HomeMy WebLinkAbout3444 LUPINE CIR - Building Permits�
�non����wn: 3444 LUPINE CI
ankmru�Eiv�u�wm: CHILES, DARBY C
moxess: CHILES, LILILEE
3444 LUPINE CIR
COSTA MESA,CA
, MPL. WJIlNO ADDRE54:
IRECT OP EN�IEfA:
ON EN0.'410011E53:
UM:
OPHER FLOOD: AH-38
SON
92626
uc. no:
UM:
cor+m�crarsruxe ROYAL ROOFING ( 714 ) 449-7750
ca+m�crorcsMuurw 135 W SANTA FE AV
�op�: FULLERTON 9Z63Z CA ��,�; 432352
uxr:
LICENSEU COMPACTOFS DECL�RATION: I Mreby eR'rm uMx parely d perjwy tIW I em liceroed �uder patima d CMpr 9
(oommantlnp xith Sxiian ]000) d Pn'aon ] d I�e Buunea ard Vro/eaabns Coda. end mY lioenae o in /ull brca end slletl.
cmuc.no.:046668 uc.cuss: C-39 uc.No.: 2352 EXP: 12/96
od.: ''.'!— ZY—yG co���a:
OWNEP BUILOEF DECLAR�TON: I hereby ellum untler panelly d njrty thm I em uemp Irom tM CaMretlm Lioen�e Iaw la iM
Idbxiq eeemn ($etlion'1OJ15 Bueneat end PMseaione Cade: Y a �qmb xidd� nCuirea e Wm� lo mutruet. e11ar.'vnpova.
;�.;y'pnwleh, a repai ury nrucwm, prior b ee'vauence, eho requ' eppl'vam t« avch peimt �o fJe e eqroC petameM tlW M a�he
��i IkenmE punueni �o iM pvmo'n M ths Conireaoro l'xmae law ICMqr 9(mrvnem'vq v.nh Serlion )000) d Diroion 9 d tM
�uuepu enJ Rdaauns Codel a�� h^ a M^ b exemq therakan eM IM b�s la Ne albped uemqion. My voltlion d SWion
)031.5 by enY 00Dliuni 1« e permil wbjede �M rppl'rant to a aN pera�y d rot mara ihen IMe Iwrdred doAen �5500�.
� I, u owiwr ol Ihs popony ar my empb�eee wih wapea u ihei ede rompeme�ian, xill do the xwk, eM tM niuclun h mi IntendeE
a ollemd br eeb (Seetion ]Du. Bueiirv eed Protaesiau COEe: The Caurman Liorne lewAaes M eVPMIo en ownerd p�opeMy
who buiE� a inpw» ihereon. ud v.M Eroe ewh xwk lim»M a hvee� aWaph hu a her own emWwM*. P�'ded the adi
unpewemeNe ere nal imeMad a dtereE la vab. p. IwMerer. tM bntlinp a inpvuaneN u rolO wilAn ans yeer d mmplst'vn. tlr
owmrbuiNer xiA heve iM bu�den d K��q M or eM Eid nol buJtl ar'unpove In Re W?as d eebl.
❑ �. e� wmer a �ne wwdn..m uduB�Mr mve.ane wan 4mivee m�w.c�u, m munw �n. wa� Iseeon �w. au.'vw. ene
Fdeaiana Cae.: Tne Caaream l'sema lew mm m epMi ro en oxrer N w�Y Ma ddM « ino�'m tlr�an entl �Nio
crnuecu lor wrh popne wdh e mmreaor(s) liceved pvauw to tM Comrama l'vns lanj.
� I un uemp uMx Sactian: B. 8 P C., la Nb �amon:
Dele: �
I do M�ebY ���'/ ihtl I am awue d erd uMselentl Ne �eV���mb d Wlimiu Ibetlh eM SdW Cods SWim� 25505.?551i. eM
25SJ�. aM Nm I tt M' INwa bukn0 � wi0 / xiA nallmcb one) nead ro comPN wi� uid pets � entl 1!w nCm�xYs br
•pemNlaamNiqionamad'dwionlmm�MA'r ue�ty arupenwtl0elritl.RvadaNelmWM'vieppite�iduenusnqhdnNm�
pomione.
Dele: AppGsnl:
WONKER'S CONFENS�TION DKUNATION: 1 Mreby e1Nm uMer penMy d pxryry ane W IM Idbvrinp Aeduetom:
� IhewvdwJmeintenecMJ'raledmwnttoWlimureMwkere'cwnpmemion.npa.iAeAfalySeaion3100diMleEn
eoa. �v �n. v«tomiene. a u. wo�k e«.,IiN, �ne o� m��e.
❑ in.�..na.a�i.:,.ona.�canro�+a,���.%+�wm�Msaaa�aoam.i.n«coe..iorwpmwmumau»
.�i«»�w�w.o.�mm�a.Mr.«��'��.°(��'�«m,eoac�.r�w.m.: EXPIRES
cd,�.:
Pdic/ Number. 11 / O S/ 9 6
ITnb eenion need �a w�nd.ree i nre vmma 9 ro, o,�. n��dree ddra,. R,aal w�..�
� I ceniy Nn in Ne pa�wmerwe d ihe work lor whch ihia pamG o iaeuaE, I nheA M ampb� ury paaon m ury meviar o n lo
beeam abjed b iM xvelma' eompenution lera d Celtlaw. eed epes tlat Y I Mwk bamir rA�ea to �M v.a�hws'
comDMation pwiaio/na� d Seeio/n �]W d �he lebor Cada. I eheOlwlhx/ilh m�mYN wilh Oiws pwmms.
Oma: �� Z- `f � J b MDrceN: / �
W�m/n0: F�Nun M��cun wort�r�' eompxwtlon eovereps Is undMU ntl Msl/ u!/�ef �n �nploya to dIMrW p�rultl1s uW
elv/l flnvs'q ro on� Irwdred fhouun00oll�n (Sf00,W0A M edL/tlw b fM emf ol romp�nutbn tlamsp� u pvvMW br N
9wHon 3](I6 0l M� Le6ar Cotls. Inhrosf, an0 ettorvroYa /su.
CONSTFUCTON LENDINO pGENCY: I Mreby �em uMer pendy d perlNrv �� �� u e mrutiutlion kndinp epezy br IM
perlwmv�m d iha xoM la whiN Ihe peemY ia beued (Seelion 90B1. CM. C).
LENDEN'S NAIAE:
LENOEP'9 ADDNE55:
I cenM Oim I heve reeE �hie epqicmion uN elme Ihel tM ebwa inlammion ia mrtea. I prea lo campty wil� ell dry enE counry adi�xncm
eM eW e 4vn ieleimp io buiMinO ���^ � hereby eNhorize repeaenlalivea otthp ary io anter upon iM ebon�memioned poparly
�o���av«ro�v��o�a. JASON CINARUSTI
Deta: —Z —�
(5151J6.WP) WM1ne-Buildip 8 Sebry; GreaerFle: Cenery-Appirant: Rnk-Revenua; OOldenroFNawmr
CITY OF COSTA MESA — BUILDING PERMIT
,PERM NO: B 079618
PERMIT NO: B 079618 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOH DESCRIPTION : T/O 6 REROOF W/COMP SHINGLES SQ FT: 5,000
CLAIM VALUE: 5,000.00 CALC—VALUE: 5,000.00 GROUP OCC: R-3 /
COMMENTS: REROOF 2500SF RESIDENCE W/COMP SHINGLES
x *�r+�+�*�rx�***�r**�r*+r****�r**�+��*x **+�****�r***�+r+�+r+�+�+��r*�*****�r�*�+r�r� � *�r**�r**�****�r***
Z O N I N GS ERTEHQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 41217818 ZNE: REF NO;
PLANNING NOTES>
i. �
Ik IE if IE IE iF iE 1E 1E iE iE iE 1E 1E 1E 1f if iE 1k 1f if 1f if 1f iE 1f 1k 1F IF �E iF 1F iF iE IE iE iE 1E iE iE 1E 9I� ik iE iE iE if iE 1E fE iF iE iE if if 1f IE 1E 1F 41f IE 1f 1k if iF ff iE iE iE if ik iE aE 1E iF if fk iE
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
ZONING APPROVED HY DATE:
HUILDING APPROVED HY : DATE: � ,+
APPLICATION ISSUED BY: DATE: 1�
1k1E1E1E1l1EiE1fk1f1kif1f7E1fk1fik1E1F1E1f iE1Elfififll1E1E1EiE IEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/itES♦ GRADING
PERMIT 99.75 .50
SMIP/NON—RES
PLAN �
ZSSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 100.25 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
99.75
TOTAL PAID DUE
100.25 100.25 .00
100.25 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
.50
iE ft iE 1k fE 1! 1E iE 1E iE iE 1E 1E IE 1E 41E 4 iE if 1E 1f �4lE 1E 1E 1E if �F iF if if if 1E if iE �E iE IF'1E IE iE 1f 1f if If iE if k 1E 1E 4 k 1f IE 1f IE if 1F 1E iE 1f 1E 1E 1f iE 1E 1E iE If iE if-!F i(� 1E 3E iE IE 1E
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
1.�� 5r���,��
01 DD21`544—U021554` T GT SOO.ZS
DATE� 09/24/9S TI11E: OE:17
CO�IUN AND PLANNING POG SPA � -
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
L Temporary Electrical Service or Pole 52. Pool & Equfpment Locatlon
2. Soil Pipe•Undr9��d� _ 53. Steel Reinforcement
� 3, Electrical Conduit l7tility�Undrgrnd. 54. Forms �
. 4.:Electrical Conduft�Ur;tlrgrnd: - 55. Electricai Bonding =�
5.5teel Reinforcem�nt= 56. Rough Plumbing & Pressure Test
6. ElettricalUFERGrnd. 57. APPROVALTOCOVER�GUNITE �'
^ 7. Footings -- ' 58. Electricai Cond�ciI-Undrgrnd.
�.� Foundation � 1 59. Gas Pipe, O Urit�Fgrnd., Test
�- 9. Water Pipe�Undrg�nd.- 60. Backwash Lin€s,P-Trap, O Undrgrnd.
�10. Structural Floor Syscem 61. APPROVAL TO.DECK
1Y. Property Sewer Line & House'ConneMion fi2. Backwash & Receptor�Final '
12. Sewer Cap � _ 63. Heater & Vent-Final
13. Roof Drains � ' 64. Plumbing SYs[em - Pinal
14. flough Plombing 65. Electrical�Final •
�5. Rough Electric3t�Conduit ;r 66. Solar System�Final
16. Rough Electric Wiring 67. Fencing & Access AnProval
�17. Rough Wiring Sign '' � 68. APPROVED F�.R PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSFEMS FINA�
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
r �
20.-Rougb FactoFy Fireplace - - - =x ,= APPAO�%AIS. ' Permit # �
21.�bures, inStrIIctur`e,` � � � Y� 70�'Unde�tjcouhd Nydro '
22. Ducts,Ventilating=, r �� _� � 7�, ProducT:Piping•Qfias �OOiI
23.-Gas`Pipe=Roii9h &•Pesc � _ y F ' � ' h 72. Under'gwund Eipsh � �
24. Root Praming. � . . _ . ; _ ' 73, Undergmd.Stora�eTank �Gas ❑��Oil
25. �Roo4 Sheathing � :: - 9 y��'.f - (/ � - �tj�Overhead Hyd�L'��� `
- " /'.�/ �' =
26.'"T-Bar Celling (Structural) &�Monocoat ,. " � ` �;;: 7,5. Dry Chemical��' • � - -
27. Frame and Plashing{ _ � 'k � ' 76. �Dry Stantlpipe_ `� � '
28. "Lathing2. Sidingii:= =• - a' K s' ��: 7;7. fIXED-SYSTEM.FINA�LJ � ,
29. Insulati6n = _, y` - '' " � h h' � ' � }g, FIRE PREV. FINAL ;..- �
� 30. Drym�all�laili�g �, ' " * � � � i.tt..� _ HEALT�i DEF�hAEOUIREMENT
i
31. Plaster Brown Co`a�,iy� _ T � � I� r, 79. FINALIN$PECTi10N x r _ -
32.`Electrical Po'vuer Me"ter-Final �� ' y' . ' � '
�, $0; FOOD CE7�TIFJEATE �SSUED
33. finat Electric ' * �''' � � ; � ' Rjotes: _ +� _ .
Y
34. Finai Heating_& Air'Conditio�ing. , ' I',%� �" .`-.' �r � -
� ^ - -
35.rfinal,GasPipe-Test�� . � '* (' � t� _"
: ^. � =i �.
36.� Rood or_CanoPY V �� _ _ k- - - � c. - y T
37."FinatFaitoryFirePlaee� �' � ''�� -- -
.
38. Final Plumbin9 �L ' ' . -. _ • -" ' r= n: � _ . . ;
' 39. Water Service�Finei- � , . i ��: � ('� r � � - _
i I � � - �
40. Gas Service-Finat "� . r ' , , t* � ` � - '
41. Solar pomest+cFinal - �^ • x �, � v� ,c,_� ��
' - �e
42."�8ackflow Pre�enterr� �- - � � `. ��„ . # ,- .- . .
43. Backflow Irri9ation:.; � 5 � � � . = � _
44. Landscape lirigation System. ',,', �� r - � _. - ' -
- i r -� � ti t c..
:
°45.'Sound Attenuation, - .. �. - z r- " �, � • .
�, � �
�'716.-Handicap Regulations = x =� "' �_� � "�^ �
K
�47.'PINAtSTRt�CTURE&BUttDING .. �D-)-96 / ' � ., .. .
48. FINAL PLANNING' '� �. ' _ �
49. Elecfric ReleBse to Edison � � � - -
50. Gas.Release to Sou[hem Califomia Gas Co ` , , - , _ ._, . ,
51. CERTIFICATE OF;OCCUPANCY _ - ' ,
No � Date
' Aoolieant to flll In a11 spacas azceo< <�ose wit�in heavY Oortler Iines ana sign all aoDrooriata Eaclarations.
TY OF COSTA MESA � , PERMIT NO. , THACT NO. ' LOT.NO. , BL
NSTRUCTION P.ERMIT ' E�s 2� - " - � '
IiCenl'S Meiling rd,fess ��Q O , G r '�� TMPE OF CONSTRUCTION � " NEW ADD ALTERA7'ION': ,REPAI R
�Y'Y �" �N� �• G � C, i ❑ CONVERSION -❑ DEMOLISH �OTH R'� �
ject Addreu . - . �
OwneriName�--a �'Q- � hone'�'39-/GyD D CRIPTI OFWORK - 'Zw� a'a'G �L G ��C..
��4'�tf [.� �,v.d,s a� ci _ 0 L�o ke e�2 a�
Address, "
Arch/Eng- . � License No. �
Address ' "
Contrector's Nam � � hone
Addresslmailing) , ,
Licenu No.
LICENSED CONTRACTOR ECLARATION � �
I hereGy a}firm that 1 am Ilcenzotl_ untler provlsions ot Charter 9(commancing
with zectlon 7000) oT Divislon 3 of tbe Business antl vrofasslons Cotla, antl .
my Ilcense Ii In full force antl'eftect. � � ,
L1C8n58 Claii LitenSe No.
Date ' Si9nature f
1yORKERS' COMPENSATION pECLARATION . ' ' '
%y,re0y a//irm.that I �dv0 a c¢rd/lwta of consent to salHnsure or a.certlfiwte.
���N�Norkers' Compenzatlon InsUrance, or a certlfletl copy t�ereof (Sectlon
-��ao. uo. c.l . , . . .
Pollcy No. � Company .
BCertlfletl capY Is �ereby furnlshetl. • '
CerHfletl copy Is tiletl wlth the tlry Bulltling DIvi5lon. . �
Date � AOPIKant '
EXEMPTION FROM WORKERS' LOMPENSATION DECLARATION
jThis sectlon neetl not be tomDlatatl I� tha permit I5 (or one huntlretl (E100) or
less�.
I Certi(y �Nat in the perfOrmance O/ Ihe work (Or whiGh th15 perm�t Is IsSueG I
s�all not employ any person In any mannlr so as to become subjecl to t{�e ,
Workers' Compensation Laws of Californla.' � �
Date � � � Slgnature � - '
NOTICE: If,�after making.Mis tldclaration, you shoultl become sub7ect to lhe 1
Workers'� Compansztlon provlsl0�s of the Labor Cotle, you must. forthwltn ,
comply witn such p�ovlilons ,oi this permit �shall �e tleemetl revoketl.
CONSTRVCTION LENOING AGENCV " . '
I �ereby attirm Mat there Is a:co�structlon lentling agency for the�performan<e �
of the work far, which thls permit is IssueO (Sectlon 309] Civ. C.� '
Lentler's Name
Lentler's Atltlreu �
OWNER�,BUILDER OECLARAY�ON , � . �
Aructure, prlor to Its issuante
91e a SlqneE statemeul',that hep
Contiactor'S License Law (CPa�
ISion 3 ot [ne'Bu5ine55 antl Pi
'efrom antl tbe� bas15 tor the al
1.5 Gy, any applicant for. a�
alty o/ not more than tive hu�tl
I;- a5 owne� of� the property t
�pensatlon wlil�tlo Ihe work: a
sale�(Sac�ion 7044', Bu9ness
.nse Law Goes not aDP�Y to an �
'¢On, and wh0 tl0¢5'suGh wOrN
�loyeos, provitletl t�xt such ImF
. If, however, the bullding of ii
iorine purpoze
as owner of the
LJ I am-exempt untler
Data
Drivers' Litense or
CM F �0865-46 rev. 1
TYPE OF PERMIT GRADING FOVNDATION STRUCTURAL
❑ TENANT � ELECTRICAL 7LUMBING, ❑ MECHANICAL � ' '
, ❑ �OTHER � - �
PRQIECT DESCRIPTION � 5�. F7. - oCCUaANCv
CONSTRUCTION TVPF VALUATION $
ZONE GRADING CU. VDS. �� ACRES
Remarks: , � . �
Sink '
cflow Preven[er
cflow Irriga[ion
Floor Orains
Flaor Sinks
Gas Service
IntercePtors
Kitchen $in4
Sewer CaP .
- - SeW2f CAnnECtiOn
Solar Collettat5
� Saler Pipin
, , I Sol � e�tl
in Spa .
. Uri e B} S� —
, Water Clout ', �
Outlets
anG ProTesslonal�Coae: Any city or P-Trap '
t, al[er, improve, tlemolish ot re0air �
I Wres the applicant for suth parmit ROOf D�ains �
ensetl pursuant to the provisfon5 of
>mmencing,wlth�5ection 7000) of .- ' . _
s, Cotle) br� thaP he/she isiexempt • ' Showe�s �
�mption.�Any vlolatiodof.5ection ' .
subjects the appliwit to a'dvll � � Service5ink' ' �
rs (y500). , � . � '
nployees with wages as thelr sole � ,_
:ructure•Is not intentletl orofhreO ' ' �
fexsional.Cotle: The.Contr3ttor'S .
a property.wlio builtls or improves � . goiler ^ •
/herSeH or thraugh his or har own
ds are.not intentletl or otferetl for -
ent is soltl wltnin on ' f com- Duct �Under Giound
e year o
proving he/she tlltl not bu110 or Im- � Duct - Structural � �
•. � �
uery contracting�witn,licensetl con- � �
44, Business antl Prote55ion5 Code:_. Duct ; Ventilating . �__,�. _
�ply to an ownar of property who , .
racts (or such pro�ects with a con- Exhaust Systam ❑ Multiple ❑
',s License LawJ. j � �
e. 6 P. C. for this reason � Firepl/FaCt.81t. ICBO # '
�
_ p(y�p� . - � ' , Heating System & Dut[ing � '
hare reaG tnis�application�antl state that the abow• �❑P700,000BTU-0100,0008TI
agree t0'comply wit� all city, antl county ortllnances �
o builtlin9 construcilon, antl hereby authorize rapre- Hood o�
to enter!upon the above-mentlonetl �pr perty for Type I ❑
W�,/_;_/� �, G , Cano T ell ❑'
i(/� PAd— Date
� . Registers �
W�Ite - Builtlin9: Canary - Applicant; Pink - Accounting;
Water Service � ' �
" Reinspection Fee , $15
� Isua Fee � $ 3
1qIVIl:HL '
i
Refrigeretion System � ,
❑P100,OOOBTU ❑100,OOOBTU�
�
System Repair/Alteration .
. +_ `
I i
� Reinspeaion Fee�� $15
. laue Fee , $ 3
A. P:9h
PLNG. REF.Yp
LEFTSIDE VARD
PKG. SPACE RE�.
STREET WIDTH
- -36�6 �✓IC1.::
_
. � �. . ' '' ; t
Automatic Washer.
Constr�ctian Pole
Cooking Unit '
Dishwasher
Dryers ❑Gas �lectric "
F.A.U.
Fixtures '
Device Boxes
Outlets
Switches
ZONE �
BUILDING - �
SETonrv GL cT
FEAR VARD (TO P/L)
RIGHTSIDE YARD
PflOVIDED
PARK FEE $
iMete�_.vover 100 amps �
Sub Panel' �
Sub Pole �
Motors DO-1 HP ❑1X-8
,Inc.Solar 09-15 HP 016-15+ �
Pole Light �
Fan9e... . '
Tresh
Sec[ions
;
�
_ . ..I -: _� . I.. -I;
Garbage �isposel ' . - �
Generetor 00-5 KW �5-75 KW , .
Transformer 015-50 KW
� ❑5U+KW � ReinspectionFee
Meter ❑up to 100 ampi laue Fee
Zoning Approred By ' Dete _
Appliption Approved By Date —
� , �Applimtion laued By '� � � ! Date �
j ; , ' SUMMARV OF FEES , . ' '
i �
'BUILDING PERMIT $ SMIP � $ �
�PLAN CHECKi ' $ � I ISSUANCE $ �
�PLUMBING , : $� ' . � .
,PLAN CHECK � $ '�' p^ ' .. GRADING i � $ � •
ELECTRICAL $ � � - . $ '
� MICROFILM $ • � �
PLAN CHECK $
�MECHANICAL � $ � TOTAL FEE� $
PLAN CHECK $ � LE55 � � �
, ' ADVANCEDPC $: ,�1
� �' FINAL FEE � $ � �v
,. .
iRUCTION AND�PCANNING
:'APPROVALS �, Permit # -
1. Temporary�Electrical Service or Pole
� 2. Soil Pipe-Undrgmd. � ,
3: �Electrical Conduit Utilitv-Undrgrn�l.
. 4: Electrical Conduit-Undrgrnd. � '
5: �Steel Reinforcement
6: �Electrical UFER Grnd: �
7. Footings , ' -
8. Foundation � .
9.�WaterPipe-Undrgrnd. ,
10. Structural Floor System ' .
11 . Property Sewer Line & House Connection �
12. Sewer Cap � , � '
13. Roof.Drains '
14. �Rough Plumbing
15. Rough E�ectrical-Conduit - ""' '
i6. Rough�ElectricWiring�
17. Rough Wiring Sign ' -� ,
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. �Rough �Factory Fireplace
21. Ducts,in Structure
22. Ducts,.Ventilating �
' 23. Gas-Pipe-Rough & Test �
-24. Roof•Framing� �
25. Roof Sheathirig
_26. �T-Bar Ceiling'�Structuralli & Monocoat
27. Frame and Flashing
28.-Lathing & Siding '
29.. �Insulation . -- -
�
30. Drywall Nailing . .
�37. Plaster Brown Coat
�32.'Electrical Power Meter-Final
33. Final Electric • .
34. Final Heating &'Air Conditioning
35. Final Gas Pipe-Test -
36. Hood or Canopy �
37. Final Factory Fireplace� _ �
38. Final Plumbing •
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow lirigation . '
44. Landscape Irrigation System . �
45. Sound Attenuation •
46. Handirap Regulations � �
47. FINAL STRUCTURE & BUILDING '
i
48. Special Requirements Completed
''
49. Electric Release�to Edison.
�50. Gas Release to Southern California Gas Co
N�CERTIF�CATE OF OCCUPANCY
� "� � Date
POO L ?A -
��Date Inspector qPPROVALS Permit�
� 52. Pool & Equipment Lowtion �.
� 53. Steel Reinforcement _ �
' � � 54. Forms . �
55. Electrical Bonding � ,
- 56. Rough Plumbing & Pressure Test � �
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrornr{.
' 59. Gas Pipe. O Undrgrnd., Test
� � 60. Backwash Lines, P-Trap,�O Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor-Final
' 63. Heater & Vent-Final � � .
64. Plumbing System - Final _ ' �
� 65. Electrical-Final � � � �
' � � - 66. Solar System-Final � � �
� ' 67. Fencing & Access ADProval `� �
� 68. APPROVED FOR PLASTERING . �
69. POOL/SPASYSTEMSFINAL .
• FIRE DEPT. REQUIREMENT
APPROVALS Permit# ;
� 70. Underground Hydro
- 71. Product Piping O Gas ❑ Oil .
�i 72. Underground Flush
" 73. Undergrnd. Storage Tank O Gas ❑ Oil
� '�' ' � 74. Overhead Hydro �
� .;�i 75. Dry Chemical �
�r � '� 76. Dry Standpipe �
Ct �. 77. FIXED SYSTEM FINAL .
��
;� . 78. FIRE PREV. F�NAL
Notes: �
e
Date � InspecWr
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require
the return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be
issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the proposed
property improvemen/t. ❑ Yes � No
2. I(have/have not) ,l 4 v�� signed an application for a building permit for the
proposed work.
3. I have contracted with the following person �(firm) to provide the proposed construction:
Name ��/�wo A�n/ l�l �1�1��5 �'M.2
Address —
Phone ( 1
Contractor'S �ic.
Clty
4. I plan to provide portions of the work, but I have hired the followin9 person to coordinate,
supervise and provide the major work:
Name
Address —
Phone ( 1
City
Contractor's Lic. No
5 I will provide some of the work but I have contrected (hired) the following persons to provide
the work indicated:
Name
Address
Phone � Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the
State of California Health and Safety Code and have completed the above information to the best of my
personal knowledge, in compliance with this State law.
Signed: /7 �� �� Date: �� � 6 �g 3
Name: v � � �%� lN'Z � -S
(Pri ted or Typed)
D.L or S.S. # �
CMF 3042-46 7545273
�
PflQIELT p�OflESS: 3 4 4 4 LUP I NE C I
OWNEP'S NPME: RUMBLE DON L
aooeEss: RUMBLE� JOAN F
3449 L{TPINE CIR
COSTA MESA,CA
APCN/ENGINEEN: 7 5 4— 7 6 9 2
aooeess:
UNIT:
92626
PEG.NO.:
uxiT:
�� PEBMITTEE: DON RUMBI,E ( 714 ) 754-7692
aooxcss: 3444 LIIPINE CI
C M CA 926�26
LICENSEO CONTNACTOH dELLPiiFTION: I AereUy af�irm that I am Iicen5e0 unAer pmvision5 0l C apter 9(commencinp witA Seclion
7000� ol �ivision 3 af ihe Business antl Pmlessions Cotle, antl my lirense is in lull force an0 eflecl.
CITY LIC.: STATE UC.: CNSS:
�a�e: Signalure:
WOflKEflS' COMPENSRTION OEGIAMTION: I �ereDy atlirm t�a� I �ave a cetliliwie ol consen� to selbinmre ar a cetliliwte oI Workers'
Compensalion Insurance, or a cenifieA copy Ihereof (Sectian 3800. LaU. C�.
POLICV NO.: E%P. DRTE:
COMPRNY:
rJ Cerlilied copY is hereby fumishe�. ❑ Cenifie0 coDY is fileE wit� t�e ciry BuilAinA Division.
�aie: Ap0licanP.
EREMPTION FBOM WOBNE85'COMPENSpTION OELLABPTION: (T�issection neetl noibecompletetlilihe permi�islorone hunAreA�5100�orless�.
I certily Ihal in Ihe pedormance oi the woB �or which this De�mit is issued, I shall noi employ any person in any mann¢r so as to hecome
subject to 1h¢ Workeri' Compensa�ion Laws ol Califomia.
Oa�e: SignaWre:
NOTICE: It, aRer making ihis Eeclaration, you ShoWC bewme 5u�lec� ta ihe Workers' Compen5aiion D�ovisions of �he Labor
Coae. you musi brthwilh comD�Y wii� suc� pmvisions or Ihis permi� shall be deemea revokeC.
CONSTNOCTION LENUING �CENCY: I here6y allirm ��at �here is a cons�mclion lentling ag¢nry �or I�e pedormance ol ��e woM1 lor
w�ich I�is Dermilis issuetl (Section 3097. Civ. C).
LENDEfl:
FDOflESS:
OWNEP BUILOEN OECIAPATION: I �ere�y allirm Iha� I am exempt imm the Contractors' State License Law for tAe Pollowing reason
(Secli�n 703t.5 9usiness antl Pmlessional Cotle: Any city of county which reQuires a permit to conslmc�, alter, impwve, tlemolish, or
repair any slmc�ure. Orior to its issuanc¢, also requires the ap0lican� lor Such permit lo lile a signetl statemenl Ihat helshe is licensed
pursuam �o Ihe provisions of the Conlracmrs Slale License Law �ChaD�e� 9 Rommencing with Section 7000) of Division 3 of the Business
an0 Pro�essions Code) or ihat he/she is exemv� �herelmm anU the �asis for ihe alleAeO exemption. Fny violation of Section 7031.5 Uy
any applicant for a permit subjecis �he applicanl Io a ciNl penalry o� not more Ihan five huntlred Collars �5500�.
� I. as owner ol Ihe pmperty or my employees wi[h wage5 as IAei! sole compensation, will do Ne wolk, antl �he
stmcmre is no� intenaetl or allereE lor sale (Section 7044, Busmess anU Prolessianal Cotle: T�e Contractors' Slate License Law
tloes no� apply lo an owner o� a pmperty who OuilOs or impmves t0ereon, and who does suc� work �imsell/hersel� or thmugh
his or her own employees, providetl ��at such impwvements are nol iniended or o�fere0 �or sale. If, Aowever t�e �uildinA or
impmvemen� is sold wilhin one year o� comple�io4 Ihe owner will have Ihe Eurtlen ol pmvinp he/she Uitl not �uiltl or improve
lor Ihe purpase a� sale�.
I. as owner of the propeny, am exclusively coniracting with licensetl contractors to consiruct t�e prolect (Section 7044, Business
❑ and Protes5ion5 COUe: The Coniracmrs' Stale License Law tloes nol apPty lo an owner of DmDenY who bmltls or impmves ihereon
antl who tOntrac�s �or Suth pmjetls witA a contraCtOf�s) litense pur5Uan1 �o ��e Con[raC�ors' $lale Litense Law�. I am aware
Ihat proof o� I�eir Worker'S Compensation insurance ShoWd he D�ovitletl Io me.
� I am erempt untler Section: B. 8 P. C
for ihis reason:
Daie�, �,/ n/J � � ���� O�vner:
I Ao hereby cenily iha� I am aware ol antl untlers�anA ine requirements ol Calilomia Health and Satety Cotle Sec�ions 25505, 25533, an0
2557A and Ihai I or any WWre buildinA occuDant will/will no� (circle one) neetl �o comply wi�h said s�ale cotles antl I�e �equiremenls �or a
permit �or consimc�ion or modtlicalion Imm I�e Air Oualiry Managemen� DiSVicL FeSitleniial cons�mciion apDlications a�e exempt hom
tnese o�ovisions.
Date: Nppiicant:
I �ereby Wtli�y I�a� I have rea0 ihi5 a0�litalion �nd sla�e ��at ihe above inlormalion is correcL I agree m comply wilh all cily an0 coun�y
ortlmances antl slatelawsrela�inglo buil0ing copf�mction ana �ereby aulhor@e repre5entalive5o�i�is utyto enteruponi�e above-mentione0
O�operly lor inspec��on purposes.
�a�e�'�n ^' G�9a Signature: �� '
Oriver's Li�ense or Social Security n: �
I6at�o6 Wbite—Bwltling: Grem—Cotlo Enlorcamenl', Canary—Appl¢enl: Pink—Revenue: Goltlenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05569
PERMIT NO; E 055696 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION ; LEGALIZE PORTABLE SPA ELECTRIC WORK SQ FT:
CLAIM VALOE; CALC—VALUE: GROUP OCC; /
COMMENTS: NO OTHER WORK PERMITTED
�r***�r*�e***�*x�*x�*x �e**�t*+�*�r**�t**��e�t***�ra�**+e***�t******�r*�t�****x**�t***�r*+t�***�t****
7 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARICING RE(� • PROV: PARCEL: 41217818 ZNE: REF NO:
PLANNING NtSTES>
i
it iE iE iF iE iE iF iE iE iE �If k i! if iE if if if !f if if iE iF if iE k iE if iE IF iE iE iE iE 1E iE if iE ik if iF 1f if ik if 1f 1F �f fE iE If 3E iE ik if if 1F 1F if 1f iE if �F iE iE �E ii if if iF iF iF iF if 1F if iE iF if
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
ZONING APPROVED HY ,
BUILDING APPROVED BY :
DATE:
DATE;
APPLICATION ISSUED HY; � DATE; ���
ifiFikklElElEififlf�filif3tkififlfkifiEif ifiEk3E�E1FiE1f1k1EiF�i� *af
M if ik if iF iF if ik iFif k iF ik iF iE iE if k k k iE k i! if if ik k k iF ff 3k if if it if if iE if �t If 1f �F �f if iE �F 3f it iE if ik if k �f iklf i! if iE jf iE iF �E if if iF iF iE k if 3! ik 3f iE IF 3F 1F IE �F
LEGALI2ATION;Y F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES� GRADING
PERMIT 22,00
SOY SMIP/NON—RES
Pr,�
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 22.00 15.00 0,00 37.00 37,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 37.00 OVER/SHORT: ,00
BLDG PNiT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
37.00 ._
if if ik if k iF if ak ik iE iE if iE iE iE if i! 3E iF 1E if ik iF iF ik if �E 1E ik ik iElf iF fE iE �k iE iF i! iE if k k if 1E if iF if iF �E if if �F iE �E iE �E k�E 1E ik k 3E if �3(� iE if k iE 3E �k if if iF if 1E iFiE iE
� I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
ELE
1 MISC CONDUIT
� EXpIRED
Incomplete Inspect�ons
l7dt@ ��s_..�m— SIg ''��-
�
�OT LISTED REQ PERMIT
END OF FEES
11,00
�!: , �.;f•: ' _.
� �'. .1.� ] ,. ..
11.00
ti
CONSTRUCTI0�1 AND PLANNING POOL ,,, aPA
APPROVALS Permit # Date Inspector qPPROVALS Permit # Date inspector
1. Temporary Electrical Service or Pole . 52. �ool & Equipment Location
2. Soil Pipe•Undr9rnd. �� 53. Steel Reinforcement
3. Elect(ical Condutt Utilitv-Undrgmd. 54. Forms ,
- 4. EleMrical Condu�t•Undrgrnd. 55. Electrical Bonding
5• Stebf'R�inforcement 56. Rough Pl�mbing & Pressure Test �
6. Electtical UFER Grnd. 57. APPROVAL TO COVEfl�GUNITE-
7. Footings 58. Electrical Conduit-Undrgrnd.
8, Foundation 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe-Uncirgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
17. Property Sewer Lina-& House Connection 62. Backwash & Reczptor-Final .
72. Sew�r Cap 63. Heater & Vent-Final I
13. Roof Drains 64. Plumbing System • Final
14. Rough Plumbing { 65. Electrica6Final
15. Rough Electrical-Conduit 66. Solar System-Final
76. Rough Electric W�ring 67. Fencing & Access Approval
17. Rough Wiring 5ign 68. APPROVED FOR PLASTERING
18. Rough Electric��•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT�
20. Rough Factory Fireplace APPROVALS � Permit #
21. DuCts, in Structura . 70. Underground HYdro
22. Ducts, Ventildt��g �. 77. Product PiRing OGas OOiI
23. Gas Pipe-Rough & Test - 72. Underground Flush ' �
24. Roof Framing , 73. Undergmd: Storage Tank O Gas ❑ Oit -
25. Roof Sheathing ' � � 7A.'Overhead Hydro �
26. T�Bar Ceiling (Struc4ura1) & Monocoat 75. Dry Chemical -
27. Freme 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. Plasier Brown Coat . I � 79. FINAL INSPECTION � �
32. Electrical Power MeterFinal i � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � � Notes: -'
34. ,Final: Heating $� Air Conditioning ` • �
35. Final Gas Pipe-Test � - � �
36. Hood or CanopY � - .
37. Final Factory firepiace � - -
38. Fina� Plum6ing . � ' - �
39. Water Service-Final � � - '
40. Gas Service-Final , . - _ -
41. Solar pomestic-Final '
42. Backflow Preventer
43. Backflow Irrigation � -
44. Landscape Irrigation System � . , .' � 9
- �-
45. Sound Attenuation E X _};�D
46. Handicap Regulations " � I�COrtt ete inspections
47. FINAt STRUGTUFiE & BUII'DING . �tC 4' ,j� Qv �- �l'
�v
48. EINAL PLANNING ' ' .
49. Electric Release to Edison ��
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY
No. Date
. . _ . � J.. .. . .. . .
CITY OF COSTA MESA RP.QUE� FOR OCCL.nfiCY
`%7 �� %� -
��. ���
TRACT NO.�S ��
toT r;o. d
ADD?iE S S �
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreemen:, ackaowledges that
(he-she-they)__1�Z // (was or kere) i/�/cr'�lp� advised that tnis t:act has
not been given final inspection nor has it been accepted by the City o: Costa Mesa
2s having co:c:plied with the conditions of 2pproval wnich were iu�posed by the City
zt tne time the final tract r.iap kas approved.
T_he Cit}• assu^ies no liability for the eaforcement of tne conditions
necessar}• fo: approval other than those conditions protected 'oy surety Soad.
The undersigned agrees to'iada�nify and hold the Citp ha rn+less fro3
nay claim resulting in damage or personal injury to tne undersigned Sy reason
of the aforementioned uncompleted condition.
RECEIVED
CITY OF COSTA MESA
PLANNIN; �EP7.
OCi � 19�;;
A� 4M
7i$��J��-� i:d.�%>H;4��,6
�
BY
� . � =/
L . . '9 � A�-._i.i�; �`�
� Developer and/or authorized
representa�ive
BY 1� .,��/�:_ l ��r��
Lender
OWNER j,pgWl
JOB ADDRESS
GENERAL CONTRACTOR
AP No. LO'
I " �.��''�='TIONS
-�;::::_ -_
$�G.4t'
GAS
W ATER
ROUGH PLUMBING
PROP. SWR. LINE OUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AN� AIR CON�ITI
TEMPORARY SERVICE OR POLE
UNDERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS STE
FLOOR SVSTEM
BON� 6EAM � STEEL REINF(
SHEATMING
FRAME AN� FLAS IN
LATHING - IN OUT �
PLASTER, BROWN COAT
STRurTURAL, FINAL
HE , VENT., FEFRIG. AND A.
DATE
SUBCONTRACTOR
ERMIT
Ph11i
.3i�4� ? �^R 11-73�.;� 00 653:: •,,.'r12i�.05
COSTA MESA BUILUING•SAFETY DEPARTMENT
C 2O1BR P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVE BV DATE FiFCEIVE DATE ISSUED
BUIIDING 3444 Lu ine Circle `=�� :IPR 10 1973
z .
ww
aV
Z
Z Q
ON
dm
J �
J N
Q W
Q] J
- p]
J a
U �
Za
W �
aw
wZ
J Q
m z
J �
W w
� _
z �-.
w�
� �
70
H
Z
Q
U
J
a
a
a
�
F
N
Z
O
H
U
�
�
�
N
Z
ADDRESS
OWNER Larwin Southern California, Inc. A.P•NO. -�
MAI L BUILDING
ADDRESS 16255 Ventura Boulevard ADDRESS,j �{ `
cirv Encino. California No�986-8890 raacr 7557-
BRANCH 16255 Venfura Boulevard
ADDPESS Fni-inn i�n�ifnrnin
CONTRACTOR �ar
ADDRESS 162551
aTv Encino
uc No. 191311
S12E
OF LOT (�'�
SIZE OF
SO. CO�1{.
.L•__ �I..J -
1
NOL 273 �'f'iV'�
/. �"�I��S� CO.
lifornia, Inc.
IR
TEL. ZONE
ifornia No.986-8890
CITV VARDS
IIC. NO. g�� MAIN
NO.OF BLDGS. (FROM Gl
S I NOW ON LOT RONT /
NO. OF
USE OF BUIIDING AND WORK TO BE PERFORMED
Construction Sinale Familv Residence
REAR �
DISTANCE BET.
MAIN BLDGS.
VAR. #
BiOLD
I hereby acknowleCpe ihat I hava reatl this appllcation antl state
thai ihe ebove informatton is corract entl apree to comply with
all lews reBuleUnp builtlinp consttuction, entl I shall not employ
any parson in violetlon ot the workman's compansation laws of
Me Staie of Calitornia. / �
I hereby certify that I am prope�ly licansetl as e conttactor under Sn• �
the State of Californie Business end Profezslons Cotle, D(vision 3, THE AMOUNT
Ghapter 9, and that such licanses are in f�ll force and effect, or 1 THE PURPpSE i
am azempi from Ma provisions of the State of California Business VALUATION
antl ProtassionsCoda, Divisipn 3, Chaptar 9. �
SIB�ature�-'�� J . �. Downs $ ,�.,�.'loo
Permltte ..I ��L�—
Au�horized Agent
VAWE
DATE% ��'
USE OF NEW f�
�/' BUILDING ATT�•
DATE
APPFOVED
/ � O
DER VALUATION IS FOR '
iING A PERMIT FEE ONLV: Q
T FEE $ $3.00 j
CHECK $ 41.50 E
124.50 LL
_ FEE $