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217 16TH PL - Building Permits
(714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.VffJMBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 217 16TH PL Suite No F Vicinity: UNIT F Parcel Nunmber: 93673069 Applicant: �Gi.Ll.l / 5�hYtc.jl Address: 17390 MT CLIFFWOOD Phone:,... 714-241-.1414 FOUNTAIN VALLEY ;,fir,' Zip'.=92708- Owner: KOJO, HIATO J TR Address 217 16TH PL #F' T`�'" _ Phone "COSTA MESA'; CA Zip: 92627 - ISSUED BY: Status: ISSUED Applied: 12/06/2005 Issued: 12/06/2005 ♦Q - SCOPE OF PERMIT "1 WATER HEATER CHANGE OUT FOR SFD, CONDO UNIT F. FEE SUMMARY' Contractor: COAST ROOTER PLUMBING HTG AND AC Address:.- 17390 MT CLIFFWOOD AMT - ,QTY -_-; AMTS Phone: 714-241-1414 $23.50 FOUNTAIN VALLEY Zip: 92708 •.0 ., Sump�Pump License: - 529127- -� - Backflow iaigahon $000 0 Landscape Irrigation-., ISSUED BY: Status: ISSUED Applied: 12/06/2005 Issued: 12/06/2005 ♦Q - SCOPE OF PERMIT "1 WATER HEATER CHANGE OUT FOR SFD, CONDO UNIT F. COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446-06 (600) FEE SUMMARY' AMT-- QTY -- �- 5' -- AMT - ,QTY - t - AMTS QTY ISSUETEE �. $23.50 Laundry,Tub/Washer � $000 •.0 ., Sump�Pump - $000. 0 Backflow iaigahon $000 0 Landscape Irrigation-., $0 00 -. -0Swimming Pool $0 00 ,. 0 Backflow Preventer �. $000", %'O--", P -Trap.. $0.00 ""10 `Trap Primer _ �; $0.00 <'� 0 Bathtubs- - $0.00 -`0- Pressure Regulator $0.00e0 Urinal= ;" $0.00; 0 Clarifier, System $0.00 0 - - __- - `Process Piping (per 101t) .$0.00 ,_0 < r Vacuum Brkr Bkflow(14) - '$0.00. 0 Connect (Ice,Soda etc),..„ $0 00 , _0 =: ;Receptors. �;; a\-'. $0 00=0': ` Vacuum Brkr Bkflo_w(5+) , $0:00 0 Dental'Units d °"`'.$0JOU -0" Septic Tank" -$0.00.` 0 Wash`Basin - $0.06 0 ,- Dishwasher - - $0.00 0 Sewer Cap for Demo ;$0.00 0 WashBasinSet $0.00 0 Drain, Floor $0.00 0 Sewer Conned $0.00.__. 0 Waste and Vent System -- $0.00 0 Drain, Rainwater I $0,00,:_1 0:; Sewer Private Line $0:00 < - 0 Water Closet (Toilet) •- $0.00 0 Drain, Roof $0.00 `�0 Shower - $0.00 0 Water. Heater/ vent - $12.30 1 Drinking Fountain ",>;. $0.00 0 - Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 , :0-- Sink, commercial . $0.00 0 Water Re -pipe - $0.00 0 Gas Earthquake Valve $0 00 ,'Y,O=- Sink, Floor- „$0 00 0 WaterService$0.00 0 Gas (1-4 outlets) , =._ $0.00 ''+0 F. Sink kit6hen $0.00. - 0 --,.; Water Softener, $0.00 0 Gas (Over 4 outlets)" $0.00 01, ,,,,Sink, service/mop •, - ,$0.00 0 -- OTHER $0.00 Gas Repipe $0.00 0 - Spa (private)' .. $0.00 --0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public);, $000 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) ""?$000" 0 r `� REINSPECTION "'� $0.00 0 Interceptors (Sand Auto) . $0.00 0- - - - -- TOTAL CALCULATED FEES: $35.80 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446-06 (600) DECLARATIOMS 1, i 11 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ;*' l have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. —MY works/��s'com ensallon Insurance canter and policy number are: G Carder.. - ...}-v� (�( Q.�AA. CD Pollcy.Number:, ���0 D%S!7 (dissection nebd not be completed if the permit is valued at one hundred dollars ($100) or less.)---_____ _ ❑ 1 certify that In the performance of the work for which this per 't is issuad, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califor ' ,and agree that It I shoul a me subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with mese provis' s. Applicant Signature: __Date: Z 7 - 49 WARNING: FAILURET S ORKERS' COMPENSATION COVERAGE IS Utjl WFUL AND SHALL SUBJECT AN EMPLOYE TR O CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATI®, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under rovision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business an�%rofessions Cade, and my license is in full force and eHeCCLi k=• 2 Class R ContractorsSign alure: £ (Di �C" Z— 7" CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code), Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a'peroit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he'or.she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of'not rio}e than five hundred dollars ($500).): 1, , ❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will'have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: - Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................. ....................................................................................................................................................................................................................................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................ ........................... ....................................... .............................. -.......................... ............................ ... ................................. ............................. ... ....................... ............................. ................................................................................ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ NO (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ....................................................................................................................................................................................................................................................................................... .........I.................................................................................. 4 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this 2pplication a�ermit for such construction or modification South Coast from the Air Quality Management District or from any other air pollution control district or agency? U Yes No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................ .................................................. ....... ........................ ............. -......................................... -.................... ................................ ........................................................................................... ............................... .......... ............................ 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑ No ........................................................................................................................................................................................................................................................................................................................... 8 (IF "yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to y or allow occupancy of any building authorized by this permit until final inspection. re Of Legal er Date And/Or Author nt' - - Date CODE t. INSPECTION TYPE OATS INITIALS CODE I INSPECTJONTYPE I INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical r V 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 4 PROJECT ADDRESS: 1; 217 16TH PL. UNIT:D,E OWNER"AAME: BRIGGS DEVELf NT ADDREss:AVANETA CARLOT;A I b ARCH/ENGINEER: REG.NO.: , ADDRESS: UNIT: PERMITTEE: BRIGGS DEVELOPEM.ENT' (714)380-0686 ADDREfS 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERSCOMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C). POLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant'. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be cpm etl it the permit is for one hundred ($100) or less). I certify that in the performance of the work for which Rls,�ermit Is Issued, I shall not al a TD rson I ny manner so as to become ScojecI to the v kers Compensation Laws of California. Dale: 19 Signature: NOTICE: It, after making this declaration, you sh .became subject to the Work s' Compensation rovisions of the Labor Code, you must forthwith comply with suC isions or this permit shall be d ed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction le mg agency for the performance of the work for which this permit is Issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ I. as owner of the property ormy 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' Stale License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselllhersell or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business TJ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects wile a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section: B. 8 P. C. for Ihls rea nnJ (l`� Date Owner: I do hereby cerody that I am aware of and understand the reelected of California Health and Safely ode Sections 2 05, 25533, and 25534 and that l or any future building occupant will/will not (circle one) need to comply with said stat cones and the requirements for a permit for construction or modification from the Air Quality Management District Residential construction applications are exempt from these provisions. Dale: Applicant'. I hereby certify that I have read this application antl state that the a ordinances and state lays relating to building construction and hereby property for ii speclioGpurposes. Dale: Q i 3 Signature: Driver's License or Social securlly # information is c c agree to comply with all city and county Drize reoresen rid his city to enter upon the abovemnentioned 1641-46 While—Building. Green—Cade Enforcement: Canary—ApPhcanl: Pink—Revenue; Coldenrotl—Assessor CITY OF COSTA MESA — BUILDING PERMIT JohRM Ni PUb31VV PERMIT NO: P 063100 PLAN CHECK NO: N l I; N bu r: N CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU PURPOSE: NEW JOB DESCRIPTION : ,NEW 3 UNIT APARTMENT BLDG SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / COMMENTS: RELOCATE 2 GAS METERS Z 0 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 BUI.LDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT 1:N PARKING RL••Q• PROV: PARCEL: 42520106 ZNE: REF NO: PLANNING N TES> > D E V E L O P M E N T S E R V T� C E S R E Q U I R E M E N T S ZONING APPROVED BY G DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: ititiF7F'P'i TW7-•3F'3iTrIf#####%##tolb NW iv A toxxiv N## LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 14,00 25% i SMIP/NON—RES PLAN !. ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLrAN=CHECK TOTAL PAID DUE TOTALS ---- > 14.00 20.00 ^ 0.00 34.00 34,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 34.00 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 34.00 L ' 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 •,r PLU 2 GAS SERVICE „ 7,00 14.00 END OF FEES D , 01 00143136-00143136 TOT 34.00 DATE: 07/19/93 TIME: 14:52 1 ' CQNSTBtCTION AND PLANNING APF7;OVALS Permit# Date Inspector POC. , SPA APPROVALS Permit, Date Inspector +k. Temporary Electrical Service or Pole r 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -4. Electrical Condwt•Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 'I 6. Electrical UFER Grnd 57. APPROVAL TO COVER-GUNITE Footings / 58. Electrical Conduit Undrgrna. -€_ Foundation 59. Gas Pipe, ..i Undigrrd., Test t '. Water Pipe-Undrgrnd. 60. Backwash Lines, P Trap, ❑ Undrnrr,d 10. Structural Floor System 61. APPROVAL TO DICK 11. Property Sewer Line & House Connection i' 62. Backwash & Rece;a c' 13, 12. Sewer Cap 63. Heater &Vent-F.nal!. j 13. Roof Drains 64. Plumbing System Finel 14. Rough Plumbing 15. Rough Electrical•Condu't -_ _ 65. Electrical -Final 66. Solar System-Fin„I 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 FIRE DEPT. REQUIREME;,!T APPROVALS pormit j 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydio 22. Ducts, Ventilating 71. Product Piping C;Gas 'Qi! 23. Gas Pipe -Rough & Test 72. Undergtould F.,.'1- 24. Roof Framing 73. Undergrnd. Swraijri Tank O Gas�O�- : 25. Roof Sheathing 74. Overhead Hydrn 7I,. Dry Chemical--` 76. Dry Standpipe FIXEDSYSTE'i1'rINAL - J -_- " 26. T -Bar Ceding (Svvcturall & Lionocoat 27. Frame and Flashing 28. Lathing & Siding - 177. 29. Insulation 76. FIRE PREF. Flt.AL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION ; 80. FOOD CE19TIFIC_1\7E �qq 1- - Notes: 7�.,c.r+^`3 �-OM ---_--- ----------_-- - --- --- ----- --- _ -- - 31. Plaster Brown Coat I 2 Electrical Power Meter Final I I 31, Fical Electric 34. Final Heating & Air Corot: oning 35. Final Gas Pipe -Test /�-(-- "r � - 36. Hood or Canopy - 37. Final Factory Fireplact 38. Final Plumbing T--_------^ --� -- - _-- -- 39. Water Service -Final j 40. Gas Service -Final { 41. Solar Domestic -Final j 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations .' 47. FINAL STRUCTURE & BUILDING ~ 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cu j 51. CERTIFICATE OF OCCUPANCY No. Date ^ -- - CITY OF COSTA IV \ BUILDING SAFETY D. .SION ^- POST IN CONSPICUOUS K... ;E ON THE 10B NOTICE You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 754-5627. PLANS SHALL BE ON JOB AT ALL TIMES.38. 32. Electrical Porn leter-I-inal 33. Final Electric - 34. Final Heating & Air ConditioningI?WJL�t LFQ 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Facory Fireplace 4.4wAPPROVED Final PlumbingCgo A. P. NO, DATE(IS UED C- t G / G� I 39. Water Service -Final TYPE GROUP -� PERMIT NO. � �_-1 --- '�A) 40. Gas Service -Final 41. Solar Domestic -Final BUIL ING ADDRESS 1 1. `i)` 7:>/L- / 42. Backf low Preventer TRACT L BLOCK 43. Backflow Irrigation NEW ADD " ALTER REPAIR I MOVING DEMOLISH 44. Landscape Irrigation System � 45. Sound Attenuation OWNER ' I ! EaS f i f ,0 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING USE ' CALL 48. FINAL PLANNING S4-5620 ' POOL & SPA APPROVALS Permit =I# SETBAAKS Front Yd. e Yd. /�L - 562pt Rear49. Side Yd. L Rear -"'^- _ f Pool & Equipment Location 50. Steel Reinforcement CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector 51. Forms 52. Electrical Bonding , 1. Temporary Electrical Service or Pole 53. Rough Plumbing & Pressure Test 2. Soil Pipe-Undrgrnd. 54. APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. 55. Electrical Conduit-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 56. Gas Pipe, 0 Undrgrnd., Test 5. Steel Reinforcement 2.0 Q(9 57. Backwash Lines, P -Trap, 0 Undrgrnd. 6. Electrical UFER Grnd. 58. APPROVAL TO DECK 7. Footings 59. Backwash & Receptor -Final B. Foundation 60. Heater & Vent -Final 9. Water Pipe-Undrgrnd. 1 61. Plumbing System -Final 10. Structural Floor System l0 62. Electrical -Final 11. Property Sewer Line & House Connection '; 63. Solar System -Final r 12. Sewer Cap 64. Fencing & Access Approval 13. Roof Drains 65. APPROVED FOR PLASTERING 14. Rough Plumbing fy`� L.(yc 66. POOL/SPA SYSTEMS FINAL 15. Rough Electrical -Conduit FIRE DEPT. REQUIREMENT APPROVALS Permit # 16. Rough Electric Wiring g j �Z 17. Rough Wiring Sign 67. Underground Hydro 18. Rough Electrical -T Bar Ceiling 68. Product Piping 0 Gas 0 Oil 19. Rough Heating & zadi ' ' fy C450' 69. Underground Flush 20. Rough Factory Fireplace 41 6 70. Undergrnd. Storage Tank 13 Gas 0Oil 21. Ducts, in Structure 71. Overhead Hydro 22. Ducts, Ventilating 72. Dry Chemical 23. Gas Pipe -Rough & Test 73. Dry Standpipe 24. Roof Framing 74. FIXED SYSTEM FINAL 25. Roof Sheathing v 75. FIRE PREV. FINAL 'Z I7Lj 26. T -Bar Ceiling (Structural) & Monocoat Notes:Sr 27. Frame and Flashing 28. Lathing & Siding (C.• ��. !/;.� t� -� _ Z J 29. Insulation ^.� ` Q .O S �'j2. OK To WeA "-- _ 30. Drywall Nailing 1�. /:'-'F '-'f•1� 42 31. Plaster Brown Coat y _ (see re erre for additional notes) CMF 0559-46, rev. 12/82 CITY OF COSTA Mr BUILDING SAFETY DI4,..ION POST IN CONSPICUOUS VLACE ON THE JOB NOTICE You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESPECTIVE INSPECTION. CALL 754.5627. APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. 32. Electrical Powe iter -sinal 33, Final Electric 17111A, 17 I f 34. Final Heating & Air Conditioning CIAO 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final FaltjV Fireplace 38 Final Plumbing i2iti ' c. (t.0 A. P. NO. ISSU DATEED ICJ 39, Water Service -Final TYPE GROUP PERMIT NO. I_)��I ��•c1 40. Gas Service -Final 41. Solar Domestic -Final BU LOING ADDRESS - i t;41 1" 42. Backflow Preventer Backflow Irrigation TRACT LOT nq F NEW ADD ALTER I REPAIR MOVING BLOC � D MO 44. Landscape Irrigation System I CAL L 45. Sound Attenuation OWNER i J4 -?6 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING USE 754'5627 ,q8, FINAL PLANNING POOL & SPA -'- APPROVALS Permit# SETBACKS Front Yd. Side Yd. L R Rear Side Yd. L R Rear 49, Pool & Equipment Location - 50. Steel Reinforcement CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector 51. Forms 52. Electrical Bonding 1. Temporary Electrical Service or Pole 53. Rough Plumbing & Pressure Test 2. Soil Pipe-Undrgrnd. /V `f' 54. APPROVAL T000VER-GUNITE 3. Electrical Conduit Utility-Undrgrnd. 55. Electrical Conduit-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 56. Gas Pipe, ❑ Undrgrnd., Test 5. Steel Reinforcement p 57. Backwash Lines, P -Trap, O Undrgrnd. 6. Electrical UFER Grnd. 58. APPROVAL TO DECK 7. Footings 59. Backwash & Receptor -Final 8. Foundation 60. Heater & Vent -Final 9. Water Pipe-Undrgrnd. 61. Plumbing System - Final 10. Structural Floor System 2, jo,g 62. Electrical -Final 11. Property Sewer Line & House Connection -7 63. Solar System -Final 12. Sewer Cap 64. Fencing & Access Approval 13. Roof Drains 65. APPROVED FOR PLASTERING 14, Rough Plumbing V R E CW 66. POOL/SPA SYSTEMS FINAL 15. Rough Electrical -Conduit FIRE DEPT. REQUIREMENT APPROVALS Permit # 16, Rough Electric Wiring 8$� 17. Rough Wiring Sign 67. Underground Hydro 18- Rough Electrical -T Bar Ceiling 68. Product Piping 0 Gas ❑ Oil 19. Rough Heating & Air Co i i 1'( C4W 69. Underground Flush 20. Rough Factory Fireplacei b/ly fZ 4ZO 70. Undergrnd. Storage Tank O Gas ❑ Oil 21. Ducts, in Structure 71. Overhead Hydro 22. Ducts, Ventilating 72. Dry Chemical 23. Gas Pipe -Rough & Test 73. Dry Standpipe 24. Roof Framing 74. FIXED SYSTEM FINAL 25. Roof Sheathing 75. FIRE PREV. FINAL 26. T -Bar Ceiling (Structural) & Monocoat Notes 112 27. Frame and Flashing �/ rt [,� S .. s 28. Lathing & Siding'y` 29. Insulation !"[, �t4r _'- C !/may O,C 770 C"v ti' t.* 30. Drywall Nailing' ; ,, l/ ��14-1� l % /L £sir • _ t �.4_• 31. Plaster Brown Coat 9 �- (see leverse for additional notes) CMF 0559-46, ,ev. 12182 UTHWEST INSPECTION & STING 10826 SOUTH NORWALK BLVD. SANTA FE SPRINGS, CA 90670 (310) 941-2990 111 (714) 526-8441 • FAX (310) 946-0026 T/, J. REGISTERED INSPECTOR'S DAILY REPORT Balli Job No Zc-�-7 D84.Z3 9z TYPE OF INSPECTION REOUIRED 0 Reinforced Concrete ❑ Post Tensioned Concrete ❑ Reinforced Masonry Structural Steel Assembly ❑ Quality Control ❑ Fire Proofing ❑ Oth r ❑ Asphalt Job Add`es � / ! �A _ !1_ CC / City n_ , Job rjame Per it No. Issued By Type of Structure Architect r A P7 =� M rial Description typ grade, source) ^ U Engineer,/ %-f04 .ha; ' ils5oc-. Inspector(s) Na ^ S Contractor Subcontractor r —T- AC : TESTS PERFORMED TYPE OF SAMPLE SLUMP QUANTITY IN SET ADDITIONAL REMARKS ON SAMPLES All inspections based on a minlmu minimum. In addifio , any In URE OF REGISTERED INSPECTOR hour minimum. f>, Approved By SPECIALTY INSPECTION SUMMARY — LOCATIONS OF WORK INSPECTED, TEST SAMPLES TAKEN, WORK REJECTED, JOB PROBLEMS, PROGRESS, REMARKS, ETC. INCLUDES INFORMATION ABOUT - AMOUNTS OF MATERIAL PLACED OR WORK PERFORMED, NUMBER, TYPE 8 (DENT. NO'S OF TEST SAMPLES TAKEN: STRUCT. CONNECTIONS (WELD MADE H.T. BOLTS TORQUED) CHECKED: ETC. Pr WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR AIlAxnnpe'41% 410 `J PAGE I OF HIS I O.T., 4 SITE COPY 8 hour q n8 CERTIFICATION OF COMPLIANCE CONTINUED ON NEXT PAGE ❑ 1 HEREBY CERTIFY THAT I HAVE INSPECTED TO THE BEST OF MY KNOWLEDGE ALL OF THE ABOVE RE POR WORK UNLESS OTHERWISE NOTED. I HAVE FOUND THIS TIME IN TIME OUT REO. WORK TO COMPLY WI T APPROVED PUNS, SPECIFICATIONS, AND APPLICABLE SECTIONS OF G VERN G BUILDING LAWS. All inspections based on a minlmu minimum. In addifio , any In URE OF REGISTERED INSPECTOR hour minimum. f>, Approved By SPECIALTY N0, AGENCY Pr WHITE - OFFICE COPY, CANARY - ACCOUNTING COPY, PINK - INSPECTOR PAGE I OF HIS I O.T., 4 SITE COPY 8 hour q n8 GEO-ETKA, INC. C :.Y GRADING REPORT JOB No. CLIENTt I y �, YN �� IY TIME DATE¢ -,9 JOB LOCATION ' %O TECHNICIAN I MAX. DEN. STD. GENERAL CONTRACTOR GRADING CONTRACTOR WEATHER CONTRACTORS SHIFT FOREMAN LOCATION OF FILL APPROX. YARDAGE MOVED INSTRUCTIONS: SUPPLEMENTARY REPORT DESCRIBING EQUIPMENT USED FOR HAULING, SPREADING, WATERING, CONDITIONING AND COMPACTING, THICKNESS OF LIFTS, TEST TYPES AND DESCRIBING ANY MEETINGS AND VISITORS. ANY OTHER PERTINENT INFORMATION... 6'' �5W b V VO Of OhN c AILY TIM RECORD START STOPW RKP RFORMED HOURS SPEEDOMETER f� �f PAGE OF TOTAL PROJECT ADDRESS: 217 1 6TH PL OWNER'S NAME: '•BRIGGS DEVELOPEMENT f ADDRESS: AVANETA CARLOTTA ARCH/ENGINEER: ADDRESS: REG.NO.: UNIT: D,E,F CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 054391 PLAN CHECK NO: 04053-91 A CONSTRUCTION TYPE: V -N PERMIT TYPE: STR UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions I Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date'. Signature'. WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate okedoesent to sell -insure or a certificate of Workers' Compensation Insurance. or a cemlied copy thereof (Section 3800, Lab. Q. POLICY NO.: EXP. DATE: COMPANY: h] Cedified copy is hereby furnished ❑ Carolled copy is filed with the city Building Division r Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION OECLARATIONi (This section need not be completed if the permit is for one hundred (8100) or less), I Gerdy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. _ Date: Signature: NOTICE: It. after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply wdh such provisions oL this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the pedomeance of the work far which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law far the f (lowing reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improv , demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/ he is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 the Business and Professions Code) or that he/she I$ exempt therefrom and thebasisfor the alleged exemption. Any violation of Sect 7031.5 by any apphwni 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 :in levees 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 bonds or improves thereon, and who does such work himselt/herself or through ' his or her own employees, provided that such improvements are not Intended or offered lot sale. II, however the nothing or improvement is sold within one Year of completion. the owner will have the burden of proving he/she did not build or improve lot the purpose of sale). p. a, owner of the properly. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business no Professions Code: the Contractors' State License Law does not apply loan owner of raper wno b ills Or Improves thereon and who contracts br such projects wim a contracmr(s) lic4Dr0wo t (cense Law),I am aware that proof of their Worker's Compensation insurance shoulo me.�I am exempt under Section: B. 8 P. lot this reason./7Date: tel-erg^YI do hereby ceNfy that I am aware of and understand the requiremeIth antl Safety Code Sections 25505, 25533, antl 25534 and that I or any future building occupant willlwill not (circle oly with said state codes and the requirements for a permit for construction or modification from theAirAir Quality Manageeadential Construction applications are exempt from these provisions. Dale: Applicant: hereby certify that I have read This application and slate That the above I a' i5 rcn tt agree to Comply wI II Lily and ordinances and state lava relating to building construction and her u . ase five this City to enter upon the bovemt properly for inspection purposes. Date:— rSignature: Oriver's License or Social Security a' 1641-46 While—Bwlding, Green—Code Enforcement: Canary—Applicant Pink—Revenue: Goldenred—Assessor PERM NO: B 054391 GOVT: N .SUPP: N t . PURPOSE: NEW JOB DESCRIPTION NEW 3 UNIT APARTMENT BLDG SQ FT: 1,818 CLAIM VALUE: CALL -VALUE: 290,774.70 GROUP OCC: R-1 / COMMENTS: NEW 3 UNIT APARTMENT BLDG NE BE 9F * 9E;YF iE 9F 9E 9F 9E 9E 9F 9E 3EiE 1E iE.x.9E 9E M Nf iFiFif 9E 9E 9E BE 9e 9E 9f NF *iE 9L 9E 9EBE 9E iE BE9E 9E 9E iENF iF iE• if iEif iEiE i( -M 9E iE iE 1F "!f i4 9E iE 9EBE RF iPiE iE iF lE i(iE iE dt ik dF. Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ AIN BUILDING ---------- --------- ACCESSORY BUILDING -r-------- FRNT: 86 FT IN REAR: 15 FT IN FRNT: FT IN REAR: FT IN LEFT: 5 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FST IN PARKING RE((��: PROV: PARCEL: 42520106 INE: R2 REF NO: DR80-09A PLANNING N(S S> BUILDING #2, CONSISTING OF UNITS D,E, AND F. > * 9F 3E iP iF 9E�F * 1E * BE iE IP 9E * * * 3F * 8Flk9F *iF AE 9F 9E BE iF 9E iE iE iE iF 9E iF Rf iE 9E * iP kE aE iE k k if IE if * * * * iE * RE IE* iF * * 8E IE * iF BE * iE 9P iE iE aE * aE iE iE 9E Rf iE D E V E L 0:P M"E:N.T S E R V I C E S R E Q U I R E M E N T -S• ZONING APPROVED BY_;'; :''<! G • �- DATE: t.o. •5 \ BUILDING APPROVE6 BY! DATE: APPLICATION ISSUED BY: IaJ S�Idiii *--rC DATE: / b IF 3F IF k IF BE IF * iE 9F 9E 9f BE iE 9f 9F aF BE iE it 3E 1EiF,iF,iEiFiFiFiF�F�'iFif'EFifiF3FlF'R�iFif�F3F�iFiF�iFiF iFif3FiF'i�iF if if iF iE of if BE iF ie iE'3F��ii��lE iE iE*9E le*iEBEi¢9t9EBeBE*9k**iEiElE3fiP BF BE**iElE9t 3t 9Ek3EitBEft9tBEiE3tkiPkiE9lB!*******kifiEBE3E9eiE*iFiPiE9E9EiPiEiFIPk*iE9litBE*9t if 9f LEGALIZATION:N F E E ,,S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTR-IC`- MECHANIC. FIiE SMIP%RES GRADING PERMIT 1,308,00 r 29,08 PLAN 1y SMIP/NON-RES 212.55 ISSUE FEE ` BUILDING -DIV_>. - PERMIT ISSUE PLAN` -CHECK TOTAL PAID "' DUE TOTALS ---- > 1337^08 0.00 212,55 1549.63 1549,,63. ^00 REVENUE DIVISION TOTALS_-> -COLLECTED: 1549.63 OVER/SHORT: ,00 .. BLDG PMT PLUMBING'ELECTR.tC MECHANIC ;FIRE SMIP/TOTS; GRADING PLAN -CHECK �08 2.12.55 k iE IE iP iP IE 9f 9E SE * aEaF iE aP iE LE aF * 9P 3f IE 3t *Y;t 3E * 9P 3t * * 3E iF 3t 9E iE * BE.Jt * iE * SE iEiF 9E 9t k Lt3eiE * 3E * Bt * ** iF'1F * * iE i(- ae 9E Bt iE * iF JE it * iE aP * * iE iE I N D I" .V I D U A L 14 E• E .cB . R E A K D: 0: W N TYPE QTY , ; D. E S I Fi 1 O UNIT COST ;.TOTAL COST SFR 3925 DWE-TYPE V -WOOD FRAME "`i' ?'j. GOOD ?:rfi9.00 270, 825.00 SFR 1314 RES -BALCONY, EXTERIOR rSTAIRWAY "13.80 18,133.20 SFR 105 RES -GARAGES TYPE V .�• 17,30 1,816.50 c - END OF FEES. •y t OF POCWPA ' CONSTRUCTION AND PLANNING XPPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary. Electrical Service or Pole 52. Pool & Equipment Location ,2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3: -Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. 'Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement ,� OV 56. Rough Plumbing & Pressure Test ' -'6...Electrical UFE14 6rnd. 57. APPROVAL TO COVER-GUNITE _ - 7.. Footings . 58. Electrical Conduit-Undrgrnd. 8. Foundation _ 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 6 Q2 40(L�- 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 Sigh68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling ,19. 69. POOL/SPA SYSTEMS FINAL Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT +APPROVALS ' : Permit # - 20.,Ro6gh Factory Fireplace r- r a. J: - -- P _ T' P. 21 .'Duc't's, in Str ctu[e ` 9 _ 't70. �Jhde� round H dro !` g. t Y. 22. Ducts, Ventilating . r •:71. Product•Piping (:7;Gas OOiI 23. Gas Pipe=Rough & Test - 72, Underground FlusFc _ 24. Roof Framing =r - r. . - .. ; 73. Undergrnd•. StorageTank Gasj❑Oil 25. Roof Sheathing ? �? B•�'-� " 74; O.verhead'Hydro q (": 26.,T -Bar Ceiling (Structural) & Monocoat ,. _ �. 75c7,D_ry Chemical - - 27: Frame and Flashing 'F _ _ lInIq,_ 7& Nry Stantjpipe ;- " •' 2B. Lathing & Siding -:'z- = r r 77. FIXED SYSTEM FINAL, 29. Insulation 7B;7 FIRE PREY. FINAL -. 30. Dr wall'�Nailin ' � c y g , HEA LTH'DEPT�. REQUIREMENT 31. Plaster Browo Coat 79: FINAL INSPECTIpN v 32. Electrical' Power Meter -Final' CERTIFICATE ISSUEDi� - :,SO.,FOOD 33. -Final Electric _ ' -' 'r "Notes: X34. Final Heating & Airr''Conditioniog- . .: UK 5 iAL t2EQ PEE��=���� 35. Final Gas Pipe -Test- � 36. Hood or'Canopy- - - ,1 /i4 �- Lk mss` ( 37. Final Factory Fireplace -* s y - 38. Final Plumb -F.1 g •' • f- ', r Z,� qL 239. -Water Service -Final. _ 40. Gas Service-Final�- :%41.Solar Domestic -Final , •• f �a: t v 42`Backflow Preventer' - '' T = •- * p �.= 43. Backflow irrigation,. - , _. .- , c� �g ��.� Qr .• 44. Landscape Iyigation System. _ .r _ " fk; ,, __ J .V 45'Soun l Attenuation „ >, 7 +: C 4 ,46. Handirap•Regulations E47. 'ALSTRUCTURE&BUILDING (� 731 y 4 Al ' n s 49.- learic Release to d son 50. Gas Release to Southern California Gas Co '51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 217 16TH Place, Unite D,E,F has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Rl Occupancy. Use of Building 3 UNIT APARTMENT Legal D 425-201 (See reverse side for Metes and Bounds) Building Permit No B 54391 Electrical Permit No. E 54423 Plumbing Permit No. talt t'. Mechanical Permit No M 54428 ISSUED TO- Brines Development 23046 avaneta carlotta LAGUNA HILLS. CA 92653 Number of apartments and/or guest rooms Building Official Tony C'De Baca f � r by. J Date January 19, 1993 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File Project Address: Lot Number: _ . Permit Number: By Civil Engineer: FINAL GRApING CERTIFICATION 217 16th Place. Unit D Lot 1 of Tract 14384 i � 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 drama0e of surface water fron each buildine 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 s_rfaces to approved disposal areas. The final monuments as shoa-n on the recorded tract map were set. All `nal Eradin_ eleva- tions are within = ];l0 of t e desi ned elevations. Supervising Civil Engineer L Re_. No. 31720 ($igra:um) atirm Date 12/4/92 1. a 1i2 rnM 42 ie f CAUE���\e- c=--•'? _):! Sari; Project Address: Lot Number: Permit \umber: By Civil Engineer: FINAL GRATING CERTIFICATION 217 16th Place, Unit E Lot 1 of Tract 14384 ffl• •t, #• 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. 157c Fall for asphalt surfaces and landscaped areas. 0.59 Fall for concrete surfaces to approved disposal areas. The fic_1 monuments as shown on the recorded tract map vete set. All ;;nal Eradipeeleva- Dors are wiihin = I,'@ of the desien 4111(l Supervising Civil EngineerReg. No. 31720 Daie 12/4/92 QRS Ln �f9rF 1 O f Project Address: Lot Number: .. Permit Number. By Civil Engineer: FINAL GRADING CERTIFICATION 217 16th Place, Unit F Lot 1 of Tract 14384 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. 0.59 Fall for concrete surfaces to approved disposal areas. -he iiC81 Monuments as S'ae�a�n on the r..cord[d tract r,.ap 'a'er[ s[t. All ii'zl Eradine eleva- tions are within = 1,10 of the d[si_ ed elevations. Sup[r`•ising Civil En_ineer ilk Re_. No. 31720 (SiFraat) Daft 12/4/92 ATY OF COSTA MEhA CALIFORNIA 92628-1200 1P. O. BOX 1200 Insulation Certificate 217 E. 16th Place Unit D E F Costa Mesa Number and Street City . ' Orange part of Tract 14384 County Subdivision LotNunber Description of Installation ROOF Material Brand Name Thidrness (inches) Thermal Resistance (R -Value) EXTERIOR WALL Material FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness (inches) 3h" Thermal Resistance (R -Value) R-11 CEILING- BauorBlanketType FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness (inches) 9 1 /2" Thermal Resistance (R -Value) R-30 Loose Fill Type Brand Name Contractor's minimum installed wcight/ft lb Minimum thicimcss. inches , Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R -Value) SLABFLOOR Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Width (inches) FOUNDATION WALL Material Brand Name Thickmess (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 Administrative Code. BRIGGS DEV. General Contractor (Builder) Signature "Title _ Para on Insulation Co., Inc. ZCo hasufation lgnature� Title Licertse Number Date Liccnsc Number i r7 N O V 2 0 1992 y i PROJECT ADDRESS: 217 1 6TH PL UNIT: D, E, F OWNER'S NAME:$ BRIGGS DEVELOPEMENT ADDRESS: AVANETA CARLOTTA ARCHIENGINEEH: REG.NO.: ADDRESS: UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) 0l Division 3 of the Business and Professions Cotle, and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab, C). POLICY NO.: EXP. DATE: Cenifietl copy is hereby furnished. ❑ Certified copy is filed with the city Building Division, Date: Applicant: r.� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be jongleted if the permit is, for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I Shall not Employ any person.in any manner so as to become subject to the Workers' Compensation Laws of California. r Date: Signature: NOTICE: It. after making this declaration. you should become sbbject to the Workers' Compensation provisions of the Labor Code, you must footage comply with such provisions or this permit shall be.deemed revoked. l CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction JXnding agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the fallowing reason (Section 7037.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to Its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business antl Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. asowner of the property or my employees with wages as their sole compensation, will do the work, and the Elstrnet ure is not intended or offered for sale (Section 7044, Butomess and Professional Code: The Contractors' State License Law does not apply to an owner or 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 or completion, the owner will 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' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a cornme or(s) license pursuant to the Contract"' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C, — ler this reason 7: Date: �L� /_/ Owns. do hereby certify that am aware of and understand the requirements of alilornia a and Safety Code Sections 25505. 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to c with said state codes and the requirements for a permit for. construction or modification Irom the Air Ousily Management District. esidential construction applications are exempt from these provisions. Date: Applicant. I hereby certify that I have read this application and state that the above ordinances and state laws relating to building construction and hereby a1 property tfor inspection pwpo / Date: /! �/ Signature: Driver's License at Social Security a: with all city and 164146 While—Bwlding', Green—Code Enforcement: Canary,Appl'oant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 054419 PERMIT NO: P 054419 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU PURPOSE: NEW JOB DESCRIPTION ; NEW 3 UNIT APARTMENT BLDG SQ FT: CLAIM VALUE: CALC—VALUE: 'GROUP OCC: R-1 `/ COMMENTS: REF B54391 iE iE 9E iL 9E lf dE if iE jE iF iE+E9E if iF iEiE %dE iE 9E * RERE RPNf * dE 9f ie if 9f 9F 9e 9F �(• 9f * * 1E BE iF iE NF iE iE JE iE * iF iE 1F if iFiE iE 1E iE iE+Pif RE iE iE iE iE RE iE RE * if iE RE * of 9E Rf 9E 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 REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42520106 ZNE: REF NO: PLANNING N TES> > * iF Jf iE iE 9F 9F * 1F 1F 9E Bf iE iF iF if IE * iE 3f iE iE iE 9E 1E * BE k iF 9E 9E iE fE iE iE 9E1E iE iPiE iF EE iE iE 9E 9�'� iE iE iE iE iE * BE * is 9e ie * iF iF * * iE RF iF iP iE � Jf iE 1F IF JE * 9F * * 1F D E V E L O P M E N T S E R V I C E S',.AR E Q U I R E M E N T S ZONING APPROVED BY ;: DATE: BUILDING APPROVED BY :_ DATE: APPLICATION ISSUED BY DATE: /(J if !E iE iF * iE iE 9E iE 1E * iE iF BF iE 9F iF 3F iE lE IE iF-1F aE iE if iE IP RF ik!(•7FiFit 7F�iFiEik ikif iE*iE iE*iE it 9E 91F iEiP iP iE iE*iE iE*iF iE iE iE kiE JriE 9iFk iE******iE 9E fiE 3E**9E iF*iF 9E it iE JE JEiP iF iF iF 9FiF iE 9F iE*iF 1r 3E JE*iE*ik if iF Jf iF*iE iE LEGALIZATION:N F E E U M M A R Y STRUCTURAL SEGMENT:N k_ BLDG PMT PLUMBING EL RIC MECHANIC FIRE SMIP/RES GRADING PERMIT 111 00 '5Y SMIP/NON—RES PLAN ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSU PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 111,00 3.00 0,00 114,00 114,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 114.00 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 114,00 iE if 1E iF iE JE iF 9F Bf OE 9E * 9F iE iE fE * * jFRE IE 9E BF iE iE BE # if * iE * iE iE * 1E iE 9F iE 1E JE 9E lF iE iE 1F iE iE * * # * iE 4E 9E iF iE aE 9E IE 9ERF * RE 9f * * iE 9F aE IE # Of 3f 9E BE iF ie aE BF 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 8 BATHTUB 200 1600 PLU 3 DISHWASHER 2..00 6..00 PLU 3 LAUNDRY TUB OR WASHER 2.00 6,00 PLU 3 SINK, KITCHEN 2.00 6.00 PLU 11 WASH BASIN 2.00 22,00 PLU 8 WATER CLOSET (TOILET) 2.00 16.00 PLU 3 WATER HEATER AND/OR VENT 2.00 6.00 PLU 3 WATER SERVICE 2.00 6.00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2,.00 2.00 PLU 8 GAS PIPING SYS 5+ OUTL—PER OUTLET .-50' 4.00 PLU 3 GAS SERVICE -' 2;00 6.00 NSTRUCTION AND PLANNING �(.PPROVALS Permit# Date Inspector POO A APPROVALS Perm Date Inspector . LE1Temporary Electrical Service or Pole 52. Pool & Equipment Location Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. -Electrical Condt`nt-Utility-Undrgrnd. 1 � 54. Forms i A3,Electrical Conduit=Undrgrnd. 55. Electrical Bonding ' • 5 `Steel Reinforcement- n 56. Rough Plumbing & Pressure Test .'6.,Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - 7. Footings 58. Electrical Conduit-Undrgrnd. G '6.. -Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Un&g*md. / 60. Backwash Lines, P -Trap, 0 Undrgrnd. ' 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ( ` 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final " 1� _ 13. Roof Drains 64. Plumbing System - Final - 14. Rough Plumbing-'- !y 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 98. Rough Electrical -T Bar Ceiling •& 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating Air Conditioning FIRE DEPT. REQUIREMENT - Permit # - - - - 20 Rough Factory Fireplace.APPROVALS, f 21 'Ducts, in -Structure" .. .'c z7 � ' 0. L7ndefgcound Hydro , 22. Ducts, Ventilating' . .., - ` .'71. Product Piping OGas 00iI l72. 23:-Gas-Pipe`-'Rough&•Test ;rte 1t - Underground Flush, - 24.- Roof Framing ; _ 73._ Undergrnd. Storage Tank:O Gas ❑Oil_ 25. Robf Sheathing-`7gOverhead Nydro� ' 26. -T -Bar Ceiling(Structural) &.Monocoat - - - 75.. Dry Chemical - '''- ,;•s-. ; - _ _ 27. Frame and Flashing 76.'DryStan pipe ' �`-''! ="^ 28 "Lathing& Siding ; L;- r• > e 77. FIXED SYSTEM FINAL- INAL>'29. >'29.Insulation - 78" FIRE PREV. FINAL =y � 30. Drywall -!Nailing HEALTH DEPT. REQUIREMENT ' _31. Plaster Brown Coat' r J9" FINAL INSPECTI9N = r 32._ Electrica`t Power Meter -Final. t . ` 80.,1FOOD CERTIFICATE ISSUED 337iFinal Electric - (f. (Notes: - J �• _'x 1 - ':34`Firial Heating& Air,' Conditioning - `"- ,, y ,' ' 'r ; 35. Final Gas Pipe -Test, �.. �� %i x _•� - . -36.-Hoon or :Ca nopY r - '•; "' _ ,3 37. -Final Factory Fireplace •> - i - '38. Final Plumbing q� (rsl�' - "' ,_ ,,?39. Water Service -Final rc ti�Tl`l�CAWj` r -�. v�; Iq -_40. Gas Service -Final X41. Solar Domestic -Final ' 42.'Backflow Preventee. 43. Backflow Irrigation L- �44. Landscape Irrigation System.. - J _ ; -? o c-, .. c. '.- ,- , _ - _nom �7^ >45 -Sound Attenuation r,- >' - a ,x• 1�46.^Handicap Regulations - •47 FINAL STRUCTURE & BUILDING • 1 -; p 48:•.FIN'ALPLANNING ,:49.= Electric Release to Edison 50. Gas Release to Southern California Gas Co ,' ' ' "' - •` ' �' 51. CERTIFICATE OF:000UPANCY No. Date qE .. -v <D-') \ PROJECT ADDRESS: E UNIT: OWNER'S NAME: ADDRESS: PERMIT NO: P 054419 PLAN CHECK NO: 04079-91 N PAGE: 2 ARCHIENGINEER: REG.NO.: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ADDRESS: UNIT: PLU 3 SEWER, BUILDING / TRAILER 5,00 15.00 PERMITTEE: END OF FEES ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7900) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cerfificate of consent to self insure or a certificate of Workers' Compensation Insurance. or a cerrified copy thereof (Section 3800, Lab. C). POLICY NO.: ESP. DATE: COMPANY: ❑ Carousal copy is hereby furnished. ❑ Cerilied copy is filed with the city Building Division DateApplicant. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit Is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forhwlth comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 301 the Business and Professions Code) or that he/she is exempt therefrom and the basis lot 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. as owner of the propeny or my amloyees with wages as their sole compensation, will do the work. and the . •. C3 structure is not intended or offered for sate (section 7044, Business and Professional Code: The Contractors' State License Law Ices not apply to an owner of a property who builds or improves thereon, and who does such work himselUherself 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 at completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale)- ), as owner of the propeny. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon , and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware i that proof of heir Worker's Compensation insurance should be provided to me. .L ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: f I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505. 25533. and 25534 and that I or any future building occupant wilVwill not (circle one) need to comply with said slate codes and the requirements for a , permit for construction or modification from the Air Orality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby pertly that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property for Inspection purposes- ' Date: Signature: ' Driver's License or Social Security n: r 1641-46 White—Budding: Green—Code Enforcemeri Canary—Applicant: Pink—Revenue; Goldenrod—Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POC SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11, Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace •c 21.}Ducts, in' i Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23: ;Gas'Pipeflough &Test 72. Underground Flush 24.-Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26.T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. "Frame and Fleshing 76. Dry Standpipe 28`'Lathing"&Siding 77. FIXED SYSTEM FINAL 29. Insulation •ri 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 31 f inN Electric Notes: 34 Final Heating& Air Conditioning a 35.-Final Gas Pipe Test 36.,Hood or Canopy ' 37.,-.Final Factory Fireplace 38. Final Plumbing 39 Water Service-Final 40:,.Gas'Service-Fina I 41. Solar Domestic-Final 42., Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48.,FINALPLANNING " 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 217 1 6TH PL OWNER'S NAi BRIGGS DEVELOPEMENT ADDRESS: AVANETA CARLOTTA ARCHIENGINEER: ADDRESS: REG.ND.: UNIT: D,E,F CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 054428 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby aurm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 01 the Business and Professions Code. and my license is in full farce and etlecl. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab, Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Candied copy is hereby furnished. ❑ Carolled copy is filed with the city Building Division. Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be Completed if the permit is for one hundred (5100) or less).' I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to became subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It. alter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any pity of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (8500). 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 lot 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 handed, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sate. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the pmjeCl (S coon 7044. Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who ar int es (hereon and who contracts for such projects with a contraclot(s) license pursuant to the Contractors St Lia se . I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Secuon: B. 8 P. C. for this reaasssoonn: ,�,� nj / Date: /LL;��� Dwner. — — I do hereby cenity that I am aware of and understand the requirements of Californi Health d ely Code Sections 25505. 25533, and 25534 and mat I or any future building occupant wilVwill not (circle one) need to comply aid state codes and the requirements for a permit led construction or modification tram the AirAir 0uahly Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby cemly that I have read this application and st®rebf or . I agree to comply with all city and county ordinances and slate laws relating to building constructioes of ihk city to enter upont eabove-mentioned propen mspecUon DulpOs�Dale: �SignaturDriver's License or Social Security a: Green—Cotle Enlorcamenl: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor PERM NO: M 054428 GOVT: N SUPP: N PURPOSE: NEW JOB DESCRIPTION ; NEW 3 UNIT APARTMENT BLDG SQ FT; CLAIM VALUE: CALL—VALUE: GROUP OCC: R-1 / COMMENTS: REF B54391 if 9E iF * iE iE iE iE NE 9f TE 9E �1F * BENE 9r' * 9E 9F iP iE NE 9E * 9t 1E ie iE BE iE iE NE * iE 9E 9E BE BE 9E iE 9E iE NE iF iL-BE iE iE iP 9E * iE iE * 9f 9X 9E BE 9E NE iE 8k iE iF 9E 4E BE 9E iE iE iE9k iE iE iE iE if 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 i FRNT: {LEFT: -- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FT IN REAR: IN FRNT: FT IN REAR: FT IN FT IN RGHT: IN LEFT: FT IN RGHT: FT IN FT FT 164 1.46 White—Building: PARKING RE& PROV: PARCEL: 42520106 ZNE: REF NO: PLANNING N TES> > ♦E iE 9E * * Nr' BE iF iE IE * iF Br' 9E iE 9E ik iP ii 9t 9k * * BP 9X iE * k jE BP iE iE iP iE i(-Bf.iF Br' ie 9P iP iP BE 1Fit BE BE Br' 3F iE iE 9E 3t IE * iE k iE 9F iE * * * 9E iE BE ie 8E 3E * OF * kP * iE iF * 1F k D E V E L O P M E N T S E R=V I C E°S R E Q U I R E M E N T S ZONING APPROVED BY N; DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: APPLICATIONISSUED DATE: 1(2 It Be iE MiE }^A^�iE it iM1 iFiF iE if it Tr' Bk iFi(• iEBFlt9E9EiFBX9EBPiP*)E*iPBFiEaFiXiEiE9k*9tiLiPiE9Ek8E**1P3Eif3E9P9E9fBP9FiF8F iciFBt8EIE9f9f9Etttt9E9EiEiPtE9P9f8E1E9PiE9EiP9E9P9t9fiEBEiF*x9EIEBL LEGALIZATION:N F E E S U M A R Y STRUCTURAL,SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 88,25% '' SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 88.50 15.00 0,00 103.50 103.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 103,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 0103,50 iF BE 1r' iE 1E BF 9P iE iF BF iE 9E i61f iE * * iP iP * iF iF * * 9r' iE 9E 9t 1E 9r' iE iE iF iF 9E 8P iE 8l• BE BF iF 3r' iF 9F k BF iE iE iE 9E aP k iF * ±:9E * Br' 9P * * * iE 9E * BE IE iP BE 9E 1F 9F iE IE 9E 9P 9F aE kF I N D I V I D U A L -F E E B R E A K D O W N v TYPE QTY D E S C R I P T 110 N UNIT COST TOTAL COST MEC 3 INST FORC—AIR/GRAY-FURN <= 100 K BTU 9.00 27,00 MEC 1 GAS PIPING SYS 1 — 4'OUTLETS 3.00 3:00 MEC 8 GAS PIPING SYS 5+ OUTLETS PER OUTLET 75 6.00 MEC 3 FACTORY FIREPLACE t* 6.50 19.50 MEC 3 INST HOOD W/DUCTS FED BY MEC EXHAUST 6.50 19.50 MEC 3 VENTILATION FAN CONN TO SINGLE DUCT 4.50 13,50 END OF FEES i ) do Awk CONSTRUCTION AND PLANNING 1r POO MWA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location i. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.'Electrical Conduit- Utility-Undrgrnd. 54. Forms .� 4.,Electrical Condgitt;Undrgrnd. 55. Electrical Bonding 5tSteel Reinforceprent 56. -Rough Plumbing & Pressure Test " .--6-',Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE. ; •7: Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 19. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap J 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 Sigh 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Condltlonin y /it CAO FIRE DEPT. REQUIREMENT :APPROVALS :Permit # , - n ,•-:: �• 20...Roigh Factory Fireplace s r .'14 21 ,-Ducts, in Structure_ - "; ; t70. Uhde�gcbU66 Hydro ` .... 22. Ducts, Ventilating i -C• .71. Product= Piping 0Gas OOil 23. Gas Pipe -Rough & Test72. UndergFo unit Flusht Z4,Rodf Framing , .• '. - - 1. a73cUndergrnd.Storage-Tank flGas 00il 25. Roof Sheathing J, -` �• - '�; 74; Overhead'Hydro= ` r 26. T -Bar Ceiling (Structural( & Monocoat - ��,a 75. Dry Chemical 27.'Frame and Flashing: t .1 : ._ 76:� Dry Stan pipe ; T _ v 28.`Lathing$ Siding %- - r > 77- FIXED SYSTEM FINAL• a.: - ' '29. Insulation x ^ I - 7g_'FIRE PREV. FINAL 1 = 30. Drywall Nailing I t, - ff f HEALTH DEPT. REQUIREMI NT, .: Z Plaster Brown Coat 79. FINAL INSPECTION ,31. .� i'.. a J•'C ' 32. --Electrical Power Meter -Final > „ , SO,T FOOD CERTIFICATE ISSUED - >33.'Final Electric •_ - r r Notes: �((e�`q= M- 34. Final He>,ating& AirConditioning - ( t'L '•• 6 -`�' '' - _ >1 35. -Final Gas Pipe -Test- - ,36.lHood or`CanoPy 37. -Final Factory Fireplace S' - yM/_ r- '38. Final Plumbing _ `' •• 1 j i � . . n• :39. Water Service -Final,. - > ,-•o`- - ' z t > Y 40. Gas Service -Final - 41. Solar Domestic -Final L • - 42:'Backflow Prevente; 43. Backflow Irrigation 44. Landscape Irrigation System'_r : - -• ' ', �`'� • ._ , i:45._Sound Attenuation > _46. Handicap Regulations 47.,FINAL STRUCTURE & BUILDING `48. FINAL PLANNING r r "' ; r 49.. Electric Release to Edison 4 50. Gas`Release to Southern California Gas Co .p .. I 51. CERTIFICATEOF. OCCUPANCY No. Date INI0JEC7 ADDRESS: 'l, UNIT _217 16TH PL D, E, F CITY OF COSTA MESA — BUILDING PERMIT OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: AVANETA CARLOTTA PERMIT NO; E 054423 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION NEW 3 UNIT APARTMENT BLDG ADDRESS: UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 Of Divsion 3 of the Business and Processions Cede. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to sell insure or a certificate of Workers' Compensation Insurance. or a certified coDY thereat (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: p Confided Copy is hereby furnished. ❑ Catchup copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Th s 5dcliml need nal be Completed if the perm) is let aro hundred (5100) or less). I Cenity that in the performance of he work for which this permit is issued.) shall not employ any person in any manner so as to became subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must lonhwilh 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 at the work lar which this permit is issued (Section 3D97. Giv. Q. LENDER: kkkkkkkkkkkkkkkkkTEkkkkkkkkkkkkkkkkiEkkkkk kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk ADDRESS: LEGALIZATION:N F 'E E I S M M A R Y STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law muhe following reason BLDG PMT PLUMBING ELECT R MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of manly wRch requires a permit to construct, alter, improve, demolish, or PERMIT 1 17 5 repair any structure. prim to its issuance. also requires the applicant for such permit to life a signed statement that Noland is licensetl = SMIP /NON—RES pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing in Section 7000) at Division 3 of the Business and Professions Code) or WI he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7131.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty at not more than live hundred dollars (SBOO). ISSUE FEE 15 .00 I, as owner oI the property or my amyloyees with wages as their safe compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or altered lorsafe(Section7044.Businessand Professional Code: The Contractors' State LlcenseLaw TOTALS ---- > 117.75 15.00 0.00 132.75 132.75 .00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/hersell or through his or her awn 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 for the purpose of sale), f, as owner of the property. am exclusive N contracting with licensed Contractors to construct the Project (Section 7044, Business 131 and Profession Cade: The Contractors' State License Law does not appy to an owner of propeA who, builds oa proves hereon and who contracts for such projects with a contraclons) license pursuant to he Contract tate Lice aw),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. b P. C. for this reason: n x 1 1 PERM NO: E 05492 GOVT: N SUPP: N PURPOSE: NEW SQ FT': CLAIM VALUE: CALC—VALUE: GROUP OCC. R-1 / COMMENTS: REF B54391 kSE 9t9tkkkkSE�kSE SE DEk*SEkk**alk�SE*k*kk k9tkk kkk*kk*itkk kkkkkk kk�tkk�kk�kkk kBtkkk*itiFSEkkSE*kkkk 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--------- /� f �— FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE&(� PROV: PARCEL: 42520106 ZNE: REF NO: \ PLANNING N(STES> > s kkkkkkkk kk kkkkkkkkkkkkkk kkkkk kkkkiEkiFkkkkkkkkkkkk kkkk kkkkkkkk kkkkkkkk-iE-i�E iE lE iE iE 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 T S �✓N ZONING APPROVED BY DA/TE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: kkkkkkkkkkkkkkkkkkkkkk kkkkk'lEkkkk�iF£kk Dale: i/ _t1z^' / Owner. Y I do hereby canny that I am aware of and understand the ni "re lents at Cal dmno Hea 5533. and 25534 aha mat I or any future building occupantMIT' Int � said state codes and the requirements for a permit for construction or mOddicalion Irom the An uabty Management District.ntial Construction applications are exempt from these provisions. Dale: Applicant: z- _ — - - I hereby certify that I have read his application and slate that the above tr)IOmi Vin' ordinances and state laws reaping to budding emr tructibn and hereby a li 'orrect. l ee to comply with ad F' eso d•eI enter uppinnn I M\n properly car inspection purposed � Date : ��� ' Signature: /� f �— Driver's License at Social Security a: _ 1641-46 Whae—Budding: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessar REVENUE DIVISION TOTALS--> COLLECTED: 132.75 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAJ!—CHECK 132.75 k itkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk 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 ELE 3925 NEW RES BLDG FOR 3+ UNITS / SQ FT .03 117.75 END OF FEES ' CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PO L SPA APPROVALS Permit # Date Inspector - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -' I.-Electrical ConduitUtility-Undrgrnd.- 54. Forms A. Electrical Conduit-,Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement- 56. Rough Plumbing & Pressure Test ' ;§.. Electrical LIFER G_rrid. 57. APPROVAL TO COVER-GUNITE 7-. Footings ,' "� 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9, Water Pipe-Undrgi-nd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final , 12. Sewer Cap-Final63. Heater & Vent 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 .APPROVALS- ' -Permit # 20.-•Ro4h Factory Fireplace -. __ 21. Ducts, in Structure„ .. - " r :.; i70. Undergro4ic Hydro > 22. Ducts, Ventilating '' .� L': .71. Product'Piping OGas ❑Oil 23.-Gas Pipe-Rough & jest '- _ _ 72. Underground FlLIsh: 24.•RoolFraming - - - `73._Undergrnd7StorapgeTank0Gas ❑Oil 25. Roof, Sheathing Hydro - 26.�T-Bar Ceiling (Structural) & Monocoat o .: ' r + . 75.=Pry Chemical _ 27. "Frame and Flashing _ 76. Dry Standpipe } -' 28. Lathing & Siding _ �•� 77.- FIXEDSYSTEM.FINAL '29. Insulation a 78=FIRE PREY. FINAL -,30. Drywall Nailing 4> j -- HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat' ' _79:�FINAL INS2ECTIpN• - - -32.: Electrical Power Meter,-Final I �• - , T ..FOOD CERTIFlCAT6 ISSUED , 33, final Electric t,�/ ,,,�� [/Q� ) N ies, _ •' _ r34.. Final Heating'& Air.Conditioning: p _ 35. Final Gas Pipe-Test •' �'' '' ,10 r z36. Hood or'Canopy v s _37. Final Factory Fireplace -38. Final Plumbing. - = - -39. Water Service-Final ` ' - �.40. Gas Service-Final- - 41. Solar Domestic-Final 42."Backflow Preventer• 43. Backflow Irrigation' - x • " ,44. Landscape Irrigation SystemY, %45.:Sound Attenuation > r .'46.:Handicap Regulations 47.,,FINAL STRUCTURE & BUI,LDING C• 48. FINAL PLANNING _- t ,; ,� r " 49.. Electric Release to Edison _ .50. Gas Release to Southern California Gas Ca h , 51. CERTIFICATE OF OCCUPANCY No. Date , PROJECT ADDRESS: 2 1 7' 1 6 TH' PL UNIT: A, B, C OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA SUITE 31$ LAGUNA HILLS CA • ARCHIENGINEER: REG.NO,: ADDRESS: UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date NO.: Signature: DN DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' or a ter0fled Copy thereof (Section 3600, Lab. C). EXP. DATE: Certified copy is hereby furnished. ❑ Scribed copy is filed with the city Building Division. Date: Applicant:• EXEMPTION FROM WORKERS' COMPENSATION DECLARATION- ($IR section need not be completed if the permit is for one hundred (Sl 00) or less). I certify that in the penormance of the work for which this permit is issued: I shall not employ an to become subject to the Workers' Compensation Laws W.California. Date:- Signatures. NOTICE: Ifatter making.this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions "his permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a conS4u6ion lending agency for the performance of the work for which this permit is issued (Section 3D97. Civ. CI, LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors' State License Law for the fill g reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construcy�alter. -mord demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed sta enc that a/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Corte) or that he/she'is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($SCO). 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 himselNhersell or through his or her own employees, provided that such improvements are not intended or offered lar sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build Or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business [X and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects With a conbactor(s) license pursuant to the Contralpers' Slate LicLea Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. am exempt under Section: B A P. C. for this reason. Date: 0 er I do hereby Certify that I am aware of and understand the requirements of I r is and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to c with said state codes and the requirementsfor a permit for construction or modification from the Air Duality Management Dishic esidentlal construction applications are exempt from these provisions. Date. a Applicant: hereby certify that I have read this application �rlI stale that the ab ve info" gl. area to comply with all dy and ordinances and slate taws relating to buildmg dorEVuchonano hereby r' resyp a 5( this city to entero bve-m¢ property for inspection purposes. I Can:-0�Signature'. Driver's License or Social Security p: CO 1 41964 164146 While—Bmldumg: Green—Code Enlorcemem: Canary—Applicant: Pmk—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 054389 PLAN CHECK NO: 04051-91 A CONSTRUCTION TYPE: V -N PERMIT TYPE: STR JOB DESCRIPTION : NEW 3 UNIT APARTMENT BLDG CLAIM VALUE: CALL -VALUE: 303,148,10 PERM NO: B 105438 GOVT: N SUP•P: N i,s�; PURPOSE: NEW 1. SQ FT: 5,462 GROUP OCC: R-1 / COMMENTS: NEW 3 UNIT APARTMENT BLDG - ######################################################################9F######## 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: 20 FT IN REAR: 80 FT IN FRNT: FT IN REAR: Ft IN LEFT: 5 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN •,t PARKING REQ• PROV: PARCEL: 42520106 ZNE: R2 REF NO: DR90-09A PLANNING N TES> BLDG, #1, CONSISTING OF UNITS A,B,AND C. 1� ############JF'•###if##_#####jEjf.###df######Il•##################################aE##______3Ejjjjjj���FFF### D E VE -L 0 F, M:k,N T S E R V I C E S REQU I REM E N T"S ZONINGPPROVED BY `' • �, .' DATE: 1'.2, , t C1 t BUILDING APPROVED BY, : 1 DATE: APPLICATION-ISSUED;BY• :" ��\ DATE: ' LEGALIZATION:N F E E S -U M M -A R Y STRUCTURAL SEGMENT_,'. BLDG PMT PLUMBING ELECTRIC "-MECHANIC E',FIRE SMIP/RES GRADING PERMIT 1,353,50 30:-31 PLAN 219.95 y" JSMIP/NON RES ISSUE FEE o BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 1383,81 0,00 219:951- '1603.76 1603.76 •00 REVENUE DIVISION TOTALS-- > COLLECTED:; 1 1603,76, OVER/SHORT:' 00 BLDG PMT PLUMBING ELECTRI MECHANIC` FIRE' SMIP/TOT GRADING PLAN -CHECK 1353,50,30,.31 219.95 1 - r _ I N D I V I D U A L F E ,E - B' R-E--A:,K D� O _4 N tt TYPE QTY D E S C R I P T I O.N `` •UNI.T COST TOTAL COST SFR 4043 DWE-TYLE V<WOOD FRAME- " -GOOD !169,00 278,967,00 SFR 105 RES CONY, EXTERIOR?STAIRWAY.-_- / 13.80 1,449.00 SFR 14 S -GARAGES TYPE V 17.30 22,732,20 END.OF'FEES, .J NSIRUCTION AND PLANNINAWF SPA MW Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - `3.'.Electrical Cond Uit-'Utility-Undrgrnd. 54. Forms -4. -.0ectrical Conduit_Undrgrnd. 55. Electrical Bonding ' 5.; Steel Reinforcement, �-� 56. Rough Plumbing & Pressure Test 6. ;Electrical UFI W6rnd. 57. APPROVAL TO COVER-GUNITE .' 7-7 Footings _ NS'= 58. Electrical Conduit-Undrgrnd. _ '8.; Foundation ,nom, 59. Gas Pipe, O Undrgrnd., Test L 9�.cWater Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, E Undrgrnd. 10 Structural Floor System & Q7- 61. APPROVAL TO DECK 11.: Property Sewer Line;& House Connection r 62. Backwash & Receptor -Final ' 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains ro 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 ElectriGrt l -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT :APPROVALS, _Permit \- 20..Ro -9 FactocY Fireplace s r :P• _ j . x 21 Ducts, in.Stryct E; -, a '' S "� > X70. Unde�i'gyoun`d Hydro „ 221 Ducts, Ventilating - r il _t c,... x c71, Product F ping E•Gas E�Oil x'72, 23.CGas PipeRough &Test '- - --'•; , _ tR ,� M`.;- Underground FI"as, 24.,Roof Framing..S73t Undergrnrb. StaragerTank.❑ Gas• E QII 25. Robff,Sheathing¢ q2. �✓ � P '74'bverhead'Hydrn-,-'` P 26 !-Bar Ceiling (Stryctural) &<Monocoat J 75. Chemical r c Dry - .V t; 27 -Frame and Flashing= Gy �" 76` Dry Standpipe ' 28°"Lathing.& Sidingy ,-• -- y .•.. 77: FIXED SYSTEM.EINALr X29. Insulation 78.tFIREPREV.FINAL x - .;30. Drywall Nailing HEALYH:DEP7. R.EQUIREIVIEiAT :31. Plaster Brown Coat s i -f' r7g• FINAL IN$eECTLQN 32. -Electrical Power Meter -Final ` ; 80., FOOD CERTIFECATE ISSUED' - 33.'rFinal Electric .� "i :r': Not; Heating ,& Air,: Conditioning :T •' '' s1,34.-Firia4 bf 9r 35.,Final Gas Pipe -Test' T .' 1 e t _ c;yr•-•,��'S ,� 0136. Hood or_Cano PY � -: .• �� - I [r >-I L ",�'G �1 C� � '. P "�f 37! -Final Factory Fireplace>..- -7t `344 8. -Final Plumbiri9 - tr a; -• L'_ �� 4 r L _392Waier Service-FinaF. -, Ll 3 s t .r -. ,-� T, Service- .inal- - ;:41. -Solar Domestic -Final,:_ r 42P'Backfiow Preventer"' 'L 43. Backflow Irrigation - r• � • 44. Landscape Irrigation System,:r'II J - .i. rL "-'.'-• s l _ i ;'45r'Sound -Attenuation - - f r •46. Handicap Regulations C ri�L�-Q Q -47. FI AL STRUCTURE & BUILDING /• �� �YJ. ,Ej�=; Y> �• r ,49 • leciric Release to,E -s 50. Gas Release to Southern California Gas Co j it r '- `''L°• ", - 51. CERTIFICATE OF OCCUPANCY _ No. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY NO. P. O. Box 1200 Costa Mesa, California The Building located at 217 16TH Pace, Units A,B,C has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R1 Occupancy. Use of Building i Unit Anartment Legal Description 425-201-1716 ISee reverse side for Metes and Bounds) Building Permit No B 54389 Electrical Permit No. Plumbing Permit No. P 54418 Mechanical Permit No. M 54427 Number of apartments 3 and/or guest rooms ISSUED TO: Briggs Development 23046 Avaneta Carlotta Laguna Hills, Ca Building Official Tony c'ne RAGA by --k` Date January 15. 1993 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/83 White - Owner:Canary - Numerical File;Pink - Bldg. Permit File Project Address: Lot ,Number: _ PermitNumber: By Civil Engineer: FINAL GRADING CERTIFICATION 217 16th Place, Unit A Lot 1 of Tract 14384 ME", 0 J 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%r Fall for asphalt surfaces and landscaped areas. 0.59 Fail for concrete surfaces to approved disposzl zrers. The final monumenu as sio-xn on the recorded tract ,�.ap were cet. All `nal grading elevZ- tions zre within = 1;10 of the d-Mc.e elevations. Supervising Civil Engineer Reg. No. 31720 _ (SiEra:un) Date 12/4/92 / I QR�OFf SSI pN CID v Z W M 1/42 1r �l�lf Of CAS A; . ti Project Address: Lot Number: _ Permit Number: By Civil Engineer: FINAL GRADING CERTIFICATION 217 16th Place,. Unit B Lot 1 of Tract 14384 DR -90-09' 0 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 »ere set. All *15-n--,1 grading elegy•=- tions are within 1;10 of the des' n elevations. Supen•isin2 Civil Engineer Reg. Ko. 31720 Mie 12/4/92 O\N LW m cr. /92 �l9lf Of CAS _? an:! S:t;; 1i . Ll FINAL GRAgING CERTIFICATION Project Address: 217 16th Place, Unit C IM Number' —_ _ Lot 1 of Tract 14384 Permit ;umber: By Civil Engineer: I certify to the satisfactory completion of grading in accordance with the approved pians, 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 dater 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. 0.59 Fall for concrete surfaces to approved disposal areas. The fral monuments as shown on the recorded tract map were set. A'.1 final grading eleva. tions are within _ 1;10 of the desisned elevations. Supervising Civil Engineer Rei. No. 31720 . (SiFra:uro) Date 12/4/92 .4R�OF/�SS p F C At &L A OF COSTA MESIO CALIFORNIA 92628.1200 . P. O. BOX 1200 Insulation Certificate ' 217 E. 16th Place, Unit A B C Costa Mesa Number and Street City Orange part of Tract 14384 County I Subdivision Lot Number ROOF Material 7-hickness (inches). Description of Installation Brand Name Thenal Rmi=ncc (R -Value) EXTERIOR WALL Material FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness (inches) ' 3�,;,. Thermal Resistance (R -Value) R-11 MILING- Batt or Blanket Type FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness(inches) 9 1/2" ThamalResistance (R -Value) R-30 Loose Fill Type Brand Narne Contractor's minimum installed weighdit Ib Minimum thickness incus Manufacturer's installed weight per square foot to achcive Thermal Resistance (R -Value) RAISED FLOOR Material _ Thickness (ince SLABFLOOR Material Thickness (inches) Width (inches) _ FOUNDATION WALL Material Thickness (inches) Brand Name Thermal Resistance (R -Value) - Brand Name Thenal Resistance (R -Value) Brand Name 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 Administrative Code. BRIGGS DEV. rk al Contractor (Builder) Ucctuc Number Daw ' ri t 1 N0V 2 0 5992 ;II ��00 ------------------------- 911114101CO ' U 'r pg »C-C�r APAL1�V� zi7 G. e� ��,�ccE CLOS A ��(MESS;}, Cf4 Certificate of Conformance Certificate N° 9273 —91 THE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the structural wood products identified below and marked with a collective mark of American Wood Systems (AWS) were man- ufactured in accordance with the specifications indicated below. %X ANSI Standard A190.1-1983, for Structural Glued Laminated Timber CI El Job Name BARR LUMBER c/o CASCADE EMPIRE CORP. Job Location COSTA MESA, CALIFORNIA Customer's Order No. 71338 Date 5-08-92 C 320386 JN Signature company B SE CASCADE CORP Mfgr's Order No. 09-00248 e= Title QUALITY CONTROL SUPERVISOR Address P • 0. BOX 50 Date BOISE, ID 83728 IT IS HEREBY CERTIFIED that the structural glued laminated timber production of the above-named manufacturer which carries a collective mark of American Wood Systems (AWS) is subject to regular audit by American Wood Systems, such audit consisting of the inspection with reasonable frequency of the manufacturing process, with adequate sampling to verify the quality of glulam construction and the adequacy of glue bond. y? �VORgl J'`J,�Ii SEAL :`mss by Michael R. O'Halloran Executive Vice President 111%liASHING, AMERICAN WOOD SVSTEi.IS - A RELATED CORPORATION OF AMERICAN PLYWOOD ASSOCIATION 516 CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT -MESA UNIFIED SCHOOL DISTRICT Developer/Applicant: Address: l�C�I� G3YRC0�i`f !}ILLS %?6�� Telephone Number: 3 490 Tract/Parcel and Lot Number(s): Location of Project: Number of Square Feet of36SmFr Residential SpaceL�i- S�GL7S4 $1.50 Total _,?15q,00 s�36,08 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. we sk Busi-ness Manager Newport --Mesa Unified School District The above representati n as to square footage is true. Developer/ Applicant agrees that i it is later determined that such representa. tions are not true then is certificate shal ut tically terminate and the appropriate City/ ounty shall b j Date: /a -g- 91 J DD Ticant PROJECT ADDRESS: 917 . 16TH- PL OWNER'S NAME: BRIGGS `DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA SUITE 315 LAGUNA HILLS CA ARCHIENGINEER: ADDRESS: REG.NO.: UNIT: A, B , C UNIT: PERMITTEE' BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a candidate of Workers Compensation Insurance, or a certified copy thereof (Section 3800. Lab. Cf. POLICY ND.: EXP. DATE: P Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Daie: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thissedion need not be tl inpleted it the giant is for one hundred ($100) or less). I cenlly that in the performance of the work for which this permit is issued, I shall not employ any person inanymanner so as to become subject to the WorkersCompensation laws of California. Date: Signature: NOTICE: If, alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. , - CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for toe performance of the work for which this permit is, issued (Section 3097, Civ. CL ! LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT -—P RM NO, P 054418 PERMIT NO: P 054418 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: NEW SOB DESCRIPTION NEW 3 UNIT APARTMENT BLDG SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-1 / COMMENTS: REF B54389 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 REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42520106 ZNE: REF NO: PLANNING N TES> > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY APPLICATION ISSUED BY: ###################### LEGALIZATION:N F E E U M M A R Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELEC I C MECHANIC (Section 7031.5 Business and Professional Code: Any d y of county which requires a permit to construct. alter, improve, demolish, or PERMIT 1 1 1• 0 0 repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5 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 7931.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ISSUE FEE 3.00 ' DATE: DATE: DATE: vll *** *71RRFWigi ######## ####### S'FRUCZURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES . Date: l(�-OwnPLU BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my em7loyees with wages as their sole compensation, win do the work, and the El structure is not intended or offered for salelection 7044, Business and Professional Code: The Contractors' State License Law TOTALS ----> 111.00 3.00 0.00 114.00 114,00 00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however the building or 1 ' DISHWASHER J00 improvement is sold within one year of completionthe owner will have the burden of proving he/she did not build or improve .for REVENUE DIVISION TOTALS--> COLLEC:TED • 114.00 OVER/SHORT: the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC - FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business ® 114.00 PLU 3 and Professions Code: The Contractors' State License Law does not apply to an owner of pro cin y who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Grain 'Stateli se Law). l am a ware that proof of their Worker's Compensation insurance should be provided t me. `**Sf-*jCie JC{FT(.)¢*Tt {C 7{jc#IC iC {C {��L*j%*1C {{=�L,l##{IL {(.'{i..)G .y(.{##{F#{p#i(.1(.#i(•##.IF I N D I V I D U A L• F E E #. if.9(. iE #if. iF {(. j(. {F JE {F�k+E 1(. al.#if OF##.###### B R E A K D O W I am exempt under Section: 8. 8 P. C. provisions. PLU 11 kir this reasom TYPE QTY D E S C R I P T I Ox -N UNIT COST TOTAL COST . Date: l(�-OwnPLU 8 BATHTUB 2,00 16,00 I do hereby certify that I am aware of and understand the requirements 33, and ecludns 255 , 255 PLU 3 DISHWASHER 2 00 6 00 25534 and that I or any future building occupant wiNwill not (circle one) need to coli,151y with said state codes and the requirements for a PLU3 LAUNDRY TUB OR WASHER , 2 00 , 6 00 permit for construction or modification Iron the Air Outlay Management District. Residential construction applications are exempt from these PLU 3 SINK, KITCHEN , 2,00 , 6.00 provisions. PLU 11 WASH BASIN „ 2,00 22,00 Date: Applicant: PLU 8 WATER CLOSET (TOILEET) 2.00 16.00 I hereby cendy that I have read this application and Stale roar thea ire mf rm s a to comply Nth all city and county PLU 3 WATER HEATER AND/OR VENT 2. 00 6 , 00 ordinances and state laws relating to building construction and If your esema v of 't to enter upon bove-mentioned PLU 3 WATER SERVICE 2. 00 6. 00 property far inspection purposes PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2.00 2.00 Date Signature I PLU 81 GAS PIPING SYS 5+. OUTL—PER OUTLET 50 4.00 _!_!//� PLU 3 GAS SERVICE -2.00 6.00 giver's License or Social Security a: 1641 d6 wane—Building: Green—Code Enforcement: Canary— Icant: Pink—Revenue: Goldenrod—Assessor P• SPA CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' ,3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4.,Electrical ConduiCUndrgrnd. 55. Electrical Bonding n. Steel Reinforcement 56. Rough Plumbing & Pressure Test , �.. Electrical UFER Cprnd. 57. APPROVAL TO COVER-GUNITE' Footings`*. 58. Electrical Conduit-Undrgrnd. 8.'Foundation� 59. Gas Pipe, O Undrgrnd., Test 9l.Water Pipe-Undrgrnd. 3G 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. *Structural Floor System 61. APPROVAL TO DECK _ 11. _Property Sewer Line &House Connection 7 62. Backwash & Receptor-Final_. 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing �Q'j� C.1D 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 APPROVALS -Permit 20..Roirgh Factory Fireplace - -. - - 21."Duct's, in Stryctu'r�:_X70. Underground Hydro - 22. Ducts, Ventilating ' s. .71. Product Piping ❑Gas El Oil 172. 23. Gas Pipe Rough & Test ,-r Underground Flusk 24. _Roof Framing •n r.73.t Undergrnd. Storage Tank ❑ Gas 0 Oil 25. Roof Sheathing ' to :';w '74, Overhead 'H ydro- 26. -T-Bar Ceiling (Structural) & Monocoat _ i I'll 75. Dry Chemical �- _ ;'y •r • - ' '_ 27.+rameand Flashing ; 76. Dry Standpipe �5 -• of ,r � 28: Lathing& Siding ' _-� z � e 77. FIXED SYSTEM.RINAL• 29. Insulation •' - ' '" ` 76,-'FIRE PREY. FINAL • � 30. Drywall y Nailing I u , ...•.. �- HEA LTH�DEPT-. REQUIREMEN.T .31. Plaster Brown Coat': _ I �� , 79.- FINAL• INSPECTION 32. Electrical Power Meter-Final. I-,.80.. FOOD CERTIFICATE ISSUED 33. ¢tool ElectricNotes: -�✓�__ '34, Final Heatingt& Air Conditioning 35: ;Final Gas Pipe-Test ,36.'Hood or'Canopy 37:_FinaI Factory Fireplace c r�- '38. Final Plumbing i -�39. Water Service-Final rig •+ �� :40. Gas Service-Final 41. Solar Domestic-Final,• 42. Backflow PreventeT 43. Backflow Irrigatiorn .'�- Landscape lrrigationSystem a; ;` ,44. :-''=, >45.-Sound Aitepuation . T - '46. Handicap. Regulations- 47.-FINAL STRUCTURE & BUILDING r 48. FINAL PLANNING -49.-Eleotric Release to Edison i 50.,Gas_Release to Southern California Gas Cnez - -- -• `-. , ', '; ' 51. CERTIFICATEOFOCCUPANCY No. Date J PROJECT ADDRESS: UNIT: OWNER'S NAME: ` ADDRESS: ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Omsmn 3 of the Business and Professions Cotle, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab, C). POLICY NO.: EXP. DATE: OMPANY: Certified copy is hereby furnished. ❑ Certified copy is filed with the City Building Division. Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: ((This section need not be Completed it the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: 11, after making this declaration, you should become Subject to the Workers' Compensation provisions of the Labor Code. you must lanhwilh comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city at county which requires a permit to construct. alter, improve, demolish, of repair any structure, prior toils issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions o1 the Contractors' State License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I. as owner of the property or my employees with wages as their sole Compensation, will do the work, and the ❑ structure is not intended or offered for sale (5¢ction 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 himselflherself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an owner of propely who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' $tale License Law). I am aware that prool of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. for this reason: Dale: Owner: I do hereby Certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and trial I or any future building occupant wili not (circle one)need to comply with said state Codes and the requirements for a permit for construction or modification from the Air Oualily Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction and hereby anal representatives of this city to enter upon the above-mentioned properly for Inspection purposes. Date: Signature: Driver's License or Social Security N.: 1641 46 White—Building: Green—Cade Enforcement; Canary—Apphcam; Pink—Revenue; Goldenroki—Assessor PERMIT NO: P 054418 PLAN CHECK NO: 04078-91 N PAGE: 2 TYPE QTY D E S C R I P T I O N PLU 3 SEWER, BUILDING / TRAILER END OF FEES UNIT COST TOTAL COST 5.00 15.00 +S Il 1 " ti i t r UNIT COST TOTAL COST 5.00 15.00 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector PAW SPA' APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .-3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding `o. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring. 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Eectory Fireplace L 21 ?Ducts, in'Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 000 23. ;GasPipe-Rough & Test 72. Underground Flush 24.,Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roq''f Sheathing 74. Overhead Hydro 26..T -Bar Ceiling -I Structural) & Monocoat 75. Dry Chemical 27..'Frame acid Fleshing 76. Dry Standpipe 28. Lathing'& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33.,Fin5l Electric - Notes'. -! 4 G�-Ttau�_w_�*s•_e._t 34. , Firial Heating&',Air Conditioning 35. -Final Gas Pipe -Test 36.,Hood or Canopy 10.2 37._Finll Factory Fireplace 38. Final Plumbing CA* 39. Water Service -Final L `i 40'�Gas,Service-Final 41:jSolar Domestic -Final 42.,Backflow Preventer 43. Backflow Irrigation 44. Landscape U -r igation System - 45. Sound Attenuation 46. Haridicap Regulations 47 -FINAL STRUCTURE & BUILDING 48.,f MAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 217 1 6TH PL OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA SUITE 315 LAGUNA HILLS CA ARCNIENGINEER: ADDRESS: UNIT: A,B,C CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 054427 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC REG.ND.: JOB DESCRIPTION NEW 3 UNIT APARTMENT BLDG UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is is full force and effect. CITY LIC.: STATE LIC.: CLASS: Date, Signature: WGhKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab, C). POLICY NO.: EXP. DATE: OMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EX Ell PITON FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for One hundred ($100) or less). I comfy that in the performance m the work lot which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: II, after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or flus 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. Cw. C). LENDER: ADDRESS: CLAIM VALUE: CALC—VALUE: PERM NO: M 05442 GOVT: N SUPP: N PURPOSE: NEW SQ FT: GROUP OCC: R-1 / COMMENTS: REF B54389 *kkk*kkkkkkkkk*kkk**kk*kkkkkkkkkk*k�kkkk*kkkkkk�kkkkkkk�kkkkkkkkkkkkkkkkk*k**mak Z O N I N G S E T B A C K S R E Q U I R E M E N T S ---------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE&(� PROV: PARCEL: 42520106 ZNE: REF NO: PLANNING NOTES> > 'kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkklE3kkkkkkk�kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk D E V E L O P M E N T S E R%^V� I C ,E "S R E Q U I R E M E N T S 'ZONING APPROVED BY DATE: BUILDING APPROVED BY : APPLICATION ISSUED BYe kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkM LEGALIZATION:N F E E S OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTR (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve. demotish, or PERMIT repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed PAID pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000( of Division 3 of the Business structure is nor intended or offered for sate (Section 7044, Business and Professional Code: Ile Contractors' State License Law and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7034.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ISSUE FEE DATE: DATE: /O / kkkkkkkkkk kk kikkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk M M A R Y STRUCTURAL SEGMENT:N MECHANIC FIRE SMIP/RES GRADING 88 50 '5% SMIP/NON—RES 1-5.00 - I. as owner of the properly 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 nor intended or offered for sate (Section 7044, Business and Professional Code: Ile Contractors' State License Law TOTALS ---- > 88.50 15.00 0.00 10 3.50 103.50 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself at through .00 his or her own employees. provided that such improvements are not intended or offered for sale. If. however the building or 10 improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for REVENUE DIVISION TOTALS--> COLLECTED • 103.50 OVER /SHORT • 00 the purpose Or sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of the properly, am exclusive] y contracting with licensed contractors to construct the them (Section 7044, Business IX 103.50 -'- and Professions Code: The Contractors' Slane License Law does not apply to an owner of prop ho build Improves thereon and who contracts for such projects with a connfactor(s) license pursuant no the o a- Law). l am aware kk3Ekkkkkkkkk3k iElklklk lEkBEkiF lk ik iE ikkik ik 3k ik ik 3E iE ik jk{kBklk ik iklk ik{k 3k lk{k{k ik ikk{k{k lk ik{k1k{kkk{k{k.Lkk.lk {k k{. k. {kk.N. il.k3k 3(. K.k{k {L. that proof of their Worker's Compensation insurance should be provided to \\ I N D I V I D U A L F E E B R E A K D O W N ❑ 1 am exempt under Section: B. 8 P. C. for ma reascm l� ii^ TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale: owner. MEC 3 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 27.00 I do hereby certify that I am aware of and understand the requirements of California H and Safety Code Sections 25505. 25533. and 125534 MEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3 0 0 3 00 and matlorany mwre building acupanr wilVwill not (cirdeonel need to c0 with said stale codes and the requirements fora permit for construction or modification from the Air Dually Management DlStrltt. esidential construction applications are exempt :tom MEC 8 GAS PIPING SYS 5t OUTLETS PER OUTLET , .75 , 6,00 these provisions. MEC 3 FACTORY FIREPLACE 6.50 19.50 MEC 3 INST HOOD W/DUCTS FED BY MEC EXHAUST 6.50 19.50 Dare: Applicant: MEC 3 VENTILATION FAN CONN TO SINGLE DUCT 4.50 13.50 I hereby dearly than I have read this application and slate that the above a red agr in w If all city and county END OF FEES ordinances and state laws relating to building construction and here o many Ih a toe er o he above-mentioned property Itlnspeehot purposesl^�,. Date: ty Signature: Driver's License or Sonat unity x: 1641-46 White—Building; Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor PCW SPA CONSTRUCTION AND PLANNING 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 1Electrical Conduit-Utility-Undrgrnd. 54. Forms --4.-Electrical Conduins drgrnd. 55. Electrical Bonding ' S.. Steel Reinforcement 56. Rough Plumbing & Pressure Test i .- :.-6.-Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE ' T. Footings 58. Electrical Conduit-Undrgrnd. ,�;=' B. -Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 -Undrgrnd. 10.'Structural Floor System 61. APPROVAL TO DECK _ 11 .,Property Sewer Line & House Connection 62. Backwash & Receptor -Final - 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 2 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 Electri6l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning �r�(QZ [�/jp FIRE DEPT. REQUIREMENT .APPROVALS' =--Permit 20:.;Rotgh Factory Fireplace z n -x 21 ?Ducts, in Structu ex j .: -`,70. Ugdergrgynd; Hydro ' 22. Ducts, Ventilating - _ * .� qr r!71, product Piping O'Gas O'Oil 23. Gas Pipe =Rough&•Test r - _72. Underground Flush - ti` _ ,¢ 24..Roof Framing X73.="UndergrndtStoragq_Tank OGas 0011-=•{'- 25. Roof Sheathing.`: Fiydro-' - 0;'I574,=Overhead 26.T -Bar Ceiling (Struatural) &-(ylonocoat 'r � x 75: -Dry Chemical - _- v 27. Frame and Flash+ng". Nr„ 76.'Dry Standpipe �jt"' 28. -Lathing-& Siding 77:1:'.FIXED SYSTEM;FdNAL' - � '' -4 '• "29. Insulations • .. ,• I, 78 -FIRE PREV. FINAL; .,,, - - r30. DrywalliNailing � I N .r L HEALTH:DEPT+REQUIREMENT'_': - 131. Plaster Brown Coat; P 79: FINAL ItJSP_ECTION S. :, r 32. -Electrical Power Meter -Final ` I =80:.FOOD CERTIFICATE ISSUED '33. -Final Electric i " h. _ "Notes:IL Final H,eating,& Air C}onditioning:,- C,j34. ` 35:,Final Gas Pipe-Testi - - r ` . •r.S , Ir �:-•r a _ _ x: p _ r36:rHoo8 or Canopy - - r + '. ` k >; 37 =Fi al Factory Fire P�a ce, ti: Y >: w' r _ -38. Final Plumbing •.39. Water Service-Finalr * ,^c"- " r V, 40. Gas Service -Final s; I 01- ,3 r X41. Solar Domestic -Final -_ "' •• + = e Z - - I t'• 42.'Backflow Prevente{, a t �� •r ,.:r .r, - 43. Backflow 10igationt "'.`-••'-. t '-T,, -� �� t'� l n44. Landscape Irt9a tion System; - r ' .- '45._Sound Attenuation r, - 46%Handicap Regulatiens '" -" '' 47. FINAL STRUCTURE & BUILDING 48: FINAL PLANNING :..49. Electric Release to Edison � r •f - 50. _3as 1ReIease to Southern California Gas Co > ,`, ". . '• 51. CERTIFICATE OF -OCCUPANCY - _,• _, �, -� No. Date PROJECT ADDRESS: 217 16TH PL UNIT' A,B,C CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054424 OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA PERMIT-NO:'E 054424 PLAN CHECK NO: N GOVT: N SUPP: N SUITE 315 LAGUNA HILLS CA CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: NEW ARCHIENGINEER: REG.NO.: JOB DESCRIPTION ; NEW 3 UNIT APARTMENT BLDG SQ FT: ADDRESS: UNIT: / PERMITTEE: BRIGGS DEVELOPEMENT (714) 380-0686 CLAIM VALUE: CALL—VALUE: GROUP OCC: R-1 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS: REF B54389 LAGUNA HILLS CA 92653 ikMikiTkikEEr>ESE***�E+E�ET6�E�E*�E�ETE�EEEaE�LTL*�E�EaEEE�E�E+E*�t�E�E�E*+e�E�E�E�E�E�L�t**�E+r�E**�taE�Hx�E7E�E�EiF�L�E�E�E�E LICENSED CONTRACTOR DECLARATION: I hereby alhrm that) am licensed under provisions of Chapter 9 (commencing with Section Z O N I N G R E Q U I R E M E N T S 7000) of Division 3 0l the Business and Prolessions Code. and my license is in full force and effect. S E T B A C K S CITY LIC.: STATE LIC.: CLASS: Date: Signature: ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS' COMPENSATION DECLARATION: heerebyrebyaffirm that have a certificate of consent to sell -insure or a certificate of Workers' Compensation Insurance. oraCondone copy thereat (Section 3800. Lab. C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING RE • PROV: PARCEL: 42520106 ZNE: REF NO: El Certified copy is hereby famished. El Certified copy is filed with the City Building Division. PLANNING N TES> > Date. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be com*ed if the pemet ¢ fm one hundred (5100) or lea). I cerely that in the performance of the work for which INS pernut is issued. ) Shan not employ any person in any manner So as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: II, after making this declaration. you should become object to the Workers' Compensa ion provisions of the Labor Code. you must forthwuh Comply with such provisions or INS 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: iE iF iE k 1E ik iE iE ik iE iF ik if iE iE ik iE ik ik ik ik ik ik ik ik iE iF ik it ik iF * ik *.* ik iE ik ik ik ik ik * ik ik ik iE iE ik ik ik * ik ik 1E * iE iF iF ik ik ik * ik iF ik ik ik * iE ik ik * * K * ik iE Fk D E V E L O P M E N T _cz P' -R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: J BUILDING, APPROVED BY : APPLICATION ISSUED /Y iF iElE iE 1E 1E iF if lE iE ie it iE iE iE iE 1P iF it iE *itkik*ik ik ik ik kik ik ik kifkff ik ik lk *k*ik LEGALIZATION:N F E E OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING EL ECT I C (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to construct, alter, improve, demolish, or PERMIT 12 ¢29 repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/She is licensed 50* pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business PLAN and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit sublects the applicant to a civil penalty of not more than live hundred dollars ($500). 1 ISSUE FEE 15 .00 DATE: DATE 3F'ik"iFiFiFiF iFiFiFiFiEifiFiFif'iF iE lE*iE iE ik iF iF ikik £iFik it MiE if ik ik iE*Bk ik**iF***iE**iEit ikkikikik it ik iE ik ak*iE iE**kiE* M M A R Y STRUCTURAL SEGMENT:N MECHANIC FIRE SMIP/RES GRADING SMIP/NON—RES I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE LAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered lot Sale (Section 7044.Business; and ProfessionalCode: The Contractors' State License Law TOTALS ---- > 121.29 15.00 0.00 136.29 136 29 00 does not apply to an owner of a property who builds or improves thereon. and who does such work Nmoll/hesell or through his or her own employees, provided that Such Improvements aro not intended or offered for Sale. IL however the building or improvement is Sold "thin one year of Completion, the owner will have the burden of proving he/she did not build m improve for the purpose of sale). I, as owner at the property, am exGusively Contracting with licensed contractors to construct the project (Section 7044, Business IX and Prolession5 Code: The Contractors' State License Law does not appy Io an owner of prom build or improves thereon and who contracts for such projects with a Coathiclons) license pursuant to the Contract se Law),I am aware that proof at then Worker'$ Compensation insurance should be7,A ❑ I am exempt under Section: G. a P. C. for this reason: Date: ��/ 4/ I do hereby certify that I am aware of and understand the requirements J California He nd Safely Code 505, 25533, and 25534 and that I or any lulure building occupant waWll not (cirGe one) rte es and the requirements for a Permit for construction or modification from the Air OuaMy Management District. dental construction applications are exempt from these provisions. Dale: Applicant: - I hereby certify that I have read this application and stale that the above II fomlat m' act. I .ee to cc ly win city and county ordinances and state IS m etahng to MNdmgconstruction and hereby 1 > a ena sn 1 e' uponth a e -mentioned property for inspection purposes. ynny�n Date: _���2ySignalure: Driver s License or Social Security .: 1641.46 wroo—eu4dmg: Green—Code Enforcement: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor REVENUE DIVISION TOTALS--> C LLECTED: 136,29 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 136,29 lk ik iE kik ik ik iE iF lEif iF tF iE ik at iF �!*ik ikk*iE iE ik ik ikik ik iE*iE*fFikit iEk Bk ik ik lE ik ik ikMit ikiE*ik ik ik♦E iE ik 1E**iE*iF*ikiE iE*ik if ik ik ik iE kik ik iEk 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 ELE 4043 NEW RES BLDG FOR 3+ UNITS / SQ FT ,03 121,29 END OF FEES CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL 'A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.: Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Eleotiical Conduit-U.Odrgrnd. 55. Electrical Bonding T, 5.. Steel Reinforcement 56. Rough Plumbing & Pressure Test - .Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE % _ 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8.� Foundation 59. Gas Pipe, 0 Undrgrnd., Test - 9. ;Nater Pipe-Uncligrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. -Structural Floor System 61. APPROVAL TO DECK 11.. Property Sewer Line & House Connection 62. Backwash &Receptor -Final , 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final - 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric:Wiring 67. Fencing & Access Approval `J 7. Rough Wiring Sygn 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT.'REQUIREMENT o^ .APPROVALS1 -rmit # 20. Rough Factory Fireplace - _ .. 21 'Ducts, in Stryctu�re; f70. Jnde?g,ognd Hy`ilro 22, Ducts, Ventilating . L • .71. Product=Piping O'Gas 00il `72. 23: Gas Pipe -Rough &Test Underground Flush; ` - 24�,-Roof Framing 1' :. - :73FUndergrnd. Storage TankC. Gas ❑Oil 25. Roof Sheathing ` - 74 Overhead Hydro- ' 26`T -Bar Ceiling (Structural) &,Monocoat i 75. -Dry Chemical - 27. Frame and Flashing' •^ r _ ' 76. Dry Standpille 1 ' 28. Lathing & Siding 77.- FIXED SYSTEMAINAL z " r 29. Insulation ' ! _ 78.'FIRE PREV. FINAL A„30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat' I Ia r79• FINAL INSPECTION 32. Electriedl Power Meter. -Final � 80.rF00D CERTIFICATE ISSUED _ �33.'Final Electric r 'Notes;W00 ° r .34.. Final 116tin j & A 7 (: onditioning. 35.,Final Gas Pipe -Test r ,36. Hood or Canopy 37. -Final Factory Fireplace l 38. Final Plumbing • • �, : , - i X39. Water Service -Final. t =40. Gas Service -Final s41. Solar Domestic -Final 42.'Backflow Preventer - - z 43. Backflow Irrigation _ .44. Landscape Irrigation System- 45. Sound Attenuation- -46: Handicap Regulations ✓ 47..FINAL STRUCTURE & BUILDING " 48. FINAL PLANNING X49. Electric Release to Edison f. _ -50.`Gas Release to Southern California Gas Co , ( n '.51. CERTIFICATE OF OCCUPANCY No. Date _ PROJECT ADDRESS: 2 1 7 16TH PL UNIT: OWNER'S NAME: 'BRIGGS DEVELOPMENT ADDRESS: 23046 9315 AVENIDA DE LA CARLOTA LAGUNA HILLS CA 92653 (714)380-068A ARCHIENGINEER: ROBIN B. HAMERS REG.NO.: RC"31 120 ADDRESS: 234 E 17TH ST"IT' 205 COSTA MESA CA 92653 PERMITTEE: BRIGGS DEVELOPMENT ('114)380-0686 ADDRESS: 23046 CARLOTTA AV 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certdied copy thereof (Section 3000. Lab. C), TLICY NO.: EXP. DATE: OMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. DateApplicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(S100)ar less). I cenify 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 sebfeet to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this beclaration. you should become subject to the Workers' Compensation provisions of the Labor Ca& 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. Gy. Cl. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or 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' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 Of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). ❑ I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044. Business and Professional Code: The Contractors' Stale 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 said within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale), I, as owner of the property. am exclusive)y contracting with licensed contractors to Construct the project (S n 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an owner of pro ly who W.ror Improves thereon and who contracts for such projects with a contractor(s) licItoy nt to I nl t•aV�aw), I am aware that proof of their Worker's Compensation insurance shoulde. ❑ 1 am exempt under Section: B. S P. C for this reason: �/ I do hereby certify that I am aware of and understand the requiremenn H h and Safety Code Sections 25505, 25533, and 25534 and that l or any future building Occupant wiNwill not (circle oy with said stale Ades antl the requirements for a permit for construction Or modification from the Air Quality Manageesidenlial construction applications are exempt from these previsions. Date: Applicant: I hereby certify that I have read this application and state that the ordinances and state lawn relating to building construction and hetet property for iasid/coon p/of oposes. Date: �1� Signature. Driver's License or Social Security a: , • 1641 46 White—Bmldon, Green—Code Enforcement: Cana Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BPU5i57` PERMIT NO: BP 051575 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU STR PURPOSE: DEM JOB DESCRIPTION DEMO SFD W/ATT GARAGE/INCLUDES SEWER CAP SQ FT: CLAIM VALUE: 1,000.00 CALL—VALUE: 1,000,00 GROUP OCC: R-3 /M-1 COMMENTS: DEMOLITION ONLY. NOT A BUILDING PERMIT! Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING---------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN --------- ACCESSORY BUILDING-------- FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV; PARCEL: 11715115 ZNE; REF NO: PLANNING N TES> > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY:.DATE: l J 9F)E##ii##90##(##!16##ie#k3f##1r w.r£'R�'#iFRTi3F �:#t Nif Nic#iiiF ii7Fi�i'iFiFi�}k. ##iE#RE###########aF iE#k##IF#k####IE Y.-iF#ii•#iE##If lb### '##1(#Y##iF####9F##iE14X#kiE#Je#if-#3r ii#'Y.###-k LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 25.00 2,00 25% SMIP/NON—RES PLAN . ISSUE FEE 3,00 50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 27,50 3,00 0,00 30,50 30.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 25.00 5.00 ,50 ##1E#aF###'1i##########idf###Y+f-##76##?r±(##iF#i(•#Y-�'#ji1F###ib#iF-1F iE if?F##:'##?e#}: {(.#jti-#-)E##N###ilF ?r IM1 #-# 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 SEWER CAP / DEMOLITION END OF FEES EACH 2,00 2,00 CONSTRUCTION AND PLANNING APPROVALS Permit # Ft)a7t,1npector F , & SPA APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O 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-Fina) 12. Sewer Cap - 63. Heater & Vent-Final ' 13. Roof Drains 64. Plumbing System - Final , �r 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 PLASTER1NG r. 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OQil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural( & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning - - 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing l (f g3 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date LIMITED STATEMENT . RESPONSIBILITY TO WHOM IT MAY CONCERN: NOTARIZATION REQUIRED 217) E. 16th Place & 210 E. 16th St. Street Address f Bldg. Permit # This Permit # rl7 (5 ( (,- AP Number I, Edwin J. Briggs as Owner in Title of the above referenced property, do hereby authorize: Lee James 714-380-0686 Name Telephone No. 23046 Avenida de la Carlota #315, Laguna Hills. Ca. 92653 Street Address to obtain permits in my behalf, as'owner/builder, for 8 dwelling units. at the above referenced property. Should any -parson become an empinyee engaged in the improvement of the property, 1 shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- son. comoanv or corporation. ss from any I STATE OF CALIFORNIAJ�ii Iss. COUNTY OF.— nLcIIKI'T/Vi9 On_y/1�, 9 i/j !23s,�ec�A� ,before me, the undersigned, a Notary Public in and for said State, personally appeared__dtij, , 3• 44 i44 S personally known to me (or proved to me on the basis of satis. factory evidence) to be the person(s) whose name(s) is/are sub- scribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESSmyhanda dofficialseal. signature LC-f�•LL.t, /�(,&"ey ' OFFICIAL, SEAL TAMMY M. WIILIAM$ON ffeTAAY PUBLIC • CALF OW e@AA'GE Ceu"I M/ Cam. F3P'vei rrp.I7,1991 (This area for official notarial seal) • , �` -�j ALS Il .Lir jl•,., f , ENGINEERING DIVISION"APPROVAL ;FOR SITE ACCESS PERMIT (10. 'r272 RICHT OF WAY Ui:OEt;GilOUT:D,FEn1.111 NO, 1V/,4 RIGHT OF WAY. Cc7iSTRUCT10f1 FERMIT N0. 4�11-1 ENGIIIEER: GNAT{F> DATE: Q/r/91 CAI • SITE GRADIIi4 PEWMIT, MUSI UE OBTAINED FROM IIIE UUILL)WIC SAFETY DiVIS101! (2N0 FLOOR) A+ 1 ,'ITY OF COSTA MESA a I 0 .OWNER/. SUBDIVIDER f; is 'BRIGGS.., DEVELOPMENT CORP. 23046, AVENIDA DE LA CARLOTTA LAGUNA HILLS, CA 92653 I M IN THE S SANTA 1,7j AN vim. CL OF 15 A AN r 10.7' CURB RE , .l f 1 • , �` -�j ALS Il .Lir jl•,., f , ENGINEERING DIVISION"APPROVAL ;FOR SITE ACCESS PERMIT (10. 'r272 RICHT OF WAY Ui:OEt;GilOUT:D,FEn1.111 NO, 1V/,4 RIGHT OF WAY. Cc7iSTRUCT10f1 FERMIT N0. 4�11-1 ENGIIIEER: GNAT{F> DATE: Q/r/91 CAI • SITE GRADIIi4 PEWMIT, MUSI UE OBTAINED FROM IIIE UUILL)WIC SAFETY DiVIS101! (2N0 FLOOR) A+ 1 ,'ITY OF COSTA MESA a I 0 .OWNER/. SUBDIVIDER f; is 'BRIGGS.., DEVELOPMENT CORP. 23046, AVENIDA DE LA CARLOTTA LAGUNA HILLS, CA 92653 I M IN THE S SANTA 1,7j AN vim. CL OF 15 SANTA AN FACE, 10.7' CURB RE , .l PROJECT ADDRESS: 217 1 6TH PL UNIT: NER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: AVENITA CARLOTTA ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: BRIGGS DEVELOPEMENT (714)380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab. CL POLICY NO.: EXP. DATE: COMPANY: r❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permt is for one hundred (5700) or less). I certify that in the pantomimed of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of Calilorma. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with Such provisions or INS permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant lot such permit to file a signed statement that rte/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing "In Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). I, as owner of the properly or my emIoyees 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 vitro does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sate. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 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 noes nor apply to an Owner el pr erlyy who bor S or improves thereon and who contracts for such projects with a centraclor(S) license pursuant to the Conn"W's' Slate I-pri Law). I am aware that proof at (heir Worker s Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. 8 P. C. tar this reason: Dale: Owner I do hereby certify that I am aware of and understand the requirements of Calrorm eabh and Safety Code Sections 25533, and 25534 and that l or any future building Occupant wilUwill not (circle one) need to with Said stale codes and the requirements for a permit for construction or modification tram the Air Quality Management District. Residential construction applications are exempt from these provisions Date. Applicant: I hereby cedlly that I have read this application and state that the ordinances and state laws relating to building construction and her property for inspection pure _Date:_/!l � Signature: U Orive(s License or Social Security a. With all city and 1641-46 Whue—Building: Green—Cade Enforcement: Canary—Applicant Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 054431 PERMIT NO: B 054431 PLAN CHECK NO: 04091-91 A GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; OTH JOB DESCRIPTION ; RET WALL W/ FENCE & TRASH ENCLOSURE SQ FT: 305 CLAIM VALUE: 2,920.00 CALC—VALUE;. 8,350.00 GROUP OCC: M-1 / COMMENTS: TRASH ENCLOSURE & RET WALL W/ FENCE kkkkkkkkkkkkkkkkkkkkkkkkk�*kkkk�*kkkkkkkkNkkkkkkkkkkkkkkk�E>,E*Tr+E+E�E *�E iE �E��r��r*��-�E SE r* Z O N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 00000000 ZNE; R3 REF NO: PLANNING N TES> 225 LI. FT. OF 6" RETAINING WALL ALONG SIDE PROP, LINES, > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY S v DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED DATE: / 1 kkk*�-k*�-kkkkkkkkkkk **� FiFiF'k'�iFiFBF-9F7Fkkk**kk*B�k kk LEGALIZATION:N F E E S M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTR MECHANIC FIRE SMIP/RES GRADING PERMIT 108.0084 PLAN 17.55 SMIP/NON-RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLA =CHECK TOTAL PAID DUE TOTALS ---- > 108.84 0.00 17.55 126.39 126.39 .00 REVENUE DIVISION TOTALS--> COLLECTED:" 126.39 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 108.00 ,84 17,55 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 SFR 225 RES—RET WALLS <= 3.FT W/SURCHG/ FT. 30,00 6,750,00 SFR 80 RES—TRASH ENCLOSURE /FT. NOZONE 20.00 1,600.00 END OF FEES Ir , t s rrrf., irl NSTRUCTION AND PLANNING POOL SPA If Permit #_ Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement j '3.; Electrical Conduit Utility-Undrgrnd. 54. Forms i 4; Electrical Conduit-Undrgrnd. .r 55. Electrical Bonding ' 5. Seel ReinforcemeSt. 56. Rough Plumbing & Pressure Test ;6.' Electrical UFER 6rnd. 57. APPROVAL TO COVER-GUNIT.E =, 7.t Footings 58. Electrical Conduit-Undrgrnd. '8.' Foundation 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 1b. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final , 12. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final/ t 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 Sj9n 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •APPROVALS' rYer'mit 20.°Rough Factory Fireplace .:� T' •Z - 21. Ducts, in-Structure. s �.70. Underground, Hydro 1 22. Ducts, Ventilating r ± r71. Product,'rPiping D-Gas DOiI 23:-Gas PipetFough &'fe t '' _ - T 72. Underground Flush- - 24.-Roof Framing 't_- '• _ r 73..UndergrnWStorage�Tank E3 Gas DOiie 25. Roo,( Sheathing 17)74.Overhead Hydro,_ -' 26.'T-Bar Ceiling (Structural) &Monocoat - 1' •.11 75.=Dry Chemical 27:'Frame aV Flashing. 76.' Dry Standplpe � �. 28. Lathing & Sidings • + > 77.- FIXED SYSTEM-E-INAL' ` _��-i• '29. Insulation ", 78s;FIRE PREV. FINAL '*30. Drywall Nailing _ • I r HEALTHbEPT. REQUIREMENT .31. Plaster Brown Coag S ,- (: -,79:'FINAL INSP.ECTI9N Y •'- - - 32. Electrical Power Meter-Final _L _ .• ,60. -FOOD CERTIFICATE ISSUED 33.,Final El"ctric. Notes: �/p 9L 1 34,-Final Heating.& Air'Conditioniog, 35: Final Gas Pipe-Test '� = kIf ' * • �!' - X1(1 71 T2_V, d7t 36. Hoodor`Canopy,_:�• i •�_; � .. , s •� >;.=r o� �� �� // fT ,�(7` 37.-Final Factory Fir2Place S , 38.-Final Plumbing + , iQ ^89.-Water Service=Final t '• b - - ,,.40. Gas Service-Final %_ '. ,-4L:Solar Domestic-Final `• •• - _ ;�- _ r 42. "Backflow Preventer 43. Backflow Irrigation - „> _ 'r•` ' - ;_44. Landscape Irrigation System. -45:rSound Attenuation -'3' • > "'� •t 46.`.Handica6 Regulations r r - - •;: '� 47.-FINAL STRUCTURE & BUI:LDING (( C13 AjO•• - _ r 4B:•FINAL PLANNING . 49t Electric Release to Edison - - t 50., Gas'Refease to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ... , No. Date PROJECT ADDRESS: 212 3 1 6TH PL UNIT: OWNER'S NAME: BRIGGS DEVELOPMENT ADDRESS: 23046 4315 AVENIDA DE LA CARLOTA LAGUNA HILLS CA 92653 •� (714)380-0j ARCMIENGINEER: n REG. aODNEss: ROBIN B. HAMERS RC 120 234 = 17TH ST 05 COSTA MESA CA 92653 T PERMITTEE: BRIGGS DEVELOPMENT (714)380-0686 ADDRESS: 23046 CARLOTTA AV 315 LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licenser) under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full lone and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a cenificale of consent to Sell -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab. q - POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is hied with the city Building Division. Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thissecdpn need not be completed if the period is for one hundred q$lDD) or less). I Ceroly that in the performance of the work Ior which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dale'. Signature: NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must formula comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a constnction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as (heir 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 orthrough his or her own employees, provitled 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 provinghjYsMe tlnid Id or improve for the purpose of sale). I,as owner of the property. am exclusively contracting with licensed Contractors ® and Professions Code: The Contractors' Slate License Law does not apply to an and who contracts for such projects with a contractors) license pursuant to tl that proof of their Worker's Compensation insurance should be provided to V, ❑ I am exempt under Section: 8. 8 P. C. for this naso Dale: _/—/ —� Owner. I do hereby lenity that am awa a of and and under encs of Clintmi afety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wiNwill not (circle one) neestate codes and the requirements for a permit for construction or modification from the Air uality Management Dinstruction appliwlionS.aFe exempt from these provisions. �7 Date: Applicant: I hereby certify that I have read this application and stale that the above mlormat ordinances and state laws relaling to budding construction and hereby authorve ' property ffoorr maps )iron p nooses. Date: �a ZJ. �?/Sionature: fnlefanrM—Accwecnr 1 CITY OF COSTA MESA - BUILDING PERMIT PERM, NO: BP 05157E PERMIT NO: BP 051576 PLAN CHECK NO: IN GOVT: N SUPP: N CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU STR PURPOSE: DEM JOB DESCRIPTION DEMO SFD W/ATT GARAGE/INCLUDES SEWER CAP SQ FT: CLAIM VALUE: 1,000.00 CALC-VALUE: 1,000.00 GROUP OCC: R-3 /M-1 COMMENTS: DEMOLITION ONLY, NOT A BUILDING PERMIT! #######•###%##}'•#########%#iE###########-Y.-###ii######1f###N'M:#######fE jF 3{iE 1E #jiBF 3E##iF#iFiE Y=±i-1! Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- F'RNT: FT IN REAR: FT IN FRNT: FTS IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REp: PROV: PARCEL: 11715115 ZNE: REF NO: PLANNING N TES> D E.V E L 0 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 1 ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE.- APPLICATION ATE;APPLICATION ISSUED BY: DATE: LEGALIZATION:N F EE S U_ M A R Y STRUCTURAL SECMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 25,00 2)00 FLAN 25% SMIP/NON-RES ISSUE FEE 3,00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 27,50 3,00 0.00 30,50 30.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.50 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING FLAN -CHECK 25.00 5.00 .50 #ar##########i%#•%###%%"?E±f}:##•#jE######If#'lr#iE#!f-iF#ik##iE##%####dE##}'.##Fv`4###iF ?F it#}#3E w>:,4: iE ?F #7F 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 SEWER CAP / DEMOLITION EACH 2.00 2.00 END OF FEES ri 01 00084254-Oi5084256 T vvT GATE: 04105/91 TIrT: 1494,; CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POS, & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. '54. Forms ' 4. Electrical Conduit -Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection V. Backwash & Receptor -Final., r 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 -r - •r � 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 t 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping El Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank DGas 0Oil - 25. Roof -Shea thing: -•': • 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 7B.. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final _ /Y,;° 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air.Conditioning 35. Final Gas Pipe -Test 141 36. Hood or Canopy '%jam 37. Final Factory Fireplace r-°- 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42.'Backf low Preventer- 43. Backflow Irrigation - 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY No. Date LIMITED STATEMENT Or RESPONSIBILITY TO WHOM IT MAY CONCERN: NOTARIZATION REQUIRED 2171 E. 16th Place & 210 E. 16th St. Street Address Bldg. Permit # j This Permit # 1/7 15-( �.S_ AP Number I, Edwin J. Briggs , as Owner in Title of the above referenced property, do hereby authorize: Lee James 714-380-0686 Telephone No. 23046 Avenida de la Carlota #315. Laguna Hills, Ca. 92653 Street Address City State Zip to obtain permits in my behalf, as owner/builder, for 8 dwelling units. at the above referenced property. Should anZ-aa aon become an Employee engaged in the improvement of the property, I shall immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per- --son. coma or.corooration. ss from any STATE OF CALIFORNIA Ol7,na 1/ p iss. COUNTY OF �7 le/T/U6if-I On `%i1Q:4 /'17 OS 1,r19l before said State, personally appeared 1rY11J-n % 5r• A6 - personally known to me for proved to me on the basis of satis. factory evidence) to be the persons) whose name(s) is/are sub- scribed ubscribed to the within instrument and acknowledged to me that he/she/they executed the same. WITNESS my hand e d official seal. Signature the undersigned, a Notary Public in and for OFFICIAL, SEAL 1AMMY M. WIl11AhtSOn NOTARY RBUC-CAliegrG oR.INGE couhaY NI Conn FUYe� rrD, i1, 199 (This area for official notarial seal) ENGINEERIf,JG DIVISIONAPPt20VAL loo SITE ACCL::: PERMIT 110. HICHI Ur i7AY FUXIT NJ,_L�))_ RlCiil Of 1'.f.i PEHIdIT liJ. RIA EN�mIER: ,HA►Z�6> DAIL: CN • S11E L' L Ulti; PL664,I MUSI UE MAINEU fHUk IiIE bUllUltti SAfLIY UIYI:IUR (?NU fLUOR) ;TTY OF COSTA MESA OWNER/. SUBDIVIDER BEN :,. IN THE S BRIGGS DEVELOPMENT CORP. SANTA 23046 AVENIDA DE LA CARLOTTA CL OF 15 SANTA AN6 LAGUNA HILLS, CA 92653 FACE. 10.7 CURB RER CA cv _01 I� �:I PROJECT ADDRESS: 217 1 6TH PL UNIT: OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA SUITE 315 LAGUNA HILLS CA 92653 3800686 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: • I PERMITTEE: TEMP POWER SYSTEMS (714)632-1999 ADDRESS: 1111 N. TUSTIN AVE ANAHEIM CA 92806 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am Wagered under provisions of Chapter 9 (commencing with Section 70001 0l Division 3 of the Business and Professions Code, and my license is in full force and that clrr LIC.: 3 /9 (12 4 STATE uc.: 4 8 3 4 3 3 uss: C —1 Date: �l J — IhereSignaur _ _ WORKERS' COMPENSATION DECUBATION: here y alb (have a certificate d p0nsenl to sel4inwre or a certificate of Workers' Compensation 11it py,gt big, a1 W,6 Wetgdh,Sectmn 3BOo. Lab. 1* 0 1 / 9 % POLICY NO.: NATIONWIDE/JWItlUUI/ EXP. GATE: 1 MPANY: , r� Cori copy is hereby furnished. ❑ Cenified copy Is fielel cityBuilding Diva' gate: J -/.> / � Apd�a _ L/� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Itis seam need rot be mmp§IW if the Ia=a tar one hundred(5100)or Nss), I fairly that in the performance at the work Jeff which INS permit is awed, I shall not employ any person in any Gunner so as to become subject to the Workers Compensation Laws of California. Date: Signature: NOTICE: If, alter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or INS permit shad be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Protessional Code: Any city of county which requires a permit to construct, alter, improve. demolish, or repair any structure, prior to its issuance. also requires the applicant for such format to file a signed statement that helid a is licensed pursuant to the provisions at the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that He/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property or my empDloyees with wages as their sole compensation, will do the work, and the Cl structure structure is not intended or offered sale (StthOn 7044, Business and ProlessiOrW 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 himseltlherself or through his or her own employees, provided that such improvements are not intended or offered for sale. II, however the building or improvement is sold within one year of completion, the owner will have the burden of proving helshe did not build or improve Or the purpose of sale). 1, as owner of the proper)y, am exclusively contracting with licensed contractors to construct the project (Section 7D44, Business ❑ and Professions Code: The Contractors' Slate License Law does wt apply to an owner of grope rry who builds or improves thereon and who contracts Or such projects with a contractor(S) license pursuant to the Contractors' State License Law). I am aware dial proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. A P. C. for this reason: Date, Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505. 25533, and 25534 and that I or any future building occupant WIONA not (circle ane) need to comply with said state codes and the requirements for a permit for construction or modification from the Air alkly Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby eerily that I have read this application and state that the above information i5 correct. l agree to comply with all city and county ordinances and state laws relating to building construction and hereby aulhorbe representatives of this c y to enter upon the above-mentioned property 1 r inspection purposes, Date: iq t Signatur e,;00� Driver's License or Social/Security x: 1 1 64146 While—Building: Green—COOe Enforcement: Canary—Applicant: Pink—Revenue; Goldenro l—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05695 PERMIT NO: E 056950 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; V—N PERMIT TYPE; ELE PURPOSE: OTH JOB DESCRIPTION ; TEMP. POWER POLE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC; R-1 / COMMENTS: NEW RESIDENTIAL PROJECT 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 REAR: FT /- IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE&�j PROV: PARCEL; 42520106 ZNE: REF NO: PLANNING N(STES> D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY DATE: DATE: APPLICATION ISSUED BY: DATE: c=4— LEGALIZATION:N F E E• S M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTR. MECHANIC FIRE SMIP/RES GRADING PERMIT 15 0 Ot SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERM,IT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 15.00 15,00 0,00 30,00 30,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30,00 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 ELE 1 TEMP SERV PWR POLE W/OUTLETS EA, 15,00 END OF FEES 15,00 CONSTRUCTION AND PLANNING APPROVALS . Permit # Date Inspector I POOL 'A PPROVALS Permit # Date Inspector Electrical Sere ce or Pote')a ? /� �( r2. Pool & Equipment Location 53. Steel Reinforcement 2. Soil Pipe.Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 54. Forms " 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60, Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House, onnection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65, Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 000 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. :-INAL INSPECTION 32. Electrical Power Meter -Final 0. ' SOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing -' 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill In IITP.... except those within heavy borer lines and Sign all appropriate declarations CITY OF COSTA MESA CONSTRUCTION PERMIT PER - N�. �� TRACT NO. LOT NO. UNIT NO. A P ,16 Zone Project Address S Main Building: Accessory Building: TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION RE R ❑ CONVERSION ❑ DEMOLISH ❑ OTHER TEFYAcE L M7NA % aG Applicant's Mailing Address /&?/ S% /LS y/ /z- a E T Front Z 0 l Dtz.7�N Owner's Name �v`7 // ST Phone Address DESCRIPTION OF WORK/USE OF BLDG. ' A Rear N K Right N Arch/Eng. License No. Address/ TYPE OF PERMIT GRAOING FOUNDATION STRUCTURAL El TENANT El ELECTRICAL PLUMBING C1 MECHANICAL 1:1 OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATIONS 20NE GRADING CU.YDS. ACRES S Left G R Contractor's Name ReQ?e6$S&1LA �ua.1.[—Phone Jaf9-?/y Address (mailing) �fi,3�-Sf-4;:* %-.1 City License No. yiy�Z— Ping. Ref.# Parking Req./Provided E Planning Notes: M T S. LICENSED CONTRACTOR DECLARATION Remarks: I hereby affirm that I am licensed under provisions of Charter 9 (commencing ELECTRICAL FEES A 1 with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. / _ License lass C' s_ teen e No. 5 �7-r Date Signature _ WORKERS' COMPENSATION DEC LAR I hereby affirm that 1 have a Certificate co ant to self -Insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 1, Lab. C.) '/ ' ,iccy rvo./lJ-�07L,i Company ��FU D BCertified copy Is hereby furnished. Certif.Zit ?ris filed with the city B tiding Dlvlsion PLUMBING FEES Automatic Washer Transformer ❑ 15.50 KW Construction Pole $ub. ❑ 50+ KW Bar Sink Showers Backflow Preventer Service Sink Cooking Unit Meter El up to 100 amps Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel Clarifiers Solar Collectors - Fan Motors (]0-1 HP ❑ 1 % - 8 Date G 6 Applicant __ EXEMPTION FROM WORKERS' COMPEyy N DECLARATION (Thissection need not be completed if IoVoerTnit is for one hundred (5300) or certify that In the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to tke Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP E]16 -15+I Drinking Fountains Solar Tank Fixtures Microwave Workers' Compensation Laws Of California. Date Signature Floor Drains Swimming Pool w/Spa Device Boxes /' Pole Light 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 Outlets Ran 9 e comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYif Gas Service Outlets Water Closet �1 A� Switches Sign 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 Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator E10-5 KW E15-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any Structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) Or that he/She is exempt Lavatories Auto -Wash P - P—Trap Laundry Trays Roof Drains — Reinspection Fee $15 Issue Fee $ B ' ' :lereirom and the basis for the alleged exemption. Any violation of Section •",'^'1.5 by any applicant for a permit subjects the applicant to a civil fly of not more than five huntlred tlouars (E500). u I, as owner of the property or my employees with wages as their sola compensation, will do the work, and the structure is not intended Or offered forsale (Section 7044, Business and Professional Code: The Contractor's 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 We. If, however, thebuilding or improvement is Sold within one year of Com- pletion, the owner will have the burden of proving he/she did not build or im- Prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- lraclorst0 construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of properly who builds or improves thereon. and who contracts for such oroiects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Proof of their Worker's Compensation insurance should be provided to me, ❑ 1 am exempt under Section B. & P. C. for this reason DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By / Dat Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES Boller Hood Or Type I ❑ Canopy Type II ❑ SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ Duct - Under Ground Duct -Structural Refrigeration System ❑0.100,000 BTU 0100,000BTU _ i Duct - Ventilating Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBG # Fire Dampers Date Owner 1 hereby certify that I have read this application and slate that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection p rposes. Heating System & Ducting ❑0-100,000 BTU El 100,000 BTL$ Registers MECHANICAL TOTAL FEE $ V PLAN CHECK 25% $ Reinspection Fee $15 Issue Fee $ 3 ,� Signature Date Drivers' Licens or I o1 !70031 ``-s75 tt f R DAT Et 04v for 2,Y TrFE. 0865-46, rev. 5 8 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor r, CONSTRUCTION AND PLANNING Date APPROVALS Permit # A.. Inspector POOL 'A ' 0 APPROVALS Permit # Date Inspector 1. Tempora{y Electrical Service or Pole / '� 52. Pool & Equipment Location ?. Soil Piper Undrgrnd.' ,53. Steel Reinforcement 3.,Electrical Conduit UtJlity-Undrgrnd' 54. Forms 4:•Electrical' Conduit-Undrgrnd. %' 55. Electrical Bonding 5. Steel -Reinforcement: 56. Rough Plumbing & Pressure Test - 6' Electrical UFER'•Grnd. / 57. APPROVAL TO COVER-GUNITE 7.' Footings' - ,� '/ 58. Electrical Conduit-Undrgrnd. 8. Foundation .� .i .' /Vj•- 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. PrFoperty Sewer Line & House Connection 62. Backwash & Receptor -Final s 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains i 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 APPROVALS Permit # 24 Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24.*Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 25, Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ;� -, 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 8Q. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:c'4-V-81 Nor I2e4w. C.c.D 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final f!/ F 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison ^ 50. Gas Release to Southern California Gas Co •'-'j ' 51. CERTIFICATE OF OCCUPANCY No. Date -• Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CIfiY OF COBTA MESA CONSTRUCTION PERMIT PE5,41 F_1,10. _ ITRACT NO. LOT NO. UNIT NO. ProjecLAddress _ii?=Pi- ,Applicant's Mailing Address Owner's Name -Alan _EaWw_.n Phone 9 77 Address 43 eGCRCefoLLDR.-,—Costa— esa,_CA Arch/Eng, License No. Address Contractor's Name_Crmk-RCOS,_ROnf.LnLJ--CBPhone r' —5569 Address lmailing)_l.26_CommerJ:.ial—WaYf_COSfa MAca 92627 City License No. _40867.7 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full force and effect. License Class 6 ansa N 405677 Date _91233 Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selftinsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Lab. C.)P Policy No. ISC11&WCompany 62 Home Certified copy is hereby furnished. X Certif�'te p i filed with the City BW IdIr r Iv ion. Date 7 �� � Applicant l.railK' gyros. Roofing Co. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred (5100) or less). I certify that in the performance of the work far which this permit is Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date - Signature 'NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with, such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any City or county which requires a permit to Construct, alter, Improve, demolish or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that ne/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfeSJons Code) or that he/she Is exempt therefrom and the basis for the alleged bxemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner Of the property or my employees with wages as their sole compensation, will do the work', and the structure Is not intended proffered for sale (Section 7044, Business and Professional Code: The Contractor's 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 com- pletion, the owner will have the burden of proving he/she did not build Or Im- prove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts, for such projects with a con. tractors) license pursuarit to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have read this application and state that the above nformation,is correct. I agree to comply with all city and county ordinances and slate laws relating to building construction, and hereby authorize repre- sentatives of this cit to enter upon the above-mentloned Property for inspection purpo Signature a Date Drivers' License or SS qF Z TYPE OF CONSTRUCTION LJ NEW 19-+ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER AP rM, DESCRIPTION OF WORK/USE OF BLDG. S Main Building: re—roofingrear u i TYPE OF OF PE�GRADING AT FOUNDION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION SO. FT.� %f N1 OCCUPANCY_S.it7916— I K Right CON STRUCTION TYPE residpnf in/ VALUATION$17J ,-[�_,S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: _ Plannlnq Notes: 0669 9/23/85 Zone Accessory Building: Parking Req./Provided Icn' Z O N 1 N G R E Q M T S CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING FEES L ' Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer 0 15-50 KW 050+KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Clarifiers Solar Collectors Dishwasher Meter ❑over 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors E10-1 HP 01X- 8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09.15 HP 016-15+ Floor Sinks -- .Urinal- Fixtures Microwave ' - - Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal ! Standing Sections .P—Trap Laundry Trays Generator 00.5 KW 05.15 KW Trash Compactor Roof Drains Reinspection Fee $15 Issue Fee $ 3 Reinspection Foe $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By ell) Data 9 Boiler r Hood or Type 0 Canopy Type II 0 Duct - Under Ground Duct - Structural Duct - Ventilating Refrigeration System ❑4100,000 BTU 0100,000BTU PERMIT $ PLAN CHECK $ PLUMBING � $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ F SUMMARY3FEES ��r �S SMIP. $ PERMIT ISSUANCE S ENERGY P.C. $ GRADING S MICROFILM s c TOTAL FEE $ �S'S Exhaust System 13 Multiple El System System Repair/Alteration Firepl/Fact. Bit. ICBG # Fire Dampers Heating System & Ducting Registers 00.100,000 BTU 0100,000BT Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor M CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL - SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:.. 34. Final Heating & Air Conditioning - 35. Final Gas Pipe -Test m 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation , 44. Landscape Irrigation System 45, Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date W z J o: A MESA BUILDING DEPARTMENT f P. 0. BOX 317 COSTA MESA CALIFORNIA C.L. OF STREET __i ROP. LINE T — — FT. FOR 60 FT. STREET Y OR OSCL 0 w N 1 W W rc iv I N I O. I I O; � V- m J m ILLI \I = INtp W z J o: A MESA BUILDING DEPARTMENT f P. 0. BOX 317 COSTA MESA CALIFORNIA C.L. OF STREET __i ROP. LINE T — — FT. FOR 60 FT. STREET Y OR OSCL 0 w N 1 Permit No. iv Date eceiv Date ssu a to F I Won o O; � V- m Permit Fee $ ` a 04- ^ U Plan Check $ ,F°� Z —_PROP. LINE --- L.` OF I ` m 40 FT 60 H W W F N LL 0 J () ST MAXIMUM 4 FT. FENCE MAY BE PLACED ON DOTTED LINES ------ MAXIMUM 6 FT. FENCE MAY BE PLACED ON SOLID LINES 5927 FOR APPLICANT TO FILL IN MTTTnMTi nnnOCC0-3/7—__7 /0— .0 -Z-/ a��� Mail Kd res .e. &A C"-' City l= *GF/6 0 _ -Ph. No- _ - _ - _ _ Contractor �LCi Ph. No. City_ Lic._N_o.. _ _ _ _ _ _ _Sta_te_/Li_c. _No. _ _ _ _ Size of Lot/A40X /a_'__Z_AP No.�/ Setbacks: C/L Street '0� Rear If /J Side Yard - Righy� © n Lef Type I hereby acknowledge that I have read this application and state that the above is correct and agree to comply with all City Ord- inances and State Laws regulating building construction. qi, ,,t... it . 6 /1 0 FOR OFFICE USE ONLY Permit No. iv Date eceiv Date ssu Ila I VLUA ION Permit Fee $ /f ^ $ / Plan Check $ TOTAL FEE $ USE REVERSE SIDE FOR DETAILS DEPARTMENT OF BUILDING & SAFETY CITY OF COSTA MESA, CALIFORNIA Federal, State and City Laws require you must adhere to the following when you build a house (or other structure) yourself, and in the course of such construction employ persons outside of your immediate family: 1. You must register with the Federal and State Governments as an employer: 2. You must withhold income taxes on every employee working on the project: 3. You must withhold and report to the proper authorities social security and unemployment benefits on every employee: 4. You must carry Workmen's Compensation Insurance on every employee: 5. A separate and additional city permit must be obtained for Electrical, Plumbing & Heating, Lath & Plas- ter, Chimney & Masonry, and Tile work as required by City Ordinance: 6. You must furnish list of all sub -contractors to Building Department before final inspection will be made: You cannot legally sub -contract any portion of the work to any person who is not licensed by the State of California: and/or the City of Costa Mesa: 8. You cannot legally build homes or other structures which are intended for sale, unless you have a con- tractor's license: 9. You can build a home for your own occupancy. 10. Be sure to check with your local Building Department and State Contractors License Board to avoid dif- ficulty during construction. I have read and agree to fulfill and abide by all the above requirements, if permit Is granted. '. Permit No. J--�;o 0 Signature of Owner -Builder Date 5031 COSTA MESA BUILDING DEPARTMENT P. O. BOX 317 COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN l -;.13. • E ,EI C ��- COSTA MESA. CALIFORNIA OWNER/�{^/./.✓ Vdrv� �1^� MAIL ADDRESS TEL. CITY Ihj-CITY � C(/Q 0� �"/J /I' NOA�;, �/'' NO. ARCHITECT QQ /! LIC. OR' -�RNo /. ADDRESS III N //J/� .1 T. ADDRESSOI 1l{1?V/7 NO, k LEGAL LOT J �', -3 SIDE YARD RIGHT DESCRIP110N NO BLOCK TRAC 7 II ADDITION A.P. NO. / -�S� 1 SIZE /Arl/1 % �1 OF LOT (/ V /� / NO. OF BL NOW FN LOT ® FEE RECEIVED FINANCNEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. I /) ?RIjjT ���RECEIVED BY DATE RECEIVED (RECEIVED BY DATE RECEIVED yATE ISSUED 5� 3 7�'1 BUILDING I FIRE /(Ql ozc I ZON Ili 20NE APPF B SETBACK LINE FROM J CENTER OF STREET REA YARD -3 SIDE YARD RIGHT EFT DESCRIPTION OF WORK NEW ALTERATION' ADDITION REPAIR MOVING DEMOLISH BUILDING /U °NO. OF �/ SIZE v %- ROOMS STORIES EXTERIOR WALL ROOF p / COVERING COVERING VG%C, USE OF NEWE �ThL BUILDING ,v STATE TIM! THE ABOVE CITY ORDINANCES AA TION. SIGNATURE OF PERMITTEE AUTHORIZED AGENT THAT I HAVE CORRECT AND L jr- COSTA MESA. CALIFORNIA J-- 7- -< APPROVED CITY OF COSTA MESA pt SUBJECT TO G. DEPT. REG. BY DAT 1D THIS APPLICATION AND aNE TO COMPLY WITH ALL O FEW 1' CONSTRUC. � ✓ VALUATION ? (Jp PERMIT FEE $ .J 9TOTAPLAN CHECK S /7 - TOTAL L FEES '6— — vVF .,9. OWNER MORRiS80NO--jtRS-. C-. DATE 4-18-57 JOBADDRESS 219 E. -16th St. BU I LD ING PERMIT NO. #4862 GENERAL CONTRACTOR Bert Hornsveld VALUE $ 31960.00 AP117-1 -o9 L 43 BLOCK TRACT Npt. Hgts. Residence GROUP I TYPEy ZONE R4 FIRE DISTRICT 4894 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench " 5� Foundation Forms and Grade to Garage j Rough Framing P l umbing, Rough to Slab _ 5`�/_5% fit -rd's -i 'S- 9��. ✓ Plumbing, Rough Complete & _ Temporary Pole Wiring, Rough MAY 1 6 1957 VCB /T 5= ��_S 7 </5�:3 ✓ Heating, Rough %%%� S `-/d'� �/- ay�S % !�`/J ✓ Heating, Final Sewer, House Sewer, St. //S 7 —/ — f7 cJ ( / y Septic Tank or Cesspool J L ig, In Y Out R —4:40 E P,__.erin9 i'9i71 S" 04-5% Plumbing, Final, Fixtures Completef)hly Plumbing, Final Gas Test A/¢.S 7-/0 "V a- ' � ��,.� 7 / Wiring, Final 7"'97fr (loco nnnry �- s r -. FORM 210 3M 1055 4862 DA IOB ADDRESS 221 & 223 E. -16th P18CB BUILDING PERMIT NO. #F1,QRh r- ")UP IIvePECTIONS DeVilla Bldg_ VALUE $ TRACT FIRE ZONE DESCRIPTION OF WORK TYPE V ZONE R4 PLAN NO. DATE I SUBCONTRACTOR I -.-.- L ITS 4984 OWNER DATE ]OB ADDRESS P17 & 219 E_ 16th Place BUILDING PERMIT NO. - #4983 fiENERAGCONXRACTOR Tlov4 i i e pT A� VALUE $ l A, nRA,. nn AS, PFR TTnr AP. No. LOT 53 TRACT FIRE ZONE DESCRIPTION OF WORK Dup. watt. Gars. GPOUP I & J TYPE V ZONE R), I.—IECTIONS I DATE I SUBCONTRACTOR M. OWNER FISHBACK, June E. & Carrie DATE 10-22-57 _ JOB ADDRESS 217-219-221-223 E. 16th Place BUILDING PERMIT NO. 5900 1 GENE - NTRACTOR - d VALUE$ 376.00 NEW LOT TRACT FIRE ZONE DESCRIPTION OF WORK Redwood Fence G --7P TYPE ZONE PLAN NO. Sq�q INePECTIONS I DATE I SUBCONTRACTOR I _ __ PERMITS ISSUED Trenches Farms coat P) 'np Fixtu FL :3as Test 5900 .rx DATE BADDRESS 222 East 16th Street V BUILDING PERMIT GENERAL CONTRACTOR Owner -Builder VALUE $ L100,00 L AP## 117-151-21 BLOCK TRACT Garden Wall, 122' long, 6, high GROUP i TYPE ZONE RLI FIRE DISTRICT 1000 IIySPECTIONS / DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench LOS too Foundation Fo�d Grade to Garage Rough -Framing e.Q Plumbing, Rough to Slab Plumbing, Rough Complete Temporary Pole Wiring, Rough Heating, Rough Heating, Final Sewer, House Sewer, St. Seutic Tank or Cesspool I ig, In Out Plastering ^lumbing, Final, Fixtures Complete Plumbing, Final Gas Test Wiring, Final R_ Occupancy OWNER PARKER, Oakleyr.,DEC 31 1957. DATE 9-16-57 JOB ADDRESS 223 E. 16th Street MAR 1Q 195g BUILDING PERMIT NO. 5698 GEN L ONTRACTOR Owner -Builder VALUE $ 37n -Go 1 0. LOT TRACT FIRE ZONE DESCRIPTION OF WORK Fence COUP PLAN NO. I,.oPECTIONS DATE I SUBCONTRACTOR PERMITS ISSUED A A / DATE NUMBEF coat Gas Test OWNER PARKER.O- OAKLEY-0• DATE 4-17-57 JOBADDRESS 223 E. 16th Street 1411ta BUILDING PERMIT NO. #4855 GENERAL CONTRACTOR Otmer Bldr, VALUE$ 14,772.00 AP117-141-13 1 BLOCK TRACT Dup. Hatt. gars- AS PER U.B.C. GROUP I & J TYPE V ZONE RLL FIRE DISTRICT h838 INSP CT 1 �, ,,t yAT /S SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench _ Foundation Forms and Grade to Garage Rough Framing! r Plumbing, Rough to Slab/(�%f/$ L =5 J ce4' 9 SC 91 Plumbing, Rough Complete TeTt nn!mt e Wiring, Rough Wiring, 'u-)' -A / -sy� Z.2 6 z 2 - Heating, Rough C/%"j MHS g ---3/-,S 9 99 ✓ Heating, Final Sewer, House Sewer, St. 1,16. / Septtc•TankdR-Bes eel [y,,... L�...ing, In / Out F. =ring/�[_f� Plumbing, Final, Fixtures Complete fjS 116141117 -2 --Ig U "LiloaiG r f----i�-vx �l 4z- 7 .2-� ��wo,. dL'•-C•� /091 9% I/ /1 /_�� ✓ �� Q Plumbing, Final Gas Test/S-/5- Y 2 -al- n ,h Wiring, Final ('� �•� :' _ FORM 210 3M 10.03 4855 5030 COSTA MESA BUILDING DEPARTMENT P, O. BOX 317 }I COSTA MESA. CALIFORNIA II. FOR APPLICANT TO FILL IN ADDRESS ',�I/N ,A I4. F Il0 FEE RECEIVEGD�� E -� -q f FINANCE PT.I l APPbjtV,b lLftAFfi5, PERMIT BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY l s, / ` RECEIPT NO. PM 7 � OWNER F �(INb %/� �/� MAILRECEIYL. ADDRESS Gyya �L C°E-o1Py1 BV DATE RECEIVE s- 3 � DATE ISSUED �S�.lx!*ieed�1 TNo /%ls/63 NG CITY E ADDREBUILDSS SS ARCHITECT l LIC. f ✓O.V COSTA MESA. CALIFORNIA OR TIPEER µ NDGir NO. n ! 6/(p ADDRESS I��y J/i ..J, /r � G'E ZONFIRE E 091111E CITY No: ONF— ZONE PLOANs TYPE cROVP CONTRACTOR /U0/ ,f A0.9 4,10 10/0 PROVdD •] ADDRESS NO BY DATE / LEGAL LOT RRECT IONS DESCRIPTION IND, BLOCK TRACT A.P. NO. �- SIZE y / D / NO. OF BLDG.. ]!� OF LOT ^ NOW ON LOT USE OF fT1_V EXISTING SLOG. ywn SETBACK LINE FROM e CENTER OF STREET REAR YARD /fay / Al q �( V SIDE YARD RIGHT LEFT DESCRIPTION OF WORK TF ' OFN T 9 NEW ALTERATION ADDITION REPAIR MOVING DEMOLISH DING �% NO. V SIZE Q ROOMS STORIES EXTERIOR WALL ROOF COV ERI/NG_ OL K _COVERING F N USE OF NEW r N / / D BSI f� If'L l(,tj'(/. QO vy HEREBYNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THA HE ABO EI IS CORRECT ANO AGREE TO COMPLY WITH ALL C ITV ORDINANCES A D STATE LAWS REGDLATING BUILDING.CON TRDC- VALUATION ,/n 3 ilorv. SIGNATURE ON / PERMIT FEES v PERMITTEE PLAN CHECK $ IJ a [� AUTHORIZED AGENT TOTAL FEE S J md- I-W,