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Home My WebLink About455 16TH PL - Building Permits(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 455 16TH PL Suite No Vicinity: KITCHEN Parcel Number: 42515116 Applicant: IVERSON, ELAINE Address: 455 E 16TH PL COSTA MESA, CA Owner: LINDSEY, JOHN S Address: 455 E 16TH PL COSTA MESA, CA Contrector: Address: MECHANICAL PERMIT Phone: Zip: 92627-3216 Phone: Zip: 92627-3216 Phone: 2ip: License: Status: ISSUED Applied: 07/01I2003 Issued: 10/16/2003 �,. � � • ✓. � � SCOPE OF PERMIT REF: 803-01120. ADD 85 S�. FT FIRST FLOOR TO EXISTING SFR. SCOPE OF WORK TO INCLUDE: EXTENSION OF KITCHEN. MECHANICAL TO INCLUDE: 1 HOOD W/ MECH EXHAUST. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Re(rig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV BOx Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > t0000ctm Floor Fumace Floor or Suspend Heater $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.65 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refngeration Unit Ventillation System Evaporative Cooler Commercial I n cinerator Domestic Incinerator Compressors I Absorption Systems Upto3hp./t00kBTU 3To15hp/SOOkBTU 75 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspecdon Fee Quantity $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 so.00 0 ao.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 so.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 $0.00 ao.00 NOTICE: The work authorized by this permit shall comply with all applicabla hantlicap access requirements under California statutes and related regulations. (Ord. No. 92•2B, § 7, 1241-92) EXPIRATION: This parmit shall automatically expire and become void if work is not commenced within 780 days, or If work Is suspended or abandoned for a period of 1 BO days. � INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with a�appli ac ble codes, and all requlred Inapections antl flnal approval mus� be obtained. Failure to obtain inspections and final approval will result in t e�expiretion ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2aaaae �eroo� WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty oi perjury one of ihe tollowing decleretions: ❑ I heve end wlll mainteln e cetliflcale of consent to self-Insure br workers' compenseHon, as provided for by section 3700 of Ihe Labor Code, lor the pertormence of the work for wMc� t�is permit Is issuetl. ❑ I have and wlll maintein workers' compensatlon Insurence, es requiretl Dy section 3700 af the labor Cotle, for the peAormance of t�e work for whlch this pertnll is issued. My workers' compensetlon Insurence cerrler entl policy numher ere: Certiec Policy Number. (This secfion need not be comp/eted I! fhe permi( is veluetl et one hundred dollars ($100) ar less.) '�I,certity the� in the peAormance t for which this permit is issued, I shall not employ eny person in eny manner so es to become subject to the workars' �—compensetlon laws of Calif d ee t Fi� sh ultl Dewme sub�act to Ihe workers' compensation pmNsions ol Sectlon 3700 oi the Lebor Code, I s�ell fotlhwlth comply wlth these rov' i� y� Applieenf5ignatura: fDate: a�(J��(/ � WARNINOoFAILURETOSE ENSATIIXJWVERAOEISUNLAWFULANDSMALLSUBJECTANEMPLOYERTOCRIMINALPENALTIESANDCIVILFINESUPTOONENUNDRED THWSAND DOLIARE (5100,ODD), IN ADDfTION TO THE WST OF COMPENSATION, DAMAGES AS PROVIDED F-0R IN SECTIOtJ 3�O60F THE LABOR ODDE.IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirtn Ihat I em IicenseA untler provisions oi Chapier 9(commencing with Sec�ion 7000) of Divisian 3 0l the Business and Professions Cotle, entl my Ilcense Is in full torce and eNect. LJa a Gless a Contrector's Slgnaiure: Date: CONS7RUC710N LENDING AGENCY: ❑ I hareby eMirtn Ihat there is e construdion lentling egency br ihe pertortnance ot t�e work tor which Ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lentlers Name: Lenders Address: Siqneture: Dete: OWNER-BUILDER DECLARATIONS: I hereby aRirm thet under penelry ot per�ury thet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for Ihe lallowing reason (Sec. 7031.5, Buslness entl Professions Cotle: Any ciry or county which requires e permit to canstruct, elter, Improve, demolish, or repair any structure, O�or to its Issuance, also requires t�e applicant far such permit to file a signetl statement thet �e or she Is Ilcensed pursuam to the pmvislons ot the Contrectors License Lsw (Chapter 9(commencing with Sectlon 7000) of Dldslon 3 of t�e Business end Professions Code) or that he or she Is e:empt therefmm and Ihe basis for the alleged exemptlon. Any violetlon of Sectlon 7031.5 by eny appllcant for e pertnit sub�ects the applicant to e civll penalry ot not more Ihen five huntlred tlollers ($500).): ❑ I, as owner ol the properry, or my employees wlth weges es their sole compensatlon, WILL DO TXE WORK, antl the structure Is not Intentletl or ofleretl for sale (Sec. 7044, Business and Professions Cotle: The Contrectors Llcensa Lew does not apply to en owner of propeny who builtls or improves thareon, and w�o tloes such work himself or herself or t�rough his or her own employees, provided Ihat such improvements are not Intended o� oHared lor sele. II, however, ihe buiiding or improvement Is sold within one year ot completion, the owner-builder will have ihe burden of proving that he or s�e did not build or improve tor purpose oi sale.). • ❑ I, es owner ot the proparty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Protessions Cotle: The contractors Llcense Lew does not epply to en owner ot property who bullds or improves thereon, and who conirecls /or such pro�act wlth e conirecbr(s) license pursuent to t�e Contractors License Laws.). ❑ I em exempt under sec. Siqnelure: Owner ID veAfled by dnvers license. ❑ Ves � No Business antl Protassions Code for Ihis reeson: Verlllcetion at Ownership by (type oi document, i.e. - properry �ax blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMITCER7IFICA710N: Drivers License No. Date: Expires: ❑ I hereby certity ihat no excavation live (5) or more teet in depth into which a person is required ta tlescenq wlll be mede In connectlon with work eutharizad by Ihis 9 pertnit, and Ihat no buildinp siruciure, scalloltling, telsework, ar demolition or dismantling Ihereoi, will be more then ihiny-six (36) feet high. (Chep. 3.2, Grp 2, Art 2, Sec. 341, lltle B, Celtlomle Administrative Cade). ❑ As ownerbuilder, I will not employ enyone ro da work which woultl require a permit trom the Division of IntlusMel Satery, es noted above, unleu such person hes e pertnit to do such work Irom Ihe division. Signature: Division of Indusinal Satery Pertnit Number: Date: CEHTIFlCAlE OF COMPLIANCE AND AUTMORVJITION OF EMRY: I certify under penelry of perjury Ihat I have read this application end state thet the intortnetion given Is wrrect. I agrae to comply wlth all stete lews entl ciry ortllnances relating to tuiltling conslruction, end authonze representatives of Ihe Ciry of Cosla Mesa to enter upon Ihe above-described property for InsDection purposes. I egree not to occupy or allaw occupancy of any building authorizetl by lhis permi� until finel inspection. COQE �. MSVELTIONTYPE 1618 Flxetl System Finel Flre PravenNon 1288 Pool Spe Final 200 Final Re-Rool 201 Finel BIocWRetalning Well 202 Flnel FedOry Fire Place 203 Finel Sign 204 Finel Demolition Qe¢, Qjj�$ �� INSPECTIONTYPE 20fi Final Mechenlwl 208 Flnal Plumbing 270 Final Eletlrical 212 Final Fire Preventlon 220 Final Plenning Approval 222 Final Slte 250 Final Buildinq/Occupency (714) 754-5273 • Fax (714) 754-4856 • wv+w.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 455 16TH PL Suite No Vicinity: KITCHEN Parcel Nunmber: 42515176 Applicant: IVERSON, ELAINE Address: 455 E 16TH PL COSTA MESA, CA Owner: LINDSEY, JOHN S Address 455 E 16TH PL COSTA MESA, CA Contractor: Address: • Arch / Eng : Address: ISSUE FEE Backfiow irtigation BackFlow Preventer Bathtub Clarifier System Connecl (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof PLUMBING PERMIT ISSUED BY: Phone: Zip: 926273216 Phone: Zip: 926273216 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 07/01/2003 Issued: 10/16I2003 SCOPE OF PERMIT REF: B03-01720. ADD 85 SQ. FT FIRST FLOOR TO EXISTING SFR. SCOPE OF WORK TO INCLUDE: EXTENSION OF KITCHEN. PLUMBING TO INCLUDE: 1 DISHWASHER, 1 GAS (1-0 OUTLETS), 1 KITCHEN SINK, 1 WASTE AND VENTSYSTEM. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 so.00 $O.OD $0.00 FEE SUMMARY QTY AMT Laundry Tub / Washer $0.00 0 Landscape Irrigalion $0.00 0 P-Trap $0.00 0 Pressure Regulator $0.00 0 Process Piping (per 10 k) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 1 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Sel Waste and Vent System Water Closet (Toilet) Waler Heater / vent AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 7 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended Or abandoned for a period of 180 days. // INSPECTIONS: In order tor Ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in �he expiration ot thfs permit. FOR INSPECTIONS CALL: (714) 7545626 2448d8 (fl�00) WORKERS'COMPENSAnON DECLARAnON: I �ereDy ettirm under penelty of per�ury one o1 ihe tolloWing tlecleretlons: ❑ I heve entl wlll melntaln e cenlflcete oi wnsent to self-Insure for workers' compensetion, es provided for by section 3700 oi the Labor Code, br Ihe peAortnence of Ihe work lor whiCh this pertnit Is Issued. ❑ I have and will maintein workers' compensation InSurance, as requiretl by sectlon 3700 ot Ne Lebor Cotle, for ihe peAortnance ot t�e work for which this pertnit is issuetl. My workers' compensatlon Insurance wrtler and policy number ere: Cerrier: Pollcy Number: (Th/s secNon need no! be comp/etetl I/ the permit !s velued et one hundred dollars ($100) or less.) �'I cenity thet in t�e pertorma'G od tor vfyeh��is Dermit Is Issued, I shall not employ any pereon in eny manner so as to becoma sublect to the workers' Compensallon laws ot C IMo nd e h� II I sho Itl become sub�ect to Ihe workers' compensation pmWsions oi Sectlon 3700 oi the Lebor Code, I shall forthwlih comply with ihes pr / /� Applicam Signeture: Date ! (��(o '"0 � WMNING�FAILURE TO 5 ORKERS' CO�dPEN5ATI0N COVERAQE IS UNLAWFUL AND SW1LL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED THOUSAND DOLLARE (51 W,000). IN A�DITION TO THE COST OF COMPENSu1T10N, DAMAGES AS PROVIDEO FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, M10 ATiORNE1"5 FEES. LICENSED CONTRACTORS DECLARA710N: I hereby eHirm ihat I am licensetl un0er provlsions of Chepter 9(commencing with Section 7000) ot Dlvlsion 3 0l the Business and Professions Cotle, end my Ilcense is in hll force entl eflect. Lic. q Cless n Contrectors Signature: Date: CONSTRUCTON LENDING AGENCY: ❑ I hereDy ettirm �het there is a consiruction Ientling epency tor the pertortnance ol ihe work br which this permit Is issued. (Sec. 3097, Civil Code). Lendef9 Neme: Landef5 Adtlress: Slgnature: Date: OWNER•BUILDER DECLARATIONS: I hereby aflirm t�et under penalry of perjury thet I am E7(EMPT FROM THE CONTFiACTORS LICENSE LAW for the tollowing reesan (Sec. 7031.5, Business entl Protessions Code: Any ciry ar counry w�ic� requires e partnit to construct, alter, Improve, demolish, or repeir eny structure, pnor to its issuance, also requires the applicam tor such permit to lile e signed sletement that he ar she is Ilcensed pursuem to I�e provislons of Ihe Contradore lJcensa Lew (Chepter 9(commendng with Sectlon 7000) ot DlNsian 3 of the Business entl Pmfesslons Cotle) or thet he or she is eaempt therefrom and the basis lor the elleped exemption. Any vlalatlon of Section 7031.5 �y eny applicent for a permit su6jects the eDC�icant to e civil penalry oi not more ihen Ilve hundred dollars ($500).): ❑ I, es owner ot t�e O�operry, or my employees with weges as thelr sWe compensetion, WILL DO THE WORK, en0 the sWcture Is not ImentleA or otteretl tor sale (Sec. 7044, Business entl Professions Code: The Contrectars License Lew does not epply to an owner of proparry who 6uilds or improves thereon, end who tloes such work himself or hersell or through his or her own employees, provitletl t�at suc� Improvements ere no� Intendetl or oMered tor sale. If, hov.•ever, Ihe building or Improvemem is sold within one year at completion, ihe owner-builder will have tha Durden ol proving thet he or she did nol build ar improve for purpose ol sale.). • 0 I, es owner ol lhe properry, am EI(CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to construct the prqect (Sec. 7044, Business and Professlons Code: The contrectore License Lew tloas not apply to en owner ot pmpeny who builds or improves thereon, and who contracts for such pro�ect with a contrectar(s) license pursuant to ihe Conirectors License Lews.). ❑ I em exempt untler sec. Business and Prolessions Cotle for NIs reason: Signeture: Daie: Owner ID verHied by dnvers license. ❑ Yes ❑ Na Orivers License No. Verlflcation at Ownership by (rype oi tlaument, I.e. - properry ta: hlll or Ceetl): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certiy thet no evcava�lon live (5) or more teet in depth into which e person Is requlred to descen4 wlll be made In connection wit� work euthorizetl by this permlt, antl thet no Duildinq structure, scattoltling, felsawork, or demolition or tlismantling Ihereol, will be more then thirry-six (38) feet high. (ChaD� 32, Grp 2, Art 2, Sec. 341, Title 8, Callfomia Administretive Cade). ❑ As owner-Guiltler, I wlll not employ enyona to do work w�ich would require e permit iram t�e Division of Industnel Sefary, es noted above, unleu such person hes e permlt to do such work from the divislon. Signeture: Date: Division at Industrial Salery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVATON OF EN7AV: I certify under penalry ot perjury that I heve reed this flpplication and stete that Ihe Intortnetlon given Is correct. I egree to comply with ell stete laws end ciry orEfnences relatinp to bullEing constructlon, end authorize representatives ol the Ciry af Casta Mesa to enter upon Ihe ebove-descn6etl property lor inspection purposes. I agrea not to occupy or ellow occupency of eny huilding euthorized by Ihis permit until final inspection. GOOE t. INSPEC110NTYPE � 1676 Flxed System Finel Fire Preventlon 1266 200 201 202 203 Pool Spe Finel Final Re-Roof Finel BIocWRetalning Wall Flnel Factory Fire Placa Finel Sign 204 Finel Demolition ,iw: ' j�QQEa INSPECTIONTYVE 206 Final Mechenlcal 20B Finel Plumbing 210 Finel Eleciricel 212 Finel Flre Prevention 220 Finel Planning ApDroval 222 Final Site 250 FinalBuilding/Occupanc PA7E It�EL$ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa�ELECTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 455 16TH PL Suite No Viciniry: KITCHEN Parcel Nunmber: 42515116 Applicant: IVERSON, ELAINE Address: 455 E 16TH PL COSTA MESA, CA Owner: LINDSEY, JOHN S Address 455 E 16TH PL COSTA MESA, CA Contracloc Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+unit5) Pool / Spa Lighting Fixfs Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 7000a Molors to 1hp Motors to 10hp Motors to SOhp Motors to 100hp Mo[ors over 100hp Communicatlon drops ISSUED BY: Phone: Zip: 92627-3216 Phone: 2ip: 92627-3276 Phone: Zip: License: Status: ISSUED Applied: 07/01/2003 Issued: 10I16/2003 SCOPE OF PERMIT REF: 803-01120. ADD 85 SQ. FT FIRST FLOOR TO EXISTING SFR. SCOPE OF WORK TO INCLUDE: EXTENSION OF KITCNEN. ELECTRICAL TO INCLUDE: 11 LIGHT FIXTURES, 9 OUTLETS, 6 SWITCHES AND 4 RES APPLICANCES. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 512.70 $9.90 $6.60 $0.00 519.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 �uantity 0 0 0 71 9 6 0 4 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 k Standing Section Misc ElecVical Equipment Transformers up l0 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Winng System / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand ONer Electrical Fee Invesligation Fee �uantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work Is no� commencetl within 180 tlays, or if work Is suspanded or abanifoned for a period of 180 days. , INSPECTIONS: In order for the work authorizetl under this permit to be considered legal, such work must comply with all applicaWe codes, and all required Inspeetlons and final approval must be obtained. Failure to obtain inspections and tinal approval will result In the expira oF ofthis permit. FOR INSPECTIONS CALL: (714) 7545626 2C4&48 (8�W) WORKERS' COMPENSA710N DECLARATION: I hereby aXirtn under penelry of perjury one oi Ihe tollowinq decleratlons: ❑ I heve end will maintein e certificate ot consent to setl-Insure br workers' crompensetion, es pravitled for 6y sectlon 3700 at the Lebor Cade, for t�e pedortnence of the wOrk IOr whlCh �his pertnit IS ISSued. ❑ I heve end wlll mainteln workers' compensecion Insurance, es requiretl by sectlon 3700 of tha Lebor Gode, for the pertortnence of Ihe work for which Ihis pertnit Is issued. My workers' compensetlon Insurence carrler end palicy number ere: Cerner: Policy Number: (Thls sectlon need nof be comp/etetl i/ fhe permit Is ve/ued ef one hundred dollars ($f00) or /ess.) �� cetlity thet in the pertoy+ie ol} p� work tor which this permit is issuad, I shall not employ eny person In eny manner so es to 6ecome subject to the workers' _�compensetlon laws YC �r�l ,! egree thet 1 I should become suD ed to the workere' compensatlon provisions of Sectlon 3700 of t�a Lebor Code, I shell forthwlth complywiththes n:�(/ /� / ApplicaM�Slgnature. 'Dare:• f!/'�l!/'O� WAHNING:.FAILURE TO C WORKERS' COMPENSATION COVERAOE IS UNLAWFUL AN� SHA�L SUBJECT AN EMPLOYERdO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED TFiOUSAND DOLLARE (E100,000), IN A�DITION TO THE C0.5T OF COMPENSATION, DAMNGES AS PROVIOED WR IN SECTION 3108 OF THE UBOP CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hareby attirm ihet I em licensed under pravislons of Chepter 9(commencing with Section 7000) of Divislon 3 of the Business entl Professlans Cotle, end my license is In tull force end ettect. Llc. N Cless q Conirectors Slgneture: Dete: CONSTRUCTION LENDING AGENCV: ❑ I �ereby atfirm that there is a construciion Ientling egency for the peAortnance oF the work for whic� this permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Lentler's Adtlress: SignaNre: Dete: OWNER-BUILDER DECLARATIONS: I hereby eXirm Ihet under penelry at per�ury Ihet I em E%EMPT FROM 7ME CON7RACTORS LICENSE LAW for the lollawing reason (Sec. 7031.5, Buslneu end Professions Code: Any ciry or wunry which roquires e permit to canstrua, elter, Improve, demolish, or repair any siructure, prior to its Issuance, alsa reqWres the applicant lar such pertnit to file a slgnetl stetement that he or she is Ilcensetl pursuant to the provisions oi the Contractors Llcense lew (Chapter 9(commencinp with Sectlon 7000) of DlNsion 3 of t�e Business end Prolessions Cotle) or ihat he or she is exempt thereirom and ihe basis for the allegetl e:emption. Any violetlan of Sectlon 7031.5 by eny aOPlicant tor e pertnit subjects the epplicent to e civil panelty af not more then fiva hundred dollars ($500).): ❑ I, es owner of the properry, or my employees with weges es Iheir sole wmpensation, WILL DO TNE WORK, antl iha structure is not Intended or oXared lor sale (Sec. 7044, Business end Protessions Cotle: The Coniractors License Law does not apply to an owner of properry who Duilds or Improves Ihereon, en0 who does such work himsetl or �ersell or ihrough his or her own employees, providad that such improvements are not Intended or oHereO for sale. II, however, ihe builtling or improvement Is soltl wit�in ana yeer af completion, iha owner-builder will have Ihe hurdon of proving ihat ha or she tlitl not build or improve for purpose ai sale.). • ❑ I, as owner of the property, am E%CLUSIVELV CONTHACTING WITH LICENSED CONTRACTORS to construct ihe prolect (Sec. 7044, Business end Professions Cotla: The wntrecmrs Llcense Lew does not epply to en owner of property who builtls or impmves ihereon, antl who contrects lor such pro�ect wl�h e coniractar(s) license pursuent to the Contractors License Laws.). ❑ I am exempl under sec. Business antl Professions Code tor Ihis reason: Signeture: Da�9: Owner ID venfied by dnvefs license. ❑ Ves ❑ No DriveYs License No. E:pires: Veriticetlon of Ownership by (type ot tlocument, I.e. - property la: hlll or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity thet no excevation ilve (5) or more feet In tlepth inta which a person is requiretl to descend, wlll be matle In connectlan wi�h work euthorized by this permit, antl that no building structure, scettoltling, falsework, or tlemolition or disman�ling ihereof, will be more than thirry-siz (36) teet high. (Chep. 3.2, Gry 2, Art 2, Sec. 341, Tltla e, Celifomia AtlminlStreUve Code). ❑ As owner-bulltler, I wlll nat employ enyona to tlo work which would require a pertnit from the Division ol Intlustrial Sefery, as noted ebava, unless such persan hes e permit to da such work from the divislon. Signatura: Dale: Division ol Industrial Sefery Permi� Number: CEHTIFlCATE OF COMPLIANCE AND AUTHORVJITON OF EMAV: I certiry under penalry ot perjury thet I have read thls epplicatlon anO stata t�et the iniormation given is correct. I aqree to comply wllh ell steie lews antl city ortlinances relating to builtling construction, end euthorize representetives ot Ihe Ciry of Coste Mesa to enter upon the above-describetl properry for InsDection purposes. I agree not to accupy ar ellow accupency ot any building au�horizetl by this permit until finel inspecllon. CODE t. RISPELTIONTYVE 1616 1268 Fized System Finel Flre Preventlon Pool Spa Finfll 200 Flnel Re-Rool 201 Flnel BIxWReteining Well 202 Final Fectory Fira Place 203 Final Slgn 204 Final Demolition Qe¢, Ijj� f�QQF,! INSPELTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site � 250 Finel Building/Occupancy � ��I e- �� CITY OF COSTA MESA ` . BUILD/NG DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ��a��sa-s2�s • Fax(714)754-4856 Job Address: Suite: Vicinity: 455 16TH PL HOUSE 8 ATTACHED GARAGE Parcel Number: 42515116 Applicant: COOTER, LYLE Address: 23015 DEL LAGO #D2 CA LAGUNA HILLS BUILDING PERMIT Zoning: Phone: (714)598-8360 Zip: 92653 � \ PER T NUMBER 699-01473 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 09/14/1999 Issued: 09I14/7999 Owner. SCHOBER, LEON Address 37 ROSY FINCH LN . - ; .� ' Phone: _ . , - � ��. 'ALISO VIEJO, CA �. � - � Zip: 92656 � - � _ Contractoc � FONTAINE�AND ASSOCIATES � . � - Address: � 23015 DEL"CAGO #D2 � - , - CA ' " Phone: (714)598-8360 , � -•� � LAGUNA"HILLS . � � Zip: 92653 � License: 708917 � Arch : , ' � � , � � � � Eng: Addresr. � - Address: ' -Phone: � - Phone: Zip: , �� License: License: SCOPE OF PERMIT �. REROOF EXISTING SINGLE FAMILY RESIDENCE 8 ATTACHED GARAGE (20 SQ). TEAR OFF EXISTING SHAKE ROOF & - RESHEATH WITH 1/2" CDX PLYWOOD_INSTALL 7-LAYER OF 30C FELT UNDERLAYMENT 8 REROOF WITH CLASS'A' 25 � YEAR GAF COMPOSITION SHINGLES. FEE SUMMARY • Plan Check: � $0.00 - Calc Valuation: 53,000.00 � Permit: $83.25 - ,' Claim Valuation: ss,000.00 SMIP Res: $0.50 ' SMIP Com: $0.00 _ - Other. $0.00 � � � Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0. 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 PLANNING & ZONING LeR 0-0 Right Left 0- 0 Right Pr000sed: ' 0 0- 0 0.0 NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectione end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARA710N: I hereby aHirm under penalry of Derjury one ol the following tleclarations: ❑ I have entl wlll meintein e cartificete ot consent to seli-Insure for workere' compensation, as provitletl tor by section 3700 oi t�e Lebor Code, for ihe pertormance of the work for which this permit Is Issued. � I have antl will maintain workers' campensation insurance, as required by section 3700 of ihe Labor Code, for ihe peAormanca of Ihe work tor which ihis pertnit is issued. : My workers' compensation Insurance carner and policy number are: 1 . b��yf O/ Carrler. �l:eFYH �^JT ��9 Yt f�` policy Number. W A% 9 9 � p G (This secfion nee0 nof be comp/efed il fhe permif is velue af one hundred dWlars ($ f00) or /essJ ❑ I certify t�et In Ihe performance of the work tor which this permit is issuetl, I shall not employ any person in eny manner 5o as to become subject Io Iha workers' compensetion lews of C lifomia, end agree thet if I should become subject to the workers' compensation provisions of Section 3700 of the LaDor Code, I shall torthwith campty with these proh o � /� Applicant Signature: Date: ��/ 7 � WARNING: FAIWRE TO SE RE WORKERS' ODMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBIEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THWSAND OOILARE (510p,00p). IN AODITION TO THE COST OF COMPENSATION, DNMGES /S PROVIDED FOR IN SECTIIXJ 3lOfi OF THE LAB�JR CODE, IMEREST, ANO ATiORNE1"5 FEES. LICENSED CONTRACTOfiS DECLARATION: I hereby aHirtn Ihat I em licensetl under provisions ot Chapter 9(commencing with Section 7000) ot Oivision 3 of Ihe Business and Prolessions Code, antl my license is in full force antl eHect. Lic. N '7�0 ��-� Class k_ _ C�� P Contreciols Signeture: ��,�- Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby aHirm thet there is e consimction lending egency lor the partortnance ot the work tor which �his permi� Is issuetl. (Sec. 3097, Civil Cotle). Lentler's Neme: Lenders Address: Signamre: Date: OWNER-BUILOER DECLARA710NS: I hereby aHirm that under penalty of perjury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or county which requires e parmit to constmc6 elter, improve, demolish, or repair any siructure, prior to Its Issuence, elso requlres tha applicant for such permii to tile a signetl statement ihat he or she is licensad pursuant Io �he provislons of Ihe Contractors License Law (Chapter 9(commencing with Section 7000) oi Divislon 3 of Ihe Business antl Professlons Code) or t�et he or she Is ezempt therefrom and fhe basis for the alleged exemption. Any violation oi Section 7031.5 by any epplicant for a permit sub�ects the applicant to a civil penelty ol not more than five hundretl tlollars ($500).): ❑ I, as owner of the pmperty, or my employees wit� wages as their sole compensation, WILL DO THE WORK. antl ihe structura Is not Intended or oHered for sale (Sec. 7044, Business end Protesslons Code: The Contracbrs License Law dces not apply to en owner ol property who builtls or improves thareon, and who does such work himselt or her5elf or through �is or her own employees, provided thet such improvemenis are not Intended or oRered for sale. If, hawever, Ihe building or improvement is sold within one year of completion, the owner-builder will have the burtlen of proving that he or she did not builtl or improve for purpose of sale.). ❑ I, es owner of t�e properry, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to wnsiruct iha pro�ect (Sec. 7044, Business an� Professions Code: The comrectors License Law does not epply to en ownar of property who builtls or improves thereon, antl who coNrecis for such project with a contractoqs) license pursuant to the Comractors License Lews.). ❑ I am exempt under 5ec. Business and Profassions Code for lhi5 reeson: SignaNre: Date: Owner ID verifiad by dnvefs license. ❑ Yes ❑ No Dnver's License No. Expires: Veritication ol Ownership by (rype of daument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenify �hat no ezwvation live (5) or more feet in tlept� into which a person is requlred to descend, will be made in connectlon with work authorizetl by this permit, end that no building siructure, scaRoldinq, talsework, or tlemolition or dismantling thereof, will be more than thirty-sis (36) feet hlgR (Chap. 32, Gry 2, An 2, Sec. 341, TIOe 8, Celifomia Administrative Code). ❑ As owner-builtler, I will not employ anyone ta tlo work which woultl require a pertnit imm the Division of IntlusMal Safety, as noted above, unless such person has a pertnit to do such work from the tlivision. Signature: Dete: Division of IntlusMal Safety Permit Number: CERTFICATE OF COMPLIANCE AND AU7HORIZATION OF ENTAV: I certify under penalry of perjury that I have read this epplication and stete that Ihe information given is correct I agree to comply with all state laws and ciry ordinances relatinq to huilding constmction, and authonze representetives of iha Ciry of Costa Mesa to enter upon the ebove-describetl propeny for ins0ection puryoses. I egree not to occupy or allow occupancy of any builtling authonzetl by ihls permit until finel Inspection. CODE 1. INSPECTIONTYPE 7616 Fizetl System Finel Fire Preventlon 1266 200 201 202 203 204 2446-66 Pool Spe Finel Final Re-Poot Final BIocWRetaining Well Final Fectory Fire Place Final Sign Final Demolition P9IE INTRIALS � /��s��,o —� � � oa�a UEN INSPEC710NTYPE 206 Final Mechenical 208 Final PlumDing 270 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DRTE INTRIALS �ooRessovem�ou+c: q55 16TH PL ow�xs""'E""'°"":SCHOBER, LEON -%D0"� SCHOHER, SHARON F � 37 ROSY FINCH LN APPL.WRINOADDXE59:ALISO VIEJO,CA 92656 ARCXRECT ON FN�IFEP: ucx on exa.�s �ooeess: GONIN�CTOReNAYE: caxrx�croas�uiaa �uo�ss UNT: uc.xo: uxr: uc w_ uxr: LJCENSED COMX�CTOXS DECLAP�TION: I h�nby Ntrm undx prWy d pr�ury Nq I am IMneeE uMx pwi4ms d Cheper B (oommendnp Mlh Scibn ]000) M DMbion a d N� Budnau end VmfaYm� CaEe, aM my Ibenw b in full faa end dlea. cmuc.No.: uc.cuss: uc.No.: EXP: NEX BUILUEfl DECIAfl�TION: I hneby eHiim uMar qrWy d psrWry �MI I em uemq Imm Ihe ComraGas Lirome lew Ip Uq Idbxiq �aewn (Sadion ]0]1.5 &nnm aM Prdevbn� Cods: AnY cN a oouMy whiN nW'um e Oe�ma to mroWn. Mv.'unpo.a. hmdah. a repei ury nwnun, pria b ia e+uenn, ebo rsQu"vu IM eppimN la wrh pamil to fib e ep�wd pmsmeN IIW M a�he 'x,we w�u w me a� a u» wu,wa, ucem. �.. �Q+wa e(mmm«ono wnn s.ao� �oaq a d:eian a a ue row vd Nolwiom CoMI a Ihtl ha a Ms u amnq iherahan ud �M bma la Ihs dbped nemqian. �^Y vidation d SWion �I.S b� ury epp&ent la e permn amjeaa �M eppl'rsM �o e dW periMy d nd maa tMn fMa hunE�eE EaOen �SSW��. ❑ 1. ea ovmer a�M VOPonv a mV anMM� wtn we0es %+�Mi We oomce�bn. vnll do Ne wak. eM Ne evucnire e iw imeMed a dle'ed I« sela I�� )aa. Buaironvd Proleseiom Code: The ConVxfon Liroroe lew Eoee not eppry lo en ox+wrd qopery wAo buids a inD�ovee Ihe�eon. eM r.fio Aoee auth wa�k Nmroll a Mnell a WaqA he n har own emVbY�+. p�eE �IW w A "unpo.anaNa ve nd imerded a WereE lor ub. tl. howewr. IM driNirp or inprawnam e eold wnhin an yav N mmpldon. the owrorduka NI heve �M EUNm d peovinp he a eha dd m buJd a impon la IM WTos< d ub�. � I. m amsr d tM YWaH. em udar�elY canimpnY xM 4canaM cmUectae m rnmue tM V� (5wion ]OH. Buair�a md Pmleuionv Code: TM Conlrmm licenae lew tloee M qpply lo en ovmer d popMy Ma Wike n"unpwm Ihereon ad x1a wmract� lar wM pqede wi1M1 e wmreewle) licemed W�� o iM Comrepon Limme lewl. �] IemeaemquMerSeabngp�pqq e.av.c..ro�miereara�:OWNER HUILDER Dme: Owner: I Eo hereby nnity Net I em ewue at enE wWnwd iM mpui�mmmis d Cellomie HeMh W Sefery Cade Seuiwa 25505. 25St3. enE 255�4, enE Ihd I IX eny INurB buildiip rcwpenl will / wil nq (dRb aro) naed t0 canpN w�h veid dma cadp eM the rx�uiremenb br e partn'il br oone�runionamoCifie�ion hpn�he R'v�epement Dislna. RefiEeMiel con¢Irud'nn eppiceliona ere awamq trom Ihese prwispns. De�e: RpdiceN: WOPKEP'S COMVENSATION DECIARATION: I hmeby elfimi �nEer psnMy d pwj�vy oro d tM Idbxi�q dedermum: � I hera uM vril maniein e ce�tlice�e d canaent io esH�ineurc M xwkere wmpenW ion, es povided Iw by Sedion 3100 d ihe leEa Cada, fa tha perlormence o11M xoA la which �hie permii ie iuuod. � I hew end �ml meinten woMon' compenaiun inwrarca. ee reQuired by Sepim 9]00 d I�e Lebor COEe. br IM pMormence d IM work fa xhid� Ihie permn ie mued. MY ��A �mpenaelbn ineurenca remx erd pdiry number va: Cem . PdwyrNumber. �'SecYion nesd na be compbled / iM perme ia br we hundred ddlerr (SiOp/ w IuaJ I cehty IM1aI in Ihe pMormenu d iM woM la xfich �hu pem�i� n iseuad, I eM1dl �wl empby eny penon in eny menner eo av io a eubjea �o tM workere' compenu�ion lewa d Celilomia, eM agres �het il I eMuk bacome euEjed Io IM xorkers co pevat pewiaum d Saeian J]W d Ihe LeEor Code. I ehell lat A oomp�y vmh thwe o�a — z r— 9 l �� .,—�, ..��'�� minp: F�Yun ro�etun woMwi compeNeHon eovenp� li unlewN( anG sNll HA/�cl en Mployn fo e�IM�u/ psneltlu eM c/vll flraa up ro ons huntlretl �M1ouurM eollan (SfOQ000A �� Iflon ro M� cwl ol compsrwtbn, tlamepu sa provltleL br In Sxtlon 9)O6 0l Ms L�bor COM, InM1n+q antl ettomsy i Iw. CONSTIIUCTON LENDINO AOENCY: I heieby �rm �Mer pereXy d perary Ihtl IMre u e oon�rvtlion bMinp q�ercy la Ne penamence a �ns wA mr Mea ine ro�� e eww lsmun xs�. cM. cl. LENUEN'S NMIE: LENOEX'S RDONE55: �CB1��'/��IBI��1BVBlB9�I�1L9 B�CBIq11Yld 9BIB1�1�1G GbM'BN�qTBIpfIY CORBtl.�GYfM�OCO111i�N11�l1��f1�'8114 OJllll�i0ldlflBf101 eM slele lexw nleleq b buitln0 cmmWbn utl herebY eNharse reYau�ie�ive� d Ika elY b eMa UD� IM ebv.e-man�nneE pvpatry la ieapeaion pwpo�ea. LEON SCHOHER Dete: /� Z �� 90 (5t5t<e WP) WMe-Buikiq 8 Selery: ��aer�Fb: Ce�wy-�ppicenl: Pink-Re.anue: GddmroA-N�emr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 077385 PERMIT NO: P 077385 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION : INSTALL COPPER PIPING FOR SPRINKLER SQ FT: CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 /U-1 COMMENTS: ZNSTALL COPPER PIPE IN GARAGE AREA FOR SPRINKLER SYSTEM et�+�+�*��x*****�****+�***�r****�***�**+�**ie+��t��txie*****�x�at*�*�x**�**�**+�**�x*irit�**+�� 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: 42515116 ZNE: REF NO: PLANNING NOTES> � ' !f iE 1E if if 1f if iE fE �E 1flf 1FlE ik 1F IE iE iFlE 11-iE 1E iE 1E 1E i4 iElE k 1E iFlk 1k 1F iElf 1t if iF if iF if iE 1F iE if 1f 1E iE iE 1k iE 1ElE 3E 1E iE fE 1E 3E fE IE 3E iE iE iF �f if 1E 1E 1E fE fE 1E 1E 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 S ZONING APPROVED BY DATE: BUILDING APPROVED BY : ' DATE: S �� APPLICATION ISSUED BY: ! /Q� DATE: iFiEitieieitiEkiE�-ie�[-iElfififiEiEitieiEitTfTF3FlF3FfF7F3FiFTFTfTFSFiF3F�FSFiFTF'�F7F7F�F'iF3FiF�ft��F7F7FiFTf�*i�*x�ie****at �-�t- LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7.00 25t SMIP/NON—RES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 7.00 20.00 0.00 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 27,OO�OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CIIECK 2%,OQ if 16 if if iE if 1E if !k 1E jE �E 1E 1E ik 1E iF jE fE 1E iE 1ElElElE 1E iE fE iE iE fE fE IE �E IE 1E IF �FlE 1F 1E IE fE 1E �E 1E 1E iE iF iE * iE iE IE iElElE 3E fF fE iE iF fE 1E �F if if 1E IE iE iE jE jE 3E 1E 1E 1E IE M 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 0 N UNIT COST TOTAL COST PLU 1 WATER RE—PIPE END OF FEES 7,00 �'1 ',�, ' _�' 1 �t _ " `i:T_ ..— . ._- ."r, '. .. � _. _ . . _ _. �.:_ 7.00 C�'JSTRUCTION AND PLANNING �� A . �� Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit # 1.: Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion _. 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • � 3. Electrical Conduit Utility�Undrgrnd. 54. Forms �' 4. Electrica� Conduit�Undrgmd. 55. Electrical Bonding � ' 5. Steei Reinforcement 56. Rough Plum6ing & Pressure Test � . 6. Electrical UPER Gmd. 57. APPROVAL TO COVER�GUfJITE _ 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. lNater PiPe�Undrgrnd. 60. Backwash Lines, P-Trap, � UrSdrgrnd. 10. Scructural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finai � 12. Sewer Cap 63. Heaie� & Vent-Final . 13. Roof Drains 64. Plumbing Syuem � Final �� 74. Rough Plumbing 65. Electrical-Final ' ! . 15. flough Electrical•Conduit 66. Solar System-Final 76. Rough E�ectric Wiring 67. Fencing & Access Approval - 77. flough Wiring Sign 66. APPROVED FOR P�ASTERING , 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rou9h Factory Fireplace APPROVALS Permit # 27. DuCts, i� Structure 70. Underground Hydro 22. Ouas, Ventilating � 71. Product Piping O Gas OOiI 23. Gas Pipe-Rough & Test • 72. Undergrountl Flush 24. Roof Freming � 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Cei�ing (StructuraU & Monocoat - 75. Dry Chemical 27. Frame and Flathing 76. Dry Standpipe 28. Lathing & Siding 77, FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT 37. Piastei Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final HOating & Air Conditioning 35. Final Gas Pipe•Test 36. Hood or Canopy � - 37. Finai Factory Firepiace 38. Final Piumbing u��`P��-7 {AVN SCXZI JK�Zb y 9� FN 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 . 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Etectric Release to Edison 50. Gas Release to Southem California Gas Co 51. CERTIF�CATE OF OCCUPANCY No. Date , ADDHESSOFBUIlqNO: QSS 16TH PL owr+Eas""YEi'��x'":SCHOBER, LEON �op�SCHOHER, SHARON F 37 ROSY FINCH LN ALISO VIEJO,CA 92656 APPL.IW I1NG �DDflE55: MCHRECT ON ENtlXFEP: MLK ON FNO.'S ADDRESS: CONfAACTOX'SW11�: cam�crarswuuNo JODNE55: uc. ra.: uc xo: uNT: CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO: E 077604 PLAN CHECK NO: N CONSTRUCTION TYPE: V—NR PERMIT TYPE: ELE UNT: UNT: 110EN5ED CONfFACTONS OECLAflATION: I lnreby afltrm uMx per�ely d periury IMt 1 am licensed uMer povivms d Chepler 9 (eommenaip w�lh Sxtion ]000) d Oivison 3 d i�e Busineav eiM Protaenioen Cade, eM my lioense b in lull laea eM eMee1. CRY LIC. NO.: • LIQ CL155: LIC. NO.: EXP ; oele: conuae«: OWNEH BUILDEH OECLAFATION: I Mmby effirm unEer penely d perjury thet I em evmq Imm Ihe CanVeeae Liceroe law far iM IolbvnnB �eeeon (Sedion 1031 S Bueimea and Proleaaions Coda: Any cry a wunq xfiich requiroe e pertnu lo conevun, el�er, improve, Eemo�eh, or ropair eny avucture, qin b ila awe�e, eho requiree Ihe epplrani br wch pamin to fb e siprwd nlelemenl ihel he a eM liromed Wrsuanl lo Ihe qa�iona d iM Coniredon Lironse lew �Chepler 9(wmmmo�p xi1M1 Satlon ]OW) d Direion 3 W ihe ianev aM Rdeviona Codel a Ihel M a she ie axamq Iherehum e�W iM bnfn la Ne elleped ueenqun. MY vide�on M Senion , 031.5 by eny epplimn� Iw e permil wbjetle Ihe epplceM lo e tivil parelry d m1 mae Ihen �He huMred ddlen �5500��. �1, m o�mer d Ihe propany a my empbyeea wih wepea ea ihai eale wmpenealion, will Eo Ihe wo'k. eM �he ei�uciure e nm intended a oXereE fa eeb (Seciion ]W0, Business enE Prolessiom Code: The Comrenon liceme I.ew daea nd apDW�o en owner ol poperry wlw buWs w inD�'es �hereon, eM wlw doea eu h wwk himmH or herseC w ihrouQh he or hx own emDloyeee, pmnded �hm euch impwemema ere nd intenEeE a otlereE 1« mb. X, however, �he WJCiip a'vnpwemaM n eold wnhin aia ymr d mmpbtion, Ne owirorbuiker xill heve tM burden d P�'iM M« sha ak �wl Wik w imP�'e Ia iha Wmose oi aalel. � I. ea armer d IM O�CaM. am e�dusively mmredm9 �h licenaed wnirec�on lo wnshud iha prol� (`�� )�. �inss eM Proleesans COEa: The Conirenon License lew doae nd eppy io en owner d popMy who WiNs or imqovm ihe�aon arM w1w conlrecls br wM prol�s wil� e conVada(a) Icenxd W��I lo Ihe Conlrepon License L�ew7). /J � I am� 'uMer Secl': �� B. 8 P.C.. M ihie : f_'6 /� //� !I C /" o�e: 7 0.,,�,: �'�" �/v I do hereby cerlity �hat I em eware W ud uMerslend Ihe reQuiremeMs M Cel/omie Heellh end Selety Goda Sediona 25505. 255�, eM zs5st. erd ine� 1 a enr Mure W iNirp omioNt will / wil rrot (dreb «w) need b comoM wpn aeid eteia codes arM tM reauirem.m. M aParmillammwction«modifimianhantMAi ue�i'l�y aneYameniDis�ia.Residmiielmmrueuneppira�iomeressemqlmm�heae pfOM910119. Dale: rlppl'ranl: WONKEN'S COMPENSRTION DKLAPATION: I hereby atfirm ueqm paneM1y d pe�jury are d Ne IWloxirq dade�miom: � I hero vW xi1 meinlari a cenA'irsle d mnsenl lo aetlinw2la wakera' cwnpametion. n pwided la by Seqian J100 W IM lsba COEe, im tM pe�lortnence ot tM work fa w1icM1 Inh parmil a iaued. � I heve enE WA meinlein vroAe�s' oompanselun inwrarKe, es repuired by Senim 3]00 N tha Lebor Coda, M iM perlormence d iM wwk Iw xfiidi ihie permX b iasued. My w«kan' mmpenee�ion inwrariea r,eeriar eM poliq numbar era: c�a: Pdiry Numbm: iis section riaeE nd be cwnpbred'A�he peimrt is bi one hundred EWlers /SI W) or bsa.) �] I cenM �� in iha perloimence W IM work Iw wfich thie permit is i»ueE. I ehell rat emdW em' Da�� in vry mennx eo m �o becane subpG lo �he xarkere cwnpense�ion lev.s d CelAanie, end eprea AW il I ehoub bacama wbjecl lo Iha xorYen' �mmw�sm� wa+som d sea�on a�oo d ina iaeor cme. i.ndi ionn.un comWv wen inme p�o�;sons. oma�. nvWK�i� Wem/n0� Fellun ro�wuro woikon' comperuatlon coveraps b unlewlul, entl �MII subJsct an miployer ro ctlMlul peneltb� enL clvl111mi uy ro on� �untlrsL tMuund Oollar� 1Sf00,000A �� Itlon ro Me cwt ol rompewt/on, Ganupu u povlJM ror In Sxtlon JI05 0l Me l.�bor Cob, InMxit, antl atromey'� Iros. CONSTFUCTON LENOINQ RGENCY: I M1areby eHim uMer panelry N perryry Ihe11Mre u a mnstiud'an bMinp egenty lor ihe �IB(�OITBIICB 0��118 N91�{�Of W111C�IIh9�IB11111115 69YB� (�iBC1U11�J�iH%.CiN.Ci�. LENOEN'S NAME: LENDEfl'S RODNE55: � oeniry �nm � nsre reed inn eodKmian d,e ume ind me mwe mioimvio� b mirea. � m�� m mmpy.mn el� mv �e <w,on «ainence, eM aieie lexs relaiin8 �o building cnnsvuqian erd hemby emhorae represanlelives d ihis dly to enmr upon �he ebove�mentoned prtpe,ly brimpepion purpoees. LEON SCHOBER m � oa,,: S 9 — 9�' Signe�ure d OwnedRBenURpD�^enVComraaa (5151d6 WP� Whne-6uikip 8 Salery; GreemFle; Cenery-RppGani: Pink-Revenue: Gddenm�/useaor DESCRIPTION : ELECT FIXTURES UPGRADE M VALUE: CALC—VALUE: PERM NO: E 077604 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: R-3 / T UPGRADE ��ieie�r�*x�ir+�*�rieitxitx�atitit*itit�r�*itat***ieitie**ieie*ie*iEitx��tit*atatxieieieie*ie*it*�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 AEQ• PROV: PARCEL: 42515116 ZNE: REF NO: PLANNING N6TE5> % ��. fF iF ih ii' il' iF ih if il' iF ii' ih ik �ElF ii' ii' i41! 1k iE ii' if fE iI' ih 1Elf 1E iEi%!k i%lE1EiF 1f if i41F i4 iF i%if if ii' iElf 1F if iE ih iI' iE iF if ih it 1E if i%if ik 1E ik if i4 i4 ih ih 1F iI' i%i%!E i%'IF �! fE D E V E L O P M E N T S E.R V I C E S A E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: f APPLICATION ISSUED BY: DATE: ^ � �`1 iE1E1EfEiE1E1E1f1E1E1E1EfE7E1E1E1fiFiEiEiE4 IE1E'1E1E1FIE1EiblEih 3EiE LEGALIZATION:IJ F E E' S,U M M A R Y STRUCTUAAL SEGMENT:N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15.00 • SOE� SMIP/NON—RES PLAN � ' ISSUE FEE 15.00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 15.00 15.00 0.00 30.00 30.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30.00 iF1E�F�flfiElfiEiElE�fiEiF1F1E1E1E1E1E1E1E1E1EiElkiElEfflElE�EiFiElEiEiE1E1E1ffElElEfE1i1E1E1E1ElFiflflFiflEiElE�E1E1ElE1E1E1k1i1EfE1E1fif1E�E1EiEiE1E1FfEiFif � I N D I V 2 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 �10 " FI}CTURES LIGHTING 1 ST 20 .. EA. ... .75 7.50 _ RECEPT/O�]TLET _ •1 ST 20 EA. .75 ' 7,50 BND OF PEE5 / !� •�. L' , � - - - ` t'; .nl.• _. " II,� �_ _4 � CONSTRUCTION AND P�ANNING "`' POOI. 'A APPROVALS Permit # Date Inspector APPROVALS Permit # Date inspector t.'Temporary Electrical Service or Pote 52. Pool & Equipment Location . ' 2. Soil Pipe-Undrgr�d. 53. Steel Reintorcement ' '�3_'il�trical Conduit Utility-Undrgrnd. 54. Forms ,`e,��iegtricat Conduii-Und�grnd. ' 55. Etectrica4 8onding . � '�jsh�l Reinforcement 56. Rough Ptumbing & Pressure Test ( -,f?� Nectrical UFEft Grnd. 57. APPROVAL TO COVER�GUNITE ��T�FoQtings 56. Electricai Conduii-Undrgrnd. , � B� F-0u'ndation • 59. Gas Pipe, C U�drgrnd., Test 9:' Water Pipe-Undrgrnd. f 60. Backwash Lines, P�Trap, C� Undrgrnd. 10. Structural Floor SYstem 61. APPROVAL TO DECK 11. Property Sewer line & Nouse Coonection 62. Backwasfi & ReceptorFinai 12. Se�kr Cap .' 63. Heater & Vent-Final 13. Roof Drains 64. Piumbing System - Final 14. Rough Piumbing 65. Electricai�Final 75. (iough Electricai-Conduit `.. 66. Solar System-Finai 16. Rough Electric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPRdVED FOR P�ASTERING 18. Rough Efectrical�T Bar Ce4Vinq 69. POOU5FA SY5TEMS PINAI 19. Sougt� Heating & Air�Conditioniog, � S �. �,� .� �.R m F�,E$FBT.,f3EQU1REMEIV-T �--7 - ' � - - � r - � �; � �:, :-� r i� -- 20. Rnu�3 Factory'Fi�ePlace �b" �' Y S�-+ ^_'# � AppROVAI"5�!�-' Pe`rmit #* -� "'•T' �,� � s.� t-. e �-:� �_ .��. r•. . m Y, A � .• .• H .�.. $ ` h! H � � i 21. [Suctz; in�Stru�ture,�. i S � ..a �1x � 70. �Jndergrowncl F{ydro -r 22. @uct4; VerltildtSng."� , y�: r C1 ^; :J �A ' 71. Produ��iping�' as f�Qil � 23. Gas .Pipe-i�ou� &�T'�'st _ '' �" c '¢ � .�' ` � ' -'r, � � .,._ , , ' TtT' � r [T Sx ,-: 72. Undergrnund F�lush � �� 24.Roof�raiaing :r* T r - x� M x__,}> •7�Undergmd.Stoiai�eTanR�'CGas❑Oil 25. Roof.5heathing F',` �; ° v�'' � - � �'"`F 'a �'' �r ..y >� � ;�K 74. Overhead Hydrb;;� . Z6. f-Bai.GeiGng (StruJetpral} & MoEeSoat # C .>+ R, Cx 7 V; Dry Che�ical �_ � r �'� 27. Ftarre arn3� Flashi ^�` = Se � a � m� mi. F� <^ =:q � i ] `�:* �.,IaCV � x >.* 76. DryStar�P�Ae,��, .r,^ .i. --.r. , 28. LatMSe9 $� Siding ro�! � r77E C f` .( ..� 77^ FIXED �TETi�'FINAC �- ` v.': 29. Insulatio:i, *; � �� y 5 j '�,� 7� FIRE PREV. FI.PfA� W� � !=, 30. Drywali Nailing *� r E� ;f S nb16ALTtfi9EPT, REQUIRfC�IENT � r - !"- �37.Plaster8nwnaCoatr" iE,F .;y �` 79.FINALI,N�PECTLb�1 �:, . 32. EJectrica�Pov[er Mecer�Ficai � x � �i 80= FOOD CERTIF�tCrTE 13Si�ED-^ ,.� • �_ .. ^+ 5: �n i e(' 3 -� �.. ,y �. �.-., m /� � �� :*1 ' 33. Pina � le ric�. " � �ji N tes: � � � .. �c � � r--� Fy � %�_ _ l�� ''" � _ tUiC� c�c's!'i!)// %Lv�4/�.�_! _ •J - t : ' �. :. � i i � n "TTC- �- -. 34. �ina�:}teai�ng�& Air oRditionin9 t7 g� � .. .� � F¢ X^ `� - 35. Final Gas'?ipe=Test * ��~ " � " j h' � ^x�' ��' = r�p:r �. �.� !�: r. ..; � w r� L,r- =,36.kbo�or CanoP4 y J� � wtq :� x � � 't ..= � - � 1 m _ .rr . - �: t �--� i--� �-' %: ` � �' �37. Final•Factory Firepl�t:e:, � �, ' � i • iv �x �.Z; � � ' -=38. Finaf Plumbing X i-q� � ! � -� �t :' t: c, * y 39. Water Service•Final �F � ' ^ * G � }� : oT r. ^ !-c�' '✓. s � � �-�c.� • i: c: �c:�; "• 40. Gas Service-Finai � `T� y' �' " ` .; 1 .�'.v �; x i� F i- C� r i tr: • o E �x � -i41. Solar pomesticFinaH� T! > V� I N+ [^ '-�o c � m ^ N .:. H Oi S t v� • ,.: .. � _ . 42. BackfioevPreventer ,; �; ��" � ';� �- m" x F� 43. Backflow Irrigation "� �'^ � �� * S � � ' ^ � ' :r r S 7c t �1i * 3 .� �-✓ ~ J �' � .uTT � x. (^ JK �. L'� !4�� •�. �... 44. ,LandscaKfe.Irrigation;5Ystem ��_, ;q r eZ �. ,� g £ u Ou a S °- 45. Sou�d Ftttenu"ation'� ', " .: ' " y ." T '-'� � ' tr' �' '�^' E"t' ° Lt c p; � ..x t / rtU ••H A 46. Handicap'Regulatio�`s `-� ; � s � t'r , rj ,7 ` � * d7. FINaL STRUCTUflE & BUILDING v�'- � !X i c' . F ni .K K:+ r r. f' »' �i 48. �IN,g�PLANNiNG�: ' :��`' ; i' C� c+i S k �i �9. �lectric Release to Edison � ?� I 4 . _ a; • -� . J rT. C . 5�. Gas ¢elease to Southern Califor� _Gas Co ,� � , . = : �. ��; , s ., ��,;a„ 51. CERTIFICATE OP OCCUPANCY " ' , No. Date �, � Applicant to fill in all soaees exceot ihose within neavY DorOer Ilnes anC sign all aooropriata Eeclarations. :i7� o�F COSTA rA�O zST�R C��(]] N PERMIT 'Aroject A(�ress �J� �v��' / �' �� A�'Plicant's Mailin/g Address !7�!w-�/_ ��ry� ' cS/ir ��ic,�g� Owner'sName "��r�'� �'�^�� "-'`,�� Phone6��-��OU Address �� 6�1 %�� `ot%/�- �%[�i¢� ��%LF 27 ArchlEng. �w��r� License No. Address Convacmr's Name L 2 Phone Address (mailing) City License No. _ LICE ED CONTRACTOR DECLARATION 1 hereby a I am licensetl tl ovisions a! Cnarter 9(commencin9 with seCtlon 7000) o " the Busine55 antl Pwfe55ion5 Cotle, antl my Iicenze is i9yJtf rce antl effect. . �alc Si9nature WORKERS'COMPENSATION DECLARATION I hereby aftirm that I have a certifitate of consent to sel/-Insure or a certificate ^' Workers' Compensation Insurance, or a certifietl copy Ihereof (Section `0, Lab. CJ . .icy No. Company L� Certilietl copy Is nereby turnisnetl. -�� ❑ Certitietl copy is tiletl with the ciry Builtling Division. Date Applicant � E%EMiT10N FROM WORKERS' COMPENSATION DECLARATION (Tnis seclion neetl not be mmpletea it the permi[ Is tor one huntlretl (5300) or iess). I certify tnat in the performance ot the'work for which this permR is Issuetl, I shall not employ any perzon in any manner as to become b" he Workei5'' Colnpfni�tlgn Laws of Californl Da[¢ S � �'�d T Si9nature NOTICE: If, afte� making this tleclaratlon, you shoultl become SubjeGt to the Workers' COmpCnSation provisions o( the Labor Cotle, you mu5t /Orthwith comply with such orovlsions or this permit shall be tleemetl revoketl. CONST0.UCTION LENDING AGENCV 1 hereby a((Irm that there li a constructlon lentlin9 a9en<y tor the performance of tha work for which this permit is issuetl (Sectlon 3097 Clv. C.) Lentler'S Name 1_entler's Atltlress OWNER BUILDER DECLARATION I hereby attirm lhat I am exempt from the ConlractoYs License Law for tne /ollowing reason (Section 7031.5 Business antl Professlonal Cotle: Any cl[y or county whic� requires a permit to construct, alter, Improve, tlemolish or repair any struclure, prlor to ils issuance, also requires [he applicant for such permit l0 f11C d SIIfOCtl statement that h2/SbC IS IICEl152tl pOfSOdfll f0 [FIE pIOVI5�0OS O} the Contractor's Ucense Law (Cnao�er 9(commentin9 with Section 7000) o( Division 3 of the Businesz anU Professions Cotle) or Ihat ne/she is exempt merefrom and the basis for tne allegetl exemption. Any violation ot Section �1.5 by any appliGant Por a permit subject5 Iha a001icdnt lo a civil elly of not more tban five huntlretl Dollars (E500). ✓�asl.,wner oi the orooerty or my employees with wa9as as their sole mmpensation, will ao [he work, antl the structure I5 no[ In[entletl or otferetl for sale (Section 7044, Businezs antl Pwfessional Cotle: The Contrattor'S License Law tloes not appty to an owner of a property who builtlz or impmves [he�eon� antl who tloes such wo�k him5elf/herself O/ thrOugh his ot he� own emU�oYe�, Provitletl that iuch improvements are not intontletl or otferetl for sale. If, owever, the builtlinq or imOrovement is soltl within one year of com- pletion, the owner will have the burtlen oi provin9 he/she tlItl not builtl or Im- prova tor the ourpose of sale). ❑ I, as owner o1 Ihe property, am exclusively contractinq with licensetl con- traGtors to conStruCt the prOject (Section 7044, BusinCss antl Professions Cotle: The Contractor's License Law tloes not apply to an owner ot property who builas or Imoroves thereon. ana who tontracts for zuch oroiects wltn a con- tractm'(s I�cense pursuam to [ne Convactor•s License Law). I am aware thac proof o� their Worker:s Compenwtlon i 5 ran<e ihoultl be Orovitletl to me. � � I am exempt untler Section B. d. P. G�tor his reason Date "�2 - a° pwner I nereby certity that I� nave reatl this applicatlon antl state that the above Information is correct. I a9ree to comply with all clty antl county orAlnances antl state laws relating'4abuiltlin9 construction, antl hereby autnorize repre- sentatives ot this city to'en er uy on above-menlionetl properly for InSpettlonpur SeS. // ��zyE89 Signature �7 .�y f� • -` Dat Orivers' License or 55 " - - " 086 -46, rev. 5/BB 3M �� 8a�`t I l7 l`( _I 8" I— TYPE OFCONSTRUCTION NEW P.DD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHE DESCRIPTION OF WOR�US^O�BLDG. 0 TVPE OF PEFMIT �J GRADING L�l.FOUNDqTION ,!'SJ STRVCTURAL ❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5� T nrr acn�rv qC CONSTRUCTIONTVPE ��'f'M VALUATIONS�L(t 20NE GRADINGCU.VDS. ACRES— Remarks: ��' � / S�� Bar,Sink Backtlow Preventer � Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains : Floor Drains Floor Sinks Gas Service Ouclets Interceprors Kitchen Sink Lavarories P-Trap Roof Drains Reinspaction Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Ezhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑ o-i oo,000 eTu � i oo,00a eT� Reinspection Fee � $15 White � Builaing; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connectiort � ` Solar Collectors', Solar Piping Solar Tank � . Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Treys Issue Fee Hood or Type I ❑ Canopy - Type I I ❑ Refrigeration System ❑0.100,000 BTU ❑100,000 BT System Repair/Alteration Fire Dampers Registers Issue Fea e $ 3 FEES A.P. # /� S Main Buildi E T Fron[ B Rear A d C Right K Left S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishavdsher Fan F.A.U. Fixtures Device Boxes 2one B Req./Provided ELECTRICAL Trans(ormer ❑ 15-50 KW ❑ 50+KW Meter Llup to 100 amps Meter �over100amps Sub Panel Motors �0.1 HP �1'f.-8 Inc.Solar �9-75 HP �16-15+ Microwave Pole Light , ' Switches Sign Garbage Disposal Standing Sections Generator �0.5 KW 05-15 KW Trash Compactor FEES O N 1 N G R E Q M T S. .� Reinspection Fee �$15 � � Issue Fea � 9S�'7(� DEVELOPMENT SERVICES REQUIREMENTS: v Zonine APProved BY �{,� Date �� Building Appravad By Date Application Issued By Date�� SUMMARV OF FEES BUILDING PERMIT $�0�, OO SMIP $ �.� 7 PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICA� ^y � �6 •dO GRADING S PLANCHECK 50% $ MICROFILM $ MECHANICAL $ � TOTALFEE $ �� PLAN CHECK 25% $ �: �no,a�5-_ ,o��i6s �� :�,�- DA'_ uS/OiJ;Y T:IIE: 10e/i� � �C(,�NSTRUCTION AND PLANNING POOL `A , . , APPROVALS Permit #_ Date Inspector AppROVAIS Permit # Date Inspector i L�Temporary Electrical Service or Pole '� �" ' 52. Pool & Equipment Loc.ation w 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .3�.: Electrical Conduit Utility-Undrgrnd. , 54. Forms � 4`Electrical Conduit-Undrgrnd �,� 55. Electrical Bonding . • 5. Steel Reinforcercient 56. Rough Plumbing & Pressure Test i� i ,6�, Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE '� ' 7� Footings .� � � 58. Electrical Conduit-Undrgrnd. S�Foundation �� ' � � 59. Gas Pipe, � Undrgrnd., Test ' '9.I Water Pipe-Undrgmd. ' . • 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 I � ' 64. Plumbing System - Final 14. Rough Plumbing � j � 65. Electrical-Final 15. Rough Electrical-Cond`uit 66. Solar SYstem-Final 16. Rough Electric Wiring S �Q,� 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceil� g 69. POOL/SPA SYSTEMS FINAL 19. Rough�Heating & Air Cond�oning FIRE DEPT. REQUIREMENT 20. Rough F�ctory Fireplace ,,; APPROVALS Permit # 2.1. Ducts, in Structure �,f 70. Underground Hydro 22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil 23: Gas Pipe-Rough & Test �-� 72. Underground Flush 24� Roof Framing �;,� ,p 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. •Roof Sheathing ' '. - � � � � 74. Overhead Hydro 26. T-BaFCeiling �Structural) &��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 Coai�/, ^'�• 79. FINAL INSPECTION � 32. Electrical Power Meter-Final.- 80. FOOD CERTIFICATE ISSUED -;'� 33. Final Electric . 6� B� Notes: � -� r 34. Final Heating & Air Conditioning 6_� _ G 2� ,,� �, � f 5 35. Final Gas Pipe-Test � � 36. Hood or Canopy ( 37. Final Factory Fireplace . '38. Final Plumtiing " � � 39. Water Service-Final . .. 40. Gas Service-Final - � 41.. Solar_Domestic-Final` � _ 42. Backflow Preventer � � 43. Backflow Irrigation �' , , ;. , • 44. Landscape IrrigatiomSystem .�' ' ' � 45. Sound Attenuation: 46. Handicap�Regulations � 47. FINAL,STRUCTURE & BUILDING p(�� i 48. Special Requirements Completed � . 49. �Elect�ic Release to Edison : - � � � 50. Gas Release to Southern California Gas Co '�' . ' 51. CERTIFICATE OF OCCUPANCY � ' ;''�� _ • • . No. Date � ." ' � , ,(. moxEssaea�oc�a 455 16TH PL oxr�xsruYeiva+orn+:SCHOBER, LEON ,moxeu:SCHOHER, SHARON F ' 37 ROSY FINCH LN ALISO VIEJO,CA 92656 �vv�. �uuNc �oo�ss: YKNRECf OP ElYMFFA: APCN OIIFNO.'SiWDPE59: wem�cTarsruwE CAUSEY ELECTRIC CONf11ACTOff8YYldlO 3 VANDERHILT ,��:IRVINE C 92718 110EN4ED COMP�GTORS DECL�X�TION: I MnEy eRim urder panely d pmjury (mmmenaN wn� Seciion )000) d Oniaion � M Ns Bue"ubn W Pmfudam CoEe. end cm.cw„no.:017 7 5 4 _ uc. cuss: C 10 uc. yu.-�--3,10 u�: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; E 077303 PERMIT NO: E 077303 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V-NR PERMIT TYPE: ELE PURPOSE: ALT ucra: JOB DESCRIPTION : LEGALIZE SERVICE UPGRADE & JAC. CONNECTI SQ FT: UNT: (714)855-9610 A uG„o,; 331064 uNr: Net I un fcanwE uMm prv.moru d Cheqr 9 my Gcmw u'vi htll lau uM eflaa. 64 '�EXP: 02/97 `I------------ MAIN HUILDING ---------- � FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN CLAIM ��ALOE: CALC-VALUE: GROUP OCC: R-3 / COMMENTS: LEGALIZE UPGRADE TO 200AMP 6 JACUZZI CONNECTION *�*«�**�**�****�*�*�*�**��*+�*�*��*+�x**x�**�*�**�*****�*�+��*�*�*��+�**�***� Z O N I N GS ERTEB�AUCIKRSE M E N T S �OWf1fN BUILtlEA OECIANRTON: I hsroby etfmi unMr prWy d per�ury Ihtl I un a�emqNpn �M Ga4reqon Lkaus Lawla Ihe Idbx'vq iasmn (Seaion 1W t.5 &niin� end Pralmeon� Coda: Mf' cIy a aounb whidi r+Vwn e V�t to mnuun. etla.'unpo.e. damd'e�, a repv vry ntuctun, pia b Ya'seue�Ke, e6o �pu'vae �M eppfimM la ach pamE lo fib e iq�wd slatemeM tlut M a she � IimroeE W�� o iM pawiona d IM COMrada� licems lew jCheqx 9(�ma�q �h Saaion lODO) W Diveion 3 W Ib �nr�aa aM Ndwuns Cotlsl a �htl M a eM is awamq �hrelmm end iM Waia ta Ne dkG� uanNion. Mrv vidmion d 3edion .OJt.S Ey ary epplifaM fa e permn wEjW� IM epplicaM to e dvil penally d M man IMn INa hurMnE EdW �5500��. � I, ea owner d IM1s papany ar my ampbyaea xAh wepea ea IMi wla compsneetion, will Eo Ns woA. eM Ne nrucYuro c m� intandeA a ollorad la sele (�lion ]061. Buuroo erd PMaeebnaCOEe: The ConirMpa Liwnes lewdoea mt eppy�o en owmr d poperry wb Wida w inprwa� iherson, and who doee �uM xak himeW a henetl or Nraph he a Mr own ampbysn, pmriEaE IMt wM --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42515116 ZNE: REF NO: PLANNZNG NOTES> i iF if iF if if 9E iE iE 1F If ff if !E!t iE 1E iE if iE 1F IE iF iElE if !E if 1E Ik 1E 1k 1F if if iE iE 1E 1E ik 1f if ik IE 1E 1f IE fE 1E iE iE fE fF IE iE If �E fE IE 1E 1E 1E 1k If iE ik 1E if !f 1E iE iE 1E IE �E fE IE iE fE fE 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 impv.ememeva�wimendadaWxedtnuk.X,howavar,tMbuiki�pwinpwanemu�okwil�inansyevafcanpation.Na ZONING APPROVED BY DATE; ownar-0uilMr wll haw �M buNan d pwi�p M w Me ditl nd Ndk or impwe lor tM WTaa d eeb�. ❑ 1. n wmer d �M papeny, em udwively mnueenp v.41� GwnrA contrectws �o m�mw Ms pojsa (Ssaion �ou, Bwiross aM B U I LD I NG AP P ROV ED H Y : DAT E: Pmleuidu Cab: Ths CoMreda+ licema Lew Ewe nol WN'/ b en owr tl pWMY r.ho bWda a impm'x tMrson eM who q cqNrecb for wdi prqetlf hith e mMredM(e) licenssd punueM Io IM Canlretlas Li[en�a lew). ^ r ❑ ��sx�q�oders«ia�: e.aP.c..�oruar�e�: APPLICATION ISSUED BY: I DATE: � 1�2' /� �x-i�-iF *iriF+� * *i�+�+�rtft *� *� * * *�iFliTFTFiFTF�F'iFiF;F3FiF3F�F7i- iF3FTFTFTFid�FiF7F3F'fF'iFiFTFiF * *+t *ie+t+tiE * * yrit o°'° °wneC LEGALIZATION;Y F E E S U M M A R Y STRUCTURAL GMENT:N I do Mrsby c�Nly tIW I em ewve d eM wtlsnleM iM rpuinmoMs d CN/omu MeMh entl Setaty Cads SeGiana P5505, ?55]3, uM 255J1,vdNalnenyMunWikirymaip�mwill/wiliwl(dicban)mMioeanyywYheeiAewemdaudtMrayu'vamenbbr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING •psmdlawrov�nionamadifwonhmi�M�r ue�y enq�ememDiqrip.Pxidxuielmm�utlianappfutiauanaasmqlmmiMu PERMIT 59.0.0 pwinam. °"• ^°a"'°�' PLAN 50'2 SMIP /NON—RES WOflKEN'9 COMPENS�TION DECLARATION: I Mnby elfirm unAu penelry M pa�ury aro d tha bllowiip Eetluubns: I S S U E F E E 1 5, 0 � � IhewenEwllm�Imeinewntlicmedromm�uo�NlJnmrolurwahan'compemLLian,mpwld�dlwbySapionW00d�Ml�bor $UILDING—DIV—> PERMIT ISSUE PLAt�]—CHECK TOTAL PAID DUE cae.,r«u.o.eo�.mu»��m��nm�.��nnh.�e. TOTALS----> 59 . 00 15 . 00 0, 00 74 . 00 74 . 00 , 00 i n....�e �;� �wm.� woM.� �w�.mo� i�w�... m��.e M s.a� aroo a m. �.e« coa.. m. m. o��w a�ne i wwk la xhich �hh p�rmn h IuwA. My wabn' com nulbn Inwr uW pdiry numbu v�: I c�.,: FE�ERAL�N�S, EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 74.00 OVER/SHORT: .00 ' roikrNumw: 10/01/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK M...nhn ns.e nor a. comr�.roe! th. v�^^x 6 ror on. nuner.e dw�en Isrool a kaJ �] I nniy Ihe1 In Ib prtlom�erms d tM xroM la whkh Ihie qrtnd h layeQ'f91�hm4�moiw �y oJ 0o i eny menn�r p u lo b�cam �ublb to iM xorken' wmpenWlon kxs ol C�itomis. �n Odl � Ntl M Iy houW p(oo abjtl to iM wnilmii penW ion p om W 8� ion a)a0 W iM lebor Cotl�, I�hdl lonh ' o �fi6lhw� Ia '' e. ua: � �ppliunl: W np: F�llu b ��eun wo�lrx�'rompmuHon rov�np� l� unl�wN, �nd �Mll H.dJ�e m�mplayw fo eNMn/ pxrMu md m n�.. w ro o�. n�e..d mouwne ewr... ltioa000l, in nana� ro m. �o.r o� �o no�, a,m.w .. v�Hew ro� m 9�eHon 91fM ol M� L�bor COM, InM1nif, �ntl �ttomry'� Iw�. � CON9iNUCT10N LENDINO AOENCY: I Mroby dflrm undar penelry d perND' �hel Ihan le e mnNmdion ISMinp epsncy lor Ihe peApmarica ol ihs woik la w1iiW I�o permY Is b�uW (&ed'pn 30D'l, CN. C). LENOER'B NAME: LENOEP'9 AUOXE59: I n�iN �� I hev� neC I�I� epplcmian eM pet� Ihet Ihs ebwe inlametion u eonM. I apiee lo eanply xith ell ciry ud muny adiwiee� vd �teU lax� reW inp io bulMip conqruqion erd Mnby sinhoriia repr�eentetrvm W ihn tl�y io �ntar upan iM ebwe-menlbnM propeny , lor impatlion W rpo�L EW I S � [ . �, �_k/.-----� (51st.�ewP) wnns-Buileip Pink-Mwnw; (bWemo�Naevew 74.00 1f !k iE 1f iF �E iE jE iE 1P IE IE 1E 1E 1E IE k k k IE 1E �E iE �E iE iF k 1E if IE �E iE iE IElE �E 1E if iE 1E IE IE 1E fk 1E 1E if 1f 1ElF iFlf i6lE iE �E 1E �E ik iE iF 1E 1ElE 1E 1E 1E 1E �E 3E iE IE IE iE 1E IE iE 1E iE 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 1 SERVICES HELOW 600 V&.BELOW 201 AMP 18.50 ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT 11,00 END OF FEES ' ..�1. V ' �f-� i �� '°� z�!�I�I� ' � � � -: ' 18.50 11.00 CONSTRUCTION AND PLANNWG � �� .-� P�b� �A ,� � ` � APPROVALS Permit # • Date i�spector APPROVALS Permit #• Date inspector 1� Temporalv Electrical Service or Pole 52. Pool & Equipment Location 2. Soii Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit U2ility-Undrgrnd. 54. Forms 4. Elec2rical Conduit-Undrgrnd. 55. Electrical Bondiny • 5. Steei Reinforcement ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gr�d. 57. APPROVALTO COVER�GUNITE 7. Foodngs 58. Electrical Conduit�Undrgrnd. • � 8. Foundation 59. Gas Pipe, � Undrgmd., Test � 9. bVater Pipe-Undrgrnd. • 60, Backwash Lines, P�Trap, �7 Undrgrnd. 10. Structural Ftoor Syscem � 61. APPROVAL"TO DECK 1 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 1 63. Heater & Vent-Final � 13. Roof Drains � 64. Plumbing System � Final , 74. Rou9h Plumbing � 65. Electricat-Final � 15. Rough Elearical-Conduit 66. Solar SYstem-Final �' 76. Rough Electric Wiring 67. Fencing & Access_ApP�ovai � � 17. flough Wi�ing Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling � 69. POOUSPA SYSTEMS FINAI 79. Rough Hsating & Air Condixioning: - FlRE DEPT. REQUIREMENT 20. Rough Pactory Firep(ace � ' � APPROVALS Permit # 21. Ducts, in Structure - . . 70. Underground Hydro 22. Dutts, Ventilating .` 71, Producf Piping L7Gas GOii 23. Gas Pipe-Rough & Test 72. Undergrour�d Flush ' . 24. Roof Framing � , 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro � 26. T-Bar Ceiling (Structurali & Monocoat 75. Dry Chemicai ' 27. Freme and Flashing � 76. Dry Standpipe � - 28. Lathing & Siding' • 77. FIXED SYSTEM PINAC. 29. Insulation � 76. FIRE PREV. FINAL 30. Drywall Nailing HEALTN DEPT. REQUIREMENT 31. Plaster B�own Coat � . 79. FINAL IN�SPECTION , 32. ElecYrical Power Meter.Finai 80. FOOD CERTIFICATE ISSUED 33. final Efectric . " � Notes:�s"%alc�� 5 �D.<�f/�JA-QI�� .Q 34. Pi�af Heating & Air Conditioning � � - 1-�C.S t-E�t D��C�1t��Z_J�r--'�,� 35. Finai Gas Pipe'-Test , . � 36. Hood or Canopy - ." � . . : . 37. Final Factory Firepiace . . 38. FinaF Piumbing . , 39. Water Service-Final ' , , _ 40. Gas Service-Final � � 41. Soiar pomestic-Final 42. Backfiow Preventer _ � 43. Backflow Irrigation � � 44. Landscape Irrigation System _ 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL S7RUCTURE & BUILDING � -" 48. FINALP4ANNING . A9. Electric Release to Edison � 50. Gas Release to SouYhem California Gas Co _ 51. CERTIFICATE OP dCCUPANCY . o No. Date i �• � April 24, 1996 I �Y3'Y OF COSTA M�SA CALJFORNIA 8262&1200 P.O. BOX 12W DEVELOPMENT SEfiVICES DEPARTMENT Leon & Sharon.Schober 37 Rosy Finch Lane Aliso Viejo, CA 92656 SUBJECT: •455 16th PLACE, COSTA MESA Dear Mr. & Mrs. Schober: The following is a list of deficiencies at this address discovered by our inspection on April 16, 1996. Mr. Schober was present at the time of inspection. 1) Electrical and plumbing work has been performed without first obtaining required plumbing and electrical permits from the City of Costa Mesa. ie: installation of jacuzzi tub, hot tub, and water piping to lawn sprinkler system. 2) Electrical service has double and triple lugging.at circuit breakers, unfused feeder conductors to subpanel, open knockouts in subpanel dead front etc. The main service panel needs to be replaced with a panel which has capacity for enough circuit breakers so that each circuit is protected by it's own circuit breaker. The subpanel below the existing main service can be incorporated into the new service. 3) Receptacle in den/dining area is loose in outlet box. This outlet box is not flush with the wood wall paneling. 4) Nonmetallic sheathed cable wiring in garage is exposed to damage. 5) Cord wiring with open splices to fluorescent light fixtures in the garage. 6) 7) Unlisted flexible tailpiece at P-trap of kitchen sink. Water heater lacks drain to exterior on temperature/pressure relief value. 8i Water heater lacks adequate seismic resistance straps. � 77 FAIR DRIVE Building Divison (714) 754-5273 • Code Enlortement (714) 754-5623 • Planninp Division (714) 754-5245 FAX (714) 750d856 • TDD (71a) 754-5244 % 9) Elevate water heater in garage so that the gas burners are located ax least eighteen (18'�) inches above the garage floor. 10) PVC water piping has been installed on the interior of the garage. Please submit applications for permits to the Building and Safaty counter on the second floor of the Costa Mesa City Hall at 77 Fair Drive in Costa Mesa, within (10) days of the date of this letter. The work shall be completed, inspected, and approved within thirty (30)•days of Che date of this letter. If you have any queations, please call Fred Norton, (714) 754-5629. Sincerely, Tony C'De'Baca Assistant Dev. Svs. Dir/ Building Official By. Fred Nortori Housing & Code Enforcement Inspector/Consultant BUILDING PERMIT LOG � ��3g3 TYPE OF PERMIT: SQUARE FOOTAGE: ACTIVITY (03/27/98) UILDING PERMIT SYSTEM __� (11:26:18) BP74 BROWSE INSPECTION RESULTS NUMBER: 455 STR: 16TH PL UNIT: PERMIT N0: E 077303 PLAN CHECK N0: 9601507 PARCEL: 42515116 OCC: R-3 / NOTES: PERMANENT CERT. OCCUP: DATE: TEMPORARY CERT. OCCUP: EXP DATE: CODE D E S C R I P T I 0 N DATE INIT Y/N 0000 ELECTRICAL 05/03/96 FN F 0000 LOCKED 05/06/96 RB F 0000 CORR. OS/07/96 RB F 0000 EXPIRED 02/04/98 KC F FUNCTION: F:FORWARD N:NEXT T:TOP U:UPDATE X:EXIT NEXT CODE: MSG: NO MORE RECORDS FILE: ACT PRINTER: REM � .OWNER LLOYD, JAS. & MARTHA DATE 7-$-58 JOB ADDRFSS �55 E. lbth P1aCe � " BUILDING PERMIT NO. 7093 GENBRAL CONTRACTOR Q�ep VALUE $ I.I.� � Z7L{.00 - 1 P. o. LOT 8 TRACT 1%14 FIRE ZONE DESCR[PTION OF WORK Res. and Det. Gar. Gr "`llP I& J TYpE 5 ZONE R(.� PLAN NO. INaPECTIONS I DATE I $UBCONTRACTOR I PERMITSISSUED DATE NUMBER r— F. 7093 .- • '70q,3 � � �OSTA MESA BUILDING DEPARTMENT P. O. BO% 31] COSTA MESA. CALIFORNIA FOR FILL IN �. COSTA MESA. CALIFORNIA � � ( . � -Y'y�a-�c �' �EGn� ILOT OE6CRIPTION ryQ, A.P. NO. SIZE � OF LOT USE OF E%ISTING BLDG. �� N� LIC. NO. TY TEL. NO. BLOCK I �> �� NO.OF 9 � NOW ON SETBwCIt LINE FPOM j� % �I CENTER OF STREET '�(J REAR YARD y NEW REPAIR BUILOING/ 512E E%TERIOR W. COVERING USE OF NEW ftiGNi VJ � LEFT !D' � DESCRIPTION OF WORK ALTERATION ADDITION MOVING DEMOLISH / �+� � � NO. OF �V ROOMS S6TORIE: //I� 1LERING�� .� ,. �IL ��L�L"u�i u..., i � L y/•' �' J �' �i fINANCE DEPT. ' ,,, �� ..ncTn r1Fcq APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY RECEIPT NO. PEAMIT NO ?093 ECEIVEO BY OATE RECEIVED ORT 99 i n -v�., f7 _�_— S- 7 a%.E' BUILDI ADORE � COSTA MESA. CALIFORNIA FIRE � ZONE ZONE /� NO.OF rypEy y � PL/�N$ ..� `{/ � /%�n7� % DATE CORRECTIONS E EF'T: �O � , �`--��- �/ !, � � . �LIr l� l4[ •VE NE.�� THIS 1PPLICAlIVfi Af�p . STRTE TXAT TXE /�BOVE I$ CORRECT AND .�GMEE TO COMPIY WITN ILL CITY ORO�NAN 1ND $T�T�S NEGUL�TING BUILryylG CONSTRUC� TiON. w� VA�UATION � �G�` PERmiT FEE $ � SIGNATU PERMITT ' g �� a7/� � y PLAN CHECN $ �` �` AUTHORIZED AGENT TOTAL FEE S J % OWNER F JOB ADDRESS GENGRAL CO Af 117- INSPECTIONS SOIL GAS W ATER ROUGH PWM91N� PROP. $WR. LINI SPRINKLING SVS MISCELLANEOUS ftOUGH HEATING ANO AIR CON�ITIONING UN�ERGFOUND U POWgq U FOUGH WIRING TRENCHES � FORMS STEEL REINF. FLOOR SVSTEM SI:I PI 5'. EINFORCE oi�ii niur- ciuni �//�� ,2/r�A DATE 4_ SUBCONTRACTOR � I� �� PAIO APR 13-70cnsa�0 �i.2�' �**�25.50 , ' , COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT Fo� Applicant to Fil/ in Completety �� ` , RECEI ED BV OqTE RF�EIVEOD �� UEp� BUILDING f� � H ADDRESS � � � OWNER �Tlt/D V�JI�'G�ry/'/S A.P.NO. � � �I��'IN.Z MAIL �_ 7/✓ / ADIDfiIE S S� � z ADDRESS � W W /JQ� '/� � TEL. TRACT lOT BLOCK a U CITV (� I(/�- NO. ZZ Q CANSTRUCTION / � G NEW ADD A P O N LENDER � L d m J � BRANCH � J N n OWNER m J ADDRESS �Q/` VALUE �/ /� Jm ARCHITECT TEL. S • $/IO�U•� Q OR ENGINEEfi N . Z Q FIRE ,y'� w � ADDRE55 ZONE �TV�P/E//J _GROUP a W APPROVED %///�/� ATE �` ��/( W Z CONTRACTOR L BV f�6 6 J Q . ;i m z' /J // J � ADDRE55 ,6O(//Op'S `� � W W ZONE NO.OF VSE OF NEW � Z= CITV � NOL PIANS BUIIDIN .� • H — � STATE CITV �'AROSAPPROVED YARDSAPP VED N CL . �I0. NO. LIC NO. MAIN BUILDING ACCESSORV BUIIDING �� SIZE NO.OF BLOGS. (FROM C/L ST� OF LOT NOW ON LOT FRONT USE OF /� , � EXISTING BLDG. �(,U l ` S ' H SIZE OF NO.OF '^f Z N6�Y6Y99 � AOOMS STORIES L.SID k� U EXTERIOR WALL ROOF COVERING COVERING REAP FT J USE OF BUILD G AND W RK TO BE PERFORMED DISTANCE BET. BET. MF a I I MAIN BLD(i,.. ACCE55. a Q � � VAR.# DATE O — C.U.P. �} qpPROV ~ APPROVED � z 0 UI hereby acknowletlga that � have reatl this application antl state � that the above intormation.is correct antl a8ree to comply with � all laws regulating builtling consttuction, and I shall not employ r any person in violation of the workman's compensation laws ot (q the Staie ot Calitornia. zI heraby certity that I am properly licensetl as a contractor untler /�� SQ. FT. � the State of Californi usiness antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER V Chapxer 9, antl [ha su licenses are in full force a tl effect, or I THE PURPOSE OF ESTABLISHING A am exempt from e ovisions of the Stat t CaII rnia Business yALUATION antl Professions o, Divisi0� 3, Chapte� . � PERMIT FEE Signaiure Permittee 5// � O PLAN CHECK Authorized ABe TOTAL FEE & _� m 0 IS FOR � ONLV: m ¢ �D � 30 E s sv LL (714) 754-5273 • Fax (714) 754-4856 • www.d.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 455 16TH PL Suite: Viciniry: KITCHEN Parcel Number: 42515116 a.pp�icant: IVERSON, ELAINE Address: 455 16TH PL COSTA MESA, CA Owner: LINDSEY, JOHN S Address 455 E 16TH PL COSTA MESA, CA ConUactor. Address: Zoning: Phone: 714-012-2375 CELL Zip: 92627 Phone: Zip: 926273216 Phone: Status: ISSUED Applied: 07I01/2003 Issued: 10116/2003 ISSUED BY: � Zip: License: Arch : DLCA Eng: JG CIVIL ENGINEERING Address: 2022 ORCHARD DR . Address: , 8452 TULIPWOOD CIR Phone: 714-971-3016 Phone: 714-890-0620 NEWPORT BEACH, CA WESTMINSTER, CA Zip: 92660 License: C17069 92683 Llcense: C038192 SCOPE OF PERMIT ADD 112 S�. FT FIRST FLOOR TO EXISTING SFR. SCOPE OF WORK TO INCLUDE: ALTERATION/EXPANSION OF KITCHENIPANTRY. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $172.41 $265.25 $1.54 $0.00 $0.00 $0.00 $439.20 SETBACKS ' MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0-0 PARKING Existinq: 4 NOTES: Rear 0- 0 Rear 0-0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Re uired: 4 Proposed: 4 Calc Valuation: $15,348.80 Claim Valuation: So.00 Right Right 17- 6 NOTICE: The work euthorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulatlons. (Ord. No. 92-28, § 1, 12•21-92) � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned Por a pedod of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable es,�d all requlred Inepeetiona end flnel epprovel must be obtained. Feilure to obtain inspections and final approval will result in the axpirallon o�ffii� permit. POR INSPECTIONS CALL: (714) 754-5626 2048i8 (8N0) WORKEHS'COMPENSAnON DECLARAnON: � I hereby effirm under penalry ol per�ury one of Ne tdlowing Oedaretions: . ❑ I heve end will malnteln e ceNficate oi consent to selt-Insure for workers' compansation, es provlded lar 6y section 3700 at the LeDor Code, la Ne pertortnence of the work tor whic� ihis pertnit is Issuetl. ❑ I heve end will maintein workew' campensation insurence, es reduiretl �y section 3700 ot Ihe Lehor Code, tor Ihe pertormence oi Ne wark lor whic� NLq pertnit is Iswed. My worken' campensetion Insuranca certier and pdiry numDer ere: Cerrler: Polity Num6er: (This sectlon neetl nof be completed l! fhe perm/f!s velued et one huntlretl0ollers ($100J or less.) ily thet In the pertormence h or w Is pertnit Is Issued, I shall not employ eny person in any manner so es to Oecome sub�ect to t�e workers' �ensetlon laws of CeINy a epr t I sh Id become subject to the workers' compensatlon provlslona ot Sectlan 3700 of the Lebar Catle, I s�all IorthwiN ily with t�ese pr ' '� � � ,�� '� � ilgneNre: � Date: 'AILURE TO SEWflE WORNE0.5' COMPENSATICMI COVEMOE IS UMAW FUL AND SHALL SU6IECT AN EMPCOrIER TO CRIMINAL PENALTIES AND CML FlNES UP TOONE NUNDRED OOLLARE (E100,000), W ADDITION TO THE COST OF COMPENSAT70N, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE L4BOP CODE, IMEREST, AND FTTORNEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm Ihat I em Ilcensed untler provislons ol Chapter 8(commencing with Sectlon 7000) of Dlvlslon 3 0l Ihe Business end Prolessions Code, end my Ilcensa Is in tull lorce end ettect. Llc. a Class a Contractors Slgnamre: Dete: CONS7RUC710N LENDINO AGENCY: ❑ I hereby ettirm thet there is a cansiructlon lending agency br ihe peAormence of I�e work for which this permit is Is9uad. (Sec. 3097, Givll Code). Lendels Neme: LentleYs AAtlress: Signatura: Date: OWNER-BUILDER DECLARAT10N5: I hereby efllrm t�et untler penalry ot perjury that I em E7(EMPT FROM THE CONTAACTORS LICENSE LAW tor Ihe Idlowinp reason (Sec. 7031.5, Business end Protessions Catle: Any ciy or wuny which requires e permil to construct, fllter, improve, tlemdlsh, or repair eny siructure, prior to Its Issuance, also requlres Ihe epplicant for such pertnit to file e sipned stetemem that he or s�e Is Iicensetl pursuant lo the provisions of tha Contractora Lkense Lew (Chapter 9(commendng wIU Section 7000) ot DNWon 3 ot the Business entl Professions Cotle) or Ihet he or ahe is exempt thereiram antl the besis far Ihe ellegetl exemptlon. Any violetlan ot Sectlon 7031.5 by any epplicant lor e pertnit subjects ihe epplicent to e Gvil penalry of not more than Me �unCreC AWlars (5500).): ❑ I, es owner ot the property, or my employees wliti weges es their sde compensation, WILL DO TT1E WORK, end Ihe strudure is not Intended ar oHeretl for sale (Sec. 7044, Buslness end Prole55ions Code: The Coniractors Licensa Law does not apDN �o an mvner oi properry w�o bullds or impraves thereon, end who tloes such work himself or herselt or through his or �er own employees, provided that such improvements ere not intended or oMered tor sale. If, however, Ne building or Unprwement is soltl wit�In one year af completion, the owner-builder will have the 6urden of proving thet he or she did no� builtl or ImDrove tor purpose ot sale.). ' ❑ I, as owner of ihe properry, am E%CLUSIVELY COMAACTING WITH LICENSED CONTRACTORS to consWct ihe prqect (Sec. 7044, Buslness antl Professions Cada: Ttie contractors License Lew does not eppry to en owner ot properry who builtls or improves Ihereon, enA who contracts tor such pro�ect with a contracror(s) license pursuant to the Contrectors License Laws.�. ❑ I am exemp� under sec. Busineu end Professions Cade tor Ihis reason: Sipnature: Date: Owner ID venfied by tlrlvefs license. ❑ Yes ❑ No Drivers License No. Verificatlon of Ownerohip by (type ol daument, I.e. - properry tex blll ar tleed): Expires: DIVISION OF INDUSTRIAL SAFE7Y PERMf7 CERTIFICATON: ❑ I hereby ceritly tha� no excevetlon flve (5) or more leat in depih Inio which a person Is requlred lo descenU, wlll ba metle In connection with work euthorized by this pertnil, entl that no bulltling sirucNre, scaHolding, lalsework, or tlemolition or dismentling ihereof, wlll be more Ihan Ihirty-slx (38) feet hiph. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Tltle 8, Celifomia Adminlstrative Cotle). ❑ Ae owner•bulider, I wlll not employ enyone to tlo work which woultl reqWre e permll from the Dlvislon of Industdel Sefery, es noted ebove, unless auch pereon hes e pertnit ro tlo such work trom the dlvlslon. Slgnature: Date: DiWsion of Intlusinel Sefery Permit NumDer: CERTIFlCATE OF COMPLIANCE ANO AUfHORIZATION OF EMRY: I certify untler penelry of perjury that I heve read this epplketion end state thet the Inlartnation given is cortect. I egree to comply with ell siete lews end ciry ordinances ralating Io building constructlon, end euthodze representetives oi the Ciry o1 Costa Mesa to enter upon t�e ebove-descdbed propeny tor inspectlon purposes. I egree not lo occupy or allow occupancy ol eny building eu�hodzed by thls pertnit until finel inspection. I�t INSPELTIONTYPE 1818 Fixetl Systam Flnal Fire Praventlon 7288 Pool Spe Flnal 200 Final Re-Root 201 Flnel BIocWReteinln0 Well 202 203 204 Finel Feclory Fire Place Finel Slpn Final Demolitian �g �� f,d MSiEC110NTYPE 208 Flnal Mechenical 200 Flnel Plumbing _ . ._.. 210 Finel EleCtdCel 212 Final Flre Prevention 220 Finel Planning Apprwal 222 Finel Sice 250 Final BuIlding/Occupancy � 0 �� I�� COUHTY OF ORANG& � BUILDING DEPT. 636 No. Broadway Santa Ana� California Phone: KI 2-6211 - Application for Building Permit AND FOR A Certificate of Use and Occupancy Petmi[ No.....,�_��•.7 � �/ -----�_�� ' Da[e.._. OWNER'S IVAME--��D_��IY� .�-/-�-X--��------------------ PHON � - `�--�1'!-�� MAILING ADDRESS�,(:��f?._� � _._...___ CITY _ D .C�/f_._._�$ S � - ___ Name ._ Address City ---_. Stace Lic. No. G "- ---------'----------� (Architea or Engineer) �/ � � Phone --_-....__.. Name� �'-�.�-----��.Jf1_//_ .�C-L/__�--�-�----- � �7 (Concractor) Address.-----\�.._../t./Yf--C--�-------------' -------- City .__-- State Lic. No. PROPOSED USE: - --_. _.4�_W _�_L/ � ` =----'" — -- -----._.. 2. JOB LOCATION_/�sy_._�-----�-----/�-�.-��----------- (�'iouse No.) (Name y�Stree[) .� /� � / 3. 4. LEGAL DESCRIPTION: Lot __.__��`.__________________l___Block .._Y_.___�(`v � --- ; (Meres and Bounds Des<ription—Use reserse side af form) CORNER LOT ( ) IIVTERIOR LOT ()( ) THROUGH LOT ( •i - Phone ..---------- or Sch I yDistfict) �1/ �-�-_-,- i a�c�/1'--4�_-=C-�-/-----�f� -�-- SLOPE OF LOT ( ,� , 5. SIZE OF BLDG.��.�.�a'�_7___AREA:._L_�8_�____._.__.SIZE OF LOT:....�Y.��__AREA:�o�L.-��__.__..___ � / 6. HEIGHT OF BLDG.: .._��____ —__...._______.CEILING HEIGHT:..__ �______..___....__.._. IVO. OF STORIES____�________ 7. NO. FAMILIES ______________�._ /��L_�_.._. S�ie of Kitchen: ._._._�_ 6 --_______.....Size of Smallest Bedroom: ----�--- �� _9_____--_---- 8. EXTERIOR WALL CONSTRUCTION:.___��f�_C_C_P_.___.INTERIOR WALL COVERING�L4Sf�_✓______ (Frame, Stucco, E[c.) - / - (Plaster�Drywall, Etc.) 9. SETBACKS: Front Yard- £rom Center Liae of Street_________�� __ ______._____.._________.___ _- —___.___ / p / �/ � Nearest Side Yard.____�_______Rear Yard.__fJ__O_._..______-Distante in Feet Between Bldgs. on Same Lot ___._.L�.�.____._______________ ]0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRU(.'TURES AND USE OF EACH. // � � ii /� I1. For (a) Footing: Width___�T._______.______Depth in Ground.___.��_.......__-___Wid.th of Wall�.e�_�.��.__�..�..__. Accessory Bldgs., and / ' Similar (6) Size of Studs:._�_..%._�_._.______Spacing_______l_U'.____._--____"CC Matetial of F1oor...0.!✓C.t�£�£=_ Structures: IS j$$UED (c) Size of Floor Joists: --__-----__--_-.-_-___-__.Spacing ___----lj'$IS _-P�RM��; • J , gUB�ECT TO A�7Y FEDER9I+ ----------- - -- ------------5 acin - -- -'- - (d) Size of. Rafters: _�_.i..{ P B 2 �;S�ygj.'(,-'-`}'-��, . 12. VALUATION OF PROpOSED( /W'O2RK: Including al� labor, plumbing, electrical wiring, heating, fire sprinklers, paino ing and sewage disposal �.____.___l-OL�%�___�� ' . _______________-_ li. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CO[�ISTRUCTIOIV WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE,OF CALIF,ORNIA_APPL�CABLE THERETO. Plans F:led: ��j�/�f S�g Bd. ""_' ""'_"'_'F__ _____________ • FEES: Bldg. Pennit Plan Check Total - Receip[ No. Paid m Daze --------- (Owner) (Auchorized Agenc) FOR DEPARTMEIVTAL USE ONLY � � GROUP_- � -_ - ---- ' dD T']'PE- - -- -- ----- ------ ---- � DIST. ----- � NtAP----�------ � ----- _ SHEET NO.___�__.._.___ i BY iALTH.-- --_--------- 2E �RSHAL ---------- --- ATE - - ------- - ---- --- / PERMI $yJED By : +y/ l/ ,//� DATE- -------�-- ��l,; _ --- - �Gi�/ / 5M->-30 � V