U��GI' �
� �3 �,. �. yov �
TM8 AMOUH! OXOWry UND6R VALUATION IB POR TH8 �
�URPO![ OP �DTAlLIlHINO A PlRNIS Pi8 ONLY. �
VALUATION � .— �
PBRMIT FE6 �
a/o7,90?� X � �— w
TOTAL REH �
l,