The URL can be used to link to this page

Home My WebLink About473 20TH ST - Building Permits0 ''. `' IZ � CITY OF Applicant's M�i1� Add/r�e�u Owner's 1�[qe —�Z.(s Address , �� Arch/Eng.� Address Contractor's Name' ` Address (mailing) City License No. �� LICENSED CONTRACTOR I M1ereby af(irm that I am li� with section 7000) ot Divi�. my license is in tull torce ary N��C��N PERMIT sS[�1?l£ � 7 PhoneR� �—_License No. — ' hon ARA710N under pr si n arter 9 ot th¢ sin antl r�s� AOD�icant to fill in all spaees except those within neavY ou!�-r'Imeiana sign ali approvriate aeclarations. PE9MIT NO.. i TRACT NO. - LOT NO. uNIT Nn Date Signature WOR ERS'COMP NSATION OECLARATION � �,ereby affirm that I have a certificate oF consent to elt-insure or a certificate i Workers' Compensation Insurance, p� a certi, tl;cOpY ihereof (Section J800, Lab. C.) � . ' • � Policy No. Cornpany ❑ Certilietl mpy is hereby furnishetl._ � ❑ Certifietl copy is filea with the city BUilding Division. Date Applicant_ . EXEMPTION F0.0M WORKERS' COMPENS I N DE A0.ATION (This section neetl not be completetl if the p mit s far ne untlre ) r less). % I certity that in the pertormance ot the rk for w ch thi issuetl I shall not Dlo any on in any m' o b �ect to e y. e i Workers' yp h[io s of CaliPor � Date Si9nature NOTICE: If, atter makin9 his tleclaration, you shoultl}}} ome subject to the Workers' Compensation provisions of the Labor CeQ, Ybu must forthwith comply with suc� p�ovi5ion5 0� this p¢rmit iShally 6e deemed revoketl. CONSTRUCTION LENDING YiGENCV / �' � I hereby affirm that ttiere is a construction lentlid.fagency tor the performance ot the wo�k for whlch this permit„is i55uetl (Sectian 309] Civ. CJ Lentle�'s Name Lentler's Atltlress �� OWNER BUILDER DECLARATION--- I heteby affirm that I am exempt trom the Contractor's License Law for the following reason (Section ]031.5 Businpss antl Professional Code: Any city or county which requires a permit to construct, alcer, improve, demoiish or repair any structure, prior to its i55uance, also �equires the applicant for such permit to tile a signetl statement that he/she is licensetl pursuant to the provisions of the Contractor's License Law (Chapter 9(commencinq witn Section ]000) of {;i?:g,jvision 3 of the Busine55 antl Profe55ions Cotle) or that he/she is exempt �!.>erefrom antl the basis for the allegetl exemption. Any violation of Section 'sy'031.5 by any applicant for a perm{T subjects the applicant to a civil "'"tiE�dlty ot not more than tive huntlretl dolla�s ($500). . ❑ I, as owner ot the property or my employees with wages as their sole compensation, will tlo che work, antl th¢ structure is not intentletl or otferetl for sale (Section �044, Business antl Professional Cotle: The Contractor'S License Law tloes not apply to an owner pf a property wno builtls or'improves thereon, and who tloes such work himselt/herselt or tnrough his or her own employees, p�ovitletl that such improveMents are not intentletl o� offeretl for Sale. If, nowever, the building or imp�oyement is soltl.within one year ot com- pletion, the owner will have tM1e burtlen of provin9 he/she tlitl mt builtl or im- �rove for the purpose of sale). I, as owner of tM1e property, am exclu5ively contractin9 with licensetl con- tractorsto mnstruct the project (Sectiori �044, Business antl Prote55ion5 Cotle: The ConVactor's License Law tloes not appry to an owner oi property who builtls or improves Ihereon, antl who contracts tor such projecis with a con- tractor(5) license pursuant-to-the ConVactor's license Law). I am aware that p�oot of th ' WorkeYs Compensa ' insurance shoultl be provitletl to me. ❑ I am exe pt nCer c'on B. & P. C. for this rea5on Date I hereby ce tify t a 1 intormation s mrr . 1 antl state la el sentatives ot i inspectian purp Signature Drivers' License ar 55 � CMF 0865-46, rev. 4/84 above TYPE OF CONSTRUCTION LI NEW U ADD LJ ALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - q.p, # DESCRIPTION OF WORK/USE OF BLDG. � -- S Main Building: E TYPEOFPERMIT ' ❑GRAOING ❑FOUNDATION ❑STRVCTURAL � T Front' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING' ❑ MECHANICAL B Rear ❑ �OTHER. - A - D PROJEC7 DESCRIPTION Sp. FT. OCCUPANCV C Right K Left ,CONSTRUGTIOIVTVPE � VALUATION$ ' � $ ZONE ' - GRADING CU. VDS. ACRES p�ng. Ref. # aemarks: , � - � � � Planning Notes: � � PLUMBING � FEES Sink Irrigation Drinking Fountains Floor Drains - Floor Sinks Gas Service Interceptors Kitchen Sink Lavarories P—Trap Roof Drains Reinspeition Fee Outlets $75 Boiler Duct- UnderGraund �uct-Structural • Duct- Ventilating Exhaust System ❑ Muliiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ a� oo,00a sru O i oo,000 eT� Reinspec[ion Fee � $75 Builtling; Cana�y - Applicant; Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet - Water Heater Water Service Issue Fee Hood or Type I ❑ Canopy Type I I ❑ 1 Refrigeration System ❑0-7�0,OOOBTU ❑100,000 Issue Fee Automatic Washe� � Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fi%tUIES� Device Boxes Outlets Switches Garbage Dispoul Generator �03 KW �5-15 6035 9/!2/84 Zone ! ELECTRICAL � Transformer ❑'15-50 KW" ❑ 50+ KW $ 3 Reinspection Fee $15 FEES � DEVELOPMENT SERVICES REQUI Zoning qpproved By Building Approved 9y APPlication Iwued BV `'/ $ 3 Meter W up to 100 amps Meter ❑over100amps Sub Panel Motors �0-i HP � 1%- 8 IncSolar 0&15 HP �16-15+ Microwave ' Pole Lipht ^Standing Sections �Trasfi Compactor t � luue Fee — NTS: . 12.BG T� FEES $ 3 Z O N I N G R E Q M T S. `�-�SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PIAN CHECK ' 25% $ ENERGY P.C. $ E�ECTRICAL $ � GRADING $ PLANCHECK 50% $ MICROFILM $ T1� MECHANICAL $ TOTAL FEE $ _� �S2S� PLAN CHECK 25% $ �-CONSTRUCTION ANDPLANNING��' � � P��`��PA�� Y '.i1PPRQVALS Permit# Date Inspector ,AppROVALS � Permit# ' � Date ' Inspector 1. Temporary Electrical Secvice.or Pole. 52. Pool & Equipment Location ', 2. �S�'��l�Pipe-Undrgrnd. � . � 53. Steel Reinforcement . • . 3. Electrical Conduit Utility-Ondrgmd. .' � 54. Forms. , -. � ,. 4. Electrical Conduit-Und�g�nd.' 3 55. Electrical Bonding . , - . � 5: Steel Reinforcement ;� , .. ' 56. Rough Plumbing & Pressure Test . � 6. Electrical UFER Grnd.'u: ' � ` g�� 57. APPROVALTO COVER-GUNITE �7..-Footings � - . . 58. Electrical Conduit-Undrgrnd. . '8. Foundation _ . -� - ' � 59r Gas Pipe, 0 Undrgrnd., Test 9.: Water.Pipe-Undrgrnd.,� - � - - 60. Backwash �ines, P-Trap, O Undrgmd. ' 70. Structural Floor Sysfem " 61. APPROVAL TO DECK �. ' 1:1. Property Sewer Line & House Connection - '62. Backwash & ReceptorFinal�* � , 12. SeweYCap � ° � . � �= ` � . �63. Heater & Vent-Final . . 13. Roof Drains ' ' � . 64. Plumbing System - Final � � - ' - 14. RoughyPlumbing � 65. Electrical-Final � ' , � 75. Rough�Electrical-Conduit ' 66. Solar System-Final , - -- - 16. Rough Electric Wiring � ' . . 67. Fencing & Access Approval � - - - � 17. Rough Wiring Sign �� ' .. 68. APPROVED FOR PLASTERING , � 18. .Rough Electrical-T Bar Ceiling- , 69. POOL/SPA SYSTEMS FINAL � : � � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT , � � 20. Rough Factory Fireplace . APPROVALS, Permit# � � 21. Ducts, in Structure � 70. Underground Hydro - � � � 22. Ducts, Ventilating � 71. Product Piping �Gas ❑Oil � .' � � 23. Gas Pipe-Rough & Test � -� � 72. Underground Flush ' � � � 24. Roof Framing '� � . . 73. � Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � , �' 74, Overhead Hydro � � ' ' !. 26. T-Bar Ceiling (Structural) & MonocOat � � 75. Dry Chemical � �= � 27. Frameand Flashing � 76. Dry Standpipe • `; , 28. .Lathing & Siding , 77. FIXED SYSTEM FINAL ._ �� ' 29. Insulation -. . ; 78. FIRE PREV. FINAL •t� =� � - 30. Drywall Nailing HEALTH DEPT. REQUIREMENT '- �; � ` _ 31. Plaster Brown Coat � � � 79. FINAL INSPECTION , �� ; -, 32. Electrical Power Meter-Final 9 80. FOOD CERTIFICATE ISSUED � `; 33. Final Electric , � 'Notes: ' 34. Final Heating & Air Conditioning' � ' ' .��_"' � , 35. Final Gas Pipe-Test � • . , � ' ' , � ' ; 36. Hood or Canopy � , , � , � � ' 37. Final Factory Fireplace , . 38. Final Plumbing - � � � 39. Water Service-Final' ' . ' - 40. Gas Service-Final � 41. Solar pomesticFinal , . � � - ' � 42. Backflow�Preventer , . � . 43. Backflow:,lrrigation . ! _ i ' � � . � 44. ,Landscape Irrigation System - 45. Sound Attenuation , , , , - '� 46. Handicap Regulations � ' . � 47. FINALSTRUCTURE&'BUILDING � ' � 48. Special Requirements Completed • - 49. Electric Release to Edidon ' � � � _ � 50. Gas Release to Souihern California Gas Co � � 51. CERT�IFICATEOFOCCUPANCY : � No. Date CITY OF COSTA MESA ° BYILDIN6 DMSION � > � F DEVELOPMENT SERVICES DEPARTMENT P98-00518 ,• � PERMIT PERMIT NUMBER �� (774) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92628 PLUMBING PERMIT Job Address: Suite No Vicinity: 473 E 20TH ST Parcel Nunmber: 42632406 Applicant: MARCOPULOS, STATHI Address: Owner: MARCOFLUS,�STATH,I G � Address MARCOPLUS, LINDA K -� � - , �COSTAMESA,CA � ,,_,� - -- �, 473 E 20TH ST j j� ;� .i � /i !i:✓ �.�,�'� V /�'� o �/, -�n % ��. / i/,� . Cont�actor� ��"� ,.Phona:� 714-260-4629 Zip. --- - . . _ � Phone: Zip: 92627 . . , i ,., Address:�� j; -�' � '! � Phone:-% i �' A, i /.-, . ' - ' � , , r - . . . . Zip: � � . - � - �Cicense: , ;! � _ � � � . �' J -/ . _ . � _ ArchlEng: CAddress: , - � - � � � � �Status: ISSUED � �' Applied: 06/26l1998 Issued: O6/26/1998 ��. � � . � \, \. � .��., .j �� „\ i ' � \��` �,"�� ,;:, > � � i . � ;;,� - � Phone: Zip: License: �i ��J � % �� SCOPE OF PERMIT ,� � - CONDTRUCT 180 FL 6' HIGH BLOCK WALLALONGSIDE:AND FRONT OF PROPERTY. INSTALL , � t� SPRINKLERS IN YARD , LAWN AND RAINWATER.DRAINS TWENTY ' � � �, FEE SUMMARY � ; � �`.AMT QTY =,AMT : QTY '. -� AMT QTY ISSUE FEE', ', ,�E22.00 Laundry Tub I Washer $0.00 0 Sump Pump" ' , $0.00 0 BackFlow ivigation'� , $0.00 0 Landscape Irrigation $0.00 0 Swimming'Pool �� $0.00 0 BackFlowPreventer $0.00��, 0 �� P-Trap ' �� , �� $0.00 0 TrapPrimer $0.00 0 Balhtub . $0.00; 0 Pressure Regulator , �$0.00 0 Urinal �, $0.00 0 Clanfer Systern�� • $0.00 ��- 0, Process�Piping (per-10 ft)� , 587.50 � 10 Vacuum Brkr Bkflow(1-4) '$0.00 0 ConnectQce,Soda,elc) $0.00 `� 0 �� ' Receptors � �".' ' �$0.00 � 0'.� "VacuumBrkrBkFlow(5+)' $0.00 0 Dental Units • � 50,00 - 0 A ' . . Septic Tank -- �� . , .; $0.00 - 0 " , Wash Basin , , ,' $0.00 0 , Dishwasher � $0.00 ' � 0 � � � � �Sewer Cap for Demo � � $0.00 � 0� : . -. - Wash Basin Set � $0.00 0 Drain, Ploor $0.00 � 0 � - � Sewer Connect � � - � $0.00 _ �0 - - � Waste and Vent System $0.00 0 Drain, Rainwater $175.00 � - 20 ; � Sewer Private�Line � , , - $0.00 � 0 - � Water Closet (Toilet) $0.00 0 Drain, Roof $0.00 0�- Shower - $0.00� � 0 Water�Heater/vent $0.00 0 Drinking Fountain $0.00 0., � Sink, bar $0.00 0 Water Piping jlnst or Rep.) $0.00 0 Ezpansion Tank $0.00 0 ��-' Sink, commercial � .$0.00 0 ' Water Re-pipe $0.00 0 Gas Earthquake Valve 50.00 0- . Sink, Floor $0.00 0 Water Service $0.00 0 Gas (1< outlets) $0.00 0 - Sink, kitchen ' ,. $0.00 0 Water Softener $0.00 0 Gas (Over 4 outlet5) $0.00 0 Sink, 58rviCC/mOp $0.00 0- � OTHER ao.00 Gas Repipa $0.00 0 Spa (private) $0.00' � 0 VIOLATION $0.00 Gas Service 80.00 0 Spa (public) - $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 0 TOTALCALCULATEDFEES: $284.50 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shall automaticalry expire and become void ii work Is not commencetl wfihin 180 days, or If work is suspended or abandoned for e period of 180 days. INSPECTIONS: In order for the work aulhoAzed under ihis permit to be considered legal, such woAc must comply with all applicable codes, and all requlred Inepectlons end flnel epprovel must be obtetned. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (7/4) 7545828 WORKERS'COMPENSATONDECLARATION: - I hereby eifirm unOer penalry of perjury one of the fdlowing tledaratlons: • ❑ 1 heve end wlll melntein e centlicete af consent to sell-Insure for workers' compensetion, es proNOetl ior by sectlon 3700 of the Lebor Code, for ihe peAortnance of Ne work for w�ich this Oertnit Is Issuetl. ❑ I �eve erM will melntain vrorkers' campensatbn insurance, as requlreA by seclion 37(q ot Ne lebor Coda, for the peMortnance of ihe work tw which Ws pertnit Is issued. My workers' compensatlon Insurence mrtier enE pdiq numDer ere: Gartier. Policy Number. (Thfs sectlon neetl nof Oo com0leted /I Me pe�m/f!s valued et one huntlretl tlollars ($ f00) or /oss.) ❑ I ceritly �het In Ihe pertortnence ot the work for which thts permit is issued, I shall not employ eny person in eny manner ao es to become sub�ect to the workers' compenSeUon lews ot Celifomla, entl epree Ihat It I should beoome sub�ect ro t�e workero' compensetlon provisions of SeMion 3700 ot t�e Lebor Code, I shall fonhwlth comply wlth Ihese provislans. Applicent Sipneture: Date: WARNINO: FAILURE TO SEWRE WORNERS' COMPENSATION COVEMOE IS UMAWFUL AND SHALL SU&IECT AN EMPLOVER TO CFIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED TlpUSAND OOLLRFE (5100,000), IN AODRIIXJ TO THE COST OF COMPEN54TION, DAMAGES AS PROVIDED F-0R IN SECTIIXJ 3108 OF THE UBOfi CODE, INfEREST, PND ATfORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here6y ettirm thet I em licensed untler provisions of Chapter B(commencing wlt� Sectlon 7000) ol Dlvision 3 oi t�e Business end Professions CoAo, end my Ilcense is in full forCe entl BNed. LJc. M CI859 M Contrectors Slgneture: Date: CONS7RUCTION LENOIN6 AGENLY: ❑ I hereby aMirtn U�et there Is e constmcUon lendinp agen�y for Ihe pedormance oi the work lor w�ich t�is pormlt is issued. (Sec. 3097, Civll Code). Lentlers Neme: Lendets Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: 1 hereby ettlrtn thet under penelry ot perjury thet I em El(EMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe tollowing reason (Sec. 7031.5, Buslness end Professians Code: Any clry or county which reQuires a permit to consiruct, elter, lmprove. Aemolish, or repair eny strudure, pAor to its issuance, elso requires Ne epplicant for such pertnit to lile e signetl stetemant Ihat he or she Ls licensed purwant to the proWsims oi Ihe CantreIXors Lbense Lew (Chapter 9(commendng with Senlon 7000) of DlNsion 3 ot Ihe Business and Professions Cotle) or thet ha or she is exempt theretrom and the basls for the elleged exemptlon. Any viola�ion of Sectlon 7031.5 by eny epplicant for e permit su its the epplicant to a dNl penalry ot not more Nan five hundretl tldlars (5500).): 1, es owner oi the property, or my employees wiN wages es their sole compensetlon, WILL 00 TME WORK, and the sirucNre Is not imended or oNeretl for sele (Sec. 7044, Buslness antl Professlons CoCe: The Coniredors License Lew tloes not epply to en owner ot property who builds or improves t�ereon, and who does such work himsetl or �erselt or t�roug� �Is or her own employees, proWded Nat such Imprwements are not Imended ar afleretl far ule. If, however, the 6ulltling or Improvement is �sold wlthin one year of completian, the owner-builtler will have t�e burden oi proving Ihat he or she tlitl not hulld or improve for purpose of sele.). I, es awner ol Ihe D�aOarry, em E%CLUSIVELV CONTHACTNG WRH LICENSED CONTRACTOHS ro construd Ihe project (Sec. 7044, Business end Pmtessions � Coda: The conirectors Llcense Lew does not appty ta an awner ot properry who bulltls or Improves thereon, end who contrects tor such project wlth a coniredor(s) license pursuent toJre Contractors License Lews.). A ❑ lam Owner ID veAfietl by tlrlvets Ilcense. ' ❑ Yes Vedflcetlon of Ownershlp by (type ot document, I.e. ��ines entl Professions Code tor Ihis reeson: Date: � Drivefs llcense No. Ezpires: teu bill or tleetl): _ _ _ DIVISION OF INDUSTRIAL SAFETY PERMR CERTFlCATON: ❑ � �ereby ceNiy ��et no exceveilon Me (5) or more feet in depth inta w�lch a person is requiretl �o descend, will be metle in connectlon wlth wark authorizetl by Ihls pertnit, entl Uet no Dulltlinp structure, scattdding, falsework, or demditlm or tlismentlinp t�ereof, wlll De more ihen thiny-siz (38) teet �Ig�. (G�ep. 32, Grp 2, An 2, Sec. 3C1, Tltle 8, Gelifomia AtlministreWe Code). ❑ Ae owner�builtler, I will not employ enyone m tla wark whlch woultl requlre e pertnit trom Ihe Dlvlslon ot Industdel Sefery, es noted ahove, unless such persan hes a pertnit to do such work from Iha tlivlsbn. Signeture: Date: Division Of Intlusiriel Setory Permit Number. CERTIFlCATE OF COMPUANCE AND AUfFiOR¢A710N OF EMRY: I cenify under penalry of per�ury that I heve reatl this application entl stete thet the inlortnation given is cortect I gree mply with all s e laws end city orQi ences relating to building construction, end euthodze representaUves o� the Clry oi Costa Mese to enter upon the e d d rope or in purposes. I agr not occupy or ellow occupency oi any bullding euthodzetl by Nis permlt untll final Inspedion. � . �+•_�"��,o � •�5s Sianewre OI Le 1 Owner(sl De�e And/Or AuNodzetl ApD��cant Date COpE �. INSPELTONTYVE �¢ 11iSIDE65 1818 Flzetl System Finel Fire Prevention 1288 200 201 202 203 Pool Spe Flnel Flnel Re-Raof Flnel BIocWReteining Wall Flnal Fenory Fire Place Final Sign 204 Finel Demolitlon zaese �4pFj INSPEC110NTYPE 208 Flnel Mechenical 20B Flnal Plumbing 210 Fnal ElecMcel 212 Final Flre Prevention 220 Flnal Planninp Approval 222 Finel Slle 250 Flnel Bullding/Occupan�y �ff �� • ` • �7+,� �� ✓ CITY OF COSTA MESA �-- ` � � ° BYILDIN6 pIVIS10N ._y � DEVELOPMENT SERVICES DEPARTMENT 898-01139 �• � PERMIT PERMIT NUMBER �� (714) 754-5273 • Fex (714) 754-4856 gUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 473 E 20TH ST Suite: Viciniry: Parcel Nunmber: 42632406 npplicant: MARCOPULOS, STATHI Address: Zoning: Phone: 714-260-4629 �Z�p - � '" - . owner: MARCOPLUS, STATHI�G Address MARCOPLUS„CINDA-K" ' COSTA MESA,CA ` � ' ' 473�E 20TH ST�, �� '"�> , / � i i�''� � � 4 . Contractor /��%//� �� / � �/v'/ / � Address. �; . < , %_ .; `, � �� ' �' Status: ISSUED � Applied: 06/26/1998 � Issued: O6/26/1998 i � " Phone: _ . . " � � - — ' Zip: 92627: � � ' �- . .. . _ _ . . ` ' - y . "� � `. < \ \ �', ��- i �� < i � �� /��, i/.� � �`,A ,� i �' � `.�,/�//.-.. Phone: ,;h-.- � �.�;f- � . /�� Zip: ��,�.:,�� . � .1 %� // � /i �%� License:�^ �. . � ) �, �l/' /•.o;' �/ - . Arch/Eng: �, ";'�i 'y. , ' � ,,'�y;; �, Address: �;� �: , , � i��i J . . . . -,;- _ -•Phone:._ ' ,� . " � ' .:/Zip . > `� � �License �,l . • ..J , , ' '; /_ �-i . ' - — - �.. , ' - � � � . � � . ., � . `� . � � , � �;_ � � SCOPE OF PERMIT � � 5 ,, �CONDTRUCT 180 FL'6"HIGH BLOCK WALL ALONG SIDE AND FRONT OF,PROPERTY. � , .A ` / . ' _ . - � - - - - ' � . ' . '�� / . ._ -��_�i� � �� ... " '' � �FEE:SUMMARY� � � . � �, Plan Check: '$0.00 � -_ Calc Valuation: Sa,soo.00 ' Permit: '' $9975 �' i ` Claimed Valuation: $a,soo.00 � �SMIPRes: �,"$0.50 _ _-'� . _� ,-- � �� r r�� =� ._ � � SMIP Com: � $0.00 -- _ � % / �„ Other� . �'$0.00 � � / � � ' . Inspection:. ,$0.00 - � - ' _ __ — �Total � ` $�100:25 � � � � `�t�A �� VA�,• ' " --. � . -�, `_`'V `��. ;PLANNINGBZONING � .� � ,. �t n � � SETBACKS�' �, � � � � "� � , �: � `� ,,. - ' MAINSTRUCTURE Front 0-0� \-`-Rear ��0-0�' � ��yleR' :,:0-0 � , r �� ACCESSORY Fmnt 0-0� . - Rear 0-0 �` • Ceft � 0.0 PARKING NOTES: Existinui- �0- ��' Required: �0- . Proposed:� � 0 �'. Right 0.0 Right 0-0 , EXPIRATION: This pertnit shall automatically wcpire and become vofd if work is not commenced within 180 days, or if work is suspended or abandoned for a perlod of 780 days. INSPECTIONS: In order for the work aNhorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectione and flnel epprovel must be obtained. Failure to obtain inspections and final approval will iesult in lhe e�iration of this permit. FOR INSPECTIONS CALL: (714) 7545626 - WORKERS' COMPENSA710N DECLARATION: ' ' I hereby affirtn under penalry ot perjury one of Iha following declaretlons: ❑ I have end will meintaln e certificete of cronsent to seM-Insure for workers' compensation, es provitled for by section 3700 of ihe Lebor CoOe, for the peAortnence oi Ihe work for which this permit Is issued. ❑ I �ave end will meintein workers' compensetlon insurence, es required by section 3700 of ihe Lebor Code, tw �he pertamance o1 the work for which ihis pertnit Is issued. My workers' compensation Insurence cartier end poliq number ere: Cartier. Policy Number. (Thls secdon need nof be comp/eted l/ fhe peimit is velued ef one hundred dollers ($100) or /essJ ❑ I certity ihat In the performance oi the work for which t�is pertnit is iuued, I shell not employ any person in eny manner so as to become suD�ect to the workere' compensetion laws of Celilomla, end egree thel A 1 should Eecome subJect to I�e workere' compensetion proNsions of Seclion 3700 of the Labor Code, I shell forthwith compy wiN these provisions. Applicent Sipneture: Dete: WARNINO: FAILUflE TO SEWRE WORKERS' COMPENSATION COVERAOE IS UNLAWFlIL M'D SHALL SUBIECT rW EMPLOVER TO CPIMINAL PENALTIES AND qVIL FlNES UP TO ONE HUNDRE� T/iOUSAND OOLLAHE (E100,000). IN AD�RIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR ODDE, IPrtEREST, AND ATTORNEY'S FEES. LICENSED CONTFiACTORS UECLARATION: I hereby ettirtn thet I am Ilcensed under provisians of Chapter 9(cammendng with Sedlon 7000) of DiWsion 3 oi the Business end Professions Code, and my Iicensa is in full force end effact. Lic. # Class # Contractor's SigneWre: Date: CONS7RUCTION LENDING AGENCV: ❑ I hereby eflirm Nat there is e constructlon lending egency for the pertortnance oi the work tor which Ihis pertnit is issued. (Sec. 3097, Civil Code). Lendefs Neme: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby ettirm ihet untler penelry of perjury Ihet I am E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reasan (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requlres a pertnit to construcl, alter, improve, damolis�, or repair any structure, pnor to its issuance, also requires t�e epD��eni for such pertnit to file e sipned stetement thet he or sha is licensed pursuant to the provlsions ol the Contrenors Llcense Lew (Chaptar 9(commenpng with Section 7000) of Division 3 of Ihe Business and Professions Code) or ihet he or she is exempt t�erefrom end Ihe basls for the elleged exemption. My violation oi Section 7031.5 by eny applicant for e pertnit sublecls Ue epplicant to e dvil penalry of not more Oian five huntlretl Collars ($500).): � I, es owner oi the properry, or my employees with wages es ihelr sole compensatlon, WILL DO TME WORK, and ihe structure is not intended or olfaretl for sale (Sec. 7046, Business entl Professions Catle: The Contractors Llcense Lew does rwt epply to en owner of properry who builds or improves thereon, end who doas such work himsetl or hersetl or ihrough his or her own em0�oyees, provitled Ihet such improvements ere not intentletl or olfered for sale. If, howevar, the building or Improvement Is �old wlthin one yeer at completlon, iha ownar-builder will have ihe burden of proving that he or she tlitl not Duild or improve tor purpase oi sale.). , es owner of the property, em EXCLUSIVELY COHTAACTING WITH LICENSED CON7RACTORS lo construcl the pro�ect (Sec. 7044, Business end Pmtessions Code: The contrect License Lew does not epply to owner of property who bulltls or improves therean, end w�o contrects far such pro�ect wlth e contrector(s) Ilcense pur ent t e C ntrector 'cense Lews.). ❑ I a iness entl Professlons Code for this reason: Signeture: — Date: — Owner ID ed by drivers license. ❑ Ves ❑ No Dnver's Licanse No. Ezpires: Vedticetlon o1 Ownership by (rype oi tlocumenL i. .- proDerty tex bill or tleed): DIVISION OF INOUSTRIAL SAFE7Y PERMR CERTIFICATION: ❑ I hereby certlly ihet no excevation five (5) or more teet In tlepth Into whlch e person is required to descend, will be metle In connecllon with work euthoMietl by Ihis permfl, entl ihet no building structure, ScaHoltling, falsework, or tlemWitlon or dismantling thereof, will be more then ihirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title e, Celifomla AdminiStretNe Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom ihe DMsion of Indusinal Safery, es noted ebove, unless such person hes a pertnit to da such work from the division. Signature: Date: Division o1 IndusMel Satery Pertnit Number: CERTIFlCA OF CO PLIANCE AND OROATON OF ENTFiY ceRily under penelry of perjury ihet I hava read this epplication end stete Ihet Ihe iniortnation given is corre I e to ply wi ell st s end ciry ordinences r ting to building construction, and euthorize representatives of the Clry ot Costa Mesa to en�er upon ihe -d Iba ei%y�spec � s I�t lo �r ellow occupancy of any building authorized by ihis permit until finel�pectlor. / /� � C/ .t ( ��—_ Slonatura Oi Leaal Ow rfs) Date COOF �. INSPECTIONTYPE 1618 Fizetl System Flnal Fire Prevention 1266 200 201 202 203 Pool Spe Finel Finel RB-Roof Finel BIocWReteining Wall Final Fectory Fire Place Finel Sipn 204 Finel Demdillon 244&48 �E �� yp[1 IHSPECTION TYVE 206 Final Mechanicel 208 Finel Plumbing 210 Finel Electncal 212 Final Fire PrevenUon 220 Final Planning Approvel 222 Final Site 250 Final Buil7ing/Occupancy DatB �� _ . `� " � . , PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this �� day of �/�i , by and between � � l ��a hereinafter referred to as "LANDOWNER," and _ �� GuG�/2 P��', hereinafter referred to as "ADJACENT PROPERTY OWNER" It is hereby agreed that a party wall will be constructed on the property line between �(J l �^�' �T3 E. �� (Address of �oining Properties) in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER ADJACENT PROPERTY OWNER --��K� ..... ��Ai C�✓r ✓ (Sig�� (Sig�ure� _STATN�_k�0_A..L OS g�L'n. f{_._W-owQ_r Name (Typed or Printed) Na e(Typed or Printed) ��3�.G__Z�r� SF/[<t G,NeJN ��%--�l�t 2Z0}'�t—.�l_r (Address) p�, i6 t � ( ddress) 7– �es l � ��.ld C �' Sz a�.� NOTARIZATION RE�UIRED 1906-46 r ,, � ' STATE OF CAT,IFORNIA COUNTY OF a_� � On(�(�%%�j �� , 199�, before me, the undersigned, a Notary Pu`bl�ic, in and for said ounty and State, personally appeared 4-�� /�i�% G/ (./�(•� personally known to me (o•r— �cssed--t.�� ^n—t]ae—be��i� of s�; =f= ��r., �•,; �'�^^e) to be the person,(s� whose name(-c) is/�e subscribed to the within instrument and acknowledged to me that he/sbe�key executed the same in his/hery�their authorized capacity(i.ee�j, and that by his/hPr�thPir signature(s) on the instrument the person(s.), or the entity upon behalf of which the person(s�acted, executed the within instrument. WITNESS my hand and official seal. � .-,,:. �...:q= +�- --�'_" " .- a ' 3 �37 3 �\o . a-.�•. - . - �, �,..., "��"�Vl:. " -.rA��7'](" STATE OF CALIFORNIA ) /'� ) ss. COUNTY OF v%l/rf�e ) � d�S tary Pu 1' On (��/%� � q, 199 �, before me, the undersigned, a Notary Public in and for said County and State, personally appeared l��U[/ne L� • ✓�GWPit� � � ^�"�+ �enerr�*e-me (or proved to me on the basis of satisfactory evidence) to be the person(sl whose nameFs) is�re subscribed to the within instrument and acknowledged to me that �,e�she/the}c- executed the same in h�s/her/theit, authorized capacity(iesa„ and that by hiS.�her/thair signatur2.(s) on the instrument the person(g,}, or the entity upon behalf of which the person(s� acted, executed the within instrument. WITNESS my hand and official seal. �. //// ././� / �/ � � . . ,. S �` ' C�-\ f.;r . ,'Jy~j7 .. :�� v�_-,'� - - '�Yb,�,o ''-�r -�...-�:...�_„'Y � '�r:-- -:'ws4D'�iOC� `I ��$ �� ` CITY Of COSTA MESA PLANNING DIV. SUBJECT TO BLDG. D�T REG. DATE�BY �fi � � 11 y ��JTE �.. =cl_`;;!�'1:tS, ,�,R CORRECTIONS SHALL �, �_�.,. , _ ��flf� PLAWiJIPlG�DIb'ISION � NEi�D[NCE 1�CV 1SiON±� OF COSTA t ESA EETY . Ai'PR�`S'ti� /.'-��`%�i o Oa�a �f ----�_ �� .� � nis set ot plans and sp•citications MUS7 be kept on thls pb at ail iim�s �d'1 is unlav,��1 l•� Ra�� y�y �ynges or aBeral'an on same v�Ahou! wr�1e� t��ssien tromttie Oivis'wn of Bui�,(:r.J and Salely, City of Casta Mesz• pprv,' ��i ne6H,�lROThenelAtcpe�2:�iatnhea�a ihastampi�gotthlsq�'na*dspzci,.�a.io ,�,,?!l:f�:ic:ff98i1'�IGfSl8ibi3':�. Gj ii'.0 V10��2110[1 Of ^u;S� rNVlil011F Ji C�O,� (:ii�l Oi C:0£'.•� �.•�fl• , ,, � n r ; � � � � ; �It a-,u uil9 ii lr.e h�i�dmg • Thsae p;a^� anU Pem� i a � . �, r, ��i!h',1�0 d3ys ot issuarc„ ,: r,.rrr.'u: ' cP;i'A7: . . , .. �,-.b ; ,!^f�(i°. . . � N[EID[NGf /o' STREET � � p 'D i � IIEtIDEMCE R[{IDEMC[ �{�3 �• � W .ZO T/� � h �o' � a 1Zl �YIO � 1 CITY OF COSTA ME PLANNING OIV. SUBJECT TO BLDG. DEf TYPICAL 6�� CONCRETE BLOCK FENCE Cemen[ Coping Ootional — Channel BIoCk With 1�3/8�i Horizontal Top of all Fences 0 For Fences 5' or Less Ven. Bars 3/8"y5 at 4' -0" O.C. For Fences Higher Than 5' Ven. Bars 3/$"��at 32" O.C. � Fill Cells Solid With Grout Where S2ee1 Occurs Reinforcing $teel Shall Conform to $ec.A-15-39 A.S.T.M. All Steel to 6e Lapped 24" or to Codc NATURALGRADE ii�% `;n;.. �(� � WO 3/8"4 OARS � CQNTINUOUS TOP � 90TTOM H021ZSTEEL MUST BE TIED IN P�A(;E AT TIME OF TRENCH INSPECTION. a = �� r w �_ c . >Z a f � w o U F 2 w n � � uA N ^ O _ D ' � WIDTH � SEE CHu v BELOW D.I'n FOOTING REQUIREMENTS CHART GENERAL- NOTES MORTAR: p�e pait Plastic Cement, and Three Parts Sand GROUT; One Part Cement 7hree ana One Holf Parts S'and COPING: One PaH CemeM, Three Parts Sand CONCRETE: W¢II M+xed 1:2- I/2: 3- I/2 MaY. of 7- V2 Gol;ons ot Water Per Sack of Cement GiiOUT MAV BE POURED FROM THE TOP OF THE FENCE IN CELLS WHERE STEEL OCCURS. CELLS AND AREAS OF HORIZONTAL REIN� PORCEMENT SHALL BE CIEAR, CLEAN & FREE OF ALL MORTAR DEeRIS, E7C. �H GF E4RTNTCOTH V3 ir1E HEIGTti Of FENCE �OW BOTTOM OF FOGT�NG SCALE: I/2��= I' , WIDTH 14�� . . . . . . . . . . .14�� . . . 12��. . 12�� • • � THICKNESS ,. 10�� . . . . . . . . . . .10'� . . . , . 9 ". 8 �� ' � DEPTH OF- EARTHTOOTH � . ' 24� 20�� , 16��. . . I2�� .' SPACING• OF EARTHTOOTH. . 12' 14' ..., 16'. . 16' City of Costa Mesa, California Building Department i�aV,"5E� NOV. e2 l� � /� ` � w�a —_'� �,Y �� W � � A Q ,� � v . _ L3 � �-�Y �D � � / q _ CITY OF COSTA MESA � ' BUILD/NG DIVISION DEVELOPMENT SERVICES DEPAR7MENT PERMIT ��ia� �sa-sz�s • FaX ��ia� �sa-aess • www.ci.costa-mesa.c�U1LDING PERMIT ,lob Adtlress: 473 E 20TH ST Suite: Vicinity: ROOF Parcel Number: 42632406 Applicant: JEFF LEHMAN Adtlress: 2415 MARGARET DR NEWPORTBEACH,CA Owner: MARCOPLUS, STATHI G Aqdress 473 E 20TH ST COSTA MESA, CA Contracror. J.S.L. ROOFING INC Address: 2415 MARGARET DR NEWPORTBEACH,CA Zip: 92663 Arch : Address: 2oning: Phone: (949) 646-3571 Zip: 92663 Phone: Zip: 92627 Phone: (949) 64G3571 License: 747706 Eng: Address: PERMIT NUMBER J803-01239 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: � Status: � ISSUED Applied: 07/22/2003 Issued: 07/22/2003 Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16 O.S.B. SHEATHING, 50 YEAR, COMPOSITION SHINGLES, PRESIDENTIAL. 25 SQUARES FOR RESIDENCE ONLY. Plan Check: $0.00 Permit: $13925 SMIP Res: $0.69 SMIP Com: $0.00 Other: $0.00 inspection: $0.00 Total: $139.94 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existin : 0 Rear 0-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Le(t 0- 0 Proposed: 0 Calc Valuation: Claim Valuation Right 0- 0 Right 0- 0 $6,900.00 Ss,soo.00 NOTICE: The Work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (OrQ. No. 92-28, § 1, 12-21-92) EXPIRATION: 7his permit shall automatically expire and become void if work is not commenced�within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections antl final approval will result in Ihe expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 2446dfi(N00) WOR�PENSATION DECLARAnON: � I hereDy i er pa�i etly of perjury one oi ihe following declarations: r ❑ I have end wlll maintain e cartificate of consent to sell�lnsure for workers' compensetion, es provitletl for by section 3700 of the Lahor Code, for the peAo mance ot the work for which this pertnit is issuetl. ❑ I�have end will malntain workere' compensation insurence, es raQulretl by section 3700 of the Labor Cotle, tor t�a pertortnance of the work tor whic� this pertnit is issueG. My workers' om nsation Insur ce cer' ntl Dolicy num6er ere: �✓ G Carrier: ' �i '� �K � Policy Num6er. Z� 7 I p F� (This secti�eed not be canp/eted i! the permif is valued et one huntlred dollars ($f 00) or less.) ❑ I certiy thet in the peAo compensation laws of C comply with Ihese provi. Applicant Signature: _ WARNING FaILURE TO SECURE iHOLISAND OOLLARE (E100,000), LICENSED CONTRACTORS DECLARATON: I hereby eHirm that I am torce end eHect. Lic. N_ Contractor's Signeture: lor which pertnit is issueU, I shell not employ any person in eny mennar so as to became suDject to the workers' that if I ould become sub�ect to Ihe workers' compensation Drovislons af Section 3700 of Ihe Labor Cotle, I shell fonhwith � �aca: '1 �LZ--O 3 COVERAG IS UNLAWFUL aND SHALlSUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDPED OF COMPENSATION, DAhNGES A$ PROVIDED FOR IN SECTION 3]O60F THE LABOR CODE, IMEREST, FND ATTOFNEY'S FEES. (commencing with Section 7000) of Division 3 0l the Business and P e ons Code, and my license is in full Clessk �i� � Dete: ��%iz"�� CONSTRUCTION LENDING AGENCY: ❑ I �ereby aHirm thal there is a construction lending agency tor ihe DeAormence ot tha woB for which this permit is issued. (Sec. 3W7, Civil Code). Lenders NemB: Lentlefs AAtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn thet under penalry of perjury that I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for �he tollowing reason (Sac. 7031.5, Business and Profassions Code: Any ciry or counry which requires a parmit to construct, alter, improve, demolish, or repair any structure, pnor to its issuance, also requires the applicant for such permlt to tile e siqned statemeN that he or she is licensed pursuent to Ihe Owvisions of t�e Contractors License Ww (Chepter e(wmmencing with Sedlon 7000) ot Division 3 ot Ihe Business entl Proleuions Cotle) or that he or she Is exempt Iherefrom end the basis lor fhe elleged exemption. Any violation oi Section 7031.5 by any a0��icant tor e pertnit subjects Ihe epplicani to a civil penalry of not more Ihan five hundred dollars ($500)J: ❑ I, es owner oi ihe property, or my employees with weges as iheir sole compensation, WILL DO TME WORK, and Ihe siructure is not intentlatl or oHeretl fo� sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not epply �o an owner of property who builds or improves thereon, and who does such work himselt or herself or through his or her own employees, providea t�at such improvaments ere not Intended or oMered for sale. If, however, the builtling or improvemem is sold within one year ol completion, ihe owner-builder will heve�tha burden of proving that ha or she tlia not build or Improve lor purposa of sale.). � � I, es owner of the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstruct tha prolect (Sec. 7044, Business and Protessions Cotle: The conirectors License Law tloes not apply to en ownar of property who hullds or Improves thereon, and who contracis lor such pmject with e contractor(s) license pursuant to Ihe Contractors License LBws.). ❑ I am exempl under 5et. Bu5ine5s end Professions Code tor Ihis raason: Signature: Date: Ownar ID verified by drivers licensa. ❑ Yes ❑ No Drivefs License No. Ventication of Ownership by (rype of dxument, i.e. - property tax blll or tleeA): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CER7IFICATION: ❑ I �ereby certity thet no excavation five (5) or more feet In tlepth Into which e person is required to descend, will be made in connection with work authonzed by this permit, end ihet no builtling simcture, scaRolding, talsework, or demolition or dismantling thereof, will be more than thirty-siz (36) feet hiqh. (Chap. 32, Grp 2, Art 2, Sec. 341, Tlile 8, Califomla Atlministrative Code). ❑ As owner-Duiltler, I will not employ anyone to tlo work which woultl require e permit from the Division of Indusirial Safety, es noted above, unless such parson has e parmit to do such work irom the division. Signeture: Date: Division of Industrial Salety Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENTTiV: I certity under penalry ot perjury t�at I have read this eppliwtion end state t�at the infortnation given is correct. I agree to comyly with all state law nd city ordlnances releting to builtling consiruction, and authodze reDresentatives of the Ciry of Costa Mesa to enter upon Ne ebove-described propq/ly for inspection poses. I egree not to occupy or allow occupancy of any �uilding authorized by this parmit until tinal inspeaion. 400E1. �ns7ecnoATvve• i616 Fixad System Final fire Prevention 1266 Paol Spa Final 200 Final RB-Root 201 Final BIocWReteining Well 202 203 Final Fecrory Fire Place Finel Sign 204 Final Demolition Q� I[+�LS `r� � Date 7 � Z-z-� > Data COOE I INSPECTION TVPE 206 Final Mec�enicel 208 Finel Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinryOccupancy i��r�cnuc��j VNOJECTAUDHESS: 4�3 E 20TH ST OWNEP'S NPME: CULP LEONE �i ET AL aooness: 47 i� 20TH ST C05TA NaESA,CA 92627 7?4 654-9986 APCMIENGINEEB: NEG.NO.: AO�PESS: uNiT: UNIT: PEflMITTEE: GEORGE. BRAZiL ( 77 4) 535-7905 aooeess: 3022 N. HESPE IAN WY 101 TA ANA CA 92706 UCE ONTflACT CLAPATION: I hereby Ifir ha� I am licensed unaer D�ovisions o� Chapier 9 �cammencing wiN Sectian � I ol 0 ision 3 e th Busines Pmlessm Ce , antl my license is in lull �orce anA e�feci. ruc. 02 i.9 sT ic.:4 . 64 cuss: C-36 �j ai ' Sign 1 . � _2 S ' • � WOflNEPS' COMPENSpiION DFCUflATION: I nereoy allirm �hal I luve a ceniliWte ol consent to selbinsure ar a cenifitate of Worker5' Compenulion Insurance. o� a cendied copy I�ereot (Section 00, LaD. C�. POLICYNO.: WCOZ 93 P.ORTE: �� 1 �92 c xr: UNZ'E PACIFI Ce itBe cooY is ere� umisnetl. � Ce� he copy is fil ' tAe cily Building Division. �— 2T-9 / aie:. p iION FAOM WOBREBS' COMP SATION OECLABATION: (iM1i55ettian neeA nal be tompl¢Ietl il �he Oermii is lar one hundred (E700) Or 1e55). I cetlily Inal in I�e Dedormance o1lhe work tor w�ic� �his permit is issued, I s�all nol employ any person in any manner so as �o become su��ecl to �he Workers' Comp¢nsation Laws of Calilornia. Dale: Signa�ure: NOTICE: II, a�ter making ihis tleclaration. you s�oultl 6ecome su�lect Ia IAe Workers' Compensa�ion Orovisions ol Ihe Lahor Cotle. you mu51 lorihwilh comply wilh suc� provisions or Ihis permil shall De tleemetl revokeE. CONSTPUCTION LENUING PGENCY: I hereby a��irm ihai ihere i5 a constmclion 1¢nAinp aAency lor Ihe pedormance o� Ihe work far w�ic� ihis oermii is issueA �Seciion 3097. Civ. C�. LENUEH: AOOPESS: OWNEB BWLOEB OECIABpTION: I hereby a��irm Ihai I am ezempi Irom I�C Conlratlors' S�ate License Law for the following reason �Seclion 7031.5 Business antl Pmiessional CoOe: Any city o� counry whic� requires a permii lo cons�mc6 alier, improve, tlemolish, or repair any simclure. prior lo its issuance. also repuires t�e applicant for suc� permit to li�e a signetl stal¢ment tAat he/s�e is license� purSuanl�o Ne O�ovisions ofthe Conlraciors'Slale License Law(Cha0�er9�commencinp wil� Section 7000�o10ivision 3 afihe Business ana Piolesvons CAee) or ihal helshe is eMemO� therelrom antl ine basi5lor Ine alleBea exemption. Any violation af Section 7031.5 �y any aD7liWnt br a permit subl�ts tAe aoDlitdnl to a tivil penalry ol MI more than live hundreA Aollars (5500�. I. as owner ot ��e pmperiy or my employees vni� wage5 a5 I�¢ir sale compen5aiion, will Uo Ne wnM1, antl the ❑ struclure is not intenEea or oitere0lar sale �Section 70a4, Busines5 anG Pmfessional Cade: The ConVaclors' State License �aw Goes no� apply to an owner o� a O�oDertY w� Ovilds or imOmves I�ereon, and wh0 GoeS suc� work �im5ell/he�ulf or �hmugh �is m �er own em0�oyees. pmviAea ihai suc� impmvemenis are nol intenEed or otlereG �or 5ale. Ii, �awever ��e huiltling or impwvemen� is soltl wi�hin one year of cam0leiion, Ihe owner will �ave the burden o� proving he/she Citl noi Dui10 or imOmve lor Ihe purpose of sale). I, as owner of �he pmpehy. am evclusiv¢Iy contra[ting with IitenSeG cOnlracl0rs Io [ons�mci IAe pmlecl (Seclion 7044, Business ❑ and Pmlessions Code: ihe ConlractoK S�ate Lkense Law tloes nol apply la an ovmer o� propeny wAo 6mI0s or impmves thereon dlltl w110 CO�IfdLIS i�f S�CA D�OjCCIS wllA d COlI(fdt10f�5) IiLEIISE pUfSUdfl1 �0 IIIE COfIIIdC�OfS S�ate License Law). I am aware Ihat pmof of Iheir Worker's ComDCnsation insurance s�ou10 be D�oviAeO lo me. � I am erem0� untler Section: B. 8 P. C. lor IhiS �eason: Da�e: Owner. I do hereby cenity tha� I am aware oi an0 unaerslan0 ihe reQmremems o� Calibmia Heallh and Sa�ery CoOe Seciions 25505, 25533, anA 2553a antl Ihal I or any iWure building occupant will/will no� (circle one) neeU lo comply with saitl staie cotles and �he reduiremen�s �or a permil lor conslmciion or motlificaiion imm Ihe Fir Ouahty Managemen� �isVici. ResiOenlial cons�metion applica�ions are exempt �mm IhC60 provl5ion5. Oate'. AOOlicant: I �ere�y c y Ih I have read Ihis licalian antl slaie �hai Ihe 6ove inlarm n is wrrecL I agree Io comDly wi�h all city ana coun�y orOmanc antlslat lawsrelalino' 0.Uingcon5lmclionan0�e� �yaul ke .preSenla�ive5ol1hi5ciryio¢nterupon�hea�ove�men�ionetl p�ope� i �a� inspec ion Ourpas�.. �� Dal �. �rive�'s Lmense o� Socia� Secwi�y e: 16ab46 Wh�te—Building; G�een—CaCe Enlorcement: Canary—ApPlicanl; Pmk—Revenue; Goltlenrad—Assessor CITY OF COSTA MESA — HUILDING FERMIT PERM NOc M 05079_ PERMIT NO; M 050793 PLAN CAECK NO; N GOVT; N SUPP: N CONSTRUCTION 1'YYE: V—N PERMIT TYPE: MEC PURPOSE: OTH JOB DESCRSPTION : REPLACE 100K BTU FAU SQ FT: CLAIM VALi.iE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REPLACE 100K BT[J FAU ��*x-*��x��*�xx�*xxx**x��*��x�x��x�x��f�x*�*xx�x��+�*xx�x��x*x*��cx*at�x�*x+��xxx Z O N I N GS ERTEAQAUCIKRSE M E N T S ------------ MAIN HUILDING ---------- --------- ACCESSORY BJILDING --------- FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT iN RGHT: FT iN PARKING RE • PROV: PARCEL: 42632406 ZNE: REF tu0: PLANNING N TES> > iE M� iP if iE if iFlF ff jE iEiE �K� iE k i6 �lF lF �)F # iE iE 3E 3e �If i(� �lf if �%� if IE % IE 3f if �1F 3E �lf It �N� �lE i61F �# lE IE 3E 3F fE iF if iP i!� If �lf iE i43f # IE lF lE �If iE k:f if N� if ie 1F iF if i4 if if jf df 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 5 ZONING AFPROVEU BY DATE; BUILDING APFROVED BY : DATE: APFLICATION ISSUED BY• - �/�2� �-lc DATE: �_/ 14 if iE�IE N� �IE �If �If )E if 3f �E �%%iF iF i(�!(� If 1E if ih�iF iFiF FiFii�7C'£�i"iF'i�A'TF'iF' - ... . - If 3f # if� lF If if 1f �1f- iF7f .�iF if i(�%ifif�lfifiFiEiPlfif�N��1EiEK�IFiF�(1E%iFiEif�3FiEif�ififlFifiEjtK3Fj(�3fN�X�3f �IFI4�IEiE3Fif3f761fiE3ElfifiEiEX�if�iElfiE�P�(�lE-ff�IPM�I(�N�X�if3hN�ifiFlEif-%if LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT FL'JMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING FERMIT 925� SMZP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT SSSUE PLAN—CHECK TOTAL PAID DiJE TOTALS----> 9.00 15.00 0.00 29.00 .�.4,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 24.00 OVER/SHORT; ,00 HLDC FMT PLGMBIt�G ELECTRIC MECFIANIC FIRE SMIP/TOT GRADING Pi,AN—CHECK 24,�� iE If iF %ifii ii'7fii'ii'i%if"1%i4 if j('If'K'if i% if'if if 3i'ifif if i% i('if'if%ii'M'if iF'ifib �%ii�i% if N' ii'if ifi%')i'i%ii'}:'�ji' 1('i%if K'if af ii'iEii'ifiF lE'7F iF'7f i4 i%i('i('ii'if if'N'IFif ih I N D I V I D U A L F E E B R E A I{ D O 43 N TYFE QTY D E S C R I P T Z O Iv UNIT COST TOTAL COST MEC 1 ZNST FORC—AIR/GRAV FURN <= 100 K BTU 9.00 9,00 END OF FEF.S 02 OD0741S9-00079189 T C+3' 24.D0 6ATE� O1/?5/91 TIflE: 15:43 CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector t. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utili[y�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Stee� Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPi70VAL TO COVER�GUNITE 7. Footings � 58. Electrical Conduit�Undrgrnd. 8. Founda[ion 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash �ines, P�Trap, O Undrgrnd. 10. Structural Floor SYstem 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar SYstem-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REnUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test . ,. 72, Underground Flush 24. Roof Framing � • 73. Undergrnd�. Storage Tank O Gas ❑ Oil 25. Roof Sheathing ' . 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing ', J HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electrical Power Meter-Final � , 80. FOOD CERTIFICATE ISSUED � 33. Final Electric ; Notes: 34. Final Heating & Air Conditioning 9 ' 35. Final Gas Pipe-Test ��s' 36. Hood or Canopy i 37. Final Factory Fireplace 38. Final Plumbing � 39. Water Service-Final • 40. Gas Service�Final 41. Solar pomesticFinal 42. Backflow Preventer ' � 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handiwp Regulations 47. FINAL STRUCTURE & BUILDING / 48. FINALPLANNING 49. Electric Release to Edison � � �, 50. Gas Release to Southern California Gas Co �•' i 51. CERTIFICATE OF OCCUPANCY No. Date MTIN OFFICE IG9! WEST GAYLOFO ST.. - P.O. BO% 900! LONG BEACN f0, CALIFOflNIA HEMLOCN 0�>993 6PRUCE S�SOBI Twinina Exatnuiation No. Project Sample from e- Laboratoraes .� � o� csouE�iezn January I1, 1961. QTNITE RrPORT OI' � T�ST CYLINDER SC60-1222 ROIIERT PAI.NIEft YARDLEY 473 E, 20th St., Costa Mesa, Calif. Gunite Swim Pool Architect Contractor D4ix 1-4Z \Vater, gal./sk. cement Sizc 6� x ll�x Date cast 12-14-60 Date tesced 12-21-60 C��linder No. 1 CO�YIPRGSS[OI�' TEST 7 Days Total load co desiruction, lbs. 80,500 Pounds per square inch 2,624 Cyli�ider made by Cylinder delivered by Cylinder recei��ed on cc: Yardley Costa hfesa Bldg, Dept. SA Lab W. 0, Koch Van 12-15-60 b� x 12 1-11-61 2 28 Days 98.5� 3,210 lR�NCH OFFICE Ipl�� NORTN M/�RPEF 8T. lANTA /.N.�. CILIFOHNIA J[iFEN80N 1�30�0 JEFFERSON I�i0�0 znfa, �nc. 3 "Hold" uA`�� 1� 1961 �m' °� Costa Mesa ,Buildin8 DsPt. , `y�j�,,� //J !/-:' ""_v'/�/ ��c �L. ",.a� . ALL REPOFTS RRE SUBMITTED PS THE CONFIOENTIAL PROPERTY OF CLIENT6, AUjHOP12/�TIOM FOR Py! LIL�TION OF OIIN REPORT6. CONCLUSION9. OR FI. TP/�CTS FqOM OF flEGNRDING THEM IS flESERVEG PENOING OUR WRITTEN APPpOVAL AS A MUTU6L PSiOTECT1011 TO CIIENTB, TX8 PUBLIC ANO OUflSELVEO. OwNER YARDLEY, ROBERT PAL?jSR DATEIZ-S-60 JOB ADDRESS 73 E, ZOth ST.• EIIILDING PERMIT NO. LOT TRACT FIAE N- ''ECTIONS DATE l ,raround Soil ?-..�.0 U.G. Water �� ix„/_ . OCCUPANCY DESCRIPTION OF WORK t'�'L � TYPE ZONE SU6CONTRACTOR Form 210—SM-11-59 S-B P , 133(�5 �.33�r� � �"��..�. ��-.�.� ,�:, ,, �OSTA MESd BUILDING-SAFETY DEPARTMENT �� DEC 5�[p P. O. BOX 917 COBTA MEBA. CALIPORNIA '"�,'Vl��'��L �[_r I. For Applieanf fo Fill In Complefely APPLICATION �FOR�PERAMMITESA TYPE OR pRINT BUILDING ADORESS � � . ZO • S` � COSTA MESA. CALIFORNIA For Office Use Only HECEIPT NO. PERMIT NO. OWNER ' AL.MER e � 3 MAIL RECEIVED BY I/OATE` E-E,V� I/�ATE 198UEO AODRE55 � . � ~ � � � — TEL. v BUILDING 1d � cin p C�1PSD No . "7 ADDRE55 �< ARCH�7eGi TE�. COSTA MESA, CALIFORNIA OR ENGINEER NO. ADDRESS ' FIRE ZONE TYPE GROVP APPROVED !' , f T- CONiRAGTOR U BY � ATE ADDRE68 ...a... , ING ZONE • NO. OF USE OF NEW �`,�Ty 2 � PLNNB � BUILDING � STATE TEL n LECA� /'e� LIC. NO. N 4 S /^ DEBCRIPTION �^'v � SIZE ' '� NO. OP BLpGB. OF LOT �' % NOW oN LOT � p, p, NO. .f I �� '� �S U68 OF YARDS EVES E%18TINGBLOG. w�'��, APPROVED ALLOWED HHTpACK YNf YROM <CENTHP LINB BT.1 ._ _, n ._ CENTeR ov e�E� REAR YARI SIDE YARP I LEFT I RIGHT DESCRIPTION OF WORK SIZEy��•V l � �ROOMS EXTERIOR WAL �. ) IROOF COVERWG C/ COVERII USE OF BU�LOING qND WORK TO BE i FT. �I"O �OC�L IN. FT. IN. — FT. IN. � ' '1 �.� .OATE I��il�� 1 HlR89y ACKNOWLC�GE TXAT 1 HAVE REAO THIB APPLIGTION THE AMOUNT BHOWN UNOER VALUATION 18 FOR THE AND 9TATE TXAT TXE A60VE IB CORNECT ANU AOREE TO LOM• pURPO6E OF EBTABLIBHING A nEqMIT FEE ONIY. PLY WITH ALL GITY ORDINANCEB AND STATe IAW9 REGULATNO Bu1talNo coNernucnoN. VALUATION �j� SIGNATURE O PERMIT FEE $ �l PERMITTE /n � m $//�� — PLAN CHECK $ � AUTHORiZED AGENT � F ¢ TOTAL FEE $ / a u YARDLEY, ROBERT PALh1EER R GENERAL CONTRACTOR OVmer-Bldr, VALUE nr. xo.118-293-15 LOT T1tACT FIRE ZONE DESCRIPTI02 Itu;"+:;�::a�C710N5 I DATE I GROiTP J TYPE � SUBCONTRACTOR OCCUPANCY 12-5-60 Form 210—SM-11-59 5-e P ].3 .� �� ..� 1��ss �-�� :.�,�,s�t �,, COSTA MESA BUILDING-SAFETY DEPARTMENT �� 4f �`' 1°�� ' y P. O• BOX 917 C08TA M66A. CALIFORNIA FINNRCE DEPT. Fo� A lieanf fo Fill In Com lefel CITY OF COSTA MESA PP P Y APPLICATION FOR PERMIT � �TYPE OR `PRINT gUILDING ADD EIBB H7J . 201h �. COSTA MESA CALIFORNIA For Office Use Only OWNER PDL x 0.EC61PT NO. PlRMIT NOi MAIL )' r ne �v er owTe nace ven} o�re iesueo ADDRE85 T7 � . �M � �% �4 U r/'a/ �S -60 CITY NO , �{ �� BUILDING _ �/O 7'W ADORH88 Cy � ARCMITECT � � 7E� COSTA MESA. CALIFORNIA OR HNGIN ER N H. U N� Z� _./ � FIRE ADDRH88 � + �!L =ONE TYPE GROU CONTRAGTOR L BYPROVEO DATE l Z� � b D ADDRE65 �i C 1� 1 � ING 20N NO.OF UBE OP NHW C�ry �.. I rurve BUILD�NO �OO `'- STA7E TEL. � LIC. NO; NO� �eae� � O88GRIPTION SIZE ! � I NO. OP OILO6. / OP LOT '- NOW ON 1.ot � p, p, NO. '� � �� ^ U6E OP � EXIBTI G LDG L YARDS EVES — APPROVED ALLOWED 9LiH6CK YN� �OM 1('3MTtX uN[ BTJ' _ ¢rmn o� 6n+aer REAR YMD FRONT FT. E �N. 91DE YAR7 LEF7 I RIGHT R.61DE FT. IN. DESCRIPTION OF WORK L.SI�E � I FT. IN. NEW I ALTERATION I IIADDITION I REAR FT. IN. � ' REPAIR I IIMOVING I IIDEMOLISH I BYPftOVED I , OATEGz �"�l� BUILD7NG NO. OF ' SIZE 'ROOM6 STORIES EXTHHIOR �MALL ROOP • COVERING COVERING USE OP BU�LDING, ND WORK TO BH PERFORMED n i I HeRBBY ACI(NOWL8D06 THAT 1 XAVB R6M iN18 ��PLIWTION TH6 AMOUNT BHOWN UNDeR VALUATION 19 FOR TM[ AND 8TAT8 TNAT TX8 ABOY6 IB CARRLCT AND AGRC6 TO CAM- pYRP088 OR ¢9TABLIBHING /� PeRMIT FHe ONLY. PLY WITX ALL CITY OIipINANCQB AND 9TAT8 LAW9 pBGUUTNO eUILDINO CON UGTON. . VALUATION Q.O BIGNATUR6 OP �n PERMIT FEE $ �D PERMITTE (�� p� l�p n S% Y�`D PLAN CHECK S lS AUTHORIZBD AGHNT �f/�J � p TOTAL FHE �� n <? � OWNER R1'PIIdSKI, ALAN inSPECTIONS Pool Location _ Forms Main Drain _ Steel Reinforce Elec. 9ond _ Appro�al to Cover Underground Electric _ Gas Piping Test Filtering System Lines _ Backwash Lines and Recep. Electrical Final ' �ter and Vent Final _ . ..er SYstem Final Backwash and Recep. Final Fencing Final DATE 4'u'7�' SUBCONTRACTOR ng Z . a cwj HZ Z� O �n am J � J N Q W (O J m J Q U N Za W ¢ aW W Z J Q m Z J � W w O= Z F- W � � O 3827� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA_ CALIFORNIA 92626 �.e� „-,�:"<<`oa 43, � �.so � t: �. � ,:,�: APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely qE i o av D TE RECEI ED O TE Is�ueo BUILDING ST e n'ii (]' w// ADDRESS Q� 2_I��I� PER OWNER � A.P. NO. V � MAIL � BUIIDING �� O� �• ADDFESS � O sT2ec /aDDRE55 TEL. TRACT((Jit LOT BLOCK CITV � NO. CANSTRUCTION W ADD A P LENDER �OQS! �eLR L SRy/iv BRANCH / ' ` OWNER ADORESS VAWE /� ^ `D' ARCHITECT TEL 5 � $ ((/�'"C/ OR ENGINEER FIRE T ADDRESS ZONE VPE GROUP •-� APPROVED CONTRACTOR �/k^(dQ�� BV DATE ADDRESS � ��, TEI. 7[ ZON NO.OF � USE OF NEW spL� CITY C� T LA� NO. ��L PLAN$ Z BUILDING f�JGp� STATE CITV �ARDSAPPROVED VARDSAPPROVED IIC. NO. '2'Z LIC. NO. MAIN BUILDING ACCESSORV BUILDING 512E NO.OF BLDGS. (FROM C/L STREET) 1 OF LOT Q �( � U NOW ON LOT `� FROfYT FT. �� FT.� l• VSE OF EX15TINGBLDG.�eSI �r�'CG. T. FT.'� SIZE OF NO. OF NEW BLDG. `� ROOMS '� STORIES — L.SIDE FT. 22 FT. COVERINGALL �- COV�EflING �- REAR FT. ( O FT. � USE OF BUI�DING AND WORK TO BE PERFORMED DISiANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR. # DATE C.U.P.� APPROVED APPROVEDi �. M ��'�� W`U 1 I hereby acknowletlga chat I have read this aOP��ation antl state that the above information is correct and agree to comply with all laws rogulating builtling consvuction, antl I shall not employ 07 any person in violation o( the workman's compenzafion laws ot the State o� Celifomia. I hereby certify that I am properly licensetl as a conttactor untler SQ. FT. the State ot California Business antl Protessions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licen5ez are in full force and effect, or I THE PURP�E OF ESTABLSHING A PERMIT FEE ONLV: am exempt from the provisions of ffie State of California Business antl Professions Cnoe, Division 3, Chapxer 9. VALVATION PERMR FEE ^y • � SiBnetura of � Permlttee �� $�/�L�1 �� PL4N CHECK $ r- ll��l� �. lrri Authorizetl Agent TOTAL FEE S