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Home My WebLink About497 16TH PL - Building PermitsMECHANICAL PERMIT Job Address: 497 16TH PL Suite No Vicinity: Parcel Number: 42575109 Applicant: HOUSEPIAN, RONALD DEE TR Address: 497 E 16TH PL COSTA MESA, CA Phone: (949)646-8560 Zip: 92627 Owner: HOUSEPIAN, RONALD DEE TR Address: 497 E 16TH PL COSTA MESA, CA Contractor: OWNER BUILDER Address: Phone: (949) 64G8560 Zip: 92627 Phone: Zip: License: 000000 ISSUED BY: Status: ISSUED Applied: 11/07/2002 Issued: 11/07/2002 SCOPE OF PERMIT ADD SPA INSIDE EXISTING POOL. RELOCATE POOI EQUIPMENT. MECHANICAL TO INCLUDE: NEW 400 K BTU HEATER. GAS PIPING. ISSUE FEE Inst FAU <100 k BTU . Inst FAU >100 k BTU Repair / Alt Coolin9/Heat Inst / Rep. Recess Wall Htr Refrig 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 < 10000c(m Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorb6on Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial In cine rator Domestic Incinerator Compressors / Absarption Systems Up to 3 hp ! 100 k BTU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee ' TOTAL CALCULATED FEES Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $27.15 1 $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 $0.00 $56.60 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiraments under California statutes and related regulations. (Ortl. No. 92-20, § 7, 72-2t-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2406�48(6/00) WORKERS'COMPENSAnON DECLARATION: r � I hereby attirm under penalry oi periury one of the following decleretions: ❑ I have end will maintain a certiticate ot consent to self-Insure tor workers' compensation, as provided for by section 3700 of the Lebor Code, for the pedormance ot the work tor which ihis permit is issued. ❑ I have antl will maintain workers'�� insuranca, as requiretl by section 3700 of the labor Cotle, for the pedortnance ol the oM for which Ihis Pertnit is issued. My workers' com penr '0 1 urenca er nd policy number are: � Cerrier: � J Policy Number: (ihis section neetl not be completed d fhe ermif is velued a( one hundred dollars ($ f00) or IessJ certity Ihat in ihe pedormance ot the work for which this permit is issued, I shall not employ any person in any manner so as to become sublect to ihe workers' compensation� of��gr that if I should De e subject to the workers' compensation provisions of Section 3700 o the Labor Cotle, I shall forthwith comply with Ihes p isio ' �� I� �� Applicent SignaN � Date: WAFNING: FAILURE TO SECUR WORKERS' CAMPENSATION CAVERAG UNL4WFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PE LTIES AND CIVIL FINES UP TOONE HUNDPED THOUSAND DOLI.ARE ($100,000), IN ADDITION TO THE COST OF COMPENSATIPY, DAMAGES PS PROVI�ED FOR IN SECTION 3]O60P THE LABOR WDE, INTEFEST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLAHATION: I hereby attirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is in tull torce and ettacL Lic. N Class» Contrectofs Signature: Date: CONSTRUCTION LENOING AGENCY: ❑ I hereby aflirm Ihat there is a consimction lending agency for the pertormanco of ihe work for which �his permit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentler's Atltlress: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby attlrm Ihat under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness and Professions Cotla: Any ciry or counry which requires e permit to constmct, elter, improve, demolish, or repair any sWCNre, prior to its issuance, also requires ihe apDlicant for such permil to file a signetl statement ihat he or she is licensed pursuant to the Orovisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) oF DlNsion 3 of the Business end Professions Code) or ihat he or she is ezempt therefrom and ihe besis for tha alleged e:emption. Any violetlon of Section 7031.5 by any epplicant for a pertnil subjects the applicant to e civil penalty of not more than five hundred tloilers ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and ihe stmcture Is not Intended or ofleretl for sele (Sac. 7044, Business and Professions Code: The Con�ractors License Law dces not apply to an owner ot property who builds or improves ihereon, and who tloes such work h' sell or herself or ihrough his or her own employees, provided thet such improvements ere not intended or oHeretl lor sale. If, howevar, the building or improvement is oitl within one year of completion, Ihe owner-builder wiil �ave the burden of proving ihat he or she did not build or improve tor purpose of sale.). I, as owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consirucl t�e prqect (Sec. 7044, Business end Professions Code: The contractors License law does not appty to an owner of property who builtls or Improves thereon, entl who contrac�s for such project wtlh e contrectoQs) license pursuant to tha Contractors License Laws.). ❑ I am ezempt under sec. � SignaWre: Owner ID verifietl b dnver's lice se Vetllicetion at Ownershlp by (type of _�—, Business and Protessions Code for this reason: _ ./ � �5c�'� - Date: —7 � .� ❑ Nob Driver's License No. _ a ires: �� CJ 6 i.e. - pmperty tea bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cetlify that no excavetion fiva (5) or more fee� in tlepth into which a person is required to descend, will be metle In connection wlth work euthonzed by INs permit, and that no building slmcNre, scaHolding, falsework, or tlemolition or dismantling thereol, will be more ihan ihirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Atlministrative Code). ❑ As ownervbuilder, I will not amploy anyone to do work which woutd roquire e permit imm the Division ol Intlustrial Selery, as noted ebove, unless such pereon �ae e pertnit to tlo such work trom the division. Signature: Oate: Division of Intlustrial Safery Permit Number. CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF EN7RY: I cerlity untler penalry of perjury that I have reaa f�is application antl stete Ihat �he IMormatlon given is correct. I agree t y with a state laws and ciry ortlinances relating ro building consiruction, and authodze rapresentatives ot ihe Ciry ol Costa Mesa to enter upon �he above-des � d prT� i� ectioo purpos s. agr e not to �upy or allow occupancy oi eny builtling authonzetl�y tpis p6rtnit unI fi al inspection. Signature Oi legal Owner(s) —�� Date AnNOr Authorized Appticant Date GQ�E I, INSPECTIONTYPE 1676 ' Fixetl System Final Fire Prevention 1268 Pool Spa Final 200 Final pe-Roof 201 Finel BIocWRetaining Wall 202 Final Factory Fire Place 203 Flnal Sign 204 Final Demolition Q� It�Lfl CODE� INSPECTIONTYPE 206 Finel Mechanical 20B Finel Plum6ing 210 Finel Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Q� fi� 5-20-03 �r�•� UD.l` (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 497 16TH PL Suile No Viciniry: Parcel Nunmber: Applicant: Address: Owner. 42515109 HOUSEPIAN, RONALD DEE TR 497 E 16TH PL COSTA MESA, CA HOUSEPIAN, RONALD DEE TR Address 497 E 16TH PL COSTA MESA, CA Contractor: OWNER BUILDER Address: ISSUE FEE Temp service le5l Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixis Recepl OuUeLs Switches Non Res Appl Res Appl Service to 2ooa seryioe ro �000a Service over 1000a Motors to 1 hp Motors l0 10hp Motors lo SOhp Motors to 100hp Motors over 100hp Communiratlon drops Sub panel to 200a Phone: (949) 646-8560 Zip: 92627 Phone: (949) 6468560 Zip: 92627 Phone: Zip: License: 000000 ISSUED BY: Status: ISSUED Applied: 11/07/2002 Issued: 11/07/2002 SCOPE OF PERMIT ADD SPA INSIDE EXISTING POOL AND RELOCATE POOL E�UIPMENT. ELECTRICAL TO INCLUDE: NEW 50 AMP SUBPANEL, 2 MOTORS; 1 MOTOR TO 1 HP AND 1 MOTOR TO 10 HP., 1 LIGHT FIXTURE. $23.50 $0.00 50.00 $0.00 $0.00 $0.00 $1.10 $0.00 $0.00 $0.00 $0.00 $0.00 so.ao so.00 $4.75 $12.30 so.oa $0.00 50.00 $o.00 530.50 Quantity 0 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 0 1 FEE SUMMARY Temp Dist System / Lighting Busway /100 fl Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up l0 50 kva/kw .................up to 100 kva/kw ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misa Conductor circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Eiectriral Fee Investigafion Fee Plan Check Fee Quantity $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $1820 1 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 50.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicablA handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be consitleretl legal, such work must comply with all applicable codes, and all requlred Inspactlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit. FOR INSPECTIONS CALL: (714) 7545626 zaasael�oo� WORKERS' COMPENSATION DECLARATION: — � I hereby ettirtn under penalry oi perjury one of the lollowing declaretlons: ❑ I heve antl will maintain e certifiwte of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Lebor Code, for Ihe pertormence of the work tor w�ich this parmit is issuetl. ❑ I have and will mainlain work�rs' ompensation insurence, es require� by section 3700 of ihe labor Cotle, for the pedormance ot the work t w this pertnit Is Issued. My workers' compensa o In5 r e rjer �nd policy number are: � Carner. � �� PWicy Num�ec is sectlon need not be comp/eted i! fhe permi( is valued at one hundred dollars ($100) or /essJ I certity Ihet in ihe peAormence rk tor w�ich his permll Is Issued, I shall not employ eny person In eny manner so es to become subjact to Iha workere' compensatlon laws of Ca ia, a egr t il 1 ould become s � c to the workers' wmpensation provisions ol Sectio 3700 of the Labar Code, I shall forihwit� comply with these p ia�s. � / I� 7� I� Applicam Signature: w Date: � WARNINQ: FAILURE TO SECUFE RKERS' COMPENSATION COVERAGE IS U W FUL AND $MALL SUBJECT AN EMPLOYER TO CRIMINAL P TIES PND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,OW), IN A�DITION TO THE COST OF COMPENSATION, UAMAGES AS PROVIDEO FOR IN SECTION 3/08 OF iHE IABOR COOE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAHATION: � I hereby attirtn that 1 am licensed under provislons ot Chapter 9(commencing with Section 7000) ol Division 3 of the Business and Professions Code, end my license is in full force end eflea. Lic. a Clau» Contrectofs Signeture: Date: CONSTRUCTON LENDING AGENCY: ❑ I here�y eHirtn that t�ere is a consiruction lending egenty lor ihe pedortnence of the work br which Ihis permit is issuetl. (Sec. 3097, Crvil CoAe). Lentler'S Neme: Lentler'S Atltlress: Signeture: Dete: OWNER-BUILDER DECLARATIONS: I here6y ettirtn I�et under penalty ot per�ury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business antl Professions Coda: Any ciry or counry which requires a permit to wnsWct, elter, improve, demWish, or repair any siructure, prior to its issuance, also requires tha applicant for such permit to file e signed statement that he or she Is licensetl pureuent m Ihe provisions ol the Comrectars License Lew (ChaD�er 9(commencing wich Sectian 7000) of Division 3 at the Busineu and Profeulons Code) or Ihat he or she is exempt therelrom antl Iha Cesis for Ihe alleged exemption. Any violetion of Section 7031.5 by any epplicant for a pertnit sublecis �he applicant ta e civil penalty of not more Ihan five hundred dollers ($500)J: ❑ I, as awner af the property, or my employees wilh wages as their sole compensatian, WILL DO 7HE WORK, end ihe structure Is no� intended ar aHeratl tor sele (Sec. 7 usiness and Pmfessions Code: The Contrectors License Law tloes not apply to en owner of Droperry who builds or improves ihereon, and who does such work ' self or hersell or through his or her own employees, pravitletl Ihat such Improvements are not intentled or oflered br sele. It, howaver, the building ar improvement is sold within one year of completion, t�e owner-bulider will heve the burden of proving ihat he or she did not �uiltl or improve for purpose ot sale.). I, as awner ol the proDerty, em EXCLUSIVELY CONTRACTNG WITX LICENSED CONTRACTORS to consiruct the pro�ect (Sec. 7044, Business and Profeuions Code: The contrectors Licanse Lew does not epply m en owner ol property who bullds or Impmves t�ereon, end who comracts for such prolep with a comrector(s) license pursuant to the Cantractors License Laws.�. ❑ lem Signature: Owner ID Verilicatian of Ownership by (type ot Business and Protessions Cotle tor I�i9 reeson: Ves ❑ No Drivefs Llcense No. n, i.e. - property ta: blll or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION: Date: � L_ �� ' exP��: i3 • dv ❑ I hereby certity ihat no excavatlon live (5) or more feet in depth into w�ich a person Is required to tlescend, wlll be made In connection wlth work euthonzed by Ihis permit, antl Ihat no builtling stmcWre, scalloltling, felsework, or demolitlon or tlismaniling t�ereof, will be more than thirty-si: (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, T1Ne 8, Celibmla AdmlNstretive Code). ❑ As ownervbuilder, I will not employ anyone to do work which woultl roquire e permit Irom ihe Division al Intlustrial Safery. es noted abave, unleu such person hes e permit to do such work tram the division. SigneWre: Data: Division of Industnal Sefety Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORVA'f10N OF ENTRV: 1 cenity under penelry of perjury ihat I have read this application antl state that t�e infofmation given is correcl. I agree to co Ilh ell stete laws end ciry ordinances relating to bullding conslruciion, anA euthonza reqqqresentetives ot Ihe Ciry of Costa Mesa lo enter upon the above-describ ro for i cti purposes. I ee ot to occupy or allow occupancy of any building autho'z�d by Ihig e�ntil finel inspection. �:��-� - ��gr � SignaWre Ot Legal wner�s) Data AnNOr Authanzed ApDliwnt Date COpE 1. IHSPELTIONTYPE ps¢, �$ 7616 ' Fixetl System Final Fire Preventlon 7266 200 201 202 203 Pool Spa Final Final Re-Roof Flnal BIocWRetaining Wall Final Factory Fire Place Final Sign 204 Final Demolitian COUEt INSPECTIONTYPE 206 Finel Mechanical 20B Finel PlumDinp 210 Final Eleclncel 272 Finel fire Prevention 220 Final Planning Approval 222 Final Site 250 Flnel Building/Occupenq � �� -ZJ-�3 � (7i4) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 ,lob nddress: 497 16TH PL Suile: Viciniry: INSIDE EXISTING POOL Parcel Number: 42515109 Zoning: Applicant: HOUSEPIAN, RONALD DEE TR Address: 497 E 16TH PL COSTA MESA, CA owner: HOUSEPIAN, RONALD DEE TR Address 497 E 16TH PL COSTA MESA, CA ConVactor: Address: Zip: Phone: (949)646-8560 Zip: 92627 Phone: (949) 6468560 Zip: 92627 Phone: License: ISSUED BY: Sta[us: ISSUED Applied: 11/07/2002 Issued: 11/07/2002 p,rch ; Eng: Address: Address: Phone: � Phone: Zip: License: License: SCOPE OF PERMIT ADD APPROX 30- SQ. FT. SPA INSIDE EXISTING POOL. RELOCATE POOL EQUIPMENT. Plan Check: $72.31 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $184.06 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0. 0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0. 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Propased: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0. 0 ss,000.00 $5,000.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 1241-92) EXPIRA710N: This permlt 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 for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapactlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. 0 FOR INSPECTIONS CALL: (714) 7545626 244Bd8 (6/00) WORKERS'COMPENSATIONDECLARAnON: ! '� I hereby aXirm under penalry ot Oerjury one ol the tollowing declerations: ❑ I heve entl will melntein e certificate ol consent to sell-Insure lor workers' compensetion, es pmvided tor by section 3700 ot ihe Lebor Code, br Ihe peAormence oi Ihe work for w�ich this permit Is Issuetl. ❑ I have antl will malntain workers' compensatlon insurence, as requlred by section 3700 ot ihe Lebor Catle, for t�e pertormance ot the work for which Nis pefmit I5 issuetl. My workers' compensation Insurance carner antl policy number ere: �� Cerrier: �To�"— Policy Number. (This section need not be completed i! Ihe Oermif Is velued et one hundred dollars ($100) or /essJ �% I certify that in Ihe peRortnence ol the work lor which t�is pertnit is Issued, I s�all not employ any person in eny manner so as to become wbject to Iha workera' � compansetion lews ol California, end egrae Ihet il I should become subject lo Ihe workers' compansation pmvisions ol Section 3700 of the Le6or Cotle, I shell forthwith comply with these provisions. Applicam Signeture: Date: I I �� Gi�L WARNING: FAILUFE TO $ECURE WORKERS' CAMPENSATION CAVERAGE I$ UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAI PENALTIES AND CIVIL FlNES UP TOONE HUNORED THOUSAND DOLLPRE (5100,000), IN ADDITION TO THE COST OF CAMPENSATION, OAMAGES AS PPOVIOEU FOR IN SECTION 3�06 OF THE IABOR CAOE, INTEREST, AND FTTOfiNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hareby aMirm Ihat I am IicenseA untler provisions ol Chapier 9(commencing with Section 7000) ot Division 3 of Ihe Buslness and Professions Gode, and my license is in tull force end etfecL Lic. p CI85s k Contractofs SlgnaWre: Date: CONSTRUCTION LENDING AGENLY: ❑ I hereby eHirm that there is a consiruction lending egency for lhe pertormanco of the work Por which ihis permit is issuetl. (Sec. 3097, Civil Code). Lentlefs Neme: Lentlets Atltlress: Signaiure: Date: OWNER-BUILDEii DECLARATIONS: 1 hereDy afllrm that untler Denalry of Derjury ihat I em E%EMPT FROM THE CONTFiACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or wunty whic� requires a permit to construct, elter, improve, demolish, or re0air eny strucWre, D�or to its issuance, elso requires the applicant tor such pertnit to tile e signed stetement that he or she is Ilcensetl pursuam ta the proWsions ot t�e Contrectors License law (Chepter 9(commendng with Section 7000) of Dlvision 3 ot t�e Busineu enA Profession5 Cotle) or t�at he or 5he i5 exempt Iherefrom antl Ihe Oasis for Ihe elleged Bxemplion. My videtlon of Section 7031.5 by eny applicant lor e pertnit subjects ihe epplicant to a civil penelry ol not mora lhen tive huntlretl tlollars ($500J.): ❑ I, es owner ot ihe propeny, or my employees with weges es Iheir sole compensation, WILL DO TME WORK, end the structure Is not intentled or oflered tor sele (Sec. 7044, Business and Professions Code: The Gontractors License Lew does not apD�Y �o an owner ol propeny who builds or improves ihereon, and who does such work ' setl or hersetl or ihmugh his or her own employees, provided that such improvements ere not Intended or aHeretl tor sale. If, however, the builtling or imprwement is old within one year of completion, ihe owner-builder wlll have Ihe burdon ol proving Ihel he or sha did not build or improva tor purpose ol sale.). I, as owner oi Ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Prolessions � Code: The contrector5 LicenSe Lew does noi epply Io en owner of property who �ullds or Improves Ihereon, antl who contratt5 tor such pmject with e conlractor(s) license pursuam to the Comrec�m1rs LicenAse Laws.). ❑ I am e:empt un , t/ // i Bus'ness end Professions Code tor t�is reeson: , �� Signeture: ��G � '' Date: I I � Owner ID ventietl by E�vers Iicensa �'es ❑�No Drivers ucense No. �/ E�ires: �/ 3/ d6 Vedfication oi Ownarship by (type ot tlaument, i.e. � property lax bill or tleea): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity Iha� no eacave�ion five (5) or more feat in depth inta which a person is required to descend, wlll Ge metle In connection with work euthorizad by this pertnit, end thal no building slrucNre, sceHWding, lelsework, or demolition ar Aismantling t�ereof, will be mare than t�irty-sl: (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title B, Califomie Atlministrative Cotle). ❑ As owner-builder, I will not employ enyone to do work w�ich woula require e permit Irom ihe Division al Intlustnal Sefety, as noted abave, unless such person hes e pertnit to tlo suc� work trom the tlivision. Signatura: Data: Division of Industrial Sefery Permit Number. CERTIFICATE LI CE AND AUTHORIZA710N OF EN7AY: I ceniy untler penelry ot parjury thet I have read this epplicetion and stete ihat the Infortnelion given is correcL I ee omply i ell st laws end cuy ordinances relating to building construcilon, an0 euthonze represemetives of the City of Costa Mesa to enter uDon �he ebov esc�� rt� ins e n�rposes. reg not to accupy ar ellow accupency at any building euthoriz�� it � ti;;nal inspection. � � ` � -, i u �_� —� Rinnxwrn Ot Leaal Ownerfsl Date And/OrAut�orizetl AppliCen� Date COpE I. INSPEC710NTYPE pajj �$ 1616 Fised System Finel Flre Preveniion 1266 Pool Spa Finel 200 Finel Re-Rooi 201 Finel Block/Reteining Wall 202 Final Factory Fire Place 203 204 Final Sign Final Demoli�ion CO�E I INSPECTION TYPE 206 Finel Mechanical 20B Flnel PlumDing 210 Finel Eledncal 212 Flnal Fire Prevention 220 Final Planning Approval 222 Final Site 250 Finel Builtling/Oaupency �g. � CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPAFiTMENT PEFiMIT (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT ,lob nddress: 497 16TH PL Suite: Vicinity: RIGNT AND REAR PROP LINE Parcel Number: 42515109 Applicant: GRIEGO, MANUEL Address: NUMBER 144 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07/25/2002 Issued: 07/25/2002 Zoning: ISSUED 6Y: Owner: HOUSEPIAN, RONALD DEE TR Address 497 � 16TH PL COS7A MESA, CA" Contracror. M G CONCRETE Address: 3134 S RITA WAY SAN7A ANA, CA Zip: 92704 Arch : Address: Phone: 714-525-3844 Zip: Phone: (949) 646-8560 Zip: 92627 Phane: 714-5253844 License: 384563 Eng: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT A 6 FT HIGH 125 LF BLOCK WALI (60 LF WALL ALONG THE RIGHT PROPERTY LINE AND 65 LF ALONG THE REAR PROPERTY LINE) AT AN EXISTING SFD PER CITY STANDARDS. Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $137.86 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 20-0 PARKING Existing: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Propased: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0-0 s2,soo.00 so,00 NOTICE: The work authorized by ihis permit shall comply vnth all applicable handicap access requiremenis under California statutes and ralatad regulations. (Ord. No. 92-28, § 7, 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 for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspeetions and flnel epproval must be obtained. Failure to obtain inspections and tinal approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 . tas�ae �aoo� WORKERS'COMPENSAnON DECLARATION: "'�� I hereby affirm under penalry of perjury one oi the following tleclarations: ❑ I heve end will maintain a certiticate oi consent to self-Insure for workers' compensetion, es provitletl tor by section 3700 of tha Lebor Code, for Ihe pedortnance of the �ork for which Ihis permit is issuatl. have antl wiq maiqqqtain workers' compensation insurance, as required by section 3700 of fhe Lebor Code, for the peAortnance of thev/ork tor wp Ich this� pertnit is issuetl. My work63YEom�tlop�Ir�SGrance carner antl pollcy number are: ��. /� /�� Carner: �__;A `l-! J11� PolicyNumber: �� L7 (This section need not be comp/eted il fhe perryi�s velued at one huntlred dollars ($100J or less.) ❑ I certify t�at in Ihe performance of compensatlon laws of C if � rl comply wilh Ihese pr si s. Applicent Signeture: WARNING:FAILUFETOSECURE ORKEPS'� THOUSAND DOLLARE (5100,000), IN ADDITION LICENSED CONTRACTORS I herehy affrtn that I am li � torce end eHect Lic. » � Contractors Slgnature: _ CONSTRUC710N LENDING AGENCV: ❑ I hereby aHirtn ihat there is a constmction Lender's Name: SignaNre: ch this permit is issued, I shell not employ eny person in any manner so as to 6ecome su6ject to the workers' I shoultl become subject to the workers' compensation provisions ot ection 3709 ot the Labor Code, I shall forihwith Date: � ��// {� CAVERAGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI AL PE TIE D GVIL FlNES UP TO ONE HUNDRED F COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]Ofi OF THE LABOF CODE, IFIrERE$T, AND ATTORNEY'S FEES. Chapter 9(commencing with Section 7000) of Division 3 of the Business tl Pro ssions Cotle, antl my license is in tull ��ass � �" a � _J. _—. .__. ._. .. Da�e: �. a 7 pertormance ot the work for which Ihis permit is issued. (Sec. 3097, Civil Cade). Lender's Adtlfess: Date: OWNER-BUILDER DECLARATIONS: I �ereby ettirtn that under penelty ot perjury that I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Protesslons Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair eny structure, pnor to its issuance, also requires the appliwnt for such pertnit to file a signetl statement that he or she is Ilcansed pursuent to iha provlsions oi ihe Contrectors License Law (Chapter 9(commencing with Section 7000) oi Divislon 3 oi the Business and Profeuions Code) or ihat he or she is exempl therefrom end the besis for Ihe elleged e:emption. Any violation oi Section 7031.5 by eny epplicant tor e permit subjects Ihe apPliwnt to a civil penalry of not more than five hundred dollars (5500).): ❑ I, as owner of the property, or my employees wlth weges as their sola compensation, WILL DO THE WORK, and ihe siructure is not intentletl or oHered for sele (Sec. 7044, Business end Professions Cotle: Ttie Contractors License Law does not apply to an owner of properry who builds or improves thereon, and who tices such work himself or herself or ihrough his or her own employees, provitled that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner�6uiltler will have ihe burden of proving Ihat he or sha did not build or improve tor purpose ot sale.). ❑ I, as owner of the properry, am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Professions Cotle: T�e contrectors License Law does not epply to en owner of proparty who builds or Improves thereon, and who coniracts for such prolect with a contracror(s) license pursuant to ihe Contractors License Lews.). � ❑ I am exempt under sec. Business end Professions Code for ihis reason: Signelure: Dale: Ownei ID venfietl by tlnvefs license. ❑ Ves ❑ No Dnvefs License No. Expires: Veriticatlon oi Ownership by (type of document, i.e. - propetly tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certily that no eacavation five (5) or more feet in depth into which a person is required to descend, will be made in connection wi�h work authonzed by this permit, and that no building sirudure, scattoltling, falsework, or tlemolition or dismantling ihereot, wili be more Ihan thirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title e, California Administrative Code). ❑ As owner-builder, I will not employ anyone to tlo work w�ich would require e permit from tha Division of Indusinal Safery, as notetl a0ove, unless such person hes a permit to do such work irom the division. Signature: - ' "' "� " Date: Division ot IndusMal Safety Permit Number: CER7IFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENfAY: I cenity untler penalty of perjury ihat I have read this application and state that the infortnation given is correcL I agree b comply wlth ell stat a and ciry ordinances relating to building consiruction, antl authorize representatives ut the Ciry of Gosta Mesa to enter upon the ebove-descnbed property for inspe�ti n purp ses. I egree not to occupy or allow occupancy of any building authonzed by Ihis permit until final inspection. GODE �, INSPECTIONTYPE 1616 Fixed System Final Fire Pr 1266 Pool Spa Final 200 Finel Re-Roof 201 Final Block/Retaining Wall 202 203 204 Final Factory Fire Place Final Sign Final Demoiition �jF I pL � - 9 -f�t '� &ODE� INSYECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy ate � Dai&' pRTE INTRIRLS "fi�S SKEfa-I LS FOR L�IFORMATIONAL PURP066 OM.Y. APPLICANI 6 RFSPONSIELE FOR PROVIDING AN ACCVRATE REPRESFMATION OF 7}ffIIt PROPFRIY IN CASE TFIE SHAPE AND SI� DO NOT OORRF�OND WRFi TF� WFORMATION PROVIDID ON 1H15 SHF1r1'. 8 m • SOUD WALLS/FQJQ�S BEIWEII9 2'�' h 6' P7 }�]CHT SHALL BE SETBAQC AT IFAST 30' FROM FROM PROPEltIY I.iNE • SOI.m WAISS/F�SJ�S SifA[.L NOT �(� Y 6' IN F�IGHf N7Ii�J 10 OF'liff FRONf�PROPERIY i1NE �(Of CVRB IAIE�. r,•' ' ( • VERIFY D6TAN� FROM CURB TO PROPERlY UNE f AND g10W ON Pf�1N `VFRIFiUTION FROM TF� Q1Y5 � ENCRJEHtWG DIVSION 6 REQU6tFD. CAII. (!14) 754� AD �ox u;mo�pori. _ - - 4 .';:'+'_�''' --•- ,, .,�_.� � �� -- ��^ -- � CITY 0` Guo�� ;.._ _.,, r,�v ,� RESOEMQ � � �� BLDG. UL'' �.�� }l �: I I � I r � c� �I � i - - �� ` ; UiViSIC)�.� f�i�' �3iiii �' _- =� '��is a;p;;!�,r,nx��;aaJ; xE90EM¢ :;!S� 14:�'I�9^,�¢9oEu(E, ?� ,� y � w� a.r.,a, ::;ti;iclUiv, 'il/di�:gY'J?i; TMt ! n�np4 � n! i�;1S li�?;1(!!; ::� i' l'IC•:: `f Cl G"y':(�� :F7��:r.:��'.i„ ...... _a.: � ��_. . -,.�.:., ::. .,.: ,.,. . ...... � •"""'"""'""""'"' ' "...""_!' i \ �__ _ � � QF cf�bfi �=$�,' I ROi�k; { a ` `� L � _ — _ ---- ° ;;i i ea kRa� t ��i q�� g11;14nPa dfltl ll IP Anl wfN t+� r„av16F:;,re:�nt;�rri a�aefrm�h AK�ronot unutng ;G � �!.a!!Cc SF1'J.Liiiii:sl; kllo ?^nfl f1aU@@I� 9109.t,1 ��n: :.; c: ::•�s.:.,,e a iirr ncr�c •r.r�'.r 81, ro In�r. .,.;. _. ._._ • , � . , f�� :,��.,� i;;r;hcilui SigCi "c..� .;.�:i1�y,;efi•'ilti:l:^7(id,J�5CI1G'!'�fl�. , ' '"" ' '........-...� /; _ ��' �'""' STREET _ �ik� 6 ��%u qt, %� at� a- - - BLOCK WALL LAYOUT FOR BUILDING PERMIT �6 �' P� PLANNING DIVISION � � Cemenl Coping Op��onal r Channel8bck WiU� 1-3/B� � Horirontal Top ol all F encef For Fencea 5' or Len Vert. Bars 3/B"y5 a� 4' �0" O.C. For Fences Higher Th>n 5' Ven. Ban J/B"m at 32" O.C. ' Fill Cells Solid Wi�h Grou1 Where Sleel Occurf f7rt�nlnrcing 51•.el Shall Conlorm lo Sec.A�15�39 A.S.T.M. All S�eel to be lapped 24" or to Code NATURALGRADE- � TWO]/B"d8AR5 CONTINUOUSTOP b BOTTOM HORIZSTEEI MUST BE TIED IN VLACE AT TIME OF iRENCN INSPECTION. � TYPICAL 6�� CONCRETE BLOCK FENCE a 0 a x 1� F z �n T' n � un n V�—I�IDTH � SEE C�+e � � BELOw ' FOOTING RE�UIREMENTS CHART WIDTH � . . . . I4� . . THICKNESS . . .10�� . OEPiH OF EAFTHTOOTM 24� SPACING OF EARTHTOOTH. 12� 14" 10" 20" I4� BUILDING DIVISION 12 e�� 16" 16' GENERAL- NOTES MORTAR; p�e Part Ploslic Cemenl, and Threc Parts Sand GROUT; One Port Cemenl TMte anA One Half Parts S�and COPING: � pne Porl Cemen�, Three Pa�15 $ond CONCRETE: Well M�aed C2-I/2:3-I/2 Ma■ of 7- I/2 Gollens ot Walar Per Sock ot Cement GROVT MAV BE VOUREO FROM TNE TOP OF TME FENCE IN CELLS WNERE STEEI OCCURS. CELlS AND AREAS OF NORIZONTAL REIN FORCEMENT SHALL BE CLEAR, CLEAN 6 FREE OF ALL MORTAR DEBR15, ETC. N CV' C4RTMTCOTH V` fuE NEtGTM Of PENCE �LOW BOTTOM OF i'OGT�NG SCALE: I/2" = I' � 12„ 8" 12� 16� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cB��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 497 16TH PL Suite: Vicinity: 2ND STORY ADDITION Parcel Number: 42515109 Applicanc SHAM, ZACHARY Address: 2600 NEWPORT BL SUITE 154 NEWPORT BEACH, CA owner: HOUSEPIAN TRUST Address 497 E i6TH PL COSTA MESA,CA Contractor: Address: Zip: Zoning: Phone: (949)675-7322 Zip: 92663 Phone: (949)646-8560 Zip: 92627 Phone: License: Arch : ZACHARY SHAM & ASSOCIATES Address: 2600 NEWPORT BL SUITE 154 Phone: (949) 675-7322 NEWPORT BEACH, CA Zip: 92663 License: Eng: Address: ISSUED BY: Status: ISSUED Applied: 10/03/2000 Issued: 11/13/2000 Phone: License: SCOPE OF PERMIT NEW 853 SQ FT 2ND FLOOR ADDITION TO EXISTING SINGLE FAMILY RESIDENCE TO ADD 2 NEW BEDROOMS & 2 BATHROOMS. ALSO, ADD 30 SQ FT TO EXISTING FIRST STORY 8 9 SQ FT TO EXISTING GARAGE. REPLACE ALL EXIST. WINDOWS . INTERIOR ALT. AND RELOCATE THE KITCHEN. REMOVE EXIST. SLABAND FOUNDATION IN THE FAMILY , KITCHEN AND GARAGE AREA AND REPOUR. EXISTING GARAGE WILL BE WIDENED TO CONFORM WITH CURRENT 20' BV 20' MINIMUM CLEAR INTERIOR DIMENSION STANDARDS. 2ND STORY WINDOWS EITHER ORIENTED AWAY FROM PROPERTY TO WEST (WHERE HOUSE IS CLOSEST), A MINIMUM OF 32' AWAY FROM THE WEST PROPERTY LINE, OR HIGH ENOUGH & BEHIND A CLOSET POLE SO AS NOT TO IMPACT NEIGHBORS. 8' HIGH WALL PROPOSED ALONG IRVINE AVENUE CONSISTENT AND OK WITH CITY STANDARDS BECAUSE OF NOISE LEVELS GENERATED ALONG IRVINE AVENUE BUT SEPARATE PERMITS ARE RE�UIRED. APPLICANT TOLD STRUCTURAL CALCS WILL BE NEEDED FOR THE WALL. Plan Check: $704.18 Permit: $1,083.35 SMIP Res: $11.57 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,799.10 SETBACKS MAIN STRUCTURE Front 24- 0 ACCESSORY Front 0- 0 PARKING NOTES: Existinq: 2 Rear 26- 0 Rear 0- 0 Required: 2 FEE SUMMARY Calc Valuation: S>>5,eee.00 Claim Valuation: go.00 PLANNING & ZONING Lefl 22-0 Right Left 0- 0 Right Pro osed: 2 5- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related �� regulations. (Ord. No. 9248, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this peimit to be considered legal, such work must comply with all applicable codes, antl all requlred Inapectlone end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 z++s<s(erool r WORKERS'COMPENSAnON DECLARAnON: - I hereby eflirm under penelty of perjury one of the following declaretions: ❑ I heve and will mainteln e cenificata of conseni ro setl-Insure br workers' mmpensation, es provided for by sectlon 3700 oi the Lebor Cotle, for lhe peAortnance ofQhe work tor which this permil is i55ued. ❑ I �ave anC will meintain workers' compensation insurance, as requiretl by sectlon 3700 al Ne Lebor Cotle, tor the peAortnance of the work tw which this permit is IssueO. My workers' compensation Insurence carner antl policy number are: Certier: Palicy Number: (This section need not be cnmplefed il fhe permit is velue0 al one hundred dWlars ($100) or less.) ❑ I certih/ thet in the peAormance ot ihe work tor which this permit Is issued, I shell not employ eny person in any menner so as to become subject to the workera' compensatlon laws ot Celilornla, end agree that it 1 should bewma sub�ect to the workere' wmpensetlon provisions oF Sectlon 3700 ot t�e Labor CaAe, I s�ell tort�with comply with these ptovisions. Applicent Signature: Date: WARNING: FAILURE TO SE WRE WORKERS' COMPENSATIpJ WVERAGE IS UNUW FUL AND SMAl1 SUBIECT rW EMPLOYER TO CRIMINAL PENALTIES ANO CNIL FlNES UP TO IXJE NUNDRED T/IOl15AND OOLLARE (5100,000), IN A�pRION TO TME WST OF COMPENSATION, OAMAGES AS PROVIOED FOR IN SECTION 310fi OF THE LABOR COOE, IMEREST, ANO ATTORNEV$ FEES. LICENSED CONTRACTORS DECLARATION: I hereDy ettirm Ihat I am licensed under provlsions oi Chap�er 9(commencing with Sectlon 7000) of Division 3 0l ihe Business antl Professions Cotle, and my Ilcense Is in tull force and eHecL Lic. a Cless x Conirector's SlgnaNre: Dete: CONSTRUC710N LENDMG AGENCV: ❑ I �ereby ettirtn thet there is a conswction lending agency for Ihe peAormance of Ihe work lor which �his permii is issueC. (Sec. 3097, Civil Coda). Lentlefs Name: Lentler's Atltlrass: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eftirtn lhet untler penaly of perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor ihe following reason (Sec. 7031.5, Business entl Protessions Code: Any ciry or counry which requlres a pertnit to consiruct, alter, imprave, demolish, or repair eny siructure, pnor to its issuance, also requires the applicant for such pertnit to file e signed atatement ihet he or she is Iicensed pursuant to the provislons ot the ComrectoB License Lew (Chapter 9(commendng with Section 7000) ol Dlvislon 3 ot ihe Business enA Professians Cade) or lhet he ar she is ezempt theretrom and the basis tor Ihe elleped exemption. Any violetion of Section 7031.5 by eny epplicenl for a pertnit s�cts Ihe epplicant to e civil penelry ot not more Ihen five hundred dollars (5500).): I, es ownar ol Ihe properry, or my employees with weges as their sole compensation, WILL DO THE WORK, and the struclure I5 not intendetl or oHeretl for sale (Sec. 704d, Business end Professions Code: The Coniractors License Law does not apply to an owner ot property who builtls or Improves thereon, end who does such work � himself or hersell or through his or her own employees, provided ihat such improvemenis are nat intended or oHered for sale. If, however, ihe building ar improvement Is ��soltl within ona yeer ot completion, the owner-builder will have the burtlen of proving that �e or she did not build or improve for puryose ot sele.). �1, as owner ot the property, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRAGTORS to constmct tha project (SecJ044, Business antl Professlons Cotle: Tha contrectors Licanse Law tloes not epply to an owner of propehy w�o bulltls or impmves ihereon, end who contrects lar suc� project wlih a contractor(s) license pursuent to ihe Contractors License Laws.). Business entl Professions Code for this reeson: �tneff6veriiied bydrive�'s c�fY�ise. ��"'--- � No Verification of Owners�lp by (type of document, i.e. - properry �a�c bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION: ❑ I hereby certily ihet no excavetlon five (5) or more Feet in tlepth into which a person is required to descend, will be matle in connection wiN work euthodzetl Dy Ihis pertnit, and that no building sirucmre, scaHolding, falsework, or demolition or Cismantling Ihereot, will be more than thirry-six (36) teet high. (C�ap. 32, Grp 2, An 2, Sec. 341, Trtle B, Califomia Atlministrative Cotle). � As owner-builder, I will not employ anyone to tla work which woultl require a permit from the DlWsion ot Industrial Sefery, as notetl ebove, unless such person has e permit to do such work from the tlivision. Signature: Date: Division of Indus�nel Sefety Parmi� Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTHV: I cenity under penalty of perjury that I heve reatl �his application antl steta Ihat Ihe infortnetlon given is correct. I eqree to c wfjly with a tate lews end ordinances relating Io building constmction, end aulhorize represantativas ot ihe City of Costa Mesa to en�er upon t�e abov�d n ropeAy for i c0on puryose . I agree not to occupy or ellow wcupency of any builtling emhorized by ihis permit until final inspaction. � Si ega � And/Or Aut�orizetl Applicant Daia COOE t. INSPECTONTYPE 1616 Fiaetl System Final Fire Prevention 1266 Pool Spe Final 200 Final RB-Roof 201 Finel BIaWReteining Wall 202 Final Factary Fire Plece 203 Final Sign 204 Final Demolition PeIE IlflITIpLS cooe� ixsrecnoNTrve 206 Final MeChanical 20B Final Plumbing 210 Finel Electrical 212 Finel Fire Preventian 220 Finel Planning Approval 222 Finel Site 250 Finel Building�Occupancy PAg II�Lfl ,..�:. . .:. : . �� NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 7600 AND AB 781 To: ) City of Costa Mesa ) City of Newport Beach ( ) County of Orange ND�Sp��/ Applicant: Address: Telephone . .. 3437 District Receipt No. ��'� Plan Check No.�pU_V /$7� TrecUParcel and Lot Number(s): ��- �� I' n I Location of Project: ��.$7 Pr eEt M� Sq Number of Square Feet of: Residential Space Commercial and Industrial Space Commercial/Industrial Project is: (Check One) _ Warehouse _ R8D _ Movie Theater _ Mini-storage _ Heavy Industrial _ Regional Shops _ Light Industrial __ This project is exempt because �_x $1.84 x $ .30 _ Motel Bank _ Neighborhood Shops _ RacqueVHeaRh _ Hotel Medical Office Office Park Total Total ��r•Z� _ Preschool _ Auto Repair _ Hospital _ Large Office _ Office Bldg. _ Restaurant Fast Food fhis certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Pemils for this square footage in this proposed development may now be issued by your jurisdicGon. Checks are to be made payable to Newport-Mesa Unified School District. Representative The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true, then this cerBficate shail automatically terminate and the appropriate Cily/Coun hall be notified. '��%'7// ^ HOV 13 2888/2:58 PH/f 1624.72 /�i � � � RWTN:81-B96A683 Date: � � Applicant Insulation Certificatc o�'�� I 5`1 `1 ' y i % C. /G �' /"�!u �e ��c'� /vl � G Number and Sveet Ciry �YZ� v� «- Counry Description of Installation $ubdivision Lo[ \unber ROOF I,, Material —�J_ s- _L i.. C' r Brand Narne �� G,ti. A w'C.� vi,,�� l�t Thickness (�ches) Thertnal Resiscance (R-Value) _(f�_3v CEILING � BattorBlanke[Type ��c�-�S — �ja,,,,� (n%�f BrandNarne �Gv�P %✓tu�^�ille Thickness (inches) �(� �� 'Ihertnal Resis�ance (R-Va1ue) — 3c� Loose Fill Type Brand Name Con�actor's minimum installed weighd(t` Ib Minimum thickness inches ;�fanu(actuter's installed weight per square Cooi to acheive Thertnal Resistance (R-Value) EXTERIOR WA L Material n�,.,-. ��G9P �ti�P BrandNarne �o+v•t l�[c-nYil�-P Thickness (�ncheT— ��i " Thermal Resistance (R-Value) —�� RAISED FLOOR Material Thickness (�ch� SLAB FLOOR biaterial Thickness (inches) Width (inches) _ FOUNDATION WALL Materi�l Thickncss Declaration Brand Name Thermal Resistance (R-Value) Brand Narne Thcrmal Resistance (R-Value) Brand Name 'Ihermal Resistance (R-Value) I hereby certify that the above insulation w�s ir.stalled in the building at the above location in confomance wi�� the curren[ Buildine Energy Efficiency Standards for new residential buildings contained in Tide 24 of the Signatu:e and Ti�e S u6Contracwr (Guul uion Ins[alle: ) Signattue and Title Compliance Forms �//�' License Number 3-3v-�� Dace License Nw�nber January� 1. 1995 (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.Ca.us 77 FAIR ORIVE, COSTA MESA, CA 92626 Job Address: 497 16TH PL yuite No Vicinity: Parcel Nunmber: 42515�09 Applicant: BASS, BEN Address: 10041 BONSEAAV GARDEN GROVE, CA Owner: HOUSEPIAN TRUST Address 497 E 16TH PL COSTA MESA, CA Contractor: Address: Arch / Eng : Address: PLUMBING PERMIT ISSUED BY: Phone: 774-534-5403 Zip: 92840 Phone: (949) 646-8560 Zip: 92627 BASS & SONS PLUMBING COMPANY 70041 BONSEAAV Phone: 714-534-5403 GARDEN GROVE, CA Zip: 92&40 License: 270215' Phone: Zip: License: Status: ISSUED Applied: 12/15/2000 Issued: 12/15/2000 SCOPE OF PERMIT 2 BATHROOM ADDITIONS, 2 BATHROOM REMODEL 8 KITCHEN REMODEL TO AN EXISTING SFR. 2 BATHTUBS, 1 DISHWASHER, 1 L4UNDRY TUBNVASHER, 2 SHOWER, 1 KITCHEN SINK, 1 DRAIN TRAP FOR SWIM POOL, 2 WASH BASINS, 2 WASH BASIN SETS, 4 WATER CLOSETS, 1 WATER HEATER 8/OR VENT, 1 WATER SERVICE, 1 GAS (1-0 OUTLETS), 1 GAS (OVER 4 OUTLETS), 1 SEWER CONNECT. REF: B00-01577. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub / Washer $9.80 1 Sump Pump $0.00 0 Backflow irti9ation $0.0o 0 �andscdpe Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap �$9.80 1 Trap Primer $0.00 0 Bathtub $19.60 2 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping (per 10 R) $0.00 0 Vacuum Btkr 8kflow(1-4) $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bktlow(5+� 50.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $19.60 2 Dishwasher $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $1g,60 2 Drain, Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $OAO 0 Water Gloset (foilet) $39.20 4 Drein,Roof 50.00 0 Shower 579.60 2 WaterHeater/vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, wmmercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service g9.80 7 Gas (1-4 outlets) $6.15 1 Sink, kitchen $9.80 1 Water Softener $0.00 0 Gas (Over A outlets) $1.70 1 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $p.p0 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors (Sand Auto ) So.00 o �1�3 � j� regulations. (Ord. No. 92-28, § t, 12-21-92) GUmmtN I S/ SPEGIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period 01 18D days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ail �equlred inapeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this parmit. FOR INSPEGTIONS CALL: (714) 7545626 2d4fi-OB(8N0) WORKERS' COMPENSATION DECLARATION: I hereby aNirm under penalry of perjury one ol the following tleclaretions: ❑ I have entl will maintain a certilicate of wnsent to sel4lnsure for workers' compensation, as pmvided br by sectlon 3700 ot Ihe Labor Code, br the pedortnence ot the work for which Ihis permit is issuetl. �1 have end will maintain workers' compensetion insurenca, as required by section 3700 of the Labor Cotle, for Ne peAortnance ot the work br wNch Ihis pertnil is issuetl. My workers' compensation Insurance wrder entl policy number ere: Cerrier: Policy Number: (Tfiis section need nat be complefetl il the permil is valued et one hundred dollars (5700) or /ess.) ❑ I cenity thet in the peAormance of the work lor which t�is pertnit is issued, I shall not employ any pereon in eny manner so as to become subject to Ihe workero' crompensetlon laws ot Calitomia, and agree that if I should 6ecome subject to the workers' compensetlon pmvisions oi Sectlon 3700 of Ihe Labor Code, I shall lonhwith complywiththese ovisions. Applican�SlpnaNre: �fl �e..m�'o P,L�� oa�a: /a/lS��o WARNING: FAIWPE TO SECUP ORKERS' COMPENSATION COVERAGE IS UNL4WFUL AND SHALL SUflIECT fW EMPIOVER TO CRIMINAL PENALTIES AN� CIVIL FINES UP TOONE HUNDREO THOUSAND DOLIARE (5100.000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVI OED FOP IN SECiION 3]OB OF THE LABOii CAOE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 �ereby aflirtn that I em Ilcensed under proNslons of C�epter 9(wmmencing with Section 7000) oi Division 3 ot the Business end Pmfessions Cade, end my license Is in full torte entl eNect Lic. N CIaSs q Contrector's Signemre: o.n.LN-n�� L` Date: �, /S O 0 CONSTRUCTON LENDING AGENCY: ❑ I �ereby aMirtn Ihat Ihere is a construction lending agancy for Ihe peAormance of ihe work br which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Signeture: _ OWNER-BUILDER DELLARATIONS: Lendefs Address: Date: I hereby aRlrtn Ihat under penalty ot perjury t�et 1 em E%EMPT FROM TME CONTRACTORS LICENSE LAW Por Ihe lollowing reason (Sec. 7031.5, Business entl Prolessions COAB: Any city or county which requires e permit lo constmct, elter, improve, demolish, or repair any stmcture, prior to Its issuance, also requires Ihe epplicent for such permll to file a signed stetement thet he or she is licensed pursuant to ihe proNsions of Ihe Contrectors License Lew (Chepter 9(commencing with Sectlan 7000) of Dlvislon 3 oi ihe Business end Professions Cotle) or that ha or she is exempt therefrom an0 the Dasis tor the alleged exemptlon. Any vloletion ot Section 7031.5 by any epplicent tor e pertnit subjecls tha applicant to e civil penelty of not more than live hundred dollars ($500).): ❑ I, as owner of Ihe property, or my employees wi�h weges es �helr sole compensation, WILL DO THE WORK, end Ihe siructura is not intentletl or oNered for sela (Sec. 7044, Business and Professions Cotle: The Contractors License Law does not apply lo an owner of proparty who builds or improves Ihereon, and who does suc� work himselt or herself or through his or her own employees, provitletl that such improvements ere not Intended or ottered for sale. It, however, tha building or Improvement is soltl within one year of completion, the owner-builder will have the burden of proving that he or she did noi builA or improve for purpose ot sale.). ❑ I, es owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business end Professions Code: The contrador5 License Law does not eppty to en owner oi property who builtls or Improve5 ihereon, end who Conlracls for such projact with e contrector(5) license pursuam to the Comrectors License Lews.). ❑ I am exempl under sec. Business and Professions Code for Ihis reason: Signature: Date: Owner ID verilied by tlrivefs license. ❑ Yes � No Dnvers LicenSe No. Veriticetion of Ownership by (type ol document, i.e. - pmperty tez Dill or deed): E:pires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify that no excavatlon five (5) or more feet In depih into which a person is requiretl to tlescen4 wlll be made in connection with work euthodzed by Ihis permit, and that no building siructure, scaflolding, talsework, or demolition or dismamling ihereot, will 6e more than thiny�six (36) teet high. (Chep. 32, Grp 2, Ah 2, Sec. 341, Title B, Celifomia Atlminis�rative Cotle). ❑ A5 owner-builtler, I will not empioy enyone to tlo work which would require a permit irom the Divislon of Indus�rial Safety, es noted above, unless such person �as e permlt to do such work irom ihe division. Signature: Data: DiviSion of Industnal SafBiy Pertnit Number: CERTFICA7E OF COMPLIANCE AND AllTHORIZATON OF EMRV: I certity under penalty of perjury that I heve rea0 Mis application end state that the intormetion given is correct. I agree to comply with ell state laws end clry ordinances reta�ing to builtling construction, antl aut�odze representatives ot ihe Ciry of Costa Mesa to amer upon Ihe ebove-described D�operty for inspection purposes. 1 egree not to occupy or ellow occupency oi any building euthorized hy this permit until finel inspection. SignaWre Oi Legal Own qs) Date �;�..�. �.,i�� Ja�/sJ a G AnNOr Aulhonzad Aoolicent Date GODE 1. �Nsveenonrrve 1616 Fixetl System Pinel Fire Prevention 1266 Pool Spa Finel 200 Final Re-Raof 201 Finel BIocWRetaining Wall 202 203 Final Factory Fire Place Final Sign 204 Final Demolition 7Aff. U�E45 COpE� INSPECTIONTYPE 206 Finel Mechanical 20B Finel PlumDing 210 Finel Electncal 212 Finel Fire Prevention 220 Final Plenning Approval 222 Final Site 250 Finel Buildin<yOccupency Qdg II�LS � (7ta) �5a-5273 • Fau (�ta) 75a-ae56 • www.ci.costa-mesa.ca.us 77 FAlli �HIVE, GOJIA MtSA, GA y2ti2C Job Address: 497 16TH PL Suite No Vicinity: Parcel Number: 42515109 Applicant: Address: Owner: NEWLANDER, MARY HOUSEPIAN TRUST Address: 497 E 16TH PL COSTA MESA, CA MECHANICAL PERMIT Phone: 909369-1364 Zip: Phone: (949)646-8560 Zip: 92627 Contractor: MAGNOLIA HEATING & COOLING Address: 5841 MISSION BL Arch / Eng : Address: RIVERSIDE, CA �9� .T7S<7t:DF�qY:7iKI.'L! Zip: 92509 License: 658758 Phone: Zip: License: . ... ....�..-.1.Y_�. Status: ISSUED Applietl: 03/052001 Issued: 03/OS/2001 . t ISSUED BY: SCOPE OF PERMIT REF: B00-01577. INSTALLATION OF HEATING AND AIR CONDITIONING SYSTEM INCLUDING DUCTS FOR ADDITION AND REMODEL TO SFR. ISSUE FEE Insl FAU <700 k BTU Inst FAU >700 k BTU Repair/Alt Cooling/Heat Insl / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refng Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Boz Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 70000cfm Floor Furnace Floor or Suspend Heater 523.50 514.80 50.00 so.ao 50.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 50.00 50.00 so.00 50.00 50.00 50.00 50.00 so.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair I Alt Refrigeration Unit Ventillation System Evaporative Cooler Comme rcial I nci nerator Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3 To 15 hp ! 500 k BTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 7,750 BTU Boilers Upto3hp 3Tot5hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantiry 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 57a.70 t 50.00 0 50.00 0 50.00 0 50.00 0 50.00 50.00 50.00 E53.00 F4 ,, NO710E: The work authorized by this permit shall compty with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period oi 180 days. INSPECTIONS: In order for �he vrork authorizetl under lhis permit to be considered legal, such work must comply with all applicable codes, and all requlretl Inspectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a+e�ae (am) WORKERS' COMPENSATION DEGLARATION: I �ereby ettirm untler panelry ol perjury one of the tollowing tledarations: ❑ ave end wlll maintein a certllicate ol consent to self-Insure for worker5' compensetlon, es provided Por by sactian 3700 of the Labor Code, lor the peAormence ot Ihe work lor which this pertnit Is issuetl. �I heve end will me My workers' com( Cerrier: (Th/s secf/on need no ❑ I Certify thet In Iho compensation IeN comDW wi�h �hBSY workers' WARNINO: FAILURE'NSECURB THOUSAND DOLURE (5100,000), rensetlon insurance, es raquiretl by section 3700 of the Labo� Code, for Ihe peRortnance of the work for wl Irj� Nis pertnit is iswetl. �fa�ner antl pollcy number ere: �^ Y��— Policy Number: V' �ermi( Is velued et one huntlretl tlollars ($100) or less.) � work lor whlch th ermit Is lssued, I shall not omploy any person In eny manner so as to become s lect to the workers' agree Ihet If I sh ul eco sub�ect lo the workers' wmpensation provislons oi Section 3700 oi the Lebor Code, I shall torthwith Date: ✓ � T� I ��' ENSATI OV GE IS UMAWFULlWD SHRLL SUBJECT M! EMPLOYER TO CRIMINAL PENALTIE$ AND qVIL FlNES UP TOONE HUNDRE� COSTOF SATION,DAAUGESASPROVIDEDFOfiINSECilON3]OBOFTHEUBORCOOE,INTEREST,ANDATfORNE1"SFEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihat I em licens under Orovision of Ch ter 9( ncing ith Section 7000) ot Divislon 3 0l Ihe Business antl Pmfessions Code, and my license is In tull force entl ettect. Llc. q Class p Contrector's Sfgriatur 1 Dele: �-- — CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirtn Ihet ihere is e constructlon lending agenty for Ihe peAarmence of the work for which t�is permit is luued. (Sec. 3097, Civil Cotle). Lentler's Name: Lentler'S Atltlress: Signeture: OWNER•BUILDER DECLARATONS: D8�9: I here6y eMirtn thal untler penelry af perjury thet I em EXEMPT FROM 7HE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7031.5, 8usiness and Prafessions Code: Any ciry or counry which requires a permit to conslruct, elter, impmve, Aemolish, or repair any sWcture, prior to ils issuance, also requires Ihe epplicant br such pertnit to lila e signed statement that he or she Is Iicensed pursuent to Ihe proNsions al the Cantractore License taw (ChaO�er 9(wmmencing with Sectlon 7000) at Division 3 o11he Business end Prolesslons Code) or that he or she is e:empt lherefrom and Ihe basis tor Ihe allegetl exemption. Any violetion of Section 7031.5 by any appliwnt tor a permlt subjects the epplicam ta e civil penalty ol nat mare than five �untlratl dollers ($SOO�J: ❑ I, as owner ol the property, or my employees with wages es their sale compensatlon, WILL DO THE WORK, entl the slrucWre is no1 intendetl or oMeretl for sale (Sec. 7044, eusiness end Pmtessions Code: The Contractors License Lew does not epply lo an owner oi property who builds or improves thereon, and who tloes such work himself or �ersell or throuqh �is or her own employees, provided that such improvements ere noi intended or oflered for sale. If, however, the building or improvement is soltl within one year of completion, the owneo-6uilder will have ihe burden ol Owving that he or she did no� build or improve br purpose of sale.). ❑ I, as ownar of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 704d, Business and Professions Code: The contrectors Llcense Law does not apply to en owner of property who builtls or Improves ihereon, and who contracis for such prolect with a wNrador(s) license pursuant to the Contrectors License Laws.). ❑ I am exempt under sec. Business antl Professions Code tor this reason: Signeiure: Date: � Owner ID verilietl �y drivers license. ❑ Yes ❑ No Drivers License No. E:pires: Vedlication at Owners�ip by (rype at tlocument, i.e. - property tac blll or Aeed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ 1 hereby cetlity ihat no axcavelion five (S) or more leat in deplh imo which e person Is required to descend, will 6e made in connectlon with work euihodzetl by this permit, antl �hat no builGing siruciure, scaildding, lalsework, or demolition or dismantling �hereot, will be more then thirty-siz (36) feet high. (Chap. 3.2, Gry 2, An 2, Sec. 341, Tllle 8, Celllomia AtlminlslratNe Cotle). ❑ As owner-bulltlar, I will not employ enyone to tlo work wMch would reQuire e pertnil Irom the Division of Indusirial Sefety, es notetl e6ove, unless such person hes a permit to do such work tmm the Eivision. Signeture: Data: Division ot Intlustnel Satery Pertnit Number: CER7IFlCATE OF COMPLIANGE AND AUTYiORR/1itON OF EN7AY: I certity under panalry of perjury that I �ave read this epplication and sWte ihat ihe inlortnaGon given is correcL I agree to wmply wlth ell stete laws entl dry ortlinances relaGng to builtling construction, and euthotlze reD�esenta�ves ot Ihe Ciry ol Costa Mesa to enter upon the ebove-0escnbed praperty lor inspectian purposes. I egree not to occupy or ellow occupanry of eny building authorizetl by this pertnit until linel inspection. CQOE I. INSYECTIONTYVE V "" QS¢ �LS 1616 Fixetl System Finel Fire Pravention 1268 Pool SOa Finel 200 Finel Re-Raol 201 Final BIocWRetalning Wall 202 Final Feciory Fire Place 203 Finel Sign 204 Finel Domdition .3 � C��e � � Dai9 COOE� INSPELTIONTYVE �pe¢ � �$ 208 Flnel MechaNtel � � �� J iv 208 210 212 220 222 250 Final Plumbing Final Elettrlcal Finel Fire Preventian Final Plenning Apprwal Finel Site Final Building/OCCupenty (714) 754-5273 • Fax (7� 4) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT JobAddress: 497 16TH PL Suile No Vicinity: Parcel Nunmber: Applicant: Address: Owner. Address Contractor. Address: ISSUE FEE Temp service test Res. alc package New Res (7-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Swilches Non Res Appl Res Appl Service to 200a Service to 7000a Service over 1000a Motors to 1 hp Motors ro 10hp Motors to SOhp MotorSlo 700hp Motors over 700hp Cammuniwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 42515109 VAUGHT, LAIN 18685 MAIN ST SUITE A299 HUNTINGTON B�ACH, CA HOUSEPIAN 7RUST 497 E 16TH Pl COSTA MESA, CA PIERSIDE COMPANY 18685 MAIN ST SUITE A299 HUNTINGTON B�ACH, CA Phone: (714) 920-0867 Zip: 92648 Phone: (949) 646-8560 Zip: 92627 Phone: (714) 920-0867 Zip: 92648 License: 768421 SCOPE OF PERMIT ADDITIONIREMODEL OF AN EXISTING SFR. 28 FIXTURES, 60 OUTLETS, 30 SWITCHES, 1 RES APPL, i SVS TO 200A. REF:800.01577 E23.50 50.00 50.00 $0.00 $0.00 $0.00 527.84 557.20 529.30 50.00 Sa.75 530.50 50.00 50.00 50.00 50.00 50.00 50.00 $0.00 50.00 50.00 so.00 $0.00 323.50 $0.00 Quantity 0 0 0 28 60 30 0 1 1 0 0 0 0 0 0 0 0 0 0 � 0 � 1 0 FEE SUMMARY Temp Dist System I Lighting Busway I700 ft Standing Section Misc Electriwl Equipment Transformers up to 1 kvalkw ................up to 10 kvalkw .................up to 50 kva/kw .................up to 100 kva/kw ............:.....over 100 kvalkw Low Voltage Equipment Low VOIt Wiring System I Ckt Misc. Contluit Misc Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 12/72/2000 Issued: 72/12/2000 ISSUED BY: �uantiry $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 $0.00 50.00 $0.00 $0.00 TOTAL CALCULATED FEES 5190.59 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this p0rmit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 7, 72Q7•92) EXPIRATION: This permit shall automatic811Y expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work eutnorized under this permit ta be considered legal, such work must comply with all applicable codes, and all requlred Inspectlone and final app�oval must be obtained. Failure to obtain Inspections and final approval will result in Ihe expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 zma+e �evo� WORKERS'COMPENSATION DECLARATON: _ I hereDy attirtn under penalry ol perjury one of ihe tollovnng tledaretions: ❑ I have antl vrill meimain e certificate of conseni to setl-Insure lor workers' compensation, as pmWded br by section 3700 0l Ihe Lebor Code, for the pedortnance o1 Ihe wark for which t�ls Pertnit Is issuetl. ❑ I have flnd will mein�aln workers' Compensa6on in5urance, es requir0d by SBctlon 3700 of the Labor Cotle, for Iho peAormence ol lho work tor whiG� Ihlq pertnit lv issuetl. My workers' compensation Insurence carrier antl pdky number are: Cartiec Policy Number. (This sectian need nof be comp/efed ll Me permit is veluetl et ane �untlretl tlW/ers (5700) or /ess.) [] I certify that In the pedarmence af the work Por which this pertnit Is issued, I s�ell not employ eny person In eny menner so es to bewme subject ro the workers' compensetion laws af Calllomia, end egrae that If I^ acaaacu6�ect�to-the workers' compensallon provlslons of Soctlon 37 0 of the Lebor Code, I shell forthwith comply wlth these pr '� ns. Applicant Slgnemre: � Date: �/�7'��-� v WARNINO: FAILURE TO SECURE WORKERS' COMPENSFTION COVERAGE IS UNLAWFUL PND SMALL SUflIECT AN EMPLOVER TO CRIMINAL PENALYIES AND GVIL FINES UP TOONE HUNDRED T10USAND DOLURE (E100,000�. IN ADDITION TO THE WST OF COMPENSATION, DAAMGES AS PROVIDED FOR IN SECTION 3]OB OF THE UBOR ODDE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aHirtn thal I em Iicensad under prmisbns ot Chapter 9(commend ection 7000) at Division 3 0l the Businesa entl Professlons Code, entl my Ilcense L9 In lull lorce antl eNect. Lic. a Cless p CONrector'sSigneWre: � , Dele: . � �� . CONSTRUCTION LENDING AGENCY: I❑ I hereby attirm ihet thoro is a conswction lendinp egoncy br tha peAortnence of Ihe work for which ihis permlt is issued. (Sec. 3097, Civil Code). Lendefs Neme: Landers Adaress: � SignaWra: Date: OWNER-BUILDER DECLARA710NS: I here6y attirtn Ihet under penelry ol per�ury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor Ihe following reasan (Sec. 7031.5, Buslness entl Protesslons Code: Any ciry or county w�ic� requires e permit to conswct, alter, improve, demolish, or repeir eny stmcture, prior ta its Issuence, also requires the epplicam tor such petmlt to lila e signetl stetement that he or she is licensed pursuant to the provislons W Ihe Contradors LJcense Lew (Chepter 9(commendng with Sectlon 7000) of Division 3 01 the Business and Professions CoOe) or thet he or she is ezempt thereirwn and the besis for tha alleged ezemption. Any Woletlan ol Section 7031.5 by any epplicent tor e pertnit sublects the epplicent to a clvll penalry of not more Ihan five hundreC dollars (5500).): ❑ I, 85 owner ol the property, or my employee5 with wages as l�elr Sole compensation, WILL DO THE WORK, anA Ihe 5tructure 15 nol InlendeO Or oMere0lor salB (SeC. 7044, Business end Pmtessions Code: The Contradors License Law does noi appty Io an owner of property who tullds or improves Nereon, antl who does such wwk himself or herself or thmugh his or her own employees, provided t�et such improvements are not Intendetl or oHereA lor sele. If, however, the bullCing or Improvement Is sold within one year af campletion, iha owneo-builder will have lhe burtlen ot Droving �hat he or she tliC not builtl or improve tor purpose of SaleJ. ❑ 1, es owner of U�B properry. am EXCLUSIVELY GONTRAGTNG WITH LICENSED CONTRACTOHS to construct the pro�ect (Sec. 7044, Business antl Professlons Cotle: The cantractors License Lew does not epply to en owner of pmparty who Ouiltls or Improves t�ereon, entl wha wntracts tor such pmjeci with e conirector(s) license pursuant to the Contreciors License Laws.). ❑ I em exempt un0er sec. Signature: Owner 10 verifled by tlriver's license. ❑ Yes ❑ No Business end Profe551on5 Code fOr �hi5 ree5on: Veritication of Ownership by (type ol tlocument, i.e. - properry lac bill or deed): Drivals License No. Date: Ezpires: DIVISION OF INDUSTRIAL SAFETV VERMIT CERTIFICATION: ❑ I hereby certify t�et no excavetion frve (5) or more feet in depth Into which e person Is required to descend, will be made In connection with work eut�orizetl by t�ls permit, entl that no DullAing strucWre, scettdtling, talsawork, or dertrolitlon or dlsmantling ihereof, will be more t�an Ihirry-six (36) leet high. (C�ap. 3.2, Grp 2, An 2, Sec. 341, 7tle B, Calitomia AdminlslretNe Code). ❑ As owner-builder, I wlll not employ enyone to tlo work which woultl require a pertnit twm t�e Division of Intlustnel Sefary, as notatl above. unlesa such pereon hes e pertnit to do such work irom the division. Signewre: Date: Division ot IndusMel Safery Parmit Number. CERTFICA7E OF COMPLIANCE AND AllTHORVA710N OF ENTRY: I cenity under penalty of perjury that I have reea this epplication and state Ihat the inlormation given Is correct. I egree to compy with all state laws end ciry ortlinances relating to builtling construction, antl authodze representatives of the Ciry ot Cwta Mesa to enter upon the ebove-descnbed property tor inspection purposes. I agree nol to occupy or ollow occupency of eny building euthorized by this permit until linal Inspactian. I aIu ner(s) Dete /a� /a Q O % AndOr Authodzed Applicant Date COOE�, INSPECTONTYPE 7616 Ficetl System Final Fire Preveniion 1268 200 Pool Spe Finel Finel Re-Rool 201 Finel BIxWRetelning Well 202 Final Feciory Firo P�ace 203 Final Sign 204 Final Demolltion �g �f j�Qpf,j INSVECTIONTYPE 206 Finel Mec�enical 208 Final Plumbing 210 Final Elecirical 212 Final Flre Preventlon 220 Finel Planning Approvel 222 Final Site 250 Final Bulldinq/Occupancy BAIF � It� DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS Bldg. Permit # This Permit # Street Address: / / / L-- � � � /"�� f/d �' �ed�-� , Cf'j AP Number: 1. I(we), �e,n�(�.c /�1 ��CJuStil��, U , declare that I am the Owner of Title of the above referenced real property, and that 1(we) hereby authorize: Name: � t E� Sr D � C � Telephone Number. % � / 'S/1 � �� Slreel Address: / Q /� d�'� � -/f�r /N -f % � � � c;ry: %�JN�/N G 70,✓ %1 c /� State: C�i- Zip: ��6 7 � to obtain permits in my behalf, as owner/builder, for L �ec �-� i�, / /-e r�+. � 1-P at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Workers Compensation Insurance coverage and cause a ceRificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As ownedbuilder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the Ciry of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other paRies as a result of work authorized by the permits from the City of Costa Mesa. 5. 1 declare under the penalty of perjury that the foregoing is true and correct. . Executed this �� day of /��J e.r 20 !�U , at c GS � ��` Cg �+ Print Name: �✓�� i� k f i G ti Signature: � Date: � �/a' � l U�' Note: This auttrorv_ation does not grant authorization to perform the work as owner, it solely provides for limited power of attomey to secure this permit in any behalf. O]'l4d6 (rev.11/00) California. PFOJECT AOOflE$S: q 9"� 1 6 TH P L � OWNEN'SNAME: CRAIG, RONALD V aooAEss: y 9 7 1 6 TH P L � COSTA MESA,CA ' (714)642-1286 PflCHIENGINEEfl: AODflESS: 92627 UNIT: NEG.NO.: � uxir: PEPMITTEE: RONALD V, CRAIG ( 714 ) 692-1286 aooness: qg� 16TH PL COSTA MESA CA 92627 LICENSEO CONiNFCTOfl OELLABATION: I here0y allirm ihai I am licensetl untler pmvisions of C�aO�er 9 �commencing wiih Seclion 7000) ol Division 3 ol I�e Business ana Pm�essions CoOe. antl my licen5e is in lull lorce and eliec�. CITV LIt.: STPTE UC.: CIASS: Da�e: Signalure: WOPREPS' COMPENSATION OECIAflRTION: I hereby allirm I�ai I haue a certilica�e of consent Io sell-insure or a cetlifica�e o� Workers' Compensa�ion Insurance, or a cenilie0 capy Ihereal (Seciion 38p1. Lab. C�. POLICY NO.: E%P. UpTE: COMPPNY: �] Cgnilie0 copy is nereUy fumished. ❑ Ce�ifie0 copY �s �iletl with Ihe ciry Builtling Division. Daie: Applicani: EXEMPTION FPOM WOPRENS' fAMPENSATION OELLAflRTION: RNs sttlion neetl iro� be campleteG il lhe permil is (Qr one hunEreU (5100) ar less�. I certify ihat in ihe p dormance ot I�e work for which W5 permii is issued. I shall o' ¢mpl y Derson in ; manner so as �o became s�u�'�,yi jm Ihe Wo erY C pensaiion Laws ol Calilomia. � j � �ale! � Signature: � NOTIC . II, all making I�is eclaration. you shou c e SUUleci l0 1 e Workers' ensa�ion pmvisions of Ihe Labor CoOe. you m I Ionliwil� comO�Y �� suc� pr mns r IN5 Dermil s�all be Geem re keU. CONSTBUCTION IENUINC AGENCY: 1 hereby allirm t�at there i5 a con5imclion Iendin ncy br ��e pedormance af Ihe work lor � which this permu is issued (Sectmn 3p37. Civ. C�. I LENOEfl: I ROOPE55: I' OWNEB BUILOEB OECIANPTION: I �ereEy allirm IAat I am exempUwm the ConVactors' Stale License Law fo� Ihe bllowinB reason (Seclion 7031.5 Business and Professional Cotle: Any ci�y ol counry whic� 2puires a permi� to cons�mcl, alier, im0�ove. Aemolish, or repair anY slmcture. prior to its issuan[e, also repuires l�¢ applicani br such permi� lo �ile a 5igneU Slaiement Ihal he/s�e is licensea Oursuam Io I�e pmvisions ol i�e Comraciors' S�a�e Licenu Law �C�apter 9(cammencinq w�� Section 7000) o� Oivision 3 0l ��e Business antl Pmlessions Code� or ihat he/s�e is exemD� I�erefrom antl the basis lor Ine allege0 eKemplion. Nny violation o� Seclion 7031.5 by any aD01i[an� lor a DQ�mii SUDlecis ��e a001icant to a ciWl penalry ol noi more �han live �unEreE dollars (5500�. I, as owner ol ine D�oDeny or my employees �nin waAes as Iheir sole compensation, will ao tAe work, ane Ine ❑ slmcWre is no� intenUed or ollere0 far sale �SetliOn 7MC, Bu5ine55 anE Pm�essianal Code: The Cqnira[IOR' Siale LitenSe Law Does nal apply to an owner of a D�oOe�y wM Guiltls or im0�ove5 ihereon. anA who tloes such work himselV�ersell or Ihmugh Ais or her own employees, pmviae0 I�ai suc� impmvemen�s are no� iniendea or aflereU lo� sale. II, however �he Euiltling or impmvement is soltl within one year ol [am0�elion, ihe owner vnll tuve Ih¢ burtlen oi Dmving he/she tlitl noi build or impmve lar I�e purpose ol sale�. I, as owneroi Ihe D�oDeriy, am exclusively conlratling wit� licensed coniractors lo con5iruct the pmleci (Section 7044, Business ❑ antlProle55ion5Code: T�efAniratlors'S�alelicenSeLaw4ce5nOtapplyl0anowner010mperlY��UiIG50nm0�oves�hereon and who mnlratls lor SUCh Dmietls wi�� a tOnlratlor�s) license pursuan� lo ��e Conlrati0r5' Sla(e Lit¢nse Law�. I am aware Inai pmol ol Iheir Worker's Compensa�ion insurance 5hoW4 Ee pmntled lo me. � I am exempi unaer Seclion: H P 7 O 4 4 B. 8 P. C. n ma�eson: BY OWNER 6 FAMILY ��j �� Dale' Owner. {� I tlo here cenity al I am awa ol antl underslantl Ihe repuirem¢nis o I ornia Heal�� antl Salety Cotle 5 ti s 25505, 25533. and 2557a ane �Aal I or any iWure �uil0ing occu0anl wiil/mll not (circle on need �lo com0ly wilh SaiA Slale cotle an the requiremen�s �or a permil �ar consimtlmn o� motlilication Imm ihe Fir Oualiiy Managemenl DislricL Pevaential cons�mction pp'' ations are exempt Irom ihese provisions. Oate: AD�licant: I here�y cetlily ihat 1 �ave �ea0 this aOD�iwiion antl state Itul lhe above inbrmalion is corrttL I agree �o c pty vn�� all ciry and counly oremance5and5�alelawsrelatingta�uiltlingcon5imclionanOherebyauthor¢erepresen�ativ Ith¢ci`yio t upon�heabove�menlionetl �pm! �ny lolr ms ction p ooses. W3�� ( � � SignaWre: � Driver's License oi Saial Securiiy �� t64t n6 WM1iie—Builtling; Green—Co�e EniorcemenL Canary—Applicant: aleenro�—Assessor � \`. l CITY OF COSTA MESA — HUILDING PERMIT PERM NO; B 065761 PERMIT NO: B 065761 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PUAPOSE: ALT JOB DESCRIPTION ; T/O SHAKES,RESHEATH W/1/2"CD}C,APPLY COMP SQ FT: 7,800 CLAIM VALUE: 7,800.00 CALC—VALUE: 7,800.00 GROUP OCC: R-3 /M-1 COMMENTS: RESHEATH O/SPACED SHEATHING / REROOF INCLUDES PATIO CkO{�VER �� C/�.TO R, +t***********�r�t�r�r***+t�r�t+r�r�r�eie*+�**x�+r*x��r**x�**+r***********�*+r�r*�rx�+�IVI�� e��/�. Z O N Z N GS ERTEBQAUCIKASE M E N T S �7 ED ------------ MAIN BUILDING FRNT: FT IN REAR: LEFT: FT IN RGFiT: REC�UIR -------- --------- ACCESSORY BUILDING --------- FT IN FRNT; FT IN REAR: FT IN FT IN LEFT: FT IN RGHT: ET IN PARKING REQ: PROV: PARCEL: 42515109 ZNE: REF NO: PLANNING NOTES> - _� if !t 1E if ik iE if if iE 1f iE if iE 1F if 1E iE iE 1f f! 1E iF iE fE iE fElE iE if 1f k iE if if if iE 1E iE fE 1E iE 1E fE iE iElE iE 1f iE 1E if 3E iE iE iE ff fE fE 1E if iF tf iE iE iF iE iE!! 1E iE fE if 1ElE iE iE iE iE iE D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N•T S ZONING APPROVED BY DATE; BUZLDING APPROVED BY ; �_,� DATE: APPLICATION ISSUED BY: if if iE iE iE iE if jf 1E 1E iE i! M iE�E 1t if iE if ik IE i!� ik �! if 1f !f iE if If if iE 1t 1t 1f 1E 1E 1! fF ff 1f !f 1E 1f 1! LEGALI2ATION:N BLDG PMT PLUMBING PERMIT 99.00 1f iE if if if if ff 1f !F 1f fE iE �JF 1E ik!! iF if iE 1k iE ik iE i! iE ff k 1E F E E S U M M A R Y� ELECTRIC" MECHANIC FIRE / , DATE: �, f! 1E �E if iFlk �M 1E�FiF iFiF3i-3F 1f iF il� iFif iE if if iF iE iE M 1f ih 1f jt it if if IE iE iE if iE 1E iE STRUCTURAL SEGMENT:Y SMiP/RES GRADING 78 PLAN r .. SMIP/NON—RES ISSUE FEE � '� � � ' � BUILDING—DIV—> PERMIT ISSUE Pli'AN:`CHECK TOTAL PAID DUE TOTALS----> 99.78 0.00 ;� 0;00 99,78 99,78 ,00 REVENUE DIVISION TOTALS--> COLL'ECTED�� ' 99,78 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 99.00 , , rA .78 k 1t iF M!E!! 1E 1f iElF 1f fE iE it 1E 1t fk 1t iF fk iF iE it i! i! 1E fE if if M if fE if 1E 7f iF iE iE 1E ff if'if it if if ff iE fE N%iF iE if �E i! M if R 1k 1! iE iF if iE iF iP iF iE iE fE if if 1k ik i! if IE 1F iE I N D Z 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�� ,i' UNIT COST TOTAL COST SFR 7800 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 7,800.00 END-OF FEES . �- . _ �"'C//�// I � f / �'C c/�•��fw'�. �� i 'troud%t � • /G�`' �QQ�, _ �+Q fr�c c�+..lj, �� _�_�/2s��y � `�`` � U1 �!�1S34u1—GJt).SS?Q "�e.��, 9�„ _ GA[E� 4ii29J4% TI%E: I;:59 CORSTRUCTION AND PLANNING I (� � PdOt .PA I ; -� Date Inspector Crte �I^no�ctor � APPROVALS Permit=m I APPROVALS Permrt � � I� � 7, Temporary Electr�,cal S��e or Pole 52. Pool & Equ;l�mzrt Locat on A 2. So�I PiPe�Undrgrnd. I 53. Stcel Ileinforc�•m�•nt I ' . --+-- -�------- --------"------ ---- 3. Elcctrica Contici? U'��tY�Und�grnd. I I I 5�. Forms � � ___ _-- -�___.-1-- ___'_ _ _- _ ',-_-* .`._ _ _ _ 4. E�a�tr'ca Cond��FLr,d-;.�"d. ! � 55. Eiectncal Bord r.;,� 5. St.=1 R��into�cam:�� J.- --�- -�--� SG. I;ocnh Plumh ng N, `�. dro ?�.• -� 1-- -�-' ��'. --f--- -�---- - - - ' - , , � 0 F.:�ctncz� UFeR GrrJ ' � ' �7. /�PPqOVAL TG COVi 6 G ,�-�; � � . - -�--- -�--- ------- -� ' - - --` -- %. Fnotinge ---- �I -�------ I 58. Elec;ncal Cocr'u�t U��d�:�n�. � '� � -- ' 8. FoundaLon - _- ' - -� I � 59. Gas P�pe. C; UrUra�, d Tui _ - _` _ ,. _ ' _ __ -"�'--- �i'-- -- - 9. ',5'ater Rpe�Ur.;lrgrrd. - I � 6p. ii.�ck�Y,�sh l m I'� �a� . - - . . __ J�__ _ 70. ST�uctural Ploor Sv'-'rr� � � � 61 AFPR(?\�AL ii) J[ �,K � . 11. ProPc�tY Sve:er Line R• F!o�.e Co�rcet�on �--_ �..._-__j ___ _ _' __, _ _ -, __ __ _ I � 62. Ba�:�la>n iS+ R�,ca�,�� r�,�� -- �----- -- { ---'---------- ��---- -- - - � - _ .- - ' _ - - . 72. Se �ier Cap ---' - I 63. Flect�r & V:n!�F„ ; � -�' ' . - -- --�-------- -----1------ �- -- - � 73. Roof Dr��ns �� 4. Piumh�nn Sy��em � f��a' ' --__ _ �-_ _-� _'�_ _____- _ __- ___ � __- -__ i__' _ _ 14. Roc�'� Pwm��g � G5. E•e-tricai�F nai i � 15. Rou h Electriwi-Condurt --- ----�- �---- - -- - - -- - - - -- �---� - --'�---� - - � - 9 66. olur Sy,tci•�-Fir:, _i`- -_ � ._ .' _-_- _ _ . _ ' 76. Rou h E�ectriclV��nn � , �3 9 i i 67. Pencing & Acurs•� Anpro�.3i i 17. Rough t:'ir�rg Si7n �, 68. APPROVeD P0� '�i�5:- ; - -- �. - ---� - - - - 18.Rou9hEiect�icai.TBzrCe�i��q � �iS°f.SYST="SFiNA'��.�---------------�--� 19. Ro�gh Heat�ng & A�r ,^_o^d�t�rn� .g �-FINr LE?T FE�UIRElo.E.�.T `20. Fough Faet�ry F!re�lacc �. -r-----� APPRqVALF -- � n �-� '�-_ -_-_ --�---- - - � �----�� - � - 21. DucLs, in SViicturu � � I 70. Ucdrry�o� nd !Iv�:"i "�� . 22. Ducs, Vantll.ah�• - --t- �i--- ---- �---- - - � - I ---, - . � -�_J.-_ ' %S. irutuc:Pip..:�..G_�5 __�_-_'_-'__ _"I" " _ ' �- "" _ 23. Gas Pipe Ro�an & Te�.•-- > .'9. 1.,,:1e.�•,. . � n �. : . -- ---�-------�-- ------."---- -- - - �---- - 24 flaof Frun,r-9 I � I i3 Jni��inm�.. Sri:;,�.c Tc^ia -' u,�� " - ' i75 °�.;'Shc"c''�� -_ '__-_- � ��-D��PiG(/�-74 (�.,. ,a;,,., "_ _ ' _ _ . _ . _ _ . • _ �--------- - - -- - - -- -- - - -� -�-- - _ . ' _ � --� �-�- ; �- - . . . - - 2�. i�fia' Ceihng IS' :�rL�ai� �'•,'prcm+t � � I , �/5 fJry (:hem.r;.' ._- -_ _-_�___.t___•�_ _ _.'.1__.____ _. _. ___ _._ . _ _ _ - , . 2i. (r�;rnt ur,ti h-'.ai:. ^.;d i i � 7t. L•" Sl.:nu� ..i. , ,� . 23. L:iri.�n;-S .� ..� -_' _ _ _-' _ __� '( *, I 77 f '. D .. � ' � .1 � -_ _ .' _ _ , _ _ .. ; - :, -- - --= � -.L --- � - ' - -- i - - -- •- ' 29. Insu:atinn . � --f�_ -�-. I iti. FINL �,h".,.� F��;.1n� � .. ,- - '__-_..__ --_-__'�______ _ i i __ _. . _ _.. _ -_ _ _. ' , . � J0. 7�; •t.�i �d'.'�,r.� I II[ALTI-i Ol-PT I"'.Ff,l I:--,ii.._.-.�T . ------ �--- --�------ _----- - - - - - ' - - - - - � - � �1 .s(r� ;ro�'� C�::! �__ '. i�o C�. . �. r � ��. � �� , L__ ._ _ ._ _ . _ ",' _ _ ", " 1 _} _ _ _ _ _ ' ' . - _ I•' / � �2. h,eirCal��u�.e� ��.�:r ,� I . � t� Lf_);:i �. If-iCia ! i� ;� i� .' , . � _ .. '�' _� ' r _ _ _ /) _ _ _ . --� ' A♦ � �Z. 'dl E': Ct _ " ' _ .' - _ _ _' _ ' ' _ __. "- _ . _ _' _ �' _ ' 7✓`Gititnn.� � -r��w�¢1/ � "' �j4 F�n?I F!r�t �C &' p•"_�L�r'-a' ---- --I -�- - - I -`-- I ( -- - � - - G r ~ - -- -1 .I� . +_ -/��_ VG�`-i . !�� (Q�! � � i �,f,. � ��c� Gds N�p�-Tz�: � i --�.--,-.c. ' 'c. .-i��a o, c,:�,p:, - ----- - - - - -- - - -, � - -� '� � -�.-.>- _ . I / �-- --- ---- � -�-^- '- -- `"-' -,�� -�i"'.�� a�l >��'t`f I 37. f-,nai Far.to•y F�•an�aee � ' � Q - T--- r38.I h1�31?lumb�„y --� --_- � _ -r--- -- ---- -- -----. _.. I � 39. lVater Scrv�ce�F;�al �' -_�-j - __ __I_____'I_____'_ __-_�_-- --_____---_-__ A0. Gas Serc�e= F.na� �il Sola�Uor!',es;PF�nt�-_" ___�___.._� '. __..'____._____-_ ._ __.--__ _. __-. . -_-___' -___ -___,--I_.____-__--__-.-___ _- _ _ . .. _ _ _ . ___ . 47. 3ackt�o�v Pre��enter � � 43. Bac:ct'on L'ri�;at o� -- ----I--- � ------- -- - --- -� - - - - �1'- _,rd.c�Pe I�. -.t,urC�. .�-- --t- ---�I - - - - r ---- -- - --- - ----- - � ; r I -------.- -- --.-�- -� - I 45. Sound A[ten,�ation �, I -� - -- � � -- - - � - - --'- - - � -- - -- - - - - � �---------{`-�s'- ---- --t�---- --+-- ---� -- --- - - - - - -- -- - - - � .,1. F;��,d-c.iP 4ey,��.�!�,or^ I I �- - - ��-�Y -��-,- --- ---- - - - - - -- - - � n�. `If�F.L STRUC-i UF'T ^� ;'J:LD:':G --(o I------ � - - ---- I-- ---- �--- - - --- �- - - - -- - -' - -- -- -t-- -- - - i 4II. fINALPLAt��li�r_ � _ I � ------ ---- -- - ---- - --- - - --- - ---- - � 4S, cl� c:�ic Reless: to'Zd.' �1" . s �-- _ � _{.-- -� - - - --------- - ----- - FO G&s Rzleasc t� S�uth¢-'1 Cahtomre Gas Co � 1 51. CGR7IFICATeOi`-G:w1�Af�'Cl• �-----------J- ---�-� - l1No.� ---- _�ate--- - - I -- --�-�----------------- - ---- - ----- - -- ' � "°°""' qg7 16TH PL �sxam[: CRAIG RONALD V aoonEss: 497 1�iTH PL COSTA MESA,CA AHCNIENGWEEfl: �714�642-1286 p�DHESS: UNIT: 92627 XEG.NO.: UNIT: PENMITTEE: RONALD V. CRAIG ( 714 ) 642-1286 aoonEss: 497 16TH PL COSTA MESA CA 926�27 UCENSEU CONTNACTOB OECIABRTION: I �ere�y aflirm �hal I am licensetl under pmvisions ol C aDter 9(commencinp wi�� Seclion 7000) ol �iv�sion 3 0l the Business and Pmlessians CoUe. and my lic¢nse fs in lull lorce ana eftecl. CITY LIC.: STl1TE IIC.: CIASS: Da�e: SignaWre: WOPREPS' COMPENSATION OECIAXATION: I Aereby allirm Nal I have a ce�ilicale ol consen� to sell-insure or a cetli�icaie of Workers' Compensation Insurance, or a cenifie0 cooY �hereoi (�ction 3800. Lab. C1- POLICY NO.: EXP. OATE: COMPANY: ❑ Ce�ihed copY is hereby fumis�etl. ❑ Cehilie0 copy is liiea wit� �he ciry Building Oivision. Da�e: AODlicant: E%EMPiION FflOM WOHREfl3' fAMPENSATION OECtAMPON: (TNs senion neetl iwl be completetl tl ��e perm� is for o MreO �5100) or less�. I cerlity ttlat in I�e Dedormance of I�e work lor w�ic� ihis permi� is' ued. 1 shall not employ y person in any a er so as lo become 5uble[tl� Ihe rkers' mpensation LawS ot Califomia. �--� �ate', Signawre:' � N0T1 : I, a r making hi aeclaration, you s�o come su�lect m �e Workers' ensation provisions o�lhe Labor Co , you st lonhwitn comply vnlh such p 6io s or iNs ce�mit sAall Ue Oeem re kee. WNSTNUCTION LENOING RGENLY: I here�y affi�m Itwt ��ere is a mnstmction IenAi cy for lhe Oadormance ol �he work for wh¢h this Oermii is is5ued (Seclian 3097. Civ. C�. LENUEN: ADDflESS: �� OWNEfl BUILDEfl OECLAflATION: I hereby aflirm tha� I am eKempl imm I�e Contranars' Sta�e Lkenu Law �or IAe lollovnng reason (Section 7031.5 Busine55 and Pmiessional fAde: Any cily al county which reQuires a Dermil to construct, aller, impmve, tlemolish, or repair any Slmciure, Drior to iis issuance, also re0uires Ihe apDlicani tor suc� permit b �ile a signea Slatemeni I�al he/s�e is licensea pursuantlo�Ae piovision5 oll�e Conlraclors Slate License Law�Clwpler 9�commencinp vnlh $eclion 7000�ofDivision 3 oilhe Business and Professons Code) or that he/she is exempt I�erelmm and ihe Dasis lor ��e allegea ecemD��on. Any violation o� Seclion 7031,5 by any appbcanl lor a permit suGlec�s I�e aDDlicani Io a civil penal�y al nol more I�an five �unAred Oollars (SSOU). I, as owner ol Ihe properly or my employees wit� waBes a5 IOeir 5ole tompensa�ion, will tlo ��e work, anA �he ❑ stmcmre is not intenGeG or ollered lar sate (Section 70a4, 9usineu and Prolessimal CoOe: t�e Coniraciors' Sta�e Lirense Law tloes no� apply to an owner ol a pmperty w�o �ui105 ar imD�oves thereon, antl who does sucA work himsell/herself or thmugh his or �er own emDloyees, proviEeG t�al suc� improvemenis are notintentle0 or oflerea for sate.lf. however Ihe 6uilding or improvemen� is soltl wiihin one year o� [ompletion. IAe owner will have Ihe �ur0en o� proving he/s0e OiA nol Duiltl or imOrove lor ��e pur005e of Sale�. I, as owner ol I�e pmpeny, am eeclusively canlracling wiih licensetl wmracmrs Io conslmc� �he prole�� (,Section 70aa, Business ❑ antl Pmlessions Co�e: The Coniranors' State License Law aces not appry io an mmer of D�oDeM •ho Dmles a� im0��es iAereon anC w�o conlracis lor suc� Orolec�s wit� a conVaciaqs�license Oursuanl to t�e Canirac�ors' S�a�e License law�.l am aware Ihal prool ol Iheir Worker'S Compensatian insurance 5hou10 �e O�m'�dea to me. � I am exemp� unUer Sec�iore H P.� O 4 4 B. 8 P. C. � m�misreao�: y OWNER S FAMILY Daie: �C � Ownec � I tla �ereDy o tlify Ih I am aware ol and untlerstana ��e reQuiremems o il nia Health antl Safely Code I ns 25505. 25533, anA 25534 and Ihat I or anyfuture Cuilaing occupanivnll/vnllnol (circle o ne¢G comply wilh saiU slate co� Ihe reQuiremenislora permil for cons�mction or mo4A¢ation Imm �he Air Oualiiy Managemenl OisVict. Fevdential constmcii ap ica�ions are eKemp� �mm Ihese pmvisions. Date: Apvlicanl: I he�eUy cetlify I�a� I �ave rea0 t�is applicaiion ana s�a�e I�ai ihe above inlormation is ortlinances antl sialelaws relating�a0uiltling can5lmclionantl hereGyaulhoriZerepte5¢nt proper�y lai ins cuon p o5e5. oate: � � ' Signamre: river's License Saial Security w' —ApObcant: Pink 1 agree to com� �his ciiy �o en�er Goldenrod—Assessor CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO: P 065763 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU JOH DESCRIPTION : AEPLACE SOLAR PANELS AFTER REROOFING CLAIM VALOE: CALC—VALUE: PERM NO: P 065763 GOVT: N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: R-3 /M-1 COMMENTS: RE: B65761 ar�**�***+r*�r**+r�****x-+rtt-x��t�r*�*ar�r�r�*x�+t�t***x�*****it�r*�r**��r+��-*-n*-�r�r«wrr+r-�r�-*��r�tx-�t+��t�**+� Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGIiT; FT IN LEFT; FT IN RGHT: FT ZN PARKING REQ; PROV: PARCEL; 42515109 ZNE: REF NO; PLANNING NOTES> > i494 iF iE if iF iF iF if iF iF iF iflf if it iE iE if iE 3t �E iE iE iF 3f iF If iE iE iF 1f iE if iE if iF iE 1E iE iE 9E dE IE iE if 3E:E 1E 3F iF if if if �f iF 9F iF iE �%3F if if i� iE iE 3E iE iF # iF iF iF {E iF 3E iE if 1E D E V E L O P M E N T S E R V I C E S R E Q U T A E M E N T S r2+1,�i.ia�.ill.i�u�l.�:y� BUILDING APPROVED BY : APPLICATION ISSUED BY; ��/�/��. 4 if iE it 1E iE %i! i! M i! iE it iE iE if 1F iE iE 1! 7F itiF S 1kiFfEiffFlflfiflElEfllEff1E1f1lkfEiFiF7kifikkiktfiFifkifiFiEiEifiEiflFiElE 1EiEiE LEGALIZATION:N F E E S U M M i, DATE: DATE: '��--� DATE: ///�,9�� iF�'iF iF'iF"iFiF3i"iF'iFiF ie if * ie it ie fk iE it iE±F`iFiF'i k *�t ik iE 1f iE 1E i! %if fE iE iE iE if M ii fE 1E fE fE ff ff 1f ik it iF iE i! 1E 1f iE iE 1E 1E iP A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC� MECHANIC FIRE SMZP/RES GRADING PERMIT 3,00 ..�� PL� 252 ,�- � ,, SMIP/NON—RES ISSUE FEE 20.00 -- . " �� BUILDING—DIV—> PERMIT ISSUE PL'AN.`—CHECK TOTAL PAID DUE TOTALS----> 3.00 20.00 % 0.00 23,00 23.00 .00 i REVENUE DIVISION TOTALS--> COLLECTED: 23.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 23.00 � `; '� � ; � IF 9F 1F IF if iF if it iF 1F �E jF iE iF iE iF iE 1E M jE iE 1E iF if iF iF iE M iF iF iE iE iF iF if�iF iF iE iF 1E iF it it 1E iE iF if i! if iE i4 3E iE if it iE M it if if 1E if iF ik ik M%if iE iE if iE 1FlE iE fE iF IE ik I N L1 I V I D U Alv � F E E B R E A K D O W N TYPE QTY D E S C R I P T I'O Ni� UNIT COST TOTAL COST 1 PLU 1 SOL, COLLECTOR COMPL�• UP TO 1000 SF 3.00 3,00 END,�OF FEES 1� �/�T'ITTTTT'�T'�T /�-�`�e .�.L a��(e� ' ,� ��cT�-., , lG l QQ.S d+^P�r; . �� I '' �12s19�i��`' ., :; r � '� n 1 i�1 7��c:.,��—�G153YE° T:� � _ DATE: 7i.'i': ':'_ ,.:°+ \ �� - - -�- - -- -- -- � - - - -- CO�STRUCT101AlOPLA\RING ."00+ PA � ( D�[u I!�.p�ciar I � Uate � Ir,�ec"�- ' '� APPRONALS Permit5, _I � I APPROVALS Prrmit.�_ i ----�---- -- �-,-� '.. — , --- ------- , i � 1. Temrynrary Fl:ctnca. 5_ c� o� Po'._ � i 52. Pum a Equ.,�.,. �.• '.,.-,� _„ � i � -- - - - � - -----�. 2. So'I Pip^.U^dromd. --�-- � --�_3 S�crl Itei��torc�..,-,..�' � � � . . �--- -- ----- --- - -- ` ---- 1 - - - '�--- --- - - -- -- -- - - --- � -'-'- - � - 3. Eiectr'cal Co�d� t J.' t l. � a�rL � -i� r i, � G. �I V CuI C7',J� . �. t�"" ,� __ _. _ _ ___ — _. tiJ [ "iWi �� ll i i � _ " _ . _.r_ _ __ - . _— _ - S. St .I qiinia•C"n'.nt _ ._ _' ' _ _ _' "_ -� �i; _�'rl ?!�� li � "° . '. i( �_ _ __. � ' " _ _ _ _ . -_ _ __ _ -' '-_ _"t _._ .� _ _'_ _ __. -"'"'___ . . __ - -_ ��+ F,.ti c'' . GEP'��.rd 57 i✓PI�V i � L: `h q G. '. � I_ — __ _ ._. - _ _' _ ; - . 7. Fnot�n�s ' ' SL-' �'�_ ... �' „ � .. i _ ' . . _ _ ____ _ _ _____ "i _ ' � '_ ' _ . _ _ . _ _ _ _ . . _ _ . _ .. I 9. Fo�naation � �, ', �d. l�az Pipe. ,_ U� u� � a �,. , . _ _ _ _ _' _ . _ _ _ _ _ - _ + _ _ . _ _ _ - . _ . _ . _ _ . _ _ _ _ _ _ . _ t _. _ ' _ - - '_ i �. . � ii ?ip� i;' .ir �. ' ,... :i...,�.t �i. � . .I' � . . .. 7D 5 -� F� ❑ S .,_- - . . , ..- -- - - rt a�: ;nv i,, . � � - - ,---- - - � - - - -- - - - --� - �-. .- - -- - - - - - -- li.Vrai. v$. r r.i r'. �-.... r� ' . ii2 • �' _ _ ' . � _ :.c•..,.'i : r,_ � ,�__ _ _ _ __ ' ' _ 17 5: •. =• G; p - - - --- - - -- - . � �3. �. . !, r S. � ��'t ; . ' �13RoufDa�—�.____'___ `______.,___-_I_`____-fS_._ ,_—____-'_____- __ r-------'---- --- - - - r--- - -'- - --�� ------ -- - --- - � - - - ' - - --- - - i. 3'��'�"�'� � � �7� t'C.�IF �� 75 Nc g . E�Ec•� cai.Co^�-' --- - - - - '�._ . . . E6 c,�� . �rt _� ,�- - - - - --, --- -- - - -- - �6. 7a �. E;ec:�.� .Y�nna � Ei7 Fenr�nn & Rcc �� •i :: ,:, i i1/ No..3�'.._ -C_ --- _ __� _.'_. _ . ________ `�;.• U�i�').`O�;?� �.� .._, ' ___� __ _ ' _ _ _ _ � ^ _.f_ -_J.-- � ___._- - _.___-__ _._ _ _ ifl Ro�ghEer.•:cd�?5z'"'- v-- --- �� gg. p��, c�„�,.;';"SFi':A_ i 1^� 4 � I'ca• •R ,•,--_-------� -- — ------V"iNl_ u�".. F�LOI;�-3'- _ -_ - - - - - - _ i I 2C. 3;;.0', c,r'�.•,.' -..._-_--_._-___i ._ ___,---_ _ � APPRC'��'..1 S . ��. . __ -_. _ _ � - ------- ------'---y----�-------- �-- --- ---�----- --- �21. Du.:,.l-•5:-��ct,.:-� � ' '� /0. L�_, _o..;,�,.. , •� �--------- --- -- ---- �- -- - -� ------�-- -- - -- - -� - --- - - - ---- �- �- - I 2Z......\'.�..,. : � /i.,..,c-'.'�� :� ., • �i - , . . � ... ., , � ----- --- - -� -- - - - - - - -`- - - - - - --- - � � - - - - - �� - - ! 23 C:z� Pii;r.a�.iP 1� '.... . ' � !.". '.. . . . ' . ' . � '_-_____'._ _ _ ^' ' ' ' _ __- _' _ _ .".__. ' _ _' . _ � _' � 24 ,a'.,! Fr��r. .•-_ � %3 1 • �. � . ' � • f , - �. I . . ~ - o.. .. 5. L- - -- - - - - - - - - , . . . ; . � . � - - �� - � : ' 2ti. i ut" Cc� Sr _ _ ' , . �. . � f - � -- � '- � �: !'� . .. . , . '. . I___.__--___ _ _ .' _ _ �. _ _' ; ' _ ' ' _ _ , 4 " �- Zi. i-�; .: Jr'O Y.... -1 �, I • /li. � , .�.' .nr � . , . � j 7:�._ s__'_- _. _ _ _ ' __. " " _ " _ . ' . ,. . _ ' _ ' . ' , _ .� .' i. _- _-' ____ _- -"_ _ _" ' _' _ _ _ _ _ "" _' . � / /. ' _ � \ _ _ _ _ � ' I � - ' . � . � . . f • ' i9. ��i��i�lb!�un i )i' r�i.�� ,�[ir�v ��. i �._ _ _ _ _ _ _ ' _ _" ._ : s_ ' _ I. _ ' F A' I:.l �T... , �il-; _ I / _ "1! i : j. , I . . , � _ . ,. . . %. f -- {,'— — - '. �-i ` ' �' / � " % i � �7 6 r� r G�I I''.. �, i-,,. � � � ..0 i�LJ 1�.1 �� l'.' ! i i � r7,",+ F'..�� _ � .r. , _ __ _ _ _ . .. _ _ , j _ �� . . •_. '1 i �' _-__ -�_ , __ __ -_-_ _ ' ' - _ _ _ " .- . � . /�-•Q -��1-�`^�'�. 34.F��;��i:atr��i,e, _. .,, ,,. � � � � _. '� '_ � !i�?�"� ✓c.�..r � �6 /�Yln.S�� ✓Lt.¢_ 35. 'ir�l Ga. F�a- i , - - - - I I , I � � /9 �--- ------- - - — - - � - -� . - � � • � , `. 'G 3G. 1'coC ar C- �cp•. I � / �____'___'__ _' ._-._-___.t__'_ i _'__- I.. _' _ . . . - D("S( � � 37. F.nel Fz�:u�v Freo�cc. � �. • ��—_'____. _ ' ' _ _ .''.'�'' '_ ,'__. _' ' "' _ ' ' ��- . � 38. r�.,a� Ptum��g � � ' ; � -• -- -- -- -� - - � - --- - - - - - - --- - - - - 39. ��ter Se.� e�FiFa•,ai -- -- � � --- - - � - - - - - - - �- -- �' � � � � - - � - ---- - ' � � ' -- � - - - - - - . . _ - - - � . . _ 40. Gas Scrric � � ii. o.�� Jo ��. . oF .� I - - - . --------- - - �- - , �--__ - - ----- -- - - - - I 4?. 9acuflow Preventer � ' 43. Dac:cflo.a• Ir� ivat.o�� ---- --- - - I- ----+ I- - - --- -- - . --- -- - � - - - - - - -- - - f- ---- -- - - --- -- - --i- � - -- - -- � 1 - - � - - . ti�._ �:,rtl�,c,�Fr. I. ,^;t o�_S� . ._ _ - _ _ • _ _ _' .. _ . ' . I _ _ _ . . . _ 'I lE. Sound Atten�i2;�c� J � � � . '-- — - - -- -. _. . .,.- - ' •ib f;..�-C!.:3p Z[y ! . . '_ _' _ - ' _ �� l ' _ n�. � :n� =� sr��c- :. �F � ;.. �� :;; i _ _ , � , � _ �_ _— - - •- - — � 48. FI(QAL PLAf�iINC � ' • � ',-- — ---- ----- --�'- -- -- ' - - - � �- - - -- - - - - - - - - - - - -- - v£. GiC.•�� : �_�: ro._� -.i . I � I "------------------ - --- � -i� i - - - - --- - - - - - -- - - � FG. G^_s !��Ic�sc to So�!�r��, C�.,I�iom�a Gas G.i� . . i _ _ 51. C�RT�F;CA-E OF O�CUPA7�.C"- - �I -- - j - � �I � - - --- -- - - -- - . . . - - - Na. ,.,,!r � --- � I -- - -i-- - �� - -- --' - -- - - - .' . . - ' - - - -- - - Y � RONALD V. CRAIG 497 SI%TEENTH PLACE COSTA I1ESA, CA_ 92627 phone (714) 548-1631 August 22, 1994 Burt D Morgan, Plan Checker City of Costa Mesa P.O. Box 1200 Costa Mesa, CA 92628-1200 Re: Perm. No. B-065761 Dear Sir: I obtained the above listed permil January 19, 1994 to re-roof my residence. Do to very valid circumetances beyond my control, I was unable to begin 'the project until juel a few day3 ago. AC the advise of t1'�e planning department, I was asked to notify you of this delay. I am now doing this and hope I haven't Fouled up your system. I will have the roof off by Wednesday, 8/24/94 and will seek your required inspections very soon after that. Si cere y, � �� 1 I � �.��G '�'i�S�qY .� '. CITY OF COSTA MESA '� CONSTRUCTION PERMIT ApplicenCa Maili ddren Project AdCrezs � 7 �— Owner'a Name � Address � Arch/Eng. Addrezs Contrecto� i Nam Addrez� (meiling) License No. LICENSED CONTRACTOH DECLARATION I nBreDy a/firm that I am Ilcense0 untler D�ov wlt� sectlan 7000) of Divislon 3 ot tha my Ilcense is In /ull force yntl efle9t�, � oi an0 ADVllcant to 1111 In all spaeaf exeept t�ose wI1Mn �eary DorGer Iinef anC sign all approoriatv Ceclantlons. = I TVPE OF CONSTHUCTION ❑ CONVERSION ❑ I AITERATION LJ REPAIR TVPE OF PERMI� LJ GRA�ING LJ FOUNDATION' LJ STRUCTURAL NO. ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL � �1 ❑ �OTHER ,Qg�yq� QIECT DESCRIPTION 5�. FT. OCCUPANCV_ � —� CONSTRUCTIONTVPF VALUATIONS ' ZON� GRADING CU. VDS.� ACRES_ � Remarks: � � � 9 (commencing � ons otle, dntl � �z§��3 WORKEAS' GdMP'NSATION DECLARATIOfJ' ' ,'� be�aGy�affl�m t�at 1 �dve.d Ce�Ufltdta Of con5ant to SBINnsu o a certlfira[ �''�,'�-,`„�=':iWorkers'�mpensa lo,n Insur-n ,� cartlf copy t r f(Sectlo �:.'CUO� LaD. ' v�Pollcy No. � ' pan � �rtifie <oDY �e eby furnisnea. � i � Ii�th¢2 ui wi� Date Appliwnt � EXEMPT N�FR M WORKERS' COMPENSATION DEC A ATION � (This secllan nee0 not be complatetl if Ihe permit ii for on h Uretl (5300) or � less). . , • ' I<ertl/y t�at in tha Derformance ol tha work for whith thli perm�t is issuetl I s�all not employ any person In any manner so as [o Oecome sub7ett. to t�a � Workers' ComDenulion l.awz o} ��}ornia.� � . Data � �ignature � ' NOTICE: If, aiter-making this tlaclaratlon, you should became subject to tne Workers'� Compensatlon Orovlilons of the Labor Cotla, you.must forthwilh � comply �wlth such Drovislonz-or thts permil shall be GeemeC rovokeG. ' CONSTRUCTION LHNDING AGENCV , I herebY affirm t�at thera Is a ton5truction lentling a9ency for thepe r/ormanca of the ,work 1ar w01ch. [�Is permi[ �is IuueO (Settlon 309] Civ. CJ ' l.anAer's Name l.endOr's AtlOress OWNER BUILDER DECLARATION 1 �ereby afflrm that I am axampt Irom the Contractor'S Llcanse Law for the /ollowing reazon (Sectlon'7031.5 Business antl Prolasslonal Cotle: Any city or county wl�ich redulres a permlt to conitruct, alter ImOroOa, tlemolish or, mpalr any i[ructure, D��or to Its Issuance,�also requlres t{�a aOPlicant for suth permil ,�'S_S�yytram anC tho Dasls for tha allageE exemption. My violaflon ot Soctlon '; ��;1.5 Dy any applirant for a permit subJetti the appll�ant to a tivll � rs, sblty of not moro than five �unareG Collars (5500�. . � .. LJ 1, as�owner of the Oroperty or my employees witn wa9es ai thelr sole compansation will Co t�e work, an0� tha stru<ture I5 not intentled or ofterotl br salo:(Sec�ion 7044, Business antl Pmtesslonal COEe: Tbe Conlraclor'i Llcenie Law tloes not aOPly to an owner of a proper[y who bulltls or imProvas thareon. antl who tloes such work himselt/�arsalf or [�rouaM1 M1ls or her n amp�o eas, proviaCa Inai sucn improvamencs are oox inxenaoa or oiie�ea �or � seie. I, nowever, the Duilaing or Improvement Is solE within one year ol com- � platlon, t�o owner will �ava tha burtlen of proving he/she tlitl not DuIIC or Im- �rove for t�e purpose of sale). 1, ai owner of fhe OroDerry, am exUuzivery contracting.with Ilunsatl con- " tractorito construct tha proJect (Sec[lon 7044, Business.antl Prote551ons COCe: The Contractor's License Law does not apply to an owner of property who Gulltls or Improvat'tharaon, antl w�o contracts for such Drojec[s wit� a con- tractor(5)Ikenie pursuantto tbe Contrac[orY License Law)., � ❑ I am exenlD� untler Saction - B. 6 P. C. for thls reason Date ' • Owner. � � � � , 1 hareb y� certlty that I have read-thli�ap0liwtion anA-state ttiat ttie abova� , informalion I5 cor . 1 agree to comply wit� ali clty anU county ortlinances antl:state lawi r atl g o EuilOing <o�struction,�antl heraby authorize repre- santativas of th' ' y to antertup(.� the abovamentlonetl p pe�y lIlr Inspectlon Durpo . A `�j � �)2 Signature / v' 7� Dat 0 , DrlverY Llcensa or�55 � _ � — �� . I' I Registers :MF OB6546 rev. 12/82 White - Builtling; Canary - Applitan[; Plnk - Accounting; Goltlenrotl - Assessor Preventer Irrigation FI00� DfelnS� FloorSinks � GasSanic� Incercep[ors� Kitchen SinK Lavatories P—Trep Roof Drains Showers ' ServiCe Sink . Solar Collectors , Solar Piping � , Sotar Tank � � � i Swimming Pool wlSpa ' � � Urinal Water poset ' . ' � Water Heater � e Water Service Boiier . Duct - Under Ground � Duct - Slructurel Duct - Ventilating Exheurt $y5tem ❑ Multipie Firepl/Fact. Blt. ICBO 5W Heating,System & Ducting - ❑a100,000 BTU �100,000 Hood oi Tvoe I ❑ � _ � Reinspection Fee , S15 Isue Fee � 5 3 ❑6100,000 BTU ❑ 100,000 HTU I c:...e.., ne..e:.lni.e.a.:.... .. � � Reinspection Fee• � � j laue Fee $15 $ 3 PLNG.REF.� LEFTSIDEVARD � PKG.SPACE REQ. STREET WIDTH SCECIAL CONUITIONS: W25A2! _ Unit U. iice Boxes tlets D2'i? bll:i/3:i 19.a:: TL BUILDING y'FTBA(�`l� `(�I CT REARVARD(TOP/U � . RIGHTSIDE VARD • - PROVIDED PARK FEE $ , . � ELECTRICAL Meter, �over iW amps . Sub PaneL , Sub Pole , Morors 0-1 HP O1X$ Inc.Solar �9-15 HP 016-15+� � 'Microwave � Pole Light . . Range � Sign — Standing Sections Trash Comoactor Garbage Disposal Generaror �0-5 KW 05-15 KW Transformer �15-SOKW � ❑5U+KW. Meter ❑up to 100 empe Zonin9 ApProved BY . ApPliption ApProved BY . Appliption Iaued By f Reinspection Fea . � . E15 � ' SUMMARV OF FEES • . BUILDINGPERMIT $ ' � SMIP � $ . PLAN CHECK $ PERMIT PLUMBING $ � � ISSUANCE S GRADING 8 � PLAN CHECK $ ELECTRICAL $ � � � � $ ' .PLAN CHECK � $ MICROFILM . $ MECHANICAI $ ' TOTAL,fEE E PLAN CHECK $ � LESS , f ADVANCEDPC $ ,� � � . . • � . FINAL FEE' $ ' I ""CONSTRUCTIONAND'PLAN G ; t � c �; � - , � ��-; o- POOL ��^`eaA • - � F- r � ' ` '" ' ' ' � �:./�� - �Date � %Inspector y '� � x� - - Date Inspectoi ' � f� • � APPROVALS =- Permit #--�-L4 . � APPROVALS� ` Permit # _ . � _ ry d; Temporary,Electr,ical Service or Pole `� " . � - _ ' '•52:: Pool &`Equipment Location � . - � 'J ' ' - _' _ .•,�,. -_ _ [ - -`�•. . . • . �2: ,Soil Pipe-Undrgrnd. � = � y ' r,- , � . 53,� Steel Reinfo[cement � . - ' - - �� 3! Electrical Conduit Utilitv-Undrgrnd, v- = ._ �54� Forms � ' ' �� - � - ' � 4; Electrical Conduit-Undrgrrid'. - . . - ' y � " �' '55c �Electrical Bonding ', � - � . � � 5: Steel Reinforcement � - � � � � .,'_ � = `�.; - ,56.� Rough Plumbing'& Pressure Test - 6: �Electiical UFER Grnd. _ - � ": �_ _ ' � 57.- APPROVALTO COVER•GUNITE � -• 7. Footings � , � " 'n'� •:� �_ �58. Electrical:Cpnduit•Undromd. - 8. Fountlation � � , � _ � ' ' �; � 59. GAs Pipe,`-O: Undrgmd., Test � 9. Water Pipe-Undrgrnd. -_ � ' � 80. Backwash Lines, P-Trap,�O Undrgrnd. - 10. Structural FloorSy,stem - � . � -- ;- - ,�61. APPROVALTO�DECK � ' � . - � 11. Property Sewer Line & House Connection : � ' � � `62. Backwash & Recepior-Final - � �� . [ r 12. Sewei Cap • I ' ' � - � 63. Heater & Vent-Final ` - I i 73. fioof Drains � , , ; � � � � 64. Flumbing SYstem - Final� � . . 14. Rough Plumbing ' ' - - � - , � 65. Electrical=Final " ' � � � � - '-15.`�Rou h Electrical-ConduiY-� � - .r"ir-' -'--'-" -- T-'-" ' ' '�' � � - F 9 j � � j 661Solar System-Final - �it6.'Rough.Electric�Wiring � � c , � "„-' = y"�--"� �,� 1"c- � _ �� 67.� Fencing &�AccetsApproval � . ^ °,17. Rough Wiririg Sign" �� '� : - '� � - . �- ; ; { ' , � , �68.� APPROVED F,OR PLASTERING . - _ � � c � ' 1�8. �Rough-Electric`a1-T.Bar Ceiling' ' . � � i � ' � ,69':i POOUSPA SYSTEMS�FINAL ' • - t, p 19. Fough^Heating &IAir�Cond,itioning ' 2 � � • �FIRE DEPT.�REQUIREMENT _ � _ �. -,' ' � . ��3 : . . i _ , � . � i , . � � 20. „Rough Facto'ry Fireplace '� � ' '. � � � � APPROVALSI � Permit�# ' � > � �� . - . , . . . . . 21. ;Ducts,.in Sfructure � , � � - � I � 90.� Underground Hydro . ; ",�' 22. �Duc[s, Ventilating � �, � ' � � � i � � 71t; Product Piping O Gas ❑ Oil � � i � `�23. ,Gas�Pipe-Bough & Test :- ,{� i� - �• ' � �7.2. Underground Flush� � - q,'�Roof Framing�, � � � "; . i � � •,' '. 73.� Undergrnd.StorageTank�OGas ❑Oil ' � r �25. ��Roof Sheathirig � � ' � :5 . �� 3 -- , : � - J4.� OJerhead Hydro � i . �; 26. T•Bar Ceiling (Structurall. & Mono'coat ' i = � , i ; ' � • � 75.i Dry Chemical � � ' � 27. �,Frame and �Flashing � � i '76:� Dry Standpipe , - ' 28. Lathing & Siding - ' � i � � �� 77.� FIXED SYSTEM�F�INAL . ` � 29.�Insulation _ _ � i � � I � ; � � �78. FIRE PREV. FINAL � `�30.'�Drywall Nailing �. • . � ' j � ' , �Notes:� _ �a �` � N ",�31. Plaster Brown Coat ' .. - - - �-� � . - , � . � � -s-�a � , ` �T�- , � � 32. Electrical Power Meter-Final ' � ' � ' " � � �' i t' .:i � f ' �L33..Final Electric � � � ' . � � � 34. Final Heating &'Air; Conditioning . , , � � � , • - 35. Final Gas Pipe-Tes[ � i � �' � � , � . ; � - � � � � . .� . � � . ,' � 36. Hood or CanopY�� . . � _' . ' � - • . . � ' � - � 37. Pinal F.actory Fireplace`, _� r' �� . ' �' � i - � 38. Final Plumbing ; i � ' � � i � ' 1- � I , � � � � �' _� . - 39. Water Seivice-Final; � , , ' ' � j ; � � � � ` � ' :' � � 40. Gas Service-Final ' � ' „ � � ' ' � � � ' �� 41. Solar pomestic-Final i � . � _; � _ _ _ � ; ��- ��- r 42. Backflow,Preventer _ � � � . .. - - --_ - . ._ � . . i 43. Backflow Irrigation " � ' � i � =''" '•� � -�':. � . � , � , ' 44. Landscape Irrigation�SYstem i - - � � � � �, � � - ' ` ' -. � ,- - j ; i ; i � , ' .. . . I 45. Sound' Attenuapon � �-, i�, � � , � � • ' 46. Handicap Regulations, � �� . '" � i ; � � � ` , � ' ' � � 47. FINAL STRUCTURE & BUILDING i � � ' ' ; t � � � � `- � i.' � '� � 48. Special Requirements Completed . . � ' . � � � � - � � � � . . - ._� . . . 49. Electric Release�to Edison j . _ ._ _. .. _� . _ .. . , -' 50. Gas Release to Southem C,alifornia Gas Co � � � � ' i I' � � � � 51. CERTIFICATE OF;OCCUPANCN ' _ I _. _ _ ! '_ _ . ' � No Date � � � t � � ' � ' ' _i ` no jCITY OF COSTA MESA' � . ' � � � CONSTRUCTION PERMIT �' ApplicanYs Mailing Addrea , : Prqect Addreu � � Owner's Name � � hone , � Z'&� Address � 7 � V' � I � � Arch/Eng. License No. � Addreu CantrectoriNam Phone' Address (m.._'!' 1 . � , . � IY � License No. .. . , . . . II LICENSED CONTRACTOR DECLARATION t I hereEy affirm that I am Iite�satl untler provislons oT Charter 9(commencing wl[h saction 7000) oi DIVISIP� 3 oT the Busineu antl Professions Cotle, an0 ' Ty II<enSG IS in tull torce antl�effBct. , ., ' '� LJcerise Class License No. ' Date� Signature �� WORKERS'COMPENSATION DECLARATION ' '�ereCy affirm [hat I have a cerpTiwte of tonsent to self-insure or a certlfiwte �`��.�:`..Workers' Companutlon I�suranca,'or a certlfleE coOY theieot (Sectlon �'i'`"-d0. Lab. CJ . . �`e Policy No. ' � Company � eCertiTietl-copy Is hereby furnisfied. . Cartlfietl copy Is /11e0 with the city Builtling Divlslon. ' , Data qppliwnt � IE%EMGTION�FqOM WORKERS` COMPENSATION OECLARATION ' (T�is section neatl not be comVlatetl If the permit Is for one huntlretl (§300) or ; lass). . . ' ' � ' I cerUfy [hat in tha pertorma��a oi lhe work for which t�is perm�t ii issuatl I shall not employ any person In any manner so'as to become subject co i�e � WOrkerS'�Compansatlon Laws of Callfornla. , Date ' - 5(qnature � � ' � � � NOTIGE:If,afte� making thi4_tleclaratlon, you shoWdbecome supject to tha � �� Workers' Gompensatlon D�e��5ion5 oi the Labor Cotle, you muzt Torthwitb ' compty ;with 5uch provislons or this�permit �shall be Aeemetl revokeAr � �CONSTRUCTION'LENDIN6 AGENCV �� - � �� I hareGy aftirm Ihat Nere is a'�onstructlon lentling agency for the performance I of tha work for whlch,-tn�5 perTlt 75'issuetl (Sectlon 309� Clv. C;. • ILeneer'z� Name • ' - ^ . � _' Lentler's Atldress � ' � ° ' ' � • � OWNER•BVILDER OECLARATION' �� „ � ," i . ( � I,� as'owner oT• the properry or saie. ir, nowever, tne bulltlini pletlon, [he ownar �wlll have � �row for the purpose of�sale) LJ I, as ownei ot the proper7 tractorsto consGuct the'proje The Contractor's Licen;e La� builtls or improves tharean, � t�acto�(5) IiC¢nte pur5uant to i ❑ 1 am ezemD� ��tier Sectio� � Date O� I hereby� certlty Ihat I'�have Informatlon Is correct. I a9re� pliwnt ta flll in all spaeas azeeD� those witMn heary Uo�tler anG Sign all ipproO/Iate Oeela�ations. 10. � BL . � TVPE OF CONSTflUCTION � LJ rIEW L.I ADD IJ ALTERATION ❑ CONVERSION ❑ DEMOLISH '❑ OTHER � � DESCRIPTION OF WORK � , TVPEOFPERMIT GRADING FOUNDATION '.STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBIN6' ❑ MECHANICAL ❑;ATHER PRQIECT DESCRIPTION SQ.FT. OCCUPANCV— ' CONST`RUCTIONTVPF Vt1LUATI�NE� ZON� GRADINGGU.YDS. �ACRFc Remarks: . Sink cflow Preve�2er <flow Irrigation Solar Collectors Solar Piping ' Solar Tank ' Swimmino Pool REPAIR Drinking Fountains � Urinal � . - Floor Drains' � Water Closet � Floor Sinks • - � Water Heater � - � - - Gas Service Outlets : Water Service � � � Interceptors , . , . , ' Levatories � � �� P.—Trap' � . ' Roof Drains . . Showers � ' � ; Service Sink . 'an owner of a proparty who builtls or Improves Boiler �. ' r+ork hlmself/h¢�Self or throu9h his o� her own ' Imorovements are'not intentlatl or offeretl for , or Improvement is soltl wlthin ona�year of com- Duct- Under Ground ie burtlen of proving he/she tlitl mt bulltl or im- � ' � � � Duct-Structural � am axclu5ively contracHng.wi[h�licensetl con- t (Section 7044, Businesz antl Profe55ions Cotle: Duct - Ventilating '• � � doas not appy to an owner of Oroperty who . - , itl who contracts tor such projects with a con- Exheurt System ❑ Multiple ie Contractor'S License Law).' , , 9. & P. C, tor this reason ' " Firepl(FaCt 81t ICBO # � Drivers' License or 55 � ��-�� CMF 0865-46 rev. 12/82 Whi�e - Builtling; Canary - Appliwnt; Heating System & Ducting : �e above �-; ❑0-100,000 BTU �100,000 ilnances � � ' .e repre- � Hoad or T ' �rty far � VPe I ❑` �� Cano T e I I ❑- fiegisters , Accounting; Goleenrotl -Assessor . � � . . � , . ReinsDection�Fee $15 Isue Fee $ 3 IANICAL Refrigeretion System ' ❑0-100,OOOBTU ❑100,0008TU � - '� .. . Reinspeccion Fee $15 Iswe Fee � S 3 A. P. �' PLNG. REF. qW . IEFTSIDE VAfl� ' PKG.SPACE REQ. STREET WIDTH SPECIAI CONDITIONS: Washer �oking Unit ishwasher Fan F.A.U. , Fixtures Device eoxes A I9GL III �Idi . _ I:Ja1I�J � T(. BUILDING coTonrv r�� er REAR YARD (TO P/U RIGHTSIOEYARD ' PROVIDED PAFK FEE $ Meter Llover100amps Sub Panel t , Sub Pole � � Motors �0-1 HP ❑1'f.$ 'Inc.Solar•�9-15HP �if Microwave . ' ' Pole Li9ht ; , � 'Range _ _ . _. _ . Garbage Ufsposal ' Generator OO-5 KW 05-15 KW TransFormer �15-50KW ❑5U � KW Meter ❑up to 100amps Zonin9 APProred BY � Appliption Approved By Applintion laued By Trash � � Sectians f i t SUMMARV OF FEES � �BUILDING PERMIT $; SMIP , , $ ' .PLAN CHECK; . $' � � �� PERMIT � ' � PLUMBING ' $ � ISSUANCE � � $ PIAN CHECK , $ � • GRADING . $ � ELECTRICAL $ � ' � $ � PLAN CHECK $ � ' MICROFILM $ � MECHANICAL $ � TOTAL;FEE, ', $ � � �PLAN CHECK � $� LESS � � . .ADVANCED'PC . $ . � FfNAL FEE � $ � i��`�CONSTRUCTION_ANDPLAN ING�;,� ,C'-.`��'`;-`=�:�`�c�`--��..�OL_ A,�:• :... - `�. . •- �i ' - £ '� �� ^ -._ � z�Date .Inspector - - � - - Date � Inspector' � i`.qppROVALS;� Permif# � - � =�APP.R'OVALS.; Peimit# . f;1 J i :vr:- 'T' .>� - ,• - ��r � ��7-. �Tempoiary-Electrical Service br,,P.ole I .� � � "+== � �e ;�� ' "52.'-.:Pool &�Eguipment Loca4ion , � • � ' �� ` � 2. �Soil Pipe-Undrgrnd=. _ � � `•'. : � � ' • ° y i ". � � ° � �53 Steel -Reinforcement �". �� - � , . � � ; �3. Electiical Contluit Utilitv Undrgrnd� � N�, : � � ;,� ^� ;54- Forms�I- -- . . � , - � - ;;� 4. �Elect�ical Conduit-Undigmd . � �' � ` `- � i � T3 ' � . %55�: Electrical,Bo'nding�� ' � . . ., I i � I i .a'c ��: �' I F'�: ' + .5. Steel'Reinforcement � � !" � � : � ; �: ' � ; .. = :�; �� 56,: ,RoughPiumtiing & Pressure Test - . � 6. �Electrical UFER'Grndi M1�= ' � .? r � - : �' �57' APPROVALTO COVER-GUNITE' ," _ - ' 7. IFootings � � ! : � k �� , y' = .�.' ' .�58. Electrica��Conduit-Undromrl. , . - $. �Foundation i � ; j � T o � , * � �' _ - :59. Gas'Pipe,iO`�Uridrgrnii:, Test . � ., i 9.-,Wate�Pipe�Undrgmii. � , t. � ; � ' ' ''; t; . 60. Backwash�Cines,�P-Trap,�O;Undrgrnd.� ' - . � � 10. Structural Flo`_or System '�.:� � . � �= ' .61. APPROVAL`TO DECK - 11. �Pro ert Sewer Line &IHouse'�nnection: � : ` " ' � �, P Y � � i m y_ i _ z 62. �Backwasli &��Receptor-Final� - . . 12. �Sewer CaP j ! ; �. � . n � i _ I � � � .. � � � _ . . . � : � �._ -"63. I-leatec &;Vent-F�inal 13. �AooP Drains ' � i � i t .; � , , , � .-64. Plumbing Sy:tem.> Final- - � �. -, , ' ,� 1,4.afRough:Plumbing� � � , c: � � •` - -. '��65. Electrical=Final - - ^ . ,-t ` - ' 0 ��`1'��: -Rough'Electrical=Conduit'i-'� -�.--�,,-' �- ---r--` -� "" - �;66�'Solar,System-Final � �- � � , r_ ` • ._ � . , , .. �.16. �Rough�Electric,Wiring, � ; �, i aY �'�- ��Y--: � ��_ , '67 � Fencing & Access Approval � � �� o i a. a � n' _ I n. ' _ �' �� 17. �RoughlWiririg�$ign� �� 6 �" I � � F j ,�'`. � f': G j x �. �; :681 APPROVED FOR PLASTERING � '� _" ' 78. �Rough-Electrical;T�Bar� Cei�ing�� f �; �-� � � �� i ', j � i . ;69.� POOL/SPA SYSTEMS-FINAL � � . � � . � n' � I 19:��Rough.Heating &�Air�Conditioning �� ' � �- � � I �_ i ' } � ;FIRE DEPT.!REQUIREMENT � - � � ; � 20.4Rough;Factory Fireplace 1 � �i �', '� '_ � � ! � AppROVALS� ! Peimit,# � : , m I� ' i �' i � � i � r � � � _ , ,� . � . . ., i 21. D'uctsiin St_ructure� � � I �� ' � � � j70. UndeFgrountl Hydro ` ' s � ----y � � � , � � ., , � � 1 � � c�i22.;Ducts, �Ventila'ting ". '^ ��, u� (� ! i t � � � �71.' Product Piping O Gas OOiI � - �F23. �Gas:Pipe-Rough & Test 4 ' i .�� I � � � � � �72 Underground Flush . . �'-24. ��Roof Framingi ( � i �' � �'� � � � 7 " j �'2 � � f '_ � � Z3.' Undergrnd. Storage Tank�O Gas ❑ Oil ' � r , � i u'y : _•- � . ' f : i _ 'd �. . � , I - � . Y � . � � 25. �Roof Sheathing � j � ,�� } , I �' � . � - � S I = � ? � f74 ; Overhead Hydro � � � � '-- ..-. .,. � u ��u 'iz:'-1_ _� � .,. . i S i-26. ,'T-�Bar Ceiling ��Structural�, & Monocoat' � � - . :: � - � � �z i � �75.� Dry Chemical � - . , i- � :�,27. �Frame and �Flashing: - . ` ' � �� l • � " � i . t � 76.� Dry Standpipe ; - ° �' 28..�Lathing &�Siding' �' ; � i �� Ii � `( i �; � � ��77 � F�IXED SY$TEM�FINAL , � � W c 29. �Insulation �` _ i�', "' ^. I I , � � I i � � � � (78� FIRE PREV. FINAL � ' i � '30. Drywall Nailing ! �' ' � ! �� ;, � � , i � i •Notes:! � ' �- , � ri � i � c ' � • r--, � �r�-- -'_ ' � , - . . � �� -. . - - �- � � - ':31. �Plaster Brown Coat � � � �� G ��---� � � , � , . . ^ y�'32. �Electrical�Power MeterFin�al ( �� !; � � � j , I � ' � � � , ' �� , � • . ' � i I 1 - 33.�FinalElectric � • ; � ��_ � � � � ; � � � ' . ; � ; '- 34. Final f�ieating�&�Air Conditioning p � � � ; � .�� i+i �, r.i ' I - �i - - 35. Final Gas�Pipe=�Te'st; �- �.n I �;I =� ',� ' `� �� 1,='i � `�' � I�w i� I�, � • i '�, �� • . . . . . . �- r N L�� m �_ . 36.Hood�or�CanoPY'��'�i�'�n �' I'��'"�� `�-i�, �.��-. . . � .,.. . .:- � n 37. Final Factory' Fireplace� � - � ol �I � ` i;� � "c ( � I � � ' • i �c �� ` ' 38. Final Plu�mbing I i � � I �� - ' ' ' 38. Water Se�;vice-Final� � � I "�� : � ' � � � -" , , i � ,t 40. Gas Service-Final � � � ' ` � � ' � ! ' � � � � � � � . i 41. Solar pomesticFinal � ' � ' � � ! ' � ' ' � � I � L - -� �� ?' -. ' - - +_. .: ; : i . � . ,- • 42. Backflow Preve �ter� � I � + � ?ir., �-�.- - � -� .t �- -_� -� ' - - r . . . ' : . 'v uR� -� -' .: i i � ,:�A �.: �; i � � ~ ; � -.- i 1 r � i , i . � - � . , 43. Backflow� IrrigaNion' r � i,�: � - ' - ''. � � ,. r . , ,N , � ,"i .��i �.1 n . � i ��;=�: � , .� . 44. Landscape Irngation;System � i- �i' - � ; � = a � � ' �,I �; ; � � � � . � - r i.. I � ��., �z i 6. ._i,.i1;� i �- ' ' i . . . � - . 45. Sound �Attenuation . � , , ' ' � �.- �� I`:.�n-� �� ' � I � � - • ' 46. Handica`p Regulatio`ns � i ., I � ti i� i ' ,: ' "'I , � ' � i ; ' , `� ' : � . ' 47.�FINALSTRUCTURE&BUILDING� � � ��. i � ' I � � ' � r � i i ; I, . 48. Special RequirementsCompleted ; I I f �" i';� i i � , 49. Electric Releasejto Edison� I i � �,_f__I _�_� _ _�� _.�_ _ . '_ _ �- . � , � i i� !: i r � -� , . � 50. Gas Release to Soufhem Celifornia Ga�s Co � � � i ' � � � . . � � ' � ; . i 51. CERTIPICATE OF OGCUPANCY � � . _._ ��- �, _I __ �. < < ' ' _ --- � � � No. I' �� ( i ' Date � . , ' ' �i- - . � � - , u.. --..,�.... - 1_ _ .� � �_ i _ i.. ' ► �, �� .SOLr�I, F�:�1S1�11.iT'( itti;.�^ �ONAc p i/ �QAI� an�:�:s � 9 � F i� �-C�u�Z CZ^_`: G �' S%%1 /`'1 E s A ZI? C�D2 �C!1 PGO:f� G� �� ` /� �� (.i+L'�) ! { L� ._ .. � 1744 W. I<A'(ELLA Ui:l I 1 S�j' j,( j� �f �� ORANGE, CA 926E7 V V iJ fI �;.L•hrvr � f�� ,� ...-., II;T� 3�3v ��3 :�SA? iG' BUSL'i::�3 ?�Cii3 S �' � /Cv j / T�s c_ cc:��or. c- 3 0 - orrrr"s � � aD�s 3 s:c�ac� ��.� s_y: �� c-q � cora,�^c�s � s,.,�Sr�F. yxa� S_GPA^v:i �-.:�5 �:C��=� C^ A K A C� F 3OOc^ TZ?�' .S N d L/� GOT �.�T_ :3 �.u�c{ 5�.�: ��C? C`A �. aCO? CC:�LL=Zc� OI� E^" 'i?:^? ,,....i .--•..�._i� � A 2 � L � =COt' SI.C?� !�° . .,: • m� ..,.�_ _... _ ..._ �cT �r_�., �,:,:. �;:c� _y__;_�� s _ . c��i�� : �:.� �o �isi. ^o �.� �=�;� � � � � �ac:� (:*�T Jli.'L_tiC:.� /vo ?�� =.u^' T..:..��:T= r S O. F l, i1iR'IC i.�.^,JJ �` - � /y, �L! sr�, C�:rC�� SL;� Iv /R -- ae_sz�� _o ;�� s--� /v/� ;�ae� c� =a•r�� 6 q s �o c.-r Gs T�c �:�-, Mcvr �or ��rc�z NF�+Tc -rc e:Ae�cF . (�/CLG[.! pi.�i/L 7j ��,c� �� C'✓�L � .t-,.�"� ",`.t�.�.O x,�'� �a_ ef .�° ��9��.�5�,� r ' , � � � G��Y Of �� ,�w�:-�. ;�E�1 =�"��A Building Deparf:nent 1 ��J---�---�-. Dai � ' Permit �` GE 7 �3S - ,THIS NUMBER MUST ACCOMPANY � ALLINSPECTION REQUESTS � s�,_,,,e 5s�;zac,� wn�rs.2. r�rq,-�,�- �� 7N �[.ACr' � I1 �� -� i-- G/i2QiuG � S o, ��-�T�.S � x� 27"0� I � ' S1a..�. N o. ! 'SU�_ 3'x8' Collectors IA4M0 # 5� z � � � # , OLIN II 3'x8' Collectors IAPMO N 5-2131 } INDEPENDENT ENERGY C-30 CONTROL U.L. A MH-11153 (M) GRUNDFOS PUMP U.L. # Z-58326 RHEEM SOLAR STORAGE TANK IAPMO W 5-5782 BRADFORD- ' WHITE SOLAR S70RAGE TANK U.L. k hBi-11701 � � T �� I I �# �r 0 i� T � � I D�`t�'/NC - I ,�-��r- ; y �. �R�T�- ' -2 "��",e�waon _ ...- � � � � n��'�(�J yi{°�AGtJ. -�-�" �� `� 3/8".�(� "-Lti6 /��PE-�°i�.c.E Joi:. r r�,� �::..�:: �� n: �:�,�R JOISC SIZE:_X_ . �pF '!1'PE: 5l4,.�_ TIIL_ Q^l•1P._ CII'1tER T3X�I' PI'I`UI: __ ---- -- --- a - - � 3'� � • X� � gd�r a ��__. -� ". ��.. � � _. c� �:,..,_. .. .�:•. _ ii _ r. t� ` OC:'_'. ' �D2.�'3: I :J�:: - �^y.T:�.J.� __ Sys�e:� for: . Desi�,n=� by: �::�:` � ,:. MAIN OFF(CE Ifi35 WEST GRYLORD ST.. - P.O. BOX 9089 LONG BERCH 10, CALIFOFNIF HEMLOCK 5-�993 SPRUCE 5�2081 F ' �w�rininer -�Laboratories Examinafion No. � Project Sample from Architect . Contractor Mix \'Vater, gal./sk, cement >6iam�cx S [ Z E Date casf Date tcsted BRANCN OFFlC£S B9] 5/�NTIAGO ST.� SANTA ANA � KIMBEFLV ��6890 � 9]813 N. fiTH 6T. EAST - P.O. BOX p]B PALMDAIE - WI NDSOR D3911 ot �out�Ze2n �a�l f o¢nfa, �nc. Aug�st 3, 1960 "GUNITE" REPORT OF ��3 TEST CYLINDER C6o,2586 For - Anthony Pools, tnc. - 5871 E. Firestone Blvd. South Gate, Californla Cylinder Na. COMPRESSION TEST Total load to destruction, lbs. Pounds per square inch Cylindcr made by Cylinder delivered by Cylinder received by SWIM POOL - Weston Residence �l97 E. 16th PI., Costa Mesa, Callf. Gunite 5 3/�-t" x 12" 7-6-60 7-13-bo � 7 days 63,000 2,429 Van Arnam 7-7-bo 8-3 -60 2 28 days 69.500 2.6']8 � AU� Z � 196p Bui�n��PL�a, j "Hold�r cc: Ahthony Pools TVVINING LABORATORIES OF SOUTHERN CALIFORNIA, INC. � �Neston Residence � /� ��/1 Costa Mesa B1dg.Dept. /�'+�•�� `iy�'w�`•� . SA Lab ALL PEPORTS ARE SVBMITTED AS "HE CONFIDENTIqL PpOPERTY OF CLIENTS, AVTHORIZATION FOR PU9LICATION OF OUR NEPORT9. CONClV51pNS. OR EX- TRwCTS FNOM OR REGAR�ING THEM IS RESERVEO PEN�ING OVR WpITTEN hPPROV�L AS A MUTUAL PflOTECTl01� TO CLIfNTS.THE PUBLIC ANO OU0.3ELVES. � ,. � ,.,� � 9��`�0 '�' I�� ,��- u�'i� isU COSTA MESA BUILDING-SAFETY DEPARTMENT fINANCE DEPT. ` P.O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA FOR APP[/CANT TO F/LL /N COMPIETECY APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING ��i // ��d/�� A�DRE55 / l0 N+"� COSTA MESA, CALIFORNIA FOR OFF/CE USE ON[Y �J�—•iS NE 2 I RECEIPT NO. I P (MI^ NOa OWNER � J MAIL ��/ /-n../ OCN �O� A�,E,��EO BY DATE HECEIVED O�E I85UED ADORESS ��! ��^' '� I�' -- C I r n TEL. BU�LDING � cirrlo��a 47£L HR�Z No.��`f� pD4JRE55 ARCHITECT T T i/QY.r- No. 8.37 �/ COSTA MESA. CALIFORNIA / OR �"91NEER •I-' LT f'� ��(. ADL...._dS 2`l I� C Q�ST U/ `= � FIRE : // ZONE � .a L CONTRAGTOR �W /�.� �{2 LIC. NO. ByPROVED ��r/ DATE `��S S/ ., r . nooRess S/frsE ZONING LEGAL I LOT /S I I�J� ZONE� I NO. OF I USE OF NEW OESCRIPTION NO. BLOCK TRACT PLAN9 BUILDING A.P. NO. / / � � � � � � � BYPftOVED DATE � d t SIZE �� x�Q NO.OF BLDGS. ypRDS EVES OF LOT nOw ON �oi NO REOUIRED ALLOWED USE OF ��.� (CENTEN LINE ST. J EXISTING BIDG. � FRONT L �'� IN. se're�cK urve vno�n SD REAR YARD /I �� CENTEH OF STREET R.SIDE S FT. IN. SIOE VARD I LEFT / Q I RIGHT S �. SIOE /✓ Ff� IN. DESCRIPTION OF WORK � }� REAR FT. IN. NEW I'\IIALTERATIONI IIADDITION I � e � REPw... I I MOVING I DEMOLISFI I �y,A.,�/ r9� y'j �� 5=E DING I�/ f i ROOMS S STORIES / • -r.c J EXTERIOR WALL I ROOF SN%II�� COVERING �� COVERING USE OF BUI�D�G A/ND WORK TO BE PER��CH�D L L-r . . ��J 2R ,L--� 1 NEflEBY ACNNOWLEOGE THAT I E E THI6 APPLICATION ANO 6TATE TH/�T THE ABOVE IS OHF A O AGFEE TO COM- THE AMOUNT BHOWN UNDER VALUATION IS FOp THE PLY WITH ALL O 6T LAWS FEGULATING PURPOSE OF ESTABLI6HING A PERMIT FEE ONLY. BUIIDING corv iF CilO . VALUATION SIGNATURE OF / �' /7 � `PERMIT FEE $ 3'�, � PEftMITTEE g /) � C� � PLAN CHECK $ /'. � / J AUTHORIZEO AGENT .;z '� � TOTAL FEE $ � owrr�.s FISHER, WsE. JOB ADDRESS �97 16th Place -�r — GENERAL CONTRACTOR �er-gui3der F i�-9 LOT TRACT INnr'ECTIONS i I.✓ I DATE DATE 6'15-59 VALUE $ 1Lt,ZZ%.00 FIRE ZONE DESCRIPTION OF WORK R OUP I TYPE V ZOL SU6CONTRACTOR I PERMIT515� iJ� Form 210-3M-4-59 9 OWNER WESPON� JOB ADDRFSS _l GENERAL CONTRACTOR AP. No. � ��(�1 -q LOT INSPECTIONS T� �reround Soil FY/N U.G. P OCCUPANCY Farm 21�SM-11-59 5-B P DATE VALUE FIftE ZONE DESCRIPTION GROUP TYPE SUBCONTRACTOR I ___ � �., ' 12416 � . . C�STA MESA 6UILDING-SAFETY DEPARTMENT P. O. BOX 919 COBTA MEBA. CALIFORNIA For�Applieanf fio Fill In Complefely TYPE OR PRINT BUII�ING /� �i' // %� ADDRE66 / r� COSTA MESh CALIFORNIA OWNER�� Ed7O�✓ I STCTNo�'//i 7 USE OF EXISTING BLDG,_ HETBACK LtN6 FROM �� ,�� ,g„� ,�UN 221960 fINAI�CE DEPT. APPLICA�,{�p� {iQ6(',(Q$ib�ABfE$A BUILDING For Offiee Use Only RECEIPT NO, VlRMIT NO. RECE�VEO �Y DAi£ RECEIVED OATB 185UED ,�� 6 aa �-6 0 � BUILDING � ADORESS COSTA MESA. CALIFORNIA � APPROVED TEL.� d��Z J D I �vo�� NO. , I NO. OR BLD08. DESCRIPTION OF WORK EXTERIOR WALL COVERING USE OF QI{ILDIN I� HfiREBY ACKNOWL8pG8 TXAT ; HAVE ReAD THIB APPLIGTION AND BTATE THAT THB ABOV! IB COPRCGT AND AGREB TO COM- PLY WITH 11LL QTY ORGINANCEe ANO BTATE ' WB qlOUTATINO BUILDINa CON9TRUf.Tf�N. ccervrers ZONING NO. OP U8E OP NE�`v..1 PLANB � BUILOINO lr . . , rilN�. l/�- 36/ - � eti� �.�-- � � 7 TXE AMOUNT 9HOWN UNOfiR VALUATION �8 POH TH¢ PURPOBE OF EBTABLI8NIN0 A PEflMIT F6! ONLY. gasoo, °-0 AGENT �y ��'�'�y , ' TOTAL FEE $ lS N e Z . a U ZZ Q Q N am J � J � O] J J m Q U N Z¢ W aw wz J p m Z J � W W O= Z F- w � N � � � '-i PA1l Ih's; —3-7?cr: 4i� n�n ;,:..;.; � "f COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BV � DATE RECEIVED DATE ISS BUILDING /J /% {�/�Gu � '3.� / 7 ,_� AODRE55 7 (1 ��L V � / / PER OWNER ONF} @ Vr CI� Ol A.P.N — MAIL ' BUIL�ING ADORESS (�� ,�` a. V�' ADDFES C.Q_� CITV ^�� f`�� NOL6•y�� TRACT � LOT BLOCK �0.� CANSTFUC710N W ADD A TE P �ENDEF I✓!?�/ BRANCH OWNER - \ ADDRESS � VAL ARCHITECT TEL. SE .I�'�� U' OR ENGINEER N . FIRE A�ORESS ZONE TYPE FOUP CONTRACTOR O � ByPROVED �� DATE ` WNEs •-B�u�A �P ADDRESS TEL. ZON NO.OF USE OF CITV NO. PLANS BUILDIN STATE CITY �'ARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM GL ST.H6ET) OF lOT NOW ON LOT FRONT PT FT. USE OF � EXISTING HLDG. S FT FT. SIZE OF NO. OF NEWB�DG. �fi00MS $TORIES I.SIDE FT. FT. /.- EXTERIOR WAIL ROOF COVERING COVERING REAR FT. FT. US�OF BUILDING AND WORK TO BE PE/RFOflMED � �� DISTANGE BET. BET. MAIN & �V G PJ � I��O �� S Y MAIN BLDGS. ACCESS. BLIXoS. VAR. # DATE C.V.P.# APPROVED APPROVED 1 hereby acknowletlge that I have reatl this application antl state that ffie above information is wrrect and agree to comply with all laws regulating bui�tling consvuciion, antl I shell not employ any person in violation of the workman's compensation laws of ffie State ot Calitomia, m � I hereby certity ffiet I em properly licensetl as a wntractor undet SQ. FT, o the State of Calitornia Business antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOF � Chapter 9, antl ffiat such licenses ere in tull force and effect, or I THE PURP�E OF ESTABLISHING A PERMIT FEE ONLV: ¢ am eaempx from the p�ovisions of the Stare of Celifomia Business antl Professions Code, bivision 3, Chapter 9. VALUATION ` �"" m PERMIT FEE 5 � � Signamta ot m Permittee �12 � ` $ Cj�� PLAN CHECK $ E /{ o Auihorizetl Agent �� LL TOTAL FEE $