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HomeMy WebLinkAbout1929 ANAHEIM AVE - Building Permits a r a CITY OF COSTA MESA t ` r,55-1-1,TG4''`4 BUILDING DIVISION 0:. ', 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesas us • O. 1.14111 . - FOR INSPECTIONS CALL: (714)754.5626 et%yearso't PERMIT NUMBER: E07-00821 PERMIT TYPE ELEC STATUS: ISSUED DATE ISSUED: 09/24/2007 ::ISSUED BY: RMD JOB ADDRESS: 1929 ANAHEIM AV CM r Suite/Unit Vicinity: THOUGH OUT HOUSE- SCOPE OF WORK: ELECTRICAL:PEf�?- --RMIT TO BRING ILLEGAL ELECTRICAL WORK DONE WITHOUT PERMITS UP TO CODE THOUGH OUT A SFD. 1 OUTLET AND MISC CONDUIT. REF#CD 07-1075. -` i , �/ - i. ;_.y tib_ w Ah' OWNER: FOSTER, ROBERT-AND PATRICIA Address::- 147,45 6300 ROAD:Unit_: PHONE: 920-209-4739'..i "' -;City/State/Zip: :MONTROSE,CO.., , I(•^ .i.• -t _i APPLICANT: FOSTER, ROBERT AND:PATRICIA. ', --- ° Address: '14745 B300 ROAD''Unit: - PHONE: 920-209-4739 ' ./ ,2, `• City/State/zZip: MONTROSE,CO " CONTRACTOR OWNER BUILDER- - 'License, No. - 000000 Address: Unit Ii:I - PHONE } • - _ _ _ . - City/State: -ii; ZipCode: i CELL: - ELECTRICAL PERMIT FEES ,'"' ; Electrical Plan Check Fee $0:00 Electrical Permit Fee: `,, , $42.80 Reinspection Fee $0.00 . - . • S TOTAL FEES ''.:-,1;,., •"4--,1,c,_ $42.80 . , „ • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. Poe I. INSPECTION TYPE E INTTALS SODEt INSPECnoN TYPE DPS INIITIALS 1818 Fixed System Final Fire Prevention 208 Final Mechanical 1286 Pool Spa Final _ 208 Final Plumbing wit) 200 Final Re-Roof 210 Final Electrical ��/9/�7 yL.IP(llJ t) 201 Final Block/Retaining Wall _ 212 Final Fire Prevention (� 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive. ❑Yes ❑No—. I hereby affirm under penalty of perjury one of the following declarations: Drivers.License No. z 5:'� 6 y/�G(2— :97? ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.•property tax or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: • permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (ThsseaS need nor be completed the perms is valued al one hundred Odors(SIW)a'less) 2,Art 2,Sec.341,Title B,California Administrative Code). Policy Number: ❑ As owner-builder, I will not employ anyone to do work which would ECTSICertify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the worke•=' compensation laws of California, and agree that if I should become sur ec to the workers' compensation provisions of Section 3700 of the Labor Cod shall forthwith •r pl 'th ese provisio Applicant'sSignature Dale Division of Industrial Safety Permit Number: Applicant's Signature e..,, HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code,and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes ❑No Lic.# Class# (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely Contractor's Signature Date hazardous materials equal to or greater than a weight of 500 pounds, or a • volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lendels Name: hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that 1 am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification Irom the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Cale requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the Califomia Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of.proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. `CICENSED:CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection .r .ses. I agree not to occup or allow occupant of any building authorize `permit.ugtil fin- n • >'on. r ' a se Ofrat-- G� /A xtlxd% Otgnalure ol Legal Owner(`). •ate Signature- 4 Dale 3057.46(3/07) C�1 AnWor Authorized Applicant Date • ZIADDxess: 192 gANAHEIM AV uxlr: D CITY OF COSTA MESA – BUILDING PERMIT PERM NO: E 067241 F^ OWNER'S NAME: F057Y'' ROBERT ADDRESS; poor-fitPATRICIA PERMIT NO: E 067241 PLAN CHECK NO: N GOVT: N SUPP: N e249-6879 5 RD M 6300/IROSE CO 00000 CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE: OTH ARCH/ENGINEER: 3 REWNO.: JOB DESCRIPTION : REPLACE SERVICE SQ FT : ADDRESS' UNIT: CLAIM VALUE: CALC–VALUE: GROUP OCC: R-3 / PERwm PATRICIA FOSTER ( 303) 249-6879 ADDPSS: 14745 6300 RD COMMENTS• X MONTROSE CO 81401 ****+r*iEBF**a6**+tiF***+taF*aEaf*+E**+tithe*******a¢+E,F**iEa¢****r+aarlF*****+E***yE*+F****** t+r**+E**+r* LICENSED•ONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQU IR EMEN T S 7000)as vision 3 of the Business and Professions Code.and my license is in full torte and checl SETBACK S CITY/-IC.: STATE LIC.: CUSS: Drib. Signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a cenilicate of consent to sell-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT : FT IN • POLICY NO,: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: ' r3 Certified copy is hereby furnished. ❑ Cenilied copy is tiled with the city Building Division. PLANNING NOTES> > • Date: Applicant: ********{4*******if**iE**1f****************4E**********it-***************iE*****)F*if***iF EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: . need not be competed it me permits for one hu dred(5103)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the perlormanee of the work for which this per • ed.I shall not employ anyr n manner so as to become subject to theAylprkers Compensation 7Laws'Of California. _ ZONING APPROVED BY DATE: .—is Date' _�C —Z'd '/ Signature: ICA a ",..JVC "t_ NOTICE:It,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.yore most forthwith comply with Such provisions or this permit shall be deemed revoked. {-� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: �2.1..�1� DATE: C ( 20'44 which this permit m issued(Section 3097,Civ.C). ***********************-*******************.N.___3�;fff---lllttt**********-1F****ac*******3r.�.* ***vk*ii. LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E S U M M^A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC r MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 4050 / repair any structure,prior to its issuance,also requites the applicant for such permit to fife a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commenting with Section 7000)of Division 3 01 the Business -S0% r SMIP/NON–RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN • any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). ISSUE FEE • 15 :00 - -3 I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and Inc BUILDING–DIV—> PERMIT ISSUE PLAN—CHECK 't TOTAL. PAID DUE Q structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS––––> 40, 50 15. 0 0 , 0. 0 0 5 5. 5 0 55. 50 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through , his or her own employees,provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion,the owner vril have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 55 . 501 OVER/SHORT; 00 lot the purpose of safe'. BLDG PMT PLUMBING ELECTRIC MECHANIC ' FT'RE" SMIP/TOT GRADING PLAN–CHECK I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 55 . 50 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon o - , and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware **********.*****4e**{¢*.x.*.N.{f.**{(.************i¢*****'{(.'.)f*.x.{E***{I.***{(.**y.*************.y,***.K. That proof of their Worker's Compensation insurance shouts be proved to me. ❑ I am exempt under Section: B.A P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY D E S C R I P T I O N /UNIT COST TOTAL COST Dale:___45_..721.2j1.71� e (7 .„4_0..,_.a ELE 1 SERVICES BELOW 600 -V & BELOW x201 AMP. 18 . 50 18 . 50 I do hereby certify that I am aware of and understand toe requirements of California Health and Safety Code Sections 25505,25533,and ELE 1 SUB–PANEL • !, 11 .00 1 1 , 0 0 25534 and that I or any future buildag occupant wilily/1g not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from EL E 1. M I SC CONDUIT NOT 'LISTED REQ PERMIT 11 , 00 11 . 00 Mese provisions. EXPIRED END OF FEE • Date: ApplicanCn incarrpfete !rspect!ans I hereby and that I have read this uildication and state that fl 'b.ta_c,,, • a information is correct. agree tD comply calm all city and c0umy ,�ordinances and state laws relating t°Mtildingconstruction and hsentativesof Ups City to entero fe-mened Opmpeny In inspection Dmposes.q(/Date: 5 7 Q _/ 7 Signature: • ') 05/20/94 60896 T nT 55.30 ) DATE: 05/20/94 TIME: 10:51 Drivers License or Social Security v: , r 1641-46 White—Budding:Green—Cope Entrapment;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor •;.----•----T- POOL SPA LAIy' C11`• CONSTRUCTION AND PG Date Inspector Date Inspector APPROVALS Permit•t' APPROVALS Permit I 1-------- rv,ce or Pole 52, Pool & Equipment Location --I-1I 1. Temporary Electrr 1 F__________2SoilI. rnd" _ 53. Steel Reinforcement -_ I I 3. EIer _ Cord'u t U'..hey-L'ndrgr_a, r 54. Forms E`_ Meal Conduit-Undrgrnd. . 55. Electrical Bonding _ i i r 5. Ste-: R, ntorr'men: 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE I I - J. Footings 58. Electrical Condult•Unurgrnd. }` - - 8. Foundation .} 59. Gas Pipe, 0 Undrgrnd.,Test I -- - 1 I 9. CCat✓ P P• Undr=•rd. -- ( 60. Backwash Lints, P Tr P, - Uno'grr I _ 1 rt I 10. Structural Fluor System 61. APPROVAL TO DECK t 11. Property Sewer Line & Ho-'e Connect:on 62. Baekc;ash & Aewptn:-Final -I -i I 12. S-.ver Cap 63. Heater & Vent-Fin:;1 -t - 13. 1?00+ :rain: - 64. Plumbing System • Final 1 F--r� __ - __ -_-_ _,_ -I 1 �4. Rouen Plumbinn } h--� 65. Electrical-Final i 15 Rnuah E:ectrica!-Conduit 66. Solar System-Final _ I ''II 16. Rn„yh. Electr'c hiring 1 67. Fencing &Access Approval . - -I- 11 i 17. Rough tVhingSign 168. APPROVED FOR PLASTERING 1 18. Rotate FlectricalT Bar Cy il rig69. POOL/SPA SYSTE'.:S FINAL i I 19, .Rte h Hearin & Air Co: ultAn,n i II 9 9 g ( FIRE DEPT. REQUIREMENT 1 7D, Rui'Srac".'rrq Frap:,.o_ APPROVALS Permit t I 21 D_Ictr, 'n Structure -- 70. Underground Hydro I ' 22. C t-, Vent-54;r i f--- _, I- - i1, Product Piping I,Gus Li Cd _ 4 - ' 23. Gus ,p”Rough & Test 72. Lint:ewe:limri Fit,"' I yI • 24 9 Framir-y - -- -` ^- 73. Undergrnc.Storages Tank G,.; U . , J 25 ha_' Ste .aihmg -� 74. Overhead Hydro I--- -I, _ - H. _, 26. C Ting IStruttu.a�, i : -u'u,;.at 75. Dry Cllem,ral _ ___ 76. Dry S,acC!•:;ie 1 23hh -.g G S d -.3 - ` 77. FIXED SYSTEM F,NAL - _ - _ _-- I L-29. 1su.at:ix 78. FIRE PREV. FINS+'_ '� C JO. Dryv- 'i N-innng II _ HEALTH DEPT. REOL'lfle,l.Ic".T 31. P -.st,.• C.:o`, Coa - - - _ 179. FINAL INSPECT10•r--- - - _- - I-- - -- j 32 :Mtn,c_i Pu..er I1 i,•ter Fi,.,,, 80. FOOD CERTIFICA1. F !SSUEO 1 I 33. Fioai E4Cr,, Notes; I -- 5/..74..1/4 7 45r<1�2 im'r Pg' `� 34 Env! Hearin:• & ArCuniet,on - Loth_I 1_---- CO "el_IS _KSS! utcva,, ct i Q`/f=r - - r 35. ?ed.' Gus Pipe-Test v 381A 136. Hood or Canopy ry/' -0-AI' /1 /(/p /• Q • -37. F.ia. Factory Fireplace 1--- 37. -- (,1L�/ t WV_ , u / `__--_ _V.,(-,L�t ' 38. Fina: PiurrSirg i*� ./ lJ 59. Y:ater Service•Fi,al �{„j t-V"- �'u 1�40. Gds Seretce-Final 0r ri (�nS�2FG4i_c -- - -- 1-41. Soar Domestic-Final ` C 42. 8„ckflov: Prevanter 43. Backflow Irrigation 44. L'rdsta.c: li •gation System - ^---- - - - - ---- -45. Sound Attenuation � -1-- --V- __._ __ - _ - _ --. - __" -45. H„ndicap Rcru' tions � ` -- --- ----- --- --- -- t - - i 47. '-!KAL STRUCTURE & BUILDING 48 ?ILAL PLANNING --- ._ -- - __- - _ _ - - I- 4Q. E'r,cte c Petease to Edison ---- 50 Gds ,a'lc.,c to Southern California Gas Co j 51• CERTIFICATE OF OCCUPANCY +� - -' No. .__-__ Date 1I PROJECTADORESS: 1929 ANAHEIM AV UNIT: D CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 067732 OW w NER'S NAME: FOSTER, ROBERT 'nDDRESS: FOSTER PATRICIA PERMIT NO: P 067732 PLAN CHECK NO: N GOVT: N SUPP: N 14745 L300 RD MONTROSE, CO 00000 CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 303-249-6879 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : NEW GAS SERVICE SQ FT: ADDRESS: UNIT: CLAIM VALUE; CALL—VALUE; GROUP OCC ; R-3 / PERMITTEE: RICHARD SPARKS (714 ) 432-0855 ADDRESS: 936 JASMINE CI COMMENTS : X C.M. CA 92626 ***********************************xOr*****u**1E****+C** +E***OE***+r***** EOE*******+roc LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMENT 5 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: EXP ; Dale: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN POLICY NO.:COMPANY: EXP. DATE: PARKING REQ• PROV; PARCEL ; 42214215 ZNE; REF NO: ' '7 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: **********************************************4******************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT S E R V'_I C E 5 R •E Q U I R E M E N T S I certify that in the performance of the work for which this permit4irdpensationprovisionsoftheLabor shaany pers in any manner so as to become t sub'=,moo the Wrtkers'Compensation Laws of California.S� ZONING APPROVED BY DATE: E ^� signature: BUILDING APPROVED BY f.after making this d• lavation.you should becoof the Labor . ++. DATE: Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. •s . G ` 1 9� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: -, •s e� *** / •-- DATE;4 I which this permit is issued(Section 3097.Civ.C1. *********************************** ******** '.)' ",,.. 'Q, x rt#*************** LENDER: ***************************************)t*******************************4 ******* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SiGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 12 , 00 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLANt. and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE 20 . 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors State License Law TOTAL S----> 12 . 00 • 2 0 . 0 0 — 0 . 00 3 2 • 0 0 32 . 00 . 0 0 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If, however the building or REVENUE DIVISION TOTALS--> COLLECTED• 32 . 00 OVER/SHORT improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 32 . 00 '© and wo Professions sdo The projects with State contractor(s) ontraseLzwdoesrsutao theownerCotfproperty' aLicense Law).ol thereonas ************************************44****************************************** and who contractsCo for he Contract with a e License Lawlicensenot pursuantly to the Contractors'Stateh builds improves s aware that proof of their Worker's Compensation insurance should be provided to me. IND I V IDUAL .T E E BR E AK D OW N ❑ I am exempt under Section: B.&P.C. for this reason: C:R / A # 550525 TYPEQTY DESCRIPTIO S C R I P T I O N 14 �^ p,/ �/N/ / UNIT COST TOTAL COST l r Owner: PLU 1 GAS PIPING SYS OF '1 TO 4 OUTLETS 5 . 00 hereby certify that I am aware of and understand the requirements of California Health and Sat y Cod533,and PLU 1 GAS SERVICE 7 . 00 5 • 0 0 7 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. Date: Applicant' ' I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relating to building construction and hereby autho ize representatives r ,is city •enter upon 'e above-mentioned • 01 00162848-00162848 TOT 32.00 property for inspection purposes. ` / / :}ATE: 06/24/94 TIME: 09:36 p6 ^)-`1 V Signature. ,\ .4� ,,,,e,^\ Driver's License or Social Security a: ////��� 1641.46 White—Building':Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor /' 1 •CONSTRUCTION AND PLANNING • POO ,SPA APPROVALS Permit Date Inspector APPROVALS Permit + Date Inspector 1 Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 0 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Unclrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final • a 14. Rough Plumbing 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. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame anti Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 6 ^Z� ) -14 -335. Final Gas Pipe-Test 0?-14- 36. 6. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final !_21S ��Q,/(Q� 41. Solar Domestic-Final ( 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING 4B. FINAL PLANNING 49. Electric Release to Edison ' • 50. Gas Release to Southern California Gas Co ' ' 51. CERTIFICATE OF OCCUPANCY No. Date ,� I _l '` ssr ► FEE CEIVED COSTA. MESA BUILDING DEPARTMENT (- (V\ n_ 16 l q.C1 Q P.O. L 1 �FIINR DEPT. COSTA DEPT. FOR CALIFORNIA �����Tyy FOR APPLICANT TO FILL IN APPLI'�'ATInnFOW SFORE PERMIT BUILDING /Q BUILDING ADDRESS COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY R. RECEIPT NO. PERMIT NO. OWNER Mil,/ Ci /4 fa .S / E 6'73 '7 RE V BY DATE RECEIVED DATE I SUED !MAIL ADDRESS /q3/ ANAA 5/M S— < /e y S 9. .s7 CITY ,ISA Mff A TEL. BUILDING 4 SA- EL. NQ MeAODR ESS ARCHITECT LIC. OR ENGINEER NO. COSTA MESA. CALIFORNIA FIRE ADDRESS ZONE 207?0 NO.OF TYPE FUP ,^ CITY LIC. PLANS V GU ,P 1/4 CONTRACTOR 0 VINE, NO. V TEL. APPROVED U ADDRESS NO. BY DATE -LEGAL ,-AIRYyxVSI 'L' `/'ItAMS CORRECTIONS DESCRIPTION NO. S BLOCK PO/ZSAelr !l� A.P.NO. t 32 •(G� -f4 APPROVED SIZE )9Q —� 22 'O.OF BLOCS. y/ OF LOT ( o �J IOW ON LOT / USE OF C LI I Y CW (/�S I A MtSA EXISTING BLDG. �1..(1/�j S Q _/1 ` PI avR;YPI fFP"1' SETBACK LINE FROM / � �,`/`� .�OF� , - EU TO L G. DEPT. REG. CENTER OF STREET K. E EA YARD 1/d- W K•,�I-�/(J� SI DE YARD RIGHT e 6J LEF' T I. ly -/ f -BY 2 r ' 'ATE DESCRIPTIONYOF WORK PLAN TECH/ NEW " ALTERATION ADDITION REPAIR // MOVING DEMOLISH BUILDING 2. 4 V C/Z ROOMS NO.OF 31 STORIES / • EXTERSIZE �(y}-//.n_��� RO �{�i -COVERIING OR WAL�WW.�E-� COVOERINGF (?/ apA.- 11.31S .- /V� � ' //�I US OF NEW // / ' - -/ 5L0 B DING • I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL ' CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUC. /( TION. r� VALUATION PERMIT FEE $ �Q SIGNATURE OF /1 ////� /!� //}� • PERMITTEE • /�� ll LC / PLAN CHECK $ / D AUTHORIZED AGENT TOTAL FEE $ pJ Q 0.KF I 51�. FEE I,cCEIVED COSTA MESA BUILDING DEPARTMENT (nr. '^ { //�/ P.O. BOX317 I \^' ` 6/ ( q )I^ v/may COSTA MESA, CALIFORNIA FINA DEPT. \ FOR APPLICANT TO FILL IN APPLQIj'YAQFI&@$TfF(filKSAPERMIT BUIDDLDRESINSG /,2_40 sac �„,�,,.e. , BUILDING A COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY t F ..e {, RECEIPT NO. PERMIT NO. OWNER /`/U t LI .. X . 1 o l/ 4� -6-73,S MAIL R es../'D BY AT RECEI O DATE ISSUED ADDRESS 1Q3/ '(km A 6, KI /V .s��1� ,.3"7 _.s---;L%-- 2 '/ `-iaYv O,/y TEL. 4A BUILDIN CITY . ADDRESS ARCHITECT' LIC. ENGINEER ENTICTER NO. COSTA MESA, CALIFORNIA FIRE ADDRESS ZONE CITY LIC. ZONE4� PLANS TYPE V T / GROUP/I�) CONTRACTOR 0Witic A NO. CY/I/� aA [ TEL. APPROVE ADDRESS '-I'/eve, ` NO. C BY DATE LEGAL /' /eve,11Y /4,C A,l DESCRIPTION NOT 2 r LOCK a 2 �y •CORRECTIONS A.P.NO. /l S— 2 22 —• St-6 SIZE NO.OF BLOCS. 4/ APPR®� D OF LOT My 203 NOW ON LOT USE OF //�'� CITY op C TA MESA EXISTING BLDG. ' 1 t/y `'ELS " i ce"' PLANNI 'f DEPT. 'SETBACK LINE FROM ` / 7D/ _ �1 1 / SUBJECT TO B G. DEPT. REG. CENTER OF STREET SO '+ REARR YARD i/S — OA . ill SIDE YARD J RIGHT / i# t LEFT 54W t A , S-- r— DESCRIPTION OF WORK PLAN Ti: • NEW �\ ALTERATION ADDITION REPAIR MOVING DEMOLISH { BUILDING ^� / r NO.OF / / SIZE /L(� X J ROOMS 6. STORIES EXTERIOR TT U COVERING WALLY `/(v =RING ,�(S�''�7''�i ` '.f ) �j ,, ,. BUILDINGUSE OF EW pdp/� /c �! vL AI / cACO 15c/c..r�if� ♦ 0 , 3 _ 11- ( �3R`Te 5 J w,^, ND. arP20vED I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND A, 61 /7 STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL , 4 4 CITY ORDINANCES AND STATE LAWS REGULATING BUILD -CONSTRUC- TION. / f� J VALUATION SIGNATURE OF T/% PERMIT FEE s j cL '� PERMITTEE $ iI// 3�a-./ PLAN CHECK s / 7 '- TOTAL FEE S S/ �' BA, AUTHORIZED AGENT I `/�' \A