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Home My WebLink About2021 IRVINE AVE - Building Permits OWNER PARRY, Dr. & Mrs. L. J. DATE 4-10-63 JOB ADDRESS 2021 Irvine Ave. BUILDING PERMIT NO. 19212 GENERAL CONTRACTOR Robert Forbes VALUE $ 18,650.00 AP No. 118-302-05 LOT TRACT FIRE ZONE DESCRIPTION OF WORKRes.Wi8tt 'r. INSPECTIONS Signature DATE GROUP I&J TYPE V ZONE R-1 tl Soil 4/-1.2-43 S PERMITS ISSUED q Gas 4�—Ced SUBCONTRACTOR DATE NUMBER 4 Water t-1q .'//f-�S y'' ,7-'61 < Rough Com. Refrig. 0 Air Cond. Q Rough Heating .1 M , /(� s /p_6 /1 / V Rough Plumbing `%i_ 'it __ " - e--_I . eo- 7-/8-d o ' %/7/ Miscellaneous ,�.0 _ / Prop.Swr.Line House Con. U St.Swr. /V S- '/-2,g-(0,3 __ � -��4_Z y _.153.4,0 --"�I3Il Sprinkling System _ Construction ole rio !/-1C-L3 d Underground 0 Power 0J� 0-fl-13 r97a,3 ---`., _Rough Wiring ,g4 o"72[a1W�. AZ-2?G Trenches 0 Forms 0 Steel Rei ��J �p -�'~---/ -�d Floor System %t • 'C� -r1-1-/(�,3 Bond Beam 0 Steel Reinforce ❑ _ Sheathing Jj,}�'JQ Co Frame and Flashing _ -�/( X73 Lathing — In R' Out 2' Wiled/Cd G- 4&3 Plaster, brown coat 7Yfff 7-/Q-6, Refrig. 0 Air Cond. 0 Final Heating, Final /14'1-5 70-2-63 - Final Plumbing Fixtures, Final /rh J�2(J Final Gas Test/r / c/� /� Electric Fixtures, Final fr /'26 '40� Building, Final _/✓fi-S 0-9. 03 - OCCUPANCY FIRM RHA.SM - r.Fl 1 001 0 OWNER HENDERSON, Vetne 0. "It 9-29-76 JOB ADDRESS 2021 Irvine Avenue BUILDING PERMIT NO. 42786 GENERAL CONTRACTOR Owner/Bldr. DESCRIPTION of WORK Retaining Wall AP No. 118-302-41 LOT TRACT FIRE ZONE VALUES 1.150.00 "'tPECTIOHS Signature Date TYPE V GROUP 'J ZONE R-1 SUBCONTRACTOR PEpAIITS ISSUrED p tJAS Data I Number f Signature WATER Plumbing ROUGH PLUMBING PROP: SWR. LINE LI HOUSE CON. ❑ SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING' EMPORARY SERVICE OR POLE • UNDERGROUND ❑ POWER Q ROUGH WIRING Heatin• and Vent. TRENCHES ` FORMS STEEL REINF. l• pre,„%wACL'0 FLOOR SYSTEM BOND BEAM n STEEL REINFORCE fl SHEATHING FRAME AND FLASHING LATHING - IN 1^ OUT fl PLASTER. BROWN COAT STRUCTURAL. FINAL Iertric H 'NG. VENT., REFRIG. AND A.C., FINAL 1 BING. FINAL AND GAS TEST n • ELECTRIC, FINAL BUILDING, FINAL Aft tte0 'l • 7-ip • `ate t = C1Tl)OF COSTA MESA BUILDING DIVISION 9 -,•v. DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER Vs PERMIT , 602-01633 twPoncesoe (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa..Ca.uSBUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2021 IRVINE AV Status: ISSUED Suite: Applied: 10/07/2002 Vicinity: Issued: 10/07/2002 Parcel Number: 42625232 Zoning: Applicant: DOFF,RICHARD ISSUED BY: Gat- Address: 1132 W BARKLEY AVE Phone: (714)744-5996 • ORANGE,CA Zip: 92868-1213 , Owner: HARLEY, BETTY L TR Address 2021 IRVINE AVE Phone: COSTA MESA,CA Zip: 92627-2172 Contractor. SOUTH COAST ROOFING INC Address: 1132 W BARKLEY AVE Phone: (714)744-5996 ORANGE;CA Zip: 92868-1213. License: 365271 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: • SCOPE OF PERMIT TEAR OFF INSTALL 1/2.OSB,2-15L6 FELT AND 30 YR COMP.CLASS A. FEE SUMMARY , Plan Check: $0.00 Cato Valuation: $7,860.00 Permit: $153.25 Claim Valuation: $7,860.00 SMIP Res: $0.79 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $154.04 PLANNING &ZONING SETBACKS • MAIN STRUCTURE Front -0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 t Right 0-0 PARKING Existing: 0 -_ Required: 0 - Proposed: 0 NOTES: • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/0) DicCLARAT/ONS • ' WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ,V ❑ I have and will maintain a certificate of consent to sell-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. fiI have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Cod ance of the work for which this permit is Issued. • eworkers'compens(etlon Insur ce carder end�poE\c �rmpa y nuoare: eller. J7 4_r t \ in ay L-W L— W t—V tJ 0 Policy Num r:?:)Sb �7his section need not be completed if the permit is valued at one hundred dollars($100)or less.) candy that in the performance of he work for which this permit is issued,I shall not employ any person in,any manner so as to become subject to the workers' court:•-:tion laws of California, . d agree that if I should become subject to the workers'compensation ovisions of Section 3700 of the Labor Code,I shall forthwith P • - ' �1�`C�`70' :••plicant Slgn��eW :. \ Date. - INOrFAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 15 UNLAWFUL AND SHALL SUBJECT AN PLOVER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOIURE(S100.000),IN ADDMON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SE 706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I here irt.1 that I a ' ns nder provisions of Chapter 9(commencing with Section 7000)of Divisio of-the Business anq.professions Code,and my license is in full /f ce a Med. N x �,Lk. CI 13 l t9nat te -)n I - ( na, CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting 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 five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,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 pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers license No. Expires: Verification of Ownership by(ype of document,Le.•property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feel in depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration-formfofor acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Cale,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)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required,hes Section 25534 of the California Health end Safety—Code been fully complied with?-0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application apereit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? 0 Yes ❑No (It 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? 0 Yes 0 No _._.ye_.____....__.___ _____ ___..._.....____.._......_..._._ 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 penalty of perjury that I have read this application and state that the Information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. gnat ..' :g.gOwner(s) Date QI lea And/Or Au •• .. •.•Ilcant noes/ INSPECTIONTYPE gAIE MELS con E INSPECTION TYPE v PEE =ALA 1818 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof (Q7 brl'O Z— 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site • 204 Final Demolition 250 Final Building/Occupancy •' bSTp'kV CITY OF COSTA MESA • t M9 BUILDING DIVISION ` • • r,� , DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 1.1 ...._�... 1 PERMIT 800-01614 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.n�DING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2021 -IRVINE AV Status: ISSUED Suite: Applied: 10/06/2000 Vicinity: Issued: 10/06/2000 Parcel Number: 42625232 Zoning: — • I• . r Applicant: - CAtON, JIM ISSUED BY: a ./ Address: 714-638-2315 - Phone:• UUU Zip: Owner HARLEY, BETTY L , Address 2021 IRVINE AVE Phone: COSTA MESA:CA Zip: 92627 Contractor: JIM CATON MASONRY Address: PO BOX 1288 Phone: 714 638-2315 GARDEN GROVE CA Zip: 92642-2315 License: 305339 Arch : - - Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 5 LINEAL FEET OF BLOCK WALL 6 FEET HIGH FEE SUMMARY Plan Check: $15.28 Calc Valuation: $500.00 Permit: $23.50 . Claim Valuation: $500.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other $0.00 Inspection: $0.00 • Total: $39.28 • PLANNING &ZONING ' SETBACKS MAIN STRUCTURE Front 0-0 _ Rear 0-0 Left 0-0 Right ,p-o - ACCESSORY Front 0-0- Rear 0-0 Left 0-0 Right 0-0 " PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446<e(6.00) 1 DECLARATIONS 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. ❑ I have and will maintain workers'compensation insu,I.:,as required by section 3700 of the Labor Code,for the performance of the work for this permit is issued. My workers'compensation Insurance a and•• nu-#414:r are: Cartier: Policy Number: 0)41 (This section need not be completed if the permit is va/u at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for whl a this permit is issued,I shell not employ any person in any manner so as to become s led to the workers' compensation laws of C mia,and agree t at if I o Id become subject to the workers'compensation provisions of Section 700 of theheLaborL/ Code,I shall forthwith comply signat these p b l Dt V\T AppllcenLSigneture: // ��i � Date: WARNING:FAILURE TO�BECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE TIES 0 CML FINES UP TO ONE HUNDRED THOUSAND DOL.LARE($100,000),IN ADDITON 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 provi ii J*tof .:•er 9( • mendng with Section 7000)of Division 3 of the Business and Professions Code,and my license Is in full force and effect.IJc.e U �r 4.i Class A ."Cbhtrectors Signature.�ii�i�i��i�I� i Date: CONSTRUCTION LEtfDING 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 dvil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code;The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,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 pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,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,Grp 2,An 2,Sec. 341,Title 8,California Administrative Code). ' ❑ -As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safely,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 Wit 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 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas al standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safely Cale been fully complied with? ❑Yes ❑No ___ _ _ __«such't or ititureititurbuildingsubject or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ 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 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes-,the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safely Code Section 42303 been made? ❑Yes 0 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 penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until finnnl aaeeyinspection.n`l adocapipir Of L,4.11111lier, er(s)' n•Or Au '!Irzel •plica Date CODE I, LISPEC110NTTPE PATE iiillil15 CODE( INSPECTIONTTPE PATE. MALI 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1286 Pool Spa Final 200 Final Plumbing . 200 Final Re-Roof /_�vl 210 Final Electrical 201 Final Block/Retaining Wall '0-ons✓ 6cc 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy • ADC SOF BUILDING: 2021 IRVINE AV ' MT( CITY OF COSTA MESA — BUILDING PERMIT °w"ERsf"LEIEKNOWN: BETH HURLEY PERM NO: P 073531 ADDRESS: 2021 IRVINE 2021 IRVINE PERMIT NO: P 073531 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 90272 APPL.MAILING ADDRESS CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH ARCHITECT ORENralEER: LTC NO: JOB DESCRIPTION : INSTALL NEW GAS LINE SQ FT: ARCH OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / C0H1numr"wa LAGUNA NIGUEL PLUMBING ( 714 ) 495-6803 CONTRACTOR'S MAILING 25131 ADELANTO COMMENTS: X ADDRESS: L.N. CA ucNo.: 565218 +E**AEif******* EAE*RE***AEREAr***x*dEAP*AEAE*x**+E*x+E+r**x************RE**+ESE***********+E****** 92677 wit ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)d()Maim 3 d the Business end Professions Code,end my license is in full force and effect. CITY UC.NO.: LUC.CLASS: C-36 uc o.; 65218 EXP: MAIN BUILDING ACCESSORY BUILDING r / /4� Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ° OLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN O NER O LDER DECLARATION:I hereby affirm under pen°ly of perjury than lent exempt from the Contractors license Law for the foflowkg reason(Section 7031.5&n:»»and Professions Code:Any sty a county which requires a permit to coastmm.alter.improve. PARKING REQ: PROV: PARCEL: 42625232 Z NE: REF NO: demash.or repair any smrcKK lun,D- to is issuance,also requires the applicant for such permit to fib a signed statement that he a she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES> einem and Professions Code)of that he or she is exempt therefrom and the basis for the alleged exempion.My violation of Section > 1 , !--Ng 31.5 Many applicant for epermit subpdetM applicant macivil penalty dnot more than fire hundred doter I5500R. ******************************************************************************* a I,as owner of the property or MY employees with wages as their sole compensation,will do the work.end the structure a not intended or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply loan(new of property - DEVELOPMENT SERVICES , REQUIREMENTS who builds a improves thereon,and who does suds work himself or herself or through his or her own employees.provided that ace improvements are nit intended or offered for sale.If.however,the building or improvement is sold within one year of completion.the ower.builder wit have thebudenofprovingheorshedidrobuldorimproveforthemimosadme). ZONING APPROVED BY '----, DATE: ❑ I.as owner of the properly.Ion°aWtiwly contracting with licensed contractors to construct the project(Section 7044.Business and /. '1 y l Profession,code:The Contractors Lbense law does not apply to an owns of prepay who mads a improves Diatom and who BUILDING APPROVED BY : . /! DATE: contracts ler such projects with a c nurador(s)licensed pursuant to the Contractors License Law). ❑ lamexempt under Section: B.AP.C..Ice this mason: APPLICATION ISSUED BY: DATE: Dale: Owner: *****************************************C * ******************** * ***Cf* I do hereby certify that lam aware of and understand the requirements of Cali/enlist ist Health and Safety CodeSections 25505,25533,and LEGALIZATION:N F E E SUMMARY _ STRUCTURAL SEGMENT: N 25534,and that I Of any future building occupant will/will not(circle one)need to comply with said state odes and the requirements for a permit for construction IX modification from the Air Quality Management District.Residential construction applications aro exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provision& PERMIT 5 . 0 0 D ate: Applicant 2 5 2 SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:Ihereby affinnunder penalty driw' palmy of the following declarations: PLAN CII have end W m°irasin a certificate of consent to setfinure for wan' compensation,keprovided for Section 3700 the Labor ISSUE FEE 20 ,00 `7 Code,for the pedolmanceeltework for wNchthirmna permit is as by dBUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE [(,J 'h.,end will mainlan workers'compensation instrancees required by Section 3703 of the Labor Code,Ice the performance al the TOTALS----> 5 .00 20 . 00 v 0 .00 25 . 00 25 . 00 . 00 work for whim this permit is issued.My workers'compensation insurance carrier end policy number are: Carrier: REVENUE DIVISION TOTALS--> COLLECTED : -- 25 .00 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK .is ionneednotbecompletedIthe pemkitor one hundred dollars($100) ors.) 25. 00 I panty that In the performance of the work for which this peninnot on is Issued.I shall employ any person in any manner so n to become subject to the wakens'compensation mora d Califon*. and moa that B I should become s,gect to the workers' *******************.************************************************************ mpeneat Prow d Sectlom 3700 d the labs Cab.I h py with plan• . at „/�/�JC' Appian: ..... INDIVIDUAL-- FEE BREAKDOWN Warning:Fel Nreto secure workers'compenatIon coverage is unlawful,and shah autfsct an employer to criminal penalties and TYPE QTY D E S C R I P T I OT N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars($10mWo),In eddltiun to the coat of conp°nsafbrt damage,all provided for in Section 3706 of the Labor Code,Interest,and attorneys fees. • CONSTRUCTION LENDING AGENCY:I hereby affirmunder warty pithere Is perjury that e construction lending agency to the PLU 1 GAS PIPING SYS OF 14 1 TO 4 OUTLETS 5 , 00 5 . 00 performance of the work for whim this permit is issued(Section 3097,CN.C), END OF FEES LENDER'S NAME: LENDER'S ADDRESS: ... I certify that I have reed this application and data that theand above information is cored.I agree to comply with all city county ordinances / 1 end stats laws relating to buildingconstruction and d hereby authorize representatives this city to enter upon the abnw'mentiaed properly i 1 for inspection purposes. I 1 PAUL WESSELMAN 6 " ��"" � lentName /�+ e ull.�/f/�1 �� rte— Date: f/ //j'Sr— - 01 00137360-00137360 TOT 25.00 5ignn, downedAgentiAppicenucontrada DATE; 03/01/95 TIME: 09.23 (515146 WP) White-Building&Safety;Green-File Canary-Applicant Pink-Revenue:Goldenrod-Assessor • CONSTRUCTION AND PLANNNQf`.,1. POOL 1 P - *; APPROVALS Permit# 1/4-/ Date Inspector APPROVALS Permit# ' Date inspector 1. Temporary Electrical Service orrPote 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 2 53. Steel Reinforcement :‘ ?F• ctrical Condu UtiiHty•Undrgrryd. 54, Forms , `'E11;Frc{rical ConduEldrgrnd. 55. Electrical Bonding - y y s,3teY: q Reinforcement 56. Rough Plumbing& Pressure Test '• y.�e trical UFE d. 57, APPROVAL TO COVER-GUNITE t `3r '7•tJ L14. r 1 7. Partings tr1S i 58. Electrical Conduit-Undrgrnd. 14 8. Foundation.- _- a0 as ro 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undriind. V Oks 60. Backwash Lines,P-Trap,10 Undrgrnd. 10. Structural Floor$ystem tu " 61. APPROVAL TO DECK 11. Pro3erty Sewer Eine18t HouseZo2ection 62. Backwash & Receptor-Final i 12. Sewer Cap �+ -- . _� m 63. Heater& Vent-Final 13. Roof Drains v /" 64. Plumbing System - Final 14. Rough Plumbin c n x i 65. Electrical-Final 15. Rough Electrics6Cotuit er r 66. Solar System-Final • 16. Rough Electricjringl / 67. Fencing & Access Approval • • r 17. Rough Wiring Sin 68. APPROVED FOR PLASTERING 18, Rough Electricad- Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough He tin & ,r Conditionin F PT.8EOUIRFMENrT, • m � 1� n 1 rr�-i to. tt .� m . M ir• PLR - 20. Out F.,,or Fir �.t.ce sty . � a•PPi�V •�HL"Pe'rjnit# • 21. Bi7cts+in 6tructurrirt%r •• •• H IF S O ri* 70. 'Inder 4t9 Hitiro F y M S%r S IF (J t•A (lIF .. 22. 9uct ,V it n E"* t4 Ii‘ J d * ' M C : .i 9Nm * d •Q fJ Ht; 71. Produce ling .r./ Gas @Oil 23. Gas Pipe-Roue& Test tri IF P7 17' O>" 72. Undergr�rtd Flt7sh' ': '" n M XJ.r L[r'1b 6,• 0.,%1C S* O „+ Y: Y 24. F''oof-TFraipm9" W I H{-1 •• * 7 • tr. * ' tri > :-1.:, * > cc i-i* •737Undergrnd.Stoitiuy9;TanktOGas OOil 25. Root-Sheathing ' " v v* t7 > N* 74?Overhead Hydra 26. LBa'r;ceiljgg tStructiral) & hr�i:Oa-bat * 0 lil j1 OIF 7 Dry Chemical c-•= < - - a. S m C • ? . t :. t 27. tame and+Flashing * ptetg it T >1 COIF 76. Dry Stat e ' 7.n- x r-a 5 t H M r-1 t*' Ar 11* P -4,.-. . -r t' 'i: 428. Lathing& iding IF rn 'iey x a IF Z ' .. .. 7 FIXED t+52 (13 g, O * r^•d ea"oT6IT41.NAts -. -, c 7. •s v 71 a 29. Insulation? z S IF H n 7> . rbIRENREV. FIIJ L . 30. Drywall Nailing ",.IFt H ISoni oALTIjDEPI.REQUIREMENT AU o- 00.61 AU ON - Is 31. Plaster BrWtvn(Coat * X 1 core • 1 79. FINAL INSPECTION T. re M n IIS u-e______',71 .^, -. 32. Eiectrical:Powar Metf1Th%al i * a al 80TJFOOD CERTIFE ATE ISSUED_ a - - _ . . _ _' fi - t. 33. FinatrElectric> s to ' •- NEM I NO"1'es- < �J "!�n 34, nal-'Heating &Air Gonditioni -' - - r � ` 35. F(nal Gas`7ipe-Test ; 0-44' - //r��'� Ei- +' -.6. �'Z ZS 7 . .,M , rr 36. Hooter Canopy , '', ;Lt.:: 7-_, : n ;l0 .t. ^O x r. Yl -'37. Final Factory Fireplace• - 444: 40,- r.:7 r: 11.MMINI x _. -38. FinaljQlumbing t r , w ti7Z1� �- -A c 39. Water Bervice-Final r cc • b •• 4, r ♦ • . l T til _.40. Gas Service-Final '" ?' -21r,r S .5 m x C ,, e is >< t Hr t': r F• • of . • _41. Solar Domestic-Final. - • `y 3 r - - ,. s 42. Backflow Preventer " :u s tg :r t t: --, n OHI- $r r+ +' M r11 C..' _ 43. Backf low Irrigation • v- i I �• . * i -. 0) '+ - r 4j. Landscape'Irrig �Sation' stem 4:444-1-2;(4tt: "' 1" r n O!- c is t' ,c ` ,' 45. Sound Attenuation -, •- t rest C' cC • - • 46. Handicap Regulations C F ,� , `'' 7 47. FINAL STRUCTUREt& BUILDING n ;, 1 t• - A 48. FINAL PLANNING & x -.----44, • r, v a 49. Elect; Release-to Edison t• •'-^ n c :r • 50. Gas Release to South-ern Califorr6a as Co r •, '' 51. CERTIFICATE OF OCCUPANCY c - No. Date r • w . � 19212 I • F\E�� RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT F4 RECEIVED MAR 2 8 1963 P.O.BOX 917 COSTA MESA:CALIFORNIA ` FINANCE DEPT. For Applicant to Fill In Completely ArdleATISNCQSiAP TYPE OR PRINT BUILDING BUILDINGFor Office Use Only ADDRESS O-V a l 4'1-41...(iyI�QJ ll 4A-1-1 RECEIPTNO. PERMITT C,•?/�- COSTA MESA, CALIFORNIA o RECEIV¢ Era7374 D EUEO fa OWNER ,DP.('MRS. I-- T. PA aY = 3 fit MAIL - BUILDING ADDRESS ADDRH89 TEL. FIRE ZONE TYPEDGROUP CITY NO -- _ / ARCHITECT •� TEL APPROVED p OR ENGINEER YEt;AI /-titan L.b NO. BY ATH NING PAI AD- -SS 2.052 Al -I PO Rr`a 1-V a- CM • EOR I NO.OF I UBEOPNBW u'�/�/r�.i .�• Q� PIANS -/�I BUILDING ../�Bljyl/ CON TRACTOR�E 13 LAT F'D IRS ' I / / 1/ 9_ • ADDRESS - DESCRI- ON ' CITY a5T-A MESA A.P.NO. JUg7"'Q:� NOTE: NO SAVE OVERHANG SHALL BE LESS THAN LIC.TE NO. I IS 75.4/ -81 rzo. MI. 6-a_5Z SO'TO SIDE Q REAR P.L. EAVES SIZE ( `,3 L I NO.OF NOW ON LOT . ALLOWED (U.B.C.REQUIREMENT) 1 OF LOT D /� USE OF YARDS APPROVED YARDS APPROVED EXISTING BLDG. MAIN BUILDING ACCESSORY BUILDING -- (FROM C/��5REET) / - SETBACK LINE FROM ' / 'C/ FRONT (J `�FT. FT. CENTER OF STREET 3 C.J Cir REAR YARD ..C.: S . • SIDE YARD' LEFT J 1 3 1 RIGHT S I J R R.SIDS L/PT. FT. • DESCRIPTION OF WORK L.SIDE .55FT.T. 3 FT. NEW ✓ ALTERATION ADDITION REAR , FT. FT. DISTANCE BET. BET.MAIN a F 'R MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDGS. VAR.* DATE SI•.�EDING /6-2Eir NO.OF 6 SIZ (� ROOMS. STORIES C.U.P.# I^ APPROVED 'J J EXTERIOR WALL Oho I COVERING,$ug/CE APPROVED �. /I ,y/ DATE _-/} -6 COVERING �/�/!' USE OF BUILDINGGAND WORK TO BE PERFORMED / P SIr4s LAS TAMC• 4RES. tA'T'tAGHEA cmL{ 'y ea' / 11 /671�S0.FT. 4 tn.d (I 541° c I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATI N IS FOR THE S AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. D PLY WITH ALL CITY O-- 'S ANO STAT LAWS REGULATING VALUATION m BUILDING CONSTRU • •/ �_ N PERMIT FEE $ /(� j SIGNATURE OF -, r S j J�� R PERMITTEE '� OV/J 0_ 3o — E 0 AUTHORIZED AGENT /' I` a N TOTAL FEE $ 9 0 - • • PAI ,; . . $ `� ;cP ?9-76-67;7001562:= ****18.50 • 42786 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 0A _RATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RE I��Wy/✓q}(BY DATE RECEIVED DUED BUILDING� E,tS ADDRESS Q Z[ S�iJ/ IvG � _ E may, �(J,� OWNER VEeW E A areseV A.P.NO. Ite - 02-11 PERMIT NO. MAIL ADDRESGS 2-ot t N n BUILDIN ` '` ADDRESS c-. .0.,)-c-. .0.,)-/ r IC u i n/ F. AvAve_ TEL.// CITY TRACTZ 1 / 4 LOT•f`/Y(� BLOCK ✓� 5?'f} n'1FS+4 NO•Co sfS-773' CONSTRUCTION NEW `ADD/ ALTER ,,EPAIR JNOVINf: DEMO)1514 LENDER ?A • DD ��1// �� ADDRESS OWNER \)t aN� 0. h - xi,1- P-41, VALUE �) ARCHITECT TEL. USE P1 _A/72,47 $ [ I -7" OR ENGINEER NO FIRE ADDRESS ZONE '�,Illlll��TYPE DATE GROUP--3-2- S -- APPROVED �j CONTRACTOR O�/zl/�n �_ 44I L L1. EIZ BY ADDRESS TECITY NO. ZONE 124 IPLANS2. USE OF BUILDING EW t 3 �g}f�$1►{A _ F STATE CITY YARDS APPROVED YARDS rAPPPRROVsED`ry��e� LIC. NO. LIC.NO. J MAIN BUILDING ACCESSORY BUILDING (s.I SIZE NO.OF BLDGS: (FROM C/L STREET) Or OF LOT NOW ON LOT FRONT FT. I2ii FT. G USE OF N 4 EXISTING BLDG. R..SIDE FT. ei FT, O VI CCL/�..////T7(' /�'I F Separate permits are required for L.SIDE FT. L/ FT.(/ electric,plumbing and heating work. , (1 WREAR FT. FT. L. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& � Q MAIN BLOCS. ACCESS.BLOCS. �O `2 n lj • 29 1� VAR.# DATE Q J XM-. ICP C.U.P.# APPROVED APPROVEtNer/, 9---",---9116°.�� / L/ r va RY DATE a . W QI hereby acknowledge that I have read this application and state n g that the above information Is correct end agree to comply with m L all laws regulating building construction, and I shall not employ Z any person In violation of the workmen's compensation laws of u IT, . the State of California. °a 3 I hereby certify that I am properly licensed as a contractor under SO. FT. cm the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR a Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONL : b am exempt from the provisions of the State of California Business / O y and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ / n PLAN CHECK $ s� `n Signature of ,,fit/ �yv ` c Permittee -f1-s4 11 /mss• ne-i.orl.••vs $ .0 �j (: ` TAX '$ U Authorized Agent TOTAL PAID $ / .S