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LICENSED COMNACTOFS OECL�PRTION: I hereby eflim uMer paneYy d perjury ihel I am liceneed uMer prwieWu d Chaqx 9
�mmmentlip Mh Sectan )000) d Diwun ] M the Butlnen enC Prolecvone Code. end mY limnw u in IWI Mce and eHea.
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OWNEN BUILDEfl D CIANATION: I Mreby tlfirm uMar penelly d perN�Y �� �� emnq hom iM CONretlas lxenae Law fa ihs
Idbwvp ren+on (Saeion ]031.5 &reiwse eM Roleuione Code: Airy ciy a couny xfiidi requ'ues a permn b mrewcL etlr. improva.
� ,�amoleh, a rpei eny elr�clure: pior b ila owaMa, e6o reyuim tM eppliam ta wch permu lo fila e sgME etelamenl ihet M a ehs
'- �1�,-; I�icenead punuenl �o Ihe pwuimf al IM Conlredae L'xame Lew �Cheqv 9(oanmmaiq wilh Sai]ion ]OW) W Oirvebn 3 W tM
: i�ana5f enE Folevioru Cadal a Iliq Ir a ehe b e[emp ihxNmm enE IM bmis.la„Ma NbBb axemNon. My viob�on d SeQon
".]W 1.5 by enY aOW�t Iw e permn eubptle IM epplicenl to e i'I pendry W ml maa ihan liw huMred dd4n �SSW�I�
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� I.mmwwrWlMpope�Ywmyempbyeeev.ihweqeemiheiwbwmpeneelion.willdolhaxak.e�dihseN�dunorwl'vnaMeA
or Meradl« eab (Senion l0aa. Bueimo e'M PMnebna COEe: Tha Coniredonlioeme lewEme nol epplyto en ownerd piopeity
who buiM « inMaen inerem. aM Ma aoee •ucn xwk HmaeH w havel m WwOh he «her own emWmaa. V�aE �hm ach
impovemenW ara M inleMed a d1aeE fa eab. p. howmx.lhe Wikiip a inpwemeM ie edtl xilhin oroY� d mmpb�ion. �he
owiwrbuikw will heve IM WNm d povi�q M w Me Etl ml buiN ar imprma /a the qvpma d eebl.
� I. m owiwr d �M -pooenY. em extl�MY conirec�q wnh bved oonvectae ro wlneUiw IM pda (Sed'on'lou. Bue"vwa erd
r,ae�m. coa.;me c�vma. ucense �.. eo.. �a mNr m.� ,w,�,. a awenv .n„ wuf. a mww« in.�em ene .ro
wnVazle la wN qqetl5 wiN e wNreCw(e) IcenSeE queuenl Io lM Cantiedm liwnae Isw).
� I em ezemq uMr Seciion: B. 8 P.C., br Nie -ieean: �— �
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I do hereby wnEy Uui l em ewere M vd uM«aunA the npuiiemeMa d Caliomie Haetlh ard Salery COEe Setliam 25505. R5533. vd
25534. enJ Nat 1 a ury Mure Wikinp ¢apam xill / wil mi (�` �) ��o cwnpy wih eaid mta mAa enE tM nqu'nemeMe br
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WONREN'S COYFENSATON DKL�N�TION: 1 hweby df �uds parel�y d pajury an d tM tdbwinp dWxmoro:
� I hera enJ vnl meiNen a cenRrata W mneent Io eMimun lur xvken' oom0ermalian, o Aa'� la bY SWim 3'la0 d �M Lebor
coee. i« ins osd�. d in. � i« �n ma o�n 4 4.�d.
�� n.ue ena.A meimew wonwY wmo�on inurenoe..s rea��e M swn, aroo a ub �mar coa.. ror me o«�«mvre a me
wak la wliich Mu pem� o iesued. My waFen' mmyeramun ireurem<an'v end pd'v.y numbar ue:
��;,,: SII�fE F'UNL rXFIfc65
Pd'ryNumber. L VV U7bU 64i3"v/�t3
(1M1is aMion mad rat 6e mmC�eC ] �M Gmmt e b aro �uMmd Edlers IS100/ w ba.J
� I cenay � in iM1a pa�lamerrw d On wark lar xfich t�ia pemN b imusd. I Mdl ml employ vry preon in enY manMr ao m lo
becoma w4� to �M1e xoMen' canGM��bn kxa M Celibmu. eM Wree tIW il I ahwk bemme euM� b IM xMae'
wmianxtion Vr 'aone SeUion 9)00 d iM labor Coda. I ehell I wn� mmpfy ' iA�o.w/ prowaru
Oua: Appl'raY' C [ �
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� Wamlip: Fallu ro sxun wohan' compxwtlon mwrep� /a un/awN( �nd�hsl/ ubJ�ct m xlplqw b NMnsl pwMs� uM
c/vll flro� up ro om hunCretl fMuunA ao1Hn (S1W,000), M aAf/tlon ro M� cwt ol rortp�nutbrt a�pu u provWM br In
S�ctlon 9)O6 of Me 4Dor Cade, Intxuq mtl �ttornryllNa.
CONSTRUCTON LENOINO AOENCY: 1 Mmby etFrm uMer pendry W perN�Y �� �� a e can9�udian bidip epenry br Ihe
pe�lwmeMe d iM xwk /w whidi �hc permi is bauad (Seaion 309]. C'v. C�.
LENpEN'S NAME i.,
LENOEN'S AUUNE34: �
I ceniy Ihel I luw reeE Nia epplcetion enE peu �hel Me ebove iMormelion ia conan. I epree to compy xith NI My erd counly adine�ee
enE eie�e lexs releiinp b buildup ca�ruabn eM heraby einharaa reprecentetivee d Ihu dry ro mtx upan �ha above�maMioneE prtrpery
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(515b48.WP) Whne-Buildiiq 8 Selely; 0 Fle; Cenery-App!iraN; Pink-Revanue; Ookenm�Avan.w
CITY" iiF COSTA MESA - tiUILuING PEkMIi
P�.RM NO: F 085G01
PEkMIT NO: F G85t�81 PLAN CHECA NO: N GOtiT: N SOFP: N
Ll.1NtiTRlICT1l.1N 1 YYG; v-N Pc:i'tMI'I i iiFr:; FI�'u PURPG3E: NEW
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JVH 1.lE.SI'.RZPIIVN ; LdL6St' $1NliLfi I��AMILY Rt7S11), �/UJL' IiAKI1lsL S(f l�l:
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FLU 1 LI�UNuiiY 'ftlb iih iiAs'[ie:(i f3.75 8. i5
riG 2 Silvv7lli a.'7� !'7.50
Pi.ii 1 STNii, riI YCiiEN CITY OF COSTA MESA �' •" ". �"
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CONSTHUCTION AND PLANNING � PQOL SPA
APPROVALS Permit# Date Inspector ApppoVALS Permit# Date Inspector
..`
7. Temporary Electrical Service or Pole , 52. Pool & Equipment Location
2. Soii Pipe-Undrgrnd. ''� - ����� 53. Steel Reinforcement �
ti .
�r?�3: ElectricaCGenduit-Utility-Undrgrnd. . 54. Forms � '
� '�4'. ElectricahCOndQit�Undrgmd.� . 55. Electrical Bonding
,����`$teei Relnforceme9t - 56. Rough Plumbing & Pressure Test
���6.' -Electrica{�I�FERGtnd. � 57. APPROVAL l'0 COVER�GUNITE -
,�i.�
,~7= Footings�.;; -' � 58. Electrical Condui[1Undrgrnd.
.�$' Foundatior'v " 59. Gas Pipe, O Undfgrnd., Tett - �
9. UJater Pipe-Und�md. � � S� . Backwash Lines, P,Trap, O Undrgrnd.
70. Structural FloorSvstem 67. APPROVALT ECK
t t. Property Sewe� Line� House.�Connection, � G. Backwash & Rece�ptor-Final •
. i ���
12. Sewer Cap �' � o �63. Heater & Vent•Fir7al '
13. Roof Drains .`�, __ `. 64. Plumbing System � Final -
t4. Rovgh Plumbin4� . 85. Electrica6FinaV
. 15. Rough Electricat Contluii . 66. Solar SYstem-Fin� '
16. Rough Electric,tT�iririg„ �, 6�. Fencing & AcceSs-ApProval
77. Rough Wiring S'rLn �� � 68. APPROVED P�R�PLASTERING
18. Rough ElectricaJjT Bar Ceiling -* � 69. P00 VSPA SYST�MS FINRL �
� 19. Rough H, tiry & Ai� Conditioning _-_ �, r F�jtE�J�EPT,.jiEQUIBEMEiVT „ � ? _ _ _ _ _, _ �� �
20. �ou� F�tor,b Fir�¢lace S�r �� , � '� � � ;T AppF�IOVAl�S � Pe[mit #��� � � � ' � ' _ _�
, i -�
- - � .
27.'Ducts,in_Stn7Ciure7>� � .•.. •-4 r S = .-+:� J �._'+^ ,.
c .- � �r H ,-� 70. _tJnderq+'otu�d I��dro �
22. 9ucu'�, Ve}�ul3�t�ng.� r. • , J '� •7/ � r�. 71. Prodtiej. iping L.-S'ias � Oil
23. as�R:pe�ough & Test .r53 �O�yq� / '� ^ � 72 Undergreund F'tUc7� +� -'
_ „ _ �,`..
24.'�oa�Frafiin „ e - � .. � i � _ �� r. . - -. ^ .� -+•- : - - �� -
9 = t �.y r .... 7�j Undergrnd. Stowyi� Tank O Gas O�il
25. Roo6.She�thing �r� a � v � � � �� � -� K e
74! Overhead Hydrd �
26. �-Ba'r�Ceiling (Struct'ural) & i��o�oat r � r '� � � 7� Dry Che�iGal _. j . � l � -� } � i - ' -
27..�rzme and F;ashiri � :� ,�, .. . ., ,- �. ` ' • _ f _ _ _ _ -� .� .
9 s �'X:: f � 76. DrY Sta��,ne,-.� ` � �{� .-� ,i _ i. : - -
"28. LattrTngffiSiding r:�'� "��-` "L• '% 77� FIXED'�StijSTE�r�'�_i�.NAk,� - j�"
J ��
.� ^ �� :i,
29. Insuiation K ^> M1 �• �� _ ' ���. 7�. �FIRE�PREV. F'IfVyl�L � �� �� �.� '�tr,.- _ -
n.�
30. Drywall R+�piling k_ f r '_.� _; j;�-f,EALTC� DEP�':�iEQt.JIREIVtE~NT=, _�'� �;�
. .: . � ,-r-- - i-.n-_'
. 31. Piaster B.fowrr.Coat .-> -� i F 79. �FINAL CPl�PEC D J '" ' •
. . � � �� _ __ ___ _ �-
_' 32.;Electricai�onV.er tvie;'er=piqal '�7 �1' � 8Q? FOOD CERTI��CATE I$SL1EQ, y''
� ., . ..
- 33. �Ina{;Elegtrics� 4 . � a .� Notes: � �.�� � � � - '
� -
�� 34. �Finat�Heafing_� Air Condicioning � ;� '4 , ( � I� -• � �� . ^ - _
' 35. ��inal Gas pip6 Test , �,�_ .. /(0 /� � ' - :j ��� k � � � , ' � - -
, �
� ;1
'� 36. Hood�or GanoPY k �� . Y � �� x � � r ^ - T � :. -r • - ' '
3 " ' �, -
= � �' ` �: . . ,
- 37. E.inai.Factory Firepiace ._ - .,: . � ' - . : �i� ..
' 35 FinaRPlumbing r: �' • ] -'�' `� i t�C {���I -y : F � . ----
- ' • ] % hJ_7.'. � , ... . r. ., �
� 39. WateiSer"vice-Final � � .i. � ��".�i , _ :� r , '�
��40. GasSzrviee-final ' ---' - e r. i � a � � *`
-;41. SolarOomesticFinal` = � " " � � . ' ; -
_ �a � _,
42. 3ackflow�PreVenter � � � � P - - -
J �
- 43. Backflow�irrigation ,: - � � - ; �� '' . . �. ' ' . . -
i
' -
44. Landscape IrLigatiorNSystem � K % 7 - 'V ' --' _.� + _ ' � ' ` � � ' - '
- S 5' n :�. �
45. '�bund Atten�ation ` " „ ; { - � " ' � _ l '' _ -
.� 7
d_�6. �hiandicap.Regulatioru - - • � K _ � � , °
� ' ./ - t
47. �INl3i STRUETURE & BUILOING ` r '` ' = .
i . _ � �
4g. F�N<SL PLANNING ` � � � '� � _ ` . �
49. Electi�c Reiease to Edison ' : ,' ' ; - . '
�.
50. 6as f3elease to Southem Califor�iafGas Co � � a . • J = • - _ « _, . - .
57�. CER.T.IFICA7EOf OCCUPANCY � - � �� ' = � � , - - -
No. Date
ADDFES�OF BNLOING:
OMNER514YEIFNlONN:
♦
� �ow+�ss:
1PPL.AW1$M �UOPE55:
AXCNRECTOXFNfd1FFA:
ARCN.OP EINi.'S ADDPE55:
uc. ra.:
CONfNACTpfS1U1�:
CONiFACTOR4YY1C10
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UNT:
PtRMII Nir; F G85u81 i�iAN iii�.i'Ii iVir: u4154-�J'7 N ,. ".
3{ iF #;r ii �w ii ii ii li # if iF ;t ie iFtif "rF 3f 'rP �if ;i ie ## ii iF i'r iF iF �;e w# iF;l.itiF 1R;4» ii;f if;4'sr ii- ii� ii� if #��F w•;r �w if ti;e ie i4 ri�1F;r :f ie ii� �w iE 3'r 8i ie •%:r it iti i'e ir i'r've R
'lYP� Q1'Y u t S � R I r T T O Iv uiVi'.i' C�ST 't'tifAL C�Si
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LICENSEU CONfHACTORS UECLAflATION: I hereby eflim uMer penelly d pe�ury ihet I em IicaixE undar prrnisiom d Cheqer 9
(cwnmantlrp wilh Section 9000) d �Hbion 3 d ihe Buv�rees eM PrWeeeians Cab, erd my limnse u in lull brca end eXarJ.
CT' LJC. NO.: LIG QASS: LIC. NO.:
Da1e: Conlee�fa:
OWNEN BUILDEfl DECLAHRTION: I Mreby alfirm under paneXy d perNrY �� I em ecemp Irom iM Comreeoee licenee Lew Iw Ma
Idlowip rasvon (Seaion )W 1.5 Buanma eM PMes�bro COEe: Any cily a counry xfiitli rpuirea e permtl to oorehuG, eMr, improve,
'wndoM1, w rapei eny st�w.lure, pv �o i�s bsuarwe, ebo repuiree �he epplimM /a wch permil lo fib e eip�wd etabmenl UW he a aM
icenseE Wnuenl �o IM Ma+eiona d Ne Con�redon Ucenu lew �Cheplm 9(oomme�M vrilh Setlbn ]000) W Oirvebn � d �M
rea erd Prdea'vn Codel n Ihm M a aM ia uamq thaekan arM �ha besw la Ihe dbpad azemqun. Am'violetion d Saaian
.031.5 Ey eny epWirenl for e permil aubpea iM epplceM lo e dvil penely d� mae tAen fve hundreE ddlen �SSOOp.
� I.eaownardlhaproparlyormyemployemwY�wepesesiMiedeoompenaeiian,willdothewak,endNselruclureendintenEeE
or Mered lar sde (Sedion ]0«. Busiiwss end Prdesaiona Coda: Tha Conlraciore Limme lewdoea iwt eppyto en ownmd peoparry
wM10 hlds a inpoves Ihereon, eM wlw daea auch wak Nmsell a Mnetl a throuph h6 or Mr ovm empbyeas. pronaeE ihet wch
impwamenb ere nd iMentletl rc oHaed la eeb. M, however, the WiNinp ar inpovemeN ia edd wtlt�in one yeer W oompblion, tha
ow�wr-0uildx will have �he Wrden d pwi�q M a ehe d'd rM buiH «impwe la IM quposa G eeb).
� I. m owr�er d tM1e PWeM. em exduaveN coniredM wilh lioensd wnVMon w omprud Ihe pN� (Setlion tOH. Bwi�» uM
Pmleacions Gode: Tha Comrenon Lironse lew doee M appry b en owner W prapeity who buika a imqwm iherson uM who
coMrecie for euch prol�a wil� e mnVmor�c) IkenseE punuem to tM Contreeoro Licensa Lewl.
� I em exemq uiMer Seciim: B. 8 P C., i« Nia �aeaon:
Deta: ��:
I do Mraby cenAy the� I em ewere W eM uMenteeM iM repuiremame d Celiwnie Nedih end Sefey Code Seeioro ?5505,?55]3, eM
25530. erd thel I a vry Mun buikirq ompeM will / wil nd (dreb me) �eeE to compy wIh aeid alete codee eM the repuiremema br
epaminlwmna�ruclbnormoERraiiwhwntheRi u�6Tl.renegamanlDielnd.ReakeniielmnsVudioneppl�ionsenmemq/mmNaee
provisions.
Dale: ApW���
WONKEH'S COYPENSATON DECLAX�TION: I hereby dfirm uMs pmMy d psjury aa d �ha Idbwiry dedvmiom:
� IheveenEwilmanlenecenEiutadoonaeMloaell-inaureMxorkeAcanpeneelion,mpovMeEfarbySedian3]OOdiMLebar
Cale, ta iM perlame�e d tha xnM lor wNch �M1ie permil ie ieeueE.
� I heve eM wi0 mein�en wakeie' wmpemeton insurarKa. m required by Secim 3100 d Ihe lebar Cade. br iM pa�lrcmenca d tM
wM Iw xhidi Mia pertn� b unued. MY workan' cwnpewtion inw�uice rartier eM pdi.y number ve:
Cemx:
Poliry Number:
ds se�s;wr neee rwr ae cwnnbred r rM aa+�a;e ror one nuneree eo�bm Isrool or bse.J
� I cMAy ihel in tha pe�lamerce d tM work for wM1ich �his pe�mil ia neued, I ehell ml empby ary pemn in eiry mennx n n to
becmre eubjed lo Ihe uoNsn' canpe�uetion lewe d Celibmu, eM egree Mel X I MouM become wbptl to IM xwken'
compenaaiion pwisoro ot Setlian 3100 d Iha lebor Coda, I ehdl lathv.'rh mmpy wnh ihme prwuioro.
Da�e: Mp���
Wam/ng: F�INrs ro ssc�ro wartwi romperuetlon rovereps h unNwNl, ane Msll �ubJect en smploysr to cNMnsl pm�ltls� utd
elvll llrro� up N ons hundrstl fhouunC tlollan (S1W,000), In e�JlHon h Ms ro�t ol rompxwfbR ��pm sa pravlME br In
Swtlon J]O6 0l Ms Labor CaW. In(xuf. antl etrornsY�� /sex
CONSTHUCTION LENDING AQENCY: I Mmby effirtn wiEer peneAy d per'Nry �hm �hae u a c�nn�ueian bnd'uq epmcy lar Ihe
penwmeM. a �n..�on� roe wnlN �ne w�nY u ewed (seaon 309'!. cM. c).
LENOEq'S NANE:
LENDEF'S ADDflE34:
', ceMiN Ihet I heva reeE thh epplcetian eM 9e�a Ihel the ebove informelbn is caneq. I apree iocamply wnh ell dry enE mumyadironm
and aime lewa releim9 to Wikiq wnarvnion vd Mreby eulhorae repreaentetives dihe d1Y lo entm upon �he ebwe-manliaied paperry
Id inspedion W�Wsas.
Dete:
Sp�alure d Ovnar/AgenVAppYmnUConirean
(St51d6.WP) W�ne-BuilEip 8 Selery; Oreer�-Fle; Cenery-Appicenl; Rnk-Flevenue: GOltlenro�Aeaumr
y
1 i;AS 5�RV1i:�:
1 SE:WEit, CvNNr',�iIiiN
u."/S
1`ii 6UTT,uTiJG EACIi 2"l.GG
�:Ni; or- Fi�:s
�D ��. � D
OCT 0 81997 �
CITY OF COSTA MESA
8 . "i S
IG.VII
� ` POO: �PA .
CONSTRUCTION AND PLANNING -
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
'=-�
7. TemporarY Elec[rical Service or Poie ' 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcemen[
3. Electrical Conduit Utility-Undr9rnd. 54. Forms
4. Electrical Conduit-Undr9rnd. 55. Electrical 8onding
5. Steel Reinforcement 56. Rough Plumbing & Pressure l'est
6. Elecirical UFER Grnd. 57. APPROVAL TO CdVER•GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. �Nater Pipe�Undrgrnd. 6Q. Backwash Lines, P�Trap, O Undrgrnd.
10. Structurai Floor System 61. APPROVAL•TO DECK .
11'. Property 5ewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 63. Heater & Vent-Pinal -
13. Roof Drains 64. Plumbin� SYstem - Final
74. Rough Plum6ing 65. Electrical-Final
15. fiough Electrical-Conduit 66. Solar SYstem-Final
76. Rough Elearic Wirin9 � 67. Fencing & Access APProval
17. Rough Wlring Sign � � � 6$. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heacin� & Air CAnditioning FIRE DEPT. REQUIREMENT 1
24'• Rough:Facto y Firepiace APPROVALS Permit #
27-: Or+tts, in 5truciure 70. Underground Hydro ,
22, D�as, Ventilating 71. Product Piping O Gas ❑ Oil
23: Gas Pipe-Rough & Test 72, Underground Flush
,
24. ROof Fram�ng' 13. Undergrnd. Storege Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
2� T?Bar CeilinB,�Structuraq & Monocoat 75. Dry Chemical
27. Frame and F�ishing 76. Dry Scandpipe
28. L�thing & Siding 77. FIXEO SYSTEM FINAL
.
29. IctsulaCion a � 78. fIRE PREV. FINAL
30. D�.ywaR NaAing HEALTH DEPT. REQUIREMENT
37. Plaster�BroW�*+Coat 79. FINAL INSPECTION
32, Esectri�al Pox�r MeterFinal S0. FOOD CERTIFICATE ISSUED �
33; Final Electric-. r, Notes:
34. Final Heat�n�&7Air Conditioning
. ,
3� F�pal Gas Pipe�Fest .
3� Hood or Cano-b� � '
x-
3F_, Final Factory�i�eplace �
3 . Fipal Plumbing _
3�,o W�ter Service�Final _
40- Gas Service-F2nal ' '
i
41; Solar Oort+estic-Final
42. Backflow Preventer - .
43. Backflo}v IPCigation
44. Landscape hiiqation System
45. Sound Attenuation
46. Handicap Reguiations
47: FINAL S7RUCTURE & BUILDING ,
48' FINAL-PLANNING
49. Eiectric Release to Edison
50: Gas Release•to 5ouchern California Gas Co
51. CERTIFICATE OF OCCUPANCY .
No. Date
�unness a e�nidxc: }�y 1 � 1 S�1 J-1�
wniExSNnuEIFa+a.va: NL•WPC�AT HTS lWC�
' �oow�ss 15�1 WESTCLIFF
N.&, 9266G
WUURY AWHE55:
ARCNRECTOXFNtlNFEN: (j(��JIS ENGINEERING
�xcxonerx+.•s�oon�ss: 9400 CAMPUS DR
N.B.
CONfpACTqf4NAME PACIrIC GRAND CONST
CMiPACT0A4YAlUNC 1501 WESTCLIFF
UNT:
lIQNO.: Q
ur+r:
CA 92u60
(719)031-7433
�ss: N.B. CA ucr+o.: 739904
92bbU unr: 260
UCENSED COHfNACTOPS DECLAflATION: I Mreby eRirm undar paneky d pe�jury Ihe� I em Icenaed uMx prwiaiwre ol Chaqer 9
(mmmendep wilh Saetion lOW) M Divirion 3 o11Aa Buaiirom vM Prafename Code. eM mY ���� � in /ull bce end elled.
cmuc.No.:07 118 uc.cuss: uc.No.: 7349 � EX,�: 06//9 8
� ode: � c�vmo,: � �`�✓�'�"K
OWNEP BUI� R OECIAPATION: 1 Mieby df�m uMer paaly d perjury i1W I em exanq trom Ihe Camretlon Lioene Lew ta tM
�dbhn0 reavon (Setlion )W 1.5 &n'sress arM %deevms Coda: Arry c�Y a cwn1Y wliitfi re0u'ven e Oertnil �o cambucl. edm.'vnPwa.
'+mdeM1, ar repei e�ry slrudure, qior lo na eweze, el+o reyuime �he epplirant la auch permn b fila e aqmd etetemem Me� M a eM
•iceosae wauem m me wovision. d ine com,en«a ucense �e. Icnena s(ownmmdre wnn saaw� �aoo1 a oh.ion a a �b
nav eed Prdeaiwu Code� w Ihe1 he w ehe is avemp iharelmm ene IM basu Ia Me elbpeE mampion. My vidalion W Safon
)W 1.5 Ey vry eppliran� for e permil aWpc�a IM epplicent b e mil pm�elry d nal mae Ihen Me huMnd Edlva �fS00�.
� I. aa owmr of ihe v�nY or my «npbyem wYh wegas m Ihei eda oompeneelion. vrill Ao ihe wak. eM Iha etruclura e ml inlmded
or oXared lor eele (Sec�ion )006, Butinesa end Prolesaiona Code: Tha Conireclore Liceme lawdaee mt appyto en owner W qopary
who Wida a inpvros iMreon• vM wFa does euch wa�k limaell m hanetl or ihrouBh hu a hx own mmpbyeee, prwided Ihet vuch
impo+emmU are m� imeMed rc Wared for seb. p. Mwewr. �M Wipi�p n inpmremeM b wk wi1Nn one Y^u d compbtion. tle
�,�,�ua« �;n na� ma w� a wo+��o n. «.na ad oa w�u «�mww. ia m. wmo�. a�I.
❑ I. es ovmar W ihe prapaM. d^ e�cluaiveh �ired'mp wilh liceneed conirecMon ro canetrud iM pmptl (Seeon )014. &rei�s vM
Profe�ione CaEe: Tha Conirman lironse Lew doea nd eppty to en owner d qoparly wlw buiWe a impovq �hereon eed wfio �
mnlrxn /n wd� piopea wiTh e mmema(e) IcenxE W�� to iM Comrmore Lieeroa fawl.
� I em uemp uMar Senion: B. 8 P.C.. br Nia reeaon:
Dale: Owner:
1 do Mnh' �en�N thei 1 em awere W eM uMersieM Hro reVuvemaro d Cellomie Heetlh erd SdM' COEa Setlbm?5505.455�. entl
2553a. end Mm 1 a e�ry Mun buikirp oeeupent will / xill rwi la�eb me) rieed b mmply wiM1 veid mms eods erd tM reery'vemenb br
e pmmil lwmnnrvnon a maE'�lraiianham iheAiSa tiyl�vagemenl Distnd. Rpidential ooneliudion eppiratiamen uemqimmiMee
prwieiona.
oma: nod�:
W ORKEN'S COMPENSATION DECLAF�TION: I hareby aifiim urdm peneXy W perjury aw d ihe blbwiiq dadve�iom:
� I heva eM wil meiMeN e aer4l�a d mmm�l to sellinwm la xaken' canparoetbn, m providetl fa by Setlim �100 d �he Labor
Coda. lor iM perlomwice d Ne wwk in w1Ycn �M1ia pxmil is ioiwd.
I7 I heve eM wil maMen xwke�e' mmperue�ian iroureMe. a� roquired by Seim 3]UO tl �he labor CoEe. far iM pe�ormerca d iM
7C" w� br which Min pe�mn ia issued. My warkare cwnpenwan inaurence certier vM pdiry numM va:
c�,: STATE FUNU EXPIRES
vw�N�me� n �� O4J30/98
,nu se�+� �..d �m ne canvroree e rM w�x i� ror me nuneree ddiars Isial a�%+.1
� I centy thm in Ihe perloimvra d ihe wak fa whkh ihie peimil is isaueE. I shell iwl empby eny peram in eny mennx o u to
eacon�e wbi� �o me women� canro��a� m... d ce���a e�d wree mm a i aroub neconb wtiea �o �hs ..aken�
�v��, o. �s�. a eaia, a�oo a me iee« code. i.ndi /ran/�n p� n mm W� �povoa�e�
ome: _ nvN��: //7
�Wam/ny: FeNu ro�xuro workeri rompruetlon rowreps Is unleTwlul, �ne Mtll �ubJect m aryrlo ro crlMro/ psns/tlIs erM
e/H/ �nu up ro om hvrdrM Mouurtl Jallan (JIO[{000), In �Cdltbn ro tlt� ewf ol rompwwHort S+�P� u provWM br In
Sxtlon J]O6 o11M La6or COW, Infans4 erM ettomsy's /eu.
CONSTHUCTION LENDINa AGENCY: I Irereby elfirm uMer parehy W parNry ihel �Mn ie e mnet�uaion bMirp epenq br iM
perloimenw d tha xwk lor xfiiM ihe parml ia owed (�� �>. C'v. C).
LENDEF'S NAME:
LENOEN'S ADOFE55:
��CBlllh'��1BI��1BV01B6f�1�119 B�ICB�WIIBIb 918181�1�1G 9bMB111�OfTBll0119 EOfI%1.�0QRlIOPo111G�Y'MI1�1BOMiGIId Cqlfl�i0l�iI11dKB8
eM etaie lews mWfq ta WiMvq muvuaion ard hereEy eu�Mrca nqemnimivp dthc'ny to eMm upon iM ebwa-men�iaied popaety
r« msv«�� wm�. ftONALD LEGft�iND
(5t51Jfi.WP) Whne-Buik'vqBSelely:Greee�Fle;Carary-AppSuni;Fnk-Revenue:Gakenmd��Aa»na
CITY uF CGSTA MEsA — BU1LuING PEHMIT
PERi�i Nti; M u�350U0
PERMIT NU: M v8508G PLAN CAECK NO; N GOVT: N SUPF: N
CONSTRi7CTIGN TYPE: V—N PERMIT TYF6: MfiC PUi'cPOS�:: N�W
JOB DESCRIP'IION ; 23235F SINGLE F[1MILY RESIL, 57uSF GAAAi;E Si1 F'T;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 i
COMMENTS: REF:B-850'70 "GARBAGE DISPOSAL"
*ie�ifif*r;r�e*�;rifi!**ifiFvE**�Fx�ririEiFiFiF*;r;rik;riFifif;rii*ifiF;cifiFil�**ieiF�Jf;riiri;rifik*if*iEw*iFikiF�7exif-1f*�xifxxxx;tx
Z O N Z N G R E Q U T R E M E N T S
S E T b A C IC S
------------ MAIN BUILDZNG ---------- --------- ACCESSOkY BUILDING -------�---
FRNT: FT IN REAk: E7' IN FRNT: F'T IN AEAR: F1' Liv
LEFT: FT IN RGHT: FT IN LEFT: FT TN k�Hl': FT 1N
PARRING AEQ: PRUV: PAItCEL: GGOGOOOG ZNE: REF' NO:
PLANNING N01'ES>
� � "
;,_. L E V fi L G P M E N T
NINt; P.FPRUIiEU bY .
ILLYNG APFRGVED bY ;
I�:�f��\�����J����
fF 3't 9F iF iF iI'iF if iF 9f ie sF if if'%f if' iFif it if if iF iF il'ie dF iF iF iF iF 9f if iF it'1'e i4 i'r iF'1F i'e Jr iQ it i! i'e ie it if
5 E R V I � E S R E{d 0 I R E M� N 1 S
LAIE;
uP.'I e: ;
LEGALIZATIGN:N F E E 5 U M M A R Y SI12UC'TURAl, SBi;M�NT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRr. SMIPi12ES GRALING
PERMIT 98,25
25Y SMIP/NtiN—H�5
PLAN
ISSUE FEE 22,00
BUILDING—LIV—> P6RMZT ISSUE PLAN—CHE(;St TO'1'AL PATD LUE
TOTALS----> 48.25 22.00 0.00 70."l5 7G.25 ,0'v
REVENUE LIVISIUN TOTI+.LS--> COLLECTED: 70.25 OVHRISHUR'T: ,"v"v
BLDG PMT PLUMBING ELECTRIC MECHANIi: FIRE SMIP/1'OT �RAUlNG P7,AN—CHEi:R
70.25
sF iF iI'if iF 3'r iF it if if iI if �F 9F iF f'e if if iI' iI"Jf i{' iF 9F iF 3F if 9FiF iI'iE i! 9I' iF 9I' iF i'r 9F iP iF IE iF 9FiF'JE sF'� iF iF iF s{' 3F iE iF'IF itiF iF %f 9F II' iEil' iI' iI' iF'JI"Ji' iI"IF w iF ik'JF 9F iF i+':i"I'e
I N U I V I L U A L F E E B R E A K D O W N
2YFE QTY L E 5 C k I P T I U N UNI'f CUSI 1'U'!'A'L CUST
HEC 1 INS7 FGRC—AIRIGRAV FURN <= iGu FC bTU 13."l5 13.�5
MEC 1 FACTORY FIREFLACE 9.SG 5.�'v
MEC 1 INST HOGL W/LUCTS FEu bY MEC EXIfAUSI 9.Si1 9.50
MEC 1 VEN?ILAZIuN FAN CuNN TG 5 LE iiUCi �.50 0.50
ME� 1 fiACH APFL NVT IN UT�,RpC�V1i�f'�E. 9.50 9,SG
ocr o s �ss�
CITY OF COSTA MESA
CONSTHUCTION AND PLANNING POO ;PA • .
APPROVALS Permit # Date Inspector qppflOVALS Permit # Date Inspector
�
i ,
t. Temporary Elecvica{ Service or Pole� 52, Pool & Equipment Location �
2. Soil Pipe�Undrgmd. 'j v�?, �7 3. Steel Reinforcement -
=.3i Electrica�Condult-Utility-Und�gmd. 54. Forms ' -
�'�r4': Electrical�Candutt_{lndrgrnd. 55. EleciricalBonding ��
J
��,-.S�.Stee7 Reinfnrcemest � . 56. Rough Plumbing & Preswre Test �
� �6�.�£Iectrica���EB�G�nd. 57. APPPOVALTOCOVER�GUNITE '?
} ��7; Pootings�'� „�y 58. Electricai Cond'ui't�Undrgrnd.
�S' foundati�n=� _' � 59. Gas Pipe, �7 UhUigmd., 7est . �
.-'C � n �
9. Water Pipe-Und��nd. j 60. Backwash Lines� �Trap, Q Undrgrnd.
10. Structural FioorSvstem -61. APPROVALT��ECK
7 i�. PropertY Sewe� Line$ Hous'e4-Connection 62, Backwash & Rece{�tor�Final �
12. Sewer Cap ' ' �o , 63. Heater & Vent-F'rnal '
13. Roof Drains �_ ' � �. 64. Plum6ing System - Fina4 ��-�
14. Rough Piumbing� �+" 65. Electrical-Pinal .
75. RoughElectrica�Cw�duie -'r� � • 66. SolarSystem�F�inal -
16. Rou9h Electric.lNirir�g, � .,� 67. Fencing & Access-Ap�roval r �
17. Rough Wiring Sign _ % - � 68. APPROVED F�yR',PLASTEft�NG � -
�.' �
18. Rough ElectricaT�T Bar Ceili g . � � 69. POOUSPA $YST�MS�FINAL ' � '-
79. Ro�gh Heatin� & Air Conditioning` _/ � �,� F j�EPT_REQUIREMENT
.� -i , . , n m r+ � Z .'Y _ � � .. , ��i� ; . . k r �'F � �':e.
� -• - - � . ihiy •2�7 '.K I- i. 1� �. 1: 7�� rt' .K .>+ C+7�ryi i*7iT7
20.,.f�ough Fa�tojj} Fi:��lace , � �'�, y�
�
.. ,., .z. S._., ',:` -ti ' a ,. e , APP OVAI i.,, Pe mit # .:. ��,_ .�, i
21. �Ducts, in�trflttunol � � .. .. �-+:� � � '7 �_ r: 70.H7.1ndergY�i{��.d sdro r .
22. DuctS. Ve1ttif�Iin�,�';: ' �S .K �7 y '; x} 1 77. Prodtlel�iping„t "as �Oil
23. �L'ias�Pape,�ouQh & Test i .r'� � n ;� �1 r, �z. UndergrsLtid FYt1.9�, .� ^'
24. itoof'-FraY in ' T �
� 9 r ;: � � � �� y '� ;� �� ,_� K '.: 7� Undergr�d. Sto�e� Tankt � Gas ��il � � ^
25. Roo,L.Sh�thing m t. •i � r i. '� �[7 '� v i: � 7'A�. Overhead Hyd?� � R,
26. T�Ba:%Ce�iing (StruciKual) & f��tz:oat ': ;� �~ �" r 7� Dr �i '� ` ��' �, �.-��� �';T
�� � .. n s , .r 7 F Y Che, cal ..D � � : . ���y -
27.,� r2mc and FlashiRg k �'x � K�� N �. r. �-m�-sT� ,��� i�;t
76. Dry $ta�4Sipe �,y , y ,5 .
- 28. LattSng ffiSiding .1 � '� �:7 � � � ��� 7 y FIXED;�S�TFy}�i��INA�. _, r� ;j:a;_ -Y�
..I �r
� 29. Insulatiort <i; « _ �5 .� •• � �� 78 fiRE PREV. FI(��L ' = ^ '1 �� '��'�
30. Dry�vali t�ilin9 ,',��`� � � • �} �� � � �r ��f�ALT�y' DEPI':�NEQ1JIFj�P�t�N'f,�
� 31. Plaster Br`r,pwrrGoary r.S r,- �r I �i: 79. FINAL ID:SPECTsDN r � �<��---�
.. �. L����...'� � ~ ` " -
32.'.�lectricaY"Po�r ��1et�er�FiSaI i �' "� � i< <' 8Q? FOOD CERI'll",�CATE I�S�JE�� �M', -�--
�-__`�'
33. flna�:Eleecric� '_'�t ...'r e �^ :; .. i 's � NDtes: �� ���*7 r.':' � ;�,SC: .; .
' 34. FinaEHeayting"��& Air'6ond'rtioning:� ,r .�;17�9� 1 �'1�/ �� � �S ���5 � i� r � ,� �' �
' 35. �,in�i"Gas'"Piae Tesi i. �J .: � ._, �r . ;;.0 7 � � ` 'N - ^ '
� 36. Hood�or.8anopY ".� - ," � � • l � f: �1.� �+. ^ �� .� ,� - .
� . � �.T� � 4 1T� �'C�i T. ��.iJ '
'iy � �. � 4 IF ' . . ..
� 37. €inai.Faciory FirePlace ,� , - � i: � ' ��: „� �.� �F � -i = • � _
��. � r�.
� 38. Finaf=Plumbing ' - ' � ' � n s •'., _ .;. z N ��. -
K.�t � 1 C �1..7dJ P �•7•
� 39. Water Ser4ice-Final ; . � �,� `r ! ' '" - ,j"� i " H ��-, = -
: _ r,.
; 40. Gas Service-Final t 7 a: �"^ - + ,7 "" � i �o •_n v .r � -' �. -
+ c v E t. c,
_ 41. Solar porpestirFina�_ s � ^ " ° -T " ~' ` -
�-! r { . { .r -]'v �T r .� J
42. �ackflow�Preventer F % . r � � �t ' '? - -: �J �
.. r. ':, a O -^
43. Backflow�irriJation k :rS�s h,z , V'`� � ^ • • • • • -
� k .l
44. Landscape IrrigationSystem'^"!•': •^. �� ��� '7 O ��.i: �' v 3 :^. � :� •i� v-» �.-
Y : F. :E '� : f ._
��
45. 'Sound F�t,tendation ` J '; ,� 1� ^ �� a *1 r ^ : � � e+ +; '
4:6. Handicap�Regulations a t *�� S 7v �� . ,
� � . r �t - '� j 2
47. FINA�L STRUCTURE & BUit'DING ` � " " -
} � ' � T 6 '�
48. FINRLPLANNWG• -, � •� '� ' �'� � � -
' �E '� 1 �1 - � ^' .
49.'ElecRic Releaseto EFJison � � r r•+f '� 1 , � , _. � •
� =
I
50. Gas ftelease to Southem California-Gas Co �F. ! -i "� l� � - - • • �+ - � • • ' •
.- r _' "! f 1 �� ii.��� . .
57. CERTIFICATE pF OCCUPANCY� � � t :. �: :,�� - • -� . _ ... _
No._ Date y
1
(A
�
�
�oonas oc amiwn: 3 t31 21 S 1 S T
OYMERSWWEIFpqWN: NL'WPVR�I HTS TWG
. � �ooxess 15G1 WESTCLIFF
N.S. 92G60
APPL. MIIIlNO AOURE55:
u�T: CITY GF CGSTA ME.riA - D'UILi)tNG PEl<MIT
PERMII' NV: E O85"v79 PLAN CHECIC NCN: �- N
/JiCXRECTOPfNf�NFEN: GGUVIS fiNGINEERING uc.no.: G
nxcxon�a•s�ooxess: 4400 CAMFUS AR uxr:
N,b. CA 916uG
CONiR�CTqI'S NAME Fl�C I'r' I C t;RANU � �NS T, i 714 > 0 31- 74 3 3
cam�crorcsxuuwo 15G1 WESTCLIFF
.NDRESi N,Fi. �A ue.w.: 734904
�jZbbG yM; Zb�l
110EN5ED CONfflACTOq3 DECL�F�TION: I hemby ellim U� pa�elY d psjury tlut I em I'reneed under prwieione d Cheqx 9
(commanaip wnh Sacibn ]000) d Division 3 al t�a &aireo e� P�essone GOEe, eM my lioense u in hll loru enA Niw.
cmuc.xo.:u7 118 uc.cuss: uc.No.: 7349"4w{ EXP: 0'S8
�ome: conveda: � /
OWNER BUIL EP OEC fl4TION: I Iweby elfi�m uiker penP�Y d perjury Ihet I em eaemq han �he Cp4retlon Limme Lew ia lM
tdb'niiB rmsm (Sedion ]W 1.5 &miaae eed PMesebne Code: AnY UY m eauM' whitli reWim e G�e to oduo-un. aXr. imVa+.
bmdah, a rapei eiry neucturo, prior lo Gi evuvwe, ebo �W� Ihe eppliau ta wrli pemd to Rb e apned etetmwM Nel he a�he
iie�aea w+�� m in. a��+ a me can.eaas �kenae �ew Icnepe. a(�me�vq .nn seaon �000l a dyeon a a �ro
.uvireu eM PrMmeiau Codel a t1u� he w eM 6 uemq ihaahan vM �he bmb la Me eAe9� eicemqion.lm'vidmion d Sepion
]W1.5 by enY WV��t la e permn wEptla IM epplicW lo e� PenehY d M mae �hen Me huM'eE Eope'e �$SOp11�
❑ �.mmmxWineawenramv«nWwe«vdnwep»m�neiwammpenuuon.w�eomexakenemeeu�euntinnunerdee
aMe�adMublSeeiion)OII.B�vmeaud PmleeaiwmCotle:TheCamrmwaL'vualawdoeenalnVGNloenoxiwrdpapeely
wM WIJs a inDrwm ihemon. vd who Eme euch wak M1meeX a Mnd a Nraph h6 or har am emWeYw+. p?�d ilw wcA
impovemenla ere nol inteMed w dlaed la aeN. tl. howe�er. the buitli�p a inpowmM ie eald wn�in ona Y� d mmplstun. tlp
wrerbuitlx Mill lave iM Wrden d qwiip he a ehe db nal b�ik or imqwa la tha puryme d mbl.
� I. ea oMne� d IM papMy. em ex�onaly oonlretlip wiN �sed cmVeclas lo construtl IM ptqetl (SeUion )011. BueiMee aM
Proleaeione Code: Tha Contwon licems lew doea nd eppM w en owner d poparry xRw buW or imprwn iMrem eM Ma
comfecH la wM MMed9 wilh e wnlreqor�H) Icanaed WRuent �O �M ConUatlaSlidnva leM). .;
� I em uempt uMer Sanim: B. 8 P C., � Nu �eeaon:
oeta: owo«: �. •�
I do Mroby cMily ihel I em awve d uM uMenuM tM �aquirem� d CalAomie HaeXh eM Seley Code 9aq'vn 25505, 25533, and
255�C, vd ihet I ar eny lulun WilEiip ocapenl will / will nW (dmb aw) need to wmpy wih seid aWe codee enE IM mquirommh br
epermitiwmneWcibnumodifraiionhaniMRi uaTy�epemem0iefnd.ResidenlielcansVutlbneppY�iauerseaamqlmmthw
prmisiona.
oda: nvW�nc
WOflKER'S COMPENSATION DECL�R�TION: I MreEy elfirm uMar peneliy W perjury ma d iM /dlowi'p Eetleretom:
� IheveenExilmeimenecenifcmedmnwnttoseH�inw�eMxake�ecompenaeton,mpoviEeEfaby&atlbn3)OOdlhalebor
, caa..�«mew�o,m�<.au�.w�ww�nm�.w�u��a.
'I I.l � neva ena xi� meimen xvnfere oomro��, losu,.rce.•• �a��red M seeian alao a ine Lae« cm.. ror ine w�.�w a �n.
X� wak fa wliich ihia permn ie ieaued. MY ��n wm eation insurence �amx ud pdiry number ue:
c�,: S1�ATE FUNU �:XFZRES
PdiryNumber. VV b bG 04/30/98
,ma .mn;w1 n..e nor ne camobroe r rn. v�x c ro. on. nu�ee dw�.,.ls�oo/ o. bs,.�
� I cenN Nm in IM V�ameMe d IM work br whc� Ihu P�n in m��ed. I ehell ml emWW �Y Oa� in enY menner w u lo
bacmia wbjm io tM wikere' canpmution lewe d Celibmie, eM epiae ihet il 1 ehouk becaro wApc b �he xwkan'
mmperoatian po 'eiom Sedion �I00 d IM Lebor CoEe. I sMll �wnh mmpy tMa pw'v'me.
Dma: Appl"ran�� _ �
7
Wam/ip: F�Nu ro ucun wortw�i comqru�tlon rovxpl �i �bwN4 /�tlW/l uOfM br • Iqw b alMiul pwltlr �nJ
e/H/ nnu �p ro om h�nMW tlrouuM tlolkn lsIP0,P001, M+���n ro fhs erot o/ ronpw�uWn, dtmspn u proHJsO M In
CONSTNIICTION LENDINO �OENCY: I M�aby elfi�m urxbr Pa�eM d perjury thm tMn e e c�ns�un bMvq pervry for ihs
partoemerce d Ihe v.ork br wAiM ihe D�Y u bweE (Sedion �4I. CM. CI.
LENDEfl'S NAME:
LENUEH'S RDDNE55:
1 canM �hei 1 heva ned Nia roWicetian eM elw the� tM ebova iritmre�ion o mrted. I e0�ae io comVM wnn M tlly enE mwb adinemw
eM eteta levn �elq'xp to Wildiq con�truaion eM M1ereby eu�Mrze representemea d �he ary�o anter upon IM ebwe-menlbneA pmperry
-��`��'°"'��W`°�"' At�NALU LEGkANU
(5151-48WP) Whdo-BuilEvp6Sekly;
om.: . 4 9l
Pink-Hevanue; GoldenroE-Aeeeamr
Y�:RM NU: E "vi3�"v79
GuV?: N Sf7FF: N
CGN�TRUCTI�N TYPE; V-N PERMIT TYYE: rL� PUitPiiSE: N6W
JUH DESCRIPTION : 23235F SINGLE i'AMSLY RESID. 5705F vARAGE SQ F'f;
CLAIM VALUE: CALC-VALUE: i,RGUF GCC; R-3 i
CuMMENTs': REF:B-85�770
iF iF if iF M# iF iFie'sE iE�1F 3t iF iF ie fF iFiF iF if iF if'sf if iF iF ## iF iF if iFaf if iF iF if 9F iF iF iF if iF if iP jF ie MiF itiF if ii:tif �F 3't iF ii ie i4 i'r iE iF iF'rE 3t 3F i't ie % iF ie i'e iP iei'r ie
Z O N I N G k E Q U Z 1't E M E N'f 5
S E T b A C Ii S
------------ MAIN HUILDTNG ---------- --------- ACCESSORY bUILDIiVG ---------
FRNT: FT IN REAR: FI IN FRNT: FT IN k�:Ait: FI' IN
LEFT: FT IN RGHY: FT IN LEFT: FT IN RGFII': FT ItJ
PAftKING REQ: PROi7: PAACEL: OGG�GG00 ZNE: AEF NO:
PLANNING NOTES>
i . r .. �.
iF iF if ie ilikie if if if if 3F iF M ik iE 3f 3E if iF if iF if if if if K M if if iE iE iF iF iF if iFif iF 3f iflF 3t iF if if ii if i4 iF iE i� itiE iE iF iF if iFiF iiw ie #� if �7't iF if ie i+iF ri if ii iFif ie iF i�
L E V E L O F M E N T S.E R V I C E S Ft £¢ U Z R E M E N'Y S '
ZGNING AFPROVED HY ' UATE;
HUILLING APFRt�VED HY ; DATE:
AFFLICATIUN ISSUEU bY: �' DATE: �
iFilifil'9f9FiPiriFlt'1FiF3FiEiE9I'9FiF9IifiFlf 1t l! 1t ltnifiFiE'lI'i{'iEiFiF%iIP R R'R Yt �f �
LEGALZZATION;N F�,E �E S U M M A R'Y SIRUCTUiiAi SEGMENi:N
HLDG PM'T PLUMHING ELE�TRIC MECHANIi: FIttE SMiFiRES GkALING
F�ERMIT 119,.70
5"vt SMIF/NON-'NE:S
PLAN •
ISSUE FEE 22,:Of1
&UILLING-LIV-> FERMIT ISSUfi YLP,N;CHECK iOfAL yATD liUE
'Pi�TALS----> 119.7"v 22.�7G - G.OG 141.7"v 141.7"v .00
REVENUE LIVISIUN TUTALS--� CULLECTEL: 141.?0 GVER/SIiURT: ."v0
bLDG PMT PZUM&ING ELECTRZC MECHANIC EIRE SMIP/TG7 �kAUING Yi,AN--CHEi:K
141,70
i{�1F*lf1l1ll�'�'*�'1�'�1'�'k1�a!**'�ft'af1("K1�'1t*!F*Y�'1�'1l1F*1l1�ilkl�'1t1f1t'1F�!'1�'1!*1F�f'It'1�"*ftl�ltvQl�jl�'%!'1('�'{t1F11' %1' %t1l1t )lif9tlT'%?l1'11"R'fi1t
I N U I V I L U A L 'F E E B R E A K L U W N
TYFE QTY" L c' S C k I P T I U N UNli COSI' T'GiAi Cv57
ELE 1 FI3iiURES, iIGHI'ING 1 ST iu �,A. 1, "v0 1.G�
ELE 2 RECEF'IiGUILET �1 SI' 20 EA. 1,Gv 2."v"v
tL�. [ kECEFT/SWITCH ,_1 SI 2u EA. 1,"v� 2.0�
r.Lc. 1 MOTUk/PGWR AFFARATUS � G,u - 1'v riP 4.25 4.25
ELE 22G9 Ne�w RES biLG FUR 3t UNI p �,GS 11G.45
. ��v �, � _- - � D
�
OCT 0 81997 �
CITY OF COSTA ME�A
CONSTRUCTION ANDPLANNING P4�` 'PA "
�APPROVALS Permit# - Date Inspecior AppROVALS Permit# Daxe inspector
7. Temporary Electrical Service or PoTe 52. Pool & Equipment Location '�
2. Soil Pipe-Undrgmd. ' ' 53. Steel Reinforcement .
=���ElectricaC6�ndo7t-UtilitY-Undrgrnd. 54. Form5 ' �
� �?�4' Elec[ricat�,bndwY_J.lridrgmd.� 55. Electrical Bonding '
..� .
,�5-'. Sceet Reinfnrcement 56. Rough Piumbing & P�essure Test
:���Iectrica�t�fEF.�G�md. 57. APPROVALTOCOVER�GUNITE r
� Z'. Pootings_ ; �� 58. Electrical ConduihUndrgmd. -
:ig' Foundatio(�� y^ - 59. Gas Pipe, � Urtdrgrnd., Test - '
_�„ ^ •:
9. Water Pipe-Und7y� rnd. -; ' 60: Backuvash Linet;.�Trap, u�Undrgrnd.
10. Structural Flodr'Svstem 6l. APPROVAL T�'gECK
71. Property Sewer Lin�& HouseConnection 62. Backwash & Receptor-Fi�ai' �
12. Sewer Cap � � �r, "63. Heater & Vent-PiRal �
13. Roof Drains _' �_ � � 64. Plumbing System - F inal
14. Rough Plumhin�c} 65. Electrical�Final '
75. Rough Electrica�-Coanciuit 'r � �6; lar Svstem-Fina) .
0
16. Rou h Electric_ iri � )� / �J � -�`�
9 �� F�9.n •� /�/'f%[�'/ -' - -) �/. Fencing & AcettSyApProval .
17. Rou h Wirin n •� � C``
9 9�9 i . 68. APPROVED F�R'.P�ASTERING �
18. Rough Electrica�T Bar Coiling -� 69. POOLlSPASYST•EMS FINAL -
18. Ro�gh Heatin & Air Conditioning FjpE_.[�EPT.,REQUIp EMENT � �
� ,5 . �. r�, �.�-.� �.� i� •� •�+ 'f '7 - -
20. �Ftough Facta�N F• � �lace ' ;-1- ' •.�', `. , ' -'-� + _ APP,ROV_A � ', P'e�mit # � " '7 7 . 7 7
.�. a ir � s i-a ;r r. l. . y� �-. �
21.+Jucts, in�triutur'ff � �.. .. ��S * S O �� k I M1 "�� "� y � '
- .� �, �ti r . � .. 7Q. Z)nde'rgr�ou�d k^.ydro �
22. ,Duc�. V�B'rtil�tingJ K i ` j � n y �� , �
•�; �j ,-�: 77. Produey iping�u�us �Oil
23. �asPipe-(-iio�njh & T�st � -.5 � i�7 7' � •_l r ? 72, Undergreuiid F"Ut� ` " ''
� � ti Y 1. 'Y
24.`T?oof'FraFhin ' ,� r • `^,� �- e'> •j .T .t �-. > ��� t. ...
- 9 . �, � . '> '� .- i: � 7�'3s Undergrnd. Sto�� Tank O Gas ❑ Oil �
- ,
25. RooHSh�thing �:� ,- : v ,i i. � � �� � 'J ic 7a'. Overhead Hydtg � ;.
M F
26. '-Bai? Ceiling (Str� yuraq & fv: �"' oat ;: y �F -' ��"�� '� 7 ` �� ' ' '
5 Qft. �� r� -�. i7�� 7�g. Dry Chatnital ;...,•� .~..7 ....�
27.;.}i.rarye and Flashipgr �'� : �' - �'� 'n !. 76. Dry StaF¢pipe�' -' � ,_ �% '� �
- yT t•r r
" 28. Lathing & Siding "'� yrT x •. �` .'i: 7,'} F�XEDF�'SYJST6�mFINAjL-� �l r�-'. p j
29. Insulation ! J S •• `.r � 4 7. FIRE PREV. F' iT_AL �' � "� ��
" 30. Orywall,l�ailing � H �� �_., � K � ; jFiEAL���EP;T`.'bEa"u�c��i��yJ-�
� 31. Plaeter B(own'�Coat �e. S '• �-� � 79. FINA� L�J9PECT�'OPl �� ^`^
-�-, i � c �-� -,� -
32. �Iectric3nPov�r Me��t�.Unai � � � 1 � �' ' ���_ FOOD CERTIF(C;C�E I�SUEQ, '.�- �''
r i .i; � -Tj�- �� -,- ? ` ,
; 33.:.. ina�7�Eleetnp Y i-7 � ,2; � _yy� (. � � .• tes: �,^y ^ � � - � .� • n
..v�_ . _..�r,_ �r � v r : t
,� 34.�FinaCHea�incj'�B�Ai(Cpnditioningc � k t I�' � ����G Hc �� :: .h/1 '�'-
, r ��: '� ��. � 0 Iva,� .
y 35. ,inal Gas Pipe.Test e,-�� .. i: . � _ �'� � � �7�=a �� J�J•v �.-+,.•
� .�
=-;,-�, . .-.
= 36. Hood or �anoPV �� �� � �^� 7 ' .K ; . I a . '� � � r. � .• ~:� .r -
r �: •-� ��� �. � + � �.� r.r .�.
= _ �.a , � .a� � �� „ �. � _ _. :.; ----
= 37. ��:inal:Factory FirePlace:: i r•'-, � v' � � �p' s ^ .. • '
_ 4
� 38. FinarPiumbing �. .- � � r '� •S - � z ._, ��� -�--
14 ' -+�> 1
39. 6Vater Sewice•Final r � � '" .;: - �'(,. � � ..y' , ;..y � - - . � �
� t �• .i' � r
� 40. Gas Service-Final �' ��7 6'^�r .s + T� `r ' �'3 + • � . � �
�� -� � x I✓ tF . oE � '
-41.SolarOotY�esticPina�.� �-'� .. ��,_ � tr . -j.� .,-; ] . . '_'.
- -, : <
42. -Backflow.Preventert r ft � � �� =� � -
- ��� i �-� k i? ,:7•j 4 �
. .43. Backflow Yrriyation r � �„ S S ;. .� .r . " s ' • • • • ,
�44. LandscaPe Irf.4gatiori SVstemT�.^ � '� � :T1 :� '7 = K ._ .. �s? s '� -ti i J �� � � - .' :, �
'45. Sound Atterivation�, �i' � "� ;. � ry � ;,� * r ;r • -��7 t
46. HardicaR�eg�lations �-+ �� K � + = � = = � - '
� �• t� r �
47:. FINAL STRUCTUfi'E & BUf@DING � I _ `' ' � - . , ,
�
48. FIN9L PLANNING � -� ' "'•� � I � �; .' � c i � �
49. Electric Release to Edison . a a ` � ' , ,
'. / ` '� S '�-' � . .
50. Gas Belease to Southem Califor�ia�Gas Co �R � "' .��� � � • = •� � '' � • • • �
.> �.� - � � 5.�.i. .
51. CERTIFICATE OP OCCUPANCY � -- � • - - * •� �•- - - i _. .
No. Date
BUILDING PERMIT LOG
NUMBER: TYPE OF PERMIT:
ION: SQUARE FOOTAGE:
- l IME IS TO BE CACULATED TO THE NEAREST 15
iIBLE IN RECORDING ACTIVITIES
� 1UOPESSOiBULqNO:
QYNERSIUYEIFqpWll: '3B1 1isr sr
"°°"Eu: NEWPOAT HTS TWO
15G1 W£STCLIF'F
N.b. 92660
�vvi. xuuxa �ooness
UNT:
MCNRECT ON B!�lFFA: llt. N0:
�xcx.on�•s�oon�ss: VpUVIS ENI,INE�RING V�"T�
9q00 CAMPtis' Utl
���� N,B, CA 92bb0
CWfN�CLORSYYWqFACIFiC GRANL CUNST. (714)b31-7933
��s+ IS"vl WESTCLIF.F ��=
N.B. CA 7u3q9b9
LICENSED CONTNRCTOFS OECLAP�TION: I MmEy eflim �h�r�� d pe�ury tlW I em liceneetl under pa.idao� b�Aeqx V
(mmm<�q wd� Seclion 1000) W DiWion 9 at ihe Busiiwm end Pmimebm Code, and mv 4nva e in tu0laro eM Mtw.
cm uc. No.: uc. cuss: uc. No.:
o�a G70 18 ��,�o;,' 'i3496 EXP: 0/98
OWNEH BUIL CLAP ON: I�M dR�m uMm per�ely tif pe ry tAa I em aumq han 1 eCo m Lioem� w ar iM
Idbwinp reeson (Setlion )OJ1.5 Bue'vMs eM PMenbna Cade: Any cAY a aountY �� �^Vuiree e perm �o muWct. dler. imqwa.
demdch. a rapei eiy ai�ucturo. p'v b ta bwaMe. ebcm�wrea Ihe eppiun� la wch psmil to Ns a vpned eletanwM thm M a�hs
� rKa,.ed w�u m me yowim. a m. caareaors�ucrose �ew Icnea« e(oommendno wnn swun �000l a o,.:� a d in.
�uainev eM Pralae'vu Codel a �M M«ehe M uemq iherehvn uM tM beti Iv tlro ^Aeped ssomqion. MY videlun d Seeion
]03t.5 by eny epplirani In e permn NbpG+�M1e �icaN lo e tivY peroM1y d M maa then INa hunEred doAen �5500]�.
� I.mawrortltMqopenyamiM�O�qa��hwapean�Mistlammparuqion.MipEothaMvk,mdtM�wmvsenal'vdadad
a allered la veb (SecYan ]Ou. B�� eM P�Wm�a ('.ade: TM Comrom l'ae� lewdom nal eGW to en wnwrd propmy
i.no num « maa« �n.mm. rw.To eoe.:uM :An� Ivmaen «n.�aN o, m,aph ne «n. o.� «�o�l.o. a� �nm .,ui
'unpro�emema ere nd inisdad N�� lor eeb. tl. however, iM dntlinp a inpaanaN u edd within ona Y� d mmpk�un. Ns
vxrw�-0uitl« wiN hma tM bmdM� d P�m M oi eM did mt MdN a unpow la Ns Pm�e d edal.
❑ i. d o.mm w me ww.m. ��e�v:+sr �vau:ro �.nn �wmee cmo�u. io c�mvw m. o�daa lseao� ro... a,.:�...�e
Prolesmare CaAe: TM Contred0� �enae Lew doea nol xpply b en owmr d papmly who Wads a'enpnxea thaaon ud Mn
comracta Iv W� pqeae v.nh a��ale) IceiueE W9�t to �he Conlretlae lioensa lewl.
� I em ummq uMer Seclion: �- �.�. B. B.P.C.. br Nis imwn:
i'
Dme: Owner:
i eo n«.W ronM mm i.m ...,e d r�e �d..�e me .xi��w, a cmeomt. Haeen .ne swn ceaa s.e�a,. assas. zuu..ne
255�i. eM Nm 1 a anY Muro WiMinp arupam xill / wil ml (�b me) neeA io cwnply wih �d qets wEm W tM npu"vemmb M
a G�n IamnVunion a mod'ifirationhomiMAi�ene0��� Diqrid. RmideMiel oontl�utlion ePV��broerouemqimnNae
a�.
ome: Acv�d:
WORKEN'S COYGp14�TON DECUA�TON: I hareby eNmm vqs pr�My ol pxp�y pe d iM b0ox'vq Asdueluro:
❑ I Mw eM wJ me'vuew s caW'rlls W mnwtl to seeimiva br waken' m�pewlion. n pwidM for b/ Sardon 3)W W tM lebw
Cods.la �M psAmnence d Me �M la wlic� tliw pame u usued.
❑ � neva ena wi� meua.n wn�s.• aomo�un vm,reno.... �a�ed M swion a�oo a m. �ee« coa.. b, me w��. a a.
jC ,.oh �a w�d, me cermn m m.�.e. Mr.aw..• mmv.iwia, m.,mz. m,;...�e cofii� �wnn« m.:
c°'"°' S3�li'S FHP18 EXPIRES
aaKVN�mn,�: - -- 04/30/98
�ihis settim neeC nof be romWNM /�M 0�l 'a M aro uMied n ,
� I cMGy ihet in IM pe�amerce d IM wak Iw xfich Ihie peimil i� ivaueE. I Nell M ampby eny penm in eiry mennar n n to
bacwne wbjea to iM Mwkere' �penmlion levn d CelHoma, arM epree ihel X I eMuk becoms wEjefi io iM Mwkr�'
� ca�oe�wc� o. � om d s e� aroo d me iem. coe.. i wu t wnn aomoN ! ��Y
ue: �odtiem: �
�
Wamlip: FaYun b ueun rortri ro��tlan rovwp� h unl�wlul, uMSIWI ubJ�ct en rlplqr roWMrW pwWtlu �n0
Wll Ilroi W m aw h,ntliW thousM�d aoll�n fJt%OWA b� eANfbn ro tln cmt ol oo�V�doM1 Janrpp u G+ovMW ror In
Sectlm J]G6 0/ IM Le6or Cob. InfM+t +� ��my� /wa
CONSTIIUCTION LENDINO �OENCY. � M�ebY eMum uMm pmdry d psjiry Ihet tMrs u e omuruaion Wi�p yscy lar Ihs
perlamvra d tM work tar MtiN IM1e V�i u ewed (�� �). CM. CI.
LENpEN'S NRNE:
LENDEP'S ADDNE44:
1 ceMy tliet I heve reaE I�o eppficetian ad ame �MI tlw aEwe inlamalbn ie oonw. I epne �o canpy xilh a� ory an0 cpmry Wrtxrce�
eM elate lexs mletng �a buildip eonq�uaion eed MreEy eNhaeize reqeaeniaihp d t�iv dly ro mter upon iM ebow�membned poparry
ro� ��sc«ro� o�.weas.
RONAt�L LEi;kANb
• Pnnt Name� /
i� � �/ /
��/u.....�I i...aCX� Dme:
Sq re M W+KK/IpenV rma
d SeletY:Onan-Fb: Ce^W-APP��: Pink-Ravmue: (3oNruoFN�emr
�ITY OF COSTA MESA - BUILVING �ERMI'T
FERMIT NO: H 085070 PLAN CHECK NO: G2259-97 A
GOV'I: N SUYY: N
CONSTRUCTION TYPE; V-N PERMIT TYPH: S'!'R FIJItPiiS�:: N�.W
JUb DESCRIPTION : 23235F SINGLE FAMILY Rfi5IL. 57GSF GiaRAGE SQ r'T; 2,919
CLAIM VALUE; 15u,000.OG CAI,C-VAL'JE; 199,955.12 GROUP UCC: R--3 i
i:OMMENT5; 36SF �GRCH "PLAN 2"
;r�r*;�*�r;�**�w*�r*�c*�r�rw;r*r**r+r�r+r;c**�c*a�**r*;�*�r*�r�c*;t;c*�r;��ra�*�t;�;�� �*;�w��;c;�;:**��t�x�tarfi-�;��c;:��:
Z U N I N G R E Q U I R E M E N"T S
S E'f B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSuRz BUILDING ---------
FRNT: 10 FT IN REAk: 1G FT IN FANT: FT IN kEAk; FT' IN
LEFT: 19 F'T IN RGHT: 40 FT SN LEFT: F'T IN RGAT; FT IN
PAkKING AEQ• �� 3 PRi�V: 3 PAACEL: OOOOOGGO ZNE; R2MD REF' NO:,UR9�705
PLANNING NtSTES> ONE, 2-STORY UNI1' W/ATT 3-Ct'�R GARAGE (GNE OF o LETACHED'
> UNITS iOF'! A COMMON INTEREST DEVELOPMENI') . P/FiEi5li /.'
iiiF iE i'r iF iE iP i' if if iF i@iE ie ieiFif if if if if if if if�ie iEiF iE iF iF if Yr if iE iF iF ieie iE iE i4 iF iF if iE if'sF iE iii* if if ii 1e iE iEii iE w iE i'r iE if if iF iE if iE if i'r if ieii ir ie iE ib if ie
D E V E"L u P. M' H' N�I' S c R ti I C fi S k E S; u I k E M E N sT� S.
ZONIN� AYPRuVEI'i bY �. ��_n
bJIiDING i�FPAOVET� B�: ;,: � ' `� %il
APFLICATIGN ISSUED bY: '' ' �
i4iE;eiE+FiFaEiEiEiEitiFiEiEiex�i4iEiEiF'rEiF3'r�Fx3F7fieir�FT''i€rFiFvFiF7Fa�aF�FiF �F �FiFieviirxiF'�e�ie�e
LEi,ALIZAT'IGN;N F E E S U M M A R Y
BLDG PMT bLUMHING ELECTkIC MECHANIC FIk
PERMIT 1,387.25
PLAN 225.43 '
ISSUE FEE -
bUILLING-DIV-> YERMIT ISSUE PLAN-CHECIt
TOTALS----� 1407,25 0.00 225.93
REVENUE DIVISION TOTALS--> CGLLECTED:
bLDG PMT PLUMBING ELECTRIC MECHANIC
1'd7 5
L-1711� E : -�
DATfi ; ?� -• �.
.,�, ,q
uAIE; ' '
iiifii��ii�ieiFi'rieif x�e�uitifi't
ST'hUCTUAAi, SEu'Mc:iJ1':Y
5MIP/AES GkAllIlv�
20.00
SM1F/NGN-RES
TOTAL PAID uUE
1632.68 1ei32.68 .00
1407,25 OVERISHiiRT: .00
FIRE SMIP/TO'C i;RADING PLAN-CHECK
J .l 2"v.uG
i't if iF iF ii ie iF if'vF if 'sE iF iE ie'sF ii if iF ii ae iF ir ie ie if i49eie R iF iF i'r �F iF it ii� ii ii w w w w iFii iF if iF �w iF if if ii ie'vf ie �7F if ie 3e w i't it'sF �e'st i't ie iF tii i'r ie've ii ie �ie ie �le i r ie
Z N D I V I L D A L' F E E b R E A K u G W N
TY"PE �TY L E S C R i F T I G�N UNIT CGST iGC.4�, CGSI
SFR "[323 UWE-TYPE U-WGuL FRAME -GGOL BG.oG 187,233.8G
SFR 3b RES-PATIG CGVER-PGST�6 SGLIL ii0(i't� 1b.11 5dG.32
SFR 57G RES-GARAGES TYPE U 21,3"v 12,1d1.Gu
END ' 'h' �e
�,'�". ..- "'"' �
`r, ��U 1 IJ D
. 0 8 97 �
CITY OF COSTA MESA
,
CONSTRUCTION AND PLANNING POD. oPA
APPROVALS Permit # Date inspector qppROVALS Permit # Oate Inspector
1. Temporary Electrical Service or Pole_ . 52. Pooi & Equipment Location'� .
2. Soii Pipe-Undrgrnd. ;� . � 53. Sieel Reinforcement
3;iEleetricai Conduit�Ut?��tY�Undrgmd:: 54. forms �
'�4:;Electrical ConduiY;l'Jniirgrnd. � � 55. Electricai Bonding '
�5�'�teei Reinforcement� , 1�-�� Q� �ps�-� 56. Rough Piumbin9 & Pressure Test
��'��lectrical ttFE,R Gin�1. `B�l�-q7 u/(L 57. APPROV'Al. TO COVER-GUNITE
J.�,F,00tings _��r =�� � lp.�`s �� GWy- 58. Electrical Condua,Undrgmd. �
8i Foundation' =' + a� /n� j,�„ f��, � 59. Gas Pipe, O Uniitc,�'nd., Test � .
.: ': ;'.,1,_-P-'�, �U �„ _.
9. Water Pipe�Undrgrrid. - 60. Backwash Lines,-:P*�i'rap, � Undrgrnd.
10. Structural Floor SVstem 61. APPROVAL TO=p_L'CK
71. PropertY Sewer Line & House C.qnnection 62. Backwash & Recep{or�Final '
12. Sewer Cap V ��� 63. Heater & Vent-Final •
13. Roof Drains " . � 64. Plumbin� System - Final '
74. Rough Plumbing,-�, '� . 65. EleCtricai-Final ' .
15. Rough Electrical-Cond,u5,ft :. .. - 66. Solar SVstem•Fina�
76. Rough Eleciric Wi`ung��..: •> .� �_ 67. Fencing & Acce55 ApProval �, � �
77. Rough Wiring Siga - ?� �; . 68. APPROVED FO�,R� �LASTERING
78. Rough Electricab'rBar Ceiling � "' 69. POOUSPA SYSTEMS FINAL '
19. Rough� Heaxing & Air Conditioning - F '�r, -_ _ FI E R PT. �EQUtRF�MENT
� �
20. Ra�gh �act9ry FireplaFe �.r � - . �� ;. �QPPRbV �Ai:S�.����Pera�it # i Y x..� -
21. Dtrcts, in Stiuctare �TS-° "" ' �- '` ' '- "r �'70. UndergT�od c� H �1ro '�
-� c K �. '� c-i r-� -� �: � i�
�. ..� �; I ' S :r .'1 r. ., c
22. Ducts, �Ventl�attng 'v r . �.., � - ' -, r .�Jt. Produot;E�'Ping ❑ �s� �e0i1
23. GasPipe-Rouqh'& TeStt ��✓ �'.5 +:r r S, � K;7y. �Jndergro'd'ntl F��sfi1'�-' �' '� • -
24. Raof Framin9 ' � � � -, K � , , �� � < < ��� -� �-�M�� . ` �� u �
y K c . �r. . •.73.jl;ndergmd. Stor:�y,�Tank l7 Gas ❑ Oil
25. Roof Sheathing �S `Z-jT�R,7 �y(j,��� ! J74 �6verhead Hydrei�'„ ''
26. T-B�r Ceilin� (St�ucf�r�i� & Mo �wt '�4�.,. j ,�, �� " F 75ip{Y �aherr3i�-�,I ,� j !' �_.� =3
.. : .
27. Frame and Flashing �r r �:: /Z �2 t�/+y.7 6� �'a 76. Dry StancTprpe � r �� �,�„�
^ � - ! � •: •�,
�YB. Lathing& S7ding ', ; ''� ;� ��� �Q &q.Q ���•,�; 77�j FIXEO SY�S�7EA� �INA�, � -. �;� �ij
�29, Insulation �e . � K .S .. .. ��,--�� �,r 7$EfIRE PREV. FIN7�L r �� �� �� � -
3�1. Drywail Nail:"9 � J k ,-i - � �-7:.,�8 (y� ��. ; f�fiALTt�EPT`�R'�Ql7iR �'��.M��NT
�7. Plaster Brow'n Coa; �:.� i �t*• ;�,4 r � � �r <79.�FINAI 1I�tS6ECTt�N +� �� �= .�I*� N -
. .. . .n.�._ _i ...-f �-. '-�i
� ' �,p'Q.:'i f' Ti ' 1 rl
' 2. EleFtrical Po"wer7�eie�;F�^�al ,�S r � 'r �80._FOOD CERTIFI�ATE IS�IiED�.: ;��r
$3. Firal E�ectr.y� ,: �s�. w -) � � 3:�'. ^ ' � 1K NOTCS: OLD T!^'1� , .. ..•''- ~ -, i .,.J,y M��
-' �_ =-._-.c's;�L�RE_QUFRE TC
34. Fin�l Heatirr9 &?air Cd�diti0ning S �� " `' ' � " -� �= r R ---� . + _
�. r ��y •> � ;: ti � !� a; K .----�
. �
35. Firi'�I Gas Pipe�Test x ,�r ` � �y�r t� � � I +# _ � �v "- ��-_r � +' ,
�
36. Hood or CaiVo e� :� _ , m �-, ; ti. . -. � t.: S '^ �� - ' � .
= _ �, � °Y ,: , '' ` . �=', ° , ' � '' HOLD_FOR_S.P_ECIAL�REQUIREMENTS .
37. Finai Paao_ry FirePiaCa _ , _ �i��; � � � :; _ o ., .
d
�8. Final Plumb;ng ; i. +�'u _ � ��� �. � � 3s ` � - - r .n . 'i - ---
y r� - _(. . � .c -i e ;) -
.;
39. Water ServiEe-Firial �; ;.- � ^,j; �� •, � � �* ;. �' ,, r � J
40. Gas Service-final� � 7 5�y,.. '*;':, +"' � � j` '7 .. ,: � r .
- S �. vi
' ` 1 � -
4]. Soi`ar pomestic�Final � ' �r � -� � � - � � i: , y�r. ..� `y = ] .
42. Backflow Preventer r � � �� x ' * "
- - � - � - n �
-43. Backflow Iriigataon i, ,:, �' ' �r' p --; � ��l � - � . � -
; k 'J t ,
44� Landscape ftripation Svsrem ' T��:� ' t' • �� _ '� _ • - � - ` i �� •�J -
� E ��?�^ - ia - �.'S
S -1 - g _ - ��' i P L - ' -1 J' .. _ •_••
45. Sound Attenuation . �- �: .. ':,:,� c ,^ e'y . -= 7 t
46� Handicap Re9ulations + - _ `� k � ` •S 7�' ! +� .
� , K r �=:� .. �'i �
47'.,FINAL-STRUCTURE & BUILDING y=�l.�g ��iL/'; ; �`" ` -
-ri{y--
48� FINALPIANNING � ' ^, '3/;.9� � � � , � ; � ". �^ �
49� Electric Release to Edi on . F s` `- ' ' ' "- -
. � '' • � f�''� a .� ,
50�Gas Release�to Southem Califomia�GasCo t � , ��� - 7 � � �� � • • •
fi - 'i •
51. CERTIFICATE OF OCCUPANCY ^ ' " -' - •' � ' ^ - -
No. Date
S�C�H�U�L�L�E�R
Residential Building Insulation
Installation Record
Batts & Blankets
Description of Area Sq. Ft. ot Insulation R-Value � Thickness
Ceiling R-�/Q ��/�
i
Ceiling
Wall EXTERIOR WALLS R-13 3 5/8"
Wall
Floor GARAGE CEILING AREAS R-13 3 5/8"
TITLE 24 FOAM CAIILKING::
If batt or blanket insulation has been installed in enclosed cavities, those cavities are deep enough to allow insulation to
expand to the labeled thickness unless exceptions are noted above.
Blow(ng Wool in Ceilings
Nominal Net Sq. Ft. Minimum
Bag Weight Insulated No. of Bags R-Value Required Thickness
Blowing wool, if used, has been installed in the ceiling in conformance with the manutacturers requirements shown
on the bag. ' .
Location j�L'Cr �/5c�� �
st. o� �oi u �or� 3 GI�tN� % —.3� / Z/s% S"T7'F�T
City rncmn MCCT rr
Builder
Company Name
Signature
Insulation Contractor
Company Name 5
Signature
Schuller Internationai, Ihc.
Building Insulation Division
P.O. Box 5108
Denver, Colorado 80277-5708
Date •