HomeMy WebLinkAbout379 MONTE VISTA AVE - Building Permitsr
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PP0.IECT.AOOBESB:' }7�j MQNT� VIBTA AC� ' " `�uxiT:� ,
� OWNE?'SN�ME: Q[jj(;�{» LEV - ' �_ . .
, RDOHFAA ?.3046 AV£N7DA DE LA CARLO
' S'f 315 . ' •
� + LAGUAIP. HII.LS . •
.7t30-Obf36
' �RCHIFNGINEEP: .)'AP�NO'IA- GR EER �a•Na•� C; 1 U 9 � Q
nnoxess: 100f3 COAST HWY �, uxR:
LAGUNA. DEACIi CA 97651 •
� PENMRIEE: F'jRIGGS DEV� ( 714 ) 3130-06II6
�ooness: 2309b AVENIDA DE L:A�CARLOTTA 715
LAGDPIA TIZI.LS ' CA 92657
UCENSEO CONTMCfOP OECIAMTION: I IrcaOy affirm tlwt I am p�e�eE unEer D�o�s ol CMD�er 9(commencinq with Sectlon
7000) at Division 3 of IAe Business and Pmlessions Cotle, an0 my I{�ease a in tull lorce antl etlect. �.
CITY llt.: ' . ST�TE 11C.: . C1A38: , - ... �
Date: ' �0���: - .
WOpIlERS' COMPENSATION OECUMTION: 1 ImreEy atlirm ttut I ty� a�cale ot con5eni to SUNmure or a urtiliwte o1 Workers'
'amDenution Insurance, or a certifie0 copy tAereot (Secfion 380U. LaE. q. � '
�ucr No.: Exv. wn: � ,
wMr�xr: ,
❑ CertifiOA topy is �ereby Iumishe0. ❑ Certifred copy a �+ed witn tlre ary B(dMinp 0'rvisbn , . "
Oa�¢: ' - - A7VOCani: . ' ' ' ,; ,
E%EMPfION FROM WOHNERS' COMPENS1nON �ECIAflAT10N:,, (R� ucpp� � ip( p¢ �mple�W il tlk pe ' is �a ane huMreC (f100) or IeSs�.
I cerUy that In the perlormance at the work lor cA tlris permit k isgue . shall not employ any in a anner w as ro Oecome
suoiect to Ihe W 2rs' mpensatian Lavrs GLlomia. �• ,'n �
�ate: . Z Z-� • �' Siqnaturt: �• ' .
NOTICF: tl, afln nulanq Itos Oetlarauon, you stioul0 Oe sWja.1 to t�e Worke Co nsation D���o� ot Ne LaEar
CaCe. you must tarlMrii� comply wit� suc� D��� �� AermR sMll Oe O revokeG. ' .
CONSTHULTION LFNOINO �GENCY: I AereDy atlirm, WI Nert is a�qvuction IeMup apex/ tor Ne periwmance al Ne work lor '
wluth Ihis perrtti� is issuM IStttiOn 3097. G1v. q. f, .
IFNOFR: � 'f t � � _ � t
' RDOBESS: . ' . • � .. ' .. .
� . , �
OWNER BUILOER DECIAMTION: I tcerehy alfirm Itwt I am exemD� fmm Ne Cont2ctors' State Lkense Law lor t�e lollowinp reamn �
(Sectlon 7031.5 Business an0 Proleuional CoOe: My city al wunty w�ic� reQuires a Dermit to constmct'alter. Impmve, tlemalish, or �
reDair any structure, prlor ro Its Iswance, alm repuires IM tODllcam tm such permit to lile a si0ne0 atatamenLtlut hUs�e is licensed �
pursuant to tAe D�avislans ol l�e Contractors' State License Law (CMpter 9(commencinq wilh SecGon 7000) ol Uivlsion 3 0l I�e Businass �
anE Vrolessions COAe) ar tlwt Ire/she 5 aempt Itxre(rom uiE t�e D� lor IM allepM eKemD�lan. My viaWtlon ol Sectron 7031.5 by '
any aDP�iwnt lor a permit su�lects the apDfunt to a UMI penalry o� not rtwre ttun irve IwnEmE OOIWra (5500): � �
�
���I, as awner ol t�e DmOeM or my em7loyees �wlih wdyes as I�eir sole comDansatlon, will do t�a xrork. and the '
slructure Is not IntenOM or ottereE tor sale (Seclbn 7011. Buyness aM pmlessimal Code: TM Contnctors' State License Law .
tices not aDGN �o an mmer oi a propeM � �uilCs or ImDroves tlrerean. anE wM tlaes 5uc0 wod �imsell/Aersell ar Ihroup�
tris a Mr orm ampky,ees, DrmriON WI wU ImD�ment� � ipt intenEM or attereG ta sale. It, Ipxrever Ne MrilOinq or .
. improvement is wIU vntAm one year ol comdetbn. IAe oxx�r vri� tuve t�a GuNen ol praNnO hUstw OIO not huilE or improve ;
lar tAe purpose of s�le�. � � ' ' �
. I, as owner ol Ihe propeity, am ezGuslveN mrrtracUrp wiN tlG� �p�ctors to construct the proje�t (SecOon 7014. Businesi
❑ an0 Protessidu CaOe: The Cantactas' State Lkmse Uw GOey np1 apply to an wmer ot propef1y wtnluiWs ar imprwes Nereon
3nE wlla ConlraC25 tOr Sutll pfo�eC6 wii� a wnlracior(s) IICQ�e D�rtuan� to ��e ConlnqOrs $I310 LICE05¢ Lew). I dm awa�0
IAat D�I ol t�eir Worker's Compemation Insurance slnul0 prpviOM ta me. .
� I am exempt uMer Sectlon: . 8. 8 P. C � -
lor Inis reason:. / / /J -.
Data: z�z�/Q� " � / Qwner: "� • - /
I Eo nereCy�ceniryinat 1 am avrara oi an0 un0ersund tM reqWmments ot Calil 1 Hea1tA anE Safery C rons 25505. 25533, a�l
25531 aM IAat I or any luture EuiWinq accupant wiNvrill not (drde a�e) neetl to comqy with SaIE stat a an0 Ne aquircmenis lar a
permit lor camtnrction ar maOifipiion Irom Ne�M�napemem U¢Irict. PaiEeniial cantrupqn aDM��atio�n are exem0� ��om
t�eu Dravislons. .
Date: nppfiranc
1 nertby cenlry that I tuve reaa tNs appiwiian arW sute ttat Ilu a0ove inf rmatian a conetL I apree to m ly vritn all ary ana counry
oNinaxaaMstatelaxsrelawpto0u0EuipmntwcYanaM�ttaMaUt represenutivuoitlucity ru ahove�memime0
pmDerty lor Ins ctbn pu . � ' �
Daro: Z � � ` SiqnaWre: �
Oriver's �iunse ar ocia� Secudry x: � �
1841�48 W�Ite--Builtlirw: Oree�+-CaEe Enbrcemem: Canerv,ppoi�w�k pink-Revenue: OdEanroE-Avwaor
. ' C1 C•Y C3I �O5TA �4F..SA - klU7LD7:NC PGRMIT , PC•.lZt4 NO: t; Q4G� 49
P�:RMIT td0: G U46149 PLAN CHF.CK NOi 0278`l-)0, A GOVT': il SUPP: 11
CONSTRUCT]'ON TYPE: V-N � ' '�PF.RMTT 'TYPC: 'E7,G� MEC .PL6 STR• PURF'C?SE: NEW
JOF7 DESCR,IPTION . i677SF RES S 470SP GARAGF S� �'T: 2'q070
� f.
CLA.iM VALUEe. 120,000.00 CAL'C-VALUE: ' b1.0,593..0U •<�ROON OCC: 'R-Jj /M t�
COMMENTS: LESS S£ IN VAL TO COINCIDE W/}?ST. VAL . ' ('� '
lE1EiFiEitiFiiklEiEiEiE�kihiEiEififlEl:�ifif�)kiE1E,1¢ikiEtiE!!ff�%#iflt%iFiEil��lE#1F7FiEiElF�kfEikiF�%�iE1klk�liflE�K3(-3f.�k3E.iElEi!�i!�iEiliF7E�F?tiElEi;3E1t1Eif .
'l. U N I. N� G� R F Q U I R' F. M E N' T S �•
5 E T D A•C K.�. .' ' j =.
- MAIN BUILDING• -.---=;---- � ---------- AC,CESSORY BUILDING - ` �
FRNT v 20 PT IN REAR: it �T �.IN FRNTc .:FT � IN REAR: ` FT, ;A]
LEPT: 78 FT IN RG}I'T: � 5 FT IN I.EFT: ; F'T I�1 RGIiT: , FT Itd ,
PARI(ING REQ: 2 PROV:• 'l PARCEL: A�91512f ZNE: R7.� R�G' :� .
PLANNTNG NOTES> A 1796 SF, 2-STORY APT UNST WIT�IL TT �j���i���3E
' • . > (PPRT UF_ A.2�-UNIT' PROJGCTI : aQ]11.�R�4"""' •
1E Ih if ih iE if iE k iE'iE 3t.iE iE if jEi4 if if It.k # 3tit�X ���lE iFjf:�1E�7Pi: ?E iF if iE 7E if iF if i! 3( lE 3ElE )t�it X� iE-k it�k 3f #�l( i:� �1F )f if-'-lf �E iE it iE iF i(� iE iE ic i(yAE 3E k#i-iE if K�9E iE #.•
U E. V ti:,•.L O� ht C�N �� + S li R V (T C F i " uR. k- �`i U. I' R, E M E N T S�
i . I/ , ( : f. I'� !!i' ' f._ .
ZUNING APPRUVEfi; BY' ,,. �,T.��� , _��� �� ,�_^ DATti:, 2= L.O��j
-� , _„ '.. . .� . � DATE •. ' �
tIUILD'!NG APPROC?,ED BS�; ;•� -- -
� �'� . . ; i' �: ,7 �/�-'. .: (�].\� �a � C� . '- � s -�,
APPLICATZON 2S5UEP�Y:f" > ��77�"� �� DATE:2.-ZO�..-�/�
�:-+��x�*ie*�ti�x��tx-,�?�+t.�**�. *;f�F"i�3 � .�r. � *3r�r�-�r�x�-x�**�'?�F.�F"�'�;i�*�ir
f�frx�**r*�i�x�*��r****�ru�r**r`.�t��x�t�*�Fi:x��x�*�;r*�*x*w*x�x�x�x��r��r*��-+t**a���cx��-�x�t���tx�-?�+6'+�r-l���!-�t�±t�Y ,
LEGALIZA'�ION:N 'P Y. G S U M M A R Y • -STRUC'fURAI. st:crterrr:y
. . ! . .. . . " . • . . . . '
BliDG P1dT PLUMDZNG ELECTRIC-:i'MECHAAj'�C FIRL• SM�IP/RFS • CRAT?.Lt�C
PGRMIT %1�3.00 . 27.00 , 5(1.SG` - ]5: 0 ' 8.4A , '
� 258 503;i 2�ik SM�IP/NON-RGS
PL,A[J � t 15. 06 . � � '
r.ssue r•cr: , �.00 i5.o'U�. � ' ts.00 . , •
DUII,DING-pIV-: PERMIT ISSUE PLAN-CIjECK :'_' TOTAL � PAID DllE
TO'fALS- �--> � 822.50 37.00 I1��:II;f, ,. 971.36' 9%1..J6 ' .UD
Ri:'VL"NOE DIVISION TOTALS--> COLLECT$D�'�� 971.3G �OVER/FiHORT: ' , 00
BLDC PMT PLUMDING ELECTRIC MECHANIC FIRL•' SMIP/TOT GRADING PLI�N CHECY.
71 J,. 00 ]0.00 73. Sfi JO r�0 �, . , 0. 44 .' 11 5. f26
. " �
��f iE k?f ik if 3E iF # iF 1F 34 it i! iF if iE %� i!� M it #�lE H-if IE iE �N• M iE �1' if iE 3f if if if if !(� iE Ik �P ih iE 1E if if if 1E it �1l�M 3f +E ik lf !f if 3E i! k iE iE ik Y,;i! �E iE?:-�YS?t� 1E If # 3h i(�?f �f i(
,, I N D I V I D U A L F,?E ,.E D' R E:A iC 'A A W Tl
��. � .., . - , �
TXPF. QTY D i: 5 C R I P T I O N�; � ,,UNST CO$T TOTAL COST
SFR 1G40 DWti-TYPE V-WUOD PRAME �, .�,;,-�`GOOD 69.00 '111,160.Q0
SE•'R 430 RES-GARAGES TYPE V ' , 17.J0 . 7,A79.00
LLL•' 1673 NEW RES Bi.DG FOR 1 OR 2 f]N�ITS/ �p F'T .Oi ' S8.56
t4EC 1 IPI5TALL FORC/AIR FURN <_' 1�00 K'BTU/EI 4.00 � 9.00
MEC • 1' FACTORY•FIREPLACE f � 6.50 6.50
PLU . 2 BATHTUB � � 7.00 • 4.QC�
PLU � 1 DISHWASHER �; . 2..00 2. �?D
PLU 1_ SINR, KTTCHEN p'� 2.00 2.OU
PLU ] WATER CLOSET (TOILE'f) , ?_.00 ' 6..Q�)
PI,U 1 WATGR HEA'1'ER AND/OR VE•:NT . : ,� • 7.00' 2.00
E'LU 1 WATER SERVICE f�:,,• �, � 2.00 2. GO
,;,, ,,n;� .
- : %4'_.�l; . . . .� .
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�� CONSTRUCTION AND PLANNINb " ; . - �OL & SPA
APP�iOVALS Permit # Date Inspector AppROVALS ,Permit # Date Inspector
�.' .
•�7. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
r
� 2. Soil Pipe�Undrgrnd. � , 53. Steel Reinforcement � j�
3. Electrical Conduit Utility-Undrgrnd. ' �� � 54. Forms .
, 4. Electrical Conduit�Undrgrnd. . � 55. Electrical Bonding ..
5. Steel Reinforcement � . ' 56. Rough Plumbing & Pressure Test �'
6. Electrical UFER Gmd. � ' S7. -APPROVALTO COVER�GUNITE -
7. Footings _ � �, 58. Electrical Conduit�Undrgmd.
8. Foundation �,r 59. Gas Pipe, O Undrgrnd., Test �'
- '.i.
9. Water Pipe�Undrgmd. �' �� �. 60. Backwash Lines, P�Trap, � Undrgrnd. �•_
10. Structurel Floor System � . ' 61. APPROVAL TO�DECK +- '
71. Property Sewer Line & House Connection � r 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 Electriwl-Conduit � 66. Solar System-Final i��d!'� � v
16. Rou'9h Electric Wiring 67. Fencing & Access Approval �;.V
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING '
c 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 O Gas ❑ Oil �
23. �,as Pipe•Rough & Test , 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � �,(Af 74, pverhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - �
27. Frame and Flashing �/j � 76. Dry Standpipe ' .
28. Lathing & Siding � - s�.� (�p(Nt �' 77, FIXED SYSTEM FINAL
29. Insulation � )'i'� 78. FIRE PREV. FINAL
30. Drywall Nailing � ��L�j �p(,�j HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ; 6w 79. FINAL INSPECTION
_ 32. Electrical Power Meter,-Pinal 80. FOOD CERTIFICATE ISSUED .
� 33. Final Electric . Notes:,_ �
34. Final Heatirig & Air Conditioning y� �J � �
35. Final Gas Pipe-Test y� _, . .
36. Hood or Canopy � , _ F �, �
37. Final Factory Fireplace b 4Q �%
i
38. Final Plumbing ' � �f a (ilLl�
39. Water Service-final :<.. L�
n
40. Gas Service-Final "` �p / �
a:
41. Solar pomestic-Final �, �
42. Backflow Preventer �' �
43. Backflow Irrigation ti .
Q
. 44. Landscape Irrigation SYstem �; �
45. Sound Attenuation � �
�
46. Handicap Regulations �� - '
47.,FINALSTRUCTURE&BUILDING 1,�� g� 6W�
48. F��� IZIhBl
49. Electric Release to Edison
50. Gas Release to Southern�California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
�
PNOIECT FODNESS:'
OWNEfl'S N�MF:
�ROOHESS: '
�
�pCNIENGINEEP: '
11DOIIF33:
PENMRTEE:
�ooaesa:
1 ,
' , ' flE0.N0.:
" UNR:
.i
IICENSEU fANTMLTOH OECUMTION: I AereEy alfirm IAa� I am Ikerxe0 un0er prouisbia ol Gupter 9(cammendn0 ��� �tbn
70D0) ot Uiriskn 3 0l IM Businas an0 irolessions COEe, and my Ocense Ls in full tmca an0 eltat.
CITY LIC.: � 6TR7F LIC.: CUSS: �
Oate: Sipnature:
WONKERS' COMPENBRTION OECLAMTION: I IcereE aflirm that I Aave a certifiwte ot mnent to ull-huure or a certitkate ol Workers'
ompensatian I�urance, or a ceNileO capy Ilkreol �Sectlon 3800, La�. C). �
7L1CY NO.: . � � EXP. O�TE:
, COMP�NY: � ' �
❑ CertifieG copy ¢ �ere0y tumLS�M. ❑, CertifieA coDY is �letl wit� Ne dry BWIEinp Dluisian. '
. ^ .. � i: r' ., . . .1
Date: ApWinnt: �'
E1�MifIOM FNOd WOBK8L4' COYPEIISATIOM OEGAN�ITIOX: (116s sectlm nn0 not Ee m�qlete0 tl Ihe D� c irane IiudrtG (5700) w larl.
El M
I certity I�ut in tlle peRafmance of Ne wOrk for wltitJl No pEmlit is Issuetl, I SIWI not empby Lry plr50n in any mMntt 50 az l0 Decoma
suEject to Na Workers'Compensation Laws ot Callortuar, , �d
Daro: � Sipriature:
HOTILE: II, alter maMinp Na Oeclaration, }%ushouW Oacame sub�ct ta the Workers' Compe�ation provisions o1,IRa LaDor
COGe. you must toilhMl� cumqy wit� wc� D���ons ar tNs permit slwll be EeemeO rewMSC. >' �
fANSitiUCTION 1FN01N0 �GENCY: I IrereCy �Hhm ttui t�ere is a castructbn IpiEinp apm�y tar the pertwma� ol Ne wark for
wlocn tltis Pemtit b.isvuE (Secliw 3W7. Gv. CI. , n'( ,./..�
LENDEP:
�OOIIEE8: . . � . .
� ' � .
OWNER BURDEB OECUMTION: I IxrtDy attlrm that 1 am exemD� ��m IAe Contactors State Lkerrse lrx lor IAe lollowinp reason
(Seciion 7037.5 Business aM Prolessknal CoOe: My ciry ol counry wMU repWres a pertNt ro mm�mcl, alter, Imprave. Eemolh�, or
apair any stmcture. D�r m its icsuarice, also requires Iha aD0licant lar sucA permit to f�e a SqnN statement ttwl �Us�e is Ilcense0
pursuant m itie prmrisions of Itq ContactoB' Sute Licenso Law (C�apter 9(commencinq wlt� Sectiw 7W0) ot Divisian J of Iha Buslnass
an0 Pmfessions CaEe) or WI Oe/stie ¢ exempt tAerelmm anA t�e Easis lar I�e alle0ed exem0��� �Y WOWtion ol Section T071.5 �y
anY apWicant far a Dermn SuDl�s Ue applirant to � civil penalry ol nat mara Ihan Me �wOreO Oollars (5500). ,
I, u owner al Ne Droperty a my empioyeu wltn wapes ss tneir sae wmpensauon, wio ao tne work, ana ma
❑ swcture 5 not imenEeE or ofiereE lor sale �Section 706C, 8uvness an0 Prolessional CoEe: TAa Convactors'�Stale Liunse Law
tloes not appy to an v«ner ol a propeM � �uil0.s ar Improves Ihereon, arq wtp Eces such work Nmself/Aerull or thrDup�
Ns or �er own emplayees, provided Wt tuU ImDrovements am not inteMeO or otlere0 tar sale. II. �owever t�o OUJdinp or
imDravement rs soW wifAin one year.ot completlon, tM owner wi0 have t�e CurUen of Dravinp trJshe Ei0 mt Ow10 or improve
for ihe Durpose ol sale). � '
1, u owner of Ne D�operty� am �Gusivery cantrutinp with ticense0 conVactors to wnsvuct tM Drol^� (�� ��� Buslness
❑ arb Professau CaUe: TM1e Contractors' Strta lkrnse Law Ooes not apqy to an axner oi'property wta Dw1Q5 or ImDroves �hereon
an0 wM conUac[s lor wch Drojec[s wiN a contractor�s) license pursuant ro ttw Convactors' SUta Lkense Law�.'I am aware
WI proof ol U�r Wohzr's Compensatbn insurance SMUIE Ee D�eO�to ma.
� 1 am e�empt under Seclion: . B. 6 P. C.
far Ihis reason: . . .
Data: � Owner.
I Oa MreEy aNy Itut I am aware al anU uMerstanE tne reQuimrtrenis ol Catilomla Hwtl� anE Salery CaEe Sectb� 25505, 25533, an0
25531 ana IAai I or arry Mua WilAinp acupant wiIVw10 rrot (circle one) neaE ro compry witn uW siate wOu an0 Ue repulrements.lor a�
pertnit for camtruction or mo0i/iption trom t�e Ai�ualiry Manapement Distrkt. NesiEentlal cqniruttbn appllptions am anamD� �mm
tll¢50 p10V1510115. � .
Oate: � Appliwnt �
I �ereDy cenily WI I tuve rea0 ttns apD���onSnO sWta that Ihe a�ove informalion is wrrect. I aprza to comply wit� all ciry an0 counry
ortlinances an0 state laes relatin0 to GWGinp cwWruction antl �ere0y authoriza reyesenuthes ol tlns tiry to enter upon Ne a0mamentione0
properry tori�pection purposes. � . .
Oate: ' SiOnaWre: `
Driver's License or Sacial Securiry N:
18C1-48 Wpita—BuiWiip; Green—CoEa Enlo¢emanl: Canary—Applican�; Pink—Revenue: GOIEenroC—Asseuor
PL•'itMTT NO: G 045149 . PLAN CFIECK NO: 02'1II?.-90 A �� � 1?AGE,: ., 7,
iE IE iE �It iE �1F 3E iE iE i(� if 3k iE iE iE k it 1P iE i:-3P �F 1F 9(� i� i( iE if 1!� �' #�IE Y.�?E!: iE iE iF3(� iE �)E iF 1E iE it if it if iF it it it #�IE if � 3E ih iE 3f # iE ih iF iE iE it iF lhdt # if-�1E it 1k ?E iE ih iE
TYPE QTY D E S C R T P�T I O N UNl'T COFiT TO�'AL COST
PLU 1, GAS SERVICL' 2.00 � 2.00
PLU 1 BUILDING SEWER / TRAILER PI:RK SIiW�R 5.00 5.00
PLU ] LAIJNDi1Y TUII UR WASAER ?.00 � 2,00
END OF EEES �
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� oi oaas4ss�-�onscss2 rur s; i.-. .
� DATE: U2/2p/q0 TIPiE: ll:s'0 .
. J • � �
/' � .-� �'� -�� . . . . .
��'
.
� . CONSTRUCTION AND PLANNING ' - . rvOL & SPA
,AP�ROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical $ervice or Pole 52. -Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utiliry-Undrgrnd. - 54. Forms
4. Electrical Condui[-Und�grnd. � 55. Electrical Bonding
5. Steel Reinforcement . � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � ,�� .�� 57. APPROVAL TO COVER�GUNITE �
7. Footings _h p �p 58. Electrical Conduit-Undrgrnd.
8. Foundation � � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undr9rnd. -��j (��� 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 $Ystem - Final
14. Rough Plumbing 65. Electrical-Final
15. flough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval
� 17. Rough Wiring Sign 6$. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas OOiI
� 23. Gas Pipe�Rough & Test � 72. Underground Flush
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing ��.[(p ��� 7q. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ,i7.� 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation . �S•'� 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CEFTIFICATE ISSUED
33. Final Electric ' � Notes: ��; �
34. Final Heating & Air Conditioning
S'i.� Z - 0
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace � 4 ��
v `3
38. Final Plumbing �
L O
39. Water Service�Final �
40. Gas Service-Final
�o � o
41. Solar pomestic-Final � ,
42. Backflow Preventer
43. Backflow Irrigation �
44. Landscape Irrigation SYstem . . -
45. Sound Attenuation
:
46. Handicap Regufations .
47. FINAL STRUCTURE & BUILDING
� 48. FINAL PLANNING �
�
49. Electric Release to Edison
/
50. Gas Release to Southern California Gas Co '
51. CERTIFICATE OF OCCUPANCY
No. Dace
♦
nonnessasm�owc: 379 MONTE VISTA AV
�r+easwu�e�v�vw: ALAN MCDERMOTH
'0°"�`' SAME
�vr�. �,vunc mox�w:
u�cxrtecT an e+'m+�n:
Mtll OP FNd'S IODNE53:
uhr: H
CITY OF COSTA MESA - HUILDING PERMIT
a�..� PERMIT NO: P 076082 PLAN CHECK NO:
. � CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
uG"°.: J08 DESCRIPTION : C/O WATER HEATER
uNr:
���T�T""� NOCK PLUMHING ( 714 ) 895-1246
camucroxs�uiwo 11610 SEABOARD CIR
�o��% STANTON CA �� 511971
90680 uNT:
IJCEN9ED GOMflACTOP4 DECLAN�TION: I Mroby Nim uMa pe�Wly d par�ury Net I em licansed uMm pwubns d Clupar 9
(cammmtlN xilh Seclian ]000) d D'rv'vion J M �ha Butl�e eM Vmlmslau Cads. W mY Iberoe u in lu4 brce vd Nled.
cmuc.No.:050386 uc.cuss: C-36 uc.r+o.: 5 1971 EXP: 02/96
�a. i-�� —s� �o�„�o,: ►Jo c� Pv��n�..�G� �,uc
OWNEN BUILOEfl OECIIP�TION: I hereby e1Nm wMer penety d perMT �� I em aumq ham Ihe CONratlan liwma Lew /a IM
Idbxip �uaon (�� ��1.5 &niw`a end Prdxsion+ Goda: Any eiry a eaurtly xfiirh �oq� e pumil to aonsleueY. ellr, imprwe.
Eemd'eh, a�epai eny ehucarte, pria b ee uvuaMe, eMo rapuiree tln epplimnt ta euch pmm0 �o fib a eqrod etmm�sni �hat M a aM
ia liceneed W�� �o tM povieian� d Hro Camrenan Licenee Law �Cheqm B(mmmmaiq wilh Sedion ]000) d Di+oion 3 d iha
Businea vd Grdwiaw Cotle� «�Iw ha w Ma ia uemq Ihselmm eM ihe bati la tlre alMped memqion. My voletiin ol Sadon
�a9� s W enr wp�u t« a wrmu wbisa+�ne epd�,� m e c�i� caneM d na mae inen �Ne nwwea mmn I`�U.
� I.avowierd�MpopeMwmyemplo�eeawvnwepeeastM'redewmpensalion.xiOEOlhewwk.eMNesWclurewirotinleiMeE
woilmedforsebl5eetion)Osa.B�r�eedProfessionsCoda:TheComredonLioenaeLewdoa mtepplytoenownerolpropeM
who buNa a in Va++thereon. eM xtn eom such wwk h'uneetl a MneY a Waqh he a her own amWvJae. pwidad �!w wch
impmaneNa ara mi mtmded aWemE /a aeb. tl, howcrer, �ta buikinp a mpv.anmtl u wld vrilhm ona yw d canpbtun, tM
owmrbudder vNl heve Iha Ewdm d pwirq M or ehe Ek nd Wik a impove la tha purywe W aebl.
� I. aa oxnsr d ihe popanV, em utluvN/ wntrmiq wi�h liunaad convetlaa ro muvud ths pM� (Seeun ]WI. Buamaa eM
Frdewima Code: The Caureaon Licmv Law doae m� eCdY ro en owror d pW�Y xM WdNn a imP'a'm �hneon eN x}a
wnveen la adi peqMs weh a mmrodor(e) IcenxC W�eueM to ihe ComrerJm Licmee law�.
� I em vamq urder SSUan: 8. 8 P.C., fa Nu �aeaan:
Dma: O.mer:
I Eo her�by cenJy Nel i em eware d ud uMentenE �Ae reQuiremenn d Cellanu Hmlh eM Selary COEe Sedam u505. 255�. enE
255�1. enE OW I a vy Mure EuiNirp acaqnl will / wil nd lc�cb me) neetl Io comply w�M1 t�iE peta wd�� vM �M ,apuinmante M
e W�u IoeoomVud'an a moddiwianhan iM �i-G�Tilyl%nepemenl D'utritl. HmkemW mMiurl'an WO�bm en eaemq fmm Iheae
„�..
Deie: Applceni:
WOFKER'S COMPFN9ATION UEC4R�TION: I Mraby elfimi �nder pereXy d perjury ar d tM /o0oxinp Oedardiom:
� I hew eM �1 meimen � canifcme W coneem to veX-inaure Iw xakere' mmpen�eton, m pwideE lor by Sadan �MO M Ihe LeEa
Code, la ihe pe�iwmeece d the xwk Ia wlueh ihn peimn ia iauetl.
rj I here uM wil meinten r.orken' mmpemNun imunze. ai rtpuireE by Saaion 3]00 W tM laEu COEa. br tM perlormarce d Ihs
f� wak lor xfiidi ihia pertnn n wsued. My wvken' compensmion inwrance urrier eM pofiry number us:
c�.: STATR EXPIRES
PdicyNumber. ,��Wra�i � a�nn 09/30/96
(Ihis sennon need � 6e wnplsted / Ne perml o!a wre hundred Edbis /S1aV� w bss.l
❑ i cenN mm m m. wnomerce a me .� m...ncm m� w�n n�.d. �.nen �w �cni vn w�, m dn m��e..o e. �o
become wd� Io �M waMra' canD�e�ion lewe d CalAan' U�2`I�wM bw,vme �u4� t xaken'
mva�� w.�-� %a se/e�� aiao a in< �eo� coee. i ionn � oomvN �n w�`ao„,�,.
eie: ' �+'T — 7 L �odK��
�—
m/ny: F�Ilun ro ucun wortw�'roniperu�tlon rov�n0� �i un/awlul, mtl slWl ub/�ef �n �mployw ro eAMrul psiu/tlu enJ
elv/l flnu ,q ro aro h,ndrM tMuaud tlolNr� (ffOq000A ���Itbn ro M� rosf o/ rorrpxwWR Eameps u provltls0 br In
Sxtlon ]106 0l th� Ltlar COW, IMenal, uW �ttomry i Iw.
CONSTRUCTION LENDINO �OENC'/: I hwaby elR�m uMer pendry d peiryry Ihtl ihan u e cvn%�udian bMvp epeiwy M �M1e
pe�lwmuKe d t�e noM1 la xfiirh �hc peimi ie eeued (�pn �OB). Lv. CI.
LENOEN'S NRNE:
LENUEH'S ADDRE53:
I cenity �MI I Mve reatl Nu apqration eM aele Ihel Ihe ebove iniwmeiion b cortee. I epne �o comply vmh M cry utl county adirericee
arM etnle lewf rdmiq w britl�q confVWion vd Mraby eNhwua ropeeenlelivse d Ihu dry lo atlr upon IM eEwe.manl'vneE popoM
lor inpeaion qnpowa.
�-, RON NOCK
(S15t-�6.WP)
Dma: / jZ ( - Fl�
WhEo-Butldnp d Sefery: Groe�b: Canery-Fpplcent: Pink�-Nevenue: C+ddxvo�Naeaor
CLAIM VALUE:
CALC—VALUE:
y
PERM NO; P 076082
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-1 /
COMMENTS: X
�*�x���r�r*�*��*�rx x ***x *x�*x�******���**+��r*****�r*****�**x ***�r�x�x��*+�**x *���***x��x�**+�+�
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARRING REQ: PROV: PARCEL: 00000000 ZNE: REF NO:
PLANNING NOTES>
i �
ik if ii 1ElE IE iE iE iE iE 1E 1E iE1E 1E if if 1E if iE iP iF iE 1F * iE iE 1! iE iE iE aE iF 1f iE iE 1E iE IE iE iE iE fE iE IF 1E iF iE1E iP iE ft iE if iE iE iE iE iE iF 1E iE iE iE if 1E iE if it iF iE iE IE iE iE 3E iE iE 3E
D E V E L O P M E N T S E R V I C E S,� R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BUILDING APPROVED BY : !�.'� DATE:
i� ? p/
APPLICATION ISSUED HY: �-^' DATE: � 2✓ / V
1P1fiElfKMiEiEififlFiE1P1f1F1fiE1f1FlElFif rtiEififlFiklEitiklf �EiE
LEGALIZATION;N F E E S U M M A R Y STRUCTUR SEGMENT:N
. y
BLDG PMT PLQMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7.00 = •r
25t :. � " SMIP/NON—RES
PLAN G ;: ��
ISSUE FEE 20.00 � �x v' �`
BUILDING—DIV—> PERMIT ISSUE PL'AN—CHECK � TOTAL PAID DUE
TOTALS----> 7.00 20.00 �'� '� 0�.00 27.00 27.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: - 27.00 OVEA/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MEGHANIC ,FIRE SMIP/TOT GRADING PLAN—CHECK
2%.0� .y 1„
�� (i. h ��
*at�r*�at**�et*�ret*x **ie***iF�rt*iriEit�rit*ie�r****it�r+t�riEiE*x;ir*it***�**�*****it�t�r*etet�*atrtitieit�*x ***
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
� �;
PLU 1 WATER HEATEA AND/ORrVENT 7.00 7.00
END OF FEES�,�
r 1 i ..
. �' � �. '
1�� � .
� -
. r.. - - _ - , -
f '. .
� �
6
'
� CQtJSTRUCTION AND PLANNING POOI & SPA ,
APPROVALS Permit # Date Inspector qppROVALS Permit �h Date Inspector
1. Temporory Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. �, 53. Steel Reinforcement
a;
-�.rElectrical Conduit Ut�lity�Undcgmd. 54. Forms
�
.�A^Elearical Conduit�V�drqrnd. 55. Electrical Bonding
•-�. Steel Reinforcerrient:• � 56. Rough Plumbing & Pressure Test
"''.+6. Electriwl UFER;�md. 57. APPROVAL TO COVER-GUNITE
_, �•
"• -7. Footings ; t '� 58. Efectricai Conduit;Undrgmd. �
:�$. Foundation �... c 59. Gas Pipe, O Un'drgrnd., Test �
'.� r..t .
: 9. Water Pipe-Undrgr(�$1. . �- ' 60. Backwash Lines, P�Trap, � Undrgrnd. , �
'10. Structurat Floor SVstem 61. APPROVAL TO S3ECK
11. Property Sewer Line & House'Connection 62. Backwash & Rece�Ior-Final
�
12. Sewer Cap �� � 63. Heater & Vent-Final
13. Roof Drains 64. Plumbin� SVstem � Final '� �
14. Rough Plumbing, � - 65. Electricai�Final
15. flough Electrical-Conduit �- 66. Solar System-Fi4at� 1
16. Rough ElectricN/iring' .- 67. Fencing & AccessAppro�al
� 17. Rough Wiring Sign ._ 6$, APPROVEO F(y�t�'LASTERING
�
78. Rough ElectricaGf Bar Ceiling^'` � 69. POOUSPA SYSTEMS FINAL'
19. Rough Heating & Air Conditioning t FIRE DEFPT. REQUIREMENT
� ,�-co
20. �oug� FacFory Fir,Ptilace '�''� � i 'J H tt"„ � f�PPi�V'i;�j; � Pei�i�it #.�,-
. �. F
21 . buct5; in StruQura*' x •• �- t� 5 y G �- r' i 70. tlnderg`riiun� H�dro '` -
22. QyM�Vemiia�ing;��,'� � �� �Kr, 4 f, r� ,71. Product•QipingLlGas q0i1
i:
23. as �pe-B.ough & Test r�-.�, , K�- � Gx � 72. Undergrdund Pfosh ' �
24. R'oof Framing" •`' ` ;; '� j��,,, *•, 73 Undergrn2i. Storape Tank;D Gas ❑ Oil
25. Roof She`a3hi�g ',: . �.�'�� �7 Ny � 7q; Overhead Hydrw
�
26. T-Bar Ceiling (Str�ctural) & Mo�tbFbat { � N� `' j.�`, 7�,�"' Dry Cherqical ; ���� �'�
27. Fiameand Flashing : j�a: f, ^ y m. 76 DryStanapir�e F`t� *� r.
�28. Lathing &�Siding k " ` n� =� � s '" "# 7�.FIXED ��TEj}1'FtSIAL� _ � , -
F J r. .. .. � ! . '. .� . , µ�
' 29. Insulatioc� � � • �� ' m 7� FIRE P4tEV. FWFCI. t' �
30.Drywallt�jailing � a_E„ � � �.�„� �i'7E.�LTti�DEPT�:�REQiy1FtENtENT
.31. Plaster Brown,Coat s_. - i� ;r �• 79.��FINAL INSPECTIpN -C
-�32. Eiectrical�ow�r Meter-Final � v , �'80yF000 CERTIFl�ATE ��S��EDH �
�-33. �i'nal:,�leC ic j : -, � �c �� , * Notes:. � � � T^�
7T . ��Q��(�o-l�CO QMF '�4C!^AE�_��F'i
z'�34. Einal'tleating&AirConchtioning'.; C� _ � t 'T' ��.= + - ^.
� . - K ^ :, � l'1 �,_i�_K,ni� E�i_�� �._.� - -
.*35. �inal`Gas Pipe;Tesi �: ; ' . +- o-+ �r. /y T x% U'� r S_ cr
���'_( �r.� 04L�C$a��. �� �'i.4-sCi�
.:.3B.HoodorCanoPY ` _ ,-�; : ;.� � - r GJ'�(���'�=�;�,J1� x L2�`� ' �
� �C�Sa � C"�( �
�37. Fjnai`F.actory Fireplace F ,- . _ •.'^ _� `�� /�_p/� _
! � / T''i'�(,�'' "r�,_
9�`
-�38. FinaltPlumbing !� -, ' = ��/f� _ � N "
tc _ _ � �
+ i �a [ , �_a.�.
�39. Water-Service-Final K s: • r K'�
=,40. GasService-Final t r- u,;*r• 5 �^> > ^:- �t.� x
'� �:� ro � [-+ � � a. ,.
-41. Solar pomesticPinal' �- �, - " �;`.- `_" '
-, t* ._ r •. -
42. Backflow Preventer r � `'-- ' 7 '-
-, T `
43. Backflow Irrigaiion � ' �" � G u ,; � ? '
44. L.andscaPe IrriCation6Ystem ^cT'�.: � T C ti�v ::.; r' ''
- - : r-
45. Sou�d Attenuation � •' - ` � ~r � `" r-' � �; r� � '
� 4� :T .�C C <✓ '
46. Handicap`Regulati0ns - ;! s � � � - G, � -'c. --
n r",
, 47. R1NA'1 STRUCTUR� & BUILDING } ^ ; � ' � ;
* ` ..
48. FINR�L PLANNING * . . - ' -'' ', < '" �'
.� -
49: E�ectrie Release to Edison � t �. � � '
50. Gas Release to Southern Califomia Gas Co . � ' J• �^ !" ' �
< - } -
51. CERTIFICATE O� OCCUPANCY ' � "� = - -'
No. Date
� � ' �
�
c
�
�\
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-m85a.Ca.us 77 FAIR DRIVE, GOSTA MESA, (:A 926ze
PLUMBING PERMIT
Job Address: 379 MONTE VISTA AV
Suite No
Vicinity:
Parcel Nunmber: 43975159
Applicant: NOCK, TIM. �
Address: 71612 KNOTT ST � -
" � Phone: (714) 89&1246
GARDEN GROVE, CA" Zip: 92841
� , �- ,
Owner: MC DERMOTf, ALAN J
Address 379 B MONTE VISTA
� �.. Phone: 949-548-7008
COSTA MESA, CA Zip: 92627
Contractor: NOCK PLUMBING
Address: 11612 KNOTT ST- � � �
Arch / Eng :
Address:
ISSUE FEE
BackFlow irrigatlon
Backflow Preventer
BathWb
Clarifer System
Connect Qce,Soda,etc)
Dental Units
Dishwasher
Drain, Floor
Drain, Rainwater
Drain, Roof
Drinking Fountain
Expansion Tank
Gas Earthquake Valve
GARDEN GROVE, CA
WATER HEATER CHANGE OUT.
AMT
823.50
50.00
$0.00
50.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Phone: (714) 8951246
Zip: 92841
License: 707775
Phone:
, ZIP .
License: � . �
SCOPE OF PERMIT
" .FEE SUMMARY
QTV AMT
• Launary Tub I Washer 50.00
0 Landscape Irrigation 30.00
0 � P-Trap 50.00
0 � Pressure Regulator 50.00
0 Process Piping (per 10 ft) $0.00
0 Receptors $0.00
0 Septic Tank $0.00
0 � SewerCap for Demo $0.00
0 Sewer Connect $0.00
0 � - � Sewer Private Line $0.00
0 � Shower � $0.00
0 - Sink, bar 30.00
0 Sink, commercial $0.00
0 Sink, Floor $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Siatus: ISSUED
Applied: 0227I2003
Issued: 02/28/2003
ISSUED BY:
AMT
Sump Pump 50.00
Swimming Pool $0.00
Trap Primer $0.00
Urinal $0.00
Vacuum Brkr BkFlow(1-4) $0.00
Vacuum Brkr Bkflow(5+� $0.00
Wash Basin $0.00
Wash Basin Set $0.00
Waste and Venl System $0.00
Water Closet (Toilet) $0.00
Water Heater / vent 512.30
Waler Piping (Inst or Rep.) $0.00
Water Re-pipe $0.00
Water Service $0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This parmlt shall eutomatically expire and become void if work is not commenced within 180 days, or il work is suspended or abandoned
tor a period ot t80 days.
INSPECTIONS: In order for tha work authorized under this permit to be considered legal, such work must comply with ali applicable codes, and all
required Inspeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of Ihis permit.
FOR INSPECTIONS CALL: (714) 754-5626
_ sene-ee �aroo�
�
WORKERS' COMPENSATION DECLARA710N: .
I hereby aflirtn under penalry oi perjury one of the tollowing tleclarations: •
❑ I heve end will maintain a certilicate of consent to self-Insure for workers' wmpensetion, es providetl tor by section 3700 of the Lebor Cotle, for the pertormance of Ihe
Work tor whic� this pertnit is 15suetl. ' +
�I heve end will melntaln warkers' compensation Insurance, es redulretl by secUon 3700 of Ihe Labor Code, for Ne peAortnence of the woAc for wNU this pertnit is issua0.
'My warkars compe's �i�urence farder and p y nu b�a: �/��/ -{- ^� a l ocJ
�ema�: �;� Sv � e� f r � Yil I/ If Policy Number. 4- C. �i�(/VO �
(This section need nof be comp/etetl i/ the permif is va/ued et one hundred d lars (5100) or less.) _ .
❑ I certily thet in the peRorm nce ot ihe w c lor which Ihis pertnit is Is5ue0, I 5hall not employ eny person in eny manner 5o e5 to become su6�ed to the workers'
compensatlon lews oi al� omie, end e ee thet it I should become sub�ect to Ihe workere' wmpensetlon provislons ol Sactlon 3700 ot the Lebor Code, I shell tort�with
comply with ihese pro si s. �_� ��
Applicant Signeture: Dete:
WMNINO: FAILURE TO SECUR 5' WMPENSATION COVEMGE IS UNLAWFUL AND SHPLL SUBJECT AN EMPLOYER TO CHIMINAL PENALilES AND GVIL FlNES UP TOONE HIINDRED
TYqUSAND DOLURE (5100,000). N DITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOf11N SECTION 31W Of THE LABOR COUE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I here6y aflirtn thet I em licensed under pravisic
torce end eNect. Lia M 7
Contracrofs Signeture: �
9(commencing with Section 7000) oi Divislon 3 of the Business end Pr assions Cotle, entl my license is in full
� Class N C�� � o.�
� Date: -a - � �t/�—
CONSTRUCTION LENDING AGENCY{ -
❑ I hereby aHirtn Ihat t�ere is a construction lentling agency tor the pertormance ol ihe work for which Ihis permit Is Issued. (Sec. 3097, Civil Code).
Lenders Name:
Signa�ure: _
OWNER-BUILDER UECLARATONS:
Lendef5 Addr855:
Date:
I hereby eHirtn that under penalry oi pehury that I em E%EMPT FROM THE CONTRAC70RS LICENSE lAW for the tollowing reason (Sec. 7031.5, Business end Professions
Code: Any ciry or county whic� requires a pertnit to consiruct, alter, improve, demolis�, or repair any structure, prior to its iuuance, also requires the epplicant for such pertnit
to file e signed statement that he ar she Is Ilcensetl pursuant to the pmvisions of the Canirectors License Lew (Chapter 9(commendng with Sectlon 7000) ot DlWslon 3 of the
Business entl Professions Gode) or Ihet he ar she is ezempl theretrom and the basis lor the allegeE e:emption. Any violetion ol Section 7031.5 by eny eppllcent for e permlt
sub�ects the epplicent ta e civil penalty of not more then five hundred tlollars ($500).):
❑ I, as owner al the pro0er�y, or my employees wilh wages es lhelr sole compensetion, WILL DO TME WORK, antl lhe structure is nol intended or aHeretl for sele (Sec.
7044, Business entl Professions Code: The Conlracbrs License Law does not apply lo an owner of properry who builds or improves �hereon, and who does such work
himseN or herself or thmugh his or her ov+n employees, pmvidea that such improvements ere not imendetl or ottered for sale. If, however, Ihe building or Improvement is
sold within one yeer of completion, the owner-builder will have Ihe burden of pmving ihat he or she did not build or improve tor purpose oi sele.). '
❑ 1, as owner ot the pmperty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to conSWct �he pmlect (Sec. 7044, Busineu end Professions
Coaa: The coniractors License Lew does not apply to an owner of property who Culltls or improves Ihereon, end w�o contrects tor such pro�ect with e contrector(s)
license pursuent to the Conirectors Licensa Laws.).
❑ I am exempt untler sec. Business and Prolessions Cotle lor this reeson:
Signature: Date:
Owner ID veritied by tlriver's license. � Yes ❑ Na Orivers License No. Expires:
Vedilcation ot Ownership by (type of document, I.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certify ihat no excevation five (5) or more leet in depth into which e person is required to descend, vrill be made in connection with work euthonzed by this
pertnit, and ihat no building siructure, sceNolding, felsawork, or tlemolition or tlismantling theraof, will be more then thirry-slx (36) teet high. (Chep. 3.2, Gry 2, Art 2, Sec.
341, Title 8, Callfornia Administrative Code). ,
❑ As owner-�ulltler, I wiil nol employ enyone to da work which woultl requlre a pertnit trom the Division of Industnel Sefety, es notetl above, unless such pereon �as fl
permit to do such work tram the division.
SignaNre: Date:
Division of Intlustrial Safery Pertnit Number:
CER7IFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penelry of perjury �hel I have read ihls applicatlon antl stete that the infortnation given Is
correct. I agree to wmply with all stete lews d ciry ordinances rela�ing to Gulltling conslmcUon, and euthodze representetives oi t�e City of Cwta Mesa to entar upon the
above-described property lor inspection pur�s. I agree not to oaupy or allow occupancy of eny building authonzed by this pertnit until final insDection.
COpE �. INSVECTIENTYPE �TE � p
1616 Fixed System Final Flre Preventlon
1266 Pool Spa Finel .
200 Flnal Re-Root
201 Final BIocWRetaining Well
202 Final Factory Fire Place �
203 Flnal Sign
204 Final Demoliiion
CODE� INSPECTIONTYPE
206 Final Mechanical
20B Finel Plumbing
210 Finel Eletiriwl
272 Finel Fire Preventian
220 Finel Planning Approval
222 Finel Slte
250 � Final Bullding�Ocapancy
� �
��
rxaecT�oosess: 379 MONTE VISTA AV
OWNEfl'9NRME: bRZGGS DEV,
aooeess: 23046 CAFtLOTTA AV#315
LAGUNA AILLS
� CA
(719)380-0686
AflCNIEMGINEEfl:
� IIUONEBE: �
xEa.xo.:
uxrt:
PEIIMI7iEE: g�IGGS DEV CORP ( 714 ) 380 -06F36
�oneess: 23046 AVENZDA DE LA CARLOTTA 315
LAGONA HILLS CA 92653
110ENSEU COMMCTOR DEClAMT10N: I �ere0y amrm ttut I am (cense0 unOer proNsions ol Clwpter 9(commencin0 wltA Sactlon
70W) of ONivon 3 0l Itce Busi�ress anO Protessions COGe, anE rtry Ikense h In hdl force anE e11M.
LI7Y 11L.: STRTF LIC.: ClAS3:
Oate: Sipreture:
WOBNEflS' COMVFNSATION OECLAM710M: I Mre amrm Ilul l have a ceNfrate oi corrsent to utl-imvre or a aNOata o1 Workers'
Campensation Insurance. ar a aNfieO copy Nereal�Section 3800, LaE. C).
PoUCY NO.: E%P. WiE:
COMPRNY:
� CeNfieG coDY is AereUy fumrsheC. ❑ CeNfieE copy a fileE wiU Ne ary BuilEinO �on.
Date: � nppGcant� •
E%EM7f10N FIIOM WOflNEAE' COMPFASAl10pDFL1AN�TION:� (fA's sec6m neeE not Ce mmplfleE il Ne pdmt's fa om AUNrN (f100) or les).
I ceNy ttat in tAa peAormarice oi the wnM for wttich fl� pemut's iSwM. I slu0 rot empby arry persan m arry manner w az to Dawme
suhlect to the Warkers' CompensaGon Laws. of Catitomia. �
Date: ' Sipnature:
N0710E: If, atter maWnq W5 Oeclaration, you shoub 6ewme whjM ro Ne Workers' Compenution Drwisiom af Itre LaOor
CaAe, yau must IortAwilh fAmply wiili'suUi prwl5ioM15 m Illit pEmut S�uA Ee AKmed reVokM.
CONSTIIUCTION LENOING �CENCY: I Aere6y amrm Wt tlrere is a cor5truction ImEmp apency for tlre perlarmance of Ihe work lor
wNc� tNs Permit is Lxvutl (Sectian 3C97,'Civ. Cl.
� lFNOEB: � '
ROONES&:
OWNFR BUIIDER OECIAMT10N: I IcereOy alfum Wt I am eumD� ��m tlu ConVaclors' Sute Licerise law tar the IOIIowInO �easan
(Section 7031.5 Business anE Pra7essianal CoCe: My Nry ol counry wAkli repWres a pemrit ta crostrup, atlar, ImDrove, OemollsA, or
repair mry struclura. prbr to �5 issuance, aho reQu4es tM appOcant tu sWi pemtil lo fue a sipne0 sutemem ttut Irclshe B IlcenseE
pursuant m Ne provivons of ine ConVadws' Suta Licensa �aw (Cnapter 9(commmdnp wiN Sectlon 7000) ol DNision 3 ai Ine Business
an0 Pmfessions CoEe) or ttut AUstre I5 exemD� ��emimm anU tln hasis lor Ne allepa0 axemption. My Wolatlon oi Section 7031.5 Ey
anv aPD�t lar � perimi su0jecls Ne appfinnl to � dvtl penalty oi mt mort ttun Me nuMred adlars (`�1•
I, az owner ol Ue DropeM or my empIqees wit� rnpes as Neir sda compeivatbn, vA0 Co tM woA, anU Ihe
❑ siructura ¢ no� inienEM a otlerW lor sale (Sectbn 701a. B�nas aM Pmlssssio�W CoOe: TM Cantnpors' Stata lkense Law
Aces nat appty In an owner ol a D�aperry who OWI4s or improves eMrmn, an0 who Oaes such work Nmself/�ersell or IArouph
Ms or �er ovm emD�W�, W�� ��+� ��mD�wemmts are mm intaMeE or ottereE lor sala. II, however I�e CWIEInp or
im0�wement i5 mW xitldn aro year ol mmpeUon. Uro ormer w10 Aave Ne EurOm ol prwinp 1reJslro ON not OuiW w Improve
for tAe Durpose of sale�.
I, az awner al Ne propeM1y am exdusN�y coniracMp wIN GumaE cmvatton ro construct Itro prqat (Sectbn 701I, Business
� entl PMOSSims C000: TM COnifxtors' $Inte LiClnSE Law EOF4 n01 dpply lo an wmef al pNpErry wTo Euil05 or ImD� I�ereon
an0 x1p tontrac(S ta wN projec�s i�N a conttatta(5) Ike�se purwanl to Ne ConlracloB' State Lkeme Law�. I am axara
Ihat prool ot tnNr WorMer's Campens:F;on insurarce StpulG Da D�� to ma.
� I am exemD� unEer SecGan: B. E P. C.
lor tOk reazan:
Date: 7�' i3— 9�
Omrer.
I Oo �ere0y urtiy Wt I am aware o1 aM w�0ersiaM Ne repuirements oi ' mia H W an0 Safe e 'o�z 25505, 25533, anO
2553C aM ttut I a any tuture EWAtinp occupant wilUMO not (drtle one) n Io comply vAU said 5 8 mEa anE Na repuiremenl5 for a
permit fOr consinittion or motlRration Irum IM Air ry Manapement Oistria. HeslEenlial mnsiruawn applications ara exempt Irom
1�em Dravaions.
Date: Fpplicant:
I Aere�y ceNN �t I tuve reaE it¢s ap0licatim aM SWte Nat Ne abme inlor tion 5 cprtat. I a0r mDh M+N all dry anO counry
ordinances an0 state Wvrs rtlaUnO Po OuilOinp consirvcfion an0liereGy am rtpresematives ot tlus t nter u Ne a�ovo-memianad
Droperty tor insptttion pur{pses.
Date: % �-3 �[% SiOnaNre: r .
Driver's license or Soria� 5ecuriry M:
1641i6 Wl�ite—BuiWing: Green—CaCe Enforcemem: Canary—FpVlcant: Pink—Revenue: GONenroE—Assenaor
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: B 048238 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR
JOB DESCRIPTION : SO LIN FT OF CMU WALL @ 6' HIGH
PERM NO: B' 048238
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT: SO
CLAIM VALUE: CALC—VALUE: 1,U00.00 GROUP OCC: R-3 /N-1
COMMENTS: RE;B96149 S B46150 PRIMARY BLDG. PERMITS
�r�tx**�t***+t*�t******#�tx�t�t��t*��***��r***�t**�tn****x ��**�*+�*�tn+t*�t�*�t�****�*�ru*�*n�*�c�
Z O N Z N G R E Q 0 I R E M E N T S
S E T B A C K S
----------'-- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARI(ING REQ: PROV: PARCEL: 93915126 ZNE: R2 REF NO;
PLANNING NOTES> 6' BLOCK WALL SETBACK 10' FROM FRONT
>
if iE iE iE iE iE iE 1t iE iFlE if if 1E ik if ?f if iF iE iE if ?E iE?E if !F!f # iF dE iF �E 1' iE if iE iE iE iF iE if 3F'lE?E!E iE it k if if �IE ik?E iE if jE iE iE?f fE iE iE iE 1E'F?E fE if'.f iElE if if iE iE �E iE iE
D E V E L O P M E N T S E R V I�C E 5 R E Q U I R E M E N TY 5�
ZONING APPROVED HY _/�/� ��a���9 / DATE: 7-�3 QO
BUILDING APPROVED BY :_L ���� DATE; % Z-3'�p
APPLICATION ISSUED BY: �C�=5�7i1 y" �(i�!� DATE: 7.�.1��0�
iE##ik#ifi(�if�iEiE±[-itlf##it#iEitiki!�E�iF�Fkte'��if�`.�#�£i�iEiEifiFiE%ifiF�lfific��_ iEiE
#ikikiFM##ifiEiEititifititiElfiEifif?iiEif#�EjEitjFififiFiEifif�!(�?F3EiFifitiE �'.ifiEiFiFitifiEiF#ififiEiEiEiEiEitifiEiFiEj(-�EiEiEiEjEiEiEiEBEif'�EifiFiF
LEGALIZATION:N F£ E 5 U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMZP/RES GRADING
PERMIT 25.00 50
SMZP/NON-RES
PLAN "
ISSUE FEE
HUILDING-DIV-> PERbtIT ISSUE P�L'11N-CHECK TOTAL PAZD DUE
TOTALS----> 25.50 0.00 �` 0.00 25.50 25.50 .00
REVENUE DIVISION TOTALS--> COLVECTED: 25.50 OVER/SHORT: .00
BLUG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
25.00 , .SO
iE ##!f iE iF # 7f 1k iE fk if itlF 7E if ## if iE if if it 1F iE if fE if if iE �If if if ?E iF iE iE iE %if !f ik iFif !E!f �)f iE if 1f # if if iE jf iF ik if iF if 1E if if iF iE iE iE �E 1Elk �lE �lf !f �t iE i4 if iE �(�
Z N D I V I D U A�. F E E b R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 50 RES—CONCRETE BLOCFC6NDLOF FEES � FT. 20.00 1,000.00
01 70065E71—GOOb5Ei2 �'n-� �q �L,
DA7E: U7l2's/40 iIFfE: 04:42
CONSTRUCTION ANDPLANNING - POC SPA -
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
' 2. Soil Pipe-Undr9rnd. 53. Steel Reinforcement �
� 3. Electrical Conduit Utility�Undrgrnd. 54. Forms .'
i
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 7-�C(1�p �W 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings _�a (��,/ 56. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test -
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. ''�
s
10. S[ructural Floor SYsrem 61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �%
i.
� 2• Se`^ie� CaP 63. Heater & Vent•Final �
13. Foot Drains 64. Plumbing System - Final �
14. Rough Plumbing 65. Electrical�Final ,�
15. Rough Electrical�Conduit 66. Solar SYstem-Final �
16. Rough Electric Wiring - 6J. Fencing & Access ApProval `
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. fiough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas OOiI
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Foof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation � !%�' 78. FIRE PREV. FINAL
30. Drywall Nailing /: -� ; HEALTH OEPT. REQUIREMENT
31. Plaster Brown Coai 1• 79. FINAL INSPECTION
32. Electrical Power Meter-Final -� ��' . 80. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes: 7_zs �_ Q�.
34. Final Hea[ing & Air Conditioning % � i ���
�
35. Final Gas Pipe�Test � �
_ ;,/
36. Hood or Canopy � � �
�
37. Final Factory Fireplace ��
i
38. Final Plumbing :
39. Water Service-Final '
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape IrriQation System
45. Sound A[tenuation
46. Handicap Regulations
FINAL STRUCTURE & BUILDING _ j�� (`W �
48. FINAL PLANNING t•
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co � � �:
51. CERTIFICATE OF OCCUPANCY
No. Dat¢