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Home My WebLink About424 FORD RD - Building PermitsOWNER W. G. LdNG C0. � DATE 6- -6� JOB ADDRESS L�QLt-A Ford Rd. BUILDING PERMIT NO. � ��(�p(� GENERAL CONTRACTOR OwnPr vALUE S�n.F.7F nn DATE OCCUPANCY SUBCONTRACTOR I PERMITSISSUED �Fo�m 210—SM-11-59 SB P uivl� e\Ucµ/ IiOLD.FOR SPECIAL REQUIREMENTS ., : A (Q�/�'y'� 'Y' J{��V�V COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COSTA M68A. CALIFORNIA For Applicant fo Fill In Completely TYPE OR PRINT I MAIL ,.�.�,i _ i7 - iir.-�-�- �,--- COSTA MESA GALIFORNIA [� NO. OP B�D68. use oF 63.'7" E%1 ING BLDG BRBACK L1N8 PROM cHNTeR oP elReH1' / � REAR YARD SI�E YARD LEPTt I RIGHT � DESC[tIPT10N OP WORK 1 1 HfiPBBY ACN�IOWL8p08-TXAT I XAV6 IiGDCTFI9 APPLIGTION AND BT�TH THAT TH8 ABOVB IB CORqBGT AND AOfl6H TO COM- PLY WITH ALL CI}Y OFDIIANCEB.AND BTAT LAWe R80ULATINO BUILDINO ��18TRU ON BIGNA7URE OF PERMI E AUTHORIXED AGENT FEE RECEIV�� [�AY 2 61�1 U° FINANC� d��T. f�ITY 0� C6�'fA IVIESA APPLI ATION FOR PERMIT BUILDING For Ofilce Use Only RBCBIPT NO. �_�RW` �� !Y � DATHJiHC81YHD / �i OA 11 cosrn rnEsa � ZONING zoHe %f I xo. ov ��j�uet'or n iJ� PI.�N9 ` I BUILDINO L[OAL O D88CAtPT101 A. P. NO. � YMDB EVE6 (QNTBR LINB 9T.1 TH8 AMOUNT BNOWN UNDBP VALUATION 1! POR TNt PURP08H Op 68TABLIBNINO • P6RMIT FeE ONLY. S ' PLAN CHEGK $ �/ (/ /� � '7 � — i r� 9_��'� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX S17 C08TA MEBh CA4�PCRN�A For Applieanf fo Fill In Complefely TYPE OR PRINT BUILDING B� C � �O/4L /l�l ADGRESB COSTA MESA CALIFORNIA OWNER � (J� LO N � MAIL 3o D I� GOAcST N� �I � ADORE.fi/b / �irv/V�I..�i�n .�T BEA�1 i�En�/6%iL" CONTRACTOR I�I. �O' �/�/G Gm ADDRESS v O O � fy �Sj' yrtp (�Y, ciTvlV�nln�P'o�T ,8��9c� LIC.TNOl�/ /�v� NO. /' �77� / BIZE I NO. OP 91D08. � R PROM /} � iTR¢eT /Q� � 'g�T REAR YAR[ L�O' , J . FT � RIGHT DESCRIPTION OF WORK IX II ALTERATION I II AODITIO 81ZH �"�� %� � � ROOMB � STORIE6 � EXTERIOR LL ROOF .�J_ COVERING CGO COVERING �+" L� US8 OF BUILDING AND WORK TO BE PERFORMED ,Qlf1°L�J� cfr//TJ An/11 ��Ta-�.riE,p �.5�� Po i2T I H8f18BY ACKNOWL8p0H TXAT 1 XAVE PEAO THI6 APPLIGTION ANC BTATH TXAT TX6 ABOVB IB CORRECT AND ApRlB TO COM- PLY WITX ALL CIiY O�IN C69 AND BTATe WB R80ULATINO BUILDINO CONBiRUQfON� � BIGNANRE OP � y A � ZON6 LBOAL F E RECEIVED �A1AY 2 61961 FINANC�E ¢D�EPTg,�� APPL{E�V'I��i POR��khTf BUILDING For Off?ce Use Only nccc�rr wo. nesnu� COSTA MESA. CALIFORNIA ZONING NO. OP I UH6 OP NHW PLANB BUILDIN6 <Cdf1TiR i1Ne 8SJ � I AUTHORI2ED AGENT' V � ' �/I � � �, EVES 7 (i" �...a-c�vo /AWATION 19 POR TN8 • PBRM�T PEE ONLY. FEE $ / / �� HECK $ �Q• S � PEE $ lc �� .rD (714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 424 FORD RD Suite: B Vicinity: UNIT C AND DETACHED CARPORT Parcel Number: 41920106 Applicant: HURLEY, RICK Zonin9: Status: ISSUED Applied: 08/10/2001 Issued: 08/10/2007 ISSUED BY: ' Address: -' . ,.-�, , � - , - � - i>,. �/ _�'-- Phone: 949-951-6724 , �� / jl�i' - Zip: � . • �' j' � -; � y � � Owner. PARKER, STEP.HEN�J AND EL'IZABETH D �, �' � �� `��:-,�� Address 307COLCEEN�PL � � � �� - _- - - � ��,. � �'/� � , � _ . �Phone: 714-229 2330_ , - � • � • �� " COSTA MESA; CA' -' ;. � - � Zip: 92627 : � �.. �,�� '� �• � /�,�� : � � ' � �V� // ' •, _� � . Contractor: '�HURLEY ENTERPRISES � ',� � �,� �� , � � � . Address: 23251 PER4LTA"DR � ' � � �. � � - , UNIT R,, �. Phone: �974.951-6724 . � � � � � . LAGUNAHILLS � ` �� . �� , ` Zip: 92653' License: 314783 , � - - . � Arth : Address: Zip: Phone: ; � � - License: � Eng: , ' . . Addie4s:� � , / RE-ROOF UNIT B AND C OF�AN EXISITNG TRIPLEX. COMP. - � �� - "- " " Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: � Total: SETBACKS ACCESSORY PARKING NOTES: $0.00 $63.15 $0.50 $0.00 $0.00 � $0.00 i $63.65 Phone: License: �VYt VF YCKMII ' NITS ARE AFfACHED. RE-SHEATH AND COVER WITH 20 YEAR .-. - -" <...-' --. ' � . . FEE SUMMARY :��;.- , � � � - - - Calc Valuation: i� Claim Valuation: . , % , i' .. . , � . ' . . _ . . ..,. . . Front 0- 0 � Rear 0- 0 Front ��0- 0 .. Rear 0- 0 Ezistioa: � � 0 ReoWred: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 , Pmoosed: 0� Rigtlt 0- 0 Right 0- 0 i $1;780.00 57,780.00 NOTICE: The work authonzed by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become vold if work Is not commenced within 780 days, or if work is suspended or abandoned for a period of 780 days. - � INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlone and Iinel approval mus� be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2as�ee �eroo� WORKERS'COMPENSAnONDECLARAnON: I hereby eftirm under penalty af perjury ane of tha tollowing declarations: ❑ I heve end wlll meinlain a certificare oi consent ta self-Insura tor workers' compensatlan, es provitled tor by sectlon 3700 of the Lebor Code, for the performence of Ihe work for which ihis permlt Is Issued. ❑ I have and wlll maintein warkers' compensatlon Insurence, es reqNreO by section 3700'af the LebLr Cotle, for Ihe peAortnance ot the work tar which Mis permit is issued. My worker9' Compensetlon Insurence cerrier end p011Cy number ere: Cartier: Policy Number: (lhls sectlon nea0 nof ba complefed /l the permlt 75 ve/ued et one hundred dollers ($f 00) or /ess.) ❑ I certity thet in the peAortnence ot Ihe work for w�ich this Oe�mil is I55ueQ I shall not employ eny person in eny menner so es to become subject to the workers' compensation laws of Celifomia, end egree thet If I should become sub�ect to the workere' compensatlon provislons of Sedion 3700 at t�e Lebor Code, I shall forthwith comD�Y �ih �hese proN5i0n5. Appllrant Slgnature: Dete: WARNINfi: FAILURE TO SECURE WORKERS' GYk.IPENSATION COVEMOE IS UNUW FUL M!D SHr1LL SUBJECf M! EMPIOYER TO CHIMINAL PENALPES AND CML FlNES UP TO ONE NUNDRED T}10USAND DOLLFRE (5100,000), IN ADDITION TO TME COST OF ODMPENSATION, OM4IGES AS PROVIDED FOH IN SECi1pN 37060F THE UBOR CODE, If�lrEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS �ECLARATON: I hereby atflrtn Ihat I am Ilcensetl untler provlslons ot Chapter 9(commencing wlth Section 7000) of Divislon 3 of ihe Businass and Professions Code, end my license is in tull force entl ettecL Lic. a Class q Contrectars Signature: Date: CONSTFiUCTION LENDING AGENCY: ❑ I here6y affirtn that there Is a construction lending egency lor the Dedormance ot the work for which Ihis pertnit is issued. (Sec. 3097, Givil Code). LenCefs Name: � Lendefs Address: SigneWre: Date: OWNER-BUILOER DECLARATIONS: 1 hereby aflirm that under penely of per�ury ihet 1 am EXEMPT FROM TME CON7RACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business entl Professlons Code: My ciry or counry which requlres e permit to consiruq, elter, improve, tlemolis�, or repelr any sWCNre, pnor to its issuance, elso requires Ne epD��eN tor such permit lo tle e signetl stetement that he or she Is Ilcensetl pursuant to the proNsions of the Cantrectars Llcense Lew (Chepier 9(commendng with Sectlon 7000) ot DMsion 3 af Ne Business end Professians Cade) or that he o,yshe is exemD� ��erefrom end the basls for Ihe alleped axemption. Any violation of Sectim 7031.5 by any epplicant for e perm+: sub�ects the epplicaM to e dvll penalry oi not more Ihen five hundred dollers (5500).): ❑ I, es owner of ihe properry, or my employees wit� weges es Iheir sole compensatlon, WILL DO 7ME WORK, anC Ihe sWcture Is not intended or ofteretl for sale (Sec. 7044, Business and Professions Code: The Coniractors License Lew tloes not apply to en owner ot properry who 6uilds or improves thereon, and who does such work himself or hersetl or ihrough his or her own emplqrees, provitled t�at suc� ImD�ovemenis ere not intended or oXered tor sale. If, however, the building or Improvement is soltl within one yeer o1 completion, the owner-Oullder wlll �ave the Ourtlen of proving that �e or she did not build or improve for purpase of sale.). ❑ I, as owner of Ihe properry, em E%CLUSIVELY CONTiiALTNG WITH LICENSED CONTRACTORS to con5truct lhe project (Sec. 7044, Business and Protessions Code: The contredors License Lew does not epply to en owner of property w�o builds or imprwes Ihereon, antl who coniracts for such prolec� w�th a comrectoqs) licanse pursuent to ihe Contractors }icense Lews.). ❑ I em exempt untler sec. �+' Business entl Pmfessions Coda tor this reason: Signe�ure: Date: Owner ID verifled Dy tlriveYs license. ❑ Ves ❑ No Drivels License No. Expires: Veriticetion ol Ownership by (rype oi document, i.e. - properry taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certity Ihet no excavetion five (5) or more feet in depih into which e person is required to descend, will be made in connection with work authorized by ihis pertnit, end that no building structure, scalloltling, lalsework, or tlemolltlon or tlismantling t�ereof, will be more than thirty-six (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec. 347, Title 8, Celitomia Administrative Cotle). ❑ As owner-bullder, I wlll not employ enyone to tlo work which would require e permlt Irom Ihe Division of Intlusinal Sefery, es notetl abave, unless suc� person hes e pertnit to do such wark tram the division. Signetura: Date: Division ot Indusinal �Sefery Pertnit Number: CER7IFlCATE OF COMPUANCE AND AUTHORIZATION OF EHTRV: I certiy under penalry of perjury ihet I have read this epplication and state that ihe infortnation given is conect. I egree lo compty with flll stete laws end clry ordinances relatinp to builtling construction, end euthonze represenlaWes oi the Ciry of Costa Mesa to enter upon t�e above-descnbed property for inspedion purposes. I egree not to occuDY or allow occupancy of eny building authorized by ihis permit until final inspaction. Signeture Ot Legel Owner(s) AnNOr Authonzed Applicant Date cooe �, ixsvecnoN*rve 1616 Fixetl System Finel Fire Prevention 1288 Pool Spe Finel 200 Finel Ra-Roof 201 Finel BIocWRetelning Well 202 Finel Fectory Fire Place 203 Finel Slpn 204 Finel Demolition PLiE II�LS / �� GOOE� INSPEC710NTYPE 206 Final Mechanical 208 Final Plumbing 210 Flnel Electncal 212 Flnal Fire Prevention 220 Finel Planning Approval 222 Final Slie 250 Flnal Builtling/Occupancy PAffi U�d4H (714) 754-5273 • Fax (714) 754:4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 424 FORD RD Suite: A Vicinity: UNITAANDB Parcel Number: 41920106 Zoning: npplicant HURLEY, RICK ISSUED BY: Address: _ - -...- � _ �,..i Status: ISSUED Applied: OB/102007 Issued: OS/10/2001 �-'�/%`� __ __ .Phone: 949-951 6724 - � - '.-,i�_ '� Zi: i. .//�'. . P , � � .�'_\ � / _ �j.ii . � ��,��, Owner. PARKER;,STEPHEN J AND ELIZABETH-D �� ' �% -,�\ Address 307 COLLEEN�PL� � `� � i — � — - - - � � � � �� ' :; ', - - _ , / ��V',� / ��, �\ . ` _ _ " Phone: 714-229=2330�: �\�. . ,'��\ �. �,�� _ ;C09TA MESA; CA � Zip: 92627 �,C ` V . ��i " -' _ ��- � � � � =��1 Cont�tor:� `HURLEY ENTERPRISES �� ; � � � '; ��. Address:, 23251 PERALTA"DR �� , ' � -, UNIT R�" �� Phone:,,� 714.951-6724 -`\A � � : LAGUNA HILLS � . ' � . Zip:, "92653', � - License;.: 314183 , � - _ , , Arch : � ` ., .�,� , " .� Eng: _ . . . Address: � . ' , � � ; � Address.� , ' � ` .. . ' _ , - . .� � � _ Phode: - . . - . __ - .; A , , , . . -� Phone: . � . � . � ` ",� �,.. : ;". _ �Zip: , ' � � � .- License: -� � License: � � ' , JIrVYt VI' YCKIYII I ' - i� � � ,i RE-ROOF UNIT A AND DETACHED�CARPORT OF AN�EXISITNGTRIBLEX�RE-SHEATH AND COVER WITH 20 YEAR COMP SHWGLES. .. .,.... __ `_.'_ _ "._.,_. . _.._ _._ , , � � , , � . � FEE SUMMARY y; � , � Plan Check: � $0.00 -- � — =-- --- ,' - -- �" � - = Calc Valuation: � ga,000.00 � Permit: $9725 � � � � - � � - -- � , � ' Claim Valuation: � � $a,000.00 SMIP Res: $0.50 " " � � � SMIP Com: $0.00 � � _ � - Other: $0.00 „ Inspection: $0.00 - .. . � .��::� - '„ . �.Total: $97J5_ � �� . � . � _ - _ , ; � � - �` �, � - � FLANNING & ZONING „ ; j, � SETBACKS, � �• �� - �"�� ' � MAIN STRUCTURE FroM 0- 0 � � Rear 0- 0' Left 0- 0 _ Righ[ 0- 0 � ACCESSORY PARKING NOTES: Front 0- 0 Existinq: � 0 . , Rear � �0- 0 � Required: 0 Lek 0-A ' Pr000sed: 0- Righl'� ' 0-0 , NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requiremants under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become vold it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zasss �eroo� WORKERS'COMPENSAnON DECLARAnON: I heraby aHirtn undar penelty ot perjury one of the tollowing deGeretions: ❑ I heve and will maintain e certificate of consent to selt-Insure for workers' compansatlon, es proNtletl for �y saction 3700 oMhe Lebot,. ode, for the peAortnence at ihe work for which lhis pertnit is issuetl. ❑ I have antl will maintain workers' compensation Insurance, as requiretl by sectlon 3700 of the Labor Cotla, for the pedortnance of the work for which this parmit Is Issuetl. My workere' compensatlon Insurance caMer entl policy numbar ere: Cartier. Policy Number. (ThIs section need naf be complefed /l Me permlt is velueO at one huntlred dollars ($100) or /ess.) ❑ I certity ihet In the Dertormence of ihe work for which this pertnit Is issued, I shall not employ any person in eny manner so as to become subject to ihe workers' compansatlon laws of CelHomie, and egree that if I should become su6Ject to the workers' compensation provisions ol5ectlon 3700 of the Laboi Code, I shall fotlhwith comply with ihese provislons. Applicent SlgnaWre: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIqJ CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMIWIL PENALTIES AND CIVIL FINES UP TOIXJE HUNDRED TLKKISAND DOLLARE (5100.000), IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SEGTIqJ 31080F iHE UBOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSEU CONTRACTORS DECLARATION: I hereby aNirm that I am licensed under provisions of Chepter 9(commencing with Sedion 7000) af Divislon 3 ot Ihe Business and Professions Code, end my Ilcense Is in tull force entl eRecL Lla M Class a Conirec�ors Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aMirm ihat there is a construction lending agenq for Ihe peAormance of tha work for which Ihis pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: Lender'S Addre55: Signature: Dete: OWNER-BUILDERDECLARATIONS: �v;;r I hereby eHirtn thel under penalry of perjury ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Busineu end Professions Code: Any ciry or counry which requires e permit to consiruct, alter, Improva, tlemolish, or repair any sbudure, pnor to its issuance, also requires the epplicant tor such pertnit to file e signetl statement thet,he or she Is licensed pursuant to the provisions of ihe Contrectors License Law (Cheptar 9(cammencing wlih Seclion 7000) 01 DiWslon 3 of t�e Business end Professions Code) or ihat he or she Is exempt theieirom and tha 6asis for t�e alleqetl exemption. Any violation o� Section 7031.5 by any epplicent for a pertM: subjecis the applicent to e civil panelTy of not more than five hundretl dollars ($500).): ❑ I, es owner of the proparry, ar my employees with wages as their sole compensation, WILL DO TNE WORK, entl the siructure is not intentletl or oHered for sale (Sec. 7044, eusiness and Professions Cotle: The Contractors License Law does not applY lo an owner of property who builds or Improves thereon, and who does such work himself or herself or ihrough his or her own employees, provided that such Improvemenls are not Intended or oHered lor sale. If, however, ihe building or improvement Is sold within one year of completion, the owner-builder will have ihe burden of proving ihet he or she did not build or improve tor purpose of sale.). ❑ I, as ownar of the properly, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professlons Cotle: The Conirectors Llcensa Lew tloes not epply Io an owner of property who bullds or Impmve5 thereon, end who contrecls for such project with a wnirector(s) license Dursuant to the Contrectors License Laws.). ❑ I em exempt under sec. Business antl Professions Code for this reason: SignaNre: Owner ID veniietl by tlrivals license. ❑ Ves ❑ No Drivels License No. Venficatlon oi Ownership by (rype of document, i.e. - properry tax biil or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Date: Expires: ❑ I hereby cerlity Ihat no excavetion tive (5) or more feet in depth into whlch e person Is raquired to tlescentl, will be matle In connection with work authorized by ihis permit, and ihet no building siructure, scalfolding, talsework, or tlemolition or dismantling thereoi, will he more ihan thirty-six (36) fee� high. (Chep. 32, Grp 2, Art 2, Sec. 341, 71tla B, Celifomia Atlministrative Code). ❑ As owner-builder, I wiil not employ enyone to do work which would require a permit from Ihe Division of Intlustnal Sefery, as notetl ebove, unless such person has e permit to do such work from Ihe division. Signature: Date: Division of Industrial Safery Permit Number. CERTIFlCATE OF COMPLIANCE AND AUTMOHIZATION OF ENTRV: I cenify under penalry of perjury Ihat 1 hava read this application end state ihet the information given is correc�. I agree �o comply wlih ell stale lews and clry ordinances releting to bullding consiruction, and authorize representatives oi iha Ciry of Costa Mesa to enter upon the above-descnbed property for ins0ection purposes. I egree not to occupy or allow occupancy of any building authorized by this permit until finel inspection. Signamre Ot Legal Owner(s) And/Or Authorized Applicant COOE I, INSPEC110NTYPE 1616 Fixetl System Finel Fire Preven�ion 7286 200 201 202 203 Pool Spe Final Final Re-Root Flnal BIocWRetaining Well Final Factory Fire Place Final Sign 204 Final Demolition �: � .�m ��/ D/ ¢�K COUE I INSPECTION TYVE 206 Final Mechanical 208 Flnal Plumbing 210 Final Elettdtal 212 Final Flre Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency PA7E INIIfIAL3 /D°"�0FB1°`0P1Gi 424 FORD RD ONNER4NNIEIFRlON% SOLTSICK, JOHN EUGENE JR '0°"ES' 424 FORD RD UNIT A COSTA MESA,CA 92626 urcxrtEcr on �¢x MCR OH ENN49 �55: uNT: �o-P uc w, uMr: °0'""AQf01fSN"'�NOCK PLUMHING (714)895-1246 CONfP"�0�"u�'0 11612 KNOTT ST "�^�S% GARDEN GROVE CA �� 511971 92641 �T 17 LICENSED COMN�CiON4 DECIAXATION: I haaby dfem udar paWy d psjuy Nm I em G.w�esd �vds pw�biwis tl CAeqx 9 (rmvnr�aq xdh Ssfv� ]000) d Orvb"v� J d tha Bmea md P�daiam CoM. W my bsus u in hA Iva end aHw. cmuc.no.:050386 �'0�` C-36 �`'NO'` 511971 EXP: 02/98 Dms: �+da OWNEP BUILOEN DECLAfUTiON: I hreby Nfirm imtlx paWy d pxWy �hel I am emmp livm �he Comradm Liosae lew la tM , •yywiq reemn ISeaion'lhm�s &nTevs md Ndw'vn Cada: �m W a odvay MiN ny�em e O�v to mmmct etlr. inPow. � emd'uh.nrW+��YstrucMe.p'vnb"svwo.drompmmNe�p6mYlnvrAO��toflseo�pp��edMammVtl�MaMs e 4mmed pim�uv b ihe prwwiona d tlr CMietlas lirome lev �Chepr e(mnimemq wdh Swion 1000) d Ox'vion J tl tM B�en erd Rdea'vn Codal a Ne M a ehs u memW �hashan md �hs bea la ihe sAsped mempion. /u�Y vdmion d&eaon 1031.5 by eny eppfraM tn e perrtN abptle Ne eppGsn to a dW penely d nd mas Wn IHs MVWsd EOWn �5500�. ❑ I.mwnsdthap�opeityamyanpiq+ox'thwepnmNeiWemmpe�emi,WEOlhewakendNaMCWraunal'vVmdsd «Meied br aeb (5eeian NM. ein'vea ene Pedaa�a Cade: TheCaN�aCan licen» Lew don ia ewN �o en ownxd qoperiy wno ddda a inD�� haean. nd Mc doee axh wh IimxC a henN rc O+aph hb a her am emd�Rs�. V�b ihet ach impwemerb aa m�'vaeMed a MMod la mk. tl. hows.ar. tM buldv�p n inpwwnra u wN wtlhn ar yaer d mnplelion. IM owmr�buiCer rn9 Mro �hs bvden d pw'vq M a ehs Sid nol ddd a'vnporo la Ne pryws d vb). ❑ I. n wrtr d �M pqwH. em mriu�d/ mareai9 w'uh forueE mmrms m mmn�u Ne p9� (Saa'vn 10H. &eiw� end wd.mom coee: me com�eaa, tn� �eo mo m mvN n m, o.,r a o�r wno nwn. «:ro�o+e m«ean .nd .ro ooni�act� br eudi nVms xvh a m+�eCMa) fcm+ad wo+�+to tM Caurador� lim�ue laW. CITY OF COSTA MESA — BUILDING PERMIT PERMIT NG: P 072747 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: PLU JOB DESCRIPTION : C/O DISHWASHER PERM NO: P 072747 GOVT: N SUPP: N SQ FT: PUAPOSE: OTH CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT �tx�*x�**�r�t�t* * � �r**�r**�r***�rr*�r�t�t�-x��-**�c-*****rt�t�t�t�-**iti��t�t�ti��r*�t-**�t*x-�x-�-********�e*rr Q Z O N I N G R E Q U I E N T S S E T B A . -� �- -- M N BUILDING --------- --------- ACCESSORY BUILDING --------- F FT IN REAR: FT I FRNT: FT IN REAR: FT IN LEFTc FT IN AGAT: FT I LEFT: IN RGHT: FT IN PARKING REQ: PROV; PARC : 4197 ZNE: REF NO: PLANNING NOTES> i iE1EiE1EfE1ElE1EiFIFlEifiEiEffiklEiE1f1E1fiEiEfEiFlElEiE1ElffklEiFiflF1FlE3F iElf1E1ElEiE��EiElflEklEiflE�fff1ElEiE1EiElElEififlfiEiEif�EiEiE1E�EifiFlEiE D E V E L O P M E N T S E R V C E S� R E Q U I R E M E N T S ZONING APPROVED BY , BUILDING APPROVED BY ; DATE: DATE: ❑ i,�,��q�e«s«w�: e.av.c..i«u,e�: APPLICATION ISSUED BY: ' DATE: Dale: Qver k1E1EiE1EiEiElffEiflEiEiEiFlEifihifiE1f1f1f ^ iElElfiEiEiEiEfEkiE��iFfE1E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N iron�nv�nmmmi.m..y.aw�eu»nm*.�.nacw,m.irmn.�asd.vwe.sw�.zs�m.us:n..m • - 2S�iJ�. md Nm I a+M haun d+itl'vq omVd+ wJl / rp nol (drtb ane) roM ro canDN wN oitl mts codx eM IM �W��wa br epamplacwawctiona�mEGwianhamNalir�eneamra0inr'vf.Rdsaelmmwioneppire�iauanemmqlmmlMva BLDG PMT PLUMBING ELECTR•IC MECHANIC FIRE SMIP/RES GRADING ^"^°'"" � PERMIT 7.00 wonKen�s couvownoN oEcun�noN: i iww�.rc.m w. wroer a� o�. a m. mm.:p eeaemno.: � IhcnenExYmei�venecenCraiadmromtloutlauuestorxwkas'mpanWbn.mpwidadlaEy6er�ion]]IIOdiMLebar coe.. �« in. wn�. w m..m� i«.�n u� wma d m�.a. ❑ ina..�e�;��a�.�,•aoma��.M..m�.am.a�rsw��oowm.tmaue..ro.m.w��.ain. work la whidi Nie V�N e musd. MY wvlen' mmpsnmion'vmvenc� urr'w md V�Y mmEx ms: ceniw: STATF EXPIRES Pary�� ].16�99�—QS 03/O1/96 �m;:.�riun �..e �wr a. m�p.r.e. w c«m� o b, �. n�e,.e doae,. rs�oo� o. w,d � � mnA' Net In Ne OMamuwa d Ne work ror �MiN Nu o�e u buaE. I NeA nd +mMW M' V�� In anY manrwr o n �o become wbptl to �M xa�keee' mnpaiWim Isw� d CeNurie. erd roM �! I Jwk Oeconr wbpq lo IM xwMen' cano�ion O�sbr M 6seian J�Oo d �M teEar COM. l NN taNwvh mmVN wN Cew pmmo'u. om.: wd�: W�mlrp: F�Nun ro wcvn woikr�'ro�nutlon covw�p� l�'ml�rM. uMWll ND/�e! in �mployw� ro e�IMlrl pn�Mp �nE NHI Ilnu ip ro aw huWnA lM�und doltrn (1tPq000A p��n ro tlw ml ol mrpww(bR Wnap� u prorWM bi In S�ctlm ]106 0l M I�Dor COW, IN1ruG �nd ttbmry i hu. CONSTfiUCl10N LENqNO AGENCY: I hnaEy e1Nm uMr penelry W per"�vy ihn ihas's e aonqwion bMinp epe�wy M Iha parlamerce W iM Mvk b xfiidi i�u O�Y b'sewd (5wion ]061. Civ. CI. LENDEP'9 NRME: LENOER'S �DOflE53: 1[atiy Ihet I hm rotl Nu eppl'retim aM Ytla Ihel tM ebava iNmwion e oonq. l ppw b wnWly xdli dl dy end wuruy adLurcr eM ala�e lewe rMel'vq b Wildvq wubutlion eed IweEy eNlior¢e ispaesn�Mrvee d Ihe r'Ly b aNx upon IM ebove.meNioned poperly lor inspadion W�rofea. kON NOCK v�w w�. Dms: Sgreturo d Owir/Npem/AppireiwCanroea (515t-a6.WP) WhasBwWipBbde�Y:a�ee�FFb:Caner/+�W�'�:NnkJievenua:Oddx�oE-Asxma 25t SMIP/NON—RES PLAN ISSUE FEE 2 0 D_ BUILDING—DIV—> PERMIT SS C CK TOTAL PAID DUE TOTALS----> 7.00 ,00 27,00 27.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 27.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 29.00 ' 1E iF 1E 1ElE IE �k IE fE �f iE k k k k fE iE iE 1f iE 1E 1E 1E if 1E 1E fE iE 1E Ik if k M �E fE �E fE 1E IE iE iE IE if IE iE iE iE fE fE iE IE IE iE iE IE fE iE 1E 1E 1! 1flE 1f IElt iE iE �k if 1F iE iE 1k iE f4 ik i! iE i! I N D I V I D U A L F E E B R E A K D O W N TYPE QTY PLU 1 D E S C R I P T I O N L�1�9;1:t;bY41_�l:l END' OF' FEES UNIT COST TOTAL COST 7.�0 %.�Q CONSTRUCTION AND PLANNING . PO� S SPA APPROVALS Permit �k - Date Inspettor AppROVAIS Permit # Date Inspector 1. Temporary Electritai Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgmd. 53. Steel Reinforcement . 3. Electrical Cpnduit U[ility-Undrgrnd. 54.. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pretsure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Poundation 59. Gas Pipe,'O Undrgr�d., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structura� F�oor System 61. APPROVAL TO OECK 11. Prope�ty Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Fina� 7 3. Roof Drains 64. Plumbing SYstem - Final 14. flough Plumbing 65. Electrical-Final 75. 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 Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL � � 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Firepiac � APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Te 72. Underground Flush 24. Roof Framing 73. Undergrnd.Stora9eTank �Gas OOiI 25. Roof Sheathin9 74. Overhead Hydro 26. T-Bar Ceiling (Strue urai) & Monocoat 75. Dry Chemical 27. Frame and Fiashing 76. Dry Standpipe 28. �athing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PpEV. FINAL 30. Drywall Nailing LTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FIN ECTION 32. Electriwl Power MeterFinal 80. FO � CE IFICATE ISSUED 33. Final Electric Nates: 34. Finai Heating & Air Conditi t��1{�F- -C/NdL' ��(�� n/ �� o�v r � i �� 35. Finai Gas Pipe-Test � 36. Hood or Canopy � - - '� 37. Final Factory Fireplace �� .� 38. Final Plumbing � / - �-47 39. Water Service�Final � � 40. Gas Service�Final � 41. Solar pomestic•Final J 42. Backfiow Preventer 43. Backflow trrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regutations 47. FINAI STRUCTURE & BUILDING 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date � ( Cn Fpplicant to fill in all spaces excevt those witnin heavy Oorder lines antl sign all appropriate tleclarations. Ci7v.�F COST,4 MESA CONSTRUCTION PERMIT Project Address � 'e ApplicanYs Mailing Address .-�5`6.Q _S. —•l�f04lr2�. Gbt Owner's Name �� '�+/a � Phone S';L'S Address �-2`f- ,Ffl2D ,�1� • i7�//�L�k.9RG Arch/Eng: ' License No. Address Contrecror'sName S/�lo�rH6RNJon� Phone `39�-�=�5 Address�mailingl� 6S3�S. Gr9,COn/ER s— G.PNNG�C'% 9�.Gf�� City License No. C33.8'!�y' LICENSEO CONTRACTOR DECLARATION � ' 1 hereby a/firm that I am licensetl untler provisions af Charter 9(commencing with section 7000) of Division 3 of [he Business antl Professions Cotle, antl my license is in full force antl eftect. License C�ass �' 3 g L�i/ense �No. 3 0�(0/ �' Date%��=T.F% Signature ��'r�/..+�-� ��+ WORKERS' COMPENSATION DECLARATION � ' I hereby affirm Ihat 1 have a certificate of mnsent to self-insure or a certificate oi Workers' Compensation Insurance, or a certified copy thereof (Sectlon 3800, Lab. C.) Q �i Palicy No. ��7/�� /� Company ST'`1TL' �N�t1� �Cer[ifietl copy is hereby furnishetl. . Certifietl copy is filed with tM1e city Builtlin Division. �ate � �-�'% Applicant �.� �= ��"'�^�— EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section n¢etl not be tompletetl if Ihe permit i5 to� one huntlr¢tl ($300) or less): � I certify that in the performance of the wo�k tor which thls perm�t is issuetl, I ' shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. , Date Signature NOTICE: It, afte� making this.tlecla�atlon, you shoultl become subject to th¢ Worker5' Compensation provi5ion5 0( the Labo� Cotle, you must (ortnwith tomply with such provi5ion5 or this permit Shall be tleemetl revoked. CONSTRUCTION LENDING AGENCV . 1 hereby affl�m that there is a construction lentlin9 agenCy for the per(ormance ot the work for which t/�is permit is issuetl (Section 3097 Civ. C.) ' Lentler's Name �A LenCer'S AtltlreSz " OWNER BUILUERDECLARATION ' 1 hereby affirm that 1 am exempt irom the Contractor's License Law for the tollowing reasOn (Section ]031.5 6u5ine55 antl Profe55ional Cotle: Any ciry o� county which requires a permit to wns[ruct, al[er, improve, demolish or repair any structure, prior,to ils issuance, also repuires che applicant for such permit . to file a signetl statement that he/slte is licensetl pur5uan[ to the provisions ot the ContractOr's License Law (Chapter 9(commencing with $ection ]000) of 'DiviSion 3 ot the Business antl Profe55ions Cotle) or that he/she is exempt th¢rffrom antl the ba5i5 tor the alleqetl exemption: Any violation of Section �]031.5 by any applicant for a permit subjects the applican[ to a tivil �enalty of not more than five huntlretl tlollars (g500). i, as owner of'tne property or my employees witn wages as their sole compensation, will tlo tne work, antl the structure is not intentletl or olteretl fo� Sale (Section. J046, Business and Professional Cotle: The Cont�acto�'s License Law tloes not apply to an owner ot a property who builtls or improves thereon, antl who tloes such wo�k himtelf/herself ar IhrOugh his or he� own employee5, provitletl Ihat such improvements are not intentletl o� oHeretl for sale. If,.howeveq the builtling or improvement is soltl within one year of com- pletion, the owner will have tM1e burtlen of provin9 he/she tlitl not builtl or im- p�ove for the pu�pose of sale). ❑ I, as owner of the property, am exUusively tantrac[inq with licensetl con- tratto�s to consiruct the project (Section 7044, Busines5 antl Professions Cotle: The Contractor's License Law tloes not apply to an owner of property who builtls or improves thereon, antl who mntracts for such prqects with a con- tractor(s) �icense pursuant to the ConVactor's License Law). I am aware that proof of their Worker'S Compensation insurance shoultl be provitletl to me. ❑ I am exempt under Section B. & P. C. for [his reason J) ' C. ! "C P TVPE OF CONSTRUCTION ❑ CONVERSION ❑ TVPE OF PE ❑ T T ELE � H E RR ��O"1 PROJE T DESCRIPTION CON UCTION TY Remarks: Bar Sink Backflow Preventer eackflow Irrigation Bathtubs � Claiifiers _ Drinking.Po� floor Drains Floor $inks Gas Service Interceptors Kitchen Sink Lavamries P-Trep Roof Drains Reinspection Fee Outlets �W LJ ADD �.(�LTERATION IJ REPAIR SH ❑ OTHER IF BLOG.P��O�Nc<<� �c ia�v.cV� LJ FOUNDATION L.� STRUCTURAL ICAL PLUMBING ❑ MEGHANIGAL '4. y�� OCCUPANCV �CS, � VALUATION$�Q GRADINGCU.VDS. ACRES- $15 Boiler Duct�UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. BIL IC80 # Date owner Heating System & Ducting I hereby certify.that I have reatl this'application antl state that the above ❑0-100,000 BTU �100,000 intormation is wrrect. I agree to comply wrth all city antl Wunty ortlinances antl slate laws relating to Guiltlin9 �on5t�uction, antl he�eby authorize repre- sentalives ot lhis city to enter upon the above-mentionetl property for inSpeG[ion pur ses. Signature,� Date� Drivers' License or 55 � — Reinspection Fee IF OB65-46, rev. 30/84 White - Builtling: Canary - Applicant; Pink - Acwunting; Goltlenrotl - As5e550/ $15 PLUMBING Service Sink Sewer Cap - - Sewer Connection �, SOI2f COIIQCLOlS Solar Piping � Solar Tank Swimming Pool w/Spa Urinal Water Clo� Service Issue Fee Hood or Typel ❑ Canopy Type I I ❑ Refriqeration System ❑aioo,000sTu ❑ioo,00a System Repair/Alteration Fire Dampers Registers Issue Fee .✓-s • 3126 3/02�87 A.P. # Zone S Main Building: Accessory Building: E T Front. B Rear A C Right ' . " ' ' g l.eft Ping. Ref. # � � Parking Req./Provided ' Planning Notes: - � ' Automatic Washer ' Construction PoleSub. . � - Cookin9 Unit . ' _ ' Dishwasher' - � ' Dryers ❑Gas ❑Elecvic � Fan F.A.U. $ 3 FEES $ 3 Device Boxes , O utlets Switches Garbage Disposal Generator �0-5 KW Fea ELECTRICAL Transformer ❑ 15-50 KW � 50+KW Meter LJover100amps Sub Panel . � Motors 00�7 HP O1 %- 8 Inc.Solar �9-15 HP �16-15+ Microwave Pole Light, Range Slgn ' Standing Sections 5-15 KW Trash Compacmr $15 Issue Fee ' DEVELOPMENTSERVICESRE�UIREME Zonin9 APProved By � Building Approved By 30e50 TL 0 FEES $ 3 Z O N I N G R E � M T S � SU MARYOF.FEES BUILDINGPERMIT $ � SMIP , , $ O.SA PLAN CHECK ' $ PERMIT , , PLUMBING $ ISSUANCE $ � PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL. �$ GRADING $ PLANCHECK 50% $ MICROFILM $ � MECHANICAL $ TOTALFEE $ ��'S� PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL & 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-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-Undrgmd. - . � 8. Foundation � � � 59.-Gas Pipe, O Undrgrnd., Test . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final � 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Elettrical-Final 15. Rough Electrical-Conduit 66. Solar System�Final ' 16. Rough ElectriCWiring � 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYST.EMS 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 O Gas ❑ Oil 23. Gas Pipe-Rough & Test �J �, 7Z, Underground Flush 24. Roof Framing �� ,�r 73. Undergmd. Storage Tank O Gas ❑ Oil i 25. Roof Sheathing �` . ,�1% 74, Overhead Hydro � , 26. T-Bar Ceiling (Structural) & Monocoat �`Yit� r , 75. Dry'Chemical ' � 27. Frame and Flashing �. 76. Dry Standpipe � ��-, 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing '.� , HEALTH DEPT. REQUIREMENT , 31. Plaster Brown Coat 79. yFINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � � 34. Final Heating & Air Conditioning � �. . � 35. Final Gas Pipe-Test 36: Hood or Canopy ` 37. Final Factory Fireplace � "- 38. Final Plumbing � 39. Water Service-Final . • � 40. Gas Service-Final � 41. Solar pomestic-Final . ' , ' 42. Backflow Preventer 43. Backflow Irrigation � 44. Landscape Irrigation System . ' - �45. Sound Attenuation 46. Handicap Regulations � ' 47. FINAL STRUCTURE & BUILDING p � . � 48. Special Requirements Completed . � 49' Electric Release to Edison . . 50. Gas�Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY . No. Date ' � ' � AOONFSSOFBNLdNG: QZQ FORD RD ox�r•sruxeiva+aYr+: SOLTSICK, JOHN EUGENE JR �� 424 FORD RD DNIT A COSTA MESA,CA 92626 �vv�. Wuima �oo�ss: /JiCNRECT OX FHdNEEP: ANCII OP ENG.'S AODflE55: uc. No.: UNT: Unr� ? ? � CITY OF COSTA MESA — BUILDING PEAMIT PERMIT N0: P 072747 PLAN CHECK NO: N � e�"� CONSTRUCTION TYPE• P MIT TYPE: PLU JOB DESCRIPTION : C/O DISHWASHER UNf: CLASM VALUE: LC-VALUE: CONfNACTpi'SNAME: NOCK PLUMBING ( 714 ) 895-1246 cwm�croaswuuxc 11612 KNOTT ST eom�ss: GARDEN GROVE CA ucr+o.: 511971 92641 uxf: 17 LICENSED COHfRACTOqS OECL�RATION: I MreEy eRirm �Mer penely d pe�jury Nel I un liceneed uMer proviaims M Cheqm 9 (commmd^G xi�h Sxtion )000) d Oiviaion 3 al IM Bus�wa eM Prdesaioru Code, end mY licenae o in lull Mce eM efietl. c r+o.:050 86 �� C-36 uc.No.: S 1971 EXP: 02/96 o a �o�n�a _N�� P��t��•�l� NEP BUIIDEX �ECIAXA ON: I hxeby etfrtn uMx penely d pmjury �hn I em vemq hom �M Conhadon Lioeme lew la ihe Hlow'vp raeaon (`�ion ]0.'f1.5 Busmve eM Prdmeiorre Code: AnY ciY a oountY �� 9uirae e partnn to oorobun. e11x. imprwe. �amd'eh. a repeir eny siruclure, pior w na ivauerce, elvo reyuirae ihe epolicant �w such permil to fib e ag�wE etatemem ihei M a aM ia liceme� Wn��l to iM pranaians M Ma Contrmare Lironae lew �Cheqer B(canmendip wXh Setlion ]UW) d Oivebn J d tlr Buaineea aM Prdev'vre Codel �� a ehe b memq Ihereimn erd the bems fa ihe dbped uemqian. My violetion d Sed'nn ]W 1.5 by a�ry appliraru /or e perm� abpce �ha epplcam �o e dvil penelly d M more then INa huMnE dMen �5500�. � 1, es axvrer d IM propeity or my emplvyeee wnh wegee av �hei eda compenaetim, will do ihe xak, and tlre svunure i nd intanded m Meretl Iw aeb (Section ]000, Bueirou eM Prdessiona COAe: The Comracion Lioeme Lewtloee rw1 epptylo en ovmerd OropeMy who WiEa ar inpovea tMrean, eM r.1w dom euch xwk IimeeH ar henell or tMaqh he or her own empbyw, pwided thm wch impweinenb ara nd inteMed a dlaad la sab. M.1pwv.er.IM Wiltlirp ar inpiweinaN's add xilhin meY� d mmplelion.lhe ownar-0uiNar xill tava iM buNen N pa+'up M a she d'E rial build w impo.e /a �M q�ryme d eeb). , � I. es owner d Ihe qopeM. � adiidraly mn�reninp wiN limnead conVeclon to mntlrutl ihe prol� (�� ]01d. Bueirose eM a�aession. com: Tne comreaa. �renm �.. doea na .oWv w en ow�r a aroe�r wi,o w�n. «�po.�.. ma�.o� .�a wno contrecte la wd� pq«fa wM a aoraredor(e) licemed quauam �o �he Can�reCps Li�eroe Lewl. � I am ezemp uMx Seclion: B. d P.C., br Ihie reeaon: Oeta: Owner' 1 Ao MreM �M IMt I em ewe d ud uMxaieM Me re9uifamame d Cellanie IbNh xM SefelY COEe Saaiam?5505.2553�. eM ?SSJI, erd that I a eny INure Wiki�q ompent will / wil not (dreb om) need ro canply wih eeid qats codo eM Iha repuiremsnd br epermnfwcwnvuctionwmod'ifirationhanlMA'x eSu 4rv�y anepemem0ipnq.RaeideMielcontl�udianapptimtioneenexemqimmihesa pro��a. Dete: ApqcaM: W OflKEfl'S COMPENSATIIXI UECLRN�TION: I hereW e/firm uMer peneliy W parjury pro d IM Idlovrirp dederetiom: � 1 heve uW Mil meintein e cMilcela d oonxnt lo aallimun W xarkwe' wmpemalun, n pwiCeE la by Satlion 3)W d tM lebar coe<. i« m. ron�s a ma wwx i« wnon m� v� a n,�d. I heva eM wii manten waken'rompen�elon inaurer�ca. en �puirotl by $eUion 9100 d Ne laba COEa. lor tM petlumance d IM wark /or which ihie peimi� ie iaeued. My w«ken' cam eaiion inaurence ramr vM pdicy number me: c�«: S1�ATE EXPIRES ra�r+�mn« — 03/O1/96 ( This section n e e d nw b e rom det e C l � M ro�'t is b r we nun e m d G d l e r a / Sfoo l n b s eJ � I caM/Y I�et in Ihe peAwmenrw d Ihe wark Iw whch Ihn permil is ivueE. I sheN ml em enY V� In enY menner eo a to n.�om. wM� �o ine xwkg�s• compmamlon lawe a celilanie,. y4w�e u�m q�r� e«aro ampd m �ne �.o�Ya.� �� nnnit.m: � u—f��. " � -__. ro ucun workxi ronpwetlon rov�rp� Is unlMul, uM slWl Hb/�ef �n �mploy�r ro MM�uI pauMp uM �ra h'ntlrod tlpusmd do/4n (S1Pq000A M Mllfbn ro tlro cwf a! rompewtbM1 CarnqA� u poHJM br In CONSTfl11C110N LENDINO AQENCY; I hereby ��m unAer peneXy d perjury ihel iMro u e canet�uaion bMinB epercy Irc the perlortnenoe d �M wak la whirh the peimi ia iseued (Sedian �09]. CN. C�. LENDEP'S NI1ME: , LENOEA'S ADDflE34: I<er1iN ihet I heve read Nia epdKa� ��ma �het Ihe ebova in/ormNbn u c«rec. I pres to cpnpy vmh eA ory xd wi�nly wdi�wKee end etae lewe rdNiq b WiNvq em%euqion eed Mraby einh«¢a repeaentelrvm d ihb dly b emm upon iM ebo.e�memoned prtpery �� 9°�" °�`D�"� RON CK Pim lame (//'� a/�\ De�e: `t� � sis�awm o cfranu �e (5151-16.WP) Whne-B�ikiq 8 Sefely:Oreen-Fle: Ganery-AppGranl; Nnk-Re�enue; Oddenrod-Asxaeor COMMENTS: NO OTHER WORK AUTHORIZED HY THIS PERMIT +r�*+��**�r***+��****�**��*****�******�*��*+r��****�� Z O N I N G R E Q U I R E S E T B A C K S ------------ MAIN BUILDING ---------- --------- FRNT: FT IN REAR: FT IN FRNT: LEFT: FT IN RGHT: FT IN LEFT: PARKING REQ: PROV: PARCEL: 41920106 Z PLANNING NOTES> > *�r��**�*�***�t*�***at�r�t**x�****x�*+t*i�**i�x�*�r****iti�*�r�t*�r�*� • D E V E L O P M E N T S E R V 2 C E S.� R E � ZONING APPROVED HY . b h' �E NO: P 07279 VT: N SUPP: N . TH SQ FT: GROUP OCC: R-3 / +�*��+�*****+�*+�* T S OBY/��ILDING --------- !I� REAR; FT IN IN RGHT:. FT IN REF NO: 1E1EiflFifihiElkiElfifiEf(�1EiElElEfElE1Ed(�1FiFiF U I R E M E N T S DATE: BUILDING APPROVED BY : � DATE; APPLICATION ISSUED BY; DATE: �r � �F3FifiElFiEiEiE1E1f3EiElElElElflEiElEikiF1(' 1Elfif�fiFiFlkifiEiF IEih LEGALIZATION:N F E E S U M M A R Y � STRUCTURAL SEGMENT:N. BLDG PMT PLUMBING ELECTRdC,� MECHANIC FIRE SMIP/RES GAADING PERMIT 7.00 � ' 258 � '� =' SMIP/NON-RES PLAN - C; r � � ISSUE FEE 20.00 ' BUILDING=DIV-> PERMIT ISSUE PLAN=CHECK TOTAL� PAID DUE TOTALS----> 7.00 20.00 ,; 0.00 " 27.00 27.00 .00 REVENUE DIVISION TOTALS--> COLLECTED"�; 427,00� OVER/SHORT: 00 BLDG PMT PLU ZHI N�� G ELECTRIC MECHANPC FIRE SMIP/TOT GRADING PLAN-CHECK jF �F ik iF 1F 1F 1F k iE if iE iE iF 1E iFiE 1f iE iF fk ik 1F 1E 1f �f 1E * 1t 1E if 1E iF iE i!!F 1F if,1E�iElE 1k 1E'if 1E iF fE 1E 1E 1f iE iElF iE ik 4 ik iF 1E k iE 1E 1E iE IE 1E 1E 1E 1ElF iF if �E 1E 1F it 1k �k fElE 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 ' �: 1 PLU 1 DISHWASHER ;� ,� 7,00 7.00 fiND OF` FEES � ., rl � 4' -, • i i. �S �� QO�O:OTi�JOji1-�v7Y i�J 5 .^:%.JL� DATF: D6.'(lY/Y` TIME: 09:F1 � CON5TRUCTION AND PLANNING;� PO�.. & SPA r Date I�spector Date Inspector APPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical Service or Pofe 52. Pool & Equipment Lowtion � 2. Soil Pipe-Undrgmd. �. 53. Steel Reinforcement . �`3: Electrical ConduirUtilitY-UndrgrAd. 54. Forms ' • � _ : ;,¢. �lectricai Conduit�Un,drgmd. � . � 55. Electricai Bonding . , c, •`�::Steei Reinforcemen[ � 56. Rough Plumbing & Pressure 7est � �{. _Electrical UFER G'rcui. 57. APPROVAL TO COVER-GUNITE 7�.,Footings �� r� ' 58. Electricai Conduit-Undrgrnd. �18. Poundation -� 59. Gas Pipe, O Undrgrnd., Test � �9. Water Pipe-Undrgmd. , - 60. Backwash Lines,�P;Trap, O lJndrymd. '-10. Structural Pioor SYstem � 61. APPROVAL TO DECK . , 't t. Property Sewer Line.ffi House Connection 62. Backwash & Receptor�Final �12. �ewei Cap � - 63. Heater & Vent�Final ,- � 13. Roof Dreins �� 64. Plumbing System � Final , 74. Rough Plumbing� - 65. Electrical-Fina! ' � 75: Rough Eiectric�f-Conduic - ' 66. Solar SVstem-Final . - 7:6. Rough Electric Wiring. __ � 67. Fencing & Access Approval � ' 77. R gh Wiring Sign ' I 68. APPROVED FQR PLASTERING ' t•. � 18. Roiigh Electricai_T 8ar Ceiling - 69. POOI/SPA SYSTEMS HNAL 19. Rough Hea:in9 & A ��Conditioning �, _ � FIRE DEPT, REQUIREIVIENT .,, r 20.;.Hough Factory Pir,eplace - `�,�: � -� �� r„ i ` APP�?QVAI'5,,� Permit #T� ~ _� 21.�Ducis, in Structure" •• •• - � _ - � 70.'�Underground Hydro x 22. Duccs, Ventilatinj' �. � - �- F; ,_, 71 rProductiPiping � Gas � Oii 23. Gas�Pipe-Rough & Test -} ?± M r. ��, �- 72. Underground Ffush - 24.'Roof�Freming' �- . ' � ��- �`" � ; 73. Undergmd.StorageTank OGas ❑Ofl 25. Root�Sheathing - �i : x � :'�� 7q, pverhead Hydro, ' 26. -T�Bai' Ceiling (S[rycturaq & Mpnocoat � �_ '" - ''��' 7�5. Dry Chemicai _., _. t 27. Freme and Flashing. -- s� r� �, --�. jg, Dry Standpipe��^ � � - � �' 28. Lathing&Siding��; ' _ �`; y = ' ' 'y' 7,7,. FIXED�SYSTEM�F�INAL,. - 29. Insulation -• e � 78. FIRE PREV. FIN%aL "_' �^� 30. Drywall,Nai{i�g ;': ; N �� F ,y �- HEALTH DEPT�. REQUIREMENT 31. Piaster Brown Coa; ••; e + 79. FlNAL INSPECT.ION +� _ ,- 32.' Electrical'Power Ntet`er-Final -� ' 80, F00 EFTIFICATE fSSUED 33.�KinabElectric.. , � _ '' Notes: _ _ �� T Uu!� � 34.'FinaCHeating & AirlConHitioning'=� , s 4 � _ � - � �� 'i�E� �P3..lJr3 35.�,Finai'GasPipe:Tesf, � . y � �� _ =r� ��-- 36. Hood or CanoPv _ � -- -. ' 9. r �, �� -�' - 37 . . �'' � ,. - � �-- L:- � -- 38. Final'Plum6ing :" � � - � � ' . � , � -. . . � ter Service-Finai . "`� ' 40. Gas Service�Final 7� i - - � • 41. Solar pomestio-Final�-� , � �„/'� �/�a/�� _ IQ 1 + 1 42. Backflow Preventer�. i '/ �I/A C1G�" -"� 1 43. Backflow Irrigation ' D "- ' `^ � v" `"' � 44. Landscape Irri,`�on SYstemi '� �� ,�..1�iS O� i] o'-Id l�-a �45.'-5ound Attenuation, ; �O �n.n �l _ �n ` ;46.�Nardicap�Regulations (�p �� C� `1(-1 �/�� `� A7."FIN�laLSTRUCTURE&BUI F..JL,�.c�S� '�\� �"`�`-"'�^-'V 1 A8.^EINALP�ANNING� � t(�Q�IfL�� ,��.('� t'S II -49.-'Electric Release to Edison lYl ��f' . � `.�,.,� � y `¢ ,�l �� „^ � . ,r � � �„ -aF � i � �-r � , 50._Gas Release to Southern Cali ' 51. CERTIFICATEOF.00CUP/ � �� No. Date _ _ _