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HomeMy WebLinkAbout216 20TH ST - Building Permits 1 1 t • , + 1 r yip MF CITY OF COSTA MESA BUILDING DIVISION Fy 4 ) DEVELOPMENT SERVICES DEPARTMENT PER NUMBER PERMIT 4" IPA B03-01392 (714)754-5273 • Fax(714)7544856 • www.ci.costa-mesa.cILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 216 E 20TH ST Status: ISSUED Suite: Applied: 08/15/2003 Vicinity: Issued: 08/15/2003 Parcel Number: 42620119 Zoning: Applicant: VALOFF,WILLIAM OLS-- ISSUED BY: Address: 8902 SAILPORT DR Phone: (800)854-0011 HUNTINGTON BEACH,CA Zip: 92646-2664 Owner: SETZLER, CHARLIE Address 216E 20TH ST Phone: COSTA MESA,CA Zip: 92627-2218 - ►" '! Contractor: STAR COURSE ROOFING CO. - 6 Address: 8902 SAILPORT DR t� Phone: (800)854-0011 •'+ ' HUNTINGTON BEACH,CA Zip: 92646-2664 License: 532778 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT • TEAR OFF EXIST.WOOD SHAKE.INSTALL 1 LAYER 30 LB FELT,7/16"OSB AND 50 YEAR COMP.SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,900.00 Permit: $167.25 Claim Valuation: $8,900.00 SMIP Res: $0.89 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.14 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONSI `•, • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ^ a , ❑ I eve and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the ork for which this permit is issued. P ,_ nd wig maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the . .nce of the work for which this permit is issued. se $o ers'compensation Insurance carrier and policy number are: ---/ I/ 2 Carrier: � - �_QVV1 \ Iy. X70 �7 JA ) Policy Num.:r: 13-7/ 9 C!,3_�7J'7 (Th ::aeon need not be completed It the pem{Ir is valued at one hundred d tars($100)or less.) ❑ 11Cartily. :I In the performance of the work for which this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' /comw.-: .. :ws of Cattle ,la, :.d ag ee that If I should become subject to the workers'compensatlon,provlslons of Section 3700 of the Labor Code,I shall forthwith .molly with th,s2 p :vis,; Applicant Sign: . : / % i l We: Or Date: •• - : ARURE T• EOURE WORKERS'•• PE SATION IXWERAGE IS LNUWFLA AND SHALL SUBJECT AN EMPL R TO CRIMI PENALTIE AND CML RNES UP TO ONE HUNDRED THOUSAND DOLLARE(5100,000),IN ADDITION TO MST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTIONS-Me OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: ereby affirm t t lam licensed nder provisions of Chapter 9(commencing with Section 7000)of Divi '. o the Business and Prof ions Code,and my license is in full antractors I azure: .. wYeslifan / %De: • CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that ho or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly,or my employees with wages as their sole compensation.WILL DO THE WORK.and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the properly,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,Ia.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will riot employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a ., permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous - material? 0 Yes (I No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant orpresent or future building occupant need to file a registration formfor acutely hazardous materials? ❑Yes ❑No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Depanment by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the ap st Air or iMa a future building o from at other for the work ntl the or age of this LI estion a Brit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency! LJ Yes �No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 10001eet Irom the outer boundaries of a school? ❑Yes ❑No (If yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District-or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described properrtyfffo�i r$nJ� inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. L _,(XI / /• "7 r ar dzed Appli ant 1 4;M --a---- CODE I INSPECTION TYPE WE IN®AL1 SODS! INSPECTION TYPE PATE INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof S 6/� 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA • BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT 603-01392 • 754-5273 • Fax(714)754-4856 • trOILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 216 E 20TH ST` / Status: ISSUED Suite: V Applied: 08/15/2003 Vicinity: Issued: 08/15/2003 Parcel Number: 42620119 Zoning: Applicant: VALOFF,WILLIAM ISSUED BY: Address: 8902 SAILPORT DR • Phone: (800)854-0011 HUNTINGTON BEACH,CA Zip: 92646-2664 Owner SETZLER, CHARLIE Address 216 E 20TH ST Phone: COSTA MESA,CA Zip: 92627-2218 Contractor: STAR COURSE ROOFING CO. Address: 8902 SAILPORT DR Phone: (800)854-0011 HUNTINGTON BEACH,CA Zip: 92646-2664 License: 532778 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXIST.WOOD SHAKE. INSTALL 1 LAYER 30 LB FELT,7/16"OSB AND 50 YEAR COMP.SHINGLES. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $8,900.00 Permit: $167.25 Claim Valuation: $8,900.00 SMIP Res: $0.89 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $168.14 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: 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 this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury ono of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code, work for which this permit Is issued. ❑ I have and will maintain workers'compensation Insurance,as required by section 3700 of the Labor Code,for the performance of the work for which My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall fonhw. comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(5100000),IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060f THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.N Class q Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toe civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,es owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,Le..property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth Into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title B,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater then a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health end Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 9 Yes 0 No 6 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE 1 INSPECTION TYPE RALE IIIIQIE15 CODFf INSPECTION TYPE RAIL INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Electr 200 Final Re-Roof S©— 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy t_,ARRETT ENGINEERING AoSOCIATES CONSULTING STRUCTURAL ENGINEERS May 1, 2006 City of Costa Mesa Building Division 77 Fair Drive Costa Mesa CA 92626 Attn: Building Inspector Reference: Shingle reroof, 216 E. 20th St. GEA No. 060501 A site visit was made to the referenced project by a representitive to this office to view the roof sheathing. Several randomly selected areas were uncovered, and the following observations were made. The 7/16" OSB was installed with 8d nails at 6" o.c. at edges, and 12"o.c. in the field, in accordance with the California Bldg Code, and applicable City ordinances and recommendations. The felt installed is 3011 ASTM felt and the shingles are 50 Year Composition shingles by Celotex. Sincerely, "nnif!✓ ,1FsESS/ON,,. ti Larry Garrett, S.E. c."3J No. ,• " m Ujer MAR / 1 2008 T, it Exp. SPiliuCTU OFC103% psi P.O. Box 834 • Westminster, CA 92684-0834 Telephone / Fax (714) 893-2979 GARRETT ENGINEERING ASSOCIATES CONSULTING STRUCTURAL ENGINEERS May 1. 2006 City of Costa Mesa Building Division 77 Fair Drive Costa Mesa CA 92626 Atm: Building Inspector Reference: Shingle reroot, 216 E. 20th St. GEA No. 060501 A site visit was made to the referenced project by a representitive to this office to view the roof sheathing. Several randomly selected areas were uncovered, and the following observations were made. The 7/16" OSB was installed with 8d nails at 6" o.c. at edges, and 12" o.c. in the field, in accordance with the California Bldg Code, and applicable City ordinances and recommendations. The felt installed is 30# ASTM felt and the shingles are 50 Year Composition shingles by Celotex. Sincerely, • QRpFESS/p� Q�� . a. G49 l arry Garrett. S.E. /rt MAI2o3r .10 8 , * J' Exp. `rq TRUCIOj,,Q OF cp`\Pr 5 --7 -,1 P.O. Box 834 Westminster, CA 92684-0834 Telephone / Fax (714) 893-2979 0 March 2, 2006 Chief of Inspection, Ed Petros City of Costa Mesa P.O. Box 1200 77 Fair Drive Costa Mesa, California 92628-1200 Dear Mr. Petros, I recently received a letter from Mary Jane Weidenkeller of the Building Division informing me that the city had not received a copy of the final inspection on my newly upgraded roof. (Please see attached copy of the letter from Ms. Weidenkeller). I have contacted the contractor, Mr. Bradley Faubert, of Star Course Roofing Co., License # C-39-532778, and he explained he had received documentation from the City of Costa Mesa of approved final inspection of my new roof and he would fax a copy of it to you folks by Monday, March 6, 2006. As of this date, I have not received a copy of this document from Mr. Faubert nor the city but will request one for my records. According to Ms. Weidenkeller's letter,my permit to improve my roof expires Monday March 6, 2006. In case Mr. Faubert does not get his copy of the approved final inspection to you by the deadline, I am requesting an extension until this matter can be cleared up. The PERMIT NUMBERS are: B03-01392 FOR: Re-roof PROJECT ADDRESS: 2T6E30th:St:,.Costa:Mesa, Ca. 92627 Thanking you in advance Andrea R. Baird 216 E 20th St., Costa Mesa, California 92627 714-878-2347 949-631-1771 `� , Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. Z CI-.Y OF COSTA MESA P�/F�t��(/y7'Dip. TRACT NO. LOT NO. •BLDG.NO. • CONL'TRUCTION PERMIT (7 / G— g39 ItirwoaCr Ftc -213 Sem Project Address i Z lip Efis; 2 old Sr TYPE OF CONSTRUCTION„��,,// Owner JDN,J t99TFQtA Phone�/8!{7L 1 ❑ NEW INADD 0 ALTERATION 51238 9/I E/01 `(Io h(1 . Address CePvIC 0 REPAIR 0 CONVERSION El DEMOLISH ZONING REGULATIONS Arch/Eng. 24...(2 (00,:acic License No. ❑ OTHER A.P. -'1fp _ z„ .0,, / OG Address '23 E, 171b DESCRIPTION OF WORK 4 ' Accesses $U)t.coot7 _ 1rvie-Cl ZONE PLNG. REF.qF Contractor ()newt* PhonetVSt/t)13 TYPE OF PE IT BUILDING • to Mare But Address / 1OJPI.2f �/ L SETBACK C/L ST.G •5Mare [7L/j� SiThiC 4 (-1At (034,4idR0❑ GRADING Me-FOUNDATION i-TRUCTURAL Ip YARD F1 1 LICENSED CONTRACTOR DECLARA ION VVV 0 TENANT IWELECTRICAL MCLUMBING ❑MECHANICAL �S5EIopEE VARD Non I hereby.affirm that I am licensed under provisions of Charter 9(corn- RIGHT3 c mencing with section 7000) of Division 3 of the Business and 0 OTHER 3T Professions Code and my license Is In full f redand effect. REAR YARD(TO P/L) Ucense C ssjo 1 PROJECT DESCRIPTION �/I + Signature �7 9 PKG.SPACE REQ. PROVIDED Date SQ. FT. �� WORKERS'COMPENSATION DEC RATION - OCCUPANCY ONSTRUCTION TYPE �L•. N STREET WIDTH PARK FEE$ I hereby affirm that I have a certif care of consent to self-Insure or a VALUATION yntOrZONE ZONING APPROVED BYncc` C_Jlrl sw I DATEd .15_Dsl certificate of Workers' Compensation Insurance, or a certified copy thereof(Sectiorgq.gppr�l-a b.C. GRADING CU.YDS. ACRES SPECIAL CONDITIONS: 'r To Exceed 'Icy No. e(444l3 Company FflierlO+�r ..�.--s- Certifiedcopyisherebyfurnished. REMARKS: Sly 6U /� �kr .P--1 �rtifled copy is filed with the city Building Division. �) ���ut,c 1F/ ect EXEMPTION FROM WORKERS' COMPENSATION DECLARATION /(p- dellib •6•,�� . (This section need not be completed if the permit Is for one hundred Ripe �l ($100) or less). I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. uwtlu NG GAHgbt Date -- 4 Signature BATHTUBS SHOWERS SQ FT. SO FT NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+ KW CONSTRUCTIONrevoketl. KIT.SINKS DISHWASHERS • ' v MOTORS LENDING AGENCY . 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS • `, 7 (INC.SOLAR) 10-50 HP +HP formance of the work for which this permit is Issued (Section 3097 t Civ. C.). ,1/� FLOOR SINKS FLOOR DRAINS _ 2FIXTURES S OUTLETS'3SWITCHES 2SO Lender's Name u Lender's Address DRINKING FOUNTAINS . ,. GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that 1 am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP ' LUNSI nut.I LUN Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN- SUB quires the applicant for such permit to file a signed statement that he y n is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE .•L OUTLETS L-_ '.-- SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the - _ Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - cis for the alleged exemption. Any violation of Section 7031.5 by 1 ( applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS lot more than five hundred dollars ($500). • •� rri, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS ' sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE �• Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY Q/�S'�7/ who builds or Improves thereon, and who does such work himself or ISSUE FEE DATE` /(J through his own employees, provided that such improvements are not If, ho intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion,the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT BUILDING $ yy•�o SMIP $ S� ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ As•12. PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ • an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to ,SYSTEM ' - S GRADING $ the Contractor's License Law). / . 100,000+BTU PLAN CHECK $ _ ❑ 1 am exempt under Section B. P.C.for this BOILERS BTU ELECTRICAL s 5�`7 $ reason - MICROFILM $ PLAN CHECK $ 9 I S��� SYSTEM REPAIR,ALTERATION _ _ Date Owner �' TOTAL FEE S —' MECHANICAL $ 1 hereby certify that I have read t dr.•licalion and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information is correct. I agree amply with all city and county PLAN CHECK S VANCE PC $ ordinances and state I ws relax” o onstruction,and hereby authorize representatives of is - upon the above ent'oned _ property ction ci /,-� Signature Date v / FINAL FEE S +1_.....- Drivers' Li or SS# ISSUE FEE 8 • 41-, CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor C/ 1 •- Y CONSTRUCTION AND PLANNING - POOL& SPA �.•' APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit-Utility-Undrgrn 45. Forms • 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings C q,a9 4-c-1 - 49. Electrical Conduit-Undrgrn 8. Foundation50. Gas Pipe, D Undrgrn,Test 9. Water Pipe-Undrgrn 51.• Backwash Lines. P-Trap. 0 Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection • 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System - Final • 14. Rough Electric-Conduit - .56. Electrical-Final 15. Rough Electric-Wiring 9_Z-*-2- ,9 , 57. Solar System-Final 16. Rough Heating & Air Conditioning 5B. Fencing &Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-.Rough &Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing RAID 21. Roof Sheathing 99,-/4--16A- sR �/ NOTES: -Locker, ! C. ..D X'_r _%1,r 22. Frame and Flashing •rJ-/S.- $R B '>'-► IJJ.. 23. Insulation - __ , �tJ•riettwq 0 •i. �'4Mfa 4--ix..; - 4i- 24. Lathing & Siding q-/S-nQ 917 J 11 • 25. Drywall Nailing 10��-'+--- 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 3 2 -t e_e v • 29. Final Heating & Air Conditioning/ 30. WI Gas Pipe-Test 1/24,-An, errazt old p//9/ - ?1" 31. Final Plumbing 32. Water Service-Final 33.' Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinklinq System 36. Sound Attenuation _ 37. Handicap Regulations ///J�� 38. FINAL STRUCTURE & BUI LDI NG - *NI/% 30k issg oec 424k- 39. Special Requirements Completed 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. •BLDG.NO. CONSTRUCTION PERMIT p E J 014 7 Project Address Lk, Ef 2ots •)( . TYPE OF CONSTRUCTION565 f' ' 9/2Z15 Mar: Ti Owner .achto?eTe2 KA Phone 0 NEW fd'ADD 0 ALTERATION Address cPrme 0 REPAIR 0 CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. (Z1 Q eauCeplc License No. 0 OTHER DESCRIPTION OF WORK A.P.eF Address 2314 6. i1D C M ZONE PLNG. REF.la Contractor ®-- Si Phone TYPE OF PERMIT BUILDING TOUILDING C!L ST. BUILDING LINE Address _ 0 GRADING 0 FOUNDATION 0 STRUCTURAL SIDE YARD LICENSED CONTRACTOR DECLARATION LL F I hereby affirm that I am licensed under provisions of Charter 9 (com- ❑ TENANT ELECTRICAL PLUMBING ❑MECHANICAL SIDE YARD mencing with section 7000) of Division 3 of the Business and 0 OTHER RIGHT Professions Code, and my• license Is in full force and effect. REAR YARD(TO P/L) PROJECT DESCRIPTION License Class License No. PKG.SPACE REQ. PROVIDED Date Signature - SQ.FT. ' WORKERS'COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE • STREET WIDTH PARK FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY, DATE certificate of Workers' Compensation Insurance, or a certified copy . thereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: Policy No. Company ❑ Certified copy is hereby furnished. REMARKS: ❑ Certified copy is filed with the city Building Division. - - - - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ (This section need not be completed if the permit is for one hundred' ($100) or less). I certify that In the performance of the work for which this permit Is Issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. - -- UW ELLIN(a (OA HAGE Date Signature BATHTUBS SHOWERS 5Q FT S0 FT NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW - revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS • SUMPS (INC.SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 Civ. C.). • FLOOR SINKS I ' FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIE POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's-License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL I PTr P LOINS I nut.I ion' Any city or county which requires a permit to construct, alter, ;POLES METERED SUB Improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE - RATION PANELS MAIN SUB quires the applicant for such permit to file a.signed statement that he , is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE 'IUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the • Business and Professions Code) or that he is exempt therefrom and the WATER HEATER 4 fit BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNE 10 of not more than five hundred dollars ($500). QUI, as owner of the property,or my employees with wages as their SOLAR TANK OLLECTORS . sole compensation, will do the work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYSt ISSUE FEE 3 Contractor's License Law does not apply to an owner of a property ----APPLICATION APPROVED BY who builds or Improves thereon, and who does such work himself or ISSUE FEEDATE through his own employees, provided that such improvements are not . Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion,the owner will have the burden • �: of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING C PERMIT $ SMTP $ El I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project .(Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon,.and who,con- REFRIGERATION '0-100,000 BTU PLUMBING $ 6J tracts from such projects with a contractor(s) licesned pursuant to SYSTEMA — _ GRADING $ the Contractor's License Law). a - — - • -100,000+BTU_ - - PLAN CHECK $ • ❑ I am exempt under Section - B7& P.C.for this - /�—* $ r - - BOILERS. . BTU ELECTRICAL $ reason - ` - — MICROFILM $ • SYSTEM REPAIR,ALTERATION PLAN CHECK $ Date 9 -Alm _ TOTAL FEE$ I hereby certify that I have read 411application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ ts AD- Information is correct. I agree o complywith all cityand countyPLAN CHECK VANCEPC$ VANCE PC $ ordinances and state laws relating to forst ructio n,and hereby authorize representatives of is ci to e ter upon the above mentioned property for ' Spe I 01 p - • /)er r Signature Date �/'� FINAL FEE $ / Drivers'Licens r SS 46 ISSUE FEE - - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA ' . APPROVALS . Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool &'Equipment Location 99/-6I ' e :L° 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn46. Electrical Bonding 5. Steel Reinforce - 47. Rough Plumbing & Pressure Test • 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation - 50. Gas Pipe, ❑Undrgrn,Test 9.- 9-a/ C. C- 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, ❑Undrqrn 10. Structural Floor System - 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55. Plumbing Svctem- Final - - 14. Rough Electric-Conduit Z6. Electrical-Final 15. Rough Electric-Wiring - - 57. Solar System-Final _ 16. Rough Heating & Air Conditioning 58. Fencing &Access Approval . • 17. Ducts, in Structure 59. APPROVED FOR PLASTERING . 18. Ducts, Ventilating - 19. Gas Pipe-Rough &Test . . 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing - 21. Roof Sheathing - I _ 22. Frame and Flashing NOTES: • 23. Insulation tgrr Carlati • SiZv/d'it' G.EO 24. Lathing & Siding ' 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final .. ' 28. Final Electric 29.NFinal Heating & Air Conditioning - 30. Final Gas Pipe-Test 31. Final Plumbing - `- 32. Water Service-Final ' 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System ' 36. Sound Attenuation - 37. Handicap Regulations • 38. FINAL STRUCTURE & BUILDING -e .i/c o �� 39. Special Requirements Completed / ' - v -�� 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY ' No Date 1 --- J Applicant to fill In all spaces excel. --.:ry border lines and sign all appropriate declarations. �� • TRACT NO. LOT NO. BLDG.NO. 1- 8F Ch�•'� MES° _ ' PE•MIT NO. pf�ERMP' STRIA?IO r 2LZ .e.; - al ing Address 241.6 E-ZC? • Sr COSTS in r s TYPE OF CONSTRUCTION •1 r NEW . ADD I. ALTERATION ill REPAIR • ' Project Ad ss ZI/(• C. "ado SC- Q7st)4 W1 5$ 1:1 CONVERSION ❑ DE •CISH ❑ OTHER ' .I 04'p Perect A phpne�D f 49/3 • DESCRIPTION OF WORK • it-- S s-. aIf ' Owners Name ♦ ZONING REGULATIONS ' 21 b e. '2o UT sr Qr,�u M • 'TYPE 6 yG MIT e! �P Ti FOUNDATION�gQ�latE lnr w- y� Address FPERMITr� Ll GRADING I� Ip ® STRUCTURAL A.P.qW jji�! .�/ z,(�' ZONE -(•--•/ Arch/Eng. KNAa/ ASSOG' License,,Noo� -'�^� ❑ TENANT .1 ELECTRICAL PLUMBING •H]I MECHANICAL ,{ -.BUILDING ,� - ./ 00S71q 4l IR OTHER P,1_Ct-(L kLL • • CR $ce TO BUILDING s�., 1 $Frnnrx rrr er Address Z31 �- Cl M Ss TO 1' s REAR YARD(TO P/L) �(� Contractor's Name.N�A ,�,,I{ arl SU/ acid Phone�rlairn f3 PROJECT DESCRIPTION 5q.�, ��� s OCCUPANCv PROPERTY LINE /7 �� 10 Address(mailing) iJ'3I1q'MpCi'. -Yi/s Ale *WI Ng 9�3 CON STRU TION TYPF �L VALUATION$• 110 5 c LEFT SIDE YARD SI - RIGHTSIDE YARD /3Y Y�Z'/0 • ZONE -/ GRADING CU.YDS- ACRFc PKG.SPACE REQ. ;2, GOb`�zs rX PROVIDED r s_CV JJ ' \ 1 License No. Y . . . _ _ l: vii tJLu - `z, LICENSED CONTRACTOR DECLARATION Remarks: .29.6. aes Oea; STREET WIDTH �0! PARK FEE S• 6 I'hereby affirm that I am licensed under provisions of Charter 9(commencing p nc x� pp IRIA, i_li'�� with section 7000) of Division 3'of the Business and Professions Code,and SPECIAL CONDITIONS: HOW QUI( S[I.CIAI. lµ%QUasts!s!_"•'r ( my license Is In full force and effect. I, �/ Qy� - - - License.Cl �g� - LlceylgLJ�•'`l�v J PLUMBING I N Date l /1 7 Signature T . Bar Sink Sewer Cap' ELECTRICAL 1KERS'COMPENSATION DECIw - - ' eby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Pre'enter ._. • / Sewer Connection - / Automatic Washer ' Meter Dover 100 amps' • / 1560 ch Workers' Compensation, Insurance,'or a certl/led;copy thereof (Section ' - - 3800, Lab. C_) - °" - - - Construction Pole Sub Panel ' ' FOs41S FR12jna.iT Backflow Irrigation Solar Collectors` Policy No. Company• 1 - `" - iCertifled copy IS hereby furnished. i - 2 Bathtubs Solar Piping // t)0 / Cooking Unit .Sub Pole : - / Certiflgycopy tit with the cit in 'Dishwasher 'Motors 00-1 HP ❑1X-6 Date d--.5 r Applicant y , C ierifiers ' Solar Tank _ • / / y.cJ •EXEMPTION'FROM WORKERS'C SATION DECLARATION • - - - - Dryers ®Gas- ❑Electric Ina Solar ❑9-15 HP U16-15+ '(y0 \• (This section need not be completed I e permit Is for one hundred($100)or - Dishwasher Swimming POOI w/Spa_ r!•p �- less) - - .Microwave ' I certify that In the performance of the work for which this-permit is Issued I. Drinking Fountains Urinal i Fan i/ t �I. shall not employ any person in any manner so as to become subject.to the - - - /� / F.A.U. Pole Light /� ..Workers' Compensation Laws of California- ' Floor Drains - 2, Water.Closet 7 • • �• Date qignatuthis - • - Fixtures . NOTICE:If,after making this declaration, Labor ould'become subject to the Floor Sinks . / Water Heater• -- 2 041'�Z- I Range Z (� Workers': Compensation provisions of the Labor Code, you must forthwith • Device Boxer comply with. such provisions' or this permit-,shall be-deemed revoked. • Gas Service ,Outlets• I, / Water Service - Z Q' - Sign CONSTRUCTION LENDING AGENCY • ' - - .i/Q Outlets" (� • I hereby affirm that there Is a construction lending agency for the performance Interceptors H V Standing Sections I 62.0 i ' of the work for,„which this yermi ,s •Is ued (Se of 3 7 Civ. C.) - - Lender's' Name 0A.1E-E7 C' f- 3civll '1`Ts•10 L[YrTn/ ,/: _, , • ' , ?.Switches ,, Trash CompactorO-(� Kitchen'Sink 1�({,t7 c • Lender's Address �f 1N - - ` ECSJ7rWJE241 U• ' III , I ♦, ./ Garbage Di osal - . Lavatories 9 sp (1_O OWNER BUILDER DECLARATION - ; - - - • 1.. - - QO I hereby affirm that I am exempt from ss ntractor•s'License Law for the p-Trap - Generator 00-5 KW 05-15 KW • following reason (Section-7031.5 Business and Professional•Code: Any city or p• L'DO , county which requires a permit to construct,alter Improve,demolish or.repair - , Transformer.❑15.50 KW • any structure, prior to Its Issuance, also requires the applicant for such permit Roof Drains) - , ' I ' 1 -- ,1 2�0 (• - I • • r _file a signed statement that he/she Is licensed pursuant to the provisions of , ' - v ' I❑50-1 KW. - t ��Contractor's License Law(Chapter 9(commencing with Section 7000) of • - - - - einspeetion Fee $75 �'"sion'3'of the Business,and Professions Code) or that.he/she is.exempt '1/ Showers i - einspection Fee ' •$15• e:'refrom and the basis for the alleged exemption. Any violation of Section Meter up to 100 amps Issue Fee - •$ 3 .7031.5 by any applicant for a permit-subjects the applicant to a civil ! _ _ A. gena Ity of not more than five hundred dollars($500). ' / Service Sink I -• Issue Fee $ 3 ,cloning Approved By I 'Date LJ I, as owner of. the property or my employees with•wages'as their sole - - - . •" t .compensation will.do the work,and the structure Is not intended or offered MECHANICAL Application Approved Br• C'dr- Date a S J •' • for sale (Section 7044; Business:and'Professional Code:.The Contractor's x License Law does not apply to an owner of a property who builds or improves goiter I Refrigeration System /. , C • � thereon,-and who does-such work himself/herself or through his or her own - - Application Issued By_ ` s . ' • J Date ,• employees, provided that such improvements are not intended or offered for ❑0.100,000 BTU ❑100,000 BTU - . - , - sale- If, however, the building or improvement is sold within one year of com- / Duct-Under Ground p a° •' cSUMMARY F FEES • • pletion, the owner will have the burden of proving he/she did not build or im- - •• •.' 4 D •(.7 P -T ' q • rove for the purpose otsale). • • • - Duct-Structural System Repair/Alteration BUILDING PERMIT $ �• V SMTP $ `•1 ✓ I, as owner of the property, am exclusively contracting.with licensed con- - . ractors to construct the project (Section 7044,Business and Professions Code: / Duct-Ventilating ' I 00 PLAN CHECK, $' 2-1 I Z_ PERMIT • The Contractor's License Law does not apply to an owner of property-who • I ZR;(�. ISSUANCE $ ' ' builds or Improves thereon, and who contracts for such projects with a con- ,. Exhaust System ❑ Multiple 0 PLUMBING fr" $ tractor(s) license pursuant to the Contractor's License Law). e .PLAN CHECK �:� $ 13•(10' GRADING $ I ❑'l'am exempt under Section B• .& P.C.for this reason / Firepl/Fact.Blt. ICBG 5k/�/ (1v _ I f f3-f1 / •1 I' $ • nate ) • Owner Heating System& Ducting • Q0, ELECTRICAL. $ V , , I hereby certify that I'have read this application and state that the above ✓ o-100,000 BTU ❑100,000BTL- - l y_ (PLAN CHECk - y, $ JY!•SQ MICROFILM' $ .Information Is correct. I agree to comply with all city and county ordinances - :Iy CC Z7•I(,ZQ ✓ TOTAL'FEE• $ i 4 ' and state: laws relating to building construction, and hereby authorize repre- - 'MECHANICAL C_AL $ I. sentatives of this cit t0 s le above-mentioned HOod or - , Yproperty for Type I ❑ einspectian Fee, $15 // ,v0 '. ;• LESS Inspection pusVe pp `r - Canopy Type II 0 .PLAN CHECK $ ADVANCED PC $ Signature ' i ate 0^J Off ,,, - 1 Drivers' Lice S 3 1 /2 Registers ' Issue Fee $ 3 .1 �1, FINAL FEE. $ �p�`I:`�� • `MF 0865-46 rev.12/82' White-Builtlln9i Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - - '- -- -^. // STRUCTION AND PLANNIN , - r. ct ! - _P- . SPA - ^ - 4y_ .e.'. =Date ' Inspector - - • Date Inspector ROVALS Permit# - C . - :APPROVALS - -'Permit#' ,1.••Tiirpoiary, Electrical Servicre;or Pole , 'i. n C t 52: Pool & Equipment Location • 4•A..ioil Pipe-Undrgrnd`. : '=• 1.!::''' • 8 a140Opt 53.-Steel Reinforcement ', 'Electrical Conduit Utility-Undrgrnd. rr,C. - - 54. Forms- • • " - - • ;h.`Electrical Conduit-Undrgrnd. , i, .( L`', ,55' Electrical Bonding - - - ' /' , 5.•Steel Reinforcement ' 1, p - -56. Rough•Plumbing&'Pressure Test 6.'Electrical UFER Grind, ; °• 13 - J-(?4R .57? APPROVAL TO COVER-GUNITE. • 7.'Footings • ' I 'bis- , g 3- 58. Electrical Conduit-Undrornd. • 3.•Foundation o/l S. ' $.43z, 59. Gas Pipe, O Undrgrnd.,Test - - 9.•WaterPipe-Undrgrnd. ' . , 1•7/0;7 ./' 'C 60. Backwash-Lines,P-Trap, 0Undrgrnd. 10. Structural Floor System N_ges 5 , W'l339� •61. APPROVALTO DECK - - ff-29-53 , . � : r11.,Properly Sewer,Line & House Connection 8�s-- 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater& Vent-Final 13.•Roof Drains :64. Plumbing System -Final _ -- _ 14.;Rough'Plumbing ' /p/i7 • _ re -6a Electrical-Final - T I , 15. Rough"'Electrical-Conduit' ",'('r ---- 166. Solar System-Final - -` - : n 16. Rough Electric Wiring !;- '43-pi - (p ... ;. 67.. Fencing&Access_Approval . . - 17. Rough Wiring Sign: • 1 - l . = I - ' 68. APPROVED FOR PLASTERING 18.. Rough Electrical-T,Bar Ceiling 11 ' ; i - i - ;69; POOUSPA SYSTEMS FINAL ' • 19. Rough Heating & Air Conditioning oo i<ftFIRE DEPT. REQUIREMENT 1 20. Rire ough Factory Fireplace i '' ;. � i I i ' APPROVALS ' Permit# ' 21. Ducts,in Structureil ! ; ! 70. Underground Hydro ucts; Ventilating I '' n l ' 71. Product Piping 0 Gas 0 Oil ` Gas-Pipe-Rough&Test liq j " I ..72. Underground Flush • 214. Roof'Framing !l.,' °' )'' , h �•,: ; •• '., . ' p ' . 73. U,ndergrnd.Storage Tank 0 Gas ❑Oil 25. Roof,Sheathingl' ' ' I ',;, ip, 74: Overhead Hydro - 126. T-Bar Ceiling (Structura-IP& Monbcoat ! • ; 75. Dry Chemical ' - 27. Frame and Flashing ! '. ! . 1 76. Dry Standpipe ' 28. Lathing & Siding 4 - ' ' , " IN') 77'. FIXED SYSTEM FINAL - 29. Insulation: ' r! , " , MI'1?-r 78. FIRE PREV.-FINAL - 30. Drywall Nailing q)\C . '+' ' Notes: 31..Plaster Brown Coat ' , 71/), r f g ��-�,3z4v �i.;:frsz Vic, 32. Electrical Power Meter-Final r ° s !„� e„�. 1 � J 33. Final Electric i. Tir 34. Final Heating & Air Conditioning ; �- f3 `, 35. Final!Gas Pipe-Test ! - -f 4 ottr pe aN. •c/N-�.p e1-r& r 36. Hood;or Cenop'j• _. 1 _ •_ k % ,Q '7- >nS _ 37. Final factory Fireplace - i • (.7✓" "r)' err 5.64 I F'n•Ni hqj 4S lint. r 38. Final Plumbing i -� F ,'i€-�S�.�5- L:neer sloth• S'�Ib 'fr.11 • O k 6 ... . i h �• % fY1P 39. Water Service-Final• , , ` c p .• ,%�/oTb. 0,25-25.![7. tS�7l�.p�joas � on 10.p 40. Gas Service-Final • , I i' 1 /215,71. 3 As>reic!-'S7��t�i�- At _ - / ttroi L-. � ' z,.e� _ 41. Solar,Domestic-Final ' j ' , _ _ .. v. ' yam ` c Sc. _-,. 2 c. /3 -$ 42. Backflow Preventer . !.-.• ;[- � 'tet % w 9-ilo> � . � 43. Backflow Irrigation .. • - - _ I _ 44. Landscape Irrigation_System ;r_ - - _ I ('• 1, ; - 45. SoundcAttenuation . ;, ' I 46. Handicap Regulations , • - I. I' 47.-FINAL STRUCTURE& BUILDING; co 5 -,, 1274(83 • C 48. Special Requirernentstompleted di ! nVOKC - 49. Electric,Release to Edison 50. Gas Release to'Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY A ' ' .. a _ - No, Date '' i • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA a PERMIT NO. TRACT NO. LOT NO. •BLDG.NO. 3970 :B/I5/FI j I.-t•I' CONSTRUCTION PERMIT ea�l f - , • F Applicant's Mailin3g, ddress�•� ' ` P`r S`L TYPE OF CONSTRUCTION ❑ NEW U ADD U ALTERATION U REPAIR - • Project Address r' Py C // h 2�n c�/• ❑CONVERSION ❑ DEMOLISH ❑ OTHER - - : Owner's Name n/�f✓ f-7/7Fir /f%'n Phon e"/YS - - W/3 DESCRIPTION OF WORK - - ZONING REGULATIONS Address ';// SyienpAr^""$ I - TYPE OF PERMIT ❑ GRADING -U FOUNDATION. Li STRUCTURAL _ A.P.`# - . - - ZONE - Arch/Eng. _ - Licens• e No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL PLNG. REF.yk - BUILDING - • , Address .,r- / ❑.,OTHER - TO BUILDING cora err rr. cr ContractOrs Namg/�i^`! �r/ ��+hPhone PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ PROPERTY LINE' • REAR YARD(TO P/L) • , LEFT SIDE YARD RIGHT SIDE YARD. Address(mailing) /T ���7Cry m✓r" CONSTRUCTION TYPE VALUATION$ PKG.SPACE REQ. PROVIDED 20.JL - ' ZONE • GRADING CU.YDS. !ACRES - License No. ••__ - • • ' LICENSED CONTRACTOR DECLARATION • Remarks: G (4.7�9 STREET WIDTH - PARK FEE$ - - . I hereby affirm that I am licensed under provisions of Charter 9 (commencing - with section 7000) of Division 3 of the Business and Professions Code,and - SPECIAL CONDITIONS: - • my license Is in full'$o fe and effect. o•Sr p ' : Ucen+�e I ss i cense o ��'"' 6 PLUMBING . Datei'a Signature Area ---.... Bar Sink Sewer Cap- • ELECTRICAL I t ER COMPENSATION DE LARATI• • • - - - eby affirm that Lhave a certificate of consent to self-insure or a certificate _ Automatic Washer ' Meter Dover 100 amps _ , or Workers' Compensation Insurance, or a certified,copy thereof (Section Backflow Preventer • -- Sewer Connection - - --- — - - - - 3800, Labt.) r - Backflow Irrigation Solar Collectors Construction Pole, Sub Panel Policy Nom l yl /• Company r4" +"�w� - -- - • Cooking Unit Sub Pole ' i ' 8 Certified copy is hereby furnished. Bathtubs Solar Piping , Cert I tl cI ilea with the city .quJ�}ng D�/ision. • . Dishwasher Motors 00-1 HP 01 S$ Oat Ce 7d c Applicant tci • i G. ' Clarifiers Solar Tank , f ' - EX ION FROM WORKERS'COMPE NSATI Wv ECLARATION - Dryers-0Ga5 ❑ElEctric - Inc.Solaf-09-15 HP 016-15+ (This section need not be completed if the permit s for one hundred($100),or Dishwasher Swimming POO!w/Spa less). - - - ; Fan Microwave . I certify that in the performance of the work for which this permit is Issued I i Drinking Fountains Urinal ,1 - • • , shall not employ any person In any manner so as to become subject to the F.A.U. •• Pole Light Workers' Compensation;Laws of California., I , Floor Drains Water Closet i ''' • I Date Signature I I • I - - • • Fixtures ; NOTICE:If,after-making this seclaratibn,you should.become subject to the- --' Floor Sinks _. .. _Water.Heater _ - . . ,. . - _ Range i Workers', Compensation provisions of the Labor Code, you must forthwith Device Boxes comply with' such ,provisions or'this ,permit ;shall be ,tleemetlr revoked. Gas Service' Outlets 'Water-Service - , Sign ' CONSTRUCTION LENDING'AGENCY ' Outlets ' I hereby affirm that there Is a-construction lending agency for the performance • interceptors j "-• - Standing Sections . , ) of the work for which this permit is -issued (Section 3097 Civ. C.). - - I - Com • Switches • Trash C Lender's Name - Kitchen Sink _ - p Lender's Address • ' - ' OWNER BUILDER DECLARATION Lavatories , - - Garbage Disposal , , I hereby affirm that I am exempt from the Contractor's License Law for the • - - - Generator 00-5 KW 05-15 KW , following reason (Section 7031.5 Business and Professional Code: Any city or , , * P-Trap'. _ ' - - - - _ • county which requires a permit to construct,alter,improve,demolish or repair - - - Transformer 015.50 KW • any structure, prior to its issuance, also requires theapplicant for such permit . Roof Drains "' •- - - ' file a signed statement that he/she Is licensed pursuant to the provisions of 05U+KW • Reinspection Fee :,Contractor's Ucense Law(Chapter 9(commencing with Section 7000)of - - ' Pe $75 1.<i sion.3 of the Business and'Professions-Code).orthat he/she is exempt Showers • - - , . Reinspection fee . $15 - refrom and the:basis for the alleged exemption. Any-violation'of , Meter pup to 100 amps Issue Fee .$ 3 -7031:5 by any applicant for a permit-subjects.the applicant to a civil ' - �naity of not more than five hundred dollars($500). ' . = - Service Sink - I • Issue Fee r. $ 3 Zoning Approved By Date• ' I, as;owner of;the property or my employees With wages as their sole MECHANICAL • compensation will do the work,and the structure is not Intended or offered Application Approved By 'Date, ' for sale (Sec/ion 7044, Business and Professional Code: The Contractor's '^K License Law does not apply to'an owner of a property who builds or improves Boiler Refrigeration System ys r•� thereon, and who does-such work himself/herself or through his or her own t Application Issued ByThn U • Date " /� /� •� employees, provided that suchdmprovements are not Intended or offered for I - ❑0.100,000 BTU ❑100,000 BTU sale, If, however, the building or Improvement Is sold within one year.of com- Duct-Under Ground i SUMMARY OF FEES ' pletion, the owner'will have the burden of proving he/she did not build or Im- . - - , ! Urove for the purpose of sale). - Duct-Structural I System Repair/Alteration BUILDING PERMIT $ ; -SMIP I $ 1,as owner of the property,am exclusively contracting wlthilicensed con- - - tractors to construct the:-,project `Section 7044,.BUsiness,and-Professions Code: ' Duct-Ventilating I I ' !PLAN CHECK $ - PERMIT ' The Contractor's License Law does not apply to an owner of property who ' L • - . - ' ISSUANCE , ' $ ' builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 04 'PLUMBING $ / r— tractor(s) license pursuant to the Contractor's License Law). ,PLAN CHECK $ • , GRADING • $ 0 I am exempt under Section - B.&P.C.for this reason Firepl/Fact.Bit. ICBO# , - I - ' ' ' $ ' - ELECTRICAL $ V Date Owner • ' Heating System& Ducti •ng MICROFILM $ - I hereby certify-that II-have read this application-and state that-the above 00.100,000 BTU 0100,000 BTU _ _ PLAN CHECK - $ 1 Information Is correct. I agree to comply with all city and county ordinances • i TOTAL FEE $ ' and state laws relating to building construction,and hereby authorize repro- MECHANICAL S. , sentatives of I•'s city to ter u•on the above-mentioned property for •• Hood or Type ❑, I LESS • inspection Pu,.•s•s. ) rt Canopy Type II 0' Reinspection Fee. $15 PLAN CHECK. - $ ADVANCED PC $ ' Signature i is ltvatoi• - Date £ , . Drivers' LI ense or'S 'r • Registers I Issue Fee $ 3 FINAL FEE $ /•'-�'�• ...-____ --MF 086546 rev.12/82 White-Building;Canary-Applicant;'Pink-Accounting;Goldenrod•Assessor •- - - - - - ' '— .• 1 '?CONSTRUCTION AND•PLANNING - -• v. - . - PO( SPA .' r ' - Date ,Inspector ,Date Inspector -- -,'APPROVALS . Permit# n'i" _ . APPROVALS - P.ermit# " - - ,1: Temporary•Electrical Service or,Pole _ ; - , i . 52. Pool & Equipment Location • `.2: Soil Pipe-Undrgrnd. - 53: Steel Reinforcement ' 3: Electrical Conduit Utility-Undrgrnd. „- . - 54. Forms -•4. Electrical Conduit-Undrgrnd. - - - - 55. Electrical;Bonding - - ,5. Steel,Reinforcement . - - 56. Rough Plumbing&Pressure Test - ' '6: Electrical OF ERGrnd. - = 57: APPROVAL TO COVER-GUNITE- 7. Footings - , _ t 58. .Electrical Conduit-UndrarnH. . 8. Foundation ; - ! -• X59. Gas:Pipe, 0 Undrgrnd.,Test = 9. Water Pipe-Undrgrnd. ' a ' - '60. Backwash Lines,P-Trap, 0 Undrgrnd. _ 10. Structural Floor System j .61. APPROVAL TO DECK ` 11. Property Sewer Line & House,Connection: 62. Backwash & Receptor-Final- 12. Sewer Cap - I 63. Heater & Vent-Final 13. Roof., Drains I ' : 64. Plumbing.System- Final' _ • 14. Rough Plumbing ' - - 1 65. Electrical-Final - - , 15:Rough-Electrical-Conduit -- - ; - - - -''- , . - 66:Solar'S9stem-Final --- - ; '- 16. Rough Electric Wiring i !r7;:--1-1 - 67: Fencing&Access Approval . - -- 17. Rough Wiring Sign' r, . i- . : < , • , _ 68: APPROVED FOR PLASTERING 18i: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 Structures „ ,, ( 70. Underground Hydro - 22. Ducts, Ventilating ?! # • ' 1 ` 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough&Test;, ,, _ I ' I , i ' 72. Underground Flush I , , „ 24. 'Roof Framing_ I ' �' i:-, I - 7,..., '73. Undergrnd.Storage Tank 0 Gas 0 Oil _25. Roof Sheathing I - 74. Overhead Hydro - 26. T-Bar Ceiling (Structural);& Monocoat • ' - i ' - 75. Dry Chemical R 27. Frame andFlashing ' t 76. Dry Standpipe • 7 28. Cathing&Siding .' . 1 'i 77. FIXED SYSTEM FINAL ' 29.1l1hsulation` -. . 78. FIRE PREY. FINAL -30. Drywall Nailing , . Notes: . 31. Plaster Brown Coate , ' 1 ' / 32. Electrical Power Meter-Final - 33. Final Electric _- _ _ - 1y�/d'3 .CC 34. Final Heating &Air Conditioning /2,29.0.7 . a : - \* 35. Final Gas Pipe-Test • - 36. Hood or'Canopy. •., 1 . - • 37. Final Factory Fireplace ' ` I 38. Final Plumbing' ' �I '/y�, // 39. Water Service-Final ! ' ! " I i 40. Gas Service-Final I h18"43 . , 41. Solar Domestic-Final • . ' I • 1 - +__ ; 42. Backflow Preventer r ' 43. Backflow Irrigation t _. - - - I - 1 44. Landscape Irrigation:System !' , q I ' ' 45. Sound Attenuation - - - ` ' - - 46. Handicap Regulations, ' • 47. FINAL STRUCTURE & BUILDING 7- ' 48. Special RequirementsCompleted i ' 49. Electric Release totEdison .. - _ _ .__ - . . • • .1 50. Gas Release'to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY i' ' _ _ . l No, . ,. Date ._. __ _ - J •'—• "•. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY.OF COSTA-MESAk. - _ PERMIT NO - ^ TRACT NO. LOT NO. BLDG.NO. I _ , i6L 1 / 1 / _ . I.,'1 'CONSTRUCTION PERMIT arS1/f Applicant's Mailing Address J` S n e r O '4" R y / t!X. TYPE OF CONSTRUCTION i-'-NEW ❑ ADD ❑ ALTERATION LJ REPAIR . _ \ Project Address L �'/r S/� /J ❑ CONVERSION ❑ DEMOLISH ❑ OTHER, '+ry \'\L ' N 6 6 di 6grs-5/9/J DESCRIPTION OF WORK Owner's Name Pt✓�1e v+i"-At; Phone ZONING REGULATIONS • t1 iv Address '/5_37/nore✓r. /9,�jRc<_ 7 _ TYPE OF PERMITy�yS5 0 GRADING ❑ FOUNDATION U STRUCTURAL A.P.# - ZONE Arch/Eng.- License No. ❑ TENANT ALJ ELECTRICAL El PLUMBING El MECHANICAL PLNG.REF.* ' - BUILDING Address� _ ❑ OTHER ScTRerir rn S•T w Nip 6a r4////t Phone - _ 5. ` TO BUILDING • _ _ REAR YARD(TO P/L) - . . , \. .o Contractor's Name r / n r/-/ � PROJECT DESCRIPTION Sq. FT. ZQ�© OCCUPANCY F� PROPERTY LINE _q r It/ Lp LEFT SIDE YARD ' RIGHT SIDE YARD SS //!ANliP.se '4- 9r/9 !f/ / 3 CON STRUCTION TYPE VALUATION$ Address Imailingl� / /� - - _ , LicenseNO. __ 40 S(e� ZONE - GRADING CU. 'ACRES PKG.SPACE REQ. • PROVIDED r.. LICENSED CONT ACTOR DECLARATION - Remarks: r• 4 . STREET WIDTH PARK FEE.$ ; r (whereby affirm7 that I am licensedion under provisions of Charterro9i ns Code, nd - " •'��� with section 7000) of Division 3 of the Business and Professions Code, and r SPECIAL CONDITIONS: mylkense is in full ce and:effect. license Cl ss Lken o.1 Z PLUMBING • ' . i Je'• Signature _ - Bar Sink Sewer Cap ELECTRICAL RS'COMPENSATION D CLARATI . . - , :Yeby affirm that I have a certificateof conseo tito.self-Insure or a certificate - _ _ - • ._. �. Automatic Washer _ Meter Dover 100 amps , ` I Of Workers' Compensation Insurance,'or a ce titled'copy thereof (Section ' Backflow Preventer---1-- -- Sewer Connection . .. 3800, Lab. Ct.--4(,...\-- ! ; Backflow Irrigation Solar Collectors I ' • Construction Pole . Sub Panel Policy No. i I Company • - - • Cooking Unit `' • .Sub Pole ertified copy is hereby furnished. - Bathtubs Solar Piping , I ertitl d opy Is filed with the city B n - i ' Solar Tank '• Dishwasher Motors 00-1 HP ❑1Ya-6 • Date /T�Q' S Applicant �� Clarifiers .- - - EXEMPT ONIFR'OM WORKERS'CO PENSATI E�RATIAN . Dryers"-❑Gas ❑Electric - ' - - Inc.Solaf ❑9-15 HP ❑16-15+ ' - ' • , (This section need not be completed if the perm' one hundred ($100)or Dishwasher Swimming Pool w/Spa less). , 4' Fan , Microwave ' I certify that in the performance of the work for which this permit is Issued I ; Drinking Fountains ' Urinal ' - - . shall not employ any person In any manner so as to become subject to the - - - r, F.A.U. r { .•ti • Pole Light • , Workers' Compensation Laws of California.: I : Floor Drains Water Closet ' - ' Date Signature ' - - - - -- - NOTICE:-If,after making this declaration,you should become Subject to-the--• ' Floor Sinks i. Water Heater _ - - - .. Fixtures !/ Range - Workers'. Compensation provisions of the Labor Code, you must forthwith - Devise Boxes comply with' such provisions.:or this permit shall be 'deemed revoked., ' Gas Service Outlets _ Water Service • • I Sign, CONSTRUCTION:LENDING AGENCY- - - ' I hereby affirm that there is a I construction lending agency for the performance I - Interceptors I I-• ' I r - I Outlets " ' Standing Sections , ' of the work for which-this' permit is Issued -(Section 3097. Civ. C.) . -' '- - ' - • i Lender's Name' • I = • - • - '" '' ' : Kitchen'Sink' - Switches ,Trash Compactor Lender's Address. - I " ' _ I Garbage Disposal OWNER BUILDER DECLARATION' r „ < - Lavatories • 1 - I hereby:affirm that I a'm exempt from the r Contractor's License Law for the - - - - ' Generator 00-5 KW 05-15 KW : - ' following reason (Section.7031':5 Business and Professional Code: Any city or P-Trap - - - - - • county which'requires a permit to construct,alter Improve,demolish or repair . - i Transformer ❑15-50 KW - •• any structure; prior to its•issuance,•also requires the applicant for such permit Roof Drains _ - • ' .Tile a signed statement that he/she is licensed pursuant to the:provisions of - - '.- I ❑50-I KW• ' Contractor's'License Law(Chapter 9(commencing:with Section 7000) of ' - .Reinspection Fee $15 Y,51sion 3 -of the Business and'Professions Code).or that,he/she Is exempt Showers , , • Reinspection Fee , $15 - - .ierefrom and the'basis for the alleged exemption..Any;violation of Section ' _ '- Meter ❑up to 100 amps Issue Fee, . '$ 3 .7031',5 by-any applicant fora.permit'subjects'the ,applicant to a'.civil - - - . - genalty of not more than five hundred dollars($500) � , _ . i . 1 Service Sink - Issue Fee t $ 3 Zoning Approved By ' Date • LJ I, as owner of:the property or my employees With wages,as their sole MECHANICAL • compensation will-do the work,and the structure is not Intended or offered _ i _ Application Approved By - ' nate for sale'(Section 7044; Business'and Professional Code: The.Contractor's - - i j • Refrigeration S stein I� •/S'� License Law does not apply to an owner of a property who builds or improves Bailer g Y Application Issued By 'Date thereon,:and who does,such work himself/herself or through his or her own - - 1 employees, provided that such improvements are not intended or offered for Duct-I i ' ❑0..100,000 BTU ❑10Q000BTU. - - , sale. If, however, the building or improvement is sold within one year of com- SUMMARY OF FEES pletion, the owner'will have the burden of proving he/she did not build or im- i - - - • LJorve for the purpose of,sale). . , - i I Duct-Structural • System Repair/Alteration BUILDING PERMIT $ SMIP $ • ' I, as owner of the property,am exclusively contracting with'licensed con- i . , , . 1 tractors to construct the project (Section 7044,Business and Professions Code: l . Duct-Ventilating •_ , - _ - ' _ j _ _ _ - PLAN CHECK- $' - PERMIT The Contractor's License Law does not apply to an owner of property who - - I ISSUANCE ) i $ builds or Improves thereon,and who contracts for such projects with a con- - Exhaust System ❑ Multiple❑ PLUMBING $, ( tractor(s) license pursuant to the Contractor's License Law). 1 'PLAN CHECK' $ GRADING $ ❑'l am exempt under Section B.& P.C.for this reason - Firepl/Fact.Bit. ICBG# , - �� $ 'ELECTRICAL S. ' Date - Owner- ' I Heating�System&Ducting i MICROFILM $ ' • I hereby certify-that.) have-read-this application and state that the above- 1 ❑0.100,000 BTU 0100,000 BT1r-- _ _ _ _ - :PLAN CHECK' $ Information Is correct. I agree to comply with all city and county ordinances ' I I TOTAL FEE' - $ and state laws relating to building construction,land hereby authorize repro- Hood or Type I ❑ 1 • 'MECHANICAL $. , sentatives of is.cit ,to ent- pon the above-mentioned property for yP Reinspection Fee; - - $15 I ' LESS / Canopy. , .PLAN CHECK $ , ADVANCED PC ! $ Inspection o- es. , Type II ❑ , i Signature Date i ' ' 1 - ( Registers• 1 ( ' Issue Fee I I t (-` Drivers' :cense or'S„ram. _ ( i $ 3 I , FINAL FEE $ ' �J .-------.__().65.14_6-rev.12/82 - White-Building;Canary-Applicant;Pink-Accounting;..... oldenrod -Assessor - _ - -- - .. _ • : i'.'GONSTRUCTION AND,PLANN - • - PO `SPA - " t • •Date Inspector - Date Inspector "APPROVALS Permit# = 63-'1APPROVALS Permit# ; d, Temporary Electrical Service or Pole 52. Pool & Equipment Location • - 2. ,SoilPipe-Undrgrndr ' ' - - 53. Steel Reinforcement - - • . ^ 3: Electrical Conduit Utility-Undrgrnd: : ' -54. Forms .. • .4'. Electrical-Conduit-Undrgrnd'. - . 55. Electrical Bonding - . 5. Steel Reinforcement - ' 1 ._ _ 56. Rough Plumbing & Pressure Test- - , '6. Electrical LIFER Grnd. .....* ..,. . ' . - . 57. APPROVAL TO COVE R-GUNITE 7. Foings ! 58. Electrical Conduit-Undrornd. _ 8. Foundation ._ ' - -59. Gas'Pipe, 0 Undrgrnd.,Test. - 9. Water Pipe Uridrgrnd.- ..;., _,_ 60. Backwash Lines,P-Trap, 0 Undrgrnd. . 10. Structural Floor System ' • i 61. APPROVAL TO DECK ' , 11. Property Sewer Line &;House Connections -• ' - 62. Backwash &;Receptor-Final -! 12. Sewer Cap .• ' . ' 63. Heater & Vent-Final ' • ' 13. Roof Drains - ' . ' 64. Plumbing System -Final • - 14. 'Rough Plumbing' - I 65. Electrical-Final - ' 15. Rough Electrical:Conduit 1 " - -- --- - "--' - ` .66.--Solar System-Final - _ •_16. Rough Electric Wiring, - 1: ' - -- ,67. Fencing Si-Access Approval - . 17. Rough Wiririg`Sign`. , i ,68. APPROVED FOR.PLASTERING - 18. Rough Electrical-T.Bar Ceiling ' ' '1 - 169. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air:Conditioning } ! - , FIRE DEPT, REQUIREMENT ' 20. Rough.Factory-Fireplace j APPROVALS Permit# 21. Ducts, in Structure j 701\Underground Hydro , 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oil - 23. Gas Pipe-Rough & Test`, 72. Underground Flush , 24. Roof Framing I - - �, _ - 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25, Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural)i& 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 - Notes: . I 31.'Plaster Brown Coat I 32. •Electrical Power Meter-Final ! - , • 33. Final Electric ! _ , J2/5/ _ CC . i 34. Final Heating&Air Conditioning /2-8 87' 35. Final Gas Pipe-Test ' ' ': I't --. • - 36. Hood or Canopy - 37. Final Factory Fireplace - , . 38. Final Plumbing. I /Zj-f3 1i� : 39. Water Service-Final ' ' ' 40. Gas Service-Final i � , (2--s-e, 41. Solar Domestic-Final - - 42. Backflow Preventer - i 'y'. - .. 43. Backflow Irrigation ? 44. Landscape Irrigation System, . . , 45. Sound.Attenuation r ,L - 46. Handicap Regulations t '; 47. FINAL STRUCTUREI& BUILDING ' i' • 48. Special Requirements Completed - ' 49. Electric Release to Edison _ - ._ . - • 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY , in No, - Date . OWNER BURR, E. T. / DATE 6-13-56 JOB ADDRESS 216 20th Street BUILDING PERMIT NO. 3176 GENERAL CONTRACTOR Crank Brothers VALUE $ 200.00 I. BLOCK TRACT Reroof Dwelling GROUP I TYPE V ZONE Rh FIRE DISTRICT 3206 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISSUED DATE NUMBER Footing Trench U Foundation Forms and Grade to Garage / Rough Framing `� Plumbing, Rough to Slab dit7 L Plumbing, Rough Complete Temporary Pole Mir 1. Wiring, Rough I�,. t LV Heating,Rough T L Heating, Final LI&' / 1r Sewer, House Sewer,St. .' ' • Septic Tank or Cesspool I • V•Hng, In OutJcr F, :ring Plumbing,Final,Fixtures Complete Plumbing, Final Gas Test Wiring,Final _ Occupancy FORM 210 3M 10.25 3176 =' Costa Mesa Building I$t1Z3inent . APPLICATION FOR PERMIT P. 317 3206 BUILDING 1 I' COSTA MESAESA,, CALIFORNIAC FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN Receipt No. Permit No. Building Zit -.2 off' - , t 3/ 7 G Address Costa Mesa, California Received by /Date Rec'd._/II Date Issued Nearest 0 O I(p -/1 —S vi 4 - /3 t( ' Cross St. t/ re n el Building P.r e d r r Address Ma ler �1 •/ Costa Mesa, California Address .21 4, - X204, Nearest City O S to M esa TeNol.A/ r / Cross St. p Jp Q( Zone ' / No.of Type Group /J Architect or Lic. -�� Plans I // �// Engineer No. Approved/ by Date Address CORRECTIONS NI 1--ntractorpan k/•4I/��( t'e5 . No. ��)99 ...dress 12.(, (Anlieniptid I WO % Legal I Block Lot I I / Description No. I Tract _ (Attach Metes and Bounds) 1 No.of Bldgs. ��� /711;\ , 11 Size of Lot I Now on Lot I �- �L7 �,( t� liseof I No.of I No.of " '� 0 Existing Bldg. Families Rooms �_� 1• z Setback Line from Rear Yard i/',•' 7 - _ _ - Center of Street Side Yard " 1 ,. 3 Z �,�� r DESCRIPTION OF WORK ��/t New I I Alteration I I Addition I G'T I/ "1 L. Cfl c'!Ar .. �,�, ../ —in 1':-14W Repair I /` I Moving I I Demolish I Building No.of Size Rooms Stories Exterior Wall I Roof — Co-Bring Covering APPROVALS B._dingeW Q 0 �Q dj Foundation Location Inspector • Date Forms,Materials, ® " Ow i n 7Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Int. with all City Ordinances and State Laws regulating building construe i Lath.Ext Si nature of Permittee v L'�C``q� Plaster, Int Authorized Agt. Plaster,Ext Valuation Permit Fee $ a _ Masonry Reinforced �� O Plan Check$ Bond Beam $ Total Fee $ I FINAL • t C 0 J c J C o a a JUN 13-56Peyesar 92ca! ' Z.(`0 Street PLOT PLAN Show location and distances from property line and between buildings. ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FI77i13TiniTl]t7 'PERMIT 5e 50 TL; P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A REC BY PERMIT - 5 O For Applicant to Fill in Completelytel� — Use Ink Only /AVX 1Vf ADDRESS BUILDING 2,1Ge�j •.. A.P. NO. 2$?6:-, —2-co-2-coOro OWNER OR \® efr€g ADDRESS 214 E. 2o /4/ S . TENANT t/ G� MAI LINO b UNIT N ADDRESS a' lel to �((. R SPACE jO. CITY Cc� 04112--SANOL♦���ry 4l tom' LOT �� 213 BLK. NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION Now�s LENDER ^ ///��� ♦ �" BRANCH �p !/.,/ �J �� OWNER /may ADDRESS V(/ - VALUE (ADO ARCHITECT ...—..e TEL. USE E J OR ENGINEER NO. s(��) ADDRESS 1sC ZONE 1�� TYPE GROUP p/ CONTRACTOR Yvfl>!aA Coe, APPROVED DATE �O/71 ADDRESS 6 t 7.a11�srFF llss�r CITY ". -ns,. 041 _- - N0 1-. 6 4i Stmi3 F STATE � CITY APPROVED SETBACKS LIC.NO. 'tra LIC. NO. kl SIZE 'NO.OF SLOGS. (FROM C/L STREET/ D. OF LOT NOW ON LOT FRONT FT. E USE OF V) EXISTING BLDG. tOgiSsestii al R SIDE FT. ta Separate permits are required for L.SIDE FT. E. Gi electric,plumbing and heating work. REAR FT. F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a Q CtentA Cly - 1 _ kkl SI APP R VED�. C`l� Lv(RDJ/- �Ves gnCa La . O. I hereby acknowledge that I have read this application and state a that the above Information is correct and agree to comply with M. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of o ILI the State of California. I hereby certify that I em properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the provisions of the State of California Business VALUATION PERMIT FEE ��v Y and Professions Code, Div`*.n 3,C :•ter 9 $ v+ / m PLAN CHECK $ 'n Signature of _ -.' ��7• o .r/ l:.l,- -. Permofttee I-. /�s S COO TAX $ O, rt) U Authorized Age r,/•ate p0 � TOTAL PAID $ 5 Co 'COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 SOGc 7%Dn-,nn 1I"a 26 TL •. RECEIV BV PERMIT - /� " For Applicant to Fill in Completely —Use Ink Only ( `J" so- 7 •Z_S " BUILDING A.P. NO. LIZ4-Zo1 - 1/tC ADDRESS 216 E•2o tr. 1 y OWNER OR ADDRESS 7-16e . 207.••L' sr TENANT J . 1) -rere r MAILING •4� SPACEONO. ADDRESS 4Igo E. -2da'l sr 13 TR.NO. 1 LOT BLK. TE CITY COSTI9 COlint NOL6NS4il3 NEW ADD ALTER (REPAIR MOVING DEMOLISH CONSTRUCTION ��� LENDER 1----' II �-p BRANCH OWNER �/ IIPer a K41- ADDRESS ,/� VALUE ppp ARCHITECT \ T� S 1_n1 - TEOL.49405. USE 3 Fr` E6� r OR ENGINEER J aYlot�-G.�sW /J �770'Iw /Ks �^ ADDRESS q'62 'bwlO AVE. Cfij ZONE ,\ I/� TVP& ri GROUP JQ_ 3 Ntwpoel- 11 � � Ic APPROVED. _ Q 2g_ PO CONTRACTOR ! 1t� R BVc (,(.(J(` DATE G ADDRESS )& CI �.0� ` _o• ilk 3 CITY COS•{d M+ } TNGL.640913 F' STATE tt�� CITY APPROVED SETBACKS LIC. NO.p3�' S 21 LIC.NO. tal SIZE NO.OF BLOCS. �yfr � (FROM C/L STpEET) 1 OF LOT I NOW ON LOT ""r•-•:" FRONT 25 FT. 0 Q USE OFF/ e, cn EXISTING BLDG. R SIDE _lFT. 0 /r FSeparate permits are required for L.SIDE S FT. fel G electric,plumbing and heating work: REAR /r 7 FT. 6 / IW.. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ASTION . zeS� o_2' /.3'47-80 DATE l ' R '" N^CW tb.asr 6Ja..aGAO S_ 5o—(3SS2 APPROVED g-33-go >•' .c25-25 T .HY ROtY�a�l�/f DATF7a-5 .-1 IY W 0 I hereby acknowledge that I have read this application and state N cg that the above Information Is correct and agree to comply with ei 11• all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of tIOLD FOR SPECIALQUIREMENT$ F. W the State of California. 2 I hereby certify that I am properly licensed as a contractor under 2oS�SD.FT. 67, 98 — 61 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of Cal ornia Business VALUATION PERMIT FEE and Professions Code, Div Ion 3,Cha :r 9. 2.23• n E n PLAN CHECK E 4 ; / S d n Signature •fs0110. ' �/-yy o 9 Per mlttee n $67/ ,t/9 TAX $ 4.7/ Authorized Age.Date or , 20 // / `•— TOTAL PAID E 6.7: '2 V u • .y COSTA MESA BUILDING-SAFETY DEPARTMENT APPLIC TION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 _ r RE CEI PERMIT For ApplicantictotoFill in Completely —lJUse Ink Only N� 5 01 G 9 ADDRESSG ` /4, ( LO `� S7` A.P. NO. � z ��/ — O BUILDING ea. as �j icaa OWNER OR ,/ / `C, '— J _ ' ADDRESS L(, • TENANT I�//vLsis.t. if2{�(�•�/ .. .__ UNIT OR MAI LING Ca``J SPACE NO. ADDRESS TSR NNO�. j.�� LOT�T 4BLK. CITY NOL6Ys-Yfl' ' / R R t 21 VI I 1 CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLIS LENDER w/ BRANCH OWNER ADDRESS 0r te VALUE USE $ rot ARCHITECT TEL. J OR ENGINEER NO. ADDRESS ZONE crITYPE GROUP(�API CONTRACTOR 020-102—es BVPROVED DATE J/��/� ADDRESS TEL. CITY NO. APPROVED SETBAQIilif OF COSTA MESA --i STATE CITY LIC. NO. LIC.NO. 0. SIZE NO.OF BLDGS. (FROM C/L STRE :. _ _ 6, OF LOT I NOW ON LOT FRONT FT:, r sem ' I 'Iv-v'i.[!/y/,I d . 1 . S.ey.= I,l1F/// Q USE OF CA EXISTING BLDG. R.SIDE FT. ' col PAW FSeparate permits are required for L.SIDE FT. u _._... G electric,plumbing and heating work. _ REAR FT. (—I USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q l DATE ��,/Q/p� APPROVED Q ! V r q 90 JAc A ROVED%? LS DATE ED Z CJ DCIV """[LL� v C�� x w aI hereby acknowledge that I have read this application and state n x that the above Information is correct and agree to comply with A. all laws regulating building construction, end I shall not employ sl Z any person in violation of the workman's compensation laws of 9.1 I the State of California. ; m I hereby certify that I am properly licensed as a contractor under SQ. FT. w D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E and Professions Code,Division 3,Chap J ` m Signature of PLAN CHECK $ o Permittee $ Soo TAX $ u. , s-D u. or �J� Authorized Ag Date �--�s (� TOTAL PAID $ C- St U