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HomeMy WebLinkAbout211 19TH ST - Building Permits Mac - 001 CITY OP-COSTA'MESA ( '\ BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENTPE IT NUMBER r/� I PERMIT 00" EN-00245 I (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 211 E 19TH ST Status: ISSUED Suite No Applied: 03/27/2006 Vicinity: Issued: 03/27/2006 Parcel Nunmber: 42540420 Applicant: PALOMARES, PATRICIA V Address: 211 E 19TH ST ISSUED BY: Phone: 949-929-1254 COSTA MESA,CA Zip 92627 Owner: PALOMARES, PATRICIA V Address 211 E 19TH ST Phone: COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: , Phone: Zip: License:000000 . . SCOPE OF PERMIT ELECTRICAL PERMIT TO REINSTATE EXPIRED PERMIT NO E075530. WORK TO INCLUDE: 12 LIGHT FIXTS, 16 RECEPT OUTLETS, 11 SWITCHES AND 1 MOTOR. FEE SUMMARY , Quantity Quantity ISSUE FEE $23.50 - Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 . Misc Electrical Equipment $0.00 0 New Res(3+unit5) - $0.00 0 - Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 .. 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 ''0 Other Electrical Fee $0.00 Motors over 100hp $0.00 - 0' , Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a ., $0.00 0Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 ' 0 TOTAL CALCULATED FEES $23.50 Intermed Pole $0.00 0 COMMENTS I SPECIAL CONDITIONS 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)7545626 2446-66(6/00) 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 insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ` -k{--'Icertify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' 1 compensation - agree that it t should b= • e subject to the workers'compensation provisions of Sec on 3700 of th Labor e,1 shall forthwith comply with t ems' Applicant Signature:_ '�C�y�� rOate:—�3 WARNING:FAILURE TO SECURE WORKERS'MEW It • ERAGE IS UN WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMI PENALTIES A CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.it Class N Contractors Signature: Date: 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(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 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 ursuant to the Contractors License aws.). ///---'''��� ❑ I oder s: . Business and Professions Code for this reason:aft �� V CSlgn&Wre:.- ` Fiat / /f _Own i ID verified b nse. ❑Yes 0 No Drivers License No / / Expire-sr-1 a/70/(X/ Verification of Ownership by(type of document,i.e.-property tax bill or deed): 11 ( _! 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,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 parson has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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 ❑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 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)? Cl 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 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 a permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes 0 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 0 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 California Health and Safety Code Section 42303 been made? 0 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 final inspection. Signature Of Leg: • ner(s) rat' �— fir.:r Authorized App''•. COPE r INSPECTION TYPE g1E INTtAL6 ;ODE r INSPECTION TYPE 17r,TE INf=ALB 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical '/47• 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 • ADDRESS OF IMAUANG. 211 E 19TH ST UMrn CITY OF COSTA MESA - BUILDING PERMIT ONNER'SNAMEIFMMNN: PALOMARES, FRANK PERM NO: E 075530 ADURES& PALOMARES, PATRICIA V COSTA MESA, 1CI ig:i: 9�2t27714-642-6748 PERMIT NO: E 075530 PLAN CHECK NO: N GOVT: N SUPP: N • APPL.MMUNMADDRESS: I,[� CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ADD ARCHITECT OR ENGINEER: U(1;N Lj LpR ilk `Cj34 -1335 z g let§t tt'ttiN ' Able i©ia 8V AbbtTION /ELECTRICAL SQ FT: ARCN.OR ENG.'S ADDRESS: DE7N,VT'Y: CCJ tlNi: LAGUNA BEACH CA 92651 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / I CONTRACTOR'S NAME: CONTRACTOR'S MAILING COMMENTS: RESIDENTIAL ADDITION OF 1012 SQ FT / REF B-75526 ADDRESS =NO.( **************************************** ************************************** UPC: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Stine under penally of perjury tine I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)or Di ision 3 of the Business end Professions Code.and my license is in lull force and efea. CITYVC.NO.: UC.CLASS: LC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN D"°: ContractorLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law for the following reason(Section TWts Btdiaas end Professions Code:My wig county which requires a perms to construct.alter.improve. PARKING REQ' PROV: PARCEL : 42540420 ZNE: REF NO: h.astructure:anystructure:Door to its issuance.also requires the applicant for such Derma tads signed sWameraer dhe or she c,n.amensedr pursuant to the provisions d the Contractors License law(Chapter 9(c mmeq ng with Section 7000)d.oyyn 3 d the PLANNING NOTES> i -nness and Professions Code]a that he or she is exempt therefrom and the basis for the alleged exempfi.n.Arty°""r`��d Section > • 41)',SS's by any applicant laepenna subjects the appliraritme Si parstlydna mea than/se hundred dollars($50!0 �.• **************************************************i(ifiElEiElfiEiEiE1E1E1E1fiEiFlE****1EIE9flEifiF*** ❑ L ea owner d the properly or my employeesweb wages as their sole compensation.ova do the work.and the elrucnurr�Imended DEVELOPMENT SERVICES R E U I R E M E N T S o offered for sale tn7044.euslress and P such ssion Cod°:The Caa tre « Lu soerue Law donlo na apply an ownliofpopery 4 who Wide or improvesovesthereon.end who does work himself or herself or through M or her own employees. that such improvements are ave theintended buurrdm°oof pwig hei«sheamdid t buildbuilding or imnprove tor the pupurppose within one et �'� ZONING APPROVED BY DATE: 6 I.as ower d the property.am evLdvW cedreaiq with licensed conbect«e to caemaa the project(Section 7044.Business and r' Professions Code:The Contmctore License Law 630::: es non apply to es owner d property wtn bslds G. esno es tryi6n ad wed BUILDING APPROVED B Y : DATE: contracts for projects With a corarana(e)liicensed pressed to the Coniums License Law). f( p- ❑ I am exempt under Section: . P.C.. • 1 lJ° APPLICATION ISSUED BY: DATE: /2— D -� �6�`�11 *********************************************** d�********************* ** �; Date: i2` �`�,� owns 7+ %>�4+ LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N /' 1 do hereby cendy top 1 am aware d end understand the requirements d rads Health end Sdery Cale 25505.25533.and 25534.and that I or any future building occupant wil/%a nee(circle one)need to campy with said store codes and the requirements for ' apenile for wn°1rucnonornodetpahonIron the Air Gouty Management District.Residential.. ..nation awlwore exaemptfrom these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING Provisions. '-77 I �� --moi 4 PERMIT 32 . 25 / Dora: I lll$lq 5 Appfnad: gWaiM� + .-� 50% SMIP/NON-RES WORKER'S COMPENSATIONNNNDECLARATION:I hereby affirm under penally d•!'tea! o;Ilf owing dedarat• : PLAN o Ihaend will maintain d W; M te consent to workers'aaaensation.as provided for Section 3700 of Labor ISSUE FEE 15. 00 ve Cod•.for the performaceof the wokfor which thspemwsSued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ Ihave and MImacompensation required bySalim 3TWMperformance dm dtheLaborCodefortonce , TOTALS- > 32 . 25 15. 00 0;00 47 . 25 47 . 25 . 00 work fa with this perms is Sued.My woman'compensation insurance carrier and policy number are: Caller: REVENUE DIVISION TOTALS--> COLLECTED : 47 . 25 OVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN-CHECK I section need not be completed I the permit is for one hundmd dolled(S!W/or Ian.) 47 . 25 id I certify that in Oue performance of ph•work for which this permit Is soled,I shall not employ any pens any manner es as to become eubj•d to the workers' ompreaon be d California endwitagree rceoernN'a•t teIt ashouldwuld.become ecome m the wMere' campmm �prAW'� Section 3TW d the Labor De: 15 Appfrad ��st:er11 � A *************************************************************** **************** IND I VIDUAL • F E E B REAKDOWN Warnbp:FWurearcurewO*rs' compensation coverage Isunwhd..l' !e. an employer w penalties and TYPE QTY DESCRIPTIO N • ' UNIT COST TOTAL COST civil lines up to one hundred thousand ddlare(5100.000),In addition to :•coal of compensation,damages as provided for In 5.aaan3lDsaf Labor rom end. .r•fees. ELE 12 FIXTURES LIGHTING 1 ST 20rEA. . 75 9 . 00 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of MAIM paha there is a construction landing agency ler the ELE 16 RECEPT/OUTLET 1 ST 20 EA. . 75 12 . 00 padatnaceofthework fowhicthipamtis Wooed(Seann3097.CMC). ELE 11 RECEPT/SWITCH 1 ST 20 EA., C d .75 8 . 25 .s LENDER'S NAME 0. HP e' LENDER'S ADDRESS: ELE 1 MOTOR/POWR APPARATUS 0 . 0 - 1. . „t3 .00 3 . 00 END OF FEES ��er lrS�ept10. - OD, 9'4 f ' !candy that l have read this application and oras that the above information stoned.l agree to comply MTh N ay and county ordinances IOCOMP ) 7 t . end state ewerelatig to Wddiq CaMrudion W hereby authorize representatives d this city to enter upon the ahee.meetened properly la inapedwn Wrposea. _4114-41... y, �,I �+' j� . — PATOU PALOMARES =d _ ; ft D Print . .40-1,1„..-1. earl. .• 'g Date: ' 1 V /_ U:_ .;. f' (5151-46.WP) Wbee-Buydiq 8 Safety:Green-Flo;Canary-Applicant Pink-Revenue:Oddatod-Assessor - ‘A CONSTRUCTION AND PLANNING POOL �A APPROVALS Permit# • Date Inspector APPROVALS Permit# Date Inspector _ r' 1, Temporary Electrical Service or Pole r. 52. Pobi & Equipment Location ' ' 2. Salt Pipe-Undrgrnd. , ; 53. Steel'Reinforcement r �� ' a3.^,Elettrical Conduit Utility-Undrgrnd. 54. Forms -. _ c • - 5.4,. Electrical Qtln�j r5bit-Undrgrnd. r 55. Electrical Bonding ❑ ;..Steel Reinforcement 56. Rough Plumbing & Pressure Test - eVElectrical LitEll Grnd. 57. APPROVAL TO COVER•GUNITE . ..n7..Fogltings _x 58. Electrical Conduit•Undrgrnd. '•e'8,Foundation•1d 59.,Gas Pipe, 0 Undrgrnd., Test _ . rJ;W$.1Fr Pipe-Undrgrnd. t' 60.'1Backwash Lines,P-Trap,tt'il Undrgrnd. c 10.'Strl ctural Floor System 11 61. APPROVAL TO DECK 11=•Property Sewrtc Line & House Connection i. fit 62. BackiJash & Receptor-Fina4. 12. Sewer CapI T: 1 1 ' 63...1 ,,rer &Vent-Final 13. Rckbf Drains -' ' r. 64. Pit{, 9 System •• Final . 14. Rough Plumbiag -, 65. Electrical-Final . - Y l 15. Rough Electrical-Conduit 66: Solar System-Final 1 ' , _--- 16. Rough EWectric Wiring IN% •- 67. Fencing & Access APProvaf 17. Rough Wirt Sign 68. APPROVED FOR PLASTERING f ._1 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FI-jtE REPT. EQUIREMENT 20. ,Loin Fa or, Fisrlace ' a:n. .....1:::-; T, 2 C =,F ''APPIThV M`S=`" Pdcmit# * < { • . n t a 1- 21, 13uctsl in Sti•uk2ure.,,i •• •• '-�' .r S 17 rI* - 70. 'llnder r ,„.rr'' dro ` 22. gL t Viht11 ngFu*, r * 7 G; j p;t ; 71. Product''iPin IMas 9 u, I oil 23. Gas Ripe-Rough & Test 71...;_ >< i*. Cr' C C' 72. Underground Fftlih : F• 24, !Too n rar iing" nj* F'E" • F 0 a 1-1*. 73y Undergrn'd.Stor~dcle Tanla.O Gas 0.5i'-1,.- 25. Roo Bheaihing C t ,r.* v v aC ,t n'* 74? Overhead Hydrt F 26. T•BaV;Ceiling (Stn, ral) & kTicadloat * p C `TY r - • - r' . _ c:i * O rJ a: 7�r_.• Dry Chemical 1.-. F .,rritn • I! w S p, t.2 ,. _ :'t :.rr . , 27. Eramieand•Flashing u _ 4 ' Y 76. Dry Stani3pibe ?tic-'•`. ; - --•T- J _ rn ...Cr' -128. Lathing&Siding * "' ` el'• , r. z '• "f "; 7i FIXED kk1 ST INAt -• rrt."r•YE', 29. Insulation:-. 0* S •• l' 7 . FIRE PREY. Fl�L 1• - x ?,:z.','",&... •C'30. Drywall Nailing Ey'. r * 1.. .* ~ EALTR,Q,EP't,f4EtrUIREM {V.T, : 31. Plaster BrownrCoas:v : r,-' .t t;, . ' 79. FINAL I1_ASPECTION * - t. • ;,32. E)ectrical'Ppw"'er tvg., rIF43al ! ,'r-4 -t I fv ' eC FOOD CERTIF5CAit I .SED-, r. ". o• 'y -I F 1 tr r. cr. 'f t. Lli 1. . c^ t•33. Eioa(-Eleoiaic_ •-tx Cr; I C +. N6tes: *"" `- ;34. j;jnay�featihg;$i Alt Conditioning= tr. .. I !* - ' .. ' l 35. i-jnarGas'Dipe,iestu K -u ! rei . , T.,;;4,1.4 - - -51 P r/ C 'r. I rr•� d I- in r* .v co r 36. Hcod9 (?anopy , - _ _. m �^ v. * �. �:�K 0174 DF *FC�Jt�S y37. F.inat. actory Fireplace ;, : f-+F a. F ' v- rr I f� rr x "38. Finaq'lumoing y `t- * k S `, * : - +y t- 7:: ;st I J. F f- M F i 39. Wate}Ser,`iice-Fin44: z , - •. L, . ` 1 a -n r, ,;. t - n x40. Gas Service-Final + m ''r,_t RI ` Cf.- •^C X41, Solar Domestic-Fi ts' s " * L' a `` J F .. , . r.• ^, r r s.. 42. Backf low Preventet'* ro t 'f tY * r.:.- "- ,t t r, O r -, 1. r try i�J c i- ,-- r r. SSS r ..r. t. _.. 43. Backf low Irrigation r * s. + t • • • • 44. Landscapg'lrrilationlSystem !• * "' - 7: ill lc r` z^ ' S• � .r 45. Sound Attenuation :• F t- r-•4, t , H r! ... L..-y:,F ,t m RI C.1* . C IT •2 • FC% a 46. Handicap Regulationsr C r •. x ^ V4) 1, - r cf ,Y m Y 427. FiE r NAi STRUQTUR5 & BUILDING :4- , 6 P ' _ 48. FINAL CL PLANNING*. F r .� '1 h ~ 49. F1ecWic Release to Olson is I t. '; r, F 50. Gas Release to Southern CalifdrhiaasCo t Cil? 4 C yf * _Si. iVIG- CERTIFICATE OF OCCUPANCY ' No. Date -47 ADDPESsoF' ILMS: 211 'E 19TH ST WIT: CITY OF COSTA MESA - BUILDING PERMIT vvUo ow...'i.L.mai p 'N: PALOMARES, FRANK PERM NO: B F075526 ADDRESS: PALOMARES, PATRICIA V 211 E 19TH ST PERMIT NO: B 075526 PLAN CHECK NO: 04929-95 A GOVT: N SUPP : N COSTA MESA,CA 92627714-642-6748 ADM..WISING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ADD ARCHITECT OR ENGINEER: DENIS LA ROCHE uCRa: C-13756 JOB DESCRIPTION : ADD 1012 SF ADDITION SQ FT : 1 , 012 AROKOR EMI ADDRESS: 361 FOREST AV uMT: 102 LAGUNA BEACH CA 92651 CLAIM VALUE: 40, 000 . 00 CALC-VALUE: 78, 834 . 80 GROUP OCC: R-3 / CONTRACTORSNA E: camuctorrs MAILING COMMENTS: RESIDENTIAL ADDITION OF 1012 SQ FT OGRESS: UC No.: **************************************** *********************iE1E1EiE1E1Ei(iE***1E1E�E*** SPIT: Z O N I N G REQUIREMENTS / "LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of penury that I am licensed under Provisions of Chapter 9 S E T B A C K S (commencing with Section 7000)d D'msun 3 d the Business end Professions Code.and my license Is in full lora and effect. CITY LIC.NO.: LIG.CLASS: LIC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dae: Contractor: LEFT: 70 FT 6 IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: 5 FT IN RGHT: 9 FT 8 IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby alarm under penally of penury that I am exempt from the Contradots License Law for the • following reason(section 7031.5 Business and Professions Code:Any city a county which requires a permit to construct,alter,improve, PARKING REQ: • ' P RO V': ,_M / PARCEL: 42540420 Z N E: R1 REF NO: Jamas h,or repel any structure.prior to its issuance.also requires the apptront for such Pena to fib a signed statement that he or she Is licensed pursuant to 1M provisions of to CaNradon Lienee Law(Chapter 9(commencing vmh Salon 7000)of Division 3 of IM PLANNING N TES>' 1 , 012 ' S F 'GROUND FLOOR ADDITION TO A SINGLE FAMILY HOUSE. Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section .,>_v - - X 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of no more dun lata hundred dollen[S5001). ****************1F*iEif•1E1EiEiE1E1EiEIE1E1FiF1ElkiklEiEIEIEIEik****1E1E1fiEIEIEiE#1tiEltifikiElElEiE1EIf1E1EiE1E**,*1E1E�EIEIE�Ei6Se* • 0 I.as owner of the properly am nrysmployeeswithwagestheisobcompensation. willdoteworkendtesnatureisnotinterded D E V E'.L O P M E. N ,- SERVICESS R E 1rf�y -U I R E M E N T' S or offered for sale(Section 7044,Business and Professions Code:The Contractors er License Law does notapply to an ownof property y,` who bolds or inproves thereon.end who does such work Newell or areal or through his or her own employee•,provided that such improvements are rot Wended or offoWloW • .O,however,IM building or improvement is sold within one dm hin r yearmpletion.tis ZONING APPROVED BY KL.7 DATE: (2- T /J owrer-0ulder will have the burden of proving he or she did not build or improve for the purpose of sale). I,as owner of the property.am exclusively contracting with licensed Conrado•to construct the project(Section 7044.Business and ' 44'-� Q Professions Code:The Comrades•License Law does not WPM m Owner d o a en Owner Property who builds pprMenemoveMenemand who BUILDING APPROVED BY. :. B e. '• DATE: 12— 7- /S contracts for such projects with a contrwors)licensed pursuant to the Contractors License w). t-25- ../- .N... . "At: ❑ fan exempt under : In ' /B.6 P. . ' ' n: APPLICATION ISSUED:BY:'L• r"' ,: ! J DATE: Fi O' S 112 +F1EltikiEiF***lkiFiEiE♦E1EiE♦EiFiE•iEMiEiEiFiEiEiFiFifiEiFi ******RFiFifiF**. iFiFiflFifiFiEiFiF****#***1F Fr I� Dale: (� '`' LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y iL Ido hereby certify that I am aware d and understand the requirements of California Health and Safely Coda Sections 25505,25533,and - j 25531,and that I or any future building occupant will/will not(circle one)need to comply wkh said data codes and ee Me requirements for �s -w a permit for canetadfon or modificationhwntheAir Quality Management Diddct.Residential oonnruuon applications are exempt from se BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE -• SMIP/RES GRADING provisions. PERMIT 545 . 00 - "+ ' r 7. 88 Date: Applicant: PLAN 88 . 56 , l SMIP/NON-RES , WORKER'S COMPENSATION DECLARATION:I hereby atrium under penally of perjury one of the followingdoduatione: ISSUE FEE .'+ o I have and wit maintain a certificate of consent to self-insure for workers'contperwatial.Id Provided for bY Settion 3700 of lho Liter BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK ' TOTAL PAID DUE Code,for the performance of to work for which this permit a Issued. ❑ willInave end maWancompensation nrce.a•reqwSection md n376eLaborCole.frtep.ama,cecite TOTALS -- > 552 . 88 0 . 00 88 . 56 641 . 44 !641 . 44 . 00 work for which this permit is issued.My workers'compensation insurance carrier and poky number are: t^ Carlen REVENUE DIVISION TOTALS--> COLLECTED: , i 0552 . 88 OVER//SHORT: . 00 Porky Number BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT•"^GRADING PLAN-CHECK (m.mak 'wed not becanganlthe perm*isfor one hundred dollars ntoolalen) 545 . 00 '' 7 . 88 • ® I cooly that in the performance of the work for which this permit Is Issued,I shell not employ any penin In any manner so as to became subject to the workers'compensation awe of California,and agree that R I should become subject to the workers' ******************************************************************************* compensation q�oQ^• nsssof Section 3700 d the Labor Cod forth h comply with those provision. I N D I V I D U A L F E E. H �R E A K D O .W N Data: laL] t Applicant ''' � ' 1 Warning:Failure to secure workers'compensation coverage la unlatch/161alaub/act an nainrPloyarrocdminl penalties and TYPE QTY DESCRIPTIO N•� ( a UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($700000),In addition twt of compensation damps as provided for In , r''• Section 37aserthe Labor Code,dntae.tand aromay'slees SFR 1012 DWE-TYPE V-WOOD FRAME A -GOOD 77 ."90 78, 834 . 80 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty Of parry that there is a construction lending agency for 0e END OF FEES =-' ,ti perfomance of the work fa which the panel is issued(Secon 3097.Cb.C). .� . . LENDER'S NAME: wj ial v L�' w' LENDER'S ADDRESS: - * Iced!that I have read Na application and state that the above intonation bcorrect.I agree to comply within city end county ordinances and state laws relating to buldist construction and hereby authorize representatives of this city to enter upon the above-mentioned property _ /(' r for inspection prnpeeea. \ . 110 r 1 i PATOU OMARES . !!! t ��'.-l•c• Pe� Dm: oC � ^ h.• f /� / til J�'4;q•. _ --, w _ A. (SIg.....`.rodOwner/Apert aContMor D \ DP!E' 1.. ,J,• ." % (5151-46.W P) f White-Building&Safely; a Green-R e:Canary-Applicant:Pink-Revenue;Goldenrod-Assessor __ _ .` 5 -r'`. - .i R . 7' 7 N. v , CONSTRUCTION AND PLANNING r, POL..•& SPA '+ APPROVALS Permit Date Inspector APPROVALS Permit Date Ilnspector. 1. Temporary Electrical Service or Pole- 52. Pool & Equipment Location ' • 2. Safi.Pipe-Undrgrnd. 53. Steel Reinforcement a 3" Electricalt_Gond,uit Utility-Undrgrnd. 54. Forms _ 1r4a lectrical'Coneluit-Undrgrnd. . -55. Electrical Bonding ' - q �5 Steel Reirtfgrcement /1-'( _.9 /Cc 'i'- 56. Rough Plumbing & Pressure Test rt8'C¢Iectricale,ER Grnd. IL-6-96- 604( 57. APPROVAL TO COVER•GUNITE _.r72-Frwiings(--1..."� gra 6,:ji. 58. Electrical Conduit-Undrgrnd. M_ a:Foundation: 49-qy CGS 59. Gas Pipe, 0 Undrgrnd.,Test Cr - '9i4WaJPr Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10?;Structural Floor System ' 61. APPROVAL TO DECK - I. ' 11?Prp*erty Sewer! Line & House Connection 62. Backwash & ReceptorFinal 12. Sewer Cap 63. Heater & Vent-Final 13. Rc6.1 Drains ' ' 64. Plumbing System - Final ' 14. Rough Plumbing tit 65. Electrical-Final • Y 15. Rough Electrical-Conduit cr 66. Solar System-Final 16. Rough El tric Wiring 67. Fencing & Access Approval - 17. Rough Wiiirit9 Sign68. APPROVED FOR PLASTERING • - 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& E.Air Conditioningy r. FLEE EFT. 1EQUI R MENT r' r..,5-g.,' d * Cl i*!' l: m r tr- 20. 'ougHFa<toryFicglace ��, t,..,r � 'APPpV�i;_ F. Petmit# m r. 21. Ductiin'Stru lures* : ' •• r^ ` ". - �a ' 70. h.�'ndergrgy l I-Ir;,dro t S ny ".r •-• C ;,:-.3' J H ;l.r . . CRucts,Vee?{t il0ngy T. - :i.,- 22. = `( c i 5rco +. �• 6 [J * • 71. Produt' ping L16as ('t1 Oil 23. Gas tApe-Rough &Test I �� m= t m Cr < Of • ' 72. Undergrodrid F',(Us'tlf' * H al 24. RooFFranlin • • FF , 7' O r'' ,_ i-+c V r 9 172:. t; ,- ,-* `. 7 Undergrrid.Storogec�ankrO Gas 0.6i1 25. Root.Shedthin * C 0 / ny 7' 6b x 9 • . l,�/i 6 � tl 74%�verc�iead HYdr�2 .i: 26. BaTCeiling (Str ral) & Aii4cV•oat j*.` t0 C, r:a rr = - - iirinini r �. r 7x;$rVtC-+heLniGal 3 27. EranlganctFlashing;w ' •-'ml h' - b Gut. 76. Dry Sta ..etbe r l T _ ea 28. Lathin &Si a cc aQ V. rec '$ 7"" F• IXED6\ T fINAL n r g 'ri'g `"'' rjGF Cl.�:� L�p � w�: Z9 �4.. � J' y I 29. Insulation'. _ d - 2_13-_R(, Lv�:• 7 F• IRE PREY. Ff r L = '' � ' 30• Drywall Nailing ;yx r, , a, 7 -Y ) 4.4..a.... SALTI1'DEPt.REtUIRfMENT k L. %31. Plaster Brown'Coatc* = 2 '- �$r-t*,- ' � t 79. FINAL I1VSPECT3DN * O 32. jectrical4$ow;r MetirCFinal ' t j7 SOy FOOD CERTIF GATE 'Saw E0. T 33. E]nal:Eleotric: •-.;f r I a; a. c Notes: '1 un * '7 0 3;m =34. FinafFHea8ngFAtt^c.onRitio iny-T• r 4 ; I -r21(_1'Cr- 5fi�, 4t6 aa,_ ca-cdee/ _ • 35. inaf Gas-Pipef]'esr,- OL .."n1 • t....7fri * "• 6 eae if 36. Hood or Canopy '- Itr '---I /.4.::/4_,20.4--z... x t • . CU 3• 8. FtnalrPlumbi * n: a t' 6:1-1.- '- a !-"' / '39. Water Service-F`,inal ;r z ��� t rrc 44 61-4/1 " 40. Gas Service-Final *. m a:t�14- * t-' '1u C ...-V A.3' ` "41. Solar DomestcFina& S .k: I lr t,., _,.c. ' Backflow4 I r f-. - .- 42. Preventer * Pa * cc JF- • r C r. 43. Backflow Irrigation ,y.� .• ,- t p�� � r . ✓ Mala 44. Landscape-IrrvgationtSystem tt(.^ X r m O a Ca ' n: c • 2 -�:d v => 4 n i7 :}. i-i ..l . C. •: T Y -- H r+x r r. -, cr LA', T• 45. Sbund A. t -ien tfation�: .-. .. .. - * i--- m m* t^ Q • i-.O 1. 46. Handicap Regulations -4 O? r Y: . r; •S C< g •r .. n * c •. * S I k* - mc0 r * V. F1NAt STRUCTUR,V & BUILDING 7:647.2.(,_,C0 4-, 474;/�j n'w i is * F -'i+ri. ' rC -1 * r. V 48. FINALPLANNING 4 1 r•'F ''• ") -I * t 7., , ti c t F j Y. 'f4-. 1, ., S • 49. Electric Release to Edison i: :.../..t.` • $. •�, ' - a 4 i. 50. Gas Release to Southern Califorwa_GasCo r ' ' ` I r, C' or i• 51. CERTIFICATE OF OCCUPANCY * "" " r' ` No. Date AOonLSOE"MWINO: 211 E 19TH ST MT: CITY OF COSTA MESA - BUILDING PERMIT ��✓ / l.'��D`" I WNE(<SNAPEtEtI0'N: PALOMARES, FRANK PERM NO: P 075524 »4DDRES PALOMARES, PATRI.CIa V 211 E 19TH ST' PERMIT NO: P 075529 PLAN CHECK NO: N GOVT; N SUPP : N 92627714-642 6748APL.MAIUNG CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ADD MCNRECTORENt9NEER: DENIS LA ROCHE LIC.NO.: C-13756 JOB DESCRIPTION : ADD 1012 SF ADDITION /PLUMBING SQ FT: ARCIL OR ENG.'S ADDRESS: 361 FOREST AV - MT: 102 LAGUNA BEACH CA 92651 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTORS NAME: CONTRACTORSMAR-IG COMMENTS : RESIDENTIAL ADDITION OF 1012 SQ FT / REF B-75526 ADDRESS: LIC.NCO *dE***9E*KiEIERbAE*****iEdE*RpiE1i**45-***iE1E*iE*iEdE*****#*dEdERb#iEiEiE*RETE*ie*IEib****ib*Rpdf*dplb*ib*1EifReiEipu* OMT: Z O N I N G REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commenting with Section 7000)of Division 3 of the Business and Profusions Code,and my license is in full lora and effect. CITY LIC.NO.: LIC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING Date: comacim FRNT: FT. IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:1 hereby affirm under penaSy of perjury that I am exempt from the Contractors license Law for the Slowing reason(Section 7031.5 Business and Profession Code:Any ciy or county which requires a pnmt to construct,avec improve, PARKING REQ: P RO V: PARCEL: 42540420 Z N E: REF NO: demolish.or repair any structure,prior to its issuance,also requires the applicant for such permit to Ab a signed statement that he or she s licensed pursuant to the provisions of the Contractors License low[Chanter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> Business and Professions Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My y vvi lation of Section > 7031.5 by any applicant for a permit subjects the applicant to aavinotpenahy of nmore thanfNe hundred dollen iERE9E9fiEgEiFikdEiEK#dEibibiFRE1ElESFiEREREdi REiERbiERElEihii REiEdEiflEiElE1E1E#E1f1E1EiE1E.N1FiE1E1ElEiE#EIEiE#[ E#iElE ipiF1E1E1f1EiEiE#iElfiklFlEiElElk a 1,asownsr of the property or myemployees with wages es their sole compensation,will do the work.eneds structure a not intended DEVELOPMENT S ER V I C E Sjc R EQUIR EMENTS ler or offeredsale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who bolds or improves thereon.and who does such work himself or herself or through he or her own employees,provided that such improvements ere not intended or altered for sale.II.however,the building or inpoement is sold wnhirione year of compson,the ZONING APPROVEDBY DATE: owner-builder will have the burden of proving he or she did nddd Wor improve Ip purpose npose of sale). I,as owner d the property,em exdusMd/contracting with licensed contractors to wit W the poled SSection 7044,Business end 1 Professions Code:The Contractors License Law does not appy to an owner of prcpeal,who builds or.tngroves thereon and atm BUILDING APPROVED BY : ----• J. DATE: contrasts for such projects with a contradorls)licensed pursuant to the Contractors License Laa, ). isv o / p arn B.A P.C., u Section: f salon: fit' APPLICATION ISSUED BY: �/ 4/ - DATE: /241-95— #SEiEiEiEREltiE*** ***RiREii*iEdEKifli**iE*ii****ii °at « q REiti9RElEdtlidEihifitLEGALIZATION:N F E E S. 0 M M A R Y STRUCTURAL SEGMENT:N do hereby cents am aware I aaware d end understand the requirements d California salt and Safety Code Sections 25505,25533,and , n / ' T' ' T) • 26534,and that I or any future building occupant.will I will not(circle one)need to comply will said mate codes end the requirements for i A apenna lemstmdionormodifiWion hanlMA. u y enpemenl Maria.RavdaniW mufrwonrnppiWiom en axrnp from these BLDG se BLDG PMT PLUMBING ELECTRIC t MECHANIC j FIRE SMIP/RES GRADING Ixe'^t PERMIT 47. 00 -- •' +4 1.-4 - ' Dpte: Applicant: 25% -• r1' _ . SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under presb & y perjuryof the one following dedarmu io : PLV, I 1\ / n ISSUE FEE 20,00 .v ` .^v. a Chave hileendwilhe ntioscnce dMwaktnvertlor nself-insure lf-insthis eifaiuued�compensation, 'uprovdedfor bySecon3700&the Labor BUILDING-DIV—> PERMIT ISSUE PLANS-CHECK A- - TOTAL PAID DUE a Ihaws and waamaintanwwFes'oompenuloninsurance.asrequuWSection the bySe3700ofthelaborCode,fortheperformanceelTOTALS -- > 47 . 00 20 . 00 0 . 00 if t' .67. 00' 67, 00 00 work for which this permit is issued.My workers'compensation insurance cancer end policy number are: Carrie: REVENUE DIVISION TOTALS--> COLLECTED': ;I ' 671: 00-COVER/SHORT: . 00 Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC ,FIRE " SMIP/TOT GRADING PLAN-CHECK This section need net be completed If the soma is for one hundred dollars/Si00)or less.) 67 . 00 - --,; A n 7 t B) I certify that in the perlomrc se of the wank for which that Peons is to ms S'ssued.I shall not empoy any personany manner ea to `r .' , _ cbecome ompany!. dto ethe workers'n3700e the laws of California. end, •. ger ',Ishould' •-• • .,.. subject to the workers. **KRE iE4**iF iE**iE IE i9IfMIf IE IE lrr lf♦E♦EKif IE**iF RE41f RE If RE*1frIF*1E*iF'dF iEdfK*IF 1(•♦E Bh'RF dF*tip dF if RE*IE dE*IEIF IE 1E RF if dE*If iF*d@1E If If dE canpnntal' prove d Section 3700 d the labor ..-'� W .. / .... ....•�; .. - ) �y o�ll ..►r -��� IND IV I D U A L' F .E E - BR E A, K D=0 W N Ode: lL I �5 Apdicant: f� i`w ; %1 Warning:Failure to secure worries'compensation coverage Is unlawful,a . `an employe to nal penalties ed TYPE QTY DESCRIPTIO NV ' In a i ' '� UNLT' COST TOTAL COST civil fines up to one hundred thousand dollars 0I04000A In addition to dna coat of compo satbry damps as provided ler In Sidon 3700 of Ma Labor Code,Interest,andatromsyi/sae. PLU 1 BATHTUB ^ -fir v 2,^ _ 7 .00 7 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm Seder penalty d Perjury that there is a construction lending agency for the PLU. 1 DISHWASHER ''1 -7 .00 '7. 00 7 . 00 pedpmance o the work for which this pmmi a issued(Section 3097.CN.C). .PLU 1 SHOWER '>. r I i f.., - '.- • 7 ,0 0 7 . 00 LENDER'S NAME: \ q 7- .il LENDER'S ADDRESS: PLU 1 SINK, BAR • \ I,,, V' 1 , ti •--7 . 00 7 , 00 PLU 1 SINK KITCHEN ;I ^ 7 .00 7 . 00 I certiythsl have read thieppiwtion and Malethm the aboveidormalion a coned.)agree locornpy with allay and oountyordinanoes PLU 1 WATER CLOSET (TOILET) 1\2 ^ •__7 .00 7. 00 arid state laws relating to Wdkg cansaud'an and hereby authorize rgxesentatiwe of the city to enter upon the above-mentioned popery > "— -5. 00 5 . 00 larinspaion purpoeea. PLU 1 VACUUM BRKR/BACKFLOW ,PyROT„ 1 efp '4 , PATOU PA OMARES END Ofi• FEES v • '� Pmt .4 . / c /7, y r\4 - ��`!'�• Osis: h1 ?/ �J .' •Y % if. -1. _. .. a'Iso a `•A -/AganW - t/Coninctor 111/// ` � if.I — (5151-46.WP) Whue-Buidig Si Safely:Green-Fle;Cenary-Appicant:Pink-Revenue:0aklenrod-Assessor -"I'v , . /CONSTRUCTION AND PLANNING >: POOL aPtiA tiiithrtOVALS Permit# Date Inspector APPROVALS Permit# Date ;Inspector _ 1:1 Temporary Electrical Service or Pole 52. Pool & Equipment Location-7, ri-Hi 2. So Pipe-Undrgrnd. • . -. 53. Steel Reinforcement ,u , <,3<bl4ctrical[Gondv it Utility-Undrgrnd. 54. Forms aI FElectricaIl06Ln-'it-Undrgrnd. 55. Electrical Bonding ' •ti.Y n aSteel Reintoeceinent 56. Rough Plumbing & Pressure Te - Test r• i --"c6'Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �! '. '.,. xr7`,Fpotings ,..-?...El!.-- 58. Electrical Conduit-Undrgrnd. 4! - rd8 �oundaticriy 59 . Gas Pipe, 0 Undrgrnd.,Test t-! N 74t:Nater Pipe-Undrgrnd. i r`• ., 60. Backwash Lines, P-Trap, CTIVodrgrnd. 10+Structural Floor System .:F , 61. APPROVAL TO DECK ,' - 11:'Property Sewed Line & House Connection . . r '62. Backwash& Receptor-Final.; i r 12. Sewer Cap r,• 63. Heater & Vent-Final 13. ROI Drains ^' - 64. Plumbing System - Final • 14. Rough Plumbing r 2_ -.S j '65. Electrical-Final 15. Rough Electrical-Conduit o~ 66. Solar System-Final ' I'' - - - - 16. Rough Eltric Wiring - 67. Fencing & Access Approval _ 17. Rough Witing Sign - 68. APPROVED FOR PLASTERING te. 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning - ,-. . .-� + .-, r,•.. x c^ O d t ' ^ F!AEH DECPT.I$EOUIREMENT _-1 �'^Lr Cr CC 20. pugiFaeor Firxp ce • Th C 4O = " * ;APPYV F;PecTmit# ,.k >i �' -.1"' � i 21. diict5,in Structure 'I• .• •• H S ) 'A: "t 70. ;t 7nderfjr'tkirid Hydro ` -_ rr -n .7> * [;i ... -)t .'1 E. U K 22. f2ucts�'-. VentilajingH, ^c * <* =3 IT' I r ' i N-, - - i--M < 71. Product-j ping L•;as 0Oil 23. Geaas Pipe-h-oug-fi & Test , . _ < Q>-; 72. Undergrd0nd Flos1 !•- 24. Rbof=Fraifning" t^* E"E 4' 0 a '; S r. n:x * > HM ' :73?. Undergrrf�.S[o;a.,gTankiLs Gas ❑Oil y V'1 j �. f t•t ,, . . } j 6 25. RoofSheIghing :El* 4, e vt C% > N_M 74v Overhead Hydra * 26. T=BarFCeilin (Struet rali & Modb�oat a: w n r t * '-' % t�•= ADDRESS OF MOM: 211 E 19TH ST ' TNT: . - CITY OF COSTA MESA - BUILDING PERMIT • OWNER'S NAME IF KNOWN: PALOMARES, FRANK PERM NO: M 075531 k t• N*REss, PALOMARES, PATRICIa V 211 E 19TH ST - - PERMIT NO: M 075531 PLAN CHECK NO: N GOVT: N SUPP: N COSArA MESA,CA 92627714-642-6748 APDL.MAUNO ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: ADD ARCNRECTORENrmEEB: DENIS LA ROCHE ULNO.: C-13756 JOB DESCRIPTION : ADD 1012 SF ADDITION /MECHANICAL SQ FT: AMR.ORENG'S ADDRESS: 361 FOREST AV UMT: 102 LAGUNA BEACH CA 92651 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / CONTRACTORS NAME CCHTRACTORSIIIMNO SQ k** *S*** ADDRESS: uCNo. r1EfF* EEfE* * E*** *** * FtiRi * E* r« EEf*** EFEBFfFfEFEE****** f# FFEEEf* f*+ (NT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Nim under penalty o perjury Net I am licensed under provisions o Chaster 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business end Professions Code,and my frarse is in IN forte and Ned. CITY LIC.NO.: LIC.CLASS: LIC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dae: Contractor: - LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt from the Comrmod License Law for the followkg reason(Swam 7C0t.5 Busies,and Professions Code:Any city or county which requires a penny to contend.alter,improve, PARKING REQ: PROV: PARCEL: 42540420 ZNE: REF NO: demolish.or raper any eoucture,prior toes issuance.ebo require*the applicant for such perm to fife a signed statement that hem she is licensed pursuant to the provisions d the Contractors License Law[Charter 9(commenting with Section 7000)d Division 3 of the ,.P LAV NK I NG NOTES> Business and Professions Code]or that he or she b exempt therefrom and the lam for the alleged exemption.My violation of Section it r' > 7031.5 by anyappbwnotn afor a permit subjects the applicant to a civil penalty of nmothan foe hundred dollen I 0OD. `***********************************dE*.iF,***************************************** e*°�d�eprees or m�dt� TOceowths esand Swam a"r°nded � DEVELOPMENT S E R+VI C E S R E Q U I R E MENTS«offered for we(S044,Broes anProessoMVOS ns Code:Tne C«u Ue*Law dnot apply too en Omer of progeny • who builds or inprwe*thereon.end who does cud,work tinsel or hand or through his or her own employees.provided That such . v - tnpmw vemee an rid intended or ollred Ian sale.O.however.the building ingimemerd is sad withinone year d W compon,uw •ZONING APPROVED BY _ DATE: owdee wit havewiden a the den proving he or she didr riot build improve forupr the Duman d sale). 6 I.as owner of the progeny.am exclusively contracry with licensed contractors to construct the Paled(Sec( 7014.Business and Pweaabne coda:Tie codradde Licen a Law does not apply b en owner d property who vias d hnprove thereon and who 'IB U I LD I NGk APPROVED B Y : � DATE: �/y[•� 4( contractst b ashwide Sect with a contractor(*)licensed pursuant to IM Contractors Bowe toy. r __ _1F 1F_ / iF iE 0 Iemaempuadr5rvoo: B.AP.D.,fo RAPPLICATION ISSUED BY: DATE: Z ************************************************ ************* ** **** D"°' IZI RqS Owner: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby wily NJ I am aware d W understand IM requirement d California Heath and Safety Code Sections 25505.25.533.and A 1- ' .s. ,.. "Crr- 1 s 45536,and dWlorryhadaftidmp¢aheAiri rangit not ecbme)seedromntlywahsaidoweoodardtMrpuiremenNese BLDG PMT PLUMBING ELECTRIC - MECHANIC ': " FIRE SMIP/RES GRADING a pans lda WI or any Uwe eWiliin from theAr3wTy Management District.Residential construction eppire ends exempt Irons these provisions. PERMIT " 111 . 00•- Date: Appraa: v25% _. SMIP/NON-RES WORKERS COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of d the following daatons: PLAN . : o (have ands maintana certificated mmfan M consent workrs'compesdbn•=provided for by Section 3700o the Lobar IUFEE 15 .0A Code.Irtepanrw ooeof the wrkfrpermit BUILE LDING-DIV-> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE o Ihave and wlmaidd:awrkr.'mwnsationisurance.aSection TOTALS----> 11 . 00 15 .00 0 . 00 26:00 26 . 00 . 00 work for which this puma is issued.My workers'compensation insurance carrier and policy number re: n Carrera REVENUE DIVISION TOTALS--> COLLECTED: .. " '26'.00 OVER/SHORT: . 00 PoicyNpmber: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE' ' SMIP/TOT GRADING PLAN-CHECK Tis swim need not be completed I the permit b fro one hundred dollars(31001 r Am.) 26-.00 .- r ® I ow*that'n the performance el the work for which this permu Mai not b issued,I Mai ampler any person in ammannerrymannerso as to ,f .tom r ' become sublet to the wvdrrs'mrpesabn laws o California.and agree gut i I should become styled to the workers' ******************************************IE************************************ \ ' mnpw^�aton provisions of Section 3700 of the Labor Code MN campy with Sae P :stn.. INDIVIDUAL F 'E E r //H R ^E A K D O W N /`(. bets: ,2 1 "' ` 1 / Applicant: ' Warning:Failure to secure waiters'compensation coverage Is rmbrvhlL eyaetN employer rocriminal penalties and TYPE QTY DESCRIPTION . - UNIT COST TOTAL COST civil Nes W to one hundred thousand dollars(3I00,000),hi Often to the coat of compensation,damages as provided for In - s.cdomalapfNab etorCo6.InMasLand atbmey'5foe*. MEC 1 FACTORY FIREPLACE -T 6 . 50 6 . 50 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty d perjury that then is a construction lensing agency for IM MEC 1 VENTILATION FAN CONN TO SINGLE DUCT -' 4 . 50 4 . 50 performance o the work for which this permit is issued(Section 3097,Cb.C). END '.OF FEES , LENDERS NAME: LENDER'S ADDRESS: 1- h "il i y' . I comfy that I her read this applcaton and mw that the above Information is cooed.I agree to comply with all city and county ordinance. -. aryl state fern relating to buddies construction and hereby authorize representatives of this dry to enter upon the abort-mentioned property ,n —• for inspection purposes. \rrJJi pnatuAp �PATOU PALOMARES 1Vk �- r .7. ,.:. • .' '. .1, C TC T Ped '1 Sn :Met `� \UNs: 1�"\ ILL GJ a 4: ,L' 1 7. . . 7?C: :tL r (5151e8.WP) Whin-Buldip 8 Safety:Green-Fle:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor :CONSTRUCTION AND PLANNING '< POOL, .8A Li ' f4. Date Inspector Date 6nsnector , 'ArrROVALS Permit# APPROVALS Permit# cc C tTemporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement • 3. Electrical[Ggnduit Utility-Undrgrnd. 54. Forms d - -4 Electrical,onduit -Undrgrnd. 55. Electrical Bonding - „6`.`'Steel Reinforcement 56. Rough Plumbing & Pressure Test cr -4,:`-3,1/21ectricaL.t.ThWR Grnd. 57. APPROVAL TO COVE R-GUNITE 7 F ' in s`er`fr_ 58. Electrical Conduit-Undrgrnd. .H - -8:-Fpundatitme: 59. Gas Pipe, 0 Undrgrnd.,Test Cr 971Wajer Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10:-Structural Floor System 61. APPROVAL TO DECK 11?Preperty Sewer Line & House Connection • 62. Backwash & Receptor-Final- - 12. Sevier Cap 63. Heater & Vent-Final 13. Reif Drains - - 64. Plumbing System - Final _ 14. Rough Plumbing r 65. Electrical-Final r 15. Rough Electrical-Conduit 66. Solar System-Final ' 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Mig Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heatingg & Air Conditioning 4� F''{{t,gF (nSEPT. ppEQUI MENT t._ 20. !Judi FQtor Fi-'4face 1 -.rr7 t'' t?'APPrOV 2.O Pjr it # " Y r:rt X -. ! tr aW R .x .: -< Fr: ,; 21. Ducts•in5trtl&uralt: 1 ••• •• •✓S . /.i�- O r-+* �' 70. nder rm I }-dro ,,` 22. Dlics,VAhtild n9I�* 0� �"3 - � 'n t 71. ProdutsJping LJasl Oil 23. Gas Ripe-Rough & Test t+:S * M 7 C C 4' -+ 72. Undergr thrl Fj$ '' H r •-tife t • m tr :+- r 17 C t r1 i---iv 'K >. ;+;r 1 I.-1 ..H "' > O gr: ''r '-: F 24. Roof Fran-.lring" ��a r * ,--,� "': 73; Undergrnd.Sto�2r TankrO Gas ❑Oil Y. Y.• - ,.. ;1 O -J- s t7 v i .: -$ 25. Roo Sheathing O; < v V* t7 > [L* 74? Overhead Hydra _ i t- r::s t� tti rn n t 77- ,. 26. BarCeiling (StrtctJsral) & ftTPu'inctoat coco0 r'* 7� DryChe Ical �� ` T2,:tt 27. Fran and;Flashing i c .. t C i s 76. Dry Starslpipe• H w ' ^. F'F- 28. Laihn XSitlin �* :-- •-•,-4:: n = "' * ` G - _, 9 9 ¢* Or>;H C, * , I> 7'�j-.� fIXEDS,`€STEtV[FINAl .- y� '29. Insulation: O . S -• 1 6. 7 FIRE PREY. F1((pL J, = S r' r n 30. Drywall Nailing •-, F, * ALT DEPL tEQU1REMENT c., .�F . a • 1-' t C t c'.- -.3- 1. Plaster Brown-Coat '7. ' "r + I ilt r 79. FINAL rN PEC-NON t - l 32. EiectricaLEo der A L rtP al fi co * r) 80FOOD CERTIF`1c5ATE IztS,dED_. , -33. jnahEleetric . r. C - . 1 * i" Notes: '7:+: +"7 0 Str. 34. FinaRHe mg l Atr+conditiorfing s r' '7/ �` [�.^;c. *. = r�C 4. tes "Fr 35. FInat Gas'Piptlres�y� C,� .. < 1-; ' I rp xp Y > r E _ `2 `Sr-�_6 n Dyt�Sf, LJ 6� ^ M£sYf7 IL 36. Hood'or elaano `- 1 trlr] 4 * r) 't ` t n0 3-_>.:_,�� Htr' c^ n r* rl 1 a;cn ' I f `, 4'K eT•�r' x, .`%t e9 S vs L-S-. . : xH stn w <. r. -,�. . 37. Final Ea44ry Fireplace r, : F-•t• 4 x 's + � c �- ro -138. Final-`Plumbing rr t et * ` n 1.-i1.-irxt to k I L(5--.77 ..- (- ) - SLg.';CSc_Y t • 39. WaterSer"ce-Fin4`". S t * c: 1 1: �. iI- E.SVE L-: r164.� NOS!T $Uuft_Q� r 0 - ='40. Gas Service-Final to.r rn rr' S t' r4 ^ C ` F * - OWNER FQpV%SrE6 4T0 Rhc ,EST 1ASPEc77 41 .. . -a-- LL 41. Solar Domestic-Fi tt " -r: -c , *-io rr- * r. D 'nS ^, 42. Backflow Preventer. n. * ix, 0. .t r t 0 1---•- •4.1r-.r1--f - 4 :-.1 l':::: 1 _ C- 43. Backf low Irrigation .�• a • • -1 4 . Q * t) 44. Landscape;Irripatiorii System It-i r7: 51 ri r; r: r� r: x i• I r� CO oras: tr rC dao 2, z O' •#' S F r. H.^.,i-- Cr k `2. F t-r HY C: 1-i45. Sound Atten`R,tion* hi '- -- i' m tr)* :•. ,+ Cr r; • Ht: 1 + t: 46. Handicap Regulations 1-4 C, * d c: M _ - _ g .. _ ' lit rr: O .. 47. SINAL STRUCTURE & BUILDING r i- ' I- rt, -t '-• .. - c: .t r^ - * f. 48. FINAL PLANNING . . t-•:- t - - ' 1" b r :- d * H - * - •-r T. r , • . , cc c. - C 49. ETectrrc Relea(ee to Edison 1 * - 50. Gas Release to Southern California-Gas Co * ,* E. " :J ; u r ,' C • - r a r * :1 • 7....- 51. 51. CERTIFICATE OF OCCUPANCY * cm, ' ' NoDate , Costa Mesa Building Department PLICATION FOR PERMIT 111 EAST 20th TREET COSTA MESA, CALIFORNIA 20 BUILDING 1 FOR OFFICE USE ONLY FOR Buildin �IAPPLICANT TO FILL IN -Receipt No. Permit No. Address SC ,1 (O e / Th. 5teec r I Ace 6 Recely by Date Recd. Date Issued Costa Mesa, California f / J � [ Nearest /}� [' n F �0- 2 c.1- -CS / Q�� "1 S Cross St. Bung) 476° Address Owner % t, 5. R,e,G!` "l`'/eRfkY Costa Mesa, California Mail Address .. /I 1, /, Z$ drfeFP r Nearest , ,�`` Tel. . Cross St. City Arsr' a - No. A- , .. Q. 0 Zone, I No.of I Type ,V/ I Group 7 Architect or tic. ((11 Plans Engineer No. Approved by Date address _ CORRECTIONS City Lic Jntractor�,�Q/35�,e RQS, No. (5(' QC'b Address / ' innve�-°C//Jb th4 k..2 LegalLot Description I No. I Block I Tract � /� � a � (Attach Metes and Bounds) ' t No.of BldgOCT � Size of Lot I s (.1ow on Lot 9 _ Use of I No.of I No.of - 1 U A ..Existing Bldg. Families Rooms Setback Line from Rear Yard a Center of Street Side Yard DESCRIPTION OF WORK OF CUSjA D MESA r1 i New I I Alteration I I Addition I Repair I I Moving I I Demolish I Building No.of Size Rooms Stories I `erior Wall Roof iering Covering ✓ APPROVALS Use of New Building Foundation Location Inspector Date Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext with all City Ordinances and State Laws regulating building construction. Signature of Plaster,Int Permittee Plaster,Ext Authorized Agt. Masonry Reinforced Valuation Permit Fee $ Plan Check $ _Bond Beam $ /42-C1 Do Total 00Fee $ , a — FINAL FORM 204 0-H 2M 5-54 0 • • • J Y Q o s. • •a 1 � •"y a COSTA ,,�, . ;, • ncT 214- 5P�dtS'a ao7 �•..;r . 2.�0 • i 1r \ � i 1 . ..y. I y 1. . _.. • Street C . •-1 - - I ),• . I . . PLOT PLAN Show location and distances from , property line and between buildings. • . I . I I r