HomeMy WebLinkAbout912 VAN NESS CT - Building PermitsF
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PflOJECT RUUBESS: �j S 2 VAN NESS C't'
owNcesxame: HENCSTELER, DAVID E
aooRess: HENGSTELER PAM
912 VAN NE§S CT
COSTA MESA,CA 92626
AHCMIENGINEEfl:
ROOflESS:
NEG.NO.:
uNiT: CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 067796 PLAN CHECK NO: N
CONSTRUCTZON TYPE: V—N PERMIT TYPE: STR
UNIT:
PENMIREE: $ILT—WELL ROOFING ( 719 ) 756-3501
aooxess: 3310 VERDUGO
LOS ANGELES CA 90065
UCENSE� CONTNACTOB OECLAflRTION: I hereUy atlirm I�at I am licensed unUer pmvisions af commencing with Section
7000) of oivision 3 otihe Business ana Prolessions Coae, anU my license is in Iulllorce antl
CITY LIL.: � �ATE LIC.: Q � �3 . — ❑
oa� % —��
WOflNENS' COMPENSATION OECIAXATION: I �¢r¢Cy a��irm Iha� I Aave a cerlihW e n re or a terii�iCa�e o1 Wotkef5
Compensaiion Insy[a9,cP,.,or a cenilietl coDY Nereol (Section 3800. Lat. C.
PQUCY NO.t W i 1/ S U 1 4 S 4 EXP. OPTE: !� 3I
COMPANY: CAL COMP INS.
❑ Cetli�ietl copy is hereby fum'i/shed. � Cerlilie0 coOY is IileU wilh ihe ci�y B�leing Division.
Dale `�� ^ � " Npplican�.
EMPTION FpOM WOPKEBS' COMPENSATION OECLANATION: (This seclion nee n d it �he Dermi ' or one hundretl (5100) or less�.
I �erii�y Ihal in iM1e pedormance oi Ihe work br whic� Ihis OFrmit is issuetl, I shall not employ any 1 any manner so as to become
suojecl lo ihe workers' Comoensation Laws ol Califomia.
Oate: Siqnamre:
NOTICE: II, after making ��is Geclaraiion, you s�ould Uecome SUDlect ta I�e Worker5' Campen5ation Dmvisions al ��e LaEOr
CAtle. you must tonnwitn como�Y w��n sucn provisian5 or inis permil snall �e AeemeU revoked.
CONSTNULTION LENOING AGENCY: I �¢r¢Gy aifirm I�ai ther¢ i5 a tonilrut�ion 1¢n0ing aqenty �or IA¢ 0¢�ormante oi the work �or
whicn Ihis Oermitis i=_sued (Senion 3097. Civ. C�.
LENDEfl:
RUONESS:
OWNEfl BWIOEB DECLABRTION: 1 �ere�y allirm Ihal I am exempl irom Ihe Contracbrs' Sia[e License Law tor IAe following reason
�Sec�ion ➢0.91.5 Business antl Pmlessianal Cotle: Fny cily ol coumy w�icA repuias a De�mi� �o consirucl. al�er, impmve. Gemolish, or
repair any stmcture. pnor lo ils iuuance. atso repuires the apD�icant Ior such permit to file a signea statement ttWt ne/sne is licensetl
Ctu 9 t� Se C 7000 f �' ''0 3 0l t�e 8 siness
PERM NO: B 067796
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION ; T/OFF 6 REROOF WITH COMP. 6 BUR ZN BACK SQ FT: 1,100
CLAIM VALUE; 1,100,00 CALC—VALCTE: 1,100.00 GROUP OCC: R-1 /M-1
COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM 6 HALLWAY
x��*#+r�x��**�*+r*�r*u�r#*�u���***�r�*�*���*�**��**�rx�**�r�*���#*�*��**�##*#�**+�#��*****#
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDIA]G ---------- --------- ACCESSORY BUILDING ---------
RNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
L FT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING RE • PROV: PARCEL: 41808340 ZNE: REF NO:
PLANNING N�TES>
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D E V B 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: �/��1�� DATE: �_�8 �
�t�tiE�t*frft�r*�**itiFit�tx�fr�r3ri�jt�3rTrTr+r��r��rTe+r�rTr3.,��l��3'F+rer�x�ir�r'�r+f�riFk3F3F**�rit*�*x�*it r�F,.,F<..x�/,F�*�
ifitil�itilifililiEiEiE±l�it#iFiEifiE3E�1EiEi(�iEifiEiEitiEitiEiElEif�ltifil�iEiEitiFititif�iFiEiEiE##iEiEkiEiclEiFiEifiFiFiEiFiE#itififiFiFiF itiE##iE##it
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM2P/RES GRADING
PERMIT 27,00 .50
pursuant�o�hepmhsionsoi�neConlraclorsS�ateLrt¢n5elaw� pter �cammenanpvn cion �o msin � SMIP/NON—RES
and Pml¢SS�OnS COOe) or Ihat he/s�e is eeem0� Ihere�rom an0 ��¢ Dasis br I�e allBpeE eeempti0n. Any violation a� Set�ion 7IXiL5 by PLAN
any aooiicant ror a vermit suojecis me aooiiwnt ta a civii penairy af not more inan iNe hunareo donars �S5o0�. I S SU E FEE
i. as owner ot ine pmDeny or my em ioyees �in wapes as meir sole campensation, win ao me wan�, ana me BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ stmcwre is nountenaed or onerea mr saie �S�eaian �0aa. Business ano Professional Coae: Tne Camractors' Sta�e License Law TOTAL S---- > 2 7, S 0 0, 0 � 0. 0 0 2 7. S 0 2 7, 5 0 , 0 0
Ooes not apO�Y �o an awner ol a pm0eny who huilds or imD�oves t�ereon, an0 who tloes such work himseli/hersell ar ihrouph
his or her own em0loyees, provitleG thai such imp�ovemems are not intentled or otlere0 for sale. If, however tAe huildinp or REVENUE D I V I S ION TOTALS--> COLLECTED • 2 7. 50 OC�ER /SHORT : , 00
Ior�ineepupoeeoisale�jninoneyearoicomvietion.iheownerwmna�etne�uraenoiDmvingne/sneaianothuildorimpmve HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner a� �he pmperty. am erclusively wnVacting wit� licensetl coNraciors �o cons�mc� �Ae pmlec� (Sec�ion 7044, Busin¢55 2 7•�� , 5 Q
❑ ana Professions Code: The Comractors' State License Law tloes not apply to an owner oi pmDe�Y who bmlas or impmves thereon
antl who contrac�sfor suc� pmlec�s wiih a conlraC�m�s) license pur5uanila ihe Contraciars' Slate License Law�.l am aware
Itlai pmof Oi �heir Worker'S Campensa�ion insurante Sh0U10 be pmvitleU Io me.
� i am exempt under Seaion: 0. 8 P. C,
lor Inis reason:
Date: Owner.
t Ao nereby cenity ihat I am aware ol antl unUerstantl Ne reVuiremenis ol Calilomia Healih and Safety Cotle Sections 25505, 25533, ane
2553a antllhat lor anyfulure building occupaniwill/willnot�circle one� needto comply wil� saiC state codes anEtherequiremenis lora
permil lor consimc�ion or modilication from �he Air �uali�y Management DiSVict. flesidenliai con5imc�ion applitalions are eKempt �mm
IM1CSC pf0V1510115.
Oale: Applicant:
I M1ereUy certity inat I have read t�is apDlication an� slale Ihal i�e aUave
orEinazesane 9atelawsrelatingto Ouileing conSVuclian and �¢�ebyaulA
pmDerly lOr inspection purpo5e5. �
to compty
ta en�
Date /- � "— �� Signamre:
river's License o� socia� Securi�y w:
i64t�46 Whne—Builtlmg: Green—Cotle Enlo¢ement: Canary—Ap0licanl: Pink—qevenue: GolEenroO—Assessor
i! if it if if iE if 4 iE �lE iF iE it if i(� it it it iE iE it if iE iE if iF it� i! It �lE ik ik it ik iF iE iF it iE i(� iE 14 M if i4 iE �Ih ik iE # iE iE * if iE iE ie �E iE iE iE if iE # 1f iF iE iE 1E iE # iE iE # iE ## iE 1E
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
SFR 1100 REROOF BY VALUE RESIDENTIAL N020NE 1.00 1,100.00
END OF FEES
01 00163303-00153304 T4 7 27.Sp
DATE: 07/ffl/94 TINE: 08:55
CONSTRUCTION AND PLANNING POOI & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit� Date Inspector
i. Temporary Electrical 5ervice or Pole 52. Pool & Eyvipment Location
2. Soil Pipe�Undrgmd. 53. Steel Reinforcement
3. Electrical Conduit UtiticY-Undrgrntl. 54. Forms
4. Electrical Conduii-Und�9�nd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgmd.
8. Foundation � 59. Gas Pipe, � Undrgmd., Test
9. Water Pipe-Undrgmd. 60. Backwash Li�es, P�Trap, O Undrgrnd.
10. Structural Ftoor Svstem fil. APPROVAL TO DECK
11. Pronerty Sewer �ine & House Connection 62. Backwash & Receptor�Finat
12. Sewer Cap 63. Heater & VenrFinai
73. Roof Drains _ 64. Plumbiny Sysxem - Final
14. Rough Plumbing �. 65. Electricai-Fina�
75. Rough Electrical�Conduit 66. Solar System-final
16. flough Electric Wiring � 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPRQVED FOR PLASTEfiING
18. Rou�h Electricai-T Bar Ceiling 69. POOL(SPA SYSTEhAS FINAL
19. Rough Heating & Air Condition'ing FIRE DEPT. REQUIREMENT '
20. Rough Factory Fireplace APPROVALS Perinit #
21. Duc2s, in Structure 70. Undergrouad Hydro
22. Ducts, Ventiiating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe�Rough & Test � 72. Underground Flush
24. Roof Framing 73. Underymd.StorageTank OGas G�OiI
25. Roof Sheathing � _, 7�$-qG( �o..(� 74. Overhead Hydro �� ' .- � ' I
26. T�Sar Ce;ling {Structuralf & Mtonocozt 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Laihing & Siding 77. FIXED SYSTEA-0 FINFIL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster 8rown Coat . 79. FINAL INSPECTION
32. Electriral Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating � Air Conditioning ,
35. Final Gas Pipe-Test
36. Hood o� Canopv �
37. Final Factoiy Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service�Final
47. So1ar OomesticFinal
42. Backflow Prevenier
43. Backflow Irrigatio�
44. Landscape Irripation 5Ystem
45. Sound Aitenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �O �r c� ��L-
P
48. FINAL PLANNING
49. Electric Release to EdiSon "
50. Gas Release to Southern California Gas C�
51. CERTIFICATE OF OGCUPANCY
No. Date
Pfl0.1ECT ROOBESS: 9 1 2 VAN NE55 CT uNir:
owNexsr+ame: HENGSTELLER, DAVID
eooness: NENGSTELLER PAM <
912 VAN NES� CT `
COSTA MESA,CA 92626
(714)»6-3111
AflLNIENGINEEB:
flEG.NO.:
p00flESS: UNIT:
� PENMITTEE: GEORGE BRAZIL ( 714 ) 535-7905
nooeess: 3022 N. HESPERIAN WY 101
m� SANTA ANA CA 92706
'`' LICENSEU LONTBRCTOP OELLAflRT10N: I heieby allirm I�ai I am licensed untler pmvision5 a� ChaDter 9(cammencing wi�� Seciion
a�� 7000� ol �ivision 3 0l I�e Business antl Pmlessions CoOe, an my license is in lull force and ellect.
y� cirr uc.: G'�'7-r.QS srnTc uc.: 4 4 3 0 6 cuss '' 3 6A' �^�/
T� Oate: � � � y� SipreNre � . �'`�'�KY
WONNERS' COMPENSpTION DECLABFa7'10N: I hereby atfirm t�at I Aave a certilicate ol consent m sell-insure or a certilicate ot Workers'
POIICY N0. ��'�d�� �'d`v is1e7 c��1�/ lereof (SectiEXPB� TEaO. � 1 I O 1/ 9�
comrnxr: ELIANCE I,.NyS,C'O
❑ Cenified caOY is hereby Iurnis�eG. LJ CenilieA cop is lil 0 with he ' BuilAin n. � /
Date: � ^ /--_._� ApplicanL •
EXEMPTION fNOM WOflNEflS' COMPENSATION OECUPATION: (ihis senia neeA not �e [omDle�etl if fAe permit is for ona �unOreO �5100) or less�.
I cerlify Ihat in Ihe pedormante of Ihe wo�k for whic� �his permil is i55ue0. I s�all no� employ any person in any manner so as �o become
SuDle���o �he WorkeR' Compensation Laws ol Califomia.
�ate: Signa�ure:
NOTILE:II. atler making tnis aeclaration, you snoul0 Oecome subjectto ine WOM1ers' Compensation provisions ol tAe La6or
Code. you mus� IOhhwiih mmply wii� SUCh pmvisions nr I�iS permil Shail b¢ U¢¢me0 revoked.
CONSTNUCTION LENDING AGENCY: I �ere�y ai�irm �hal ��ere is a wnstruction lentling agenCy for I�e peAormanc¢ 01 t�e wOrk tor
which inis De�mil is issuea �5¢etion 3W7. Civ. C1.
LENDFfl:
nooxess:
OWNEfl BOILDEB OECUBATION: 1 �¢rBEy atlirm lhat I am ex¢mpt �mm the ConlratYors' State license Law lor tne iWlowing reason
�Sec�ion 70�1.5 Business anA Pmlessional Cade: Any cily ol counry whic� requires a p¢rmil Io constmci, aller. imD�ove. tlemolish, or
repair any 5tmciure. prior to it5 i55uance, also repuires ��e applicani tor such permi� to �ile a sipneG 5latemeni Ihal �¢/She ¢ lic¢nsetl
Durouant io t�e pmvisians ol i�e Cantractors' Staie License Law (Ctupter 91�mmendng with Section 7000) of UNision 3 al ��e Business
ana Pmlessions Code) or t�at �e/sne is exempl iherefrom and t�e basis for t�e allegea exemD�ion. Any violatian af Seclion 7031.5 by
any aODlicanl lor a vermit suUiecis ihe ao0licanl to a civil penalry af not more ihan live AunAreA dollars (5500).
I, as owner ol ine pmpeny or my employees with wages as tAeir sole com0ensatian, will Oo ine work, antl IAe
❑ simcWre is not intenUed or otferetl Por sale (SecUon 7044, Business antl Pmiessional Code: The Coniractors' State License Law
aoes no� apply to an ovmer oi a pmDe�y who Ouiltls or impmves [hereon, antl who does such work �imsell/herseli or tAmugh
�i5 Of her own employee5, pmviae0 ihal Suth improu¢menls are noi inlen0ed or o��¢r¢4 lOr Saie. If, Aowever ��e 6uiltling of
improvemenl is soltl wilhin one year ol completion, ihe owner will have ihe �urUen ol proving �e/she ditl not builA or imOmve
lor ihe purpose ol sale�,
❑ I, as owner ol Ihe pmpetlh, C exclusively cantrac�ing wiih licensetl wnirac�ors lo constmc� �Ile Omlec� (Seclion 7044, Business
5 C L 0 I I 1 o e ol a ert who �uilOs o im mves thereon
CITY OF COSTA MESA — BUILDING PERMIT t��:xr� tv�: t u�yt�
PERMIT NO; E 059230 PLAN CHECK NO: N t, vi: tv u i�;
CONSTAUCTION TYPE; S—N PERMIT 1'YPE: ELE PURPOSE: OTH
JOH DESCRIPTZON ; A/C CHANGE OUT SQ FT;
CLAIM VALUE; CALC—VALUE; GROUP OCC: R-3 /
COMMENTS• CHANGE OUT Ot3LY. RE• M59229 MECH, PERMIT
x*��c�*x-�ic*�xw*��*x*�*�c#�r�*�#**�#*#��*#�****��r*#*�*x�***�n��r*�*�*x#*�**���****�*#*
Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MASN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRN'P; FT IN REAR: FT IN FRNT: FT ZN REAR: FT IN
LEFT: FT LN RGHT: F't IN LEFT; FT IN RGHT; FT IN
PAftKING RE • FROV; PARCEL; 41808340 ZNE: REF NO:
PLANNING N TES>
i
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D E V E 1� 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
ZONI�G APPROVED BY - DATE:
HUILDING APPROVED BY : - DATE;
APPLICATION ISSiIED BY; ' . �a.i� DATE; `/ 9-2
iE'IEK"IFiI'iE!!'IE3EiI'JEiEIFlI'IFIfiI'iI'IEiEIEiF3FiFF! T' t3rltn'JtA' 'n'A'iF tlt&�/ iF Ri[i-tit'TF iFttR�FiFi4M'II'iF'M'iEiEH'ff 1 C '1f7P
i(�iE1f%3Fi(�1f14iflEiFiElhiElE�EiEIEif3tlEi(�iE1f3EjhiFlE1E3E±f--1EA(i(-3E�1F3EiFiEiFkiElf%{� :jE##IF�1fiEiEiEiEihiFifkiEM�#Klf1E3Fif�f-ie3F3fifiElf3EiEiE3e�7f�
LEGALIZATION;N F E E 5 U M,u A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC cZAE� SMIP/RES GRADING
PERMI'P 7 , 50
508 SMIP/NON—RES
PLAN
ISSUE FEE I5,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
'I'OTAL5----> 7,�0 15.00 0.00 22,50 22,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 22,50 OVER/SHQRT; 00
HLDG PMI' PLUMBING ELECTRIC MECHANIC FIRE SMIY/TOT GRADING VLAN—CHzCK
22,54
an4ProfesswnsCoEe. T e omrac�ors la�e rtense aw oesno apPY oan wn r pr D y � 0 ,N.3l,.K..x.,lf.K,X.,K.if,il.i(.#%#N.1E�.%K.if.%..x..%,#fi�lEifiElE�EiEiE�1F�1kiElE�lFifi(�it36#1tihlEifihiE##Ik�?F±ElE3E�)f!F#iE�6lhiEjFiE3EaE{(�jF{(�fEN��k3EiFi'riE{F3hi6
and wAo tOntfatis br SUC� pmle��s wilh a comracmr(5) liCense pursuan� lo t�e Comra[rors' S�aie Lit¢n5e Law�. I am awafe
ma� pmo� o� Neir worker's Comoensa�ion insurance shauld be provided m me. 1 N D I 11 I D G A L F' E E B FZ $ A F( D � jd N
� 1 am exempi unEer Section: B. 6 P. C.
mrmisreason, TYPE QTY D E S C R S P T I O N UNIT Ct�ST TOTAL COST
oaie: ��e� ELE 1 MOTOR/POWR APPARATiJS 1, 1 — 1 O, O HP 7, 50 7, 50
1 Ua hereGy cenity tnat I am aware ol anE unAersiand ��e reQuiremems ai Califomia Healih antl Safety CaOe Seciions 25505, 25533, anG END O F F E ES
25570 an0�ha1 IOranyluiur¢ GuilOing occupanivnlVvnllnol (cirtle one�n¢¢G to compry wilh saiC Slaie coEeS anai�erepuiremenfs lo! a
permit lor conslmction or moaiticaiion hom �he Air OuaLry Managemenl Oistricl. Residenlial cons�mctian applications are ¢xemDl imm
Inese provisions.
Date: pODlicant:
I hereDy Cerii�y I�ai I �ave tea0lhh applitaiion anE s�ai¢ I� I ih¢ ove intorma�ion i5 torrtti. I agree Ia tamOH'Mlh all Ciiy an0 tounty
ortlinances antl slatelawsrelalinglo Uuilaing conslmQion an here aN rize repres ��iscirylo enleruponlhea�ove�meniion¢A
pmperly lor in50 �io Dmpo 5. �y�., ,/
—� Date: _C�i__j�� SignaWre: �i� e— �7�r[. Y -
oriver's License or Sociai Seariiy a:
t64t�46 White—BuilEmo: Grean—Coae Enlorcemem: Canary—Aoolicant; Pink—Rwenue; GOltlenro0—Assessor
i . .
CONSTRUCTION AND PIANNING POOI. & SPA
APPROVALS Permit � Date Inspector APPROVALS Permit # Date Inspector
7. Temporary Electrical Service or Pole , 52. Pool & Equipment Location
2. Soil Pipe�U�drgrnd. � - 53. Steel Reinforcement �
3. Electrical Gonduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UPER Gmd. 57. APPROVAL TO COVER-GUN�TE
7. Footin9s 58. Electrical Conduit-Undr9rnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test -
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
70. Structural Floor System : 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap _ • 63. Heater & Vent-Final
73. ,�oof Drains 64. Plumbing System - Finaf �
14. Rough P�umbing . 65. Electrical-Finai ��1
15. Fiough Electrical-Conduit 66. Solar System-Final
16. Rough Etecvic Wiring 6�. Fencing &`Access ApProval, •
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough EleCtrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in 5tructure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Fram�ng 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing " 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Wthing & Siding 77. FIXED SYSTEM FINAL
29. Insulation . 78. FIRE PREV. FINAL
30. Drywa�l Nailing '� HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ; ' 79. FINAL INSPECTION
32. Electrical Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric / C� /�� Notes:
34. Final Heat�ng & Air Conditioning ( • �
35. Final Gas PiPe�Test
36. Hood or Canopy
.
37. Finai FactorV Fireplace �
38. Final Piumbing -
39. Water Service-Final '
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape Irrlgation System
45. Sound Attenuation
46. Handicap flegulations
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �
57. CERTIFICATEOfOCCUPANCY
No. Oate
I�i
Pfl0.1ELT R�OPESS: q S 2 v�.N N�SJ" CT
owxes•sxnrne: HENGS'fELLER, DAVID
Ao0flE55: "rIENGS'1'ELLGR��i �AM
512 VAN NESS ��T `
COSTA MESfI, C}:` 92626
(714)556-3111
RflLH/ENGINEEfl:
�OONE55:
flEG.NO.:
uNir:
UNIT:
veeMmec: GEORGE BRAZII. ( 714 ) 535-7907
aooness: 3022 N, HESPERIAN WY 101
SANTA ANA CA 92706
LICENSED CONTpqCTOB OECURFTION: I tlereDy affirm IAaI l licensetl untler pmvisions oi C�aD�e� 9(cammencing wilA S¢tlion
7000) ul Oivision 9 ot the �usiness aPtl Pmfessions Cotle, antl y licen is in full force an0 eile . �
cirr uc.: � s,e uc.: 4 4 3 0 f 4 �uSS���
�
Date: � SigreWre: � �,� �.�
WOflKEflS' COMPENSRTION OEClABA710N: I hereby a��i inai I nave a cenificate oi cansem to selbinsure or a cenilicate ol Workers'
Comoensa�ion �IqspJye cer co Nereol (Section �800, La
POLICY NO.: '�„ V��� Y�� � 1 cxe. oar 1/ 01 / 9 3
cornraNr:xELIANCE I,N}�S,CO
❑ Cenifietl co is he hy �umis�eC. L' 1 Certi�ietl copy s lil wit the 'ry Buildi ion.
�
Date: AppliCani:
E%EMPTIONFROMWOflRENS'fAMPENSpTIDNDECUB�TION: � i55et�ionneeAno�becompl¢�eGil�hepermi�iS�oronehunCr¢E�5100�or1e55�,
1 ce�ily ihal in Ihe Dedormante ol the �+ork lar wnicn inis oarmit is issued I shall not em0�oy any person in any manner so as lo eecome
su�l�� �0 I�e Wark¢ri Campen5atio0 Laws of Calitomia.
�ate: Signalure:
NOTICE: II. alter making ihis tleclaration. you shoNA �ecome SuUlecl lo t�e Workers' Compensation D�ovisions of lhe La6or
Coae. you must fonhwith comDty with such pmvisions or ihis permii shall be deemea revoked.
CONSTPUCTION LENOING RGENCY: I hereby at�irm Iha� Ihere is a conslNc�ion IentlinA aAe��Y �or ��e Dedormante ol I�e work lor
wnich Ihis Dermil is issue0 (Section 3�91. Civ. C).
LENDEN:
noosess:
OwNEN BUILOEH OECIANaTIDN: 1 nere0y affirm �nat I am exemo� �rom Ihe CAntractors Stale License Law lor tne followinp reasan
�Stttion 70.31.5 Business antl Pmfessional Coae: My ciry of wunty w�ich repuires a pe�mit to Lronslruc6 alter, im0�'e. demolish, or
repair any slmcWre. prior to ils issuance. also repuires Ihe applicant lor such Dermit to lile a siAneE statement ttwt �e/s�e i5 li[ense0
pursuant to tAe Omvisions ol i�e Convactors' State License Law (C�apter 9(commencing wii� Section 7000) of Division 3 of i�e Business
and Pmlessians Catle) or Ihat he/s�e is exempl therefrom and �he basis for Ihe allegeU exemp�ion. Any violation o� Sec�ion 7037.5 by
any a0plicanl lor a Dermit su�lects tne applican� �o a civil penalty ol not more IAan live hunO�eU tlollars ($500�.
I, as owner ai t�e OmDenY or my employees wit� wages as iheir wle campensatian. will Ao lhe work, anG t�e
❑ simcmre is not intenEea or ollerea lor ule ISection 7044, Business antl Pmfessional CoOe: T�e Comracmrs' State License Law
tloes nol appty �o an owner o� a OmDehy who builds or imOmves �hereon, ana wha Aoes such work himsel�/hersell or Ihmugh
�is or �er own employees, pro�0ea tAa� such im0�ovemeni5 are not intentled or aflereG lor sale. If, however t�e builtlinp or
improv¢ment is SOIE m�hin one year o� completion. Ihe OvmCr vnll luv¢ the Gurden of pmvinq he/she Oitl noi buiM ar imprave
for Ihe ourpose ol sale).
1, as owner oi ihe Dmpeny, am e�clusively coniracting with licensed comractors lo consimct ihe pmlect (Section 7044, Business
❑ ana Pmiessions Code: T�e COnlracmrs' State License Law Qoes nm aDPN �o an owner ol pmperry wAo builtls or improves Ihereon
an0 w�o coniracts for such pfolecis with a comracloqs)littnse pursuant m ihe Coniractors' State License Law�.l am aware
Ihat pmo� of Iheir Worker'S Compensation insurance s�oultl Ee pmviaetl to me.
� I am eremp� under Sec�ion'. B. 8 P. C.
lor �his reasan:
Date: Owner.
1 do �er¢Oy cetlity �ha( I am aware 01 3nE untlerstan� the requir¢menls ol Cali�omia Heal�b antl Salely CoAe Sec�ions 255Q5, 2553J, anC
2553C and��a�loranyfuiure buil�ing acupan�vriNvnllnot�circle one) need�o comply wii� 5ai0 siate caGes anGi�e requiremenlslar a
permi� lor con5lmtlion or m00ilitalio0 �mm I�e Air Ouably ManaAemeni OiSlriti. flesiAenlial tonllmciion appliw�ion5 are evempi �mm
ihese provisions.
Daie: ApPlicanl:
1 �ere�y cetlity ��al I have reaE �Ais apPlicalion antl slale Iha� Ihe aLo information is rorrect. I agree to compry with all city and counry
orUinance5anO5talelaw5rela�inplabuildinBconsimclionana reby I�orize epre aliv¢So�Nisc enteruponl�ea�ove-mentioneU
O�opeiiy �or inspet � p poie5. �
- � mi� �.���:^�Cl��/'
Date: � igreWre:
Driver's License or Sociai Security x: �
t6abd6 WM1i�e—Bui�tling; Green—G�o Enlorcement; Canary—Applicanl; Pink—Ravenue; GolOenro4—Auesmr
CITY OF COSTA MESA — BUILDING PERMI'f
PERMIT NO: M 05927.y PLAN CHECR NO: N
CONSTRUCTION TYI>E; 5—N PBRMIT TYPE: MEC
P�HM NU; M U�ylly
(�UV�1�; N SUk'Y: N
PURPOSc: OTH
JOB DESCRIPTION ; A/C CHANGE OUT SQ FT:
CLAtM VALOE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS• CHANGE OUT ONLY, NO 'H' PERMIT INVOLVED.
�#���*u***�c�*x*�r�*�r�ri��*��*�******��r**�t�x��#�x�rx�**�+��*�*�t**+t�r�-�r�r�r�t***�*�t*�r+�**��e��•
2 O N I N G R E t,� U I R E M E N T S
� S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACLESSORY 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 REO• PROV; PARCEL; 41808340 ZNE: REF NO;
PLANNING N(STES>
�
ff iE-1F iE # 1E If K� # IF iE iE if iF if iE IEiF 3F iE ic iF-?E iE if ih %�IE 1l 1Elk iE it iE iE iF 9f� if �1F iE iE iE iE iE iE iE 1E if 1E iE ie If !E iE 3E �lE iF iE #!f # ik 3(� K� 3f 1! iE iE iE iE iF 7E ie 3F 3E IE iE # iE
D E V E L U P,'� E N T S E R V I C E S R E Q U T A E M E N T S
ZONZNG APPROVED HY �r DATc;
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY• DATE: % Y S'�
if�iEifafiFiEiEK�iE�lEif�(��lEitiFiEifieiEifiE7F �t� �vrxf�ft�.��`.r � . � xiElPififif�EiE3F�76lt st�lEif
�3EikiF1E�(��1F%�3F%��14iFifif�3eiflFiFlfiEXifiliflf�iEiEiFiflEi4)f�(-�If•lFiF3EifiE3F?t3f�iE#3EaElflf n�M�M�iEiFif3F?fiE14i(�if#3fiF�3F3F�k3ki6N��1fi(�#�1FiFjfiEiE'k#
LEGALTZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRS SMIP/RES GRADING
PEkMIT � 9�Sp�
PLAN
ISSUE FEE 15,00
SMIP/NON—RES
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TC>TAL PAID DUE
TOTALS----> 9.00 iS,UU 0,00 24,00 24,00 ,00
REVENUE AIVISION TOTALS--> COLLECTED: 24,00 OVER/SHORT; 00
HLDG PMT PLUMBING ELEC7'RIC MECHANIC FIRE SMIP/TOT GRADING PLAt��—CHECK
24,��
iE iF if iF iE iElf if !f iE # iE 3f-�lE iE iF i(-!E iF iE 3!!f 1E iF iF iE 3f it 3F if� IF �lE �1F-If if 34 N� M� iF 3F jE iE if 3E if it iE if fp # 3E 1E IE �E iE 3f iF iF iE if 3E if �lf it if� 3E iE 3E iF IE IF 1(� if # iE �)f iE 34 3(�
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
MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9,00 9,OU
END OF FEES
CONSTRUCTION AND PLANNING POOI & SPA
APPROVALS Permit# Date Inspector qPpROVALS Permit# Date Inspector
t. Temporary Electriwl Service"o� Pole 52. Pool & Equipment Location
i
2. Soil Pipe�Undrgmd. 53. Steel Reinforcement �
�3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electricai ConduihUndr9rn8< 55. Electricaf Bonding
5'. Steel Reintorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7.�rootings 58. Elecaical Conduit-Undrgrnd.
��
8. Fo�ndation - � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � • 60. Backwash Lines, P�Trap, O Undrgmd.
10. Structural Floor SYstem - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap � � 63. Heater & VenrPinal
73. Roof Drains � 64. Plumbing System - Final
i4. Rough Plumbing ' 65. Electricai-Final
15. Rough Electrical•Conduit � 66. Solar System-Final
16. Rough Electric Wiring , 67. Fencing & Access Approval '
17. Rough Wiring Sign - 68. APPflOVED FOR PLASTERING �
18. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT�
20. Rough Factory Fireplace APPROVALS Permit #
s
21. Ducts, in Structure 70. Underground Hydro
22: DuMs, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Undorground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. �nsulation I 78, FIRE PREV. FINAL
30. Drywall Nailing i ,� � HEAITH DEPT. REDUIREMENT
31. Plaster Brown Coat � � 79. FINAL INSPECTION
32. Electrical Power MeterFinal � . 80. FOOD CERTIFICATE ISSUED
33. Final Electric � �' Notes:
34. Final Heating & Air Conditioning �4//�19Z G�rj
35. Finai Gas Pipe•Test � �
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Plumbing
39. Water Service-Final '
40. Gas Service-Finai �
41. Solar pomestic•Final
42. Backflow Preventer � � ,
43. Backfiow �rrigation
44. Landscape Irripation System �
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINALPLANNING '
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �'�
51. CERTIFICATE OF OCCUPANCY
No. Date
R
!
a
CITY OF COSfA
RDQUFST FOR OCQJPANCY
�,� �: �� �vs ��: �� s, , s� d
rrn tao. q'��`
ADDRESS �'�lJ/TE� �L/�/1� ( ih ��, ("•4-YI �r. ' /�/�-� .•
Zhe developer of the above entitled tract desires to sell the above set forth
lot prior to the time that the tract has been obnpleted and its streets
accepted b� the City of Costa Mesa.
By exea�ting this agreement', the undersigned a�cnwledges that he/she/they
was/aere advised that this tract has not been given final inspection nor has
it been accepted b� the City of Costa Mesa as having cortplied with the conditions
of approval which Mere irtposed b� the City at the time the Final Tract Map was
approved.
The City assiurns no liability for the enforce�re�t of the oonditions necessary
for approval other than those oonditions protected b� surety bond.
The undersigned agrees to indemnify ar,d hold the City harmless fran any claim
resulting in da�ge or personal injury to the undersigned ty reason of the
aforenentioned uncoRpleted condition(s).
r�_;Li'Jt� BY �
�,_., „_ ,_,- .•- (Si ture of Purchaser)� .,
.1AN ^ Q 1°8�
PM
�igi9iluelliuiii�ci3i4�5i6
_ �
BY IXsG-��%�L`��11!
Sign ture of Devel r and or
authorized representative
0
.
� r'
TRACT N0. ��Jr7�7�� DATE
LOT N0. / �
►;1 � ;��.�9
Development Services Department
Planning Division
City of Costa Mesa
77 Fair Drive
Costa tdesa, CA 92626
Attention: Tir. Paul Dudley
Dear Mr. Dudley:
Please be aware that the undersigned are aware that a certificate of ::occupancy
on the above referenced lot and unit is being requested prior to the entire
tract and its streets and co�on areas being completed and accepted by the
City of Costa Mesa. �
BY. �
(SIGNA URE OF PURCHASER)
F
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COSTA MESA BUILDING•SRFETY DEPARTMENT
P.O.BOX1200 COSTAMESA,CALIFORNIA92626
For Applicant to Fill in Completel�v - U�Cqe �Ink O�nly
BUILDING�i// /)�7 �i,� � //�� /v
OWNER Biddle'Development, Inc`.
MA�� �g48 Campus Dr. Suite 116
ADDRES
TEL.
cirv Newport Beach, CA No540
CONSTRUCiION __,.
BRANCH
ADDRESS
ARCHITEC-r&add Kelse Woodard TEL.
OR ENGINEE � y � N .
180 Newport Center, Dr. B
ADDRESS
coNrancroaBiddle Development, Inc.
ADDRESS �ROR camp„G nr_ S�,itP 116
CITV Newport Beach, CA .No�540-5505
STATE CITV
uc. No. g� gzg6614 LIC. NO.
SIZE � NO.OF BLDGS.
OF LOT — I NOW ON LOT —
USE OF
EXISTINGBLOG. TfSl(10Rt.181 -
S�para�e pleim�.s aregtequire4d�foi 4� L
electric, plumbing and heating work.
UILDING AND WORK TO BE PERFORMI
Jnit �k 95 �A) 1284sq.ft.
96 (C) 1603sq.ft.
0
�
I hereby acknowletlee that I have read this application antl stete
t�at the above information is correci and agree ia comply with
all laws raguleting builtlin8 construction, entl I shall not employ
any porson in vlalatlon of the workman's compensation laws ot
the State of Calitornie.
I hereby certify ffiat 1 am properly Iicensetl es a controctor under
the State of Californle Business antl Professio tle, Division 3,
Chaptar 9, antl that such licanses are i fo e antl eftect, or I
am exempt from the provisians of Sta t California Business
antl Professlons otle, Division ha r 9.
Signatu of
Per e
thorizetl Agent �
�' �. �p /�J'%79 285.32 TL
._ ... _ _ _..
APPLICATION FOR STRUCTURAL PERMI'I
PECENED BV DATE RECEIVED pqTe Issueo
AD1DRE S �� ���J 9� �Wq �6�L/• +
TRACT LOT BLOCK
FIRE
0
�-�DIPLANS � BUII.DING EW J�!'�
e���
YAROSAPPROVED YAROSAPPROVED
C URP# �JLJ/� APPROVED /(/ �p'
APPROV � ' /D, 7 ( �
v
iOLD FOR SPECiAL EOUIREMENT� ^
�
� T
mMM�
m,r'
� 1�
m
SQ. FT. � O �
THE AMOUNTSHOWN UNDER VALUATION IS FOR �
THE PVIiPOSE OF ESTABLISHING A PERMIT FEE ONLY: �
VA�UATION PERMIT FEE $ �
m
$ l�//�J PLAN CHECK -$ 1O
�y/ � �� � \
✓ // TAX $ LL
� �
TOTALPAID $ � ,D
a C. 7
'�u�G. #� 3}�
COSTA MESA BUILDING•SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
P.O. BOX 7200 COSTAl�:sSA,CALIFORNIA 92626
RECEIVEDBV PERMIT �� I
For Applicant to Fill in Completely — Use Ink Only �
BUILDING .. _ A.P. NO.
ADDRESS
BUILDING
OWNER OR ADDRE55
TENANT giddle De EL E
UNIT OR
MAI LI NG SPACE NO.
ADDRE55 38 g
TR.NO. �OT BLK.
TEL.
dTV NO.
NEW ADD ALTER REPAIR MOVING DEMOLISH
CONSTRUCTION
LENDER
BRANCH
OWNER
ADDRESS VALUE
ARCMITECT TEL. USE E
OR ENGINEER N .
ADDRESS ZONE TVPE GROUP
Biddle Develo m0nt InC. BYPROVED OATE
CONTRACTOF j> >
ADDRE55
TEL.
CITV NO.
STATE CITV APPROVEDSETBACKS
LIC. NO. LIC. NO.
SIZE NO.OF BL�GS. (FROM C/L STREET)
OF LOT NOW ON LOT RONT FT.
USE OF
EXI5fING BLDG.
Separate permits are required for L SIDE Fr.
electric, plumbing and heating work:
REAR FT.
VSE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION
DATE
� APPROVED
Permit — Tract 10445 �ROVED
1 �ereby eeknowletlBe t�et I have raetl this application and state
that t�e above information is eorreet and agree to comply with
ell laws reBulating builtling consiructlon, and I zhall not amploy �
any person in vio�ation of Ne workman's compensation Iews ot
Me State of Cali�ornla.
I hereby cartlfy that 1 em properly licensetl as a contrecior untler SQ. FT.
t�e Swte of California Business antl Professions Cotle, Divlsion 3, THE AMOVNT SHOWN UNDER VALUATION IS FOfi
Chepter 9, antl that wch lice s er II force anA effect, or I THE PUflP06E OF ESTABLISHING A PERMI�T jFEE ONLY:
am exempi from the oyi ion he S ie of Calitornia Businass VA�VATION PERMIT FEE S a Y�� �
antl Professions CPtl , fvisi , Che r 9. �
Signatura ot PLAN CHECK $
Purmlttee $ TAX $
or
Authorizetl Agent Date � TOTA� PAID $��
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