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HomeMy WebLinkAbout274 19TH ST - Building Permits ,n . PROJECTADORESS: 274 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P UbU /t1 OWNER'S NAME:DALBY, ANTHONY CHASE ADDRESs:DALBY, TAFFY T !' —`-- PERMIT NO; P 060721 PLAN CHECK NO: N (JOVE: N SUPP; N 4 •2:14 E 19TH ST COSTA MESA, CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : RELOCATE GAS SERVICE (METER) SQ FT: ADDRESS: UNIT: a CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: ANTHONY CHASE DALBY ( 714 ) 646-1221 ADDRESS: 274 E 19TH ST COMMENTS: RELOCATION OF GAS METER DUE TO NEW SIDEWALK CONSTRUCTION • COSTA MESA CA 92627 ********;EkE**�E�E�E************SE*****sr FE*�F*�ESE�E�F***�H�¢+tit** ****S¢**�F*�F****4�E ********** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS -70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: Date: signature: MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.lab.C). E POLICY EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42628115 ZNE: REF NO: I PLANNING NOTES> ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. > ******************************************************************************* Date: Applicant: DEVELOPMENT S E R VJI C E S-• R E Q 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). >r^ I certifythat in the performance of the work for which this permit' ued.I sha/r A employ anyperson in an annex so as to become I, subjecto the Workers'CompensationenLaws of California. / / p y ,/ ZONING APPROVED BY J i,1 DATE: Date: or - BUILDING APPROVED BY : ////�/(/ DATE: Code,y:If.gust making tcio declaration,with such should become i subjectpemishalltthe a - tis' rempenSalio Covisions of the Labor 1F i NOTI E:u muse fkinh home) with n,y shouionb c thismejt h be r r¢med 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: which this permit is issued(Section 3097,Civ.C). ** K ** '� * *'*'*'*'*'*****'*'**'*" ******** ** LENDER: **************************************** ************************************ ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N 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 SHIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 7 ,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 2 5 t SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE 20. 00 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE tI, as owner of the property or my employees with wages as their sole compensation, will do the wont, and the TOTALS----> 7. 00 20 , 00 0 , 00 27. 00 27. 00 . 00 1J structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a properly 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--> COLLECTED: 27. 00 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 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/TOT GRADING PLAN—CHECK , for the purpose of sale). 27, 00 I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: TheContractors' License Slate Law does not apply to an owner of property who builds or improves thereon ******************************************************************************* ( and who contracts for such projects with a clor(a)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY • DESCRIPTION UNIT COST TOTAL COST Date: l—��- 5> Owner: ^ / ' de / PLU 1 GAS SERVICE 7. 00 7. 00 I do hereby certify that I am aware of and understand the requirements oI California Health and Safety •r• .ections 25505,2 it. ,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the require is for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: . I— sy Applicant: I hereby certify that I 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 'prize repr:j natives of this city to enter up the above-mentioned property for inspection purposes. • ^ Date: 1—`' s�i 3 Signature: 4 ,/ 7 Driver's License or Social Security ' - • 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING' POOL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1, timporary 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 UFEf1 Gmd. 57. APPROVAL TO COVER-GUNITE 7. FootingsI 58, Electrical Conduit-Undrgrnd. .8. Foundation ' 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. i 10. Structural Floor System 61. APPROVAL TO DECK _ . 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -'f 17. Sewer Cap 63. Heater & Vent-Final 13i 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 Conditioningr - • FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - - _ * APPROVALS - " Permit # 21. Ducts,in Structure • - _ - 70. .Underground Hydro • 22.,Ducts, Ventilating - - . . 71. Product Piping ❑Gas 0 Oil 23. Gas Pipe-Rough &-Test r 72. Underground Flush 24. Roof Framing - - C 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 - • r.28. Lathing& Siding _ - ; ' 77. FIXED SYSTE( INAL : 29. Insulation • - I I 78. FIRE PREY. FINAL - 30. Drywall Nailing ' - - i I ' HEALTH DEPT.REQUIREMENT 31. Plaster Brown Coat - I 79. FINALCNSPECTtON 32. Electrical Powet Meter-Final 1 lc.-• 80.80. FOOD CERTIFICATE ISSUED 33. Final Electric - r. i ' . j • Notes: - 34. Final Heating& Air Conditioning f :1 ' 35. Final Gas Pipe-Test Y''//al - , _ 36. Hood or Canopy _ ' f - • i 37. Final Factory Fireplace • . - - I l ` r 38. Final Plumbing 39. Water Service-Final I I 40. Gas Service-Final - , • - 1 i IS . _ 41. Solar Domestic-Final - 42. Backflow Preventer I I 1 _ - 43. Backflow Irrigation . , - 44. Landscape Irrigation System - ` 45. Sound ,Attenuation . • - - 1 46. Handicap Regulations ' ' 47. FINAL STRUCTURE &BUILDING 48. FINAL PLANNING } ' 49. Electric Release to Edison - I/1 • .` 50. Gas Release to Southern California Gas Co - I I - -- . 51. CERTIFICATE OF OCCUPANCY I • -• No. Date PROJECT ADDRESS: 274 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IB 058068 • ' OWNEWS ADDRESS: DALBY, ANTHONY CHASE ADDRESS: DALBY, TAFFY T PERMIT NO: IB 058068 PLAN CHECK NO: N GOVT: N SUPP: Y 274 E 19TH ST COSTA MESA CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: OTH STR PURPOSE: ALT ARCN7ENGINEER: ( 714 ) 646-1 A121 REG.ND.: JOB DESCRIPTION : WINDOW CHNG. /OUTS—NO INCREASE IN R/O'S SQ FT: \II ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 PERMITTEE: TONY DALBY ( 714 ) 646-1221 ACORESS. 274 E 19TH ST COMMENTS • REINSTATE EXPIRED PERMIT #1349038 COSTA MESA CA 92627 *ar*+F****4 ****************;'F*+E*******************;' **************xkF*•iE***>E**x***** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Processions Code.and my license is in lull force and effect. SETBACKS CITY LIG.: STATE LIC.: CLASS: Date: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a cerllficate(ol consent to self-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN F RNT: FT IN REAR: FT IN . Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: EXP.DATE: I COMPANY: PARKING REQ• PROV: PARCEL: 42628115 ZNE: REF NO: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > . , Date: Applicant: ******************if-,************************************************************ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: Reis ion need not be completed if Me permit is for one hundred($100)or less). DEVEL 0'P M EN T SERVICES REQUIREMEN T S I certify that in the performance of the work for which this perm is ed.I shat not employ any person in y manner so as to become 4 subject to the Workers'Compensation Laws of California. ZONING APPROVED BY LI • DATE: Date: n 2-9, Signature- NOTICE:If,after making this declaration,you should come subject to the Wo ers'Compensatio revisions of the Labor BUILDING APPROVED BY DATE: Code.you must fonhwitri comply with such provisions or this permit shall be erred revoked. 41 CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a constructio nding agency for e performance of the work for • 1 / 's DATE- which this permit is issued(Section 3097,Civ.C). 3Af.p*ipeiLFM.*******XI(.{S(.*iUElECD'�t'*iYF{(.*.1e***********N.****.*itiE. ***%.****.****.******.*�l**;.kEM .R+. .>F*.lf** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y 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 SNIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 30 . 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 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)hal 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($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 D1 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----> 30. 00 0 . 00 0. 00 30. 00 30 . 00 . 00 does not apply to an owner of a property who builds or improves(hereon.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• 30 . 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 30 . 00 ❑ 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).l am aware *.**.*.**.***.*.*.***.***.*.**.*****.**.*****.*.*.**.*.*.*.*.*.*..***.*.*.*.*.**.*.***.y.**.***.***.*.***.*.**.****af,*** that proof of their Worker's Compensation insurance should be provided to me. r.7 1 am exempt under section: BP7044 B.&P.C. INDIVIDUAL F E E BREAKDOWN W for this reason: ALL WORK BY OWNER / / j" .and TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Date: j'�1 —1Z Owne '�PIdo hereby certify Owl lam aware of and untlerstana the requirements of CaliforniaHealth and Sal Code SectionsINS 1 BUIL INGRE—INSPECTION FEE 30. 00 30. 00 25534 and that I or any lulure building occupant wiluwill not(circle one)need to corn*with sa• le codes and thements for a END OF FEES permit Ior construction or modification from the Air Duality Management District.Residential construction applications are exempt from :° 4 these provisions. Date: Applicant: EXPIRED I hereby certify that I have read this application and state that the above informali is correct.I agree to comply th all city and county t plate II'U pect(CN1S ordinances and slate laws relating to building construction and hereb Ihoriie rep entatives of this city to enter u the above-mentioned property for inspection purposes. Q�� _ Date:r7—�"57�` Slgnatur __'^6 Ot EJO11::u7 g2iIi184o - ;ATE: 0: .'0'r 92 E: as Drivers License or Social Security a: • a. 164;46 White—Building:Green—Lace Enforcement:Canary—Applicant; J ant;Pink—flevenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING - POOL - 0PA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole +e, 52. Pool & Equipment Location 1,,,, _.t . ,2. Soil Pipe•Undrgrnd. - 53. Steel Reinforcement �, , I. ,3. Electrical Conduit Utility-Undrgrnd. -rl 54. Forms ifl 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding y S • 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 1/" .Y 59. Gas Pipe, 0 Undrgrnd.,Test -�. 9. Water Pipe-Undrgrnd. ) 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - y 61. APPROVAL TO DECK ,' ..:2? 11. Property Sewer Line & House Connection '� 62. Backwash & Receptor-Final ,%"-' 12. Sewer Cap 63. Heater & Vent-Final '"/� .1, 7 13. Roof Drains 64. Plumbing System - Final - `. . 4, y 14, Rough Plumbing - ' �1 65. Electrical-Final �{ / 7 ---71 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 Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing Q_([..yy 6 C44---76. Dry Standpipe - 28. Lathing& Siding t��.- 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREV. FINAL " 30. Drywall Nailing 1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 1 79. FINAL INSPECTION 32. Electrical Power Meter-Final I 80. FOOD CERTIFICATE ISSUED } 33. Final Electric Notes: -.e 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopyr r - 37. Final Factory Fireplace - 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final 41. Solar Domestic-Final . - 42. Backflow Preventer I. 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 I - 51. CERTIFICATE OF OCCUPANCY - No. Date PROJECT ADDRESS: UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 058070 , OWNER'S NAME: 174 E 19TH ST ADDRESS: DALBY, ANTHONY CHASE DALBY, TAFFY T PERMIT NO: B 058070 PLAN CHECK NO: N GOVT: N SUPP; N 274 E 19TH ST COSTA MESA(CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: OTH ARCH/ENGINEER: (714 ) 646-1L21 REG.NO.: JOB DESCRIPTION : INSTALL WALL SIDING .CEDAR SHINGLES SIDN SQ FT: 2,000 ADDRESS: UNIT: CLAIM VALUE: 2, 000 . 00 CALC—VALUE: 2, 000. 00 GROUP OCC: R-3 /M-1 PERMITTEE: TONY DALBY ( 714 ) 646-1221 ADDRESS: 274 E 19TH ST COMMENTS: CEDAR SHINGLES TO BE FIRE RATED COSTA MESA CA 92627 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: 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 3800.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING RE • PROV; PARCEL; 42628115 ZNE: REF NO: 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING N TES> > Date: Applicant- ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred WOO)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is' ed.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: 7-7 Signature: NOTICE:If.alter making this declaration.you should ecome subject to I Workers'Compe n provisions of the Labor BUILDING APPROVED BY : DATE: Cade.you must forthwith comply with such provisions or this permit s be deemed revo . I CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: �— DATE: R(n( cj A which this permit is issued(Section 3097,Civ.C). ***********.**************************** * ******************.******* **** **** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y 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 45. 00 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 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 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, wit do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended ar offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 45 , 50 0. 00 0 , 00 4 5 . 50 45 . 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 or sale. II,however the building or improvement rl BLDG PMT PLUMBING ELECTRICMECHANIC FIRESMIPTOT within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE —_ S / /S forthepurpose GI sae) GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 45, 00 . 50 ❑ 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),l am aware *************{L.****************************.************If.*y,.*******.*************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN Ns I am exempt under Section: B P 7044 B.A P.C. for this reason: ALL WORK BY OWNER TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date: 7-7"17 Owner: Q SFR 2000 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 2, 000. 00 I do hereby certify that I am aware of and understand the requirements of California Health and Sal y Code Sections ,25533,and 25534 and that I or any future building occupant wilUwill not(circle one)need to oomph/with sa ate codes and requirements for a �[ END OF 5 EES permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from [+ 41 these provisions. S K i • Date: Applicant: EXPIRED I hereby certify that I 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 hereb rte re esentatives of thistly to en port the above-mentioned P 1e IFLspeCt Wr1L , property for inspection purposes. ' `- I K g Date'7'7 —.S� - Signature: � A� an YG !J_� sig 01 0D11 57U'I_U11GG71 ._r.;' 5,..,,-. Driver's License or Social Security x: H0982945DATE: 07/0702 I"�:2 TT1:::4 ! _. 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor _,,j f • CONSTRUCTION AND PLANNING POOL ?A APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -r . 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utilitv-Undrgrnd. "i 54. •Forms .11i../: 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. r 8. Foundationr59. Gas Pipe, Q Undrgrnd., Test ' S. Water Pipe-Undrgrnd. t ;� 60. Backwash Lines, P-Trap, 0 Undrgrnd. - y 10. Structural Floor System i1 , 61. APPROVAL TO DECK -'I 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final / ''1 y - '' CC 12. Sewer Cap ri 63. Heater & Vent-Final t t•:. 9• /r~• 13. Roof Drains 'rte 64. Plumbing System - Final `-° 2 �: 14. Rough Plumbing - r 65. Electrical-Final -. - -% 15. Rough Electrical-Conduit , g 66. Solar System-Final 7 16. Rough Electric Wiring 67. Fencing & Access Approval ! ' Y O 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 , •1 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. Undergrndi.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 , T` 28. Lathing& Siding - 77. FIXED SYSTEM ANAL I 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing r HEALTH DEPT. REQUIREMENT T 31. Plaster Brown Colt 79. FINAL INSPECTION 32. Electrical Power Meter-Final (. 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test : • ) 36. Hood or Canopy . ' 37. Final Factory Fireplace ' '38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 41, Solar Domestic-Final 42. Backf low Preventer , 43. Backflow Irrigation . 44. Landscape Irrigation System . 45. Sound Attenuation • 46. Handicap Regulations s 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 PROJECT ADDRESS: 274 E 19TH ST tom CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 058069 OWNER'S NAME: DAISY, ANTHONY CHASE ADDRESS: DALBY, TAFFY T PERMIT NO; E 058069 PLAN CHECK NO: N GOVT: N SUPP: N 274 E 19TH ST COSTA MESA CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH ARCH/ENGINEER: (714 )646-1p121 REG.NO.: JOB DESCRIPTION : ELECTRICAL APPARATUS FOR PORTABLE SPA SQ FT: ADDRESS: UNIT: PERMITTEE: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 ADDRESS: TONY DALBY ( 714 ) 646-1221 274 E 19TH ST COMMENTS: REINSTATE EXPIRED PERMIT 4E49039 COSTA MESA CA 92627 ***********************************:E******EE*+E****************** EE************x* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE IIC.: CUSS: Date:_ Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby 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.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: 42628115 ZNE: REF NO: O Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Oate:_ Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This . ion need not be completed If the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES REQUIREMENTS I cenity that in the performance of the work for which this perm 1 ed,15'i 0 not employ any person r ny manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: .7^ `rk - 52- ignatur' /.4.. .I.ed• 46—.NOTICE:If.alter makingthis declaration,you shou d•come subject to the •rkers'Compensat rrovisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such provisions or this permit sh.11 • deemed revoked. CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency f• the performance of the work for APPLICATION ISSUED BY: \`\ DATE• 7 J7 ( `l which this permit is issued(Section 3097.Civ.C). ***N.*****.*.*****.**************ie***{t.*.****** ****.**.*i[.****.**K.*{,f.***.*.{e**.*..*.. {sse jr ir* 7 ** LENDER: ******************************************************************************* AODRESs: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Stale License Law for the Wowing 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 1100 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed (:)% $MIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Prolessions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My 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(5500). 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 sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 11 . 00 15 . 00 0 . 00 26. 00 26 . 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.II.however the building or improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED:_ 26 . 00 OVER/SHORT: 00 , forthepurpose olsale). 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 26. 00 ❑ 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 Licenso Law).l am aware *******{p*******-********************************.*******•*.****.*****,**,**,*,*******,*,** Inas proot of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN 51 f am exempt under Section: B P 7 0 4 4 B.a P.C. for this reason: ALL WORK BY OWNER AO, j /�( Al / TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: --7-.. � Owner _ •• k�.1-A .' air 9. I do hereby certify that l am aware of and understand the requirements of California ieallh and Safet Code Sections 2 .25533.and ELE 1 , MISC APPARATUS NOT LISTED REQ PERMIT 11 . 00 11 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and th. •uirements for a t END )OF FEES permit for construction or modification from the Air uality Management District.Residential construction applies( are exempt from these provisions. ExPiRED Date: Applicant: _ ) Piet ILu FXeCtlOn I hereby certify that I have read this application and state that the above information is correct.ives I agree to comet with all city and county (5 S ordinancesertfand state on purpose to building construction and her IhJrltn r�sentatives of this city town, •• the above.mentioned �`L. .•� progeny for inspection purposes, / ere V 9 Date: —/ —7.Z` 5ignalure: - / ' ' �'- CJ11y T 0�. 277)- Li72 Y _ J'J Driver's License or Social Security re: \ y,q DATE: 07/07/72 TUT: 1.1 xas� 1641.40 White—Building:Green—Code Enforcement:Canary—Aoolicant:Pink—Revenue:Goldenrod—Aenr J CONSTRUCTION AND PLANNING POOL ?A APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector � t 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location li' ',-' • 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement ✓' 3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms n 1;1 4. Electrical Conduit-Undrgrnd. I 55. Electrical Bonding UJ 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 f 0 59. Gas Pipe, 0 Undrgrnd., Test ,�!f 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. ^"r 10. Structural Floor System �� , 61. APPROVAL TO DECK I 11. Property Sewer Line & House Connection �� 62. Backwash & Receptor-Final .7 �s _ Cap 12. Sewer r�3 63. Heater & Vent-Final 4 1 13. Roof Drains 64. Plumbing System - Final c-'.; '1 14. Rough Plumbing 9 (� - �"= 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • :'I •� i. -> 16. Rough Electric Wiring67. 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 Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe ' 1,0 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - - r 31. Plaster Brown Coat 79. FINAL INSPECTION • i • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -s • 33. Final Electric 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 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY No. Date 4RA274 E 19TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 049039 OWNER'S NAME: DALBY, ANTHONY CHASE ADDRESS: DALBY, TAFFY T PERMIT NO: E 049039 PLAN CHECK NO: N GOVT: N SUPP : N 274 E 19TH ST COSTA MESA CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE PURPOSE: OTH (714 ) 646-1`221 • ARCH/ENGINEER: REO.NO.: JOB DESCRIPTION : ELECTRICAL APPARATUS FOR PORTABLE SPA SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /M- L PERMITTEE: TONY DALBY ( 714 )646-1221 ADDRESS: 274 E 19TH ST COMMENTS : SMOKE DETECTOR( S) REQUIRED IN HOME. COSTA MESA CA 92627 ******************************er**********+ ***ac.***it*H*iE*******;c-************+T***iE LICENSE')CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING R EQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY UC.: STATE I16.: CLASS: MAIN BUILDING ACCESSORY BUILDING - Date: Signature: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that have acertifcate of consent to sell-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT : FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). PaucY NO.: EXP. PARKING REQ: PROVO PARCEL: 42628115 ZNE: REF NO: "•OMPANY: PLANNING NOTES> Certified copy is hereby furnished. 0 Certified copy is tiled with the dry Balling Division. > Date: Applicant: DEVELOPMENT SERV ICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Rus section need not be completed If the permit is for one hundred($top)or less), 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 ZONING APPROVED H Y subject to the Workers'Compensation Laws of California. DATE: pate: Signature: BUILDING APPROVED BY : DATE: _ _ _ NOTICE:II,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor – — — /' STRaTyou manDINGWAGcomply with such yprovisions pis a construction lending deemed rewkeo. • APPLICATION ISSUED BY : DATE: q�tg7 d CONSTRUCTION LENDING AGENCY: Thereby affirm that there sacastructim lending agency for the performance of the work for *************************YA..of*** +Fsrit-4-o vonr t ****a ***************-7 Sr wriE;,+e3-if*** which fhb pernutsissued(Section 3097.Civ.C). ****************************************** ** r r***************************,***** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from to Contractors'State License Law for the followingreason 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 11 . 00 • repair arty strocture,prior to Its issuance,also requires the applicant for such permit to rue a signed statement that he/she Is licensed 5()Ii SMIP/NON-RES • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ISSUEFEE 15, 00 -- any applicant for a permit subjects the applicant to a civil of not more than five hundred doom(5500). . –-..- BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE I. as owner of the propend or my employees with wages as their sole compensation, win do the work, and the TOTALS----> 11 . 00 15 . 00 0 . 00 26 . 00 26 . 00" . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law • 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--> COLLECTED: 26 . 00 OVER/SHOAT ,00 improvement is sold within 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 far to purpose of sate). 26 . 00 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business ❑ and Professions Code: The Contractors'State coicemeLaw does mtapply toanowner ofproperty who bwMsor Improves aware ******************************************************************************* and who contracts for such projects with a controverts)(s)license pursuant to • •ntraoos'Sate License Law).I am aware that proof of their Worker's Compensation insurance should be provided to IND I V IDUAL F E E BREAKDOWN 6 I am exempt under Section:B P 7044 B.A P.C. . • ror Ude reason: ALL WORK BY OWNER Iv/ / TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date:_ 9- c---70 owner. /i.-�1L%L L� !'__ ELE 1 MISC APPARATUS NOT LISTED REQ PERMIT i 11 . 00 11 . 00 I do hereby certify that I am aware of and understand the requirements of.-. omia Health and Safe Code Sections 2 5533,and 1 END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said 5 e codes and Mel irements for a ) permit for construction or modification from the Air Duality Management District.Residential can motion applicxtio .re exempt from 1 these provisions. EXPIRED Date:_ Applicant: :::------oni plete Inspections I hereby certify that I have read this application and state that the..,4 .tion- .•sect.I agree to comp with all city and county ordinances and sate laws resting to buildup construction and herebyyy�,,k re• _yyy1 Wes of this oente • the above-mentioned Q�. 01 00069794-00049794 -f i-f "'h.03 properly for inspection purposes. I'� / k SigDate: 9 �'�d sgnatue: ly' �9 Vete OATS: 09/18/90 TIrE 09: fid\ c/ Driver's License or Soda)Secority x: - +k 1641.46 White—Building:Green—Code Enforcement:Cann/—Appllcanr;Pink—Revenue;G... rod—Assessor ` • No ,} • CONDUCTION AND PLANNING POt. . 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. • 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 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 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ` 31. Plaster Brown Coat 1 79. FINAL INSPECTION • - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 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 Y - 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer .1 43. Backflow Irrigation 44. Landscape Irrigation SystemP t U E X � �_ stion5 45. Sound Attenuation :11';enlete IR'.,? 46. Handicap Regulations '1L�S1g 47. FINAL STRUCTURE & BUILDING udtW -__ UU'�• 48. FINAL PLANNING • a 49. Electric Release to Edison 15 50. Gas Release to Southern California Gas CO 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 274 E 19TH ST UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 049038 OWNER'S NAME: DALBY, ANTHONY CHASE ADDRESS: DALBY, TAFFY T PERMIT NO: B 049038 PLAN CHECK NO: N GOVT: N SUPP : N 274 E 19TH ST COSTA MESA CA 92627 CONSTRUCTION TYPE ; 5-N PERMIT TYPE: STR PURPOSE: ALT J` ( 714 ) 646-1121 '' ARCH/ENGINEER: REG.NO.: . JOB DESCRIPTION ; WINDOW CHNG, /OUTS-NO INCREASE IN R/O' S SQ FT: 2, 000 j�� ADDRESS: UNIT: CLAIM VALUE: 2 , 000 . 00 CALL-VALUE: . 2, 000 . 00 GROUP OCC : R-3 /M-1 PERMITTEE: TONY DALBY ( 714 ) 646-1221 • ADDRESS: 274 E 19TH ST COMMENTS : SMOKE DETECTOR(S) REQUIRED IN HOME. COSTA MESA CA 92627 *****er**4**erar***********x*******+e ****************** #****** ****er** *******4* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQU IR EMEN TS - • 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect. SETBACKS CITY LIC.: STATE LIC.: CUSS: Date: Signature: FRNT: FT MAIN INBREARING FT IN FRNT: FTCESSINYREARLDING FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT: FT IN LEFT : FT IN RGHT: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). POUCY NO.: EXP.DATE: PARKING REQ: PROV: PARCEL : 42628115 ZNE: REF NO: COMPANY: PLANNING NOTES> I Certified copy Is hereby furnished. 0 Certified copy is filed with the city Building Division. > ******************************************************************************* Date: Applicant: DEVELOPMENT SERVICES REQUIREMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). 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 ZONING APPROVED BY DATE E ,subject to the Workers Compensation Laws of California. Date: Signature: BUILDING APPROVED BY : _ _ _ _ NOTICE:If,after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor DATE Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. APPLICATION ISSUED BY: DATE: /� CONSTRUCTION LENDING AGENCY:3097,Ciy affirm that there isaconswction lending agency for the performance of the work for *************************-nx * ` ,*****1" ..4,, f.x*iF*1 #**************},dTA. "„ ���ii*rr ****• ;which this permits issued(Section Civ.C). ***.**.*.*..*********.***..**.*.*.*.N.**.***.*****,****,, *** . ****.*.**.*********,****,*,1(,************ ADDRESS: LEGALIZATION :N F E E S U. M . A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law Mr the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 45 , 00 . 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 SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID / DUE I, as owner of the property or my employees with wages as their sole compensation. wit do the work, and the TOTALS———-> 45 , 50 0 .00 0 , 00 45 , 50 45 . 50 ::, , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an owner of a property who builds or improves thereon.and who does such work hinsellmerself 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 : 45 . 50 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 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING, PLAN—CHECK for the purpose of sale). 45 . 00 . 50 I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044.Business • ❑ and Professions Code: The Contractors'State License Law does not appy to anavmer of property who builds or improves thereon *******************************).,*********************************************** and who contracts for such projects vet a contractors)license pursuant to the Contractors'State License Law).I am aware that proof of their Worker's Compen tlioon insurance should be provided to me. IND IV IDUAL F E E BR E A K DOWN QI am exempt under Section: 044B.S P C. - � Dor this reason: PALL WORK BY OWNER/ // TYPE QTY DESCRIPTION UNIT COST . _ TOTAL COST Date: 9— Q ^ftt0 Owner. Alt Ia%'•''4- air., SFR 2000 ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 2 , 000 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Sal• Code Sectio . • 05,25533,and 11 END OF FEES _ 25534 and that I or any future building occupant wllgw111 not(circle one)need to comply with said ate codes and uiremens lora b. ? B:- _ =_^ permit for construction or modification from the r Oualiry Management District.Residential construction appl: .ns are exempt from y, s fif 9 — r 1 -- �—_—v-- these provisions. r. EXPIRED ';V-'�T�V '—= ..,, Date: Applicant: Incomplete Inspections , I hereby certify that I have read this application and state that the a''- information is correct.I agree to comp with all city and county ordinances and state laws relating to building construction and here Drize re, "sentatives of this city to ent pon the above-mentioned • - propertyforinspectionpurposes. V / Dated___ _ Sig 01 00069792-00069793 TOT 45.50' l _ D �/, / DATE: 09/18190 TIME: 09:34 / Date: T7 i Signature' F •Driver's License or Social Security#: / 1641-46 While—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Go nrod—Aeseesor , I . • CONtTRUGTION AND PLANNING - POL I SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit # • 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 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, 0 Undrgrnd. • 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final 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 0Gas 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final •' ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test / • , 36. Hood or Canopy "Ey' 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 ,,I 44. Landscape Irrigation System EXPIRED 45. Sound Attenuation I I In ompl a I11SDectIor ""t 46. Handicap Regulations •' 47. FINAL STRUCTURE & BUILDING Lale Y. �S6 -___.�___-�.., r1 .1 1 ;l 48. FINAL PLANNING 49. Electric Release to Edison t '�}, 50. Gas Release to Southern California Gas Co • _ 51. CERTIFICATE OF OCCUPANCY- t• No. Date N; • ' VROWEf�l'DDRESS: 274 E 19TH ST UNIT: CITY OF COSTA MESA BUILDING PERMIT • PERM_ NO: B 045888 .40WNER'S NAME:,DALBY - • - -- - - ADDRESS: SAMEI PERMIT NO: B 045888 PIAN :CHECK NO: N • GOVT.: 'N. SUPP : N • CONSTRUCTION TYPE: • PERMIT T • YPE: STR PURPOSE: ALT 719 ) 646•—].221 'ARCH/ENGINEER: - - , ,REG.NO.: ' - JOB DESCRIPTION REPLACE 3 WINDOWS:W DEL PANE SQ FT: .; 950 - , ADDRESS: - . - • • 'UNIT: ' CLAIM VALUE: 950 . 00 CALL—VALUE: 950. 00 GROUP OCC: 12.-3. . / PERMITTEE: DALIIY • ( 714 ) 646-1221 , - - ' ADDRESS: 274 19TH ST _ COMMENTS: 3 DEL PANE WINDOWS IN ( E) OPENINGS • - ' CM CA 92627 **•>E*EEL****i****i** *******ilt******lt*****************i***4E**ati**3(m-** -iE***vitt***3E*** , LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section I . -' Z 0 N I• N G REQUIREMENTS . • 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. • . _ SETBACK 'S CITY UC.: STATE UC.: , CLASS: 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 at Workers' FRNT: FT • IN. REAR ; - FT IN - FRNT; FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800,Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT: FT. IN RGITT: s FT IN POLICY NO.': EXP.DATE: ' _ COMPANY: PARKING REQ: PROV: PARCEL: 42628115 2NE: REF NO: r ' Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. , PLANNING NOTES> - . ... .. . . . - > . . . •- . • . .. .. . _ . • Date: Applicant: • *************'************44*******************************************r********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). D , E V'1 E L O P •M E N T 'S ER V IC ES R 'E Q U IR EMEN ,T 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 ' I" _ subject to the workers'Compensation Laws of California. ZONING. AP PRO.V ED 'BY DATE:E — Date: ' Signature: ' - - •'DATE: - - - - NOTICE:IL atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING AE4 P•1;OV ED BY _ 'DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. ��J �_ � • . � /—�/ CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y:fiV DATE: aT3F"�t which this permit is issued(Section 3097,Civ.C). ************fit****it*3+it* FF.3t�t E*i ** dE*if********************+'+t �7� ** UNDER: • *********************************** *** ************ ADDRESS: - , - • . ' LEGALIZA•TION:N F E E " S ,M -M A R. Y STRUCTURAL 'SEGMENT:Y • OWNER'BUILDER DECLARATION: I hereby affirm that l am exempt trom.ihe 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 25 _00 . • . 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 BusinessSMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by ' PLAN . . . r any applicant for a permit subjects the applicant to a civil penalty of not mare than five hundred dollars($500).; - ' ' . ISSUE FEE - ' I, as owner of the property or my em loyees with wages as their sole compensation,.will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ® tructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS'—,---> .1 2 5 . 5 0 ' ' 0 . 00 0 . 00 2 5 . 5 0 •' 25 . 50 ' . 0 0 does not apply to an owner of a property who builds or Improves thereon,and who does such work himself/herself ar through '. his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or -REVENUE DIVISION TOTAL S--> COLLECTED: 1 25 . 50 OVER/SHORT• 0 0 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build orimprove for the purposeofsa1). • 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 • 25 • O O -�' 5 O ❑ - 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 contactor(5)license pursuant to the Contractors'State License Law).l am aware **it**********************************#************************************.***** that proof of their Worker's Compensation insurance should be provided to me. I N D "i V I D U A L 'F E E B R E A K D O 14 N ❑ I am exempt under Section: B.S P.C. . • forthisreason: TYPE QTY DESCRIPTIO N. 1 - UNIT COST' TOTAL COST Date: Owner: SFR ' 950 STRUCTURAL BY VALUE -PER $1 , 00 1 . 00 950 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.2isi3,and END :OF FEES • 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 modification from the Air Quality Management District.Residential construction applications are exempt from • these provisions. - • Date: - Applicant: - ' I hereby certify that I 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 thiscity to enter,upon the above-mentioned , property for inspection purposes. . Date: Signature: • •• 01 00052927-00052928 T C1 T 25.50 Driver's License or Social Security#: ' • • DATE: 01/29/90 TIME: 16:46 1641.48 White—Buildifiot Green—Cede Enforcement:Canarv—Applicant;Pink—Revenue:Goldenrod—Assessor . - - - • -- -- i1 �+� 1 , ; /CONSTRUCTION AND PLANNING' POO ;PA r - - Date .Inspector Date Inspector , •.., APPROVALS Permit# APPROVALS Permit # - 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2.-SoilPipe-Undrgrnd. , 53. Steel Reinforcement . 14 ' 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. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK . 11. Property Sewer Line'& House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains . v - 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final - • 16. Rough Electri Wiring 67. Fencing & Access ApproJal • 17. Rough Wiring Sign _ 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning i. c r , FIRE DEPT. REQUIREMENT 20.-Rough Eactor'y Fireplace - it.: - o. , ; ' , +APPROVALS _ ,_,Permit# - 21:_Ducts, i-n-Structure' - - -" 70. Underground Hydro : 22.-Ducts, Ventilating.- a _ - . .•71. Product.Prping O Gas OOil 23.-Gas-Pipe-Rough& Test E ' r' -,72. Underground Flush - 24."Roof Framing -r, 34-:24k94w./ .;737 Undergrnd.StorageTank:O Gas 0 Oil 25. Roof Sheathing - - 74' Overhead Hydro_ _ 26.,T-BarCeiling (Structural) &-Mem-Ocoat ' s. ' . �- 75,-Ory Chemical ' 27 Frame and Flashing, - - ' 76. Dry Standpipe , 128. Lathing:& Siding-,;' `•' ,c if, 77[, FIXED SYSTEM FINAL _ 29. Insulation . _ 7t2/4O (04/7-J' 78::FIRE PREV. FINAL - - ' 30. Drywall Nailing I. ; ,-, , i 1; .. :HEALTH-DEPT'. REQUIREMENT -31. Plaster Brown Coat` 79. FINAL INSPECTION ;32.. Electrical Power Mete-Final i 80:.,E000 CERTIFICATE ISSUED, 733. FinalElectric ;)•i. Notes: 34.2Final Heating& Air Conditioning= _ • '• 3•-27-19--Lv 9 Air �,ai� O1 _6 35.Final Gas Pipe-Test ' - it .• [. /// ci,r/K+r,-!•+ jl\J 36. Hood of CanoPY=' < � .-fc "I r. _ 37.-Final Factory Fireplace ' - '1yj'i� t. a - • 38. Final PI'umping - •,,` ` 1 .1 39. Water Service-Final 4 r • ill' .^ *. , 40. Gas Service-Final ' r '" 41. Solar Domestic-Final ' • 42. Backflow Preventer^ .' y' s. - - 43. Backflow Irrigation •t • • - "44. Landscape IFrigation System ' • _ r _1 r _ "' n.t - . '45:Sound Attenuation �`-.• •• - , - r-1i - .� 46. Handicap Regulations - A. + - r _ - - . -- r - ' Fla: - 47rFINAL STRUCTURE & BUILDING 6- -f' G`v - - - _ r 48.-FINALPLANNING +--f - i 1./"-. < - r: - ." 49.-Electric•Release to Edison - .. ' • - 50. 'Gas Release to Southern California Gas Co t ' `I•, - - _ _ ' 51. CERTIFICATE OF'OCCUPANCY No. Date 44 —,1114HWECTAOORE38: 274 E 19TH ST UNIT: CITY OF COSTA' MESA — BUILDING PERMIT PERM NO: B 045887 - OWNER'S NAME: DAL BY • . ADDRESS: SAME • ! PERMIT NO: B 045887 PLAN CHECK NO: • N GOVT.: N SUPP : N CONSTRUCTION TYPE: PERMIT TYPE: ,STR . PURPOSE: ALT 714 ) 646-1221 . ' • ARCH/ENGINEER: IIEO.NO.: •JOB DESCRIPTION : NEW SIDING' 6 INS W/R-11 SQ FT: 350 ADDRESS: . UNIT: • CLAIM VALUE: 350 . 00 CALL—VALUE; 350 . 00 GROUP OCC: R 3 / • PERMITTEE: DALBY ( 714 ) 646-1221 ' ADDRESS: 274 19TH ST COMMENTS: NEW SIDING 6 INSULATE W/ R-11 CM CA 92627 ****************************************EE***ye***•w***************x** ea>EyEetaa****** 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 i5 in full force and effect. . . - SETBACKS . • ' • CITY LIC.: : . STATE LIC.: CLASS: . Date: Signature: - MAIN BUILDING ------------ --------- ACCESSORY BUILDING ---• WORKERS'COMPENSATION DECLARATION: I hereby affirm that)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.ora certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT . I N POLICY NO.: EXP.DATE • : COMPANY: PARKING REQ: PROV: PARCEL : . 42628115 ZNE: , • REF NO: Certified copy,is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> - ' 1. - > . . . . . Date: Applicant: ***********************iE**************************9E*****************If'********** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (this section need not be completed it the permm permit )is fore hundred WOO)or less). : D E V E- L O P M E N T S E R V I -C E S R E Q U I EVE M E N �TS I certify that in the performance of the work for which this peit is issued.I shag not employ any person in any manner so as to become r subjectto the workers Compensation Laws of California. ZONING APPROVED BY _ __ .DATE: 1' '• . ---- Date: - - Signature: - - - - • -• . - - -- - NOTICE:If,after making this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY i : DATE: —• n - 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 performance of the work for APPLICATION ISSUED BY: DATE: 0/`Z9 '�j Q which this permit is issued(Section 3097.Civ.C). **********************';T' e - F**********W********** *'* LENDER: ********************************* ** .******************************it***** *I!* ADDRESS: - • I,EGALIZATION:Y -- FEE U M M .A R Y . STRUCTURAL SEGMENT:Y ' OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECT IC 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,Orp ERM I T- 30 . 00 . 5 0 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.Dnision 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 , any applicant for a permit subjects Ila applicant to a civil Penalty of not more than five hundred dollars(1500).' , ISSUE FEE ' I, as owner of the property or my emyloyees with wages as their sole cornpensatwn; will do the work, and the BUILDING—DIV—> 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--—--> 30 . 50 0 . 00 0 . 00 30. 50 30 . 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 REVENUE DIVISION TOTALS COLLECTED : 30. 50 OVER/SHORT: , 00 improvement Is sold within one year of completion,the owner wig 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 30 . 00 ' S 0 ❑ 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).l am aware ***************************:**************************************************** that proof of their Worker's Compensation Insurance should be provided to me. IND I V IDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Date: Owner:• • SFR 350- STRUCTURAL BY VALUE PER $1 . 00 1 . 00 350 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505,25533,and END OF FEES ' 25534 and that I or any future building occupant wiWwlg tt(circle me)need to comply with said state codes and the requirements for a • permit for construction or modification from the Mr OuaSry Management District.Residential construction applications are exempt from these provisions. • . Date: Applicant: - I hereby twirl),that I 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 bulling construction and hereby authorize representatives of this city to enter upon the above-mentioned _ _ property for inspection purposes. I •Date: Signature: ' 01 00052925-00052926 TOT • 30.50 Driver's License of Social Security it DATE: 01/29/90 TIME: 16:45 - 164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • - .- , i r r - POO ;PA CONSTRUCTION AND PLANNING 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 r. • 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, 0 Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater& Vent-Final 13. Roof Drains - n. 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final t 16. Rough ElectricWiring 67. Fencing & Access Approval • 17. Rough Wiring Sign 68.. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. 'POOVSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . _FIRE DEPT. REQUIREMENT 20 r- Rough Factory Fireplace = j; APPROVALS :. .Permit# 21.-Dulls,inStructur_e - -:11 * •_ 70. Under round Hydro 22. Ducts, Ventilating , - • .71. Product-Piping OGas 0-Oil 23. Gas-Pipe-Rough & Test = " r: - -72. Underground Flush -- - 24 TRoof Framing . t73..Undergrnd.StorageTank 0 Gas 0 Oil 25. Roof Sheathing - _ _ _ 74. Overhead Hydro;;_- 26. T-Bar Ceiling (Structural) &•Mbribcoatr-. 75_Dry Chemical - . - 27. :Frame and Flashing ac a 76. Dry Stand•pipe _ '-28. Lathing& Siding ' , . , • I ) ; ;. 771' FIXED SYSTEMFINAL.. _ 29. Insulation _ -i ' • 78` FIRE PREV. FINAL - 30. Drywall-Nailing ' _ ; ' ' f• 4 ` HEALTH DEPT: REQUIREMENT .;31. Plaster Brown Coat, -: -: • "79. FINAL INSPECTION ' 32..Electrical Power Meter-Final • "I 80L.FOOD CERTIFICATE ISSUED_ _ -.33.[Final Electric ' _. . 4`Ii Notes: . - 34. Final Heating& Air-Conditioning _ - '/ '• ` - - ' • 35.-Final Gas Pipe-Test., -- -- • 1..,:�;:-I - _ .- r t 36, Hood or Canopy ' - - " - '" ' - _ _ • - _- 1 37.-Final Factory Fireplace: - - - i. - ._Y • +' 38. Final Plumbing ' N ,` 39. Water Service-Final; - . - .40. Gas Service-Final - - - " " - -- - 41. Solar Domestic-Final ' t. 42."Backflow Preventer • ` + 1 • 43. Backflow Irrigations .I - r . ry o. 44. Landscape Irrigation System a - _ _ -45.-Sound Attenuation - -1 - - 46.•Handicap Regulations - - - , ,47.-FINAL STRUCTURE & BUILDING (o-G--to acv - 48.:FINAL PLANNING - - ;• 4-"; ' r . ' .. 49. Electric Release to Edison 7 ff , I. 'S0'-Gas.Release to Southern California Gas Co • �.; �' . •51. CERTIFICATE OF•OCCUPANCY y t No. Date , 411111 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. '� CIT'7 OF COSTA MESA PUAIT N TRACT NO. LOT NO. B}jl .�0. CONSTRUCTION PERMIT L� �.5'3 1 • 1997 12/i16/1; B.140 TL Project Address h. .27q S. a TYPE OF CONSTRUCTION - ' Owner At Lk/• m. EDY Phone 0 NEW 0 ADD 0 ALTERATION �£.9 Address !T 0 REPAIR 0 CONVERSION ❑DEMOLISH " ZONING REGULATIONS Arch/Eng• • License No. 0 OTHER _ A.P. ' DESCRIPTION OF WORK Address '( Sja_arrniFFF:Zen- ZONE PLNG. REF.9p Contractor eQ.Re9 4-Nft 17/EL Phone 9626097 TYPE OF:PERMIT r BUILDING Tp gU'�pI G AddressSETBACK C/L ST. PROPERTY LINE _ �vs •ry jRD- sr F.v. CA- 9itaq 0 GRADING . 0 FOUNDATION 0 STRUCTURAL,t Elm YARD • LICENSED CONTRACTOR DECLARATION 0 TENANT X,ELECTRICAL ❑PLUMBING ❑MECHA.NICAL SIDE YARD - - I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT moncing with section 7000) of Division 3 of the Business and 0 OTHER ' Professions Code, and my license is in full force and effect. REAR YARD(TO P/L) - License Class C/0 ' License No. 409030 PROJECT DESCRIPTION PKG.SPACE REQ. PROVIDED Date jS.-4t.-2t. Signature 0 -4c/waac.e SQ.FT. WORKERS'COMPENSATION DECLARATION .OCCUPANCY_CONSTRUCTION TYPE STREET WIDTH PARK FEE 8 I.hereby affirm that I have a certificate of consent to self-insure or a VALUATIONZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: thereof(Section 3800,Lab_CJ• GRADING CU.UOS. ACRES . • 'Icy No. Company :ertlfied copy is hereby furnished. - -REMARKS: - - - Certified copy is flied with the city Building Division. • EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - ' - - - — --_ ((This section need not-be-completed if permit is for one hundred($100) or less). • - -- - - certify that in the performance of the work for which this permit is Issued, 1 shall not emloy any person In any manner so as to become PLUMBING PLAN CHECK - ELECTRICAL - PLAN CHECK subject to the Workers'Compensation Laws of IHgrnia. - UWLLLING - - taAHAbt Date iZ � `a_ LaG ' ' Signature E. BATHTUBS SHOWERS SQ FT SO FT - • - NOTICE: If after making this declaration, you should become subject TOILETS" URINALS - ' GENERATOR .0-1 KW_ KW ' to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - APPLIANCE 10-50 KW�50+KW • _ revoked: '- KIT.SINKS - DISHWASHERS -MOTORS CONSTRUCTION LENDING AGENCY 0-1 HP 1-10 HP ' - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS . • SUMPS - — (INC.SOLAR) 10-50•HP 50+HP- - formance of the work for which this permit is,issued (Section 3097 _ - I'— Civ. C.). FLOOR SINKS FLOOR DRAINS - FIXTURES 2 OUTLETS " SWITCHES Lender's Name _ Lender's Address - DRINKING FOUNTAINS GAS TUBE SIGNS - - - OWNER BUILDER DECLARATIONINTERCEPTORS 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 . - LUNDI HuLI tuts ,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 quakes 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 SERVICE .AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - - • - -cis for the alleged exemption. Any violation of Section 7031.5 by ' ' ' applicant for a permit subjects the applicant to a civil"penaltySEWER CONNECTIONS - - - -' --- lot "lot more than five hundred dollars ($500). _ - u I, 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 • - 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 who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY - . • DATE • through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK • SUMMA RV.OF FEES • Is sold within one year-ot completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). BUILDING - , - . f-, _ HEATING SYSTEM 0-100,000 BTU_ - PERMIT $ SMIP $ U'I, as owner of the property, am exclusively-contracting with AND DUCTING - - .licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ ' .PERMIT and Professlons Code: The Contractor's License Law does not apply to - - - ISSUANCE $ - -- an owner_of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 STU _ .. PLUMBING $ - tracts from such projects with a contractor(s) Iicesned'pursuant to SYSTEM GRADING -$ . the Contractor's License Law). 100,000 +BTU - PLAN CHECK $ e [] I am exempt under Section B.& P.C.for this BOILERS BTU ELECTRICAL $_O-L 'E reason - PLAN'CFIECK $ MICROFILM $ SYSTEM REPAIR,ALTERATION ' "Owner - - -' _ TOTAL FEE E' I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL E LESS AO• information is correct. I agree to comply With all city and county PLAN CHECK $ - VANCE PC b ordinances and state laws relating to construction,and hereby authorize • - representatives of this city to enter upon the above mentioned property for -inspection roses. - . " / ^ Signature 0' pappooses. 'A ate n 21a>02, FINAL FEE E_gi Drivers'License or SS 7P '� ISSUE FEE " —• - - .. . - CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor , F CONSTRUCTION AND PLANNING '' t POOL &SPR-••�_••--‘ APPROVALS Permit # F-5-9S3 Date Inspector APPROVALS Permit# Date Inspector _ 1. Temporary Electrical Service or Pole ti I; 43. Pool & Equipment Location - - -- - - .. --••---• 2. Soil Pipe-Undrgrn• - 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn . 45. Forms _ 4. Electrical Conduit-Undrgrn f_/6-S3 f-t0 46. Electrical Bonding - - -- ... . . __ ._ - 5. Steel Heinforce _ 47. Rough Plumbing & Pressure Test .- - . -- . . .. _. . . ._ • 6. Electrical LIFER Grn //nib? C-_ e__ '48. APPROVAL TO COVER--GUNITE - - . 2:1 . t l "- - 7. Footings- ` 49. Erectrical Conduit-Undrgrn 8. Foundation . 50. Gas Pipe, 0 Undrgrn,Test - 9. . Water Pipe-Undrgrn --_ 51. Backwash Lines,P-Trap; St/nth-gm - - • - 10. Structural Floor System _ 52. APPROVAL TO DECK----" - -• - -- --- -• 11.. Property Sewer Line & House Connection _ 53. Backwash & Receptor-Final ' 12.. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbing System - Final 14. Rough Electric-Conduit - 56. Electrical-Final I • 15. Rough Electric-Wiring - - - - - - - - - 57. Solar System-Final 16. Rough Heating & Air Conditioning - . - . b8. Fencing &Access Approval .- 17. Ducts, in Structure __ _ 59. APPROVED FOR PLASTERING 18. - Ducts, Ventilating - _ _ _ _ _ 19. Gas Pipe-Rough &Test • 60. POOL/SPA SYSTEMS FINAL . • • 20. Roof Framing . . . _ - ' ' , - • 21. Roof Sheathing " - • - - - . - - - . � - , ' ;•.?2. - Frame and Flashing - _ • NOTES: "`-23. 'insulation - ' 24. Lathing & Siding - - ' - . _ _ - , 25. Drywall Nailing _ 26. Plaster Brown Coat - ' • . ' . . - 27.... Electrical Power Meter-Final - _ . - -128. *Final Electric -- - " . _ - 29. Final Heating & Air Conditioning _ • _ 30. Final Gas Pipe-Test . _ . - . • ' .. 31. _Final Plumbing • - 32. `Water Service-Final - 33. Gas Service-Final - _ 34. Solar Domestic-Final 35. Landscape Sprinkling System _ • ' 36. Sound Attenuation • . 37. Handicap Regulations . 38. FI NAL STRUCTURE&"BUILDING _ - - • , 39. Special Requirements Completed • - 40. Electric Release to Edison - _ • - - - 41. Gas Release to Southern California Gas Co. .. 42. CERTIFICATE OF OCCUPANCY • .. • .' •No • • Date . -- - . _ . .. _• _ .,. • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. GTN OF COSTAUCTI MESA PE$JN`T NQ_8 / . TRACT NO, LOT NO. BLDG NO. . CONSTRUCTION PERMIT E" S /T/ �/CY n Project Address B-'274 .E - - TYPE OF CONST• RUCTION Owner 4L _m • [l' Phone 0 NEW ❑ ADD ❑ ALTERATION ( 1A - - t9(11 I /rls�/uaa i:•,131; TI Address - ❑ REPAIR 0 CONVERSION ❑DEMOLISH %l ZONING REGULATIONS - Arch/Eng. License NO. 0 OTHER - Addfe55 -_ ' DESCRIPTION'OF WORK A'"P-t ZONE PLNG. REF.v? Contractor c R R UA/VW LEG Phone 9r '601 TYPE OF PERMIT BUILDING To gUI LDI ryG Address /$315 syL ���!�' SETBACK PR OPERTV LINE 1 1 7I ' V. Sr . C1i'L AJ 0 GRADING ❑ FOUNDATION 0 STRUCTURAL ' SIDE YARD LICENSED CONTRACTOR DECLARATION •' ❑ TENANT)QELECTRICAL ❑PLUMBING ❑MECHANICA LS IiDET 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' - • - Professions Code, ace! my license is in full force and effect. REAR YARD(TO P/L) . License Class C�e' `/94930 Lions PROJECT DESCRIPTION - • PKG.SPACE REQ. PROVIDED - Date 1 x'20 -3 Signature SO.FT." . WORKERS'COMPENSATION DECLARATION OCCUPANCY " CONSTRUCTION TYPE STREET WIDTH PARK FEE $ - I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION ' • ZONE ZONING APPROVED BY I DATE certificate of Workers' Compensation Insurance, or a certified Copy - SPECIAL CONDITIONS: thereof (Section 3800, Lab.C.). GRADING CU.YDS. - ACRES ' • C,�Icy No. Company - . - _. _ - "..ertified copy Is hereby furnished. REMARKS: - - - -• _ ''Certified copy Is filed with the city Building Division. • - ' EXEMPTION FROM WORKERS', COMPENSATION DECLARATION - — - -- - (This section need not be completedif the permit is for one hundred - - . .. _ _ • ($100) or less). -- - ""- 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 PLUMBING - - PLAN CHECK ELECTRICAL PLAN- CHECK - . subject to the Workers Compensation Laws ofCalifornia. UW tLLINO VHHHtaE Date /Z'21 42. Signature ' A. -C rS0 4At a BATHTUBS SHOWERS e . - - NOTICE: If after making this declaration, you should become subject TOILETS' URINALS -'GENERATOR 04 KW_1-10 KW - • to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER • forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE - 10-50 KW 50+KW , revoked. - . •. • - ' CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 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 SINKSFLOOR DRAINS FIXTURES 1/ OUTLETS - SWITCHES :' , 40 Lender's Name Lender's Address DRINKING FOUNTAINS -GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS 'CLARIFIERS POLE LIGHTS . ' ' 4 ' ' - 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 - LUND I Rut.I IU-N. 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 . ' MAINSUB - "-- " 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 SERVICE - .AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the cc,) D Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT . . . • ,basis for the alleged exemption. Any violation of Section 7031.5 by "' .' - ' applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS . • - 'iot more than five hundred dollars ($500). . .• ' _ I, as owner of the property, or my employees with wages as their SOLAR TANK - COLLECTORS - A •- sole-compensation, will do the,work,and the structure is not Intended or offered for sale. (Section 7044, Business and Professions-Code: The SOLAR PIPING SYS. ' • ISSUE FEE . .s. 'ce Contractor's License Law does not apply to an owner of a property - APPLICATION APPROVED'BV DATE who builds or improves thereon, and who does such work himself or ISSUE FEE through his•own employees, provided that such.lmprovements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK • SUMMARY OFiFEES - •' is sold within one year of completion, the owner will have the burden : t, of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING - - ' ❑ I,'as owner •ot the property, am exclusively contracting with AND DUCTING - PERMIT $ •- SMTP _E licensed contractors to construct the project (Section 7044, Business 100,000+ETU 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 BTUPLUMBING $ - tracts-from 'such projects with a contractor(s) licesned pursuant'to SYSTEM - - "'GRADING •$ • ' ' the Contractor's License Law). 100,000 +BTU PLAN CHECK. $ ❑ I an,exempt under Section B.& P.C.for this • s BOILERS BTU ELECTRICAL $ 4?-'4711°! reason - MICROFILM $ SYSTEM REPAIR,ALTERATION PLAN CHECK - $ 'Date_ Owner - - -- _ TOTAL"FEE S.- ' ' I hereby Certify that I have read this application and state that the above .EXHAUST SYSTEM . MULTIPLE MECFIA,NICAL $ LESS AD- - information Is correct. I agree to comply with all city and countyPLAN CHECK $ VANCE PC $ ._ .ordinances and state laws relating to construction,and hereby authorize - representatives of this city to enter upon the above mentioned - - - ' property for. inspection 'au/poses. 4•./Q signature /F . Date_/Z' 24 frit FINAL FEE $ o �/' • Drivers' License or SS 46 / - ISSUE FEE - ' - — ' - • • - . . . CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor 1 u CONSTRUCTION AND PLANNING POOL&SPA> ': . _ ` APPROVALS Permit # Date Inspector APPROVALS Permit# -- - _ Date Inspector ' 1. Temporary Electrical Service or Pole -'t .',,- ' 43. Pool & Equipment Location .. 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - . 3. Electrical Conduit Utility-Undrgrn 45. Forms_ 4.4. Electrical Conduit-Undrgrn /-/c-'6 CC 46. Electrical Bonding _ 5. Steel Reinforce . - 47. Rough Plumbing &Pressure Test - • . 6. Electrical UFER Grn _ - " I'-io-ifg C C 48. AP,PROVALTO COVER-GUNITE - 7. Footings ' 49. Electrical Conduit-Undrgrn 8. . Foundation . '. _ 50. Gas Pipe; ❑Undrgrn,Test ' .. 9. Water Pipe-Undrgrn " 51. Backwash Lines. P-Trap:-fl'Undrgrn • - - =- ' . 10. Structural Floor System - - .52. APPROVAL TO DECK - - . - -- -- - • ' 11. Property Sewer Line & House Connection , 53. Backwash & Receptor-Final • ' 12. .Street Sewer Connection„ • . 54.- _ - 54. Heater &Vent-Final 13. Rough Plumbing 55. Plumbina System -Final 14. Rough Electric-Conduit - - -- - '56.. Electrical-Final - __- 15. Rough Electric-Wiring - - - - - - - • 57. Solar System-Final - - ' 16. Rough Heating & Air Conditioning - . 68. Fencing&Access Approval 17. Ducts,in Structure 59. APPROVED FOR PLASTERING - --18. - Ducts, Ventilating _ • - _ 19. Gas Pipe-Rough &Test - _ 60. POOL/SPA SYSTEMS FINAL 20. .Roof Framing . . • _ • - - . 21. Roof Sheathing - _ - . - • , -22. Frame and Flashing NOTES: "23. "Insulation . - .24. Lathing.& Siding . _ . .. _ __--. _ . 25. Drywall Nailing . - _ .- ' . _ 26. Plaster Brown Coat - _ . _ ' - •' - . ' , 27. Electrical.Power Meter-Final - _ _ _ _ . . _ ' ' . 28.E-Final Electric " - - ' ' l 29. Final Heating & Air Conditioning __ _ _ ' . 30. Final Gas Pipe-Test ' • ' i 31. _Final Plumbing .. __ _ " _ '32. Water Service-Final _ • - 33. Gas Service-Final 34. Solar Domestic-Final - .• 35. Landscape Sprinkling System - • 36. Sound Attenuation ' 37. Handicap Regulations 38. FINAL STRUCTURE & BULLDING ' 39. Special Requirements Co'rrlpleted 40. Electric Release to Edison - - • - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' Date - • i Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CAT/ OF UCT MESA • PER 8L^NQ �� TRACT NO. LOT NO. •B�DCyN9, CONSTRUCTION PERMIT GEL ' SOV % /� • - Project Address C 279' dr. #Pd TYPE OF CONSTRUCTION ' • Owner 4LL�/✓- in . REF✓ 1 Phone ' ' ❑ NEW 0 ADD ❑ ALTERATION t^s/j I 9t9'),.i 2/2(]� 1? ao 40 11 Address /' - 0 REPAIR 0 CONVERSION 0 DEMOLISH -,O ZONING REGULATIONS Arch/Eng. License NO. • ❑ OTHER A.P. - - .. DESCRIP_TION'OF WORK - ' Address G .. t, - . , ZONE , PLNG. REF.of Contractor C4AUI�N_ h ,th4t Phone 962.'6097 TYPE OF PERMIT • BUILDING - TTp g�Jlt)-INC tl SETBACK CA,ST. P ROPERTV LINE Address ge/S/ 'U(� Sr A ((/- c - 92 7e - ❑ GRADING • 0 FOUNDATION.-❑ STRUCTURAL SIOETYA RD -. - ' -LICENSED CONTRACTOR DECLARATION 0 TENANT ELECTRICAL ❑PLUMBING OMECHANICAL siDgE 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 ❑ OTHER - - Professions Code, and my license is in full force and effect. •PROJECT DESCRIPTION REAR YARD(TO P/L) License Class / Licenfs No. ye 401d PKG.SPACE REQ. - PROVIDED . Date lb • $0 VI" Signature 4 -$Q/itaanes SQ. FT. S WORKERS'COMPENSATION.DECLARATION - OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK'FEE$ I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ` ZONE ZONING APPROVED BY GATE certificate of Workers' Compensation Insurance, or a certified-copy thereof (Section 3800,Lab. C.). •I . GRADING CU.-YDS. " ACRES SPECIAL CONDITIONS: ^-'icy No.' Company _ . . _. -_, - • 7ertified copy Is hereby furnished. - - - - REMARKS: . ' - - Certified copy is filed with the city Building Division. - ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - • - - - - - (This-section-need' not be completed if the permit Is for one hundretl •- . . - ($100) or less). - •'', - - .' ' - • . Certify that in the performance of the work for which this permit is • issued, I shall not-employ any person in any manner so as to become PLUMBING • - PLAN CHECK • ELECTRICAL - PLAN CHECK ' -subject to the Workers'Compensation Laws of 12 -2-0 Call nia.---' -• - • - • - UW tLLIN(a (aA HA(aE Date - -RSignature ^�' BATHTUBS SHOWERS 50 FT SO FT • • - . , NOTICE: If after making this declaration, you should become.subject TOILETS URINALS • • • GENERATOR -0-1 KW. - 1.10 KW " to the Workers' Compensation provisions of the Labor Code,you must _ TRANSFORMER - . forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS • APPLIANCE 10-50 KW_50+ KW ' ' . - " -revoketl. - - - - - KIT.SINKS DISHWASHERS - • MOTORS - ' 0-1 HP - - CONSTRUCTION LENDING AGENCY �1-30 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS. SUMPS -- ' •' " ' (INC.SOLAR)- . 10-50 HP -50+HP - - .formance of.the.work for which,this permit Is issued (Section 3097 _ - ` ' Clv. C.). FLOOR SINKS FLOOR DRAINS ' �. ' ' -FIXTURES OUTLETS'' SWITCHES -- 0 .Lender's-Name _ _ Lender's Address • DRINKING FOUNTAINS' - • • GAS TUBE SIGNS' - -- - - ' ' 4- ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS ' POLE LIGHTS - -: - - - -' I hereby affirm that I am exempt from the Contractor's License Law for ' the following reason (Section 7031.$-Business and Professions Code: SWIMMING POOL P TRAP - - - LUNSI NUL i IUI . - .. _ - ' _ __ _ .Any_city. or .county which requires a permittoconstruct, 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 ' - SERVICE- - ' - ' AMPGi7 5 on (Chapter 9 (commencing with Section 7000) of Division 3 of the _ ' _ Business-and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - - • "- - basis for the alleged exemption. Any violation of Section 7031.5 by __ _ applicant for a permit subjects the applicarit to a civil penalty SEWER CONNECTIONS_ - of more than five.hundred dollars ($500).- _ _ _ _ .. r " • i, 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. - - "" .. or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. • ISSUE FEE - -- ' ' 300 Contractor's-License Law does not apply to an owner of a property -gPPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or ISSUE FEE . - through-his-own employees,-providetl that such improvements are not _ _ 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). •• ' BUILDING- - - _ - - HEATING SYSTEM_ 0-100,000 BTU PERMIT $ _ SMTP. ' . $ • la I,-as owner 'of the properly, am exclusively contracting with' AND DUCTING • - - licensed contractors to construct the project (Section 7044, Business 100,000+ BTU PLAN CHECK $ PERMITr and Professions Code: The Contractor's-License Law does not apply to --- - - - -- - - ISSUANCE -$ - - •- • an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts 'from such projects with a.contractor(s) !teemed pursuant'to SYSTEM - ' - - __ • - - • GRADING -$' _the Contractor's License Law). 100,000 +BTU PLAN CHECK .$' e - - • ❑ I am exempt under Section B.& P.C.for thisBOILERS BTU ELECTRICAL $ O l�O $ - ieason - - PLAN CHECK $ ' " MICROFILM $ SYSTEM REPAIR,ALTERATION Date - -' - - ' Owner - - - — - • - MECHANICAL S TOTAL FEE$ I hereby certify that I have read thisapplicationand state that the above EXHAUST SYSTEM _ MULTIPLE -, LE55 AD- _ information is correct. I agree to Comply with all city and county PLAN CHECK $ - VANCE PC $ • • ordinances and state laws relating to construction,and hereby authorize. - - representatives of this city to enter upon the above mentioned- - property for- in�sp ectio�n� 1rposes.. - i/O Signature. C. "" Date /2 -t0;PC - Ss TT FINAL FEE $ G Drivers' License or SS# - ISSUE FEE . " ' - ...... - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor . a CONSTRUCTION AND PLANNING POOL&SPA ' - " - Date Inspector • - • -. 'Date Inspector . APPROVALS Permit # APPROVALS Permit# 1. Temporary Electrical Service or Pole I' "` " ''43. Pool & Equipment Location - - -• -. _2. Soil Pipe.Undrgrn _ 44. Steel Reinforcement - _ - 3. Electrical Conduit Utility-Undrgrn _ 45. .Forms . _ . _ 4. Electrical Conduit-Undrgrn - r,fp-gg e to 46. Electrical Bonding _ _ 5. Steel Reinforce _ . . 47. Rough Plumbing& Pressure Test ' `.l• �' • - 6. Electrical UFER G rn_ _ _ "' • J_/p' 3 C Co 48. APPROVAL TO COVER-GUNITE - 7. Footings - _ 49. Electrical Conduit-Undrgrn .. . ' 8. Foundation . . . . _ _ . y ' _' - 50. - Gas Pipe, ❑Undrgrn,Test : - - 9. . Water Pipe-Undrgrn - _ 51. Backwash Lines, P-Trap,- l Uridrern - ' • - - - • 10. Structural Floor System 52. - APPROVAL TO DECK - -' - ' '- - -- 11. Property Sewer Line & House Connection - 53. Backwash & Receptor-Final - 12. _Street Sewer Connection - - . 54. . Heater & Vent-Final - - , 13. Rough Plumbing -_ - - - 55 Plumbing System - Final ' •-" _ - - - ' 14. Rough Electric-Conduit - • - - - -56.- Electrical-Final- - 15. Rough Electric-Wiring - - - - - - - 57. Solar System-Final ' '" - - - • • . . . 16. 'Rough Heating& Air Conditioning- -. . - . b8. Fencing & Access Approval 17. Ducts, in-Structure - _ - - 59. APPROVED FOR PLASTERING - - ' 18. Ducts,-Ventilating _ _ • - - _ -. _ i - �_ _• _ _ 19. Gas Pipe-Rough &Test - _ I _ - 60.. _POOL/SPA SYSTEMS FINAL • -20. - -Roof_Framing.' _ • ' ' ' - . ' 21. Roof-Sheathing - --` -- -_ _ - 22. Frame and Flashing - - _ _ _. __ . •-' NOTES: - ' `-"23. -Insulation- - . _ - _ _ _ _ .. _ - - 24.. Lathing & Siding.-_ - _ - _ -.. - • - _ - 25. Drywall Nailing -._ _ - - - . . - ' 26. Plaster Brown Coat . .. . - 27.. Electrical Power Meter-Final ' - • _ _ - - - - - 28:2, Final Electric - - -- - - - - -- _ _ 29. Final Heating.&Air Conditioning . 30. Final Gas Pipe-Test _. - _ i 31_ Final Plumbing ' ' 321 ' Water Service-Final. ' - - _ - _ 33. Gas Service-Final. _ _ . .. - , - - 34. Solar Domestic-Final • - - 35. Landscape Sprinkling System - - - - ' 36. Sound Attenuation - I _ 37. Handicap Regulations - - : 38. FINAL STRUCTURE&.BUILDING 39. Special Requirements Completed '• - . . ' - 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. _ - - - - 42. CERTIFICATE OF OCCUPANCY __ - - Date - • - _ -' -- - -- - - -, 4`OXPAits9 CITY OF COSTA MESA CALIFORNIA 92626 P.O. BOX 1200 . ..4 F1it t � J " O FROM THE OFFICE OF THE PLANNING DEPARTMENT 'Cc*POARRo'43 TO WHOM IT MAY CONCERN RE: Property at 274 East 19th Street The City of Costa Mesa was incorporated in 1953 and has no records of houses built prior to this date. Any structure that was legally built prior to incorporation and subsequent zoning to R1, but not meeting the present land use, would be considered a nonconforming use. Said use may be continued and maintained for a period representing the useful life of said structure as set forth in the Municipal Code. Sincerely, 4144, Lie/ Richard D. Dahill Chief-Current Planning RDD:js i 77 FAIR DRIVE (714) 754-5245 JAN 30-67 00 962 i*****2.00 -,- 26617 <., COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 120 COSTA MESA, CALIFORNIA 92625 For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING ADDRESS 2 `C /9'I � �'f For Offlce U» Only Y RECEIPT NO. COSTA MESA. CALIFORNIA Zvi+ 1 TT o— RECEI •• D SY • TE RECEIVED DATE ISSUED OWNER '/((++��AI// - h .0 4 IG. `J _ / -J B I L G MAILADDRESS A� • '1 ear S 'r/(}-•� ADDRESS 2 / ` F,�— /9/ 4/ we/I. 0 CITY ©S ( / PJ•9 TELSTQ JE64 ZONE -FIRE _ TYPE-WT. GROUP .7T / HITECT D(/J/7e�/, TEL. it., 2- APPROVED DATE ( b7 NGINBERC.N. ZONING ADDRESS 1 pK 6734,6u /J ^1 ION POOP ,/� BUILDING DI NEW Y�/5�; ,, ` V( / -� PLANS / / SYILDING l/�"'A/ 44r/t. \\ • CONTRACTOR � % // ry1 ADDRESS DESCRIPTION (A r/7f 7? L/�ar 'ice.+• (1 CITY A.P.NO. /I(� '///-{ / J2j / STATE TEL NOTE: NOEAVE OVERHANG SHALL BE LESS THAN ` �/ 3 /$� HQ, 80'TO SIDE&REAR P.L. LIC.NO. l S/ZEOF LOT ,,,( /v�+ / I NO.OF NOW ON DGS a ALLOWED (U.B.C.REQUIREMENT) \� OT YARDS APPROVED YARDS APPROVED I �; USE OF MAIN BUILDING ACCESSORY BUILDING \ EXISTING BLDG. (FROM C�/L^STREET) SETBACK LINE FROM FRONT a� I FT. PT. CENTER OP STREET REAR YARD �I � /y/ SIDE YARD I LEFT I RIGHT R.SIDE Fr.A�It�/ V de Ijimfr. DESCRIPTION OF WORK L SIDE PTA/}'/{/-) I I�]�/(� orrr. _ ALTERATION ADDITION REAR FTA//, ,h ''"u s en. -- I DISTANCE BET. BET.MAIN& REPAIR MOVING DEMOLISH MAIN BLDGS. ACCESS.BLDOS. BUILDING NO.OF VAR•# DATE SIZE ROOMS STORIES C.U.P.* APPROVED EXTERIOR WALL. / ROOF APPROVED /—�-47 COVERING COVERING IT DATE USE OF BUILDING AND WORK TO BE PERFORMED W /%V,T Las a, e ��-� s-- _ 9 /,q( et // s Og l f— 8Q.PT. I HEREBY ACKNOWLEDGE THAT.I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE O. AND STATE THAT THE ABOVE IS CORRECT AND AGARS To COM• PURPOSE OF EETABLISHINO A PERMIT FEE ONLY. PLY WITH ALL CITY ••i - AND STATE LAWS OYLATNS WILDING CONDTSU VALUATION p 5 ` � ,r,4'' ,. - I PERMIT FEE j �v O PB NATU_ .�I>-�/ wVta�l� / "a E X O� PLAN CHECK S —" w AUTHORIZED AGENT , 2 .00 TOTAL FEE j -' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT ' P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 R CEIV D 'PERM-4, 069 For Applicant^ to Fill Jm Completely— Use Ink Only Ci ADBUILDING DRESS /�/ ( �J I4 St A.P.NO. / OWNER OR,/� )� �T �� ADDRESS BUILDING a7y co /y 144 TENANT /7h1 H it .Lt C,c//U den.; ��./v [�P//(! MAILING r yy-- /`� UNITOR ADDRESS/934 —1 iH IPKAA co SPACE NO. �t /� pC TR.NO. LO � SLK. CITYA&/30(grf'.jjJJ ,acid, 0192,4 NOLtVd t9OO r NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER ,�{{ / HIS � V �/y BRANCH OWNER 7/7,, Fav. (///\(!//,fl,, /370.m'y ADDRESS // 11fff 1 ( VALUE ARCHITECT TEL. USE 4'e / $ OR ENGINEER NO. ADDRESS ZONE LTYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. CITY NO. F�yy STATE CITY APPROVED SETBACKS W LIC.NO. LIC. NO. SIZE NO.OF SLOGS. (FROM C/L STREET) O. OF LOT I NOW ON LOT _FRONT FT. . Q USE OF 'Ca EXISTING BLDG. _B SAIF FT. rn (-1 Separate permits are required for L.SIDE FT. electric,plumbing and heating work: REAR FT. (�.i USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a 0 • afeli/,/h,24.r /�G['/71d'� r DATE _ /// ��@` rr` APPROVED x APPROVED y. " CC/- ,l/�/ Stiu c/u_kdl /tem s _BY DATE '� 1 A/Yl� sz Q I hereby ackno edge that I have read this application and state n. m p! that the above Information is correct and agree to comply with 0+ all laws regulating building construction, and I shall not employ i Z any person in vtolation of the workman's compensation laws of 14the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. .m`+ the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business rte_a and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE $ M Signature of //y/S1� ^///' ,/�/l /J PLAN CHECK $ o Permittee (� $ TAX $ 4 Authorized Agent Date *2-7/ 7/1,71•T7 • TOTAL PAID 817S,