HomeMy WebLinkAbout408 18TH ST - Building Permits(7ta) �Sa-52�3 • Fax (7�a) 75a-ae5s • www.ci.costa-mesa.��LDING PERMIT �� FAIH UHIVt, GV51 A MtJA, GH 8LOG0
Job nddress; 408 E 18TH ST
SuitC:
Vicinity;
Parcel Number: 11733239
Appliwnt: SCOTT GRANGER
Address:
Owner: GRANGER, SCOTT
Address 408 E 18TH ST
� COSTA MESA, CA
Contractqr:
Address:
Zip:
Arch :
Address:
Phone:
Zoning:
Phone: 949-6603541 �
Zip:
Phone: 949-6603541
Zip: 92627
Phone:
License:
Eng:
Address:
Status: ISSUED
Applied: 09I29/2000
Issued: 09/29/2000
ISSUED BV:
• �
� �/
►
/iV
►
Phone:
Zip: , , License: License: �
SCOPE OF PERMIT '
" REMODEL EXISTING 2 BATHROOMS, INSTALL NEW BATH-TUB. • , '.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Oth2r:
Inspection:
Total
$72.31
$111.25
$0.50
$0.00
$0.00
$0.00
$184.06
SETBACK$,� � ."
MAIN STRUCTURE�Front 0- 0
ACCESSORY Front- 0-0
PARKING Ex�"stfnq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEESUMMARY
PLANNING & ZONING
Le(l 0- 0
LeN 0- 0
�Proposed: 0
Calc Valuation:
Claim Valuation: �
�� � � �.
�
Right, _0-0;, � �,'' •
i •
Rigtit 0-0� '-'
$4,900.00
$4�,900.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regula[ions. (Ord. No. 92-28, § 1, 1241-92)
EXPIHATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days. .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred inspaetlona and (inal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
24a6�4616/00)
WORKERS'COMPENSAnON DECLARATON:
I hereby aNirm under penelry of perjury one of the lollowing declarations:
❑ I have end will maintein a cenificate oi wnsent ta seli-Insure for workers' compensation, as provitletl fw by section 3700 of ihe LeDor Cotle, tor ihe peAortnence ot Ihe
work far w�ich this pertnit Is issued.
❑ I have and will maintain workers' oompensation insurflnce, es required by secUon 3700 of Iha Lebor Code, for Ihe pertormance ot the work for which this pertnll is issuetl.
My workers' wmpensation Insurance carner antl policy number era:
Cartier. Policy Number.
(This section neetl nof be canpleted il fhe permit is velued ef one hundred dWlers ($100) or less.)
❑ I certity that in the p9dortnance ot tha work tor which Nis permit is iuued, I st�all not employ flny person in eny menner so as to become subjact to the workers'
compensetion lews o� Califomie, and agree thet if I should bewme subject ro the workers' compensation provislons ot Section 3700 0l ihe Labor Code, I shell forthwith
comply with Ihese prohsions.
Applicant Signature: Date:
WARNING: FAIWRE TO SEWRE WORKERS' COMPENSATION CpVEMGE IS UMAWFUL ANO SHALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES M1D CML FlNES UP TOONE HUNDRED
THWSAND DOLLAFE (5100,OW). IN AODfrION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3lOB OF THE IABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTOAS DECLARATION:
I hereby attirm that I em licensed under provislons ot Chapter 9(commencing wit� Section 7000) of Division 3 ot Ihe Business antl Professions Code, antl my license is in full
force end eftecc Uc. a Class a
Comractors�Slgnawre: Date:
CONSTRLLCTION LENDING AGENCY: .
❑ I �ereby atfirm that IM1ere is a construction lending egency for ihe peAormance of the work for which Ihis permit is issued. (Sec. 3097, Civil Code).
Lendels Name: Lenders Atltlress:
Signeture: Oate:
I hereby aHirm IhePurid'ai.penalry ot pei�ury IhePl am EXEMPT FROM TME CONTRAC70RS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business and Protessions
Code: Any ciry or couny which raqmres°e permit to consiruct, alter, improve, demolish, or repeir eny siructure, prior to its issuance, elso requires Ihe epplicant tor such permit
to lile e signetl stetement that he or sFe'141lcensetl pursuant to the pmvlslons of Ihe Contractors Licensa Law (Chepter 9(commencing with Section 7000) ol Dlvlsion 3 ot ihe
Businass and�Professions Code) or that he or she is exempt theretrom antl t�e basis for the alleged exemption. Any violation of Sec6on 70.31.5 by any epplicent for e pertnit
subjects the applicant to e a�� penalry oCno6more than five �undred dWlers ($500).J:
❑ I, as owner ol ihe pwpeey or my employeas with wages as their sole compensation, WILL DO THE WORK, and t�e sirucNre is not intentled or oHeretl for sale (Sec.
7044, Business and P�ofessions Cotle: The Contrectors License Lew does not apply to en owner af properry who builtls or imp�oves t�ereon, and who tloes such work
himseN or herseli or ihrough hls or her own employees, provitled ihat such improvements are not intended or oNered for sale. If, however, Ihe building or improvament is
sold within one year o� completion, �he owner-builder will heve ihe burden of proving ihat he or she did not 6uild or improve for purpose of sale.).
I, as owner of the proPerty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Prolessions
Cade: The coniractars License Lew tloes not apply to an owner ot property who bullds or Improves ihereon, antl who coniracts lor such projact with e contractor(s)
license pursuent to tha Coniractors License Lews.).
❑ I am exempt und ' �
7 SlgnaNre: �
Owner ID venfietl by dnvers
�—�
❑ ves ❑ No
Business entl Pmfessions Cade br ihis reas
� Data: �
Drivets �cense No. �
Verification ot Ownarship by (Npe ol dwumen6 La. - property lax bill or aeetl):
DIVISION OF INDUSTRIA4 SAFETY PERMIT CERTIFICATION:
Expires:
❑ I hereby cenify that no excavation fiva (5) or more feet in depih into which a person is required to tlescend, will be meCe in connectlon with work authorizetl by this
permit, afM ihat �ro bUi�difg structuce, scallolding, talsework, a demolition or dismaMling ihereot, wilV be mrne ihan ihirry-six (38) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Tille 8, Celifomie Adminisiretive Cade).
❑ As owner-builtler, I Will not employ anyone to tlo work which would require a permil lrom the Division of Industrial Safery, es noted ebove, unleu such person hes e
pertnit to do suc� work irom the division.
Signature: Date:
Division of Indusirial Safery Permit Number.
CER7IFlCATE OF COMPLIANCE AND AUfHORIZATON OF ENTRY: I certify under penalry of perjury that I have read this application end state tha� ihe iniormation given is
correct. I agree to comply Wi -41 stat aws and ciry ortlinences relating to building construction, and authorize represeniaWes of Ihe Ciry of Cos Mesa to enter upon the
ebovadescribed propem/ for n i purposes. I agrea noI to acupy or ellow occupancy ot e9y building authorized by Ihis pertnit until tinel inspe i�n.
/ D�
Signalure LegalOwner(s) Date
And/Or Authonzetl Applicant
COOE �. INSPECTION TYPE
1616 Fixetl System Fina� Fire Prevention
1266 Pool Spa Finel
200 Final Re-Roof
201 Final BIocWRe�aining Wall
202 Final Factory Fire P�ace
203 Final Sign
204 Final Damolition
pAg Iti�Lfl
COUEI INSPECTIONTYPE �
208 Final Mechanical
208 Final Plumbing
210 Final Elecldcal
212 Final Fire Preventlon
220 Final Planning Approval
222 Fiaal Site
250 Final Building/Occupancy
P,IF.
(714) 75a-5273 • Fax (71a) �54-4856 • www.ci.costa-mesa.ca.us 77 FAIH UMNt, GV51 A MtJA, GH `JLOZD
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant
Atldress:
Owner:
Address
Contractor:
Address:
ISSUE FEE
Temp service test
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool / Spa '
Lighting Fixts
Recept Outl��s �
Switches ,
Non Res App1 �
Res Appl
Service to ZOOa . �
Service to 1tl00a� �
Service over t000a
Motors to 1 hp
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communica(ion drops
Sub panel to 200a
Pole Light Pkg
Sign Circuitg
Temp Pwr Pole
Intermed Pole
408 E 18TH ST
11733239
SCOTT GRANGER
GRANGER,SCOTT
408 E 18TH ST �
COSTA MESA, CA
Phone: 949-6603541
Zip:
Phone: 949-660-3541
Zip: 92627
Phone:
' Zip:
License:
status: ISSUED
Applied: 09/29/Z000
Issued: 09I292000
ISSUED BY: �F�
�
� • ' I'`
, .,
- I
�'
SCOPE OF PERMIT
REMODEL EXISTING 2 BATHROOMS, INSTALL NEW BATH-TUB. INSTALL 1FIXTURE, 20UTLETS,
2SWITCHES AND 1 RESIDENTIAKL APPCIANCE, RE:B00-01560. � �--
$23.50
$0.00
50.00
$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
$5.50 -
$0.00
$0.00
$0.00
50.00
$0.00
FEE SUMMARY ,,
Quaritity .. � � �
0
0
0
0
0
0
Q . .
,Q .
0
� `0 .
Q' � ,
0
0
0
0
0
5
0
0
0
0
0
- Temp Dist System / Lighting '
Busway /100 ft
Standing Section
Misc Electrical Equipment
Transformers 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 / Ckt ��
Misa Conduit
� Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights) ,
Chdstmas Tree Stand
Fireworks Stand �
Other Electrical Fee ,
Investigation Fee
Plan Check Fee
Reinspedion Fee
Quantity
50.00 0
$0.00 0
50.00 0
$18.20 1 ,.
$0.00 0
$0.00 .,0 � .
$0.00 0 '
$0.00 . 0
$0.00 �- 0 _
$0.00 -" 0
50.00 0
$0.00 0
"$0.00' �� ,;0
; $0.00 � � � 0
$0.00 0
$0.00 0 ,
.$0.00 � � 0�"
$0.00 .
�
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES §47.20
COMMENTS / SPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and re�ated
regulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a penod of 180 days. • � .
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred In�pectiona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
Z44B-66 (&Wl
WOflKERS' COMPENSA'nON DECLARATION: �
I �eraby ettirm under pena�ry of perjury one of lhe lollowing declarations: ' '
❑ I heve end will melntain e certificate of consent to seli-Insure for workers' compensetion, es provided tor by section 3700 of the Lebor Code, for the pedormence of the
work for which this pennil is iuued. .
❑ I have antl will mainta�� woAcers' compensation insuranca, es requiretl by section 3700 ot I�e Labor Code, tor tha peAortnance of the work for which tttis pertnil is issued.
My workers' compense��on Insurance cartier entl pdicy number ere:
Cartier. Policy Number.
(This section need nof be Gomple(ed il fhe permit Is ve/uetl e! one huntlretl dollars ($ I00J or Iess.J
❑ I certify Ihet in Ihe pertormance of ihe work for w�ich this pertnit Is issued, I s�all not employ any pereon in eny manner so as l0 6ecome su6ject to the workers'
compensetion lews tl� Callfornia, entl agree thet If I should become subject to ihe workers' compensetion provisions of Sectlon 3700 0l the Lebor Cotle, I shell forihwith
comply with these provisions.
Applicant Signature: Date:
WARNING: FNLURE TO SECUAE WORKERS' ODMPENSATION COVEMGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE HUNDRED
THOUSPND DOLLARE (E10U,OW). IN ADDITION TOTHE COS70F 001APENSATION, DAMNGES AS PROVIDED FOR IN SEGf10N 3%O60F TME IABOR COOE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy ettirm that I am Iicensed under provisions of Chapter 9(commencing wilh Section 7000) 01 Divislon 3 of t�e Business and Professions Code, antl my license is in full
lorce end eHecl. Lic, a Class N
Contractors Signature: Dete:
CONSTRUCTIQN LENOING AGENCV:
❑ I �ereby attirtn that Ihere is a consiruction lending egency for the pedortnance ol Ihe work for which this pefmit is issuetl. (Sec. 3097, Civil Code).
Lendars Name: Lenders Adtlress:
Signature:
Date:
OWNER-BUILDER DECLMATIONS:
I hereby aHirtn the� under penalty of Derjury thet I em EXEMPT FROM 7ME CONTRACTORS LICENSE LAW for Ihe tollowing reeson (Sec. 7031.5, Business end Professions
Code: Any ciry or counry wh�ch requires e pertnit to construct, alter, improve, demolish, or repair any slrucNre, pnor to its issuance, also requires the epplicant tor such pertnit
to file e signetl statement that �e or she is Ilcensetl pureuaN ro the pmvisions of Ihe Contreqors License Lew (Chapter 9(commendng with Sectlon 7000) ol Dlvision 3 ot Ne
Business and Professions Code) or that he or she is exempt Nerefrom antl the basis lor the alleqed exemption. Any violation of Sec�ion 7031.5 by any epplicant for e pertnit
sublecis ihe epplicant to e d�il penalty ot not more then five hunCred dollars ($500).):
��.
❑ I, as owner o� Ihe propeny,,or.my employees with wages es �heir sole compensation, WILL DO THE WORK, entl the slructure is not intentletl or offerad for sale (Sec.
7044, Business�and P�ofessions Code: The Contraciors License Law does not epply to an owner of property who builds or improves thereon, and who does such work
himself or herseH or�lMou9h his or her own employeas, providetl ihat such improvemeMs are not intantled or oiFeratl for sale. If, however, the building or improvement is
sold within one year o� �mpletion; ihe'owner-builder will have Ihe burden oi proving that he or she tlid not build or improve for purpose of saleJ.
❑ I, as owner oi.the propetly, am EXCWSNELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolecl (Sec. 7044, Business and Professions
Code: The contractor5 Lkense Law tloes not epply to en owner oi Ompetly who builtls or Improves ihereon, and who contrects br such project with e contractor(s)
licen5e pursuanl to Ihe Conlractors License Lews.).
❑ I am exempt under se��
Signature:
Business entl Professions Code for ihis reason:
Owner ID vanfied by tlriver's license. " QNes ❑ No Drivefs License No. � � Expires:
Venfication ot Ownership by (rype of document, I.e. - property taz bill or deed):��y (� �
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby certify Ihai n0 ezcavation five (5) or more feet in tlepth Into which a person Is requiretl to descend, will be made in connectlon with work authorized by �his
pertnit, and that no building strucNra, scaHolding, falsework, or demoliiion or tlismantling thereoi, will tre more lhan Uurty-six (36) teat high. (Ghap. 32, Gry 2, AM1 2, Sec.
341, Title 8, Celitomia Atlminislrative Code).
❑ As owner-builder, I will nat employ anyone lo do work which woultl require e pertnit from ihe Division of Industrial Safery, es noted ebove, unless such person has e
permit to do such work hom the division.
Signature: Date:
Division of Industnal Salety Permit Numbar:
�
CERTIFlCATE OF COMPIJANCE AND AUiHOR1ZAT10N OF ENTfiV: I cenity under penalry ol perjury that I �ave reatl this application antl state t�at ihe information given is
cortect. I agree to Compty w�th ell state laws end ciry ordinences relaGng to bullAing consiruction, antl euthorize representatives ol the Ciry of Costa Mesa to enter upon ihe
above-tlescribad prope Ip����i�� urp� agree not to occupy or ellow occupancy oi eny building authorized by Ihis pertnit until tinel in pecti .
/ _y�U v
ture LegalOwner(s) Dat
IAnd/Or Authorized Applicant Date I
tooe �. ixsveenoxrrve
1616 Fixed System Final Fira Prevention
1266 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetalning Wall
202 Final Factory Fire Plece
203 FinalSign
204 Final Demolition
PAIF IIII�Ifi
COOE 1 INSPEC710N TYPE
206 Flnal Machanical
20B Final Plumhing
210 Final Electncel
212 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
PAIE
0
��w_ .
(��a) 75a-5273 • Fax (7�a) 754-a856 • www.ci.costa-mesa.ca.us 77 hAIM UHIVt, GVS �A mtan, �.N azom
1ob Address: 408 E 18TH ST
Suite No
Vicinity:
Parcel Nunmber: 11733239
Applicant: SCOTT GRANGER
Address:
Owner: GRANGER, SCOTI"
Address 408 E 18TH ST
COSTA MESA, CA
Contractor. � � �
Address:
Arch / Eng :
Address:
PLUMBING PERMIT
Phone: 949-6603547
Zip:
Phone: 949-6603541
Zip:, 92627
Phone:
Zip:
License:
Phone:
Zip:
License:
Status: ISSUED
Applied: 09/29/2000
Issued: 09/2912000
ISSUED BY: C �
� '
+ ��r
. ! ��
1'
SCOPE OF PERMIT
REMODEL EXISTING 2 BATHROOMS, INSTALL NEW BATH-TUB. RELOCATE 1 WASH BASIN AND 1 WATER
CLOSET, RE:800.01560. � � - -
ISSUE FEE
Backflow irrigation
BackFlow Preventer
BathWb
Clarifier System
Connect (Ice,Soda,etc) ��,
Dental Units
Dishwasher
Draiq Floor
Drain, Rainwater
Draiq Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
Gas (1-4 outlets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Inierceptore (Grease, Oil)
InterceptorS (Sand Auto )
AMT
$23.50
$0.00
$0.00
$9.80
$0.00
$0.00
so.00
30.00
50.00
50.00
50.00
so.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
so.00
$0.00
�
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landswpe Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
�Process Piping (per 10 ft) $0.00
Receptore $0.00
Septic Tank � 50.00
Sewer Cap for Demo 50.00
Sewer Connect . 50.00
Sewer Private Line � $0.00
Shower $0.00
Sink, bar 50.00
Sink, wmmercial $0.00
Sink, Floor � $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
QTY
0
0 -
0
0
0
0-
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
SumpPump ' ,
' � Swimming Pool
Trep Primer . �
-Urinal �, � ' .
.. � Vacuum Brkr BkBow(1-4)
, Vacuum Bikr Bkflow(5+)
' Wash Basin '
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater I vent
Water Piping Qnst or Rep.)
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
50.00
80.00
$0.00
$0.00
$0.00
$0.00
$9.80
$0.00
$0.00
$9.80
50.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: E52.90
QTY
0
0
0
0
0
0
1
0
0
1
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or ii work is suspended or abandoned
for a period of 1 BO days. -
INSPECTIONS: In order for the work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all
requlred inspeetions end final epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545628
24a8d8 (8�00)
WORKERS'COMPENSAnONDECIARAnON:
I hereDy eHirm under penalry ot perjury one oi ihe tdlowing tledaratlons:
❑ I heve entl wlll maintein e certificate ol consent to sell-Insure tor workers' compensatlon, es providetl for by sectlon 3700 oi Ihe Le6or Caea, for Ne pertortnance ol the
work for w�ic� Ihis pertnit is issuetl.
❑ I have arM will maintaln workers' compensation Insurence, as requirea by section 3700 of the Lebor Code, for ihe peAortnence of the work for which Ihls pertnit is issuetl.
My workers' compensatlon Insurence carrier enA polity number ere:
CerAer. Policy Number:
(Thls secHon neetl no( be completed i! the pertNNs ve/ued er are nundred dollars ($ 700) or /ess.)
❑ I certity Ihat In the peAormance of the work tor whlch Ihis permit is Issued, I shall not employ eny pereon In eny menner so es to become subleci �o the woAcera'
compensatlon lews ot Califomla, and agrea that tl I shoulE becane suC�ect to the workers' compensetlon proWslons af Sectlon 3700 0l Ihe Lehor Code, 1 shell torthwit�
comply wlth these provisions.
ApPllcant Slgnature: Delo:
WARNINO: FARURE TO SEWRE WOPo(ERS' OOMPENSATION COVEMGE IS UMAWFUL M!D SHALL SUBJEG! AN EMPLOVER RJ CRIMINAL PENALTIES M!D CML FlNES UP TO ONE HUNDRED
TqUSAND OOLLARE (5100.000), IN ADIXiION TO THE COST OF Op.IPENSATION, OAMAGES r15 PHOVI�ED FOR IN SECfION 3108OF THE IABOF CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eXirm Ihat I am licensed under provisions ol C�apter 8(commenong with Section 7000) at Division 3 0l the Business antl Protessians Cotle, entl my license is In tull
rome ena enect. uc. a ciass a
Conlrectors Signature: Deta:
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirtn thet t�ere is a consiruction lending egency lor ihe Oertormance of Ihe work for which Ihis permit is Issued. (Sec. 3097, Givil Code).
Lendefs Neme: Lentlels Address:
Signeture: _
OWNER-BUILDER DECLAflAT10NS:
Date:
I hereby eXirtn thet untler penalry ot perjury ihat I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for Ihe Idlowing reason (Sec. 7037.5, Business anE Professlons
Code: My dty or counry which requires a pefmit to conswct, alter, Imprwe, demWish, a repair any sWCNre, prior to its issuance, elso requires the epplicant lor such pertnit
to tile e signetl statement t�at he or she is Ikensed pursuant lo the provisions ol ihe Contractors License Lew (Chapter 9(mmmendng with Section 7000) of Dlvision 3 of Ue
Business end Profeuions Code) or t�at he or she is e:empt Iherefrom entl the besis for the alleped exemption. Any Woletion ot Section 7037.5 by eny applicem for e pertnit
subjects the epplicant to a dvil penalry of not more than Me huridred dollars (5500).):
❑ I, es owner ol the property, or my employees wlih weges as Iheir sde compensaiion, WILL DO TME WORK, antl ihe struaure is not interMetl or otteretl for sale (Sec.
7044, Business antl Professions Cotle: The Contractors License Lew tices not appty to an owner ol properiy w�o Dullds or improves thereon, and who tloes such work
himself or herself or Ihrough his or her own employees, pravitletl t�at suU imprwements ere no� inten0etl or oXered tor sale. If, however, ihe building or imprwemem is
sold within one year ot comD�etion, Ihe owner-builder will �ave ihe burtlen ot proving thaf he or she tlitl not build or improve for puryose of ule.).
❑ I, es owner of Ihe propeny, am E%CLUSIVELV CON7RACTING W17H LICENSED CONTRACTORS to consiruct the projact (Sec. 7044, Business anC Professions
Cotle: The contrectors License Law does not epply to en owner at property who bullds or Improves ihereon, and who contrecis for such project with a contraccor(s)
license pursuent lo th`e Contractors License LewsJ.
�❑ I em azompt under�
SignaWre:
Owner ID vedfeC Dy tlrivers
y
Business end Protessions Code tor thi5
❑ No Dnvefs License No.
Veriticatian af Ownership by (typa at document, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTFlCATION:
❑ I �ereby ceNfy Ihat no excavation live (5) or rtwre teet In deplh into which e person is requiretl to tlescend, wlll be mada in connection with work authorizea by Ihis
permi�, antl Ihat no builtling structura, swNdtling, telsework, or demolition or dismantling thereol, will be more ihen thirty-six (38) feet high, (C�ap. 32, Grp 2, Ah 2, Sec.
341, Tltle B, Califomia AOminisiretive Cotle).
❑ A5 owner-builtler, I will not employ enyone to tlo work wNch woultl require a permit Irom Ihe Division ol Industrial Selery, as notetl ebove, unless such person hes e
pertnit to tlo such work irom t�e tlivision.
Slgnature: Date:
Division of Intlustnal Salety Pertnit Number.
CERTIFlCATE OF COMPLIANCE AND AUTHORIIATION OF EMRY: I cenity under penalty of perjury ihat I �evo reaa this epplicetion and sWte thet the Inlortnation given is
cortect. I egree to ply it� ell siate laws entl dty ordinances relaUng to building constructlon, an0 eut�odze representetives of the Ciry of Coste Mesa to entar upon Ihe
ebove-described / �nspection purposes. I agree not to oaupy or ellow xcupancypf eny building authorized by l�is perm},u 11 tin�l inspec� .
� � �
� / �oC / /
,..,se�.e M i o,.oi n�,�ed�� Dat
AnNOr Authorizetl Applicant
CO�E 1, INSPECTIONTYPE
7618 Fixed System Final Fire Preventlon
1288 Pool Spa Finel
200 Finel RaRool
201 FInaI Block/Retaininp Well
202 Finel Fectory Fire Place
203 Finel Sign
204 Finel Demolilion
PAIE Iti�Li
CO�E I INSPECTION TYPE
206
208
210
212
220
222
250
Final Mechenical
Final Plumbing
Final Elecirical
Finel Fire Preventlon
Final Planning Approval
Finel Site
Final BuIlGing/OccupanCy
PAiF. U�ELfi
f
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
�7 - J •�
�
PER NUMBER
""` B9&01294
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suita:
Vicinity:
Parcel Nunmber:
408 E 18TH ST
11733239
Applicanl: GAZA, TOM
Address:
Owner:
Address
BUILDING PERMIT
Status: ISSUED
Applied: 07117/1998
Issued: 07/1717998
Zoning:
% �_ �. s=Phone:-_ 949-642=8989 . -
/�i - . Zipt - � ' � �
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� License: i I ' � ��� ��� ����
: � ��
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�% ��, �ry r_'�.�� �I d� � �� , ' �i�.
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/ �-'r, �-, �_ Zip: � � ` � �
�� �L'�� �
� �� '; "-- � License: � A ,
� . � �
;,--�� � � � SCOPE OF PERMIT V '
�TIO�EXISTANDRER00FW/ASPHALTSHINGLE:•�����i�� � � � ; :. �A
. n �� . , , % .,
r -- � -> >� �r�� _ �.- .;..\': ,'c. -:. ., ., e, `
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Check:. + s� $0.00
Permit `, ' $29.25
IP-Res ��. ,� $0.50
P.Com V����.$0.00
Other;:A ��,�$0.00
r.,......... , �
��.A �',�
�Total:
���
\ .
� ��
SETBACKS�� _
MAIN STRUCTURE.
ACCESSORY
PARKING
NOTES:
�
\ .�, FEE SUMMARY % '
;,1- '��: � >. �'�=: L :., _. Calc Valuation: '
.. _G. ='�f^'r /- \ � ' - �
� __ _ - Claim Valuation:--
� .
� � �
� ',
� _ . '�
� � ,� ( �., i� ',
.i � �, � _� ,,, .
_i; �, �� , � ,�,� ,
5800.00
$B00.00
,,
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� ,.
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� ,
,� ����ti. . ���, � � _._. i-: i
�/� \\� �': ° � S�'PLANNING & ZONING � j% � ;
\ ��
,.
� �\ � ,�' �_ , C�, � i
� !� ,�j� � -,.,� �- . "�� � � .U/ �'
� �
Front �0;0 � �� Rear _0=0 ��� � �CeR' 0-0 - = Right � 0-0
�� �, �;� i -- _ � --; -- � � /';�,
i
Front�0=0, � � �Rear -0.0 -� __ � Left 0=0 �� � ,� Right �,0-0j�
�'
\c�� 'V��:`-� i , _ �." . � �'� `��
' , i'.';
Existinq: �0� Z,',Reauired: �0- �� .��, Pr000sed:. � 0 � ->-����, .
_ _ .. ..... .. .... .ir�,
� _ - . . .. . .� �"�_ - "
EXPIRATION: This pertnit shall automatically explre end become void ii work is not commenced within 1 BO days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order lor the work aulhorized under this permit to be considered legal, such work must comply with all appllcable codes, end all
requlred Inepectlone end finel approvel mus� be obtained. Failure to obtein Inspections and finel approval will result In �he expiration of this permlt.
FOR INSPECTIONS CALL: (714) 7545828
WOFiKERS' COMPENSATION DECLARATION: �
� �ereby effirtn under penelry at per�ury one of Ihe fdiowing dedatations: �,
❑ I heve entl will malntein a ceNficete of consent ta selt-Insure for workers' compeaaetlon, es provitletl for by aectlon 3700 at Ne laEor Code, for Ihe pertormence of tha
work tor whM7i Nls pertnit Is 155uetl.
❑ I have entl will maintaln woAcers' compen5etion inwrence, es recryired Dy gection 3700 oi the Lehor Code. for Ihe peAortnance ol NB work for which this pemtlt Is lssuetl.
My woBers' compensetlon Insurance cartfer end poliry number ere: .
Cartler. Pdicy Number.
(This secNon need nof be cwnpleted I/ Ne pertn/t!s veluetl et me �untlred dol/ers ($100) or less.)
❑ I certity that in tha pertortnance oi the work for whlU tNs pertnit lv issued, I ahell not employ any person in eny manner eo es to become sub�ect to 1he workere'
compensetlon lews of Celitomla, end egree thet It I should become su6�ecc to the workers' compensation provisions ol Section 3700 ot the Lebor Code, 1 shail torthwilh
wmply with these provisions.
Applicent Sipneture: Dete:
WARNINO: FAILURE TO SECURE WORKERS' COfAPENSATON COVEMGE IS UMAWFUT AND SINLL SUBJECf AN EMPLOVER TO CHIMINAL PENALTIES PND CML FlNES UP TO ONE MUNDRED
TIqUSAND DOLIARE (5100,000), IN ADORIIXJ TO THE COST OF COMPENSATON, DFMFOES AS PROVIDED FOR IN SECTION 3]080F THE IABOR W�E.IMEREST, AND ATTORNEI^S FEES.
LICENSED COHTRACTORS DECLARATION:
I hereby effirm ihet I em Ilcensetl untlar provlslons of Chepter B(commenGng wlth Secllon 7000) oi Dlvision 3 of �he Busineu enC Professions Code, end my Iicense Is In full
fo�ce end eNect. Llc. a Cless p
Contrector's Signeture: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby atfirtn thet there Is e conSlructlon lendinp epenty for iha peAortnance of ihe work tor whlch Ihis permit is issued. (Sec. 3097, Civll Cotle).
Lenders Name: . __ _. _ ___ __ Lentlefs ACdress: _ ._ _ _ .. _ ._ .
Slgneture: Date:
OWNER•BUILDER DECLARATIONS:
I hareby affirm that under penalry o1 per�ury thet I em EXEMVT FROM THE CONTRACTORS LICENSE LAW tor tha following reason (Sec. 7031.5, Business end Proteulons
Cotle: Any ciry or counry which reqNres e pertnit to consWd, elter, improve, tlemdish, or repair any sWcture, pdor to its issuance, elso requires the applicant lor such pertnit
to file e slgnetl stetement thet he or she Is Iicensed pursuent to t�e proNslons ot Ihe Contrectors License lew (Chepter 9(commencing with Section 7000) of Dlvision 3 ot the
Business and Professions CodeJ or Ihet �e or she Is exempt ihereiram end the besis tor Ihe elleged exemp�ion. Any violation ot Section 7031.5 Dy any applicant tor e permlt
sub�ects the applicent to e Uvil panelry oi not more Ihen five hundred dollers ($500).): -
, es owner ot t�e property, or my employees wlth wages es their sole compensatlon, WILL DO 7NE WORK, antl the structure is not Intentled or otlered Por sale (Sec.
7044, Business end Professions Code: Tlie Contrectors tJcense lew does not appty to an awner ot properry who builds or improves thereon, and who does such work
himselt ar hersell or ihrough his or her own employees, proWded that such Improvemenis are not intended ar atlered for sale. If, however, Ihe building or Imprrnement is
soltl wiihin one year of completlon, the owner-builder will heve �he burden of proving ihat he or she ditl not builtl or Improve fa purpose o1 sale.).
❑ I, as owner af the pmperty, am EXCWSIVELY CONTRACTING WRN LICENSED CONTRAC70qS to construct the praect (Sec. 7044, Business flnC Professions
Code: The contractors License Lew does not eppy ro en owner ol pmperry who builds or improves thereon, flnd who wntrads lar such prqect wlth e conirector(s)
license pursuant ro the ContreMors Llcense Lews.).
by drivets Iicense. ❑ Yes ❑ No
Business and Pmfessions Cotla tor this reason:
� /���.,� Date: 7— '
Drivefs License No. �-( � Explres:
Verlflcetion ot Ownership by (rype of tlocumenL i.e. - properly te�c bill or deeO):
DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION:
❑ I here0y ceNfy ihel no emcavatlon Me (5) or more feet in Aepih into which e person Is reqWretl to descentl, will be mede In conneclion with work authodzed by Nis
pertnfl, end that no builtling struqure, scattdding. IeLSework, or tlemollUon or tlismantlinp thereot, will be more then Ihirty-six (38) feet �Ip�. (C�ep. 3.2, Grp 2, M 2, Sec.
341, Title 8, Calitomla AtlminlslreWa Code).
❑ As owner•bullGer, I will not employ enyone to do work which woultl requlre a permit iram the Dlvlsion of Induslriel Sefery, es noted ebove, unless wch person has e
permit ro do such work trom the EhAsbn.
Signeture: - Date:
Dlvlsion of Intluslriel Sefery Permil Number.
CERTIFlCATE OF CAMPLUWCE IWD AUiHOR¢ATION OF EMAY: I certity under penalry ot perjury thet I heve reed ihis eppllcation antl stete thet the Inlortnetlon given Is
cortect I egree to compty wlth ell stete �ews end dry oMinflnces relaUng to building canstruction, and authodza representalhres ot the Ciry ot Costa Mesa to enter upon Ihe
ebovaCexd d property for inspection purposes. I agree not to occupy or allow occupancy ot eny building authodzetl by this pertnit until final ins�c�+ �on.
�- /i'%71
� Slpneture OI Legal Owner(s) Dete
AnNOr AuNorizetl Applicant
COOE �. MSVECTOXTYP!
7816 Fl.etl System Flnal Fire Preventlon
1288
200
201
202
203
204
2asNe
Pad Spe Finel
Flnel Re�Roof
Finel Block/Retelnlnp Wall
Finel Fectory Fire Plece
Final Sign
Finel Demolitlon
�� ��
CODE I Q/SPECTION TYiE
206 Flnel MeChenitel
208 Finel Plumbing
210 Flnel Electdcel
212 Flnel Fire Preventlon
220 Fnel Planninp Approvel
222 Flnel5lte
250 Fnal Bullding/Occupanq
GAg It�ll&
I � I
-PFU�'T AOOflESS: UNIT:
OWNEfl'S NAME: 4 V� E 18 TH S T
aooness: y08SE� 18THMST �
C,M, CA 9267—
AflCHIENGINEEB: 7 1 4� 6 4 2 — 8 9 b 9 pEG.NO.:
nooxess: SCOTT BROWNELL 11��:9
1950 W. PACIFIC COAST HWY
PEflMITTEE: N. B. CA 9 2 6 6 3
aooness: TOM GASZ ( 714 ) 644-3764
('� p4q08 E 18TH (`n q9
LICENSED CONTflACTOffOELLAPATION: I hereUy allirm ihat I am licensea wCerytWisio6sVl���r 9(commencinA wi�� Section
7000� ol Oivison 3 of Ih¢ Business and Prolessions Cotle. an0 my license is in �ulllorce an0 el�ec�.
CITy �IC.: STRTE IIC.: CUISS:
E:SP :
Dai@: SiAna�ure:
WOqNEBS' COMPENSqTION oECIAMTION: I hereby atiirm that I nave a certilicate of consem to sell-insure or a certilicate ot workers'
Compensation insurance. or a cenitie� copY �hereof (Section 3800. Lab. C�.
PO�ICY NO.: E%P. �pTE:
COMPANY:
❑ Ceniliea copY �s hereby fumishetl. ❑ Certiliea copy is Glea vnt� tAe city BuilainA Division.
ate: Ao7licanC
i E%4MPTION FflOM WOflNEflS' fAMPENSRTION UECNPATION: _(iNs seciion neetl not Oe completeE if Ihe pami is for ane �unCreG (E7 W) or leu�.
I ceniiy Inat in Ine p¢tlormance ol ine work lor wnicn ihis pe issueA. I shall not emoloy any person in any manner so as to become
suhj¢�i to th Wo i s' Com ensation Laws of Calilomi y�%/�' .
Dat¢; - Siqnfl�/�^?!/H9/�i
NO tE: If. aner making ihis Aeclaration, you u6iect to tlle woBerS' Campensation Omvisions oi t�e Lahar
Cqtle. you must lortnwitn comDly WitA sucn WONsians ar this Dermit shall Ue tleemed revak¢E.
CONSiRUCT10N LEN�ING AGENCY: I nereGy altirm ttut ttrere is a wnstruction IerMirp aqeM,y tm tAe perlorrrurKe o1 the xmrk Por
wllic� ��i5 nermil is �ssuetl (Seclion 3Q97. Civ. C�.
LENOEfl:
ADUflESS:
I �I
�
CITY OF COSTA MESA — BUZLDIC7G PERMIT / PEP.M DJO: B 06990• ��
PERMIT NO: B 069909 PLAN CHECK NO: N GOVT: N SUPP: 1+1
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE: CON
JOB DESCRIPTION ; CONST. 5205F CAP.PORT SQ FT: 520
CLAIM VALOE: 9,000.00 CALC—VALUE; 7,696.00 GROUP OCC; M-1 /
COMMENTS: REPLACES ISSUED PERMIT ItB67931 FOR GARAGE. FOR PLANS RE:2274-99L
iF �E r iF if 1E if jE iE iF if -1F it i� it iF a if �f it ii if iF iF if ic if if iF M s if 1t �f iE iE iF i1 iF iF ic if it if it iE+f iF �F 1c if jF ih it �E Jf 1f iE iF if iF iF aF iF M r ac jF+f �t iE if +f M if +F aF iE at
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: PAOV: PARCEL: 11733239 ZNE: R1 REF NO:
PLANNING NOTES>
i
+E iF iF r if if �c iF iE iE 1E 1f M+41F r iF if r r iF iF iF iF if iF iE it i41F ii if if iE �E if af it if if if ic �c iF if i: iF ii �F �R Yc i� if iF r iF {E iF R iF 3E if iF iF 11� r�M i(� iF ac ac iE ic �Y-+E if +i jf iF
D E V E L O F 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 GIS�i� bATE: IC�I �C(
HUILDZNG APPAOVED BY : DATE: '
APPLICATION ISSOED BY: bATE: l�Q L
iFifNi:1E#'iR�fi*ififiR�fiEiFiflFiFiF1F1! . aFiEifiEiEifKiFi4M. if if-lf
if ii-if iF iE if jf iI' 1F iF if if 1F if 1f i'' �IE 1E 1F iF * iF �f iM1 ih'lf if 1F iR if if M a(' if aF AF'M IF if iM1 %K aR if iR iF if If iR if if aF if iR if 1F if iE af if aE iF aa'� iF iF M'lt i�' iE iE?E iF j(' if �f iF if {f
LEGALIZAT20N:N F E E S U M M A R Y STP.UCTURAL SEGMENT:Y
OWNEBBUILDEN�ECLABA710N: I�er¢�yaffirm��atlamexemptiromt�¢Contractors'StateLicenseLawfarthefollowinpreasan BLDG PMT PLUMBING ELECTRIC MECHAAIIC FIRE SMZF/AES GRADING
ISPCIiOn 7031.5 BuSinesS an0 Pwiessional Cotle: Any tity ol Coun�y w�ith ropuir¢s a pefmi� 10 ConSimd, ali¢r, im0�ave, Oem01iSA, Or
repai� any stmcmre. prior io its issuanc¢, also repuires the appliwm lor such Oermit to lile a signetl statement itwt �elshe is IianseU P ERM I T 9 9, 00 , ,% 7
pul5uani lo Ihe piovisi0n5 0l I�e COniratlors' Sta�e License Law (C�apter 9(commencing vnN Section 7000) ol Division 3 0l the Buvneu � SM I P: NON—P. ES
antl P�ofessions Caae� or ihal �e/she is exempt I�erefmm ana IDe Dasis lor t�e alleAea exemption. Nny vialation oi Section 7031.5 by pLA�� � •
any ap0licant lor a permil SUElectS t�e applican110 a civil penaliy oi not more lhan �ive AunOreO O011ars (5500), jSSUE FE.t'. .
i. as awner or tne pmperty or rtry em iayees wim waqes as�meir soie comperisation, wie ao the woM, arw the BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL PAID DUE
Q simcmre is nat imeneea or onerea mr saie (S�ectron �oaa, eusiness and Professional Cotle: Tne Cantracrors' State License Law TOTAL S----> 9 9. 7 7 0, Q � 0, � U 9 9. 7 7 9 9. 7 7 . 0 0
tloes not aOCry m an owner of a propeny who �uilds orimpmves t�ereon, an0 who does such work �imseli/herseli orihrough .
his or her own emDlayees. D�ovitle0 that suc� imDmvements are nal intentled or ottertE for sale. Ii, hpw¢v¢r t�e EuilOinq or
impmvement is sola within one year of completion, ihe owner will have Ihe GurAen ol pmvinp �e/she ditl not 6uiIG or imOrove RE\.�ENUE D I lr I S ION TOTALS --> COLL ECTED ; 9 9, 7 i OV ER / SHORT : � 0
mnneourposeo�saiel. bLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I. as owne� o� tl�e p�openy. am evclusively convaciing wii� Iicen5e0 coniraciors �o [on5imci �he pmject ($¢c�ion 70Ed, Business 9 9, 0 0 , 7 7
� and Pmfessions COEe: iAe Con�ractors' Siate License Law Ooes nai aDON �o an wmer oi pmperry wAo 6mI0s or improves thereon
antlw�oconlraclslorsuchprojeciswilhacontractor�s�licensepursuan�[ol�eCantrattars Sfal2LitenSeLaw�.lamawafe ************�*********************�*******r****X*************�******�********�*
that pmoi oi t�eir Worker's ComDensation insumnce shoul0 be pmvi0ed to me.
� am ezempt under section: e. s P. c. I N D I C' I D U A L F E E B R E A K D O W N
� �o��/�� BP7094 ///_��� -
JNER—BUILDER TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
oaie: // � rnvn - , .
� tlo nereby certify ��a� I am aware of ana unaerstantl ihe require rnia Healtn ane Sa�ety Cotle sections 25505. 25533. ana S FR 5 2 U RES -CARPORT 1 4, 8 0 7, 6 9 6, 0 0
2553a ana mat i or any iumre ouiioing occuoam win/wlii not Ictrcie onel neea m comoly wnn saio state coaes ana tne repuiremems �or a END OF FEES
PCrmit far cons�mnion or moddication fmm t�e Air Oualiry Management Disiricl. NesiOential constmction aDPlications are exempt imm �
ihese O�a�isions. _
�a�e: PpplicanC _
� �¢reby cetlity ��al I �ave reaC I�is aOP�itation and Siale ��a� I�e
of0inances anC s�atelawsrelalinglo�uiltling con5tmciion anE �er
�mpetly b�-i50e On O�Urposes. '
,� (� Oate/ j'� gnamr
\ " 1 Orivei's license or Social Securny x:
/
mation is correct. I aprte to wmply with all city anA counry
f2D�=SEfIldINES O�11115 LI�Y�OCOI2fVP00I11E 2EOVE�111EIII10112A
16aFa6 - White—Builtlinq: Green—CoGe Enlo¢emenL Canary—AOG���anC Pink—Revenue; GolEenroE—Assesmr
0
�J
Ut dU17157E—aDi1S57s T i� T i4,7i
�pTE: ii/1#/9¢ TIIfE: 51�23
CONSTRUCTION AND PLANNING
APPROVALS Permit #
t. Temporary Electrical Service or Pole
2. Soil Pipe-Und�g�nd.
3. Eiectrical Conduit Uti�ity•Undrgrnd.
4. Electrical Conduii�Undrgrnd.
5. Steei Reinforcement
6. Electrical UPER Grnd.
7. Footings
8. Foundation �
9. VJater Pipe-Undrgrnd.
70. Struciural Floor SYsiem
11. Properiy Sewe� line & House Connection
12. Sswer Cap
73. Roof Drains
14. Rough Plumbing
15. Rough Electricai�Condua
16. Rough Electric Wiring
77. Rough Wirin9 Sign
18. Rough ElectriGal�T Bar Ceiling
19. Rougfi Hea2ing & Air Conditioning
20. Rough Factory Fireplace
21. Duas, in Struoture
22. Ducts, Ventilating
23. Gas Pipe�Rough & Tes2
24. Roof Framing
25. Roof Sheathing S
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. La:hing & Siding � �
29. Insulation
30. Drywall NailSng
37. Piaster Brown Coat
32. Eiectrical Power Mecer-Final
33. Final Elecirc
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 pomeriie�Final
42, Backflow Preventer
43. Backflow Irrigation
44. Landscape irrigation System
45. Sound Atten�ation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �
48. FINRL P�ANNING ,
49. Eiectric Release to Edison
50. Gas Release to Southern California Gas Q
51. CERTIFICATE OF OCCUPANCY
Date
Date
POO L � >
Inspecro� APPROVALS Permit #
52. Pool & Equipment Location
53. Steei Reiniorcement .
54. Forms
55. Electrical Bonding
56. Rough Plumhing & Pressure Test
57. APPROVAL TO COVER�GUNITE
� 58. Eiectrical Conduit-Undrgrnd.
�✓ 59. Gas Plpe, t� Undrgrnd., Test
Y 60. Backwash Lines, P�Trap, t7 Undrgrnd.
61. APPROVALTO DECK ,
62. Backwash & Receptor-Final
63. Heater & Vent�Final
64, Plumbing System � Final
65. Electrica�-Fina�
66. Solar Sys:em-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOUSPASYSTEMSFINA�
FiRE DEPT. REQUIREMENT
APPROVAIS Permit=
70. Underground Hydro
71. Product Piping �Gas ❑Oil
72. Underground Flush
73. Undergmd. Storaye Tank O Gat � Oil
�Gt/ 74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
76. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
J9. FINAL INSPECTION
80. FOOD CERTIFICATE iSSUED
Notes: S'L�"7 S- G(i B�
�Z..�l -�� - �
Date � Inspector
r�
�oonessaeunnwc: 408 E 18TH S'P:
owxeasw,we�c�oawr+: GAZSI, THOMAS E
�� 408 E 18TH ST
C.M, CA 9267-
714) 642-8989
APVL.IWlII10 �DDNE54:
uHr:
�xcxrtecTox�+a��+: SCOTT BROWNELL ucra.: 11839
AIICN.ORFN0:81�URE5S: L9SO W. PACIFIC COAST HWY uar:
N.B, CA 92663
cowm�croas w�:
ca+rn�croxs �uir�+
�oo�ss ue. w�
uMT:
LICENSEO COMRAGfOP4 DECL�P�TION: I hersby ellim uMw pa�Wy W pujury Ntl I un IiceneaE imAr pm�iaime d Cheqx B
(mmmandn0 wilA Saction ]000) d Oimian ] d the Buainaw end Pralp�ioru CoEs, end mY limnw b In IW Iacs eM eflsq.
cm uc. r+o.: uc. cuss: uc. r+o.: EXP :
�ets: Camwa
OWNEX BUILOEN DECL�R�TION: I IwWy eRum wdx pw�Y a p�/ W�et I em awnp tmm �M Caqretlas Lionua lew la IM
dbvnp �aefan (Seqcn 10]1.5 WoiMa eM AdsavMu Cotle: MY vY Or oWm�y Wii1i npu'um a D��Y lo mroNcl. Mx.'unMa*.
EmmdeR a repar arry �tructirte. p'v m m'vauence, tlro reC� tM eppfren tn arJi pertM lo Ns � eqned �ttlertwN Mm M a�M
e Iior�+eE W�e�u �o Ne pwiyp�� d Oe Cwvrman Lioenu Lew �CAeps 9(mmmenmq rdh SMion 100D) d Oiveion 3 d tb
BmMw ud hWmbm Codel m �het M> Me u esemq therYmm W tM bsa b Na NkpaE axunqion. MY vulmion W Sed'an
)031.5 by em/ epd� lor e pmryiii tubpn� IM eppfraeu lo e wi poretly d M mon then frva �wMred doAen �5500�.
❑ Ldowiwamao�ramv�oM��••nwepnmin«.d.mmc.��..maouewak.d,eme.wnume�tinimded
«Mmed tar ee�e (5«um 1wa. BuaM+e ene Piansons eoee: ins Conteerlon Lieen.s law eae.'wt eooN �oen ownarm omoeM
wno WaEa w'vnpovae Inerem, uM wtn doaa euM wvk IimaeM a henN a thiaph he a Mr own amployees. providad �tW euch
impo.anew ua nd imaKyA a WareE la veb. tl. howawr. lhs Ouitlinp or inprv.emeN e wk x'vnm ona Y� d wmpblion. tlro
owror-0wldr Mi01+ew Ihe huNen d povinp M a aM did ml Mitl a impws la Ne pupws d ub).
� I. n ownx d �M G�Wab. am ud�Y mvroeYq wtlh 4weM cmnwn� m camutl iM PM� (Sedion l0aa. Bua'er� ud
rw..sa,e coee: me ccm�.eon �k«,.. �.w eoe. no� mnN a.e o.ner a o�v�r •nw b�Aa. or impw.. ma.m .�d wro
cW�acb tar w�tli V�4a�'�tlh a aau�eCMs) feaneW p�nueN b tM CaY�aGne lbwe Lewl.
�Cj i�...�, � BP7044 e.av.�%ONAIER-HUILDER
Dele: � �
1 do Mieby c nAy Mtl I em ew a M W unAraWd tM aNs d CNiame HeeEA ud Stlay Cods SW bm 25505.255�, vd
255y6. enE �Mt I a ury Mun Wildinp acapani �ill / wil mi (�V �+) � b cmply w�h uk mla coda uM IM rpuiramant� br
eosrmnfaowutrutlianamoEifrypnhaniM�� u�y eropomwn0inriri.Raddeeuelomkiud'nneppM'atbnsenaaemWimm�hese
I ov.: �cc�+:
W ONNER'S COYVENS�TON OECIAR�TON: 1 MreEy alfinn under pruEy d pspey ana d Na IODo�.inp Mtluat'vu:
� I hm� anE W me"vuen e p�Alwa d au�reu to utlti�wu� b r.arkan' �ion. n pwided la b/ 6wion �)W d IM leEv
CoM. ta IM pMmnence d tlr Mak la wlirJi Nb pemN u bswd.
� i n.».w wi� me��.� .ak.n• mno�o� �au�.ros... na�.e M s.aAn �roo a m. �.e« coe.. a m. w�+wm.no. a m.
work Ia whidi Ni� pwmil4 isuM. My warken' camDuiWion irourmce mrtier eM poliry n�mber va:
Curiar:
Polcy N�mEor:
�rn�, ..cYk�, new na a. romvrored r �n. pvml u ro. w» n�iwna ed�.i. R�ml w!r..)
� 1 wnN Nm In ur OM�ca d �M wch br whiN Nb vmm0 h svrd. I NeY m rnoM am' D� In eny manmr o m io
pecmw wbptl to IM xpkxJ mmparoetian levn d CefdaMe. W epns Ntl E 1�AwM Eecmie aEjatl �o tM Maheii
canVe�+e�ion O�+�ioro d S�aion �1W M tM lebv Cod�. I tlu0lonAvmh oomPh we� Unw pwiem�.
Ueu: bp�:
W�m/np: F�Nun ro��cun woNwti'rompxwtlon eov�np� I� un4Hul, �rrtl Mtll w4Jcf m wmplryw ro erlMnl p�n�ltl�� �rW
nw nn.. w ro o�. nme..e �ro�,.�.a eorw. (s�atowi n wnao� ro m. �o,r o� �o�«wrwn e.�.w. u wo.+aw ro. i�
9�ctlon �1a6 of Ih� I�Dor Cay, InfwL uM �tNm�/"� /�a.
CONSTFUCIION LENDINO RpENC�: I heroEy elfi�m uMer penNry d pap�ry thm iMn ie e aonn�ueian bMinO W�% br tM
pe110mlBllta d IM Nqk M! N111Ch IA0 DMm1 4 sfVed (:Mt1011 .b8). C.M. �.�.
LENDEF'4 NRME:
LENDEP'S AOOpE39:
I carlEy Il+u Ilaw nai the epplreiion W tlma Ihat Ne ebws'vdametcn u conp. I eyee to arnply r.it� Y�Ly end coumyadinenu�
� udeN�alaxsrMetMbdddMmmVutlionendhareq'aWnrc�Ip�araetiWe�dNe�AYbWeruD�tMebo.c.maNnnedpWMY
�°' inaped� °�`0�"' TOM GAS I
nu Ne�+r
^'jo 7��✓ /' �
I �
/ �rodOx.w/ApmVAVC��mreua
1\ (S151J6.WP) W���qd5elep:��eerv-R�e:CUWY-�DOk'd+t:Pink-Rew�ur:OdEe�vob-�s�asw
___ , CITY OF COSTA MESA - BUILDING PERMIT
PBRM NO: E U78281
PERMIT NO: E 078281 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PORPOSE: CON
JOB DESCRIPTION : CONST. 520SF CARPORT, RE:#H69904 St] FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: 0-1 /
COMMENTS: REPLACES ISSUED PERMIT ttB6793i FOR GARAGE. FOR PLANS RE:2274-94L
*�trtit*it*�e�**�r�*��+�rt*r**�*�itit***�r*r*it**+tx�***�r***iE**it�r��itx�+�+��**���tit*atit�tit�itit*�t��rie**
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 REAA: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN AGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL; 11733239 ZNE: REF NO:
PLANNING NOTES>
i
1E 1f �E ff 1f 1E iE 1E iE 1E ik i(� 1E 1E iF 1E 1E 1E iF 1k iE 1E iE 1E 1f 1F 1k iE fE 1E 1E 1E 1E ik iF iklk �IE 1E if 1f 1E 1E iE 1f 1E fE 1E 1E 1E fE fE �E 1E iE 1E 1k 1E 1E �E �E fE iE iE if 1E i! 1f if ik 1f 1! 1k iE 1! ik iE 1E 1k
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 .
BUILDING APPROVED BY ;
DATE:
DATE:
APPLICATION ISSUED BY: 3-�1-F/i- DATE: �� '"�
ifititx��t�titiEiEititit+E�titx�f�f�*iFit*id7F'fF{F�fFTF��FiFiF7FiF3FiF�i�fF7F�tiFitiF�tit�r*iEiE it�
LHGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 550t SMIP/NON-AES
PLAN
ISSUE FEE 22.00
HUILDING-DIV-> PERMZT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 5.00 22,00 0.00 27.00 27,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
2%.��
iE 1E 1Flf 1k ik 1! if 41F M 1F 1F if if 1E k 1E 1E 1E iE 1f M iF M fE 1E 1E k 1E 1E iE M 1f 1E 1f 1i if 1f 1E 1E 1t M M M i! 1! 1E 1f ff ik IF 1(� ik if 1E 1t 1E Ib 1f� iE if fE fE 1E ik iE iE 1E 14 iE iI� iE 1k 1F If 1f k if
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O�N UNIT COST TOTAL COST
ELE 2 FIXTURES LIGHTING 1 ST 20 EA. 1.00 2.00
ELE 2 RECEPT/OEITLET ' 1 ST 20 EA. 1.00 2,00
ELE 1 RECEPT/SWITCH 1 ST 20 ' EA. 1.00 1.00
END OF FEES
�
_ -- �
,;' .. : ? . _, —
CONSTRUC710N AND PLANNING -� P<+�� & SPA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1. 7emporery Electrical Service or Pole 52. Pooi & Equipmen[ Location
2, 5oil Pipe-Undrgrnd. 53. Steel Reinforcement .�
�'3 _�Iectricat:Conduit Utility-Undrgrnd. 54. Forms C � '
z�'4. �Iectrical�C'oiiduibUndrgrnd. � 55. Electrical Bonding � -
� 5. 5�ee� Reintatcement c� 56. Rough Plumbing & Pressuce Tesc c:
T .
'�'fi: ,�Iectrical-llFER Gmd. ` 57. APPROVAL TO COVER-GUNITE �
: "y}���Foutings - 58. Elettrical Conduit�Undrgrnd.
��_8. FoundaUonJ , �, 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgmd. � 60. 9ackwash Li�es, P•Trap, � Undrgmd.
10. Structural Floor System - 61. APPROVAL TO DECK
11, Property S�'��i e� Line & House Connection `�'- 62. Backwash & Receptor�Final
12. Sewer Cap ^ � 63. Heater & Vent-Final
� i
t
13. Roof Drain{�� � 64. Plumbing System - Final '
14. Rough Plumbing X ^ 65. Electrical-Finai
15. Rough EIE'ctrical-Conduit : ;;; 66. Solar SVstem�Final
16. Rou9h Elp,ccric Wiring 67. Fencing & Access Approva� �
17. Ro�gh Wiring Sign 68. APPROVED FOR PLASTERING -�
18, f2ough Electripl�T Bar Ceiling 69. POOI/SPA SYSTEMS FINA�
79. F{ough Heating & Ax Conditio Tiny `` ` ��_ F E.DEPT REQUIE3EME�,T �� .
�(,
20. �ou�h Fa�tocy F�Eplace .-�,: ;qQ: ,' ; �x � APP��VAr„�r PfJ # x �
mit
' �
21. �ducts�, in�5truciur� � ' •. •. r,s' S � "'* - � �'". ,.
_r, � f, �., i�.. r 70.'�Jnder�yto��td Fi�'dro .�
22. Oucti,Vgntil�sin�",°. . T� Q��x 77. Product�i�ning��]'f5as E70i�
23. Gas Pipe-Rou�h & Tesc t":.� !�' m^ 4 �_ x� * !-
� i,� _,� . 72. Undergrsy�d Rrih�h r .w
2A. Roof Fra m . `"� ..•� �' `' � x �' � ° �,�
q� 9 M,. � o� .. x� 7� Under9rnd. S[ora� Tank � Gas ❑ Oil
25. Roof•Sh2athing �: ^ ? '� � * ,� : �'� � 7d� Over6ead Hydrtz�, s
26. S�Ba: Cei�ing (Sirut�urall & Mo`�o`foat ; ` . � � 7� D�y Che�ical ; .'� �. � �- �:^
27. f�ameand Flashing. =c^5 +:T r yr 76. Dry Stapdplpet� �� -+ n.� �o i-
' 28. Wthing &'�Siding � ; "' `' J :' �j ;� `' ..� .. ..y 7� FIXED.SY�TENi;�INAL�- i � �*;. -�
�
29. Insulation• � � � y � ! �* 7� FIRE PREV. P�,N�L "" �'�'��`
� 30. Drywall Nailing �.7,.� k ,_ , y �, � '� -�- ;,}IEALT,F{QEP�. REQ�IIREME.NT
� 37. Plaster Brdwn'Colt:+ :' � �. '� a � ti 79. FINAL fN�PEC7�ON r J,, - -
� � . ,; • �, -
' 32. Electrica�.Power Me�et>Ft�al . � a Stly FOOD CERTIFfCA�E 1.�'iSl'jED -
A . v .,
_ 33. Finat�Electric ��_ � r+: d; 6z� t�� " Notes: Z �� k'�� '•
, �. . : _ 6 �.�Y�-2_� i ^��y�� e•e _
34. Final"He�jng�& FSit�Con6ltionirig-`• C' ; ' � .• ` •�L •� �'' ; � _
..,__ �n ' je: .-•. _ p � �:
35. Final Gas Pipe-Teit ;. �,LL .. x�� � c •. .. t'�r ���- �t: � ---'�'
�. .. r, # ,r
� 36. �k(ood-or'CanoPv r"�" �= . "•_• " "C. ' ^o % T
- .-, „ �, � � , :*; - r•.
y • k• I I �t. ' � y. .�
37. Fina�.Faccory FirePlece ; � �t• i
1 r er x
_ 38. Fina�'�IuMbing ��, _ �: v' � • !'' 'r � t =.
yl c. i �..� . _� e. � r, r
"39. Water'Sewice�Fina _ � .. x ,� !- .,r ,-. %- . �u V ":T.�
p r: �n C -
-.40. Gas Service-Final ' � : � '�� '- �', , r ~'-' "`ti' • . .
. � �, �., �. . �. �. r: . ;
41. SOlar Oomestio-Pina�� ,;� . " ' , �. r ' -� �" n ,-. D
- �
42. 8ackflow Preventer ' . :� � s , ' � � �', � T , F
43. Backflow Irrigation t� y '-' �r ^ +: Y ' - : � . .
r.' K
A4. LandscaF� Irr�'i�atiar�SYstem;�";•� � r�.-, t - OM � j -j„ 1' �, F � `-'
45. Sound Attenuation� � �• .. � cr ^�_ �' • `
.Y �I�l
�F6. Hendicap Regulatio�5 * ^ , ` � _' - �
r r �.+ t
i� ` . ,
47. FINAL STRUCTqp,� & BUIL'DING fi�, � i-- < a� t
48. EINALPLANNINB* r'0" c i � r.; � � ` -
>. � � �� +' -i'
49. E�ear,'�c Release to'Edison � : " ;: ; Q - �
. .;
50. Gas gelease to Soutfiem Califor2i�_Gas Cn � _ ;��' � - � � � -� � -
51. CERTIFICATE OP OCCUPANCY ' � " � �
No Date
PflOJELT FDOPESS: Q O B E 1 8 TH $T UNIT:
OWNEiHS NRME: GAZ S I, THOMAS E
nooness: q08 E 18TA 5T
,-- C.M. CA 9267—
714) 642-8989
pRCH/ENGINEEN: SCOTT BROWNELL xec.xo.: 11839
nooness: 1950 W. PACIFIC COAST HWY uxiT:
N,B. CA 92663
PEBMITTEE: TOM GASI ( 714 ) 644-3764
aooeess: q 0 8 E 1 8 TH
C,M. CA 92626
LILENSEU CONTBRCTOP OECLAMiION: I hereDy ailirm i�a� I am IicenseE unaer prov6ions ol CtwD�er 9(commencinp wiiA Section
7000� 01 Oidsian 3 01 Ihe BuSineSS an0 Pmtessi0n5 Lotle. and my litense is in full �orte an0 ellecl.
GTV UC.: STRTE UC.: CLRSS: EXj7 ;
Date: Signature:
WOPNEBS' COMPENSATION OECUIIA710N: 1 hereGy allirm Ihat I �ave a cenilicate al wnsent to ul4insure or a ceniliute ol Workers'
ComDensa�ian Insurance. ar a cenifiea coDY i�ereof (5eciion 3800, Lao. C�.
I PoLILV NO.: E%P. URTE:
COMPRNY:
� Certifi¢d fApy is �ereDy IurnlS�eO. ❑ Cenifie0 copy is lilea vntn lne ciry BuilEinO ��n.
�ate: ApOlicant:
E%EMPfION FflOM LVOPIIEflS' COMPENSATION OECIAMTION: (��i5 sttYron neeG �roi Ue ampletN il Ne perml6 M me MmtlreG (570� or less�.
I t� ity Itul in Ihe pertOrmante 01 lhe wark tor w�i[� I�is permi� is rsSueO. I SIWII nal empl0y any persan in any manner 5a az l0 Uetome
SCu�etl Io I e W kerY Comp¢nsation Laws oi Califomia.� O�yy,J� �
�Oa;e: Sipwture'/ AY%��
71 E: II. atler makinq t�is Oeclaration. you s�ou su le�� o t�e Workers Compematron provisioris ol t�e Labor
CoOe. you musl IanMnlh compry witn wcn pmvisions or iNs Derrtut Shall De deeme0 rovoke0.
CONSTflULTION 1FN01NG AGENCY: I �¢r¢Gy atlirm Iha� lhere i5 a tonsimt�ion IenEinp apency lor I�e peAOrmanCe nl I�e work �or
wNcn inis cermil is esuetl (Stttion 3W7. Civ. CI.
LENDEP:
ROOflE53:
IOWNEP BUIILEB �ELlAf1AT10N: I hertq� allirm ttwt I am exem0� ��om t�e Cantrapors' Svte License law far t�e lallovnnp reasan
�Section 7031.5 Bu5ine55 anE Profes9onal COtle: Any tity ol county wllich rEQuirR a perrtut to COnSifutl, alter, improvl, Gemolish, or
Rpolf dfly SIlYClUfO. D��O� IO IIS 1S50dOLC. dIW fCQp�l25 I�C 3ppliWlli IOI SOC11 pBfrtGi IO Id0 i AQIIGE SIdIGfIICOi 11Wi IIE/5110 IS IILEIISCE
oursuant to ine orovivons ol t�e Comractori Siate Licenu Uw (CIwO�er 9lcommencinq wit� Sectbn 7000) al OiWsion 3 of tne Business
an0 Pmfessions COEe) or rtw� �Gs�e 6 exempl I�erefrom anA �he �asis lor I�e aAe0e0 eeemption. My violatlon al Section 7031.5 Oy
any aOW�nt iw a permit wOjeces tAe aDVliwnt to a civil Denalty of nol more tlun Irve huntlre0 Eollars (5500�.
I, as wmer ol tne pmpeny or my employees wii� wa0es as �neir sole compmsatron, wiA do tAe woM, ana ihe
I❑ stmcture is not intentleE or ottereE lor sale (Section 70aa. Busineu anE Professional Caae: T�e Coniractors' Stam License Law
aces �wt apON ro an owner ol a pmpenV w� Ouiltls or imD�aves t�ereon, anC wtq Uoes such woM himsell/hersell or tAmug�
nis or ner ovm emoloyees, proviaea Inal sucn imo�a�emenis aR not intenep0 or oflereE for 5a1e. II, Ipwever tne Euiltlin0 or
' im0�ovement 6 Sob vnihin one year o� completion, t�e owner vriil lave t�e GurGen ol Drovin9 �E/s�e GiE not GuiIE or impmve
for the Wrp05e ol Sale�.
i. az owner ol me pmpeny, am exclusivery contracting vni� IicenseG wmractors lo wnsirutl tM prqeci (Sectlon 700d, Business
❑ anG Pmfesvws CoOe: ihe Contracrors' Siate License Law Ooes not apON �o an owner ot Dmpe�1y wlio EmIEs or impmves Ihereon
antl wllo tonVaclS tor Sut� D�Wet�S wiN a wnVatlOr�s) liCense Wrsuant Ia f�e CAntfat�ats' $�a�e LkenSe Law�. I am awaa
I�ai prooi ot �Anr Workei 5 ComDensalion in5urante ShoVltl Oe prOvid¢G IO mE.
a I am erempl uneer Sec�ion: H p 7 Q 4 q B. d P. C.
mrim rez n: OWNER—HUILDER �
ate: � , � ,
I ere�y cenity ttut l am aware ol an0 unUerslanU Ine repuiremenis ol Cablomia Healin ana Salery COae Sectians 25505, 25533, ana
53L an0 Ihat I or any lu�ure WilOinq acupanl wilUwill nol (circle one) neeE lo fAmply wiN Saitl state Ca0E5 an0 i�e reQuiremenis for a
p¢rmil �Or conSlmtiian ar m00ditali0n IrOm I�e Air Oualily ManaOemenl OiSlriti. Re9Aeniial tonSlrutii0n aOD��a�ion5 ar¢ ¢xempt Irom
Ineu prOvisions.
Oate: ApDlicanl:
I �ereGy cenity I�at I �ave reaa t�is applicatian an0 stata �ha� Ihe aEove inlormation is wrreci. 1 apree to comply wilh all city antl county
or4inancesantlstateWKsreW�ingto0wl0mqwns�mclionan0�ere0yamAorae epresentawesol�NscirymemeruDonl�eabove�memioneG
r�y lo insp ctwn 0 u5e5.
Dale' Signamr ^
i
��ers license or 5ociai Secwiiy .:
i6ai�a6 WM1ne-9uil�inq: Green—Cotle EnlorcemenC Canory—AOPlicant: Rnk—Revenua; GOltlenroC—Assessor
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT P10: B 067931 PLAN CHECK NO: 02274-94 L
CONSTRUCTION TYPE: PERMIT TYPE: STR
PERM NO: B 067931
GOVT: N SUPP: iJ
PURPOSE: CON
JOB DESCRIPTION : CONST. 440SF GARAGE SQ FT: 440
CLAIM VALUE: 6,000.00 CALC—VALUE: 8,184,00 GROUP OCC: M-1 /
COMMENTS: CONSTRIICT 440SF GAAAGE
*�w#��i�����#*ir#t�*�*****x���#**��*�r**#�u�*x��#*�#*�� **�**#�-#��u*�����t�-+���*��*�-#��k ���; #� w
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
------------ MAIP1 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: 44 FT IN REAR; 6 FT iN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; 16 FT IN
PARKZNG REQ: PROV; PARCEL; 11733239 ZNE: R1 REF NO:
PLANNING NOTES> ADD A 440 SQ.FT, WORKSHOP TO THE SIDE OF AN EX. DET GARAGE.
> CORR: REPL 16' WIDE OH DOOR W/ DOOR 7' OR LESS IA] WIDTH,
***x�**********�**�t�t****�*�r*****�r*****�r***********+�***�*+�;�+�*��**�r�**+r*�r**�-w��#x��w
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 �l�jV � DATE; � � � �4
HUILDZNG APPROl7ED BY ; DATE: �
APPLZCATION ISSUED HY: DATE: �
iFi(�ieitiFiFfEiEiEiFiEiEi[�iFiElFiEiEitiElEiE x iF'it fF ieRiF ftitfFlt ir ###iFiEiEikiFii7kit
iEifiEfEif1ER#if#!f#1Flti'f(�iEiEiFifiFiEi[�i!#�FjFif�ElEiFiEififlFitiFifi4f£iE#itiPif#ihifftiEiFff#fEifififiFi�ififiF#iElfiEilfF
LEGALIZATION:N F E E S U M M A R Y STR[ICT[iRA
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT LO8.00
PLAN 70.20
ISSUE FEE
BUILDING—DIV—> PERMIT ISS[lE PLAN—CHECK
TOTALS----> 108.82 0.00 70.20
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMHING ELECTRIC MECHANIC
108.00
FIRE
Yr #'iF iF It 1! # iF*
SEGMENT:Y
SMIP/RES GRADZNG
82
SMIP/NON—RES
TOTAL PAID DUE
179.02 179.02 .00
108.82 OVER/SHORT; 00
FIRE SMIP/TOT GRADING PLAN—CHECK
.82
ih i! ih ih if fE!(� # 1t i! 7f 1E 1F iE iE if i"t 1E if iF jE iE iE iE iE IE iF # iE iFlf iElE fE if iE iE iF iE iE 1k iE 1Elf # if fE �IE if iE if iE!! if iE!! it if !E iE if ik iE # it if 1E if # ih it iE �1k ## fF iF 3t 1E
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
SFR 440 RES—GARAGES TYPE V 18.60 8,184.00
. END OF FEES
� � � Y � �
�.�la. s F lo/I 9 SIG. �_
t. :.. .._._...�,.._. �... .._ .. ....... ..... ._....__...
• DUE TO A CHNr��s- To '171E SCoPE oF We�z..�, L
�� 1�7E1�J Q(.A1sS �i�TH THE LN�NcoES WE—R-� SU(3iYI1TTED
$ A(11�"w P�-MlT w«� riE iss�� ��_/c REF��te
�.-�=` RhZ�U�T w RS � r
O1 OO1h3637—OOib3b38 T�] T lOE.E?
� gUR,Vn�Tt'�D'• �� �ATE: G7/03/94 TIt1E: 11:`3
l�
COi1STRUCTION AND PIANNING �`� r'OC SPA " �
APPROVALS Permit # Date� '• Inspector qppROVALS Permit # Date Inspector
�
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe�Undrgrnd. 53. Steei fleinfo*cement .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Elettrical 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. E{ectricaf Conduit�Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrgrnd., Tesi _
9. Water Pipe�Undrgmd. 60. Backwash Lines, P�Trep, Cl Undrgrod. •
10. Structural Floor Svstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Conneciion 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. Fough Electrical-Condu�t 66. Solar SYstem•Final
16. Rough Eleciric Wiring 67. Fencing & Access Approval
77. Rough Wirin9 Sign 68. APPROVED FOR PLqSTERING
18. Rou9h Electrical-T Bar Ceiling 69. POOL/SPA SYSTEPAS F�NAL
19. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Struct�re )0. Underground Hydro _
22. �ucts, Ve�t��ating 71. Product Pfping �Gas ❑Oil .
�
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Underymd.StorageTank OGas ❑Oil -�''� _
25. Roof Sheathing 74. Overhead Flydro �r. o j
26. T�Bar Ceiling IStructural) & Monocoat 75. Dry Chemical �, ..
27. Frame and F�ashinq 78. Dry Standpipe -
s`
28. Lathing & S�ding 77. FIXED SYSTEM FINAL
29. insulation 78. FIfiE PREV. FINAL --
30. Drywall Nailing HEAL7H DEPT. REQUIREb1Ef�YT "
31. Plaster Brown Coat 79. FINAL INSPECTION "-
32. Electrical Pv�Yer Meter-Final 80. FOOD CERTIFICATE ISSUED ._. . --
33. Final Elec:ric Notes: •
34. Final Heating & Air Conditioning -
35. Final Gas Pipe-Test ' -
�
36. Hood or Canopy
37. Ft�at FaaorV Fireplace
38. Final Plumb��g �
39. Water Service�Finai
40. Gas Service-Final
41. Solar pomestic-Final '
42, Backflow Preventer •
43. Backflow Irrigation
44. Landsca0e Irrigation Syscem
45. Sound A[tenuation . -
46. Handiwp Regulations
47. FINAISTRUCTURE&BUI�OfNG ' '�
48. FINAL PLANNING '
49. Electric Release co Edison ,- _ _
50. Gas Release to Southern California Gas Co � '
51. CERTIFICATE OF OCCUPANCY •
No. Dace
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. � 2
COSTA ME5A BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For App��cant to Fill in Completely
AD�RESS !I'� � ��O �� S! I
OWNER GPR� �• GO'SO)Zf
MAIL =�.0 0 2.I�/'�' S%
ADDRESS y�
CITV COS � �%���5� NO`•J�p—�IS
CONSTRUCTION �.. _ n
BRANCH
ADDRESS
ARCH^TECT TE L.
CONTRACTOR � �T�^^'�-d.1L.t,
ADDRESS �0 1 � { ��- S��
/�yJ TEL.
CITV V /�/PSi� NO.��=P.
STATE CI7V
LIQ NO. LIC. NO.
SIZE NO.OF BLIX'>S.
OF LOT I�.i. I! X / C I NOW ON LOT
EXISTING BIDG. RQ S'd hf C�
SIZE OF � . �/ NO. OF
NEW B�DG LL ROOMS STOF
EXTEFIOR WALL .. {/ ROOF /
COVERING 4/L[[O COVERINGS/j�Y'
USE OF BUILD�,(`�G AND WOFK TO BE PERFORMED
Jlil14-64cnsaQ01116# �**�i�3.50
APPLICATION FOR BUILDING PERMIT
REC VED BV DATE qECE�VE DATE IS U
m-, 7 _ /c/_h�/ � i� %°9'
A.P. NO. / � J c�/�L' - U
BUILDING
ADDFESS 6 g (� �;� '
TRACT LOT � BLOGK
W AD A P
X
OWNER
VALUE ,/�O�Q� '
S � $ �fT
FIRE..� -�
ZONE � TYPE GROUP �
APPROVE� /l1� N /O�//J
ZONE I NO.OF
PLAN$
YARDS APPROVED
MAIN BUILDING
(FROM C/� STR�ET) .
OISTANCE
APPROVED
I hereby acknowledBa thet I have reatl this epPlicetion antl state
that Me ebovo intormatian is correct antl agrea to comply wiM
all laws regulaNnB buildin8 construction, entl � shall not amploy
any person in violation of the workman's compensatiOn laws of
t�e State of Californie.
I hereby certify that I am properly licensetl as a conttactor untler �� n. FT.
the State oi California Business antl Professions Code, Divisicn 3, THE AMOUNT S
Chepter 9, antl thet such licanses are In (ull torce antl eftecg or I THE PURP�E OF
em exempt from the pr isions of the State of Celifornla Business VALUATION
antl Protessions Cotle, islon e3 Ch ptar 9.
Sipneture of /✓ �, ��� �
Parmlttee ��� 5
Autnorized Aaen2
USE OF NEW �B.g.�yL
BVILDING � ���%f
G
VApDSAPPROVED
ACCESSORV BUILDING
BET. MAIN &
ACCE$$. BLDC
DATE
APPPOVED
.,.�� 7�
m
0
VALUATION IS FOR '
A PERMIT FEE ONLV: Q
s �i c� �
. ry
K s 5�• SO o
S ��J��� LL
�,.-' -�-'.. �786�
�� f
COSTA MESA BUILDING DEPARTMENT
P.O.BOX 31]
COSTA MESA, CALIFORNIA
FOR APPLICANT TO/ FILL IN
BUILDING �`/� ii� � /C/
ADDRESS sU X 71
COSTA MESA. CALIFORNIA
MAIL
ADDRE55
C�T�
ARCHITECT
OR ENGINEER
AOORE55
�ccn� LOT
DESCRIPTION �.fQ,
A.P. NO.
SIZE
OF lOT
USE OF
E%�STING BLOG.
SETBACK LINE FROM ��
CENTER OG STREET
�
TEL.
NO
LIC.
NO.
CITY UC.
NO.OF BLOGS.
/
YARD
% ��� j � �
SIDE YARD RIGHT ( FT �
DESCRIPTION OF WORK
NEW ALTERATION ADOITION
REPAIR MOVING � OEMOLISH
BUILDING NO.OF
SIZE ROOMS STORIES
EXTERIOR WALL ROOF
COVERING COVERING
USE OF NEW '�/I'I[r N/ A/� i�
i1��� ��(�' r'r
�'T����""--� "773a itoirizolJ.O� ^
C 1- ue..�
�z'/k��Q� �i£�.
(f E.J � J�� �
;4PPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. pEPMIT NO.
`�/-G� t-i� fz
COSTA MESA. CALIFORNIA
FIRE �
ZONE
20N NO.OF � � TVPE
PLAN
�, '� /n r r
APPROVED / �Q
BV � DATE
CORRECTIONS
BY
C[TY OF TA �tES�� ' I III �
�� , i \
i�aiaCT TO G. DEPT. REG. �
STPTE THI.T TNE ABOVE IS CORRECT �NO AGREE TO COMPLV WITH /LL
CITV ORDIN/.NCE$ AND ST�TE L�WS flEGUITTING BUILOING CONSTRUC�
TiOrv. /T � , ' � n VALUATION ,
� PERMIT FEE $
SIGNATURE OF _r
PERMITTEE
� �! U' �� PLAN CHECK $
$
AUTHORIZED AGENT TOTAL FEE $ � ��' ��
i ♦..
��, - 10633
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 317 COSTA MESA. CALIFORNIA
fOR APPL/CANT TO f/LL /N COMPLETELY
TYPE OR PRINT
BUILDING l/O � _
ADDRE55 7
COSTA MESA, CALIFORNIA
OWNER �1%ch�F�. �. �r/,c�r�a �� "
MAIL _ _ _ �/w / � . .. �' � T
� ARCH ITECT LIG.
OR ENGINEER NO.
ADDRESS
STATE
�[c�t LOT (j
OESLRIPTION NO. // / BLOCK
A.P.NO. � �
OFLOT GSX IoiSOg INOwa
USE OF
EXISTING BLDG.
9ETORCK LINE FFOM
DESCRIPTION OF WORK
NEW I IIALTERATION I II�+DDITIO
REPAIR I II MOVING I II DEMOLIE
BUILDING NO.OF
SIZE ROOMS STOR
EXTERIOR WALL IROOF � r
COVERING COVERING
USE OF BUILDING AND WORK TO �E PERFORMED
COV�R/t�[1
1 HEFE9V ACKNOWICOGE THAT I HAVE NEAD THIB APPLICRTION
•ND ST/�TE THAT TNE ABOVE IB CORFECT /�ND ilGREB TO COM-
PLV WITM ALL GITY OPOINANCES AND STATE L6W9 FEGULATING
BUILDINQ CON6TyFUCTION.
SIGNATURE OF /h _. f� �!r_ /O ..�_, D__ D_ �
� AUTHORIZED AGENT
�
n=EE RECEfUED
-�cl io,�/—S`�
FIIdANCE DEPT.
APPLICA�TION�UFsf��t �'tEH MIT
J
BUILDING
foR officE vsE oa�y
I RECEIP� NO. I PEFM�T NO.
iCI�(p'3�
IIVED BY / p/j,TF AEC¢IVED I_ DATE ISSUED
COSTA MESA. CALIFORNIA
FIRE �-
ZONE TYPE GROUP �
APPROVED � S✓f _"__ � b L/ f'
BY
REAR
Z'ONING
NO.OF U6E OF N
PLANS �� BUIL�ING
}//�, / �
I ( � � �DATE
�
v-
THE /�MOUNT 6MOWN VNOEN VALUATION 18 FOP THE
PURP08E OF ESTABLIBNING A PERMIT FEE ONLY.
VALUATION Q U
PERMIT FEE $ ^�
'/ , � 6 PLAN CHECK $ ,
$ /
^,c
TOTAL FEE $