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Home My WebLink About333 19TH ST - Building Permits(714) 754-5273 • Fex (714) 754-0856 • www.ci.costa-mesa��DING PERMIT 77 FAIR DRIVE, GOS7A MESA, cA 92626 Job nddress: 333 E 19TH ST Suite: Viciniry: Primary Occ: Parcel Number: Applicant: Address: R-3 pwellingsl Cong Res <70 11725416 FARAH,ROBERT Owner hARAh Address 333 E�1< / ; `%�i ; , ; COSTA � � �\ Contractor: OWNE .Addre55:� �'� /� i. �� , Z; I'i�/%i Type of Construction: V-N Zoning: � .,. � ��, - " i'�%i- �(_�,� \ , , %, J ,. ri � � �'' \ `.�� . tOBERT G�AND MELISSA ST� � � �� . ; -_ . � i i ; . � � -/ SA fA��z�i� ip. ..: „ . _ %iLs� .— --- Arch' i � �'/�5' � j ' - , �ri�- , � �'_, "� - Address: `� '� �- ' `� ' ��,`�Phone: " �. � , . ' � j".. ��•.' , � �.Zip: � � t� � \ !License: i / . ,.� . Status: ISSUED Applied: 07I07I2004 Issued: 1112?12004 . " �" - - ISSUED BY: � Phone: ,949-230-3200; �. ' Zlp: . / ;�f��_"_ �i l � _ � <� '-. i ' v� / ��•'�='`� �i .� /r ii _ � _ / '� �\ Phone. _ \ i �\ ,. \� \�'\ � . / Zip: 92627-2348 ��"�,: , , j �.� �� ;.�� . . / � - �� , ;� i. � �v.'-� ' ,. � �� 'Phone: `,� �;A. , . �� .,� License: 000000 � ' - %"" Eng: STEPHEN K AHUNA ? � - _- -- Address: 25101 VIAPORTOLA --� -- . . - - -- ' �� i - . LAGUNA NIGUEL, CA 92677�, ��. Phone: License: � �. 949-495-3214 i,Lyi:'1 , , . ',f ��; - �--v �-qJGVYt.Vr.YCKMII , -� -� ' CONSTRUCT 303�SF ADDITION TO AN EXISTING SINGLE-STORYISFD.,WORK TO INCLUDE EXPANSION OF THE KITCHEN WITH THE �� ADDITION OF A PANTRY AND LAUNDRY ROOM. REMODEL-2:EXISTIIJG BATHROOAAS, ADDITION OF A CLOSET IN 2 BEDROOMS AND A NEW PREFAB MAJESTIC FIREPLACE (IC60 '� - � #5677) IN THE EXISTING LIVING ROOM/LOUNGE. Al:SOINCLUDES REMOVE AND REPLACE A�L EXISTING WINDON/S WITH LIKE. , � n.. ., .,�;p , - � ,.�, '.t //�' Plan Check: Permit; SMIP Res: SMIP Com: Other. Inspection: �. , � 5405.63 � , $624.05 ' $4.80 `$0.00 $0.00 � � $0:00 _ : �,�� , _.,, i �:: _. $1,034.48\��' ", . '�% , �; ��.�. ,. - �, `_.: :, .. �, ;,: .,,� ;.:r..r,� ` ,`' sr . -� / �'�� ° u J o,^_� Calc Valuation: ' Claim Valuation: , ,i��. - , , � ,', - /// ,�`,,,�..� i�: r �� % i�/ , ` � � �> � i; ; � � � �� ` �� PLANNING & ZONING � �" � ` " ' �� `� ' /��A � _° � - � _� _ �� O �`:� �"�� SETBACKS �_?`, �-, , � .,,,, __ , - �_" � i � ,%� . MAIN STRUCTURE Frbnt �20= 0, -.Reai . -30. 0 - � , Left -S 0 � �, ,�� Right ) � �3�0 f j `- . _ � �,�� ` � , � . i ACCESSORY Front 0. 0 � `�� Rear" 0. 0 ' ' � Left" • �0= 0�` � - � Right � �0-�0� ; � � -' ' ��.._ '- . " .-- • ' _ _ � �i,�' PARKING Existin : 0 � Requlretl: �-0, =;, �---Proposetl:,i0'!j�^" $47.99�.20 � SO.00 �, .' ,'� NOTICE: The work authofized by this permit shall comply wlih all appllcable handicap access requirements under Califomia stalutes and related regulatfons. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: This pertnit Shall eutomatically a�cpire arW 6ecome void if work is not commenced wl�hin 180 days, or if work is suspended or ebandoned for a period of 180 days. INSPECTIONS: �n, order for Ne work authodzed under this permit to� be considered legal, such work must comply with etf applfcable eodes, and all requlred inapectlona end flnal epproval must be obtained. Failure to obtain inspections and final approval will� result in [he explration of this permit. FOR INSPECTIONS CALL: (714) 7545826 zuau �e�oo� WORKERS'COMPENSATON OECLARATION: � � 1 hereby eflirm unCer penalry of perjury one ol the tWlowing declaratlons: '� � � ❑ I have an0 will maintein a cenifcate ot wnsent to sell-Insure lor workers' compensetlon, as provided�for by section 3700 at Ihe Lebor Cotle, lor �he peAortnance ot t�e wOrk for whiCh thl9 permli is Issuetl. ''�' ' � ' . ❑ I heve and will malntein workers' compensation insurence, es repulred by sec6on 3700 of the Lebor Code, for the perfortnance ol the wark tor which�tltls pertni I is Issued My workers' compBn58tion InSurence carrler entl policy number ere: � '' Cerrier. Policy Number: ' (This secUon need not be complete0 i! Ne perrNt is va/uetl et me hunEred dd/ers (S100J w less.) ; I cenity that In t�e pert nce W the work far whicFi this {iemut is issuetl, I shell not employ eny person In eny manner so es to become sub�ect to ihe workers' ' compensetlon laws oi omla, and apr t It I shoultl become subject to the workers' compensatlon provisions oi Sectio 3700 oi Ihe Lebor Code, I shall forlhwlt� complywiththese ' i . L A cant SipneWre: ,1�-p �� 6'�0 � I WARMN/Ca'.FNLURETOSEWREWORKEfiS' $ATIONOOVEMGEISUNUWFULlWDSWLLLSUBIECTANEMPI�I'FAT CRIMINALVENALTIESANDCMLFlNESUPTOONEHlA1DRED TIOUSrWD OOIJ.ARE (5100.000), IN ADDITION THE WST OF COMPENSATION, UAAIFGES AS PRWIDEO FOR IN SECfIIXJ 3'1080F THE LABOF CODE, IMEREST, M!D ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATON: � I hereby aHirm the� I em Ilcensed under proNslons at Chapter 9(commencing with Section 7000) ol Oivision 3 of iha Business enG Prolesslons Cade, antl my license Is In lull torce ana eHect. Llc, p Class x i Contrectors SlgneNre: Date: . _ I CONSTAUCTION LENDING AGENCV:� � ❑ I hereUy ettlrtn t�et thare is a canstruCtion lending agency lor Ihe peAormance ot the work for whiCh ihis permlt is issuetl. (Sec. 3097, Civll Cotle). Lentlefg Name: LentleYs Atltlress: SigneWre: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn thal under penelry of perJury thet I em EXEMM FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7037.5, Busines Cotle: Any dry or counry wNch requires a pertnll to consiruct, elter, Imprwe, Aemdis�, w repair any swcture, prior to its iuuanca, alw requires Ihe epplica to file e signed atatement Uat �e or she Is Iicensed pursuent lo the provisions ol Ihe Contrectors LJcense Lew (Chapter 9(wmmenUng with Section 7000) < Business end Protessions CoOe) or thet he or she is exempt therelrom antl the besis tor the ellegetl e:emption. Any violalion ot Section 7031.5 by any epp sub�ects the epplicent to e clvll pBnelN of not more than frve hundred dollars ($500).): �0ti I, as owner ol the properry, or my employaes with wages es their sWe compensetlon, W R� DO 7HE WORK, end ihe strucW re is not Intentletl or oXere� ✓ 7044, Business and Professions Code: TTe Contractors License Law tloes not appty to en owner ot pmperry who builds or improves thereon, anO who � hi etl or hersetl or through his or her own empiqees, provltled ihat such imprwemenis are not intendetl or oNereC lor sele. It, however, the building c Id within one year ot wmpletion, Ue owner-builder will have Ihe burden of proving that he or she tlid not Duild or improve for purpose ot sele.). � as owner oi Ue propeny, am E%CLUSIVELY CONTRACTING WITH IICENSED CONTRACTORS lo construct the project (Sec. 704d, Business and `� Code: The contractors License Law tloes not appty to an owner ol property who builds or Imprwes thereon, and who contracts tor such prqect wlih e c license pursuay�the Contractors Llcense Lews.). � ❑ lem �Owner ID'verified by ddv� Verification o1 Ownership Business and Professions Coda tor this reason: ❑ Yes ❑ No ( document, i.e. - property le: hlll or tleetl): antl Pratesslons I br such pertnit Dlvision 3 of Ihe ant for e permil is DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certily thet no excavetion fNe (5) or more teet in depih into which e person is required to descentl, wlll be mede In connection with work euthorizetl by this pertnit, end that no building structure, scattdding, telsework, or demWition or tlismanUing Ihereot, wlll be more Ihan t�lrty-slx (38) teet high. (Chep. 32f Grp 2, Art 2, Sec. 341, Ttle 8, Celllomla AtlminlslretNe Code). � ❑ As owner-bullder, I wlll not empby enyone to do work whic� woultl require a permil from the DlNslon ol Indusirial Salery, es noted above, unless such person �es e permit to tlo such work trom the tlhrision. I Signature: Dete: � Division ollndustdal Selety Pertnit Number: � HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION: � 1 W III ihe applicent or present or tuture builEing oaupant neetl lo lile end certity a Buslness Plan for emerpency response to rolease or threateneO releese of e herardau matedel7 ❑ YBS ❑ No � (Sectlon 25505 01 Ihe Celifomia Heelth and Sefery Cotle requlres, wit� somo e:ceplions, ihet e Business Plan De liletl wit� I�o Costa Mesa Fire Department by every Dusiness which has at eny ona time tluAng a reporteG year e Quantiry of hezertlous materials equel to or greeter than e weight o1500 pounds, or e volume ot 55 pellons, or 200 cubic teet ol compressed gas et stentlartl IempereWre end pressure). I .....................__..............__.................. _..._.._ '__""""__...................__..........................._......................................................... �................ __._...—_"_ 2 Does or will the 6ppliCanl or pra5enl or future builAing occupant need to tile e rogi5lretlon form for etutely �azerdous metedal57 � Yes ❑ NO � (Section 25533 0l the Celifomie Heelt� flnG Safery Cotle, with some a:ceptlons, requlre5 reglSlreti0n wll� �he Casie MeSe Fira Depatlment by each business w�kJt et eny one time hes on harW a Quantiry of ewtey hazerdaus materialv equal to or greater than e welght oi 500 pounds, or a vdume ol 55 gellons, or 200 wblc faet ot como�essetl pes et stentlard tempereWre end Dressure). , ;epplicant or Dresent Or fuWre Duiltling acupant nee0 io prepere en RMPP (Risk Menagemem end Prevention Program tor eately �azerdous materfals)7 No t ot the Californla Health enG Satery Code provides that ihe Costa Mese Fire Depenment may require ihe preperatim, certification entl liling with Ihe Fire en RMPP by businesses which ere requlred to register eatety hezerdous meterials wilh ihe Fire Department. j 4 tl en RMPP is presemty require4 has Section 2553a ol tha Celiromia Heaith en0 Satery GoOe been Wiry compned wrtn7 LI ves LJ rvo .................."__......"._.._... __..__..—.....................__...................._............................................................................_............._..._........"_"..........—. 5 Does or win the eppicam or prasent w luture buAding ocwpent require for �he work which is the subject ol this a plicetion a�e rtnit tor suc� construcUon or rtwdtlicatlon ffom �he SOu�h Coesl Air Oualiiy Menegemeni DISM<t or Irom any other eir pollution contml district or egenc)? � Ves �J No � (Section 658502 of t�e Califomia Govemment Cade reduires lhat tha requested intortne�ion DB fumishetl on epplications for nan-resitlentlal buiming permits). ......._ .....................'__...._..._ .__._ .._... ._......_..._'__............................................................_"""._ "........_......'—_'— e Will anv oert of I�e taclliN to be constructed under this oermit 6e within 10001eeI trom Ihe outer poundaries oi a school7 ❑ Ves ❑ No (If yes', the lacility must meet the raquirement ot Sectlons 25534 antl 42303 0l the Celifomia Heelth end Safery Code). � ..........................................................._._.................._............_...._..........................................._.........................................................................................................................................__..............._..............=.................._.._...........'_ 7 It e pertnit from the South Coest Air �ualiry Management District or other eir pdWtion contml tlistdct or egency is required tor the work which Is the su6ject of Nis epplicailon, �eve ell 01 the tlisclosures preuriGeC by Celitomie Health and Sefety Code Section 42303 been matlel ❑ Ves ❑ No ' ......._.._..__' —.�..._..._.__ ............................_......_........._... ._._. B Qf yes', etiach certiticate of compliance irom the appro0�ate air pollution contml otficer). � CERTIFICATE OF COMPLIANCE: I cenity that under penalry ot perjury t�e inlartnation given above is cnrtect. I egree to compty with all state laws antl dry ortlinances regarding Ha�rdws Matenals antl Emissions. i Signaiure: Date: � CERTIFICATE OF CAMPLIANCE AND AUTHORVJITON OP EMFiY: I certity undor ponelty ot perjury thet I have reatl this application and state that Ilie infortnation given is carrecL I egree to 9�pty with all stete le f end dry ordlnances relating ro builtling consiruction, enA eut�odze represenWilves of I�e Ciry ol Costa Mesa ro enter upon the ebovedescrib r i�e y for inspeMi� asas. I agree not ro acapy or albw occupency of any builtling euthorized by th' rm�t u lil tinal inspectiwi. �- � �lo��. � S naWr Of LeyaTOwner(sl � Data � � P I And/Or Autharized Applicam Date � COUE I, INSPELiIONTYPE •.•- • • • . • .•.. •QAIE � L�J�S• 1616 Fl:etl System Final Fue Preventbn _ 1266 Pool Spa Finel _ 200 Final Re-Rooi � _ 201 Final BIacWRetelning Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demditlon � CODE� INSYECTIONTYPE � 206 Finel Muchanicel' 20B Finel Plumbing �210 Finel Elecidcal. � 212 Flnel Fire Prevenlion 220 Finel Planning Approval' 222 Final Sita 250 Finel Builtling/Occupancy' (714) 754-5273 • Fex (714) 754•4858 • www.ci.cosle-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 333 E 19TH ST Status: ISSUED Suite No Applied: 11/16/2004 Vicinity: Issued: 11/22/2004 Parcel Nunmber: 11725416 Appliwnt: FqRAH, ROBERT Address: . - �_ . , . Phone: 943230-3200 - ZiP Owner. FqRAH; ROBERT G AND MELISSA ` Address , 333 E�19TH ST � . _ - � ` . . , � . Phone: ' COSTA MESA; CA . Zip: 92627-2348 Convacror: O W N E R-8 U I LD E R Address: - . Phone: � Zip: \, � � License:000000 ISSUED BY: i'�� /� � i , � . , �� , A ��` , - � � � �� . � . � � �, . , � � SCOPE OP PERMIT ` � � . CONSTRUCT 303 SF ADDITION TO AN EXISTING SINGLE-STORY SFD. WORK TO INCLUDE EXPANSION' OF THE KITCHEN WITH THE ADDITION OF A PANTRY "AND LAUNDRY ROOM. REMODEL 2 EXISTING' �, BATHROOMS, ADDITION OF A CLOSET�W 2 BEDROOMS AND A NEW PREFAB MAJESTIC FIREPLACE . (ICBO #5677) IN THE EXISTING LIVINGROOMILOUNGE: ALSOiNCLUDES REMOVE AND REPLACE � ALL EXISTING WINDOWS WITH LIKE. REF: 804-01227 � - � � � %- V ' � �/ � �� °G�,� -- � - " , . - — ' � , - � ELECT. PERMIT IS FOR 19 FIXTUf2ES; 15 OUTLETS, 11 SWITCFIES, 8 SERVICE UPGRADE (200 � ;', � ' AMP.) � ��" . .� - _, ' , � . - � � � FEESUMMARY �� ci - ` � ��' �� . i ,�� . ' „{, �'-'=�;i; � Quan6ry < `:>� ,,; � � • � Quantity _...,1 �.. ISSUE FEE� � ��.�$23.50 = k?r�'0` �' Temp Dist System I Lighting 50.00'%��0 �� Temp service lesl '�' � �; ��0.00 : � J:" '. • Busway I100 k' • , , 50.00' ;' 0 �; - �, %', � �.. , Res. alc package� '$D.00 -. - � ' ' Standing Section > _ • , �- -$0.00-� 0 � � �- � New Res (1-2 units) �� $0 00.� 0 Misc Electripl Eqmpment SO 00 0 �, /, New Res (3+units) ,� � $0;00 � . 0 " , " ' Transtormers up to 1 kva/kw . SO 00 . ; , 0 � � Pool / Spa . . � , - 50.00 - 0.; . � � ........... ...up to 70 kva/kw � �. � $0 00 `. p. � Lightlng PixLs � � ' $20:90� . �19 -> ' • . ...........up to 50 kva/kw� $0 00 . �� 0 ! i i � cs_ ':....-� , Recept OuUets . �. '$18.50 - = 15� � �_ � �' _ � . . ................:.up to 100 kva/kw�� ( $0.00 / ,0� %,'� Switches � � 572.10 - . � ' 11' , � .....:............over 100 kvalkw , ��.' $0.00 "- 0� � Non Res Appl -$0.00 ��- � 0� �. Low Voltage Equipment 30.00 . 0 Res Appl ��,$0.00� 0� - Low Volt Wiring System / Ckt 50:00 .� �� 0 Service to 200a $30.50 �� 1�.. � Misc. Conduit .� �, 50.00 0 Service to 1000a $0.00�� -- - 0 � �.- . ,�'�`Misa Conductor � = �'�50.00 0 Service over t000a $0.00 ._ 0==; ;� __ Circus ( gen or nde),%=� % $0.00 0 �. NOTICE: The work aulhorized by this permit shall comply wlih all applicable handicap access raquirements under Califomla statutes and related regulafions. (Ord. No. 92-28, § 7, 72•21-92) i EXPIRATION: This pertnit shall automatically ezplre and become vaid II work Is not commenced wlthin 180 days, or if work is suspended or ebandoned for a period of 780 days. INSPECTIONS: In order for the work authorized under this permit lo be considered legal, such work must comply with all epplicable codes, and all requlred Inapeetlona entl finel approval must be obtained. Failure to obtain inspectlons and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 2as�ee lemo) WORKERS' COMPENSATION DECLARATON: ' � . I hereby eflirtn under penelry of per�ury one oi Ihe tollowing tloclereNons: � � ' ' i ❑ 1 heve end will meinteln e certllicete ot consent to self-Insure lor workers' compensallon, 99 proNtleO tor Cy seciion 3700 of I�e Lebor Codo, lor Ihe peAormance of the work lor whiCh this pertnit is issuetl. • , ❑ I have entl will meintain workere' compensatlon Insuranco, as requlretl by section 3700 0l tho Lebor Code, lor t�e perfortnance o1 t�e work tor whlch Ihis pertnit is IssuoC. My workers' compensatlon Insurance cerrler entl pallcy number are: Carriec Policy Number: (Th/s section need nof be comp/efed I! fhe permil is valued af one hundred dollers ($100) or less.) , „ . „ �ertify thel In t�e pedortnance of the work for whlch ihis permit is issued, I shall not employ eny�person imany manner so es to became suD�ect ro the workors' compensetion law ot omia, end egre et il I shoultl becwne sub�ect to the workere' compensation provislons of Sectlo 3700 oi the Labor Catle, I shell larthwlth �„�,��,ha� o�-- �— ('p �1%G �6J' Applfwnt'S naN�o:-� I al� WARNIN�fi.' FAILURE TO SEWRE WORKER ' ENSATON COVEiiAGE IS UNLAW Fl1L AND SMALL SUBJECT Ml EMPCOYER TO CRI P TIES AND CML FlNES UP TO ONE HUNDRED TFI0USMID DOLIARE (510D,000),IN ADDIT THE WST OF COMPENSATION, DAM1LIGES hS PROVIUED FOfl IN SECiION 31060F TNE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLAfiAT10N: 1 �ereby eftirm ihat I am Ilcensed under provisions ot Chapter 9(commencinq wit� Section 7000) ot Divisian 3 at Ihe Business antl Proteulons CoOe, end my Ilcense is In full force and atfect. Llc. p Class q Contrectors Signawra: Date: CONS7RUC710N LENDING AGENCV: ❑ 1 hereby aHirm Ihat there is a conswciion IenCing egency for the pertortnance ot the work for which Ihis pertnit is issued. (Sec. 3097, Civil Code). Lendefs Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eNirtn Ihel under penalty of perjury t�at 1 am EXEMPT FROM TME CONTRACTORS LICENSE LAW for lhe tollowing reason (SeC. 7031.5, BU5ine55 entl Protesslons Code: My ciry or counry whic� requires e permit to constmct, alter, Improve, demolish, or repair any struaure, prior to its issuance, elso requlres the eppllcanl lor euch permlt to tile a signed stetement thel he or sha is licensetl pursuaN to the pravisions of Ihe Camrectors License Lew (Chapter 9(commencing with Sectian 7000) oi Divislon 3 of ihe Business and Protessions Code) or that he or she is exempt therefrom end the basis tor the elleged exemption. Any violation of Secilon 7031.5 by any epplicant for a permit subjecis ihe epplicent ta a civil penelry af not more than five hundred dollars (3500).): ❑ I, as owner ol ihe properry, or my employees with weges es thelr sole compensatlon, WILL DO TME WORK, and the structure Is no1 Intended or oHered tor sale (Sec. 7044, Business and Professiwu Gode: The Contractors Llcense Lew does noI apply lo en owner ol properry who builds or impwves thereon, antl who tloes such work himself r herself or through his or her own employees, pravidetl that such impravements ere no� intentleC or aHeretl tor sale. It, �owever, �he building or improvement is so rthln one year of completion, Ihe owner-builder will heva the burden oi proving that he or she did not build or imprwe tor purpase of saleJ. ' es owner of ihe pro0erty, am E%CWSIVELV CONTRACTING WITH UCENSED CONTRAGTORS to construct t�e project (Sec. 7044, Business end Pmfessions Code: The contrectors Ucense Lew tloes not epply to en owner ol properry who builds or impmves Ihereon, and who contrects tor such pro�ect wlth e contraaor(s) license pursuant to the Contrectors License Lews.). ❑ I am ex Oe se� Signeture: Owner ID ve led by tldvels Verilicatian ol Ownership by Business end Professions Code for this reason: �/ ❑ Ves ❑ No Driver's Llcense No. of tlacumem, I.e. - propeny tax DIII or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 hereby certify t�at no excavation ilve (5) or more leet in depth into which e person is requireC to tlescenC, vnll be made in connection with work authorized by this permit, and Ihat no Duiltling sirucNre, swttoldlnp, lalsework, or demolition or dismantling thereof, will Ee more than Ihirry-slx (38) teet high. (C�ap. 3.2, Grp 2, Atl 2, Sec. 341, Title 8, Calltomia Adminisiretive Cotle). ❑ As owner-builder, I will nal employ enyane to tlo work w�ich woul0 require e permit Irwn the Division of Intlustnel Sefery, es notetl ebove, unless such person hes e permit to tlo such work from lhe Aivision. Signature: Date: Division at Intlustdal Sefery Permit Number. CEHTIFlCATE OF COMPLIANCE AND AUTMORVA710N OF EMAY: I certily under penelry ot perjury that I hava read this epplicalim end state thet �he intormatlon glven is correct. I egree to with ell stete laws end ciry ortlinances relating to building construction, end euthorize representetives ol tne Ciry oi Costa Mesa to enter upon tha above-describ r rry br ins ecti se I egree not to occupy or ellow occupenty ol eny builtling eut�orized by Ihu perm' ntil li I inspgption. 5 natur OiLegalOwner(s)c:.= � �� l '-- AnNOr Au�honzed Applicant Date COUE I. INSPELTONTYFE 1616 Fi:etl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Root 201 Finel BIocWRetelninp Well 202 Final Fectory Fire Place 203 204 Final Sign Final Demolitlon Q� � �mt. yQUE 1 INSPECTION TYPE 206 Finel Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fira Preventlon 220 Final Planning Approvel 222 FinalSite 250 Final Building/Occupancy 2�IE � It�Lfl (71a) 75a•52�3 • Fax (714) 754-0856 • www.ci.wste-mese.ee.us 77 hAIFI UMIVt, GU51A MCOA, l:A tlZ62ti Job nddress: 333 E 19TH ST Suite No Vicinity: Parcel Number: 11725416 Applicank FARAH, ROBERT Address: - �/ " - MECHANICAL PERMIT . , , - rnone: �a-aou-oeuu , ' , . � - �� Zip: Owner: �. FARAH, ROBERT.G AND NIELISSA ' , i; Address: � �333 E 19TH ST- . .� . ' " � � - Phone: .� _ COSTA MESA, CA Zlp: 92827-2348 Contracror. OWNER-BUILDER � Address: , � _ , . � - � � Phone: � . . . _ ; Zip:' , ' - , ' � � License:000000 ISSUED BY: _ �� Stalus: ISSUED Applied: 17/19/2004 Issued: 1 t122/2004 SCOPE OF PERMIT REF: 804-01227 - NEW 3,406 SF SFO. WORK TO INCLUDE: 1903 SF 1ST FLR AND 1503 SF � � 2N FLR. ALSO INCLUDES 81 SF COVERED DECKS (1 AT FRONT AND 1 AT REAR); 227 SF ' FRONT PATIO COVER AND357. SF SHADE STRUCTURE`CONNECTING 70 NEW REAR � STRUCTURE. — - - - - -/ - � • - � � � ' � ' � REP.: 804-01515, ZA-04-30, DR-04-04. � � , . � , , _ ' - NEW 5 BEDROOM, 3.5 BATH-SFD , �. .- - -- ;� �� . , MECH. PERMIT IS FOR; 1 FACTORY-FIREPLACE, HOOD WIMECHANICAL EXHAUST, 2 VENT � FANS. -�,% ,, " i:' . � FEE SUMMARY '�' % ' � � ._ i � \ �' , � � � Quantiry . ,i �� ., � Quantity ISSUEFEE ' � \ � , 523.50 „ti . ' ��Repair,/AltAbsorbtionUNt � � �' ��3000 �0�, Inst FAU <100 k BTU - 50.00 0 . Repair/Alt Refrigeretlon Unit� '..'i 50.00 0� Inst FAU�>100 k BTU �% � � 50.00 0 � . Venlillation,System ,_ �, �i�' , 30.00� 0 Repair / Alt CoolinyHeat � ., � 50.00 �0 - � , � Evaporative Cooler .� � '. . %� " 50.00 0 Inst / Rep. Recess Wall Htr� ;' �,�50.00 0 � � " -„ Commerdal Incinerator . 50.00,%� 0 Refrig Sys <100 k BTU ' � 50.00,, c0 - � �Domestic Incinerator _ , � ,-50.00 0 Refrig Sys >100 k BTU � � 50.00 �<0 � - ' ,; . . Comoressors / Absorption Svstems .'� , , � Gas Piping � � � ` 'Up to 3 hp /-100 k BTU � " � ��' �50.00 0 � �l��f50.00_ �p�=,C�.x, ..'��/=/ Faclory Fireplace -� � � , -510.65 � � 1 - - ' � - �- ��3 To 15 hp % 500k BTU- � - . , � '�' 50.00 0 Hood w/Mech Exhaust �� ,,� 510.65. 1' � - � 15 To 30 hp / 1,000 k BTU �' - ' $0.00 0 VAV Box � �� $D.00 0 : 30 To 50 hp l, 1,750 k BTU �' � $0.00 0 Vent Fan / Single Ducl �"514.50 2' � '' Over 50 hp /,Over 1,750 BTU ' - 50.00 0 Appliance � �50.00- 0 '� � � _ -Boilers - . , . Fire Dampers $0.00,�-' ,0, � � -- � �� `. - - Up to 3 hp� w $0.00 0 Smoke Dampers 50.00 '�0_ '- �- 3 To 15 hp �, �' ,� .�� 50.00 0 -._ � :_ , . - . I NOTICE: The work authorized by this permit shell compiy with all appliceble handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) � EXPIRATION: This permit shall automatically ettplre and become void if work is not commenced withln 18p days, or if vrork is suspended or abandoned ' br a pedod of 180 days. � INSPECTIONS: In order for the work authorizeE untler this parmit to be considered legal, such work must comply with all applitable codes, and all Irequlred Inapeations and final epprovel must be o6talned. Failure lo obtain Inspections and final approval will result in the expiraUon of this permit. FOR INSPECTIONS CALL: (714) 754-5628 zaaere �a�ao� ffi � � e � WORKERS' COMPENSATION DECLARATON: � . I hereby eHirm under penalry ot perjury one of Iha following dedarationr.' � '� '� ❑ I heve entl wlll maintain a certilicate ol consem m sel6insure tor workers' com0ensetlon, es providetl tor by sectlon 3700 0l iha Labor Code, for the DeAortnenca at the work for which this permit is issuetl. • � ❑ I have entl will maimain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the pertortnance ot the work br w�lch this permit Lv issued. My workers' compensatlon Insurance carriar end pollcy number are: � Cerder. PoliCy Number: (Thls secNar neetl not be complered il the pemuNs velued et one hundred dollars ($100) or /ess.) „, , , [Jti cenity that In tha performance of Ihe work tor which this permit is issuetl, I shall not employ any person in any menner so es to become subject lo �he workere' compansetlon laws F�alifomia, entl a�r t�a tl I shoultl become SUC�ect ta the workers' campensetion proNSions of Sectlon 3700 of Ihe Lebor Cotle, I s�all lorthwlth comply wlih th 6VI510 . � ,�e�.e o a ilf6,�° .� WARNINO: FNLURE TO EWRE WO E0.5' OMPENSATION COVERAGE IS UNLAWFUL AND SMALL SU91ECf Ml EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO pNE HUNDRED TIKK15MlD DOl1ARE (5100,000), IN AD TO THE OOST OF COMPENSATION, DAMAGES AS PHOVIDED FOR IN SELTION 3IOBOF THE IABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I herehy eflirm thet I em licensed under provlsions ol Chepter 9(commencing with Sectlon 7000) of Division 3 of Ihe Business entl Pmtessions Cotle, end my Ilcense Is in tull force entl eNect. Uc. # Cless a ComreCtor's Slgnature: Date: CONS7RUCTON LENDING AGENCY: ❑ 1 here0y eflirtn that there is e construction lending egency tor t�e pedortnence oi Ihe work for which this permit is Issued. (Sec. 3097, Civil Code). Lendefs Neme: ' Lentlefs Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby eNirtn ihat undar penalty ol per�ury that I am E7(EMPT FROM THE CON7RACTORS LICENSE LAW for the lollowing reason (Sec. 7037.5, Business enE Profeuions Cotle: Any dty or counry whic� requires e parmit to conslrucL alter, improve, demolis�, ar repair eny structure, prior to Its Issuance, elso requires the epplicent Por such permit to tlle e slgned statement that he or she Is Ilcensad pursuant to Iha D�a�islons ol the Conirectors License Lew (Chapter 8(wmmencing with Sectlon 7000) of Dlvislon 3 ot the Business entl Professions Code) or that he or she is exempt Iherefrom end the basis tor ihe elleged exemption. Any violation of Section 7031.5 6y eny applicant tor e permit �ects the appllcant to a civil penalry at not more than tive hundred dollars ($500).): I, as owner of the property, or my employees with wages as Iheir sde compensatlon, WILL DO TF1E WORK, end ihe siructure Is not intended or otteretl iar sale (Sec. 7044, Business and Professions Code: The Con�ractors Licensa Lew does not appy to an owner of proparry w�o Duilds or improves Ihereon, and who does such work himsell or herself or thmugh his or her own employees, providad that such Impwvements are not intended or oHered lor sele. If, however, Ihe building or improvement is A wit�in one year oi completion, the owner-builOer will have the �urden ot pmving that he or she tlid not build or improve for purpose of saleJ. I�as owner ot ihe pmperty, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business and Professions ✓Code: The comrecrors License Law tloes not eppty to an owner af pwpeny who builtls or improves thereon, antl who contrects for such pwject wit� a wntrectar(s) license pur�ant to the Conire�tore License Wws.). Veriticetlon Business and Professions Code for this reason: �a. ❑ Yes ❑ No of tlaument, I.e. - property tex 6ill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICA710N: ❑ I hereby certity that no e:cavetlon Ilve (5) or more feet in tlepth into which e person is required to tlescend, will be mede in connection with work euthoAzed by Ihis permit, entl ihat no building structure, sceHdtlinp, falsework, or demdition or dismantling thereof, will be more than thirry-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, 71t1e 8, Califomia AdministretNe Cade). ❑ As owner-builder, I will noi employ enyona to tlo work which would require e permil Irom the Division ol Industrial Sefery. es notetl ebove, unless such person has e permit to tlo such work from the division. Signeturo: Date: Division of Indusirial Satery Permit Number. CERTIFlCATE OF COMPLJANCE AND AUTNOR¢A710N OF ENTRY: I certity under penalry ot perjury that I have reatl this application and state that the inlortnatlon given is correct. I egree to coJAp�with ell stete la s entl dry orAinances relating to building construction, antl authonze representatives of the Ciry of Coste Mesa to enter upon the ebove-describe p E{� �r(y tor inspe 'e —�gree not to occupy or ellow occupancy ot any building euthorized 4y� pertryt until fnal inspecNon. f 6/a� �ana re Ot Legal Ovmehs) � Oa�� C nNOr Auihodzetl Applicent Date F�.nr�r.E�r�a�[.r.�:+» 1616 Fixed System Final Fire Preven0on 1268 Pool Spa Final 200 Finel Re-Root 201 Finel Block/Retaining Well 202 Finel Fectory Fire Place ps¢, �¢ �[ INSPECTIONTYPE p 206 Final Mechenical O � 20B 210 212 220 Finel Plumbinp Finel Electrical Finel Fire Prevention Flnal Planninq Approval 203 Finel Sign 222 Final Site 204 Flnal Demolltlan ' - 250 � Final Building/Occupancy r (7t4) �54•5273 • Fax (7�4) 754-4856 • www.ci.casta-mesa.ca.us 77 FAIH UHIVt, GVJ IA MtJA, GA tlLbLO PLUMBING PERMIT .lob Address: 333 E 19TH ST Suite No Status: IS$UED Applied: t1/16I2004 Issued: 11122/2004 Vicinity: Parcel Nunmber: 11725416 , '�� -- , : - ISSUED BY: Applicant: FARAH, ROBERT'��"�� ; �� - -_ .'./.��L , ' � ti Address: /� ��_,� � �' � �� i i ' ' - , / �- � \ �� ,Phone: 944230.3200 � , . ( � �� - � %,�� /A � . /; � � \ ' / � ,� . . � . Zip: _ ' / . �� : . i ; �' /� i' � , /!�� / !\ \�/ / C = � . . , �., �,i�� \ , � \ \ � / ,/ � /�� " ,. .� � Owner.' (' FARAH,-ROBERT G"AND MELISSA / � A � � �� ` ' �\\`�\' • ' Address 333 E 19TH�ST�/ � �� //i%. .��, � ,�� , , , / i -� , ii// Phone: �� ,.=AA�/ . , i� ��'-;/ �• � � ; COSTA"MESA,CA Zip:"',92627-2348 �'�� , � � �� i,//� � t:. _ _ , . . / '^ , �-,_ , /� / i '_ �- � ,. ..�. . . , _ Contractor. ,%OWNER-BUILDER � f `-�:��`'' , .Address: 'i� � � y�j :-. „" _-: -�-- � , . _ . ' ' �' - � �c�, � _ , ..� � ' , i / ��..- .� Phone: - _ . ; � - . ' ' . . O . ' � �. . . - .. . . �'� \, j� Zip' - ' � , ' � , - � � ' i License: 000000 �� , � rY -��v�� `�� ' !,- I ,1 i�, - � � � � r.�; n l iN ��. � � 1` ' - ' SCOPEOFPERMIT=' -= ' CONSTRUCT 303'SF ADDITION TO AN EXISTING SINGLE-STORY.SFD. WORK TO INCLUDE EXPANSION � OF THE KITCHEN WITH THEADDITION OF A PANTRY AND LAUNDRY ROOM. REMODEL 2 EXISTING . BATHROOMS, ADDITION OF A.CLOSET--W 2 BEDROOMS'AND A NEW PREFAB MAJESTIC FIREPLACE � - • .(ICBO #5677) IN THE EXISTING LIVING'ROOMILOUNGE. ALSO INCLUDES REMOVE AND REPLACE, , � � � '� ALL EXISTING WINDOWS WITH LIKE. �� `� ' -" /% .1' � , �. � � , �` �� -_ � , � REF: 604-01227 � � ! � :-! _- � ' � j " � � . - . '-_.'�_ . . � - . � � PLUMBING PERMIT IS FOR: 1 BATHTUB, 1 DISHWASHER, 1 GAS SYSTEM (1-4 OUTLETS);<t�' /'� - �_ �� i' LAUNDRY TUB/VJASHER, 1 SHOWER,.2 SINKS. 1�KITCHEN SINK, 2 TOILETS. -� �, , \ .__ ,,,, .;% . �� FEE SUMMARY s .�„'ssY ;,�/ ' i � � AMT V QTY - � �. ', ' AMT QTY o "�,F / / � . 'AMT ISSUE FEE � >� ,$23 50 � �\ � `Laundry Tub / Washer �"� $9 80 �1. �,i /Sump Pump `� j - $0.00 Backflow irrigahon�� 50 00 � 0 �� VLandscape-lmgahon� $0 00 . � 0 ° ��Swimming Pool �' � $0.00 Backflow Preventer� `• �, $0.00' �r �0� ��P-Trap � � $0.00 � 0� Trap P'rimer � ' � � $0.00 �_._ Bathtub . �"$9.80 ;. 7,'�� PressureRegulator. �- - -�$0:00<.'0=� �Unnal/i� %�'��,'� $0.00 Clarifier System �$0.00 �� 0� i j ��Process Piping (per 10 k) $0.00� � 0 ��Vacuum Brki Bkflow(1-4) $0.00 Connect"Qce,Soda,etc) $0.00 �,' - 0� �',%; '� Receptors $0.00-' 0��, `�Vacuum�Brkr,Bktlow(5+) 50.00 Dental Units $0.00� `0 �. � Seplic Tank ��. � ' -� � - � �� $O.W �--�0 '.. � ` Wash-Basin 50.00 Dishwasher $9.80 � � 1�� 'Sewer Cap for Demo,� �� -_ � $0.00 � --0. �� ;Wash Basin Set 30.00 Drain, Floor $0.00 0. �' Sewer Connecl' � „_ $0.00'" ��0 %. °Waste and Vent System 50.00 Drain, Rainwater 30.00 0 � � �Sewer Private �ine $0.00 _;0� �� `� � " Water Closet (Toilet) $19.60 Drain, RooF $0.00 0 'ShOwer -'� , ' � -c_�c-Jc-�$9.80_�.1-� WaterHeater/vent $0.00 Drinking Fountain $0.00 0 Sink, bar '�- -- ----� $19:60 2 Water Piping pnst or Rep.) $0.00 QTY 0 0 0 0 0 0 0 0 0 2 0 0 NOTICE: The work authorized by this pertnit shall �comply wlth all applicable handicap access requirements under Callfomia statutes and related regulations. (Ord. No. 92-28, § t, 12-21-92) EXPIRATION: This pertnit shall automatically expire and become vold if work,is not�commenced wlthin 180 days, or if work Is suspended or abandoned for a period ol 180 days. INSPECTIONS: dn order for the work authoAzed under this permit �to be considered legal,.such work �must compty with all applicable codes, and all requlred�lnapeetlona and flnal epprwel must be obtaineA. Feilure to obtain Inspectfons and final.approval will result In the expiralion ol this pertnit. FOR.INSPECTIONS CALL: (714) 7545626 zae+e (erool WORKERS'COMPENSATON DECLARAnON: , I hereby aHirm under penelry of perjury one ot t�e fdlowing declarations' �� .� � � i� ❑ I heve antl will maimain e certllicate of consent to selt-Insure tor workers' compensatlon, as proWdetl br by section 3700 at t�e Labor Cade, for 1he pertortnance of the work for which t�is permlt is luuatl. " � � � ❑ I have end wiil maintein woAcere' compensation insu2nce, as required by seqion 3700 of the Lehor Cotle, for Ihe peAortnence oi the work far whic� Nis pertn114a issued. My workers' compensatlon Insurence wrrier end policy num�er ere: ' Cerrier. Policy Number: (lnls sectlon need nor be oompleted i! tne permit is valued et one hunareC tlollars (5100) or less.) � I certity t�a� in the perto qnce ot Ihe �work tor whiih tMs pertnit is issued, I shall not employ eny person in any menner so es to beiome subject ro the workers' - campensatlon laws of IRomia, erM egre ' at if I shoulA become subJect ta Ne workero' compansatlon proWsions ol SecLon 700 qqq1 the Lebor Code, I shell toMwlth � with these io . � � / / A am S pneture:= g�B; l� 0 r WARNINO: FAIIURE TO SECURE WORICER CO ENSAiION OOVEMGE IS UNUWFUL AND SHALL SUBJECT AN EMPL9YEp'TO CRI I PE ES AND CML FlNES UP TOONE HVNDRED TFqU$AND DOLLAFE (5100,000), IN ADDRI THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3108 OF THE LABOF CODE, IPREREST, M!D ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eXirtn that I em Iicensed under Drovislons of Chepter 9(commenGng with Section 7000) ol DlNsion 3 of tha Business entl Prolessions Code, entl my Iicense is in tull lorce entl eHect. LJc. a Class p Contrectofs Signeture: Dete: CONSTRUC710N LENDING AGENCY: � ❑ I hereby eHirtn Ihal lhere is e construction lentling agency lor the peAormance ot the work for which ihis permit is issued. (Sec. 3097, Civil Code). Lendefs Nema: Lendefs Address: SlgneWre: Date: OWNER-BUILDER DECLARATIONS: I �ereDy eXirtn Uet untler penalry ol per�ury that I em EXEMPT FROM TME CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Protesslw�.s Cotle: Any city or county which requires a permit to constnrc�, alter, Imprwe, tlemolis�, ar repair any structure, prior to ils issuance, elso repuires Ihe flpplicant tor such pertnit lo lile e signetl stetement Ihat he w she Is Iicensetl purwant to ihe provisions ot Itie Cantrectors Llcense Lew (Chapter 9(commenGng with SecUon 7000) of DlNsion 3 of Ne Business end Professlons Code) or that he or she Is exempt theretrom enG ��e besis for the ellaged eaemption. Any violatlon of Section 7031.5 Cy eny epplicent for e pertnit subjects the epplicant to a civll penalry of not more than Me hundretl tlWlars ($SOOj.): tC_71 I, as owner at the property, or my employees with wages es thelr sole compensatlon, WILL DO THE WORK, and the structure is not intentled or otleretl for sale (Sec. ��7044, Business end Prolessions Cotle: The Contractore License Lew does not apply to an owner ot propeny who builds or improves ihareon, end who does such work hlm r hereelf or through his or her own employees, provided thet such improvemenis ere nat Intended or oHeretl for sele. 11, however, the building or Improvement is within ona year of completion, the owner-huiltler will heve Ne burden of proving that he or she did not 6uild or improve for Durpose of sale.). � � �� I, as ow,ner of the properry, em EXCLUSIVELY CON7RAC71NG W17H LICENSED CONTRACTORS to construct the pmject (Sec. 7044, Business and Pmtessions Cotle: TTe coniractors License Lew tlaes nm appty to en owner ol propery w�o builAs or imprwes Ihereon, and who comrects tor such pro�ect wit� e contraccor(s) license pursuanjto tha Contrectors License Lews.). lam Owner ID verilied by drivers Vedflwtian of Ownership by Business antl�Professions Code tor this reeson: i✓ ❑ Ves ❑ No oi documem, i.e. - pmperry tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I here6y cenity that no escavetion five (5) or more teet in tlepth Into wnich e person is reQuired to descend, wlll be made in cannectlon with work euthadzed by this pertnit, end that no building Slruqure, scattdding, talsework, or demdition or dismantling Ihereol, will ba more then thlrty-six (38) teet high. (Chap. 3.2, Gry 2, Ari 2, Sec. 341, Title B, Celifomla Atlminlstretive Code). ❑ As owner-builtler, I will not employ enyone to tlo work which woultl require a permlt Irom the DivLsion ol Intlustriel Sefety. es notetl e6ove, unless such person has e pertnit to do such work tmm t�e tlivision. Signeture: Data: Divislon of Intlustnel Satety Permil Number: CERTIFlCA7E OF COMPLIANCE AND AIJfHORQATION OF EMRY: I cenity under penalry of perjury that I have reatl this applicaUon end state thet Ihe Infortnetion given is correct. I egree to co 6Y�vlth all atete law5,and Gty oNinances relaqng m bullding consWction, end euthonze representelives ot Ihe Ciry of CaSte Mesa to enler upon Ihe eDove-descdbetl � lar In ec' p lSses. agree no110 occupy or ellow occupency ol eny building authorizetl by this�it til fi el inspecUon. -��{ ' J Si fLegel�Owner(�_. Date �� _ �_,xas�. .• And/Or Aut�orized Applicant ��e COUE L INSVECTqN ME ' ``- "' ` '' Qd¢. ^ Ii$�45 1616 FixeC System Flnal Fire Prevention 1268 Pool Spa Flnel 200 Finel Re-Roo1 � 201 Final BIocWRetelninp Wall 202 Finel Factory Fire Place `. � '�' 203 204 Final Sign Final Demdition " �( INSFEGTIONTYPE 206 � � Final Mechanical 208 210 212 220 222 250 Final Plumbing Final EleCtriCel � � � Flnal Fire Preventlon Final Planning �ApproveP Final Site � � Final Builtling/Occupency � �g � �� (714) 754-5273 • Fex (714) 754-4856 • www.c(.coste•mesa.ca.us 77 FAIR DAIVE, COSTA MESA, CA 92626 BUILDING PERMIT ,lob /+ddress: 333 E 19TH ST Suite: Viciniry: ROOF Primary Occ: R3 Dwellings/ Cong Res <10 - Type of ConsWction: V-N Parcel Number: 11725416 Zoning: Applicant: HAMMARSTROM, HOGAN Address: 18903 SAN CARLOS ST � FOUNTAIN VALLEY, CA Owner: FARAH, ROBERT G AND MELISSA Address 333 E 19TH ST � � COSTA MESA, CA � � Convacror: ABSOLUT ROOFING CO Address: 18903 SAN CARLOS ST FOUNTAIN VALLEY, CA Zip: 92708 Arch : Address: Phone: Fhone: 714-6552231 Zip: 92708 Phone: 949-230-3200 Zip: 92627-2348 Phone: 714-655-2231 License: 761118 Eng: Address: SUtus: ISSUED Applied: 04/12/2005 Issued: 04/12/2005 ISSUED BY: ^ " Phone: 2ip: License: License: SCOPE OE PERMIT TEAR OFF EXISTING COMP SHINGLES, INSTALL 30#�FELT UNDERLAYMENT, 8 REROOF WITH 30 YEAR CERTAINTEED COMPOSITION (20 SQ). _ Plan Check: $0.00 Permit: $125.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existinq: 0 Rear 0- 0 Rear 0. 0 Re uired: 0 0 FEE SUMMARY PLANNING 8 ZONING Left 0- 0 Left 0. 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 ss,o�o.00 Ss,o�o.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPiRA710N: This permit shatt aufomatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days, INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applieable codes, antl all requlred Inspeetlone end final epprovel must be obtained. Failure to obtain inspections and tinal approval wlll result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5628 � WORKERS' COMPENSA710N DECLARATION: I hereby eHirtn under penelry of perjury one ot the I011owing declaretlons: ❑ I heve end will meintein e cenificate o� �onsent to salf-Insure lor workors' compensetlon, es provided lor by section 3700 of t�e Lobor Code, tor the pertortnence ot Ihe work for which this pertnit Is issued. 0�_F'have erM will maintein workers' crompensetlon Insurence, es requlred by section 3700 al the Lebor Cade, br the Oerlortnanco 01 t�o work br which this pormlt is issuod. My workers' comper�aeilon Insurenca cerrler end policy number ere: r Cerrier� n' 19 f� 'f'li /J� p ry �NumCer; %SU �55� jThls sectbn need nof be complefed il the perm07s velued e1 one hundre0 dollars (S I00J or less.) O � Certily thet in the pertomience of �he N'o � br which this pertnit Is Issued, I shall not employ eny person in eny manner so es to become suDjed ro the worknro' campensetion la 5 f C litomi and egr e thet Il l shauld Oecome sub�ecl to the worken' crompansatlon provisions o1 Section 3700 of the LeDor Code, I shell lorthwlth comply wit� the ns. ( Ppplicant Signeture: �in /t n o�� y- I Z- 07 WARMNfN FARUiiE TO SEWRE WIXiKERS' W�dFENSATION COVERA�E IS UMAWFUL AND SHALL SUBIECT AN EMPLOVER TO CiiIMINA� PENALTIES AND CML FlNES UP TOONE HUNDRED T110USAND DOl1ARE (3100,000�, IN ADDITION Ttl TNE COST OF COMPENSATION, Dr1MAGE5 AS Pi1GVI0ED FOR IN SECTION 3lp80F THE IABOR COpE, INtERESi, AND /TTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrtn that I am liCensad under p Nsions af Chepler 9(crommencing wlih Seciion 7000) ol Division 3 Of e.8usine55 and Profe55bns Cafa, and my Iltense is in �ull �_':l farce antl etteG.�t Ic.�h I 1 1 ,s.«) r- 3� Coniractor'eSignature: �Dn� ��- 17. • tli CONSTRUCiION LENDING AGENCY: ❑ I hereby eflirtn tha� �here i5 a tronsWdlon Iending egency lor ihe pedormence ol Ihe work br which �his permil is issuatl. (Sec. 3097, Civil Code). Lender's Name: Londar's AAtlrass: Signeture: Date: OWNER-BUILOER DECLARATONS: I hereby attlrtn thet under penelry of per�ury thet I em E%EMPT FROM TME CON7RACTORS LICENSE LAW tor Ihe Ioliowing reawn (Sec. 7031.5. Business an0 Professlons Cotle: Any dry or counry w�icl� raquires e permit to construct, alter. Improve, tlomdish, or repair eny structure, prior to its issuance, also requiraz the aDP��< <or such pertnit b file e sgneC stetement thet he or she is Ikensetl pursuent to Ihe pmNsbns oi Ihe Contreccors License Lew (Chepter 9(commencing with Sectian 7000) of DMsion 3 ot the Business end Pmfessions Code) or t�at he ar she Is e�empt t�emlrom end Iha besis br Ihe elleged axemption. Any Wdetion o1 Sectbn 7031.5 by eny applicent far e pertnit su6jects t�e epplicent to e cWil penalry ot no� more than Ilve hundred ddlars (E500).): ❑ I, es owner ol the pruperty, or my employees with weges es t�eir sde compensetion, WILL DO THE WORK, an0 ihe siructure is not inten�eE or oflered for sale (Sec. 70aa. Business antl Professions Coda: The Contrectors LJcense Law does not epply lo en owner ol properry w�o builas or improves thereon, and who does such work himself w �erself or through his or her own employees. O�aNded ihat such improvemenis are not Intentletl or oHered for sale. If, however, Ihe building oi improvement is sold within one year of completion, the owner-builaer will have the burden ol proving that he or she did noI build or improve for purpose of uleJ. ❑ I, es owner of I�e properry, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS to conslruct the projact (Sec. 7044, Business antl Professions Catle: Ttie contrecrors License Lew daes nol apply to en awner ol propeny who bullas or Improves Ihereon, antl who wntracts tw suU projea with a contrector(s) liCenSe Dursuant to the Conlractors License Lews.). ❑ I am erempl untler sec. Signatura: Owner ID vorifiatl by Crivers license. ❑ �es ❑ No Busino55 end Prolessions CoUa for Ihis reason: Verification ol Ownership �y (type of document, I.e. - propeny tex �III or tlee0): DIVISION OF INDUSTAIAL SAFETY PERMR CERTFICATION: Drivels License Na. Date: Espiras: ❑ 1 �ereDy ceNly t�at no ezwveiion tive (5) or more teet in depth into which e person is required to descen4 wlll be metle in conneclion with work authodzed Dy Nis permi6 antl t�at no Duliding siructure, S�attoltling, telsawork, or demditlon or dismantling thereol, will be more then ihirry-siz (36) feet high. (Chap. 3.2, Grp 2, Ar12, Sec. 341, Title 8. Celilomia Atlminisiretive G�e)� ❑ As owner-builtler, I will not employ enyo^e to tlo work whlch would require e permit irom �he Division ol Intlustnal Sefery, as noted above. unless such person has e pertnit to do such work irom the divisia�. Signature: Date: Division ot Industnal Safery Pertnit Number: CEHTIFlCATE OF COMPIIANCE IWD AllTHORVATON OF ENfRV: I cartily un0er penalry ol perjury thet I �evo reetl Ihis ap0�ication and state thal lhe inlormation given is correa. I egree to wmply wlih ell stete lew9 enA cl�y ortllnences relating lo bulltling conswcllon, end euthodze ropresentellves ol the Ciry ol Costa Mese to eNer upon ihe ebovedexrj ed propetly br inspedian purposes. I egreo not to occuDY or allow occupancy ol any building authorized by thls permit until tinel inspection. � Si aWre Of LeBal Own ) r_ oate / / 2 • v �- And/OyAWtwrizetl'AppllceM rDa1e�----.-+. COOE �. INSVECTONTYYE 76�6 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Rool 201 Finel Blak/Retaining Well 202 Finel Fadory Fire Place 203 Ffnal Sign 204 Final Domolilion GAIE iMrtuts —z�.—O S � CO�E� INSPECTIONTYPE 206 Finel Machanical 208 Flnal Plumbing 210 Finel Electricel 272 Finel Flre Prevemian 220 Flnel Planning Approval 222 Finel Site 250 Finel Building/Occupency QAIE ItQQIeL$ CITY OF COSTA ME� V� � � '' BUILDING DIVISION F _� DEVELOPMENT SERVICES DEPARTMENT 898-01007 � PERMIT PERMIT NUMBER �� (714) 754•5273 • Fax (714) 754-4856 gUILDING PERMIT n FAIR DAIVE. COSTA MESA, CA 92626 Job Address: 333 19TH ST Suite: Vciniry: Parcel Nunmber. 11725416 Applicant: ROTH, HANNA B Address: 333 E 19TH ST Owner: Address Contrador: Address: Amh/Eng: Address: COSTA MESA,CA .. ROTH, HANNA B "- � � 333 E 19TH ST '.�� -- � COSTA MESA,CA `. ' .' _, � � � � . � .-/:%�: �� - � ��./ Status: ISSUED Applied: O6/10I1998 Issued: O6I70/1998 Zoning: Phone: , Zip: 92627 � � Phone: '_ . - , ,� . Zip: 92627 - - � ' �� ' = - ' � ��A--�� .J� �� , � V�\ ;�� =: A�� . ��_. �: -.�� - . � : �� , \� `��'\ `/ - �- Phone: '�>� , ." � 2ip: A�:` �,� ,A ��' �� License: � , � , , . . �" Phone: �, ` • � . i � � ` . ��P� - . ___ . . : License: . .. :' - � — _ . 1 ' � �� SCOPE OF PERMIT �'. � . Interior alteration to an existing single-family dwelling.REMOVE EXIST. BEARING WALL'& INSTALL 6x 12 BEAM 8 RERARANGE �� EXIST. BATHROOM. ILLIMINATE EXIST. WASHER &'DRYER &.INSTALL PLUMBING.FIXTURES. FINAL IS PER INSPECTORS FIELD APPROVAL. WORK ALREADY DONE � . - - � „ , ' .. .... � � . � � Plan Check: $121.71 Permit: $187.25 SMIP Res: $1.20 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 � �MARY r' • �i / y ../ --. Ca1c Valuation: si2,000.00, Claimed Valuation: Stz,000.00 �- Total: $310.16 �- ' � � � � � � - � � • � � � � ' PLANNING &�ZONING - % � � � ' � � . � � , -� / SETBACKS MAIN STRUCTURE Front 20• 0 � ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear , 24 0 Left -S 0 Rear 0. 0� , � Left 0- 0 Reauiretl:�, 0 . , Pr000sedr � "0 0 Right Right SO 0.0 EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned tor a period of 180 days. , INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspectlone and final epproval must be obtained. Failure to obtain Inspectlons antl final approval will result in the expiration of this permlt. FOR INSPECTIONS CALL: (714) 7545848 � � r'+�._ WORKERS' COMPENSATION DECLARATION: � I here6y eHirtn untler penalry of pe�ury one of the tollowing deGeretlons: � ❑ I heve enO wlll mflinlein e certiflcete ot conaent to aeH-Insure tor workers' compensatlon, es praNdetl tor Gy section 3700 of the Lebor Cotle, for Ihe pertortnance of ihe xrork fa whlcli t�ls pertnit Is iuued. ❑ I have arM wlll meintein workers' campenseUon insurence, es reQuired by section 3700 oi the Labor Cotle, for Ue peAortnence of Ne work tw which ihis pertnit is IssueE. My workers' compensetlon Inwrance cartler entl pollq number ere: Cartler. Pollcy Number. (TiJs secflon need not De oomplefetl !I t�e pe�mlf /s va/ued at one huntlied tlollars ($100) or less.) ❑ I ceNfy Uiet in the peAortnance of the work tor which ihis pertnit Is Ls,wed, I shell not employ eny peroon In eny manner so es to bacome auD�ect to the workers' compensetlon lews of Celitomle, end egree thet II I shouW become sub�ecl to the workera' compensatlon provisions ot Section 3700 of Ue Lebor Code, I s�flll lorihwlth compty wIN Nese proNSlons. Applicent Slgnature: Dete: WARMNG: FAILURE TO SECURE WORKERS' C�OMPENSATIpN CO�/ERA(3E IS UNLAWFlIL AND SIIALL SUBJEGT AN EMPLOVER TO CRIMINAL PENALTES PND CML FNES UP TO ONE MUNDRED TIqUSAND DOLLAHE R��•�)• IN ADOfiION TO THE CpST OF COMPENSATION, DAMAGES PS PRONDED fIXi IN SECTION 3/060F TME LABOR CODE.INfEREST, AND ATTORNEYS FEES. LICENSED CONTHAC70RS DECLARATION: I hereby atfirtn Nat I em iicensed under provLsions oi Chepter 9(commenring with Sectbn 7000) at Divisian 3 ot ihe Business and Professions Code, and my license is in full force and eHect. Lic. N Cless p c«itraaors s�gnemre: oace: CONSTRUCTION LENDINC AGENCY: ❑ I here6y etflrtn that there Is e construcllon IenOing egenq tor the peAoimence ot Ihe xrork tor which this permit is issued. (Sec. 3097, GMI Code). Lentlels Name: Lenders Atldress: Signeture: Date: OWNER-BUILDER DECIARATIONS: I �ere6y etflrtn Net under penelry ot perjury thet I qm EXEMPT FROM THE CONTiiACTORS LICENSE LAW 1ar t�e lollowlnp reason (Sec. 7031.5, Business flnO Prolessions Cade: My dry or counry which repuires e permlt to consUuct, elter, Improve, tlemdls�, or repelr eny structure, prior to IU issusnce, elso reQuires Ue appllcam tor such pertnit to file e signed stetement Nat he or s�e is Ilcensetl Dureuant to Ue provisiwu of Ihe Contrectore License Lew (Chapter 9(mmmendng wlth Section 7000) of DMsion 3 of the Business entl Professions COtle) or Ihat he or shb is exempt theretrom end tne besb tor the elleged exemption. My violation of Seclion 7031.5 by eny applicaN for e pertnit sublects tt�e appliwnt to a civil penalry of not morg Wan five hundred tldlars (5500).): ❑ I, es owner at Ne propeM. or my employees wIN wages as their sole compensetlon, WILL DO TF1E WORK, enA Ne structure is not InteMed or oHeretl for sele (Sec. 76M14, Business and Protessbns Cotle: The Contracrors Llcense Lew does not eppty to fln owner ot properry w�o builds w improves thereon, and who does such work himsetl or �erseM or through hls or her own employees, providetl t�at such Improvements ere not IntenAetl or ottered for sale. Ii, however, the buildinq or improvement Is sWtl withln one year of completlon, Ihe owner-bullOer wW heve Ne burden of proving tt�et he or she tlid not bulld or improve for purpose of sale.). I, es owner of Ihe roperry. em EIICLUSIVELY CONTRACTING WRH LICENSED CONTAACTORS to canstruct the project (Sec. 7044, Business antl Professions Cotle: The cont rs nse Lew tloes nat epply to en owner of property who bullds or improves thereon, end who contrects far such pro�ed with a contrector(s) license pursuflnL o G ntrectors lJcense Lews,), ❑ lem Signature: vednceuon or Busineu en0 Professions CoCe tor thls reawn: Date: � ❑ Vo9 ❑ No Drivefs Llcense No. Expires: tlocumenL i.a. - property tex bill or Ceetl): DIVISION OF INDUSTRIAL SAFETV PERMR CEpTIFICATION: ❑ 1 hereDy cenlly thet no eacavetlon Ilve (5) or more taet in depth into whlch e peraon is redulretl to tlescentl, will be matle In wnnection wiih work authorized 6y ihis pertnit, enA thet no buildinp siructure, sceHolding, felsework, or demolltion or dismantling thereol, wlll De more then ihirty-siz (36) feet hlph. (Chap. 32, Grp 2, An 2, Sec. 347, TWe B, Celifomle AEminlstrative Code). ❑ As owner-bullder, I wlll not employ enyone 16 do work which would requlre e permlt irom Ne Dlvislon ot Intlusiriel Sefery, es noted above, unless such person hes e permil to tlo such work irom the division. Signeture: Date: Division of InOusidal Sefery Pertnit Number: CApE I. MSYECTqNTYVE Qe7e �{$ 1616 Fxed System Finel Fre Preventlon 1268 200 201 202 203 Pool Spa Final Flnel RaRaof Finel Block/Reteining Wall Finel Fedory Flre Plece Flnal Sign 204 Flnal Demdltlon zase-ee GO�EI MSVECIIONTIPE 206 Final Mechenlral 20B Finel Plumbing 210 Flnel Electncal 212 Finel Fire PrevenUon 220 Flnel Planninp ApProval 222 Final Site 250 Finel Bullding/Occupency GAff It�llS �' . � _ � .- v � � CITY OF COSTA MESA • * � � BYILDIN6 DMSION F � � DEVELOPMENT SERVICES DEPARTMENT P98-00469 � � PERMIT PERMITNUMBER .� � (714) 754-5273 • Fax (714) 754-4B56 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT , Job Address: Suile No Vicinity: 333 E 19TH ST Parcel Nunmber: 11725416 Applicant: ROTH, HANNA B Address: 333 E 19TH ST Owner: Address Contractor: Address: Arch I Eng : Address: Status: ISSUED Applied: 06/11/1998 Issued: O617 7/1998 - Phone: . _ � .' . COSTA MESA,CA , � � - Zip: 92627 ' �' ._ _ � , / ' , , �i ROTH, HANNA B , , � -/" - i � � ' `� 333 E 19TH ST'. � � _ = - - ' � � ��. �� .• � , = � . , ' - -- --- `_'-�c��A;/ � ��\ . . .� .�-,-�Phone: -�\: _'�_ � �• ' `\:.,� _ � _�_ _ .- �� -r � V ' � \ COSTA MESA.CA � Zip: 92627 �V� _� � - �� '� -� , , .� ��i- / A: _ � � � �� i . `� �; �:.A� �;,� , ' :� .:>� . � � � �; . . � � - Phone�; .' . . . � �/" : : Zip: i �:. - i ' . . ', �'License: � , , . . _ � - _ '. -" ��, , �. Phone: �� - - ZiP: -. , - �� . � � Litense: . � . , .. • . . SCOPE OF PERMIT REMOVE & INSTALL BATHTUB, SINK 8 TOILET. 8 INSTALL NEW - �� ,��.� BATHTUB & SHOWER, SINK 8 TOILET. SANITARY�DISTRICT FE,ES HAS , /�_ BEEN PAID � � ISSUE FEE BackFlow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Denlal Units Dishwasher Drein, Floor Drain, Rainwater Drein, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-a outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $22.00 $0.00 $0.00 517.50 $0.00 50.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 50.00 � 0 � FEE SUMMARY- =�%, - AMT QTY Laundry Tub / Wasfier . � $0.00 0 Landscape.lrrigation $0.00 0 P-Trap � $0.00 0 Pressure Regulator . 50.00, 0 Process Piping (per 10 N) �$0.00 � 0� Receptors � . _ � % $0.00- ' 0 ._ - � SepticTank � $0.00 ' 0 �` �� Sewer Cap tor Demo �' 50.00 °, 0'-- Sewer Connect � � - $0.00 0 � Sewer Private Line � $0.00 0 . �Shower $0.00 0 . Sink, bar - $0.00 0 Sink, commercial . $0.00 �0 " Sink, Floor - � . �$0.00 0 .; Sink, kitchen � $0.00 � 0 ' �� Sink, service/mop - $0.00 � 0 Spa (private) - $0.00 0 Spa (public) $0.00 0 COMMENTS / SPECIAL CONDITIONS Sump Pump � � Swimming.Pool Trap Primer Urinal � Vacuum Brkr Bkflow(14) "� Vacuum Brkr BkFlow(5+) ' Wash Basin, , Wash Basin Set � Waste and Vent System Water Closet (Toilet) Water Heater I vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $17.50 50.00 $17.50 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 50.00 so.00 TOTAL CALCULATED FEES: $74.50 .� 0 Qn 0 0 0 0 0 0 0 2 0 2 0 0 0 0 0 0 EXPIRA710N: This permit shall eutomatic811y expire and become void ii work is not commenced within 1 BO days, or if work is suspended or abandoned lor a perlod of 180 days. INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectlona end Mal epprovel must be oblained. Failure to obtain inspecllons and final epproval will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 754-5828 WORKERS'C�OMPENSATON DECLARATION: � I hereby eifirtn under penalry of per�ury one of Na fdlaxing dedaretlons: ' ❑ I have entl wlll meinteln e certllicate of consent to setl-Insure br workers' compensetion, es provlded br �y sectlon 3700 ot Ihe Lebor Code, for Ne peAortnance of Ne vrork tor which ihis permit is Lasuetl. ❑ I have e�M wW meintain workere' compensatbn insurance, as requiretl by section 3700 of the Lebor CoCe. for Na peAomisnce of Ihe work for whkh Ws peimit is iswetl. My workera' compensetion Insurance certfer anO policy number ere: Cerrler. Policy Number: (Thls sectlon need nof be completed!! the permlf !s valued at one hunOretl dollars (S �00) or less.) ❑ I certlly t�et in Ne peAortnence ot �he work tor wNch NLs pertnit Is issued, I shall not employ eny person in eny manner so es to become wb�ect to Ihe workers compensetion laws of Califomla, end egree Ihet ii I should Decome suD�ect to the workers' compensetlon provisions oi Sectlon 3700 ot the Lebor CoCe, I shell foRhwlih comply wlih Ihese Provisions. Appllcant Slgneture: Dete: WARNINO: FAILURE TO SEd1RE WORKERS' COMPENSATION G�OVERA�E IS UNUW FlA AND SMALL SUflIEGT AN EMPLOYER TO CRIMINAL PEN�LTIES M1D CML FlNE$ UP TO ONE HUNDHED iFqUSAND DOl1ARE (5100,000), IN ADDfTION TO THE CQS'T OF COMPENSATION, DMIAGES AS PROVIDED FOR IN SECrION 31080F TME IABOR OODE �MEREST, AND ATTORNEYS FEES. UCENSED CONTRACTORS DECLARATION: � hereby efllrtn thet I em Ilcensed under proWslons ol Chepter 9(commencing wit� Sedlon 7000) of Divislon 3 0l Ihe Business end Professions Cade, entl my Iicense Is In tull iorce and efleCl. LIC. N Class q Convemore Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 �ereby etfirm that there La a construMion lending egency tor the paAormance of tha work for which Ihis permit Is Issued. (Sec. 3097, CINI Cotle). Lenders Neme: Lentlers Atldress: SlgnaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby etfirm t�at untler penalry oi perJury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW Por t�e follov.•Ing reeson (Sec. 7031.5, Business enA Professions Cotle: My clry or caunry which reQWres e pertnit to construct, alter, improve, tlemdlsh, or repelr eny structure, pdor to Its luuence, e�w requires the applicant tor such permit to file a slpned statement Nat he or she Is Iicensetl pursuant to ihe proWsbns of tha ConVaclors IJcense Lew (C�apter 9(canmendnp wIU Section �000) of DWWon 3 of Ne Businass anC Professlms Code) w that he or she is exempt therefrom entl Ne besls tor the elleped exemptlon. My Wdation oi Sectlon 7037.5 by eny applkent for e pertrtit sub�ecLs Ihe epplicent ro e civil penalry ol not more Nan five hundred ddlars (5500).): ❑ I, as owner of Ihe Oroperry, or my employees with wages es Iheir sde compensation, WILL DO TFIE WORK, flntl ihe sWdure is nat Intendetl or otteretl for sele (Sec. 7044, Business entl Professions Code: The Contractors License Lew does not eppty to en owner o1 property who builGs or Improves ihereon, and w�o tloes such work �imsell or �erseH or t�rough his or her own employees, provltleC ihet such Improvements are not Intended or ottered for sale. It, �owever, ihe building or improvement Is sold wlthln one year of compleUon, the owner-builtler will have the burden ot pmving that he or ahe tlid not build or improve tor purpose of saleJ. - �I, as owner of the r rty, em E%CWSIVELY COMRACTING WITF1 LICENSED CONTRACTORS to consiruct the praJect (Sec. 7044, Business and Professions Code: The cont s nse Lew Coes noi appy to an owner o1 pwperry who builCs or Imprwes thereon, end who contrecW for such pro�ect wlth e conirectoQs) IlcenSe pu u � o e Vactors �canse Lews.). s. Business end Profe55ions Code lor Ihis reason: Signatur : Dat��1 —�cr —%Ir , veAfl d' �en . ❑ Ves ❑ No Drivefs Lkense No. ��_/ - E cl plres; VeAflcatlon of p oi tlocument, i.e. - properry tax blll w deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: ❑ I hereby ceNiy thet no excevatlon 11ve (5) or more teel in depN into which e person Is requlred to descend, wlll be mede in connectlon wlth work euthodzetl by this pertnit, entl lhet no building atrucWre, sceMoltling, telsework, or demolitlon or tlismamling thereol, will ba more then Ihirry-slx (36) feet high. (CheD� 32, Grp 2, An 2, Sec. 341, Title 8, Cellfomia AdminislretNe CoCe). � As owner-builder, I will not employ enyane to do work which would require e pertnit trom Uie Dlvlslon of InCusirlal Sefery, es noted ebove, unless suU peraon has e pertNt lo do such xrork from the dMsion. Sipneture: Date: Dlvision of Industdal Satery Permit Number. L411EJ. ItlSPECII9N rrvE 1816 Fixed System Finel Fire Preventlon 7286 Pod Spe Finel 200 Flnel Pe-Root 201 Finel Block/Retaining Well 202 Finel Fac[ory Flre Poece 203 FInalSign 20C Flnel Demdluon 2M8�8 �g � i.uu. (�j� dSiECiIONTYVE 208 Flnel Mechanicel 208 Finel Plumbing 210 Final ElectriCel 212 Final Fire Preventlon 220 Final Planninp Apprwel 222 Flnel Slie 250 Flnel Building�Occupency �ff � CITY OF COSTA MESA � � BYILDING DMSION ; y• DEVELOPMENT SERVICES DEPARTMENT E98-00545 �• PERMIT PERMIT NUMBER �� (714) 754•5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 333 19TH ST Suite No vciniry: Pareel Nunmber. 11725416 Applicant: ROTH, HANNA B Address: 333 E 19TH ST Owner: Address Contractor. Add2s5: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa .Lighting Fixts Recept Outlets. sWaoneS Non Res Appl Res Appl Service to 200a Senice to t000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole tighi Pkg Sign Circuits Temp Pwr Pole Intermed Pole s�aws: ISSUED Applied: O6I10I7998 Issued: O6/10I1998 Phone: COSTA MESA,CA . , 2ip 92627 � - . , `� "�- � _ '. � ._ _. . ` � ROTH, HANNA B�, " � � � � � � � ,; i; 333 E 19TH�ST � . . , � . . - . �'' �� - . . �;, � ., �. . - � � - / . Phone: , . . , - � � , ` �' � � COSTA MESA,CA . - Zfp:- �92627 -� -�=y - �-�' -,�. � � � . -. '� . • ��\\� ';' \�j`.\ � , , . �A��, � •�- \:: � �� A� _ ,r. / _ - i �/', - � � �� l t � �� \; �� ' • �.. Phone['j �:' � , - � , Zip: ��; -, i ; _. . . , , . , . { . � �� .\,�1 . . Licensa:- , . . . I .' . . , i i ' � . ' " - - ' - ' " ' ' SCOPE OF PERMIT - 2 LIGHTS, 2 OUTLETS & 2 SWI7CHES. / 522.00 $0.00 $0.00 $0.00 $0.00 $0.00 52.00 sz.00 $2.�0 $0.00 $0.00 $0.00 $0.00 E0.00 , ^ ao.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 so.00 $0.00 $0.00 $0.00 �, " . FEE SUMMARY ' Quantity �� " - � - . Temp Dist System /� Lighting - ' Busway /100 ft - " , �-: -..- '��.� .,, . - _ . -- Standing'Section � . � � � ,_o - ' - 0 0 2 z 2 0 0 0 0 0 0 �. 0 . 0 � 0 0 , 0 0 0 0 ' 0 - � ; -Misc Electncal Eqwpment - - Transfortners up to 1 kva/kw ..............r.up to 70 kvalkw .............- :up l0 50 kva/kw � ............:.'..up.to �100 kvalkw ..................over 700 kvalkw '` Low Voltage Equipment �- � Low Volt Wiring Systam / Ckt - -Misa Conduit . . Misc. Conductor � � ' Circus (,gen o(ride) � � � ' Circus (mech ride or lights) , , � � Christmas Tree Stand ' " � � Fireworks Stand � . ' � Other Electrical Fee � Quantity $0.00 0 , 50.00 0 so.00 0 to.00 o," $0.00 0 50.00 0 $0.00 0 ' , $0.00 .-�0 . so.00 o' $0.00- , -, 0 i $0.00 - 0 $0.00 0 $0.00 0 $0.00 0 30.00 0 50.00 0 50.00 ` 0 $0.00" � Investigalion Fee . . $0.00, � Plan Check Fee , 50.00 Reinspedion Fee � . , SO.QO TOTAI CALCULATED FEES E28.00 COMMENTS I SPECIAL CONDITIONS � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned I for a perfod of 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must compty with all applicable codes, and ell requlred inapeetione and final epprovel must be obtained. Failure to obtain inspeelions and final approval will result in the ezpiration of this permit. FOR INSPECTfONS CALt: (714) 754-5828 I WORKERS' COMPENSATION DECLARATION: I hereby ettirtn under penelry oi perjury one oi t�e lollowing tleclaretions: ❑ I heve entl wlll melnteln a certNlcate oi consent �o eelf-Insure tor workers' compenseUon, es providetl 1or by sectlon 3700 of the Lebor Catle, br Ihe pertormance of the vrork lor which t�ls pertnit Is IuueO. p I heve erM vAtl melntein workers' campensetion Insurence, es repuired by section 3700 W Ihe Lebor Coda, for the pertartnance ol Ihe work for wlikh this portnit Is IssueG. My workera' compensetlon Insurence cerrler entl poliq number ere: Certler. Poliry NumDer. (7nls sectlon need not ee oomp�ered!! me permlr Is ve�ued ef one n�ntlred dol�ers (Sf oo) or �ess.) ❑ I certity that in the peAortnance ot tha work tor which this pertnit Is Issue4 1 shall not employ any peraon in eny menner so es to become subJect to Ihe workera' compensation lews of Calitwnia, end egree thet il I shoultl become subJect to the vrorkers' compensetion proNsiore of Secllon 3700 af the LaDor Cotle, I ahell lonhwit� compy wlth these vroNslons. Applicant Signature: Date: WARMNO: FAILURE TO SEWRE WOPoCERS' COMPENSATION OOVEMGE IS UM.AWRIL AND $HALL SUBJECT M! EMPLOYER TO CRIAUNAL PENALTIES AND CML FlNES UP TO IXJE HUNDRED iHOUSAND DOLIARE (5100.000). IN AODRION TO TME CQST OF COMPENSATION, DPIMCES AS PROVIDED FOH IN SECf10N 3lOB OF 7HE IABOR ODOE, INTFAEST, M'D ATTORNEI^5 FEES. 4CENSED CONTAAC70RS DECLARATION: 1 hereby eflirtn t�at I em licensed under provisions of Chepter 8(commencing vnih Section 7000) of Dlvision 3 of t�e Business end Professions Code, end my license Is In tull foroe and eHect. Lic. N Class N Contrectofs Signeture: Date: CONSTRUCTON LENDING AGENCY: ❑ I hereby afflrtn Nat there is e consiructlon lending epenry tor the peAormance ot the xrork for which this pertnit Is issued. (Sec. 3097, CINI Cotle). Lentlef9 Nflme: Le�tlefs Atltlress: Signeture: Dete: OWNER-BUILDER DECLARA710NS: I hereby etllrtn t�at untler penelry of per�ury thet I am EXEMM FROM THE COMRACTORS LICENSE LAW tor Ihe fdlowinp reeson (Sec. 7031.5, Buslness end Professbns Code: My Ury or counry which requires e permit to conswd, elter, impmve, demolish, or repair eny strudure, priar to Its Issuence, eLso raquires the epplicent for such pertnit to Ole e sipned stetement that ha or sha Is Ikensed pursuent to the D�� ot Ne ConVeMoro Llcense Lew (Chapter 9(commendnp with Sectlon 7000) 01 Dlvision 3 of Ihe Business end Protesslons Code) or lhet he or she is ezempt therefrom entl Ne Desis tor Ne fllleged exemption. My Ndation ot Sectlon 7031_5 by eny epplicent for e pertnit sub�ects ihe eppllcant to e dNl penalry of not more Nan five hundre0 ddWro ($500).): ❑ I, as owner of the property, or my employees wlth wepes es t�elr sde compensaLon, WILL DO THE WORK, end the siructure is not intended or otteretl for sale (Sec. 7044,�Business enG Protessions Code: The Contrectors LJcense Lew tloes not eppy to an owner oi properry w�o bullds or Improves thereon, anO w�o tloes suc� work �hlmselt or herself or t�raugh his or her own employees, prodaetl that such Improvaments ere not Intended or ofleretl for sale. If, however, ihe building or improvement is sold wilhin one year ot completlon, t�e owner-builder vnll have ihe Durden of proving Ihet he or she tlid not Duild or Improve for purpose of sele.). � I, es owner of Ue property, am EXCLUSIVELV CONTRACTING WfT}I LICENSED CONTRACTOHS ro construq the pro�ect (Sec. 7044, Business and Prafesslons Code: The contredars License Lew Ooes not epply to an owner ol property who builds or Improves thereon, end who contreds for suc� pro�ect wlth a coniractor(s) Iicense pursuant to t�tractors LJcense Lews.). veencauon Businew end Professions Cotle for Ihis reason: Date: ❑ No Drivels License No. � F�cOires: I.e. - pmperty lea bill or tleetlj: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I �ereby ceNfy ihet no excavetlon iive (5) or more laet In depih Into which e person is requlretl to tlescenQ will be ma0e in connecUon with work euthoAzetl by t�is pemiN, end Ihet rro bullding structure, scaHOltling, teLaework, or demdltlon or dlsmanlling Nereof, wlll be more then �hiny-aL� (36j leet high. (Chep. 32, Grp 2, Art 2, Sec. 341, T1tle 8, CalitoMe Atlministretive Code). ❑ As ovmer-builtler, I wlll not employ anyone ta tla wark w�ich vroultl reauire e pertnit hom Ne DMsion af IndusMel Sefery, es noted ebove, unless such person hea e pertnit to do sucli work hom the division. Signeture: Date: Dlvision ot Industrial Setety Pertnit Number: CERTIFlCATE OF COMPLI D A ORIZ4TION OF EMFiV: I ceNiy under penalry oi per�ury Ihet I �ave read this epplicaGon end stete thet ihe Inlartnetlon given is conect. I egrae t ompl � i I ws end Gty ordinences ralatlng to builAing coreWctlon, end eu�hodze ropresenletives oi the Ci�y ot Coste Mesa lo enter upon the eDovadexdCed rope nspe tlon ryoses. I egree not to occupy or ellow occupenq of any bulltling aut�odzed by thLs permit unU tinel Ins ectlog , p 5 ' n u e f Legel�Wner(s) Dete1 WOE 1. MSPERpNME � OAiE II�LS 1616 Fixed System Finel Fire Preventlon 1266 Po01 Spe Final 200 Flnal Re-Root 201 Final Block/Retaining Wall 202 Flnel Fectory Fire Plece 203 Flnel Sipn 204 Flnel Demdltlon 2a8-'e f�! INSPEC110NTYPE 206 Finel Mechenical 20B Finel PlumDinp 210 Flnel Electrlcal 212 Finel Flre Preventlon 220 Finel Planning Appravfll 222 � Finel Slte 250 Finel BuilEinp/Occupancy �g _ �S ��$ a / l /J �oonessaea�ow¢ 333 E 19TH ST OWNER9IUYEIFq1U1N: ROTH HANNA °D0"�` 333 � 19TH ST :��5'��S�A,CA 92627574-1899 I�wexrtecron��n: u�cx on e++a.�s �ooxEss: - carrrnAcrarsxua: COHIHICTOR4YIM1dA �OOPESS °�` CZTY OF COSTA MESA - HUILDING PERMIT PERM NO: B 078202 PEAMIT NO: B 078202 PLAN CHECK NO: N GOVT; N SOPP; N CONSTRUCTION TYPE: V-N� PERMIT TYPE: STR PURPOSE: AEP 1GND� JOB DESCRIPTION : REPAIR GARAGE DOOR SQ FT: 200 UNT: CLAIM VALUE: 100.00 CALC-VALUE: 200.00 GROUP OCC; R-3 / IIC.ND: urrt: LICENSED COMHACTOHS DECIAN�TION; I Iwrepy ellvm uMer poealy d perjury tlut I em lieenxd uMer provnions ol Chepler 9 (comma�M xilh Sanion 1000) d Oivi+ian � d IM Bveiren eM Ratma'va COM. eM my lienee n in lull bres uM aMap. cm uc. No.: uc. cuss: uc. No.: EXP : Oma: Cmuearc: OW NEX BUILDEP OECIAflATION: I Metry affum wder pruly d paejvy �hat 1 em axemp han ihe CmVapon lbems lew la tle -'dlown0 rsason (SeUian ]Wt.5 Busiima eM Roleseion� Cada: �M uY a auvuY MUN nVuiim e G�u �o oon�hucl. Ner. imMova. ��mdsn, a rapei eiry evucture. pna m es'v�y�, aho rpima ihe app&an la auch parme �o file e sgmE slelemcn �hn M a sM : �Ken..d w�� o �ne av.i,iom d me cavrecas uoene �aw Icneqer s lwuun«�c .an seaon �000l a o:sion a d �b 8uaiina eM Prdea'uu Codel a thel he a eM u uemq Iherehan end the Wa Ip IM eYepeE uamqan. My videton al5edion ]031.5 by enY aGVlifanl Iw e permil eubjwfa �M ep�Jicenl lo e tivJ penelly d nal mas Ilun live huMred Adlen �$500�). � I.mownerdlheMW�Yam/�^Dqve�wt�rpmutAeinbmm0eromion.iwYdotMw�k.eMtMaWctu�ewnd'weMW w Meree be eela (`�� )�. Budney yM PmleaaiomCode: TM CamreGan Li�aeue law Eom nolryplyta an oxnmd popany who buiEs a mV�� Mimi. mtl Mie do» wN wk 1"vnmll a MnN a Waph Ae a Mr own emWWae�. pwide0 thn wc� impwemmn ma m mteedeE a dtrM tu Wa.1. horwa. Ne buld'vro u inpowmW u wtl wdAn ar Y� W�oM�un. Ne ownarbwka rritl heva �!a dvdm d prov'vq M a Ne Eid ml dald a'unpwe la Ne WN� af xb). �] i... o.�w a �ns wwhv. em a.hulrory mvrenw .vA b..e mweaas m mme�a ns c�dx� Is«aun roa.. animss em Pm/essiau CoCe: The Cmuretlae lipus LaW tloae �w eVdY m en xho builtle a'unpu'iw Ihenon uM Mfio conlrec�a 1« euUi ' e wah e mNrafw(e) IiemaE pun ihe on e lex�. � I en m ion: B. 8 P.C., W e reem� De�e: O�nw: I Eo nereby Net em ewvs d eM iuqe�sWd Yw npu"vemaro d Cel SNny COEe Seaiom R55o5.?55�3. enE 255,1�. mq U� I a mry M�ne Euddinp omq�ma .ri91 W mi leveb me) mnpt� NM1 wtl ame oodu eM tM 1eW'nsmmn br .wmu�«mumw�id,amoaRmiono-anm.�:�y m�wao:erie.a.ra.+'dmnvruain,wc��+.....�a��^ub.. WONKEN'9 CONVEN4�TION DECL�P�TON: I hereby dfirm uider penMy d parjuiy ons d Ns fdbwi�q detludions: � I hew eM xJ meiMen a ceniliute d oawnt io �ell�iuw� la warkae' oompenmbn, m pmiEW ta by 9atlian �]00 d �M Lebor COGe.Ia �M pe�amu�ce d �M xwk fa �� ihis perme u mued. ❑ � n�..�a w�� n�.mw+• oo�owmo� �w�n.... �.a nr s.a� 3�0o d m. �mo� coe.. w iro w�«�o. d in. work la wAitli Ihb pemin u uaued. My wnken' mnpmwqn mmvca wr'rr uM pdiry number ma: c�«: Pdry Number. (T�is ee tian nee0 mt W evnnk�ad 1 rNWmI u M ms huMM EaOen (3iro1 w bn.1 QI mnAy tIW in Na parlamerca d Ne wyk la xfic� �ho pamE b'4vW. I I mi i o eery perrm in enY menner w m �o pecome s I� �o i le vMers' can�erieelion 4w� d Ce6lomia erd epr I• uM becmw wbjera w IM worken' com ul 0� � 1 Sdion 0100 N tM labor GOEe. I Mel' IaNwE� o �Orispns. Dete: MW�: W�mMO� F�Nun ro peu roM�n' conpNn�tlen eovwp� li,nlawtu( xW I �n loy�r ro cMmlrW pm�ltlu �M elvu nrw w ro arr n�neiW MouuM Lo�l�n (s1PqOWA ti�d^n ro m� ol Uon dln+W� u provMW br In 9setlon J106 0l tlr� LiDor Cob, /nf.ruL uM �rtomry%� Na. CONSTRUCl10N LENpNO �GENCY: I lweby Nfi�m ivMx pwiely d pwjry �Aea tMn u e m�q�Wbn 4M'vp epenry lor ihe pa�lamenm W IM xak M xfirA the D�1 e ewed (5wfion �091. C'v. CI. LENDEN'9 NMIE LENDEP'4 AD�PESS: I cenih �� 1 heve ieed thia eppicetian eM qals �M1et iM ebwe'ndamNion e carW.l epiee lo canpy wqh M iny erd couMy wtlinencee erd sime lawe reletip to bwtliq eonmuecn eN hereby aNhoeca npeomia�w d �hu ary b amer upon tM ebwe-mambad popmry �IX IMpBClp1 p{YPY!!. _ A. ROTH _ _ _ ro �,�. Dme: qbl e �OOk'eNMmVeda �SIS1�a6WP) Salety: G�earFb: C+nM'-AVV�4 Rnk-iWanue: 0okemo�Naeaor COMMENTS: REPLACE GARAGE DOOR 1k 1E ik ik 1k iE IE 1F 1f 1E 1k k it iF 1f M iF 1E if M iE if 1f 1f IE IE 1F 1E If 1E 1k ik k 141E 1E iE 1f 1E 1E 1E 1E 71� 1F 1F it �h 1f 1E 1E iF11� iF iF 1F 1F iF if 1f iP if 1k 1E if 1f i! 1F 1F ik i! 1E 1F 1f 1k iE 1k if �E k Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT ZN REAR: FT IN FRNT: FT IN REAA: FT IN LEFT: FT ZN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 11725416 ZNE: REF NO: -, PLANNING NOTES> � ' 1E 1E M iE� if 1E ik 1E 1E 1E 7E 1f 1@ 1k 1E 1E i! 1E 1E IE Ik iE ik 1k if i! iE 1E iF 1! iE iE iE iE 1F 1E IE 1E IE 1t 1E 1E 1f ik if k k iF 1f 1E M if iE iE k 1f 1E if iE it if it iE 1@ k iE iE IF 3f 1E 7E ik iE iE ik i! iE iE if D E V E L O P M E N T S E R V I C E S R E Q U I R E M E NiT S ZONING APPROVED BY IJ �4- DATE: '� BUILDING APPROVED BY : W5 S DATE: ��'/% I� APPLICATION ISSUED BY: DATE: C�'�� 1EM1fiflfiEiElEIEIEIEfEiEMiElfiFiElEiE1k1E7FiF 7F3fiF�F�F�{F�F{F�{F1ElkitikiElEiEltiE1E fEiE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PNT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 21.00 SO SMIP/NON-RES PLAN ISSUE FEE HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL pAID DUE TOTALs----> zi.so o.00 o.00 zi.so zi.so .00 REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 21.�0 .5� if 1F1E 1E 1f iE fE 1E IF I! 1f 1E iF iF M ik M if k 1k 1f if k 1t 1F 1! 1f if 1k IF K iF 1E IE IE ik if if if if if 1f 1F iE 1E 1E 1E 1E 1E 1E 1k iE ik 1E 1E 1E 1E ik k iF 1E 1E 1F ik iE ik it fE 1E 1E 1E ik 1k ff M iE k 1k iE I N D I V I D U A L F E E H R E A K D O W N TYPE. QTY__, D E S C R I P T I O N UNIT COST TOTAL COST SFR 200 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 200.00 END OE FEES f1' UY�.�� _ '� _�• r;, .�. - .- - ' '_ '. � , CONSTRUC710N AND PLANNING :'� P�� . SR�+ APPROVALS Permit# Date Inspector APPROVALS Permit# Da[e Inspector a' 7, 7er�porery Electrical Service or Pole 52. Pool & Equipment Location � 2. So�Pipe-Undrgrnd. 53. Steel Reinforcement . � �.�EIeLRrical Conduit UtilityUndrgrnd. 54. Forms ��i,_�lectrical Conduit�Undrgrnd. 55. Electrical 8onding - ,i�,,..yteet Reinforcement 56. Rough Plumbing & Pressure Test -'•Fi;'Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE �: � � Foo'tings 58. Eleclrical Conduit•Undrgrnd. r.: 8. �oundation 59. Gas Pipe, � Undrgmd., Teu ^ 9. WatEr Pipe�Undrgrnd. � 60. 8ackwash Lines, P�Trap, O Undrgrnd. � 10. 5[rJctural Floor SYstem 61. APPROVAL TO DECK 11. Prd�i,erty Sewer Line & House Connection . . �2. Backwash & Recaptor-Finai ' �2• Sev"e� CaP � 63. Heater & Vent-Final • � 13. Roof Drains 64. Plumbing System • Fina� 14. Fough Plumbing r 65. Electrical-Final 15. Pough Electrical�Conduit 66. Solar SYstem-Final 16. Rough Etearic Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bat Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FI�E ��,PT. gEQUIR�MEN�T r i m- -n . � �^' C f 7' e-i �: �. f3 e?, h � � .^ < �h * 20. FYouq�Fa'cior�Fir��ace � �� PP V '��'Pe��it# �. I.� [T' CC A' � S 4 '`R � r-i F� . 21. Dr�ct9�in Stru�4LreT!f t'.. .. r-� � * O'�?` 70. �Jhderg7o� Hp�ro r 22. [kucc�Ve�d�iia�'`ng Ej,',� � `� Y C ��..;* ,71. Produq*,mj17,��ping L�.`C�s C1�0i1 23. ^s �',:pe��ougb& Test ry K t, ¢ �x +72. Undergr�iitl Fla, sfi�� r F- _ 24. �tlof�#ra�ing" �� c'r" y✓' � „�* ;,7�Undergrrtd.Stora9�T�ink�Gas ❑�V 25. Roof�She3�hing v,�r. � � V K I _ ��Y 74�O�erhead Hydro; * 26. �BafiCeiling (Strule�rall & Nlo�`oat � G " � C a 7�pjy Cher�aical E.,p R~ � 27. �amer.Aanc��Flashingt# p��; .K p� �- c9: 76. Dry Stan�tpe F� *~ • r' -QB. Lathr�ig �id�g �� S� C k� .. ..r� 77.cy FIXED �,'fE{��INAt. H�1 '�29. Insulatior� • �� S • *�� K 78EFIREPREV.FIN�1 *'' '� �T'30. Orywall ling r;a'. � � M F, � I S AF�LTF�EP� ii�QY11R�f/IENT `;31. Plaster 8rewn,Goat�r ; p+;r x � � �t . 7g, FINAL IpSP.ECTIQ.N � ��" - o._ - ^32. ET'PciricalYowe{ Met�t��-+q,al � . � N I' i� '•86mF000 CERTIF�S�TE IS��ED,.., G ' C � - - . t 1 + .�. �33. FMhalr,�,fe`�t�iC> � m .= x � Nates: `[r' -.- ti<; !v34. �nal�lea�+hg ffiAir G'�bndF:ionin'g'- T, .� „ ; � � � 5 �� S Cct i 35. P,��al as Pipe=. est y� pj . x ri � � `s �� Cae �..+ r Ht* a96. Hoo�r Canopy M� �[^'7 � * n + � s' flo t: �:C' - � C'� .%: ('7 � � � }� ^7 x c A' lTl `= I*1 � r! 7 � . - � : • - - ,-37. Ftnal�.actorY FirePlace - � F�. cn x� ' � w �,n+ �-fl8. Final�lumbing � R,�� i �a; .� � � y � t� �. '�39. Water"$ervice�Final x y � � :; Q. i • - • x � � i =.40. Gas Servlce-Fi�l e m �T^ S * M i � �� O--, r„n, � r1 :-� m >. # F-� ' O �. %-41, Solar pomesti�inal� = �� ' �, ` � ' ��= � . _ �, o C * '•' _� . . . � .. ^ - � � 42. 8acktlow Preventer .r N * � � - � �" ' ' -- �R ti >. tTi rr, �N :Y h+ S �F � � � ~ 43. Backflow Irrig,2'��tion ,��. „ .k � * : � v � f • � 44. (,andscaP�Irrig9tion�SYstem dt*,iJ �C �!'"� rJ %+ N n' TC� .r N�' r-. ^� F^ r. `G E N ii :' s S i- �' r.. � w - 45. SQ�+nd Attenua�ion x ,�-., ..r. `� a m ?!� � .r^, � = . _p , 4§. Handicap Reguletionu - .. t~ r x•_ O� s � � I r T. ru' r 4�, FR�IA�STRU�TUR�:& BUILOING G' Z�:.l�fj �' , �� i C r 48. �INAL' PLANNING *. . �^f^ � N t �+* ; N � * �' 49. E�,ectdi¢ Releas�to E�son � • ' ;� �� , ; k � r -^ v �. . Cias Releacato Southern Cali(ornia�GasC4 ` ' `� � • - - ' �' • <�-- l" �c �J 51,. CERT�PiCATE OF OCCUPANCY � ` � � . - " No. Dace ; �5�� COS?A MESA BUILDING-SAFETY DEPARTMENT P. O. 60X 9f7 C08TA M68A. CALIRORNIA Fo� Applieant fo Fill In Compleiely TYPE OR PRINT BUILD�NG�'S� � ADDRESS a COSTA MESA. CALIFORNIA IAD�RESS �,�� TEL. FIRE FEE RECEIVEQ Ff��C13 '� �CC7 3 196 t ANCE DEPT: � ��- APPLICQTIOf�7" FOK' PERM IT BUILDING For Otfice Use Only RECEIPT NO. P$�A^MIT�lIO Ep / �.¢i ` �I � D�V�'��V/ I� oI V �65y$��/ J � �� f�� , COSTA MESA. CALIFORNIA � S�. _� • ZONING IZOy�'�j/ NO. OF ^ Y8E OF N 0 l � I I PLANB `�\ I OUIL�IN6 /` T� O(� �� TEL. I�S(!] U X« L80AL f�� L% "� % NO. OF BLDOB. USE OF El(�g77NG BLDG 96TBACK LINH FflOM DESCRIPTION OF WORK WALL � USE � ROOF COVERII K j'p BE icexrea ur+e er.> APPROVED I H8R6BY ACKNOWL6D08 THAT 1 HAV6 RHAD TH19 APPLIWTION TXE AMOUNT eHOWN UNDER VqLUAT10N IB POR TX6 AND 9TAT6 TXAT BOVH IB CORRHC ANC 8 TO COM- PLY W�TH ALL C INANCE9 • AT P�1RP096 OP 88TABLI8H�N0 A P¢RMIT FEB ONLY. BUitmHo COxB U N. VAl,UAT10N �� SIGNAYURE ,� � �, ,��j � PERMIT FEE $ � ' PERMI'ITE S /6Q � � PV.N CNEGK S • AUTHORIZHD