HomeMy WebLinkAbout481 20TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.a3UILDING PERMIT
Job Address: 481 E 20TH ST
Suite:
Viciniry:
Primary Occ: R3 Dwellings/ Cong Res <10 Type of Construc6on: v-n
Parcel Number: 42632407 � Zoning:
Applicant BILL WOODALL
Address:
Phane:
Zip:
Owner: BOWER, PAULINE
Address 481 E 20TH ST
COSTA MESA,CA
Contracror: BALBOA ROOF
Address: 7730 pomona #4
costa mesa,ca
Zip: 92627
Arch :
Address:
Zip: ��
A i'� ; �S'S�
F.•;� i - .� r-.
�_, � .,.
tloff sheath anc9''ra�oof 1800sf�res
,f,�z�
� : fx;r �.•,�'
�fi ���,j
Plan Check:-:! $0.00
Perriiit:�� $112;26,
ni. e
SMIP�Res:=; $0.60"
SMIP Com, :� $O�OO:i
Othe .r. ;. ,�,,,1,�,$D;AOa
I nspect!iorr:;:-rJr�;�,$O:OQ�
Tof I:y' 1`''a'$1'12.85
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0- 0
PARKING xi o
NOTES:
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ione: ,
r ,+ -
'Jr �{
. k.
shingles. smok
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: p' 4
e
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
ApPlied: 11/09/1998
Issued: 11/09/7998
ISSUED BY:
Phone: .�1
Zip: 92627 r j- `a'..
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� ~'i, i. �t,�9
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Phone:y949-631-50�A�';�,*.�* :' �
1
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ic-A' : , .. , ' � 1,y 't v�'�` . ?4.
ense 320195""` ;F,} : � �
E_ : �`�. (� 1..�,�- �'.,+n
```',� Eng:`,i� �...'.T��
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�Address:�,� '"
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� `����' �'
E OF'P.ERMIT
�ors required per 94ubc.
1 . I
`Sl7MN1ARY
I�" Calc Valuation:
Claim Valuation:
PLANNING & ZONING
Rear 0- 0 Left 0- 0
Rear 0- 0 Left 0- 0
Reauired: 0 Pr000sed: 0
Right 0- 0
Righl 0- 0
/
Phone:
License:
$6,000.00
ss,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremeMs under California sta�utes 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
lor a period of 1 BO days.
INSPECTIONS: In order lor Ihe work authorized under lhis permit to be considered legal, such work must comply with all applicable codes, and all
required inspectione and final approval must be obtainetl. Failure to oblain inspections and final approval will resull in ihe ezpiration ol lhis permit.
FOR INSPECTIONS CALL: (714) 7545626
!d46�d6(6/00�
WORKEFS' COtdPENSATION DECLARATION: � •
I nerrby afium untler penahy ol per]ury one ol Ihe followinq tleclaralions: ' '.
❑ I �ave �nd will main�ain a cortihcale cl consenl Io sel4lnsure for work�rs' cornpcnsation, as proviUed tor by soction 9700 of Ihe Labor Cotlo, for iho pehoimance of Iho
work for wliir,h ihis Permil is issuad. "
� I �iave and wtll main�ain workeis' cortipens�lien inswaneo, as requuetl by section 370U ol thn LaLoi :otle, foi the perioimance 0� Ih� work br which IhiS permif is issued. .
Idy wor4ars' componsalion Insurance carrier antl policy numbei arr�:
L'aniar� Policv Number.
/Tbi:: section neon nol Ga complered J �fio permif is valued. ( one hur,died Jollars �$100� or lessJ -
❑ I cenity Ihai In iho p°rtonnanw ot uie work for w'nich �his permit is issued, I shall not ertiploy nny pe�son in any manner so as to become subjecl �o Ihe workers'
comoensa�ion lavvs ol Celifomia, nntl zgrae Uial i� I shoultl becoma subjgct to Ih�+woikors' compensalion provi5ions ol SocliOn 3700 0l Ihe Labor Cotlo, I shaA fo�ihwilh
u0mply with t,h�sa provisuns.
Applicant SlgoaWio: Dalo�.
\VqPNING. FAILURF 10 SECURE N'ORKERS' GOMPENSAiION COVE�iNGE IS UNW WFUL N!U SHALL SUNECT 0.k Eh1PLOVER TO CqiMiPoAL PE��/LTI[5 nNO CIVLL FlNES UP /0 OrvE HUNDRED
THOUSAND DCiLARE I5�4].('�I. IN ADDITION 10 TN[ COST Of CAMPENSAiION, DAIAAGES AS PRUVIOEU FOR IN SECTIOP: ��G60F THE LABOR CODE, IMEREST, ANO AnORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I heroby aflhm �hoi I am Ilcansed untl¢u pmvlsions ol Gnnplor 9(commenany with Saclion 70001 0l Ulvlsion 3 of tho Buslneas and Prolosslons Cotle, dnd rny Iwen=e Is in tull
torce antl ef�ucl. Lia d Class h
Conuaclor's Signaiine: Date.
CONSTRUCTIOI� LENDI��G AG[NCV:
❑ 1 herobV aflmn ihat Ihero Is a conslruclion landin4;�$l�ncy for Iho podornianr,e ol Ine woik br which Ihis parmlt is Issued- jSe�:. Y097, Civil Cotle).
Lend-er's Namc LenJer's Atldress'
SignaNie: Date:
OWNER-6UILDER DEC6ARATIONS: /';-� ., i
�
I here6y attirm Ihat under penalty ol peijury Ihat I am EXEMPT FROM THE CONTRACTORS UCENSE LAW lor Ihe following reason (Sec:17031.5; 8usiness �nd Pmiessions
Cotle; Any ciiy or counly which requiros a parmlt �o construcl, eper, Impmve, tlontnlish, or repalr any slmcWre, prior to i15 issuance, also ropWre9-�he appliCa01 lor such parmil
lo file a signetl stalomnnt ihat he or shu is licenseel pursuan� lo Ihe provisions ul Ihe Coniractois License Law (Chapler 9(comme��ciny wlth Sectlon 7000) ot Division 3 0l Ihe
f3usiness antl Pmfession< GoOe) or Ihal he or she is exompi Ihereirom and Uie Uasis lor ihe alleyetl aremplion. Any violflUon af Sectiori 703t5�hy any applicaol 1or a permit
subi�3cts �he apDlicant lo a �ivil penalty o� nci more Ihan live hundred dollars (5500).): \, . �.
� I. as owner of Ihe property, or my employees wilh ria9es as iheir sole compensalion, WILL DO TME WORK, antl ihe slrucWra Is not inlended or ofleietl br sale (Sec.
704a, Business antl Protessians Cotle: The CoNracbrs License Law tloes not appty to an owner of pro0erty who builds or Imprwes thereon, antl who tlaes such work
himself or hersali or �hrough nis or her own employees. pmvitled that such impmvements are�not Intentletlpr oNered lor sale. II, however, ihe builtling or improvemem is
sold within ono year oi cumple!ion, Iho owner-builUor wlll hava Ihe burtlen ol proving'thet he o� she tlid no6builtl or lmpmve; fPr purpose ol sale.).
❑ I as ov:ner ni ihe picpcirv, am E%CWSIVELY CONTRACTING WITH LICENSED CONTflACTORS,to constiud me prol� (Soc.7044, Business antl Pmlessons
Code: l he conlracto�s Licunso Law tloes nol apply lo an owner ol,pmperry who builds or Improva= Ihereon; entl who coNrec�s lOr such projec� with a conVaclor(s)
license pursuanl lo Ine CoNracrors License Laws.). �� ` ,, � � /" � ' • ' - �
❑ I am exenipi untlei 4ec. �Business antl Professions Coda for Ihis reasem �. �
$ignaiurc: �� ' � i .. � . � f' � (/' ; . ' � Da1e: �� - 1
Owner IU veiilied Uy tlriver's license. ❑ Ves ❑ No +"?�� � .Driver s License No � s' � � Expires'
V�rihcation of Ownorshi b (I � ol Uocumenl, i.o op ���� ) , `j ���' ' �!.,i �� ?. ��, '
p Y iPv,�, . . . - Vr ertY,�� bill or tleed., . , .' ,.. . ^. '' I
DIVISIONOFINDUSTfiIAL`SAFETYPERMITCERTIFICATION: . . � - �
� r i � -
❑ I hereby ceriily tha( no excavation fve (5) or more feet in tlepth imo which e person is requiretl m descend, will be matle m cennamion with work amhorimtl by Ihis
nermii, antl tnat no buiitling simclureJ scattoltling, falsewoik. or demolilion or tlisman0ing Ihereof. �,vill be more Ihan Ihirry-six (36) feel high. (Chap. 32. Grp z, An 2, Sec.
341. Tiilo 8, Calliom�a Atlminisira�ive Code). . � ' / � =, ;���{
!"z.� ' '- � ' � � � . f � . 1
❑ As o�+'naf-builJBr,'kP Will�not ernploy anyone �o do Wofk which woultl requife a permit flom'Iha Division ol Intlusliial Safeiy. as noled above, Unle55 Such per5on �as a
nermit :o tlo such wOrkdrom the divislon. ; '' . - �""
� � .
Siynalur�� _ �� � �...._ � ' . .
�. �. . , �
Uivision o� Intluslnal Sa�ary Permi� Number: � _ �
Da�e:
i VJill Iho applican� or p�eSenLor INure.builtlinp occupanl need to tile antl cei�ity a Business Plan loi emorpency roeponse lo roleaso or Ihieatenetl release ol a hazardour.
material? ❑Ves �tr�No' w��'
�
(SeClion 25;U5 oi thb-0alifornia Health and Satery Cotle requires. wi�h suine e.cep�ions, thal a ausiness Plan be liletl with Ihe Costa Mesa Fire DeU�nmeN bv evcry
U�.isinzss which has a� eny cne lime tluring a reporled year a yuanlily ol hazartlous malerials er�ual m or greater Ihan a weigM1l ol 500 pounds, or a volume ut 55 gallons,
w 200 cubic feM ot canPressetl yas at standaid temperaWre and pressure).
........... .............. .. .......... . ............... .. . . ........... . ........_. ....._. .........._... ......... ... .. ............ . . , .......... ...........
2 �oes or will Ihe applicanl or present or IuWre bwltling occupant neetl to �ile a reqisira�ion �orm tor aculely hazardous rnalerials? ❑ Yes ❑ No
(Sechon 25579 0l rtio Califomia Ho�IRi and Salery Cotlo, wilh soma exr,oplions, roqulres rogielratlon wiih Ihn Cosla Mesa Flre Dapanmonl by each businuss whlch a; any
onn �imv has en h�nd e yuantiry oi aw�oty hazartlous mnterials equel to or yrea�or then a woigln oi 500 Pountls. or a volumo ol 55 galbns, or 200 cubir, foot ol
�cinprossetl Uas el stan�:ir<f tampeieWre antl presswel.
............. ...:,,... .................. ............. .. . .,............... . .... .......... ........... .. ........._.. . ............ .,,.......... . .. ............... ........_....................
o Does or will In� ;�pplic3nl or piesenl or (uwre builtliny uccupanl need lo prepare an HMPP (Risk Idanagement antl Preeention Prngram lor aculely hazardous ma�enals)?
� Yes ❑ IJ�
�Sectien 25534 0l Ine Cahtomia Heallh and Salety Code pmvitles Ihal Ihe Cosia Mesa Fire Ueparlmen� may ienuire Ifre prepaialion, conitication antl hling wilh Ihe Fire
I)epa�7men1 oi an RIdPP by �usinesses which a�e reyuiretl b regisler acWely hazaidous rnaierials with ;he Fire Deparlmeni.
._......... ............. ...._ ........ .. ................ . . ......,....... ....... ........... ....__..._......,,. . ......... ..............._. .... ._........... ............ ...........,......_... .......
a II un Fill�PP ln piesun�ly requirotl, hes Secfion 7_5534 ot tho CelHornla Haalt� antl Salery CoAe ber,n'ully compliotl with? ❑ Ve� ❑ No
,,,......_ ................. .................. ............. . .......,......... ..._............ ..,. _....._..... ............ .,..,,... ......... .................. ....._...... .....................
� Doos oi will me aypliCant or pieseut ur IuWie LuilWng Occupant iaquiro lor mo work whmh is tlia subjecl ol Ihls a�pllcaiion a erml� lor such consimehon or inod'dicalion
imm tfe Soulh Goa;l,4ir Cualtly Idanayament DisWct or Imm any oUiei an pollulion conVol tlishicl er agency? � Yos � No
fSnr.liUn 55(i>0.2 of Ipe Caldomia Goveimmenl Code requires Ihai ihz repuesied inlorma�ion be lumi5h?tl on apPliCalious lor non-ie5idenlial buiWinq pmmiis;.
W ill any pan ot �he faci6ty m he constmc�etl untlei �his pennil be within 10001oet irom IhE: ou�ei bountlaries ol a school? ❑ Ve> �J No
fll "yes", ihe fauliiv must meet Ihe requiiemeni of Seclio��s 25534 and �2303 0� Ihe Gabloinia Neatlh and Szfety Cotle).
Rnm 1lio bouin �,oa5� /�v
iiev!� �II ui Ihe disclosuru5
or omoi au ponuuon comra oisina or agency is reqwrea ioi mo �
i antl Saloty Cotle Secllon 42303 been mado? ❑ Ves ❑ No
(II "yes", aVacn cetlifiGate o� cumpliance Irom the apUropiiate alr pollution conhul oflicer).
CEf1TIFICAI E OF C���NLIAIJCE: I cerlily ihal under penaliy of perjury Ne infunnation given above is correa. I ayree lo comply wilh all s�a�e laws antl ciiy oitlinances
regartling Hazartlous ���aterials antl Emissions.
SignaW�e:
Da�e:
CfiRT1FICATE OF COtdPL�ANCE AN� AUT}10RRAT10N OF ENTRY: I cenity under Uenalty of perjury that I have read �his applicatiun anef stale Ihat R�e inloimation given is
couecL I Tgree tn complv with all stale laws and city ortlinances relatinq to bullding construmlon, an� aulnorize repre;entatives oi tne Ciry of Costa Mesa tu m�1er upon Ine
r�booe-Uescriued propmiy �or mspenicn purposes. I agiee not to ocwpy or alloa� occupancy ol aiy builon�g autnoiized by Ihis permii uniil linal in;pec�ion.
Siynature OI Leyal Owneqs)
And/Or Aulhonzed ApDllCanl Dale
Cooc ,. IY.SPECTION TYPE
1616 Fixed Sys�em Final Fire Pieveniion
t2GG ,Poo SI pe Flnal. } � \
;
2U0;� FinalFe-Rool �'`ti�;�...,_-�
! `�
201 `� finel Block/Rotaimny Wall
202 �i � Fnai Faaory Frt5 Placs�r,• -..
� �'
2U3 `. Final Sign •":'."- �
2DA Final�DemMiiion:-���-'
pATE INTRIAL$
...r*"' �. '�'.4''_
�'. 3 : 'i-� . , .� ��4�
� _ _ � �'�„ nY'� .
f.
�tst bi ' . � I -
' �_.�K�i. � ��
�� .
LO�EM IN�'ECTiONTYPE
20G Final Mechanical
ZOB Final Plumhing' �
210 ��,Final Becincxl � �' '
� .
212��; FinalFirePrevention'„V'
I'
220 Flnal Plamm�g Approval
222 _� Fine15ite
r
250. . Finel6wldinuiOr,wp:mcy
DATE INiRIALS
�'.""—• �.�. � _
`��`ti!,' ''`i�, � �. ; �,.
r i"SF'�*,'��i
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(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�fiLDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
�ob nddress: 481 E 20TH ST
Suite:
Vicinity: 2ND STORY OVER EXISTING GARAGE
Parcel Number: 42632407
Applicant: WHITE, PAUL
Address: 1275 N CHRISDEN ST
SUITE P207
ANAHEIM,CA
Owner: BOWER, PAULINE
Address 481 E 20TH ST
COSTA MESA, CA
Contractor: PRESTON PAUL WHITE
Address: 1275 N CHRISDEN ST
SUITE P207
ANAHEIM,CA
Zip: 92807
Arch :
Address:
Phone:
Zoning:
Phone: 714-267-1971
Zip: 92807
Phone:
Zip: 92627
Phone: 714-267-1971
License: 413663
StaWs: ISSUED
Applied: 01/23/2003
Issued: 04I08/2003
Eng: RODRIQUEZ, RUDY
Address: 14172 80WEN ST
GARDEN GROVE, CA
Phone: 714-636-7705
Zip: License: License: 2ffi10
SCOPE OF PERMIT
ADD 557 S.F. (105 S.F. 1ST F�OOR WHICH IS BEING CONVERTED FROM GARAGE TO LIVING SPACE AND NEW 452 S.F. 2ND FLOOR) 2ND
STORY MASTER BEDROOM SUITE AND BATH OVER 557SF ATTACHED GARAGE (322SF NEW GARAGE PIUS 235SF RECONSTRUCTION OF
EXISTING GARAGE). ADD 105
S.F. DECK TO NEW 2ND FLOOR BEDROOM. NO OTHER REMODELING WORK TO BE COMPLETED.
REF: ZA-02-53
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$49124
$755.75
$s.so
$0.00
$0.00
$0.00
$1,253.49
SETBACKS
MAIN STRUCTURE Front 34- 6
ACCESSORY Front 0-0
Rear 29- 0
Rear 0- 0
FEESUMMARY
PLANNING & ZONING
Left 12- 0
Left . 0- 0
Calc Valuation:
Claim Valuation
Righl 3- 0
Righ� 0- 0
$65,001.90
so.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire antl become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable=codes, and all
required Inapections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expl2tion of ihls permit.
FOR INSPECTIONS CALL: (714) 7545626 /
244&OB (8/00)
WORKERS�COMPEM3ATION DECLPRATION: '
I hereby aftirm under penalty of perjury one o1 iha followinq tleclarations:
❑ I have and will maintain a certifice�e of consent ro salf-Insure tor workers' compensation, es provitled for by section 3700 oi the Labor Code, for the pertortnance of the
work for which this pertnit IS i55uetl.
❑ I have antl will maintein workers' compensation insurance, as requiretl by section 3700 of the Lebor Cotle, for ihe pedortnance of Ihe work for which this permit is issued.
My workers' compensation Insurance cerner end policy numher ara:
Carrier: Policy Number:
(Ihis sec(ion need not be wmplered i! fhe pennif is veluetl at ane hundretl tlallars ($f 00) or /ess.J
�- 'I certify Met in the pertortnance of Ihe work for which this pertn' issuetl, I shall not employ eny person in any manner so es to become sub�ect to the workers'
compense�ion law lifomia, 0nd e that it I shoultl co 5ubjec� �o t�e workers' compensation provisions of Settion 3700 ot ihe Wbor Code, I shall forihwith
comply with the a pro/ �ons. o
Applicanl Signeture: / �i.�`C Date: �/�/Q�
WARNING FAILURE i0 SECURE WORKER5' �MPENSATION COVERAGE IS UNUWFUL AND SHALL SU61EC� AN EMPLOYER TO CRIMINN. PE TIES AND qVIL FINES UP TOONE HUNDRED
THOUSAND DOILARE (5100,000), IN qDDIT10N T� TME CqST OF CqMPENSATION, OAMAGES AS PROVI�EO FOR IN SECTION 9]C6 pF THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CON7RACTORS OECLARATION:
I hereby aHirtn that I em licensed u9tl�e�r r9 v}i io�n,s of Chapter 9(commencing with Section 7000) of Division 3 0l ihe Businass
force and eHect. Lic. N__�_='�f'/.� �/la� /�) Cless N=
Contracror's SignaWre: ��1b�-T �� - . Date:
and my license is in full
CONSTRUCTION LENDING AGENCV:
❑ I hereby ettirtn that there is a construction lentling agency for the pertormance of ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle).
Lentler's Name: Lender's Address:
� Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby eflirtn ihat unde� penalry of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which requires a permit to constmct, elter, improve, tlemolis�, or repeir eny simcWre, prior to its issuance, also requires Ihe appiicant tor such permit
to flle e slgnetl statemeni that he or she �s licensad pursuant to ihe pmNslons of the Contrectore License Law (Chapter 9{commencing with SecBon 7000) of Division 3 of the
Business and Professions Code) or Me� ha or she is exempt therefrom antl the basis tor the allegetl exemption. Any violetion of Section 7031.5 by any applicant for a permit
subjects the applicant to e civil penalty oi not more ihan five hundretl dollars ($500).):
❑ 1, as owner of ihe properry, or my ampioyees wi[h wages as ihelr sole compensation, WILL DO THE WORK, and ihe simcture Is not intendetl or oflered for sale (Sec.
7044, Business and Professions Gode: The Conirectors License Law tloes not apply to an owner of propeny who builds or improves Ihereon, and who does such work
himselt or hersetl or thmugh his or her own employees, providetl that such improvemenis are not intended or oHered for sale. tl, howeveq the builtling or improvement is
soltl within one year ot completion, the owner-buiider will have ihe burden of proving ihat he or she did not build or improve for purpose of sale.). �
❑ I, as awner of the pro0arty, am EXCLUSIVELY CONTRACTNG WITM LICENSED CONTRACTORS to cOnstruct ihe project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of propeny who builtls or improves ihereon, antl who contracis tor such prolect with e contractoqs)
license pursuant to t�e Contractorb �icense Laws.).
❑ I am ezempt untler sec. Business antl Protessions Code for this reason:
SignaNra: Date:
Owner ID veritied by tlriver's license. ❑ Ves ❑ No �river's License No.
Venfication of Ownership by (type of tloGument, i.e. - properry taa bill or deetl):
Expires:
DIVISION OF INDUSTRIA� SAFETV PERMIT CER7IFICA710N:
❑ I hereby certity ihat no excavation five (5) or more feet in tlepth into which a person is requiretl �o tlescend, will be matle in connection with work euthonzed by this
parmit, and tfiat no buildinq siruciUre, scaffdtling, talsework, or demolition or tlismaMling iheraot, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
347, Ttle B, Calitomle Administrati�e Code).
❑ As ownervbullder, I will not employ anyone to do work which would requlre e permit from tha Division of Indusirial Satery, as noted ebove, unless such parson has a
pertnit ta do such wark from the di��sion.
Signature: Date:
Division of Industrial Safety Permit Number:
CERTIFlCA7E OF COMPLIANCE AND A��AIZA710N OP ENTHV: I ceniy under penairy of perjury that I have reatl this application antl state Ihat the information given is
correct 1 egrae to comply with all state lews and city ordinances relating to building consWction, end euihorize representatives of ihe City of Costa Mesa m enter upon Ihe
above-descnbed property tor inspection purposes. 1 agree not to occupy or allow occupancy of any building authorizetl by this permit until final inspection.
ignetur f � Own r(
� 1f�
And/Or Authonzed Applicant
CODE t, INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1286 Pool Spa Final
200 Final Re-Roof
201 Final8locWRetaining Well
202 Final Fedory Fire Place
203 Final Sign
204 Final Demolition
PdL inrmn�s
, 6 Z 3 a�
CODE1 INSPECTIONTVPE �
206 Final Mechanical
20B Flnel Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Buiiding/Occupency
P97E ItII�Lfl
�
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
CER7IFICATE Of COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
To: (� Cily a( Costa Mesa
( ) City of Newport Beach
( ) County of Orange
Applicant ,�,� .r.C�� "To�C/ �A�� l.f%��/T
Address: ,� '�^tJ� � ZD � � -�� %y%��'''9 G� yZ6Z7
Telephone Number. � ( 9`�9� ���g �Z6� 7
TracUParcel and Lot Number(s):
Location of Project:
Number of Square Feet of:
Residential Space
Commercial and
Industrial Space
E. Zo�
CommerciaVlndustrial Projed is: (Check One)
Warehouse
R8D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
_ This project is exempt because
N° 4238
DisUict Receipt No.
Plan Check No��-Q�I I �
/!'%C"�`L7, C...A �G�vZ 7
��J% x a�.ae
x S .30
_ Motel
Bank
_ Neighborhood Shops
_ RacqueUHealth
_ Hotel
_ MedicalOffice
_ Office Park
To��� i, c� Z�-1 gg
Total
Preschool
Auto Repair
Hosptal
Large Office
Office Bldg.
Restaurant
Fest Food
This certifies that the above-named Developer/Applicant has paid school faatiry fees in comp6ance with Government Code sections
53080 and 65995. 1Te Building Pemiits for this square footage in Mis proposed development may now be issued by your jurisdic5on.
Checks are to be made payable to NewpoA-Mesa Unified School District.
By
The above represehta6on as to square footage is true. Appticant agrees that if it is later determined that such representations are not
true, then this certificate shall automatically terminate and the appropriate City/Counry shall be notl6ed�3 2�fl3/2:16 Fd/5 1024. B5
kL."T�:51 §Ii17,6
/�,, � � �'"" 124?§_'
Date: ��,f r1/L l�ii 03 � M �b1�,., `��.-G�
�
. �-
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENT SERVICES DEPARTMEN7
November- 27, 2002 - -- - - - - - � - -
Gary Sullivan
2824 Stromboli Road
Costa Mesa, CA 92626
RE: MINOR DESIGN REVIEW ZA-02-53
481 EAST 20T" STREET. COSTA MESA
Dear Mr. Sullivan:
The minor design review for the above-referenced project has been completed. The
application has been approved based on the following project description and findings,
subject to the conditions set forth below:
PROJECT DESCRIPTION
The applicant is proposing to construct a second-story, 490 square-foot addition to an
existing one-story, 2,238 square-foot, single-family residence. The addition includes
an expahsion to an existing 2-car garage. The second-floor addition consists of a
bedroom, bathroom, and a 105 square-foot deck. The proposed second floor complies
with all setback requirements; the second floor is setback 6 feet from the side (west)
property line and 29 feet from the south (rear) property line. Access to the second
floor will be via interior stairway.
The home abutting the site to the east (483 East 20`" Street) has a studio over a
detached garage (approved under ZA-01-71). The residence abutting the site to the
west (473 East 20`" Street) is one story. Five windows (one providing light into the
stairway and four for the bedroom) are proposed on the west elevation. These
windows have been designed to reduce direct lines-of-sight into the yard area of the
adjacent residential property.
The intent of the minor design review process is to ensure that scale and massing of
proposed second-story design is compatibie with the neighborhood, as well as the
existing design for the residence. The addition has been designed to be physically and
architecturally compatible with the existing residence and neighboring uses. Existing
on-site trees will provide additional visuai screening of the addition.
BuilGirq Division (714) 75b5273 • Cade Enforcement (714) 754-5623 • Planning Division (774) 754-5245
FAX (7ta) 75C-4856 • TDD (714) 754-5244 . www.d.costa-mesa.ra.us
ZA-02-53
November 27, 2002
Page 2
�
Included in this request is a minor design review to exempt this project from current
parking requirements. Code requires two garage spaces, as well as two open parking
spaces when bedrooms are added to existing homes. Code allows use of a minimum
19-foot long ciriveway leading to the garage as satisfying that requirement; however,
in this case, the portion of the driveway that can be used for the two required open
spaces has an inadequate backout area. The applicant cannot reasonably comply with
this requirement without removing additional landscaped yard area and possibly __
removing several mature trees. With the proposed plan to aliow improved back-up
ability, the property will effectively accommodate two vehicles parked in the driveway.
FINDINGS
A. The information presented substantially complies with Costa Mesa Municipal Code
Section 13-29(g112) in that the proposed project will not be detrimental to the
health, safety, and general welfare of the public or other properties or
improvements within the immediate vicinity. The construction will not be
materially detrimental to the health, safety and general welfare of the public or
otherwise injurious to property or improvements within the immediate
neighborhood. Specifically, the proposed second floor complies with all setback
requirements, the addition is architecturally compatible with the existing residence,
and second story windows have been designed to reduce direct lines-of-sight into
the yard area of adjacent residential properties. Granting the minor design review
will not allow a use, density or intensity, which is not in accordance with the
general plan designation for the property.
B. The proposed project complies with Costa Mesa Municipal Code Section 1 3-291e)
because:
•. The proposed development and use is compatible and harmonious with
uses on surrounding properties.
• Safety and compatibility of the design of the buildings, landscaping, and
o.tk�er site features including functional aspects of the site development
such as automobile and pedestrian circulation have been considered.
• The project is consistent with the General Plan.
• The planning application is for a project-specific case and does not
establish a precedent for future development.
C. No parking impacts are anticipated even though the configuration of the existing
driveway precludes compliance with the required two open spaces. In this case,
the portion of the driveway that can be used for the two required open spaces
has an inadaquate backout area. The applicant cannot reasonably comply with
this requirement without removing additional landscaped yard area and possibly
removing several mature trees. With the proposed plan to ailow improved back-
up ability, the property will effectively accommodate two vehicles parked in the
driveway.
�
ZA-02-53
`November 27, 2002
Page 3
�
D. The project has been reviewed for compliance with the California Environmental
Quality Act (CEQA1, the CEQA Guidelines, and the City environmental procedures,
and has been found to be exempt from CEQA.
_ E. The project .is exempt from_ Chapter XII, _.Article _ 3, _Transportation _System. _ __
Management, of Title 13 of the Costa Mesa Municipal Code.
CONDITIONS OF APPROVAL
Ping. 1. Street addresses shaii be displayed on the fascia adjacent to the main
entrance or front door in a manner visible from the public street.
Numerals shall be a minimum 4 inches i� height with not less than YZ-
inch stroke and shall contrast sharply with the background.
2. The conditions of approval for ZA-02-53 shall be blueprinted on the face
of the site plan as part of the plan check submittal package.
3. Demolition permits for existing structure(s) shall be obtained and all work
and inspections completed prior to final building inspections. Applicant
is notified that written notice to the Air Quality Management District
may be required ten (10) days prior to demolition.
4. The applicant shall contact the Planning Division to arrange for a
planning inspection of the site prior to the release of occupancy/utilities.
This inspection is to confirm that the conditions of approval and code
requirements have been satisfied.
5. Existing mature vegetation shall be retained wherever possible. Should it
• be necessary to remove existing trees, the applicant shall submit a
written request and justification to the Planning Division. A report from
a California licensed arborist may be required as part of the justification.
—Replacement trees shall be of a size consistent with trees to be removed,
and shall be replaced on a 1-to-1 basis. This condition shall be
completed under the direction of the Planning Division.
6. Second floor windows on the west (right side) shall be designed to
eliminate direct lines-of-sight into the yard area of the adjacent residential
property, subject to review and approval by the Planning Division. Every
effort shall be made to maintain the privacy of abutting property owners.
7. New and existing construction shall be architecturally compatible with
regard to building materials, style, colors, etc. All elevations shall have
enhanced architectural details and/or window treatments per the
direction of Planning staff.
Eng. 8. Maintain the public right-of-way in a"wet-down" condition to prevent
excessive dust and remove any spillage from the public right-of-way by
sweeping or sprinkling.
za-oa-sa
•November 27, 2002
Page 4
CODE REQUIREMENTS
i
The following list of federal, state and local laws applicabte to the project have been
compiled by staff for the developer's reference. Any reference to "City" pertains to
the Gity of Costa Mesa.
Ping. 1. All contractors and subcontractors must have valid business licenses to
— - - - -� -'- - - do -business "in the -City--of -Costa Mesa. - Final- inspections, final
occupancy and utility releases will not be granted until all such licenses
have been obtained.
2. Approval of the zoning action is valid for one (1) year and will expire at
the end of that period unless building permits are obtained and business
commences or the applicant appiies for and is granted an extension of
time.
3. Development shall comply with ali requirements of Section 13-32, Title
13, of the Costa Mesa Municipal Code relating to development
standards for residential projects.
4. All new on-site utility services shall be installed underground.
5. Installation of all new utility meters shall be performed in a manner so
as to obscure the installation from view from any place on or off the
property. The installation shall be in a manner acceptable to the public
utility and shall be in the form of a vault, wall cabinet, or wall box under
the direction of the Planning Division.
6. Any mechanical equipment such as air-conditioning equipment and duct
work shall be screened from view in a manner approved by the Planning
Division. Roof-mounted mechanical equipment is prohibited.
Bidg. 7. Comply with the requirements of the Uniform Building Code as to
• design and construction.
8. Construction, grading, materials delivery, equipment operation or other
noise-generating activity shall be limited to between the hours of 7 a.m.
`�and 8 p.m., Monday through Friday, and between the hours of 8 a.m.
and 7 p.m., on Saturday, Sunday, and Federal holidays. Exceptions
may be made for activities that will not generate noise audib�e from off-
site, such as painting and other quiet interior work.
Eng. 9. At the time of development submit for approval an off-site plan to and
grading pian to the Building Division that shows sewer, water, existing
parkway improvements and the limits of work on the site, prepared by a
civil engineer or architect. Construction access approval must be
obtained prior to building or engineering permits being issued by the
City of Costa Mesa. Pay offsite plan check fee to the Engineering
Division. An approved offsite plan and fee shall be required prior to
� engineering/utility permits being issued by the City.
10. A construction access permit and deposit of 9350 for street sweeping
will be required by the Engineering Division prior to the start of any on-
or off-site wo�k.
ZA-02-53
November 27, 2002
. Page 5
�
Fire 1 1. Provide approved smoke detector(s) to be installed in accordance with the
1 997 Edition of the Uniform Fire Code.
SPECIAL DISTRICT REQUIREMENTS
The requirement of the following special districts are hereby forwarded to the
applicant:
Sani. 1. Developer shali contact the Costa Mesa Sanitary District at (949) 631-
1 731 for current district requirements.
School 2. Pay applicable Newport Mesa Unified School District fees to the Building
Division prior to issuance of building permits.
State 3. Compiy with the requirements of the Caiifornia Department of Food and
Agriculture (CDFA) to determine if red imported fire ants (RIFA) exist on
the property prior to any soil movement or excavation. Call CDFA at
(714) 708-1910 for information.
The decision will become final at 5 p.m. on December 4, 2002, unless appealed by an
affected party or a member of the Planning Commission or City Council, including filing of
the necessary application and payment of the appropriate fee.
If you have any questions regarding this letter, please feel free to contact the project
planner, Mel Lee, at (714) 754-5611 between the hours of 1 p.m. and 5 p.m., Monday
through Friday.
Sincerely,
� ��/��--
PERRY L. ALANTINE
Zoning Administrator
Enclosure: C`onceptually-approved plans
cc: Engineering
Fire Protection Analyst
Water District
Building Division
Pauline Bower
481 E. 20`" Street
Costa Mesa, CA 92626
Stathi G. Marcopulos
' Cox, Castle & Nicholson LLP
19800 MacArthur Boulevard, Suite 600
Irvine, CA 92612-2435
A
�
PLANNING APPLICATION SUMMARY
Location: 481 E. 20`" Street Application: ZA-02-53
t
Request: 2-Story, 485 sq. ft. addition to 1 story single family residence___
SUB.IECT PROPERTY: SURROUNDING PROPERTY:
J Zone: R1 North: All surrounding properties are zoned
General Plan: Low Density Residential Souih: R1 and improved with residences.
Lot Dimensions: 60FT X 135FT East:
Lot Area: 8,100 SF West:
Existing Development: Existing residence and attached garage
DEVELOPMENT STANDARD COMPARISON
Development Standard Required/Allowed Proposed/Provided
Lot Size:
Lot Width 50 FT 60 FT
Lot Area 6,000 SF 8,700 SF
Density:
Zone 1 unit/6,000 SF 1 unit/8,100 SF
General Plan 1 unit/5,445 SF 1 unit/8,100 SF
Buildin Coverage:
Buildin s N/A 2,268 SF (28%)
Pavin N/A 1,365 SF (17%)
Open Space 3,240 SF (40%) 4,467 SF (55%)
• TOTAL 8,100 SF (100%I
Buildin Hei ht: 2 Stories/27 FT 2 S[ories/22 FT
First Floor Area (Including Garage) NA 2,238 SF
Second F.Iner Area - NA 490 SF
2nd Fioor% of lsi Floor` 80% 20%
Setbacks:
Fro�t 20 FT 34 FT, 6 IN
Side (leftlri ht) 5 FT/5 FT 12 FT/3 FT"
Rear 20 FT 37 FT, 6 IN
Parkin :
Covered 2 Spaces 2 Spaces
O en 2 Spaces 1 Spaces
TOTAL 4 Spaces 3 S aces'"'
Driveway Width: 10 FT 16 FT
rvui a coue reyuuernen[
"The site is legat nonconforming
� "'The applicant has requested an exemption form this requirement.
CEQA Status Exempt
Final Action ZA
�
,-- �_�03
(71a) 754-5273 • Fax (714) 75a-a856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address: 481 E 20TH ST
Suite No
Viciniry:
Parcel Nunmber:
ApplicanC
Address:
Owner:
Address
42632407
PRESTON PAUL WHITE
1275 N CHRISDEN ST
SUITE P207
ANAHEIM,CA
BOWER, PAULINE
481 E 20TH ST
COSTA MESA, CA
Contrector: PRESTON PAUL WHITE
Address: 1275 N CHRISDEN ST
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fixts
Recept OutleLs
Switches
Nan Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over t000a
Motors l0 1hp
MotoB to 10hp
SUITE P207
ANAHEIM, CA
Phane: 714-267-1971
Zip: 92807
Phone:
Zip: 92627
Phone: 714-267-1971
Zip: 92807
License: 413663
Status: ISSUED
Applied: OB/71I2003
Issued: OB/11I2003
ISSUED BY: �
SCOPE OF PERMIT
ADD 557 S.F. (105 S.F. iST FLOOR WHICH IS BEING CONVERTED FROM GARAGE TO LIVING
SPACE AND NEW 452 S.F. 2ND FLOOR) 2ND STORY MASTER BEDROOM SUITE AND BATH OVER 557SF
ATTACHED GARAGE (322SF NEW GARAGE PLUS 235SF RECONSTRUCTION OF EXISTING GARAGE). ADD
105 S.F. DECK TO NEW 2ND FLOOR BEDROOM. NO OTHER REMODELING WORK TO BE COMPLETED.
REF.: 803-007 71
ELECTRICAL TO INCLUDE: 22 IIGHT FIXTURES, 15 OUTLETS, 14 SWITCHES, AND 1 SERVICE TO
200 AMPS.
$23.50
$0.00
50.00
50.00
so.00
50.00
$23.46
576.50
$15.40
$0.00
$0.00
530.50
50.00
50.00
$O.Oo
50.00
Quaniity
0
0
0
22
15
14
0
0
7
0
0
0
0
FEESUMMARY
Temp Dist System / Lighting
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transfortners up to 1 kva/kw
................up to 70 kva/kw
.................up to 50 kvafkw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( qen or ritle)
Circus (mech nde or lights)
Christmas Tree Stantl
Quantity
$0.00 0
ao.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
50.00 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
$0.00 0
NO710E: The work aulhorized by ihis permit shall comply with all applicable handicap access requirementa under California statutes and related
regulations. (Ord. No. 92�28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void ii vrork is not commenced within 180 days, or ii work is suspended or abandoned
for a period of 7 BO days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapectione and final epproval must be obtained. Failure to obtain inspections and tinal approvfll will result tn lhe expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5828
2M&d8(B/00)
WOPKERS'COMPENSAnON DECLARAnON: � ,
I hereby effirm untler penelty ol parjury one ot Iha tollowing tleclaretions: ,
❑ I heve entl will maintain e certBicate af �yent to sell-Insure br workers' mmpensalion, es provided lor by section 3700 of the Lebor Cotle, tor lhe pertormance of lhe .
work for which this pertnil Is issuetl. � '
❑ I have enC will maintain workers' compensaUon insurence, es repuired by section 3700 ol tha Lebor Cotle, for Ihe pedormance ol lha work for whicti Nis permi� is issuetl.
My workers' compe75ation Insurance W�ner antl policy number are:
Cartier: Policy Numher.
(T�is section need not be complefed l! Ne permitls velued et one hundred ddlers (5700) or less.)
� I certiry thel in Iha paAormencs of che wOrk lor which this partnii is issued, I shell not employ any per5on in eny menner so es to become 5ub�att to IhB workers'
compensation lews a, antl e ree that It I should De ub�ect to the workers' compensatlon proWsians ol Secilan 3700 0l Ihe Lebor Catle, I shallloMwlth
comply wiih �hese rovislo .
Applicant Signeture: ��L � Dale: �/��/�3
WARNINO:FAIWRETOSECUREWORI(EiLS'GVMPEN$qTIONCOVEMpEISUNLAWFULANDSWLLLSUBIECTANEMPLOYERTOCRIMINAl. ENALIESMIDGVILFlNESUPTOONEHUNORED
TTIOUSAND OOLURE (Sf OO,OOO�.IN ADDfiION TO THE WST OF OOMPENSATION, OAMNGES /S PROVIDED FOR IN SECfIIXJ 3]080F TME UBOR CODE, IMEREST, AND ATTORNEI^5 FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby eflirm that I em Ilcens tl un e rovlsions of C�apter 8(commenpng wiih Section 7000) of Division 3 0l the e
torce antl aHect. Lic. a Cless a
Contractar's Slgnature: (�/ g � Date: _
Codo, end my IlCense is in tull
CONSTRUCTION LENDING AGENCV:
❑ I heroby eNirm thet there Is e constructl0n Ientlinp egency lor iha pertormance ol the work for which �his Dermit is issued. (Sec. 3097, Civll Cotle).
Lenders Neme: Lentlefs AtlAress:
Slgnature: Dete:
OWNER-BUILDER DECLARATIONS:
I hereby eflirm t�ai untler penelry of per�ury the11 am E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business and Prolessions
Cotle: Any city or county which requires e Da�it to construct, elter, improve, demolish, or repair eny structuro, pnor lo Its issuance, elso requlres the epplicant for such pertnit
to file e signed statement thet �e ar sha is licensed pureuent Io Ihe provisions oi Ihe Contractors License Lew (Chapter 9(cammencing wlth Seclfon 7000) ol DiNsion 3 ot Iha
Business and Prolessions Code) ar thet he or she is a:empt thereirom end the besis lor the alleged exemption. Any violetion ol Section 7031.5 Dy eny applicent for e Oertnit
subjects Ihe epplicant to a civil penel�y ol not more than live hundred dollers (5500).):
❑ I, es owner ot Ihe property, or my employees with wages es Ihelr sole compensalion, WILL DO THE WORK, entl ihe structure Is nat Inlendetl or oMered for sala (Sec.
7044, Business antl Professions Code: The Contractors License Law does no1 appry ro an owner of propeny who builds or improves ihareon, and who does such work
himsetl or herself or Ihraugh his ar her pwn employees, provitletl that suc� impmvemems ere not imended or oRered br sele. II, however, Ihe bullding or improvemem is
sold wit�in one year ol completion, the pwnerDuiltler wlll �ave�the burden of proving ihat he or she did not builtl or improve for Durpose ol sele.). �
❑ I, as owner ol Ihe properry, am E%CLU$ryELY CONTRAGTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Pmfessions
Code: The contractors License Ww does not appy ro en owner of properry who builds or improves Ihereon, end who contracts tor suc� project with a contrecror(s)
license pursuant to ihe Con(rectors License Laws.).
❑ I am exempt under sec. Business and Professions Coae (or this reason:
Signa�ure: Date:
Owner ID vBn1iBA by tlrivers license. ❑ Y85 ❑ No Drivers License No.
Verllicatlon oi Ownership Dy (type ol document, i.e. - properry tau bill or deed):
Eapires:
DIVISION OF INDUSTRIAL SAFETV PERMfT CERTIFIGATION:
❑ I hereby ce�ity iha� no excavation Me (6) or more teet In depth imo which e person is required to descend, will be made in connection wlih work euthotlzed by Ihis
permit, entl tha� no building siructure, s�Holtling, talsework, ar demolition or dismanUing Ihereol, will be more �han thirty-si: (36) teel hiph. (Chap. 3.2, Grp 2, An 2. Sec.
341, Titla B, Califomla AOminlstretive Cptle).
� As owner-builtler, I will not emplay enyone to tlo work which would require a permil twm the Division ot Intlustrial Salety, es natetl ebove, unless such person hes e
permlt to do such work Irom the tlivision.
Signature: Date:
Division ot Intlustrlal Safety Pertnit Numbar:
CERTIFlCATE OF COMPLIANCE AND AUTf10RVA710N OF ENTRY: I certity under penalry ot perjury t�al I have read this epplication and state that the infortnetion given is
correct. I egrae to compty with all state laws end dry orCinances relating to �uilding construcUon, end euthonze representetives ot the Clry ol Coste Mesa to enter upon t�e
aDove-described property tor inspection purposes. I agree not to occupy w allaw occupenty of any building authorized by Ihis permit until linel inspoctlon.
- /Le—�al n s Date
✓.�.lr.�.�0'� e — ��"�3
� AnNOr Aut�oriied Appllcant Date
COpE I, INSPECTONTYPE "QdjE V�ELS
1676 Flxetl System Finel Fire Preventlon
1266
200
Pool SOe Finel
Final Re-Rool
201 Final BIocWReteininp Well
202 Flnal Factory Fire Place �
203 Finel Slgn
204 Final Demolition
COOE� INSPEC110NTYPE
206 Finel Mechenicel
20B
210
212
220
222
250
Finel Plumbing
Final Elecirical
Flnal Fire Preventlon
Final Planning Approvel
Final Site
Final Building/OCCupency
PAIE � 1t�49
CALIFORNIA PROJECT INSPECTORS
PO BOX 3238, REDONDO BEACH, CA 90277
�
� - GPI
(310) � Fax (310�
3.3��iz3 <5�i4-3'7R4
DAILY INSPECTION REPORT
Building Department l�Ti� �..lC-:fS►� Reporting Period � I"� —C� �
Permit# '13D3— �� 1 \ 1
Project Name Si—�-ta.or�,"cia•-7' lob Phone
Projact Address � 8 1 � 2e'�- yi '
Owner's
General
Beeper
Fa�c
Site Comact_ Beeper
Sub Contractor Phorre Fax
Site Comact
Engincering
Address i N l''32 P�a�..C.i �si � 61�.� CrrwuCr Fax
Name in Seal ��_ Q�,pQ; b�� Contact
ArchitecturalFirm -rqvfh,Ip»Gu �o'tip,�s Phone
Address �-3 2`i 'ST't�n. P+alri P.+r�� c.a�'1e-c:c�a . Fax
Name in Seal Contact
TYPE OF INSP$CTION: Reinforced Concrete, _Gunite/Shotcrete, Prestress, Framing, _Rebar,
_Hi-Tension Bolts, �Anchors, _Structural Masonry, _Welding, Other
To the Building �cial: Buildingfnspector:
I hereby certify rhat the jollowing porlions of the work at rhe above address which required SpeciaUDeputy /nspection and for
which I was employed to inspecl, were inspected by me, to the best of my ability, and comply wrth the npplicable provrsions of the
Building Codes and rhe approved drawings:
' a. u � •� ■ ■ < < �
Inspector (Print)_ 1 �y �,ii�+TlEy(,�1�..A' License: (C�i�jt'� Type: _ �i�i
Inspector
rr...--�.
HOURS: Mon, Tues, Wed, T6urs, Fri, Sat, ' Sun
verified ay: (Print & si�) _� l/;i1 L l,(J/� T� n..0_ ���
INSULATION CER'. �, �'ICATE � IC-1
�S/ �. 2 o L^ S771EET Crs7s� /f?EsA
Number and Shee[ �ty
_ a�P/1Nr$E Cod�
County Subdivision Lot Number
Description of Installation
1. ROOF
Material
Thickness (inches)
Brand Name
Thermal Resistance (R-Value)
CEILING
Batt or Blanket Type ,�if`7% Brand Name .T f{NS /y%ANY/�E _
Thickness (inches) (o �z � Thermal Resistance (R-Value) �Q-! q
Loose Fill 7'ype Brand
Contractor's min installed weight/ft' _Ib Minimum thickness ��� ihches
Manufacturer's installed weigh[ per square foot to achieve Thermal Resis[ance (R-Value)
3. EXTERIOR WALL
Frame Type /,//���'j
A. Caviry Insulation
Material
Thickness(inches) � Z
B . Exterior Foam Sheathing
Material
Thickness (inches)
4. RAISED FLOOR
Material
Thickness(inches) �
5. SLAB FLOOR/PERIMETER
Material
Thickness (inches)
Perimeter [nsulation Depth (inches)
6. FOUNDATION WALL
Material
Thickness (inches)
Declaration
Brand Name �./o///VS /y%/�d/l//�E
Thermal Resistance (R-Value) ,P /3
Brand Name
Thermal Resistance (R-Value)
Brand Name n �,G�/ /1%RX////C�E
Thermal Resistance (R-Vaiue) � �)
Brand Name
Thermal Resistance (R-Value)
Brand Nlame
Thertnal Resistance (R-Value)
I hereby certify that the above insula[ion was ins[alled in [he building at the above location in conformance with [he current
Energy E�crency Standards for residential buildings (Title 24, Part 6, California Code of Regulations) as indicated on the
Certificate of Compliance, where applicable. �
? -3-�y , f�iSt �oL �t/i�Z�t�
Item #s Signature, Date '/��� Installing Subconhactor (Co. Name) OR
General Contractor (Co. Name) OR Owner
Item #s
Item #s
Signature, Dace
Signamre, Da[e
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
Installing Subcontractor (Co. Name) OR
General Contractor (Co. Name) OR Owner
Revised March 1, 1996
City uf Costa Mesa — Planning Division
Builder ���/'v �UL ��T
!ob Site �S/ E• 20 � S%/ �A15
SUBCONTRACTOR LIST �
P. O. Box 1200, Costa Mesa, CA 92628-1200
Iress 2�a97�E�E.�%�. Phon�7Go�-729-8¢e9
lyy,a�sg,od !4 9z�8
2E�A /_'A S3Z6Z7 Date dGN /z, Og
� ��--�
Permit # tg0'�'LYJ/// Valuation
TRADE
ASPHAL"f
CABINl:TS
CARPE"I'S ��`
CARPENTRY �
CEMENT CONT.
CEMENT TRANSIT
CLASSIFIED SPEC.
CLEANUP/HAULING
DOORS(GARAGE)
DRAPERIES
DRY WALL
ELECTRICAL
ELEVATOR
EXCAVATION
FENCING
FIRE EXTWGU[SHER
FLOORWG/DECKING
FORMICA
FOUNDATIONS
GLAZING
HEATING
WSULATION
LANDSCAPING
LATH W G
LINOLEUM/ASPHALT
TILE/GUNITE �
MASONRY
PAINTING
PLASTERING
PLUMBING
POOL
REFRIGERATION
ROOFING
SANDBLASTING
SEWER
SHEET METAL
SHOWER DOOR
SOLAR
SPRINKLERS
STEEL REINFORC.
STEEL STRUCT.
STUCCO
TRUSSES/GLU-LAMS
TV ANTENNAS
WALL COVERINGS
WEATHER STRIPPING
OTHER SPECIALTY
CMF 0701-30, rev. 30/85
SUBCONTRACTOR
6MGi
/HEN>
si/-2
/f%f1Tf%EW l/E�as
�L� ��NE
r�
�
1 S�mE2 /�ao2 Co.
ZA2.
ADDRESS I PHONE
�
� "(0 3z -77�07 "�(P9oB 6
562 D bS
999 (�B9i27
Zz�! S49¢
�/noi-Lt7/�A /iA9/CL
-G-
CITY OF COSTA MESA
DEVELOPMENT SERVECES DEPARTMENT
PLANNING DIVISION
OWNER BU[LDER CERTIFICATE OF EXEMPTION
I am fully aware of the responsibilities as owner buildcr. 'flie persons named below are my
'employees and I agree to withhold the following required dediic[ions: Federal and State Income
Taxes, Social Security payments, and Workmen's Compensation Insurance Premiums. My employer's
number is .
Further, I hold no objection ro a copy of [his cer[ificate being forwarded [o any governmental
agency upon their request for same.
Employee's Name Address Social Security No.
�
Under penalty of perjury, 1 declare that the above statement is true and correct to the best of my
knowledge and belief. �
, Signature
Address
Date
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626
Job Address: 481 E 20TH ST
Suite No
Vicinity:
Parcel Nunmber: 42632407
Applicant: PRESTON PAUL WHITE
Address: 1275 N CHRISDEN ST
SUITE P207 .
ANAHEIM,CA
Owner: � BOWER, PAULINE
Address 481 E 20TH ST
COSTA MESA, CA
Contractor: PRESTON PAUL WHITE
Address: 1275 N CHRISDEN ST
SUITE P207
. ANAHEIM,CA .
Arch / Eng :
Address:
ISSUE FEE
Backflow irtiga6on
BackFlow Preventer
Balhtub
Clanfer System
Connect Qce,Soda,etc)
Dental Units
PLUMBING PERMIT
Status: ISSUED
Applied: 06/12/2003
Issued: O6/12/2003
ISSUED BY:
Phone: 714-267-1971
Zip: 92807
Phone:
Zip: 92627
Phone: 714-267-1971
Zip: 92807
License: 413663
Phone:
Zip:
License:
SCOPE OF PERMIT
ADD 557 S.F. (105 S.F. 1ST FLOOR WHICH IS BEING CONVERTED FROM GARAGE TO LIVING
SPACE AND NEW 452 S.F. 2ND FLOOR) 2ND STORY.MASTER BEDROOM SUITE AND BATH OVER 557SF
ATTACHED GARAGE (322SF NEW GARAGE PLUS 235SF RECONSTRUCTION OF EXISTING GARAGE). ADD
105 S.F. DECK TO NEW 2ND FLOOR BEDROOM. NO OTHER REMODELING WORK TO BE COMPLETED.
REF.:803-00111 � - .
PLUMBING TO INCLUDE: 'I BATHTUB, 2 SHOWERS, 2 WASH BASINS, 2 WATER CLOSETS, 3 HOSE
BIBS AND 1 WATER HEATERNENT.
AMT
$23.50
$0.00
$0.00
$9.80
$0.00
$0.00
$0.00
FEE SUMMARY
QTY AMT
� Laundry Tub / Washer $0.00
0 LandScape Irrigation $0.00
0 P-Trap $0.00
1 � Pressure Regulator $0.00
0 -- Process Pipiag (per 10 fQ $0.00
0 Receptors $0.00
0 Septic Tank $0.00
OTY
0
0
0
0
0
0
0
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr BkFlow(1-4)
Vacuum Brkr BkFlow(5+)
Wash Basin
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$19.60
QTY
0
0
0
0
0
0
2
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. �
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetlone and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expira�ion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2aas-as (s�oo�
WORKERS' COMPENSATION DECLARATION:
I hereby ettirm under penalty of parjury one o� the following declarations:
❑- I have end will maintain a certificale Of con5ent to 581f-Insure tor workers' Compensation, es provided for by section 3700 of ihe Labor Code, tor the pertormenca of the
work for which ihis permit is issuetl.
❑ I have and will maintain workers' compen��ion insurance, as requiretl by section 3700 of ihe Labor Cotle, for the pedormance of ihe work for which Ihis permit is issuetl.
My workers' compensation Insurance carrier entl policy number ere:
Carner: policy Number:
(This section need nof be completed i/ tbe permit is valued et one hundred dollars ($100J or less.)
� I certily thet in the pedortnance of lhe wbrk for which this pertnit is issued, I shall not employ any person in any manner so as �o become sublect to the workers'
compensation laws of Califomia, and e ree that if I shoultl co a subject to the workers' compensation provisions ot Section 37p0 oi Ihe Labor Cotle, I shall forthwith
comply with the pro sions. �//� /a z
Applicant Signeture: �� .�,J._, Deta: ��% �
WARNING: FAILURE TO SECURE WORKERS' WMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CPIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
T}IOUSAND DOILARE ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED F9R IN SECitIXJ 3106 OF THE LABOR CODE, INrEREST, PND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm �hat I am licensed under provisions of Chapter 9(com}� @ncing with Section 7000) ot Division 3 of ihe Business d Protessions Coda, antl my license is in full
forca and eHea. Lic. # GJ / ) Class tt �. i
ContractofsSignaNre: J� e� Dete:�oLL D7
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirtn that ihere is a construction lentling agency for the pedormance of the work for which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lender's Adtlress:
Signa�ure:
Date:
OWNER-BUILDER DECLARA710NS:
I hereby aHirtn that under penalty of perjury ihat I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business and Professions
Code: Any city or counry which requires a permii to construct, alter, improve, demolish, or repair any simcture, prior to its iuuance, elso requires ihe epplicant tor such permit
to tile e signed statement that he or she is Ilcgnsed pursuant to ihe provisions of the Conirectors License Law (Ghapter 9(commencing with Section 7000) of Division 3 of the
Business entl Protessions Code) or ihat he or she is ezempt therehom and Ne basis tor the alleged azemption. Any violation ot Seclion 7031.5 by eny appilcant for a permit
subjects Ihe applicant to e civil penalry of not more than five hundred dollars ($500).):
❑ 1, as owner of the property, or my employaes with wages as fherr sole compensatlon, WILt DO THE WORK, entl the structure Is not intended or oHeretl for sale (Sec.
7044, Business and Professions Cotle: 7Fie Contractors License Law dces not apply to an owner ot properry who builds or improves ihereon, and who tloes such work
himself or herself or ihrough his or her own employees, provided that such improvemenis are not Intended or oNered for sale. If, however, the huiltling or improvement is
sold wiNin one year of compietion, the owner-builtler wi�l have ihe burden of proving ihat he or she did not build or improve tor purpose oi sala.). �
❑ I, as owner of the property, am EXCLU$�VELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the proiect (Sec. 7044, Business and Professions
Cotle: The contractors License Law tloes not apply Io an owner of proparty who builtls or improves iheraon, and who contracts for such project with a contraclor(s)
license pursuant b the Contrectors License Wws.).
❑ I am exempt untler sac. Business and Professions Code tor this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Ves ❑ No Driver's License No.
Verificetion ol Ownership by (rype oi document, i.e. - property tax bill or deed):
Expires:
DIVISION OF INDUSTRIAL SAFETY PEHMIY CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet in depih into which a person is required to tlescend, will ba made in connection with work authorized by this
permit, end that no builtling strucWre, sCeflolding, talsework, or tlemolition or tlismantling thereof, will 6e more �han ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Califomia Atlminisirative CcWe).
❑ As owner-builder, I will not employ anyone to do work which would require e permit irom ihe Division of Indusirial Satery, es notetl above, unless such pereon hes e
permit to do such work irom the division,
Signature: Date:
Division of Indusinal Safery Permit NumDer:
CERIIFlCATE OF COMPLIANCE AND AU7HORIZA710N OF ENTRV: I cenity under penalry of perjury that I have reatl this application antl stata that ihe information given is
correcL I agree to comply with all stete laws and ciry ordinances relating to building construction, antl euthonze representetives of ihe Ciry of Costa Mesa to enter upon the
ebove-described property for inspection puryoses. I agree not to occupy or allow occupancy of any building authorized by this permit umil final inspection.
ign O�i I r ��i�0 2
�.C�elda��� J
r AOMortzed Appiicant Date
COpE t• INSPECTIONTYPE Q�F INTRIRI.S
1616 Fixed System Final Fire Preven�ion
1266 Pool SOa Final
200 Finel Re-Roat
201 Finel Block/Reteining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
CODE� INSiECTIONTYPE
206 Final Mechanical
208 Final Plumhing
210 Finel Electrical
212 Finel Fire Prevenlion
220
222
250
Final Planning Approval
Final Site
Final euilding/Occupancy
�:l �t
�� ��
.lob Address: 481 E 20TH ST
Suite No
Vicinity:
Parcel Number: 42632407
Applicant: PRESTON, PAUL WHITE
Address: 1275 N CHRISDEN ST
SUITE P207
ANAHEIM,CA
Owner. BOWER, PAULINE
Address:. 48� E 20TH ST
COSTA MESA, CA
Contractor: PRESTON PAUL WHITE
Address: 1275 N CHRISDEN ST
SUITE P207
ANAHEIM, CA
MECHANICAL PERMIT
Phone: 714-267-1971
Zip: 92807
Phone:
Zip: 92627
Phane: 714-267-1971
Zip: 92807
License: 413663
ISSUED BY:
Status: ISSUED
Applied: 09/OS/2003
Issued: 09/05/2003
SCOPE OF PERMIT
ADD 557 S.F. (105 S.F. 1ST FLOOR WHICH IS BEING CONVERTED FROM GARAGE TO LIVING
SPACE AND NEW 452 S.F. 2ND FLOOR) 2ND STORY MASTER BEDROOM SUITE AND BATH OVER
557SF ATiACHED GARAGE (322SF NEW GARAGE PLUS 235SF RECONSTRUCTION OF EXISTING
GARAGE). ADD 105 S.F. DECK TO NEW 2ND FLOOR BEDROOM. NO OTHER REMODELING WORK
TO BE COMPLETED.
1 INST FAU < 100K BTU, 2 VENT FANS/SINGLE DUCT. � ,
REF: 803-00111 - � �
ISSUE FEE
Inst FAU <100 k BTU
Inst FAU �100 k BTU
Repair/Alt Cooling/Heat
Inst / Rep. Recess Wall HU
Refrig Sys <700 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 < 10000c(m
Air Handlers > 10000cfm
Floor Fumace
$23.50
574.80
so.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
514.50
$0.00
ao.00
30.00
$0.00
$0.00
So.00
50.00
Quantiry
1
0
0
0
0
0
0
0
0
0
2
0
0
0
0
0
0
0
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair / Alt Refrigeration Unit
Ventillalion System
Evaporative Cooler
Com mercial I ncinerator
Domestic Incinerator - �
Compressors / Absorotion Systems
Upto3hp/t00kBTU
3 To 15 hp / 500 k BTU
15 To 30 hp / 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Bailers
Upto3hp
3To15hp "
15to30hp
30to50hp �. -
Over 50 hp "
Other Mechanical Fee
Quantity
50.00 0
30.00 0
ao.00 0
$0.00 0 ,
$0.00 0
$0.00 0
$0.00
so.00
$0.00
$0.00
$0.00
ao.00
$0.00
$0.00
50.00
50.00
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall compty with all applicab�e handicap access requirements under Califomia statutas end reiated
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 7 BO days, or if work is suspended or ebandoned
lor a period of 180 days.
INSPECTIONS: In order for ihe vrork authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all
requlred Inapeetiona end (Inal approvel must be obteined. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626
246&48 (8/00)
WORKERS' COMPENSATION DECLARA710N: ��
I hereby ettirtn un0er penalry of per�ury one of i�e fdlowing tleGaratlons:
❑ I heve end wlll meintaln e ceniticate of consent to seH-Insure for workers' compensation, e9 provitletl for by secllan 3700 0l the Lebar CoAe, for the pertormence ai Ihe
work for which thi5 pertnit Is issued.
❑ I have and wi0 melntain workers' oompensatW� insurance, as requiretl by sectlon 3700 0l the Labw Catle, for the peAortnance of Ihe wwk lor xTic� UJs peimit is ls.wetl.
My workers' compensatlon Insurance wrtief arM pdiry number ere:
Cerrior. Policy Number.
(7h/5 settbn need nof be Pompleted l! Ne pemtitls va/ued ef one hu�retl dol/ers (5100) or Iess.J
� I ceNty thet in the pertarmence of Ne work la� which this pertnit b IssueQ 1 shell not emplay eny pereon in eny manner so es to become suD�ecl to tha workero'
�� wmpensatlon laws of Calllomla, end a ree Ihet it I shoultl e suh�ect to Ne workers' compensatlon proWsions ol Sectlon 3700 of the Lebor Coae, I shall farthwitl�
comply with N r sions. /� ��//�
ApPlicent SlpnaWre:��iO�.rYi i Dete: ..SF.U/• d n�
W�Wi1N0: FNLURE TO SEWRE WOPo(E0.5' COMPENSA7�ON OOVEM�E IS UMAWFUL M1D SMiLL1 SVBIECf AN EM0.0VER TO CRIMINAL ENN.TIF$ AND CML FlNES UP TO ONE HUNDRED
TMOUSAND DOLLARE (f/00,OW), IN AODfTqN TO THE O�T ���T�'7. ��GES AS PiqNDED FOR IN SECf10N 3)OB OF THE IJ�BOR OODE, INfEREST, AND ATfpVJEY'$ FEE$,
LICENSED CONTRACTORS DECLAHATION:
I hereby aHirm that I am lkensetl urnfe� prWsbns ai Chapter H(comme�t� wiih Sectbn 7000j o1 DNsion � oi tho B�
brce and eflect. Llc. p Cless a
CAnlrectore5lgnaWre: � _ • pz� Dete:_
Cade, anE my Ifcense fs fn tult
CONSTAUCTION �ENDINO AGENCY:
❑ I hereby eHirtn thet there is e consiructlon le�tlinp epency far Ihe peAormance oi the work tor which IhLs parmlt is IssuoC. (Sec. 3097, Clvil CoAej.
Lendefs Name: LenCers Address:
Signeture: Date:
OWNER-BUILDER DECLAfiAT10NS:
I hereby aHirm Ihet untler penelry of perjury thet i am EXEMP7 FROM THE CON7fiAC70R5 LICENSE LAW far the followinp reeson (Sec. 7031.5, Business enO Professions
Code: Any Gry or caunry which requires a permit to consiruc6 elter, improve, demWish, or repair any strucWre, O�or to tls Issuance, elso requlres t�e epplicam tor such pertnit
lo flle a signeC statemeN t�at he or she Is Ilcensed pursuant to Ne provislons oi 1he Contractors LJtense Lew (C�epter 9(commencing wilh Sectlon 7000) of Dlvision 3 M t�e
Business end ProfesSions Code) or Nat he or she Ls exempt therefrwn antl ihe basLs lor the allegeC exemption. Any Woletlon of SecUan 7031.5 by any epplicent for a pertnit
sub�ects the epplicent to e Gvll penalry of not morp �han iive hundred dWlars (5500).):
❑ I, es owner ot the properry, or my employees w��h waqes es Iheir sde compensetlon, WILL DO THE WORK, and Ihe structure b not Intended or aHered for sele (Sec.
7064, Business end Prolessions Code: The Cwmactors L.icense Lew does not eppry lo an owner of property who builtls ar improves thereon, and w�o does such work
�Imself or �erself or ihrough his or her own employees, provided that such improvements ere not Intended ar otteretl lor sele. If, however, Ne building or Improvement is
sold within one year of compleUon, the owner-builder wiil have the burCen ot pmdng thet he or she tlid not bulld ar Improve lor purpose ot saleJ. '
❑ I, es owner ot Ihe property, am EXCLUSIVELV CONTRACi1NG WITH LICENSED CONTRACTOiiS to construct the project (Sec. 7004, Business and Protessions
Catle: The contrecrors License Lew tloes not appty to en awner of property who hullds or Improves thereon, end who wmrects tor such pm�ect with e contractoqs)
license pursuant to ihe Comrectors License L.ews.).
❑ I em exempt under sec. Business end Professions Code for ihis reason:
SlgnaNre: Date:
Owner ID veritied by dAvers license. �Ves ❑ No Orivefs License No. Expires:
Verlllcatlon ot Ownershlp by (lype ol document, i.e. - p�Werty �ex DIII or deed):
DIVISION OF INDUS7RIAL SAFETY PERMR CEATFICATION:
❑ I hereby certity t�et no excavatlon fNe (5) or more leet In depth Into which e person is required to descen4 wlll be mede in connection wIN work eulhoAzetl �y this
permlt, end that no bulltling swqure, sceMoltling, falsework, or demWitlon or dlsmaniling Ihereot, will be mare then ihlrty-six (38) teet high. (C�ap. 3.2, Grp 2, Art 2, Sec.
341, Tltle B, Celltomla Atlminisiretive Cotle).
❑ As owner�builder, I will not employ enyone to do work which would require e permlt Irom the Divislon ol Intluatriul Selery, es notetl e0ove, unless such person has e
pertnit to do such work Irom the division.
Signature: Date:
DlNslon of Indusirial Selery Pertnil Number:
CEHTIFlCATE OF COMPLJMlCE AND AUiHORI7A710N OF EMAY: I certily under penalry af per�ury that I heve reed this eppllcetlon end stete thet Ihe Iniarmetion given is
correct I eqree to comply with ell slete lews end Gry ordinances relating to 6uilding wnsWction, entl eulhodze representetives oi the Ciry of Coste Mese to enter upon Ihe
ebove•described property tor inspection puryoses. I egree not to occupy ar allow accupency al eny building euthorized by Ihls permit until finel Inspedion.
CODQ �. INSPECTIONTYYE
1618 Fixetl System Final Fire Preventlon
1268 Pool Spa Finel
200 Finel RB-Roo1
201 FIneI B1acWRetelning Well
2a2 Finel Factory Fire Place
203
204
Flnal Slgn
Finel Demolition
�r—/��S G3
e�a . _
QdjE � �Qpjj INSVECTIONiYPE
208 Finel Mechanical
20B Finel Plumbing
210 Finel Electricel
212 Flnal Fire Preventlon
72� Flnal PlanNng Appmvfll
222 Finel Site
� 250 Finel Building/Occupency
ACplieant to fill In all sDaces exea0< <�osa within �eavy DorEar Iinaa anC sign all aoa�ooriate Gaelantions.
CITY OF COSTA MESA ' , � � PER IT NO. TRACT N0. LOT.NO. , BL . . � � � ' 4 .
CONSTRUCTION PERMIT - = ' Z L�% ; ` • • • ' ' �
Applicant's Meiling Ad>dress `J��� w• ��c TN c+' ^' � - NPE OF CONSTRUCTION NEW ADD ALTERATION'- EPAIR. - ; � ., '6�� � 4�I'.� I I�3 - _- �JoL�� ;TL
P�ojBctAddfeu �o � � �n �; •��'�oT %c-rA IIoSA ' ❑ CONVERSION ❑ OEMOUSH ❑ OTHER � . ' � . + . . ' , ,
n1a�i�..w' ��n�-�-t/" .- Phone`S �E'S'Z4S�% DESCRIPTION'OFWORK �+�`e �E'-i-`� 'Q' G-� >`a4� - ' � UL TI S
Owner's�Name _ ' � - � ' - �
Addf855 �A�'a - �TVPEOFPERMIL � �GRAOING FOUNDATION STRVCTURAL� 7a.P.qW '- 20NE � '
Arch/Eng:. /u`�^+'� ' ' LiC2n5E NO. � � ❑ TENANT� O,ELECTRICAL �PLUMBING ❑ MECHANICAI ' ' ' •P�NG. REF qW ' . • . BUILDING -�
'� �OTHER ' � � f
Address � � . . � - � � � ' . . TO�B EILDVNGNE .. ! ' flEAR VARD (TO P/U • - � �
Contracm'r's Nam u hone ?� ���� PRaECT DESCRIPTION • 3q. F7. � �OCCUPANCv _ ' . -
� (d��_ � ��' LF��d� CONSTRUCTIONTYPF/ � � VALUATION$ _ LEFTSIDEYARD � i ' RIGHT�SI�DEVARD ' . '
Addresslmailing) � ' � , � . � � , ,
' ' ,7[a'•2��7�Z , " . . , � ZON� GRADINGCU.VDS.. ,ACRES PKG.SPACEREQ. , PROVIDED ,
Cicense No. " ' � ' "
LICENSED CONTRACTOR �ECLARATION � Ramark�: - ' . . ' ' i STREET WIDTH i ! � , ' 'PARK FEE $ � �
I,hereDy alfirm t�at I am Ilcenietl untler Drovl5ion5 0! Charter_9 (commentln9 � � � � . . . .
' wit� sectlon 7000j of Olvision 3 of the Business antl Protesslons Cotle, antl � ' � • • �. , � . ' . SFECIAL CONDITIONS: ' ' ' • �
�, my Ilcensa'is in full force ana etfect. � � ! ' ' � ' . � �. � � -
u<enie Iass � , c � oyZZ�]7Z-' { ; ; � . - ' : PLUM8ING . � . . � � � � ' • � ' � . ' . �
Date�_`Signapure' - � , . gar5ink . ' SewerCap ' ' ' � � ELECTRICAL ' ' � �
.�pKERS' COMPENSATION DECLARATION � ' ` ' . • - ' � - = � , . � �
''eDy aftirm Ihat I have a.Eertltiwte of.mnsent to salNnsure or_a certiflcate .._ _ ' ' _ _- _ � _, Automatic Washe� � IMetCr �ove� 10�) amps . _
�/orkers' Compensatlon InsurSnce,:or a rerSifiea.copy thereof (Sectlon , � B�kflow�Preventer -SewerConnection� = � . �• - � - -. - � 1
..t;.��b, Ldb. CJ ' � �, �j>�p� � ; ' ' ' � . � � Backflow Irngation - $olsr Coliecrors � � ' Construction Pole � .Sub Panel � � ;
Poliiy No. w�- 1:61'� b � comoany�A�� Gb � - � � - " - . - ' ; Co'oking Unrt � . I - 'Sub Pole � ' ' � �
❑ Certliletl mpy is nereby fumisbetl. . � 60thtub5 � ' . Solar Piping � � � � , � .
.�l.Certifiga �pyJ;fLleawitnthecityBu iRg �/�� � � . . . � r � � Dishwasher ` ' :Motors �0-t HP �1X-8
$ate ✓ 6 •ti ' �. � � I ; Clarifiers � Saiar Tank ; i � � ' �
Ap011cant� , � , . � 1
� EXEMPTION:FROMWORKERS'�COMiENSATION�ECLARATION � , � - - � � Dr erd�OGes`OElec�nc-"'� � � In'c.SOlanO9-05HP 016-15+ -��
i Dishwasher % Swimming Poal w/Spa j � � . � . . •
�(ThiSSectian naetl not be cOmplatatl If tne parmit Is for one hUntlreC (5300) or . � , . . ,
� less '- � 1 . : . � 1 . . . . � Fan � �
1. � � . i i � � � � �Microwave �
' I certify�that in Ihe performdnce of the work for�which this perm t is issuetl I . Drinking Fountains � � , Urinal . � � � � i � � �
' shalh not amploy any person in any manner so.as to becoma SUEject to t�e � � - . � �, - . � i F.A�U. I � 'PoIE'Light � '
workers' Comoanzation'Laws of Calltornia. � , . ' . � ; Floor Diains' �� � I Water�Closetl � 1 � . � � � �
� Da[e: � � • : 519nature ' . • • i ; . . � . � . . .
� �NOTICE: If,after making�this Geclaratlon, you•shoulE become 5uD7ac4lo the -'� � �-{ Floor Sink6��'�---L-- j. --._ _.� _ . � _ _ ' . Fixtures . ; ', !Ran C. _ ' ) � _
�. WO�kerS' COmpBnatlOn o�ovisions,of the Labor Cotle„you must forthwith� ' -y � Gas Servic' ' ' ' � Water Heater - — " ��� Device Boxes � ' � 1 � 9 ` - �
' comply ,with, suth Drovislons�or.this.'Dermit znall be;tleemetl revokeC. - . ' e� • �.Outlets 1 WateiService . .. � � �Si9n� , � ;
CONSTRUCTION•LENDING �AGENCV • I � ' . i � i , ' , ' - - ` ' � � � � I � t OUtlats ' i i � I � • � ' i
� I ha�oby aHi�m that th0re Is alconiVuctlon,lentling agency�fo� the Oe�formd0<B I � Int¢�C2ptOf5,� � r1, . �-� � i, , Standing Sections � ! , � �
01 the �work forv whlch=thls peimlt � Is �iuuetl' {Section :3097, Clv. C:)_ � ^ _ . � � . ' Switches ; ' � ' �
', Leneer•s. rvame � � ` ' - ' - Kitchen,Sink - � ' � ` ' ;g � ;� � � . ' � ;Trash Compactor � � ' .
� LenGar's Atltlress • � ' ' � � � �- ' -- _ _ � ' - � ' i
� OWNERiBUILDER DEpLARATION �: ' - f � • i LevetOries. � ' I, _ ; ; �- : �'i � - Ge�bege Dispo9al 1 � : ,
� I nerebyatflrm th5t I am��exemp[ trom the�Contractor's Llcansa L.aw /or the� ; , �� ^� r: 4; � Generator �0,5 KW 05-15 KW � � � ; �
tollowln9 roason.(Settion 7031:5'Buslness antl Profa551onaliCOCe: Any <Ity or P-Tiep <( in ` j . . � �. I
' �county whlch requlres a Oermiteo'canstruci, alter, ImDrove; tlemoliin;ocrapatr � _ � � . , . �. ; ; � � . � , � Transformer �15-50 KW ' � � ' { ' �
;�any structure, prior to itsdssuance, also reqWres the appllcant !or such permit • Roof DrainS ��, �.- - ��. ;... . � ' � ' i
�(o f110 a si netl statament that tia she I5 Ilcensetl ursuant to the; rovls�ons oi ' - � ` ' "� �' '' - i � .
the Contractor's Ucense Law�(Cnapter 9 (commencing.with•Se<tlon 7000) 01 " - : ' " F 1 '. � - - ' � ' ' � � •- ' i �5U + KW � � � � 'Reinzpec[ion Fee � I $15
� R�;- lon �3 �o} the •Businesi anA. Pro/essions Cotlo) ror that he/5M1e is. ezempl ' ; Showers � �� Reinspection Pea . S75 , � , , - ;
� -�rTrom �anp the; basls /or lha allegetl exemption. My vlolatiod of Sacnon . � . `. � ' ; ' ; , ' - Meter ❑up t0 100�ampi � :Issue Fea! � � ( ' $ 3
�y,.5 by: any applicant for a permit SUCjectS tha aDP����� to a' civll � � �
g5�§Ity q/ riot moro than /Iva�hunOretl tlollars (5500). , . , ,- , � i Service Sink: _� • �_ � � Jaue Fee ;; I ' $ 3 Zoning Approved 6y � � . Date ' ,
, iJ I;'as�owner oh the�proparty or'�my amployees with wages as their iole - . • ,�� � ' '� �MECHANICAL ! • ' ! ' � � • � � �
' tompensation' will'tlo the work', anE Me structure I5 no[ IntenOetl or offeretl ; �' � Appliotion Appro�ad By �Date
! for sale `(Sec�lon 7044', Business antl� Profaszlonal Cotle: Tha! ContractorY � � �. . . . . . . . �
; Llcense Law Eoes pot aDP�Y to an owner of a proparty who �uiltls or Improves � Boil¢�, �' .� � Ref�i9e�ation System � � � ppplicatiun Isduad By �•�� � Dat9
� thereon,�antl who tloes�such work himsalt/herself or through his or har own � '•� � i ' i � � . .'
� emoioy ea5, piovltlBtl thit Sudh ImprOvements are not Intentlea or offeretl for - ' � � ❑O�.100,0008TU ❑1OQ000,BTU � '
' sale. If, nowavaq Ihe bulldln9 or Imorovement Is zoltl wltnin one year.ol com- � � Duct = UndenGround ' , � , , � i i : � - SUMMARV OP FEES � �
. pletlon, tne ownor.will have tna burtlen of provin9 ho/she Citl nol buiiE or im- , � � � ' � . • 1 � � �
i �roveforthepurposeo(sale). � ; � ; .' ; • ! Duct-Structural i SystemRepairjAlteiation i ' BUILDINGPERMIT $, '� SMIP ' ' t $, � i
I, as owner ot Ihe Droperty, am excluslvely tontractingtwit�•Iicensetl cbm • . - � , ) , � . . � •
; Vacmrsto construct the�project_(Section 7044,.Business antl Professians Cotla: ' _ Dutt- Ventilating, _ � _ '_, , I _ _ i _ _,.�_ ;_ _ � PLAN CHECK. $, ' • � ' PERMIT ' .
,�Tha ContractorY �icense Law doez not aOV�Y to an ownet o! properry who ° � . - ; , , ' • QQ � � ISSUANCE � . $ ! '
. bullAs or Improves thereon, antl who contra<[z tor suc� projacts with a con- � Exhaust System ❑ Multiple ❑ j ' � � � PLUMBING � $, � - � �
tractor(i) Iicanse pursuant to l�e Contractor'S LI<ensa law). : • � - � - � . . ' � GFiADING . �� $ �
, O�I am exempt untler Sactlon B. & P. C, fbr tnis reason � FiiepUFaCt.81t. ICBO # � i � ' P�N CHECK` $ � �
� Date < ' � Owner. � I - � � � � ' � Heating'System & Ducting , , � ' $� � � ' � $ '
, , . . . . • ' � ' . , ' 1 � . MICROFILWi
� 1 hereDy'. cerU(y� that I� havo reaa tniz-applicatlon-antl� ztate�that-tha-above �- —;- �06100,OOO.BTU Od00;0008T -- -� -+- -i ^^ � � - �--•---; � 'P�N CHECK $� $
� Information is corract. I agrce to compi with ali tlty, antl county ortlinances � . � '� � � - �MECHANICAI ` $ � ' TOTA VFEE, �$� '
antl•-stata la �eiatine to buil�nq o ruction,,antl �ereby authori e repre- : • Hood o� ' ' ' ' ' - ' � '
', sentatives tbis � ty!���000 grtter • p the above-mentionea pro rty tor � TVPa � �j , Reirapection Pee� $15 �pLAN CHECK; $ � - : �ESS � � ' � '
�� insoection s /, `.L.�� ' _`�� f , Cano i T' e II ❑� , � . . . ' . 1 . • ADVANCED�PC � g � �
� Sigriature l�/ Date � � • '' j , • � . ' � ' ' FINAL FEE% . $ i�
Drivers' License or:55 � �< ��� ��' Registe�s ; IsSi�e Fee $ 3 QO
. . . . . .. . . � : . � . �
"_ _._ _. ......._"' _' _"' _..' " " _"_"'_"' _"_'._.�. .__ _, _"'__'__ "" . .."�_ _ .,' ' _. �_ _.�."" _' "' '. _ . � _ . . .. _
CMF 0865-46 rev. 12/82 White - Builtling: Canary - Applicant; Pink - Accounting; GOldenro0 - Assessor �� , � " � ' "` " - ' -' -' " '
t '.•CONSTRUCTION AND PLAN ING - �� � � � � - - -. - ��� � �'�' - -
� .�Date �Inspector, ` � ' ' Date Inspector
- .-APPROVACS Permit � � APPHOVALS Peim�t �
��1. Temporary Electrical Service or Pole . . - . 52: Pool & Equipment Location � _
`-� 2. �Soil�Pipe-Undrgrnd.' � . . � � � 53' Steel Reinforcement �
- 3: Electrical Conduit Utilitv-Undrgmd. , -� 54: Forms ��-
4; Electrical Conduit-Undrgrnd. � - � � 55� Electrical Bonding. -' � , -
�5. Steel Reinforcement � ' �� ` _ � . .56.. Rough Plumbing & Pressure Test
16: ,Electrical UFER Grnd: � - , � � �� 57. �APPROVAL TO COVER-GUNITE��� �
). ,Footings � ' � - 58. �Elearical Cpnduit•Undrarod. .
8. �Fountlafion � � - 59. :Gis Pipe,.O Undrgrnd., Test
9. Water Pipe-Undrgrnp, . - - 60. Backwash Lines, P•Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVACTO DECK
11. Property Sewer Line & House Connection 62. Backwash &'Recep[or-Final _ .
12. Sewer Cap , � �'63. Heater & Vent-Final �
�
13. Roof,Drains � � - ` � ' • ' '64. ,Plumbing System - Final
14. �Rough Plumbing � - '65. Electrical-Final "
�15.,RoughElectrical�Conduit' ' - ' •- � -•66: SolarSystem-Final � � • � �
� .16. 4Rough� Electric Wiring � - ' : � - , . �` ' - '67. Fencing & Access•Approval � - - .
".� 17. Rough Wiring Sign�. � , , ' '_ ' - gg, APPROVED FOR PLASTERING
`78. �Rough Electrical-T<8ar Ceiling �' I69. POOUSPA SYSTEMS FINAL
19.-Rough Heating & Air Conditionin9 � . FIRE DEPT, FEQUIREMENT .
i
20.'�Rough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Siruaure i - �� � '' � J0. Underground Hydro '
� t
�.22.�Ducts, Ventilating _ � � � � . � �71.� ProduaPiping OGas ❑Oil
23. Gss�Pipe-Rough & Test _ � � ; , 72.: Underground Flush
. 24. Roof Framing • - � � . � � 73: Undergrnd.StorageTank OGas ❑Oil
- 25. Roof Sheathing -- � J4. Overhead Hydro
26. T-Bar Ceiling (Structurall,& Monocoat . � � �75. Dry Chemical �
.�•27. Frame and Flashing' .' � , • 76. Dry Standpipe '
28. Lathing & Siding� ' ' � 77. FIXED SYSTEM FINAL �
� 29. .Insulation• � � � ' 76. FIRE PREV. FINAL
30. Drywall Nailing , � Notes: . -
� `31. Plaster Brown Coat ' ' � � , - �
32. Electrical Power Meter-Final � � . � � �
33..Final Electric � � , �
34. Final Heating & Air Conditioning ; � • ' , '
� �
35. Final Gas Pipe•Test � _ � � /�/ �J E T ' - � � .
36. Hood or,Canopy:' . , ' `. � � � .
37. Final Factory Fireplyce' �_ � ' � , , . ' ' '. _
�
38. Finai Plumbing � � � � � � �� ; � . '
39. Water.Service-Final � � , � , �, , " �
� i
40. Gas Service-Final , � . ' ' , ' � - '
�
41. Solar pomestic-Final . � � .
42. Backflow Preventer � , ' �� ' � '
43. Backfiow Ircigation � ' - : . � � � .
44. Landscape Irrigation Sy,s[em � - ' � ' � : ', i � ' �
i
45. Sound �AtienuaYion �- �_ , _g ' . __ ��
46. Handicap Regulations� ^ � � � � , � � �
47. FINALSTRUCTURE&BUILDING ' � ' , '
48. Special Requirements Completed . � � �
49. Electric Release to Edison _ _ _Y � . . _.
--r
�
50. Gas Release to Southem Califomia Gas Co ; � ,. �
51. CERTIFICATE OF OCCUPANCY , , . _ � _ . . _ " �
No � �� � Date ' • � �
I7
AVpllcant to till In all s0aees exceD� those wI1Nn
I ' CITY OF COSTA MESA
CONSTRUCTION PERMIT
ApplicanYs Mailing Address � u � � o`
(��'/J� ProjectAddres� �8i � '��'� SYK.��r C�.13((�e5/-`
�A\' OwneriNam,r PAULINC ��...oe� onone. y9- _,—)
•�)� Address ` $� L� " ,2nlll �m7 � ��v IL1�s.7
�\ Arch/En9. �Q•-^'� - Licenm No.
` Addreu x
^' ContractoriNamaS�� w ���P �^�'��- Phone63�����3
I� Addresslmailina7'. �4' W 1� ��LPC�T G���d i�{�SA
License No. �` � �� ��
LICENSEU CONTRACTOR DECLARATION ,
I,tie�eEy aftl�m that I am Iicensatl untlar provi5ions ot C�arter 9(commencln9
with 58CtIOn 7000j Of DIvISiOn 3' of t118 Bu51na55 antl ROte5510ns CoGe, anp
� my Iicense Is in /ull for antl etfect.
IJcansa Class • c
Date� �� � Signature
WORKERS'COMPENSATION DECLARATION '
u'{�qra0y afflrm that I have a cartltifate ot consen o sal - nsure or a tartllicate .
�r�-,Workers' Compensation Insurance, or a cerSitietl,co0` ��ereof (Sectlon
� _ �0� `�'. `. g�a�ComPany .
Policy No.
��CertlfieE copY �s heraby turnishatl. ,
CertNleG copy iz filed with t�e city Bulltling DlviSion.
' Da[e �_.a.3 g' 3 APPlicant So-,I:H S�{oi� C+-�S`.
' EXEMPTION FROM WORKERS COMPENSATION DECLARATION
(T�is sectlan neatl nat be completeU If [he parmit Is far one huntlr¢tl (5300) or
less):
� I certlfy that in Ihe performance of the work for �whith thi5 parm�t is I52uBC I
' snall not employ any permn in any manner zo a5 to become su�ject to t�e
' Workers'�Compansation Laws of Gllfornia.- .
Date ' � Si9natura
NOTICE: If, atter making this tleclaratlon, you ihoultl become subject to the
Workers' Compensatlon provlslons of the Labor COGe, you mus[ forthwilh
comply wlth� such OrovlSions or tnis permit shall be tleemetl ravoketl.
CONSTRUCTION LENDING AGENCV � '
I hereby aHirm that [here Is a con5truction IenEin9 ag¢nty for tha pGrfOrmance
of tne work tor which thlt Dermit is IzSueC (SecNon 3097 dv. C;
LenOnr's Name
Lentler's Address
OWNER BUILDER OECLARATION • ' _
antl the basis ior the allegeE exemptlon. My vlolation of.5octlon
� any appli<ant for a permlt subjlcls tha applltant to a'civll
not more t�an tive �unEreU Collars (E500).
wner of'tne property or my amo�oyeas with wagas as their sole
lon wlll Eo the work, an0 the 5tructure is not in[entle0 or offered
iec�lon 7044, Buziness antl Vrofeulonal Cotle: The Contractor'S '
w tloe5 �ot ap01y t0 an Owne� Of a p�ope�ty who bulltls o� ITp�oves
ntl .who tloez such work nlmself/harself or through hi5 or her own
, provltletl t�at such Improvementz are not Intantlatl or offareE for
wovaq the Duilaln9 or Improvement is soltl witnin one year o! com-
a owner wlll �ave the burtlen of proving he/sha tlitl not bulltl or im-
he purpose of sale). .
Ld I, as ownei of the property, am ezclusively contracting with Ilcensetl con-
3ractorsto constru<t the pro�ect (SecHon 7044, Businass antl Aofe551ont Cotle: �
The Contraclor's License Law tlOOs n0[ apply t0 an owner ot prop<rty who
bulltls or improves thereon, antl w�o contracts for such projects wlt� a con-
[ractor(5)Ilcanze pursuantto the Contractor's Llcense Law).
❑ I am ezemp[ untler SecHon B, & P. C. tor tbis reason
Date Owner �
1 hereby ceriify tnat I hava reaa this a p' tion antl state that th aDove
Informatlon is corSect. I agrea to c pl M all city. antl county or inancas �
an0 state laws lating to bull.�in to ction,�antl hereby authori e rep e-
Sentatives of is/;dty tb t up � bova-mGntlOnetl pro arty or '
In5p8Ction p o 5.
Signature � Date.
TVPE OF CONSTRUCTION LJ NE
❑ CONVERSION ❑ DEMOLISN
DESGRIPTION OF WORK T/ i2
ana tlgn a11 aoProorlata tleclantlons.
ADD IJ ALTERATION P9.8EPAIR
'HER G//tC Kr�.4�ilL
TYPEOFPERMIT LJGRADING LJFOUNDATION L�J�STRVCTURAL
❑ TENANT �.ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5�. FT. oCCUPArvCv
'CONSTRVCTIONTVP�y2�4in6 VALVATIONE ����
ZON� GRADINGCU.VDS. ACRES '
Remark�:
$ink
Preventer - - � � Sevuer Connectii
Irrigation Solar Collecton
' . Solar Piping
' Solar Tank
ing Fountains Urinal
Drains' ' Water Goxt •-"
Sinks - Water Heater
;rvice Outlets Water Service .
Interceptors
Kitchen Sink ..
Levetories .
P—Trep
Roof Orains .
Showers . ' .
Service Sink - I
Boilei
Duct - Under Ground
Duct-Structural ' �
Duct - Ventileting
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO �/k
Heating System & Ducting :
❑o-i au,oao eru O i oo,000
Hoodar Typel ❑-
. Oriders' License or 55 $ _ x � Re9isters
� CMF OB65-46 rav. 12/B2 White - Builtlinq; Gnary - Applicant: Pink - Accounting; Golaenrod - A
. Reinspection Fee � $15
laue Fee $ 3
MECHANICAL '
� Refrigeretion System
Oa�oo,000eru ❑�oo.000sru
System Repair/Alteration
Reinzpeetion Fee $15
Izwe Fee $ 3
PLNG. REF, qY�
LEFT SIDE VARD
PKG.SPACE REa.
STREET WIDTH '
Auromatic Washer
Construction Pole ,
Cooking Unit �
Dishwasher ' �
Dryers ❑Gai ❑Electric .
Fan t
F.A.U. ,
Fixtures
Device Boxes
REAR VARp (TO P/U
RIGHTSIDE VARD
PROVIDED � �
PARK FEE $
i
Meter LJover 100 amps •
Sub Panel � '
Sub Pole '
�Motors �04 HP ❑1X-8 ,
Inc.Solar �9-15 HP �16-15+
Microwave -
Pole Light '
R ange ,
Sections
���
1
� Swrtcne5 Trash Compacror �
Garbage Disposal
Generator �0-5 KW �5-15 KW '
Transformer ❑75-50KW �
❑5U+KW ReinspactionFea S75
Meter ❑up m 100 ampi ' laae Fae � S 3
Zonine APProvad BY � Date
I,
Application ApOroved By Date
Appliption laued BY �� Date �
� SUMMARV OF FEES Sa
BUILDING PERMIT $ �// -�r SMIP � S .
PLAN CHECK $ � PERMIT
PLUMBING . $ � ��UANCE � $
P�AN CHECK $. ' � GRADING ' • $
E�ECTRICAL $ � � ' $
PLANCHECK $ MICROFILM $ �
MECHANICAL ' $ � TOTAL FEE $
PLAN CHECK $ � LESS � �
. • • ADVANCED'PC � $ �
' . . � FINAL FEE � • $ . �. i r
0
`_� � CONSTRUCTION ANO,PLANNING `� . ,' ' ' . '� � POOL =` �� �:'A . -- - , , -
._ 4,
Date �Inspector� � � Date Inspector�
� =APPROVAIS ' Permit# ' �f-"� - . AP.PROVAL�.S �- Permit�# � �
� 1; Temporary �Electrical Servic� or,Pole � . _ - - 52: �Pool &:Equipment Location ". , : �
+u 2'. iSoil Pipe-Undrgrnd, _ � � ,� - . 53. Steel R'einforcement � , , . � •
}. 3! Electrical Conduit Utilitv-Undrgrnd. � q - ' 54. Forms� = ' � �- . - �
° 4. Electrical Conduit-Undrgrnd. � - _ � r' ' 55� Electrical Bonding � � - -
'n i '
5. Steel �Reinforcement � � " - ' _ . , ,56. Rough Plumbing & Pressure Test
W_
8: �Electrical UFER �Grnd. . � .' � � 57: APPROVAL TO COVER-GUNITE
7. Footingi , , � � - ' !'�' �- - � 58. ElectricajConduit-Undrarorl. ' -
8. Foundation I . � - - ,59. Gas.Pipe; �.Undrgrnd., Test ' � .
� ' ' '
9. W�ter Pi;pe-Undrgrnd. �! ~' � 60. Backwasti Lines, P,-Trap,�O Und�grnd. . -
10. Structural Floor SYstem � 61. :APPROVA'C TO DECK �
11. Property Sewer Line &�HouseConnection- �- ,62. Backwash & Receptor-Final - �
n ' n
12. Sewer Cap - , . c � " _ � 63. Heater & �Vent-Final - � - -
13. �Roof'Drains , ' , - _ � •64. Plumbing System - Final � -
74. Rough Plumbing � � - - ' ' � 85. Electrical'-Fina( � �� ' �
� 15.�RougFElectrical=Conduit ---, - ` ' '-. ' -- ��� �66.'SolarSystem-Final' � �, � � �- "
' �-16.'Rough Elecfric Wiring� � • • ,� , -� .3 - ' � -67. Fencing &�Access-App�oval � � , . -
O;'�(, ' C.�1
` .�17.?RougKWiring Sign•� � �, ' ; � -� ' � � '68. APPROVED FOR�PLASTERING ' , .,
, 18.� RougtrEleqtrical-T'Bar� Ceiling • � - • - � � 69. POOUSPA SYSTEMS FINAL ' -
;` 19.'iRougti Heating & Air.Conditioning � . , � ' �FIRE DEPT,IREQUIREMENT- .
_ i i
� 20.'Rough_Fa'ctory Fireplace � � � � � ' � APPROVALS' Permif # " �
i c '
:. '1 21. �D'uc[s,`in Structure " , ; � � ; � '70. UndeFground Hydro . •
�22. �Ducts, Ventilating _ . � • , � .71. Product Piping O Gas ❑ Oil
��.23. •Gas'Pipe-Rough & Test ' . � �� � � � � � � ' j 72.� Underground Flush � .
`' ��24.;Roof Framing , ��� �� _�_�3 - 73.� Undergrnd.StorageTank OGas ❑Oil �
� ' 25. Roof Sheat6ing i - • ,: ; , . , , � , � I � J4. Oyerhead Hydro '
. 26. T-Bar Ceiling (Structural) & Monocoat� � ' � , 75. Dry Chemical - �
. 27. Frame and Flashing, , � , B � �76.. Dry Standpipe �' '
28. Lathing & Siding •' . �, I i . �77. FIXED SYSTEM.FINAL
29: �Insulation =.. " , . �� � � , I i78: FIRE PREV. FiINAL
� 30.'Drywall Nailing ! , , � i � ' ,Notes: � ' ,
�� '31. �Plaster Brown Coat . ' �' j �� � � � - � �- �-� 1 - -� , �- �
�. �32. Electrical.Power Meter-Final � �! � . � � • � -
� 33.'Final Electric � � � �1 /2-53 ��.� _ � � ! . � � • �
`' 34. Final Heating &' Air Conditioning � ' i . '� � , � i '
.i
35. Final Gas Pipe-Test - .' ' , � .
36. Hood or CanoPY '.. '' . . ' I: . � - � - �� � � . . � - ' ' � . � .
37. Final Factory FirePlace^� � � . � , � ' ' � � . � ' �
38. Final Plumbing • ' � j � I , � � ' , - '. , �
39. Water Se�vice-Final � � ' • , • ' � i � . - .
�
40. Gas Service-Pinal ' � � � ' � � -
l i � i , � , i , , . .
, i � i �
41. Solar pomestic-final , " ,_ } _: _ 1 _ ___ _ . , � +; _ _ _ . . • ' � �
42. Backflow Preventer _ , ' � ' � � ' �
.�. � • � ��- -- - � -�-�----. . . . _.
-. �. � �s^ -. . - � � , - � , , . .
43. Backflow Irngation , t � � '. � ;; , - �� � - �
.:.� . � : . ` � _ . , .
44. Land ticape Irrigation-System '�;' , � '� ' `. �' � �r � � �
_ ; _ � - � i � i . I - . , .
45�.� Soundi.Attenuation , � _ � � - , . 1 ' - , , � , . .
�.46. Handicap.Regulation"s � u . ,`` � r ' ' ' ' I � . ' .. ^
4Z. FINALSTRUCTURE&BUILDING; i: :_��_&3� C�+ i ' � • �
� 48: Spe`ial Req�uirements Completed , � i � � , � � ' � ' . � .
, 49. Electr�ic Release�to�Edison� ' � . _ _ � _ _ : . _ _ � �. ._ .
a n � � �
50. Gas.Release;to Southem California Gas Co , • ' � , � � , � �
�•51. CERT,IFICATE�OF OCCUPANCY _ _ _ , _ " , , .
^ I i
No " �� � Date � . � , ' ,
�-•_
COUNTY OF ORANGE
BUILDING DEPT.
636 No. Broadway '
Santa Ma, Cali(ornia
Phone: KI 2-6211
<����
PermitNo.�-1..0.-------. -
Application for Building Permit
AND FOR A
Certificate of Use and Occupancy
• Datc..... JeI1L1aTY._]15a.._1952 ..............-..
�. OIVNER'S NAME..D.J_. .Fa...l(�t11st ........................................................................................ PHONE:.......................------�--..
MAILING ADDRESS....��3...F.AS.t....`I..Q.G�L..St ........................................- ................. CITY...Q08:Y..a..MBSHi---C81........
Name-- ............ ... ................... - --- --� -...........-----.....---.......... II Name .. D-e J.e...�IQ11� 9ti..--.............__._...--------.................
(Architect or Eng(necr) (Contrecror)
Address ......._ ..................... ---� �-.._.................._._......... I Address 483.. Efl9t._ 20th._tS_'..�....................--------��-----.........
City
Scace
Lic. :
PROPOSED
2. JOB LOCA
c,ry --- Costa._Mesa,.._California......-.--------•----...--
State
Lic No...11�158.- ..... B.. �..-...... Phone......._ ------ ..._-----� --
i�
(House \o.) (Name of Sueet) �i� (Town or School District)
3. LEGAL DESCRIPTION: Loc.--`J- � ............ . ............... Block �� ...__...... -• - -- --. Tract.. �l. - ......_...............
(Metes and Bounds Descripnon—Use rwerse cide of (orm)
4. CORNER LOT ( ) INTERIOR LOT ( Z) THROUGH LOT ( ) SLOPE OF LOT ( )
i. SIZE OF BLDG.:..36%40-6_-.,-_-qRE,q:---130QS.(],Y�-----SIZE OF LOT:...'�LQ...7f,--.�n?.rJ--.------.AREA:
6. HEIGHT OF BLDG.:._�5-_�-------------------------CEILING HLIGHT:--._8_ �.................NO. OF STORIES....�_..-.----.._..--------.
7. NO. FAMILIES......._l-------------_----_._.....Size of Smallcst Eedroom:.__1�.2......---..----_..... Size of Kicchen-_���-_--------.--.....
8. EXTERIOR WALL CONSTRUCTION:.....8:_tuCCO INTERIOR WALL COVERING_P.1a9t8T&lmOptY
(Frame, Smcco, Ecc.) (PlascervDrywall, Etc.) i21e
9. SETBACKS: Fron[. Yard From Center Line of Street.....64._Y86t
� ............................................. ----................ -- --- �----........--
Ncarest Sidc Yard.._..�.i�e......._.Rear Yard....�a....�. e...._Distancc in Fcet Between Bldgs. on Same Lot ............................................
I0. A COMI'LETE PLOT PLAN 1S REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. ��
1]. For (a) Footing: Width_.......�.4...�AGt1...........Dcpth in Ground_...12...�Y1L`�71.._..Width of Wall
Acccssory . -----�
Bldgs. and n .
Similar �b) Si:e of Studs:..2S�SE27CB......Spacing..16 ....................: CC Matcrial of Floor...C.SIII@II.f................_..........
Structures: �
(c) Size of Floor Joists:.--__•.._.—�..�_ ...Spacing-----------------�_...:..-�:'---.....:'CC
(d) Size of Rafters:. :�4.. &....�.�....5......--'--....--'--..Spacing-'---....���.- ...................: "CC
12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, eleccrical viiring, heating, fue sprinklers, painting and
sewage disposal $.�.2.�.Q.QQ�QO ..................._
13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS
APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF
THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO.
, // f // (Owner)
Plans Filed: '--- '- ....."' -- ----- ....._... ' ._.........._. U (/
BY' -- ' "- ' --� . . ............................-------- -- ----- -'-------------------'-----...--
(Authorized Agrn[)
FOR DEPARTMENTAL USE ONLY
Bldg, Pcrmit
Plan Chcck
Total • •
Receipt No.
Paid to •
llate ...........
FEES: p��
s....�.�-
�-
$......._-a�-..- ----�------
: � i �-
caour......L- r�� J. -- � � �
TYPE.............C............. -......
DIST.
MAP-----C---A-/ -... ---� -
SHEET NO......'� ...............
DATE---��-.. ...8 ��. .. r�..-�P'....--
5M-2�01
APPLICAT
ZONI NG ...............�--....----
PLANS AND �
SPEC'5 ..............................
CORRECTIONS
BY
HEALTH ............. ----.:.......
FIRE
r9ARSHAL--- ._...--------......
STATE..._- ---......._...------
ENGINEER