HomeMy WebLinkAbout940 18TH ST - Building PermitsI �
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PROJECT ADUflESS: 9 4 O W 1 8 Tx JcT
I• owxen�s eame: WU KEH CHANG TR
FDOHESS: P � B�}( 795
WESTMINSTER.CA
832-4868
pRCHIENGINEEN:
ROOflESS:
uwT: C-1
92689
HEG.NO.:
UNIT:
PENMITTEE: GOLDEN WEST HUILDING CO ( 714 ) 529-5249
nooxess: 109 S HREA BL
BREA CA 92621
LICENSEo CONTBBCTOq �ECIAPATION: I hereby aflirm Ihal I am Iicense0 under pmvisions ol ChaD�er 9(commencing wiln Section
7C001 of �imion 3 0� the Business ana Prolessions Cade. and my Ikense is in �ull �o e��x1.
cirr uc.: 0 5 21 17 STRTE LIC.' �I O%y� cus .
Oat¢ � ��'- 5 � (Signaiure: • _„_ _
WOflMEBS' COMPENSPTION DECIABATION: 1 hereDy attir that I have a cenitifa� consent to seu-insure or a ceniliwre a1 workers'
cpmpensation �s�a�c§ o� ��tined coov ihereoi� ion 3804 tab. ��4 / O 7/ 9 S
�OLICY NO.: . EKP. OATE:
'OMPANY: STATE .c�
J CenifieA copy is nereby lumishetl. 1�1 CenilieU ca AeA iin the ' Iding Div' ion.
Daie: � '- /�l �" 7 � Applican�: -
El(EMPTION Ft10M WOFKERS' COMPENSAi OECLARA71 ' This SeCtron n¢ed no b mp1eKA if the perrtnl is tor orrc handretl ($100) or 5j.
I cetlify Ihal in ��e pedormance ol Ihe work lor which Ihis permi� is issuetl, I ihall no� employ any person in any manner so as �o Dec me
5u0jecl m I�e Workeri ComDensalion Laws of Calilomia.
�ate; SignaNre:
NOTICE: II, af�er meking (hi5 detlaraiion. y0u 5�oultl Oecome Su01e�� �o lhe Warkef5' Compensation prmisions of tne La�or
COtle. you must Ianhvnln com0ly witn such provisions or iks Oermit sAau ee �eemetl revokeU.
CONSTPUCTION LENDING FGENCY: I her¢�y aHirm Ihal �h¢re is a tOnslmttion Ienaing apen�y �or Ihe pedarmanCe ot �he wOrk lor
whic� Ihis permit is issuetl (Seclian 3W7, Civ. C�.
LENOEP: '
aooxess: , -
OwNEB BUILOEB �ECUPATION: I hereoy aflirm ihat I am exempt imm ine Cantracrors' Slate License Law 1or ihe followinq reason
(Sec�ion 7031.5 BusineSs an0 Pmlessional Co�e: Fny ciiy pl county which requires a permi� to canslmc�, alter, improve. Eemolis�, of
iepair any slmcime. prior to its issuance, also repuires Ihe ap0licant br such permi� io lile a signed slatemen� thai �e/she is licen5ed
Dursuanl lo IAe OmNsians oi l�e ConVactors' Siate License Law �ChaDter 9(commencing wii� SEttion 700�) of Division 3 0� 1�e Buvness
and PmIe55ion5 Cotle) or lhai he/5Ae is enempi thealrom ana I�e ba5i5 lar ihe alleged eKempiion. My Nalation o� Seciion 7031.5 Oy
�I any applicani �or a p¢rmii Su�lecl5 Ihe apPlitanlio a civil penatly 0� n0i mOre Ihan �ive hunOr¢d Dollars (5500).
I. as owner of tAe Oropeny or my employees vntA wages as t�eir sole compensatlon, will tlo tAe wark, an0 ihe
� s�mcmre is not imenAeU o� o��ereA lor sale (Section 70aa, Business an0 Prolessional Catle: T�e Cantraciors' State License law
Aoes nal apply Io an owner o� a pmpeny who 6uiltls or imD�oves t�ereon, ana w�o does such work himsell/herselt or ��rouAh
• nis or her own employees, pmvideU Iha� such impwvements are not in�endetl or olle�etl for sale. I�, how¢v¢r the building or
imD�ovement is so10 wilhin one y¢ar al completion, t�e owner will have the �urtlen af proving �e/she Oitl not build or improve
Iorihe purpo5¢ oi sale).
I, as awner ol Ihe pmpetly, am er[lu5ivel contracting with IicenseG contractors to constmci ��e prole�� l�ction 7044. Ousiness
❑ an0 Pmfeuiong goEe: ihe Contractors' �tate License Law Oces noi apply to an owner ol pmcerry wAo bmltls or impmves ��ereon
anA wno coniracis for sucn projecis w�tn a coniractor(s) license pursuant to tne Contractor5' Stale License Law�. I am aWere
ihai pmof of I�eir Worker's Compensa�ion insuran�¢ 5�ou10 De pmvided Io me.
� I am exempi unaer Setlian: _ B. 8 P. C.
for I�is reasan:
Dale'. Ownec
I tla nere0y cenify tha� I am aware al ana unaerstanA Ine reQuiremems ol Califomla Health antl Safeiy Cotle Sections 25505, 255J3, an0
25534 antl I�al I Or any fuWre building occupant willlwill nal (cirCle one) need to Compty with Saitl 5�ate c0ae5 antl ihe reQuiremenis for a
permit loi con9mc�ion ar modilicalion trom ihe Air Oualiiy Manag¢men� DiSlricL Residenlial con5imclion apDlicalions are e�empi 6om
inese pmvislons.
Oa�¢: Npplicanl:
I h@�epy ceriity thai I have reatl ��is applitali antl Sia�e illa aUa inbrmaiion is tOr e. agree tomOty ��h all Ci�y antl c uniy
Orainancesantlstaielaws�elatinglobuiltling onsimctionan ereoyau iorirereprese �di ollhisciryt enleruponNeabove�me �OneO
pmpeny loi inspetlion purp05e5,
oaie:�/h � � � Signaiure:
Oriver's License or Social Securily x:
iCWi�<fi whne-BwlOing: Green-COEe EntorcemenL Canary-ApO���anC Pmk-Revenue: Gokonrotl-Assessor
CITY OF COSTA M$SA - HUILDING PERMIT , 57
PERMIT NO: HEP 050552 PLAN CHECK NO: N c, . ,
CONSTRUCTION TYPE: PERMIT TYPE; ELE PLU STR PURPOSE; REP
JOB DESCRIPTION : FZRE DAMAGE REPORT � SQ FT: 1,500
CLAIM VALUE: 1,500.00 CALC-VALUE; 1,500.00 GROUP OCC: R-1 /
COMMENTS: X
�***��**�**���***��r*****�*�r+�+�***�***���*�+�*****��****�*** **�*�r****��r**xu��
Z O N I N GS E�TEBQAUCIKRSE M E N T.���E �E�EC���
'------------ MAIN BUILDING --------- --------- ACCESSORY H��IF-i-C-:ty=---
FRNT: FT IN REAR: FT IN fiRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT TN LEFT: FT IN RGHT; FT IN
PARKING REO• PROV: FARCEL: 42434110 ZNE: REF NO:
PLANNING NaTES>
�
iE aE �E iE iE iE if �F iE �E iE if iE if df �1f If X�±E 1E �f ff iF 3E If iF iF If IF iE 3f % IE iE if �f -1F if �E iE iF if 3f aE if iF 3E iF 1f !E iE �k IE iF jE 1E�(� if if iE !f !f if if iF IE If iF 3E if !F �1F if i6lf iF i6 �F if
D E V E L O P M E N T S E R V I C E S�. R E Q U I R E M E N;.T S
20NING APFROVED BY DATE; -'
BUILDING APPROVED HY ; DATE:.
APPLICATZQN ISSUED BY• " DATE•' .,��+'�d
ifiFlE3FiE�FiEiFlEjfjEikiE3FifiEjfiEiElf�E-lf 3fiE�IE�f�EffiFiflFiE {EiF
if !f !E iE if �lE 1E iF iF iF iE iF iF 1F 3f iE if �E aF �E 3F iF if 3F 3f iF IE iE aF if iF iF if iF iE it if if �if iE 1f if iE if iF if iF *iF if aF iE i(�!E if �E jE a(-iF 3E iE iE iE �E iE jF iE af:iE,if iF iE lE 1E 1F iFlF IE iF
LEGALIZATION:N F E E' S U M M A R Y STRUCTURAL.SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RESti GRADING
PERMIT 35,00 ' 4+�53 503 SMIP/NON-RES
PLAN
ISSUE FEE 3.00 15,00
BUILDING-DIV-> PERMZT ISSUE PLA13-CHECK TOTAL PAID : DUE
TOTALS----> 40.25 18.00 0.00 58.25 58.25 •i. ,00
REVENUE DTVTSION TOTALS--> COLLECTED: 58.25 OVER/SHORT: �. 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
3S.00 %,OO SJ.%S ,SO _
ik iE If 3f iE iM if il� IP iE iF ii� if �lF if iF iE 3E iE if 1E iE iE 3f iE iF fF iE fF iE if if if jE iF 1F �1E if 1E iF IE iE if 3E )f if IF ik 1E iE IF 4k 4!f ib ik IE iF 3f iF if !F jE �F iE iE �E 3f if IfdE �E !E j! 3f 3F dE iF iE
I N D I V I D U A L F E E B R E A K D O W N ,
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 1500 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1,00 .;1,500.00
ELE 1 RECEPT/OUTLET 1 ST 20 EA. 75 75
PLiJ 1 WATER HEATER AND/OR VENT 2,00 " 2,00
PLD 1 GAS PIPING SYS OFEND10F FEESUTLETS 2,00 �` � 2.00
G! UU0�7751-D0477764 i"C+S �3.zg
DATE: Ol/iC/91 iltfE: 0°:`i6
. f ,
CONSTRUCTION AND PLANNINO=- P` ='& SPA
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
-i. 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
6nElectrical UFER Grnd. •- 57. APPROVAL TO CQVER�GUNITE
7. Footings � ' 56. Electrical Conduit�Undrgrnd.
�8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. - � 60. Backwash Lines, P�Trap, O Undrgrnd.
1Q. Structural Ploor SYstem ' � ' ' 61. APPROVAL TO DECK
11. Property Sewer Line & House Connectioh 62. Backwash & Receptor-Final.
12. Sewer Cap . " , ' 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System • Final
14. Rough Pfumbing 65. Electrical-Final
15. Rough Electrical�Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling " 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUfREMENT
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Ducts, in Structure. • 70. Underground Hydro •
22. Ducts, Ventilating - .� 71. Product Piping Q Gas ❑ Oil
23. Gas Pipe-Rough & Test ' 72. Underground Flush.
24. Roof Framing • 73. Undergrnd.S[orageTank OGas ❑Oil
25. floof Sheathing ., ' ' . 74, Overhead Hydro �
26. T-Bar Ceiling IStructural) & Monocoat • - ' 75: Dry Chemical �
27. Frame and Flashing' . � 76. Dry Standpipe ". �
28� Lathing.& Sidin9 �• • ' - � � 77. FIXED SYSTEM FINAL .
29. Insulation . . � � ( . 78, FIRE PREV. FINAL � • .
30. Drywall Nailing � ` � i � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat i � i' 79. FINAL INSPECTION.
32.. Electrical Power Meter-Final . I � 1= 80._.FOOD CERTIFICATE ISSUED
33. Final Electriq '�;��,l�hl� �„ I 'Notes: , , � ,
34. Final Heating & Air Conditioning, � ' I I �� . . . . �� ,
35. Final Gas Pi�pe-Test ' I I �' � ' . � . • .
36. Hood or Canopy � � I ( � � -
37:-Finai Factory Fireplace l �'�' ' .
38. Final Plumbing • . I((!Cu I L����
39. Water Service�Finat � � � � �
40. Gas Service-Final . � I � � .
41, Solar pomestioFinal � ( '
42. Backflow Preventer I � � � .�_ �
. 43. Backflow Irrigation � . ' �
44. Landscape Iriigation System �'� . • � • �
�-45. Sound Attenuation� ' � � . , .
46. Handiwp Regulations - . �
47..FINAL STRUCTURE & BUILDING 'L' - � � -. '1
.
48. FINALPLANNING � �
49. Electric Release to Edison � ��
50. Gas Release to Southern California Gas Co ; i � -
I � •
51. CERTIFICATE OF OCCUPANCY , . . . •
No Date
.\
�
N
PP0.IECTAO�flESS: 9'iO W 18TH ST
� OWNEN'S NAME: K, C, Y'IU
nooxess: 5321 VALLECITO
WESTMINSTER
CA 92683
(714)897-3521
uxrt: HLD D '
AflCHIENGINEEH: flEG.NO.:
ADOHESS: IINIT:
PEflMITTEE: ROGERS ROOFING ( 714 ) 995-2826
ADOflESS: 991Z LINCOLN
CYPRESS CA 90630
LICENSEO CON�RACTOP OECLAflATION: 1 here�y atlirm Ihat 1 am IicenseJ unUer pmvisions a� ChaO�er 9(commencinA with Sec�ion
7�00) of �ivision 3 of Ihe Business antl Pmlessions Code, and my license is in �ull �orce and eflec�
ciTvuc/._: �0�350�g49 sTpTEuc.:968879 �_ ass:_C39 EXP: 09/94
Date: _/—/ z �v� Sipnature: —� ��i =
WOHI(EPS' COMPENSF7ION oECIANATION: I here0y anirm tnat I have a cenificate ol consent ro seli-insure or a cenilicate of Workers'
Compensaiion I a�e, or a cenih oo �hereof (Section 3800, Lab G
POLICY NO.: ��� Z�; 1��� � E%P. OATE: Z/ i E/9 S
comvaxr: GOLDEN EAG,yLE
, 0 Cenilietl caOY is hereby lumished. Lf Cenified copy is IileA wAith the city B'tling Division.
Da�e: �0 / a���% Applicant: � % �c'�l�/'/
—T
E%EMPTION FBOM WOflHEPS' COMPENSATION UECLAflATION: (This section neetl no� be completetl ii the permit is for one AundreA (5100) or less).
I certity Ihal in the pedormance o� �he work for which Ihis permi� is issued, I shall no� employ any Derson in any manne� so as lo become
Suble�� �o Ih¢ Worker5' Compensation Laws oi Calilomia.
Oate: � Signa�ure:
NOTICE: I�. aM1er making �his declaration, you shoultl become suble�� �o the Worker5' Campensa�ion pmvisions ol ��e Labor
Cotle. you musl fotlhwilh comply wit� such provisions or this permi� shall be Oeemed revokeE.
CONSTBUCTION LENOING FGENCV: I �ereby aifirm Ihai ��ere is a Cons�mt�ion lending agenCy Ior ihe pedormanCe 01 ��e wOrk �or
w�ic� I�is permii is i5sue0 �Sec�ion 3097. Civ. C�.
LENDEN:
aooeess:
OWNEP BUILOEB OECIAflRTION: I hereby a�lirm ihat I am ex¢mpt �mm �he Contractors' S�a�e License Law �or �he lollowing reason
(Sec�ion 7031.5 Business antl Pmlessional COAe: Any ciry of county which requires a permit m cons�mc�, al�er, improve, Oemalish, or
repair any stmcture. prior to iis issuance, also repuires t�e applicant for suc� permit to lile a signetl statement t�at �e/s�e is licensetl
pursuanl w t�e pmvisions af ihe Cantractors' Slaie License Law (Chapier 9(commencing wi[h Sectian 7000) of �ivision 3 0l tAe Buvness
�� antl Proiessions Code) oiinal he/she is exemD� Iheretmm and I�e basisforihe allepetl exemption. Any viola�ian al Se[tion 7031.5 6y
any applicant �or a permii 5u01eci5 I�e applicant to a civil penalry o� not more �han �ive �unEreG Dollars (5500).
I, as owner al IAe pmperty or my employees wi�h wages as Nei� 5aie campensa�ion, will tlo tha work, antl �Ae
❑ simc�ure is not intende0 ar of�ered lor sale (Section 7044, Business and Pmiessional Code: The Cantracbrs' State License Law
aoes no� aoPly to an owner of a pmpeny wno builtls or imD�oves thereon, antl who Ooes such wofk tlimself/herself or throuph
�is or �er awn employees, pwNtleG i0at such impwvements are not inimaeU or attereE lor sale. Ii, however Ihe builtlinq or
im0�ovement is solA wit�in one year o� completion. I�e owner will have ihe hurden al prodnq he/she Aid no� build or impmve
for Ihe purpose of saie�.
I. as owner of t�e pmperty. am exclusivety contracting with licensetl contractors to constmct t�e pmle�� (Section 7044, Business
I❑ anC Pmfessions CaOe: The Coniractors' State License Law Ooes not apDly to an ovmer of pmOeM who bmitls ar imDmves tAereon
antl who contracis lar such pmlects wi�h a canVacmqs) license purzuaN m �Ae Contractor5' Sta�e License Law�. I am aware
��al pmol o� iheir Worker's Compensa�ion Insurance 51wu10 be pmviEeJ lo me.
� I am e�emo� unaer Section: B. 8 P. C.
lor ihis reason:
Date: Owner
I tlo hereby cenify inat I am aware of antl unaerstanA ihe repuirements of Calitornia Healih an0 Safety Coee Sections 25505, 25533, an0
2553< antl t�a� l or any lulure buileing occuDant vnlVwill not (circle one) neeG io comply vnth saiC 5taie cotles an0 the reQuiremenis �or a
permil lor con9mction or ma0ilication �mm Ihe Air �uality Managemen� OisVici. HesiOentiat constmciion aOPlica�ians are eKempt �wm
ihese provisions.
Da�e: ADD�icanc
I �eieEy Certify I�ai I hav¢ reaa INs applicalion anE sta�e I�al ihe above informaiion i5 carrecL I aA�¢e �a �amON �^�h all cily an0 fAunry
OrOinance5 anC sla�elawsrelalingio DuilOing COn5lmtiion antl her¢�y auihorrze repr¢sentatives Olihh ciryl0 enier upon lhe above-mention¢E
pmperly lor in50ec�ion purposes. �rG //II
I oa�e: /�—�'2 9y Signalure- %� � ��''%�'�
Driver's license or Saial Securily er
�6at a6 Whne—BuilEing; Green—GoOe Enbrcemen�; Canary—ApplicanC Pink—Revenue; GOIEenroO—Assassor
CITY OF COSTA MESA — BUZLDING PERMIT PERM NO; H 069278
PERMIT NO; B 069278 PLAN CI-IECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PORPOSE; ALT
SOH DESCRIPTION : REROOF W/COMP SHINGLES SQ FT; 4,000
CLAIM VALUE; 4,000,00 CALC—VALOE; 9,000,00 GROUP OCC; R-1 /M-1
COMMENTS: SMOHE DET. REQ IN EACA UNIT 91UBC, REROOF 65005F 6 UNIT APARTMENT
**�.**���*��**��*�***�**�**�*���**���*�*����.,�**�*�*��*�#���NIOK`E�D`Ei`ECTOR
Z O N I N G R E Q U I R E M E N T
S E T B A � K S REQUIRED ___
------------ MAIN B[]ILDING ---------- --------- ACCESSORY BUILDIN� -----
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; PT IN RGHT; FT IN LEFT; FT IN RGI-IT; FT IN
PARKING RE • PROV; PARCEL: 42434110 ZNE; REF NO;
PLANNING N 'fES>
>
iE # iE i! iE if if'k it iE 1(� 1t iE it i!!t iF it if ik iE ik if if if it iE i! iE if ## iE it ib it if iF ik iE?E iE # if !E iE it iF if ik 3t ie iE if 1k M iF iE iE if i(� iE iF iF i(� jE iE iE iF ii-iE it i! r iE it iE iE 1t
D E V E L O P M E N T S E R V I C E S R E C,� U I P. E M E N, T S
ZONING APPROVED BY DATE;
BUILDING APPAOVED BY ; DATE;
APPLICATION ISSUED BY: �. DATE; �(��_�2��_t`
1E1EitifiEitiEitklllflEiElE�IfitiEiEiliEiEitiEiFlFfFiEiEil�iF14iE1filil�lFiEil9EiliEft7E ifiFif,r�eiFiFiEilik# if![�iEaEiEiFlF�)fiE3f9FifrtiExiFititllieiF���if
iElf iE 1F 1E iE 1E i! iE iE iE iElE iE iElk �h if !E ik!! ik ff ik 1F 1E iElE iflf f! iE if iF 1E itlE iE iF k i! i! iE if !E 1E iE if iE 7f iF k 1E ff 1tlf i! iF iE if i! fF M-k it i! it i! # iE iE iP 1f iE fE fF i!!F 1f
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
HLDG PMT PLUMHING ELECTRIC MECHANIC FIAE -- SMIF/AES GRADING
FERM2T 63,00 ,50
• SMIP/NON—RES
PLAN
ISSUE FEE • .
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAl PAID DDE
TOTALS----> 63.50 0,00 0,00 63,5� • 63.50 .00
REVENUE DIVISION TOTALS--> COLLECTED; 63,SC OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63,00 ,50�=
s, i�
iF ik i! iE iE iE fE if iE it i! iE iF iE 9F iE iE iF iE iE iE if it 1E if iE 1E if if if �E iE iE iE iE iF K iF if iF3f iE iF iE iF it jE iE i6 iE iE iE iE if if iF M k iP if if iE it iE iF iE iE jf if if if iF # if 3E iF iF iE iE
I N D 2 V I D U A L� F E E B R E A h D O W N
TYPE QTY D E S C A I P T I O N UNIT COST TOTAL COST
SFR 4000 REROOF BY VALUE RESiDENTIAL N020NE 1:00 4,000,00
END OF FEES
• i.
DS 601694�51-00164482 T C�T 53.�Q
�ATE: 10/13/94 TIHE: 16:25
s-''� . •
CONSTRUCTION AND PLANNING POOL. _rA '
APpROVALS Permit# Date Inspector qPpROVALS Permit .# Date Inspector
1. TemDorary Electriwl Service or Poie 52. Pooi & Equipme�t Location
2. $pil Pipe-Und�gmd. 53. Steel fleiniorceme�t
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical 8onding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Tzst
6. Electrical UPER Grnd. 57. APPROVAL TO COVER�GUN(TE
7, FoOtingS 58. Electrical Conduit-Undrgrnd.
8. foundation � 1 59. Gas Pipe, O Untlrgmd., Test �
9. Water Pipe-Undrgrnd. ' 60. Backwash lines, P�Trap, O Undrgrnd. '
10. Str�ctural Floor System ; 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Recep;or�Final .
12. Sewer Cap � ' 63. Heater & Vent�Finai �
13. Root Drains � 64. Plumb�ng Sys[em � Fina�
14. flough Plumbing 65. ElectricabFinal
15. Rouyh Electrical-Conduit 66. Solar System�Final
16. Rou9fi Elecvic Wiring 67. Fencing & Access Approvat
17. Rou9h Wiring Siyn 68. APPROVED FOR P�ASTERING
18. Rough Eiectrica67 Bar Ceiiing 69. POOUSPA SYSTEPAS FINAI.
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVALS Permit #
21. DuGts,in Structure 70. Under9round Hydro
22. DuCts, Ventilating 71. Product Piping C7Gas DOiI
23. Gas P�pe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Svuctural) & 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 OEPT. REQUIREMENT
31. Piaster Brown Coat 79. FINAL INSPECTION
32. Elec2rical Power MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Fin�� Electric Notes:
34. Final Heating & Air Conditioning `�� /2�L�/� � � �.����
! �
35. Fina� Gas Plpe-Test �L�.�C
36. Hoad or Canopy
37. Finei Factory fireplace
38. Final Plumbing -�j,
39. Water Service�Final '�
.
40. Gas Service-Final
47. Solar pomestic-Final _ •
42. Backflow Preventer
43. BackFlow Irrigation �}„ `�...l�_!� �.�
44. Landscape Irrigati4irSYstem .r�� _
45. Sound Attenuatiotry �
46. Handicap Regulationi' � � �
47. FINALSTRUCTUR�E�&�3QILDING �1,/f�/
{
� 48. FINAL PLANNINC-�- C';_� ._.�
��; ��
49. Eleccric Release to E�sori,:,, r_,
,
50. Gas Release to Southe�n California Gas Co �}
5t. CERTIFICATE OF OCCUPANCY
No, r Date
� PflOJECT ROOflE55: 9 4 O W 18 TH $T
� OWNEB'S NAME: K, C, WO
aooness: 5321 VALLECITO
� WESTMINSTER
CA 92683
(714)897-3521
�
T'� I
FflCM/ENGINEEN:
PDONESS:
flEC.NO.:
uNiT: HLD C
UNIT:
PEflMITTEE: ROGERS ROOFING ( 714 ) 995-2826
nooness: 4912 LINCOLN
CYPRESS CA 90630
❑CENSEU CONTBACTOP OECUIflATION: I her¢Gy aHitm t�at 1 am li[en5e0 unE¢r Omvi5ion5 ol ChaO�er B kommentin0 wiih $ecli0n
70D0� of Oivision 9 0l Ne Business aiM Pwiessions Co�e. an0 my license is in futl force and eif¢ct.
ciTrulc.: 035p049 STATELIC.:468874{O cuss: r39 EXP; 09/94
Oate' ( ���� "� Y Signamre: _(i� �
WOFREflS' COMPENSATION DELNBATION: I �ere0y atfirm t�at I �av¢ a cerlifi[aie consem to seti-insure or a certificate at Workers'
Campensa�ion I surarvP w a ce�ti'�¢tl-copy,tnereol ISedion 3800, Lan. 1.
POLICV NO.: � W�' z z 4 1 7 b V J EXP. DRTE: z/ Z G I 9 S
comvaNv: GOLDEN EAGLE
❑ CertilieU CopY is here0y Wmished. O' Certitie0 topY yis �ileE vnlh IAe C�ry mlEing OiNsion.
�ate: /� /2�7 y ApDlicanL v � ��'�'�
�
ESEMPIION FflOM WOHIIEPS' fAMPEN5ATI0N OECIAPRTION: (itis seclion nttd not De campkicd if Ne permil is for one huMreG (5100) a kss�.
I cenity t�at in I�e pedormance ai t�e work �or wliic0 this p¢rmit is i55uM. I s�ail not empl0y any De�n in any manner so as to hecome
subjetl to Ihe Workers' Compensation Lav2 oi Calitomia.
Date: SignaWre:
NOTICE: II, altet making Ihis tleclaration. you shoultl Oecome su0ject to the worker5' ComDenSaiion provisions of tha Labar
Coae. you must IortAwit� compty w��� suc� D�ovisions or I�is permii shall Ge GeemeO revaketl.
CONSTXUCtION LENOINC RGENtY: I nereey allirm �nat there is a mnsimction IenOinq apency for ihe performance oi the work lor
which t�is Oermit is i5su¢0 �Sedion 3097. Gv. C).
LENOEB:
AOOflE$5:
OWNEB BUILUEB OECUBATION: I �ereGy atlirm tlwI I am exemD� «am Ihe Contracrori State Liceirsa Law lor tAa �Mlaxin0 reason
(Section 7031.5 Business ane Pmtessional CoOe: Any ury ol counry xTicn repNres a permii to construct, alter, improve, demolis�, or
repair any slruc�we. o�ior ta its iuuance. aLso repuires the appliUnt lar wGh permit to lile a 9qnetl statement tAdt hPls�e is Iicense0
pursuant io i�e pmvisions ai the Cantracmrs' State Littnu Law (Clwpter 9(cammencinq wit� Section 7000) af Division 3 of ihe Business
antl ProIe55ion5 COtle) Of l�al he/s�e 6¢x¢mpliherelmm anG tM1e Oas¢ for I�e all¢p¢G lxem0��on. Any vi0lation 0� SeCliOn 7031.5 Oy
any aDDlican� br a Oe�mi� subjects lhe aDPliWnt �o a civil penairy o� nol more llun hve �unUretl Oollars (5500).
I, as owner ol t�e pmperty or my empbyecs wit� wa9� as t�eir sole campensatlon, will do t�e work. and the
❑ simcture is not inttn0e0 or olfere010r sale (Section 70C4. Business anE Pro1M5i0nal Coae: 7he fqnirattors' State License Law
aoe5 nal appty t0 an ownef oi a prOperty wlp Oui105 or imprOveS ��ereon. an0 wtW does SUth work �im5¢II/h¢full or throUOh
his or �er own emDloyees. D�ovqeE ttut suc� improvements are not inlentleG or otterea for sale. II. �owever tAe huilUing or
imDmvement is solG vnihin one year of com0�etion, ihe awner vdll �ave I�e burGen oi pmvin0 �Ushe OiE not EuiIE or impmve
lor Ine Duroose of Shce�.
l as owner ol the propeny, am e.Uusivery convaciin0 wi�� IkenuG contractars to wnstruct the D�oject (Section 7044, Business
❑ and Pmlessiws CoGe: TAe Conlractors' SIaI¢ L'¢ense Law Ooes not apDH �o an ovmer of properry who 6mIEs ar impmves Ihareon
antl w�o camracis lor suc� Omjecis wit� a comracmqs) license pursuant to the Comractori State License Law�. I am awara
Nat pmof al t�eir Worker'S fAmOensation insurance sMWU he DrovitleG to me.
� I am e�empt unAer Section: B. E P. C.
lar Ihis reasan:
Daie: Ovmer.
I aa nert0y cenify �hat I am aware ol ana uneerstanE �ne reQWrements of CatilorNa Mealtn aM Satery Catle Sections 25505, 25533, antl
2553< an0 ttut 1 or any luture GuilOing accupan� wilVwill not (urGe ane) n¢e0 to comON ��h uitl state codes antl lhe repuiremenis br a
p¢rmil b� can5tmciion or moEAiwliOn Imm I�e Au Ouadty Manapemenl OistricL HesiGential consVuction appliwti0n5 are exempt imm
inese pmvislons.
Date: ApO�icam:
I her¢Gy cetlitylAai Ihave t¢aCt�is a0�lica6on anG SlatelAai lhe abweinformalian ¢ wrrep. lagrte t0 camply wil� allti�y anE munry
ordinances anE state law5 relaGng ta OuilOmg con5iruttian aM hereby aNhoriZe represenidtives oi iNs tiry to enter upon t�e above-mentionetl
pmpetly for in50ec�ion OurpoSes.
oaie: ( V �'^ � y Signalure: � �
�riv¢r's llcense or Saial Securiry a:
16a1-a6 W�ne—BuilEmg; Green—Gotle EntorcemenL Canary—Applican�: Pink—Revenue: GdEanraC—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 069277 PLAN CHECK NO;
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR
JOH DESCRIPTION ; REROOF W/COMP SHINGLES
�
PERM NO; B 06927"i
GOVT: N SUPP; N
PURPOSE: ALT
SQ FT: 4,000
CLAIM VALUE: 4,000.00 CALC—VALUE: 4,000,00 GROUP OCC: R-1 /M-1
COMMENTS: SMOKE DET. REQ IN EACH UNIT 91UBC, REROOF 6500SF 6 ONIT APARTMENT
ih iF iF iE if li'1F'k' if if 1f IF # iE if if iF iF iE #'X' iE if il� i! iE 141E if k 1E i(� IF i! # If iM1 1E 1F # iF iE if iE iE 1E if iE 3F i(� if if iE # ib iF if 1E if if fE iE ### 1f # S} �%if # iF iF # i�' �F i� Y a.
ZON ING REQU I REMENTS�OKEDETECTOR
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BR!E,��.WIREp---
FRNT: FT IN REAR; FT IN FANT; FT IN REe1et; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT ZN RGHT; FT IN
PARKING REQ • PROV: PARCEL: 42434110 ZNE: REF NO:
PLANNING NdTES>
1
1f it 1F 1F if iE it iF iF iElE 1ElElt iE # iElf if !E �E !E!E !E iE iE if it!! 9E iE # 1! # if if iE ft 1f iE iE if if if if 1E i!!F i! k# i!� fF # it iElF it iE 1E # iE 1f # 1f 1f ?E iE if.lf iE 1f !E iE il� ### iE
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 APPAOVED BY : DATE:
APPLICATION ISSUED BY: DATE: �a 1� (rql�
it it at iE iE it it it it� it� iF it iE iF 3E it it �E it 3t iE itiFiFiF3F;F3FiF3FlF3F3F iFiFiFiFiFiF7Fif i'r iF�F iFiF i. �F iF r�3Fir'iFiF* *�t ic� * iF �t *� i��� r�—r ,'F� £;e at
�)E # if iF iE 1F iE iF 16 iE 3E 1E iM1 ih iE it iF iE iE iF i! iE 1E iM1 # 7F 7k k'rf it ik iE if iF iF iF iE %it iE iF fE ie i4 iF if iF iF iF if if if iE if� iM1 ik iE ib iE it iE 1E iF 1F iF # if 3Fl: iF iF iF iE iF if it i� it #
LEGALIZATION:N F E E S U M M A R Y l STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/RES GRADING
PEAMIT 63,00 .50
PLAN SMIP/NON—RES
ISSUE FEE '
BUZLDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 63,50 0,00 0,00 63,5� 63.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 63.50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT. GRADING PLAN—CHECK
63.00 ' ,5p
i! 1E iE jF iF 1! if it 1E iE if ik it it iF it iEl4 i! iE iE fE iE if iF fk iE iE iE if 1E iE %i! it it iE it 16 i4 fF iE i! i! 1f it it iE ih i! it iFlf ik 1f iF 1f # iE ih 1F it �lE iF iE if if iE i4 iE 1E k if 1E iF iF 1! i! #
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY D E S C R I P T I O N
4000 REROOF HY VALUE RESIDENTIAL NOZONE
END OF FEES
UNIT COST TOTAL COST
1,00 4,0OO.Ob
/
0± Q0169i�3—OD16943ti T CJ T 63.5�
DASE: 10/1319; TihE: 16:26
..-
CONSTRUCTION AND PLANNING
APPROVALS Permit#�` Date
t. TemPorary Electriwl Service or Pole
2. Soil Pipe�Undrgrnd.
3. Electrical Conduit Utility-Undrgmd. �
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
s. Electrical UFER Grnd.
7. Footings
8. Foundation �
9. Water Pipe-Undrgrnd.
10. Structural Floor Svstem . '
11. prpperty Sewer Line & House Connetiion ,
i
12. Sewer Cap .
73. Roo( Drains
14. Rough Piumbing
15. Rougfi Electrical-Conduit
16. Raugh Electric Wiring
V. Rough Wirfng Sign
18. Rough Electrical-T Bar Ce�ling
/9. flough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Oucts,in Struct�re
22. Ducts, Ventiiating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T�Bar Ceiling (Structural� & Monocoat
27. Frame and Flashing
28. Lath�ng & Siding
29. Insulation
30. Drywall Nailing
37. Plasier Brown Coat
32. Electrical Power Meter�Finai
33. Fina� Electric
34. Finat Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Firepiace
38. Final Piumbing
39. Water Service�Final �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation -
44. Landscave �rrigation SYstem
45. Sound Attenuation �� � � ;"
46. Hand�wD Regulations � �
47. FINAL STRUCTURE &�BUiIDING �/?.f
48, FINAL PLANNING � �
49. Eleccric Release to Edison -
50. Gas Release to Southecp California Gas Co
51. CER7IFICATE OF OCCUPANCY
Dace
POO L A
Inspector APPROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical0onding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical ConduirUndrgmd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor�Fina�
63. Heater & Vent•Final
64. Plumbing System � Final
65. Elecvical�Final
66. Solar SVstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL;SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
.-L �
�
70. Underground Hydro
71. Product Piping � Gas fl Oif
72. Underground Plush
73. Undergrnd. Stora9e Tank O Gas ❑ Oil
74. Overhead Flydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUiREM[NT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes: /n�/��A(f ,nK .�
pate �Inspector
i
PflOJEtT AOUXE55: 9 4 O W 1 S TH ST
OWNEfl'S NRME: K, C, WU
aooxess: 5321 �'ALLECITO
WESTMINSTER
CA 92683
t: (714)897-3521
ARCHIENGINEEfl:
_. p00flE55:
/
�
�I
XEG.NO.:
uNiT: HLD A �
UNIT:
PENMITTEE: ROGERS ROOFING ( 714 ) 995-2826
aooness: 4912 LINCOLN
CYPRESS CA 90630
LICENSEo LONTBRCTOfl DECLABATION: I nereby affirm Inal I am licensed untler provisians ot Cnapter 9(commencing witn Seclion
7000� oi Oivision 3 af ihe Business antl Pmtessions Cotle. anU my license is in lull brce antl eifect.
ciTruc%. 0350G49 STRTELIC.: 468H7�I cuss �%�39 EXP: 09/94
Oa�e: / V �1 "7 � Signamre: �_� /1:. I
WOflKEBS' COMPENSATION DECLANATION: I hereby alfirm Ina11 �ave a cenificaie o consent to selLinsure or a cenificate of Workers'
Compensalion I sunnce w a cerN�e$c�yjinereoi �Section 3800, �an. fU. z� z 6/ 9 S
i�w�224i�
voucv no.: GOLD EN EAGL E E%P. ORTE:
COMPANV: ,
❑ Cetlilie0 copY i5 here0y lumisheE. �' CertilieA copy i5 �iletl vnlh t�e ciry B/uiJlGinp Division.
�ale: �J//L �� AOPlicant � � /1.`+ �
�
E%EMPTIONFPOMWOBREBS'COMPENSATIONOECIAHRTION: (ThissectionneednotbecomDleletliithepermiiislmone�unaretl�5lW�orle55�.
I cenity that in ihe pedormance oi t�e work for which ihis permit is issued. I shall not employ any person in any manner so as Io become
5u�leci to the Workers' Compensation Laws of Califomia.
Date� Signature:
NOTICE: 11. alier making l�is dedaralion, you shoultl b¢wme Subjett b lhe Wafkers' ComDensation pmvisions o1 ihe La6or
Cotle, you mUs� �orlhwiih tomply wilh SUc� prOvisions or I�iS permit 5�all 6e tleemeE revoked.
CONSTXUC710N LENUING AGENCY: I �ere0y alfirm ihat t�ere is a consimction IenOing agency tor the Dehormance al the work tor
wnich inis permi� is issue0 (Section 3097, Civ. C�.
LFNOEH:
AUOXESS:
OWNEP BUILOEB OELLRNATION: I hereUy a��irm t�ai I am ¢x¢mD� ��Om �he Coniratlofs' State License Law for me follovnnp reason
(Section 70.31.5 Business antl Professional COEe: Any ciiy oi county w�ic� reQuires a Oermit to constmct, alter, impmve, EemolisR or
repair any simcture, prior to its issuance, also requires the applicant tor such permil la lile a signeE statemenl tAat Ae/she is IicenseA
pursuam m t�e pmvisions ot Ihe Con�raclors' Slate License Law (ChaO�er B(commencinp wiih Section 7000) oi Division 3 of Ihe Busines5
an0 Pm�essions Code) or Iha� �e/she is exempl therelmm and I�e �asis lor the alleged eeemption. Pny viola�ion of Section 7031.5 hy
any applicant lor a permit sublects t�e appliWnt ta a civil penally al not more ihan five �undre0 dallars (550�).
I, as owner ol tne pmpeny oi my employees witA wages as tAeir sole comDensatian, will Oo ine work, an0 the
❑ stmcture is not intenOeE or offere0lor sale (Section 70aa. Business ana Pmleuional Catle: The Contractors' State License Law
does nol apply to an owner ot a pm0eny who builtls or improves t�ereon, antl who Goes such work �imsell/tlersell or tAmugtl
his or her own empl0yee5, prOviOeU �ha� Such improvemenis are not intenAeO or otlerea tor sale. II, nowever the 6uiminq or
impmv¢ment i5 Sdd vn�hin one year ol compleiion, �he owner vnll have �he 6uitlen o� pmving �e/she tlitl noi Duild o� impwve
tar t�e Durpose of sale�.
I, as awner ol I�e pmDeny. am e�clusively coniractinq vnt� IicenseE comractars to constmcl Ue pmlact (Section 7044, Business
❑ anU Professlons Cotle: The Contractors' State License Law tices not aODN �o an owner of Droperry who Emlds or impmves tAerean
dnU w110 COOIldL15 IOf SYCh 0lUI=��5 Wllll d CO�I�ddOf�S� IILC(ISE OUf511211i IO IIIE �.OltlfdL101S' $IdIC LICE058 LdW�. I dffl 2Wdf0
t�ai 0��� ol IAeir Worker's Compensatian insurance s�oNA Ue pwvitleG Io me.
� 1 am exemp� unAer Section: . B. 8 P. C.
�or Ihis reason:
Oate: Ownec
I Oo here�y cenity inal I am aware ai ana unaerstantl ihe requiremen6 0l Calibmia HealtA ana Safery CaEe Sections 25505, 25533, and
2553a ana t�al I or any tumre builtling ouupant vnlVwi�l not (circle ane) nee0 m compty wit� said state m0es anG the requirements br a
peimi� lor con9mciion or mo0ificalion Imm Ihe Frt Oualiry ManaOemeni Oisiricl. fles�denlial cOnsimction application5 are exempt irom
IhP52 QfON310115.
Oate' ADPlicani:
I �ereby certify Ihat I have reatlihis aDPlicalion ana slate Ihat t�e aUove informalion is correct. I agree lo comply wilh all city antl county
orEinanres and slale laws relaiing lo Uuiltling cons�mc�wn anG OereUy aNAorke reD�esentalives of ��is ciry to enier uDon t�e aEove�mentionetl
pm0erly/for in5peciio^n Ourposes. A
/� ��a�e: /V'�'2iV Signamre: L �
ori�er's ucense or Sociai Secuniy x:
i6<t-4fi Wbuo—Builtling; Green—Co�e Enlorcament: Canary—ApplsanC Plnk—Revanoe; Goldenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 069275 PLAN CHECK NO:
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR
JOB DESCRIPTION : REROOF W/COMP SHINGLES
N
PERM NO; B 06927`_
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 3,000
CLAIM VALUE: 3,000.00 CALC—VALUE: 3,000.00 GROUP OCC: R-1 /M-1
COMMENTS; SMOKE DET. REQ IN EACH UNIT 91UHC, REROOF 42005F 4 UNIT APARTMENT
,���.����.�**���*���*�*�*��.�*���***�*����*****��**����.�***�**5��.�,KE.,pETECKi�OR
Z O N I N G R E Q U I R E M E N T S
S E T B A` K S REQUIRED___
------------ MAIN HUILDING ---------- --------- ACCESSORY BUII,L1Nl, —
FRNT: FT ZN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGFIT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 4243411Q ZNE; REF NO;
PLANNING NOTES>
>
1E iE it� iE iE �lE if iE if iP iE iE iE i! iE if !E it iF it # if it iF if iE it if ik iE fE ft il� iE 1E iE ih iE 1t it iF iE % it iE iF iF i! iF±f it iF iE M if� i! iE ie� iE it it iE ir it 1E if iE iM1 iE jE if it iE iE it il- if iE 1f
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 HY DATE:
BUILDING APPROVED HY ; DATE;
APPLICATION ISSUED BY: � DATE; �(�� ���( L`
iEifiEifiEiEiEiElEiFiEiEiEYElFifiEifififiEif it iF �TFiF�1F3E3E#iFiFiEiEkiExm iFi�i+'1FiF�li`�1EiE
iE iF it iE iE iF 3E if iE iF if iE iF iE iF iF 1f iE if if if iE it it if if jf if i! ih it if iF iE iE iF iE fE iE k it iE fE if if iE iE i! M iE * iF iF ie if it if iE 3t iE iF iE iF �E 1E iE iE iE if 1f if it iE �E 9E iE iE 3E iE
LEGALZZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FI�E SMIP/RES GRP.DING
PERMIT 54.00 : ,50
SMZP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL y, PAID DUE
TOTALS----> 54.50 0.00 0,00 54.50 �-, 54:,50 ,00
REVENUE DZl'ISION TOTALS--> COLLECTED; 54,50 JVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM1P�T G ADING PLAN—CH C
54 , 00 ,..�0 � - E K
iE iF it!! if i! if if i! # it i6lE it iE fE iE if itlhlf iE it iE iE if k it iE iF iE iE 1! iE iF # it if iF k 3f iE k i! iE 1! iE iE iE 1t iE k if 1E it fElf #' # 1E iE 1E k iF k iE iF i! if ik if 1f !t it it ft i! ik ih
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UP1IT COS'f TOTAL COST
! i
SFR 3000 REROOF BY VALUE RESIDENTIAL NOZONE 1.00. � 3,0OO,Ob
END OF FEES � '"
OS ODFo443`.—D0169436 T C�T
�ATE: 10/13/94 TIME: 16:26
r�
,
, :�
`4.50
_ + n/�
CONSTRUCTION AND PLRNNING POOL 'A
APPROVAIS Permit# - Date laspector APPROVA�S Permit�k Date Inspector
i. TemporarY Electrical Service or Poie 52. Pool & Equipment Locaticn
2. Soil Pipe-Undrgrnd. 53. S[eel Reinforcement
3. Electricai Conduit U[ility-U�drgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steei Reinforcement 56. Rough Pfum6ing & Pressure Test
S� Electr�caVUFEAGrnd. 57. APPflOVALTOC4VER�GUi31TE
7. Footings 58. Electrical Conduit�Undrqrnd.
8, Foundation . 59. Gas Pipe, O Undrgrnd., Tesc •
9. Water Pipe-Undrgmd. � 60. Backwash Lines, P-Trap, O Undryrnd.
10. Structur;l Floor System 61. APPftOVAL TO DECK �
11. Property Sewer Line & House Connection . 62. Backwash & Recep[or•Final . �
12. Sewer Cap � �� 63, Heater & Vent-Final � I
�
73. Roof Drains ' 64. Plumbing System - Final ,�
14. Rough Plumbing 65. Electrical�Final �
15. Rough Electrica6Conduit 66. Solar SYstem�Final
16. Rough Electric Wiring 67. Fencinc� & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Elzctrical•T Bar Ce�iing 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit �t
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping �Gas ❑Oii
23. Gas Rpe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Underyrnd.Stora9eTank OGas DOiI
25. floot Sheathing 74. Overhead Nvdro
26. T�Bar Ceiting (Structuraq & Monocoat 75. Dry Chemical
2J. Frame and Plashing 76. Dry Standpipe
28. �a;hing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Dry�vali Nailing HEALTN DEPT. REQUIREMENT
31. Plaster BroH'n Coat 79. FINAL INSPECTION
32. Electricai Power Meter-F�nal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
�
- ---j
i
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'- cc-o'1L-G_��� `�`°+v
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PH0.IECT RDOflE$5: 9 4 O W i S TH ST
OWNEfl'S NpME: K, C, WU
noosess: 5321 VALLECITO
WESTMINSTER
CA 92683
(714)897-3521
FflCH/ENGINEEP:
AOONESS:
flEC.NO.:
uxrt: BLD E I
UNIT:
PENMITTEE: ROGERS AOOFING ( 714 ) 995-2826
nooness: 4912 LINCOLN
CYPRESS CA 90630
LILENSEO CONTNACTOB OELLABATION: I here�y allirm that I am Iicense0 un0er o�ovisions ol ChaD�er 9(commencing with Section
7000� ol Division 3 of �he Business anC Pmlessions CoOe. and my license is in tullioae an0 eVect.
cirruc.: 035099 srarcuc.:'16887�4D/� cu�jsg: C39 EXP; 09/99
Date: I'� �� Z � � Signature:.L�Lk+�-�1"'�
WOPNENS' COMPENSpTION DECLAHFTION: 1 �ereby aitirm t�at I �ave a certiticaie of mnsenl ia selbinsure or a celiiliCate o� Warkef5'
ComOensa�ion I uonfe o a utif d-copy Inereol ISection 3800. La�. Cl.
POLICYNO.: �W�'2��i1�bVj E%P.DFTE: VZ/2G/9S
comrar+r: GOLDEN EAGLE
� Cetlili¢d coDY is �ereby tumishetl. �' C¢�ilieG capy is filetl vnth I�e ciry BuilGinA Division.
Da�e: � �"� -7 � A�Plicani: �� ,C%.�5��`��
E%EMVTIONiflOMWOPREBS'COMPENSATIONUECLAPATION: �TAi55eclionn¢¢Eno��etomple�etli�Ihepefmili5�oronehunOretl�1100�orIe55�.
I cehify I�al in Ihe Detlormance ol Ihe work for which �his pe�mit is issued, ISAaII not employ any Den�n in any manne� so as to hecome
subleci io Ihe Worker5' ComDensatmn Laws al Cali�omia.
Dale: Signature:
NOTICE: If, afier making I�is Oeciara[ian, you s�oula Uecome 5ublect �o ��e Workers' Compensation O�ovisions of ihe Labor
Cotle, you mus� lorlhwil� compty wilh such pmvi5ion5 or lhis De�mil shall be Aeemetl revaketl.
CUNSTHUCTION LENOING AGENCY: I here0y ailirm I�ai 10ere is a con5imc�ion IenEinA aAenry lor 1�2 OCAormance ot �h¢ work tar
whic� Ihis Dermit is issue0 (Seclian 3W7. Civ. C).
LENOEN:
FODNESS:
OwNEB BWLOEB OECLAPp710N: I nere6y allirm tnai I am exempt Imm ine Contracmrs' State license Law tar ihe followinq reason
�Seqion 7031.5 Business antl Pmfessional CoEe: My city of county whic� reQuires a Dermit to consimct. alter, impmve, demolis�, or
repair any simc�ure, prior m its issuance, also iequires ihe apolicam for such permit to lile a sipne0 statemem Inat ne/she is licensed
pursuant to ihe pmvisions oi �he Coniracmrs' State License Law (C�apter 9(commencing with Section 70W) of Division 3 of t�e Busineu
antl Pmlessions Cotle� or iha� �e/she is exempt��eretmm an0 ihe basis lar Ihe allegeJ esem0�ion. Nny viola�ion ol S¢ciion 7031.5 by
f n t more than tive nunered dollars 5500 .
f ivil nalt o o )
rmi� suti ects Ihe a icant Io a c e (
any apDlicant lor a pe I PP P Y
I, as owner oI Ihe pmpe�y or my empl0yee5 with waAeS as ih¢ir sole campen5aiian, will 00 l�¢ waM. antl ihe
❑ simcmre is nol intentletl or offered lor sale (Section 7044: Business antl Pmiessional CoOe: The Coniractors' State License Law
Oaes not apDly to an owner of a pm0etly who �uiltls or impmves ihereon, and who Uoes suc� wnrk �imself/herself or thmugh
�is or �er own employees, pmvi4eU ihat such impmvements are not intendetl or ottere0 for sale. II, however t�e GuilEinA or
imo�ovemem is sold within one year ol comoletion. the owner will Aave Ine burtlen of pmvinA he/she Oi0 not huiltl or impmve
tor Ine purpOse ol sale�.
I. as owner oi I�e pmDerty, am evclusively contractinp with licensetl contracrors ta constmcl I�e D�oletl (Section 70aa. Business
❑ ana Prot¢59ms Cotle: The ConlraCl0r5' Sta�e License Law Ooes not appN �o an owner ol D�operty wno OWas or improves t�erew
antl wha contratls tor such pmjecis wit� a comracbqs) license pursuam m tAe Conlractors' State Licensa Law). I am aware
i�at pmol of Iheir Worker's Compensation insurance shoula be D�ovi�eG Io me.
� I am exempt untler Sec�inn: B. 8 P. C.
lor this reason:
Dale: Owner.
I tlo nereby cenily thai 1 am aware oi antl unaerstantl the requirements oi Calilomia Healih antl Salety Cotle Sections 25505, 25533, antl
2553d antl ��al I or any lulure building occupan� will/will not (circle one) neetl �o comply with saitl s�a�e cotles and �he requirements �or a
permii lor con5imction or motli�ica�ion Imm Ihe Fu Ouality Managemeni �iSVict. Fesidenlial cons�mc�ion applicaiions are ¢xemp� from
�hese provisions.
Daie: ADplicanl:
I �ereUy cetlilyinal I Aave rea0 Ihis applRation and stale��at I�e a0ove inlotmation is wrrect. lagreeta comDly wit� all city anA counry
ordinances antl stale lav5 relating to �uiltling tons�Nction anU nereby aulhorize representatives af I�4 tily lo enter upOn IAe above�mentionetl
pioperty Iorin50eclion Durposes. �%
Oa�e: �'l��2..sy Signaiure: L � �](N� �i�
od�ei's Lmense or Sociai Searny e:
t641-a6 W�i�e-BuilEing: Green-Cotle Enlo¢omenC Canary-Applicam: Pink-Revenue: GOltlenroC-Auessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; H 06927�
PERMIT NO; B C69279 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; REROOF W/COMP SHINGLES SQ FT; 1,000
CLAIM VALUE: 1,000.00 CALC—VALUE; 1,000.00 GROUP OCC: M-1 /
COMMENTS: REROOF 560SF CARPORT
*arxar�t+t�r+�xit�+t�**�x �r�t*��**+Fx���*�t�*at***+F�t��x���f�riFaf*it�it*�*x��c*x+tx�+t��x �*�a:�+E�at+F+�x*r�
Z O N 2 N G R E�l U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ; PROV; PARCEL; 42434110 ZNE: REF NO:
PLANNING NOTES>
� •
iE if 1E i! iE it iklt 1E 1E iFlf if iE if !f 1k 1k i! iF i! i! i! iFlE ## iF if iE # iE iE if iE Ht if ik i4l1-1! iF it iF iF ih iE 9E iE iE 7F iE if i! iE if iF 4!h it iE 1E iE iE �1! iE �If jE 4 if !f iE it if 1f i(� iE #' iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
bUILDING APPROVED BY ; DATE; �'
APPLICATION ZSSUED BY; �1� DATE• 1Dl IZ�q�
fE 1t iE iE 7F iF 7! 1f iE i(� iE if iE iE i�F iE 1f if i! i! ik 1F �i�'iF�FiE if 1t iE iE �E iE * ic 1E3e ia�iFicif� �F {FlFiFitif iE
iF k it k it k'k it iE iF it if i! it if if if it iE it it it it i(� ik i6 iE if iE if iE 3E i[� iF it iE if i! iE k iE it it iE iE iE if 3! i! iE iE if M if iF if iF if iF iF * iE iE if 3E �lf iE iF iE it iF iE iE iF i! iE �le iE #
LEGALIZATION:N F E E S U M M A R Y STP.UCTUAAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25,00 , • ,50
SMIP/NON—AES
PLAN ..
ZSSUE FEE a_
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 25,50 0.00 0.00 25.50 . 25.50 ,00
, J
RECENUE DIVISION TOTALS--> COLLECTED: 25.50 OVER/SHOg•T; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T,OT GRADING PLAN—CHECK
25.00 ,50 .
iF iE iE fF iE iF 1! 1! 1E i! i! it iE if iF i(� if iE if 1F iE if if 7F iE iE it lE iF iE iE it iE # iF iE iF iE if iE 1F iF if !f !E!E iE iE 3E if 1Elt M iE if M-!(� if i(� iE 1E if iF iE�! it iE �lF jF if 3f it if if if?t fk if 1E
I N D I V I D U A L F E E B R E A K D O W A]'
TYPE QTY D E S C R I P T I O N UN3"f COS.T � TOTAL COST
SFR 1000 REROOE BY VALUE RESIDENTIAL NOZONE 1,00 � 1,000,00
END OF FEES '
�. ,
01 t701694??—OOt6958D T O i'
OATE: 10/13/94 TItlE: ib::5
/
,�
.,
V
25.50
,,
4 � ♦._
CpNSTRUCTION AND PLANNING POOL 'A
APPROVALS Permit# Date Inspecto� APPROVALS Aermit# Date Inspector
t. 7emporary Electrical $ervice or Pole 52. Pool & Equipmer�t Location
2. 5oil Pipe�Und�grnd. � � 53. Steel Rainforcement
3. Electrical Conduit Utiliry-Undrgrnd. > 54. Forms �
4. Electricai Conduit•Undrgrnd. 55. Electrical Bonding
5. Sceel Reinforcemenc 56. Rough Piumbing & Pressure Test
6. Eiectrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings , 58. Electrical Conduit�Undrgmd. �
8. Foundation �, 59. Gas Pipe, O U�drgrnd., Test
9. Water Pipe-Undrgmd. 60. 8ackwash Lines, P�Trap, C! Undrymd.
10. Structural Floor Svstem �' � 61. APPROVAL TO DECK •
11. Property Sewer Line & House �onnection ' 62. Backwash & Reteptor�Fina! '
12. Sewer Cap ) 63. Heaier & Vent�Final ,�
73. Roof Drains 64. Plumbing System - Finai
14. Rough Plumbin9 65. Electrical-Final
15. Rough Electrica6Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access A�proval
17. Rough Wiring Si9n 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Hea2ing & Air Conditioning FIRE DEPT, REQUIREMENT
20. Rough Pactory Fireplace APPROVALS Permit #
21. Duas, in Structure 70. Underg�ound Hydro
22. Ducts, Ventilating 71, Product Piping �Gas ❑Oii
23. Gas Pipa-Rough & Test 72. Underground Flush
24. RJof Framing 73. Undergrnd. Stora9e Tank G Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling IStructurap & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry StandPipe
28. Lething & Siding 77. FIXED SYSTEM fINAL
29. Insulation 76. FIRE PREV. FINAL
30. O�Ywali Naiiing HEALTH DEPT. REQUIREMENT
31. P�aster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter�Finai 80. F000 CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Condition+ng
35. Final Caat Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace • ��
i _
38. Flnal Ptumbing - j �
39. Wzter Service-Final `
40. G�s Service-Final
41, Sotar OomesticFinal
42. BackflowPreventer p��3_qy �,� � �O.c_ �' �
(_.
43. Backflow Irrigation
44. Landscape Irrigation System !..-(6 �!6 yj,�' `,� �,/�
/. T `-
45. Sound Attenuation �'G(� ��
46. Handicap Regulations
47. FINAL S7RUCTURE & BUILDING //.,�
48. FINAL PLANNING �
� 49. Electric Release to Edison
50. Gas Release to Southem California Gas Co �-�
51. CERTIFICATE OF OCCUPANCY
No. Date
�
PNOJECT AODflESS: 9 4 O j^i 1 aTfi $T
OWNEfl'S NAME: K, C, WU
nooeess: 5321 VALLECITO
WESTMINSTER
CA 92683
(714)897-3521
ur+iT: HLD B
� �AflCNIENGINEEfl: NEG.NO.:
� � AUDflE55: UNIT:
PEflMITTEE: ROGERS ROOFING (719)q�S—LLi�b
nooaess: 4912 LINCOLN
CYPRESS CA 90630
LICENSE� CUNTflRCTOfl OECIABRTION: I hereby aflirm I�ai I am IicenSeC unGer pmvisians of Ctupter 9 �commencinp wit� Section
70110) ol �ivision J ol ��e Business ana Pmlessions Code, and my licensa is in full force an0 ellect.
ciTruc.: 035049 srnTeuc.:468879 cass, C39 Ei{P: 09/94
J �
Date'. I V� �2� y Si9nature; ��� �r
WOHI(ENS' COMPENSATION OECIAMT10N: I �ere0y aifirm ihat I Aave a certiliwte t ronsent m selbinsure or a cenificate of Workers'
Compensation I m a•cuW O� thereoi (5ection 3800. LaE.
POLICY NO.: ���� 1•! 1�u�� E%P. ORTE: Z/ 2 G/ 9 S
comeaxr: GOLDEN EAGLE
� Cehitietl coOY is �ereby fumis�etl. � Ceniliea covY �s filed with tne c/i�ry/�u iltling Oivision.
Date: �U ��z // � ppplicant: � _�����
E%Eh7PTI0N FpOM WOBNEflS' fAMPEN5RTI0N DECUBATION: (TM5 section nee0 not be compieied il �he permil i5 tor one hunOreO (51 W� or less�.
I tertity �M1al in the pedormante ot �he work far whit� IhiS permil is i55Ue0, I s�all not employ any person in any manner so a5 to �ecome
5u6jen to �he WorkerY Compensation Laws al Calitomia.
Daie: Signamre:
NOTICE:II. after making inis tleclaralion. you 5houl0 Uecame suDject to ihe warker5' Compensation O�a��sions ol ine Labor
Cotle. you must lon�wrt� comply with suth pmvisions or Ihis permit shall be tleemea revoke0.
CONSTHUCTION LENOING AGENCY: I here0y a�lirm �hai Ihere is a conslmciion lentlinp apency for lhe Dehormance ot Ih¢ work lor
whic� Ihis permil is issuetl (Seciion 3097, Civ. C).
LENOEfl:
aoosess:
OWNEH BUILOEB UECLABR710N: I �ereby affirm ihat I am eMempt Irom tAe Coniractors' State License Law for t�e following reason
�Sec�ion 7031.5 9usiness antl Professional Coae: Any ciry oi couniy w�ic� repuires a Dermi� to conslNct, alier, impmve, tlemolish, or
repair any s�mcture. prior to i�s i55uance. also require5 i�e aOVlicant �or such permi� to tile a sipned statement I�ai he/she is licensetl
pursuan� to I�¢ pmvi5ion5 oi Ihe Comratmrs' Siale Litense Law (ChaD�er 9(CammenCinA wi�h Setfian 7000) o� OiVisiOn 3 of the 9usine55
antl Pmfessions Code) or I�ai he/she is exemp� �herefmm anC �he �asis for the alleqeE exemption. My violati0n ol Sec�ion 7031.5 �y
any aDPlicam lor a permit subjecls Ihe applicant to a civil penalty ol nat more than five Auntlre0 Uollars (�`�).
I. as owner ol ihe D�oOeny or my employees vntA waAes as I�eir sole comDensation, will Eo the wark. an0 t�e
❑ s�mcture is not inten0etl or ofiereC lor sale (Section 70aa, Business antl Pmlessional CoOe: T�e Contracmrs' State License law
Ooes no� apply �o an owner 01 a properly wAo 6uiltl5 Or im0�m'eSlAereon, and w�0 eoe5 SutA wark �imsel�/�¢rSeil or Ihmuph
nis or her own employees, pwvi0etl ihat such impmvements are not imentlea or offereE Por sale. If, however the 6uil0inp ar
impmvemem iS SaIU wi�hin one year of com0letioq the owner will have Ihe buraen ol pmving he/she tliU no� builtl or imOmve
lo� Ine puroose of sale�.
I, as owner ol ihe pm0erty. am eKclusively contractinp wilh licensetl conlraclor5 io con5�mci lhe pmjeci (Sec�ion 7fW4, Business
❑ antl Pmfessions Catle: The Comracmrs' Siate License Law aoes not appty to an owner M D�aDerry w�o buAas or Improves thereon
and w�o comracis br such pmlects vnin a contrac�oqs�license pursuant to t�e Contraclars' State 4cense �aw�. I am aware
�nai prool ol �neir worker's Compensation insurance snoula Ue Omvitle0 m me.
� I am eaemp� under Seclion: B. b P. C.
ior mis reason:
Date. Ownec
i tlo hereby certily that I am aware ai antl untlerstantl tne requirements ol Calitornia Mealih anU Safery Co�e Sectians 25505, 25533, antl
2553a antl �ha� I or any fumre 6uiltling occupam will/vnll not (circle one� nee0 to compty wii� saiA siate coUes anC t�e requirements for a
pe�mi� �or consVuciion or rtro0ificaiion Iwm Ihe Air Oualiiy Managemenl Disiricl. NesiGen�ial conslmction apDlicalions are exempi tmm
IIIC52 O�OviSi005.
Oal¢'. FpPlitani:
I hereby cetlily ihal I nave reatl t�is application antl state t�at ihe above inlormation is correcL 1 aAree to comply with all city an0 county
oi0inances anU sla�e laws relating lo GuilUing conslmction anU �ere0y authorize represemalives of �his ciry ro enier uDon Ihe a0ove�mentioned
pmperry lor in5pection Durposes. ��//— /j/
oa�e � I��/z � 7 Signa�ur� / G���
orivei's �icense a� Socia� Searity a:
t641-a6 Whiie—Builtling; Green—GoEa Enbrcement; Canary—Applicanl; Pink—Revenue: GolEenrotl—Assessor
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: B 069276 PLAN CHECK NO; N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR
FERM NO: H 069276 ,
GOVT: N SUPP: N
PURPOSE: ALT
JOB DESCRIPTION ; REROOF W/COMP SHINGLES SQ FT: 3,000
CLAIM VALUE: 3,000.00 CALC—VALUE; 3,000,00 GROUP OCC; R-1 /M-1
COMMENTS: SMOKE DET. REQ IN EACH UNIT 91UBC, REROOF 4200SF 4 UNIT APARTMENT
*,�*��*��,�*�#�*����*�#��*#*�.����,�;���*�.�#��.*##***���#****SI1110�E*D"ETECTOR
Z O N I N G R E Q U I R E M E N
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY'bv1��Y��R E D______
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGFIT; FT IN
PARKING REQ: PROV; PARCEL: 42434110 ZNE; REF NO;
PLANNING NOTES>
>
1!!! iE iE iElE iF 1t iE %1E if 1E 1h if i! iE iM1 1E it if if if i!!E 1! 1f 1f'k!f if iE it k if if'k if if ff iE # 1F ft ff i(� jf 9F IE iE if if iE 1E iE k 1f !E it i! 1F if� # iF �Ih iE # if �)F it ik ik if jE iE iE �E if-if
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:
HUILPING APPROVEP BY ; DATE;
APPLICATION ISSUED BY; �t— DATE: �D �.�I.1.
u��trti�*�r*�ri��r�t***�x�it�r*x��r�t�e3rTrx��i3Firx�r�r��r���Tt�r+riFir��'�r�t�c�F��r�r�r'�r*iri�x�*ir**it�- �rxxrx �tic-
i! iE if if if 1E �F iE i! if 1! iflE 1E iE it if 1ElE 1! 1E ff !E iElt 1E iE if iE iE if 1E i:1f ff iE jE 4 fE Yr 1t iE iE 1E iF iE 1F 1E iE i(� ik ik ff ff iE iE iF it i! if if if ik iP �E?E iE 1f if iE 1E if iE iP * iF jt 1f it
LEGALIZATION;N F'E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE ." SMIP/RES GRADID7G
PERMIT 59,00 .50
. SMIP/NON—RES
PLAN
IS5UE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL �;• PAID DUE
TOTALS----> 54.50 0,00 0.00 54,5/0/ 54,50 ,00
V
REVENUE DIVISION TOTALS--> COLLECTED; 54,50 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT•' GRAbING PLAN—CHECK
54,00 ,50�
iE iE il� iF iF k 1E i! iE iE 1E iE # if iE 1E iE iE if i! iE iE ih iF iF ft i£ 1f iF iE it iE iE it iE iE iE if iE iE iE iE if if if iE 1E i! if iF if iE iE iE if iE if it iE it iE iM1 # iE 1E if ±E if iE iE i! iE iE iE iE ih k if 1F
I N D I V I D U A L F E E B R E A K D O,W N
�,
TYPE QTY D E S C R I P T I O N UNIT COST • TOTAL COST
SFR 3000 REROOF BY C�ALUE RESIDENTIAL NOZONE 1,700 . 3,000,00
END OF FEES .
61 OG169b37-00169488 TC�T
C�ATE: 10/y3/94 TIt1E: 16:27
�
V
54.`Q
;
.Y
CONSTRUCTION AND PLANNiNG
APPROVALS Permit #
i. Temporury Electrical $ervice or Pole
2. Soil Pipe-Und�gmd.
3. Electrical Conduit Utility•Undrgrnd.
4. Elecirical Co�duit-Undrgrnd.
5. Steel Reinforcement
6. Electrica� UFER Grnd.
7. Footings
8. Foundation
9. Water Pipe�Undrgrnd. �
14. Scruccurai Ptoo� Svscem ,
7 7. Property Sewer Line & House ConnectioA
12. Sewer C2P
i
13. Roof Drains '
14. Rough P�umbing
15. Rouyh Electrica!�Conduit
76. Rough Electric Wiring
17. Rough Wiring Siyn
78. Rough E�ectrical�T Bar Ceiting
19. flough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Duc:s, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. fioof Sheathino
26. T-8ar Ceiling (Structural� & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Naiting
31. Plaster Brown Coai
32. Etectr�ca4 Po�ver Meter-Fi�al
33. final Electrc
34. Final He3ting & Air Conditioning
35. Final Gas P�De�Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plum6ing
39. Water Service�Final
40. Gas Service-Final
41. So�ar �omesticFinal
42. Backflow Preventerw.E
43. Backflow Irrigation ;'-
44. Landscape Irripation�ystem
45. Sound Attenuatiom ' �'
46. Handicap Regulations • ��
47. FINAL STRUCTURE & aUILDING
48. FINALP�P.NNING� � �
.� :
49. Electric Release to Edison�
50. Gas Retease to SoutFiern Cafifornia Gas Co
51. CEFTIPICATE OF OCCUPANCY
Date
Date
POOL ?A
Inspector AppROVAIS Permit #
52. Pool & Equipme�t Location
53. Steet Reiniorcement
54. Forms
55. Electrical Bonding
56. Rough P�umbing & Pressure Test
57. APPROVAL TQ COVER�GUNITE
58. Etectrica� Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines, P•Trap, � 1 Undrymd.
61. RPPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent�Final
64. Plumbing System - Final
65. Electricai�Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEP,7SF�NAL
F1RE DEPT. REQUIREMENT
APPROVALS Permit #
7D. Underground HYdro
77. Product Piping �Gas G�Oi1
72. Underground Flush
73. Undergr�d. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIflE PFEV. FINAL
HEALTH OEPT. RE�UIREMENT
79. FINAL INSPECTION �
8�. FOOD CERTIFICATE ISSUED
Notes:
�
Date �Inspector
�
.ow!'aeaem�aw: 940 W 18TH ST
•ONNEN'41UYEIFIQlONN: WU KEH CHANG TR
.onnEss: 16`7 LUHEN LN
ARCADIA,CA
wtt. �u�a+o �oo�u:
u�exrtecr oe e++m+�nn:
91006
cor�m�croirsw� VIRGILS ORNAMENTAL IRON
op(m�crorts�,uian 6900 OSLO CI
uNT:
uu ra:
UM:
(714)670-8270
�oox�ss: B. P CA uc.xo.: 47816
90621 �: A
110EN5ED COHfRACfOXS DECL�PATION: I hma�y dfrm uMa pnNy d pajury tlW I em fi�wead �udr prwmwn d GWar e
(commaid�q Milh Sectian ]WO) d Owo'vn a d Ne Buvi�ron end Pmfaviana Code. end mY Goena u in Iu01au end allsp.
cm . r+o.: uc. cuss: C 2 3 uc. No.� 7 8�6�EXP ;
.: � cav.ao.:�P7
OWN BUILDEP �EClAP1T10N: 1 hraby dfirm uMx prW y d psjury IMI I em exemq han IM Can�enm lioeme Lew tar tha
p'aw� (Sauian )03tS Bueneas end Rdmian CaM: MV W w wWy x/id� �eV� e P�e lo mmbuci. aGw. biwa*.
� d"e�, a repei eiry s��uciine. prior b ia eeuerca, abo �pu'vx �M epplinn� la ac� permil lo fJe e epnod qmanrM Na b a ehe
`fis liovned wmunl to Ihe wo-miane d iM Comredas Liceme law �cheqw 9lmmmanen0 xiln Sed'on ]000) d Dxebn a d tlr
Bua'vwa uM Pedwiom Coda� a �hat M a 4ro u aRemq tMrelmm eM tM ba�u la tle eAped Qemqion. Nry videtion al Satlun
]0]1.5 by my epp4renl la a prmtl amjaa� tM epplieN to a dW penely N nd mas �Mn fin MW�aE do0en �SSOOp.
� I.nowMrdlMpeapanyamyanpbY��hwpmmlMisdsaompMudion.v.�9dotlrvM.endlM�WCNniiw6nadW
a a11xW M e+b (Sec1on 101�. Busroa vd Prd»umf COEe: TM CaM�atlat licems lewdou ml Wp1Yloen ownsd qopMy
who buid� a inpo.ee �hanm. eM Mn Aom �ud� xak hinatl a Mnd a Wa� Ae rc Mr own anWvysn. pa'idW thr mrA
"unpvwnwv ers M"vaeMed a WxeJ lar aeb. tl. howws. �M GriNieq a inPa'd�en u wtl xillim ans Y� d mmObbn. tM
awner-0uddor x�0 hew �he WNen d o�+�u he or Me EN nd bwld a impm+lv �hs p�vpas d Ws). -. "
❑ i.,. �. a in. ww«n..m ��+�+oo�u�.aro ..m� w.�.ae �o-.na, m oo�,aw m. c�a.d �swo� rou. e�.. �a
v�wn:on. coa.>me cw�.ea. lie�e �.. me. �a ewN m.n oMw a ww�r •ro bu5f. >:�pw« m..on .ne wno
rnnvme ror aMi wda� wN a m+rmMel4censW Wnuem lo �M Caarmb� L'oma la�. .
� I em e�emq uMer SeUion: B. 8 V.C., b Nis �eevon: .
Oela: �
I do �eieM ��h � I am ewere W end urdseteM IM �uimnsnU W Cd/ania Msellh eM Sdmy COEs Saeom 25505.255J3. e�d
25.U1. arN tIW I a eM'tulws buitluq om�peni xill / wil m� (wcb ane) neeE ro oomPN wYh uid tlme oodm eM IM i+V�� Ws la
.a«nmea�d,.wnion«�wea.manhan m.�:�uT'�ia�x�a uuhf. nma..r ooim�won.ov�mim.n.*.�w emm m...
a�.
om.: �ca�u:
WORKEN'8 COYPENS�TION DEC WIATION: I MnEy alfmn undar psutly d pxjivy ar d IM fo0ow'uq dedutbro:
� I heve eM wil meinien a cMi( sta d aomm�i to sall�imuro M wake�e' compametion, n qovided la by Swbn 3100 d IM lebar
Coda, ia �M pe�amenca d tM wak Irc w1irJ� ihn pxmil u iuwtl.
❑ � nm. w rri� maruen woelw.� mmo�:� ��.,�vo. e. row� M saion a'!ao a m. Lwe. eoa.. lor �n. w�� a �ne
wpk lor wAich ihis pe�mil i� u�ued. MY wa�' �Ve�w� ineurenca renier vN potlry mimbm ve:
c�..:
Pd'ry Number:
//��(TAia/�seCion rieed iwt Ds mndeted'f tM P�k ia lw wro hvrMrod EOMn R1001 a Nn.)
:�y I mrlly �het in iM peetormenee d tM wak tor whieh Ihie psimil u iaueE. I Mell rwl emplry arry penon in enY mennw w o lo
T becoma wbjed to tM w�kms' mnWsneatun �ers d Cdilanie. enA aprse tlW il I Mouk becaro mib�rf lo ihe wvFen'
1 n�p�qu/���/^��/��` d/ SeGian �)OU d iM lebar Cods. I dJWl Mhwilh w�/n{N/. w�M� ��w pivri�b�m.
�� �T'�/ � .[ ADW'rant: / ti.0 N� /W� •
w.minp: F.Ilun ro wcun wo�kln' mrrpwuetlon cover+W l. vnlnrNl, .na �NII a�C/�er m wrplqw ro aIMNI paWtle en0
elHl ll�ros up ro ons Iruntlrotl tMua�ntl doll�n /tIOQOW), M�tldltlon b fM ewt ol romvxuafbR ��p� N po✓� br In
91cHon 91PB ol IM Le6or Co�N, Inlerul, eM ettomsy'� I�u.
CONSTfiUGTON LENDINO �OENCY: I Mreby alfirm �e.. �M d�y iw m«e A e w�a�,ao� w�e�oo m«Ky �« n»
pAwmvim d tM Mwk M whid� tho prml u owed (`�� ��. Giv. CI.
LENDEF'S NAME:
LENOEH'SADDPESS: �� ELECT
i�en�y mm i n� reee m�� eoW�m�.�L id'slasIria 6.sli��ian ie eortxf. I n0� lo eamWY xith dl d1Y eed mwXY atlme'm�
eM steta kvn ielelinp lo huiNvp conSrudion W heroby eulhorixa �epeventalives d Ihu dly lo an�x upon �M ebove�mmlianed popery
�°`��'P°'�0�`°�� VIRGIL LACISTE
(S151JB.WP) Whue-Buik'ry d SaIMy:
DW: �
Pink-Rwmus: (3ddenmaMem
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 079807
PERMIT NO: E 079807 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
JOH DESCRIPTION : 6' HIGH WROUGHT IRON GATE SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: U-2 /R-1
COMMENTS: WROUGHT IRON GATE ONLY
*atat�atitx��*�t�t*�t�t�*+t�tat*�t�t**itat*et�ititat�titat*it*�tatatit*�t*�tit*x�*****�tit****it***�t******at�*at�af*it
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42253110 ZNE: REF NO:
PLANNING NOTES>
i
i(� if if !F 1E 1ElE iE iE iE 3E iE 1E iE iE iE 1E if 1E 1F ik IE 1E iF if if 1F IF iF Ik 1E k 1E 1E 1E 1ElE �E if 1F 1E k 1E 1E k iE 1E IF 1F Ib 1ElE fE 1E fF 1F iE 1FlE iE 1E If� f! f! 4 iE 3E 1E fElE ik 1E 1f iE iE IE if If iE
D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � � DATE: � � �
jE1EiEfEiElElE1EiFlEikiElEikiEiflElEfE1F1FfEiF�F3F�EiF±F3F3F7FiFiF�,�iF� �iF7FiF�FiF±FifiFiFiF3F�FiFfE�EfliEiEiFifiElEif fEfE
LEGALIZATION:N F E E S U M M A R Y. STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECIiANIC FIRE SMIP/RES GRADING
PERMIT 20,50
508 SMIP/NON—RES
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 20.50 22.00 0.00 42.50 42,50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 42.50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
42,5�
1F iE 1E'IE iElE 1E 1E iE 1E 1E 1F fE 1E iE 1E fE fk iE iE iE 1E �k 1E 1E �lE k iF 1E ik 1F IE 441E 1E iE 1E 1E iE iE 1E iE iE k �E iE k 1k iE �E 1E k iE 1E ik 1f fF iElE 1f 1f� 1(� 1E fE 1E iE f! fE 1E iE 1f if �E iE if !f!f if
I N D Z V I D.0 A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 1 MOTOR/POWR APPARATUS 0,0 — 1.0 HP 4.25 4,25
ELE 1 MISC CONDUIT NOT LISTED REQ PERMIT 16.25 16.25
END OF FEES
�1 QOTSb<40—��21644� TO T 42.50
DATE: 10/04/95 TIME: 14:40
+{ CONSTRUCTION ANDPLANNING _ . POC .�SPA -
-�� �� APPROVALS Permit # � Date Inspector AppROVALS Permit'#� Date inspector
,
t. 7emporary Electrirai Service or Poie' ' 52. Pool & Equipment location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
-�3. �lectrical Conduit,lftifity-Undrgmd. - 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�U�drgmd. -
' 8. Foundation ,'-' . ` 59. Gas Pipe, O Undrgrnd., Test : �
9. Water Pipe�Undigmd. 60. Backwash Lines, P•Trap, C7 Undrgrnd. . � �
10. Structural Fbor Svstem 67. APPROVAL TO DECK
17, Property Sewer-line & House Connection 62. Backwash & Receptor�Final
�z• SQ'a'e� CaP -. ' 63. Heater & Vent-Final
13. Roof Drains - - 64. Plumbing System � Final
14. Fough Piumbing ' � / 65. Electrical�Final -
75. Fough Electriczi'•Cqnduit . 11 � y�/y 66. Solar SYstem-Final�
. � ����� 17l
16. ftough Electric_Wiring 67. Feqcing & Access Approval �
17. Rough Wt�ing Sign �, AppROVED FOR PLASTERIfdG
18. Fough Electricai-T Bar Ceiling � • 69. POqUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditio�ing FIRE DEPT. REQUIREMENT
20.�Rough Factory Fireptace • � . _ - APPROVALS' . Permit # lr
21. Ducts, in Stru'ctur.e ` -' _ . - ,�- 70.: Underg,ound Hydro � r
22.Oucts,Ventil8j��g� , � �*'- 71. Product�PipingOGae CJOiI
23. Gas �Pipe-Rough &- Test _ � '� ' 7Z, Underground Flush
24. Roof Framing ._ .- •- p3, Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing : „ � � - � � � 74, Overhead Hydro �
26. T�Bar Ceiling (Struciural) &_Monocoat '- - 75. Dry Chemicai . - . . ._
27.-Frame and Flashing' _ '. 76. Dry Staildpipe: ..: -
28. Lathing & Siding , . . . . r 77. FIXED-SYSTEM�FINAL .
29. Insula2iori " - '. ' - � ` 78. FIRE PREV. FINAL - -
30. CJrywall Nailing ;-� �� � � . rHEALT-H DEP.T-PEQUIREMENT
31. Piaster 8iownCoa�,� _ _ . 79. FYNAL iNSPECT.tiON ': � -� -
. 32.-Electrical-Power MeterFinal � '- �- 80. FOOD CERTIFICATE ISSUED
33..Finai Eleciric '` �r ;, ��/4%� _ � Notes: _ . _ - - _
t
� 34. •Final- Heating.& Air�Conditioning. � , . . • - -
35. Finai Gas Pipe-Test ' � - -
36.' Hood orCanopY • - _ - n - � � " r
t
- 37, Final'Factory Fireplace � - " � "� ' . ' ' ..
. 38. Fina6 Plumbing ,. .. .. .. , � . . .� �
39. Water Service-Final � : � � - - -- " _
� 40. Gas Service-Final . . ; .' . ; � � � • _
� 41. Solar pomesticFinal - � _ ' _
_ � _
42. Backflow Preventer. ' . ' . � . - �
43. Backflow Irrigatiom � � . - . . '
44. Landscape Ir.cigation System_, �: � - , -- � � . - �� - �
45. Sound Attenuation • • - - - - - ` ,
46.'HandicapRegulations ' _ ' _ � _ - -
47. FINAL STRt�CTURE & BUILDWG ' - . • '
,� . _
�
48..FINAL PLANNING: '. • • �
.49. �Electric Release to Edison � , . _ " �
50. Gas Release to Southern California Gas Co - . � � � •
51. CERTIFICATE OF OCCUPANCY - : -
No Date "
0
wonessaeu�aw: 9q0 W 18TH ST
oxxeaswweira+owre WU KEH CHANG TR
' �� 165 LUHEN LN
ARCADIA,CA
�ve�. �,uuxu �oonsss:
uwxrtecT an eiux�n:
�pCH OP EN�.'SIDDNE54:
uxr:
91006
ur xo_
UNT:
coxrxAcrarsru� VIRGILS ORNAMENTAL IRON ( 714 ) 670-8270
cam�crars�uw+o 6900 OSLO CI
�ooness: B. P CA uc no.: 4 7 81 6
90621 uNr: A
LICENSEO COMRACTOflS DECU1fl�TI0N: I Mreby efltm uMs pane�y d pmjury tl� I am fieeneeE uMer prwirion� ot Cheqer o
(mmmenaM wilh Sxtion ]OM) M�ivuion 3 d Na &eiroe eM P�ale�ams Coda. vM mY Yoenee o in M1A Mn eM Mlatl.
c ua �o.: !O(�(SL uacuss: C23 uc.No.: 47816 EXP:
�,� l/�� ��� U,�,� �f
WNEP BUIL�EP DEC WIATION: I Iweb/ dfimi uMs pmNy al perjury ihet eRemq fmm �M Cauraqas L'crus lew la IM
bwrtp rte+on ISeGion )0.t�.5 Buaima eM Rdessio�u Cads: MY ciY o couM' xfiidi raVuiree e Dermn to mmNwt. Mer. imMove.
demd'oh, or ropar eny awc�ure, prior l0 4s eve�, e6o npu"vea �he epplimm tor wcli pmnt lo fJe a eqneE abbmx�l tlW M a eM
e lice�ued Wmiiem b �M Vweiom d Ne Cam�mas lironu law ICheNa 9lmmmentiq xilA Sedion ]000) d Oiveion 3 M �he
Buainesv eM Proleseona Cade� w IM1et he or ahe b e�emq thardrom ad tM 6erie Iw tlw ellepaE eaemqion. My violalion al5edion
�mis M Nr mp��� I« a wmm +Wpus �n. epN+'am �o s aw wroM a m ma. �nen Ma huMred da0an �sswp.
� I.moxnardlMV�GeMa_mYemd�'^sx'thwepmm�MiedecomO�.wNEotliexak.adtlesWdureum�'v�rNed
a artaeE for aeb (Sarvan )ost. Buuren end Pmleamna Gode: TM CaNredas l'mne law Eo» M eVONIo en ownerd piapeny
wno wus «:nwo�� me,:on: ena .no do.a.ua� wonc hmsen «nuee� n mmuW nc «ner o.n en,Ww�. wwbed mm wcn
imponmmu are nol'uNe�Nad a dlued la eab. tl. howewr. �M dnitlieq u inP�� b wk wGM ans Yser d eomWe�ian. ihs
w�,w�ue...ai na.. ina w� a wa�o ne «.n. au �a wud o. �wa+t« u» �vo.. d w.).
❑ �. m oxn« w me mwsm..�, �a�nn.h ��:a �n Yoan.ee convacmn w canww Ne wq� (swion rou. avsr..m
Proleaiora CoEe: The Comraon Lioen» lew daea na epply m en owner d papMy who WiNe a impova �hereon eMl Wa
eonveete b axh prqetls w4h e mv�euar�e) liromed pwsuaex b �ha Com�etlara liwua lewl.
❑ 1 am uamV� �mdx Serf' �� 8. a P.C.. br Ne nem:
Deb: �
�. I do Mmby eenEy ihet I em awara d vd undenWM �he eapuuamwa d Celiwnie LkaM eed Stley COEe Sed'an� 25503. 555�. eM
25534. erd ihet I a vry M1nun bnMinp omrym��. vnT / w11 iwl I�b ana) neM b oomp/y wih uid ems wdn eM ths nyuinmeMe h
a p�rr�M/wmrow�Yiana modifmionhanlMM�v�epemru Oivrie. RnMrael mut�utlion eppimtiauan wmq han tlwa
ao�.�,..
Deb: �00��:
WOPKER'S COMPENS�TON OEC WIATION: I hxab� elfum wdar pw�eEy d psryry ane d IM IoYvx'vq ErLra�iom:
❑ IMaeMVAmeinle�eeaW'rmadmim�ita�diimusbwMen'mnpeeumion.nqwkatllabySWion9l00dtMlebor
c«�.. �« �n. wnwmv�c. d m. wix �o. w:rl� Uri. o� a o.�.e.
� I hew aM wll meinlei� v.orkei+' mmpemNon iimevra. o iapuiead by 9atlim ]]W d Ihe Lebor Cade. M IM pMamenee W IM
work Iw whieA iAia pamA is iesued. My wake'i eomVemtlion im�rerce umx aM VdwY m�mber en:
, c.m..:
Pdiry NumMr.
�rn; ..aianMee�ora.cand�rwv«meaw,n,.n„�medddw.R,00law..�
1 cmlh/ ihet in Ne pMamerce d ths work lor r.fiich Ihe pemiu u uaeE. I NeY nol ampb� ury prcn In ury menw w n lo
wbjed ta iM workere' campn�elion 4we ol GeGlomie. vM ap�es Net H I houM Ecome eWptl to tM Mabri
pemetion Pa+eiom d Sedian 3100 d tM labor Cods. I W�I fa�hwrtly��ON wil Mr pw�m�.
�T��S� vT
b /. �oaium: � c �
Wun1�0: F�llun b�ecun woik�ri �n«u.no� �o...nro� �. ��.�.�..�a.wn.�elK�.� «ro�or.r ro enmiwv.�wn...�w
clv/l nMs � ro on. nunC.�d tnomne do1W. ftfo4aaoA Mi aM/don ro m. cwt ol rompru�tron ��W •a povM�e ror In
9�ctlon 91t16 ot tlH /eOorCodr, Infw4 �d aMmry%� /w�.
CONSTilUC710N LENDINO AOENCY: I Mreby elfirtn i�Mx pmeAy d perjury ihm tMn h e oonq�udion brd'up epancy M IM
paNameMa d IM wak br r.fiitli tAe pa�mi u m�ed (`�� �). Cb. CI.
IENDER'S NMIE
LENUER'S �DDPE49:
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�ortrwvae�w�oons�. VIRGIL LACISTE
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(5151de.WP) Whno-BUTdYp 8 Se/&y: GreemFb: Ce�ary-Appirant; Rnk�ivnnue; OdEenmE-Meanor
CITY OF COSTA MESA — BUILDZNG PERMIT
PERM NO: B 079806
PERMIT NO: B 079806 PLAN CHECK NO: 04080-96 L GOVT: N SUPP: N
CONSTAUCTION TYPE: PERMIT TYPE; STR PURPOSE: OTH
JOH DESCRIPTION : 6' HIGH WROUGHT IRON GATE SQ FT: 25
CLAIM VALUE: 7,100.00 CALC—VALUE: 250.00 GROUP OCC; U-2 /A-1
COMMENTS: WROUGHT IRON GATE ONLY
*ir*ieitit**x�***itat�x�at*at*jt*at**atx �rieitie*�*�*ititititat*�at�r**�*� it*�*�at�*�rie**itatat**it*it+����atir�**
Z O N I N G R E Q U I R E M E N T S
S E T B A C R S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42253110 ZNE: R3 REF NO:
PLANNING NOTES> INSTALL 6' HIGH SECURITY SLIDING GATE AT THE FRONT OF`BLDG.
> GATE SETHACK 25' FROM FRONT P/L/. O.K. BY TRANS.
1E 1E 1E �)E'X"If' 3f jE * i! �If iE iE iE iF fF 1f iF if if iE jf �IElF �If iE dE 1h 1h 3E if �Ih 3E if iFlE iE iE �lE jE 1E'IF fE iE 1E IE 1f iE 1E 1F iE 1f if iF �IE if iE 9E iElE if ib iE if� 1F �E fE if-9E iE if !E if iF if iE iE �E fE
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 � G DATE: �'-
BUILDING APPROVED BY : /�/I, . DATE; /q I�-1 IY �
/ " �r,_
APPLICATION ISSUED BY: DATE:
*�*******�r�*+�****+�**+r+� ���**�**�*��'i�x�*
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRI•G MECHANIC FIRE SMIP/RES GRADING
PERMIT 21.00 ` - .50—
PLAN 13.65 � SMIP/NON-RES
ISSUE FEE `
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID . DUE
TOTALS----> 21,50 0,00 '•�. 13.65 35.15 35.15 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.15 OVER/SHORT: � .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
21.00 i�' .� ; .50 13.65
iE1F1fif1ElEfE�F1EiE1E1lfFklEiEiEfliflElfik1E1E1F1l1E M1E1EIE1EfE1E1F1E1k1ElE1lfE1E1Elk1E�FiElEikifiElfiE1lfE1E1FiE7lfEiEfEiE1k1liF1FiklElEiEiEiE1F1ElEfflElf
I N D I V I D U A�L �� F E E H R E A K D O W N
TYPE QTY D E S C R I P T I•MO N UNIT COST TOTAL COST
ti
SFR 25 RES—W, IRON/CHAIN`L'INK FENCE / FT. 10.00 ' 250,00
END OF FEES _
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01 002164:1—OOZldif3 TCl T .i5.IS
DAiE: 10/0</4S iIME: 14:40
, �.
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'• CONSTRUCTION AND PLANNING POOL.. SPA-
Date Inspector � - �����1 Date Inspector
QPPROVALS Permit # � APPROVALS Permit #:r
4 ,
7. Tempora�Y Electrical $ervice or Pole 52. Pool & Equipment Location '
2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement � �
�_'3. ElectricalConduirtUtility-Undrgrrttf. 54. Forms "
�4. Electrical Condvit�(liidrgrnd. l/ ��'� ��� 55. Electrical Bonding ' -
'5: �Steel Reintorcement 56. Rough Plumbing & Pressure Test -
6. �Electrical UFER`,Grnd. 57. APPflOVAL TO COVER�GUNITE �
.�)�.i Footings ^ 58. Electrical ConduibUndrgmd. -
�8. Foundation - " 59. Gas Pipe, � Undrgmd„ Test � � �
�.'9. Water Pipe�Undrgmd.r 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor Svztem 61. APPROVAI. TO DECK
11. �Property Sewer ��.,ine & House;Conhection 62. Backwash & Recepmr�Pinal '
12. -Sewer Cap � - -' 63. Heater & Vent�Final
-c
13. Roof Orains 64. Plumbing System � Final
74. fiough Plumbirig � 65. Electrical�Final
15. Rough Electricai:Condu"rc 66. Solar System•Final
16. Rough ElsctricJNiring 67. Fencing & Access ApP�oval
17. Rough LViring Sign ' 68. APPROVED FOR PLASTERING
78. Rough Elactricai-T Bar Ceiling 69. POOL/SPA SYSTERAS FINAL
19. Rough Heating & Air Cond(tioning FIRE DEPT. REQUIREMENT
20.�RoughFactoryFireplace �;,•. - � - b�^�^ APPROV&LS'C• Permit#'� �
�-
c c r
21. Ducts, ir�_StrutturY�:' ; ; . "_ ` _ � 70.`:Undecgrou�d IZ�dro ,:z �
22. Duc[s, �%e�tilyting..: - - � �' �c;�� - 7�, Produft-Fipingl7Gas DOiI
23. Gas'Pipe�ough &'l�st r„ T � �_ 7z, Unde 9round Ftush�, � �_;
24. �Roof Framing! ' .. � i �� � 7�. Undergrnd. Smraga Fank O Gas Q'Oil
25. Roo'YSh"thin _ �- , r•' =?: '{:-'=�
y: g� 9 . ,,`: u., 74.. OveLhead Hyd�O
26. J•BahCe;Gng 4Scructural} & 4vtonocoat - -. .v= 75'. Dry Chemicaf - -�'�
27.�Fremeand Flashing, - _ � �� ^'• �r, 7G. Ory'Sta��lpjpe� � -' �� �,
�'' 28. L.athing�& Sidin9i r. � r . j � • r" 77t FIXED-SKSTEf�FINAL-. .�.
�� � 29. Insulatiqq � " ��'� - _ � 7$. FIRE PREV. FINAL 7 -
��� 30. Drywall ailing * t�� � - �, -;HEALTi� DEPT. REQUIf{EMENT
�� 31. Plaster B�wr}CoSt'.:: � � ' �`r � 79. PINALa��PEC�ON �` - - ',�.
'� - � - "' � - - Y
� 32. Eiectrical Power Meter;Final � -� .- 8�� FOOD C�{�TIFICATE kS�UED
33. Fin�f Eleciric. ., � ' �_ ;' ' - Notes: `a �3� _7�(O�- � �t�p. CQ�
'' 34. -FinaPHeyting`& AirNCondjtioniriy�-� , � �;. • c-T ( � /
� _ �PIG..,.�s�{� - �C:�e-� CC� •
� 35.'Final•Gas�P�Pe'Test N „ �- � �Q / _ ` `^;�� �
36. "Hoo`dor.�anoPY � - R �- - . - � ,'� . _ `�,�� +, ' ;K
37.'Final Faciory PirePtace. ? -•' " � `'� . � * � �T �
�
/ .. . ._ � . . .. _ ._ . > u
� 38. �inai„Plumbin9 ;,, . . - , - r., n
' 39. dNat¢r. Service-Final • � �' � � � ' � � � �= a �
Y Z
;�� 40. Gas Service-Final ". ,� � � _ " ` ' _ r" � ' '
� _� _ ;�.
: � 41. �So1ar pomestic�Fina� S � � • • r ' - : _ -+
' 42. �ackflow Preventer; � -. . _ . - . . . _ . .
43. Backflow Irrigation _ "
44. Landscape ��ripation System.- - � . � •
45. Sound Atcewation ' - - • '�' ,
46. Handicap Re9ulations ' -
47. FINAL S7RUCTURE & BUILDING z-s'!Z? ��+- _ � d(Sr BY -�m6� C�� P� s� ��
48. FINAL PLANNING . ' - � �
49. Electric Release to Edison -- ' �- .
50. Gas Release to Southern California Gas Co '
57. CERTIFICATE OF OCCUPANCY ..
N0. Date
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SUBIECT TnO otDG C
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STRUCTURAL APPROVAL ONLY
SEPARATE PERMITS ARE REQUIRED
FOR ELECTRICAL, PlU°�BIVG,
HEATI�:G, VE1:T'� ",TING AND
REFRIGERATION 4VORN
P�u �°� # � 0
THi: ;� . ��=: � �a r,CCG�.9PANY
ALL IP;S2_C�fJ�J R�QI;cSTS
� FO � 3�:L0 `. S.._ � PE'S;�;S ARE TO
I BE ELi?��,�J, ,:c �.,.;,.cS! THAi iHE
ST;,TE Uf C LrJ.,��IA DIViSION Of
li'�.ST41AL S'ffTY BE COIVSULTED FOR
All;:�i�u��,,l REQUIR�MENTS.
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B'fJILD*,�i�IG SAFETY DEPARTMENT . N�. 1443 �
'P. O. Boa No. 317
Costa Mesa, Califordu -
� ne�eJ— ? 7 — �l
CITY OF COSTA MESA •
CERTIFICATE OF OCCUPANCY
Building Permit No /� �� E//lect
Use of Building l uC��ti
Plumbing Permit No.
The building located at 9�! ri iGil �>f, �' ���c�tRl-I
Legal DeSCiiptlon
(See reVerse side for Metes and Bounds)
has been inspected and found to comply wit6 the provisions of all City of Costa Mesa Ordin-
ences appllcable thereto for a Group �Occupancy.
ISSU TO:��� ��y Bo� • e Ofiicial _ �
l,� (�.1
(Owner of B ding) B���-� ' �
CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ n� d copy—E ison Co. ❑ 3id copy—File
Form 208 S-H P IM 1-80
��. • . �Q.73g7 �%- /0�/OZ�/03//04
� COSTA MESA BUILDING-SAFETY DEPARTMENT
• P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
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For Applicant to FID in Completely — Use Ink
ILDING �� ' ,�� f(./ �^S-,
iORESS
OWNEF
MAIL
ADDRE
cirv 4
BRANCH
ADDRESS
ADDR
CONTRACTOR
ADDRESS
CITV
STATE
LIC. NO.
SIZE
OF LOT I
USE OF
TE
TEL.
NO.
CITY
LIC. NO.
INO. OF BI�OGS.
NOW ON LOT -G3—
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO 6E PERFORMED
'i3ti-v `� A — d- � n� � r
F�QT, f�L'D `� C►.1� P�1Ttact+E1.7
I hereby acknowledge t�et I have read this applieation antl state
that the abova informetion is correct and a8ree to comply with
aU lews re0ulatfn8 builtling construeti0n, antl I shell not emptoy
any person in violation of ihe workman's compensation laws of
the Stata of Caltfornla.
I hereby certify that I am properly licansed as a contractor undar
tha State ot California Businass anA Protessions Cotle, Division 3,
Chepter 9, antl that 5uch litenses are in fu11 force entl etfeci, or 1
am exempt from tha provisions ot the State of California Business
antl Profess(ons Cotl/e,��O�ivJ'ston 3, Chapter 9.
Signature of �,/ � `,��
PermiKee X=GCGeG «'C.C�--
Authorized Aae�t
A.P. NO. I I(D �
BUILDING
ADDRESS �
T
� �223 2/08/79 2 4,�K�T�.
���3223 2/08Y79 2�Q.
•�flL28•! OQQ04A73 97 I p jI''
.��t V'C.i.I ��(/
FOR STRUCTURAL PERMIT /�y �%' .
�p.T`E�CEI�D DATEISSUED '
7
��
FIRE
ZONE T
APPROVED
BY
ZONE NO.OF .
PLANS �
YAROSAPPROVED
DISTANCE BET.
MAIN BlDGS.
rAri o��i��
HOLD FOR SPECIAL
i[
DATE
U5E OF NEW
BUILDING ��M�
YARDS APPROV ED
ACCESSORY BUILDING
BEf. MAIN &
ACCESS. BLDGS.
DATE � //��
APPROVED
THE AMOUNTSHOWN VNDER VALUATION IS FOR
THE PURPOSE OF ESTABIISHING A PERMIT FEE ONLY:
VALVATION �/� PERMIT FEE §
% v' PLAN CHECK $
$ J�9 TAX $ .�,
���JTOTAL PAI D 5 i�9 /L ��
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3224 2/OB/79
COSTA MESA BUILDING-SAFETV DEPARTMENT 3224 00004473 98
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 _. - �-•
A L ATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RE I D D E R EIV D DATE ISSUE❑
BUILDING r'4Q �aT�"�j ST•
AOORESS �1
OWNER
MAIL
CITV
BRANCN
ADDRESS
A.P. NO. �(9 � � (Jr'r /�
AOIDRE55 �ILLI�� I 7C �' I 7 I
�, � ' FIRE
ZONE
APPROVED
CONTRACTOR � p(�]�ER
ADDRESS
TEL.
CITY NO.
STATE CITV
LIC. NO. IIC. NO.
SIZE NO.OF BLDGS
OFIOT 13ax3oo INOWONLOT '8�
USE OF
E%ISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
I hareby ecknowlatlpa thet I have �aetl this eppllcation and atote
thot the abova Information Is corract entl aBrea to comply wlih
ail Iews regulating builAinp consttuction, ond I shall not employ
nny person in violation of tha workmen'a compansetlon lews of
t�e Staca of Colifornie.
I �ereby cettify chat I am proporly Ilcensetl as e contractor untler
the Smce ot Callfornia Businesa entl Profazatona Coda, Dlvision 3,
Chepter 9, and thet such Iicenms are In full force entl effaet, or I
em axempt from tha provisions of the Sta[o of Callfornie Bu�lnev
antl Profauions Cotla, Dlvision 3, Chapiat 9.
Sipnetura of /(�
Permittea � /12 (
Authorizad ABant
�i
224.85 TL
224. 85CitT0
-IA ' --
�
ZONE NO.OF USE OF NEV�(j,y�
3 PLAf�S � BUILDING O
VARDSAPPqOVED VAROSAPPROVED
MAIN BUILDING ACCESSORV BUILDIN
(FROM �REET)
RONT FT. FT.
SFT
L. SIDE T.
REAR F . FT.
DISTANCE BET. 9Ef. MAIN &
' %CJ �� APPROVED 7����
�
t10LD FUR SPECIA REQtiIREPoIEpTS �
m
i
!r¢- iui�v� �
SQ. FT. /e O a
THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF ESTA9LISHING A PERMR FEE ONLV: ��
VALUATION PERMIT FEE E �
n
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PLAN CHECK S ^�
5 I�� TAX E � � M
��9� .� „�
TOTALPAID '
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3225 '2/09/79 299.69GKTD
COSTA MESA BUILDING•SAFETY DEPARTMENT �225 00004289 69 I ll, /
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 . .. _.. . �� /
AP Ll ATtON FOR STRUCI'URAL PERMIT U
For Applicant to Fill in Completely — Use Ink Only
flEC D p-q/ TE CEI E DATE ISSUED
BUILDING � /� � �A'r�..,/ �,r C T ��
AODFESS `Y'��
OWNER�VI�UE mA►.bo�c��a�:
MAIL I_nOQ f.. . OC��iA1F
ADORESS COl l.Al
TE
CI7V %]F61dn2T �F.C! 1..1 NC
BRANCH
ADDRESS
ADDRESS �27(o Y�L(att�S 'DR. N.i7
CONTRACTOR
ADDRESS
TEL.
CITV NO.
STATE CITV
LIC. NO. LIC. NO.
OF lOT ��' �Z NOW ON LOT ��
X 3ao
USE OF
E%ISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
VSE OF BUILDING ANO WORK TO BE PEFFORMED
I hareEy acknowladpe thet I have �eatl thif epplicaiion end rtate
chet Ne abova Informatlon ia corract antl aB/ee to comply wlth
atl lews raBulnilnB bullding connrucHon, antl I shall not employ
eny penon in vialatlon of Mo workman's eompenzetion laws of
Ma Steie of California.
t hareby eertlfy thet 1 em p�operly Iicanaetl ne a eontractor untler
tha Stete of Cellfornie Businasa antl ProfessiOns Cotle, Dlvlsion 3,
Chapier 9, end that sueh Iicenses ere In full force antl otfoct, ar I
em axempt trom t�e provlslona of fha Stata of Cali4ornia Business
antl Professiona Code, �Ivlslon 3, Chapter 9.
SlgnatufB of „f l �/J _�
Parmlttae �� � L_�L./-Z �U�
Authorizad Aqant
A.P. NO. /�(! �
BUILDING /]. .
FIRE
ZONE T
APPROVED
BV
ZONE � NO.OF .
PLAN$ �
YARDSAPPROVED
MAIN BUILDING
�FROMGL$=PEET) ,
VAR. �
�
VALUATION
��
USE OF NEW
BUILDING
DATE
APPROVED
P�
��
APPROVED
&
CIAL UiRE C
m
'�f2 'm
� m
T. N
SHOWN UNDER VALUATION IS FOR m
�F ESTABLISHING A PERMIT FEE ONLV:
e
PERMIT FEE S �
PLAN CHECK S 6 2/ o �
v�
� TAX E / � �
U
TOTALPAID E
0
� . �, �'%Dl�/02� 10.3� /�y/�S/ 26 G2/�B/79
COSTA MESA BUILDING-SAFETY DEPARTMENT 3026 2/O8'/79
P.O. eOX 1200 COSTA MESA, CALIFORNIA 92626 �226'� OOOtl4474 00
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
BUILDING('�, � ��K-{�i R__
OWNER
MA1L
ADDRESS
arvNE
BRANCH
ADDFESS
ARCHITECT 1• ��_ �/� TE
(IRFNf.WFG�1`� +�iO�u�.IL NC
CONTRACTOR
ADDRE55
TEL.
CITV NO.
STATE CITV
UC. NO. �IC. NO.
size 13a ��� I NO.OF BLDGS.
OF LOT NOW ON LOT -��
USE OF
EXISTING BIDG.
Separate permits are required for
electric, plttmbing and heating work.
VSE OF BUILDING ANO WORK TO BE PERFORj��1 ED
2.LT � 11 — � UA1LT �6�T
1 he�eby ecknowlatlge that I have reetl S�Is applicatlon entl rtate
that ihe abova Informatlon is correct antl egree io comply with
all laws re0uiating builtling conntuct(on, antl 1 shall not employ
any person In violetlon of the workman's compensation laws o1
ihe Stete of Ceiifornla,
I heraby certify that I am prope�ly Iieansetl as e conttactor unaer
the State of Callfornla B�siness anG Profenfons Cotla, Dlvlsion 3,
Chaptar 9, and ffiat such lieenses are in tuil force antl aftact, or I
am exempt from Me provisions af ihe Siate of California Businett
antl Profeulons Co�d/e, �Division 3, Chapter 9.
Signaiuro of _/�-/ �/ _ I
Permittee [��-� ���'����
Authorized Agent
BUILDING
A�ORESS
OWNER
ZONE
YARDSAPPROVED
MAIN BUILDING
(FROM C/1STREET) ,
FOR
THE AMO
THE PURP(
VALVATION
PERMIT
ir
USE OF NEW / �
BUILOING
YAFDS APPROV ED
BET. MAIN &
YN UNDEft VALUATION IS FOR
"ABLISHING A PERMIT FEE ON�V:
PERMIT FEE E
PLAN CHECK S /S /J�.�C
��r
TAX $ � .i6
77
TOTAL PAID $�9 / �
�i
n
m
i
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N
7 /m
e V�
"N
�m
m
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� � � � `' t �°,,�'
�. COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O, BOX 1200 COSTA MESA, CALIfORNIA 92626
�
For Applicant to Fill in Completely — Use Ink Only
REC V
ADOFE5S 'iGK� ��T / aT,
OWNER�
MAIL
ADDRES
CITY
CANSTRIJ
LENDER
BRANCN
ADDRES
ARCHITI
CONTRACTOR'—
AODRESS
CITV
F STATE
� LIC. NO.
ta7 SIZE I �
�. OF LOT
a USE OF
TEL.
NO.
CITY
LIC. NO.
INO.OF eI�OGS
NOW ON LOT `��
.,�. EXISTING BLDG.
y
FSeparate permits are required for
� electric, plumbing and heating work.
�.W., USE OF 9UILDING AND WORK TO BE PERFORn
a
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ADORES:
OWNE�R _ 1
SE
FIRE
ZONE
APPROVED
BV
ZONE �
VARDSF
MAIN e
(FROM GL'.
c.0
3227 2%08/79
FORSTRUCTURAL
�'E�E" LCA DA'
LOT
VALUE
NO.OF USE OF �
PLANS L BUILDING
'ROVED VARD
� 1 hareby eeknowledpa thet 1 have reetl thls epplicallon entl stata
ry Mat the abava Informatlon Is correct and agree to iomply with
a ell laws ra9u{at{ng builEinB �onstructlon, and 1 shaN not employ
W any petso� �� ��oletion of the workmen's compenaation laws of LD
x the Stete oi Caiifarnle.
3 I hereby'GarBfy chai I am properly Iicansetl as a coniractor undar �� S�
the Stata ot Californla Business antl P�ofeuions Cotle, Division 3, THE AMOUf
Chapter 9, antl that such Iieensas nre in full force entl effect, or I THE PVRPpSI
am examp< from the provislons of the Stete of Celifornia Business
and Professions Cotle, Dlvialon 3, Chaptar 9. VALUATION
Sipnatura of /��� �
Parmittae -Q 2.� � L�L $ /�l
V I/ (l
Autharizetl ABent
^21•30 TL
� -
IT NO.
11�1�
APPqOVED
&
N
n
m
`
�1ReMEN'IJ „
VN UNDER VALUATION IS FOR m �
'ABLISHING A PERMIT FEE ONLV: e
PERMIT FEE y a �
J�
m
PLAN CHECK S ^�
o ^
TAX $ � �\
TOTALPAID $ - %J u�
` . COST;4 MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Comple[ely — Use [nk Only
BUILDING O � . �r / C�
ADORE55 ��� 0
OWNER OR
TENANT ��"' �
MAILING
ADDRE55 � �•�n Q �j U
CITV �� O��h10L
APPLICATIONF6��'SIRLiC�Tt3�tA�.;PERMIT 5.50 TL
RE I D Y PERMIT *jp 48753
���
A.P. NO.
BUILDING �
ADDRE55 � �� . �'
UNIT OR
SPACE NO.
NEW I ADD IALTER IREPAIR
BRANCH
OWNER 1
ADDRESS VAIVE %
ARCHITECT TEL. USE b
OR ENGINEER N
ADO ZONE � � TVPE � GROUP
APPROVED
CONTRACTOR �"� BV �ATE
ADORESS l �� } l� 3�� \
c T E L.%- �
CITV )-Pf/� Op D�— NO. '- J i%9
F"' �r ^n ^P APPROVED SETBACKS 1n
� �C NO. C"� J'�O �0 LICVNy�D�/p �J
SIZE NO.OFBLDGS.� (FROMC/LSTqEET) �.
GW. OF LOT NOW ON LOT
� USE OF
EXISTING BLDG. � 5 � ,
� �
FSepara[e permits are required for L.5 DE
� electric, plumbing and hea[ing work: REAR FT.
� USE F BUILDING D WO TO BE PERFORMED PLP.NNING ACTION i
F
Q 1 J
Ci
a _ �+p_ ya DATE
LN'�-�/4G„� APPROVED
� APPROV �.... ,T
r
a
x
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� I herab acknowletl e that I hav '
Y 9 e reaA Mis application and s[ate �
(y� Mat the abova information is correct and agree to comply with �
� all laws regulatin8 builtling construction, antl I shall not amploy �
Z any person in violation of Me a�orkman's compensation laws of m
Sthe State of California. �
3 I hareby certify that I am proper�y �i�ensetl es e eonttactor untler SQ. FT. �+
tha State of Calitornia Businass a�d Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, antl 2hat such licenses ere in full torca antl effect, or I THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLV: e
am exempt from Ne provisions of the Siata ot California Businass VALVATION PERMIT FEE E a
en0 Protessions Cotla, Division 3, Chapter 9. �n
^ � m
$i8^etufe of / • � PLAN CHECK § r-- —'^
Permittea � SDO'OO TAX E ,
or
$ • SQ
Authorizad ge�rt �ate r_� TOTALPAID S_�. �(�
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COST,4 MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
l'�RESS �!C/ I/.� /�T S��
OWNER OR
TENANT L
MAILING �
ADDRE55
C�TV N�
CONSTRUCTION
LENDEF
BRANCH
ADDRESS
ADDRESS
CONTRACTOR
ADORESS
CITV
STATE
LIC. NO.
SIZE
OF LOT �3�
USE OF
�
1G �o
J �,
�
� �
'1�A'�69 9/18/79 24.50 TL
TION FOR STRUCTURAL PERMIT � '
� PERMIT 1�T0 48814
�.�
A.P.NO. �2Q � �%�
BUILDING
ADDRESS
VNIT OR
SPACE NO.
T0..N0.
NEVJ ADD
P—
�
LOT
4LTER REPAIR
L. USE � IT�/� P
20NE � VPI
APPROVED
CITY
LIC. NO.
NO. OF BLOGS.
NOW ON LOT
Separate permits are requ'ued for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
� - r�,� �H �<<,5�:�
�Gl G !�� C %_An� G�M21D
APPROVED SETBACKS
PLANNING ACTION
APPROVED
1 vr.
BL'
MOVING DEMOLI
V�t• vPK/ �f.
VALUEE //���
DATE
DATE
�
I hereby acknowledge that I have read this epplication entl stete P
n
ihat tha abova information is correct and aprea to <omply with
ell laws reBulating building construction, antl I shell not employ �
any pe�son in violation of the workman's compensation laws of d
the Stata ot Californla.
m
I hereby certify that I am proparly licensetl as e contractor untlar SQ. FT. N
the State of Calitornie Business and Protasslons Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
C�epter 9, and that sueh licenses ara in tull force antl effact, or I THE PURPOSE OF ESTABLISHING A PERMIT ONLV: �
am exempt From the provlsions of She Siata at Californie Businass V ALVATION y 4
end Professions Cotle, Oivision 3, Chaptar 9. PERMIT FEE Qd �
n
Sipnaiure of / � �/� PLAN CHECK $ �� Q
Permii�ee � /���+ $ ��/ /' / OO �
or � � �/ yV TAX S . S
Authorizatl ABent Date _ TOTAL PAID g�y. �q V
APAP
BUSLDIN
ADbRES;
OWNER/
MAILING
, .
IC'rATION FOR BUILDWG PERMIT COUN7Y oF
�F.`TT TO FTLL IN AREA WITFIIN HEAVY LINFS ONLY. oRnNce
� .yJ /� -C • DESCRIPTION OF WOR!
/i✓ l.� �y
� NEW ❑ ADD lJ ALTER ❑ REPAIR C
� SIZE NO. OF
/,/� )��G/ Sq. FT. �~Q �y�j_/ STORIES ,
�'7 //' f'l� /��� �S3/ USE OF �t S� 'O7 G�
$TRUCTURE �(//'J
. � .� . A/I_ _ _ LEGAL ILOT � LOGK
i��x.s� �
7�
CMECKE�BY�(� ��✓ DATP �/�iECLEAflEQ�L
VLOT PLAN PULLY OIMEN810NEDl YEB � O� !
•LL BUILOIN08p110WN ON PLAN (PER A LIC Tl l�
MRIN U9M v^CC. UB�ZONB.��DI87. MAPIl6-nn ,
/
HEOUIflED BUILDIN6 81TE FftONTACHt YE9 V NO
9111LDING HEIGHTf 9TORIE9��\NO FEET
HEpUIN6DLANDAflEAI _Y�ES � NO
VAFIANCEXEOVIflEOI Nc� .ppqOVED NO.�, L�
' v
STNEET WIDTN ' OjiNE Lp{�T IlNT.LOTI�
BUILDIN08ETBACKC�;S�'�' /'"'�O �l �T`� �
//
SIOE YANO,NIGHT EAVE PROJECTION��
�{�� /�/l! � I/
610EYRPD.LEFTj�Yyi'C_y!/ /.EM1VEPflOJECTION��
REAN YAHD (TO P�U�Y • n`�NIOTH OP ALLEY
2P'
SEPRflAT10N DETWEEN BVILOIN68
CNIMNEY IN PEOUIREO SIOE YAftD PNOJEC'
PORCHIN REOUIRED YANO PROJECTS
STAIRS IN flEOUIREO VARO Pft0lECT8
PRNKING qREAflE0U1RED CAPACITY.CAHS
:.la
FEE g
VALUATION $ �OO EE $
I HEREBV ACKNOWLE�GE THAT I F
CATION AND STATE THAT THE INFOI
VIDED IS CORRECT AND AGREE TO COh
ORDINANCES AND ST TE LAWS REGUI
STRUCTION.
i1GNATURE OF.
PERMI7'fE
�OUNDATION: LOCATION �.
. ORMS AND MATERIALS. �
REINPORCED �;�
MASONRY OR CONCRETE hl
BOND BEAM
�
UNDERPINNING �� �
ftOOF SHEATHING . � Q Q _
AEMARK81�/� Ti�_ns ���/ �e �J� �I _��r 1FRAMING
� / L!/ �7 !{( i�/
/� � J LATH OR DRY'
r�L � �� 2� �'S e�( i�I(�{� INTERIOR
FOR OFFICE USE ONLY LATH
neceiveu a I e sc�o.,� I v s iea�so _ EXTERIOR
Y � PLASTER
r��N crvecee er r Hce wv�poveo BROWN COAT
veuoenon or
FINAL
\
�
LIES
READ THIS APPLI-
'ION I MAVE PRO-
WITH ALL COUNTY
JG BUILDING CON�
��
IJISTHI6UTION 1. NOUTE 1�{yCOIATELY 2. OFFICE 9. 6T ISTICS FILE � C. OWNER'S COPY
OF COPIES: TO INSPECTOH � WONK COPY FO COUNTEH U6E OF PEftMIT
C. W. DONOHUE - BVPEFINTENUENT 99E N. BflOADWAY 54NTA ANA. CALIP.
DEP�nTuee�T OP BUILDING ANO 6AFETY VALIDATION
B MAR 19'S7 97213 , 4.00 1
}lLLeR �Te PERMIT NO. � PERMIT FE6
HAROLD L.GOLDV �
C111EF BUILUINO INSPECTOR
.50 � 4.50 #
COD6 PLAN CHECN TOTAL �
• � � = � � 2'758
CASTA MESA BUiLDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. GALIRORNIA
Fo� Applieanf io Fill In Compleiely
y����.io �da�
COSTA MESA.CqLIFORNIA
C)
■ BTATE
I� BETBACK LIN6 FROM
TEL.
NO.
TEL.
�EE RE�CEIVED
/F�'�y��PE�9� T����T.
APPLICATION FOR"PQRIRI��
BUILDING
For Office Use Only
aece�ri No. YrsM�T 110. .
er
BUILDING
AODRE6S
COSTA MESA.
�' ZONIMG
O� I� PLA e� � I BUILDIN�
��-f
�� � LE6AL � �
� �� DEBCRIPTIO � UO `
NO. OP BLDOB. �
Now ON �oT A. P. NO. —/�^
� � YARDS EVES
'L�-� APPROVED ALLOWED
(CPMHR LINe BT.1 /
DESCRIPTION OF WORK
EXTERIOR WALL ROOk
ICOVERING COVQ
U38 OF BUILDING AND WORK TO
II'1 HBPHBY ACILNOWLHOO6 THAT 1 MAVB R6AD TN19 APPLIWTION
AND BT�TB THAT TH6 ABOVH 18 COppg� I�ND AOP68 TO COM-
PLV WITX ALL GITY OPDINANCEB AryD BiATH L�WQ q80ULATNO
BUILDINO CON9TRURION. /
■ AUTHORIZED
r
\
�
-:
TH6 AMOUM BHOWN UNDEP V�LUATION IB FOR THe
PYRP086 OP, EBTABLI8H�N0 A PEHMIT F5E ONLY.
VALUATION `
Q p PERMIT FEE $ �� �
$ a �� P
� PLAN CHECK S ��
F
� p �
TOTAL FEE � �
x
.,' , � 1642� •
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA MEBA. CALIFORNIA
For Appllcani fo Fill In Complefely
TYPE OR PRINT
COSTA MESA CALIFORNIA
� 98TBACK LINB FROM
� E%TERIOR
TEL.
NO. OP BLDOB.
DESCRIPTION OF WORK
BE
'/ // V � !
I HlREBY ALY IOWl�46 THAT 1 HAVE READ THIB MPYGTION
ANO BTATH TXAT TNQ A90VE IS COPRECT AN� AOREH i0 C014-
PLY WITX ALL CIiY Of�INANCE9 AND HTATE LAW9 R80ULATINO
BUILDING CONBTR ONo. •� /p/�
61GNATURE �IL_•_,Y / � i� _
� AUTH00.12ED ACaENT
FEE RECEIV�D
FE8.161962 �
FIfVANCE OEPT. ,�
CITY OF COSSA MESA "
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
N¢CEIPT NO. P6PMlTJI�
/ 7 v �vv — i � �•-,
COSTA MESA, CALIFORNIA
�J
NO. OP /1 I UBH OP N
vUNB V CUILDINO
�R ' o�
'/ / .... 1 l d - _
(CBMHH LIN6 9TJ
APPROVED
TXH AMOUM 6�lEWN UNDBR V�LUATION 18 ROR TH!
PUAP086 OF EBTABLIBHINO A PeftMIT FEB ONLY.
VALUA ON ��
PERMIT FEE S
S % � PLAN CHECK S •
/ TOTAL FEE -
Y
�
� �FP-C�'7UPAc��O 139K itft�tit2 .��
• 37909. ��a� •
� �COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. 80X 1200 C0.STA MESA; CALIFORNIA 926I6
APPLICATION FOR BUILDING PERMIT
For Applicant ro Fill in Completely qECEI VED 8 V OqTE RECEIVED
�- DATE.ISSUED
ADDRE55 ��O � �11 �/�'��
PEFNn �]
OWNER u,+ A.P. NO. ""/ � J i
ADORESS -1 � � Y� ST �+DDRESS LJ W � �� �_T
a � TEL.
CITY�,� � L, NO. TRACT��� LOT BIOCK
Z
Z Q OONSTRUCiION W A A
ON LENDER
6, p]
J � BRANCH
-�� OWNER
a w AD�FESS �
m m VALUE ' tgC)
J Q ARCHITECT TEL. O L S �
OR ENGINEER N
U Q FIFE � /7
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W OC ADDRESS
a w APPROVED �
WZ CONTRACTOR �j� BV DATE '�� !''
J Q
m Z
J � ADDRESS C�
W w � TEL. ZONE NO.OF USE OF NEW
�= CITY NO. P�� BUIIDING_ ,.�
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0 STATE CITY YAROSAPPROVED VARDSAPPROVED
y Q UC. NO. LIQ NO. MAIN BUIL,DING ACCESSORV BUIL�ING
J O (FFOM GL STREETI
SI2E NO.OF BLOGS. � � ��
OF LOT NOW ON LOT OM FT. T
USE OF
E%ISTING BLDG. 1 F FT
f' S1 Z E O F /'1 j��p'j( 8�,�!% NO. O F �
Z NEW BLOG. POOMS / STORIES L.51 E FT. FT.
a EXTERIOF WALC (�% flOOF y�/ (!Q
V COVERING COVERIN6 ��� REAR FT. � FT.
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a MAIN BLOCS. ACCESS. BLDGS.
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O � C,U.P.�s APPROVED
� � APPROVEq'�� rLL _ _ �`/
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UI heraby acknowledpo thet I have reatl Mis applicotion antl steta `\�
� ihat the abova informatlon ia corract and aBree to comply with ��
� ull laws rogutet'rng builtl7np eOnstruction, nntl 1 zhell not amploy %
� uny person in violation ot Ma workmnn'a compensation laws Ot 3S .a �
y Ma State of Calibmla. � � �" �
? I Aereby cerUfy that I am properly licensetl as a contreciar untler Sn. FT. o
[ha 5[a[e at Califomfe Business end Professions Coda, OivfsiLn 3, THE AMOUNT SHOWN VNDER VALUATION IS FOR j
CAaptar 9, antl 2het such licenzes are in }ull force entl effxt, or I TNE PVRP�E OF ESTABLISNING A PERMR FEE ONLV: m
am exempt fram tiie provisions Ot the State ol California Buzinau Q
VALUATION h�'[/ m
antl Professions Cocie, Division 3, Chepter 9. PERMIT FEE 5 ✓ °'
_/ 7
Sipnature ot �Y �/��J//J � I/� � m
Permittee ��� �O � ����G�' �K/ $ / [� PLAM CNECK 3 / F
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AuthOrizad Apent � �v LL
TOTAL FEE 5
r
� .. , . ~ 12�93
.; ;,
GOSTA MESA BUILDING-SAFETY DEPARTMENT
P. o. BOX 917 C08TA MEBA. GLIiORN1A
For Applicani fo Fill In Completely
TYPE OR PRINT
BUILDING �� D � /�� �/,
ADDRESS
COSTA MESA CALIFORNIA
� AftCHITECT
SIZE
OF LOT I..��Iw /
U6E OF
EXISTINC� BLDG.
BETBACK LINe FROM
TEL.
NO.
TEL.
^ I NO. OR 0L�p8.
�J NOW ON LOT
= 4�.L� /i F%�� .l:
REAR YARD
I RIGHT
IN OF WORK
INO. C
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ROOI
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WORK TO
STORI
BUILDING
ADORESS
FIRE
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APPROVED
BY
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APPLICATION FOR PERMIT
BUILDING
For Office Use Only
REGEIPT NO. PHNMIT NO.
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COSTA MESA. GALIFORNIA
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1 HEIiEBY ACKNOWLHD6G THAT I HAVE IiBAD TH18 APPLIWTION THE AMOUNT BHOWN IIND¢H VALUATION IB FOR iHF
AND BTATH THAT rHe ABOVC �8 CORRECT ANO AGR86 TO COM- pUFtPOBE �P, EBTAHUBHING A PEqMlT FEE ONLY.
PLY WITH ALL CIT' Of3��NANCEB ANO eTATE LAW9 PeOUTATINU
BUILDINO CONBTRUCiION. VALUAT ON
� !
SIGNATURE OF � � � �'ERMIT FEE $ �
PERMITTE
$ / / PV.N CHECK $ �_
AUTNORIZED AGENT �
TOTAL FEE � ��