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HomeMy WebLinkAbout210 16TH ST - Building Permits fl PROJECTADORE55: 210 E 16TH ST UNIT: A CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 054430 r 'OWNEfl'SNAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA PERMIT NO: B 054430 PLAN CHECK NO: 04090-91 A GOVT: N SUPP: N SUITE 315 LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: NEW 3800686 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : RETAINING BLOCK WALL W/WOOD FENCE SQ FT: 330 ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: 3, 700 . 00 CALL-VALUE: 1 , 950 . 00 GROUP OCC: M-1 / BRIGGS DEVELOPEMENT ( 714 ) 380-0686 1 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS: RET ALK WALL W/FENCE & TRASH ENCLOSURE LAGUNA HILLS CA 92653 ***************************** *****+r*TEFF*******TF*****FFkF********************FF**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)at Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date' signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: l hereby affirm that I have a certificate of consent to self.insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 42520106 ZNE: R2 REF NO: Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> 225 L. FT. OF 6" RETAINING WALL WITH 5 FOOT WOOD FENCE > ABOVE, Date' Applicant* *********************** ****************************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed it the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES 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 Califomia:' ZONING APPROVED BY �- GC DATE: 1,____Dale: yshoe: • BUILDING APPROVED BY : DATE: NOTICE:y:N.atter making thiscdeclaration,wwiyou shosio seoomi subjectedeemed empensation provisions al the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. *3F * / CONSTRUCTION LENDING AGENCY: I hereby affirm Mat there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; � - - - DATE•• 9 which this permit is issued(Section 3097.Civ.C). - ********************** ********** * *** **** LENDER: *********************** **************************************************** ADDRESS: LEGALIZATION:N FEE ' SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I 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 45 ,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 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 - 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 7. 31 p any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). 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'State License Law TOTALS----> 45 . 50 0 . 00 ; • .-, 7. 31 52 , 81 5 2 . 81 . 00 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.Il,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 52 . 81 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 • - torMepurpose ofsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 11\\ I,as owner of the property.am exclusively contracting with licensed contractors to construct I ' . .feet(Sectio• I'',Business 4 5.00 . 50 7. 31 1 1 La and Professions Code: The Contractors'State License Law does not apply to an owner of pr.. who build . improves thereon and who contractsfor such projects with acontractorls)license pursuant tothe Cant• State ' se Law).I am aware *****************************************'************************************** that proof of their Worker's Compensation insurance should be provided . me._ - I N D I V I D U A;L F E E BREAKDOWN ❑ I am exempt under Section: B.B.P.C. . for this reason:so� / 9 / / 400.100v ' TYPE QTY DESCRIPTIPO N UNIT COST TOTAL COST �_ Date:_LS� �/ — e r �s /fete SFR 65 RES-RET WALLS <= 3- FT W/SURCHG/ FT. 30 .00 1 , 950. 00 I do hereby certify that I am aware 01 and understand the requirements of Califo ra Heal and Safety Code Sections 25505.25533.and 'END OF FEES 25534 and that 1 or any future building occupant will/will not(circle one)need to come•with said state codes and the requirements for a permit for construction or modification from the Air Duality Management Disiri. ••sidential construction applications are exempt from 1 these provisions. Date: Applicant: - J., I hereby certify that I have read this application and state that lh• love int.mall. 's co .1 a. 'e to comply with.f 'ty and county ref and statelava relating to building construction and ebyaul 'sent. es of •s ity .ever upo .ve-mentioned property for inspection// purposes. d _s/ , Date' `� //�/ Signature: _/ /r'/ Driver's License or Social Security': 1641-46 White—Building:Green—Cade Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod-Assessor r CONSTRUCTION AND PLANNING POC WA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.,•Electrical Conduit Utility-Undrgrnd. 54. Forms c 4:,Electrical Conduit-Undrgrnd. 55. Electrical Bonding • ' .5 Steel Reinforcement_ 56. Rough Plumbing & Pressure Test r t.',Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings _ 2 1�.„4"4_Jh 58. Electrical Conduit-Undrgrnd. Cl 8. Foundation - 59. Gas Pipe, ❑ Undrgrnd., Test 9:-Water Pipe-Undrgtnd. 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 ; - I 12. Sewer Cap 63. Heater & Vent-Final _ 13. Roof Drains _ 64. Plumbing System - Final 1 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final f 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 20.-Rough Factory Fireplace _ .. _APPROVALS -Permit # yl I 21. Ducts, in Structure' - r70. Underground Hydro 22. Ducts, Ventilating . " ' _ + :71. Product Piping 0-Gas ID Oil 23. Gas Pipe-Rough & Test ' S ; 72. Underground Flush • 24. Roof Framing • - • :73. •Undergrnh Storage-Tank-0 Gas ❑Oil 25. Roof Sheathing _ •_ - � '74-Overhead'Hydro_ • 26.-T-Bar Ceiling (Structural) & MonocoatL:.; r _ •. . . 757 Dry Chemical - 27._Frame and Flashing - : l'.' 76. Dry - -Standpipe _ - • 28.' Lathing i Siding- . . •- . • .. .. -. . • 77. FIXED SYSTEM FINAL? .q "29. Insulation r - " r ° ' 78:•FIRE PREV. FINAL -30. Drywall Nailing '. � • - . • HEALTI-DEPT. REQUIREMENT .31. Plaster Brown Coat .. 79 FINAL INSPECTION - - '- 32._Electrical Power Meter-Final 4 I . :•80. FOOD CERTIFICATE ISSUED • 33/Final Electric ' .- ' • ' : Notes: 2 r' ',Z , .QLC Td 41/40.. 34. Final Heating& Air Conditioning ' ' -Y/o//": 35.3Final Gas Pipe•Test• i 9. • . - 36. Hood ortanopy • _37.-Final Factory Fireplace • t 1, - - - " -r :, rt • - 38.•fina1 Plumbing _ . ' ' "' .39. Water Service-Finals t . - • r; r I . . .. - 40. Gas Service-Final ' • ,. ' • 41. Solar Domestic-Final. . • 42. Backf low Preventer - - - ' - 43. Backflow Irrigation ' . - i; c - . ,r r * 44. Landscape Irrigation Systema' .1 ,, �- _ - .-,'� , c• .1 . 45:4Sound Attenuation • •> T - - - - - • . is j46:•Handicap Regulations - • 47.-FINAL STRUCTURE & BUILDING - 4. gun 48.fINAL PLANNING I; •,'.; 49.-Electric Release to.Edison '. ; T :, i ' 50. Gas Release to Southern California Gas Co ; ' ' ''. .51. CERTIFICATE OF„OCCUPANCY . - 1. No. Date PROJECT ADDRESS: 210 ' UNIT: CITY ' Ili. r ;": PERM k' BP r- E 15TH Si iii CGTA MESA - BUILDING PERMIT PERM NO: O 157E OWNER'S NAME: BRIGGS DEVELOPMENT ADDRESS: 23046 #315 PERMIT NO; BP 051578 PLAN CHECK NO: N, GOVT: N SUPP: N AVENIDA DE LA CARLOTA LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: =-N PERMIT TYPE: PLO STR PURPOSE: DEM ( 710 ) 380-0686 ARCH/ENGINEER: ROB LN B . H.yMERS REG.NO.: RC DN ,1720 - JOB DESCRT.PTION : DEMO SFD W/ATT GARAGE/INCLUDES SEWER CAP SQ 1': ADDRESS: 212 17TH ST . 205 COSTA • MESA CA 92653 CI,ALM VALUE: 1 , 000 , 00 CALC-VALUE: 1 , 000, 00 GROUP OCC : R-3 /M- I. PERMITTEE: BRIGGS DEVELOPMENT ( 714 ) 3.80-0686 ADDRESS: 21046 CARLOTTA AV315 COMMENTS : DEMOLITION ONLY . NOT A BUILDING PERMIT' '.AGU:NA HILLS CA 92653 :FwSFkY :tlF :. F!iK: i •.s'i.4{vti;44.0.Et*. Vi1Ff! ati::*** ,E+.ai Y:i:.ui. . ii. 4 i. x .+fki3FY{.r-i�i!Frit i++.. LICENSED CONTRACTOR OECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section -, ONING R E O LJ R EMEN TS 7000)of Division 3 0l the Business and Professions Code.and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: S E I 8�A C R S Dale' "--Signature: - ;°IAIN BUILDING --- ---- ACCESSORY BUILDING —' '-- • WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cemficate of consent to sell-insure or a certificate of Workers' =.RN 1 : Fl IN REAR : FT IN r RN I': S! IN REAR: N T IN Compensation Insurance.or a certified copy thereof(Section MO.Lab.C). LEFT: FT IN H.P; F T IN LEFT: F I iN R Gii T: FT IN - ZOLICY NO.: EXP.DATE: COMPANY: PARKING REQ PPOV: PARCEL : i. 1"15115 ZitE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Budding Division. PLANNING NOT ES> > Date: Applicant: .2.rif -!(.aY1F>a4*ko.o..4 xxr#t+ :.✓No.pro i*t.F' O **X <r.fiKllf E'Fcw}*w•af<Ff,-s..s{. . e.*>::fi+*/+t+xtix-YYiE:rri✓ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(S10O)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to became subject to me Workers'Compensation Laws of California. ZONING APPROVED SY _ _ _ DAT': •Date: Signature: NOTICE:II,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED 3Y :_ - DATE: Core.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 APPLICATION ISSUED LH�f which this permit is issued(Section 3097,Civ.C). t DATE PI TIGKll lF Ei9FBY;4i ti 17'� � n. T.�F�F F'•�IF iTF'ti)F}:JE DATA :TFgT. �i*1: LENDER: „4,t4 44.1“.“.GA-i-4-3AW¢A31L:)•AtAi WA:¢tA:i+-A;li-YXI A.KCI:i,.Y Yi xlLw.iijf►%Y4-mao%i Kfi**Fi*FM** t4O(fl V {,j l* ADDRESS. LEGALI2AT ION; N F E E SUMMARY STRUCTURAL SEGMENT: ? OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason U J rH4 T'CJfT PL UMU I V L- E L E(:T'q T C yM F(_'.P AN'r.L'. WTRE0:.'#1)a f R[r N NG (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolip hRish,orI T 25 ,110 '2a 00 ...o OR r 1�.I7_. 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 701)0)of Division 3 of the Business ;),5% ' 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 P LAN . 50 any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S500). ISSUE FEE 3 . 00 •I. as owner of the property or my emptoyees with wages as their sole compensation. will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE r3 structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS-.---> . 27 . 50 3 . 00 0 . 00 ,)10 . 5 30 . 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 offered for sale. IL however the building or _ 7 m. improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve R VENUE DIVISION TOTALS—> COLLE C T ED: 30 . 50 OVER/SROR T: t . 00 for me purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN-CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25 . 00 7 . 00 . 50 LW 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 protects with a contractors)license pursuant to the Contra tors'State Licen . Law).lam aware .— i y.at i lc i it 4 i i iF* i...w..**i•F i i x X.*i 4 34*i k+;i of:*of i i M i+F i)r M.+'.)c ie'r•;:X-+**i.*-rd tF+i+i of+k+ l},.fir i u*:F y*- that proof of their Worker's Compensation insurance should be provided to me. I N DI 0 I am exempt under Section: B.A P.C. V I D U A L F E E B R E A K D O 14 N for Ons red on: - TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST • - Dale: L/ S / 9 Owner: A_ ✓/�' 1 P / P_ O 1 SEWER CAP / DEMOLITION EACH 2 . 00 ..4 . 00 I do hereby certify that I am aware or and understand the requirements of C afornia nd Safety Code Sections 25505.25533.and 25534 and that I or any future building occupant will/will not Icicle one)need to co•. ith said state codes and the requirements for a END OF FEES ., permit for construction or modification from the Air Duality Management District.) idential construction applications are exempt from these provisions. \\1y"11//7� ordin Applicant: I hereby certify that I have read this application and state that the above informatir • . agree .comp y . I city and county oroperty sandslachonprelating to building construction and hereby aulh.riyr- - motives oft'AL to enter upon t ementioned ' .property for inso cbon pr rposes. / / _, 49 /�' -] Dale: e/f Sh y Signature: /�'- •"�wkaa' A p1- 01 000E4243-000242'0 7(3T 3:_I•:,I / or iZt67NQ ) DATE: 0+/05/91 Tli-in 14:41 Driver's License or Social Security e: : ..J 1641-46 Wrote-Budding:Green-Code Enforcement:Canary-Aoolrc .Pink-Revenue:Goldenrod-Assessor \ S ( 5 - f/ 7-7 0 ! 7.0 ecq . "SOFBwLMIa: 210 E 16TH ST LINT; A CITY OF COSTA MESA — BUILDING PERMIT t ee® H'S NAME IF MOWN:KNIPP, TODD PERM NO: E 081498 ADDRESt210 E 16TH ST #A COSTA MESA,CA 92627 PERMIT NO: E 081498 PLAN CHECK NO: N GOVT: N SUPP : N APPL.MAILING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD ARCHITECT OR ENGINEER:STEVEN AHUNA UGN°.: 34264 JOB DESCRIPTION : ADD 15SF TO 1ST STORY FAMILY ROOM & SQ FT: ARCH.OR EMO.'S ADDRESS: 210 E 16TH ST WIT: C .M. CA 92626 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / cONTRACTORSIAME:ROB ERT J. MASONIS ( 909 ) 699-9335 CONTRACTORSMMID.3 P,O.BOX 1804 COMMENTS : 15SF BAY WINDOW TO 2ND FL, REPLACE & ADD WINDOWS, INT TI, #B81497 MAO.:ADDRESS:TEMECULA CA NO.: 399654 **************aEftiEiE�titaErtSETE***UAE****ataEu**u **x*�r�E�ESEAt �LitAt**SE+tat+L*St+tatAtx*4************ 92593 UMT: Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I em licensed under provisions of Chapter 9 SETBACK S (commencing with Sect 7000) DTwbn 3 d license Business end Proles' Code,and my licee Sin full force end effect. CITY LIC.No.: QLc) LIC.CLASS:B LIC.N .: 3 654 XP: MAIN BUILDING ACCESSORY BUILDING Z^(y �1 Cad mor C—��yMl/ (Ny7/ FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I em esem rom the Contractors License Law for the , following reason(Section 7031.5 Business and Professions Code:Any city er aunty which requires a permit to con stma,alter,improve, PARKING REQ: P ROV: PARCEL : 42520125 Z N E: REF NO: emdbh,or reps[any structure.prior to its'issuance,also requires the applicant for such permit to fib a signed statement that he or she r licensed pursuant to the provisions of the Contractors License Law[Chapter a(commencing with Section 7000)of(*Sion 3 of the PLANNING NOTES> Business and Professions Code]or that he or she is exempt Iherehom and the basis for the alleged exemption.My violation of Sedan > 7031,5 by any applicant for a permit subjects the applicant toy awl penalty of no more than live hundred dollars lS50I). ******************************************************************************* 0 I,as owner of the pr pedy or my employees with wages es their sole compensation,wll do the work,and the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044,Business and Professions Code:The Conlradors License Law does not apply to en Owner of property who bulds Of improves thereon,and who does such work limsed or herself or through his or her own employee..provided that such improvemerds ere nd intended altered lor sale.If,however,the building or inprovemerd S add within One yew d completion,the ZONING APPROVED BYDATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). I. property,owner of theproperty,am exclusively contracting with licencontractorsnaedcontractorsto construct the project(Section 7044.Business end BUILDING APPROVED B Y - Professions Code:The Contractors License Law does notapply man owner d property who builds or improves(hereon and who DATE: contracts for such projects with a contnaaor(s)licensed pursuant to the Contractors License Law). jj ❑ l amexernpl under Section: B.A P.C.,for this reason: APPLICATION ISSUED BY: DATE: aECp ************************************************* ************************ ** Date: Owner LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sedans 25505.25533.and a5rmitfand omioany or mod wildirrmtheoccupant w;n/wRnaegem(Circle one)aii Recomply ldeMallna°idmtewdeaemmeremptfm.mafo BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provovisione construction wmodMatanhomihe Ai u0�6e ty epement District ReeidentvJ construction eppicetian are uemptfmm these PERMIT 18 , 00 Dale: Applicant: 50% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:Ihereby affirm under penalty d perury one of lite following declarations: PLAN ISSUE FEE 22 , 00 Code, nd wU mair°an a certificate d consent to sell-insure peore mr workers•compenwion.=provided la by Sedan 3700 d the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.for the performance of the work for(Mich this permit is issued. I have and sal maintab workers'compensation insurance,ea required by Section 3700 d the tabor Code,for the performance of the TOTALS > 18 , 0 0 2 2 , 0 0 0 , 0 0 4 0 , 0 0 4 0 . 0 0 00 work for which this permit S blued.My workers'compensation insurance anier and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 40 ,00 OVER/SHORT: . 00 A Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed?the perm?is for one hundred dollars MOO)or lea.) 40 . 00 `'d I certify that in the performance of the work for which this permit is yyissnett I shall not employ any person in any manner so as to become waled to the workers'na700 albn kava d Cath miey lit thin B I elwuk tisane aubjep to 1M worken' ******************************************************************************* compensation provisions d^�Section 3700 d the labor Code,I Mh comply h provision. // INDIVIDUAL F E E BREAKDOWN Dais: L—(0 —`l 1 Applicant: (� /J Warning:Failure to secure worker[conpensatlon coverage/s unlawful,and )act an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($100,000),In addition to the cost of compensation,damages as provided ler In Seedon 3706of Me Labor Code,Interest,and attorney'lees ELE 10 FIXTURES, LIGHTING 1 ST 20 EA, 1 .00 10 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the ELE 5 RECEPT/OUTLET 1 ST 20 EA, 1 .00 5 . 00 performance o the wet dor which this pert is isued(Sedmn 3037,CW.C). ELE 3 RECEPT/SWITCH 1 ST 20 EA. 1 . 00 3 . 00 LENDER'S NAME: END OF FEES .. ': ' c,ir LENDERSES ADDRES T may; l LECT WORK I certify that l have read thisapplication and dale that the above information is cated.l agree to comply with all city and county ordinances tt y and slate laws relating to building construction end hereby authorize representatives d this city to enter upon the abovemamboed Drapery • for inspection purposes. ROBERT MASONIS " ` a Lid Date: z_ 17 EXPIRED MY OF COSTA MESA • Signature d Owner/AgendAPpkandCornreda DATE 5 6 o6 (5151-46.WP) White-Building5 Safety;Green-Fila:Canary-Appicant:Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING P00.-,c&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 • i.4. Electrical Conduit-Undrgrnd'. - 55. Electrical Bonding 5. Steel Reinforcement . _ , 56. Rough Plumbing & Pressure Test 6. 'Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUM-1E 7. Footings • : 1 - 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 t 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final - 16. Rough Electric Wiring 67. Fencing& Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - - APPROVALS Permit# 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 0 Gas 0 Oil 25. Roof Sheathing _, 74. Overhead Hydro 26. 5-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 1 - HEALTH DEPT. REQUIREMENT - • 31. Plaster Browri Coat 79. FINAL INSPECTION • 32. :Electrical Power Meier-Final - 80. FOOD CERTIFICATE ISSUED - -. 33.'Final Electric, - Notes: - -- `(J, ' 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 • - 42. Backflow Preventer . • • •43. Backflow Irrigation • - I 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 ofiq ADDRESS OF BUILDING: 210 E 16TH ST um.: A CITY OF COSTA MESA — BUILDING PERMIT Rai00 OWNERS NAME IFIWOWN:KNIPP, TODD PERM NO: P 081499 ADDRES&210 E 16TH ST #A COSTA MESA,CA 92627 PERMIT NO: P 081499 PLAN CHECK NO: N GOVT: N SUPP: N . APPL.MMUNGADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE : PLU PURPOSE: ADD BARCNRECTOREMGNEER:SdEVEN AHUNA uC.ND.: 34264 JOB DESCRIPTION : ADD 15SF TO 1ST STORY FAMILY ROOM & SQ FT: ARCH.OR ENG.'S ADDRESS: 210 E 16TH ST INT: C .M. CA 92626 CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / co nucrowsrw ROBERT J. MASONIS ( 909 ) 699-9335 CONTRACTORS MAU% P .O.BOX 1804 COMMENTS : 15SF BAY WINDOW TO 2ND FL, REPLACE & ADD WINDOWS, INT TI, #B81497 AODREss:TEMECULA CA uC.No.: 399654 ######################################## ###################### ####### ####### 92593 WU: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penal of perjury the I am licensed under provisions of Chapter 9 SETBACKS (commandos with Section 7000) ion 3 d the Business and Proles Code and my license is in full forte and effect. CM(LIC.NO.: L AIALIC.CLASS:B LIG. .: 3 654 EXP: MAIN BUILDING ACCESSORY BUILDING V�/� n / FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dae: Z—�+ s11 Contractor: w"� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law for IM following reason(Sedion 7031.5 Business and Professions Code:Any city«county which requires a permit to construct,alter,improve, PARKING REQ: PROV: PARCEL: 92520125 Z N E: REF NO: 'emdeh,«repei any structure.prior to its issuance,else requires the apgimnl for such permit to fib a signed statement that he«she PLANNING NOTES> licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)d Division 3 of the Business end Professions Coder 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 subpW the applicant to a chi penally of nor mom than five hundred dollars l55001). ##########################################*****4(############################### ❑ I,mowner ofthe properly or my enployeeswsh wages as Mei sole oompeestllon,will do the NOM,WA the structure eria mended DEVELOPMENT SERVICES .— R E Qr� U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply loan owner of property fid who buids or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such improvements are not intended or offered for sale.If,however.the building or improvement is sold within ane yearn completion,the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she dM not build or improve for the purpose of sale). ❑ I,as owner Or the properly,em exclusively contracting with licensed contractors to oanetrua the project(Section 7044.Business and BUILDING APPROVED BY . !'f t DATE: Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a owNrador(s)licensed pursuant to the Contractors License Law). ❑ I am exempt under Section: B.A P.C..for this reason: APPLICATION ISSUED BY: DATE: Z (4 ('I1 ############################################## ############################## DatLEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: N I do hereby certify that I am aware a and understand the requirements of California Neah and Safety Code Sections 25505,25533,and25 apermad that)«°n or ture modfuitiingoccupantom hwill/wRM(gaent e)Ojed Reside plywihe°idaeawMeaamexemt from guise for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2534,a«commrnan or modification ray aacammtDi nee to ocompiy mnasaiionapcodes and ethe remgeme provisions. PERMIT 5 . 50 Date: Applicant: 25% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: I SSU _ ISSUE FEE 22 . 00 o l have and wit maintain certificate a consent to self-insure for workers'compensetton,as provided la by Section 3700dthe Labor BUILDING—DIv—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.for the performance of the work for which the permit a issued. ❑ Ihave witaint manworkers' Code,fortheperformanceoftM TOTALS > 5 , 50 22 . 00 0 . 00 27 . 50 27 . 50 . 00 and - work for which the permit is issued.My workers'compensation insurance carrier and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : 27. 50 OVER/SHORT: . 00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK • (This section need not be completed iris permit is for one hundred doors(5100/or less.) 27 . 50 1 I codify that in the pedormence of the work for which)hie permit a ued,I shall M employ any person in any manner°onto ' become subject to the workers'compenaetion laws d caldom deg the if I should become aubpct to the workes' ############################################################################### compensation provisions of^Section 3700 of the Labor Code,I sh rthwilh mpy alto t provisions. I N D I V I D U A L F E E B R E A K D O W N Dae: t2 _L 1 / Applicant: z" I Wam/ng:HNure ro secure wodrre'Co panus°n cosi rage a unlawfid,errtl alnatl she en srnloyer ro edninsl paruroesane TYPE QTY D E S C R I P T I O N o UNIT COST OS T 7 civil fines tp to one hundred thousand dolws(51O4 COCA In addition to the coat of comnsation damages a.provided for In - .•sn3765ofdbor to ,Interestsedatronsyafees. PLU 1 GAS PIPING SYS OF 11 TO 4 OUTLETSI SO CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty ol perry that there is a construction lending agency for the END'OF FEES performance of the work for which the permit is issued(Section 3097,assn C). y ft: �f y��j LENDER'S NAME: '� V LB t1 j LENDER'S ADDRESS,RELOCATE GAS PIPING .,$5 au Ft LYr' • I candy that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances p(� pr Saar and slate laws relating to building construction and hereby authorize representatives of this Sy to enter upon the above menti reed property .ort Or COSTA R [:cif r�6'a for inspM on Poses MASONIS �t vZ—G -9) Data: • V1I Signature dOamr/ApenUApptiranUContr or (5151 d6 W P) White-Building&Safety;Greer-File;Canary-Applicant:Pink-Revenue;Goldenrod-Assessor I CONSTRUCTION AND PLANNING POOL SPA e^111 J APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector I 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe<-Undrgrnd. 53. Steel Reinforcement - - 3. Electrics; Conduit Utility-Undrgrnd. 54. Forms 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 • - 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 20.:Rough Factory Fireplace - - - APPROVALS Permit 46 •• • _ 21. Ducts, iii-Structure 70. _Underground Hydro . 22. Ducts, Ventilating 71. Product-Piping 0 Gas 0 Oil Gas Pipe-Rough &a. -,L'-o�'1 61•.1 -6M 72. Underground Flush 24. Roof Framing - - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing . , - - 74. Overhead Hydro i 26. T-Bar Ceiling (Structural) & Mon&coat _ ' 75. Dry Chemical ' 27. Frame and Flashing. - 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation -. 18. 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 N'o j4.'''a- 1' �• GAS LuNE �fl(y'�Gh ' OK t �� 34. Final Heating.8( Air Conditioning -. • _• ���9¢' - 35. Final Gas Pipe-Test ., . -- L" v � 36. Hood or Canopy 37. Final Factory Fireplace id 38. Final Plumbing • 78�y8 /j1O1 .. 39. Water Service-Final .. L / „' If'�_ -' 40. Gas Service-Final • 41. Solar Domestic•Final - 42. Backflow Preventer' 43. Backflow Irrigation . n•• 44. Landscape Irrigation System = - . - 'r 45. Sound Attenuation - - - 46. Handicap Regulations -1 • - 47. FINAL STRUCTURE & BUILDING - . i:•-•-• 48. FINAL PLANNING ' 49. Electric Release to Edison - is , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date Illft. w- • . ammwmmw 210 E 16TH ST LMT, A CITY OF COSTA MESA — BUILDING PERMIT OWNERS NAME IFKNOW KN IPP, TODD PERM NO: B 081497 ADDRESS:210 E 16TH ST #A COSTA MESA, CA 92627 PERMIT NO: B 081497 PLAN CHECK NO: 00411-97 L GOVT : N SUPP : N APDL.WIN ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ADI) ARCNRECT ORENwdEER:STEVEN AHUNA uexo.: 34264 JOB DESCRIPTION : ADD 15SF TO 1ST STORY FAMILY ROOM & SQ FT: 18, 000 ARCNORENflA30fEss: 210 E 16TH ST DMT: C .M. CA 92626 CLAIM VALUE: 18 , 000 . 00 CALL—VALUE: 18, 000 .00 GROUP OCC : R-3 / cONmsc rsNAMwROBERT J. MASONIS ( 909 ) 699-9335 cONIRACTORS MAIMS P .O. BOX 1804 COMMENTS : 15SF BAY WIND. TO 2ND STORY, REPLACE & ADD WINDOWS & INTERIOR T, I ADDREs&TEMECULA CA UCN0.: 399654 ***�r*+E*�E4* *N**x***********IEAE*xsl* *******iE************************************N 92593 WMT: Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury Nat I am licensed under provisions of Chapter 9 SETBACKS (commencing with )000)d Division 3 of the Business and Proles' Code,end my license a in tun force and effect. CITYuc.NO.: 11(1tuc.cuss:B uc.NN, 359654 EXP : MAIN BUILDING ACCESSORY BUILDING 2 _(0^91 (( u_'_„'Y/ FRNT: FT IN REAR: 20 FT IN FRNT: FT IN REAR: FT IN Date: Contractor. LEFT: 16 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penaly of perjury that I ern exe from the Contractors License Law for the ' 'olfowng reason(Section 7031.5 Business and Professions Code:Any city o county which requires a permit to tonin a.eget improve, PARKING REQ: P RO V: , PARCEL: 42520125 Z N E• R2—H REF NO: demolish,or repair any structure.poor to is inane*.also requires the applicant for such pent to file a signed statement that he or she ' a licensed pu t to the provisions or the Contractor.License Lew(Chapter 9(commencing with Section 7000)of Division 3 of We PLANNING NOTES>!MISC$LLANEOUS':INTERIOR ALTERATIONS INCLUDING A 1ST FL-R, BAY Business and Professes Code)or la he or she is exempt therehom and lFs bra f«the alleged exemption.Mry vialetion d Salon > WINDOW:- ADD' NEW WINDOWS . RELOCATE DOOR- 7031.5 by any applicant for apene subjects the applicant to a evi penalty of not more Own fa hundred dollen;j$5001). ***************'**************************************************************** ❑ I.as owner althe proronyormyemployeea with wages es their sole compensation.will do the work.and the structure a net intended D E V E- L O P M E N T ' SERVICES REQUIREMENTS «offered for sale(Sedan 7044.Business and Professions Code:The ContractorsLicense Law does not apply to an owner of property who beide or improves thereon,and who does such work himself or herself or through he or her own employees,provided that such improvements are no.intended or offered for sale.11.however.the building or improvement is sold within one year d completion.the ZONING APPROVED' BY • ' ' C-,E DATE: 2-1 ". (ti1 owner-builder wit have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as°^rrofthe Prapeny.ant eeduavely mtreaitg with Icahsed cantatas m can aro project(Section row.Bathe and BUILDINGAPPROVED BY, :" ' - • DATE: ' Professions Code:The Contractors Dioses.Lew dor not y m t appen owner d progeny who builds or improves thereon end veto contain for such Projects with a cotmd«(s)licensed pursuant to the Contractors Liana Law). • • ❑ Iern exempt under Section: B.AP.C.,for this mason: APPLICATION ISSUED BY: (� DATE: 2'1w (�1l **************4******** **If************************ ***********************e **************** ***** Dale: at °Mef LEGALI'ZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware d mrd understand the requirements of California Health and Safety Code Sections 25505,25533,end 25534.and that 1 or any future building occupant will/wD not(coda one)need to comply with said state codes end the requirements for .permit l«mruuction o'modification from the Ails y enagement District.Residential mmnrd'on aerations ere exempthom these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE ' -SMIP/RES GRADING provisions. PERMIT 262 . 25 1 . 80 SMIP/NON—RES Date: Appy a n PLAN 170 . 46 - WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following activations: ISSUE FEE o lhaveadMperam°nsne°ndWOs°vkfos hno1h� fat :'oonosnvn .rprodedt«bswu3)wdThe Labq BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK ( TOTAL PAID DUE P TOTALS----> 264 . 05 0 . 00 ' 170 , 46 434 . 51 ' 434 . 51 . 00 0 1 have and wit workers'compensationman tan Insurance.Insurar , required by Section 3700 d ,ford the Labor Cede, the performance the { work f«w a Naparmeissued.lsMywokaa'°ompemsa o is insurance anand policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 264 . 05 OVER/SHORT: . 00 t Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK vt(-Th�is section need net be competed/the pratk a ler one hundred dmna (S1w«lam)r.) 262 , 25 . 1 . 80- . _ • V I rely that in the performance of the work for which this permit e' ,I slut not employ any person ih any manner an as to • - - become subject to the workers'compensation laws of C tag that it I should to the workers ******************************************************************************* compensation provisions of Saba 3703 of the Labor Code.I with ' Nor provisions. INDIVIDUAL "F --EE BREAKDOWN Dale: 2-4 -1-7 Applicant Warning:Failure to secure womn' onpmaadon wastages unlawful,and fact en employer to criminal penalties and TYPE QTY DESCRIPTIO 1,1 •- % UNIT COST TOTAL COST civil lines up to one hundred thousand d dollars(S1O4OX),In addition to the cost a/compensation,damages as Provided for In P - SeoNon3ros°iNe/aborCode.Intone.endafomayaler. SFR 18000 ALTER BY VALUE RESIDENTIAL NOZONE 1-. 00 : 000 , 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under peaty of perjury that there a a atnamaion lading agency fur the END OF- FEES 41 performance d the work for which this permit is issued(Section 3097.Cir.C). _ - ,ri LENDER'S NAME: r J+� E-?<-=" it LENDER'S ADDRESS: - v �L �e. ' hi {] 1 I centythat lhave red this application end dale that the above id'xmatnnbcorted.lagree to pompy with ell city and county adinerhcas I V �F^ o(y'fS '991 and state Laws rotating to buldig construction end hereby authorize representatives of this city to enter upon the ebovementbned property S eC. LU `" for inspection purposes ROBERT MASONIS 4jh) 1nI Print Name • (s{ �/ Of CjOS►R En— nilDale: Z'_L_17 VIII Vt re d OmsdAgena moor (5151s6.WP) Whte-0dtlig&Safety;Green-Fl:Canary-Amount;Rnk-Revenue:Goldenrod-Mases« COOSTRUCTION AND PLANNING -r-fRJL SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. t nporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undtgrnd. 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 1 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 20. Rough Factory Fireplace - APPROVALS Permit # 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 0 Gas 0 Oil 25. Roof Sheathing2.j 47 ��� 74. Overhead Hydro 3 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 41-1111-41.741-1111-41.7 Q�/ 76. Dry Standpipe • 28. Lathing& Siding - -6[ 117 �,4 /q 77. FIXED SYSTEM FINAL 29. Insulation /1�/ 78. FIRE PREV. FINAL 30. Drywall Nailing 'ttra-17 6&J41-- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat fL- v V aed 79JFINAL INSPECTION 32. Electrical Power Meter-Final ((((.••• 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: -- 34. Final Heating & Air Conditioning 3 "412' bl e 35. Final Gas Pie-Test t�i i v' "'� 36. Hood or Canopy 3 21 f17,_ L%e-e& 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 C1 t\0v 'fl -140- Ic )')ediiy 44. Landscape Irrigation System I media()rpt' J 45. Sound Attenuation • - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 144-91 61441--- 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • - 51. CERTIFICATE OF OCCUPANCY No Date ADDRESS OF fIILWM 210 E 16TH ST UHT: A CITY OF COSTA MESA — BUILDING PERMIT wlrLERCNMIEtFUUit :KNIPP, TODD PERM NO: B 081500 ADDREss: 210 E 16TH ST #A e; 1,4 COSTA MESA,CA 92627 PERMIT NO: B 081500 PLAN CHECK NO: 00485-97 S GOVT: N SUPP: N APDL.SWUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR EIONEEA: UC.NO.: JOB DESCRIPTION : 3OLF CITY STANDARD BLOCK WALL SQ FT: 30 ARCH.OR DIG'S ADDRESS: UHT: CLAIM VALUE: 600 . 00 CALC—VALUE: 600 . 00 GROUP OCC: R-3 / CONTRACTORSNANE:ROB ERT J. MASONIS ( 9 09 ) 699-9335 CENTRACTORS SWUNG P ,O,BOX 1804 COMMENTS : BLOCK WALL ADOREStTEMECULA CA ucNO_ 399654 + +last**ft*at******se*****stxststx****sin****stet*st*st**x>fstitit*st*xst*xstst ****itat *it*et********sin u 92593 WIT: ZONING REQUIREMENTS DCENSED CONTRACTORS DECLARATION:I hereby aim under comely of perjury that I em licensed under orations of Chapter 9 SETBACK S (commencing with Son 7030`d Desire 3 d the Business end Professions Code,end my tense is in hill effect and efe CmuG.NO.: 11'I�l 1\ LIC.CLASS:B uay 3 54 XP: MAIN BUILDING ACCESSORY BUILDING �—(� _ Contractor: IV� �jtu[ FRNT: LEFT: FT IN REAR: IN RGHT: FT IN FRNT: LEFT: FT IN REAR: FT IN °r FT FT IN FT IN RGHT: FT IN 'WNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exem from the Contracts License Law Ice the h ee nese(sectionmasBeemrdPeea°orecone:AaWea romayeeeofepratwmeeesir.eepe. PARKING REQ: PROV: PARCEL: 42520125 ZNE: R2HD REF NO: is or repel tissuance. ( permit thestatement pursuant to prior dttheCrmosLicenseLaw(C for mencingwitSect700O)dO&isnPLANNING NVTES> CONSTRUCT A 30 INCH HIGH BLOCK WALL IN FRONT SETBACK.-— Buvness and Prot-sesta Code]or that he or she is exempt therefrom and the bast for the alleged exemption.My violation of Section > 7031.5 by any applicant fore Prime subjects the applicant to a civil penalty of not more than live hundred doles(SSDO]). ******************************************************************************* ❑ 1,as owner of the property or my ermployees with wages as their sole compensation,will do to work.and the*immure is not intended DE V E L O P MEN T S ER VIC ES R E �y U I R E M E N TS or offered for saleProfessions(Section 7044,Business end Cade.The Contractors License Law does not apply to an item of prapemy M who builds or improves thereon,and who does such work himself or Miser or through his or her ova employees.provided that such improvements ere mr tiered intended fered frsaewor .If.howe .the buildinginprovemenl is rdcompletion. 1,sold vrilhin one year completion.the ZONING APPROVED BY K� DATE: 2-46119owner owner-builder will have the burden d proving he or she did not build or improve Ir the repose d sale). ❑ I.as owner or the roperry.am exdlvwy osurmkp with licensed contractors to centrum the reject(Stet Thu.Bushws and Professions Code:The Contractors License Law does not apply loan owner of property who builds or improves thereon and who BUILDING APPROVED BY : DATE: • contracts for such projects with a cortrador(s)licensed pursuant to the Contractors License Law). / ❑ Iaro exemr punderSection: ,r' B.E. APPLICATION ISSUED BY: DATE: 216( 57 .. ********************************************** ******************* **** ***** Date: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Health end Safety Code Sections 25505,25533.end 25531.and that I or any future building occupant will/Wil nal(circle one)need to comply with said slate codes and the requirements for e permnlr construction rmodification brnthe Ai Quaky Management Budd.Residential construction applications we exemprlront Nese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 23 . 75 . 50 Dale: Applk:ent: PLAN 15 . 44 SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the followng dadaretiore: ISSUE FEE k❑ Ihave end veil maintatacertificate dwm consent nrefrworker:wmpenman. provided Section BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the prmnedthe tissued. TOTALS----> 24 . 25 0 . 00 15 . 44 39 . 69 39 , 69 . 00 c❑ I have end nil mainsail workers'compensation insurance.es required by Sect on 3700 of the Labor Code,for the performance of the ' work for which this permit is issued.My workers'compensation insurance cater and poky number dee: Caner REVENUE DIVISION TOTALS--> COLLECTED: 39 . 69 OVER/SHORT: . 00 r PolicyNumbec BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK section need not to cwmplered l the permi t for one hundred dollar lafO0l or ass.) 23 . 75 . 50 15 . 44 I eerily that in the performance of the work for with this prime is',. .,I shall nor employ any person in any antler so as to became subject to the waken'compehsrcn laws d Cald• . .rte Net f Amid ld becMe to the waken' ******************************************************************************* provisions d compensation provisions Sectiond 3700 the Labor Code.I .h i comply , .• provisions. INDIVIDUAL F E E BREAKDOWN Date: 2 -G -57 APPrcara: Warning:Failurerr Failure to secure wke 'conpensadonaovarsah ps is unlawful,and al4..lett an employer to adrenal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines tee to one hundred thousand dollars($100,w0),In addition to the cost of conpudance*as provided for In Section a°n3yoyNaLmorcoee,lrraatand°mfeat attorney's SFR 30 RES—CONCRETE BLOCK WALL / FT, 20 . 00 600 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that Theis e a construction lending agency for the END OF FEES c--;!:, ram,J performance of the work for which this permitis issued(Section 3097,Civ.C). ,._ _ l'-. ,;. { t LENDER'S NAME: •. c S r='�� LENDER'S ADDRESS: : �j{l�{7kj��l I certify that I have read this application and aide that the above information is coned.Iagree to comply with all oily end countyrdinences j `C�_ r • 6 199 and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property f._ 1 i L L� �) 1•+vv� for Inspection purposes. R//A. ERT MASONIS µVna`'vf/-Pd Wri"b z_c,_E;—, CITY of COSTA MESA Dae: Signature of Orw/AprhUAppirar/Conumr (5151 A6.W P) White-Building&Safely:Green-Fe:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor CC-INSTRUCTION AND PLANNING � e.& SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. kmporary 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 ' 7_-2-.3-' 7 &Gct 56. Rough Plumbing &Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 7-4.3--"77 0‘6 - 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 20. Rough Factory Fireplace APPROVALS Permit # 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 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 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 -. l 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 t( &--'jg 4 uiy 48. FINAL PLANNING -` tx'^'V 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: 210 E- 16TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B '054395 OANEEt3 NAME: BRIGGS DEVELOPMENT /.li%QoREss: SAME PERMIT NO: B 054395 PLAN CHECK NO:. 04055-91 A GOVT: N SUPP: N 'p CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW 1363SF RESID, 431SF GARAGE, 24SF DEC SQ FT: '1 , 363 ADDRESS: UNIT: CLAIM VALUE: 70,000. 00 CALC—VALUE: 101 , 834 . 50 GROUP OCC: R-3-" /M-1 PERMITTEE: BRIGGS DEVELOPMENT ( 714 ) 380-0686 . ADDRESS: 23046 AVENIDA CARLOTA 315 COMMENTS: SFR LAGUNA HILLS CA 92653 ***********************************+t*****iE***********************+F*Aru*********+E LICENSED CONTRACTOR DECLARATION: I hereby attirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT;• 72 FT IN REAR: 20 FT IN FRNT: FT " ' IN REAR: FTr---...ZN Compensation Insurance.or a certified copy thereof(Section 38w.Lab.C). LEFT: 5 FT IN RGHT: 11 FT IN LEFT: FT IN RGHT; TI\ POLICY NO.: EXP.DATE: oMPANY: PARKING REQ: PROV: PARCEL: 42520106 ZNE: R2 REF : DR-90-09A Certified copy is hereby furnished. 0 Certified copy is Med with the city Building Division. PLANNING NOTES> UNIT "B" OF A TWO—UNIT COMPLEX CONTIGUOUS WITH A SI --UN- / > COMPLEX ., I Date: Applicant: **********************9f** *************************iF********************•******* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)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 Sr 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 ' - (5, , F; //it , F; DATE: (-61k-d -1-9i 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: 1 hereby affirm that there is a coristruction lending agency for the performance of the work for APPLICATION ISSUED -BY: ' ' / I which this permit is issued(Section 3097,Civ.C). *************************************** Ei * e **********D4UE:i, t*C1f F* F LENDER: ******************************************************************************* ADDRESS: • LEGALIZATION:N F E ES U"Jl4; M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Lawtor 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 6 4 6 . 5 0 — - 10. 18 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 MOO)of Division 3 at 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 105. 06 - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE '%, I. as owner of the property or my employees with wages as their sole compensation, wit 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'State License Law TOTALS----> 656 , 68 0 . 00 �' 105. 0S - 761 . 74 761, 74 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through co • \ 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 completiondik ,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COIL EC,TED• 761 . 74 OVER/SHORT• ' . 00 for me purpose of sale). 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 pried (Section 7044,Business 646. 50 e- , 7 10. 18 . 105 . 06 LX and Professions Code: The Contractors'State License Law does not apply to an owner of propert�✓o builds it improves thereon .• ', and who contracts for such protects withacontractor(s)licence pursuant to m¢Contractor"ate Li eLaw).l am aware *.*******************************.w*,***:***********.*.**..**.*,*******.*******,*********** that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A—rL F-1 EE ,B' R E A K D O W N ❑ I am exempt under Section: B.8 P.C. ' rf• 4- tor reason: Ogrft/� � - TYPE QTY D E S C R I P T It;O N" .' UNIT COST - TOTAL COST 'a^ Date: ' • Owner: y=�,���' i s s . SFR 1363 DWE—TYPE V—WOOD FRAME- • -GOOD 69 . 00 • 94 047. 00 I do hereby certify that I am aware of and understand the requiremen . a i orri H. • .nd Safety Code Sections 25505,25533,and i 25534 and that I or any future building occupant will/will not(circle one)need to co ith said state codes and the requirements for a SFR 24 RES—BALCONY EXTERIOR STAIRWAY 13 . 80 331 . 20 permit for construction or modification from the Air Duality Management District, • menial construction applications are exempt from SFR 431 RES—GARAGES TYPE W. '• a 17. 30 . " 7, 456 . 30 these provisions. LEND-'OF FEES , Date: • Applicant: / , ' I hereby certify that I have read this application and state that the...ye in 4 gree to comply ' .all c d county - !)" ' ordinances and state laws relating to building construction and he my author' �Ihi-ci to enter mentioned . 'f property lot inspection purposes. • - /,g Q/' /,%�� Date: le'—/v ^// Signature: -/ - . Driver's License or Social Security x: 1 1641-46 While—Budding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor . ( '):RUCTION AND PLANNINGPOC�'PA ...It-APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector -ft 44 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.:,Electrical Conduil UIility-Undrgrnd. 54. Forms , ;7 4. Electrical Conduit'Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement, 56. Rough Plumbing & Pressure Test '-r 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE / - 7; Footings - 58. Electrical Conduit-Undrgrnd. --i- ' ' 8, Foundation _ 59. Gas Pipe, O Undrgrnd.,Test .9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK . 11. Property Sewer Line'& House Connection 62. Backwash & Receptor-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 20.•Rough Factory Fireplace 'i _ APPRQVAL"S-' 'Permit # •• 21. Ducts, in Structure' ,- _: '70. Undergiogpd_Hydro n 22. Ducts, Ventilating -• - C 71. ProductPiping O6as O.Oil 23-Gas Pipe &Test 4 c a • 72• Underground Flush: _ 241 Roof Framing : 73.•Undergrnd.StorageTank OGas OOil 25. Roof Sheathin l' •` 9 t " 01-'1'. 74.=;O'verhead Hydro_ 26. T-Bar Ceiling (Structural) & Monocoat"• - T. ; 75 7Dry Chemical - 1 r 27 -Frame and F1shing y0141 ! " 76. DryS'tandeiee s' _ - • • 28. Lathing:& Siding , a-5 Cr• .. 4"2...- c •• . 77.- FIXED SYSTEM FINAL '29. Insulation ; - •.„ • Y t✓ ei - 78_,:FIRE PREY. FINAL .r =• ; 30. Drywall Nailing _ C/ J HEALTH.DEPT. REQUIREMENT .31. Plaster Brown Coat; (art ly,aa- ,79 FINAL INSPECTION - a. I -32,:Electrical Power Meter Fina II ' • _ • . • r80.:FOOD CERTIFICATE ISSUED - ' W LDFOR-SPE-CTAE RE UIREMEN"- 33., Final Electric, i IL ', . No. s. Q PT .j34::Final Heating& Air.Conditioning - - ' 1 I. e_j :Lo I ,,: c 7•�, /i. _ 40. 35.!FinalGas Pipe-Test • _ _ / 1L :� 1# ; w•�+v} �r ,36: Hood or.eanopy . - • _ a Jrr 2,10 - 37.-Final Factory Fireplace,- , - ' '"38: Final Plumt>;ng 17rW_ 1 .000 39) Water Service=Final" _ -i -•- -. - `-/ 40. Gas Service-Final ; , ,- " . , . 41:-Solar Domestic-Final - _ - _/ • • 42. -Backf low Preventers - I. I I. ' 43. Backflow Irrigation ' . , • . ' - 44. Landscape Irrigation System. T .. ,,, - _ y / , -- • 1 45._Sound Attenuation ,/u Lr VC Q(< :46E Handicap Regulations ` P, 40.-FINAL STRUCTURE & WADING rto _ ) _,•,..4.,,a_.4 NNNrg • • /9.•-Electric Releau -Edison - • C • 50., Gas Release t�fhern California Gas Co . • - • . .. • : - - '51. CERTIFICATE OF OCCUPANCY . - , , i - c No._- _. Date • FINAL GRAQING CERTIFICATION j •Project Address: 210 "A" 16th. Street • Lot Number: Lot 3, Tract 14384 • . Permit Number: DR 90-09 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 the grading permit, grading plan and grading ordinance have been installed. Adequate provisions have been made for drainage of surface water from each building site. The minimums are: • 2% Fall from structures within 5 feet from exterior walls. 1% Fall for asphalt surfaces and landscaped areas. 0.5% Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded tract map were set. All final Gradin_ eleva- tions are within _ 1 '10 of the desi ed elevations. Supervising Civil Engineer Utut Reg. No. 31720 (Signawrr) Date 8/21/92 • • , ceOFESSI0A, • • F. • � Qo�cb HA . ��2 �U --- C., N0. • ccRCE31i20 m EXP. 12/31/92 • • JTitF OF i V O0\\Q 1: CITY OF COSTA MES1. CALIFORNIA 92628-1200 P.O.BOX 1200 Insulation Certificate 210 16th Street Unit A Costa Mesa Numbs and Street City Orange part of Tract 14384 County Subdivision Lot Number• Description of Installation ROOF Material Brand Name Thickness(inches) Thermal Resistance(R-Value) EXTERIOR WALL Material FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness(inches) - 31/2" Thermal Resistance(R-Value) R-11 CEILING Batt or Blanket Type FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness(inches) 61/4" Thermal Resistance(R-Value) R-19 Loose Fill Type Brand Name Contractor's minimum installed weight/ftt lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) • FOUNDATION WALL Material Brand Name Thickness(mches) Thermal Resistance(R-Value) • • Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. • BRIGGS DEV. General Contractor(Builder) License Number • Signature and Title Date _a Lig ULA I• •v• a 274283 .ub-Contractor(Insulation Installer) License Number • 5-25-92 RAY RAS"• Signature and Title PRESIDENT Date 1 PRbJECTADDRESS: 210 E 16TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05441° OWNER'S NAME: BRIGGS DEVELOPMENT r ADDRESS: SAME PERMIT NO: P 054415 PLAN CHECK NO: N GOVT: N SUPP: N . CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW 1363SF RESID, 431SF GARAGE, 24SF DEC SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROU OCC: R-3 /M-1 PERMITTEE: BRIGGS DEVELOPMENT ( 714 ) 380-0686 ADDRESS: 23046 AVENIDA CARLOTA 315 COMMENTS: REF B54395 LAGUNA HILLS CA 92653 ********4***+erE*rE*******kE***kH*4****kH*+E*************+E*********** x****>E********+ESE LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date, Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.CI. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42520106 ZNE: REF NO: .1 1 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> Date: Applicant' r **********************************************.* ******************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the perms(ii for one hundred 1310))or less). DEVELOPMENT SERVICES -.REQUIREMENTSS 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:II.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 there is a construction lending agency for'the performance of the work for APPLICATION ISSUED BY• —��� DATE• I O ) � which this permit is issued(Section 3097.Civ.C). ********************** ************.**.***. ((. *** LENDER: **************************************** ************************************** ADDRESS: LEGALIZATION;N F E E S a 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 following reason BLDG PMT PLUMBING ELECTR 'C 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 3 7,0 0 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5t SM I P/NON—RES pursuant 10 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.My 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(S500). ISSUE FEE 3 . 00 I, as owner of the property or my employees with wages as their sole compensation. wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PL 'N—CHECK TOTAL 'PAID DUE ❑ structure is not intended or offered for safe(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 37.00 3 . 00 0 . 00 40. 00 40 . 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 ro herm own employees.onevyearded that mpl improvements me are notthe intended or offered pfor sale.Ie however build building yr REVENUE DIVISION TOTALS--> COLLECTED: 4 0. 00 OVER/SHORT: , 00 I his or hof soldmwithins.one year of completion.limp the entsr will have the burden of provingdforhe/she did not the or improver for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 40 .00 1 LX and Professions Code: The Contractors'State License Law does not apply to an owner of prop.• who builds o 'mproves thereon and who contracts lot such projects with a contractor(s)license pursuant to the Contract "State Lice aw).l am aware ***.*******************-********************************************.****.*.**.*.***.*.*. i that proof of their Worker's Compensation insurance should be provided to me. / , INDIVIDUAL F E E BREAKDOWN I ❑ I am exempt under Section: B.8.P.C. for lois reason: r,,rIi �� TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: 9/ on �� a PLU 2 BATHTUB 2 . 00 4 . 00 I do hereby certify that I am aware of and understand the requirements of ., let . • .... • .. . . ,25533,and PLU 1 DISHWASHER 2 . 00 2 . 00 25534 and mat I or any future building occupant will/will not(circle one)need to co .ith said state codes and the requirements thr a PLU 1 LAUNDRY TUB OR WASHER 2 . 00 2 , 00 permit for construction or modification from the Air Quality Management District.A idential construction applications are exempt from these provisions. PLU 1 SINK, KITCHEN 2 . 00 2 , 00 PLU 4 WASH BASIN 2 . 00 8 . 00 Date, Applicant: PLU 3 WATER CLOSET (TOILET) 2 . 00 6, 00 I hereby certify that I have read this application and state that the abo . alio coir agr' o comply wi . cit and county plat] 1 WATER HEATER AND/OR VENT 2 , 00 2 . 00 ordinances and state laws relating to building construction and here. shod . sentali • of lhi:_Ty to enter upon he a..v'mentioned PLU 1 , WATER SERVICE 2 . 00 2 . 00 property for inspection purposes 7i- /� PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 , 00 2 . 00 M --1(----Date: --1(----�7 Signature: • PLU 1 GAS SERVICE 2., 00 2 , 00 PLU 1 SEWER, BUILDING / TRAILER 5 , 00 ', 5 . 00 Wirers License or Social Security x: . - - ' 1641-46 White—Building;Groon—Codo Enforcement;Canary—Applicant,Pink—Revenue:Goldenrod—Assessor Ea> o F P 5 CONSTRUCTION AND PLANNING _-. POO111WA ' i APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector ,",4 1. Temporary Electrical Service or Pole ///''',,,...,,, 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Stip q,�& 53. Steel Reinforcement �' 3,:.Electrical ConduitUiility-Undrgrnd. °`3"' [✓ // "" 54. Forms • i :-4: Electrical ConduittUndrgrnd. 55. Electrical Bonding . ,, „- . • 5. Steel Reinforcement_ 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ,' c • 7. Footings 58. Electrical Conduit-Undrgrnd. "8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pi a-Und end. t t P r9 f'!i(Qz.. (,� 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 litgiljt'ad) 65. Electrical-Final - 15. Rough Electrical-Conduit -�7 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 20. Rough Factory Fireplace . :Y _ . APPROVALS -_Permit# _ 21..Ducts, in-Structure- - • _ _70. Undergrowd.Hydro 22. Duces, Vent hating .. r -' t 71. Product'Piping 0 Gas OOil 23. Gas Pipe=Rough &•lest '; ' 72. Underground FIUsih , 24.,Roof Framing Ay: r •• 1' .73.E UndergrndeT :Storagank 0 Gas 0 Oil - - 25. Roof Sheathing _ S T " �7q=.Overhead Hydro•• 26. -Bar Ceiling (Structural) &•Monocoat - -:- ‘ - 75:Dry Chemical J - • _ +'• -•'7• , s'� : ^ " 27. 'Frame and Flashing: ' r .12, - _ 76. Dry Standpipe i '" ,�. .•s 28. Lathing,& Siding - : - • •• fir . 77, FIXED SYSTEM.F;INAL• ;x , it x-29. Insulation •• •• `' I ° 't• 78,rFIRE PREV. FINAL .r• ,a _ .30. Drywall Nailing • r r . - " HEALTH.DEPT, REQUIREMENT' �• -c' ;.31. Plaster Brown Coat' ,79-TIIN'AI:NSPECTION - - _ • 32. 'Electrical Power Meter-Final: I : ,80.'FOOD CER�TIFI,CATE ISSUED 3 _ 33. Final Electric - -r ° I ' Notes: ''• - ;34.-Final Heatingt.& Air.Conditioning; .,--, I ,r. a. r, •x Z' . 35._Final Gas Pipe-Test I - , 36. Hood or,Canopy - - . > - F 37.Final Factory Fireplace._ , - - r _ 38. Final Plumbing -- 7!3(hi £ ? • ` ! - 39. Water Service-Final.- s Ila//ti '; - • ' ' i40. Gas Service-Final . r' - _ ; ,,,• ' -41. Solar Domestic-Final , t_ . } . n __ - 42.--Backflow Preventer, - t: ' 1 • y - ' 43. Backflow Irrigation- - 1' - . - . - . . . . :44. Landscape Irrigation System - - - - - , _ _ .45. Sound Attenuation • - `'-> ., '46. Handicap Regulations - - • ; �• - 47.-FINAL STRUCTURE& BUILDING - i • t • - 48.'FINAL PLANNING _ . . r, i - 49. Elearic Release to Edison ,. r '50.-Gas Release to Southern California Gas Co . (• . ,;, '� . . -51. CERTIFICATE OF OCCUPANCY , No. Date PROJECT ADDRESS: 210 E 16TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 054425 OWNER'S NAME: BRIGGS DEVELOPMENT ADDRESS: SAME PERMIT NO: M 054425 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW 1363SF RESID, 431SF GARAGE, 24SF DEC SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: BRIGGS DEVELOPMENT ( 714 ) 380-0686 • , ADDRESS: 23046 AVENIDA CARLOTA 315 COMMENTS: REF B054395 LAGUNA HILLS CA 92653 **tH*Ar>EEE*4:t**at->E***************EE**:E**N**DH*** ************+E****IE********at*tE******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and ettect. SETBACKS . CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure ora certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Compensation Insurance.or a certified copy thereof(Section 3000.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT. IN POLICY NO.: EXP.DATE: • � COMPANY: PARKING REQ: PROV: PARCEL: 42520106 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Dale: Applicant: -**:**********it*************3k3E***iE*3F3E*lF,iE******.**if***********1F*****if*4f***3F******** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(Stp)or less). - D E V E L O P M E N T S E fI1V I C E•S R E Q U I R E M -H 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 tabled to the Workers'Compensation Laws of California. : ZONING APPROVED BY ' • .DATE: Date: Signature: NOTICE:II,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 there is a construction lending agency for the performance of the work for , APPLICATION ISSUED B --�= DATE: / C>j which this permit is issued(Section 3097.Civ.C). ********************** - ********** ** * * *** LENDER: ************************************** *************0************************* ADDRESS: ' LEGALIZATION:N F E E - 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 following reason BLDG PMT PLUMBING ELEC RIC 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 34 ,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 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/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($500). ISSUE FEE 15,00 I. as owner of the property or my employees with wages as their sole compensation. wit 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'State License Law TOTALS----> 34 .00 15. 00 0 . 00 49 . 00 49 .00 . 00 ell 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 o�lsalejnin one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE BLDGDIVISION PLUMBING ELECTRIC MECHANDICFIRE9 ,SMIPO/TOT/SGRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 49 .00 IX and Professions Code: The Contractors'State License Law does not apply to an owner of p,rt who builds or improves thereon ' and who contracts for such projects with a contractor(s)license pursuant to the Co CIO icense Law).l am aware ***{(************************************************************************]f** that proof of their Worker's Compensation insurance mould be provided t me. sorINDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: , O it TYPE TYPE QTY DESCRIPTIO N' UNIT COST TOTAL COST ,___ Date:_�(/ ' _ Owner rte' - MEC 1 IAST FORC—AIR/GRAVGS 4FURN = 100 K BTU 9 . 00 9 . 00 I 5oherebycertify that utuaware ofaotlupantwandidsrt(circle oneo'dliM1/Pea wiand Safetyt Codeand 25505.25533. a NEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3, 00 3 , 00 25534 andr that or any or o budding occupant Airiwill/will not ae one) Dis amply with saidstate i codes and the requirementsmfor a NEC 1 FACTORY FIREPLACE 6 . 50 6 . 50 permit for construction or modification from the Duality Management District.Residential construction applications are exempt from these provisions. MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAUST 6 . 50 6 , 50 MEC 2 VENTILATION FAN CONN TO SINGLE DUCT 4 , 50 9 . 00 Date'. Applicant. /Ale END OF FEES I herehy certify that I have read this application and state that the abov•�.y_LU{d �� ., ..see to comply with all city and county ordinances and state laws relating to building construction and her. -R}-.- .'^�2 r uron ova-mentioned property lot inspection ppurP0sPe_y� /'I / J I 1 j r_a� T _ (a // —/� �/'� '� ttl'rl 1.J f_ . , V Date: Signature: Driver's License or Social Security x.: 4—� 1641.46 White—Building.Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 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 Condu_it=Utility-Undrgrnd. 54. Forms , -4. Electrical Conddit_Uridrgrnd. - 55. Electrical Bonding . . , • ' 5. Steel Reinforcers u. 56. Rough Plumbing & Pressure Test, 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. - -8. Foundation59. 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 r., 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 Sig'n 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning iiltiffni CaC FIRE DEPT. REQUIREMENT 20._Rough Factory Fireplace x T ��l qj, rAPPROVALS'"•'Permit # _ , • r 'Y�'�lf Qr+'VrIY• Al.!: 21:'Ducts, in.StructurE .. .. _ - - .70. Underground Hydro 22. Ducts,.Ventilating - _ - C • -71. Product`Piping ❑Gas OOil 23F-Gas Pipe=Rough &Test ' _ 72. Underground Flush 24.>Roof Framing - • `73:rUndergrnd:Storage Tank 0 Gas ❑Oil` 25. Rooms Sheathing _ -',=.., •. 74.:-Overhead Hydro, • r , 26�T-Bar Ceiling (Structural) & Monocoat - .3 75. Dry Chemical _ ' - •' 27,'Frameapd Flashing • _ 'L ;r° , 76. Dry Standpipe -.';' ' '•'' '' ' 28. Lathing& Sidingt - ,S . _ w r' 77.. FIXED SYSTEM FINAL_ J - `29. Insulation I _ 78. FIRE PREY. FINAL > , 30. Drywall.Nailing L . • 1 'I : HEALTHEDEPT, REQUIREMENT:.7 -_31. Plaster Brown Coat_ �. I r ,79:-F I NA L INSPECTION ' `: , 32. Electrical Power Meter,-Final _ I ( v t .80..FOOD CERTIFICATE ISSUED > .33.�Fins!I Electric T i - F ' Noyes: _ r 34,Final Heating;& Air,Conditioning; 7/31142- to + yr - : ' • 35.1Final Gas Pipr - I. I I . T Pipe-Test; _ Y .--1 - : 1_36. Hood orrCanopy i ,. . ' 37:-Final Factory Fireptacex. 7p447._ uto [r . _ s '.38. Final Plumbing -. - . C39. Water Service-Final• I j• - .. -) - ' • - F ,;40. Gas Service-Final . _ �,i_ T i ;y . -, r, : - >11. Solar Domestic-Finals 3- I ti - ••42.'8ackflow Preventer` ' • X - - 43. Backflow Irrigation '^'s. • :. - •- - a. ,;.44. LandscapeIriigationSystem: - . r : - . r .-c.�o -.. - = PROJECT ADDRESS: 210 E• 16TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054420 OWNER'S NAME: BRIGGS DEVELOPMENT ADDRESS: SAME PERMIT NO: E 054420 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW 1363SF RESID, 431SF GARAGE, 24SF DEC SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: BRIGGS DEVELOPMENT ( 714 ) 380-0686 ADDRESS: 23046 AVENIDA CARLOTA 315 COMMENTS: REF B54395 LAGUNA HILLS CA 92653 6*******4+E******+F*********+E**+ESE*******DL*+raL***************+E**+E*+L*+LSE**kF******kE*•kF* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING RE PROV: PARCEL: 42520106 ZNE: REF NO: �❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N TE$> Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVEL OP MEN T SERVICES REQUIR EMENTS I certify that in the performance of the work ton 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,alter 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 there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• Old_— DATE• i 3097.issued(Section C). *********************{E • '_'_�-�•rz:. • z•s•s:s.r�. . -.-• . .-• . • . . . . . . . . • . • . • ********3(.* KIEL*** LENDER: *************************************** -*************************************** ADDRESS: LEGALIZATION:N F E E S MMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECT: C 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 47 71 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed S 0 t SHIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Cadet 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($500). ISSUE FEE 1500 00 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'State License Law TOTALS----> 47. 71 15. 0 0 0 . 00 62 . 71 62 . 71 . 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• 62 71 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 or me purposeolsalel. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN CHECK ix I,as owner of the properly,am exclusive) contracting with licensed contractors to construct the p:' t(Section 7044,Business 6 2 . 71 and Professions Code: The projects with'Stale License Law does not apply to an owner of ptoDer builds ori •I thereon andwhocontractsforsuchproletlsaconlractor(5)license pursuant tothe Contract. .¢Lice .lamaware ******************************************************************************* .that proof of their Worker's Compensation insurance should be provided to m. - INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for mis reason: //l/ TYPE QTY DESCRIPTION UNIT COST TOTAL COST 10---7(--- 9, � �K// Dale:_ _ .mer. — � ELE 1363 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT . 03 47. 71 I do hereby certify that I am aware of and understand the requireme of Ca ifornia Agar.. •y ode Sectons 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)nee. o comp/said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. al construction applications are exempt from these provisions Date: Applicant: ® �J� / I hereby certify that I have read this application and state that the above.inb•`7:IIC� td Comply with AI cit. .nd county ordinances and Slate laws relating to budding construction and hereb Ch. —'^►10P� i to •ter ove antiered properly Im inspection Durpos ���� �� f Dale [4 .—� Signature: ��/ r(tl. • 1.,. � •r .� affilri Onver's License or Social Security x: 164146 White—Building:Green—Cole Enlorcemenr:Canary—•pplicant:Pink—Revenue:Goldenrod—Assessor —.11111111111 CONSTRUCTION AND PLANNING lb PO( PA 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 / • 6. Electrical UFECQprnd. 57. APPROVAL TO COVER-GUNITE ' ": 7. Footings -Gt- 58. Electrical Conduit-Undrgrnd. ' $'. Foundation 3. . 59. Gas Pipe, 0 Undrgrnd.,Test / 'rc. S. Water Pipe-Undcg:nd. 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 L 64. Plumbing System - Final - ,f• 14. Rough Plumbing - 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric-Wiring !jv/qz g 67. Fencing & Access Approval 417. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - • `. • " . . ,APPROVALS„;PerMit# • 21.'Ducts, i`Stwctu4e, . _ _ . 70. Undergrou• nd Hydro 22. Ducts, Ventilatirig, - - It •• =71. Produce Pi ng OGas Oil 23:Gas PipetRough & Test p r L f ,-,. 72, Undergiound Flush - r• v 24-Roof Framing :. ,^, 73. . . -. tUndergrna.Storage;TankCGas 13Oil 25. Ro9f Sheathing C ^ ''J ,�" ' - 7q�Overhead Hydro , 26.-T-Bar Ceiling (Structural) & Monocoat 75.: Dry Chemical r _ • 27:-Frame and Flashing �u -'` t . 76. DryStandpipe :.-),:"..] ` 't • 28. Lathing'& Siding r - j r ;:r. . T • 77= FIXED SYSTEM:FINAL- v 1 29. Insulation - - 78 FIRE PREV. FINAL 730. Drywall Nailing • ' f I a HEALTH'DEPT. REQUIREMENT :31. Plaster Brown Coat' < r I" 79'FINAL INSPECTION ' - '- t32.-Electrical Power Meter-Final. ' • % .t. ,•80., FOOD CERTIFICATE ISSUED - x 33:-Final Electric / �Notes. " r .UjFinl Heatih�& Air:Conditioning, - 'c ' art �`:- i`t` , is - 35.J Final Gas Pipe-Test- - - - 1 t i . - - a.' - -' r - , I 1. :::� . , , .36.rHoosJ or:Canopy - - - - I .. - X - ,, t -371:Final Factory Fireplace : - i "' .r c 'i- , • t -38. Final Plumbing -..,2 •• ' r-.•:- -•.:Y . •' I I. r n' ` - _ „39. Water Service-Fina4 .: r ^ - [ :40. Gas Service-Final ' • -• 'I 5:41. Solar Domestic-Final- • .. I i - - - it •.-, ---, 42. -Backflow Preventer •' " I ' ' -:� - . 43. Backflow Irrigation 37:-.;:--- • • 'r -- • 44. Landscape Irrigation Systems, -_ - • . - • v -45:_Sound Attenuation ra t tt4 X46.,Handicap Regulations _ 47..,FINAL STRUCTURE & BUILDING _ 48:,.FINAL PLANNING • i• `• - .,-49.:-Electric Release to Edison T i • j - 50. Gas Release to Southern California Gas Co : ; . . o t • . 51. CERTIFICATE OF OCCUPANCY • .. - ,/A No. Date / 31 1i 93 13: 54 Z 7143800921 BRIGGS DEV CORE 02 1 E . . I i' . .. i '.' 71,4 Are PS41 • tne :A . ,a '.-5iff f'.4:-.4"• on git" - • •f,, ': conAIA a ,.'}.F;Fifftfi rig:',ft2,;(g. '32: Electrical Power Meter-I'ina..... . , , ELI i‘a ' SAFETY DIVISIL. P1,,i.-teil ...4 133:•Final Electric ' !,' ' :,*,;' e '., .' . •. (3/5nZ • • POS I IN :.COASP,ICUOUS:,:. Pi.ACE.,.!cji!t'..u.r. ..A H,:..Firitirl-t-e.aiingl&AB' Conditioning : : ',• iNfriti Z.,1.40 , . ON ' THE JOB ... ••''',. ' 1 i e 35. Final Gas Pipe-Tpst • • ..,: , , 7/3(14"it., Leo> NOTICE ; , ... 36. . Hood or CanoPY ' You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH .NRF-SP CTIVE INSPECTION. .CALL 754-1827.1 ....37„ Final Factory Fireplace: „ . • • . 1 - ',.ii: 7&114re. UP ._ is (-tar SHALL BE/ON: JOB At ALL,1:. sa.sl . tisis-: Final Plum mu ..".‘...V.., J2. .1d41 7(41/le tra •". lf.liP-P-11-8.°!V.F19.1'4•P' ...r....12.:I... t it'',It.I lc't.....• ..... r.T..•• .4:WASS - . ' ISILj-EFQIil it' %:;.'.. .,39. Water. erv;t-e'Firlal."-:-.r.Ty'....iSttIft'ilra, Veirkt zegi) h.P.NI.). P.:,• ',..,.4.0'... 4,.. , ,44,,..., ..-A. -4; ••1-, , '4.e{.:j:-.1:11t.'"Tf Hi.t.‘.;,,-. - f'es . - (nt -‘1 ,-, - - - VP e "..::: . PERMIT NO. ' ' ' " 40. GES Servita•FInal • r !HI,: ••• ' ' 'i ' ' E. , • ,. I OF1OUP 41. Soler Domestic-Final . 7 I • WILDING ADDRESS -- -1 '.... .' , 16-1 . Ck-• $- A-• 42. Backflow Peeventer • , . , . . 'RACT - ,. LOT BLOCK 43. Backf low Irrigation ' • . . • NEW I AOD ALTER I REPAIR 1 MOVeNCI OEMOLISK _\. 44. Landscape Irrigation System . ' ac SA I Ind Attenn .alinn - ww.... . . 1 . CITY.OF COSTA MESA ,• ii!...F. ...*: ....: •'32. Electrical Power Meter4;inal t : 1 /z0/1,2- ..-,/I ..... .. sykLDING SAFETY DIVISION'i:-`4:! '',1;i1:14;_.:.!..ii . •4., -.4-i• ..:.•-..-• •-.,J..pc...;:i /J.4 5 iLekii,:c.. 33. Final Eliot:it .•--.- ...:.-- .: i•.-1.1 -iy);15- 1. 4, POST IN CONSPICUOUS.r. PLACE - --..---- ...... -... - - . - - • . 'k •:. - ..•• • - .4. . •,...„......, Dr!•,•i ' 34..Final Honing &Ak Conditioning ' : I i '5' 1/0/Iirri.' ON - THE JOB . • .. . ......:• ...- NOTICE 35. Final Gas Pipe-Test , ' . (ou must furnish PERMIT NUMBER and the JOB ADDRESS Hood or Canopy 'OR . EACH RESPECTIVE sPPLANS. iNSPECTION. CALL 7545627. ‘ 37.,Final Factory Fireplace . , . • • • PROVED_ ..SHALL tic..ON•JOB 'AT ALL:Times.'":: , - - -.. - .,. , ...-... .1/4_ ,.. •,..4.' . .1 .,. ..:.•..:...:.S.S.E.P..f.i.J.....7tiC. Final Plumbing - .. , i.; .11,.i. 7fralirr e Issua •.- • .I:i. I• :- '.4'`R;;;',01 .ire'. • • ;,:'. cwrk ci,i 1.01:c1„jrz ,•,313.,Igater Service-Final - •••• ;,...1.,, 7 ,• . • ".',..... ZW' 7/34•11 PE , ' - GROUP, :..' PERmIT NO. ' . --. Ta, 40. Gas Sorvice-Final - • ILDING ADDRESS .. ' 41. Solar Domestic-Final r2.-- i O ( (...;-11C-.` . c4. -i3 R . . 42. Backflow Preventer aLoCsc ,. ' "• 43, Badalow Irrigation • • . .. . d...... , - • EW ADO ALTER REPA 01 MOVING A pcmot..514 44. Landscape Irrigation system . . .. .:-•;,..-,,, .. . . .. / 7., '5„,„&ound Attenuation • . • ' ; '. ' I r'. -1: f titiktElarkicap Regulations , . • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT 7Y) ,24/;?-' 63 ' ,D 7 BLDG. 2, LOT D, PLAN B Project Address 210 16TH PLACE TYPE OF CONSTRUCTION 1 9775. — 12/21/BI 7.00 7L Owner THF HARBOR COMPANY Phone 6 3 1-45 0• XXNEW . 0 ADD 0 ALTERATION Address 31+0 OLD NEWPORT BLVD. , STE. 6, 0 REPAIR 0 CONVERSION ODEMOLISH ZONING REGULATIONS Arch/Eng. License No. - 0 OTHER , DESCRIPTION OF WORK A.P.$ Address INSTALL HEATING ZONE PLNG. REF.8r Contractor L, d Ski •k � Phone 2_ 44 TYPE OF PERMIT BUILDING a2OBP I ksiNG SETBACK C ERTV LINE A.• ' q, Lsn_ji(g:IaIG.CitA,fl !ta.*&$fLS 0 GRADING 0 FOUNDATION 0 STRUCTURAL L$I DFE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING SYMECHANICA SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER REAR YARD(TO P/L) Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION License Class — I y, - License, •:: PKG.SPACE REQ. PROVIDED Date 12-16-81 Signature �ln— — 1 (�r !/ r SQ. FT. WORKERS'COMPENSATION DECLARATION / • CUPANCV_CONSTRUCTION TYPE STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VAL •TION ZONE ZONING APPROVED BY DATE certificate of Workers' CompensationpInsurance, or a certified copy tx •eo (Section Qplvp4Gmpany FREM(JNT GRADING CU.YDS. ACRES SPECIAL CONDITIONS: r No Z to y Ly .artified copy is hereby furnished. REMARKS: B /393 XXCertiried copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section need not be completed if the permit Is for one hundred (6100) or less). I certify that in theperformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California. UW ELLIrvb VHHAtaE Date - Signature BATHTUBS SHOWERS • • NOTICE: If after making this declaration, you should become subject TOILETS - URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER C1 forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50+KW - O revoked. KIT.SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 +HP No formance of the work for which this permit is issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES N. Lender's Name - Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS " 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNSI HULL WN Any city or county which requires a permit to construct, alter, POLES METERED SUB improve,demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP LChapter 9 (commencing with Section 7000) of Division 3 of the •isiness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT• ' 's for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS not more than five hundred dollars ($500). • ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work,and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING HEATING SYSTEM 0-100,000 BTU 1 PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU 4.00 PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+ BTU PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this -BOILERS BTU ELECTRICAL $ • $ reasonPLAN CHECK $ MICROFILM $ SYSTEM REPAIR,ALTERATION Date Owner TOTAL FEE$ 7 OD I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $/ 4-14LESS AD. Information is correct. I agree to comply with all city and county PLAN CHECK $ - ' VANCE PC $_ ordinances and state laws relating to nstruction,and hereby uthorize representatives of his city to en er upon the above olio ed . Property P i n Purp /, //_ Iml Signature e G \ FINAL FEE $ 7.00 Drivers' License or SS 4f ISSUE FEE 3.00 CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • • CONSTRUCTION AND PLANNING oCllA �� • POOL&SPA • APPROVALS . • Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce - 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines.P-Trap', ❑Undrgrn - 10. Structural Floor System 52. APPROVAL TO,DECK • • 11. Property Sewer Line& House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbina System-Final 14. Rough Electric-Conduit -56. ' Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning (2,a 4-1KeriPt. 5B- . Fencing &Access Approval 17. Ducts, in Structure - 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating &Air Conditioning t/t/5 7yf- /5'I 30. Final Gas Pipe-Test • 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final •• • 35. Landscape Sprinkling System • ' 36. Sound Attenuation • 37. Handicap Regulations • 38. FINAL STRUCTURE & BUILDING . . .... 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date ' • t ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 7562 10/28/81 39e ! I TL CITY OF,COSTA MESA PERMIT fyV. � \ TRACT NO. LOT NO. •BL G.NO. CONSTRUCTION PERMIT a /.560 Y Project Address 2 /0 g t<.,(, pi LA C € ` TYPE OF CONSTRUCTION ^G • Owner / Hr/ E A /v] G j/' ,o • Phone }•r 0 NEW 0 ADO 0 ALTERATION \/` Address ,jyo ©ho At Ely nfl r RtvD 0 REPAIR 0 CONVERSION ❑DEMOLISH .>a ZONING REGULATIONS Arch/Eng. License No. 0 OTHER - DESCRIPTION OF WORK A.P.5 •-• Address _ ZONE PLNG.TpREF.yE Contractor ED jFQ C ol-jv hi phones-4m, TYPE OF PERMIT BUILDIN C/L ST. PROPERTINLINE Address .2 it - 23s� rt. I i ` 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD LICENSED CONTRACTOR DECLARATION ❑•TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL LSIIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mencing with section 7000) of Division 3 of the Bu3.siness and ❑ OTHER - - Professions Code and my _license is in full force d effect. REAR YARD(TO P/L) License gess e-- ii, — Igcense N•. /O 1s - PROJECT DESCRIPTION 4 ' e . ti, - SQ. FT. PKG.SPACE REQ. PROVIDED Date '� '- gnat ure STREET WIDTH PARK FEE$ WORKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE - I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY DATE 'certificate of Workers' Compensation Insurance, or a certified copy thereof(Section 3800, Lab.C.). SPECIAL CONDITIONS: GRADING CU.YDS. ACRES ' y No. Company - -- - - ertified copy is hereby furnished: - REMARKS: L-•Certified copy is filed with the city Building Division. n �/[ . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ,6-i s.lJ ' • • (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 PLUMBING •PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California. - - tLrvt. /Lt A RAGE j Date Signature BATHTUBS SHOWERS uwu SO FT. / ! 'I bSO FT 7 XD (/ 9/, NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW__1-10 KW � to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER 7 forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS 'APPLIANCE 10-50 KW 50+ KW revoked. — - - CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS. SUMPS (INC.SOLAR) 10-50 HP 50 + HP formance of the work for whichthis permit is issued (Section_3097 — . Civ. C.). . FLOOR SINKS FLOOR DRAINS 'FIXTURES OUTLETS SWITCHES Lender's.Name Lender'sAddress - DRINKING FOUNTAINS ,GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUN5I KUL I IUry i / Any city or county which requires a permit to construct, alter, POLES METERED / SUB .0 improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant-for such permit to-file a.signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE f0 AMP 5' � (Chapter 9 (commencing with Section.7000).of Division 3_of the -' - - "- t/ Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT ' • • -is for the alleged exemption. Any violation of Section 7031.5.by - - applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS2 o lot.more than five hundred dollars ($500). - 7 PR- 1 e‘--R, A/C., U I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do-the work,and the structure is not intended - .i or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE 9 ;,.- Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY . DATE through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden - - - of proving he did not build or improve for the purpose of sale). BUILDING ❑ I, as owner of- the -property,- am exclusively contracting with HEATING SYSTEM 0-100,000.BTU PERMIT - - $. - SMIP4 $• AND DUCTING licensed contractors.to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and ersof Code: Thebuildsor Contractor's License Law does a not apply to ISSUANCE $ an owner of property who a improves thereon, and whoa con- REFRIGERATION 0-100,000 BTU PLUMBING $ tractsC from such projects with a contractor(s) licesnetl pursuant to SYSTEM GRADING $ the Contractor's License Law). . .. - 100,000+BTU _ _ PLAN CHECK qq ' ❑ I am exempt under Section B.& P.C.for this BOILERS BTU - ELECTRICAL $ z5 . /1 $ reason • - '" MICROFILM $ SYSTEM REPAIR,ALTERATION •PLAN CHECK $ Date - Owner MECHANICAL $ TOTAL FEE$ I hereby certify that I have read thirapplication and state that the above EXHAUST SYSTEM _ MULTIPLE LESS AD- information is correct. I agree to comply with all city and county - PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction,and hereby authorize - representatives of his , ty to ter upon the above menti ned Property-for do urpos ?�^,,� ./ _ Signature n�/L�THs.rf a4/ Date��7% Si - • FINAL FEE $ ' ? Drivers'License or SS$ ., / ISSUE FEE CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor nit I9EY I. \, '•.\. I ,..c'\ CONSTRUCTION AND PLANNING POOL& SPA - ' , APPROVALS Permit# -VZ-c J1& Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - y'• 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn is-a9 S/ � 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49- Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrqrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, E Undrgrn • 10. Structural Floor System 52. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System -Final 14. Rough Electric-Conduit - •56. Electrical-Final _ 15. Rough Electric-Wiring /- C-L'., 57, Solar System-Final - . 16. Rough Heating & Air Conditioning b8- Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING • 18. ` Ducts, Ventilating 19. , Gas Pipe-Rough &Test • 60. POO L/SPA SYSTEMS FINAL 20. Roof Framing - . 21. Roof Sheathing 22. Frame and Flashing NOTES: • 23. Insulation • 24. Lathing & Siding 25. Drywall Nailing - - • - 26. iPlaster Brown Coat' 27. Electrical Power Meter-Final i • -28. - Final Electric • y-f-$Z- •C- d-- - . ' 29. Final.Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing • 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations •• 38. FINAL STRUCTURE &BUILDING 39. Special Requirements Completed , 40. Electric Release to Edison Wel 41. Gas Release to Southern California Gas Co. f 77 • 42. CERTIFICATE OF OCCUPANCY No Date • Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. li . • ,CITY OF COSTA MESA PERMI NO. / / TRACT NO. LOT NO. •BLDG.NO. CONSTRUCTION PERMIT Jam Project Address - 5::I:: 1'/I4/'•:i I '. u. I' / E /67H i•A LE: TVPE OF CONSTRUCTION Owner ink/JO-ar/ Phone ❑ NEW 0 ADD 0 ALTERATION Address !co A) evouw/ Itf 6LUO 0 REPAIR 0 CONVERSION ilagDEMOLISH Arch/Eng. License No. 0 OTHER ZONING REGULATIONS Address - D SCRIPTION OF WOR /Or" .54tre e 41- A-P-$ • Iwc:L., L/ L , jr. ' •-• ZONE PLNG. REF. Coontractor 0 if Can) L. Phone ;,..-3. L- TYPE OF PERMIT a• • ' TTpo ggUUI LPI ryG Address / JO / 0 GRADING 0 FOUNDATION 0 STRUCTURAL SEETTEBACKRC/LST. PRQPE RTV LINE LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING '❑MECHANICA �5'opFE yyA RD I hereby affirm that I am licensed under provisions of Charter 9 (tom- RIGHT mencing with section 7000) of Division 3 of the Business and ❑OTHER • Professions Code and my license Is in full force and effect. PROJECT DESCRIPTION REAR YARD(TO P/L) License Class - / •ce Nod = PKG.SPACE REQ. PROVIDED '�.. , Date Signature /._.A . . III SQ'�' OCCUPANCV_CON T STREET WIDTH PARK FEE$ WOR ERS'COMPENSATION DE. ARATION /J.-. S• RUCTION TYPE • I hereby affirm that I have a certificate of consent to self-insure ora /Pu JV�� ZONE ZONING APPROVED BY DATE certificate of Workers' Coa,mfp�e �rnsati o1on Insurance, or a certified copy VALUATION thereof(Sepao.n-3iiO),lo64 014 I. y e? -_ g•' GRADING CU.YDS. ACRES SPECIAL CONDITIONS: cY No.LLCC _ 7 V r`Pa it'e,runt( .;ertified copy is hereby furnished. REMARKS: - Certified copy is filed with the city Building Division. • _ _ XEMPTION FROM WORKERS' COMPENSATION DECLARATION . - - (This section need not be completed if the permit is for one hundred - - - ($100) or less). - . 1 certify that in in the performance of the work for which this rmit is issuedDate s Vj•OrkersPCo net ure do La of mei la/¢come PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK // A^ BATHTUBS SHOWERS UWtLLirvb L.MHHGL Signature 1,V\ 6 SO FT SO FT NOTICE: f after making this d rat on, you should become subject TOILETS URINALS GENERATOR 0-1 KW,1=10 KW • to the Workers' Compensation p visions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LVKW-50 _APPLIANCE 10-50 KW 50+ KW revoked. -- - ' - . CONSTRUCTION LENDING AGENCY KIT.SINKS DIS H S MOTORS 0-1 HP_1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS M S (INC.SOLAR) 10-50 HP +'HP .formance of the work for which this permit is issued (Section 3097 Civ. C.). FLOOR SINKS 06 R DRAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address DRINKING FOUNT I S GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LOINS I NUL.I i UN Any city or county which requires a permit to construct, alter, POLES METERED SUB ' improve, demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN • SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP j,Chapter 9 (commencing with Section 7000) of Division 3 of the ssiness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT Is for the alleged exemption. Any violation of Section 7031.5 by / applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS not more than five hundred dollars ($500). �� ' ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY who builds or improves thereon, and who does such work himself or ISSUE FEE DATE • through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK is sold within one year of completion, the owner will have the burden // SU,MMMAIRY OF FEES ��) of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT UILDING $'f 7•J[! SMTP $ r S•) ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for thisBOILERS BTU $ ELECTRICAL $ (� reason PLAN CHECK $ MICROFILM $ ((•��a Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE S Wp I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK LESS E -, information is tarred. I agree to comply with all city and county $ VANCE PC $ 11 ordinances . d sta laws i -. 'to to to truction,end hereby authorize d V� propertyoresc esif.[his icy to upon the above mentioned -Signature yr I�•ec.n urvo ..---- a.-4,- '/ MI 0 OCs Signature -//eoa �!� ISSUE FEE Pt CMF 0865-46 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLA ING' POOL& SPA APPROVALS Permit Date Inspector APPROVALS Permit# • - Date Inspector ".- 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ' 2. Soil Pipe-Undrgrn 44. Steel Reinforcement ' ' 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressure Test - ' 6. Electrical LIFER Grn • 48. APPROVAL TO COVER-GUNITE -. _ 7. Footings _ 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑Undrern 10. Structural Floor System 52. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final . 12. Street Sewer Connection 54. Heater& Vent-Final 13. Rough Plumbing 55. Plumbing System -Final - -• - • ' 14. Rough Electric-Conduit -56. Electrical-Final , 15. Rough Electric-Wiring 57. Solar System-Final 16. -Rough Heating & Air Conditioning _ bit Fencing &Access Approval 17. Duct's, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - 19. Gas Pipe-Rough &Test _ 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing 21. Roof Sheathing ' ' 22. Frame and Flashing .NOTES: • 23. Insulation _ .' • 24. Lathing & Siding ' , 25. Drywall Nailing • 26. Plaster Brown Coat 27. Electrical Power Meter-Final _ 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test _ - 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System • 36. Sound Attenuation • 37. Handicap Regulations 38. FI NAL STRUCTURE & BUILDING P-) Of-As-->E, ' 39. Special Requirements Completed . 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date 7 • Applicant to fill in all spaces within'heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PI=R�.-I /� TRACT NO. LOT NO. BL[JG NO. 0599 1 /13/82 - 11 .00 TU CONSTRUCTION PERMIT J�// 'C/ • • • Project Address ,b27//)___. //‘ ate_ 1.) TYPE OF CONSTRUCTION ' . ' - 1 ' Owner t..1Acl' , qZ Co Phone(_3/ 43,24 NEW ❑ ADD 0 ALTERATION ' • " Address -a¢>lna 3' C) `�I' -iv - 0 REPAIR ❑ CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. License No. - ❑OTHER DESCRIPTION OF WORK A.P. Address - ZONE PLNG.REF.$ - . Contractort4(}Z33,«Z_ CO Phone - TYPE OF-PERMIT BUILDING �QBUILDING SETBACK Ca.ST. Address_ _ . _ 0 GRADING 0 FOUNDATION 0 STRUCTURAL SI OE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT ❑ ELECTRICAL ❑PLUMBING OMECHANICAL siDE YARD - I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT ' mencing. with section 7000)- of Division 3 of the Business and 0 OTHER Professions Code, gel my license is In full force and effec REAR YARD(TO P/L) License Class Lic� - No. � PROJECT DESCRIPTION� -- PKG.SPACE REQ. PROVIDED _ Date -/--13 i2Signature 'ir'' ' • SQ. FT: ,_ WORKERS'COMPENSATION DE A- • 10 . OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK FEE$ I hereby affirm that I have a cert tate of consent to self-Insure or a VALUATION ZONE ZONING APPROVED BY DATE 'certificate of Workers' Compensation Insurance, or a certified copy - -reof(Section 3800, Lab.C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: • cy No. Company Certified copy is hereby furnished. - - REMARKS: ❑ Certified copy Is filed with the city Building Division. , , 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 PLUMBING - , PLAN CHECK ELECTRICAL PLAN CHECK _ -subje t to the WO r5'Compensation Laws of Hernia. UwtLLirvb- S�TGt • Date , Ignat ure BATHTUBS SHOWERS NOTICE: If after making this decla lot ou s uld become subject TOILETS URINALS - GENERATOR - 0-1 KW_1-10 KW to the Workers' Compensation provi ons of the bor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - - APPLIANCE 10-50 KW 50+KW- " revoked. - - .. --. - - CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS -' - MOTORS 0.1 HP 1-10 HP' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS '- SUMPS - - (INC.SOLAR) 10-50-HP 50+HP formance of the work for which this permit is issued (Section 3097 - - Civ. C,). -' FLOOR SINKS FLOOR DRAINS- - FIXTURES OUTLETS SWITCHES -- • Lender's Name _ .. - Lender's Address - DRINKING FOUNTAINS GAS TUBE SIGNS - - --- - OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS - ' - - '" '- I hereby affirm that I am exempt from the Contractor's License Law for - e . the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P.TRAP - Lurvbt nut_ Juni - - - - Any city or county which requires a permit to construct, alter, POLES METERED SUB 1 improve,demolish-Or repair any structure, prior to its issuance,also re- WATER SERV ICE ALTERATION - PANELS MAIN - SUB quires the api.licant for such permit to file a signed statement that he - - Is"licensed pursuant to the provisions Ofthe Contractor's License Law GAS SERVICE OUTLETS 'SERVICE -- - - ' AMP- ' (Chapter 9 (commencing with Section 7000) of Division 3 of the - `usiness and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT . - • - . ' - Isis for the alleged exemption. Any violation of Section 7031.5 by ' '� ,y applicant for a permit subjects the -applicant to a civil penalty SEWER CONNECTIONS - - of not more than five hundred dollars ($500). • ❑ I, a5 owner of the property, or my employees wits wages as their - SOLAR TANK - COLLECTORS - sole compensation, will do the work,and the structure is not intended _ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ' ISSUE FEE -- - - Contractor's License Law does not apply to an owner of a property -APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE - - through.his own-employees, provided that such improvements are.not - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES- ' ' is sold.within one year of completion, the owner will have the burden - of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING- - ❑ I, as owner of the property, am exclusively -contracting with AND DUCTING - _ PERMIT $ I SMTP $ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ - PERMIT and Professions Code: The Contractor's License Law does not apply to -- ISSUANCE S ' - an owner of property who builds or Improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ -tracts from such projects-with-a contractor(s)-licesned pursuant to SYSTEM - - - - - - • - GRADING $ ' • the Contractor's License Law). 100,000 +BTU PLAN CHECK'.$ - _ _ ❑ I am exempt tinder Section - - B.& P.C.for this BOILERS BTU ELECTRICAL $ - $ reason ' - - - MICROFILM $ ' SYSTEM REPAIR,ALTERATION PLAN CHECK s Date -Owner - _ _ TOTAL FEE$ - ' MECHANICAL $ /, 00' I hereby certify that I have read this application and state that the above EXHAUST [/TSS YYST�EE((M/�+r�1 1�MULTIPLE LESS AD- ordinaacis id tatrela agree to comply with all her and county `.=I'�+/LeS.JlI -fa`� '��� PLAN CHECK S -- - VANCE PC $._ -. ordinancesand state laws relating[o.construction,and hereby authorize - representatives of this ci y to enter upon the above mentioned // Property.fpr 75et .n .�r.a __ 'aro ba Signature e -1���+eaa _ a. e �� (/%/�' FINAL FEE $ // —` Drivers'Licen.e or'Illi �� � ,��� ISSUE FEE Gg al .- - - -- Li,CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor • CONSTRUCTION AND PLANNING �j I POOL&SPA APPROVALS Permit# sA'n315 Date Inspector APPROVALS Permit# - Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - •- - • - 3. Electrical Conduit Utility-Undrgrn 45. Forms • 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trap. ❑ Undrgrn - 10. Structural Floor System 52. APPROVAL TO DECK "_ 11. Property Sewer Line & House Connection 53. Backwash& Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55 Plumbing System - Final 14. Rough Electric-Conduit --• •- 56: - Electrical-Final 15. Rough Electric-Wiring - - 57. -Solar System-Final 16. Rough Heating & Air Conditioning ( 4(-t67•- b8• Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - _ - 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL r .. 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating &Air Conditioning Jf/f/a-2- _-64 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - . No Date - - A kJUTS LLItt Clad O. LU4.0 o.SCCu rJ.(.ttt4& C . BUILDING PERMIT NO.C4W . Ab GENERAL CONTRACTOR Guaranteed Homes VALUE $115778.00 C. -6. r— AP No117-151-19 LOT TRACT FIRE ZONE DESCRIPTION OF WORK res w/att gar I' ECTIONS Signature D•T GROUP I&J TYPE V ZONER2 S. " L — PERMITS ISSUED Gas yl / SLI OSUBCONTRACTOR DATE NUMBER Water / . / '.2L LS Rough Corn. Refrig. 0 Air Cond. 0 7 Rough Heating -•',,(%'_,. - (44-2-ern,. :2-d-6 r 2 75// Rough Plumbing =' 4 j%t ' '- //2l`%r 6/4,-,e Miscellaneous Prop. Swr. Line nouse Con. St. Swr. ❑ .4---- - - c r 5//C 73 Sprinkling System ��� Construction Pole a! Underground ❑ Power 0 6 Rough Wiring /12.69 7•v/.G.- ?.c,...;-,, 0.-,- - .2/14r" i '9 Trenches ti Forms 55 Steel Reinl. 0 04 22/05- Floor System 1- Bond Beam 0 Steel Reinforce 0 e( <aca•Soit.d _�5 Sheathing ,p 2, - ,p Frame and Flashing �1 f� �� —"�—l' Lathing — In(Rt/ Out I„loan Plg ?er, brown coat C j�/j��� Cc :a 0 Air Con. 0 Final `� <r_ He"a"ting, Final Plumbing Fixtures,��.�Frinal /, I $ Final Gas Test [�^ �/ � f Electric Fixtures, Final /L/ __ Building, Final !_,4' {J//9h 5 23408 , FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JAN 14 1965 P.O.BOX S/7 COSTA MESA,CALIFORNIA FINANCE DEPT. Sr; PARMA For Applicant to •Fill In Completely APPL��I I TYPE OR PRINT BUILDING For Office Use Only BUILDING /J' / � ADDRESS N(O /(/7 RECEIPT NO. PERMIT NO. COSTA MESA, CALIFORNIA 23`/08/ /(^/ //. A/ now BY 117117.4.> gAT)6 - c c OWNER \ \ -17gi i-- / l' /!' -(c//�� MAIL �/ .O %— / f! i ADD/REI88 ,C5 p 1 6 7/l ' / ADDRESS/////I 2 /j�J /TEL. ��'' •-�. CITY Oaf 4i ///�4 NO. o.1.-7).7 8ZONE �"T TYPE ,_ GR• [_ �l APPROVED/ / ' • .24 S� ARCHITECT /' 1 TEL BY C: �7 DAT' OR ENGINEER C7 v�� /c///W NO. .�'J7.694 (�� `. ADDRESS 496.6 e&m,4//Irp ( NTNG �f�,A Cf... LT_ B �/ I PLANS /I USELPNE ,� A l / /� PUNAY BUILDING ' ly.� ry CONTRACTOR[7U/f�.�7IG/ /Ijtiv (n� �W I'b LEGAL 0 tl '` Lo fi S'-3 /06,62o / DEaCRIPTON ADDRESS�-/06,62 o el/00, /74!! / ICY/ / QQ CITY Y / NOSTATE yy TEL S'` 7 Q 30'IE: NO EAVE TO SIDE&REAR P LNG SHALL LESS THAN LIC.NO.�/7 Z 2J70 / NO, d �/ -I2(/' Z, 30' EAVES d /3/• IGS/ I NOW ON LOT 1L� ALLOWED SIZE NO.OF BLDGS. ALLOWED (U.B.C.REQUIREMENT) OF LOT YARDS IN BUILDING ACCESSYARDS ORY BUILDDING USE MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. /grir (FROM C/L STREET) �� SETBACK LINE FROM FRONT S UFT. FT. CENTER OF STREET REAR YARD �� SIDE YARD I LEFT I RIGHT d R.SIDE 5 . FT. DESCRIPTION OF WORK L.SIDE ,7� Fr. Fr. NEW I/I ALTERATION ADDITION REAR /�](// - FT. Fr. /_ \ DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. VAR.# DATE BUILDING yr, • NO.OF ��7// SIZE y--,-.91- 7 ROOMS / STORIES C.U.P.# APPROVED EXTERIOR WALL / ROOF J APPROVED / '/ / COVERING ��LQG I COVERING CIO BY �/I .L DATE � '� "�S USE OF BUILDING AND WORK TO BE PERFORM 111 (242-1n427e1 /o-Po ! CO HOLO FOR SPEC AL REQUIREMENTS//jf (�iXzb //i7. G�Yv}/L ( L� )7I ' ' LV tr„4 G( Y (OR SO. rr FT. 3 -t I HEREBY ACKNOWLEDGE THAT I HAVE :HAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE _' AND STATE THAT THE ABOVE IS CO” C AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDIN ES A • ST Ti LAWS REGULATING BUILDING CONSTRUCT! VALUATION _GEC' CO SIGNATUREOF PERMIT FEE $ -7 j PERMITTER '( ..1-0° $ / �I 7 7g/ PLAN CHECK S V Q — AUTHORIZED AGENT // > St TOTAL FEE $ 7 a JOB ADDRESS 210 E. 16th P1. BUILDING PERMIT NO. 23407_ GENERAL CONTRACTOR Guaranteed Homes ap..Q.J� • L. VALUE § 400.00 /_!� 6S T AP No. 117-151-19 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORKDem°.! Res. F ECTIONS Signature DATE GROUP I TYPE V ZONE R2 PERMITS ISSUED Gas - SUBCONTRACTOR DATE NUMBER Water Rough Corn. Refrig. 0 Air Cond. 0 Rough Heating Rough Plumbing Miscellaneous dp � na-v /$$ c!_/,7 ....�s.'�-.J /-/9 f Sest 7,- — Prop. Swr. Line•0 Hae Con..0 St. Swr. 0 / Sprinkling System Construction Pole Underground 0 Power Rough Wiring Trenches 0 Forms 0 Steel Reid. 0 Floor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing — In,0 Out 0 _ PIV,er, brown coat >a�=d,`�'. 0 Air Con, 0 Final Plumbs , Finxl t _ Plumbing Fixtures, Final Final Gas Test �4 -- - - - _- Eleelrie Fixtures, Final -- -- - —�-- — --- Building. Final _ _ _ `(I /! . ___ FEE REULIVLU -,..ii2 407 - JAN 14 1965 • COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P.O.BOX 317 COSTA MESA.CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ;. BUILDING ,•I //1 7 For Office Use Only ADDRESS 2I U p_ /6_4-- / I ��)•• 7 RECEIPT NO. ` �f� l ' COSTA MESA. CALIFORNIA G Ly (^p (/ �/w L r D E BCC I�•D • TE IS7ED OWNER ( . f , . 17/7 G/C dANLK r Y /I / �P/. MAIL ADDRESS - 0 SFIRE 7 TEL. CCJJ ZONE - GROUP CITY _ /f / .��.i NO.LI _ APPROVED Mr• A! AF 'TECC/ / , O J /NEER 7c/�lj"/ NONO cr37 '. • • c ADDRESS - 1// 4I •�� ,NO.OF USE OF NEW r- PLANS 0 BUILDING 'p, ADDRESS 6/7 0066,`Y////,1�/zn 7/f q ^ u 1 CITY deZde Gr/P A.P.NO.• / d r 1 / 7 7 �7 NOTE: NO EAVE OVERHANG SHALL BE LESS THAN LIG.NO.ATE l/ z' 2c { 2 NO.es -,QeZ SO TO SIDE a REAR P.L. / EAVES SIZE 1 /q 7! /_� I NO.OF NOW ONLOT L SLOGS ALLOWED (U. APPROVED YARDS APPROVED USE OF LOT 77! S// USE OF MAIN BUILDING ACCESSORY BUILDING EXISTING BLDG. ' (FROM C/L STREET) SETBACK LINE FROM FRONT FT. FT. CENTER OP STREET . REAR YARD SIDE YARD I LEFT I RIGHT R.HIDE • I FT. DESCRIPTION OF WORK L.SIDE F7. I FT• REAR FT. FT, _ ALTERATION _ ADDITION DISTANCE on. BET.MAIN a MAIN BLDGS. REPAIR MQVING DEMOLISH I• ACCESS.BLDGS. VAR.# DATE BUILDING NO.OF SIZE ROOMS STORIES C.U.P.# APPROVED EXTERIOR WALL I ROOF APPROVED I n /1 /. 1 • E I—/1/ COVERING COVERING SY �•f/�/ p • 1l `r USE OF BUILDING AND WORK TO BE PERFORMED ;ern* //L/7a4") P. f C5 N SQ.Fr. I HEREBY ACKNOWLEDGE THAT I HAVE R T S APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE 9 AND STATE THAT THE ABOVE IS CORRE AND ORES TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G ' PLY WITH ALL CITY ORDINANCES D ST TE LA S REGULATING VALUATION BUILDING CONSTRUCTION, y.p 0 // l PERMIT FEE 5 SIGNATURE OF '�q� S PERMITTEE fffNNN� �•T * 4 0 PMN CHECK S AUTHORIZED AGENT •Jo. TOTAL FEE `..A C9sta Mesa Building Department APPLICATION Fun ca:tZNft ' - .41 .1' •. _...-cAST 20th STREET 1113 _ . BUILDING, . _-•_ ._.'�- �. COSTA MESA, CALIFORNIA -- L .. — FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY Receipt No. Permit No. ' Building Address - ' /7 � , ' _ //O .Z./ es _/(Q 2/0 Costa Mesa California Received by Date Recd. Date Issued iI54- 4` Nearest �] S S Cross St. Cei-[.1 "- • - Building . Address Owne '2. - Costa Mesa, California • Mail L Addresse � a,04.—y/‘ „.. /esarn S4_4t Nearest ; Cross Art hitect or r,/�4.1 NoLicA/. r! tcy Zone�t� : I Plans of I Type , . I Group J- Engineer y-z No. J"'�' Approved ' V by Date irtss CORRECTIONS . City Lie. t,ontractor ' W - No. Address JA�/ C %e'w ' Legal Lot /� GJ • Description I No. I Block I Tract / (Attach Metes and Bounds/'//7y So..- 3 I No.of Bldgs. Size of Lot I Now on Lot Use of I No.of I No.of z y_ Existing Bldg. Families Rooms 0 Setback Line from // Rear Yard -' Center of Street fel-0 -PL • Side Yard$'y jj�./ y DESCRIPTION OF WORK • �/i__ r New I I Alteration I I Addition I CITY OF-COSTA COSrA�FC/�-- Repair I I Moving I I Demolish I �tiR--- Building No.of °Ize/ Rooms / Stories / :crier Wall Roof _ .vering r _n_ I Covering ' e APPROVALS Use of New �''� � 11��� ///�/ Foundation Location Inspector Date Building ,•� ' � i."'C'�'� 9 Forms,Materials, P Under-Pinning _ 1 Frame: Fire Stops, � [/ -�'[^ — Bracing,Bolts `• Lath. Int. I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building construction. Signature of ' if. Plaster, Int. Permittee lGuC� Plaster,Ext. Authorized Agt. Masonry Reinforced ValuationPermit Fee $ c2.0 'D Plan Check $ s-,-, Bond Beam $ et9. I Total Fee $ 02,S-O FINAL Form 204 C,-H 151 1.2-53 r i c 44 ern o -L-1 a ` c----, a L. Dd¢ A oPR-14i***2.50 a. I0 #1041/41.1.1 H Is d J �cv"� 43 u I IS Ste // PLOT PLAN Show location and distances from property line and between buildings. r 1 CITY OF COSTA MESA I 4 t, BUILDING DIVISION 4 t)) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714c 754-5271 • Fax(714)7544856 • www.ci.costa-mesa.ca.us ).4 FOR INSPECTIONS CALL: (714)754-5626 fi • PERMIT NUMBER. E07-00893 PERMIT TYPE ELEC STATUS: ISSUED DATE ISSUED: 11/09/2007 ISSUED BY: BJK JOB ADDRESS: 210 B E 16TH ST CM Suite/Unit: • B Vicinity: REAR YARD SFD • - SCOPE OF WORK: ELECTRICAL PERMIT FOR WATER FOUNTAIN(1 MOTOR TO 1 HP)AND LOW VOLTAGE LIGHTING AT THE REAR OF AN EXISTING SFD,UNIT 13, , OWNER: KLEINSASSER,STEVEN K AND CRAFT,JOANNA: Address:- 210 E 16TH ST Unit: PHONE: - _ City/State/Zip: COSTA MESA,CA APPLICANT: KLEINSASSER,STEVEN K AND CRAFT,JOANNA Address: 210 E 16TH ST Unit: PHONE: 949-631-3248 City/State/zZip: COSTA MESA:CA • CONTRACTOR: OWNER-BUILDER - - • - License No. 000000 Address: Unit: - PHONE: - - City/State: ZipCode: CELL: • ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $53.25 • Reinspection Fee $0.00 TOTAL FEES $53.25 . . R R.. • 1 p . . , . . 3 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t, INSPECTION TYPE DATE INTITIALS CODE INSPECTION TYPE a. INTITIALS 1616 FixedlSystem Final Fire Prevention 206 Final Plumbing 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 7/( (k 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place / 220 Final Planning Approval 203 Final Sign Z I((7(8. 222 Final Site 204 Final Demolition - 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by tlriv:e. / Expires:1II f /I 1 O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-properly tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. t ❑ 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This secs/on need not be completed ethe prvmas valued at one hundred dMars($100)or less) 2 Art 2,Sec.341.Tile 8,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ieI certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless sued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of Califomia, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date j1.th Labor Code,I shall f with comply with these provisions. j- 'V— �' /w I O Division of Industrial Safety Permit Number: Applicant's gnalure Dal HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: W RNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE Will the applicant or present or future building occupant need to file and UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect, a registration form for acutely hazardous materials? ❑Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No Lender's Address: (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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: r( - Health and Safety Code been fully complied with? 9 Yes ❑ No I hereby affirm that under penalty of perjury that I an EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve. demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance.also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I. as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE-OF,COMPLIANCE: I certify that under penalty of,perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH �y/JI city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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 authoriz by this permit unti al inspection. / ^ . . / I1 ) 1 ) 0 o Lam- 1 D CP-4...----/`�l�— Signature of Legal Owner(s) ' Date Signature ale 305 d6 3/07) And/or Authorized Applicant Dale a 1 1 CITY OF COSTA MESA r '' 4y BUILDING DIVISION F, � ., A(B 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.ca.us 73. FOR INSPECTIONS CALL: (714)754-5626 o PERMIT NUMBER. P07-00580 PERMIT TYPE PLUM STATUS: ISSUED DATE ISSUED: 11109/2007 ISSUED BY: BJK • JOB ADDRESS: 210 B E 16TH ST CM Suite/Unit: B Vicinity: . . , SCOPE OF WORK: GAS OUTLET FOR(OUTLET 1-4) FOR AN EXISTING SFD, UNIT B..NO OTHER WORK AUTHORIZED WITH THIS PERMIT. - OWNER: KLEINSASSER, STEVEN K AND CRAFT,JOANNA • - Address: . 210 E 16TH ST - - PHONE: - City/State/Zip: COSTA MESA,CA ' APPLICANT: CRAFT,JOANNA - . Address: 210 E 16TH ST • : . PHONE: 949-631-3248 • - City/State/zZip: COSTA MESA,CA CONTRACTOR: OWNER-BUILDER License No. 000000 • Address: PHONE: City/State: : ZipCode: CELL: PLUMBING PERMIT FEE SUMMARY PLAN CHECK FEE: $0.00 4 . PERMIT FEE: $29.65 - rt TOTAL FEES: $29.65 ita 3 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE/ INSPECTION TYPE DATE INITIALS CODE! INSPECTION TYPE DATE IPTTRL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing '1/ —Q BW 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 r WORKERS'COMPENSATION DECLARATIO . Owner ID verified by � Expires: —I /I I // I O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the.work for which this permit is issued. ❑ 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: 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 Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Thu seam neer,not be competed athe penn4 is valued at one hundred cbtlars($100)or less) 2,Arlt Sec.341,Title B,Califomia Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would j] I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of theiLabor Code. I shall forthy�th comply with these provisions. Applicant's Signature Dame i I I oj '01 Division of Industrial Safety Permit Number: Applicants Signature Dame HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: W NING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No Lic.# Class# (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 Contractor's Signature Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5. the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by Califomia License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No 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 • 8. (If"yes",attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF,COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information'given above is correct. I agree'to comply with all'state laws and I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinancesregarding Hazardous Materials and Emissions. LASED CONTRACTORS to construct the project(Sec.7044, Business and rofessions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy f any building authoor'z{pend Eby this permit u9t' finalainspection.n�c /l//J'�^V{,/— I 0 Signature gall wner(s) v Dat signawre— ✓ - C le 471 And/or Authorized Applicant Date i CITY OF COSTA MESA •,, // ,. II CALIFORNIA 92628-1200 P.O. BOX 1200 , f 17{ G Rift DEVELOPMENT SERVICES DEPARTMENT .41h44e{EG •_ _ - • September 17 , 1991 To: Building Safety Division Newport-Mesa Un. School Dst. (2) Code Enforcement Pacific Bell Communications Police Dept.. - Ping. & Research Copley-Colony of Costa Mesa Santa Ana Heights Water Company County Administration Office Sanitary District Engineer County Clerk/Bd. of Supervisors Southern California Edison Co. County Registrar of Voters Southern California Gas Co. County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Fire Admin. -Training OfficerU. S. Post Office - AIS Fire Prevention 'U.S. Post Office, Adams Avenue File (2) Mesa Consolidated Water Dist. The City of Costa Mesa wishes to advise you that the following addresses have been changed or added: OLD ADDRESS NEW ADDRESS A.P. NO. 210 E. 16th Street 210 E. 16th St. "A" 425-201-06 210 E. 16th St. "B" 217-223 E. 16th Place 217 E. 16th P1. "A" 217 E. 16th Pl. "B" 217 E. 16th P1. "C" 217 E. 16th P1. "D" • .217 E. 16th P1. "E" 217 E. 16th P1. "F" 217 E. 16th Pl. "G" 217 E. 16th P1. "H" Your cooperation in this matter is appreciated. • Sincerely, • RICHARD WELMERS Planning Intern (210E16TH.ADO)II cc: Ed Briggs 23046 Avenida de la Carlotta #315 Laguna Hills, CA 92653 77 FAIR DRIVE Building Division(714)754-5626 • Code Entorcement/eusiness License(714)754-5234 • Planning Division(714)754-5245 1 FAX(714)556-7508 PROJECT ADDRESS: 210 E 16TH ST UNIT:hp CITY OF COSTA MESA — BUILDING PERMIT PERM NO: GRA-• OWNER'S NAME: BRIGGS DEVELOPEMENT tea' :4„ ADDRESS: 23046 AVANETA CARLOTTA PERMIT NO: GRA 054388 PLAN CHECK NO: 04049-91 A GOVT: N SUPP: N SUITE 315 y LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V—N PERMIT TYPE: GRA PURPOSE; NEW s 3800686 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : GRADING FOR 4 RESIDENTIAL BLDGS SQ FT: ADDRESS: UNIT: CLAIM VALUE: 7, 000. 00 CALC—VALUE: GROUP OCC: R-1 / PERMITTEE: BRIGGS DEVELOPEMENT ( 714 ) 380-0686 onus: 23046 AVANETA CARLOTTA 315 COMMENTS: GRADING FOR 4 NEW RESIDENTIAL BLDGS LAGUNA HILLS ' CA 92653 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: 20 FT IN REAR: 78 FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT: 16 FT —. IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN '\ POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL : 42520106 ZNE• R2 REF NO• DR-90-90A r 0 CemOedcopyisherebyfurnished. (1] Certified PLANNING NO ES> UNIT "A" OF TWO UNITS ON A LOT CONTIGUOUS WITH ANOTHER LOT— > WITH SIX UNITS IN TWO BUILDINGS. ^(P la Date. Applicant' *************************************************ie *M** *iF****iE*-****_it*3E********/ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed d the permit is for one hundred($100)or less). D E V--E L O P M E N T SERVICES REQUIREMENTS 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 subjecto the Workers'Compensation Laws of California. ZONING APPROVED BY CO L r'. DATE: (-01(-4491 Date: Signature: - '� k . 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. .. / I � I CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ' DATE• �R R J kI which this permit is issued(Section 3097.Civ.C). ************************************ * * * {1********************* * *** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: l 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 75 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed 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 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 5 . 63 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 00 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'State License Law TOTALS----> 75.00 3 . 00 5. 63 83 . 63 83 . 63 . 00 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 REVENUE DIVISION TOTALS--> COLLECTED: 83 . 63 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 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TUT GRADING PLAN—CHECK I,as owner of the pmpeny.am exclusively contracting with licensed contractors to Construct the project(Section 7044,Business 78 . 00 5 . 6 3 04 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 Contractorls)license pursuant to the Contractors'State License Law). l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. / INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this n i�/� TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date, (�=42_T_ Owner/_ �� %�s NO FEES WERE SELECTED FOR THIS PERMIT I do hereby certify Thal I am aware of and understand the requirements of 'orni:, / �yA ode Sections 25505.25533,and 25534 and that I or any future building occupant willvill not(circle one)need to a.05— .te codes and the requirements for a permit for construction or modification loom the Air Quality Management 0: ,rt7F�. struetion applications are exempt from these provisions. Date:.__ede Applicant: iG� � ' - _ _ _ I hereby certify that I have read this application and state matt (above m, on i orr�wi' '�•��• •11 city and county u -. ordinances and state laws relating to building construction and• reby aul pre 'ryre� enlioned properly for inspection purpposes.o Date:_7(.. /.-- , ( Signature: �� A04-9 wl' w ! L f C ! .a- 4 r Driver's License or Social Security a: err t` 164146 White—Building:Green—Code Enforcement:Canary—Appncam-nnx— evenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POO 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 ConduitUiility-Undrgrnd. 54. Forms .4.-Electrical Conduit-Undrgrnd. 55. Electrical Bonding • ' 5'Steel Reinforcement 56. Rough Plumbing &.Pressure Test • frr Electrical UF ER Grrid. 57. APPROVAL TO COVER-GUNITE ,. 7.' Footings 58. Electrical Conduit-Undrgrnd. - '18;Foundation ;. 59. Gas Pipe, 0 Undrgrnd., Test , 9..,Water Pipe-Undrtgind. 60. Backwash Lines, P-Trap, 0 Undrgrnd, , 1'0. Structural Floor System 61. APPROVAL TO DECK I Ii 11.;Property Sewer Line.& House Connection - • ' ' 62. Backwash & Receptor-Final , . .r. • 12. Sewer Cap 63. Heater & Vent-Final !t, ' 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 ''117. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • ar- 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.;Rough Factocy Fireplace ,: 4 . o - I, APPROVALS „.Permit# 21'Ducts, in.Structure, _ 4 . `:70. Unde?ground Hydro �. 22. Ducts, Ventilating . > c . -71, ProducePiping0Gas 0Oil 23i.Gas Pipe=Rough & Test `r., - x ' : 72. Underground Flush ; 24:Roof Framing .- - 73 .Undergrnd.Storage Tank0 Gas 0Oil 25'Roof Sheathing 4 >_ .. .74-Overhead Hydro 26;T-Bat Ceiling (Structural) &_(vlonocoat j . , 75. Dry Chemical - 27:.Frame and Flashing •T • 76. Dry Standpitie ' 28�CLathing.& Siding''. j.' " _ 77, FIXED SYSTEM EINAL• - . > 129. Insulation ' ' - 6 a, 7B; FIRE PREY. FINAL 530. Drywall Nailing s . ; r .. HEALTH-DEPT. REQUIREMENT '131. Plaster Brown Coat, r r -;.. ; 79.1 FINAL INSgECTI9N .. e. :.32._Electrical Power Meter-Final ' I 1 ; 80.. FOOD CERTIFICATE ISSUED' l 33?Final Electric = S ' "Notes: - i • . ;'34,.Final Heating & Ai4 Condition ng: s._ I ' . re = - ,TOLD FOR. SPECIAL RCCL'1EMENT_ I' 4• . 35,:.Final Gas Pipe-Test• r - : ^ t - "' • r-. .. . ' ••Z, ,. , - t _ • 36^Hood or Canopy'" '� -- - . - t. • 37'Final Factory Fireplace - Sic' - it a r - - "38-Final Plumbing •• '•- .-t -" t. r �i 39^Water Service-Finab - I _ - t• • ' 409 • Gas Service-Final • x t -. , >41. Solar Domestic-Final„ 1 -•t _ * t'42?Backflow Preventer, • ,u .i Ir tr ti-- r T ..- 43. 43. Backflow Irrigation iE S - s > t p rt. , L. Y . !.i:-44. Landscape Irrigation Systerra,`,C,° �.y_'.; . _ ;45'Sound Attenuation -. `•+ > * n. .. .. , r x _ - ... �46^HandicapRegulatidns - `-' •-•. 1 't J, r -$ r i 47. FINAL STRUCTURE & BUIILDING 5/2 Ilk : ..r 48"FI NALPLANNING i t. T 49.;Electric Release to;Edison ; -50.,Gas Release to Southern California Gas Co ( �} -51. CERTIFICATE OF.000UPANCY ; ;' ' :o._ Date r , PROJECT ADDRESS: c210 E 16TH ST UNIT: B CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 054394 OWNERS NAME: BRIGGS DEVELOPEMENT 'ADDREss: 23046 AVANETA CARLOTTA PERMIT NO: B 054394 PLAN CHECK NO: 04050 91 A GOVT: N SUPP: N I� SUITE 315 'J' t LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: NEW 3800686 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW SFD 2 STORY SQ FT: —2, 320 ADDRESS: UNIT: ' 4 • CLAIM VALUE: CALC—VALUE: 133, 454 . 50 GROUP OCC: R-1 ' ' / PERMITTEE: BRIGGS DEVELOPEMENT ( 714 ) 380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS: NEW 2 STORY SFD . LAGUNA HILLS CA 92653 ******>E***********IE*******+ESE+F+E**********************+E***** +F+E*+E*kE******+F******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS • " 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S 3 .. CITY LIC.: STATE LIC.: CLASS: /. A� Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selhinsure or a certificate of Workers' FRNT: I 75 FT IN REAR: 20 FT IN FRNT: FT IN REAR: FT' IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C6 . LEFT: �/ 5 FT IN RGHT: 11 FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: DMPANY: PARKING RE PROV: PARCEL: 42520106 ZNE: R2 REF NO: DR-90-09A Certified copy is hereby furnished. IDCertified copy is ted with me city Building Division. PLANNING NOTES> UNIT "B" OF TWO UNITS ON A LOT CONTIGUOUS TO ANOTHER WITH > SIX UNITS IN TWO BUILDINGS. �e: Applicant: ******************** ********************************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E L O'.P .M -E, N'T SERVICES R E Q U I R E M E N TS 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 • _ sublect to the Workers'Compensation Liws of California. ZONING APPROVED BY • : - CO e C'_ DATE: (.o Ili= /9 I Date: Signature: ` NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation provisions of the labor BUILDING APPROVED BY r DATE: , Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. .. - i ,y� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED 'BY•: 2 S [ , (-1 DATE. t o -***4:14** t_)3 which this permit is issued(Section 3097,rCiv.C). *********************4**********************- * �titit****************** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY 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: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 758 . 50 . • . 13,35 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 123 . 26 .r •and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by - •+ any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE _ I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK. ' TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7(134,Busmen and Professional Code: The Contractors'Stale License Law TOTALS——--> 771 . 85 0. 00 123. 26 895 . 11 895. 1 1 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 895 . 11 OVER/SHORT; 00 improvement is sold within one year of completion.the owner wit have the burden of proving he/she did not build or improve for me purpose of safe). BLDG PMT PLUMBING ELECTRIC MECHANIC /FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner al the properly.am exclusively contraCNng w tis licensed contractors to construct the project(Section 7044,Business 758 . 50 i 13 . 3 5• 123. 26 ix and Professions Code: The Contractors'$tate Licerise Law does not appy to an owner of property; 'builds or improves thereon and who contracts for such projects with a con:ractor(s)license pursuant to the Contractors;.ate i-se Law).l am aware **************************************;)(-*****i***********906********************* that proof of their Worker's Compensation insurance should he provided to me.Contractors, INDIVIDUAL F;E E •t B R E A K D O W N - ❑ I am exempt under Section: B.&P.C. ��s r • for this reason: '''C '` , TYPE QTY DESCRIPTION • UNIT COST TOTAL COST Date: AO ^ld -9/ x'R:_/�/��hst, SFR 1805DWE TYPE V—WOOD FRAME —GOOD 69 . 00 124 , 545 . 00 Ido hereby certify that I am aware of and understand the requirements of atlfornia and Safety Code Sections 25505,25533.and SFR 515 R ES—GARAGES TYPE V -• • •" / 17. 30 ' • 8, 909 . 50 25534 and that I or any future building occupant wilMwill not(circle one)need to co with said state codes and the requirements fora END OF FEES permit for construction or modification from the Air Duality Management District. •esidential construction applications are exempt from these provisions. Date: Applicant: 4 — ' ' I hereby certify that I have read this application and slate that the above i •y /airiglir I ogre• r comply wit' . 'ty and countyyA% ' ordinances and state laws relating to budding construction and hereby out if lhi jr Ir n r u•rn the \ honed 1 t , property for inspectionspgpurposes '/., Date: /C�_1U^�j Signature: SII � "�/ Driver's License or Social Security n: •' -- 1641-46 whim—Building.Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor ( N....ITRUCTION AND PLANNING PO(OPA APPRCSVALS Permit# Date Inspector APPROVALS Permit #- Date Inspector i 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.-Electrical Conduitrthility-Undrgrnd. 54. Forms -•.4.-Electrical Condcit_U_odrgrnd. 55. Electrical Bonding 5._Steel Reinforcement /-/7.'Z , 56. Rough Plumbing & Pressure Test lr 6. Electrical UFER Grnd. 57. APPROVAL TO COVER.GUNITE 7...Footings _ /^/7-92„. 4,46 G 58. Electrical Conduit-Undrgrnd. a -t B.-Foundation r. - 59. Gas Pipe, 0 Undrgrnd., Test "! 9.:Water Pipe-Undtgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. • 10.-Structural Floor System 61. APPROVAL TO DECK 11: Property Sewer Lipe & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • 1 13. Roof Drains _ 64. Plumbing System - Final 14. Plumbing Rough ' 9 9 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval • 17. Rough Wiring Sigh 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20:'RoUgh Eactocy Fireplace ¢- • c - :APPROVALS-,11::::-Permit # - - 21. cts, in.StrLct {e` ' - . . 'Du `70. Unde?giround Hydro , 22. Duc_is, Ventjiating ; ^ _ ''•-: - y '71. Product Piiping 0 Gas 00il 23-Gas Pipe-Rough&Test : `- • - ; - - - . 72. Underground Flo h' r' - 24.-Roar Framing • r u 73z Undergrnd.Storag Tank 0 Gas 0 Oil- 25. Roof Sheathing , : T74�Over Hydro- 26`T-Bar Ceiling (Structural) &jNonocoat• • , - . • 75.•Dry Chemical J.1: • 27:-Frame and Flashing . •�J yJiE. 7 76: Dry Stan pipe C> r ' .•. __ ; 28: Lathing_& Siding t c 77., FIXED SYSTEM.EINAL• 2 J 29. Insulatioh r' - "" ` ail; , 78y.FIRE PREY. FINAL ' -, r hr ■. -30. Drywall-Nailing - I. 4 � I ,HEALTHDEPT. REQUIREMENT =31. Plaster Brown Coat: _ r t a ad p4}-' : , 79 FINAL INSPECTION o - - 2 °_32.-Electrical Power Meter-Final. * : r80.;;FOOD CEA IFICA,TE ISSUED' �,33.1Final Electric .- _ • " * NoteHQLD F..+:?: . - 34.-Fina! Heating'& Ai[ Cbnditioning �. _j. 1111111 .. Cid. .%O.L8M . ^35.rFinal Gas Pipe-Testi - 7.:. _ - •• In- !L 2; 2: Aid ,-36. Hooji or Canopy C. • - • In'- •, - . •.i r t > �37.=Final Factory Fireplace _ T El: r4S e�� �� ; _ a , 38.-Final Plumbing .- - n ` 39:-Water Service-Final .G ^ _ ,40::Gas Service-Final t, • r * _ , 0� i ' s...41. Solar Domestic-Final - • - i. " S- - r - . 42. Backflow PreventeF . y - - 43. Backflow Irrigation - . - •i - _44. Landscape Irrigatign System- :::!„i .ti - { s- _ � � - 45:Sound Attenuationr �%/(• ,9Z .r�•L nQJ X46. Handicap Regulations (;/ Jz �o !fitg .47. FINAL STRUCTURE&BUILDING # i U ._ uP,;LP • SIN[0, 1/, A A ' r '9. Electric-Release to E. _ I j r• - • - - ., '.50. Gas Release to Southern California Gas Co - - , _ , :51. CERTIFICATE OF OCCUPANCY ; ; - No. . - Date • FINAL ;RAPING CERTIFICATION j • Project Address: 210 "B" 16th Street • Lot Number: Lot 2, Tract 14384 • Permit Number: DR 90-09 • • 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 the grading permit, grading plan and grading ordinance have been installed. Adequate provisions have been made for.drainage of surface water from each building site. The minimums are: 2% Fall from structures within 5 feet from exterior walls. 1% Fall for asphalt surfaces and landscaped areas. 0.5% Fall for concrete surfaces to approved disposal areas. The final monuments as shown on the recorded tract map were set. All final grading eleva- tions are within _ 1,10 of the d izned elevations. Supervising Civil En_ineer Reg. No. 31720 (Sigrature) Date 8/21/92 • • okeff SS/04, X00 ���F� N0. :rnr" RCE31i10 • EXP. ]1/31/92 iPA jFOF CAO° • • sem.2 and S7(7.: • -TY OF COSTA ACES CALIFORNIA 92628-1200 P.0.BOX 1200 • • Insulation Certificate 210 16th Street, Unit B Costa Mesa Number and Street City Orange part of Tract 14384 County Subdivision - Lot Number Description of Installation ROOF Material Brand Name Thickness(inches). Thermal Resistance(R-Value) EXTERIOR WALL Material FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness(inches) - A" Thermal Resistance(R-Value) R—)1 CEILING - Ban or Blanket Type FIBERGLAS BATTS Brand Name OWENS CORNING FIBERGLAS Thickness(inches) 61/4" Thermal Resistance(R-Value) R-19 Loose Fill Type Brand Name .Contractor's minimum installed weight/& lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Width(inches) • FOUNDATION WALL Material Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration • I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. • BRIGGS DEV. / General Contractor(Builder) License Number • /CENT Signature and Title Date fl/CCENT I .ULATION COMPANY 274283 ub-C.- -. .. -r LU , ion Installer) License Number 5-25-92 RAY r'AK� Signature and Title PRESIDENT Date OJECT ADDRESS: '210 E 16TH ST • UNIT: B CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 054416 OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA PERMIT NO: P 054916 PLAN CHECK NO: N GOVT: N SUPP: N • SUITE 315 LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V N PERMIT TYPE: PLU PURPOSE: NEW 3800686 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW SFD 2 STORY SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: I GROUP OCC: R-1 / PERMITTEE: BRIGGS DEVELOPEMENT ( 714 ) 380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS; REF B54394 LAGUNA HILLS CA 92653 ***************************�E*** ****�E�E�F�F*********+FSE*�E******* ***+E�E�E>E>F�F�F�6>F�E***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in lug force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800. Lab.C). LEFT: FT IN RGHT: FT IN .LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL : 42520106 ZNE: REF NO: Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > date' Applicant: .. ******************************** 1E************ 3E*****************************1E* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permitis for one hundred($100)or less). DEVELOPMENT **, R V 4 C E S=: :REQUIREMENTS 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 . �r• 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 there is a construction lending agency for the performance of the work for APPLICATION ISSUED : • • _ Sr.- DATE. IO L which this permit is issued(Section 3097.Civ.C). ******{(.*{(..)(.**{(.********• ,--- --_ ----- f ********** *+p* *. ***.* . LENDER: ************************************** ' *************************************** ADDRESS: LEGALIZATION:N F E E = 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 following reason BLDG PMT PLUMBING EL TRIC 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 41 00 0 repair any structure.prior to its issuance.also requires the applicant for such permit to life 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 SMIP/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($500). ISSUE FEE 3, 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT IS E PLAN—CHECK TOTAL PAID . - ' DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 41 . 00 3. 00 0 .00 44 . 00 44 , 00 •- . . 00 does net 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 REVENUE DIVISION TOTALS--> COLLECTED; 44 . 00 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 exclusive) contracting with licensed contractors to construct the oro ect(Section 7044,Business 44 . 00 lX and Professions Code The Contractors'State License Law does not apply to an owner of propert ' o builds or i proves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractor ' tate Lie, . aw).l am aware .******.***.**.***.************.K.***********************************.***.*.**,*.*.**.*.**.**.**, that proof of their Worker's Compensation insurance should be provided to INDIVIDUALA L F E E BREAKDOWN ❑ I am exempt under Section: B. &P.C. , / for reason: ' 47 re TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date' • / / er: �/r, i iv ' PLU 2 BATHTUB 2. 00 4 . 00 Ido hereby certify that I am aware of and understand the irem t os f r,Immia and SafeCode Sections 25505,25533 PLU 1 DISHWASHER 2 . 00 2, 00 25534 and that I or any future building occupant will/will notof(circle one)need to coco• with said state o o pisearet2menis for a permit for construction or modification from the Air Duality Management Distric sidential construction applications are exempt from PLU 1 LAUNDRY TUB OR WASHER 2. 00 2 , 00 these provisions. PLU 2 SHOWER 2 . 00 4 , 00 Date: • Applicant' /. / PLU • 1 SINK, KITCHEN 2 , 00 2 • 00 PLU 4 WASH BASIN 2 . 00 8 , 00 I hereby certify that I have read this application and stale that the abo •infor . . orrec agree to comply with all city and county PLU 3 WATER CLOSET (TOILET) 2 . 00 6 , 00 ordinances and stale laws relating to building construction and hereby a•.••' : ear�sentativ/•I 'is dy to•nter r r•• he above-mentioned PLU 1- WATER HEATER AND/OR VENT 2 , 00 2 . 00 properly for inspection purposes PLU 1 WATER SERVICE 2 .00 2 , 00 Date. . 0-7�9/ Signature: e��r�fr S PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2 . 00 2 . 00 / PLU 1 GAS SERVICE 2 . 00 • 2 . 00 Driver's License or Social Security a: 1641-46 White—Building:Green—Code Enforcement;Canary—Applicam:Pink—Revenue;Goldenrod—Assessor — rUCONANDPIANNING • POOI PA II`• APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 'til 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. oVici/r/lle 53. Steel Reinforcement 3EIecfrical-ConduivUtility-Undrgrnd. 1 / 54. Forms :4.-Electrical Condgit,llrjdrgrnd. 55. Electrical Bonding . . 5.;,Steel,Reinforceme"nt- 56. Rough Plumbing & Pressure Test ,f - 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 Lind'& House Connection 62. Backwash & Receptor-Final - i. 12. Sewer Cap ,i 63. Heater & Vent-Final . • - • 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing y/L t, G,ep 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16- Rough Electric Wiring 67. Fencing & Access ApproQal i' 7r17. Rough Wiring Sigh 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough F-actor.y Fireplace .^� .- 0 . _ , APPROVALS Permit# • > ' 21..Ducts,in'Structu?e 1, .' , 79- `70. Undirgrouno-Hydro , 22. Ducts, Ventilating v '^ - ` •:71, Product Piping 0 Gas 0 Oil •23:-Gas'Piper-Rough &'lest w • ,. - _72. Underground Flush, 24._Roof Framing - - - ,� _ T :.73: :Undergrnd:StoragCTank OGas-0Oil•-. --) • •- -25. Roof Sheathing , .; .r - : ' ' `74.'Overhead Hydro_ 26.tT-Bar Ceiling (Structural) &•Monocoat 0 Oh . 75.-Dry Chemical 27<Frame and Flashing' T`.< r ., - 'i^ .- if - - 9p. ,'r,r. >+ a 76. .Dry Stand Pipe [-J.'`,r - �_ - _28. Lathing& Siding -. ..72 7 ...-;7,..- ti: a > 77.: FIXED SYSTEM:FINAL` i .._• >29. Insulation "• " • `- 78 -FIREPREV. FINAL ' . - , ,` =30. Drywall Nailing -. -� .r. I HEALTH-DEPT`, REQUIREMENT '-L ,•- nr ` 31. Plaster Brown Coat; ` ,•79. 'FINAL'INSRECTION - s` ' - . �' • 32..Electrical Power Meter-Final • 430..FOOD CERTIFICATE ISSUED' 3 v �33.'Finil Electrid '. - . , • . Notes: - ' - ..0 -7- - ;`.. • .34-Final Heating& Air Conditioning, . ' It' ` S - - - I y I • r '.r 35.:Final Gas Pipe-Test.- _ - 7.��Z Gra?-- - ,-36. Hood or Canopy y _ - 37. Final Factory Fireplace ' w ' ^ l Fireplace i N _ :38. Final Plumbing ` 'Iii; 21 GED tr; x ` `- 39. Water Service-Final, - -/&/qj LEp '- 'A0. Gas Service-Final _ " ' r ! ; 7,41. Solar Domestic-Final'. - I ' . •- • ' I! Ir J - 42.-Backflow Preventers . I - • 43. Backflow Irrigation; Sins..7s ;44. Landsca e frsi ation S stem- - . 1, ?.45.2Sound Attenitation' .7; i-. -• > 2 `' ' e t .i ` 4' •1 ..• i . - A `-46:,-Handicap Regulations - ' ' 47.:FINAL STRUCTURE & BUILDING • . 48.10INAL PLANNING •' r„) I. ," ..49.-Electric Release to Edison >. • 50.,Gas;Release to Southern California Gas Cu I 77 o . . . .' r51. CERTIFICATE OF:OCCUPANCY . - -.c -coo:...:1_..- No. Date —DR 10JECT ADDRESS: UNIT: OWNER'S NAME: ADDRESS; PERMIT NO: P 054416 PLAN CHECK NO: 04076-91 N PAGE: 2 • ARCH/ENGINEER: REG.NO.: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ADDRESS: UNIT: PLU 1 SEWER, BUILDING / TRAILER 5. 00 5 . 00 PERMITTEE: END OF FEES 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 ora certificate of Workers' Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: COMPANY: I Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division, Dale: Applicant: EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section'need not be completed 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. ii Date: Signature: ' NOTICE:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. . CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a'bonstruction 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 are 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 7001)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 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 0 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 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: t I do hereby certify that 1 am aware of and understand the requirements of California Health and Satety 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 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 to enter upon the above-mentioned • property for inspection purposes. • Date' Signature: • Driver's License or Social Security h: 164146 White—Budding:Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING PO SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. (Jzlgz Lep 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 20.1Rough Factory Fireplace APPROVALS Permit# 21.`-Dudts, id Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23:'Gas Pipe-Rough & Test 72. Underground Flush 'p'4.-Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil o. Rodf Sheathing 74. Overhead Hydro 26:T-Bar Ceiling;(Structurall & Monocoat 75. Dry Chemical 27.-Frame and Fleshing 76. Dry Standpipe 28.. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Pdwer Meter-Final 80. FOOD CERTIFICATE ISSUED 33,Final Electric Notes: tt!! ` eedelin' 34.-Final Heating•& Air Conditioning 35:-Final Gas Pipe-Test 36.;Hodd or Canbpy 37.-.F Mel Factory'Fireplace 38. Final Plumbing 39. Water Service-Final 40:. Gas.Service-Final 41:1Solsr 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 PkJECTmans: -210 E 16TH ST UNIT: B CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 054426 OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA PERMIT NO: M 054426 PLAN CHECK NO: N GOVT: N SUPP: N SUITE 315 LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE; NEW 3800686 ARCHIENGINEER: REG.NO.: JOB DESCRIPTION ; NEW SFD 2 STORY SQ FT; ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / PERMITTEE: BRIGGS DEVELOPEMENT ( 714 ) 380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS: REF B54394Y SFD LAGUNA HILLS CA 92653 ***********************************************RETE****RL**gE**********>E*********** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z OWING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.Cf. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: if MPANY: PARKING REQ• PROW: PARCEL: 42520106 ZNE: REF NO: Certified copy is hereby furnished. O Certified copy is filed with the city Building Division. PLANNING N TES> > Date: Applicant' *************************************BE**************W************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if me permit R for one hundred(S100)or less), DEVELOPMENT S E R'V I C E S REQUIREMENTS I certify that in the performance al 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; Dale: Signature: NOTICE:If,alter 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 there is a construction lending agency for the performance of the work for ' APPLICATION ISSUED BY• ilil 411111111111°11.111111---s— DATE• d which this permit is issued(Section 3097.Civ.C). ********************** ***********#**BE*A*tti* LENDER: ***************************************** ' ************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I 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 34pp00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5 t 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 and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(8500). ISSUE FEE 15,00 • 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 sate(Section 7044,Business and Professionat Code: The Contractors'State License Law TOTALS----> 34 . 00 15 . 00 0 . 00 49 . 00 49 . 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 ownemployees,provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> COLLECTED; 99 . 00 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 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 4 9 •0 0 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business . rx and Professions Cade: The Contractors'State License Law does not apply to an owner of prope a ho builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contract.. ale Licens' rw), l am aware ***if it************************************************************************* ************************************************************************ * that proof o1 their Worker's Compensation insurance should be provided to me INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: ........?Y--..,,, TYPE QTY DESCRIPTION UNIT COST TOTAL COST"----..Date: /0 /(— 9/ Owner: � ��� ir — . NEC 1 INST FORC—AIR/GRAN FURN <= 100 K BTU 9 .00 9 . 00 I do hereby certify that I am aware of and understand the requirements of Cali it . ' Code Sections 25505.255 . • NEC 1 GAS PIPING SYS 1 — 4 OUTLETS 3. 00 3. 00 25534 and that I or any future building occupant will/will not(circle one)need to comm said slate coses an. a requirements for a NEC 1 FACTORY FIREPLACE 6. 50 6. 50 permit for construction or modification from the Air Quality Management District.Rr.•ential construction applications are exempt from MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAUST 6 , 50 6 . 50 these provisions. MEC 2 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 9. 00 Date: - Applicant: END OF FEES I hereby certify that 1 have read this application and state that the ab' format; • • •e to comply with all city and county ordinances and state laws relating to building construction and h• •y auth•j�•resentativ' -s• to•nter Le1 above-mentioned property for inspection purposes.�//� ,// �— Date: r/7 / / Signature: / ....... / I _r _ ti y- - ' Driver's License or Social Security a: 1641,16 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue.Goldenrod—Assessor CONSTRUCTION AND PLANNING PO' WA I: APPROVALS Permit Date Inspector APPROVALS Fc'mit # Date Inspector I • t 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - . 3. Elecirical Conduit Uiility-Undrgrnd. 54. Forms .- 4. Electri , cal Conduit'Undrgrnd. • 55. Electrical Bonding •,l S.,Stee1 Reinforcement 56. Rough Plumbing & Pressure Test ' • r . 6 _ .•„Electrical OF ER Grnd. - 57. APPROVAL TO COVER-GUNITE . r 7_• Footings [ 58. Electrical Conduit-Undrgrnd. jB. Foundation . - 59. Gas Pipe, 0 Undrgrnd.,Test • 9.iWater 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 v4ykz UtP FIRE DEPT. REQUIREMENT 20,aRoggh Factory Fireplace - ; 4. r . r• APPROVALS- -,=Permit #- .. _ r. - 21.Ducts,in Structu e` I „ „ ^ - \ _ 70. UJnde?gro[!nd Hydro 22. Duets, Ventilating • _ - L'r • .71. Product-Piping O'.Gas 0-Oil 23.-Gas Pipr-Rough & Test ' �,- " , _ 72. Underground Flush r- 24.-:Roof Framing r, - .' .. X73. Undergrnd.Storage Tank OGas, 0 Oil . 25. Roof Sheathing ; •'74:.Overhead'Hydro_ ; 26.--T-Bar Ceiling (Structural) & Monocoat i_ , , + 75.•Dry Chemical : - 27.:-Frame and Flashing. �, C� 76. Dry Standpipe --:2i: ,28. Lathing,`;} Siding - t ,_ .+x • 77„ FIXED SYSTEM FINAL _ 29. Insulatityn1. , 78,-FIRE PREV. FINAL x _ .r ` "30. Drywall-NailingI l I- HEALTIiDEPT.. REQUIRE -F, -.31. Plaster Brown Coat:- • - - i I:: - 79- FINAL INPECTI9N • '- -1• > - •"32.-Electrical Power Meter-Final _ • I i • .80., FOOD CE1R71FICATE ISSUED :IC' - ,`'_ 33.-Final Electric + •' I h , • Notes: _ 34;Final Heating& tic Conditioning ill*. t :, ',. 'r - 2. _ - � t. 35_final Gas Pipe-Test' r, • ' . • 10 3.•_ .J ;36.`Hood or Canopy , - _ , ,- . . . . >- o .. . ,. :r, - 37-Final Factory Fireplace ' I 1• - - '; -_ n 38. Final Plumbing :. • '71b (� t i .. r Y .^39. Water Service-Final, . • •, • •l. k5:=- t _ 40. Gas Service-Final rr - 41. Solar Domestic-Final - • • - 1:7-1. --> - - '42?Backflow Preventer. _ I _ _ 43. Backflow Irrigation .. S-> • r • - - ,• n i .I :: •.� - 44. Landscape Irrigatioh System 3. . r - _ - �- 45.-Sound Attenuation ,- - +' - . 46.,Handicap Regulations _ . .. 47. FINAL STRUCTURE & BUILDING • -' ,.- - •'. 48:',FINAL PLANNING ;;, y r• 49<Electric Release to Edison - • r i - 50. Gas Release to Southern California Gas Co ' i ; r,51. CERTIFICATE OF OCCUPANCY „ _ No. Date -- t t r..r — PROJECTADDRESS: 210 E 16TH ST 0NIT B CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 054421 OWNER'S NAME: BRIGGS DEVELOPEMENT ADDRESS: 23046 AVANETA CARLOTTA PERMIT NO: E 054421 PLAN CHECK NO: N GOVT: N SUPP: N SUITE 315 LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: NEW • 3800686 ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : NEW SFD. 2 STORY SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / PERMITTEE: BRIGGS DEVELOPEMENT ( 714 ) 380-0686 ADDRESS: 23046 AVANETA CARLOTTA 315 COMMENTS: REF B54394 LAGUNA HILLS CA 92653 ********>F*** ***************** ****+E***x*****************************>E********* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)0l Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Dxte: Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FR NT: FT IN REAR: FT IN FR NT: FT IN REAR: FT IN Compensation Insurance,ora certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: OMPANY: PARKING RE PROV: PARCEL: 42520106 ZNE: REF NO: Certified copy is hereby furnished. ID Certified copy is filed with the city Building Division. PLANNING N TES> > • Date: Applicant: • ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (this section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS 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.alter 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 there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: `— DATE: . 0 / / which this permit is issued(Section 3097.Civ.Cl. ********************** ********** * * * *** LENDER: **************************************** . ************************************** ADDRESS: LEGALIZATION:N F E E S MMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTR " 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 63 8 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 0,t 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 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($500). ISSUE FEE 1 • ,00 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'State License Law TOTALS----> 63 . 18 15. 00 0. 00 78. 18 78. 18 . 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 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED• 78 . 18 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 exclusively contracting with licensed contractors to construct the project(Section 7044,Business 78 . 18 yy and Professions Code: The Contractors'State License Law does not apply to an owner of proper who builds or improves thereon and who contracts for such projects with acontractor(s)license pursuant to the Contrac ' se Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY. DESCRIPTIO N UNIT COST TOTAL COST ��ate: /t�/ 9../ w / jO,/ � r �����.' ELE 1805 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT .03 63 . 18 I do hereby cuddy that I am aware of and understand the requirements of California. and Safety Code Sections 25505,25533.and END OF FEES ' 25534 and that I or any future building occupant will/will not(circle one)need to co,r with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. •esidential construction applications are exempt from these provisions. Date: Applicant: `- _. __ • I hereby certify that I have read this application and state that the above i arrnation', .I ogre- r comp---"Ax. city and county • ordinances and state laws relating to building construction and hereby a,: die fntativ.-of thi y to enter upon e.pi • (entioned .- - _ - property for inspection our uses it J •'LTc' -� ` en,.7... -/ l air 1 Date: T Signature: i Driver's License or Social Security a: Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING ell PO' -. 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 i% , , .tElectrical Condaii.Utility-Undrgrnd. 54. Forms 17.4.:-Electrical Conduit,Undrgrnd. • 55. Electrical Bonding ...• •"5..,Steel,Reinforcement • 56. Rough Plumbing & Pressure Test "7 � a: Electrical UFEH.O d. 57. APPROVAL TO COVER-GUNITE 147.7,Footings _ 58. Electrical Conduit-Undrgrnd. T r. 8.,Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9.-Nater Pipe-Und?g?nd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK - - ' 11._PropertySewer Liner& House Connection 62.•Backwash & Receptor-Final � - A� 12. Sewer Cap 63. Heater & Vent-Final '' 13. Roof Drains •r. 64. Plumbing System - Final - 14. Rough Plumbing - 65. Electrical-Final �. . " 15. Rough Electrical-Conduit66. Solar System-Final U • 16. Rough Electric Wiring L�//q/4Z f 67. Fencing & Access Approval - -17. Rough Wiring Sign 7 68. APPROVED FOR PLASTERING __i 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT r •- u, 20:'Rough Factory Fireplace - . * . • - _ APPROVALS. .. .Permit# 'Ducts, in Stryctur'•e', _ - :« - r � �, 21. ., -_ 0. Uhdeground:Hydro 22. Ducts, Ventilating.• i• - _ L4 i 7:71. ProductPiping O'G'as QOiI 23:leas Pipe9Rough &'Test '' : ' ,. _ - s ; .,72. Underground Flush= - ,- 24.rRoof Framing; - • > _ : * '73 a'UndergrndtStorayeTank 0Gas. 0Oil 25. Roof,Sheathing _ • , _ , '74.: Overhead Hydro- 26.,T-Bar Ceiling (Structural) &iMonocoat - . .-.1f • 75.-Dry Chemical • . _ ` 27. frame and Flashigg, 1 cf 1. • le76. Dry StandeiQe • v 28: Lathing& Siding - - T' o - >' • 77.- FIXED SYSTEM-RNAL_ - 29. Insulatign 5 -" •• . . A r 78,...FIRE PREV. FINAL u X30. Drywall-Nailing I 14 -4 _ HEALTH•DEPT! REQUIREMENT _31. Plaster Brown Coat' S :r•-• • r I t: . ,79. FINAL IN3P_ECTION - - -32.:Electrical Power Meter-Final; ` _ -. I (' , 080..FOOD CERTIFICATE ISSUED c 33 ;Final Electric = �•Z '> "No4es:. - 34.%Final, Heating`•& Air,C&nditionirig, Inr, _ , ' u- 7 35:1Final Gas Pipe-Test . _ _ Ilali' ,-1 ; .. 36.- Hood or Canopy -3 - -i s r •• , � 37.4Final Factory Fireplace- ,' ` '- - -38. Final Plumbing ••••,- -39. Water Service-Final••• t' l" ' ' I ,• .v. ._ - '40. Gas Service-Final 1 _ I _ ., '' z41. Solar Domestic-Final,S t : I i, •- - _ .A-. -, 42.'BackflowPreventer` ``1 , 43. Backflow Irrigation' c"- • y `� 144. Landscape Irrigation System, j:,4• ,, - -'45 :Sound Attenuation Y - - s '7. -- , , i•-•:•c: . .. . 3 a ., C. . :'46 Handicap Regulations J • 47._FINAL STRUCTURE & BUI:LDING .. r x , u 48.:FINALPLANNING '_` '' .z •r_ : q :� , c49. Electric Release to Edison t 1 • r > - 50..GassRelease to Southern ; l tv - California Gas Co - ` 3 - - " T• 51. CERTIFICATE OF OCCUPANCY . ;j;_ - - No. Date 01'06/93 11: 54 S 7143600901 - ?GGS DEU CORP 02 ( t Uj -fti ' ' c.{ ' R c� rf ..u..i•J r I�s4�aG 1 i I n st o ran?,TV �A C. ,Sfff, 6 32' Electrical Power Meter t-inal i ; 1 7/7s qL Rtej BUILDING SAFETY DIVISI91.1.1 � . 3'� ' t 8/s4Z E .. ..,.,. .FI "y;, 33 Final Elecrrm POST IN CONSPICUOUS : LAC � P','" 34;.Final Heating&Air Conditioning ! 7k3(gz cA ON THE JOB• `' ,a -I 35. Final Gas Pipe•Test r4 ;. 7/.'(1er/ £4> i;.‘„:...• .j , NOTICE ,• 36. Hood or Canopy ,,,i , You must furnish PERMIT NUMBER and the JOB ADDRESS FOR EACH RESP CTIVE INSPECTION. CALL 754.5527,q ,37. Final Factory Fireplace ;:;,,'•',..A.;,. 7f$1�4z. LIP • , APPROVED P SHALL S ON'JOB AT AL 1IMES^�� •:r..o p.� tt4 ' .,iCriLp 11'1 Y'{I�.oi'Y.��.:',t+,,:, wn r6id•.u��.Nii:Atlt k'3$y.Flflal.,Plumbing .:'..u�.:.).,!�Ex,.`.,11.A:^er4C%1�:�' [w� 4 P NO. J - 01.141-, 1 l/E5,) ' fl tr ,p39. Water Service•Final k k„gtt, Z z ... :.:a.A'itif< i;y��,1'fflt`.L`:t,'�hr'.:4 l�lis' ..,,,- C�� (pt`�Ft\""�.;1 ...... .: . . 'i1i:i��c �d1�9�' 'WE r GROUP ''1 PERMIT NO, e ' : 40. GIGService•Final .Ir' ' 1. 'I , ' . . a 'J "' CH 3 .41, Solar Domestic-Final j i . {GILDING ADDRESS i' . . , ' r'2.: O.' .:;.e-i. t\L.0 S�• 4- ' . 42. Backflow Prevanter . 31. •! ;;;:. .I - 43. Backflow Irrigation • NEW ADD ALTER REPAIR MOVING DEMOLISH ' _ 44 Landscape Irrigation System • '' SR. $nOnd Anennettnn I . • .': CITY.OF COSTA MESA t I 32 Electrical Powar Metnr final / ` • BUILDINGS Ely.DIVISION i ij {i; tAil I ' . ! e e- POST IN ¢ C 1;P.� ,I �; � '. ONSPJCII,OUS 111 P4ti Final ElectNc? r it s+, 'rl 9ay 1:''' `ii ON •THE 108 '''''''"'-"--"'"4.40''” „ ' '�' 4f 34 1 Final g&Air Conditioning ; 1; 7f td( kir : ' .-- 35. Final Gas Pipe-Test ift inert to. NOTICE fou must furnish PERMIT NUMBER and the JOB ADDRESS 3S.- Hood orCan opy , . !, :OR :EACH RESPECTIVE 'INSPECTION. CALL 764.5627. 37. Final Factory J'AROVED PLANS SHAD"iBE ON'JOB `AT ALL'TIMES , -' ' . t . :.Fireplace • , ,< c. .-.-(l92 L.+ P ''':ler •7 :.' 38 Final.Plumbing .p,.# 't. 1 DATE 1k�SUa - Li . i 1. l es I i 6 I r it.1771Q:• 3g;r Water ServlCdPinal r PE GROUP J r •-, : "•• 7/af. , 1 L ' PERMIT NO. r' .40,'Gas Service-Final ,i : � ,.� ILDING ADDRESS : • 41. Solar Domestic-Final ACT .,. , • L . ' aLOCK 42. BackflowPreventar :1 bT/�j....... 43. Backflow litigation Ew - ADD . ALTER REPA*k MOVING n.EMOL15H n� 44. Landscape Irrigation system .. .. . . , o ( aritHarkicap Regulations .. . 4` PR0. S NAME: 210 E 16TH ST UNIT: o fl' NAME: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05559E ADDR SS: BRIGGS DEVELOPEMENT 23046 AVANETA CARLOTTA PERMIT NO: E 055598 PLAN CHECK NO: N GOVT: N SUPP: N SUITE 315 LAGUNA HILLS CA 92653 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH ARCH/ENGINEER: 3800686 gEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : TEMP. POWER POLE SQ FT: PERMITTEE CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 / ADDRESS: TEMP POWER SYSTEMS ( 714 )632-1999 1111 N. TUSTIN AVE COMMENTS: * ANAHEIM CA 92806 ***EE+t***sE************** ear***EE********EE**********Er*****EE*******sr*+t***EE*EE******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITYLIC.: 9 STATE uc:483433 a CLASS: C-10 )Ale., /Ct( Signature:_ _ !fir _ _ A - - _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of •nsent to selbinsure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 380 ,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN • POLICY NO.: 73WC0085780004 EXP.DATE: 10/01/92 COMPANY: NATIONWIDE PARKING REQ: PROV: PARCEL: 42520106 ZNE: REF NO: RI Certified copy is hereby furnished. 0 Certified copy is filed wi the city Building Division. PLANNING NOTES> �7 �Z'v7r > Dame i ApPlica ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (lois section need not be completed if the permit is for one hundred(5113)or less). DEVELOPMENT S -E.,R V I C E S REQUIREMENTS 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; a Date' Signature: , NOTICE:II.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. -7 CONSTRUCTION LENDING AGENCY: hereby affirm that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; d j� DATE: .`Y-2.3 *. lE F which this permit is issued(Section 3097.Civ.C). *********************e*********** *{f * LENDER: ******************************************** ******************************** ADDRESS: LEGALIZATION:N F E E, SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l 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 15. 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 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SOY SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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($500). ISSUE FEE 1500 00 I. as owner on 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 sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 15. 00 15. 00 0 . 00 30. 00 30 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale. 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 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,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 30 . 00 ❑ 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 theContractors'State License Law).l am aware ********************************.*.****.**.*.*.*.**********,***,*****.***********,******** that proof of their Worker's Compensation insurance should be provided to me. ❑ lam exempt under Section: B.&P.C. INDIVIDUAL F E E BREAKDOWN for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: ELE 1 TEMP SERV PWR POLE W/OUTLETS EA, 15.00 15. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wilt/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 a fydmply with all city and county ordinances and state laws relating to building construction and hereby aal !f•..representatives of lh6 'y Center upon) e-mentioned - -.=_ :1 -`�: — property rims ion proses. L Date:I Signatur. — r' J _- '_ Driver's License or Social Security e: Applicant:Pink—Revenue:Goldenrod—Assessor • I , ^CONSTRUCTION AND PLANNING I POOL & SPA , LPPROVALS 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 4 6. Electrical UFER'.Grnd. - 57. APPROVAL TO COVER-GUNITE '7_ Footings •- - 58. Electrical Conduit-Undrgrnd. . -8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • 9i, Water Pipe-Undrgrnd. i ; 60. Backwash Lines,P-Trap,CI Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK . 11. Property Sewer Line-& House Connection - 62. Backwash & Receptor-Final -, .---- ° t 12. Sewer Cap 63. Heater & Vent-Final '/(.: . -/- 13. r13. Roof Drains 'fi ' 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 20. Rough Factory Fireplaceu_ �; - -i • APPROVALS Permit # _ 21. Ducts,in Structure . r ' - - 70. Undergrourrd--Hydro - 22. Ducts, Ventilating . _ .' 71. Product Piping D Gas 0 Oil 23. Gas Pipe-Rough & Test r, 72. Underground,Flush- - 24. Roof Framing ,73. 'Undergrnd'Storage Tank 0 Gas D Oil 25. Roof Sheathing "74. -Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat r - 75.=Dry Chemical • 27. Frame and Flashing I . F , - " 76. Dry Standpipe ` 28. Lathing & Siding _ 77.--FIXED SYSTEM FINAL '29. Insulation r '' " .. ' n . . 78.ziFIRE PREV. FINAL t $0. Drywall Nailing HEALTH DEPT. REQUIREMENT la '31. Plaster B(own.,Coat i ' 7 FINAL INSPECTION-' ' 32. Electrics) Power Mete Final L // _ - FOOD CERTIFICATE:ISSUED 1 31 Final Electric y %% Notes: '" '. -34. Final Heating & Air•Conditionigg ; - -t, • , • , 35. Final Gas Pipe-Test i' - ' -36. Hood or Canopy ' - - -_ - . _ - 37. Final Factory Fireplace _ t >' . ' " i Ai, ' - r2 38. Final Plumbing , =- r .�� •'' - 39. Water Service-Final - - - z 40. Gas Service-Final - - 41. Solar Domestic-Final - _ - s 42. Backflow Preventer.' - - I - I. 43. Backflow Irrigation z ii4. Landscape Irrigation System • . - . 45.•Sound Attenuation - 46. Handicap Regulations ' 4 . . 47. FINAL STRUCTURE & BUILDING r _ 48/FINAL PLANNING -49. Electi'ic Release to Edison , - .50. ,Gas Release to Southern California,Gas Co I ' 51. CERTIFICATE OF OCCUPANCY _\ . No. • Date /� PROJECT ADDRESS: 210 16TH PL UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 052692 Ol4NER'S NAME: PAT FORBES ADDRESS: 210 E. 16TH PL PERMIT NO: P 052692 PLAN CHECK NO: N GOVT; N SUPP: N UNIT D COSTA MESA, CA CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: 65 O—62 18 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : INSTALL WATER HEATER SQ FT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ADDRESS:TTEEEARLS PLUMBING ( 714 ) 772-3470 1533 W. LINCOLN COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME ANANHEIM CA 92801 +t**+e***************AP**+r****#************************sP******sE****TE***TE****+ETA**** 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. ZONING R EQUIREMENTS CITY LIC.:--7(y� S S.9 8 STATE LfC.:217 652 PLASS' SETBACK S ' Date. 79_/ Signature:___ �� MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm e a c`ertificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 38110.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POucY ND.. UC A-11686 EXP.DATE: 03/01/92 COMPANY: UNICARE PARKING REQ• PROV: PARCEL: 00000000 ZNE: REF NO: ❑ Certified copy is hereby furnished. Certified copy is filed with the city B 'din Division. PLANNING NOTES> •` > —Date'( 7(197/9/ Applicant: � ***BP*RiF*BF***9e*IE***BF************************************************************* EXEMPTION ROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(SIR or less). DEVELOPMENT SER V I C E S• REQUIREMENTS 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: Signature: DATE; _ NOTICE:If,alter 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. f CONSTRUCTION LENDING AGENCY: I hereby affirm that Mere is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• � I OW *� which this permit is issued(Section 3097.Civ.C). DATE' LENDER: **************************************** *********************************** ADDRESS: LEGALIZATION:N FEE :SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason PERMIT 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 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'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% 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 10 a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 00 ,` ..i' I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—D 1V > PERMIT ISSUE PLAN-,CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2. 00 3. 00 , - 0. 00 5.00 5 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through His or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 5. 00 OVER/SHORT: 00 for the purposeof sale). 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 5. 00 ❑ 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 **********************************vg**** **** **,********************************,** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. INDIVIDUAL ' F E E BR EAKDOWN 4 for this reason, . TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: l''' I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,255'19,and PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 25534 and that I or any future building occupant wilvwifl not(circle one)need to comply with said state codes and the requirements for a :END. OF FEES / permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from 7.: '_// 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 to enter upon the above-mentioned _ property Int inspection purposes. ` y,„_ -- y:J . J - /7� -Dzte'—�7/9// /7Signature:G �. �i�r� -- Driver's License or Social Security e: Applicant:Pink—Revenue:Goldenrod—Assessor ; �:I_ 1 CONSTRUCTION AND PLANNING POOL & SPA • APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Servifr f Pole. - 52. Pool & Equipment Location - L. Soil Pipe-Undrgrrid. - +. ' 53. Steel Reinforcement r _,3':..:EI thea- Condwt U4lity-Uh6rgrnd. 54. Forms r • - 4: Electrical Conduit-Undrgrnd. 55. Electrical Bonding ,..`6,`.'.Stee?,,:}..einforceme% 5. 56. Rough Plumbing & Pressure Test •6`'Eleat?ical 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 . a v 61. APPROVAL TO DECK �f 11. Property Sewer Line& Hoase Connection' 1 62. Backwash & Receptor-Final 12. Sewer Cap T.. _ (. 63. Heater & Vent-Final 13. Roof Drains ? 64. Plumbing System - Final ii 14. Rough Plumbirtg 65. Electrical-Final ' 15. Rough Electrical-Conduit rl r 66. Solar System-Final , 16. Rough Electric'Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrictal,-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - - _ o r - - 20. Hough Factory Fireplace . c 11 - • -+: 'APPRQVALS' Permit# 5 • - 9 a 4 u 21.>Ducts, in Strtfr',tufe,r .. ) _ , .t �y0. >-' '-'.i-' Hyd_to 22. Ducjs, Vbnti ting - r s t, :21. Product ibing CTGas DQil 23.-Gas'Pi e'Ro &'1'Rst i' LT - • . ; .72. Undergror�l Fluslj , 24.-Roof Framing- • 'z ° = c - r z5;73.'Undrgrnd?Storan ank 0 Gas ❑Oa 25. Roa Shflathin rt. >' Cc; C::? - v �. 9 : •� .. ;�N r �4.�Overhead Hydro._' r 26.-T•Bari Ceiling (Struttura I) & Monocoat -, „ y C -`14 ' 75.,-Dry Chemical - • C s 27.;frame and Flashiggr. ,_ t, y - - ,�: 76.''Dry StandY. pipe :_n , e Eq •28. Lathing& Siding: ; - • t Y - ,: 77.-FIXED SYSTEM-FINAL' '29. Insulation - - :. r 1 `• .: 78.sFIRE PR EV. FINAL *. .'30. Drywall Nailing .• ,.A t - 'HEALTHOEPTtREQUIREgVIENT s 1 .i 4, i 31. Plaster Brown Coat , ,.,,. r .;t v -79, 'FINAL7NSP-.ECTIQN - ' y .32.£Iectricat.Power Meter,Final • - I•' • 4 1' •'80.-FOOD CERTIFICATE ISSUED y33.��fina' Ele tric, ,, d r • I ,,,/i: .� •Not•es: 9/n if 'bo•OKEa'o -Careso-AEY, ,34.:Final.Heating-& P.ir:Conditionings. t ^ • i.,.yr iul 7.� Q h_apiaED' pa, Zai tiny Cap 35. final GasPipe`-T "' '" ' I. ¢t. c �I _36. Hood or Canopy t-• _ _ c. - �' • t is >: c r .c- . r 4 r . • ` `4! '. Fti_ r r. '37.•FinaTFactory Fir4pI'aee, ' S r O '`-` �- �' t" - - .. 38. Final Plumbing t - • + -s - a „ . - y • IL - fir . •39. Wete7 Service-Final` . 1. ' -, AO. Gas Service-Final . Ti -4,•1.....1 ,S , 'Ti Ir %41. Solar Domestic-Final `• •' - r 5.=-- - * r . _ u 42. Backflow Preventer ' c'; t• 4. ,z _ y 43. Backflow Irrigation' 'r -. :. i• 3., W 3 ;44. LandscapE Irrigatio; Systema •. ... .I, : . .A ;v - o L ' ': _r ,t a , - % Applica;t to fillTailspaces within heavy border lines and sign all appropriate declarations. 7449 1 0/26/81 47.00 IL' - CITY OF COSTA MESA PERM].G1(yp�� rtnc(' NO. • LOT NO. •BLDGkNO. •--- - - - ^ ^•• CONSTRUCTION PERMIT P .La+ Project Address 2(0 IL ' Pica f.. TYPE OF CONSTRUCTION 1 1 Owner 1:�W d+ . Phone 0 NEW ❑ ADD ❑ ALTERATION Address - 0 REPAIR ❑ CONVERSION 0 DEMOLISH - ZONING REGULATIONS Arch/Eng. T License No. 0 OTHER s •a" a A.P. Address n/4 SW P¢µ,(6 DESCRIPTION OF WORK S¢ ' Contractor Phone ��// ZONE PLNG. REF.BE /S'31 PND nen JG CO�fG�I��7VPE OF PERMIT BUILDING TTop gg�LJ/I LLpDING SETBACK C/L ST. PROPE RTV LINE Address 0 GRADING 0 FOUNDATION ❑ STRUCTURALSIDELEFT YARD LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ISPLUMBING ❑MECHANICAL S IEOE YARD v I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mencing with section 7000) of Division 3-of the Business and • 0 OTHER ) Professions Code, and my license is in full fort . d ¢flier. REAR YARD(TO P/L) vPROJECT DESCRIPTION License las . '� an; -�( PKG.SPACE REQ. PROVIDED 'S7 '- SQ.FT. r Date ' 1/41 "- At Signature A "-'-' STREET WIDTH PARK FEE$ - WORKERS'COMPENSATION DECLARATION- OCCUPANCY-CONSTRUCTION TYPE - I hereby affirm that I have a certificate of consent to self-insure or a •VALUATION ZONE a _ ZONING APPROVED BY DATE certificate of Workers' Compensation 'Insurance, or a certified copy SPECIAL CONDITIONS: thereof(Section 3800,Lab.C.). GRADING CU.YDS. ACRES Policy No. Company " 0 Certified copy is hereby furnished. REMARKS: /3J—/3 15 Certified copy is filed with the city Building Division. MPTION FROM WORKERS' COMPENSATION DECLARATION ' • - - - s 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 PLUMBING PLAN CHECK s ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California. - UWtLLINIa • UAW-Vat - Date Signature BATHTUBS SHOWERS SO FT. SO FT I NOTICE: If after making this declaration, you should become subject TOILETS 3 URINALS r GENERATOR 0-1 KW_1-10 KW - to the Workers' Compensation provisions of the Labor Code,you must `y� TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES / DOUBLE LAYS - /Z APPLIANCE 10-50 KW_50+ KW revoked. - - - - KIT.SINKS //` DISHWASHERS 1 - 6p--- MOTORS -' 0-1 HP HPCONSTRUCTION LENDING AGENCY / I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - SUMPS . (INC.SOLAR) 10-50 HP 50+ HP - formance of the work for which this permit is issued (Section 3097 -' Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - Lender's Name • Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS ' OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNS I KUI.I . Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE / ALTERATION 2-- PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE / OUTLETS Z SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the • Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS / BTU OUTPUT .' _ ;••�'' - basis for the alleged exemption. Any violation of Section 7031.5 by / ` • any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS 2- of not more than five hundred dollars ($500). . ❑ ' - owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS sol ipensation, will do the work,and the structure is not intended ' or . ed for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE ' Contractor's License Law does not apply to an owner of a property �� APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE 3 through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING 'PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ 7-- tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM 100,000 +BTU PLAN CHECK $ GRADING $ the Contractor's License Law). ❑ I am exempt under Section B.& P.C.for this RS BTU ELECTRICAL $ $ reason - MICROFILM $ PLAN CHECK $ Date - - Owner SYSTEM REPAIR,ALTERATION TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL 8 PLAN CHECK $ LESSANE P ordinancesaca is tatrela I agreeito comply with all cityand th ri County VANCE PC $_ and state laws relatingconstruction, IR,Aherebyrepresentativescity upon the above mentioned property foyIiec n p p C..,_____-- 0.'7.4,41 �� q1 - FINAL FEE $ Signature / Date J( �� Drivers'License or SS gjr So Y CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor ✓.I .. • : : :.\ CONSTRUCTION AND PLANNI ( POOL&SPA APPROVALS Permit # - 1 ? Date Inspector APPROVALS Permit# �� Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location •- _ 2. Soil Pipe-Undrgrn •aft_7/Pe 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn ( 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . • 5. Steel Reinforce 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn ' /o/4Y/A/ r 51. Backwash Lines.P-Trap. ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection /Q/,�7/9/ /jI¢ 53. Backwash & Receptor-Final 12.. Street Sewer Connection - 54. Heater &Vent-Final 13. Rough Plumbing /�¢Y �- 55. Plumbing System-Final 14. Rough Electric-Conduit .56. Electrical-Final 15. 'Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning bd. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing • 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning i7 57r Z- 30. Final Gas Pipe-Test 1 "'" 3- y 31. Final Plumbing /e/1/,fl- 32. Water Service-Final 33. Gas Service-Fin& 34. Solar Domestic•Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY No Date ,f Applicant to fill In all spaces within heavy border lines an a Declarations. • ITY F COSTA MESA PERMIT NO. / TR CT NO. LOT NO. BAWL q,, CONSTRUCTION PERMIT t. �� ��� 1 ,C. 7 - Project Address 4 rtie /SI Jq� i TYPE OF CONSTRUCTION Owner `Q Phon 3 -�z� KNEW ❑ ADD ❑ ALTERATIONeie 7012 • Address G' MO /VV�((/fft f Al O- 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING 1 U TIO 338.63 TU Arch/EnyPZfeQ.s+laa//'9 Inc License No.2/87 0 OTHER ,fl REGULATIONS DESCRIPTION OF WORK N/e S714CE A•P-* 42.€- e207 -is Address "2310F. /T//ys j OZ ,c6 c. is_ �'O./1hODN//�/.fi�N SrSi, 7F_ - E/-67 ewp ^ ZONE PLNG.ppREF.9F Contractorill]� 4 Phone�'S/.�zI TYPE OF PERMIT SETBACK CIL ST. /11 P ROPEIRTVNI NE 8c Address3gQ act A/Ecthave •fr . ^/z. ❑GRADING ❑ FOUNDATION 0 STRUCTURAL SI DpDETYARD 51 1 ❑ TENLICENSED CONTRACTOR DECLARATION-- ANT ❑ ELECTRICAL OPLUMBING ❑MECHANICAV RIIGHYARD ( o I hereby affirm that I am licensed under provisions of Charter 9 (corn- -• mencing with section 7000) of Division 3 of the Business and ❑ OTHER REAR YARD(TO P/L) Professions Code, and my license Is In full force and effect. PROJECT DES RIPTION I License Class License No. / / �j 20 /' 'C PKG.SPACE REQ. 3 PROVIDED 3 SQ. FT. ( C� 'eV T LV WD's Date Signature "� STREET WIDTH Co a PARK FEE$ 6,/a/L 40 WORKERS'COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE � � ZONING APPROVED BY��c. / 1 DATE /��/sem&/ certificate of Workers' Compensation Insurance, or a certified copy s.w M thereof(Section 3800, Lab.C.). GRADING CV.YDS. _ ACRES SPECIAL CONDITIONS: llicy No. Company Certified copy is hereby furnished. REMARKS: - _j � h n 0 Certified copy is filed with the city Building Division. $ / EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 7f Cr/2-1- / �' �� E This section need not be completed if the permit is for one hundred $100) or less). 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers'Compensation Laws of California. DWELLING • GAHAt,E Date - Signature BATHTUBS SHOWERS SO FT SO FT NOTICE: If after making this declaration, you should become subject" TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW - revoked. - KIT.SINKS DISHWASHERS - MOTORS 0-1 HP 1-10 HP CONSTRUCTION LENDING AGENCY " i I herebyaffirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS ,. - (INC,SOLAR) ' 10-50'HP_50'+ HP formance of the work for which this permit Is issued.(Section 3097 - Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name ' Lender's Address ^ DRINKING FOUNTAINS GAS TUBE SIGNS ' OWNER BUILDER DECLARATION INTERCEPTORS - CLARIFIERSPOLE LIGHTS - I'hereby affirm that I am exempt from the Contractor's License Law for - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL -PTRAP LUNSI HUL IIUN Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve,demolish or-repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP - (Chapter 9 (commencing with Section 7000) of Division 3 of the ' txyls for the alleged exemptiess and Professions on.At he is nyviolation' f Section 7031.5 by pt thereom and theWATER HEATERS BTU OUTPUT //-:-y applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS . . &_a. not more than five hundred dollars ($500). - ' I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation,will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE who uicense' es areo not aply to an her a prims if tyor APPLICATION APPROVED BY / DATE/.�/ �G/O who builds or Improves thereon, and who does such work himself or ISSUE FEE / V/ • through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement -MECHANICAL 'PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden �• e et proving ownerdid oof note buildoertyor l amove for the excl exclusively contact ng se of se). plit h' HEATING SYSTEM 0-100,000 BTU • _ BUILDINGERMIT • E r •�0 SMIP $- b3 licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) llcesned pursuant to SYSTEMGRADING $ the Contractor's License Law). 100,000+BTU • '- PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this -BOILERS ' BTU . ELECTRICAL $ $ reason Jl�s ///tt _ PLAN CHECK $ MICROFILM $ - Date Owner ,vR rL C�le44/OT SYSTEM REPAIR,ALTERATION TOTAL FEE$ I hereby certify that I have read this application and slat that the above EXHAUST SYSTEM MULTIPLE , , MECHANICAL $ 'PLAN CHECK LESSANE P AD- information is catrect, eaten to comply with all city and county - $ VANCE PC $_ ordirepresenta i and state laws ity elating to c- u o and hereby authorize zd property five th"city • u-o he above mentioned rJ fo�•ec p r.. ,+ A /!�C///'••' 3�,G3 Signature -it Sir ISSUE FEE - [ - a CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor 'A - 'an' . CONSTRUCTION AND PLANNING p- POOL&SPA APPROVALS Permit# R--1 32Date Inspector APPROVALS Permit# Date Inspector 1... Temporary Electrical Servicelor. Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn - 45. Forms . . 4. Electrical.Conduit-Undrgrn 46. Electrical Bonding - 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn .. 48. APPROVAL TO COVER-GUNITE 7. Footings sn.. ,u t. -:tp"A' -i ,5 to-a) ct 49. Electrical Conduit-Undrgrn • B.. Foundation . ,Qq4c- S 1pA4n/R-r 50. Gas Pipe, ❑Undrgrn,Test •• 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap. ❑ Undrgrn - 10. Structural Floor System - 52. APPROVAL TO DECK 11. Property SewerLine & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing _ 55. Plumbing System - Final 14. Rough Electric-Conduit - •- -56. Electrical-Final • 15. Rough Electric-Wring • 57. Solar System-Final 16. Rough Heating & Air Conditioning 66. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing Shoo/ t->61-5 Ly(s- h /2.12-4( fl 3 22. Frame and FlashingNOTES: es,) rR�-hco/ n aeL tee,- 23: Insulation D'3 5-2 -Y� aon75u$_r ?t' F-�A,A•- . 024) !ft ..,& �S t 24. Lathing & Siding D5 `�-^a- i2 rufS yu-Qt-/Ae."..c a. L.* 44dh��ei�`, 6A$�7t4e A-/3,A%/ 25. Drywall Nailing 0 3 p. 2''ff .y ...s 0.1.v,- �i(aA , &,'-&Ph Ln�a.`5 �itana ,jet- 26. Plaster Brown Coat PN ? - l"-"'� eic Ayr-ret, tohA-C -f- eatts:oLe_..- +r, 27. Electrical Power Meter-Final _ ba- t .3 ' is-kwz.e4 Ft x. A. .2 sfon $D.cArne, 3'•-e SV,,-.t8 r,•f%OK 28. Final Electric 6kt k� -,.,� u tkat- in1-tro L.A-i- i/-a'-,g l b S 29. Final Heating & Air Conditioning F0.04 Ja (lAi. ;._ n- y,•-1 - fjp e4 S .21..n‘k i,,A, n.. a'_Q c 30. Final Gas Pipe-Test N Ales•Fe12.:..g z o r S•f" (c a )4j en ht1(iAa s • I Y , ¶)A44"�"6'�^ 31. Final Plumbing DS i-Iq�.R i C7 32. Water Service-Final fnlSu...efft;tot) 4)a ,O(S-f3> �[,S p¢Q.0 i,)-i .J• Cn j4 33. Gas Service-Final .Sc-s _b-5 t-t34-12 -, 34. Solar Domestic-Final Fe/ G[,p..Qo.cf� 5 rx &:S-L: (C ry•e.¢.,� .IS 35. 'Landscape Sprinkling System - ci f 9791nra Ca e+ As (w '2-. rc 36. Sound Attenuation • 37. Handicap Regulations - - 38. FI NAL STRUCTUR E & BUI LD I NG D - 7f-. st' P. 39. Special Requirements Completed fl &# 1 ap/s2r'-`iocc 't't7577r- \'may/^( Vne L B� 40. Electric Release to Edison - ---------_____!---A 41. Gas Release to Southern California Gas Co. tptpinZ Pi,� 42. -CERTIFICATE OF OCCUPANCY ' No Date 77 .40. . N• . I .' •. ' id,SI,- . i ._4 , COUNTY OF ORANGE li BUILDING DEPT. • - ' • Permit No 636 No. Broadway Santa Ana, California ' Application For Building Permit Phone:KI 2-621.1 AND FOR A Oa' Ief/ eC rtificate of Use and Occupancy . . / i 1 . see--"4"- __Igi-r-rszt- Pr: , 'a OWN Date ... . -14ir-46-4............,ficoasit-(1 • . I•R'S NAME... a.441-40 .---...eto • PHONE:S.....a.n. , MAILING ADDRESSTritoe....a. ; CITY1-friirrratia abo Name S. Name . agertirce it ar4-4-adj, elt... (Architect or Engineer) (Contractorf" Address . Address LO a. "V 4 "Cte- fit • City City 4r-6.r d2nveeetiAlL7 • State State L-- Lie. No Phone Lic. No .11-1)2.-e. Phonenc-...4/..r.r.1114. PROPOSED USE• snit-G.0Th Siff. - A ex/s /- , 2. JOB LOCATION.A.A.9".. e.ettAst,,,.. C.e...rta.. hi es.a...a.., Cal le_c_r (House Na.) (Name treet) .j 446 ei/ letn or School District) >4. LEGAL DESCRIPTION: Lot cortnn 9 Tract (Metes and Bounds Description—Use reverse side of form) 4. CORNER LOT ( ) INTERIOR LOT ()< ) TROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF tint" i.a...A I y AREA:./4' a SIZE OF LOT:./..4.?.2;IS.71,r 7 AREA- 6. HEIGHT OF BLDG • /3 1 CEILING HEIGHT- P ' NO. OF STORIES J 7. NO. FAMILIES i Size of Smallest Bedroom: -air ic ti," Size of Kitchen./.&.K 7'f?" 8. EXTERIOR WALL CONSTRUCTION:. . . '. INTERIOR WALL COVERING. ela-ila.. (Frame, Stucco, Etc.) ' .. (Plaster-Drywall Etc.) 9. SETBACKS: Front Yard From Center Line of Street Itt i 114 -r-r0 ' I. 1. a 1,./c. e-,---- • Nearest Side Yard./../.1:- Rear Y DVangilic FeEt 13etween-SUgs. on Same Lot.uteri 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. 6 II it II. For (a) Footing: Width Depth in Ground ..P.2° Width of Wall 41 Accessory Bldgs. and Similar (b) Size of•Studs:.A.X y Spacing /A " "CC Material of Floor sioara Structures: (c) Size of Floor joists:..S...K.Ir Spacing /6 i f "CC . (d) Size of Rafters- a 4 y Spacing a 4 12. VALUATION OF PROPOSED WORK: .j.ncluding all labor, plumbing,electrical wiring, heating, fire sprinklers, painting and sewage disposal $ .trireitiltge .er7" ,°s_ 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTIO14 WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. ri421LA-. x- ---,- Plans Filedyv5 / Signed- (Owner) By• (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: CHE G BY 11:1:67-"P GROUP ... APPLICATIO /IHEALTH Bldg. Permit $ Plan Check • $ 71. ' Cr..° TYPE , If ZONING _el: FIRE Total - • .....ri$ Sr 4-9, DIST. --- MARSHAL — r - PLANS AND ---ii i Receipt No.• • /.*e. .2-Sr 7 MAP SPEC'S t i ,./STATE Paid to • - SHEET NO Sle CORRECTI ENGINEER Date VERIFIED CAL PERMIT ISSUED BY: DATE SIVI2.51 A.1‘. ti J - 2 : - METES AND BOUNDS DESCRII Mt • • I� ' xc Z iT �'3V 4I0 5,0 610 ■__ ■ ■ ■ S_.J■ ■ ■■ _ ■■■■■..■- --_ .--■a.■ ...:.pinwi . .t mil 1 1 111 .1 so momm m 1 ._ : .■■lll u�r■ . ar'unp nil I I Em PIE H---r -'11+1 - rair hi i I V / TE 1 I ■_I• rI ; IIImiir. 2 irk : n --::::I: �i:F-1 I st 1 PIP IC irI e 1iIL- kgT F-Vr.1111111:1 4P2saeII!uI!Ijd,IAIILI _ I ■ �, ■ ■ ■(o_ C mm ms! & _Ialfl i 1■■: _ ---�-- et pr. lee �' !-iF -i • rash' WI' I� I I L ■ TI I I I i-I ±,_[/,e4 '. i 1 W■i■ n■ ■■ ■ L_i I I I ■■■U iffl - : IiIiI . - �i - "'ii ■ ■ :aa■■■■Ems m■:■■■.■ ns mmm 1� -Fn r ■:S.■..■■ii - INa■� n■■■■■:::II _ RRJ.: -INC ::ejj1aRzi!iInuunu. :Pmal il I I I il- ■■ : a■: Gal JO I III C•':1•i: uI I...::: :: ��:. r. li AMA" M alalIEL n►. ■■ ■■::■■:::r�■.■■.■■■■■ i■ . ■■ ■■:■:ui: _ : n� , "nn61,1 CME.■ ■■■■■■'■■a:■ aaa ■nnaan:' . 7111111111114,1111111111111, 1 1111111 uiiii- ■ ■■e� ■■■■■ ■ ■■■■ ■■■.■■ - -►- - I f Iii III IIIIIIIII]IIIII III aIIIIIIIIaI- LE11+10111111Piniddi - ■' t' AIM Di■:: - :a11aIIIaI- _Gn■ ■:� ■ ■■11111nI ■■■■■_ as _ -I■ ■■■ MIiuT'" ■■ 1 _pi �! ann � :: umiluaa II an..n:■::'::: :: :::..an.aa•• I 1 I1 . far■:■. :a ■■ ■■■n■■■:i: aaaa I 1 � . 4 ■.p■.:■■ n■■n .:■ ■ ■■■ 1 - 1 mg21111111 11 II 11 ._ 11 :•■ ■■■ minn• II . ■■ . :IIIM ■ 1■ I■I■ii■■:■ �p� :■ ■ IL ta::■■■■■■■a _�_- ■ p■• � ■ . . ■ La ■■■■■■■■. _ _p : •. : ■:9 :■■■■ MI�: I _'I 1.■a:: : :a a : i ■ :: :::8 :.::l8 :■�: On a •:■ • • ■■■■■■ ■n■■. ■ ■■■■. ■n -- _:' : ■■ ' : a.aa aa.a :. ■■ ■:::::aaa•aa■ _ �:I I .: EI �.n■. aa .I tnna■a..■.■. per•. ■:iii. 1011 ■ . : aI_:: :. aaaaa -- MO m- : :F: m---,I p8:. : x�qa. :: .6: : ��a899�::9 co I COUNTY OF ORANGE - - BUILDING DEPT. - Permit No O 636 No. Broadway - Application for Building Permit Santa Ana, California - Phone: KI 2.6211 AND FOR A 3/ja/y rtificate of Use and Occupancy yi----- (/ Date_ nat ck f/ f 7S Z M' ER'SNAME .a.4e_-/f,- ' n_ -. /� PHONE:3C... 6 / ??J,yz[V( MAILING ADDRESS-a�_D-d-'-/ 6z ttf `e CITYalit•' f�/ ana_� c Name Name (Architect or Engineer) (Contractor) Address Address City City State State Lic. No. Phone // Lic. No. (/Phhoon�e t PROPOSED USE: - __ tttss.�E�NN// -37 6770 tp -e /y� 2. JOB LOCATION 1.6JJi_f-_- 5 _#__-Z. d _ _.0,/ar-2 -. } (House No.) ' (Name of Street)s (Town or School District) S-- 3. LEGAL DESCRIPTION: Lot �cY T C� ��`ff'i' c 0gTract (Metes and Bounds Description—Use reserse side of form) 4. CORNER LOT ( ) INTERIOR LOT (,XZ THROUGH LOT ( ) SLOPE OF LOT ( ) 5. SIZE OF BLDG.:/ _2s__LD AREA• f Z O r _.__.SIZE OF LOT: to x f cfa AREA: n 1 6. HEIGHT OF BLDG.: L3 CEILING HEIGHT LS NO. OF STORIES / I 7. NO. FAMILIES Size of Smallest Bedroom: Size of Kitchen: 8. EXTERIOR WALL CONSTRUCTION INTERIOR WALL COVERING (Frame, Stucco, Etc.) // / (Plaster-Drywall, Etc.) 9. SETBACKS: Front Yard from Center Line of Street /l.l -- �7 • ' U ...--.e- •- t 3 So s$ Nearest Side Yard _, Rear Yard L r Distance in Feet Between Bldgs. on Same Lot___.,>r 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. .f�tq L .y 1 / t / II. For (a) Footing: Width .l Depth in Ground Width of Wall (p Accessory Bldgs. and (b) Size of Studs: 4-1 X a Spacing 1 40 "CC Material of Floor L&9-o--6-a.-__ Similar Structures: (c) Size of Floor Joists:y� �" X Spacing .....-_____ _________ `CC (d) Size of Rafters: ._..___- e Y I" Spacing Z / "CC 12. VALUATION OF PROPOS WORK: Including all labor, plumbing, electrical wiring, heating, fire sprinklers, paint- ing and sewage disposal $----- 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. � Signed: _ - t }. -._. „_!t' t%°�' Plans Filed- l(//(Owner) By: (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: 2 m o CH KING BY Bldg. Permit - $ GROUP .4.. --------- APPLICATION-_-_ HEALTH oa Plan Checkm / o= TYPE y ZONING Le FIRE Total - - - $4 DIST. 6 _ MARSHAL Receipt No. - - y O PLANS AND (/ P � _`� MAP SPEC'S STATE Paid to /Lt-a_t__(_o SHEET NO._____ CORRECTIONS ENGINEER Date " "Lfr1/ _a7,- VERIFIED CAL PER, r, filar. s . E COU TY DU16@N' l I ' SPECT R DATE - /1 A L /h I' F M SM.-7.50 �v EPV i� 61 METES AND BOUNDS DESCRIF N: • IIO 30 •4,0 510 610 0 - - - 4 N • • • • . o o -- -- - • -� -- --- o - o -- - - o a t City of Costa Mesa PARK FEES 001266 Fee /Payment Receipt Project Address 7YDAe•/74�i Z/ ? 1Iv79172, . A.P. Number VO'' — 2o! —Obi/9 Building Permit Number ^^�� � Owner's Name cL` Ldi�, 1,)i.- S � Mailing Address 30 �/, <e = __ •---z= is • ' • - 441 8.4 if _ Total number of dwelling units in project e Total number of existing dwelling units to be �. /f'3ii90¢09 demolished or removed as a part of project - Net number of units subject to fees .3 Net • Type of Unit' Number of Units Fee** Amount Single Family liC X $5,748.82 = mLZI. Multiple Family X $3,940.34 = 1182!, c . .IFe:-:� / /i •At L Planning Division Approval Date • - / Applicants' Signature 'jL• R�'SUC�t9�1C1 • 'City Ordinance 89-28 City Resolution 91-53 ����-�` - 0174-30 rev.7-91 Waite-Planning;Canary-Planning... -Finance;G•,.enrod--Applicant