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Home My WebLink About447 19TH ST - Building Permits(714) 754-5273 • FeX (774) 754-4856 • www.ci.costa-mesa.�pj�LDING PERMIT �� FAIR DFiIVE, GOSTA MESA, (:A 92626 Job Address: 447 E 19TH ST - Status: ISSUED Suite: Applied: 01/Ot/1993 Vicinity: Issued: O1I01/1993 Primary Occ: R-3 Dwellingsl Cong Res <70 Type of Construclion: V-N Parcel Number. 11734131 Zoning: App�icant: ;IOSEPH, DAVID R, BONNIE S Address: 447 E 19TH ST . Phone: ISSUED BY: COSTA MESA, CA � Zip: 92627 . owner: JOSEPH, DAVID R Address JOSEPH, BONNIE S ` COSTA MESA,CA Phone: � 447 E 19TH ST Zip: 92627 contractor. OWNER-BUILDER ' Address: . � Phone: Zip: Arch : Address: Zip: Phone: License: RENEW EXPIRED UNDER RRIP PROGRAM. License: 000000 Eng: Address: SCOPE OF PERMIT Phone: License: CONVERT EXISTING 2 CAR GARAGE TO FAMILY ROOM BATH, LAUNDRY, AND BEDROOM. ENCLOSE BREEZEWAY. FEES DIFFER DUE TO FEE CHANGES. REF: 8060182 FEE SUMMARY ' Plan Check; $361.89 Permit; $556.75 SMIP Res; $4.79 SMIP Com; $0.00 Other; $0.00 Inspection; $0.00 Total; $923.43 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 14- 0 ACCESSORY Front 0-0 PARKING Existina: 0 Rear 14- 0 Rear 0- 0 Left 11-0:. Left 0- 0 �.- . Required: 0 Pr000sed: 0 Calc Valuation: Sa�,as5.00 Claim Valuation: 3a�,aes.00 Right Right 11- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requlrements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) . EXPIRATION: This pertnil shall automa�ically ezpire and become vold if work Is not commenced within 180 dayS, or il work is suspended or ebandoned for a pedod of 180 dgys. INSPECTIONS: In ordar for the work authorized under this permit to be considered legel, such work must comply wilh all applicable codes, and ell requlred inapeetione end flnal epprovel mus� be obtained. Feilure to obtein inspections and final approval will result In ihe expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545626 j� / zaaaae (eroo) � WORKERS'COMPENSATONDECLARATON: � I hereby effirtn under penelry of perjury one ot Ne following tledaratlons: ❑ 1 heve entl will malntein e ceNlicate of consem m sel4�nsure tor xrorkers' compensetlon, as pmWded tor 6y sedion 3700 of ihe Lebor Code, tor Ihe pertortnence of Ihe rk for which this pertni� IS is5uetl. I have arid vAll melntein workers' tompen5ation insurance, as raquire0 Oy sectbn 3700 0l the LaDor Code, for the perfortnance of Ne work fw whitli this pertNt Is issuetl. My workers' compensetlon Insurance cerrier entl policy number are: Cartier: (7A/5 sj Q'}I Certih/ that In Ihe ,/ compensetlon lew comPN wIU Uese naWke�n�9ionawre: � _�- — WARNINO-FAILURE TO SE THOUSPND DOLURE 15/O Policy Number: ie pemJ! is veluetl e hundretl tld/ars ($100) w lessJ Ihe work for whi t pertnit ig luued, I s�all not employ eny pergon in eny menner so as lo become su��ect lo fhe workeB' ntl egree Ihat if IA become suD�ect to the workem' mmpensation provisions ot Section 3700 of t�e Lebor Code, I shail lort�with xr— �oe a. lO —�— o �S_ �EAAOE IS UMAWFUL M!D SMALL SU&IECT AN EMPIOVER i0 CRIMIN�L PENALTIES AND CML FlNES UP TO pJE HUNDRED TOTME COST OF COMPENSATIpJ, pA1.NGE5 AS PROVIDED WR IN SECTION 3]OB OF THE LABOR CODE, INfEREST,lWD ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATON: I hereby eHirtn Ihet I em Iicensed under provislons ol Chapter 9(commenGng with Sectlon 7000) of DlNslon 3 of ihe Business end Profeulons Cade, entl my license Is In tull force end eHecL Lia a Cless k CoNrectofs Signature: Date: CONSTFiUCT10N LENDING AGENCY: ❑ I hereby aMirm thet thera is e construction lending egenty for the pertortnanco ol the work lor which Ihis Dermit is issuetl. (Sec. 3097, Civll Cotle). Lendefs Name: Lendefs Adtlress: Signeture: _ Date: OWNER-BUILDER DECLARATIONS: 1�'� I hereh aHirtn that under �� y penelty ot pe ury tfi t I em E, ,� PT FROM 7ME CONTRACTORS LICENSE LAW tor the Following reason (Sec. 7031.5, 8uslness antl Protessions Coda: Any Gry or wunty ivi(W reqWres e pertnil to consWct, elter, imprwe, demolish, ar repair eny sWCNre, prior to its Issuance, also requires the applicant for such permit ro file e signetl slgtement thel he or sha Is licensed pursuant ta the provisions of the Cantrectors Llcense Lew (Chaptar 9(commencing with Sectlon 7000) ot DMsion 3 oi Ihe Business e�9'P ' ssbns CoCe) or Uat he or she is exempt Iherefrom enA t�e besLs for Ihe ellapetl e:emption. Any violation of Seaian 7031.5 by eny epplicent fa e permit 'sub�ects Ih��pp�t ta a GNI panalry of not rtwre Nan tive hundred ddlars ($500j.): ❑ I, as owner olTtle property, or my emplqees with wagas as their sole compensatlon, WILL DO 7HE WORK, end the strudure is not Iniended or otteretl tor sele (Sec. �� 7 usine9s antl Professions Cotla: The Contractors License Law tloes not epply to en owner of property who buil0.s or improves Uereon, and who tloes such work setl a hersetl or Nmugh hls or her own employaes, proWdeA ihet such improvements ere not intended or oMeretl tor sale. N, however, Iha builtling or improvement is oltl within one year o1 completion, the owner-builder will have the burtlen of proving that he or she tlid not build or improve for purpose of sale.). I, es owner of Ihe properry, em EXCLUSIV Y CONTRACTING WfTH LICENSED CONTRAC70RS to construct the pmject (Sac. 7044, Business antl Pmfassions f Code: The cynt�ectors License Lew does apply ro en owner ot property who bullds ar Impmves thereon, and who contracis for such pro�ect with e contractor(s) Iicense o�`uenllo tne Coniradors Li s Laws.). OWnBf ID VBrI Vedflwtion of c;:Ial Dy(type Business en0 Professlons Code for Ihis reeson: -0 Na properry taz Dill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICA710N: ❑ I hereby certity thet no excavetion frve (5) or more fee� in depih Into whic� e person Is required to descend, will be made In connecllon with work euthorized by ihis permlt, entl Ihet no builtling siructure, scaflolding, falsewwk, or demdition or tlismantling �hereol, will be more ihan t�irty-six (36) teet �igh. (Chep. 3.2, Grp 2, ArI 2, Sec. 3d1, Tltle B, Celllomle Atlministretive Cotla). ❑ As owner-builder, 1 will not employ enyone to do work which wou10 require e permit Irom Ihe Divisian ol Industrial Salery, as noteA eDove, unless suc� parson hes e pertnit to tlo such wark Irom Ihe Olvision. Signalure: Date: Divlsion ol Industrial Sefery Permit Number: CERTIFlCA CO PLIANCE AND AUTHOR¢ATION OF EMRY: I cenity under penelry oi perjury thet I have read this epplication end state t�at the Informatlon given is correct. I ee to w ply wilh all stete la entl dry ordinances relating to bullding constructlon, and authorize representatives of the Ciry ol Coste Mesa to enter upon the above�d cdbed Dro erry tor Inspectlon,p�poses. I agree not to occupy or ellow occupancy ol eny building authorized by ihis permit until Onel Inspoctlon. INSVECTON TYYE Fixed System Finel Fire Preven�on 1288 ' Paol Spe Finel 200 Finel Re-Rool 207 Flnal BIocWRetaining Well 202 Flnel Fectory Fire Place 203 Finel Sipn 204 Finel Domolilion Qdg � yjQf,,,( INSPECl10NTVPE 208 Final Mechanlcal 200 210 212 220 Final Plumbing Flnel Elecincal Final Fire Prevention Final Planning Approval 222 Final Site 250 Final BuilCing/Occupanq � � .mi" ' (714) �54-5273 • Fex (714) 754-4856 • www.ci.costa•mesa.��,SCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job nddress: 447 E 19TH ST Suite Np Vicinity: Parcel Nunmber: Applicant: Addresg: Owner: Address Contractor. Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 uni1S) New Res (3+units) Pool I Spa Lighting FiMs Recept Outlels Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1hp Motors to tOhp Motors to SOhp Motors to 100hp MotorS over 100hp Communiwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 11734131 REYNOLDS,GRANT 10681 CORT AV STANTON,CA JOSEPH, DAVID R 447 E 19TH ST COSTA MESA, CA OWNER-BUILDER Phone: 714-821-5169 - Zip 90680 Phone: Zip: 92627 Phone: Zip: License:000000 RENEW EXPIRED UNDER RRIP PROGRF REF:E060349 AND B93-00002(B060182) 12 LIGHT FIXTURES, 20 OUTLETS, 8 SWITCHES, 1 SERVICE TO 200A S�atus: ISSUED Applied: 10N32005 Issued: 10l03l2005 ISSUED BY: O r�- ,t."� � CONVERT EXISTING 2 CAR GARAGE TO FAMILY ROOM BATH, LAUNDRY, AND BEDROOM. ENCLOSE BREEZEWAY. FEES DIFFER DUE TO FEE SCHEDULE CHANGES. $23.50 50.00 $0.00 $0.00 50.00 50.00 $13.20 $22.00 58.80 50.00 50.00 530.50 50.00 $0.00 $0.00 50.00 $0.00 50.00 50.00 $0.00 30.00 SO.00 $0.00 $0.00 50.00 Quantity 0 0 0 12 20 8 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System I Lighting Busway /100 ft Standing Section Misc Eleclrical Equipment Transfortners up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System I Ckt Misc. Conduit Misa Conductor � Cirws ( gen or ride) � - Circus (mech ride or lights) Chnstmas Tree Stand � Fireworks Stand � Other ElecUical Fee Investigation Fee , Plan Check Fee - Reinspection Fee $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50:00 $0.00 $0.00 $0.00 $0.00 $0.00 E0.00 $0.00 TOTAL CALCULATED FEES 598.00 �uantity 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulatlons. (Ord. No. 9248, § t, t2-27-s2) EXPIRATION: This parmlt shall automatically expire and become void if wark is not commenced within 180 days, or It work Is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considared legal, such work must comply with all epplicable codes, and all requlred Inepectl0na end final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiratlon of this permlt. / fOR INSPECTIONS CALL: (714) 7545626 / �� zaasas �aroo� WORKERS'COMPENSAnON DECLARAnON: I hereby eHirm under penalry of per�ury one ot the following dedarations: � . ❑ I have en0 wlll malntein a cenNicate of consent Io sel4lnsure br workers' compensatlon, es proWtled for by section 3700 of the Lebor CoCe, br the peAortnance ot Ihe �/ work 1or whlch ihis pertnll is issuetl. !9� I have end wlll melntaln workers' compensatbn insurance, as requlred by sectlon 3700 of Ihe Lebor Code, for the peAortnence ol the work for which Nis pertni� Is iswed. �lAy warkera' wmpensatlon Insurence cartiar anU policy number ere: Certier. neetl no( [ �halinthe ��fc�'��:�d Policy Number: ipleteC /f the pemtif !s velu a( one hundred tlW/ars ($100) or less.) ance of the work for ich Ihis pertnit Is i eQ I shell not employ any person in eny manner so as to become subJecl lo tha workers' fomie, end agree t f 1 shoultl Eecome �ect m t�e workers' compensatlon pmNsions oi SecOon 3700 ot t�e Lebor Cotle, I shall tort�with 0l19. — — oe�a:, �L� — 3— o� ERS' COMPENSATION WVEMGE IS UMAWFUL AND SNALL SUBJECT AN EM �PL�OYER TO CRIMINAL PENPLTES AND CML FlNES UP TO ONE MUNDRED IN ADDRION TO THE C06T OF COMPENSATION, DAAUGES AS PROVIDED FOR IN SECiION 31080F THE LABOR CODE, INTEREST. AND ATiORNEY u FEES. LICENSED CON7RACTORS DECLARATION: , I hereby efllrtn that I em licensed under provisions oi C�apter 9(commencinp wlth Secilon 7000) ot DlNsion 3 oi Ihe Buslness and Pmfessbns Cotle, end my Iicense is In full force anE ettect. Llc. M Class a ComrectoYs Slgnawre: Dete: CONSTRUCTION LENDING AGENCV: ❑ I herehy eXlrm thet ihere is e construction lending egency lor ihe peAormence ol the work tor whlch Ihis permit is issuetl. (Sec. 3097, Clvll Codej. Lentlefs Neme: Lentler's Atltlress: Slgnature: Dete: OWNER•BUILDER DECLARATIONS: I hereby eHirm that untler penalry at perjury t�at I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Prafessions Code: Any clry or counry which requires a pertnit to constn�ct, alter, improve, tlemolish, or repair any structure, prior to its issuance, elso requires the ep011cant for such pertnit lo file e signed statement thet he or sha is licensed pursq� ta Iha proNsions of Ne Contrectors License Lew (Chapter 9(commendng with Sectlon 7000) at D'Msion 3 of Ihe Business end Professlons Code) or ihat �e or she is oiept therefrom entl the besls for the elleped eaemption. Any violation o1 Sectlon 7031.5 by eny epplicant tor a permit �uD�ects Ihe eDD��e�� o a civil penelty of not more tli��ALndrad ddlers (5500�.): 3 I❑ I, es owner th�property. or rtiy,employees wii}�wages es their sole compensatlon, WILL DO TNE WORK, and �he structure Is not intendetl or oNered tor sale (Sec. 1 7044, ineu end P�afessions CoQ�The Cantractors License Lew does not epply to en owner of properry who builds or Impmves thereon, entl w�o dces such wodc hl 1 or �ersell oi through ILLs Or her own employees, proviOed ihflt such imprwemenis are no� Intended ar oMeretl tor sale. If, however, Ue building ar Impmvement is d wit�in`one year4l completion, the owner-builder wili heva the burden oi proving that ha or she did not build or improve for purpose of sale.). I, es owner e roperry, am EXCjN SIVELV COHTRACTING WITH LICENSED CONTRACTORS to construq the D�oject (Sec. 7044, Business and Professions � Code: contrac rs License LevJdoes not appty to an owner of praperty who bulids or Improves thereon, antl w�o contracts tor such prqect wiN a coniwctor(s) licen pursuent ihqConiraclql� ucense Laws.). Business en0 Professions Cotle lor this reason: Owner ID d by dAvefs license. � rg< RNo vedticetlon Ownersnip by (type oi tlocument, i.e. � property tau blll or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON: ❑ I �ereby ceriify t�at no excavetion five (5) or more feet in Oept� Into which e person Is required to descend, will be mede in connection wit� work euthorizeC by this pertnil, entl that no bulltling strudure, scallolding, lalsework, or demolitlon or Alsmantling thereof, will be more than thlrty-siz (36) teet �ig�. (Chap. 3.2, Grp 2, Art 2, Sec. 341, 77t1a B, Celifomia AtlminlstraMe Cotle). ❑ As ownervbullder, I wlll not employ enyone to do work which would requlre e permit tmm the Divislon of Indusirial Sefery, as noted ebove, unless such person �as e permil Io do such work Irwn the division. Signature: Dete: DlNslon of Intlusidal Sefery Pertnit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 7 WIII Ihe epplicant or present or fuWre building ocwpent neetl to tile entl certlly e Business Plan for emergency response to release or threeteneE release ot e hazartlous matedal7 ❑ Yes ❑ No (Section 25505 oi the Celifomia Mealth end Salery Gotle reQuires, wlih some ezceD�lons, Ihe� e Business Plen be filed with Ihe Coste Mesa Fire Depanment by every Dusiness which has et eny one tlme Cunng a repotletl year e quantlry of hezarOous matedals equel to or greater than a weight o1500 pountls, or e volume of 55 gallons, or 20o cubic leet ot compressetl gas at standard tempereture and pressure). ......__ ......................'_""...__...'_'._"_'_""""_" '..._'_...—_......."_..........._._.............................................._.............._..___"'—___ 2 Does or wlll ��e eDPlicant or presenl ar tulure building occu0ent nead to lile e regislration tortn tor ecutely hazardous materials7 ❑ Ves ❑ No (Sectlon 25533 of t�e Califomia Health end Sefery Code, with soma exceptlons, requires registratlon with Ihe Coste Mese Fire Depanment by each Duslness which et eny one time hes on hand a quantiry of ecutety hazardous materieLv equal to or greater then e weight of 500 pounds, or a volume ol 55 gellons, or 200 cubic feet ot compressed ges el stendard temDereture anC preuure). or 25534 oi the Califomia Health ent of en RMPP by businesses en prepare an afery CoUa provides that Ihe Costa Mesa Fire Department may r ere required to register eately hezerdous metenels with the Fire . '._..__.._ ................'__..................._......................... 25534 of tha Calitornie Heellh antl SefeN Cotle been tully comD�i� 5 uoes or wln Ine eppucern or present or mmre ounamg occupem reqmre ror Ine wonc wmcn is Ine suo�ea ot tnis a� fmm the South Coest Air �ualiry Management Distdct or tmm eny other elr pollutlon contml Alstdct or egencyt � (Seciion 658502 of Ne Califomia Govemment Code requires Ihat the raquested infortnation be lumished on applica .........................._..................._.__._............—_—__....—.......................__....................."_...................._............................................ 6 W ill eny part ol ihe fadlity ro ba consiructed under this pertnit be within 1000 feet fmm the outer bountlanes ot a sch� Qf'yes", I�e fadliry must meet the requirement of Sectlons 25534 end 42303 0l Na Celifomia Healih end Safety Ca ......__ ..............__._.._. "' '..—_............._..'_'_' 7 II e permit irom the South Coest Air Qualiry Management Distnc� or other eir pollution conirol tlistrict or egency eoolicatlon. �ave all of the disdosures orescnbetl bv Califomia Health end SafeN Code Seclion 42303 been maAe? certllication end filing with Iha Fire Ves LJ No ........ __..._..... f armll �or suth � ND nomresiAential G NO o! B QI'yes', etteth CBNflCete ot COmpliance trom tne epplopnate elr polWtbn Conird anlCBr). CERTIFICA7E OF COMPLIANCE: I certily Nat under penalry of perjury the Intortnetion given above is conect. I egree to compry with ell state laws and dry ordinances regertling Hazerdou5 Materials antl Emiuions. Signature: Date: CERTIFICA COMPLI CE AND AUTMORQATION OF EMRY: I certify un0er penelty of perjury Ihet I have reeG Ihis epplicelion end state that Ihe infortnalion given is correct. I ee to comply 'th all state laws d ciry ortlinances relatinp to bullding constructlon, end authorize representatives ot the Giry o1 Coste Mesa to enter upon tha ebove- scnbed prope or inspection pu es. I agree noI to acupy or ellow occupancy oi eny building emhonzed by Ihis pertnit until finel inspec6on. CODE �. IN57ECTIONTYYE 1816 Fiaed System Finel Fire Preventlon 1268 Pool Spe Finel 200 Finel Re�Root 207 Finel BIxWReteiNng Well 202 Finel Fectory Fire Place 203 Finel SIBn 204 Finel Demolition Q�jF, ��j �j INSPECTIONTYVE 206 Final Mechanlcal 20B 210 212 220 222 250 Finel Plumbing Final EletinCel Finel Fire Preventlon Final Planning Approvel Final Site Final Building/Occupency � S'�J �oe�a �. veg u�e�,s -0 6 7v� ��ia� �sa-svs • Fex (714) 754-4856 • www.ci.cosia-mesa.��s MBING PERMIT Job Address: 447 E 19TH ST Suite No Vicinity: Parcel Nunmber: 11734131 Applicant: REYNOLDS, GRANT Address: 10681 CORTAV STANTON,CA - Owner: JOSEPH, DAVID R Address 447 E 19TH ST � COSTA MESA, CA - Contreaor. OW NER-BUILDER Address: Phone: 714-827-5169 Zip: 90680' Phone: Zip: 92627 Phone: Zip: License: 000000 SCOPE OF PERMIT RENEW EXPIRED UNDER RRIP PROGRAM. REF: P060351 AND 893-00002 (8060182) / i rnin univ�, i.uo i n mwn. �.n acvcv Status: ISSUED Applied: 10I03/2005 Issued: 10I032005 ISSUED BY: R R , A 1 DISHWASHER, 7 WATER HEATER/VENT, 1 SEWER CONNECT, 1 WATER PIPING CONVERT EXISTING 2 CAR GARAGE TO FAMILY ROOM BATH, LAUNDRY, AND BEDROOM. ENCLOSE BREEZEWAY. FEES DIFFER DUE TO FEE SCHEDUIE CHANGES. AMT ( ISSUE FEE $23.50 Backflow irrigation � $0.00 i Back(low Preventer $0.00 i Bathtub $0.00 i Clarifier System $0.00 i Connect (Ice,Soda,etc) $0.00 i Dental Units $0.00 i Dishwasher $9.80 � Drain, Floor $0.00 i Drain, Rainwater $0.00 I Drain, Roof $0.00 i Drinking Fountain 30.00 I Expansion Tank 50.00 I Gas Earthquake Valve 50.00 I Gas (1-4 outlets) 50.00 I Gas (Over 4 outlets) 50.00 I Gas Repipe $0.00 I Gas Service $0.00 I Interceptors (Grease, Oip $0.00 1 Interceptors (Sand Auto ) $0.00 - 1 FEE SUMMARY iTY AMT � AMT � Laundry Tub I Washer $0.00 0 Sump Pump $0.00 0 i Landscape Irrigation $0.00 0 Swimming Pool - $0.00 0 I P•Trap $0.00 0 Trap Primer 50.00 0 I Pressure Regulator .$0.00 0 Urinal $0.00 0 I Process Piping (per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) 50.00 0 � Receptors $0.00 0 Vacuum Brkr Bkflow(5+) E0.00 0 i SepticTank $0.00 0 WashBasin $0.00 0 Sewer Cap tor Demo 50.00 0 Wash Basin Set $0.00 0 � Sewer Connect $24.65 1 Waste and Vent System 50.00 0 i Sewer Private Line $0.00 0 � Water Closet (Toilet) 50.00 0 i Shower 50.00 0 Water Heater I vent 512.30 1 i Sink, bar $0.00 0 Waler Piping (Inst or Rep.) $9.80 1 i Sink, commercial $0.00 0' Water Re-pipe 50.00 0 � i Sink, Floor 50.00 0 Water Service 50.00 0 i Sink,kitchen $0.00 0 WaterSORener $0.00 0 i Sink, service/mop �$0.00 0 OTHER $0.00 � Spa (private) $0.00 0 VIOLATION $0.00 � Spa (public) -. $0.00 0,. , , PLAN CHECK $0.00 � � �� REINSPECTION $0.00 0 COMMENTS / SPECIAL CONDITIONS � �TOTAL CALCULATED FEES: 580.05 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92•28, § 7, 1241-92) E%PIRATION: This permit shall automatically expire and become void il work Is not commencad wlthin 180 days, or il work is suspended or abandoned for e period of 180 days. INSPEC710NS: In order tor the work aulhorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectione and finel approval must be obtained. Fallure to obtain inspections and final approval will result In the expiratlon of this permlt. POR INSPECTIONS CALL: (714) 7545626 zs+s-ae �eroo) WORKE 'COMPENSAnON DECLARATON: 1 hereb emrtn under penalry of perjury one of tha tWlowing tledarations: � ❑ have end wili maintein e cenificate of consent to selldnsure tor xrorkers' campensetlon, es pmNded tor by section 3700 0l Ihe Lebor CaCe, br the paAortnence of the work lor which Nis pertnit is Issuetl. I have end will melntain workers' compensation Insurence, es required by sectlon 3700 of Ne LaOor Code, lor ihe peAortnance ot Ihe work tor whkh this pertnit Lq Issued, My woAcers' compensation Insurence cartier and policy number ere: Certier: need not M � Policy Numher: or less.) thet in Ihe perfo e of Iha work lor w ch this pertnit is issueQ I shell not employ eny persan in eny menner so es ta �ecome su��ect to Ihe workers' isetion laws o eltla lla, end agree th I should become sub�eG to Ihe xrorkera' compenseilon provislons of Sectlon 3700 ot the Lebor Cotle, 1 shall forthwlih wttn Inese ovis4 s. �amre:_ roere: �U-3-OS— .URE TO S RE PENSATION MBH6 UNUW Rll. Bi�LL SUBIEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CM� FlNES UP TO ONE HUNDRED M1ME (51 , TO THE OOST OF COMPENSATION, DAAt4GE5 �lS PRO�IDED FOR IN SECTION 3/060F THE UBOR COOE.INfEREST, AND ATTORNEVS FEES. LICENSED CONTRACTORS DECLARATON: I hereby ettirtn thet 1 em Iicensetl under proNSlons ot Cnapter 9(cammendng with Sectlon 7000) of DlNsion 3 0l Ihe Buslness and Prafesslons Code, end my license is In tull force antl ettect. Lic. a Class A Contrectofs Signeture: Daie: CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirtn Ihat there Is a construction Iendinp epency tor the peAortnance of the woAc lor which this pertnit Is iuuetl. (Sec. 3097, Civil Codej. Lantleta Neme: Lentlefs Adtlress: SigneWre: Dete: OWNEH•BUILDER DECLARATIONS: I hereby eHirm thet under penalry ot perjury Ihat I em EXEMPT FROM TME CONTRACTORS LICENSE LAW far the following reason (Sec. 7031.5, 8usiness anC Professirns Code: Any ciry Or wunry whic� requires a permit to consiruct, alter, improve, tlemolish, or repeir any structure, pnor to Its iuuance, elso requires Ihe flpplicant for such permit to fila e slgned stetement thai he or;he Is Iiceriaed purb.uant ta Ihe pmWsions ol ihe Comracbrs Llcense Lew (Chepter 9(commencing with Section 7000) oi Division 3 of Ihe Business end Prolessions Code)�.or Ihet he oi�6F�e mpt tharefrom entl Ihe besis for Ihe ellepetl exemption. Any violetlon of Sedlan 7031.5 by any applicant tor e pertnil sub�ects Iha epPlicant ta a civil'pena tyof not me�e hundred dollars ($500).): tnJa I es awner at� e m �� m I wa es as their sole m n ❑ ,,(h p pertyr0 p oy t� g w pe satlon, WILL DO 7HE WORK, antl t�e structure is not Intended or offered for sale (Sec. I� j� ., Busin nd Profe ��Oa: The Coniractors License Law tloes not apply to an owner ot properry who builds or improves Ihereon, and who does such work y elt or he or ihro fs or her own employees, provided ihat such Improvements ere not Intanded or otteretl �or sele. II, howaver, Ihe building or improvement is r� �,W'jihin on �- r of completion, fhe owner-builder will have the burtlen ot pmving Ihat he or she did not 6uild or improve tor purpose ol sale.). �as�ner e roperty, am EXC}�1SIVELV CON7RACTING WITF1 LICENSED CONTRACTORS to construct Ihe project (Sec. 70a4, Business and Professions CodS."Th ntra tors License Ley/does nat epply to en owner ot pmperry who builtls or Improves Ihareon, antl who wntracts lar such prqect with a contractor(s) IlcenSe r5uan o the COnired0� Ucense Lews.). ❑ I em�xemptyf(tler sec. dr'rvefs licensa. ❑ Yes � No 8usiness and Ownership by (rype ot document, i.e. - properry tav bill or Ceetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATON: Dat�� —OS ��, ,.T-/9—o5T ❑ I hereby certity �het no excavetion tive (5) or more �eet in depih Into which e parson is reQulretl to tlescend, will be matle in connection with work euthodzetl by Nis pertnit, end thet no building structure, scaffoldinp, falsework, or tlemolitlon or dismantling thereoi, wlll be more Ihen Ihirty-sl: (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tltle 8, Celitornla Administretive Cotle). ❑ As owner•builder, I will not employ enyone lo do work which would requlre e permit Irom the Dlvlsion ot Industnal Safely, es notad above, unless such person hes e permit to tlo such work trom the division, Signeture: Daie: Dlvision ot Intlustrial Safery Pertnit Number: I CERTIFlCATE MPLIANCE AND AUTHOR¢/1TION OF EMRV: 1 cenity under penalry ot per�ury that I have read this epplicalion antl stete t�et the infortnation gHen is I � cortect. I a to co ply'+dt� all state laws antl dry o��arcas relatlng to bulltlirvp construabn, and euihodze representaUves ot the Ciry ot CosW Mesa to enter upon Ne I ebove-d cnbed prop M for inspectlon py�poses• I egrae not to occupy or allow occupenty ot eny building authorizetl by this permit uniil Mal inspection. yQpf,,,�( INSPECTIONTYGE 1816 Fixed System Final Fire Prevention 1288 Pool Spe Flnal 200 Final Re-Root 201 Finel BIocWRetaining well 202 Final Fectory Fira Place 203 Finel Sign 204 Finel Demolition ueie u�s � COOE 1 INSPECTION TYPE 206 Finel Mechanical 20B Finel Plumbing 210 Finel Electrlwl 212 Finel Fire Preventlon 220 Finel Plenning Approvel 222 Flnel Site 250 Final Building/Occupanty Date � 3 ��,5- —Uaie.v,,� � 1�� ia� �sa-52�s • Fa,c (�ia� �sa-aess • www.ci.cos�a-mesa.ca.us 77 FAIR DRIVE, GUSIA MESA, GA 92626 Job Address: 447 E 19TH ST Suite No Vicinity: Parcel Number: 11734131 App�icam: REYNOLDS, GRANT Address: 1Q681 CORTAV S7ANTON.CA Owner: JOSEPH, DAVID R Address: 447 E 19TH ST COSTA MESA, CA Cantractor: OWNER-BUILDER Address: MECHANICAL PERMIT Phone: 714-821-5169 Zip: 90680 Phone: Zip: 92627 Phone: Zip: License: 000000 SCOPE OF PERMIT RENEW EXPIRED UNDER RRIP PROGRAM. REF: M060350 AND 893-00002 (8060182) 1 INST FAU < t00K BTU, 1 GAS PIPING (1-4 OUTLETS) Slalus: ISSUED Applied: t0103I2005 Issued: 10/032005 ISSUED BY: CONVERT EXISTING 2 CAR GARAGE TO FAMILY ROOM BATH, LAUNDRY, AND BEDROOM. ENCLOSE BREEZEWAY. FEES DIFFER DUE TO FEE SCHEDULE CHANGES. ISSUE FEE Inst FAU <100 k BTU Insl FAU >100 k BTU RepairlAlt CoolingMeat Insl / Rep. Recess Wall Hh Refrig Sys <100 k BTU Refrig Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan I Single Duct ApplianCe Fire Dampers Smoke Dampers Inst or Relocate App� Ven� Air Handlers < 10000dm AirHandlers> 10000cfm Floor Furnace Floor or Suspend Heater 523.50 $14.80 $0.00 ao.00 50.00 50.00 50.00 $6.15 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 so.00 50.00 $0.00 $0.00 $0.00 Duantiry FEE SUMMARY Repair / Alt Absorbtion Unit Repair I Alt Refrigeration Unit Ventillation System Evaporetive Cooler Commercia l I ncine rator Domestic Incinerator Comoressors I Absorption Svstems Uplo3hp/100kBTU 3To15hpI500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp I Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15to30hp 30 l0 50 hp � - " Over 501ip Olher Mechanical Fee . - Investigation Fee� . Plan Check Fee Reinspedion Fee Quantiry $0.00 0 $0.00 0 $D.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 so.00 0 so.00 0 50.00 0 50.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 " TOTAL CALCULATED FEES E44.45 NOTICE: The work authorized by ihis permit shall comply wlth all applicable handicap access requirements under Califomia statutes and related regulations. (OM. No. 92•28, § 1, 72•21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihia permit to be cansitlered legal, such work must comply with all applicable codes, and all required inepeetlone enq final epprovel must De obtained. Failure �o obtain inspections and tinal approval will result in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 754-5626 24t&/B �&W) WORKERS' COMPENSATION DECLARATION: , � I hereby eflirtn under penalry ot perjury one oi Ue 1ollowing declaretlons: - ❑ I have entl will mafmain e ceNficate ot consem ro setl-Insure lar workers' compensation, es proNded lar hy section 3700 ot Ihe Labor Cotle, br the pertormence ot the �work ior which Ihis permit is issuad. I have and vAll malntein workers' compensation Insurence, as requireA Dy section 3700 oi Ne Lebor Code, for Ihe peAortnance oi Iha woAc for whidi lhls peimit 45 issued. �� My workera' compensation Insurance carder end policy number ere: Cerder Pollcy Number: (Th/ ecf/on need nat be comp ' the pertnit Is valuetl f one hundretl dollars ($100) or less.) � 3 I certity Ihet in ihe pe rmance f ihe work tor whl his permit is Issued, I shall not employ eny person in any menner so as to become sub�ecl lo tha workers' wmpensetlon laws Celtlomi , entl agree Ihet I oulC became sub�ect to the workers' compensatlon provlsions ol Sectlon 3700 ot Ihe Lebor Cotle, I shell tort�with comDhw�t�t�ese rovisi Appll�ant' . Bn5 ei ture . _ rDate'' f O•- 3— a�- WARNINCi:'FAILURE TO SEdI OFiKERS' E IS UNL4WFUL rWD SHALL SUBJEGf AN EMP�pYER TO CRIMINAL PENALTIES AND dVIL FlNES UP TO ONE HUNDRED Ti10USM10 OOIURE (5100, , IN ADD CO6T OF CpAPEN54T10N, DMl4GE5 AS FROVIDED FOR IN SEGTIXJ 3%OB OF THE UBOR COOE. INiEREST, AND �TTORNEVS FEES. LICENSED CONTRAC70RS DECLARATION: I hereby attirm that I em Ilcensetl under provlslons o} Chepter 9(Commendng wit� Sectlon 7000) of DMsion 3 0l ihe Business and Professions Code, end my Iirsnse Is in full IOrCB Bntl BRBCL LIC. M CI95S q ContreCtofs Slgneture: Daie: CONSTRUCTION LENOING AGENCY: ❑ I hareby aMirm thet there is a constructlon lentling egency tor the pertormance of the work for wNch tNs permit is Issuetl. (Sec. 3097. Civil CaAe). � Lentlefs Name: Lentler's Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eftirtn Ihet under penelry of perjury thet I am,EJ(EMPT FROM THE CONTAACTORS LICENSE LAW for the lollowing reason (Sec. 7031.5, Business end Prolessions Cotle: Any Gry or counry wNch reqmres e permil'fo' construct, elter, improve, demolish, or repair any sW cture, pdor to its issuance, also requires the eppliwN tor such pertnit to file e slpnetl statement that he or she is Iicensed pui4uant ro the provlsbns of Ue Contractors License Lew (C�apter 9(commendng with SecUon 7000) of DNWon 3 of Ne Business entl Professions Cotle) or,(fiat he or she is enampt therefran arM ihe hasis for the alleped eaemptlon. Any videtion of Sectlon 7031.5 by any epp�icant tor a permil sub�ects the epplitanl to a cMl Qansiry of not more tharvfrve hundred dollars (5500).): •� Lxr�.., . �❑ I, e9,ov+ner e propertq tl� myemployees wlth weges es Iheir sole compensaGon, WILL DO THE WORK, entl the siructure is not intended or oHered tor sale (Sec. ��7044; ness end Profdssfons'Code: The Contractors License Lew tloes not appty to en owner of properry who builds or improves iheraon, end who does such work ��1.4TI`�� _ f or harselflor Ihrough his or har own employees, provitletl that such impmvements are nol intentletl or oflered tor sale. If, however, the builtling or Imprwement Is r ld4within one year o1 completion, the awner�builder will have Ihe burtlen of proving ihat ha or she ditl not build or improve for purpose at sale.). �I, es owner ot Ihe roDerry, am E7(CLUSIVE Y CONTRACTING WIT}1 IICENSED CONTRACTOiiS to construct tha project (Sec. 7044, Business and Prolessions Cotle: The c re ors License Law tloes n eppty to an owner ol propeny who builds or impraves �hereon, and who contracts for such project with a contraqor(s) license pu uent t the Comrectors Licens ws.). D�I.am�e pi u er sea Business end Professions Cade for this reason: Sig�ure:`'` ----.- �oz�e: t — o�— Owner ID venile drivar's licensa. ❑ Ves DAver'sllcense No. � Expires: — .�--�— � Vedflcetion ot Ownership by (rype ot Gocument, I. .- properry tea blll or deed): _ DIVISION OF INDUS7RIAL SAFE7Y PERMR CER7IFICATION: ❑ I hereby certity Ihat no exwvation frve (5) or more teet In Aept� into which a person is required to descend, wlll De matle in connection wit� work euthodzetl by this pertnit, entl t�et no building struclure, scaHoltling, talsev+ork, or tlemolition or dismantling thereot, will be more ihan t�irty-si: (36) feet hiph. (Chap. 32. Grp 2, Art 2, Sec. 341, T1tle 8, Califomla Atlministretive Cotle). ❑ As owner-builder, 1 will not employ enyone to tlo work which would require a permit trom ihe Divislan ol Industriel Selery, as notetl eDove, unless such perswi hes e pertnit to do such work Irom Ihe diWsion. Signeture: Oata: DiNslon of Industdal Safery Permit Number. ARDOUS MATERIALS AND EMISSIONS CERTFICATION: WIII Ihe epplicent or present ar future 6ullding occupent need to tile end certity a Businass Plan for emergency rasponse to release or threatened relaese of e �ezerdous meterial9 ❑ Ves ❑ No (Sectlon 25505 of Ihe Calitomia Heallh end Satety Code reQuiras, with some exceptions, Ihel e Business Plen De fileG with the Caste Mesa Fire Deperiment Dy every Dusiness which has et any one time tluring e reporietl year e quaniiry ol harartlous metorials equal to or greater Ihen a weight of 500 pountls, or e volume ol 55 gallons, or 200 Cubic feet of compressetl gas at standard tempereture and preuure). ..............................................._..............""__"'..._"..............."'_'........................__.........__..................._.................................................................... .......... _........"'_'._............_ Daes ar will the applicani or present or �u�ure building octupenl neetl lo lile e registra�lon fortn tor ecutely hazerdous me�eriel57 ❑ Yes � No (Sectlan 25533 of ihe Celifomia Health antl Selery Cade, with some exceptlans, requires reglsiretlon wlih I�e Gaste Mese Fire Depanment by eech Eusiness which at any one time hes on hend e quantlry ot acutey hazartlous meterials equel to or greeter than e weip�t of 500 pounds, or e volume oi 55 gellons, or 200 cu�ic leet of wmoressed ues et slandard temoereture enC Dreuure). or Wlll ine appflWnt or 25534 0l the Calitomia Health ent oi an RMPP by businesses II en RMPP i5 presentty required, has Section 25534 ........................................_...._......_.....__..._..._................_..._._ Does or will Ihe epplicant or present or tuWre bulltlir prepare an that the Costa Mesa Fire Department may require the preDaration, certifiwtlon end Iiling with the fire ter acutey hazerdaus matedals with the Fire DepartmeN. ..._._._._......�_.........� ...............................................__..__................_.................._._._.."_ _— le Healt� antl Safety Code heen fully complied with? ❑ Yes ❑ No ...__.........._.._ .............�_............................................._..__........_............_..._..."'_'..............._._..............._._ quire for the work whlch is the subJect of this �plicetion a ermit lar such conSWction or modificetlon fmm Ihe South Coest Air Oueliry Menagement Dls�dcl or trom any other eir pollution control tlislnct or egency7 LI (Section BSB50.2 ot ihe Galifomie Government Gode requires thet Ihe requested informellon be tumishetl on applice�� ....................................................._..................................................................._......................................................................................................................................, 6 WIII eny part ot ihe faciiiry ta be consiructed under t�is permit be wit�in 7000 feet trom tha amer baundades af a scN (It "yes", the tauliry must meet the requirement ol Sections 25534 antl 42303 of the California Heal�h antl Safoty Cotl ........................................................................................................................_.__..................................................................................................................................... 7 II e pertnit from ihe Sout� Coast Air OualitY Menaqement Distdct or other air polWtion crontrol distnct or egency eoolicatlon. have ell of the tlisclasures oreunbed W Califomia Health and SafeN Cotle Sectian 42303 been matle9 Qt ye5". atlach certifi CERTIFICATE OF C regarding Ha�rtlous Slgneiure: wrrect. I e<y4e to u No lor nomresidential No I certity that under penelry of perjury the information given ebove Is wrtect. I agree to comply with all stete laws antl ciry oMinences Emissions. Deta: :E AND AllIHOR¢AT10N OF EMAY: I certiy under penalry of perjury thet I heva read thls epD��on and state that Ihe inlormatirn gNen is all slate laws and ortlinences relating lo bulltling constructlon, end euthorize rapresenia�lves of Ihe Clry of Cosla Mese to enter upon the ;pection purposeg�gree not to occupy or ellow occupancy ot any building euthonzetl by this pertnit until final inspeMion. COOE �• 1818 Fivotl System Finel Fire Preventlon 1288 Pool Spe Flnel 200 Flnal Re-Rool 201 FIneI Blak/Retaining Well 202 Flnal Fectory Fire Place 203 Final Slgn 204 Final Demdition �g COpE1 INSPECTIONTYVE 208 Flnel Mechenical 208 Final Plumbing 270 Final Electdcal 212 Final Flre Preventlon 220 Final Plenninp Approval 222 Final Site 250 Final Bullding/Occupency Date li� . �-os- �-/�� 6 •�•-- �I I � � 7NQIECT FDDFESS: 4 4% E 1 9 TH ST uxiT: OWNEfl'SNAME: JOSEPH„ DA.V3D R a�ness: JOSEPH BONNIE S �,-' 447 E �OTH ST COSTA MESA,CA 92627 AflCN/ENGINEEN: HAROLI� C�.$$ flEG.NO.: S98t� AODPESS: P O HOX 1 3 0 6 5 2 uxir: BIG BEAR LAKE CA 92315 PEXMIREE: DAVZD 6 HONNIE JOSEPH ( 714 ) 646-1706 aooxess: q Q 7 E 19TH ST COSTA MESA CA 92627 LICENSEO CONTBACTOB UECIANATION: I hereby affirm �hat I am licensed under provisions ol Chap�e� 9(commencing wiih Sec�ion 7000) al Div��sion 3 ol I�e Business antl Pmfessions Cotle, ana my license is in fullforce an0 e�feci. CITY LIC.: STRTE LIC.: CIASS: Oate: Signawre: I WpqKEflS' COMPENSRTION OECUflpTION: I �ereby affirm t�at I have a cenilicate ai consent ta seli-insure ar a certificate oi Workers' Compensation Insurance. or a cenilietl copy ��ereol (Sec�ion 3800. Lab. C�. POLICY NO.: E%P. OATE: COMPANY: � Cehifietl coDY is hereby lumishetl. ❑ Ceni�ied copy is �iled wi�� fhe ci�y Builtling Division. Oate'. _ Applicant: E%EMPTIUN FNOM WOflMEBS' COMPEN$pTION OECUBRTION: (This sec�ion nee0 nol Ue completetl il the permit is la one hundr� (S/W� or kss�. I cehily Iha� in ihe pedormance of ihe work tar whic� this permil is i55ueQ I shall noi employ an� er5on in any manner sa as �o become su�lecl Io �he Workers' Compe a�ion Laws of Calilornia. Date: � � SignaWre: NOTICE: I�. atier making his tleclara�ion, you shoultl �ecome sublect m Ihe Work¢rs' C Densa��on Dmvisions o� �he LaUor Cotle. you mus� tanhwith comDly wiU such provisions or �his permii shall be tleemed r oketl. CONSTNUCTION LENUINC FGENCY: I here�y allirm that there is a coretmc�ion lentling agency lor ihe De�ormance ot Ihe work for, w�ich ihis permit is i55ue0 (Section 3097, Civ. C�. � ' LENOEfl: aouxess: BREE2EWAY ATTACHES GARAGE TO RESIDENCE OWNEfl BUILOEB OECIABRiION: I here�y aflirm �hat I am exempt tmm ��e ConVac�ors' State License Law for �he �ollowinA reason (Sec�ion 7031.5 Business anU Profes4ional CoOe: Any city o� county w�ich requires a permi� to cons�Nci, atler, improve, demolish, or repair any stmcture, prior �o iis issuance. also requires 1he applicant �or suc� permii �o file a signed s�atemen� �hat he/she is licensed � S' 7000 � �' i i n 3 � �he Business CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 060350 PERMIT NO; M 060350 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE; MEC PURPOSE: ADD JOB DESCRIPTION : CONV 602SF GARAGE TO LIV SPACE, BATH ALT SQ FT; CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 / COMMENTS• ENCLOSE 156SF BREEZEWAY ALTER BATHROOM RE•#H60182 *�r�r*�r��r�r�r�e�r��rx*�r��*+�**�*�r**�rx��r�r�r*��r�r�r*�r�**�r�r****�r*�r�***�r***�r*�r*�r****�r+r*��r*+r�*�r�r Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 11739131 ZNE; REF NO; PLANNING NtSTES> i �*�e�t�t****�t*�****�r*�r****�r�***+t***�t*�t*�e�e�**�**x�**�r�r,r***�*****�*�*�r�r�r�r******�r**�**« � D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S �ZONZNG APPROVED BY DATE; BUILDING APPROVED BY : - DATE; �APPLICATION ISSUED BY• ;F�� DATE: 1'2—� �� 41 ,�iE1EiEif�FiFiFiFiFiFkiFjflk�fiFikiFlfiEj{1E�Fif7F7F7F7F7F7F7FiFiFaFiF'�F�FiF�F if�f"iFif7Eif�if7FifTF�FiElF�F�kifiFiF1E�F�E��FiFiFit �ik jf k�k ik 1F k ik 3k i! iF if iF k!F It iF if if 1F iFiE if iF ik k kiF iE ik k if if if �! if �E iF 1E iF 3f if ik ik�f iElk �f ik ik 1E �F If i! k�E iElE iFlF �F 1f �FiE �E 1E iF iF iE �! iFif iE iFiE iE �E �F if LEGALIZATION:N F E E S U M-M�A R Y STRUCTURAL SEGMENT:N in �' BLDG PMT PLUMHING ELECTRIC NIECHANIC FIRE SMIP/RES GRADING PERMIT �-- �'� :.� �1'2 00 �f\ J=!- `,G �^ ;\,r'�52 SMIP/NON—RES pursuan� ro Ihe pwvisions oi Ihe Con(rac�ors S�ate License Law (Chapter 9(commencing wi�h ec�ion ) o rv 5 0 o pLAN �, ' antl Pmfessions Coae� or Iha� he/she is eMemO� Iherefmm an0 �he basis for Ihe alleAetl exemption. Any violalion o� Sec�ion 7031.5 Ey � � e any aOPlicant �or a Dermii su6le��s �he apD�icanl Io a ciNi penalry oi not more than fiv¢ huntlred Aollars (5500�. I SSUE FEE /l� '� rl 5, � � ." i, as owner ol Ille O�aPeqy or my emymyees wi�h wages as meir soie compensatian, will do the wone, ana the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK '�, TOI'AL PAID '��• DUE ❑ sirucmre is noi imen0e0 or o$ereA br sale (Section 7044, Businew anG Pmlessional Code: T�e Contracrors State License Law TOTAL $-- --> 1 2. 0 � 1 5, � � �. � � • z%, � � 2%, 0 � ^- _� , Q Q Ooes no� aDPly to an owner p� a pmperty w�o Uuiltls or impmves �hereon, antl who tloes suc� woM him5el�/herseli or thmug� � 1 � his or her own employees. Gmvidetl �hat such improvements are not intentle0 or ottereA tor sale. If, however t�e �uildinA or imProvement is soid witnin one year oi comP�e�ion, tne owner win nave ihe buraen o� nmving ne�sne aid not buiio or impmve REVENUE DIVISION TOTALS--> COLLECTED� • 2%. 00 OVER /SHORT ; �—� r` i, 00 BING ELECTRIC M C � C`�` FIRE 5 lor me Puroose of sale). L as owner of t�e pmDe�y, am exclusively conVacting with licensed conVacmrs m cons�mc� Ihe pmlec� (Section 7044, Business ❑ antl Protessions Code: The ConVac�ors' State License Law Ooes nat apply to an owner of pmpe�ty wAo Owlds ar impmves lherean ana who contracls lor such p�ole��s wit� a contracbqs)ticense pursuant to the Contractars' State License Law�.l am aware Iha� pmo� o� ��eir Warker'S Campensauon insurance s�ould he D�ovitleA �o m¢. � � am exempi untler Section: B P% O 4�i B. 8 P. C. �ormisreason: BY WNER / NO EMPLOI�ES Date�. � �/��= � 7 Owner �� I tlo hereby certiry ihal I am aware of ana under5tan0 i�e requiremenis o� Calitomia Hedlth antl Sa�ery Cotle ctions 2550.5. 25533, antl 25534 ana I�a� I or any tulure �uilding occupani wililwill noi (circle one� neetl Io compty wi�h 5ai0 5taie coDes anU fhe requiremen�s lor a permil for conslmction or motlilication iwm �he Air Oualily Managemen� DisVict. HesiDential construclion aDPlica�ions are exemD� �rom ��ese O�ovisians. Date: ApPlicant: I �ereby cerOty��al I have rea�lhis applica�mn antl siale Iha� Ihe aboveinlormaiion is CorrecL I agree to comply wi�h all ci�y an0 county ordinances an0 s�ate laws relating �0 4uilding conslmction antl hereby authorize represen�aiives af Ihis c' y to enl�on Ihe above-men�ionea propetly �orinsDeclion purp es. �� Daie: �%— Si9naiure: � v Oriver's License a� Social Securily N: 16<La6 Whi�e—Buildina: Green--COGe EnforcemenL Canary—Noollcanit Pink—Revenue: Galtlanrod—Assessor BLDG PMT PLUM E HANI MIP/TOT GRADING PLAN—CHECR 17.Q0 'l 4 1f 1f iF iF ik if �f if �E iE �lE iF if ik iE if i! IF iF �E �F 3F M�f iFif iE if if iE 1FiF iF if it iE i! 3f iF iE iF M iFM � iE 1F�F�E if kik iE �k IF iEiE�E i! 1E iE iF iE �ElF iE iE iF if if k i!i! if �1t 1E iE �F if I N D I V I D U A L =-�FnE E"' B R E A K D O W N TYPE �QTY D E S C R I P T T� O N� ;}� �/ UNIT COST TOTAL COST MEC r� 1 INST FORC—AIR /GR �V FURN �<'�10�0 K BTU 9, 00 9, 00 MEC 1 .—�G��I� SYS 1— 4 OUTLETS `l 3,00 3.00 �� p � ��t� END( OE FEES i' �/�� '''� �•�y- '� � b��,� '� EXFIRED i'I�e:C-'/1� �'��'":�.- � �iiLSG��/ �'�� "`w`� •',r� _ �"�/� q19,3 DATE1 I `i'=�� POOL PA. C,OjSTRUC710N AND PLANNING. - - [ ' APPROVALS Permit # Date Inspector APpROVALS Permit # � � Date Inspector t�'femporary Electrical Service or Pole ' S2. Pool & Equipment Location - �' 2. Soi� Pipe-Undrqmd., , 53. Steel Reintorcement - �. � ,,3.`,�IRCYricai'ConduR.Uiility-Undrgrnd. � 54. Forms - " ,; � , � :4. E1ecYrical.Co�tirlui�F-Undrgrnd. �55. Electrical Bonding - - � `• 5' $ieel. Reinto�etnerff .56. Rough PV�mbing & Pressure Test' _ -�^�._E�ectricatUFER:Grfid. � �57. APPROVALTOCOVER�.GUMITE . f -�i;.� �odtinge `� ��'� . 58. Electricai Conduit�Undrgrnd. ' � = •8: �oundation: � �' ' -�59. Gas Pipe, O Undrgrnd., Test _ � � 9. Water PipeTUndFgmd. •, � � 60. 9ackwash Lines, P�Trap, O Undrgrnd. ;� �. � . 10. 5tructural Flodr SYsiem ; 61. APPROVAL TO DECK 1 t, Property Sewer line & House Connection ' 62. Backwash & ReceptorFinal "-" 12. Sewer Cap ,i - 63. Heater & Vent-Final , �� 13. Roof Drainsw-' - � � 64. Plumbing System • Fina! • •_ 14. ftough Plumbing � � 65. Electrical�Final � 15. fiough Electrica!-Condu�t � 66. So�ar SYstem-Final ��--� � � 76. Ftough E1ect�ic Wfring 67. Fe�cing & Access Approval � 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � _ FIRE DEPT. REQUIREMENT r. .n , � � . : 20.:�RoGgh F�ctd�1 Fireplace � -� �: C'� '� G '� c' � < .qppRpVA�.S;`"=Permit # � ' - • �. �. . « � .:4 .. S i tt'> x ,�. �"Ti7' 21 zDucis, in StractureY c ,` " J �','` - ' '" � '� ' `- , i• -� S S x�� 70. U�dergtoY7nd� Hy.tlro 22�DuF_4;, Ventifatin9.�. � �� Y r � �•�`. ��yJ1. Product�Pi�ing O�G�s d;0il -. i � "` i � � � f- t � . i I ' - � 23.�a5_�ipejiouth &��est i , � _ 7 ,7 .�•� x ,7z, �ndergin�nd Flushi . , . - 245Fioof F�aming ��s t f�!-� ^ n 7 " �i ��P ''�73r Undergrnd:Stor�t��;Tank OGas OOiI�" _�..�. ^ 25. Roof SHeathing r: �: 4_, y? :, v v F�i ��;. x• �' .� Y -„_� .h �." . �74rOverhead H dro�� "`�; ! 26.�Y�Bar Ceiling (Structuraq &�lonocoat � � 'L = 'x � 75..Ory Chemrcai " "' - �� "; •�'�:, ' 27-Frame and flashin ` - . � ` ' -" " ` - � -- ^y �. S - _ � �;.�� g: ;�.., �•_ > :.r. � 76.� Dry Standpipe a. i �28. �l.athing�& Siding'�i � cc �l¢; " � s ��-> Y 77h' FIXED 3YSTE pyINAL'; � .. "'-' ' f � f'1 - ) . 7'1 1- �' .�� '. �29. Insulation ,-� ^ � " �. �;: Y' 78:. FIRE PREV. FINAL n :� - ' _ ��'� � � T30. Drywall.Nailing �.t' � � x � +� •� � •HE�ALTH�DEPT. R�EQUIREMENT `?' ` , . � . �, '.31. Plaster B�owqC63t,''. � % � 79' FINAL I(V$P�CTION '; - �Y �. �? � �y32.-Electrical Pdwer Mete�-Final� ^�� - . � �- S0. FOOD CERTIFIGATE ISSUED� � � �33:�Final Eliectric � _ � � '�" K ;, 'Nqtes: � ' �, � '� � . ' � ' : �34:,FinaiHesting,&Ajr:Conditiorling; i; � i `. / :�//1 � /�� '/^ - _ ' �' k � 6�t '�C/l�� a-il�.T�_�l Q '35:[FirlalGasPi e�TesN - ' _ '" `' � r �p �' ..��~ r T - -�b �- ` /' ��fLYw"� .,L36. �Hood or.GanoP4�� , -. � .� . - ;, r; .. � • , _ * . � ; _ . . _ ... , . �^ T f 4� K ��-�,--� � �.� . 37,-Final Factory Fice�lace_ _ .'� ��. . ,; ' �L�=l� r�..T/_!�,-z-- - - - � , .. , .� 38. Final Plumbing A 4 ~� �� Y • ' - T � 39. Water Sewice�FiriaP ' " '. :` � , -' = .r '��'x n v - � . L- �z - -• �40. GasService-Final ', � �I.. .. r n ._. ' • _ r `41. Solar pomesticF.inal'.i ^ - x r; t� -- -� ~ ..,e. . [ 1p R � � '�- �A. �. 42.'Backflov� Preventerx � x '" . > �7 � � �, �� 43. Backflow Irrigation• �- :• . � " • - , `- '1" ` �_ ' - .: .. '. . '-� - r "_ t. . .. . _ �;44. Landscape liiiga�ion System; r�, , - - .: �. r: - .. .� �� •� -- -- w- =.45,'Sound Atten'uation J-" - � % y '" �` , " "` � } , � t • � -1 �46.,Handica-p,Regulatiqns _ , � . .�. . �� " �47. FINAL STR�JCTURE & BUfLDING ` - �- � � , y ; ` f - 48: fINAL PLANNINCa ' r�r ` `#. M U � y v I �-49t Ele�tric Release to �Edison � � - - \ � `50.�Gas.Release to Souihern California GasCo � � .-� x y 51. CERSIFICATE OFACCUPANCY q . � r . R 'r _`- No Date � � Pfl0.1ECTRUOflESS: Qe�'] E 19TH ST UNIT: OWNEX'$NAME: JOSEPH,• D,AVID R - •• , ni3ness: JOSEPH BONNIE S � p'� 947 E fOTH ST '"`�` COSTA MESA,CA 92627 AflCN/ENGINEEfl: HAROLD CASS � sec.No.: gggq aooness: P O BOX 1 3 0 6 5 2 uxiT: BIG BEAR LAKE CA 92315 PEHMITTEE:DAVZD 6 BONNIE JOSEPH . (714)646-1706 R�OflESS: Q Q�] E 19 TH ST COSTA MESA CA 92627 UCENSEU CONTPFC70B OECIABRTION: I herebv affirm t�at I am licensetl untler D�ovisions ol Chao�er 9(cammencing with Section 7000� o� �ivision 3 0l I�e Business antl Professions fAtle. an0 my license is in lull lorce antl e11ecL '' CITY LIC.: STRTE LIC.: CIASS: } Dale', Signalure: ` WOPNENS' LOMPENSRTION DECUINATION: I nereoy affirm ihat I have a cenilicale of consent to sell-insure or a cenilicate af woBers' Compensa�ion Insurance. or a cenilieA cooY �hereoi (Section J800. lab. CI. POLICY NO.: E%P. DRTE: COMPANY: - ❑ Cehilietl CoOY is AereOy Iumi5�e0, ❑ CeniliaG capy is �iletl with IAe city Builtling Oivision. Uale: � Ap0licant: EXEMPTION fBOM WOPNEPS' COMPENSATION OELLRPRTION: (This SeCiion neeA n0l be compl¢�eG i� Ihe pelmi� is la! one hUnOretl (E700) or Ie55�. I cetlily ��a� in Ihe p2rlormance o� Ihe work for which I�is permil is issue4l shall no� employ any D son in any manner So as �o become subieai m�he Wo�k/e{a ComO/Rnsation Laws ol California. � Oale'. �7�/� /�Z Siqnature: Q'�"�� NOTICE: II, aller making I�is deciaration. you shoul0 become suGleci Io �Ae Workers' Com nsaii0n pm sons o� Ihe LaOor Code. you musLfohhwith comply with such pmvisions or �his permil s�all Oe tleemed reu ed.'�; CONSTflI1CTI0N LENUINC RGENCY: I hereGy ailirm Ihat t�ere is a constmclion IenUing aAency for Ne pedormance ol ihe woB tor wnicn ihis permit is �ssuetl ISeaion 3097. Civ. C1. , LENOEfl: � naoxess: BREEZEWAY ATTACHES GARAGE TO RESIDENCE OWNEN 9UIlDEfl DECLAPRTION: I �er¢by ai�irm Ihal I am ewempi �mm t0e CanVacbrs' Slaie LicenSe Law Im ��e lollowinp reason (Section 7031.5 Business anA Pmlessional CoOe: Any ciiy ol coun�y whic� repuires a De�mil lo consimcl, alter, impmve, OemolisA, or repair any SlmC�ure, prior Io i�s issuanCe, als0 reQuires Ihe applicani IDr SUCh permii b �ile a SiAneO Sia�emen� �ha� he/She is licensetl pursuam lo the pmvisions ol ihe Comracmrs' State License Law (Chapter 9(cammencinA with Section 7000) ol Oivision 3 of the 9usiness ana Pmiessions Cotle) or that he/she is exempt �nerefmm ana ine hasis for the allepea exem0�ion. Any violation of Section 7031.5 hy any aDOlicanl tor a permit subiecis Ihe aDPlitani lo a civil penalty of noi more inan five hunOretl Ooilars �5500). I, as owner ol ihe Dmperty or my employees wil� waAes as iheir sole comDensation, will do t�e wark, anA ihe ❑ slmcWre is not in�enUed or offeretl lor sale (Sectmn 70d4, Business antl Pm�essional Code: T�e ConVac�ors' Sfale License Law tloes not apDly to an owner of a pmpehy who builtls or impmves tAereon, antl who aoes such wark �imself/herself or tAmuAh nis or her own employees, pmviUeO inal such imorovemeNs are not inleneee or offereU lor sale. II, however ihe Ouildinp or impmvemen� is sold vn��in one year of camDlelion, ihe owner will have Ne OurOen ol pmvinA he/she tli0 not builtl ar impmve for ine puroose oi sale). I, as owner al Ihe OwOeny, am exclusively conUac�ing wilh licensetl contractors �o cons�ruct �he pwlac� (Section 7044, Business ❑ antl 7m�essions Cotle: The Contraciors' State License Law Uoes not appty m an owner al DraDerty who �wlEs or imDmves tAereon and w�o contracls far sucA Dmle��s wii� a comracmqs�license pursuanito the Contraclars' State License Law�. I am aware Ihat pmof ol ineir Worker's Comoensalion insurance shoultl be pmviUetl to me. � � am exempt uneer Semion: BP7O4 4 B. a P. c, m� mis �easore B�(f� OWNER / NO EMPLOYEES Date: �..z ��,�� / Z Owner. � I tlo �ereby cenify thal I am aware ol and untlerslantl ihe reQuirements of Calibmia Health an0 Sale�y Coae ections 25505, 25533, and 25534 antl I�at I or any IUWre building occupanl willlwill nol (circle one) need lo comply wiN saitl siale coAes and tM1e requiremenls lor a permil lor constmclion or modilicalion Imm t�e Air Oualiiy ManaAemem Dislrict. Hesitlenlial consimc�ion applicalians are exemD� ��om ��ese Omvisions. �ale: Applicanl', I hereby cetlily Ihat I �ave reatl �his aD0lica�ion and state �ha� �he above informalion is correci. I agree to comply wi�� all ci�y antl counry ortlinanres antl statelawsrelatingto building consimclion and hereby aui�orize represenla�ives ollhis ci�y` o enteruponlAe above-mentioneA pmDerly lor inspecl' n pur ases. D /� � fl ' Dale'. Z Signdlure: �f'Yti'� ��f�'1�� t--- od�ers �icense o� sociai Securiiy x.� t6At�A6 W�i�e—Bvildinp; Green—Cotle EnbrcamenL Cenarv—Aoolicam; Pink—Revonua Goltlonr —Assxssnr CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 060351 PERMIT NO: P 060351 PLAN CHECK'NO; N GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE; PLU PURPOSE; ADD JOB DESCRIPTION ; CONV 602SF GARAGE TO LIV SPACE, BATH ALT SQ FT; CLAIM VALUE: CALC-VALUE; GROUP OCC; R-3 / *�******ir�r*�**�*********B******�*�r�t�t�***�rB****�*�t�t**�t+�rB**�****+t�r�r�r�r�r�t*�r�r*�r**�t Z O N I N G R E Q 0 I R E M E N T S sETaAcxs ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL: 11734131 ZNE; REF NO; PLANNING NOTES> � iF iflf M�F it if iF M�F itlf M M iF it it M if if it iE iF 3F ik %ikik �F if iE IE iE k iF iE if �k IE �E iE iE iFlt i! 1E iF if k If 1E �f iF iF k iF fE iF ikif iF iF 1E 1t�E iF iE iF 1E ik if iF if IF MiE If �E �t D E V E L O P M E N T S E R V�I C E S R E Q U I R E M E N T 5 ZONING APPROVED BY -4 DATE; BUILDING APPROVED BY : L' TTTE� r . i APPLICATION ISSUED BY• �-' DATE; ��z-I �(� �, k�1FMifiklFifihk�fiFififiFiklhlFiFitlflf�kiFif�F'�iF'iF'iFifiF7F7F'iFiFiE3F'R �f�f3fih3kiFifiFiEik 3kif ' �E iF if M�k iflE if �f iF It iE iFik if !f if iF k if iE if iF iF it iF k it k iF iF iF iF if iF if iF iF ik M iF iF�F i! it iF iE iE�f �l�E iiif iFif 3f iE iE �F M �E if i! 1FiF �E IFiF iE iF if iF ik iF k if �F iE iF LEGALIZATION:N F E E S U M M A�R�Y .- �. STRUCTURAL SEGMENT;N c-- � �.- � ,,�! ,� BLDG PMT PLUMBING ELECTRIC MECHANIC-' ,., FIR'E SMIP/RES GRADING PERMIT 36,250� , ,. �,,, ' _ �i' �; PL� . , , , .. r SMIP/NON-RES ISSUE FEE 20.00 ' `�� ` f _ . . BUILDING-DIV-> PERMIT ISSUE PliAN-CHECK '' � TOTAL � PAID DUE TOTALS----> 36.00 20.00 , �0.00 56.00' � 56,00 .00 L� � � ` � REVENUE DIVISION TOTALS--> COLliECTED:�, . 56.0'0 OVBR'/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANI,C%� '�FIRE- SMIP'/TOT� GRADING PLAN-CHECK 56.00 '., ' � 7 .` ', " , i � %'; � �% pl . � k 1f �f iF ik if 1f �f if �F %iFif 1k ik iE if iF k 1E it iF k iFlF �f iF iF ik 1f 1E iFlf IF if�ik 1t �F ik k il� if iF iklf 1E iF if k if 1F3E IE �k IFiFlE�f i(� fF�if iEiFlE 1E ik if 1F iF dk if �E iF �f ik1E �F ff �f I N D I V I D U A L ? FNE�,.E . B R,E -A K D��O�;W N TYPE QTY D E S C R I P I O�N ��' �''" �UNLT COST TOTAL COST -� �. .- ' / PLU 1 DISHWASHER .t -7 00 7,00 PLU 1`-{'�EATER AND/OR%VENT �. �. ,. �.7.00 7.00 PLU 1 CONNECTION TO BUILDING EACH� � 15,00 15.00 PLU �. I PAIR WATER PIPING EQUIP; 7,00 7,00 END �OF, FEES . .l' �7�(a =;��''" � � . � • � ./ _—" ,, �'', A+ � L I ; f; n.,.� P�� . m..� /2� 8[/ 9��/ �� rlI ; � �; l' � / —� �,�„ .L � 'J . K�'�/� . � i "r'V i/ 0`...0"r r�r�- � � �:�3 "�//9/4-3 Cd��STRUCTION AND PLANNING POOL ,PA . . A�'PRQVALS Permit# Date Inspector ApPRQVAIS Permit# Date Inspector 1'}Temporary Electrical Service or Pole 52. Pool & Equipment L'ocation ' 2. Sail Pipe•Undr�qmd. • - � � � i� _ �y3. Steel Reinforcement Y � ` : ; •. � � �f-1 3., �IectricaZ�Co,ridciiS,Utility-Undrgrnd. '�4. Forms �, �. � G: El2ctrical.Conduif-Utidrgrnd. % 55. Electrical Bonding ;� ' 5. y`ieEl ReintorcerSien'�' ='66. Rough PWmbing & Pressure l'est�_.� "� ...fi,.F1ECtricS:UFE6�6rtd. 57.. APPROVA�TOCOVER�GUt�kISE . '=2;�Fp',qtings ;�� "= Y�B. Electrical Conduit-Undrgmd. r " ��:$ ptfundatiom � p� ,� .'�9. Gas Pipe, � Undrgrnd., Test � 9. V,eyter Pipe�Jndcgrnd. � '.60. Backwash Lines, P-Trap, O Und�rnd. �� 10. 5 ructural,Floor System .,61. APPROVAL TO OECK � 71, r•operty Sew�r�Lirre�& House Connection ;62. Backwash & ReceptorFinaf �� '�1 72. Sewer Cap _ � ' `63. Heater & Vent-Final , � " � 1�. Roof Drains - ^ ` 64. Plumbing System - final 14. Rough Pfumbi� �' �u -� � 65. Electrical�Final � � � t StJPta_srNi tc _ r 15' Rough Electrica7-Condu�t 66. Soiar System-Final `1 16. ROugh EtectricWiring 67. Fencing & Access Approval �� 17. Rough Wiring Sign � 68. APPftOVED FOR PLASTERING 18. ROugh Electrical,-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - ' - ' - - .r „�.-„ : • .�. • - tr r , , 20. Rough G2ctoQr�y �ieplace � ;�,?' ,5�� ^ -� �r % •APPR6VAL6��'-Per;eiit # � �._ - - � ' � . .> .,. - i ' �..� � .. . 21: DucIs, in $tructure, •. .. � _ � .. - t� : _ �;70. Undergrophd� Hy11ro � - � 22. DuLKs, Ventilating�", i r�'� ;� �` n -�='� "�71. Product�P�i�g O Crtas CFDiI �: 23:`GaL�,ipe= ou h&��esc � � �• �T '4A , - ,- ' i � ��, �: ... R 9 i r� s �_., q O<• �72. Undergrounm Fiush� _ C. e 24.7Robf Framing� :;�-!' � E-�E- •�:r Y :> C 'r " A �73:°Undergmcl:Stor'age_Tank OGas OOiI � ��1� �� ' 25. Roo� Sti�athing y� y . ' � � ;L � „ ' 74-. �Overhead�iydro`.•' _ _' : _ �.. ii :ns. .. .. 1 - ,; r:': o-� �..,, � 26: T�Bar Ceilin9 �Scruetural) &;AAonocoat ?� 75ti Dry Chem�cal _ - _ s r, ,_, ' 27: frame and Flashing� _� � .t ' . s • � �-�.�. ns „ ,. ., � . � 5:� a. , �< - y _ a.: 76.�Dry Standprpe > y•T � � -- �-28.'Wthing, Sidin4'' � "-�.z ^ x Z: "k ` 77? FIXED S�'S��TEM'RI{j�AL:' � . �� "'' � �29. Insulat(oo ', `> > � � ". � � _ � 78.= FJRE P.REV. FINAL � _. � ` ' �7y'�" - -30. DrYwalLNailing -T•= � � ^ . *' y "� �N�ALTH'DEPT:REQUIREMENT� j ' • ' 31. Plaster Brown Coa[, .� � �� , ;: �; ,-79. F�INAL'INSS,R�CTION x ' ' , � �J32:.'Elecvicai,Power MetaP�Final: � r �� B0. FOOD CERTIFIC�ATE ISSU„ED �� ; 33;Pinal El�ctric, y.` , � � ,� T' � . "Nqf�s: � '' = . -, , _ - . - � - - '��i'�;�i�[c,iti xc c�_ �:34:-Fina� Heating;&Ajr,Conditionigg:� .', a t (��_[l,cy ��<�f-.�r�*�<< � 35.� Final Gas Pipe-Te�st� `= - t2 Z(� _ /�'j.¢-�/i� -�?�LL��2�S �_i r36. �Htlod or.CanOPY A . _ . ' i'. e T _ � �)� 1%� i' /� � _ ' , " ' C-. . " = - - ' _37.-Finel Factory Firepiace.{ ' . " ;. � " � y _ ) �' ' .. .� . -/-��J�<�f - 38. Final Plumbing � � --. � � _�/% �.?� -� 2�T �C�y �_ 39. Water Service�Firi�l� _. �� ,/�� r^ _ -Z�i -9� S��(�C �V_t�?'�-' Ttc/�t "t�- 40. Gas Service-Final „ „ ,y , � .� . t I Z �r � '�r" q=��2_B�4�Y�Q"�i' 'Ca�pT" °41. Solar pomesticFina�'> '' � ` K ¢ - - T , .� . . . : . c �r� p�r^r�GG� � 42.�Backflow Preven�r., �t � l../p e/ �� _��_ /r�Y�t_r� ! l ( �Lf�-� 43. Backflowlrrigation• �-��' " ' �" ': , , , y - _ : �hr �� - 44. Landscape Irrigaiion Systert1C ��? c � - J ' - � .. -- - ' - 45.=Sound Atterivation - '' ' ' -' - -� ..'` •. . z � ,r `, �. 46: HandicaP.Re9ulations " _ . . �. � ., �c - • '47. FINALSTRitJCTURE&BUILDING - ' '' - , � x - � _. . � 48. FIf�AL PLANNING: . ,. • .n � ; - 49. £lectric Release to fdison � � = s'_ � 50..Gas Feleaze to Southern Califomia Gas Cn � i � " -- � � I- 51. CERTIFICATE OF OCCUPANCV i � , :. . . . t• � ` ' No. Date � � ♦ � " uxiT: ' PflOJEC UNESS: Q a� 7 E 19 TH ST � qL4�P6NAME: �jOSEPH; DAVID R �' nooxEss: JOSEPH HONNIE S 447 E �OTH ST COSTA MESA,CA 92627 AflCH/ENGINEEfl: HAROLD CPi$$ NEG.NO.: 5 9$ Q nooness: P O BOX 130652 uxiT: BIG BEAR LAKE CA 92315 PEflMITTEE: DAVID 6 BONNIE JOSEPH (714)696-1706 ADOflE55: QQ'] E 19TH ST COSTA MESA CA 92627 LICENSEO CONTBFCTOP OECLABATION: I hereby af�irm Ihat I am Iicense0 un0er pmvisions ol ChaD�er 9(commencing wi�h Sec�ion 7000) ol Division 3 oi I�e Business ana Pmlessions Cotle, anU my license is in full lorce antl efiect. LITY LIC.: ST�TE LIC.: C1A55: Date: Signalure'. �� WONI(ENS'COMPENSpTIONDECIAMTION: Iherebyaifirmt�all�aveacehifica�eolconsentmsel4insureoraceniliwrealWarkers' Compensation Inwrance. or a certified coDY ihereol (Section 38011. Lab. C�. ' POLICY NU.: EXP. ORTF: COMPRNY: � Certilie0 copY is AereOy IurnisAetl. ❑ Certilietl coOY �s IileG wii� ��e ciiy BuilOing Division. Date: Molicam: . E%EMPf10N FflOM WONKEflS' LOMPENSRTION OELUP,ITION: (iAis sec�ion neM irol �e wmplele0 il �he permi is fa one �uMreO (5700) a less�. I cetiily thal in I�e pedOrman[e o� I�e work �or whith (�is permi� is i55ueJ, I 5hall no� ¢m01oy a person in any manner sa as m 6ecame suGjetl to I�e Workers' mpe aiion Laws o� GalitOrnia. �� Date: _ « Signaiure: NOTICE: II. alter making this aeclaratian, you shaultl become suUject to ��e Workers' C�pensa on pmvisions of ihe Labor Code. yoU mu51 IOritrm�� Comply wiih 5uch pmvisions ar INS pefmi� Shail OC EGemetl r oketl. CONSTPULTION LENOING FGENCY: I hereby allirm ihat ihere is a constmction lentling agency tor ihe pertormance ai t�e work for wAich Ihis Dermil is issuetl (Seclion 3097; Civ. C). LENDEN: aoosess: BREEZEWAY ATTACHES GARAGE TO AESIDENCE UWNEB BWLUEP OECUBRTION: I heaUy attirm that I am exempt irom t�e Contracmrs' State License Law for t�e followinp reason (Seclion 7031.5 Business an0 Pro�e55lonal Code: Any city o� county which requires a Dermi� �o can5tmcl, al�er. impmve, Aemolis�, or reoair any slmcWre. Orior to its issuance, also repuires ihe apolicant lor such permil lo file a sipnetl statement ihat he/she is IicenseA pursuam to Ine D�avisions ol I�e ConVaclors' State License law (COap�er 9(cOmmencinA �� Stttian 7000) of Oivision 3 0� 1�B Buvness antl Pmtesvons Code) ar I�at �e/s�e is exempt t�eretmm an0 the basis lor ihe allegeE exemptioa Any violation of Section 7037.5 Gy any ap0�icant for a permit su�jects ihe applicant �o a civil penalry of not more ihan hve hunaatl Oallars (5500). I, as awne� of lhe properry or my employees wit� waqes as tAeir sole compensa�ion, will Go I�e woM, antl I�e ❑ s�mcmre ¢ not imenJea or aiferea lar ule ISecnon 70a4. Bu9nes5 anE Pmfeuioiul COGe: 7he Convacmrs' State Licenu Law 00¢5 no� aD�ly la an awner o� a pmpehy w�o builtls Or imD�oves t�er¢On, antl who tloes Suth woM him5ell/Aersell or IOmuAh his Or �er awn ¢mDl0yee5, pmvi4eA �ha� 5uch improvemenls are noi intenCeO or o�fere0 for Sale. tl, howev¢r Ihe Uuiltlinp or imprOvemenl is SoIU vn��in one y¢ar oi complelion, th¢ owner will tuve ihe Eurtlen of D�wing �rlshe Ai0 noi build or imDrove . for Ne Ourpose ol sale�. I, as owner ol t�e propeny, am eKclusively coniracting with IicenseJ coniractors to consimct ihe pmlect (,Seclion 7044. Business ❑ ana Pmlesslons CoEe: T�e ConVaciors Sia�e License Law tloes not apply lo an ovmer o� propeM w� hmlQt or imD�oves I�ereon anE w�a cantratls tor such pwjetls with a cantracmr(s) license Oursuant ta ihe Caniractors' Slate License Law�. I am aware t�al pmof ol Iheir Workei's Compensation insurance should 6e Drouidetl Io me. � am e.empt untler Section: H P 7 Q Q 4 6. 8 P. C. � /j /yqY OWNER / NO EMPLO EES im t�is reas n: p Date'. ��// %S'/ /'L Owner. iL I Qo �ereby ceniiy Ihal I am aware ol antl understan0l�e repuirements ol Calilomia Healih and Safety Cotle Se lions 25505. 25533, an0 25534 anG Ihal I or any INure Guilding occupan� will/will no� (circle ane) nee0 �o comply wi�h 5ai0 Sla�e mUes ana Ihe requiremenis for a permil for cons�mclion or motlilication tmm the Air Ouali�y Managemeni Oislrici. Resitl¢ntial cansiruction applications are eaemp� Imm IfIESC pf0V151005. Date: Applicanl: I �¢r¢by tertity t�al I tuv¢ r¢ad Ni5 appliw�ion an0 51aie �ha� ��e abov¢ in�ormaiian is mrreci. I agree to compty wi�h all ciry an0 taun�y orUinances arb siate laws relatinq to Uviltlinq constmctian and nereby amtwrize reD�esentaiives ol ��¢ ry lo emer upon 1�e a�ove�mentioneG pmpetly �or inspecti Durpo es. � Date: — SgnaWre: —� o�i�ers ucense o� Sociai securiiy a: IBat�a6 Wn�te—Bwlmng: Grean—Cotle Enforcement: Canery—np0�icant; Pink—Ravenue: GolEenrotl—Fssess�'r CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 060349 PERMIT NO; E 060349 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; ADD JOB DESCAIPTION : CONV 602SF GARAGE TO LIV SPACE, BATH ALT SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: ENCLO5E 156SF BREEZEWAY ALTER BATHROOM RE;#B60182 ***+r+r�e��r*�r�r�r�*�r*�r�r�*�r+r�r+r�r*�r**�r*��e�r(��r�r�e�r*�r+��r�r*��r4**�r***�r�+��r�r**�r+r*�r+��r�**�r*��r+r�r Z O N I N G R E Q U I R E M E N T 5 S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PLANKNINGRNO�'ES> PROV; PARCEL; 11734131 ZNE; REF NO; i **�e�*��*,e��r**�r�r��****�r**�**�**�e��e�e***,�« *��*+e�*��r*,��r�r�r��****«�*�r��r��**+�*�r��* D E V E L O P M E N T -'S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY ; -' DATE: APPLICATION ISSUED BY• -� ��— DATE• �L I�LGt�I. iklfifitiFiflF�FiflEiFlFiEiFikkiF3fiFiklF1F�F7F��FiF'�F�FiF�FifiF{F3FiFiFiFiFiFiF'{F�F'iF iFaFi�F'�FiFiFitlFlkikdkiflklflF�t if�F if �f ik iF iF if i!!F �f ff iF ik it iFik 3t if iEik iF if if if k 1f if if ik iE ikiF iE iE �f lkdk if if if ik if ik�k ik iflf if ff if iF iF if if iF if dk iFiE 3k k k iF �f 1k iF iF iFif iP 1k 1k ik iE iF �! iE iEiF if LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N PERMIT BLDG PMT PLUMBING ELE48R50 MECHANIC FIRE SMIP/RES GRADING �Ot SMZP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 48.50 15,00 0,00 63,50 63,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 63.50 k iF ik iF 1k 1k ff 1k 1t 1E iF k ikiF iF M�F iE iF Mif 3f if M iE if ikiE if iF if if iE iF i! 1F if 3f if iFlF iF ik if if ik �f iE k 1f �!i! �f ikiE if if if iF iF �f iE M k �E it iE iF iE k iflf �k iE iE 1E iE ik iF Z N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N { UNIT COST TOTAL COST ELE 12 �'FIXTURES L�I _T�NG 1 ST 20 EA, ,75 9,00 ELE 20 ' RECEPT 1 ST 20 EA, ,75 15,00 ELE 8 RECE„1? �S,k7�GFI. ctions 1 ST 20 EA, , 75 6. 00 ELE 1 SERUI' 5t" L1S�600 V 6 HELOW 201 AMP 18,50 18.50 �zt�c�s� �t �-�e.�..r'6.� �+q..��. � 5--1�� / �,; � '��r.� - /2l8�93 �e i i d �.u._�/wn o%oli��/A�"�� %- �a.f a�a.�i • - / / �- �// 4�93 � � POOL �A � J�CONSTRUCTION AND.PLANN WG , - - Date Inspector Date in:pector '� j APPROVp�LS Permit # � � APPROVALS Permit # �� -`•i i. Temporary Electrical Service or Pole 52. Pool & Equipment Location �� „ i 2. Soil Pipe=Undrgrnd. �� 53. Steel Reinforcement � ' � _3.:Ej,ec(ricaCCortd,Wit:l}tility-Undrgrnd. �. i ;b-4. Forms ' , '-^�i.�Et2cYriwi_ConduibUfidrgrnd. �."j •65. Electrical Bonding � % " n � 5. Siee} Re�iflforup�men; ,�56. Rough Plumbing & Pressure Test •� 6 EYecfricaf UFEd3 Grrad. ��57.'. APPROVAL TO COVER•GUN17r� �. �.- ,7. FQo�ings :; �`�?�'= �'$S�. Electrical Conduit-Undrgrnd. • ��8. �oandatioa• � F . 59. Gas Pipe, O Undrgrnd., Test -„� , 9. Water PipP�Jnd�grnd. 60. Backwash Lines, P-Trap, O Undrgmd. - 10. Structural�Flodr System y : 61. APPROVAL TO DECK 11. Property Se�i r Linp & House Connection -62. Backwash & Receptor-Final ^ - n . 12. Sev�er Cap � 4 �� :63. Heater & Ve�t-Final � . �" ti 13. Roof Drains L � 64. Plumbing System - Final �� ' r� 14. Rough Ptumbir}'g ' ,f 65. Electrica�-Final 75. Rough Electrical-Conduit 1 66. Solar System-Final ;, �i 16. Rough Electric;�Viring 67. Fencing & Access Approval �i 77. Rough Wiring S<gn 68. APPROVED FOR PLASTERING + 18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � . _ . ... _ . ... Q �� Ct_ ,.. � ! .•: , r� t 20.'RoGgh F3ctor-y FuAplace � � T� C ' � � .� U'a : , ppR6VA'S?J�-Perinit # �' .�-' � , � .L' r1 T:p I1Cp �..Z J ' ?+.n , �. �'� U f:? 21.. Ducts, imStructure- ��. `� ,�� ,. t7 i r r .70. Undergro�d Hytlro � 22.� Ducis. VentiFatin��Y i �`�i � r„ r�� ' �";77, product�Pipi�g O Gas Oy0i1 � 23�-.Ga;}�iPe�Roujh&�'�est � � -- ,.. ��.,. � r i i �_�_ � R � � ?�S f� .*� r� �i G � s ,J2. UndergPoufd Flush� � 24. RoOfi Framing � 4 ' F F *? ` T H*� 573. �.Indergmd: Stor',�qe Tank Q Gas O Qil' -" • 25. Roof Sh��athing � u z �; ;.'�' �j V =�; �� 74; Overhead Hydro�-. t . � 26.':i-Bar Ceiling (Str.actural) &'dAonocoat K „ � :•-� : 75 �bry ChemTcal ( ' � _ J .��Y � C � 27.FrameandFlashiny,�' _ '' '' - '" `�� "' ' :�' `�'� , _ �;, � m , r 76. Dry Standpipe _ -: r, . � . , i-�8.��Lathing& Siding-: 4 �. -t.t -' - x �: ••> � 77:- FIXED SYSTEN},EINAL' � . �`•`'- ". •"+ � - r-� - a � .� c-. "� �'c �i ' ;Ur_ �.-._ . '�29. InSulaiipS Lw�` � �- � � 78.,,FIRE PREV. FINAL . . ,- t ' � .. _ ._ .•30. Drywall-Nailing � � s - HEALTH�DEPTrREQUIREM€NT' • . F. ,`-31. Plaster �o�vnCoai' � � : r � 9�'FINAL INSPECTION". '; c� `- �=i- v i� .. t 32:rElectricaLPoWer Meter.•Final i� �1t� $0. •FOOD CERTIFICA-FE ISSUED ,. t ., ,33.`EinalEl,et;ri� , � •. `"- * 'Not�'s: ._c., ' F G = ' : � . w .� i34.�-FinaZ Heatingj& l.�jr.Conditioning> �'� : �� ' � + - , ; - . _ ' �. r , - � 35.�Final G5s Pi�e�Te�it.; � '- ' ��'= " � ^ ^ - r G � - • * � � .c,. - � .aJ.� � - � � ' z36.�Hoqd oc �CanoPY x p � r -. �., � t' x ,c + s �J .. , ,- � - �` ..r .r, r. -37.�FinatFattory FirepJace _ ' � � `� � ` ' ' -�^=1' ` I 4 � 1 . .. � ' - �38. Final Plumbing : ,o � - � + �• �' �39. Water Secvice-Final' � � � " , -. ` - i � : � r A � 40. Gas Service�Final > i,. : �z ,t -- .� � - . • : �41. Solar pomesticF.inal s '� � •• R'=� r ' � � '` ,r ; � a r - + - 42.'8ackflow Preventer� J � � „ � • . �, 43. Backflow Irrigation^ y S'� � � � � , , , ' .. ':44. Landscape li-rigation SYstem,F, A ; r � 7 - J * � z .�� .. �.. � � �� .r - � - A5.•Sound Attenuatior� � •� �'' ' �� - r�u, :t�. _ - . : : - ..,, � . �336.`Handicap.Regulatiops " � f � - � - z � „_. � - 47. FINAL STRUCTURE & BUILDING t "^! �' ` r •48.'�FIfV`ALPLANNING, �. �. . _.. � � r • � ,49.�_Electric Release to Edison , '_50. GaL�elease to Soutfiern Calitocnia Gas Co � � j , . - � � � � � ;51. CERTIFICATE OF.00CUPANCY w ' , � i +: •...„ No. Da[e .� �_ ness: 447 E 19Tg ST "�^f JOSEPH, "llAVID R . aoneess: JOSEPH BONNIE S ; . 447 E �OTH ST ' COSTA MESA CA 92627 UNIT: r•, • ''� ABCH/ENGINEEN: HAROLD C�iJ$ BEG.NO.: JC989 ;� anonEss: p O BQX 130652 unir: BIG BEAR LAKE CA 92335 PERMI7TEE:DAVTD 6 BONNIE JOSEPH (�14)646-1706 nooxess: 447 E 19TH ST COSTA MESA CA 92627 LICENSEO CONTBACTON OFCIAflATION: I �ere�y a�iirm t�al I am licenseo unaer pmvisions o� Chapler 9(commencing with Section 70(q) ol Division 3 of Ihe BuSineu antl Pro�essions Coae. anE my license is in lull force antl eflect. qTY LIC.: STpTE UC.; CIASS: Date: Siqnatwe'. WOBHENS' COmPEN5NTI0N DECIAlIAl10N: 1 hereoy affirm �hat 1 have a ceniticate ot consem to setl-msure oi a cenitica7e o1 Wotners' Canpensation Insurance. or a cenifi¢d copy t�erea� (Section 38W, lab. C�. POUCY NU.: E%P. O0.TE; COtAPaNY: � Cenitiea copy is hereby twnishetl. ❑ Certiliee wDY �s liletl witA tne ciry BuildNg Divisian, Oal¢: MP�'a�t'. E%EMPTION FpOM WUFNENS' COMPENSpT10N UfCIFNAT10N: �itns seclion need no� be comph1cd N fhe pa�m b Ip mre AUM�ea �570� m less). 1 ceM1ity Iha� in lhe p¢rlarmance al lhe wwk lof wM1ic� thi5 pa�mil is issuetl. I Shall nol emD�oy any perso� i� any �nanoer so as lU �ecome suDlecl to IAe Workers' Campenulian Laws ol Calilornia. ��,�� /��,, � � Date: �.`2��0�' Signawie�. �� ^"_"-"' • � �%!�� NOTICE: tl, afler making iMs Oeclaralion, yw shouM 4ecome subject to ihe Worke� Compereation provisions oi the La�or Code. you muA �anhwith compry vntn xucA pmvisians or tNs permit sAall be deemed revokeG, CONSTNUC7IUN LENOING pGENCY: I here6y atlirm that [here is a consimaipn lenaing aAency 1or the peAormance of fhe work lor whicM1 iM1is Oermil is issued �Seclion 3097. Civ. C). lFNOEfl: nooeess: BREEZEWAY ATTACHES GARAGE TO RESIDENCE OWNEB BUIIOER OELtARpTION: 1 herebq aitirm t0at 1 am exem0� ��am the Co�tracwrs' State license law tor tl�e IWbvrinp reason (Sectian 70.3L5 Busi�gss anE Prolessional LotlE: Any CitY o� county whicll reQuires a permit to conSlrucL alier, impmve, aemolisA, or repair anV slmcture. D�ior lo ils issuance. also requires ihe applicant for such p¢rmil lo file a siAned slalement �hat he/she is Iicense0 C � h$eCC 7000 / Ui �' 3 i �b B� CITY OF COSTA MfiSA — BUiLDING PERMIT PERM N�; H 060182 PERHIT NO; B 060182 PLAN CHECK NO; 04034-92 L GOVT; N SUPP: N CONSTRUCTION TYPE; � PERMIT TYPE; STR PURP�SE; ADp JOB DESCRIPTION ; CONV 602SF GARAGE TO LIV SPACE, HATH ALT SQ FT: 36,5Q7 CLAIN VALUE; 50,000:00 CALC—VALUE: 47,845,00 GROUP OCC: R-3 / *��+Erww*ir�rw***�*********B+Rr**��+Ar+Yr�rle�e�*******��*�e+rr+r�r�rr�r*�r*�r�e*�r�r*r***+r******r Z O N I N GS ERTEB�AUCIKRS& M E N T S ------------ HAIN HUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT; 19 FT IN AfiAR; 19 FT 11 IN FRNT; FT IN REAR: FT IN LEFi; li FT IN RGHT; 11 FT IN LEFT; FT IN RGHT; 4 FT IN PARKING REQ• PROV• PARCEL• 11734131 2NE: RL REF NO• PLANNING NOT'ES> CONVERT fiXISTING 2—CAR GARAGE.TO FAMILY ROQM BATA 11ND �e*�rr**x+e�*r**r*****�*��rr�D*+ar�*�*ir**+Nr**�**+r*�***+Ir�*�r*****+�e+r***+r�e�r+e�r�r�r�e�e�*�r+r�e D E V E'. L O! P M E N T;,— S E R V/I C E S R E Q U I R E M E N T S ZONING APPROVED_ BY=, ; ��/R°� _ DATE; /2��cJ2 HUILDING APPROV.ED HY•;' L DATE; la-( APPLICATION ISSUED HY: �' � DATE; 1 2 .�$ �F M iklF�F if it iFiF1f ff if if �f,if M!F if iFl�F fF iF iFit if �F IE 1F it itlE aEiFiFi1��F�F'k i! lfififfFiFMifikiFifltifMMifffltlEitifiFlFifkiFfFkMif'1tMMlkifkMififlFlt�fkififft lEkifiEitiFlfk�EkkkkitltfElflfiFlFififkk�flFlfkififkit LEGALI2ATION;N F fi E S U M,M A�R,Y�.:., ,J STRUCTURAL SEGMENT;Y c BLDG PNT PLUMBING ELECTitIC , MECFiANIC�, : FIitE SMIPlRES GRADING PERMIT 401 , 50 •, f � .: i' 4, 79 '' oursuam m me o�ovisions ot me Contracmrs State L¢ense Law ( hapter 9(commenanp wit ion � a vision o e uvness - � ' ' , • . $M I P/NOPI—ii$S an0 Pmiessions CoOe) or �ha� �e/she is exempt fieretmm anO l�e basis 10� tne allege0 e�emption. Arcy viohtion M Section 7037.5 by pT+� 2 6 0. 9 8 � .� � � �. . ' any appNcant !a a p¢rmit 5u01�t5 the applicaat b a civil p¢naltY 01 not mare ttian Irve huMretl dWars (SSlpl. I S SUE FE E . 't .'-" ,� -. �.' , . ., N i, as owner oi ine owoeny or my empioyees witn waqes as iheir �le comDensaOon. will tlo Ihe wor�, ana me BUILDING—DIV^> PEFIMIT ISSUfi P.LAN—CH$CK� :�� ` TOTAL �� PAYD DUE ❑ siructur¢ is nm imen0ea o� a9e�e0 fo� sale �5ec�ion 7M0, Busmess anb P�ofessional CoEe: Tre Coniractas' State Liceme Law TOTALS-- -- > 4 0 6. 2 9 �. � 0 „ �2 6 0`: 9 8 66 7. 2? �. ,. 6 6 7. 2 7 . D O tloes nal apWy to an awner oi a O�ePeny wfw builRs or impmves Nerenn, and w�o pae5 such wnA himsellPoe6eli or lhrough •, � t .', y ,� hi5 0� h¢r own empl0yee5. provitled Iha� 5uth improvemen�5 are n0I inlBntl¢d or O�leretl �or sale. I( howeVer the EUilding or . improvemenl is m10 within one year oi comolefon. tne awner will �ave ine eurtlen oi pmvinp nrJsne eid not Oui1tl or improve REVENUE D I V I S ION TOTALS--> CDiLECTED ;' +- r-* �'4 06 '2 9;�� OVER%� SHOR'1' ; 0 � , im in➢ pwD�3e of 5ale). I, as owner ot Ibe propeny, am ezclusively conVacting witA licensed coniraclors lo constNct Ihe praject (Section 704E, Business ❑ an0 Pr9t¢SVOns COOe: The CAnirapots' State License Law Ooes nol appty to an ovmer of pmperty who Emlds m imp�mes �hereon a�W wM10 cwUuts Iw wc� praj¢cls vnln a cantractw(5) iicense W?�ant tu Ihe Cpntraclad SWIe License Law). I am aware ih2f prpo� aI I�Cir WofXer's Compen5atipn insuran[e ShoWd Oe D�aVitl¢4 �o m¢. � i am exemPt under section: BP704 4 B. s v. C- ia��s�eason_ HY OWNER / NO EMPLOY�pE�ES �ate: ��q2 Owner. ry'"/'�)/�/ �, ��S.�7� � I da Aere�y ceNly lhdl 1 am aw3te n� 3n� untl¢rStenC lhe requirem¢n�s ol Califomia Meal�h antl Safery Code SettrortS 25505, 25533, an0 25534 ana IAaI I o� any fuWre building occupant will/will nat (circle one) neeA to comply with saiA state cotles and Ue repuiremenis tar a permil lor tonslmclion or moedicalion irom Ihe Air ualily Managemenl OisVict Residential conslmc�ion apD�icalions are exem0� ��om ihese provisions. Oa1e'. ppWicanP. I �ere0y certity I�aI 1 have rea0 Ihis aDD��ation and slate Ihal 1�¢ abwe Intormalian is cortecl. 1 agree to comO�Y ��h atl city an0 co�nry aainam�.es ano sta�e laws relatinq �o Outbinp construction antl nere�y autt�anze reaesentatNes W tNs ciry toenter upon t�e aEove-mentioneG pm0eny for inspeG�ian Ourppse5, Date: ta��/ g.i' Si9nature: � /�—� S• ,r - D�iver's License o� Social Secority k: �46 W�ue—BuAamq; GreO�—COGe EnlorcemenL Canerv—ApolicanL Pink—Reven�e: GOIEenrotl—Asansmr BLIIG PMT PLUHBING ELECTRIC NECHANIC ",FIRE SMP,PlTOT:� GRADING PLAN—�HECK aoi.so ., -� �i,,3 , , A:�9; 1f k!f if fk iE iflt if if iF if k it it if �F �f N M M k 1t k iFlF M N it iE if it �f iFif if * ff if it.if if K iF�f iFM it if iF iFit 1f if ikiFM �f it M!f ikif dlif iF 1k �f iFi4if 1F iF1FlFlf ik 14ik I N D I V I D U A L +� F-' E E� B^. R E A R�Ds O� W N TYPE QTY D E S C R I P T I O� N �'_ �, UNIT ;COST TOTAL COST SFA z 156 •DWE—TYPE V—WOOD �E �/ GOOD � '74,00 11,544.00 SFA 43000 ALTEA BY VALUE R£SID6NTIAI, NOZONE � 1.00 3,00'0;00 SFA 33351 T BY VALUE PER 51.00 'E '� 1.00 33,3 1. 0 END"OF FEES , -,� i: � �' �� . _ - �, .' ' �;�- e P� �.�t+�''aw , {� � 5�y � �., , . �c-. rc.�. o.�, ��z,j �//8� 93 -wa.- �.r . ' _ �-1'�. ._�.. ' . `��/�.. (r� �! � /�� , �'' \� �`� - f ,!`� � /'{' �-,� , p�l'Q19� . ' � �� . �� ; "ONS�k�UCC'�ON AND PLANNWG- � POC SPA � - Date Inspector Date Inspector �PPROVALS Permit # � APPROVALS Permit # � , ,. Temporary Electrical Service or Pole 52. Pool & Equipment L-�cauon� - Z. Soil Pipe,_Undrgrnd� � 53. Steel Reinforcement ' .-- a �b�c rica�o�iwZ�, . ility-Undrgrnd. �0. Forms s ��fSc£ricart7CoF�'wt-t�6drgrnd. %S� Electricai Bonding .� � �' 5� St: ReiAfor mE`� � _. �� _ �„ � � �S Rough Plumbing & Pressure Te`t� �; 1��T3.QCrica7UP'ff8"Gr»d. �53. APPflOVALTOCOVER-GUNl.�f _ � �,-• � �vF��ngs ,Y�r: � FS�. Electrical Conduit•Undrgrnd. ' r F'E;� � t-� (��"i9. Gas Pipe, O Undrgrnd., Test L � �oundatiow� , � 9. Water Pipe;,tJnc!'pgrnd. ti�0. Backwash Lines, P�Trap, O Undr�rnd. � 10.5tructuralrF.lom^SYstem �t. APPROVALTODECK � 1 i. Prop�erty SevGQr Lin�& House Conneaion ` 2, gackwash & ReceptorFinal �. � � 12. Se � Cap y y *;63. Heater & Vent•Pinal . �� - � 73. Roof Drains;-' � 64. Plumbing System - Final ' � '�^ 'Jf 14. Rough P�umbi�jy '' 65. Electrical-Final .'i 15. Rough Electrica4-Conduit - 66. Solar System-Final -- 16. Rough 2lectriC�Niring 67. Fencing & Access ApP�oval -� `; 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electric�•T Bar Ceiling 69. POOVSPASYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT c.T U'1-.T-, ,{ r� c. �I.UN 20.nRoGhR3ct FviAj�lace �x� Q7 * O.% tr'*:� ppR61/A �:?�Per�iit# ' >' '"''�• iT. � � �'�.A f�'r T.¢ � S %� '3'i:r, � �.'r+� -. ��. 21 ucis, iq,zStrQctur`�r i�.. ,..rS x S �. r-�+c :� �70. tdndergrvimcYHWro 22. u',�T'nti tin�� i :JS x� S :'f x i, product'�irg Q� s�'Oil IR �"'� y �; . ,R Y ♦ i 23.. a�'iP@�oi�h 8i��esc � a.� - � x � .-,.� ..� -r � i .a � a � :� C � c�S � T o' C n,c � 72. UndergioGl�d Flusf;•� A: "'�y ' �." '� .. `. � 24.�Ao6i Fr'aming S� i FF �•� �> O a�� y' .73�Undergm�Stor��.T'�hk E]Gas.�(3P,� •�� ' ( '7a,: g n r. � tiF f,. • 1 ✓. r C u �-; . __ 25. Rog(Sh�athin9 ,^�� d '�; ' �B.L�_F.� .� .� 74�@yertiyad�IYdro;� >� -f'"'�iG, •._. _ L 26.'�T-9a7 Ceiling (Stcuctural) &Ylortocoat:"•' F� s � t_t� r 75�brv Itemical �� K�-" G OeL:J ��Y " `' n. ^� . � .; . � .a .� r.,�{I; . %✓"„ .... r i- -c � J� *.5 ro !a�.ti .� - 27�rameaa� F�sh� _�� _ �/* ��p .` ¢r K 76. �YSta�d�ipe F,y x i m� - � (�� /• i-�8. Lathing�Sitlingv*i: �a2 tc��7i7.��t�- � tc 77�FIXED9,Y5TE ;�NALK� �' �'' �. f�� : _ �29. insulati � ' G �-! •. > •� m � r 7 � i •' (4>+x' . .-' ' -- Q5� . �;r S ..�n �c gK 78gFIREPREV.FINA{. !:> T� 4. ..�� . -.. � � t.e y�.�, r� Y '• r: < --� H£ALTFI�DEPT?RfQt'IR2M€NT � + � .�30. DrywalKNaikCAg '� � �, i �� t � � �: t . � C'- > 7 = C� p� t �1. Plaster �'row�jCc�af� S � ��, FC' �Z.7.�� ,� 9. -FINAL IN�P.ECTIt`�1 .� L,�+; ,��I r-.32.�+ElectricaYPower CGvtanFinaL• r [1� �Y N � z:� :80;*FOOD CERTIFI�ACYE ISSUED J 1 � y � �.33. in EI�j tri .t ^ :•' ^`'�c "r �! '' T'N �r. C�7 ��1 �. L� �� Yv` S 'K C7 I G 1, ac . KK 9 Z �B -=fTj'�r (L�jG YT_�sGY fl. ;,$4i�Fingj Heating�+&!�[>:Conditioni�� ":� ��: - = k � / `- C`5 �/ S , � ' �' J.. - , =� - . -, , �y-r� 4f'.' � (p�,r "�G_� Hi�*l�G�G�✓ � 35.��in�dl Gaa� Pif;Y'T�� ,�:C ^:r, x K �� :S/�� ,� *' S?'.O . . '�! N x h: 'r'�pNM�r�,. ,. �. w�✓� �,.. _T' t ,>. - �. . _ l`./ ' ••i/�� i-T�`� � � ��// /�� 36. oqd or�anoPY � J i[�^ -: �� r Ct � k x Z `Q�, -�,-:T'r' S �KA� f'�7C.Q/ r''�`tiTf� - .-, '�7 �-Fin91 Fa ory Fi, c� � S:T I.•:.1: x r �x x. C'• x �q :£� � r, i -�- 4.,�: : x � 3 =�.8 `� �� _� s�� e� �t f ' - } � T � .-38.cFindl Pli�nbicg S w ;u i , s (�i a-rw y.G t� . Y�t_ �,�G�'F`r14 =�-�t� :�9RNatFr S6F4ice'Fin I« ~' � �. . �Y � t • q q r -?' -' S n_'i / �/ '�/, - r. e�.xf � ;��)�'s. x. -i0' I�l'� .�:'�.='�J(1 " K�/�i ::;40`GasService- �nal "`` � /^ p'/ • ' �-" _. i X .r C!r rr S i � ' � r � x '-�7 � ! `�( �.^. � � . it �A"r2-�Gv_%�Z�L�E� :r`A1 �Solar pomeRlcFin�l� C�� •�'7: x Gs � s �p ` o x r.- • .. <� Y�/[-Q�i?.��•�,_ 42. 8ackflo •Preventer;� `� `�`: �'" � ' * b1 ��r_'-�-�� +N. x o_ . e: :, x e. x O/;S' �%7'� <ySe4 �i 9P,(�l2" . 43. Backflomrlrr;�atior+i '��s ��i " `x ' L 1' �C ;` • � Y M P�i3�Qt� � M cc cc ' � : s : x ,_. ;, . �44. Landscage IFi.iqatio� Systerr,�rr,{; :x' •�� ;�t :7 p ;'z: a r, ?; � r� .0 ooc . � �"A5:w�'ound A,ttenuatio * �-"��--' r'� : ' � r _ :.JX � �.., _ � _ i-q y � f 'n i=: ¢ -, . . �" • �i6:,Nandicap.RAgulati6ps � .a" •,�'� ...'�, . � � -�. '.' , �s .� .: -. �47.�IIVAL STRI�CTUFiE & BU.f�LDWilG `: * � ' ' '��5' � - � l� 'r ta r �: � X ' 48.:FIP1i4LPLANNIN� i �~ . ,_ - . � , n ¢ ._,_,�_ a19.rEleotric Release to Edison i a . �' �' r � � - '' : -��%:� "r,�-n t �('�_ - `_50.-�Gas�iel Sse to Sou�hem Calijoulid Gas Co �` ( . = � ;n r � "_- , .. . c � r • '•� ..k�. .'51. CEF�TIFICATE O�,ACCUPAN Y .>. =. � � x �co . No. Date - wot+ess a ewlwlG: y 4! i 1 7 1 ti J 1 w�r�xswu�iFa�wrc JOSEPii, DAVIL� R - ' �oopEs� JOSEPH, F30NNIE S 997 E lOTH ST COSTA MESI.,CA /ippL. WUIING AD�RE54 9'1627 UNf: �xcxfre.cronviaxFsn: HAROLD CASS ��: 5984 �XQp�:g�p�. P O HOX 130652 uM: HIG BEAR LAKE CA 92315 car+m�ctars xwe: caNm�croRs �uta+c �oox�ss ue xo_ uxr: UCENSED CONTNACTOHS DECLAFATION: I hereby eRkm under parely ot parjury ihet I em Icanaed uMer prwiume ol Cheqx 9 (mmme�ep xiih 5xtian )000) d Drvoon 3 d ihe &wmss eiM Prteariaw COEe. enE mY lieeme u in � 6xm eM Nled. cm uc. No.: uc. cuss: uc. No.: �t�' Deta: CoMmda: OWNEH BUIL�EP OECLANATION: I Iw1aCy e/firm under penely d perjury the� I em eomq hom tM COMretlon licenee lew fa Ihe Idlowuq raeeon (Setlion ]W 1.5 Businesa eed VMenions COEe: Any e1y a munry xfiiM laquirea e pa�mil to cawbuet, Mer, improve. bmolah. a ropai eiry struc�un, prior to ns bwvKe, dso raQuirea iM epd�� a wch pemin to fib a epMd sWertent Ihm ha n ahe IicenseA pumium to tM pwieiara ol Ne COMredon Lice�ae lew �Cheqa 9(wmmemip wi�h Sedion 1000) W D'weion 3(f tM �uarbsa ad Prdmaare Codel « ihm he a eM'v exemq �herelmm erd �M Ene la tM elk9� eRemNion. Am/ vblmian al Seaion ]031.5 by eny epplicem br e permil aubpea tM epplcent b e dvB panelry d no1 mae ihen Me h�rd�od dd4ie �f500p. � I, m owner dthe proparly a my emplryeea wYh weges ee thei eab mmpensetion, will do Iha v.wk. eM �he sVutlure e m1 mlendaL or oMered fm aele (�ian )006. Businem end Proleseians Code: Tha Gantrenwe L'u»nae lew Eoee not epply lo en ownerof propa�ly wM builEa w mprovas Ihereon, and xfio doee suM work Nmmtl or harsall w Mrap� he a her own mmpbyeee, pwided �hm wc� improvemeiva ere ml inleMed a dlxed lor ub. II. however.lhe Wikirq a inqwxnail u vold xilhin anY� d comWa�bn. tM owr�m-0uida will heve the burden at povi�p he a ahe d'd m� bwN «impma In the Wryose af sebl. � 1. as ovmer d �he propeM. em exdumvely mniredip wilh licenaetl canUacYae lo mnstr�p iha prajeU (Sedion ]OM. Bue'vwa end Proleaiom Code: TM Conirmma licenm law Caea ml apqy b en ovmer d pmpMy who buiNa a impwee thxean ard who �convecn la wch pro'aas mot � Ikemed nuent m the Co r a L ��emq ��d� s«�io�� ' �� B. d P: W br Ihia reeam: � r' � NO EMP L OY Daia: � � eo nereW cenM uie� �.m ewme d ene ud.nta�d ma reauiremew d cel�anie IbeAn ene seraN coee seevo usos. 2ss33. e�d 25550. and thm I«eny Mure buildi�p aaupenl will / wtll rw� (o�cY one) rieed �o wmpy wih aeH mele oodee uM Re requinme� br epe�mitlorcanavuciionormodif�celionhamtheRi u�0-eiiyirepemenlDietnG.ReeiEeMielconatiud'nneppicelioneanavmqlmmNaes a�s�a,a. Dete: AGW'ram: WOPKER'S COYPENS�TON DECLMATION: I hmeby dfirm urder penMy d parjwy ane d Me tdbwiiq dederetom: � I heve arM xil meiMan e cerlifcata d cortxnl to eap-inwre br workers mmpensetian, m provided Iw by Seqion 3)00 N �M laEa COGa.lor tha peifamence W Ihe wwk la which I�is pe�mil ie imued. � I have end wJ meiMein wwMere' mmPerueiion inwrerce. av mQuired M Setlian 3�U d iM lebor Code, br iM Cerbrmu�m d tM wak lar whiM iho pamn u iseueE. MY ��' �^Pe^�a^ imu�v�ea e�arwr eed pafiry numbsr ere: c�. Pdiry Numbar �This se Yion need iwt be complefeE! fM permR b lor one hwdispCWlars /S� W) m bae./ � I mrlily ihet in the peelormenea d the work la whch Ihie pamiN ie iesued. I ehdl mt empby erc/ penm in airy men�ror eo m �o becama euEjaq �o tM woikari romqnution lexs d Celilomie. eM pree thm M 1 YwuM Eecwne wbjetl lo iM MOMe�e' �omo«�� w�o� a sea� mao a ma �.e« em.. i.n.0 eonn.mn �wr wnn mo.o wo+�.. Dme: AppficenL Wem/np: FalNn ro uc�n woilren'romps�wtlon rovsrep� h unkwNl, enC aIWI sub/ecf en �mployx ro MMmI p�neMw eM clvll flroa up ro om hundrstl fMuuM tlo/kr� (f10q000), In etlrlltlon ro Ms ewt ol rompsnsetbM1 dameps u proHWA ror In Sxtlon 9]P6 0l Ms LaborCOW, Irrteroa4 aiW ettomsy's Iww CONSTIiUCT10N LFNdNO AOENCY: I Iwreby elfiim uMw peratly d pvjury ihat �here u a wnYwtion bMiiq epency lor Ihe pen«menm a �na waM �« wnirn ma v�� ie ewea (seaon 309%. cH. cl. LENUEH'S NNIE: ! �exoens�ooness:BREpEZEWI�.Y}^ A ACHES GARAGE I cenify Ihei I hem reed Nia epplicetion ��eis IM1bI�'aS� iY i wrtad. I eprte to mmpty wilh eIl ay eM oouny pdinenree �eMsteteleMeroletn9tobuJdiqcmmutlimerdMrebY � dihuceY�om�eruP��MMaa�meMiantlpiaperly bi�petlion purposes. �� Dete: � (5151de.WP) While-Build'vq 8$afely; OreeMFle; Cenery-App5ram: Pink-Rewnuei Galdenro�Mmssor CITY OF COSTA MESA — bUZLD2NG PERMIT' PERMIT NO: E 060399 PLAN CHECK NO: N r�xr� rvv: t nv� : laV . YY: CONSTRUCTIUN TYPE: PERMIT TYPE: ELE PORPOSE: ADD JOH DESCRIPTION : CONV 602SF GARAGE TO LIV SPACE, BATH ALT SQ FT: CLAZM VALUE: CALC—VALUE: , GROUP OCC: R-3 / COMMENTS: ENCLOSE 1565F HREEZEWAY , ALTER &ATHROOM, RE:#B60182 ***�*�****ic*it�+��e*�t*ae***�**�;�*�c*��**��*rt��***ir�*�***�**it��*��**�*�***��cat�*x�+F*** 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 ---- FRNT: FT IN REAR: FT LEFT: FT IN RGHT: FT PARiCING RE(2: PRUV: FLANNING NOTES> i iE iE if je �E 1k if iE if iF±f iE if if iF iF jF if jE iE iE iE iE iF i! iE ie �f iE D E V E L O P M E N T ZONING APPROVED BY . BUZLDING AP�ROVED BY : APPLICATION IS jE iF �E jf i� jE fE fE jF iF iE �Jf� iE ik LEGALIZATION:N ---- --------- ACCESSORY bUILDING -------- IN FRNT: FT IN REAR: FT IN IN LEFT: FT IN RGHT: FT IN PARCEL: 11739131 ZNE: REF NO: 1E iF iF iE �F iE if iE if if iF')E if X' 3E iE if iI' jE'IE'Jh #'JE iE �E')E ie iE'IE'� 3E'IE iE jE iE iE'JE'1F')E')E iF iE �1"t'J'r iE'iR E R V I C E S R E Q U I R E M E N T S F E E S U M M A R Y DATE: DATE: I'iATE � Z dF iE 1E iF'1E �f 3E iE iE ft 9c'iF STRUCTURAL SEGMENT:N HLDG PMT 1�Nt4bING ELECTRZC MECHANIC FIRE SMIP/RES GRADING PERMIT 98?�50 ; S'OY SMIP/NON—RES PLAN ii . • i ISSUE FEE !22��0,0 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 48.50 15.00 �;'�-- 0.00 63.50 63.50 .00 i � r+.l REVENUE DIVISION TOTALS--> Ct�LLECTED: 63.50 OVER/SHORT: .Ot7 BLDG PMT yLUMBING ELECTRIC MECH'ANIC FIRE SMIP/TOT GRADING PLAN—CHECK 70.50 ` o iF iE if 3E if if iE iE �k �E jf �F iE if 3E ii' �lE iE �f 9E �E iF �1f 1't if jf iF iE if 1E iF iF iF,if iE�iF ifliE iE �l@ iF iF � iF iE iF iE iE iE iE if if iE jf it if jF iElE 1E ii� if fE 1E iE iE �f -if aF 3f iE if if iE if it iF �74 iE I N D I V I D U A'I;• F E E B R E A K D O W N TYPE �iTY D E S C R I P T I� N UNZT COST 'TOTAL COST ELE 12 FIXTURES, LIGHTING'��1 ST 20 EA. .75 9.00 ELE 20 RECEPT/OUTLET !�• 1 ST 20 EA. .75 15.00 ELE 8 RECEPT/SWITCH ��'1 ST 20 EA. ,75 6.OG ELE 1 SERVICES BELOW 600�V'�& BELOW 201 AMP 18.50 18.SU =�ENU: OF FEES � .4 !� 1� T f. ''i�� .t � i CONSTNUCTION AND PLANNING POO. SPA - r APPROVALS Permit # � Date Inspector . APPROVALS Pesmit # Oate Inspector L Temporary Electricat Service or Pole 52..Pool & Equipment Locatioo 2, $oil Pipe•Undrgrnd. 53. Stee� Reinforcement 3.. Electrical Conduit Utility-Undrgrnd. 54. Forms ' � 4. Electrical Conduit�Undrgmd. � 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & pressure Test 6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE �.` � 7. Footings . 58. Electrirai Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, � Undrgrnd., Test . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, 0 Undrgrnd. 10. Structural Floor System � " 67. APPROVAL 70 DECK �� 11. Property Sewer Line & House Connection � . 62. Ba�icwash & Receptor•Final 12. Sewer Cap ., � 63. Heater & Vent-Fina� - � 13. Roof Drains � .' � 64: Plumbing System - Final . 74. Rough Plumbing -. � 65. EleCtrica6Final 15. Fough Electrical-Conduit� '� . , 6fi. Solar SYstem•Final , '' 16. Rouqh Electric Wiring - �.- � - 67: Fen.cing & Access ApProval - 17. Rough Wiring Sign ' � 68. APPROVEO FOR PLASTERING � 18. Rough Electrical�T Bar Ceiling � - -- • - 69. POOL/SPA SYSTEMS FINAt ' 19. Rnugh Heat'rng & Air Conditioning '� - FIRE DEPT. REnU1REMENT � 20. Rough Factory Ficeplace APPROVAIS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping O Gas O Od 23. Gas Pipe-Rough & Test 72. Underground FIUsh 24. Roof Framing _ 73. Undergmd.S[orageTank OGas ❑Oil 25. Rpof Sheathing . 74. Overhead Hydio 26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ' 7. FIXEO SYSTEM FINAL 29. Insulation . $, FIRE PREV. FINAL 30. Drywall Naiiing HEAITH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final ' 80. FOOD CERTIFICATE ISSUED 33. Finat Electric - Notes: �I Z2 -C17 /QG�{�%/�(�P�- 34. Final Heating & Air Conditioning v 3/.26_ _%Pg �eFf a�«� Xnoc� _,�-f 35. Fi�al Gas Pipe�Test 36. Hood or Canopy � � 37. Finaf FactorV Fireplace � , 38. Final Plumbing 39. Water Service-Final 40. G0s Service-Final 41. Solar pomestic-Final 42. Backflow Preventer - -43. Backflow frTigation 44. Landscape Irrigation System � 45. Sound Attenuation ' � 46. Handicap Regulations , � 47. PINAL STRUCTURE & BUILDING 48. FINAL PLANNING `' . 49. Electric Release to Edison + � 50. Gas Release to Southem California Gas Co "� . • 51. CERTIFICATE OF OCCUPANCY No. Date = YNOJECT FOOBESS: . Q Q%. E 19TH ��iT � , OWNER'S NFME: SOSEPI'I, bAV�iDfR a aooness: JOSEPH BONNIE S 497 E �OTH ST COSTA MESA,CA AXCH/ENGINEEfl: AODHESS: ' � UNIT: 92627 qEG.NO.: . .., UNIT: PEHMITTEE: DAVID JOSEPH ( 714 ) 646-1706 RUDBESS' Q Q�] E 1 9 TH ST COSTA MESA CA 92627 UCENSED CONTHFCTOfl OECLAHATION: I hereDy alfirm �hal I am bcensed untler provisions of C�dD�e� 9(commencing with $ec�ion 7000) o� Div�sion 3 oi Ihe Business antl Pmtessions Cotle, and my license is in full force and eHecl. CITY LIC.: STATE LIC.; CIASS: �aie: SiqnaNre: WOBKEflS' COMPENSATION DECIAflATION: I hereby aHirm that I have a ceM1ificate o� consen� �o self-insure or a certificate ot Woders' Compensation Insurance. or a certilied capy (hereof (Sec�ion 3800, Lab. C�. POLICY NO.: EXP. OATE: COMPANY: ❑ Cenifietl tapy is hereby fumished. ❑ Certifie0 capy is �iled wi�h ihe ciry Building Division. Jate: . ApDlicant'. EXEMPTION FBOM WOflNEflS' COMPENSPTION pECLAflRTIOR (This sec�ion nee0 no� be campleted ii the permi� is for one hunOred (5100) or less�. I cerlity �hal in the pedormance of �he work fo� which ��is permit is issued, I s�all no� employ any erson in any manner so as �0 6ecome suti eci to �he/ W'ork rs' CoQ ensation Laws ol Cali�omia. n � , � Oate: /./ ��/Z SignaNre: �+'^�'�, � NOTICE: II, aRer making this tleclaraiion, you should Oecome subleci �o Ihe WOBers' C�Densa�ion pmvisions ot ��e Labor Code. you must forthwith comply wi�� suth pmvisions or �his permi� shall be tleemetl �evokea. CONSTFUCTION LENOING PGENCY: I her¢by afhrm �hai there is a conStruCtiOn lentling agenCy for Ihe pedormanCe of �he work �or which �his permit is issued (Sectian 3097. Civ. C�. , LENDEN: aooREss: OWNEN BWLDEH DECIABpTION: I �ereby aflirm �hat I am exemp� irom the Contmctors' S�a�e License law �or the following reason (Section 703L5 6usines5 antl Protessional Catle: Any ci�y o� coun�y which repuires a permii �o cons�mc�, al�e�, impmve, demolish, or repair any s�mc�ure. pnor Io ils issuance, also requires Ihe applican� tor such permi� [o �ile a 5igne0 s�a[ement �ha� he/s�e is licensetl pursuan� �o ��e pmvisions of �he Contmctors' State License Law (Chap�er 9(commencing wi�h Sec�ion 70W) of Oivision 3 of Ihe Business ane Pmfessions Cotle) or �ha� helshe is ezemp� t�ere�ram an0 Ihe basis �or �he allegetl eKemplion. qny viola�ion o( Section 7031.5 hy any applicaM br a permi� su0le��s �he aDDlicam m a civil penalry o� no� more �han �ive hundre0 tlollars ($500). I. as owner of ihe propertV or my employees with wages as their sole compensation, will do the work, antl ihe ❑ stmc�ure is not in�ende0 or offeretl �� sale (Sec�ion 7044, 6usiness an0 Professional Code: The ConVactors' Sta�e License Law tloes na1 aDPty lo an awner o� a propeny who Ouiltls or impmves thereoq antl who tloes such work Aimsel�/hersel� or thmugh his or her own employees. provitlecl Iha� such improvemen�s are no� in�ended o� ofteretl �or sale. Ii, however the building or improvemeni is soltl within one yea� a( complelion, Ihe owner will have ��e burden ol proving he/5he Oitl not builtl or imD�ove _ lorihe purvase af sale). I. as owner of Ne pmpetly, am exclpsively conVac�ing wit� licensetl con�rac�ors to cans�mcf �he pmlec� (Sec[ion 7044, Business ❑ ana Pmfessians Co�e: The GonVaciors' Slaie License Law tloes nui apply �o an owner oi Omperty who builtls or improves thereon ana who conirac�s for suc� pmlect; with a contractm�s) license pursuan� �o �he Contrac�ors' Slaie License Law). I am awa�e Ihai proo� ot their Worker's Compensation insurance shoul0 be pmvitled m me. � I am exempt untler Seclion: $ F1'7 Q t� t} e. 8 P. C. mr mis �eason: ALL WORK HY OWNER oate: {_/ %� /�Z Owner I do hereby certi�y Na� I am aware o� an0 untlerstan0 the reQuiremen�s of Califomia Heal�h antl Sa�e�y Cotle Sec ns 25 O5, 25533, antl 2553G and Ihat I or any tuture building occupant wtll/will no� (circle one) neetl �o comply with said sta�e codes a Ihe requiremen�s Por a permit for conslmction or mo0ilicalion �mm Ihe Nir Ouali�y Managemen� OisVicL Resi�ential con5iruction applica�ions are exemp� �mm ��ese pmvisons. �a�e'. Npplicant: I hereby ceriify ihat I have reatl ihis applita�ion an0 s�aie �ha� ��e above in�orma�i0n is correCL I agre2 i0 Comply wilh all ciry antl Coun�y artlinances antl siate laws relaiing to bwltling constmction antl hereby aNhorite representaiivesof this ciry to en�er upon ihe above�men�ioned pmperiy for mspe iion purp ei _ I Oa�e'.�LO— !_//— Signamre: ��/1�{ oriver's ucense or soclal securi�y x: �—, �— � 1641-a6 Wbite-9uiltling, Green—COAe EnbrcemenL Canary—Applicanl: Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA.MESA — BUILDING PERMIT PERM NO; P 060101 PERMIT NO: P 060101 � PLAN CHECK NO: ' N GOVT; Y SUPP; N CONSTRUCTION TYPE: 5—N PERMIT TYPE; PLU PURPOSE; OTH JOB DESCRIPTION : RELOCATE GAS METER SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: RELOCATE GAS METER DUE TO 'CITY'S' CONSTRUCTION OF SIDEWALKS. iE iF iE iE 3t iE iF 1k 1f �k if if 1f i! if ik if 1t if if if �F iF iE if �F �F if 1k it iF 1k if ik iF iF iFlf k k�k iF �f if iE �E it �f ik �! IFlf k iE �f if i! iF iF if !F!f i! ik iF Ik 3f ik ik if if 1f k iE if 1Elt 3F iF 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 IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL; 11734131 ZNE: . REF NO; PLANNING NiSTES> i **�r�,�,��r�r�r**��,��r��r*�r*��**�***+��**��*;�e,�*�**�v��r��*�*,�,r�r*,�*****�*�*+��**�*�r�**� D E V E L O P M E N T S E R V''T�, C E S�'?' R'E�� Q U I R E M E N T 5 20NING APPROVED HY �.�� `'`; �.%} DATE: BUILDING APPROVED BY : _ �' ',` DATE: APPLICATION ISSUED BY; � u� DATE; �� iE�kikitiFiEikifkiklEiElklfiEiliflliFklFlf lkifiEiEiEiEiFiE1F3! iFi! �EiEiEiEKiEiElEiFiFfE1E�EfE1E1flElflFifiFiEiEiE�EiEiEfEfEiE1E�EiflEfEiFffiflFiE1F�ElEiFff1F !ElfiF3fiEiEtEiEiEiEiEiEiEiE9fiEiElE3EiEkiEikifiFifiElE*iF3k LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7,00 25Y SMIP/NON—RES PLAN ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> O.UO 0,00 0,00 REVENUE DIVISION TOTALS--> COLLECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE TOTAL PAID DUE 0.00 .00 ,00 .00 OVER/SHORT; 00 SMIP/TOT GRADING PLAN—CAECK iF iE iE �k iE if iE iE �E iF 1F iE if iF if iF IE ik iE ik iE 1F1f 3tiF iE 1E iF iF iF iE iF �E it iE 1! iE i! ik iE iE i! iF ik it iFif iFiF iE iE ik iElE 1E iElE �k iE iE lEiF iE if iF 1E iE 1E iF ik if at if IE iE iE iE iF iE , I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 GAS SERVICE 7,00 7,00 END OF FEES .� f � CONSTRUCTION AND PLANNING , POOL � A� �„� ' �APPROVALS Permif# " Date Inspector AppROVALS Permit# Date Inspector ' t. Temporary� Electrical Service or Pole 52. Pool & Equipment Location � � ,2 ,SoiLPipe-Undrgrnd., � " 53. Steel �ReinforcemeM � - �� ,�_ i : i . /•r _ . �3.;..Elec rical CondeiY �U'iility-Undrgrnd. - 54. �Forms � ��- l, " a-Elecirical Con�iYUndrgmd. - 55. Electncal Bonding� ' �.� `') '_� 5' SSeef Reinforcemeniy ' 56. Rough Plumbing & Pressure Test� - L '��6.%ElectricalUFER`Griid. . 57. APPROVALTOCOVER�GUNYT:E �� .. '*7��iootings �{'r . 58. Eiectrical Conduit-Undrgrnd. ' . � " 1��_' , t]. t-'T3. Foundation i- � 59. Gas Pipe, � Undrgrnd., Test ��, -t ,- 9. Water Pipe-Undrgmd. - � 60. Backwash Lines, P�Trap, O UndTgrnd. 10. Structural Floor Svstem _ - 67. APPROVAL TO DECK � � �11. Property Sewer Lirie & House Connection 62. Backwash & Receptor-Final --- 12. Sewer Cap -„ � 63. Heater & VerYt-Final � �,il 13. Roof Drains � '� 64. Plumbing System � Final . 7 �. 14. Rouqh Piumbing '� � Y� 65. Electrical-Final � 15. Rough Electicai-Conduit � 66. Solar System-Final _`,�• r�� 16. Rough ElectriC=Wiring 67. Fencing & Access Approval +� 17. Reugh WiringSign 68. APPROVED FOR PLASTERING�"� - 18. Rough Electrit�l-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL "19. Rough Heating & Air Conditioning � � - � FIRE DEPT. REQUI�REMENT �. r. -.,. _ ,_' . , r cr -.cc:- .c x - J 20;�Ro�gh �cto Y �ir2Place � x r � � �` � �!" ^ '{1PPR: V ^��Pe�mit # " � 1' R a Yt' .P :� X �# s ��_-{ �- ? -�."�- G. - _ � 21. -Duyts, in� StGuctu.r� i••r -+_� �. x"70. l�ndergxnuntl H�ziro r - „ 22� Duc#s, Vent'+IatinJ,. . «t �` ^ � �" `. ._. ",� .. 9'" - '71. Producl,P,�p�ng O'C�ias Oil 'S .1 . x C� x 'J rC r � - .� .4� _ 1 �... Gas_PipR,Ro�h &� est i ,c ;q a: n i; y �j < x. 72, Undergro¢nd FlustC »: �=� 24'r Rob F ming �_%� � ''-- ;; ; � � -r ,q � � ;73� Undergrnd. Storage Tank� Gas ❑ Oil 25. Ro"af S athin � '-' " '��d - . _ 9 � �r ,. v ., -� Y. -x �74�Overhead�Hydro',� 26�T�89r Ceiling (Strucwral) &`Monocoat ' = 7x � 75s Dry Chert.�jcal ` ^ �� -% ,.. � .. .. ', % �: ^ :D n .K � r- Tl . `�% � - . 27 �;Frame aad FIasF�ing; '�-{ x .,� ,J. y,.., � 76. Dry StandW.Pe r..,xj � r" '' - ��-28. LafAing& Siding� { "^ _�4_- 'X �.x .�. �'•�, y� 77� FIXED SY�TEf�Ai�INA�, _ t : � �'�29. Insulatiqn =;�x �� , �...• '� �i � � y �- k� � , < y. 78i-, FIRE P.,REV. FINR�L y�'z T30. Drywall'Nailing�r!t V a; '-��` � �'-'• •MEALTH�DEPTCR�EQUIR�EMENT , : �- '� n' � � 17 !". '-{31. Plaster�Biown Coak; � � �rir �� i�79�."F'INAL`IN�RECTIQN * ` "� -.�� '-32TElectrical Power�Met2'r�Fina4 �' '� '� �` ; .SO:nF00D CEFiTIFYC4l'TE I9SUED - .-, ,. � .. n �r , _ c- r. I (-# 1 C %�!T. '") tX{" r. - ;S X f ��33.�Final FKI.�,ctriS ;�;� r � � ,,� ;, ' NOtes: - y,� ;� .., U ,- :c34:��Finel Heating & Air. ConditionFng C; x A K x � ;�;_ x ._, = < 'il Z "+ K ��-' Y � S _ % '�,4 ('; C� !Y, �j .< 'e `j , 35� �Final Gas Pipe-T,est ,� , �� J�f ,r,�, i�, �_ -� r- r . . .r � • ' ' , �36. Hood or CanoPY- ;.. i rr -+ _, � .-, x :; - } ;jc ,. � r - , i.- �i . . � - � n � r, - .-_ � ; w� � � ! ; 737�Fin,�a) FaMory Fire�lace,. � "= �.'� '°'T -�a �' � ? �-,38. Final Plumbing 4_� s ' � J -- !` 3 Q7 � '� •._� _ 5 .-� x '- �cr h �=39. Wa'ter Service�Finaf• � � � � # _q . _ n � " -` . �_ v � 5,40.GasService-Finar;,.n e(o'^ 'i $ ��'xx c="u - � 41. Solar pomesticFinsG� i � " '� ' a � :� .: _ .tc -� -- A , �c ' � .-� � '�42�'Backflow Prevenie4 J s,� ,,�� - . .,� y � � x � ''-; , 43. Backflow Irpgatjorr � �� ' -'� ` " ^ ,z � « r � � : < .c x x :.j t". ;�44. Landscape Ifripa(ion SysterrL._�y: :; � i�? - <�" ;u ;3 �r[2 � . _. _ i'n '. -.,. . = 1� �'>; -, . _..xxt` - ' :�o cc 45..Sound Atte�uatioh � .. '� I'�. i r ri ±S t} �n �� ?, +c ' �T' .�; • _ a : '_. :.. "fl a..x � ,c - .. . .-. .' .. y " � \ K / .`'�,46:,,Handica,pRegulaYi¢,ns - �'" u; � -7_, � x 47vFIIVAL STRAICTIJflE & BUI�LDINGy x J � �"�'j'� { � % 1� `; ' ' .i i .L`3. � � fi �_ � ,T, i 48:FINALPt.FCNNING i';�Fc �~.� � I�t�`�x-.s'..' ; a � � : �49�; Electric Release toeEdison i �r j � K .� _ : � ii ' - x i :e �50.aGas,'RefeasetoSouthernCaliforniaGasCo ;; {��K„�.: � - . `'-� ' �51. CERTIFICATEOF;OCCUPANCV •; ta.s :�� _.=� r x . o No. Date ' � � • APO��anl to fi�l in all ipaces axcept those wit�in �eavy Dortler lines anE si9n all approoriate tleelarations. ciTytGF COSTA MESA CONSTRUCTION PERMIT � ProjectAddress �.E �q T� 5�• � Applicant's Mailing Address �� s��n'�--�'� � �� Owner's Name ��%� � � Phone Address 4�0 F �4 � $ � • ' Arch/Eng. • License No. Address `/ Convacror'sNam Y�lJ[e�r ��'�(C Phone�7 Addreu Imaiiingl � �'��v��0'L �.iF /i'/r% Ciry License No. � �1 IICENSED CONTRFCTOR DECLARATION I hereby affirm tnat 1 am Iicer�setl untler provisions of Cnarter 9(commencing with section ]000) of Divisio� 3 ot the Buslness antl,Professions Cotle, antl my license i5 in �ull t rc¢ tl¢«ect. ��0�� License Cla s No. Date �� Sl9natJ � WORKERS' COMPENSATION DEC ATION I nereby aftirm tnat I nave a certificate of consent to selLinmre or a certiticate ' Workers' Compensation Insurancn, or a certifietl coOY thereof (Section J00, Lab. C.) ' POlicy No. r COmpdny eCertifieA copy is hereby furNshetl. Certifietl capy i5 filetl with [he city Builtling Divislon. �ate Applitant EXEMPTION FROM WORKERS' COMPENSATION OECLARATION (This section neetl not be completetl if [he permit is tor one huntlretl (5300) or less). I certify that in the per/ormance ot Ihn work tor hi<h this perm�l iz �ssuetl, I I s�all not employ any pe�son ln any m�pyla�s�o become zubject [o the Date � i —�(Lp� Sig�awre � � NOTICE: If, after making this tlnclarati , you shoultl becoma SubjeGt to tha Workers' Compensation provis�ons of [he Labor Cotle, you must forthwith comply witn suc� p�ovlsion5 0� thls pe�mit shall Ce tleemea /evoked. CONSTRUCTION LENDING AGENCV ' 1 hereby affirm that there is a constructlon Ientling agency for the performance of the work for �whl<h th15 p¢rmit i5 IsSuetl (Section 309] Civ. CJ Lentler's Name �Lontler's Atltlress OWNER BUILDER.OECLARATION 1 hereby aftirm [hat I am exempt from the Contractor's License Law tor the followin9 reason (Section 7031.5 Business antl Professlonal Cotle: AnY city or county which rfquives a pe�mlt to ConStruct, al[er, imp�ove, tlemolisn or repai any structure, prbr to Ils issuance, also requires the applicant tor such permit to (ile a SlOnetl StatemGnt [hat Ile/she Is IicenS¢tl pur5uant t0 the p!O'/�sions ot oivi5ion 3 ot the Buslness ai�tl Protessions Coae) or that he/she is exempt 'herefrom antl the basis tor the alle9ed exemp[ion. Any vlolation of Section �31.5 by any applican[ for a permi[ subjects the applicant to a civil enalty ot not more [han tive huntlretl tlolla6 (5500). ❑ I; as owner of tM1u prope/ty or my employees wilh wages as their sole compensation, will tlo the work, antl tne strucWre i5 not intentletl or ofleretl for sale (Section ]044, BUSiness antl PrOf¢STional Cotle: The Coqtractor'S Li<ense Law tloes not apply to an owner of a property who builtls or improves [he�eon, dntl who tlaes SUGh �+'o/k himself/herself or through his o� h¢r own employees, p�ovitletl [hat suct� ImDrovements are not Intentletl or offeretl for sdl¢. It, howev¢r,-Ihe builtling o� imprOvemen[ i5 SOItl within One y¢a� ot com- pl¢tion, Ihe owne� will hav¢ the burtlen o( prOvin9 he/she tlia not builtl ot im- p�Ove tOr tM1e purpo5¢ Of Sale�. ❑ I, a5 owne� of the prOpertY, am ¢zclusivery contraCting with lice�setl con- Lratto�sto wn5[ruct the projeC[ ISCOI�UfI %044� BlIS10C55 dOd PfOi25510f�i COtlE: The Contractor's Licenze Law doe5 nOt apply lo dn owner ot property who builas or improves thereon, a�a who contra<ts tor such projects with a con- Vactor(51 IicenSe pursuant to the Contracior'S License Lawj. I' am aware that proof of tnelr Worker's ComPansatlon insurance shoultl be provitletl to me ❑ I am ezempt untler Section B. & P. C.4or (his reason Da[e _ I hereby informati� antl state sentatives insvection Signature � .,.,e.. _ Owner I have rea� I aaree to # 1 this aoP��ation antl state that tbe zbove comO�Y N'ith all city antl couniy ortlinances 9 �Onst�uctlon, antl hereby autho�ixe /ep�¢- u0on the above-mentionetl property for' �� TVPE OF'CONSTRUCTION LJ NEW LJ ADD LJ qLTERATION IJ REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHE DESCRIPTIONOFWORK/USEOFBLDG. ��t i TVPEOFPERMIT GRADING FOUNDATION ❑ STRUCTURAL ❑ TENANT ��ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION � SO. F7. oCCUaANCY � CONSTRUCTION TVPE � VALUATION $ ZONE GRADINGCU.YDS. � ACRES ' Remarki:, ' � Backflow Preventer ' Backflow Irrigation Bathtubs ' � Clarifiers Dishwasher . � Drinkin9 Fountains � Floor Drains . • Floor Sinks . Gas�Service� Outlets Interceptors ' Kitchen Sink - Lavatories ' P—Trap '. � Poof Draips Reinspection Fee $15 Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Neating System & Ducting ❑0.100,000 BTU �100,000 Hainspection Fee � $15 CMF 0965-46, rev. 10/B4 White - BUIItlMg; Canary - Applicant; Pink - Accountlng; Goltlenrotl - AziesSor Showers Service Sink Sewer Cap - Sewer Connection Solar Collectors ' Solar Piping . Solar Tank Swimming'Pool w/Spa' Urinal ' Water Closet Water Heater � - � WaterService• � Auto-Wash ' Isue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration System � ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers ' Issue Fee , . FEES $ 3 FEES $ 3 . 6933 II/10/86 A.P. # ' _ • _ � . ' 2ana S Ma�n Building: Accessory Building: E T Front ARear C Right. � � -� - " . - K g Left Ping. Ref. # Parking Req./Provided Planning Notes: � Automatic Wesher Construction Pole$ub. Cooking Unit Dishwasher Dryers��Gas ❑ElecEri Fan F.A.U. Fixtures . Device Boxes Outlets Switches - Garbage Disposal Generator O0.5 KW 05� ELECTRICAL Transformer ❑ 15-50 KW � 50+KW ' Meter up to 100 amps Meter ❑over 100amps Sub Panel Motors �0.1 HP 01 h- 8 Inc. Solar 09-15 HP �161 Pole Light � Range Si9n . Standing Sections 15 KW _ Yrash Compactor Reinspection Fee $15 Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Aonliwtion Issued Bv . _ _. SUMMARV OF FEES BUI�DING PERMIT $ SMIP . PLAN CHECK S PERMIT PLUMBING . § � ISSUANCE PLAN CHECK 25% $ ENERG� P.C. ELEC7FICAL $ �� GRADING PLAN CHECK 50% $ � MICROFILM MECHANICAL $ TOTALFEE 7LAN CHECK 25% �$ , $ 8.00 , TL Z O N 1 N G R E Q M T S � FEES � $ 3 CONSTRUCTION AND PLANNING , POOL & SPA APPROVALS Permit # Date .Inspector qppROVACS 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 UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas�Pipe; O Undrgrnd., Test 9. Water Pipe-Undrgrnd. .1 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final �4. Rough Piumbing 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 • 77, Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing � 73. Undergrnd. Storage Tank � Gas ❑ 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 _�f_ 80. FOOD CERTIFICATE I$SUED 33. Final Electric Notes:��13-F6 /I/`oij� 17 � �, 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 pomesticFinal � - 42. Backflow Preventer '43. Backflow Irrigatipn � . � 44. Landscape Irrigation System . 45. Sound Attenuation � 46. Handicap fiegulations . y� 47. FINALSTRUCTURE & BUILDING '�� 48. Special Requirements Completed . 49. Elearic Release to Edison - 50. Gas Release [o Sou[hern Ca�ifomia Gas Co � . 51. CERTIFICATEOFOCCUPANCY � � No. Dare _ __,�.,_ u � AOo��ant to flll�in all spatts except tnose within neavy boraer Iines ana sign all apo/opriate aeclarations. CITI' GF �"aST7CMES� A` �CONSTR UCTION PERMIT P MIT T TRACT NO. LOT NO. UNI^ T NO. � ►� �- �,�z�_ �� ,� Project Address �-�Z__E ApplicanYs Mailing Ad ress • ' Owner's nlame � �- - � hone Address , ��✓�&- %q5 ��JO�.�- Arch/Eng. License No. Address Convacror's Name ��LQJ �(7f.i� Phone="4-'=� � �? � Address (mailingl C " City License No. LICENSED CONTRACTOR DECLARATION I hereby affi�m tbat I am Iicensa0 untler provi5ion5 ot Chart<r 9(cOmmenUng with section ]000) of �ivi5ion 3 of the Business antl Professiont Cotle, antl my license is in /u❑ rte antl effect. • LicenzeqC�la-s�s� -"� 'rensa o Da[e �L '� Si9nature . WOHKERS' COMPENSATION DECLARATION � 1 nereby affirm that I nave a certiticate oi consent to snlf-insure r a certlficate � Workers' Compensation Insurance, or a cerii(ietl <opy Ihareo( (Section .00, Lab. C.) � olicy No. GomOany �.dy..i� ` eCertiile0 copy is hereby furnishea. Cert'fletl copy "5 (iletl wilh th¢ Uty Bui v i /j-/ �ate� APPlicant �A`�"^ . EXEMPTION FR M WORKERS' COMPENSATION DEC ARATIOfJ� (This section neetl not be comple[ed it the pGrmit IS for On¢ huntlrltl ( 00) Or iess) I certify that in th¢ Perfo�mance ot the work tor whl<h this p¢rm�t IS ISSu¢tl, I snall nol employ any pe�son in any mann¢r 50 az t0 become suEjecl to Ihe WorkerY Gompensation Laws ot Califomia. Date $i9nalure NOTICE: If,.after making this tleclaration, you shoultl betome suG�ect to the _ Workers' Compensation provisions oi the Labor Cotlo, you must forthwith comply wi[h such O�oviSions or this permit Shall be tleemetl tevok¢tl. CONSTRUCTION LENDING AGENCV I hereby atfirm tnat tfiere is a<onstructlon lentling agency for the Derformante ot the work for which tnis Oe�mit is iszuetl (SettiOn 3097 Clv. C.) Lentler'z Name Lender's AtltlreSs — OWNER BUILOEN �ECLARATION I hereby af(irm that I am ezemp[ from the Con[ractor's License Law for tbe lollowing reason (5¢ction ]031.5 Business antl Protessional Cotlek Any Uty or county wnicn requires a permit to construct, alter, improve, aemolish or repalr any st�uclur¢, priot to Its is5uance, also requires Ihe applicanl to/ Such parmlt '[o tile a Si9netl statem¢n[ that Ile/she i5 licensetl pur5u0nt [O [tl� Provi5ion5 0/ �, the Contractor's License Law (Chap[er 9(commencin9 wi[n Saction 7000) of ��Division &of [ne Business�antl Professions Cotle) or tnat he/sha is exempL �� here(rom antl the basis for th¢ allegetl exemption. Any violdtiOn Of $ecUon � `31.5 by any applicant for a permit subjects tha applicant to a clvil nalty of not more than five huntlretl tlollars (5500�. .J I; as Owne� of th¢ p�operty o� mY ¢mDloyees with wages as thelr sole compensatlon„will tlo the work, antl the Structule Is not Intentl<tl Or offeretl for sale (Section• 7044, Business antl Grofessional Cotle: The .Contractor's LiGense Law tloez not�apply t0 an own¢r Of a p�operty who builtl5 or imp�ov¢s thereon, antl who tloes sucn work himself/herseli or throu9h nis or her own employee5, provitletl that such improvement5 are nOt intendetl or otteretl tor sale. I/; howeveq tne builtling or improvement is soltl within one year ot com- pletion, tne owner will have the burtlan of proving he/she tlla not builtl or Im- prOve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensetl con- tra<tors to consHuct the project (Section �044, Business antl Professlons Code: The Contractor's License Law doe5 nOt apply to an owner of proper[y who bulltls or improves thereon, ana who contracts for such projects witn a con- tractor(s) i�cense pursuant to the Contractor's Litense Law). I am aware that proof of thelr WorkeYs Compensatlon,insurance shoWtl be provitlea to me. ❑ I am exempt under Sectlon B. & P. C. for this reason �ate I hereby certiry tha[ information is correct antl state laws relatin sentatives of this cit insoectlon purvoses Si9nature Drivers' License or 55 _ owner _ have reatl this upon tdte tltat-the dbova tl county ortllnances •by aulhoNze �ep/e- lonetl. properly for Da�n � � TVPE OFCONSTRUCTION LJ NEW I�ADO LJ ALTERATIOIa LI REPAIR � C❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' D_ESCRIPTIONR �p5.�( U�SE OF B DG. �ti�LQ�� '� M _� I7 I�It7 'KM. � 'QI�SID�t�+G�L TVPEOFPERMIT^— GRADING�� FOUNDATION RUCTURAL � TENANT llTELECTRICAL L�PLUMBING ❑ MECHANICAL O •OTHER PROJECT DESCRIPTION 5c�'�. oCCUPA CONSTRUCTIONTVPE �, VALUATION$ .ZONE GRADINGCU.VDS. ACRES v Preventer Irrigation Drinking Fountains Floor Dreins ' ' Floor.Sinks Gas'Service Outlets Interceptors . . Kitchen Sink � . avatpries '�• '� - —Tr2P .1 - IoohDrains' - � '- � �=' Reinspection Fee� $75 Boiler Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # � Heating System & Ducting ❑0�100,000 BTU 0100,000 Reinspection Fee � �$15 CMF 0865-46, rev. 10/84 Whi[e - guiltling: Canary - Appllcant; Pink - Accountlnq; Goltlenrotl - Assessor PIUMBING Service Sink ' Sewer Cap Sewer Connection $Oldf COIICCtOlS Solar Pipinq Solar Tank �' Swimming Pool w/Spa Urinal Water Closet Water,Heacer ( � Water,Service. Auto-Wash � Laundry Trays i J Isue Fee iANICAL Hood or Type I ❑ � Canopy Type I I '❑ Refrigeration System ❑aioo,000sru ❑ioo,000 System Repair/Alteration Fire Da ers . - Registers� i - luue Fea A.P. # — � S E T Front A Rear � C� Right• �� g Left Z � Ping. Ref. # � Planning Notes: �� Automatic Washer Construttion Pole Su6. Cooking Unit � Dishwasher Dryers ❑Gas ❑Eleci Fan F,A.U. Fixtures„ . N �_�. �L�-� - �. /! ' Zone Parking Req./Provided ELECTRICAL 2 O N I N G R E Q M T S Transformer ❑ 15�50 KW , "� 50+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel: � Motors �0.1 HP � i X- 8 Inc. Solar 09-15 HP 016-15+ Microwave Pole Light . Outleti �� '�' Range ' Switches � �i- . Sign' - Garbage Disposal � Standing Sections = j GeneraioC �0.5 KW,�5-15 KW Traih Compactor " $ 3 Reinspeaion Fee $15 FEES �DEVELOPMENTSERVICESF�E�UIR 2oning APProved BV-�� f��{,� ��%y Building Approved By ' $ 3 luue Fee SUMMARV-OP FEES � " BUILDING PERMIT� $ �r.s�• SMIP PLAN CHECK $ PERMIT PLUMBWG . , $ DO ISSUANCE PLAN CHECK 25% $ Ir S�l ENERGV P.C. ELECTRICAL , $ �� O GRADING PLANCHECK 50% $ O•t�U MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $� FEES 9 S 3 g D. SO �CONSTRUCTION AND PLANNING POOL & SPA � 1 APPROVALS Permit # Date ,Inspector, AppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' � 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plum6ing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings , S'S'j �L 58. Electrical Conduit-Undrgrnd. 8. Foundation � , 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Und�grnd. � . 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 12. Sewer Cap � - � 63. Heater & Vent-Final ' 13. Roof Drains � 64. Plumbing System - Final ' ' � 14. Rough Plumbing �� 65. Electrical-Final 75. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring p,�_�� . 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 t��,. 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating -' 71. Product Piping 0 Gas ❑ Oil � 23. Gas Pipe-Rough & Test 72. Underground Flush , . 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing g ��' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. FrameandFlashing 2��.D(f„ 76. DryStandpipe .• 28. thin & Siding a'6 ��- 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:B�Q D q�►� p/ ��- ��i 34. Final Heating & Air Conditioning �6 .`�K _ I_ �ST, O� D p, rv 35. Final Gas Pipe-Test . O 36. Hood or Canopy 37.`'Fihal Factory Fireplace 38. Final Plumbing 0 /�� ' 39.�WaterService-Final � � � i 40.' Gas Service-Final - '41. Solar pomestic-Final .42. Backflow Preventer 43. Backflow Irrigation � 44. Landscape Irrigation System 1 . , � ,45: Sound Attenuation 46. Handicap Regulations � � 47. FINAL STRUCTURE & BUILDING �� p� 48. Special Requirements Completed � 49. Elearic Release to Edison ' „ .�, 50. Gas Release to Southern California Gas Co ,� ". 51. CERTIFICATE OF OCCUPANCY ' � No. Date _ _ � � �ounfy of Orange Building Deparlmenf Room 322 Court Hause Annes $an#a Ana, California Phone: KI 2-6211 1. OWNER'S : APPLICATION FOR PERMIT � , ,930 ,� � \ t' MAILING ADDRESS !n :,t b /• -� � � h •4 T �+ (Svese or P. O. Bo No.) NAME /A/..rit lFY�� (Archit�ct or Enginaer) a� CITY Scatc I.ic. No. PfiRMIT NO. � n�� S 2' � CITY l"�/.�-��( A A I � L p[C�_ NAME,�Ii-u.UG� C�`-R�v'I �/"�r//, �.�( (Contncwr or Bui'�/r) � ADDRESS��_� �-O(-�/ i�� CITY �J : . . �.o--vl �� l`. � t a n '�+ - S[ate Lic. No. ` Phone L S 3� 2. JOB I,OCATION E� � % r � i' ��t l� `-�""- ".�/� '� � 'L'(�— . (Houw No.) � (N�me of SoreeH (Town ar Schooi Difaia,),�` �,' �/ � 3. LEGAL DESCRIPTION: Lo�-9 Blorl- � �� Tract ��/��(//�"'_ " /�u'� �^ 4. Meets and Bounds Description — Use Reversc Side of This Form. V �� /� S. CORNER LOT () INTERIOR LOT (�() THROUGH LOT () SLOPE OF LOT�.f1.1� K_ THIS AFPLICATION CANNOT BE P$OCESSED LTNLESS LEGAL DESCRIPTION , IS ACCURATE �YND COMPLETE. 6. PROPOSED WORK: New Building (xj New,SFmctyr.e O Addition O Repaic ( j Alterations (' ) � Move (.�) � Demolish ( ) Conversion ( ) 7. PROPOSED USE: ��/ �`=��-'�`-�qj' �"'U 8. SIZE OF BUILDIN['y�}�� D AREA�i ,� — SIZE OF LOT�P�� AREA �(z �- O� 9. CEILTNG HEIGHT� � TOTAL BUILDING HEIGHT � 3• NO. OF STORIES � ]0. NO. LIVING UNITS_� SIZE OF SMALLEST BEDROOM 9-ti k 9 CSIZE OF KITCHEN� 1 I. EXTERIOR WALL CONSTRUCI'ION: Brick O Concrete Tile O' .' Monolithic Concrete O Wood Frame (x) S[eel Framc ( )' Concrete Frame ( ) l2. WALL COVERING Wood (�O Metal .( ) Stucco (x) Other_�L� � �-�P l3. FRONT YARD SETBACK FROM CENTERLIIVE OF STREET ��J� 14. DISTANCE TO PROPERT]' LINE: Side Yard � O Rear Yard y/ _ 15. SHOW ON PLOT PLAN EXISTING BUILDINGS NOW 0[V LOT, STATE USE OF EACH. 16. DISTANCE IN FEET FROM PROPOSED BUILDING TO NEAREST EXISTING BLDG.� %I *�� l7. VALUATION OF PROPOSED WORK: Including All Labor, Plumbing, Electrical Wiring, Heating, Fire Sprink- lers, painting, Sewage Disposa[ $!� � 2�� 18. I HEREBY CERTIFY THAT TO THE BEST OF MY„ KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCT70N WORK WILL CONFORM TO ALL LAWS Or THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. � �- % p �� G' Plan Filed. SIGNED: r�!/�"* l`�� '� '~ ��`�✓'��/ ^-d Owner or Authoriud Age�u Date_ � - 1 2 - ,Sb gy '%1-s,P ? a[A _C� � r�l� _ i FOR DEPARTMENTAL USE ONLY 19. GROUP � TYPF � DISTRIC'I' MAP G"��i [Vp. � e o PERMIT FEE $-2 �� RECEIPT NO. �S� PAID TO ��-J DATE ��'� a-� CHECKING FEE $ RECEIPT NO. PAID D TF PERMIT GRANTED Z 19�, C• W. DONOHUE COUN7v BUi�aiNG � f FNSPceTAR-- PLANS CHECKED BY�/�j,� ��,/ • CHECK SH E �' • EPUTY APPROVED BY: . �, , HEALTH DEPT STATE FIRE MARSHAL STATE DIV. OF HOUSING ew-iz.+s �� County of Orange Building Deparfinenf Room 322 Court House Annez Sanfia Ana, California Phone: KI 2-6211 L OWNER'S N APPLICATION FOR PERMIT Z<tI S_4. ��, �;�� ,,� . � P&RMIT NO 3-� �-S 3 ____��-��-�--- , 19,�i O / �- PHONE: MAILIIVG ADDRESS G�� "l�V �� C1T6�' �""^� /''��/ // (S[ree�_P. O. Bo: No.) �A//!If �/ �"� ` �I � NAME v /�'� �� ' NAME �� (Arthittc[ or EnQineer) (Comncvor ar Builder� ,^ I� ^_ ADllRESS ADDRESS�v—'- 3 d � � � �� / CITY CITY � ��L //, �'� '�%� Scatc Lic. No. Phone Statc Lic. No. Y Phone a�� 2. JOB LOCATION—`�' 7` � z / 7!//.l /1/ "�r-✓t /` � i a K �'L- (Houao No,) p (N�ma of S�reeo� (Town or $choal Diaric�) / 3. LEGAL DESCRIPTION: Loc / Block �� u Tract_��d�tir�__��C�� 4. Meets and Bounds Description — Use Reverse Side of This Form. 5. CORNER LOT ( j INTERIOR LOT ( jO THROUGH LOT O SLOPE OF LOT �� ✓�-� THIS AFPLICATION CANNOT BE pROCESSED UNLESS LEGAL DESCRIPTION IS ACCUR�AND COMPLETE. 6. PROPOSED WORK: New Building (X) Alterations ( ) 7. PROPqSED New Sttutture ( ) Addition ( ) Repair ( ) Move ( ) Demolish ( ) Conversion ( ) 8. SIZE OF BUILDING � ��i� ARE� � 0 � SIZE OF LOT G o �.2 � AREA� � 2 O 9. CEILING HEIGHT Q TOTAL BUILDING HEIGHT ,LD NO. OF STORIBS 10. NO. LIVING UNITS SIZE OF SMALLEST BEDROOM SIZE OF KITCHEN 11. EXTERIOR WALL CONSTRUCTION: Brick () Concrete Tile () Monolithic Concrete () Wood Frame ( ) Steel Frame O Concrete Frame ( ) l2. WALL COVERI[VG: Wood O Metal ,( ) Stumo ('O Other_ 13. FRONT YARD SETBACK FROM CENTERLINE OF STREET � , � ��g1�� 14. DISTANCE TO PROPERTY LINE: Side Yard h �-Reer"`�Y�d� �� _ I5. SHOW ON PLOT PLAN EXISTING' BUILDINGS NOW ON LOT, STATE USE OF EACH. 16. DISTANCE IN FF.ET FROM PROPOSED BUILDING TO IVEAREST EXISTING BLDG.: 17 1 S. VALUATPON OP PROPOSED WORK: Including All Labor, Plumbing, Electrical Wiring, Heating, Fire Sprink- lers, Pain[ing, Sewage Disposal $ G�O, � d ' I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THER$TO. , _ Plan Filed. SIGNED: �—' M� A/�+ ��+'1 �' /T ��/I' � L�11 OM[[ Or AVlLO[izlA Ag M • � Date (.� - :L 2 — S� BYT'1.i��.Lt.%i� /�� (�� .d�(C FOR DEPARTMENTAL USE ONLY 19. GROUP •, T'YPF � DISTRICT MAP_� NO. �r PERMIT FEE $�� RECEIPT NO. 2`� PAID TO 7'�J DATE �� ^ a'?� CHECKING FEE $ RECEIPT NO. PAID TO_ PERMTT GRANTED Z 7 r 79 S a, PLANS CHECKED BY /�, � � �, / • �CI-3ECK SHEET, APPROVED BY: HEALTH DEPT. STAT� FIRE MARSHAL STATB DIV. OF HOUSING 6M-12��9 !NoP_;;TOR COUN1'Y OF ORANGE BUII.DING DEPT. 636 No. Broadway Santa Ma� CaGlornia Phonr. KI 26211 , . : Application for Buildin9 Permit AND FOR A Certificate of Use and �ccupancy Permit NoJ...L.�_3...1... - 3- .� v .,,,, �....: .. ..... .............. 1. OWNER'S NAME ..Y...I..1�-C(._L.L .._.V-:--.�-Q-U.P�/-, ........_- - --- _._. PHONE:6!FE}--...%Q.iR.>I.� MAILING ADDRESS- �_�-1....... C.'.......1.7 -�h --'�'t .... - - ...-- - ................ CITY_.�Q...S.T�/'..._X.:.!_�.5.�....... Name ... Acldre:=_ Cicy ----- Stxte Lic. No. (Architect or Engineer) Phonc................ .. A'amc Address City Statc Lic. 2 (Contrac[or) Yh on e ...............- PROPOSEDUSE:........-. -' --. ...` .1�- ........._ - -- - ..... - - ..._.__..._.. - ...- -- -- - - ._-- ... ... -...__ -- .............. �1�{��%- . �a,J/ JOB LOCATION ...�-T-.�.._......- _......��-��:�M...._.�'[.... - _.. �._l """�"` ......- ..........._........- (House No.) (Nam o treet) ' (Town or School District) i ,/ LEGAL DESCRIPTION: Lot�-E: �.Y.�:�a.. . 1Q - Block - ... ............... ` - "- Tract..��.T..........._._........... (Me[es and Bounds Description—Use rev se sidc of for� - CORNER L07 ( ) fNTER R LOT (�) THROUGH LOT ( ) SLOPE OF LOT ( ) /�,,�Q�i NO I.y�7 AREA:../ SIZE OF BLDG.:----wQ.�.�'O-.......AREA:-------�ll? .!�(�:SIZE OF L07:--...-. ---�. ---./..-.---- 7(�..YQ/�.. ,... �(�. u�v (�.�� V HEIGHT OF BLDG.:___......�I�:�:t ..............CEILING HEIGHT:......Q...�j=.!'............._NO. OF STORIES_.��................. i(/ D NO. FAMILIES._------__ .. ..................._Size of Smallest Bedroom:---..........---...._.......---......--- Size of Kirchen----.--._--_` ..............-.-- F. EXTERIOR WALL CONSTRUCTION (Frame, Smcco, $tc.) q � �i ERIOR WALL COVERING ........................ ................ (PlascerDrywall, Etc.) SETBACKS: Front Yar From Center Line of Street_----------/..V-_-�'...._ ........................ .._....-.--..--.._..-.----...-.--_- Nearest Sidc Yard..._�.'✓.. .....Rear Yard..J.Q ._...Distance in Fcet Between Bldgs. on Same Lot......�� ................ A COMPLE7'E PLOT PL N IS REQUIRED,�SHOWING ALL STRUCTURES AND USE OF EACH. GI For (a} Footing: Width.----------�� -------------..Depth in Ground--'----'�.........._.Width of Wall..._ ................-......... .......... Accessory ! Bldgs. and b Size of Smds:__..:?.......-�- . Similaz � � � � ------..Spacing-------._�.V� .............'CC Material of Floor-----'--�-- -'- - _ -'- ---......... Strucmres: _, (c) Sizc of Floor Joists:-----.--^J-------.__.._.Spacing......_._`.........._.......--.-------...CC (d) �ize of Rafters:.---------v �-- ��-------....---Spacing............r...�--�----------- �CC 12. VALUATION OF_ PROPO ED W � Induding al] labor, plumbing, elecvical wiring, heating; fire =_prinkler:, painting :md eewage disposal $-------�_Z....- -----_�..... 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KI�'OWLEDGE AND BELIEF THE •INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM ?O ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CAL1F0&NIA APPLICABLE THERETO. 5 i g n e d:---" ��...<..�_�..-. ----�F.."% �.6.Fr?�.::... _� --- ....................... / IS� Z.� � (Owpefj Plans Filed:--_..-�� --�/- .... ........ ......................._BY --- �- ..__ .................................. -- .._._...........-- .............._...._. ' (Authorized Agent) FOR DEPARTMENTAL USE ONLY FEES: Bldg. Permit Plan Check Total - - Receipt No. Paid ro • DATE..... .. . -- ...... ... L ................. � 3��- 9 M-O-•vl GROUP ... �.t.. _.......... TYPE..........�.. - DIST. �J �i7 MAP....�.1.......V'.-.. �.--....._. SHEET NO.._.. -�-------------_. 1:3'! APPLICAT ZONING ...................� FIRE PLAI�tS AND MARSHAL ......................... SPEC'S.. ....- - � STATE..._:........ ---- ..... CORRECTIONS ENGINEER ��