HomeMy WebLinkAbout344 16TH ST - Building Permits`J ' � CITY OF COSTA MESA • � �
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B{/ILDING D/VIS/ON
i 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wv+w.G.wsta-mesa.ca.us
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'!��m� FOR INSPECTlONS CALL: (774) 754-5626 � `
PERMIT TYpE: B COMBO
Sub Type: POOLSPA
ros nooRESs: 344 E 16TH ST CM
APN: 42521114
Vicinity: � - � '
Const Type: SQ. FT:
Zoning: , ,
450
P
PERMIT NUMBER: BC08-00402
STATUS: ISSUED
DATE ISSUED: 08/25/2008
ISSUED BY: KJB
Suite/Unit:
Primary Occ: R-3
Valuation: 540,000.00
SCOPE OF WORK: CONSTRUCT 450 SQ F7 POOL AND SPA. 1 GAS OUTLET FOR BBQ AND 1 ELECTRfC OUTLET FOR BBQ.
STANDARD PLAN SW07-0348. ENGINEERING DETAIL #220 FOR WALL ON BOND BEAM.
OWNER: BEACH, ERIC AND LEIGH -- Address: 344 E 16TH ST Unit COSTA MESA,
CA
Phone: 949-923-0542 - City/State/Zip: _ ,
APPLICAN7: ELLISON, PAUL � Address: 711 W 17TH STREET � Unit: :STE G4
Phone: 949-646-3466 City/StatehZip: COSTA MESA, CA
CONTFtaCTOR: PURE WATER POOLS License No. 615280
Phone: g49-646-3466 Address: 711 W. 17TH STUnit:
Cell: � City/State: COSTA MESA, CA
ARCHITECT:
ENGINEER:
License No.
-. License No.
COMBINATION PERMIT FEE SUMMARY
Building Plan Check: $353.11
Building Fees: $543.25
Electrical Fe�s: � $75,20
Mechanical Fees: $50,65
Plumbing Fees: $90,40
SMIP Residential: $4.00
SMIP Comm�rcial: $0.00
TOTAL FEES: $1,116,61
'•Re(ar to /oe re�eip�y lor all fees paid for prqect
SUITE G-4
ZipCode 92627
PHONE:
PHONE:
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relaled
regulations. (Ord. No. 92-28, § 1, 12•21-92) -
EXPIRATION: PERMIT EXPIRES 180 DAVS FROM DATE OF ISSUE OR DATE OF IAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply vrith all applicable codes, and all
required Inspections and Flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
COOEL INSPELTIONTWE DATE NI l0iAL5 COUE� INSPELTOMTYPE OpTE IN71i1RL
1818 Fixed System Final Fire Prevention 206 Final Mechanical
1288 Pool $pa Final �� 208 Final Plumbing
200 Final Re-Root 210 Final Electrical
201 Final Qlock/Retaining Wall 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Plannin9 APOroval
203 F'mal $ign 222 Final Site
204 Final bemolition 250 Final Building/Occupanty
i •
WORKERS' COMPENSATION DECLARATION:•
I hereby aRvm untler penally of perjury one of the following declarations:
❑ I have and will mainiain a certi(cate o/ consent to sel4lnsure for workers'
compensalion, as providetl for by sec�ion 3700 of Ihe Labor Cotle, for Ihe
pedormance of the work for which this permit is issued.
❑ I have antl will mainv�n Horkers� compensatbn insu2nce, as required by
sectbn 3700 of the Labor Code. tor the pedormance of the wark for which this
pertnit is issued. My workers' compensation Insurance carrier and policy
numberare: ���
�3rrier.
(Thssea.anneetlmtbewmOtMd(hepe� 4�aWetlatmenundretleonars(SfOOJa�ess)
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I cehify that in the performance of the work for which this permit is
issue0, I shall not employ any person�y manner so as to become subjecl
lo Ihe wotkers' compensation la o( alifornia, and agree that i( I should
become [ w r' co ensalion provisions of Seclion 3700 of
ihe La r Code I ha th ply wilh Ihese provisi s.
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�, _yli s $ipnalure � Oa�._. te %
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W NING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000�, IN ADDITION TO THE CAST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions C de, and
my license is n t ty/(cy,�yajnd effect.
_ Lic:.# �� �U " f Class # �� 2
�
� on - oi na e – Dale �
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CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that Ihera is a consiruclbn lentling agency for the
peAortnance o( the v.ork (or wfiich this pertnit is issued. (Sec. 3097, Civil Code�.
Lender s Name:
Lentler's Atltlress:
Date
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty ot perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW /or lhe following rea5on (Sec. 7031.5,
Business and Professions Code: My city or counry which requires a permit to
construct, al[er, improve, tlemolish, or repair any stmcWre, prior to its
issuance, also requires the aOPlicant for such permit to fle a signed statement
that he or she is licensed pursuant to the provisions of ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pro(essions Code) or Mal he or she is e:empt there(rom and
lhe basis for the alleged exemption. Any violation of Seclion 7031.5 by any
applicant for a permit subjects Ihe applicant lo a civil penalty of no� more Ihan
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
wmpensation, WILL DO 7HE WORK, and the structure is not intended or
oftered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who dces such work himself or herself or l�rough his or her ovm
employees, provided ihat such improvements are nol intentled or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of ihe propeAy, am E%CLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to constmcl the project (Sec. 7044, Business and
Professbns Code: The contractors License Law dces not apply to an ovmer of
property v.ho builds or improves thereon, and who contracls for such project with
a cont2cta�s) license pursuant to the Contractas Ucense Laws.).
❑ I am exempt under sec.
Business and Professions Code !or Ihis reason:
305]�a6 �3IW)
�
c �
Owner ID venfied by Arive nse. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ovmership by (type of tlocument, i.e. - property taz bill or tleed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: .
❑ I hereby certAy that no excavation fine (5) w more feet in depth info wfiich a
person is required to descend, will be matle in connection vrith v.ork auihorized
by Ihis pertnit, and [hat no building sWcture, scaFfdding, false�+ork, or demolition
or tlismantling thereof, will be more [han thirty-six (36) feel high. (Chap. 32, Grp
2. M 2, Sec. 341, Tille 8, Califomia Administ2tive Code).
❑ As owner-Duiltler, I will not employ anyone to do work whic� vrould
require a permit from the Division of IndusVial Safety, as noted above, unless
such person has a permit to do such vrork fmm Ihe division.
ApOhcanl'S SignaWre Dale
Division ol Industrial Safety Pertni[ Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe appliwnt or present or future building occupant neetl to file and
ceAify a Business Plan for emergency response to release or Ihreatened
release of a hazartlous matenal? ❑ Yes ❑ No
(Section 25505 of the Calitomia Health and Satety Code requires, with some
exceptions, that a Business Plan De filed with the Costa Mesa Fire
Department by every business which has at any one time dunng a reportetl
year a quaMiry of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at slandard temperalure and pressure�.
2. Does or will Ihe applicant or present or fuWre building occupant need lo file
a registration fortn (or acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Heal[h and Safery Cotle, with some
exceptions, requires regislra�ion vdth the Costa Mesa Fire Depariment by
each 6usiness which at any one time has on hand a quantity of awtely
hazardous matenals equal [o or grealer than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic (ee[ of compressetl gas at stantlard
temperaWre and pressure).
3. Does or will Ihe applicant or present or tuture building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials)? ❑ Yes � No
(Seclion 25534 of the Califomia Health and Safety Cotle provides that the
Cosla Mesa Fire Department may require the preparetion, cerlification antl
filinq with the Fire Department of an RMPP by businesses which are requiretl
to register acutey hazardous matenals with the Fire Depanment.
4. I! an RMPP is presently requiretl, has Section 25534 of the Cali(omia
Heallh and Safery Code been fully complied with7 ❑ Yes ❑ No
5. Does or will Ihe applican[ or present or fuNre building occupant require (or
tha work which is the subject of this appliwtion a pertnit for such conslruction
or modifcation from the South Coast Air Quality Management Districl or from
any other air polNtion control tlisMct or agency9 ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Cotle requires that Iha requestetl
information be (umishetl on applica�ions (a noo-residential builtling pertnits).
6. Will any part of the faciliry to be constructetl under this permit he within
1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No
(If'yes", ihe facility must meet the requiremenl of Sections 25534 and 42303
of the Califomia Health and Safety Code�.
7. If a pertnit (rom the South Coast Air Ouality Management Disirict or other
air pollution control tlisMct or agency is required tor the work which is Ihe
subject of this application, have all of the disclosures prescribed by Califomia
Health antl Safety Cotle Section 42303 been made? ❑ Yes ❑ No
8. (If'yes', attach certificate of compliance fmm lhe appropnate air polWtion
control offcer).
CERTIFICA7E OF COMPLIANCE: I certify thatuntler penalty oPperjury the
informalion given above is cortect. I agree to,comply with all state laws and
ciry ordinances regarding Hazardous Materials antl�Emissions.. ,
CERTIFICATE OF COMPLIANCE AND'AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application antl state that
the information given is correcL I agree t ply with all state lavrs and city
ordinances relating to building constr on, d authonze repiesentalives of
the City o osta Mesa ro r pon e above-tlescrib d property lor
inspec' n purp es. r not occ or allow occupan of a bui ding
auth �zed by t' pe i ntil al in ction.
r9c - ure rta)� � Dale _
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Job Address:
Suite:
Vicinity:
344 E 16TH ST
BEDROOM & GARAGE
Parcel Nunmber: 42521114
Applicant: . RALPH RINGO
Address:
CITY OF COSTA MESA ' -
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning:
Ph 949 225 8310
PERMIT NUMBER '
+899-01250
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Slatus: ISSUED
Applied: 08/09/1999
Issued: 08/10/1999
one. ( ) -
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Owner. THOMPSON, CHRISTOPHER H. � � � . � � ,'
Address 344-E;16TH ST �- �- - � - - � - � .' ,
�'/ . , �'. . Phone: (949)64E5681 ., - , _ -
�;� �COSTAMESArCA':-.- � � ' Zip: 92627 - - _- - � �� �
L / _ - � , i i ��
Contiactor: .O� N�/?: \\
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�Address: � - � �� �
� - , � Phone:, � ' .
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� � -Zip: : , License: � - .
Arch : - -. - . � � . ,�= .. Eng: � ,
Address: � � � ' , r , � . -- � ' Address: � ,
, , i j , ' ,,� ' Phone: -� � - - Phone: ;
1 . ' . I P. - � �
,, � Zip: r �: � _ � License: . � �"License: .
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�
,/ ' SCOPE OF PERMIT �
� ADD 51 SINGLE STORY BEDROOM ADDITION & 252 SF SINGLE CAR GARAGE. AND ENCLOSURE COURTYARD WALL NEW `
� � CEILING! � . , , . . . . . _ ... , . . . . ' � � �
l,
�
, , . . _ _ � - --- - . � L �. . . - - , .
�'
�Plan Check: . ' $126.91
Permit: $195.25
SMIP Res: . ,$1.00
SMIR Com: . . $0.00
' Other: $0.00
Inspection: $0.00
Total: $323.16 �-.
, ".
�.
SETBACKS
MAINSTRUCTURE FronL 26-0
ACCESSORY Front 10-.0
PARKING Existinq:
NOTES:
— - ttt SUMMARK '-
-- . ,� ,
Rear 0- 0
Rear 0- 0
� Reauired: 1
Calc Valuation: ,
Claim Valuation:
PLANNING & ZONING
LeR 11-0 Right�
. LeR 0-0 Right
Proposed: 1�
$10,030:50
so.00
,-
NOTICE: The work authorized by this permit shall comply with all applicable handicap accass requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a pe�iod of 180 days. . .
INSPECTIONS: la order tor the work autRorized under this permit to be considerad legal, such work must comply with all applicable cotles, and all
requlred Inapeetiona end tinal approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiretion of this permit.
FOR INSPECTIONS CALL: (774) 7545626 `
WORKERS' COMPENSATION DECLARATION:
d hereby attirm under penalty of perjury one of the tollowing declaretions:
❑ I have antl will maintain a certi(icate of consent to self-Insure for workers' compensatlon, es provitletl for by section 3700 of the Lebor Code, for the peAormance of the
work for which Ihis pefmit is issued.
❑ I have antl will maintain workers' compensation insurence, as required by section 3700 of the Lebor Cotle, for the pedormance oi ihe work to� which this permit is issued.
My workers' compensa��on Insurenca carrier and policy number ere:
Certier: Policy Number.
(This sectlon need not be cOmpleted il the permit is valued et one huntlretl dollers ($100) ar less.)
❑ 1 certify that in the pertortnance of the work for which this permit is Issued, I shall not employ eny person in any manner so as to become subject to the workars'
compe�sation laws of Califomia, and agrea thal if I shoultl hecome subject to the workers' compensation pmvisioas ot Section 3700 W the Labor Cotle, 1 shall torihwith
comply with ihese provisions.
ApplicaM SignaNre: _ Date:
WARNWG FAILURE TO SECUFE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SMALL SU6IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND OOLLARE (8100,0001. IN AD�ITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOED FOR IN SECTION 3]O6 OF THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aNirm that I am licensetl untler provisions oi Chapier 9(commencing wiih Section 7000) of Division 3 of the Business and Pmfessions Code, antl my license is in full
force and eHect. Lic. # Class u
Contrectors Signawre: Dete:
CONSTRUCTION LENDING AGENCV:
❑ 1 hereby attirm ihat thera Is a consirucllon lending agency ior the paAortnance ot Ihe woB tor w�ich ihis permit is issuatl. (Sec. 3097, Civil Code).
Lender's Name: Lendefs Adtlress:
Signature: Dale: ��
OWNER-BUILDER DECLAflAT10NS:
I hereby affirtn Ihat under penalty of perjury tha� I am E%EMPT FROM THE CONTRAC70R5 LICENSE LAW for �he following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requiras a permit to consWct, alter, improve, demolish, or repair any strucmre, pnor to its issuance, also requires the applicant for such permit
to file a signed statement ihat he or s�e is licensed pursuant to the provisions of the CoNrectors Licensa Lew (C�apter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is eaempt tharefrom and Ihe basis for ihe alleged exemption. Any violation of Seclion 7031.5 by eny applicant for a pertnit
subjects the applicant to a ci�il penalry of not more than five hundretl tlollars ($500).):
❑ I, as owner of the properry, or my employees with wages as their sole compansatlon, WILL DO THE WORK, end ihe structura is not intendetl or otteretl For sale (Sec.
7044, Business antl PYofessions Code: The Coniractors License Lew does not appty to an owner of property who builtls or impmves thareon, and who Ooes such work
himself or herself or ihrough his or her own employees, provided ihat such improvemenis are not intended or ofleretl tor sale. II, however, the builtling or impmvement is
/�°Id within one year of �mpletioq the ownerbuildar will have the burtlen of provi� tha� he or she ditl not buiW or impmve tor purpose ot sale.).
[!�i I, as owner of the properry, am E%CLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to construct the projed (Sec. 70aa, Business and Professions
Code: The coniractors License Law tloes no� apply to an owner of proparty who builds or improves thereon, entl who comracts for such project with a contrector(s)
' license pursuant to the Coniractors License Laws.).
❑ 1 am exempt u e se �+— Business antl Proteuions Cotle for this reason:
SignaWre: ��/ Date: 10
Owner ID venfietl by tlriver's license. ❑ Ves ❑ No Driver's License No. � �- Ezpires:
Verification ot Ownership by (rype of document, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certiy that no excavation five (5) or more feet in depih into which a person is requiretl to tlescend, will be matle in connection with work authorizetl by ihis
permit, and that no builtling stmcture, scattolding, felsework, or tlemolition or tlismantling thereof, wlll be more than thirty-six (36) teet high. (G�ap. 32, Grp 2, Art 2, Sec.
341, Title e, Califomia Administrative Code).
❑ As owne�-builder, I will not employ anyone to tlo work which would require a permit from �he Division of Intlustrial Satety, as notatl above, unlass such person has a
permit to do such work from the tlivision.
Signature: Date:
Division of Industrial Safety Permit Number:
CERTFICATE OF COMPLIANCE ANO AUTHORIZATON OF EN7RY: I certify under penalry of perjury that I have read this applica�ion antl state Iha� ihe intormation given is
corract I agrae to comply wi� 3µstate laws and ciry ordinances relating to builtling construction, entl euthonze representativas of ihe Ciry ot Casta Mesa to enter upon ihe
abova-descnbed properry for 650ection pyrpases. I a9ree not to occupy or allow occupancy of eny building euthorized by this pertnit until final Inspection.
�� %' � g li��`i9
`—�Siqnature e Owner(s) Date
And/OrAuthorized Applicant Date
COOE I' INSPECTIONTYPE -
1616 Fixed Sys�em Finel Fire Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetainin9 �^lall
202 Final Faclory Fire Place
203 Final Sign
204 Final �emolition
OpTE I RL
COUE 1 INSPECTION TYPE
206 Final MeCheniCel
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Finel Plenninq Approvel
222 Fin8151�9
250 Final Building/Occupancy
OATE - INTRIALS
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Job Address:
Suite:
Vicinity:
344 E 16TH ST
FRONT OF HOUSE
Parcel Nunmber: 42521114
CITY OF COSTA MESA "
BI/ILpING D/VISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
BUILDING PERMIT
Zoning:
Applirant: THOMPSON, CHROSTOPHER H.
Address: 344 E 167H ST -... ..,
Phone:
COSTAMESA;CA�;'. Zip: 92627
/ ''
� .
owner: THOMPSON, CHROSTOPHER H.
Address 344 E-16TH ST - ' -
i `` � , _
� , Phonei - �
!, ��� COSTA MESA, CA" �- -' Zip: 82627
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;Address: � ��i i�>''��
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• � -ZiP: ' . . License:
- Arch : � � . - � - �
Address: ' - � ' -
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Eng:
Address: .,
PERMIT NUMBER
99-01254
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 08I10/1999
Issued: 08/10/1999
ISSUED BY:
� ,�-'.
.. �Zip: . - - ��� License: . �
� , ,
i ` " � ' SCOPE OF PERMIT �
% 69 LF OF 6'-0" HIGH CONC BLOCK WALL PER CITY STANDARD�DETAIL AT FRONT OF HOUSE.
Phone:
� �
Licensa:
`
� � � .,, � _, . . , _ � . .
� FEESUMMARY ,
� Plan Check: �, $33.12 �, Calc Valuation: S�,sao:oo
� Permit: , $50.95 - Claim Valuation: so.00
SMIP Res: ' - $0.00 � '
��.SMIP Com: ' $0_00 � � � ,�
; ` Other. � � $0.00 - �-_ �
Inspection:. $0.00
��� Total:� 584.07 �
� � � PLANNING & ZONING
� � � �. �
SETBACKS� � � � � �
MAIN STRUCTURE Front 0- 0� Rear 0- 0 Left �0- 0 Right 0- 0
ACCESSORY Front 0. 0 Rear 0- 0 Left 0- 0 Right 0- 0
PARKING Existin :� 0 Required: - 0 Proposed: 0 �
NOTES:
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia stetutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall au�omatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for e period of 180 days. .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectiona end flnal approval must be obtained. Failure to obtain inspections and final approvel will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON:
•I hereby ettirm under penalry ot per�ury one of the following tlecleretlons:
❑ I have end will melntain a certificale ot consent to self-Insure tor workers' compensation, es provided for by secNon 3700 at the Lebar Catle, for the pertortnance oi the
work lor which this perMl Is issuetl.
❑ I have end will maintein workers' compensation insurance, as required by section 3700 al ihe Lebor Code, for the perfortnance oi iha work tor which this pertnit is issuetl.
My workers' compensetlon Insurence carriar end policy number are:
Cerder: Policy Numher:
(fhls seclion need nof be completed ll the percnlf Is veluetl e( one huntlretl tlollere ($100) ar less.)
� I cenity that in the peAormance of ihe work for which t�is permit is issued, I s�ell not employ eny person in eny manner so as to become subject to the workere'
compensation lews oi Californla, and egree ihat it I shoultl become subject to the workers' compensation provisions of Section 3700 of Ihe Lebor Cotle, I shall forihwith
comply with these provlsions.
Applicent Signature: Date:
WARNINO: FAILURE TO SECURE WORKERS' WMPENSATIIXJ COVEPAGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOVEP TO CflIMINAL PENALTIES AND pVIL FINES UP TO ONE HUNDRED
THOUSAN� Dq14RE (5100,OW), IN ADDIiIIXJ TO THE COST OF COMPENSATION, DAMAGES A$ PROVIOED FOR IN SECTION 31O60F THE LABOR COOE, INrERE$T, AND ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm that I am licensetl under provisions of Chepter 9(commencing with Sectlon 7000) of Division 3 of the Business end Professions Code, antl my license is in full
force entl eNect. Lic. N Class q
Contractofs Signature: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirm that there is e construction lentling eqancy tor the peAortnance of the work br wNch lhis permlt ISlssued. (Sec. 3097, Civil Code).
l.entler's Name: Lentlets Address:
Slgneture: Data:
OWNER-BUILDER DECLARATIONS:
I hereby ettirm that untler penalry ol perJury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires a pertnit to consiruct, alter, Improve, demolish, or repair any structure, pnor to its issuance, also requires the appliwnt For such pertnit
to file a signad siatement thet he ar she is Ilcensed pursuant to ihe provlslons at the Cantrectors Ucanse Law (Chepter 9(commencing with Sectlon 7000) of Division 3 ai Ihe
Business and Professions Code) or that he or she is ezempt t�erefrom end ihe besis tor the allegetl exemp�lon. Any violatlon ot Section 7031.5 by eny apP���ent tor a permit
sub�acts the eppliwni to e civil penalry of nol more than tive huntlretl tlollars (5500).):
❑ I, as owner of Ihe propeny, or my employees with wages as their sole compensetion, WILL DO TME WORK, and t�e struciure is not intentlea or ottered for sale (Sec.
7044, Business and Pratessians Catla: Tha Contrectors LJcense Lew does not epply to en owner of property who �ulltls or improves thereon, and who tloes such work
himselt or herself or through his or her own employees, provided that such improvements ere not intended or offered lor sale. It, however, the builtling or improvement is
/5oltl within one year ol completion, �he owner-builder will have Ihe burtlen of proving Ihet he or sha tlid not huiltl or improve lor purpose of sele.).
[� I, es owner ot tha properry, am E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to conSWd the project (Sec. 7044, Business end Protessions
Code: Tha contrectors License Lew does not epply to an awner oi property who builtls or impmves ihereon, entl w�o contracts tor such proJect with a coniredor(s)
license pursuant Io the Contrectors Licensa LawsJ.
❑ I am exempl u Sec.
SignaWre: �
Owner ID verifi dnvels li
Business and Professions Cotle lor this reason:
❑ Yes ❑ No Drivers License No.
Verification of Ownershlp by (rype at daument, i.e. - property tex bill or deed):
:
Expires:
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: -
❑ I hereby cartity Ihat no eacavetion five (5) or more feet In tlepth into which a person Is required to tlescenC, wlll be matle in connection wlth work euthorizatl by this
permit, antl ihat no builtling swcture, scaHolding, falsework, or demolition or dismentling ihereof, will �e more ihan thirry-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec.
341, Title 8, Calitomia Adminisiretive Code).
❑ As owner�builder, I will nat ampby anyone to do work which would require a parmit irom Ihe Division of Intlustnal Safety, as noted above, unless such person has a
permit ro da such work Irom Ihe tlivision.
Signature: Date:
Divislon of InCuStrial Safety Permit Number:
CERTFlCA7E OF COMPLIANCE AND AIfTHORVATON OF EMRV: I certity under penalty of perjury thai I hava read this application and state that the information given is
correct. I agree to comply w a state laws antl ciry ortlinances relating Io builtling constructlon, antl authonze representatives of ihe Ciry oi Costa Mesa to enter upon the
above�tlescdbetl prope r inspectlon uryoses. I agree not to occupy or allow occupancy ol any bullding euthorized by this ermii until iinal inspectlon.
�/7 �- �'�(oiqq
Igneture Owner(s) �r Date
And/Or Authonzed Applican� Date
COOE I, INSPECTIONTYPE
1616 Fixetl System Final Fire Preventlon
1266 Pool Spa Final
200 Finel Re-Roof
201 Finel BIocWRetaining Well
202 Finel Fectory Fire Placa
203 Final Sign
204 Finel Demolition
res.=cy
• _ 1 .1111:
�� �
\•I•
COOE� INSGECTIONiYPE
206 Final Mechenicel
20B Final Plumbing
210 Finel Electrical
212 Finel Flre Prevemlon
220 Final Plenning Approvel
222 Finel Site
250 Final Builtling/OccuDency
QSjE INTtfIRLS
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us
BUILDING PERMIT
.lob Address: 344 E 16TH ST
Suite:
Vicinity: FIRST & SECOND STORY ADDITION/REMODEL
Parcel Number: 42521114
Applicant: FR�TWELL, SHAY
Address: 24192 SALERO LN
MISSION VIEJO, CA
Zoning:
Phone: 949-472-2377
Zip: 92691
Owner. THOMPSON,'CHROSTOPHER H.
Address 344 E 16TH ST
COSTA MESA, CA
Contractor. ON� TIME CONSTRUCTION
Address: 24192 SALERO LN
MISSION VIEJO, CA
Zip: 92691
Arch :
Address:
Phone:
Phone:
Zip: 92627
Phone: 949-716-0566
License: 784966
77 FAIH OFIVE, COSTA MESA, GA 92626
Status: ISSUED
Applied: 07/10/2001
Issued: 07/03/2002
ISSUED BY: �
Eng: NEXTECH ENGINEERING INC
Address: 3454 W FIRST ST
Phone: 213383-8011
, LOS ANGELES, CA
Zip: License: 90004 License: S4164
SCOPE OF PERMIT
CONSTRUCTION OF A 1482 SF ONE-STORY ADDITION TO AN EXISTING SINGLE-STORY SFD & ADD A 148 SF PATIO
COVER. ADDITION INCLUDES S7UDI0 "A", FAMILY ROOM, MASTER BEDROOM/BATH & A DINING ROOM.
HOUSE CONTAINS 2 BEDROOMS AND WITH THE REMODEI AND ADDITION WILL STILL CONTAIN 2 BEDROOMS.
Plan Check:
Permit
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$755.14
$1,161.75
$12.91
$0.00
$0.00
$0.00
51,929.80
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Pmnt 0-0
PARKING Exi_stinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
Calc Valuation: S�zs,oss.�s
Claim Valuation: So.00
PLANNING & ZONING
Left 0- 0 Right
Lek � 0- 0 Right
Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under California statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 18D days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inspeetlons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626 .
zaae�eeldoo>
WORKERS' COMPENSATION DECLARATION: � f
I hereby aHirtn under penalry ot perjury one oi Ihe following declarations:
❑ I have antl will maintain a certificate of consent to selbinsure lor workers' compensation, as provitled for by section 3700 oi Ihe Labor Cotle, for the peAortnence of ihe
work for which this permit is issuetl. .
❑ I heve and will maintain workers' compensation insurence, as required by sectlon 3700 of Ihe Lebor Cotle, tor the perfortnenca of Ihe work tor which this permit is issued.
My workers' compansation Insuranca carner entl policy number are:
Carriec
(This s
❑ I cetlity that in the pedorm
compensation laws o�'
Comply wilh these pr si
Applicant Signature: �
WARNINO: FAILURE TO SECURE 1N
TFKKISAND DOLLARE (5100,OW), IN
one
.• PolicyNumber:
�
ihe foywh�ermit is4�sued, I 5hall mploy any person in any manner so a5 to become subject Io Ihe workers'
r Cffiet' hould b Fe subject to th r✓ ers' compensation provisions of Sectio 3700 0l ha Labor Code, I shall torthwith
oa�a: 7 �3�42—
SATION COVERAGE IS UNLAWFUL A JD lIRLL SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FMES UP TOONE HUNDRED
THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31O60F THE LABOR CODE, If�lrEREST, AND ATTORNE`f5 FEES.
LICENSED CONTRAC70RS DECLAHATION:
I hereby attirtn that I am licensed ynder provi '
force antl eHect. Lic. #
Contraqor's Signeture:
7000) of Division 3 of ihe Business and Profeuions Cotle, end my license is in full
Class a
Date: �% J
CONSTRUCTION LENDING AGENCY: '
❑ I hereby aHirtn ihat there is a conswction lending agency br ihe pedormance of ihe work for which this pertnit is issuetl. (Sec. 3097, Civil Code).
Lender'S Neme: Lentler's Adtlress:
Signeture:
Data:
OWNER•BUILDER DECLARATIONS:
I here6y eftirtn ihat untler penalry ot perjury thal I em E%EMPT FROM THE CON7RACTORS LICENSE LAW tor the following reason (Sec. 7037.5, Business and Professions
Code: Any ciry or counry which requires e permit to construc6 alter, improve, tlamolish, or repair any structure, prior ro iis issuance, also requires ihe applicant tor such pertnit
to file e signed statement that he or she Is licensed pursuant to the provisions ot ihe Contradors License Law (Chepter 9(commencing with Section 7000) of Divlsion 3 ot ihe
Business end Protessions Code) or that he or she Is e:empt therefrom and the basis for the allegad ezemption. Any violation of Sedion 7031.5 by eny applicant for a pertNt
sublecis iha applicant to a civll penalty of not more ihan five hundred dollars ($500).):
❑ I, as owner of the properry, or my employees with wages es their sole compensation, WILL DO THE WORK, and ihe siructure is not intentletl or oHeretl tor sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of properry who builds or improves thereon, and who does such work
himself or herseN or through his or her own employees, provided ihat such improvemenis are not intended or oHered tor sale. H, however, the �uiltling or improvement is
sold within one year of complation, the owner-builder will have ihe burden of proving Ihat he or she did not build or improve for purpose of sale.).
❑ I, as ownar of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business and Professions
Cotle: The contrecrors License Law tloes not apply to an owner of property who builds or improves Ihereon, antl who coniracts for such projact with a contrector(s)
licensa pursuant to ihe Conlractors License Laws.).
❑ I am exempt untler sec.
Signature:
Owner ID verified by drivers license. ❑ Yes ❑ No
Business antl Professions Gotle for this reeson:
Ventication of Ownership by (type of document, i.e. - propeny tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION:
Dnvefs LicenSe No.
Data:
Eapires:
❑ I hereby certify Ihat no excavation tive (5) or more taet in depih into which a person is required to descend, will be made in connection with work authonzed by ihis
pertnit, antl that no building simcture, scaHolding, talsework, or demolilion or dismamling thareot, will be more than Ihirty-six (36) teet high. (Chap. 32, Gry 2, Ar12, Sec.
341, Title B, Calitomia Administretive Code).
❑ As owner-builtler, 1 will not employ anyone to do work which would require a permit from the Division of Industdal Safery, as notetl above, unless such pereon has a
permit to do such work from the tlivision.
Signature: Date:
Division of InduSinal Sefety Permit Numbar.
CERTIFlCATE OF COMPLIANCE AND AIJTHORIZA710N OF E : I cehity under penalty of perjury ihat I have read this eppiication and state Ihat ihe information given is
correct. I agree to comply wlih all s�ata laws and ciry ordinanc .relating t mlding constmction, and emhorize representatives of Ihe qty of Costa Mesa to enter upon ihe
above-described property For insp� puryoses no wcupy�w occupancy of any building authorized by this permit until final inspection.
CQDE t. INSGECTIONTYPE VATC
1616 Fixed System Final Fire Prevention
1266
200
207
202
203
Pool Spa Final
Final fie-Rooi
Final BIocWRetaining Wall
Final Factory Fire Placa
Final Sign
204 Final Demolition
� � 0°�-
Date
IN7 , �h INSPECTIONTYPE
206 Final MeChaniCal
20B Finel Plum6ing
210 Finel Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
P� INTRIRLS
(2-24-� �
�
m
NEWPORT-MESA UNIFIED SCHOOI DISTRICT
CER7IFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 187
,.
. '
To: City of Costa Mesa
) City of Newport Beach
( ) Counry of Orange
Applicant:
Address:
Telephone
�l Gl c.t �l�C/� ii
N° 4028
District Receipt No� �� �
Plan Check No. �
TracUParcei and Lot Number(s):
Locafion of Project:
Number of Square Feet ot:
Residential Space
Commercial and
Industrial Space
CommerciaUlndustrial Projed is: (Check One)
_ Warehouse
_ R&D
_ Movie Theater
_ Mini-storage
_ Heavy Industrial
_ Regional Shops
_ Light Industrial
_ This project is exempt because
r
�;�C� x 31.84
z $ .30
_ Motel
Bank
_ Neighborhood Shops
_ RacqueUHealth
_ Hotel
Medical Otfice
O(fice Park
� , (I-� �i 262
Total
� �
�� � �
�►� � �
_ Preschool
_ Auto Repair
_ Hospital
_ Latge O(fice
_ Oi6ce Bldg.
_ Restaurant
_ Fast Food
This certifies that the above-named Developer/Applicant has paid school faciBty fees in compNance with Government Code sections
53080 and 65995. The Building Pemifs tor this square footage in this proposed development may now be issued by your jurisdic6o�.
Checks are to be made payable to Newport-Mesa Unified School Dishict.
The above representation as to square footage is Vue. App6cant agrees that if it is later
true, then this cerlificate shall automaticalty terminate and the appropriate�City/Coya4y
,Dat� / —� U �
that such representa6ons are not
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address: 344 E 16TH ST
Suite No
Vicinity:
Parcel Number 42521114
Applicant:
Address:
Owner:
FRETWELL, SHAY
24192 SALERO LN
MISSION VIEJO, CA
THOMPSON, CHRISTOPHER
Address:' HAMLET
COSTA MESA, CA
344 E 16TH ST
Contracror. ONE TIME CONSTRUCTION
Address: 24192 SALERO LN
MISSION VIEJO, CA
Phone: 949-716-0566
Zip: 92691
Phone:
Zip: 92627-3257
.Phone: 949-716-0566
Zip: 92691
License: 784966
ISSUED 6Y:
Status: ISSUED
Applied: 07/03/2002
Issued: 07/03/2002
SCOPE OF PERMIT
CONSTRUCTION OF A 1482 SF ONE-STORY ADDITION TO AN EXISTING SINGLE-STORY SFD &
ADD A 148 SF PATIO COVER. ADDITION INCLUDES STUDIO "A", FAMILY-ROOM, MASTER
BEDROOM/BATH, & A BEDROOM CONVERTED TO A DINING ROOM. REF.: BOt-01063
MECHANICAL TO INCLUDE: 1 FAU < 100 K BTU, 2 FACTORY FIREPLACES, 1 ALT TO
EXISTING DUCT WORK.
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU >100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >100 k BTU
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < t0000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
$23.50
$14.80
50.00
$13.70
$0.00
$0.00
$0.00
$0.00
521.30
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
Quantity
1
0
1
0
0
0.
0
2
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillation System
Evaporetive Cooler
CommerCial I ncinerafor
Domestic Incinerator
Compressors / Absorption Systems
Upto3hp/100kBTU
3To15hp/500kBTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Upto3hp
3To15hp
15.to 30 hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED PEES
COMMENTS 1 SPECIAL CONDITIONS
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00
$0.00
$0.00
$73.30
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and becoma void if work is not commenced within 1 BO days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetlons and (Inal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (774) 7545626 _
264646 (6/00)
WORKERS'COMPENSAnON DECLARAnON: •
I hereby aHirm under penalry of perjury one of the tollowing tleclarations:
❑ 1 have antl will maintain a certificate of consent to self-Insure tor workers' compensation, es provided for by section 3700 of ihe Labor Code, for the peAormance of Ihe
work tor which this permit is issued.
��I y6ve antl will maintain workers' compensation insurance, as requiretl by section 3700 of ihe Labor Code, for the pedortnance of t�e work for which Ihis pertnit is issued.
\�v warkers' compensation Insurance carriar end policy number are:
'i.errier: Policy Number:
(This section need not be completed i/ fhe permif is velued ef one hundred dollars ($700) or less.)
❑ I certify that in ihe peAormance ot ihe or which this er t i sued, I s I not employ any person in eny manner so as to becoma subject to ihe workers'
compensatlon laws of Calitofwl'a7. e rea th u be e sub' the workers' compensation provisions of Secf���pppn 37ppQ0 of the Labor Code, I shell forthwith
comply with these provi ' 6 / /� /� / � �
Applicant Signeture: Date: � �� �
WARNWGFAILURETOSECLIFE RKERS' E RAGEISUNLAWFULANDSHALLSUBJECTANEMPIOVERTOCRIMINAL ENALIESANDCIVILFWESUPTOONEHUNDRED
THOUSAND OOLLARE �E/ W,OW), IN ADDIiI O THE COST OF COMPENSATION, DAMAG6S AS PROVIDED FOR M SECTION 3'lO60F THE I:ABOR WDE, �MEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION: �
I �ereby attirtn that I em licensed
force end efled. Lia N
Goniractor'sSignaWre: _�_
CONSTRUCTION LENDING AGENCY:
with ion 7000) of Division 3 of the Business and Profeuions Code, and my licanse is in full
qass #
Date: �% O !�I
❑ I hereby aflirtn that there is e constmction lending agency for ihe performance ot Ihe work for which ihis permit is issued. (Sec. 3097, Civil Code).
Lendafs Name: Lenders Address:
Signature:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aftirm ihat untler penelty of perjury ihat I am EXEMPT FROM THE CON7RAC70R5 LICENSE LAW tor ihe following reeson (Sec. 7031.5, Business entl Protessions
Code: Any ciry or wunry which requires e permit m construct, elter, improve, tlemolish, or repair any strucWre, pnor to its issuance, also requires ihe applicant for such pertnit
to file e signetl statemenl ihat he or she is licensed pursuant to the provisions oi the Conirectors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of lhe
Business and Pmfessions Cotla) or that he or she is exempt therefrom end Ihe besis for the alieged ezemption. Any violation of Section 7031.5 by any epplicant tor a permit
sublects Ihe epplicant to a civil penalry of not more then five huntlred tlollers ($500).):
❑ I, as owner of ihe pwperty, or my employees with wages es iheir sole compensation, WILL DO THE WORK, and Ihe siructure Is not interWetl or oNeretl for sale (Sec.
7044, Business and Professions Cotle: The Contractors License Law dces noi apply to an owner of properry who builds or impmves Ihereon, and who does such work
himsal� or herseli or ihrouqh his or her own employees, provided ihat such imDrovemenis are not intended or oHered for sale. tl, however, ihe building or improvement is
sold within one year of completion, the owner-builder will have ihe burden of proving that he or she ditl not 6uiltl or improve for purpose of sale.).
❑ I, as owner ot ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS �o consVuct the project (Sec. 7044, Business and Professions
Code: Tlie contractors Licansa Law tloes not apply to en owner of propetly who builds or improves ihereon, and who contracts for such projed wl�h e coniractor(s)
iicense pursuant to the Coniractors License Laws.).
❑ I am e:empt untler sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Driver's License No. Expires:
Verificalion of Ownership by (rype of documenl, i.e. - property tax biil or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify thet no excavation five (5) or more feat in depih inm which a person is required to descend, will be made in connection with work authonzed by this
permit, entl ihat no building strucNre, scaHoiding, talsework, or damolition or dismantling ihereot, will be more than thirty-six (3fi) teet higR (Chap. 32, Grp 2, Art 2, Sec.
341, Title e, California Adminisiretive Cotle).
❑ As owner-builder, I will not employ anyone to do work which would require a parmit trom the Division of Industrial Safery, es noted a6ove, unless such person hes a
pertnit to do such work tram the division.
Signature: Date:
Division ot Industnal Safery Pertnit Number:
ICERTIFlCATE OF COMPl1ANCE AND AUTHORIZATON OF EMAY: I certity untler penalty ot perlury �hat I have read this application and state ihat ihe informetion given is I
cortect. I agree to comply with all state laws and ciry ordinances relating to building consiruction, and authonze representatives of ihe Ciry of Costa Mesa to enter upon the
above-described property fo��pection puryoses. I agre�not to occupy or allow acupancy ot any building authorized by ihis pertnit umil final inspection.
p00EI, INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Paol Spe Final
200 Finel Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
��
INTRIALS
Date
� �
Date
COUEA INSPECTIONTYGE
206 Final Mechanical
20B Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
PdIF
� z�zy-�
.-,
(714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
1ob Address: 344 E 16TH ST
Suite No
Vicinity:
Parcel Nunmber. 42521114
Applicant: FRETWELL, SHAY
Address: 24192 SALERO LN
MISSION VIEJO, CA
Owner: THOMPSON, CHRISTOPHER
Address HAMLET
COSTA MESA, CA
344 E 16TH ST
Contractor: ONE TIME CONSTRUCTION
Address: 24192 SALERO LN
MISSION VIEJO, CA
Arch / Eng : '
Address:
Phone: 949-716-0566
Zip: 92691
Phone:
Zip: 92627-3257
Phone: 949-776-0566
Zip: 92691
License: 784966
Phone:
Zip:
License:
ISSUED BY:
Status: ISSUED
Applied: 07I03/2002
Issued: 07/03/2002
SCOPE OF PERMIT
CONSTRUCTION OF A 1482 SF ONE-STORY ADDITION TO AN EXISTING SINGIE-STORY SFD & ADD A
148 SF PATIO COVER. ADDITION INCIUDES STUDIO "A", FAMILY ROOM, MASTER BEDROOM/BATH,
& A BEDROOM CONVERTED TO A DINING ROOM. REF.: 801-01063
PLUMBING TO INCLUDE: 1 BATHTUB, 1 GAS (1-4 OUTLETS), 1 SHOWER, 3 WASH BASINS, 2
TOILETS, 1 NEW WATER HEATER (RELOCATE ALSO).
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect(Ice,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Draiq Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oip
Interceptors (Sand Auto )
AMT
$23.5D
$0.00
$0.00
$9.80
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$6.75
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
FEESUMMARY
Laundry Tub / Washer
Landscape Irngation
P-Trap
Pressure Regulator
Process Piping (per 10 ft)
Recep[ors
Septic Tank
SewerCapforDemo
Sewer Connect
Sewer Private Line
Shower
Sink, bar
Sink, commercial
Sink, Floor
Sink, kitchen
Sink, service/mop
Spa (private)
Spa (public)
AMT
$0.00
$0.00
50.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacu�m Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System �
Water Closet (Toilet)
Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$29.40
$0.00
50.00
$19.60
$12.30
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
QTY
0
0
0
0
0
0
3
0
0
2
1
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applirable handicap access requirements under California statutes and related
COMMENTS / SPECIAL CONDITIONS
EXPIRATION: TFiis�permit�shall automatically expve an ecome voi i wor is no commence wi in 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 _
2db6d6 (6�00)
WOHKEHS' COMPENSATION DECLAHA710N: �
I here6y aRirm untler penalty of perjury one oF the following declarations: �
❑ I heve and will maintain a certitiwte ot consent to selbinsure tor workers' compensation, es provided for by section 3700 ot the Lebor Cotle, for the petlormance ot the
1 work for which t�is pertnit is issuetl. .
ill maintain workere' compensation insurance, as requiretl by sectlon 3700 ot the Lebor Code, for Ihe peAortnance of ihe work for which this pertnit is Issued.
compensation Insurance cgrrier and policy number ere:
Cerner.
(This sectlon neetl
❑ I certify that in the pertortn
compensation laws of Cali
comply with t�ese provi�ic
Applicant Signeture: � /
WFRNING: FAILURE TO SECURE W
TFIOUSAN� Oq1ARE (5100.OW). IN
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I am licensed unde�/py vi/gic
torce and eHecL Lic. M_--�i=E[-s=�
Contractor's Signature:
Policy Number.
ot'i thi rtnit is i ued, I sh employ any person in any manner so s to become subject to Ihe workere'
ould becom sub�ect to orkers' compensation provisions of S,tlon 700 of /th�e L_abor Cotle, I shall forihwiih
� Date: � I
COVERAGE IS LINL4WFUL AND SHALL SUBIECT AN EMPLOVER TO CRIMINAL PEI ALTIES AND CIVIL FINES UP TOIXJE HUNDRED
= COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, IMEREST, ANO ATiORNEV'S FEES.
7000) ot Division 3 of the Business and Protessions Cotle, and my license is in tull
Class # _ �� �i
Date:__ _ '-/( b,/_[ �—_
CONSTRUC710N LENDING AGENCV: �
❑ I hereby aHirm that Nere is a construction lending agency for ihe performance of Ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: .... Lenders Address:
Signature:
OWNER•BUILDER DECLARA710NS:
Date:
I hereby ettirtn ihat under penalry of periury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or counry which requires e parmit to construct, elter, improve, tlemolish, or repair any simcture, prior to its issuance, also requires the epplicant for such pertnit
to file a signed stetement that he or she is Iicense0 pursuant b the provisions of the Contrectors License Law (Chapter 9(commencing with Section 7000) of Divislon 3 oi the
Business and Professions Code) or thal he or she is exempt Iherefmm and iha basis tor the allegetl a:emption. Any violation oi Section 7037.5 by any applicant for a pertnit
su6jects ihe epplicant to a civil penalry ot not more than five hundretl dollare ($500).):
❑ I, es owner of �he property, or my employees with wages as iheir sole compensatlon, WILL DO THE WORK, and ihe strucWre is not intended or oHered tor sale (Sec.
7044, Business and Pmfessions Code: The Contrectors License Law does not apply to an owner oi property who builds or improves Ihereon, and who dces such work
himself or herseN or ihrough his or her qwn employees, pmvided that such improvemenis ere not Intended or oNeretl for sale. If, however, ihe building or improvemem is
soltl within one year of completion, the owner-builder wiil heve the burden of proving ihat he or she did not 6uild or improve tor purpose of sele.).
❑ I, as owner ot the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to consWct the projact (Sec. 7044, Business antl Professions
Code: The contractors License Law tlo9s not apply to an ownar of property who huilds or improves thereon, antl who contracts for such proiect with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am ezempt under sec.
Siqnature:
Owner ID verified by driver's license. ❑ Ves ❑ No
Business and Protessions Code for this reeson:
Venfication of Ownership by (type of tlocumeht, i.e. - properry tax bill or tlaed):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATION:
Drivers LicenSe No.
Date:
Expires:
❑ I hereby certiy that no ezcavation five (5) or more feat in depth into which a person is requlretl to tlescend, will be made in connection with work authonzad by this
permit, antl t�at no building siructure, scaffolding, falsework, or tlemolition or dismantling thereof, will be more than ihirry-six (36) feet high. (Chap. 32, Gry 2, Ar12, Sec.
341, Title 8, Califomia Atlministrative Cbde).
❑ As owner-builder, I will not employ enyone to do work which would require a permit irom the Division of Industriel Safety, es noted above, unless such person has e
permit to tlo such work fwm the division.
SignaNre: Date:
Division of Industnal Safety Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUTryORIZATION OF EMRV: I ceni under penalry ot perjury ihat I have read ihis application end state t�at ihe infortnation given is
correct. I agree to comply with all sta�e laws end city ordinanc relating mlding constmctlon, and authorize representatives ot ihe Clry of Costa Mesa to enter upon the
above-described propeAy for inspection purposes. I egre occupy ow occupency of eny building authorized by this permit until tinal inspection.
CO�E �, INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Finai Re-Rooi
207 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
� 2 ,l ate
i V
�i Date
IA IMR �� INSPECTIONTYPE
206 Final Mechanical
208 Finel Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Occupancy
P9IE 1�4
-� "�- �`�
(714) 754-52�3 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
,lob Address: 344 E 16TH ST
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
Contractor
Address:
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept Oullets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors to 1hp
Motors to 10hp
Motors to SOhp
Motors l0 100hp
Molors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
ELECTRICAL PERMIT
42521114
FRETWELL, SHAY
24192 SALERO LN
MISSION VIEJO, CA
THOMPSON,CHRISTOPHER
HAMLET
COSTA MESA, CA
344 E 16TH ST
ONE TIME CONSTRUCTION
24192 SALERO LN
MISSION VIEJO, CA
Phone: 949-716-0566
Zip: 92691
Phone:
Zip: 926273257
Phone: 949-776-0566
Zip: 92691
License: 784966
ISSUED BY:
Status: ISSUED
Applied: 07/03/2002
Issued: 07/03/2002
SCOPE OF PERMIT
CONSTRUCTION OF A 1482 SF ONE-STORY ADDITION TO AN EXISTING SINGLE-STORY SFD & ADD A
148 SF PATIO COVER. ADDITION INCLUDES STUDIO "A", FAMILY ROOM, MASTER BEDROOM/BATH,
& A BEDROOM CONVERTED TO A DINING ROOM. REF.: B01-01063
ELECTRICAL TO INCLUDE: 37 LIGHT FIXTURES, 31 OUTLETS, 20 SWITCHES, 1 SERVICE UPGRADE
TO 200 AMP. ,
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$34.41
$30.03
$22.00
50.00
�0.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
37
31
20
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / Lighting
Busway /100 k
Standing Section
Misc Electrical Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misa Canduit
Misa Canductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
50.00
$0.00
TOTAL CALCULATED FEES $140.44
COMMENTS / SPECIAL CONDITIONS
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 1 BO days., ,+
INSPEC710NS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626 _
2d4646(N00)
WORKERS'COMPENSqnON DECLARATON: �
I hereby attirtn under penalry of perjury one ot the tollowing declerations:
j] I have and will maiqtain a cartificate of consent to sel6lnsure lor workers' wmpensation, as D�o�ided tor by section 3700 ot the Lebor Cotla, for the pertortnance of the
t\ work tor whiCh this permit is issued.
�jFnave and will maintain workers' compensation insurance, es raquired by section 3700 of Ihe Labor Coda, for the pedortnance of the work for which this pertnit is issuea.
My workers' compensation Insurence carrlei and policy number are:
Carrier: Policy Number:
(This secfion need nat b0 cromplefed il the permi ' elued et one hu 100) or I .J .
❑ I certify ihat in ihe pedortnanc f Ihe for hi�.P�5 i5 d, I shall n ploy any person in eny manner so as to become subject to the workers'
compensation laws of Ca' �e at if I� i6uld becom bject ro t rkers' compensation provisions ol Section 3ZZ00 oi a Labor Cotle, I shall fort�with
comply wlth these p�a� o �/�� ��
Applicant Signature: Date: �
WARNING FAILURE TO SECURE WORKERS' COMP SATION COVERAGE IS UNIAWFUL AND SHNLL SU&IECT AN EMPLOYER TO CRIMINAL PE TIES AND dVIL FlNES UP TOONE HUNDRED
T}IOUSANDDOLURE�$t00,ppp),INA�DITIdJT ECOSTOFCOMPENSATION,DAMAGESASPROVI�EDFORINSECTION3lWOFiHELABORWDE,IMEREST,ANDATTORNEYSFEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aHirm ihat I am licensed under ovis
force and eRect Lic. #
Coniractofs Signaiure:
with Section 7000) of Division 3 ot t�e Business antl Professions Code, and my license is in full
Class a
Date: �
CONSTRUCTION LENDING AGENCV: � �
❑ I hereby aHirtn that ihere is e consVuction lending agency for Ihe performance of Ihe work tor which this permit is issued. (Sec. 3097, Civil Cotla).
Lender's Name: _ Lender's Address:
Signeture:
OWNER-BUILDER DECLAqA710NS:
Dete:
I hereby aflirm that unde� penetly of perjury ihat I am E%EMPT PROM THE CON7RAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Pmtessions
Code: Any ciy or county whiCh requires a permil to construct, alter, improve, demolish, or repair eny structure, pdor to its issuance, also requires Ihe epplicant for 5uch pertnit
to file a signad statement that �e or she Is Iicensed pursuem to Ihe provisions of ihe Contractors License Lew (Chapter 9(commencing with Section 7000) of Division 3 ot ihe
Busineu end Professions Code) or thet he or she is exempt iherelrom and the hasis For the elleged ezemption. Any violation ot Section 7037.5 by eny applicent tor e pertnit
subjects t�e applicant to e civil penalry of not more than five huntlred dollars ($500).):
❑ I, as owner of Ihe pmper�y, or my employees with wages es t�eir sole compensation, WILL DO TME WORK, an0 i�e structure is not intentletl or oHered tor sele (Sec.
7044, Business antl Professions Code: The Contractore License Law dces not apply to an owner of property who builds or improves thereon, and who does such work
himseN or herself or Ihrough his or her own employees, provitletl ihat such improvemenis ere not intentletl or oHeretl for sale, N, however, the building or improvement is
sold within one year of completion, Ihe owner�6uiltler will have ihe burden ot proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the p�operty, am EXCLUSIVELV CONiRACTING WITH LICENSED CONTRACTORS to cons�ruct ihe project (Sec. 7044, Business and Protessions
Cotla: The contractors Licensa Lew tloes nol apply to en owner of property who builds or improves thereon, and who contracts for such project wlth e contractor(s)
license pursuant to the Conirectors License Laws.). �
❑ I am exemp� under sec.
SignaWre: _
Owner ID ventied by dnver's licanse. ❑ Yes ❑ No
Business and Professions Cotle for ihis reason:
Verificetion of Ownership by (type ol document, i.e. - properry taz bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION:
Drivefs License No.
Data:
Expires:
❑ I hereby cetlity Ihat no excavetlon five (5) or more feet in depih in�o which a person is required to descentl, will be made in connection with work euthonzetl by this
permit, and that no building stmcture, scallolding, falsework, or demolition or dismantling ihereoi, will he more than thirty-six (36) feet high. (Ghap. 32, Gry 2, Art 2, Sec.
341, Title B, California Administrative Code).
❑ As ownerv6uilder, I will not employ enyone to do work which would require a permit irom the DiWsion of IndusMel Sefery, as noted above, unless such person has e
permit to do such work from the division.
Signature: Date:
Division of Indusirial Satety Permit Number,
ICERTIFlCATE OF COMpUANCE AND AUTHORIZATION OF ENTRY: I certity under penalty oi perjury ihat I have read ihis application and state Ihat the information given is I
correct. I agree ro comply with all stete lews and city ordinences relating to building construction, and authonze represemetives of Ihe Ciry of Costa Mesa to enter upon the
ebove-described propeAy (or inspeclion purposes.�ree not to occupy or allow occupancy of eny building authorized by ihis permit until final inspection.
GOOE �. INSPECTION TYPE
1676 Fixed System �inal Fire Prevention
1266
200
201
202
203
Pool Spa Final
Final Re-Roof
Final Block/Retaining Well
Final Factory Fire Place
Final Sign
204 Final Demolition
Applicant
p/�jfi INTRIALS
� �/ � ate
�� Date
CODE• INSPECTIONTYPE
206 Final Mechanical
208 Final Plum6ing
210 Final Electncal
212 Final Fire Preven�ion
220 Final Planning Approval
222 Pinal Site
250 Final Building/Occupancy
Qsg INiln1
i � `
�
CHRIS & MAGGIE THOMPSON
344 EAST 16TH STREET
COSTA MESA, CA 92627
Tel: (949) 646 5661
8th November 2001
To the : BUILDING DEPARTMENT - CITY OF COSTA MESA
REFERENCE: PLAN CHECK NO. B01 - 01063
We would like to apply for an extension.
We are in the process of making changes to the plans originally submitted, and
therefore will require extra time beyond the specified time period ot 180 days.
Please refer to the above Ref. No. that you have on file, as I am not sure when the 180
day period expires, but i know that it is soon.
Please could you notify us in writing that an additional 180 day allowance has been
granted.
Thank you
Yours sincerely
�--/ "'�\\ -/ ' "`Q���
Chris & Maggie Thompson
November 13, 2001
)
CITY OF COSTA MESA
P.O. BOX 7200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMEM SERVICES DEPAR7MENT � O
V _
�
Chris and Maggie Thompson
344 East 16`h Street
Costa Mesa, CA 92627
RE: Request to extend plan review time on application BO1-01063
Deaz Mr. and Mrs. Thompson:
I am writing to confirm my receipt of your letter dated November 8, 2001 requesting an
extension of time for the plan review of your construction project.
Your request has been approved. You now have until July 4, 2002 to complete the plan
review of your project. Please note, we may only grant an extension one time. I trust
that an additional 180 days will be sufficient. I have made the necessary updates to your
files at the City's Building and Safety Division to reflect the extension of time.
If I may be of further assistance, you may contact me at my office Monday through
Friday, 7:00 a.m. to 5:00 p.m. at 714.754.5615.
Sincerely,
�X�ati=����/ U
Burt D. Morgan
Chief Plans Examiner
Cc: Building/Safety File
Building Division (714) 754-5273 • Code Enforcement (714) 75d-5823 • Planning DWision (774) 754520.5
FAX (71d) 754�aB56 • 7DD (714) 75C-5244 • www.d.costa-mese.ca.us
CITY OF COSTA MESA �'
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(�ia) �sa-s2�s • Fax (714) 754-4856
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
344 E 16TH ST
BEDROOM & GARAGE ADDITION
Parcel Nunmber: 42521114
npplicant: THOMPSON, CHRISTOPHER H
Address: 344 E 16TH ST
CA
COSTA MESA ' �
Phone: (949) fi46-5661
Zip: 92627
Owner � THOMPSON, CHRISTOPHER H.
Address �: 344 E 16TH ST
, �� CA ` - � Phone: (949)646-5661
�' -� � COSTA MESA ' � � Zip: 92827
� , j .
, ,
Contractor., -- -
Address:- - = �
..,Phone: . .
, Zip:
� ^ � � � License:
��
PERMIT NUMBER
E99-00775
77 FAIR DRIVE, COSTA MESA, CA 92626
ISSUED BY:
Status: ISSUED
Applied: OB11711999
Issued: 08/17/1999
' � SCOPE OF PERMIT
INSTALL 17-LIGHT FIXTURES & 16-RECEPTACLE OUTLETS FOR GARAGE & BEDROOM ADDITION.
� ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixts
Recept Outlets
Switches
Non Res Appl ,;
Res Appl
Service to 200a .
Service to 1000a
Service over 1000a
Motors lo ihp
Morors to tOhp
Motors to SOhp
Motors to t00hp
Mo[ors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Cirouits
Temp Pwr Pole
Intermed Pole
REF:899-01250
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$18J0
$17.60
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
Quantity
0
0
0
17
16
0
0'
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
. �
Temp Dist System / Lighting
Busway/100ft
Standing SeIXion
Misc Eleclriwl Equipment
Trensformers up to 1 kvalkw
................up to 10 kvalkw
.................up to 50 kvalkw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Quantity
so.00 a
$0.00 0
$0.00 0
$0.00 0
$0.00 , 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 . 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES E59.80
COMMENTS I SPECIAL CONDITIONS
0
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related
regulations. (Ord. No. 9248, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commencad within 180 days, or if vrork is suspended or a6andoned
for a period of 180 days. .
INSPECTIONS: In order for �he work authorized under this parmit to be considered legal, such work must comply with all applicable codes, and all
requiretl Inepectiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in tha expiration of this permit.
FOR INSPECTIONS CALL: (714) 754•5626 /
WORKERS'CPMPENSAnON DECLAFATON:
I hereby eMirtn untler penelty of perjury one of Ihe following tleclarations: "
❑ I heve and will melntaln e ceRffiwte ot consem to sell-Insure for workars' compensetion, as pmvided for by sectlon 3700 oi Ihe Labor Code, for Ihe peAormanca of Ihe
work for which this permit is issuetl.
❑ I have and will maintain workers' compensatlon insurence, as required by seccion 3700 0l ihe Lebor Code, for the perfortnance of the work tor which Nis pertnit Is issued.
My warke�s' compensation Insurance carrier arttl poliry number a�e�.
Carrier: Policy Numher:
(This sectlon nBed no( be comp/efed il fhe permit is ve/ued et one hundred Oollars ($f 00) or /ess.)
❑ I certify Ipat in the peAormance oi the work for whic� this permlt is issued, I shell not amploy any person in any manner so es to become subject [o Ihe workers'
compens8�ion laws of Celif , entl a9ree ihat if I shoultl become subject to the workers' compensation pmvisions of Section 3700 of Ihe Lebor Code, I shell fohhwitM1
comply with these provisi s. �/ �
Applicant Signe�ure: �� i Dete: g I � T I�
WARNING: FAILUPE TO SECURE WORKERS' NSAT70N COVEPAGE IS UNLAWFUL AND SHALL SUBIEGT AN EMPLOYER TO CRIMINAL PEN TIES ND CIVIL FINES UP TO ONE HUN�RED
THOUSAND OOUARE ($100,000), IN ADDITION TO iHE COST OF COMPENSATION, OAMAGES AS PROVIDED f-0R IN SEGTIIXJ 3106 OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm Ihat I am licensetl untler provisions of Chapter 9(commencing with Sectlon 7000) ot Division 3 of the Business and Professions Code, and my license is in full
force and eHacL �c. a Class M
Contrecmfs Signawra: Date:
CONS7RUCTION LENDING AGENCY:
❑ 1 hereby an�� lhat there is a conshuction lend(ng age�y tor the pertortnance ol the work tor which chis permit Is issuetl. (Sec. 3097, Civil Cotle).
Lendefs Name: Lenders Atltlress:
Signature: Data:
OWNER-BUILOER DECLARATONS:
I hereby affirtn tnat untler penalry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the follaving reeson (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requiras a permit to construct alter, improva, demolish, or repair any strucWre, pnor to its issuance, also requires the applicam for such permit
to file a signed s�atement Ihet he or she is licensed pursuant to ihe provisions of ihe Contrectors Llcense Law (Chapter 9(commencing with Sectian 7000) ol Divislon 3 oi Ihe
Business antl Professions Cotle) or that he or she is eaempt therefrom and ihe basis for iha allegetl exemption. Any vlolation ol Sectlon 7037.5 by any applicant for e permit
subjecis the epplicant to e civll panalty ol not more ihan Ilve hundred tlollars ($500).):
❑ I, as owner of the property, or my employeas with weges as their sole compensetlon, WILL DO THE WORK, end Ihe siructure 15 not intended or oNered for sale (Sec.
7044, Business entl Professions Cotle: The Contractors License Lew tloes no� apply to en owner of propeRy who builtls or improves thereon, entl who does such work
himself or herself or through his or her own employees, provitletl that such improvements era not Intended or oflered for sele. If, however, ihe building or improvement is
sold within one year of completion, �he owner-builder will heve the burtlen of proving that he or she ditl not build or improve for purposa of sale.).
❑ I, as own6� of the property, am E%CLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to constmc� Ihe pro�eCt (Sec. 7044, Business end Professions
Cotle: Thp conirectors License Law does not epply to en owner of property who builtls or improves ihereon, end who contracts for such project with a coniractor(s)
license pulsuant to the Comractors License LawsJ.
❑ I am e:empt w
SigaaWre: �
Ownar ID venfied by
❑ Yes ❑ No
Business antl Professions Cotle for Ihis reason:
Date: $ l�
Dnvefs License No. $��'�" � Expires: O=—��I — O �
Verification of Ownership by (rype of tlxument, i.e. - property tar blll or deed):
DIVISIDN OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby caniy that no excevetion five (5) or more feet in tlepth Imo which e person is requlred to descend, wlll ba matle in connecHon with work authorized by this
permil, and tha� no builtling stmcture, scaHoltling, falsework, or tlemolition or dismentling ihereof, will be more ihan thirry-sIx (36) feet hlgh. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8. Celifomia Atlminisirative Code).
❑ As owner-builtler, I will not employ anyone to do work which woultl require a pertnit imm tha Division of IndusMel Safery, as noted ebove, unless such person has a
permit to Go such work from ihe division.
Signature: Date:
Division of Indus��al Safety Permit Number:
CERTIFICATE OF COMPLIAN E AND AUTHORIZATION OF ENTRY: I certity under penelty of perjury �hai I have read Ihis application antl stete ihat tha information given is
wrtact. I egree to comply h II state I�v/s and ciry ordinances relating to buildinq construction, and authorize represanlatives ol the Ciry of Costa Mesa to enter upon the
above-descriDetl p�apert or inspec' r(Grposes. I egree not to occupy or allow occupency of any buliding aut�orizetl by this permli until tinal inspection.
gil�-�99
Sign ure Oi wner(s) —� Date
[.jd7�•j�[q2�NJ7
1676
1266
200
And/OrAuthonzed Appliwnt Date
Fizea System Flnel Fire Prevention
Pool Spa Finel
Finel R�-Roof
201 Finel Block�Retaining Wall
202 Finel Feciory Fire Place
203 Final Sign
204 Finel Demolition
�g
� QQpgj INSPECTIONTYPE
206 Final Mechanicel
208 Final Plumbing
210 Final Electncal
212 Finel Fire Preventlon
220 Final Planning Approval
222 Final Sile
250 Final Builtling/Occupancy
PPSE
`'/'f '° ►
•��onessaem�owc: 344 E 16TH ST
ovmeasruYeivaiavx: DOROTY WALKER
"0°"�' 3 4 4 E 16 TH S T
C.M. 92626
�rr�. wmwc.00x�ss:
�xcxrtECT ox w�a,�n:
�x
IPCII.OP ENG'S JOONESS:
CONf11ACi0R'S NAI�:
CONfP�CiOX'S YNtRlO
wo�u
uxT:
ur no,
UNf:
uc w:
urir:
11CplSEU COMN�CTONS OECLAXATION: I Mieby Nim u�Mer peroly d pijwy Net I un Icamd under poNe'vn d CAeqw 9
(wmme�xi�q �h Senion ]000) ol Drvoian � d Me Bw'vma eM Pmlmeinm CoM. erd mY 4oerm u m NA lace erd aflea.
cm uc. No.: uc. cuss: uc. No.: EXP :
Delet CanVeqp:
OWNEN 8111LOEF OECIAFATION: I Irreby elfiim under per�Ny d perN�Y �� � em naemq liwn IM CoMretlae Lironee lew lar ihe
dbwiq �aeeon (SeUion ]0�1.5 &nima enE Admeiana CoEe: My cry a eounry v,hidi �pwres e pmnA �o aombup. ells. imprws.
Eemdeh, a repai e�ry ev�ciwa, prior b G� ewvwe, ebo �eVWrm �M applirenl tor wch pumtl lo Rb a vpneE eimemmi thm M a eM
u �Ken.w w��� w ine wo+mm+ a un co�vaaon umme Lew Icnea. e lownmercim .un s«ta, �aool d oh�ew� a a �6e
Bwmem vk Prdaaiaru Cade� or ihat M u ehe 6 xamq �hrelrom uM IM beau la Ne aAepeE aaemption. My videtion d Setlon
]OJI.S b/ vry epplimnt Iw e permil wbjW� IM epplirsm to e dvil pmelry d rot mws �hen fva huMred EoAen �55001).
�I,esawnerdtMprope�yamyempbyeeswYhwapmmtheisdemmpenealon,Milldo�M1ewwk,e�MlMeUuduroeirotiMendeE
or oflared br eab (Sedion )OM. Busi�ava uq Pmfmsiwa Cotls: The Conirraon linnae LewEaea �weVPNtoen oxnm d popeny
who bulda a inpmm 1lwiean. md Wa dose suM wark himeetl ar MnM a Nraph he a hm own empbws. pwidaE IM� wch
impma�am me nal iMeMed n dlemd In seb. tl. lawever. tM builli�p v inpwanaq u wN wilhin ma Y� d wmdMbn. IM
owner-0Wder rriA heve tM duden d pwinp M a ahs did na WdE a'vnpwa In Ihe qvpma d eele�.
� I. n owrr d iM pW�Y. am etlutiMJ mrurmn0 �4h 4oemW contrMa+b w�W Mo pNaG (5ee'vi Au. Bw'vra and
PfO�MfIOM :�iO�B:1110 �.C141etl01t �1CMW �IW b..'M M G�/ b N OMINf (� PWM�Y'M�p b111�i V PI�G'Y I�IM0011 Gtb N�q
conVecb la e�M pqwa wiN e aMreeoHe) liceiwd µuvueN to ' CaNrmae lioeroe law).
em �emq uikee Sxtian: � B. 8 P.C.. ror //�� � /� / � ,
De1e: —�'� �� Owner. li � �liltGa+"�///�/1�+/�
i eo .er �r mm i.m.�.a,a d�e �w«.w�e ub �.a�w. d ceu�,�. �wm� .m sd.n caae sm�. uws. usx..�e
. vd Nm I ar eny haun dNduq amqeni wi4 / wil nd (wcb me) nesC ro conWY xvh ui0 qe�s mEea uM IM nW'vammb tar
Dete: Applicem:
WORKEP'S COMPENS�TION DECL�RATION: I Mraby elfimi under perel�y d pe�jury aw d Ila bllowirp Eeqereliom:
❑ i n.�..�a wu m�me�, e un�'cme d m�wm m..n;�w,. n,.�wa: comro��. �+o�owee �n M smm a�oo a m. ien«
Code. la iM pe�orme�we d Na xak Iw which �his permn u bauetl.
❑ i n..�..�a w meime:, waken• oomw�umo� �nwrerce..s rea�u.e M swim aroo d m. Vno, cae.. io, me w�r«m.�m d m.
wak ia MucN tM1b pamn u mueC. MY workere' oompeiuetun imuruics miier anE pdiry number are:
c�«:
Pdiy Numbar.
(7Aia aecfion need rrol b comd�� / fhs p�mY ia br one M1urMred LdM2 (51001 w Im.J
� I ceniy thm in iM palormeMe d �M wwk br r.fich ihu parmil ie'waueC. I ahell nal empby eiry peaan in ury menmr o m to
becme wbjeq to iM wM1ne' mrt�pemation 4x� d Catilamie, enE epree Nu A I ehauld baconn nApe to tM xoiMn'
compe�ueiian P�++om d Secion 3]W d the lebor Code. 1 dull lonhwuh comWl wbh Oiwe pwieims.
oa.: �oa�n:
Wam4p: F 9un ro wcun rolkra'romprwtlon rov�rp� li unY�Nl, uMWll ub/cf an wAvlqs ro MMkI pwltlu uM
mm �nu w ro m. mnana nwu,.ro ewr.n (rtataaoA m.mirwn ro m. co.r o� ro�ro�rwn ��p+ u n+ova.e ror �n
S�ctlon 9TM ol IM Lebor Coas, InferuS ��4 ��mq i ha.
CONSTIiUC110N LENDINO �GENCY: I hmeby eH uMm penalry d perjury thm tMe u e omurmion Wdiiq epeM.y tor Iha
pMameMe d �M woh M whitli tM P�Y u eawE ISwion �09J. CN. Cl.
LENDEfl'S NANE:
LENOEF'S AODNESS:
I ceniy ihe� I Mw metl Nis epplcetian end qW ihm tM ebow infpmelbn b cvne. l epree to cpnply rmh aA r'ay ud wmly ortl'vienwe
uM etele levn reldmB �o Wikmp wnseuaian end hereby eWwr¢a repreaenteirvn d Ihe dryto enler upan tM ebae-meniiorrA popry
lor inapedion purpowe.
� DOROTHY WALKER
om,: y—G — 9.s"
�SIStd6 WP) Whna-BuiWiq 8 Sebry:OreerFb: Genery-Appicanl: Nnk-Revanue:0otlenro�Acaeaear
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 073110
PERMIT NO: B 073110 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : REPLACE GLASS 6 RAISE SILL ON WINDOWS SQ FT: 2,400
CLAIM VALUE: 2,400.00 CALC—VALUE: 2,400.00 GROUP OCC: R-3 /
COMMENTS: X
�*+�*+�*+�*���*�**�+�ir�it�+�+��*�rit******rtat*�**+�x-*�****��**��*�**�**�*+�**ieit��**�at**��**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FANT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42521114 ZNE: REF NO:
PLANNING NOTES>
i
if 1FlE 1E if 1E 1E �f iE if iE iE 1ElElE iElE 1E iE ik 1E 1E iE iF iF 1k 1E iE 1f iF aE iE 1E iE 1k iF iE if �E �E jE aE ik iE fE iF iE if iE iE if iE 1f 1E iE �E iF iE if 1F jE iE �f iF iE iE �E �E iE 1E if fE ih iE 1E if iE �E if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY ____ DATE:
BUILDING APPROVED HY ; DATE:
APPLZCATION ISSUED BY; DATE:
+�*�t+t+t+���t�t**�r**+t�t*�r�**�t *�r*��**�*�� �
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GM NT:Y
BLDG PMT PLUMHING ELECTAIC MECI-IANIC FIRE SMIP/RES GRADING
PERMIT 54.00 ,50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 54,50 0.00 0,00 54.50 54.50 .00
REVENUE DIVZSION TOTALS--> COLLECTED; 54.50 OVEIi/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
54,00 .50
1F if k iE 1Elf iF 1k iE �f iE 1k iF 1k iE i! iE if 1E k 1k iE iE fE iE if 1E ik 1f 1f if �E iE 1E iE M IE iF 1E �E iF fF fElE if if iE iF iE 1f 1F iE it 1E k iE iflf 1F 1E iE 1E 1f iE iE fElE 1f !E 1k iE iE if k �F iE if 1E 1!
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY
2400
D E S C R I P T I O N
ALTER BY VALUE RESZDENTIAL NOZONE
END OF FEES
UNIT COST TOTAL COST
1.00 2,400.00
Ql GCi£551Z—Cui'd3F�13 "; r' _. ;�
O�TE: L'?.'�S��E TifE; Cc:v'
,
j CONSTRUCTION AND PLANNING � �� P�.,L & SPA
APPROVALS Permit # Date Inspector , AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pooi & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electricai Conduit UtilitY-Undrgrnd. 54. Forms '
�
A. Electrical Conduit•Undrgrnd. 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. E�ectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Wa:er Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVRL TO DECK
11. Property Sewer Line & House Cannection • 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 Electricai-Cond��t 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Rccess Approval
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling 69. POOUSPA SYSTEMS PINAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Duas, Ventilating 71. Product Pipin9 �Gas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaye Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat � � 75. Dry Chemical
2J. Freme and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FiXED SYSTEM FINAL
29. Insulation 78. FIflE PREV. FINAL
30. Drywall Nailing HEALTH DEP7. REQUIREMENT
31. Plaster 8rown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Ftnal Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy '
37. Final Factory Fireplac¢ -'
38. Final Plumbing
39. Water Service•Final
40. Gas Service�Final �
41. So�ar Oomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation,
44. Landscape IrriQation SYstem
45. Sound A[tenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �( y1�5' G�/bL
_�
48. FINAL PLANNING '
49. Electric iielease to Edison �''
50. Gas Release to Southern California Gas Co ,/
51. CERTIFICATE OF OCCUPANCY _
No. Qate
DNISIQN OF BUILDiNG SAFETY
GlTY PF GC7STA t�iE5A
A1PI'itQVED _�
This sst af ple� an specificalions MUSi 0e F,eV� un �his joq at all
dnd it is tmlavtfN td eke any changes or alteraaon an same wi�„^��• ,
pemtission irom the ivisi� ot Building and Sa!+=,,, '": -;;,. x���
�-�-
ihe Stamping ollhis P� � e�'f'^"'° "� ar, -::)i he heid t�'�
Ot to b�B n epDravai oi t, �a alion fll anY v.�� •... �- '. tY N��'t ot
�u a�Minance anNar I te taw.
y?.:�s end permit
B Ouildplg or work is �
( wiNin 180 aays ot i:
(�'
�.��Zh
_.�,�� a�-�
axruei��'i�;', �'�vciA�t
na, c�t . .
0
���
0
A�
��+�.L�1�`�
0
��� �i`a1,L���
�-
I I'� r`^�N
���,Is,O
ai C��OF
�1i:s S e l
°e d'�� �0�pi 9�'>'p� STq���C
�he ��`O"ad�air �°s ��'�' hFSq `9•�F
s o o n
�1l0 �o �p� �' �,� m�ke Pc��Mdii �}'
sa �vn �eo�� . �'hs,�a��� °�s\
T4�, �i'y,.� a'Do�p�h�Sp�J °o� /'ange�GST pv
�b�i/�":�v ,�ea�� or�hP anasp ��ianga'aij�bP�ea� �
/w//hhl�0�h�p�'��liols/d�0%��`���oc��0drio �asa�P�.�l°nn�his.
B�aay���s��shaii � n0t�n�ssH f �'!�oame ,�a�a/i
���Ss�ar,�Prer,�%bYi,�� yPl��s�/1.�o`6ECpS�aMP��I �es
P��. �J/ip ��Oi hP/ 6d.
9am °aq >%'Ci o'�n
�v/n/J/� °bc��"n tyojC�aa
� ,i� .ii�a
�U6C y0�0'�I
-I-,-�Vl. , \ '��3
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�UDNESSaFBUILqNO: 3�}Q E 16TH ST
wn,Exs`b"e'°'aa"": WALKER
�o�%% 344 E 16TH ST
C.M.
548-2586
�vx. �uia+o �oo�ss:
uicxrtECT on Q+ow�nn:
urcx. on exa�s woncss:
ue no.:
UNT:
uxr:
���T�� PREMIER ROOFING (909)674-7052
cwm�cra+s�uiwo 13154 HROKEN HIT CI
munEss: CORONA CA ucno.: 634404
91719 u�:
UCENSEO COHfP�CTOP3 DECUN�TION: I M�eby elfrm wMx pmely d pxjury Nel I am I'saned under prw�uiwu d CAeqm 9
(cpnmercinp wGh SMun 1000) d Divann 3 tl Ne Bua"uwa end Pmleasiun COEa, eM my fiow�n u in /NI lau aM eHod.
c c.No.:061266 uc.cuss: C_39 uc.No.: 634404 EXP: 03/96
�me: CaNrada:
NEN UILDEP DECIANRTION: I herWy elfnm uMm penely d per'ryry ihal I em exemq Imm iM Contream licenm lew la Ihe
'olbvnn0 roawn (Seuion ]0�1.5 Buemeee eM Prolmziona Cada: Any ciry ar mumy whirh raquiree e permN lo mn�Vucl, Ma, improve.
bmole�, or repei eny eiiucture, piiar io de owence, ebo reyuiree IM epplirant lor euc� parmil lo file a eipmd eletament ihet M a eM
ia liceneM punuent �o IM ywieone d iM Conireume Lironse lew �Cheqx H(oommendrp wilh Sadion )000) d D'vepn 3 d Or
Buv�wea W Praleaione COEeI «Net M«ehe o ummG� ihereM1an end IM bers I« ihe el�+aed uanqun. MY videlion a Satlbn
]W t.5 by arry appliuni la e pmmu wEpGs �he eppli�am io e riril perWy d m� mora �hen liro hund�aE Edlen �f500�).
� I. ea owiwr d �ha O�WnY m mY �Gb'/� �h wnyea as �ha'r ede cwnpenaetion. will do tM waA. eiM ihe �Vucturt e �wllntendeE
a oMered lor aele (��n ]01<. Bueiinav eM Proleasiona Code: TM COMreGae Limnse Lew Eoes not epply lo en ownm d papeM
who buiEa v inProvas �Mman. eM who Eoee euch xaklimeetl rc haneY a Mraph ha a Mr own emDM+�. pa'� Ihel wch
impwemMe va mt iNendM a d1aeC ta eeb. tl. howamr. the bntl'uq a inpwanw u wld rmhin one Y� a�0��. �
ow�wrbWEw xill Mn ihe buNan W Va+�q M or ahe Etl na drik ar impaa lar iM W�O� d oela).
� 1. u mmer d iM p'aperry. em a�tlueively conlradiq wuh limued wntrec�as io cmmrue the pmjea (Seeion JON. &ni�a eM
vraeaean. coee: rne com,moi. uceme �.. eoe. m ewN a��, d wwd+r wno wib. «�mpove. m«aan .na wno
wnvecn br wch W4�� wiN e mmreeMe) Ikamed Wnuenl to ihe CaM�euan Lioema ler.'1.
� I em eaanq uMr Sec�c�: B. 8 P.C.. tor thie �mm:
Daie: �
i eo ns�er wner � i.m •••e,• a.oa wa..�e m. na��a+u d cauom. w.en d,e smmr coa� seeo�. z5ws. zszn..�d
255JI. end UW I a M' Mws buMiiq omWw wYl / W m� (aecb aro) med to oomdY wih seid ems mdn ud tM nON�sib br
e D� IamuwNbn a moEtirmion ham�helv�ereqenwm Oittrid. RauEaniY mM�utlian �VG�iwean memq fmm tlra
pwiavu.
Dme: Appli�an:
WOPKEN'S COYPENS�TION DECUNATION: I hereEy aihm uitlx pmietly d psjvy ons d Ms IaOo�iiq ddamiom:
� I W wd mdruen e wnLPala d wmni m eatlimiva br wvken' oompnumion. m prwked la Dy 9atlian 310o d ihs lebor
oda. la �M p�lamuce d IM wk la wNch Nb pamY u ivueE.
I hevs eM �1 maiman xnNaes' oompenm�un inaururca, ea rpu'ued by Saeim J)00 d tha LaEor COEa. br iM peilarmerKe d IM
wpk Iw xfiiM ihn peimil u mued. MY wa��' �G^^�b^ imurvice �rier end pdiry number va:
c.m«: STATE FUND EXPIRES
va:v M,mn.: — 10 / 2 8/ 9 5
(This sectiar rreeC rwt b romplMeE l Ns pemik n Iw one hundred Ldbrs (5100/ w less.)
� I eerlAy ihei in �ho pe�loimanae d �M wak Ia whkh �hie peemN ie i�I eM1ellna,tmpby vry pemn In eiry enner o u lo
bacwns wbl� �o tM v.wkere' canpenmlbn kwe d Cdilan' d ie�'IK I 4wuW beroms wEj to iM MOM1en'
cpn yeiun pwieiov d Saaian �]00 d iM lebor Code. I 6nh �mm ' h iMm proviebn.
��, i
Dma: o/if( �/ S I RVWirenL
Wam/np: FT ��cun workn�'ronpwu�tlon cor�rp� unlawNl, entl �NIIWb/Icf �n wrplqw r/Mnl p�n�ltlu �nJ
GHI 11� �p ro m� �indlM tM�urtl dadbn (SIPq000A M WJltlon lo tlw cwl ol rompNwWM1 u provx�M ror �n
Sxtlon J]OG ol IM I.�boi Cods, Infxut �d �ttumsy'� lwa
CONSTfiUCf10N LENMNO �OENCV: 1 Mnby alfirm uMa per�My d par'Fvy IMt IMn u e awWrvdion bM'vq epaK/ lar Ne
pertormerux d tM v.aM la xfiitli ihe pem�i e eweE (Sedian 309]. Civ. C�.
LEN�ER'S NAME:
LENOEH'4 �ODNE9S:
nlim ud vele tlut IM ebv.e iNamelion's caned.l Wiee to camdY xilh ell M/ and aamiY adiwcaa
mmmWun ud Meby eWurce �epreeantmives d itw dry m antx upon �M eEws�meniivrE popany
ERT EDWARD JR
1 �
(5151<6.WP) WM1n�uikip 8 Selety; 0 r�-File: Canery-�ppiren�: Rnk-Rmmw:Ooken�o��ewuor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: H 072881
PERMIT NO: H 072881 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE: OTH
JOB DESCRIPTION : T/OFF RESHEATH & RE—ROOF W/COMP. SHINGLE SQ FT: 3,000
CLAIM VALUE: 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC
*x***��***�*�r*�*x����**��****+�******��*���***�**x��**�**��**x��*****��r�r**+�*�*�*�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 42521114 ZNE: REF NO:
PLANNING NOTES>
i
iE iE iE iE iE if iE 3E 3E iE iE * iE iE fE 1E 3E iE 1E 1E Ik IE 1E 3E iE i! 1E if 16 if 1E 1E iE iE iE iE iE 1E f! iE iE iE ii 1E 1E 3E 1E iE 1E �E if 1F if IF 1E if iE if if if IE if 1F 1E iE 3E jE 1E iE iE 1F iE if jF iF iF 1f if K
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
HUILDING APPROVED HY : DATE:
C+ �
APPLICATION ISSUED HY; DATE: � I�
�r*rt*�r�r��**��r�r�r+r*+�*+�*��r �+r*�****x�+� **
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GME T:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 50
PLAN SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 54.50 0.00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANZC
54.00
TOTAL PAID DUE
54.50 54.50 .00
54.50 OVER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN—CHECK
.50
1F k 1E �E fE fk iE 1E ik iilE 1E 1k iF 1F if iE if fF 1E 1k if 1F 1t 1! 1! ik 1f 1! 1F 1k k 1E fE iF 1F k 1E iE iE 1E 1E ff iElE k 1f k Ik if iE 1f 1k 1F fE i! 1E i! iE 1! i! if 1E 1E iF 1E iE k iElE 1E iE 1E iE iE if it IE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY D E S C R I P T I O N
3000 REROOF BY VALUE RESIDENTZAL NOZONE
END OF FEES
S�pKE p�E�'ECTQR
�EQUIRED ,
UNIT COST TOTAL COST
1.00 3,000.00
U! Ji l: ` -J �:2:"�2 -' : �� •"
,,�. �� : _ = J:
-.
, CONSTRUCTION AND PLANNING� PO� , d SPA
b
APPROVALS Permit 9F Date Inspector APpROVALS Permit # Date Inspector
1. Temporary Electricaf Service or Pofe 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement • '
-3. Electrical Conduit Utility-Undrgmd. 54. Porms . t
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Plumbing & Pressure Tett
6. Electrical UFER Grnd_ 57. APPROVAL TO COVER-GUNITE '
7. Footings � 58. Electrical Conduit�Undrgmd. �
8. Foundation � 59. Gas Pipe, O Undrgrnd., Test , �
9. Water Pipe-Undrgrnd. 60. 8ackwash Li�es; P-Trap, L� Undrgrr.d. .
10. Svuctural Fioor System 61. APPROVALTO;OECK , �
i i. Property Sewer Line & House Connection 62. Backwash & Receptor-F,inal
12. Sewer Cap 63. Heater & VenbFinal ` �
13. Roof Orains 64. Plumbing SYstem - Final
14. Rouqh Plumbing - 65. Electrical�Final 1 �
75. Rouqh Electriwl-Conduic 66. Solar SYstem-Final .
76. Rough Eleciric Wiring 6J. Fencing & Access ApP�oval � I
17. Rough Wiring Sign 68. APPROVED FOR PIASTEftING .
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' , APPROVALS Permft #
27. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating , � 71. Product Pipinc� � Gas ❑ Oil
23. Gas PiPe•Fough & Test ' ' 72. Underground Flush -
24. RoofFraming � 73'. Undergmd.StorageTankLiGas ❑Oil
25. Roof Sheathing • � Z�� q.� �QL//� 7q. Overhead Hydro
26. T•Bar Ceiling (Structural} & Monocoat � 75. �Dry Chemical •
27. Freme and Flashing . 76. Dry Stantlpipe� `;,
28. Laihing & Siding "' , ' 77. FIXED SYSTEM FINAL
29. Insulation � - � ' 78. pIRE PREV. FINA� ' ���
30. Drywall Nailing � _ HEALTH DEPT. REQUIREMENT__�
37. Plaster Brown Coat � 79. F�NAL I-NSPECTION ' �'T'f ,
32.,Electtical Power Mecer�Final 8Q. FOOD CEfYTIFICATE tSSUED
33. final Electric - ' Notes:�( Z( QS �1�t0 �,r�. v Q%� ���
34. Final Heating & Air Conditioning ' � - �%
� �1Y
35. Final Gas Pipe-Test . ;
3fi. Hood or CanoPY - ' � �
37. Final Pactory Fireplace , � _ _ ' ' , �
38. Final Plumbing '• ' _
39. Water Service-Final . _ ' "
40. Gas Service�Final � •
.
47. Solar pomestic-Final � . �
42. Backflow Preventer �
43. Backflow Irrigation . � .
44. LandScape IrriGation SYstem
45. Sound Attenuation, � ., - : .
46. Handicap Regulations _ �
47. FINALSTRUCTURE&BUILDING 7 S'4S �G�/� ,
48. FINALPLANNING� ' •
49. Electric Release to Edison .� �
50. Gas Release to Southern Cali{ornia Gas Co � �
51. CER7IFICATE OF OCCUPANCY . " �
No. Date -
Pfl0.1EtT AUOflESS: 3 4 4 E 1 6 TH S T r �/u uNiT:
OWNEfl'SNAME: S �i�O�Q\� �S� wQ
RUDflESS: 2 �'S'$�A�rN(�+ E � �
�j(ltMGCOSTA MESA,CA 92627
714) 548-2586
PflLHIENGINEEH:
ADOHESS:
flEG.NO.:
UNIT:
rexmirrEe: LESTER ELECTRIC ( 714 ) 675-8271
aooness: 417 EDGEWATEA
BALBOA CA 92661
LICENSED CONTNACTOP OECLABFTION: I here�y a7firm itut I am IicenseC un0er pmvisions ot Cnapter 9(commentinA w+�h Sectbn
7000) ot Div io 9 0l I� usiness an0 Pmlessions COCe, an0 my lirense is in full brce an0 eibct.
uc.: ��69�� STRTELIC.:Cp` LLASS: C—iO EXP: 00/00
oai � 2 �—�� siqnawre: G-���C
HNEXS' COMPENSATION oECIAflATION: I hereby aflirm tnat I nave a cehificate of consent to selbinsure or a certifitatt of Warkers'
Comoen5ation Insutance, or a cer�ili¢E WDY ��e�eol (Section J800. Lae. q.
'OL1CY NO.: E%P. DRTE:
COMPFNY:
j ❑ Cetlifie0 copy is �ereby lumishetl, ❑ Cehilietl copy is filetl wit� �he ciry BuilOinp Division.
Da�e: ADPliwn�:
E%EMPfION FflOM WONKEFS' fAMPENSATION DECLAMTION: Rh6 stttron nettl noi be wmpleteG il N¢ pemn ¢ for one �uMreO (5700) a less�.
I ceNty that in ��e pedormance ai ihe work lor w�ic� Ihis Dermii is issuea. I shall noi ¢mploy any�n in any manner 5o a5lo hefAme
-^t to t�e Wo'kers' Compensalion Laws ol Cali�omia.
L �
le: � Signamre: �� g-�+
OTICE: If, alter making ��is declaration, you shoultl hecome su�ject to t�e Workers' Compensation provisions of tAe Labor
Cotle. you musl lort�vn�� [omD�Y �^'��� suc� pmvisions af I�is p¢rmit s�ail �e 4eeme0 fevoketl.
CONSTPUCTION LENOING pGENCY: I Oere�y affirm Ihat ��¢re is a cons�mc�qn lentling agency lo� ��e p¢tlormaMe o� I�e woM fa�
w�ich ��is permil is iuueG (Seciion 3W7. Civ. C�.
LENOEN:
RDOflESS:
OWNEB BOILOEP OEUAf1A710N: I here0y affirm I�at I am e�emD� �mm the Caniractors' State License law tor tlre following reasan
�5¢[Iion 7031.5 Busineu anE Prohuional CoOe: Any cily of wun�y whic� Rpui2s a permi� to constmcl, alier, impmve, tlemolis�, or
reoair any simcture. prior toits issuance, also repuires the applicant lor such permit to file a sign¢0 statement tlut hPlsAe islicensed
purSuanliol�e ptovisions o�i�e ConVati0r5' $�a�e Li[ense Law(Chapter 9�commencing wilh Set�ion 7000) o�Dlvision 3 ol��e BuSineSS
and Pmfessians Cotle) or Ihal he/she is eremD� Iherelwm an4 ihe hasis for Ihe alleBed exemplion. Any viola�ion o� Seciion 7031.5 by
'� any applicantior a permi� sublecis Ihe apDlican� to a civil penally of not more �han �ive hunare0 dollars (5500�.
I, as awner ol ihe pmDeny or my employees witA waAes as t�eir Sole comDensation, will do tAe work, an0 ihe
❑ simcWre is not intenGeG oro�lerea far sale (Section 70a4. Business antl Pmle55ional Coae: TAe ConVaciors' State Liunse Law
aoes nol aODly Io an owner ol a OmDeny wlro DuilGs or impmves ��ereon, anE wlio Goes suc� wnrk �imsell/�ersell or t�mugA
�is or �e� own emDlOyees. pmviAeO Ihal Suth improv¢ments are n01 intentleG or aflereG �or sale. II, how¢ver l�e bWEing or
impmvement is soltl within one year ol comple�ion, �he owne� vnll have lhe Curtlen at pmvinA ��she did nol 6uild or impmve
�or Ihe purpo5e oi sale).
I, as owner ol the pmpeny, am exclusively conlraciing with licensed contraclors �a cons�mcl lhe pmle�� (Seclion 7044, Business
� and Pmlessions Cotle: The Contrac�ors' State �icenu �aw tloes noi apDN �a an owner of praperry wAa DuilOs or impmves Ihereon
antl wM convacts lor suc� pmlecls vnth a coniracmqs) license pursuam m t�e Contractors' S�ate ticense Law). i am aware
itut p�ool ol Ineir Worker's Campen5aiion insurance SMuld �e O�ovitlM to me.
� I am exempl unCer Sec�ion: B. 8 P. C.
br �nis reason'.
Oale: Owner.
I ao hereby cenity �hat I am aware o1 an0 untlerstantl tne reQuirements ol Califomia Heat�n anU Safery COEe Sections 25505. 25533. an0
2553A ana t�al I or any INute Guildmg Otcupdnl wilVwitl not �circle one) nee0lo camply vn�� SaiG slale COUes and t�e tepuiremenis for a
peimit lor wnsimction or motlilicaiion Iwm ��e Air Oualily Management DiSirict. fle5i0eniial constmction aDPlicalions are eKemp� Irom
I�ese provision5.
Daie: Applicanl:
1 hei¢Dy cerUfy Ihal I have reaa Iha aD�licalion anU S�ate Ihai I�e aUove inbrma�ion i5 tarreci. I agree l0 wmON �'^�h all Ciry and tounry
or0inances antl stale Wws retating �o Cwldmg cws�mction anA �ere0y authoriae repreuntaiives o� iha� u Wn Itre a�ove�memimed
pwperry lor inspection purposes.
��I �� � � — � �
i64L46 WM1ne—BmMing; Geeen—CoOe Entorcemenl; Canary—Applicanl: Pmk—Ravenue; Gddenro0—Asseswr
-_
CITY OF COSTA MESA — BlIILDING PERMIT PERM NO: E 068586
PERMIT NO; E 068586 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : C/O OF PANEL S UPGRADE TO 200AMP SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: /
COMMENTS: ONLY ELECTRIC WORK AS DESCRIBED
�r�r**�r�r+t+r+r*+r+r�rx��r*x�x�x��rx�****+r�*�r*x�*x��r�r�r*�r*�r+�**�t**+��x�****x�*****x�**�rx�+r�tx�***�x��rx-�e***�
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT: FT IN REAR• FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV; PARCEL: 42521114 ZNE: REF NO;
PLANNING NOTES>
i
ifiEiEiEiElEifiEilflfEfEfEilkfkflfffflEilikkilillkiFfflEflifiEiEiEifklEffifiEiEifM1liEiEiEfEfF%iflfiEifiEifik�fifiElEiEklEiEjEfffEiEiklkihiliFifiFiEifiE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPAOVED BY DATE:
BUILDZNG APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:
fkiEitkifitMititiEiEfEiFitiFfEilfkiFfEitit 1tililiEiFfEiEititiE � �
1EiFiFif7kiflfiEififiElkitfFiflF�EfklffffEiffEifiEfEibitltitfEiE1(�iElFiEIPiEififiEiFlEiEik1llEiEiFikiEfEifjE�Eifi6iEifitkiliElElEiEiFifiE�E 1FiFiE ifififih
LEGALIZATION:N F E E S U M M A R Y STROCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECIiANIC FIRE SMIP/RES GRADING
PERMIT 29.50
SOR SMIP/NON—RES
PLAN
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 29,50 15.00 0,00 44,50/ 44.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 44,50 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
44.50
i!iliEiEiFkffiEfEiElEltftifltkitifiEifftilitffiliEiElfiEiElEit1liEitifiEilifitiFiEiliFltikiEfEiF%iEiEiliEiEifiEillkifiElE�EiEiEiEiEitifkkiEiFiEiEiFiliflf
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E 5 C R I P T I O N UNIT COST TOTAL COST
ELE 1 SERVICES BELOW 600 V 5 BELOW 201 AMP 18,50 18.50
ELE 1 SUB—PANEL 11.00 11.00
END OF FEES
/
ui t�Q16647i-00166�7? T O T 44.5D
DATE= 09/23/94 TIME: OE:3a"
CONSTRUCTiON AND PLdNNfNG , H�JL & SPA `
APPROVALS Permit# v" Date Lnspector APPROVALS Permit?k Date Inspector
1. Temporary Eleccricat Servfce or Pate 52. Pool &£quipment Locaiion
2, Sbil PiPe�Undrgrnd. 53. Steel Reinforcement
3; Electrical Conduit Utility-Undrgrnd. 5A. Forms
r4; Electrical Conduit-Undrgrnd. 55. Electrical Bondmg
', j5;t Steei Reinfoicemen2 58. Rough Pfumbing & Pressure Test
�
i6..ElectricalUFER�Gmd. 57. APPROVALTOCOVER-GUNITE
r, _
J. Footings - 58. Elecirical Conduit-Undrymd.
�8.''Found'dt�on . 59. Gas Pipe, O Undrymd., Test
;,9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�i'rap, L7 Undrgmd. �
10. Structural Floor System 61. APPROVAL TO DECK �
11, PropertY Sewer Line & House Connection 62. Backwash & Receptor�Final
�
1"'. Sewer Cap 63. Heater & Vent�Final
YV. RaoE �rains - . 64. Ptumbing System - Finai
�
� i'��'r. Rough Pl�mbing ' - 65. Electrical-Final �
1,5�. Rough Electrieai�Condurt-. 66. Solar System-Final
1� Rou9h Electric Wiring 67. Fencing & Access ApProval
T7�. Rough Wirinq Siyn " 66. APPROVED FOR PLASTERING
i�. Rough Electricai•T Bar Ceiling 69. POOL%SPA SYSTEti1S FINAL
19. Rough Heating & Alr Conditioning FIRE DEP7. REQUIREMENT
i
20. Rough Factory Fireplace . . � �APPROVA�S 'Permit#
2L �Oucts, in, Structure �. , . - � : , 7Q, Undergraund Hydro
22. Ducts, Ventilating . ; 77. Product Piping � 3as � Od
23.'Gas Pipe-Rough & Test � 72. Undergroand Flusfi
24. ,Roof Framing 73." Undergmtl. Storage Tank O Gas ❑ 0�I
25. Roof Sheathfn9 � . " `, , 74. Overhead HVdro 4
26. T�Bar Ceiling (Strucwral) & Monocoat ' 75: Dry Chemical •
27. �Frame and Flashing 76. Dry Standpipe ,
28.'Lathing& Siding � . � •i 77. FIXED SY5fEh9 FINAL �
29. Insuladon ''� � ' 78." FIflE PREV. FINAL
�30. Drywall Nailing � . � � . � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � �. FINAL �NSPECTIpN, �� I
�--
32. Electrical Po�var Metec�Final � �/;25_9 I"�. ' OOD CERTIFICRTE ISSUED I
33, Final Elearic � (�-',n• s: � �
�-Z�-9y �.
34. Pina.l Heating,& Air Conditioning � ..1 . .
� -
35. Final Gas Pipe-Test � , , _ ' _
36.'Hood o� Canopy � , - ' �
37, Final Factory Fireplace ' � �,
�38. Final Plumbing � � �� �
39. Water 5ervice�Finai � � � .
40. Gas Service-Final
41. Solar pomestirFinal
42. Backflow Preventer i � � ' ' -
43. Backfl0w Irrigation � '
44. landscape Irripation Syscem � .
45. Sound Aitenuation - �
46. HandicaD Regulations -
47. FINAL STRUCTURE & BUILDING .
i.:.
48. FINAL PLANNING ' � .
49. Electric Release to Edison '
50. Gas Release to Southem Califomia Gas Co -
51. CERTIFICATE OP OCCUPANCY ..
No. Date �
CITY OF COSTA MESA PLANNING D�PARTMENT
A. P. No. 117-231-18
Bldg • Perm�t No . � � � % �
Project Addrese
Owner's Name
, SEV 30-71��,S�OO 944Ro**�'�ZS `��
PARK AND RECREATIONAL FEES - Apartment Developments
Fee Pa.yment Receipt
344 E. 16th Strcet
J. E. Crar�ford
Bachelor or 1- Bedroom Units � @$25•00 = E25.00
F.� :�: • •�
G $40.00 =
3 - Bedroom Units @ $55•00 =
4 - Bedroom Units @ $70.00 =
5- or more Units @�75,pp- 525.04
� Total Fee
Total numb�r of Dwelling Units
Planning Department Approval Date. ��2����
idLD:pd Applicant's Signature
Park Area No. B
CITY OF C0.STA MESA PLANNING DEPARTMENT
4. P. No. 117-231-1°
Bldg. Permit No. � � G %�
PARK AND
��P30-7iv�mOO 9'�o'��c'{�'Zi."C
cns
FEES - Apartment Developments
Fee Payment Receipt
Project Address 344 E. 1Gth Stt'eet
Owner's Name 4. E. Lranford
Bachelor or 1- Bedroom Units 1' @$25•00 =�25.00
2 - Bedroom Units (� $40•00 =
3 - Bedroom Units
$55•00 =
4 - Bedroom Units @ $70.00 =
5 - or more Units @ $75.00= �25.00
Total Fee
Total number oY Dwelling Units �
Planning Department Approval Date. 9'29'�� Park Area No. $
gy WLD:pd ppplicant's Signature ; / �•' % ���
OWNER
J08 AD
� �R,
'Ai, Ao.
J. E.
SWR. LINE � I NOUSE CON.
MISCELLANEOUS
FOUGH HEATING
TEMPORARV SER
UNDERGROUNO [
ROUGH WIRING
TRENCHES �
FLOOR SYSTEM
BONO 6EAM �
SHEATHING
POWER
FOftMS Lf STEEL ftEINF.
STEEL REINFORCE I-I
FRAME AND FLASHING
L' '�NG - IN [�
F 'ER, BROWN COAT
F
DATE g_29-71
BUILDING PERMIT N0.
VALUE
SUBCONTRACTOR
,�..'_T -._. .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
�or Applicant to Fill in Completely
ADDRESS _/L�¢ F. /l� � S� �
OWNER II�I �(.�LG✓�I�LI^
MAIL �� � �/ / /_ ♦ � ` 1 /
ADDRESS tc � �
/J/ �'� TEL.
CITV ` / NO.
BfiANCH
ADDRESS
ARCH�ITECT`� hr UCC ��i(S NEL.�
ADOFESS L�e I ��I//I e- �e—� l l/
CONTFACTbR
ADDRESS
� TEL.
CITV NO.
STATE CITV
LIC. NO. LIC. NO.
SIZE NO.OF BLDGS.
OF lOT I NOW ON LOT
VSE OF %% SC C/ C �!
EXI5TING BLOG � � � G( � `
srzeoF,,._/�`f"Y274 e°;.°� / �r.,o�«
EMERIOR WALL�(�/ �}"(,( � ROOF (�Q � � �
COVERING / GOVERING
USE OF BUILDING AND WOFK TO BE PEFFORMED
� ivGci G�u !�J !%i ��
S�P 3�1-r_J��i����l c)i�_q e ;-'.'.' �''.�.�
FOR BUILDING PERMIT
C1J�E4_-i� ��%� 1 G
BUILOING ,
ADDRESS �
TRACT
R
FIRE
' 20NE
APPROVED
NE J � NO.OF
PIAKS i
VAROS APPROVED
MAIN BUILDING
DISTANCE BET
MAIN BLDGS.
VAR. #`
C.U.P. �
I hereby acknowletl8e tha[ I have reatl this epPlication anA stece
thet tha abOVe into�mation is corract antl apree to comply wlth
all lews rapWaNrtg buittlinB �ortsbucNon, antl 1 shall not employ
any person ih ��plation ot the workmen's compensatlon laws ot
Me State of Califomia.
I hereb certit that I am SQ. FT.
V y prop¢rly licensetl as a contractor untler
the State of Culifornia Business antl ProYessions Cotle, Dlvisicn 3, THE AMOUNT SH(
Cheptar 9, and thut such licenses are in f�ll forca antl affect, or I THE PURPOSE OF E
am exempt trem the provisians of the Stete ot Californie Business VALVATION �
entl Protessio�s Cotla, ision 3, Chepter 9.
i
SiB�ature of �,G^ $ ��0�
Permittee
a�cnor�:ea aee�t
0
� GROUP b'
DATE ' Z
USE OF NE ..Qi
BUILDING C
VApOSAPPROV
ACCESSORV BUIL
BET. MAIN &
b
0
IN UNDER VALUATION IS FOR �
ABLISHING A PERMIT FEE ONLV: m
¢
� 3,O° �
PERMIT FEE S �
Q m
PLAN CHECK S / � � E
0
-, � LL
TOTAL FEE $ �S � S
�s$a I�Ilesa Building Department �� APPLICATION FOR P/�ERMIT
1N EAST 20th STREET B U I L D�� • w7 ___'
COSTA MESA, CALIFORNIA - - "'— '
FOR OFFICE USE ONLY '
FOR APPLICANT TO FILI� IN Receipt No. Permit No.
Adtiress 3�+�+ �6th Street � =. �D �-� ��� --'
Costa Mesa, California Received by� Date Rec'd. Date Isdued
Nea rest I .c � ��
c�oe9sc. Sar.ta Ana & Tustin s�cm��9 � �1��
Address 5C � _ �� ��
ow�« Harley Benedict Costa 1liesa, California .
Mail
AddreSs 306� Snug Harbor Nearest � � �
Tel. Cross St. , '
citr Newport Beach No. L280725 zo�e,(� No.or I Type ✓ i Group�'
Architxt or Lic. +` � I P�a�g � �
Engineer No. Approved
by Date
Addresa , CQ�R}ij C��NS
City Lic
ContractorHlCkOTy HOI118S No, 220 � �
Address 21J�6 Ne�•7poTt BlVd. � C.M. � '
legal Lot
Description I No. 21 I Block I Tract�02 — � ��
. + .
(Attaeh Metes and Bounds) � vj �l�}�t
� C� No. oT Bidga nOne • '
Size of Lot 6o X�-3l I Now on Lot = - �- -'- p
Useot I No.of I No.ot � ,��81954 p
Existing Bldg. Familles oo � (,�
Setback Line from C � Rear Vard � ''� '" " - �� Z
Center of Street J� Side Yard 1 u D
DESCRIPTION OF WORH . � � ��jyiQFT ��A�t� �
�n-e_m
New I X I A��eration I I Addition I
Repair I � Moving I ) Demolish I
' Buiiding r7f1 No. of
' Size /75 SG.F't oms �'� Staries 1
Exterior W II UCQ O Roof
Ccvering �8 1�100C1 I Coveri g��ngle APPROVALS
Use af New ,� C/ Foundation Location Inspector Date
Build(ng ��� +7Residence (�«rJ'— Forms, Materials,
� J( JC .�C�� �����_� ��lcf� Under.Pinning
�� Frame: Fire Stops�
Brecing, Bolts
Lath. Int.
I hereby acknowledge that I have read ihis Application
and state that the above is correct and agree to rnmply Lath. Ext.
with all City Ordinances and State I.aws regulating
Uuilding construct' n. �
Signature of �� Plaster, dnt.
Permittee ���—"` �'���
� Plaster, Ext.
Authorized Agt. �/,.fG��—
Masonry Reintorced
Valu,ation Permit Fee $ /� -
� Plan Check $ � � Bond Beam
, $ 6550.00 7otal
Fee g 2�� � FINAL
� �:,,..,, zoe r.-i[ in� t2-sa '
t�r:Y, �IYL'Y.1:AiV�. y,y-)
• •tv5f'r �i_� ((1�
Show location and distances from
property line and between buiidings
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