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Home My WebLink About498 18TH ST - Building Permits� (714) 754-5273 • Fau (714) 754d856 • www.c�.costa•mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 498 E 18TH ST Suite: � Vicinity: RESIDENCE ONLY Parcel Number: 11733221 Applicant: SELL, RON Address: 18032 LEMON , - YORBA LINDA , CA � Owner. ENGCISM;"LANCE M TR , Address ,'498 E�18TH ST � _ _ - i� i. � �'�,' � .. , � . i-COSTAMESA..CA' . Convactor: �'SELL ROOFING COMPANY Address: 78032 LEMON` . i ,,, , � , YORBA LINDA , CA . . ��Zip: - 92686� ArCh : Address: �Zip: _ � - ' ., . � Phone: �� ;�- ' � - _! � �" Cicense: Status: ISSUED Applied: 01I07/2003 Issued: 01/072003 Zoning: ISSUED BY: Phone: p14) 528-1758 � - Zip: 92686 � ; - �' � j Jr ;� \ \� , , A �� A�� \ Phone: � - � � � � � � � " � " i �VA�_� '. Zip: 92627 � `= . /! �`..,-.� _ �`,\ � , : / , � �' � � � , ��' �:�: �� Phone:`�(774)52&1758 �`�� . ' : License:' 323842 � _ - _ �� . � �s � . � � � '�— - _ Eng: � - _ Address: _,. � , '; �� Phone: , % " . C \ � �� License: - � . � , � �,,. SCOPE OF PERMIT — ,� � REROOF RESIDENCE ONLY: T/O COMP.SHINGLES, REBAIR/REPLACE SNTG.AS.NEEDED;�1 LAYER 30# FELT, APPLY'30•YEAR COMP �. SHINGLES' 18 SQUARES - , , ' � `� � � � � � � �. FEE SUMMARY �>� �' ' ' � Plan Check: $0.00 - - � �. " Calc Valuation: St,9oo.00 � Permit: , $66.20 � � � � ' ' � ; Claim Valuation: ; 5i,soo.00 �;�SMIP Res: $0 50 �� ' � SMIP Com: � . Othe�: � `Inspec4ion: -� � Total: ' , $0.00 � $0.00 $0.00 � $66.70,- _ — ,,;- . ,.;.:., � � � ��% � � � PLANNING SETBACKS. � � MAIN STRUCTURE Front 0. 0 � Rear - 0. 0 � ��Left � . ACCESSORY Front, 0= 0 � - � PARKING Existinq: o,; Rear 0. 0 Re uired: ..0 � Left � . ,�;i;; „ � �, , �� : - :��,, � / & ZONING ,'r,�: �� ;� �� i � 0- 0 � Right ' 0= 0 %'� 0- 0 '�. Right� � 0= 0-' / � �-� ., . Proposed: 0 , .., -. _-�-'�, NOTICE: The work authorized by ihis pertnit shall comply with all applicable handicap access requiremenis under Califomia statutes and retated regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1B0 days, or if work is suspended or ebandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlone and final approval must be obtainad. Failure to obtain inspections and final approval will result in ihe expirallon of ihis parmit. FOR INSPECTIONS CALL: (714) 754-5628 2d46-08 (fl�W� WORKERS'COMPENSAnON DECLARAnON: � I hereDy eifirm undar penalty of perjury One of ihe following declarations: ❑ I heve antl wlll malntein e ceRificate of conseN to self-Insure lar workers' compensation, es provided for by sectlon 3700 ot the Lebor Code, for Ihe peAortnance oi the rk for which t�is permit I5 issue0. • I have and will ma t�in workers' compensatlon Insurance, as required by secGon 3700 ot Ihe Labor Gode, for �he pertormanca ol the work tor which this pertntl is Iswetl. My workers' com tlo Insurence� enA ' number are: � / y' / Cerner: � .� Policy Number. � Y � ��/ (Tis sectlon need not be completed i! t�e permiNs ve/u d ef one huntlretl dollars ($100) or IessJ ❑ I certify ihat in the peAormance oi Ihe work tor which this permlt is issuetl, I shell not employ any person in any menner so as to become sub�act to the workers' compensallon laws of Celifomla, Bree that it I oultl become subJect to the workers' compensation provlsions o1 Sectlon 3700 of the Lebor Catle, I shell forthwith comply with these provisions. ' /^/ _�� [1 Applicant Signature: � _ Date: / WARNINO: FAILURE TO SECURE WORKERS' ��1FENSATION COVEMGE IS UNLAWFUL AND SHALL SUBJEGT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDREO T/IOUSAND DOLURE (b100,0007, IN ADDRION TO THE C06T OF fAMPENSATON, DMUGES AS PROVIDED WR IN SECfION 31080F TME LABOR CO�E, IFIrEREST, AND ATfORNENS FEES. LICENSED CONTRACTORS DECLARAnON: I hereby aHirm that I am licensed force end eHect. Lic. p GONrecto/s Signature: _ 9(commencing with Sectlon 7000) of Division 3 of Ihe Business and Proless ode, antl my Ilcense Is In full � cless a � �� oe�e: /G — —O CONSTRUCTION LENUING AGENCY: ❑ I hereby eHirtn Ihat Ihere Is e consiNccion Ientling egency lar the peAormance of the work for which this permit Is Issued. (Sec. 3097, Civil Code). Lenders Neme: LentleYs AOdress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirm Ihet under penelry of perjUry tha[ I em EICEMPT FROM THE CON7RACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business and Pratessions Cotle: Any ciry or counry which requires e pertnif to construct, alter, Impmve, demalish, or repair any structure, Drior lo its Issuance, alw requires the applicant tor such pertnit to file e signetl statement thet he or she Is Iicensed pursuent to �he pmNsions oi the Contrectors License Law (Chepter 9(commencing with Section 7000) of Divlsion 3 ot the Business and Professions Code) or �het ha or she is esempt iherefrom end ihe 6asis for Ihe alleged exemption. Any violation of Section 7031.5 by any epplicant for e pertnit su6jects iha epplicant to e civil penelry ot �ot more ihen fve hundred dollars ($500).): ❑ I, es owner ot ihe property, or my employaes with wages as their sole compensetlon, WILL DO THE WORK, end Ihe siructure Is not intentletl or oHered for sale (Sec. 7044, Business antl Professions CPde: The Contractors LicenSe Law does not epply to en owner ot property who builds or Improves Ihereon, antl who tloes such work himself or herself or through his or her ov.•n employees, provided that such improvemenis are not intended or oHered for sale. If, however, the building or improvement is soltl within one year o1 completion, Ihe owner-builder will have ihe burden ol proving that he or she did not build or improve for purpose of sale.). � ❑ I, as owner of the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business and Profeuions Code: The contrectors License LeW does noi apply �o an owner ol pmperty who builds or improves thereon, and who contracis tor such projetl with a contractor(s) license pursuam to the Coniractors License Laws.). ❑ I am exempt undar sec. Business and Professions Cotle for �his reason: Signature: Date: Owner ID verifled by dnvefs license. ❑ Yes ❑ No Dnver's License No. Expires: Verification of Ownership by (rype of tlocument, I.e. - properry te�c bill or tleed): DIVISION OF INDUS7RIAL SAFETV PEAMR CERTFICATION: � I hereby certlty that rto ezcavation t(�e (5) ar more teat in deplh Into which a person is requiretl to Aascand, will ba made ln wnnectbn with worlc euthorizetl by thls permit, antl that no building structufe, scallolding, lelsework, or demolition or tll5mantling thereoi, will be more then ihirty�sis (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celllomia AtlministratNe Cotle). ❑ As owner-bullder, I wlll not employ enyone to tlo work whlch wauld require e Dermll from ihe Dlvlslon ot Industnal Safery, as notetl ebove, unless such person has e permit lo da sucli work trom the division. Signature: � Data: Division of Industriel Setery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUh10RIZA710N OF ENTRY: 1 certity under penalry ot perjury that I have reatl Ihis application and state thet the information given is correct. I egree to comply with all state 10ws end ciry orCinances releting to builtling conswction, end euthotlze representatives ot the Ciry ot Casta Mesa to eNer upon the ebove-descnbed properry tor inspection purposes. I egree not to occuOY a� ellow occupency of eny building euthorized by this permit until finel inspection. �� pi I �(s) Date L / -- 7 --� 7' And/Or Autha�zetl pliwnt Data cooe �, iNsvecnoxTvve 1678 Fixetl System Final Fire Prevention 1266 Pool Spe Finel 200 Final Re�Rool 207 Final Block/Retelning Wall 202 Final Fectary Fire Place 203 Finel Slgn 204 Finel Demolltlon QAIE It�LS CODE� INSPECTIONTYPE 206 Finel Mechenicel 208 Finel Plum6ing 210 Final Electncal 212 Final Fire Preventlon 220 Finel Planning Approval 222 Final Site 250 Finel BulldincyOccupancy � 1[� CITY OF COSTA MESA CONSTRUCTION PERMIT Ro�ct MEm�: �� ro1-S7 I 8Yh � Ilnit:� Owaat Nama: �4 �� L�— MErm: �� -f} f}3w �NCAJEnCIma: flW. Na: iqp�: . Unit:. � P'aml�b�'. Mlrm: %� i e s F SR- 110EXSEO COMTMCIOH OFClAN�110N: I �ere0y affirm Nat I am Gcense0 uMer pwisions ol Gupttt 9 �commendnp wiN SecUon 7000) ol Orvison 9 0l me Business ariG Professions CoOe. a my Yttnse is in full tace aM efhcl. GTY 11C.: >�� S�fAfE L1C.: CLASS: � Oale: __�1�7_'— SiOnamrt: " WORKEBS' LOMP M&U 6MDEClAHl1T10N: I �ere0y atlirm I�at I han a cerlilicate al consent ro selbinsure or a cenllicale ol WorMers Compensation Insurance, or a certilied'cap� tAeaol (Section 3800, IaD. C�. � POLICY NO.:� � • ' F%P. OIITE: , . 'OMMNY: � . ' "� , ' J Cetlllied copy is �ImreEy lurnis�ed. ❑ Cert�ea wp�r is eA, with the cRy BuilAinO.Division.. oate: ' ApWicam: FRFMPfIOM FII011 A[FIIE' COIIPENGiIOM DEClAM110X: (T1 u uclion nee0 nol Oa completeE If the permit a tar onc �unOrcE (5700) or kssl. I urtity IAat in ihe pertormance oi IAe waM /or w1�kn tNs ce� �S �ued, I sIW mt crtWq' �nY D�rsan n ary nwmer m as to Uewme suOR� In Ne NbM1srs' CanDensatlon laes ol CafilaNa. D�te: ' Sipru[ure: - ' . NOIICE: n, �Iler mana Na Eetlartim. YW sMUE becmie s�6d� to tM Nbrl¢rs Cortpensauon Dm+f sms a me l�Ea coae. w� mw r�rtlw�an cmw �n sucn av.�s a tla o� vw ce aeanm maYee. CUNSfMICf�OM LENOINO ABENCI: 1 �e2b� atfirm that tlere 6 a wnnruceion Iendinp a0enry for tAe perfar� rtunce al Ine v.o�k for wNCA eNs permit is IsweE (�on 7097, Civ. q. IEXDER ' . . _ . ' . �oa�u: qYIIER WIIDEII DECUIUQIOM: . I �ertEy aM'vm that I am aempt hom the CaM2ctors Sta1e License law Im IM lollowinq rtuon (Sectim 7037.5 Business aM Prafessional Code: My ciry oi counry whlU reQulres a permit lo con.urucl, Lter, ImD�. ��s4 or 2pair airy structure. prbr to its issuance, also requlres tM apDl4 cam lor suc� permit to file a s�0�� emem ehat hNSAe is IicenseC pursuant to tAe pmvisions N lhe Comnc- tors State Licenu law (CMD�er 9 �commmicinp wit� Section 7q001 ot Oiviskn 3 0l t�e Business anE Pmhssbns m CoEe� or Itut h�s�e is ettmpt IAertlrom an0 the Oasis far Ne alte0� �mptlon. Am Nolation of Section 7D31.5 Ey airy D��+m lor � permit suE�ects Ine applkant to a civil penalry ol nm more ��an live AunOreO Oallars (SS00�. I, as awner o11M D�D�nY will Eo t�e v.oM, an0 IAe stmctura is noI IntenEeE or oflere0 far sale (Section , uvness and Prolesslonal Coae: TAe Can- Iactors Stafe License l�w dcef nal appy ta an rnmer oi a O�Oerty wAo OuilEs or improves therean, an0 w wM Eas wcA wwk himselUAeneli or t�muph Ais or Aer ovm emplayees, O�wiEatl that suc� imprwemems are nM intende0 a aHert0lor sale. I( hoxe�er the huildinp or improvement u solG vnlMn one year ol com- qetbn, I�e o.mer vnll �aro me OurCen ol D«np he/she tlW nM GmIE or imD� �or the purpose M sale�. V I, az wmer ol I�e D�De�y, am ettlusiveIy cont2cting wit� IicenSeA contrzdors to construct t�e pmjeel (Sect�on TkO. Business an0 ProMssions CoAe: The Cantraclors' State License law does nm apply lo an ' mrner ol DroDeM1Y w�o �uliM1s or im0�s tMreon anE who camacts tor suctl O�olecis vnt� a coniractar(s) � -licenu Wrsuam m tne Cattactors' Su1e License law). I am aware tlwt D�1 al t�eu WOMzr's Compensa- tion insumnu StrouW he Dm�iEeE to me. � � I am nrempl unCer Section: � : B. d P.�C. ' i ' , lor Na reuon: � — . , I � � �ate: Ownec I do hea6/ ceNry Ina� I am re af antl un0erslana iAe require o Califamia Healt� anE Salery COEe Sec- �, tions 25505, 25533. anE 2553C an0 itut I or airy futu2 builGinp occupant tetltlaNLoN (cimle one) neeE to cwnply � xiN 5ai0 stata coAes uW Ue re0�urtmeMS ta a pemit M conslrunion or mo0i1'icalbn hom Ne Rir Ouallry Manape- iu �I meol Dictdct. ReslOemial consiruclion a00��ions are e�em0� �rom t�eu prwisions. � Data: ApDlicant: � � . I heaEy cerliy I�at I �ave reaA tAis aDVliw�ion anJ state tha(the aLae information Is correct. I aA�e ta compry x9t� all ciry and caunry oNinances an0 state larys alatinq ro EuilOinp consWction anC �ereEy authonze 20resen- latives ol Nis clty lo eMer upon IAe aEoue-memioneU D�7erty �/ msDen�on purposes. � . Orte'. _=�2�- Sipnature: _ . • � Orner's Lkense a Soclal Seanry M: . ' ` ' APPLICANT: DO NOT FILL IN SHADED AREAS: PERMIT NO. E SdZZD � PURPOSE: ❑ NEW ❑ ADDITION ALTERAI ❑ CANVERSION ❑ DEMOLITION �ER_ DESCRIPfION OF WORK/USE OF BLOG. � /� (v i l� � Ac� 7... UNIT MODEL ❑ REPAIR / . TYPE OF PERMIT: ❑ GRADING ❑ FIRE ❑ SiF�UCrURAL � SIGN IJyELECfRICAL ❑ PLUMBING ❑ MECHANICAL ❑. REMSPECfION JOB DESCRIPTION: O 50. Ff. OCCUPANCY GROUP ' CONSTFUCfION TVPE VALUATION $ ; ' GRADING CU. VDS. _ 1 CATEGORY: O MINOR CANSTRUCTION' � MA.IOR CONSTFiUCfION (UrWer 200,000 sq.ItJ ❑ MNOPoHIGH RISE (O.rer 200,000 sq. it.) q� . � � , Remarl¢: A �� '1� � -.. � � �'I 1� � � : . Backflow Prevemion � Backtlow Irrigation Bar Sink ' Bathiub qaritier Dishwashar � Drinking Fountain � Floor Drein Floor Sink Gas Service � • � Gas System ' Outlet intercepror " Kitchen Sink lflundryTray� - P—Trep � Reinspettlon Fee . � Boiler. � Duct—UnEerground � Duct—Stmctuiel � ' Duct—Ventilating Ez�aust Systam ❑ Mutliple ❑ Fan Flre Damper -' - Fireolace/FeM. BIL IC80 N oess-�e ,a�,. iores W�iro - BuilEl�p; Green - CoOa EnbrcemeM; nary - Fpplicant; Plnk � Rewnue: GdEanmtl � Aasassor � �; PWMBING Rapipe ROof Drein Service Sink Sewer Cap - Sewer Connection Shower Solar Collector ^ Soler Piping � Solar Tank �Swimming Pool w� Toilet • Urina� Wesh Basin ' Washing Machine Waler Heater water Sarvice l Iesue Fee � FEES' ' ' 3 53 FEES Heating System 8 Duciing ' � ❑ P100.000 eTU + � 100,OOO.BTU +' Haod or' Type 1 ❑ � ' - Canopy Type 71 ❑ Rafrigeration System • ❑ P700,OW BN a � 100.000 HTU r� Iawe Fee j A.P. p S Main Buil E Front T B Lefl A C Right K S Rear >Ing. Raf. p 'lannina Notes: Aurometic Washer' C11ri51m85 TrBB Loi� Conslruc�ion Pole Sub Pole Cooking Unit' Dis�wa5her Oryar O Gas ❑ F.A.U. Fireworks StanO , Fixture GeneretOr: Size _ Meter � up ro 200 Meter O over 200 Microwave \ �� Maror O 0.1 HP O 1�10 HP : ❑ 70.50 HP ❑ 50.700 HP � ❑ wer 100 ; Outlel . • Pole Liaht ' . . Square Faotage Fee, Stending Seclion Sub Panal Swimmin USpa . Swilth Temporary Work With r��srom,e. Size RSlnspection Fee 'S30 bsus Fss � DEVELOPMENT SERVICES REOUIREMEN75: � Zonlrg Appmretl By Bullding Approvetl By Application IssuoE By �<.,I' � SUMMARV OF FEES BUILDING PERMIT S MECHANICAL 5 PLAN CHECK � $. PLAN CHECK 254b'S PLUMBINCa $ , SMIP ' S PLAN�CHECK 25% $i GRADING ' $ ELECfRICAL - � s3 ' �% ' PLAN� CHECK � 504b S� ' TOTAL FEE � ! '. 575 _ �J1� OOf'"�C'.-�;i�s�7h5U'r F,ti � E' , ii/�J?, 4C _ `iiir �ate Dete Dete � N G R E O M T S. CONSTRUCTION AND PLANNING... ��APPROVALS Permit# 7. Temporary Electrical Service,or Pole ,� r . �t.� . 2. Soil_Pipe�UndrgrnH`• , , _ ical Date v' 5��:SYeel- Reinforc merit �� 6:'Electrical UFEPT�G�nd. 7-�Footing5 � -f. a , 8. F.oundation [� � f( � 9.� Water Pipe-Undrgrnd. ' �• � � ; :� i tOnSt�uctural Floor System ,j • � 1 11. Property Sewer �Line & House Connection - 12. Sewer Cap � 13. Roof Drains 14. Rough Plumbing 15. Rough Electrical-Conduit 16. RoughElearicWiring7 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Contlitioning 20. Rough Factory'Fireplace � 21. Ducts, in Struc'ture 22. Ducts, Ventilaiing 23. Gas Fipe-Rou9h & Test ' 24. Roof Framing� 25. Roof Sheatfiing� 26. T-Bar Ceiling (Structural) & Monocoat . r' 27. Frameand�Flashing 28'.` Lathing & Siding 29. Insulation :.�- 30. Drywall Nailing 31. Plaster Brown"Coat 32. Electrical Power Meter-Final� 33. Final Electric^;�, 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 pomesiic-Final . 42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irrigation SYstem : 45. Sound Attenuation . 46. Handicap Regulaiions ' 47. FINALSTRUCTURE&BUILDING 48. FINAL PLANNING 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co 51. CEFTIFICATE OF OCCUPANCY No. Date +l.��rylYwi'a� C%,''Y.`�'t:��'w}�<}� T.`{. �;ty:�S.;:, , ...t; _7, . Y a. ..;..G__ ;�•.�tr.:,ry,xMl..ti: . ifMni'..``��.Y}.t.�,..,...w�'r'�1JL.V�4�-'�:�,�1�.t�::... '_i ' P� SPA Inspector qppROVALS rermit# Date Inspector • 52. Pool & Equipment Location � � 53. Steel Reinforcement � �,_ 54. Forms _ � 55. Electrical Bonding - "� 56. Rough Plumbing & Pressure Test v 57. APPROVYAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. .. 59. Gas Pipe,�0 Undrgrnd., Test �� .g: 60. Backwash� Lines, P-Trap, O Undrgrnd.' '�� ,_ ' 61. APPROVAL TO DECK ":,i �' ' � �_ 62. BackwasFi & �ieceptor-Final � � �� 63. Heater & Vent-Final ,' � , 64. Plumbing System • Final �'i 65. Electrical-Final /^ 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING . 69. POOL/SPASYSTEMSFINA� FIRE DEPT. REQUIREMENT � APPROVALS Permit # 70. Underground Hydro 71. Product Piping OGas ❑Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT.REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: �= N nooness: q g g E 18 TH 5T asxnMe: KATALEEN E13GLISH nooeess: SAME AS AHOVE 714/642-6158 ABCHIENGNEEA: ROONESS: NEfi.NO.: UNIT: UNIT: PERMITTEE: HART ROSA ( 714 ) 548-0163 aooness: 1540 SCENIC DR COSTA MESA CA 92626 IICENSEO CUNTHALTUN OECIAFATIUN: I herehy allirm Ihal I am GcenseA unCec pmvisionS al Chapler 9(Cammenting wilh $e[fion 70001 ai �ivision 3 0l I�e Business ane Pro�essions Cotle. antl my license is in tull lorce anG ellec�. CITY �IC: S7ATE �iC.: ClASS: 9atel SiBnalure'. WOHRENS' COMPENSRTION OECIABATION: I �¢reby aflirm Iha� I Oave d cetlilicate al consent lo sel�-insure or a cetlilicale o� Workers' ComOensa�ion Insurance, or a certitietl copy thereol (Seciion 3H00, La�. C�. °OLICY ND.: E%P. DRTE: COMPANY: , 1] Cemfie0 co�Y �s �ece�y lumishetl. ❑ Certilied wpy is li{ed with the uty Bu�IG�q Oivis�. Dale: Ap0licanf E%EMPTION FRUlA WOBI(ERS' COMPENSATION UECIARA�ION: (�his sectian aeed not �e completeU il ll�e Oemut Is far one huntlretl (5100) or less�, I cerlity thai in Ihe Oedormante al �he wOrk IOr w�ith IhiS permii rs is5ueQQQ. I Shall not ¢mploy any person in any m3nnef 50 as lo become Sueject to tRe �tke�_ 5' Gpmpen5atlun laws of CafilarNa. � oa�e: / r 3! ,.d SiAnaWre: �A� NO71tE: II, alter making ihis aeclaraiion. yau shouia Oecome suElec� to ine Wo�kers' Campensation 0«�ons ol tAe Labar Code, you musl Ion�wiU compty wit� suc� Oiovisions or rtlis permit s�all be 4eemeG revoked. CONSTBUL710N LENOING AGENCY: I hereGy aifirm ihat Uere is a caretruction IenAing apency for ihe petlormance of ihe work �or , which this D°�mil'a is5uetl (Sectian 3�97, C'�v_ C�. LENDEB: i. pODqESS: OWNEH 9UILOEN DECIAHATION: I hereGy aifirm iAat I am e+empi Imm t�e Cantractors' Slate License law fo� i�e follovnng reason �Section 7031.5 Bu5ine55 and ProSestional CoOe: Arcy city ot cwnty which �¢O�res a permil 10 tonslluci, alin, impiove, Oemo6s�, oi reoair any stmclure, prior to ils issuance, also requ�res Me applicant for such permit lo lile a sipned statemenl tnat Ile/she is licensea pmsuam to ��e pioWsions of the Convaciois' State Ucense Law �Chapter 9 �commencinB wit� Section 7000) ol Oivision 3 oi the Busi�mss ane Professions Coee) or inal he/she is e�empt iherelmm antl Ihe �asis lor Ihe allegetl exempl�y�' pny violation ol Section 7031.5 by any aDDliCanS 10� 3 pe�mi� Suhj¢ct5 \he applicent Io a tivil pena�ty ot nol mOte lRan �iv�.jyinQlCO dolla�s �4500). r. • I, as owner d tne D�openy e.�u{ixy , " n�! M � �� , will da Ne work, anU �he � stmcture is not intenAeA or offereG lar sale (Seclion 70a4. Business anC Pmtessional Cotle: TAe Connaclors' Slale License Law does nol apply l0 an owner o� a O�oOBtly w�o huiltls or imOroveS �h¢reon, and w�o tloes 5uch work himSelV�¢rself Or [�rough his or �er own employees. provi0ea �hat suc� improvemems are not inten4e0 or ollered for sale. If, twwever tAe 6uiltlinA or ' improvemenlis soltl within one year ol com0letion,Ihe owner will have t�e burtlen ol proving he/she tliU not 6uiltl orim0�ove ior t�e OurOase ol sale). 1. as owne� ol t�e propeny, am excWsivel9 conttactinp wilh lic¢nutl contractars lo conArucl the O�Wetl (Sectwn 7Md, 8usi�5s ❑ anU Pro�essions Cotle; The CanVa[lor5' S�ace L¢¢nse Law does no� a00N �o an owne� oi pmpeny who builds ur improves iheaon and who ConUac�s la� such pwjetls wi�h a contr2c�or(5� licens¢ Oursuani �a Ihe ConVac�Ors' State LicenSe Law�. 1 2m aware �hal proo� Oi Ih¢ir Warkei 5 Compensalion insUranCe 5h0ultl bC pmvided �a me. � I am exempf un0e� Seclion: B. 8 P. C. for ihi5 rea5on: Date:��/��O 'Owner. � � I tlo hereby cenily ihai I am aware o� and unaerstantl t�e reQuiremenis of Califomia Healih antl Safety Cotle Sections 25505, 25533, anA 2553a ane iha� I oi airy iuime bulMinq occupam wilVvnll irot {circle one� nee0 so co�Wly viit� said state cotles and the requirem¢nts to� a p¢rmil lor cons�mc�ion or modifica�ion �rom I�e Air uaiiry Management Oisirict. Fesitlential constmction applications are eeemD� ��om Ofne Dtov;i0ns. Date: Pp0licanl: I hereby ceNlythal I haveread Ihis applicalion antl slalethat Ihe a0ove information is correcl. I aA�¢eto compry with allcity and county orOmances an0 stale laws �elating ta bmltling r,on5�mc�ion and �ereby auihorize represenP rves o� Ihis ciiy to enter u�on Ihe abOve�mentionetl O�OP¢tly IOf �OSp¢cli0n purp05¢5. � / K� � ' Oate'. _�Q(.3.(_�� Si9natme: orive� s �icense or Saciai Secunty a: t6ai-a6 W�il2—Builtlin9� Gre2n—COtlO EnIOrCemenL Canary—Applicdnt: Pink—FevvOue: GolEpnro�—As5as50r CITY OF COSTA MESA — BUILDING PERMIT PERM NO; E 04971 . PERMIT NO: E 0q971�5�"` PLAN CHECK NO; N GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYFE: ELE PURPOSE: OTH JOB DESCRIPTION : ELECTRIC METER UPGRADE/RELOCATION Sg FT; CLAIM VALUE: CALC—VALUE: GROUP OCC; / COMMENT'S: NO STRUCTURAL WORK BEING DONE ***a�*�t�e+rx�**�***�t �****�*+�****�r*****�r�r***�r**�x**+��e****�+�**�*********�+��r*�***+�*+�** Z p N T N GS ERTEB�AUCIRRSE 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 SN LEFT; FT IN RGHT: FT IN PAi2RING REQ• PROV: PARCEL: 11733221 ZNE: REF NO: PLANNING NCSTES> 1 k if ik ik 1E ik iE iF if iF 1f iF iE 1Fik iF k 1F iF iF 1F1k 1k if 1F ikiE if iF ib iF If iF iFiE ik1E i4 kiEtF iFiE fk 1F iF ik �f ik iE1E iF 1E ik IF it 1F aF lF jE 3E i! jE iE iF �F M iF�E iF it iF iF �F �F�F if iF�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 ZOt1ING APPROVED BY DATE; ' HUILDING APPROVED BY ; � DATE; APPLICATION ISSUED HY; DATE; �� (� itit�lEitk;FiFit1E1E1EfEiEkfEiEiFiEltlEiEiE itlfiE�fiFititiElkiE iFlF If if if if �F if IF iF iF if k if IE 1Elf IF 1! 1F ff iE iflElE iElf IF fE iE 1E 3E iE iE if 1F 1f 1t ff if If k iF �E k ff if iFlf M IE k�E M iFif ikif IE iF illf �f IF iF iF iE If IE if 1F if iF 1E �f if iF aE if iE if LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT;N PERMIT BLDG PMT PLUMBING ELE18R50 MECHANIC FIRE SMIP/RES GRADING ' SOt SMIP/NON—RES PLAN . ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 18,50 15.00 0.00 33.50 33,50 .00 REVENUE DIVISION TOTALS--> COLLECTED; 33.50 OVER/SHORT• 00 HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 33.50 if 1F 1f �f �f If IE if 1F iF k if iE if M k M k if �f iE iE iE if iF if iF IE iF 3F if i! if ik k 1f if iF k IE �f if If 1E �E iE �f k k k 1E iE #E #E �E fE #E k iE iE iE 1FiE #E 1E iE iE iP �E iE iE!! Ik iEiE iE IE if if I N D I V I D U A L F E E B R E A K D O W N TYPE (aTY p E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V s BELOGi 201 AMP 18,50 18,50 END OF FEES IIt QOD73?29-00473?T9 T s�i� Za,Sp CAiE: IC/31/SI} TItIE: i2:<^p CONSTRUCTION AND PLANNING ?�.-� & SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrod. 53. Steel Reinforcement .. � ;3 �Electrical ConduTt�Utility-Undrgmd. 54. Forms _� y ^-4: ElectriCal Conduit'UQdrgrnd. 55. Electrical Bonding �-�., �. - �'5:�Steel R2inforcemerii; 56. Rough Plumbing & Pressure Test .-l6tuElectrical UFER Gmd. 57. APPROVAL' TO COVER-GUNITE � '_ -`- `. �r7�:Footings �' 58. Electrical Conduit-Undrgmd. ;_$; Foundation �; 59. Gas Pipe, O!Undrgrnd., Test � 9. Water Pipe-Undrgrnd. J' 60. Backwash 4ines, P�Trap, O Undrgrnd. 10. Structural Floor System ,'� 61. APPROVAL TO DECK � i� 11. Property Sewer Line'& House Connection � 62.'"Backwash & Receptor�Final ' ,, 12. Sewer Cap W 63. Heater & Vent-Final � 13. Roof Drains +c 64. Plumbing System • Final - �� 14. Rough Plumbiri§ `r � • 65. Electrical-Final 15. Rough EleatricaJ-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wlring $ign 68. APPROVED FOR PLASTERING 78. Rough Electric'a`4�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' _ ' _ _ _ -� 7 -�F s . �r� 20.bRough Facior� FiFeplace • �,.; �:. -_ � = ;� � �� _ �p,ppROVALS%�-Permit # " �•" �. LO f^ : :\ N Jx 7. t{ .yN{� � u. 21.;_Ducts.in��Str,uaure,- �r- -�c }. t� -- .�,..- " � ;��-�y :,� ., ;:i S l7 -;70. Unde�ground,Hydro 22. Duas, VeM��ating T '' S �' v`f � dT �� s77, product'Piping O�'Gas ❑'Oil 23. Gas Pipe-`ROu9h &�Test R�- * i„ �. '; �72, Underground Flu`sti� - .. 24.!RoofFraming• '+ � ��! �• �:> G T `� � �73�Undergm8'Stora,ge_Tank��Gas��Oil 25. Roof Sheathin z :'1 �' G'� Sv �:J �� n ^ ��--r ! ,, 9 - .�. p � ,i;n y"74?Overhead Hydro^ i 26: T•Bav Ceilin9 IStructuraq &.Monocoat =� r_� � t� �• 75�Dry Chemlcal ,�� C�� ^�Frame and Flashiny; `; ',,, 4� � �; � ` 76E Dr Stand�'i e �"' ' '� � - „ .,r _ u� • , Y PP. i_ � . �2 . Lathing:& Siding, � -. �;y;G `,�,, �. s . .. �.� T 777FIXE0 SYSTEM�FINAL� � _ � �29.�Insulation � ^ �� ' : ,',' `� � � t; : 78:; FIRE PREV. FINAL ' � i. '� •=30. Drywall Nailing � � � �� • �� :r. - HEALTH�DEPT: REQUIREMENT . ' C �91. Plaster Brow,n�Cqaz;;, � ; �,�.r, ,, � � �;� ;` .J9 'FINAL INSP.ECTION: ' �" �r „I ' V, r't. - � - 32.,;Electrica�iPoveer Meter: Final: � �� ; � ! � ;. -80.+�FOOD CERTIFI.C.tCT.E ISSUED� � .. _ .T ,.33�Fin`I Electric r"'� � , ` " �7 �' � � �� x `' Nofes: �. S i '� .� + _:a - �' �.34.-Final. HeatiOg'& Air:Conditioningr �i a- J� � � r: ;;�.n� �V S �;:, < � _ -r i r. 35.j,Finat Gaf�Pipe�Test?' ~ -� - ' I � t* � : io>* o:' _ {r �- y �:� ._ .T :Y �- � � t�. � C7i-r t�•- -36' Hood or�CanoPv � p� i : - • :�. -� ! i w +- _ �. %io � �a ` _.� - � �,-.-. � •n ',.• -37 �Final. FActory Firep�ace� '�� y � t , �. .r '- � �. '�C. 2 i' - >� s � .. .. � - ' _, ��38. Final, Plu`mbing x �; i r� � ( � rr. �` � - ,;:7 c : 39. Watei Service�Final•• ' ' � • � i � `� �' "' .^ ` "� � > . �; , � _.y �. • ��,40. Gas Ser4�ce-Final ' i7 � ,., a ,s; I i. � `� v Gu ^�N . ''� " .� � � 91 . Solar pomesticFinal 5 :l� •• '' � I I •� r �i" � ` er� x I ' ix a L�� J �- �C t'42 `Backflow Preventer;. r' v :� �' � f �-. �` � :;�^ �, v . 43. Batkflow IR�ation' .� G"s� ��.� ' r'J U�-: y-,� :; "1. S G:� • - 1V ',44. �andscape Ir,cigation Sysrem�r;;� +;n � r : x,�� N �Z:,. i' o �45:;Sound F\tten:uation' �C:; � t' , .- E- [� '-w * " �-� :� 'v =a ik`� • ti n - + .n In ee�+- : 7' kL ••.,!_ T c c � � ' S i rq . . ..F v: � . � ... �.� ..., , U46:'Handicap.Regulations _ 't ,, �; � x , C-p � �r 47-.�IfdAL STRUCTURE & BUtLDING ` - � I � �� +� � i'•i .- • .t � cv � f : .. -r i i . .�'48.�fIN'ALPLANNING`. . �� C,; I .�' �j , :, �q �' . y �A9 cEleciric Release to Edison = I � :�i =, '�: - � - v � � �. r d .i� . `� 50.�Gas.Re�ease to Sou(hem Califor ia Gas Co : •" S` �" . �; •�- r' I i�i�• , � ;51. CERSIFICATEOFOCCUPANCY _. _ - ,;, �� :� � No. Date ,. Applicant to fill in all ipaces excepl thoSe within �eavy EorOer oF COST,4 MES,4Q[�CONSTRU,�CT�/IO�N GP,,E�RMIT : ' Project Address 4` t^ �• � 7'JT� � J i • ,. w �Applicant's Mailin ddr ss /� ' � Owner'rName �� l��ioneG�-f. Addreds. ��_�.. "— � L _ ��"� ArcMIEng. License No. Address � Contrector's Name '� �('7c�Phone Address (mailingl � City License Na - LICENSED CONTFACTOft D�CLARATION I hereby atti�m that I am licensetl untltr p�ovislons of ChartCr•9 (commencin9 wi[h sectidn 7000) of DlviSioq 3 ot the Busin�ntl(�Prote55iOn5 Cotle, and my license is in full force antl et(ect. � License Class ce se o� - �ate � - � Signature ORKERS' COMPENSATION DECLARATION ' . hereby affirm that 1 have a certiticate of consent to self-Insure or a terUfiCate of Workers' Compensation Insurance„ or a certitietl copY thereo( (Soctlon_ 3800, Lab. CJ �/ � Policy No. Company BCertifietl copy is hereby turq�shetl. Certifietl mpy Is filetl with the dry Builtling Dlvision. , Date /,PPlicant � EXEMPTION.FROM WORKERS' GOMPENSATION DECLARATION (Thisseclion neetl not be compllt<tl if the permit i5 fot one huntlretl (E300) or less). • I certify that In the perto�mante Of the wo�k tor which this pe�m�l i5IS5uetl, I shall not employ any p¢r5on in any mdnn¢r 50 as [o bec� Subject to Ihe Worker}' Co�yen�liory _�w5 Of Calit r ia�/�J •� . Oate �? G �' Signature �l�' �� 'NOTI[E: I(, aiter makin9 this tleclaration, you shoultl become ' bject to the -Workerz' Comoensation provisions of the Labor Cotle, you must torthwlth comply witn sucn provisions or this.permlt shall be'tleemetl revoketl. CONSTRVCTION LENDING AGENCV '� ' I nereby attirm that tnere is a cOnstruction lentling agency for the performance of the .work for which- tbis permit is issuetl (Section 309� Civ. C.) LenUer's Name ' , Lentle�'s AAE/ess � - OWNER BUILDER DECLARqTIOfJ I hereby affi�m that 1 am ezeTpt trom the Cont�actor'S Lic¢nse Law fo� lh¢ following reason (Section 7031.5 Busine55 antl Prote55ional Cotle: AnY tity or county which requires a oermit to construct, alter, imDrova, aemolish or reoalr any structure, pNor to �ils issuance, also requires the applicant for suclt permit � file a signetl statement thal he/she is IlcCnsetl pursuant �o the p�ovisions o! ie ConVactor's License Law (Chapter 9(commencing wi[h SecUon 7000)-of .ivision 3 of [ne Bu5ine55 a�d ProfeSslons Cotle) o� that he/she is exempt the�efrom antl the basi5 to� the all¢9etl exlmption. Any vlolatiOn o( 5¢CtiOn 7031.5 �by any aOG��ant tor a permit subje<ts the -applicant lo a civll �enalty o( not more [han (ive huntlretl tlollars (E500). � I, as owner of tne property or �ny employees with wages as thelr sole campensation, will ao the work, antl the sbucture is not intentletl or otterea for sale (Section ]044, Busin¢ss an0 Professional Cotle: The Contractor'S License Law tloes not apply to an owner of a properfy who builtls or Improves thereon, anC who tloes sucn work nimself/herselt or lhrough his or her own employees, provitletl that such ImOrovements are not intentletl or offeretl for sale. It, howev¢r, the builtling or improvement is Soltl wlthin On¢ year of com- pletion, the owner will' nave the bu�tlen Oi Provin9 ne/She tlIC not bulltl Or Im- �rove fo� the Purpose of sale). I, as,own¢� of the property, am exclusiv<ly cont�actlng with Ilcensetl Con- Vactors to construct the prajeht (Section ]044, BuSiness antl Pro(esslons Cotla: The Contractor's License LaW tloes not apply to an owner of property who � builtls or imvroves Ihereon, antl who contracts Por such projects with a con- tractor(51 Ilcense punu5nt to the,Gon[ractor's License Law). I am aware that proot o� lhel� Wo�ker'S Comp¢n5ation insurance shOultl be proviDetl to me. \ ' ❑ I am exempt under Section B. & P. C. tor this reason /� Date �� I'h¢r¢by informati antl state 520IdI1VE5 inspection X Signature Drivers' L =3 ` x � Owner : certiy that I have reatl on is cortecL I a9ree to c laws relatin9 �o builtling o/ this' c�ty to enter � a antl sign all appropriale Oeclara[ions. — 5�96 6/25/85 �4,03 TL ��. UNIT NO. � - . . � . - . - . � . . TVPE OFCONSTRUCTION LJ NEW U ADD �J ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � DESCRIPTION OF WORK/USE OF BLDG. �QJL�i — . . TVPE OF PERMI7 GRADING � FL1 ourvon7ioN � s7RUCTURA� .' - ❑ TENANT ❑ EIECTRICAL ❑ PLVMBING ❑ MECHANICAL - ❑ �OTHER � - ' PROJECT DESCRIPTION Sq. F7. occuPANCv' ' CONSTRUCTION TVPE VALVATION $ �� ZONE GRADINGCU.VDS: � ,ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers ' Dishwasher ' ' Drinking Fountains � Floar Dreins FloorSinks �� Gas Service Outlets Interceprors - Kitchen Sink Lavatories - � P—Trap Roof Drains Reinspaction Fee � $15 ea�ie� Duct - Under Ground Duct - Strucmrel Duct - Ventilating Exhaust SyStem ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ductin9 � ❑ ai ao,000 aTu O i oo,000 0 Reinspaction Fee _ � $15 CMF 0865-46, rev. ]0/84 White - guiltling; Canary - Applltan[: Pink - ACcountln9: Goltlenrotl - Assessor � Showers Servite Sink " ' Sewer Cap . Sewer Connection � Solar CDllectors Solar Piping Solar Tank � Swimmrng Pool wlSpa Urinal Water Closei ' Water Heater ' -Water Service Auto-Wash Isue Fee Hoodor Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,0006TU ❑100,000 System Repair/Alteration Pire Dampers � Registers � luue Fee FEES A.P. �i`- ( S Main Building', E T Front "� � B Rear - A C Figtit gleft � Ping. Ref. #� � Planning Notes: ' Automatic Washer � Construction Pole Sub. Cooking Unit � Dishwasher Drye:s ❑Gas ❑Electric Zone Parking Req./Provided ELECTRICAL � ' � Transformer-� 75-50�KW ❑ 50+KW� Fan' F.A:U. Fixtures Device Boxes � Outlets SWilches Garbage Dispoul Generator �0.5 KW 05-15 KW Merer ❑up Lo 100 amp5 Meter ❑over100amps Sub Panel Motors OO-1 HP O1,%j- 8 Inc.Solar �9-75 HP �16� Microwave ' Pole Light Sign ; $tanding Sections Trash Compactor $ 3 Reinspection Fee $15 Issue Fee FEES DEVELOPMENTSERVI�KGPUIRE NTS: 2oning Approved By Building Approved By —� ApplicatiOn laUed By $ 3 Z O N I N G R E Q M T S $ 3 �./yl�y�rt.L SUMMARV�F FEES S� BUILDING PERMIT $ 38 • S SMIP g PLAN CHECK - ' $ � S •(� � pERM1T �. , PLUMBING $ ISSUANCE $ PLAN CHECK 25% $� ENERGV P.C. $ ELECTRICAL g GRADING ' $ ' PLAN CHECK 50°6 $ MICROFILM $ � MECHANICAL $ TOTALFEE $ '� � PLAN CHECK 25%, $ r � �CONSTRUCTION AND PLANNING AP,PROVlLL$ Permit # 1. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrnd. � . 3. Electrical Conduit Uti(ity-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. S[eel Reinfarcement � � 6. Electncal'UFER Grnd. � 7. Footings � . 8. Foundation • i 9. Water Pipe-Undrgrnd. _ 10. Structural Floor System - � 11. Property Sewer Line & House�Connection 12. Sewer Cap 13. Roof qrains 14. Rough Plumbing 15. Rough Electrical-Conduit 76. Rough ElectricWiring 17. Rough Wiring Sign 18. .Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 2i. Dacts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. iioof Framing � . 25. Roof Sheatliing � : , 26. T-Bar Ceiling (Structural) & Monocoat 27. �Frame and Flashing 28. Lathing & Sidinq 29. Insulation 30. Drywall Nailing . 31. Plaster Brown Cpat i 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fiieplace 38. Final Plumbing . ' 39. Water Servioe-Finat � 40. Gas Service-Final ' • 41. Solar pomestic-Final 42. Backflow Preventer ' 43. Backflow Irrigation � 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUC7URE & BUILDfNG 48. Special Requirernents Completed 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co � 5l. CERTIFICATE OF OCCUPANCY Date Date P. _ & SPA Inspector qppROVALS Vermit # 52. Pool & Equipment Location � � 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test �� 57. APPROVALTOCOVER•GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, � Undrgrnd. 61. APPROVAL TO DECK � 62. Backwash & Receptor-Final � 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING ' 69. POOL/SPA SYSTEMS FINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil i � - 74.� Overtiead Hydro ' 75. Dry Chemical 76. Ory Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: �iiA �`i'� ,:�' rT,. /� .�.i�l " i I t Date Inspector i � I �� .i i , i' i '` . aecr aooeess: .:.,,^ � E 1 i3 TH S T OWNEH'SN►ME: LANCE ENGLISH RODNE53: S�yj.�E 642-6158 AflLN/ENGINEEN: AODflE3&: uxrt: CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 04II206 PLAN CHECK NO; 04921-90 S CONSTRUCTION TYPE: V-N PERMIT TYPE: STR nea.xo.: I JOb DESCRIPTION : STD bLOCFC WALL UXR: VEHMITiEF: CLAIM VALUE: 900.00 CALC—��ALUE: Q2420T15THNSTETE GMASONRY (714)548—")593 �ooxess: N.B. CA 92660 110ENSED CONTMCfOH DECUM7ION: I here�y allirm ttut I am IiceinW uMer provlsiona ol Guptu 9(commeirclnp w�t� Sec�bn 7000) of D'MSion 3 0l IIR Bu5ine55 2nE Pfofo55ipn5 COEe. anU rtry IicenSB a In lull iwco eM aflecl. ssi ciTr uc.: 016 6 9 9 sr�re uc.: p �uss: C— 8 Da[e: �' � �'� V SlOnatum: - - WOqKER3' COMPENSATION OEIXAMTION: I �ereW aifirm Ihat I have a ceniikata o1 cansem to utldnsurt or a ceNliwte oi Wohers' Compensatlon Insurance, or a cenilleE mpy tlmaot (Seclion 3800. LaU. G�. roucv xo.: exr. o�Te: COMP�NY: ❑ Cenilie0 copy B lure�y IumisAeE. ❑ �9rtHietl wDY �S tileE wii� IM dry Bu1lElrp Divisbn. F � , ��ADPlicant:�l IXEM7f10N FlIOM V10NKEN8' COMPENSIlION qEGAMTION: (iTis ucUon need mt be ampeted'A the pertnt ¢ ta oiro AUMred (5100) a less�. I certity that in t�e Dedarmance al I�e vroB lor w�ic� t�is De�mit is issued, I sAall not employ any person in airy manner so as ro hecome sublect ta the Warkers' Compensation Laws!at Caltlomia. _ Daie: � ' � Y " � u ��s�onature: �- NOTICE: II, atter makin0 � de��on, you shoulU 6acome suElett �a �� Workeri Compensation D�srons ol tlre Lahor Coae, you must tonliwlN compy w�tn s��h OroWslans ar Ilus permit s�all Ee AeertceU rewkeE, CONSTIIUCTION LENDIXO �GENCY: I �emyy amrm thaLt�era is a camYnrctbn ImEinp apmcy tar tM peAormance ol Ihe xrork lor wNCh 17�is permit u isued I�CGon 3(b7. CIV. �. IFNDEfl: eoouss: OWNER BUILOEH OECIAFWTION: 1 �ere0y aifirm Ihat I am examD� ��m Na Coniactori State License Law lor IM lollowinp reazon ($ection 7031.5 Businw aM Professbnal CaOe: My Ury oI counry wNc� reQuirez a permit lo conSVuct, alier, improve. OemolisR Or revair arry structure. prior �o ns fsswxe. xbo repuira tlu applkant tar wN cemm ro file a sipne0 statement tlut nNSLe L5 Ikensatl pursuant �o tlre provrs�mn of tt�e Coninctors' State liunse Law (CluDjer 9(commendn0 wl�� Secibn 7000) ol Divlsion 3 al Iha Businass an0 Profesvons CaGe) or W� he/sM rs exemOt t�erelrom an0 Ihe Easis lor Ne alle0� exemD��. �Y NOWIion ol Section 7031.5 Ey zny ap06tani Iw a permit LAject3 tM aVC�2flt to a avil pEnally of not rtqre tlWl frve hunErtM a011dt5 ($500�. � i, u owner o� tlro propeM w my em �qrees witn xapes as meu sde conwe�5auon, Miu ao me wonc, ana ene ❑ structure is frot inte�MN or onereA lor sale 1�lon 7041. Buzness aM Pmfessional Coda: TM Coniractors' State Lkense Law . �ces nat appy to an mmer al a propeM � DuilEs or improves IAereon, and wM Ooa suc� work himselt/liersali or thmuph �is ar her own emDloyea, D��4eE ttat suc� imDmvemen6 am not imen�etl or oflere0 tor 5ale. II, Imwever I�e Wiltlinp ar imD�ovement rs solE wiWn we year ol wmD�etion, Ue owner vnll have Ne Eurden al provinp �yshe OiU not OUJO or Improve for ttre Purpose ol salel. I, az owner oi tM Droperty, am axdu=rveN crontacting wii� licensed contaclors ro con5vuc11M Droject (Sectbn 70/4. Business LJ arM Protessions Cotle: The Contaclors' State Lkense Law Oces not appy ta an mvner oi properrywho bu4Es a ImD�%% ��reon antl wM cantracts tor such pmlecis ryt� a contrecmr�s�license pursuant m[Ae Contacrors' State Licensa Law),I am aware Wt praof al Neir Warker's Compens:lion insurance 5houlU 6e D��ded ro me. � I am exempl unOer Section: 6. 8 P. C. 1or iNs 2asan: Date: Owner: I do trcreby certiy Wt I am awue ol and umurslanE the requirertrents ol CaliforNa HeaIN an0 Safery CoGe Sectlore 25505, 25533, and 2553/ an0 tlut I w airy fumm Ou401n0 �upanl wllVwlll not (tlrde one) nee0la comply wlt� said sute coEa and Ne repulrements lor a permit lor construcGon ar rtqElircation Irom ��e r ualiry ManaO�ment Oisirkt. RavOenlWl contirunion apD��s are exampt Iram Inese Dravisi0n5. Date: MD��: I �erzby certiy Wt I tuve reaE IAts applirati7n anE state tlwt IM a0ova intomuuon B cortect. I apree ro comDN �� all cily a�M counry orEuw¢es artl state laws rWUnp W EWOinp consinwtlon anE �ereby autlwr� reD�e��uims oi tlds alY �o emar upm Ure aGove�mentionaG property tor inspectlon Durpous. ,�f�� I � oate: � ` � � �q � 9amwre:�/� ./1 o�iver•s u«ms m saaai securitr �: White—Buitlin9: Graon—Cotlo Enlorcamant: Cennry—Npplican4 Pink—Pevenue: PERM NO:.=H 098206 GOVT; N SUPP: N PURPOSE: OTH. SQ FT: 29 580.00 GROUP OCC: R-3 _ / COMMENTS: 29 LF CITY STD BLOCK WALL *��#**�*��t-�x-*�*�c*+e#nx �c�c#�i�ar*�*x��i�-****+t*�t*-x�**x�**�t��**�t�trt*x��**��n�t*�u�+�*it*+t��r�*��t*�t*� Z 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 BUILDZNG ---------- --------- ACCESSORY BUILDING --------- FRNT: 36 FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN LEFT: FT 2 IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PAOV: PARCEL; 11737213 ZNE: A1 REF NO: PLANNING NCSTES> 29 LF 6 FT. HZGH BLOCK WALL BUILT JUST OFF THE LEFT > PAOPERTY LINE. if )E!f �7F'N� if if 1f if i' 1E if iE?F ii' if �E N' iE i%14-0f ik ik if if if?(�'%�F'lE �E'lf 1f ±E �E'� jf �E if if if if i! il' if'X� 3h if if if it'7F i(' if if iE if fF')f i4lf 1i if it if �f if iF 1('i{ {f ih'1E if if if if �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 20NING APPROVED BY • �GC� �j � DATE: ��' �'� '�(� bUILDING APPROVED HY ; DATE: APPLICATION ISSUED BY: DATE: C%%•��n ififiEifif3fi4i£3EifjE34�EjF#i4i43fifitikif : . 1fN�iFiEi(�ififiFifiF ��f# f� i s iEiEiEiFiEiF?EiFiEfE%iFikitik?EiEiflE##ifiEiEiFif3EiEikifiEiEi�i'iFiEitiErtif ;ikifi(-iliEiFitiEil-jFiEaEiEjFiEiEiEiFiEiEiEifiEiEiFaEi(�iEiEiFihi`ikiFiFifiFiF LEGALIZATZON:N F E E 5.,, M M A R Y STRUCTURAL SEGMENT:Y y . bLDG PMT. PLUMBING ELECTR.,C�?,MECHANIC FZRE SMIP/AES GRADZNG PERMIT 17.00 ' t',� .50 y�" ; ' 't SMIP/NON—RES PLAN 11.05 •f'! •,T. R;. � ISSUE FEE • BUILDING—DIV—> PERMIT ISSUE P��.N�CF�ECK ;., TOTAL PAZD DUE TOTALS----> 17.50 0.00 �.^11�:05 � 28.55 28.55 .00 REVENUE DIVISION TOTALS--> COLYECFEp,�, I 28.55 OVERJSHORT: 00 BLDG PMT PLUtABING EiECTRZC MEC�AIX_Cr' PIRE SMZP/TOT GRADING PLAN—CHECK 17 , 0 0 '�`+. • r"' . 5 0 1 1. 0 5 '+� i� �*�r�*�**�**�r�r***�**��*��r+��****�**��'�*ie�f��,��x*+t�t***�e�r�e�r�r****��+t�rx��r�r�tx�*�***�t�t+r* I N D I V I D U A L' i? ' F'i y, E B R E A K D O W N TYPE �TY D E S C R I P T I O;!'N �i �� UNIT COST TOTAL COST SFR 29 , RES—CONCRETE BLOCK��WAL2,'� -/ FT. 20.00 580.00 EN,1� OF�; FEES' ` - 1 � � � ` •(' . . .t�l� ,�, f � , . �t. ( r 01 06Db5592�-G6Q65694 T�3 T 28.55 �RTE: D7J19/90 TIflE: 12:36 ! , CONSTRUCTION AND PLANNING POOL £ 4 APPROVALS Permit # Oate Inspector AppROVALS Permit # Date Inspector 1. TemporarY Electrical Service o� Pole 52. Pool & Equipment Location -- 2. Soil Pipe•Undrgrnd. � 53. Steel Reinforcement . 3. Electrical Conduit Utitity-Undrgrnd. 54. Forms , � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings � ' Zo-[tp e,t✓ 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Svuctural Floor SYstem . 61. APPROVAL TO DECK 71. Property 5ewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent�Final 13. Roof Drains 64. Plumbing SYstem - Final _. 14. Rough Plumbing 65. Electrical-Final 75. Rough Electrical�Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access ApProval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrital�T Bar Ceiling 69. POOL/SPA SYSTEMS FiNAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Fough Factory Fireplace APPROVALS Permit # 21. Ducts, in 5tructure 70. Underground Hydro 22. Oucts, Ve�tilating 77. Product Piping OGas ❑Oil 23. Gas Pipe�Fough & Test 72. Underqround Flush 24. Roof Freming 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. F�NAL 30. Drywall Nailing HEALTH DEPT. RE�UIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION ' 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Eleccric Notes� � 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test 36. Hood or Canopy 37. Final Factory Fireplace 7 2�',� e� � 38. Final Plumbing fi--- 39. Water Service-Final 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape IrriGation System 45. Sound Attenuation 46. Handicap Regulations 47 FINAL STRUCTURE & BUILDING �.1_t�Q W 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date l. :. � . i2� �0 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 817 COSTA M88A. CALIRORNIA For Applieani fo Fill In Complefely TYPE OR PRINT ADD EI6S • P �� O �r � �C•la%/' COSTA MESA CALIFORNIA ARCHITEGT TEL. �^ OR F' -��NEER .�� NO. � �� qDDRF66 ' CONTRAGTOR �/ AODRHSS E' lO '^ • cin A � 8TA76 TEL. , C=�O�� LIC. NO. NO. O SIZE o � I NO. OF BLD09. OF LOT /JDr /QO - I xow pN Lar / USE OF EXI87' NG BLD BETBAGK LIN6 ppOM CENT6k OF BTit¢8T RHAR YARD SIDE YARD I LBFT I RIGHT DESCRIPTION OF WORK NEW II ALTERATION Iv II ADDITION I REPA�n � tlMOViNG I IIDEMOLISH I BUILDING NO. OF SIZE ROOMS � STORIES EXTER�OR WAL ROOF Q COVER�NG COVERIN r 115 F BUILDI G AND WORK TO BE PERFORMED D � � �_. e � �„ �., � , a �$� s�'y 0 1 HBRBBY ACKNOWLHOOB THAT � HAVH ReJ1D TXIB APiLIWT10N AND OTAT6 TXAT TX6 ABOVE 19 CORR6CT AND AGR E TO CAM� PLY WITN ALL GITY OfiDi C68 AND BTATE LAW R8 L�TIN6 6UILDINO CONBTRULT . BIGNA�RE ,,Q PERMI AUTHORIZED AGENT � EE ��c��v�.�, ,y�.� �-��. ��, FINANCE DEPi. elTy (1F !'OSTA MES 1 APPLICATION FOR PERMIT BUILDING For Ofiiice Use Only HECEIPT NO. PlP. COSTA MESA. CALIFORNIA APPROVED/� �u �/J.G N BY [.�. � DATE J ^ZONING � Z ' INO. OF I O8E OP NEW i PLANB � OUILOINO ` "` �G �' /d 1 y-Gt' l / DEBCRIPTION A.P.NO. /�� J� _ � I YARDS EVES APPROVE� ALLOWED ICENTHR IJNE 6TJ % � TH! AMOUM BXOWN UND¢R VALUATION 19 FOR TNH PUttP088 OP EBTABLI9HING A P¢RM�T P68 ONLY. VALUATION ��{/// / � / j` PERMIT FEE $ � � / i� a 0 S PLAN CHECK $ �_ a_ z ¢ TOTAL FEE LL �. _ ` � .� �3'75� COST� MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA MEBA. CALIPORNIA For Applieani fo Fill In Complefely TYPE OR PRINT BUILDING O � � !� ADDRHSS O J CASTA MESA CALIFORNIA OWNER + I `, � MALL^^^ /tnS7 t lO/Ti�' . �._. a r� I NO. OP tLD68. USE OP l �� / �� . EXIBTING BLDG. J/ i�� SBiO�CK LINe Rrtom /�� ^ REAR YARD � C6MER OP 9TtCET (O BIDEYARDI�EPT ��/ B� IRIGH7 ,�" DESCRIPTION OF WORK NG // / :RIOR WALLC,�uLGO I COVE :RING W OF BUILDING AND WORK TO .... ,,.i �,)'_ " _ FE,F�RECEIVED JAN 27 1961 �FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Offiee Use Only M8C81VT NO. /P M�T NC GY I OATH X¢ClIV¢D I OA�7 �! COSTA MESA. CALIFORNIA PIRE ZONE TVPE / GROUP. APPROVED �/�.f „ _ _ J � ZON[R�/ I�u BP /� I BUIIDINO �a.,� rt� %�S �� DHBGNI�TION A.P.NO. II /— JJ\1�.�� YARD6 EVES APPROVED ALLOWEC IC6NT[p lJN[ BT4 � � FFONT ,�-� FT. R. BIOP I v FT APPROVED � I H¢R80Y AGNNOWlPD08 TXAT I HAVE HCAO TXi9 ATYGTION � TH6 AMOUM BHOWN UNDlR VALUATION 16 IOR TNH AND BTATB TNAT TH8 ABOVB �B GORRER AND OR88 TO CON- pYNP08E OP, EBTABLIBMIN6 • PERMIT F66 ONLY. PLY WITH ALL CIiY OPOINA ANO 8TA ' W8 � ULATHO Bu1tLiNa CONernucnoN „ VALUATION � � BIGNATURE OR � PHRMIT FEE S PERMITTE n � D�Q � S�y' // JI � PLAN CHECK $ �� Y �/ AUTHORIZHD A6ENT � � TOTAL REE � .. . � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to FHI in Completely — Use Ink Only BUILDING �`,�u CT ADDRESS � /7 � TENANT�R 7 /C l'yR�O C�Ct�is MAILING / }.. `. ^� ADDRE55 / /r> �• /� �� TEL. CITV (�/� � NO. .`�Q CpNS�RUClION LENDER BRANCH ADDRESS � ARCHITECT TEL. CONTRACTOR ADDRESS j CITV _ i � STATE i LIC. NO. ' {ay S12E 6. OF LOT a USE OF � EXISf1NG BLDG. y 7 � CITV � LIC. NO. / NO. OF BIDGS. NOW ON LOT FSeparate perrttits are requued for � electric, plumbing and heating work: �.W., USE OF BUILDING AND WORK TO BE PEFFORMED Q 0 �. � ` J C W �.. / "ii rr / 8�.`��2 �.2��/�9 30,50 TL APPLICATION FOR STRUCTURAL PERMIT RECEIVEDB� PERMi7 /, nn n _ A.P. N(I'.� �� .:/ W' a�,��/9�8- ,� ADDRE55 UNIT OR 57ACE NO. TR.N LOT N A LT REPAI OwNER d F� USE ,�f.v(� L J^pp/yY-- �j�d APPROVEDSETBACKS -O� i� REAR YIFT. PLANNING ACTION Y— MO V I NGI DEMOLISH DATE DATE E E � I hereby acknowlatlpo thet I have reatl this applieotion and stete � q� Met the ebova In/ormetion is correct antl aprea co comply wIM � � ail lewa re9��atinp builtlinB construction, antl 1 shall not employ � any parwn In violation of tfia workman's compensation laws of ? � Mo Stam of Celifornie. /' ' _ �� 3 I haraby canlfy thet I em proDarly licansetl as e eontractor untler SQ. FT. �m`+ the Suro ot CalHornie Business end Profezsions Cotle, Division 3, TME AMOUNT SHOWN UNDER VALVATION IS FOR m Chapnr 9, antl t�at such Iicanaes ere in I torce entl affect, or I iHE PURPO6E OF ESTABLISMING A PERMIT FEE ONLV: � am exompt from tha provisions of th ta � o( CelHornia Businass VALUATION O. o PERMIT FEE E 7- L7 anA ProfassionaCatle, Dlvlsion 3, Chapmr . � Sipnetura of /� PLAN CHECK E � D� oc� "�p " Parmittaa $ /7'/O �OO 7qX E �f or /� I Authori tl ABant Date TOTAL PAI D E O . S'd I