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HomeMy WebLinkAbout495 18TH ST - Building Permits(714) 754•5273 • Fax (7�14) 754-4856 • www.ci.costa•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 � ELECTRICAL PERMIT JobAddress' \ 95 E 18TH ST Status: ISSUED Suite No Vicinity: Parcel Nunmber: 11737212 Applicant: WILSON, BOB Address: Owner: PALMER, JAMES J Address 495 E 78TH ST -� � COSTA MESA; CA Contractor: BI WILSON AND SONS Address: 485 E 18TH 5T ISSUE FEE Temp service test Res. alc package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appi Res Appl Service l0 200a Service to t000a Service over 1000a Motors to 1hp Motors to 10hp Motors to SOhp Molors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Lighl Pkg Sign Circuits Temp Pwr Pole Intermed Pole COSTA MESA, CA Phone: 949-646-1740 Zip: Phone: Zip: 92627 Phone: (949)646-1740 Zip: 92627 License: 377487 ISSUED BY: Applied: 12/O6/2000 Issued: 12/O6/2000 SCOPE OF PERMIT REF: B00-01831. ADDITION AND REMODEL TO SFR. 16 LIGHT FIXT., 24 OUTLETS, 12 SWITCHES. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $17.60 $24.92 $13.20 $0.00 so.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 16 24 12 0 a 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY _ .. _ 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 kvalkw .................up l0 100 kva/kw ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring Syslem / Ckt Misc. Conduit Misa Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 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 so.00 TOTAL CALCULATED FEES 579.22 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) 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 ihis pe�mit to be considered legal, such work must comply with all applicable codes, and all required Inapeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 2anuas (srool / WORKERS'COMPENSATON DECLARAnON: I hereby aHirm under penalry of perjury ona ot the following tledarations: ❑ I have end will meimain a certiFiwte oF consent ro setl-Insure for workers' compensation, as O�aWded for by section 3700 ot t�e Labar Cotle, tor ihe pertortnence of Ihe work tor which this pertnit is issued. ❑ I have arW will mainiain workers' compensaGon insur nFa, as required by sectlon 3700 of Ne Labor Cade, for the perfortnerke oi Ne work fa which is pertnit Ls issuetl. My workers' wmpensation Insure carrier an0 licy u ber are: Carner. PoliCy Number. (TM1is section need not be comp/efed i/ th permit i' I ed at one hundred dW/ars ($100J or /ess.) ❑ I certify Ihat in the perfortnance of ihe work tor hich this pertnit is issued, I shall not employ any person in eny manner so as to become s' ct to the workers' compensation laws ot Calitomla, antl agree iha if I should become suDjact to the workers' compensation provisions of Section 3700 of t� bor ode, I shall tort�wlth comply with these provision�sJ. ' AppGcant�SigneWre._ 7..1�-f.�-�:. ,le.l�v,tn.r Date: WARNING: FAILURE TO SECURE WORKERS' CQMPENSATIqJ COVEMGE IS UMAWFUL AND SNALL SUBJECT AN EMPLOYER TO CHIMINAL PENALTIES D d IL FlNES UP TOONE HUNDRED iF10USAND DOIURE (5100,000�, IN A�DIiION TO TME COST OF OOMPENSqTION, UAMAGES �S PROVIDED FOR IN SECTION 31080F TME UBOR CODE, IMEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: � I hereby attirtn that I am licensetl under proNsions ol Chepter 9(cammencing with Section 7000) of Divisian 3 ot the Busineu and Protessions Cotle, end my license is in tull force and ettect. Liu k Class e Contreaors:Slgnature: Date: CONSTRUCTION LENDING AGENCV: , ❑ I hereby atfirtn thet there is e construction lentling agency for the peAormance ot the work for which this permit is iuued. (Sec. 3097, Civil Code). Lentle/s Name: Lentler's AOdress: Signature: Date: OWNER•BUILDER DECLARATIONS: I hereby ettlrtn that under penelry ot perjury that I am E7(EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professlons Cotle: Any ciry or counry which requires e permit to construct, elter, improve, tlemolish, or repair any swcture, priar to its issuance, elso requires the epplicant for such permit to file a siqne0 statement ihat he or she is Iicensed pursuant to Ihe proWsions of the Contrectors License Lew (Chepter 9(commendng with Section 7000) ot DMsion 3 of t�e Business and Professions CoCe) or Ihat he or she is exempt iherefrom end t�e basis for the ellegeA e:emption. Any violation of Section 7031.5 by any epDlicant tor a pertnit sublecis ihe aDDlicant to a civil penalry of not more ihan live hundred dollers ($500).): ❑ I, as owner of tha property, or my employees with waqes as Iheir sole compensetion, WILL DO THE WORK, end ihe structure Is not intentletl or oMered for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law dces not eppty lo an owner of proparry who builds or improves thereon, antl who does such work �imself or herselt or ihrough his or her own employees, provided Ihat such improvements ere not intendetl or oHeretl tor sale. If, however, the 6uilding or improvemeM fs sold within one year ot completion, ihe owner-builder will have the burden ol proving t�at he or she tlid not build or improva tor purpose ol sale.). � I, a5 owner of lhe property, em EXCLUSIVELV CONTflACTING WITH LICENSED CON7RACTORS lo wn5irucl lhe project (Sec.7044, Business entl Pmfession5 Code: The wniractors License Law does not appty to an owner af pmperry who builds ar improves thereon, antl who wniracts tor such project wlth e coniractor(s) license pursuant to the COnirectors License LewsJ. ❑ I am exempt untler sec. Signature: Owner ID veritied by dnvers licen5e. ❑ Ves ❑ No Business end Protessions Code for this reason: Venfication at Ownership by (rype at document, i.e. - pmperry tex bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Dnvers License No. Date: Eaplres: ❑ I hereby certity that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in conneIXion wllh work euthorized by this pertnit, and that no building 5�ructure, scaHolding, falsework, or demoli�ion or dismantling t�ereol, will Ge more than t�lrry-six (36) teet hlg�. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Atlministrative Cotle). ❑ As owner-builder, I will not employ anyone to tlo work which would require e permit irom the Division of Indusirial Sefery, es noted above, unless such person hes e pertnit to tlo such work frpn the tlivision. Signalure: Dele: Division ot Industnal Safery Permit Number: CERTIFlCATE OF COMPl1ANCE AND AUTHORQATION OF EMRY: I certity under penalry of perjury that I have read this applicatlon and stete that the infortnatlon given is correct. I agree to comply with all stata laws antl ciry ordinances reta�ing �o building consiruction, antl authorize representetives oi ihe Ciry ot Costa Mesa lo enter upon the above-described property tor inspection puryoses. I agree nol �o occupy or ellow occupancy ol eny huilding authodzed by t�is permit until final inspedion. CODE �. INSPECTIONTYPE 1616 Fixetl System Flnal Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final BIocWRetelNng Wall 202 203 Final Factory Fire Place Finel Sign 204 Final Demalition QSIE INfIfIALS CODE� INSPEGTONTYPE 206 Finel Met�enical 208 Final Plumhing 210 Final EleCtncel 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Sita 250 FinelBuiltling/Occupancy PAIE Iti�LS �m� (714) 754-5273 • Fax (714) 754•4856 • www.c�.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 495 E 18TH ST Suite: Vicinity: FAMILY ROOM, LIVING ROOM, PORCH ADDITION Parcel Number: 11737212 Appliwnt: WILSON, BOB Address: 485 E 18TH ST COSTA MESA, CA owner: PALMER, JAMES J Address 495 E 18TH ST COSTA MESA, CA Contractor: BI WILSON AND SONS Address: 485 E 18TH ST COSTA MESA, CA Zip: 92627 Arch : Address: Phone: Zoning: Phone: (949)646-1740 Zip: 92627 Phone: 2ip: 92627 Phone: (949)646-1740 License: 377487 Eng: Address: ISSUED BY: StaWs: ISSUED Applied: 11/14/2000 Issued: 12/06/2000 Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 496 S� FT ADDITION TO EXISTING SINGLE FAMILY RESIDENCE TO ADD NEW FAMILY ROOM ATTACHED TO REAR OF HOUSE & TO WIDEN EXISTING LIVING ROOM. ALSO CONSTRUCT NEW 100 SQ FT PORCH. Plan Check: $385.94 Permit: $593.75 SMIP Res: $4.40 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $984.09 SETBACKS MAIN STRUCTURE Front 20. 0 ACCESSORY Front 0-0 PARKING Ezistin : 2 NOTES: Rear 56- 6 Rear 8- 6 Required: 2 FEE SUMMARY 0 PLANNING & ZONING Left B- 6 Left 8- 6 Proposed: 0 Calc Valuation: Claim Valuation: Right 5- 0 Right 33- 0 saa,ozo.00 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and relatad regulations. (Ord. No. 92•28, § 1, 12-21•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 this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetions and final approval must be obtained. Failure to obtain Inspections and Final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 i ' 2446d81fl�W) . �/ � WORKERS' COMVENSATION DECLARATION: _ I hereby atfirtn under penalry of perjury one ot the Iollowing tleclarations: ❑ I he end will maintain a certificate of consenl to sell-Insure for workers' compensetlon, as provided for by section 3700 of ihe�ia..br Cada. for Me pedortnance of the rk for whiCh this pertnit is iuuetl. I have end will maintain woiicers' compe lon insurance, es repulred by section 3700 of Ne Lebor Code, tar Ne peAortnance of the wark tor which � Iipertnit is issued. My workers' compensation In urence car eran ollcy number ere: � Cerrier: ' Policy Number: (This section need not 6e comp/efed i! the p it /s velued e! one hundred dollers ($100) ar less.) ❑ I ceRify ihat in the peAormance ol th ork for which ihls pertnit is issueq I shell not employ eny person in any mannar so as to become s ject to the workers' compensatlon laws ot Califomla, end egree Ihet II I should Decome sub�ect to the workere' compensatlon provislons ot Saction 3700 oi the Labor Cotle, I she0 torthwlih comply with Ihese proNslons. .n // ��n /� Applicant Signature� � �L• G�� Dete: r WARNINd: FAILURE TO SECURE WORKEFS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALT S AND C IL FINES UP TOONE HUN�RED TIIOUSAND DOILARE (5100,000). IN ADDITION TO THE COST OF CAMPENSAiION, DAMAGES AS PROVIOED WR IN SECTION 3IOB OF TME LABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm that I am licensed untler provislons ol Chepter 9(cammencing with Section 7000) of Division 3 of Ihe Buslness and Professions Cotle, and my license is in full force end e(fect. Lic. N Class a Contractors Si9nat`--ur� e1. �ate: .. . CONSTRUCTION LENDING AGENCY: . ❑ I here6y eHirtn t�et ihere is a construction lending egency for Ihe pedormence ot Ihe work tor which this pertnit is issuetl. (Sec. 3097, Civil Code). Lende/s Name: Lentlefs AOtlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eNirm �het under penelry ot per�ury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business end Professions Code: Any ciry or wunry which requires e Oermit to construct, alter, Improve, tlemolish, or repair any structure, pnor lo its issuance, also requires the applicant 1or such pertnit to file e signed stetement thet he ar she Is Ilcensed pursuent to tha provisions of the Cantrectors License Law (Ghapter 9(commencing with Sectlon 7000) of DPdslon 3 ot the Business end Prolessions Code) or thel ha or she is exempt theretrom and Ihe besls for the ellegeA exemption. Any viWetion of Section 7031.5 by eny applicant for e pertnit subjecis ihe epplicant to a civil penalty of not more than tive �undretl tlollers ($500).): ❑ I, as owner of the property, or my employees wl�h wages es Uelr sole wmpensation, WILL DO 7HE WORK, antl ihe structure Is not intentletl or oHered for sflle (Sec. 7044, Business antl Professlons Cotle: The Contractors License law does not apply to an owner of properry w�o builds or impmves thereon, and who does such work hlmself or hersetl or ihrough his or her own employees, provided that such improvemenis ere not Intended ar oflered for sele. It, however, Ihe building or Improvemem is sold within one year al completion, the owner�builder will have �he burden of proving thet he or she did not build or improve for purpose of sale.). ❑ I, as owner oi the properry, em EXCLUSIVELY CONTRACTNG Wli}I LICENSED CONTiiACTORS ta construct t�e O�oject (Sec. 704a, Business anA Professions Cade: The contractors Llcense Lew does not epply to an owner of pmpeny who builds or Improves theraon, antl who contracts tor such project with a contredor(s) license pursuent to the Contractors License Lews.). ❑ I am exempt under sec. Busineu antl Professions Code for this reason: Signature: Date: Owner ID verilied by drivefs Iicense. ❑ Ves ❑ No Orivers License No. Expires: VeAfication of Ownership 6y (rype ol dxument, I.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTFICATION: ❑ I hereby cenify thet no ezcavetion tive (5) or more feet in depth into which e person Is requiretl to descend, will be made in connection with work authodzad by this permit, end that no builtling structure, scaHolding, falsework, or tlemolition or tlismantling ihereof, will be more than thirty-six (36) feet high. (Cnap. 3.2, Grp 2, Art 2, Sec. 341, Title B, Celifomla Administretive Code). � As owner-builder, I will not employ anyone lo do wurk which would require e permil from the Division oi Indusinal Safery, as noted above, unless such person hes e permit ta do such work trom the division. Signawre: Date: Division of Industrial Safery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUIHORVATON OF ENfBY: I ceniry under penalry of perjury that I have read this appliwpon and state thet ihe iniormation given is corred. I agree to comply wil� all state laws end ciry ortlinances relating to building consiruction, end authodze representatives of tha Ciry ol Coste Mesa to enter upon �he above-described property for inspection purposes. I egree not to occupy or allow occupancy ol eny building authonzed by ihis pertnil until tinel inspection. COUE �, INSPECTIONTYPE 1616 Fizetl Sysiem Final Fire Prevention 1266 Pool Spa Finel 200 Finel Re-Rool 201 Finel BIocWRelaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Finel Demolition Q�¢ fNf171�L5 �� INSPECTIONTYPE 206 Final Mechanical 20B Finel Plumbing 210 Final Eledncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Oaupency PAg QiiIDlLS (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, CASTA MESA, CA 92626 ,lob Address: 495 E 18TH ST Suite No Vicinity: Parcel Number: 11737212 Applicant: Address: Owner: Address: WILSON, BOB PALMER,JAMESJ 495 E 18TH ST COSTA MESA, CA Contrector: BI WILSON AND SONS Address: 485 E 78TH ST Arch / Eng : Address: COSTA MESA, CA MECHANICAL PERMIT Phone: 949-646-1740 Zip: Phone: Zip: 92627 Phone: (949) 646-1740 Zip: 92627 License: 377487 Phone: Zip: License: ISSUED BY: SCOPE OF PERMIT REF: B00-01831. ADDITON AND REMODEL TO SFR. GAS PIPING FOR NEW MASONRY FIREPLACE. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair I Alt Cooling/Heat Inst / Rep. Recess Wall Htr Re(rig Sys <100 k BTU Retrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cim Floor Fumace Floor or Suspend Heater $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 50.00 $0.00 50.00 so.00 $0.00 so.00 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Repair I Alt Absorbtion Unit Repair / Alt Rafrigeretion Unit Ventillation System Evaporetive Cooler Com me rcial I ncine rator Domestic Incineretor . Compressors / Absorption Svstems Upto3hpN00kBTU - 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3Tot5hp 15to30hp 30 to 50 hp Over 50 hp Olher Mechanical Fee Investigation Fee Plan Check Fee Reinspedion Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: Applied: Issued: ISSUED 12/O6/2000 12I06/2000 Quantity $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 S0.0o 0 $0.00 0 50.00 0 50.00 $0.00 50.00 E29.65 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (OrU. No. 9248, § 1, 12Q7-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or ii work is suspended or abandonad for a period of 180 days. INSPECTIONS: In order tor tha work aulhonzed under this permil to be Considered legal, Such work must comply with all epplicable eodes, arM all requlred Inepectlona and (inal approval must be obtained. Faiture to obtaln Inspections and final approval will result in the ezpiration o� this permit. FOR INSPECTIONS CALL: (714) 7545626 zaao-ae Iamo) / � WORKERS' COMPENSATION DECLARA710N: � I �ereby aftlrtn under penalry of perjury one ot ihe tWlowing dedaretions: ❑ I have end will maintain e cenificete af consent to selt-Insure tor workers' compensation, as proNEed lor by sectlon 3700 0l ihe Labor CMe, tor the pertormance of Ihe work for which ihls permlt I5 issued. �' � ❑ 1 have ar�d will maintaln workers' compensatirn insurence, as re)�IreA Dy secUon 3700 ot Ne Letwr Cotle, lor the peAortnance of the work ta xTld� W ertnit is iswetl. My workers' wmpensetlon Insurence carrier ol(cy numb are: � Carrier. `- Policy Number. (This section need not be completed I! the permit is veluetl e! one dre0 dollars ($100) or less.) ❑ I cenity that in the pertortnance of the work tor w�ich Ihis t Is Ltwea, I shell not employ any person in eny menner so es to become su t to Ne workers' compensatlon laws of Celitomla, entl egree t�et If I ahould me sub�ecl co the warkers' compensatlon provislons of Sactlan 3700 oi the lebor Catle, I shall torNwith compy with these provisio�ns�p. ' �(� / J' �y / AppticamSigneWre: -� 7�0� �% u�C�i�.. Date: /O/��/ WARMhG.'FAILVRE TO SECUHE WORKERS' COMPENSATION COVERA(iE IS UMAW RIL AND SWLLL SU&IECT AN EMPLOYER TO CRIMINAL PENALTI AND L FlNES UP TO ONE HUNDRED THOUSMlD DOl1ARE (5100,000), IN ADDfilp! TO THE COST OF CaMPENSATION, DMNOES AS PROVIOED fOF IN SECiIIXJ 3�080F THE IABOR OODE.INfEREST, AND ATTO{iNEYS FEES. LICENSED COHTRACTORS DECLARATION: I hereby eHirm that I em Ilcensed under O�ovisions ol Chapter 9(cammendng with Secllon 7000) of Dlvision 3 al Ihe Busineu entl Protessions Code, end my license Ls In full lorce end etlect. Llc. M Class p C\mrectols Signature: _ _ _ Dete: CONSTHUCTON LENDING AGENCY: ❑ I hereby aflirtn Ihat there 6 e cOnswction lending e8ency for the peAormance ot t�e wark tor whlc0 ihis permit is issued. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lendefs Address: SigneWre: Date: OWNER-BUILDER DECLARAiIONS: I hereby aflirtn Ihet under penetry of per�ury Ihat I em EXEMPT FROM THE COHTRACTORS LICENSE LAW lor Ihe tollowing reason (Sec. 7031.5, Business end Professions Code: Any Gry or counry which reqNres e permit to construct, elter, improve, demolish, or repair any strucWre, pdor to Its issuance, elw requires the eppliwnt tor such petmil to tile e slpned stetement ihat ha or she Is Iicensed pursuant ta the proNsions at Ne Contrectoro License Lew (Chapter B(commenGng with Section 7000) ot Division 3 of Ne Business entl Protessions Cotle) or I�et he or she is exempt theretrom end Ihe basis lor the allegetl exempiion. Any vloletion of Section 7031.5 by any epplicant for e pertnit su6�eds ihe appllWnt lo a civll penalry ol not more ihan tWe hundred dollers ($500).): ❑ I, as owner ot ihe properry, or my employees wlih weges es their sole compensetlon, WILL DO THE WORK, antl Ihe structure is not intentletl ar otteretl for sele (Sec. 7044, Busines5 and Professions Code: The Contractors Licensa Lew does not eppty lo an owner of properiy who Ouiltls or Improves Ihereon, and who does such woAc himselt or herself or through his or her own emD�%'ees, provided Ihat such improvements are not Intentletl or oHered tor sele. It, however, ihe building or imprwement Is sold within one year of com0letion, Na owner�builder will heve Ne burden of proving thet he or she did not build or improve for purpose ot sale.). ❑ I, es owner of the property, em E%CLUSIVELV CONTRACTING WITF1 LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business and Professions Cotle: The coniractors LJcense Law tloes not epD�Y �o en owner of propeny w�o 6uiltls or improves Ihereon, entl who contracts tor suc� projec� with a contredor(s) license pursuent ta the Comractors License LawsJ. ❑ I am exempt untler sec. Business antl Protessions Cotle br this reason: Signature: Date: Owner ID verifletl by CriveYs Ilcense. ❑ Yes ❑ No Ddvers License No. Vedlicalian at Ownership by (rype af document, i.e. - pmperry tex bill or deed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Expires: ❑ I hereby certlty that no excavetlon Ilve (5) or more leet In Cepth into which a person Is requlretl to tlescend, wlll be matle In connectlon with work euthodzed by this permit, end ihat no builtling strucNre, scaHolCing, lalsework, or tlemoliilon or dismantling thereoi, will Ge more ihan t�irry-si: (38)leet hig�. (C�ep. 32, Grp 2, Ar12, SeC. 341, Ttle B, Calilomla Administrative Cotle). ❑ As owner-DUlltler, I wlll not employ enyone to tlo work whlch would requlre a parmlt irom the Dlvislon of Indusirinl Selety, es noted ebave, unless such person hes e permit to tlo such work Irom Ihe divislon. Signeture: Date: Division of Intlusirial Salery Parmit Number: ICERTIFlCATE OF COMPLIANCE ANU AUiHOR¢A710N OF ENiAY: I certity under penalry ot perjury that I have rea0 t�is epplication end stete Ihat the information given is I wrrect I egree Io comply wil� ell stete laws end dry ortlinences relating to builAing consiruction, end euthodza representetives of the Ciry of Costa Mesa to enter upon Ne ebove-tlescn6ed property tor Inspection purposes. I apree not to occupy or ellow occupenq ot eny building eut�orized by Ihis permit until finel inspeciion. L..". YI!. 11' 1676 Fixed System Final Fire Preventlon 1266 Pool Spe Finel 200 Finel Re•Rool 201 Flnal BIocWReceininp Well 202 Finel Fectory Fire Place 203 Final Sipn 204 Final DemWltion �.�]���I'�1111/1�{ .. / � . �.: � COOE� INSPECTONTYVE 208 Finel Mechenicel 200 Final Plumbing 210 Final ElectdCel 212 Final Flre Preventlon 220 Final Plenning Approval 222 Finel Site 250 Final Building/Occupency //� ---� � PflOJECT R�UPESS: 4 9 S E 1 8 TH S T OWNEfl'SNAME:KINCAID PAT aooeess:495 E 1�TH ST COSTA MESA,CA 92627 ABCH/ENGINEEB: XEC.NO.: UNIT: RUONESS: UNIT: PENMITTEE: PAT KINCAID ( 714 ) 548-6201 aoneess: 495 E 18TH ST C,M. CA 92627 LICENSEo LONTBACiOfl OELIANATION: I nereq' allirm tlWt I am IittnSeC unaer W��s ol Chdo�e� 9lcommencinp with Section 70001 0l Orvision 3 ol Ine Business ana Protessions Coae, an0 my license is in lulliarte and etfecl. CITY UC.: STRTE UC.: CLASS: Oale: SiBnaWre: _ WOflNEPS' COMPENSATION OEClAflA710N: I �ere�y aflirm tlWl I have a cenifitate of consent to self-insure or a rertilicate ol Workers' Compensalion Insurance, or a certAiea coDY ��e�eot (Section 3800, LaC. CI. POLILV NO.: E%P. OqTE: COMPpNY: ❑ Cetlilietl copy is hereDy �mnishetl. ❑ Cenifie0 copy is tiletl wilh �he dry BuilNng Dirition, Ja�e: Applicani: E%EMPTIONFpOMYlOflNEflS'COMPENSITIONOECUMTIDN: (Tldsse�iqnneeGnot6emmpk�eCilNepermilistaone�mMrtd�5100�m1ess). I ceriily Ihai in the pedormance ol Ihe work for whic� �hi5 De�mil is iSsuetl. I s�all no� employ any person in any manner so as to become suUie�� �o ine Warkers' mpensa�ion Laws oi Calitomia. �� �� �� oa�e: 9 so�ature: N ICE:It. a er making Nis OeGaration, you Stloul4 CeCome suGject to t�e WoderS' Com0en5ation provisians ol I�e Labor C e. you musl tonnvntn como�' ��n sucn O���oi6 w tli5 pprntit stWll Oe ee¢meA rewkeC. CON5T80C710N LENUING �GENCY: I AereOy alfirm ttat Nere is a constmciion lentlinp aqen�y br the petlormance ol tAe work lor w�ic� Ihis Oermit is i5sue0 (Setiion 3097, Civ. L�. IFNDEfl: nooeess: OWNFfl BUIL�EN OECLAflATION: I �ert�y afiirm WI I am exemp� imm t�e Contaciors' State Lkenu Law lar Ihe lallowinp reason �Seclion 70J7.5 Busineu an0 Pmles9onal COGe: My city of COunty which repuires a permil to cansirucL aller, imD�ove, Oemotis�, or repai� any structute, p�ior to ilsiisuance. also repUires tAe aDdK:nt Iw wU p¢rmit to ide a signeE statement ihat �Ns�e is IicenseA pursuanl io ��e pmvisions ol Ne Coniranors' State License Law (Chbp�¢� 9(�ammencinp vni� Sttlion 7000) ol Uivisi0n 3 0l l�e Business anU Proletsions Cotle) o� i�at �e/s�e a exemD� ��e�e��am anE t�e py� lor Ihe allegeE e.emD�on. My violatian ol Section 7037.5 6y any applitan�for a permil SUUlecis I�e aDDlican� to a Civil Denatiy of no� more IAan Ilve hunAr¢U tlollarS (5500�. }� I. as owner ol tlle Ompeny or my emVl0yees with yr3p¢s as Iheir Sole comp¢nsalion, will Ao I�e wark, and IAe 'CJ stmcWre is not imenaeA o� otferee lor sale (Sectron 70aa, Business an0 Prolessional Cotle: The Coniractors' Stata License Law does nol appty la an owner al a D�opcny w�o UuilUs ar imp�ave5 tlleaan, anA w�o Goes such wofk himselV�ersell ar tAmuOh �is ot he� own employees. O�oviOetl Ihat suc� imD«'emen6 are not intenAed or ollereE lor sale. II, however I�e Oulldinp or impmvemenl is so10 wil�in one year ol com0lelidl. Ihe awner will have Ihe �urden of provin0 �e/s�e tlid not Guild or impmve lorihe purpose ol salel. I, as awner ol ine o�openp, am exclusively coNraclinq wii� licensetl conUaclois lo conslmct iho prolom (Seclion 70da, flusinoss ❑ antl Prolessions COEe: The Cantractars SWie License Law tices iwt aODN �o an owner ol pmpe�ty wlw builOs or im0�oves therean and w�o coniracls lor such pmjecls wilh a conlraclor�s) li�ense pursuanl Io I�e ConVactors' Siale License Law�. I am aware Inat pmol ol l�eir Worke(s Compensdlion insurante s�oultl Oe proviGea to me. � I am e�em0� untler Seciion: B. 8 P. C. �or I�is reaso-7n: /, vy �� � oaie: ��� ! /Y� Owner: ��/� — I Oo �er� cenily al I am aware al anE unGerstantl I�e repuirtmenis ol Calilomia_Healt� anU Salety CoOe Sections 25505. 25533. ana 2553< antl I�at I or any luture Ouiltling acupanl wilNvill nol (drele bne) nee0 to wmply wit� SaiG state cOtles antl lhe repuiremenis lar a p¢rmil lor tonSirUtlion Or mo0dita�i0n Imm I�e Ait Ouabry Manaq@menl Dislrit�. He50eniul ConSlrucli0n ap0������5 ate e�empt Imm inese pmvisions. Da�e: Pypliwnt: I hereby cetlity I�at I nave read tnis appliWtion and stale t�at t�e abpve intarmalion is rorBcl. I agree to comply vrit� a0 ciiy antl county orCinances ana s�a�e Wws reW�inq �o DUBNng ca¢�nrcibn antl �ereEy autnorize reprrsentatives ot th¢ dry to enter upon tne ahove�mentpned p�00Q�iy 101 IM1 ¢C�iO�y� OU� OSCS. �,� � oa�e: / siqnawre: � — odver ice�se o� Souai secudiy .: _ Wpi�a—ButlCing�, Green—CoEe Enlomemem: Canary—qpplicant: Pink—Revenue: Golaenro0—Assessor CITY OF COSTA MESA — BUZLDING PERMIT �� • PERMIT NO; E 060778 PLAN CHECK NO: N —GOV'�I�SDYF�� CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; ALT JOB DESCRZPTION ; REWIRE RESZDENCE, RE;#B60777 SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 / COMMENTS: INSTALL SKYLIGHT ICBO# NER 216 REPLACE WINDOWS *�r�rr*�e�rx�t�*�t*�rxx�r�r�r�r�r�exx�r��r�r**�t*�er+r�r��r�r��r�r�e*�r�r*�t�rr�r**�*�e*�rr*�r**�e�r�t**�r�t*��r*���t*� 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; 11737212 ZNE; REF NO; PLANNING NOTES> i *****��r��e***�e*********�e****�r��e+��r�*�r*�r**�r�r***�*�r**�r�e�rr�e**�r�r�r+r�r�r*�*�r****�e�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 HY: ' DATE; � Z1 �� �fififMiFkifkifNiFiFlflfMlFlfMif�FiFiF dfikifiEiliFiEitkiF IEiF MkiFkihlf�tififkMifiFifififlfikkififkiFiFitlEikilklflfkklfitiFitiFitiFikififkiFkikkiFifififikkllMiFifiFlfifkikifif�likiflElEiklFiEiFiEiEiE1E1E LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADZNG PERHIT %i'soi SMIP/NON—RES PLAN ISSUE FEE 15.00 HUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 71.25 15,00 0,00 86,25 86,25 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 86.25 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK � 86.25 iFMM1FiElfMifMlfiFklEMlfiEkMiEifiFMMitifiFifiFiEMiFiflFiF1FlE1EMMMifKaf�fiE1FM1EiEKltMifiFMkiEkifMlkiFiEMiFMififiElfiFifitlEiEiElFifif I N D I V I D U A L F E E H R E A K D O W N TYPE (JTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 20 FIXTURES, LIGHTING 1 ST 20 EA, ,75 ELE 15 FIXTURES LIGHTING ADDITIONAL EA. .45 ELE 20 RECEPT/OGTLET 1 ST 20 EA, ,75 ELE 15 RECEPT/OUTLET ADDITIONAL EA. ,45 ELE 20 RECEPT/SWITCH 1 ST 20 EA. ,75 ELE 15 RECEPT/SWITCH ADDITIONAL EA. ,45 ELE 2 MOTOR/POWR APPARATUS 0,0 — 1,0 HP 3,00 END OF FEES �� ' . _ . _ ' ' _ " ii. � - . • 15.00 6.75 15.00 6.75 15,00 6.75 6,00 �� CONSTRUCTtON AND PLANNING ROOI & �rA Date Inspector Date Inspector APPROVALS Permit �''r APPROVALS Permit # �. 1. Temporary Eiec[rical Service or Pole 52. Pool & EquiPment Location , •:2,. Soil Pipe•Undrgrnd. 53. Steet Reinforcement � ' �. electricalContivitkluiity•Undrgrnd. 54. Forms ''A. Efectrica� ConFLuit�Undrgrnd. 55. Electricel Bonding 5.� Steel Reinforcement 56. Rough Plumbing & Pressure Test . ' �. fiectricAIUFERT'irnd. 57. APPROVALTOCOVER•GUNITE � T.�E.poongs 58. Electrical ConduirUntlrgrnd. ' 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test � ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK � , 11. broperty Sewer Lih' & House Connection 62. Backwash & ReceptorFinat • � 12. Sewer Cdp � 63. Heacer & VenbFinal � ' 73. Roof Drains ._ ��. 64. Plumbing SYstem � Final • 14. Rou9fi Pfum6ing i 65. Etectricat•F.inal � 75. Rough Electrical•Conduit 66. Solar SYstem•F(nal 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough IN�ring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEh1S FINAL 19. Ro�gh Neating 8{Air Contlitioning _.� u Flf}E QEPT. EQUIREMENT „ . O V �"1'i� .'� � . 20; Ro,ji9h;kactgry FireP'ace ; r .s : ` � r' � APPROVKL�'-�" Pesmit �' .. _ 21. Du�ts, in Sttuctutg. "^ `ti ' � , ' 70. Undergrouq� Hqdro �, 22iDtwts,�VenjJlatit�� � -'. - ��n= 77, Produ�qFTipingO�as f�0il ± _ 23. GarPipe�Rough &�Test � ��� - =" * • 72. Undergrpurid F1mh '� � 24.'Ro�f Fryming '; ' ' '� ' �' _ , . � ,' :73, Undergmd.StoKd4�TankcOGas ❑�Oii " � 25. R6of Skeathing-' - �� ' 74. Overhead Hydro 2� T�Bar Celing (Strucrorall &'4�nocoat ,'�, ,; ' - , 75: Dry Chemical ., ' ' . , 27. Prame m�d Plashmg �� t c • ^ 76. Dry Standpipe i . � " 28. Lathiryq&Siding,x,'� �"" ' � 77_ FIXEDSIySTEi�f�INAI - 29. Insulauc�n * ' • 78, FIRE PREV. FI[VdL " �•' � � 30. Drywat�Naihng _ " . ;' ; � .NEALTH DEPT. REQUIREIbEN1', • 31. Plaster 8ro�vn Co2t ; •t r 79. FINAL INSPECTION • .. �, 32 Electri�al Ppwer MeterFinal ,� t i� 80_ FOOD CER7IFI�AT� 1$$UED ': - ' .. (//_"AJ - i- - - - • 33. Fi�al Efeauc ', r Z �{, I ;oYas: � - r . _ - 34: Final Heating & Air Conditiomng r � � - = • ' 35^ Final Gas Pipe�Feu .�, •. ' . - -, ..: • � , 36. Hood or Canapy, .. ' - • " ` ' �' ` ' _ . .c -.�' - � .. . 37'. Fioal �ctory Fireplace � . �.,, . � • , � _ � 38. Final Piumbing � .- � - -• " , - - �. " 39. Water Service-Fin� � ' . ' - � . , ,: 40. Gas Service-Finab � • • = � % ^ . � ' ` 41. Soiar pomesticFi�af' � ' `: `� � 42. Backflow Preventer � � �• � • ? . - , 43. Backflow Ipiigation ' :•' + 1 � ' - . . . . . 44. Landsrape lrrigation System `� i " � � � _ � - , -- • ' 45� Sound Attanuation � , . R ' �. � _ _2 ; � 46.• Handiwp Regu�ations � _ � 47 � FINAL STF#UCTURE & BUILDING' f ; ' 4$_FINALPLANNING � � i ` '! ' � " 49. Electric Retease m Edison , , 50: Gas Release to Southern California Gas Co � ' - •• � 51. CEfiTIFICATE OF OCCUPANCY � ' ' ' ' No. Date y PflOJELT RODHESS: 4 9 S E 1 8 TH ST OWNEX'S NAME: KIN�AID PAT nooness:COSTA MESA,CA 92627 UNIT: ANCHIENGINEEN: HEG.NO.: , PDOflESS: UNIT: PEHMITTEE: PAT KINCAID ( 714 ) 548-6201 AD�NESS: 4 J S E 1 8 TH ST C,M, CA 92627 LICENSED CONTNACTOfl OEL�pqpTION: I �ereby allirm Ihal I am lic¢nseA untler pmvisions of Chapter 9(commencing wi�h Section 70001 0� Diwsion 3 0l ihe 9u;ines5 an0 Pmiessions Code. antl my license is in full �orce anA eifecl. CITY LIC.: STATE LIC.: CLRSS: Daie: S�g�amre: WONNEBS' COMPEN5pTI0N OECLABpiION: I nereey allirm Ihat I nave a cen�ficate of consenl �o sell-inmre or a cenilicate o1 wotlters' Cqmoensx6on Insurance. ar a cenihea covY ��ereol I�etion 9800. LaE. C�. POLICY NO.: E%P. ORTE: COMPRNY: ❑ Cetlifietl copy is �ereby lumis�etl. ❑ Ce�ilieU copy is fileU with Ihe ciiy Builtling Division. Oa�e: ADPlicanl: E%EMPTION FAOM WOflREflS' COMFENSATION OECIABATION: (ihis seciion neea not �e camplete0 ii the De�mi� is brone hunOreO �57�0) or less�. I certily Iha� in Ih pedormanCe al �he work �or which Ihis permi� is issu¢d, I shall no� employ any Derson in any manner so as �o hecome su�lecl lo Ihe ork rs CA �ensalion Laws ol Caiifomia C Oale: Signalure: �� �� . N E: II, ali making �his Ueclara�ion. you ShoWE Decome subjecl �o �he Workers' Compen5alion provi5i0n5 0� ihe La�or Ca e. yau m t lorihwith comply wi�� such pravi5ion5 or lk5 permil shall De aeemeC revoked. CONST UCTION LENUING PGENCY: I �ereUy allirm Ihai I�ere Is a con9mc�ion len�ing aAenry lOr t�e periormance o� t�e wark lor wnich Ihis Dermii is issued �$¢ction 3W7. Gv. C�. LENDEP: p00NESS: OWNEfl BUILOEfl DECLAB�TION: I hereCy aflirm I�at 1 am exempt tmm t�e Coniractors' Slaie License Law for lhe lollawing reason (Seclion 7031.5 Business antl Pmlessional Cotle: Any ciiy ol counry which require5 a permit �o conslmcl, al�er, impmve, tlemolish, or repair any s�mc�ure. D�ior to its issuance. also reQuires ihe aDPlican� lor such permit to file a signeC slaiement �ha� �elshe is licensetl pursuanuo �he pmvisions ol Ihe Contmaors' State License Law �Chapler 9(commencinp wi�� Section 7000) o� Oivision 9 0� the Business antl Ptole55ion5 COtle) ar �ha� he/She is ezemp( Iher¢Imm antl the hasi5 fOr ��e alleged exemplion. Hny ui0la�ion ol SeC�ion 7031.5 by any apolicant lor a permit sublects the aoo�icanl to a civil penalty of not more t�an five hundrea Oollars (3500). 1. as owner al i�e pmperty or my emVloyees vni� wages as their sole compensatian, will do lhe work, antl ihe � stmcmre is noi imentlee ar olferetl for sale (SecUon 70aa, Business and Pmiessional Coae: i�e Coniractors' Siate License law OoeS nol ap01y to an own¢r of a O�aperly w�o Uuilas or im0�ov¢5 �here0n, and who Ao¢5 Sut� work �im5el�/herseli or throUA� �is or ner own emD�Oyees. pmviAeO that suc� impmvements are not intentle0 or otlereE lor sale. II, �awever I�e buil0ing or impmvemenl is sold wit�in one year ol comDlelion, ��e owner vnll have Ihe burden ol provinA �e�s�e tlia no� �uilA o� impwve �or th¢ Ourpase 01 sale�. I, as owner o� Ihe pmperty. am e�clusively comraclinA wilh licensed contractors m cons�mc� t�e pmlec� (Section 704d, Business ❑ antl Pmfessims CoEe: The Contracmrs' Slate lkense Law tloes not apDN �o an ormer ol Droperry wM bml� or imprwes thereon antl who coniracts �Or suc� pmletls wilA a conlracloqs�li[ense pursuanito Ihe Canlrac�ars' State L¢ense law�.l am aware Ihal prooi oi I�eir Warker'S Compensation insurance 5hou10 Ge pmvi�e0 �o me. � I am eeempt untler $ection' 8. 8 P. C, lor ��is re son: /� Dale: Owner. �� % ��L ` I Oo here�y c �i�y Iha� I a aware ol antl untlerstan0lhe requiremenis ol Cali�omia Healih and Satety Code Sections 25505, 25533, anJ 2553d and a� I or any I ure buil0ing accupant wiNwiil nm �circle one) neeU to compry with saitl state coUes an0 the repuiremenis for a permil Im constmction or moaificalion Imm I�e Nir Ouabty Management Oisinci. flesi0ential conslmction aODlications are exempt imm inese o�ovisions. Da�e: _ I nereoy or0inanc o�oveny Oale:'1 �river'sl isai as A001¢anC Ilidve reatlihis applicaiion ana 51aie I�a�i�e a�oveinl0rmaiionis correci. I agRelo tamply Wilh allcily antl caunty laws rel3�ing to �uflEing canstmction an0 h¢reby aultp(it¢ re0�senlafive5 al tMs dty to enter upon fhe a6ave-mentmm�e� ioo purppses. „� � � � r � / 7 J SignaWre: _ Saciai Securiiy Green—Cotle Enlorcemen�; Canary—Appllcanl: Pink—Revenue; Goltlenmtl—Assessor CITY OF COSTA MESA — BUILDING PERMIT �� PERMIT NO: M 060779 PLAN CHECK NO: N —ti� —o��3v�-:—�� CONSTRUCTION TYPE: PERMIT TYPE; MEC PURPOSE: ALT JOB DESCRIPTION : RESIDENCE REPAIR, RE;�FB60777 SQ FT; CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 / COMMENTS: INSTALL SKYLIGHT ICBO# NER 21b REPLACE WINDOWS 3f 1f if M ik �f i! k M!f if if it iF 1F k k i! If ik ik �f if �k iFit iFlF iElf iE iE iF iF ilif iF iE if iE;E ik fE if k iF iF ltik if ik 3f IE iE1F iF if it iE iE ik iE iFiF if i! iF iF iE fE ii iE iE 1E if ilif iE if 2 O N I N GS ERTEB�AUCIKRSE M E N T 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: 11737212 ZNE; REF NO; PLANNING NtSTES> i ' i! 1f 1f M ik k ik fF iE if if if 1f ik iE if if if if 1E 1E if if ik if i!!F ik iE ik it if iE if 1f if iE if ik fE ft IE k!F ik iF 1F iE 1E if 1F 1E k i!!k if 1f if iE ik 1E ikiE iE iE �k ik �E �F iF if 1F ik iF 1kiF )f iE iE D E V E L O P M E N T S E RjV.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: 2'1�`l3 ikM3k1fiFlfMiFif�kif3E1fiflf�fikklFifitlfiF�iFiFiF'i �, kikifiklEiEiklfiklE �7FiE�f ikifkikMiFifaE3FiF3fififififiliFifiFifitMlFiE�EifiFifikikiFiFifiEkkaf 3tkif1flliklfifiF3FitlfifNlfiflEiEiElEiFiflElEitlFiElFiEifiFitiEkiEifilkiliE�t LEGALIZATION;N F E E 'S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 9'152 SMIP/NON—RES PLAN ISSUE FEE 15.00 HDILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 9.00 15.00 0,00 24.00 24.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 24.00 OVER/SHORT; .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24,00 iE ik if ff �f M if ik k k ik if �f �flE �f iE if iE iF if ik if if iFif iFitiF if 1f ikiF k k iF k ikik M k iF if if 1E if if if 1f ik If *{f {f k�! �f iflF iF k iF iE iF k if iFiflf if k ik iF k if if it �F i! I N D I V I D O 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 MEC 1 REPAIR/ALT AEATING UNIT/SYS W/CNTLS 9,00 9,00 END OF FEES �J1 1�.: �. ,�. - " � nti�� r. . _ .. . . . CONSTRUCTION AND PLANNING P��� `''PA Date Inspector Date 1�spector � APPROVALS Permit # ., ., APPROVALS Permit � t. Temporary Electrical Service or Pole 52. Pool & Equipment Location '! 2:iSoil Pipe-UndrgrnF4. �.,i . ' S3. Steei Reinforcement � � Electrical Cortduii�Utility�Undrgrnd. 54. Forms . � '�4.� Hectrical Coq�.uit-Undrgrnd. 55. Electricai Bonding . �5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ` � ',t6LE,JectricalUFER�Grnd � ' 57. APPROVALTOCOVER•GUNITE � " � � 7. �Footings 56. Electrical Conduit�Undrgmd. . ' 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ,!, � 9. ,�(Jater Pipe�Undt9rnd, / 60. Backwash l.ines, P-Trap, `J Undrgrnd. ' 10. Structural Flaor Svstem 61. APPROVA� TO DECK i �' • 11. �Pioperty Sewer Line & House Connection ', 62. Backwash & Receptor•Final � 12. Sewer Cap _ � 63. Heater & Vent-Final ' � 73. Roof Dfains � - � .64. Plumbing System � Fir.al � ' ' � 14. Rough P;umbtng 65. Electrical�Final ' 75. Rough E�ctrtc8�-Conduit 66. So�ar System-Final ' i 16. Rough Electrie Wiring 67. Fencing & Access ApProval u� 77. Rough WirSng Sign 68, qPFROVEp FOR PLASTEftING , � 18. Rough Electriral-T Bar Ceihng 69. POOUSPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning ^ FI,jiE pEPT, REQUIREMENT " � �, 20: Rovgh'-fac�rysi(eDlace ti . �,., . ,r;` ,', i APPRDVF�'L�_ �' PeSmit � • 21. Ducts, in Struc �fl�'e .. .. - t � � X A. 70.'Undergrowzd Fjqdro i 22� Dc�ts,-�/enr.latirig ,; � • . •`,�, i , 71. Produci•�ipin9 �3��s � Oi� 23• Gas Pipe-Rough &•Teet � _ � � _ •�'� • � 7y, UndergroLhd FtUsli �� ' � 24". ftobf Fiamin " J" ` 9 � : ' ` �. � ; . � 73. Undergrnd. Sro�ei�e Tank O Gas ❑ �il � 25. Roof SFeathing! •[ �.� v+ .. � 74. Overhead Hydrb . � 26: T•Bar Ceiling {g�7uctural) & Manocoat t �' '. 76. Dry Cheg�ical , _� ' � I 27. Frame and Flashiag ; c.� . . 76. Dry Staadhipe- ' � ��. � _ ' 28. Lathing & Sidin��; �"' : S� '- 77. FIXED'-$Y�T�M-'FINF�,_ � 29. Insulation : K �• 78. FIRE PREV. FINAL '� - �- 30. Drywail Nailing ; � ��NEAL �kl DEP7. REQUIREMENT 31. Plaster$rown Coat . ., • 79. FINALihtSPEC7i0N � _ w� 3� Electriial Pqwer'Met2rFinAl �' Y= 8(f, FOOD CERTif jCATE f$SUED � -- 3 , Final E�ectric r - � � � - Notes: � - . � �' 34: Final Heating & Atr Conditioning ' � C � � � ' � - � : ir. _.� __�� _ _ , , 35, Fina� C�as Pipe-Tes,t - „ � � , � • ; � . - - : �. _ 36. Hood ar CanoPY - ' ' ^ � ' �'� �. , . �� 37. Final F'actory P{replace_ ". . � ���� ; �: � � _- � 38. Final Pfvmbi�g j; ' • : ' - � < t 39. Water Service-Final - , " ` ' 40. Gas Service-Finaa '..� ^ � • � -' - 41, Solar pomest(c�FtoaP ' - � . - . - i ' . 42? Backflow Preveriter �. � . . . � - - 43. Backflow IrtigatioS ' ' � . . . . 44. Landscape-Irripativn SysteM �' � • =- - ' � � � - 45; Sound AtFenuatibn , ` ' ' ' _ � � � � '; . ' 46, Handicap Reguldtions _ x • • -> . ' 1 47e FFNAL STRUC7URE & BUILDING i ' • ' � - 48. FYNAL PLANNING ; � �' _ � �• 49. ElBctric Release to Edison � �' : _� ' - 5Q Gas Release to Southern California Gas Co ( I � • _ - 51. CERTIFICATE OF OCCUPANCY � • � - • ' ` No. Date / PflOJECT ROONE55: �i 9 S E 18 TH 5 T OWNEfl'SNAME:KINCAID PAT pDDflES5:99S E 1�TH ST COSTA MESA,CA 92627 AHLH/ENGINEEfl: NEG.NO.: UNIT: FOONESS: UNIT: PENMITiEE: PAT KINCAID ( 714 ) 548-6201 nooness: 495 E 18TH ST C.M, CA 92627 LICENSEO CONTBACTOP OECIABRTION: I nereUy atlirm Inal I am ficenSeG un0er proviAons al CMpie� 9(tommentinA wi�� Section 7000) ol Division 3 of I�e BuSineu anG Pro�Mvons COGe, an0 my littnse R in lulliarce anE efiecl. LITY ��L.: STATE LIC.: ClA$5: Daie: Signamre: WONREPS' COMPENSATION OECIABATION: I her¢byatiirm I�a� I �ave a Ce�iliCale o� wnsent �o Sell�in5ure Or a certifiCa�e oi Work¢rs' COmpensation Insurance, or a ceNlieO topy IDereo� 1�cti0n 3800. LaD. C). POLICY NO.: E%P. ORTE: COMPRNY: ❑ Cendietl caDY is hereby tumisned. ❑ Cenilied copy is IileO witn ine dly Bufltling Divisian. Jdie: Appluani: EXEMPfION iNOM WOflI(EBS' COMPEN511TION OELlAiIAPON: Rhia uciion �reeU roi h cmWeteO it Uie primi is ta px �uMred (5700) or Nst�. I ceriily ��at in the periormance ol I�e work for whic� t�is permil is issued. I shall nol emD�%' any persan in any manner so as �o �ecome SU�IeCI lo Ihe Work¢rs' Compensation laws ot CalJ\omia.�%%�� Oale: Signal�re'Y ^ N CE: if, af� r makmg t�a declaratian. you S�ou�-become subjxt to ttre WOAers' Cortrpensatiart provisiorts o� !he Labor C De. you musi �ort�with comply wii� such pmvisions or Ihis permit shall he deemetl revaketl. CONSTRUCTION LENOING pGENLY: I �ereDy allirm t�at �here is a consimction Ien4inA aAency for t�e Derlormance of Ne work lor wnich �nis oermit is Issuea �Section 3097. Civ. CI. LENOEN: nooxess: OWNEfl BWLOEfl OECUBATION: I h¢r¢Oy a��irm I�a� I am evempi IrOm Ille CAniraclar5' Sfd�C lICC058 �dW �Of IhOIOIIOw10p (Cd50fl (Seq{on 7031.5 Business anE Pmlessional Cotle: My 6ry of wunty wNcti repuires a Dermit m wnstmct, al�er, imDmve. CemoliSR or reDair anV simcture. prior to i�s issuance, a150 repuires t�e ap0�icant lor sucn pe�mi� to lile a si0ne0 stalemenl I�at �e/she is licensetl ptu5uanliol�¢ pmvisions ollAe ConVaCiors'$Iale Litense Law�Cha0�ef9(tommentinp wilh $¢LiiOn 7000�O�OivisiUn 3 o�l�e Bu5ine55 anU protessions CoGe) or Rwl he/s�e is e�em0� ��etetmm and t�e DasR lor t�e alleqeG exemp�ion. Any tialalion ol Section 7Q'71.5 by any applicanllor a permii su�lects I�e applicani Io a civil penaliy ol noi mom Ihan hve Aun4re0 4011ar5 (5500). y_, I, as owner oi ihe pmDeny or my em loyees wilh wapes as iheir Sole compensation, will tla Iha work, antl �ne •�� slmcmre is not intenUea or olle�eE loi sa@ (�Iron 70aa. Buvness anE Pmleuional Catle: Tne Contncmrs' State License Law � Uce5 n0i aOVM lo an ownBr o� a D�OpMy �0 OUiItlS Or improvp5 �peRWl. an0 whp Gp¢5 5uth wprk �irM15el1/�er5¢II Or I�raup� nis or ner own emDloyees, pmviQeO 1tWt sucn imprwemenis ate noi in1eMM ar ofler¢E for Sale. 11, nowever ihe DuildinA or imD�ovCmeni ¢ 5a10 vnWn on! year ol Wmplefbn. (M mmEr witl have 1�0 buNen of prOvinq ONs�e UiG nat Oui10 ar impmve lor Ne DurpU3e of Sale�. ' I, as owner ai the propen . am ¢ACWsiveIy wntractinq wit� licensetl convactars to constmd t�e pmlecl (Sectian 70eE, Business ❑ anG Pmlessipi5 CoOe: TKe Contnctars' Sta�e Li�¢nse Law Uces not appy m an wmer of Droperry wM Ou�lOs or improves t�ereon an0 who contracis �or such pr01ec15 wi�h a[anlrac�or�s� license pursuanl Io I�e Coniraclors' Siate License taw1. I am aware �nat piool af ineir Worker's CamOensalion insurance snoula be D��+eea m me. � I am eKempl unaer Sec�ion; B. 8 P. C. lor Ihis �eason: c i�ate: Pmer. l/v'Y/ � I oo hereG cenity t 1 am aware ot ana un0ersun0 ihe repuiremenis ol Calitornia HealtA an0 Safety CaEe Sectians 25505. 25533, an0 2557a ana tlu� I or any future Guildm0 prdupant wiM.9�l ipt (utde onq neCd to compy with said sta�e coCes ana �he reQuiremenis lor a Dertriil lor tOnSImClipn ar mOCilicaiion bom I�e Air Ouahiy Manag¢meni OiS�riCi. flCSiCen�ial ConSlNtiian apDlita�i0n5 are eeemp� Irom I�PqQ pfON510M. � �A �+ �aig: ApPlicani: � I hereOV <crt��V �hat I have read Mis aop�K'ati0n arb slale ihat ihe a�ove ink�malion is co/�ecL I ag�ee la compty wit� aA city ana counry oidinance5 an0 S�aielawsr¢la�ingl0 �uiltling tonSimCiion anA �ereGyaulhory¢ repres¢n�afive5o�M5Giyto ¢nfefuDonlh¢ above-m¢nii0netl pmperty lar inspection purpases � //f� v �+ �ate: S9nam�e'N �f �.�(/'—� — �rio s�icens r Socui Secu�ity .: $ 16n��a6 WMe—BuilQing: Grean—CnEe EnlorcemenC Canary—AppLcanl: Pink—Revenue; GOWenrop—Asseswr CITY OF COSTA MESA — HUILDING PERMIT �F�p� PERMIT NO; P 060780 ' PLAN CHECK NO; N I GUpT�—SIIP'P: TT— CONSTRUCTION TYPE; PERMIT TYPE; PLII PURPOSE; ALT JOH DESCRIPTION : RESIDENCE REPAIR, RE;2tB60777 SQ FT; CLAIM VALUE: CALC—VALUE; GROUP OCC; R-3 / COMMENTS• INSTALL SKYLIGHT ICB07t NER 216 REPLACE WINDOWS � �rr**�r�r�r*****�r*x�t*��e*�r�e*��t�t�t�r**r�r�r�r�rx ��r�r*�r*�r�e**��r�r�r��t�r�r�r��r**�***�r*�r*�r�r�r�r*�*�r**�e� Z O N I N G R E(j U I R E M E N T S sErsAcxs ------------ 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 RE�• PROV: PARCEL; 11737212 2NE; REF NO; PLANNING N 1'ES> i f �t�t**�r�*�t�t+t*r��r*�t�r�r�r�e�e**�*�r�t**�e**�r*��r�t�r�t*�r*�t�t�r*+t*�r�t�***�r�r�r�r***�r***x�*�r*�r*�r*�r*+�*�* D E V E L O P M E N T S E R V Z C E S�- R E(J U I R E M E N T S ZONING APPROVED HY `.. DATE; BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY• ' DATE• �' �-7 ��1� MifkMMifififlfififififiFifkikiFiF�k3Fk , iFiEiF�F1FiklEitiFiF ** if it M k If 1f if if k �f it M�F �f 1F M ft if M if �f if M Ik M ff if iF if iF if if if k iF �f iF if iF if iF iFiF if iF il�it if k if k 1Fik if jt M�f {t it If iE iE if k iF If iF if if iE if ff iE 1f 1F iF iE iFif LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/RES GRADING PERMIT 14,00 25i SMIP/NON—RES PLAN ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 14,00 20.00 0.00 34,00 34,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 34.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 34,00 k!f M!f if if if IF if if if if if 1f k 1f IF if iE iF M iE if if 1f 1F M iF 1flE iF1E if ik ik if ik iF if iF if k ik ik iF k 1kM if iF M 1f af IF iE iElf if iF IE 3f iF iF iF if 1F IE 1F if 1f iF if iE iF if k it ik 1t 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 2 P T I O N UNIT COST TOTAL COST PLU 2 REPAIR/ALTER DRAINAGE/VENT PIPING 7,00 14.00 END OF FEES !,. � — ' . - . ' CONSTRUCTION ANDPLANNING APPROVALS Permit�`'r i. Temporary Electriwl Service or Pole ,2, SOiI Pipe-Undr�rnd. .3. Efeccriwl Contlui2'Pltility-Undrgrnd. �4. Electrical Conduit-Untk9md. �S,:Steel Reinforcement ',6` �iectrical UFER�md. � B. Foundation ' � 9. lh'ater Rpe-Undrgrnd. � 10. Structurel Floor System � 1 i. �operty Sewr,r Line & House Connection 12. Sewer Cap 13. Roof Drains : 14. iiough Plumbing 15 Rough ElectriCal-Conduit � i6. Rough EleCtri¢�Viring � il. flough Wiring Sign 18. Rough Electrical-T Bar Ceiiing 1�, Ro,{�gh Heating 8{Air Conditioning l .: T 20� Aoi�9h'�actqry �'i5`rP�ace � s.- - ; 21. Du ts,in Structuie� " - '� ` i S s .ROOL & oe'A Date Inspector n ` j 22�Du3ts,Nentilating� i ' . . 23 Gas Pipe•Ro�gh & Tesc i k� � - r. � r' 24. floof Praming -`� '� � '' 25. Roof S!ieathing ' � _ 26. T��ar Ceiling ISv�tturaq & Monocoat 23_ Freme and Flasliing ' ' ' 28. Lathinq& Sidinj F ' ' , 29. Insulation . • 30. Drye,a�I Nailing . : � 31. Plaster Brorm Coat ; � • . 32. Electrical PaweriVfQterFinal ' 33, Final Electtic � � . . �� 34; Firial Heating & Air Conditiororiy �� 3�. Final Gas RAe-Fest �• �. , - 36. Hobd os Canopy , � - - > ' 3�:.Final Pactory Frteplace . , � 38. Firial Plum6ing � _ ' 39. Water Service-Final . 40. Gas Service�Finak ' 41. Solar pomesticFiqal 42. Backflow PrevenFer 43. Baekflow Ireigation �; ' � 44. Landscape Irrigation System * � 45. Sound ,Attenuation ' 46. Handiwp Regulations 47. FIfdAL STRUCTURE & BUILOING 4A. FINALPLANNING � 49. Electric Release to Edison 50. Gas Release to Southern California Gas Ca Date � � � r O � � APPROVAIS Permrt � 52. Pool & Equipment Location 53. Steel Rei�forcement 54, Forms • 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit•Undr�rnd. 59. Gas Pipe, 0 Undrgrnd., Test 60. Backwash Lines, P�Trap, O Undrgrnd. 61. APPROVAL TO DECK ' 62. Backwash & Receptor-Pmal 63. Heacer & Vent�Final � 64. Plumbing System • Final / 65. Electrical-Final ' 66. Solar SYstem-Final 67. Fencing & Access Appruval 68. APPROVED FOR PLASTERING . 69. POOL/SPA SYSTEMS FINAL � FIj3E DEPT.�iEQUIREMENT :� . ., .APPi�OVEFCS"' ' Permit #��- "` ' 70. Undergro��d HVrJro ". �. .r 71. Product 1�iping � Gas � Od • .� i ��""" . 72. Undergrb�nd FlUsh • � ��� e • 73; Undergrnii. S[o�a9e Tank O Gas ❑ Oii ' - 74. Overhead Hydro� , , x a - � ., 75. Dry Chemical - 76. Dry Standpipe - ' 7�. FIXED SY�TEIVl1-1'�JAI ,- � - - -�--2- 76: fIRE�PREV. FMAL - ^ ' ' NE'ALTH DEP'f.`AEQt11R'Ch1ENT - 79. PINAL INSPECT�ON � �;. � 8Q_ FOOD CERTIFJ'�ATE ISS�IED_ _ • N6tes: - ��, Y : ' . � ,;, � I r.. • ' , ' I �- ' . . r� . Date Inspectnr I r I I T � PHOJECT ADUNE55: 4 9 S E 18 TH .�T OWNER'SNAME:xINCAID PAT nooness:495 E 1�TH ST COSTA MESA,CA 92627 PPCHIENGINEEfl: AOUPESS: PEG.NO.: UNIT: UNIT: PEflMITTEE:PAT KINCATD ( 714 ) 548-6201 AD�XESS: 4 9 S E 1 8 TH $T C.M. CA 92627 LICFNSE� CONTBACTOfl UFLIAflATION: I nereUy allirm �pal I am licensed under pmvisions ol ChaD�er 9(commencing with Sectlan 7000) ot �ivision 3 oi ihe Busine55 an0 Prole55ions Coee. an0 my license i5 in full fotte anG eflect. CITY LIC.: STATE LIC.: CLASS: Date: Signalure: WOqREBS' COMPExSATION oEClAPl1TI0N: I nereDy aflirm Na� I nave a cenilica�e of consem m selbinsure or a cenilicate ol workers' Compensation Insurante. ar a cerlilietl copy ihereaf (Seclion 9800, LaC. C). POLICY NO.: EXY. DATE: COMPRNY: ❑ cemaea coov �s nereoy mr��:nea. ❑ Cenilie0 wpy i5 IileO wit� t�e ciry Builtling DiviSion. ' Ja�e: ApO�icant: EllEM7710NFflOMWOflREflS'COMPENSATIONOfCIAflATION: �TAissectionnee0no�becompleteal�ihepermitisloronehunOreG�5100�orless�. I ce�ify ��at in Ihe pedormance ol �he work lor w�icA Ihis permit is i35ue0. I s�all noi ¢m01oy any person in any manner 50 a5 io become su�l�� la Ihe Worker ' Cqmpensation Laws ot Catilomia. �y/ Date: Signalure: ������� N ICE: If �Ier making Ihis 0¢tlaralion. y0u Shauld p¢�qme SUCI�� �o l0e Warkers' CAmDensa�i0n prOvi9on5 0l I�¢ LaOor e, you mus� �orl�vnt� compry vni� suc� pmvisions ot ��i5 permit slwll be EeemeG revaketl. CONSTPUCiION LEN�ING AGENCY: 1 hereUy allirm Ihai ��ere is a ConSimclian lentling apency lar lhe pertormance al lhe work lor w�ich �his Dermit is i5sue0 (Sectian 3097. Civ. C�. LENDEX: aooxEss: OWNEN BUILOEfl OECLAHRTION: I �er¢Oy allirm Ihal I dm ¢e¢m0� ��om I�e fAniratiors' State License Law for the lollowing reason (Section 7031.5 9usine55 antl Pm�essianal CoOe: Any ciiy al county w0ic0 reavir¢5 a permii Ia conilmct, aller, impmve, Demolish, or repair any Slmciure, prior �o ils issuance. atso repWres ihp ap0licant �or suc� permil �o lile a 5igneE Slaiemenl Nal �aJShe i5licen5e0 pursuanl �o Ihe pmvisions o� �he Coniracbrs' S�ale License �aw (Chapler 9(commencinq wil� Sec�ion 7000) ol Division 3 0� Ihe Business an0 Prolessions Cotle) or Ihai hehhe is exempl Ihere�mm an0 Ihe basis lor ��e allegetl exempiion. Any violation of Seciion 7031.5 by any apPlicanl for a permit SUGlac�s �he applicant �o a civil penally ol noi more �han live Aund�etl Oollars (ESIXI�. �� Y. I. as owner a1 ihe pmpeny ar my employee; unlh wages as fheir sole Wmpensation, will Aa Ihe work. ane (he 'CJ slruciwe is not intenGeE or oHere0lor sale (Semion 7pG4, Business anA Protessional Cotle: T�e Comracmrs' State License law tloe5 noi apply lo an owne� o� a Omp¢rty wtw Emitls or im0��'es ih¢reon. an0 wM does 5uch work him5ell/Aersel� ar �hra�gh �is or her own emplayees, proviOeA t�at suc� impmvemenis are not intenUeO or oflereG lar sale. II, �owever ttle 6uiltling or '� impmvement i5 5a10 vA�hin one year oi comple�ioq. Ihe owner vnll have Ihe 6mUen ol pmvinA he/she Gid not bui10 or imDrove for �he pur0ose ol sale�. I. as owner o� ihe pmDehy, am eetlu5ively tOniratling wilh liCens¢0 tonVat�Ors lo ConSlfut� �he pmleCl (SeC�ion 7044, Busine55 ❑ and Profeuions CoOe: The Contraclors' Stale Lice�se Law Ooes not ap01y to an owner ol proDeny who 6wltls or improves ihereon ane wno conlrads �or suc� pmlecis wi�� a conira��oqs�l¢ense pursuani Io I�e Coniractors' Slaie Ucense Law�.l am aware ��at pmal oi I�eir Warkefs ComDensalion insuraqce s�oultl G¢ O�a�iAetl to me. � I am exempl under Section: B. 8 P. C. lor this reason; �� �� t �ate'. Owncr: � I Oo here retlity ih� I am aware ol ana un0erstantl t�e raQuiremems ol Califomia Health anG Salely Code Seclions 25505, 25533, anU 25534 a �Aal I or a y lulme bwitling occupani willlwill no� (�i�cle one) need to comply wiih 5ai0 sla�e cotles antl Ihe requiremenis lor a permit lor cons�mction or modilica�ion imm Ihe Air �ualily ManaBemenl Orstric�. ResiOenliat con9mction applicalions are eeemp� irom IhCSC O�ONSi005. A /./ _��� Date: ApPlicanL _//7 I hereby cer�ify I�at I have rea0 Ihis applicalion an0 s�ale Ihal Ihe above in�ormation is correcl. I aAree to comply with all ciry an0 county or0inances antl slalelawsrelaling�o builtling consimclion antl herebV aulhorize repre5eniative5 ollhis ci�y�a enleruponthe a6ove�mentioned pmperry for Inspactian purposes. p� Daie: �T�_�1�- Signature: !/G� � � Drivei's mensep soc�ai seamy x: ) 16at E6 Whlte—Builtling; Green—CoOe Enlorcemenl', Canary—Applicnnl', Pink—Ravanua; Goltlenrotl—Assossor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 060777 PLAN CHECK NO; N CONSTRUCTION TYPE; PERMIT TYPE: STR JOB DESCRIPTION : INSTALL WALL SIDING ICBO#3567 6 2319 '- •i ' i�i -:. -._- PURPOSE: ALT SQ FT; 2,000 CLAIM VALUE; 2,000.00 CALC—VALUE; 2,000,00 GROUP OCC: R-3 / COMMENTS• INSTALL SRYLIGHT ICBO# NER 216 REPLACE WINDOWS i! iFlflF 1k iF 1f 1F 1f iFiF ik �E �E iF k iE M iE 1F iF iF if if if �f ik �f iF fE �EiE ik iF k iE �F �E if IE �F 1f iF iF �IE iklf if ff * M!! 1k �F fF �f 1f 1k iE �kif *!! iF iF if iElf fF iE IFlE iF 1f iF iE iF if ik 2 O N I N GS ERTEH�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGAT; FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 11737212 ZtJE; REF NO: PLANNING NZST'ES> > it�tit�tiE+e*+��r�r*+t�r�tak*iE+t�e*if**�rit�t*�rir�E�r�e+t*at�r+�*�rx+�**it*tt�rie�r�ratatiE�riE*ftit�rk*+tit*+E+�+t�raEx�*+��iF�t�r*�t�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' S ZONING APPROVED BY DATE: " BUILDING APPROVED BY : DATE: � APPLICATION ISSUED BY• DATE• � �I 'L�1 � �� 1fiFitMikififlFififkikiFiElEififiFiFiEiFifiFiF�7F3F7FiF7FiiiF{FiFiFiFiFiFiFiF iF�fTi'�F'iF'iFiFif1l�1li4ikififiFiFif . 3E1E 3k itif ik iE iF if iF 1E k Mif 3f iFif i! 3f i! ik iE iFiE iF if �k i! kiF �t �E �E �f k�f if if k!E �Eik if if if M If it if �Fif it iF!! iE if ik iE if it itlF ik iE iE ik iF iE 1F IE �E fE if �E iF iFif 1E ik it if LEGALIZATION;N F E E S U M M A R Y STROCTURAI,�SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP•/RES� GRADING PERMIT 45,00 . .50 1 SMIP/NON—RES PLAN ,, . ISSUE FEE ' — " ' ' HUILDING—DIV—> PERMIT ISSUE PLAN=CHECK.• TOTAL PAID DUE TOTALS----> 45,50 0.00 ;_.� !',0.00; � 45.50 45,50 ,00 REVENUE DIVISION TOTALS--> COLLEGTED:.; ' 45.50 OVER/SHORT; 00 BLD�GSP00 pLUMBING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING PLAN—CHECK a i M 1k ik if iE iF M if M M if �F 3E if �f �)E if 3f df �f iF iF �E iF if 3E iFif iF iE iE iF ik �F iFiF iF �F�iF if i! iF k iE k k If iE3f �k �F iF iE ik fE if ik iE iE iE iE iE jF iF iE iE i! it iF ik iE 1F If iF iF 1E if ib it I N D I V I D U A L��::F, E E B R E A R D O W N TYPE QTY D E S C R I P T I O^N �-- � UNIT COST TOTAL COST SFR 2000 ALTER BY VALUE RESIDENTIAL N020NE 1,00 2,000,00 END �OF FEES � ..� a . ti N� . �' � L '. �.1� . S ' ' ' _ ' ; � -ft. � . . . . - J � CONSTRUCTION AND PLANNIN6 APPROVALS Permit # t. Temporary Electrical Se�vice or Pole 2. Soil Pipe-Undcgrnd. •3. Electricai Codddit-UtiliEY•Undrgrnd. f4: Electrical Conduit�Undrgrnd. 5. Steel Reinforcement .6. Electricai UFER Grnd. 7. •Footings 8. Foundation �� 9..Water Pipe•Undrgrnd. 10. Struciural Floor System 11. Property Sewer l.ine & House Connection 12. Sewer Cap �: 13. Root Drains � 14. Rough Plumbing 15. Rough ElectrfCal•Condua 16. Rough E�ecirie Wiring � 17. Rough WiringSign 18. Rough Electrical�T Bar ��iing 19. Rough Heating & Air Cpnditiohing 2Q� Roi�gh,Eactnry'�veplaGe , " � : .� 21. DnCte �in St7uttUre ' ' • � • 22. Oj;tts,'VenTilating= . , 23. Ges Pipe-R�gh & Test r - y _ 24: Roof Framirig � •- ^�Fr 25. Roof S�eathing� • • � 2� T•Bar Ceiling (Sxuctura�l & �onocoat 27� Freme and.Flas}tjng P 28. lathing & Sidin`g" ' -�"= - 29. Insulatinn �• ��. � �� �•• 30. DryvaalJ NaBinq " 31 . Plaster Bro,wn Goat ; _ 3�; Electri�yl Pdwer�NleterFinal 33, Final Ejeccric ': 34. Firial Neating & Air Conditioriing �- 3�'; Finai Gas f�ibe-Tezt ,�"' . 36. Hood or Canopy � ' 37: Fioal Faaory Fi�epla£e � � _ --+ - 38. Final Ptumbing�j� � � - 39. Water Service-Final 40. Gas Service-Final • -_ . _ 41. Solar �omEstic-F�naP �� ' 42. Backflow PreveJtiter�� 43. Backftow irrigatiQn :'' 44. Landscape Irrigatian Syste� : ._, - - 45. Sound Attenuati(Jn '�, , � 46, Handicap fieg�lations - 47+ FINAL STRUCTFJRE & BUILDING 4�. FI'NAL PLANNING � 9 Eiectric Release to Edison 50. Gas Retease to Southern California Gas Cc Date POOL � .rA Inspector pppROVALS Permit # � 52. Pool & Equipment Location 53. Steel Reinforcement . 54. Form: 55. Electrical Bonding ' 56. Rough Piumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE 58. Electricai ConduibUndrgmd. � 59. Gas P�pe, � Undrgrnd., Test 60. Backwash Lines, P-Trap, L7 Undrgrnd. 61. APPROVAL TO DECK Y 62. Backwash & Receptor-Final - 63. Heater & Vent-Final { 64. Plumbing System � Final 65, Electrical�Final 66. Solar SYstem-Final S7. Fencing & Access ApProval 68. APPROVED FOR PLASTERING 69. POQLlSPA SYSTEMS FINAL � ,� , „: FI�REpEPT..REQUIREMENT ' . ; � ;, ; APPRQVA�'�." - Parmit #�_ - =�t=.e - ` 70. Undergrcu{tid HVdro ' ., _�.. � < � 71. Produci;Q�ipin9 C7j'ias rl0i� � - > 72. Undergr:c,"uhd FIUsh- � - -x. i �; a. 73� Undergrqd. Storsje �ank O Gat � ail - 74; Overhead Nydro v • ' - �� � 7�. Dry Chemical ' , ` �T �T � � � , 76. Dry StarWpipe - � ` � '"`' 77. FIXED:�XSTER4-FINA� , �--��----�++ �� 78. FIRE PREV. FINAL ` � � f I' �- 7iEALTB DEPT: REQUIREM'�. �I � 79. FINALiNSPECTIO��-�'V �-_ r I <�� ` � � SO_ FOOD CERTIIJCATE [$SllED_ ; Notes: 2�%i /CQ� N ri-i,/„"L J,_ - - �0- -� � , . x, < - :. � _ . � I L/M,O�, •Y,�c�� �r s/, ; ( L / - [ i . " , J . . � . ' . ` K ' . . " LGUHHNGY I� I - � � ' ' 7� ' • Date Date I Inspector ! �i � �� PXOJECT AOOflESS: 4 9 S E 1 6 TH JC T awxEesxnme:KINCAID PAT noosEss:495 E 1�TH ST COSTA MESA,CA 92627 ANCM/ENGINEEfl: pODflE55: NEG.NO.: UNIT: UNIT: PEHMITTEE: PAT KINCAID ( 714 ) 548-6201 aoosess: 495 E 1$TA ST C.M. CA 92627 LICENSEO CONTBACTOfl DECUIBATION: I hereby a��irm Iha� I am licensed untler Owvisions oi C�apter 9(cammencing wi�h Seclion 7000� ol Oivision 3 0� the Business an0 Pmfessions Cotle. an0 my license is in full force and ellect. CITV LIC.: STATE LIC.: CLASS: Date: Signalure: WOflNENS' COMPENSATION OECLAPATION: I hereby affirm that I have a cenificate of consent to self-insure or a cenihcate of Workers' Compensation Insurance. or a certified cooY �hereol (Section 3804 Lab. C�. POLICY NO.: EI(P. UATE: COMPANY: ❑ Cerlilied copy is hereby Iumishe0. ❑ Cetlifie0 wpY is tile0 with ��e city Builtling Division. Ja�e: ApDlicanC EXEMPTIONFflOMWONREPS'WMPENSATIONOECLpppTION: (Thissec�iannee0no�becampleteOiiUeOarmi�isforonehundrea�E700�arless�. I cerlily Ihal in he Oehormance of �he work far Which Nis De�mit is issued. I s�all no� employ any person in any manner 5o as �a Oecome 5u0jecl to I Workers' ompensation Laws ol Calilomia. � .�L_..[ �i� �- Y/ / L� Oate: � SignaWre: �V,;G��f1�" _� " N ICE: I�, ai r making this Oeclara�ion. you 5hou10 become sublect to the Workers' ComDensa�ion pmvisions o� the Labor Oe. you 9 tanhwith compty with such provisions or ihis permit shall Ee tle2med revoketl. CON UCTI LENUING FCENCY: I hereby aflirm ��a� there is a constmciion lenaing agency for the petlarmance o� the work �or which �his permit is issuetl (Section 3097. Civ. ��. LENOEfl: � ROONESS: '(��� � i OWNEB BWIUEB OECLFBATIUN: I hei_oy af�irm I�al I am exempi imm the Conlraciors' Sta�e License Law for lhe �ollowing reason (Section 7031.5 Business antl Pwfessional CoOe; Any ciry ot counry w�ich repuires a permit �o constmct, alter, impmve, tlemalis�, or reDair any stmcture, prior ta i�s i55uance. also �¢quires Ihe appiicant for such permi� lo lile a signed statement t�at he/she is lic¢nsed pur5uan� to �he D�ovisions oi ihe Coniractors' State License Law (C�apter 9(commencing with Section 7000) ot �ivision 3 0� the Business anA Prolessions CoOe) or t�at he/she is exempt �herefrom antl Ihe basis tor t�e alleAed exemD�ion. Any violation ol Section 7031.5 Uy any ap0�icant lor a permit suble��s ihe applicaqi to a civil penal�y o� not more Nan �ive hundretl �oliars (5500�. � 1, as owner of the pmpeM1y or my ¢mpl0y¢es with wage5 as �heir SOIe LOm0en5a�ion, wili Oa lh¢ wOrk, an0 Ihe s�mcmre is no� intenAeO or oilerea �or sale (Sec�ion 7044. Business an0 Pmiessional CoOe: The Contrac�ors S�a�e License Law Ooes not apply ta an owner ol a propeqy who builtls or improves ��ereon. antl who does such work himself/herseli or ihmugh his or her own employees. D�ovitled Iha� suc� imprbvemenls are no� inten0ed or ottere0 fot sale. I�, however ��e builaing or improvemenl is soltl within one year al comple�ion. �he owner will have Ihe 6urden ol pmvinA �e�she tlid noi build or improve for ��e purpose of sale). I, as Owner ol Ihe properly, am ezClusivyly conVac�ing wiN licensed conVac�ors �o constmct [he pmlec� (Section 7044, Business ❑ ana Pmlessiuns Code'. The Convactars� $�ate License Law tloes not apply to an owner ol propeny who GuilGs or improves t�crwn antl who conVacts tor suc� prole��s wi�h a coniractor�s� license pur5uani �o ihe Conlrac�ors' $[a�e License Law�. I am aware Ihat pmol ol t�eir Worker'S Compensa�ion insurance should �e pmvided to me. � I am exemp� under Seclion: B. 8 P. C. fartNs reason: %�/ �9/ �" Daie: 2 � Owner: � �" � "'�` I do her y ceNty 1� I am aware ol antl untlerstan0 the reQuirements of Cali�omia Health ana Sa�ery Cotle Sections 25505. 25533, ana 2553a n0 ��a� I Wany IuWre builtling occupanl will/will nol (circle one) nee4 io comply wi�h saitl s[aie co0es and �he requiremenis �or a permii'lor const(udion ar modificalion Immihe Nir Ouali�y Management DistricL ResiAenlial constmction applica�ions are exempl Imm Ihese D�ovisions. �a�e', ApplicanC I �ereby cer�ity Iha� I have reatl Ihis aOPlica�ion and sla�e �ha� Ihe above inlormation is correcL I agree lo comply wilh all ciry and counly ortlinances ana s�ate laws relaiing lo builtling consimction antl here6y authorize represen�atives o� this ciry to e�ter upon the ahove-men�ioned pm0etly for inspeclion JO�urposes. � � Date: �� / J" 3 Signamre: �� � 164t-< Sociai Seanty a: uiltlinq: Green—Cotle En�orcemenP. Canary—Applicanl: Pink—Revenue; oltlenrotl—Assessor CITY OF COSTA MESA — HUILDING PERMIT PERM NO: B 060783 PERMIT NO: H 060783 PLAN CHECK NO; N GOVT: N SUPP: N CONSTAUCTION TYPE; PERMIT TYPE: STR PURPOSE: ALT ,70B DESCRIPTION : INSULATE WALLS, RE;#B60777 SQ FT: 300 CLAIM VALUE; 300.00 CALC—VALUE; 300.00 GROUP OCC; R-3 / COMMENTS: X *�r�r*��r�t�r�t*�r�e�r�t�t*���t�e*��*�t*�t�t+t�t� ****�r*�r�x �r�r**�t*�r***�r*�t***+t*�t�t��r�r�t**�r�tx�r�r�*�r�r�t*�r�r 2 O N I N G R E Q U I R E M E N T S S E T H 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 TN PARKING REQ• PROV; PARCEL: 11737212 ZNE; REF NO; PLANNING NZST'ES> % n iE iF iFiE if �E if ik k if if iF iElf 1k i! if iF iFiE if iF k 1k if if if if ik iF iFit 1E ik i! if iF k iF ik �F 3E ik iE iE iF iF ikif if Ik iflF itlf if i! if iE iE �E1E 3E �F iFlf �F iE iF'iE 1f IE ik iE 3F�i iE�F �f 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;/l � 1 APPLICATION ISSUED BY; DATE,� °� �Z-� � �� iFiEikkiFiE�FiFikklfllltifiEiFiEiEiE�fiEffif�if�iF7FifiFif7f�f7f�fiFifiF�?fif��fiFiFiF�FiEiEiFiEif�lliflF�lf�IF ( iEiE 3k iE iFlE iF �t iP 1flk ik �E Ik iE ik dk iF iE fE �1! �E iE iE iF 1! �E �f it iflf ik if if if jE it IE iF �F if if IE �l1t if 1F�E if �t iF �t ik if 3F �f if it 1E if iE iF 3E 3F iF iE iF iE 1E k* IF iE iF iF iE IF iF ik it iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL�'SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG PERMIT 15,00 50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECH TOTAL PAID DUE TOTALS----> 15.50 0.00 0.00 15.50 15,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 15.50 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 15.00 .50 iE 3F �f iE iF if iFiF it �F ik if iF ik ik 3E it 1E ik iE iE iklk 1k if iE iF iE �E k iF iE iFiE iE iE 3E �F iE iF iF iF ikjF iF if if k 1k iF iE �FiE if iFif iE iFiE iE iE iE iF iE iF if 3E �E�F iE iE k iE iE iE 1E3E if iE I N D I V I D U A L F E E H R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 300 ALTER BY VALUE RESIDENTIAL N020NE 1,00 300,00 END OF FEES ��. �1;. - _ �,-i_' ` . . ' ' .' ;' . �.! : J .. _,_. . 'i .. ' . CONSTRUGTiON AND PLANNING- . PQOL . ..PA Date Inspector Date Inspector i APPRpVA4S Permit # APPROVALS Permit # .,..- 1 i- r� 1. Temporary Electrical Service or Pole ' _ 52. Pool & Equipment �ocation 2. Soit Pipe-Undsg�nd, =� � 53. Steei ReinforcemeM � ;�� 3. El�ctricai Conduit•Utility•Undrgrnd. 54. Forms .. - � 4. E(Actricai CQnd�it�Undrgrnd. 55. Electrical Bonding � . 5:� Steel Rein'.orcement - 56. Rough Plumbing & Pressure Test . i �_ 6. -Electricai UFER Grnd. 57. APPROVAL TO COVER�GUNITE � 7. Footings � � 58. Electricat Conduit-Undrgrnd. ' 8, Foundation - _ 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe�Undrgrnd. - 60. 8ackwash Lines, P-Trap, L7 Undrgrnd. y� 70. Structurai Plcor System �% � 67. APPROVAL TO DECK , �� 11. Property Sewer �in'e�& House Co�nection � 62. Backwash & Receptor-Finai � ' I 12. Sewer Cap � -� 63. Heater & Vent�Final 1'� '� 73. Roof Drains , � ' 64. Plumbing System - Pinal � 14. Rough Plumhing 65. Electrical-Fina� �, 15. Rough EleGtrical�Conduit 66. Solar System-Final � 16. Rough Electric Wiring 67. Fencing & Access Approval . � � I 77. Rough 4Viring Siyn 68. APPROVEp FOft PLASTERtNG . �� �- 18. Rough Elettrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ` ' 19. Rough Heating & Air Conditioning � FIRE DEP7. R.EQUIREMENT j .. _ _ - . ,- , .. _ •. .i�.. � -. a . ' 20 �Rou�h �ec:o;V F�replace � ; '� i ' '� ,; .; APPROVALS � 1'ermit #�- I 2L fluets, iri:5trt�ctura� �- •• - � "� , X 70. Under�roun�' Hydro 4 � 22,,�-Ouecs,Venti(atin9.; � - „,� �-, -`" -71. Product.Pi�ingL�Gas 1�6ii 23. Gae Pipe-Raugh & i'est � +� �-t � ' 72, Undergroonii Flush�- - ,- 24.'floo�fFraming � �"`- ".r' ; • � �J „` 73.-Undergrnd:S!orageTa�kOGas ❑OiI I 25. Rooi Shr,,athing - ; . . � � _ : 74! -Overhead Hydro� � � 26."�T•Bar Ceilirg (Struc4urel) &'Mdr�ocoat � � 'r ' 75.. Dry Chemical . II � 27„Frame a�d Ftashincy< "„;, . . 76. Dry Standpipe ... � r. 28. Lathing:�c Si4ing �'. =v�� . ' ..i . 77: FIXED S1�STEIt��.'INAL; 29. Insulation � - • 78. FIRE PREV. FINRCL -- � ^30. Orywail'Naiting K � � � HEALTHDEPT. REQUIREjNENT . . � � `-;37. Plaster S�o�Kn Coat„ � r �- . . -79. FINAL WSP.ECTIQN - - 32. Electrica4 ?ower Metei-Final �� "` •80. FOOD CERTIPICATE IS�SU,ED � � � w .� � � .. • - . � �__� 33.;Finai Electt�a � - Notes: . . ' .. .' 34. Final Heating& AirCortditioniag> - � _ � • _ r -. - 35. Final Gas PiPe�Test, •-'' : 1 , _ I ° _ . . ' " ��36. Hood or.CanoPY �- • .- x ' ' Y � 37:�FinatF�acloryFireplace " �� - ' _ �� � 38. Pina! Plumbing • . � . � + . . .T---- i �39. YVat�r Service;Final, , - I - " � 40. Gas Service-Fanal . - • � � � - x i '41. Solar pomestirFinal � - � ` - - � c 42. Back4tow Freve�ter . � �>. � >,. • ' � r 43. Backfiow irr�ation;� ' i `' : � '•' ' �44. Landscape icripation System � -. , - ' - . • •� - �45.�Sound Attenuation -' ' ' � "'' "'�- ., � � -46.�NandicapReguiatians � ' ' r� I . : ` � � - - 47:FVNALSTRUCTURE&BUFLD{NG � - . y�t�s 48. �PINAL PLANNING - � . � � � � ' i i 49. Electric Re�ease to Edison I � �. .50..Gas_Release to Southem California Gas Co � � _ 51. CERfi1PICATE OF•OCCUPANCY - - � � ' No. Date PBOJE�T AOOflESS: s sWI�Ex'S NaME: E S B TH ST � nooncss: JIM PALMER P O BOX 1562 NEWPORT BEACA,CA AflLMIENGINEEfl: nooxess: UNIT: 92659 XEG.NO.: uNiT: eenminee: WHITNEY ROOFING ( 714 ) 548-0769 aooaess: 15396 PO BOX IICEN$ED CONTBACT P DEBCIANATIQN: I hereby allirm �hat I am license CA ions o aD� ommencinA wi�h Section 7000� ol Division 3 o� Ihe Business and Pm�essions Code, and my license is in full brce antl e�� c�iTvuc.f���6�1—sTnTeuc.:406022 c�nss:C_ • /95 n r 7� Signaiure' OBKEBS' LOMPENSRTION OECLAHATION: I �eBOy a�lum Itlal I have a c¢riifit e ot consent ro seu�insure ar a cenilicate ot workers' ComOensalion Insurance. or a cetli�ietl copy thereo� (Sec�ion 3800, LaO. C�. roucrNo.:2g595UUNIT328 EXP.UR7E:OSIO1/9G comrnNv: STATE FUND ❑ Cenilie0 copy is �ereby lumishetl. � Cenified copy is filea wit� t�e city BuilOing DN . pa� — (� � % ApDlicant: %EMPTION FflOM WOPKEflS' COMPENSRTION OECLABRTION: (This seclion nee0 no� be compl IeJ i� Ihe permit is �or one hunOretl (E700) or le5s�. I certily Ihat in Ihe pedormance ol Ihe work for w�ic� t�is permi� is i55uetl. I s�all not emD�oy any person in any manner so a5 io become SUEIeCI lo Ihe WOrkers' Compen5alion Laws 0� Caiitomia. Oate: Signature: NOTICE: I�, ailer makinA ���5 declara�ion. yau 5hou10 become SuUjetl to I�e Wo�kers' Compensa�ion pmvision5 0� Ihe Labor COUe. you mus� torihwit� comply wi�h suc� provisions or Ihis permit sllall 6e tleemeC revoketl. CONSTNUC710N LENUING pGENCY: I hereGy afiirm Ihat Ihere is a constmction IenOing agency for Ne De�ormance ai the work for w�ich Ihis Oe�mit is i5sue0 �Sec�ion 3�97. Civ. C�. IEN�Efl: aoonEss: OWNEfl BIIILDEfl OECLANATION: I hereby affirm (hat I am exempUmm the Conlractors' State License Law br Ihe followinA reason (Seciion 7091.5 Business an0 Prolessional Cotle: Nny city of counry wAich repuires a permit to con5imct, alter, impmve, tlemalish, or reDair any slruqure. O�ior lo �is fuuance. also repuires �he applicant br 5uc� permi� lo lile a siA�e� sia�ement t�at Atlshe is licensetl pur5uani lo Ihe prOvisions al thE Conirac�ors Stare License law ICnap�er 9lcommencin0 �+�h Section 7000� of Division 3 0l me Business an0 Prof¢ssions Code) ar tlui �e/she is exempi lheretmm ana ihe basis lor Ihe allepe0 exemption. Any violation o� Sec�ian 7031.5 Oy any ap0licant lor a permit subjects t�e apD���ant to a civil penalty of not more t�an five �unErea Oollars (5500�. I, as owner ol IAe O�oOeny or my employees wit� waAes as Iheir sole Gompen5alion, will tlo ihe work, antl l�a ❑ s�mtWre is not inlen0etl or oflerea �ar saie (Section 70a<, Business and Pmfeuional Cade: TAe Contractors' Stale License Law aaes not aDPly to an owner of a pmperty who buAtls or imD�oves ihereon, anA who Ooes such work Nmsetl/Aersetl ar tAmuq� �i5 ot �er own employe¢5, proNtl¢G t�al Suth impwvemenls are nOtini¢nUeO or onereE �or sale. Ii, howev¢r I�! GuilOinp of impwvemeni is solE wilnin ane year of completion, t�e owner wiil �ave ihe Eurden of proving 11e/stle ditl noi OuiIE or impmve lor Ihe purpose ol sale�. I. as owner of ihe pmDeny, am exclusively contraclinp with licensed coniractors lo consiNct lhe prolect (Section 7604, Business ❑ ana Prolessions Cotle: T�e Coniractors' Stare License Law Goes not aDoly lo an owner of pmperiy who bmlds or improves t�ereon ana wno camracls lor 5ucn Dmlecls wii� a comrac�oqs�license pursuant Io Ine Cantractors' Slate Litense Law�.l am awaf¢ Ihal proo� al Iheir Worker'S Compen5aiion insurance 5�ou10 Oe pronaeE lo me. � I am eKempt unaer Sec�ion: B. 6 P. C. lor I�is reason: Daie: Owner. I ao hereby ceNly Ihal I am aware ol anA unGerSiand Ihe reQuir¢men�s of Califomia Mealth antl Safe�y CoOe Sections 25505. 25533, anG 25534 and iM1al l or any luture Ouiltlmg accu0ant wilVwill not (circle one) need to cam0ly wit� SaiG state cotles antl ihe repuirements for a permit for cons�mnion or moaificatmn imm tne Air Oualiry ManaAement District. Resitlential constmction applicatians are eKempt Imm Ihese provisions IJ_ ._ Oaie: ADO���anl: - I h¢r¢Gy C¢tlily I�ai 1 �ave reaa I�iS applitaii0n and Siale 1 ve inlorm ' n i5 wrreci. I agre to campN ��� atl ci�y an0 counry or0inances anG slate lavrs relating Io building consimctio ere�y autlro' presentatPoes of t�is � to enter upon the aGove-mentioneE �0 ¢rty lar inspeclio (O�wpos¢S. ,p ¢: � � �) Signature' OnveYs License a� Social Securiiy •: l6at�a6 wni�o—Bmitling: Green—CODe Enlarcemem; Canary—Applicam: Pink—Revenue; Golaenroa—nssessor CZTY OF COSTA MESA — BUILDING PERMZT PERM NO; B 070936 PERMZT NO; B 070936 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; REROOF OVER COMP. W/COMP, SQ FT; 1,320 CLAIM VALUE: 1,320.00 CALC—VALUE: 1,320,00 GRO[lP OCC: M-1 / COMMENTS; +t***+f*it+c�*�t�r*��***r�x+t*+tr�rrarac*x�**u*at**rr*+��r*****r*�*�r**+raF****a*+a*+t**r-rtat�c�cic*****�t* 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 AEQ: PROV; PARCEL: 11737212 ZNE: REF NO;o F�LANNING NOTES> > if iF if riE ifif if iE iFif 1f 1f jfaf if if if if M aFiE if �f r af if af % jf�t ifif ifaf iFaf if if if if 1f M icM if r MiF ifiR if�tif if {f{f Kif if iF ifif if K�1Rif iF iciE jfiE if iE ff if iE jf jE D E V E L O P M E N T S E R C' I C E S R E Q U I R E M E N,',T, S ZONING APPROCTED BY . BUILDING APPROVED BY : , ��&�*+�5:'*���r:�f�:�:��'��X#�'iKx?�'i:�$?�R"������t��a u�i��F� jf �1F iE iF iF if 3f # af +E iF if ik if i(� iF+f it tt 4 i41t ih sf # iF.c+f if �t if at it?E it i! if it 4 if if 4 �h 1f �f if if if if iF LEGALI2ATION;N F E E S U M M A R Y HLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 33.00 DATE; DATE: ''' % i4 M�txxltitiEi�iFlF4itiflfit�hMfElki!MMjf+tif STP.UCTURAL SEGMENT:Y FIRE ,-� SMIP/RES GRADING • .50 SMIP/NON—RES PLAN ` � ISSUE FEE � ' BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL TOTALS----> 33,50 0,00 0.00 33.50 PA2D DUE 33.50 ,00 REVENUE DIVISION TOTALS--> COLliECTED; 33.50 OVER/SHORT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK 33,00 ,50.. if i! iE if iE M if it if 1! ff if ff if it if it it 1t iF if if if if i! if if if if it if ik iF if iE 1E it 1f it V 4 if it K fk iE ik if r if i1 jF iE it if iR M if if jf-1k if if if iF if it r it iF iF iF if if ff aF if iE if I N D I l7 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 2 O N' UNIT CO5T TOTAL COST SFR 1320 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 1,320.00 END OF FEES 5 • �� � . ,ie:) 1e.ql:Li ,�` 9 �. ��.JAN� b i$9a ; . ���'� ��� JA{pIH R+�d!'Y •CONSTRUCTION AN� PLANNING POOI � �PA ; APPROVALS Permit # Date Inspector APpROVALS Permit # �ate Irispe2tor i. TemPorary Electtical Service or Pole 52. Pool & Equipme�t Loca[ion z, gpil Pipe-Undrqrnd. � 53. Steel Reintorcement .,,1 3. Electrical Conduii Utflity-Undrgrnd. � 54. Forms '7� 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding ' S. Steel Reinforcement ," 56. Rough Plumhing & P�essure Tzst ,; 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings � 58. Electrical Cond�it�Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Tesc 9. Wacer P�pe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgmd. 10. Svuctural Floor SYstem 61. APPROVAL TO DECK t t. Prope�ty Sewer Line & House Connection 62. Backwash & Receptor�Final . 12. Sewer Cap , ' � 63. Heater & Vent�Final 13. Roof Drains _' _, 64. Piumbing System • Finai 74. Rough Plumbing � 65. Electrical-Final 15. flough Electriral-Condua 66. Solar System•Finai 16. Rough Eleuric Wiring 67. Fencing & Rccess Approvaf 17. Rough Wiring Sign 68. APPFOVEO FOR PLASTERING 78. Rough Electrical•7 Bar Ceiiing 69. POOUSPA SYSTEPdS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. RoughFactory,Fireplace � �� APPROVALS Permit# 2L �uCts, in Structure �-• 70. Underground Hydro 22. �ucts, Vent(lating .� 77. Product Piping QGas DOiI 23. Gas PiPe�Rough & Test • 72. Underground Flush 24. Roof Framing . � '• � 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing .' � 74. Overhead FlYdro 26. T�Bar Ceiiing (Structural) & Monocoat . 75. Dry Chemical ,' 27. Frame and Flashing ,� � 76. Dry Standpipe � � � 28. l.athin &'Sidin � . . - ' 9 9 . 77. FIXED SYSTEM FINAL - 29. Insulation � - • • , 78. FIRE PREV. FINAL • 30. Drywall Nailing �� . HEAL7H DEPT. REQUIREMENT 37. Plaster Brown Coa[ - . 79. FINAL INSPECTION � Y 32. Eleciricai Power eter��inal 80. FOOD CERTIFICATE ISSUED 33. Final Elec.rc �. - , _ � Notes: �� q,�Q�y� �r �yps �C'�df1 34. Fin9l�Heating & A r Condhioning = � i� p c� 1�+ hao_�� -�a_�-r 35. Fina� Gas Pipe-Tes�t � 36. Hood or Canopy I� �� �' � ,. 37. FinB��Factory Firaplace �� 38. Fin81 Plumbfng `� ' ' , . 39. Water Service-Fin�� . ' ' ' 40. Gas Service-Final �: . , - � �, � 41. Soiar pomesticFi�al � ' I , . P.... . 42. Backflow Prevenie�_ 2 � _Ll !7 �. �p,`a -` � 43. Backflow Irriga2io(t � , ��� ��cJ_t-[ �� c� 1+��. `"..... 44. Laodscape irrigation System � . � • , ' 45. Sound Attenuation ' . ,_ ' . 46. Handicap Regulations - � ���� ' - "• i... i.%� 47. FINALSTRUCTURE&BUILDWG 2�1��(s 6��¢ . �_�_,-.,-.� �= �-�_..-t 48. FINALP�ANNING � „' � . . ' "a,,,,,;�,,,..� 49. EleCtric Release to Edison ' 50. Gas Release to Southem California Gas Co -� ' , 51. CERTIFICATE Of �CCUPANCY ' No. Date �� ;� Cnsta Mesa Bailding Department APPLICATION FOR PERMIT ��; COSTA ME A? CAL FORNIA �%e� B U I L D i N G ' FOR OFFICE USE ONLY FOR APPLICANT TO FILL IN I Receipt No. ( ay ic � Buildln9 Ed,ST �O �~ p�� � � ' Address Rece ed by Date Redd. I Dah Issued -• - Costa, Mesa, California .�, I /n - c'-t ; �l ii� � �„ _.< Owner c-' � -� �G Costa Mesa, California Mail p ` Address .(C�15 Fncr �D �� .JT Nearest — No. NL`•2 Bvi/oE.6 Cft� SE/� _ . No. Lot Metes Bloek Size ot Lok G Q�/�Q � I Now on Lot Use of '� No. of No. ExistingBldg• /�D E I Families�l Roc Setback Lina from � Rear Vard �� New Plans Date I•�,��1��� � � �. 11 VI �. - - ..�„a / • I rve. oi / Sfze •� —ZSSF%oms SWries f-+er�or wa�1 � ,�toof gppROVALS erin9 rg'TfIG'��i0 ' CoveringCo�q . JNi� ._.: of New . Buildfng . Foundation Loeation Inspecto Forms, Materials, Under-Plnning ' Frame: Fire Stops, Bracing, Bolts I hereby acicnowledge that I have read Uvs Applicatlon and state that the above is rnrrect and agree to cOmply Lath. Int �-�� with all CYty Ordinances and State Iaws regulating building cronstruCtion. Lath. Ext Signature oi � p Permittee _. ��� C �Rw�4�C.. Plaster, Int. Authorized A9t• Plaster, Ext Valuation Pe�mit Fee $ / o�.�= � Masonry Reinforoed ��� � Plan Check $ o!. �� gond Beam s � ��_ rota� � o v Fee $ . FINAL ana 2a s-sr aat e-ss ' • ^ ' � . •�_.. . � ,. .� � • \� �CT -5-SSP��Esn" � o�a - �` t u.nn a�.�,�,: Bhow locatlon and dist,�nces from property Iina and between buildings. 0