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HomeMy WebLinkAbout224 16TH ST - Building Permits • ens Ess OF BUILDING: 224 E 16TH ST tMT: A CITY OF COSTA MESA - BUILDING PERMIT rY.dtri I'lV: r Ul>. .Do ; i owalivmlfmmt GENE ROBERTSON ADDRESS: SAME PERMIT NO( P 071367 PLAN CHECK NO: N UllVd : rl null : x CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: NEW APPL.WdUND ADDRESS: JOB DESCRIPTION : SUPP ; EMENTAL TO P-71281 SQ FT: ARCHITECT OR Oaten TAYLOR ARCH LICJ40d C14978 ARCN.OREEIG'S ADDRESS: 234 17TH ST WET: 203 CLAIM VALUE; CALC-VALUE ; GROUP OCC: R-3 /M-1 C ,M, CA 92627 CONTRACTORSNALa VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS ; REF; B-71278 Ca(TIIACTOfMMWC 1048 IRVINE AV ##+'-u-##***********4“9 9f*******L1-44393999-9-99 9'4.af..****94 4***-14*LP 44****4.44*** c####a~#Ac##49e,#,ua494PM dr- ADDRESS: N,B , CA UC.NO.: 658963 Z ONING REQUIREMENTS 92660 UNIT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under prwaiona of Chapter 9 (commencing with Section 7000)of Division of Me Business and Professions Code,and my license is in full force and effect. MAIN BUILDING ACCESSORY BUILDING CITY LIC.NO.: LIC.CLASS: B LIC.NOj�6� 58963 EXP; FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN tr- j "i_ a s Contractor:Contractor: i(M LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN• ER BUILDER DECLARATION:I herebyaffinn under penalty of perjury that am exempt from the Contractors Liceme Law la thePARKING REQ; PROV; PARCEL; 42520117 ZNE; REF NO: following reason(Section 7031.5 Besrrss end Professions Code:Any city or county wad,requires a permit to coreagd,alter.improve. PLANNING NOTES> "�aprriolah,or regal any structure.prior to its issuance,also requirested applicant fa such permit 1:).Z a Sgned statement Met M a she i"-'I'mcensed Wnuant m the provision d Una Connwsors Liceroa Law(Chapter 9(oanmendng Section 7GOD)d Da®ion 3 d tut > E :ilainev and Prol tt?i Cod°I a that he or she is exempt therefrom end the base la the alleged exemption.Are violation of Sedan ***********************a:**##-R*******##*#**4144*49**4F**44*49*i:####**9****44-94*****###-P## 031.5 by any apptcant fora Wrath subjects the applicant to a civil penalty d nes more than me hundred dollen MOOD. DEVELOPMENT SERVICES R E LT I P, E M E N T S 0 I.as owns of the property or my employees with wages as thee sole compensation,will do the work,and the soucture is not intended Q or offered for sale(Section 7044.Business end Professions Code:The Contractors License Law does not apply to an owner of properly who bolds or improves thereon.and who does such work HmesN or herself oihrough he Or her ownemployee°,aovidedthat°uch ZONING APPROVED BY • DATE; or improvements are a intended or offered for sale.N.however,the building or improvement a sold within one year d completion,the ' ownerbuilder wit'have the burden of proving he or ibuild or purposeof shedMAimproeforthesale). BUILDING APPROVED BY o I,as owner d the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business andDATE: Professions Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon end who > contracts for such projects with a ocntredgr(s)licensed pursuant to the Contradors License Law). APPLICATION ISSUED BY.: . . DATE; Afir❑ I am exempt under Section: B.S P.C.,for this reason: #***************ac**** ***** ********* # ****#****#4-****1d********#* - , 13.** Date: Owner: ****************************************************************41*** .**ff******41 I do hereby candythat l am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505.25533.and LEGALIZATION;N F E E SUMMARY STRUCTUR L SEGMENT:N 25534,and that I or any future building occupant will/Will not(circle one)need to comp with said state codes and the requirements for a permitforconsuudion or modification from the Al enagement Distdd.ResidemW construcionappGatbe ere exempt from Mese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 1 3 3 . 00 J Date: Applicant: 2 5% SM I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty o perjury one o the following declarations: PLAN ISSUE FEE 10 , 00 ❑ I Idave and nil inaintah a cenificate a consent to selhinsure for workers'compensation.=provided for by Section 37C0 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the performance of the work for which this permit is issued. I have in and wilt maintaworker°'compensation insurance,as required by Section 3700 ofe Leber Code,for the performance d the TOTALS----> 133 . 00 10 . 00 0 , 00 143 . 00 143 , 00 00 work for which this permit is issued.My workers'compensation insurance carrier end policy number are: Canter: REVENUE DIVISION TOTALS--> COLLECTED : 143 . 00 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK . need not be completed)the permit is for one hundred dollars($100)or lass.) 143 . 00 yI • nit that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to Io pensationprow°a�sdsectin3700oft IL California. provisions. **#****#*#*##*****##*#**#**###*##***********.u.*********'Ol`a]tS r r. .."*' c an. I N D I V I D U A L F E E B R E A If 3E3 d 7f.77Y$a � **** 3.00 IQ C3 .23 Applicant dti '.:Q13. 3L„- TI?VE.: 09:54 Mg:Fsllure b secure workers'compensation coverage launlawful,and shall subject an employer to criminal penalties and TYPE QTY D E $ C R I P T I O N UNIT COST TOTAL COST civil fires up to one hundred thousand dollars(S100,000),In addition to the cost of compensation,damps as provided for In Section 37D5of the Labor Code,Interest,and attorney''tees. PLU 2 BATHTUB CONSTRUCTION LENDING AGENCY:1 hereby affirmunder penally of perjury that there is a construction lending agency for 1M 7. 00 17 . 0 0 performance d the work for which this permiaasued(Section 3097.CS.C). PLU 1 DISHWASHER 7. 00 7 . 00 PLU 1 LAUNDRY TU3 OR WASHER 7 . 00 7 . 00 LENDER'S NAME: PLU 1 SHOWER 7. 00 7 . 00 LENDER'S ADDRESS: PLU 1 SINK, KITCHEN- I certify that I have read this application and stele that the above donation is cored.l agree to campy with all city and county ordinances 7 . 00 4 . 0 0 and state laws relating tobuiion herebyautorizereaewrw.othis city enter up tatito enton the above-mentioned property oPLU 2 WASH BASIN (SET) 7. 00 14 . 00 diag constructand for inspection W�A at ` PLU 3 WATER CLOSET ( TOILET) . 7. 00 21 , 00 fir / ���& PLU 1 WATER HEATER AND/OR VENT 7 . 00 7. 00 Print Name PLU 1 WATER SERVICE - 7. 00 7 . 00 a/ � �� PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS . 5 . 00 5 . 00 sgaurev :^^AgervAppke . DedDat PLU 1 GAS SERVICE 7 , 00 7 . 00 (5151'4S.WP) Whita-Building B Safety:Gree °nary-Applicant:Pink-Revenue:Goldenrod-Assessor • CONSTRUCTION AND PLANNING ' POOL 3PA , Date Inspector -t Date Inspector lit 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-Undrgt-nd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 7 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd. 10. Structural Floor System - I 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 ❑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: , ,-_11 _,4S nrocM 7VAdr UK. ( /ya 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 4-)3-G S ptc-r1ri 36. Hood or Canopy �- A� 37. Final Factory Fireplace A "L`irl5 flltlAL 38. Final Plumbing - -Q 39. Water Service-Final e-25?-9s r? 40. Gas Service-Final 6-29 41. Solar Domestic-Final 42, Backflow Preventer a 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 N, ADDRESS OFF BUILDING: • UHT: C{WNNk1'i NAME IF 190Th: • ADDRESS: PERMIT NO: P 071367 PLAN CHECK NO: 00792-95 N PML,L: .. ##**#iE######**4u######m**** F#####4 ******##44##*######k#+r•#######it#####*Y-4######## ADPL.MAIUNG ADDRESS: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ARCHITECT OR ENGINEER: UC NO.: ARCH.OR ENG.'S ADDRESS: WIT: PLU 1 SEWER, BUILDING / TRAILER 15 , 00 15 , 00 PLU 1 SEWER, CONNECTION TO BUILDING EACH 15 , 00 15 , 00 CENTRACTORSNAME: END OF FEES CONTRACTOR'S MMUNG ADDRESS: DC.NO.: UNIT: LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty a perjury that I am licensed under provisions of Chapter 9 (commendng with Section 7000)of Division 3 of the Business and Professions Code,end my license is in full force and effect. CITY UC.NO.: LIC.CLASS: LIC.NO.: Date: Contractor: OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that 1 em exempt from the Contractors License Law for the following reason(Section 7031.5 Business end Professions Code:Any city or county which requires a permit to construct,alter,improve, demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she h licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the dusiness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than foe hundred dollars($5001). ❑ I.as owner of the property or my employees with wages as Mak sole compensation,will do the work.and the structure is not intended or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not applyto an owners properly who builds or knproves thereon.end who does such work Nmseff or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.B,however.the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ 1,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business end Professions Code:The Contractors 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)licensed pursuant to the Contractors License Law). ❑ I am exempt under Section: B.&P.C.,for this reason: Date: Owner: 1 do hereby cenity that I am aware of and understand the requirements of Cailoma Health and Safety Code Sections 25505,25533,and 25534,and that I or any future building ampant will/will not(circle one)need to comply with said mate codes and the requirements for a permit forcomstmctin or modification from the Ak uety anagement District.Residential construction applications am exempt from these provisions. Data: Applicant: WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and coil maintain a certificate of consent to seg-insure for workers'compensation,as provided for by Section 3700 a the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and WI manes workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the work for which this permit is issued.My workers'compensation insurance carder and policy number are: Carver: Policy Number: (This section need not be completed I the permit is for one hundred dollars($000)or less.) ❑ I comity that in the performance of the work for which this permit is issued,I shall nal employ any person in any manner so as to become subject to the workers'compensation laws of California.and agree that it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Date: Applicant: Warning:Failure to secure workers'compensation coverage is unlawful,and shall subject en employer to criminal penalties end civil goes up to one hundred thousand dollars($lOg000A In addition to the cost of compensation damages as provided for in Section 3706 of the Labor Code,Interest,and attorney's lees. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that them is a construction lending agency for the performance of the work for which the permit is issued(Section 3097,Ca.C), LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and state that the above information is cosec.l agree to comply with all city and county ordinances *DUPLICATE RECEIPT* and male laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly US 00177782-00177782 TOT 143.00 for inspection purposes. DATE: 03i68r95 rlMP: ago; Print Name Date: Signature of Owner/AgenVApplicant/Conireda (5151-46.WPI White-Building A Safety;Green-Ale:Canary-Applcank Pink-Revenue;Goldenrod-Assessor .4 I 0700 _ SPA RCONSTRUCTION AND PLANNING _ Date Inspector Date Inspector i APPROVALS Permit # APPROVALS - Permit # v 1. Temporary Electrical Service or Pole MN 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. , 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd._ IMIIIIIIIIII 54. Forms j 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding j 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 1M 6. Eiectrical UFER Grnd, 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. j 8. Foundation MM. 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. alla 60, Backwash Lines,P-Trap, El Undrgrnd. 1 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection11111111.11111i i 62. Backwash & Receptor-Final 12. Sewer Cap MIMI 63. Heater & Vent-Final 13. Roof Chains allill 64. Plumbing System - Final11111111 i 14. Rough Plumbing 65. Electrical-Final Ma 15. Rough Electrical-Conduit 66. Solar System-Final I 16. Rough Electric Wiring Mil 67. Fencing & Access Approval I 17. Rough Wiring Sign a 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling MI 69. POOL/SPA SYSTEMS FINAL i 19. Rough Heating & Air ConditioningMN FIRE DEPT, REQUIREMENT 20. Rough Factory Fireplace Ma. APPROVALS Permit # ' 21. Ducts,in Structure 70, Underground HydroIIIIM j 22, Ducts, Ventilating Mil 71. Product Piping 0 Gas 0 Oil I 23. Gas Pipe-Rough & TestIIIIII 72. Underground Flush MI j 24. Roof Framing IIIIIII 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing la 74. Overhead Hydro la I 26. T-Bar Ceiling (Structural) & Monocoat MI 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 111110 29. Insulation 11111111 78. FIRE PREV. FINAL I 30. Drywall NailingMIN HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat .1111 79. FINAL INSPECTION 1 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED j 33. Final Electric Notes: 34. Final Heating& Air Conditioning Mil t 35. Final Gas Pipe-Test I 36. Hood or Canopy 1111111 37. Final Factory Fireplace Ma 1 38. Final Plumbing 39. Water Service-Final MI 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System IIIIIII 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison MI 50. Gas Release to Southern California Gas Co1111111 -II 51. CERTIFICATE OF OCCUPANCY -- No. Date . 1 t PROJECT ADDRESS: 224 E 16TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 070876 OWNER'S NAME: ROBERTSON GENE H ADDRESS: 536 SEAWARD RD PERMIT NO: B 070876 PLAN CHECK NO; 00285-95 L GOVT: N SUPP ; N CORONA DEL MAR, CA 92625 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: CON a ARCH/ENGINEER: ROBIN HAMMERS BE ASSOC, REG.NO.:317,n JOB DESCRIPTION : CONST. 3FT RET. WALL E 6 ' WOOD FENCE SQ FT ; 65 ADDRESS: 234 E 17TH ST U 1 ' 205 C,M, CA 92627 41:—.1:1 CLAIM VALUE; 1 , 000 . 00 CALC VALUE; 2, 600 . 00 GROUP OCC; R-3 / PERMITTEE: VNE DEVELOPMENT INC ( 714 ) ADDRESS: 1038 IRVINE BL 363 COMMENTS: CONST 65LF 3 ' HIGH RET. WALL W/6" HIGH WOOD FENCE NEWPORT BEACH CA 92660 *+t****+F1r***** -*******FFx-**aa****1r*******************************+F*********+F***aF** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. CITY LIC.:O5 75 STATE LIC.:658963, � B EXP: 12/95 S E T B A C K S at Signature: ///`/ FRNT: FT C MAIN BUILDING ACCESSORY BUILDING s WORKERS'CO PENSA ION DECLARATION: I hereby affix that I have a certificate of consent to sell.insure or a certificate of Workers' 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; 42520117 ZNE: R2HD REF NO; DR-95-02 ❑ Certified copy is hereby furnished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES> 65 LINEAR FEET OF RETAINING WALL (NO MORE THAN 4 FEET ABOVE > THE FOOTING PLUS WOODEN FENCE NOT TO EXCEED 6 FT, Date: AODlicanl: ***************************************************************** **'********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($1W)or less). DEVELOPMENT SERVICES REQUIREMENTS Ice if 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 , leo o the Workers' /mope tion Laws of California. 4 ZONING APPROVED BY DATE: " ate' 1!r///ti� _L S Signature: AL NOTICE:I.atter king this declaration,you should be me 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. CIV p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ( //� . DATE: Q ii 1'' which this permit is issued(Section 3097,Civ.C). *************************************** ****************** ******** - ^ •** LENDER: *************************************************************************** *** ADDRESS: LEGALIZATION;N F E E 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 54 . 00 , 50 repair any structure.prior to its issuance.also requires the applicant for such permit 10 file a signed statement that he/she.is licensed pursuant to the provisions of the Contractors'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 35 . 10 any applicant for a permit subjects the applicant to a civil penalty of not more Than live 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----> 54 , 50 0 , 00 35 , 10 89 . 60 89 , 60 • 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• 89 . 60 OVER/SHORT fon the improvement of sae)hin one year of completion,the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 54 , 00 50 35 . 10 ❑ 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).l am aware **********************************************.*..µ**.N.**_********.N.*.******.*.*.**.*.*.***.* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN 9 I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: Owner: SFR 65 RES—PILASTER WITH WOOD, ETC BET/ FT, 10 . 00 650 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and SFR 65 RES—RET WALLS <= 3 FT W I SURCHG/ FT. 30 , 00 1 , 950 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from END OF FEES 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.menlioned 01 00175562-00175564 TOT 89.60 property ern inspection ppatpos� / DATE: 01/25/95 7I HE: 14:20 X6.7 Ills/1 Signature'. //`�4+� G �Bffver's License or Social Security 1641'46 White—Building:Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • ICONSTRUCTION AND PLANNING POOL 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 • l 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 ' 3/414c t,. 58. Electrical Conduit-Undrgrnd. 8. Foundation' - (/-' 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, 0 Unclrgrnd, 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 r 22. Ducts, Vehtilating • 71. Product Piping Utas obit 23. Gas Pipe-Rough & Test •72. Underground Flush' • 24. Roof Framing 4 ' ' .73.iUndergrnd.Storage,Tank0Gas 00u 25. Roof Sheathing -. .. 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75.'Dry Chemical -. 27. Frame and Flashing . . • r 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 .. • t. • . • 36. Hood or Canopy I _ .. '37. Final Factory Fireplace ' - '1 I 38. Final Plunbing 1 = , 39. Water Service-Final I - . - , :40. Gas Service-Final ' ' ' ' 41. Solar Domestic-Final .. - - _• 42. Backflow Preventer - ' 43. Backf low Irrigatioh . - 44. Landscape Irrigation System ' - ' 45. Sound Attenuation 46. Handicap Regulations . . • 47. FINAL STRUCTURE & BUILDING /o=7,-qf o,. 4! 48. FINAL PLANNING L ' ✓ - • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - • 51. CERTIFICATE OF OCCUPANCY No. Date `. f LUV'RESS OFBMLIIPfO: 224 E 16TH ST 0MT: B CITY OF COSTA MESA — BUILDING PERMIT MLnP% r,td; a vilcoc OWNERSNAiEIFIW01YN: GENE ROBERTSON e. _ ADORESY SAME PERMIT NO; B 071282 PLAN CHECK NO; 00374-95 A LPvvs : 1,4 oui-r : : • CONSTRUCTION TYPE; PERMIT TYPE; STR PURPOSE; NEW ADPL.MAUND ADDRESS: JOB DESCRIPTION ; 690SF 1ST FL, 1200SF 2ND FL, 445SF GARAG SQ FT; 2, 235 ARCNDECTom E:0mm: TAYLOR ARCH UC.NO.: C14978 AIICN.OR ENG:S ADDRESS: 234 E 17TH ST UMT: 203 CLAIM VALUE; 150, 000 , 00 CALC—VALUE; 140, 737 . 00 GROUP OCC; R-3 /M-1 C .M. CA 92627 cwAcroasNAIIE: VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS; 2235SF SINGLE FAMILY RESIDENCE cawconuaiuxo 1048 IRVINE AV ***####+c-v####*#N.*.Ic########*####->F******#*##ac###a* :+c+c#aFx##+ *******# ##### +l-iF****+I ADDRESS: N.B . CA LIC ND.: 658963 Z ONING REQUIREMENTS 92660 utar: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury am I am licensed under provisions of Chapter 9 (commencing with section 1000)a DMsion 3 d me Business and Professions code.and my license s in lug lace and stied. MAIN BUILDING ACCESSORY BUILDING crrYuc.NO.: LIC.CUSS: B uC,No.: 658963 EXP; FRNT; 10 FT 2 IN REAR; 10 FT IN FRNT: FT IN PEAR; FT IN f�I�� Iy r LEFT; 5 FT IN RGHT; 16 FT IN LEFT; FT IN RGHT; FT IN / / Contractor: (IL, f---- ER ER BUILDERDECLARATION:I hereby 8Pom under Penally perArytham exempt has the Corareded License Law la the PARKING REQ; ; PROV; PARCEL ; 42520117 ZNE; R2 P.EF NO; DR-95-02 Wowing sawn(Sedion 7031.5 Business ed Professions Code:Any city a county which requires a panne to construct altar.improve, PLANNING NOTES> UNIT "B" OF TWO UNITS, &mash,or rapes any structure,poor to in issuance.also rpnirsa the applicant tar such permit to fora signed etalerned that he or she ' a licensed pursuant to the provisions d IM Co Tactors License Law(Chapter 9(commencing with Section 7000)d Division 3 01 the > Business and Professions Code)«then Ma she is exempt therefrom and the basis for me alleged=maim.AravioWion of Section **-IE**#*********if***if*ir***+fF********#*************#eF****iL *******#*#***if*<iF*f*** 7031.5 by any applicant la a permit subjects the apdicanl to a MA penalty d rot mala than five hundred dollars 15500D. DEVELOPMENT SERVICES REQUIREMENT ❑ I.m owner d the property or my employees with wages as the sole compensation,will do the work,and the structure end intended or offered for sale(Section 7044,Business and Professions Code:The Contractors license Law does not applyto an ownerd properly who builds or inpmas thereon,red who does ouchwaft Newell ahesef or through he Of her ownempoyaes.proridedtflth ZONING APPROVED BY DATE; • . improvements are rid intended or offered fa sale.I.however.the building or improvement is sold within as year of congeries,the owner-0ol]er wig have the burden dproving haashe did not build aimprove/a the purpose dente). BUILDING APPROVED BY ; w. II DATE; 2 �� ❑ i n owner d the property.am exclusively contracting with license conestars m wroNogg the ojw(Section 7044,Business and Professions Cob:The Contractors License Law does rid apply 0 an ower d Property who bolds or Mamma threat and who ^� contracts prolan with prolawith amared«(A licensed cc/Sunni the Contract=Lkeme LAO. APPLICATION ISSUED BY; VI_^ DATE; • e it m ❑ I eexempt under Section: •B.&P.C..for this reason: ***##:**************************tc****** *** ***********************r - '-w.' .-4-IC7c-- *#****#*****************************************df* *****************Af ***** Dem: ex's` LEGALIZATION;N F E E SUMMARY STRUCTURA SEGMENT; Y 155 hereby that I r a I M re bt a and understand Merequirements(mole a e Be ray �s2fyi'f'_coign a5.534,and aanconyMm°daM'egomtheAgiGFranaernent jartid ° 'ram lair BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING permit gwotamMCration from the Ai"Ba.Ta'ti�acnapemra Neon Itdm Provisiats. PERMIT 783 . 00 14 . 07 Delo Applicant: PPQUIREt� PLAN 127 . 24 SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedayens: ISSUE FEE ❑ Hum and MImaimaM a certificate cl consent to sed.insure for waken'compensatim,as provided fa by Sedion 3700 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Cole.for the performance dme work for wale this permit eissued. TOTALS----> 797 . 07 0 . 00 127 . 24 924 . 31 924 , 31 . 00 o Mums and wig maiman waken'compensatk^insurance,as required by Sedge 37005 the Laker Coda,for the performance of the work for with this panne eissued.Mvworkers'compensation insurance carrier and policy number are: Cartier: REVENUE DIVISION TOTALS--> COLLECTED ; ` 797. 07 OVER/SHORT; . 00 Policy Number: BLDG PMT PLUMBING QELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Mrs section need not be competed rthe pe,mr if for one hundred daler(Srop/«kraal 783 . 00 14 , 07 I tartly that in the performance a the work for which this permit is issued,I shag not employ any person in any manner so as to becomewbjed to the workers'mmpereation law,of California.and ease tatilehouldbecOme°ubjes to the waWe pensaonprone« aSeden3100athe Labor cee. shall forthwith corn with those ************#*******##*+ *********** f***#+ **********r****i #*#*** **+ ************* Date: 2)1'7 0.-- 7 / IND I V IDUAL F E BFEAYDOWN Warning:Failure to secure workers'runpwvadun coverage Is Unrnv4,,andd She WNW en employer to criminal penalties and QTY TYPE DESCRIPTIO N UNIT COST TOTAL COST civil fines tip to one hundred thousand dollars($704WO).M edition to the cwt of compensatory damages as mashies!for In Snauot3rosofineLabor Coots,Interest.and etlomeyefees. SFR 1790 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 132, 460 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of per cry that there is a construction ending agency ler the SFR 445, RES-GARAGES TYPE V 18 . 60 8, 277 . 00 performance dwork the for which this w permit is Sed(Section 3097,Can.C). END OF FEES LENDERS NAME: LENDER'S ADDRESS: I cendy that I have read this application and dale that the above information is correct.I agree to comply with ell lay and county ordinances and state laws miming to building construction and hereby authorize representatives of the city to enter upon the above.memioned properly for inspection purposes. nN i ke,�e�G P niNeme 01 00177320-00177321 TOT 797.07 Dene: 2 )7 r DATE: 02/27/95 TINE: 10:50 Signature AKaoan ed« (5151'48 WP) White-Building A Safety:Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor ' CONSTRUCTION AND PLANNING POOL a 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 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 01 57. APPROVAL TO COVER-GUNITE 7. Footings 8 ("VC 58. Electrical Conduit-Undrgrnd. •` 1r 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 . f)(140 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ((�� 75. Dry Chemical 27. Frame and Flashing �// sc" e- 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe•Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ld-L7-Q's'6w 48. FINAL PLANNING - 49. Electric Release to Edison 1.• " 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY N0. Date I',:!' i' CITY OF COSTA MESA 32. Electrical Poer Meter-Final 7! '. dretec `.1 wBUILDING SAFETY DIVISION L 3 il Electric i;'' POST IN CONSPICUOUS PLACE 34. Final Heating 8AirConditioning 1 .s..Fi if i•'::. Fin ON THE JOB 35. al Gas Pipe-Test ✓e- 95-rjs + , , 3, yy NOTICE 36. Hood or Canopy , _fi,,;:,. �� j. You must furnish PERMIT NUMBER and the JOB ADDRESS FOR 37 Final Factory Fireplace /E-n_ j,! EACH RESPECTIVE INSPECTION. CALL 754-5627. APPROVED I• PLANS SHALL BE ON JOB AT ALL TIMES. 38. Final Plumbing ✓C• V ij-I ; AP.NO. DATE ISSUED 39. Water Service-Fina! �•�{ to 2- 2 [1- 4) !✓��s 1.:i 4.t; TYPE GROUP PERMR NO. 40. Gas Service-Final - chi A. ea; V/AI (Rls,14 0 5-/2R2 41. Solar Domestic-Final fti `: -l:'� tit- BUILDING ADVESS _ � � 2 2 4 - L- 14 f.' S-I tt (3 42. Backflow Preventer 54-5..c. 'i :i. TRACT LOT 43. Backflowlnigation 95- . s• s:i':i• till-'NH NEW ADD ALTER REPAIR MOVING DEMOLISH 44. Landscape lmgation System Cr - t /V • 4, (1 i ' ✓-- 45. Sound Attenuation Ci(I99to;L. ONN - L• ogE�t-�Sory �'Eivl- 46. Handicap Regulations I 1 , USE 47. FINAL STRUCTURE8BUILDING •' ,1 t!, 48. FINAL SPECIAL REQUIREMENTS Stisi9s C. •E- is^ :,5 POOL a spa • ii.;;; 1,.ci APPROVALS Permitt SETBACKS +f t'F;t Front Yd Side Yd. L- R- Rear - 49. Pool 8 Equipment Location s; d • .: it?, Side Yd. L- R- Rear 50. Steel Reinforcement fI,-i : 51. Forms •+ ;;�, CONSTRUCTION AND PLANNING atato,tto, . `,i .i!• APPROVALS Permit• 52. Electrical Bonding_ 1. Temporary Electrical Service or Pole _ 53. Rough Plumbing 8 Pressure Test . i i? t i 2. Soil Pipe-Underground 2-2St rick(4' 54. APPROVAL TO COVER-GUNITE " '` /3. Electrical Conduit Utility-Underground I' sc_ 55. Electrical Conduit-Underground 4. Electrical Conduit-Underground _ . 56. Gas Pipe 0 Underground Test jf t- 5. Steel Reinforcement 57. Backwash Lines,P-Trap,El Underground ?,.i.° i..( 6. Electrical UFER Gmd. 58. APPROVAL TO DECK ri lY. ilic 7. Footings 4- 59. Backwash 8 Receytor-Final Via;'44- 8. Foundations %r 60. Heater 8 Vent-Final 'tttlft t^4? 9. Water Pipe-Underground 2-3% 61. Plumbing System -Final 10. Structural Floor System 62. Electrical.Final +;F �.,.���� 11. Property Sewer Line 8 House Connection 2-2395 1�.4' 63. Solar System -Final -.'t ' i'+I- 1 12. Sewer Cap ----- 64. Fenny_&Access Approval le •:': 13. Roof Drains 65. APPROVED FOR PLASTERING 14. Rough Plumbing 7•EJI�: 66. POOL/SPA SYSTEMS FINAL 16. Rough Electrical-Conduitr� FIRE DEPT.REQUIREMENT t6. Rough Electric Wiring If17-g- /J't4 APPROVALS Permit II 17. Rough Wiring Sign . 67. Underground Hydro 18. Rough Electrical-TBar Ceitng 68. Product Piping ❑Gas D0il 19. Rough Heating8 Air Conditioning ✓ r g .4 69. Underground Flush • 20. Rough Factory Fireplace ✓ 70. Underground Storage Tank 0 Gas QOif 21.Ducts,in Structure 71. Overhead Hydro .� -^ I• 22. Ducts.Ventilating /�/d 72. Dry Chemical r' . r.--s 23. Gas Pipe-Rough 8 Test V 4R1-(754"1 ,73. Dry Standpipe }1 I t; 24) oof Framing / 74. FIXED SYSTEM FINAL i�.,25. Roof Sheathing 0/44-7SFIRE PREV.FINAL "ii: 1 26. T-Bar Ceiling(Structural)8 Monocoat //- Notes: Trig "Stt it4 Q� !o cog-. ti: `i, :: (2) Frame and Flashing i-Lek 5' c 111 q/j7/t ;ipS.v t Off, mac- 7 cA " el,": •a•' �- - 28. Lathing 8 Siding 2 &a 'j s, ..s..t H 29. Insulation '1,-p-t t 44- , .,. 30 Cu weYHeiiirB r (�',�eRaailailid . L.Plaster Brown Coat F (see reverse for additional notes) '3i• �` ;�erne Pel,.,Ma ; a I • City of Costa Mesa California 92628-1200 P.O.Box 1200 - Insulation Certificate , Permit Number i(p.' 224 16th Street • Costa Mesa, ('' Number end Street City a lir Orange II County Subdivision Lot Number Ft Description of Installation ROOF Material Fiberglass Batts Brand Name Owens/Corning LThickness (inches) 6 1/4a Thermal Resistance (R-Value) 19 ¢ EXTERIOR WALL Material Fiberglass Batts Brand Name Owens/Corning it- Thickness (inches) 3 1/2" . Thermal Resistance (R-Value) 13 ; CEILING y , Batt or Blanket Type Bat Brand Name Owens/Corning 1a>>1 Thickness (inches) 6 1 4 thermal Resistance (R-VAlue) 19 'It'll Loose Fill Type nnn: Brand Name Pt)?' Contractor's minimum installed weighUft2lb. Minimum thickness inches 1 Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) F RAISED FLOOR • r= • Material none Brand Name Thickness (inches) Thermal Resistance (R-Value) flit" SLAB FLOOR none f Material Brand Name P,!;� Thickness (inches) Thermal Resistance (R-Value) .. Width (inches) • 6l1��')i` AN. FOUNDATION WALL ' none _ r.. Material Brand Name ,. :,u Thickness (inches) Thermal Resistance (R-Value) ifiii 141 =M • Declaration .i. 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 •1':1 • California Adminstrative Code. 'g -r. il':'- General Contractor(Builder) License Number 4.1 xE Signature and Title Date *-.11Schmid Insulation Contractors Inr-. 221517 I' Sub-Contractor(Insulation Installer) License Number ( June 22, 1995 1 $ T' e ifi�,f Kim Collins, A�I�`fffr�t�ative Assistant Date • Id r1907-46 . • , • . • I . I • "•:;:-.. ORANGE AVENUE lit ,..0 . 0. a.0. A LI . ?....• 34b . 112.9;;;;;JAD l'CR'I;frQ ihigla,0 ,i3i.z.ri ,,,,,t4 0, Age,g.® „ann..- 1 .c ,.•A-Ix ' 4 . :N.-A 1 ? ' .#7-A ..er 4 se si) T , --...,' 13382' ..( ili 2 I •, ...• _r , ----,- : 4=,,,,si-al,. _ :-. ,:-LI- !---:-= 7 L' L'.12-&. "=''. n.-",-. .-4:---7-----rn • I 7. , 7.:---±f.-:: \-z't. : a.‘j - ‘c IT- — — c= . — • — • -Tr .— —'L • ,,23.„ 3„ _ ii--- 20:6ANS 54.1. Iz• 6 c.IC EN:EN:ED Z`ERTM x7G L r. V 1 . ;..., i 02 . . . 1.12—__??,-, % ---- -- *!-----:c-7-/+:77,7,77,-7,-<, .--2,--Pic:2c io •ar a — - —w— • T • HzG7li..7 it. — • 224 B tea I ).,-,,•,-,;,.., •-•, -t4 11 / f!..,• ••• 224 A .) i e• NIIROWI y .R ?2!:. 1 91-42-7--L-L,:lcom.0 (A ) t.J. 0 0 10051 ± ICX 30 Ill, 16'--: 1. I X N.., i !VII!‘ . ' i East en dil rc r 2 . V , . • . / 1 / N 10190 FS GAR. ' . . V- : ..•--------_______ • 4.., . Cr , '0 . yr N Pd.• ' "o;6 1 2, o, • ..---- :<1(100 0/ •Cfr ii,e •' ,14 • k 0., . : % °.4 V.". m'ciee. •0 h \,. 0 ON 0 .,.• • '0.: :?, .re,, • 4:PQ /. ii, 'Lfit „ , 4- • , „, , ‘g o°0 0 ....00. ...„.„ .._ h. :9, EXIST.SEWER LAEER ...• .4.4 LA4.-5-4,.: ' Q€.4,..- — . .. ID . Tr ! ILL/ 1, . . 2V--- —...---.'11— ""...\"..-741S1.7E—.....—tICE Ilim (.3 ........_ ,..,,, ec.... .0 ,•,14‘...3SIN 131 112' 1°e °°‘x‘r0 jf-r: I i.' ,y,) N 40'00'00'E 167.52' , 4 ... . la ..: A N 'a-• -• I /re/ (17,A.42'2 I SIAN i ve .. , -/ 'l lilt e i . • -Of* . CITY OF COSTA MESA :(1``( '*9 CALIFORNIA 92628-1200 PO. BOX 1200 yJ mia-xmu• O; .J. a: DEVELOPMENT SERVICES DEPARTMENT C7.4fteTEp March 2 , 1995 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 Officer U.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. 224 East 16th Street 224 A East 16th Street 425-201-17 2241 East 16th Street 224 B East 16th Street Your cooperation in this matter is appreciated. Sincerely, GABRIEL ELLIOTT Associate Planner c18 cc: Gene Robertson P.O. Box 156 Corona del Mar, CA 92625 - VNE Development 1048 Irvine Avenue #363 Newport Beach, CA 92660 77 FAIR DRIVE Building Division 714)754.5273 • Code Enforcement(714)754-5623 • Planning Division(714) 754-5245 FAX(714)556-7508 ADDRESS OF BUIRMAO: 224 E 16TH ST MT: A CITY OF COSTA MESA - BUILDING PERMIT t'6rAn r+v: bv / i4in owe ITS.1LAE IF MOWN: GENE ROBERTSON ( ADDRESS: SAME PERMIT NO: B 071278 PLAN CHECK NO: 00375-95 A i ' ; r4 %lie CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE; NEW APPL.MAILING S ADDRESS:s li JOB DESCRIPTION ; 690SF 1ST FL, 990SF 2ND FL, 445SF GARAGE SQ FT; 2, 125 MainCT OR ENGINEER: TAYLOR ARCH UC MD.: C14978 ARCH.ORENG.'SADDRESS: 234 17TH ST WIT: 203 CLAIM VALUE; 150, 000 , 00 CALC-VALUE; 132, 597. 00 GROUP OCC: R-3 /M-1 C ,M, CA 92627 CONTRACTOWS NAME: VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS : 2125SF SINGLE FAMILY RESIDENCE CaITNACTORSMMUNG 1048 IRVINE AV +(*****+F**q:at"1i*******x*ac*ir-ic***+t+c*acacicaur"M..N.:iFac.>FqF+t**icx**4****** oopsraca.+t*ac.u4;Facuac N.**.u.K"icx"ua: ADDRESS N.A . 92660 CA m404 658963 Z ONING REQUIREMENTS uNT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby Slim under penalty d perjury that I em licensed under provisions of Chapter 9 (cmmencingwilh Suction MOO)&Divisor 3 d the easiness and Professions Code.and my license is in full fore and effect MAIN BUILDING ACCESSORY BUILDING CITY LIC.NO.: uc.cuSS: B UC.No.: 6589y1 EXP ; FRNT; 20 FT IN REAR ; 10 FT 2 IN FRNT: FT IN REAR; FT IN J ` LEFT; 5 FT IN RGHT: 16 FT IN LEFT: FT IN RGHT; FT IN Date: 1 C contractor: rl{ • NERBUILDE- DEC RATION:Ihereby affirm under penatydperp hal axonal PARKING REQ; 3 PROV; 3 PARCEL: 42520117 ZNE: R2 REF NO; DP,-95 02 following reason(Section 70315Busthess and Padessi«a Code:Any city or county wild.esquires a pe�mnlo construct.alter.improve. PLANNING NOTES> FREESTANDING 2-STORY RESIDENTIAL FRONT UNIT ( PART OF 2-UNIT s • demolish,or repair any structure,prior to Es issuance,also requires the applicant for such panne to file a signed statement that he or she > PROJECT) , •licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)d of Division 3 the usircas end Rahman Codel or that heor she is exempt therefrom end the basisfor the alleged exemption.Any violation d Section **********i4*******at***********************4**********4****************4******** 703t.s by any applicant for a permit subjects the applicant m e cid penalty ado remore than(bn R e Hundred dolleSODI). DEVEL O 'P H E N T SERVICES REQUIR E M E N T S o 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 Professions Code:The Contractors License Law does not apply to an owner of propend /-y y-� 5 who builds co improves thereon,and who does suds work himself or herself or through he or herown employees,provided that such ZONING APPROVED BY (r C— DATE; E..:-.-.- C.. improvements are not intended or offered for sae,If,however,the building or improvement S sold within one year of completion,the owner4wiM«win have the hederha proving he«she did not buil«improve i«the pamee.aeate). BUILDING APPROVED BY ; �(v 11 DATE; 2I= 0:1—. ..if- ❑ I,as owner of the property.am mdnmery centredkq with licensed contract �SeMMn Toll,Business and Professions Coda:The Contractors License Law does not apply to an owner,3ofiWri{a} mr ir�raJ• DATE: �' contracts for such projects with a own°ctor(s)[caned pursuant to the Cmtratos (� $PLICATION ISSUED BY; /Y.Yl•. Dl S"- ❑ Ism exempt under Section: B.BP.C.,for this roman: �t"u********************"ty*****4******istf /1E� _#4*******)t•***W*.4********4**** 'If*** RFQUIRFD ***********4*****************************3**********4**********4444******4& **** Daleewer' LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,955+3,end 25534,and that I o any Mur°building occupant will/will not(circle cgs)need to campy with said date codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING e permit for Dmmctionor modthmhiry•an . tion «^the Aagenant owns Residential md mtn lon applicatio nare exempt from these provisions. PERMIT 755 . 00 13 , 26 Date: Applicant: SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one d the following dedersions: PLAN 12 2 , 6 9 ISSUE FEE ❑ Ihave and will maintain acertificate dconsent losell-insure for workers'compensation,aprovdSection BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE cde,r«the pedotmanoedmew«nil«wuohm®pennni.imaed. TOTALS----> 768 , 26 0 . 00 122 . 69 890 . 95 890 . 95 . 00 ❑ I have end tel maintain workers'compensation insurance,as required by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued.My workers'compensation insurance caner and policy number are: carrier REVENUE DIVISION TOTALS--> COLLECTED; 768 , 26 OVER/SHORT: 00 Policy Number. _ BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK ,This s' ion need not be completed A the permit is fisc one hundred ddara/$t00)or Ices) 755 . 00 13 , 26 • 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 •• one subject to the workers'compensation laws of Caffomia,end agree that RI should become subject to the workers' ******'t*****F*****44*********i4*****44**i4**4***d4**t4***4444.***if**4**4444*i***********4 ••mpermilon• kx iaa• Sect'. 3700 of the Labor Code, shell forthwith ognply INDIVIDUALA L F E E BREAKDOWN D..t: 1 Applicant: 1.,�I7T,/�. W • ..;Failuretosecureworkers'conperaationcoverageIsunlawful,andshallsubjectanemployertocriminalpenaltiesand TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil floss lop to one hundred thousand dollars(5100,0001 In add/tion to Use cost of compensation,demon in provided for In Section 3706 of the Labor Code,interest,and attorney's fees. SFR 1680 DWE-TYPE V-WOOD FRAME -GOOD 74 , 00 124 , 320 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there ii a construction lending agency for the SFR , 445 RES-GARAGES TYPE V 18 . 60 8 , 277. 00 performance of the work for which the permit is issued(Section 3097,Civ.C). END OF FEES LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and date that the above information is correct.I agree to comply with all city and county ordinan® end stere laws relating to build' •construction end hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. �/ t• Ii. KC E.1,,. .-Fr Pion 01 00177322-00 1773 23 TOT 768.24 A 4 Date: DATE: 02/27/95 TRIP 10:51 Signaler.dOwner/ •:HVA••- : • rector (515146.WP) While-Buiknq 8 Safety;Green-File:Canary-Appicent:Pink-Revenue:Goldenrod-Assessor . 1 • CONSTRUCTION AND PLANNING 1 POOL .,PA APPROVALS Permit -# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pdle 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • .3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. Z74/,11/ 57. APPROVAL TO COVER-GUNITE 7. Footings .l r/ 58. Electrical Conduit-Undrgrnd. 8. Foundation !yr- 59. Gas Pipe, 0 Undrgrnd„ Test • • 9. Water Pipe-Undrgrnd. 60. Backwash Lines. P-Trap, O Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final a 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. POOLJSPA 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 ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing trA40/f ` 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing Ø /cr S 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80, FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy :: '1 -. - 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /0.2.,-15- &W, 48. FINAL PLANNING 49. Electric Release to Edison - _• 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date NEWPORT-MESA UNIFIED SCHOOL DISTRICT 14 7, CERTU-ICATE OF COMPLIANCE OF DEVELOPNr,AT FEES PURSUANT TO AB 1600 AND AB 181 ��yy TO: ( City of Costa Mesa District Receipt No. Z ci ( ) City of Newport Beach ( ) County of Orange Plan Check No. Applicant: V/ve ill�/l�g j•r-/� Address: /13 Til-+J/ rue # 3A 3 A/ CA- 921060 Telephone Number: 7/LeStil 30 2 Z Tract/Parcel and Lot Number(s): Location of Project: ZZy / & Si CWS 3360 Number of Square Feet of ,�/tq / VO �[ Residential Space U o �j ! x $ 1.72 Total ��7J Oa• 7 b Residential/ / •/ 0 Sr. Citizen Space x $ .28 Total Commercial and Industrial Space x $ .28 Total Warehouse Space x $ .2235 Total Commercial/Industrial Project is: (Check One) Warehouses _ Motel Preschool R & D Bank Auto Repair Movie Theater Neighborhood Shops Hospital Mini-storage Racquet/Health Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park Fast Food This project is exempt because This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. J o By: I/X-1JAentafve The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true then this certificate shall automatically terminate and the appropriate City/County shall be notified. Date: �a/94S`' Ayr Applicant CL 42 ' // h6-17 `• CITY OF COSTA MESA ?^ Electrical Power Meter-Final i ad BUILDING SAFETY DIVISION incl Electric �� POST IN CONSPICUOUS PLACE 34. Final Heating&Air Conditioning .2t- 't' i. : ON THE JOB 35. Final Gas Pipe-Test ••n-4 va; ': _ NOTICE , 36. Hood or Canopy i • You must furnish PERMIT NUMBER and the JOB ADDRESS FOR 37. Final Factory Fireplace rfjj EACH RESPECTIVE INSPECTION. CALL 754-5627. APPROVED PLANS SHALL BE ON JOB AT ALL TIMES. 38. Final Plumbing -?7 9! t. 4) A.P.N° DATE Issuso 39. Water Service-Final '�{'S s . I:1° - 2_ 2E'-41� L {..r, !.� TYPE `I G/R(�(u P/7 PERMIT No. 40. Gas Service-Final • - �%t "`/3 /M-1 Yl� 21 41. Solar Domestic-Final eUl ADD ESS a(-1 - C IQ U- sl - 4r A 42. Backflow Preventer TRACT LOT BLOCK43. Backflow Irrigation ' •[Yj r r NEW ADD ALTER REPAIR MOVING DEMOLISH 44. Landscape Irrigation System 1.25)5,•wOri nie: i. 'is .J 45. Sound Attenuation • ,.;3•,,'_p OWNER 46. Handicap Regulations • ,.p:"' "Ro (SIr tT Soni, c[i- 47. FINAL STRUCTURE&BUILDING i.:,...1:1 `- USER 48. FINAL SPECIAL REQUIREMENTS g . IS r„ POOL&SPA 1:141.:it:: POOL APPROVALS Parinit I 'F.,.;1;T: SETBACKS T`11-Pr' -'s' Front Yd-Side Yd. L-R- Rear 49. Pool&Equipment Location f,i F; ^, Ii ii Yd. L-R Rear 50. Steel Reinforcement PTI.`!.fiI't<_. CONSTRUCTION AND PLANNING Date inapenix 51. Forms APPROVALS Permit 4 52. Electrical Bonding 1. Temporary Electrical Service or Pole 53. Rough Plumbing&Pressure Test 2. Soil Pipe-Underground 22S 54. APPROVAL TO COVER-GUNITE 3. Electrical Conduit Utility-Underground _ 55. Electrical Conduit-Underground 4. Electrical Conduit-Underground 09Vq 1: 56. Gas Pipe ❑Underground Test :a: , 5. Steel Reinforcement 57. Backwash Lines,P-Trap,❑Underground 6. Electrical UFER Gmd. “ii % 58. APPROVAL TO DECK 7. Footings / (Clr --- 59. Backwash&Receptor-Final {•�''' 8. Foundations OlVd 1/ 60. Heater&Vent-Final • 155',:!F.i,.' 9. Water Pipe-Underground 2- i.15 4 I 61. Plumbing System -Final 10. Structural Floor System ,r62. Electrical-Final 11. Properly Sewer Line&House Connection 2-74'3 4/ 63. Sdar System -Final : :I. 12. Sewer Cap 64. Fencing&Access Approval 13. Roof Drains l 65. APPROVED FOR PLASTERING 14. Rough Plumbing S/Et-Et-4114' .I, 'O 66. POOUSPA SYSTEMS FINAL • 15. Rough Electrical-ConduitFIRE DEPT.REQUIREMENT 7t 16. Rough Electric Wiring Y-3?-' fr//, APPROVALS Permit* 17. Rough Wiring Sign _ 67. Underground Hydro , 18. Rough Electrical-T Bar Ceiling l,{ 68. Product Piping ❑Gas El oil 19. Rough Heating&Air Conditioning 't4-21- 11!- II 69. Underground Flush - ' 20. Rough Factory Fireplace 5i-1/4 70. Underground Storage Tank El Gas❑Oil 21.Ducts,in Structure 71. Overhead Hydro 22. Ducts,Ventilating 72. Dry Chemical 23. Gas Pipe-Rough&Test 44 % 'F'4 73. Dry Standpipe cep Root Framing 74. FIXED SYSTEM FINAL • :. 25. Roof Sheathing y�l i 75. FIRE PREV.FINAL -=r' i. 26. T-Bar Ceiling(Structural)&Monocrat Notes:�,rI .7-1.2.g * SttD-wen_- fn.( TD ®2 Frame and Flashing �� i ' yy IFy 6/ft/it O~-/ cse ra[J�'4'OCZ 28. Lathing&Siding -27-g bc•4I 29. Insulation c -L)-R. 644 t . ' i Drywall Naili a 'r' ..�. yaP' •• .h . Wit..; i;: ^3 -1 ,•. .,r i;;' 4.3tS 4 P aS pa wi Coen'/ (see reverse for additional notes) f. S�. maa•tPmm.6a1 { City of Costa Mesa . California 92628-1200 P.O.Box 1200 . Insulation Certificate 4'. Permit Number i• 224 16th Street Costa Mesa, Number and Street _ City Orange s County Subdivision • Lot Number i- t Description of Installation f. ROOF Material Yibgrglass Batts Brand Name Owens/Corning Thickness (inches) 6 1/4" Thermal Resistance (R-Value) 19 EXTERIOR WALL '• • Material Fiberglass Batts Brand Name Owens/Corning Thickness (inches) 3 1/2Thermal Resistance (R-Value) 13 l'' CEILING F'' Batt or Blanket Type Batt Brand Name Owens/Corning Thickness (inches) 6 1/4" Thermal Resistance (R-Value) 19 Loose Fill Type none Brand Name �;t",i,g,, Contractor's minimum installed weight/ft2 lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) l • RAISED FLOOR 414 it Material none Brand Name Thickness (inches) Thermal Resistance (R-Value) f ( SLAB FLOOR y;, none Material Brand Name 1, Thickness (inches) Thermal Resistance (R-Value) Width (inches) ° •ii FOUNDATION WALL none • Material Brand Name i Thickness (inches) Thermal Resistance (R-Value) Declaration , s 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 Adminstrative Code. t f. General Contractor(Builder) License Number i,. Signature and Title Date Schmid Insulation Contractors Inc 221517 Sub-Contractor(Insulation Installer) License Number June 22, 1995 r. Signature and Title Date Kim Collins, Administrative Assistant . to 190746 1'+ PROJECT ADDRESS: 224 E 16TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 070646 OWNER'S NAME: ROBERTSON GENE H ADDRESS: 5366 OSEAWARDMRD, CA 92625 PERMIT NO: B 070646 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: NEW ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; DEMOLISH 2 EXISTING UNITS SQ FT: 2, 500 ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: 2, 500 . 00 GROUP OCC: R-3 /M-1 PERMITTEE: VNE DEVELOPMENT ( 714 )645-7588 ADDRESS: 1048 IRVINE AV 363 COMMENTS: DEMOLITION PERMIT N.B . CA 92660 *+E***********+e+E+E*****+E+E***********Rr******+E*******+E*********a*N*+r*************** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Owston 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS CIT ATE LIc.:658963 1O .B EXP: 1 MAIN BUILDING ACCESSORY BUILDING Date Signature: _ FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN ERS'COMPENSATION DECLARATION: I hereby affirm that I have ace ificate of consent to sell-insure or a cenificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab,C). POLICY NO.: EXP.DATE: PARKING REQ: PROV; PARCEL: 42520117 ZNE; REF NO: COMPANY: PLANNING NOTES> 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. > ******************************************************************************* Dale: Applicant: DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). I certify that in the performance o1 e work for which this permit is issued,I shall of employ any person in any manner so as to become ZONING APPROVED H Y subiect to the Worker Corn en .tion Laws of California. DATE: t. •••"" BUILDING APPROVED BY ;Signature: II 11 DATE; 'TICE:I.after making this declaration.you should becot to the Workers'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED H Y: CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work fr DATE: Owhichthispermitisissued(Section3097.Civ.C). * * hs LENDER: ********************************************************************** ***** ** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;Y OWNER BUILDER DECLARATION: I hereby affirm that lam 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 54 , 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 SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the TOTALS----> 54 , 50 0 . 00 0 ,00 54 . 50 54 . 50 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED ; 54 . 50 OVER/SHORT; 00 improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC F IRE SMI P/TOT GRADING PLAN—CHECK for the purpose of sale). 54 , 00 . 50 I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner ofproperry 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. INDIVIDUAL F E E BR E AK DOWN ❑ f am exempt under Section: B.&P.C. lor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: SFR 2500 DEMOLISH BY VALUE RESIDENT, NOZONE 1 . 00 2, 500 . 00 I do hereby certify That l 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 will/will not(circle one)need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify That I have read this application and slate That the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereb au horize represe atives of this city to enter upon the above mentioned proper for ins tions jurposs�eser e al ecl7 Signature: T QAk: 01/09/951JFI[IE 16:4672 19 54.50 Driver's License m Social Security a: 164146 White—Building:Green—Codd Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING POOL _ 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 .1 3-Electrical Cor4p r,)ltility-Und1'grnd. 54. Forms :A:'E ✓ lectrical Conduit-Undrgrnd 55. Electrical Bonding 1 'Steel Reinforc;?_raent 56. Rough Plumbing & Pressure Test , 6:•Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE •-,7. wootings ;; ' t 58. Electrical Conduit-Undrgrnd. •-.43: Foundation 59. Gas Pipe, 0 Undrgrnd.,Test B. Water PI a-Undr rnd. ••, P 9 .�' 60. Backwash Lines, PTrap, D. Undrgrnd. 10, Structural Floor System -- 61. APPROVAL TO DECK 11. Property Sewer Lirie & House Connection 62. Backwash & Receptor-Final 12. S2wer Cap 63. Heater & Vent-Final , 13. Roof Drains o p 64. Plumbing System - Final 14. Rough Plumbing ,. 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough ElectrYCWiring 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 201 Rough Factory Fireplace ' r-" ` i - `; ' APPaoVPNLS_ . Permit # 21;;Ducts, in St[ctpre _ -,n : 70. UndergNoiirrd HH ' 21ro 22. Duets, Venadatirrg' ' , e, • �, •, ; 71. Product Piping ©Gas O Oil 23.,Gas,Plpe4Roggh & est - - -C 3. ., 72. Underground FIusb S . . 24.'Roof Framing '^ '• ;;; mss . �' " d.Stor. e.Tank ❑Gas COiI 73 Under 9rns?9 25. Rolaf Sheathing r_ , ; _ S 74h Overhead'Hydro - 26.. T-Bar Ceiling (Structural) & Monocoat -" '" ; ; 75i. Dry Cherpicat _ 1 . ' 7 ;'. 27,_,Frame and Flashing , : r 76.�'Dry Standpipe- >, - - -428' Lathing& Siding' • -r y -:T. zc -- "^ ' 77i; FIXED SYSTE-1PFINAL n1.- M 29. Insulatign 1r . 7B.. FIRE PREV. FINAL A • •I' 4 _ 30. DrywalfNailing - i I HEALTFj'DEPT. REQUIREMENT 31. Plaster Brown Coat", r i ' SRECTION .f 7' • ,�•. I I !� 1:•79: FINALIf _ r •32.'Electrical Power Meter-Final � l I, : '`;80 ;FOOD CERTIFICATE IgSUED , ";: -33.. Final El ctriE , • I Notes: y;t 34: Final Heating& Air Conditioning*. n I : t _. ',t T . 35.' Final Gas Pi Pe-Test; ,I �•, ` :, -36. Hood or Canopy - v -t 1. I. -j' , �I_. r, • :ry ?? . 37.;Final Factory Fireplace , -' , I r• * ' 38. Final Plumbing . ' . I I - • • r r 39. Wailer Service;Finat ' - , r1 I r , ,. 40. Gas Service-Einal • , • . , • n1 I 1 •o : .. s •41. Solar Domestic-Final= �� I 1 - , 1 A 42.-Backflow Preventer r . ' ' .• • a- ` '7 . 43. Backflow Irrlgatiort - - ' t• •' r • r .4 li ;44. Landscape irrigation System; : - . m1 "! ; T q. Y1 : t - *45.:Sound ttenuatiori ' ' -' - 1 ' . :46.`. -landicap RegulationsC _ ?.[ 1 I ,...--1, . 47-FINAL STRUCTURE & BUftOING /9•z3,-q!• a.4elitt, ' ' - - .. : 48.--FINAL PLANNING I 1•- I' r • -• 49.•Electric Release to Edison ' (, ' 450._Gas Release to Southern California Gas Co • 'Si. CERTIFICATE OF-OCCUPANCY - - Y : - : > • No. Date PROJECT ADDRESS: 224 E 16TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 070878 OWNER'S NAME: ROBERTSON, GENE H ADDRESS: 536 SEAWARD RD PERMIT NO: E 070878 PLAN CHECK NO: N GOVT: N SUPP ; N CORONA DEL MAR, CA 92625 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: CON ARCNIENCINEER; ROBIN HAMMERS B6 ASSOC. REG.ND.: 3170 JOB DESCRIPTION : CAP SEWER SQ FT; ADDRESS: 234 E 17TH ST u T: 205 C,M, CA 92627 CLAIM VALUE; CALC-VALUE: GROUP OCC : R-3 / PERMITTEE: VNE DEVELOPMENT INC ( 714 ) 548-3072 ADDRESS: 1038 IRVINE BL 363 COMMENTS; TEMPORARY POWER NEWPORT BEACH CA 92660 ****T6+E*************fir*******Tk******+P*****TEr*****a6**+k*********Te*********+fir***+r** LICENSED CONTRACTOR DECLARATION: I hereby atlirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R £ Q (3 IR EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full torce nd effect. CITY LIC.:0637 8 sTAELlc.:658963 CLASS: 13 EXP; 12/95 SETBACKSS Da : ), r(5--lS Signature: — MAIN BUILDING ACCESSORY BUILDING RKERS'COMPENSATION DECLARATION: I hereby affirm that I have a c Nicole 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 thereol(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: 42520117 ZNE: REF NO: ❑ Codified copy is hereby furnished. 0 Certified copy is filed wit he city Buil ' 'vision. PLANNING NOTES> • ' Date: Applicant; **********************************************************************,********* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section n ed not be completed it 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 is ued.I shall of employ any person in any manner so as to become Sail'. to the Workers'Compensa Laws of California. ZONING APPROVED BYDATE: eale; ' 71•-• Signature: I NOTICE:It.alter making this declaration,you should become s jest to the orkers'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• ©' En C which this permit is issued(Section 3097.Civ.C). 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 following reason BLDG PMT PLUMBING ELECTRIC MECHANIC F IRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 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 5 0% SM I P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 . 00 I. as owner of the propeny or my employees with wages as their sole compensation. wit do the work, and the BUILD ING—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----> 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.If,however the building or improvement is sold within one year of completion,the owner wit 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 budds or improves thereon and who contracts for such projects with a contractor(s)license pursuant tolheContractors'State License Law).I am aware ******.N.**************.*******.*.******.***.)F*.**.µ.JF**.)f.**..N.*****.***.*****,****,**,*,**,******* that proof of their Worker's Compensation insurance should be provided to me. IND IV IDUAL F E E BR EAK D O W N ❑ I am exempt under Section: B.8 P.C. 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 m any future building occupant will/will not(circle one)need to comply with said stale codes and the requirements for a permit for construction or modification from the Air uxlity 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 an ereby authorizer presentalives of this city to enter upon the above-mentioned pro r inspection purposes TOT 1 -12C-61� signawre: 01 00175567-00175567 T DATE: 01/25/95 TIME: 14:43 is License or Social Security 164146 Moe—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL ,,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 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, D Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Hough Factory Fireplace • t. 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 ❑Oil 25. Roof Sheathing - - - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monotoat 75. Dry Chemical 27. Frame and Flashing: • 76. Dry Standpipe • 28. Lathing & Siding - ' , 77. FIXED SYSTEM FINAL . 29. Insulation • - ' 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat X79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric. Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe:Test • 36. Hood or Canopy - • 37. Final Factory Fireplace 38. Final Plumbing • 39. Water Service-Final ' . ` 40. Gas Service-Final • 41. Solar Domestic-Final - 42. Backflow Preventer 43. Backflow Irrigation - ! 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations - ' 47. FINAL STRUCTURE & BUILDING /047-q5- 64.41-- 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRE9 BUILONc 224 E 16TH ST UW: CITY OF COSTA MESA - BUILDING PERMITr rl Mel; menti vii ie OWSNAMEwmwm GENE ROBERTSON ADDRESS SAME PERMIT NO: GRA 071276 PLAN CHECK NO: 00376-95 A vvvi : IN o urr ; IN CONSTRUCTION TYPE: PERMIT TYPE; GRA PURPOSE: NEW APPL.MAIMS ADORES$: JOB DESCRIPTION : GRADING FOR 2 SFR SQ FT; ARCNREcr ORwaHEEx: ROBIN HAMERS & ASSOC ucNc., C31720 ARCH.OR ENG.'S ADDRESS: 234 17TH ST UMT: 205 CLAIM VALUE : 2, 000 . 00 CALC-VALUE: GROUP OCC : R-3 /M-1 C .M. CA 92627 coNmAcrar3NAMe VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS : GRADING FOR 2 FAMILY RESIDENCES CONTRACTORS DAMNS 1048 IRVINE AV + *+c******x-x*ar•*aEac.>F*+E****->F*****4a *************4-**ie+got +r•******if:t**a.a**.r*.Frier****—**** ADDRESS: N.B . CA uc.No.: (SS 89 6 3 Z ONING REQUIR EMENTS 92660 UMT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions code,and my lienee is in full force and effect. MAIN BUILDING ACCESSORY BUILDING CITY LIC. LIC.CLASS: g UC.N0.: 658963 EXP ; FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ly� �1� LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN e Aft contratlor. ER BUILDER DECLAR ION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the PARKING REQ: PROV; PARCEL; 42520117 ZNE; REF NO: following reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,after.improve, PLANNING NOTES> demolish,or repair any structure.prior to its issuance.also requires the applicant for such permit to fib a signed statement that he or she S licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Sedion 7000)of Division 3 of the > liminess and Professions Code]or that he or she S exempt therefrom and the basis for the alleged exemption.MY violation of Sedion ****************************************************************.y.****r***5a4*i:*** 7031.5 by any applicant fora permit abjeda the applica t to a civil penally of not mere than Me hundred dollen(S5009. DEVELOPMENT SERVICES R EQUIREMENTS 0 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 Professions Code:The Contradors License Law does not apply to an owner of property - whobuidsorimprovesthereon,andw/o does such work himself or herself or through his or her own employees,provided that such ZONING APPROVED BY DATE: improvements are not intended or offered for sale.I,however,the building or improvement is sold within one year of completion,the 'y!`, 1 c�^� improvements have the wdendpovirg he«ma old not wind«imprae for the perymedmb). BUILDING APPROVED BY ^ Y j Li- DATE: 2l 4 ❑ I,as owner el the property,am exdaivey contredig with licensed contractors to casing the project(Section 7044,Business and 1 Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who n contracts for such projects with a contra dor(s)licensed pursuant to the Contractors Limnee Law). APPLICATION ISSUED B Y: /S��''� DATE- C_ e ❑ I am exempt under Section: B.B P.C.,for this reason: *********************************** A- * ************7r************ 9** ********************************************************************** ***** .** Date: Owner. LEGALIZATION:N F E E SUMMARY STRUCTURAL 'EGMENT:N I do hereby sena),that I am aware of and understand the requirements of Caloma Health and Safety Code Sectiam 25505,pcc71,and Pectt,and that I or any future building occupant will I will not(circle one)need to comply with said state codes and the requirements for e permit for construction Ormodification from the Air Duality Management DiarnelResidential canstndion°ppictlions are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 64 . 50 Date: Applicant: SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby atom under penally of perjury one of the following ded«siora: PLAN 5 . 63 ❑ Ihave end elmaintaaceifateof consent toself-insure for workers' ww compenion,aspdedforbySection3700oftheLabor BUFEE 3 . UE n Code,fortheperformanceoftheworkforwlichthispermitisissued. BUILE LDING DIV-> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ Ihave and witmaintanwoM«e'compensatininsurance,as required bySecion37GOdthe Labor Code,for the performance oftM TOTALS----> 64 . 50 3 . 00 5 . 63 73 . 13 73 . 13 00 work for whim this permit is sued.My workers'compensation insurance miner and policy number are: Carver: REVENUE DIVISION TOTALS--> COLLECTED : — 67 . 50 OVER/SHORT; . 00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK �—Th/is�ecfion need not be completed I the perms is ler one hundred dollars(Sf001 or hese.) 67 . 50 _\ certify that in the pedermance 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 re.*compensation sore of California, and agree that if I should become subject to the workers' ******************************************-***********'K.******************i'.****** censer provisions sealon a7Co d the Labor Code.IMall fort ih comply with those provisions. I N D I V I D U A L F E E B R E A K D O W N Date: �/?- l i c APPlicort Ar `tc _ amino:Failure tosecu wo*en'comperwtlon coverage is unlawful,and shallsubl°cf an employer to criminal penaltlea and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up m one hurt rod thousand dollars($104000),In addition to the cost of compensation,damages as provided for In Section 3706 of the Labor Cods,Interest,and attorney's(ser. NO FEES WERE SELECTED FOR THIS PERMIT CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which the permit is issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and date that the above information is corned.I agree to comply with all dry and county ordinances and state laws relating to buildig construction and hereby authorize representatives of this city to enter upon the above-mentioned popery for inspection Dar Alf_ t\n kit -r &bfltr J P"" °"° 01 00177319-00177319 TEAT 67.50 ata d «/AgeM/Appimn� Date: 2/Z1 ti1 DATE: 02/27/95 TIliE: 10:49 (5151-45.W P) White-Buildi g&Safely;Green-Fle;Cary-Appicant;Pink-Revenue:Goldenrod-Assessor . CONSTRUCTION ANO PLANNING POOL ,. PA _ APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1111- 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 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.GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit :66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning - FIRE DEPT.'REQUIREMENT 20. Rough Factory Fireplace - APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 7.1-. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test , 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low Preventer 43. Backf low Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING f0 `ir6,c✓!� 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No Date - FINAL GRADING CERTIFICATION Project Address: 224 E. 18h Street, Costa Mesa • Lot Number: • Permit Number: 9500033 A 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. 15-c Fall for asphalt surfaces and landscaped areas. 0.55', 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 J1]0 of the designed elevations. Supervising Civil Engineer !Y " Reg. No. 31720 (Sirnature) Date 6/22/95 • .°2°FESsio 2 9 c4RCE31 i N0.:0 m•9i y CC EXP �il�b i^ 4^ * •Z; CIVIL �P* it CIVIL CAL1?°P • • ST/;..SE) and sited 0.•w .. :•i.' n-.•f' , ,:u)t ;• '�-iJ ;S 7-nti�,x.: '��' 1 n : c'.-- ._ •r„�..•. .•Xti:.0 . 47rY'...iii• $2":r , d_ S:',xbh .... ....±,- . •-•'•• ADDRESS OPBUILMNG: 224 E 16TH ST WMT: A CITY OF COSTA MESA - BUILDING PERMIT rL'ttn rev; r v ' .L coz. OWNERMOWN:S NAME IF OWN: GENE ROBERTSON " ADDRESS SAME PERMIT NO; P 071281 PLAN CHECK NO; N Uuv i ; ry .-.urr : N CONSTRUCTION TYPE; PERMIT TYPE; PLU PURPOSE: NEW APPL.SWUNG ADDRESS: JOB DESCRIPTION ; 690SF 1ST FL, 990SF 2ND FL, 445SF GARAGE SQ FT; ARCKRECTORE LEER: TAYLOR ARCH UC.NO.: C14978 . ARCH.OR ENG.'S ADDRESS: 234 17TH ST um: 203 CLAIM VALUE; CALC-VALUE: GROUP OCC : R-3 /M-1 C .11, CA 92627 caNmncrarswiUE VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS ; REF: B-71278 " GARBAGE DISPOSAL " CONTRACTOR'SMNUNG 1048 IRVINE AV *****************************************49 SrtfithNr*; **.rt9ttrN.ac+r•******+t+c******a~*ac**** ADDRESS N,B . CA LIG.NO.: 658963 Z ONING REQUIREMENTS 92660 UMT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under pone-kY of perjury that I em licensed under provisions of Chapter 9 (commencing with Section 7000)49 Darrion 3 o the Business and Professions Code,end my license is in full force and erred. MAIN BUILDING ACCESSORY BUILDING CRY UC.NO.: LIC.CLASS: B _ Lia.NO.: 6963/ EXP; FRNT; FT IN REAR; FT IN FRNT: FT IN REAR : FT IN /�C/ l( LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN Date. ^)�A 1 CorNraaw: �,L ER BUILDER DECLARATION:I hereby affirrn under penalty of perurythel lent exempt from the Contractors License Law for the PARKING REQ: PROV: PARCEL ; 42520117 ZNE; REF NO; following reason(Section 7031.5 Busi,ess and Professions Code:Any e y or county which requires a nem*to construct,atter,improve. PLANNING NOTES> demolish,of reps:any structure,prior a is issuance.abo requires the apdrd icafor such peril to file a signed statement that he Of elle licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)d Division 3 d the > siness and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section **+r1F**'rE******if******************3************+4**ASM**********df*******Csi*******ic* d31,5 by eny applicant fora permit subject the applicant to a civil parent of nal more than five hundred NM=Iss00]). DEVELOPMENTSERVICES REQUIREMENTS CII.as owner ofthe property or my employees with wages as their sole compensation,will do the walk,end the structure is not intended or offered for sale(Section 7044,Business end Professions Code:The Contractors license Law does not apply to en owner ofproperty •builds Cf inpmves thereon,and who does such work himself or hernial or through his or her own employees.provided that such ZONING APPROVED BY DATE; improvements are not:mended or offered for sale.R.however,the buileirg or improvement is sold within one year of completion.the owner-builder will have the burden of proving he or she did not build or improve for the purpose crl sale). BUILDING APPROVED BY DATE: ❑ Las owner d the propend,em exclusively contractig with licensed contreclon to construct the project(Section 7044,Business and Professions Code:The Camradors license Law does not apply to en owner of property who builds or improves thereon and who /'� contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). APPLICATION ISSUED B Y; DATE; 1 ❑ I am exempt under Section: B.A P.C.,for this reason: ************************************* ' 4 ****r*******as**************a.** * rs•'* :*M ******************************************M*M*************************a ******** Date: Owner: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that 1 am aware d end understand the requirements of California llealth end Safety Code Sections 25505,25533,end 25534,end that I or any Allure building occupant will f will not(circle ane)need to comply with said pate codes end the requirements for a permit forconstruction or modification horn the Ai euMtyManagemem District.Residential construction appfrstionsae exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/AES GRADING provisions. PERMIT 7 , 00 Dale: Applicant: 2 5% SM I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby ene under penalty of perjury one of the following declarations: PLAN ❑ !have and wimenacenificateofconsenttosefinsr urefwakers'compensation,esprovidedforbySection3700ofthetabor ISSUE FEE 20 , 00 will maltase theperfomen<edlha work for wIth this pemlisiaspod. BUILDING PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,tor Elco I have end wit maintain workers'compensation insurance,as required by Section ion 3700 the Labor Code,for the performance of the TOTALS > 7 . 00 20 . 00 Q . 00 27 . 00 27 , 00 . 00 work for which this permit is Sued.My workers'compensation insurance carrier end policy number we: carrier: REVENUE DIVISION TOTALS--> COLLECTED; e .-27. 00 OVER/SHORT; . 00 Poly Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 'on need nor be completed I rho permit is for one hundred dellen($100/or less.) 27 . 00 rr I coney that in the performance of the work for which this permit permit is issued,I shall not employ any person in any mannerso as to ha bled to the workers'compensation laws of Celibma,end agree that d k subject m the wakes' ****************?S****************************************-****1S***************** <ompe�pe/I"�provia of sic 370049 the Labor Code. shall forth INDIVIDUAL F E E BREAKDOWN Data: .e1 -1 4 Applicant: {p�°�/�//^� Warning:Failure to secure workers compensation coverage Is unlawful,and shall aublect an employee to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Section linea sipp to of one e/hundred thousand dollars e�me�)in saAaddifion to the coat of compensation,damages as provided for In PLU 1 FIXTURE SET/TRAP W/PIPING 5 BACKFLOW 7 , 00 7 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES • performance of the work for which this pent is issued(Section 3097,CN.C). LENDER'S NAME, LENDER'S ADDRESS: I certify that I have read this application and state that the above informpon is correct.l agree to comply with elI dry and county ordinances • end state laws relating construction to building end hereby authorize representatives of this dry to enter upon the above-mentioned property ' Mr inspection purposes. • M IlC. hm yr Prem ante " ` Date: 1•31? 4/?7 U 01 00177316-00177316 TOT 27.00 S',rr,,.,.•: . 7-MgenVA.. . .. tractor DATE: 02/27/95 TIME: 10:47 (5151-4s.WP) While-Building A Safely;Green-Fe:Canary-Appkent:Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING ! POOL 'A APPROVALS Permit - Date Inspector APPROVALS Permit'# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. j 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding t� 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. 60. Backwash Lines, P-Trap, Q Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK , 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ; X12. 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: 4 - 1, ,C.rS� rat,77 34. Final Heating& Air Conditioning „.27 (,��- ((. 35. Final Gas Pipe-Test 4 -zr -7s 2n G 41; 36. Hood or Canopy • 37. Final Factory Fireplace 38. Final Plumbing TI f 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - NQ. Date ADDRESS OF BUILDING: 224 E 16TH ST UNIT: A CITY OF COSTA MESA - BUILDING PERMIT rrSt4-i x' ; T•l u7:2ov OWNERS NAME IF MOWN GENE ROBERTSON . • - ADDREsS: SAME PERMIT NO; M 071280 PLAN CHECK NO; N uvv L : Pi o Orr : au CONSTRUCTION TYPE; PERMIT TYPE: MEC PURPOSE: NEW APDL.MARMG ADDRESS: JOB DESCRIPTION ; 590SF 1ST FL, 9908F 2ND FL, 445SF GARAGE SQ FT; ARCHITECT OR ENGINEER: TAYLOR ARCH ticm, C14978 ARCH.OREND.'S ADDRESS: 234 17TH ST WIT: 203 . CLAIM VALUE: CALC-VALUE; GROUP OCC; R-3 /M-1 C.M. CA 92627 cONTRACTORSNAMe VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS : REF; B-71278 cWTRACTORSMNLIG 1048 IRVINE AV +t*+cacic**aF-x-*+t**+c*+tx**+Esc*tE**air•*******tttt****.MMtFxx***ac+c*,FaF*xx+*aa******aFtic*acacx***aF+r.**x.N.ac ADDRESS: N.B . CA uc.to., 658963 Z ON ING R EQU I R EMENTS 92660 OMT: 363 SETBACK S LICENSED CONTRACTORS DECLARATION:I hereby affirm under peraay of perjury Nal 1 am licensed under provisions of Chapter 9 (commando°with Section 7000)01 Division 301the Business and Professions Code,and my license is in fun force and effect. MAIN BUILDING ACCESSORY BUILDING CITY UC.NO.: UC.CLASS: B UC.NO.: 65896 EXP ; FRNT ; FT IN REAP.; FT IN FRNT; FT IN REAR: FT IN FT IN LEFT: FT IN RGHT:_ contractContractor:RBDILDER DECLARATION:I hereby affirm under perely dp«guy that lam exempt lfromNeCrdredon License Law for the PARKING REQ- PROV; PARCEL : 42520117 ZNE: REF NO: FT IN reason(Sectim7031.5 Elusive.and preiessiam Code:Any city«county whkN requires epermit to mom+.eh« LEFT; FT ,improve. PLANNING NOT'ES> IN RGHT; demolish.or repair any structure.prior to its'esua nen also requires the applicant for such permit to file a signed statement that he or she j 9 licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Dwnan 3 of the > • uainess and Professions Code)or that he or she is exempt therefrom and the base mpl for the allegedexeiom.M1: if Y violation of Section *************************************************4***4k* ***** ***************** (1:1331.5 by any applicant fora perma subjects the applicant to a civil Penally del rmore than Toe hundred dollars IMOD. D EV EL OPMEN T SERVICES R E Q U I P. E M E N TS o I,es owner of the property or my employees Oh wages as their sere mmlensatim,will do the work.and the structure is not intended or offered ofessions Code: he rs se Law does nol loan Owner of property who boldsor sale(Section or improves ther044,Business and eon,and who does sruch work himselfTor herself orthroughhhe or her own employees, provided that such ZONING APPROVED B Y • - DATE:• improvements are not intended or offered for sale.B,however.the building or improvement ie sold within one year of completion.the ownevbuilder win have the burden d proving he or she did not build or improve for the purpose of sale). BUILDING APPROVED BY DATE: //Z o I. d Professions dtheproperty,am exclusivelycontractingaredoevnth Iapplyt a nore mme.ty the buildsj (improvtheBusiness wo �^ Code:The Contractors a License Law does not WAY to t owner of rs Limn who w) «improves thereon and who DATE;contecd br such projects with a marm«Isl licensed pursuer m this Contractors L<eose Law). APPLICATION ISSUED b Y; /�///�_ **************************************,`-RSR it4�t{E*******+F***4*********** o Ism exempt under Section B.b P.C..for this reason: *********************************************************************** ***** ** Owe: _ owner: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT:11 I do hereby candy that I am aware of and understand the requirements of California Health end Safety Code Sections 25505.25533,and 25530.and that 1 o any future building occupant iw wil not IdreIe one)need to comply wih said state codes and the requirements for e permit for ratruction or modihcetonh«ntle AiOnty Management DStid,Residentalconstruction appicatidaereexempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC9FIRE SMIP/RES GRADING provisions. PERMIT , 00 Date: Applicant: PLAN 25$ SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby ohm under penalty of perjury one of the fofowing dedaazau: ISSUE FEE 15 . 00 ❑ I have and will maintain a certificate of consent to seff.insure for workers'compensation.=provided far by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code.for the penomwaedthe work for which this porn*isissued. TOTALS----> 9 , 00 15 , 00 0 . 00 24 , 00 24 . 00 . 00 o I have and will meimai,workers'amponsatan insurance.as required by Section 3700 d the Labor Code,br the performance of the work for which this permit is issued.My workers'compensation insurance carrier end pdiry number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED; — 24 . 00 OVER/SHORT: . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC . FIRE SMIP/TOT GRADING PLAN-CHECK his ion need not be completed I the pearl a for one hundred dollars/51001 or less.) 24 . 00 I uniy that in the performance d the work for which this permit is issued,I shall not employ any person in any manner so m to become subject to Na workers' awed California,and gree testalshoutd become subject to the w«Mn' *****************************************************************************.** pave d ion 3700 d the Lab«Code,1 shall forthwith comply with those provisions. per�q{Tp�PL.� a, • INDIVIDUAL F E E B R E P. K D O td T7 Dote: 111 1 (/l S) 1 _ Applicant: Warning:Failure secure workers'rorrywustlon coverage launlawful,and shall atlect an employer to cHMml penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dears(5100,000).M addition to lire cost of compensation.damages as provided for In Section 3700oIMeLabor Code,Interest,and a(tamers Iees. NEC 1 • INST FORC-AIR/GRAV FURN c=. 100 K BTU 9 , 00 9 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of Perjury that there is a construction lending agency for the END OF FEES performance of the work for which this permit is issued(Section 3097.Cb.C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I have read this application and date that the above information is correct.I agree to comply with all dry and county ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property r for inspection purposes. ` . L'Nri t ( I/III n(n(lNam ;-'). .1/1 Signature aPwM/ApenuAlWlirarh mad« Date. 01 00177325-00177325 TOT 24.00 DATE: 02127/95 TIME: 10:52 (5151-4e.WP) White-Building&Safety;Oreen-Rle:Canary-Applicant:Pink-Revenue:0ofdenrod-Assessor CONSTRUCTION AND PLANNING d POOL :A 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 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. 60. Backwash Lines,P-Trap, ❑ Undryrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Cor(nection 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 1-21(7-76-,`i�� 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: Cf u% O 4 eon. wta 34, Final Heating& Air Conditioning 4... 'G�� 4--/ '? -?5-- 35. Final Gas Pipe-Test r 36. Hood or Canopy + /- -z9 -5:1- 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date - ADORESS OF 111110010: 224 E 16TH ST UHT' A CITY OF COSTA MESA — BUILDING PERMIT ellIK11 IVU: rt V /130: OWIIERSNAMEIFIOMWN: GENE ROBERTSON ADORES& SAME PERMIT NO: M 071365 PLAN CHECK NO: NLgvvd : ,ii JVrr: z 4 CONSTRUCTION TYPE; PERMIT TYPE: MEC PURPOSE: NEW APPL.MMLMO ADDRESS: JOB DESCRIPTION : SUPP ; EMENTAL TO M-71280 SQ FT: AncNNECTORmwaa: TAYLOR ARCH Lk.NG: C14978 ARL'ILORENa'S ADORES&: 234 17TH ST um: 203 CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /M-1 • C .M, CA 92627 CONTRACTORS NAE VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS: REF: B-71278 CONTRACTORSmama 1048 IRVINE AV ************+e+Fac*******it+r•u-sl:u*+E*ertic*r+t*r*:t•*c*ujr-**-K*****.x st,4Fs*rc*err►+A****lc+.mar i*cK*ter 4 k LA ADORES& N,B . CA uc.No: 658963 Z ONING REQUIREMENTS 92660 WIT; 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I are licensed under provisions d Chaser 9 (commenmg"MAS«Uon7000)of Division 3 of the Businenend Professions Cods,and my limns,M in fug force and.nect MAIN BUILDING ACCESSORY BUILDING CITY LIC.NO.: LIC.CLASS: B uc.Np.: 6963 EXP : FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN D 3-4—gs Contractor: '^- LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN •BUILDER DECLARATION:I hereby affirm underpenaly of perjury then are exempt from the CaNmsan License Law for the PARKING REQ• PROV: PARCEL ; 42520117 ZNE: REF NO; I• •reason(Section 7031.5 Suellen and Professions Code:Any city a county wiidi requires a permit to mnsmrs,alter,improve, PLANNING N TES> demd'eh,a repel any evuctae.prig to is Maurice,also requires the applicant toe such permit to Ne a signed statement that he a she 's licensed pursuant to the provisions ci tie Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the > usiness end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section ***********************Ar-*******4f.*#**************if****4**********i************** /031.5 by any applicant for a permit ajbleds the applicant to a ciN penalty of not more than Inde hundred doter*1550O1). DEVELOPMENT SERVICES R E U I R E M E N T S pro ❑ I.as owner of the pend or my employees with wages as their sole compensation,will do the work,end the structure is not intended Q or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an Owneral progeny who builds orimproves thereon.and wig does such work limed or Meet or through his or her own employees.provided that axdt ZONING APPROVED BY DATE; improvements are not intended a offered for sale.t,however,the building or knprvnme t is sold within one year of completion,the owner-builder will have the burden of proving he a she did not build a improve for the purpose d vale). o I.as owner dthe progeny.amexWrselycontractigwthlmrdedcontractors toconWuctepropd(Secion7044.Busineesand BUILDING APPROVED BY ///t7 DATE; - _ Professionstracs Code:The Contractors License Law does not apply to an owner d property whoL builds«improve.thereon and who / Ito contracts for such projects with a radrador)a)licensed pursuant m ms Contractors License Law). APPLICATION ISSUED B Y: Y* DATE: �F ❑ I am exempt under Section: B.A P.C.,for this reason: ************************************ ***************$v'**********' ** ************************************************orf******************4** 4 ****** Cone: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SE 'MENT: N I do hereby ceniy that I anon.ware or end understand the requirements d California Health end Safety Code Sections 25505,25533,and 25534,sod that I a any future building ocwgant will/will not(circle one)need to comply with said state codes end the requirements for a pent to mnevuctiin or modification from the Ak0OiiyMenagement Oland,Residential construction applications are exempt from these BLDG PMT PLUMBING ELECTRIC ' MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 13 , 00 Date: Applicant: 25% SMIP/NON—RES WORKERS COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedarstions: PLAN I have and wit mencertificateacertificated 9i certificate consent to eensure ler workers'compensation.as provided for by Sad/3n 3700 d the Labor ISSUE FEE 4 50 ❑ maintain Cods for the performanceof the work for which this panne Missued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ I have and v.il maintain workers*compensatifin insurance,as required by Section 3700 of the Labor Cole.for the performance of the TOTALS----> 13 . 00 4 . 50 '0 , 00 17 . 50 17 . 50 . 00 work for which this permit M issued.My workers'compensation insurance carrier end policy number are: caner: REVENUE DIVISION TOTALS--> COLLECTED ; 17 . 50 OVER/SHORT : . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK needseaion nor be completed r the panne is r«one nmeneedw. ted,I shall less17 , 50 certify that ine the performanceworker of the work compensation with this permit is issued, athh not employo any person ini any manner so as s' suOnp to the woM1rM n3700 ofthe lowed California.and agree Natal should become'abject to the workers' *******************.4f*****?f********** *****k<****************************** compensation provisions of Seson 3700 the Labor Code.I shall I�tnwtb cern with those provisions. I N D I V I D U A L F E E B R E A K D O 67 N ate 91-3 —c J Apo. / doll Fwroafoeece rdrwrterecthousar°depftsadon coverage rs ggg isuniaawfs4tangier,tom: ay shall o'ieo�rrpnnriroada wpermete.endd TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST rovided tor In 6actlon 3706 p/tha Labor Code,Interest,and attorneys'fees MEC 2 FACTORY FIREPLACE 6 , 50 13 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penal/d periay that there M a construction lending agency for the END OF FEES performance of the work for which this permit M issued(Section 3097.CM.C). .. LENDER'S NAME LENDER'S ADDRESS: I certify that I have red this application and done that the above information is caned.I agree to comply with at city and county ordinances and state laws relatag to Wddsg and hereby authorize representatives d this city to enter upon the above-mentioned property for i.pwm purposes. ( fk:L6o� 01 E' 03/08/95 TInE TCET 27.40 �L GATE= n3/OE/95 TI!iE: OS:So Print Name (``r A . , .141/ r Date: 3-3—7 d _ (5151-46.WP) While-Building&Safety,Gree se ppkvt:Pink-Reeve:Goldenrod-Ms®r CONSTRUCTION AND PLANNING• POOL ?A 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 OF 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. 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: t 4rO 34. Final Heating & Air Conditioning -Cr i C 35. Final Gas Pipe-Test 36. Hood of Canopy 6 -21 -If" 37. Final Factory Fireplace -•S 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date lew ADDRESS CEUtia: 224 E 16TH ST WIT: B CITY OF COSTA MESA — BUILDING PERMIT rnnM NUT r Uy1 Jb0 oWNEr 4A E4q : GENE ROBERTSON s ADDRESS: SAME PERMIT NO; P 071368 PLAN CHECK NO: N UUVA : N Stier ; z CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: NEW APDL.MAIUND ADDRESS: JOB DESCRIPTION ; SUPPLEMENTAL TO P-71286 SQ FT; ARDNNECTORBalaR: TAYLOR ARCH iia: C14978 ARMOR Dal ADDRESS: 234 E 17TH ST DM: 203 CLAIM VALUE; CALL—VALUE; GROUP OCC: R-3 /M-1 C.M. CA 92627 cotancroRsNAME VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS: REF: B-71282 cmmwonmmum 1048 IRVINE AV 4545*************-1C***iter*aE**aaayc*acacaac-1:45-e-** *.15-*u+cic**ac+f•**+:ac*ar•+ic;(-s*4axa:+rac ocac*w.-IC*-Nat.M**.***.. ADDRESS: N. B . CA ucxO.: 658963 ZONING R EQU I R EMENTS 92660 UM: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby Nim under pensly of perjury that I em licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3of the Business and Professions Code.and my license lebfut force end effect. MAIN BUILDING ACCESSORY BUILDING 3LIC.NO.: / UC.CLASS: B uC.ND.: 658963 EXP ; FRNT; FT IN REAR; FT IN FRNT; FT IN REAR ; FT IN pp S I LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN NER BUILDER DECLARATION:I herebyelrm under penalty d perjury that I am exempt from the Contrdors license law for the PARKING REQ; PROV; PARCEL ; 42520117 ZNE ; REF NO; allowing reason(Section 7031.5 Business end Professions Code:Any city or county which requires a permit to construct.after,improve, PLANNING NOTES> demd'sh.re repel any structure.prior to its issuance.also requires the applicantpermit foe such peto file a signed statement thal he or she •licensed pursuant to the provisions of the Connmore License Law[Chapter 9(oommendrp with Section 7000)al Deision 3 of the > .sinew and Professions Code)or that ha or she is exempt therefrom and the basis for the alleged exemptinn.MY violation d Scion *4.*************4.***y*******************fi****ii*ji,*lf***************?f****** *-144.4-*** ,031.5 by any apg cam 1«a permit subjects the applicant to a civil of not nmore than r MOOD. e hundred dollenDEVELOPMENT SERVICES REQUIREMENTS ❑ 1,as owner of the property or my employees with wages as thei sole compensation,will do the work,and the structure is not intended or offered for sale(Section 7044.Business and Professions Code:The Contra/ion License Law does not apply to en owner of properly who bolds or knproves thereon,end who does such work Nns.0«herself«wupn ohis her.or r own employeprovided that such ZONING APPROVED BY DATE; improvements ere incl intended or offered Ice sale.I.however,the Wilding or improvement is sold within one year of completion,the in cer.rcuilderw;BMretneWro at>co .nningheorsbed not build«impA..for the purpose dsab). BUILDING APPROVED BY ° . DATE: ❑ I,as owner of the property,errs esdlmvely contracting with licensed contractors to consmues the proles(Section 7044.Business and Professions Cods:The Canaan License Law does not apply to en owner ci property who builds«improves thereon anal who APPLICATION ISSUED BY; . contracts 1«such projects with.manad(e)licensed pursuant to the Contractors License Law). DATE: • ❑ *********4.***4.************************i * *�iY*****,f** ************ —. ' I am ramp under Scion: B.8 P.C.,ler this reason: -' •** ***********************************************************1R******Y*' K* .******.K' Date: ewerLEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT; N I do hereby candy that I em aware of and understand the requirements of CsJ«aa/kWh end Salary Code Sections 25505.25533,and 25534,end also I or any More building occupant wit/wa not(arch one)need to comply with said pate codes and the requirements ler a permit l«construction«moddhcalion from the Ai h iy °naemenl Distdd.Residential omatnuction°ppiMions en°cemgh«n thew BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING proKskne. PERMIT 1 3 3 , 00 Date: Aparna: 25% SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of pequry one of the following declarations: ISSUE FEE 10 , 00 ❑ Iham and idmsintenacertificate ofconsent loself-insure for workers'compeneetion.as provided l«bySadion3700oftheLabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.l«the p°d«maooedthe work f«wlr<h this parrot is issued. TOTALS 133 . 00 10 , 00 0 , 00 143 . 00 143 . 00 . 00 c ❑ I have and veil maintain workers'compensation insurance,as required by San 3700 d the Labor Code,for the performance al the work for with this permit i,issued.My workers'compensation insurance carrier and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED; 143 . 00 OVER/SHORT; , 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK •:section need not be completed a the panne is ler one hundred dollen(Sf001 or less.) 143 . 00 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 p became subject to the wake 'compensation laws of Catania. and agree Matt shad I shk become to the workers' **** f*;4** * * * 'R ***f* ** ****** * ********** ** f * *** ***************************s* * ** * *. .. .. . ... . . kw a s.dkhh 3700 a the Labor code.I Shen forthwith,q$,ry with at. 'l: INDIVIDUAL. FE E BR E AK D OWN 1 ` re :Fallon tosecure works&cortpensation coverage Is unlaanM,and shall abject an employer to cv#Mnslpenaar end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST -I fines t to one hundred thousand dollars($100,000).In addition to the cost of compensation.damps as provided for In - Section 3706 ol the Labor Code,Interest and adomey'slees. PLU 2 BATHTUB 7 . 00 14 , 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under p-ally of perjury that there is a cantata lending agency for the PLU 1 DISHWASHER 7 . 00 7 . 00 ped«marnwathe work for Midi this permitisissued(Sean 3097.C:.C). PLU 1 LAUNDRY TUB OR WASHER 7 . 00 7 . 00 LEN'S ADDRESS: PLU 1 SHOWER 7 . 00 LENDER'S ADDRESS: PLU 1 SINK, KITCHEN 7 . 00 7 . 00 Iceniy that l have mad this application arc!eats thal to above information is correct.l agree b comply with army end cavity ordinances PLU 2 WASH BASIN (SET) 7 . 00 14 . 00 and stere laws reWsgkbakkp constriction anp lm.bysyhprce�a%=wnuaMgalto mto this upon the prwery PLU 3 WATER CLOSET ( TOILET) 7 . 00 21 . 00 1«inspedion purposes �(6/T//SIT PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 ,v-,..., PLU 1 WATER SERVICE 01. 002?Dia—QQ177781 TOT 7 . 0123,00 ii: ' 3_8--SLI PLU 1 GAS PIPING SYS OF 1 I TO 4 OUTLETS DATE: 5)3M/95 TINE: 09:53 5 . 00 spwarealOme/Ager Date PLU 1 GAS SERVICE 7 , 00 7 . 00 - 46.WPI White-Buikig 8 Safely;Green-Re;Canary-Appicant:Pink-Revenue:Goldenrod-Assn r CONSTRUCTION AND PLANNING .• POOL PA 4$APPROVALS Permit # Date Inspector APPROVALS Permit # � Date Inspector a• 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ~ 2. Soil Pipe•Undrgrnd. , 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, V Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Fiael 12. Sewer Cap - 63. Heater & Vent-Final , 13. Roof Drains 64. Plumbing System - Final 4. Rough Plumbing GI__/ L`jL !�L 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. POOLJSPA 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:4 if -<; � •c4*- }or.;yj f.---77k 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test -n5 A.G 4 - t 3 '', Ret zs-L 36. Hood or Canopy 4-2_1 _�S Ster ��y 37. Final Factory Fireplace c•'� 38- Final Plumbing 6 .z9 - • • 39. Water Service-Final 4/19 ► - 10 40. Gas Service-Final b-4'5 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING: uNT: ONNEWS WOE 1013401Th ADDRESS PERMIT NO; P 071368 PLAN CHECK NO: 00793-95 N FItt,t ; 4 if#14****ififif#itiEififi* if-1 ***-0-* faf Y-ilif?f#*if***is if**V.**le**if YiFiliF****lfsif A4-*44, f Kilaclt*40***N-SSfi 4** APPL.YAIL010 ADDRESS • TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ARCKITECT OR ENOOIEEA: UC.NO: ARMOR EMI ADDRESS: Dxr: PLU 1 SEWER, BUILDING / TRAILER 15 . 00 15 . 00 PLU 1 SEWER, CONNECTION TO BUILDING EACH 15 . 00 15 . 00 CONTRACTORS NAME END OF FEES CLMRACTORs SA L IM ADDRESS: UC.ND.: UNT: UCENSED CONTRACTORS DECLARATION:I hereby dim under penally of perjury 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 NO force and effect. CRY UC.NO.: UC.CLASS: UC.NO.: Dale: Contractor: OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury thal I am exempt from the Contractor'License Law for the following reason(Section 7031.5 Braless end Professions Code:Arty city or county which requires a permit to construct,alter,improve, demolish,or repel any structure.prior to its issuance,alto requires the applicant for such permit to fib a signed statement Mel he or she is licensed pursuant to the provisions of the Contractors License law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or the he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant fore permit subjects the applicant to a civil penalty d not more then five hundred dollars 15500D. ❑ I,as owner of the propend or my employees with wages as their sole compensation,wM do the work,end the structure is not intended or offered for sale(Section 7044,Business end Professions Code:The Contractors License Law does not apply to an owner of properly who bolds or improves thereat and who does such work himself or henel or through he or her own employees,provided that such improvements are not intended a offered for sale.B,however,the building or inprovemem is sold within one year of completion,the owner-0uilder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ 1,es owner S the progeny,em exclusively contracting with licensed contractors to construct the project(Section 7044.Busies and Prde®ds Code:The Contractors License Law does not apply to en owner of property who builds or improves thereon end who contracts for sod projects with a contrada(e)licensed pursuant to the Contractors License Law). ❑ I am exempt under Section: 8.S P.C..for this reason: Date: Owner I do hereby certify Oat I am aware d end understand the requirements of California Neagh end Safely Code Sections 25505,25533.end 25534.end thal I or any Mum building occupant wit/wR riot(circle one)need to comply with said state codes and the requirements for e permit for construction or modification frond's Air eaty eroprnent District.Residential constnaion applications are exempt fmm these Provisions. Date: Applicant: WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury aro of the following declarations; ❑ I have and oris maintain a certificate el consent to self-insure for waken'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 veil maintain workers'compensation insurance,as required by BeWon 3700 of the Labor Code,for the performance of the work for which this permit is issued.My workers'compensation insurance canter and policy number are: Carver: Policy Number. (This section need not be completed it the permit is la one hundred dollars/5100/or less.) ❑ I certify the in the performance of the work for with this permit is issued,I shell not employ any person in any manner so as to become subject to the workers'compensation laws of California.and agree that B I should become subject to the waiters' compensation provisions of Section 3700 of the Labor Code.I shall forthwith comp wth those previews. • Dee: Applied: Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject an employer to criminal penalties and civil(Mu up to one hundred thousand dollars 161040001 In addition to the cost of conpensatlort damages as provided for In Section 3706 of Me Labor Coda,Interest,and attorney's/see CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is a wrensdion lending agency ler the performance of the work to which the permit is issued(Section 3097,Cl.C), LENDER'S NAME LENDER'S ADDRESS: I certify that I have read this application end este that the above information is coned.I agree to comply with all dry end county ordinances and stale laws reeling to bilkp construction and hereby adherbe representatives of this My to enter upon the above-mentioned properly nn vv for inspection purposes. d U�•s�1.�-ATEREGEFFa"r' 01 00177751-00177781 T E=ST 143.00 Print Name OfliE: 03!08/9` 'I11E: 09:5x3 Dale: Signature of OwnedAgent/Applcant/Contrador (515146.WP) White-Building&Safety:Green-Ale:Canary-Appicsnl:Pink-Revenue:Goldenrod-Assessor CONSTRUCT ION AND PLANNING POOL ..rA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 4 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Form`s 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe.Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing " 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe.Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING: 224 E 16TH ST uMT: B CITY OF COSTA MESA — BUILDING PERMIT L'Grun LVLJ; r V 1 .1Z00 OWNER'S NAME IF KNOW GENE ROBERTSON ADDRESS: SAME PERMIT NO; P 071286 PLAN CHECK NO: N CIL),.• d : IN n urn ; I.3 CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE; NEW APPL.MMLDio ADDRESS: JOB DESCRIPTION ; 690SF 1ST FL, 1200SF 2ND FL, 445SF GARAG SQ FT: ARCNIrtCFmmemEER: TAYLOR ARCH UGMD, C14978 ARMOR ENG.'S ADDRESS: 234 E 17TH ST ulT: 203 CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 /M-1 C.M. CA 92627 camucrarsMYYt: VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS ; REF; B-71282 " GARBAGE DISPOSAL " comnronmam 1048 IRVINE AV +r****a<*;E*1F*****4<*r**N******** -.'Ric***+r***r+r+E;E+r***vu+rrac..c<*9r.Erik****<*****&(-4E«4535**yE ADDRESS: N. B . CA utNO_ 658963 Z ONING R EQU I R EMENTS 92660 uta: 363 SE TBACKS UCENSED CONTRACTORS DECLARATION:I hereby affirm under pe al),of perjury the I am licensed under provisions of Chapter 9 (commencing with Section 7090) Deleon 3 d the Business and PMaeeiau Code•and my kens,w in full law and ell / MAIN BUILDING ACCESSORY BUILDING em uc.NO.: '4.) [�7l)'g Lie.CUSS: B uc.No.: 65 963 / EXP ; IQ �� FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN ci �11 5h IIIn ^ LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN bb 1 cwpaO« RA A4 S ReuILOER ECLARATION:Ihereby affirm under penally dperjury the lemexempt horn the Contractors License Law for the PARKING REQ: PROV; PARCEL ; 42520117 ZNE; REF NO: weg reaeon(Section 7031$Bus ess and Professions Code:Any aty or county which requires a prmit to construct.ad.improve, PARKING PLANNING NOTES> demolish.or repel any structure prior to its issuance,also requires the applicant for such peon!to Nee signed statement that he a she 'v licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of Dimon 3 of the > ueoese end Professions Code)or that he or she is exempt therefrom arid the basis for the alleged exemption.My vitiation of Sedvn ***********************-*******************************************************if .031.5 by any eppicant for a permit subjects the appliwnl to a dol penalty o not more than live hundred dollars[MOD. DEVELOPMENT SERVICES R EQU IR EMENTS E: I,as owner of the property or my a mpcyees with nestles then sole compensation,will do the work,and the structure is not intended or altered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to en owner d property whobrudsorinprov«threw.and who does such work hmseuaherswawoaghhlsaiwownemployees.provided thatwch ZONING APPROVED BY DATE; W proemeas are not intended or offered Sr sale.B.however,the building or W Provemere S sold*thin one year of completion,the ownerbuilder will have the burden of proving he or she did nd build or improve for the Pmpoee Or sele). BUILDING APPROVED BY ❑ I.as owner d the property.am exank ly contracting with licensed contractors to construct the project(Section 7044,Business end DATE; Professions Coro:The Contractors License Law does not appy to an owner of property who builds or improves thereon and who J mnaeots foraW)Pralerte with emrrada(s)l weed pursued tothe Corarsctors lkerae law). AH. IGATTON ISSUED BY: DATE- E—• MI r ❑ I amexernq under Section: B.SPC., or this realm: 4444054i-}dA£41:;44C#J4R # a:0.a1& >- #& &(" *499i•Si YSFuJi i&** n: tai***-.K 3C-S4C#*+:4-*#+F45***19$994-41,* 4e. - +-45* Date: Owner: •' > rY :.rT5 444:e:.l:4:****** *******r******it**+.r*************s****s[*******.r** tgaRtiII I do hereby certify that I am aware d end understood the requirements of hr Cationic.No and Safety Code Sellaend s 25.505,25533. II8N N F E E S U M M A R Y STRUCTURAL SEGMENT;N 25534.and that I or any noun building occupant.will/will not(circle one)need to comply with said stale codes end the requirements for m a permit for caonh uctionorad'dralionanlheAsaualtylraneperwnt District.Residential actlnxlonepplca ors we mind from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 7 , 00 Date: Applicant: ` 5.)1 SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following declarations: PLAN ❑ Ihave and eiImaintain certificate otensed toself-insure for waken'wmprrWon,esprwoedfomo Bormby ISSUE FEE 2000 Code,for the earthman.ou»workforwhichthisprmhisissued. BUILDING—DIV—` PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ Ihave and nil mant:nworkers'compeweininsurance,asrequired bySection 3700dmeLabor Code,fathe perormanceothe TOTALS > 7 , 00 20 . 00 0 , 00 27, OV 27 , 00 00 work for which this permit is issued.My workers'compensation Insurance carrier end policy number are: caner: REVENUE DIVISION TOTALS--> COLLECTED: , 27 , 00 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK lit section need not be completed y the parrot is for one hundred dollars fit00/or less) 27 . 00 I with that in the perfomance of the work for which this permit is issued.•1 shall not employ any person in any manner so as to become subject to the workers'compensation laws oCaltornle. end rpwtal h l o become abject to the workers' *****************************************************************_*******+R****** cornpensati rovisoof nod n 3700 the Labor Code,I shell fonhenh ply with provisions. n�� ( IND I V IDUAL F E E BR E AK DOWN i. 31 4\. Applicant: IAfA�1s Warning:Failure to secure °dews'coiopsnsation coverage Is unlawful,end Ism t an employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST chit gnu up ro one hundred thousand dollars(OIIX{UOO),In sddldon no the coal of compensation,damages as provided for In Section 3,Osotmmw eLorco ,mtrl aaendarc � omeyroes. PLU 1 FIXTURE SET/TRAP W/PIPING S BACKFLOW 7 . 00 7 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perFsy that there is a construction lending agency for the END OF FEES performance of the work to which this permit is leered(Section 3097,C .C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and date that the above information is coned.I agree to comply whh all city and county ordinances and state laws relating to building wndradion end hereby authorize representatives of this city to enter upon the above'memioned property ' for inspection Purpwes. a , •'I Print Name ,. Dere: 1/ G4n•( C0177317-001'731,2 TOT 27.00 fi SignatureDATE: 02/27/95 TIME: 10:47 dOwwr/AB�;� d; T- �•or (5151-45.WP) White-Building&Safety;Green-Fle:Canary-Applicant;Pink-Revenue Goidenrod-Assessor CONSTRUCTION AND PLANNING / POOL 'A 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 UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 5 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, El Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final . 13. Roof Drains _ 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling _ 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80, FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ,fir �, ,c_r7 Jam- ., 35. Final Gas Pipe-Test � r Zi .S� mr� 2 � 36. Hood or Canopy (n ZT�±5.-76- 2Mk 37. Final Factory Fireplace 38. Final Plumbing I :?-9‹ 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low 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 ADDRESS OF BUONO: 224 E 16TH ST UMT: B CITY OF COSTA MESA — BUILDING PERMIT rnnrt IVv; rt ut. zo..) oNNEWSNANEIF KNOWN: GENE ROBERTSON ADDRESS: SAME PERMIT NO: M 071285 PLAN CHECK NO: N uvv : ; IN ,D carr; n CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: NEW APDL.WIUNG ADORES& JOB DESCRIPTION : 690SF 1ST FL, 1200SF 2ND FL, 445SF GARAG SQ FT: ARCKIrECT OR ENGINEER: TAYLOR ARCH ucxo.: C14978 ARMOR Dal ADDRESS: 234 E 17TH ST UNR: 203 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 C.M. CA 92627 CWIUACTarSNAIe VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS; REF: B-71282 caranAcmm MAILING 1048 IRVINE AV ***+a*+t+r+Fit*+a;r+rrt*+r*a,F**************************rani****; ,r.;rs**ir**x**+t*+f+r•+l.*a.r*+:***** ADORE% N, B , CA uc.ND.: 658963 ZONING REQUIREMENTS 92660 MIT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaky of prtjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Division 3 o the Businessand Professions Code,and my licensee in full tau and effect. MAIN BUILDING ACCESSORY BUILDING �rykC.NO.: UC.CLASS: B UC.NO.: 65896 EXP : FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN I(�/�) 421 I(�, //S LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN d/ Contractor: //"' OWNER BUILDER DECLA ATION:I hereby affirm under penaly of perjury that I amexemp from thecontradom License Law to the PARKING RE PROV; PARCEL: 42520117 ZNE: REF NO; blowing reason(Section 7031.5 Business arid Professions Code:Any ciy or county which requires a permit to construct,aper,improve, PLANNING N TES> demolish,or repair any armature.pier to is issuance,also requires the applicant for such permit to file a signed statement that he or she ".licensed pursuant to the provisions d the Contradas License Law(Chapter 9(commencing wih Sadiron 7000)of Division 3 of the > nineaaed protonic."CodelorthS he a she i exempt therefrom and the basis for the alleged exemption.Any violating Strike ' ******************************************************************************* 331.s by any apptkant for a permit subjects the applicant to a evil penally d not mere than the hundred dollen MOOD. DEVELOPMENT SERVICES REQUIREMENTS O I,as owner of the property or my employees arab wages as their sole compensation,will do the work,and the structure is not intended or oferedfor sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to en owner of popery ZONING APPROVED BY DATE: win who builds or improves thereon.end o does suds work himself or herself or through he or her own employees.provided that such improvements are not intended or offered for sale.S.however,the building or wayear d dio i pronent sold within one compin,the ownerbuiber wig have the burden of proving he or she did not build or improve for the purpose of sale). o I.es owner of exclusively property,am excontracting with buto wnsed outworeconsortia the project(SBusinessn 7044,Business ad BUILDING APPROVED BY DATE; Professions Coda:The Contractors License Law does not appy to an owner of Progeny who builds or improves thereon and who (� contracts for such projects with a mmrector(s)licensed Pursuant to the Contractors License Lew). APPLICATION ISSUED B Y t - /(� DATE: 17 C O I am exempt under Section: B.$P.C.,for this reason: ********************** .. . . - ' - - - - 'emir . . . . . *. ********** * 44-34 ****************************************************r-***************** **** -*** Date: ONS: LEGALIZATION; N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby unify that I am aware of and understand the requirements of California Neehh and Safely Code Sections 25505,25533.and 25534,and that I a any future building arvpen will'will not(droit one)need to comply with said pate codes end the requirements for epalm*for construction armdifiiulionhom the Ar u anegemenI District.ReekantiNootpmdien appinatire ere exempt fromtese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 9 . 00 Date: Applicant 25% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under fy of pe perwrjury one of the fatowirg dedaretions: ISSN IUILE FEE 15 , 00 El Imes and heerfinceefKtwadurawhito hhself-insure tor workers'compensation.mprovided ler by section 37094m.labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the performance of IM work for which this permit is issued. I have end coil maintainworkers'compensation insurance,as required by Section 3700 o the Labor Code,ler the performance o the TOTALS----> 9 00 15 , QO 0 00 29 00 24 00 00 work for which this pend is issued.My workers'compensation insurance carder and policy number are: Cartier: REVENUE DIVISION TOTALS--> COLLECTED : 24 . 00 OVER/SHORT; . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK his section need nor be completed I the panne is for one hundred dollars($1001 or lent) 24 . 00 , I certify tml in the performance of the wok for which this permit is issued,I shag nor employ any person in any manner so as to became subject to the workers'compensation laws o u California,and agree pat f I should become subject to the waken' *******************.******************************************************ef***** •• Denaatre ian provisions of ion ofLabor 3700the Code.I shall forth foals mpynn those provisions. INDIVIDUAL F E E BREAKDOWN sue: APPlicant At Ing:Felursm urawo ere compensation coverage Is unlawful,and shall subjection employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil lines w to ono hundred thousand dollars($1040001.In addition to the coat of compensation,damagesprovided for In S«don32asofma aborcma,lntanatand aroaysfsa. a MEC 1 INST FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 CONSTRUC11ON LENDING AGENCY: I hereby affirm under penalty of perjury the!there is a ocesmidion lending agency for the END OF FEES performance of the work be which this permit is issued(Section 3097,Ci.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have mad Ni application and sale that the above information is coned.I agree to comply with at city and county ordinances and state laws Sethi'to beariig construction end hereby authorize representatives of the city to enter upon the above-maenad property for iaPadian PUMgeet `� 'Thdi �LPC.PN_ a ^/ �7�� S 0100177324-00177324 TOT 24.00 Date: �1DATE: 02/27/95 TIME: 10:52 • Signature of Owner-crr A.,-.11W/V, der tractor (5151-46.W P) White-Building A Safety:Green-the:Canary-Appicem:Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL ,'A APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Poie 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 fest ' 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. I 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 T p 2t /���Y�'�'i FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace 0 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: /' 9C e sVta M 34. Final Heating & Air Conditioning d Zet 57 /? 1-73 -'?1 35. Final Gas Pipe-Test - ! -2/ _T5- (1 j VSs_ 1 r,4Jr _ 36. Hood or Canopy ,, 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date I • ADDRESSOr WILDING: 224 E 16TH ST WIT: B CITY OF COSTA MESA — BUILDING PERMIT F ,1-UI ^7U; In UIl.oc OWNER'S NAME IF 10l0101: GENE ROBERTSON ADDRESS: SAME PERMIT NO: M 071366 PLAN CHECK NO: N bvV s ; N a ur'r : I CONSTRUCTION TYPE; PERMIT TYPE: MEC PURPOSE; NEVI APPL.MA1W ADDRESS: JOB DESCRIPTION : SUPPLEMENTAL TO M- -1— SQ FT; ARCKRECT OR ENGINEER: TAYLOR ARCH TKO.: C14978av\-112 ARCH.OR ENG'S ADDRESS: 234 E 17TH ST um: 203 CLAIM VALUE: CALL—VALUE; GROUP OCC; R-3 /M-1 C .M , CA 92627 CONTRACTORSfW : VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS : REF: B-71282 " GARBAGE DISPOSAL " coNTRACTORSMNUtM 1048 IRVINE AV *******+n**+ ******-><-***-,•**+r*****acaE***.N..>r.0 . '.**,E**aF->E.R*** . .. *;Fx*;'r -aF*.->raFaFaEaF*;r.a:x*******u. ADDRESS N.B . CA UC.NO.: 658963 ZONING REQUIREMENTS 92660 WIT: 363 SE T BACK S UCENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000)of Dweion 3 ofIhe Business end Profeesios Code,and my licensee in full force and effect. MAIN BUILDING ACCESSORY BUILDING Cm UC.N0.: UC.CLASS: 9 UCC NO.: 658963 EXP ; FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN D:ie: y Contractor; "LA L LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN OWN•' BUILDER DECLARATION:I hereby affinn under penalf of PeriulY than am exem19 from the Contractors License Law for the PARKING REQ; PROV: PARCEL; 42520117 ZNE; REF NO; f. . ' .reason(Section 7031.5 Busnees and Professions Code:Any OM or county which requires a permit to construct.alter,improve. PLANNING NOTES> demolish,or recce any structure,prior t0 its issuance.also requires the applicant for such permit to file a signed statement that he or she S licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of()Melon 3 of the > Business end Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section ****************************************************44***49***************4 :**** 70a1.5 by any applicant fora permit subjects the applicantal to a ciel penalty of nmore than fee hundred dollars 135001). D EV ELOPMEN T SERVICES REQU IR EMEN TS ElI.as owner Of the propend 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 end Professions Code:The Contractors License Law does not appy to an owner of properly who builds or improves thereon,and who does such work Nmcelf or herself a through he a her own employees.provided that such ZONING APPROVED BY DATE: improvements are not intended a offered for sale.K.however.the building or improvement is sold within one year or completion,the owner-builder will have the burden of proving he or she dM not build or improve for lhepurpoee of sale). BUILDING APPROVED BY ❑ I,as owner of the properly,am excitant*contracting with licensed contractors to construct the project(Seders 7044,Business and DATE; Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who • ,, cio .ctssuchpraiseswithartmdo(s)IcensedpuauaatotheContractorslicenseLaw). APPLICATION ISSUED BY: nfacoDATE ; ❑ I am exempt undo Section: B.A P.C..for this reams: *************************-es****M****. 3939************************** v 4 *4 *********************************************************************.'** -*3949*** Dale: Owner: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT: N I do hereby certify that I am aware of and understand the requirements of Calaania Health and Safety Code Sections 25505,25533,and ae" it� any °occupant ibneed r wth said end :exp"° pmmaons ormm from Wanapemengstrt.R eandion xwaMtfrom BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING praasiona. PERMIT 13 . 00 Date: Applicant: 25% SMIP/PION—RES PLAN - WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE 4 , 50 ❑ I have fand rthepeaintainceoftca°ofonsentoselfinsureforworker�compensalen,asaccededforbySection370odthelabor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the performance of the work for which this pemha'n issued. TOTALS > 13 , 00 4 , 50 0 . 00 17, 50 17 . 50 . 00 I have and ail maintain workers'compensation insurance.as required by Section 3700 of the labor Code,ler the pedamarhce of the work for wtnci this permit is issued.My workers'compeneaim insurance miner and PART number we: Caller: REVENUE DIVISION TOTALS--> COLLECTED; 17 , 50 OVER/SHORT; . 00 Pdcy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK s section need nor be completed y the roma is ler are hundred dollars(31001 or less.) 17. 50 II I redly that in the performance of the work for which this Derma is issued.I shall not employ any person in any manner to as to become subject to the workers'compensation lawn of California.anda'thgree that alaltouM became subject to the workers' ***************************************************3939******.******************** • sensation provisions of Section 3700 of the labor Cada I Mall forth comply wait Nose provisions. INDIVIDUAL F E E BREAKDOWN nae: —I Applicant: t We ng:Faillurtosecure workers,compensation coverage hunlawful,and shell subject anemployer tocriminal penalties and TYPE QTY DESCRIPTION UNIT COST TOTAL COST -I fines w to one hundred thousand deers 07o4000),In addition to the coat of compensation,damages as provided ror In Section 3706 of to Labor Code,interest,endartomey'l fees. MEC 2 FACTORY FIREPLACE 6 . 50 13 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the END OF FEES performance of the work for which the permit is issued(Section 3097,Cir.C). LENDER'S NAME: LENDER'S ADDRESS: , • I certify that I have read this application aid state that the above information is correct.I agree to campy with all city end county ordinances and state laws relating to build/lig/y�na�tru - a/yd hereby ashore tawee of this city to enter upon the above-mentioned properly for inspection purposes. /TFI -r/A t" I^� -f!` / 1 �PV. tut" 'All 3-2-9j- -2-9 j DATE 303/69/5)5 TIME: 09 55 17.:0 Dae: 7 5gnsture d• r�T�"...'.. .Ired• (515146.WP) While-Building&Safety;Green- nary-Appimm:Pink-Revenue;Goldenrod-Assessor ,, :CONSTRUCTION AND PLANNING POOL & 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 {{ 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 j '' 9. Water Pipe-Undrgrnd. - - 60. Backwash Lines, P-Trap, ❑ Undrgrnd. ') 10. Structural Floor 5Ystem ' - 61, APPROVAL TO DECK - 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ` IIII 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 4__tt ayc .n# 4 at. /0 34. Final Heating& Air Conditioning of .1 3 -54s- 35. Final Gas Pipe-Test 36. Hood o5 CanopyJar �� 37. Final Factory Fireplace 6-i-9sr 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING: 224 E 16TH ST WIT; B •�'. CITY OF COSTA MESA — BUILDING PERMIT rcnrl rlV; t. u , sa o't t ,WNERSf EIFKNtT: GENE ROBERTSON 1 Si ADDREss SAME PERMIT NO; E 071289 PLAN CHECK NO; N kali,: 3 ; IN Durr ; n CONSTRUCTION TYPE; PERMIT TYPE; ELE PURPOSE: NEW APPL.IW UN0 ADDRESS: JOB DESCRIPTION ; 690SF 1ST FL, 1200SF 2ND FL, 445SF GARAG SQ FT; ARCNDEc7ORENaN R: TAYLOR ARCH mist: C14978 ARCM OR END'S ADDRESS: 234 E 17TH ST UMT: 203 CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 /M-1 C.M, CA 92627 CONIRACTowsNAME: VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS: 2235SF SINGLE FAMILY RESIDENCE CO1TRACTOR'SYuuNG 1048 IRVINE AV **** ? ******+F***r-*****RE**ItRF*********atx**aF***ark****4>aFa *************w4******ap**** ADDRESS: N.B . CA UC.NO.: 65896 3 Z ONING REQUIREMENTS 92660 PIT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (Commenting with Section 7000)of Dhienn 3 of the Business and Professions Code,and my license is in tun force mM effect. MAIN BUILDING ACCESSORY BUILDING CITY LIC.NO.: UC.CLASS: B LIC.No. 1589 3 EXP ; FRNT; FT IN REAR: FT IN FP.NT ; FT IN REAR; FT IN y.�l � LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN QBUlLDd ContractorCLARATION:IherebyeffirmunderpeneXydperjurylh°tit°mexemglmmlheConu 'umectorsLeaLewforlhe PARKING REQ: PROV: PARCEL : 42520117 ZNE; REF NO; reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to construct,alter,improve, PLANNING NOTES> demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she > is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7030)of DNsion 3 of the Business and Professions Code]or that lie or she is exempt therefrom and the baso for the alleged exemplion.Any violation of Section *******************************jF.*+F***if*************ih****if**4*******4*******{p4**. 7031.5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred d01W IS5000.. DEVELOPMENT SERVICES REQUIREMENTS 0 I.as owner of the property or my employees with wages es their sole compensation,will do the work,and the structure is not intended or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply oy • to an owner of prope whobulds or improves thereon.end who does such work himself or herself or through hie her own employees.provided thel such ZONING APPROVED BY DATE; improvements ere not intended or offered for sale.It however.the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). BUILDING APPROVED BY ; t' DATE: o I,as owner of the property.am exclusively contradaig with licensed contractors to construct the project(Section 7044,Business and Professions Code:The Contractors License Law does mol appy to an owner of property ala builds or improves thereon and wt,o contracts for such projects with a rontador(s)licensed pursuant to the Contractors License Law). r APPLICATION ISSUED BY- . DAT E o l am exempt under Section: B.A P.C.,for this reason: ************************************* ******************** **** *" * .*4 ******************************************************************** ,****4***** Dale: owner: LEGALIZATION;N F' ET SUMMARY STRUCTURAL SEGMENT:N I do hereby certify that I am aware of and understand the requirements of Caliama Heath and Safety Code Sections 25505,25533,and 25534,and that I or any future building occupant will/wit not(circle one)need to comply with said state codes and the requirements for apermit for caowdianammtcaltonlamthe Arhy anagemaaDistrm.Resieemialconatrudtonappraatt eareexemptfromthese BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING Provisions. PERMIT 71 . 4 0 Date: Applicant: PLAN 50% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby dram under penalty of perjury one of the following declarations: ISSUE FEE 15 . 00 ❑ I have and MI maimain a certificate of consent to selhinsure for workers'compensation,as provided for by Section 3700 of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Coda tor the performance dthe work fawhich this panne'tsissued. TOTALS----> 71 , 40 15 , 00 0 , 00 86 . 40 86 . 40 . 00 o I have and will maintain wakes'compensation insurance,es required by Sedan 3700 of the Labor Code,for the performance of the work to with this permit I.issued.My workers'compensation insurance earner and policy number are: Gamier: REVENUE DIVISION TOTALS--> COLLECTED; —86 . 40 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This sed/on need not be competed I the permit is for one hundred dollars($1001 or less.) 86 . 40 ea I certify that in the performance of the work for which this permit is issued,I shall ltd employ any person in any manner so as to became eu' to ilia workers'compensation laws of California.and agree that Bbecome I kit bee subject to the workers' *** if ********* ***** tf ****** *************4*******s*****************4****1E********* ions d Swim of the labor Code,I shall fortcampy hwth Ileions //��/ I N D I V I D U A L F E E B R E A K D O W N Warning:Failure to urs workers'compensation coverage le unlawful,and shall abject an employer to criminal penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil Dna W to on hundred thousand dollars($104000),In addition to the cost of compensation,damages as provided for In S°Cdon3706ofthe Labor Code,mterapand atromey'alees. ELE 1 FIXTURES, LIGHTING 1 ST 20 EA, . 75 . 75 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the ELE 1 REC EP T/OUTLET 1 ST 20 EA. . 75 . 75 performance of the work for which this permit eissued(Section 3097,Cir.C). ELE 1 RECEPT/SWITCH 1 ST 20 EA. . 75 . 75 LENDER'S NAME: ELE 1 MOTOR/POWR APPARATUS 0 , 0 — 1 .0 HP 3 . 00 3 . 00 LENDER'S ADDRESS: ELE 1890 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT . 03 66 . 15 I certify that I have read this application end state that the above information is coned.)agree to comply with all ply and countyordinances END OF FEES and nate laws relating to building Co^sttcudf^ hereby authorize of of this city to enter upon the above-mentioned property for inspection purposes. m i nll kumA in Print Name / Date: __ 5 01 00177318-00177I18: lGOT 86.40 Signature of Ovl44 ontred / c 8 (5151.46.WP) White-Building&Safety;Green-Fle:Canary-Applicant;Pink-Revenue;Goldenrod-Assessor --M CONSTRUCTION AND PLANNING-; POOL 6. .31).4 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-Undrgtnd. 54. Forms -.4. Electrical Conduit_Undrgrnd. C- 55. Electrical Bonding 5. Steel Remforcerrient 56. Rough Plumbing & Pressure Test i 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. 1 , r ;8. Foundation: 59. Gas Pipe, 0 Undrgrnd., Test ' - 9. Nater Pipe-Undrgrnd.r 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 -I 63. Heater & Vent-Final _ 13. Roof Drains '11_ 64. Plumbing System - Final 1 14. Rough Plumbin9. ,-I 65. Electrical-Final i 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough :Wirng Eiectric :y �%�f/�� 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 z 20. Rough-Factory:Fireplace I a..: - Li `'. `T APPROVAL'S:'_', Permit# 21. Ducts,in Structure -1 -F. - t 1 - _ 70.;Underground Hydro 22. Ducts, Ventilating: 1 „....., - 57 'c' " 71. Prod 1.14.Pi pin t1 Gas 0 Oil A 23. Gas Pipe-Rough&Test ;T ..1 - a., - 72. Underground Fiush I 24. Roof Framing I 2 i;' _I ' 7.; Undergnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - - 74. Overhead Hydro I 26; T-Bar Ceiling IStructurall & Monocoat r� y 751 Dry Chemical _• 27. Frame and Flashin 9 `r .• -. .. 76. DryII' • ' rStandpipe- 28. Lathing& Sidin` .. i + r. S - •'' ;'' rgi, r�l�:-, O �I �I !•k r.: 7?; FXEDi�kSTEM FINAL 29. Insulation x• .„) - i. i.., - I 1 ;-ii ,; iJ triu I r;: t Z8, FIRE PREY. FINAL 30. Drywall.Nailing::: ,_ Iii -_ I I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Goat •- ; 79'. FINAL INSPECTION 32. Electrical Power Meter-Final b%&?%4- 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS 224 E 16TH ST OANEWS aElFlwwm: GENE ROBERTSON UNT: A I a- CITY OF COSTA MESA — BUILDING PERMIT 1-'C.11.73 14:J; L vyiZ f , ADDRESS SAME PERMIT NO: E 071279 PLAN CHECK NO: N Vt./V i : Al Ovrr ; rJ CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; NEW ADPL.MMWIG ADDRESS: JOB DESCRIPTION : 690SF 1ST FL, 990SF 2ND FL, 445SF GARAGE SQ FT: ARCNRECT OR ENGINEER: TAYLOR ARCH UC.No, C14978 MCN.OR ENG.'S ADDRESS: 234 17TH ST OMT: 203 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 C ,M, CA 92627 CONTRACTORSNAME VNE DEVELOPMENT ( 714 ) 645-7588 COMMENTS: REF: B-71278 caITRACTORSMNUNG 1048 IRVINE AV ***********+ ****+ax*****'*********K'«*******x* .*.*-,;.; *x.x*******->F#.>E..,*ar.,cx **x**.*.*x**** ADDRESS: N,B . CA UC.ND.: 658963 Z ONING REQUIREMENTS 92660 uMT: 363 SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury the I am licensed under provisions of Chaper 9 (commencing with Section 7000)of Division 3 o the Business end Pmlesaiooa OOde,and my(keno,is in full force and effect. MAIN BUILDINGACCESSORY BUILDIN.,G CITY UC.No.: - LIC.CLASS: g UC.No.: 65896 EXP ; FRNT; FT IN REAR: FT IN - FRNT: FT IN REAR: FT IN 1 r Conaaaor: . LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN OWNS: SUILDE' DEC RATION:I hereby affirm under penalty o perjurytha I am exempt from the Contractors License Law for the PARKING REQ; PROV; PARCEL ; 42520117 'ME; REF NO; folio.' .reason(Section 7031.5 Buaicen and Professions Code:Any city or county which requires a perm'10 mrotruct alter.improve. PLANNING NOTES> olish,or repair any structure,prior to its issuance,also requires the applicant for such permit to Re a signed eletement that he or she is licensed pursuant to the prwiaime of the Contractors License Law[Chapter 9(commencing with Section 7000)of DMeion 3 of the > liminess and Professions Code]or that he or she is exempt therefrom end the basis for the alleged exemption.My violation of Saxon *******************{E******x****43€****46**x******3if*****xx*€****x***4********iter 4A 9€ /031.5 by any appliranl fora permit subjects the applicant to a civil penalty o not more than five hundred dollars 15500).. DEVELOPMENT S E -P. V ICES REQUIREMEN TS o an owner of the propend or my employees with wages astheir sole compensation,will do the work.end the stricture is not intended or offered for sale(Section 7044,Business and ProfessionsCode:The Contractors License Law does not apply 10 an owner d properly who buids or inproves thereon.and who does such work Nmself or herself or through his or her own employees.provided that such ZONING APPROVED BY DATE improvements are not intended or offered for sale.ff,however.IM building or improvement is sold within one yew of completion.the owner-builder will have the burden aproving neor she did or w not w «m or improve sums o.. eal.). BUILDING APPROVED BY ; DATE; —a- 0 I.as owner d the properly.am exclusively contradnm g with licensed contractors to natruct the project(Section 7044,Business end / ProfeacontractonsCode:The ContmaomucenseLawdoesnawpytoanownerapropemwrowima« mproesma.aand wro APPLICATION ISSUED BY; DATE; 2 / 2, 9 � r Professi for such pnheCo coral a mntrense L w doe. Wnuw to the wnermos LamsLicense w Law). ►►IEEE ❑ I am exempt under Section: El.A P.C..tor this reason: ' ************************************ *4*ifx*N******+F.c***************xi- x**-if x*xx ***************************************************x**************************x Date: Owner: Idohereby certify thatiamaware oand udrequirementsHealth CaliforniaomialandSafeyCodeSeacts25505,pc '1,end LEGALIZATION:N Ft E, SUMMARY STRUCTURAL SEGMENT:N 25534.and that I or any tenure building occupant will/wit not(circle one)need to comply with said ams codas and the requirements for a peri'fagnaVuctionor modification from the A'i tWy aagermnl Diploe Residential construction applications are exempt from Inds BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 64 . 05 Dale: Applicant: 50% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedVCons: PLAN ISSUE FEE 15 , 00 o 1 have Code,bndwRmaintnceofinmeofconsenthoselfinsurehaworkes•compensation.as provided for bySaAnn3700of the Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,for the performance d the work for with this permit is issued. El Ihave and wiimaintanworkers'compensatoninsurance.arequired bySedlcn3700ofthe Labor Code,for theperformanceofthe TOTALS ---> 64 , 05 15 . 00 0 , 00 79, 05 79 . 05 00 work fortieth this peon'is issued.My wakes'compensation insurance center and policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED; —79 , 05 OVER/SHORT; . 00 Perry Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ,is section need not be compered y dor permit is toren*hundred dollars(5:001 or less.) 79 . 05 I certify that in the performance of the work for which this peon'is Sued,I shall no.employ any person in any manner so as to becprne abed 10 the workers'cempenaati0n ewe of California.and agree that'1 should become subject to IM waken'ojsc **.)y.********.)(..**w.****.K.**.N.Ry..y..K..)♦**..K******,k.,iy., ***. .* ** ************************x*****x cempensation prove' a seam 3)00 a the Labor cove. mall loon_ ptn campy Inca prwiek»,a. INDIVIDUAL F E E BREAKDOWN e: f ti< Applicant: /IA ng:Falure to secure workan'conpersadon coverage lsun/eWN(and shall subject an employer rou/Mral penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fins W to one hundred thousand dollars($10Q000).In addition to the coat of compensation,danMges as provided ler In Section 3705 el the labors code,mtweagaed attorneys fees. ELE 1 FIXTURES, LIGHTING 1 ST 20 EA, . 75 , 75 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction ending agency for the ELE 1 RECEPT/OUTLET 1 ST 20 EA, . 75 . 75 performance othe work for which this pane is issued(sedin3097.Ch.C). ELE 1 P,ECEPT/SWITCH 1 ST 20 EA, . 75 . 75 LENDER'S NAME: ELE 1 MOTOR/POWR APPARATUS 0 , 0 — 1 , 0 HP 3 , 00 3 , 00 LENDER'S ADDRESS: ELE 1680 NEW RES BLDG FOR 1 OR 2 UNITS/ SQ FT . 03 58 . 80 I certify that I have read this applicaeon and wale that the above information is coned.I agree to comply with ell thy end aunty ordinances END OF FEES and stale lava relating to bui construction and hereby authorize representatives d the thy b enter upon the above.mentoned property for inspection purpnaa. • / Print Name • F3 T 75.0., V IJr ons.; 4,12-1/1� 01 00177317 0D1r7317 7tF1t: 02/27/995 PAP: 10:48 Signature d Owner/Agent/App mdc7� (5151'46 WP) White-Building&Safety;Greene;Canary-Appicant;Pink-Revenue:Goldenrod-Assessor 'CONSTRUCTION AND PLANNING POOL 'P . APPROVALS Permit# Date Inspector APPROVALS Permit# I Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd- L 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrjid. 54. Forms ' ' • 4. Electrical-Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical`UFEFL.Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings`- `�;;j �' 58. Electrical Conduit-Undrgrnd. • - 8. Foundation • a 59. Gas Pipe, 0 Undrgrnd., Test I 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System f .' 61. APPROVAL TO DECK ' T t , 11. Property Sewer Linen& House Connection 62. Backwash & Receptor-Final 12. Sewer'Cap / 63. Heater & Vent-Final 13. Roof//Drains "T 64. Plumbing System - Final 14. Roue Plumbingt - 65 Electrical-Final 15. Rough Electricai-Conduit 66. Solar System-Final 16. Rough Electric4NiririgW a' 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough ElectricatT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning a. FIRE DEPT. REQUIREMENT c' 20. Rough Factory Fireplace ' :;, - - ;� �' - ._' APPROVALS- _ Permit# 21. Ducts,in Structure •• •- 70.''_Underground Hydro w22- Ducts, Ventilating - - . '. s 71. Produrt?Ripingt'0 Gas 0 Oil 23. Gas Pipe-Rough & Test ; -• - " 72. Under _ ground Flush "24. Roof Framing - • _ 73 Undergrnd.Stdrage Tank OGas 0 Oil 25. Roof Sheathing 74: Overhead Hydro 26. T-Bar Ceiling (Structural) &Monocoat ,l - !7:: 75. Dry Chemical rli27: Frame and Flashing + �'� -176. Dry Standpipe. • 28, Lathing& Siding • ;.• 7 FIXED SYSTEM FINAL 29. Insulation • ' i 78: FIRE PREV. FINAL 30. Drywall Nailing r ` ;< •HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' j ' •_.• 79: FINAL INSPECTION 32. Electrical Power Meter-Final 6/20/5,312,11/// 80. FOOD CERTIFICATE ISSUED 33. Final Electric 7/aNotes: 34. Final Heating & Air Conditioning d/ 35. Final Gas Pipe-Test - 36. Hood or Canopy • 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40, Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Fri PROJECT ADDRESS: 224 E 16TH ST 0N1T: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 070877 .,OWN1's NAME: ROBERTSON GE1,1E H a ADDRESS: 536 SEAWAt.D• 'RD PERMIT NO; P 070877 PLAN CHECK NO; N GOVT: N SUPP : N CORONA DEL MAR,CA 92625 CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: CON ARCH/ENGINEER: ROBIN HAMMERS B& ASSOC, REG.NO.: 31"�2TO JOB DESCRIPTION : CAP SEWER SQ FT: ADDRESS: 234 E 17TH ST 205 C.M. CA 92627 CLAIM VALUE: CAL C—VALUE: GROUP OCC : R-3 / PERMITTEE: VNE DEVELOPMENT INC ( 714 ) 548-3072 ADDRESS: 1038 IRVINE BL 363 COMMENTS ; CAP SEWER NEWPORT BEACH CA 92660 ********+E**+e+E*******************+r*is*x****+r*******9E******asr*r* -**************+r*9r LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACK S CITY MC.: 0675 ST TELIC.:658963 CSS ' EXP; 12/95 Signature: MAIN BUILDING ACCESSORY BUILDING r• RS'COM ENSATIO DECLARATION: I hereby affirm that have acedicatz of consent o self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN . pensahon Insurance.or a certified copy thereof(Section 3800.Lab.C). L EFT; FT . IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ; PROV; PARCEL ; 42520117 ZNE: REF NO: 0 Certified copy is hereby furnished. 0 Certified copy is tiled with the city Building Division. PLANNING NOTES> > Jate: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS' OMPENSATION DECLARATION: (This section need not he completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in e perform. ce oft 'work for which this permit is i sued,I shaJMot employ any person in any manner so as to become subject to ill orke�C. .'n ion Laws of Cahfornia. ZONING APPROVED BY DATE: a `7 Signature: DTICE: .after ma g this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILD I NG APPROVED BY DATE; ode.you must ton i tin comply with such provisions or this permit shall be deemed revoked. ONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for AP PL I CAT ION ISSUED BY ; ( • ' DATE; i ®s r !which this permit is issued(Section 3097.Civ.C). ***********************************. * * ************************** .*.* LENDER: *********************************************************************** ******* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: I hereby aflirm 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 7 . 00 repair any structure.prior to its issuance.also requires the applicant for such permit to lite 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 2000 • 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 orolleredforsate(Section7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 7. 00 20 . 00 0 . 00 27. 00 27 .00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/hersell or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: " 27, 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 27 . 00 _ ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'Slate License Law).I am aware ******************************************.*****.***.***************************** that proof of their Worker's Compensation insurance should be provided to me. IND I VIDUAL F E E BRE AK DOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCR IP T ION UNIT COST TOTAL COST Dale: Oconee PLU 1 SEWER CAP / DEMOLITION EACH 7 . 00 7 . 00 I do hereby certify that I am aware 01 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 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 slate laws relating to building construction and hereby authorize repr enlatives of this city to enter upon the above-mentioned property r in ecllon uposPy 1 I /`I 1111A'cz/. `?1 00175561-00179561 1—(111— DATE:Date. Signature: DATE: 0112`/95 TINE: 14:19 Dr'.rs been .or Sociav Security a: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor _,i _ •`CONSTRUCTION AND PLANNING POOL . A 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. El-ectrical'Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. tectrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. :Footings' 58. Electrical Conduit-Undrgrnd. 81. Foundation 59. Gas Pipe, 0 Undrgrrd., 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 4-W_ 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 OGas 0 Oil 23. Gas Pipe-Rough & Test • • 72. Underground Flush 24. Root Framing • 73. Undergrnd.Storage Tank OGas ❑Orl 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bat Ceiling (Structural) & Monocoat 75. Dry Chemical • 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. . FIXED SYSTEM.FINAL 29. Insulation 78.-7FIRE 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 4--1 3 -9 5ST c.cz 36. Hood or Canopy A 37. Final Factory Fireplace' 4 _2 G_ 38. Final Plumbing y. -Qc c ` 7 • 39. Water Service-Final ,((-JJ 40. Gas Service-Final •• • 41. Solar Domestic-Final 42. Backflow Preventer • • 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING . 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date COSTA MESA BUILDING—SAFETY DEPARTMENT 8175 ._2/26/81 7.00 TL P. 0. BOX 1200 r Costa Mesa, California PERMIT NO. PLUMBING PERMIT APPLICATION TRACT NO. RECD. BY 11/64. CONTRACTO' Nf Laths /iv inatz,erAle. LOT NO. DATE ISSUED - BUILDING USE • Address/ng L). ,t hke/ 4 CE City-4/ 5"/m Zip Code%23-0/ ABuilding ddress o E /(/.ti' ;Cr 5) State License No. /7457 Class. 6-__y-,,t M Owner'2l' p'- Olit ui City License No. \' ' Tel. No.'7'r c cr/� Addr il s.7ori Ci kto H Q NUMBER TYPE OF FIXTURE OR ITEM FEE Ci 4- 1�t / Tel.No. 4 r3 c� C Bathtub It .5- -I Laundry Tub or Tray I hereby acknowledge, that Shave read this application and Automatic Washing Machine state that the above is eoriect and agree to comply with all City Ordinances ari''State`Laws regulating plumbing. } Shower I certify,/alULpossess the above valid State of California classi- Sink, Bar ficationeorl(I am the legal owner of the residential property de- er Sink, Kitchen scriyediabove. LU Wash Basin(Lavatory) wA I certify that I have obtained a permit from the State Division of Water Closet(Toilet) ^ a ` 1 Industrial Safety for excavations,other than swimming pools,five Cl feet deep or deeper and into which a person is required to descend. CC Drinking Fountains .p'q , •19- y 1 -- signature of Floor Drains . ."(_i 11%)P Permittee Z Interceptors 1) 2' W Receptors . i-�. ti - INSPECTION ,' CORD i Sinks,Commercral,ortlndustusl `� Sinks, Floor .-tfl \ v..M .-- w.' '-,--rs '. - "_".-..rt , . rill* • Sinks,Servide T y 1~ —. - 'r 13¢ 43-`61 2 SwimminieB ol" /� �q 1 W -Urinals) ' !�"'` - Ora*, at "%wadi a. I 1 .V Dishwasher 2 11., Garage Disposal Water Softener 02)0 / Water Heater and Vent - 7/ } Gas System...Outlets... APPROVALS , Roof Drains co Water Piping Alteration INSPECTOR DATE Backflow Preventer U/G Soil I- Lawn Sprinklers(Res or Non-Res) , U/G Water Property Sewer... Feet Services—Water 0 Gas O Solar Piping Rough Plumbing Cesspool,Septic Tank Sprinkler System Sewer Cap Gas Miscellaneous Property Sewer Pool Receptor Filter System Sub-Total / 06 Pool Heater Reinspection Fee Miscellaneous Processing Fee Aa) , oar I �\. Final Gas TOTAL FEE I 2 I W I Plumbing Iii/ i, Co.Final Notified strg ei,___CMF 0450-46 BLDG. PERMIT NO