HomeMy WebLinkAbout2660 ELDEN AVE - Building Permits •
E Eti AVENUE, 2660' - - -
775 - 3-18-55 res w/att gar $6,500;
;1],2118 - 11-22-57 Pleg. NC (fix)
45(5 6-29-7d 7 Unit Apt;. 215,000.001
41142 - 5-17-77 Be mo.Re s.& Gar.
500.001
45253 - - 2-7-78 Blockwall - 3,600.
a - - .1:R;-®
- CID ,4702 OPENED 5/23/84 I
l°%VrY-dB MIL
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:Vater heater / —
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.a1111121109=111EMETICIZ ®
B 51255 Unit 101 {
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77/7/9/
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12.ILAT LEGAL
it
• lista Mesa Bunning Department , APPLICATION FOR PERMIT
111 2( .' • COSYAEAST 20thMESA, CALI ORNIA _TREET Is ') BUILDING
1
NekFOR OFFICE USE ONLY
(
FOR APPLICANT TO FILL IN RceiNo. 1 Perm.J
N....":„..-
Building
Building Oea {tAddress
Received by Date Recd. DZ Issued
Costa Mesa, California /y.,/ i
Nearest_.%?% iii N/ o)-�0i7'��/-
Cross St 2,1�[ Building /J
Address 4 '0 -1 rattj
Owner e.,.. " Costa Mesa, California
Mall
/
AddressNearest ), /• Vee
/� �� Tel. Cross St. t�2 LLQ /2/ a ---
City
City/ n! Alli.1-, ..--40 ' No. Zone / No.of I Type— I Grougi
Architect or / Lic. ee�/ Plans , 7
Engineer No. Approv
by . Date
Address i CORRECTIONS
, /J� City uc. ////
Contractor/ 4 ,ym, No./�� .Z
Address / .er 4i4 .ce C o—, f y��
crap Lot / ;D A r
Description No I Block I Traet3�
(Attach Metes and founds) • •
/ ,../� No.of Bldgs
Size of Lot /643,7 0 I Now on Lot DEC 2 1 1954
Ole of �////'' No.ot No.of 0• - A
• Existing Bldg. 1[J/,Jii.f r#I Families Room`� Lr
Setback Line from /�/ ReariYard y- • • CITY OF COSTA MESA 5
Center of y
DESC,/RJPTION OF WOR
New• ~ - I v Alteration I I Addition I • -
' Repair I I Moving I I Demolish I
SX 3j No.of
Size et,
Rooms �� Stories
Exteriorall I Roof /� p • APPROVALS
Covering Roof
Building Foundation Location Inspector Date
Forms,Materials,
_ /�2. 3XeM / Under-Pinning
'1;Z l T s Frame: Fire Stops,
/� •J Bracing,Bolts -
' 59
If hereby @ wledge that I have read this Application Lath. Int.
and state that the above is correct and agree to comply Lath.Ext
with all City Ordinances and State Laws regulating
building construction.
Signature ofPlaster, Int.
Permittee ' �r
Plaster, Ext.
Authorized Agt. . Masonry Reinforced
Valuation Permit Fee $ i g,o0
V Plan Check $ a a 0 Bond Beam
$ 6,70id\ Total `�—
✓v \ Fee $1l / _ b AFINAL
rnou one n.0 9u II-MA ,J�./
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PLOT PLAN - .
Show location and distances from - :
' property line and between buildings. • _ . .I-
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PAID
- 43565 rEaz"3-77t„S?OO12o4c' **A290.75
r COSTA MESA BUILDING-SAFETY DEPARTMENT UN/73 /tv- a�/2.3r/041-/or
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 /. Send €2-O-?
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely -Use I Onl ' DATE ISSUED
RECEIV r TE RE
CV
BUILDING /a /f-/ ✓// ' /� an
- /O-
ADDRESS (� L- C/-//v ��^ 'yam/�/yN.W~/'
OWNEF/'/Z/ 1 e''Cif� A.P. NO.//' t 3/ i(J P ✓✓sL/
• B LDING / (./Ni
MAIL •
ADDRESS - 2 Ai i lit rdf _G DRESS Q / E y a ej ----.
TCITY of 1/424 /,2c ! NELi__ yr,
TRACT SO '�w OT -- BLOCK
CONSTRUCTION J (3-91,0 5-9 f`{Et^� ADD ALTER REPAIR MOVING DFMOI ISH
LENDER - /
BRANCH '
ailOWNER �}f�//C :,;•11')/di, J
ADDRESS
//� �l^�// ALUta/c�
OR ENGIN ER i✓�lJ/�/ /���-/ NOLC� t����9 USE 7G�//l/ �iO(I
AL-r/o FIRE
ADDRESS .. ,J�,/j �� / -gyp ZONE TY'E GROUP J 2
!"'/*-, /�f- , 5 /� /C APPROVED. r /• ` �)/
CONTRACTOR / .-/I S BY // • DATE(,( �� �'
ADDR' � / / (J / i /✓� 2 //� NO.OF .I USE OF NEyY9
CITY ,......C.4.9,-/A-17)t-,./9 Not' s '' O/ PLANS BUILDING �/
F STATE ,--, CITY YARDS APPROVED YARDS APPROVED
LIC. NO. ,9osr?
LIC.N — IN BUIL
DING ACCESSORY BUILDING
I (FROM C/SIZE I NOW OSFRONT /FT �CC� /l S� `��0. OF LOT ,A- ?/S
USE OFti
EXISTING BLDG. ------- R SIDE ST. FT.
H
F Separate permits are required for L.SIDEnT. FT.
electric,plumbing and heating work.
ci REAR ?/" T. FT-
l.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q MAIN BLDGS. ACCESS. BLDGS.
VAR.,1`- DATE
O T �J� /�
Ll Q ��� �� C.U.P.#72— 1N APPROVED/-d-
'it
PPROVED//7-
a —BAYPflOVEDr 1 'i�j/ /j OATF Ic-I L/-
al
o1 hereby acknowledge that I have read this application and state 03112C
(Y that the above information is correct and agree to comply with HOLD FOR SPECIAL RkQUIREMENT$ yi
au all laws regulating building construction, and I shall not employ _
z any person in violation of the workman's compensation laws of ---- E
the State of California. A
3 I hereby certify that I am properly licensed as a contractor under ` �� SO. FT. �-V �� 0-.1�V
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m�
Chapter 9, end that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b VVV"``
am exempt from the provisions o the State of California Business VALUATION
tie PERMIT
and Professions ,D stoN
/ PLAN CHECK S 17A,/0 m
ignet o atS 2/JOOO TAX /5,05/ LL
Authorized Agent TOTAL PAID 9 trays ,
•
s �/ �y PAID 'I*..*I!
`7 ✓� II IN 1n-77c,M-7001243ii�• ~ 59.59
7 COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely —Ur Ink Only
RECEIVED BY DATE RECEIVED D//ATE ISSUE
ADDRESS
BUILDING D err / - r/^ /-Id-
![/
• j / P'J-
OWNER J / r A.P. NO. ^ `_)
MAIL BUILDING ADDRESS N et1! O ,�� � aFife
ADDRESS TEL. TRACT I LOT BCITY NO.
CONSTRUCTION NEW ADD ALTER REPAIR MOVINjer:DE
LENDER
BRANCH •
OWNER >
ADDRESS /
VALUE ��J
ARCHITECT TEL. USE $ • �-
OR ENGINEER NO r
FIRE V
ADDRESS • • i
TYPE / GROUP �'
o APPROVED
CONTRACTOR??Z..1�� I/� if BY DATE
ADDRESS ' /
•
TEL. ZONE INO.OF USE OF NEW
CITY NO. PLANS BUILDING
H STATE CITY YARDS APPROVED YARDS APPROVED
LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLDGS. (FROM C/L STREET)
4 OF LOT NOW ON LOT FRONT FT. FT.
Q USE OF
ch EXISTING BLDG. R.SIDE FT, FT.
co)
Z Separate permits are required for L,SIDE FT. FT.
G electric,plumbing and heating work. REAR FT. FT.
LIA
I—i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& —
Q= rafted MAIN BLDGS. ACCESS.BLDGS.
I /�I, VAR.# DATE
a C.U.P.# APPROVED
APPROVED
>. - BY DATE
'U
k1
0 I hereby acknowledge that I have read this application and state n
pg that the above Information is correct and agree to comply with y�
On all laws regulating building construction, and I shall not employ
' Z any person in violation of the workman's compensation laws of E
E
the State of California.
m.:
I hereby certify that I am properly licensed as a contractor under SQ. FT. fl
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F E ONLY:
am exempt from theprovisions of the State of California Business ��jj�� � �o
p VALUATION PERMIT FEE $ �i VU O
and Professions Code, Division 3,Chapter 9. J�
in
PLAN CHECK § 07
Signature of o
/ LL
Permittee ffi /// TAX $ 2
o
Authorized Agent TOTAL PAID $ pa
44142 JUN 14-77cn`s 001773* *****5.50
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
RECEIVED BY DATE RECEIVED //DATE I(S/$UF$/
BUILDING j
ADDRESS 2.60 Eld_n g e . �! `,7 jj1J Q//7
OWNER Mike Stitzi�nygerU A.P.NO. /(qr-�'°-L5-6 P /2C2
MAIL P. 0. Box ry 2682 BUILDING .2�Gr� `�U ._ / s�/�/((s/e
ADDRESS 6 L fit/
ADDRESS r�•� / [�
CITY Seal Beach, Ca. TEL. TRACT -J/ ;(7 I LO /2 BLOCK
CONSTRUCTION NEW ADD AI TER IRE-AIR {MOVING DFMOIJcH
LENDER
BRANCH Oke
�()
OWNER //X S 1/41,661
ADDRESS 6:1, (,I.n $ 5��
ARCHITECT TEL.
alas/2�7/�f.D SG.i(N-
. OR ENGINEER NO
FIRE •�J��
ADDRESS ZONE A �TYPE V GROUP.t
CONTRACTOR JOhn Dodd Company
APPROVED die
/DATE 044/77
--tong
1723 E. 3rd St. , r�
CITY Long Beach, Ca. ;EOL-/� ZO E, rI IPLOANS O BUILDING EW Eby/0
F STATE Q[1 CITY 6U'/o J. YARDS APPROVED YARDS APPROVED
I LIC.NO. 103898 LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE INO.OF BLOCS.
(FROM CO.STREET)
0. OF LOT NOW ON LOT FRONT FT. ( 4 FT.
Q USE OF
.�. EXISTING BLDG. R.SOW F . �c 0 F .
cz, CJJ C/
E Separate permits are required for L.SIDE FT. FT.��_
electric,plumbing and heating work. 1!--
W - REAR FT. FT.
(.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. GET.MAIN&
Q �.r /I
J ./] I�K�////��J/'J MAIN BLDGS. ACCESS.BLDGS.
..1 7 I /,/i �, f.' _`��d!����L 1! VAR.9W DATE
Q .,,��jrn�� �liC.(� /Y C.U.P. //'' APPROVED
1ROVED(6 ,p DATE L( /G/ 77
0 I hereby acknowledge that I have read this application and state 'n
X that the above information Is correct and agree to comply with n
as
Y
all laws regulating building construction, and I shall not employ i
Z any person In violation of the workman's compensation laws of m
.W�, the State of California.
3 I hereby certify that I am properly licensed as a contractor under SQ. FT. n
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: b
am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ e
and Professions Code,Division 3,Chaptertr.,
of I / -A PLAN CHECK $ eno
Permittee e4.4.:‘,...1 4. a Ifs LL
% $ 4Y 4 _� TAX $ ' d u
Authorized Agent 1� �� TOTAL PAID $ i
.• 45253 3294 12/21 /77 16070 TL
COSTA MESA BUILDING-SAFETY DEPARTMENT (G/�_
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicantryp(too Fill in CompletelyJ - Use Ink Only REGI/Vj/}�D BY DATE RECEIVED DATE ISSUED
BUILDING df' cc e1SB.t/ Alit LA 7/ /��D( - 0-ori-7
ADDRESS 111
OWNER /Y/. 'e S' //ALA
/Y r�yC-j� /� A.P.NO./7? O3O"✓..ex y� i .
AMAIL
DDRESS I/423:2LDS' ALAA4//(}7$ SZ ADDRESS ���J c(�/t��,7� VC-� .
CITY Las ALA4,/ras NOL,-98 J5`/ TRACT 3�rG - �y� BLOCK
CONSTRUCTION - NEW AD7ALTER REPAIR MOVING 'DEMO;ISH
LENDER s
BRANCH OWNER /)//Kr`-74ZfiO yJ
ADDRESS
TE 7 to C . am L/yALUE DO
ARCHITECT TEL. uSE !� L� 'C C/ $✓VNV ^�
OR ENGINEER NO
FIRE 7
ADDRESS ZONE - TYPE i GROUP/ I/
•
CONTRACTOR Mt/ire S! / Lz P in, • APPROVED A A' DATE (p/ .
ADDRESS //23s7 LCOS ALAM I/OS ND`,
/ �
TEL.oa/3 ZONE!? ANO.OF USE OF NEW
CITY 4h 4 ALAM / /Q„�' "°-6-95'-‘759 PLANS BUILDING
iwi F STATE CITY YARDS APPROVED YARDS APPROVED
gLIC.NO. 32025-,, LIC.NO. MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLOCS. (FROM C/L^ STREET) i—
G. OF LOT I NOW ON LOT FRONT ' / f! % / te..."=�T. fey`
Q USE OF �&L ,4 1 .
ct EXISTING BLDG. -R.SI "ale
#/s 2
Separate permits are required for L.BIDE � //�f7 P
electric,plumbing and heating work.
C1 REAR FT. FT.
USE OF BUILDING AND WORK TO BE PE 0 ED DISTANCE BET. BET.MAIN&
Q 1 MAIN BLDGS. ACCESS BLDGS.
VA
Q � � i.(.n.... A .nC /4/ CORP.s/•�/A
APPROVED �/J
} SAAPPROVE /Sid wad-2%27_1.
a
•
w
0 I hereby acknowledge that I have read this application and state
N
C4 that the above Information Is correct and agree to comply with
coa
all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of
the State Of California.
I hereby certify that I am properly licensed as a contractor under SQ.FT. w
the State of California Busine. and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and t uch li• are in full • ce-a • - act,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt fr• the prov of the :ta of Ca (ji:i ss VALUATION PERMIT FEE $ 2 ��'
' and Profess •ns Code,Div- 3,Ch:•ter '. n
/'�— PLAN CHECK $ q m
Signature • '' - /i,0 /� / L • at) c
Permit-tea 1`%- �� ff�� $/I/•'S 0 TAX $ aI 2
Authorized Agent !/«<///CJs:� iv/ ///,..U//////
TOTAL PAID $(� Q
•
PROJECT ADDRESS: 2660 ELDEN AV _ UNIT: 101 • CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05125
OWNER'S NAME: CHARLES CAPLINGER, PHD '
ADDRESS: P.O. BOX 479 PERMIT NO: B 051255 PLAN CHECK NO: N . GOVT: N SUPP; N
MIDWAY CITY •
CA 92655 CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT
(714 ) 892-6000 •
I
ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL 3 ' 0"X6 ' 8" DOOR/GARAGE 'TO NOOK SQ FT: 200
ADDRESS:
PERMITTEE: CHARLES CAPLINGER, PHD UNIT:
( 714 ) 892-6000
CLAIM VALUE: 200 . 00 VALUE VALUE: 200 . 00 GROUP OCC: R-1 /M-1
ADDRESS: . 479 P.O. BOX . COMMENTS: CONVENIENCE DOOR FROM GARAGE TO NOOK•
MIDWAY CITY CA 92655 • +PAF******�r�t**x**** * + ******�r**x+ + *+e**�P*************>E**************TP************
LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING R E Q U I R E M E N T S
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:
Date: 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 ND.: EXP.DATE: •
COMPANY: PARKING REO` PROV; PARCEL: 43922151 ZNE: REF NO: •
❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division, PLANNING NOTES> •
•
> _ f ^"1
Date: Applicant: ********************************************************************BE•**********
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D EV EL OPMEN T S .E R V I C ,E S R E Q U I R E M E N T '.S
I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become
subject to the Workers'Compensation Laws of California. . ZONING APPROVED BY DATE
Dale: Signature: i
NOTICE:If,after making this declaration.you should become subject to the workers' Compensation provisions of the Labor BUILD ING APPROVED BY / / / DATE: .e",7
Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. // / .--�
•
CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY• ;artier
/(,�,��,ra . DATE: '(.r"/
which this permit is issued(Section 3097.Civ C). ********************** :****)e***** **** � ****
LENDER: • ************************************, * , ***************************************
ADDRESS: LEGALIZATION:N F EE S MMARY STRUCTURAL SEGMENT: Y
OWNER BUILDER DECLARATION: I hereby affirm that I 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 15. 00 J 0
repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed
pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business • 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 five hundred dollars($500). ISSUE FEE •
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
Lligl structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 15. 50 M . 00 0.00 15 . 50 15 . 50 . 00
does not apply to an owner of a property 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 will have the burden of praving he/she did not build of improve REVENUE DIVISION TOTALS--> COLLECTED: 15. 50 OVER/SHORT: 00
for the purpose of sate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 15 . 00 . 50
❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware *******************************)E*******************************************•**** •
that proof of their Worker's Compensation insurance should be provided to me. • INDIVIDUAL ,F E E B R E A K D O W N
❑ I am exempt under Section: B.8 P.C.
for this reason:7� q •
TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
Date: .��] "- /` O'"'"er SFR 200 P.LTER BY VALUE RESIDENTIAL NOZONE 1 . 00 200 , 00
I do hereby certify that I am aware of and understand the requirements of California,Health and Safety Ca Sections 2 05,25533,and END OF FEES
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
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 state laws relating to building construction and hereb or a representatives ity to enter upon the above-mentioned • 7
properly for inspection purposes. , '
Date: 3 S
_ '— /, Signature: •1 \ Of 00081992-00081993 TOT T 15,50'
Driver's License or social Security , . . .
i
N. . DATE% 03/0$/41 TIME: 11:14.
164146 White—Building:Green—Code Enforcement:Canary—Applicant,Pink—Revenue;Goldenrod—Assessor t '
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-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
• 5: Steel Reinforcement- 56. Rough Plumbing & Pressure Test
6. Electrical UFEh Grnd. 57. APPROVAL TO COVER-GUNITE
_.7. Footings ='` 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test /-
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. - `�t •
.
10. Structural Floor System 61. APPROVAL TO DECK •
11.. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' r / •
12. Sewer Cap 63. Heater & Vent-Final • 'i
13. Roof Drains - 64. Plumbing System - Final ,
14. Rough Plumbing 65. Electrical-Final ,.A ,•. ' - 4
15. Rough Electrical-Conduit 66. Solar System-Final ! 'T
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 ' 1 - 1-1 ' • APPROVALS .Permit #
21. Ducts, in Structured - - 70. Underground.
-Hydro
22. Ducts, Ventilating •• - - 71. Product.Piping 0Ga's 0 Oil
23. Gas Pipe.Rough &'Test _ 72. Underground Flush- -
24. Roof Framing - _ 73.AUndergrnd.Storage Tank 0 Gas 0 Oil
25. Roof,Sheathing , - ' - - , -74.'Overhead Hydro i
26. T-Bar Ceiling (Structural) & Monocoat . _ 7 - . • • 75.;Pty Chemical • -
27.- Frame and Flashing ` 76. Dry Standpipe <
28. Lathing & Siding ' _ . - 77. FIXED SYSTEM-FINAL
29. Insulation - - •- . 78.--FIRE PREV. FINAL .
I
'30. Drywall Nailingms
E •: HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat, - I „79. FINAL INSPECTION -
• 32. Electrical Power Meter-Final --,417%' .80...FOOD CERTIFICATE ISSUED
33. Final Electrici .. `` --i• <�' Notes: .
34. Final Heating & AirCbnditioning• t J. r, -'` - _- -
35. Final Gas Pipe-Test' - •-/,.� .:12 _
.l
36. Hood or Canopy - 1 G 4 - .
37. Final Factory Fireplace ' n . - . i - ,
38. Final Plumbingv - 3 J.
:39. Water Service-Final K
-, i
40. Gas Service-Final '
'
'41. Solar Domestic-Final y -
a -
v .
42. Backflow.Preventer' 1 I.
eC
43. Backflow Irrigation ''' ' a.
4 '
,44. Landscape Irrigation System . . ; ri - - ' I -, -
45. Sound Attenuation
46. Handicap Regulations - : ' - , -
JJJ /
47. FINAL STRUCTURE & BUILDING 1�,/10 i'..
�/ ,. - - _
48. FINAL PLANNING' •. `IY' l! - c-
/
49. Electric Release to Edison •..,•••
50. Gas Release to Southern California Gas Co `{ - .
•51. CERTIFICATE OF OCCUPANCY - r I
No Date _ '
ADDRiraBULc": 2660 ELDEN AV WIT: 103 CITY OF COSTA MESA - BUILDING PERMIT
♦D""EmeriElrua""AYZIN MICHAEL _-4I RM NO; B 080291
ADDS:VAYNERAYZIN, INNA
5277 RURAL RIDGE CR PERMIT NO: B 080291 PLAN CHECK NO: N GOVT: N SUPP: N
ANAHEIM, CA 92807
APPL.lwL210 ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: DEM
ARCHITECT OR ENGINEER UC.NO.: JOB DESCRIPTION : DEMOLITION DUE TO FIRE DAMAGE SQ FT;
ARCH.OR Dal ADDRESS: DMT:
CLAIM VALUE: 1 , 000 . 00 CALC-VALUE: 1 , 000 . 00 GROUP OCC: R-1 /
cartRACTarsNAMEANDERSEN CONSTRUCTION ( 310 ) 531-9336
CCNIRACTOBSY4UN017455 RURAL RIDGE CI COMMENTS : DEMO ROOFING DRY WALLS 6 FRAMING
AODREss:ANAHEIM CA ucx0a 460494 **************ir♦f1E1klE+EikiE+r+E1E1E+rlE+r+e1E+E*+E+ ***ick****+Eif1E*****iE+E1k***lk+E♦f1E7E********♦EiF***Ik**ick
92807 IMT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby aim under penalty of perjury that Ian licensed under provisions of Chapter 9 SETBACKS
(commencing vet h Section 7000)of DiSion 3 d the Business and Professions Code,and my license is in lull lora and Sled.
CCU LIC.CLASS:B uc.x p g MAII BUILDING ACCESSORY EAILDING
API-
FRNT: FT IN REAR:
R; FT IN FRNT: FT IN REAR: FT IN
.,- °
°" °°° LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
R BUILDER DECLARATION:I hereby affirm under Penal),of perjury that I am ave$from the Contractors Limes Law la the
' Storing reason(Section 7031.5Bushes*and Professions Cade:Any ayorcounty M.rewires apermit toconstruct,SerthM.improve, PARKING REQ: PROV; PARCEL: 43922151 ZNE: REF NO:
b licensed erepairany
to mature,
provisions d the Contractors LicenseLissuance.eiso requires aw[Chapter applicant 9 mmmerrvc such permit lwwtile,hi Seddim 70signed 00)df Deleon he or the PLANNING NOTES)
Business end Professions Code)or the he or she is exempt therefrom and the baa for the alleged exemption.My violation d Sedan > -
7031.5 by any applkaaIce a perm subsets the acerate to a Owl penalty ofnot more thenrNe hundred agganla5000. *********************************************************************•**********
❑ I,as owner dthe property armyenWoleee nth wages saawe sole compensation,wiTdothe work and the WWlm'nnalintended DEVELOPMENT SERVICES R EQUIR E M E NJT- S
or offered for Bale(Section 70dd,Business ed ProfessionsCode:The Contractors License Law does not appy to en byres of prepay .
who bAids or barons herself thereon,and who doessuch work lensed or hersor through his or her own employees,provided that such
impoanees srend Wedel cc aawedla sale.A,howww.thele sgai"Povrnn s said wthnaaYew dmmpsibn.the ZONING APPROVED BYDATE:
owrr-0md paving lder MA have the Paden p he or she nd baa d improve for the purpose of sale).
❑ I,rcomer dthe proary,emesthavyamtadhgwN'tensed amrrmammmnnthe proed(Swun70N,Bronerand
BUILDING APPROVED BY : DATE:
Contractors aan r d p
Professions Code:The Cractors License law doesl apply toow, operbuilds y who bor improves thereon and who
contracts for such defects with a corarador(s)licensed punned to the Contractors License Law). •:" /�
ElIamexempunder Se on: B.aP.e..m this soon: APPLICATION ISSUED BY: *{ ^ e DATE; 7 •
********************************** *************************** **
De°' Owner LEGALIZATION: N F E E SUMMARY STRUCTURAL SE MENT:Y
I do hereby candy that I an aware d end understand the requirements of California Noah and Slay Code Sections 25505.25533.and
e "riaany building hndneed on `� mes
samis toromnlmatonn ormal ti !eats rGuiSyAansgem Demi Ren ielcontridion�pplmmaWeexempt the BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
proneiars. PERMIT 34 . 75
Dale: Appecant: SMI P/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby dram ceder penalty of perjury an of the following ddaratbns: PLAN 50
ISSUE FEE
❑ Ihave.forhe eiottrnaarirewaanrmmsolemofrwoked'amanmW.asprovidedfaWsection37malheLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
Cal,for the pdmrunce d the work for Mich this pend is issued.
o Ihave and witnaihwaked'compnmioni'eaemw.arewdSedan theedTOTALS > 35 . 25 0 . 00 0 . 00 35. 25 35 . 25 DO
m
work for which this permit Is Sued.My waken'compensation insurance curiae and policy number we:
Cada: REVENUE DIVISION TOTALS--> COLLECTED : 35 . 25 OVER/SHORT: . 00
Po5cy Monter BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(rob action rd not a competed 1 the Fermib Insone hawed dollars 131001 or Ins) 34 . 75 . 50
❑ I eerily oat in the pddmance of the work for which this fermi s sad,I Mall not employanyperson n any manna ens to '
become subject to the workers'canpeaetion lenofCeians.ad rygaw*Dad elshodd becanna4dwo
to theM1as' *******************************************************************************
\ ppadm a era°°"370D d the Labor Code,I that �°°,mh/°y °h'orations. — INDIVIDUAL F E E BREAKDOWN
• /�Y i Appfua: (�
wm hundredthousand do($11408301` peiein eunanalut L In owl the offal oeiooaWempl"yer to criminal pa pe for nalties
TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
.v11 finess«don3706oftheLaborCode,rntdel,and•imrneyef NO FEES WERE SELECTED FOR THIS PERMIT
`INSTRUCTION LENDING AGENCY:I hereby affirm under penaby of peDry that then s a dmdiddion lent"agency for the
Amanoe of the work la Mich the panne is issued(Section 3057.Cb.C).
LENDER'S NAME
LENDER'S ADDRESS:
:INSTRUCTION
that have read this application and dm that the above Womhaian is cond.I agree to comply with all day and Dowdy ordinances
Ir sitsew bowing condsrdon and hereby authorize tepresersdves d this day to enter Wen the above-mentioned papery
SCOTT ANDERSEN 01 00218482-00218483 TOT 35.25
/� ,,(*///{ //�� AL-5/'��//�/�/ DATE: 11/04/95 TIME: 10:54
--_"'0 eltr /./� Dae: 4 V
Sq re d OwadApaNA
(5151 dd.WP) White-Bulbs;&Safely:Green.-Fk:Canay-Appi ad:Pink-Rmave:Goldenrod-Assessor
• POO. . SPA -- •
CONSTRUCTION AND PLANNING
APPROVALS Permit# Date Inspector APPROVALS Permit# •
NDate Inspector
-till. Temporary Electrical Service or Pole 52. Pool & Equipment Location • N
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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
r 7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, Q Uhdrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Gap 63. Heater & Vent-Final 11/
13. Roof Drains 64. Plumbing System - Final
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 ❑Gas DOil
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 and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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
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 Domestic-Final
42. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /`,/9',(,// e'
48. FINAL PLANNING jv [/^'
49. Electric Release to Edison
•
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
\ I
ADOFESSUf8tJlW: 2660 ELDEN AV UNIT: CITY OF COSTA MESA — BUILDING PERMIT
`mwm14EwleaykAYZIN, MICHAEL ' PERM NO: M 080441
ADDRESS:VAYNERAYZIN, INNA
5277 RURAL RIDGE CR PERMIT NO: M 080441 PLAN CHECK NO: N GOVT; N SUPP : N
ANAHEIM, CA 92807
OKL.MMLIM3 ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH
ARCNITEOT ORENONEER: LJC NO.: JOB DESCRIPTION : DRYWALLS, REFRAM ROOF JOISTS 6 RAFTERS SQ FT:
ARCH.OR EMG'S ADDRESS: lifE
CLAIM VALUE: •
CALC VALUE: GROUP OCC ; R-1 /
canRACmRSNAIaANDERSEN CONSTRUCTION ( 310) 531-9336
comiuowsulnu1D17455 RURAL RIDGE CI COMMENTS : REF : B-80439
ADOREss:ANAHEIM CA uc.No.: 460494 *******************************************************************************
92807 WIT: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty Of Perjury that I are licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Desist 3 of the Business and Profession Code,and my license is in hA force and effect.
.NO.:
•
C : uc.CASs: B uc.No.: 460494 EXP: MAIN BUILDING ACCESSORY BUILDING
�fyy,Q6
c....,540,4140..._____.,540, 0..._____ £RNT: FT IN REAR; FT IN FRNT: FT IN REAR : FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt Iron the Contractors License Law for the •
following reason(Section 70315 Business end Professions Cede:Any city o cemay Meth requires a permit to constr ct.alter,improve. PARKING REQ: PROV: PARCEL : 43922151 Z N E: REF NO:
demolish.or repair any structure,prior to its issuance.ebo requires IM applicant for such permit to We a signed elatemem that he or she
is licensed pursuant Io the prm+oons of the Contractors License Law[Chapter 9(commencing with Section 7000)of Dirision 3 d the PLANNING NOTES>
Business and Professions Code)or that he or she is exempt therehan and the basis for the alleged exemption.My violation d Section • - > ._-
7031.5 by any applicant for a permit subjects the applicant to a civil penally of nil more than fine hundred dollars 155001). ` '****************i*******************iE'******************************************
• I.esowoer 0theprepeay ormyernployeeswith wages eaMei sole compensation,MA do the wore and the structure bred intended I DEVELOPMENT SEIVVICES R E U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does ltd appy to en Owner of property Q
who bolds thereon,or byname and who does earl work himself or herself or throughhe Or mployprthat her own employees.Provided such t -,
improvements are not intended or offered for sete.f.however,the he building or ir.provennenl is sold within one year of completion,the - ZONING APPROVED BY ' ) DATE:
ownerbuilder will have the burden of proving he or she did ed build or improve for the purpose d sale).
❑ 1,as owner of the property.am exclusively contreding with licensed contractors to constnd the project(Section 7044.Business and
Professions Code:The Contractors license Law does and ewe le ea owner d properly who builds or imam..thereon and who BUILDING APPROVED BY : ,.-- DATE: _
contracts for such projects with a cenlredor(s)licensed pursuant to the Contractors license Law). h
❑ IemexemprundarSecuona: B.AP.C..for abreason: : APPLICATION ISSUED BY: '` DATE:
*************************************�* ************************* 4 b
Date: Owner: LEGALIZATION :N F E E S MMARY STRUCTURAL EGMENT:N
I do hereby certify that I am aware of and understand the requirements of California Neakh and Safety Code Sections 25505.25533.end ---
25534,
--
e�itomonswniaorptmodificationpre omthhoccueAirt anageercleq astd.RRd esi Residential comply constsaid ruct applid catioe ns BLDG PMT PLUMBING ELECTRnts for ' IC MECHANIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 19 . 50
Date: Applicant: — U_ 25% SMIP/NON—RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury and the e folowing declarations: I S .
ISSUE
U UE FEE � —. l 22 , 00
o I have and val maintat nertificate d°onion!to self.insure for sorloone compensation.=provided for by Sal 3700 of Ihe Labe. BUILDING—DIV—> PERMIT ISSUE PLiAN=CHECK TOTAL PAID DUE
Code,for the peaonwse of Ne work for which this penal is issued.
• j❑
In...end wmaide:,workers'compensation insurance..semeedbySecion3roodthe Labor Code.for the performance dge TOTALS > 19 , 50 22 . 00 0 . 00 —41 . 50 41 . 50 00
work for which this perm is issued.My workers'compensation insurance earner and policy number we: ' h
• Carrier: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: Z41 . 50 OVER/SHORT: . 00
Play Number: Fir05/11 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
frmssemnneednotbecompletedfor one defiant >
d 41 . 50
❑ I certify that in the performance of the work for which this penni is issued.I shell not employ any person in any nervier so ss to
become sublets to the tykes'compensation laws d Cafdonit and agree that l I ahold become subject to Inflaters' ***************************************,****************************************
• penseti n provisions of ion 3700 of IM Labor Code.I shall forh mom with those meow's. I N D I V I D U A L '_ F,;E E BREAKDOWN
p��y-� Applicant: —
brg:Failure to secure workers'compensation coverage Is unlawful,and shag SWIM an erholoyer to criminal penalties and TYPE QTY DESCRIPTIO: N UNIT COST TOTAL COST
civil fines w to one hundred thousand dews(Sf00•000),in addition to the cost of compensation, as provided ar in
Secdo37osofn»Labor coe as eat andadony.fe MEC 3 VENTILATION FAN CONN �TO SINGLE DUCT 6 . 50 19 . 50
CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that[hoe is a construction leafing agency for the END—‘-OF FEES
Performance of the work for which the permit is issued(Section 3097,Civ.C).
LENDER'S NAME:
LENDER'S ADDRESS:
I certify that I have read the application and state that the above information is cared.l epee to comply withal thy and county ordinances
and state assn relating to bolding construction and hereby authorize representatives of this city to enter upon the above-mentioned properly
for inspedion purposes.
SCOTT ANDERSEN j�)
Pnntwm. L' / Z 01 00219174-00219174 TOT 41.50
'j i'natureofOwner/Agent/Appl . • . Date: `/� (J } , DATE: 11/14/95 TItlE: 12:18
it
(5151415.WP) While-GuiMdq A Safety:Green-File:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POOL '" 'PA
APPROVALS Permit# ! Date Inspector APPROVALS Permit # Date Inspector
�I. Temporary Electrical Service orliole - 52. Pool & Equipment Locations
2. Soil Pipe-Undrgrnd. .t , 53. Steel Reinforcement a ! •,Vii40 ;
3. Electrical Conduit Utility-Undr rad. 54. Forms b, ;;�
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, O Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 41 60. Backwash Lines, P-Trap, O Uhdrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK h.,.
11. Property Sewer Line & House d4nection 62. Backwash & Receptor-Fina✓'�
r
12. Sewer Cap 63. Heater & Vent-Final '
13. Roof Drains 64. Plumbing System - Final 1
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 �a
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning - Ira.3_cl� Qn( FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas D Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24, Roof'Framing 73. Undergrnd.Storage Tank O Gas 0 Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. 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:
i `ct6 No ACCESS €Snl
34. Final Heating& Air Conditioning Ia•S•9c 4i
/ } -S- L RCuoH NVAC c Q �
35. Final Gas Pipe-Test -5. fq� R �iNA J-I ZE �\ 1'x€2
36. Hood or Canopy •] l 1�i1 '.
J�
37. Final Factory Fireplace
38. Final Plumbing /
39. Water Service-Final
40. Gas Service-Final .
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
�s-
No Date -:'1
10‘ A*nofalmeea: 2660 ELDEN AV WIT: CITY OF COSTA MESA — BUILDING PERMIT
w,mEWSNAUEIPIoavhAYZIN MICHAEL PERM NO: E 080440
ADOREss:VAYNEhAYZ IN, INNA
5277 RURAL RIDGE CR PERMIT NO: E 080440 PLAN CHECK NO: N GOVT: N SUPP : N
ANAHEIM,CA 92807
APPL.YAWNS ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH
ARC/MCI OR MINER UC.ND: JOB DESCRIPTION : DRYWALLS, REFRAM ROOF JOISTS & RAFTERS SQ FT:
ARCM OR ENC.'S ADORESS: UMT:
CLAIM VALUE: CALC—VALUE: GROUP OCC : R-1 /
CHm*CTDIISRAUE:ANDERSEN CONSTRUCTION ( 310 ) 531-9336
CONmAcroRsltmpg17455 RURAL RIDGE CI COMMENTS : REF:B-80439
AoofEstANAHEIM CA uc.No_ 460494 x****************************** Sr****SEN***Sr*SrsE*,E****HESE*********5E+E+r*>Ex*SE********
92807 urn: ZONING R. E Q U I R E M E N T S
LICENSED CONTRACTORS DECLARATION:I hereby Ann under penal),of perjury that 1 am licensed under provisions of Chapter B SETBACKS '
(commencing with Section 7000)of Division 3 of the Business and Professions Code.and my license is in hall force end effect.
MTV UC.NO.: uc,cuSS:B uc.No 460494 EXP : MAIN BUILDING ACCESSORY BUILDING
L,(/ FRNT: FT
IN REAR: FT IN FRNT: FT IN REAR: FT IN
�r 7 T �� contractorLEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
BUILDER DECLARATION:I hereby affirm under penal),of perjey thei I°m exempt from the Contractors lienee Law l«the
reason(Section 7031.5animas and Professions Code:Mymay«county AIM raeuinnapermit toowwa,alter,improve, PARKING REQ: PROV: PARCEL : 43922151 ZNE: REF NO:
demolish,or repel any structure,prior to is issuance.also requires the applicant for such permit to the a signed statement that he or she pLANN ING NOTES>
is licensed pursuant to the provisions of the Contractors license Law(Chapter 11(commencing with Section 7000)of Derision 3 of the
Business end Professions Code)or that he Of she is exempt therefrom and the base for the alleged exemption.Any violation of Section > -
7031.5 by any applicant l«a permit subjects the applicant to a civil penally of not more than fire hundred dollars ISSOOD. *******************************************************************************
❑ I.as owner of the property or my employees with wages as their sole compensation,will do the work,and the structure is nor intended DEVELOPMENT SERVICES REQUIREMENTS
or offered for sale(Section 7044,Business end Professions Code:The Contractors license Law does not ow
apply loan ners popery
who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such
improvements are not intended Of offered for sale.II.however.the building or improvement is sold within one year a completion,the ZONING APPROVED BY DATE:
ownerbuilder will have the burden of proving he or she did not build or improve for the purpose of sale). ---
❑ I.esower el"Pmam'.amexd'avaymnlraci:gvAllelicensed mtactatI°wma"°the projed(Sedmnroe'•Baakiessand BUILDING APPROVED BY : DATE:
Professions Code:The C«aractas license Law does non apply to an owner a popery who builds or improves thereon and who 6
contracts ler such projects with a contractor(s)licensed pursuant to the Contractors License Law).
o 1amexempt under Scotian B.IIP.C.,for the reason: APPLICATION ISSUED BY : .. .4eL__ _ DATE:
**********4;11W*7
Dale: Owner LEGALIZATION: N F E E SUMMAR Y STRUCTURAL SEGMENT:N
I do hereby cenily that I am aware of and understand the requirements of CaJornia Hearth and Safety Code Sections 25505.25533,and
25534,end that I or any future wilding occupant will/wil not(circle one)need to comply wih said state codes and the regiurements for
permitOrconstructionI BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 62 . 75
Date: Applicant 502 SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm under panty of Pedal'One Of the fofbwiig(Mdarukss: ISSUE FEE 2200
.
❑ Ihave and wiimentalacantcwdmnsenttoselfirop«
nsurekr%%WO ' msetion.npovidedforbySedon3TWaNtheLabor BUILDING—DIV— PERMIT ISSUE PLA —CHECK TOTAL PAID DUE
Cade, .ag»wakl«wNdhwap«mais issued.
TOTALS----> 62 . 75 22 . 00 0 . 00 84 , 75 84 . 75 . 00
}n I have and sea maintain workers'compensation insurance.ea required by Sectio,3700 a the Labor ,for the performance of the
work i«wind,this permit is issued.My workers' io
n insurance�aearner and miry number are:
•
Carder: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED; 84 . 75 OVER/SHORT: . 00
Policy Number: NWC.3 /830 /00 05/11 /97 " BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
(This section need nor be completed I'the p«mCis for one hundred dollars MOO)orless.) 84 , 75
❑ ty that in the performance of the work for which the permit is issued.I shall not employ any person In any manner ens to
subject to the worker.'compensation laws of California. end agree that a I should become subject to the workers' *******************************************************************************
•
-7pro'Y•ionsofSedin37cooftheLaborCode,tshagf hcomplywiththoseprovwaw. I N D I V I D U A L' F E E BREAKDOWN
-f App ma: le'6`G -
�
Warning:Failure to secure workers'compensadon coverage la unlawful,and shall stdiect en employer to criminal penalties and TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
civil Ones w to one hundred thousand dollars(5504 col,inadd/lan to the coat at mmr
pnatlom es provided for In
Sectlw 3706 of the Labor Code Interest,andettomy's Ina ELE 3 FIXTURES, LIGHTING. 1 ST 20 EA, 1 . 00 3 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there s a construction lending agency for Oa ELE 8 RECEPT/OUTLET 1 - ST 20 EA. 1 . 00 8 . 00
penamasa of thework fa which the permit is issued(Section 3O97,CW.C). ELE 3 RECEPT/SWITCH 1 ST 20 EA, 1 . 00 3 . 00
LENDER'S NAME: ELE 3 MISC CONDUIT NOT ,LISTED REQ PERMIT 16 . 25 48 . 75
LENDER'S ADDRESS: END OF FEE
I certify that I have read this application and date that the above information is conal.I agree to comply with all dye and courtly ordinances
and slate laws relating to building construction and hereby authorize represenslives of this cry to enter upon the aban'mamiand property
for inspection purposes.SCOTT ANDERSEN
Priest Name lf� � 01 00219173-00219173 TOT 84.75
ie .....,:int a- oma:
DATE: 11/14/95 TIME: 12:18
Signaler.el oeradAgerwA.... : ,r. !resat(S151d5.WP) While-B0We%)d UMW;Green-Rb:Camry-Appicant:Pink-Revenue:Goldenrod-Assess
---11,11•1111111111r_
CONSTRUCTION AND PLANNINGPOOL PA
APPROVALS Permit# / .1 Date Inspector APPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pcile 52. Pool & Equipment Location;
2. Soil Pipe-Undrgrnd. .J-' 53. Steel Reinforcement 'r
3. Electrical Conduit Utility-Undrgrnd. 54. Forms Y`
4. Electrical Conduit-Undrgrnd. '%t 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & PressureTest .i
6. Electrical LIFER Grnd. 57, APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe•Undrgrnd. / 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Conflection 62. Backwash & Receptor-Finale'
12. Sewer Cap r�r - 63. .Heater & Vent-Final
13. Roof Drains � 64. Plumbing System - Final
14. Rough Plumbing I 65. Electrical-Final i
15. Rough Electrical-Conduit I 66. Solar System-Final
16. Rough Electric Wiring ( 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING i?
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 and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final L.i ( - 80. FOOD CERTIFICATE ISSUED
33. Final Electric a, a? fiLik Notes: /-a,-f 2 e446d7d X
rpr
34. Final Heating & Air Conditioning 1/
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 Domestic-Final
42. Backf low Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
s'r
51. CERTIFICATE OF OCCUPANCY
No Date '•�
Awr3SOFIBMLazo: 2660 ELDEN AV on CITY OF COSTA MESA - BUILDING PERMIT
OWNER'S NAME IF KNOWN:Ay IN, MICHAEL PERM NO: B 080439
ADDREss.VAYNERAYZIN, INNA
5277 RURAL RIDGE CR PERMIT NO: B 080439 PLAN CHECK NO: N GOVT: N SUPP: N
ANAHEIM,CA 92807
AnL.MUImoADOBEss CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: OTH
AMCKRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : DRYWALLS, REFRAM ROOF JOISTS & RAFTERS SQ FT; 7, 000
Allot OR ENGl ADDRESS: WIT:
CLAIM VALUE: 7, 000 . 00 CALC-VALUE: 7,000 . 00 GROUP OCC : R-1 /
cotenActowsNAMEANDERSEN CONSTRUCTION ( 310 ) 531-9336
cONmACmlrsMMuilo17455 RURAL RIDGE CI COMMENTS : FIRE REPAIR
AOOREs&ANAHEIM CA min, 460494 ****AE+E**4****N•*** ****N•*********s(-se*s(-*NSE*****MSE***N**->ESW*stx**stx-***IE***IE**+ESE******
92807 uMT: Z ONING REQUIR EMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Slim under penalty d perjury that I am licensed under provisions of Chapter 9 SETBACKS
(commencing with Section 7000)of Division 3 d the Business and Professions Code.end my license is it hA force end shed. .•
LIG.NO.: UC.CLASS:9 UC.NO.: 04 4 EXP: MAIN BUILDING ACCESSORY BUILDING
r FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
r COnbBtlo LEFT: FT IN -LIGHT: FT IN LEFT: FT IN RGHT: FT IN
• ER BUILDER DECLARATION:I hereby alfum under penal),d perjvy that I am exempt from the Catrados lkerae Lew for the
Are =MY reason(Section Dueness PARKING REQ: PROV: , PARCEL : 43922151 ZNE: REF NO:
demolish,or rept*any structure,prior to its issuance.also require the applicant for such permit to file a signed statement Mat he or she
is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 d the PLANNING NOTES> �)
Business and Profea'vns Coe]or that he or she is exempt Mershon and the ism for the alleged eamplen.Any violation d Section >
7031.5 by any applicant for a permiL
® pd *Is the apercent to a i penalty of of not mothan fire hundred dc0ens(S500D. ************************.**r******************************************4**********
o I,as owner of the property or my enmbyees with•vages as their sele compensation.will do the work.end the stncture is nol intended D E V E L O •P. M E' 'N 'T SERVICES R EQ U I R E M E N T S
or offered for sale(Section 7044.Business and Professions Code:The Contrition License Law doe not appy to an bwnerd property
who builds or in proves thereon,and*to does such work himself or o N
herself raor gh hiher own a mpbrthe sch
es.Provided u '
inproreneis areM Sanded adfeedfasale.it.however.th building a mpmvemad 1 sad wbhnon•Yew dwrWalnn,Ne ZONING APPROVED BY -, •I DATE:
owner-builder will have the burden d proving he or she did not build o improv fa the',areas*pe ale).
❑ I.as over d the progeny,am exduwey°Dunedlg with licensed conbaclas to canerud the pro act(Sedion 7044,Buainass and BUILDING .
Pmit fasskre Coda:The Contractors License Law does napply to an owner d properly who build,or improves thereon and who
BUILDING APPROVED B Y : DATE: '�_
contracts for such projects with a mrmxo(s)licensed pursuant to the Caoamre License Law). ./ .'
❑ lamexempt•ndarset e.SP.c.. aw.reaaa: APPLICATION ISSUED BY: i :' I✓S� E� DATE:
**************************St************** * * *• *
Omer: Owes LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby certify that Ism aware of and understand the requirements of California Health and Soley Code Sections 25505.25533.and
25534.and that I or any future building occupant will/will not(circle one)need to comply with said este codes and the requirements for
apemmfor construction ormodification Iran the Aio M aaganantDebbi.ResidenllslDdmradknagpEwiaameexempthantee BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
provisions. PERMIT 124 . 75 . 70
•
Date: Apptaa: PLAN SMIP/NON-RES
WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one of the blowing ambushms: ISSUE FEE
❑ I have and will maintain a CertifiCale ol oonsent lo sell-insure for workers'compensation,et provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN;CHECK TOTAL PAID DUE
Code,for IM pedmneve d 044 work for which this perms is Issued. ,
.rl have andel!!maintain insurance, d
workes'compensationurance,es required by Section 3700 the Leber Code.for the pevdthe o TOTALS----> 125 . 45 0 , 00 0 . 00 125 . 45 125 . 45 . 00
1� work for with this permit is issued.My workers compensation insurance carder and poky number are:
Carrier: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: A'125 . 45 OVER/SHORT: ; 00
Policy Number. NWC37830100 05/11 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(This se limn'need not be completed if the perm*is for one hundred dollen f$100)or Ire) 124 . 75 . 70
o I canDy Nal in the performance of the work for which this permit is issued,I shell not employ any person In any manner to as ID
bemnasublof to the workers'compensation lawn el California.and, a that S I should became subject le the*Odin' *******************************************************************************
pent/t gprr�ovisiorya`/d(f�ddan 3700 d the Labor Cod•,l shell f corn ' ddoe.proddaa. IND I VIDUAL F E E BREAKDOWN
mw Nal* lip Appficenl:
am/ng:Failure to secure wonkes'conpenntion canna IsunlawNM,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTIO N" UNIT COST TOTAL COST
doll fines ue,to one hundred thousand dollen(non In edd/tfon to the cost of compensation.dame e a Provided for In tr. _
Seddon 37D$of the Labor,00de,bteeb edit om.fa len. SFR 7000 FIRE DAMAGE/VAL RESIDENTIAL NOZONE 1 . 00 7, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there ls a construction lending agency for the END OF FEES
performance of the work for which this permit is issued(Section 3097,Civ.C),
• LENDER'S NAME:
LENDER'S ADDRESS:
I certify That I have read this application end state that the above information is cared.I agree to comply withal thy end county ordinances '
and state laws reWng I0 building ccaaudion and hereby authorize representatives of this city to enter upon the abrwewmentioned progeny
tor inspection purposes.C` '
�CO'C C ANDERSEN 01 00219171-00219172 TOT 125.45
Print Name DATE: 11/14/95 TIME: 12:17
Signature of Owner/AgenVAPpHcan ontrad-
(5151a9.WP) White-Buildg B Safely:Green-file:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor
• _ CONSTRUCTION AND PLANN NGPOOL PA.
• APPROVALS Permit# � ' Date Inspector APPROVALS Permit# r Date Inspector
1. Temporary Electrical Service o%Anle 52. Pool & Equipment Location;:g
t ! r
2. Soil Pipe-Undrgrnd. :iy 53. Steel Reinforcement ‘Y
:n
3. Electrical Conduit Utility-Undrgr et. 54. Forms 4/" e
•
4. Electrical Conduit-Undrgrnd. /' 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System �� 61. APPROVAL TO DECK •r-.
11. Property Sewer Line & House Cdbnection 62. Backwash & Receptor-Final”)
12. Sewer Cap �it 63. Heater&Vent-Final /, I
13. Roof Drains 64. Plumbing System - Final
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 OOil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ,/'_/y O /, . 76. Dry Standpipe
28. Lathing & Siding ^ 7� h 77. FIXED SYSTEM FINAL
29. Insulation ��$-p6 C441 78. FIRE PREV. FINAL
30. Drywall Nailing l2-rf- `lb 6.44-14:- 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 -2- -- 51/14 a„ :'-
35. Final Gas Pipe-Test / l'r'! w
36. Hood or Canopy /-4
37. Final Factory Fireplace
38. Final Plumbing 4
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING /_�/ V -
48. FINAL PLANNING l-EE-G ;�-
49. Electric Release to Edison ,a
50. Gas Release to Southern California Gas Co ;
51. CERTIFICATE OF OCCUPANCY -r,
No Date
•
imaE9sa9MDwo 2660 ELDEN AV MT: CITY OF COSTA MESA — BUILDING PERMIT
Gym9WSN ain:ovaAYZIN, MICHAEL PERM NO: B 080438
ADDRESS:VAYNERAY ZIN, INNA
5277 RURAL RIDGE CR PERMIT NO: B 080438 PLAN CHECK NO: N GOVT: N SUPP : N
ANAHEIM,CA 92807
AOPL.SWUNG ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH
ARCHITECT OREIaIEER: LK N3.: JOB DESCRIPTION : T/OFF 6 REROOF COMP, SHINGLES SQ FT : 5, 000
ARCA OR ENQ'S ADDRESS: UMT:
CLAIM VALUE: 5, 000 . 00 CALC—VALUE: 5, 000 . 00 GROUP OCC: R-1 /
comarroPSNutANDERSEN CONSTRUCTION ( 310 ) 531-9336
cam*crowsual91D1745S RURAL RIDGE CI COMMENTS: X
.DOREsmANAHEIM CA ue.N0.: 460494 ****+E+rAS+r***********Asps*+Ess****EEEEx*AE*EE E*******+ESE+rSt*iE+SitirSESEEr*****SE**** ******At***itiE*
92807 WET: ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby Slim under pertly of perjury dna I am licensed a provisions of Chapter 9 SETBACK S
(commencing with Section 7030)of Division 3 d da Business and Professions Code.end my Scenes is in hal In and effect.
CITYUC.NO.: uC.CLASS:B UC. : l04 4 EXP : MAIN BUILDING ACCESSORY BUILDING
� • l�I ,, �q FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
1 [ Can"°d°C LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
• R BUILDER DECLARATION:I hereby drum under PSM*d Mall em Wena frits the Cadr.aas Nowa law la the
loglinvia reason(Section 7031.5 Banana and Professions Code:Any Ply cr county which requires a permit to caramel,dlr.improve. PARKING REQ: PROV: PARCEL: 43922151 ZNE: REF NO
md
dash.arePa aytrumae,
sprnrbtssewrce,al"reaurppd
"uthea5cela suchpemilo Neeeipwd"'men'Da Moshe PLANNING NOTES-> -
is icpummel en ed to the provision d the Connectorsuras License Law(Chapter 9(commencing with Seddon 7000)d Division 3 d the
Business and Professions Code)a that he a she is exempt therefrom and the basis lade alleged exemption.My videlun of Section > •
7031.5 by any appkwd for a perm subjects the applicant to a civi penally of not more than fire hundred doors 1S5001). *******************************************************************************
❑ I.as owner cl the property or my employees with wages as Ma sole compensation,will do the work,and the structure is not Sanded DEVELOPMENT SERVICES REQUIREMENTS
or offered to sale(Section 7044.Busier and Prdesions Cale:The Comrectoa License Law does not apply to an Irma el property
who bolds a Mauves thereon,and who does such work Mored a herself a through be a her Cel anNoM..provided IMI etch
inaoven.et.we not intended a alaed la sie I.however.the bdldiga Wpmwmw u*ad wNJn ale Yea da delnn.ms ZONING APPROVED BYDATE; '.• ,.
owns/reedier will have the burden of pansy he a Ne did not bad a improve for the purpose of sale).
❑ I.ail irendmea°per'Y.ere`cWaelYwnnaan9withh°eaed°MD' "m`°'"°titin Po'aa(Sectir7D".Busk."end BUILDING APPROVED BY : DATE:
Professionsdoes ed
ae Code:The Conusde License Law apply t d en owner prapedy dao builds a Spars Mama end left
contracts kr Withprolede with a coralaaa(l)licensed Pursuant lo the Contrea°n License Law).
❑ Iamexempt sedan: B.AP.C..fams /reason: APPLICATION ISSUED BY: DATE:
under ********************** **********7 �*
Dal" °x"` LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:Y
I do hereby catty diet I em awee of ad weaved the requirements of Cdtaso Heath end Safety Code Sedans 25505.25533.end
2553e,and llalaary Mae building occupant wM/OND na(arole ae)rdad to campy win rid rpte robe ed the requirements nr BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
eapermit for wnsbucriw a modification Iran the As Gamy Management District.Residential msrudion apple tam ere exempt from tr. PERMIT 99 . 75 , . 50
De,, A,pt „d; SMIP/NON—RES
PLAN
WORKER'S COMPENSATION DECLARATION:I hereby affirm veer penally of popsy one al the allowing declarations: ISSUE FEE I
❑ Ih.veedVeil Maintain crlrweawrsentm.etmalteforworkers'wmpeaann.rProvided faIll S.mon37DOdthe 1sba BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
Code.for performance a
theh..aklaw:mhthis Permieissued. TOTALS----> 100 . 25 0 . 00 0 . 00 100 . 25 100 . 25 . 00
�❑
Have end OND maintain
workers'compensationinsurancerewired insurance. reed by Section 3700 d t e Labor Code.la the performance d the
wok for whit.this Rami is issued.My wakens'cons sann inavcarrier
aneeandpolicy man ber we:
Cada: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: / 100. 25 OVER/SHORT: 00
Poky Number. NWC3 /d30 /UU 05/11 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
(7wsection need not be completed Ithe penMletor one hundred dolwR7wialrej 99 . 75 ' , 50
❑ I catty that in the peso a of the work for which this pend is issued,I ins it employ any person in any mama o as to - -
eubjeatothewakers'wmppeneaicn laws of California.an Mati t slava became subject to the workers' *******lt***********************************************************************
/// epero„°n provisions` j°°.3700 d'"° "b° cads.""°° 'Ora web tae provisions. I N D 'I V I D U A L F E E B R E A K D O W N
Dae /f/f'J Applicant:
anirg:Falun to secure workers'wnwnsadon covergels ode.nn•and shed aewct al aroyoyer to Sendwnsm„aw TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
dii linen rpt to one hundred tlaueard dollars($104000A n eddhdon to me coat of compensation damage*r provAled der In
Secdn3'°s°r" L'no'c°e 'n"a'k""'"omWala` SFR 5000 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 5, 000 . 00
CONSTRUCTION LENDING AGENCY: I hereby affirm under penally d pe.lsy that thin is e ecotnpnn Make agency der i.e END OF FEES
perk:mance of the work for which this peri is issued(Section 3097,Cir.C).
LENDER'S NAME:
LENDERS ADDRESS: '
I certify that I have reed this application and app thal the above information is cared.I°pes to carry with ep My and county ordinances r
and state laws Nang so bdkip wmauann ad hereby authorize representatives of thinly to enter upon the above-mentioned propertyj
.
to inspection Prlotem SCOTT ANDERSEN
Print Name 01 01700219169-00219I70:0 OT 100.25
Date:/may
(5151d6.WPI White-Solidly&Safety:Green-Fie:Canary-Appim l:Pmk-Revenue:Goldenrod-Assessor
CONSTRUCTION AND PLANNING POO) ;PA
'4 " APPROVALS Permit ` ! Date Inspector APPROVALS Permit #y Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location:
•
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-UndrapJ. 54. Forms •rt 77
4. Electrical Conduit-Undrgrnd. „t „ 55. Electrical Bonding ,°
5. Steel Reinforcement •�'r 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
9. Water Pipe-Undrgrnd. ! 60. Backwash Lines, P-Trap, 0 Undrgrnd.10. Structural Floor System 61. APPROVAL TO DECK J. ,
11. Property Sewer Line & House.Cc tlnection 62. Backwash & Receptor-Finab .
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final •,
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit / 66. Solar System-Final %:
16. Rough Electric Wiring 67. Fencing & Access Approval
s•
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 /Z-71-t6 &t.vf/ 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. 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: AA
34. Final Heating& Air Conditioning 12--
35. Final Gas Pipe-Test
36. Hood or Canopy c"
37. Final Factory Fireplace
1 _
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING (--a
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY 0.1••••••
No Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
' CITY.OF COSTA MESA C N T UCTI PERMIT -� PE Rmir' 0,�/ �S , ^ TRACT NO. LOT NO. U y,(, ,
A66,6 c i cR /f� _l7 7 /N< (J� •
3586 1/21 /88
Project Address � � 5000 TL
•Applicant's Mailing Address /7 q,.�TYPE OF CONSTRUCTION U NEW CI ADD U ALTERATION U REPAIR
Owner's Name�/ C'kAf? W.�-��•. n Phone.416-6-t4'0ZS ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - A.P.# 1Zone
1 Address ;Jac.° kelp L? .�/� •
DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: ,
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING 01 FOUNDATION ❑ STRUCTURAL T Front O
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N
^ @qi�P
Contract 'TO 4Tin h C0J!'rj • C Right - - G3- CI OTHER -
6ct Phone _
mix;c r r�` PROJECT DESCRIPTION SQ. FT. OCCUPANCY
�.0,� / d
Address(meiling)d� CONSTRUCTION TYPE VALUATIONS S Left
City License No. 00-6--q53-0 ZONE GRADING CU.YDS. ACRESR
LICENSED CONTRACTOR DECLARATION Ping..Ref.# Parki1ng R¢q./Prq�v}itl E
a
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes: ���`VFD JAN OO M
with section 7000) of Division 3 of the Business and Professions Code, and - R
my license is in ful fo a nd effect. - T
License Cla 5 ` :. / .. S
/(� /
Date /, III Signature ,... __ _ PLUMBING FEES
W WORKERS' COMPENSATION DECLARATION Bar Sink Showers • - ELECTRICAL FEES
1 1 hereby affirm that I have a certificate of consent to self-Insure or a certificate
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink
1800, Lab. C.) Q •�- Automatic Washer Transformer 0 15-50 KW -
Policy
No. �ci19 I6 Company Zit Backflow Irrigation Sewer Cap Construction Pole Sub. 050+KW
`4% ].Certified copy is hereby furnished.
Cer/tif/'ed py i f' d with the city Bu dig v I Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps
Date V -(FRO ' Applicant ��1 /� �'1
•
EXEMPTION FROM WORKERS'COMPENSATION ECLARATION Clarifiers Solar Collectors - Dishwasher Meter Clover 100 amps
s). eaten need not be completed If the permit Is for one hundred ($100) or -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel
I certify that in the performance of the work for which this permit is Issued I
shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8
Workers' Compensation Laws of California.
Date Signature Floor Drains Swimming Pool w/Spa - • ._ F.A.U. Inc.Solar 09-15 HP 016-15+ -
NOTICE:If,after making this declaration,you should become subject to the - - _
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures
comply with such provisions or this permit shall be deemed revoked. Microwave
CONSTRUCTION LENDING AGENCY Gas Service . Outlets Water Closet Device Boxes
I hereby affirm that there Is a construction lending agency for the performancePole Light
•
of the work for which this permit is Issued (Section 3097 Civ. C.) Interce tors Water Heater
Lender's Name - p / Outlets Range •
Lender's Address • Kitchen.Sink - Water Service Switches Sign -
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License-Law for the ' Lavatories Auto-Wash' Garbage Disposal Standing Sections '
following reason (Section 7031.5 Business and Professional Code:-Any city or
county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry
• any structure, prior to Its issuance,-also requires the applicant for'Such permit Trays y - Generator ❑0-5 KW ❑5-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
the Contractor's License Law(Chapter 9(commencing with Section 7000)of '
Division-3 of the Business and Professions Code) or that he/she Is exempt - - -
therefrom and the basis.for the alleged exemption. Any violation of Section
031,5 by any applicant for a permit subjects the applicant to a civil • - -
:nalty of not more than five hundred dollars($500).
J I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 ' Issue Fee $ 3 ' '
compensation, will do the work,and the structure Is not Intended or offered Reinspection Fee_ I $15 Issue Fee $ 3
for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL -FEES
-
License Law does not apply to an owner of a property who builds or Improves
' thereon, and who does such ,'work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: . '
employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0
• sale. }f, however, the building or Improvement Is sold within one year of com- Canopy ' Type II 0 • Zonin9APproved By • Date
y p , the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground - eUildirig Approved By -_. - Date
proverove for the purpose of sale).
Xc
❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES
builds or improves thereon,and who contracts for such projects with a con-
tractor(s)
Exhaust license pursuant to the Contractor's License Law). I am aware that System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
proof oftheir Worker's Compensation Insurance should be provided to me. PLAN CHECK $ RMI/, APER MIT /�jJ��
❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# — Fire Dampers PLUMBING $ �OU ISSUANCE $
' Date Owner Heating System&Ducting Registers PLAN CHECK 25%. $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $
, information is correct. I agree to comply with all city and county Ordinances •
and state laws relatin toIdin. -nstruction, and hereby authorize repre-
sentatives of this y�y�ey/l�h n the .bove-mentioned property for -
inspection pure (A / /�'`..110 MECHANICAL $ TOTAL FEE $ Oe
• 7
Signature 11� 4. Date d 0 •
Drivers' License or SS .
-Accounting; Goldenrod - Assessor
CONSTRUO,TION AND:PLANNING POOL& SPA
APPROVALS PernliY# Date Inspector APPROVALS Permit# Date Inspector
1(tTemporary Electrical.$'ervice 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 y 56. Rough Plumbing& Pressure Test
6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNI•TE
7. Footings 58. Electrical Conduit-Undrgrnd:2:
8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test-
9. Water Pipe-UJndrgrnd. 60. Backwash Lines, P-Trap, 0 Ui;drgrnd.
'
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line &.House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final •
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough 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 and Flashing _ 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREY. 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:; ','5�' 770 /1,917-0d -
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy -
Jj1
37. Final Factory Fireplace ! f•'
t,
38. Final Plumbing
009 L CO
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer
• 43. Backflow Irrigation .
44. Landscape Irrigation System
45. Sound Attenuation -.
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed •
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY •
-
No. _ Date •
_
r