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Home My WebLink About117 23RD ST - Building Permits S CITY OF COSTA MESA 40,-0144.4, BUILDING V►VISION A• a 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.costamesaca.clov tFOR INSPECTIONS CALL: (714)754-5626 44*-0- toe. PERMIT NUMBER: B12-00095 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42605405 • DATE ISSUED: 05/04/2012 ISSUED BY: RMD • JOB ADDRESS: 117 23RD ST CMSuite/Unit: . Vicinity: UNIT C Squares: • 700 Valuation: $2,400.00 SCOPE OF WORK: TEAR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 30#FELT ON A 5:12 PITCHED ROOF AND REROOF WITH COMP SHINGLES ON REAR UNIT C ONLY,APPROX 700 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. COMPLIANCE FORMS ATTACHED TO JOB CARD AND CITY PERMIT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s) is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: O'NEILL,CAROL Address: 117 E 23RD ST Unit: PHONE: (949)574-1848 City/State/Zip: COSTA MESA,CA APPLICANT: GLAITSKY, GUY Address: _ • Unit:,_: PHONE: 714-965-2387 City/State/Zip:' CONTRACTOR: G G ROOFING CO INC License No. 364151 Address: 19792 POTOMACUnit: PHONE: 714-965-2387 City/State/Zip: HUNTINGTON BEACH,CA 92646 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY - Reroof Plan Check: $0.00 Reroof Permit Fee: $83.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $84.25 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010 -PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thru 6:00 pm. Prohibitied all hours-Sundays and the following Federal holidays New Years Day,Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODES INSPECTION TYPE DATE IN111IAL§ CODE# INSPECTION TYPE DATE I41111AL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof X 5 I 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.Darilolition 250 Final Building/Occupancy 41111. WORKERS'COMPENSATION DECLARATION: Owner ID verified by driverense. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: r Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the 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 this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized Carrier: "at-A cc cJ .> s - 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 Tly_sec(mneeed not be completed A the permit is valued at one hundred dollars($100)or less.) c..,�.._. // 22,Art 2,Sec.341,Title 8,Califomia Administrative Code). Policy—NNumber: -14C-ZG�I7 J \�T.- 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should• become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code, I shall forthwit o with these provisions. � LS4g-12-- Dale (L Division of Industrial Safety Permit Number: •• "7.,- / '`.pr 'erratum \J !Date CDale HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAI RE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No � Lic.# 3‘ 161 C r"_CIaSs#.'= G-3 9 (Section 25533 of the California Health and Safety Code, with some ?-; - 61-7—C&/ „u '� exceptions, requires registration with the Costa Mesa Fire Department by v -7 each business which at any one time has on hand a quantity of acutely a sSignature. Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ 1 hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own 8. (If"yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. r Signature of Legal Owner(s) _ Date Signature Date 0,,c../2----- 3057-46(3/07) or Authorized Appliaxnt I ,_r.Date. -- ! ., , Prescriptive Certificate of Compliance: Residential CF-1R-ALT Residential Ahem/ions (Pa 2e 7 of 5) Project Name: - I Climate Zone ti / 111 of Stories • General Information Site Address: I I1 fi 2,3rA I Enforcement Agent 4.,,1 �-yI Rate: "C.,I t�'I1( building Type 0 Single Family Multi Family Circle the Front Orientation:N,E,S,W,or degrees J� Conditioned Floor Area(CFA): Project Type: d Alterations 0 Envelope❑Fenestration 13 Roof O HVAC Replacement or Change Out 0 Duct Replacemeni ❑ Water Heater NOTE: Mignon is not to be used jar Newly Constructed Buildings or Additions - Insidrtion Values For Opaline Snrfeces,(far Fuiring use the Mass and Furring Strips Construction table below) Assembly Alteration ❑Opening of framed cavity alone-Alterations that involve the opening of the framed cavity of wall ceiling, or:floor must install the mandatory,minimum insulation value per§150 for the altered assembly. Fill in Columns A-C and enter mandatory insulation value in Column H. ❑Replacement of entire assembly-Replacement of an entire wall, ceiling,or.floor assembly requires the installation of Component Pack ge-D insulation values in Table 151-C. Fill in Columns A-J. Opaque Surface Details For the furred portioned of Mass Walls see Furring Strips Construction Table below. .A Ii C • I D • E . _ . F C _ M ] ' J Pro used Sfe h°" Standard Values From JA4 Table Framing Thickness, Framed Continuous JA4 Proposed Tag/ Assembly Name Material Spacing, U- JA4 Table Cavity Insulation Assembly Assembly ID' or Type' and Sizez or Other' facto? Numbers R-value'' R-Valuer Cell Value' U-factor9 • .Rote:For furred assemblies,accounting for Continuous Insulation R-value,see Page JA4-3 and Equation 4-1. For calculating furred walls use the Mass and i Furring Construction table below. I.For Tag/ID indicate the identification name that matches the building plans. 2.Indicate the Assembly Name or type:Roof/Ceiling, Walls,Floors, Slabs, Crawl Space,Doors and etc...Indicate the Frame type and Size:For Wood, Metal, Metal Buildings,Mass,enter 2x4,2x6, or etc...see JA4 for other possible frame type assemblies. 3. Enter the thickness for mass in inches or Spacing between framing members enter; 16"or 24"OC; or Other for all other assembly description such as Concrete Sandwich Panel,Spandrel Panel.Logs,Straw Bale Panel and etc.... 4. Based on the Climate Zone;enter the Standard U-facto from Table 151-B, C or D for each different assembly Name or type. 5.Enter the Table number that closely resembles the proposed assembly. • • 6. Enter the J7-value that iv being installed in the wall cavity or between the framing;otherwise, enter "0". 7. Enter the. Continuous Insulation R-value for the proposed assembly;otherwise, enter "0". 8.Enter the row and column of the U-factor value based on Colunm F Table Number and enter the Assembly U factor in Column J 9,The Proposed Assembly U-factor, Column.1, must be equal to or less than the Standard U-factor in Column E to comply. Furring Strips Construction Table for Mass Walls Only A It c DIE F Id 1 H I 13 t u L M l'roposed Properties of Masonry and Concrete Added Interior or Exterior Insulation Walls From Reference in Furring Space from Reference. :Mint Appendix Table 4.3.5,4.16.4.3.7 Joint Appendix'Ruble 4.3.13 = y = a - C u U O V m _ LL 3 Assembly - j a c A F- ~ ..� n o-u Final . y .. E e. „ Muss Name m JA4'hb: J r u = E g t°o t q V ? y 5 Assembly Thicket:ss' Type' Number' < 2 = u; ,t G if, r < '. w U-factor" Comment• - •Registration Number: Registration Date/Time:: HERS Provider: 2008 Residential Compliance Forms August 2009 (___ ti Prescriptive Certificate of Compliance: Residential CF-1R-ACT 2csidenfial Alterations (Page 3 of 5) Project Name: I Climate Zoo I ii of Stories ROOFING PRODUCTS (COOL ROOFS)§151(012 ll'hen the area of exterior roof cutftee to be replaced exceeds more than.S(7%of the existing roof area,or more than 1,00(1 frj, whichever i.s less, the nein roofing urea must meet the roofing product"Cool Roof'requirements of,§152(b)/P/i, 152(1,)IHll,or 152(b)1 iliii. Check applicable alternative ar exception below if the roof alteration Cr exempt from the roofing product "Cool Roof"requirements.Note:If any one of the alternatives or exception below is checked,the Aged Solar Reflectance and Thermal Entltmrrce requirements for roofing products in ISM are not applicable. Do not fill table below. ,§ 'eel hoofs Not Required in Climate Zones 1-12, 14,and 16 with a Low Sloped. Less or 2:12 pitch. Cool Roofs Not Required in Climate Zones I through 9 and 16 with a Steep-Sloped Roofs(pitch greater than 2:12)and product unit weight less than 51h/f1'. Alternatives to§152(6)1111 and §I52(1)Flii,Steep-slope roof(pitch>2:12) O Insulation with a thermal resistance of at least 0.85 hrft2.°F/lira or at.icast a 3/4 inch air-space is added to the roof deck over an attic;or O Existing ducts in the attic are insulated and sealed according to§1510)10;or ❑ In climate zones 10, 12 and 13,with I ft2 of free ventilation area of attic ventilation for every 150 ft'of attic floor area,and where at least 30 percent of the free ventilation area is within 2 feet vertical distance of the roof ridge;or ❑ Building has at least R-30 ceiling insulation;or O Building has radiant barrier in the attic meeting the requirements of§151(02;or ❑ Building has no ducts in the attic;or ❑ In climate zones 10,I I, 13 and 14,It-3 or greater roof deck insulation above vented attic. - Exception to§152(b)l Fliii,Low-slope roof(pitch 52:12) O Building has no ducts in the attic. Other Exceptions ❑Roofing area covered by building integrated;photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. . :O Roof constructions that hove thermal mass over the roof membrane with at least 25 lb/ft' is exempt from the below Cool Roof criteria. • - Note If no CRRC-1 label is available,this compliance method cannot be used,use the Performance Approach to show compliance,otherwise, _ Check the applicable box below if Exempt from the Roofm 7 Products"Cool Roof'Requirement: Roof Slope Product Weight Product Aged Solar Thermal CRRC Product ID Numbest << 2:12 >2:12 < 51b/ft' > 51b/ft' Type' Reflectance314 Eminence SRI5 ❑ I ❑ 0 0 ❑4 1 ❑ 1 ❑ 0 0 04 I ❑ I ❑ 0 0 ❑'+ 1 ❑ I ❑ 0 ❑ 04 0 0 0 ❑ ❑4 I. The CRRC Product ID Number call be obtained from the Cool Roof Rating Council's Rated Product Directory at rvww,coolroa(c.ore/oroducts/search,ohp 2. Indicate the Ape of product is being used for the roof top,i.c.single-ply roof;asphalt roar,metal roof,etc. 1. If the Aged Reflectance is not available in.dre Cool Roof Rating Council's Rated Product Directory then use the Initial Reflectance value from the sane directoy and use the equation(0.2+0.7(pthus—0.2)10 obtain a calculated aged value. Where p is the Initial Solar Reflectance. 4. Check box i(the Aged Reflectance is a calculated value using the equation above. . 5. Calculate the SRI value by using the SRI- Worksheet al hue://wwn'.enern'.cawov/title24/and enter the resulting value in the SRI Column above and attach acopy of the SRI- Worksheet to the CF-IR. To apply Liquid Field Applied Coatings,the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage ' recommended by the coatings manufacturer and meet minimum performance requirements listed in§118(i)4. Select the applicable coating: ❑ Aluminum-Pigmented Asphalt Roof Coating I❑ Cement-Based Roof Coating I❑ Other • • Registration Number: Registration Date/Time: HERS Provider: 2008 Residential Compliance Forms - August 2009 , Prescriptive Certificate of Compliance: Residential CF-112-ALT R ositlentitt/Alterations i (Pa 2e 5 of 5) Project None: [ J// Climate 2.on f S of Stories El HERS VERIFICATION SUMMARY The enforcement agency should par special anenrion to the HERS Measures specified in this checklist belay. A completed and signed CF-4R Form Jar all the measures specified shall be submitted to the building inspector before final inspection. Duct Sealing & Testing HEIRS verification is required for this meanac. 0 YES 0 NO YES:In Climate Zones 2 and 9-16,if more than 40 linear feet of new or replacement duct:are insulted in unconditioned space,the ducts are to be sealed per§l52(b)lDii and the newly installed ducts arc to be insulated per §151(1)10. ❑ EXCEPTION:Existing duct systems that are extended, which are constructed,insulated or sealed with asbestos, ❑ YES 0 NO YES:In Climate Zones 2 and 9-16, if the existing space-conditioning system(HVAC equipment and ducting) is replaced,the ducts ate to he sealed per§l52(h)1Di. ❑ YES 0 NO YES:In Climate Zones 2 and 9-16:if the existing HVAC equipment is replaced (including the replacement of the air handler, outdoor condensing unit of a split system,cooling or heating coil,or the furnace heal exchanger)the ducts are to be sealed pet §152(b)lE. ❑ EXCEPTION:Duct systems that are documented to have been previously sealed confirmed through HERS verification iu accordance with procedures in the Reference Residential Appendix RA3. ❑ ,EXCEPTION:Duct systems with less than 40-linear feet in unconditioned space. . ❑ EXCEPTION:Existing duct systems constructed,insulated or sealer) with asbestos. Refrigerant Charge- Split System HERS verification is required for this measure. ❑YES ❑NO YES:In Climate Zones 2 and 6-15,when the existing HVAC equipment is replaced(including the replacement of the air handler,outdoor condensing unit of a split system A/C or heat pump,cooling or heating coil,or the furnace heat exchanger)a refrigerant charge measurement shall be verified per§152(b)lF. Central Fan Integrated (CFI)Ventilation System and Fan Watt Draw The ventilation requirements of§150(0)do not apply to existing residential homes. Ducted Split Systems-Air Conditioners and Heat Pumps: Airflow HERS verification is required for this measure. - ❑YES 0 NO YES:In Climate Zones 10 through 15,when the existing space-conditioning system(H VAC equipment and ducting)is replaced.the airflow and fan watt draw shall be verified per§152(6)1 Ci to meet the reouirements of§I5 MM. Documentation other's Declaration Statement • I certify that tis Certificate of Compliance documentation is accurate and complete. Name: I Signature: Company: Date: • Address: If Applicable❑CEA or 0 CEPE (Certification N): City/Stnte/Zip: Phone: Responsible Building Designer's Declaration Statement • lam eligible.under Division 3 of the California Business anti Professions Code to accept responsibility for the building design identified on this Certificate of Compliance. • ]certify that the energy leaning and performance specification:for the building design identified of this Certificate of Compliance conform to the requirements of Title 24,Pam I and 6 of the California Code of Regulations. • The building design features identified on this Certificate of Compliance me consistent with the iniorntatiot provided to tlueomen this building design on the other applicable compliance/terms,worksheets,calculations,plans anti specification':submitter/ to the enforcement _a'ency fo apprnvaI with this buildiug permit application. _HunteSignature: Cr( am.CSC. I'"��-- (_o npanyl -IYittee: pina= C-• Aildress`4 chicense'r "IR cc L -aw.-a,t . City/titatellihr. � ^ - , ' C 1t+ - '--tc c -- 'VI 165 2337• For assistance or questions regarding the Energy Stantlartlx, contact the Energy Hotline as: 1-80(1-772-3300. iteitsiaiion Number itugitu-arion bate/Time: PIERS Provider: I: r In 4Lo 6 9 CITY OF COSTA MESA • ��@@@ BUILDING DIVISION e g Ar- DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 "Ka PERMIT 'A-` oRgisp1g• P00-00529 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 117 23RD ST Status: ISSUED Suite No Applied: 09/21/2000 Issued: 09/21/2000 Vicinity: BATHROOM Parcel Nunmber: 42605405 ISSUED BY: Applicant: O'NEILL, CAROL Address: 117 E 23RD ST Phone: (949)574-1848 COSTA MESA,CA Zip: 92627 • Owner: O'NEILL, CAROL Address 117 E 23RD ST Phone: (949)574-1848 COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 0 Arch I Eng: Address: Phone: Zip: • License: SCOPE OF PERMIT PLUMBING PERMIT FOR BATHROOM REMODEL OF EXISTING SINGLE FAMILY RESIDENCE. INSTALL 1 WASH BASIN, 1 WATER CLOSET,& 1 BATHTUB. FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units S0.00 0 Septic Tank $0.00 0 Wash Basin $9.80 1 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet(Toilet) $9.80 1 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $52.90 COMMENTS/SPECIAL CONDITIONS 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 2446-48(6/00) . I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one 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,for the performance of the work for which this permit is issued. O 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 this permit is Issued. 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 California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith 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 DOLIARE 15100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S 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.# Class# Contractor's 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). Lender's 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 to a civil penalty of not more than live hundred dollars($500).): .34-1-177s, wner 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,as 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 p uant to the Contractors License Laws.). ❑ I am em ndrot%fit 4 ^ Business and Professions Code for this reason: Signature: Q � Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires:q Verification of of Ownership by(type of document,i.e.-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,Gm 2,Art 2,Sec. 341,Title 8,California Administrative Code). O 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: 1 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 ❑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 al 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 ❑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 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)? ❑ves 0N (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 ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LI Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 WI/1 any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penally of perjury that I have read this application and state that the information given is correct.Ito comply wit al .te laws and city ordinances relating to building construction,end authorize representatives of the City of Costa Mesa to enter upon the above-d:td y••erty fo#fsP/. u D.es.I agr not to occupy or allow occupancy of any building authorized by this permit yRtil ina insp6q(ioh. `` Yq (rA d //Vl)ill Signature 0 Legal Ow r(s) And/Or Authorized Applicant Date ;ODE t INSPECTIONTYPE RAIL =ALS ;ODE( INSPECTION TYPE GAIL 'MGM 1616 Fixed System Final Fire Prevention - 206 Final Mechanical • 1266 Pool Spa Final 208 Final Plumbing OM/et 49r,brAy 200 Final Re-Roof 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 BuildinglOccupancy I Brr_ss: 11723RD ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 063201 'S NAME: SCHER MICHAEL J TR ADOREss:8418 i'UCCA TRAIL PERMIT NO: B 063201 PLAN CHECK NO: N GOVT: N SUPP; N LOS ANGELES, CA 90046 CONSTRUCTION TYPE: V-N PERMIT TYPE; S'I'R PURPOSE: REP 213) 654-3740 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT: 20, 000 ADDRESS: UNIT: CLAIM VALUE: 20, 000, 00 CALC-VALUE: 20,000 . 00 GROUP OCC: R-3 / PERMITTEE:JAY C. EVANS CONSTRUCTION ( 714 ) 660-4590 \ ADDRESS: 1300 BRISTOL ST 100 COMMENTS: LUMBER 2 , ,t REPLACE DRY WALL & CEILING 3 . NEW SIDING 4 PULL E/M/P NEWPORT BEACH CA 9 �J ***>E*x,EN+r******* >ESE>E *ce************ E�E�6 *Nx*#�6fr�E***********stx*TE**** **** ***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I a 1 ' t .ed under pr. Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,a.: y Ii se is in I,'ir• d effect. SETBACKS CITY LIC.: STATE LIC.:5309,4 , C ': 'P hate: -27-Q 3 Signa e:_ _ MAIN BUILDING ACCESSORY BUILDING �% WORKERS'COMPENSATION DECLARATION: I he 'by all 't have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR : FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy ther.f(5' n y:O0.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.:1 1 8 2 6 3 2-9 2 EXP.DATE' . 4/01 1 4 mw- .STATE F 'NT' PARKING RE • PROV: PARCEL: 42605405 ZNE: REF NO: 'h 'J enilied copy i ereb . .. ed. IV t' ified c•. is filed dh ty : ilding Division. PLANNING NOTES> I EXEM• 11 WORKERS'COMPENSATION DEC •RATIO. ( section need not be completed if the permit is for one hundred MOO)w less). D E V E L O P' M E N 1X S SERVICES R E Q U I R E. M E N 'fir S 1_,0••y .tin the performance of the work for hich - permit is issued,I shall not employ any person in any manner so as to become ,. - • le to the Workers'Compensation Laws. ornia. ZONING APPROVED BY , , DAT rate: Signature: e1� k (;� NOTICE:II,alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED B' ; ) + DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. ^ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED if : ' ` /r� DATE- 7G� which this permit is issued(Section 3097.Civ.C). *****************#OI***** - m.*********** i� *************x***********Xdr ****It *4 UNDER: *************************************** ** :**************************I1'********* ADOREss:REPAIR FIRE DAMAGE TO SFR LEGALIZATION:N F E E SU . M A R YSTRUCTURAL SEGMENT; Y ,'x 1 . REPLACE ALL FIRE DAMAG OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the fotowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE—"SMIP/RES v GRADING (Section 7031.5 Business and Prolessional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 207 . 00 2 00': repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed .e pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7010)of Division 3 0l the Business !../. SM I P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by P LAN • f • •any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE ' I. as owner of the property or my employees with wages as their sole compensation, wilt do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-*CHECK TOTAL PAID ' DUE ❑ structure is not intended or"tiered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 209 ,00 0 , 00 i ' 0 . 00 209% 00 209 . 00 - . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--, COLLECTED : 209 . 00 -OVER/SHORT: . 00 for the purpose 01 sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP,/TOT GRADING PLAN-CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 207. 00 '..2 . 00 . i ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware *.****.***.*****x,**,****,****.*.****if****.1********.***.**************.********icAdt******** that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.A P.C. I N D I V I D U A L F E E B R E-4 K' D 0 W N for this reason: TYPE QTY DESCRIPTIO N UNIT COST tOTAL COST Date.- Owner:— ..• - SFR 20000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 .. 20, 000 . 00 I do hereby certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES qI i 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a t' permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. _ • /' • Date. Applicant: Sq. a ./ ,i• n . I hereby certify that I have read this application and state .1 the above inf. .tion is corn-• / to comply with all city and county :/ v.". ordinances and state laws relating to building constructlo .nd hereby autho'a represent. to enter upon the above.mentillned property for inspection7purposes./� /' Si 00143634-00143635 TOT 207.00 -----Itre: /—G 7- 73 Sign tire: „ DATE: 07/27/93 TIME: 11:34 Driver's License or Social Security s: 1641,46 White—Building:Green—Cade Entorcemen Ganary—Applicant:Pink—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING I POO- SPA I f ' APPROVALS Permits;- Date Inspector APPROVALS Permit -11-- Date 1lnsucrtor • 1, Temporary Electr:cai Sercicc or Pole 52. Pool & Equidmcnt Location ; 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit litd.ty-Und•grnd. i 54. Fomes I I -_ -h--- I ---' . 4. Electrical Candu,bUnd-mnri / I 55. Electrical Bnrdmg i - S. Steel Reinforcement 56 Rough Plumb n,& Pressure Test 6. Electrical OF ER Grnd 57. APPROVP I 'O COVE R.Gl ' :' E - - - -- ------ - --�- - - -LL --- . 7. Footings 58. Electrical Condu tiUndroma. • 8. Foundation 59. Gas P,pe, �i Uruig'nd , Test I 9. Water Pipe-Undrgrnd. t 60 Backwash Luta:, P•Trap, 171 cl'ndrm rid it_ 1 10. Structural Floor Systen , 61, A'PF.OVAL TO LEC'C 1 11. Property Sewer Line & Hours Connection 1 E2. 2 cc.esh & Rcc . --- I--- r-- - - 12. Sewer Cap • 63. Harder & Vent-Final - --_� 13. Root Diains 34. Plumbing System F ••al j 14. Rougn Plumbing 65. :leclrical-Final 15. Rough Electrical-Conduit 66. Solar System-Finui _ - 16. Rough Electric l."iring 6/ Fencing & Access Appro„a! '' I 17. Rough tYLnrg Sign --__;-- B. APPROVED_0R P LASTERLLG --_-- -- - 18. Rough Electrical-T Bar Cay. rn 69. I'OO L/SPA SYSTL'.:S FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 2C. Rough Factory Firep'act APPROVALS Perritt 4 _ _ I ' 21. Ducts, in Structure 70. Underground Hyino I 22. Ducts. Ventilating 71 Product P:ping '1 Gas J Oil 1- 23. G:s Pipe-Rougn & Test 77. Ucde-a'ou',i Ra,- ----r-- 24 Roof '-ram:ng -_ - - -- i -_- -_ 73. jrcl:rrr.o.E'n tai : _- - - -- - H-- - - 25. Prof Shr alinng 1 I �I74C - --1 . :rhd H eavt�ro I- -�- 76. T-Bar Ceding (Structural' & Monocoat I I 75. D Chem'r..i Ir o•-- 27. Flame and Bashing - -- - i/f / 76. Dry Stanup. 'a --- - _ --- L. --- -! - 'I 25. Lathing & Sd.ngi I 77. FIXED SYSTEM FINAL - _ 29. Insulation _ 78. FIRE PREY. FINAL 1 _ 1 39Dry:ell a„inc / I //(yam I HEALTH DEPT. REQUIREi.,FfJ,- 3:. P'.;,ster :•oweCoat _- _ -- _ - lG�-/TI" _ - 79. FI's.>LR_.. :-C c - _ AI 32 Electrical Power Meter Fi^„1 _ 80 FOOD CERT:Fit1_\TE 'SS::1_D 1 33. Final E'ectric I Rut.-s: a� - /f__�/,- 4( �d-� • !(4/ 34. Rm.: Heating & Air Co'drtior.r.g [ 1-A o 3 /�se� 35. Final Gat Pi pc-Test 33. Hood or Canopy ------ - - �-'-'_-' - - - ---- -- ----- - -- - - 37. Fa-al Factory plrrp'a c- -- -- - --- --- - - -- I -- --- Lam. -- - -- - -- - - -- - -- -- -- .. 33. Fina. Plumbing rag. Water Service•Final 40. Gas Service-Final 41. Solar Dame>tic-Finalri---__-- --.1 -,,, r Le, 4r - aCelL. 42. Baacf low Preventer u 43. Backflow Irrigation 44 Landscape Irrigation S•, '.tem # - -_---- ----- - 45. Sound Attenuation 46 Handicap Regulations 1 47. FINAL STRUCTURE & BUILDING ` /-- 10. 5Ett4 c � ml- ---0tGO-X 48. FINAL PLANNING 49. Electric Release to Edison i 50. Gas Reltase to Southern California Gas Co 51. CERTIFICATE OF CCCUPANCY - - No. Date - - -' • . City of Costa Mesa California 92628-1200 P.O.Box 1200 Insulation Certificate Permit Number v 3 2c) (/o d;z`^� `� 1/7 23eos % C0s7A Plc=5 4 �^ A ' Number end Street City 7241k)q O CC County Subdivision Lot Number Description of Installation ROOF Material • mvn/it Jr1/, )& r-c-- Brand Name Thickness (inches) Thermal Resistance (R-Value) EXTERIOR WALL Material _69-7- Brand Name e,o5 ec>/G,J"` c. Thickness (inches) G - Thermal Resistance (R-Value) /7 CEILING Batt or Blanket Type (Y/7 Brand Name ocJ6-ZS-CoetJnoC. Thickness (inches) /U" Thermal Resistance (R-Value) 20 Loose Fill Type Brand Name Contractor's minimum installed weight/ft2_ lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) RAISED FLOOR • Material Brand Name Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Adminstrative Code. 604 coin /NC. s s o q c{ ¢neral Contractor(Builder) License Number Pr�,•p /( -1-93 Signature and Title Date all_SC. 6-c}a-Ai5 6arj-C�V:7 C S'3098 `1' ntractor(Insulation Installer) License Number A/ (Ft—f 3 Signature and Title Date 190746 PROJECT ADDRESS: 117 23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 063204 ADDRESS:OWNE SS: SCHER, MICHAEL J TR oDR : 8418 YUCCA TRAIL PERMIT NO; P 063204 PLAN CHECK NO; N GOVT: N SUPP ; N LOS ANGELES, CA 90046 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP ARCMIENGINEER: 213) 654-3740 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT; PERMITTEE: CLAIM VALUE: 20, 000 , 00 CALC—VALUE: GROUP OCC: R-3 / RORE55: JAY C. EVANS CONSTRUCTION ( 714 ) 660-4590 1300 BRISTOL ST 100 COMMENTS : REF; B63201 NEWPORT BEACH CA92 h *********'***x-x'X*****z'4E'>EKx-******>E.*�E******x.****a6****x*N-�pxx**>E* *Utz*-X** ****z*** * LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under prows s o .pter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 0l the Business and Professions Code,and . ' •r e is in full an. Oct. CITY LIC.: STATE LIC.:S 3 0 9 1) + C 6 SETBACKS _____-rig 7-27-q3 Slgnatu : � _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I henry affirm I l h a certificate of consent to self-insure or acertifica• .I Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation Insurance.or a certified copy mer.1(Sec ir 35e1. ab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: 1182632-92 EXP.DATE: 04 /01 /94 MenNiedST ATEyfFUND Certified PARKING REQ; PROV: PARCEL: 42605405 %NE; REF NO: ❑ �C PLANNING N(5TE5> • > Date: Applicant: *************1hK-*iE**iE*****fE*********IE*****IE**lE*3liE**M**ft************3h* ********** EXEMPTION P:• • ORKEMS'COMPENSATION DECLARATION:, (This sec i.•• ,.not be jujr•. the permit is for one hundred(5100)or less). DEVELOPMENT S E R V I C E S , R E Q U I R E M E N T S I certify '. in the performance of the work for which this perm' ' ssue•, sh. oy any person in any manner so as to become sub: to the Workers'Compensation Laws of California. �/ / • ZONING APPROVED BY DATE; Signal .-- ITICE:If,after making this declaration,you. ould .•co • subject to the Workers'Compensation provisions . .e Labor BUILDING APPROVED BY : I DATE: Code.you must forthwith comply with such 4 rovi '. s.- "is permit shall be deemed revoked. • r ( CONSTRUCTION LENDING AGENCY: I hereby: that there is a construction lending agency for the performance of the work for - -e '�� which this permit is issued(Section 3097.Civ.C) APPLICATION ISSUED BY; la • - DATE: —a ************************* * :**** ****** ,. ***IFft**************-***IE* *,e****fix** LENDER: • ****************************************** -.***fE*************-******************* ADDRESS: REPAIR FIRE DAMAGE TO SFR LEGALIZATION;N F E E S U/M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC `1 MECHANIC FIRE SNIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 1 0 0 '=` repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . 5% ,°' n SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN /2"any applicant tor a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 20 . 00 I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHEC}, TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 21 . 0 0 2 0 , 0 0 01'. 004 41 . 00 41 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED, 41 , 00 OVER/SHORT; 00 , for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 41 , 00 - • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • and who contracts for such protects with acontractor(s)license pursuant to the Contractors'State License Law).lam aware **,****,*,**„**************************i(******************************************* that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.Si P.C. INDIVIDUAL, F Et BREAKDOWN for this reason: , TYPE QTY D E S C R I P T I O,N UNIT COST TOTAL COST Date: Owner: • PLU 1 BATHTUB mi ? 7 , 00 7 . 00 I do hereby certify that I am aware of and understand the requirements of Califorcompl alth and Safety Code Sections 25505,25533,and PLU 1 WASH BASIN 7, 00 ] , OO 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements fora permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from P LU 1 WATER CLOSET (TOILET) 7. 00 7 , 00 these provisions. END OFt FEES Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agr to comply with all city and county ... 1 ordinances and state laws relating to building construction and here. •ipresentativ of ' city to enter upon the above-mentioned y 1 • , property for inspection purposes. - / • • Rale: /2—?713 Signet j I. ' 01 00143637-00143632 TOT 41.00 Driver's License or Social Security#: " I. 1 DATE: 07/27/933 TIME: 11:32 1641-46 White—Building;Green—Code E .cement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL SPA ' AP; ,:OVALS Permit# Date Inspector APPROVALS Permit ; Date Inspector ' 'I. Temporary Electrical Service or Pole i- 52. Pool & Equipment Location 1 2. So Pipe-Undrgrnd. - 53. Steel Reinforcement '3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding I I 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test Iii 6. E.r;tnca' UF ER Grnd. 1 ' 57. APPROVAL TO COVFR-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. I 8. Foundation - - 59. Gas P.pe, 0 Undrgrnd.,Test v I 9. Meter Pipe-Undrgrnd. I 60. Backwash Lines, P-Trap, C+ Undrgrrd. - 10. Sructura! Floor System - 61. APPROVAL TO DECK t ---1 ! 11. Vi-opc-ty Se:.ar Line & House Connection 62. Back vash & Receptor-Final , r - , 1 12. Scorer Cap - / 53. Heater & Vent-Final -yI 13. Firm. Dram, /" - 64. Plumbing System Final 1 14. Rough Plumbing leifi Ifle 65. Electrical-Final 15 Ru.:ah Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rai.gh Wring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Ro.eh Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Roiigl• Factory Fireplace . APPROVALS Permit -tri- 21. r 21. 0.-is, •n Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas C Oil 23. Ga: Ripe-Rough & Test 72. Underground Flush 24 Roof Framing 73. Undergrnd.Storage Tank C Gas C Gd 25. Roe* Sh:ath'ng 74. Overhead Hydro I I 26. T•Bar Ceiling (Structural) & illonocoat 75. Dry Chemical { 27. Frame anc. Flashing 76. Dry Standpipe Xi 28. Latn�ng & Siding 77. FIXED SYSTEM FIi,AL 4 29. InsulationI 78. FIRE PREY. FINAL I 30. Dryv.all Nailing I! HEALTH DEPT. REQUIREMENT 1 31. ?raster Brown Coat ( 79. FINAL INSPECTION ! 32. Electrical Pov.er Meter-Final 80. FOOD CERTIFICATE ISSUED I. Notes: -{ 33. Fina; Electric q//_/?-foo �r T7= sfee •_ 34. F:na. Heat.ng & Air Conoitionir,g I y/ 35. Final Gas Pipe-Test " i 36. Hood or Canopy it Y -r_Scrii 37. Final Factory Fireplace i -- --- -.---- - ' 36. Final Plumbing 1/ -7/1q G� _ - I 39. Water Service-Final !I :0. Gas Service-Final j 1 T -� 41. Solar Domestic-Final --1,, 42. Backflow Preventer - -., 43. Backflow Irrigation I 41. Landscape Irrigation System 45, Sound Attenuation - -i ii 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING t 48. FINAL PLANNING _- 49. Electric Release to Edison ' ! 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 1 PROJECT ADDRESS: UNIT: ---..._ OWNER'S/NAME: 417 23RD ST CITY OF COSTA MESA - BUILDING PERMIT PERM NO; E 0632.021-" -- ADDRESS: SCHER MICHAEL J TR 8418 YUCCA TRAIL PERMIT NO; E 063202 PLAN CHECK NO: N GOVT; N SUPP: N LOS ANGELES, CA 90046 CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: REP ARCM/ENGINEER: 213) 654-3740 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT: • PERMITTEE: CLAIM VALUE: 20, 000 . 00 CALL-VALUE: GROUP OCC; R-3 / ADERESS:JAY C. EVANS CONSTRUCTION ( 714 ) 660-4590 1300 BRISTOL ST 100 COMMENTS; REF; B63201 NEWPORT BEACH CA 92660 ****** * *n..x..>EBF*** ** ac-+L -x***x ..,Ex..****>t •x**x*>E* **** Lx•rt****>t**4(*** *4(*** **** E LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIR EMENTS 7000)of Div. on�j oL the Business and Professions Cade,and my Ii..r • is in lull force d effect. CITY 71 STATE uc.: LASS:,.i S E T B A C K S 2 93 5309 ' Signet : MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: the .y affirm .rl h. •• ificate of consent to self-insure or acenificate of Workers' FRNT: FT IN REAR; FT IN FRNT; FT IN REAR : FT IN Compensation Insurance.or a certified copy ther of(Sec` 3811.Lab.Cl. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.:1182632-92 EXP.DATE: '4 /01 /94 CDMPANY:STATE FUND_ PARKING REQ: PROV: PARCEL: 42605405 ZNE: REF NO: ❑ Certified copy is hereby furnished. 7F' Certified c,'• is filed wi the '.—r• l 4 '.•n. PLANNING NOTES> %!) • �J > • 7% 7'13 Aim ant: • ' *********************************0*!f***********************************.******** EXEMPTION FROM WORKERS'COMPENSATION 0 •RATH . (This- 'ed not be co.•n•Ieted if the.: 1 is for one hundred($100)or less). DEVELOPMENT S 44R VICES REQUIREMENTS I certify that in the performance of the work I• whi • is per - r :•ed,I shall • e ploy.• •erson in any manner so as to become e. l to the Workers'Compensation Lar • alilornia. Dat / ZONING APPROVED BY '7 r DATE: Dale: Signa e: /` NOTICE:II.after making this declaration,yo sho 4 become subje to the Workers'Compensation provi . • he Labor BUILDING APPROVED BY �/ DATE: Code.you must forthwith comply with su pr. Ions or this permit shall be deemed revoked. �,,�� CONSTRUCTION LENDING AGENCY: her.. um that(here is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: if L DATE c 7�7 which this permit is sued(Section 3097, . ,,C). *********************4 — r. .. ********4* ****** * ** LENDER: ADDRESS: ***********************************12•*** . ************************************* REPAIR FIRE DAMAGE TO SFR LEGALIZATION;N FEE ' SUMMARY Y STRUCTURAL SEGMENT: N OWNER GUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING .(Section 7031.5 Business and Professional Code: Any city of 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/she is licensed PERMIT • .7'.50 pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0 t SM I P/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15. 0%0 I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 7. 50 15 . 0 0 ...0 , 0 0 22, 50 22 . 50 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 22. 50 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHAN C FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the prnpeny,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 22 . 50 ' • ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***_*.**.***.****x*****.*,**********iE********.*^3E************************************** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.E.P.C. INDIVIDUAL F E E BREAKDOWN for reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and ELE 6 REC EPT/OUTLET 1 ST 20 EA. 75 4 50 25534 and that l or any future building occupant will/will dot(circle one)need to comply with said state codes and the requirements for a ELE 4 RECEPT/SWITCH 1 ST 20 EA, , 75 3 . 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES these provisions. Date: Applicant: I hereby certify that I have read this application and stale that t , . •v, formation i iv.---.gree to comply with all city and county ordinances and state laws relating to building construction an. •reb thoriz• •;.-' NC of this city to enter upon the above-mentioned property for inspection purposes. Dom. 7-27-93 Sign ure: / 01 00143631-00143631 TOT 22.50 k DATE: 07/27/93 TIME: 11:32 Driver's License or Social Security+: • 1601-46 White—Building:Green—Code r IorcemenL Canary—Applicant:Pink—Revenue:Goldenrod—Assessor \ "°` POOL .,PA i CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector '1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility•Undrgrnd. 54. Forms 1 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding l 5. Ste. Reinforcement 56. Rough Plumbing & Pressure Test - i 6. Eeetr a' UF ER Grnd 57. APPROVAL TO COVERiGUNITE ' I 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. : 60. Backwash Lines,P-Trap, a Undrgrrd. 10. Structural Floor System 61. APPROVAL TO DECK i 11. Property Sewer Line & House Connection 62. Backr:ach & Receptor-Final 12. Sarver Cap - , I63. Heater & Vent-Final I 13. Roof Drains , ' 64. Plumbing System - Final I 14. Rough Plumbing 65. Electrical-Final 15 Rough Electrical-Conduit • 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing& Access Approval I 17. He ugh W.r.ng Sign 68. APPROVED FOR PLASTERING 18. Rrugh Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ?0. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil I f 23. Gas Pipe Rough & Test 72. Underground Flush 74. Roof Framing 73. Undergrnd.Storage Tank C Gas Ti 0i' 25. Roo' Sheathing 74. Overhead Hydro 26. T•Bar Ceiling (Structural) & ivlonocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lath.ng & Siding 77. FIXED SYSTEM FINAL 29. Insuttion I 78. FIRE PREV. FINAL i 30. Dryr.ali Nailing HEALTH DEPT. REQUIREMENT -31. Plaster Bro,vn Coat - 79. FINAL INSPECTION -1 32, Electrical Power Meter-Final 1 80. FOOD CERTIFICATE ISSUED I Ai) 33. Final ElecHeatingc ll_-Q7 k!vS4 Notes: - 34. Final Heating & Air Conditioning - I 1 t -' 35. Final Gas Pipe-Test I I 36. Hood or CanoPY I - 37. Final Factory Fireplace {f 38. Final Plumbing I i 39. Water Service-Final 10. Gas Service-Final F-_ -• i E41. Solar Domestic-Final i I 42. Backflow Preventer 43. Backflow Irrigation I--- -H 44. Landscape Irrigation System 45. Sound Attenuation 45. Handicap Regulations I j' r47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49, Electric Release to Edison - , 50. Gas Release to Southern California Gas Co •- 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: .11 .iAD ST OWNER'S NAME: UNIT: y CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 064609 SCHER, MICHAEL J TR ADDRESS: 8418 YUCCA TRAIL PERMIT NO: P 064609 PLAN CHECK NO: N GOVT: N SUPP: Y LOS ANGELES, CA 90046 CONSTRUCTION TYPE: V—.N . PERMIT TYPE: PLU PURPOSE: REP ARCH/ENGINEER: 213 ) 654-3740 REG.NO.: ' • ADDRESS: UNIT: JOB DESCRIPTION : REPAIA11'FIRE DAMAGE TO A SFR (AUTO.WASH) SQ FT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC : R-3 / ADDRESS: JAY C. EVANS CONSTRUCTION ( 714 ) 660-4590 . 1300 BRISTOL ST 100 COMMENTS : REF: 863201 .6 P63204 NEWPORT BEACH CA ;60 ***->E*****�6*kl-�Far�r�l-*aE*�P***********************ac**+est-itx,e-�6******N-+r -yt�t*�r**+r***�F**�r***** LICENSED CONTRACTOR DECLARATION: I here y a firm that I am licensed under provisions of hap er 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my licens s in lull ce and effect. Z ON ING R EQU IR EMEN TS CITY LIG.: STATE LIC.: SETBACKS 057796 530984 H Date:_/0-z$-4.7 Signature: — MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby hats e a certificate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: 'FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof ton 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY ND.: 1182632-92 EXP.OATE: 04 /01 /94 COMPANY: STATE FUND PARKING REQ• PROV: PARCEL : 42605405 ZNE: REF NO: . 0 Certified copy is hereby furnished.FUND= Certified Copy is file. ith the city Building Division. PLANNING NOTES> ! Date: /0 —ZS4 > .1; � � Applic... **********************************************4******************************** EXEMPTION FROM WORKERS'COMPENSATION DEC •'ATION: (This section need not be completed if permit is for one hundred(51W)or less). DEVELOPMENT S E R V I C E S REQUIREMENTS I certify that in the performance of the work to •hich this.' it is issued.I shall not employ any person in any manner so as to become subject to the Workers Compensation Law;of Calif. a. ZONING APPROVED BY • Date: ignature: DATE: NOTICE:II,alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : ,�' DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �/f� CONSTRUCTIONtiserm LENDINGeAGENCY: .hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: • '/�// [.9'I-GJ- f�C� DATE: /d Z—,S which this permit is issued(Section 3097.Civ.C). ********************************* ****aaa///****jy`;$F • LENDER: ********************************************* ********************************* ADDRESS: *********************************3************ FIRE DAMAGE TO SFR LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7,00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($500). ISSUE FEE 10 . 00 I. as owner of the properly or my employees with wages as then sole compensation, wit do the work, and the BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 7 . 00 10 . 0 0 0 . 00 17 . 00 17 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.II.however the building or improvement is sold within one year of completion.the owner win have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 17. 00 OVER/SHORT: . 00 tor the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 17 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ********,****,***************************************************DD************** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN mems reason TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 LAUNDRY TUB OR WASHER 7 . 00 7 , OQ 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions, Date: Applicant: I hereby certify that I have read this application and state that the above information i5 Correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby author 'representatives of this city to enter upon the above-mentioned property for inspection purposes. Date.//7 G) 3 Sign. . : /i 01 00149494-00149494 TOT 17.00 DATE: 10/25/93 TIME: 08:07 Driver's License or Social Security 4: 1641.46 While—mudding:Green—Code Enforcement.Canary—Applicant;Pmk—Revenue:Goldenrod—Assessor • CONSTRUCTION AND PLANNING POOL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector -1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test I 6. Electr.cal UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. - i 60. Backwash Lines,P-Trap, 0 Undrgrrd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15 Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing SYM./G/ -- 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1?.'23RD ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 064583 OWNER'S NAME: SCHER, MICHAEL J TR ADDRESS: 8418 YUCCA TRAIL PERMIT NO; P 064583 PLAN CHECK NO: N GOVT: N SUPP : Y LOS ANGELES, CA 90046 CONSTRICTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: REP ARCH/ENGINEER: 213 ) 654-3740 REG.ND.: ` ADDRESS: UNIT: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT: PERMITTEE: CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 / ADDRESS: JAY C , EVANS CONSTRUCTION ( 714 ) 660-4590 , 1300 BRISTOL ST 100 COMMENTS : REF: B63201 & P63204 NEWPORT BEACH CA92E6(1 a6+r***FE*kP+ x�r�ra ******a6********+r*ar* •*******FE*****at**ar*aF�r�rar�r*x******** -x-**** ****ar* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed um• provisions o per 9(commencing with Section Z O N I N G R E Q U I R E M E N T $ 7010 al Division 3 of the Business and Professions Code.and m lice. .I fora . r eflect. • CITY LIC.: 572.16 sTaTE LIC.:5309 : S E T B ACK S Dale / V Sgnam' MAIN BUILDING ACCESSORY BUILDING WORKS S'COMPENSATION DECLARATION: the . thatI have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy th• •r i . that :Ito,Lab.c). LEFT: FT IN RGHT,: FT IN LEFT: FT IN RGHT; FT IN POLICYND.: 1182632-92EXP.DATE; 04 /01 /94 cOMPaxy: STATE FUND PARKING REQ• PROV: PARCEL: 42605405 ZNE: REF NO: 0 Certified copy is hereby furnished. Cr- CMrpy is filed ; ity Building Division. PLANNING NOTES> > .4—'2.4—'2 Date- AY2//��7. Applicant: Aar ***************************************'**************************************** EXEMPTION FROM WORKERS'COMPENSATION DEC 'r•i N: (This section need not be completed if the permit is for one hundred 4100)or less). D EVEL OP MEN T S E R V..I C E S R EQU IR EMEN TS I certify that in the performance of the v rk for w'' this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws• California. ZONING APPROVED BY .✓ Date: Signature: DATE; NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for �� qq APPLICATION ISSUED BY: • . .RDATE;l0 2 (�1 ( —1-.2 which this permit is issued(Section 3097.Civ.C1. ****************************************** ************************************ LENDER: ******************************************************************************* ADDRESS: REPAIR FIRE DAMAGE TO SFR LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT :14 OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 1200 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 10 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 12 . 00 10 . 00 0 . 00 22 . 00 22 , 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.II,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 22 . 00 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 22 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors)license pursuant to the Contractors'State License Law).l am aware *,***,***,****,******,************************************************************** that proof of their Worker's Compensation insurance should be provided to me. am exempt under Section: B.&P.C. IND I V IDUAL F E E BR E AK D OWN for this reason TYPE QTY DESCR IP T ION UNIT COST TOTAL COST Date: Owner: - I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5 ,00 5 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU 1 GAS SERVICE 7 , 00 7 , 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from END OF FEES these provisions. • Date: Applicant: I hereby certify that I have read this application and state that the above inform.tion is correct.I agree to comply 'h all city and county ordinances and state laws relating to building construction and hereby author' epresentatives of this city to este an the above-mentioned property for inspection purposes. T 7 oat .142/71/i73 Signature: ,_ DATE:110/21/931i9342 TII E: 14:T36 22.00 Driver's License or Social Security C: -/ 1641,46 Mao—Budding:Green—Code Enlorcemenh Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL & A APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement 1 L" 3. Electrical Conduit Utility-Undrgrnd. 54. Forms �r ", 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ r 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval ' 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping D Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80, FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test */i173 d � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44, Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PRONES ADDRESS: UNIT: OWNER'S NAME: SSS' 2CITY OF COSTA ' FSA — BU , LD_N(i PERMIT PE•tM NO: P 053620 R0 S'MICHAEL SCHER, J .,018 YUCCA TR PERMI" NO: P 053620 PLAN CHECK NO: N GOVT: V SUPP: N ..OS ANGELES,CA 90046 CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: 223 654- 3740 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : CPGRADE GAS SERVICE SQ FT: PERMITTEE: • CLAIM VA`aUE: 1 , 850. 00 CALL-VALUE: GROUP OCC: R-3 / ADDRESS: ADEE P_ MB 6 HTC ( 213) 759 -9101 :1457 CRFNSnmw BLVD COMMENTS: SMOKE DETECTOR REQUIRED iN THE HOME ' 0S ANGELES CA 30043 #+ ******4**#*•+�#�F##r:##u##%u# +<#**r********A*#*******#.::n#vx#X-�F$*„X+r#;(-#u*#####;.•Ta' # LICENSED CONTRACTOR DECLARATION: there y affirm that I am licensed under provisions of Chapter 9(commencing with Section z ONING R EQU IR EMEN ' S 7000)of Division 3 of the Business and Professions Code.and my licen is in full force and effect. SETBACKS CITY LIC.: O zn 7 O STATE LIC.: 2401 5 ` SS: C- O• v-� �Oale: Z q I Signature__ \ ---- MAIN BUILDING --- ---. ----- ACCESSORY BUILDING - --------- WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to selbinsure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: w l It REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGH T: FT IN LEFT: F-" IN RGHT: F" IN POLICY NO.: Y;C21610331t90_ 1 EXP.DATE: 05/01 /92 COMPANY: ., :BER'.YPARKING REO: PROV: PARCEL: 42605405 'INF: REF NO: R f- Certified copy is hereby furnished. `a Certifi led vet a city Buildin PLANNING NOTES> TES> j Dale: Applicant* #�4''IEiF*X'##k#*###?S**##*#####iF*afX##*#*?E*K #3i#**#�,ivT%Y'•##**0.x- ###Y. w%k#:(*ie*i?<a'•#if*r#*3i ti it EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DSVELOPMENTS E R V- 1 C E S REQUIREMENTS 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 California. P T- - ZONING APPROVEBY DATE: Date: Signature: NOTICE:If.cher making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : , — DA7E: _ _ Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. /�/�� rr CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• I ' "/• DATE• Si"' 2 which this permit is issued(Section 3O97.Civ.Cl. Ke*****#***: ******se)e t*-H;4rx* • ..t *< *II:, ••n --**it*..****.-/tit k#:E* Y.•#*#i:*YTc.F7ntt .*te:SikN LENDER: *::#***#*****#****%*##X.**-********************eh ****#*a#***:t*%tut#*A*ii***#* i;t( Ki.#*h'X ADDRESS: .EGALIZATION:N F .E E SUMM R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 2 5% SM I P/NON' RES and Professions Code)or that he/she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUEFEE 3 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 2 .00 3. 00 0. 00 5 . 00 5 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTAL S--> COLLECTED: 5. 00 OVER/SHORT- . 00 for the purpose Lit sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to theContractors'Stale License Law).l am aware *#***#*#*#****#***#*%**********#**)t*****#***X*******#*****k**#******* ***X#***** that proof of their Worker's Compensation insurance should be provided to me. ( j. NDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.A P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: owner: PLU 1 • GAS SERVICE 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and I END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and ale that the above information is correct.t agree to comply with all city and county ordinances and state laws relating to building construct' hereby luth ' .representative:-. 's city to enter upon the above-mentioned property for inspection purposes. , Q ✓Date l]�� c Signature: Driver's license or Social Security•: 1641.46 White—Budding:Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. f / -2 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test i • 9. Water Pipe-Undrgrnd. - -. 60. Backwash Lines, P-Trap, 0 Undrg!d. L� 10. Structural Floor System -- 61. APPROVAL TO DECK • 11. Property Sewer Line & HouseConnection 62. Backwash & Receptor-Final 12. Sewer Cap ; . 63. Heater & Vent-Final 13. Roof Drains -,r.. 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar System-Final '+ •s 16. Rough Electric Wiring 67. Fencing & Access Approval • 17. Rough Wiring Sign `% 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test (,rjj.' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ,5/jeq (60 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date 11C8c.."...2 \.. PROJECT ADDRESS:' / UNIT: OWNER'S NAME: 117 21RD 'ST j' CITY OF COSTA MESA - BUILDING PERMIT PERM NO: N 06320 AS NAME. SCHER MICHAEL, J TR 8418 'UCCA TRAIL PERMIT NO: M 063203 PLAN CHECK NO; N GOVT; N SUPP; N 111 LOS AVGEI.LS, CA 90046 CONSTRUCTION TYPE; V-N PERMIT TYPE: NEC PURPOSE: REP '213}Cu54 3740 ' ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT; -"ADDRESS: UNIT: ' CLAIM VALUE: 20, 000 . 00 CALC-VALUE: GROUP OCC; R-3 / PERMITTEE:JAY C: EVANS CONSTRUCTION ( 714 ) 660-4590 ADDRESS: 1300 BRISTOL ST 100 COMMENTS: REF: B63201 NEWPORT REACH CA 92660 x*�E*+;�6*�Ex*>E xx�c�F*�F> *** *�E�c >F****i( 6�E****** �F�6�cxxx**�E7Ez-�E>F�r�cx-xxxxxal>F•x'xxx�c�E�c-x>F **x�E LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licen •r nder provisions of Char (commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and • • s• in full force ... . . CITY UC.: STATE uc.:5 3 0 9 8 , CLASS:r, S E T B A C K S 2. • 7- /nT^9/ Signatu :_ _ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I henry affir ha . .certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy there,I(Sec irn .00, ab. C). LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY N0.:1 1 ' '6 3 2-92 P.DATE: (y /01 /94 Cer iedryis et FUND PARKING REQ• PROV: PARCEL: 42605405 ZNE: REF NO: 19,,,,.. ❑ Cer led ray is .deb urnished. �1 C•• Ted copy filed • the cityB l ma PLANNING NOTES> > .*D.,- / . Applican *******************************************************TETE********it****if**-****** XE ' . ' ION FROM WORKERS'COMPENSATION DECLAR• ION' his section••ed not be completed if the permit is for one hundred($100)a less). DEVELOPMENT S E R<VI C E S REQUIREMENTS rlify that in the performance of the work for whic •' permit is iss -d.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY , DATE: Date: Signature: • NOTICE:lf,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; , C. r DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: / / DATE; i-2- -7 f3 which this permit is issued(Section 3097.Civ.C). ******************************** *) *1c-it**** ,x:************if******le****it *aF*it*dr*** LENDER: ************************************x**** • *******************************:E**** ADDREss:REPAIR FIRE DAMAGE TO SFR LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: N e OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5-Business and Professional Code: Any city of county which requires a permit to construct,alter.improve.demolish,or PERMIT / 9 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business n , 25% SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE • 15 , 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 9 , 00 1 5, 0 0 r .,•, 0 , 00 24 , 00 24 . 00 . 00 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COL ECTED: 24 , 00 OVER/SHORT; . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC M CHPNIC FIRE SMIP/TOT' GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 , 0 0 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon - andwhocontractsforsuchprotectswithacontractor(s)license pursuant to theContractors'State License Law).I am aware ***********************************•*)****************************************** that proof of their Worker's Compensation insurance should be provided to me. o I am exempt under Section: ' B.a P.C. INDIVIDUAL' FEE BREAKDOWN tor this reason' TYPE QTY DESCRIPTIOIN UNIT COST TOTAL COST Date: Owner: A I do hereby certify that I am aware of and understand the requirements of California Reallh and Safely Code Sections 25505,25533.and MEC 1 I NST/RELOC RECESSED/ WALL HEATER 9 , 00 9 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • these provisions % • Date: Applicant: . I hereby certify that I have read this application and stat that .above' formation/+: dA!I agree to comply with all city and county ,-. ordinances and state laws relating to building construction. . ereby a Drize rep 'sof this city to enter upon the above-mentioned 1 property for inspection 7 pp7ection purposi s. .1 it • ��ate: 'L — / ' Sign. re: - 01 00143633-00143633 T CL T 24.00 Driver's License or Social Security»: or DATE: 07/27/93 T 111E 11:33 164646 White—Building:Green—Code n orcement: { C. ary—A plicant;Pink—Revenue;Goldenrod—Assessor ..' . • CONSTRUCTION AND PLANNING I POOL SPA i APPROVALS Permit ;r I Date Inspector APPROVALS Permit �c I Data I In p, .'. I 1. Tempora; ' Electrical Service er Pole 52. Pool & Equipment Location • 2. Soii Pipa-Undrgrnd. 53. Steel Reinforcement j 3 E.-cHical Conduit Ut.Iity•Un*grncl. ,' 54. Forms __- - r 4. Ereeir ,ar Conowt•Undrgrnd. 55. Electrical Bondng s r- 5. 5..t....• Fa:nforce:^ent 56. Rough Plumb�rg & Pressare Tcst %I-6. Elc:.a:ca! UF ER Cn nd 57. APPROVAL TO COVERGUNITE ,I( 7. Footings 58. Electrical Conduit•Undrernd. -•l2 .8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, 55 Ur.drgrnd 1.-- 10. Structural Floor System • 161. APPROVAL TO DECK 15. Property Sewer Lire & Hcur:e Cnnn,.cr.on , I 62. Bac'c.:.m & 7.captc- F'. I 12. Sewer Cap - I I 63. Heater & Vent-Firm _-- _ 13. Root Drains 64. Rumbire) System - F:••:.! 14. Rough Plumbing 65. Electrical-Final _ ( - - 15. Rough Electrical-Conduit 66. Solar System-Find) 16. Rough Electric Wiring I 67 Fencing & Access Approv.! 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18 Rough Electrical-T Bar Ceireg 69. POOL:SPA SYSTEMS FINAL I 1 19. gh Heating & Air Conditioning FIRE DEPT. REQUIREMENT + . 20. Rough Factory Fireplace APPROVALS Permit #- 21. Ducts, in Structure 70. Underground Hydro {i 22. Ducts. Ventilating 71. Prode rt P-n:nq Gas .J Oil I I73. G:.s Rp 9-Rough & Test --- - - 72. Unci -r-oun. c,ini --- - - !i 24 Roof Framing I 173. Un:'_.r--nr..S:nr; lurk G,:s . 'C. {1 -I- 2 • 5. Root Sheathing ---- i { 74. Overi•t.c' Hyuro - - -- 1 --- -- 26. ii-Bar Ceiling (Structural) & Monocoat 75. Dry Chimera. -- 77. Frerne and Flashing 76. Dry St.-rejoice T 28. Lath ng & Sid:ng -_---- -I 77. FiXED S"STE : i !NAL - - - - 29. Insulation I 78. FIRL PREV. FOCAL I 30..Drywall NailingI .' I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I • l 79. FINAL INSPECTION I 32. Electrical Power'Meter Final i - , 80. FOOD CERTIFICAT E ISSUED -1 I I Notes:/p_7___27 r �-33. Final Electric- ---- --- - , I N /l/_-7"_2J> Col7✓acC�t�s/J--41o/ 1 34. F r_! Heating & Air Cor vile ` n /fll9ji-.-•- I .rola �� 35. Foal Gas P. ., Tes: - P°' ------- -- - l I •• 1 --- -- - - - ------ ---- ---- - -. r-- II- I 36. Hood or Canopy I I37. Final Factory Fireplace - --- ) --- _ ---- _ 1 38. Final Plumbing I _-_ 1 39. Water Service-Final ' r40. Gas Service-Final ----�- I • I F I 1 41. Solar Domestic-Final • 42. Backflow Preventer 43. Backf low Irrigation 44. Landscape Irrigation System 45. Sound Attenuation - 46. Hu-d:cap Regulations ---- ------ --- - - -- L67. FILAL STRUCTURE & BUILDING . 48 FINAL PLANNING 49. Electric Release to Edison 1 50. Gas Release to Southern California Gas Cc. • 51. CERTIFICATE OF OCCUPANCY Iiiiiii._ Datc --------I "PROJECT ADDRESS, 117 23RD ST UNIT: ^ fr* CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 063692 OWNER'S NAME: SCHER MICHAEL J TR ADDRESS: 8418 (UCCA TRAIL PERMIT NO: E 063692 PLAN CHECK NO: N GOVT: N SUPP: N LOS ANGELES,CA 90046 CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: REP ARCH/ENGINEER: 213) 654-3740 flEG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : REPAIR FIRE DAMAGE TO A SFR SQ FT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / ADDRESS: WRIGHT ELECTRIC ( 714 ) 673-1180 9ON HELIOTROPED1 /2 *O****RTE****************************************(e**************:r**************** CORONA DEL MAR CA 92625 UCENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 2 ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITYLIC.: 05 22 STATE LIC.: 611878�r CLASS:�,,]11 ��,C10 Date: �P2( 93 Signature:_4 c 47614 MAIN BUILDING ACCESSORY BUILDING WORKERS'COLAAtPPENSATATON DECLARATION: I hereby affirm that I have at<ie'rtir'cate of consent to sen-insure or a certifiateol Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN ',wren.: 1058689-93 EXP.DATE: 01 /01/94 COMPANY: STATE FUND PARKING RE • PROV: PARCEL: 42605405 ZNE: REF NO: ❑ Certified copy is hereby furnished. ER Certified copy is filed with the city Building Division. PLANNING N TES> • /� > -"co Date:_ g4 Applicant: W.� ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This secti need not be completed it the permit is for one hundred(S1 )or less). DEVELOPMENT S iE R V I C E S REQUIREMENTS 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 \ r .. subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - DATE: Date: Signature: NOTICE:If.after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. - r /7d / /p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• • \/ DATE• .P/2 / which this permit is issued(Section 3097.Civ.C). ***********{E***{t***********iE.**{t*.**.****TTTEEE if iF*************************Y **iii«C** ** LENDER: **********************************1E******************************************** ADDNEss: REPAIR FIRE DAMAGE TO SFR LEGALIZATION;N 'F E E" SUMMARY STRUCTURAL SEGMENT:N 1 . REPLACE ALL FIRE DAMAG A OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 85 50 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed }A. pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business tot $ SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN } any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 1 5.'00 I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 85 . 50 15. 00 / 0 , 00 100. 50 100. 50 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through or improvemenr her ts solemployees. withn onevided yarr ofthat completioimprovements the owner will have intended the burden of offered proving he/she did not bold or the r improvelREVENUE DIVISION TOTALS--> COLLECTED• 100. 50 OVER/SHORT: 00 for the purposeof sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 100. 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon .. % and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***********.******.*****.*.**.**********,***.*****,*,*******, *,**, ***,*,*,*,*,*,***,*,*,*,**,**,K,*,**,*, that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and ELE 10 FIXTURES LIGHTING 1 ST 2 0 EA, . 75 7• 50 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a ELE 2 0 RECEPT/OUTLET 1 ST 2 0 EA. . 75 1 S• 0 0 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ELE 16 RECEPT/SWITCH 1 ST 20 EA. . 75 12 . 00 these provisions. ELE 1 RES APPLIANCE NOT OVER 1 .0 HP 3 . 00 3. 00 ELE 2 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 5E 7. 00 Crate: Applicant: 0 0 ELE 1 SUB—PANEL 1 •y ��a`+ . I hereby certify that I have read this application and state that the above information is correct.I agree to comply nlh all city and county END OF FEES •iI - $ Ti. ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspectioninypurposes. (J) '-/ nate: dl�-��'3 Signature r'•A'k'i.. . ° _ AUG 2 d 1993 (_ 1 ,J • Driver's License or Social Security r: 1641-46 White—Budding:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor CITY OF COSTA MESA CONSTRUCTION AND PLANNING POOL .PA 4 APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ,a. F,IebtricalConduit.lhility-Undrgrnd, ' •54. Forms '4. Electrical Conduitdrgrnd. -. , 55. Electrical Bonding 5. Steel Reinforcemelt`' = - 56. Rough Plumbing & Pressure Test 6.rElectriial UF Clod. 57. APPROVAL TO COVER-GUNITE . i7{lFootirigs 58. Electrical Conduit-Undrgrnd. 8,,ISotrnda,Ion . - - 59. Gas Pipe. 0 Undrgrnd., Test tt : 1 9. Water Pie-Undrgrnd. . _ `.60. Backwash Lines, P-Trap, 0 Undrgrnd. 16 Structural Floor System _ 61. APPROVAL TO DECK `. 11. Property Sewer Line-& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap ,.. 63. Heater & Vent-Final i. 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT S a r 20. Rough Factory F•¢eplace i --..,11 ,r:1•7 x - i U'.- r'• APPROVALS ICPermit # • -r : t J '1 21.1qu�f{, i? $tr l,tu? ` -.• '• 1 y Ir.. ,t• I - �, r .. .. ._t , + , 170. Underground•Hy.- ir, c 22. Ducts, Ventilating- .. o'- S ¢* r• 71. Product Piping Deas OOil 23.'GasliPipe'Roiujh &-Fest ; .. Z 7 t i; e. `; ' . ' +72. Undergildund Fluslj , 24.1 Roof Framing. ;,r r .; • ••1 , > n 7' . 73.•Undergrnd.StoragJ-Tank E)Gas 0 Oil ' 25. RootSheithing 'I'' ' „,- td l't1 1 C---). :�;,';`, ,t 74;Overhead Hydro`�', 0 ,- �, 26. T-Bal Ceiling (Structural) &-Monocoat w CI 75. Dry Chemical •- t + - 1*" 1 r 27."Frame and Flashing- u' "' 76! Dry Stand'I e N rr ' rii ' 28.- Lathing,& Siding • : , • aljiij;t,-' x T, 1---.- .. --.•,. - 77.l. FIXED SIYSTEM•FINAL� •r. ^: • 1 29. Insulation `r" 1 278 FIRE PREY. FINN,. t 1• 130. Drywall-Nailing c*, t, _r S IIr . HEALTH DEPT;R.EQUIREMENT- t 31. Plaster Browr�Coaj , . It " _ t: t- -r T''- r / ri 79. FINAL INSPECTION • ;_:l32..,ElectricabPoer PAeter,,Final: t' /i.cSf 'i' 80. .FOOD CERTIFICATE ISSUED " .1 • 1^v 33.�Final Electric 1 ' `° -:p; N tf?s. / , • 7 ' ;�34.,Find):Heating& At„Conditioping .. c�-/\ 1 ,, "- " , =,• • , . • C. 0 Y. , � � 35.,IFinaltGIs Pipe-Test,* 1 t '-HoodorCanopy`n� - I • 1 1 . n . t. . 36. • 1 37.''_Finaf Factory Fireplace • - 1 a. st • 38. Final.Plumbing 'j .1 _ x 39. Water Service-Final 1 - - `40. Gas Service-Final • -- q 4 1 • •" ,41, Solar Domestic-Final ? t' M , r. :42.`Backflow Preventers 1 ' I I. Backflow Irrigation/.. ' - _ . _ r' _ - . . -,:.14. Landscape I i.attb'f1 System _ . _ . . .45. Sound Attenlration•c I s. - t - - I . I • • 46. Handica`p••RAgulattotts `' '- •• 47.-FINAL STRUCTURE & BUFLDING -- j 48.-FINAL PLANNING ; :,�I - 49.:jlectfic Release to Edison 1 ar . A i-.. 50. Gas Release to Southern California Gas Co .' _�. - -. r - • - • 51. CERTIFICATEOF,OCCUPPNCY No. Date PROJECT ADDRESS., 11'7 23RD ST UNIT; B CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 064456 OWNER'S NAME: SCHER, MICHAEL J TR ADDRESS: 8418 YUCCA TRAIL PERMIT NO: E 064456 PLAN CHECK NO: N GOVT: N SUPP: N LOS ANGELES,CA 90046 CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH 213 ) 654-3740 • ARCH/ENGINEER: REC.NO.: • ADDRESS: UNIT: JOB DESCRIPTION : INST UNDERGROUND FEEDER TO NEW SUBPANEL SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: WRIGHT ELECTRIC ( 714 ) 673-1180 ADDRESS; 402 HELIOTROPE 1 /2 COMMENTS: THIS PERMIT TO COVER UNDERGROUND ELEC . LINE TO BACK UNIT ONLY CORONA DEL MAR CA 92625 **********+r+E*****+r ***************+Farar******>E*****+r*+F*************eEaE****a:******* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQU IR EMENTS 70001 of Divi el.nusiness and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: 5 STATE LIC.:611878 Cuss: 10 Dale: /40(by'. Signature:_r22 . e MAIN BUILDING ACCESSORY BUILDING WORKERS COMPENSATION DECLARATION: I hereby affirm that I have a c ifivate of consent to self-insure or a certificate 01 Workers' FRNT: FT IN REAR : FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800, Lab.Cl. LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN min.: 1058689-93 EXP.DATE: 01 /01 /94 COMPANY; STATE FUND PARKING REQ: PROV: PARCEL: 42605405 ZNE: REF NO; ❑ Certified copy is hereby furnished. li Certified copy is filed with the city Building Division. PLANNING NOTES> t!1 ' _ Date: /9/1411) Applicant **********************************iE.******************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section nee of be completed if the permit s for one hundred WOO)or less). DEVELOPMENT S --EIR V I G. E S REQUIREMENTS 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 California. ZONING APPROVED BY — DATE: • Date: Signature: • \ G NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : - • _ �• DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; / r /j` DATE: 0 ,3 which this permit is issued(Section 3097,Civ.C). ********************** _ ********** ** LENDER: ********************************1f********************************************** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 11 00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 C/2 SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 70315 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 15 . 00 I. as owner of the property or my employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 11 . 00 15 . 00 0 , 00 2 . ! • 26 . 00 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 01r: OVER/SHORT• 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC — — SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 26 . 00 ❑ )( and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ,****,************,****,**,******,**,***,*,********************************************* that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under section: B.s P.C. INDIVIDUAL F E E BR E AKD OWN for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date'. Owner. I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and ELE 1 SUB—PANEL 11 .00 11 , 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES • permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date'. Applicant'. I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned Lproperty)for inspection purposes. Date; /�, IC{� Signature. f/) ' 01 00148887-001488°7 TOT 26.00 Driver's License or Social Security tl / DATE: 10/14/93 TIRE: 12:04 164146 While—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • f` CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. t J 53. Steel Reinforcement • 3. Electrical Conduit Utility/-Undrgrnd. 54, Forms 4 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6- Etectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation . : 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Undrgrnd. . 10. Structural Floor System `t. 61, APPROVAL TO DECK 11. Property Sewer Line & Houser•onnection 62. Backwash & Receptor-Final • 12. Sewer Cap - - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT l• 20. Rough Factory Fireplace • APPROVALS Permit# 21. Ducts, in Structure .. 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • 27. Frame and Flashing 76. Dry Standpipe - 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electrical Power Meter-Final .80. FOOD CERTIFICATE ISSUED 33. Final Electric l9e /1 ��'////", Notes: 34. Final Heating& Air Conditioning r+�+ 35. Final Gas Pipe-Test - 36. Hood or Canopy • 37. Final'Factory Fireplace 38. Final Plumbing 39. Water Service-Final • - .40. Gas Service-Final 41. Solar Domestic-Final 42, Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System • 45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 117'423RD ST UNIT: 1 /2 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06704? OWNER'S NAME: SCHER, MICHAEL J TR ADDRESS: 8418 YUCCA TRAIL PERMIT NO: P 067043 PLAN CHECK NO; N GOVT: N SUPP : N LOS ANGELES,CA 90046 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: JOB DESCRIPTIONSQ INSTALL WATER HEATER & 4 " SEWER CLEANOUT FT: CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 / PERMITTEE: AEA PLUMBING COMPANY ( 818 ) 336-2617 ADDRESS; 1627 CHALEMONT COMMENTS ; RELOCATE WATER HEATER IN BACK OF HOUSE & INST, 4" SEWERCLEANOUT HACIENDA HEIGHTS CA 91745 +r***y ***4****if***"E*+6Ts**yEx*yE******x*yF+r*y6yr*************i *****yF*************+F***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING R EQU I R EMENTS 7000)of Division 3 of the Business and Professions Code.and m e is in full force and effect S E TB ACK S CI LIC.: STATE LIC.: 67602 CLASS: C Date S f V Signatur /h — MAIN BUILDING ACCESSORY BUILDING RKERS'COMPENSATIONDECLARATION; thereby Irmthat lhave acerlilicateofconsenooself-insure oracertificate ofWorkers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ• PROV; PARCEL; 42605405 ZNE: REF NO: ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > • Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This >:.," -eed not be completed if the permit is for one hundred($101)or less). D E VEL OP MENT SER VICES REQU IR EM EN TS I certify that in the performance of the work for which this per ' issu:..I shall not employ any person in any manner so as to become so,- 1 to the Workers'Compensation Laws of California. .,„."7 ZONING APPROVED BY OSIS--EY signal /3• / +?ice DATE: NOTICE:If.after making this declaration.you sh..• recome subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: � DATE *.*.*. which this permit is issued(Section 3097,Civ.C). * ******************************* *** ************************ .** LENDER: *********************************************************************** ******* ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 22 , 00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN - any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE 20, 00 ' I. as owner of the property or my employees with wages as their sole compensation. will do the work. and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS——--> 22 . 00 20 . 00 0 . 00 42 , 00 42 . 00 , 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 42 . 00 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 42 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon — andwhocontractsforsuchprojectswithacontractor(s)license pursuant to the Contractors'State License Law).l am aware *.,*.***.*,*.*,N..**,*,N,**,**,*,.N,**,*,****,N,**,*,*,**,*,*•*,*,*N,*,***K,*, ,***,*,***********_*,**,*************** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.A P.C. INDIVIDUAL F E E BR E AK D OWN mr this reason: TYPE QTY DESCRIPTIO N,, UNIT COST TOTAL COST Date: owner: PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 , 00 I do hereby certify that lam aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 1 SEWER, BUILDING / TRAILER 15 , 0 0 25534 and that I or any future building occupant will/wall not(circle one)need to comply with said state codes and the requirements for a 15 . 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from END iOF FEES these provisions _ Date: Applicant: I hereby certify that I have read this application and state that the ab, :' formation is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and her-^ rim representatives of this city to enter upon the above-mentioned pro City for inspection purposes. /X Oi 00160023-00160023 TQT 42.00 /7 ./TTJi� s DATE: 05/OB/9i TIfE: 03:39 at / Driver's License or Social Security 4: 1641-46 White—Building:Green—Code Enforcement.Canary—Applicant:Pink—Revenue:Goldenrod—Assessor POOL PA .._- CONSTRUCTION AND PLANNING APPROVALS Permits Date Inspector APPROVALS Permit # Date Inspector - -4 i. Temporary Electrical Service:'r Pule 52. Pcol & Equipment LucaLdn ___I 1 2. So.: Pipe-Undrgrnd. _ _ _ 53. Steel Reinforcement -_ Ii 3. E :ct• ca' Corrluit lit 'ity•Undrgr;.d. 54. Forms I I---1' 4 EH': c.' Co' r,i, -Undrg'nd 55. Electria! Hrn•i rig .. 5. S' it 4,., ,,c ^-r-'t _ � 56. 3eL:;`, 11I:,r.b n ; r., o,.:<sure Test II - - - - I -i 1 i. S' - UFER C .n. 57. A°P^CV^,,. - ^ C:A"R G'L : TE ' -- --4-- - -- --- 1 J ` �c---.gc I 58. e_ectr.:a corua.t rdtgrc,^.. -1 8. Foar.0 ctmn I 59. Ga. P.p.,, 1 l Li-nrgn.u., stI I ! 9. 6C ate• ip-Undrprno. - 60. 8acxwasn Irises, P•Tr,o, Undrprnd I I 10. Srcctura' Hurt'System 61. APPROVAL TO DECK I 1 11. Property S^✓, 'rt no & House Connection 62. 8ael'. :n PCL'u'c-Final I II I ' 12. Sewer Cap _ 63- Hea+,:r r„ Pi I I & \ nt--final I 13. pu:r Drains - 64. Plumbing System F nal t� -y -_ __-_ _ _ I _-I '4. Fu..c F,LrIG;ng 65. E._etrica:•Fi.,al I T I- 1 Rn :g^ E" ‘r ¢'-COi1tiu tI 66. Solar $yst'.m•i' u i 16. 13r,urn Electric\Tiring I 67. Fene.ng & Acc'ss Annroval I JI 17 'nuc:h .-3. -ire Sign II 68. APPROVED FOR PLASTERING '`F ?r-:gin Eltctrtal-T Ser C,:!•nc I 39. POOL 'SPP SYS'E --S r'7IAL I -_ _ F'.....,•1 'm & A'r Cc'Jn'nOL-P1 .FIRE OP1 . REQUIRE v".LNI 1 -, ._ F ,._, rtl_ _,. I -1 a°PRC;'A.' S P. unit . I , 21 C,! ^i „!r 1,c .. L' tu °D. �,o; .nc Fisu c - _ -- g 71. Prudun JAI ping Gu. . . ijii 33 Gam: 4. u,'•L,atgh & Mit _-_ 72. Urdein•o,n,d FL;,, I 24 Roof F al rcra � - 73. UnJcrnr:•.,'. Stared .^k T Gr.. T 0 '7 I -- 9 74 0ast,•:d Hyd:o I-2'p. ` gar C::i.nq IStructu•a'I & :onocoat 75. Dry L"cr ,f. I 1 27. ''. rpt t, i r'd.h.np - - 76. Dry Sur.du.ur - - - -----_.-_-I I al -. LL Sd r - - -- - .- ii--- g 177. FIXED SY$TE Fi, HL ; - l__ Ina l,.'.on _ 78. FIRE PRE V. FINA_ --_- - - -�--- - - y 37 D•YIii " nn } HEALTH DEPT REOUIRE.VE'VT 1 - ? .. lCo't I- ---�79. FI`.A' *icor :T It` . - ---- i- - -- ii - ` 3.: E' 01 et-----H. r-. .'etnr r ----- _-_-r-- - -_I 3J_ .1(-,ITh ,'E 1?;' I!"yt-c L';L.:1D _ -_ ------ - - t- --_ 33. Era t_ j Notts: I__ _L_ __-_._ _ -____ _ _- - _. __ _ _ 34 Fna Nc_. ri , A r Cori Tor Cf +1 35.- Fine. Gas P,par 51 . 5= 24-c4-_.__ c-c,- ___0 bL 0 - r - 1 36. Hoed or Canopy I 37. r-iral FeRory Fireplace ___ _ __ .__- _ _ I 38 F I_t-thing -- S---2.44-1:a---- Z44-( - ---- ---- - ---------- ---- - - 39 ...ter S. ere Final 1, 4C_ CCat &!nice-Final - --__ _ -_ _--- -- --____ _ 41. Solar Dorncstic-Final 43. Lick-hose m Pva __-- -- - - --- --- = J 43. Ba cicflow Irrgatitiun un 44. Landsc pt Irtiparon System 45. Sound Attenuation 43 Narfv.p Regu eticrs 47. .=GeAI_ STRUCTURE & RUILD.NG --_-_-- ----- ----- - 48 FINF,LFLANNING - --- _ - --_---- ------ - --- ----- 49. Electric Release to Edison _ - - { 50. Gas Release to Southern California Gas Co _ I 51. CERTIFICATE-OF OCCUPANCY - -'i No. Date I - - ---I PROJECT ADDRESS: 117 23RD ST i UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 063656 OWNER'S NAME: •4 SCHER MICHAEL 'J TR ADDRESS: 8418 YUCCA TRAIL PERMIT NO: B 063656 PLAN CHECK NO: N GOVT: N SUPP: N LOS ANGELES,CA 90046 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP 4 ARCH/ENGINEER: 213)654-3740 REG.NO.: ADDRESS: UNIT: JOB DESCRIPTION : REROOF 1200SF RESID W/COMP SHINGLES SQ FT: 600 PERMITTEE: JAY VALUE: 600. 00 CALC—VALUE: 600.00 GROUP OCC: R-3 / PE ADDRESS:TJAY C. EVANS CONSTRUCTION ( 714 ) 660-4590 1300 BRISTOL ST 100 COMMENTS: REROOF W/COMP SHINGLES NEWPORT BEACH CA 92660 ***+F**+ESFSr**SHx***SE***sF**+F+F**SF*****+E** *srx*********** ***+F******** -+E*******x:H**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professio and my license is In lull force and effect. SETBACKS CITY LIC.: STATE UC.: 530984 C t� Date. .1 '�'1� Signature: l ACCESSORY BUILDING WOPKE �COMPENSATIONDECLARATION: (hereby affim rthatIhaveacertificaleofconsenttoself-insureoracertificateofWorkers' FRNT: FT MAIN BUILDING IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: 1182632-92 EXP.DATE: 04/01 /94 COMPANY: STATE FUNIL PARKING REQ: PROV: PARCEL: 42605405 ZNE: REF NO: ❑ Certified copy is hereby furnished LX Ce t"•• ,. is filed with the city:r.-ng Division. PLANNING NOTES? p/ q l �'> ..�] Date.T1— l'1-J Apptcan' Oa. L' jF****************************************************************************** J EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (this section need not be completed it the permit is for one hundred(SHOO)or tess). D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S I certify that in the performance of the work for which this permit is issued. shall not employ any person in any manner so as to become t subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: NOTICE:Il,atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: ".,- Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 6 JEW p ' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: which this permit is issued(Section 3097,Civ.Ct. ******************************************* ** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE • SMIP/RES' GRADING (Section 7031.5 Business and Professional Code: Any city 01 county which requires a permit to construct,alter,improve,demolish,or PERMIT 17. 00 . 50?, repair any structure,prior to its issuance.also requires the applicant far such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID ?, DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 17. 50 0. 00 0. 00 17. 50 17. 50 • 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED. 17. 50 OVER/SHORT. .>•.; • 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING' PLAN—CHECK I,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 17. 00 • 50 ��. ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon ' and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *********************************************,,**,*************,*******,************ that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.S P.C. INDIVIDUAL F E E BREAKDOWN forthis reason: TYPE QTY DESCRIPTIO N UNIT COST ,,TOTAL COST Date: Owner: , I do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and SFR 600 REROOF BY VALUE RESIDENTIAL NOZONE 1 , 00 600. 00 25534 and that for any future building occupant wilwill not(circle one)need to comply with said state codes and the requirements for a END OF FEES 't.) permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. . Date: Applicant: I hereby certify that I have read this applicati,'^- .e that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction a •—eby authorize representatives of this city to enter upon the above-mentioned property I 'spec on purposes. LDal T� Signature- *DUPLICATE IPT* Drivers License �, i 0100145700-00145701 TOT 17.50 DATE: 08/26/93 TIME: 15:27 164146 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Assessor I i c;,\ CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit # - `Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Serviceyr Pole \, 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. --- 53. Steel Reinforcement r, - - . r •t` 3, Electrical Condo rULlity-Undrgrnd""t ••- 54. Forms t"" , '4,' Electrical Condyit-klndrgrnd. 55. Electrical Bonding 5. Steel ReinforcerGgt `•C. _ 56. Rough Plumbing & Pressure Test ' +•LElectrical UFER rnd. tj 57. APPROVAL TO COVER-GUNITE %I Fomings _ o. 58. Electrical Conduit•Undrgrnd. _ 8.1 tOtndation C. 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System el 61. APPROVAL TO DECK - 11. Property Sewer Liner& House-Connatidn t. 62. Backwash & Receptor-Final . 12. Sevber Cap ' ' 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System • Final 14. Rough Plumbing = 1. 65. Electrical-Final -, 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sjg0. 68. APPROVED FOR PLASTERING 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT C1 - i ' ., r . - v r ` ., •.. '-i i' CP -I O( 4. rr.)20.•Rough Fgttory Fireplace •Irrn r+ 'l a. 0 .-1..., r* LAPPROVA'LS iCF Dermi ,.t # ' T rrt .-r - ' r tr.0 . . ,y It .. n .tri:-r . t3 .. 21.'D uses', i tr✓Ji:ture " t-.t- t.S P 'J '1• .r - ""a is r. r V. r1.. , b F_, I-4:-. , -70. Underground-J-Iydjo 22. Ducts, Ventilating .4 •. ` '41.1'. x v71. Product`PiQuig EITOs ❑Oil 1 • n r-> x " T1.J 23. GastPlpe=fou &•Fest - • " TIS * to '-0 i O f z. 142. Undergroubdl Flts44 t-• -- 4. ' ....s.. A Li ." .-., 24.rf3ootFraming1 r,. tit- ••t- . ' 0 ur' . e' ?3.JUndergrncf?Storagt Tank 0 Gas ❑Oil) : 25. RootShathin N 4 'Il p -' 13° ' `" '-'` n '` 9 �" �: ,� .',� � „ `74.�xerhead Hydro, 3 a 26.rT-Bar,Ceiling (Structural) & Mopocoat .n .:J •i 4. . 75.Ary Chemical �J, . .4 ra . >4. - ' 'ci A.-41 J' r.. , 27. Frame and Flashings ' tT' v 76.1 Dry Stand �e C: " ' •T - ,28. 'Lathjttg alSidjng;; 4 3 ' fy: :r a. ; •• t 77,trFIXEDSN -, ni LNAL`74-j '*' r _, .. ' �'Y r t •29. Insulatiop' r x LI ( 1* : 78.y-FIRE PREV. FINIAL .k.- ; T,. -30. Drywall Nailing r-•• - 3 • a MEALTH,6EPT*R-EQUIREMENT 1 ' t )tr, r-, 1- ai. Plaster BTwCoal • I .CFINAL IMSgECTION ''' t: • ' r' (❑❑I ! i t� r ._.1,--i ). t, ._.1,-- R •3 xt 4 32.4Electric4Powpr Metet;Final , tr t r80..3FOOD CERTIFICATE ISSUED 33.'Final Electric' ' 't ^ *7" .I.,' i'NotFs: ' LT. r. ,n - .: : q a n t '7 '11.71I `f _l n, X r Y }[ .i. , t : I-1,. 34. Final'Heating4 Air;Conditio4rrak, r , 1 ;z n� , S J'7 r -1 r.,,t e, r 35. Final�Gas Pipe:Test' - 3 ' ' x r ' n .1.-, ` o `-'- AL3 .. }. . .. . tti I .. x 0 1', .> t I-' - F .r I. ,36. Hood orsanopy . -� :* I ,r '-' r, I . Ti: x ;-- r inn .•t s 37. lace' _ 1 'c' -1=°" n I Final.Faetory Fireplace' Iwi caay t 38. Final Plumbing , ., . ct - '" <x V a T. C 39. Water Service-Final.- • I + * X ( r• .' -+. i r _ > 410. Gas Service-Final r I -' , 41. Solar Domestic-Final4.: : i' 14 Zry - 1111 '1..., z z a b I / j 42. Backflow Preventer` ,3 I, .' t., a. . Cl,-.,-. 43. Backflow Irrigation .�. _ - .t C• ' , • ?3 . t'1 • 44. Landscape I;ciigation System,. , ;� n .-t r+ ;d -„ • �3 b .hy G _ 45.iSound Attenuation • r x ' - - . . r •- 1 11 ," A C 46.rHandicap•Re4ulatio isini I, 117. FINAL STRUCTURE & BUI,L-DING /)-;Son ceCCIt'.i `. �- q,`� 4444!��, 48. -FINAL PLANNING` ' .�•, . Ito 49. Electric Release to Edison -' - • > 4.. „ - 1- • .50. Gas Release to Southern California Gas Co ,, " - -, , 51. CER3TIFICATE OF.000UPA,NCY `"-r,. , > '.1 r. -. No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT P44T NO. .�.� I TRACT NO. LOT NO. UNIT NO. Project Aduress 117 E. 23rs Street f��.'23-�-I ppy Applicant's Mailing Address 5457 Crenshaw Blvd TYPE OF CONSTRUCTION H NEW LI ADD U ALTERATION LTREPAI R Dr. Michael Scher 656-8890 ❑ CONVERSION ❑ DEMOLISH El OTHER Line 3—Out. A.P.# Zone Owner's Name Phone ESCR TION QyyVORK/USE OF BL1PGGyy Address S + k lgjen.je_ tti74_, L( S Main Building: Accessory Building: E Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRAPING t FOUNDATION STRUCTURAL T Front 0 Address ❑ TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL B Rear • N ❑ OTHER Contractor's Name Adee Plg & Htg InQ'eane759-9101 �f C Right N Address(mailing) 5457 Crenshaw Blvd PROJECT DESCRIPTION SQ. FT. . I -- OCCUPANCY 2_S K G 030203 CONSTRUCTION TYPr ?F_) VALUATION$ S Left R City License No. ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref. 4 Parking Req./Provided I hereby affirm that I am licensed under pr visions har er 9 (commencing Remarks: t (( Planning Notes: M with section 7000) of Division 3 of the uslness Pr scions Code,and ��`�-`�1 L' � �� '� T my license is pia.ie force and effect. k.l License Class .0 0186 • S Date77_75—AR Signature]f PLUMBING FEES • WORKERS'COMPENSATION DEC LA ION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consen o self-Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 15.50 KW 3800, Lab. C. Automatic Washer Transformer Policy N6Rhq R7 Company Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW ��1L Certified copy is hereby furnished. AA Cytifiedi py's sled with the city��uilding Bathtubs Sewer Connection Cooking Unit Meter Cup to 100 amps \k Date 1� Applicant 7t (_/^J` EXEMPTION FROM WORKERS'CO MPENS N D C RATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for hundred ($100)or less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel • I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fantors 00-1 HP Di'h-8 Workers' Compensation Laws of California. — _ ' Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 1:19.15 HP 016-15+ NOTICE:If,after making this declaration, you should become subject to the — Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY 1 Gas Service 3 Outlets Water Closet 00 Device Boxes Pole Light • I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets • Range Lender's Name - Lender's Address — Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the 1. Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays f Generator 00-$KW 05-15 KW! Trash Compactor r any structure, prior to its issuance, also requires the applicant for such permit - to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section-7000)of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section '031.5 by any applicant for a permit subjects the applicant to a civil ' renalty of not more than five hundred dollars($500). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee i $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 Zoning Approved By Date sale. If, however,the building or Improvement is sold within one year of com- Canopy Type II 0 pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By a Date prove for the purpose of sale). IIII, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By tar% /�7i.•--. .. Date (b /1 O tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU S MMARY OF FE- builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that —Exhaust System 0 Multiple ❑ ystem Repair/Alteration BUILDING PERMIT $ _ _ SMIP $ proof of their Worker's Compensation insurance should be provided to me.I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING $/'Y// PLAN CHECK $ PERMIT 000 ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read t ' application and state that the above ❑0-100,000 BTU ❑100,000BTL ELECTRICAL $ GRADING $ information is correct. I a' ee to co ply with all city and county ordinances and'state laws relating t .uilding 0,4 • .n,and hereby authorize repre- PLAN CHECK 50% § MICROFILM $ sentatives of this city ler p4 th'/ ove-mentioned property for 6—: inspection purposes. I1 .�., MECHANICAL $ TOTAL FEE $ `-' Signatur- 11I� ♦ Date s11-15-88 1 Drivers' License or SS -- Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 01 00019666-00019666 T O IT �' nATr. 441.! 1*" v)r^. .•s.nr r/CONSTRUCTION AND PLANNING POOL & SPAPPROVALS Permit.# Date Inspector APPROVALS Permit# Date Inspector 1.Temporary Electrical•Service or Pole 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 1. 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.+�' 57. APPROVAL TO COVER-GUNITE 7. Footings . 58. Electrical Conduit-Undrgrnd. 8. Foundation . 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe'-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK • • 11. Property Sewer Line V& House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 9 67. Fencing & Access Approval • 17. Rough Wiring Sign68. APPROVED FOR PLASTERING ( 18. Rough Electrical-T Bar Ceiling ,1 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# / 21. Ducts, in Structure 70. Underground Hydro • • • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25. Roof Sheathing • . . - 74. Overhead Hydro ' • - • - 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe „ 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL j , 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 'i ` • 31. Plaster Brown Coat • . 79. FINAL INSPECTION - •• 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED . 33. Final Electric Notes: •,"s' 34. Final Heating& Air Conditioning - 35. Final Gas Pipe-Test INzea - Cd • • 36. Hood or Canopy • • 37: Final Factory Fireplace . 38.. Final Plumbing ii-1t4t /.rco . 39. Water Service-Final 40. Gas Service-Final t., -•41. Solar Domestic-Final -•-42. Backflow Preventer • • t - - . • J_j. - ->t ;43. Backflow Irrigation . _ - I 447 Landscape Irrigation System •45. Sound Attenuation i • 46. Handicap Regulations I • 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed r . , 49. Electric Release to Edison • ' t 7 P. i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. - Date _ ,• - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CI•T 1 OF COST SA TqU CTiI PERMIT PER T TRACT NO. LOT NO. UNIT NO. Q/�p," Project Address 23rd .street p 3 Q r]a vr_ ith UU f1 Applicant's Mailing Address 5457 Crenshaw Blvd TYPE OF CONSTRUCTION ❑ NEW H ADD H ALTERATION REPAIR 1 Michael Scher 2 656-889C ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A•P.# • Zone Owner's Name (46) DESCRIPTION OF WORK/USE OF BLDG. Hot/Cold Rep,�lpe Address 8418 Yucca Trail - L.A. S Main Building: Acces -Idi rnitztiht 6-Fix Arch/Eng. • License No: TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION El STRUCTURAL T Front N. Address - ❑ TENANT ❑ ELECTRICALX I PLUMBING ❑ MECHANICAL BB 1�ys rRear tlt 4 Contractor's Name Adee Pig &&Hta Il phGr,e 759-9101 CI OTHER C Right JUN 01 •`•8" I� PROJECT DESCRIPTION SQ. FT. - OCCUPAN Y Address(mailing) 5457 Crenshaw Blvd 210000 K Left 030203 CONSTRUCTION TYPE VALUATION$ S. City License No. ZONE GRADING CU.YDS. ACRESc/�fl/��L rrLL L�y•3sl� ■■ `a R LICENSED CONTRACTOR DECLARATION 77y 1 / � ///// Ping. Ref.# Parking Il�.R'rgldsAN11• ^•�••�•} E I hereby affirm that I am licensed under pr.• ions of ar er 9 commencing Remarks: //s T �jiM1/�I.'��"�'^�s�a�'^� Planning Notes: M with section 7000) of Division 3 of the -mess a ofess :5 Code, and — /Isar. !. my license is in full force and effect. T Licens Class 6 ns� fa. _ • g - - S Ka 0a5- in- Signature lira ••! PLUMBING FEES A. WORKERS'COMPENSATION DECL' RATIO Bar Sink Showers ELECTRICAL FEES V I hereby affirm that I have a certifica • of consent to self-insure or a certificate I f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 300. Lab. c) Automatic Washer Transformer ❑ 15-50 KW A Policy No. 686987 • company • • Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW '•l/ Certified copy is hereby furnished. P Certified copy is filed with the cit Buildijp] / '/ 2 Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 5-18-89 -Applicant . �I//.._. EXEMPTION FROM WORKERS'COMP NSATIO •ECLAR•TION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if t e permit is or one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 0o-1 HP 01'A-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ ' NOTICE:If,'after making this declaration, you should become subject to the Workers' Compensation provisions bf the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance POI¢ Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Name Range Lender's Address 2 Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the 2 Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or _ county which requires a permit to construct,alter,improve,demolish or repair P-Trapf any structure, prior to its issuance, also requires the applicant for such permit Laundry Trays Generator ❑D-$KW ❑5-15 KW Trash Compactor . to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000)of _ Division 3 of the Business and Professions Code) or that he/she Is exempt .P,hverefrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil nalty of not more than five hundred dollars($500). '"L] I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered foryp Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By Date grove for the purpose of sale). O (/ `/ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repait/A Iteration BUILD G PERMIT $ _ SMIP $ proof of their Worker's Compensation insurance should be provided to me. - ---_- - PLAN HECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers s ' . PLUMBING .-�$ ISSUANCE $ 3 ne Date Owner Heating System& Ducting Registers Incomo ate Inspee.ions $`• -z ENERGY P.C. S I hereby certify that I have read this .-plication and state that the above 1:10.100,000 BTU ❑100,000BTL ELECTRICAL $ GRADING $ information is correct. I ee to comp ith all -Ity and county ordinances and state laws relating t 'b i ding c• s uctionfntl hereby authorize repre- sentatives of t Is city o ter u•.�/ e •ntioned property for inspection our oses. le ir� MECHANICAL $ TOTAL FEE $ 9-00 Signature .,— Date 5 18 89 Drivers' License or�S# � Reinspection Fee $15 I-. e Fee $ 3 PLAN HECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor POOL&SPA .•' •t'- .' CONSTRUCTION AND PLANNING ;-•-• ''' Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# p-- • ,c; r I s:a 1. TemporaryjElectrical Se vice or Pole 52. Pool & Equipment Location "`A :2 rad 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - ? ».2! 3. Electrical Conduit Utility-Undrgrnd. 54. Forms :-' 3 t n. Lfl4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding u + -u2 Vr 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test-4' . 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE .,..• 7. Footings ?;. 58. Electrical Conduit-Undrgrnd. . • - B. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water PipeUndrgrnd. - 60. Backwash Lilies;P-Trap, 0 Undigrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property`Sewer Line & House Connection 62. Backwash & Receptor-Final c - 12. Sewer Cap 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough'Plumbing 65. Electrical-Final 15. Rough`•Electrical-Conduit 66. Solar System-Final 16.‘Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough. Heating & Air Conditioning FIRE DEPT. REQUIREMENT , 20. Rough Factory Fireplace APPROVALS Permit# ill 21. Ducts, in Structure 70. Underground Hydro r . i 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test _ 72. Underground Flush a a24. Roof Framing"` 73. Undergrnd.Storage Tank El Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe i 28. Lathing & Siding 77. FIXED SYSTEM FINAL . ' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ti 31. Plaster Brown Coat 79. FINAL INSPECTION ' I. 1 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: • '-' 34. Final Heating & Air Conditioningr . r - • 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing s 39. Water Service-Final 40. Gas Service-Final - , 41. Solar Domestic-Final - - .' • 42. Backflow Preventer / • 43. Backf low Irrigation • T ,- 44. :Landscape Irrigation System r 45. Sound Attenuation t X P 1 R L G III 1n;OHlple v InsoeCtiOnS , 46. Handicap Regulations c .• 47. FINAL STRUCTURE & BUILDING Date 0 ..--- SiK 48. Special Requirements Completed 49. Electric Release to Edison i ti 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY tr- No. Date _ • . _ •1:) OWNER SCH,0TI{AM, JOE DATE 7-22-60 JOB ADDRESS 11/ E. 23rd St. BUILDING PERMIT NO. 12590 GENERAL CONTRACTOR Owner-Bldr• VALUE $ 225.00 AP. N0,118-01.04-09 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK Patio Cover INSPECTIONS DATE I GROUP J TYPE V ZONE 02 *J";rground Soil U.G. Water PERMITS ISSUED U'A'ergrouad Gas --- SUBCONTRACTOR DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenches Forms Steel Floor System Steel Reinforce Chimney Re•Rod Bond Beam Sheathing Fxe and Flashing PP� „51g, In Out aster, brown coat Plumbing Fixtures, Final Electric Fixtures, Final Building, Final ;r 'J'IY{ S(-2,y'^b,., OCCUPANCY Form 210-5M-11-59 S-b P 12590 12590 . ,E COSTA MESA BUILDING-SAFETY DEPARTMENT -RECE� ' _0 P. O. BOX 917 COSTA MESA. CALIFORNIA .1--- 7 } For Applicant to Fill In Completely FI ANCE DEPT. PPP Y APPLICATION ORcPERMITIESA TYPE OR PRINT _CIO P vv.•• -P r y y- BUILDING ADDRESS BUILDING J / / Y L 3 ni -4-- COSTA MESA. CALIFORNIA For Office Use Only yry RECEIPT NO. PERMIT NO. OWNER OE U/ Q n MAIL �j RECEI BY D RECEI D ADDRESS ../I�y'O.4 3. 4L �( �p �/1 • /7 Z9C OIl .. -7 �7 11 CITY i9J-e ,ec .7../dict-s-,Ll NoMp in, ADDRESS ' // / / t 23 ARCHITECT TEL. COSTA MESA. CALIFORNIA • OR ENGINEER NO. J ADDRESS FIRE /'� /J ZONE TYPE GR,O(YP -(ry// CONTRACTOR`(,jilell[t-t!L (/SfyG'I APPROVED (ZONING/ DATE/i//' ADDRESS � / ZONE NO.OF USE OP NEW CITY 6/�1/'�LANS 7 I BUILDING ../ (�/ STATEIC.NO. TEL. LEGAL E /�'C e,�/` 3 / R. / /-/ LIC. NO. DESCRIPT SIZE y �/ 1 NO. OF BUDGE. j�}/ �%y S LOT ,1 �' (x '37 NOW ON LOT A.P.NO. I 1 S)—O II / / - O / USE OF �^ C- YARDS EVES EXISTING B DG S N� APPROVED ALLOWED SETBACK LINE PROM (CENTER LINE ST.) J'--�J c---.,,� • CENTER OP STREET REAR YARD FRONT pa ' ' FT. /7Z- - - IN. SIDE YARD I LEFT I RIGHT R.SIDE ✓ •t5-FT. + IN. DESCRIPTION OF WORK L.SIDE y/7 FT. N. NEW I II ALTERATION I II ADDITION I� REAR [.C %. 6) �F•Ip2��1 IN. �) REPAIR I 1I MOVING I II DEMOLISH I APPROVED(2) `7 '//IDATE� .7_ /-66) BUILDING / ✓/r RNO. OF OOMS STORIES (A / IY SIZE EXTERIOR WALL (ROOF COVERING COVERING USEJOS BLU-DING AND Waft „TkB E PERFORMED 2 / / U C• a I HEREBY ACKNOWLEDGE THAT I HAVE EAD THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE AND STATE THAT THE ABOVE IS CO CT AND AGREE TO COM- PURPOSE OP ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CI ORDI CrSTA W GULATING BUILDING CO i• VALUATION °'• SIGNATURE OF (,�i Jla f7�/ayp �1 PERMIT FEE S _ PERMITTEF TB L� •r�VY e Sc2� PLAN CHECK S AUTHORIZED �. AGENT I i TOTAL FEE 0 • OWNER SCHIOTBOM, JOE DATE 7-12-60 JOB ADDRESS 117 23rd St. BUILDING PERMIT NO. 12536 GENERAL CONTRACTOR Owner-Bldr. VALUE $ 540.00 AP. No.11S—Obit-09 LOT TRACT _ FIRE ZONE DESCRIPTION OF WORK Patio Cover ifyakEGTIONS DATE I GROUP J TYPE V ZONE C2 iliciW ground Soil U.G. Water _ _ SUBCONTRACTOR PERMITS ISSUED Underground Gas DATE NUMBER Overhead Water and Gas Rough Heating Rough Plumbing Miscellaneous Prop. Swr. Line House Con. St. Swr. Sprinkling System Heating, Final Plumbing Fixtures Final Gas Test Construction Pole Underground Power Rough Wiring Trenches Forms Steel Floor System Steel Reinforce Chimney Re-Rod • Bond Beam Sheathing F e and Flashing L .ng, In Out Plaster, brown coat Plumbing Fixtures, Final a Electric Fixtures, Final ` _I, )9n r Bilding, Final / l / d OCCUPANCY Form 210-5M-11-59 5.9 P 1 538 12538 EELL , *** IgCOSTA. MESA BUILDING-SAFETY DEPARTMENT 112-C nE58147 ***Mt P. O. BOX 3)7 COSTA MESA. CALIFORNIA S4 ja 121"ChNANCE DEPT.�u1 For Applicant to Fill In Completely APPLICATIg NFUR 41411M TYPE OR PRINT BUILDING BUILDINGDRESS q a 7 2.9 id ..4.2— BU .L I COSTA MESA. CALIFORNIA For Office Use Only ' ET_ p �ELL. .5 /I /) ` 1RECEIPT NO. I 1FBeeG[)+y OWNERLp/yrVl/ MAIL RE7D 'BfiI DATE I D•TrIBe ADDRESS 8 Cri 3 2-if /Pr ,4,1 7/ 6p y CITY �cte-o-4r ,J r.o.0 No:aR 411 S- AB DDFIDE S S /i q - 2 � ...a. ARCHITECT TEL. COSTA MESA. CALIFORNIA OR ENGINEER NO. �''T�"� ADDRESS FIRE f' GROUP � /' pp/� ZONE TYPE-�. CONTRACTOR Qiliu.-t.- n. - `�//c11- APPROVED BY DATE ADDRESS ZONING C ZONE .).......1 NO.OF USE OF NEW CITY C PLANK I BUILDING `` C LNO.E TEL. DEGAR P 0 n / 71 ,39 t m I /`/ LIC. NO. I` �-( / U\ T r 9 DEHCRIPTION SIZE OF LOT 3 J x NO. OP SLOGS.r 1 /I/ O 7 //I/�d 5- � �� (I/NO�W O�NLaOTTy A.P.NO. [' ? -U �'/7 - 0 _ EXISTINGUE BLDG. tX �N"'4-�"-��- / YARDS EVES APPROVED ALLOWED SETBACK LINE PROM (CENTER LINE GT.) CENTER OP (CREST REAR YARD FRONT 7 FT. 4e221---11"' IN. SIDE YARD I LEFT I RIGHT R.SIDE t5-FT. / IN. _ DESCRIPTION OF WORK Tr L.NEW I /' II ALTERATION I IIIADDITION I ' ` REARIE �n/SFT. IN. REPAIR I ,II MOVING I II DEMOLISH I APPROVED W j1 / DATE -2-f?-4o BUILDING b I NO. OF L%-771 SIZE /by ROOMS STORIES EXTERIOR COVERING WALL I COVd COVERING ROOF en_'f t USE OF BUILDING AND WORK TO BE PERFOD (Pa. &o-c2en- I MEREST ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM• PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. // VALUATION [JI {r PERM SIGNATURE ITTEP OF X717 J ' '? 4.7.1.42-2,7c � �7L PERMIT FEE S (' DI R /1/ _ 1 S�17�D PLAN CHECK $ 'r7/' S AUTHORIZED AGENT TOTAL FEE $ 71 - O n