HomeMy WebLinkAbout340 16TH PL - Building Permitsi 35�o c' �GTn��- �;�i�a�„s
! Address
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$D� Penn1[ Date
a.�t�Vunbcr7y,s�/ issued
CLi'Y OF C�1S'Ci� iiP:SA
I1h:PAR1?ih:::7'
OF
IlU l LD WG SMISTY
Pe�ls[ered I1rpuLy liuildii;g inspecCoc
Cec[1fSence ut Comptiunce
IL�t� ol thls Ccrcl(Le,�ce
�`^7 ��
To [he Direccor nf iluflding S:i(ety:
i hcreby r.rrtify Chat. thc follawLn� portion:; of work on thc buildings
ac che al+ove address �ahich requlred r.onttnuous 1nsp�cUun and erhlch I wa�
empinycd to 1.nspect, were inspec[ed hy me .�nd rompi_y wi[h [he provisions
of che riuflding Code applica6le chere[o. �
�1) G�ncrece :1) Ueldinp; 5J Sprr.laL Gases
2) Masonry j�r�) }tein�orced Gypswn
Swlmminr Pool 51 z�'_�',] ��!,$" Guul [e _ e/ Iland I'
Sacks CemenC,�y1i �Ibns ul Sand �7 _
Approxtm;iGe i aC water.ln aygreg:�ed ��%
I'his report cuvers wot4c eompleted dnrfng w•r��Y en�ifnt __ �—�_�/�
RF`V�RKS �
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Addroes_ �_�jp��C)d L�a071�
I,nboratory_LuJ/iU//eJ�_ 1'elephone �/7�-3 �/�'G
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Val Hilsabeck & Sons
�„ �: _..
DESIGNERS • REMODELERS • BUILDERS
:+>`�' ' � 1 O50 N. ANAHEIM BLVD.. SUITE "C"
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r: ��}I��+:i,1,� � •, ANAHEIM, CALIFORNIA 92801
I'.���� . ;�!'" PHONE (714) 5333389
��'�=`.�'= "`'r INSULATION CERTIFICATION
----_ �.= _ _.
Thio ie to certify that. in con£ormance with the current energy
regulations (Ca.11fornia Administrative Code, Title 25. State of
CaliYornia+�) and approved plana, insulation has been inatalled
in the bu�lding lodated at:
� �...._�L�.�.�¢��_�� ��.�.���----
340 �. /� T„ ��� --�-
S ree y Zip
DESCitIPTION OF INSTALLATION
ROOFS
Type o�' Material Manu.
Thickneae R Va1ue
.L%T'r�tIOR WALLS ���24=2iGCe
Type of Naterialo Manu.�
Thicknesa 3 U�. �� R 9alue �1Tr'—
CEII,INGS
B at t s: u:c�CGe
Type of Materials_�Z�i/�,�,aOD I-.anu. %%%r�
Thicknese /o R Value*� 30
FI,OQRS
Type o#' Material
Thicknes
AIITHORIZED
LICENSE � ,
i,u.
Yalue n
8 /2 0�8 S
Calif. 11dm. Code� Lhergy ineulation Standards daclaresCompliance
upon completion of the inatallation of insulation� a card certiYying
that the inaulation hae been installed in conformance with the
requirementa of theae regulations ehall be completed �and executed
bye the inpulation applicator and by the builder. This ineulation
compliance card ehall be posted at a conepicuous 1�?cation within
�te Va�lule ���the measure of the resiatence of a materia7. or building
component to the passage of heat. The resistence value of neas
type insulationa shall not include any value for reflective facin�.)
I .AOOPE BNIOPq: ]�}Q 1.fiTFi PL UNT: ���
�za: wra+am:QAKHILL DEVELOPMENT
• �� ADDRESAjOAB IRVINF.. AVF.
. r
i�EH;PORT BEACH, CA 926G0 714-825-0671
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� �urcxrtECTonet+m�vn:KEITE{ PALMER �.�= C-11096
�xcx. on era.•s �ox�ss: 10 4 fS I RC� I N E AV ur�r: 3 G 3
�IEWPORT BEACH CA 926G0
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LENDEP'S N1YE
LQIOEN'S �DOflE39:
I ceniy tAm I hm neC Nu eM tlele IMI Ns eEws'udamelbn u conad. I epns lo comply w'vh N fLy enE mumy ordineM.es
ardetatelews�NelYqm ' ojnqu�mWherebYewhaaanP�ueii�wdlhoWYrowww�lhaebwamsqionWRW�Y
0�.:3�-z.�� �
(5151d9.WP) �1Ma-BuiMnp 8 Stlery:O�eeerFb: Cwry-Appfum: Rnk-Rerenw:0oken�oE-Mamwr
.. ,%I'CY OF COSTP tdESA Bt�II�DIIJC PGRhIIT
['ERt4 1�10: B 02122:9
PERMIT NO: B 082229 FLAN CHECK NO; 04297-96 A GOVT: N SUPP: hl
CONSTRUCTION TYPE; V-N PERMIT TYPE: STR PORPOSE: NEW
SOB DESCRIPTION ; 4220 SF LIVING / 954 SF CAAAGE DUPLEX SQ FT; 5,774
CLAIM VALUE: 350,000.00 CALC-VALUE: 348,190.40 GROUP �OCC: R;3 /U-�
COMMENTS: 2110SF LIVING /472SFGARAGEFOR EACH UNIT OF TH��DUPLEHJ
iF 1f iF iE IE iE �(-�If iF fE �E If IE 1E ik 1E 1f 1E iF 1F 1f 1f 1E IE IE IE iE IF 1F 1f 7F 1E 1E jh iE if iE 1E 1E iE iE iE 1E �If IE IE IE iE if 1k dE 1E fF IE iE �'�-1f.i£.iE�iiFik ik 1E ik 1E 7E IE iE 1E iklE iE fE If # iE �M
Z O N I N G R E Q U I R E M E.N T S
s e r B A c K s HOLD FOR SPECIAL REQUIREMEPIi'S
-------- -- MAIN BOILDING --------- -------- ACCESSORY BUZLDING -- ------
FRNT: 20 FT IN REAR: 20 FT IN FRNT: FT IN REAR: FT IN
LEFT: 5 FT ZN RGHT: 23 FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ; 6 PROV: 6 PARCEL:'42521218 ZNE: R2-M REF NO: DA-y6�06
PLANNING NOTES> TWO ATTACHED RESIDENTIAL UNITS (APTS) WITH ATTACHED 2-CAR.
> GARAGES.'{�•/E/F TRAFFIC IMPACT FEE TO BE PAID PRIOR TO OCCUP
1F ff fF jE iF �E 1E fF ik fF fE 1E if fE iE iE 1E iE if if iklE 1! 1klf iE 1F1f,fE k 7E iElE iElf iE iE iE iE if iElf iF 1f !F 1f !F if iE iF � if if iF if if 3E iE iE �f if IE 1f iE if 1E 1E #1F 1E if_1F 1E fk 1E �k iFlE jE
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 ': C/s�G DATE: 3/Z$ �y
BUILDING APPROVED BY :•.. c 7 r• DATE: I(/���7
APPLICATION ISSUED-'BY:�'� �Cfc�n J DATE: �/j-����
*icaEi(�1t-*��it-x�itx�iEifiEiEiEitiFitltiElEiFiF•'F'k�FiFi � h f7 � 7FiEiEiF3F3Fi�iF7FiF'�Fit�tititiEiEiEiEiEif iE 'lFiF'iF3F 'iF aE
LEGALIZATION:N F E E S M M A R Y STROCTURAL SEGMEDIT:Y
�' "' !��
/ BLDG PMT PLUMBING ELECTR,''�C'A,MECHANIC FIRE SMIP/RES GRADID]G
PERMIT' 2,�32.25 '� rj 74.84
;7 SMIP/NON-RES
PLAN 346,49 '"
7SSOE FEE . ��`•�
BUILUING-llTV-> PERMIT ISSUE PLAW-,CHECK TOTAL PAID DU6
T'OTALS----> 21.67.09 0.00 � 346 49 2513.58 2513.58 .00
�����
REVENUE DIVISION TOTALS--> COLLEC�',ED�• 2167.09 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECt�3W]•iC`� FIRE__SMIP/TOT GRADING PLAN-CHECK
tn1 �)
29 32. 25 �})" ,r 34. f24
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I N D I V I D U A L ,� � E B R E A K D O W N
TYPE QTY D E S C R I P T I O N' �� ONIT COST T'OTAL CUST
SFR 4220 DWE-TYPE C'-WOOD FRAME'' '"' =COOD 77.90 32f3,738,00
SFR 954 RES-GARAGES TYPE: V "� 20.60 19,652.40
ENQ�bF FEES \
,� V
HOLD FOR SP�C�AL REQUIREMEf�TS
�
83-28-1997/B2:B3 PM/f�167.89
RCPTR:AI-�084118
PERMIT:B82229
' } 'CON57RUCTION AND PLANNING � P��PA
�APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector I
�empo�ary Electrical Service or Pole 52. Pool & Equipment location
2. SoiV Pipe•U�drgrnd. 53. SteeV Reintorcement
3. Electriwl fAnduit Utility-Undrgrnd. 54. Forms
4. Electrical Gonduit�Undrgrnd. 55. Electricai Bonding
5. Steel Re�nforcement �/f 56. Rough Plumbing & Pressure Test
6. Etectrical UFER Grnd. ����(''f I���y� 57. APPROVAL TO COVER�GUNITE
7. Footings � ��, �, � 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgr�d., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P•Tr:�p, O Undrgmd.
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
74. Rough Plumbing 65. Electrical•Final
15. Rou9h Electrical�Co�duit 66. Solar SYstem-Final
76. Rough Eledric Wiring . 67. Fencing & Access Approval
V. Rough W{ring Sign 68. APPROVED FOR PLA$TERING
18. Rough EleCtricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Cpndi[ioning FIRE OEPT. REQUIREMENT
20. Rough Factory Fireplace � APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas O Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Fram�ng 73. Undergrnd. Storage Tank O Gas � Oil
25. Roof Sheathing 74. Overhead Hydro
• 26. T-Bar Ceiling (Struct�rall & Monocoat 1 75. Dry Chemical
� /��,��
27. Frame and Flashing i'Zti. S'� (� 76. Dry Standpipe
28. Lathing & Siding �.3• ����i" 77. FIXED SYSTEM FINAL
29. Insulation tj 78. FIRE PREV. FINAL
30. Drywall Na�ling /f, HEALTH DEPT. REQUIREMENT
31. Plasier Brown Coat 79. FINAL INSPECT�ON
32. Electrical Power Meter�Final �, 80. FOOD CERTIFICATE ISSUED
33. Fi�a� E�ecuic Noces: �LD_FQ(ZSP_ECIAL_REQ.UIl2E-MENT.
34. Final Heating & Air'Conditioning �� 11... (�1/t�_lea �/O_/'`/-�
y�v� rww1D7W Y
35. Final Gas Pipe�Test �
36. Hood or Canopy �� �
37. Fi�al Factory Fireplace .
38. Final Plumbing -�
39. Water Service•Fina� i
40. Gas Service-Final
47. Solar pomCstic•Finai
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem ,
45. Sound Attenuation .
46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING ���J 57 ��
. �
48. FINAL PLANNING p�� (.
"(-�-�� - ti - .
49. Electric Release to Edison ,
50. Gas Release to Southern California Gas Co
51. CERTIFICATEOFOCCUPANCY
No. Date
AOOPESSOiBL'��qNO; VHtI
OWNEkS N.WE IF'YJIDWN: 1 O�i
� �oo�u
vEWP�RT• BEACH
LOPMENT
AVE
CA 9'1660 714-825-06
�wl. �u�a+c �ooPE35:
KEITH PALMEft
'u�cxrrccrox�+m+�n: 1098 IRVINE AV
�ncx.onuxismowEss: NEWPORT BEFICH
CONIfl�tTORSu��.
CONf111CTOR5MNIRlO
JDDNESR
'L CZTY OF COSTA MESA — HUILDING PERMIT
'—� PERMIT NO: B 082229 PLAN CHECK NO; 0929'/-96 A
CONSTRUCTIUN TYFE: V—N PERMIT TYPE: STR
C-11096
�� 363
CA 92660 �M:
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dM nnu'p ro an• n�.ra.d �houwna ao�kn (J�o4�A M.nd�rhn ro m. ce.t e� �enp.,..wn, evrrpr o povw.e ro. �n
sxnm sms or m. L.eo, coes. �nfrs.c arw.rconl.ri �.u.
CONSTpUCT10N LENDINO IIGENCI': I hereby ��m �Me� D�ehY d perNry Ihm �Iwe w e ow�aw}ion kMi�p q�enry lar iM
peAarmence d ihe xwk lor whiM tAe paimY n evueE I�a� ��. Crv. C�.
LENDEN'S NANE:
LENOEF'S �OOflE55:
I ceniN �het I here nad Nu wW�on ud sete �hat Nn ebwe inlamwbn o mma. I ep�m to comON wiln ell tlIY W oouNy advwaea
end elele lewe Metip w Iprildvip_�ns4udm ��il�Y,e,N �e iepeeenlelivae d tho rnyto emar upon �he ebove�memioned popeM
tor impxfion qupoees,
Dme:
Sqiwure d Ovmarlf�penVAppIW�����a
(5151-,B.WP) WINe-&iddip 8$alely; O�sen-Fb: Cdury-AppFaM: Fnk�ie�au»: (3ddsim�Nwtv
+-n.. .� n no�•�ou
r,:.rm; ai crmn. �i
PURPGSE; NEW
JUb DESChIPTION : 9220 SF LIVING / 954 SF CARAGE LUPLEX S�j FT: 5,174
CLAIM VALUE: 350,000.00 CALC—VALUE: 348,390.90 GRc�UP OCC: R-3 /U-1
CGMMENTS: 211GSF LIVING /472SFGARAGEFOR EACH UNIT GF THE DUPLEX
iiic'rf+Ejt�l'eieif iElfieiFieiFtEiiiE;'riiiriE�kjiiPiEiFifiiieifiEifr'ri"riEiiiEiiiiiexif�ii'r�ii'+Ei'riEif#i'r+iiF'r. �c�c�iie�rtxifi'riFir+EiE:riciF�Fiii'ricxw�ifxii
Z u N I N G R E Q U I R E M E N T S
s E T b.� c x s
------------ MAIN bUILUING ---------- --------- ACCESSORY bUILUING ---------
FRNT: 2G FT IN REAR; 20 FT IN FRNT; FT IN REAk: FT IN
LEFT: 5 FT IN RGHT: 23 FT IN LEFT: FT IN kGFiT: F'L I13
PARKING AE'• b PROV; 6 PARCEL: 4"t721218 ZNE: R2—i�i hEF NO: LR-56—u6
PLANNING N�TES> TWO ATTACHEL kESIUENTIAL UNITS (APTS) WITH ATTACHEu 2—CAR
> GAkAGES. P/E/F TRAFFIC IMPACT FEE Tu BE PelIL PRIOR TG GCCUP
it iF iE iE i4 it i'r iE it �ir ie ir iE ii ir �c -it i'r iE ie iE iE i'r ie �ie ii iE it iF ir ic it ie ir i't iE iF ie-lr ik ir �t i't'r' ;t iE ic if ic?e �x iE iE it ix 1r ie+e ic :t iE x Y�r. ;r if �ti if %x 'y,�6M� if x x ik vc r. 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 E N�j',S
ZONING APPROVEL BY .
BUILDING APPROVED BY :
DATE:
DATE:
APPLICATION ISSUEU BY: DATE: •�''
'1P'1'tif9E'1fYEfEic*r't'1Fii'ifiilf'lijn'1iiF'1'tiflE !t 1t fEif ft dt '9E'rt iI'fE1k* it'Ri�iEii'lfifi6i�iciEifiFi�..� 1F1F �1F 3fii
LEGALIZATION:N F E E S U M M A R Y STRUCTURA��SEvMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRALIN�
PERMIT 2,132.25 34.84
SMIP/NON—RES
PLAN 346.49
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE FLAN—CHECK
TOTALS----> 2167.09 0.00 346.49
REVENUE LIVISIUN TGTALS--> C6LLECTED:
BLLG PMT PLUMBING ELECTRIC MECHANIC
2132.25
Tt�TAL PAIU UUE
2513.58 2513,58 ,00
2167.09 GVER/SHORT: ."v0
FIRE SMIP/TOT GRALING PLAN—CHECIC
39.89
'!c if'Ii'II"IE'le iE 9c lt'R ik'lF T"IC'h"IE lE iF iF iF 9E'It Y")'E 1E' R'R'1C+.F'It'K")E iF'Jf jF 1f iE'If'K' 1t'IE"IE' II' l'e ]t"�IE'IE -Yc iE'IF 1E e@ ie')t' iF'JE lf Y1"R 3r'IF'IE'IE Y'r iE 3c'1'e j! }'1f"R'k'IE 1E iF Y`'k' Y4 F
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 5 C R I P T I O N UNIT CGST TOTAL COST
5FR 4220 UWE—TYPE V—WGOD FRAME —GOOU 77.90 328,738.00
SFR 959 RES—GARAGES TYPE V 20.60 19,652.40
END OF FEES
�
.CONSTRUCTION AND PLANNING N P��'PA
'APPROVALS Permit # Date Inspector AppROVAL$ Permit # Date Inspector
�
,'i. Temporary Electrical Service or Pole 52. Pool & Equipment Locauon
, 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Efectrical Bonding _ ,
5. Steel Reinforcement 56. Rough Pivmbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAI 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, Li Undr9rnd.
10. Structural Floor System 61. APPROVAL TO DECK
71. Property Sewer Line & 4ouse Connection 62. Backwash & Recepior-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains g4. Plumbing System - Final
. 74. Rough Piumbing 65. Electrical�Final
'75. Rough Electrica6Conduit - � 66. Solar SYstem-Finai
76. Rough EleMric Wiring � 67, Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
19. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning � FIRE DEPT. IiEQUiREMEN7
(-
~ 20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. DuMs, Ventilating 71. Product Piping OGas �Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaoe Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
.
, 26. T•Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
' 27. Frame and Flashing 76. Dry Standpipe
• 28. �athing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywali Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAI INSPECTION
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Finai Gas Pipe�Test
36. Hood or Canopy
37. Final Faciory Fireplace
38. Final Plumbing
39. Water Service�Finai
40. Gas Service•Final
41. Solar pomestic-Final
42. Backtlow Preventer
� 43. Backflow Irrigation '
44. Landscape Irripation System
45. Sound Attenuation �
46. Handicap Regulations �/J�� � "
47. FINALSTRUCTURE&BUILDING 9��/Gf� �'//./�- '-
tiy-"
48. FINALPLANNING 1�
49. Electric Release to Edison . � ��
r� ",
50. Gas Release to Southem Califomia Gas Co �
51. CERTIFICATE OP OCCUPANCY '
No. Date
"°o"�s'cce'°�°a°: l 4 0 1 6 TH PL uxT: A/ B
r'`T'E"'°"""E'°i°aw":OAKHILL DEVELdPMENT
• � "D°�° 1048 IRVINE AVE
EWPORT BEACH, CA 92660 714-825-0671
�vr�. Yuiwo �oo�ss:
�"�Ta"�+�p KEITH PALMER ��= C-11096
+���'g��� 1048 IRVINE AV �M: 363
NEWPORT BEACH CA 92660
cartn�ctan ru�
CWIflICTORS M/JNq
ADDNE55: IIC.ND:
uNr:
UCENSED COMRACTOFS DECLAHATION: I lwreby � uedx pe�uly d pa�jury Nm I em loemed uMer prmieiane d Cheqer B
(oom ' v.ilh Sztion )�ao) d Oivuion 9 d tlro Bunmv xd P�dariam Code. uM mY 4cm» u m htll lau mM eXaa.
y��N 063758 uc.cuss: g uc.No: 58963 nEXP• 12�p/96
�ome: 2 -' � - c�.a�: S�f� �.aTJ`'�
WN BUILDEN DECLAFRTION: I hemW elfirtn uMx per�ely d parjury thet 1 em ezemq hwn �M Gontrmwe license lew In �Ae
rseem (Seqion ]W1.5 &nims md Prolessiona COEe: MYW a mwnY M� nqu"vae a O�d �o oomtncl. eller.'vnPove.
dCh, O! fl09f MylhUC�1PB, plqf b G4 Y911BMN. 8{lOIBQIYM UIG fl�fdN IIX Bl�I QlIIIM �O �B B���tl110M I�IBI �I! IX B�IG
licanaed W��� to iha prwiaau d Na Canlrepore Liceve Lew ICheqa 91�menrbq vAh Setlion 1000) of Diveion 9 oi ihe
��� �a Ra�o� cae� «imm �e a.na m�..ma �ne� .m ina c�. i« nb .e,�,d .�.ma�. urv ,�wm� a sw,o�
)0]1.5 by vry epp4mnt la e permu viApm �M eppGraN to a tivi pmMy d m� mae Nen (ne hWnE EOAan [f500U.
❑ I.aeox+wd�MpWe�Y«myemd�*aswihwapeamlheisdemm0�ion.wYAotlnv.oikenEthesbuctumemliNwMeE
rc Mered br aeb l5ection )oaa. Bumrcn eM Pidmaofu Code: The Comredaa Lieiue law douml eDPNto en owrord pupnry
.no ww. «mp�.. ma�,«,, �a w�o ao�.�n.�w ��n «t�� «mro� no «n�r o.,� �Wor»*, wwb.a mm w�n
�mo�aw... � mi.,aed «on«.a �« we. n. n,..«.. m. waa�,a «mwa«oau o.aa.nnm a,. r..� d�ab�. me
�owwo««tmb«�.une,�,in,w�d.�naa+�one«�em�e�aa«�w��>�,.wuv�a.m.).
0
�. m owrer a ine o�n..m exa�oi..N m�vreanu �wn cm�wd mmnnm m mmnw me ww� Iseaon mu. an:wn am
wd..eion. c«b: rne cmuaeon �iwn. l.w me. ewi wWr m.� own« a o�r �no wim a inw�+� meeeon .�d wn
Cp11f8C18 /IX Wf1'Ipf0�B419tX1�19 OMVIMO1�9��CG119ld p119U811110��18 i�iplVOtldf �IdM1tO �tlY/�.
❑ i� a.�w ��a.� s«��,: e. a v.c., ro� w. �:
od.: o�.:
I Ao hereby cMily Um I em ewue d ud ivde�eleM IM reWi�emmp d Caliomie HaeAh enA Selery COEe Setlion� 25505. T55�, uM
45591. erd iMi I a enY Muro ddkirq omryuu �riY / wY na (amcb me) rcad �o camGN w[h uid �ma oodu ad �M nC��wa br
aM�elamrevuctianamodifimiantranlMAi�uai�liy —v�ypmruOiCritl.ReedWNmMrudionePG�bmxovanq/mmNxe
proWaona.
DNe: Appliram:
WORKEN'S COMPEN9�TION DKL�P�TION: I hwaby dhm udar pwAy d psryry me d iM Idbwiiq ddermuro:
� I hera vd wil meimen e cenJicua d coneeni to eNJnw�e br wkmi mnpenW ion. m poviEaE la try Sapion 3)00 d ths labor
Code, la tM pMamencs d N� Mak la wlich Mu prme w osusd.
❑ � n..e d,a ml meim.n.,wxn.� mmwromia, marerc...s r.w'vad w swio, mo d me l.mr cm.. br �n. o.rlam.nc. w �n.
wak la xliidi Ne G�X w b�ued. MY walmn' mmW�ion hmwee mrtiw W DdiY rwnbr ms:
Cvrier:
aaev r�ee�:
lIO 1MNY1 II!!� Ild b! MIII(�!(fj / I�M iam� O%Y pM �IYIIf/I04 f�O�N9'i]Qi� CY M{f�i
S] en Nm m tM perturtunce W Ihe xpk lor xfiirli tlJe pmtit h'waued. I dutl nd anpby vy penon M e�ry menner w m to
eubjed io ihe wters' canpanealbn bw� d CelGwnie. eM yree NN G I�hwM becmis abjotl to iM xoMna'
p nuiion Vrovieian W Setlion �W d tM lebw Code. I wnh mmW ��m�.{��, Peovnn�n+�.� D �
o e: �'L- 1't - ri1 ,�p:�.m: ��7i,lA-iLR 31-��t�CAlf[�.
W� np: F�Yun ro weun woMrwi ronpruetlon rov�rap� h imNwNl, �M NtlIWbMc! en �npl ro alm'rW pw�dtlq �nd
. I flrr� �q ro an l�,ntl� tfnuuid dd4n (tlPqlpOA N Mtldon b M� ro�t o1 rompru�WR � u povWW br In
CONSTti11CTI0N LENDINO AOENCY: I Areby ellrm under peiWry M pefjvy Ihe� �has 6 e mweuqion bM'up eparcy br IM
anom,� a in. won� ro' wn� ine �.�+ o�a cseao� wa�. cH. c�.
LENDEP'S NRNE:
LENOEF'S ADONESS:
I cerlily Ihet I ha+a mad Nb appliraum end 9ma �hm Ne ebws'vdame�ion o conw. I yrae lo comply wqh eY r'ly end aw�My ad'muv
vd ewa lexe relelip lo WJd'vq conatruCion eM hereby eNM¢e 2pe�en�evne d Iliu dry b eNa upon tM abova�menlioneA prtperly
br impedan O�rpmee.
BRUCE BENGOCHEA
�a: (2—1 � — �1C,
(5151dfi.WP) WAne-&�ddiq 8 Selery: GreeMFb: Canmy-AppimN: Fnk-Revenue: (3ddmme-N�esea
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: GRA 080826
PERMIT' NO: GRA 080826 PLAN CHECK NO: 05131-96 A GOVT: N SUPP; N
CONSTRUCTION TYPE: V-N PERMIT TYPE: GRA PURPOSE: NEW
JOH DESCRIPTION ; 4220 SF LIVING / 954 SF GARAGE DUPLEX SQ FT:
CLAIM VALUE: 6,000,00 CALC-VALUE: GROUP OCC: R-1 /U-]
COMMENTS: X
iE If IE If fE if iF if if 1F K iE if iE if if iE k iE if 1E ff if iF iF if 1E if 1E 161E iE iE 1E if 1E iE iE 1E iE 1E if af 1E If if 1E IE if if 1E iE iE iE iE ik 1F iFlE IE �f iE 1E jE iP if iE 1E iE iE 1E if iF 1E 1F iF ik ik iE
Z O N I N G R E Q U T A E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: F'f 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: 42521218 ZNE: REF NO:
PLANNING NOTES>
i !,�
��rat*��ftftit****it*if***���it***�x�***��r�**�*�r***it*+�it+�*itx�itie*itit�ititft�at**�it*��r*it***�it�it
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E-N'T S
ZONING APPROVED BY DATE: ' `
BUILDING APPROVED BY : t.� DATE: lCJ
APPLICATION ISSUED BY: �.�-� DATE:
�ritititx�**x�x�**ft*t�i�*i�x-x�*f�x��F�iF�FiF�F�F'�iF �F . �FiF 3FiFiF'�F'iF'iF7F'�F�FiFiFiF�F�F+�*x�itit+��rtrt* **
STRUCTURAL SEGMENT:N
N:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMII'
PLAN
ISSUE FEE
BUILDING-DIV->
TOTALS---->
PERMIT ISSUE PLAN-CHECK TOTAL
33.00 0.00 5.63 38.63
SMIP/RES GRADING
33.00
SMIP/NON-RES
5.63
PAID DUE
38.63 .00
REVENUE DIVISION TOTALS--> COLLECTED: 38.63 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
33.00 5.63
1E 1E 1E 1E 14 iE IE 1k 1ElE 1f if k iE 1f iElf 1E iE iflE fElE iE k 1E 1f 1f iE 1E IE k 1k 1f If fE IE 1E iElE iE k iE k 1F 1k If 1F 1F 1E fF 1f 1E fE if fE if 1E 1E 1f 1f �E 1E iE IE 1ElE 1E iE iE ik 1E IE fF if ik ik 1f iE
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
NO FEES WERE SELECTED FOR THIS PERMIT —
.� 4:.. �• ,.:„w �
DEC 11 1996 �
CITY G; COSTA ME;�
�CO(�STHUCTIpN AND PLRNNING � P��SPA - -,
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
� -L'Tempc;ary Electricai Serviceor Pole 52. Pool & Equipment Locauon
2. Soil Pipe-Undr9rnd. 53. Steel fteinforcement '
3. Electrical Conduit Utility�U�drgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforesment 56. Rough Plumbing & Pressure Test ,'
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE i
7. Footings 58. Electrical Conduit•Undrgrnd. 1
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgcnd. 60. Backwash l.ines, P-Trap, � U�drgr�d.
10. Structural Floor SYstem 67. APPROVAL TO DECK '
71. Property Sewer �ine & 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�Condu�t 66. Soiar System-Finaf
�
16. Rough Electric Wiring ' 67. Fencing & Access ApProval
17. Rough Wiring Si9n 68. APPROVED FOR-PLASTERING �
78. Rough Electrica6T Bar Ceilinq 69. POOL/SPA SYSTER9S FINAL
19. Rough Heating & Air Contlitioning FIRE DEPT. REQUIREMEN7 � i
20. Rough Factory Fireplace � APPROVAIS Permit # �
21. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas � Oil
23. Gas Pipe-flough & Tesc 72. Underground Flush
24. Roof Framing � 73. Undergmd.StorageTank OGas ❑Oil
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75, Dry Chemical
27. Frameand Flashing 76. Dry Standpipe
28. Lathing&Siding 77. FIXED�SYSTEM.�INAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing -HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Pinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric . Notes:
34. Final Heatinq & %{�� Conditioning : �_ -
35. Final Gas Pipe-Test ` �
36. Hood or CanopY � . '
37. Final Factory Fireplace . �
38. Final Plumbing
39. Water $ervice-Final -
40. Gas Service-Final
41. Solar pomesticFinal �
42. Backflow Prev¢nter
43. Backflow Irrigation
44. Landscape Irripatioo System � , � • '
45. Sound Attenuation '„- �
46. Handicap Regolations -
47. FINAL STRUGTURE & BUILDING � - • •
48. FINAL PLANNING .
Q9. Electric Release to Edison �� _ �
50. Gas Release to Southem Califomia Gas Co '
51. CERTI FICATE OF OCCUPANCY • ' ,
No. Date
�
�
�nox� em�oea: ]H �� 6 T�`�pL u�r:
'OMlENSIUYEIFp10N1t OAIC L D ELOPMENT
' .unncss: 1048 IRVINE AVE
;IEWi�ORT HEACH, CA 92660 714-825-0671
MFL. Y.UNIG AODNE55:
1pCNRECTOPFNtlXFEF: UC.Np.:
AqCN.OP ENR'S 100RE55: UHf:
caxm�crarsw,� VNE DEVELOPMENT INC ( 714 ) 548-3072
cam�cToxs�uimo 1030 IRVINE BL
,�oo�sa NEWPORT BEACH CA ucta_ 658963
92660 uxr: 363
UCENSED CONTflRCTOfl4 OECLAH�TION: I Mieby ellim uWr pnely d pa�jury Nq I em 4meetl under prarinone d Cheqa B
(commerurip �til� Seclion )ODO) d Divieon 3 M ihe Buvrwu arM Profesuoro Code. enE mY licenae ie in full iaca eM Wod.
cmuc.'.:06375 uc.cuss:g �c.�[q�: 65�963^ EXP: 12/96
Dms: Cowmm \ f/ ��
OWNEP BUILDEH DEClAF4TON: 1 henby etFrtn unMr peroty d perjuy ihm I em evmp hom �he Comeauon limiva lew In IM
"M�mO �esson (Secbn )W tb &niws� and Adaawma Cods: ��ry ciy a cauM' MiirA �eqwree e V�e m aavUucl. eds.'vnpa+.
�wleh, p repai eny eiivauro, qior b ea usueMe, e6o rapuiree �he epplixnt ta euch permil �o fib a eprod eWmmnt Met M a�he
xenaed wmaeu m �he pwuim� d IM Caurmon Liorue law ICAePa 9(evmmena^G wn Saaian ]000) d D+iion J d �M
.�airea enE PrMmaime Codel a ilw he n Me w memq Iherelmm end iM baas lor Na elkWd memqion. MY videiion d Seuon
lW t.5 Dy ury epptiuni lar e permn abpC� �M applicam io e c'nil pereCy d nal maa Ilun Ma huM�ed AOAai� �5500�.
❑ I.mowrordiMV�We�YormYanWWesex'vhw+pmnthwwbwmD�.v�AEotMwvk.andiMWucfu�aenal'vqandsd
a oflaed la eeb (5ecuon )OM. Burirom eM Prdeee'vn CaEe: T!a Camrmon liu�ne lawdoea nd epyy lo en'a�merd qoparly
wln buW a inpwe� IMiem, ad Ma doae euM xvxk h'vnd14 Mnd a WauOh hu a hm own emplvpn. Pa'�d tIW wth
imprwemeMe are nal imeMed « Waad Iu seb. M. howsva. �M EuJdiiq a inpewemaq a vold wnhm pwYw d eompM�bn. tM
owrorLUBdx Mi0 heva �M bukm M pwiro M a ehe aid nd Wik a'unww+ M ihe Pwame al eebl.
❑ �. m ow�« a �ne nwem..m ..a.tivero oommu:ro ww, �on,.e wmnm. m c�w m. c�aea (swo� ro... s�.in.. ene
VWmabm Code: TM Gomreeon licenm Lew Eoes na1 ePNY ro en oww tl pwMY xM buitle a Impavr �Iwaon uM Mn
wnoma b wdi pqede wtl� e mXmCoe(e) Iieense0 punuw to IM CoNretlan limins Lexj.
� I em uemp uMer $edion: B. 8 P.C.. la Nis eeawn:
Dete: Ownac
I 0o harebY anM tlw I em eware W xk uMe�wd the mWimm«ua G Cellomie Heetlh eM SdetY Cotle Setlioro 25505. 2553�. W
u51a, ena the� 1 w ury INun Wildin0 �P� ��� / wYl rwl (drcb ane) neeA lo compy wYh eak etete codee enE tM repuinmann M
apeemnlammWClionamodifiWionhwntMAi�6i yuTl�enepemeni0ivria.Rridentialcwmrueuneppicetomene�emqlramtAw
provisime.
Dda: Rpq'vm:
WORKER'9 CONPEM9ATION OECLAN�TION: I Mreby elfi�m uMer penelty d parjury wr d tlr fdbwirp detlermbm:
� I hew eM vril meiniew e cenNiceta d mneent io eatlinwn br v.oMeis'rompenW ion, n prwided Ia by Section 3�O W tM lebor
CoM, fa ihe peAamerce d tM wwk lor wNch Ihie paimu n luued.
� I hew eM wil meinlen waken' compenut'vn imurvw. m rpuired by Sepbn 3]00 d ihe lebor Code. br iM parlwmenm d iM
work /« xhitl� ihle permN ie isueE. My waken' mmpenealbn imurarice mrner arM poliry number are:
c�«:
adev N�mna,:
Nr sMian ros0 rof 6s cwnda'M I NsV�I "n br aro huMnd ddWa ISfOJI n bv.)
�] I mnA' ��� P��s d tM wak Iw x1�ch Ihb qimG u iaweE. I NeA iwl empb� em� pe�wn n ury men�wr eo n to
become ubptl to iM wks�' mnpenwion lew d Cefdmus, eM aprea J I elnWd Eecarc �ubjw to tM wMre'
compero lion qwie ns d eabn �1W d IM lebor CoOe. I M1wil� ' Oioea piwmms.
Date: �pq'�:
W�mbp: F�9 n ro ucu �'o ai romp�ru�tlan oov� la unlnrM, uM �IWI ueNct �n rrylayer roWMml pwlllu uM
GHI flnp �p om hindrW MouuMlWl�n (JIOQPOOA ��Itlon ro tl�s co,l ol nr�wrueWn 4+�W u porMW ler In
Sstlon J106 0l Ms l�6or Cotle, Inro�s�t, �iW �ttom�y� Iw.
coNsmucnoN �v�onw �ceNcr: i n.�nr .M� ��d« wreW d�,y mm m.e o. w�a�wo� �ro ro�r w me
penormeMe a �n..vn �« wnirh �he w�� o ew.e (seaon �041. cw. c).
IENDER'S NAYE:
LENUER'S �DDPESS:
1 ceniy ihm I heve raeE ihe epplcmion uM peb Ihel rtw ebova iniwmetion u m�f. l epne to canpy wnh ell my eM coumy ad'vw�
W ebb lawa rdmip io bwMip conWuaion eN MreEy eWiucs npeae�uetiree d �Ida dlyro eMa upan tM ebv.smmtlionod papary
�«�"'°°°�0�`D°'°° AROCfi IIENGOCHEA
Pnnl Neme ( � � ,�1
v�Dme:
� ' Sq�ure d r/ppenVRpplfanVConlreaa
(5151�B.WP) Whne-Buildvq 8 Selety; Oraen-Fle; Cerory-Applreni; Fnk-Revenue; Ookenm�Nx»or
CITY OF COSTA MESA — BUILDING PERMIT pERM NO: B 080545
PERMIT NO: B 080545 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: DEM
JOB DESCRIPTION : DEMOLISH EXISTING RESIDENCE SQ FT:
CLAIM VALUE: 1,000.00 CALC—VALUE: 1,000.00 GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
+��+eifititit*�**xit�x*��r�t���*�r�x�*rt*****��it*�t**�*�r+e**ir�*�uar*at����*�*+tit�x�*it+t�xrt**it+r�*�
2 O N I N G R E Q 0 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 RE • PAOV: PARCEL: 92521218 ZNE: REF NO:
PLANNING N TESi
i
if iE iE �f �f 41f !E iE i! fE iE fE �' iE IE jF fE iE fE fE �E fE ff iE iE fE �)E 1E �k if iElE k 1E ff IE ff 1E if iflElE �E iE iE 3E If !f iE �E fE 1k iE if !E �E �F ik 1f IF 1f fE iE iE 1f �E 1E fF �E iE 1t * 1k 1E If iE fF 1E
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 HY; DATE; �� �21�w1.
iEfflfiEiE�E1klE'M�ItiEifiEiFiEiE�FiE3EiEif1E ��FiFiFfE3E�EiFikiElElEiEiE ��iF�ffE
LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/ftES GRADING
PERMIT 34.75
PLAN SMIP/NON�-RES
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 35,25 0,00 0.00 35.25 35.25 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 35,25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
34.75 .50
�k ik if 1E If iE If fElE 1k iF 1k iE 1ElE iE 1(- IE 1FlE # iE !F 1f iE iE 1E if Itlf 1E iF iElf If !f 1E !f 1E if iE if iE iE 141E i(-iElE 1E if �E 1F 3E �ElE �klf iE * 1E i(� 1E 1E 1E iE iE iE 1E 1E IE 1E 1f 1f iF It iE ff� iE
I N D I V I D U A L F E E D R E A K D O W N
TYPE QTY D E S C R I P T I O N ONZT COST TOTAL COST
NO FEES WERE SELECTED FOR THIS PERMIT
01 00229670-00219671 TO T 35.?5
DRTE: 1!/21/9` TIME: 16:02
, CONSTPUCTION AND PLANNING P�� 'Pa
AP;'FOVALS �Permit # Date Inspector - AppROVALS Permit # Date inspector
�,7 • Tempoiary Electriral Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrqr�d. - 53. Steei Reinforcement �
3. Electrical Conduit U2ility-Undrgrnd. 54. Forms ,
4. Electrical Conduit-Undrgrnd. � 55. Electricai Bonding ��
5. Steel Re�nforcement 56. Rough Piumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. �
S. foundation 59. Gas Pipe, C] Undrqrnd., Test
9. Water Pipe-Undrgmd. � 60. 8ackwash Lines, P�Trap, rJ Undrgrnd.
10. Struaural Floor System ' � 67. APPROVAI TO CECK �
7 t. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & VeofFina� �
73. Roof Drains � 64. Plumbing SYs[em � Finat
14. Rough Plumbing 65. Elettricai�Final �
15. Rough Electrical-Conduit 66. Solar System�Final
16. Rough Electric W�rin9 67. Fencing & Access AnProval
77. Rough Wiring Si9� 68. APPflOVED FOR P�ASTERING
78. Rough Electrical-T Bar Ceiling 69. POOL/SPASYSTEti9S FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Faciory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts,Ventilating 71. ProductPiping'JGas OOiI
23. Gas Pipe-Rou9h & Test 72. Underground Flush
24. Roof Framin9 73. Undergmd. Storage Tank � Gas ❑ Oil
25. Foof Sheathing 74. Overhead Hydro
26. T•Bar Celing (Structuraq & Monocoat 75. Dry Chemical
27. Prame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. RNAL
30. Drywall Nailin9 HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power hAeter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. final Heating & Air Conditio�ing
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Plumbin9 .
39. Water Service�Finai
40. Gas Service�Final
41. Solar pomesticF�nal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation .
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING C�
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Retease to Southern California Gas Co
51. CEFTIFICATE OP OCCUPANCY
No Date
won�sscv awiowa 3 4 0 16 TH P li
°w"ERs"""e'°.aawrr OAKHILL DEC'ELOPMENT
� moxess:1048 IRVINE AVE
T BEACH, CA 92660 714-825-0671
�oo�ss
uHr: A/H
�xcxnEcron�N�x: KEITH PALMER �F"�- C-11096
�K�p��g�p�� LO4B ZRVINE AV �M: 363
NEWPORT BEACH CA 92660
���T�g� VNE DEVELOPMENT SNC (714)548-3072
CWfH�CiORSYYlWO 1038 IRVINE BL
�op�NEWPORT BEACH CA ��= 65t1963
92560 �M: 363
IICENSED COMPRCTOHS UECLIP4TON: I Mreby ellim uMs penely d perjury tAn I em ficvnaeE uMer prwieiom d Cheqer B
(commendn9 ��il� Sxtion �000) d Orvoion a a� ma Buaircu eM Pmtsewn� CoEe. W my Rmroe e in M1A lacs eM elled.
° °06 758 uc.cuss:g uc.No.:658963 EXP: ,�2/96
�o ,. �� �'� ��� '�.�w_ � c�o�=-�;�"
BUILDEfl DECLAR4TION: I hereby effirm vMn pwuly M parjury ihe11 am ezemq han ihe ncaa L'wensa lew la IM
' 9 iseaon (Safun )W1.5 Bus'vwa� eM Hdmsom Code: AnYW a mumY r.fiich nW'vee e G�! io aomWn. Mx. impova.
mdah, ar repei erry at�ucuua, pia lo da s+uarm, e6o repimo the eppErsnt iv arl� pe'mil �o fib e aqmd patemmt Met M a elro
�io.,.ee w�a,w io me pmreiom a me cau�mde um,.. ln. �chmim s Immmenano wan seaon �000l a oiieo, a a �ro
ueir�ma em Rdm.'va codel a�mm �e « eie o aumq �nerxmm end �n. bam la Me elbped mamqun. Nrv volm:n d swon
ea
]031.5 b/ eiry epdifaM fa� e permY wbjeCi IM eppficanl lo e a+d panetly d ml maa Ihen (He huMrtE EOYen �5500�.
� I.mowne�WlhepW�YamyemdW�+wfhwapmmtheisdewmD�setion.rriYEONeMvk.endNeNiudunenalmleMed
a Mmed for eeb (Sx�vi ]01�. Bu�masv enE Pmlass'vu Coda: TM Cm�t�eewa liom+e lewdoa m evVNtoen oxner tl propnry
W�10 �NIb9IX ��IIp�OYl91�1BlB011. BIId N�q dOB9 fIM�' 1 MIXk �IIIIIHld IX �M19l� C! I�1IWQ�1 � IX �1M OW119Tp0�lGf. pIW1dBd I� M1C�
�
imqovameMs ere nd imeMeE a aliwad la eab�tl, howew, tha datli�p a inp'oveinmp ie eold wil�in ms yeer W oompbtion. Me
owiwrbu� ll heve IM dndan M P�'�M M« eM eN no1 dnld «impore f« the pufpua d ubl.
� I. ea owiwr d iM pW�Y. em utivmN/ mnvmiq wbA liowad wnVsbn b muvud Ne V�M� (SeUbn 10a0. &ro'uwn enE
PMmeiona Code: Tha Coniredae liceva law doae m� epply to en o�mer d popMy Wo Wtde a impovee thaeon eM who
convecte fa vuM pqeda xnh e ronuetlor(sl GcemW punueM lo iM Convman limnse leM.
� I em memq �Mer Sedion: B 8 P.C., lor Nu iee. :
Dme: Ox+w:
I Eo hereM canM Nv I em ewue d erd udenWd ths �M���eb W CeYa�tis IleeEh W Se1W COEa Swbu 25505.25itJ, enE
2553,. uW ihN 1 n enY Mun dikvq om+P�� vnll / wil nal (tlrtY one) naed b ca^WY xih aid tltls wds� md �M nWnsmaNe br
eG�tllaomaNClbnamoGfrationkamtlnA'r ua�y anepameniDotrid.Red4eNielmMMionWGN�AvmanexemWtmmiMu
pION91M9.
Oets: �pplirsm:
WOflKEN'4 COYPENS�TION DECURATION: I MraEy elfum uMr prutly d prpry w d tM tdbr.4p drLrtlbm:
� IAevaerdvNmeintenecMifiubdconwato+atlr�wvaluewarken'mnpanWion.npo.idsdlaEySWion9NGdlMlebar
coe.. �« ine o�o��. a u» .on� ia .�:e, w. v�+ e m�.a.
� nn.�. ene wi� meimen w«Fen• cano«iwo� im�..rca. a�.m�� M swo� aroo d ms lseor cm.. ror �na w��enca ar �ne
wak la whidi thu Pmm�� u ivued. My waken' mmDu�ion imurence fa�'w md V�Y mimEer ms:
Cemer.
vdKv rmmn.,:
/%9 8%Yion nesd nof W mnC�MeE ] NeG��I if M CIp hYnGed ddlen /SI W� W IOY.i
�[] I mnh � in Ne pMamence d Ne wak la which Ihu pemn u uumd. I Netl ro� ampby ury pseon in vry menes o m �o
beconw wbpo lo �M xaken' compmnvun lew� d Ca4lomu. eM apme Net L I NwM bacams abpU lo iM Ma�ken'
ompenseiion pmnabu d Seaian 9)00 d IM leCa CoEe. I W�Y�^ v.nh oomp�y wuh Non peov6bm.
o�,: If - i-9 G ���: ' Lb�-� !3�-. �,�-r.S
mirq: Fellun ro Ncun workwi cortpwmtlon rov�np li un4wM, �ndNYl w4J�ct an wrp yw ro uIMIW pw/tlu uM
clvll Ilnu �p ro om M1urtlM tM1ouwriE tlolYn ft104000A N WtlRbn b IM ewt ol rortprruWn m�ni� u povMW br In
9�cUon 9106 0l tln LeOo� CocY, In�sroat ��d ��tom�y'� Iwa
CONSTIIUCTION LENDINO AGENC�: I MreEy alfirm imEer penely d per'Fvy �het �hen e e oomt�ion bMiep epsx.y M tM
penwmenro a �ne wM t« wWi iw wm� m b.�.a (sw:�n �09). civ. q.
LENDEN'S NlME:
LENUEF'S ADUflESS:
I cenlN �Mt 1 Mw ree0 N"v eVd�r.elim ud vme ihet Ne ebwe'vdametun w eonep. I+Pa lo can0�'vrilh M c1Y aM m+M' atlinmiws
vd atme lewe ielmn0 �o bdkaq conwutlian aM Asetrf wilvaa iepesmtetivm d �hu aY m wr uW� �M eEa�w�memiaiad papeny
lainvpedbn Wepoaee.
t3RUCE BENGOCFiEA
/5t5�-IB.WP) WMe-BuJdiq85efety,GreemFb:Ge�wy-qppFatl:Rnk-Rs.�erue:0okenmE-Asaasmr
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 080269
PERMIT NO: B 080269 PLAN CHECK NO: 04553-96 A GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: CON
JOB DESCRIPTION ; CONSTRUCT 340LF RETAINING WALL SQ FT: 340
CLAIM VALUE: 8,000.00 CALC—VALUE; 13,600.00 GROOP OCC: U-2 /
COMMENTS; PERMIT FOR BUILDING A RETAINING WALL WITH WOOD FENCE ON TOP
*�x�t***��c**�**x**�e*��*�t*�t�r*****x*****�*�**x�r*��r****�*�r**�***�*****�****x****�*�
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: 42521218 ZNE: R2MD REF NO:
PLANNING NOTES> CONSTRUCT MAX. 2.5' HIGH RETAINING WALL WITH 6' HIGH�WOOD
> FENCE ON TOP. "
if IE if i%iE iE'IE if iE 1f iF iE 1f if iE if if if if if 1f if 1E 1f 3f if iE iElF i%iF iE iE 1E iE'IE # iE if iE iE iE 1E iI' iE 1E iE if iE if if if')f!f if iF iE if !i' iE 1F # iE iE 1E'1E jF iE if iE if if iF iF iE iE iE'N' iI'
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 APPROVE �� DATE:
HUILDING APPROVEQ BY : ��/� DATE:
i.-
APPLICATION ISSOED BY; ���_. DATE• /
�IE 1! iE 14 iE 7k if IE IF 1E IElf iE 1ElE iE 1Elf 1f 1f IElE�F�3F7FiFiF�F�F�1F3F3FiFiFiFiF TF�iF�Tf�fiF7FiF�iF��7F1E 1E iE 1E 1E 1E 1E if if iE��iF3F iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
FERMIT 212.25 1.36
SMIP/NON—RES
PLAN 34.49 '
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PliAN—CHECK TOTAL PAID DUE
TOTALS----> 213.61 0.00 34,49 248,10 248.10 .00
REVENUE DIVISION TOTALS--> COLLECTED: 248.10 OVER/SHORT: 00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
212.25 � 1,36 34.49
iE if 1f 1t if 1E �E ik 1E ik fE k IF fE fk iE k iE k 1f IF if i! 1k iF if iE IE fE if 1t 1f iE 1E 1E iE iE 1k iE fE i! iE if iE iE iF 4 iE iE 1E if ff 1F iE if IE k iE iE iE if k if iF 1E iE iE 1FlF 1E 1f fE fE fE ff fE iE fE i(
I N D I C� I D U A�L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I 0 N UNIT COST TOTAL COST
SFR
SFR
340 RES—PILASTER WITH WOOD,ETC BET/ FT
340 RES—RET WALLS := 3,-FT W/SURCHG/ FT
END OF FEES
,
10.00 3,400.00
30.00 10,200.00
Ui QD2i3356—�Q2133`8 T O T 243.10
OR7E: 12/01l95 TIt(E: 09:35
'CONSTRUCTION ANDPLANNINGM P�SPA
� APVROVALS Permit #�- Date I�specior AppROVALS Permit # Date inspector
�. i. Temporary Electrical Service or Ro1e 52. Pool & Equipment Location•
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement . i
3. Electrica� Conduit Utility-Undrgrnd. 54. Forms �
4. Elecirical Conduit�Undrgmd, - 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & P�essure Test
6. Electrical UfER Grnd. //1 5�. APPROVAL TO COVER�GUNITE ' �
7. Footings //��(� �� 58. Electrical Conduit�Undrgrnd. .
!
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test ,•�
9. Water Pipe�Undrgmd. 60. Backwash Lines, P�Trap, 0 Undrgrnd. �
10. Structural Floor Svstem � 61. APPROVAL TO OECK �
1 t. Property Sewer �ine & House Connection 62. Backwash & Receptor�Final�
12. Sewer Cap 63. Heater & Vent-Finai '
.
13. Roof Drains � 64. Plumbing System � Final
74. Rough Plumbing 65. Electrical�Final �'
15. Rough Electrica6Conduit � 66. Solar System�Final , �
16. Rou9h Electric Wiring 67. Fencinc� & Access ApProval �
77. Rough Wirin9 5�9� 68. APPROVED FOR PLASTERING �
18. Rough Electriral-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit # I
27. Dutts, in Structure 70. Underground Hydro
22. Duas, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Undeiground Flush
24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil
25. Roof Sheathing � 7q. Overhead Hydro
26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical
27. Frame and Plashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL -
30. Drywall Nailin9 ' HEALTH DEPT. flEQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Eleccric Notes: //-l2-�G �k � ��i� �%
34. Final Heating & Air Conditi0ning •
35. Finat Gas Pipe•Test �
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BU�LDING _ 4�
(�/
46. FINALPLANNING �
49. Electric Refease ro Edison -
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
7 I
�
�oonrss a eaim�o: } y U 7 b 1 H Y L
avxEasaweiriwan,:OAKHILL DEVEI,
�ooa�,s: 1048 IRVINE A
'EV7PURT BEACH, CA 9266U 714-825-0671
ux. �uw+�+.00n[ss:
�NCNIfECT OP Q:iNEFA: UC. Iq_
uMr:
WqL OII Q16'S 10DPES: UM:
cwm�cranru� VNE DEVELOPMENT INC ( 714 ) 548-3072
������u� 1038 IRVINE HL
��,NEWPORT BEACH CA ��, 658963
92660 �MT 363
LICENSED COMFACTONS UECLAfll1TI0N: I hemby allirm undor peneAy of perjury iMt I em lice�ued uMer qwiaione N Cheqx B
(euvnerc rp r.nh Section ]OW) d Oiviaion � d Ne Buvi�e vd PMeeeiom Cada, eld m 4mnae u In lull l«w eM sHeq.
cmuc.No. 6375�8 uc.cuss:B ����^/y o.: 65 3 EXP: 12/96
Dmr � �P Canrada: �..Y )V �
OWNER BUIL EP 0 ClAN1TI0N: I hereby elfim� uMm penelY d per'�uy �het I em aump tmm �M ContMm liceme law la ihe
lobwip rmaon (Seeion ]W IS &nn»� erd Prdmeioa�e Co�s: MYW a cauNy whidi nyu"um e pwmu to moWcl, e4x. inprow.
�vnd'e�. a repei mry sl�ucuvs. pw b Ya'vwwice. ebo nQY� tM eppkara Im wM prmd to 6b e �ipneE pele�ro�u Nm Ir a eAe
4cemsa w� �o in. awiebm a me cavree«. LiceM1+e �ar Ichw> s(oomman�o wan ssuon rom) a on'ebn a a Or
dumms eM Prdm'aa Codel m ihn he a ehe e e�emp �hweM1vm end tM bmu In tlr elepeE namqion. MY vuW un W SWun
)0�1.5 Eq ury epp4rani tor a permG eubpG� Ihe epplicW 10 d� P�eM d m� mas �hen fxe himd�eE AOAen �550Dp.
� I. m owM� d tM popenY or my empbyeef �Hh wepea m iMi ede wmpenea�ion. Mill Eo IM MOA. eM IM svucl�ie w rol'vNeMed
a onered br eeb I��an'l0aa. Biuirev eM PMeeaiow Cods: TM Camrariaa 4mnaa lawdoee �w1 eppyto en oMnerd p�openy
who Wlda a in0��s t�arean. end rfio Eaee �uch wak Fimeetl u hene� a Mraq� he a Iw� am emVMm�. pa'idsd IIW auch
impvnmmie ve nd imendeE a aHeied la seb. Il. law�. �M1� buiNirp a inpm�ameM b adtl wnhin an Ym W wmplMion. tM
owner-0uiUer xill heve �M buNen d povilq M a eha db M Duik a'unpwa lu ihe purpoae d sebl.
� I. ea omier d iM P�W�Y. am eaduaivdY contradM xnh lironeed conveqae lo wnaUutl ihe pM� (Seeion )014. Bus'vre aM
Profeeeime COEe: TAa ConlreGon License lnw Eoee nd eDdY a en uv.+ix d popeily who Wik� or impova thnaon vd v,fio
wniracis Iw uxA pml�e wnh e oorurmor(e) Iceneed p�nuent to IM COMreaae lioeroe Lew).
❑ I em e �mq Ms S1e 1ian: B. 8 P C.. Nu �maon:
Dete: l Orm� �
I Ao Mraby I em ewere d eM udenund iAe nw�i°"'avn d Callmve 41eeAA eM SdaY Gods SaAbm 25505. 2553�. aM
RS53a. entl I a ury Mum WtlCvp omqent will / wil M(dreb ane) need w camply wih vaid peb mEm W IM nyw�emama b
epmnnlacauVunionarmodifimlianhanlMAi u3�l�ly.eriepa�MtOu��ie.qmWenlelmmtiutlioneppireilwuusmemqlromiMos
paveiau.
Dma: AppcM:
WONKEP'S COMVENS�TION UKLAP�iION: 1 hmaby atFrt� uMr prWy d ps'ryry ms ol iM Idbvrirp Muet'vu:
� I heve uM wil meimein e cMNicele d mnwnl to eeX.ineUro I« xvhen' wmpsnseton. m proviEeA lor by 8wion 3100 W �ha lehor
Code. fa 1he parimmence M 1M woM im wMch 1Me permn M Imuad.
❑ in....�w.,u�m.:�w��.•oomro�.mo�mw.�,n�a��anrsm�s�aoorme�eo.coe..eorma�wau»
work la wh'rh Mb V�� u mued. MY wokere wmGemelbn inwrance r'w W VdiY nwnba ae:
c.m«:
aacr Nw,n.r
��eMim nsediwl ps mnpWeC / Up pelmt u b pp huM/sE Edlen (SI001 w Nv.l
1 eenN ��� O��a d ihe woek M r.fich Ihh O�G o iaaw�. I Metl mi emplq airy panon in erry mxuier n n to
n«an. wbjetl io in. ..«F«Y wmpmwion mw. a c ..nd .0'e. mn a �.Ivaa neoon. rApn m i�. .nlen•
can r a�++�e d swin, 3)ao M ins lsm. cods. � �amwGn m N wm� tln,. p�wmoir.
Oate:�� MG�cPm: /.r
.-o y.
WaminO� fellun ro�xuro worken'rompwwtlon rov�rp� I� unl�wlW, anC �hrll r!/�ct m x�ploysr ro cNMnel pMulHq an0
c/vll flro� ,p ro one hund�ed fhovauM LNlen (SIOq000J, In �dlllbn ro fhs cwf o/ rorrp�wtbM1 tlamep� u povlEstl br In
S�ctlon 9105 0l ths LaDor CaW, InMnaf, entl sllom�y'� Isu.
CONSTpUCl10N LENDINO ROENCY: I haeby �im uMs DenMy d perprty tAm tMro b e mnneWcn Imdnp yeney lor IM
palormerae d iM xork la ntuch �ha pamY u'vwod (�� �. Cir. C).
LENOEfl'4 NANE:
�ENDEP'S RDONESS:
1«�ilY Ihel I Mva retl Nn Wdicetion eid nms ihv the ebwe mlame�ion u cwraq. I pise �o canGN rA� e0 rayud owuuY ad'menoes
eM dma lewe �Ntl^0 to bu�dn0 cacvwim aM MrabY euiMas nP�NaWm d �hu mY b erua W� IM abwe-meNioneG piapMy
1afunpetl�0°`D°°" BRUCE BENGOCHEA
� � /��.,�j(L�� Pnni NamT�) /�
�d w �l.I✓J \/ �p'JL--� Dme�.%� \ "�
SigneNro d nVAppiran4CMVmn
(5151-IB,WP) NTno-Buikip 8 Sefery: �rew�Fle: �anary-Appir 1: Pink-Revenue: (3ddan�od-Aeemwr
r C"ITY OF COS'CA t4E5A - BUILDIAIC PERMIT
PERMIT NO: P 080546 PLAN CHECK N0: N
CONSTRUCTION TYPE:
PERMIT TYPE: PLU
PERM NO: P U80546
GOVT: N SUPP; N
PURPOSE: OTH
JOB DESCRIPTION ; DEMOLISH EXISTING RESIDENCE SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: SEWER CAP FOR RESIDENCE DEMOLITION, �kB80545
**�t*************i�i�i�*�r*�********�x-x�ir**�r*�**�-**�r�t*****�-*****x��tx-***********+r�-x�*�*�-�t
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN HUZLDING --------- --------- 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: 42521218 ZNE: REF NO;
PLANNING NOTES>
i
iE if if iE �E iE iE iE iE iE 3f fE IE if iE iE 3E fE 1E iE iE iE jE iE 1ElE if If !E 1t iE 1E iE if �E �E iElE iE if iE iElE iE if 1F 1E ff �E 1E 1f ff ff iE �E IF iF iE �E 1E ik iE 3F fE 1F i6 �f �E fE ff iF 1k �f 1F 9E fF if if k
D E C� 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 ,
�HUILDING APPROVED DY :
APPLICATION ISSUED BY:
iE iE k IE IE 1E jE iE fE 1E iF fE �E iE !E 1E iE iElE 1E 1k if
LEGALZZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 8,75
258
PLAN
ISSUE FEE 22,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 8.75 22.00 0.00
REC�ENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
30.75
FIRE
DATE;
DATE:
DATE: �� 2�
ifikft�EiEiEifiE �ElE
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
30.75 30.75 ,00
J0.75 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
iE fE iE iE iE it iE if iF iE iE iE iE iE �E 1k fElf !! ff fE fF iE iE IE iF iF iE If k 1E if 1E fE!! ff !E iF fE fF iE 1E iE fE ff IE fE 1F fE 1E k iElFltlF iF 1F IE iE ik ik fE �lk 1f fE iF iF fk iE 1F iE 1F if If �E 1k 1E iE if
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 T O N UNIT COST TOTAL COST
PLU 1 SEWER CAP / DEMOLITION EACH 8.75 8,7:i
END OF FEES
OL 00219672-00219672 T OT 30.75
�ATE� 11/21/9` TIItE: 16��3
CONSTRUCTION ANDPLANNING POC SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Oate Inspecror
1� Temporary Elettrical Service or Pole .�y2. Pool & Equipment Locatibn . -
2. Soil Pipe�Undrgmd. � . 53. Steel Reinforcement� ; �
3. Electrical Conduit UtilitY-Undrgmd. � 54. Forms
4. Electrical Condui[�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE � i
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe�Undrgrnd. ,� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Struciural Floor Svstem � 67. APPROVAL TO DECK ,
1 i. Properry Sewer line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains . 64. Plumbing SYstem • Final
74. Rough Plumbing 65. Electrical�Final
75. Rough Electrica6COnduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencinq & Access Approval ,
77. Rough Wiring Sign 68. APPROVED FOR� PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FfNAt
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipinfl 0 Gas � Oil
23. Gas Pipe•ftough & rest 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
� 26. T�Bar Ceiling (StruCturatl & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Sidinq 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heatin9 & Ai� Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing . �4.
39. Water Service-Final �
40. Gas Service-Final
47. Solar pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. landscape Irriqation System
45. Sound Attenuation
46. Handicap Regu�ations
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING
49. Electrie Release to Edison
50. Gas Release to Southern California Gas Cu
51. CERTIFICATEOFOCCUPANCY
.
No Dace
_�
h
�
[G
aonnca3aFew�nuio: ]4U 16TH PT.�
an+e�x.Yeivarnm:OAKHILL DEVELOPMENT
. �ooness:104a IRVINE AVE
'6WPURT D6ACFI, CA 9266U %14-825-0671
APPL. MUl1N0 AODPE53:
uNT: A/D
�-T
�xcxnecron�m+�+:KEITH PALMER �.�.: C-11096
uux.oa�as�ooxess: 1048 IRVINE AV uNr: 363
NEWPORT BEACH CA 92660
�.�T�.S�: a�y��_N-�5 ���a;u�
caxrx�croas wuuxo p, 0. aOX 9 �-�5
�ooxEss: AN4We�M � ucra.: (0�15�`a
UNT:
LICENSED COMN1CTOflS OECIAP�TION: I hareW eflvm under Po�eIY � De�ury �hel I em IironeeE uMer pwieiom d CMqer B
(mmmena�q wi�h Seclion ]000) d Drvnun � M I�e Buainew eiM Pralaseiau Cads, ud my 4nma o in Iu0 fau enE eHetl.
cmuc.wo.06903i� uc.cuss:C-36 uc.No.:69,}5 8 EXP: O1/98
Dme: J' Z�" 9% Comreda: /�
OWNEP BUIL�EN OECIAPATON: 1 hemby effirm uMx penely rN'Y �� ����q �� �M WMrepas liceiue lew ta iM
IdbwnO ��mn (�� )0�1.5 Buaiwea uM Prolaeaions Cade: �nY ciY a munry whid� isquiras e paimit to oonawn. elter, imDrare.
bmd'w�, or repei eny el�uctun, prior w m eaueMe, ebo rpuim IM eppl'reM la euc� pemiil to fib e aymE �Wemenl iMl M a�M
IioeneeE W��� �o Ihe qovisione d �M Conlreclae Liroroe law �Chepta e(commendrq wilh Seclbn ]000) W ONeion ] d ihe
uair�ev vd Rdeeeione Code� a ihel he a ehe ia e�emq ilierehan aed �he bavie la Ihe dbped ezempian. Nry vu4tion M baaion
lo3t.5 Ey eiry epoli2ani lor e parmtl eubpes �he applicanl lo e civil panelry M na moro ihen IFa �uMmE dollen �5500��.
� I. ee owner ol iM Db0?nY or my empbysn w1h wupae av ihei ede mmpanamion. wJl do iM woh. vd iAe nrunure e r�d in�aMeE
w olisred la `eb (Seciwn )OM, Bisi�aaa vd Prolassba Code: The CoMreGore limnee Lew Eoee �wt epplyto an ownerd propoM
wM bulde or impovee Iheroan, vM Ma Eom �uch v.wk NmeeX ar hend a Mouph he u Mr own �mpbyw, pavkW tAet ac�
�impwemeiva us nal in�aMetl a WereE fa eeb. II, however, iM Widinp a'unpwemam 1� �old within ar yaar d oomDlNbn. Ne
owner-0uiker will hew the WMen d pev+iiq ha a ehe dN M Wild a imqo.a la iM WN�s d eab).
i... �., a ine wowm..�, a.� �omrea:,a .mn ro.�..e �vd.va, �o �m�e ina www (seeo�, �a.. e��. �d
Pmlauions Code: The Conireeon liwnae Lew Eroe mt eppry lo en owner d propMy w1w Witle ar impovm Iheraon end Mw
canlrecls /a wdi qqw� wnh a aoMredw�e) lcaroed punueni io tM Cantredae Liwnss lew). -
� I em eRemq uM« beciim: B. 8 P.C., br �hie raevon: :
` ,
Dele: Ovmer.
I do Mreby eerlity tlw I em awere d eM wdeestend the requiremaMe d Cddomu Heellh vM Setety Cods Seaione ?5W5, 255�3, uM
2553A, eM Nel I a eiry Mun WiNirq ooaWenl vrill / wil ml (crc4 aw) neeE lo mmyy wih wd etate mEe� end iM 1epuiremama lor
• permn IamroVuction a modlfraion hwniMA'v-6 ly�. enepement Dielriu. Rnidwitiel oma�ian epDY'�aian w eaemq Imm Nne
poviniane.
Dne: Applcam:
WORKEN'S COMVEN9ATON DECL�H�TION: I Mraby effirm untlx pmMy d pejury w M IM Idbxirp dedvYiwa:
� 1 heva eM wil mein�en � unJ' m� d oomenl to �epiruun br xorken'rompenWion. n prmiEeE fa by Setlim 9)00 d ihe lebor
COAe, la iM pMwmvice d tM xak In wNc� t�u pe�mil ie ivueA.
�� n....�e wi� meim.i,.aw«Y wmw�on nm,rence. m i+vi,vw M s.a�m a�ao a u,e �ee« coe.. ror me o�m� d m.
woA Im xfiich ihi� pertnit i� iaued. My wnken' mm eetion ineurerce cenix uk poliry n�m Wr ms:
cerrier: STA�TE FUND EXPIRES
Pdicy Number: - U��. � ���. % 9 a
mu ..n�ar ne.e � ee cw�n�.rod r ms romr� ie ro. �. n��med daie�e /fioui w rosad
� I cenAy �hel in �he pMom�vica d iM work la r.hch ihu pmmd'o ivued. I eheA �M emplq a�y prmn m uy mvuier eo m to
cobecanr �u4✓��o Ivn d Seaian ��]00 d tM lebor COEe, I anu•ionhwi�nrae Ihet�^ Nwula� euded b IM wwkon'
om,: 3- ��-9� ��: �e-�-- �,�
W�miny: F�llun ro��cvn Morkai con�vwu�tlon cov�rp� li uwnn, .�a,nui.�e�r.�.mvror.. ro��m.�nr p.n.ro.,.�e
I c/vll Anu ap ro on� I�u�tlrW tMuuntlOulMn lSIOqOWA In edlltlon ro fM cwf ol rompxuetbn, Mmsp� u povWW ror In
9�ctlon 91G6 0l IM Wor COW, /nfwuL �� eRamry i M1u.
CONSTtiUGTON LENOINO A6ENCY: I hxeby elfirtn uMx prutly d per'µy thm ihra u e mrWiudion bMirp epericy br Uw
�IBf�Of1110�1GG O� Ih0 WJf�I �IX W�IIf�11hG pllRil IB 6NBd (fMdq11 J09'/, CiN. Ci�.
LENDEP'S NAME:
LENOEN'S ADDNE49:
I cenity �hm I heva rud �hia epplkeiion eM ams thm the ebwa inlormubn ia coned. I epies ia canply wiih ell wy erd counry aEineMe�
and etele kv.n mle�mp lo buildnp mneVutlbn aM hareby aullw¢e iapaeenlmivp d IAu tiry lo eMa upan iM ebwe-mentiaietl paperly
�«��'°'tl�""0�"�JOE BLYLEVEN
CITY p� COS1'A MESP. - HUILDiNG PERMI'['
/ PERM D10: P 0812J:
PERMIT NO: P 082232 PLAN CHECK NO: N GOVT: N SUPF: I�
CONSTRUCTION TYPE: V-N PERMIT TYPE; PLU FURFOSE: NEW
SOB DESCRIPTION : 4220 SF LIVING / 954 SF GARIiGE DUPLEX SQ FT:
CLAIM VALUE: CALC-VALOE: GROUP OCC: R-1 /U-1
COMMENTS: 2910SF LIVING /472SFGARAGEFOR EACH UNIT OF 2HE DUPLE��F B-����
�t+�***x*+txx��r�x*+�**�**x*���t**�t****x*x**�r**�*******�rx*x***�*x*** � *�r*�r*� *�
7, 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 DUILDING ---------- -------- ACCESSORY ➢UILDING ------ - -
FRNT: P'I' IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: ET TN RGHT: FT IN LEF1':, FT IN RGHT: FT TN
PARKING REQ: PROV: PARCEL; 42521218 �NE: REF NO;
PLANNING NOTES>
) . � '
if 1E 1E IE'lE 1F'lF li 1E k!f !E 1k k iFlE 1f� 1k 1f� 7E k ik 1E 1E iE 1ElE 1F i(-�(-iE 1E IElE iE �lE fE ft iE dEiF iE IE iE 3f if #�lE %if iE iE 7E fE fE 1E 1E 9E ff iE iE 1E iE IE if iE fE ff.iE iF 1E 1! iE 1F 3F'K� if iE'1('
D E V E L O P M E N T S E R V,IYC E S R E Q U I R E M E N T S
r . - _"" _
ZONING APPROVED BY . � '" DATE: ��
BUILDING APPRVVED BY :
t17 rT�[�ti �! ti7`E�XYi� a��7 =l`1
LEGALIZATION:N F E E S U�M M A R Y
^'� � J
BLDG PMT PLUMHING ELECTRPC " MECHANIC�
PERMIT' 365.50 �� �i , �
25� � 4
PLAN i . � + x
ISSUE FEE 22.00 � `,' ��
u
,, FIRE
DATE: •
DATE: �-?��
**��**+�x* **
STRUCTURAL SEGMENT;N
SMIP/RES GRADING
SMIP/NON-RES
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK �TOTAL PAID DUE
TOTALS---> J65.50 22.00 _ .�i 0,.00�� 387:50 387.50 .OU
REVENUE DIVZSION TOTALS--> COLZECTEDe '-"367.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANSC . FIRE SMIP/TOT GRADING PLAN-CHECK
9f17. 50 . " ' .
: � � ,� ..
�i]
��j'y8-"17 IPLU
om•: P L U
(5151�t6.WP) Whne-BuiMiq 8 Selery:OreerFle: Cenery-Appiceni: Fnk�imenus: (3alEeniod-Nxaw
QTY
Q
2
2
Z
2
8
6
2
2
2
4
iE iF f6 ff aE if fE fE fF fF ik 1f jE iE if iE IE fE 7f If iE 1E �ElE 1E 1E iF,1ElE 1f 1E jf�1f �F iF jE i(-ik IF i4 iElElE iE if !E iE iE iE if iP 3E 1E iF iE iE iE 1k 1E iE iE iE iE
I N D I V I D U A L' F+E E B R E A K D O W N
� ' i i�. �
D E S C R I P T I O-N1� - UNIT COST TOTAL COST
BATHTUB , . '„ '� _ , •" 8.75 35.00
DISHWASHER < <� �� , � • - %�� II.75 17.50
LAUNDRY TUB OR WASHER ,,,., ' . 0.75 17.50
SHOWER ,`. 1 ? � t3.75 17.50
SINK, KITCHEN ��` � (` 8.75 17.50
WASA BI.SIN '" � � 6.75 70.00
WATER CLOSET (TOILET)'r•� • - . 8,75 52.50
WATER HEATER AND/OR"VENT � �' ' 11 . 00 83-2A-1997/83. M 7 50
WATER SERVICE •-• ' 8.75 RCPT . I 4142
GA, PIPING SYS OF 1'Tb 4 OUTLETS 5.50 pERMIT_ ��
GAS PIPING SYS 5+ OUTL�PER OUTLET 7.00
'_ _ �� ��
i I
�
CONSTRUCTION AND PLANNING POO PA
�'� APPROVAIS Permit # Date Inspector qppROVALS Permit # Date Inspector
, t..Temporary Electrical Service or Pole" 52. Pool & Equipment Location �
2. Soil PiPe�Undrgmd. ��/-C�� % A � 53. Steel flei�forcemeM
3. Electrical Conduit UtilitV�Undrgrnd. -�''� 54. Forms .
4. Electricai'Conduit-Undrgrnd. � . 55. Electricai Bonding -
5. Steel fleinforceme�t 56. Rough Plumbing & Pressure TeSt I
6. Electricai.UFERGrnd. 57. APPROVALTOCOVER�GUNITE
7. Footings 58. Electricai ConduirUndrgrnd.
8. Foundation 59. Gas Pipe, � Undrgmd., Test
9. Water Pipe�Undrgmd. � ,G� _k „;� � 60. Backwash Lines, P-T'rap, O Uodrgrnd.
10. Structurai Floor Syscem � 61. APPROVAL TO DECK
11. PropertY Sewer �ine & House Connection�lg G�7 - 62. Backwash & ReceptorFinal I
/
12. Sewer Cap 63. Heater & Vent�Finai
7 3. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing 5'� c'�7 ar[ 65. Electrical-Final
75. Rough Electrica6Conduit 66. Solar System�Final '
16. Rough Electric Wiring 67. Fencing & Aceess Approval
U. Rough Wiring Sign 68. APPROVED FOR PLASTER�NG
18. Rough Electrical-T Bar Ca��ing 69. POOLlSPA SYSTE�biS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS _ Permit #
21. Ducts, in Structure ' 70. U�derground Hydro
22. Ducis, Ventilating 7}. Product Piping GGas �JOit
23. Gas Pipe•Rough & Test 8$•S`7 2. Underground Flush
-t-- -
24. Roof Framing 73. Undergrnd. Storage Tank G Gas ❑ Oii
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling {Structurai' & Monocoat 75. Dry Chemicai ��
27. Frame and Fiashing � 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
37. Plaster 6rown Coat 79. FINAL INSPECT�ION
32. Electrical Power MeterPinai � 80. FOOD CERTIFICATE ISSUED �
33. Finai Electric • Notes: -� 0��
�1��`-�'z�.��'���� �
34., Final Heating & Air Cond�tioning _ � ���� � ��_ ��;�.��ip�L
35. Final Gas Pipe�Test � �'���',.• �_
36. Hood or Canopy
_ _ �
37. Final FaMory Fireplace - � .�� �,L,
��Q� _ - ��`"�`I`rI �c R_�t.�r �S�B
38. Final Plumbing ' .� � i/
O�
39. N.'ater Service-Finai -
_ ��I!f �i1 RS��L _ l�um�tM i CL�- - -
40. Gas Service-Final
l� % ��� �O1-L�?_krZY
41. Solar pomesticFinal . �/0�7 r-��, L �K
7 ( �f-
42. Backflow Preventer�
43. Backflo�v trriga2ion � �
44. tandscape Irrigation System _ - �
45. Sound Attenuation.
46. HandicaD Regulations - - - ^
j /�(�/ .
47. FINALSTRUCTURE & 8U1LDfNG G� j�� pr�9r
` U.
48. fINAL PLANNING
49. Electric Reiease to Edison �
50. Ges Release to Southem California Gas Co _ � . '`�,
51. CERTtFICATE OF OCCUPANCY + �
No. Daae
1DOPE44UF WILp�q:
OWNEN4IUYE IF RAWN:
. �nnnEss:
.1PPL.WJW10 ADDRESk
APCXRECT OP ENCCIEEN:
ncx.onFxo.�s �ooncn:
( �-r4 pua�
uc. w,
CONIIiAttORS W11�:
awm�crorcs �uimo
�nonEsx uc w_
�NT: /� � g
f,
uxT:
UM:
LICENSED CO!(fP�CfOXS OECLAHATION: I Mreb/ dlim ivdar pauly d peeryey Ihtl I vn fvuM vdr pmbbiu al CMpr a
(mrvnanen0'Mlh Section ]OW) M Oi.'sun a d Vw &m�ss md Pmb'tivu COM. uk my 4mnw e in IW law md etlaa.
CT'tJC.NO.: IJQClA54: LIC.NO.:
Dme: Catlntla:
OWNER BUI�UEfl DECURATION: I lveby dfiem uMr pwWy N pwj�y �IW 1 an azwnq hom �M CavMm lioave lav tar iM
�Mbwiq reaaan (Setlion )0]1S Bufien ad Rdmiom COCs: Art/ fiY w mv�Y MJN �ay�iai e VamG b m�nbud. eEx. inPon.
emd'sh, p rapei eny et�uclu�e. pi0r io m n�wice. a{ro rapimx IM app4m�tl ta such pxmE �o fJs a aqned meiemsru thu M or ehs
fcenesd Wmivu to tM pvmima d Er CONretla� Licama lmi (Chaplx 8(mmmen�p wY� SWion lOW) d Oivcion � d �b
imiea end NWeaioro Codal a thet b a da n semP Rselmn ad �M bem la Ne �AepW uwnqion. /�nY vidmun d 6edion
)031.5 EY e^Y eVD� ta e Ga� � Ne eOP� b e dN D�Y M M mon Ihm (x� huWetl EaWn �SS00�.
� I.movmsed�Mpapenyamysnpb/wrtihwq�eanlMiWemmpametion.wiYAOYrv.akeMlhe�t�udvs'snal'vtlmdod
a oflred lar veb (Sslai )OM. Bmme� aM Pmlmvw Gods: TAe Gaqretlm licwe lewdoes M cVaYto en ow�mrd p�openy
Mq buide a inpma Ihenm. eM wfio Eom fuN wqk limw! a MnN a tivuVh he a Is rnm amPblM�, p�ed IM wch
'unpwanam ero m'vuaded a dlwad la ub. tl. howwr. Ns Wld'v9 a inP�„ e tli wEhm ans yar d cvmWMun. ths
ownerbuitler wYl hew Ne daden d D�W Ae a ka diC m� bWi a imV�� la iAs pvpme d eels).
� I. m ornw d ths PowH. em mdm+W mmrean0 wh 4cauM cawacbn m mmbua IM pdb (3wun 101.1. &s"vw� ud
Pmtavon+ Code: TM Cadratlm liwme laM Eom nol apON b m ox�wr d popMy xfio dn'Ib a impwr �Anaan ud wfio
cono-r.v br adi o�l�+ wdA a mnreCMe) fiwiusd P��+ m Na Caarrm� lioere� lew).
� 1 em eRemq uMer Senion: B. 8 P.G.. far tiv rmi:
Dtle: �
i eo n.�nv �r u� i.m..... d�a �.b.,�.m m. �.o a emoM. w.en.�e s.ew eoe. sw�. sssos. zsm..oa
us�.. ena mn � w mrv w,. w�a�ro �we •m � w na �uu. m.> ne.a ro canwM•+n..d am. mds..na n. naw.nw. ror
e psimil lamatnsfon a�iontram�M�i�enepenwu Oimrie. Ruidsad omvrunion aPO�ioroen vamq Irom thas
porimm.
Dtle: MW�+:
WOPKEN'8 COYPENSATIpi DKWUilON:11w�N� Nbm uNr prrtly M prjuy w d iM bbY'vp d�Lreiwr:
� I Mn eM xil im'vuen � c�Muu M aw�e to Miimv� br raMrY m�ruion. n pwilaE la Ey SaGion T00 d tM labor
Gade, la tM pMamnc� d iM �vk ia wliN rtu pami e buH.
� I Nw rd vril mvaen wakrs' mnD��ion'amuro. n nP� M Swion �Im d tlw l�Ear CoM. br Ne W� d �M
wM la yfiiN Ne Po�ro u mueE. W raken' wmpa�stlbn imuxc� univ md Vdky mvnEr vs:
Gerriw:
Polry Number:
11iJ. swion �.w mr es cmWwee! w ro'mt u rn m.lu.sie�d emen Isrrol n ruJ
� I renN Na in Ne V�artwce d �Ir wak br Wiich IM M� u miwE, I tlu0 nol MnGM M' D�� n eny mervwr o n io
becmie wbjsq to tM woiFss' ouips�Wqn lex+ d Cefdmis, md ep�w thm ! I�IUJA Eemnr w�bjrf �o IM xaVan'
canVa�ian pwuiae d Soqian 3'!00 d IM lela CaGs. I tlra IwNWM mmON xN Yaw P��.
Otle: MM �
WamMp: FWw m ucun �wkw�i carp�ru�tlon m�np� I� vWrN, W Ntll rC/cr �n rrplqw roWMirl pwltla �n0
dM� nn., w ro wu nu�a�w �mu..w awm. (r+ataoox n.mran ro m. oo.e o� ooma.�..rwn �w .. e�He.a ro, m
Sxtlm 9)06 el M liDor Cob. liuua4 W�ttom�Y� /Ma
CONSTIi1KTON LENqNO AOENCY: I IwWy df ivder pruEy tl par'�vy �An tMn u e rmuivaion NnNnp epanry br Uw
perlarmanoe d tM xak tor xhid� rt�u pami u rtaM (�� �. C'r+. C/.
IENDEP'S NM1E:
IENDEfl'S ADDRE55:
I cenJY tAm I hme �aW Ne aOV�s� md neM iM Ne aEovs Ldametion b wneG.l qpw to mMN wh e9 inyerd mWY ad"vienw�
arM etale lews mlm�q to ddJnp oonstru9on md IwaCy eulla�ae npe�en�Ni�ae W tlie �aylo aNa upon tM abwe�mxtl"vied poperry
la unqaion Pnpwa.
Dme:
SqreWra d Ow�arlRpe�VAppiant/CoNroCa
(5151-�B.WP) Whea-&diip85alery:Grem-Fie:CwryJ�ppFam:PM-Rs.enue:CaNa�ad-Yaaamv
PERMIT NO: k' 082232 PLAN CHECK NO: 01272-97 N .
x�**it����*�x**x*x+c*�� x�at**�+���et*�it********�*at�**� k**�**�crx*k*iF**����;�*k��*;��*;���
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 2
PLU 2
PLU 2
GAS SERVICE 8.75
SEWER, CONNECTION TO BUILDING EACH 22.00
VACUUM BAKR/BACKFLOW PROT, 1 TO 4 1.1.00
END OF FEES
17.50
44.00
22.00
83-28-1997/83:48 DM/f387.58
RCPTA:AI-0884142
PERMIT:082232
; CONSTRUCTION AND PLANNING � P�� 'PA
: APPROVALS Permit # Date Inspeaor ApPqoVALS Permit # Date Inspector
i. Temporary E�ectrical 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 Piumbing & Pressure Test
6. Electrital UFER Grnd. 57. APPROVALTO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Linus, P-Trap, � Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
i t. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains 64. Plumbing SYstem • Final
14. flouqh Plumbing 65. Elettrical-Final
15. Rough Electrical�Conduit 66. Solar SYstem•Final
16. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOF PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOVSPA SYS7EM5 FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
21. Oucts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping GGas ❑Oil
23. Gas Pipe-Rough & Tes[ 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Struc[urell & 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. Dr,ywall Nailing HEALTH DEPT. REQUtREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32: Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service�Final
41. Solar Oomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SVstem
45. Sound Attenuation
46. Handicap Regulations
47. FINA� STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
,�o�n,�socawtar� 3�� 16Tfi PL
°""'fis""NEi`�v":O1�KHILL DEVELOPMENT
'D0"`�10A8 IRVINE AVE
��P�O��pB�ACH, CA 926G0 714-825-0671
uHT: A / B
"PCN1Kf0R�'�"'KEITH PALMER �N0' C-11096
"�"�0"�'4A°OPE�° 1048 IRVINE AV °NTe 363
NEWPORT BEACH CA 92660
C0N"1CT01r'""'�DLS HEATING fi AIR CONDITI ( 714 ) 965-1990
cam�crons�uiwc 8542 CARTHORN DR
"0°"�HUNTINGTON BEACH CA ��= 584220
92646 �+*
LICENSEO COMHRCTORS OECLAFATION: I hereby eflim uMx pnNy d qrjury Net I em licemed uMar pwiaions d Chaqa 0
( dM x�l� 5ectian )000) d Diveion � d IM &airow eM Prolaebru Coda. ud mY 4cema u in fuA Mce eM aflatl.
rrrucno.:06IIe589 uc.cuss:C 20 uc.No.:51�81�4220 ' �E�X'P: 10/97
Dma: � —IU � I � Gontreqa: �ls `KG�i�� �Tr
OWNEN BUILUEH UEC�ANATION: I Mreby elRrm under penetly d perlury Ihel I em examq imm iM Conveqan Licenee Law la iM
allow'xp reewn (Sadion ]W 1.5 &nnwa eM Prdea�iona Code: Any <ily a oounty whlN requiree e pertnil lo consbucl, ellx, impova,
mdeh, a repv eny evucma, p'w b ds eauerice, eleo repuiru iM epplicenl la euch permd m fib a eqmd wtemem ihel M w eM
�icemee w�wem io �ne wweiau a u�e com.ma, Lir�,.a ler �cMq« e(cammendno wan seaon ]aool a oi.vion 9 a ih.
udnen ud Ftleaioro COEeI a Ihm he u eM e e�emq iherelmn end �Ae bew la ths eAeped usmqion. �m vidatian tl becian
)OJ1.5 Ey erry epp�i ent far e psrmn eubpe� IM epplia4 io a dW pendy W nd maa �hen Me hunEred dollen �5500�.
� I. ee oMner d �M qope�Y a my employeee wIh wepes n �Iwi ade mmpeneetion. wJl do Ne xwk. eM Ne emxture u nd inleMeE
w dlared la veb (Se Yion ]Da1. Buvmo vM VMeasbna Code: Tha Gonlreclae Lioenee Lew Eoee �M eOdV�oan owns d popaily
who buiCs a inqovm Ihereon, rd Wa Eoea �uch xak Nm�eq a Mne� a Nraqh he or her awn empbyeu, povideA �M euch
impmTM�ema ue nd iMeded a atlared la seb. tl. howe.er. �M buYCuq or inG��w e wtl wAkn ona Ymr d mmdaun. tM
ownerbi lier wa heve �M buiden d pwvq he a eha did m ddd a'vnqvw la iM p�vpme d aeb).
� I. n onw d the pWab. am exdmvely marec�q w4h Gwn�eU canbeclon ro mmue Ne Pq� (Seeion 1011. &sinma eM
vmewron. coae: m. comrouuors ucen.e �.. aoo m wcN a a� owiw a ww«ir ..no wum « impwo meam ene wno
comrecta br wM prqecU wuh a owaima(e) IiemeE pueuem to iM Canireaoee L'vne law).
CITY OF COST1� MESA - BUILDING PERMIT
PERM NO: M 082405
PERMIT NO: M 082405 PLAN CHECK N0: N GOVT: N SUPP: N
CONSTRUC'IIUN TYPE: V-N PERMIT TYPE: MEC PURPOSE: NEW
JOB DESCRIPTION : 4220 SF LIVING / 954 SF GARAGE DUPLEX SQ FT:
CLAIM VAI�UE: CALC-VALUE; GAOUP OCC: R-1 /U-1
COMMENTS: REF:H-82229
***��r��r*rx*��x�**��*�r*���*x+�x�r�**����**�r**�ru�*����*���x***�**�**v�*******�*�*x�
Z O N I N G R E Q U T A 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:,A42521218 ZNE: REF NO:
PLANNING NC3TES>
i
iF iE �E �E 1E fE fE 1E 1f iE iE 1E �f iE if 3E 3f !E iE k 1f if 1E if iE 1E if iE i!� 1E ik iE 1E 1E fE IE �E k IE iE 1F 1E 1E 1f 1ElElF IE fflE fE 1E iE iE !f if it !E 1E if� �� fE �1E IF iE iF;f ik �F iE k it 4 ih if iF iF i(� iE
D E V E L O P M E N T S E R �� I C E S R E Q U I R E M E N T S
ZONING APPROVED BY " DATE:
UILDING APPROVED BY : DATE:
❑ i,m.,.�a��m,s.�: a.aa.c..ro,me�: APPLICATION ISSUED BY: //{�'
o�: o.,w: ieiF�-x-+�-**i��-�-�-*iE********* 3F��F
�����i��a�������a���������.�� LEGALIZATION:N F E E S U M M A R Y
255Js. vq tlut I a erry Mun Euitlmp ocapenl xill / wil m� (mcb me) med to rnnply wih asid pele aotlm W Ihe iepuinmaMs br f
epertnnbrcaneVuclianamodifra�ianhantM�i u�OTl.ianapemenlDietna.RaeideniidmimruaioneppicmimeenmemqlromNwa BLDG PMT PLUMBING ELECTRIC MECHANIC
°'°'""°"°' P E RM I T 2 6. 5 0
ove: �cp�u: � 2 5 k
WORKEP'SCOYPFNS�TONDKWU710N:IMrebyeK uMspenMyWprj�ymedNeldbwinpEetle�etbm:
� I heve eM xil meinien e cerlJ'rata d conaenl lo wM-inwn br xakero' wmpenu�ian. m prwked la by Sauion 9]W W IM IeEa
COEe, lw �he pa�tarmence ol the wM la which Ihie permil ie iesuetl.
❑ ineb.oewu�m.:,.�x.�.•�ro��oo�,�,��.m�.a�o-.awsaa�a�aommai.m�cm..wm.wn«�e.din.
� wpk la whirA thu parm4 e i�d. My wor4en' canpa�ian insuraze mrier enE pdicy mimber ve:
c�«
Pd'ry Number.
ssaion neee irot be mmd� r rn. wmt u ror ms nurwree ewbin Isrool w hv.1
I cM% Ihat in IM peAmrerca d tM wak la which �hi� pertnX b ivwaE. 1 ehell nal employ erry pason in em� men'ror o u lo
wbjatl to iM xo�kera' mmpenennion levn al CeNDr e�, eTd ep�es tlw ! bsmr wbjee to tM vurYss'
penmtion pwie'av d Swiian 3100 d iM labor Cods.rlWll I� wA� wm ' � pwie'v�+.
m, y -�v-S 1 .�.: � /.�
�minp: F�Nun ro��cun �oA'�n'ronpw�wtlon eov�nW l� unbwNA �M NWI rbJst an rrrployr ro elMml prvltlr vW
clHl Iln�� �q ro aro ��ndM fhouuM JdYn (tfOq000A N�JGltlon b N� eo�t o/ ro�rys�uefbM1 du�ups� W proMtlM br In
9sctlon �)OB oI1M l�borCoOs, IirtemL ���msy'� !ww
consrnucnoN �viara �eencr: i n.+nr .�� � o�+dn d v«iw �nr m.. a. mmNa� i.,�w awKv ro, e.
q�formence d �M �wrk Iv xfiirA thc pami o ewed (�� �]. Giv. Cl.
LENDEP'S NNIE:
LENDEN'S �DDRE55:
I canM thel I Mw read ihia epplice4an eM &de �hm iM ebwa inlwmmian u conM. I epiee lo campy wil� all dry aM caunry ordi�v.m
vM emie lavn reletiq b WiMiq cmmuebn antl hmeby eWhorce rtprmemmiws d ihe ary m«ux upon �M ebova�meruionW qapery
lairepedion WN��
� noia srh�ev
o�a: �/ /G ')i
(5t5tde.WP) Whne-BuJdiqBSday:oreen-FR�Gr6ry-Appicanl:Pink-Rewnue:Gddenro�Ma�ar
DATE: �'{ � I�
STRUCTORAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
PLAN
ISSUE FEE , 22.00
BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK' TOTAL PAID DUE
TOTI�LS---> 26.50 22.00 0.00 48.50 48,50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 48.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC � FIRE SMIP/TOT GRADING PLAN-CHECK
4fl.50
iE 1E �E 1f 1F 1E iE iE �E� jE k 3f iE IE iE iE iE 1E if i(' iE �E iE 1E iE iE iE iElf 1E 1E iE if !E iE IE IE iE if iE 3f 3F # If IE iE If fE� IE iE 1E if 1E iE iF if 1E iF iElf iF iE jE fE 1E fE �E iE 1E 1E if ik iE jE iE IE IE iE ff
I N D I V I D U A L. F E E B R E A K D O W N
TYPE QTY
MEC
D E S C R I P T I O.:N
2 INST FORC-AIR/GRAV FORN <= 100 K BTU
ENB OF FEES
ll
UNIT COST
13.25
TOTAL COST
26.50
84-1�-1997/81:54 PN/f48.58
RCPTq:BI-08A46B7
RERMIT:082405
CONSTRUCTION AND PIANNING��� - P��'PA .
APPROVALS Permit #� Date �nspector qppROVALS Permit # Date Inspector
, ;
1. Temporary Electricat Service or , le 52. Pool & Equipment Location - .
2. Soil Pipe�Undrgrnd. � ' S3. Steel Reinforcement 7
3. Electrical Conduit Utility-Undrgrnd. 54. Forms '�
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding •"
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electriwl UFER Grnd. 57. APPROVAL TO COVER-GUNITE '
7. footings 58. Electrical Conduit-Undrgrnd.
8. Poundation. 59. Gas Pipe, � Undrgrnd., Tert '
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. '
10. Structural Floor System ' , 61. APPROVAL TO DECK ;
1 i. Property Sewer Line & House Corinection �,��� 6 kwash & Receptor-Final =
12. Sewer Cap � 63. Heater & Vent�Final .•'+
13. Roof Drains ' _ 64. Plumbing SYstem - Final
14. Rough Plumbin9 %� 65. Electrical-Final
15. Rough ElectricabConduit , 66. Solar SYstem-Final .'
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign ' 68. APPROVED FOR PIASTERING 'I
18. floughElectrical�TBarCeiling 69. POOVSPASYSTEMSFINAL
1P Rough Heating & Air Conditioning K' LL p� (�/ FIRE DEPT. REQUIREMENT
�z � � �r
20. Rough Factory Fireplace . � APPROVALS Permit #
21. Oucts, in Structure 70. Under9round Hydro
22. Ducts, Ventilating 77. Product Piping OGas OOiI
23. Gas Pipe-fiough & 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 � • HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrica� Power Meeer�F(nal � 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
� a�_��`nrdr RFR_�y _N
34. Final Heating & Air Conditioning
8 � � _ -�_6-�i7 �o�G� _H_v_!�C _K �-Q N
35. Final Gas Pipe-Test (p 7�O ��LE�S'
36. Hood or Canopy - ,C'�L �� �, �g /(y� -
! ` li/
37. F(nal Factory Fireplace , -
38. Final Plumbing
39. Water Service�Final '
40. Gas Service-Final �
41. Solar pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING >-
48. FINALPLANNING %
49. Electric Release to Edison 'J -
50. Gas Release to Southern California Gas Cv
51. CERTIFICATE Of OCCUPANCY "
No. Date
� 1DUi�35 OF BUILqNG: � fj (� 16 T H P L' uNr: A 1 B
' axr+�+sr+^MEiF�xr+:OAKHILL DEVELOPMENT
�DDRE55: 1OQS IRVINE AVE
EWP�RT BEACH, CA 92660 714-825-0671
�vai. Muuxc nooxess:
��cxnccroxu+ax�x: KEITH . PALMER �c� C-11096
� �wcx.on�+c.•swowess: 1048 IRVINE AV �r+T� 363
NEWPORT BEACH CA 92660
caim�crarsxun: BOB ELECTRIC ( 714 ) 650-3337
COIIfRRCTOR5MNl8�G 1539 MONROVIA
ADDXE55: NEWPORT BEACH CA uar+o.: 455700
92663 uxr: 0007
LICENSED COMXACTOPS DECLARATION: I heraby aRirm under panely d parjury iha� I em licensed wMar pransiona M Gheqm 9
(mmmena�g xnh Sectian l00% d Oiviaun 3 d ihe Busineas end Prdmaiais CoEe, eM my limnm ia in tull brca eM eited.
uallo.:03j442�1y�7 uc.cuss: C 10 uc.No�45570 `. EX�: 03/98
Dme: � ' ( ' ` I Conveaor. /�/r /��•/�A•��
OW N BIIILOEN OECLAHATION: I hereby e1Frtn urMer panetly W perjury thm I em a�emq irom �M ConVedon Licansa l.ew fa IM
ing reeson (Sedion )�31.5 Busnesa and Prdeasions COEe: A�ry cilY a coun�y whidi myuirea e pe�mn �o conaWct, ellar, impova.
� �lemolsh, w reyei eny struclure, prior ta na esueze, ebo reQuirea tha npdie�sm Im such pe�mil to fib e ti8�� �emenl ihat he or ahe
i IicenseE Wnuani �o Ihe pransione d the COMraclors Licanae Lew �Cheqm 9(canmeria�q wilh Serlian ]WU) d Orveion 3 at the
dusineas end Prdessbns Code� ar thel M or ehe ia evemp thnelrom eM tM besre tor IM elbped m�amption. My vidmion M SeGion
)031.5 by eny epDlicanl lor e permA subpas ihe epplicenl �o e avil penelry oi rwt more �hen (rve hundred dollers �SSOU��.
� I, es owner d �ha propeny or my empbyeea wIh weyes av Iheir ede mmpenaetion, will do �M wvrk eM Ne structure o erol intended
or Mered far sele (Seclion ]OC6, Business eM Profeanion+Cade: The Canvedwa licerv�e lew Eaes ewlappyto en owrwrd propeM
who buNds w'unprovea thereon, enE who doea auM vrork Mmsetl or heiseN a ihrouph he a her awn emplqeen, qwkeE ihet such
improvemenis ere mt imaMed a Wlered br sele. l!, however, lhe buiNinB a in0�men� ie eoM within wie yeer d comDlMon, lhe
ow�a,-w�a�, mo na�e ma n�,da� m oA.ms na o, ane a�e �a w�a a, �ma,wa iw ma a�mo�a a��. .�.
� I. es ovmer of Ihe P�VaM. ��C�h �nlreclm9'�'�h licensed conVacMon b wnavua Hre qojeU (SMion 1W4. Busineve eM
Proteuiona Code: The Conireclae License law Eoas � apply �o an owner d peopeny who buiks or impwm tliarean aM wha
conirecta fa auch projecta wnh e oonlrador(s) Icenaed W9ueM to iha ConireGon Liceme Lew�.
❑ i�„�amq ��ee, san�oo: e. a v c. i« m� .���: - '
�e�e: Owner: - -
1 Eo hereby cMM Nel I em eware d enE uMentvM the requiremanls M CelAomie Heellh eM Safary Coda Smiona 25505, 2553�, eM
zssaa. a�a mm i«eny nnu,e a,�iema �wo�� ��� � w�n �a (d,cb o�l �d �o �maN wm se�a s�me coam ene me na���m.m. ror
epeimniamnsVuctianwmodifiralbnhaniheRi ueaTyl�enepemeniDi9nd.Rmidentielwut�udionepp6retioreeraexamptimm�heae
,.���m�.
oe�e: Aod��
WOPKEH'S CONPENSATION DECL�NA`ION: I Mreby e/firm uMer penelry d pa�ury me d Na /dlovriip Eetleretore:
� I heve aM xitl mamen e cerlHicete d mmanl to aeM-insure tw wakers companaetion, u provked la by SeGion �100 d ihe Lebor
CiOEB.�M��10 pB1�Of�11BfICB 0��118 MVf�[�W WhIC�1��119 pB1111�19198YBd.
� I have end wil meinten vroMere mmpenaelbn insurenm, av required by Sepim 3100 d Me lebor Coda, Mtha pe�lormence d iM
wak for wliich thia parmn iv ieauaE. My warkeea' mmpenmtion inwrence remer erd poliry numbar me:
c�a�:
Policy Number:
(7hia aecfion neeE not be canplated d tM permd is b� orro hundred dWbm j$� WJ or bse.)
}[] I cenAy thet in IM perloimence M the wak /a wi�ch �hie pe�mn ia ieaued, I shdl rat emd%' �Y Fs� in vry menrer ao ea lo
becoma aubjeU m ihe vrorkms mmaa�ve�ion lews oi celil«nia. ark Wree ihe� i� I.n d become wMed m iM workara'
ompeme�ion prwi ' a oi Sed'an 3]00 0l tha lebor Code. I ahellly lh m ON Ih qwiaio /
1N`ma. ?— _�l _ % nodw�n:
i Weml D� FeNun ro ewun woAsra' compeneatlon rovereys Is vnlewNl, end aMll eub xf en smp/oysr b er/Miul penaMss entl
�cL✓�l� �+ M ro me huntlreC fMuaarN tlolbn fS10q000J, M atltlltlon ro Ms cost ol compxwflory Asmspe, u provltlsd br In
CONSTNUCTION �ENDINO AOENCY: I hereby eifirm unaer penelry M parlury �tul iMre is e conslNdion IeMinB e9erwy lor the
paAormence M Iha �wM1 br which iha permN ia ieaued (Sed'on �09], Civ. Cf.
LENUEF'S NAME:
LENDEF'S ADDflESS:
I ce�lify Ihe� I heva reed tM1is epplcmion eM eie�e �het the ebove iniormelion is corteU. l egree �o camply wnh ell ory arM couny ortlineMes
arM etete lews rele�ing lo builEinB ����ion enE haraby aNharae rapreaen�etivee af Ihie ary to enler upon ihe above-memioned properry
�o� inspe�Yion W�W�s�
_ ROHERT�E�'MIER
(5151-CB.WP) WhG�BuilEing
oma: ..J / �7 /
Pink-Revenue; Goldenrod-Asseswr
f
, �-�i ' CITY OF COSTA MESA - BUILDING PERMI'f
�
PERMIT NO: E 082957 PLAN CHECK �NO: N
CONSTRUCTION TYPE: V-N PERMIT TYPE �ELE
JOH DESCRIPTION : 4220 SF LIC�ING / 954 SF GARt�E DUPLEX
CLAIM �'ALUE:
CALC-VALUE:
COMMENI'S: REF:H-fl2229 \
�If 1f 1E iE 1F iF iE df iE iE 3E 3E �E # 3F if IE if 3E 3f iE if iE 1f if if 3E if iE if 1f ib 1E iE 1f 1f 1F ih 1E iE IE 1E iE iF iE iElf iE 1E'1E iE 1E IE 1E
2 0 N I N G R E Q U I R E M E N
S E T B A C K S
PERM NG�: � 082957
GOVT: N SUPP: N
PURPOSE: NEW
SQ FT:
GROUP OCC: R-3 /U-1
IE if iE iE iE IF if if if iE iE 3f 3f iF if if �F 1F ie
------------ MAIN BUILDING --------- --- ---- ACCESSORY�BUILDING --------
FRNT: F'T IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; F'I' IN RGHT: FT IN LEFT: FT IN RGHT: I'T IN
PARKING REQ: PROV: PARCEL: 92521218 ZNE: REF NO:
PLANNING NOTES> .
� 'l1 ("# .!' �
1E 1E # fF iE iElk �E 1F fE if 1E iE if iE iF iE �)E iE 1E 1f iE iF iE iElf if i!�!E �1F iE � 1E iE iE 1E fE fE 1f 3E �lElE 1E IE fE 1E 3ElF iEl4 �lE IE 1E iE 1f 1E fE iE if 1E 1F 3E iF iE �E iE 1f iF iE if 1f �ElF iE if iE k iF 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 E N T S
/ '.
�ZONING APPROVED BY `�� •'' DATE;
BUILDING APPROVED BY : "� f UATE;
APPLICATION ISSUED BY:
1F if iElE iE iE iE 3E iE iE 1E �1E �E �E iE ff If iF iE �E iF iE���
L EGAL I Z AT Z ON : N F,'�
BLDG PMT PLUMBING
PERMIT
YLAN
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE
TOTALS----> 203.90 22.00
.,:
S U M M A R Y
ELECTRIC MECHANIC
203.90
508
22.��
PLAN-CHECK
0,00
IREVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMBING ELECTRIC MECHANIC
225.90
DATE:
3F3F�F�9EiF3EiEifiEiElEiEif 3EiE
STRUCTURAL EGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
225.90 225.90 .00
225.90 OC�ER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN-CAECK
iF iE iE jE iE iE iElf 3E aE iE �E� �f iE * 3E if 1f 1f 3F if iF if iE 1E iE iE iE jk if if iE # iElE 1E 1f 1E IE iE 1E 1E 1F'1E iE if 1E 1E IE �7E'7E �E 1E iE IFlE iE iF iE iE �E 1E iE �IElE fE'lF iF �(' iE'lE iE �! iE 1E iE 1ElE if
I N D I V I D U A L F E E H 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 4 FIXTURES LIGHTING 1 5T 20 EA. 1.00 4.00
ELE 6 RECEPT/O`UTLET 1 ST 20 EA, 1.00 6.00
ELE 4 RECEPT/SWITCH 1 ST 20 EA. 1.00 4.00
ELE 4220 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT ,04 189.90
END OF FEES
�5-19-1397/iQ:32 APIl3225.9�
�'ERhYITGT082357
CONSSRUCTION AND PLANNING "'., i P�� 'PF � I '
� AP^R6VAl3 Permit� � Date ' inspecmr APPROVALS Permit;#' ' Date Cnspector^!
�
7.'T�emporary E�ecirical ServicE� or Pole 52. Poot & Equipmen; Lacation ,
2. Soii Pipa-Un(Jfgrnd. . 53. Steef Reinforcement - I
3: Electricai Conduit UEility-U;rdrgmd. � � . � 54. Forms ��
4. Electrieal Condui2�Undryrnd. _ . � 55. Eleciricaf 6onding � (
5. Steei ftainforcement 56. Rough Plumbing & Prassure Test � �
� 6. Electricai UFER Gmd. �57. APPROVA� Tp COVEA�GUNiTE � �
- 7. Footings . - 58. Electricai Conduit�Undrgmd.
-8. Faundation 58. Gas Aipe, u tSndrgrad., iest � '� {
i.'
9. 4vater Pipe-Undrgrnd. . . � 60. Backwash �ines, P-Trap, i� Undrg: nd. � '�
1D. Structural Flaor System '� - . 61. APPROVAL TO DECK ;� '
t t. PropertySewer �ine & House Connectio� ' ' � ' �62. BackUvash & Receptor-Final � � .
72. Sewer Cap � � � " 63. Neater & VenrFinai � . '
13. Roof Drains � - ,_ 64. Plumbing SYstem - Fir�ai .�'
14. ftauah Plumbing • 65. Electricai-Finai � .
15. ftough Electrieal�Conduit .' g6. Solar SVstem-Finai �
}6. Rough Electr�cWiring / � � �
�/'�� R� � 67. Fencing & Access Apprtivai . .
U. Rough Wiring Sign � 68. APPROVED FOR PLAS7ERING ' �
18. Rough Electrica6T Bar Ceiiing � � 69, POOLiSPA SYSTEMS FINAL � I
19. ftough Heating & Air Cond�Loning fIRE DEPT. REQUIREMEN7 '
!
20. ftough FacxorY Firepiace � APPROVALS PeFmii # I
Zt. Ducts, in Siructure 70. Underground Hydro
22. Ducts, Vent'ilating Ti. Product Plping L�Gas G'0(i
23. Gas Pipe-Rough & Test 72. Underground Flush �
. 2A. Roof Framin8 - 73. Undergrrid. Storage T�nk O Gas � 04 �
�
;�� 25. Roof Sheathing 74. Overhead NYdro
26. T-Bar Ceiling (Structuraq g(vtonocoat , 75. Ory Chemieal . (
27. Frame and Flashing 76. Dry Standpipe
2$. Lathing & 5iding 77. FlXED SYSTE�L1 FING,L
29. Insola:ion 78, FIRE PREV. FINAL �
30, DryN:all Nailing HEAl3N DEPT. EtEQU1REMENT
31. Piaster 8rown Coat - 79, FlNAL lNSPECTION ( �
32. Electric;ai Power MeterFinai �(17�r����' _-l-' $0. FOOD CERTIFICA7E ISSUED ^- �-� �
% �
33. Fin;l Eleciric - (<,?� � �otes: . � ,
34. Final Heating & Air Conditioning -
35. Final Gas Pipe-Test ' ,. - . �. � .. �
.�._» _.____._ _i
1
36. Nood or:CanoPY _ i-- - -' -�
37. Final Factory Firepiace _ .
3$. �inai Piumbing ' � �
39. N,`ater Service-Finai '
40. Gas Service�Final
47. SoVar DamesticFinal �
�
� ��
42. Backflow Preventer - � - �
43. Backtio4v irrigation . � , �
44. �ardscape Irrigation System� - " �
�
45. Saund Attennation . � � - � � ��
46. Nandicap ReOulations - �
47, f(NA3 STRUCTURE & BUV�DiNG .._' � � - i
�
4$. FINAL P�ANNING . ��......-_ . -
49. Electric Reie2se to Edison • ,__...._ . � � -�
5Q. Ges Reieasa to Southern Galifqrnia Gas Co � �
51, CERTIFICATE qF QCGUPANGY - �
No. Date
1
NEIIV�ORT-MESA UNIFIED SCHOOL DISI-RICT
CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
To: ( City of Costa Mesa
( ) City of Newport Beach
( ) County of Orange
Applicant: ��1 K �f � �—�— 1/ C
Address: ��
Telephone Number:
� .Q ✓//�%� /�7 v � .
l 5�) i�2S�OCo71
�N� , S��•
TracUParcel and Lot Number(s): -�
Location of Project: 3 7 � �� � t/ '-�T''�� ���/�
i �
Number of Square Feet of:
Residential Space
Residential/
Sr. Citizen Space
Commercial and
Industrial Space
�E�' ��r�71 r�,o
Z�OD� x $1.84
Commercial/Industrial Project is: (Check One)
_ Warehouse
_ R8D
Movie Theater
_ Mini-storage
_ Heavy Industrial
_ Regional Shops
_ Light Industrial
_ This project is exempt because
x$.30
x$.30
��� '�2Q94i
• . �
District Receipt No. -3 a
Plan Check No. �Z�
Total ✓, �S�• �
Total
Total
_ Motel ���� Preschool
_ Bank _ Auto Repair
_ Neighborhood Shops _ Hospital
_ RacqueUHealth _ Large Office
_ Hotel _ Office Bldg.
_ MedicalOffice _ Restaurant
Office Park Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections
53080 and 65995. The Building Permits for this square footage in this,�rdposed development may now be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified School
�
The above representation as to square footage is true. Applicant agrees t t if.it is later determined that such representations are not
true, then this certificate shall automatically terminate and the appropriat�ity/County shall be notified.
Date: _ 3 'L 0 � 9 �
��
Applicant / l� I vt` J, / i1 ` iT'.�Gd /a
v ,T� T �7 �v
City oi Costa Mesa, Department of Public Services
Application and Permit fo�k Described Below
VENDOR NO. � ,
PERMIT �
�� U1���5�� S
AddressaLocationolWork a40 16TH Pt.AC'P Date 11/'20/9Ci .
7ypeofworktobeDone___ SI7'£ ACCESS, DEMO EXISTING AND CONgTRIICT 2 CONDOS �
Sun Date ] 1/ 2 2/ 9 E Permn Not vartl Aner 0 E! 0 2/ 9 7 �Ecpration Data) Plan No. DA — 9 6— 0 6
Con�raclofsName _ VNc LEVnLOFMENT nmress _1048 IN.VINE AVES(3IT'E 363
TeieW�oneNo.�oay)_ 645-0671 �w9nd-600-764-095@yanastate_ NENFORT BEACH CA 92660
StateLicenseNo./Class C+ryBusioess�icenseNo. 000000 (EXPt N/A )
Applicarrt's Name yn1G .����\ M���_ Address �
Telephone No. S�ML Developaf5 Name M Telephone No. ��r
Name of Insurance Ca. � Insurence Cen. No.(s)
24-HourEmargencyContact NICKAEL TALHOTT reiePnoneNo. 1-800-746-0905
FEES 4g HOURS MINIMUM RE�UIRED PERMIT APPROVED FOR CITY ENGINEER
e«w s 0.00 (�
Casn oeposa E 350 , 00 FOR PROCESSING PERMIT BY MIKE G \���
�ssuance E : 0, 0 0 Date 11 / 2 2 I 9 6
��sPecum, 5 O,OC� Accountp BI177030Q0
rornL E 9 4 0, 0C . Underground Service AIeA ID No. N 1A
Pertnmce shall contaa ihe Ciry Inspectors oRice (754-5025) at least 24 hours pnor m commencing any woA. FaiWre ro obtain proper inspections prior lo canmencement of work may
Da ceuse lor ils rejoction. THIS PERMR WfTH APPROVED PLANS MUST BE ON TNE JOB AND AVNLABLE TO CRY REPHESENTATIVES AT ALL 11MES. Yau are guitla0 by Muriiripal
CoAe SacUons 1-33. 15 -25-,15-27, 1527.1. 15-39 and 15-48.
THE UNDERSIGNED PERMITTEE HEREBY CERTIFlES:
1. Tiat all work shell De peRomroC In eccorda�e with ihe Slandard SpectficaWns lu Public Workn CaneWctlon (Wtest edMion); Slandard Draxings af ihe Ciry o1 Cosla
Mesa; special agency prm�sions; an0 all applicable laws aM ortlinances.
2. Control ol traffic shall conlortn to the Work Arna Tratfic Control Hantlbook (VJ.A.T.C.H.) (la�est eAition). Tlie permdtee ahall lumish arW/or inslall ell signs, Ights, berticatles,
VaHic conird or wamirg Jevices, flagrtren anC flashirg artow board. Tho pertnitlee shall oblain npqoval ol Ihe Tartportation Service5 Figinacr for ell sYreet clawres, Oetwrs,
tum reslrictions, paMirg prohmilipns arM metMds of accomrtpdalirg traffic. Tha permihee yaA rptity Ertiergerw,y. Fue and Pdice service5 eM residanLs w b�sir�esses tweny'
lour (24) hours in ativ�ce ol any access limRation or traffic reslriclions. '
3. That e maximum ol V lane(s) may De cbsetl N necessary to peAom� work within Ihe publk rigM of way during the hours oi 8:30 e.m. - 3:30 p.m. Montlay Nrough
irieay as lorg as traffic can be maintained in each Cirection with Bagmen unlass oNerwise epprove0 by tha Trensportation Services Ergineer.
1. That throughout ell phases of construction ihe work site shall De kept clean anA hee ol rub6ish, deCris and dust aM tlrainege shall De rtaintained.
SU&IECT TO TME NOTES BELOW: (Inspection fees over the Desic inspectlon [ime wlil be billad at Me approvetl �ourly rete.)
1. Ciry will provitle inspection betwaen 7:30 a.m. antl 3:00 p.m., Montlay ihrough Friday (e:cept on Ciry o0servetl holidays).
2. Prior to placinq Portland Cement Cw�creta or Asphatt Concrete (A.C.), Me following will have been ir�specte0 and apprwatl; nalive � and imported 0.
3. CurO antl gutter s�all not be removeE on Me Aay prior lo a weeken0 or e Ciry oEserved holiCay.
I. Fill in areas letl by cuT and gutter removal fiush with ttre adjacenl pavement on tlie same tlay tMt rertwval occurs.
5. Bore unAer ell sireels, arbs and gutters, sidewalks, crossyutlers and tlnvaway approaches. Tunneling is rwt alloweC.
6. Opan excavations must ba backfilled or plated with spikes entl A.C. tacked around eAgeS Ourirg rpn-rrorking hours.
7. Sitlewalk shall be cansYnicleG per City ot Costa Mesa Standartl Drawing No.
8. Driveway approach sAall 6e construcletl per Cily of Cos�a Mesa Stantlard Drawing No. - �c �•:. . a y
�—:_<.e:�.4-�i�.:1Sc.5 i+JT
9. No trattic allowed on concrete for minimum oi seven tlays for wriig. See UaXic contrd ehove. ��(�jr y:�_ ��; / 7=, j i�t ��`•' i^
10. Trench compadion and resudacirg shall conlortn ro Ciry of Costa Mesa Stantlard Drawing No. 873. ` � '
11. Tranches exceedirg five (5) fa¢t in dapth require a permit from the Division of InAuSirial $afery, State 01 CalifOmia.
12. Pertninee s�all pay for all S.E., compaction antl matenals tests tleemetl necessary by tne Ciry.
13. All trenches shall be pemwriently patc�ed within ten (tO) days ot compintion ol work Eelow subgrado.
ta. Pertninee s0all provides the Ciry with record tlrawings oi pertnmetl work Defore final inspection by the Cey.
15. Pertninee untlerslantls and agrees to the fwltl-hartnless agreement requira0 by CMMC Section 1&27 enG printeC on the reverse ol ihis application.
16. Ol�er: .
NOTICE: Contrac�or must nolily Ihe lollowing Utiliry Companies iwo working tlays before siarting work:
/
4;=.Dt:
Costa Meu Sanitary District Mesa ConsoliCateE Water Di�rict UNDERGROUND SERVICE ALERT
(714) 631-0731 (714) 631-1200 Tdl Free - 1�8W�{2Y�133; A/ter Houra 8 HoliEayB -(714)1333031; (T13) 6Y1-3111
INSPECTIONRECORD InspeclorofRecords: CERTFlCATEOFINSPECTON
Date �'.Re rks I hereby ceNry ihat ihe street work
enowed by mis pemui nas Daen
\ cnnsWcted eccording to Me plans
antl specifrations and I hereby
� eccept Ihe work in Nis manner.
By:
��
Dale
Ol&162 ww. rev.5/96
wi:�a. i�,as: I certify I have read and understand all of the above and that all statements made are correct and complete.
ce�r. E,y;�«,��8; _
�( � I'
Goaerom Mp�wm Applicant's Signature 1� _�:�lA,�.1i :��'^�` �,v �� Date �� �' �y f
3 COPIES OF SKETCHES OR PLANS ARE REOUIRED PRIOR TO PERMIT ISSUANCE
THIS APPLICATION BECOMES A PERMIT WHEN APPROVED AND VALIDATED �
M
BERG, RACHEL L.
From: JAMEBOZORGI, REZA
Sent: Wednesday, August 13, 1997 2:35 PM
To: BERG, RACHEL L.
Subject: RE: 340 16th Place - Final approval
Rachell,-please do'noYrelease occupancy_for subject.si
.��20�1 �
From: BERG, RACHEL L.
Sent: 13 August 7997 14:32
To: JAMEBOZORGI, REZA
Subject: 340 76th Place - Final approval
Reza,
�
According to the permit, there are some "special requirements" for this address. Traffic Impact fees have to
be paid prior to a final. Have these been taken care of? Please let me know.
Thank you,
Rachel
Page 1
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ORIGINATED BY:
Animal ConVol ❑
Building ❑
City Clerk ❑
Finance ❑
Fire ❑
Communiry Services ❑
Planning
Police
Public Services
�
�
�
m � �o
mm�
CTTY OF COSTA MESA N � 9 4 5 7 6£��
CUSTOMER SERVICE RECEIPT
aa C��
M6L
..0
/� ms�
DATE__�CJ ��J�r , 19�� � Z
': U
Received from - �A� �-i'I LL �1.3V �1. ��� m O
(,� � whose
m
m
address is
the sum of $� 4'� • i�i� , for �� _•
� 3`{U L�< <��' �— sr: �b
❑ CASH ❑ CHECK � MONEY ORDER ❑ ACCOUNT NO. LvJ
� Z3i3 2�-3� I qos57
Os05�22 Wni1e - Customer; Pi�k � Fiwnca; Cenary � Dapertmenl
Not valid udess properly velidatedlendorsed.
M
BERG, RACHEL L.
From: JAMEBOZORGI, REZA
Sent: Monday, October 13, 1997 1:59 PM
To: BERG, RACHEL L.
Subject: RE: 340 16th Place
�
Rachell, engineering has signed off on this project, Please go ahead and close out this file. Thank you.
.�E2�10
From BERG, RACHEL L.
Sent: 13 October 1997 73:54
To: JAMEBOZORGI, REZA
Subject: 340 76th Place
Reza -
Has engineering signed off on this address yet? I orognally e-mailed you back in August. Piease let me know
so I can close out the fils.
Thank you
Page 1
�
Y
FI\�AL GRA�L�'G CERTIFICATIO\'
.390 /6 ��. P«�E c�s� '"��"�9
Project Address: ��
I.ot \umber: /�� `� 7—�Z �
Permit \umber:
By Civil Engineer:
1 cenify to the satisfactory completion of gradin� in accordance v.�ith the appro�ed plans,
specifications, local and state codes. All draina�e de��iczs required by the grading permit,
=rading plzn znd erzdin� ordinznce have been instzlled. Adequate pro��isions ha�e been made
for drainaoe of surface water from each buildin�'site.
Tne mi;ii;nums are:
2�. Fzll from ctructures �tiithin 5 feet f,-om erterior �a•alls.
1� F2ll tor asphzh surfzces and ]zndsczped zrezs.
�._ /� Fall for COlICfZi� SLiicCZS 10 2}7r'0�'�0 disposzl 'ai2cS.
Tn: finz) rnor.um:;,ts zc sho�,. � on the recorded trzct m�p ��ere s:t.
l)O:S ci: �t'1i711❑ —]r�0 Oi LiZ L� 1^ d ele�•ations.
Super�;sine Ci�il Engineer Re�
� . (Sit ;zmre)
A11 fnzl �rzdina ele�z-
l�'0. �C.� �J� I�O
De,P � IL �ri
� oQ�pFESsrp;�.,
�'
��Q�O��� B, ��F?� �A� °
v� � N �'
w R <
� l � o00 �
* *
�T . CIVI� �P
9TF�F CA��F�P�
- ,
.., . ..
. ._ ,
- �.::. ,:. .
�:-.���,:;::... . � 5^u=:•'� a�d SI�1
�:,�:..�:�.,: _,... ...., ..�., .
08/I1i97 15:03 $9�0 3800 SCHHID IVSGLATI:
INSULATION CERTIFICATE
This is lo C9rtify that in8U18ti0n hes been installed in conformanCe with the CURent energy regulation,
California Adminiairative Code, Title 24, State o/ Galifom'a, in ihe buil6ing at
340 16�" PLACE, COASTA MESA
CEILINGS:
IYPE; Fiberyl0ss BATTS MANUPACTURER: Owens/Corning THICKNESS: R-30 8•1/2"
WALLS:
NPC: Fiberglass Balts MANUFACTURER: Owens,'Coming THICKNESS:R-73 3 1;2"
GENEfZAL CONTRACTOR:OAKHILL DEVELOPMENT UCENSE:
BY: TITLE:
SCH INSULATION CONT C70R5, INC.� ' UGENSE f�221517 C-2
ILF,:p,�ODUCTION MANAGER DATE:08/11/9T
INSULATION CERTIFICATE
7his is to certify that insulation has been �nstalled in r,onformance with the current energy �egulation,
California Administrative Code, Title 24. State of Califomia, in the building located a1
340 16T" PLACE, COQSTA MESA
CEILINGS:
TYPE: Fi6erglass CiAI"!S MANUFACTURER: Owens/Coming
WALI :
TYPE: Fiberglass Bads MANUFACTURER: OwenslCorning
GENERAL CONTRACTOR:OAKHILL DEVELOPMENT
�
BY:
TITLE:
THICKNESS: R-3C 9 112"
THICKNESS: R-13 3 ?/2"
UCEN$E
SCH I NSU TIO CO CTORS, INC. LICENSE #22151T C-2
BY� L: OGUCTION MANAGER DATE: 08/11/9T
�002 '
�
�uonEssaeu�w�o: 340 16TH PL
99
OYMERSN.WEIFIWOYM: VNE DEVELOPMENT
AD°"� 2'i4 E 17TH ST
• C�M. CA
� ���p� 548-3072
�xcxirr.cr on �r�ar+�+:
111itIlOB EN4'S ADDIIE55:
mwm�crars ru�:
CtlRN1fi0RSY4lIIl0
�ooness:
uNr:
uc xo.:
urar:
uc. r».:
uMr:
LICENSED COMRAttOXS UECLAXATION: I Iw�eby allim ivMs paroly M pe�ury qq 1 vn IbrnsC uMx pwie'vu d CNqx D
�rommemi�p w�lh Saction ]00p) d Orviaion 9 d IM Bud�ae W Pmleatiau Cods. end mY fimnas w in /uA lace aM MIM.
crrruc.No.: uc.cuss: B uc.r+o.: 658963 EXP:
om.: convaew:
OWNEN BUILDEP DECIAHATON: I haeby dGem untler psuly d per'�vy thel I em eumq hom iM Canrenas lioeroa taw Ip rtr
Wbxiq esemn (SeUion JW15 Buaiiefs mM Prdmiau Cadl: My Uy w aoivMy Mi'r1i npu'vm e pemiG lo mtuh�cl. etlx.'enryow.
wl"¢R a ropei ary elnclure, pia b ia eeuenro. ebo re�uirte �M appl"xan� la ach pamN Io fib a aqnad ptlameM tlW M w�M
xved W��� �o �he paneione d tM Contredwe lironae law �Cheqar 9(commandry xil� SaUnn ]000) d Div'sion 9 d tM
wi�a and Hdea'vu Codal «tAet he a ehe u ezemq �herahan eM tM Ww b Ne Nkub vemqian. �m'vdmion d 6wion
^)0]t.s by ury eppliraM la e pmml abjW� the eppliwu to e aN psnaAy W np mon Ilun M� Mutl�eE EoOen �SSOOp.
��.9fOWI9la1�1lp10pM�YIXIRYM11Vbl�YAhWBOB101��NIlO�B(9111D��.Wa�d01�lOWf11.BI141�N�hYLMORMIVdM1�l.i
«dixed I« eeb (Sectbn 1oa�. euvnew vM Pmlmaiom Cods: The Contreeae tioeras lewEme noi W W �oan ownera popam�
who W W� a inD��+�hason. md Mn dom �uN wak Nmsetl a MnM a WuM he a Ar am wrobww. Pw�dad iM ach
'vnG�TM�atla are nd iNaded u dlend tor aeb. tl. lawewr. �M bu5luq a inP��au e wtl xdhm ans Ysv d wmple�ion. Ila
oww�buldx wi0 Mre iM WNm d pwifp M a eM did nq pnlC n impo.a la iM qrtp»s d�eb�.
� I. n oxmr rt IM pW�Y. em udu+rv+l/ aoMratlM �th IioemeE canoecbn �o m�mw Ne p4a (9ed'v� ]OM. Busiir� mE
Rdm�bna Goaa: TM Caurmas lieama lew Eme no1 eDDN b en owew tl pW�Y Wp builds a impove� thersan end Mro
cantrem M eurl� P�H�++ �eh e aoNrectMe) furmed W�swM �o IM CaMretla� licame leM.
❑ I em e�emq uMar Seciion: B. 8 P.C..Ia Nb
�.: ( F�- 25 -9 (o �..,,,, �u/�c�
i eo na,wr �r mv i� e.a. a d,a �d.�,w�a m. �,a�vmm.m w creome �.an.�w s.rar s«,�. zssas. zssaa..oe
25S1a. md tlw I n enY haura build'vq omm� WI / wil'wl (meb one) need �o mnW�y wih miJ ums oods� eM �he eey�i�mmsib br
e0�etmm�WciianamodCmiantrwnNs�i ue�iY ��Oinnq.RsritlWwlmuUutlianeW�mbroanammqlmmYau
a��•.
DNe: MqKaN:
WONKEfl'8 COMPENSATON DECWIATION: I!r'aEy elfmn �uder pruEy d pa�pny ans d tM lolow'vq dederq'vn:
� I heve W W meiMen e cerlfictle d mnwni �o ealli�n Ip r.orkse' wmpsmetbn, u povtlsU la Dy SWion �lOp d IM lebar
coae. i« me o«�� a �» �n io..� w. v�n u m.�ea.
❑ �nm.wwmednenxwiw.�comc����.m�wa�.db/see:.,naoam.Lm«coe..�«u.o��a�n.
work la whid� Nu pertnu u inueE. My waken' compenW ion'uau�enca vrtix ud pdiry mimEr ua:
Carrier:
Pofry Number
� Illa SBCfi4li IIBBd /pf b mmpelB! 1 NO Lw�l 's M Me hundTd dd/M �%I W� Cv NasJ
�] I CM,Y NBI in �h0 V�m�unCO OI �M wIXk k! WhkA Ihu 0�� u iXniad. I elull ml amploy em' Gs�� in nT' Tww O tl 10
bacome w4� lo iha xaFen' mipms+�ion lews d CeWwrv+. erH qlna Nel ! 1 4auN Mcmr wljatl lo �M xabn'
Dpa: � O �j— Q�� 3]00 d tFe �� . I Ia�hMit� mmpyyrM iMw pwido�u�
�C
� V�ii�-�4�
W�mhp: FIBun b ueun workws' eo�rwtlOn roverap� Il vn4wNl. IMaIW1 rtlf�ef N ro eilMlvl pw��NN mA
GHI I/nu �p ro om �intlnd HauunJ CW4n lSfOq000A In �OC/don ro IM cwl al rompru�Wn � u poHtlW br In
S�ctlm 9]P6 al Ms LeborCotls, ImsnaL �ne attomry'� Iw.
CONSTfl11C110N LEHdNO �GENCY: I MreW atf�m uMx prWly d per�vy thm �hee u e m�utMion MMvp yury br IM
peAamenro d IM xwk br xfiich Ihe G�i u uwetl (Sedion 909). CF. CI.
LENDEfl'S N�IIE
LENDER'S RDDflE%:
I eeniN inm I nere read ihia evdiretion enE eme �het Ne ebove iMame�bn b ewrsp. � p�ee to eonwN �n M a�Y eM muniv adlew�on
erd sle�e bws rele�ip b WiW'vp wnsUWion vd haraby eNhor've iepawnle�ivae d INt tityto aMx upon �M ebo.smenlioned papMy
i« ���e�m wm��
BROCE BGNGOCHEA
�� � P��,� i�2�-96
oma:
s�o��redo..b� .�vnw�re„u�comreaa
(5151JB.WP) WNIe-Buildvq 8 Seley; Grem-Fb: Carwy-AppkeM: Rnk-Revenw: (3ddervo�Neaav
__ t
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 080194 � PLAN CHECK NO:
� .
,CONSTRUCTION TYPE: V—N PERMZT TYPE: ELE
IJOB DESCRIPTION : TEMP POWER W/ METER
i�
PERM NO: E 080194
GOVT: N SUPP; N
PURPOSE: NEW
SQ FT:
CLAIM VALUE; CALC—VALUE; GROUP OCC: /
COMMENTS: TEMP POWER
�*�**+tatat*it***��x***��r�**�**�*****�it*�*��****�*+�*x+�itiett*�***itxit�*at�it*+��rat*at*�r**�r�rie
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 HUILDING ---------- --------- ACCESSORY BUILllING ---------
FRNT: F1' 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: 42521218 2NE: REF NO:
PLANNZNG NOTES>
i
ik iE k k fE 1E iE fE fE 1E k 1f 1E IE 1ElE 1Elk i! i! k k k fE k fE 1E iE 1E 1E 1E fE ik iE 1E iE 1F 1f iE iE iE iE 1E iE fE fE 1E iE k fE fE 1E 1E iE iF iElE iE iF it if 1E 1E tE 4 fElE �E if IE 1E iE iE 1f 1f 1f 1E 1E iF
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
20NING APPROVED BY . ' __ ___ DATE:
BUIL6ING APPROVED BY : DATE: ((��
APPLICATION ISSUED BY: • DATE: �—��
��,�,�,�,��,�*�,�*�*�,�,�,�,�,��,�,���-��-���,���-������������ �,������*����� ��
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 22.00
SOY
PLAN
ISSUE FEE 22.00
HUILDING—DIC�—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 22,00 22,00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECAANIC
QQ.QQ
SMIP/NON—RES
TOTAL PAID DUE
44,00 44.00 .00
44,00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
if 1k 1k 1E 1ElE if !f 1f If 1f iF k k 1E ft fE ff 1E 1f 1k ff fElf 1E 1E fE iE fE iE iE iE fE 1E iE 1E 1E iE iE fE iE iE �E iE iE 3E fE fE iE fE iE if if iElE �E iE fE k �E fE iE iE iE it ff iElE �)E if fF iE 1E fE iE 1E iE �f iE
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. 22.00 12.00
END OF FEES
02 D021I93�-00217932 T OT 44.�Q
OA7E: IO/25/95 TIflE: 12:51
CONSTRUCTION AND PLANNING • POC SPA
APVROVALS Permit # Date Inspector APPROVALS Permit # Dace Inspector
7. 7emporary Electrical Service or Pole , 52. Pooi & Equipment Location
2. $oil Pipe-Undrgr�d. 53. Steel Reinforcement
3. � iectriral Conduit UulitY•Undrgmd. 54. Forms �
i
4. Electrical Conduit•Undrgrnd. . 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Ptumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. �
B. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash �ines, P-Trap, C7 Undrgrnd,
70. Structural Floor System 61. APPROVAL TO DECK
7 7. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final ?
73. Roof Drains 64. Plumbing System � Fina�
14. Rough Plumbing � 65. Electrical�Final ��:
75. Rough Elec[rical�Conduit 66. Solar System-Final '
76. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Eiectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilatin9 71. Product Piping O Gas ❑ Oii
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOii
25. Roof Sheathing 74. Overhead Hydro
�4� 26. T�Bar Ceiling (Structural� & Monocoat 75. Dry Chemical
27, Frame and Flashing 76. Dry Standpipe
28. Lathjng & Sidin9 77. FIXED SYSTEM FINAL
29. Insulation 7B. FIRE PREV. FINAL
30. Drvwall Nailing HEALTH DEPT. RE�UIREMEN7
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Etectricai Power Meter-Final /q � 80. FOOD CERTIFICATE ISSUED
33. Final Electric (+ Notes:
34. Final Heating & Air Conditioning
35. Finai Gas Pipe-Test
36. Hood or Canopv
37. Final Fattory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation Syscem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTUfiE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
l I
PP0.IECT AUDNESS: 3 Q O 1 6 TH YL
OWNEB'SNAME:DUNIGAN, RAY J
nooeess:DUNIGAN ALICE
34•0 E 1�TH Pi
� COSTA MESA CA
(714)646-6�62
APCM/ENGINEEN:
AOOPESS:
UNIT:
92627
NEG.NO.:
UNIT:
PEXMITTEE: �EE PLUMA ING 6 HF..ATING ( 21.3 ) 759-9101
aooxess: 5457 CRENSHAW BL
LOS ANGELES CA 90093
IICENSEO CONTflACTOP �ECLANATION: I hereby aflirm tha� I am li[enSeU untler Dmvisions of Chapier 9lcommencing wiih Sedion
7W0) of �ivision 3 oi Ihe Business antl Pmlessions Cotle, ana my license is in full force ana ellec�.
ciTvuc.:p40209q^� sTnTeuc.240186 ss: .6
�ale'. .:�_�� �/__..� SignaNre'.. — —,���
WOPNENS' COMPENSATION DECLl�BATION: I hereby a��irm �hat I have a cenifica�e of cansem to seli�insure ar a certi�icaie o� WorkerY
Compensation�5pry�ye„pr,a�e�Qfietl copV ��ereol (Sec�ion 3800. Lab C�
POLICY NO.: W L] 1 V V � E%P. URTE: O�� O S I 9 3
COMPANY:CAL COMP n )
� CeN�ietl copy is �ereby Wmished. cJ Certilied capy is �i�l� IAe ciry ing '�if'on. � � /
� / /
Daie'. ApPlicant � Gyy��tiK� �
F%EMPTION FHOM WOHRENS' COMPENSATION �ECLABATION: (This seciion need noi be tompleled il Ihe permit is for ane hun�retl (5100) ar less�.
I cerlily Ihat m the petlormance ai �he work tor which Ihis permii is issued. I shall not emplay any person in any manner so as �o became
subject lo Ihe Workers' ComDensation laws al Califomia.
Oate: Signa�ure:
NOTICE: I�. a��er making Ihis Oeclara�ion. you 5�ou10 become 5ubjeci to t�e Workers' Compensalion pmvisions ol Ihe La6or
CoOe. yau musi Iorihwi�h tOmply wit� sut� pmvisi0n5 or �his permil Shall be deem¢tl revoketl.
CONSTflUCTION LENOING pGENCY: , I hereby alhrm Iha� �here is a tons�mtlion lentling agenCy for Ihe Derformant¢ of �he waM �or
which this permi� is issuetl (Seclion 30W, Civ. C�.
lENOEfl:
AOOPESS: /'
OWNEB BWLUEB OECLAPPTION: I hereby afiirm Ihat I am exempl Imm Ihe Conirac�ors' State Li[ense Law for Ihe follovnng reason
(Section 7031.5 BuSiness and Pmlessional Code: Any city of coun�y which repuires a permii to constmc6 alter, impmve, tlemolish, or
repair any stmcWre. prim ta its issuance, also requires �he applicanl for such De�mit to ble a signetl sta�emen� �ha� he/she is licensetl
� pursuanno ��e pmvisions oi ihe Contracmrs' S�ate License Law (Chapter 9(commencing wiih Sec�ion 7000) of �ivisian 3 0l lhe Business
and Pmiessions Cotle) ar Ihal he/she is exemp� �herelrom and Ihe basis �or lhe alleged exemption. Any viola�ion oi Section 703L5 by
any apPlicanl lor a permil sublecis lhe applican� to a civil penaliy oi nol more �han �ive huntlretl dallars ($500).
I. as owner ai Ihe pmpe�y or my employees wi�h wages as their sole compensa�ion, will Oo ihe work, antl the
❑ simctureis notinten0e0 orofiere0forsale (Section 7044. Business antl PmfessionalCade: The Coniractors' Sta�e License Law
does nol apply lo an owner of a D�openy who �uilas or impmves ihereon, and w�o tloes suth work himsell/herself or tAwugh
his or her own empioyees, pmvideU I�ai suc� impmvements are no� in�enae0 0� olleretl lor sale. i�, howevet �he 6uilding o�
improvement is soltl wrthin ane year ol comple�ioq �he owner will have �he burden ol Droving he/she tlitl not builtl or impmve
for Ihe purpase ol sale�.
I, as awner of the pmpetly, am exclusvely contracting wiih licensed conirac�ors �o consimd �he pmlec� (Section 7044, Business
❑ antl Pm�essions Cotle'. The ConVaclors' Sia�e Litense Law tloes no� apply Io an owne� oi propehy w�o �uilds or impmves Ihe�eon
an0 who conlracis lor such pmlecis wilh a conVaclor(s� hcense pursuan�to Ihe Conirac�o�s' State License Law�. I am aware
�hal pmol ol l�eir Worker'S Compensation insurance shoultl be pmvitled �o me.
� I am exemp� unaer Section: 8. 8 P. C.
lor this reason:
Oale: Ownec
I Oo hereby cenity iha� I am aware ai an0 untlers�and the reQuiremen�s ol Calilomia Heal�h antl Sa�ery CaAe Seciions 25505, 25533, ana
25534 antl tha� I or any lulure building occupant will/will noi (circle one) need �o comply wilh said Slaie cotles and ��e requirement5 for a
permil for cansimtlion or modificalion �rom ihe Fir Oualiiy Managemenl DisVic�. Fesiaential conslmciion ap0lications are exemp� tmm
inese pmvisions
Dale: ApPlicanP.
I �ereby ceriify ihat I have reaa Ihis aD0licalion an0 sta�e�hat Ihe above in�o ation is correcl. lagree lo comply wilh all ciry antl coun�y
ortlinances antl s�atelawsrela�ingto builtling cons9imclion and� au� ' ep�s'nta ����is ci�yto en'er u ih' above��
properry im mspection purpases.
Date:3��3--_ Sinatu�e: � .�= � �
�river's �iwnse o� Socia� Searity ��
i6av46 Whlte—Builtlmg; Green—Cotle Enlorcemenl', Canary—Appl¢anf, Pink—Revenue; Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 061291
PERMIT NO; M 061291 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTktJCTION TYPE; PERMZT TYPE: M6C P[JRPUSE; OTH
JOB DESCRIPTION ; REPLACE WALL FURNACE
CLAIM VALUE: CALC—VALUE;
SQ FT:
GROUP OCC: /
COMMENT'S: MECHANICAL WORK ONLY.
�1F�IE �If �IE iE #�# if if 1E iF �If iE �IE if dE iE 1E-1( -%� �% # lE 9E 1E -0F �K �%�)E if� iE-1f �lE �IF if ik i! �1 -%if iF�%ih 1f� �% 1E �%it �Y.��� i(�iE�)f �7E�iF 3E-%� �i(-iE �1E9E �%� �% %�-� if � if� iE 3FdF fF �X -%� 3(..%..1E dE
Z O N I N G R E� D i R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSOHY BUZLDZNG ---------
FkNT; FT IN REAR; FT ZN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT ZN
PARKING REp • PROV; PARCEL; 42521218 ZNn; kEF NO;
PLANNING Nf3TE5>
1! 1f� if iE')f if if 1E 1flE if 1E if 1E lF 1F M� 7E lE iF if'lE iE lE 1f if'7E if' #!f 1E iE it iE IF'!t iffiE�lF if iE iF �IE 1E �1f' !E iF if lf iF'X� iE')f 1E if If iEi(' li"1Flk iF 1F 3E if -I(' iE iE !k i61E iE ii-if -lf'lE IE iE'1E
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 5
ZONING APPROVED BY •:i DATE;
BUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY• :� DATE; � � �
lEkiFit�IklEiE3fiFfEikiE�lFiFik3FiE%lEiPif�% t r � �uf� xi t. i. . c a� . e . jEltiEifih#iflE�lF�l(� xx� . w�l(�!t
if 3E iE iF iF iF iE 3E �E iE iE if iF iE ih iE 1E if !E # k iE iE iF K� if !E �f �E iF aE if if iE if�1F 7f SE IE jF if� it jE 1f d�M 1F 3E 3F if iE ih V.� iE it 3f 3E 3E i! if If %� jE IF !f 3f�iE 3(� lF 3E iE iF if ii� IE ��%� �lE ik
LEGALIZATION:N F E E S U M M R Y STRUCTURAL SEGMEiVT;N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 9,00
25t SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 9,00 15,00 Q,00 24,00 24,00 ,00
REVENUE DIVISZON TOTALS--> COLLECTED: 29.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
iE iE iE iE iE if iE iE iE if iE iF 1E iElk iF iE if it 1f iE iF 1E 1F 1E iE if if if iE iF iE iE if 3(-�E jf iE iE iE iF 1E iE iF i(� � 3F if jf if'iE jE N�iE iE-IF iE jE iF if iE if # 161E if 1P ih 1Eif if * iF 3F �f iE 3f-jf iE
I N D I V I D U A I. F E E B R F A K D O W N
TYPH QTY D E 5 C R I P T I O N UNIT COST
MEC 1 T.NST/kELOC REC6SSED WA7,L HEATER 9.00
END OF FEES
TOTAL COS3
• ��
ICONSTRUCTION AND PLANNING
1 APPROVALS Permit �`r
1. Te;nporary Elecvical Service or Pole
2. Soil Pipe-Undrgrnd.
3. ElectriCal Conduit Utility-Und�grnd.
4. Electrical Conduit-Undrgrnd.
5. Steet Reinforcemenc
6. Electrical UFER Grr.d
� 7. Footings
$. Foundation
9. Water Pipe-Untlrgrnd.
� 10. Structural Floor SYstem ��
Date
n
!'
..____ _.,._
, 11. Praperty Sewer Une & House,Connection �
' 12.� $ewer Cap ' -
� 1:}. Roof Drains
i�b. Rough Plumbmg
i
� 75. Rough Electrical�Conduit �
i
� i6. Rough EleCtric Wiring �
i
� 17. Rough Wiring Sign . ,
18. Rough Electrical�T Bar Ceiling
19, Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. floof Framing
25. Roof Sheathing
26. T•Bar CeJing (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywail Nailmg
37. Plaster Brown Coat
32. Electriral Power Meter-Final
33. Final Electric
34. Fina� Heating & Air Conditioning
�j
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Plumbing
39. Water Service�Final
40. Gas Service�Final
41. Soiar Oomestic•Final
42. Backflow Preventer
43. Backfiow Irrigation
44. Landscape Irri4atio� System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Reiease to $outhern California Gas Co
No. Date
0
roo, i sPA
Inspector pppqOVAIS Permit �
52. Pool & Equipment Locat�on
53. Steal Reinforcement
54. Forms
55. Electricai Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit�Undrgrnd.
59. Gas Pipo, O Undrgrnd., Test
! 60. Backwash Lines, P�Trap, C: Undrgred.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System � Final
65. [Iectricai-Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYS7EMSFINAL
FIRE DEPT. REQUIREMENT
APPROVAIS Permit #
70. Underground Hydro
71. Product Pipin9 O Gas ❑ Oil
72. Underground F�ush
73. Undergrnd. Storaye Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINA1.
i
78. FIRE PREV. FINAL
�� � HEALTH DEPT.REQUIREMENT
� �
' 79. FINAL INSPECTION
_r� 80. F000 CERTIFICATE ISSUED
� Notes:
u
i
0
Date � inspector
' � /+volicant to flll in an s0��es exceo� those w(thin heavy burtler Iines ana sign all aporovriate tleclarations.
�RMI� N�O.� � TRACT NO. LOT NO. UNIT NO.
Ci7Y OF COSTA MESA �NSTR�U.CyTIO PERMIT A.P. �k zo�e
Pro'ect Address /� - �U
� I ��V �"' ,�1 �/� . S Main Building: Accessory Building:
ApplicanY: Mailing%ddress ,• �N- N'�`�r ��/� �✓ TVPE OF CONSTRUCTION NEw A�D ALTERaTlO PaIR E z
i c.��� �j� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Flont �
Owner's Name �r��'�'� 'Qur"��ij ;/iv-�Phonr�� DESCRIPTION OF WORK/USE OF BLDG. I 8 Rear N
� Address ? � � E /�!� Gr%� A �
ArchlEng. LicenSENo. TVPEOFPERMIT GRAOIN FOVNDATION ❑S7RUCTURAL �' K Right G
AddreSs —�_A��—�M�� • ^� ❑ TENANT ❑ ELECTRICAL LUMBING ❑ MECHANICAL g Lefl R
Contractor's Name Fhon�%����%� � OTHER I p�ng. Ref.91E Parking Req./Provided E
PROJECT DESCRIPTION Sa. F7. oCGUP.arvCV d
O 2Z ��J'O�i.yw i✓�,. Plannin Notes:
Address (mailingl '3 Q q 9 M
Ciiy License No. �O2! �/ / �—�� CONSTRUCTION TYPE VALUATION 5
T
20NE GRAOING CU. VDS. ACRE$ $,
LICENSED CONTRFCTOR DECLAFATION
I hereby affirm tbdt I am litensetl untler provi51on5 of Charte� 9(commencing (=ema�ks:
witM1 seclion �000) ot Division 3 of the 9usiness antl Protessionz Cotlo, antl
my license is in fu I fo ,ane etrect. 3o ELECTRICAL FEES
License I ss � S2_ _Licen
Date ZfP 5i9namre . - PLUMBING FEES Auromatic Washer Transformer ❑ 15�50 KW
WORKERS' C MPENSATION D C ARATION ConStlUction PoleSUb. � 50+KW
I M1ereby affirm tha[ I have a certili te ol ton5ent to 5elt-insure or a certificate Bar Sink Show¢rs
� 'Jorkers' Compensation Insurance, or a certilietl cooY thereof (Section Backflow Preventer Servite Sink Cooking Unit Meter �up to 100 amps
- l, Lab.
Poiicy No. ��.�8� Comoany �-�-� �M�L �'�• Backflow Irrigation Sewer Cap Dishwa5her -' Meter �over 100 amps
Certified copy is hereby tumishetl. Dryers ❑Gas �Electric Sub Panel
certifie copy' ' tl witn tne'cit �'ryi q Divisi n. Bathtubs Sewer Connection
ate Z V Applicant � . Fan
E%EMP ION ROM WORKERS' C VENSATION DECLARATION Clafifief5 Solal C011eCtors MotorS OO-1 HP �1'h-B
(Thi55etiion n¢etl nol be com0�eletl If lhe permit IS tar On¢ huntlred ($100) or F.A.U. � InC. 5013� 09-75 HP �76-75+
less). Dishwasher Solar Piping
I ce��ity thal in lhe performance ot tne wOrk fOr whiCh thi5 Oe�m�t is ISsuatl, I FIXtu�¢S
snall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave
Worke�s' Compensalion Laws of CalilOrnia. '�
Date 5ignaturo ✓, Floor Dreins Swimming Pool w/Spa I� Device Boxes Pole Light
NOTICE: If, after making this tlecla�atlon, y0u ShOultl beCome Subject to the
Workers' Compensation provisions of Ihe Labor Cotle, you must for[nwitn Floo� Sinks Urinal Outlets Range
comply with sucM1 provisions or tbls Oerml[ shall be tleemetl revoked.
CONSTRUCTION LENDING AGENCV GasService Outl¢t5 W2L2fC1052t $witCh¢5 Siyn
1 her¢by affirm t�at l�ere i5 a conSbuCtiOn I¢ntling agoncy iOr th! p¢rtotmance
ot the wolk tor whi[h ihi5 permlt Is ISSu¢4 ($Bctlon 3097 Civ. C.) Iflt¢fC¢ptOtS W2t¢I H¢dt¢f G21bag¢ Di5pO5dl $tdndin9 S¢cLiOf15
Lenaer's Name bo Generator DUS KW �5-15 KW Trash Compactor
Lentler's Atltlress Kitchen Sink Water Service
OWNER BUILDEft DECLARATION
I hereby atfirm Lhal I am exempt from [he Gonl�dctor's License Law fOr the Lavarories AUtO-WdSh
following reason (Sec[ion 7031.5 Business antl Professlonal CoOe: Any clty or
county which �equires a pe�mit t0 cOnit�uGt, dltGr, ITp�ove, tlemolish o� �epair P—Ttdp LOUndry T�dyS
any structure, pr�or to its issuance, alw requires the applicant tor such permit
to file a signetl statement [hat he/she I5 licensetl Ou�Suant to the provi5ionz o! ROOf D�dinS � �O`'� (,p� NJ /L.
tne Contractor's License Law (Chapter 9.(commenting with Section ]000) of
pivision 3 ot [he Business antl Protesvons Cotle) or Ihat he/sne is ezempt
';�� efrom antl the ba5is tor the allegetl exemption. Any violation ot Section I � n�-� , emspectmn ee 1 Issue Fee $ 3
i
�.'g,�`�'' S by any applican[ for a permit subject5 tha applicant to a civil 'C�� DEVELOPMENTSERVICESREQUIREMENTS:
��?alty of not more than five huntlretl tlollars ($500). �
U I, as owner ot the oroperty or my employees with wages as tneir sole Reinspeetion Fee $15 Issue Fee $ 3 Zaning Approved By Date
comp¢nsation, will tlo the work, antl [he structu�o I5 not Intentletl o� ofteretl
�or sale (Section 7044, Business antl Professional Cotle: The Contracmr's MECHANICAL FEES Buildin8 APP�oved By Date 8�
License Law tloez not apply to an owner of a property who builtls or Improves
thereon, an0 wbo tloes such wotk hlmself/herselt or through his or her own goiler HOOd O� T E I ❑ %�Pplir'etiOn ISSUBd By D3t
employees, provitletl thal such ImOrovements are nof In[entletl o� offeretl fo� YP
wle. If, however, the bullaing or improvement Is solG within one year of mm- Canopy Type 11 ❑ SUMMARV OF FEES
Oletion, the owner will have the burtlen of proving he/she tlitl not bulltl or im- Duct - Under Ground
prove for the purpose ot sale). BUILDING PEFMIT $ SMIP $
❑ I, as owner of the proverty, am exclusivery contracting with licensetl con- Dutt -Strucmral Refrigeration System PLAN CHECK $ PERMIT
Vactorsto construt[ tbe project (Section 7044, Busines5 antl Professions Cotle:
Tne Contractor's License Law does mt appty to an owner of property who Duct - Ventilating ❑0-100,000 BTU ❑700,000 BTU PLUMBING $ �� • ISSUANCE $
builtls of imDroves thereon. antl who cOntrac[s fol Such oroieCtS wlth a con-
tractor(s) Lcense pursuan� to me Convactors License Law�. I am aware that ExhauSt System ❑ Multiple ❑ System Repair/Alteration PL.AN CHECK 25% $ ENERGV P.C. $
proo( oi their Worker's Compensatlon insurance shoultl be proviaea ro me. ELECTRICAL $ GRADING $
I] I am exempt untler Section B. & P. C. for this reason Firepl/FacL BIL ICBO dk Fire Damper5 MIC(70FILM $
PLAN CHECK 50% $
Date Owner Heating Sysrem & Ducting Registers MECHANICAL $ �•
I hereby certify tnat I have reatl tnis appliwtlon antl state that tne above ❑0-100,000 BTU �100,0008T TOTAL FEE $
information is correct. I agree to como�Y �'��h all city antl county ortlinances PLAN CHECK 25% $
dntl state aws relatinq t bulltling ConSltuction, antl hereby duthorize r¢Ore-
sentatives t s city t enter upon the above-mentionetl Oroperty for
inspection � es. �
Signature Date �
Drivers• L� se or 55 � �"� �% Reinspeetion Fee 515 Issue Fee E 3
�� OUG3)�;^r„�_a`:il . - -,
0865-46, rev. b/eu wmte � t3ulltling; Canaty - Appucanf; Plnk - AccounLng; GoiO¢nroa - sassesso� �n�c. �y� �i,/�y T_��_� iyu -
fi�
/ �.fr -�
CONSTRUCTION AND PLANNING :' POOI 'PA �
APPROVALS Permit# Date Inspector �yppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole , � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. �jr� � • 53. Steel Reinforcement ='�. �
3. E3ectrical Contluitl Utility-Undryind. . � 54. Forms
4. Electrical Conduit-Und�grnd. ' 55. Elecvical Bonding �o �
1 .c. . i i
,5: Steel Reinforcemen ��; 56. Rough Plumbing & Pressure Test ��
� 6. Electrical UFER�Grnd. � 57. APPROVAL TO COVER-GUNITE .
�
7. Footings� � � '-'i ..�a . 58. Electrical Conduit-Undrgrnd.
8. Foundat�on �'�, , -� � 59. Gas Pipe, O Undrgrnd., Tes[
9. Watei Pipe-Uridrgrnil. � _ 60. Backwash Lines, P-Trap, O Undrgrnd.
10!'StrLctural Floor System _ ,�' 61. APPROVAL TO DECK
� 11. Property SeweF Line & House Connection 5' �el �Q 62. Backwash & Receptor-Final
12. Sewer Cap `' •. ' 63. Heater & Vent-Final '
13. Roof Drains •'` �t 64. Plumbing System - Final �
14. Rough Plumbing�� "� ' 65. Electrical-Final ..
15. Rough Electriral-Conduit ' 66. Solar System-Final
.�
�16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
o�
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
�..
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Strucwre 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-RoLgh & Test 72. Undgrground_F.lush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil •
25. Roof Sheathin9 , 74. Overhead Hydro .
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Freme 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 s �}'y G/L�%
39. Water Service�Final !�. �� (.TJ)
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer i� ,.
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation . �
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING �
48. Special Requirements Completed
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co ' �
57. CERTIFICATE OF OCCUPANCY - ' •
No. Date - -
Applicant t0 till in all Spaces except thoie wi�hin heavy portler Iines antl si9n a1l aoP�ovriale aeclarations.
cirY OF COS7n MESA CONSTRU�I � PERMIT
. Project Address � � ' _
Ap�liceent's�'lailing Addreu
�
Cj4nner's Name ne
//�+dress ,,,
Arc�/Eng. License No.
Address �p
Contractor's Nam Phone � '� Op
Address Im ��� � ��� ��
City Liten N � � 1 \ _ _ _
IICENSED CONTRACTOR OECLARATION -
I bereby aftirm Ihat I am licensetl untler provi5lon5 oi Charte� 9(Commencing
wi[h uction 7000) 01 Divislon 3 of t� Business antl Pro/es)lops cotle an
my license is in fu11 force an .etf � I�
Licen .
Date 99�ature
WORKERS'CO PENSATION DECLARATION
1 h¢reDy aHi�m [nat I have a certificate of consGn[ to ze nsure o� a c¢�tificat¢
� l Workers' Co� Penwtion Insurance, or a certifietl <op there f(Sectlon
00, l.ab. G.) •t ���L t� L
olicy No. �1 11+SL, Comp y` J/�_
8 Certitietl copy i nereby /umishea. ^
Cert1' i wrtn the <ity ui ng OtOi �e
Date--js��_ Applicant
�il (This section neetl no[ be completetl it th¢ permit is tar one h tlr (5100) ar
11 less).
1 certify that in the pertormance of the work for whlch this perm�t Is issuetl, I
shall no[ employ any pe�son in any mann¢r 50 as to become subject to the
�. Worke�s' Compensdtlon Ldws of Cali(omia.
1 Date Si9nature
� NOTI[E: If, atter makin9 tbis tleclaration, you zhould Gecome subject to [he
WOrkers' Com0en3ztlon provisron5 Of th¢ Labor CoEe, you mu5t for[�wltn
comply with such provisions or tnis permit shall be tleemetl revokeG.
CONSTRUCTION LENDING AGENCV
1 hereby aftirm that Ihere is a construction IenGing agency tor lhe Darformance
of tne work for which lhis permit is issuetl (Section 3097 Civ. C.)
Lender's Name
�entler's atldress
OWNE0. BUILDER DECLA0.ATION
I nereby atfirm lhat I am exempt from the Contractor's License Law for the
following reason (Sectlon ]�31.5 BuSiness antl Professional Cotle: Any city or
county which requires a pe/mit to Consttuct, altEr, imp�ove, tlemolish or repair
any structure, p�io� to its issuante, also �equires [he a0��kdn[ fo� SUGh pe�mit
f0 tile a sign¢tl statement that he/She i5 Iic¢nsetl pur5uant lo tne prOvisions of
t�e Con(ractor's License law (Chapter 9(commencing wit� Section 7000) o(
Division 3 of,tne Business antl Professions Coae) or that ne/she is exempt
'herefrom antl Ihe ba515 tor Ihe allegetl exemption. Any vlolation of SectiOn
' �31.5 by any applican[ for a Oermit sublects the applican[ to a clvil
.nalty of not more than (ive nuntlretl tlollars (E500).
I� I^ as owner of the� property or my employees wilh wa9es as their sole
�mm �ncatinn. will tlo the wolk. antl tbe sVuctule i5 not Intendetl Of-offer¢tl
LicenSe Ldw tloes not apply to an owner ot a properry wno owias or improves
thereon, antl who tloes such work himself/herself or throu9b hi5 or ner owm
emoloyees, provitletl that such im0�ovements ara not intentlea or offeretl for
sale. If, however, tne builtling or improvement is soltl witnin one year of com-
pletion, the owner will have the burtlen ot proving he/she tlitl not builtl or Im-
prove tor the pur0o5e ot sale).
❑ I, as owner of the property, am extlu5ivelY contractin9 with Ilcensed <on-
tractors to construct the pro�ect (Section 7044, Business antl Professlons Cotle:
� The Contractor's License Law does not apply to an owner of Oroperty who
builtls or imowves thereon. antl who contracts tor such oroiects with a r.on-
lractor(s1 liwnse pursuan[ co [ne Conuactor�s License l.aw). 1 am aware that
proof ol their WorkeYs Compensatlon Insurance shoultl be provlE¢tl to ma.
� I am exempt untler Sectlon B. & P. C. for [nis reason
\ Oate Owner
1 hereby certlfy, th I hava rea�
Intorma[ion is c n t I agree to
antl state laws la n to i{tl'r
50l12dI�VES O(�� IS �f f
InSpection purp0 es
Slgnature
Orivers' �Icense or 5 �
above
nances
.Q�..'�SS6 2 � ....._. .._. �
TYPE OF CONSTRUCTION NEw noo
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. —
ALTERATION LQ-REPAIR
TVPE OF PERMIT LI GRADING U FOVNDATION f�USTRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PRQIEC7 DESCRIPTION 5�. FT, oCCUVANC,v`�
CONSTRUCTIONTYPE VALUATION$ 1IJ
20NE GRADINGCU.YDS. ACRES_
Remarks: L/II V/ I/� � "'
Sink
Preventer
Irtigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Serviee Ouclets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection,Fee � $15
Duct- Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFact. BIt. iCBO �k
Heating System & Ducting
❑ 0.100,000 BTU � 100,000 BT
Reinspection Fee I $15
OB65-46, rev. 5/88 White - Builtling aC nary - Applicant; Pink - Accountlng; Goldenrotl - Asseszor
$hoWers
Service Sink
Sewer (:ap
Sewer Connection
Solar Collectors
Solar Piping
Soler Tank
Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
Laundrv Tra{
laue Fee
Hoodor Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0.100,OOOBTU ❑100,OOOBT
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
FEES
$ 3
FEES
$ 3
A.P. �W
S Main Buildi
E
T Front
B Rear
A
C Right
K . Left
S
Ping. Ref. #
Planning Notes:
Req./Provided
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction Pole Su6. ❑ 50+ KW
Meter �up to t00amps
Meter pover 100 amps
Sub Panel
Momrs 041 HP �1'6 - 8
InuSolar �9-15 HP �16-15+
Microwave
Pole Light '
Zone
Cooking Unii
Dishwasher
Dryers ❑Gas �Electric
Fan
F.A.U.
Fix[U�¢5
Device Boxes
Outleti
Switches
Gar6age Disposal
Generator 00.5KW �515 KW
Sign � ?
Standing Section_
Trash Compactor
' Reinspeaion Fee �$15 I _ I Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning APP�oved Bv .
eu�m��a nav�o�d ev ��
Appliotion Issued By
BUILDING PERMIT $
PLAN CHECK $
PLUMBING $
PLAN CHECK 25% $
ELECTRICAL $
PLAN CHECK 50% $
MECHANICA� $
PLAN CHECK 25% $
1
N
G
R
E
U
M
T
S.
FEES
. � S 3
—
_Date
FEES •
.SMIP , �' $.
PERMIT
ISSUANCEI $
ENERGV P:C. $
GRADING $
MICROFILM $
TOTALFEE $
A1 00015196-000161E7 �CIT
DATE� 10/04/88 TItiE: 15:34
,
t2c�. 7�
. , �;
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CONST'nUCT10N AND PLANNING POOL ,PA - y
'� Date Inspector Date Inspector
APdROVALS Permit # - APPROVALS Permit #
1. Temporary Electrical Service or Pole �.. 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. • - ." 53. Steel Reinforcement � _
3.,plectrical Condui[.Utility-Undrgrnd�. • :: , 54. Forms � �"'
4..Electiical Conduii-Uhdrgrnd. � 55. Electrical Bonding ~n
5. Steel iReinforcement _ .,� � 56. Rough Plumbing & Pressure Test � �
6.� EI'ectrical UFER Grnd:, �•- 57. APPROVALTO COVER-GUNITE . , �
� �
7.�Footings • -� � � ' i ' 58. Electrical Conduit-Undrgrnd. _.. .
�S. Foundation � � � 59. Gas Pipe, O Undrgrnd., Test
�9<,•Water Pipe-Undrgrnd. ' � r 60. Backwash Lines, P-Trap, � Undrgmd.
1�pY St'ructural FloorSys�em � ' � � '� 61. APPROVAL TO DECK
i t� Prop�rty Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. �Sewer Cap , - 63. Heater & Vent-Final .
13. Roof Drains 64. Plumbing System - Final � �,
14. Rough Plumbin9 � , 65. Electrical-Final . ,
15. Rough Electriral-Conduit 66. Solar System-Final
' 1.6'. 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
�
�9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace'� • � APPROVALS Permit #
21. Ducts, in Structure . 70. Underground Hydro
22. Ducts, Ventilating . • 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test ' 72. Underground Flush
�
2A. Roo4 �rraming ('� r . � 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing '" � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoa[ 75. Dry Chemical
27. Frame and Flashing � , 76. Dry Standpipe
28. Laihing�&,Si'ding 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 M�ter-Finsl ' 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35: Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer '
43. Backflow Irrigation , �
44. Landscape Irripation System . ' �
45. Sound Attenuation
46. Handicap Regulations (o /3 po �
47.FINALSTRUCTURE&BUILDING '� ,'�� 3o3dC 198�YpJd��
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co . '�,
51. CERTIFICATE Of OCCUPANCY - ! .�
_ .�
No. Date -
�
RECti�VEO ��G 2 Q 1�5
� �u6 .?e� /`��S
� � : ( oS7A /�'fESA %��/� �/�/6 �'FafF7� -�1V/S/oni
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� � J7�'oP �f/�RE /��R � TNF ���rF o F' / %
� i (�o�n�u o�,�� �� T,`FF S72E�
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9 ���
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� / .5'i� � � f�'9
�t�a� � . .5'��` 3,�o y _
S
Ap017cant Io fill in all spaces except t�ose wit�in �eavy-EorCer Iinci an0 sign all apPropriale tleclaralions.
CITV_Oi CDSTA MESA - �CO:'� �R�Q�tUOJU PE;RQQIT
.�Pfo"ec2 Atldress � � / �W�i� � �
Applicant's Mailin Adhress
Owner's Nume �Phone
' Address
``�1�t__"" �
�Arch/Eng.� �p�icensIeNo. f✓_/� �
Address `f ��Jv��L(� i L'y...L�''�-'(/
Convnctor's Nam ^T (�_�j,��I1..�j�� P�bone^s�-1�--�1
Addrpsslmailingl��-.�L� � 6L.�Q.�%��T-.�dC� �� •t^ i
Cily Licensc NO. 1 �� %�4 ���
IICENSED CONTRAC70R DECLAR/iTION
I he�eby attirm that I am IlconSetl untler proviSionS of COarte� 9(commentlnq
wilh fection 7000)nnn of Divlsion 3 Of [ha Businesi antl Profes5ions Cotle, antl
my IiCensa is in tul�= an0 e1/ecL � �^ �Y „ �
Licunse Cl;ss Li en e No l�t�=� ��
Datc ��A- 5'9 t �1.� Ia�
WORKERS' MPENSqTION DECL R IOfJ
I hereoy aftirm that I nave a certi(icata of consent to self-insure or a certiilcate
�f WOrkers' Compen5a[ion Inw�ance, Or a certifietl copy thereof ($ection
1800, Lab.�.)�v2_ i ^�__. 1 A. ^�
PoIICY Nol�[� �a_V ComoanY u ��f�-�
Certi 'etl c99�� y is ner¢ y turnizhed.
Cert' iyyGGSS����AA a��' d with the city ui a'y�g v vo �/
Da i�� APPlicant ��l�l ��5�����F�
EXEM 10 FROM WORKERS' COMPENSATION �E�LARATION
(Tnis seclion neetl not b¢ completetl if the permit is for ona huntlretl (E100) or
less).
I certlly that in the perbrmance oi the work for which this perm�t Is Issuetl, 1
sM1all no[ employ any person in dny manner so a5 [o Decome subject to the
Worklrs' Compen5ation ��y5 01 Callfomid.
Date Si9nature
'NOTICE: I1, af[er makiqg {hi5 tloclaralion, y0u S�OWC Oecoma sub�ect to the
Worker5' Compensatlon provl5ion5 Of Ihe I�bor Cotla, y0u must forthwith
comply with such p�ovi5ion5 or lnis Dermit shall b0 tleemetl revoketl.
CONSTRVCTION LENDING AGENCY
I h¢reUy afllrm that there is a construcHon lentlin9 agoncy tor tne per(ormance
ot tho work for wh�ch this oermit iz izsuea (Section 3097 Civ. C.)
Lentler's Name
Lentler'z AtlErezs
OWNER BUILDEN �ECLARATION
I hu�oby ail7�m that I am exampl 1rom lhe Conlrattor's LlcanSe Law for the
following reason (Section 7031.5 Buslness antl Professional COCo: Any city or
county whlch requires a oermit lo consVuc[, alteq improvo, aemolizh or repair
any Structure, pdOr lo �(5 i55uance, a150 requiles Iho applicant fOr sucll permit
to (ila a slgn¢tl statemCnt that h0/Sh� I5 IlcenS¢tl pulsudnt t0 lh0 PloviSiOns of
the Contractor's Li<ense Law (Chao�er 9(commencing with SacUon 7000) ot
Divislon 3 01 the BuSiness antl PrOlci5ion5 CotlO) or (hdl ho/sna i5 exempt
thcrefrom, antl lhe basls for tho allegetl exomption. Any violatlon ol Sectlon
7031.5 by any appliCant tor a permit subjects tna applicant to a civil
�enalty o/ not more tnen fivo nuntlretl tlollars (5500).
1, as owner of tn9 propurty or my ¢mPloyee5 with wage5 as thel� SOIB
tompensalion, wi11 tlo �ho work, antl [ho structure is not IntenOetl or oHereO
ror sale (SecHon ]04d, Businass antl Professional Cotlo: Tna Gontractor's
License Law tloes nol dpply to an owner ot a property wt�o buitEs or Impmves
ehareon, antl wno tloes such work himseli/herselt or tnrou9h his or her own
.�.,�invooz o.nviaea tn,� c��cn Imorovements are not Intontlod or oHeretl tor
or
o/ the properry, am nzcl�
Vuct the OrojoCl ($ection
�'s LicenSe Law tloos nol
owias or improves v
Vaclor(5) littnse purs
proo/ of lM1eir Worke
❑ 1 am exempt untler
is soltl withln Ona yoar ot com-
�ing-he/she tlitl nol builtl or Im=
contractlng with Ilcens¢tl con-
Business antl Professions Cotle:
to an owner ol propmty who
; fo� suCh Orojecl5 wrth a con-
License Law). I dm aware Ihat
¢e snoWe be Provltletl to me.
— e. & P. C. tor lh6 rea5on
Date Owner
I hereby certi/y i�at I have redC this applicati
intormatlon is correct. I agree to compry with al
antl 5tate laws relating �o building construction,
5entatives ol this city to enter upon the abi
Inspe<tion purposes.
Si9natu/e
�Orivers' License or 55 qp
CMF OB65-46, rev. 10/84 Whit¢ - BUlltlin9; Canary
I
TVPE iSFCONSTRUCTION U NEW�ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH OT E .7 C
� OI�TJ "R�2V AA. iW ��c•
DESCRIPTION OF WORK/USE OF^ BLDG. S Main Buildi
nVCtZ � }��`�g '�—' E
TVPE OF PERMIT ❑ GRA�IN FOUNDAT ON STX�. RVCTURAL T Front �
❑TENANT�ELECTRICAL LVMBING�MECHANICAL B Real
❑ OTHER p'
PROJECT DESCRIPTION 5�. FT. oCNaA�rv.C,Qv—�— C Right �'
CONSTRUCTIONTVPE VALUATIONS.<c'�� S Left i
20NE GRA�ING CU. VDS. ACRES ping, Ref, #
Remarks: ,'P�'' �(�� _��j �Fx� ��� � �Gr_�,�rj PlanningNotes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains �
Floor Sinks
Gas Service 7'7 Outlets
Kitchen Sink
Lavatories
p-Trap
Roof Drains
Reinspaction Fee � $15
Duct - Under Ground
Duct - Sirucwral
Ducl � Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
He ing System & Ducting
� �100000BTU�100,000BT
Reinspection Fee
- Assessar
$15
Showers
Service Sink
SeuJer Cap �
Sewer Connection
Solar Collecrors
Solar.Pipin9 .
Solar,Tank
Swimming Pool w/Spa
Urinal
Water Clout
Wacer Heater
Wacer Service
Auto-Wash
Laundry Trays
Issue Fae
Hoodor Typel ❑
Canopy Type I I ❑
Retrigeration System
❑0.700,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
- 'LI I -
�,„
�11
/ ^Y
�/�
�
�
HOLD FOR
Automatic Washer
� Consvuction PoleSub.
" 2 Cooking Unit
Dishwasher �
Dryers �Gas ❑Electr
• � Fan
F.A.U.
Fixtures
Device Boxes' ,
Outle[5 � 1
7 CQ Swi[ches �'
5 3
$ 3
�
�
�
Building:
Parking Req.IProvided
ELECTRICAL
Transformer ❑ 15-50 KW
❑50+KW
Meter NJup to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors �61 HP �1 %�- 8
Inc.Solar �9-15 HP 076-75+
Microwave
Pole Light
Range
� ; Standing Sectionz
KW �5�15 KW Trash Compactor
� 515 laue Fea
DEVEIOPMENT SERVICES R
Zoning qpproved By
Buildin8 APP�ovad By
FEES
5 3
Z
O
N
1
N
G
R
E
�
M
T
S
� � � , �/ SUMMAqV�F FEES 1 /',�
BUILDINGPERMIT� $ ��• SMIP $ �
PLAN�CHECK 5 � PERMIT
/ PLUMB�NG �t •$ I' -�d ISSUANCE S
PLqN CHECK 25% $ -3�SO ENERGY P.C. 5
ELECTRICAL $ �2- � GRADING $
PLAN'CHECK'. 50% $ �-{. D MICFiOFILM $
' MECHANICAL � $ �•� TOTALFEE $ �
PLAN CHECK - Z5% $ \� OO �f 32. � �
�,
' �,�CONSTRUCTION AND PLANNING POOL a SPA �
a Date Inspector Date Inspectnr
APPROVALS Permit # APPROVALS Permit #
� �•1: Tempo[ary Electrical Service or Pole . � 52. Pool & Equipment Location
I
� 2. Soil Pip"e�Undrgrnd. �- � 53. Steel Reinforcement
� 3� Electrical Conduit Cltility-Undrgmd� L� � 5 s,js �L 54. Forms
4. Efectiical ConiluiYUndrgrnd. • 55. Electrical 8onding
�'5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
�`r6.'Electriqal�UFERGmd. � 57. APPROVALTOCOVER�GUNITE
7. Footings ��. �" �S 58. ElectricalConduit-Undrgrnd.
8. Foundation` ' . 59. Gas Pipe, O Undrgrnd., Test
9. Watei Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd.
I�10 �Structural Floor Sysxem , • 61. APPROVAL TO DECK
11. Prope�tY Sewer Line'& HouseConnection 3� �� 62. Backwash & Receptor-Final
12. Sewer CaP ' � ' 63. Heater & Vent-Final .
73. Roof Drains ,� " ' � 64. Plumbing SYstem - Final
14. Rough Plumbing � ' .�(�J,j��/� �� 65. Electrical-Final � -
15. Rough Electrical-Conduit 66. Solar System-Final
� 16. Rough Electric Wiring ���S ��� 67. Fencing & Access Approval -
I17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING '
18. Rough Electricat-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
I 19. Rough Heating & Air Conditioning �,Z,ZI�S L' '. FIRE DEPT, REQUIREMENT
I20. Rough Factory Fireplace APPROVALS Permit # �
'� 21. Ducts, �n�Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil _� ��
23. Gas Pipe-Rou,9h & Test .� ��yf`,�� 72. Underground Flush
24. Roof Framing� • 73. Undergrnd.StorageTank ❑Gas ❑Oil
25.•Roof Sheathing � � �� � �� 7q, Overhead Hydro .
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ..,`
27. Frameand Flashin �''"` ��e'''`�
9 I� z `����sS DS 76. Dry Standpipa
28. Lathing & Siding y�(�j. 77. FIXED SYSTEM FINAL.
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing �� -� � HEALTH DEPT. REQUIREMENT ,
31. Plaste� Brown Coat �/D r �i 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Electric Notes: ��� s����. T v�
34. Final Heating & Air Conditioning � 1• - p U ���$5�
35. Final Gas Pipe-Test ai �' �
36. Hood or Canopy ��Q ��S C
37. Final Factory Fireplace � . �--
<
38. Final plumbing y� �%� - . � � �+
39. Water.Service-Final �S �
40. Gas Service-Final K
41. Solar pomestic-Final
42. Backflow Preventer " _. .
43. BackflPw Irrigation '�
44. .Landscape Irrigation System
45. Sound Attenuation �
46. HandiGap Regulations
47. FINAI. STRUCTURE & BUILDING Z. D� �
48. Special Requirements Completed 3 C: .
49. Electric Release to Edison '
� 50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ADolicant to fill in all soaees excevt inosa witnin neavY Dortler Ilnas antl sign all aoV�opriate aeclarations.
Ci7Y�F cosTa CONSTRUCTION PER IT
Project Address �7 � � � • � � � �iQ- G �
�
Applicant's Mailing Address �� � L Z N• �'�C-/�� L�%i
Owner'sName +'Ql/G��+ �'J`�k�• S�-^�'� Phone G��^G-�:
Address ��'� l . ��6"� �r /"c�/�"6L�
ArchlEng. /!�"'�� LicenseNo.
Addreu -
Convactor's Nama ���n/G a� Phane ���'���
Addreszlmailingl���a N. ��'r 2-�^91� La�y
City LicenSe No. � �' � � �
LICENSED CONTRACTOR DECLARATION /�
I here�y affirm that I am licensetl untler provislons ot Cnartcr 9(commencing
wilh settlon 7000) of Dlvlsion 3 of lho Buslnei5 antl Prolesiions COCe, antl
my license is in 1 Il lorce a tl Nlect. �� 6 y�
Licenu Cljss �'� Z n�+ �� ze No. � Q-•j
Date- ��-�/— !��—J Slana�ura —�
WORKERS' COMPENSATION DE RATION _
� nereby atfirm that I �ave a certlficate ol consent to salf-insuw or a carUtica[a
Wo�ken' CompenSaliOn Insurance, O/ a certNieO cOOY Inareot ($eclion
,OQ Lab. / (� Ip�
PoIItY No. JI ��DV COmPanY 1w�
Certifietl copy is �ereby furnishetl.
ertifie"tl myy.�5� e0 wltb [he city II g Divl 1 .
Date� AVP���ant
E%EMPfIOffFROM WORKERS' C NSATION DECLA0.FTION
(This section neetl not ba <ompletetl I e parmit Is for one huntlretl (E300) or
lezz).
I ce�tify tha� in tht pertOrmanCn Of tbe wo�k to� wblth thls pCrm�t iSlszueQ I
snall not employ any pe�son In any manne� so as to become suDject to t�e
Workers' Compensalion Laws of CaliPornia.
Date Si9nature
'NOTICE:If,after making lnis declaration, you shoultl bacoma sublect to the
Worken' Compensation provitlOni Oi Iha Lnbor Cotla, y0u must torthwlth
comply wilM1 Such 0/ovl5ions or ihls Da�mlt shall bo tlaematl revokeU.
CONSTRUCTION LENDING AGENCV
I nereby alllrm that t�ere Is a construction lantling agoncy for lba pertormanca
ol Ihe work far wNGh thii permil IS issuatl (SoCtion 3097 Civ. C.)
Lantler'i Name
Lantler's Adaraii
OWNER BUILDER OECLARATIOfJ
I nereby aHlrm that I am axempt from tho Coniractor's Llcanse Law for tna
following reason (Section 7031.5 Business an0 Professional Cotle: Any city or
coun[y which �equir05 a parmlt to consl�uct, al[ar, Improve, Oemollsn o� rBpair
any struclure, ptlor lo its issuance, als0 reqWreS thn applicant to� Suth p¢rmit
[O 7ile a signetl Sta[ement lna[ he/sh¢ IS Iicensed pu�suan[ to thG prOWsionS of
t0e Contra<tor•s License Law (Chapter 9(commencin9 with Section 7000) ot
Division 3 of t�e Businass antl Profossions Cotle) or that ne/zne Is exampt
tierefrom an0 t�e basis lor t�e allegetl exemptlon. Any vlolation of Section
)31.5 Dy any applicant for a permit zubjects tha applitant _to a civil
enalty of not more than tive huntlretl Oollars (5500�.
❑ I, as owner ot tne o�aperty or my employees with wa9es as Neir sole
mmpensation, will tlo lh¢ work, antl the structure Is not intentletl or ofteretl
for wle (Saction 7040, Businais antl Profa55ional CoOe: The Contractor's
Licensa Law tloes not apP1Y to an owner O/ a Oroparty who bulttl5 Or improve5
thereon, ana wno aoes sucn work himsaH/hersetl or throu9h hls or her own
em0�oy¢e5, provitletl that such ImprovOments ara nOt IntCntlaO or ottareE f0/
Sd1G. If, hOwever, t�e builtling or improvarnent I5 soltl wltbin ona y¢ar OI tOm-
pletion, the owner wlll have tna burtlan o1 proving he/she tlitl not bulla or Im-
prom tor�pe purpose o1 wle�.
❑ I, as owner O/ �he p�operty, am axclu5lvaly Contracting wlt� IlcanSeE Con-
tratiors to construct tho project (5¢ction 7044, Buslness antl Profaislons Cotle:
The Convactor'S License Law does not aPply to an owner ot property who
builtls or Improves tnereon, antl wno conVacts tar such projacts with a con-
Ira<for(51 licenirt pursuanl�to lho ConVaclor'S LICanSo Law). I am awar¢ lhat
proof O( their Worker'S Comp¢n5atlon InsUrance shoultl be prOvitlatl lo me.
L1 Pam axempt untler Seclion B. d P. C. tor th6 reason
Dale Owner
i ne�eoy certlty t�at I �ave.read this aOPlitation antl sta[e that Ne above
intormation is correct. I agrae to comDly with all city antl county ortlinances
antl state lyys rela ing to builtling construcjlon, anp �oreby aulhoNzo rapre-
zentatives bl�tbls c v tosnter uoon the abovelm�nNonad orooer[v.fo�
TYPE OF CONSTRUCTION IJ NEW LJ ADD� ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTH�rb � p�p �
DESCRIPTION OF WORK/USE OF BLDG.
5 Main Building:
TVPEOFPERMIT GRAOING FOVrvDAT STRVC7uRAL T Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ECHANICAL B Reef
❑ OTHER A
PRWECTDESCRIPTION S�.FT. OCCUPANCV C Right
K Left
CONSTRUCTION TVPE VALUATION 5 $
ZONE GRADING CU.YDS. ACRES p��y, Ref. #
0.emarks: Planning Notes:
8ar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
�rinking Fountains
=1oor Drains '
=1oor Sinks
3as Service Outlets
Interceptors
tiMhen Sink
Lavatories
�-Trap
Roof Orains �-
Reinspec[ion Fea $15
Boiler
Duct - Under'Ground
Ezhaust System ❑ Multiple ❑
Firepl/Fact.8lt. ICBO �
� Heating System & Ducting
00,000 BTU 0100,0008T
� Signatura V " ev/ � � � -
Drivers' L� e or 55 $ '�
~ Reinspection Fea
CMF 0865-46, �ev. 30/B4 White - Bulltling: Canary - Applitant; Pink - ACGounting; Goltlenrotl - ASse55or
S15
$howen
Service Sink
Sewer Cap
Sewer Connection
$olar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/SUa
Urinal
Weter Closet
Water Hearer
Water Service
Aufo�Wash
Leundry Trays
laue Fee
Hood ar Type I ❑
Canopy Type 11 ❑
Refrigeration System
Daioo,aoosru ❑ioo,000eru
System Repair/Alteration
F ire Dampers
Registers
Iswe Fea
FEES
$ 3
E 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers �Gas ❑Elec
Fan
F.A.U.
Fixtures
Device BOxes
Outlets �
Switches
Garbage Disposal
Generatoi �0.5 KW C
Fea
� 9U3"J 3/ I i /R5
Zona
Accessory
ELECTRICAL
- Trensformer ❑ 15-50 KW
O 50+KW
Metef ❑up Io 100 amps
Meter �over 100 amps
Sub Panel
Motors�0.1 HP �i'/a-8
Inc.Solar �9-15 HP �16�15*
Microwave -
Pole Lighl
Runge
' Standing Sections
5 KW Tras� Compactor
515 laue Fee
DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning Approved By
Buildi�g Appraved By _ �
%Od- Ir
,.�
�
FEES
S 3
' SUMMARV OF FEES
BUILDING7EFMIT S SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $ �
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL 5 GRADING $
P�ANCHECK 50% $ MICROFILM .$
MECHANICAL $ � TOTALFEE $ 7.d
PLAN CHECK 25% $
Z
O
N
I
N
G
R
E
�
M
T
S
CONSTRUCTION AND PLANNING . POO. SPA
�� APPROVALS Permit# Date Inspector AppROVAIS 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. Electriral 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, 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 -
i 6. Rough Elec[ric Wi�ing 67. Fenci�g & Acce:s Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fifeplace APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating 77. Produc[ Piping OGas ❑Oil
23. Gas Pipe-Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26i T�Bar Ceiling (Structurap & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe .
' 28. Lathing & Siding 77. FIXED SYSTEM FINAL
i
'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 ' ��(j .
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 pomestic-Final .
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System '
45. Sound AttenuatioP .
46. Handicap Regu�ations ' �
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed ' ' �
49. Electric Release to Edison -�- �-� �
' 50. Gas Release ro Southem California Gas Co , ' � �
51. CERTIFICATE OF OCCUPANCY . _ . -� '
No. Date ' � ,
—�O�
r,ITYl3F COS7A MESA CONST�UC�TIO/N P !D.
. ProjectAddress �_'�j 3y� �6 � �� �'�^
Applicant's Mailing Address �
Owner's Name ����. ��� Phone
Address 3Sia 'E /6'�� S%
Arch/Eng. License No.
Address . t7���
Comractor's Numeo/� ,� r S hone7F/3/�
Address (mailing) � 7
City Licensa No.
LICENSED CONTRACTOR OECLARATION
I'hereby affl�m t�at I am IiGenSetl untlar provislons of Charter 9(commencing
wi[b section ]000� of Olvislon 3 ot lhe Business antl Professions Cotle, and
my license'is In (ull t ce ntl eftecL - t�c
License ClasS, �-�� ' t�icen� rv�o �Qa /�
oate ' �% L"- � . ce�,� ,. �%J7�n,�d�
WORKERS'COMPENSATION pECLARATION �—
I M1e�eby aftirm [hat I �ave a Certificale of con5ent to Selt-Insure Or a Cer[HICat¢
pf Worke�s' Compensa[ion Insu�ance, o� a ce�titietl copY tne�eol Sect7on
3800, Lab. Q -
Policy T1 . Company
Cerfifietl Capy is be�eby tumishetl. '
Certitietl copy is tiletl with t�e city Builtlin9 DlviSiOn.
Date Applicant
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thissection neetl not be completetl it the permiFis for one huntlretl (5100) or
less). ' � � '
I certify [na[ in th¢ performance of Ihe wo�k fo� which this petm�t Is ISsuetl I
sha11 not employ any person in any manner so as t ecqf�e zyb�'�ect to t�e
Worker�Ftxn040saLo�,l.a`NS o( CalitQ[y1a� Jl..��
Date y j YT Si9nature ���4�t'`
'NOTICE: 1t, after making Ihis tleclarallon, you snoula. b�
Worke�s' CompensdtiOn Drovislons of lne L.abo� Cotle, you must torlhwi[h
compry wiN sucn provlsions or this permit shall ba tleametl rovoked.
CONSTRUCTION LENDING AGENCV
I hereby affirm that there Is a construttlon lentling agency tor the performance
of the work for which thi5 p¢rmit Is issuetl (Sectlon 3097 Civ. C.)
Lentler's Name
Lend¢r's AOtlr¢TS
OWNER BUILDER OECLARHTION
I hereby afflrm that I am exempt trom the Contractor's Licenso Law for the
following reason (Settion ]031.5 Business anE Professional Cotle: Any clry or
coun[y whicb rGqWres a pe�mlt to Construc[, alte�, ImOrOve, tlCmolizh o� �apalr
� any structure, pAor to Its' issuance, als0 req Wras tho appllcant Aor such pormit
' to iile a�signetl statement thal he/sne I5 Iiconio0 pursuant to [ha proviston5 0l
the COn[racto�'s Li<¢nSe Law (Cnapt¢r 9.(Commencin9 wilh $Ottlon 7000) oi
Division 3 of the Business and Profc55ions COUo) or tnat ho/she Is exem0�
mere(rOm and Ih¢ ba5is tOr tbe all0ge0 Oxempllon. Any v101atlon ot Soctlon
�7031.5 by any applicanl fOr a� petmil subfttti tho applicant lo a Clvil
�enalty o� not more tnan tivo nuntlretl Eollars (E500).
1, as owner af Iho pmperty or my employees wi[h wa9os as thelr solo
compensatlon, will tlo tne work, antl the sVuctura is not Intentletl or oiferetl
for sale (Section 7044, Business antl Prolessional Cotlo: The Contractor's
License law tloes nol apO�Y to an Owne� ol a p�operty wlto bulltl5 or Improves
lheteon, antl who tloes such wOrk hlm5Gl1/he�5¢It or Ihrough h15 or her own
emD�oyees, provitletl that zucn improvaments aro not intentlea or otferetl tor
sal¢. 11, however, th¢ bull�in9 0� Improvemen[ Is soltl within ona yaar ot cOm-
pletion, tne ownor will.nava the burtlen Ot P�oving he/sh¢ tlitl nOt builtl o� Im-
prove lor lhe pu�poie ot sale).
❑ I, a5 owner ol the pro0erty, am exclu5ively contracting witn IlcanS¢tl COn-
tractors to conSUuct [he project (Section 7044, Bu5Ine55 anE Prote551on5 Gatle:
The Contractor's Llcense Law doe5 nol aPply to an owner ol O�oPorty who
builtls or improv¢s thereon, antl who coniracts lor such oroia<ts with a con-
tractor(sI license Oursuant�ro tne Contractor'S Licenso Law). I am awaro thal
proof o1 their Worker's Compensation InsuranGe ihoultl be provltletl to me.
❑ 1 am exempt untler Se<tion B. 6 P. C. for thls reason
Oace � Owner
I hereby certity that I nave reai
in(ormation I5 correcL I agree [o
an0 ztate laws relatinq to builtlir
sentatives ol thiz city to enter
inspectlan purpos
Signature
Drivers' license or 55 � _.�
tate that lha abOve.
E county ortlinances
eby au[tlorize repre-
lonetl �p�rapperlpy �1or
Date�Q�Q�
to fill In all spaces ezeao� thosa wlthln heavr boraer Ilnes ana sign all apProvrlate tleclarations.
0
TVPE OF CONSTRUCTION C�I NEW' U ADD LJ ALTERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH O OTHER A p �y
DESCRIPTION OF WORK/USE OF BLDG. -
� � S Main Buildi
E
TVPEOFPERMIT GRAOIrvG FOUNDATION S7aVCTURAL T Ffont
❑ TENANT � ELECTRICAL ❑ P�UMBING ❑ MECHANICAL B Rear
❑ OTHER A
PROJECT DESCRIPTION Sa. F7, oCCUanrvCv C Right
K
CONSTRVCTION TVPE VALUATION S ?S�O •�a S Left
ZONE GRADING CV.YDS. � ACRES p�ng. Ret. #
Remarks: G r Planning Notes:
Sink
Preventer
Irrigation
rinking Fountains '
loor Diains
loor SinkS
asService OuUets
Kitchen Sink
Lavatories
Roof Drains
� Showers
� Service Sink �
Sewer Cap
� Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal -
� Water Closet
Water Heater �
Wacer Service
Auto-Wash
Reinspaetion Fea I 515
Boiler
Duct - Under Ground
Duct - Structural
Duct � Ventilating �
Exhaust System ❑ MWtiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
O ai oo,000 eTu � i oo,000 eri
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 White - guiltling; Canary - Appllwnt; Plnk - Accountln9: Goltlenrotl - Asse55or
Isue Fee
Hood or Type I �
Canopy Typeli��
Refrigeration System
00.100,OOOBTU ❑100,000
System RepaidAtteretion
Fire Damperz
Registers �
Issue Fee
0
ES
5 3
$ 3
Automatic Washer
ConStruc[ion Pole Sub.
Cooking Unit
Dishwasher
�+/VV ��UM/.I�/
Zone
AccessOry Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 75-50KW�
❑ 50 + KW
Dryers L1Gas � IJElecttic
Fan '
F.A.U.
Fixtures '
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �0�5 KW �5-15 KW
Meter RQup to 100 amps ;
Meter ❑over100amps
Sub Panel
Motors �0.1 HP �7'h-8
Inc.Solar �9�15 HP �16�15+
Microwave
Pole Light � �
Range
! Standing Settions
Trash Compacwr
.�ru �
Z
O
N
1
N
G
R
E
Q
M
T
S
FEES
�
�
I Reinspection Fee � 315 � � Issue Fee I $ 3 I
DEVELOPMENT SERVICES REQUIREMENTS:� '
Zoning Approved By Date
Building Approvad By Oate � g
Application luuad By � I Dat
SUMMARV OF FEES �
BUILDING PERMIT $ SMIP � q �
PLAN CHECK - $ PERMIT
' PLUMBING § �SSUANCE 3
PLAN CHECK 25% $ ENE(iGY P.C. 5
ELECTRICAL $ _S� GRADING $ �
PLANCHECK 50°,6 $ MICROFILM $ �
MECHANICAL $ TOTALFEE $ O
PLAN CHECK 25% $ �
-.-
CONSTRUCTION AND PLANNING POOL & SPA
A'PPROVPLS Permit# Oate Inspector ,4PpROVALS Permit# Date Inspecror
� •
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-Undrgmd. f
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
1�. Property Sewer Line &.House Connection 62. Backwash & Receptor-Final
. Sewer Caa '� ' 63. Heater & Vent-Final
'I� Roof Drains 64. Plumbing System - Final
74. Rough Plumbing 65. Electrical-Final
15. Rough ElBctrical-Conduit 66. Solar System-Final
16.' Rough Electric Wiring .[� y Ks ���c 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
18: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. 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 She2thing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. FrameandFlashing 76. DryStandpipe
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. Flnai Factory Firepiace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation .
44. Landscape Irrigation System
45. Sound A[tenua[ion
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING _
48. Special Fequirements Completed
49. Electric Release to Edison -
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
Nn. Date
�^
� AVYlicant to Ii�� �� all spaces wit�in �eavy Dortler Iinas anE si9n all appropriata Geclaratlons.
S� CITY�OF COSTA-MESP �' vea T NO. � TRA�T NO. LO��T N„O.� �BLDG. NO.
�'!:`%!;;f9TRUCTIONPERMIT �j �2 "'�'"'
.'Pioject Address , � } j� �{ • TV�E OF CONSTRUCTION
OWnCf � G P��� " ��•� �I NEW ❑ ADD ❑ ALTERATION
Addres () h P i�+�y � ❑ REPAI0. ❑ CONVERSION ❑DEMOLISH
Arch/Eng. nUp � License No. �(�� y3 ❑ OTHER
Address j'��5 ��{��SC• • �. DESCRIPTIONOFWORK
Contrecror .� �c Phoneq y$N( TVPE OF PERMIT
Add�e55 ({ - �, � ' �, /�A ❑ G�RADiNG ❑ FOUNDATION � STRUyC�T��URAL
LICENSED CONTRACTOR �ECLARATION ❑ TENANT �, ELECTRICAL/S�PLVMBING .LY�ECHAI
I neroDy aflirm t�at I am IlcenieG untler OroviS�a�i ot Charter 9(tom-
mencln9 wlth sectlon 7000) o/ Dlvlslon 3 0� the Businass antl ❑ pTMER
Aofestlons CoCe,^ antl my Iitense Is In (ull /orce anC e/fect, pROJECT DESCRIPTION
Lltenu Class `�'' IJcenSe No.�'M�yl' /t ��
Date ���5'�� Slqnaturo 5Q'�' �� �
WORKERS' COMPENSATION DECLARATION OCCUPANC�V_CONSTRVCTION TVPE
1 haraby aHlrm that 1 have a certlficate of co�sent to self-insure or a; VALVATIO� �������� ZONE
corilticate ot Workers' Compansatbn Insuran�e, or a tertNiatl copy
thereof ($BCtlon 3800, Ldb. .). `J � -�---� GRADING CV. VDS. ACRES
-��icvno. WPi�kivU-'9��moany �'Yw�
�Brtl/ied Copy is nereby furnlshetl. REMARKS:
, Certl/l¢tl copy I5 fileC wlth the city BuilGin9 Divislon.
EXEMVTION FROM WORKERS' COMPENSRT�ON DECLARATION
(Tnls Settlon naeC not be CompleteC N t�e pelmit IS tor one hunGreG
SE100) or leul.
certlfy that ln t�a performante of tha work lor whic� t�is permi[ I5
IssueC I shall nol emPloy.any parson In any rN��er so ai la become PLUMBING PI.AN CMECK
sub�ec� to the Workers Compensation Laws of Glitarnla.
Date Signature BATHTU85 SHOWERS
NOTICE: If a(tar making this daclaratlon, you z�ou10 betoma subjec[ TOILETS URINALS
to �hB WOfktfS' CArtIpGflShcloO plOv151an5 of t11P ldEof COEe, y0u Tuit
/orthwith comply witn such provislons or this Vermit ihall be ticemetl LAVATORIES DOUBLE LAVS
�evOkBtl.
CONSTRUCTION LENDING AGENCV KIT. SINKS DISHWASHERS
1 �ereby affirm that thera I5 a conitructlon lentling agency lor th¢ per- SERVICE SINKS SUMPS
/ormante of lha ork fOr whith this Oermit IS I E(Settion 3097
���' C'�' ��-[r "�T�„� O�Q�,��-0 FLOOR SINKS FLOOR DRAINS
I.BnOGf'z NdmO ��y ,,��
Lentler'S nae.csL�uo� �L' ""�^'�� DRINKING FOVNTAINS
OWNER BUIIOER DECLARATION INTERCE CLARIFIERS
I hareby aflirm lhat I am axempt Irom t�a Cont�actor's License law (or
tha following reason (Sectlon 7031.5 Businasz anC Rofessions CoEe: �SWIMMING OOL P TRAP
Anv dlv ar countv whicb reauires a oerm�t to <onilruct. alter,
�OSI�lSS dntl PldM51005 COCI
�:�5 lor lno allogetl oxBmD��
�.gdpp�l�ant lo� a permlt �.
,';'<ot more than 1iw buntlr�
I��I, LS ow0e� ol lbe prope�
Sole ComDonsallon, will tlo th
or of/er¢tl tor ule.(Sattlon 7
Contractor's U<enie Law tlo�
who �ulltli Of ITprOV85 thlrl
IhrOugh hli Own amployecz, I
intennce or ottcrea br saic. i
Is soltl within onu year ot cor
of Droving he tlIC not buil�
❑ I, as ownel Of tt10 p�0
Iicensetl contractors to wnsti
antl ProtMSionS Code: Tha G[
an owner ol prOparty wno �
tratts trom such pro7ects wi
the Conlractor's License Law)
❑ I am exempt untler SeCtion
reason
Date Owner
� itrutWre, prlo/ to its issuance, aiso re•
i�mR to iHe a sf9^� statament ihal ha
dslons of the Ctl�baCtorY Litense Law
i Sectlon 7000) ot Division 3 ot tha
OI �hat IIG IslxOfllpl th8ralrOT antl th8
i. qny Wolatlon at Section 7031.5 by
b�ectz t�e applicaM to a civll penalty
tlollars (5500).
�, or my omployecs with wagas as thelr
work, antl Iho s�rutture Is not Intentletl
64, Busineii and �olesslons CoCe: T�a
nol apply t0 d� ��+'�ar ot a prope�ty
n, antl w110 tl00'S sUth wOrk hlTiQl/ Or
avipotl t�al sUcp Imp�OVCments are nOt
�Oweveq th0 builaing or Improvoment
�Ietlon, the owner wlll hava �ne burtlan
Or ImprOvO tOr thB purpOSB o1 ShcO).
�.rty, am exclus��ly contracting with
ct lhe pro�ett (�«�on 7044, Buiineis
lractor'S LlCensO Lav+tloai not appty to
Itls or Improves thereon, antl w�o con-
i a conlrac[or(z) Iicesnetl pursuant to
8. 6 P. C. Por thi5
1 �lreby ttrtlfy Ihat I hava redtl thli appliCatiOn A�tl Stdle lhat th¢ dbOva
Slgnature �
Drivers' Llten�
CMF 0865�46
a9ree to comply wl�h all city and county
elatlng to con5tructloP, antl nereby authorize
Ity to enler upon the above mentionetl
ourpatts. �
�%
' i55UE FEF
White-Builtling; Canary-AppllWnt; Pink-Accounting; Goltlenrotl-Asse55or
9369 7/14/�,i 164e49 Tl
ZONE
HI� HY. ... _
RENR VARD (TO �/1
PKG. SPACE RE�.
STREET WIDTH
SPECIAL CONDITIONS:
ELECTRICAL
PROVIDED
PARK FEE E
PLAN CHECK
GENERATOR 0-1 KW_1-30 KW _
TRANSFORMER
APPLIANCE 10-SOKW_SO+KW_
MOTORS 0-1 HP_1-10 HP _
(INC. SOLARI 10-50 HP 50 4 HP _
FI%TURES OUTLETS SWITCHES
GAS TVBE SIGNS
POLE LIGHTS
PANELS MAIN SUB
SERVICE AMP
t55UE
APPROVED BV
SUMMARY OF FEES � J
BVILDING Q� �� ��
PERMIT SS�2j�,..1�L!n SMIP S
PLANCHECK Sy,��✓ PERMIT
PLVMBING E y � ISSUANCE E
PLANCHECK s�—�--- GRADING E
ELECTRICAL SJ� s
PLAN CHECK E MICROFILM E
MECHANICAL S � TOTHL FEE S
PLAN CHEGK y LE55 AD-
VANCEPC b
FINALFEE SvcsP.%•T�
CONSTRUCTION AND PLANNING - . POOL & SPA ' , � •� ro
.�--'.,
APPROVALS Permit # Date Inspector qppROVALS p���;,' � - Date ►nspep�Os��
i. Temporary Electrical Service or Pole 43. Pool & Equipment Location - •
Soi ipe-Un rgrn 44. Steel Reinforcement � �-� G
3. Eiectrical Conduit Utility-Undrgm - 45. Forms •� •
4. Electriral Conduit-Undrgrn � 46. Electrical Bonding ut 1 .G
. tea ein orce . 47. Rou h Plumbin & Pressure Test -' -
6. Electrical UFER Grn " 46. APPROVALTO COVER-GUNITE -5 L I� '
7. Footings 49. Electrical Conduit-Undr rn
' 8. Foundation � � � 50. Gas Pi e, �'�Jndr rn, Test � �5-fi L �
9. Water Pipe•Undrgrn � 57. �Backwash ines P-Tra ❑ ndr rn �-'"�8
10. Structural Floor System 52. APPROVALTO DECK C�
� 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � �
12� � Street Sewer Connection - 54. Heater & Vent-Final '
13. Rough Plumbing
14. Rough Electric-Conduit - � �56. ElecVical-Final
15. Rou h Electric•Wiring �� � 57. Solar System-Final � •
16. Rough Heating & Air Conditioning � • encing & Access Approval
17. Ducts in Structure ' APPROVED FOR PLASTERING p- �$j
18. Ducts, Ventilating � � �
19. Gas Pipe•Rough & Test - 60. POOL/SPA SYSTEMS FINAL ��7 r �,7G
20. Roof Framing � ' d'd) ��'
21. Roof Sheathin � �
22. Frame and Flashin ' NOTES: , � �
23. �nsulation ' � � -
24. Lathin & Siding ' � �
25. Drywall Nailing
� 26. Plaster Brown Coat ' - � �
27. Electrical Power Meter-Final � �
28. Pinal Electric ' - � �
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test �
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Final
� �34. $olar pomesticFinal '
, 35. �Landsca e S rinklin S stem
36. Sound Attenuation
37. Handicap Regulations
38. FINALSTRUCTURE&BUILDING
' 39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co. -
42. CERTIFICATE OF OCCUPANCY
L No Date .
P�oject Address �1'LJ C
A.P. Number 40� g —
Building Permit Number _
Owner's Name �
Mailing Address _
FEE:
CITY OF COSTA MESA
PARK FEES
Fee Payment Receipt
Single Family'
2-Bedrooms or Less
3Bedrooms
4-Bedrooms
5-Bedrooms +
Multiple Family "
Bachelor or Studio
1-Bedroom
2-Bedroom -
3-Bedrooms +
Park Area
8256 2/27/85 474o3Y TL
N° � 980 ' -
Number of Units
@ $ 861.76 =
@ 1,205.67 =
@ 1,545.62 �
@ 1,810.50 =
�_ @ 474.37 = � ��. 3 i
@ 573.18 =
@ 881.51 =
@ 1,229.38 =
Total Fee "• '��`-'�37
Planning Department Approval Da e�L 1 O� By G4A.WCJ�W
ApplicanYs Signature +
• City Ortlinanca 72-46 •• Clty Ortllnance •65 ••' City Resolutlon 78-116
CMF 037432 Rav. 6/79 Wnita—Planning; Canary—Plannlnq; Pink—Finan<e; Goltlenrotl—ADP�Icant
.
1
/
CO�S�GJ �lEsa
JOB ADDRESS
INSPECTIONS I DATE
SUBCONTRACTOR
OCCUPANCY
VALUE
PERMIT NO.
Form 210—SM-11-59 5-B P �
• ll�m
, - �,�.µ�'r.i�
;:�.
COSTA MESA BUILDING-SAFETY DEPARTMENT
� r. a. eox st� COBTA MBBA. CALIFORNIA
For dpplicanf io Fill In Complefely
TYPE OR PRINT
ADDRE'8S ✓ I � E Ib �J a'�
COSTA MESA. CALIFORNIA
♦
56G3
� �: �/►'% 1 `� ?-�7
�I�OuI �� NeW�nN 1009.
BBTBAGK LINE FPOM ��
ceeiiaw OP 8'�1+E[�' I.� REAR YARD
I /
SIDE YARD LEFT �S RIGHT �
QESCRIPTION OF WORK
.._.. I` II.._��._._..li�ll.��._._..
T
IOR
��E I�ECE�VED
�.�'. �/-G- � a
(�6�`1�E DFF�.
APPLICATION�R(F{EKFif(idl� �
sua�iN�
For Office Use Only
NECEIPT NO. � T NO.
�!Y I OA`RF�CEIVFy I 116 EQ��
4 <✓ O H / (/
a . /� �y l-
COSTA MESA. CALIFORNIA
,� _,
FIRE
ZONE �1 TYPE - G
APPR E �
BY ♦ TE
Z ING
2q1P� NO. OF USE OF �
� PUNS BUILDING
J L�
LHGAL � . t � \ � C
A. P. NO. � �' Y �
YARDS EVES
— APPROVED A4L0
�� (C6NT8R LINB 8T.)� _ ,
�
FMDpEL .�XISTiNG G.4RN C-�` Ta .SoZcQ Q' � a� �
i
SEw�n,c /2�0 . 3/.S �� � �� _
1 HEflEBY ACKNOWLEDGE TXAT 1 HAVH pAAD TX�9 MPLIGTION TX8 �MOUNT 9HOWN UNDER VALUATION �e FOR TNE
AN� eTATE THAT TXE ABOVH IB CORP¢GT AND AORC6 TO COM- pURPO6E OF 88TA9LIBHING A PERNIT FEe ONLY.
PLY WITH pLL CITY OMINANCEB AND BTATE LAW9 REOULATINO
BUILnIN6 CONBiAUCT10N. � VALUATION � �a� C
61GNATURE �F PERMIT FEE $
PERMITiE / 'J � T 6� �
_ $ J/ J�10 • o PLAN CHEGK �—
AUTHORREP AGENT z, z.l �
TOTAL FEE ��
3.,f- . i c!C.r
OWNER CARUSEFLE, MLCHAEL J. DAT� 6-8-59
JOB ADDRESS 31t0 East 1 tri St. BUILDING PERiHIT ArO. 9$�=3
GENERAL CONTRACTOR �er-Builder VALUE S �
AP. No. 11 i -
INSPECTIONS
on7E � GROUP 1 TYPE
�'3 3 — SUBCONTRACTOR
a�-- —��--I DATE NUMBER___
�
, , 9543
�OSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 3f� COSTA MESA, CALIFORNIA
FOR APPI/CANT TO f/LL /N COMPLfTEIY
TYPE OR PRINT
BUILDING •�f . _ r _ _ %�?N r'•-/
COSTA MESA. CALIFORNIA
1 CITY
��ecwl ILOT
OE6CRIPTION NO.
�SIZ[
OF LOT
Y 5£T9ACN LINE FROM
■1�1I�.:
TEL.
FIRE
. �� �����.o � �� �
��g...sy
FINANCE DEPT. '� `''
e��n
APPLIGATIO'NCFOFt rPERMIT
BUILDING
fOR Off/CE USf ONLY
ING
ar
COSTA MESA. CALIFORNIA
ZONING ��C�� <<
IT4�� ZONE NO.OF IUSEOFNEW
dA � Pu�a y a�,�o,�a
— / APPROVED _
BY / � DATE Cj
Irvo. oP etncs. yqRDS E S
rvoW orv �oi REOUIRED ALLOWED
(CENTER LINE ST.) � �
�
LEFT � •� RiGHT �.
DESCRIPTION OF WORK
NO.OF
ROOMS
�IF-11.T�
1 HHNBBY RCKNOWLEOGE THAT 1 H�VE READ TN18 APPLILATION
pNO BTATE TMM1T THE /�BOVE IS CORFER �ND AfiREE TO COM� TNQ AMOUNT HMOWN UNOER VILUATION 18 FOR THE
PLY WITH ALl <ITY Ofl�INANCEB ANO STR LAWS HEOULATING PUFPOSE OF ESfABLIBHINO • PERMIT PE6 ONLY.
BOILOING CONSTRUCTION. VALUATION
SIGNATURE OF PERMIT FEE $ �
PERMITTEE � /
S �/�� PLAN CHEGK $ /(,. �'
/ / f�_
AUTHORIZED AGENT TAL FEE S/�/ �
OW NER CARUSELLE, MICHAEL & ALICE �✓ onre 5-27-55
.JOBADDRESS �uO E. ZGt}I St. BUILDINCaPERMITNO. 1339
GENERALCONTRACTOR �er-Builder VALUE $ 32•��
���
�1 ZONE �l
Livine. Room Addition 18 X 22
INSPECTIONS
I DATE I SUBCONTRACTOR I �'ERMITSISSUED
Foundation Formsand Gradeto
Rough Framing
Plumbing, Rough to Slab �
Plumbing, Rough Complete /
Temoorarv Pole
House Sewer, St.
Lathing, In Out
f ering
Plumbina. Final GasTest
Occupancy
A'orm'l]
,� Costa Mesa, Building Department -L�SS APPIdCATION FOR PERMIT
�� 111 EAST 20th STREET B U 1 L D,! N G '
' � � COSTA MESA, CALIFORNIA
FOR OFFICE USE ONLY
FOR APPLICANT TO FILI. IN Receipt No. Pe�,,,it No.
Bullding
wddress 3 O �T 6 T—" -- �33 �/
Costa, Mesa, California Reo 'ved by Date Rec'd. Date Issued
Nearest I `� � �� ` IS ^'� ��
Cross St. Buildi /
Addr � — /f�
owner v = Costa Mesa, �'i&I1fOPII18,
Mail
edd..�a ?t/n Fa.— �L T�`1 �' � • Nnarest
"ddress
mtractor
Size
B
Siie
e
/f
V�
No.
City Lic.
�.�u �o,�No.
Lot
No. I Block I Tract
and Bounda)
L' No. of Bldgs
' ��,�p Now on Lot � �
No.of � No.oi
tjjk�/,/N� I Famtlles Room
�om Rear Vard
t �X. Side vard �
ICR ON OF WORH
IAlteration I I Addition
I Moving I I Demoiish
No. oT
I hereby acknowledge
and state that the abo
with all City Ordina�
building construMion///.111
Signature o�
Permittee
Authorized Agt.
/
Valuation �0
$ �y
r..ou ana r.�w ou s-sa
ns, Materials,
:r-Pinning
: Fi re Stops,
that I have read this Application
ve is rnrrect and agree to comply Lath. Ext
ices and State Laws regulating
/� Plaster, Int.
��� 6R.°�et�� plaster. Ext
Plan
� FINAL
w
O
A
�
2
a
r
Show loeation and distances from
property line and between huildings
N
,, . . .. . ..., �
OWNER CAtUT$ELLE, MICHAEL J. DATE 'j_9_5(!
JOBADDRE&S 34WE. 16TH STREET BUILDINGPERMITNO. 39�
GENERALCONTRACTOR HICKORY HOMGS VALUE $ 8�1%S•OO
� P,�117-231-5 BLOCK TRACT _((esid@RC0
INSPECTIONS I_D�TE/ I SUBCONTRACTOR I DATE PIRMITS�NUUM6i
!
Foundation Forms and Gi
Rough Framing
Plumbing, Rough to Slab
Plumbing, Rough Comple
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
Sewer
Septic 7ank or esspool
L g j,�/ O u -
Plas�ering
Plumbing, Final, Fixtures
Plumbing, Fi�l Gas Test
Wiring, Final
Occupancy a
P'orm 'Lt0 GH IDI 12.68
r•s
C'osta Mesa Building Department APPLICATION FOR PERMIT
� � � 111 EAST 20th STREET
� � COSTA MESA, CALIFORNIA ��� --------6 U I L.D l.N G. _. ___'.
� FOR APi'LICANT TO FILL IN� �OR OF�ICE USE ONLY
� Recei t o. Permit No. ; I
Buii�ing �n (�� ��1 � � '- `y C/
Ad��ess 34x';_ 16t�'1 �- j' �(a.� i 1; r( �!�� '
Rece�ved�by, Date Rec'd. Date Isaued �
Costa 1VYesa, Galifornia � , , Q
Nearest � /�� `
crosssc. Santa Ana & Tustin e��ia��y / ,�]
Address iF � [� � ,�l�i" �
Owner Michael J.Caruselle ' Costa Mesa, California � �
Mail �
Address 3��] �2Y1C1. $t,l'08t. Nearest �
Tel. Cross St. i
City Newport Beach No. none Zon No. of Type 1 / I Group/ '
Architector Lic. ��� I P�ans I ✓ � ,[ '
Engineer No. Approved� �
by � Dale —
•ddress � CORRECTIONS �
c�tY uo.
_antrector Hickory Homas Na• 220 � '
Address zl�j(� Newuort BZVCl.. (i'.M. �
�-:� Le9�l Lot � � �/v i _' _ � :
Description I No. 21 I Block I TreCt 4�2 �
(Attach Metes and Bo�s) 1�..7.- �� �— s . � - �
No. of Bidga �
; � .
Size of Lot �� � X 135 � I Mow on Lot I70I78 _ 2•'� -- — � _ �
Use ot I No. ot I No. of ' � ^ ' �� ��. 77
Existing Bldg. F.amilies Rooms -- � � �
Setback Linefrom r Rear Vard ' ' --' �� �����- —
Center of Street 7� � Side Vard ��&1. �� . � D
DESCRIP7`ION OF WORii r' k' r
�
New I% I Alteretion I I Addition I
Repair I I Moving I I Demolish I �
.-, Building � No. of C
�ize 958Sq.F''�",. Rooms 7 Stories �.
[erior Wall $tUCC�OBC Rooi
,vering_ $gdwood I Covering Shake APPR,QVA�'
Use of New Foundation Location Inspector Date
Ruilding Resi��n�e Forms,Materials,
Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
Lath.lnt.
d hereby acknowledge that I have read this Application
znd state that the above is correct and agree to comply Lath. Ext.
with all City Ordinances and State Laws regulating
building construction. � �
Piaster, int.
Signature of ,
Permittee Plaster, Ext.
Authcrized Agt.
Masonry Reinforced
Valu.ation Permit Fee $
Plan Check $ � � Bond Beam
$ 8175. �0 Toial �^� U
Fee $ / FINAL
. u �
C � O
J � �
a J
.� d
a �
. a
%'�-
;- t:,F � . ._.
y :r� -
S 3treet
, ;, _i„PLOT PLAN
-:. -�+cfi �' 1 1:' `: i :
9how^'location, and�.distaneesi from
property line and between buildings.
' '.f s::',*..
t:{: „�
... ear..�:u.:a,.
_ l:ro�:,p.i:`.�_ :
, a ^ . .a.
%:,_ ..�,�..` �`
,x%� :+tiiiw'
.i� .
'., . "�OSTA.MESA BUILDING—SAFETY DEPAHTMENT
� P.O. BOX 1200
Costa Mesa, California
ADDRE55 � 6O% CF165'Yf1G1"F Si'. �r��
arr Alhambra TE�. r+o.282-0315
STATE LICENSE NO. Z29S4% ClASi (��� n
CITV LICENSE NO. � Z�O�
NO. II�M IACN IEIf
Dwcllinq, Sq. Ft. S
Garoge, Sq. Ft.
Fint p0 Ovtlen, soch
O��lat�, Addilional
Fint 20 Fiamn�, each
Fiaturn, Additional
Dryer
Fan
Heoter
Oven, Domesfic
Gole, Conanu�tion
Range, Demeatic
� Mitc.. W7Sf12f'
� � �� 87fID SI
Moron �See Schedulal
NP
HP
HP
Matan, ao.
Permif Fee
Suh-To1ol FNt
io�ol Faas
R
�
517�?3 9/ i ^/C I
TRACi NO. (iEC'O BY
LOT NO.
BUILDING USE
340 E. 16th St.
COSTA MES�, GIIFORNIA
.' ' TI
,
PERMIT NO.
DATE ISSUED
�—lO—$/
cirv rEi. No. 54�3304
I HEREBY A[KNOWIEDGE 7HA7 I XAVE READ THIS �YVU-
— CATION AND STATE TMAi TXE ABOVE IS CORRECT AND AGREE
TO COMPLY WITN AlL CITY ORDIN�NCES AND STATE LAWS REG�
UTATING EIECTRICAI WIRING.
1 CERiIFY THAT i POSSE55 THE AlOVE V�IIU STATE OF
CALIFOYNIA CIASSIFIGTION 00. 1 AM TNE LECAI OWNER OF
� TXE SINGIE fAMIIY RESIDENTIAL PROPERTY DESCRIlED A60VE.
SlpmNr� of y, � – / '. 1(J ,� ���,
VEYMITTEE O �. l��V'+�L.J
NO. ITEM lACM IIEf
Sipn 6 1 Tran�. 1.00
Transfarman KW
� � � ��
5 � Ganaratara I(�N
Sub�Total Fee�
APPROVALS
iMncrt
TEMF. POIE
UNDERGROUND CONDUIT
� 00 e..�r,. i
�p� eU �� For items not listed refer to Fee Schedule B�DG. PERMIT NO. _