HomeMy WebLinkAbout784 19TH ST - Building PermitsPHQIECT RDOXESS: '] 8 q W 1 9 TH ST
OWN�p'SNAME: ROy WAT3(INS
aooncss: SAME
I� 54$-3141
�AflCHIENGINEEfl:
AUOflESS:
Y
HEG.NO.:
uxir:
UNIT:
PENMITTEE: LEE ROOFING OF COSTA MESA ( 714 ) 642—"/222
aooness: 1653 SUPERIOR AVENUE
COSTA MESA CA 92627
LICENSED CONTBALT08 OECNNIITION: I nereDy alfirm that I am IicertseA untler pmvi4ons af C�apter 9(commencing with Seclion
7000) o� Orvisan 3 0� I�e Busineu anG Pmlessions Code. an0 my Ikense is in lull lorce an0 ellect.
cirruc.:028751 sraTeuc/:399686 � SSr7' p},9� �
�ate: � � 2 Z�(7 j Signature:�,(�Ot.� /�} _N �---
�WONREpS' COMPENSATION OECIABATION: I her¢by a�lirm Ihal I �ave a[ertiiitate al ConSen� t0 selbinsure or a t¢tliliCale o� Work¢rs'
ompensalion Insurance, or a certilietl caDY thereo� (Section 38q1. La�. C).
oucrNo.:4005162894 E%P.DATE: OGIBO�91
COMPpNW. U. S. F, S G. /
❑ C¢hilie0 copy is hereby �umis�e0. Certilietl coOY � �letl vnN IAe city BuilOing Division.
Oale: � r% � L Z �V MPfcanL �� N-
E%EMRION iXOM WOflNEflS' COMPENSRTION OECLAqATION: (ih's semm �reE noi he mmpktM il iM pcmii is fa aR huMrM (5700) or less�.
I cenity �pat in ��e peAarman�e o� Itle work lor wNc� lhis permit 4 i55ueE. I Shall no� empby am/ Oerson in any manner So as ta Gecome
SU01�� la Ih¢ Workers' Compen5alion Laws ot CyFiomia.
Oaie: Signamre:
HOTICE: II, a��e� makiriq pii5 Oetlarali0n. You 51roW0 betome Subjetl �o I�e WaMers' ComDensalion D�ovisions o� Ihe Labor
Cotle. you musl fo�hwn� comply wi�h suc� pmvisions or Ihis pErmil shall Oe tleemetl revoked.
CONSTqUCTION LENDING RGENCY: I Oere6y a�Iirm Ihal ��ere i5 a CanSlmtlion lenaing agenty lor the Detlormante of Ihe work tor
whic� �his Dermi� is i<suetl (Section 3W7. Gv. C�.
LFNOEH:
nooeess:
OWNEq BWLOEB OECIABATION: I �ere0y allirm that I am e�empt Imm the Contractors' State license Law lor Ihe tollowinq reason
(Sec�ian 7031.5 Business antl Pwlessimat CoCe: My ury of counry whicli reQuires a permit m consirwi, alier, imD�ove. Cemolish, or
repai� dny SVUCWre. prior 10 i6 iuuant2. also repuire510e a07ticanl �Or Suc� permit to lile a sipn¢G 5Ia1¢menl �hat he/SM1e is licensetl
pursuant �o tne pwvisians of the Contractars' State License Law (Chapter 9(commencinq with Section 7000) ol Oivision 3 0l ihe Business
anG Pr01e55i0n5 Caae) OrtM1di �e/s�e is eaemptt�erelmm anG I�¢ Easis Ioriha all¢peA eKempti0n. My viola�ion o� 5¢clian 7031.5 hy
any aOAlicant lor a permit subjects ��e apD���ani �o a ciWl penaliy al nut more tAan live hunGred Oollars (5500�.
I, as owner ol t�e propeny or my employees wit� wapes as iheir 501e compen5ation, will tlo ihe work, antl Ihe
� slrucWre is not inten0etl or olleretl foi sale (Section 70a4, Bus�ness anU Prolessional CaCe: The Contraqors' State License Law
Uoes not applY �u an owner of a D�oDe�Y w� ��Itls or improves t�ereon, an0 wlq tloes suc� work himsell/�erself or Ihmug�
Ais or �er own emplpyees, provbe0 Itwl wcA imD��ements are not intenOeG or offeretl br ule. Ii, however t�e builAlnA or
im0�ovement is Saltl wit�in ane ylar ol tqmpletion. Ihe owner wiA luve IM burden ol pmvinq �e/s�e Uitl not 6uild or imD�ove
lor Ihe purpase al Sale�.
1, at owner o� tlIe D�openy, am e�tluSiveN coniqctinq vntll licens¢G coNractms Io Constmcl I�e pmjeCl (5¢ction 7041, Business
❑ and Prafessbns Cadl: The COntractors' State L'Cense Law aol5 not aUDN lo an owner of D�opr+iy wM10 Owlas ar improves Nereon
anG who mntracts lo� wcn o�olKu �!� e wnuacmqs) �cense pu�suant to i�e Contractors' Sta�e License Law�. I am aware
��� O�ool oi their Worker's Comp¢n5aiian insurance s�ou10 h¢ pmviAeU Io me.
� I am e�empl undei Seciion: B. d P. C.
lor Ihis reason'.
Oaie: Owner.
�I Uo Ae�¢by cenify ihat I am aware oi an0 unaerslanU the cepuirements o( CaOfornia Healtn anC Safery Code Sections Z550.5, 25533, an0
255� and Ihal I or any luture Guilding acupanl wilUwill nol (cirUe one) nee0 to rAmDly mth 5di4 siate cotles anG ihe reQuiremen6 tor a
permii lo� conslmclian o� mppiliwtion Imm �he Art Ouahry Managemeni OiStric�. fle5i0en�ial Constmciion aODlica(ion5 are eeemp� Imm
�IICSC pfONS1005.
Da�e: AOplicanL
I M1ereGy c¢tlify I�ai I hav¢ read Ih¢ appliwiion an0 SIaIe I�ai �he aEWe ini0tma�ion i5 calrecL I aqree �n [Omply wi�� all Ciiy anG counry
o�einap�es ane state lavrs relating �o huilEing conslruction aM hereby amMr@e reDreumatives ot tNs ury to enter upon ihe above�me�ion¢E
pmpeqy lo� inspectian purposes / � ♦
� _-�.�.—g-o � �,�f� ��--
Daie: 0 Signature:
Oriver's License or Social Securiry a:
16C1-<4 W�ite—Builtling: Green—Cotle ENorcemenL Canary—qpplicam; Pmk—Revenue: Goltlenro0—Assesso�
�
CITY OF STA MESA — BUILDING PERMIT PERM NO: B 049555 �
PERMIT NO; B 049555 PLAN CHECK NO: N GOVT: N SUPP: N �
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : REROOF 2200SF W/CAP SHEET BUILT—UP SQ FT: 2,900
CLAIM VALUE: 2,900.00 CALC—VALUE: "1,900.00 GROUP OCC: B-2 /
COMMENTS: PERMIT INCLUDES 784 TO 788 W 19TH ST
******�e*****�����*�r�e�e***����x�rx*�e+��r*�*��*+�+��r�r*;cx���*�* rx �� * �. x�*�*
Z O N I N G R E Q U I R E M E N���� �����°���
S E T B A C K 5 {p�/��� ��p�
FRNT: FT MAIINfiREARING —'FT IN FRNT: FTCESSONY1E�9F R4iB��F7�—,s,,,—�y��
LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT: FT I,I
PARICZNG REQ: PROV: PARCEL: 00000000 ZNE: REF NO:
PLANNING NOTES>
)'
iE iE iE if if dF �1F if 1F iE 1E iF iE if if if fE iF ik it iF iE if if �)F iF �F if if if iE it jE iF iE if if if iF iE if iF iElk ik 1E 1E IE ii iE iE jE 3f ip if iE if if if ii iF �i if it ii k�%iE %%if �F ii if �E if� if �F
D E V E L O P M E N T S£ R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPRUVED HY ;
DATE:
DATE:
APPLICATION ISSUED 8Y: � DATE: ' �-2—`l0
it*�e�t�e�t*�t+rit�t*�t*.*�t�r��t�t�t3F3F�FiF,FiF'iF3FiF"iF3FiF';F';FiFiFiF��F'iF ���FiF�'iF�t�e**�t*�t*** � � e E e *?�
*+r�*�at�r*�r****at**+�+c*�*it*+�*�eu**�c*�e+��r�+�it*at**�*+tit**+�*�r****it�r�***ratx���r*��rx���r*�����**
LEGALI2ATZON:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMZP/RLS GRADING
PERMIT 54.00
PLAN
ISSUE FEF.
bUILDING—DIV—> PERMIT ISSUE PLAN—CHECIC
TOTALS----> 54,50 0.00 0.00
REVENUE DIVISZON TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANZC
54.00
SMIP/NON—RES
.S�
TOTAL PAID DUE
59.50' S4.50 .00
5q.50 OVER/SHORT: 00
FIRE SMIP/TOT GRAAING P'LAN—CHECH
.50
if ik ik if k iE iE k if it i! if iF iE �E if ik iF k if 3ElE �E iE iE 3F!f iF if ik iF M if k if if if �lE if fE iE iF �t ik 1E ik %it �k ik �f if iF iF iE 1E it if 3E ik k iE iF iF i� if it �k k k M �f aF !E 3f it iE 3f �f
I N D I V I D U A L F E E H R E A H D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 2900 REROOF BY VALUE COMMERCIAL NOZONE 1.00 2,900.00
END OF FEES
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Oi OU072479-QOQ72480 T�1Y �4.5p
UATc: SO/22;9� TJt1E= 09:42
CONS7RUCT�ON AND PLANNINV '� � JL & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole , 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement :
3: Electrical Conduit Utility-Undrgrnd. � . 54. Forms �
4, Electrical Condoit�Undrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electriwl UFER Grnd. • 57. APPROVAL TO COVER�GUNITE
7. Footings �� . 58. Electrical Conduit-Undigrnd.
8. Foundation - � 59. Gas Pipe, O Und�grnd., Test
9. Water Pipe•Undrgrnd. � � � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � 61. APPROVAL TO DECK ��
11. Prope�ty Sewer Line & House Connection - 62. Backwash & Receptor-Final -
12. Sewer Cap 63. Heater & Vent-Final '��
♦
13. Roof Drains 64. Plumbing System - Final ,
14. Rough Plumbing � � 65. Electrical�Final �
15. Rough Electrical�Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POO�/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning� FIRE DEPT. REQUIREMENT
�. �. . ,.
20. Rough Factor,y Fireplace � f ' !s �AppROVALS �. Permit #
2L� Ducts, in Structure � � � +_: " � ! 70. Underground �HyHro '
22. Ducts, Ventilating ` �'; `�:,71. Product.Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test � ���; ; � � , , i� t j2, Underground Flush,�-• • �
24. Roof Framing• ' ' � � - � ,. � j3. �Jndergmd;StorageTank OGas ❑Oil
25. Foof,Sheathing . , �
'�A L-q �t.�(�'� 74. Overhead Hydro. - t
26. T�Bar Ceiling (Structurat) & Monocoat � ''� ' '�! �� j 75. Dr�y Chemical � ' � �`
27. �Frame and Flashing, . � � �� 76.� Dry Standpipe . . : i � �
28. Lathing'& Siding� :' ' , • , • " ,� � 77, �FIXED SYS7EM�F�NAL� � �
29. Insulation . • �� � �• � � �� �r 78,' fIRE PREV. FINA�C *'• �' � _
30. Drywall Nailing � HEALTH DEPTYREQUIREMENT ', 1,
31. Plaster Brown,Coa4 � , � � �� . 79. 'FINAL INSPECTION i � ,
32. Electrical Power Meter�Final � � �> � 80. FOOD CERTIFICATE ISSUED
.�
33. Finai Electric � � - 4 � ( �! Notes: , I� : � � �
34. Final Heating $ Air Conditioning ' i � , �- � ��' � ' + � � �"
, � �
35.�Final'Gas Pipe.Test' � � � � + � , � ;,; . �' , � ,;:'
�
36. Hood or Canopy . � ' - ' I � �'� ' ' -'
1 A �
37. Final;Fa`ctory Firepiate • ' . � ' �i '-1' � ' ' '
� �. .
38. Final�Plumbing • ` � � �� , � -
39. Water Service-Final � � � � �� �� �A ' ' -
� � I: .
. . i ,� ' . -,�„ a �
40. Gas Service-Final . . � .
41. Solar pomesticFinal � � �� ' 1�"� ' ,
� i
� , � ,
42. Backflow Preventer � • • � • � �
. 43. Backflow Irrigation, � � ; ' ,
� 44. Landscape Irrigation SYstem � � � � � �
�
45. Sound Attenuation . ' � ' , , � , � ' . , �
.. i .
46.� Handicap Regulations . � � .
47. FINALSTRUCTURE&BUILDWG �-3-q2 �p,W� '. '
46. FINAL PLANNING • .
49. Elearic Release to Ed�son '
.50. Gas Release to Southern California Gas Co + � �
51. CERTIFICATE OF OCCUPANCY .
No. Date
��� ���: 784 W 19TH ST
axNeasx.Yeiv�mowx: WELLS FARGO BANK
��%% AS TAUSTEE WATKINS TRUST
778 W 19TH ST CM 92627
�vx. �uiwo �oo�s�:
u�cxrt[crono�m+vn:
/JMIL OP FN4.'! 10DPE59:
cwm�croxsrw� EMERALD PLUMBING
CQ/iPACTOR4Y111P10 9121 ATLANTA AVE
ua w:
�M CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 081240 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU
IINT:
(714)633-8712
,,on�ss HH CA ucxo, 700531
92646 urn: 313
LICENSED COMfl�CTOP9 OECLAR�TION: I hemby dlim uedr peeWy d pefiny Nn I am lieoneed uMer pwnbru d Cheqer D
�1 «�m,o wn sec�c� ]000l d uwo, a a ur euaima .�e P.dmda,. coae� m,e mr uae�w u in n,u 1«ca enee.
c.r+o.: uc.cuss: C36 u�o.: 70053Y1 EXP•
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ryw rAh wap� m �Mi ads com W��. wa Go IM voM1.
m md PmlesYoro Cotle: TM Caartam inrw laMdoo
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owner-0uJder wT Mw IM W'tlen a Pa+�O M«eM EN nol WBd «impwa 1« tM papns d We>.
� I. m ovmx d �M V WaH. em adm�eM wemaa�G weh 6osved roweebn b am�utl Ms V4b (SWion ]OaA. &�wms W
PMeasione Gade: TM COMretlm Lianae law doea na epply w en onw d popeely xfio buitls a impovee �hreon uN x1w
mwecu In wh pqw� weh a mramaohq fcomotl D�*� to IM CoN�eeon I.ioems Lew).
� I em a�emq unCar Seclion: B. 8 P.C..Ia Ne renaon:
Deb: ��
I do M1sebY �Y Ntl I em ews d ad �vW�ataM tlr �Wm�Mb d Gliaw IleeEh W Se1MY CaEe Satl'vn?5505. ?55�. enE
25531, eM Ntl I« eny Murs buildm0 �uP�� xill / wil na (mrJs ar) med ro conNY wh �eiE u�s mdx end �M nV���«m br
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WOPKEP'S COYPEN9ATp1 DK Wi�TON: I Mraby eRrm udr psWy d pr}ry wa d IAs b0ow'vq Astivtl'vu:
❑ �ne.�..neWm.:+.n.�«Wiubawn,.u�owLm..a.o�ka.•mrosWian.ov��aMswionamoa�n.lmu.
eoe.. �« �ne v.�amene. d w.ak �> .n:tl, Nie o«me e u.uee.
❑ in...w.n�n.�.An..•oomv��m.,rez....r.a�hwMswQ,modm.i.eorcro..iorin.o.na,�wK.a�n.
rak 1> xhiM Nb G�N e owd. M' wulun' mnprunion'vwvvc� un'r rd D�Y �v�mber w:
c.m..:
POGcy Numbx:
..da Hr.Ybn mM mt M mnplxM i Uw prml e b ms MMM dNWi �S1M� a 40./
� I mnYy Nm in Na pMomunce tl tM work br xhich �M parmu b WusE. I dutl M ampby ury pr�on in xry men�r n u lo
Eecoms wEjed io iM worknY ovnpa�wion lew�e d GeGlm�i nE pna tlW il I� )k Decane • Ib lo IM xaMeri
cpnpxuetbn prtxiebm d Saion �)00 d IM l�bor Cod�. I hvAih mmpl� weh f� piwuim�
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9�ctlm �106 e/ IM LNor CaM, IM�rut ���my� Iwa
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pMameiwe W iM wM M xfik.h �ha O�i u eaM (Sea'vn ]041. CM. CI.
LENDFA'8 NAYE
LENOEP'B ADDRE34:
I canih IM I hev� ned Nn epp4Wion uk ams Na tlr ebw� HamYion u canw.l �Wb to candY vrith e0 aY enE muNy ad'vimm�
Md f1B�G IOxI �OW�V b bC�10 W11i�T Nd �1MObY m1I1vC0 RDIOpNNP� 4� IIO Y1Yb MrtM Wp� IIN ObTFmMYiMNd PQVMY
�«��'D"�D�`°�"` ROY_ PEARCE /1
o�.: /—zr —5'7
(5151-48.WP) Whne-BuiW'eq85eley:GreemFla:Cenvy-Appirenl:Rnk-Rs.enue:6ddeneo�Asaeeaor
JOB DESCRIPTION : AUN NEW WATER SEAVICE TO HUILDING
CLAIM VALUE:
CALC—VALUE:
PERM NO; P 081.24
GOVT: N SUPP; N
PURPOSE; OTfi
S(Z FT :
GROUP OCC: M /
COMMENTS: NO STRUCTURAL WORK WILL BE COVERED ON THIS PERMIT
**+t+t*******x�****�r***��r�rx �����+t�r*�*x x�x���*�r***�r+t+t�r�*x+t*�r****x�**�r****�r��r+tx*�r�+t�r+r+�
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 HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO:
PLANNING NOTES>
� t/�
1E iE iE iF 1E IE 181E 18 if 1E 1E IE 1E 1E IE 1E iE If iE 1F 1E 1f� iF 1E iF ik fE iE IE IE 1f 1E 1f �f 1k iE iF 1f 1E iE iE iE 1E 1E 1E iF iF if if� IE iE If iE if !F ik ik fE 1E iE li 1F 1f 1E 1k fE it 1E 1f ik 1E I(� 1E iEiE if iF iE
D E V E L O P M E N T S E R V I C E S�� R E Q U I R E M E N T S
ZONING APPROVED BY
DATE:
BUILDING APPROVED BY : .-� DATE:
APPLICATION ISSUED BY: � ��'� DATE:� �/1
�r+r�it*+t*x x z x x x x x x x a x x�wir+tir+F�z x x��x R—iF3F3F?F7F{F"fFiF7F 7F7F�f�diFiFiFiF3FTFiFTFiF'iFit�itx�+t+riairitit Wit
LEGALIZATION:N F E E S U M M,P. R� Y STRUCTUR SE MENT:N
BLDG pMT PLUMBING ELECTR�IGy,MECHANIC FIRE SMIP/AES GRADING,
PERMIT 8,75 { � _-
25t — n SMIP/NON—RES
PLAN - „ : ' ;
ISSUE FEE 22,00 'j �i.
BUILDING—DIV—> PERMIT ISSUE PLAN-CHEGK TOTAL PAID DUE
TOTALS----> 8.75 22.00 �.� 0',00 30.75 30.75 .00
�
REVENUE DIVISION TOTALS--> COLL'EGTED:,_ 30.75 OVER/SHORT: ,00
HLDG PMT PLUMHING ELECTRIC MECHANIC � FIRE SMIP/TOT GRADING PLAN—CHECK
30.75 �
Y, i
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I N D I V I D U A L, 1:. 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 WATER RE—PIPE �' ' � 8.75
END �OF F�EES D
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CONSTRUCTION AND PLANNING PQO�' - SPA -�
ApPROVALS Permit# Date Inspector AppqOVALS Pc.,��it# Date Inspector
1. 7emporery Electrical Service br Pole 52. Pool & Equipment Location
2, $oil Pipe•Undrgrnd. 53. Steel Reinforcement
�3: Electrical Cond -"� USility-Undrgrntl. 54. Form; . " "
�._.
r.....
.-:4,. Elettrical Condwt•Undrgrnd. , � 55. Electrical Bondin9
3i S�eel ReinforceMent 56. Rough Plumbing & Pressure 7est
_a:5,_�IectricalUFER,�nd. 57. APPROVALTOCOVER•GUNITE
�;�. Footings �S . 58. Electrical Condui[�Undrgrnd.
�$r'F'oundation ''� . 59. Gas Pipe, � Undrgrnd.. Test
;�3:�Nater Pipe-Und�grnd. i - 60. Backwash Lines, P�Trap, O Ur�drgmd.
10�'S[ructural Floor System 61. APPROVAL TO DECK
1�� P�operty Sewer Line & House`�_-Connection fi2. Backwash & Receptor-Pi�al '
1 Z; Sewer Cap a �� 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing SYstem - Final
14. flough Plumbing- , 65. Elettrical-Finai
15. Rough Electrica`tConduit _ 66. $olar System�Final
16. Rough ElectritlNiring - 67. Fencing & Access Approval
17. Rough Wiring Sign �' 68. APPROVED FOR PLASTERING
18, Rough ElectricaFT Bar Ceiling . 69. POOL/SPA SYSTEMS FINA�
19. Rough Heating & Air Conditioning FIRE DEPT, fiEQUtREMENT
20. �tougp Facio'ry Fireplace - >: � - • - APPR01FA1.�'� Peer,mit # - -
� C � j. y .. ^• �
21. _Bucf�; inStructur,r.� . _ .'".. . _ • -.
' t.. r _r ,.. � IO.�Unde��gra,' Ad Hydro r
22. Dut�, Ventilating �- ,- �� _ � � 77, ProdJELPiping'�CGas OOiI
23.'Gas�Ipe=RouBh &'T¢st _��! ; _ � ,_ �' � F 7z, Underground Ftu�h � �
24. .Roof-Framing. :� �r �- �- c:. _ e ��� < 73'. Undergrnd. Storeg,8 Tank O Gas O�Oii
T �
25. RootSh�athirtg . ,_, �: ,`'_ �. �� - . < 74'. Overhead Hvd*o -
26. T-BarCeiling (Strnyiuraq & ivloc�ocoat � � ^L '. 75. Dry Chemical - ' - _
27. �Frame and FlashirLq a _�^ t �, '-� ,r . 76. Dry Stand�ipe.� rc. �.
. .
� 28. Lathing&Siding.r_ �_ - � •• • 79: FIXED�SYSTEM-F.INA^i
- 29. Insulatiq� ' '� " � � r 7g-, FIREPREV. F161AL - - '
t.
� 30. Drywall Nailing , � - � �-HEALT:a DERT.�REQUIRfMENT
4
�. 31. Plaster 87bwn Coat� ,,. _ _ _ 7�.'F1NAC WSPECT�DN ; - �� �
' 32. Electrical Power Mqie�Finai `-, � � � 80: FOOD CERT �I f�ATE 15SUED
� 33. Fina7Electric ,` � '� `'" , ��' Nbtes: �.-:i� �Q � .
: . . ,� . . ' S S_��l�f�.�Z��r
� 34. �Final-Heating & Qit.Conditionirg; � . `�� , � ' �, • - �/
. - - .�'L-�P1-��/_j� G_�'%�.�- /- � /
35. �Finai Gas Pipe�Tes�f � -' - ?. ' _, ' � ���
.. . - - �r d�i�. �- ��---�-- - -
36. �Hooi! or.CanoPY ��x; _ �' _ - _ r . � y ^ _ ^ � � • . .`/' �
- - - _ � ; , `�-� �_�'- � _
' 37. �Final Pactory FirepfaCa'�. - _ �, "• ` ,' �--- •
.. . y � ..
38. Final Plumbing �,. .. .. � G:1 �' i � �A.. � r'-
39. Wazer Seivice-Pina�*' � - • _ � � , _ !'= -
- �> -
,.� 40. Gas Service-Fina1 -' , r: z� .': r s .:. ' . i�� ,
� 41. Solar pomestic•Firtel _. ' - ' '
� � -
" 42. �6ackflow Preventer,� " F " , y ��i. �
43. Backfiow irrigatibn+� ;�= ' ! �'" '
r, ¢- i
.: : . - : r :, , .
�44. Landscapelrrl,qatioraSystem2-; ;,.:, - r_�+ r; _� r•� -. �.,
�i5. �Sound Attenuation" ' + '" r ,- `' `"" " ° '�" '
�r m 1. r 7' �. 1 - r . i �
�46. Handicap Fegplations -. - - .• .. :s . - ,_ . . ��
47. E�NAL STRI�CTURE & BUI'LDING > "" •- = ' � �`
[ � � y ' • l l
48. FINqL PIANNING� _ t. �; C � -� r.
49. Electric Release to Edison - -T' '� - E: �� f�1+
�` O� '^
50. Gas R,elease to Sout�em CatiforqiaGasCn , " . • -'r �. - ��^ .� �
51. CER7IFICATEOFOCCUPANCY � _ ,_ . _ . --�"cJ ,�i .
No Da[e 4''"'P �
Aop���ant to /ill in all spaces except tnose within neavy porEer Ilnes antl sign a11 approo/�ate eeelantions.
CIT.Y OF COSTA MESA CONSTR UCT�d PERMIT PE MIT NO. TRACT NO. LOT NO. UNIT NO.
��ProjectAddress 7��� � �9 �
ApplicanYsMailingAddress 30LZ. � µ
Owner'sName � Phone6�!'ffJJ�
Address � L/ �l l �
Arch/Eng. License No.
Address
Convactor's Nama �����- �A���� Pnonesy�'9 7S3
Addresslmailing) �3�N. �i%�+
City License No. � 2 Q9 � Q
LICENSEO CONTRACTOR OECLARATION
1 hereby altirm that I am Iicensetl untler provisions of Charter 9(commencing
with uction ]000) o( Division 3 of the Busine55 antl Profei5ions Cotla, antl
my license is In f W}�torce antl etfect. � � ^f
License Class / v�6 —� C � L ensp�N � (,.�J
Date�SlL Qi� Signalure �%�_j��
WORKERS' COMPENSATION DECLARATION
�ereby aHirm that I have a certificate 01 consen[ to Selt-InSure or a C¢rtifiCa[e
Worke�s' Compen5ation Insutance, Or d certilied c� the�eof (5¢CtlOn
s00, Lab. GJ � o T ^
Polity No. �� S� Z— �J3� Company S/ �U ✓� ,J
8 Certifiea copy is hereby furnishea.
Certifi tl opy "s fil9 tl with the city Buipiyg Divisi /. i�
Oate Applicant /�� ����1 �
EXEMPTION F OM WORKERS' COMPE SATION DEC RATION
(This section neetl not be completetl if tha permit iz for ona huntlretl (E300) or
Iess).
I certify that in the per(ormance of the work for whlch thls perm�t is issuetl, I
shall not employ any person In any manner so as to becoma subj¢<t to the
Workers' Compensation Laws of Califomia.
Date Stgnature
NOTICE: If, after making lhis tleclaratlon, you shoultl Decomo subject to lhe
Wo�keri' Com0en5allon provisions o� [he LabOr CotlO, you muit forthwilh
comply with such provisions or thi5 pCrmit snall be tlaemCtl revokatl.
CONSTRVCTION LENDING AGENCV
1 hereby atfirm Ihat t�e�e Is a conitruction Ientling agenty for the pe��o�mance
of t�e work tor whith lhis Oetmit is ISsu¢tl (Snction 309] Civ. C.)
Lentler's Name
Lentler's Atltlress
OWNER BUILDEN �ECLARATION
I hereby atfirm that I am oxempt irom the Contractor•5 LI<onsa Law lor tne
followin9 reason (Section ]031.5 Bu5Ine55 antl Professional Cotle: Any clty or
county which r¢quires a pe�mit lo Construct, alter, improve, tl¢mOlisn o� repair
any struc[ure, prlor to Its Issuance, a15o reqWres tna applicant for such permit
[O iile a Si9netl slatemenl thal he/stle IS IICrnSOG pur5udnt [O lhe pfOviSions o1
the Contracror'S License Law (Chapter 9(commencing wiN Soction 7000) ot
�IviSion 3 0l Ihe Bu5ina5i antl Pro/Ozzions Cotle) Or Ihat he/She Is azampt
±refrom anG tne bazis tor the alle9etl exemption. AnY violation o1 Section
i31.5 by any applican[ fOr a permil Tubjecls Ih0 applicant ta a civil
enalty oi not more than five nunaretl tlollars (5500).
� I, as owner oi tho property or my employecs wlth wages as ihoir sole
tompensation, will tlo the work, antl tne structura I5 not intentletl or olteretl
/or sale (Se<tion 7044, Business antl Professional Cotlo: Tha Conlrac[or's
Licenu Law tloos mt appty to an owner of a prOperty wh0 DUIItlS or impmves
thereon, antl who aoes such work nlmseli/herself or throu9h his or hor own
employeei, Provltletl tha[ such improv¢ments are nOt Int¢ntlatl or otter¢G 10�
sale. It, howaver, the builtlin9 Or improvomant Is soltl witbin on0 y0ar ol com-
pletion, tne Owne� will have [he burtl¢n Of Proving h¢/She tl10 nol bu110 Or Im-
pfOvB tof th0 Purpo50 01 sale).
❑ I, as owne� oi Ihe property, am exclusiv¢ly mnttacting wlth IlGnnsotl con-
tractors to mnslruct tne Oroject ($ection ]044, Businoss antl Prolesslons Cotla:
� 7he ConVactor's License Law do¢5 nol apply [O an owne� oi prOPerty who
builtls or Improves tnereon, antl wno tontracts for sucn projecis with a<on-
tractor(sl imense pursuant to the Contractor's Llcenso Law�. 1 am aware that
p�oot of [heir Worker's Compensallon in5urdnte snoultl ba provitletl to ma.
❑ I am exempt untler Section B. S P. C. for this reason
Date Owner
I hereby cer[ify Nat I have rea
information is corract. I agree lo
antl state laws relating to builtli�
sen[atives ot Ih' �ty to e er
insoection pur ��
Signature
Drivers' License or 55 �
tion antl state Nat the above
all City antl COunty Ortllnance5
i, antl hereby autborize repre-
bove-mentiOn¢0 DrODer(A for
f 3 33/ °/
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LI GRADING �LyJ FOVNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL LG PLVMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION SO.�FT. OCCUPANCV
CON STRUCTION TYPE VALUATION 5
ZONE GRADINGCU.YDS. ACRES_
Remarks:
Sink
<flow Preventer
<flow Irrigation
Dishwdsher
Drinking Fountains
Floor Orains
Floor Sinks
Gas Service Outlets
Interceptors
Ki�chen Sink
lavatories
P—Trnp
Roof Druins
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool wlSpa
Urinal
Water Heater
Water Service
Auro-Wash
Reinspection Fee I $15 I I Isue Fea I S 3 I
MECHANICAL FEES
3oiler
Dutt - Under Ground
Duct - Structurol
Duct � Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0-100,000 BTU 0100,000
Reinspection Fee � $75
CMF 0865-46, rev. ]0/84 Wnite - Builtling; Canary - Appliwnt: Pink - A<counting: Goltlenrotl - Assessor
Hood or Typel ❑
Canopy Type II ❑
Refrigeration SyStem
❑aioo,000eTu ❑ioo,000
System Repair/Alteration
Fire Dempers
Registers
laue Fea � $ 3
A.P. qf`-
S Main Buildi
E
T Front
B Rear
A
C flight
c Left
Ping. Rdf. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishv.asher
Dryers LJGas LJElectric
Fan
F.A.U.
Fixtures
Oevice Boxes
Outlets
Switches
Garbage Disposal
Generator O0.5 KW 05��
9755 5/C2/�.; .
Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15-50 KW
❑ SO+KW
Meter Dup to 100 amps
Meter ❑over 100amps
Sub Panel
Motors �al HP � 1 h- 8
Inc.Solar 09-15 HP �76-15+
Microwave
Pole Light
Range •
Standing Sections
KW Trash Compactor
� Reinspection Fee I$15 � � Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved 8y
Building Approved By
Appliotion Issued By �
7oUi� TI.
FEES
$ 3
2
O
N
I
N
G
R
E
Q
M
T
S
SUMMARV OF FEES
BUILDING PERMIT 5 SMIP $
PLAN CHECK $ PERMIT
PLUMeING $ i- O V ISSUANCE $
PLAN CHECK 2596 $. ENERG� P.C. $
ELECTFICAL $ GRADING 5
PLAN CHECK -50% $ MICROFILM $ �7 �'�
MECHANICAL $ TOTAL FEE $ -��
PLAN CHECK 25% $ _
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permif # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement j
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 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-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test .
9. Water Pipe=Undrgrnd. - 60. Backwash Lines, P-Trap, O Undrgrnd. .
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line�& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
74. Rough Plumbing 65. Electrical-Fina�
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rou9h Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign , fig. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling . � y� 69. POOL/SPA SYSTEMS FINAL � �
19. Rough Heating & Air Conditioning M FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro '
22. Ducts, Ventilating 71. Product Piping �Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush '
24. Roof Framing ; 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing ! 74. Overhead Hydro '
26. T-Bar Ceiling (Structural) & Monocoat = 75. Dry Chemical ,
27. Frame and Flashing „� � 76. Dry Standpipe t,�
28. La[hing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �
31. Plaster Brown Coat 79. FINAL INSPECTION •�•- .
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED "�.
33. Final Electric Notes: '
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test Srr,��(� L�� �
36. Hood or Canopy � ' '
37. Final Factory Fireplace . �
38. Final Plumbing ,j�s(d.f� LfjQ � • '
f
�'39.� Water Service-Final . � , � � �
• 40. Gas Service-Final
. �
� 41. Solar pomestic-Final . � - .
42. Backflow Preventer ' � . '
43. �ackflow Irrigation , . � ' � •
� 44. Landscape Irrigation System � . � '
45. Sound Attenuation � - � ,
46. Handicap Regulations • ' ' , . � .
47. FINALSTRUCTURE & BUILDING . ' .
48: Special Requirements Completed , • �
�'
49.° Electrie Release to Edison '� �
50. Gas Release to Southern California Gas Co •' !��\ .
51. CERTIPICATE OF OCCUPANCY . � � ..
` s
No. Date ' � �
._ ._ . t� .
1 .. � � •