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Home My WebLink About710 18TH ST - Building Permits.. ;; (774) 754-5273 • Fax (714) 754-4856 ' ' CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 710 W 18TH ST Suite: A Vicinity: BUILDING A Parcel Number: 42417410 Appliwnt: NORIEGA, BEN Address: 24000 ALICIA PKVJY #17 Owner: Address Contradoc Address: Arch : Address: MISSION VIEJO, CA THOMPSON, ROBERT B TR °hMPMS INC�. � � ' . ,' CYPRESS, CA . . P O BOX 568 � " W T R ROOFING INC 24000 ALICIA PKWY #17 MISSION VIEJO, CA Zip: 92691 Phone: BUILDING PERMIT Zoning: �Phone: (949) 768-4992 Zip: 92691 Phone: Zip: 90630 Phone: (949) 768�992 License: 764350 Eng: Address:- �. . � �-- PERMIT NUMBER B00-00138 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: Ot131/2000 Issued: 01I31I2000 Phone: �� Zip: � , � � - License: License: , SCOPE OF PERMIT .' REROOF EXISTING 12-UNIT APARTMENT BUILDING -BUILDING A- (72 S�). TEAR OFF EXISTING LAYER OF ROCK ROOFING 8 REPLACE SHEATHING AS NEEDED. INSTALL 1-LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH -TIMBERLINE- 25 YEAR COMPOSITION SHINGLES. BUILDING A INCLUDES UNITS: 1,2,15,16,17,18,21,22,47,48,49,�&�50. � � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $153.25 $0.79 $0.00 $0.00 $0.00 $154.04 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORX Front 0-0 Rear 0- 0 Rear 0-0 FEE SUMMARY,' Calc Valuation: s�,e�s.00 - Claim Valuation: s�,e�s.00 PLANNING & ZONING Left 0- 0 Right Left 0- 0 Right 0- 0 0- 0 NOTICE: The work authorized by this permit shall comply with ell applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlone end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirtn untler penalry ot perjury one ol the tollowing declarations: ❑ I have end will mainiain a cenificate of consent to self-Insure for workers' compensation, es provided for by section 3700 0l the Lebor Cotle, for Ihe peAortnance of tha work for which this permit is issued. ' ��ve and will maintain workers' compensation insurence, as requiretl by section 3700 of t�e Lebor Code, for the parfortnance of ihe work for which this permit is issuetl. —My workers' compensation Insurance carrier antl policy number ere: carrler: �- S'rAT� F J N11 . o��cy N� er: cii�S=/Yi �)uH GYYJO �f 5 7. .(This�sectlon�neetl not Oe oompleted i/ the peimif is veluetl ef ine hundred dollers ($ f00) or less.) ❑ I cenify that in the pertortnance oi t�e work lor which Ihis pertnit is luued, I shell not employ eny person in eny menner so es to become subject to Na workers' compensetian laws ol Calilamia, and egree Ihat II I should become sub�ect to the workers' campensetlon provisions ol Section 3700 ot t�e Lebor Cotle, I shall lanhwith comply with ihese provis' ns. Applicent Signeture: � ��iJ� � „a. Dete: �7/� //� v ARNINQ?FAILURETOSECUREWORKE0.5'COMPENSf� NdJVEPAGEISUNUWFULM'DSMALLSU&IECTANEMPLOVERTO'CRI IMTNALPENALTI ANDGVILFlNESUPTOIXJEHUNDRED TMOUSAND DOLLARE (5100.000�, IN AODITION TO THE QlST OF OOMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31060F THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby aNirm t�41.am�liceCsed under provisions ol Chepier 9(commanGng with Section 7000) of DlNslon lorce end eHect ILic,_q.. J 7 6 Y 3 S� Date: Code, antl my Iicense is In full CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn Ihet there is e wnsWction lentling agency lor the peAortnenca ol ihe work lor which t�is permit is Issued. (Soc. 3097, CiWI Code). Lentler's Name: LandeYs Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Da�e: I here6y aHirm that untler penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu antl Professions CoCa: Any ciry or counry which requires a permit to wnstruct, alter, improve, Oemolish, or repair any strucNre, pnor to its issuance, elso requires tha applicent tor such permit to file e signetl statement �het he or she is licensed pursuani to the provisions of ihe Coniractore License Lew (Chapter 9(commencing with Section 7000) ot DlWsion 3 ot the Business entl Professions Cotle) or Nat he or she is exempt therefrom and tha basis for Ihe alleged exemptian. Any violation ol Section 7031.5 by any appllcent (or e pertnii subJects the applicant to a Uvil penalry of not mare than live huntlred tlollars ($500).�: ❑ I, es owner of the proDerty, or my employees with wages as their sole compensetion, WILL DO TME WORK, antl the structure is not intentletl or ottered lor sale (Sec. 704a, Business antl Professions Code: 7Te Coniractors License Lew tloes not appty to an owner of property who builds or imprwes Ihereon, and who Coes such work himself or herselt or Ihrough his or har own employees. pmvided that such improvements ere not intendetl or oNeretl for sale. If, however, ihe buil0ing or improvement is sold within one yeer of completion, Ihe ownerbuilder will have the burtlen of proving that he or she did not build or improve for puryose ot sale.). ❑ I, as owner ol lhe property, am EXCLUSNELY CONTRACTING WITH UCENSED CONTRACTORS to constmct the prqect (Sac. 7044, Business antl Professions Cotle: The contrectors License Law does noi apP�Y �a an owner of property who huilds or impmves thereon, antl who contracts for such project with a coniraaor(s) license pursuant to the Contrectore License Lews.). ❑ I am exempt unOer sec. Business en0 Professions Code tor this reason: Siqneture: Dete: OwnBr ID verilied by driver'Slicense. ❑ Ves ❑ No Drivefs Ucen58 No. Venlication of Ownership by (rype ol document, i.e. - property tau bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cenity that no excavetion tive (5) ar mare feet in tlepth into which a person is reQuired to descend will be metle in connection wit� work autharizetl by this pertnit, antl Ihat no builtling structure, scaNdtling, tfllsework, or Gemolitlon or dismaniling t�ereol, wlll be more Ihan thirty-siz (3fi) leet high. (Chap. 32, Grp 2, Art 2. Sec. 341, Tltle 8, Celifomie Administrative Code). ❑ As owner-builder, I will not employ anyone to tlo work which woulC reQuire e Dertnit from the Division of Intlusirial Safety, as noied above, unless such person has a permit to do such work frOm tha division. Slgnature: Date: Divislon of Industnel Safety Permit Numher: CERTIFlCATE OF COMPLIANCE AND AUTXORRA710N OF ENTAY: I certity under penalty of perjury that I heva read this epplication and sWte that Ihe intortnation given is correct. I agree to compty with all state laws end dry ordinances relating to builtling construction, and euthorize representetives of ihe Ciry of Casta Mesa to enter upon tha above-descnbed D�aGeny tor inspection purposes. I egree not to occupy or ellow occupancy of any Dullding eut�onzea by this pertnit until final inspection. GODE 1. INSPECPONTYiE 1618 Flxetl System Final Fire Preven�ion 1266 200 201 202 203 Pool Spe Finel Final Re�Rool Final BIocWRoieining Well Finel Factory Fire Plece Final Sign 204 Final Demolition 241&<6 � 1 .1111. . I / iI /�rr � , LOpE� INSPECTIONTYPE 206 Final Mechanical 20B Finel Plumbing 210 Finel Eleciricel 212 Finel Fire Preven�lon 220 Finel Planning Approvel 222 Final Site 250 Finel Builtling/Occupanry . Data . AL � . 1 4�• M� 9 o. � ' -- h J - •��Q � (714) 754-5273 • Fa�c (714) 754-4856 Job Address: 710 W 18TH ST Suite: G Vicinity: BUILDING -G- Parcel Number: 42417410 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Applicant: NORIEGA, BEN Address: 24000 ALICIA PKWY #77 Owner. Address Contrador Address: Arch : Address: C MISSION VIEJO, CA . THOMPSON, ROBERT B TR °/aMPMS INC CYPRESS,CA � . _ P O BOX�568 - . W T R ROOFING INC 24000 ALICIA PKWY #17 BUILDING PERMIT Zoning: Phone: (949) 768-4992 Zip: 92691 Phone: 2ip: 90630 Phone; (949) 768-4992 MISSION VIEJO, CA Zip:, 92691 � License: 764350 . . Phone: Eng: Address: . _ . \ PERMIT NUMBER B00-00139 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 01/31/2000 Issued: 01/37/2000 Phone: " �, Zip: � � � License: License: . SCOPE OF PERMIT � REROOE EXISTING 4-UNIT APARTMENT BUILDING -BUILDING G(50 SQ). TEAR OFF EXISTING LAYER OF ROCK � ROOFING & REPLACE SHEATHING AS NEEDED. INSTALL 1-LAYER OF 30# FELT UNDERLAYMENT & REROOF WITH � -TIMBERLINE- 25 YEAR COMPOSITION SHINGLES. . � BUILDING -G- INCLUDES UNITS: 41,42,42, & 44. _' � � ,! � . � � ` ' � � � FEE SUMMARY ' Plan Check: Permit:, SMIP Res: SMIP Com: Other: . Inspection: • $0.00 $125.25 $0.53 $0.00 $0.00 $0.00 ' . Total: $125.78 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 Rear 0• 0 Rear 0-0 Calc Valuation: S5,zso.00 - Claim Valuation: gs,2so.00 PLANNING 8 ZONING LeR 0- 0 Left 0- 0 Right 0- 0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order tor �he work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectione end 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 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirtn under penelty of perjury one ot the following tleclarations: ❑ 1 have antl will maintein e certificate oi consent to self-Insure for workers' compensation, as providatl far by section 3700 of the Labor Code, br Iha pertormance of tha work for which this permit is issued. 1ve and will maintein workers' compensatlon insurance, as requlred by section 3700 of the Lebor Catle, tor Ne peAormanca of the work for which this permit is issuetl. �My workers' comoenselion Insurance carrier end oolicv num6er are: erone o�icyNumbe��s0� uNITQ'��%% orless.) ❑ I certiy that in the peAortnance ot the work for which this pertnit is issued, I shall not emplay eny person in eny manner so as to become subject to the workers' compensetion laws of Califomia, and egree Ihat if I should become subject to Ihe workers' compensation provisions of Sectlon 3700 oi the Labor Cotle, I shall forthwith comply with these provisions Ap�(IicyaM�Sgnature: ` ��'pa�g�1 / ��/ /QC7 WARNING�FAItt1RE TO SECURE fU(ERS' CQMPENSATI� EPAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPCO��FAiOCAIMINAL PENALTIE AND CIVIL FlNES UP TOONE HUNDRED THOUSAND OqlARE (5100,000), IN ADDfiION TO iHE C0 OF COMPENSATIIXJ, DAMAGES AS PROVI�ED FO(i IN SECiION 37060F THE LABOR CODE, IMEREST, AND ATTOqNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aNirtn that I am licensed under proNsions of Chapter 9(wmmencing with Section 7000) ot Division 3 oi ihe Business end Professi ns Code, and my license is in full force and eflect. li� i/ �/ � S� Class A� 3 ' Conirec(oYs'STgnamre:. .� o,�/� • y� / is �� /_. � 1 � �` �%— ��,. \ i 6� CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirtn that there is a cons�ruction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lentlers Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby affirm that under penalty of perjury Iha� I am E%EMPT FROM THE CONTRAC70RS LICENSE LAW tor �he following reason (Sec. 7031.5, Businass end Professions Cotle: Any ciry or counry which requires a permit to constmct, alter, improve, demolish, or repair any slmcture, prior to its issuance, elso requires Ihe epplicant for such permit to file a signed statement that he or she is licensed pursuent to the pmvislons ot the Contrecrors License Lew (Chapter 9(commencing wi[h Section 7000) of Division 3 ot the Business antl Professions Code) or Ihat he or she is eaempt Iherefrom entl the Easis tor the alleged exemption. Any violation of Section 7031.5 Dy eny applicem tor a permit subjects the applicant to a civil penalry oi not more than five hundred dollers (5500).): ❑ I, as owner of ihe property, or my employees with wages as thair sole compensetion, WILL DO THE WORK, antl the structure is not iniendetl or otteretl for sale (Sec. 7044, Business and Professions Code: The Conirectors License Law does not apply to an owner of property who builtls or improves thereon, end who does such work himsell or herself or through his or her own employees, providetl that such improvements are not intended or oNered for sale. If, however, the 6uilding or improvement is sold within one year of completion, ihe owner-builder will have the burden ot Oroving ihat he or she ditl not builtl or improve lor purpose of sale.). ❑ I, as owner of the propeny, am EXCLUSIVELV CONTFiACTING WI7H LICENSED CONTRACTORS to construd the pwject (Sec. 7044, Business antl Professions Code: The contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who contracts for such project with e coniractor(s) license pursuam to the Coniractors License Laws.). ❑ I am ezempt untler sec. Business and Protessions Code for this reason: Signature: Date: Owner ID verilied by drivers license. ❑ Ves ❑ No Dnvers license No. Veritication of Ownership by (type of documenL i.e. - property tau bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: Expires: ❑ I hereby cenify that no eacavation five (5) or more leet in depih into which a person is requiretl to descend, will be mede in connection with work authorized by this permit, ana that no builtling structure, scattolaing, falsework. or tlemolition or tlismantling Ihereof, will be more then thirry-six (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Califomie Administrative Code). ❑ As owner-builder, I will no� employ enyone to do work which would require a pertnit trom �he Division oi Indusirial Satety, as noted above, unless such pereon has a permit to do such work tmm the division. Si9nature: Date: Division ot Indusirial Safety Permit Numbar. CER7IFlCATE OF COMPLIANCE AND AUiHORIZATON OF EMRY: I certity under penalry of perjury that I have read this epplication antl state t�at the informa�ion given is correct. I agree to comply with all state laws antl ciry ortlinances relating �o building construction, end emhonze represematives of the Ciry ot Cosla Mesa to enter upon ihe above-descri6etl property lor inspection purposes. I agree not to occupy or allow occupancy oi any buildinq authonzetl by t�is pertnit until tinal inspection. CO�E r, INSPECTIONttiE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 207 Final Blxk/Reteining Wall 202 Final Fectory Fire Plece 203 Final Sign 204 Final Demoliiion 2aa6 d6 Pdg 1�ID�L3 / l,/ �/ .,. / COUE♦ INSGECTIONTYPE 206 Finel MeChaniWl 208 Finel Plumbing 270 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Si�e 250 Final Builtling/Occupancy D�TE INiRIRLS ; (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BI/ILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Job Address: 710 W 18TH ST Suite: H Vicinity: BUILDING-H- Parcel Number: 42417410 npp�icant: NORIEGA, BEN Address: 24000 ALICIA PKWY #17 MISSION VIEJO; CA . � �.- Owner: THOMPSON, ROBEF2T B TR , Address -%MPMS INP, � � � ' � CYPRESS; CA , � � - , � ' . P O BOX 568.�i , . . . %� ;!. Contrador. �,W T R ROOFING INC Address: 24000�ALICIA PKWY #17 Zoning: . . , . . ,Phone: (949) 768-4992 Zip: 92691 - Phone:}. 4 , .. - Zip: 90630 - ,, Phone: � (949) 768-4992 ; - ' MISSION VIEJO, CA ' � Zip:, � 92691- License� 764350 - Arch : � � i- � ,!� - . Eng: Address � �, , � . �;. ."�' Address:- • , . .. ' � Phone: - � � ; � PERMIT NUMBER B00-00140 77 FAIR ORIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 01/31/2000 Issued: 01/31/2000 ISSUED BY: Phone: ' Zip: . - � � . �License: License: , \ � " - , � SCOPE OF PERMIT � . REROOF EXISTING 4-UNIT APARTMENT BUILDING -BUILDING H- (28 SQ). TEAR OFF EXISTING LAYER OF ROCK � ROOFING & REPLACE SHEATHING AS NEEDED. INSTALL 1-LAYER OF 30# FELT UNDERLAYMENT R REROOF WITH . -TIMBERLINE- 25 YEAR COMPOSITION SHINGLES. - BUILDING -H- INCLUDES UNITS: 13,14,45, & 46 � � , - � —� � ' i � �� . � • - , � - _ . . ,. . . Plan Check: .. $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com:- $0.00 Other. , $0:00 Inspection: $0.00 Total:, $83.75� SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 Rear 0- 0 Rear 0-0 FEE SUMMARY' PLANNING & ZONING Left 0- 0 Left 0- 0 Calc Valuation: S2,e2s.00 Claim Valuation: Sz,s25.00 Right Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned fo� a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetlons entl flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 WORKERS'COMPENSAnON DECLARAnON: I hereby aNirm under penalry of perjury one of the tollowing declarations: ❑ I have end will malntain a certificate of consent to setl-Insure for workers' compensatlon. es provided lor by section 3700 oi t�e Labor Code, for the OeAortnence of the �� wodc tor which this pertnit is issuetl. � �I haSe end will meintain workers' compenution insurance, es requlre0 Dy section 3700 of �he Lebor Code, tor ihe pedortnance of Ne woAc for which this pertnit is issued. My' workers' com ensatian Insurance carrier entl palicy number are: ca� e� �TAT � JiV (, , P,olicy Numtier: o� S��O J,�rr D Gi.'2'J �/ S� �(7lrisaection n9ed not be comp el ed i! fhe permit is ve/ued et one hundretl tlollars ($100) or less.) �—�� ❑ I cetlity thet in ihe pertormance of ihe work for which Ihis permit is issued, I shall not employ eny person in any manner so as to become subject to the workers' compensetion laws of Calitornia, and agree ihat if I should become subject to the workers' compensation provisions of Section 3700 ot tha Labor Cotle, I shall fotlhwith wmply with ihese provision ypgican� Signature: � D� '/�7 /�� /�["7Ti YIARNINO'FAINRE TO SECURE WORKERS' COMPENSATI 1 OVERAC+E IS UNLAWFUL AND SHALL SUBJECi AN EMPLOYER TO CRIMINAL PE TMAL IES AND CIVIL FINES UP TOONE HUNDRED THOUSAND OqlARE (5100.OW), IN A�DfiION TO THE C OF COMPENSATION, DM4IGES AS PROVIDED FOR IN SECTIIXJ 31W OF?HE IABOR COOE, INiEFESi. AN� ATTOiiNEV'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby attirm €I.am'ticensed under provision ot Chapter 9(commencing with Section 7000) ot Division 3 mme ana enect„uc.`aJ "% 6�( 3 S� • CONSTRUCTION LENDING AGENCV: �^CoOe, and my license is in full ❑ I hereby aXirm ihat Ihere is a construction lentling agency for the performance oi ihe work lor which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Name: Lendefs Address: Signature: OWNER-BUILDER DECLARATIONS: Date: I hereby affirm that under penalry of perjury that I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which requires a permit to consiruct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the appllcant tor such permit to file a signetl statement that he or s�e is licensetl pursuant to t�e provislons ot the Contractors License Law (C�apter 9(commendng with Section 7000) of DiNsion 3 of the Business and Professions Code) or that he or she is ezempt Iherefrom entl the basis for ihe allegetl exemption. Any violatlon of Section 7031.5 by eny epplicant lor e permit sub�ects tha applicant to a civil penalTy of not more �han five hundred dollars ($500).): ❑ I, as ov+ner oi Ihe property, or my employees with wages es their sole compensation, WILL DO THE WORK, antl Ihe siructure is not inientletl or oflered for sale (Sec. 7044, Business end Professions Code: The Coniractors License Lew does not appty to an owner of properry who builds or improves thereon, antl who tloes such work himself or herself or Ihrough his or her own employees, provitletl ihet such improvements are not intentled or oHered tor sale. It, however, the building or improvement is sold within one year oF completioq the owner-builtler will heve the burtlen oi proving that he or she ditl not build or improve for puryose of sale.). ❑ I, as owner of the property, am E%CLUSIVELY WNTRACTING WITH LICENSED CONTRALTORS to construct the project (Sec. 7044, Business end Professions Code: The conirectors License Law tloes not epply to en owner of property who builds or improves Ihereon, and who contracts tor such project with e conirador(s) license pursuant ro Ihe CONractors License Laws.). ❑ I am ezempt untler sec. Business end Professions Cotle for this raason: SigneNre: Date: Owner ID verified by driver's license. ❑ Ves ❑ No Driver's License No. Expires: Verifica�ion of Ownerehip by (type of daument, i.e. - property taz 6i11 or dead): � DIVISION OF INDUSTRIAL SAFETY VERMI7 CER7IFICA710N: ❑ I hereby certity that no excavation five (5) or more feet in tlepth into which a person is required to descend, will be made in cnnnecilon with work authonzed by Ihis permit, entl ihat no builtling structure, sceflolding, lalsework, or tlemolition or tlismantling lhereot, wlll be more than thirry-six (36) teel high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ti�le B, Califomia Administretive Code). ❑ As owner-6uiltler. I will not emO�oY anyone lo do work whic� would require a pertnit from Ihe Division of Industrial Satery, as notetl above. unless such person has a permii ta do such work from ihe tlivision. Signeture: Date: Division of Indusirial Sefery Permil Number: ICEPTIFlCA7E OF COMPUANCE AND AUTliORIZATION OF ENTRY: I certity under penalry ol perjury that I have read this application and state that the informa�ion given is I correct. I agree to comply with all state laws and ciry ordinances relating to building consiruction, and euthonze represematives of t�e City of Costa Mesa to enter upon the above-descnbetl propeny tor inspection purpases. I agree not to occupy or allow acupancy of eny building authorized by this permit until final inspection. Signat�—re o� A�d��''z��_ COpE �, INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Finel 200 Final RaRoot 201 Final BIocWRetaining Well 202 Finel Facrory Fire Place 203 Finel Sign 204 Final Demolition 2aa&a6 DRTE INTIf1ALS s � . m ,. . I COOEy INSPECTIONTYPE 206 Finel Mechanical 208 Finel Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approval 222 FinalSite 250 Final Building/Occupancy �jf NTITA CITY OF COSTA MESA � - BUILDING DMSION � � DEVELOPMENT SERVICES DEPARTMENT � PERMIT PERMIT NUMBER �� E98-00963 (714) 754-5273 • Fa�c (714) 754-4856 � 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: 710 W 18TH ST POOL AREA Parcel Nunmber: 42417410 Applicant: DUNFORD,PHIL Address: 8283060 .,. - - " Phone: � ,' ' � � Zip: ..!/j-'� : . . . i ., . Owner: THOMPSON, ROBERT B TF2 Address °�MPMS INC, '� � � ,. "� . - - • -� CYPRESS,CA �. - - � - . Phone: '�'� P O BOX 568 �% i� "- Zip: 90630 i � , �.t , �� ` ��i/;i'. ' 1/,� ContractorC!'� �� - 'Address: � ," - i. % '' " � , ' . ' �� Phone:.`: . . ', , . . � � � .Zip:� . . - . � �' License: � -'` %� I � status: ISSUED Applied: 09/10/1998 Issued: 09/10/1998 ' � _ _ ��, ; �. - � . - . - '�� `� _ / . ,�� v • `.A� � � � � ��. � �� . \ SCOPE OF PERMIT STATE HEALTH 8 SAFETY CODE SECTION 116049.1 PUBLIC POOL GFCI INSPECTION. ..- " .. ..��. ,� � , .A � � , ��" � FEESUMMARY � � � ISSUE FEE ' • Temp service test � Res. a/c package , � New Res (1-2 units) • New Res�(3+units) � Pool I Spa . , � Ligh[ing'Fixts � � Recept Outlets • Switches � . ' Non Res Appl � , Res Appl ' � � � Service to 200a� � � Serviceto1000a�' ` Service over 1000a �� . Motors to 1hp � Motors to 10hp , Motors to SOhp Motors to t00hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits � Temp Pwr Pole Intermed Pole ��Quantity $22.00 _ • $0.00 - $0.00 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $1.00 1 �� $0.0� 0 ��$0.00 0 $0.00„ 0 -$0.00. � ' 0 ��/$0.00 � -� ; A � . � $0.00 �� - 0 $0.00 ., 0 _ $0.00 0 $0.00 0 $0.00 0 ��$0.00� . � 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 �.i' ,� ,-� -, Temp Dist System 7 Lighting. _- _ �Buswayl700-ft� �' -- ' Standing Section Misc Elect�ical Equipment Transformers.up to 1 kva/kw ...........:....up to 10 kva/kw , .................up to 50 kva/kw ' .....:...........up to 100 kva/kw � ........::........over 100 kva/kw . .i �, � Low Voltage Equipment ,� , Low Volt Winng System / Ckt " � Misa Conduit - � � � `� - � Misc.•Conductor� . '" - Cirws ( gen or ride) - � � `Circus (mech ride�or lights) � ` � . Christmas Tree Stand . Fireworks Stand � . Other Electrical Fee Invesligation Fee Plan Check Fee Reinspection Fee Quantity � $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 ao.00, o $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $23.00 COMMENTS / SPECIAL CONDITIONS EXPIRED �s 3 0 � EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendad or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS' COMPENSATION DECLARATION: _ - - I �ereby ettirtn unde� penalry ot per�ury one of Ihe following declarations: ❑ I have end will meinteln e certlticete af consent to self-Insure tor workers' compensetlon, es provided for by section 3700 oi �h�Lebor Code, for t�e performence of Ihe woAc for which this permit is Issued. ❑ I have entl wlll meintain workers' compensetion insurance, as required by section 3700 of the Lebor Code, for the pedormance of the work tor which this pertnit Is issued. My workers' campenselion Insurance certier antl pollcy number ere: Cartiec Policy Number. (This sectian neetl nof be completed 1/ the pertnit /s velued at one hundred dollers ($100) or Iess.J ❑ I certity thet in the peAormence of the work for which this pertnit is issued, I shell not employ any person in any manner so as lo become subject to the workers' compensation lews af Celifomie, end egree thet it I should become sub�ect ta tha workers' compensetion provlsions af Sedlon 3700 of the Lebar Catle, I ahall tonhwith comply wit� these provisions. � Applicant SiBnaNre: � Date: WARNING FAILURE TO SEWRE WORNER$' COMPENSATION COVERAGE IS UNLAW Fl1L AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES PND CML FlNES UP TO ONE HUNDRED ?MWSAND DOLLAflE ($100,000�, IN PODITION TO THE COST OF COMPENSA?ION, OAA4IGES AS PROVI�ED FOR IN SECiION 37060F THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMirtn thet I am licensed unAer provisions at Chapter 9(commencing with Section 7000) of Divislon 3 of the Business end Professions Cotle, antl my Iicensa is In tull torce and eHed. Llc. # Class # Contradors Signeture: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirm Nat ihere Is e consirucGon lending agency for the perfortnance oi t�e work for which this pertnit is issued. (Sec. 3097, Civil Cotle). Lenders Neme: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirm thet under penelry ot perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reeson (Sec. 7031.5, Business antl Professions Coda: Any ciry or counry which requires a permit to conslrucL alter, improve, demolish, or repelr eny structure, pdor to Its Issuance, also requires ihe epplicant for such permit ta file e slgned stetement that he or she is Ilcensed pursuan� to ihe provisions of ihe Conirac�ors Llcense Lew (Chepter 9(commencing wlth Sectlon 7000) of Divlslon 3 0l iha Business end Professions Code) or thet he or she is exempt iherefrom anOlhe basis for Ihe alleged exemption. Any vloletion ol5ection 7031.5 hy any applicant for a pertnit subjects the applicent to e civil penelry of not more t�en five hundretl dollars �$500).): ❑ I, es owner of ihe properry, or my employees with weges as their sole compensetlon, WILL DO TME WORK, and the siructure is not intended or oHered tor sele (Sec. 704d, Business and Protessians Code: The Contractors License Law does not apply to en owner of properry who builds or improves Ihereon, and who does such work himself or herself or Ihroug� his or her own employees, provided thet such improvements ere nat IntenAed or ottered tor sale. If, however, the buileing or Improvement is sola wit�in one year of completion, t�e owner-Duiltler will have Ihe burtlen of proving thet he or she did not 6uiltl or improve tor purpose of sele.). ❑ I, as owner ol the properry, am EXCLUSIVELY CONTHACTING WITH LICENSED COMRACTORS to wnstruct the project (Sec. 7044, Busineu an0 Proleuions Cotle: The conirectors License Lew tloes not eppty to an ownar of praperty who builtls or improves ihereon, end who contracts for such project wlth a coniractar(s) license pursuent to the Contrectors License Laws.). Busineu an0 Professions Code lor this reason: ID verified by drivals license. r�'Ves ❑ No Venlicatlon of Ownership by (type o1 document, i.e. - property tax bill or DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify that no eacavetion live (5) or more feet in tlep�� Inro w�ich a person Is requlretl to descend, wlll be made in connection with work authodzetl by �his pertnit, and thet no building siructure, acalfol0ing, falsework, or demolitlon or dismantlinp thereof, wlll be more then thirry-siz (36) feet high. (Chap. 32, Grp 2, Atl 2, Sec. 347, T1tle B, Celifomle Adminlstretive Coda). ❑ As owner-bulltler, I wlll not employ enyone to do work which would requlre a pertnit irom the Dlvlsion of Industrial Sefery, es noted above, unleu such person hes a permit to tlo such work trom the division. - Signe�ure: Date: Division of IndusMal Safery Pertnit Numher. CEHTIFlCATE OF COMPLIANCE AND AIJTHORVATION OF ENTiiY: 1 certify under penalry ot perjury thet I have reetl this application and state that the inlormetion qiven Is conect I egree to comply with all stete laws end ciry oNinences relatlng to building constmction, end authorize representatives af the Ciry ot Coste Mese to enter upon the abova-describetl property for inspecUon purposes. I agree not to occupy or allow occupency of any buildinp euihorized by this pertnit until final inspeIXion. COUE �. MaiECfIONTYVE 1616 Flxed System Finel Fire Prevention 1268 POoI Spa Final 200 Flnel Re-Root 201 202 203 204 24t&18 Flnel BIocWReteining Well Finel Factory Fire Poece. Flnal Sign Flnel Demolition -,��. �v�, q �-.'�) _il 4.,� ';� ,I ��C�l� �g �� CCpE� INSPECTIONTIPE 206 Finel Mechenical 208 Flnal Plumbing 210 Final Eleclriral 212 Fnal Fire Preventlan 220 Finel Planning Approval 222 Final Site 250 Finel Building/Occupancy ueg u�ets � (714) 754-5273 • Felt (714) 754-4856 // rNIH Unl V C, l.vJ i n mwn. �.n acecv Job Address: 710 W 18TH ST Suite: K Viciniry: BUILDING K - CARPORTS Parcel Number: 42417410 App�icant: NORIEGA, BEN Address: 24000 ALICIA PKWY #17 MISSION VIEJO, CA � , owner: THOMPSON, ROBERT B TR Address °hMPMS-INC , � � - ' �"CYPRESS, CA � - : ' , � P O BOX 568 . Contracror. .W T R ROOFING INC Address: 24000 ALICIA PKVJY #17 � MISSION VIEJO, CA • �Zlp: 92691 Arch : Addresr BUILDING PERMIT Zoning: -Phone: (949)768-4992 Zip: 92691 Phone: Zip: 90630 Phone: (949) 768-4992 License: 764350 Eng: Address:� ISSUED BY: StaWs: ISSUED Applied: OS/09/2000 Issued: OSI09l2000 . ' Phone: Phone: Zip: , License: License: SCOPE OF PERMIT � REROOF EXISTING CARPORTS FOR APARTMENT COMPLEX (BLDG. K). TEAR OFF EXISTING ROCK ROOFING 8 INSTALL NEW BUILT-UP ROOF SYSTEM (BASE, 3-PLY, & ROCK) - 20 S�. FEE SUMMARY �' Plan Check: • $0.00 � Calc Valuation: si,eoo.00 Permit: $63.15 � � Claim Valuation: $i,eoo.00 SMIP Res: $0.50 � SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $63.65 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0. 0 Rear 0- 0 Required: 0 PLANNING & ZONING Lefl 0- 0 Left 0- 0 Proposed: 0 Right 0-0 Right 0-0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regula�ions. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automaticalty expire and become void if work is not�commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. ' INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with all applicabte codes, and all requlred Inepactlona end ti�al approval must be obtained. Feilure to obtain inspectlons end final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5628 � WORKERS' COMPENSAnON DECLAfiAnON: I �ereby ettirm under penalry of perjury one oi Ne fWlowing tlederetlons: ❑ I heve end will malNain a certllicata of consent to selt-Insure for workers' compensetlon, es pmvitlea for by sectlon 3700 of ihe Lebor Cotle, for the pertormance ot the work for which this pertnit is Issued. ❑ I have end will maintain workers' compensatlon insurance, es required by secfion 3700 of the Lebor Code, for the pertormanca of the work for which thls permll is issuea. My workers' compensaN n Insur nce cartier end polcy number aren� Carrler. • �T�T� �`] N \1 . �PolicyNumber: (�'��DOUNIT��% (This section need nof be completetl If t�e permit75 velued et one hunEred dW/ars (5100) or /ess.) ❑ I certily Ihat in the peAortnence ol Ihe work for which Ihis pertnit is issued, I shall not emplay any person in eny manner so es to became subjecl to Ihe workers' compensation laws ot Celifomia, end egree Ihat ii I should become subjecl to ihe workers' Compensation pmNsions at SecUon 3700 0l the Lebor Cotle, I shell forUwith comply with these provisio �J� U, AppllcantSignaWre: �r� /C/ , Date: � ^ /��U�a WARNINQ: FAILURE TO SECURE WOHI(ERS' COMPENSATION O EMGE IS UMAWFUL AND SHALL SU&IECT AN EMPLOVEP TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE MUNDRED THOUSAND OOLLARE ($100,000), IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PqOVIDED FOR IN SECTION 3]Ofi OF THE LABOR WDE, IMEREST, AND A770WJEYS FEES. LICENSEO CON7RACTORS DECLARATION: I hereby aflirtn thet I em force entl ettect. Lic. a_ CantractoYs Sigqeture: (cammendng with Sectlon 7000) ol Dlvision 3 af the Busineu en�l P�es�ons CoGe, an0 my Iicense is in full Class k �� a, oate: � — 9 — CONSTRUCTON LENOING AGENCY: ❑ I here6y aHirtn that there I5 e construction lending egency tor Ihe pedormance of Ihe woB tor which this permit is issued. (Sec. 3097, Civil Code�. Lender's Neme: Lentlefs Address: Signeture: OWNER•BUILDER DECLARATONS: Date: I hereby eHirm that under penelry ol perjury that I am EXEMPT FROM TME CONTFiACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business antl Prafessions Code: Any ciry or counry which requires a permit to construct, elter, improve, demolish, or repair eny structure, prior to Its issuance, also requires the epplicant for such pertnit to file a slgnetl slatement ihet he w she Is licensed pursuant to the provlslons ot Ihe Contractors llcense Law (Chapter 9(commendng wiN Sectlon 7000) ol DiWSion 3 of the eusiness and Professions Gode) or Ihat he or she is exempt �herefrom end iha basis for Ihe ellegeU exemption. Any violation ai Section 7031.5 Dy eny applicant for e permit sub�ects the eppliwnt to e civll penalry af not mora than Me huntlreE dollars ($500).): ❑ I, es owner of ihe properry, or my employees with wages es t�eir sole compensetion, WILL DO THE WORK, antl ihe siructure is not intendad or oNered lor sale (Sec. 7044, Business entl Professions Code: The Contrectors License Lew Aoes noi apply to en owner of property who builas or improves thereon, and who does suc� work himself or herself or through his or her own employees, pmvided that such improvemenis ere not intended or oHered for sale. If, however, ihe building or improvement is sold within one year of completion, the owner-builder will have the burden ot provinp that he or she did not build or improve for purpase of sale.). ❑ I, es owner of the pmperry, em E%CLUSIVELV CONTRACTNG Wf7H LICENSED CONTRACTORS to conswct the project (Sec. 7044, Business end Professions Code: The coNractors License Law does not appty to an owner ot pmperry who 6uilds ar improves ihereon, and who comracts tor such prqeci with a coniractor(s) license pursuant [o the Coniractors License Laws.). ❑ I am exempt untlar sec. Signeture: Owner ID verified by drivers license. ❑ Yes ❑ No Business and Prafessions Cotle for this reason: VedNcatlon of Ownership by (rype ol document, i.e. - property ta�c Dill or Ceetl): Dnver'S LitenSe No. Date: F�pires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cenify thet no e:cavatlon flve (5) ar more feef In depth Into which a person Is requiretl to tlescend, will ba metle In connection with work authorizetl by this pertnit, entl that no Duiltling siructure, scattdding, talsework, or demditlon or dlsmantlinp thereof, will 6e more then thirty-sis (36) feet Ngh. (Chep. 32, Grp 2, An 2, Sec. 341, Title B, Cfllitomia Adminisiretive Coda). ❑ As owner-builder, I will nat employ enyane to do wark which would require a permit Irom the Divlsion ot IntlusMal Salery, as notetl ebove, unless such person hes a permit to Oo such work from the divlsion. Signeture: Date: Dlvlsian af Industrial Selery Pertnit Number: CERTIFICATE OF COMPLIANCE AND AUTHORQATION OF ENfAY: I cenify under penalry ot perJury tha� I hava reetl t�is epplica�ion and siate that Ihe infortnation given is correct. I agree to comply with ell state laws and ciry oMinences relatlng to building consiructlon, and authorize representatives of the Ciry ot Costa Mesa to enter upon the ebove-described propeny tor InsDection Ourpases. I egree not to occupy or ellow occupency ot any bullding aut�orizetl by t�ls pertnit untll tinal inspection. Signatur � gal Ow� � r Dat�, _^ � ( An Or AuNonze Applican� / a e �� COOEI, INSPELTIONTYGE 1616 Fixad System Finel Fire Prevention 1268 Pool Spa Final 200 Finel Re-Roof 201 Final BIocWReteining Well 202 Final Factory Flre Place 203 Finel Sign 20a Finel Demolition zme.e PAIE It�1S �$d INSPECTIONTYPE 208 Finel Mechanical c(/� L�y,�� 208 Finel Plumbinp �• !J•� (�/� � /�!� 210 Finel Elec�rical 212 FI I F' P tl na ire reven on 220 Final Planning Approvel 222 Final Site 250 Final Building/Occupancy BLIE It�ID664 .� (714)754-5273 • Fax(714)754-4856 Job Address: 710 W 18TH ST Suite: F Viciniry: BUILDING F Parce� Number: 42417410 � CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT Appliwnt: NORIEGA, BEN Address: 24000 ALICIA PKVJY #17 MISSION VIEJO, CA , Owner: THOMPSON, ROBERT B TR Address %MPMS INC � ��CYPRESS,CA . - . P O BOX 568� , � ' Contracror: � W T R�ROOPING INC Address: 24000 ALICIA PKWY #17 , MISSION VIEJO, CA Zip: 92691 BUILDING PERMIT Zoning: �Phone: (949) 768-4992 Zip: 92697 Phone: Zip: 90630 Phone: � (949) 768-4992 License: 764350 NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92828 ISSUED BY: Stalus: ISSUED Applied: OSI092000 Issued: OSI09I2000 Arch : � � - Eng: Address: � Address: � � � Phone: Phone: � Zip: , License: � License: SCOPE OF PERMIT REROOF EXISTING 8-UNIT APARTMENT BUILDING (BLDG. F). TEAR OFF EXISTING ROCK ROOFING, INSTALL 30# FELT UNDERLAYMENT, AND REROOF WITH 25 YR.'TIMBERLINE" SHINGLES. BLDG F INCLUDES UNITS 9, 10, 11, 12, 37, 38, 39, & 40 ' Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 $125.25 $0.53 $0.00 $0.00 $0.00 $125.78 SETBACKS MAINSTRUCTURE Front 40 ACCESSORY Front 0-0 PARKING Existinq: 0 NOTES: Rear 0. 0 Rear 0. 0 Required: 0 FEE SUMMARY ,� PLANNING & ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 55,247.00 55,2a7.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Cfllifomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatieally expire and become void if work is not�commenced within 180 days, or if work is suspended or ebandoned for a period of 180 days. INSPECTIONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetione end flnal epproval must be obtained. Feilure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 WORKERS'COMPENSAnON DECLAFiAnON: �- I here�y ettirm under penalry oi perjury one oi ttie fdlowing deGeretlons: ❑ I have end will malntain e ceRificate of consent to &elFlnsure tor workers' compensa�lon, as pmvitled for by sectlon 3700 at the Labor Cotle, for the pertortnance ol tha work for whic� thls permit is issuetl. ❑ I hava en0 wlll meUitaln workers' compensation inwrance, as required by sectim 3700 of Ne Lebor Code, for the peAormence ot the work ta wNch Ws permit Is Iswetl. My workers' compcensation Insurance carrier end pdiry n Der ere: . ^1 Cartier: � _7 T%�T � �t 1 l� �� . ' Policy Number. O` SS_� UO UN fT OGL� �I9 (Th/s section need not be oortrpleteClf fhe pemul ls valued et one hundred dollers ($100) or less.) ❑ I certily that In Ihe peAormance ot ihe work for which this permit is issued, I shall not employ eny parson in eny manner so es to became subject to the workers' compensetion laws ot Celitomia, and agree that tl I shoultl becoma sub�ect to Ihe workers' compensetion proNsions of Sectlon 3700 0l the Lebor Cotle, I shall torthwith comply with these provisiwi � % , � Applicant Signe�ure: z�/Uw... .c.-qt.- • Dete: 1� "' �� Q WARNIN�: FAILURE TO SECURE WORKERS' COMPENSATI CUVERAGE IS UNL4WFUL AND SMHLL SUBJECT M7 EMPLOVER TO CFIMINAL PENALTIES AND CNIL FlNES UP TOONE HUNDRED T/KKISAND DOLLAPE (E100,OOD), IN AUDRION TO TNE CQST OF COMPENSATION, OAMAGES 0.5 PROVIDED FOF IN SECfION 31080F THE LABOR CODE, INrEREST. AND ATTORNEY5 FEES. LICENSED CON7pACTORS DECLARATION: I hereby affirm Ihel I am force and effecc��Lic. M _ Comrecrofs Sipnature: 9(commencing with Section 7000) of Divislon 3 ot the Business enC Profet�ons Cotle, antl my license is In full Class a C � / _ —� ' � Dete: �' — �l — �'% CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirtn that thera is e construction lentling agenty br the pertortnence oi �he work br which Ihis pertnit is Issuetl. (Sec. 3097, Civil Code). LenCefs Neme: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eMirm that untler penalry of periury that i em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry which raquires a pertnit to construct, elter, improve, demWish, or repair any slrucWre, pnor to Its issuance, elso requires ihe appliwnt tor such pertnit to file a signed statemem ihat he or she is licensetl pursuant to ihe pmvisions oi the Contraciors License Lew (Chepter 9(commencing wlih Section 7000) oi Division 3 of the Business end Prolessions Code) or Nei he or she is exempt iherefrom end Ihe basis tor the allegetl exemptlon. Any vloletion ol Section 7031.5 by eny epplicant tor e permit sub�ects the epplicent lo e cMl penalty of not mare than five �undred dollers (3500).): ❑ I, es owner ot Ihe properry, or my employees with wapes as Ihelr sole compensation, WILL DO THE WORK, antl the siructure is not intended or oHeretl for sale (Sec. 7044, Business and Protessions Code: The Contrectors IJcense Law tloes not epply to an owner af property who builtls or improves thereon, and who does such work himself or hersell or ihrough his or her own employees, provided ihat such improvements ere not intended or oHered lor sale. If, �owever, Ihe building or improvement is soltl within one year ol completion, the awner-builder will heve t�e burtlen of proving thet he or she did not builtl or improve for puryose of sale.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CON7RACTORS to consiruct the project (Sec. 7044, Business and Protesslons Code: The contrectors License Law tloes not appty to en owner of property who builds or improves thereon, entl who coNrects for such project with a contrector(s) license pursuant to [he Contractors License Lews.). ❑ I em exempt under sec. Business and Protessions Code tor this reason: Signature: Date: Owner ID veAfled by dAvefs license. ❑ Yes ❑ No Drivers License No. F�pires: Venfication ot Ownarship by (type of document, i.e. - D�operty ta< bill or deetl): DIVISION OF INDUSTRIAL SAFE7V PERMR CERTIFICATION: ❑ I hereby ceNty thet no excaveUon tive (5) or more teet in CepN into wNch a person Is requiretl lo tlescend, wlll be made in connection with work euthorizetl by ihis permlt, entl t�et no builtling structure, scaHolding, lalsework, or demolition or dismantling thereof, will he more Ihen Ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tule B, Califamia Atlministretive Code). ❑ As owner-bulltler, I will not employ em�one to do work which would require e pertnit tmm the Division of Induslrial Sefery, as natetl above, unless such person has a pertnit to do such work irom the division. SlpneNre: Data: DiWslon of Industrlal Safety Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORRJITON OF EMRY: I certity under penalty ot per�ury that I heve read this epplication flnd sWte Nat ihe infortnaUon given is correcL I agree to compty with all stete laws entl ciry ordinances relating Io 6uilAing construction, en0 authodza representatives of Ihe Ciry of Cwia Mesa to enter upon Ihe above•tlescribetl properry tor inspection purposes. I agree not to occupy ar allav occupancy of any �ullding euthorizetl by ihis permli uniil Iinal Inspec6on. Cooe �. ixsveenoxrrae 1818 Fized System Flnal Fire Preventlon 1268 Pool Spa Final 200 Flnel Re�Roof 201 Flnal Block/Reteining Wall 202 Flnal Fectary Fire Place 203 Final Sign 204 Finel Demolition zasere � 1t�dL5 COOE� n+sveenoxrrve 208 Finel Mochenlcal 20B Final Plumbing 210 Finel Electdcal 212 Finel Fire Preventlon 220 Finel Planninp Approvel 222 Finel Slte 250 Finel BuiltlingiOccupency Date ,s- - i -�70 o C� � oa�a � u�s v- i,�. � q��' � •..:.::: � �. : (714) 754-5273 • Fax (714) 754-4856 Job Address: 710 W 18TH ST Suite: J Vicinity: BUILDING J Parcel Number: 42417410 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPAATMENT. PERMIT App�iwnt: NORIEGA, BEN Address: 24000 ALICIA PKWY #17 MISSION VIEJO, CA owner: THOMPSON, ROBERT B TR Address °hMPMS�INC - � "CYPRESS, CA � � �P O BOX 568 ' � Contracmr. W T R ROOFING INC Address: 24000 ALICIA PKVJY #17 MISSION VIEJO, CA Zip: 92691 Arch : Address: Phone: BUILDING PERMIT Zoning: Phone: (949) 768-4992 . Zip: 92691 Phone: Zip: 90630 � , Phone: (949) 768-4992 License: 764350 -" Eng: Address: . 77 FAIR DRIVE, COSTA MESA, CA 92628 ISSUED BY: Status: ISSUED Applied: 05I09I2000 Issued: OSI09I2000 Phone: ,Zip: , , � , License: License: SCOPE OF PERMIT � REROOF EXISTING 4-UNIT APARTMENT BUILDING (6LDG. J). TEAR OFF EXISTING ROCK ROOFING, INSTALL 3Q# FELT UNDERLAYMENT, 8 REROOF WITH'TIMBERLINE" 25 YR. COMP (20 S�). BLDG. J INCLUDES UNITS 51, 52, 19, & 20. � , Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Existina: 0 NOTES: Rear 0-0 Rear 0. 0 Reauired: 0 FEESUMMARY PLANNING 8 ZONING Lefl 0- 0 LeN 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 $2.499.00 52.499.00 NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is noLcommenced within 180 days, or if work is suspended or ebandoned 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 requlred inepeetlona end (inal approvel must be obtained. Failure to obtain inspections end final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 .o WOf�RS' COMPENSATION DECLABATION: I here7y aHirtn untler penalry ot perjury one af Ne IWlowi�g dedaratlons: ❑ I have enC wlll malntain e ceNlkata of mnsent to self-Insure tor workers' compensation, es pmNdetl tor by section 3700 oi t�e Labor Cotle. for Ihe pertormance ot the work for which this pertnit is fssued. . ❑ I hava end vnll maintain workers' compensation insurance, as requlred by section 3700 of the Lehor Code, tor Ihe peAortnence of t�e work tor which Ihis pertnii Is Issuetl. My worker9'tOmpensetlon Insurence carriar entl policy number ere: �l Cerrler. '�1 1�T� �ll (�`__ . r POIIcyNumber: r%SS--�/ f)N�YGY�JD�IS� (7his sect�on need not 6e comp�eO I/ the pertniNs valued ef one huntlre0 dol�"� ) or less J ❑ I certlfy that In ihe pertormance ol the wark for w�ich t�is pertnit is issued, I shall not employ eny person in eny manner so es to became subject to the workers' compensetion laws of Calitomia, antl egree thai it I shoultl bemme sub�ect to ihe workers' compensation pravisions oi Sectlon 3700 0l ihe Lebor Cotle, I shall tonhwith comply with these Drovisions. /� � Applicam Signeture: Date: �"— 7�� G WARNINO: FAILURE TO SEWHE WORKERS' ODMPENSATON COVERAGE IS UMAWFlIL AND SHML SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED THOUSAND DIXLARE (5f00,000J, IN ADDf710N TO THE OOST OF COMPENSATIpN, pA1MGES AS PROVIDED FOR IN SECfION �W OF THE LABOR CODE.INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm Ihal I am licensed lorce entl eMed. Llc. x Contwctors Signature: _ (commencing wilh Sec�ion 7000) of Divislon 3 of t�e Business antl Profes ns Cade, antl my license is in full Class x i� � � • � �� Date: C — — O O CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn Ihai Ihere is e conswction lending agency tor the peAortnance ol the work tor which this permit Is issuetl. (Sec. 3097, Civll Cotle). Lentlars Name: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eNirm that under penalty of per�ury thet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requlres e permit to construct, elter, improve, demolish, or repeir eny strudure, prior to Its issuance, elso requires the epplicant for such permit to fila e signetl statemeN Ihat he or she Is licensetl pursuam to Iha proNsions oi tha Contractors License Lew (Chapter 9(commencing wlih SecHon 7000) of D'Msion 3 0l the Business antl Professions Coda) or thet he or she Is exempt theretrom enA t�e basis for Ihe elleped ezemptlon. Any violation ot Sectlon 7037.5 by eny epplicant for e pertnit sub�ects Ihe epplicant to e civil penalry ot not more than frve �undred ddlam (5500).): ❑ I, es owner of Ue properry, or my amployees vrith wages as lheir sole compensation, WILL DO THE WORK, antl the siructure Is not intentletl or ottered lor sale (Sec. 7044, Business antl Proteulons Code: The Contractors License Lew does not apply to en owner ot property who builtls or impmves thereon, entl who tloes such work himself or herself or through his or her own amployees, proviOed ihat such improvemenis are not intended or oflered for sale. If, however, Ihe building or improvement is so10 within one year of completlon, Ihe owner-builtler will have Ne burden of proving thai he or she tlld not build or improve for purpose ot sale.). ❑ I, es owner oi the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Iha pro�ect (Sec. 7044, Business antl Professions Code: The conirectors Ucense Law does not appty to en ownar oi property who builds or improves thereon, and who rnmrects far such project with a contrador(s) license pursuant to the Conirectors License LewsJ. ❑ I em exempt untler sec. Buslness antl Protessions Code tor this reeson: Signeture: Date: Owner ID verifietl by tlrivefs Iicense. ❑ Yes ❑ No Drivers License No. Verificatlon ol Ownership by (rype ot tlocument, i.e. - property tex bill or deetl): Erzpires: DIVISION OF INDUSTfiIAL SAFE7Y GERMIT CERTIFICATION: ❑ I hereby certify Ihat no excevatlon ilve (5) or more feet In depth Into which a pereon Is requlre0 to descentl, will be made In connaction with work authorized by this permlL entl that no Duiltling structure, scettolding, talsework, or tlemWitlon ar dismantling t�ereol, wlll Ge more than thirry-six (36) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Calltomia AtlmInlSlretive Cotle). ❑ As owner�Duiltler, I will not employ anyone to do work whlch would require e permit from Ihe Divislon of Indusirial Safety, as natetl ebove, unless such person has a permlt to da such work from the tlivislon, Slgneture: Dete: Divlslon ot Indusirial Safery Permlt Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF ENTAV: I certify under penalry ol per�ury ihat I have read �his epplicalion end stale that ihe infortnetion given is correct. I egree to wmply with ell State laws and ciry ordinances relating to bullding constructlon, end euthorize representatives oi ihe Clty of Caste Mesa to anter upon the ebove-tlescrlbetl property lor Inspectlon purposes. I agree not to occupy or ellow occupancy ol eny builtling euthorizetl by Ihis permil until linel inspection. CODp �. INSPECTIONME i618 Fixed System Final Fire Preventlon 1268 200 201 202 203 Pool Spa Finel Final Re-Roof Finel BIocWReleining Well Finel Fectory Fire Plece Finel Sign 204 Finel Demolition zaaese �.1 JIII"_ �� 1/ � .� Date � _ _ � � � � � r Date CODEI �NsveenoxTrve 208 Finel Mec�enicel 20B Finol Plumbing 270 Finel Electdcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building�0aupancy Q� 1t�lS (714)754-5273 • Fex(714)754-4856 JobAddress: 710 W 18TH $T Suite: B Vicinity: BUILDING B Parcel Number: 42417410 CITY OF COSTA MESA BIIILDIN6 DIYISION DEVELOPMENT SERVICES DEPARTMENT. PERMIT ,4pplicant: NORIEGA, BEN Address: 24000 ALICIA PKWY #17 MISSION VIEJO, CA owner: THOMPSON, ROBERT B TR Address %MPMS INC CYPRESS,CA � - P O BOX 568 Contractor. W T R ROOFING WC Address: 24000 ALICIA PKWY #17 MISSION VIEJO, CA Zip: 92691 Arch : Address: Phone: BUILDING PERMIT Zoning: Phone: (949) 768-4992 Zip: 92691 Phone: Zip: 90630 Phone: (949)768-4992 License: 764350 " � Eng: Address: NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Status: ISSUED Applied: 05I09I2000 Issued: OSI09/2000 Phone: � � Zip: . License: License: SCOPE OF PERMIT REROOF EXISTING 8-UNIT qpARTMENT BUILDING (BLDG. B). TEAR OFF EXISTING ROCK ROOFING, INSTALL 30# FELT UNDERLAYMENT, AND REROOF WITH 25 YR.'TIMBERLINE" SHINGLES (38 S�). Plan Check: $0.00 Permit: $1 i 1.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $111.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front �0.0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Reauired: 0 FEE�SUMMARY ' PLANNING & ZONING , Lefl 0- 0 Lefl 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0. 0 $4,7a8.00 54,748.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia stetutes and related regulations. (Ord. No. 92-28, § 1, 72-2t-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 orcler for the work authorized under this pertnit to be considared legal, such work must eomply with all appiicable codes, antl all requlred Inapectiona end flnal epprovel must be obteined. Failure to obtain inspections end final epproval will result In the e�cpiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545828 WORKERS'COMPENSAnON DECLARATON: � I hereby eMirtn untler penalry ot perjury one oi tha tollowing tleGarauons: - . ❑ I have and will maintaln e certiflcate of consem to self-Insure br workers' compenution, es providetl for by section 3700 oi the Lflbor Code, lor the pertortnance ot Iha work lor whic� this permit i5 issued. . ❑ I have antl wlll meintain wwkars' campensation insurance. a5 requlred by sectlon 3700 of the Lebor Cade, for Ihe pertormance oi the wwk for whkh this pamtit is lswetl. My warkers' compen5ation Insurence cartier and p/o�llcy number ere: . /{ Cerner: S��Tr FL\ (��1J PolicyNumber. �Y7� QC7 l)u� l i�n�� (This setf/on neod nof De complefed i! fhe pemtit is valuetl af one hundretl tlWlers ($100) oNess.) ' ❑ I certiy that in the pertortnflnce of Ihe work for which thls permit Is iuued, I shell not employ eny person in any manner so es to Oecome subject to the workers' compensation laws of Celitomia, end agree thet it I should become subject to ihe workere' compensetion provislons ol Section 3700 of ihe Labor Code, I shall forUwith comply wlth these provisions. q Applicent Signature: ��% .[lNb._ • ' Dete: � / / d � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION ERAGE IS UNL4WFUL AND SHALL SUBIECT AN EMPLOVER TO CPIMINAL PENALTIES D CIVII FlNES UP TO ONE HONOFED THOUSAND DOLURE (5100,000�, IN ADDRION TO THE C0.ST OF COMPENSATION, DAhNQES AS PROVIDED WR IN SECfIIXJ 3]08 OF THE LABOR COOE, INTEREST, ANO ATTORNEI"S FEES. LICENSED CONTRACTORS DECLAFiA710N: I here6y aHlrtn t�al 1 em lorce entl eHect. Llc. a_ Comrectors Signature: Chepter B(commendng with Section 7000) of Division 3 of the Business and Professions Coda, and my license is in full � Class p _�' � �.—. L� Date: �— g' — � � CONSTRUCTION LENDING AGENCV: ❑ I hereDy ettirtn thet there Is a cansiruction lending agency lor Ihe peAartnence oi the work for w�ich Ihis pertnil is issued. (Sec. 3087, Clvil Cotle). Lentler's Name: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirm ihe� under penaliy ol perjury �ha� I am EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reeson (Sec. 7031.5, Business and Professions Cotle: Any ciry or county which raquires e permit to construct, alter, improva, demolish, or repair any sWcture, prior to Its Issuenca, also require9 the applicant tor such permit to tlle e signed stetement Ihet he or she Is licensed pursuani to �he provislons ot ihe Conirectors Licensa Law (Chepter 9(commencing with Section 7000) of Divlsion 3 of the Business end Profeuions Coda) or that he or sha is ezempt therefrom enA Ihe Desis tor Ihe alleged exemption. Any violatlon oi Sectlon 7031.5 by any epplicam for a pertnit sublects the applicant to e ciNl penalry of not more ihan frve hundrad dWlers (5500).): ❑ I, es owner at the pmperty, or my employees with we9es as their sole campensetian, WILL DO THE WORK, entl the sWcture is not intentled or oHeretl tor sale (Sec. 7044, Business and Professlons Code: The Contractors License Lew tloes not epply to an owner of property who builtls ar improves thereon, end who does such work himself or herself or through his or her owA employees, proviAetl thai such Improvements are not intentled or oRered for sale. It, however, the builtling or improvemem is sold wlthin one year ot completioq the owner-builder will have Ihe burtlen oi proving t�at he or she did not builtl or Impmve for purpose of sale.). ❑ I, fls owner ot the pmperty, am EXCLUSIVELY CONTRACTING WITFI LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Pmteuions Cotle: The contraaors License Ww dces not appty to en owner of property who builtls or improves thereon, entl w�o contracts tor such project with e conirector(s) license pursuani Io Ihe Contrectors License Laws.). ❑ I am exempt under sec. Signature: Owner ID verilietl by drivefs Iicense. ❑ Yes ❑ No Buslness enC Professions Code tor this reason: Vedtication of Ownership by (rype of dacument, i.e. - property tae bill or deed): Drivels License No. Data: E�Wires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTFICATION: ❑ I hareby certlty Ihai no excevation fiva (5) or more feet in depth inta which a person is required to desCend, wlll be mede In conneclion with work authorizetl by t�ls permit, and t�at no GuilCing slructure, scattolding, lalsework, or tlemolltion or Aismantling thereof, wlll be more than thirty-six (36) teel high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title B, Celifomia Administretive Cotle). ❑ As owneo-builtler, I will not employ enyone to tlo work which woulC require e permil trom Ihe �ivision of Intlustrial Salery, es notetl ahove, unless such person has a permit to tlo such work from the division. Slgneiure: Dete: Dlvlsion of IndusMal Sefery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUTHOR¢A710N OF EMRY: I cerUfy under penelry of perjury that I have read this application end state that the information given is I correcL 1 e9ree to wmply with ell stete lews end dry ordinences relatlng to building constructian, and euthonze representatives ol the Ciry of Costa Mesa to enter uDon the ebove-descdbed proDerty for inspectlon purposes. 1 egree not to occupy or allow occupency ol any building euthorizetl by t�ls pertnit until final inspection. COOE�, INSPECTIONTYPE 1818 1266 Fixod System Finel Fre Prevention Pool Spa Final 200 Finel Re-Roof 201 Finel BIocWRetelnlnp Well 202 Finel Fectory Fire Place 203 Flnal Sign 204 Flnal Demdition 2u618 �g �� 1`—=� CO�E I INSPECTION TYPE 206 Final Mechenical 208 Final PlumEing 210 Final Electdcal 212 Final Fire Praventlon 220 Final Plenning Approval 222 Finel Slte 250 Final Builtling/Occupancy o,o S � Q� �Dete C� 1t�15 % � PqOJECT POOflESS: -� 1 Q W 18 TH S T � OWNEN'S�NAME: THOMPSON ROBERT B TR nooaess: �MPMS IN� P O BOX 568 CYPRESS,CA 90630 AflCHIENGMEEN: ROONESS: xE0.N0.: ux�T: UNIT; PERmiTTEE' NATIONWIDE SECURITY ( 310 ) 676-2809 ADOFESS: 3Z16 W EL SEGUNDO BL HAWTHOANE CA 90�47 IICENSEO CONTflACTOB OECIABAT10N: I her¢Oy aHirm Ihat I am lic¢nsed un0er D�ovLsions oi twpter 9(cammencinp wilA $¢CtiOn 7000� ol �rvision 3 0l I�e Business an0 ProleSsions CoOe. an0 my license is in lutl larce an0 ellect. CITY LIC.: STRTE LIL.: CIASS: GG /1 053540 920856 � /�C_ y1• /�/�� Oaie: � SignaWre: — v��/ '��fi0 WOBNEBS' COM NS�TI N OECIANATION: I �eRDy aflirm llla�have a t¢rliliWte o� tron5¢ni to Srel6msure or a cenificate of WOAers' Compensation Insurance. or a cettilieA coDY ��ereol (SeC1i0n 3800. Lab. C�. roucvNo.: NWC29373600 E%P.ORTE: OB�OlI94 LOMPRNY: GOLDEN EACI.E � Certitiea copy is �ere0y lumis�ed. L9t Certilie0 copy is l wit� Ihe cit uil0inp Divisio .� Oate: � � I ��_� \, _ MPlicam: � � � �� E%EMPTIW FNOM WUflNFflS' COMPEN511TION OECUMTION: Rhis secUon neeG rot De campktM il Ne pumt ¢ for one AunErW (5100) a less�. �� I cetlify�inal in Ihe petlormance oi Ihe wOrk tor w�icA llti5 permi� is i55ue0, I S�all noi emDloy any person in any mannEr 5o as la betome subject lo ihe Workers' Compensation Laws oi Calilarnia. Dale: SiAnature: NO110E: If, alter making this Ceclaration, you shoul0 Eecome su0ject m the Workers' Compensation Omvisions of lhe Labor Cotle. you must lanhvmh comply vnlh sucn prwisio� or ihi5 permit shan Oe OeemeG revOkeE. CONSTBUC710N LENDING RGENCY: I �ereGy attirm ttwt there is a constmction lentlinq aBen�y tar t�e pedormance of ihe work lor wnicn ihis vermit is i=sue0 (Section 3W7. Civ. C). iEN°E": CONSTRUCT SOLF OF WROUGHT nooness: ZRON FENCE ON BOTH POMONA ST S W 18TA ST S INSTALL OWNEP BUILOEfl OECLANRTION: I �er¢Gy a�lirm ItWI I am exempi hom I�¢ fAnlratiaR' State Liceirsa Law for tne latlowinp reason �Sec�ion 703L5 Business an0 Pmte55ional Cotle: Any qty of counry wltiU repuires a perrtul 10 comlrucl, alhr, impmve, Eemolis4 or re0air any slmcWre. pnar to i�s issuance. also repuires tlle aDdk:m lor wc� perrttit ro lile a Siqnetl sWtement Itwt he/511e IS Iicenu0 oursuant m ine O�avivons ai me Coniracmrs' State lianse Law (Ctupter 9(commencinp vni� Section 7000) ol Oroision 3 0l ��e Business ana Prolessions Coae) or inat ne/sne is esempi tAemimm anU ine Oasis lor ine atleOeE eRemption. Any violation ol Section 7031.5 6y any aOD�icant for a permit wDjttts t�e aDdi�� to a tivil pmalty ol not more tlwn live �unOreO Edlars (55110�. I. as owner of Ine propeny or my emVlayees vnih w2pes as tAeir sole compenSation, vAtl Co tAa woM1, antl Ina ❑ stmcture is noi imen�eU or otlerea lor sale (Senim 70aa, Business ana Pmlexdmal CaAe: Tne Comracmrs' State License Law aoes nai appry to an mmer o� a pmpeny wno ouiids or imv�m'es tnereon. and wM tloes such xroM nimseil/nerself or tnroupn Ilis ar Aer mvn emDlpyees. proviEeC ttui suc� im0�a�ements are nol intenCeG or oflered for Sale. II, tqwevei t�e Cuil�lnp ar imo�ovement is sola wiiNn one year of rnm0�etion. �ne owner oill nave Ine euraen of 0«0 ws�a Oi0 not EuiIE or imDmve br t�e purpOse ol Sale�. I, as owner of ine O�opetly, am ¢eclusivery comraclinp wil� IicenSeG conlraclars Io construtt t�e prolect 15eqion 7004, Businass ❑ an0 Professions CaUe: T1re Contractas' State License Law Uces not appty m an wmer ol prope�ty wtq EuIIEs or ImO� ��ereon and w�o contraCtS lor 5uc� pmjects vnt� a COntracror(5) littnu W�suant t0 I�e Conlnciors Slate Lirense Lawl. I am aware Inal Oroof ol ��eir Worker's CAmpensdtion insurantt s�oNA Oe provi0e0 lo me. � I am exempl un0er Section: B. 8 P. C. lor Nis ieasan: Oa�e: O�mer. I ao nereby certily ihat I am aware of an0 unaerstan0 ihe reQuirements ol Cdlilomia Healih antl Safery fAOe Seclions 25505. 25533, anA 255� antl t0at I or any lumre GuiIGmA acupant vnNw711 no� (drele one) nee0 to compry wi�� uiG state coAes an0 t�e repuiremems lar a Oerm�l br conSVuction or mo0ilKatiOn Imm t�e Air �ua41y ManaOement District. fleAGentul conSWcibn apDliWtionS are etempt imm 1�¢52 O��Si0115. Date: po0licanl: I nere0y ceriity Ilui 1 have reaa this aDP��iOn anG Slate Ilwi I�e aUove infOrmaUon is wrr¢cL I apree to camON �Ih all Ciiy anG COuniy or4inanresanOsiaielavrsielalingloOuiltlingcroslmctionanG�e autnonzere0�e ta�ivesotiksciryt meruponmeaUove�memionea pmperty farinspec�ion Durpotes. Date:�_��3 Signawre: �river's License or Social Securiry .: tbai-a6 W�ne—BuiWmg: Green—CaEe EnlortemenC Canary—FppliranC Pink—Revenue; GdEanroE—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06996E PERMIT NO: H 064968 PLAN CHECK NO: 04553-93 L GOVT: N SUPP; N CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: NEW JOB DESCRIPTION ; INSTALL 80LF OF IRON FENCE 6 60LF GATES SQ FT; 140 CLAIM VALOE; 15,000.00 CALC—VALUE; 1,400,00 GROUP OCC; B-2 / COMMENTS: " 3" GATES AT 20LF EACH, "2" AT POMONA ST S"1" AT W 18TH ST. �r**�r�t***x�*�***********�r***�r**�t**�r*****��r*�r*********+�*�**+r*z+�+�*�***�*+r**�*�*�*�rx Z O N Z N GS ERTEBQAUCIKRSE M E N T 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 RE • PROV; PARCEL• 42417410 2NE; R3 REF NO: PLANNING N'PES> SECURITY SLIDZNG GATES (3), WROUGHT IRON DOORS (8) G APPROX, > 125' OF WROUGHT IRON SECURZTY FENCING @ EX. APT. COMPLEX x�r��r***�r�r*x�r*�r�r�tit�tx�r��r�t�r****�r*+t**�r�x-x-x��r�r**��ri�*x��r*�**rx��*******�r*-�****+�-********�- D E V E L O P M E N T S E R V 2 C E S R E Q U I R E M E N T S ZONING APPROCrED BY GE DATE: �� P7 BUILDING APPROVED BY ; DATE; APPLICATION ISSUED BY: ��C�' DATE: �I 17 it**ifititrtit***it***i�i�**�t*it�iF7FiF�F"iF3FiFiF��,�� 3F�F'iFiFiF7F3F7FiFTFiF7F3F3F'iF�FiF***i�ft*�c*+��, .x.�. **�r*�t**ir+�+r*+�***+�*r*******�r***x�***��-*r***�r*+t*+�+�*r**�txx��**�c�*+�*r�c*��-��***+�*x*x+�� LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMHING ELECTRIC MECHANIC FZRE SMIP/RES GRADZNG PERMIT 33,00 ,50 PLAN 21.95 SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 33,50 0.00 21.45 54,95 54,95 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 54.95 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.00 ,50 21.45 !f�lkMltMMitfFlfikftlfMifMifiEif4fFkkiliflE%iE1EiflfifiEifitifillflkitiFlFltifiFlEiFiEiFiEififlEifkifk%iF1flF�FMiEiE+EitlfiFMiFiE%iEififififiE Z N D I V I D U A L F E E B R E A K D O W N TYPE SFR QTY 140 D E S C A I P T I O N AES—W. IRON/CHAIN LINK FENCE / FT END OF FEES � � ,. / L' . 1� Y� i S✓ / — , UNIT COST TOTAL COST io,00 i,�ioo,00 O1 �DiS0E83—OO150E&5 T�ry T �:,�._ GATE: I1/17i93 ilhE: IE�^5 I CONSTRUCTION AND PLANNtNG APPROVALS Permit �`r 1. Temvorary Electrical Service or Pole 2. Soil Pipe�Undrgmd. , 3. Electrical Conduit Uti�ity-Undrgrnd. 4. Electrical ConduibUndrgrnd. 5. Steel f?einforcement 6. Eleccrical UFER Grnd. 7. Footings 8. Foundation 9. Water P�pe�Undrgrnd. � 10, StructureV F1oor System 17. Roperty Sewer line & House Connection 12. Sewer Cap 73. Roof Drains . 14. Rough Plumbing 15. Rough Electricai-Condu�t 16. Rough Electric Wiring 77. Rough Wirin9 Siyn 78. flough Electrica�-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Firepface 21. Dutts, in Structure 22. Ducts, Ventilating 23. Gas P�pe•Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T�Bar Ceilinq �Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Aleter�Fina1 33. Final Electric 34. Final Heating & Air Conditionin9 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. Sotar pomes[irFinai 42. Backflow Preventer 43. Backflow Irrigation 44. LandscaDe Irrigation System 45. Sound Aitenuation 46. Hand�caP Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Re�ease to Edison 50. Gas Release to Southem Gtifornia Gas Cc 51. CER7IFICATE OF OCCUPANCY Date Date PO. ,v SPA Inspector AppROVALS Permit � 52. Pool & Equipment Location 53. Steel Reinforcement 54. forms 55. Electricai Bondinq 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE 58. Etectrical Cpnduit•Undrgrnd. 59. Gas PiPe, f� Undrgrnd., Test 60. Batkwash Lines, P•Trap, Cl U�drgrnd. 61. APPROVALTODECK 62. Backwash & Receptor�Final 63. Heater & Vent-Final 64. Plumbing System • �inal 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL:SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Under9round Hydro / � � �ate �Inspector 71. Product Piping OGas OOii 72. Underground Flush � 73. Undergrnd. Storaye Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical . 76. Dry Scandpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAG HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION � 80. F000 CERTIFICATE ISSUED Notes: .+ Y! r PflOJEJA00PESS: 71O W 18TH $T , UNIT: �• ulvNensxnme: THOMPSON, ROHERT H TR � noosess: ;MPMS INC P O BOX 568 \ CYPRESS,CA 90630 ` ANCM/ENGINEEN: p0�XE55: HEC.NO.: UNIT: PEflMiTrEE: NATIONWIDE SECURITY ( 310 ) 676-2809 aoosess: 3216 W EL SEGUNDO HL HAWTHORNE CA 90247 LICENSED CONTBACTOB UECLAPATION: I hereby alfirm Ihal I am licensetl untler pmvisions of Chapter 9(commencinp wi�h Sec�ion 7000� ol Division 3 ot the Business and Pmtessions Cotle. anA my license is in full force antl etfect. ciTruc.: 0535� QQ�STpTELIC.:4208� B1ASi C61 Daie � Signalure; — BREPS' �OMPENSRTION DECLABATION: I hereby ai ha I have nilicate consent t selFinsure or a certificate ol Workers' Compensation Insurance. or a certilied copy IAereol (Sec ion 3800. LaU. C�. voucreo.: NWC24373600 E%P.UATE: OSIOLI�J4 comrnxv: GOLDEN EAGLE ❑ Certifietl capy is hereby lumishetl. �j[ Ceriitietl coDY is hle iih �he ciiy B mg Division. Daie: �I� ! !—�_T�_�� PpPlicam: �'�� E%EMPTION FBOM WOPNfPS'COMPENSATION UECIAPRTION: (Thisseciion nee0 notbe compleiedilthe permitislorona hunOreO(510��orless�. I cenify iha� m ihe pedormance of ihe work for w�ich t�is permit is issuetl, I s�all nat employ any person in any manner so as to become su�le�� 0 Ihe Workers' Compen5aiion Laws of CalifOmia. pa�e: SiAnature: NOTICE: If. afler making t�is Ueclaralion, you shoul0 become su�le�� o ihe Workers' Compensalion Dmvisions ol t�e Lahor Cotle, you mus� �onhwi�lt compty wit� such pmvisions or �his permi� shall be tleemetl revokeA. CONSTflUCTION LENOING AGENCY: I Aere�y altirm Ihai IAere is a cOn5lmtiian lending aAenty for the DCAOrmante oi Ne wark �or which this permiiis issuetl (Section 3097. Civ. C�. IENUEP: ROOflESS: OWNEB 901LOEfl DECLABATION: I �ereby aflirm II1at I am ¢x¢mp� �rom IAe ConVaCiors' State License Law tar ihe lollowinp reason �Section 7031.5 Business an0 Pm�essional Cotle: pny ci�y ol couNy whic� reQuires a permi� to cons�mci. alter, im0�ove, tlemolish, or repair any Slmciure. prior to ils i55uante, also require5 �he applitan� �or suCh De�mi� l0 lile a Signetl S�atemen� Ihai �e/5he is liceni¢A Oursuant Io ihe O�ovisions of ihe Coniracmrs' Slate license Law (Chapter 9(commencing with Section 7000) oi �ivision 3 of Ihe Business ana Pwtessions Code� or that he/she is exempt iherefmm and the basis lar ihe alleAeO exemOtion. Any violation of Section 7031.5 Oy any applican� lor a pe�mi� suEjecls �he applicani to a civil penalry o� noi more I�an liva hundred Oollars (5500�. I. as owner ot ihe pmpeny or my employees wi�h waqes as t�eir sole compensation, will tlo ihe woM, anG tAe ❑ stmcture is nat intentle0 or offere0lor sale (Section 7044, Business an0 Professional Cotle: The Coniracrors' State License Law does not aOPly to an owner ol a D�oVeny w�o builds or improves thereon, anU who tloes suc� work himsell/Aersell or t�wuAh his or her own employees, pmvi0e0 �ha� such impmvemenls are nol intendeJ or ofieretl lor sale. If, however Ihe �uiltlinp or improvement is so10 wilhin one year ol completion. IAe owner vnll �ave ihe OurOen ot pwdnp Ae/she did not Oui10 or impwve for Ihe ourpose oi sale). I, as owner o1 ihe o�operty, am excNsively coniractinp with licensea conVactors �o consimct tlle Owlect (Section 7044, Business ❑ antl Pm�euions Cotle'. T�e Contraciors' S�a�e License Law tloes not aOPty �o an owner o� Ompehy who builUs or Improves thereon an0 w�o [antratts �Ot SUth prole��s wilh a tontrat�or�s�liten5e pUrSuan� to lhe Confractor5' Siate Licenie Law),I am aware Iha� pmof ol IAeir Worker'S Comp¢n5aiion insurante S�oWU be Oronded ta me. � I am exempi wder Seciion: B, 8 P. C. �or lhis reason: Uate: Owner. I tlo hereby cenify tna� I am aware ol ana understantl the requiremenis ol Califomia Heal�� anE Safery COAe Sections 25505, 25533, and 2553<antl t�at i or any tulure buiitling occu0am will/will not (circle one) nee0 m comply with saiU state cotles an0 the requiremenis for a Oermil lor cons�mclion or modilica�ion �mm I�e Nu Ouali�y Management OiSlrici. Fesi�en�ial conslmc�ion aD0lica�ion5 are exempt Imm �Aese pmvisions. Oate: Apolicam: I hereby certily i�al I have reatl Ihis apPlication antl s�aie �ha� ��e above inbrma�ion is correci. I agree �a comDly wiN all city antl coun�y or0inance5 antl sla�e laws relaling lo Uuilaing constmction and he�e0y aut�arae reD�esentaiives ol this c Io en�er upon lhe ahave-menlione0 O�operty far in50eciion purposes. ^��// � I l 1 1 / '�lj % /�� / Oate: - $ignaWre. ��...b j Oriver's License or Social Seariiy u: �6abA6 W�ae—Bwltling; Green—Code Enbrcement; Canary—ApPlicanL Pink—Revenue; GOltlenro0—Assessor CITY OF COSTA MESA — BUZLDING PERMIT PERM NO: E 069969 PERMIT NO: E 064969 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: NEW JOB DESCAIPTION ; INSTALL 80LF OF IRON FENCE & 60LF GATES SQ FT: CLAIM VALUE: CALC—VALUE; CROUP OCC: B-2 / COMMENTS: REF: B-64968 +�x-x-�t-+�-******�c-*�a�**�*+�-�+t«+t+t�r�r**+�*,+�*+r*r*��t*x�**�=x�*�c+r****+t+�x-******�x-***��r+��+r�*�x-*+�-�#x Z O N I N G R E Q U I R E M E N T S 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BI)ILDING --------- 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• PRO��: PARCEL: 42417410 ZNE; REF NO: PLANNING N6TES> > if 1F if iE ie jE iE it if it it iE if 1f if if if iE iF iF i! it 1f i! 1f !f k 7f if 1E iE it if if if iE it 1f 7f if it if iF if if k it if 1E if 1E i:1f if if iE iE iE 1t iE 1E if if iF if 1F iE * af if R if iE if iE if iF iE jE 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: p� APPLICATION ISSUED BY: �� — DATE: �� V ir+t*it+�x�***�r�rfr+�*x�**�t***+t�t*�r+�******ri��r�r ***�*fr*��r�r'�*r*�+�****+t**x-*****+�*� �rF�*+�*�c iE it ff if jE iF 1f 1f iP iE if iE it 1� if if if if it it iE �f k if if if if if ff iE it iE %if 1F if it if 1E it jf itlf it if if if iE fE 1f 1E k 1f fE iE if iE if if iF iF iE if if if iE i: iE+f iE iF iF if if d: iF if iF iF 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 42.00 SOR SMIP/NON—RES PLAN ISSUE FEE 15.00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 42.00 15.00 0.00 57,00 57,00 .00 AEVENIIE DIVISION TOTALS--> COLLECTED: 57.00 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK 5%,�� if if if if if iE 1f 1f iElE iE iE if !E M iF ik iP 1f 1Flf 1f iE iE 1f if 1k Y 1f �f iE iE M fE ff 1f if if if 1E if M!f �E if iF �4 %if if iE {f 1E iF iElf iE 1f i! if iF i! if jf if iF ik k if iF iE iF it 1f 9E if ik iE ih 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 2 P T I O N ELE 3 MOTOR/POWR APPARATUS 0,0 — 1.0 HP ELE 3 MISC CONDUIT NOT LISTED REp PERMIT Ex,PIRE END OF FEES D� � �� UNIT COST TOTAL COST 3.00 9,00 11,00 33.00 �11 0O150EQE-001508E6 T+ a"R' ;"..p, DATF: 11/17/93 7'I�[: 16:0? ' CONSTRUCTION AND PLANNING POOL & SPA � � APPROVALS Permit # Oate Inspector pppROVALS Permit # Date I�spector i t, Temporary Electrical Service or Pole ' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electricaf Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Etectrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation �� 59. Gas Pipe, � Undrgmd., Tesc 9. Water PIpe�Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. ' I 10. Structurei Floor System ..� 61. APPROVAL TO DECK � 7 t. Property Sewer �ine & House Cohnection : 62. Backwash & RecepiorFinal 12. Sewer Cap 63. Heater & Vent�Final 73. Roof Drains , 64. Plumbing System � Final . 14. Rmagh Piumbin9 65. Electrica��Final 15. Rough Electrical-Conduit 66. Sofar SYstem�Fnal � 16. Rough Electric Wiring 6�. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEPAS FINAL 19' Rou9h Neating & Air Conditioni�g FIRE DEPT. REQUIREMENT 20. Rough Fattory Fireplace APPROVALS Permit # 21. Duas,in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping �Gas ❑Oil 23. Gas Pipe�Rouqh & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil ,«, ' 25. Rooi Sheathing 74. Overhead Hydro %;�,�; 26. T-8ar Ceiling iStructuraq & Mo�ocoat 75. Dry Chemical '�- �� 27. Frame and Flashing 76. Dry Standpipe ' . �, 28. Lathing & Siding 77. FIXEO SYSTEM FINAL �"" ' 29. Insulation 76. FIRE PREV. FINAL �` � • 30. Drytvall Nailing HEALTN DEPT. REQUIREMENT 31. Piaster Brown Coat 79. F�NAL INSPECTION 32. Electrical Power MeterFinai 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � 34. Finai Heating & Air Conditioning -� 35. Final Gas Pipe-Test 36. Hood or CanopY r� / 37. Finai Factory Fireplace 38. Final Plum6ing 39, Water Service�Pinat 40. Gas Service�Final 47. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Aitenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILOING 48. FINALPLANNING �- 49. Electric Release to Edison ^ 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPRNCY No. Date ■ ( PXOJECT RDOHESS: % 1 O W 1 8 Z�H ST (IWNEN'S NAME: ROBERT TFIOMPSON ' � RODflE55: SAME AS AH�VE 714/828-3060 FflCH/ENGINEEN: flEC.NO.: ueiT: 23-26 ROORESS: UNIT: PENMITTEE: PFIIL DUNFORD (7i4?828-3060 aooness: 6141 ORANGE AVE �. CYPRESS CA 90630 UCENSEU CONTPRCTON OECU1BR710N: I hereby allirm ihat I am licensee untler prodsians of ChaD�er 9(commencing wiin Section 7000� a� Oivision � ol I�e Busineu antl Pmle55ions Catle. antl my license is in lull torce anU efiec�. LITY LIC.�:p STpTE LIC.: //�� CLASS: . ��¢� A—/'Ls��i L Signalure:�r' �� WOBKEflS' COMPENSATION DECIABATION: I �ere�y atlirm tlWl I have a Certifiwilof tonsen� IO 5e14insur¢ or a cetli�iCaie o� WOrkerS' Comoensation Insurance, or a certilietl covY �hereaf (Section 3800. LaE. C1. POLILY NO.: E%P. URTE: COMPFNY: .� cennieo caov �s nereby mrn�sned. ❑ CenilieE copy is lilea vnt� tAe ciry Builtling Division. Date: Appliwni: E%EMPTION FPOM WOPNENS' COMPENSpTION DECUBATION: Rhis section nee0 no� be completM ii tl�e permii is tor one AunUreO (5100) or less�. I certify ihat in ine pedormance of �he wark for whicn Ihis permit is issue4l shall not employ any person in any manner so as to hecome subjetl la Ihe Worker5' ComOensalion Laws ol Calilomia. N'� ' n ' ' 'ate: �l /LS /�j L Signamre: "�^� ��'�+�✓� NOTICE: Ii. after making �his aeclaration, you sAoultl become su6ject to ihe W ers' ComDensation pmvisions oi the Lahar CoOe. you mus� fotlhwith comply wi�� SutO provisions or IM1is permit shall be CeemeO fevoked. CONSTflUCTI�N LENOING RGENCY:. I hereDy a��irm Iha� ihere is a consimc�ion lentling agency �or ��e Oenormance ol Ihe work tor �� which Ihis permi� is issuea (Sec�ion 3097, Civ. C�. LENOFfl: ROOHESS: OWNEB BUILDEH DECLAPATION: I hereby allirm tAat I am eKempt Imm tAe Contractors' State Licenu Law lor t�e follovnng reason �Seclion 7031.5 Business an0 Pwlessional Cotle: Any Ciry ol coun�y wliich requires a De�mit �o con5�mci, ai�er, improve, OemoliSR Or repair any simcture. Drior m ils issuance, also repuires Ne applicant for suc� permit m file a signe0 stalement ihat he/she is licensetl Dursuam ta t�e pmvisions ot t�e Comracmrs' State License Law (Chapter 9(commencing wth Sec6on 7000) of Oivision 3 0l t�e Business an0 PmleSsionS Coee) or Ihal he/S�e is e�empl l�ertlmm an0 i�¢ Easis for �h¢ all¢pe0 eaempli0n. Any vialafion ol Stt�ian 7031.5 Oy any apPlicanifor a permil suUjecis ine ap0litantlo a civil penally al not more ihan five hundretl Oollars (55011). I. as owner oi �he pmpeny or dry emVloyees wit� waAes as their sole compensation, vnll do Ihe wone, anU I�e � simcture 6 not imenaeU or onerea lor sale �SecUon 70aa, Busineu an0 Pwfessional Cade: The Contractors' State Limnu Law eaes not apply to an owner ol a pmDerty wno builtls oi improves Iherean, antl who does such wark nimsetf/neRelf or IhrouOh �is or �er own emDloyees. DroviEea that such impwvements are no� intenaee or aifereA for sale. If, however ihe �uilAing or im0�ovemem is soid vniMn one year of comDletion, I�e owner will have t�e CurEen of pmvuig helshe Eitl not hui10 ar improve br t�e Durpose ol sale�. I, as owner ai �Ae Droperty, am eeclusively coniractinq wilh licensed contratiors �a constmct t�e projec� (Seclion 7044, 8usiness ❑ anJ Professims CaOe: T�e Convac�ors' State License Law does noI appry to an ovmer ol pmpeM � OUAtls or impmves ihereon anG wlw mntracis lor suc� O�aiects wit� a contractor(5) license Dursuani to t�e Caniractors' Stare Luense Law�. I am aware � t�at pmol of t�eir Worker's Compensa�ion insurance shoulE 6e pmNOetl to me. � � I am exem0� un0er Section: B. 8 P. C. lar Ihis red5on: � �7� �/� � �/ le: �` L 5�'i � Owner. �+� /Kfi✓12't// I tla �ereGy ceN�y �hai I am awar¢ oi anE un0erslana I�e repuir¢menis ol Cdli�omia Heal�h antl Satety ee Sections 25505, 25533, anE 25534 an0l�allor anyfuture GuitOing ocWpaniwill/vnil nol�circle one�nee0 to Comp1Y �� 5ai0 state cotles andihe repuirementstor a permii for conslmciion or modilication Imm I�e Air uality ManaAemeni DistricL Resitlential canstmciion aDPlica�ions are exempi from I�ese provisions. Date: ApDlicanl: I hereGy cetlity thai I �ave reatl ihi5 aOPlica�ion antl 51aie Ihai Ihe aCove iniormafion is wrretl. I agree Io tomply with all ciiy antl COuniy orAinaMes ana state laws relaling lo DuilEinq consimclion antl �ereby authorae represeNatives ol t�is ciry to enter upon Ihe above�mentione0 pmpetly far inspeclion purposes �/� � � / A Daie� ��LS�§ 2 Signalure: � �+y �`�/ oriver's �icense or Sociai Securitv a.� � 16GPa6 W�ite—Builtlino: Green—Coae Enbr<emenl: Canerv—Aoolicanl: Pink—Revenue; Goltlenrotl—Assessor CITY OF COSTA MESA — BUIL,DING PERMIT PERMIT NO; B 059254 PLAN CHECSt NO; N 1'tKM NU: tt U7yL�9 IaVV 1 j N SUYY; IV CONSTRUCTION TYPE; PERMIT TYPE: S'I'R PURPOSE: ALT JOB DESCRIPTION ; REROOF/REPLACE W/30—YR ASPHALT SHINGI.E SQ FT; 5,000 CLAIM VALUE: 5,000.00 CALC—VALUE; 5,000.00 GkOOP OCC; R-1 / COMMENTS: SMOKE DETECTOR RE�UZRED IN THE HOME �*x�*x�x�**�***��t*�*xx****** �xx****��t*�cx��***�t****�t�#*�*****�****�***�-�*x#;�*u�* 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 RUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT ZN REAR: FT IN FRNT; F1' IN REAR; FT TN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; rT IN PARItING REq • PROV; PARCEL: 42417410 ZNE; REF NO: PLANNING N(5'1'ES>. �1 ? 1F �1! lE �lk iE if IE iF if iE if 3f -%� iE !6 iF iE ik if iF iFlF #�lF iE if I(� K� # if� iE iF if ih i6 it ih iE IF i! iE iE 3F 1k �1! jf iElf ih iE i(� iE 1F if jE iF iF k ik if iF iE iF iF 3E 3F iE iE 1i;iE iE iE i6 # if� if iFiF 3E D E V�"'L O P M E N T S E R V I C E S R E Q U I R E M E Nf�' S ZONING APPROVEIJ BY DATE: o-. �� BUILDING APPRO;VBD BY : DATE; � APPLICATION ISSUED BY; DATE• •�7.d�7 — Y if�M�il�ihlE�f�3E�61EiFitlElhiE.!{�i(�ifiEi4ihlEiE tr. -fc . . . . . .r . . . . . iti4ifif�ifiE�EifiF9PiF fr ir !Ek i(�ifiEi(�iEit1EK�1EiFif�lc3t�IkiEiF�E�kifiEiflfl(�iE1E1E�lEiFfEiFiE1EiFlEIEiFil�i(�-7kif1E . iElf�lElfiFiFifif�lEif3FfEfP�E1FiFiE3Fififi6iF1F -lE�1FiElEi(�iEiiifiEiP LEGAI.IZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMHING ELECTRIC MECHANIC F�RE SMIP/RES/ GRADING PERMIT 72,00 50 �� SMIP/NON�RES PI.AN � % �y ISSUE F'EE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ' PAID �� DUE TOTALS----> "/2.50 0,00 0,00 72,50 i;- 72,50 r, .00 REVENUE DIVISION TOTALS--> COLLECTED; 72,50 OVER/SHORT; 00 BLD72P�MT� PLUMHING ELECTRIC MECHANIC FIRE SMIP/TO�T GRADING ��LAN—CAECK �9 1E iE iF if ik iE it iE ik �f iE iklF iF 3f !E!E �f iE * iE if it itif 1E 3E if ik �l(� iF iFiE it iE if iE iE �lE iE if iE if IF iE �E IE if iE 3E !E iElF iF ik iE itif 3E IE �f it if �f iE i! iF i��p�:iE .f if iF �F if iE IE ik I N D I V I D 0 A L E 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 _ �I'OT�,L C051' SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE �i 1,00 `�� ,000,00 END OF FEES � � , �/ . � ! _% ,.7 !��1•1 f • � �. �. . • ' . CONSTRUCTION AND PLAN ING � ` PG & SPA � ` }�PPROVALS Permit # � Date Inspector pppROVALS Permit # Date Inspector 1. Temporary Elecirical ServiceCr Pole - ��' S2. Poot & Equipment Location `,� �• 2. � Soil Pipe-Undrgritd�. .�,--' 53. Steel Reinforcement � 3. Elec[rital Conduit UtilitV•Undtgrnd: 54. Forms � 4. Electrical Conduit-Undrgrnd. , 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Rtumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAI TO COVER�GUNITE 7. Footings � 58. Electricai Conduit�Undrgrnd. 8. Foundation i 59. Gas Pipe, O Undrgrnd., Test � 9. Water 7ipe-Undrgmd. � 60. Backwash Linee, P�Trap, � Undrgrnd. ' 10. Structural Floor System 61. APPROVAL TO DECK i t. PropertY Sewer Line & HouseC�mnection , 62. Backwash & Receptor-Final , 72. Sewer Gap " 63. Heater & Vent-Final . �j 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 >r 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electripl�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping OGas OOiI 23. Gas Pipe•Rough & Test 72, Underground Fiush �24. Roof Framing 73. Under9rnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathin9 -� QZ, �,i 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame 8nd Flashing 76. Dry Standpipe 28. Lathing & Siding , � 77. FIXED SYSTEM FINAL 29. Insulation ; ,, 78. FIRE PREV. FINAL 30. Drywall Nailing � - ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � �� 79. FINAL INSPECTION 32. ElectriCal Power Meter-Pinal '--- �. 80. FOOD CERTIFICATE I$SUED 33. Final E�ectric i ;4 � Notes: 34. Final Heatiog & Air Conditioning � �- 35. Final Gas Pipe-Test ' �� 36. Hood or Canopy r �: 37. Final Factory Fireplace � � �, 38. Final Plumbing 39. Water 5ervice-Final � 40. Gas Serv�ce-Final � 41. Solar pomestic-Final 42. Backflow Preventer � q+ Q.�C�L.� K� /., J [� OG 43. Batkflo�' irrigation � ��, 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING J�yf.q FG,�( S�V �� 48. FINALP�ANNWG ��? �� _ ��f'=�V 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co � � � 51. CERTIFICATE OF OCCUPANCY , No. Date ACo��ant to till in all spaces ex<ept those within neavy boraer Ilnes ane sign all aop�ovriate tleelaralionz. CITY OF COSTA MESA CONST UCITION� /PERMIT . PERMIT NO. , TRACT NO. LOT NO. UNIT NO. Project Address � V,",1/ ST Applicant'sMailinpg Address1 �� •ry�ab �` Owner's Name T�n�C0.0 �I�c�p s��,.� ano�e � `6 � Addrpss ' Arch/Eng. _ License No. Address Contractor's Nam ' 'Phpne �.�%� Atltlress (ma �'�,1 �� %O i �r�<bL �'L � City License No. - LKENSED CONTRACTOR DECLARATION ' I herpby affirm that I am licensetl untler provi5ions of Charter 9(commencing with ¢¢�tion ]000) of Divislon 3' oi the Business and Profe551ons Cotle, antl i my Ilcense is in full forc antl eitecL � ` �} ' LlcepS¢ pass - � � � Li ns N. � Date � Signature VORKERS'COMPENSATION DECLAR 10 , heretiy attlrm that I nave a certificate of cons t to solt-insure or a certi(icate oi Wprkers'. Compensation InSurance, or a certifietl copy thereot (Section 3800, �ab. C:)f iJ Pollcy No. �r • � � Com anY � �� Certifie0 copy is he�eb fu/nisttetl. � Ce�tif" c i5 f' ilh the city Ling �ivi i rt. �Date��Aoo�+can � E%EMPTIO FROM WORKERS' GOM NSA ON DECLqRAT10N (Thissection neetl not be com0letetl if the permi (s for.one huntlretl (E300) or iess). 1 certi(y that in the periormance oi the work r which this perm�i is issuetl I,, znall no[ employ any person in any manner so as to become subject to tRe Workers' Compensation Laws of Califomia. , Date � Signature ' NOTICE: If, after making this tleclaration, you shoultl become subject to the Workers' Compenution provislons of [he Labor Cotle, you must forthwith comply wlth such Drovi5iOn5 or tnis pe�mit • Shall be � tle¢metl �evOketl. CONSTRUCTION LENOING AGENCV I herpby affl�m that there i5 a con5truttlon lentling a9ency tor the De�fo�mance- ot [he :work for which lnis permit is issuetl (Section 309] Civ. CJ . Lender's Name L¢nQe�'s AOtlress � OWNER BUILDER DECLARATION�- � ' I heteby affirm [hat 1 am exempt from the Conlractor's License Law for the (ollOwing reason (5ection 7031.5 Buslness antl Protessional Cotle: Any city or Couqty whi<h require5 a pe�mit to conSVuct, dlte�, improve� tlemolisM1 or repal� any ztructure, prior [o its istuance, also requires the applicant for such permlt �to ille a si9neA statement that he/she is licensetl;pursuant to the provisions of the Contractor'S License Law (Chapter,9 (commencing with SecHon �000)�of Division 3 07 the Business antl Psoiessions Cotle) or that he/she is exempt � therefrom antl the bazis tor the allegetl exemption. Any violation ot Section • 7031.5 �by any dpP��cant fOr a permit subjects the apO��Gan[ to a civil �endlty of not more than five huntlretl tlollars (E500). ' I, as owne� of the O��Pe�ty o� my.employee5 with wages a5 thei� Sole compensalion, will tlo the work, antl the sVuc[ure is not inten0etl or ofteretl � for �Ie (Saction ]044, Business an0 P�ofessional Cotln TM1c Conlractor's I LicepS¢ �aw tloes not apply to dn ownEr of a property wh0 bulltl5 or Improves � thereon, antl wno aoes such work �nFmself/heiself o� th�o�gn �is or her own .empioy¢es, O�ovitletl lhat such'improvements are-nol IntenEetl or ofteretl�.for Sale, If, howeve�, the builtling Gr imptovement is soltl wlthin One year ot com- pletion, the owner will have the burtlen of proving he/she aitl not builtl orim- �oy0 for the purpose of sale). I, as owner of the property, am ex�lusively contractlng wlth Ilcensetl com trac�ors to construc[ the pro7act (Section 7044, Business antl Professions Cotle: The �ontractor's License ldw doas nof apply to an owner oi property who bulltls or Improves the�eon, antl who contraMs for sucn projects-with a con- tractor(sl Ilcense pursuant to the Con(rac[or's License Law). I am aware that proot o( tbeir Wotker's Compensatlon insu�ance Shoultl qe provitletl to me. ❑� am ¢xempt untler Section � B. & P. C. (or this reason Datg Owner I-hBreby certity that ave r¢atl lhl i in�o�mation �s wrre . I�grBe to c ly o antl state laws rela ng t bWltlin onSVu sentatives ot t' "ty o ente on tt Inspection pur se � Si9�ature � Driyers' L ense or 55 �' CMF a865-46, rev. 4/84 it¢ - guiltlln9; TVPE OF CONSTRUCTION LJ NEW LJ ADD U ALTERATION L2�REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCjPjPTIONOFWORK/USEOFBLDG. ��G�1�° -T—IR� i�(' �_L � TYPE OF PERMITv LJ GRADING ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCRIPTION SO.FT._ CONSTRUCTIpN TVPE VACVATION $ GRADINGCU.YDS. ' AI 1 FOUNDATION I�i STRUCTURAL PLUMBING ❑ MECHANICAL. Remarks: ( : � Bar Sink � ' Backflow�Preventer Backflow Irri9ation 6athtubs Drinking Fountains Floor Dreins Floor Sinks " Gas Service Outlets Interceptors Kitchen Sink lavamries , � P—Trap Roof Drains c- Reinspeetion Fee $15 Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ F irepl/Fact. Blt. I CBO ;4`- Heating System & Ducting ❑0.100,000 BTU 0100,OOOBTi �% I I Reinspection Fee � I $15 r qppllcdnt; Pink - Accoun[in9: Goltlen�otl - Assessor �Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank , � Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee A.P. #t S Main Building: E T Front ARear C Ri9ht g Left Ping. Ref. # Planning Notes: Automatic Washer - - Constructior Pole Sub. Cooking Unit Dishwasher 6169 a/13/Fl4 Zone ELECTRICAL . Transformer ❑� 15=50 KW ❑ 50+KW Dryers �Gas ❑Electric Fan' � ' F.A.U, Fixtures- _ - Device Boxes � - Outlets Switches „i, V Garbage Dispoul Generator �0.5 KW �5-15 KW $ 3 0 Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel � � Motor5�0-1 HP�iX'-�B I na Solar � 9J 5 HP � 16- Microwave — Pole Light Fange Sign Standing Sections � Trash Compactor IANICAL � - FEES Reinspection Fao $15 Issue Fee . DEVELOPMENTSEHVICESREQUIREMENTS: Hood or Type I' Q- ' Zoning Approved By Canopy Typell ❑ Building Approved By ,� � , Refrigeration System ❑0-100,OOOBTU ❑100,000 System Fepair/Alteration luua Fee � $ 3 N FEES $ 3 � �SUM/M� �V `O^F FEES BUILDING PEfiMIT $ —� y��''J'� SMIP $ ' `SQ PLAN CHECK � $ � v � ^� PERMIT PLUMBING 5 oS (JO ISSUANCE $ PLAN CHECK �25% $ ENERGY P.C. $ ELECTRICAL $ GRADING ' $ �� P�P,N CHECK 50°6 $ MICROFI�M $ G � MECHANICAL $ TOTAL FEE $ 78.9� . PLAN�CHECK �25% $ . Z O N I N G R E Q M T S. � CONSTRUCTION AND PLANNING R.. POOL & SPA ' Date ' Ins ector " APPROVALS Permit# P APPROVALS Permit# Date Inspector �� 1. Temporary Electric8l Service or Pole , '� 52. Pool & Equipment Locstion , 2. Soil Pipe-Undrgrnd. � ,.. 53. Steel Reinforcement • �"` � 3. Electrical Conduit,Utility-Undrgrnd: 54. Forms ' 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding - ' � 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7. Footings - � . 58. Electrical Conduit-Undrgrnd. . . „ B. 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. Property Sewer Line & House Connection �� 62. Backwash & Receptor-Final _ � 12. Sewer Cap . - " ; 63. Heater & Vent-Final 13. Roof Drains _ � _ 64. Plumbing System - Final . 14. Rough Plumbing � �� 65. Electrical-Final ' 15. Rou9h Electrical-Conduit ' � -66. Solar System-Final ' 16. Rough Electric Wiring - , 67. Fencing & Access Approval 17. Rough Wiring Sign' ' . 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro � 22. Ducts, Ventilating � 71. Produci Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test ' 72. Underground Flush 24. Roof Framing • ' 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 ��B ��Lj��''� �r/� 76. DrY S[andpipe 28. Lathing&�Siding 77. FIXED�SYSTEMFINAL 29. Insulation , ' 78. FIRE PREV. FINAL � 30. Drywall Nailing g� ff (f/Z5�8�f G�cl9 . HEALTH DEPT. REQUIREMENT 31..Plaster Brown Coat � 79. FINAL INSPECTION . , � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �g � ¢ b •K. r! 34. Final Heating & Air Conditioning .,V� p p/N -� 7io.�.lS, �s A : G. 35. Final Gas Pipe-Test � y3�h'� `//J 36. Hood or Canopy � ' ' 37. Final Factory Fireplace ' - 38. Final Plumbing ��'L�jy (�i7 � 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. FINALSTRUCTURE&BUILDING � ' 48. Special Requirements Completed . 49. Electric Release to Edison � �� - 50. Gas Release to Southern California Gas Co � � � 51. CERTiFICATE OF OCCUPANCY � _ No Date � n rx�.zcr AOnflEss: '7 S O W 18 TH ST owHee•sxune: ROBERT THOMPSON RODflESS: SP.ME AS ABOVE 714/828-3060 RflCHIENCINEER: IIOOHESS: xEa.xo.: uxrt: R�C. uxrt: PEflMIfTEE: PHIL DUNFORD ( 714 ) 828-3060 �ooness: 6141 ORANGE AVE 1 CYPRESS CA 90630 utExSEo CONTMQOB oEeuMnON: I nea0y anirtn tnat I am IlcenseE uMar o��s a� �D�er 91�mme�np wltn Sectlon 7000) ol Oivision 3 ot ttre Buslnass aM Professions Cotla, an0 rtry licensa o In tWl Iwce aM eXact. cm uc.: sT�re uc.: cuss: Oate: S�O�aNm: WOHKEBS' COMPENSATION OECIAM710N: I �amEy atlirm tlwt I Aava a arliliwte ol consent to sU4irrsum or a caAficaro ot WOAera' �penution I�tturance. ar a rertilie0 copY ��ereol (Secuon 3800, LaU. C�. ,CY NO.: EXP. WTE: I�roMr�xr: ❑ CertlfieE coDY a��eby Iumis�eE. ❑ CeNfieO copY Is fileO vni� Ne ary BWENp Oivison. Oate: MD�� E%FMPfION fAOM WOfll�f13' COMPEN311TION DFClAMT10N: (flos ut4M Metl not Ee mn9kfe0 A tle D�� h ta ane hutlrW (f100) m 165�. I ceNry tlut in t�e peAorma�e ol t�e work lor wAkh t�is Dermit is issued, l stwll not empby a�ry person in �m/ �wnner w as to Eecome subl�< <o tM /Wa•rken Campemation Lavrs of Califomia. �/�� Oaie: �T[�a �4 o SlpnaNre: � ^"� � NOTICE: If, aller maldnp tttis UecWratbn. you shauW Gacome wUjecl to Ne Worke ' Campewtiwi prwisions ol IAa LaEar CoOe. you must forthwiN mnply with 5Wi DroWsians or tliia permit slwll Ee EeemeA rewke0. • CONSTIIUCTION IFMDING �CENLY: I trereDy amrm Ihat Ihere I5 a coirstructlon IeMinp apen�y iw Ne pertwmarrce al IM xrork tor whiCn Uus permitis �stueE (Sactlon 3097. Gv. q. lENOER: �ooxess: OWNER BUItDER DEClAN1TI0N: 1 �ere0y amrm Ihat I am axemD� �rom tM Cont2cton' State Llcensa Law lor ttw I011owin0 reason (Sectian 7031.5 Business aM Pro'essional Cotle: My ciry af rnunry wliic� reQuira a perimt to constnn.M, aller, imprwe, Oemolis�, or ' rtDv� �Y structure. D�� ro its issuanw. aLto reQuuu t�e apD�� or suc� permlt ro fJe a sipne0 statemant �lu� �e/slia is IicensaE pursuant ro W prodsions ol the Convactars' Slate License Law (CMpror 9(comrtcendnp wlin Sectlon 7000) al DivNon 3 at Ino Business an0 Professiax COEe) ar Wt IelSM L5 exemD� �erefrom an0 Ihe EasLs lor t�e allepW exemD�� Y'�� ol Sectlon 7031.5 hy airy ap0� lor a permil subla� � aDW�t to a cfWl penalry oi not mom Uun tWe hunErW Eollars (:�1. I, a mmer oi ure v�RM � 0. �Mu ao Iha vrork, ane the swclure's ro� 4rte�e0 w otlereO lar sale ( tian 70C4. Bu nass an0 Profex4onal COGe: Tlre Contraztors' Stata Lkense Law � Eces not appy lo an a+mer ol a D�VenY � �uilQe or imprwes tMreon, aM wtn tlaa suc� work MmuAl/hersell or I�rouph Ns or Irer v.m employees, prwiOeC Ihal such ImD��'emrnts are not InteMW or atlerN lor sale. 11, tnwaver I�a OUIICinp or imD�mem u sdd witlun me year ol mmpktlon. the owner xill have Ne EurUen ol prwinp �NSLe NE not EuAtl ar ImDrove for ttx purpose ol sale). I. az owner oi Ihe 0��. � exdusWeN conVactinA'�'it� IicenSeE contracWrs to consWct Ne Drol� 1�� 7044. Busineu ❑ aiM Rolessions CoEe: e Contractors' Sute UUMe Law Eces not apqy W an wmu al property wtn adl6a or Imprrnxs Ihereon anC who contocts lor wUi D�W�s c�N a conUazta(5) Ilcensa Dursuant'to IM Cantractors' SWie LJcense Law�. I am aware ttwt proof ol ttrcir Wohsr's Compenstibn msuranm s�oul0 be provNM to me. � I am exemD� under Sxlian: B. d P. C. tor this reason: r'"l�L� �4 a Qwner. �.v �2sw� Oaa: I Oa nereoy ceniry that I am aware oi an0 unOeretanE the reQuimmanis ol Calilomia Heatt� an0 S��ery e SMIIp15 25505, 25533, 00d 25534 anE that I or any fuNre UuilOinp occu0ant willMill not (circle one) neeA to compy vnth uiA state wEes ana tAa maWremants for a permit lar mnstruction or rrwai/iwtion Imm t�e r ualiry Manapement Distdct. ResiUentlal construction applications are examp� Imm Ihese Orovisions. Date: MO�� I hem0y certiN �t I Aave reaE IMs apDuwtbn and state Ihat tAe ahova Informatlan I5 mrrxt. I apma to wmply with ell clry anC counry or0inances anE sGte laws alatlnp to OWIEInO wnsWctbn an0 hereby authorize apresentatives al Uus dry la enter upon Ihe above�mentloneA properry lorinspecibn purpases. Date: ��Z"�r� Sipnatura: � � oriver's �icense ar Socia� Secunry x: 18at-a6 W�ite—BuiWi�; Graon—CaEe Enlorcemam; Genary—npOfcam; Yink—Hevanue; tiaoenroo—weaemoi � CITY OF COSTA MESA — BUILDING PERMIT PERMIT NU: H 049095 PLAN CHECK NO: N CONSTROCTION TYPE: PERMIT TYPE: STR JOB LESCRIPTIUN : REROOF/REPLACE W/30—YR ASFHALT SHINGLE PERM NO: B 04909� GOVT: N SUPP; N PURPOSE: OTH SQ FT: 950 CLAIM VALUE: 950,00 CALC—VALUE: 950.00 .GROUP OCC: R-1 / COMMENTS: *� � *��r�r��r�r*�rx*��#x**��r�r�t**�r��r*�***��r*�r*�r�r*��r+r**�r�rxx�**�x#******x�*�r*�#+�*�**#*#***� Z O N I N G R E Q U I R E M E N T S s s T B a c x s ----------'-- MAIN BUILDING ---------- --------- ACCESSORY BUZLDING --------- 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: 42417410 ZNE: AEF NO: PLANNZNG N TES> > �r�#*#*****��*�r*�****#x�x###�r�u*�#�**�r�*x�#u*�**#��r**�t*+�+�trx#***u�r#��c�*ce�*�*�*�r*�� D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T; S ZONING APPROVED BY DATE: ', n BUILDZNG APPROVED BY : DATE; � � APPLICATION ISSUED BY; � DATE: �'�T /��9 D itifik###itiEiF#if###ikitif#ififiEif ve , ik#i4ilfl�IF##�1tiF�'IFi�'��iEi6 ifMiEi4�ki!#ilifiEff#3t#itlEiFik#ifffiFlkifitiEiEiE#iEiEiFikiFiEifi:�iE##iE#iFiE�kifiE3EiklkffiFilif#ikitikif#iflFiFiFif�kifiEifif#iElEif!l�iF##� LEGALIZATION:N F E E S U M M A R Y STAUCTURAL $EGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RE�S' GRADING PERMZT 25.00 .SO � PLAN SMIP/NON—RES ZSSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 25,50 0.00 0.00 25,50 25.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 25,50 OVER/SHORT; .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FiRE SMIP/TOT GRADING PLAN—CHECK ZS,�� ,5� YE i! i! i! �E iE iE ik iE iE jE it ik iE it iF 1E i! iE ik iE ik iF iE 3E iP 3f !f iF # 3E?F ik # ik iF iF jE � 9E iF if it iE iE if iF it if iE if iF ik iF �f if if ik if iF ik iE iF iE IE �E iF ik iE if it if if ik ik iF iF 3E iF 2 N D I V I D U A L F E E B R E A K D O W N TYPE ��oT.l QTY 950 D E S C R T P T I O N REROOF HY VALUE RESIDENIAL NOZONE END OF FEES ONIT COST TOTAL COST 1.00 950,00 � v 01 000700d2-pQp?pL`bz TCD7' -r, DATE: 04�7Non rTnc. ��.�-, =�^� � CONSTRUCTION AND PLANNI� JL & SPA ' APPROVALS .Permit# � Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Feinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrqrnd. 55. Elec[rical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Wa[er Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. . 10. Structural Floor System - 61. APPROVAL TO DECK • 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . � 12. Sewer Cap 63. Heater & VenrFinal - 13. Roof Drains 64. Plumbing SYstem • Final 14. Rough Piumbing 65. Electrical-Final 15. Fough Electricai-Conduit 66. Solar System-Final 16. Rough Elearic Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING � 18. Rough Elecirica�-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing . ' 7q. Overhead Hydro 26. T-Bar Ceiling (S[ructurall & Monocoat 75. Dry Chemical _ 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM fINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Platter Brown Coat 79. FINA� INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 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. So�ar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. l.andscape �rripacion System 45. Sound Attenuation 46. Handicap Regulations .47. FINAL STRUCTURE & BUILDING �0-j' � 48. FINAL PLANNING " 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date Aoplicant lo fili In all spaees axcao� tnosa within heavy eoreer Ilnas ana slgn all aDorov��ate aeclarations. �CIT�Y. OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. _ 9 ' TRACT NO. LOT NO. .. 11N1T NO.. ____ �fect Address �%/0 �• /Q�!- a/'j/L '�av%Z //t It�, 'pplicant's Ma�ling Address �0. �6 w cSb 9 �f{�/Kr �4. %�LY Owner's Name �ade�' � /— � � Phone g� 3p6 Address �r� [�'G-.7s /�✓� �/$ �t�,?/Fd'J � �01.2 Arch/Eng. License No, Address Contractor's Nam dµ-"� er u� � �� Phone Address (mailing) Ciry License No. LICENSED C4NTRACTOR DECLARATION I he�eby aHirry� Ihat I am licensatl unde� provizions of Charter 9(comTencing with section 7000� of olvision 3 oi tne Businezs antl Prafessions Cotle, anG my Ilcense is iry full force antl efiect. lJcenS¢ CIa55 Licensa NO. Date Signature 'ORKERS' COMPENSATION DECLARATION .iereby affirm tha[ I have a certilicate of consenbto selt-insure or a certificate of Wotker5' Compensation InSurance, or a certilietl <Opy thereof (Se<tlon 3800, Lab. C,) Policy No. Company Certitietl copy is hereby furNshee. Cerciiletl copy is tiletl with the city Builaing Division. Date APPlicant EXEMVTION FROM WORKERS' COMPENSATION DECIARATION (This section neetl not be completetl if [be permit is for one hunGre� (E100) or less). I cerlify that in tbe p¢r(Ormance Of the work f0/ which tbit p¢rm�t is ISSuetl, I snall not employ any person in any manner so as to become subject to the workar rr� e tion laws o1 Calilo I �J Dato 1 �"7�� 5�9�ature �/�� NOTICE: Ii, alter making this tleclaration, You shoul etome subject to the Workers' CompensaUon provisions ol the Labor Cotle, you must Porthwith I compty wllh such provl5ion5 Or Ihis pCrmit snall bB tl0¢metl r<vOkeO. CONSTRUCTION LENDING AGENCV � I he/eby alll�m lhat Ihere IS a Const/uctlon IenAing agenCy fOr t�e pertOrmance of lhe wark tor wbich [his permil is issuetl (Sectlon 3097 Civ. C.) � Lentler'z Name Lentltr's Atltlr¢ss OWNER BUILDER,DECLARATION ' 1 nereby atfirm thaf I am exempt irom tne Contracror'S LlctnSe l�w for the lollowin9 reazon (Sectton ]031.5 BuSineis anU Professlonal Cotlo: Any city or county whicry �equires a pe/mit l0 cOnsbuct, al[er, improve, tlCmolish or repair any'sl�uGlu�e, prio� lo it5 ISSIldOCO� d1T0 fCqW�¢S LIIB dpP��<d�t 10� SUCII pe�rt�it l0 Ille a Sign@tl statement lhdt ho/She Is IlcrnS¢tl pursuant to �he P/ovi5ion5 ot he ContraClGr's UclnSe Law (Chapter 9(Comm¢nCin9 with SOCtlon 7000) of IviSion 3'of the'Busine55 antl ProfesSiOns Cotle) or Ihat ho/Sho Is ¢xompt neref�om dn0 thC ba5i5 t0� tho allegetl GxCmption. AnY v101dtion ot Section �I 7031.5 by dny ap0�icant tor a pormit subje<ts the applicant to a civil �efally ot not more than /ivo �untlrotl tlollars (5500�. p9 1, az awqer of lhe OropMly �- License Law tloes not apply to an owner of a properry w�lo bullas or improves Ihoreon, dn0 wh0 does zucn work nimselt/herself or tivpygh b15 Or he� own employae5, prOvlU¢tl Ihal SUCh ImprOvements are nOt InlentleG O� ot1¢r¢U to� SdIC. II, hOwpvEr, the builaing or tmProvomunt is soltl wilhin ona year of com- p18UOn, lho Own¢r, wlll have tba bUttl¢n ot prOving he/She tli0 nol builtl or im- �rove tor tne purpose o1 sale). LJ I, as owner ol the property, am exclusivery tontractinq with Ilcensetl con- [�actor5to ca�st�uct the project (SCclion 7044, Buslne55 dntl Profeisionz Cotla: Tha Contrac�or'S Licensu Law does nol appry to an owno� 0/ P�op¢rty who builtls or improves thereon, antl who conVacts for su<h projacts witn a con- tractor(s) I¢Qnse pursuan[ [o the ContrdttOr'S LlcenS¢ Ww�. I am aware [hat prool of thelr Worker's Compenution insuran<e snoWtl be proviEetl to ma. ❑ 1 am exempt untler Section B. & P. C. tor this reason Data -�/V�� Owner /� • I hereby cer(�ly that I have reatl this appl inbrma[ion is correct. I a9�ea to compty wi antl slate IaWs relating to Ouiltling conslrucl Sen[dtives ot this city to ¢nter upOn the inspection purp e �� / / Si9na[ure �w✓�•✓' Driverz' Licehse or 55 � 'tata that th¢ abov¢ tl county ortlinances e�y authortze repre- lonetl pro ¢rty for DdiG Z � TVPE OF CONSTRUCTION LI NEW U ADD LI ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,p, y�6 DESCRIPTION OF WORK/USE OF BLDG. ��F•� ^'�^ J—�s�'�f S Main Building: E TVPE OF PERMIT GRADING FOUNDATION STRUCTVRAL T FfOnt ❑ TENANT ❑ EIECTRIGHlL ❑ PLVMBING ❑ MECHANICAL B Rear � OTHER �mo"/7� p' PROJECT DESCRIPTION 5�. FT.� �� OCCUVArvCY K Right COfVSTRUCTIONTVPE VA�UATIONS�-OOO�- g L¢ft ZONF_ GRADING CV. VOS. ACRES p�ng. Ref. # Remarks: �o� o� q �/fj � fyG- Plannin9 Notes: Bar Sink Backflow Preventer Backflow Irrigation Clerifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavaiories Roof Drains Reinspection Fee � 515 Boiler Duct- Under GrOund Duct - Structural Duct - Ventilating� Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ a i oo.000 eru O i oo,000 Reinspection Fee � S15 CMF 0865-46, re�, 10/84 White - Bulltling; Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor Service Sink Sewer Cap Sewer Connettion Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Treys Isue Feo Haod or Typcl ❑ CanOpy Typell ❑ Refrigeration System ❑o-iao,aooaTu ❑ioo,000 System Repair/Alteretion Fire Dampers Registers Issua Fee r S 3 $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW � Fee 5619 2/23/88 Zone Accessory Building: Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW ' Meter LJup to 100 amps Meter ❑over100amps Sub Panel Motors �Pl HP � 1'f. - 8 Inc.Sola� 09�15 HP 016-75+ Microwave Pole Light Range Standing Sections 5 KW Trash Compactor $15 Issue Fee DEVELOPMENT SEFVICES RE�UIREMENTS: 2oning Approved By _ Building Approved By _ " _ _ / 1 : BIo3G TL FEES $ 3 Z O N I N G R E � M T $ SUMM HY FEES %� � BUILDING PERMIT $ �Q� SMIP $ � � " PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE S PIAN CHECK 25% $ ENERG�' P.C. S � ELECTRICAL $ GRADING S PLAN CHECK 50% $ MICROFILM S p MECHANICAL $ TOTAL FEE $ D � � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL & SPA �"" -- - APPROVALS _ Pern7it,# Date Inspector qppROVALS Permit # Date Insaector a• 1: Temporary Electrical,'Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE . 7. Footings �� ' 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent-Final 13. floof Drains 64. Plumbing System - Final 14. Fiou9h Plumbing 65. Electrical-Final 15. Rough Electrica�-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .. 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush :ij� 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil ,G 25. Roof Sheathing �s G'-, • 74. Overhead Hydro � . i�26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � �Y� . 28. Lathing & Siding 77. FIXED SYSTEM FINAL ��.: 29. Insulation 78. FIRE PREV. FINAL '�� ., 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �. •<i 31. Plaster Brown Coat 79. FINAL INSPECTION ,- �� 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -�� 33. Final Electric Notes: 1;:. 34. Final Heating & Air Conditioning C; 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final . 41. Solar pomesticFinal � 42. Backflow Preventer � � 43. Backflow Irrigation ' 44. Landscape Irrigation System , •45. Sound Attenuation 46. tiandicap Regulations 47. FINAL STRUCTURE & BUILDING �� , 48. Special Requirements Completed 49. Electric Release to Edison � � 50. Gas Release to Southem California Gas Co 51. CERTIFICATE OF OCCUPANCY ,/ No. Date � .J ,�+ r. '` • I V'�./� . `� • CosrA MESA BUILDINGSAFETY DEPARTMENTC r. o. eox s�y coarw Meew. cw�,�ro�wu For Applieani to Fill In Compleiely TYPfi OR PRINT MESA CALIFORNIA ox iz�co. _ Z � TE^. EXIBTING BL�G BC�BAGK LIN6 FROM � I,i� FEE RECE?UED � FINANCE DEPT. nPa�iCn7ior��4Rp�eg�TA MESA BUILDING For Office Use Only AHCHIPT NO. I�MI�� / 5 ,�� I JAN �e��o2 I o�re �sa�� . Pn.. @�. BUILDING � J 3'r.'G COSTA ME6A. CALIFORNIA . ZON —� f_ I NO. OR � I UB8 OP H8 T PL�M9 B111LDIN0 � �� co. Ga� 6oy NewPo�7- oescxtvr�oH NOW ON LOT O A P. N[f I I B� I Q 7 �� I O � i�i� %i Bi�l� I IP,TION OF WORK 16 ZE �NG 7/ J/� V NO. OF � {O �� l0 O ROOMS STOR �EXTERIOR WA{,{, AOOF ///�O COVERING 1'%f/GGG� I GOVERING /G.. USE OF BUILDING AND WORK TO BH PERFORMED �Z 1 HER6BY ACKNOWL6D08 TNAT 1 HAVB RBAD TH19 APPYGTION AND BTATE TXAT THC ABOVE IB CORRHCT AND AOR[8 M COM- PLY WITX ALL GITY OPOINANC89 AMD 9TAT8 L�WC R8O TINO BUILDINO CONBTRUCTION. /p/ /� 81GNATURE OF� /��C�l69ZO1QA�[ i AUTHORIZED AGENT ,% I�MLR LIN6 9T.] /J � FRONT � � FT. % IN. � R.SIDE �� FT�� IN. � L. SIDE 3'3 � y�FT�.� �� IN. REAR �O -�F`Tr. IN. BYPNOVED ��R�� DATE I z�I Z-/NI HOLD FQR SPECIAL REQU[REMENI'3� Install sidewalks around the peri- meter of this project under the direction of the City I�inee�. THE AMOUM BHOWH UNDBR VALUATION IS POR TX[ PUPP09[ OP 68TAGL19HIN0 A PeRMIT Pi8 ONLY. VALUATION ' PERMIT FEE $ �-- v �6 � a $ �`!gf �I� PLAN CHEGK $ �'- �� TOTAL FEE � � I _ - `• � i soss C05TA MESA BUILDING-SAFETY DEPARTMENT P. O. BOl( 917 COSTA M68A. CALIPORNIA ' For Applieanf fo Fill In Compleiely TVPE OR PRINT ADDRE'88 /�� S � /�C�iT COSTA MESA, CALIFORNIA � � AR,. r� 6TATE r�� 9 `L TEL. IIC. NO. NO. SIZE �J �,Y�x �OO / I No. o! OF LOT N•K� NOW OI USE OF �� EXISTING BLOG B6TBACN LINB FROM � = !�� ,%%I of � �� A�-�T /�L� IPTION OF WORK 61ZH �rvc• � 7��f- 7i rvu. o� ROOME EXTERIOR L ROOF COVERING�Y��i� COVE U6E OP BUILDING AND WORK TO 1 HEPEBY ACKNOWLEDOB THAT I XAVB RBAD TXIB MPYGTION AND BTATE THAT TH8 ABOVE 19 CORRlGT I�ND AOP88 TO GOtl- PLY WITM ALL CI'(�' ORDINANC68 /� D BTAT[ lAW6 R[OULAfl[� 6 OUILDINO CONBcT$(1GTION'� � �` SIGNATURE OF \> U � � �. �. „ � �'FEE RECEIVED � JAN 1967 FINAN�E DEPT. 1�� CfTY Of COSTA MESA �APPLICATION FOR PERMIT BUILDING For Offlce Use Only RBCHIR NO. P R6GBIYRD_9Y � DATB R8G61V8D � DATB 198U6D COSTA MESA. CALIFORNIA �� APPROVED ZONING ZONC NO. OP �j U86 OP N6W ! %i�y PLANB L BUILDINO RG �eo�� fn -�e7' lo oy �{/� �lp� T/; DPBCNIP�ION „ e .,,, //6 — /oy —/o (GHM[R LIN6 6TJ Q FRONT � Z� FT. V� IN. R. SIDE �� FT. � IN. c L.SIDE "3 � FT. IN. REAR �a FT. IN. APPROVED 1 Z i 2 BY '�RA.f . DATE / �6 � t10LD FOR SPEGIAI, Ct�F�Q�� ,MENT� Q' � /� � 2' � -� �-�%Q !�'C�li'�- D� / ' � � �. . 'TX8 AMOUNT BXOWN UNOBR VALIIATION 16 POR THe PUPP098 OR eBTABLI8HIN0 A PBRMIT PEE ONLY. VALUA710N !�/ `D PERMIT FEE $ / L� iS S � � � /� PLAN CHECK $ ��j, � , . �� / FEE RECEIVED �f JAN 4 1962 COSTA MESA BUILDING-SAFETY DEPARTMENT � �� fINANCE DEPT. P. o. ao= g,� GOBTA MHBA. CALiPORN7A � C1TY OF COSTA MESA For Applieanf fo Fill In Complefely I APPLICATION FOR PERMIT TYPE OR PRINT BUILDING BUILDING / � � T ADDRE88 ( cos-ra ESA, CALIFORNIA For Offlce Use Only oWNER � i 1 RecCIPT No, veN�iL!/[;.� j IV �JL{t% MAIL RP � UOX '�(� MC�IVED � OATC ReCEIVEO DATi 188YCD A�ORE6S I dHfV 3 1962 •�+�V E ,a.-.. �� . _ . � TEL.�� _ nnnmvn �' 2�Z7 U. S�ZE � , x • OF LOT USE OP � EXIBTING BLDG. 9HTBACK LIN6 PflOM � � � NO; OP BLCGl. '� ILEFT C�-�� M� �VT/✓ DESCRIPTION OF WORK I ALTERAYION I IIADDITION I I IIMOVING I IIDHMOLISH I �' X J�' NO. OF �7 ROOMS 6TORIES C/ �l�CLIJ I COVERING ' /� ILD�NG AND WORK TO BE PERFORMED L�_ i� - /I df�T � � COSTA MESA. CALIFORNIA ZONE TYPE {/ GROUP /.7 � '1 APPROVED \ p BY OATE � ZONING ZON6 (J NO. OP �J UBC OP N6W =�A/�rl ¢ � R—_I I PLANB (.., I BUILDINO/(� (a �ew� P.� oeY' oY �I /I�'/ /J � DEBQIIPTION r� " '�4� T'1, � I� V� A. P. NO. I � �� JOy �I6 YARDS EVES _ 1 ` , APPROVED ALLOWED ' � , IC6NT[R YN6 8T.) p.�,, t�� FRONT ZI FT. '�""�"'� IN. R. SIDE 3� FT. � IN. L.SIDE �2y� � FT. "��y`*��..., IN. REAR �`O FT. "- '-"� IN. APPROVEO , /� � Z � / Z/6/ BY N/�J /C B�p DATE H04D FOR SPEC�wL ltcQU�htMcri'1'Yr .iCe fltrn.� � 7v♦ ��"4 . //Y •• / L•� iLLt i . � f{i 1 HEReW ACKNOWLEDGH THAT 1 HAVE q6AD TXI6 APPLIGTION {H¢ AMOUM 9HOWN UNDHR V�LUATION 1! POR THH AND BTAT6 TNAT TXE A60VQ IB COPA6GT AND A6R6H TO CON- pUliP08Q OP EBTAlIJBHINO A PCI411T Pg6 ONLY. PLY WITH ALL CITY ORDINANCH9 AND 8TAT8 LAWB RlOULATNO BWLDINo coNBT�{f N. ' VALUATION SIGNATURH O�/ � PERMIT FEE $ � r C� C PERMITTE � �'Y �� / // y / i�7'� $ �i � /' P�qN CHHCK $ �X�.�LS 'AUTHORIZED AGENT ��% �� , ITOTAL FEE S �1.�•�G I� . - � eso� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MBBA. CALIPOflN1A For Applicanfi fo Fill In Compleiely TyPE OR PRINT " BUILDING �� ADDRH6H COSTA, MESA. CALIFORNIA �� 2i z 7 !�• ,�/A-i,u 7 Zy TEL. NO. /�� / I NOW ON LOTB O BHiBAGK LIN6 FROM CENT6R OP 9TREET � I DESCRIPTION OF WORK °� �,.e.« Z WORK TO BH PERFORMED II H8R6BY ACI(NOWLCDGg TNAT 1 HAVB R6AD TXIB APPLIGTION ANO BTATH THAT THE AdWE IB GORRlCi AND AOR6E TO CAN� PLY WITX ALL CITV ORpINANGE� AND 8TAT6� W! PBQOqTNO BUILDINO CONBTRUCTIOtl. � IAUTNORIZED AGENT �/ / ///L"/J�/"`^ FEE RECEIVED Q � �,% JAN 4 1962 �j �� fINANCE DEPT._ � CIiY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Offiee Use Only aeceirr NO. PeR � ��o a. I JHN ��sa�,� °,",;n, �ia�soo� �i COSTA MESA. CALIFORNIA ZONING ��y D f ,-_ zoxe� _ y I po,.µoa I U68 OR NEW b�qnn cc z. euuoinc /i6c�,��,.,T �ew� Po� ,Pv1`' G a e/ ./�P%' /�1�^.i TR. DEBGRIPTION � _io<i— io A.P.NO. /J YMDB EVES APPROVED ALLOWEO (GEM6R LINB BT.1 FRONT �� FT�e�' IN. R. SIDE /O FT. IN. L SIDE �� FL U IN.' REAR � � FT. � IN. B PROVBD ��,(m�� DAh I7� /� i IC� •svry tIOLD FOR SPECIAL REQUIREMENT9 �/,' n l7 � ; �C�. /�e..;,,j�/�1 /1�ly �/�', �u•�S,Y � � THE ANOUM BHOWN UNOER V�LUATION 19 POH TXe .]UPP088 OP C9TABL19HIN0 A P¢RMIT �HC ONLY. VALUATION �J J� S ��(/ � PERMiT FEE $ f0�y47 // � �� PLAN CHECK $ i/ �'� J � " ( 6083 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 C08TA MEBA. CALIPORNIA For Applicanf io Fill In Complefely TYPE OR PRIN7'%/0 k/. /P�3; BUILDIN ADDRHS COSTA M CALIFORNIA �� 6TA'fE / '7 TEL. - � � I.IC. NO. �� NO. SIZE � / � No, o/ BLD66.O OF LOT iC pO NOW OH lAT USE OF � EXISTING BLDG �� fiBTBACK LIN6 FHOM � /CF /Y�' /Y'/I DESCRIPTION OF WORK ,euaowG%! �X / size Ce0 ERING A GGOI ROOF //_C�/ GOVHRING '+v �� U6E OP BUILDING AND WORK TO BE PERFORMED L � . - A-,�Ts� �EE RECEIVED. / JAN 4 1962 �1�/� �FINANCE DEPT, CITY OF COSTA MESA / APPLICATION FOR PERMIT. , BUILDING ' 2•j�_L1 �, For OM1ee Use Only ' R8C81PT NO. P{�Tryp� Q kC 811IfD BY � DAT[ NECEIVED � OATB IBBU6D cosra rnesa r�ee ' ZONING ZON6 NO. OR U66 OP N8W � � _y. I PI.ANB � BUILDINO �a.� ou �6ey ,�� TR. OHBCpIR10N A.P.NO. II�O '�,i% ` � /� YMDB EVES APPROVED ALLOWEO (CtM6R LINR !T.) ��_ \ R.61DE �� FT. �� IN. , � L. SIDE z' �� FT. IN. Z3 � REAR FT. IN. � APPROVED �/1 DATE � �"I/ L�C/ BY H� HOLD FO SPECIAL RcQUIh�MENTY ,��,, f/��''-�- p`'-,�y-�i '�! .. "� �-i1 " 1 HEREBY ACKNOWLCDO[ TXAT 1 XAVB PR�� TM�B APPLIGTION THg AMOUNT lHOWN 11NDlR VALUhT10N 16 POR rxe ANO 9TAT! TXAT TXE ABOV6 IB CORREGY AMC AOR86 TO COM• yUliP09L OP H9TABL19HINO A PERMIT P88 ONLY. PLY WITX ALL CIiY OADINAN�B AND BTA� uWd TNO Bu1tnlNo coNe oN i VALUATION L 81GNATURB OF � PERMIT FEE $ � l PERMITTE � �� , $� ��f �D/ PLAN CNECK $ , �� 7 AGENT � TOTAL FEE �� 4 " I ) '' ' � ��.� COSTA MESA BUILDING-SAFETY DEPARTMENT P. o. BOX 9f7 COBTA MEBA. GLIPORNIA. For Applfe6nf fo Fill In Complefely TYPE OR PRINT ��n L./ iGrLS MAIL � �� '�Ox � Z � ADDRES6 TEL. E � - cirr �✓/A%A No. AR ?GT %7_ "—'_ .. _/ _ .TEL. . _ ti . STATE I/:// G��'1 TEL - � LIG. NO. ��p`�• !� NO. OF LOT �d r%� 300 � I No. w BLoa6. xow o� �T b U6E OP ,� EXISTING BLDG HHTBACK LINB FROM -�� T LA- CeNT¢x OP BTRHei y REAR YAR/D� SIDE VARD I LEFT S�� I Ra1GF{'f WL�"�.• DESCRIPTION OF WORK BUILOIN / I NO. OF �7 81ZE Xi ROOM6 6TORIHB C� EXTBRIOP L IROOP COVERING O COVERING G/�. USE OF BUILDING AND WORK TO @8 PHRFORMED - T� l Z L dvn2 : �e 1 XBRHBY • OW�D6E TH T � HAVB R6AD IB A�PLJGTION AND BTATH TNAT TH6 AGOV¢ I6 GOftRBCT AIm A01166 M COM- PI.Y WITX ALL GIn ORDINAN� AND 8TA � WB R6�TIN0 BOILDINO CONB$UCTION. � AUTHORIZED i �E RECEIUED � r �JAN u 1962 �� FINANCE DEPT. / �. CITY Of COSTA MESA APPLICATION FOR PERMIT For Office Use Only F8C81pT NO. P81 !Y I -'h`N JRBCl1:J02 I JHiY / COSTA MESA. CALIFORNIA FIRE ZONING ZON[� HO. OR U8H OP NtW yRr �� y I PLAN9 � I BUIlDINO I L 1.�.�,f �ew� -�n -ls-(" 6 a Y�'� h� T/i oesca�nior+ �J/o — �0�� — /O A. P. NO. YAROS � EVE6 - APPROVED ALLOWED (C6NTER LIN6 8T.) � FRONT Z'� FT. R. SIDE /� Ff. L.61DE �Z/� FT. � wwso % r �r �'�/i APPROVED�� BY HOLD � � i z��z/6/ G TH6 I�MOUM BHOWN UND6H VALUA��ON �8 POR TM6 PIIRPOBQ OP EBTABl.18HIN0 A PBHMIT PEE ONLY. VALUATION /� /� PERMIT FEE $ d J •�' $ //�"/ ��T PLAN CXECH $ � O � TOTAL FEE �O� � � ; ' ' ��) COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA M68A. CALIPO(iN1A For Applicanf fo Fill In Complefely COSTA MESA CALIFORNIA //,(J ,4/LP/L -JS �. BPX IZI A F�rwoo7� .4�� Fx O�/IIJL1r Na.E�- � dWQC o 1 �-( 12 � �%. �%R�i,tl. A,rl-rd .� 61ZE /JOO� � OP LOi �� U8E OF �� EXI ING BIDG 6HTBACN LINQ PPOM . r, / / FEE ��CEiUtU JA 4 1962 l i � FINANCE DEPT. CITY OF COSTA MESA � ��'��PPLICATION FOR PERMIT . ��'�� BUILDING s�d�, > For OH7ee Use Only aeceirr wo. pe�t��y, � � � RHQIV� sY GATR �WVBD DATB IBBUBD �—f--<�—�_�s �. _ J[ IMI • . CASTA MESA. CALIFORNIA viRe ' ZONING ��. I Ho. o. ^� I �s. oP ��, y /r�y PLANB ` BUILDIN6 �' iao,u P�. 4i-�' (� o`! ivf.7` �lv� TR oexairt�oH / OON LOTS O A. P. NO. II(� � I O�I '� � C7 YARDS EVES APPFOVED ALLOWHD � � IC�NTCP LIN6 Rd Y�_ FRONT G' � FT. 11 l�Li� �i R. SIDE Z� FT. � II OF WORK �. sioe 3d Fr. i. 1 I IIADDITION. I REAR S/ F7. � �I APPROVED _. IIOEMOLISH I ��l.6,� nw� � �,d�� -.�.� "-J r v `� �.� ,� 0 c. v - — - �� 1 NBRHBY ACKNOWL8D08 TNAT 1 NAVB P6AD TN19 AMYGTION TN8 AMOUM OHOWN UNDtR VALUATION 10 IOq TX6 AND BTATB TH�T TH8 ABOVB 19 CORNBR AND AOR86 M CON• pUIiP09[ OP Q@TAlL19HIN0 A P6RMIT P6H ONLY. PLY WITM ALL CITY OFfl�NANCB AND 6TAT6 LAW6 R[O TNO Hu1LD1No CON IaN. . VAWATION r� 81GNATURE OF '♦ PERMIT FEE $ `/ ` PHRMI7TE �j'�7 �j �J o S � % �"J � PLAN CHEGK $ � .S b AUTHORIZHD AGENT ��-" � TOTAL FEE n 4 .-f . I609� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. GOX 917 COHTA M68A, CALIPORNIA Fo� Applieant fo Fill In Complefely ' ,. . _ TYPE OR PRINT %/A I9� /A�tL�' v� 1 AR iCf 1 81ZE CALIFORNIA TEL. NO. � Utit OF �' EXI6TING LOG. BeT9�CK_LINe F0.0M �� / FEE RECEIUED � JAN p 1962 . �� FINANCE DEPT. APPLICATION FOR PERMI�F COSTA MESA j4Li1�"' BUILDING :'8 "For Offiee Use Only RBCGIPT NO. P I� Ir a�,/V I..cw're�necst�� I o�N aaumn.-. COSTA MESA. CALIFORNIA APPROVED ZONING ZONH�-�I IPL/.NB ` IBUILDINO� �� • _I �.a�� 1.7� 6 6 Y i'�1 i%� TT � ( D OHBCp1IT10N � xo. or etoos. O 6_(G / O NOW ON LOT A. P. NO. I/ �-_ YAROS EVES � �(Jo� r�R'� fCBMLR LIN! tT.) � R,EA.� YARD / FRONT s•'S� Fi. IN. I�� `� R. 61DE �� FT. IN. OF WORK L. SIDE �� FT. �� IN. I I IIADDITION I REAR �v FT. �- IN. III DEMOLISH I BYPROVED�� OATE �i/� �/6 / F „__,,,,._ %_ HOLD FOR SPECTAL RE U F•�--- � EXTERIOR 1NALL .` �� I ROOF 1 N6R89Y AGKNOWLBDOE THAT 1 XAVE pBAD TH�B I�PPYGTION AND 8TAT8 TMAT TX6 ABOY6 16 CORREGT 111m AOP88 TO COM- PLT WITH ALL CITY ORDINANC69 }}}�� HTATe LAW9 RHOY NO BOIlDINO CONBTp1�CT1%N, _ / � ��' �J � ti 81GNATURE OF \ /// �� riA AGENT Q (R�A �_ l�•�ti,',�` � alo4. � THE AMOUM BXOWN UND¢R VALUATION I! PDR TH8 PURPOBE OP CBTABIJBNING • PlqMli PHe ONLY. VALUATION `/7 S ��7 [J t .PERM17 FEE $ V / �� '/ " G� . PLAN CHECK S�/J+S� _...... e�e e �'S� S O . �� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 9f7 COBTA MBHA. CALIPORNIA For Applicanf to Fill In Complefely TYPE OR �P/RINT BUILDING ��O � � ` 72�� ADDRE6S COSTA MESA CALIFORNIA ■ MAIL / �VI�)A ICL.`�'a QTY t�Cl l�/r� NO. OR' . .I EE � (A: NOK'' ennarecZ 1 Z% �. f�-/.�% A FEE RECEIVED �/ JAN t� 1962 i' FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only ReCel'T NO. P�ttMIT�(lQ.� �µ� (l y 11[�IVED BY I o�ta�•aearveoJ6i� DAT6 169U6D /g Jv1�+ J � � �pnn ��N BUIL�ING AODREBS CASTA MESA. CALIFORNIA .. APPROVED ADDRE63 � ZONING ZO NO. OI p U88 OP H8W � CITY /��Y I P{.�NB L I oU1LO1N0 �C.TNO. /� Z NO. oBBCnIPrI ��n `a1 �U � y�/y�+�e. /�C OF LOT � X 3GZ'�J � I No. oI sLDos. O // `— /Q Q _� d NOw OX LOT p, p, NO. USH OF �. YMDS EVE8 EXIBTING BLDG y�-� APPROVED ALLOWED BiTBACN LINB PROM �C � T (aM�SN LIN6 BT.1 � /J cHHTeR oP STReer REAR Y�D � % /� PRONT PT. -}� IN. 81DE YARD I LEFf �� RIGHT N R, SIDE � 7 Ff. "�— "" IN. DESCRIPTION OF WORK �.sioE Q FT. IN. IALTERATION I II ADDITION I RFAR /� • RL `� ua. BUILDIN p � NO. OF SIZ6 �• � X /O ROOMB STOF P�[7'HRIOR W SLGYIi� ROOP CAVHRING (/ O I COVBRING USE OP B ILDING AND WORK TO BE PERPORMEO K T> L` // '. �� Ao. I1 HBPHBY ACKNOWLHD08 TNAT 1 HAV6 R6AD TN19 AAUGTION AND BTATB THAT THH I1BOV8 IB COPNHGT I1tID AORBL TO COM• PLY WITH ALL CITY OROINANCgf1 AND BTATe tAWO RE�TINO BUILDINO CON6p[{JRIOjI. / � , AUTHOflIZED A6ENT � f 1, /,.�yo � THe AMOUM 6XOWN UHDHR VALUATION IC PON THH PUN086 OP [BTADLI6XIN0 A PCRMIT PC6 ONLY. VALUATION I PERMIT FEE S O � S ��%�/ M� // / p � PLAN CHECK $ TOTAL PEB � � is2ss C05TA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COHTA MHBA. CALIFORNIA For Applicanf fo Fill In Compleiely TYPE OR PRINT BUILOING H � � � ^I �i ■ AR ECf SIZE / ( no, oP Bto68. OP LOT �O NOW oN wT USE OP � Q EXIBTING BLDG �� BHT9AGK LINH PROM � .+ �1 �HTER oF BIR6Hr U i REAR YARD SIDE YARD I�Ff I RIGHT DESCRIPTION OF WORK OCTERIOR WALL COVHRING USE OP BUILDING � � 1\ � I XeRBGY A� ANU BTATe PLY WITN AL BUILDINO CO SIGNATURE` PERMITTEEJ I AUTHORIZED � NO. OI ROOME IROOF THAT 1 )V8 18 � F�E RECEIVED JAIV 2 9T9Bp � FlNANCE DEPT. APPLICATION ��t P�R6�ISjA MESA BUILDING For Offlee Use Only R6C61M NO. PCXMIT NO. BY �,DAT6 R6Ce1V8D_ � DAT6 199UHD COSTA MESA. CALIFORNIA FIRE ZONING ' ZONe /� NO. OP U98 OP N8W R t/. I PI.ANB -BUIIDINO T LHOAL �(�j�' �J / / � D68CNIPTION �r /--� {- (O Q � eeu., /%/— /�� /r / � (QM[R LINB 8TJ -tt�LD �FO}—R / / �-Y .ND� OR 8 O� M• T�e AMOUNT 9HOWN UNO¢q VALUATION IB FOR TNH PUHP09H OP EBTABLI9HIN0 � P6RMIT F88 ONLY. [ I.A G UU INO � VALUATION � PERMIT FEE $ � $� � �l PLAN CHECK $ � I � (/7l � / TOTAL FEE � � � a O LL COSTA �MESA BUIL I - A ETY DEPARTMENT P. O. BOX 917 G08TA MBBA. GLIRORNIA Fo� Applicanf fo Fill In Complefely TYpE OR PRINT BUILDING � �� ADDRH88 7�e W� COSTA MESA. CALIFORNIA OWNER f S�� AO�RE68 / / O�J �GU//V(j',/J � T/U�� ie a /�� ✓ TFI_ FIRE ' ptk RECEIUED FEB 7 �g FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Offlce Use Only RHCEIPT NO. � ( /�T� � ' `'�� 1o2�7�b6o?-I ��eC��- ' %/Z� ZU. /� �' �� COSTA MESA. CALIFORNIA CONTRACTOR - �(.�lVS . C6 APPROVED BY DATE ADORESS ` 33 �• T dr � ZONING v� �� J IONH NO. OP UB6 OP NLW Cli�' / � "✓' � � I PLANB BUILDIN6 � STATE TEL. /' • `Y /A�/ �goAl +^l /' LIC.NO. �%' NO. C��• �T—� 7 DeeCnIrTION /" �O � OF LOT �JOO �} Ov' I NO. oF Btnoe. / .: NOW ON LOT q, p, NO. l�` O — D USE OF . YARDS EVES EXIBT NG BLOG APPROVED ALLOWED 9RBACK LINB FROM «M�A ��MB BT•� a. O�-��-�r t[tR6R OP eTieeeT REAR YARD FRONT �OFT, � �,� . SIOE YARD I LEFf I RIGHT R.61DE FT. � / DESCRIPTION OF WORK u L. SIDE �- FT. yC� �_� ucr. I II ei rcasrioni I 11 aoo�nnu I ____ —�yb� �""-" / NO. OF WALL APPROVED � .'�i� Gl/1�.��.�. • .�?D � �( 6 "X s� yil�0 �f-'l•-C/z? /� �; X 6"„ � S'i I X8P8BY ACK WLeO08 TH 1 NAV6 PBAD THI6 APPLIWTION TH6 AMOUNT BHOWN UN�HR VALUAT�ON 19 POR TX8 AND 9TAT8 THAT TXB AB 19 CORRBR, AND AOR68 TO GOM- pUPP096 OP 86TABLIBHINO � P6HMIT P88 ONLY. PLV WITX ALL CITY INA1�C88 I1ND R U TINO BUILDINO COHB ON. � c%O YALUATION p�j (/ V 81GNATURE / PERMiT FEE $ PERMITTC '' � � $// JLn � PLAN CHECK $ (i U (l AUTHORIZED AGENT � / k TOTAL FEE .. _ �� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 91Y C06TA M68A, GLIPORNIA � For Appliednf fo Fill In Complefely TYPE OR PRINT COSTA MESA CALIFORNIA f ■ 81ZE � BHTO�CK LIN6 PPOM 0 No:G/ 3 (� � I NO, OP DESCRIPTION OF WORK IR�r EXTERIOR WALL COVERING USE OF BUILDING �'� RECEI ��D F►NANCE bDEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only PEGEIPT NO. �P$qMIT NO. !Y I OATE qPLELYeD I; DAIH IBBUED BUILDING ZON�, }� I NO. OI �� vLAN9 �ea�� n ,r r � � A. P. NO. � : YARD6 • APPHOVED IC6NT[H une sr.� FRONT _ 7 — R. SIOF �.� APPROVED ❑B8 OP HV BUILD r c �� / �. _J 1 XHRBBY ACKNOWL6D�8 TXAT 1 HAVE RBAD TH19 APPLJGTION 7NE AMOUM BXOWN UND¢R VALUATION �9 IOR iH[ ANO 9T�T8 TXAT TX8 A8W8 I8 LORR6LT ANO AOflB@ Tp CpM• pUIiP086 OP EeTABLIBNING A PBNMIT PH6 ONLY. PLT WITH ALL GITY OR��NANCea AND 9TAT8 LAWB IiHOULATINO BUILDINO CON9TRucfloH. � VqLUATION 816NATURE OP PERMIT FEE $ PERMITTE $ 'i/ / /� � �/I �� o �L�� f� � PLAN CHECK $ 6 • / AUTHORIZED A ENT i-�% � % TOTAL FE y � Aoplicant to flll in all spaeas azCept thosa within heavy �oitlar Ilnes ana sign all aoPropriata tleclaralions. � CITV�OF COSTA MESA CONSTRUCTION PERMIT . Project Address � � d �� 'L� � �'Applicant'sMailin9Address K�«- C��-13t.i/A -�ieK��j •.. � Owner'sName ��n�'r7/d�.uP'c,� Phone��'�� Address � �' � W � � � �g � Arch/Eng. License No. A�� Address ' v� Contractor's Naman�-��Cs� Cd J;JY" P"✓� Phone � i�Y`� ` Addreu (mailing � LUP t��• -A=- • � � .City License No. � �% � LICENSED CONTRACTOR DECIARATION I hereby at(irm lhat I am IlCensetl untler provisions ot Char[er 9(commencing �with section.7000) of DiviSlon 3 ot tha Business antl Protesslpns Cotle, antl my li<ense is in f�ll�rte antl effecL � �G ��/ License C ss cense Y� pat¢ Z/� 8'$- 5�9 et r- ��i'Q � �ORKERS' COMPENSATION DECLARATION�— . hereby aifirm tnal I have a certificate of consent to selt-Insure or a certiilcate of Worke�s' Compen5d[ion Insurance, o� d..certifietl copY �here0f ($ectlon 3800, Lab. C,) %� Policy No. �Cbmpany f�'.ly,-.ertifietl cop is hereby �umishetl. � � IIR� Certl co y illetl wi�h tho city B/ tpu� � Date � b APPlican[ �� EXE PTION FROM WORKERS' COMPENSATION D GLARATION (This section neetl not be corn0l¢tetl i( the permft (s for one hunqretl ($300) or less). �' 1 certify Ihat in lhe p¢Aortqanc¢ Of the work f0/ which this perT�t is issuetl, I snall not employ any person in any manner so as to become subject to the Workers' Compansation LaWs of CalitOrnia. Date Signature 'NOTICE: If, atter making this tleclaration, you shoultl become subject to tha Wo�kers' Compansation PtOvl5ion5 Of the Labo� Cotle, you mu5t tortnwith � comply wilh such provisions or this permlt 5ha11 be tleemetl revoked. CONSTRUCTION LENDING AGENCV 1 hereby afflrm that there is a construction lentling agenty for the per/ormance of the work tor whi<� thls permit is Issuetl (Section 309] Civ. C.) Lentler's Name Lentler'S AEtlress , OWNER BUILDER UECLqRATIOfi I nereby alfirm that I am exempt from the Contractor's License Law for the following reason (Secllon 7031.5 Buslnesz antl Professional Cotle: Any ci[Y or co�ner wmm� requir¢S a pe�mit lo can5[ruct, alte�, improve, tlemoli5h�o� rapair any structure, prbr to its issuance, also reqWres the applicant for such permit to tile a Si9netl Statement that he/she Is Iicensetl pu�suant to the prOvision5 ot the CmVacror's License Law (Chapter 9(commencing with Section 7000) of .Oivision 3 of tne Business antl Professions Cotle) or [hat he/she is exempl therefrom antl the ba5i5 tPt th¢ allegetl exemption. Any violdtion of Sectlon 7031.5 by any aoplicant for a Oermi[ subjects the applicant to a clvil �endlty of not more than fiy¢ huntlretl t1011ars ($500j. � LJ I, as owner of tho orOperty or my employees with wages as their sole compensatio�, wlll tlo th¢ work, antl the structure is not intentletl or offeretl fOf SdIE ($ECf1011 7044, Bp5i0¢55 dntl PIOf¢SSiOfldl COtl¢: Th¢ COf1tId<fOf'S � License law tloez not apply to an owner of a propercy who builtls or imProves thereon, antl who tloes such work hlmseli/herzelt or throu9h his or her own � employees, provitled tnat such improvements are not Intentletl or offeretl for � 5ale. 1t, nowevar, tne bulldln9 or improvement is soltl within one year of com- pletion, the owncr will havo the bur0en of proving he/she tlltl not builtl or Im- �ove for lhe pu�pose of sale). � f, I, az owner oi tha property, am exclusively.contracting wifh IicenseG con- � tractors to con5truct the prOject Sectlon ]044, Bu5Ine55 antl ProfasSians COtle: l The Cont�a<[ot's License �,yw �oes not apply to an owne� of property wh0 bulltls or improvez thareoq, antl who conVacts for such projects wlth a con- tractor(51 Ilcense pursuant to the Con[ractor's Llcense Law). I am aware tnat proof o( thei� Wo�ker'S Compensation insu�ance Shoultl be provltletl to me. ❑ 1 am exemp[ un�ter Sect�on B. 6 P. Q!or this reason Da[e Owner I hereby c¢rtity Nat I hdye /eai Information Is Correct. I agre¢ to Signature � xDrivars' License or 5° CMF 0865-46, rev. 30/84 1 tnis application antl state tnat t�e above comply wlth all city antl county orAindnces g construction,antl hereby authorize revre- �u on the above-mentionetl pro rtyp o�r �_ Datel O.� ' OFCONSTRUC CONVERSION ' 1lSNEW LJ ADD DEMOLISH ❑ OTNF�R TVPE OF PERMIT LJ GRADiNG ❑ TENANT ❑ ELECTRICAL'� ❑ OTHER - PROJECT DESCRIPTION 5�. F7.- CONSTRUCTION TYPE ZONE GRF Remarks: Bar Sink Backflow Preventer Backflow Irrigation Dishwasher . Drinking Fountains Floor Drains Floor Sinks Kitchen $ink' !� Lavatories P-Trap Roof Drains �Reinspection Fee ALTERATION LJ REPAIR PLUMBING ❑ MECHANICAL A.P. 5W (.r7fL{� � S Main Buildinc E� T Front* B Rear � A C RigMf' � K w _ _ VALUATION$ L/VV�Vv S Leftf � V�S. ACRES ping. Ref. # ' . Planning No PLUMBING Showers - Service Sink � Sewer Cap� Sewer Co ction Solar ollectors ar Piping Solar Tank Swimming Pool w/Spa rinal Wa Closet Water eater � Water Service Auto-Wash Boiler Duct- Under Ground Duct - StruC[ural . Duct - Ventilating ' Exhaust System ❑ Multl Firepl/Fact. Blt. ICBO #` Heatin9 System & Ducting ❑ 6100,000 BTU O t 00�f Reinspeccion Fee '/�Mte - Builtlin9: Canary - Applicant; Pink - qctounting; GOltlanrotl - AsseisOr $15 e $15 IsSue Fea Hood or Typel ❑ CanOpy Typell ❑ lefriger CICn System 7 O,OOO.BTU ❑100,OOOBT >ystem Repair/Alteration � �� ' Fire Dampers . Registers � Iswe Fee FEES BJ �'i'LE- $ 3 S 3 6769 I/U3/9u' Accessory Building: (� (M � �l U ParF / � �Z¢�C. ll.�fPr✓1 �g�/1.l¢ ELECTRICAL Automatic Washer� Construction Pole Su6. Cooking Unit Dishwasher Dryers ❑Gas ❑ElectriC Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator Da5 KW �5-15 KW � 5tt� Zone � �� .4LcI,N I N G R Re9./Provided . E ' =�36" n�n � T 5 � a -s , FEES . ier'O 75-50 KW � 50+KW' Meter LJup AOO;amps � Merer ❑ er 100 amps Sub Pa el Mo rs �0-1 HP �j'h' 8 c.Solar 09-15 HP �i6-15+ Micr ve ' Pole Ligh Range Sign ; Standing Sections � Trash Compactor � Reinspection Fee �$15 � .'� laue Fee � $ 3' DEVELOPMENTSEFVICESngE UIR NTS: � Zoning APProved BY J �ata ��- 3'�6 8uilding Approved By �� Date �� APPli�ation laued 6Y Date ' SUM V F FEES � BUILDINGPERMIT $. � � SMIP $� ' ��O PLAN CHECK , $ • � PEfiM1T , PLUMBING � $; ISSUANCE $ � PLAN CHECK 25% $' ENERGV P.C. $ ELECTRICAI • $ � � GRADING $ PLAN CHECK 50% $ MICROFILM $ �// � MECHANICAL $ TOTAL FEE $ �tiJ PLAN CHECK 25% $ , -' CGNSTRUCTION AND PLANNING '� _ F- ,�. & SPA • � ' - - � - '• APPROVALS r Permit# � - Date Inspector qppROVALS Permit# � • Date Inspector 1. Temporary Electrital Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement - - 3. Electrical Conduit Utility-Unilrgrnd. � 54. Forms - 4. Electrical Conduit-Undrgr�d. 55. Efectrical Bonding 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings �� G� 58. Electrical Conduit-Undrgrnd. � 8. Foundation , 59. Gas Pipe, � Undrgrnd., Test. , - .9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System � � 61. APPROVAL TO DECK 11. Property Sewer Line & House�Connection 62. Backwash & Receptor-Final, � 12. Sewer,Cap , � 63. Heater & Vent�Final 13. Roof Drains � 64: Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final _ 15. Rough Electrica�-Conduit _ _ 66. Solar System:Final - 1'6" Rough Electric Wiring _ 67. Fencing & Access Approval H Y7,., Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18.' Rough Electrical-T�Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19: Rough Fleating & Air Conditioning . FIRE DEPT. REQUIREMENT 20-Rough Factory Fireplace ' � APPROVALS Permit# � 21. Ducts, in.Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil � 23. Gas Pipe-Rough & 7est � 72, Underground Flush '�� `'� � � 24. Roof Framing � �� 73. Undergmd.StorageTankL]Gas ❑Oil � � 25. Roof Sheathing � �74. Overhead Hydro � 26. T-Bar Ceiling (Structurall & Monocoat 75.,Dry Chemical j i �27. Frame and.Flashing ' 76. Dry Standpipe 28. Lathing &.Siding 77. FIXED SYSTEM FINAL 29.�Insulation , 78. FIRE PREV. FINAL �_30. Drywall Nailing '.�; ' � , HEALTH DEPT. REQUIREMENT 31.�Plaster Brown Coat �� - ' ' 79: FINAL INSPECTION - - - 32. Electrical Power Meter-Final '� 80. FOOD CERTIFICATE ISSUED - 33. Final Electric (� - Notes: " " 34: Final�Aeating & 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 pomestic-Final. � � C• � � ' ; i! 42. Backflow Preveriter • � � " �`t 43. Backflow lrrigation ' � ',, - " � �-�� 44. Landscape Irrigation System � � � � � � - � �' 45. Sound Attenuation . � `. . � � . - . 46. Handicap Regulations �� v _ " i • � � ` ' 47. FINAL STRUCTUftE & BUfLDING b pn � � � W 48. Special Requirements Completed � ; ' � � 49. Electrie Release to Edison ;' i , ''; � - 50. Gas-Release to Southern CalifomiaGasCo .'� ' � i 1' �51. CERTIFICATE OF DCCUPANCY � . � .. f^•' � _ . _. - � _. . . , f, r ,,. Date ti. _