HomeMy WebLinkAbout904 MACKENZIE PL - Building Permitsa
AUDflE550F BNLplq: +� � �
ONMEASN41EIFq�OWN: SATO, MARK T
� woxess: SATO, HARUMI
� ;:� ° 904 MAC KENZIE PL
`:,r.' - COSTA MESA,CA
ua�. M,uLra �ooaess:
Y .
n � ' ,
ARCXRECT OP ENdNEEIi:
�RCX.Ofl EN�.'S A�URE54:
����T�s� DZ PLUMHING
19755 LORENCITA DR
92626
0
FLOUti: X 47
uc. no:
UNT:
(818)331-,6700
CONiPACTOW9M411N0 COVINA CA � 391743
ADORESS: 9 1.� .2 4 IIC. NO.:
uNr:
�IC ED COHfFACTOPS DECL�flRTION; 1 henby ell'vm under px�ely d pa�jury Net I em IicaneaE wder povieion� d Chepter B
(opmme 'rp xilh,$efJqn $ �pl0rvisim 3 W ihe Bwjpep,pn¢ PM�uan C py 1' w b in 1 eM eHetl
CITYl1C.N0.: l)tlbb�.5� uacuss: l. .ib uC.NO, �� ��I ��p: U1 /97
OWXEH BUILDEN OECIAFATION: 1 M�eby elfirm uMa penNy d p+�Vr✓� � ue q mm tM Conveuae licenea law la iha
�lowing remon (Seuion J031.5 Bueroes ud Proleaeuna Cade: Apy�S{Y a count whitli Im a pertnn to eoiuwct, aMm, improve,
md"ah, u �epei eny atnicW�a, pria w ba's��e�vn, eho �'vas tM ePW'rani t« q to fJe a e'p�ed atetement thel he or ehe
liceneed Wnuent lo Ihe pavi«re d iM Comrmon Licenae law [Cheptar 9(ewnmmaip wilh Setlion )000) M OMuion a ol ihe
Busi�ress eM Prdeaioru Cadal a ihm ha a ehe b uemq th>ehan enE tM basu lar Ne allsped exemNbn. MY vialation cf Seaion
1031.5 by eny epplirent for e Po�mil eubpec the epplira�t io e ail pereM d M mare Ilan IHa �unErad dollera �550�]).
❑ taso�,wmecrownr«mr�dm*�..�nn�e..��na:.docanro�moo.wineomawo�.d,dm..w�n,�eA�a�ma�aea
or MereC br u1e (SaGion )oab. Bue'vrsa eM PMeaeionaCOEe: YM1e Coruredwe liwnae Law does'wt eOdYto en ownerol ProDeM
who Wdde w impewas �herem. eM Mn doea eu h wwk FimWl a heneL n Nrauph hc a har own employea�, prwidetl �t� euc�
imprwemmta va nd inla+tleE a dlxed fw eela. C. howarer. ths buik'up w'nnywemen� n sok wilhin me Year d mmplMion. �he
owne�-0uiNm will M1ew �M WNen d pw'I'q M a ahe Etl nd bWk a imW� fa IM WTaa d seb).
� I. u oxmr M iM prtpeM. am exd�ely mnvmip Muh 4canaed cmvactae Io camUwa Ne qojen (Saqun ]OM. &ni�e eM
Prdenaiom COEe: TM Contrmon Licema law does na epply lo en ox+wr d popeM ��iMe or improvn �harwn end x1w
mnirecie Iw wch prqee� xiM e mpnqw(a) licemsd W�suenl lo IM Cantrmaa lioenaa Lew).
� I em exemq �Mar Seciion: B, 8 P.C., lar ihia �sewn:
oe�a�. o�,:
I do heroEq unity thet I em ewero W eM urWntuM the repuirememe d Celdomu Hmlih eM Sebty Code Seaion� 25W5, 255�3, enG
255J0. arM tlw I n enY �un Wikinp ompw will / wil rwi (ticb aro) ���dY wY� uid aata oodn end IM rpuirsmenls br
e permillwwna�rvcibn a madi(mtbn han IM�i�TiiyR%nepemen� Diund. Pesidsmid oonniuqun eppimlione ers exempl lrom Ihwe
provi.ion.. ,
om.: �cdsw:
WORNER'8 COMPENSATION DECLAN�TION: I Mraby aMum uMer p�Y d per�ury pn d Ne IWbxirp Eaderetion�:
�. I heve entl vAp muntein e ceMiwe d mnaenl to �aX�inwro br xWk� compsn�elbn, m 0�%+dad la by 6auion 9]00 d �he Lebor
CoG.la IM perlwnenca d Ne wM1 la wldch ihu pamu u bWd.
� � nnv d,e wll mein�.:i.wrkeri oomperuetion ��wr.rc.,.. e.a�nea M sw:n aloo d N. l.mr eee., �« in. e.�ro.m.nw d �n.
work la xfich I�is pertn� b ivueE. MY wabn' ��;�����+ odkr ��mw, a.: EXP I R ES
', c°""• 04 /07196
Pdiry NumEer
(Thl� sxeion nwL rrw Es romY�sd / GwO�I 'w M wn h�ndrW LdM� ISIOJ/ a hn.)
� I cenly Ihet in e pxlormenro d IM wark for whkh thb prmA b �uwE. � W➢ na empW �V Dsnm In eny menn�r m m m
come �ubla io le w Mri compn�e�ion kw� d CWane. � Wros ih ouk bscom� aaad lo tM xrorkers'
e mpene b rorl o e Satllon 3100 0l tM leEar Cads, I NP�Ilunhxith wm y m� pmW�beu,
�
i �°'. "°d�: i
.Wem/n0: F�Nun ro��eun workri eompxwtlon rov�rp�l� unl�� L{ �n �M/ IKl an �mp/oyw ro etlMn,l P�n�Poo md
<Iv// 11rw� up ro on� hMdrM fhouunJ EWNr� (tl0qpp0A b1� n b fh� ' L I mp.ru�tbM1 Gm,p� u pnv/tlW br In
Swtlon 9]O6 0l tiv LWor Cod, Inbruq entl �ttomry'� Iw.
CONSTNUCTION LENDINO AOENCY: I henby dfi`m urder pen�IlY d par'ryry ihat Ihen le e wrmrudion ImCinp epenry lor Iha
peAwmeMe d IM xoek la whitli ihe prmY u uwsE (Seeion 309]. CM. C�.
LENDEX'S NI1ME:
� LENUER'9 �DDPESS:
I ee�ily ihet I heve reed Nia epplieetian eed am� �Mi Ne ebws infamn�� ia wnetl. I q�ms to eompy wilh ell rny enE oounry oNineneea
end atete lewa role�inp io WiWvp mnmutlion and hereW eWiarza �eqaesNetiam d IAis ary to emar upon the epove- eM' etl�ry
�0""'00"101P"'PO8°'. JONATHAN MOFFATT
�.y. Pn�u Narne �J
/� � �) l\ Dma: 7
1 Sqm'1 dOwror/Paen✓AmFanuCmiratlaf 1 /
(5151de WP) Whae-Buildvq d Saimy; GreerFle; Cenery-Avo��l Pink-fievenw; GOWenm�nsaesmr
CITY OF COSTA MESA - HUZLDING PERMIT
PERM NO: P 07700
PERMIT NO: P 077000 PLP.N CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPEc PLU PURPOSE: OTH
JOH DESCRIPTION : GAS VALVE ON OWNERS SIDE Of" METER SQ FT:
CLAIM VALUE: . CALC-VALUEs GROUP OCC: R-3 /U-1
COMMENTS: INSTALLATION OF GAS VALVE FOR EARTHQUAKE SAFETY
7E iF %1E iF 1Eif iF M if if iF 1EKriE ik iFif IF if if 1FiE iE iF iE IF iF iF 1f iE iE iFif if 1f IF if ik iE IF iF 1f 1FiF 1f 1E 1E 1f if� If iE iF 1F if iE i4 iE fk iE IE iEif iFif iklf� ik 1f if !f!f iF if 1flf iFfE �E
Z 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 AEAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE(J: PROV: PARCEL: 91805233 ZNE: REF NO:
PLANNING NOTES>
i
iE If if� iE if # if 1F if iF 1f 1EIE If� if If iF 1E'It iF 141E 1E 1E iE 1f 1E iE 1F if 1k if if 1f iEif iE �f iEiF1f if 1f 1E 1f iE if iFif if k iF iFif iF ik iE If # ih iF 1E iE if iE 1flf ih 1k1E 1f �E 1E IE 1f 1l�if 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 BY .
HUILDING APPROVED BY
APPLICATION ISSUED 8Y
DATE:
DATE:
LEGALIZATION:N F E E S U M M A R Y STAUCTQRAL SEGMENT:N
BLDG PMT PLUMHING £LECTRIC MECHANIC FIAE SMIP/RES GRADZNG
PERMIT 7.00
-.- 25$ SMIP/NON-RES
PLAN -
ISSUE FEE 20.00
BUILDING-DZV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 7,00 20.00 0.00 27.00 27.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 27;00 OVER/SHORT: .00�
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
2%.��
if 1f IE If iE �f If 1f 1F if IE 1f 1%iE 1ElE iE'!f dk 1F 1f iiif iE IE 1E'If ik i! 1E it �k iE4lE if it if aF k 1f 1E ikiE 1F 1f k if i@ if k i01F ik iE 1ElFiFiE i! ik 1l' 1E f! if if iF �E'If 1E'IE if iF 1f ib if If'14 if
I N D I V I D U A L F E E B 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
PLU 1 GAS SERVICE 7,00 7,00
END OF FEES �
O1 00203649-002036E4 T4� l" g7,up
DATE: 04/�2I95 7IP{E� I5:16
rl
�
�P0.IEETPODPESS: (jOS MAC3C�NZIE PL
OWNEF'SNPME: HYDE ROBERT A
wooeess: g04 {�IACKENZIE PL
" COSTA MESA,CA 92626
�AH�M/ENGINEEfl:
� ADDNESS:
NEG.NO.:
UNIT:
UNIT:
PEflMITTEE: WAI.T' S ROOFING ( 714 ) 847-1578
nooxess: p, O. BOX 1635
H,B. CA 92647
IICENSEU CONTBACTOB DELUBATION: I �¢reEy allirm �ha� I am Iicense0 untler pmrsions o� C�apier 9 �commencin0 ��h Seclion
lpp� ol Drvision 7 0l t�e Business arb Pwfessions CoOe, antl my license is in lull force anG eltttt.
ciTruc.:050575 sTaTeuc.:q00226 �_ 1����'�9,����
oate: / r? 7— .2 (N ,/W ��"'
a% �� SignaWre: _
ilOflRENS' COMPENS�7ION OEClABA7lON: I hereby affirm ihat I nave a ceniticate of consent lo se14in5ure or a CertitiWte of Wafkef5'
Compensaiion Insurance. o� a cenAieO cooY ��e�eol (Section 3800. lab. C)
roucvNo.:1042011-97. exr.oaTe: 07/01/93
coMrnxr: Si'ATE FUND
� CetliheC copy i5 her¢by furnishetl. Q cen�red coov �s iaeo witn )i/ne��{)ty /e/yry1m9 orvision.
Oate: � �' � �' / � Appiicant: �/✓ ���/ —" " �
EXEMPTIONfBOMWOPNEPS'COMPENSRTIONOELUfU710N: (Thissectionnee0not6eromplete0ifihecermitisfaronehun�ree�E100�orless�.
I certity ��al in Ihe pedormance o� 1he work �or which Ihis permi� is i55ue0, I shall not employ any person in any manner so as �0 6ecome
subletl �o �Ae WorkerY Compensa�ion Laws ol Calilomia.
Oate: Signaiure:
NOTICE: II, al�er making I�iS declara�ion, y0u ShoUTA beCOme SuUleCl b �he Workers' COmpenSation provisians of �he La6or
Code. you musi lotlhwilh comply wilh suc� provisians or IAis De�mi� shall be tleemed revokeA.
CONSTBOCTION LENDING FGENCY: I hereCy allirm Ihai �here is a constmclion lentling agency lor �he Detlormance ol Ihe work for
which �nis permit is issuea (Seclion 3097. Civ. CI.
LENOEP:
AODflESS:
� OWNEB BUILOEfl UECURRTION: I hereGy ailirm I�al I am exempi �mm the Conlrac�ors' State License Law lor [�e followin0 �eason
I �Section 7031.5 Business antl Pmlessional Code: Any city of caunty wnich requires a Oermit to constmct, alier, im0�ove, tlemolish, or
repair any Slmclure. Orior 10 I�5 issuance. also reQuires I�e ap0litani �Or SUth permif �o �ile a 5igned SSalemeni Ihat �e/She i5 Iicen5e0
pursuani �o ihe provisions ol the Contractors' S�a�e License Law �ChaD�er 9(commencing wit� Section 7000) ol Division 3 0l lhe Business
an0 Pmles9ons Code) or Ihat he/sne is eKempt iherelmm antl Ihe Oa9s tor ihe altegetl e[emption. My violalion al Section 7031.5 by
any aODliWni lor a Dermil subie[ls ihe appliWni lo a civil p¢nalty o� not more �han five hundred dollaR (5500).
I, as owner ol I�e DmDeny or my ¢mployees wilh waBes as t�eir sole compen5aiion, will Oa lhe work, anA IAe
❑ slmciure is nol imended ar oilere0 1or sale �Seclion 704d, Business anO Vmleuional Cotle: The Coniracbrs' State Licenu Law
Goes no� aODly ta an owner ol a pmDe�y wM CuilOs or impmves thereon. an0 who tloes such wark Aimsell/�ersell or thmugh
�is or �er own employees. D�ovidea Itwt suc� imprwements are noi intenAed or oflere0 for sale. II, however the EuilOing or
impmvemenl ¢ solA vn�nin one year ol wmpletion. Ihe owner will Adve ine Uurtlen of o��ng hGsile Ai0 noi buil0 or improv¢
far ihe purpo5e ol Saiel.
I, as awner ol tne pmpeny, am eecWsively comracting wilh licensetl conVactors m consimct lhe pmle�� (Section 704d, Business
❑ an0 PmleSsionS COOe: T�e Lonlrx�ors' Sta�e License Law Gces no� appty to an ovmer oi property who builUS onmprovec iM,reon
ana wM caniracls lor sucn pmiects witn a conVactorls) license pursuanl to ihe fAniraclors' State License Law�. I am aware
I�at prool al lheir Worker'S Campensation in5uran[¢ 5Mu10 Oe proviEeG Io me.
� 1 am exempi untle� Sec�ion: 8. 8 P. C.
for ��is reason:
oate: Ownec
I do �ere�y cenily Ihat 1 am aware ol antl unaerSlanA I�e reQuiremenls of Cali�omia Health antl Sa�ery Code Seciions 25505, 25533, ane
25534 anOlhai I or any IUWre buil0ing occupanl will/will no� (circle one) neeA �o comply with said 5ta�e codes antl Ihe requiremenis lor a
permil Im constmdion or moCilication Imm �he Aii Ouali�y ManaAemen� OiSUic�. Resitlen�ial constmction aODlication5 are exemp� �mm
IheSe pmvisi0n5.
Date: AOPIiCan�'.
I �ereby certily iha� I have reatl I�is ap0licalion and slale I�a� �he abave informa�ion is correcL I aAree to comply with all city and counry
ordinances anA siate laws rela�ing lo Duil�ing con9ruclion ana hereby au��orrze represent �rves oi this ciry to enter upon tM1e aGove�mentione0
proper�y loi inspetlion purpo5e5. (/',/
�alc'. ��`� �9a Signature: � % �
Driver's Lhense or 5aia� Security x: ._
I6abafi White-8uiltling: Green—CoOe Enbrcomem: Canary—Ap0licanl: Pink—Revenue: GoltlenraC—Fuessor
CITY OF COSTA MESA — HUILDTNG PERMIT PERM NO; B 0�9712
PERMIT NO: B 059712 PLAN CHECK NO; N GOV1'; N SUPY: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION : T/OFF RtSHT. REROOF 2200SQ FT W/COMP SQ rT: 4,000
CLAIM VALUE: 9,000.00 CALC—VALUE: 4,000.00 GROUP OCC: R-3 /
CON,MENTS; SMOKE DEiEC10R RE�UIRED
ihiEif%iEififiEi(%#-IfiE�7FiEiEit�lEjEiE�EiF-X�lEifiFiF #�1f-�%#iFifiEifilk�lE-%�)FM�ki(i(�l(-%iE-Y.��IENNM�MR9E�iE#iF�%iEk#Y.�IEIEK�YiF�%#Y.�E%lEdf#!(
Z O N I N G R E Q�1 I R E M E N T S
S E T B A C K S
----------- MAIN BUILDING ---------- --------- ACCESSOttY BUZLDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGAT: FT IN LEF1; FT IN RGHT: FT ZN
PARRING REQ• PROV; PARCEL; 41805233 2NE; REF NO;
PLANNING Ni51'ES>
i'
��#��***�#***+t*#x#�r*#��x*��**�#��*xx�u�x-�#x#���#x�*�x#*��#*�xu��*r����*���#�**#*
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 i�1 E iJ �T S
(
ZONING APPROVE`D BY DATE; '
BUILDING APPROV�D BY ; DATE; �
APPLICATZON I58UED BY• ' UATE: �' a'7 1�'�
ifi%M'!h'IF'Ih'1liFfl'#iFil")t#,ifiF#iEi%##iE X�e�l'R% x 'RR]! m1lH xxR ' ff T' 'IE9I'iFi('#iE'##ii'IE '� RlFYtlFf! xtt#M'
�t*****�*��r�+r*�**+�**+t�***#�*�t�*�##***#*#####�x x�r*��t*x*��r�x#*�#��t#x#****�*#��ru x x u
LEGALIZATION;N F E E /S U M M A R Y 5TRUCT'URAL SEGMfiNT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 63,00 • .50
SMIP/NON—RES
PLAN
ISSUE FEE
HUZLDING—DIV—> PERMIT ZSSUE PLFj(N—CHECR
TOTALS----> 63,50 0.00 i 0.00
TOTAI, '.. PAZD AUE
63.50 63.50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 63.50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRZC MECHANIC FIRE SMIP/TOT GRAPING PLAN—CHECK
63,00 .50
iE # 1E iF # 1E �1E 3E # iE i(� 1E iE ## iF iE iF �F ###�IF ## if i4 fE iF itif �F # iE ik if #!E%# iF # i4 ik iE if )f iF iE # IF'IF SF-%iF iE fk # 1E iE # ih iE # iF �E !( lE %fE # iE ## ff # It M if
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I t� T I O N UNIT COST TOTAL COST
SFR 4000 REROOF BY VALUE RESZDENTIAL NOZONE 1.00 4,000.00
END OF FEES
ii. '' �.' . . . - •-
! �
�. CQNST�UCTION AND PLANNING ' POOL .PA '
� APPROcALS Permit # Date Inspector APpROVALS Permit # Date Inspector
e .
1. �Temporary Electrical $ervice or Pole 52. Poof & Equipment Location .
2. Soil Pipe-Undrgrnd. 53. $teel Reinforcement
3. Electrica� Conduit UtilitY�Undrgrnd. 54. Forms •
4. ElectriGal Conduit�Undrgrnd. � 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Ptumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Foot�ngs 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test -
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
17. PropertY Sewer Line & House Connection -- 62. Backwash & Receptor-Final �
12. Sewer Cap ! 63. Heater & Vent•Final '
73. i;oof �rains 64. Plumbing System - Final
74. fiough Piumbin9 ' 65. Electricai�Final
15. Rough Electrical-Condult 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 Pipinc� OGas OOiI
23. Gas Pipe�Rough & Test 72. Underground Fiush
24. Roof Freming 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing �� (�'L,- 74. Overhead Hydro
-�:
26. T�Bar Geiling (Structural) & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe
28. Lathing & Siding �i i 77, FIXED SYSTEM FINAL
29. Insulation � � � 78. fIRE PREV. FINAL
30. Drywall Nailing � � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final � �-; 80. F000 CERTIFICATE ISSUED
33. Final Electric � � � Notes: �
34. Final Heating & Air Conditioning i`
35. Final Gas Pipe-Test ! �
36. Hood or Canopy � !; �
37. Final Factory Fireplace � ' �
38. Final Plumbing �
39. Water 5ervice�Final � � I
40. Gas Service-Final � i
i
47. Solar pomestirFinal I �
i
42. Backflow Preventer � �
43. Backflow Ircigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �y n-��•
v r�
48. FINAL PLANNING �� �
�
� 49. Electria Release to Edison ,
�.` .
50. Gas Release to Southern California Gas Co ', I
51. CERTIFICATE OF OCCUPANCY ^�?
No. Date ,
M1
Novembez 12, 1992
To: Costa Mesa Suilding Inspectoz
Subject: Smoke Detectors,
Acting On The Advise Of "Walt", There Is Now In Evexy
Bedroom (9), In The Hall, And In The Dining Room An
Active Working Smoke Detector. All Of Which Are Subiect
To Your Review At Any Convenient Time If You So Wish.
Please Let Us Know, My Work Phone Is (719)-757-8375, And
oux Home Phone is (719)-540-9537, Have A Nice Day.
Re� '/
�
Robert A. Hyd
(Owner)
t
SSOFBUILqNG: 9O4 MACKENZIE PL unr:
,Meivaaxm: SATO, MARK T FLOOD: X 47
monEss: SATO, HARUMI
904 MAC KENZIE PL
COSTA MESA,CA 92626
1VPL. WIIIINi �NOPESS:
uaxrtecroriexcu+vn:
�RCN.OH ENG.'S AUDXE55:
CONIFACTqfS NAYE: D Z PLUMB I NG
carmncroaswuur+o 19755 LORENCITA DR
�uopEu: COVINA CA
91724
LIC SED COHfPACTOXS DECLAHPTION: I hereby Nim uMer penely d perjury Ihet I
( m cirp xilh Section ]400)d Divieon � ofihe Bueimm and PMeaeions Coda.eM m
m u. No.: 0 6 6 6�I 3� uc. cuss: C 3 6 uc. r{Q; 3 91 '7Y
uc. rro:
UNT:
(818)331-6700
uc.w.: 391743
UNT:
liromed uMm parisiona ol Chepler 9
inx is in lull brte uM e/1M.
d^y EXP: 01/97
NER BU:LDER'JEC�AFATION: I MnW, nlfirm under panel d perN M1ei l eice Imm �M Conlredwa liceme law iw IM
ollowina ��� (�ion ]P91.5 Buaima. eM Pmlemione COEe: ny c mum whi h ire. e parmn m mnetmn, aXer, improva,
bmWeA. w rapeir eny eleueNre. yia b Na seuerca, ebo requiroe 1 epplieenl tp A to (�b a eqirod elelemanl ihm M a sM
i IimnseE pureueni to iM po-nsiom d �Ire Contredon lironse lew �Cheqer 9(cpnmemip xilh SeGbn 1000) o! D'veian 3 d Ihe
duainen end PrWe»om Code� or Ihel M or ehe ie axampt Iherahom enE Iha beeie fa iha ellepeE exemptbn. Airy voleton o/5eaun
]W 1.5 by any epplirani la e permit subjw�e tM epplireni �o e ail penelry ef eM more ihen 1've hundred dollere �5500]).
� I, av o�mer diM prope�ly a my empbyeea wfh wepea av iMi ede mmpenaetion, xill do ihe xwk, and �M eleudure w� iMentleE
a oHerad br xle (Section ]OG6. Busiriess enE Profeveiona CaEe: The Conirecton Lironae Lew Eoes not eppyto en ownx M properry
wM Wide a mqores Ihe�eon, end xfio doae such waM NmeeM or Mnell a Nraph he a Mr oxn emplv/em, povideE �l�et eucM1
impro+emema ere mi intanEeE a dlered ta eab. X, howaver, �M buiMi�p a inqwement u edd xithin me yeer d campbtion, �M
ownarbuider xill heve �he buNen W provinp M or ehe d'M nM builE a improve br tM W�e of eele).
❑ 1. m oxirr W iM popeity. em eaduaivaly mntreu'vq wnh lioensed eonveeipa b mnatn�q tM peqeq (Seqion ]ON. &uiiwes eM
Prolmaiane Code: The ConlreGon Licmaa lew doee rat epply to en own« d propMy who builde a impovea �herson aM wlw
conlrecb la wcM1 D�I�e Wilh e mnlredoHa) licensetl pureuent to Iha ConVecMe licenae Lew).
� I em exemq uMer Section: B. 8 P.0., ta Ne reexn:
Dele: Owner.
I do hereEy cerliry tlal I em ewere d eM uidaniend ihe requiremenb M Gddamu Meellh end Sdery Gode Sed'wna 25505.255J3, eM
25530, end ihet I a eny iNure buildi�p oaupenl will / will nm (umb one) neeE lo comDN w�h eeiE elela mEee eM IM reQuiremenb lor
eparmiltamnevunbnwmoERWionhwn�heRi u�Tyl.�enepemenl0imiia.ResideniieloonmeuifionepplreiiamarsuemqlmmNw
prwisione.
ova: Aavi��:
WOHKEN'4 COMPEN9RTION UECL/�RATION: I Mroby alFrm unAer penelly W pe�ury me d tha lolloMirp Eatleruiona:
� I hew arW xil meinten e cenifcma d mneent 10 eeMinwro fu waken' cwnpenealion. ec wovided t« by Swion 3100 d tha labar
Coda.la iM p�lwmanca d iM xak tor wlich I�ie permu n iaueE.
.� I heve enE wil mainlem workers mmpanaelion inaurence, u rpuired by Sadbn 3]00 0l �he Lebor Code. M iM paAormence d iM
,WqIl�IXW111CI1MMGe��M1IOVlE.MYWpMB9�i�,�����°a�`�°°�`r°°'"n«ae: EXPIRES
c�«:
Pa�, N�mn�,: 0 4/ 0 7/ 9 6
�This axfian nsed nd be comdefeJ ] �he permt is Iw one �uM�eE dollan (SI00) w les� J
� I canAy �hm in a peitormenca W tM woA br whbh ihia pertnil ie iaueE. I el�ell na empby any peiwn in y menmr ro v �o
r,are wbje lo e warkns' campenwion ler.e oi Celifana, eM pree N �wld baroma wbjea io iM hdkere'
c mpem �b mvi one Seaion 3]00 WIM1e LeborCada,lehell�Jynhwilh m� ee piwniau.
eb: � ACW'rant
minp: FeNun ro�scuro wo6sa'rompxwtlon covx l� unln hrl, e • I s Hct en xnp/oyn ro ctlMnl pxu/Hu en0
nvn nn.. up ro on. nunaroe erwuund ewi.n !sf o0.oaoA n ro M a I mpmufbn, tl�rrrq� u proNdM br In
' Sectlon 3]06 0l Me Le6or COJ�, Infsnaf, and �ttomsy i/su.
CONSTRUCTION LENDINO AOENCY: I Mnby elfiim uMer panely W parjury Ihel �hera ie e mnstiudion IeMinB epeMy for �he
panoimenoe a ine woA �« wniw �nu w�� �� ea�,ee (s«aon 3091, cw. cl.
LENDEfl'S NAME:
LENDEP'S RODHE53:
I ceniy ihet I heve reed thie epdK�� �d steb Ihel �he ebova in/ormetion ia cortea. I eprea �o wmpN �h ell ary eM munly oNirencea
enE eWe lewe nleling lo buildinp conelrupion vd hereby e�nhorixe repreaemetivae ot Ihu ply ta enter upon ihe ebove emion�rry
�°"n9p0tl10"°"r0°°°' JONATHAN MOFFATT
r v�oi rv�e
/r � /� �� o�e:
��p r d Ownerl Jn q pYun ymepy
/ / /
(St51�C6.WP) WhGe-Build'fp d Selety: GreerFle; Cenery-AppYreni: Pink-Revenue; Oddenrotl-Fneeew
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: P 07700
PERMIT NO: P 077000 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTROCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE; OTH
JOB DESCRIPTION : GAS C'ALVE ON OWNERS SIDE OF METER SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /U-1
COMMENTS: INSTALLATION OF GAS VALVE FOR EARTHQOAKE SAFETY
*�*�*�*��*���*��*�***���***+�*���+�*��**�***�****+�***�*��*�*�*+�����**+�*�*�***��**
Z 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
PP.RKI^!G REQ• PROV: PARCEL: 41805233 ZNE: REF NO:
PLANNING NOTES>
i
iE 3E iF iElE if !E if if 1f 1f if if iE 1E 1E if iE ik iE 1E !E iE iE 3E 3f 3F jf 3f iE iE if iE iE iE iElE �E iE �E iE 1E fE �E iE iE iE if 1E jf 1F jE �E fElE iE �E 9E 1f iE 1E fE �E 3E iE iE IE if iE iF if ik iE fE �E iE if �f 1E
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 BY DATE:
BUILDING APPROVED BY : DATE; / / /
APPLICATION ISSUED BY: �'�— DATE: �/ / Z� � d
ititititiEiEi�-itiEifititiEititiEiEiFiEitrtiE�F�F�F3F3FiF'3F�F'iFiF3F�F'iFiF 3F�'iF3F�iE3FTF�FiF3F#�FiF"3FiF3FiEirifitifiEitit�**iF�h�b �F#'�F**
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMZT 7.00
25R SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 20.00 0.00 27.00 27.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
27,00
iE 1E iE 1E 1F jF IE �f iE 1E 1f !E 1E jE iE iF 1E 1E iE fE 1E 3E tElflf 3ElE iE jE 1E IF jE �f iF iE iE 1E i6 i6 iF 16 fF fE aE iE fElE �E �E iE iE 1E ff iE fE �f iE iElE 1f iE iE 3E 1F 3E 1E 3f 1E 1f iE iE 1E �E fE fE iE if if iE
I N D I V I D U A L F E E H R E A K D 0 W N
TYPE QTY D E S C R I P T I O N
PLU 1 GAS SERVICE
END OF FEES
EXPIRED
nn� t��l �' �l/I�
UNIT COST TOTAL COST
%,00 %,��
u'_ �C:�:: ,a UC��n�.,; •- _ ,
OkTF+ n;,i�,�l�,-' �I-;_. i���:
I
�CONSTRUCTION AND PLANNING
APPROVALS Permit # �
1. Temporary Eleciricai Service or Pole
2. Soil Pipe-Undrgrnd.
3. Electrical Conduit Utility-Undrgmd.
4. Electrical Conduit�Undrymd.
5. Steel Reir�forcement
6. Electricai UFER Gmd. � ���
7. Footings �',
8. Foundation '�,
9. Water Pipe�Undrgrnd. '��,
_,
70. Structurati F1oor System ' � . �
11. ProperxY Sewer Line & Nouse Connection
12. Sewer Cap . .• j
13. Roof Dra�ns -
74. Rough Piumbing
15. Rough Elec[rical-Conduit
76. ftough Electric Wiring
17. Rough Wi�ing Sign �
18. Rough Electrical�T Bar Ceilin9
19. Rough H�ating & Air Cor.ditioning
20. Rough Factory Fireplace
21. Duc[s, in Structure �
22. Ducts, Ventilati�g �
23. Gas P1pe�Rough & Tesc
24. Roof Framing� � -
25. Roof Sheathing
26. T-Bar Ceiling (Structurall & Monocoat
27. Frameand Plashing,
28. Lathing Ec Siding �
29. Insulation
30. Drywall Nailing
37. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Pinal Eleciric
. ... _._.___
34. Fina! Heating & Air Conditioning .
35. Finai Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing -
39. Water Service-Final
40. Gas Service•Finai
41. Solar pomestio-Final
42. Backflow Preventer .
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Aitenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINALPIANNING
49. Elec2ric Release to Edison
50. Gas ftelease to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
l�
Oate
POO. SPA i
I�spector APPROVALS Permit#
52. Pooi & Equipment Location "
53. Steei Reinforcement '
54. Forms
55. Electricai Bondiny
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, L� Undrgrnd., Test
60. Backwash �ines, P-Trap, t7� Und�,�nd.
61. APPROVALTODECK � �
r
62. Backwash & Receptor-Fin�t ��- '
63. Heater & Vent-Finai "
64. Plumbing System - Finai '
65. Electrica!-Final
66. $olar SYstem-Final
67. Fencin� & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPi. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. ProductPipingOGat CiOii
72. Underqround Ftush
73. Under9rnd. Stora�e Tank O Gas G Oil
' 74. Overhead Hydro
- 75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAI
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
a
Date Inspector
t
�
� 2����
COSTA MESA BUILDING-SAFETY DEPARTMEM
P.O. BOX 1P00 COSTA ME8A, CALIFORNIA 92626
For Appllcanf fo F(11 In Completely
TYPE OR PRINT
oe�s"c° O�b[7C 904 Pdackenzie Place
, COSTA MESA. CpLIFORNIA
NEa t1. S. Financial
I M MAIL
�I 8RlACK LIN[ 1110M
[�l BUILDINO
T8L
NO.
TEL
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FEB 17-67PnF��O 728 99.00
cnsa �` '�":'}'�
APPLICATION FOR PERMR
BUILDINCi .
For Offlce Ute On1y
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ZONIN(i
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AP.NO.
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No.oI�LOat. O ALLOW[D <U.B.C.RHQUIREM6NT7
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MAIN BUILDINO ACCECSORY BUILGIN6
irr 5' I Ria�rr 5'
DESCRIPTION Of WORK
e 6 rroaiu 1
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SQP[RFORM[D
1 N8P6lY AC![MOWL6DOC TNAT 1 NAVi RlAD TIII� MPLIGTION
•ND 6TAT8 TNAT TX8 AlOV[ I� COppaR'ANO wOpe[ TO COY•
PLY W�TM ALL CITY OPOINAI/L[/ µp RAT[ LAWY N[OYIATIMO
B W LD1N0 CONDTqYRION.
BIGNATURE Or
PERMI7TB
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�l1PPOG[ OP tYiAlL19MIN0 A PHRMIT IeH ONLY.
VALUATION � / — �
PERMIT FHB �
. o?� �Sj'- .��].� — w
TOTAL FE! S ` � ��
2w-.?..2 P
. COSTA MESA BUILDINCrSAFE7Y DEPARTMENT
P.O. BOX 1200 GOSTA M�4A� CALIFORNIA 92E20
For App1lmM fo Ftll In ComplNely
� TYPE OR PRINT
sui�o�No C�('y w ' f
AODFHYB
COSTA MESA, CALIFORNIA
MAIL
ADDR[! ry9 Cl
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Crr�a �'%lesa- o`'
r NO� 8R %'G � t C�4II/NA� NO. L.�%J.
ADOREIIY �J l=� �+�'T�� �r •
CONTM R O e O Ni •
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C1TY �/ CGr �
LIC.TNO. � Ng` me y.�z i,
61ZB No, o� eLDo�.
OP LOT NOW ON LOT
EXI� NO BLDO. f�LUGII
BeTB�CK LIN6 PROp
cerRaR oP ain[si R[AR YM
D!D 7AR LlRT RIOXT
DESCRIPTION OF WORK
ALTHRATIO ACDITION
REPAIR MOVINO DCMOLI M
8B =1LDIN0 J�'y ��I�y /� p0 M8 YTORItB
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BXTERIOR WALL ROOr
COVHRINO COVQRIHO
U➢Q OF EUILDINO AND WORK M Bt P[R�ORM W
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1 N6R[pY ACKNOWL{DO� 1NAT.1
•ND BT�T6 TryAT TX[ AOOVi IB
PLY WITX ALL CITY ORDINANCO
OUILo1N0 CONlTpYCT10Ni]/�_
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P8RM1TT8�
AUTHORIZ[O AO[NT
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A►PLICATION•FOR PERMR
BUILDINO
For Offfu Ur� Onfy
n�ccirtno. r
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ZONIN(i
Ho.or us[orxaw
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YARDB MPROVlD
MAIN BUILDINO
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RBAR.s� ` PT.
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MAIN BLD6H.
VAR. �C
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BET. MAIN
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DAT6
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T1[ ANOUM �HOWN YN06fl VALUATON 19 /OP ill[ �
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