HomeMy WebLinkAbout3081 JOHNSON AVE - Building Permits�_ ; .
�� CITY OF COSTA MESA
F BYILDING DIVISION
Ft�� 77 FAIR DRNE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754-5626
�'a*.o.m�c'F
PERMIT NUMBER: BC07-00393
PERMIT TYPE: B COMBO STATUS: ISSUED
Sub Type: RES_RRIP DATE ISSUED: 03/19/2008
ISSUED BY: RMD
�oe a�oRess: 3081 JOHNSON AV CM ' Suite/Unit:, ,,
APN: 14159303 � _' Zoning.R1;-, - " - � �
Vicinity: - Primary Occ:., R3
ConstType: V-N ., � SQ:-FT:��` �� 1315 � ��,-Valuation: $146,506.00
SCOPE OF WORK: 1315 SF2ND STORY ADDITION2 BEDROOMS AND 2 BATHROOMS W/ 2 NEW FIREPLACE ON EACH
FLOOR, ADD 2 WINDOW50N THE 1ST FLOOR. REMOVE INTERIOR WALLS OF THE EXISTING, OFFICE TO ENLARGE THE
FAMILY ROOM WITH ELECTRICAL,.MECHANICALAND PLUMBING WORK. _ .. ,. ,�
OWNER: DIAZ, RICHARD : Address ��.�308tJOHNSON�AVE , � � . . - Unit:
Phone: 714396-7574 - � ' �,City/State/Zip: ` COSTA MESA, CA -.� � � , . �„
APPLICANT: DIAZ, RICHARD ' . �� - Address: � , � � � � � - - � Unit: :
Phone: 714396-7574 � � � City/State/zZip: , �
CON7RnCTOR: OWNER-BUILDER License No. 000000
Phone: -� � Address: Unit: � . a
Celi: �. �� , � ::;,: . .. City/State. .:. .` : �
ARCHITECT: License No. -
ENGINEER: JOHNTRAN LicenseNo.62653���-,. .
COMBINTATION PERMIT FEE`SUMMARY``'
Building Plan Check: � ° �-. � $817.02- �� .
Building Fees: � -..$1,256.95.-� � _ _
Electrical Fees: . ., $183.98 � �� . �
Mechanical Fees: $89.10 <:
Plumbing Fees: � , „$108.05.. � � � .
SMIP Residential: °:?; $14.65 "� ' ��-"' , "�� � �
SMIP Commercial: $0.00 x
TOTAL FEES: $2,469:75`
"Reler to fee receipts for all fees paitl for project
ZipCode
PHONE:
PHONE:714-265-1200
NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the ezpiration of this permit.
COOE 0. INSPELTIONTYPE OATE INTl1AL5 CO�EC INSPEC110NTVPE � � INTTALS
1616 Fixed System Final Fire Prevention 206 Final Mechaniwt '
1266 Pool Spa Final . 208 Final Plumbing � 1�
200 Final Re-Roof 210 Final Electricai
201
202
203
204
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
Final Demolition
212
220
222
250
Final Fire Prevention
Final Planning Approval
Final Site
Final Building/Occupancy
���// .1.�
WORKERS' COMPENSATION DECLARATIO�..
I hereby aKrm under penalty of perjury one of Ihe following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of Ihe vrork for which this permit is issuetl.
❑ I have antl will maintain vrorkers' compensation insurance, as required by
sec[ion 3700 of the Labor Code, (or the pertortnance o! the work for which Ihis
pertnil is issued. My vrorkers' compensation Insurance carrier and policy
number are:
Carrier:
(Tnis seqion neednot be mmpleted dthe perm� is valuetl at one nunered dollais (Sf 00J w less )
Pol�icy Number:
t[� I certi(y Ihat in the peAortnance of the work for which [his permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of California, and agree that if I should
become subject to Ihe workers' compensation provisions of Sec[ion 3700 of
the Labor Code�all fprthwith comply with these provis' s�
Appliwn� gnaWre ✓Da
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE L460R CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm iha[ I am licensed under pmvisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Pmfessions Code, and
my license is in full force and e((ect.
Lia # Class #
ConVaclor's SignaWre
CONSTRUCTION LENDING AGENCV:
❑ I hereby aKrm [hat [here is a constructbn lending agency fw Ihe
pedormance o( ihe v.ork for wfiich Ihis permit is issuetl. (Sec. 3097. Civil Code).
Lentler's Name:
Lender's Address:
SignaWre
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any cily or counry which requires a permit [o
construcl, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statemenl
tha[ he or she is licensed pursuaM lo Ihe provisions of [he Conlractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exemp� there(rom antl
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five h ndred dollars ($500).):
� as:owner of [he property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the stmcWre is not iNended or
oflered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not appty to an ovmer of property who builds or improves
lhereon, and who does such vrork himself or herself or lhrough his or her ovm
employees, provided that such improvements are not intentletl or offered tor
sale. I(, however, the building or improvement is sold wiihin one year of
completion, the owner-builder will have lhe burden of proving that he or she
did not builtl or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professions Code: The contractors License Law does not apply to an ovmer of
property who builds or improves �hereon, and who cont2cts for such project with
a contractor(s) license pursuant to Ihe Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
�'/��I/ /
S� amr� � Da�e T0�
JOS'!-06 (3I0)) `� �
1
Ovmer ID verifed by a,. . s licE. _.. /, es ❑ No
Driver's License No. �% ��✓� Expires: 3�i3�1>
Venfication of Ownership by (rype of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetlHy tha( no excavation (ve (5) or more feet in depth into wfiich a
person is required to descentl, will be made in connection wi[h work authonzed
by this permit, antl that no building strucWre, scaflolding, falsework, or demolition
or dismantling thereo(, will be more �han Ihirry-six (36) feet high. (Chap. 32, Gry
2, Art 2, Sec. 341, Title 8, California Administ2[ive Code).
❑ As owner-builder, I will not employ anyone to do vrork which vrould
require a permit from Ihe Division of IndusMal Safety, as noted above, unless
such person has a permit to do such vrork from the division.
ApPliwnfs Signature oate
Division of Industrial Safery Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuWre building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous malerial? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some
excep[ions, [hat a Business Plan be filed with the Costa Mesa Fi�e
Department by every business which has at any one lime tlunng a reported
year a quantiry of hazartlous matenals equal to or greater Ihan a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed 9as
at standard temperature and pressure).
2. Does or will [he applicant or present or future building occupant need to fle
a registration form for aculely hazardous materials? ❑ Yes ❑ No
(Sec[ion 25533 of the Califomia Health and Safe[y Cotle, wi�h some
exceptions, requires registration wilh the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of awtely
hazardous materials equal lo or grearer [han a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas a[ standard
tempera[ure and pressure).
3. Does or will �he applicant or present or fu[ure builtling occupant need [o
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous matenals)? ❑ Ves ❑ No
(Section 25534 of the Cali(omia Healih antl Safety Code provides that the
Cosla Mesa Fire Department may require [he preparation, certi(cation and
fling with the Fire Departmen[ of an RMPP by 6usinesses which are required
to register acutely hazardous materials with [he Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fu[ure building occupant require for
lhe work which is ihe subject of this application a permit for such consWclion
or modification from Ihe South Coast Air Quality Management Disirict or (rom
any other air pollution control disMct or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Cotle requires Ihat the requesletl
infortnation be tumished on applications for non-residential builtlinq pertnits).
6. Will any part of the (acili[y [o be constmcted under this permit be within
1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No
Qf "yes", the facili[y must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code�.
7. If a permit from the South Coast Air �uality Management District or other
air polWtion control dislric[ or agency is required for the work which is the
subject of this application, have all of the disclosures prescribed by California
Health and Safety Code Section 42303 been made? � Yes ❑ No
8. pf 'yes", atlach certificate of compliance fmm the appropnate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty o( perjury the
infortnation given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signalore Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given is correcl. I agree to comply with all state laws and city
ordinances relating to building constmction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy f any building
authorized by this�ntil inal inspection. `1 /� D�
SignaWreofLeg Owner(s) • I`l ale 0
AnElor Aut�orrzetl AOGlican�
Address:
L'it�y a� G''aa,ta ��eda �u�:��uuy Dic�ioyt
OWNER-BUILDER
VERIFIC�`T[ON
Permit #:
A city or county, which is required to give notice pursuan[ to Section 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-
builder verification.
Attention PropeRy Owner:
An bwner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildingpermit will be issued until this
verification is received.
1. l personally plan to prov,��d "�he major labor and materials for construction of the proposed
pro improvement. �'J Yes ❑ No
2. (have ave not) signed an application for a building permit for
the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone (
City _
Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address _
Phone ( )
City _
Contractor's Lic. No.
5. I will provide some of the work but 1 have con[racted (hired) the following persons to
provide the work indicated:
Name
104p-06 (Rev. N/04)
Address
Phone Type of Nork
NEWPORT-MESA UNIFIED SCHOOL DISTRICT
CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 187
;��: ,03-l9..-�L�JO£'fQ��+'��'itE,�Y �-
_ _.__._.,._._ .1��„j
OOIz�:p�7:84<i8^.�+"�- _
N°'6831
f 3q 3$ ��
To: ( City of Costa Mesa Distrid Receipt No.
( ) City ot NewpoR Beach (�� _ ���
( ) County of Orange Plan Check No.
Applicant ���✓Til ��u2�
Address: �7J I �d �'�'�ad✓�1 �U '
Telephone Number:
TracUParcel and Lot Number(s): � yl �Jq 3d. �
Locabon of Project: �� i �U�� ���
Number of Square Feet ot:
Residendal Space
Commercial and
Industrial Space
CommerciaUlndustrial Project is: (Check One)
_ Warehouse
_ R8D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
��J�S 51.84
xE.30
_ Motel
Bank
_ Neighborhood Shops
_ RacqueVHeallh
_ Hotel
Medical Oifice
O(fice Park
This certifies that the above-named Developer/Applicant has paid school fadtity fees in
53080 and 65995. The Building Permi� for this square footage in this proposed developi
Checks are to be made payable to Newport-Mesa Unified Schooi Dishict.
AuMoraad
To�� a�( � a .1��)
Total
Preschool
Auto Repair
Hospital
Large O(fice
Office Bldg.
Restaurant
Fast Food
p6ance with Govemment Code sections
may now be issued by your junsdic5on.
The above representation as to square tootage is We. Appkcant agrees Mat if it is later termined that such representations are not
lrue, then this certificate shall automatically terminate and ihe appropriate CitylCounty s all be notified.
Date:
�I►���
Appli�aM
: ;=
CITY OF COSTA MESA
P.O. BO% 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200
DEVELOPMENTSERVICES DEPARTMENT
BUILDING DIVISION
EXTENSION NOTIFICATION
May 4, 2009
Richard Diaz
3081 Johnson Avenue
Costa Mesa, CA 92626
PERMIT NUMBERS: BC07-00393
FOR: 2"d StOry Addition
PROJECT ADDRESS: 3081 Johnson Ave., Costa Mesa, CA
This is to advise you that an extension on the above permit has been approved by Ed
Petros, Chief of Inspections. The extension is valid for 90 days. The new expiration date is
August 19, 2009. You must call 714-754-5626 for inspection at any time prior to this date
or the permit will expire. Additional fees will be required to reinstate expired permits.
If you have any questions, please contact the Building Division at 714-754-4871, between
8:00 a.m. and 5:00 p.m., and a staff member will assist you. We appreciate your working
with us to resolve this matter.
Sincerely,
a�, �-
Barbara J. Zwart
Office Specialist II
Building Division (714) 754-5173 • Code Enforcement (7t4) 754-5623 • Planning Division (7i4) 75d-5245
FAX (71n) 750-4856 • TDD (71a) 75a524e • www.ci wsta-mesa.ca,us
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Applicant to fill in all spaces except thosa within heavy EorOer lines anG si9n all aovrooriate tleciarations.
CITY OF COSTA MESAo CONSTR�U/��C'TION PE/RMIT PEFjAQIT NO ,�_ TRACT NO. LOT NO. UNIT NO.
Froject Address � ^ � �Q�I./U�� `�� '
Applicant's Mailing Address ' � /�,
Owner's Name ����� Phnna S Y/ ��
Address ���.,1'�
ilrch/Eng. License No.
Address _ l
Contracror's Name " Phone S
Address Im= �'�g� �7
City Licen N � '] �
LICENSED CONTRACTOR DECLARATION '
I hereby atilrm tnat 1 am licensetl untler provisions ot Charter 9(commencing
with settion J000) of Division 3 oi the Business antl Protessions Cotle antl
my license is in f U o ce antl ettecL µI '^J �O �
Llcense la Lice s o. •`� d
� Date ' Signature
W00.KER5' COMPENSATION DECLARATION
hereby atfirm tM1at 1 nave a certiticate of consent to sei/-in5ure or a certiticate
' Workers' Comn Upp_ �lu.ance, or a certifietl coOY tltereot (SectiJlo'
l800. Lab. J `��077� /y r^11 � �ri
Policy No.� ComPanY �%M.l /ll �CJ
ertitietl Copy is hereby furnlshetl.
CerPfie%t� �t pyy� I3/ f�itetl wrth the city iltl' g piVi r
Date-�_�C�Y�-tl+y`— APPlicant
EXEMPTION FROM WORKERS' CO P 5 O DEC A ATION
(This sec[ion need not be compleletl if [he permit i; for one hund�etl ($100) or
Iess).
I certify tha[ in Ihe performance of the work for Wh�ch thi5 pe�mi{ is issuetl, I.
5hall not employ any person in any manner so 2s to betome subjett to ihe
Workers' compensatlon Laws of Califomia. �
�ate Signature
'NOTICE: Ii, after making this tleclaration, you shJultl become sub)ect to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply wi[h such provizions or this �permit Shall b2 tleemetl revoked. ,
CONSTRUCTION LENDING AGENCV
1 hereGy affirm tM1at the�e is a const�uction IenOing agency fo� Ne Oe�fo�mance
of the work tor which this permit is issued (Section .309] Civ. CJ
Lentler's Name . ,
Lentler's Adtlress
OWNERBUIL�ER DECIARATION
I hereCy affirm that I am exempt trom the ContYactor's License Law for the
following reason (Section �031.5 Business antl PrJfessional Cotle: Any city or
coun[y which requires a permit to const�uct, alter, �mprove, tlemolisn o� repair
any stru<ture, prior to its issuance, also requires the applicant for such permit
to tiie a si9netl slatement tM1ai he/she is licensetl pursuan[ to the prOvisions of
the Contrattor'S License Law (Chapter9 (commencmq wi[h Sectlon 7000) of
-�.�?ivision 3 of [Ite Business antl Professions CodB) or that he/she is exempt
�'i„q;erefrom antl the basi5 for [he allegetl exemption. Any violation of Section
"�,�J3L5 by any applicant for a permit subjects the applicant [o a civil
��'�y5enalty of not more tban five huntl�etl tlollars ($500). '
❑ 1, as owner of the property o� my employees wltM1 wages as their sole
com0ensation, will tlo the work, antl the structure is not intentletl or ofteretl
for sale (Section �044, Business and ProfessioM�� Cotle: The Con(ractor's '
LicenSe law tloes not apply [o an Owner of a property who builtls o� improves
thereon, ana wno tlaes such work himself/hersel� or through his or her own
employees, provitletl [hat such Improvements are �o[ intentleO or offeretl for
sale. 11, however, the builtlin9 0� imp�ovement is 4oltl within one yea� o( com-
ple[ian, the owner will have the burtlen ot provin9 ne/she tlitl not builtl or im-
prOve for the purpose of sale). , '
❑ I, as owner of tM1e property, am exUuSively cOntracting with licensetl con- '
Vactorsto conslruci [he project (Sectlon 7044, BUsiness antl Professions Cotle:
Th¢ Contractar's License Law tloes not appry ttl an owner of prope�ry who�
builtls or improves thereon, antl who conVacts for such prolects with a con-
�' tratto�(5) license pursuant�to Ihe Con[ractor's LiLense Law�. I am aware [hat
proof of their WOrke�'s Compensafion insutance shoultl be provitletl to me.
,❑ I am exempt untler Section 8. & P. C. for this reason
Date Owner
I hereby certify that I have reatl this applicatio� antl state that the above
in/ormation is mrrecL I a9ree to comply with all utY antl county ortlinances
antl state laws relating to builtling construction, dntl hereby autnorize repre-
sentatives of this- city to enter upon the abo�e-mentionetl property tor
inspection p '� ses Date��
Siqnature
�rivers' Lic se or 55 � —
TYPE OF CONSTRUCTION' LJ NEW LJ ADD LI ALTERATION �LI REPAIR S
❑ CONVERSION ❑ DEMOl15H ❑ OTHER Ap #
DESCRIPTION OF WORK/USE OF BLDG. S Main Building:
TVPEOPPERMIT GRADING �FOUNDATION STRUCTVRAL T Front
❑ TENANT ❑ ELECTRICAL PWMBING ❑ MECHANICAL B Rear
❑ �OTHER . C Right
PROJECT DESCRIPTION SQ. FT. OCCUPANCV K
CONSTRUCTION TVPE VALUATION $' g LeFt
ZONE GRADING CU. YDS. ACRE$ Ping. R¢f. #
Remarks: Pianning Notes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtuhs ' ,
CldYlfl2l5 . �
Dishwasher •
Drinking Fountains
Floor Drains
Floor Sinks �
GasService Outlets
I niercepmrs
Kitchen Sink
Lavatories � �
P—Trap _
Roof Dreins
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Venti�lating '
Exhaust System ❑ Mul[iple ❑
Firepl/Fact Blt. ICBO # ^
Heating System & Ducting .
❑o-i oo,000 sTu O i oo,00a sn
Reinspection Fee � $15
CMF OB65-46, rev. 10/84 White - Builtling; Ganary � APplicant; Pink - Accoun[inq; Goltlenrotl - Aszessor
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connectic
- Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
�Laundry Trays
Issue Fee
Hoodor Typel ❑
Canopyy� Type I I ❑
Refrigeration System
❑0-:100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers �
Registers '
Issue Fae
FEES
3534 4/21/30 -. ;
Zone
Accessory Building: '
Z
O
� N
I
N
G
R
Parking Req:/Provided E
M
$
ELECTRICAL
Automatic Washer Transformer ❑ 15-50 KW
Construction PoleSub. ' � SO+KW
Cooking Unit �
Dfshwasher � �
Dryers �Gas ❑Electric
Fan
F.A.U.
Fix[ures
Device Boxes
OuUets '
Switches
Garbage Dispoul
Generator DO-5 KW �5-15 KW
Meter ❑up to 700 amps
Merer ❑over100amps
Sub Panel
Mators � 0-1 �HP � 1 X- 8
Inc.Solar �9-15 HP �16-15+
Pole Light •
Sign
Standing Section:
Trash Compactor
FEES
$ 3
Reinspection Fee $15 Issue Fea $ 3
FEES
DEVELOPMENTSERVICESREQUIREMEN7S:
Zoning Approved By ' Date
Building Approved By Data �
Appliptian Issued By ��---Data ��
SUMMARV OF FEES �
' BUILDING PERMIT $ SMIP $
PLAN CHECK $ � PERMIT
PLUMBING $ �SSUANCE $
� PLANCHECK.'25% $ ENERGV�P.C. $
ELECTRICAL • $ � GRADING S ' �
PLANCHECK 50% $ MICROFILM � $ /,
MECHANICAL . S TOTALFEE $ ��D `�
$ 3 PLAN CHECK 25% $ .
CONSTRUCTION AND PLANNING P���` 'P'�'
APPROVALS Permit # Date Inspector AppROVALS Pe�mit # 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-Undrgmd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11 . Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewe} Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough ElecVical-Conduit 66. Solar SYstem-Final
i6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & A�r Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory FirePlace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & 7est 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 7�/-y L,E!)
39. Water Service-Final
40. Gas Service�Final ��� i
47. SolarpomesticFinal �'f•
42. Backflow Preventer �;��i
43. Backflow Irrigation �''
44. Landscape Irrigation System ,_,�
45. Sound Attenuation -�
46. Handicap Regula[ions V
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
. 17071
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. HOX 917 COBTA MEBA. CALIFORNIA
For Appliean+ fio Fill In Complefely
TYPE OR PRINT
ADDRESS '30�� ThiISG �k,
COSTA MESA. CALIFORNIA
OWNER Oecidental Loan Com�anv
� ARCHITEGT
�
�
TEL. �'�.
AODRESS 2 O1 Benedict Can on Drive
cin Beverlv Hil1s. California
���TNo. Z413�5 No: c�. o-�g4o
SIZE ,,.,��� �� I NO. OF 6LDG3. �
■ 6ETBACK LIN6 FflOM
,- r'r�' .,r.-�
d' � fel��� � � �.
MAY 17 198i
�Fi�ai',�;Cc DEPT.
CIIY Of COSiA i!-iESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
FECEIPT NO, PENMIT NO.
BUILDING 3081 �Johnson Avenue
ADORE56
CASTA MESA. CALIFORNIA
FIRE t1�/ / //� ( �
ZONE TYPE • GROUP Q��' Y X7
APPROVEO �T
BY DATE
ZONING
����I I PlAN9 Z I BOILDING WI ��YL� �
�ecw� .. . . . . �
` _
(CENTEP LINE 8T.)
� REAR YARD 27 � FRONT S Z
F I I RIGHT � � R. 61DE 's
PTION OF WORK �, SIDE S
�LTERATION I II ADDITION I REAR �� /�
10VING I IIDEMOLISH I BYPROVED �. /�
a�r+�
NO. OF _. �
EXTERIOR WALL ROOF
COVERING StUCCO COVERINGWOOCI L'
USE OF BUILOING AND WORK TO BE PERFORMED
l _ Pinm Raa ur/attnr.hPf3 f::
.�/ / 3 �
I HEHEBY FCKNOWL6DG¢ THAT I HAVE READ THIB APPLIGTION
ANO BTATE THFT THE ABOVE IS LORRE� ANO AGREE TO COM-
PLY WITM ALL C�TY ORpINANCE9 AND 6TATE 8 REOULATIN$'
BUILDINO CON9/�$/ycTION. /J/
SIGNATURE OF/ / i /. d/A J// �/�/
3
TF `� /G
�/—/�`%��` / � e� :
l'�z , ��.� -
THE AMOUNT BHOWN UNDER VALIIAT�ON 19 PO� R THE
PURP09E OR E9TABLIBXING A PEqMIT FEE ONLY.
VAWATION
PERMIT FEE $ �j�
J r�
S 21�OC�.00 PLANCHECK S �C�.�.
o'
IAUTHORIZED AC�NT , a
TOTAL FEE $ �, �i �� �
O LL