HomeMy WebLinkAbout255 19TH ST - Building Permits 41.1• CITY OF COSTA MESA
F BUILDING DIVISION
‘14¢ ,; 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us
v. FOR INSPECTIONS CALL: (714)754-5626
PERMIT NUMBER: B09-00102
PERMIT TYPE B_ROOF2 STATUS: ISSUED
APN: 11721420 DATE ISSUED: 06/15/2009
ISSUED BY: RMD
JOB ADDRESS: 255 E 19TH ST CM Suite/Unit:
Vicinity: HOUSE AND GARAGE ROOF
Squares: 2500 Valuation: $6,500.00
SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS,INSTALL 1 LAYER OF 304$FELT ON A 4:12 PITCHED ROOF AND REROOF
WITH 50 YEAR COMP SHINGLES ON A DETACHED HOSUE AND GARAGE,APPROX 25 SQUARES. REROOF OF HOUSE
AND GARAGE TO BE DONE CONCURRENTLY. REPAIR AND REPLACE SHEATHING AS NEEDED.
OWNER: YANAGA, RANDALL KEN TR Address: 255 E 19TH ST Unit:
PHONE: City/State/Zip: COSTA MESA,CA
APPLICANT: JONES. JAY Address: 220 VICTORIA PL Unit: :UNITA
PHONE: 949-650-1200 City/State/Zip: COSTA MESA,CA
CONTRACTOR: ARIES ROOFING COMPANY License No. 868990
Address: 220 VICTORIA PLUn it: - UNITA - PHONE: 949-548-2056
City/State/Zip: COSTA MESA,CA 92626 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $139.25
Reinspection Fee: $0.00
.Bldg Std Admin Fund $1.00
TOTAL FEES $140.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations.(Ord.No.92-28,§ 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal. such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE/ INSPECTION TYPE pp9E INTMAL$ CODESINSPE ON�F INTm4L$
1816 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 9208 Final Plumbing
200 Final Re-Roof L 210 Final Electrical
201 Final Block/Retaining Wall • 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS'COMPENSATION DECIARATIO : . Owner ID verified by driver's license. 0 Yes 0 No
I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires:
O I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed):
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the work for which this permit is issued.
O I have and will maintain workers'compensation insurance,as required by DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
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 ❑ I hereby certify that no excavation five(5)or more feet in depth into which a
number are: person is required to descend,will be made in connection with work authorized
Carrier: /
�� C6.-11-0 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
(This section needenornorbebecompletes,dthe permit is valued at one hundred dollars(SI 00)or less) 2 Arta Sec.341,Title B,California Administrative Code).
Policy Number: L(} fJ 8y/xll
0 As owner-builder, I will not employ anyone to do work which would
O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless
issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division.
to the workers' compensation laws of California, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date
e Labor Code.I shall forthwith comply with these provisions.
jt
.
/� y ' / �/l Division of Industrial Safety Permit Number:
�y ' c.- •ml's Signawr DDDaa�flle/ � HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 Yes ❑No
($100,000). IN ADDITION TO THE COST OF COMPENSATION.DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some i
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST. AND exceptions, that a Business Plan be fled with the Costa Mesa Fire
ATTORNEY'S FEES. 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
LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons,or 200 cubic feet of compressed gas
I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure).
with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file
my license is in full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No
n i
6ic.-# '52A87,110 Class# Com"" (Section 25533 of the California Health and Safety Code, with some
/AJ exceptions, requires registration with the Costa Mesa Fire Department by
d
/G- 4-Oy//� each business which at any one time has on hand a quantity of acutely
rContrsc gnature [JJ Date 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
STRUCTION LENDING AGENCY: temperature and pressure).
❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to
performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely
Lender's Name: hazardous materials)? 0 Yes 0 No
(Section 25534 of the California Health and Safety Code provides that the
Lender's Address: 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.
Signature Date 4. If an RMPP is presently required, has Section 25534 of the California
OWNER-BUILDER DECLARATIONS: Health and Safely Code been fully complied with? 0 Yes 0 No
I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction
Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from
construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No
issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Government Code requires that the requested
that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits).
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 6. Will any part of the facility to be constructed under this permit be within
the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No
applicant for a permit subjects the applicant to a civil penalty of not more than (If yes',the facility must meet the requirement of Sections 25534 and 42303
five hundred dollars($500).): of the California Health and Safety Code).
❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other
compensation. WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the
offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California
License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No
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 8. (If"yes", attach certificate of compliance from the appropriate air pollution
sale. If, however, the building or improvement is sold within one year of control officer).
completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and
❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions.
LICENSED CONTRACTORS to construct the project(Sec.7044.Business and
Professions Code: The contractors License Law does not apply to an owner of Signature Date
property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that
❑ am exempt under sec. the information given is.correct. I agree to comply with all state laws and city
ordinances relating'to building construction, and authorize representatives of
Business and Professions Code for this reason: 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//o off Legal ggqyyynnner(s) Date
Signature Date //• �+•• - /O//�/moi'
3057.46(3/07) Andlor Auth Applicant r Date -
T UNIT:
PROP,r,T ADDRESS: 255 E 19TH ST CITY OF COSTA MESA - BUILDING PERMIT /PERM NO: P 068852
OwNER'S NAME: yANAGA RANDALL KEN '-TR-
ADDREss: 255 E 19TH ST PERMIT NO; P 068852 PLAN CHECK NO; N GOVT; N SUPP: N
COSTA MESA/CA 52627
CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE; ADD
642-7352
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD 475SF DEN SQ FT:
ADDRESS: UNIT:
CLAIM VALUE; CALC-VALUE: GROUP OCC ; R-3 /
PERMITTEE: RANDALL KEN YANAGA ( 714 ) 642-7352
ADDRESS: 255 E 19TH ST COMMENTS : REF: H-68849
C .M, CA 92627 **** -+trr-+t**dt*********w+ra.*+rr**can*ar•-u+Fyn*a.**********ar**+t***r+e+Fv*******.t<dr**as*.F ****1F-tE*
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS
CITY LIC.: STATE LIC.: CLASS: EXP:
Date: signature: MAIN BUILDING ACCESSORY BUILDING
•
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR ; FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.of a certified copy thereof(Section 3800.Lab,C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL : 11721420 ZNE; REF NO:
') Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES>
Date: Applicant: DEVELOPMENT S E R V I C E S .- R E U I R E M E N T S
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). Q
I certify 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 Compensation Laws of California. ZONING APPROVED BY ; L,t ' DATE;
Date: Signature: BUILDING APPROVED BY D
NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor Y
-1 DATE:
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. iICONSTRUCTION LENDING AGENCY: Ihereby affirm that there is a construction lending agency for the pertormance of the work for APP LI CATION ISSUED- ; r /7 DATE;
which this permit is issued(Section 3097.Civ.Cr. ********w************************************#*********************************
LENDER: *********1f******************************-** *** ********************************
ADDRESS: LEGALIZATION';'N F E E S U MSM A R Y STRUCTURAL SEGMENT:N
. . 7,
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING- ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% r ` `./
pursuant to the provisions al the Contractors'Slate License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business - SMIP/NON-RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN f '
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 2 0 „0 0 ' t;
• I. as owner of the property or myemployees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE ' PLAN-CHECK -TOTAL PAID DUE
❑ structure is not intended or offered for ale(Section 7044,Business and Professional Code: The Contractors'State License Law
TOTALS----> 33 . 00 2 0e, 00 :`, 1 0100 i 53 . 00 53 , 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through •'
his or her own employees,provided that such improvements are not intended or offered for sale. If,however the building or REVENUE DIVISION TOTALS--> ,., -r. COLLECTED': <53 . 00 OVER/SHORT
00
improvement osesfls le)hin one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC .MECHANIC FIRE' SMIP/TOT GRADING PLAN—CHECK
tor me purpose of sale).
nI,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 53 ' 0 D -
LJ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon - ''- ,'
and who Contracts tar such projects with acontractor(s)license pursuant to the Contractors'State License Law). l am aware ********'**********'******'**'!F'�f***************>**************an********************
that proof or their Worker's Compensation insurance should be provided to me. /
D I V I- D U A L -F<E E) : B'R fE A K D OWN
o I am exempt under Section: B.8 P.C. " ',a "n NI
tor this reason: TYPE QTY DESCR I 'P .T S O. N ., r '1 UNIT COST TOTAL COST
I Date: Owner: PLU 1 SHOWER [ . / l , / 7 . 00 7, 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and P LU 1 WASH BASIN , . i ./ 7 . 00 7 , 00
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU • 1 WATER CLOSET ( TOILET) : '-[ 7 . 00 7 , 00
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ,f' I
PLU 1 WATER HEATER .AND'/OR VENT 7 , 00 7, 00
these provisions. PLU 1 GAS PIPING'[SYS . ,OF 1 TO 4 OUTLETS' 5 . 00 5 . 00
Date: Applicant: END 'OF FEES ,
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned -�
property or inspection purposes. 0
Date: Signature: C • ,
1
Yr Driver's License or Social Security•: x '
1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor 1 ,."'
CONSTRUCTION AND PLANNING POO WA
1 ' APPROVALS Permit# Date Inspector APPROVALS 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 Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing& Pressure Test
6.' Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
•
j'0, Structural Floor System 61. APPROVAL TO DECK
111. Property 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. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating - 71. Product-Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test
E-21:1-c$ �f 72. Underground Flush
24. Roof Framing H, Undergrnd.Storage Tank OGas ❑Oil
25. Roof Sheathing •
,P74. Overhead Hydro
26. T-bar Ceiling (Structura ) & Monocoat . 75. Dry Chemical
27. Frame and Flashing •
76. Dry Standpipe
28. Lathing& Siding -- 77. FIXED SYSTEM FINAL
29. Insulation 4 78. FIRE PREEV'.,FFIINAL
30. Drywall Nailing �. _ l Z l S / d5T2:�a" -,'�-F _ '. j/'��
31. Plaster Brown Coat V i 791 E'� ;5)~EC�J rl /fie `41°)1).l
32. Electrical Power Meter-Final 80 EDI.9 @- &lilyI cistEer I keit _
•
33. Final Electric Ac03 QS I.�'b7 as.-r. ( {34. Final Heating & Air Conditioning � N, r-` _.qr-- � , 1�1�1J!
35. Final Gas Pipe-Test Aki
›*1--
36. Hood or Canopy Err*
37. ,Final Factory Fireplace
38. Final Plumbing /7 AL � )Z /2 -95-5 NO q4C/ 35 yr-f_i arb_/0
39. Water Service-Final
40. Gas Service-Final . -
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System •
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING .
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
J ,
-Q011,--Pir3ALi,TADDRESS: 255 E 19TH ST 0NR: CITY OF COSTA MESA — BUILDING PERMIT iTP
OWNER'S NAME: YANAGA, RANDALL KEN TR , \ERM NO: E 06885C
ADDRESS: 255 E 19TH ST PERMIT NO: E 068850 PLAN CHECK NO: N '
COSTA MESA, CA 92627 • DVT : N SUPP : N
CONSTRUCTION TYPE: PERMIT TYPE: ELE
642-7352 PURPOSE: ADD
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : ADD 475SF DEN
ADDRESS: UNIT: SQ FT:,
• 1 .
PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC : ia_3 /
RANDALL KEN YANAGA ( 714 ) 642-7352
ADDRESS: 255 E 19TH ST COMMENTS: REF: B-68849 .
C.M. CA 92627 ******+e** ** IF***Ir*IE**tE+E**+r*+F+rah+e***Itce******Irl **IE****eFlr*Ntt+t***Ir*****IE*** *+E*tE**x
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NO R EQUIREMENTS
7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E TB ACK S
\
CITY LIC.: STATE LIC.: CLASS: EXP:
Date: Signature: _ MAIN BUILDING ACCESSORY BUILDING ---- -
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR• FT r_
Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT, - IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ• PROV: PARCEL : 11721420 ZNE: REF NO:
1 Certified copy is hereby furnished. ❑ Certified copy is tiled with the city Building Division. PLANNING NOTES>
>
Date: . Applicant: ********iFiElelE****iEiE1E#iE1EiEiEiEiE9E1e1elElEiliEjF7EiEie#iE1F'1EiE1EiEaF)flEielEiE#****iF#lkikiEi4jkie)EiEiEiE****ie****ie1E#
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V EL OP MEN T S ER V IC ES REQUIREMEN TS
I certify 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
^..ec to t�hxew kers'CompensationpeLaws of California. (� / ,/ �/� ZONING APPROVED BY
'bate i � /x-T Signature: Ra,441eil tea._ / - �L. DATE:
NOTICE:1111111.alter making this declaration,you should become subject to the Workers'Compensatiol4 ivisions .. e Labor BUILDING APPROVED BY : DAT E*DATE:*
*******
Code.you must lorthwnh comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: jF .- 1
which this permit is issued(Section 3097,Civ.C). ****************************#****** ********************** * >� rE * *
LENDER: ********************************************************************* *********
ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 35 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 102 SM I P/NON—RES
and Professions Code)on that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 15 .00
I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S————> 35 . 00 15 . 00 0 . 00 50 . 00 50 . 00 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/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 will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 50 . 00 OVER/SHORT : 00
for the purpose of sate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 50 , 00
LK and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).f am aware *********************************+x.******.*************..K.*.K.*.*.**,**,**.***.*,*****,***,***
that proof of their Worker's Compensation insurance should be provided to me. IND I V ID UAL F E E BREAKDOWN
❑ I am exempt under Section: B.8 P.C.
orthis reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
ate' 1/1 V14 Owner Pa•Plidarai e4.41.
� i. ELE 7 FIXTURES LIGHTING 1 ST 20 EA. . 75 5 . 25
do hereby certify that l am aware of and understand the requirements of California Health and Safety Code Sect n 25505. ,and ELE 14 R EC E P T/OCI TL E T 1 ST 20 EA, . 75 10. 50
25534 and that I or any future building occupant will/will not(circle one)need to comply with said stale codes an a requirements lora ELE 7 REC EPT/SW Z TCH 1 ST 2 0 EA, ,7 S
permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from 5 . 25
these provisions. ELE 1 SUB—PANEL111 . 00
1 . 00
ELE 1 MOTOR/POWR APPARATUS 0 , 0 — 1 . 0 HP 3 .00
Date: Applicant: END OF FEES
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned
property torr+inspection purposes.pQQ,,s� � // 01 00167650-00167650 TOT 50.00
ate 1/I3/'J•¢ Signature' 1e4ts'L!/ / 4 ' /. id_54 DATE: 09/133/94 TIME: 11:06
DO is License or Social Security a: (J
1641.46 White—Bulyding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
�� -•� '^� POO ;PA
//-
CONSTRUCTION PLANNING / /
• APPROVALS Permit# Date ' Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
1 "
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
1. Electrical Conduit Utility-Undrgrnd. 54. Forms ,_ i ..
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9, Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd.
10. Structural Floor System • 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
f
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 24/t /AK 67. Fencing & Access Approval
17. Rough Wiring Sign '"" 68. APPROVED FOR PLASTERING .-
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
I 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS • Permit # -
21. Ducts,in Structure - 70. Underground Hydro
22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 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. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ( 79. FINAL INSPECTION
32. Electrical.Power Meter-Final / 80. FOOD CERTIFICATE ISSUED
33. Final Electric J'Z/`t/ � Notes:
34. Final Heating& Air Conditioning I r
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final 1/4
42. Backflow Preventer r4
•
,43. Backflow Irrigation
Landscape Irrigation System •
45. Soi.nd Attenuation
46. Handic2',Regulatioris
1 47. FINAL STRUZTURE & BUILDING •
48. FINAL PLANNIN'\ ' 1/4
�--'
49. Electric Release to Edison`• i
50. Gas Release to Southern Californiaa 5 ° 1 ,
51. CERTIFICATE OF OCCUPANCY v
No. Date
C
)DREs : 255 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 068849
NAME: YANAGA RANDALL KEN TR
'rS5'e255 E (19TH ST PERMIT NO; B 068849 PLAN CHECK NO: 0293.3-94 L GOVT; N SUPP: N
COSTA MESA, CA 92627
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: ADD
642-7352
CH/ENGINEER: REG.NO.: JOB DESCRIPTION ADD 475SF DEN SQ FT; 475
ADDRESS: UNIT:
CLAIM VALUE: 30, 000 . 00 CALL—VALUE; 35, 150 .00 GROUP OCC: R-3 /
PERMITTEE: RANDALL KEN YANAGA ( 714 ) 642-7352
ADDRESS: 255 E 19TH ET COMMENTS : X
C .M. CA 92627 *************�E+ **********te*** **************xT6** yHXF**�E******************tc**�E�F**
LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my-license is in lull force and effect. SETBACKS
CITY LIC.: STATE LIC.: CLASS: EXP :
Date: Signature: ' MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: 46 FT IN FRNT; FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: 5 FT IN RGHT: 28 FT IN LEFT: FT IN RGHT: FT IN
POLICY NO.: EXP.DATE:
COMPANY: . PARKING REQ: PROV: PARCEL ; 11721420 ZNE: R1 REF NO
❑ Cenified copy is hereby furnished. 0 Certified copy is.filed with the city Building Division. PLANNING NOTES> THREE ROOM' ADDITION TO REAR OF HOUSE TOTALING 475 5 . F 1
> .
Date: 'Appl-Fenl: j *******************************************************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred $100)or less). D E V E L O P M E N T S E R V I C E S REQUIREMENTS
I ce ' : 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 W
' to eW.rkers'Compensation Laws of California, '`/ ZONING APPROVED BY- 5K DATE: -. g1�.fl
I Dale' a 4�: Signature: YI/�/L///of ' `e-4,- C /
NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation pros of the Sr BUILDING APP ROVED BY , Ut4 R DATE: e Mq
Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. , �^ /-/� . y
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; C.. S DATE : /
IMF
which this permit (Section 3097.Civ.-C). SMOKE
iv.D). SMOKE DETECTOR ********************************************************************* ****** *
ADDRESS: REQUIRED LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for thelnllawing reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 323 . 50
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 3 . 52
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 210 . 28
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE _
•
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DI V—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 327 , 02 0 . 00 ' 210 , 28 537 . 30 537 . 30 , 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himsell/herself or through
his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 327, 02 • OVER/SHORT• 00
improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve
for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 323 , 50 •
3 :52
La and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).lam aware *************************************Se*****************************************
that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E .E BREAKDOWN
❑ I area exempt under Section: B.F.P.C.
- this reason: � �,/p� �p� TYPE QTY DESCRIPTIO N' UNIT COST TOTAL COST
fate Owner: "j�" "' i 4 SFR 475 DWE—TYPE V—WOOD FRAME —GOOD 74 . 00 35, 150 . 00
I d. ereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 2 25533. nd END OF FEES
• 534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from ,
these provisions.
y r : .
Date: Applicant: ( .
I hereby certify that I have read this application and slate that the above information is correct.I agree to comply with all only and county s' I 0.1 00f d765,d-007d76s2 T G'i T
ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned 327.02
p eny rinspectionpurpoosess. �,, J_ {� �� �,(�+��� DATE: 09/13/94 TIME: 11:06
Dale' 141 a/"!T Signature) gardei// /-2/ti :f"---1� ,
river's License or Social Security a: U
1641-46 While—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor
M,
.:TION AND PLANNING .' POOL PA
-.vALS
Permit Dates inspector APPROVALS Permit • Date inspector
-
,. .,nporary Electrical Service or Pole - 52. Pool & Equipment Location
t ,
21 Soil Pipe-Undrgrnd. 53. Steel Reinforcement
•
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms •
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement l2-lq-qv baa( 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. /2I /0 �t �w� 57. APPROVAL TO COVER-GUNITE
ri
7. Footings • j e. p 'Art 58. Electrical Conduit-Undrgrnd.
8. Foundation C($ r ry 6r-1-1, q/- q 4ct. 59. Gas Pipe, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd, , ,, 60. Backwash Lines,P-Trap,0 Undrgrnd. 1
10. Structural Floor System 61. APPROVAL TO DECK
i
11. Property Sewer Line & House Connection .52. Backwash & Receptor-Final •
12. Sewer Cap - 161. Heater & Vent-Final
13. Roof Drains ;64. Plumbing System - Final .
14. Rough Numbing t 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. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory FireplaceAPPROVALS Permit#
21. Ducts, in Structure 70, Underground•Hydro
22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. -Root Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing /' ,C1_ ?S a(tit/ 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat l 75. Dry Chemical
27. Frame and Flashing 3--13.-1 6J.t/a 76. Dry Standpipe
28. Lathing& SidingI 119( 1 jL/ 77. FIXED SYSTEM FINAL
29. Insulation . 3L(3'95 (jtv'►d 78. FIRE PREV. FINAL
30, Drywall Nailing • L(.13s4S 6(.r..L- HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat z_$-15 6444- 79. FINAL INSPECTION
32. Electrical Power Meter-Final ` 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: ,
34. Final Heating & Air Conditioning .. -r (a-lc-1g- F-4.5 pet 1.
35. Final Gas Pipe-Test -. ' &�
36. Hood or Canopy (-[-N--4/5"--- o4 -_
37, Final Factory Fireplace /' 1.4.----
38. Final Plumbing
39. Water Service-Final \
40. Gas Service-Final
41. Solar Domestic-Final /2-Z1_Gl�_ / , `e
42. Backflow Preventer (2-21'12--
e /. sv
43. Backflow Irrigation Al CQ N
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47, FINAL STRUCTURE & BUI LDING l �Ci£72._Z '
48. FINAL PLANNING / _.
49. Electric Release to Edison
-.50. Gas Release to Southern California Gas Co
r
51. CERTIFICATE OF OCCUPANCY /-- -- Th.
No. Date
t
PROJECT ADDRESS: 255 E 19TH ST UN1T: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 068851
OWNER'S NAME: YANAGA RANDALL KEN TR
ADDRESS: 255 E YANAGA,
ST 'ib' . PERMIT NO: M 068851 PLAN CHECK NO: N GOVT; N SUPP: N
COSTA MESA, CA 92627 J
CONSTRUCTION TYPE; PERMIT TYPE: MEC ` PURPOSE: ADD
642-7352 flEG.NO.:
ARCH/ENGINEER: JOB DESCRIPTION ; ADD 475SF DEN SQ FT;
ADDRESS: UNIT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
PERMITTEE: RANDALL KEN YANAGA ( 714 ) 642-7352
ADDRESS: 255 E 19TH ST COMMENTS: REF: B-68849
C .M. CA 92627 ***>E>FN*+c+racN****+E*****+E**It+e********* E***NNx*Ir***nix*dr•N**anx******xar***tt+r****TE*+fix*at
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQUIREMENTS
7000)of Division 3 0l the Business and Professions Code.and my license is in full farce and effect. S ETBACK S
CITY UC.: STATE LIC.: CLASS: EXP
Date: signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FR NT : FT IN REAR; FT IN FRNT : FT IN REAR: FT IN
Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT ; FT IN RGHT: FT IN
POLICY EXP.DATE:
COMPANY: PARKING REQ: PROV: PARCEL : 11721420 ZNE: REF NO:
I Certified copy is hereby furnished. El Certified copy is filed with the city Building Division. PLANNING NOTES>
> . .
Date' Applicant: *************************************iF*****************************************
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENT S
I certify 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 -
s •r' r the Wo ars'Compensation Laws of California. � /l ZONING APPROVED BY DATE;
(�rs. 9 1 ' v Signature: '(J 1'
/NOTICE:IL after making this declaration.you should become subject to the Workers Compen r provrs I the Labor BUILDING APPROVED BY : DATE:
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the penarmance of the work for APPLICATION ISSUED BY: DATE: 4
which this permit is issued(section 3097.Civ.C). **********************3E***********.*.H.** .*.K*********.******.****.**,*9e jet*,
LENDER: ************************************************************************* *****
ADDRESS: LEGALIZATION: N F E E S •U M M A R Y STRUCTURAL SEGMENT: N
OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
)Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT . 13 . 50
repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN ri.-
any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S500). ISSUE FEE `.
15 . 00
I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING—D IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Q strucmte is not intended or dieted for sate(Section 7044.Business and Professional Code: The Contractors State License Law TOTALS————> 13 , 50 15 . 0 0 0 .00 28 . 50 28 , 50 ,00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through
his or her own employees,provided that such improvements are not intended or offered for sale. If,however the building or ._im _
peLDGPMTPLUMBING ELECTRICMECHANFIRESMIP/TOT
hin one year of completion.the owner will have the burden of proving he/she did not build or improve REVENU VON TOTALS ODIC R OVER/SHORT; . 00
for the purpose of sale). GRADING PLAN—CHECK
- I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business .• 2 8 . 5 0
and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such protects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *************************************fF*****************************************
that proof al their Worker's Compensation insurance should be provided to me. IND I V I D U A L' '`F' E E BREAKDOWN
O I am exempt under Section: B.A P.C.
Otorthis reason) TYPE QTY DESCRIPTIO N� UNIT COST TOTAL COST
a ��r374 owner: �/ 53 T'4 MEC 1 RELO FORC—AIR/GRAV ,FURN <= 100 K BTU 9 , 00 9 , 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections .2559Yand MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 4 , 50
25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a
permit for construction or modilicatmn iron the Alt Quality Management Dishict.Residential construction applications are exempt from END OF FEES
these provisions. ,
Date: Applicant:
I hereby certify that I have read this application and stale that the above information is correct.I agree to comply with all city and county
ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned . ' '' 01 00167648-00167648 TCIT
pros' for inspection purposes. Zs'c6
ft 4' 13 �tk,4411 nit- 044(0.51_,
� DATE: 09/13/94 TINE: 11:05
Signature: L �
x wens License of Social Security a:
1641,46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor
J
CONSTRUCTION AND PLANNING 4 ; PO( SPA /
APPROVALS Permit# Date - Inspector APPROVALS 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 Conduit-Undrgrnd. 55. Electrical Bonding •-
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9', Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap,0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. 'roperty Sewer Line & House Connection 62. Backwash & Receptor-Final 4
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. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace .• - APPROVALS Permit #
21. OuctS,in Structure 90. Underground'Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd:StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. Tar Ceiling (Structural) & Monocoat • ' 75. Dry Chemical
27. Frame and Flashing •
76. Dry Standpipe
28. Lathing & Siding • 77. FIXED SYSTEM.FINAL
29. Insulation 78. FIRE PREY. 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:
ulk
34. Final Heating & Air Conditioning (-l9-9S- , I L-e'7-- c C-151147-- �L ar it
35. Final Gas Pipe-Test . , • g_Z7 _ -rZnL F-frAntr
36. Hood or Canopy ,•
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42, Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING "r.;
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
ADDRESS OFBUILDNO: 255 E 19TH ST wMT: •• CITY OF COSTA MESA — BUILDING PERMIT
a7lERSNANEIvaaf: YANAGA, RANDALL KEN TR
PERM NO: E 073009
y`YDRESS: 255 E 19TH ST
COSTA MESA,CA 92627 PERMIT NO: E 073009 PLAN CHECK NO: N GOVT: N SUPP: Y
642-7352
ADPL.MAILING ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
•
ARCHITECT OREIKNEER: LIC NO.: JOB DESCRIPTION : ADD 475SF DEN SQ FT:
ARCH.OR ENG.'S ADDRESS: WIT:
CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /
CONTRACTOR'S NAME:
CONTRACTORS MMLRIG COMMENTS : REF: B-68849 & E-68850
ADDRESS: Lk.NO: *if*ifdfif*ififif*ififdE*dfif**dfif******dfdfififlf****ififdfif**if*if***df***N-9f1f*******if**dfif******3f**if**
UIiT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Aim under penally of perjury that I em licensed under positions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force end affect.
CITY LIC.NO.: LAC.CLASS: LAC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING
Dater ContractorFRNT: 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:I hereby dfmn under penally of perjury dual em exempt from the Cantredore License Law for the
'Slowing reason(Section 7031.5 Business and Prolassims Code:Any city o cotrdy wdirN requires a permit to paeeuCI,alter,improve, PARKING REO• PRO'.': PARCEL : 11721420 Z N E: REF NO:
sntcl'h,or repel'any structure,prior b n issuance.ebo requires the applicant for such permit to file a signed statement that he or she
.licensed pursuant to the provisions of the Contractors License Law[Chapter 9(comneobg with Section 7000)of Division 3 d the PLANNING N TES>
Business end Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 'z'''
7031.5 by any applicant for a permitsubieds the applicant to a Goof M
penally of riot more then e hundred dollar 155008. *if***if**df*****if**if*****if df********.*df***************if*if*N•******N-**if***if*******9f*if
❑ I,m owner of the properly or my employees with wages as Mei sole compensation,will do the work and the structure is not intended D E V E L O P M E N T !S/E.-R V I C E S R E
or offered for sale(Section 7044,Business end Professions Code:The Contractors License law does not applytoan owner of properly Q U I R E M E N T $
who bolds or improves thereon.end who does such work himself or herself or through his or her own employees.provided that such
unpnnrnele we nal intended ddfeesd f«sale.6.however,the wildinget improvement s sold*thin oneyeerof completon,the ZONING APPROVED BY ' it'
owneraraw will have the burden d proving he or she Md not build or improve for the purpose of sale). DATE:
1['] I,as owner of the property,am exclusively contracting with rce sed contractors to construct the project(Section 7044,Business and
Profession.Cede:The Contractors License Law does not apply m en owner a property who[wire o improves thereon and who BUILDING APPROVED B Y : DATE:
contracts for such prajocts with a marada(e)framed penaw to the Contractors License Law). > ----7�
❑ tem GP/Z4&746—
qdder Section: B.A PC..for this reason: �} aa, l APPLICATION ISSUED BY: DATE: ( ( I#
/ Data: (0/!-4&/96— Owner: a elAilk/i I s� /{a itiEiEiFiEl(•It1EiElElEiElElEifiE9f•1fiEiflEiliEtf-iE1EiEiFiF#***,1FtE*****lE***: **IE1F****iElEtf-ifikfEiEiE1E* iF
I do hereby certify lhettem awuedend understand the requiremnbd California Health and cods u5D5,25533,and LEGALIZATION:N FjErE S U M M A R Y STRUCTURAL SEGMENT: N
25534,and that I or any future building occupant.will)wM nU(alma one)need to comply with stale codes and the requirements for
Residential the BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
pro• visions. PERMIT 18 . 50
D ate: Applicant: 50% SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby Ass under penally of perjury me of the Idww
bing declensions: PLAN
oIhand w4mdntewamarkets ofmeentloseDin ref rworkers'c«npensatin, provided of the Section ISSUE FEE 4 . 50
Huh*
Code.for the performance dN»work for which this pemwis issued. BUILDING DIV > PERMIT ISSUE PLAN CHECK TOTAL PAID DUE
ElIhave and wiidm
ma:nworkers'comnpenwioninsurance,as required bySecior3700of the Labor Code,fothe petoof
performance TOTALS > 18 . 50 4 , 50 0 . 00 23 . 00 23 , 00 00
work for which this permit is issued.My waken'compensation Insurance either end Poky number are:
Carrie: REVENUE DIVISION TOTALS--> COLLECTED . 23 , 00 OVER/SHORT: 00
Policy Number: BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need not be completed p the some)a tor one hundred dellen[Slop(«fees.) 23 . 00
o 1 certify that in the performance of the work la which this permit Is issued.I Mall net empty wry Penson in any manner n n to
became subject to the woken compensation laws of California. and agree that B I should become abient to the workers' {E{i{i{i{fih.NiE.IE.NiE{p***{pdE{i.N.Il.K.{flfit.N.**Mild.ifiE1F.1Ejh3FiE.k.N1E.lEi(.jE.N.***N.if.lflblFN,fhlElEdEiEi[•{E{i-{pi(,j(.,K#,N.***..K.{i.K..ly{(.****
compensation provisions of Section 3700 of the labor Code,I shall Inhwth comply with those provisions.
Date: INDIVIDUALI D U A L F E E BREAKDOWN
Warning:Salim*rosecure workers'compensation coverage le unlawful,and shall subject an enudoyer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
civil fines up to one hundred thousand dollen($IOGOXOA In addition to the cost of compensation demap,as prodded for In
Section 3mw « cmIns
ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES
petonnance of the work for which this permit is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I candy that I have read this application end dale that the above information is coned.I agree to comply with all dry end county ordinances
and state laws relating to buidig construction and hereby authorize representative*of this city to enter upon the above-mentioned properly
for inspection purposes.
RANDALL YANAGA
q P�Ndne 01 001&5053-001850;3 TOT 23.00
� PS AI�dowmryfiitli ppe«m O trieden « Date: /Zg/�s DATE: 06/23/95 TIKE: 11:45
(5t51'46.WP) White-Buikiig 6 Soley:Green-Re:Canary-Appicaru:Pink-Revenue:Goldenrod-Assessor
cONSTRUCTION AND PLANNING " Y
t POC . SPA
P.PPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1.'Tem ora` Electrical Service or Pole
P Y �' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 4 53. Steel Reinforcement •
-C3r Electrical Conduit Utility-Undrgrnd. t 4 54. Forms
'ovArm ff •.
,=?4_ trical Conduit-Undrgrnd. ` 55. Electrical Bonding
.---',I5riSteel Reinforcement 56. Rough Plumbing & Pressure Test -
U:tn.Electrical OF ER Grnd. 57. APPROVAL TO COVER•GUNITE
1
.-4-jjpotings 58. Electrical Conduit-Undrgrnd. , ,
-"=.8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
;-;9.,Water Pipe-Undrgrnd. Or 60. Bacl'w sh Lines, P-Trap, 0 Undrgrnd.
'10. Structural Floor System S 61.APPROVAL TO DECK
i
`1.1. `Property Sewer Line & House Connection
1 / 62. Backwash & Receptor-Final
12. Sewer Cap ' 63. Heater & Vent-Final
13. Roof Drains 2-1--64- Plumbing System - Final
14. Rough Plumbing ��
9 tri x, 65. Electrics!-Final .
15. Rough Electrical-Conduit tr p66. Solar System-Final 1
-5-
16. Rough Electric Wiring 67. Fencing& Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou h Heating9 & Air Conditioning F E.(�EPT•,REQUIREMENT
l� 1-] . $ n* I y p�'t7' ]•t ti W vet �': pb' ,L}'!r�
20. :RougTt F3atoi F lace i St. t1C� # S , , C* GAPP R",V 6 12„ Permit #
ry- . .
21.'Ducts, in-Strt3cturleJ t 1 L•` - I-IS * S 0 I-IY.t '�•.' 70.EUnde o''ari Hydro
• c; h `+� I C�. * a i-i na i- F• .- cu _
22.-Ruck, `, til in`"'� I 0 t 5 'a;a Dn tri I. it o7n°
I {a %r G cti' a I r" 71. Productt�viping 0 Gas 0011
p H • 1 •{. i-, .-. .
23. GasSipeHough & Test i trm NS . t*1 U' M 0" ^ 72. UndeLgroUyd Flush
es 24. ooPFr icing" hrt I F"t" "41' ri 0 a tyCa7T.i Undergrfid.StorageTank 0Gas 0 Oil
25. Roc$heeaathing �}t v v w C/ > n# 747 Overhead Hyd co
*
' 26.w-Bar-Ceiling (Str$u}ral) & Mc Soat 4 0 ) " On, 75. Dry Chepical
27-2rame and Flashiop;c Dx %r b' >I W% 76. Dry StaeiEpipe
'-d-r2 C
11 28. Lathing •
%&Siding-', " 'an t * S "I ", 77y FIXEDt~S,I-STEM FINAL
" �-1. .v i U n " .' a M 01 ✓
119. Insulation S * . I k 78„1• FIRE PREY. FINAL
I. _. <. 0 ., 5
t" 30. Drywall Nailing ri H I t F I I g s "-HEALTH DEPT. REQUIREMENT
is
1 31. Plaster Btowq-Coati^ S IMLs' I I :c: Cr 79. FINAL tidSPECTION
t\: .: v, P J "�?
32, Electrical Power Meter-Final ! : ,t -_1/80_ FOOD CERTIFICATE ISSUED
7 6`93'
33. Final Electric a • Notes:
34. Final.Heating & Air Conditioning • - _ -
35. Final Gas Pipe-Test . -
36. Hood or Canopy ,•
37. Final Factory Fireplace - , \-
38. Final Plumbing • �_ '
39. Water Service-Final .
40. Gas Service-Final -
41. Solar Domestic-Final
•
42. Backflow Preventer -
•
43. Backflow Irrigation -
44. Landscape Irrigation System •
45. Sound Attenuation -
46. Handicap Regulations _ - .
47. FINAL STRUCTURE & BUILDING '-
48. FINAL PLANNING r s -
49. Eledtric Release to Edison
50. 'Gas Release to Southern California Gas Co 1 - •
51. CERTIFICATE OF OCCUPANCY .
No Date
—tai.
PROJECT ADDRESS: 255 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 068852
OWNER'S NAME: YANAGA RANDALL KEN TR
ADDRESS: 255 E 19TH ST PERMIT NO: P 068852 PLAN CHECK NO: N GOVT: N SUPP: N
.COSTA MESA,CA 92627
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE; ADD
• 642-7352
ARCM/ENGINEER: REG.ND.: JOB DESCRIPTION : ADD 475SF DEN
ADDRESS: UNIT: SQ FT :
PERMITTEE. CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 /
RANDALL KEN YANAGA ( 714 ) 642-7352
ADDRESS: 255 E 19TH ST COMMENTS : REF: B-68849
C.M. CA 92627 ****I6ar*+r+r**xarT ***arar*aE*ar***SrI6Tr*x**+Ex**ie **IE* +tar*Tr+6arar********ar**Nar***ar*N+r+e+r**>FTr*+r
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS
7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect.
CITY LIC.: STATE LIC.: CUSS: MCP: SETBACKS
Date: Signature: MAIN BUILDING ACCESSORY BUILDING
WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
Compensation Insurance.or a certified copy thereof(Section WOO.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
POLICY NO.: EXP.DATE:
COMPANY: PARKING REQ: PROV; PARCEL: 11721420 ZNE: REF NO;
Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES>
>
•
, ate: Applicant: ***************************************************lstat******at************ar*****
' XEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Itis section need not be completed it the pemit i for one hundred(5108)or less). DEVELOPMENT SERVICES ' REQUIREMENTS
certify 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
• e to the Worrkk�eis Compensation Laws of California. ,/ Ur ZONING APPROVED BY DATE:
a RA3 4t Signature: fJj(.d8I' /�-ti_ • -G. •
NOTICE:If.alter mitring this declaration.you should become subject to the Workers'Compensation •.'ons of . Labor BUILDING APPROVED BY , DATE:
Code.you must forthwith comply with such provisions or this permit shall-be deemed revoked. l'
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction fending agency for the performance of the work for APPLICATION ISSUED BY: y
which this permit is issued(Section 3097.Civ.C). ,_. DATE; r
LENDER: *********************************************************************aY*********
ADDRESS: LEGALIZATION: N F E E —S U MSM A R Y ( STRUCTURAL SEGMENT:N
OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the fonowing reason BLDG PMT PLUMBING ELECTRIC MECHANIC t .- FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or PERMIT 33 . 00
repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed , i'
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 252 SMIP/NON—RES
and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN fir . _
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 20 . 00 ' /'v '
I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK '• • TOTAL PAID DUE
❑ structure is not intended or altered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 33 . 00 20 . 00 . 0 . 00 53 , 00 53 .00 . 00
does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through , '
his or her own employees.provided that such improvements are not intended or offered for sale.IL however the building or
improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED : '. 53% 00 OVER/SHORT: .00 '
for the purpose ol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business 53 . 00 ,
•3
and Professions Code: The Contractors'State License Law does not app*to an owner of property who builds or Improves thereon , 't-I
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ****•*****.******************************4.***************************************
that moat of their Worker's Compensation insurance should be provided to me. INDIVIDUAL i F-E E BREAKDOWN
0 I am exempt under Section: B.8 P.C. •
for this
areason: / y TYPE QTY DESCRIPTIO N' UNIT COST TOTAL COST
Oa I4/fit Owner: Petku 4/J Ag* /• /' ', ._•
PLU 1 SHOWER , 7 . 00 7 . 00
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Cade Sect 25505,2p$83,and PLU 1 WASH BASIN 7 . 00 7 , 00
25534 and that I or any future building occupant Advil(not(circle one)need to toms*with said state codes and the requirements for a
permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from P LU 1 WATER CLOSET (TOILET), 7 . 00 7 , 00
these provisions. PLU 1 WATER HEATER AND/OR VENT' 7 , 00 7 . 00
PLU 1 GAS PIPING SYS OF . 4- TO 4 OUTLETS 5 , 00 5 . 00
Date: Applicant: END OF: FEES '
I I hereby certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county _
ordinances and state laws relating to building construction and hereby authorize representatives of this my to enter upon the above-mentioned ,
/ . .
for inspection purposes. _
r �I Jl� 01 00167649-00167649 TOT 53.00
_1/V /-int Signature: y '`_'�` ..---- `•l
Drivers License or Social Security a: DATE: 09/13/94 TIME! 11:05
1641-46 White—Building:Green—Cede Enforcement:Canary—Applicant:Pink—Revenue:GWdenrod—Assessor
CONSTRUCTION AND PLANNING- Lerrrt- i POOL & SPA -
APPROVALS Permit# Date;_�,Inspector APPROVALS Permit # - Date Inspeq{or
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location •
2. Soil Pipe-Undrgrnd. fZtC !a 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe•Undrgrnd. ,f 60. Backwash Lines, P.Trap, J Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection , �� q 62. Backwash & Receptor-Final
12. Sewer Cap L 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. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
23. Gas Pipe•Rough& Test 72. Underground Flush
24. Roof Framing 73. Undergrnd:Storage Tank 0 Gas 0 Oil
25. Roof Sheathing 74. Overhead Flyclro
26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding • 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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 1
35. Final Gas Pipe-Test
s_rta w E CO_cca�t:; J
36. Hood or Canopy ‘
2-'7-9S' ctFs_t_ta-E - slzrcer
37. Final Factory Fireplace
38. Final Plumbing J �_ ai ir ? --Z T.S �2±-t__Q�_1-t_ _
1 4S t[./J
39. Water Service-Final _ C1K
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
it
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. • ti `1i�
CITY OF COSTA MESA - PERMIT NO. TRACT NO. . LOT NO. BLDG.NO. I
- t / k .- -
; COMTRUCTION PERMIT b� --]��o1 /y1' • _
PP g 7�i5' 'lA T{'{ �jr" � LJ � •
• . . 1Jtll 14:1983- ,
A IitanYs.MejlinAddresY TYP�FCONSTRUCTION' NEW ADD ALTERATION• U REPAIR al
' Project Address 1•-Z f3 - : LIO CONVERSION ❑ DEMOIyISHa D OTJJER - E : \'f�- ' - T ,
Owner's Name • j2AfJDY 'IVAN Phone �o'QZ"7352 DESCRIPTION OF WORK (nNVTr L/T ..,iii000 • ZONING REGU •
-
me AtiT� Fa «y �eex.� t A�tioeY /I7�1 z--,1.-;_2() �Q t E6s;A I.(L5A
Addr•ess, ^ - - TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL A.P.sW -ZONE . -
Arch/Eng `- I License No. ^ , ❑ TENANT ICJ ELECTRICAL ❑'PLUMBING ❑-MECHANICAL PLNG'.REF.W- • BUILDING �/ ,' /l' ,, '
❑,OTHER l - /CFI-RACK C/i ST LO V I
p v TO BUILDING- 4//�s I / /'/- ��/��/�
Contractor's Name ' - Phone 541'��-E PROJECT DESCRIPTION SG- FT., �210 - OCCUPANCY ' t 3' ' PROPERTY LINE I"' O / • 1 REAR YARD (TO P%U 3,Q. 906?SC/•I(9E '
Address(mailing) I0sU0{E� I - - CONSTRUCTION TYPF 'V > ' VALUATION$ 4000 . .LEFT SIDE YARD $'O/` RIGHT SIDE YARD 4Tifeil j
I - I ZONE GRADING CU.YDS. ACRES • - PKG.SPACE REQ.— PROVIDED —
License No. __ - - - ,
LICENSED CONTRACTOR DECLARATION _ -
Remarks:
STREET WIDTH 60� , r PARK FEES —�
whereby affirm that I am license3 un tar provisions of Charter 9 (commencing ' •
, _
' with section 7000) of Division 3o/ the Business and Professions Code,and : - l A•,; - f I SPECIAL CONDITIONS: , -) 1 I.
my license-1.s in full force and effect, i • j L, - - • ; -
t aeense •Class 1 - ' License No I ) . , ' , I ' PLUMBING ' ; I ' •
• i .1 Ii { f 1
Date'OKERS'C that I havSignature cNrco Bar Sink' 1 • Sewer Cap , ELECTRICAL ' '
'ORKERS'COMPENSATION toofDECLARATION , I 1 . Backflow Preventei - • Sewer Connections - Automatic
Washer . _ Meter Dover 100 amps
consent to self-insure.er a certificate.. . I ' •_ -_ .� _ _ _ _ ___ _ _ ' '
• of Workers' Compensation Insurance, or a certified.copy thereof (Section I - - • .__ .. -_
• C Sub Panel, i
I 3800, Lab. C:) 1 i r I ' Backflow Irrigation ' Solar_Collectors -',• • ��
policy No. I + Company • I - - - - _ Cooking Unit 1 Sub Pole : / -
Certifletl co DY Is hereby furnished I ! nil ' j Bethtubi j 1 Solar Piping I �'`, i I ;;7 g - ' ' 1 ' , � j'. I
• 9 Certified Copy Is filed with the city,Bulltlin9 Division. I , I ' I 1 i , t Dishwasher I 1 Motors ❑0-1 HP ❑1 Ya$ ,
1 Date ° Applicant . ' Clarifiers i ` 1 Solar Tank • .•
j Ex EMIXT1ON FROM WORKERS'COMPENSATION DECLARATION Dishwasher I I Swimming POOL w/Spat Dryers' ❑Gas-❑Electric -'- Inc Solar ❑9=15 HP'❑16-15+' - -•-"
(This section need not be completed If the permit Is ionone hundred($100) or ; ��,
i iDrinkin Fountains Urinal ; 1 `'1 • Fan I Microwave
1 certify that in the performance of the work for which this permit is Issued,I 9 I _ _ ( r , <
shalLnob employ any person In any manner so as to become subject to the - - - - , F.A.U. i ,Pule Light ' �'
workers''Cppmge atlyn Laws of Calif ornlg,.��,/ • / , I I Floor Drains, I i ' ' Water Closet j „' , t ( - ( ' I - j
Date• G/ laf 7i9} j Signature n,-you ho6l :S/czytdme-LiW4ec ' - ,w- _ _ -. .._ -. - _. _
-NOTICE;- I,aft r-rF,eking this tlaclarf the La sh ltl' dma•s eo to the.-.'• - '- Floor Sinks-:- _Water.Heater ;. Fixtures f j ( •, Range f' 1 •
Workers', Compensation provisions,of the Labor, Code, you must forthwith, • Device Boxes Sin
• comply with; such provislons-'or this permit ,sha1P be {deemed: revoked • - Gas Service Outlets . Water ServicB I - 9
CONSTRUCTION(LENDING AGENCY ' ' - • ' ' - - • ',' Outlets ' / 1DO
' I hereby affirm that there Is till - tructit is titling agency for the performance, , Interceptors ' r _ ' - . Standing Sections .--•
of the work for. t I - permit is )issued (Section-3097, Civ. C.) - -" '- - - - _ ' - , •
Lender'sI Name _ - - - - Kitchen Sink: ,,j - , 3 Switches Trash Compactor j 0 60 ;
Lenders Address I ' '� - - .- .- 1 ir Garbage Disposal , 1 )
OWNERIBUILDER DECLARATION' S i a ' ' • i j : I o I � Lavatories,; I ., i - I r y ' -
I hereby:affirm that I am exempt'from the Contractor's'License Law fo'r the. t - , Generator 0015 KW ❑5-15 KW I '
following reason.(Section 70315 Business and Professlonal:Code: Any city or' P-Trap � _ �• ,
• county which•requires a permit to construct,alter Improve;demolish,or,repair , .. - - Transformer ❑75-50 KW '
•any structure, prior to Its issuance, also requires the.applicantifor such Permit' ' Roof_Drains •
- _ - • ,
to file a signed statement-that he/she Is licensed pursuant to the:provisions of - •
050+KW. -
he Contractor's-License law(Chapter 9(commencing with Section,7000)of - j _ ' - : ,Reinspection Fee ,
)(vision,3' of the 'Business and Professions Code) or that he/she•is exempt • Showers - r' i ' . _ Reinspection Fee $15
therefrom-and the basis for the alleged exemption. Any vlolat;on of Section ; Meter Meter ❑up to 100 amps 1 'Issue Fee .$ a i,
,7031.5 by any applicant for:a permit' subjects the'applicant to' a'civil i Service Sink.- ti Issue Fee $ 3 - ( 1 I 1 /� / >' ��
penalty of not more than five hundred dollars ($500), I i , , i Zoning Approved By V/� / I I Date IC• /J'`X` •
9 P9 I,as-owner of the property • - •• ' MECHANICAL _ 16!!/{�(4�
' eempwea ec will do the work,and the Professional
Is not intended or offered Application Approved By 'Date !((
for sale.(Section 7044, Business ant Professional Code:I The Contractor's I I ! I C� I I 1
thereoe Law does not apply to an owner of a property who builds or Improves 1 'Boiler, I '!' , ' • Refrigeration System . Application •Issued BY ' s 1 Date •����'�� I
thereon,'and provided es such work himself/herself or through his or her own 1
employees, that such•immproveents are not Intended or offered for ❑0.100,000 BTU ❑100,0008TU' - -
yDuct=Under Ground , i
, sale. If, however,the building or improvement Is sold within one year,of com- , , .. I i I SUMMARY OF FEES
pf,ove , the wner;wlll have the burden of proving he/she did not build or im- • ?�f �, i•
,move for the purpose of sale)'. : - • j 1 , Duct-Structural ' i System Repair/Alteration BUILDING PERMIT $ J L•a 0 I' SMTP 1 $ 0,.�O
LJ
I,as owner of the property, am exclusively contractlngFwith'licensed con- i Duct-Ventilatin i I ' PLAN CHECK( $ Zit 12 PERMIT
,tractorsf ,o construct the,project (Section 7044,Business and Professions.Code:. , - - g- _ _. -- _ __ ,- _ _ - __. _ • , •
• The Contractor's License Law does not apply to an owner of property who . , PLUMBING I $, I ISSUANCE ' $
builds or improves thereon,and who contracts for such projects with a con- I I Exhaust System D Multiple❑r I , ' j , '
tractor(s) license pursuant to the Contractor's License Law). • PLAN CHECK $ /L GRADING '. $
❑lam exempt under Section - - B.& P.C.for this reason , • Firepl/Fact.BI t. ICBG# ) • ,T $
•
- :ELECTRICAL $ T :• i
•
Date ' Owner : Heating System&Ducting j p •: MICROFILM $ .
I hereby certify-that-I have-read this-application and-state that the-above- - ❑0.100,000 BTU•❑100,000 BIL: - - -• 'PLAN CHECK $ ��•60 I
Information Is correct. I agree to comply with all city and county ordinances ; . • 4 I _ , 1 I TOTAL IFEE� ( $
and'state laws relating to building construction,•and hereby authorize repro- ' I Hood Or. Type I D MECHANICAL' • $
sentatives of this ci to en er.upon the above-mentioned propert for , yp Reinspection Fee $15 I t LESS
Inspection purposes. • Canopy •Type II ❑ (PLAN CHECK• I $ '
Signature Al ' Date , ' l , ADVANCED PC $ r
Drivers' Ucense orjSS f - • Registers Issue Fee I $ 3 FINAL FEE, $ •_.7 /L
. - - - __. ... - - -- _ ._. •
-. _ - - -- - .. _ _ __ _
CMF 0865-46 rev.12/82 White_Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - - -
CI.`52
n,.:, , STRUCTIONAND:PLANNINGI" .s „I ..z, ._ a''o 2.-' - -_l•; -Pop_ ..SPAFf=:
•4APPROVA #04-10 LS Permit E74. 1 .'Date . ,Inspector • ''APPROVALS- Permit# - , - Date Inspector
m , . Temporary;Ele,ctricai Service or:Pole .1: C • 0., T t::: : 52?Pool &;Equipment Location - • -
• _
2: Soil Pipe-Undrgrnd.- ._ ' -' i1,:.-:". a_ ` _ -Reinforce-merit - -
I - .53_ Steel
,�. F„
3i Electrical Conduit Utility-Undrgrnd. M1- " >, ' ,54; Forms o , _ !
;4: Electrical Conduit=Undrgrnd _ • c i . : 'u i •,; `55 Electrical Bonding' - a - 'r •
5i Steel Reinforcement_ ' ; ` , = a! ' t - ,r: ' ',56; Rough PlumngTest
bi & Pressure - '+
=' ' '
•
6. Electrical OF ER Grnd. . = ' - _ 157.= APPROVAL TO COVER-GUNITE -
7. Footings It I , jl ;: i I , ;; - ", ;' . 58: Electrical.Conduit-Undrarnd.:
8. Foundation i . 1 ; 1 ° ' " ' ''E - as
.59. G 'Pipe;'0 Undrgrnd.,Test ,
9. Water Pipe-Undrgrnd. i , i-' - ;60• Backwash Lines,P-Trap, 0 Undrgrnd.- '
10. Structural Floor System . _ - , 3 ,-. 61. APPROVAL TO DECK :
11. Property Sewer Line&IHouse Connection' _. 'F' !Yr, ' : 62. Backwash&Receptor-Final r'• - - I r
12. Sewer Cap I i, , . ° .1.
•, • '63. Heater - _
13. Roof Drains : ^ I Final
'64. Plumbing System - _ _ r
R 14. Rough Plumbing ii. ' ' ' ' I ' ' 2 - '65. Electrical-Final, ' . 1-L . '• - T • •
? '15. Ro'u h'Electrical:CoiTduiC' -r - 1- t ---- -- - - r -! a-r - --- - - ---- - - •-t .
A: - 9 _ 1 T l I , ; 66y Solar System-Final ) 'f"
`
16:'Rough Electric Wiring �"""./��,�g3 '' r 4'.
- 9Approval--_ '67 Fencin &Access
,t �7-1•-i - - - -
_17'. Rough Wiring Sign ' ' ' i c !"771 „ ' , . 68. APPROVED FOR PLASTERING r
•
là R&7gh Electrical TB Ceiling i_ ii y : I I - !', i : 1 X69. POOL/SPA SYSTEMS FINAL • ;
• . 19:;Rough_Heating& AKConditioning 'i ' I i ' ' FIRE DEPT,;REQUIREMENT • • i I • •
20'.,.Rough'Factory Fireplace . :' i , • i ' i APPROVALS Permit# -r
21. Ducissin;Structurei ', : ; i 1 . : I I 70. Underground Hydro
1'22. Ducts;Ventilating i ' ii r 1 l ' ! .71. Product Piping 0 Gas 0 Oil
23. Gas-Pipee''Rough & Test . '_: r i 1 I I 72; Underground Flush -
.. c24.°Ru.,f;1-, mg L n n < , I y, ' '. l - .73. Undergrnd.Storage Tank,0 Gas ❑Oil . i '
25, Roof Sheathingi -
� ' ' � - c I, � �� ; X74. Overhead Hydro _ .
r. 26. T-Bar Ceiling (Structural),& Monocoat ; I : I •-1- v : ''!, • :75; Dry Chemical ! - .
•27. Frame and Flashing' I I, I . A) S l et, (en ,76: Drry Standpipe
., r28. 'Lathingr& Siding ri -, ; t j 1. i i , 177. FIXEDSYSTEMFINAL. _
...29...Insulation : I I I• I• i ' 78. FIRE PREV. FINAL
r130. Drywall Nailinng I ! I I/14/5�, L !�1 Notes 1
- .31. PlasterBrown Coat., i '! !, I ' I ! ) i l I I ! ! 1 -. ;1
, � I
32. Electrical Power Meter-Final ; i I . ! . ' , •
. 33.'Final EIe_ctric r_ M,____ ,• _ � .3/gy __ 1 _ _ • - _ -
34. Final Heating&Air Conditioning , ' . 1 ', i,.: ?, , '
35. Final Gas Pipe.Test r,i ° ' •- : ' ' ,r I. _ • i - - -
36. Hood onCano I. - • - • - --
py. r I I _ I - . .. -
f off r -
37. Final Factory Fireplace1 t _ _ ; , _ _
38. Final Pluinbinigl ',,,,,I! Ji Ii - i ,: •' I I 1 - ` _':
39. Water'Service-Final' I %' i ' I ' i ' E i '
li I , .
40. Gas Service:Final I i i .- „ - -
41. Solar Domestic1Firial 1 + I _1-- I - '
Is I I i t "_t -t Y- I - - - - -
42. Backflow P Deventer s •
' �� „r -- ;• --' __ I. -- . ;-•- 1- _-- I y - I
43. Backflow Irrigation -, . I ,__, , - -
44. Landscape Irrigation+_System 1i• '"_ • I _ r . � - : ,r:
• 45. Sound Attenuations j ° a i i I I i I i ; `
46. Handicap Regulatioris, i , I I , , ,i I I i - ,-47.•FINArL'STRUCTURE& BUI,LDING1. • , \i ems:: a ),.z 3 7i • , - .
1.
' 48. Special'Requirements Completed : ! : f '. .
49. Electrictheleaseto`'Edison' ' • � I_ i-_ ._1-! _ _.i__ .. _ '_ _ - _-. __ _ : . _- - ' , ••
.1 50. Gas Release;to Southern California Gas Co • , I I , , .I •, ;
51. CERT,IF.ICATE OF OCCUPANCY - - ,_. _ }'-!_-. , - -- •/ ' . '
;'� No Il ! :Date l ' ' ••
""�, •Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. •
TY• OF CUSI,A. .,SA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. '
CONSTRUCTION PERMIT $E- TOOT *9¢ /oG .
Project Address 2rs' E• f9"TH 5y. .- I TYPE OF CONSTRUCTION - it `s • •'f•-\ 0260. 6/29/82 133.59 T
Owner ��c 7y' "(A1 - Phone012-739, {NEW 0 ADD 0 ALTERATION .4 _ - -, -
Address- 2 ' a- b�2Tvl er -- - -
.0 REPAIR. 0 CONVERSION ❑DEMOLISH \] _ _ '
- ZONING REGULATIONS' '
Arch/Eng, ' - - -License No, •
Q SCRIPT - • • A P - '
_DESC RIPTION OF-WORK /�"7- Z/�f-- 71�..
Address - �- " t44GHED' •C .`�Y'ac TZONE - ie./ - •
PLNG. REF. - _ '
' Contractor- -OtA_'1J ,e • - .- Phone - TYPE OFPERMIT - _ - - BUILDING - " - / 4.
BLILDING -
Address - -- -' -- - - -- - � ` k--A. SETBACK C/ ST
.
/ OPE RTY LINE O
_ QGRADING ', 0 FOUNDATION - STRUCTURAL 'SIDELEFYARD - / 4-
LICENSED-CONTRACTOR-DECLARATION. --- _ •- Q TENANT- ELECTRICAL OPLUMBING QMECHANICAL SIDE-YARD cpJ-5 // --
0 hereby affirm that I am licensed under provisions of Charter 9 (corn, - , - -., - -V' ' TIGHT �Q O r
mencing with section -7000) of;Division•-3 of the Business -and- - Q OTHER - //./Of/_ _" - - _
Professions Code, and my license Is In full force and effect. - • REAR YARD(TO P/LI
I - _ _- - - _ , __ �.PROJEC ESCRIPTION _ DE
'License Class • License No. 0 : - " rPKG,SPACE REQ. 1. - „RROVIDED , , r 1
Date '.-"'t Signature-.
_ -.._- ._ 'r' 1 SQ. FT. 'L._ _ . - +� ._ - - -_ -• ,
tt.. ' STREET N/IDTN . . ,PARK FEE'S;
WORKERS'COMPENSATION-DECLARATION _ _ OCC UPANCVN'�� CO NSTRl1CTION TYRE�• I`� _ /
I hereby affirm that I have a certificate of consent to self insure ora 'VALUATION $9-/90 ZONE 'ZONING APPROVED BY" 'DATE-- ay/ez •
certificate of Workers' Compensation Insurance,-or-a certified-copy _ _, _ _ __ - _ I U,(,,/.ZC _
thereof (Section 3800, Lab.C.). , GRADING CV YDS. •-- ACRES ( SPECIAL CO NOITIOhgfyf',FOR SPEC '._ REIif IUIRE TS,
_ _ -.. _ -- _ _•
t' ���,s�.,.� _
_7-Certified copy is.hereby furnished.- - - - _ -_ . - . "REMARKS:: "i-i2_. _J'^ _'1 _ - . __ - _. ,""�-D flan. r/_ a, Ory_ ' T^^'""• 6-
Q Certified copy Is filed with the city Building Division.
'EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION' " --- "- li- ' - - /f/�LL'-e�'f"`r97J hQa
'(This section need not.be completed if the-permit is for one hundred - _ I ��.v����y,. w , ...,.�e�i� �r� I
($100) or less). I , - - .. -' -- •a_r/vVL/'o! ----GIS/cS7-1A/a '�//�•+1�,J "4^T': �-�
I_certify thall n the performance df_the work for which this permit is' J
,Issued, I shall not employ any person In any manner so as to become PLUMBING - „4 PLAN'CHECK - - _- '"" ELECTiiJ - PLAN'CHECK n
subject t the orkers.Compensatlan sof llforj11a,', -- - _ _
.r�� Uw tLLING HRAfa E..
(Date Signature _ e•
_BATHTUBS SHOWERS 'SQ FT - SQ FT •.7(00- _ :7 to
'BIOTIC :�If afterermaking this declaration, bt eco ct 1TOILETS 1, .•I.p r ,URINALS' _ -- • - --- "•- 'GENERATOR---o 1 KW_1 1'O.KW-- "-"-
to the Workers' Compensation provisions of the Labor Code,you must - 'TRANSFORMER " • _ . �Ur - - i..rJ
.Jforthwith comply with such provisions or this permit shall be deemed LAVATORIES (DOUBLE LAVS -` -' ' -- - - APPLIANCE "^-10-50 KW=50 +KW -- -- - -- - - 1
, _ ,
'CONSTRUCTION LENDING AGENCY '„' -KIT:SINKS•`- "' 'DISHWASHERS - IMOTO RS '" - 0-1 HP_1-10'HP - -
I - 'r,14L„i' tt , y i'_-
1l hereby affirm that there Is a construction lending agency for the per- SERVICE SI NKS•c 17.044SUMPS- ' "”'=4 - ,^- ,(INC..SO LAR). 30-SO HP SP+.HP•-- -- - -
•formance of the work for;whlch.thls,permit is Issued,.(Section '3097 - ' -
;CivrC:)t - "-- -'- -` ` - --"' - '•--- ' FLOOR SINKS"- — F LOOR DRAINS - - -" -, --- 'FIXTURES- --OUTLETS^ SWITCHES- -" - .-." j
.Lender's Name__ - _ _ - -
;Lender's Address _ - DRINKING FOU NTAI NS - 't - '- - I- ,GAS-TUBE SIGNS- - --- — - - - f
OWNER BUILDER DECLARATION " --' -•'--- ' - —INTERCEPTORS -- CLARIFIERS -'�- "
I hereby affirm that I am exempt from the Contractor's License Law for I .. �.. -�
' the"following-reason'(Section-7031-.5-Business'and Professions-Code: SWIMMING POOL "P TRAP-' - _ LUNiKUL1 ION _
Any city or county which requires a permit to construct, alter, " t ;POLES METERED "• SUB--- • ' --
Improve, demolish"or'repair•any'structure, prior to Itrissuance,-also-re- WATER SERVICE-- --- ALTERATION ' ',PANELS- -' ' -MAIN'• -•---j-, 613 S -- • - - -
g uires the apt_licant for such permit to file a signed statement that he _ _ t
Is licensed pursuant to'the provisions of-the-Contractor's License Law - -- - _
(Chapter 9 (commencing with section 7000) of''Division 3 of the G.SSERVICE �. 'OUTLETS -' - ' - -- ISERVICE- -•'Business'and-Professions Code) or that'he 15'exempt therefrom and-the WATER HEATERS" ' BTU OUTPUT -- - ---- - --- ---- ---
•alis for the alleged exemption. Any violation of Section 7031.5 by
ny applicant for a permit subjects-the•applicant to-a-civil penalty --SEWER"CONNECTIONS ____ -• _- -
if not more than five hundredbert- -Tirdollars ($500). . .. . . .. •^• '
so I, o Owner of the"property, or , d mhe_str s with not Intended.
- SOLAR TANK' COLLECTORS "" - --' - - -- - - - - •- --- - - )
sole offered
tion-,will tio_lhe 7044, B, and s str P is not " - _ ) - r - ^• - >^ 1
or ntracto for is n ,(SectionwBapiny and ProfessionswrfCode:rThe SOLAR PIPING"SVS.- I- '- -1-
;Contractor'sContractor's,License,Law does not apply to an owner of a property_ _ _ _ _ ,_ _ _ _ •
who builds or improves thereon, end who does such work himself or ISSUE FEE " I - - - `APPLICATION APPROVED-BY • - -----:-- Z9' - --
through.his-own employees, provided that such improvements are not _ _ - (c
intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK _
i5 Sold within_one year of completion, the owner will have the burden SUMMARY OF FEES „ i 1
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU I 1 BUILDING --•7�, .Sb•- - - - - - '`O•� i
PERMIT T tf 4- $"_ _
10-Ir-as-owner-of-the property,-am exclusively contracting -with AND DUCTING . ` $_t ct �f SMTP
licensed contractors to construct the project (Section 7044, Business 100,000+BTU I PLAN CHECK -$ TQ •SG ,1PERMIS.c•, ? '
and-Professions-Code: The-Contractor's•License-Law does no who con-
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU I PLUMBING $ - I r-ISSUANCE-:S I ,
tracts from-such projects- with a-contractor(s) licesned-pursuant to. SYSTEM - - - - - _ '
the Contractor's License Law). 100,000'+BTU . PL-AN-CHECK -$ ;GRADING $ 'I
Dram a xe-—tcti ��D9 ?R &�P.' (or'thi5- BOILERS BTU -- 'ELECTRICAL $ /O•-- - ' s' _ $ ') }
season •- - - "- ',PLAN CHECK $-'�= • 'MICROFILM'$
Date •1 Owner ms's`•✓Y l/�.^rVs� SYSTEM REPAIR,ALTERATION I - 7" Y
MECHANICAL $ • 'TOTAL FEE$'� '' I
hrtify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE I • `• . -LESS AD-- '
information is correct. 1 agree to comply with'nall city and county - I t.PLAN CHECK $ - VANCE PC $- -- ' ._
representatives.
ordinances and state laws relating to construction,and hereby authorize • _ ,
representatives of this-city-to enter upon-the above mentioned 11 , ' I. /?�P�
property for ccttiioo purp _ /���Q� c7
Signature •b'r^'vs•r/ �Vlfd-GI Date JlfeJ I- - - _ _ -- - FINAL FEE $
Drivers' License or SS / - { • -ISSUE FEE _ _ - - - •
CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor
..
•-
CONSTRUCTION AND PLANNIN // POOL& SPA
APPROVALS Permit# C Oo Date Inspector •APPROVALS Permit# Date.- Inspector •
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location' • - .
_. 2.. Soil Pipe-Undrgrn-.' • 44. Steel Reinforcement - .- - ._ - '
. . . ' _
-.- 3. Electrical Conduit.Utility-Undrgrn' ..\- "a\ .. 45. Forms _ - • -
,.. 4...-Electrical.Conduit-Undrgrn - - '\, _ _ • _ . 46.. "Electrical Bonding - - - - - -
_ 5;-- Steel_Reinforce _ _ _ a• 711 7_ fy_ Yea, 47. Rough Plumbing & Pressure Test • - . . - - - •
6.. Electrical UFER Gm - \- _ . - _ 48. APPROVALTO COVER-GUNITE- - •• - . , . -
,.- -
_
:j ryyl 7 -t y_ 'a 49. Electrical Conduit-Undrgrn ,. - . - - ,
50; Gas-Pipe,- El Undrgrn,Test '•' '
9. Water.Pipe-Undrgrn_ __ ___ 51. Backwash Lines;P-Trap;-❑Undrgrn • - ' _ " .
_10. Structural Floor System_ . C- Q_ _--Z-> . 0 1'i ._ 7_(9- SA, 52. APPROVAL TO DECK - - - ' - . . ' .
:-_11..' ;•Property_Sewer Line &,House Connection. _ 53...'1'Backwash.&Receptor-Final ' ' . . . .
c..94:1•=Sfreet'SewedConnectionr'.'_'.t'1..; ": -- - . - . _ -• .. 54. -Heater &Vent-Final ' -
, 13. ,Rough Plumbing --__\--`-',v:' .' ?.'r• _ . • - '-., - ' • - 4 55. Plumbino System-Final -- - - "
14. Rough Electric-Conduit . . „\ ' -.- - --- - - :56:- Electrical-Final - , -
15. Rough Electric-Wiring . . . . , . . - - 57. Solar-System-Final - ' . . .
16. Rough Heating &-Air Conditioning' - " - ' -- " - - . - ba.. Fencing &Access Approval , . .
--17. Ducts, in Structure . . - - - - ._-. ' 59• APPROVED'FOR PLASTERING - •, - . . . ' - '•
18: • Ducts,-Ventilating - - - - . - _ . _
19. Gas Pipe-Rough St Test t - -. - .. 60. POOL/SPA SYSTEMS FINAL ' .."" •
-
- 20. -Roof'Framing . . _ - . _- -. '
21: Roof Sheathing g-S-G--c.- 25 - . __ '_. '
22. Frame and-Flashing .D, '"NOTES:
9 -�--.A �!L¢ :�er� -• l I S�Qk .Sl S. . �
23. Insulation - - J . - - - -. -. :/ring rl„•.Ccr A..e a /rq . .Z'y+1 __ .,
, 24: -Lathing &Siding-- - . - - -" - - - {,/--' - - - - - - -
25. Drywall Nailing "__ _. - . - ' - _ - . .
26. Plaster Brown Coat coo _:,.,_n" a., - - - - 1. /1/,t i/tZ ,f� P?%- - - _ , . - - . . '
27. Electrical Power-Meter-Final • - " ' ' . - . . . , •
28. -Final Electric - - - t ,2a.-W3 e (' _ - - •
29. Final & Air Conditioning - -
l - ' . •
•
' 30. "-Final Gas Pipe-Test -- - - - - . - . - - . ' - - - .
-31. FinalPlumbing _ . - _ . " . . . - - - - - ' •
.
•
32. 'Water Service-Final - -- . . .. ; ' , ' ' •
- ' 33: "Gas Service-Final:, _ - - • . - • '
• ' 34. Solar. Domestic-Final . •
"35.-' Landscape Sprinkling System . - -. - .. - r
36. Sound Attenuation - - ' ' . ' -- -----
37. Handicap Regulations - �t • -- - - - - . -
38. FINAL STRUCTURE & BUILDING 44t L. fl b S - '
39. Special Requirements Completed ' - _ -. _
40. Electric Release- to Edison - - - - •
_
41. Gas Release to Southern California Gas Co. • . -
42. CERTIFICATE OF OCCUPANCY - . - '
-
No J Date
Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.
CITY OF COSTA'MESA PE3MIT TRACT NO. LOT NO. 'SLOG.NO. -- - - •
•
CONSTRUCTION PERMIT I t ' J GAO 1 '
�`
Project Address '.Z65 E (j,J.f r - /�/� -
,s� r't•-t ' J��' TYPE OF CONSTRUCTION •
Owner c,64. �DY YAi.1AA• P00086r�•7'jt5L 0 NEW 0 ADD' ❑ ALTERATION f� I 'Ott 1-9 19•
• - IS,
Address SAf"AE - -_ - 0 REPAIR 0 CONVERSION ODEMOLISH sr •NING REGULATIONS , - -
Arch/Eng. License No. .❑.OTHER - A P ^ .
Address - - - DESCRIPTION OF WORK CITY•)o')�itI
''�1 ZONE St .
Contractor tan - Phone- - • TYPE OF PERMIT BUILDING XR BUILDING
_ • SETBACK C/LST. OPERTV LINE
Address . ' - '0 GRADING�-r ❑ FOUNDATION -0 STRUCTURAL SIDFT YARD
LICENSED CONTRACTOR DECLARATION- 0 TENANT •I!S•ELECTRICAL '❑PLUMBING ❑MECHANICAL LS we YARD - -
I.hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT '
mencing with section- 7000) of Division 3 of the Business and 0 OTHER - REAR YARD(TO P/L) '
Professions Code, and my license is in full force and effect. •
PROJECT DESCRIPTION -
., -
License Class - License No. - - j ' PKG.SPACE REQ. - • PROVIDED
Date Signature -- . SQ. Ft • 4-WORKERS'COMPENSATION DECLARATION.. . OCCUPANCY-CONSTRUCTION TYPE - STREET WIDTH PARK FEES
I hereby affirm that I have a certificate of consent to self-insure or.a VALUATION_ ZONE ' ZONING APPROVED BY • DATE
certificate of Workers' Compensation Insurance, or a certified copy
'hereof(Section 3800, Lab. C.). GRADING CU.YDS. - - ACRES - 'SPECIAL CONDITIONS:
rolicy No. - - Company • - -• - •
❑ Certified copy Is hereby furnished.. - _. . . REMARKS:, . ,. _ - - _ •
❑Certified copy Is filed with the city Building Division.
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - . . . .. - "'
(This section need not b¢ completed if the permit Is for one hand red. _ Vi
($100) or less). _ - - i
I,"certify 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 becomes -PLUMBING. ., -PLAN CHECK ELECTRICAL PLAN CHECK
subject lot a rkers•Compensation ws of !Horn . - '
/ / /� BATHTUBS SHOWERSSO FT rvc. GA HAbt •'7 �' 00
• Date ( Signature - SO FT S(1 FT
NOTICE. If fter making this decleiation, you sh ul• b come 4 ect TOILETS URINALS , GENERATOR 0-1 KW_1-10 KW - •
to the Workers' Compensation provisions of the bo -•de,yo ust TRANSFORMER.
forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS • - - APPLIANCE' 10-50 KW_50-+ KW -
•
revoked.. _ _ . .. - _ "
CONSTRUCTION LENDING AGENCY , KIT.SINKS DISHWASHERS MOTORS - •0-1 HP_1-30 HP
I hereby affirm that there is a construction lending agency for the per- - SERVICE SINKS SUMPS-- .. (INC.SOLAR) 10-50 HP + HP
formance of the work for which this permit is Issued (Section 3097 - .
Civ. C.). ' - FLOOR SINKS FLOOR DRAINS •- FIXTURES OUTLETS SWITCHES -
Lender's Name "
•
Lender's Address DRINKING FOUNTAINS '• GAS TUBE SIGNS - - -
OWNER'BUILDER DECLARATION - • INTERCEPTORS - :CLARIFIERS POLE LIGHTS ' - " .-- -
I'hereby affirm that I am exempt from.the Contractor's License Law for - - - -
:the following reason (Section 7031.5 Business and Professions Code: , SWIMMING.POOL- - P TRAP WINS IRUI"I'UN
Any city or county which requires a permit to construct, alter, POLES METERED SUB ' •
Improve,demolish or repair-any structure,-prior to Its issuance,also re- ' WATER SERVICE - ALTERATION PANELS MAIN. SUB
quires the applicant for such permit to file a signed statement that he
is licensed pursuant to the provisions of the Contractor's License-Law .GAS SERVICE - OUTLETS . - SERV ICE'((JAJPEQ�" IO(JN qMP S`o
Chapter 9 (commencing with Section 7000) of Division 3 of the
iAusiness antl Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT-" - -
iasis for the alleged exemption. Any violation of Section 7031.5 by •
"any applicant for a permit subjects the-applicant.to a civil penalty SEWER CONNECTIONS - -
Vot more than five hundred dollars ($500).
, as owner of the property,or my employees with wages as their -SOLAR TANK COLLECTORS , - -' - -
sole compensation, will do the work, and the structure is not Intended 1c0
or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. -ISSUE FEE - /,///�/
Contractor's License Law does not apply to an owner of a property • - APPLICATION APPROVED BY �/b- DATE /Ass.
who builds or improves thereon, and who does such work himself or ISSUE FEE Y roll
through his own employees, provided that such Improvements are not - z
Intended or offered for sale. If, however; the building or improvement MECHANICAL PLAN CHECK . - - SUMMARY OF FEES
Is sold within one year of completion,the owner will have the burden -
of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDINGRMIT
AND DUCTING S SMTP • S
aI, as owner of the property, am exclusively contracting with - - - -
licensed contractors to construct the project (Section 7044, Business • 100,000+ BTU - PLAN CHECK $ _ PERMIT ' •
and.Professions Code: The Contractor's License Law does not apply to- - ISSUANCE S.
an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU• PLUMBING $ -
tracts from'such projects with a contractors) licesned pursuant tO SYSTEM GRADING. $
the Contractor's License Law). 7A/(/1 100,000 +BTU E PLAN CHECK -
❑ 1 am exempt under Section TTII B.& P.C.for this /S O $
BOILERS BTU
reason - - PLAN CHECK E MICROFILM $
Date_�wner4Y_s'L[(L%)Lt SYSTEM REPAIR,ALTERATION - TOTAL FEES
d.P.�[{d! MECHANICAL E
I hereby c tify hat I have read this application nd a e that t e bove EXHAUST SYSTEM MULTIPLE - • LESS AD-
information is correct. I agree to comply lh city an unty PLAN CHECK $ VANCE PC $
ordinances and state laws relating to construct on,and hereby authorize •
representatives�{�on,fs this city to enter upon the above m ntioned
property for� %eecti purgb�{,,�" A 49 z �_ /5700
Signature /-• iEi{✓Wn(/tL�L
-ISSUE FEE -
CMF 0865-46 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
Lk
CONSTRUC-iTIgr Atip•P4AN,1 UNCc POOL&SPA
�i C Sapp Date Inspector - - , Date • Inspector.--
APPROVA i ; Permit# „� APPROVALS Permit#
-- -
_1. Temporary ElectricallSeiviceoi Polei - - ' - -- • - . ; -'t-± -
-_ _ _ - 43. Pool & Equipment Location _•_ , - -
' .2. __Soil Pipe Undrgrn . ... Y_.---..--' 44. Steel Reinforcement - -- ---- - - - ' = 1= . - . •:
3.. Electrical.Conduit;Utility,`Undrgrn:.;... . , .. _ _ . .._. _ - 45.. _ Forms- - - - - - ,
4.. - Electrical Conduit_Undrgrn . - - _ . _ ._ . _ _ . __ 46. -Electrical Bonding . '- -- - • - - - - -. - -- - - _. _ .. -' 11
:__5. SteelReinforce .- _t_ _ , _ _ _ _ _ - _ 47. Rough Plumbirig& Pressure Test: - •.- - - • -
6. _Electrical UFER Grn -- _- -_ -I/12_-%7_ ac 48. APPROVAL TO 0OVER-GUNITE- •---- _ ..-_ - - - -
-.7. Footings _ __ _ 49. Electrical Conduit•Undrgrn "•1 •'- .
' 8. -Foundation . __ . . . _ _'_ -_ __. - - 50.. Gas Pipe, ❑Undrgrn;Test • • ' ' . -
9. -Water P pe-Undrgrn . .. ": _ 51. Backwasfi•Lines.P-Trap. ❑Undrgrn'' - - - - - - ' . '
:.10. . StructuraLFloor_System _ -- - _ - - -52. APPROVAL TO DECK' - '- - --
:_11. Property.Sewer Line & House-Conneetion' . : 1 - __ - 53. Backwash & Receptor=Final • ' ' '
12.__Street Sewer Connection. . . _' __- .._ 54. Heater &Vent-Final
,..13. .Rough_Plumbing- _ .. _ . • - - - -- - - - 55. -Plumbing Sv6tem`-Final - •. . _ -. '
14. Rough Electric-Conduit - -- ' -'- - - - :56. - Electrical-Final- - •i
15. Rough Electric-Wiring .. - /1-2.2--`62.2 --d C 57: Solar-System-Final • , ' . , '• ..
16:;-Rough-Heating-&'Air Conditioning - - -'' _- -- -- - --- - ' .Fencing-&Access Approval , -
- 17. -. Ducts,in Structure -, ' . - - - . I- • -. _ _ - ' • 59. APPROVED FOR PLASTERING . ' , .. • •• ,
- 18t- -Ducts;Ventilating - - - - - - - - . - __. . , _ . . . . a• _ . --lr , :':
19.' Gas Pipe-Rough &Test . _ _ 60. - POOL/SPA SYSTEMS FINAL , ..' - I• - - - ` ` '
' 20:- Roof Framing- - - - - . .• ., .
21. Roof Sheathing - _ --. - _ - _-
22.• Frame and Flashing -- _. -- !_. r _ _ NOTES: '' .____-
. 23. Insulation -- - --- -- - - - - --- - l _ _ _ .: . - - - - - - _ --- --- -- - -- - - -
r 24. - Lathing&Siding- - - --- - - - . . - - - - - - - - - - _" - --- - - - - -
25.:- Drywall Nailing !__ - - - - '. . . ..
26.1,- Plaster Brown Coat- ' ' - - __ - ' : __ , . '
27.,_ Electrical Powei:Meter-Final . - ' -
28., Final Electric._` - _ - - /! '36
- 0,-- ,
, 29.i Final Heating &-Air Conditioning _- - . _ .} . - - _ - . _- i.. - . . -
30. Final Gas Pipe•Test -
31. Final Plumbing _ _. _ _ _ -. - . -, ., , . :'
32. -Water Service-Final • - - - . _ - . . ' _ - . , . . . • -
33:. Gas'Service:Final - - --. _ • - . . _,,., . • ,
34. Solar Domestic-Final • ' - •• - iJ . .
35. Landscape Sprinkling System , r - __ _ ' . • •
' 36. Sound Attenuation . . , a ' • - i - •. •' - .
I 37. Handicap Regulations .- ' _ - •. .”138. FINAL STRUCTURE &BUILDING , - - - - _ _ - -
39. Special Requirements Completed- C -- - . -
40. Electric Release to Edison -a - - -, e _ . , --; ,
' 41. Gas Release to Southern California Gas Co. I .. . .g , I - - ,.. ', -
42. CERTIFICATE OF OCCUPANCY - - - _ - • - .
-- 'No` _. Date - - , ' + - - ' 9 :. :'t, _ J?y ` . '. _. •__"- ---i:, ..
•
--- - - - - - . --- - - - - • --. - . - -- - -- ' 7.= '11.3"t.... _ ,