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HomeMy WebLinkAbout302 16TH ST - Building PermitsCITY OF COSTA MLSA CALIFORNIA 92628-1200 P.O. BOX 1200 DEVELOPMENT SERVICES DEPARTMENT September 16, 1991 To: Building Safety Division Code Enforcement Communications Copley -Colony of Costa Mesa County Administration Office County Clerk/Bd. of Supervisors County Registrar of Voters County Tax Assessor Engineering Division (2) Fire Admin. -Training Officer Fire Prevention File (2) Newport -Mesa Un. School Dst. (2) Pacific Bell Police Dept. - Ping. & Research Santa Ana Heights Water Ccmpany Sanitary District Engineer Southern California Edison Co. Southern California Gas Co. State Board of Equalization Street Division U.S. Post Office - AIS U.S. Post Office, Adams Avenue Mesa Consolidated Water Dist. The City of Costa Mesa wishes to advise you that the following addresses have been changed or added: OLD ADDRESS 302 E. 16th Street NEW ADDRESS 302 E. 16th St. "A" 302 E. 16th St. "B" 302 E. 16th St. IIC11 302 E. 16th St. 11D" 302 E. 16th St. "EI' 302 E. 16th St. "F" 302 E. 16th St. 11G" 302 E. 16th St. "H11 Your cooperation in this matter is appreciated. Sincerely, RICHARD WELMERS Planning Intern (302E16TH.ADD)I I cc: Lloyd Miles Development 423 Poppy Avenue Corona del Mar, CA 92626 A. P. NO. 425-211-01 77 FAIR DRIVE Building Division (714) 754-5626 Code Enforcement/Business License (714) 754-5234 • Planning Division (714) 754-5245 FAX (714) 556-7508 a a 0 \N 302 E. 16th STREET f FINAL GRAI)ING CERTIFICATION Project Address: '3D Z- E - 6?� S�2eT I.ot Number: _�-21aeT tiO, 14433 Permit Number: By Civil Engineer: I certify to the satisfactory completion of grading in accordance with the approved. plans, specifications, local and state codes. All drainage devices required by;"tfie grading permit, grading plan and grading ordinance have been installed. Adequate provisions have been made for drainage of surface water from each building site. The minimums arc: 2% Fall from structures within 5 feet from exterior walls. 1% Fall for asphalt surfaces and landscaped areas. 0.5% Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded tract map were set. All final grading eleva- tions are within ± fli0 of the designed elevations, Supervising Civil En`ince Lae Reg. No. 246(- (. ignaurzc) Date June ZG M41)t- 16911C :TAMP and SIGN )gmigommilionIr .G' 9N1 Fonts it slim GIA FOPM 1486 INSULATION CERTIFICATION This it to ceetify flint, in conformance with the torrent anergy, regltlatioltt (California Administrative Code, Title 25, State of CPliforhia*) and approvocl plant, Insulation flat been installed In the building located nt: COSTA MESA City 302 E 16th ST______ [ .;t Nn. 111 Aralehlwl $Uwa retll7'f S Type of Material EXI'Mon WALLS Trpeolmewlel r1BRRGLASS CEILINGS TIMM Type of Malarial By -----ORAR F County Lot Nu ... bar lnet IJo. DESCRIPTION OF INSTALLATION Manufacturer Thickness R Value" Manufacturer HANVILLE Thlcknett 3z 11 value" 11 10, Tnd. Namw) PIBI'ROLASS Manufacturer MANVILLE_— Thlcknett 61 IT Value" 19___ Sq. FL Covered ('California Adml "Corp"dent#, UPC C-Ilfying 11,61 11•a ""O.unease of I Ne Imalanon app card (hell be pol 1"n Verne 11 en maMura of iho r.dltanto of a maleial ar bulldhy ir,,pon.nl to the nan.ge of heat. Th. r.s;oonce. Volvo tnl of moebtyne hm, alinnl their not Incl orle any Volvo for rrfl Kllve fecina.) FOAM III Farm 1186 - Ai,t. (or Trade Nern.)M.M. INSULATION CO. 4260 2nd Avenue LOS ANGELES, CALIFORNIA 90008 Phone 291-4167 LIC. 0423V19riteNumber 423670C-2 ISuu "R ItME" 1111 nm� nr Own.nl Cm v.ct or — p— G� — title Nntulalioa AD91Ica1m) vff Ete.l � envoy Inw16110n 9und.rde, decla..a of lbo InttallNlon of Insulation. a cud he.n Imulled In conlorm.nce with the t $hall bf completed and e.eculed by OR builder. Thla Irtrotatlon camptranee dcuove location within the dwal l ung . -I exCEnnT from Sec. i99IS of the Neanh and Solely Code of the State of California "No certificate of occupancy or dmllb Certification that a newlyy too. $Nutted hotel, motel, a0mtmont Imu$e, home Or olhbt relidential dwOunq II heblteble doll he owed by tush a building department urdes, the $Nuclute at lead tolidiet the minimum energy inntiallon st.nderd$.$toblirhed pursuant to thle chapter." —PUBLISHED By M AvYl;rgA4Ae?A, 5055OVEBLANOAVENUE. LOS ANGELES. CALIFOhNIAOMM—(M)1IM0111 a1/17 ICI BUILOINO INOUSTOY ASSOCIATION OF SOUTIIEBN CALIFORNIA. INC., 1511 8avhty bird., Lot Anialet, Calll. 90018- (113) 6755711 PROJECT ADDRESS: 302 E 16TH ST UNIT: OWNERS NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR,CA 92625 714)723-5300 "i ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. gITY LIC.: STATE LIC.: CLASS: e: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a candidate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab, Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Cannot copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need hot be completed if the permit is for one hundred (5100) or less). I certify that in the performance of the work for which this permit is issued. 1 shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If. alter making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Cordialness State License Law for the foltowing reason (Section 7031.5 Business and Professional Code: Any city at county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she Is licensed wrsuant to the provisions of the Contractors State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business ,no Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by !any applicant kir a permit subjects the applaud to a civil penalty of not more than live hundred dollars (S5DO). I, as owner of the property or my empployees with wages as their sole compensation. will do the work, and the ❑ structure is not intended or offered for sale(5ection 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered Ion Sale. 11, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ors' S P� and Professions Code: The Contracttate License Law does not apply to an owner of proper% who builds or improves thereon and who contracts for such projects with a dentractor(s) license pursuant to the Contractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ f exempt under Section: B. 8 forr this reason: Date: — -- fir rGyaner: �!i I I do hereby certify that I am aware of and understand the requirements of California Health and Safety a Sections 25501"25533. and` 25534 and that I or any IUWm building occupant willAvill not (circle ane) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Dually Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have read Ihis poplica - n antl state that the above information is correct. I agree to comply with all ordinances and stale laws relating to build) conalruClion and here�ut rite rep r enlalives hiply to enter nthe2 property for inspection purposesO n . �l Or Date. --:2- .^ / Signature: Driver's License or Social Security .: ��•<^+-46 While—Building: Green—Code Enlorcemem: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor C CITY OF COSTA MESA — BUILDING PERMIT PERM NO: BP 05113 PERMIT NO: BP 051135 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLU STR PURPOSE: DEM JOB DESCRIPTION ; DEMO RESIDENCE SQ FT: CLAIM VALUE: 1,000.00 CALL—VALUE: 1,000.00 GROUP OCC: R-3 / COMMENTS: X 4F iF iF iF TF BP iF iF 9F iF iE Bt iF IE iE iF * Xt * * iF BF ii * iF * * iF BF 9f iE * iF SP * iF 9FRP iF 9P iF 4P 9F * * 9F iF 9F iF iF iE iF iF XF * IF * iE * XF * if iE SF IFiF iE IE 4F iF iF iF IF IF iE it aP iE iF Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > 9F iF iE BF 1F BE 9F SF Xi iE iF iE iF iE k * iE ie iF iF ie iF Bf XF DF iF iF iF iF IF it * iF iE iF iF ie iF iF RF iF * iF iF lP iF * iF r aE * Nf Tt 9F * iF iF iFiF aF iB iE 4F * IF * iE 4t * iE aF * iF LE'iB iF iF iE k D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: Z"L If iE iF IF TF IE ♦E iE*iF *IFif it lF 3FiF**!F*iE 4F if *9FiF 9FiFiE iF iE iF* M iF iE iF BP 9F * * iF iF XF iF XF iE * SF iF iF * iF XF iF IE iF iE iE SE * iF %iF iE iF IF 9F iF �F SF XF iF iF iF iF iF iE iF iF * IF iE iF9E 7t IF iF IF iE9E iF * * iF XE iF iF 1E iF iP * K iF if IF 1E iE iF 9F IE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 25,00 2,25% SMIP/NON—RES ISSUE FEE 3.00 .50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 27.50 3.00 0.00 30.50 30.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 25.00 5.00 .50 3E IF iF if iF iH SE XF iE iF 4F iF iE iF * IF * iE 9F * iF iE iE iF iF iF K• * it iF 9r iF 9f kiE iF RF it iF 4F iF iH * 1t iP+E * * BE 9E it * iF iE iF iF kF * iF 9e iF iF 4E 9E k aF * * * * ie it iF iF * If iE 9F iH I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 SEWER CAP / DEMOLITION EACH 2,00 2.00 END OF FEES 01 00081219-00081221 _j 10.E DATE: 02/22/91 TIME: 15:01 P�{1CFS>7N AND PLS, .NG - POOL & SPA APPR 'ALS Permit Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd." 53. Steel Reinforcement 3: Electrical Conduit 4tility-Undrgrnd. 54. Forms A.'Electrical Conduit-Undrgrnd. - r 55. Electrical Bonding Steel Reinforcement, 56. Rough Plumbing & Pressure Test -_ 6. Electrical UFER�Grnd. 57. APPROVAL TO COVE R-GUNITE .7.,Footi6gs 58. Electrical Conduit-Undrgrnd. " 8. Fdundation n 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. f0. Structural Floor System 61. APPROVAL TO DECK { 1. Property Sewer. Line & House Connection 62. Backwash & Receptdr-Final 12. Sewer Cap _ = 63. Heater & Vent -Final ' 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 16. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT ,APPROVALS:"- Permit # -' 20.E Rough Factory Fireplace - _ - 170. 21. Ducts, in Strycture• .. _ S - Underground Hydro 22. Ducts, Ventilating CS _ _ '_ :71. Product!Piping 3Gas 000 23`. Gas Pipe -Rough & Test _ - ' ` 72, Underground Flush n, ,? „ 24.;:Ro6f Framing - - •"- 7 x - 73! Undergrnd.Storage,TankPGas ❑Oil - 25. Roof Sheathing "7q� Overhead Hydro- '- 26 T -Bar Ceiling (Structural) &,Monocoat •MV ! 757 Dry Chemical - 27. Frame and Flashingru a 76. Dry Standpipe ; 28. Lathing.& Siding 77.E FIXED SYSTEM FINAL' >'29. Insulation :7- 76:*, FIRE PREV. FINAL a- ,,30. Drywa 11, Nailing - •� �• HEALTH DEPT. REQUIREMENT -31. Plaster Brown Coat I 4 , 79. FINAL` INS,ECTION ` 32.- Electrical Power Meter -Final ti r :80.. -FOOD CERTIFICATE ISSUED _ Electric r- l Notes: 1_33.rFinal , .� .'34." -Final Heating.& AirConditidnipg- 35. Ficial Gas Pipe -Test - 36. Hood or Canopy ;; - --„• • . •=o 37:=Final Factory Fireplace _. ' „ , v> -38. Final Plumbing .3 e r r X39. Water Service -Final - •- •-" �• 40. Gas Service -Final .. ;'41. Solar Domestic.Finals - �• �• �'� '42�Backflow Preventer 43. Backflow Irrigation =• r r,=;. r _ .. 44. Landscape Irrigation Systertj ,�u' r - - C V• S r ru r ., 07 - 545 -Sound Attenuation %- •.� P `i - -�� i• i, '46:; Handicap Regulations 47.sFINAL STRUCTURE & BUILDING i; J `748:­FINALPLANNING� �� +{•� - • r. r Z c49.=Eleciric Release to -Edison �- - ii' i ! -50. Gas Release to Southern California Gas Co x _- '51. CERTIFICATE OF, OCCUPANCY No. Date PRDJECT ADDRESS: 3021 E 16TH ST UNIT: OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR,CA 92625 714)723-5300 ARCHIENGINEER: DUCA—MCCOY REG.NO.: C296S ADDRESS: 3840 COAST HWY N CORONA DEL MAR CA 92625 PERMITTEE: LLOYD, MYLES DEVELOPMENT ('714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9 (commencing unto Section 7000) of Dwisum 3 of the Business and Professions Code, and my license 6 in lull force and effect. CITY LIC.: STATE LIC.: CLASS: `Ute: Signature: ,MINERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to sell theme or a certificate of Workers' eompensahon Insurance. ar a eehutied copy Iherind (Section 3811. Lab. C, . POLICY NO.: EXP. DATE: COMPANY: 1-1Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Divivon. Date: Applicant: EXEMPTION FROM WOIXEIS' COMPENSATION DECLARATION: Itis section need rot be Compleled it the pernt is tin We hundred (SAAB or less). I certity that in the performance of the work for which this permit is Issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Lam al California. Date: Signature: NOTICE: It, after making this declaration, you should became subject Io IN Workers' Compensation provisions of the Labor Code. you must fonlmitn comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work tot which this permit is issued (Section 3097. Cry. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby alirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cade: Any city of County which requires a permit to Construct, alter, improve, demolish, or repair any structure. prior to its issuance, also records the applicant lot such behalf to file a signed statement that helshe is licensed ursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing worn Section 7000) of Division 3 of the Business = V CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 051175 CONSTRUCTION TYPE: PLAN CHECK NO: N PERMIT TYPE: ELE JOB DESCRIPTION TEMPORARY POWER POLE CLAIM VALUE: CALC—VALUE: PERM NO: E 05117 GOVT: N SUPP: N PURPOSE: NEW SQ FT: GROUP OCC: R-3 / COMMENTS: X #*+r�FxereL�r+t�6�6*���Fr+r*x�r*ytaP+P+6TFaE*v+FTraE+L*T6�Ei6��6+r+F+r�F�FTFx��6�T6Tr*+tr�y6��F+rTrr.+L*�6T�aF*�6�E+t*I6�F�FaFe6+<R.ar�L Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE&(� PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> ,00 > REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: 00 kkMiF lFk keF*iE k�F k kE iE iF kiF aE ik iF aF lEk MaE iF if iF iE aF BE 1F aE y6 iF iF iFiE klf aF iE#F IF 9F IE 9F 1F 1E*****rtaf*iFiF at lE aF iE lF ii iF iE *aF iE 9F#aFP*Y.9Faf D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: it DATE: iF iF if 9f ie rF * aE ee ♦E * lF k iF JE iF lE aE if iE IE MiF iF�Fif�FiFiFif7f±F7F3f7FiFiEI,Fi ith if'�FiF{F?F3F7F7f3f ii•if lF if yriE lE.... iF aE 1E k* * 1E iF iE ae iE iF M aE iF fE iF at 9E y6* Ile aF iE kF aE aF 1F if iF iF fE * aF fE iF * aF 1E iF iF at iF its �F tt 9E iE 3F ♦E * * iF 9F its * aF iF * aF aF 9F 3F iE iF 7E 1E 9F * iF aF 1E 4F 9f r * iF iF ar. of LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15,00 502 SMIP/NON—RES ova Professions Code) ar that he/she is exempt therefrom and the basis lot the alleged exemption. Any violation of Section 7031.5 by n I. aowner o t e propey, am say with protect PLAN l applicant rot a permit subjects the applicant to a civil penalty of wt more than five hundred dollars (65001. ISSUE FEE 15.00 1. as owner of the property or my employees In wages W thea sole compensation, will do the work, and the ❑ The Contractors' State License Law BUILDING—DIV—> TOTALS ---- > PERMIT 15,00 ISSUE 15,00 PLAN—CHECK 0,00 TOTAL PAID 30,00 30.00 DUE structure is not intended or offered for sale l5ection7044.BusinessandProfessionalCode: does not apply to an owner of a property he builds or improves thereon, and who does such work himselflhersell or through ,00 his or her own employees, provided that such improvements are not intended or offered for sale. IL however the building or improvement is sold within one year of completion, the owner will have the burden of moving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I haI I t tin licensed contractors to construct the Section 7044 Business 30.00 n reye ue y soat g D I W and Professions Code: The Contractors' State License Law does not apply to an vomer of groperry who builds or improves thereon and who Contracts lot were, projects with a contrador(s) license pursuant to the Contractors' Btate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. f�anaware 6 /'`///%� _ `/l/� Date: Owner: f/- /SST, ,4,l.q_ez tlo herederstand me requirements of Califorr.a H/411 and Safep/Co_de _Sections 255/05, 25533, and 25534 and that I or any future building occupant wil0wi0 not (circle ane) need to comply won said state woes and the requirements for a permit lot construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and ordinances and state lam relating to building instruction and here amhzaIdJrepresentatwn of 6 city to en r upon the above me property or inspection burp es. afi -VC Signature:�l�� ` Driver's License or Social Security rt: 1641-46 White—Building; Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor iF aF 7f aF aF k 9E * eF iE iF N- aF iE * aE +F aE aF ill ♦t 1E aE M aE aE k * k rt IE if iF * at iE rt iE aE a6 3E kF * iE aF lE * iE iF a6 iF NiF aF # #'� 9f iF )F iF aF iF iF if kF iF iE aF iF �lE a6 aP+F iE 9F iF 9F iF Xt I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 TEMP SERV PWR POLE W/OUTLETS EA, 15,00 15.00 END OF FEES DF:TE: 0_t 7; '.i,4 ,I::ic CONSTRUCTION AND PLANiv„aG APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •. ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical -Conduit -Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical UFEA Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings 17 58. Electrical Conduit-Undrgrnd. 8. Foundation- 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final ' 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains - 64. Plumbing System - Final r 14. Rough Plumbing 65. Electrical -Final ' j 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. fencing &Access Approval = 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL''' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS' ' .Permit # _ - 20. Rough Factory Fireplace 21. Dulls, in-Structura _ 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0Gas ❑Oil t.'Gas Pipe -Rough & Test ' 72. Underground Flush' Roof.Framing - 73. 'Undergrnd. Storage Tank ❑Gas ❑Oil .j. Roof Sheathing 74. -Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing �., 76. Dry Standpipe 28. Lathing & Siding .'r_ _ - - 77.. FIXED SYSTEM. FINAL 29. Insulation - 7B.: FIRE PREY. FINAL 30. Drywall.Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat: 79. FINAL INSPECTION ' 32. Electrical. Power Meter -Final 80. -FOOD CERTIFICATE ISSUED 33. Final Electric Notes: '34. Final Heating & Air Conditioning-, 35. Final Gas Pipe -Test . x 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - - - 39. Water Service -Final' - - 40. Gas Service -Final •41. Solar Domestic -Final •• - - ' 42. Backflow Preventer •„ 43. Backflow Irrigation 44. Landscape Irrigation System45. Sound Attenuation- - 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING. 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 30 2 E 16TH ST UNIT. I OWNER'S NAME: I LOYD MYLES DEVEtu'PEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 7213-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYI.ES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm That I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CUSS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cenificate of consent to set: insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3900. Lab. Q. '9LICY NO.: EXP. DATE: COMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed win the city Building Division. Date: Applicant: EXEMPTION FROM WORKERSCOMPENSATION DECLARATION: (this fiction need Out be completed it the permit is for one hundred 0100)or less). I certify that in the penormance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It. after making this declaration, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency tot the performance of the work for which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prat to its issuance. also requires the applicant for such permit to file a Signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500). I, as owner of the property or my employees wiIn wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Conlractor5' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselVherself or through his or her own employees. provided that such improvements are not intended of offered for Sale. If. however the building or ' improvement is Sold within one year at completion. the owner win have the burden of proving he/she did not build or improve for the purpose of Sale)_ 1• as owner of the property. am exclusively contracting win licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' $tate License Law does rot appy to an owner of property who builds m improves thereon and who contracts for such projects win a contractors) license pursuant to the Contractors' State License Law),I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. lot this reason: Date: �J I do hereby certify that I am aware of and understand the requirements at California Health and Safely Code Sections 505. 25533, and 25534 and that I or any future building Occupant wiNvnfl not (circle one) need to comply with said state coots and the requirements for a permit lot construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions Date: APpbcant: I hereby certify that l have read this application and state that the above information is correct. l agree to comply with all Cit and county ordinances and state la'4S relating to building construction and hereby authorpe representatives of this city to enter entioned property for nspeaion purposes Data. � �� �/ Signatu��,��/� Driver's License or Social Security =: 164146 Whae—Budde g. Green—Code Enforcement: Canary—Amil"On Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUI'LDING PERMIT PERM NO: E 05172[ PERMIT NO: E 051728 PLAN CHECK NO: N GOVT: N b.APP: ;I CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE PURPOSE: O'iH JOB DESCRIP'iION TEMPORARY POWER POLE SQ F1: CLAIM VALUE: CALL -VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51309 -B51316 "B" PERMITS. #NNiF N•:NN#iE )FN NNN Nth iFkN**:( K.)CM ieNti:•h`iEN IEit***ie****:s N#IF if if MiE 3!#ii>V:!r;au it 3e 1%iF+i-##1r ±E �F xF i!ir N•k+(##�: Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING-------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> N NiF iKN#if NN+:N#+( s:ifNNN#NNNiFN*Nie iEN iENiF!c irYu N3?NNiERN#NNNiE##iF i6N##N#•. NNN NiFNNik iiit NN#FiE-NY it N -i: ie xx D F. V E L O P M E N T S'E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY ; _ DATE: _ APPLICATION ISSUED BY: DATE: Nie iF is NN #k'iFiT )b irNNNNN}:NNlt# .: •t'r vc xiE4 '. .tiF'T.: .#iF ur +�Fir'-6r'i'iF?ENN Nif 1~ii•iA r -N. xr`r4'j �%faT�.N+f #NirNY. irNNNif irNNNIt a:K?F+4!A N9F a:Y.+fN#lEN#If }{E iF iF Nig N•IE +f-}Nir kf ii ':.ii if urrl(Ri'iF}N-#iF wli iF 3e+f#i:#+'Y. Nib ai.�iF �,#+E#if LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG'PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15.00 501 SMTP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 15.00 15.00 0.00 30.00 30.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TUT GRADING PLAN -CHECK 30.00 iENNNlNef irN}NN.NNN NNiEN NN#NNNNiE IkifNNif iEN NNNN-N•N}ipN•iF ii•ii#'NNN##k NNN NN if i%i:i(. Ni: is ieN#x->ii-fi#f'ae 9E ie ifN I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 15,00 15.00 END OF FEES DATE: CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector P, , & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test :. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. .10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation .. 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT, REQUIREMENT 31. Plaster Brown Coat 9. FINAL INSPECTION 32. Electrical Power Meter -Final 0. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38, Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: ' W 6TH ST UNIT: A OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to superstars or a candidate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: 'OMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need hot be completed it the permit is fume hundred ($100) or less). I certify that in the penormance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California, Date: Signature: NOTICE: H. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cade. you must forthwith Comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish. or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5110). I, as owner of the progeny or my employees with wages as their sole compensation, will do the work. and the El Structure is not intended or altered for sale (section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose at sale). I, as owner of the progeny, am exclusively contracting with licensed contractors to construct the Q and Professions ode; The Compactors State License Law does not apply to an owner of propem and who cord= lar such projects with a contracions) license pursuant to the Contractors' I that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Sec ion', B. 8 P. C���� � for ims reason'. Dale: �/ I do hereby certify that am aware of understand the repuiremen 01 California Health a S y Code S ons 25 . 25533, and 25534 and that I or , future building occupant willlwill not (circle one) need to comply wi said ate toles and the r quirements for a permit for consirucli pr modification from the AT duality Management District. Resitl Tal construction applications are exempt from these provisions. Date: I hereby certify that Ihav ordinances and state lav r maperty for inspecli pu Date: Onver's � se or Social 64146 While—BWldlm this 4. Applicant: 1 and stale that the nslruction and hotel Green—Code Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor 9 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052856 PERMIT NO: E 052856 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH SOB DESCRIPTION ; NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51309 PRIMARY BLDG, PERMIT. Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQQ• PROV: PARCEL: 42521101 ZNE: REF NO; PLANNING NOTES> > D E V E L O P M E N T S E,R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : n — ,If DATE: APPLICATION ISSUED BY: j DATE: APPLIC######ISSUE BY: #### ATE: ## LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 116,06 503 PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 116.06 15,00 0,00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 131,06 SMIP/NON—RES TOTAL PAID DUE 131,06 131,06 .00 131,06 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAN—CHECK I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1658 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT 03 58,03 END OF FEES V 0100092?79-010°2775 _L.i''; 3l•Jc. OFlTE: 0/23/Y1 Tint: 1el'15 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POS' & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7. Footings - 58. Electrical Conduit-Undrgrnd. 8. F6undation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 16. Rough Electric Wiring / ,y/as q� / ! 66. Solar System -Final 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structute F "70. Underground Hydro 22. Ducts, Ventilating . 71. Producv-Piping 0Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush - 24. Rolf Framing 73: Undergrnd. Storage Tank 0 Gas 0Oil 25. Ror;f Sheathing 74. Overhead Hydro- . 26. T -Bar Ceiling (Structural) & Monocoat 75.'Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing ' HEALfH DEPT. REQUIREMENT 31. Plaster Brown Coat 32. Electrical Power Meter -Final 33. Final Electric7g�/QZ ;3�Q Q2 ` qq Kc 79. FINAL INSPECTION 80.- FOOD CERTIFICATE ISSUED Notes: N� 34. Final Heating & Ai, Conditioning _ 35. Final Gas Pipe -Test - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing , 39. Water Service -Final 40. Gas Service -Final .. - 41. Solar Domestic•Final-. 42. Backflow Preventer ._ 43. Backflow Irrigation 144. Landscape Irrigation System - 45. Sound Attenuation 46.. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. -FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I I - 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 3 0 2 E 1 6TH ST. uerr: A OWNER'S NAMi LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 A _ 723-5300 ARCNIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (710723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in lull farce and effect. CITY LIC.: STATE LIC.: CLASS: C ate'. Signature'. E WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a candidate of consent to self insure or a cadd icate of Workers' ^ompensation Insurance. or a certified copy thereof (Section 3800, Lab. C). ILICY NO.: EXP. DATE: COMPANY: ❑ can red copy is hereby furnished. ❑ Certified copy is Bled with the city Building Division, Date'. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for One hundred ($110) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California, Date: Signature: NOTICE: 11, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, Or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed usu cal to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business I Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ,y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). x' 1, as owner of the property Or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not hul or improve for the purpose of sale). I. as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business W and Professions Code: The Contractors late License Law does not apply to an owner of propen who builds or proves thereon and who contracts for such projects with a emissions) license pursuant to the Contractor ate Licen awl. I am aw that proof of their Worker's Compensation map once should be provided to me. ❑ I am exempt under Section: B. &P G. m this reason / Date: �o _ Owne I do hereby codify that I am aware of and understand the requirements of California Health and S) my ode Sections 25505. 25533, and 25534 and that I or any future building occupanl wall not (circle One) need to comply with sy0 slate codes and the requirements for a permit for construction or modification fro the Air Quality Management District. Residents destruction applications are exempt from these provisions. _ Date. Applicant: 11 I hereby certify that I have read this application and stale that t in o;ons rrect. I agr to core brwith all dordinances and stare laws relating to building cpnsbucbo ereby aumori tatives of hi Icy a port lh be property ler inspection purposes Date: Signature. Driver's License or Social Security #: 1641-46 While—Building; Green—Code Enforcement: Canary—Applil Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B05130 PERMIT NO: B 051309 PLAN CHECK NO: 06848-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION ; NEW SFD SQ FT: 2,180 CLAIM VALUE: 90,000.00 CALC—VALUE: 123,303,10 GROUP OCC: R-3 /M —\ COMMENTS: NEW SFD HOLD FOR j Bg1AA9E 9E 9F9EF 0FiE jF iFii if,�7� Yi iE # ##OF dFif iE lF iE iE###iF #9C 3E****RK###dK,** Z O N I N G S E T B A C K SR E Q U T R E M E N\T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT 1. IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521.101 ZNE: R2 REF NO: DR -90-39 PLANNING NOTES> UNIT A OF 8 UNIT DETACHED APARTMENT PROJECT D E V E L O P M E N T S E R V I C E S R E Q 11 I R E M E N T S ZONING APPROVED BY DATE: 5 2 5 BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: 31`Li�I ####DATE:# 3F�iiiE# LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING PERMIT 723,50 8,63 PLAN 117,57 SMTP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 732,13 0.00 117,57 849.70 849.70 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 732.13 OVER/SHORT: ,00 BLD ,PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 23.50 8.63 ##.�1F###9E#######Rf#########aP######df##################u######9(-################## ' I N D I V I D U A L F E E B R E A K D O W N YPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1658 DWE—TYPE V— OO AME- RA—GOOD 69.00 114,402,00 SFR 37 RES— CR. STAIRWAY 13.80 510.60 — V SFR 485 RE 17.30 8,390,50 OF FEES MAR 18 1991 CITY OF COSTA MESA CONS I RUCTION AND PLAti,+INk_ APF'AOVALS Permit # Date Inspector L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd._ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -- 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test -6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE r 7.. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. - 10. Structural Floor System 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15, Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT' APPROVALS, Permit # i 20. Rough Factory Fireplace - ' 21. Ducts, in Structure . 70. Underground Hydro 22. Ducts, Ventilating .. 71. Productfiping GGas 0Oil 23. Gas Pipe -Rough & Test r 72. Underground Flush - 24• Roof Framing 73. Undergrnd.StorageTank C1 Gas C1 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat _ 75. Dry Chemical - 27..Frame and Flashing 76. Dry Standpipe - -- - 28. 'Lathing & Siding - _ 77. FIXED SYSTEM FINAL' 29. Insulation• - 78.. FIRE PREV. FINAL _ - - •30. Drywall Nailing HEALTH DEPT: REQUIREMENT _31. Plaster Brown Coat ,79. FINAL INSPECTION - 32. Electrical Povder Meter -Final - X80. FOOD CERTIFICATE ISSUED - 33. Final Electric Notes: 34. Final Heating & Air Conditioning- onditioning35. 35.Final Gas Pipe -Test - ' - ,36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final - > ,40. Gas Service -Final 41. Solar Domestic -Final - - 42. Backflow Preventer •_ ' 43. Backflow Irrigation` - 44. Landscape Irrigation System, - - -45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALP>-d�G 6.. �_ •� 49. Electric Release to Edison •. 50. Gas Release to Southern California Gas Co I - 51. CERTIFICATE OF OCCUPANCY No. Date manoftot- BHI ron" 116 BIA EDAM lens Pe('VYI1 t 4� INSULATION CERTIFICATION Thiq in to cor illy that, In confolnlnncn With tho blrrient energy rpglllAtiorn ICeliforoin Adminialretive Code, Tit ie 25, State of Cal toIAIA'I Arid aliploved plella, Inauletion bee been iris talled In the btfilding located at: COSTA MESA -- -- ---- - - -0.R-A GE--- cer pp connlr 302--E-16th ST. :`cff .il.r.i.j DESCRIPTION OF INSTALLATION fxxn e Type of Melerbl EXTEf110f1 WALLS ' Type ofMate(Id FI 13F,RGI,ASS CEILINGS Park I IS: Type of MelerDl Manulectulaf Thltlrntlt R Value" Manohtttnrtr IIA 11V I Ll,R ihhkntn .3# A valite" 11 (Or 1, ad. Narn.) -- — F111ERG1,ASS Menulttnuer MANV11,1,EThicknerf 63 RVelue"j2____ Sq. h. Covered la T'.4. Noma) ALL 10, INSULATION CO. Sub'£onhotlor Nn Mellon Applicator) Ilnwlnlon, M..ny��, -- 4260 2nd Avenue LOS ANGELES, CALIFORNIA 90008 _ Phone 291-4167 LIC. R423VtQn1eNumbtr 423670C-2 ISbn "$A1.1E"11 umr a O.n�nl Cee lr.ctor — ---- Title Date t-C.111ornla Admin *1,011 1 Code, Energy Inwlalton Sund..da, rNcbrrr: f;XCEnPT f.mn Sec. I9879 of the Ifeellh end Safely Cod@ of thr Star- 'C- ul• ' C.rUrnaim nn.nu. veon conmlrllon ret ma tnnenellon of Insulation. a ewd or California: g Thal 114 hgolallnn list hon Inllafled In eonformanc. wllh leu enn of they. .19-118111- (hall h. emmn1ned and e. ecu cad by "No C1rt1(kale of occupancy or 11mllar eerll(Icalion that a newlyy eon isilon .pMkatnr and by Ihr huildr., The Intnlollon tompp Ilam n,uclyd h-11 morel, 9-.rbnml borne, Imm1 or Oilier Rddlntial ll M pnmd al a tonmkunos IDgllon wllhin rhr dwrlling "I lh,y0 req it l ablubu shallbe luu.d by such a building dapauprvnlurden On llruclur! a1 least 0011les the minimum energy Insulallnn mlauua of Ihr 1lsislanca Of a molerlal or hnnding IUlndardt rslahl4hod pwtuant to lhlt chaplrr;'.ntto the nt...Ire of hear. Thr rosliunci Yalu. Inl of m.rblvne ns (hall notInclude any valur for rr llrli! faring 1 116-Puelr911EOBT ED Btn7(r♦ii79Afrw'f,,+r. SOSSOVERLANDAVENUE, LOS ANGELES. CALWOhNIA4005/-(5t5)$moll ht467/B/a retm 1166 - 0 BUILDING INDUST Ry ASSOCIATION OF SOU TIIE RN CALIFORNIA, INC., 1511 BeyM1y Blvd., Loi Angaiet, Calif. 60076 - 12151 675 5171 OWNER'S NAME: 3v2 E 16T1I ST ADDRESS: L1,OYD MYLES DEVEL,OFEN,ENT 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 REG.NO.: ADDRESS: 1 • 4 UNIT' A CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 05168•. PERMIT NO: P 05168.7 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLO PURPOSE: NEW UNIT: JOB DESCRIPTION : NEW SFD SQ FT: PERMITTEE: ADDRESS: JOHN JAN:.S PLUMBINL ('714)642-7764 i `;39 MONROVIA ((� 8 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am lice d under CA92k63 ol-Chhaapler 9 (commencing with Section 7000) of Division 3 at the Business and Professions Code, and my tic is in lull til• a and aIlett. CITY uc.: () 5 2 STATE LIC.' S 5 4 6 3 + CLASS: • - 3 6r Date', —/ ��— Signature: _ __ . . _ WORKERS' COMPENSATION DECLARATION: I hereby aft' that I have a Carl; ale of consent to self -insure or a Ceraticate of Workers' Compensation Insurance. or a certified copy thereof (S n 3800. Lab. C) DLICY ND.: 1091393 EXP. DATE: 1/01/92 COMPANv: STATE P Candied copyishereby furnished. ❑ Cenilied copy is filedwit the ti' wilding D' n. Date: y �7 9/ Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thi s•c nneed not be co tedif the permit is for one hundred (St(0)or less). I caddy that in [be performance of the work for which this peued. I shall not COPY any person in any manner so as to become subject 10 the WorkersCompensation Laws of California. Date: Signature: NOTICE: IL after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code, you must Warmth comply with such provisions or this permit shalt be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. Cl. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt Iron the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city 01 county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for Such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that aerate is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (3500). I. as owner of the property Or my empployees with wages as their sale compensation, will do the work. and the 11 structure is not intended or offered for sale (section 7044, Business and Professional Code'. The Contractors' State License Law ages not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that Such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build Or improve lar the purpose of sale). 1. a, owner of the property, am exclusivel contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an Owner of property who builds or improves thereon and who contracts for such projects with a Co0tractor(s) license pursuant to the Contractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided 10 me. ❑ I am exempt under Section: B. 8 P. C, for this reason: Date: Owner: I do hereby decay that I am aware of and understand the requirements of California Health and Safety Code Sections 25505. 25533, and 25534 and that I at any future building occupant will/will not (circle one) need to comply win said state codes and the requirements for a permit for construction or mootication from the Air Pay Management District. Residendal construction applications are exempt from these provisions. Dare: Applicant: I hereby certify that I have read this application and stare [hal the ordinances and state laws relating to building construction and herel Property lar inspection purposes. Date: �`� Signature Drivers License or Social Security e: 164146 While—Building; Green—Code Enforcement: Cana I agree to comply with all city and county This c enter upon the above-mentioned 4 Goldenrod—Assessor CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF B510309 ###%%k##%six * IFx##x# k##### li.A°.1E iE##•%N.•#d6 rt%#N•#dE##K xIE#)F#i4M.*N k %* %.# N*l"IF %##:1(-fE %i{K Z O N I N GS E R T E B Q A U C I K R S E M E N T S -- ------ — MAIN BUILDING ---------- --------- ACCESSORY BUILDING ----- -- =RNT: FIT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING; N TES> QTY D E S C R I P T I O N UNIT COST TOTAL COST > 2 BATHTUB 2,00 4,00 PLO 1 DISHWASHER D E V E L O P M E N T S E R V• •I C E S-; R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : APPLICATION _ISSUED BY: ,Z_ F E E BLDG PMT PLUMBING EL PERMIT 39;50 15% PLAN ISSUE FEE BUILDING—DIV—> TOTALS ---- > DATE: DATE • 0 U M M A R Y STRUCTURAL SEGMENT:N IC MECHANIC FIRE SMTP/RES GRADING SMIP/NON—RES 3,00 PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 39.50 3,00 0,00 42,50 42,50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 42,50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM,IP/TOT GRADING PLAN—CHECK 42,50 I N D I V I D U A I. F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLO 2 BATHTUB 2,00 4,00 PLO 1 DISHWASHER 2,00 2.00 PLO 1 LAUNDRY TUB OR WASHER 2,00 2,00 PLO 1 SHOWER 2,00 2.00 PLO 1 SINK, KITCHEN 2,00 2,00 PLO 4 WASH BASIN 2,00 8,00 PLO 3 WATER CLOSET (TOILET) 2.00 6.00 PLO 1 WATER HEATER AND/OR VENT 2.00 2,00 PLO 1 WATER SERVICE 1.00 :.a,00 PLO 1 GAS PIPING SYS OF 1. TO 4 OUTLETS 2.00 2.00 PLO 1 GAS PIPING SYS 5+ OUTL—PER OUTLET of QO S FSA CCPJ;i<<"0 =gT • 50 GR� fri! i5 XY1 lir r, • S.•r: S. r -_l �! CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil - 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ,3 /q QL L.Qfi 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING . 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: PERMIT NO: P 051687 PLAN CHECK NO: 01291-91 N PAGE: 2 xk###?f#T•:ii-#i4-k%f:#u####3E##x##3i•iF?Fx:rE#1F#iiie##i(#lE#x-######3ix####if x•.x.i:##xxie#ir##3ii6?!-iE %BF####x ARCH/ENGINEER: ADDRESS: REG.NO.: UNIT: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PERMITTEE: FLU 1 GAS SERVICE 2.00 2.00 ADDRESS: PLU 1 SEWER, BUILDING / TRAILER 5.00 5.00 END OF FEES LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlyisron 3 Of the Business and Professions Code. and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATIDN: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. Or a certified copy thereof (Section 3800, Lab, C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division Date; Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be MorDleled it the pant is Ip one hundred ($10D) Or less). I Cenity that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance Of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the lollowing reason (Section 7031.5 Business and Professional Code: Any City of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior m its issuance, also requires the applicant for such permit to file a signed statement that helshe is licensed Pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) of that he/she is exempt therefrom and the basis for the alleged exemption, Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1, as owner of the property at my employees with wages as their sole compensation. will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his Or her own employees, provided that such improvements are not intended or Offered for sale. It, however the building Or improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sate). I. as owner of the properly. am exclusive]y contracting with licensed contractors to construct the project (Section 7044, Business E]antl Professions Code: The Contractors' Slate License Law does not apply to an Owner of properwho builds Or improves thereon and who contracts for such projects with a contractOTS) license pursuAM to the ConNactors' Slate License Law).1 am aware that proof of their Workers Compensation insurance should be provided to me. ❑ I am exempt under Sect,H1 B. 8 P. C. hoz this reason: Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wilVwitl not (Circle one) need 10 COmplY with said state codes and the requirements for a Penn; for construction or moddication from the Air Ouabty Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that 1 have read this application and state that the above information is correct. t agree to comply with all city and county ordinances and slate jaws relating to building construction and hereby authorize representatives of INS city to enter upon the above-mentioned Property for inspection purposes. Date: Signature: Drivels License or Social Security s: 16ol-46 Whne—Buddmg: Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor -VD9. PL1C'ATE REL -E1'1'- 01 00084520-OPUB492') 'J r; DATE: 04/15/91 T:rZ: 14:1? CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: - 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST UNIT: A OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 72 3 -5 30 0 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that) 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 full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a ceNtied copy thereof (Section 3800. Lab. C). ' POLICY NO.: ESP. DATE: ^OMPANY: J Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (5100) or less) I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: ll. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to Its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the properly or my empDloyees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sae($ection 7044, Business and Professional Cotle: The Contractors' Stale License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). �.1 I, as owner of the property, am exclusivel9 contracting with licensed contractors to construct the protect (Sec n 7044, B neso .,q and Professions Code : The Contractors' State License Law does not apply to an owner of prop Who buil or impro there ❑ and who contracts for Such projects with a contracior(s) license pursuant to the Comity 5' tate L >ese LdW am that proof of their Worker's Cc sensation insurance should be provided to in I am exemp oder Section: E 8 P. C. lJ 10! IhiS Date: Own 7/ I'a hereby holy that I /aware of and understand the requirr of Ca4, 25534 and at I or any f re building occupant willlw 11 not (circle one) need to c permit for destruction or modification from the Air Ouality Management District. these provisions Date: I hereby certify that I ordinances and slate) Date:�41 Dllver s LI . Se or 164b46 hoe—E Applicant, as Signature. 10 Q Green—Code Enforcement: Code Sections 25505, 25533, and codes and the requirements for a tion applications are exempt from tee to ccZ with all city to en upon the D Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 05285 PERMIT NO: M 052857 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51309 PRIMARY BLDG. PERMIT. iERRRRRRRRRR#RRRRR*RRRRRRRRRRRRRRRR*RRRRRRRRRRRRRRiERRRRRRR*RRRiERiFRRiFRRRR*RR**RRif Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING RE&p PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> > RRRRRRRRRRRRiFRRRRRRRRRRRRRRRRRifRRRRRiE R ifRRRRRRRRRRRRRRRRRRRRRRRRiFRRRRRRRRRRRRRRR D E V E L O P M E N T S E R V I C E -.S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: RRRRRRRRRRR*RRRRRRRRRR f F'iFRRRRikRRRRR r u RR RRRRRRRRRRRiER Rik ikRRRRRRRifRRRRR RifRR RRRRRR RR RRRR RikRRRRRRRiERRRiFRRRRiERRRRRRRRifRRR LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 44,25& SMIP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 44,00 15.00 0.00 59.00 59.00 ,00 ,,REVENUE DIVISION TOTALS--> COLLECTED: 59.00 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 59.00 RRRRRRRRRRRRRRRRRRRRRRRRRRRiE RifRRRikRRRRiERRRRRRRRRRRRRRRiERRRRRRRikRRRikRRRRRRRRRR Rik I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N MEC 1 INST FORC-AIR/GRAV FURN <= 100 K BTU MEC 2 FACTORY FIREPLACE r END OF FEES UNIT COST TOTAL COST 9.00 9.00 6,50 13.00 01 00278' r_uO`27o0 7 DATE: 07/23•^,1 V CONSTRUCTION AND PLANNING Date APPROVALS Permit # Inspector POU, & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.'Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Fdotings s 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd.' 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System • Final - 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPASYSTEMS FINAL. 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS - Permit # 20. Rough Factory Fireplace i 21.•Duou, in Structure 70. Underground Hydro 22. Ducts, Ventilating :_ - 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe -Rough & Test t• - 72. Undergr6 and Flusy., , 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0 Oil 25. Roof Sheathing` '74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing' 76. Dry Standpipe 28. Lathing & Siding, 77. FIXED SYSTEM FINAL 29. Insulation ' 78.. FIRE PREV. FINAL 30. Drywall Nailing i� HEALTH -DEPT. REQUIREMENT 31. Plaster Brown Coat;.79. FINAL INSPECTION 32. Electrical Power MetepFinal k. :80. FOOD CERTIFICATE ISSUED' 33. Final Electric Notes: 34.: Final Heating:& Air.Conditioning _ .4 35. Final Gas Pipe -Test' i 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final• ,40. Gas Service -Final .41. Solar Domestic -Final 212. Backflow Preventer 43. Backflow Irrigation - - 44. Landscape Irrigation System.x. -45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING r - 48. FINAL PLANNING 1. %�r. -� • 49. Electric Release to EdisonJ�f• 50., Gas Release to Southern Calijurnla Gas Co 51. CERTIFICATEOF,OCCUPANCY No. Date - - r PROJECT ADDRESS: 3021 E 1 6 TIl ST UNIT: A OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: TEMP POWER SYSTEMS (71.4)632-1999 ADDRESS: 1111 N. TUSTIN AVE ANAHEIM CA 92806 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is Mull force and effect. CITY LIC.: 039124 STATE LIC.: 4 $ 3 re ;- 3�Z SS: — 1� (� Date: ���— Signature f OflNEflS' COMPENSATION OEC�ATION: I hereby allirm that I hav e c nicate of nsent to as ins r a ce icate of Workers' 'aid, anon Insurance, or a certified cop thereof (Section 3800. Lab. C). LICY11i 306-90UNIT83520 EXP.DATE: 11/01/91 COMPANY: STATE FUND ❑ Certified copy hereby furnished ® Certified copy is li� he cit ilding Division. Date: 3 9 Applicant: /i�z EXEMPTION FROM WORKERS' COM ENS�DECLARATION: (This Section need not be completed if the permit is for one hundred ($100) or less). I ceruly that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or Di any structure. prior to its issuance. at" requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by `-iy applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S50D). w. I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the L.I structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly, who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or uttered for Sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve Ion the purpose of sate). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 71044, Business Eland Professions Code: The Contractors' State License Law does not apply to an owner of property who wilds or improves thereon and who contracts lot such projects with a Central license pursuant to the Contractors State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. for this reason: Dale: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant vdIVw01 not (circle one) need to comply with said state codes and the requirements lot a permit for construction or modification from the Air Ouality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant hereby certify that I have read this application and state that the above information is correct. )agree io comply w1 d County ordinances and stale laws relating to building construction and hereby authorizer resenlatives Is c� nter a ,-mentioned P roperly for inspection purposes �.y Date. 3 _ .Z�'- f� Signaturr Dnver'a License or Social Security p: 164146 While—Building; Green—Code Enforcement: Canary—Applicant: Pink—Revenue' Goldenrod—Assessor CITY OF COSTA M'JSA BUILDING PERMIT PERM NO: E 051444, PERMIT NO: E 051444 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION TEMPORARY POWER POLE (1 METER 6 3 SUBS) SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51309 -B51316 PRIMARY BLDG, PERMITS, Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: F'7' IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REO• -PROV: PARCEL; 42521101 ZNE: REF NO: PLANNING N TES> D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: *j rF3f 7( LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING PERMIT 15,00 PLAN 502 SMIP/NON-RES ISSUE FEE 15,00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 15.00 15,00 0,00 30,00 30,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 30,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 30,00 #######k1E############################ic####+E#9f-###ie##t#X{(•.x'T(.{e##)E +(iE##+f#Y Y.##?f #iEY#}1i# I N D I V I D U A I, F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE I TEMP SERV PWR POLE W/OUTLETS EA, 15.00 15,00 END OF FEES Aim r- -71 CONSTRUCTION AND PLANNI�v'�.a` APPROVALS Permit # Date Inspector OL & SPA APPROVAL) Permit # Date Inspector - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Farms 4. Electrical Conduit-Undrgrnd. ,.-• 55. Electrical Bonding r 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit -. 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i APPROVALS Permit # , 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product. Piping GGas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank GGas 00il 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75.: Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL - 29. Insulation 78. FIRE PREY. FINAL - 30. Drywall Nailing HEALTH DEPT: REQUIREMENT 31. Plaster Brown Coat '� �' .79. FINAL INSPECTION 22. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33."Final Electric Notes; 4. Final Heating & Air Conditioning 35. 'Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace - •;y r � v ' 38. Final Plumbing - r-r,� 39. Water Service -Final ' 40. Gas Service -Final 41. Solar Domestic -Final = 42. Backflow Preventers 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations " 47. FINAL STRUCTURE & BUILDING i 1- 48. FINAL PLANNING 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date - 0.1ECT ADDRESS: OWNER'S NAME: 1 302 1 ' ADDRESS: LLOYD _! CA 92625 ARCH/ENGINEER: 723-5300 ADDRESS: REG.NO.: UNIT: A UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: ((•nnjp4�((2�T�13�jjyy PjO�P TPYLA�.�TVypp 99((.,995S LICENSED CONTRACTOTi OECLARATN$!: ihEer3y aAiiPo"tfi51 am licensed unoorr prroovisio9n£' isiaal 9 (commencing with Section 7000) of Onnsion 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC,: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a earthed copy thereof (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. e: 'AEMPTION certify tha subject to, Applicant Laws of P. R - - t be completed If the rind is for one hundred ($100) or less). ,is Issued. IIfshall not emD Y nY `on in IAOy ma ,so as to bee NMCE: It after making this declaration. you shoo ecome subject to the Workers' Compe n (worts of the Labor Code. you must forthwith Comply with such pmvisi s or this permit shall be deemed revok CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency Z performance of the work for which this permit is issued (Section 3197, Cry. C). LENDER: ADDRESS: IOWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption, Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty Of not more than five hundred dollars ($500). I, as owner of the property of my employees with wages as their sole compensation, will do the work, and the ❑ structure Is not intended or offered for sale (section 7044, Business and Professional Code: The Contractors' State License Law I does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business I and Professions Code'. The Contractors' state License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a conlrector(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. & P. C. ' lar th reason: Date: f 0 r— 9 Owner: �e —1 aB dy certify that I am aware of and understand the requirements of Calif nia Health and Safety Code Be - s 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need t0 comply with said stale cod d the requirements for a permit for construction or modification from the Air Ouality Management District, Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and stale that the abov ormetipn is correct. l agree to comply with city and county ordinances and state laws relating to building construction an authorize represent ti l is city toe I o above mentioned property for inspection purposes ' Date'. �` m/�� Signature: Driver's License or Social Security 1641 46 Whae—Buildmg: Green—Code Enforcement: Canary—Applri Pink—Revenue; Goldenrod—Assessor r� CITY OF COSTA MESA - BUILDING PERMIT CPERM NO: E 05770 PERMIT NO: E 057706 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE PURPOSE: NEW JOB DESCRIPTION ; HOUSE METER FOR NEW 8 UNIT SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF: B51309 -HOUSE METER iERE Rt RE kRE ik Rf RE 8f RE RE4ERE 1E REDE iE REiE RERE iE 4E RE iEiE RER(•1E iE iF �E r +r+E *DERE�t �E RE �E * �E�E �E �>f it �E�E �E�E�E �E �E+E �E�t* �E * * �E+E �E�E �E+E �E �E �E �E�E�t�E �E+E Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING .fes ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> iF RE*iF*Rk iE Sf ik BE IE RE iE 8F if 4t iE lE itRE itit BFit SFiE*iE 1P*!t*iE iEk iERr iEit****iE iE Rt*iE Blot****iERlRf REit RE iE**iEiE it *RE iRRt iE Rf it RE4EiE RtiE* ppw D E V E L O P M E N T 'S%tE R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY Y DATE: BUILDING APPROVED BY DATE: ADDT.TrATTf1A1 TSST7FT ay. \ V ` . -- DATE • —to h 1F RE RE iE Rf if * RF SF RE iE Sf RE iE iE BE iE Rt RE LEGALIZATION:N BLDG PMT PERMIT PLAN ISSUE FEE BUILDING -DIV-> TOTALS ---- > !f iE * iE iF k k RF RE iE if�iF'iFiE iF 1E 1F iFk iE RE iF*iE iE iE Rr!RE *RF RE iT Rt iE Rt RE;t 3E� #*SE*kiFiF REiE RE Rf*3FiE 4E iE****RE 4T *if iE iERE ieiEiE iE F E E S U M M A R Y STRUCTURAL SEGMENT:N PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 18.50 Sot SMIP/NON-RES 15.00 PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE 18.50 15.00 0.00 33.50 33.50 •00 REVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 33.50 ./ SF Rf iF iE Rf RF 4E 1E k RE RE RF iF BE lE 4E * if if if 1EiE BE * iE SF 1f iE 1E * MRf• k 1E RE RE RE RF RE B6 M RE RF RE iE k lE RE iF k iE iE 881E iF iE * if iE Rf if 1E * RF BF RE k iE 1EiE k IE iF iF iE Bt iE iF it I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18.50 END OF FEES 01 DATE- Qc, 11:'42 TT0 Ix CONSTRUCTION AND PLANNING, POOL & i APPROVALS Permit # Da Inspector - APPROVALS Permit # Date Inspector -1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • - • 2: Soil Pipe-Undrgrnd. - 53. Steel Reinforcement _ f 3.-Ele&tri6l Conduit Urflity-Undrgrnd. n 54. Forms' r 4: 61ectrical Condui}.Undrgrnd. 55. Electrical Bonding 5;,Steel f2Pinforcergent. 56. Rough Plumbing & Pressure Test . Ti, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE -7.. Pb7otings , - 58. Electrical Conduit-Undrgrnd. 8:, Foundation - J 59. Gas Pipe, O Undrgrnd., Test 9�Waier Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, G Undrgrnd. , 10; Structural FloorSystem 1 61. APPROVAL TO DECK I l.: Property Sewer ne.& House Connection 62. Backwash & Receptor -Final 12. Sewer Cap .� 63. Heater & Vent -Final 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing •" 65. Electrical -Final ' 15. Rough Electrical -Conduit 66, Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS,- -'Permit +___4__' T 20. Rough Factory. Fi%_place ' R 21. b ucft, inStruCtur6 S - 70. Underground Hydra < 22. Ducts, VeFltilating: 71• Product Piping OGd_'s 0 01 20. 'Gas Pipe -Bough &'%est - s -,. = „ - 72. Underground.Flush ; z `- _- 24. Roof:Framing•• .� - J•T _wr• ''73.'--Qndergrnd:-Sto rage Tank El Gas OOir 26. Roof Sheathing - 1•a , 74. Overhead Hydro 26. tBar Ceiling (Structural) & Mcnocoat _ _ '•' 75. Dry Chemical _4 - 27. Franne anal Flashirttg 76. -Dry Standpipe 28. LathvmgBiSidingJ -' 77. FIXEDSYSTEM,.FINAL _ .. 29. Insulation 78. ,FIRE PflEV. FINAL- 30. Drywall Nailing f.r x - HEALTH DEPT. REQUIREMENT 31. Plaster B own Coaf-. - 79. FINAL INSPECTION z :32. Elect rica{,Power Meter'Final l 80. FOOD CERTIFICATE >_ 3. -ina LElectric^ j _ Notes: -k Final.Heafing Air ConditioriingS _ , r 35. 'Einal-Gas Pipe' Test 36. Hood_or Canopy n x r r 37. FinalrXactory Fireplace -" K " �;. `t v S• 38. Final. Plumbing 39. Water Service. Final 40. Gas Service -Final :. `" G •, s _• 41. Solar Domestic -Final' 42. Backflow Preventer ( _ 43. Backflow Irrigation' 44. Landscape Irrigation System r, 45. Sound Attenuation* - 46. Handicap.Regltlationi 47. FINA'LSTRUCTURE&BUILDING n 48. SINAL PLANNING .49. Electric Release to Edison �. '50. Gras Release to,Southern California Gas Co _ • '51. CERTIFICATE OF OCCUPANCY IS - No. Date PROJj ADDRESS: 302 E 16TH ST UNIT: OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR,CA 92625 j 714)723-5300 1RJ/ENGINEER: DUCA—MCCOY REG.NO.: C 2 4 6 6 8 ADDRESS: 3840 COAST HWY UNIT: CORONA DEL MAR CA 92625 f PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: Ihereby affirm that) am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and,Pmfess ones Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature'. WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a candidate of consent to self insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Candied copy is hereby tarnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($1000) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date'. Signature: NOTICE: If alter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Codeyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097. Civ. C). LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: GRA 05113 PERMIT NO: GRA 051137 PLAN CHECK NO: 00162-91 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: GRA PURPOSE: NEW JOB DESCRIPTION ; GRADING FOR 8 SFR SQ FT: CLAIM VALUE: 1,000.00 CALC—VALUE: GROUP OCC; R-3 / COMMENTS: X Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> > D E V E L O P M E N T S E R V I.0 E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: w lL DATE: 71 2'L ###################### ########## ## LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING E OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason L ECTR I C MECHAN IC FIRE SM I P /RES GRADING (Section 7031 5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or PERMIT 106.50 repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed SM I P /NON —RES pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business PLAN - 5 6 3 and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by for than five hundred dollars ISSUE FEE • 3.00 any applicant a permit subjects the applicant to a civil penalty of not more ($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE L. I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the rJ TOTALS ---- > 106.50 3.00 5.63 115.13 115.13 structure is not intended or offered lot sale (Section 7044, Business and Professional Cade: The Contractors' State License Law .00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED • 109.50 OVER/SHORT: is within one year of completion, the owner will have the burden of proving rte/she did not build or improve for the BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP /TOT GRADING .00 PLAN—CHECK of s for the purpose of sale). pure 109.50 I, as owner of the property. am exclusivelyY contracting with licensed contractors 10 construct the project (Section 7044, Business builds improves C� and Professions Code: The Contractors License Law does not apply to an owner of property who or thereon and who contracts for such projects with a Conlractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section: G 8 P C I N D I V I D U A L F E E B R E A K D O W N for this reason: / V rte' j'T TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Date'. 2^.2D, %/ /Owner: NO FEES WERE SELECTED FOR THIS PERMIT I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505. 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date'. Applicant: I hereby certify that I have read Ihis application d slate that the above information is correct I agree to comply with all city and county ordinances and state laws mlating to budding co struclion and hereby a Sie: D;ze -rep tative t.y�to �mbe d the aL. W�enl.io ned property for inspection purposesf J gnaturDate: Dpyer's License or Social Security e: 1641-46 Whne—Building: Green—Code Enforcement: Canary—Apichcari Pink—Revenue: Goldenrod—Assessor 01 00081213-00081218 F$_•T _L.7 . DATE: 02/22/9! TIME: 15:00 14 CONSTRUCTJ�d AND PLANNING O L & SPA .�: APPRO�LS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location t 2. Soil Pipe- .Undrgrnd, 53. Steel Reinforcement _ 3JEiectocal Conduit Utility-Undrgrnd. 54. Forms -..A:.Electrical.Conc it7Undrgrnd. 55. Electrical Bonding - r 5.!Steel Reinforcement- 56. Rough Plumbing & Pressure Test i ,t.t6.. 'Electrical`UFEB,Grrid. 57. APPROVAL TO COVE R-GUNITE -� µ t 58. Electrical Conduit-Undrgrnd. .7.:400tiiigs =d'��i 8. Foundatip'n ,:, 59. Gas Pipe, 0 Undrgrnd., Test 0 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. , 10. Structural Floor System 61. APPROVAL TO DECK 11'. Property Sevver'Line & House Connection 62. 'Backwash & Receptor -Final 12. Sewer Cap L 63. Heater & Vent -Final 13. Roof Drains't ru „ 64. Plumbing System - Final 14. Rough Plumb lIg 65. Electrical -Final 15. Rough Electrical -Conduit - 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ;APPROVALS ,GPermit # 20;Rough Factory Fireplace ' u, P-4 i - J - : > - 21. Ducts, in Stgucture, ....:; ) - _ 470. Undeigcotind Hydro .,. 22. Ducts, Ventilatin"•^5 9' -� - Qa:+.- Produci Piping O6as QOiI d. _•,� , ,f71. 23rGas Pipe -Rough &•Testtrl ' `y ; . 72, Underground Flush. s ,. - 24. Roof Framing E ;- -• o r 5:73?'Undergrnd.Storage ❑Oil ,. 25.`Roof SheathingU `'" °; ' ' -. t- , ` 74; Overhead'HydroTank,DGas ,l 26::T -Bar Ceiling (Structural) "onocoat to _ Jr a 75. Dry Chemical V ? - 9. 't� 27. 'Frame and Flashin I �r * x. 76. Dr Stan ~' e " Y d PH? '. 28' Lathing,& Siding ., --<L:c ix $' � _ ' 777- FIXED SYSTEM.:FINAL x-29. Insulation <" 78C FIRE PREV. FINAl_ ,: rt• > .. :'30. Drywall Nailing _. Y j ti v ,. - HEALTH DEPT. REQUIREMENT 11,31, Plaster grown Coat} 797FINAL INSPECTION s , t*'n- 4: ,.-32.: Electrical Po_er Meter,-Final:' C3�80..:FOOD _ CERTIFICATE ISSUED 'r Electric r - r I a 'Notes: 533'�Fin51 a ;34: Final Heating;& Ai' Conditioriingl r - - f "35:'Final t r Gas Pipe -Testes '` r ' • - T•S ` ' ^'`t a , 36:*'Hobd or Canopy- o t - Factory Fireplace:"- -37.-Final X.38. -Final Plumbing ' s �� I •• •• -.K ; �, '' r- 'x `.V �• :_.39 -Water Service. Final. n�40`�Gas Service-Final>41.- Solar Domestic -Final. ^ •• s r_. uJ �,. I II T r �. - :t d' ' . cd 42. B ackflow Preventea r„ • ^ _ it ,U X 1 (,. 7 :± ,� It 43. Backflow Irrigation 44. Landscape Irrigation System-;,,q� u- 4 _,t - % - rr - c N ,nz: s45 =Sound Attenuation - '46: Handicap Regulations - C� 47.;FINAL STRUCTURE & 13UI'LDING 1A8t'FIIVAL PLANNING. 1 ', r, J .49 Electric Release to Edison .; "50.,Gas_ReleasetoSouthernCaliforniaGasGo `51. CERTI F ICATE OF70CCUPANCY -„ No. Date PRWE@T ADDRESS: 302 E 16TH ST UNIT: OWNER'S NAME: MC GOVERN EUGENE P TR ADDRESS: 1618 SANTA ANA AVE COSTA MESA,CA 92627 723-5300 ARCHIENGINEER: BERNARD ADAMS REG.NO.: C10183 ADDRESS: 12753 BROOKHURST UNIT: G.G. CA 92643 PERMITTEE: LLOYD MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect, CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' omeensation Insurance. or a certified copy thereof (Section 3800. Lab. C). 'OLICY NO.: EXP. GATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is tiled with the City Building Division. Date: Applicant: EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not becompleted it the permA i tonane AuMrM !a r less). I certify that in the performance of the work for which this permit is issu all not Carel a y person in any ma=ne as to beoome subjttl to the Workers' Compensation Laws of Calilorr r f�' Date: ,? ' V Signature:fir NOTICE: IL after making this declaraltpn, you should vocome subject to the WorkersCompen provisions of the Labor Code. you must tonhwith Comply with such provisions or this permit shall be deemed rev0 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Gv. C6 LENDER: ADDRESS: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B OS7287 PERMIT NO: B 057287 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION NEW TRASH ENCLOSURE SQ FT: 1,600 CLAIM VALUE: 1,600,00 CALC-VALUE: 1,600,00 GROUP OCC: R-1 / COMMENTS: TRASH ENCLOSURE FOR THE NEW COMPLEX ############################################################################### Z O N I N G S E T B A C K SR E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > D E V E I, O P M E N T S E R V I C E S R E Q U I R E M E N ''T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: 6P" y iF3F'�bFc� �e��T DATE: Ste= S — � 3r iF:esr '#7Fir###8i DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to construct, alter, improve, demolish, or PERMIT 37•00 .50 repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business SM I P /NON—RES and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by PLAN � any applicant for a permit subjects the applicant to a civil penalty o1 not more than live hundred dollars (5500). ISSUE FEE / I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING -DIV-> PERMIT ISSUE PLAN! --CHECK TOTAL PAID DUE structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Slate License Law TOTAL S---- > 3 7.50 0 , 0 0 0,00 37•50 37,50 . 00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or otlered for sale. If, however the building or - REVENUE DIVISION TOTALS--> COLLECTED: 37,., r0 OVER/SHORT: 00 improvement is sold within one year of completion. the owner will have the burden of proving rte/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHAN,I`C FIRE SMIP/TOT GRADING PLAN -CHECK 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 37.00 r .50 ® and Professions Code: The Contractors' Slate License Law ores not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors' tate License Law). l am aware##################################-###3p#################################N,*Ill ADA that proof of their Worker's Compensation insurance should be provided to me. ` •l ❑ I am exempt under Section: B. & P. C. for this reason: G TYPE Date: 6 7 Z Owner e SFR I do hereby certify that I am aware of and understand the requirements of Ca forms Health and Safety Core,5I 25505, 25533, and 25534 and that l or any future building occupant wiNwill not (circle one) need to comply with said state and the requirements for a permit lot construction or modification from the Air Dually Management District, Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that Ihave read this application and stale that ordinances and state laws relating to building construction and h property for inspection purposes. Date '.��7 2 Signature: Driver's License or Social Security x: is While—Buildinq. Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor I N D I V I D U A L F E E B R 6 A K D O W N QTY D E S C R I P T I CL UNIT COST TOTAL COST 1600 ALTER BY VALUE RES16ENTIAL NOZONE 1,00 1,600.00 END OF FEES 1 CONSTRUCTION AND PLANNINu APPROVALS Permit Date Inspector OL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55, Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd, 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 1 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final , 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING , 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush. 24. Roof Framing 73. Undergrnd. Storage Tank O Gas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final .- 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning Notes: ` 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service•Final 41, Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING 2 48. FINAL PLANNING 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date p (PROJECT ADDRESS: 302 E 16TH ST UNIT: OWNER'S NAME: MC GOVERN EUGENE P TR ADDRESS: 1618 SANTA ANA AVE COSTA MESA,CA 92627 723-5300 ARCHIENGINEER: BERNARD ADAMS REG.NO.: C 10 18 3 ADDRESS: 12753 BROOKHURST UNIT: G.G. CA 92643 PERMITTEE: PIAZZA MASONRY (714)951-1202 ADDRESS: 17321 AVALON LN H.B. CA 92647 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession Code. and my license is in full force and effect. CITY LIC.: OS 07 TATE LIC.: 9975�//////���CL7A/S$.rZoo �/f� Date: __"?L/L N AT r Signature: _Yt/t I ina L2k/_Y�c<=m' WORKERS' COMPEN ATION DECLARATION: hereby after that have a cerilicant o sell -in a or a cemicate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C). I 'tiiii NO.: i DATE: Cerrito Copy is hereby furnished. ❑ Certified Copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WOflXEflS'COMPENSATION OEC RATION:gissecneed not be completed if the permit is for one hundred (5700)or less)I cemfy that in the performance of the work for icn This ed shall n em a�erson in an manner as to became subject IO the Workers' ompensalron Law of California./pIoy�g Signature:p!/ y t� NOTICE: If, afte makin this declaration, you should blitorme 5ubfect to the Workers- Coolyp ion prov' ons of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed reveke CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work lot which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or 05204 PERM NO:'B PERMIT NO: B 052040 PLAN CHECK NO: 01661-91 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION : 1-4FT RETAINING WALL 5 16X16" PILASTERS SQ FT: 600 CLAIM VALUE: 12,000.00 CALL—VALUE; 33,240.00 GROUP OCC: R-1 / COMMENTS: 60OLF RETAINING WALL W/PILASTERS 112j- PLUS ',F -W To („6` i1—a0A Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT, FT IN PARKING REQ: PROV• PARCEL: 42521101 ZNE: R2 REF NO: PLANNING NOTES> FOR A 60 FT. LONG VARIABLE HEIGHT RETAINING WALL ALONG > PROPERTY LINE OF NEW 8 UNIT RESIDENTIAL DEVELOPMENT.. D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ?TONING APPROVED BY (5—e DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: Zig DATE: ,H 9E IE LEN-1ERf*��* 1�7 (• 3 yE� IE IPklf IFRf**iF iF iF iE iH iE iElE 1E iE*iE iF iP iE if iE 1E*iE*iH iE iE iE �t ik lE iE**1F iFif RE RE iP Nf*itkkiF iE iH if RE iP*1PiE REM*iFk iH 9E k#P RP iP AE if it kiE iE iE i#iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or PERMIT 310.50 3.32 repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed ", SM I P /ON—RES pursuant to the provisions ul the Contractors' State License Law (Chapter 9 (commencing with Section 7900) of Division 3 of the Business PLAN 201.83 and Professions Cotle) or that he/she is exempt therelrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of not more than live hundred dollars ($500). ISSUE FEE 1. as owner of the property or my empployees with wages as Inch sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I❑ structure is not intended or offered for sale (5ection 7044, Business and Professional Code: The ContractorsState License Law TOTALS ----> 313.82 0.00 201.83 515.65 515.65 .00 does not apply to an owner if a property who builds or improves thereon, and who does such work himself/herself or through his ro her own employees, provided that such improvements are not emended de offered lir sale. If, however the building vor improvement n sold within one year oft such improvements e the owner will have the ed burden of proving heishe did not rbuildthe or improve REVENUE DIVISION TOTALS--> COLLECTED • 515.65 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I. as owner of the property. am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business 310.50 3. 32 201.83 ❑ and Professions Code: The Convactois' State License Law does not apply to an owner of pmperrryry who builds or improves thereon r and who contracts for such projects with a contractors) license pursuant to the Contractors'State License Law). l am aware iH 9F*if iF*Bf iF iE iF iE*OE♦E*iE iH iEk#iE 1P JE RP iP iE if iE lE iE iE iF*kiP Bt lEfEiF{f{(.)f{({(.{FRL.{EiE{Py(.,ti¢y,.R(.4(..)t4(.{E{p*.)(.{Ey(.{f{p;t(. yE {E {E. {E.x. {e A(. jP {E**♦I. {e. {P that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L F E E B R E A K D O W N ❑ I am exempt under Section: 8. 8 P. C. , Lor this reason: T V D C QTY D E S C R I P T I O N Date. Owner: I SFR I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and I SFR 25534 and that ) or any future building occupant wil swill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouri Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: 1 hereby certify that) have read this application •nd stale XbS;� n is correct.) agree to comply with all city and milmantes and stale laws relating tp buil it stfu Ron aa' of sty to enter upon thea m[ properDale. Signature:Oliver38 `\I 641-46 White—Building: Green—Cade Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Aesesaor UNIT COST TOTAL COST 92 RES—RET WALLS <= 3.FT•.W/SURCHG/ FT. 30.00 2760.00 508 RES—RETAIN WALLS UP TO 6 FT / FT. 60.00 30,480.00 END OF FEES CONSTRUCTION AND PLAN NI NG`;k�" APPROVALS Permit# Date Inspector SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical'Conduit-Undrgrnd. r 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical' UFER Grnd. -• 57. APPROVAL TO COVER-GUNITE 7. Footings.. 58. Electrical Conduit-Undrgrnd. 8. Foundation' r 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 12. Sewer Cap 63. Heater &Vent -Final 13. Roof Drains'" 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS' Permit 20. -Rough Factory Fireplace • 'X � '�`' 21: Ducts, in Structure. .... _ a 2 j0. Underground�Hydro v 22. Ducts, Ventilating. ••• r " ° r71. Product Piping 0 -Gras O'Oil 23. -..Gas Pipe -Rough &Test >, s 72. Underground Flush; .. - 24. Roof Framing _ - - :73:`-Undergrna:.Storage--Tank OGas OOil 25. Roof Sheathing'74,=Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat .*- - - "" ' 75. -Dry Chemical 27. Frame and Flashing - r . 9 1• s: z ` r : �. �.. 76. Dry Standpipe ?: . �. ' 28 Lathing & Siding-. '. t . t T •• 77. FIXED SYSTEM -FINAL' 29. Insulation 78 -FIRE PREY. FINAL J30. Drywall Nailing 'i I HEALTHOEPT: REQUIREMENT ' 31. Plaster Brown CoatS •' I I �. r79- FINAL INSPECTION " 32. Electrical Power Meter: Final I ' i• ; 80. FOOD CERTIFICATE ISSUED 33. 'Final Electric 'Noyes: '„ 6•©le 34. -Final Heating;& Air'Ccnditioning; 35.'Final Gas Pipe -Test - I r - f C. r ,36. Hood or Canopyri ^� I 37.:Final Factory Fireplace^. i I- 38. Final, Plumbing _ - i ` ✓ ,•� -39. Water Service-Final'- �- 40. Gas Service -Final -,- 41. Solar Domestic -Final c � 42. Backflow Preventers - 43. Backflow Irrigation'" r - 44. Landscape Irrigation System. '- n, -.r,- t - _••, - .� 45.' Sound Attenuation I ' 46. Handicap Regulations 47.•FINALSTRUCTURE &BUILDING _ O •. 48. -FINAL PLANNING '` ' > ''" c- 49. Electric Release to Edison 50. Gas Release to Southern California Gas Do 51. CERTIFICATE OF,OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST OWNER'S NAME: SIDNEY CURTISS ADDRESS: 302 E 16TH ST #G COSTA MESA CA 92627 (714)645-9782 ARCH/ENGINEER: ADDRESS: REG.NO.: UNIT: G UNIT: PERMITTEE: SIDNEY CURTISS (714)645-9782 ADDRESS: 302 E 16TH ST G COSTA MESA CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby affirm that) am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Rusiness and Professions Cotle, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date', Signature: ck10flNENS' COMPENSATION DECLARATION: I hereby affirm that I have a complicate of consent to self -insure or a coniucti a of Workers' d+�,a ampensation Insurance, or a certllied copy thereof (Section 3800. Lab. C). 'POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Cornfield copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This when need not be completed if the permit is for one hunared($100)or less). I codify that in the performance of the work for which this permit is issued. I shall not employ any per ny manner so.as to become subject to the WorkersCompensation Laws of California ---i Date: I—/1—�'.�'�— 92— Sign NO CE: !I. atter making this declaration, you should become subject to the Wor rs Compensation provisions of the Labor Cotleyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance Uf work for which this permit is issued (Section 3097. Civ. C). LENDER: .E'r ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the fallowing reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the -1 structure is not intended or offered for sale (Section 7044, Business and Professional Code : The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselflherself or through his or her own employees, provided that such Improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the properly, am exclusive)yy contracting with licensed contractors 10 Construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. L] I am exempt under Section: 0. 8 P. C. for this reason'. Date'. ZL_A2_.?, &a_ 0 I do hereby Certify that 1 am aware of and understand the requirements of California Health and Safet Cade Sections 25505. 25533, and 25534 and that I or any future building occupant w I /will not (circle one) need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city tp Pon the above-mentioned property for inspeclion purposes. Date: _(( �� Signature Driver's License or Social Security a: 164146 Whne—Building: Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 060069\\ / PERMIT NO: E 060069 PLAN CHECK NO: N GOVT; N SUPP: N v CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION RELOCATEWASHER DRYER SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: RELOCATION OF LAUNDRY APPLIANCES. ******BfBfk�LiHiFiFiH*BE ifiFkifit8F8EBPitififiEk�r:t�F�H�E+trt*�t�E�Hit��E�L**�H:6*��L�E*��L�L�H*:H**��E�E�**rE�E:r��H�r�E�P**+tar Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ• PROV: PARCEL: 42521122 ZNE: REF NO: PLANNING N TES> > akk kat**at aE*at aHaE*atiEaE at aH***lFk*****aE aE aE it aE aF kaE aHat aEBE aE kaE if at. aP*4aE iHaEat aE atat at BPiH rtaH aEaH aF aE iE aE *iH ak*raE**aH *ataE* D E V E L O P M E N T S E=R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY:� v *aE iE of aE aE of ak *1E ak *aE iF*aE at. aH*aE*aE iFaHaL**aE*aE**aHataEatar aH aEaL*it. aHaL iH iE iH*iEaL*iEiL *aE aE aE aE aE aE iEaE aE *aHaHatat aEi k LEGALIZATION:N F E E S U M M A R Y PERMIT ISSUE FEE BLDG PMT PLUMBING ELECTRIC MECHANIC .75 50% 15.00 DATE • ff` 4 *BE aF aF*aE*aE*BE iF 3F �F iF 1E 1F aF*af***xaH aE**aP***iEiH iE aEataE**aE aE aF STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES - BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 0,75 15.00 0,00 15.75 15,75 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 15.75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 15.75 of*1E iF*aE aF*k1E*BH*aE*iF at. iE aH kit. aE aE iF kaF kaF aE aErt aE*aFk*aE aE*aHaEaPat aE aE aE aHaEaEaHiE aE*iE aH aH iE*iFaHaEaE *aEaE aE aE aF aE aEaH aE aF**aE i6*aE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 RECEPT/OUTLET 1 ST 20 EA. ,75 .75 END OF FEES �• f CONSTRUCTION AND PLANNlly. JOL & SPA l APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location l •� 2. Soil_Pipe-Undrgrnd. 53. Steel Reinforcement =j !A) 3.;J"ecViral Cond uit,Uji l ity-Undrgrnd. 54. Forms = 4.-EfeeCrQI Condeit-'Ufidrgrnd. 55. Electrical Bonding b. tW geinforceme'ni; 56. Rough Plumbing & Pressure Test 'c6--E€ectrlcalUFER�Grfid. 57. APPROVAL TOCOVER-GUNITE -".7 _"ooti�gs 'r 58. Eiectrical Conduit-Undrgrnd. '- 8.4oundation •� i- iI , 59. Gas Pipe, 0 Undrgrnd:, Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. \j 10. Structural Floor System � 61. APPROVAL TO DECK .' 11. Property Sewer Lim& House ConnectionC. 62. Backwash & Receptor -Final I • G� 12. Sewer Cap_ f' 63. Heater & Vent -Final .i .�',• 13. Roof Drains } 64. Plumbing System - Final _ :� 14. Rough Plumbing' f. 65. Electrical -Final '", t r, 15. Rough Electrical -Conduit ! 1 66. Solar System -Final 16. Rough Electric'Wiring Z 67. Fencing & Access Approval i 17. Rough Wiring Sign , , - 68. APPROVED FOR PLASTERING-' 1� 18. Rough Electric.T Bar Ceiling `� 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ !APPR0VALi �-J;-Permit # r" 20"RoGgh F-actoly Fytplace C. 21. -.Ducts, itS Stcnctu eY I '.. .. - N x S - r. �< r X70. Undergm Und Hydro r 22, Du. S'Ventiiati GJ ; S < x =77 ProduciP3,FPfrig E5 Gas QOiI 23: ;Gas;_Pip -Roygh & jest ;-.,;; r r) ?• q �•,x v -72. Underground Flush 24TRoof F"reming ?i; ' == 'r'> �" * ;* 731 Undergrn3.Storage-Tank'QGas 0011 , 25. Ro9S athin X ti g =t " ? N •' - 74„Overhead Hydro - C) <y < x ,. 26:07 -Bar Ceiling (Structural) &`Monocoat u7 - =�"''< 75= Dry Chemical _ 'A 27CFrame and Flash riy: r -� 76. Dry Standpipe ' "z V 'r z � s ,ox --.28. Lathing2L Siding' e: �' �r' % -� r 777 FIXED SYSTEM 1'INAL`. y i 29. Insulation s 'd << x 7&.z: FIRE PREV. FIN,%L :c = 730. DrywallrNailing �x t � qY� �; � HEALTH}DEPF:REQUIREMENT Plaster gown Cdit�'. 79. FINAL I�ECTQN, X31. x :-32.-_Electrical Power Mete2-Final'. «' '� __ rI.< •� .SO:n^FOOD CERTIFI"CVITE ISSUED 33t'�Fina El_ectrh Qj NQles:t �. ;!344•FAA, Heating &Air: CoDditiortgraK r x - - i-' � x 35:'Finil 1 Gas Pipe-Te'Z(C' GoGo --i- x36. Hood or Canopy'-.. ✓� t- r - ,n :n r, -37PFin3l Factor y"lace Y FlreD �� � r c.. 4• ; x - �-38. Figal Plumbing+! -- -• : -� - td �' 1�39. Water Service-FinaI4- '-' x -c « " � rr140. Gas Service -Final 41. Solar Domestic -Final`: 01 42SBackflow Prevente 43. Backflow Iragatiorf a:-��`• w x'- ',44. Landscape I�tigation SYsterrU:nt� -'� >-45^Sound Attenuation '"•�•'• •r "'- it r -_i'%.a '" ,' ';46..;Handicap4gulations 47SFIN:AL STRUCTURE & BUI'LDING 48;FINALPLANNING r. :j• ~ v n d - c:49rElectric Releaseto•Edison- -250 zGas-Release to Southern California Gas Co 1 > :::51. CERTIFICATE OFkOCCUPANCY No. Date i / 6k PROJECT ADDRESS: 302 E 16TH ST OWNERS NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7010) of Division 3 of the Business and Professions Cade, and my license is in full Ionto and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: 'VORXERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' ompensation Insurance. or a caddied copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby burnished- ❑ Certified copy is filed with the dry Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This Sectial need rot be completed if the formula far one hundred 1S10g or kss). I certify that in the performance of the work for which this permit is issued. I shall nof,employ any person in any manner so as to become subject to the Workers Compensation laws of California. .r Date'. Signature: NOTICE: 11, after making this declaration, you should become subject to the WorkersCompensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for which this permit is issued (Section 3097. Civ. CL LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than Irve hundred dollars (5500). I, as owner of the property or my emloyees with wages as their sole compensation, will de the work, and the J structure is not intended or offered for sale (Section 7044, Business and Prolessional Code: The Contractors' State License Law does not apply he an owner o: a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business L7 and Professions Code: The Contractors' State License Law does not appy to an owner of propertyq vino builds or improves thereon and who contracts for such projects with a Contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section'. B. 8 P. / for this reason: Date'. Owner: I do hereby certify thall am aware of and understand the requirements of nomia Health and Salety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wdVwill not circle one) to comply with said state codes and the requirements for a penml for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this applicatouriXfoul state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to building c9fistructour and hereby a rite representatives of this city to a ter uponlhea mentioned pmpeny for inspe ion purposes. Dale: Driver's Li ense or Social Security x' 1641,46 Whip—Buildina: Green—Code Enforcement: CanarY—Aoolicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 57 PERMIT NO: P 055997 PLAN CHECK NO: N t: 1)UPP: n CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU PURPOSE: NEW JOB DESCRIPTION : SEWER LINE FOR 8 SINGLE FAMILY RESIDENCE SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: X Z O N I N G S E T B A C K SR E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: #######iElE iF iF1EIF#IE IF IE#####iFiF3fiFiFiFiFi'tiF iFiF7F£iFiFiF7FiF3FfFiF %VF lF#iF"iP'iFiFiF £iF########## #3F LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 00 I x'53 SMIP/NON-RES PIAN ISSUE FEE 3.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 5.00 3,00 0.00 8.00 8,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 8,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 8,00 ##ao lE##IE#aE iFfE###########M###########IE####################IE############TE#####x•#### I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 SEWER, CONNECTION TO BUILDING EACH 5.00 5.00 END OF FEES C41t: CONSTRUCTION AND PLANNIN. APPROVALS Permit # Date Inspector JOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11, Property Sewer Line & House Connection 12. Sewer Cap ,r(,� 9` Gr�� 62. Backwash & Receptor -Final 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 2 Z 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final - 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Q01259 City of Costa Mesa PARK FEES Fee Payment Receipt r Project Address -ZOz /,&,/W A.P. Number 07.:5r- Building ZSBuilding Permit Number Owner's Name Mailing Address Total number of dwelling units in project Total number of existing dwelling units to be I demolished or removed as a part of project Net number of units subject to fees Net Type of Unit' Number of Units Fee" Single Family ' X $5,748.82 Multiple Family X $3,940.34 Planning Division Approval Applicants' Signature 'City Ordinance 99211 City Resolution 91 017430 rev. 7-91 Whue-Planning; Can Total Fees Amount .PROJECT ADDRESS: 302 E 16TH ST IiiVNER'SNAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEEfl: 723-5300 REG.NO.: ADDRESS: UNIT: E UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY CIL.: STATE LIC.: CLASS: *1Oe: Signature: JRNEFl COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' ,ompensalion Insurance, or a certified copy thereof (Section 3800, Lab. C). POLICY ND.: EXP. DATE: COMPANY: Certified copy is hereby furnished. ❑ Certified copy is tiled with the city Building Division. Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be Completed it the permit is toi one hundred ($100) or lese). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner, so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the WorkersCompensation provisions of the Labor Cotle. you must Iorlhwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve. demolish, or repair any Structure, prior to its issuance. also requires the applicant for Such permit to lite a signed Statement that he/She i5 liccra ed mirsuanl to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by rpplicanl for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500). I, as owner of the property or my employees wiN wages as their sole compensation, will do the work, and the IJ structure is not intended or offered for sale (Section 7044, Business and Professional Coe: The Contractors' State License Law tloe5 not apply to an owner of a property, who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for Sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). L as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7 4, Business W and Professions Code: The Contractors' Slate License Law tloe5 not apply to an owner of proper builds or proves thereon and who contracts Iof such projects with a contractor(s) license pursuant to the Con tors' le Licens ai wa . that proof of their Worker's Compensation insurance should be provided to m C] I am exempt under Section: B. 8 P. C. for this reasonl Date: ��R" Q I Over i Ido hereby certify that am aware of and understand the requirement of alilornia H m and Sal ety Cotle Sections 25505, 255 3, and 25534 and that l or any future building occupant will not (circle one) need to c ty with said state codes and the requirements lot a perml for construction or rnuddicalion from the Air Oddity Management Dist . Residential Construction applications are exempt from these provisions. = 1641 46 Whne—Bell Green—Code Enforcement: Canary—APPhcand Pink—Bavenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05131: ?ERMIT NO: B 051313 PLAN CHECK NO: 06844-90 A GOVT: N SUPP: N =ONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ FT: 2,153 :LAIM VALUE: 90,000.00 CALL -VALUE: 123,303,10 GROUP OCC: R-3 =OMMENTS: NEW SFD HOLD FOR SPECIAL REQUIREMENTS f #• # # # # # # iFN-dE i! iF li iF %i( # # iE lf # %iE iE iE iE iE 3E iE # lE iE # )t k lE # lF iE # lf lE % #df # aF -0f 3E i(%iF # T!%a(-if IE # # %lf %if if % TE 3E iE lE iE Tf it -1f 1E 4 14 dE Z O N I N GS ERT EBQAUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY ILDING--------- -"RNT: FT IN REAR: FT IN FRNT: FT EAR: FT IN ,EFT: FT IN RGHT: FT IN LEFT: £T N RGHT: FT IN ?ARKING REpp• PROV: PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39 ?LANNING NOTES> UNIT E OF 8 UNIT DETACHED APARTMENT PROJECT > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: 3UILDING APPROVED BY DATE: 4PPLICATION ISSUED BY: DATE: 5qI� :LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ?ERMIT 723,50 8,63 ?LAN 117,57 SMIP/NON-RES ESSUE FEE 3UILDING-DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE tOTALS ---- > •732,13 0,00 117,57 849,70 849,70 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 732.13 OVER/SHORT: ,00 BLDG PLUMBING ELECTRIC MECHANIC FIRE SMIP//T8.63 GRADING PLAN -CHECK N#####i(-#iF jF#IF##iE##lF#iF#IF iF ##iF##F###iF#if•iF##3F IF#####ik iE###iE###iF N#iE#+F if lF Tf iF #iF %3E fE####iF if iFk ff## I N D I V I D U A• I:' F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST iFR 1658 DW$-TYP -WOOD FRAME -GOOD 69,00 119,902,00 iFR 37" RES1 AL �Y EXTERIOR STAIRWAY 13,80 510.60 ;FR 485'; �J R3'YAR SE V 17.30 8,390.50 III' ppq���@Illlppp� ENDS OF FEES MAR 181991 CITY OF COSTA MESA I �JSTRUCTION AND PLAI1!'IiJG APPROVALS Permit # Date Inspector 300L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5,,,Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59, Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undigrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10: Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS; Permit #_' 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Un derground&ydro 22. Ducts, Ventilating - - 71. Product Piping 0Gas 00il 23. Gas, Pipe -Rough &Test- 72. Underground Flush 24. Roof Framing 73. Undergrnd. StorageJank O Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro _ 26. T -Bar Ceiling (Structural) & Monocoat 75. -Dry Chemical - -- 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &Siding 77, FIXED SYSTEM FINAL` 29. Insulation - 78.,FIRE PREV. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT .31. Plaster Brown Coat' _ ,79. FINAL INSPECTION 32. -Electrical Power Meter -Final • 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' �. c% 34. Final Heating & Air Conditioning, - - 35. 'Final Gas Pipe -Test ; ' •' - .36. Hood or Canopy 37. Final Factory Fireplace '38.. Final Plumbing 39. Water Service -Final r 40. Gas Service -Final - 41. Solar Domestic -Final 42. Backflow Preventers 43. Backflow Irrigation - - ,44, Landscape Irrigation System; _ s - _ •45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 2 _' 48.. FINAL PLANNING - 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Cc 51. CERTIFICATE OF OCCUPANCY No. Date - BNI FORM 1 f 6fi BIA FORM 1486 INSULATION CERTIFICATION 711it it to co'Iffy that, Irl confo/rnance with the torrent energy regula0cuit ICalilortille Administrative Code, Title 25, State of Collfofhlao) avid approved plant, Insulation tine heart Installed In the building located 6t: COSTA MESA - -- .. -- - - - -- -' - ---- --ORANGE_ --- Cltv County --—302--E--16th ST_. itE --- -- Nn. NI n..u.m•1 tn..t Lot Nurr.h.r--= tncl No. ---- - DESCRIPTION OF INSTALLATION rIL"B type of 111181011811 E2tTER1Gr1 WALLS Type ofMtledal_ FIIIFRCI,ASS Manufacturer thickness B Value'* Menul.clunf II A N V I LLE Thlckntn _ 312 B Value" 11 " for TI.d. N.,o.) CEILINGS RAtT3: type ofMalildel- F113FRGLASS _Mnulschner HANV11,1,F--_1hicknen 6w AValue" 1 9 In. ted. N.m.j Sq. FLCoyand AIT R.B. INSULATION CO. —. 4260 2nd Avenue LOS ANGELES, CALIFORNIA 90008 Sub-Eenttecmr (ln ufatimn ADoliceter) Phone 291-4167 Lic. 0423R9,se Number Ilmolnlen, Me,n-- ISbt. "SnME" 11 came n O.nn.l Conb.ct Or 42367OC_2 9y -----.-f—— _ Title fel �6 �'� Dela _i 7,c-> -- I-C.Iurv,olo Adndnisheth,i, Cod., Enarov Insul.lion 6andv dr, dacb..1: EsfCEnPT ha,n Sec. 18676 of un llrollh end Selety Cod# at the Stele "Co,n.Ilene#, Upon tonmtr lion of th. InIUll4tlocard n of lntufstion, a of California: crHNy lot that IP, h,rutatlon hes hon In rte liter 11 con/ormmca wllh the n,e0bememl of the,. r.p dpinns 'halt b# emmr,111ed and e.ecuted by "No cefllllcale of occupancy or similar tertillcation that a newlyy to,,. the Imulallan Tpllcelnr and by the build!.. This Invitation c.mpp lisnce ,rutted hotel, motel, apartmntl Imus,, home m other teilmtial Mill shell In nntt•d AI a ton,pltunus location MOW,,dq dwelling." 1 dwollb,q is h.b nab!, shall he Is,ued by such a building d,pe01men1 wdru Ih. Shutt are et lent allsfies pre minimum energy Irlmd,tlom 1^n Valor 11 Ih# meaulce of thp f.shtsoce tit 01011,101 or bullding st.nd.,dteneblhh#d purluenl to this chprer:' tornpanerll to Ih! nl,Vge of IVW. Thp rRllbnce v11ue Inl of ma1DlVme Imvl allnM •hell .01 Include Any valor for re11p0iNt IKing I Fonr tit Form 1166 - — PU ILICNED By () tet' low &0?,, A, IoSS OVERLAND AVENUE, LOS ANGELES, CALIFORNIA 00014 —Illi) 6Taoht et"2 In BUILDINO INDUSTRY ASSOCIATION OF SOUTIIERN CAUFOnN1A, INC., 1511 Beverly MAIL. Lot Angefat, Calif. 60026 - 0111 615 5 7 /1 PROJECT ADDRESS: 3 �j ` ^ E 6 T1'! T UNIT: 7 f 4` OWNER'SABNAME: JrLOYD MYLES DEVELOPEMENT . • 'AceNESS. 423 POPPY AV CORONA DEL MAR CA. 92625 ARCNIENGINEER: 7 2 3— 5 3 0 0 REG.NO.: ADDRESS: UNIT: PERMITTEE: JOHN JANIS PLUMBING ('714) 642-7764 ADDRESS1539 MONROVIA 6 8 LICENSED CONTRACTOR hereby affirm that am licensed undo revisions of Gh(aapar 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my lice in force and e clry uc.. 5; 2 STATE LIC.: 33463 1 G C'— 3 K Dale'. lw9/ Signature: _ — WORKERS' COMPENSATION DECLARATION: I hereby affirm tha ave a certificate of c enc to selbinsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 0. Lab. C). DucY 1 10 913 9 3 . DATe: 0 2/ .1 '92 COMPANY: STATE L 4 Certified copy is hereby furnished. ❑ Certified copy is filed wi a city B Ing Division. tl T Dale ��— (� Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: IThis tion need not be completed if permit is for one hundred (5100) or less). certify That in the performance of the work for which this perm s issued, I shall not employ person in any manner so as to become subject to the WorkersCompensation Laws of California Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Cotleyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. CO LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the fallowing reason (Section 7031 5 Business and Professional Code: Any City of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penalty of not more than five hundred dollars ($500). L as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Commodore' State License Law does not apply to an owner of a property who builds Or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended Cr offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section'. B. 8 P. C. for this reason' Date: _. _ — Owner I do hereby cerbty that I am aware of and understand the requirements of California Health and Safely Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions Date Applicant I hereby certify that I have read this application and state that the above ordinances and state laws relating to building construction and hereby auth property for inspection purposes. C ._ Daie'� Signature. Driver's License or Social Security N. is Cor agreelooyith all city and county Iagree ideabove-mentioned �a 164146 While—Building; Green—Code Enlorcemenunary—Applmanc Pmk—PIvbri Goldenrod—Assessor 4 CITY OF COSTA MESA •- BUILDI:NG PERMIT PERM NO: P 05169: PERMIT NO: P 051691 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ FT: CLAIM VALUE: CALC-VALUE: GR0UP OCC: R-3 /M-11 COMMENTS: REP' B51031.3 fie -X -X#####'###X'X#4c-1E#'##X#di'}:####_%#X###'##X_X He##X'aF dE#'k''####XX'##X )("#%X1E##X X•'#X;?#:#it- 'rt X•Y Z O N I N G R E Q U I R E M E N T S S E T B A C K S --------- -- MAIN BUILDING ---------- --------- ACCESSORY BUILD'ING--------- FRNT: F'C IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 425219.01 ZNE: REF NO: PLANNING NOTES> FIRE SMTP/RES GRADING PERMIT 39,50 25% SMIPINON-RES PLAN D E V E L O P M E N T S E R V.1 C E S_ R E Q U I R E M E N T S ZONING APPROVED BY DUE TOTALS---> 39.50 3.00 0,00 42,50 42,50 DATE: BUILDING APPROVED BY DATE: APPLICATION ISSil `. BY:####DATE: /xx *�_ #'#iF�x '####r. aE##±('#'##%####3F#######-#je fie ###-##}iX###'##X##X_-,ei4'# LEGALIZATION:N F E E S 0 M M 'A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELF.'.RIC MECHANIC FIRE SMTP/RES GRADING PERMIT 39,50 25% SMIPINON-RES PLAN ISSUE FEF.: 3,00 BUILDING-•D.IV-> PERMIT ISSUE PLAN -CHECK TOTAL, PAID DUE TOTALS---> 39.50 3.00 0,00 42,50 42,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 42,50 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 42.50 #sFk####X#if')k:�##34###dr##X####'##3f#'ai'Nlf 3f Y########3E 3E 3?>###D!•X#####'i(#k'-it#lr #iF i6 jF ###.#.-%3i.#.+:'##s(# I.N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 2 BATHTUB 2.00 4,00 PLU 1 DISHWASHER 2.00 2.00 PLU 1 LAUNDRY TUB OR WASHER 2,00 2,00 PLU 1 SHOWER 2.00 2.00 PLU 1 SINK, KITCHEN 2,00 2.00 PLU 4 WASH BASIN 2.00 8,00 PLU 3 WATER CLOSET (TOILET) 2,00 6,00 PLU 1 WATER HEATER AND/OR VENT 2,00 2.00 PLU 1. WATER SERVICE 2,00 2.00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2.00 2.00 PLU 1, GAS PIPING SYS 5+ OUTL-PER OUTLET 50 .50 Q9.00094723-OV034923 _t- -Fal 00a r: 0r4/15/sie1 71118. 14: ,L CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector l -_ _L 'A APPROVALS Permit# Date Inspector .1 A Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. • 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line 8t House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT- REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT, REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test �' l 36. Hood or Canopy 37. Final Factory Fireplace ' 38, Final Plumbing 39. Water Service -Final x/ 40. Gas Service -Final 41- Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE&BUILDING 48. FINAL PLANNING 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: ILICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) at Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a denificale of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3000, Lab. CL 'OLICY NO.: EXP. DATE: COMPANY: 4 ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for One hundred ($100) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature. NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Scotian 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Stale License Law lot the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alley, improve. demolish, or repair any structure, prior to its issuance. also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000( of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselMerself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve lot the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044. Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who Contracts for such projects with a conlractor(s) license pursuant to the Contractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. for this reason: Dale: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant willtwel not (circle one) need to comply with said state woes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have read this application and slate that the above intermit is correct. l agree to comply With all city and county ordinances and state laws relating to building construction and hereby rattail representatives of this city to enter upon the above mentioned property for inspection purposes. Date: Signature: Drivers License or Social Security pr 1641 46 "White—Building: Green—Code Enforcement: Canary—ApplicanC Pok—Revenue: Guldenroo—Assessor PERMIT NO: P 051.691 PLAN CHECK NO: 01295-91 N PAGE: J. X-###NIf TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 GAS SERVICE PLU 1. SEWER, BUILDING / TRAILER END OF FEES 2.00 5.00 iiSDUPLICATE 01 000349233-00034923 TIC": DATE: 04/15/91 TlrE: 1054 2.00 5.00 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector t_,L .TA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement " 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFERGrnd, 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test i 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd, " 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergtnd.Storage Tank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION I 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes. 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST UNIT: E+ OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 AflLNIE NGINEEfl: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 943 POPPY AV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (Commencing wim Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY IIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a Certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof tSection 3800, Lab. C6 POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the City Building Division Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundreo ($1 W) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: It. after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code, you must foMwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ, C). LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052865 PERMIT NO: M 052865 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION NEW SFD W/ATT GARAGE $Q FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51313 PRIMARY BLDG. PERMIT, Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING Nf3TES> > 3flE if lF*iF*iF iF**ie 1F*BE Ie iE iE**4FiE iF 4t•*fE*iEiF iP r 4EBE iE•iE*iE**kis iE*iEiE*it riE XF*ifkraE**iE BE**9F *RE iE If�***BE Rf BE *iE iE ie aA lA iP D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY i DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: 7 /� XE)F iFK*iE iE iE Be iE if *iF aE iE iF *BF iE iE iE iF f'SF'iF'if'RF£iE iE iE JE****XE* *if if iP iE iE*iF if iE iP*iE iF SE iE iE***iE iE iF IF SE iE it*♦E *if lE iE iE *it iE iEit RF BE EiF* riF iF**iF iE ifif-if if iF iE M 3E.iE iE lF iE iF iF IF iF if if if iF ie if-iE if if iE if if LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or PERMIT 44 00 repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed P to the previsions of the Contractors' State License Law tChapter 9 (commencing with Section 7000) of Division 3 of the Business '15S $MIP/NON—RES and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ISSUE ❑ I, as owner of the property or my emloyees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Eechon 7044, Business and Professional Code: The Contractors' State License Law BUILDI TOTALS PERMIT ISSUE PLAN—CHECK does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through DUE ----> his or her own employees. provided that such improvements are not intended of offered for sate. If, however the building or 59.00 59,00 .00 improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve REVENU .00 for the purpose of sale). PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING I, as owner of the property, am exclusively contracting with licensed contractors to construct the eject ( lion 7044, Busi ss 59,00 and Professions Code. The Contractors' State License Law does not apply to an owner of rope who It ds or improves reon iF iE yf ie ieiE iF*kkiE iF kiF*IEM SE iF*iE RF 3E 3t iE BF ik*1F iF IE fEif fE iE if iE and who contracts for such projects with a contractor(s) license pursuant to the to State ease Law). I aware 3(. t(. jp I N D I V I D U A L F E E that proof of their Wor r'S Com Dens n insurance should be provided to m ❑ I am exempt under coon: B. S P. C. for this rt m /J PE Dale'. Owner: I do hereby certify m l am aware el no understand the requirements of C 25534 and that or ny future nuildin occupant will1will not (circle one) nee permit lar C.hSlr Von modification from the Air Oually Management Di these provisions. Dale: I hereby teddy that ordinances and slat property Dale: Driver's )64146 W 4e—D Applicant: i and stale that the Social SecunEy n.' aiding: Green—Code Enforcement: Canary—Appl'crmt. IIn and thy Code Sections 25505. 25533, and MEC with id tate codes and the requirements for a MEC mtia onstruction applications are exempt from all GDldemod—Assessor FE 15.00 NGEDIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ----> 44.00 15.00 0.00 59.00 59,00 .00 E DIVISION TOTALS--> COLLECTED: 59.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 59,00 iF iE yf ie ieiE iF*kkiE iF kiF*IEM SE iF*iE RF 3E 3t iE BF ik*1F iF IE fEif fE iE if iE 3E if iE jF iF*lE,iE*ie BE*BER K•*iF iF if*YiE iF XF ie iF ie Mff if iF 3E iF ie XE iF I N D I V I D U A L F E E B RE A K D O W N QTY D E S C R I P T I O N UNIT COST TOTAL COST 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9,00 9.00 2 FACTORY FIREPLACE 6.50 13.00 END OF FEES / CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & PA APPROVALS Permit # Date Inspector •1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3.' Electrical Conduit Ujility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5; Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6.- Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7.=Footings ? 58. Electrical Conduit-Undrgrnd. ' ' 8. Foundation T' 59. Gas Pipe, ❑ Undrgrnd., Test - 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Troperty Sewer+Line& House Connection 62. Backwash & Receptor -Final . 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final - 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricbl-T Bar Ceiling 69. POOL/SPASYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT' i APPROVALS-' - -Permit # _ 20. -Rough Factory Fireplace \ + C - - 21. Ducts, in Structure , 70. Underg nund HycJro 22. Ducts, Ventilating - r - .r 71. Product;Ptbing ❑Gee OOil 23. ,Gas Pipe Rough &Test ` ; - r 72. Underground FlusFi-, 24.>Ro6f Framing - .. r. 73. Undergrn& Storage Tank E) Gas 00,1-- 25. Roof Sheathing74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat J - - 75. Dry Chemical 27 -Frame and Flashing,' - 76. Dry Standpipe '. % 28. Lathing& Siding. 77, FIXED SYSTENLFINAL. 29. Insulation �.; ', ' 78:> FIRE PREV. FINAL 30. Drywall Nailing + HEALTHzDEPT. REQUIREMENT -31. Plaster Blown. Coat^ 4, 79. FINAL INSPECTION 32.. Electrical Power Meter -.Final 7 80. FOOD CERTIFLCATE ISSUED >33.'FinaI Etectric . y� Notes: - 34. Final Heating & Air Corlditioning,' - fir/9 !�+ ` 35. Final Gas Pipe -Test°-- - w (r+ ,36. Hood or Canopy -' ,-• `; �� - c+ + 37. Final Factory Fire placc �•" ; '' 'y �' S' s ; _. 38. Final Plumbing -P - 39. Water Service -Finals r`" '- - • ^ • 'i 40. Gas Service -Final ;t,.,, -• , ` )'41. Solar Domestic -Final _ �• �':`- 42. Backflow Preventer. 43. Backflow Irrigation 3 i -- •. ,44. Landscape Irrigation System', - 1 �• - 1 ,. - .. _ 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 't 48. FINALPI_ANNING 49.: Electric Release to Edison 50. Gas Release to Southern Califurnia Gas Co ) j. 51. CERTIFICATE OF.O00UPANCY No. Date PROJECT AOOflESs: 302 E 16TH ST OWNER'£NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEEfl: 723-5300 flEC.NO.: ADDRESS: UNIT:E CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 052864 PERMIT NO: E 052864 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE PURPOSE: OTH UNIT:JOB DESCRIPTION ; NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALL -VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 0l the Business and Professions Cotle, and my license is in full force and effect. CITY UC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Ceritied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division Date. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is lot one hundred (5100) or less(. I Ce ify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must fodhvath comply with such provisions or INS permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the hollowing reason (Section 7031.5 Business and Professional Code. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis lot the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. asowner of the properly or my employees with wages as their sole compensation, will do the work, and the ❑ sttoo[ ure is not intended or offered lot sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the firolec ection 7044, Bull s 1z and Professions Code: The Contractors' Stale License Law does not apply to an owner of pmpe who uiltls or improves ern and who contracts for such projects with a contractil license pursuant to the ;�faclSta License LdW),I aware that proof of their Worker's Compensation insurance should be providdt ❑ Iexempt undt/'Section/ B. 8 P. C. forr t this -Cyon �� Date: / I do hereby cert that I am awd. 25534 and the or any future be permit lar r0 'truclirn or mor these provisions. Date: hereby cert"' that I h e read t ordinances and state I rs relating property f s ec Date ` , pyre; _ Owner: of and understand the requirements of C ng occupant will/will not (circle one) nee tion from the Air Olney Management Di Applicant. n and state that the above Signature: Code Sections 25505, 25533, and codes and the requirements for a torn applications are efill from all city Driver 'skIctse or Social Securey a' Applicant: Pink—Revenue: Goldenrod—Assessor COMMENTS: RE: 851313 PRIMARY BLDG. PERMIT. Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > D E V E L O P M E N T S -E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : _ DATE: APPLICATION ISSUED BY: DATE:� ###################### ########## ## LEGALIZATION:Y F E'E' S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 116.06 50% SMIP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 116.06 15,00 0.00 131.06 131,06 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 131.06 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 131,06 ############################################################################## I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1658 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT ,03 58.03 END OF FEES / J a 4L z' CONSTRUCTION AND PLANNING 1 APPROVALS Permit # Date Inspector POO LTSPA APPROVALS Permit 4A Date Inspector ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3: Electrical Conduit Utility-Undrgrnd. 54. Forms 4. _Electrical Conduii-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6•" Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7.. Footings - 58. Electrical Conduit-Undrgrnd. '8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 1Q, SFiuctural Floor System 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final ' 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 16. Rough Electric Wiring / �/� _( 11?1 66. Solar System -Final 67. Fencing & Access Approval - -'17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .APPROVALS Permit # - 20,,Rough Factory Fireplace _' 21. Ducts, in Structute'. - 70. Underground Hydro 22. Dpcts, Ventitating . • 71. Product•Piping 0Oas 0Oil 23. -Gas Pipe -Rough & Test 72. Underground Fla;h _- 24.,Roof Framing - - .73,- Undergrnd,. Storage Tank OGas 0Oil 25. Roof Sheathing '•74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Mono coat .- 75.. Dry Chemical 27. Frame and Flashin§ - 76. Dry Stand'p'ipe 28. Lathing& Siding 77. FIXED SYSTEM: FINAL 29. Insulation 78, -FIRE PREV. FINAL 30. Drywall Nailing a,• Wit. HEALTHDEPf. REQUIRI1MENT 31. Plaster Brown Coaf 32. Electrical Power Metyr-Finaly/1707/Z 33. Final Electric - 34. Final H2ating'& R,ir,Conditioning VV, ,t: / N ` 79. FINAL INSPECTION' - 80.: FOOD CEA IFtGAiE ISSUED- i ," Notes: 35. Final Gas Pipe -Test •• �,�%• r' 36. Hood or Canopy 37: -Final Factory Fireplace �! •• '- ^ -+' 38. Final Plumbing - , •. 39. Water Service -Final - 40. Gas Service -Final -41. Solar Domestic -Final,. 42. Backflow Preventer 43. Backflow Irrigation - + ' 44. Landscape Irrigation Systent ,. - r 45_ Sound Attenuation 1. r n' , 46. Handicap R2gulations 47: FINAL STRUCTURE & BUILDING- 48.FINALPLANNIN6 ••, 49. Electric Relaase to Edison 50., Gas Release to Southern California Gas Co j 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT AUDI"': 302,E 1 6TH ST "OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 flEG.NO.: ° gDORESS: UNIT: F CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO.: B 051314 PLAN CHECK NO: 06843-90 A CONSTRUCTION TYPE: V—N PERMIT TYPE: STR UNIT: JOB DESCRIPTION : NEW SFD PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: STATE LIC,: CLASS: Irole Signature. ORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a Curl of consent to self -insure or a certificate of Workers' Compensation Insurance, or a demoted copy thereof (Section 3800, Lab, C). �OLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed wild the city Building Division Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is tot one hundred ($100) or less). cerhfy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: It. alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must lorthwille comply with such provisions or this permit shall be deemed (evoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit as issued (Section 3097, Civ. Cl. LENDER: ADDRESS: OWNER BUILDER DECLARATION: 1 herehy affirm that) am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed ursuam to the Provisions of the Contractors' State License Law (Chapter 9 (commencing with Section TOM) of Division 3 of the Business 1 Professions Code) or that belshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars (5500). I, as owner of the property or my canloyees with wages as their sole compensation, will do the work, an' the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Slate License Law does not apply to an owner of a property who builds or improves Inereoa, and who does such work himselNherselt or through his or her own employees, provided that such improvements are not intended of offered for sale. It, however the building of improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 1 ` h as owner of the property, am exclusivelyy contracting with licensed and Prolessions Code. The Contractors' Slato License Law does not r antl who contracts for such pmleets with a contractors) license to that proof of their Workei s Compensation insurance should be pri I am exempt under Section: B. 8 P. C. for tots reason. c C, Date: —3 a L-( ner I do hereby oendy that I am aware of and understand the requirements C 25534 and that I or any future building occupant wilgwill not (circle o nee permit for construction or modification tram the Air Dually Management Di these provisions. Date: Applicant: thereby ferny that I have read this application and slate that the ab Ordinances and slate laws relating to building construct, y a x21 property for inspection purposes. Date. _ — Sign Driver's License or Social Security a: e actors to c truct the oject (Se 7044, Business to an o er o7 prop¢ who bu or proves in It 1 onbaclo Slate apse Lbw). I a aJe pf(Health and Safety Code Sections 25505, 25533, and amply with said state codes and the requirements fora Residential construction applications are exempt from on is c ec gree Imply Y` y and county se sot 1sc to enter above- nlioned 1641 46 Whne—BuJgmgl Giovn—Code Entomement; Co6rv—AOpllcam, Plink—Revenue: GOldenroo—Assessor PERM NO: B 05131 GOVT: N SUPP: N PURPOSE: NEW SQ FT: 2,288 CLAIM VALUE: 90,000,00 CALL—VALUE: 130,268,00 GROUP OCC: R-3 / M —k COMMENTS: NEW SFD HOLD FPR iF# E4Elit7�iKatlFkRSE'c1E Z O N I N G S E T B A C' R E Q U I K R S F M E N T S ------------ MAIN BUILDING ------------------- ACCESSORY BUILDING---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REp• PROV: PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39 PLANNING NOTES> UNIT F OF 8 UNIT DETACHED APARTMENT PROJECT > D E V E 1, 0 P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY W kik— DATE:_ BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: S S DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 748,00 9.12 PLAN 121.55 SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 757,12 0,00 121.55 878,67 878,67 .00 REVENUE DIVISION TOTALS--> COLLECTED: 757.12 OVER/SHORT;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 748.00 9,12 I N D I V I D U A,L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1758 DWE—TYPE V—WOOD FRAME —GOOD 69.00 121,302,00 SFR 58 RES—BALCONY, EXTERIOR STAIRWAY 13.80 800,40 SFR 472 —G$ ElYPE V17.30 8,165.60 END OF FEES MAR ig` 1991.. - CITY OF COSTA MESA COMSTRUCTION AND PLAN APPROVALS Permit # Date Inspector _ APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 14. Electrical Conduit-Und rgrnd. 55. Electrical Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test " 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Ffeceptor-Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # y ' 20. !Rough Factory Fireplace - 21. Ducts, in Structure. •70. Underground: Hydro 22. Ducts, Ventilating - 71. Product'Piping EI Gas 0Oil 23. Gas Pipe -Rough & Test , 72. Underground Flush - 24. Roof Framing 73.LUndergrnd.StorageTank OGas OOil 25. Roof Sheathing - - 74. -Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat + 75. Dry Chemical - 27. Frame and Flashing 76` Dry Standpipe 28. Lathing & Siding - - 77. FIXED SYSTEM -FINAL ' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH,DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION - - 32. Electrical Power Meter -Final _ 80. -FOOD CERTIFICATE ISSUED 33. Final Electric ' Note .� 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test` 36. Hood or Canopy r - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System. -45. Sound Attenuation ?. 46. Handicap Regulations' -- 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date �� BNI FORM 1/611�� RIA FORM 1488 Pefv, r 1305131 INSULATION CERTIFICATION' ' Thit it to certify that, In eenTfounnncn with file current nnargy, regulations (California Administrative Cocle, - Title 25, State of Calllolhia•) and approved plans, Insulation has been Installed in the building located at: __COSTA MESA _QBANGF—____— . --City.._._. __..__..__._. County 302 E 16th ST. vv.a Nn, til nvailahi.l - --- Su.•1 _� �_ �— --Lat Ntn..b•r DESCRIP11ON OF INSIALLA11ON r")IF e Type of Mlterhl E7(TE111Gfl WALLS Type ofMeleruf_ rIRERG1,ASS CEILINGS FlA1T6: Type of MElerlal Menufacturer Thickneft R Value" Manufecbnar UNVI LIX _ Thickness —_3; It value 11 10, lead•Nun•) -- 17illr,R(;I,ASS Monuhlclurer MANVLLL6— Thickness 6'—_let Vdue'•1y_--- Sq. h. Coynd A -- (tJr r.•d• N•m•1 I,I, R.B. INSULATION CO. 4260 2nd Avenue LOS ANGELES, CALIFORNIA 90008 Sub'Eonbictor llnulefioo Applicator) Phone 291-4167 Llc. 4423V19nse Nomher 423670C-2 Ilmnlnlon, Nun �, Elc.l ISIR• "SAME" 11 nm� nn By Title Dole (-California Adrnlnhhaq•e Cod•, energy InwlallMr. 94ndu d9, rNclu e9; "Corrntl•ncr. Upon comnlellon of the In9lallallon of Inlalallon, a cord eerllfyins 1hal Ilia bryulalmn b•f been Intoned In tanlormmct with tl,e n.yd nmena or thee- repdalinm shaft IM eamnlned and eel ed by Ure Inrrdarlan Irprellc a for and by the builder, Thil Irnrdaflan corn Hance raid +hall M rolled at a eonmleunu9 Ineallon Withlrr no dwelling'9 1"n Valu• II the mea ... nl do rghl•nca or a malerlal ar bultdi p t�rnppOnenl to file nanevr of heat. The rob port valve In) of man type I,tee vinnr (hell oat Include any vdur for ra nrctive faring I ENCE11PT tram See. 19976 of the 140th itnd Safely Cade of ;he Seale of California: No certificate of occupancy or almllar certification that 1 Mewlyy can Priv ted hotel, motel, 1Oarbnenl houte, borne or other lerldentlel dwell hep it he64,9bre 91,911 be owed by Ruch t building depulmenl urdrn the structure at lean rali91ie9 the minimum energy lomhlhnn standerd+ ellabli9hed purauanl to Ihit chapter:' FtMY lit-l`URLMI(E08y G3 AP"Vi;W^M?..A,, ]OSS OVFRLANO AVENUE. LOS ANGELES, CALIFORNIA OM34-1N31170M71 e1967mviell" Farm 1166 - el IUILOINO INOUSTRy ASSOCIATION OF SOUTHERN CALIFORNIA, INC., 1571 Iayarly livid., Loa Angelss, Calll. 90078 - 0131675 Siff PROJECT ADDRESS: ,1 3 011 E 16TH ST UNIT: F OWNER'S NAME:lilli;a DDRESS ALOYD MYLES DEVELOPEMENT 423 POPPY AV CORONA DEL MAR CA 9,'_625 ARCH/ENGINEER: 7213-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: JOHN JANIS PLUMBING (714)642-7764 ADDRESS: 539 MONROVIA 6 8 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licwsed untler oovismns o Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in f 'area and effect. CITY LID STATE 1554631 ss C-36 - Date ii7 / 78�g0 Signature: WORKERS' COMPENSATION DECLARATION: Iherebyaffirmth have a certificate of close oself-insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 00, Lab, C). IouCY NO.: 1091393 P. DATE: 02/01 92 COMPANY: S'PA'CE ( Ca mill copy is hereby furnished. IDCertified cop Y is fit rit he ct, uiltling Divisio . i5 �i Date: Applitani: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: fill action need not be co in hard i a permit is for one hundred(S100)or less). I Certify that in the performance of the work lot which this per is issued, snail not emplo y person In any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, C7v- C. - LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my empployees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale echon 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselflherself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Cade: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a comractot(s) license pursuant to the Contractors' Stale License Law). I'am aware that proof of their Worker s Compensation insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. for this reason: Date: Owner'. I do hereby certify that I am aware of and understand the requirements of California Health and 25534 and that I or any future building occupant will/will not (circle one) need to comply with s permit for construction or modification.from the Air Quality Management District. Residential these provisions. Date: Applicant: 1 hereby certify that Ihave read this application and state that the ordinances and state laws relating to building construction and herel property for inspecttiioJn purposes. Date: Y4 " io�` Signature: Driver's License or Social Security #: Safety Code Sections 25505, 25533, and aid State codes and the requirements for a C applications are exempt from With all city and County on the above mentioned l 1641 46 Whne—Building: Green—Code Enforcement. C ry—Applii Pink—RevMue: Goldenrod—Assessor VW T . CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 05169i PERMIT NO: P 051692 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ FT: CLAIM VALUE: CALL -VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF B510314 1E##f.###K•X###X..X##%###If#aE##dF###iE#If##lt lE#1i-#XX#%Ili K. l( K_ if#-0r###X. X*1*X_X##X_X_ #XIF## Z O N .I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ------ - FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT )'N LEFT: FT IN RGHT: FT IN LEFT: FT IN RGST: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING Ni 46,50 > .X X I N D I V I D U A L F E E B R E A K D O W N %#########X####%##%'x#############%%±FX#ib%X#•?EX##ii•##ii%##7`#irf####9F%}.###IF####%###IF## TYPE. QTY D E S C R I P T I O N UNIT COST D E V E L O P M E N T S E R V I C E S- •R E Q U I R E M E N T S" ZONING APPROVED BY DATE: BUILDING APPROVED BY -- —---------__-- - DATE: APPLICATION ISS'ED 7Y: #####X#iF##########%#####?f-`c9("iF t"i�af####%### LEGALIZATION:N F E E S BLDG PMT PLUMBING ELEC" I PERMIT 43.50 25% / 7?9-11 .t`* M M A RfY STRUCTURAL SEGMENT:N MECHANIC FIRE SMTP/RES GRADING SMIP/NUN-RF.S PLAN ISSUE FEE 3,00 BUILDING -DIV-> PERMIT ISS -E PLAN -CHECK TOTAL PAID DUE TOTALS-----> 43.50 3.00 0,00 46,50 46.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 46,50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAIN -CHECK 46,50 iX#####M,1y-X .X X I N D I V I D U A L F E E B R E A K D O W N TYPE. QTY D E S C R I P T I O N UNIT COST TOTAL COST Pill] I. BATHTUB 2.00 2,00 PLU i DISHWASHER 2,00 2,00 PLU 1 LAUNDRY TUB OR WASHER 2,00 2.00 PLU 2 SHOWER 2.00 4.00 PLU 1 SINK, KITCHEN 2,00 2.00 PLU 4 WASH BASIN 2,00 8.00 PLU 3 WATER CLOSET (TOILET) 2,00 6.00 PLU 1. WATER HEATER AND/OR VENT 1 00 2,00 PLU 1 WATER SERVICE 2.OU 2,00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 1,00 2.00 PLU 1 GAS PIPING SYS 5+ OUTL-PER OUTLET 01 00054P19-40034917 TOT '501 DATE. 04/15/41 TIP,F: 1::50 IP t CONSTRUCTION AND PLANNING pPROVALS Permit # Date Inspector P._L&SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location L2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement +� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -- 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains t 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping 0Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 000 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing(��% 39. Water Service -Final t 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: ARCHIENGINEER: BEG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of Consent to self -insure or a certificate of Workers' Compensation Insurance. or a candied Copy thereof (Section 3900. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the oily Building Division Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(SIDO) or less). I certify that in the performance of The work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date: Signature: NOTICE: IL alter making this declaration. you should become subject to the Workers Compensation provisions of the Labor Code, you must lormerth comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that mere is a construction lending agency for the performance of the work for which this permit is issued ISection 3097. Gv. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to Construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsSlate License Law (Chapter 9 (commencing with Section 7000) of Division 3 0l the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500). I. as owner of the property or my aDlevees with wages as their sole compensation, will do the work, and the C-1structureis not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving belshe did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Cade'. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contraclor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 8. 8 P. C. for this reason: Date: Dwner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification train the Air Duality Management District. Residential construction applications are exempt from these provisions. Date'. Applicant: I hereby certify that I have read this application and state that the above information is correct. l agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned property lar inspection purposes. Date: Signature: Driver s License or So&hSecwily'M 1641-46 White—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor PERMIT NO: P 051692 PLAN CHECK NO: 012016-91 N PAGE: 2 ###ie#'ri####3f#####-%1F#####lE#7!-!F#}.#?e#?e###a}####J4#IE##3ii'#ie%#%iE+E#u.%##ae it##Y#???i#ifu#jF i•##4iaP iE TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COSI' PLU FLU PLU GAS SERVICE SEWER BUILDING / RAINWATER SYSTEM 2.00 TRAILER 5.00 PER DRAIN 2,00 END OF FEES 2.00 5.00 4,00 _DLIP_11CA-:rrC 01 00084917-00084917 'P07 DATE: 04/15/91 TIME: 1,x:2 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL ,PA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ) 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65, Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 30-2 E 16TH ST UNIT: F OWNER'S NAME: 'LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 flEG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature. WORKERI COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a required copy thereof (Section 3800, Lab. C). POLICY NO.: EXP. DATE: -MPANY: lertified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred ($108) or less), I ter ly that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Codeyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). e LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors Slate License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that throne is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than five hundred dollars (SSIq). EJ I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the sI ruclure is not intended or offered for sale (Section 7044, Business and Professional Code : The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusivelyy contracting with licensed contractors Io constr t the or ect (Seco 7044, Business ono Processions Code: The Contractors' $late License Law does not apply to an own property ho hullds Improves thereon and who contracts lar such projects with a conlraclogs) license pursuant to I ntractors' ate Lice a Law). I am aware/ that proof of their 1 ❑ I am exempt under of this reason', Dale: - do hereby certify 1 am 25534 and that) any tutu permit for cons ctlon or n these orovslo( Dale: I hereby certify that ) have ad this minipanic w elating to property f r InSpe o B. S P. C. Owner understand the requirementss of Californiaealth up ant willlwu not (circle amen neededso to comply with �m the Air Quality Management District. Residential and stale Date: —1 <' Signature Driver's Licen , or Social Secu ty = 1641-46 Whne—Budding, Green—Code Enforcement, ;ode Sections 25505, 25533, and codes and the requirements for a ion applications are exempt from on is correct gre to comply vii icy and esenlativ¢ to enter up abovems Pmk—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 052868 PERMIT NO: M 052868 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION ; NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALL -VALUE; GROUP OCC: R-3 /M-1 COMMENTS: RE: B51314 PRIMARY BLDG. PERMIT. Z O N I N G S E T B R C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE&(� PROV: PARCEL; 42521101 ZNE: REF NO: PLANNING NOTES> > D E V E L O P M E N T S E R,V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: L LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 44 00 35% SMIP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -DIV-> PERM6Jg 0g PLAN-CHEcc0 TOTAL PAID DUE TOTALS ---- > 4 5 00 REVENUE DIVISION TOTALS--> COLLECTED: 59.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 59.00 I N D I V I D U A L F E E B R E A K D O W N TYPg QTY D E S C R I P T I O N 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 2 FACTORY FIREPLACE END OF FEES UNIT COST TOTAL COST 9.00 6,50 13.00 a/ 01 I1 00159, nlj-7l J J �L.l , CONSTRUCTION AND PLANNING PO( SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. -Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53.. Steel Reinforcement ` 3. Electrical Conduit.Utility-Undrgrnd. 54. Forms j 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. -Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grad. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. F6undation 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer,Line & House Connection _ 62. Backwash & Receptor -Final _ 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains -- 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrica'I-Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval -`17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPRQVALS ,; Permit# 20.•Rough Factory Fireplace - - x •- 21. Ducts, in Structure' ` - -"70. Underground H;dro „ 22. Ducts, Ventilating - .71, Product Piping ElGas ❑Oil }72. 23. Gas Pipe -Rough & Test ' Underground FCush - 24: Roof Framing 7 >73. Undergrnf.StorayeTank OGas OOiI:_ 25. RoQf Sheathing .- ' 74. Overhead Hydro c 26. T -Bar Ceiling (Structural) &.Monocoat - _ 75CDry Chemical y : 27. Frame and Flashing ' " 76. Dry Stand ipe - - 28. Lathing:& Siding" , y.• `i _ 77. FIXED SYSTEM FINAL• i 29. Insulation - - '' 78r,FIRE PREY. FINAL ' -30. Drywall Nailing �4+. HEALTH DEPT, REQUIREMENT 31. Plaster BI " own Coat, 1 �„ !; 79> FINAL INSPECT[QN - - 32.Electrical Power Meter -Final .80.• FOOD CEF'TIFICt4TE ISSUED 7- 33. Final Electric • '�" - ./ : •'Notes: r - r - " 34. Final Heating F.ir•' Conditioning - �+/p9 p/� '• ;`r `� - .& r - 35. Final Gas Pipe -Test h. 36. Hood or Canopy -• -` 1i 6," >• ; •' 37. Final Factory Fireplace '='' • '' ��'.a '. 15- 38. Final Plumbing a 38. I '��,-" S .. �• - i -39. Water Service -Final: - 40. Gas Service -Final ••41. Solar Domestic -Final •• •_ r• _ 42. Backflow Preventer 43. Backflow Irrigation ui - r + .44. Landscape Irrigation System ^ 45.. Sound Attenuation - - � - r 46. Handicap Regulations 47: FINAL STRUCTURE & BUfLDING 48.' FINAL PLANNING 49. Electric Release to Edison ( - + 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY " No. Date Y I PROJELTrAGORESS' , ,�0 2 E 16TH ST I owRERSRA'" LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCM/ENGINEER: ADDRESS: REG.NO.: UNIT: F UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions 01 Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERSCOMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell insure or a certificate of Workers' Compensation Insurance. Or a certified copy thereof (Section 3800. Lab, CT POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is riled with the City Building Division Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the pemart is for one hundred(310o) or less), I cattily that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for Such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle1 or that he/sne is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500). I, as owner at the property or my emVloyees won wages as their sale compensation. will do the work, and the Cl structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/hersell or through his or her own employees, provided that such improvements are not intended or offered for sale. If. however the building or improvement is sold within one year of completion, the owner will nave the burden of proving he/she did nor build or improve for the purpose of sale). I, as owner of the property. am exclusivel contracting with licensed contractors to construct the project (Section 7044, Busigpeps L)( and Prolessions Code: and who contracts lot that proal of their W- ❑ am exempt unite or Ilii Dam: do herebyt i at l am a, 25534 and that r any future permit for con ucilon or mo these orovisi Dale: _ I hereby ominanc property Date: _ Driver's 1641-a6 that I have rplo this Contractors' State License Law does not projects with contracmr(s) license p1 COmpensai insurance should be on _ B. 8 P. C. f r Owner. _ and understand the requirements o rich occupant wilUwill not (circle one) need to c from the Air Oualay Management District. Applicant: _ a and state that aware CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052867 PERMIT NO: E 052867 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION ; NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51314 PRIMARY BLDG. PERMIT• Z 0 N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REOQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NCSTES> > 1E iF 1E iE aE iE * 1E 3E aF iF 3E !F iE iF iE 3E iE ik iF iE iE iE * iE 1E iE R! 1E 3F iE iE 1E iPiE iE 3E *!E if 1E of TE BE RE iE iE RE * 3t iE * if if Rf if of N-iF iE BF if iF RE 9E iE 9f * iF aE BE iE aE aE is iF aE R iA D E V E L O P M E N T S E'R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: iE iE iE**RE it iE lE lE if RE 1E iF*if iE iE*IE**lt iFif iE*iE*iE if*1E iF iF *iE 4E iE IE aE it iE iE iE iE iF iE iE 1EiF 1E IF*iE iE*kiF 1E**1E iE SE iE if lE aF iF RE RE 1E iF iE i�iE* *1E 1E iA 1E if RE iE**ifkiElFk IE 3A if lEkiF**iE*jE iE iE ae if**4f LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 123.06 50% SMIP/NON—RES PLAN ISSUE FEE 15.00 XEhNG_D�V—> pgR T 1550g PLAN—CHECC 0 TOTAL AID DUE 18138 E1V8NU8 DIMIf3At $ ^--> COLLECTED • 138 , 06 AVER/SHORT • 00 / BLDG PMPLUM ELECTRIC MECHANIC FIRE SM TOT GRADING PLAN—CHECK S eh Code Sections 25505, 25533, ane EL E ai slate codes an requirements for a construction Spot' tions are exempt from I I to ply with all city tl c Ister upon thea a -me Social 5ecurlTyya: L / mlding: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor iE iE 1F iF if * IE iE iF as 1E RE iE 3E iE 3E IE iE iE iF 4F 4E iE 4E iE ae if * R6 i4IE RE 1E iE * iE iE iF 4E RE * K iF it iE if 1E iE IE iE * 3k iE iF 9E if iF iE iE if fE 9E if-# iF it: iE iF I N D I V I D U A L F E E B R E A K D O W N QTY D E S C R I P T I O N UNIT COST TOTAL COST 1758 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT END OF FEES 03 61.53 LTFITF: 07/ �..m_ .7 is:: :u: — CONSTRUCTION AND PLANNING i APPROVALS Permit # Date Inspector POOL :& SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 1 Soil Pipe-Undrgrnd. 53. Steel Reinforcement 13. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5'; Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical UFER,Grnd. 57. APPROVAL TO COVER-GUNITE 7. Fdotings •% 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, U Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains rL 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 16. Rough Electric Wiring j 7L�1 66. Solar System -Final 67. Fencing & Access Approval "17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough ElectricaF-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPRI3VALS,. ' Permit # r 20. Rough Factory Fireplace 21.yDucts, in Structure .. .. - 10. UndergtouPd Hydro 22. Ducts, Ventilating - - r _ ..' ,71. Product'Piping 0 Gas ❑ Oil 23. Gas PipetRough 8i Test 72. Underground Flush t24. Roof Framing :73. Undergrnd. Storage Tank 0 Gas 0 Gil 25. Root Sheathing `74. -Overhead 'Hydro c6. T -Bar Ceiling (Structural) & Monocoat - 75.: Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding: �- i •t 77. FIXED SYSTEM FINAL -29. Insulation 1 78., FIRE PREY. FINAL 30. Drywall Nailing 31. Plaster Brown Coat 32..Electrical Power Metet-Final3 33.. Final Eletctric 34. Final Heating '& Air Conditioning �4 9L �QZ, I HEALTH:DEPT. REQUIREMENT 79. FINAL INSPECTION 80. -FOOD CERTIFICATE ISSUEDt Noiei_ _ 35. •Final Gas Pipe-Tesf• 36. Hood or Canopy - 37. FinAl Factory Fireplace ,i.j�' •L 38. Final Plumbing %-•�; 39. Watet Service -Final' 4 - 1 } - - y 40. Gas Service -Final = 41. Solar Domestic -Final' 42. Backflow Preventer 43. Backflow Irrigation - - .44. Landscape Irrigation System r ' 45. -Sound Attenuation ' , 46..Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNINGt,- 49. Electric Release to Edison - - -• 50. Gas Release t0 Southern California Gas Co i v 51. CERTIFICATE OF OCCUPANCY No. Date (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 302 E 16TH ST Suite No D Vicinity: ATTIC AND BACK YARD Parcel Number: 42521505 Applicant: MCCOLLISTER, ELISE Address: 27324 CAMINO CAPISTRANO Phone: (949)766-9500 LAGUNA NIGUEL, CA Zip: 92677 Owner: CRATTY, REX ALLEN Address: 302 E 16TH ST #D Phone: COSTA MESA, CA Zip: 92627 Contractor: PREFERRED AIR CONDITIONING SERVICE CO. Address: 27324 CAMINO CAPISTRANO Phone: (949) 766-9500 LAGUNA NIGUEL, CA Zip: 92677 License: 750418 Status: ISSUED Applied: 06/04/2002 Issued: 06/04/2002 7 y ISSUED BY: SCOPE OF PERMIT CHANGE OUT FURNACE 60,000 BTU AND A/C (ELECTRICAUMECHANICAL) MOTOR HOOK UP, HP 3. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/ Alt Absorbtion Unit $0.00 0 Inst FAU <100 k BTU $14.80 1 Repair / Alt Refrigeration Unit $0.00 0 Inst FAU >100 k BTU $0.00 0 Ventillation System $0.00 0 Repair / Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst / Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys <100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys >100 k BTU $0.00 0 Compressors / Absorption Systems Gas Piping $0.00 0 Up to 3 hp / 100k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp / 500 k BTU $0.00 0 Hood w/Meth Exhaust $0.00 0 15 To 30 hp / 1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp / 1,750 k BTU $0.00 0 Vent Fan / Single Duct $0.00 0 Over 50 hp / Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $14.70 1 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers < 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers > 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $53.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646 (6/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: - I hereby affirm under penalty Of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the %Fork for which this permit is issued. ,Zz I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insejante tarn. ndd policy number are: p r .Carrier" � /O til 1yl 5 . W • PolicyNumber:f' (f Z( 1 S '7 y � o (This section need n be completed if the permit is valued at one hundred dollars ($100) or less.) �— ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of CalitoJaiN-and agJa t if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these p�pj�v'jl/ ISs ,APp� :Slgneture:a—CL 'WARNING: FAILURE TO SECURE WORl. COMPENSATION COVERAGE ITUNLAAWUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provision of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full _fo`rce and.effZ7LIc #* �JZ�`'�{ Classa, C �� Contractors Signat�: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031 .5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Cade: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, .or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................................................................................................................................................................................................................................................................................................... ....................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................................................................................................................................................................................... 3 Does or will ENO or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safely Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ........................................................................................................................................................................................................................................................................................................................................................................................ 4 IF an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ..............................................................................................................................................................................................................................................................................................................................................................................I............. 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this Nplication apennit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes Ll No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ..................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................................................................................................................................................................................................................................................................................................ 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 8 (If yes", attach certificate Of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I cBa.noHe upyroo"II"o cupancy_Of an buildina)�horized by this permit until final inspection. .An Or'Authorized Applicant_ 6/v/J ` Date ,f CODE III. INSPECTION TYPE 4 2AU INTMAL CODED INSPECTION TYPE DATE 11�ALS o 1616 Fixed System Final Fire Prevention 206 Final Mechanical 3-a&=.()3 G N 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electncal 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 302 E 16TH ST. Suite No D Vicinity: ATTIC AND BACK YARD Parcel Nunmber: 42521505 Applicant: MCCOLLISTER, ELISE Address: 27324 CAMINO CAPISTRANO LAGUNA NIGUEL, CA ELECTRICAL PERMIT Phone: (949) 766-9500 Zip: 92677 Owner: CRATTY, REX ALLEN Address 302 E 16TH ST #D Phone: COSTA MESA, CA Zip: 92627 Contractor: PREFERRED AIR CONDITIONING SERVICE CO. Address: 27324 CAMINO CAPISTRANO LAGUNA NIGUEL, CA Phone: (949) 766-9500 Zip: 92677 License: 750418 ISSUED BY: Status: ISSUED Applied: 06/04/2002 Issued: 06/04/2002 SCOPE OF PERMIT CHANGE OUT FURNACE 60,000 BTU AND A/C (ELECTRICAL/MECHANICAL) MOTOR HOOK UP, HP 3. COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 246649 (&M) FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $0.00 0 Transformers up to 1 kvalkw $0.00 0 Pool / Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 .................up to 50 kvalkw $0.00 0 Recept Outlets $0.00 0 .................up to 100 kvalkw $0.00 0 Switches $0.00 0 ..................over 100 kvalkw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $0.00 0 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or dde) $0.00 0 Motors to the $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $12.30 1 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $35.80 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 246649 (&M) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the �,work for which this permit is issued. rUd'I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' c9mp�e^nsalion Insurerpcarder an policy number are: ,Carde�-� u-�N 10!/1 (il 5 Imo? • ,Palicy Number, Gl1C Z. �00 (This section need not bb-completed if the permit Is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws alit a, and kg 1 t it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these ns. APPnCent Signature:-Q Da�e-�.CC/1 /d Z— WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($110,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade, and my license Is in lull -force and affect. Uc. a. CDC--lass �G Z� Contractots-Slgnature. -- Date:�ir. CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Data: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document. i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ...................................................................................... ........................... .................................................................... ............................. _.......................... _.._.......... ........................ ............................. _..........._................._..............__..... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................... .... ................................................. ... ........................ ................. ................................. ..................................................... ................ ...................................... ............... ................... -............ .... ................................ 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .......................................................................................................................................................................................................................................................................................................................................................................................... 4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No .............._.__..............—._...._.........................._........._.............. _—__......................... ___ .....................—_........................_—_....................._..._._......................................... _.................. __............... .................. _... 5 Does or will t-he applicant or present or future building occupant require for the work which Is the subject of this a plication agemit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? UYes U No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). ......................................................................................... .................................... -........... ....................... ....................................................................................................................... ................................... ..........................._................... ........ 6 WIII any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if -yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................................................................................................................................................................................................................................................................................................ 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .......................................................................................ian...e.f-....................................................-o--llt-i-....-c-O....................er)............................ ............................ ............ ........................................._.............._................. ................... ............. 6 (If'yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until ffiinnal inspection. awner(s)_ _—_ �( y _ CJ C— di r AuthOdzed'Applicantj_� ` Date `t CODE N. INSPECTION TYPE GdIE INTRIAL CODE;? INSPECTION TYPE DAM INTITALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1286 Pool Spa Final 200 Final Plumbing n /! / 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ON 4 YROJEL'T ADDRESS: 30" E 16TH ST UNIT: D WUF;;S NAME: LLOYPI MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-53001 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 0l the Business and Profession Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: e: Signature: .ORXERS' COMPENSATION DECLARATION: I hereby affirm that 1 have a certificate of consent to sell -insure at a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Cembed copy is hereby furnished. ❑ Ceridied copy is filed with the city Building Division. ,ate; Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thissectlon need not be completed it the permit is far one hundred(slOO) or less). I aendy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Codeyou must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031,5 Business and Professional Code: Any city of County which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed -suanl to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 0l the Business Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031,5 by applicant lot a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). I, as owner of the property or my em levees with wages as their sale compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Pini essional Code: The Contractors' Slate License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended of offered lot sale. If, however the building or improvement is sold within one year of completion, the "net will have the burden of proving he/she did not build or improve lot the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to consimc a project (Sectio 044, Busines ® and Protessions Code: Tne Contractors' Slate License Law dues flat appry to an owner of perry who builds o intimater a and who contracts for such projects with a Contactor(s) license pursuant to the Conti tms' Slate Licen Law),I a are that proof of their Workei s Compensalon insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: I do hereby Coady that I am aware of and understand the requirements of Calif 9tf/ Neal 0 Sa eciio 25505, 25533, and 25534 and that I or any future building occupant wiNvtil not (circle one) need rycomply • , said sla Codes and the requirements lot a permit lot construction or modification from the AirOuallfy Management Des riot. Re ' annul construction applications are exempt from these provision Date. Applicant - I hereby certify mat I have read this application and stal44"4 tion is W ordinances and slate laws relating to building construct nor propertyfofor inspection purppooses Date./ v/ a ^ ( Signature Drivers License or Social Security p: N5 6 1641-46 While—Buildina'. Green—Code Enforcement CaQarv—Aoolicant Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT I PERM NO: B 05131' PERMIT NO: B 051312 PLAN CHECK NO: 06845-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ FT: 2,288 CLAIM VALUE: 90,000,00 CnALL-VALUE: 'e pF1330,,226�8.00 GROUP OCC: R-3 COMMENTS: NEW SFU HiElt i(�E##aF�TIEIk�t,S�L E+H�LaE+E�E�Ea�6>Exx�E�L� K+ N �**�E•Nit9EiF9EkiE9ENBfIF9E9F9E9F9EHEk3E�E9EiEif aE >E >E Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE&(� PROV: PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39 PLANNING NOTES> UNIT D OF 8 UNIT DETACHED APARTMENT PROJECT > 9F iE iE ft iE iE iE1E iE k fE k TF iE AE k iE i4 iE k f! iE if k IE iE * k iE if iE 94 ♦E aE #E 3E 4F iE i4 iE iF aE #E IE i4 iF iE i4 if k IE 9E+t fE kir ♦~ k iE iE iE If I4 14 i4 iE iE iE iE * i4 Y iE 9f IE aE at iE>f D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY WOK- DATE: 3I 11 `L BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: S 3 DATE: 12 9f i4ki4 )a4 i4k1EiE 141E )E iE if 3fiF iE e(i4 iFM TF*iE Bk AE i4 a4 iE #4%.. ?E 94 1E if iF M iE iR IF M IFIE if IF iF BE IE i4 # iE X4 3f IF a4 k M rt IE iE aF IE IF iE iE iE iE IF iE # M IE iF iE i4 iE Rf iFif iE k fE k A! k # M k 94 k }E i4lf i4 fE iE iE IE � NIE iF * iF iF i4 iE it BE * at iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 748,00 9,12 SMIP/NON-RES PLAN 121,55 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 757,12 0,00 121,55 878,67 878,67 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 757,12 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 748,00 9.12 IF iEkaf kE if 4h kiEkiF IE It•iEM♦E i4 i4 iE 44i<IEk YIEk*4iE aE if -V iE 1Fdf Bok IF 9F aE i4 iF aE IE IF 9E 141E iE#x NlE ifkMkk�#iE iEtii4k V•1E*fEi4IE iE�?(�iE 44M*iE fE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O,N' UNIT COST TOTAL COST SFR 1758 DWE-TYPE V -WOOD FRAME -GOOD 69,00 121,302,00 SFR 58 RES -BALCONY, EXTERIOR STAIRWAY 13,80 800,40 SFR 472 Gi SZ TYPE V 17.30 8,165,60 `JJ��NN"" END OF FEES '"A MAR 1 8 199, - CITY OF COSTA MESA l ASINSTRUCTION AND PLA, ,JG OVALS Permit # Date Inspector POOL 'A APPROVALS Permit # Date Inspector i. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' S. Steel Reinforcement. 56. Rough Plumbing & Pressure Test -6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. -' 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS "Permit # 20. •Rough Factory Fireplace 21. Ducts, in Structure - 70. Underground. Hydro r 22. Ducts, Ventilating" 71. Product'Piping O Gas O,Oil 23. Gas Pipe: Rough Si Test 72. Underground Flush 24. Roof Framing - - . 73.' Undergrnd. Storage Tank O Gas O Oil 25. Roof Sheathing - 74. Overhead Hydro - 26. T -Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical _ 27. Frame and Flashing- - 76. Dry Standpipe - u 28. Lathing & Siding - 77. FIXED SYSTEM. .FINAL 29. Insulation 78. FIRE PREY. FINAL .30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ,79: FINAL INSPECTION 32. Electrical Power Meter -Final .80. -,FOOD CERTIFICATE ISSUED ' 33. Final Electric ' Notes:_ 34. Final Heating & Air Conditioning 35.'Final Gas Pipe -Test ,36. Hood or Canopy 37. Final Factory Fireplace: - , - 38. Final Plumbing 39. Water Service -Final - 40. Gas Service -Final - 41. Solar Domestic -Final - 42. Backflow Preventer. - 43. Backflow Irrigation - 44. Landscape Irrigation System .45. Sound Attenuation - 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING .. 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date G3 4N1 FORM 116 ,I p 81AFORM 1488 �' 051312 INSULATION CERTIFICATION This it To rerIlly flint, in confolmanca Willi file t'llrront energy regulations (California Administrative Code, Title 25, Stale of Califolhla') and allploved pians, insulation Iles been Installed In file building located at: COSTA MESA city 302--E-.16th ST. ST__Q_____ <r�••r Nn, 11% gr•IbFbl S'tr•a r"Y►w I Yoe of Mllellel EXTEFt10FI WALLS TyoeelMeplhl_ P1RP.RGI,ASS CEILINGS RATT9: Type of Mattllel _-- -- RANGE---- Counir Let NI .... h—_ -- DESCRIPTION OF INSTALLATION Menulactnlel lhlckners R Vslue" Manufecluter 11All V1 LLE _'Thlckntn _ 31 ITVitus" 11 for lr.de No.n.1 FI 13 ERC I,ASS _Menulectuln MANV11,1,E--__Thickness _RVelue••Lg_`__ for i..d. N.mel Sit. rI. Coveted A L1. R.B. INSULATION CO. -- 4260 2nd Avenue LOS ANGELES, CALIFORNIA 90008 Sub'£oou►clnl fin platin" Aonli siol) Phone 291-4167 Lic. 0423¢,F4roe Number lim.1.11on, Mem �, Etr.l — ----- -- --- -- — ISuu "SAME" 11 some as e.nw•1 Cmnv tic Title Otto 1•CenbmN Adrninh t,anre Cede. t Cher Infl,,I, n f Inbilli Melded "Ce mneme,. Vphe telailo flop M til• Intullrf in of olma non. t cud c•'Illrl^e pill I,1e Irnul.11nn fills been Int Ulled In conlor mend with tW ono h.memt of thele rep dpinnt shell tie tmmleted and ..eculed by the Imnlpipn nprol"hir and by the bullder. This Inooatloo cnmplisnce eud d, ell M posted at a eomoleunus mrstion within 11ne dweting"I 1••18 Va1M to the m18uus of 11+• rvilh t. of a megll.l m bonding ampppon•nl to rhe natv+q, of 11181. Th• rpunonc, vslu• (n) of mnotvne h+orle Ilnn, shall not inclmde any valve for 01eejlvt Iae,Ing I 423670C-22— ExCEnFT hom Sec. 19916 of ll+a 11,8116 end Safely Code of he State of Cstllornla: "No certllicote, of occupancy or limits, eer Ullcsllon that a newt Co.,. llruged hold, motel. Madmen( limits, home or other ,esldl•n0sl dwenlnq H b.httobl. 11.811 M Inued by brch a building denarmvnt wden If,, nruclu,e at least alidies ilia minimum tnerev InhdsOno st.nd.,dt established pwithint to his chl,plir;' FORM 111 _PUITLIAIIEDRY M Bw)taiTf&p?.,A, 3055OVERLANOAVENUE, LOS MOMS. 01-11ORNIAOM34—Itlt)110M71 biletWMI11" Farm 1119 – 0 9UILOIND INOUSTDV ASSOCIATION OF SOUTHERN CALIFORNIA, INC., 1511 9aratly filled., Loa Antale, Calif. 90018 – Itd) 67551/1 qv S PROJECT ADDRESS: 302 E 1 6TH ST —OWNER' NAME: LLOYD MYLES DEVELOPEML•NI '71N HESS: 4:33 POPPY AV CORONA DE --1 MAR CA 92625 ARCHIENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: D C-LTY OF COSTA MESA.— BUILDING PERMIT PERM NO: P 05169`_ PERMIT NO; P 051695 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: NEW UNIT: PERMITTEE: JOHN JANIS PLUMBING ('714) 642-7764 ADDRESS: 1539 MONROVIA 8 NH CA 9—, 63 LICENSED CONTRACTOR DECLARATION: 1 hereby affirm that 1 am licensed un m monist s Chapter 91 racing with Section 7000) of Division 3 of the Business and Prolessrom Code. and my license is . f I force n stied. CITY LIC.: 5'820 STATE tic.: 554631 C S: _ Dale: �/g �/ Signature: WORKERS' COMPENSATION DECLARATION: I hereby aflumthat l have aficale of consent to self- a to or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. L 1. POLICYNO.:1O91393 EXP. OAT 02/ T/92 1 COMPANY: STATE ` . Certified copy is hereby Wmished. ❑ Certified copy is fill wi the d wilding gvisror t 1 �kF Date: I applicam: EKEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This • min need of be complet permI is for one hundred (5400) or less). I cenity that in the performance of the work for which lh¢ permit , issued. ) Shan not emplo• .y person N any manner Co as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It. alter making this declaration. you should become subject to the Workers Compensation Provisions of the Labor Code. you must forthwith comply win such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: JOB DESCRIPTION NEW SFD SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 E COMMENTS: REF B510312 Z O N I N G R E Q U I R E M E N T S S E T B A C K S „----------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- :RNT: FT IN REAR: FT IN FRNT• FT IN REAR: FT IN LEFT; FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> PLAN 2,00 4,00 FLU 1 any applicant tar a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). ISSUE FEE ###V, #}:.#### kIF* ir##}'.###########ie######)r###)i�9F###le###}:######## 3 .00 D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY ISSUE PLAN—CHECK TOTAL PAID DATE: structure is not intended or offered lorsale(SSeection7044,Business and Professional License TOTALS ---- > BUILDING APPROVED BY 3,00 0.00 44 , 50 44.50 DATE: does not apply to an owner of a property who builds or improves Iherem, and who does such work himemil/herself or through APPLICATION ISSUED WATER SERVICE 2,00 DATE: .06 his or her own employees, provided that such improvements are not intended or offered tar sale. If, however the building or is CoM winner one year of Completion, the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 44 .50 OVER /SHORT •00 PLU LEGALIZATION:N F E E S VM M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from did Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECT :.C: MECHANIC FIRE SMIP/RF.S GRADING (Section 7031.5 Business and Professional Code: Any city of County which requires a permit to construct, alter, improve, demolish, or PERMIT 4 1 5 0 2,00 2,00 repair any structure. poor to Ns issuance. also requires the applicant for such Wool to file a signed statement that he/she is licensed pursuant to the provi eons of the Contractors' Stale License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business 1 LAUNDRY TUB OR WASHER . 252 SM I P / NON—R ES and Profession Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by PLAN 2,00 4,00 FLU 1 any applicant tar a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). ISSUE FEE 2,00 3 .00 4 WASH BASIN I, as owner of the property or my mr, oyees with wages as their sole compensation, will do the work, and the Code: The Contractors' State Law BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID D13'-;'0 structure is not intended or offered lorsale(SSeection7044,Business and Professional License TOTALS ---- > 41.50 3,00 0.00 44 , 50 44.50 2,00 does not apply to an owner of a property who builds or improves Iherem, and who does such work himemil/herself or through 1 WATER SERVICE 2,00 2,00 .06 his or her own employees, provided that such improvements are not intended or offered tar sale. If, however the building or is CoM winner one year of Completion, the owner wit have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 44 .50 OVER /SHORT •00 PLU 'improvement for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of the provenly. am exclusively contracting with licensed contractors to Construct the project (Section 7044, Business ❑ improves 01 44084419-2P�EY41; D T 44.50 and Professions Code: The Contractors' State License Law does of apply tow owner of property he builds or thereon and who contracts for such projects with a corbactor(s) license pursuant to the Contractors' Slate License Law). l am aware that Drool of their Worker's Compensation insurance should be provided to me. %.);.#iF#.if.#####i4<###?(####iP##li if##iF####f+E#?F#######+r;{.#.Y#rk#if#ib 3i IF ❑ I am exempt under Section: B. N P. C. I N D I V I D U A L F E E B R E A K D O W N lot this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale'. Owner: I do hereby certify that I am aware of and understand the requirements of California Health a 25534 and that I or any future building occupant wiNwin not (cirU¢ one) need IO comply with permit for construction or modification from the Air Duality Management District. Residential these provisions an Date: Applicant:_ I hereby certify [hat I have read this application and slate that ordinances and stale lam relating to building construction and h properly for inspection ` l/ectionn purposes. Date q" t, J � SignatureZ `\ r64L46 White-8mlding: Green—Code Enter, em; C Safely Code Sections 2551)5, 25533, and said state codes and the requirements for a construction applications are exempt from is cone gree to comply with all city and county ntaliv of rsciry to enter upon the dbove�meniien¢d ik—Revenue; Go demod—Assessor PLU 1 BATHTUB '2,00 2,00 PLU 1 DISHWASHER 2,00 2,00 FLU 1 LAUNDRY TUB OR WASHER 2,00 2,00 PLU 2 SHOWER 2,00 4,00 FLU 1 SINK, KITCHEN 2.00 2,00 PLU 4 WASH BASIN 2.00 8,00 PLU 3 WATER CLOSET (TOILET) 2,00 6.00 PLU 1 WATER HEATER AND/OR VENT 2,00 2,00 PLU 1 WATER SERVICE 2,00 2,00 FLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2,00 2,00 PLU 1 GAS PIPING SYS 5+ OUTL—PER OUTLET 50 ,50 01 44084419-2P�EY41; D T . w.m—; [ . r -.. FA J item' Ah rCONSTRUCTION AND PLANNING APPROVALS Permit # Date 1 Inspector PtWPA APPROVALS Permit # Date Inspector 1l� Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final , 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing p� 39. Water Service -Final C/ 40. Gas Service -Final 41, Solar Domestic -Final 42, Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a cenificale of Workers' Compensation Insurance. or a certified copy thereof (Section 3800, Lab. Q. LICY NO.: EXP. DATE: MPANY: Certified copy is hereby furnished. ❑ Confined copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason (Section 7031.5 Business and Professional Cade: Any city of county which requires a permit 10 construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit 10 file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code : The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employeesprovided that such improvements are not intended or offered for sale. If, however the building or Improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business E) and Professions Code : The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contraclogs) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. for this reason'. Date'. Owner: I do hereby oenify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that t or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that l have read this application and slate that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. Dale'. Signature: Driver's License or Social Security #: 1641 46 White—Building: Green—Cade Enforcement: Canary—Ammil Pink—Revenue: Goldenrod—Assessor PERMIT NO: P 051695 PLAN CHECK NO: 01299-91 N PAGE: 2 #N-#XX###X#1E##k#9(X?E###X##10#3i*BE###X#3E X iE****##34R#X*KX-if3FieY**3x; **44. ii+:.##.Y TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 GAS SERVICE PLU i SEWER BUILDING / TRAILER PLU I RAINioi SYSTEM — PER DRAIN END OF FEES 2,00 5,00 2.00 01 00034919-00984919 '$ O, DATE: 04/15/91 TIME: 1�:,2 2,00 2.00 A& CONSTRUCTION AND PLANNING 111W APPROVALS Permit # Date Inspector P ' SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms. 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE , 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final - 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit =6'- 20. Rough Factory Fireplace 21. Ducts, in Structure 21. 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 26. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy ' 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST UNIT: D OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby annin that am licensed under provisions of Chapter 9 (commencing with Section 70001 0l Censure 3 0l the Business and Professions Code. and my license is un fun lone and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby atfirm that I have a certificate of consent to sell insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section M. Lar. C). POLICY NO.: EXP. DATE: COMPANY: 7 Certified copy is hereby famished. ❑ Certified Copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORXERS' COMPENSATION DECLARATION: (itis seam need not be cwVWed it the pmnt 6 fo one hundred (Slog) ar Iessl. I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should became subject to the Workers' Compensation Provisions of the Labor Code. you must forthwith comply win such provisions or INS permit shag be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there 6 a construction keeping agency lot the performance at the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby aNjrm that I am exempt lmnl the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any my of county which requires a permit to Construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors State License Law (Chapter 9 (Commending with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemp0on. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (550(1). I. as owner of the property or my empployees with wages as their sofa compensation, will do the work, and the Cl structure is not intended or offered for sale(Seclion 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds; or improves Oepron, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended at offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build ar improve for the purpose of sale). I, as owner of the property, am eecfusivel contracting win licensed contractors to construct the prole (Sec n 7044, Busines and Professions Code: The Contractors' Slate License Law daps ad[ apply to an owner 01 or pert DWd or Improves that and who contracts for such projects In a Contractors) license pursuant to the Co is le Lic se ),I am are that proof of their War pr's Camper n insurance should be provided to m ❑ 1 am exempt under ,action: B. 8 P. C. for this reason: Date: Dwner. oo herebypreby c� I am aware o and understand the requirements of alilornia Nea In and S Code Section 5505, 5533, ono 2553" ono Ihal r any future bui101 octupam wilik ill not (circle one) need to comply with sai late Codes and the requirements for permit for can^ ruction or modification from the Air Duality Management District. Residential c struction applications are exempt Ir these provisio Dat¢'. A dhirant'. I hereby tardy Iha1 I h ve redo this a IiWlimlono sial . above form ori i5 c �cl ¢ a comply with ail y and c ortlinando, ono Slate Cos relating to .�prt1q canstruclan ono hereby r@ presen Iva his enter upon the eve property for - ec �ofn /purpppns. Date: v �� Signator Driver's LIc se or Social S then/ x: 164646 While—Building/ Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052863 PERMIT NO: M 052863 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC /' PURPOSE: OTH JOB DESCRIPTION : NEW SFD W/ATT GARAGE SQ FT; CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51312 PRIMARY BLDG. PERMIT. �¢*�E�**it 3lyE**�aFft**�F*41 it**4l***�F�E+tit�EXE�r+EiE+F�iEaEr**it�E�E**+f�TE�E*��ETr�yr*TEit*yr+E�ft*atr*��+E*itft+F*�+t Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO; PLANNING N TES> ifiFitiF+F�¢iFkiF�E****it�Eie��E�tyFiE+titar�E*SPT¢��E�P��Eif*�E*�E#tiEiETt*aE��E�E*�E�E�E*k��E*cif*+EitiFiE�E+ar*�FyL�F1e*ac+t**�P+fa D E V E L O P M E N T S E R.V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: L of it k OE BE eF 9F iE * 5E it iE aE ie * 3l * ie it ie iE iF �3f If * it * iE kE iF * it ie3F5�iE k IE iF*aE iE IE iF iE iF if iE iE*iF**1ElE#IP iE if iE ie*kif kif KF it lE kit*iE iFal IE iF til aF Bl**iF*#*iF if*iF SF if iE SEBE**RE aE iE iF iF aF of aF*aF iF iF it ie iF LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 44 00 25% SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 44.00 15.00 0.00 59.00 59.00 .00 REVENPE DIVISION TOTALS--> COLLECTED: 59.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 59.00 KE If iE 1e Bf it Il if 1F it ie 1F iF aF fE iE aF Bf IE it iF k k aF * * * ie 1l il1F * it jl le at 1e iF 3E iF iF if ie N• iF k * le 1E 3e it k iF if iE it rt * iE lE iF BF iE iF ae iF it iF iEiE k iF BF iP IE 5E ql I N D I V I D U A L F E E B R E A K D O W N T QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9,00 MEC 2 FACTORY FIREPLACE 6.50 13.00 END OF FEES • CONSTRUCTION AND PLANNING r APPROVALS Permit # Date Inspector POOH _ oPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.'Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical CondunAt tdrgrnd. 55. Electrical Bonding ` 5. Steel f cinforcement 56. Rough Plumbing & Pressure Test '6 Electrical LIFER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings T ' 58. Electrical Conduit-Undrgrnd. ' 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer ,Line & House Connection 62. Backwash & Receptor -Final' 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains t 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final , 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval -- 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electricat-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS: Permit # 20. Rough Factory Fireplace 21. Dums, in Structure ,70. Underground Hydro 22. Ducts, Ventilating -' ' „71. Prod uct'Ptbing 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground FlusiT 24. Roof Framing •73: Undergrnd. Storage -Tank 0 Gas 0 Oil 25. Roof Sheathing - • 74'Overhead Hydro 26. T -Bar Ceiling (Structural) & Monoeoat 75: Dry Chemical r 27.•.Frame and Flashing 76. Dry Stantip pc 28. Lathing & Siding - . . s••' i 77. FIXED SYSTEM -FINAL 29. Insulation 78., FIRE PREY. FINAL •30. Drywall Nailing I}' HEALTH -DEPT. REQUIREMENT 31. Plaster Brown Coat; -Meter ,39. FINAL INSPECTION 32. Electrical Power -Final 80. FOOD CERTIFICATE ISSUED •' r 33. Final Electric 34., Final Heating &Air Conditioning :'•*'-' Notes: 35. Final Gas Pipe -Test' _ - ,36. Hood or Canopy- 37. Final Factory Fireplace 38. Final Plumbing t 39. Water Service -Final " s i 40. Gas Service -Final. -41. Solar Domestic -Final - - 42.' Backflow Preventer 43. Backflow Irrigation' - - 44. Landscape Irrigation System; , •. - 45. Sound Attenuation 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison (� 50.. Gas -Release to Southern Califurnia Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date IRJECT ADDRESS: 3Q2 E 16TH ST uxlT: D �'• CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052862 OWNS OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV PERMIT NO: E 052862 PLAN CHECK NO: N GOVT: N SUPP: N CORONA DEL MAR CA 92625 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH 723-5300 ARCM/ENGINEER: REG.NO.: JOB DESCRIPTION ; NEW SFD W/ATT GARAGE SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV COMMENTS; RE: B51312 PRIMARY BLDG. PERMIT. CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section Z O N I N G R E Q U I R E M E N T S 7000) of DIwe1Un 3 of the Business and Professions Code. and my license is in full force and effect. S E T B A C K S CITY LIC.: STATE LIC.: CLASS: Dale: Signature: ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- WORKERS* COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent tosell-insure oracerlilicateofWorkers FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: IN RGHT: Compensation Insurance. or acertified copy thereof (Section 3800, Lab. Q. FT FT IN POLICY NO.: EXP. DATE: COMPANY: PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: ID Certified copy is hereby furnished. ❑ Certified copy is tiled with the city Building Division. PLANNING N TES> > Dale: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred 1$1001 or less). D E V E L O P M E N T S E,.R V I C E S R E Q U I R E M E N T S I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the workers' Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor BUILDING APPROVED B YDATE : Code. you must lona lh comply with such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY : DATE : �99&� e� which this perms is issued (Section 3097. Civ. Cl. � `TE`>r# ###################### r ########## ## -LENDER: ADDRESS: LEGALIZATION:Y F E;E S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby alirm that l am exempt from the Contractors' State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES �RADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish. or PERMIT 123.06 repair any structure. prier to Is issuance. also requires the applicant for Such permit to file a signed statement that helshe is licensed 50%SMIP /NON—RES pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business PLAN and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of net more than live hundred dollars ($500). ISSUE FEE 15 .00 ElsI, as owner of the property or my employees with wages as their sole compensation, will do the work, and the The Contractors' State License Law BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID I DUE TOTALS ----> 123.06 15.00 0.00 138.06 138.06 tructureisnotintendedorofferedforsale(Section7044,BusinessandProfessionalCode: does not apply to an owner of a property who builds or improves thereon, and who does such work himsett/hert ell Or through .00 his or her own employees, provided that such improvements are not intended or offered for sate. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED • 138.06 OVER/SHORT: 00 impromnt is sold purpose of sae), one year of completion, the owner will have the burden of proving tie/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 138.06 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ON builds antl Professions Code: The Contractors' $late License Law does not apply to an owner of property who or Improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' Slat License Law). l am aware that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A L F E E B R E A K D 0 W N ❑ 1 am exempt under Se 1on: B. 8 P. C. mrthls reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale: owner: ELE 1758 NEW RES BLDG FOR 1 OR 2 UN—ITS/ SQ FT .03 61.53 do hereby cemly Thal m are of d undersl nit the requirements C a and Salol Cad ec -� ns 25505 55 ,antl END OF FEES 25534 and foal I or an fulure building ttupanl will/ 'll nm Id comDl iln Saitl sla�Y es d rte requi({ is for a Perm for conslrutlt or modification from the arta a istrict. R d ial Constru on he are mpt from these provisions. Date: Doll, .. I hereby certify that I have ad this appli ion and slat at the an e i pry Ion i mect I agr o compI a ly and co y ordinances an tl sial lawslaling ui gcon5'r�Clion and here to rept¢ lalives of thit d ler upon the oveme nod for _ 00 00D52787- CUpu^i9': property In. on ses. !/ ///// Dale: Ignature: Driver's License C Social Scent, , a: 164146 Whuo Bulldmg: Green—Code Enforcement: Canary—Applicant Pm—Revenue; Goldenrod—Assessor 14 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOSPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or -Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3., Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding " 5. -Steel Reinforcement 56. Rough Plumbing & Pressure Test .. 6. Electrical UFEF7 Grid. 57. APPROVAL TO COVER-GUNITE 7. footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floot System 61. APPROVAL TO DECK - 1.1. Property Sewei.Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final _ 14. Rough Plumbing 65. Etectrical-Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 7 as 41 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,APPROVALS' .• Permit # 20. Rough Factory Fireplace - _ - _ 21.'Ducts, in Stryctuie, •� - _70. Underground Hydro 22. Ducts, Venttlatirig _ - 71. Product,Piping 0 Gas 0Oil 1` 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing .� r - ••73. Undergrnd•.Storage Tank OGas 0Oil 25. Roof Sheathing '•' ' '•74Overhead•Hydro- 26. T -Bar Ceiling (Structural) & Mono coat 75. Dry Chemical 27. .Frame and Flashing _ - ° 76. Dry Standpipe 28: Lathing.& Siding _ > 77, FIXED SYSTEM FINAL '29. Insulation 78.'FIRE PREV. FINAL - :30. Drywall Nailing •y f. HEALTH DEPT. REQUIREMENT 31. Plaster &own Coat` 32. Electrical Power Meter -Final 33. •Final Electric"` -r "/- i 3/d qz r�$� �% ' •'�., 79.• FINAL INSPECTION 80.E FOOD CE'RTIFICAT.E ISSUED Notes: ' 34. Final Heating & k.ir Conditioning- 35. Final Gas Pipe -Test - .. 36.- Hogd or Canopy" i 37. Final Factory Fireplace F" 1 - 38. Final Plumbing i - - ,• „• - 39. Water Service -Final. I 'l+ •• 40. Gas Service -Final '41. Solar Domestic -Final - 42: •Backflow Preventer' 1 JI 43. Backflow Irrigation - 44. Landscape Irrigation System 1 45. Sound Attenuation r • - . :46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING `y• 48, FINAL PLANNING '' i •i'�; ; i . 49., Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OFOCCUPANCY No. Date I OPACTADD�IESS: 302 E 16TH ST UNIT: B WNER'S NAME:, LLOYD MYLES DEVELOPEMENT /// ADDRESS: 423 POPPY AV CORONA DEL MAR CA92625 723--5300 LARCNIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (710723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. .CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a bemired copy thereof (Section 3800, Lab. C). POLICY NO.: EXP. DATE: COMPANY: Certified copy is hereby furnished. ❑ Candied copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred(SIOD) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date: Signature: ' NOTICE: If, after making this deolannu on, you should become subject to the WorkersCompensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: IOWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code. Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed ,ursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business no Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500)' , II, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale)- ,as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business N and PrOte651Ona Code: The Contractors' State License Law does not apply to an owner of prop y who builds or improve eon and who contracts for such projects with a contractors) license pursuant to the Contract State License Law). m aware that proof of their Worker's Compensation insurance should be provided tome. ❑ I am exempt under Section'. B. & P. C. for this reason: Date'. —�g 9 Owner: I do hereby candy that I am aware of and understand the requirements of dowma /Hdlalt�tthmd aide, Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need tp comaid state codes and the requirements for a permit for construction or modification from the Air Duality Management Oistnce. Rconstruction applications are exempt fromthese provisions. Date: Applicant: I hereby certify that I have read this application and state that the ordinances and state laws relating to building construction and property for inspection purposes. , Date:_ / 1�, _ 7/ Signature Driver's License or Social Security p: 1641-46 White—Building: Green—Cotle Enforcement: Ca ry—Appllcant: Pink—Revenue: Goldenrod—Assessor Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39. PLANNING NOTES> UNIT B OF 8 UNIT DETACHED APARTMENT PROJECT D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: 3/t2_(`(I BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: �_ DATE: -31-2—/91 #F BF IE iF*iE 3e BE iF iE iE RF iE iE ifxxik iE*xx3biF"iF�iFbFiFiF it WTE* itiF'ii?'FiFiFiF7F3F aE if #iF iF iE iF lE iE iF 36 x Rl• iE DE Rf M * * 1F if iF Edit iF iE M 36 a6 Bf iP ik IE a4 * * M iE iE iE if DFiE i4 !E it x i8 iE iPlE lP iE * * BE * iF iP iE TE ik Bt iF iF lE if x iE aE iF if BF iE RE 4E ie iF Rt 1F IE IE iF IE iF 3P BE iE is iF -7f LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 748,00 9.12 PLAN 121,55 �_ SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE. PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 757,12 0,00 121,55 878,67 878,67 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 757.12 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 748.00 9,12 �f'iE k #f iE iP k.x 14 # 3F iE iF # ik iF ih iE i6 of ik i4 iE iE i!# if if iE iF 1E 3f #E i(if iF if if iE if iE if if 3h if iE IE k if iF )f iF If fE iE iF iE lE 7F if if iE ±41F iF K i4 iE #4 iF iE i(ik iE x lE #f IE # )E I N D I V I D U.A L F E E B R E A K DO W N TYPE QTY D E S C R I P T I'0 N UNIT COST TOTAL COST SFR 1758 DWE—TYPE V—WOOD FRAME —GOOD 69,00 121,302,00 SFR 58 RES—BALCONY, EXTER-IOR'STAIRWAY 13,80 800,40 SFR 972 RF TWX kV OF FEES 17,30 8;165.60 " D MAR 18 1991' b CITY OF COSTA MESA 5 o CITY OF COSTA MESA — BUILDING PERMIT. PERM NO: B 05131 PERMIT NO: B 051310 PLAN CHECK NO: 06847-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: NEW JOB DESCRIPTION ; NEW SFD SQ FT: 2,288 CLAIM VALUE: 90,000,00 CALC—VALUE: - 130,268.00 GROUP OCC: R-3 COMMENTS; NEW SFD HOLD FOR SPECIAL RE9RIP �I �EiE�E�EaE�E�E�E�E�B�titxiE�Lxx�B*x* 6 raEaE�Ex*�E**�E*�E* �r*x�E*aE�+Ex*+E*x�raE�E�6*�P�k*a x�L*x Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39. PLANNING NOTES> UNIT B OF 8 UNIT DETACHED APARTMENT PROJECT D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: 3/t2_(`(I BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: �_ DATE: -31-2—/91 #F BF IE iF*iE 3e BE iF iE iE RF iE iE ifxxik iE*xx3biF"iF�iFbFiFiF it WTE* itiF'ii?'FiFiFiF7F3F aE if #iF iF iE iF lE iE iF 36 x Rl• iE DE Rf M * * 1F if iF Edit iF iE M 36 a6 Bf iP ik IE a4 * * M iE iE iE if DFiE i4 !E it x i8 iE iPlE lP iE * * BE * iF iP iE TE ik Bt iF iF lE if x iE aE iF if BF iE RE 4E ie iF Rt 1F IE IE iF IE iF 3P BE iE is iF -7f LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 748,00 9.12 PLAN 121,55 �_ SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE. PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 757,12 0,00 121,55 878,67 878,67 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 757.12 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 748.00 9,12 �f'iE k #f iE iP k.x 14 # 3F iE iF # ik iF ih iE i6 of ik i4 iE iE i!# if if iE iF 1E 3f #E i(if iF if if iE if iE if if 3h if iE IE k if iF )f iF If fE iE iF iE lE 7F if if iE ±41F iF K i4 iE #4 iF iE i(ik iE x lE #f IE # )E I N D I V I D U.A L F E E B R E A K DO W N TYPE QTY D E S C R I P T I'0 N UNIT COST TOTAL COST SFR 1758 DWE—TYPE V—WOOD FRAME —GOOD 69,00 121,302,00 SFR 58 RES—BALCONY, EXTER-IOR'STAIRWAY 13,80 800,40 SFR 972 RF TWX kV OF FEES 17,30 8;165.60 " D MAR 18 1991' b CITY OF COSTA MESA 5 o _-• r.� CON"!IIUCTION AND PLANNING APPROVALS Permit # Date Inspector POC SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,1 3. ,Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '• 5: Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE "7.' -Footings 58. Electrical Conduit-Undrgrnd. 6. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Un&grnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - APPROVALS: _Permit #-- " 1 1 1 - J 20. Rough Factory Fireplace ' _ 21. 21."Ducts, in -Structure: - ;70. Underground Hydro 22. Ducts, Ventilating - - - -71. Product'Piping ❑'Gas ❑Oil 23. :Gas Pipe -Rough & Test r - 72. Underground FlusH ' 24.iRoof Framing`73.'Undergrnd.Storage;Tank 0Gas 0Oil - 25. Roof Sheathing - '; .74. Overhead Hydro ­ 26.,,t -Bar Ceiling (Structural)y & Monocoat _ - !� - 75. -Dry Chemical .. " - •� �_i 27. Frame and Flashing ; 76. Dry Standpipe i^- 28 Lathing & Siding - - 77.' FIXED SYSTEM.FINAL-- 29. Insulation1 78.: FIRE PREV. FINAL _ =30. Drywall Nailing - HEALTHDEPT•. REQUIREMEN``T ;-� 31. Plaster Brown Coat ,79 -FINAL INSPECTION = •=�_ 32. Electrical Power,Meter-Final - .80..FOOD CERTIFICATE ISSUED- 33. Final Electric r p "Nofes. .34. Final Heating &Air. Conditioning• „ -'t; 35.,Final Gas Pipe -Test' - - I'1'• •36. Hood or Canopy- 37. Final Factory Fireplace •- 38.. Final Plumbing . 39. Water Service -Final• 3" - .40YGas Service -Final 41. Solar Domestic -Final - - 42. Backflow Preventer• - - J 43. Backflow Irrigation 144. Landscape Irrigation System' -45. Sound Attenuation 46. Handicap Regulations '.. 47. FINAL STRUCTURE & BUILDING h 48. FINAL-R{A#N1NG 49. Electric Release to Edison 50. Gas Release to Southern California Gas Coy ,- 51. CERTIFICATE OF OCCUPANCY No. Date PEjiJECT ADDWISS'.'in •7 E 16TH ST UNIT: B OWNER'S 11LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV .CORONA DEL MAR CA 92.625 ARCHIENGINEER: 7213-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: JOHN JANIS PLUMBING (714)642-7764 ADDRESS: 1539 MONROVIA 8 LICENSED CONTRACTOR DECLARATION: I hereby affirm fnal I am licensed under prrov' ns CA of Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full to antl effect. CITY LIC y�r 2p STATE LIC.:r�54631 S:: r -36 Date: . 17J9—� Signature: _ .(�.. WORKERS' COMPENSATION DECLARATION: I hereby affirm that I h a certificate of consent to -insure or a certificate of Workers' Compensation Insurance. or a Certified Copy thereof (Section ,ab. Q. `OLICY NO,: 1091393 EXP ATE: 02/01I` GC�OMPANY: STATE x,'! Certified copy is hereby furnished. ❑ Certified copy istil ills the Building Div' on Date: -/' 161— I / Applicant: .a�.0 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: issechon need dol b/cod the permit is for one hundred($100) or less). I Certify that in the performance of the work for which this mil is issued, I shall ny person in any manner So as to become subject to the WorkersCompensation Laws of Calilorni . Date: Signature: NOTICE: 11, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, of repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commending with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant tot a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). h as owner of the property or rtry employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does nor apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building of improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contraclords) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. A P. C. lot this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California, Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wlll/will not (circle one) need to comply with said state codes and the requirements for a permit lot construction or modnmalion from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant I hereby cattily that I have read this application and slate that the above information is cp r 1. 1 agree to co IY with all city and county ordinances and state laws fell to building Construction and hereby able represent i of this city) upon the above-mentioned properly lot inspection purposes. Di 5-1 t Signature: D,iver's License or Social Security a: 164646 White—Buddlog; Green—Code Enlorcenmm: ryanary—ADPIiCanl: Punk—P/Nenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05168 PERMIT NO: P 051688 PLAN CHECK NO: N GOVT: N SUPP? N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU' PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ'FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M—.l COMMENTS: REF B510310 #####%######%-###df%#####%#####k##'lE########%%iE######%##.K########%#%k)f iE ifIF ifIF 1C3E3F Y.iE%-!f Z O N I N G S TB.Acxs R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT,: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> I N D I V I D U A L F E E B R E A K D O W N TYPE #########3t;fKX####'%###########};.#####%###K If##ii####lFjfiP#ir########•###k'##3F##-}'g(.####### UNIT COST D E V E L O P M E N T S E R V I C E S• R E Q U I R E M E N T S ZONING APPROVED BY PLU 1,. LAUNDRY TUB OR WASHER DATE. BUILDING APPROVED BY _ DATE: APPLICATION IS " r'D B Ji DATE: k' LEGALIZATION:N F E E U,M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING EL' TRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 41,50 PLAN ' 25t SMIP/NON—RES ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 41.50 3.00 0.00 44,50 44,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 44.50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 44.50 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 DISHWASHER 200 2,00 PLU 1,. LAUNDRY TUB OR WASHER 2,00 2.00 PLU 2 SHOWER 2.00 4,00 PLU 1 SINK, KITCHEN 2.00 1,00 PLU 4 WASH BASIN 2.00 8,00 PLU 3 WATER CLOSET (TOILET) 2.00 6.00 FLU 1 WATER HEATER AND/OR VENT 2.00 2.00 PLU 1 WATER SERVICE 2.00 2.00 PLU 1. GAS PIPING SYS OF 1 TO 4 OUTLETS 2.00 2.00 PLU 1 GAS PIPING SYS 5+ OUTL—PER OUTLET 50 .50 PLU 1 GAS SERVICE 01 aown 90D•00084921 TOT 2.00;,5D DATE: 04/15/91 TIME: I4:53 W CONSTRUCTION AND PLANNING - y'PPROVALS Permit # Date Inspector h_. L 'A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location Soil Pipe-Undrgrnd. 53. Steel Reinforcement v 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final ' 13. Roof Drains] 64. Plumbing System - Final 14. Rough Plumbing ' 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning. 35. Final Gas Pipe -Test /p 36. Hood or Canopy , 37. Final Factory Fireplace 38. Final Plumbing ,3 /Q QZ 61U . 39. Water Service -Final 1 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer - 43. Backflow Irrigation - 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME:. ADDRESS: ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codeand my license Is in full force and effect. CITY LIC.: STATE LIC.: � CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selfinsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C). 'ICY NO.: EXP. DATE: JMPANY: L L-1 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must tormwith comply with Such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, poor t0 its issuance, alto requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) of that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I,as owner of the property or my employees with wages as their sole compensation, will do the work, and the LJstract ure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvemem'is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale) 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractions) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. E] I am exempt under Section: B. & P. C. for this reason'. Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future budding occupant will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions _ Date: Applicant r I hereby certify that have read this application and state that the above Information is correct I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this cry to enter upon the above-mentioned property for Inspection purposes. Date: Signature'. Ors er's License or Social Security 4: 1641 46 White—Building, Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor PERMIT NO: P 051688 PLAN CHECK NO: 01292-91 N PAGE: 2 TYPE PLU PLU QT'Y D E S C R I P T I O N 1 SEWER BUILDING / TRAILER 2 RAINWATER SYSTEM - PER DRAIN END OF FEES UNIT COST 5.00' TOTAL COST 5.00 4.00 r 01 000.54421-00084421 TOT 44.5p+ DATE: UV15/91 UNE.' 14=53 CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector F. `. rA APPROVALS Permit# Date Inspector (l 1. Temporary. Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping []Gas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas G Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning -'35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No Date Pf)4IECT ADORES': 302 E 16TH ST UNIT: B OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a teruhed copy thereof (Section 3800, Lab. C). POLICY N0.'. BXP. DATE: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. III : Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($700) or less) I certify that in the performance of the work for which this per mil is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Warrens' Compensation provisions of the Labor Code. you must forthwith comply with such prOVISIMS or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency br the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby alfirm that) am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city Of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1$500). I. as owner of the property or my emlevees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Slate License Law does not apply to an owner of a property who builds or improves thereonr and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving Moshe did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project IS to 7044, Bu S5 IR and Professions Code: The Contractors' State License Law does not apply to an owner of prop who b s or improves Breen and who contracts for such projects with a con(ractgr(s) license pursuant to the Contract State ease Law). I aware that proal of their Worker's Com align insurance should be provided to me. ❑ 1 am exempt unyf Section: B, S P. C. Ido hereby cerufy at l am aware QI and understand the re 25534 and That I r any future builds occupant will/will not permit for cons uction or mockhcation Uom the Air Duality these provisions. Dale: _ I hereby CE romances have read laws relallp Applicant: ion and Stale that construction and P Owner: Date: �( / T Signature: _. i I Driver's Lice se or Social 4curny 0: Canary—APPlicant: dy Code Sebdons 255 25533. arrtl ate codes antl the r irements for a ruction applicatio are %xempt from 1,r, withall city d count upon the ab a mentio Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052859 PERMIT NO: M 052859 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51310 PRIMARY BLDG. PERMIT. yt�E�E�E�E�AE+r��r*x*�F�r**fE�E�E�E�E��6�E�t�E�r��E�Eitlt+r�E�E**�E�E**�r*�E*�r��E�•�t�+Est+E�r�r*�r��Eit��E*�E�E�L�yE�ETr*+��yE��E�r Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRN•T: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> 100 K BTU 9.00 9.00 MEC 2 FACTORY FIREPLACE 6.50 > END OF FEES iF iF iE K 9E ie 9E 9E a0 iE if k9E iE 1E 9Ek*iE iF if*9F Rf 9F*1E*iF*RriE*iE 4EiE iE 4I•**9E 9E RE iE*iE 9E 9f 9f iE ik 9f****if Rf 948E iP RE *4f 3E BE iE aE *ik 9E 9e 9c at 9E 9f 9E*iE D E V E L O P M E N T S E R V I C E'S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY APPLICATION ISSUED BY: fJ1�(� iF IE if 9E 9E iF iF 9E 4 9f i! k N- aE )F iF 9F 9E 9E 9E iE ie 9E*iE 9E*iE 9E it•iE 9E IEiE 9E 9f 9E 1E iE 9F iF 9F*9E1(•9E iE iE*9F iE )E aE 1F 9E 9F if 9E iE 9F 9E *9E ik'iE.9F *iE 9F LEGALIZATION:Y F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 44.00 252 PLAN ISSUE FEE BUILDING—DIV—> TOTALS ---- > DATE: DATE: ,7 �4E9eifif9EiE9EiEiP9E #��1E9E Bf 9F 9F 1F iF 9E1E iE 9e 1E IE if * * of k 9E if aE iE 9E iF 9E M iE 1F 9F N STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES 15.00 PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 44.00 15.00 0.00 59.00 59.00 •00 REVENUE DIVISION TOTALS--> COLLECTED: 59.00 OVER/SHORT;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 59.00 T iE 1E*BF*iE if 9f iE 9E iE♦E**IE iE 3f 9E 9E 3E k 9E RE**iE iE 9E IE iF*if 9t iF iF*BE RE iF**9E BE 9t if iF**ik 9E 9E 9E RE iE 9E 9E 9E 1E 9E 9F 1E RE 9P iE 9E 9E 9E 9P iE 9E**kiE 9E iE 9E Tf I N D I V I D U A L F E E B R E A K D O W N ,� %TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9.00 MEC 2 FACTORY FIREPLACE 6.50 13.00 END OF FEES 01 0OO977E2—C00427G1 LIT DATE: 0'/23/41 TII:E: 16:40 =S . JD PO(" A CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit UFility-Undrgrnd. 54. Forms 4. Electrical Conduit:Undrgrnd. 55. Electrical Bonding - 5. -Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings 58. Eiectrical.Conduit-Undrgrnd. ' t 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. - 10. Structural Floor System 61. APPROVAL TO DECK 11. Property SewerrLine & House Connection 62. Backwash & Receptor -Final ` 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System • Final ' 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final ? ' 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT > .. *APPROVALS �' :Permit 4k 20. -Rough Factory Fireplace r: _ _ . 21.Du¢ts,inStructue,-70. underground -Hydro 22. Ducts, Ventilating " •r •,71. Product;P3ping ElGas 0*Oil _ 23. Gas Pipe -Rough & Test 72. Underground Flush ' 24. Roof Framing _ , X73.• Undergrnd. Storage Tank O Gas 0 Qil 25. Roof Sheathing '• '= t,J' •74=Overhead 7-lydro �. 26. T -Bar Ceiling (Structural) & Monocoat 75. -'Dry Chemical J •r 27.; Frame apd Flashing 76. Dry Standpipe ;. 28.'Lathing'&Siding- _ +;T �� 77,-.FIXEDSYSTENLFINAL' '29. Insulati§n 78:."FIRE PREY. FINAL ` 30. Drywall Nailing a' _ HEALTH -DEPT, REQUIREMENT 31. Plaster Brown Coat,; , • _79. FINAL WSP_ECTION 32. Electrical Power Meter, -Final, Z80., FOOD CERTIFI.C_ATE ISSUED 33. Final Electric i' ' Notes: -� - 34, Final Heating & Air. -Conditioning Gas Pipe -Test= _ X35.1inal .� ,36. Hood or Canopy -x s 37: -Final Factory Fireplace, 38. Final Plumbing 39. Water Service -Final <<' - + 40. Gas Service -Final 41. Solar Domestic -Final.- _ 42. Backflow Preventer 43. Backflow Irrigation, 44. Landscape Irrigation System-., - ' 45. Sound Attenuation '� t '• 46. Handicap Regulations r 47.<FINAL STRUCTURE & BUCLDING ✓: - - 46. FINAL PLANNING , v. y 49. Electric Release to Edison I i �. 50 -Gas Release io Souihern California Gas Co 51. CERTIFICATE OF. OCCUPANCY _ No. Date PROJECT A60RESS: 302 E 16TH ST '�'""�� UNIT' B OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 flEG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby afh — — am nsed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profession ode. and m ',errs, is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signal WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cenificale of consent to self -insure or a cerlificale of Workers' Compensation Insurance. or a Certified copy Ihereof (Section 3800, Lab. Q. POLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Certified Copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred (SIOD) or less). I certify that in the performance of the work for which this permit is issued. 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work lot which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052858 PERMIT NO: E 052858 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION T'NEtiT SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51310 PRIMARY BLDG. PERMIT. MMMMMMMMMMMMMMMMitMMMMMMMMMMMMMMMMMMMMMMMMM****MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > MMMMMMMMitMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM9tMMMMMMitMMMMMMMMMMMMMMMMMirMMMMMMM D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY `.' DATE: APPLICATION ISSUED BY: DATE: M MMMM MMMMMMM MM MMM MMMMIE FiFRiFMM MMMM MMMM MM MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM fMMMt MMMMMMMMMMMMMMMMiEMMMMMMMMMMMMMMMM LEGALIZATION:Y F E E S U M M—A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the (allowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or PERMIT 123.06 repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she i5 licensed 50% SMIP /NON—RES pursuant to the provisions of the ContractorsSlate License Law (Chapter 9 fcommencing with Section 7000) of Division 3 of the Business PLAN and Professions Code) or that he/she i5 exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by five hundred dollars ISSUE FEE 15 any applicant for a permit subjects the applicant to a civil penally of not more than ($500). .00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I, as owner of the property or my employees with wages as their sole Compensation, will do the work. and the ❑ Code: The Contractors' State License Law TOTALS —> 123.06 15.,00 0.00 138.06 138.06 structure is not intended or offered for sale (Section 7D44, Business and Professional does not apply to an owner of a property who builds or improves thereon, and who does such work himselftherself or through .00 his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building ar EVENUE DIVISION TOTALS--> COLLECTED: 138.06 OVER/SHORT: 00 ' improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve lot the purpose of Sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 138.06 I, as owner of the property, am exclusive) contracting with licensed contractors to Construct the project (Section 7044, Rosiness r Im r s t o and Professions Code' The Contractors' tate License Law does not apply to an owner Of pm y who ilds 0 p and who contracts for such projects with a contractors) license pursuant to the Contra rs'S, Llcened .I a MM MMMMMMMM MM MMMMMMMMMMMM MM MM MMMM MMM MMMMMMMMMM MMMMMMMMMMMM MMitts MMMMMM MMM MMM-1FMlE4fiti(- that proof of (heir Worker's Compensation insurance should be provided to me. I N D I V I D U A L F E E B R E A K D O W N F1 I am 4emmXnder Sectiones B. S P. C. Date: I do hereby Ce dy that I am a re oI and nder! 25534 antl lh 1 or any future uilding occupant permit for : struction or m tlification from the these provisions. Date: Applicant: I hereby certify that I have ead this apply tion and slap ordinances and slate law elating to buil igpponslruc2 property for in Ion ur ods, Owner: requirements of Calitoro Health antl Safety c of (circle one) need to comply with Said state con ly Management District. Residential construction Dale: /� Signature: Driver's License Social Security a: 164146 While—Building; Green—Code Enforcement: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1758 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT •03 61.53' / ins 25 s. 25533, and END OF FEES t the requirements for a oareexempfrom my an O1 060921'31—Or0927Cl TCe?r UATE: 07/23/91 TIr1E: ressor r_V CONSTRUCTION AND PLANNING APPROVALS Permit #_7 Date Inspector PO V'A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 12. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ;3: Eiectriml Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. -Steel Reinforcement. 56. Rough Plumbing & Pressure Test 6. Electrical UFEA Grnd. 57. APPROVAL TO COVER-GUNITE ' 7.;Footings > i 58. Electrical Conduit-Undrgrnd. - - 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer'Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. ''17. Rough Electric Wiring Rough Wiring Sign 7 �s/Q� /,�Q� 67. 68. Fencing & Access Approval APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20.,Rough Factory Fireplace _ _ 21: -,Ducts, in Strpctu4e• 70. Underground Hydro " 22. Ducts, ventilating ; ;> -• ^, .71. Product. Piping 0Gas 0Oil 23. Gas Pipe -Rough &'Test '' " • 72. Underd7ountl Flush 24. Roof Framing 73.1 Undergrnd. Storage Tank •0 Gas 0 Oil 25. Roof Sheathing ` 7q, -,Overhead Hydro. 261 27: T -Bar Ceiling (Stru4tural) & Monocoat Frame and Flashing i .. 75•_ Dry Chemical 76. Dry Standpipe - 28. LathingV Siding „4 Ps 9 -. S , '. . 77. • ' ' FIXED $Y�TEM FINAL. 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing �•. -t. HEALTH -DEPT.. REQUIREMENT 31. 32. _ 33. Plaster Brown Coat Electrical Power Meter -Final Final Electric'> I 3r9 Zi QZ 79. FINAL INSPECTIQN , 80„ FOOD CERTIFICATiE ISSUED 7 Note"s: • - 34: Final Heating & AJConditioning 35. Final Gas Pipe -Test•--"- -' 36. Hood or Canopy •, 37. Final Factory Fireplace - '�• - ' 38. Final Plumbing'' ,• .. `., " 39. Water Service -Final - 40. Gas Service -Final 41. Solar Domestic -Final - - n 42:`Backflow Preventer • ` 43. Backflow Irrigation i,- 44. Landscape Irrigatidn Systerp..; 45. Sound Attenuation 1.7 r • 7 z 46. Handicap Regulations _ "" r Y -_ ; , • 47: FINAL STRUCTURE & BUILDING 48:,FINALPLANNING i 49: Electric Release to .Edison 50. Gas Release to Southern California Gas Co j 51. No. CERTIFICATE OF OCCUPANCY Date �. PROJECT DORi 30') E 16TH ST UNIT: C OWNER'S NAME: 'LLOYD' MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCH/ENGINEER: REG.NO.: \b( ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. CITY LIC.: STATE LIC.: CLASS: • Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. r no: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the perm(is for one hundred (SIOO) or kssl. I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject IC Ile WorkersCompensation Laws of California, Date: Signature: NOTICE: It alter making this declaration, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency lot the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prim to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business id Professions Cade) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 71731.5 by ry applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044. Business and Professional Cade: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to const the pro ecl (Section Business Iasi and Professions Code: The Contractors' State License Law does not apply to an owner property o builds o proves and whocontractsof their for kern protects with a courant should license pursuant 10 the IrdClpfS ate LIC e (hal proof of ractr Worker s Compensation insurance should be s p ursu ❑ I am exempt under Section, B. 8 P. C for this reason: _ S-'7 Date: I do hereby curtly that I am aware of and understand thele 25534 and that I or any future building occupant will not permit Icr construction or modification from the Air Duality these provisions. Dale'. Applicant: I hereby certify that) have read this application and state that ordinances and stale laws relating to building construction and property for inspection purposes Daton Dan: � _Z — / 1 Signa�tu Driver's License or Social Security p: J Safety Code Sections 25505, 25533, and .aid state codes and the requirements for a construction applications are exempt from 164146 White—Building; Green—Code Enforcement; Canar y1_11PIphcant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05131 PERMIT NO: B 051311 PLAN CHECK NO: 06846-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION : NEW SFD SQ FT: 2,180 CLAIM VALUE: 90,000.00 CALL -VALUE: 123,303.10 GROUP OCC: R-3 /M-1 COMMENTS: NEW SFD HOLD FOR SPECIAL REQUIREMENTS ####•tf #af i6 9F iE 7, 0 N I N G R E Q U I R E M E N T S S E T B A C K S If ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING-=------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE: PROV: PARCEL; 42521101 ZNE: R2 REF NO: DR -90-39 PLANNING N TES> UNIT C OF 8 UNIT DETACHED APARTMENT PROJECT D E V E L O P M E N T S E R V I C E S R E Q U I R E M E NTT S ZONING APPROVED BY Wi? DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY - DATE; ✓�i1 `1 LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 723.50 8.63 PLAN 117.57 SMIP/NON-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 732.13 0;00 117.57 849.70 849.70 •00 REVENUE DIVISION TOTALS--> COLLECTED: 732.13 OVER/SHORT: •00 BLDG 3PMT 50 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 8.63 I N D T V I D U A -L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1658 DWE-TYPE V -WOOD FRAME -GOOD 69.00 114,402.00 SFR 37 RES -BALCONY, EXTERIOR STAIRWAY 13.80 510.60 SFR 485 RES -GARAGES TYPE V, 17.30 8,390.50 END OF FEES MAR 18 199 1 CITY OF COSTA MESA COISSTRUCTION AND PLANNING '- APPROVALS Permit # Date E# Inspector POOL F APPROVALS Permit # Data Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' R. Soil Pipe-Undrgrnd., 53. Steel Reinforcement ' 3: Electrical Conduit Utility-Undrgrnd. 54. Forms •4. Electrical Conduit.Undrgrnd. 55. Electrical Bonding " 5. Steel Reinforcement, 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE - 7. Footings s 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9: Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final ' 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric•Wiring 67. Fencing & Access Approval '17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT APPROVALS' '"-Permit # _ 20. Rough Factory Fireplace r - J 21. Ducts, in-Structuie• • t - 70. Underground Hydro 22. Ducts, Ventilating. _ 71. Product Piping OGas ❑oil 23. Gas Pipe -'Rough &'fest' , 72, Underground FlusFi - 24. Roof Framing -' ' - i - '73. •Undergrnd Storage Tank 0 Gas 0 Oil 25. Roof Sheathing •74., -,Overhead Hydro_ � • 26. T -Bar Ceiling (Structural) & Monocoat ! ' - 75:Dry Chemical - 27. Frame and Flashing,.0 , 76: D'ry Standpipe - ', -� 28. Lathing & Siding 77, 'FIXED SYSTEM :FINAL - - *29. Insulation 1 78.• FIRE PREV. FINAL 30. Drywall Nailing r ` * HEALTH DEPT: REQUIREMENT^i' `FINAL 31. Plaster Brown Coat.;. 79. INSPECTION - 32.. -Electrical Power MeterFinal + X80. FOOD CERTIFICATE ISSUED 33. Final Electric y 'Notes: •••... -O� 1k.. 34., -Final Heating & Air Conditioning- 35. Final Gas Pipe -Test .i ,36. Hood or Canopy. •r - s 37. Final Factory Fireplace - - -38. Final Plumbing -39. Water Service -Final r 40. Gas Service -Final `41.1Solar Domestic -Final C- - 42. Backflow Preventer. - _ s 43. Backflow Irrigation- - ' '44. Landscape Irrigation System,45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALPCR44wr L _ 1_ t .49. Electric Release to Edison _ - . 50. Gas Release to Southern California Gas Co, 51. CERTIFICATE OF OCCUPANCY No. Date - - .PROJECT AEDRESS, .;02 1 r 6T1! y,1, UNIT: G OWNER'S NAME: L LOYD MYLES DEVELOPEMENT zgdAEss: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-53 00 REG.NO.: ADDRESS: UNIT: PERMITTEE: JOHN JANIS PLUMBING (714)642-7764 ADDRESS: 1539 MONROVIA 8 NB CA 92663 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under pr ions of Cham (commencing with Section 7000) of Division 3 of the Business and Professions Code, an/Ive in full a and effec CITY LIC.: O S' 8 0 STATE LIC.: 554631 SS: —36 !- Dale'. Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm ttificate of consent 1 f -insure or a certificate of Workers' Compensation Insurance, Or a cemfied copy Ihereol (Section 'OLICY NO.: 1091393 EX2 01/ 2 COMPANY: STATE ' }� Certified copy is hereby furnished. ❑ Certified copy is file Ih th y Building Divi m Date: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (T Section need not be comate} fUs permit is for one hundred ($10o)or less). I certify That in the performance of the work for which this per It is issued, I shall not erryjr y any person in any manner so as to became subject to the Workers' Compensation Laws 01 California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must lonhwlth comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. Of LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its Issuance. also requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). , I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Corte: The Contractors' State License Law does not apply to an owner of a Property who builds or improves thereon, and who does such work himselftherself Or through his or her own employees, provided that such improvements are not intended or o0ered for sale. If, however the building or improvement is sold within one year of Completion, the owner will have the burden of proving he/she did not build or improve . for the purpose of sale). I, as owner of the property. am exclusive)yy contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code. The Contractors' tale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section- B. S P. C. for this reason: Date: Owner: I do hereby ¢edify that I am aware of and understand the requirements of California Health and 25534 and that I or any future building occupant will/will not (circle One) need to comply with s permit lot construction or modification from the Air Oualoy Management District. Residential c these provisions. Date'. Applicant: I hereby certify that I have read this application and state that the ordinances and state laws relating to building construction and here property for [ insppeeclom purposes. / Date: —/ •X— 71 Signature: ' ` Driver's License Or Social Security "= Safety Code Sections 25505, 25533, and aid state codes and the requirements fora prejudiced applications are exempt from 0 comply with all city and county o enter upon the above-mentioned A nL 1641 46 White—Building: Green—Code Enforced Canary—Applicann rnk—Revenue: Goldenrod—Assessor CITY OF COSTA MESA.— BUILDING PERMIT PERM NO: P 051.68. PERMIT NO: P 051689 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU' PURPOSE: NEW JOB DESCRIPTION : NEW SFD SQ FT: CLAIM.VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: REF 8510311 X###%##X####%it-%##X##%##X#%#######X#XX##%##XiF#######%#XX}E####*##la#}: IeX LE X_ *-K Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT:. FT IN REAR: FT IN FRNT: , FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN 1 PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> D E V E L O P M; E N T S E R V :I C E S',: ' R E Q U I R E M E N T. S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUZ • DATE: XX•########%X%## ##%'i . r .. viT--#'3'F' F'iF'iF7FF'R•'£##Xi4##li iE#X R?F# i N_y iF3F'X•X %X•#'IE#1i##%###%# vi, X: a IF )r. #N*it#X N.##ii####%IE#}'-IF LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING F;ECTRIC MECHANIC FIRE SMTP/RES GRADING PERMIT 39,50 PLAN 25% SMTP/N04N—RES . ISSUE FEE 3,00 BUILDING—DTV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 39.50 3,00' 0.00 42,50 42,50 ,00 REVENUE DIVISION TOTALS—> COLLECTED: 42,50 OVER/SHORT•00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 'SMTP/TOT GRADING PLAN—CHECK 42.50 %##X#r.###%#%%%###ii•#%x###X•####LPX#####%################X#####%#%######XX##%+###%# I N D I V I D U A L F E E B R E A K D O W N TYPE Q1'Y D E S C R I P T I O N UNIT COST TOTAL COST PLU 2 BATHTUB 2.00 4,00 PLU 1 DISHWASHER 2,00 2.00 FLU I LAUNDRY TUB OR WASHER 2,00 2,00 PLU 1 SHOWER 2,00 2.00 PLU 1 SINK; KITCHEN 2,00 2,00 PLU 4 WASH BASIN 2,00 8,00 FLU 3 WATER CLOSET (TOILET) 2,00 6,00 PLU 1 WATER HEATER AND/OR VENT 2,00' 200 PLU 1 WATER SERVICE 2,00 2.00 PLU I GAS PIPING SYS OF 1 TO PLU 1 GAS PIPING SYS 5+ OUTL—PEROOUTLETS OUTLET wi 0100649510-090914921) ;'OT 2.50?•50 DATE: 04/15/91 TDIE: 14:54 CONSTRUCTION AND PLANNING APPROVALS Permit# - Date Inspector F��L PA APPROVALS Permit# Date Inspector ' IN' Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, D Undrgrnd., Test " 9. Water Pipe-Undrgrnd. "" _ 60. Backwash Lines, P-Trap, D Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final " 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping DGas ED Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank DGas ❑Oil - 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning I 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final /d r h*A� 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer , 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: ARCHA NGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed order provisions of Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and Slicer. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cemlicate of consent to self -insure or a cenilicete of Workers' Compensation Insurance. or a certified Copy thereof (Section 3800. Lab. Cl. '9LICY ND.: EXP. DATE: ,'OMPANY: ❑ Cerored Copy is hereby furnished. ❑ Certified Copy is tired win the city Building Division. Date: Applicant EXEMPTION FRGMWORKERS'COMPENSATION DECLARATION:(in¢secodlnmdMtbecwnpletediflhepamr6fwone WMred(SlOO)orim), I Comfy that in the performance of the work for which this permit is issued. I small not employ any person in any manner so as to become subject to the Workers" Compensation Laws of California. Date: Signature: NOTICE: It, alter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must lonhwim comply with such PIovISiOnS w this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Cii C). LENDER: ADDRESS: OWNER BUILDER DECUBATION: I hereby affirm that I am exempt from the Contractors' State License Law ler the following reason (Section 7031.5 Business and Professional Code: Any City 01 County which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance. also requires the applicant lot such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant lot a permit subjects the applicant to a civil penalty of not more than two hundred dollars (5500). I. as owner of the property or my employees with wages as their sore compensation, will do the work, and the ❑ structure is not intended or offered lot sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however the buildin0 or improvement is sold within one year d completion. the owner will have the burden of proving he/she did not build or improve lot the purpose of sale). I, as owner of the propeny am exclusive)y contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: Ttle Contractors' State License Law does not apply to an owner of propene who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' $tate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. lot this reason'. Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wilUwill net (circle one) need to comply with said state coon and the requirements for a permit for construction or modification Irom the Air Duality Management District. Residential construction applications are exempt from these provisions, Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby allthoriZe representatives of this city to enter upon the above mentioned property for inspection purposes. Date: Lic:ise or Social Security .: Signature: 1631-46 White—BuiWing: Green—Code Enlwcement: Canary—ApplicanC Pink—Rw nue: Gddenmd—Assessor PER4MIT NO: P 051689 PLAN CHECK NO: 01293-91 N PAGE: 2 NiE 1E 3f if 4F i0 bE aE K N- ♦F a: fF fF K- IF iF 1F # iE * * sF X4 3A 3f IE * iF kE f(- iE iF TE r. x. it k 1i 8f aF J6 if• it * ♦F 1E N� li� * !E #.'� fF *� >E it 1E K1f N� 3E XE #r iE le �� 1F 8(-3'• 1f�?p iF w !F ar � ah � TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU i GAS SERVICE FLU 1 SEWER, BUILDING / TRAILER END O: FEES 1 A 2,00 5.00 2,00 5,00 i*DUPLICATE REE-EXPr-:* 01 00084922-00084922 TOT 42.5t DATE: 04/15/91 TIRE: 14:54 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector P. _ !A APPROVALS Permit # Date ' Inspector . 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical,T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADORES.: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 ADDRESS: UNIT: C REG.NO.: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cenificate of consent to sell insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3000. Lab. C). POLICY NO.: EXP. DATE: Ceiblied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. bate: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (TAR section need not W CompletOd it Oe Wood is for one hundred (Stip) or 1e55). I certify that in the perimm0nte of the work lot which this permit is issued, I shall not employ any person in any manner so as to become subl¢CI to the Workers Compensation Laws of California. Date: Signature: NOTICE: II, atter making thus declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you most forthwith oompy witn such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction forcing agency lot the performance of the work for which INS permit is issued (Section 3097. Gv. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt bom the Contractors' State License Law for the lodowing reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Gode1 or that he/she is exempt Iherelrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (.5W). 1. as owner of the property or my employees with wages as their sole Compensation, will do the work, and the structure is not intended or offered for sale (Section 7044. Business and Professional Code: The Contractors' State License Law does not appy to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his ar her own employees, provided that Such improvement, are not intended or offered for sale. If, however the building or improvement is sold witfun one year of completion, the owner will nave the burden of proving he/She did not build or improve for the purpose of sate). I, as owner of the property. am exclusively contracting in licensed contractors to constmtt the pm' t (Section 70 and Professions Code: The Curb tars' Slate Lkense Law does not appy to an miner of rry bWds or imps and who =iratt5 I uch pro ccs with a opiractor(s) license pursuant to Ina Cop ctori to License L that proof of (heir lorker's C Dentition insurance should be provided 1 t exempt .der $Klron B. 8 P. C. for r-Tt7 / er. : I do hereby c tdy that 1 am 411ie of and understand the requireme)y{ ,1 of Neal nd Sal a Sec A s 25505 25534 and 1 t I or an future buy m occupant will/will not I on comp) nh 5N �Codes)) d the TO permd for construct or mod( n)rom the Air ana ent trict. I esy ntlal N lion ppliwuon re these provisions. / Dale: v ADPIic. C herebyten, Incl have ead I Is application and stale that the ahoy or a' i orrect. I agree Dom ly with all ci ordinances dfar Iawsrelalin to building construction and here u res latwes of this '' upon the property to ins Pr �IAmn purp r s /(7/. / Dale: I / Signature: Diner's Lae se or Socia' Security ': 16,11,16 W ne—Buudmg: Green—Cade Enforcement: Canary_ApplicanlitPrnk—Revenue: Goldenrod—Assessor a CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052861 PERMIT NO: M 052861 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51311 PRIMARY BLDG. PERMIT, Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> k kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkl4kkkkkkkkkkkkkkkkkkkkkkkkkk D E V E L O P M E N T S E RiV I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: U BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: kkkkkkkkkkkkkkkkkkkkkk��kkkkkkkkkk Aw4rw iF kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk141kkk141E kk kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING., ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 44 00 '5% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 44.00 15.00 0.00 59,00 59.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 59,00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 59.00 kkkkkkkkkkkkkkikkkkkkkkkkkkkkkk141Ekkkkkkkkkkkkkkkk141Ekkkkkkkkkkkkkkkkkkkkkkkkkkkkk // I N D I V I D U A L F E E B R E A K D O W N 'TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9.00 / MEC 2 FACTORY FIREPLACE 6.50 13,00 END OF FEES L/ GATE: 0?+23/4: TTtS, CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOVPA APPROVALS Permit:?k Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.'Electrical Conduit.Utility-Undrgrnd. 54. Forms 4. Electrical Conduit: Undrgrnd. 55. Electrical Bonding 5. Steel Fseinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. r P. Foundation j 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe -Undigrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor•System 61. APPROVAL TO DECK -' 11. Property Sewer.Line'& House Connection 62. Backwash & Receptor -Final r 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final ; 14. Rough Plumbing 65. Electrical -Final - 15. Rough Electrical -Conduit 0 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENTt APPROVALS-.'.-Permit - - 20.'Rough Factory Fireplace 21.'Ducts, in Stryctufe .., r : �. + 70. On dergiotrnd;Hydro 22. Ducts, Ventilating 71. Product•Piping OGas ODil 23. Gas -Pipe -Rough & Test _ 72, Underground Flush ' 24. Rool Framing •73. Undergrnd: Storage Tank O Gas O Od- ' 25. Roof Sheathing ; , ` 74; Overhead Hydro- - 26. T -Bar Ceiling (Structural) & Monocoat _ 75. 'Dry Chemical 27. Frame apd Flashing-. _ ', 76. Dry StandpiQe 28. Lathing & Siding_ _ ., i. 77..- FIXED-SYSTEM.FINAL' _ 29. Insulation - - i ; .; 78„FIRE PREV. FINAL - 30. Drywall Nailing HEALTH,DEPT.: REQUIREMENT 31. Plaster Brown Coat ,79. FINAL INSPECTION 32: Electrical Power Meter, -Final r60. -FOOD CERTIFICATE ISSUED 33. 'Final Electric f ; Noies: = -� X34. Final Hailing & Air Conditioning:, 35. Final Gas Pipe -Test _ 36. Hood or Canopy s i ✓/�. .. _ , 37. Final Factory Fireplace � o 38. Final Plumbing - 39. Water Service -Final - - '- •- ' Y40. Gas Service -Final _ ' '•41. Solar Domestic -Final •' 42.`Backflow Preventer' 43. Backflow Irr;gation '. .44. Landscape Irrigation System„ =45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ✓>- 48.'FINAL PLANNING 4. _ 49..Electric Release to Edison !� ' 50.,Gas Release.to Southern California Gas Co 51. CERTIFICATEOF:000UPANCY No. Date ,- ADDRESS: ' 302 E 16TH ST (s NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 723-5300 ARCHIENGINEEB: ADDRESS: REG.NO.: UNIT:C CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05286 PERMIT NO: E 052860" PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commenting with Section 7000) of Division 3 at the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate at Consent to self -insure or a cenificate at Workers Compensation Insurance. or a certified copy thereof (Section 3600. Lab. Q. POLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This solction need not be completed ifthe permit is for onehundred(Slog) or less). I C¢mfy that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Dale: Signature: NOTICE: It, alter making this declaration. you should became subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or INS permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the penormanu.ot the work for which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECUBATION: I hereby affirm that I am exempt from the Contractors' Slate License Law lot the following reason (Section 7031.5 Business and Professional Cade: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant tar such permit to fife a signed statement that he/she is licensed It f h C ' S Cha 9 h Sec' 7000 I Divi ' 3 far B' JOB DESCRIPTION : NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51311 PRIMARY BLDG. PERMIT• *****9e if lE Oce 9F***+E it 9E****kEiE 110E*+rif-**If******kf if lF of*iF ik♦FIF*MiLiF 16*IF*iE+E i6 yi lE****+E 1F iE***a6±f iE*+f TF iE+F *iE+t Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> > iF 9E 1E Tf 9E 9E iE 9E iE iE 9E 9F**iE 9e iE 9E*9E 9E iF 9E iE iE iE+E3F**iE 9E 3E �iE,if**iF Mif 96 iE 9E**iE 3f♦E 3EM 9f iErtiE iFit*9E 969E*iErt 3F kiF iE Oce aE**3E iE 9E ie 9F iE* D E V E L O P M E N T S.E R V I C E S R E Q U I R E M E N T S tea• ZONING APPROVED BY `" DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: 12 PPLICATION if ISSUED BY: if?fiFiF'£iFRMiF if it iE iF 9E*r* ftiF iE****aaaF*iE4F*9e*kIE9EM9Ek9FIE9EiEk*ieieMiF3EiEiE9E.iEB�iFieiEBFlE9f*itiE9fk9EiE9E9fat•9t*iEaF*ieiEiE9E9t+FiElt9t**9fiE*TFiF9Eit3e9t LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 116.06 50Y SMIP/NON—RES pursuant to I e Cr sons a t e ontractors late LI Law ( ole( (commenting with Cron 1 a son a e usriess and Professions Code) or that he/she is exempt Increment and the basis for the alleged exemption. Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE El I, aS owner of the property or my employees with wages aS their sole compensation, will do the work, and the Sir uctareisnot intended oroffered lot Sale (SGCIgn7044,BusmessandProfessional Code: The Contractors' State LicensiLaw TOTALS ---- > 116.06 15.00 0.00 131.06 131.06 .00 does not apply to an owner of a property who build$ Or imDraves (hereon, and who Ones such work himself/herself or through his or her own employees, provided If such improvements are not imended an offered tar Sale. If, however In, building or improvementis Soldone year of completion. the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 131.06 OVER/SHORT• .00 fortheofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK 131.06 I, as owner of the property, am exclusively untracting with licensed contractors to g strucl the project ( coon 70M, Business and Professions Code: The Contractors' Slate License Law does not booty to an Owner of pope wM b ds or improve ¢loon and no contracts for Such projects with a contractor(s) license pursuant to the Contractors' le cense Lawl. ma IE 9f 9E SE iE iE iF iE iF if iE 9EK*1E iE 9E 9Ert*idle fE 9E*3E iE*IE 169E 9E ie iE 9E 9E iE%9E*iF iE tE iE iE Bf K9k*kid iEM9F if iE****iE S6 iE iE if 9F iE iE 1EK*1E i6*i6***iE that proof of their W(ken 's Compensation insurarroe should be provided to me. I N D I V I D U A L F E E B R E A K D O W N ❑ tam exemasonpt anderjxC'ip: I a. 8 P. C. for this re: /n / ( TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Date: _ I do hereat' cemundesta fy ha I am aware of an rnd the 25534 and that l or a• future building Occupant wilOwitlr permit for constructi n or modification from the Air al these provisions. ELS 1658 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT •03 58.03 In Hebfl no ale y Code actions 1".25533, and / END OF FEES Cold to Como` III td state codes and the requirements for a� Distncl. Resi nlia Construction applications are exempt frgpl Date: Applicant: I hereby cantly that I have read this p01¢ation and state an that thea al ordinances and state ws relating utlmngconslructmna her urn "al req proper, for ins ec np I So; Date: q Signature: CX 1641-46 White—Building: Green—COde Enforcement: Canary—Applicant the Goldenrod—Assessor C1 500927o OGGS' ,S Y � 08TE: 07/23io1 ilitc: :kbrrl L'...G6 CONSTRUCTION AND PLANNING 4 APPROVALS Permit # Date Inspector POOL PA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - '- d. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding - ' S, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNIT'E • 7.: Footings 58, Electrical Conduit•Undrgrnd. -• 8. F6undation I 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 1,1. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 16. Rough Electric WiringL 00401(67. 66. Solar System -Final Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT= APPROVALS Permit # - 20. Rough Factory Fireplace 21. Ducts, in Structute' 70. ljndergroufd Hydro _ 22. Ducts, Ventilating 71. Product -Piping Q•Gas O'Oil 23. Gas Pipe -Rough &"Test - _ _ 72. Underground Flush _ - 24. Roof Framing 73: Undergrnd. StoragaTank •O Gas ❑Oil ` 25. Roof Sheathing t ' "'' -74: Overhead 'Hydro 26. T -Bar Ceiling (Structural) &-Monocoat 4 75. Dry Chemical 27; Frame and Flashing 76. Dry Standpipe 2Fc Lathing.'& Siding * ',7 77.. FIXED SYSTEM FINAL - 29. Insulatir 78-, FIRE PREY. FINAL 30. Drywall Nailing•' li HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat;., �• 79: FINAL IN FECTION - 32. -Electrical Power_Metgr•Final; ��' // �jq yZ R ' 80.. FOOD CER`IIFICATcE ISSUED 33.`Final Electric •• lr�l QL/� Notes: ' ,34,. Final Heatiri' & 4.ir Conditioning 35.'FinalGas Pipe•Tesr .--.•'- r ti - •-• ' - 36. Hogd or Canopy , , r r ' •• _ 37...Final Factory Fireplace 38. Final Plumbing t. ' - .-39. Water Service -Final - •• + l4 - -i _ 40. Gas Service -Final - a 5 41. Solar Domestic -Final - t I 42. Backflow Prevente� 43. Backflow Irrigation - r i -44. Landscape Irrigation System J 45.. Sound Attenuation I; 46. Handicap Regulations 47: FINAL STRUCTURE & BUILDING 48..FINAL PLANNING 49. Electric Release to -Edison 50. Gas Release to Southern California Gas Co T. ( ; 51. CERTIFICATE OF, OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST UNIT: G OWNERS NAME LLOYD MYLES DEVELOPEMENT ADDRESS. 423 POPPY ALT CORONA DEL MAR CA 92625 723-5300 /ENGINEER' REG.NO.: r ADDRESS: UNIT: e PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade. and my license is in full force and effect. "ITY LIC.: STATE LIC.: CLASS: _ ate: Signature: i WORKERS' COMPENSATION DECLARATION: I hereby allirm that l have a certificate at consent to Self -insure or a certificate of Workers' Compensation Insurance. or a carolled copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. te: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that helshe is licensed influent to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business ad Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the El structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or Improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve fall the purpose of sale). - I, as owner of the property, am exclusivelyp contracting with licensed contractor It and Professions Code. The Contractors Slate License Law does not apply 10 ai and who contracts for such projects with a contractor(s) license pursuant to that proof of their Workers Compensation insurance should be provided to ❑ I am exempt under Section: B. 8 P. C.___� for this reason: Q Date: I do hereby cemly that I am aware of and understand the requi s of Call iia He no Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will not cle one) need to cc ith said state on and the requirements for a permit for conshuchon or modification from the—Cr Ouahty Management District esi ential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and stall ordinances and state laws relating to building Construction Property for inspection purposes. Date: 3- /q 'i -Signature Drivers License or Social Security n: 1641-46 White—Building: Green—Cade Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 051315 CONSTRUCTION TYPE: V—N JOB DESCRIPTION : NEW SFD PLAN CHECK NO: 06842-90 A PERMIT TYPE: STR PERM NO: B 05131 GOVT: N SUPP: N PURPOSE: NEW SQ FT: 2,180 CLAIM VALUE: 90,000.00 CALC—VALUE: 123,303,10 GROUP OCC: R-3 COMMENTS: NEW SFD�Q+FaQ Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAP.: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT- IN PARKING REQ: PP.OV• PARCEL: 42521101 ZNE: R2 REF NO: DR -90-39 PLANNING NOTES> UNIT G OF 8 UNIT DETACHED APARTMENT PROJECT MMM#M#M#MM#MMMM##MM#MM#+E IF AEMM#MMMMMMM#MM#MiP#MIF####M#MMMMMMMMM#MM#MMM#####3E #M#M D E V E L O P M.E N T S E R V I C E S R E Q U I R E M E N'T S. ZONING APPROVED BY WCbIL DATE; BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: 12 MMMMMMMMM#MMa(-iF MiFM#1F#MifiF3ilFR'TFiFii3E'iciF'iciFTfIFY'?FiFTf 3f7iiF3F3F�FiF'iF#MMMM#IFM1f iF #IF MMMMMMMMM#MMMM#M#M-IF MiFiF Mii*M MMMMMMMM##MMMMMMM#iFMM#MMM#iEM#M#MiF ifMM #1f MiE itM M#MM###MiF#MM LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING PERMIT 723.50 PIAN 117.57 SMIP%NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PIAN—CHECK TOTAL PAID DUE TOTALS ---- > 732.13 0.00 117.57 849.70 849,70 .00 REVENUE DIVISION TOTALS--> COLLECTED: 732,13 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE 'SMIP/TOT GRADING PLAN—CHECK 723,50 ;, 8.63 MMM#MMMM#M#MMMMMMMM#MM##M•M MMM#MMM#MM#MM##MMM MIkMMMMM#M###MMM#MMMMMM##MMMM#MMM# I N D I V I D U A L F E E B R E A K D O W N ,TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST /SFR 1658 DWE—TYPE V—WOOD FRAME —GOOD 69.00 114,402.00 SFR 37 RES—BALCQ Y, EXTERIOR.STAIRWAY 13.80 510.60 ,,SFR 485th E V 17.30 8,.390.50 D, OF FEES MAR 1 8 1991 CITY OF COSTA MESA CONSTRUCTION AND PLA,aNING APPROVr•LLS Permit# -Date Inspector - POOL E APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2.' Soil Pipe-Undrgrnd. , 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER.Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. ' B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line .& House Connection ' ' 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final ' 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval '17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT" 1 APPROVALS; '-Permit 20. 1Rough Factory Piieplace - 21. Ducts, in Structuie 70. Underground -Hydro - 22. Ducts, Ventilating,. _ , _ -71. Product Piping O'Gas 0Oil ' 23. Gas Pipe -Rough &Test 72. Underground Flush=' 24. Roof Framing _ - = `73.rUndergrnd.Storage _Tank ElGas 0Oil- 25. Roof.Sheathing > 7 74.`Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75.'Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding • _ - - 77. -FIXED SYSTEM;FINAL - . - 29. Insulation 78. FIRE PREV. FINAL •30. Drywall Nailing HEALTH DEPTH REQUIREMENT '- 31. Plaster Brown Coat, ,79. 'FINAL INSPECTION 32. Electrical Power Meter -Finale t' 80. FOOD CERTIFICATE ISSUED ♦ 33, Final Electric Notes: 34. Final Heating ,& Air Conditioning_ _ - .. 'i 35. :Final Gas Pipe -Test ` -36. Hood or Canopy -• -- - 37. Final Factory Fireplace,. 38.. Final Plumbing - + 39. Water Service -Final -' - - 40. Gas Service -Final :41. Solar Domestic -Final _ i- 42. Backflow Preventer.•- 43. Backflow Irrigation- 44. Landscape Irriqation System- �,= ,. • - - `� a i �45..Sound Attenuation 46. Handicap Regulations = _ 47. FINAL STRUCTURE & BUILDING Q Z 48. FINAL PLANNING .. 49. 'Electric Release to Edison 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date = PROJECT ADDRESS: .,702 E- 16TH ST a OWNER'S NAME: SIDNEY CURTISS ADDRESS: 302 E 16TH ST #G COSTA MESA CA 92627 (714)645-9782 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: G CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 060070 PLAN CHECK NO: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU UNIT: PERMITTEE: SIDNEY CURTISS (714)645-9782 ADDRESS: 302 E 16TH ST G COSTA MESA CA 92627 LICENSED CONTRACTOR DECLARATION: I hereby allum that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 at the Business and Professions Code. and my license is in full lone and effect. CITY LIC.: STATE UC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to Self-inwre or a certificate of Workers' Compensation Insurance. or a Certified copy Thereof (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy S hereby furnished. ❑ Certified copy is filed with the city Building Division. i Dale: Applicant: - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be competed if the Farm is for we hundred ($100) or less). I certify that in the performance of the work for which this rssu hall not employ any ny manner so�came subject Io the 1orkers' mpensalion Laws of California. Date: �� Sigd 1� C; i�.Lf� NOTICE: 11, alter making this declaration, you s our acOme sublecl to the W er5' COmpensationrpmvisions of the—tabor Code. you must forthwith Comply with such provisions or this permit shall be deemed revoked.. // CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency fpr the performance of the work for which This permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to fife a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Prolessipns Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($.500). I. as owner of the property or my employees with wages as their sale compensation, wiu do the work, and the El structure is not intended or offered for sale (Section 7D44. Business and Professional Code: The Contractors' State License Law does net apply to an owner of a property who builds or improves thereon, and who does won work himself/herself or through his of her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold willdn one year of Completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property. am contracting ntracting with licensed Contractors to construct the project (Section 7D44, Business L^J and Processions Cade: The Contractortillale License Law does real apply Tom owner of property who builds or Improves thereon and who contracts lar such projects with a wntractor(s) license pursuant to the Contractors' State License Law). I am aware Thai proof at their Worker's Compensation insurance Should be provided to me. ❑ I am exempt under Section: B. A P. C. for this r Date: _ILr3/J I do hereby Certify that I am aware of and understand the requirements of California Heafth and Safety Sections 25505, 25533, antl 25534 and that I or any future building occupant wilVvdll not (circle one) need to Comply with mid state Codes and the requirements for a permit for Construction or modification from the Air Nally Management District. Residential construction applications are exempt from These provisions. Date: Applicant: I hereby certify that I have read This application and state That the above information is correct. I agree to Comply with all city and county ordinances and state lava reUtingt0 building construction and h orfpresentatives of this C1 - of upon the Above-mentioned Property Tor inspection purposes. Date. .23-/9�_ Signal re: Dyers License or Social Security N: 1641-46 While—Building; Green—Code Enforcement: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor i PERM NO: P 060070 GOVT: N SUPP: N PURPOSE: OTH JOB DESCRIPTION RELOCATEWASHER DRYER SQ FT: CLAIM VALUE: CALL—VALUE; GROUP OCC: R-3 / COMMENTS: RE: E60069 kkkkkkkkkkkkkkkkk*kkkkkkkkkkkkkkkkkkkkkkkkkkkkkk k*ick*kkkkkkkkkkkkkk�-kkkkkkkkkkk Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN E B R E A K D O W N PARKING'RED• PROV: PARCEL: 42521122 ZNE: REF NO: PLANNING N TES> OR WASHER. 700 7,00 PLU 1 GAS PIPING SYS OF,-. '^1 TO > 5.00 END OF k kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk D E V E L O P M E N T S E R V I C E S-. R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : APPLICATION ISSUED BY: kkkkkkkkkkkkkkkkkkkkkk V LEGALIZATION:N F E E S U M M PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC 12 00 PLAN ISSUE FEE BUILDING—DIV—> TOTALS ---- > 25% 20.00 PERMIT ISSUE 12.00 20.00 PLAN—CHECK 0.00 _ DATE: DATE: WR'W-kkkkkkkkkk ick kkkkkkkkkkkkkkkkkkkkkkkkk STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES TOTAL PAID DUE 32.00 32.00 ,00 e REVENUE DIVISIO TOTALS--> COLLECTED: 32.00 OVER/SHORT:00 BLDG PMT LU32INNGG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK , .00 k kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N rTYPE QTY D E S C R I P T I.O N UNIT COST TOTAL COST PLU 1 LAUNDRY TUB OR WASHER. 700 7,00 PLU 1 GAS PIPING SYS OF,-. '^1 TO 4 OUTLETS 5.,00 5.00 END OF FEES CONSTRUCTION AND PLANNING POvu & SPA C APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - I 53. Steel Reinforcement •� ;i•.' 1 Conduij_iltility-Undrgrnd. 54. Forms - 4:3e6ncal a.d.1lectrieal Condait•Undrgrnd. ` 55. Electrical Bonding j f'i{ieinforcerlt�'rT 56. Rough Plumbing & Pressure Test ctcica l UFO•Gc.,;d. 57. APPROVAL TO COVER-GUNITE •c. -Footings 58. Electrical Conduit-Undrgrnd. i-`B,jounciation `- _ r, ^ 59. Gas Pipe, O Undrgrnd., Test ! `c t- 9. Water Pipe-Undrgrnd. r/ ' 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System sV•,'f , 61. APPROVAL TO DECK 1 ,' 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final • 12. Sewer Cap _ 63. Heater & Vent -Final 13. Roof Drains 2 1 64. Plumbing System - Final � 14. Rough Plumbic �L' w 65. Electrical -Final �� ' .� 4 15. Rough Electrical -Conduit r 66. Solar System -Final 16. Rough Electric°VJiring I •/ , 67. Fencing & Access Approval �{ •17. Rough Wiring §j9h • 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL7SPA SYSTEMS FINAL (i 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENTr - - J' -W- z % zc PPROVALS=OPermit 20!IRo,( "'ctoty R�1'eplace Wit*, 'd•- x G -.Dcx x '` 21:"Duc'Ss,irhStFtCt�' f, 7 ? _a .n r tc!2grpo ,% Hzto , - '-S 'r S --x % X70. x 22. DL9s, K1!ntttatirigx^S 'fS •its 171. ProducC ping ©Gas QOil 232Ga�ip Ro_4h &•.-est 1 :�� Y i x 72. Unciergroirgd F(u's1F x A 4 Ott 24:rRoia FCemii g ? 7$c Undergr F1. Stor Tank"0 Gas 0 Of l: 25. Rod Sheathing ;` r •_� ?�* 7q� Over heaeHydr _ 26-T-1 4r Ceiling (SiLe'turall G40nocoat ^ r .a m x 757 Dry Chemical _. 27�Frame d Flas '^ 76. Dry Stand'6 `A },r _'28J La1jt 4Siding =:� - 6.i x r g ••x .s 77;" FIXED S -Y TEM'64NA� x'29. Insulatfcon r 711.EIRE P,8 EV. FINAL •� r :-s x'30. DrywalldJailing •• x �..MEALTH-DEPT^..REQUIRENIENT 31. Plaster 1�ronrro Coa i 79`FIt3AL1815�ECTt�N K �v 32 -Electrical Power MeteCFinal, c 1 x 80r.FO0D CERTIFICATE ISSUED 3 33SFi I Electr s f NQies: -Z(- cl?a t�oorLy CA4o• CIE _ ,t�ocXJCP-(1LG1 i34,r,Fi el Hyating& F.i�G'ondition •3nq „ q k ��zqg (e OHS 1ri"O41'E= LFf�rCa" C ^ GEJ7 i y0 35:,Firial Gds Pik -Test' r A > x r 0 wr:> x r r36 Hood or Canopy _ • T x %• 5r °v r -37%Final Factory FireQace %k " r, -'38. Final Plumbing Y SIL' •• f V _W1 •- x z X39. WaTOr Service-FinaK v' F y R Y -� n K ' 40. G -: x r as Service -Final 'K •Y. Q:r ;r. y- X rq > x Jv C_l3 * ^ ,.41. Solar Domestic-FirrafS r' •• '?c l K < Qe -1 -42.'Backflow Prevente4 43. Backflow Ir�tl_gatiorr-x 44. Landscape Migatio'n 5 ste x ` " � `s' _ E, 45JSound Attenuation -n T r•' K '1 II r •n`k Y J J 1 J $46.:Handicaih RGulati'ons rr •' '•` " - "� � ^ �47:;FIN'AL STRUCTUfiE & BUILDINGy T48�'FINALPLANNINd - .49-ElectricRelease to,Edison .• x'. .c r .r 50,,Gas-Release to Southern California Gas Co - ::51. CERTIFICATEO.000UPANCY z w %.� [,) -'r.c No. Date 0 R*S��iE:• 302 E 16TH ST ADDRESS: irLF)YD M=/LES DEVELOPEMENT 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 REG.NO,: ADDRESS: UNIT: G CITY, OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 051693 PLAN CHECK Ni N UNIT: PERMITTEE: JOHN JANIS PLUMBING (714)642--7764 aoDREss: 1539 MONROVIA 8 NB CA 92663 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under or sions of ter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full ce and e CITY LIC8� n STATE 1 554631 SS —' F Date. !/ Signature: _ _ WORKERS' COMPENSATION DECLARATION: I hereby affirm ., I have a certificate of sent losell-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Seco 3800, Lab. C). 'POLICY NO.: 1091393 EXP. DATE: 02/U1 COMPANY: STATE '}(}� Ceraheeea copy is hereby furnished. ❑ Certified copy is filed with e c Buildivision. C Date: "7 `� Applicant: 1�. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This se need not be completed if the per %for one hundred SIDO) or less) cerlity that in the performance Of the work for which This permit ue0, shall not employ any pe in any manner so as to become subject to the Workers' Compensation Laws of California. Dale: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU JOB DESCRIPTION : NEW SFD CLAIM VALUE: CALC—VALUE: PERM NO: P 05169: GOVT: N ST.IPP: N PURPOSE: NEW SQ FT: GROUP OCC: R-3 /0-1 COMMENTS: REF B510315 ##k####k#k##k#'k######k-#'k##k##k##k.)F#9Fi(•k###k.k..k#.%.h .k.**.kc###.tj Z O N I N G S E R'I' H A C K E Q U I R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT. IN RGHT: FT IN LEFT: FT IN•RGHT: FT IN PARKING RE&p PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NC)TES> ❑ 1 am exempt under Section: B. B P. C. 1 SINK, KITCHEN 2,00 for this reason: > 4 WASH BASIN 2.00 8,00 PLU 3 WATER CLOSET (TOILET) 2.00 D E V E L O P M E N T S E R V I C E S" R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY : APPLICATION ISS LEGALIZATION:N I F E E M M A R Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason$ L,DG PM's' 'PLUMBING ELT TR I C MECHANIC (Section 7031,5 Business and Professional Code: Any city of county which requires,a permit to construct, alter, improve, demolish, or r repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 39.50 pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business 25t/ and Professions Code) or that he/she is exempt therefrom and the basis lot the alleged exemption, Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500), ISSUE FEE 3 .00 El structure as owner of the property or my employees with wages as their sale compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Slate License Law TOTALS --- — > • 39,50 3,00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or. through his or her own employees provided that such improvements are not intended or offered lot sale If however the building or DATE: >_ DATE: DATE: O¢/S`/ STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON—RES PLAN—CHECK TOTAL PAID DUE 0,00 42,50 42,50 ,00 improvement is sold within one year of completion, the owner will have the burden of proving he/ did not build or improve REVENUE D T V I S I ON TOTALS--> COLLECTED: 42.50 OVER/SHORT: .00 for the purpose of safe). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK I, as owner of the pmpertK, am exclusive)A contracting with licensed contractors to construct theproject(Section 7044, Business 42.50 PLU 1 DISHWASHER Contractors•Xy� to an of and ❑ reon ofessions de: Tfor to not roves ho builds rLaw),I e Lawhese 2.00 PLU 1 and who contracts he Contrarinter such projects with pursuants am contactorls) to tctorrs' Ede License aware that proof of their Worker's Compensation insurance should be provided to me, k###%#####'X'4'k###X###ii###########iK'##-#%#############it########## 2,00 ##############aE## # 1 I N D I V I D U A L F E E B R E A K D O W N ❑ 1 am exempt under Section: B. B P. C. 1 SINK, KITCHEN 2,00 for this reason: PLU 4 WASH BASIN 2.00 Date: Owner: I do hereby comfy that I am aware of and understand the requirements of California Health and Safety 25534 and that I or any future building occupant will/will not (circle one) need to comply with said stat permit lot construction or modification from the Air 01 Management District. Residential constru these provisions. Date: Applicant:. I hereby cattily that I have read this application and state ordinances and stale laws relating to building construction: properly I insfaction9purp0ses. Date: /S� ( Signature: Driver's License or Social Security a: 164146 White—Building: Green—Code Enforcement: Canary—Appbcant Code Sections 25505, 25533, and e codes and the requirements for a [tion applications are exempt from I agree to com 'm all city and county his citytoe ru nlheabove-mentioned Goldenrod—Assessor TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST FLU 2 BATHTUB 2,00 4,00 PLU 1 DISHWASHER 2.00 2.00 PLU 1 LAUNDRY TUB OR WASHER 2,00 2,00 PLU 1 SHOWER 2,00 200 PLU 1 SINK, KITCHEN 2,00 2,,00 PLU 4 WASH BASIN 2.00 8,00 PLU 3 WATER CLOSET (TOILET) 2.00 6,00 PLU 1 WATER HEATER AND/OR VENT 2.00 2,00 PtU 1 WATER SERVICE 2,0o0 2,00 PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 2.00 PLU 1 GAS PIPING SYS 5+ OUTL—PER OUTLET 50 _ 01 00J0tii ,/ f( 73T9Z/a i :D- , 502,"1 DATE: 04/15/91 TIpE: 14:5`„ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector Pt "" _ A APPROVALS Permit # Date Inspector =' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 51. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OOil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 0Oil - 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 26. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric -Notes: A 34. Final Heating & Air Conditioning - 35. Final Gas Pipe -Test V"If A AG 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 3 i% c" 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final ' 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: PERMIT NO: P 051693 PLAN CHECK NO: 01297-91 N PAGE: 2 ###3i#########If JtiE#iF#3h#36k###iF########•-ir 1E#le#-Y?###########a(-iE#![##ii36###ii##)F#k#4: kIP ##-}## ARCH/ENGINEER: REG.NO.: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL, COST ADDRESS: UNIT: PLU 1 GAS SERVICE 2.00 - 2.00 PERMITTEE: PLU 1 SEWER, BUILDING / TRAILER 5.00 5,00 ADDRESS: END OF FEES LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section ' 7001) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby alum that I have a certificate of consent to sell insure or a certificate of Workers Compensation Insurance. or a certified copy thereof (Section 3800. Lab. C). KLICY NO.: EXP. DATE: OMPANY: 10 Certified copy is hereby furnished. ❑ Carolled copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred ($100) of less). I certify that in the performance of the work lar which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that be/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the El structure is not intended or offered for sale (Rection 7044, Business and Professional Code: The Contractors' State License Law I does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intentletl or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build Or improve for the purpose of sale). I, as owner of the property. am exclusively contracting 'Mth licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' ytate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law),I am aware that pmol of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner I do hereby certify )hal I am aware at and Understand the requirements of California Health and Safety Code Sections 25505 25533, and 25534 and that 1 or any future building occupant will1will not (circle one) need to comply with Said state codes and the requirements for a permit lot construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby au0grize representatives of this day to enter upon the above-mentioned Property for inspection purposes, Date: Signature: *Driver's Licrtse or Social See only 4: 1641-46 White—Building; Green—C(Me Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assessor *DUPLICATE REC:EYP * 01 00084924-00084924 TOT DATE: 04/15/91 TIME: 14:55 A 1h CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector RMPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test , 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: '302 E 16TH ST UNIT: G OWNER'S.OIAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) at Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: _. __ WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Codified copy is hereby furnished. ❑ Certified copy is filen with the city Building Division Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be Completed it the permit is for one hundred (5700) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It. after making this declaration, you should become subject to the Workers Compensation provisions of the Labor Code. you must forthwith comply with such provisions ar this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 052870 PERMIT NO: M 052870 PLAN CHECKINO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT YPE: MEC PURPOSE: OTH JOB DESCRIPTION ; NEW SFD WATT GARAG SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51315 PRIMARY BLDG, PERMIT. ��F��*��F*aEJEiFifBFiE**3fiEiE3ElEif 1t RElEiEiEiEiEiF�E+E+E�F�E�E�E+E�E�**�F�*+E�r������E�E�F*�E+t�E�E�t**�E**� N *Ir�F�E�E�E�F*+r��E Z O N I N G S E T B A C K SR E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL; 42521101 ZNE: REF NO: PLANNING NOTES> > BE if iEMlE if iF iE iP ifiE lE iE iF*****4iE*IE SF IEk***iE iE iE IE iF iF*119E iE i8 iE*iF 1F*IF iE aE iE iE*iEiE iF iF BE iF iE aE*iE lE iE*iF tE**IE fE iE 7F iF iE iE lE RF** D E V E L O P M E N T S E R, =.V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: APPLICATION ISSUED BY: I ***ifkiH iE 3F aEMiE IF*iE iF iE iE iE #F iEk SE r �*EE**EE***r**��r**iFiEiE3EkieiF�FiFBEkiFaEieiFki iElEifiEiFalit3E LEGALIZATION:Y F E E S U OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors• State License Law for the following reason BLDG PMT PLUMBING ELECTRIC (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve, demolish, or PERMIT repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) at Duration 3 of the Business PLAN and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars (5500). ISSUE FEE DATE: M M A R Y STRUCTURAL SEGMENT:N MECHANIC FIRE SMIP/RES GRADING 44.00 25Y SMIP/NON—RES 15.00 1, as owner of the praoerty or my empplIoyees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7144, Business and Professional Code: The Contractors' State License Law TOTALS ---- > 44.00 15.00 0.00 59.00 59.00 .00 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her awn employees, provided that such improvements are not intended or offered for sale. If, however the building or REVENUE DIVISION TOTALS--> COLLECTED • 59.00 OVER /SHORT •00 tarptheepurrpose of sald e). onhin e year of completion, the owner will have the burden of proving he/she aid not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 59.00 ® am Professions Code: The Contractors' State License Law does not applyto an funeral prope builds or improves reon and who contracts tar such projects with a contractor(s) license pursuant to the COnlracto tat icense Law). aware iE if iE kaF SF 3E iE TE iF if iE 4FMiE 1E iE Jf*iEk*iFk lF iF aE iE kieklE4lE iE aE IE iE 1E aE ik iE iE if iE iF'IEiE'1FiE iF aE iE BF iE iE iE iE*�E iF iE iE EE iE if iE iE yE iE lE iF iF iE if i4 iE 1E that proof of their Worker's Compensation insurance should be provided to I N D I V I D U A L F E E B R E A K D O W N ❑ I am exempt under action: B. 8 P. C. for reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale: MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9.00 1 do hy11hlm,Man I am away al and and rstand the requirements of Calltarnla Heau s Safety Code Sections 255135, 25533, and MEC 2 FACTORY FIREPLACE 6.50 13.00 25534 future building occupant will/will not (circle one need to comply riI aid stale codes and the requirements for a END OF FEES permit or modification from the Air Duality Management District. flet train construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have ad this applic ion and state 0 a in mate carlyortlinant cid 5u 13 .elating to math, constru[' no hereby author' re enta01 10992792 pro Pen - uo p set. y DRT�- 07123A,'! 01. Date. V/ _�ignin ri I Driver's Lice 0r Social Secu y n: Applicant: Pink—Revenue; Goldenrod—Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Datector Date Inspector POOL & SPA APPROVALS Permit # Date Inspector ,1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement •� 3.' Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit_Undrgrnd. 55. Electrical Bonding ' 5. -Steel Qeinforcement 56. Rough Plumbing & Pressure Test - ¢Alectrical UFER larnd. 57. APPROVAL TO COVER-GUNITE 7.:Footings +'• r 58. Electrical Conduit-Undrgrnd. '- 8, Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11-. Pioperty Sewer` Line & House Connection 62. Backwash & Receptor -Final .I 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final " 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval , •17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT, - -APPROVALS - )Permit # / 20.'Rough Factory Fireplace i -3 -. 21.` Ducts, in Strctu e., 70. Gnderground Hydro 22. Ducts, Ventilating'.' -71. Product Piping 0 Gas DOii 23: Gas Pipe=Rough & Test 72. Underground Flush ' 24,sRooiFraming -• - `- <73"uUndergrnd.StorageTank Gas ❑Orb.• 25. Roof Sheathing r: `; '" "74.•,Over head'Hyd ra 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . _ tv 27.- Frame and Flashing :; - �� ;` 76. Dry Standypipe 28. LathingA Siding- 1 - •",' •i Y 77.. FIXED SYSTEM FINAL 29. Insulation 7$, FIRE PREV. FINAL .30. Drywall Nailing .� ' ' - '� HEALTH DEPT. REQUIREMENT ..31. Plaster Blown Coat' I ' 79r FINAL IN$PECT19N 1' ' T X32• Electrical Power Mete1-Final, - `»- ` 80:, FOOD CErRTIFICATE ISSUED 33`Final Electrif. Ndies: 34: Final Heating;& A♦ir,Conditioning, 35. Final Gas Pipe -Test �� ' ._ , 36. Hood or Canopy- . _• _ •?;` r h.••9 _• '"` , 37. Final Factory Fireplace - ,n Kr • - -. W 38, Finel Plumbing a -39. Water Service.Final- - .. - .., -40. Gas Service -Final - 41. Solar Domestic -Finals. 42:'Backflow Preventer ' ' 43. Backflow Irrigation - - y .. _ 44. Landscape Irrigation System-';:,- 45_'Sound Attenuation _ 46. Handicap Regulations - r 47. FINAL STRUCTURE & BUILDING 48.'.FINAL PLANNING ' ` t' .. 49., Electric Release to !Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATED OCCUPANCY No. Date IOdECT ADDRESS: �02 E• 16TH ST OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCH/ENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT:GI CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052869 PERMIT NO: E 052869 PLAN CHECK NO; I N GOVT: N SUPP: N UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature WORRIERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a cenificale of Workers Compensation Insurance. or a certified copy thereof (Section 38170. Lab. C). POLICY NO.: EXP. DATE: copy is hereby furnished, ❑ Candied copy is filed with the city Building Oivision. CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51315 PRIMARY BLDG, PERMIT, kE�**SE�r�E�F��4rTE**kEkE��it*��r�E�F�EVE�F+t�aETr�E�E�E*�E�ETE�E*TF�arTrEF�F�F�F***�r�ETr�r**�E�E�F��r�E�E�EIE*�E�ETrvETF*�F*�EVE��F Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ------------------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE8: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NTES> > [)ale: Applicant: 11- 3FiE5EBEBfiE*9E BE BEiEiFiFiF*iFrt*iEkMBf*BEiF*kkiE*BF 4F 9Ei!'OF,1kiFBEiE9EiE1E*1EiEBEiFiFkBFiEkBfiEifiEiEfE7EBEiEiEBE3E*3E3EiFk*iE9EiFIEiFiEiElEit EXEMPTION FROM WORXERS' COMPENSATION DECLARATION: (This section need Cot be Compl aml if the permit is lot ane hundred (5100) or less). D E V E L O P M E N T S -E,, R V I C E S R E Q U I R E M E N T S I certify that in the penormance of the work for which this permit is issued, I shall not employ any person in any manne(so as to become 'J subject to the workers' Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor BUILDING APPROVED BY _ DATE; Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. - , CONSTRUCTION LENDING AGENCY: I hereby affirm that mere is a construction lending agency for the performance of the work for APPLICATION ISSUED BY • k DATE: which this permit is issued (Section 3097, Civ. Q. LENDER: ! 9E iF iE BF 1E 9E 1E iF 5E iF iFiE if tF*3E 3F**iE BE iE iF aE iE TE iE aE *iE 9F 4E 4E iF9E 1E iE iE iF iF BE F9E*i EiE iE*iF iF N-iF ie iF iE 1F*iE iE iF1F*iEiE 9E iF #3F iF 9E iE iE tE*1f IE 9E ADDRESS: LEGALIZATION:Y F E E S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law lot the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she i5 licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Commencing Nth Section 7000) of Division 3 of the Business and Professions Code) or that heJshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars (5500). I, as owner of the property or my employees with wages as their sole Compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' Slate License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building Or improvement is sold within one year of completion, me owner will have the burden of proving he/she did not build m improve lar the purpose of sale). I. as owner of the property. am exclusively contracting with licensed Contractors to construct the protect (Sec d 7044, Business I.. Professions Code: The Contractors' State License Law does not apply to an owner of pro arty who buil or improves thereon and who contracts for Such projects with a insurance should license pursuant to the Contra s' R%7aw (hal proof of their Worker's Compensation insurance should be provided It me ❑ I am exempt under action: B. A P. C. for Ih15 n: Date:/r/' / Owner do hereby cacti( Inas am aware And understand the requirements California Health d Safely ode Sections 25505, 5533, and 25534 and Inas r any future building occupant will/will not (circle one) need to comply wi said stale codes and the requirements for a permit for can truction or modification from the Air Duality Management District. Reside ul construction applications are exempt from these provisions. Date: _ I hereby oWinanc property Date: _ Driver s 164146 Applicant: that I have/ead this is �It' gnalure. III �� ` Soclalsecu va: udaing: Green—Code Enforcement Canary—Applicant: Pink—Reverted; Goldenrod—Assessor PERMIT PLAN 116.06 FIRE SMIP/RES GRADING SMIP/NON—RES ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 116.06 15.00 0.00 131.06 131.06 .00 REVENUE DIVISION TOTALS--> COLLECTED: 131.06 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 131,06 iF �bjF iF k iF iE if if iE if iF lFM iE lE iF iF kiE ik iF 7F iE iEiE lE it fE BE if iE iF 3E 1F iE iF iE iF iE if if iF if iF if iklE iF lE iF iE if iF lE iE jf±E iE iE fEif if fF lF iE �If iE iE if TE iE aF lE iE iF I N D I V I D U A L F E E B R E A K D O W N T QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1658 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT .03 58.03 END OF FEES / jATE: 27/25/47 it -_ AND PLANNING PO'SPA � CONSTRUCTION Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit # L? Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3:' Electrical Condluit Utility-Undrgrnd. 54. Forms " 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding Qa'Steel Reinforcement. 56. Rough Plumbing & Pressure Test • '" 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7•�Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor' System 61. APPROVAL TO DECK 11. Property Sewer -Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains _ 64. Plumbing System • Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 67. Fencing & Access Approval 16. Rough Electric Wiring e� 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT- 'APPROVALS •' :Perm_ it # - - _ 20. -Rough F'actoV Fireplace _ 21.' Ducts, in StructurR' 70. Undeigiound Hydro 22. Ducts, Ventilating. - -71, Product Piping OGas 00il _ 23. Gas Pipe=Rough & Test72. Underground FI _;r- 24.•Roof Framing : ' •73.,Undergrnd. Storag%Tank CGas OOil 2i. Roof Sheathing _ s 't • '74,=Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat J 75. Dry Chemical 27. -Frame and Flashing 76. Dry Standpipe - 28.• Lathing'& Siding t i 77,= FIXED SYSTEM•F41\!AL` _ 29. Insulation I 78sFIRE PREV. FINAL t 30. Drywall Nailing 1 HEALTH DEPT. REQUIREMENT -31. Plaster Brown. Coat,.79"FINAL INSPECTION, 32.. Electrical Power Meter -Final ��Y 80., FOOD CERTIFICATE ISSUED- �. 33.;Final Electric I 1 1 /zn'- V - ` rDt' - Notes: 'r r x 34, Final Heating'& Air. Conditioning, ,,• _ _ 35. Final Ga"s Pipe -Test``°•= - .36. -Hood or Canopy%%•. '• - " , 37. -Final Factory Fireplace. y, 38. Final Plumbing A ••.. i j /Y „ ' r 39. Water Service -Final 7, _ 1: - -,40. Gas Service -Final . 41. Solar Domestic -Final'- 1I LI. r 42.'Backflow Preventer. '` • ' 43. Backflow Irrigation• .. .44. Landscape Irrigation System,, i %45.:Sound Attenuation - >: - ?•r; - 46. Handicap Regulations -_ •• , ' 47. -.FINAL STRUCTURE & BUILDING 48. FINAL PLANNING ...... _49.^Electric Release to Edison . 50., Gas -Release fo Southern California Gas Cv- ;51. CERTIFICATE6F.000UPANCY No. Date 1 PRDJ ECT ADDRESS: 301 E '16TH 'S T UNIT' H OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR,CA 92625 %ACH/ENGINEER: 71.4)723-5300 REG.ND.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)7.23-530C ADDRESS: 423 POPPYAV CORONA DEL MAR CA 9262.5 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Jate: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a cenificale of Workers' Compensation Insurance, or a cornball copy thereof (Section 3800, Lab, C). POLICY No.: EXP. DATE: COMPANY: Conflict copy is hereby furnished, ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (ihu se W need not be mmpNW if Ne permt is Iw one htmdred (SKID) or less(. 1 certify that in the performance of the work lot which this permit is issued, I shall not employ any person in any manner an as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or 'npair any structure, prior in its issuance, also requires the applicant for Such permit to file a signed Statement that he/she is licensed usuanl to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 700D) of Division 3 of the Business orf Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their Sale compensation, will do the work, and the ElStructure is not intended or offered ler sale (Section 7044, Business and Professional Code: The Contractors Slate License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. II, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project tion 7044• Pass and Professions Code: The Contractors State License Law does not apply to an owner i prope0pp who uilds or I. S thereon and who contracts for sato protects with a conlraclOgsl license pursuant to the Contract ' St icense Law am am that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. a P. C. for this reason: q Date: _ S I 1 Owner: do hereby certify that am aware of and understand the requirements lifornia Health an alely Code Sections 25505. 25533. and 25534 and that I or any future building occupant willivall not (circle I need to comply with id state codes and the rag Is for a permit for construction or modification tram the Air Only Mana ement District. Resldgn I construction applications ar exempt Irol�' these provisions. �/ / Date: Applicant I hereby certify that I have read this application and Stater a ab a ormationi I. Iree locooly with all ordinances and state laws relating to building construct nd here au orizer la- not s city tae er upon In in 'open f nspec/,li�a�jn}pwp /s , Dare: — J Signature I" Driver's License or Social Security a: `\64146 White—Building; Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05131 PERMIT.NO; B 051316 PLAN CHECK NO:,06841-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: SIR PURPOSE: NEW JOB DESCRIPTION :-NEW SFD SQ FT: 2,288 CLAIM VALUE: 90,000.00 CALL -VALUE: 130,268.00 GROUP OCC:'R-3 /N1 -N COMMENTS: NEW SFD HOLD FOR SPECIAL RE9 It�� # # Z O N I N G S E TB A C K $ R E Q U I R E M E N T S ' 1 ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING -------= FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT_ IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521161 ZNE: R2 REF NO: DR -90-•39 PLANNING N TES> UNIT H OF 8 UNIT DETACHED APARTMENT PROJECT > D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY y g��C DATE: 3 2 I BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: sl y DATE: ;-)r . I-)r. ##################M###'iFiF'iF'if3F'iFiFiF'#iF?Fie" if 3FiF 'ii7FiFiFiF iciF3F7FTFi�7F###IF####Y.# ## ` LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 748.00 9.12 SMIP/NON-RES PLAN 121.55 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 757.12 0.00 121.55 878.67 878.67 •00 REjy�NUE DIVISION TOTALS--> COLLECTED; 757.12 OVER/SHORT: 00 / BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 748.00 9.12 #MM####MM##iF?F##Y.#M?E##MM#MIEMMMY.-#Mit iF if iE#Tflf•1f iF#klE#3!#iE###k##k#8E#3E IE IF K3F)(-IF IF K-iF i(##aE#iE###if4 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1758 DWE-T V -WOOD FRAME -GOOD 69.00 121,302.00 SFR 58SFR 472 RESrBARAGE$ TY�EVIOR STAIRWAY 13.80 17.30 8,100.40 65.60 ' END. OF FEES MAR 18 1.991 CITY. OF COSTA MESA 1 r 1 C TRC CTION AND PLANNING Date APVA•LS Permit # Inspector POO( A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61;. APPROVAL TO DECK 11. Property Sewer*Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT' APPROVALS -Permit # 20. Rough Factory Fireplace - 21. Ducts, in Structure - - 70. Underground. Hydro 22. Ducts, Ventilating _ r71. Product'Piping 0Gas ❑Oil 23. Gas Pipe -Rough & Test - 72. Underground Flush 24. Roof Framing 73.' Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28.' Lathing & Siding. - 77.' FIXED SYSTEM FINAL •^ 29. Insulation 78. FIRE PREV. FINAL -30. Drywall Nailing HEALTH -DEPT. REQUIREMENT �= 31. Plaster Brown Coat, 79. FINAL INSPECTION :v 32. Electrical Power Meter -Final •80.sFOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning - ID 35. Final Gas Pipe -Test - 36. Hood or Canopy , •. 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final - - 41. Solar Domestic -Final r 42. Backflow Preventer " 43. Backflow Irrigation. - .. 44. Landscape Irrigation System „ v45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 2 " 48.' FINAL PEAA1114160 la�l „CID 49. Electric Release to Edison_i 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No Date LWT ADDRESS:- UNIT: OWNER'S AiNtE: 302 •E 16TH Siff $ ADDRESS: 4'�YPOPPYDS DEVELOPEMENT. CORONA DEL MAR CA 92625 723-5300 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: DRESSJOHN JANIS PLUMBING (714)642-7764 C ADDRESS: 1539 MONROVIA (� 8 LICENSED CONTRACTOR DECLARATION: I hereby affirm Ila' I am licensed t e om�iluons of Ch6apl'Jer 9 (commencing with Section 7000) of Division 3 aI the Business and Professions Code/�I an my f se lull tome an lett. CITY LIC.: STATE LIC.: S: OS?A�tY 5546 C -.E Date: �5` �� Signature: CITY DECLARATION: hereby afa-'Ificaleo nsent to self -insure oracertificate of Workers' Compensation Insurance. or a cenified copy thereof (Seb. C). POLICY NO.: 1091393 EXP. DATE: 02/ 1/'2 COMPANY: STATE Codified copy its hereby furnished. ❑ Certified copy is filed with C Fj Buil Division. x Date: _ =E •� - r ( APPlicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This sects need not be completed it the per s for one hundred ($100) or less). I certify that in the performance of the work for which this permit is i° ed. I shall not employ any p n in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors State License Law lot the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty o1 not more than five hundred dollars (5500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code : The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property. am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' M a License Law does not apply to an owner of propertywhr builds or improves thereon and no contracts lot such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Cade Sections 25505, 25533. and 25534 and that I or any future building occupant wilUwill not (circle one) need to comply, with said state codes and the requirements for a permit for Construction or modification Irom the Air Dually Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state ordinances and stale laws relating to building construction properly �lyar/ins/pectlio'n purposes. Date: J r •� �� Signature: Driver's License at Social Security r: is c erg. I agree twith all city and county of v of this City 1>,7 p on the above mentioned if 1641.46 While -Building: Greco -Cods Enforcement: Cnary-Applicant: Pink -Revenue: Goldenrod -Assessor CITY OF COSTA MESA - BUILD.ING PERMIT PERM NO: P 05169 PERMIT NO; P 051694 PLAN CHECK NO: N. GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU PURPOSE: NEW JOB DESCRIPTION NEW SFD SQ FT: CLAIM VALUE: CALL -VALUE: GROUP OCC: R-3 /M-1 COMMENTS- REF B510316 XX_*aE N -.X IF.)E%##+f'lE####%IF IT, *######a:>E MdF#ai X.*XX. #'x#####x%l:lf###-Tc###lE#IN*Y.X x#i: x*I( Z 0 N I N GS E R T E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING---------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN --------- ACCESSORY BUILDING--------- FRNT; FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING, NOTES> > D E V E L O P M E N T S E R V C E S R E Q U I R E M E N T S ZONING APPROVED BYI DATE: BUILDING APPROVEDBY APPLICATION ISSU B LEGALIZATION:N BLDG PMT PLUMBING PERMIT 43.50 258 DATE; DATE: '#'�u� P%####1F% F E E S U M A R Y STRUCTURAL SEGMENT:N MECHANIC FIRE SMIP/RES GRADING SM,IPJNON-RES" PLAN ISSUE FEE 3.00 BUILD ING-DIV- > PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 43.50 3.00 0.00 46.50 46.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 46.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 46,50 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T.;I O N UNIT COST TOTAL COST PLU 1 BATHTUB 2.00 2.00 PLU 1 DISHWASHER 2.00 2..00 PLU 1 LAUNDRY TUB OR WASHER 2.00 2.00 PLU 2 SIiOWER 2.00 4.00 PLU 1 SINK, KITCHEN 2.00 2.00 PLU 4 WASH BASIN 2.00 8.00 PLU 3 WATER CLOSET (TOILET) 2.00 6.00 PLU 1. WATER HEATER AND/OR VENT 2.00 2.00 PLU 1 WATER SERVICE 2.00 2.00 PLU I GAS PIPING SYS OF I 4 2,00 PLU 1 -PERUTLETS GAS PIPING SYS 5t OUTTO oA 00 1111 ,�-ormtT4v aD ac, rzr.�: I -c5i51 A.i/91 14: COA!STRUCTION AND PLANNING p APPROVALS Permit #- Date PL-" `& Inspector APPROVALS Permit # Date Inspector �. Temporaey Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final , 14. Rough Plumbing 65. Electrical -Final ' 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank CGas 0Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standpipe 26. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test �/1/ 9• 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 46. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS: ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: ADDRESS: LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: or a Signature: ION: I hereby affirm that l have d certificate of consent to sell -insure or a certificate of Workers' copy thereof )Section 3800, Lab. C). PLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need trot be completed if the permit is for one hundred ($100) or less). I ierely that in the performance of rhe work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date: Signature: NOTICE: If. atter making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions at thus permit Shall he deemed revoked, CONSTRUCTIONLENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance of the wore for which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city 01 County which requires a permit to construct, alter, improve, demolish. Or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cade) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1, as owner of the property or my emDIoyeeS with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale($ection 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner 01 a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement i5 sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose OI sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 1-1andProfessions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. S P. C. for this reason: Date: Owner I do hereby certify that I ern aware of unit understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wintwitl not (circle one) need to comply win said state codes and the requirements for a permit for construction of modification from the An Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that shave read this application and state that the above information is opinion, )agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above mentioned properly to[ inspection purposes. Date: Signature: License or Social Security a: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Ga1denro0—Assessor PERMIT NO: P 051694 PLAN CHECK NO: 01298-91 N PAGE: 2 +!-#####3i#3F#Nii•#ef#####ie########if.K.########!e###iF#####3F#####rF'###3e?Fie##1i3+#iE#T(N##iF##Yr### TYPE (QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 GAS SERVICE PLU 1 SEWER BUILDING / TRAILER PLU 2 RAINWATER SYSTEM - PER DRAIN END OF FEES' 2,00 5.00 2,00 2.00 5.00 4.00 3*oUPL1C: aTE F<EC:F-IPT 0100054918-6100901a TIDT 46.1:4 DATE: 04/15/91 TIME: 14:51 CONSTRUCTION AND PLANN APPROVALS Permit # Date Inspector POOL _ SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final " 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 302 E 16TH ST UNIT: H OWNER'S NAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 RFG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code. and my license is in lull force and affect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature WORKERS' COMPENSATION DECLARATION: Ihereby allirm that I have a certificate of consent to self -insure or a certificate of Workers Compensation Insurance. or a cemfied copy Inereof (Section 3800, Lab, CL POLICY NO.: EXP. DATE: Certified copy is hereby furnished. ❑ Cell copy is filed with the city Building Division. Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need ret be completed if the permit is for one hundred ($100) or less). I cenily Incl in the pedprmante of the Work let which INS permit is issued. 1 shall not employ any person in any manner W as to batome Subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith Comply with Such provisions of this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Section 3097. Div. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter. improve, Canadian, or repair any structure. prior t0 its issuance. also requires the applicant for such permit to lila a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9(commencing wth Section 7000) of Division 3 of the Business and Prolessions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself Or through his or her own employees, provided that such improvements are not intended or offered for sale. 11, however the building Or improvement is Sold Within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). rtt I. as owner of the property. am exclusively Contracting With licensed contractors to construct I project ction 7044. Bushol Ial dn0 Professions Code: The Contractors' State License Law does not apply to an owne r fly Who as or improves to and no contracts r such projects with a coniractorla license pursuant to 0 ors' State re Law),I I e that proof of their Norker's Coto/9�a tion insurance should be provide me. ❑ I am exempt u er Section: / B. 8 P. C. e/ lar eam1- �X Date: !//-- l do hereby rend Inas I am aware 25534 antl that or any future buildin( permitlor ruction or modllkatio these prowsions. Date. I hereby cemfy that I haV read INS a ordinances and state law rrelalingtpor Property lw%wdl7clmy purposN J derstand the requirements at California Hea' and S eT Code Steel 25505. 25533, and ant vnlVvnll n0iatircle one) nu to compI with sat stale codes and the requirements lora the Air Ouahty Management Distdd. Re denlial restruction applications are exempt from and state that to Date�nawre. Dn_Lr Social Se my o: 164646 While—Building: Goren—Cotle Enlorcemenl: Canary—Applicant; Pink—ROVeaao; GOIdomod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: M 052872 PERMIT NO: M 052872 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION : NEW SFD W/ATT GARAGE SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51316 PRIMARY BLDG. PERMIT, kkkkk*ick***kkkkkkkkkkkkkkkkkkkkkkkkkkk*kkkkk*kkkkkkkiFk kkkkkkk*kkkkiFkk**kkiFkkkkk Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING N TES> kkkklf*kkkkkkkkkkkkkkkkkkkkkkkkkkkkkklfkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkif iEkkkkkkkMiE D E V E L O P M E N T S E R, -.V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: A/1.ti DATE: Zz ►/ kkkkkkkkkkkkkkkkkkkkkk �%iFkk'iE7FifiFk3FiFiFIFiFkkkkifkkkkk r ick k kkkkkkkkkkkkkkkiekkkkkkkkkkµkkkkkkkkkk k fklekkkkkkkkkkkkkkkkkkkkkkkkkkkkkkklFkk LEGALIZATION:Y F E E S U M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 4400 52 SMIP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 44.00 15.00 0.00 59,00 59.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 59,00 OVER/SHORT:00 LDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK �J 59.00 /e it IF 9E iE iE 3E iE if iE iF iE ff kir if if it iE lE lE iE it iE iE if 3f iF 3F if 9f 3F iE k iE if iF if if if lk iF if iE it if iE if if if if iE iE 3E iE iE if+E if iF if if if iF iE tf aE if iE iE iF 3E it iF iF iF I N D I V I D U A L F E E B R E A K D O W N TT PE QTY D E S C R I P T I O N UNIT COST TOTAL COST ME 1 INST FORC-AIR/GRAV FURN <= 100 K BTU 9,00 9.00 MEC 2 FACTORY FIREPLACE 6,50 13.00 END OF FEES CONSTRUCTION AND PLANNING i APPROVALS Permit # Date Inspector POO'A APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms A. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test - 6.`Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings > > 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. - 10. SFructural Floor System 61. APPROVAL TO DECK 11. Property Sewer. Line & House Connection 62. Backwash & Receptor -Final, 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains • 64. Plumbing System - Final - f 14. Rough Plumbing 65. Electrical -Final , 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT Permit # 20. Rough Factory Fireplace.•APPROVALSi.-71 r 21.' Ducts, in Stryctute �. _ �, ;,' 170. Uhddjcound HyGro 22. Ducts, Ventilatingye X71, Product. Piping 0Gas 0Oil 23. Gas Pipe -Rough & Test . - r: ' 72, Underground Flush - 24. Roof Framing •`• _ '+ , "'73.' Undergrnd.StorageTank-0Gas' 0OiL 25. Roof Sheathing'74: Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 4. 75'. -Dry Chemical _ n • _ ,r 27. Frame and Flashing ',� ' 76. Dry Stan4jpe t ' 28. Lathing & Siding i ,•f•i : >, 77.' FIXED SYSTEM FINAL_• 29. Insulatig f 7B� FIRE PREV. FIOV .L S ,. •30.Drywall Nailing t•+ j;. � HEALTliDEPT..REQUIREMENT 31. Plaster Bjown Coat r 179:•FINAL IN_SPECTI•QN r t 32. Electrical Power Meter•Final /.-, '. 80.. FOOD C , E'4 IFICATE ISSUED' 33.' Final Electric r ,'" t ��'� 1 -'Notes: ' r 134, Final Heating-& Air Cdnditiotning ' J y 4 / d 35. Final Gas Pipe -Test• f - 36. Hood or Canopy . '`r '��i -��"C. t ' 37. Final Factory Fireplace �! •� 38. Final Plumbing 39. Water Service -Final •� •-.r t 40. Gas Service -Final I .' Cs �• >41. Solarpomestic-Final- 42. Backflow Preventers- r - 43. Backflow Irrigation r ,. i 44. Landscape Irrigation System �45.`Sound Atte0uation "46. Handicap Regulations i ; 47. -FINAL STRLICTURE & BUILDING (/ = 48.'FINALPLANNING - /•' 49,. Electric Release to Edison r '50,Gas Release to Southern California Gas Co .51. CERTIFICATE OF OCCUPAIqC7 No. Date GeEj< %DDRESS: 302 E 16TH ST UNIT: H owN ADNAME: LLOYD MYLES DEVELOPEMENT ADDRESS: 423 POPPY AV CORONA DEL MAR CA 92625 ARCHIENGINEER: 723-5300 REG.NO.: ADDRESS: UNIT: PERMITTEE: LLOYD, MYLES DEVELOPMENT (714)723-5300 ADDRESS: 423 POPPYAV CORONA DEL MAR CA 92625 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Oiksion 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a cenitic to of consent to self -insure or a cenificate at Workers' Compensation Insurance, or a certdied copy thereof (Section 3800, Lab. Q. POLICY NO.: EXP. DATE: COMPANY: , Cenified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division Date: Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is far one hundred (5100) or less), I certify that in the performance of the work lot which this permit is issued. I shall not employ any person in any manner so as to became subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: It. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a ConsWtion lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 052871 PERMIT NO: E 052871 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH JOB DESCRIPTION ; NEW SFD WATT GARAGE SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: RE: B51316 PRIMARY BLDG, PERMIT. *BE 3r RE*dt*�**atm*46**�E*��E�E�6�E:ritx*�ESE�r+r*�Ea6yr�F�6��riF�*�r�E*it*�r�E*��rx**�6*�E+��L�6�6+ES6♦ET6*�r**�6��6>F*�6*�E�6 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT -IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42521101 ZNE: REF NO: PLANNING NOTES> TOTAL 138,06 PAID DUE 138,06 ,00 does not apply to an owner of a property who builds or improves thereon, and who does such work himsell/herself or through > his orheri employees, provided thatmplion.the one are netintendedetlorofpr for shelsh, did not or imngor his or her o n sold within one year of t such aimprove owner will have the ed or of proving hleshe tlitl not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 138.06 OVER/SHORT: 00 BE iE BE 16It atr it a6 it ft * 9E if B6 * i6 iE IE 9e if iE it TF iF 3E * Bt it TE IE IFiE Rf 3f,iklf it iE Be * iE iE * iE 4t iE iE iF iE 3F iE iE it BE jE iE 9E 3F iE iE * * * iE iF aF iE BF � 36 R6 RE ie iE T49F RF iF RF D E V E L O P M E N T S E.;R V I C E S R E Q U I R E M E N T S (}� ono Professions Code: The Contractors' State License Law, does not apply to an owner of pro who but or improves thereon and who contracts for such projects win a contractors) license pursuant to the Conirac ' tale rase Law). l am awyra–, that proof of their W is Compensatio surance should be provided to I N D I V I D U A L F E E rr ZONING APPROVED BY I -V DATE: •1 BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE, IE iE iF IF iF i6*IF i6 iE BE iE i6 dt-*ie yE**ryE**riF it ie BE***kiEia iF iE*iE BF IE MiE RE**iE it if iP*iF iE*iE**1F iE TF*iEif iF iE It lE iE**iEi6 #9f iE if** LEGALIZATION:Y F E If S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors' State License Law for the following reason // BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any day of county which requires a Dermis to construct, alter, improve, demolish, or PERMIT 123.06 repair any structure, prior to its issuance, also requires the applicant for such permit to fife a signed statement that he/she is licensed 50% SMIP /NON—RES pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing wish Section 7000) at Division 3 of the Business Professions Code) he/she is for Any Section 7031.5 by PLAN and or that exempt therefrom and the basis the alleged exemption. violation of any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ISSUE FEE 15 .00 I. as owner of the property or my ennyloyees with wages as their sale Compensation, will do the work, and the Elstructureisnot intended oroffered for sale (Saction 7044, Business and Professional Code: The Contractors' State License Law BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 123,06 15,00 0,00 TOTAL 138,06 PAID DUE 138,06 ,00 does not apply to an owner of a property who builds or improves thereon, and who does such work himsell/herself or through his orheri employees, provided thatmplion.the one are netintendedetlorofpr for shelsh, did not or imngor his or her o n sold within one year of t such aimprove owner will have the ed or of proving hleshe tlitl not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 138.06 OVER/SHORT: 00 lot the purpose of sale). DG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I, as owner of the property, am exclusively contracting with licensed contractors to construct the project f5e on 7044, Business 138.06 (}� ono Professions Code: The Contractors' State License Law, does not apply to an owner of pro who but or improves thereon and who contracts for such projects win a contractors) license pursuant to the Conirac ' tale rase Law). l am awyra–, that proof of their W is Compensatio surance should be provided to I N D I V I D U A L F E E B R E A K D O W N ❑ Iexem t untle edion: B. 8 P. C. for t rs re �� � / Date: I do hereby tern trial I am aware oJ/and understand in 25534 ono tha at any future buildi occupant will/will permit for con ruction or mothicilion Imm The Air Oua these provistOns. Dale: Applicant: I hereby certify that I have read this app lCoron and stat( Dale: Signature: _ Driver's erase or Social Se my +: 1641.46 Whno—Building: Green—Cone Enforcement: E L E Cry Code Sections 25505. 25533. and ai state codes and the requirements lot a 'construction applications are exempt from ci comply with and ka count / silty enter Moon above-mentiC i Pink—Revenue: Goldenroo—Assessor QTY 1758 D E S C R I P T I O N UNIT COST TOTAL COST NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT .03 61,53 END OF FEES Alp POOL A CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. .Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5; Steel Reinforcement 56. Rough Plumbing & Pressure Test - - .•6e ElectricalUFERGrnd. 57. APPROVAL TO COVER-GUNITE 7. -Footings r 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd.. 10. Structural Floo&System 61. APPROVAL'TO DECK ` 11. Property Sewer. -.Line & House Connection 62. Backwash & Receptor -Final _ 12. Sewer Cap 63. Heater & Vent -Final - 13. Roof Drains -- 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final -" 1 16. Rough Electric Wiring lar ,�J�i„� Y, 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING.' 18, Rough Electrical --T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUfRCM,5NT APPROVALS+ ^CPerhiit # - 20. Rough Factory F- fireplace - -, _ x 21. Ducts, in Structure , ... g• :x x 470. UndergretrlmcJ:Hydro 22. Ducts, Ventilating,- �•� `� -77, Prod uct•Pgiing 0 -Gas O'Oil 23: ,Gas Pipe=Rough 8i 'test ' , - 72. Underground Flush- ' 24. rRool Framing - -• C '73.tUndergrnd:StorageTank 0Gas 0gt4 25. Hoof Sheathing �1 `.; rtt '-74.-Overhead Hydro -! '. 26. T -Bar Ceiling (Structural) & Mon ocoat '• 75=:Dry Chemical - - 27.-Frarpe apd Flashing 76. Dry Stand'p pe 28. Lathing Siding.-+ -. .�L - ... •• + 77.E FIXED SYSTEM FINAL y 'n 29. Insulatiqn -. ••' ;, t`' 78a FIRE PREV*. FINAL 30. Drywall "Nailing r i< -y;,� - HEALTH,DEPT.REQUIREMENT 31. Plaster Brown Coat• I '� ` ,79. -'FINAL INSPECTION 32. Electrical Power Meter -Final. 'JJ••.r'�r80.+FOODCERTIF6CAfh'ISSUED i 33.'Final Electric .3 34. Final Heating & Air.Conditioning: 35. Final Gas Pipe -Test'- 'o• •� 136. Hood or Canopy + r r >, : •" 37. Findl Factory Fireplace _ ^';' f' �.e tV: 38. Final Plumbing •39. Water Service -Final _ 40. Gas Service -Final -41. Solar Domestic -Final 42.'Backflow Preventer 43. Backflow Irrigation - • " J"A i_ ,}i: C ,44. Landscape Irrigation System .• - r -• - •' '45. -Sound Attenuation 46..Handicap Regulations 47. -FINAL STRUCTURE & BUILDING - 48' FINAL PLANNING - 49. Electric Release to -Edison I � 50. ,Gas Release to Southern California Gas Co.51. CERTIFICATE OF OCCUPANCYNo Date