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Home My WebLink About2094 MARIAN WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 2094 MARIAN WY Suite No Vicinity: MASTER BATHROOM AND CLOSET Parcel Nunmber: 42620224 Applicant: DORISH, GARY Address: 2086 MARIAN WY COSTA MESA, CA Owner: ADAMS, GENE M Address 2094 MARION WAY COSTA MESA, CA Contractor: DORISH CONSTRUCTION Address: 2086 MARIAN WY Arch / Eng : Address: COSTA MESA, CA Phone: 547-7154 Zip: 92626 Phane: Zip: 92627 Phone: 547-7154 . Zip: 92626 License: 668398 Phone: Zip: License: ISSUED BY: Status: ISSUED Applied: 06/05/2002 Issued: 06/OS/2002 SCOPE OF PERMIT CONSTRUCT 120 SF ADDITION TO EXTEND A MASTER BATHROOM AND CLOSET IN AN EXISTING SFD. 1 BATHTUB, t SHOWER, 1 WASH BASIN SET, 1 WATER CLOSET, 1 WATER HEATERNENT. REF: 802-00574 ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect pce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY NOTICE: The work authorized by this permit regulations. (Ord. No. 92-28, § 1, 12-21-92) FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo �$0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $9.80 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 ON 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Venl Syslem Water Closet (Toileq Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $9.80 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: 575.00 QTY 0 0 0 0 0 0 0 1 0 1 1 0 0 0 0 0 requirements under California statutes and related EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendetl or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlone and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of lhis permit. FOR INSPECTIONS CALL: (714) 7545626 244fid61N00) WORKERS'COMPENSAnON DECLARAnON: � I hereby aflirm under penalry of perjury one oi the tollowing tleclarations: ❑ I heve antl wlll maintein a certiticete oi consent to self-Insure for workers' compensalion, es providetl tor by seclion 3700 of the Lebor Coda, for the peAortnance at ihe work fOr whiCh this permi� i5 i55ued. . ❑ I have and will maintain workers' compensatlon Insurence, as required by section 3700 of the Labor Coda, for the peAortnance oi the work for which this pertnit is issuetl. My workere' compansetlon Insurence cartlar end policy number are: Carrier: Policy Number: (This section neetl not be completetl il the permit is veluetl et one hundred dollars ($f 00) or /essJ � I certify Ihat in the pedo nce ol ihe work br which this perm'' is issued, I shall not employ any person in any manner so es to become subjecl to the workars' compensation laws oi allf rn' r het N I shoultl e subject ro the workers' compensatlon provisions of Section 3700 of t e Lebor Cotle, I shall forthwith comply with Ihese pr ' ' . / Applicant SignaNra: Dete: �� i Q� � Q Z— WARNINQ: FAILURE TO SECURE W KER ' OMPENSATION WVERAGE IS UNLAWFUL AND SHALL SU&IECT FN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOIXJE HUNDFED THOUSANDDOLLARE($100,OW),INA TOTHECOSTOFCAMPENSATION,OAMAGESASPROVIDEDFORINSECTION3]O60FTHELABORCADE,IMEREST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that I am force antl eHect. Lic. A Gontrector's Signature: CONSTRUCTION LENDING with Section 7000) ot Division 3 of ihe Bi Class N Date: end my license is in tull ❑ I hereby aMirtn Ihat there is a construction lending agency for the pertormance oi t�e work tor which this pertnit is issued. (Sec. 3097, Civil CoOe). Lendefs Name: Lendefs Address: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby eNirtn ihat under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or county whic� requires a pertnit to consiruct, alter, improve, tlemolish, or repair any structure, pnor to its issuance, elso requires tha eppliwnt for such permit to file a signetl statement ihat he or she Is licensed pursuant to ihe provisions of the Contrectors License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of Ihe Business entl Professions Code) or that he or she is exempl lherefrom and the besis for lhe alleged e:emption. Any violation oi Section 7037.5 by eny epplicent for a permit subjects the epplicant to a civil penalry of not more then tive hundred dollars ($500).): ❑ I, as owner of �he properry, or my employees with weges es Iheir sole compensation, WILL DO THE WORK, and ihe siructure I5 not intended or otteretl for sale (Sec. 7044, Business and Protessions Cotle: The Contractors License Law does noi apply to an owner of OroPerry who builds or improves thereon, and who does such work himself or herself or �hmugh his or her own employees, provided that such improvements are not intended or oHeretl tor sale. If, however, Ihe building or improvemen� is sold within one year oi completion, ihe owner-builder will have the 6urden of proving that he or she did not build or improve for purpose of sala.). ❑ I, as owner ot the properry, am EXCLUSIVELV CONTRACTNG WITH LICENSED CONTRACTOHS to construct the prolect (SecJ044, Business and Protessions Code: The contractors Llcense Law does not apply to an owner ot property who builds or impmves thereon, entl who con�racts for such projec� wl�h e conirector(s) license pursuant to ihe Con�ractors License Laws.). ❑ I am exemp� under sec. Signature: Owner ID venfied by driver's license. ❑ Ves ❑ No Business antl Professions Cotle for this reason: Verificetion ot Ownership by (type ot document, I.e. - property tex bill or tleetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICA710N: Driver's License No. Date: EKpires: ❑ I hereby certify ihat no ezcavation tive (5) or more feet in tlepth into which a person is requiretl to tlescentl, will be matle in connec�ion with work authorized by ihis permit, and that no building simcture, scalloltling, falsework, or demolition or dismanHing thereof, will 6e more than thirty�six (36) feei high. (Chap. 32, Grp 2, Art 2, Sec. 341, TiNe B, Calitornie Administretive Code). ❑ As owner-builtler, I will not employ anyone to tlo work which would require a permit irom ihe Division of Indusirial Satety, as nated above, unless such person hes a permit to do such work irom t�e division. Signature: Date: Division of Industrial Sate�y Permit Number: CERTIFICATE OF COMPLIANCE AND AU7HORRATON OF ENTRY: I certiy under penelty of perlury �hat I have read ihis application and state ihet ihe iniormation given is correct. 1 agree to comply with all stete laws end city ordinances releting to building constmction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspection puryoses. I agree not to o�upy or atlow occupancy of any building authorized by this permit until finel inspection. LOOE1. INSPECTIONTYPE PAIE iKrrtu�s 1616 Fixed System Final Fire Prevention 1266 200 201 Pool Spe Final Final Re-Roof Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition (a�s'%dt z ��Date 0 � INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy �g � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT ,lobAddress: 2094 MARIAN WY Suite No Vicinity: ' MASTER BATHROOM AND CLOSET Parcel Number: 42620224 Applicant: DORISH, GARY Address: 2086 MARIAN WY COSTA MESA, CA Owner: ADAMS, GENE M Address: 2094 MARION WAY COSTA MESA, CA Contractor: DORISH CONSTRUCTION Address: 2086 MARIAN WY COSTA MESA, CA Phone: 547-7154 Zip: 92626 Phone: Zip: 92627 Phone: %7-7154 Zip: 92626 License: 668398 ISSUED 6Y: Status: ISSUED Applied: O6/OS/2002 Issued: O6/05/2002 SCOPE OF PERMIT CONSTRUCT 120 SF ADDITION TO EXTEND A MASTER BATHROOM AND CLOSET IN AN EXISTING SFD. VENT FAN/SINGLE DUCT � � - REF: 802-00574 ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt CoolingMeat Insl / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance � Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t0000cfrn Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ' t Quantity 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial Incinerator Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3 To 15 hp / SOO k BTU � 5 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Uplo3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Invesligalion Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantiry $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $30.75 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ortl. No. 92-28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlona and final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2a4&d8 (6/00) WORKERS'COMPENSAnON DECLARAnON: I hereby eHirtn under penalry of perjury one of the following declerations: ❑ I heve entl will meintain a certificate of consent to sell-Insure for workers' compensation, es provided tor by section 3700 of Ihe Lebor Cotle, tor the pertormance of the work for w�ich this permit is issued. . ❑ I have end will maintain workers' compensation Insuranca, as required by sectlon 3700 of tha Lebor Code, for Ihe pedortnance of the work lor which Ihis pertnit is issued. My workers' compensation Insurence cerrler end policy number are: Carrier: Policy Number: (This secfion need naf be cromp/eted il fhe permif is velued ef one hundred dollars ($ f 00) or less.J [7� I cetlity thet in the pedorm�y e ol th � I or whic0 this ertnit is issuad, I shell not employ eny pereon in any manner so as to bocome subject to Ihe workers' ��compensation lews of Cyffo ie C a r e at If I should ecome subject lo ihe workers' compensetian provisions of Section 3700 of e Lebor Code, I shell torthwith comply with these provi te Applicent Signeture: Date: � T/� � �� WARNING: FNLURE TO SEW RE WO ' OMPENSATIIXJ COVEMGE IS NLAWFUL ANO SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES rW D CML FlNES UP TO ONE HUNDRED T/qUSANDDOLLARE(St00,ODD�.M TOTHEWSTOFCOMPENSATION,DAhNGE50.SPROVIDEDFORINSECTION3]WOFTHEIABORCODE,IMEHEST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirm ihat I em license un er ' ions o (commencing wilh Section 7000) of Division 3 of tha Business rofassi n ode, and my license is in full force antl eHect. Lic. A Class N �_ Contrectols Signatura: Date: CONSTRUCTION LENDING AGENCV: � ❑ I hereby effirm that �here is a construction lentling egency for Ihe performance of �he work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Adtlress: Signeture: Date: OWNER-BUIlOER DECLARA710NS: I hereby aflirtn thel under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW far the following reason (Sec. 7031.5, Business and Protessions Code: Any ciry or counry which requires e permit to conswcl, alter, improve, tlemolish, or repeir any sWcture, pnor to its issuance, also requires ihe appliwN for such pertnit to flle e signeC statement Ihat �e ar she Is Ilcensed pursuant to Ihe provisions ol the Conlrectors License Law (Chapier 9(commendng wilh Setiion 7W0) ol DlWsion 3 o11ha Business end Professions Code) or thet he or she Is exempt therefmm antl the besis tor tha ellegetl evemption. Any violation oi Section 7031.5 by any applicant for e pertnit suhjects Ihe epplicanl to e civil penalty ol not more than tive hundred dWlars ($S00).): ❑ I, as owner ol Ihe property, or my employees wlih weges es iheir sole compansation, WILL DO THE WORK, and ihe structure is not intentletl or oHeretl for sale (Sec. 7044, Business end Protessions Code: The Contractors License Law tloes no� epply to an owner oi properry who builtls or improvas thereon, antl who tloes such work himself or hereelf or through his or he� own employees, provided Ihat such improvemenis ere not Intended or ottered br sele. II, however, Ihe builtling or improvement Is soltl within one yeer of completion, ihe owner-builder will have the burtlen of proving that he or she did not build or improve for purpose ot sale.). ❑ I, as ownar ol the property, am EXCLUSIVELV CONTRACTING WITM LICENSEO CONTRACTORS to construct Ihe project (Sec. 7044, Business and Protessions Cotle: 7�e coNrectors License Lew does not epply to an owner of propeny who builtls or improves thereon, and who contracts for such projecl with a comracbr(s) license pursuant to lhe Contractore License Laws.). ❑ I em exem0� under sec. Business and Protessions Code for this reason: Signature: Date: Owner ID verifietl by drivers license. ❑ Ves ❑ No Dnvers License No. Vedlication ot Ownership by (rype of document, Le. - pmparty tex bill or tleetl): DIVISION OF INDUSTRIAL SAFE7Y PERMR CERTIFICATtON: Ezpires: ❑ I hereby certlly �hat no excavation live (5) or more feel in depih into which e person is required to tlescend, will be matle in connection with work authonzed by Ihis permit, and Iha� no building swcture, scaflolding, talsework, or demolition or tlisman�ling �hereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, California Administrellve Cotle). ❑ A5 ownervbuiltler, I will not empl0y enyone to tlo work which would require e permit Irom the Division of Industriel Sefety, as notetl above, unless such person has e permit to tlo such work irom the division. SignaNre: Date: Division of InAustrial Safety Pertnit Number: CERTiFlCATE OF COMPLIANCE IWD AUTHORVJITION OF ENTAY: I certiy under penalry of Derjury that I have read ihis appliw�ion antl state ihat t�e intortnation given is conect. I agree to wmpty with all state laws end ciry ordinances relating to builtling construciion, end authorize represantatives of Ihe Clty ol Casta Mesa to enter upon t�e ebove-descnbed proDarty for inspection purposes. I agree not to acupy or allow occupanty ot eny Duilding authorized by this permit until final insDection. COOE I, INSVECTIONTYPE 1618 Fixetl System Final Fire PreveNlon 1266 Pool Spe Final 200 Finel Re�Root 201 Finel Block/Retaining Wall 202 Final Fectory Fire Place 203 204 Final Sign Final Demolition Q� �$ CODE� INSVECTIONTYPE 206 Final Mechanical 208 Final Plumbing 270 Final Electrical 212 Final Fire Prevention 220 222 250 Final Planning ApProval Final Site Final Building/Occupency �� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us BUILDING PERMIT Job Address: 2094 MARIAN WY Suite: Vicinity: . Parcel Number: 42620224 � Applicant: DORISH, GARY Address: Owner: ADAMS, GENE M Address 2094 MARION WAY COSTA MESA, CA Convacror. DORISH CONSTRUCTION Address: 2086 MARIAN WY Zoning: Phone: 949-548-7154 Zip: Phone: Zip: 92627 T7 FAIR DFIVE, COSTA MESA, CA 92626 ISSUED 6V: Status: ISSUED Applied: 04/29/2002 Issued: 06/OS/2002 Phone: 547-7154 COSTA MESA, CA Zip: 92626 License: 668398 nrch : Eng: EW WEBB ENGINEERING Address: Address: 6108 TRUJILLO VJY Phone: Phone: 909-681-&447 RIVERSIDE, CA Zip: License: - 92509 License: 37384 SCOPE OF PERMIT- 120 S.F. ADDITION TO EXTEND EXISTING BATHROOM AND CLOSET IN MASTER BEDROOM. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $190.61 $293.25 $1.80 $0.00 $0.00 $0.00 $485.66 SETBACKS MAW STRUCTURE Front 2& 0 ACCESSORY Front 0- 0 PARKING Existin : a NOTES: Rear 25-0 Rear 0- 0 Required: 4 FEE SUMMARY PLANNING & ZONING Left 6- 0 Left 0- 0 Proposed: 0 Calc Valuation: giE,000.00 Claim Valuation: $�e,000.00 Right Right , - . NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 , zaasse (rvoo� / � WORKERS' GOMPENSATION DECLARATION: I hereby ettirm5mder penelry of perjury one of the foliowing declarations: _ ❑ I have end wll� maintain a�rtificate of consent to setl-Insure tor workers' compensation, as provitled for 6y section 3700 of the Labor Code, tor the pertormence ot ihe work for whicti Ihis permit is issued. . ❑ I have antl will maint ' workers' compensation insurance, as required by section 3700 ot Ihe Labor Code, tor Ihe pedortnance ol the work for which this pertnit is issued. My workers' comper�atlo� Insurance carrier and policy number are: Carrier: PoliCy Number: (This secfion neetl not be complereO iI (he permi! is valued et one hundred dollars ($ f 00) or less.) � I certily that in the perto�rtn� nce of th d r which this pertnit is i d, I shall not employ any person in eny menner so as Io become sublect to ihe Workers' compensation laws ot �](�rnia, an gree th ' I should become ub ect ro Ihe workers' compensation provisions of Sacilon 3700 oi t e Lebor Code, I shall torthwith comply with these pro i`Fn /'' �� ApP�icaniSigneture: Dete: _�/_,__�f,__ �`� WARNING: FAILURE TO SECURE WOiiK CO PENSATIO �VERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIM�NPL Ph'NALTIES AND CIVIL FlNES UP TOONE HUNDRED i/iOUSANDDOLLARE($100,000),INADDR THECOSTOFCAMPENSATION,OAMAGESASPROVIDEDFORINSECTION31060FTHELABOHCODE,IMEREST,ANDATTORNEY'SFEES. LICENSED CONTRACTORS OECLARATION: I hereby aHirtn that I am force and ettect. Lic. M Conirectors Signature: with Section 7000) of Division 3 af the Business Class x Date: CONSTRUCTION LENDING AGENCYo ' ❑ I hereby aHirtn ihat ihere is a conslruction lentling agency tor the pedormance of lhe work For which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lendefs Address: Signature: Date: my license is in full OWNER-BUILDER DECLARA710NS: I hereby affirtn tha� untler penaity ot perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires e pertnit ro consWct, alter, improve, demolish, or repair any simcWre, prior to its issuance, also requires the applicant for such pertnit to file a signad statement Ihet he or she Is licansed pursuant b tha provisions of the Contrectors Licensa Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the eusiness and Professions Coda) or ihet he or she is ezempt therefrom and the basis for the allegetl ezemption. Any violation of Section 7031.5 by eny applicant for e pertnit suhjecis the appliwnt to e civil penalry of not more ihan tiva hundred dollers ($500).): ❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and the structure Is not intendad or oflerad for sale (Sec. 7044, Business and Protessions Code: The Contractors Licanse Law does not epply to an owner ot property who builds or improves ihereon, and who does such work himself or herselt or through his or her own employees, provided that such improvements are not intended or oHered for sale. tl, however, ihe builtling or impmvemeM is sold within one year ot completion, the owner-builder will heve the burden of proving that he or she did not build or improve for purpose of sele.). ❑ I, es owner of tha property, am E%CLUSIVELV CON7RAC71NG WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Professions Cotle: The contrectore License Lew does not apply ro an owner ol pmperty who bullds or Improves thereon, and who cron(rects lor such project with a contracror(s) iicense pursuant to the Contradors License Laws.). ❑ I am e:empt untler sec. Business and Professions Code tor this reason: Signature: Date: Owner ID verifietl by tlriver's licen5e. ❑ Ves ❑ NO Driver's License No. Venfcation of Ownerehip by (rype of documant, i.e. - properry ta< bill or deed): Expires: DIVISION OF INDUSTRIAL SqFETY PERMIT CERTIFICATION: ❑ 1 hereby certify Ihat no exravation five (5) or more feet in depih into which a person is required to descend, will be made in connection with work authorized by this pertnit, and that no building sWcture, scaHolding, falsework, or demolition or dismantling ihereot, will be more than thirty-siz (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, 71tie e, California Administrative Code). ❑ As ownervbuildar, I will not employ enyone to do work which would require e permit from the Division oi Industrial Safery, es notetl above, uniess such person has e permit to do such work from ihe division. Signature: Date: Division of Industrial Sefety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHOHVATION OF ENTRV: I certify under penalry of perjury that I have read this application antl state that the information given is correcc I agree to comply with all state lews and city ordinances releling to 6uiltling consWction, and authonze representatives of the Ciry ot Cos�a Mesa to enter upon the above-descnbed property lor inspection puryoses. I agree not to occupy or allow occupancy ot any building authorized by ihis permit until tinal inspaction. COpE t, INSPECTIONTYPE �� Q�I& INTRIpLS 1616 Fiaed System Final Fire Prevention 1266 200 201 202 203 204 Pool Spa Final Final Re-Root Final BIocWRetaining Wall Final Factory Fire Place Finel Slgn Final Demolition COOEN INSPECTIONTYPE 206 208 210 212 220 222 250 Final Mechanical Final Plumbing Final Elecirical Final Fire Prevention Final Planning Approval Final Site Final Building/Occupancy /- ate �'�'T �� OpTE INTITIRLS 3-zv-�3 � (714) 754-5273 • F� (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicank Address: Owner: Address ELECTRICAL PERMIT 2094 MARIAN WY MASTER BATHROOM AND CLOSET 42620224 DORISH, GARY 2086 MARIAN WY COSTA MESA, CA ADAMS, GENE M 2094 MARION WAY COSTA MESA, CA Contractor: DORISH CONSTRUCTION Address: 2086 MARIAN WY ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+uniLs) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors lo SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Inlermed Pole COSTA MESA, CA Phone: 547-7154 Zip: 92626 Phone: Zip: 92627 Phone: 547-7154 Zip: 92626 License: 668398 Status: ISSUED Applied: O6/OS/2002 Issued� O6/OS/2002 ISSUED BY: �. r SCOPE OF PERMIT CONSTRUCT 120 SF ADDITION TO EXTEND A MASTER BATHROOM AND CLOSET IN AN EXISTING SFD. 7 LIGHT FIXTURES, 3 OUTLETS, 6 SWITCHES, 1 RES APPL (BATHTUB JACUZZI). REF: 802-00574 523.50 $0.00 $0.00 $0.00 $0.00 $0.00 57.70 $3.30 $6.60 $0.00 $4.75 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / LighUng Busway /100 ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over'100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Canductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investlgation Fee Plan Check Fee Reinspeclion Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $45.85 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for,a period of;1B0:days. • . INSPECTIONS: In order tor ihe work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred inspactlone and finel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 . 2nawe �doo� WORKERS'COyPENSA710N DEClARA710N: - I hereby aHirtn unaer penalry of perjury one oi the following declarations: ❑ I have and wilf4naintain e certificate of consent to salf-Insure tor workers' compensation, es pmvided tor hy section 3700 ot the Lebor Code, for ihe pedormance of Ihe work for whiCh Ihis pertnit is issued. . ❑ I have and wlll mai�taiqwoAcers' compensation insurance, as required hy sectlon 3700 of ihe Labor Code, tor the pertortnance of tha work for which ihis pertnii is iswetl. My workers' comperi�tion Insurence carner end poliq number are: Carner: Policy Num6er: (Thls sect/on need nof be comp/eted H the permit is valued a( one hundred dollare ($f 00) or less.) I cetlify that in the perfo nce of h6W0 for w�ich th' rmit is issuetl, I shall not employ any person in any manner so as to become subject to ihe workers' compensatian laws a al' nia entl egr hat il I sho b ome subiecl to the workers' compensatlon provlsions of Section 3700 ot t�e LaDor Code, I shell forthwith comply wlih ihese pr � n. �/_fQ Applicam Signeture: Date: 5 7 '�-- WARNING: FAILURE TO SECURE W KER WMPENSATION OpVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PE ALTI ANO CIVIL FlNES UP TOONE HUNDRED THOUSANDDIXIARE(5100.000),IN D TOiMECOSTOFCOMPENSATION,OAMAGESPSP(iOVIOEDWFINSECTIIXJ3'IO60FTHELABORCODE,INiEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHlrm ihat I am force end eHect. Lic. q ContractoYs Slgnatura: CONSTRUCTION LENDING AGENCV: (commencing with Section 7000) of Division 3 of the Business � Class A _ Date: entl my Ilcense is in full ❑ I hereby aHirtn Ihat there is e construction lending agency for the pedormance ot the work for which ihis permit Is issuetl. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I here6y eMirtn ihat under penelry of perjury ihet I em EXEMPT FROM THE CON7FiACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Profeuions Cotle: Any ciry or counry which requires a permit to wnstruct, alter, improve, tlemolish, or repeir any structure, pnor to its issuance, elso requires the appliwnt for such pertnit to lila e signed statement that �e or she Is licensed pursuem to the provisions ot Ihe Conirectors License Lew (Chapter 9(commencing with Sectlon 7000) of DlHsion 3 ot ihe Business end Professlons Cotle) or thet ha or she is e:empt therafrom antl tha basis for the ellegetl ezamption. Any violation oi Section 7031.5 by any aOPlicant for e pertnil subjects the applicent to e civil penalry oF noi more ihan five hundred dollars (5500).): ❑ I, as ownar of the property, or my employees wit� wages es their sole compensatlon, WILL DO THE WORK, and iha structure is not intendetl or oliered for sale (Sec. 704A, Business and Pmfessions Code: The Con�rectors License Law does not apply to an owner of property who 6uilds or improves thereon, antl who dces such work himseli or herself or through his or her own employees, provided tha� such improvemen�s are not in�entled or oflered for sale. If, howevar, the building or improvemeni is sold within one year ot completion, the owner-builder will have ihe burden of proving that he or she did not build or improve for purpose oi sale.). ❑ I, as owner of the O�operty. am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the pmject (Sec. 7044, Business and Prolessions Code: The contrecmrs License Law does not apply to an owner of properry w�o builtls or improves Ihereon, end who comracts tor such projec[ wi[h a contractor(s) license pursuam to the Comracmrs License LawsJ. ❑ I em exempt under sec. Busineu end Protessions Code for ihis reason: Signature: Oa�e: Owner ID verified by dnver's license. ❑ Ves ❑ No Driver's License No. Expires: Verification of Ownership by (rype oi document, i.e. � property taa �ill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby catlity that no excavation five (5) or more feet in depth into which a person is requiretl to tlescenQ will be matle in connection with work euthonzed by this permil, and Ihat no huilding sWdure, scaHolding, falsework, or demolition or dismantling thereof, will be more then thirty-six (36j teet high. (Chap. 32, Grp 2, Art 2, Sac. 341, Ttle 8, Calilornia Adminisiretive Code). ❑ As awnerbuilder, I will not employ enyone to tlo work which waultl require e permit from Ihe Divislon of Industriel Setety, es notetl aDove, unless such person has e parmit to tlo such work Irom Ihe division. Signature: Date: Division ot Indusinel Safety Permit Number: ICER7IFlCATE OF COMPLIANCE 1WD AUTHORIZA710N OF ENfAY: I certily under Denalry of perjury thet I have reetl this application end state that �he information given is I correct. I egree Io compty wit� all state laws entl ciry ordinances releting to builaing wnstruction, antl authonze representatives ut ��e Ciry of Costa Mesa to enter upon the ebove-described property tor inspection purposes. I a9ree not to acupy or allow occupancy of eny building authorized by lhis permit unlil linal inspection. CODE �. INSPECTIONTYPE � 16t6 FIxeO System Final Fire Prevention 1286 200 Pool Spa Final Finel Re-Root 201 Flnal BIaWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition � /�.�z- %�TDate pdjg �fJ� �Qp� INSPECTIONTYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electdcal 212 Finel Fire Prevention 220 Finel Planninq Approval 222 Finel Site 250 - FinalBuiltling/Occupancy PAIF It�1S ii:� SPEC 'iL INSPECTOR'S RE )RT PERMIT 0 ��OO $i�� BLDG. SIZE: �`QYYLB4pe� �4��'1 TYPE INSP.: ��-p,(d �OLT� WALL TYPE: -i-Y'Yy1 �C � / � � ��• • (�' ' � � , // •. CONTRACTOR: SUB-CONTRACIurt��): JURISDICTION: ENGINEER/ARCHITECHT WELDERS: /U/� � ELECTRODES: � � ' • • • �: � " � � ' � �1 /.__ , , �X�Q � REPORT: �p�p �'7y/t/Od. [ S� 1t �k��f �'noL• S�9Jl �s re�'n• sf/• �'� �mbcl. 4 ��a/. ¢- re�'n- s�-/ (� `� prn6`a�. ��a%x/ l3 ,� - 7�`�3S ��,�s Q�s� ��/ 6'� eml�'� ,� S: rn�seh S�e.f c'�a Q.bCi�7//. �,P '� n�,'e ��,/,�s � a NOTES a HOURS: MON. TUES.� I,IED. _��UR SIGNATURES: CONTRqCTOR: / 1 7��/_ _ FRI. SAT.� SUN. � . � : �L�7)_�►%L��/I/L�%S � noosess: 2094 MARIAN WY 1� NRME: ��S GENE M RDDflE55: 2Oq9 �7ARION WAY COSTA MESA,CA 645-1333 APCN/ENGINEEH: ADOflE55: uxiT: 92627 flEG.NO.: UNiT: PEpMinEE: APPLEGA'LE ROOFING ( 714 ) 734-5191 ADDNE55: 49O E, HARRISON CORONA CA 91719 tICENSEo CON7HpCTOH DELLAPIITION: 4Aereoy allirm inat I am licensea untler pmvisions of Chapter 9(commencinp wilh Section 7000) ol �ivision J ol �he Bu5ine55 and Pmle55ion5 COAe. anA my licen5¢ is in lull lorce anU eifec�. ciTruc.:051722 srnreuc.:494608 =�s'C—�9/— Date: % � � � �� ! '� - Signalure: � WOPKEBS' COMPENSRTION OFLIAMTION: I nereby allirm ttut 1 �ave a cenitiwte ol consenl ro self-insure or a cenilicaie ol Workers' Compensalion Insurance. or a ceni�ieG topy 1�ertai (Seclion 3800, Lab. C�. roucrxo.: 0789055-91 EXP.OPTE: SZ�IO�9Z comraxr: STATE FUND ❑ Cetlihetl copy is hereEy IumiSAM. � Cetlifietl copy is IileE vnih t�e cily Builtlinp Oivaion. da�e: �% — I 5' — Q 2 Applicam: —^/ `� ��— E%EMiTION FBOM WOflKEflS' COMPENSATION UECIAPpTION: (This seclion neea not 0 compleletl i� Ihe permi� is�orone hunAred (5100) or less�. I I ceriily ��al in Ihe pedormante a� Ihe work Ior which t�is Dermit is i55u¢0, I Shall not employ any Derson in any mannef 5o a5 lo �¢came su�leti lo Ih¢ WOrkers' Compensaiion Laws oi Calilomia. Daie: SignaWre: NOTICE: II. afler making Ihis Oetlaralion, yoU ShoUitl becom¢ SuEjeti l0 IAe WarkeR' Comoensation vmvisions oi iAe LaDor Coee. you must fonhvnl� comply with such O�ovisions or tAis permit s�all be Oeemetl revoked. LONSTqUCT10N LENOING RGENCY: I �er¢Gy altirm I�ai Ihere i5 a COnSImClion I¢ntling aAe��Y �Ot �Ae petlormante ai I�e work for whic� Ihis peimn is issuetl (Seclian 3W7. Gv. C). IFNDEfl: RUOPESS: �WNEB BUILDEB OECIABp710N: I �ereby alfirm ihat I am exempl irom �he Comracmrs' State License Law for Ihe following reason �Seclion 7031.5 Business and Pmlessional Code: Any city oi counry whicA requires a permil to tonsimcl, alter, impmve, Aemolish, or repair any SlmCiure. Orior lo iIs issUance. also requires �he appliCanl �or Suth permit lo lile a 5igneA S�a�emenl t�ai he/She is litensetl pursuanl lo I�e provisions ot ihe Comracmrs Sla�e License law (C�apter 9(commencinp with Section 7000) of Division 3 0l ihe Business anE Pmlessions COAe) or t�at �elshe is eMempt I�erelrom an0 Ihe basis lor Ne alleged eeemptian. Any violation of Seclion 7031.5 by any applicant tor a Dermil sublecis Ihe applicant to a civil penal�y ol not moro ihan live hunJreU Aollars (5500�. I. as owner ol the pro0etly or my employees wilh waAes as Neir sole compensation, will ao ine work, an0 I�e ❑ stmcwre is not imen0e0 or olleretl for sale �Section 70aa. Business an0 Pwlessional Catle: TAe Cantraclors' Slate License Law does not apPly m an owner of a pmperty who 6uiltls or impmves tAereon, anU w�o tloes such work himsell/herseli or thmugh his ar her own ¢mployee5. pmvitleU �ha� SUt� impmvemenis ar¢ n0i inlen0e0 Of Ofieretl �or Sale. I�, hOwever Ihe UuilUing or improvemen� is sala wilhin one year ol completion, ��e owner will have ihe Uurtlen of pmving he/s�e tlia no� builA or impmve �or �he purpose ai sale�. I, as owner ol ihe D�openy, am exclusively conlracting with licensed coniractors lo consiNct ihe pwject (Seclion 7044, Business ❑ an0 Professions CoOe: The ConVaclors' S�ale License Law aoes nol apDly to an owner ol DmDenY w�o bw105 or improves ��ereon anA wha contrac�s for such pmle��s wi�h a contraclor(5) IicenSC pursuant �a Ihe Conlrac�ors' S�ate License Law�. I am aware ��ai pmof of iheir Worker'S Compensa�ion insurance 5hoW4 Ge pmnaed to m¢. � I am ezemo� under Seaion: B. 8 P. C. lor Ihis reason: Date: Owner I ao hereby ceniry ihat I am aware ol an0 uneersianU the reQuiremen�s ot Cahbmia Healtn ana Safery COAe Sections 2550.5, 25533, an0 25534 and Ihal I or any IUWre builCing occupant will/will noi (circle one) neeU Io comply wii� saitl Slale wdes and t�e requiremen�s �or a permil lor conAmciion or moailicalion irom t�e Air Ouality Management Dislricl. FesiAenlial canstmttion applicalions are exempt irom IAese piovisions. �ale: Applicanl: I here�y t¢rufylhail have reaU Ihis apDlitalion an0 S�ate��aithe abmeiniormalionis tOrreCl. I agreeto Camply wi10 all Ciiy anU tounty o�tlinaMes antl slale Wws relatingto builtl�n9wnslmciion an0 AereUyaulhorRereptes¢nlalivesolth6 dryt0enteruponlheabove�meniionetl pmperiy lorinspedion purposes. % � Date: q � � s — `� Z $ignaWre: —_ �, � — Oriver's License or Social Seanty x: 16<Fn6 W�ile-6uiltling; Green—Lotle EnlarcemenC Canary—AOP��anl; Pink—Revenue; GolEanroE—Assessar CITY OF COSTA MESA — BUILDZNG PERMIT' PERM NO; H 0590B1 PERMIT NO; B 059081 PLAN CHECH NO; N GOVT; N SUPP; N CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/OFF RESHEATH 6 REROOF 40YR FIBGL COMP SQ FT; 5,080 CLAIM VALUE: 5,08U.00 CALC—VALUE; S,O60,00 GROUP OCC: R-3 / COMMENTS• REkOOF 2000SF PART OF RESID W/FIBGL COM �� T�(��Lrj� kiEiEiFifiFikiEiEiFif3E3(�1EiiiE�lFkiEifiEi6it�fiE3FiEifiEifiE�ififM�3EifiEiEiklEfElkiElfilifiEiFiEitifiEiflEiliF!! iE �r �1Fif i(�iE Z O N I N G R E Q U I R E M E N T$' S E T B A C K S p��'��5� �r�� ------------ MAIN BUILDING ---------- --------- ACCESSt�4'"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 PARKING_REQ___ PROV; PARCEL; 42620224 ZNE; REF NO; 1E ft k iE iF �E �E iF 3t �E iE 1f iE if K-9f if if if �If� if ik �f iF �F iF �f �E iF k 1E iE 1E k iF i(� k �k 9f ik �1! iE iF if iE jf iE ik iE iE 3E iE Ik if iE 3k iE iE iE iE rt �f af 1k iE iF * iE�iF'iE iE iE ie iE �e iE if if if D E V Ey�.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 BY DATE; BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY; DATE; ? ( . ikiEiEiklFlkiFiFiflfiEiEi(�if�IFiEifiFltifffdf ifif3FiEiEiFiFiflEiE �' #hM. iF iE iE if iF �k 1E iF IE iE iE ib iE iF iE iE iF iF iF iE iE iE 1E �f ik If iE if iF iE ik IE if iE 1E 1E iE if iE IF iE if If iE fE iE �f if iE IF iE iF k If X� 1f iE if ik if if iE jF aF aF iE iF iE if iF iF if if 1EiE iF iE IE ih LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMHSNG ELECTRIC MECHANIC FIRE SMIP%�ES GRADING -PERMIT 81,00 ,51 PLAN SMIP/1�DN—RES ISSUE FEE HUILDING—DIV—> PERMTT ISSUE PLAN—CHECK TOTAL PAIH` DUE TOTALS----> 81,51 0.00 0,00 81.51 81,51� .00 � REVENUE DIVISSON TOTALS--> COLLECTED: 81,51 OVER/SHORT: ,00 BLDG PMT PLIJMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADS,NG PLAN—CHECIC 51,�� ,51 : 1F �E 1F iE iE iF �E 1E iE iE iE iE �k iE iE iE iE-IF ik 3E iE if iE iE �E iE if if lf iE iE IF 1Eif iE iE iE if if ik iE ik )f # if iE 3F iE iFlF if iE iE IE fk �E ik �( if jE iE fFiE if� if if �k�F if iFlf iF if iE iF iF ih iF iE I N D I V I D 0 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 UNZT COST TOTAL COST SFR 5080 REROOF BY VALUE kESIDENTIAL NOZONE 1.00 �� 5,080,00 END OF FEES r�; , � � � � , '% G. : : . ,� , . : _' _ , . ;`; . .. . �. - ..._. i_:t, � CONSTRUC7�ON AND PLANNING - P�� A f APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector . ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �2. Soii Pipe-Undrgrnd. i 53. Stee4 Rein4orcement 3. Electrical Conduit Utility�Undr,grnd. 54. Forms 4. Elettrical Conduit�Undrgrnd. � 55. Electrica� Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footiogs 58. Electricaf Cqnduit�Undrgmd. S. Fo�ndation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-U�drgrnd. 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-Pinal 73. Roof Dreins � � 64. Plumbing System � Final 14. Rough Piumbing 65. Electrical�Final 15. Rough Elect��ca�-Conduit 66. Solar SYstem-Fina� 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiting 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT 20. Rough factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating � 71. ProducC PiPing OGas ❑Oil 23. Gas Pipe�Rough & Test 72. Underground Flush - 24. Roof Framing �73. Undergrnd. Storage Tank O Gas � Oil 25. Roof Sheathing ��7�pL ( p„�L 7q. Overhead Hydro -` 26. T-Bar Ceiling (S[ructural) & Monocoat 75. Dry Chemical 27. Frame and Flashirlq 76. Dry Standpipe 28. Wthing & S�ding � 77. FIXED SYSTEM FINAL 29. Insulation � 76. FIRE PREV. FINAL � 30. Drywall Nailing I I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � � 79. FINAL INSPECTION 32. Electrical Power Meter-Final � � � 80. FOOD CERTIFICATE ISSUED 33. Final Elec[ric. . � Notes: � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test I � � 36. Hood or Canopy � . � 37. Final FactorY Fireplace �. 38. Final Plum6ing � � 39. Water Service-Final ! 40. Gas Service-F�nal j � I � 41. Solar pomestic-Final � � � 42. Backflow Preventer � � ! 43. Backflow Irrigation 44. Landscape Irriqation System . 45. Sound Attenuation 46. Handicap Regulations �,,,��.��Z„ �� ,� ' 47. FINAL STRUCTURE & BUILDING �I�Z_ L.� ��, /. - IC! l.�T/ 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southem California Gas Co I � 1 51. CERTIFICATE OF OCCUPANCY No. Date V1YIV[K HpDROGI, WZ�+1� UAIC �-14-69 JOB ADDRE55 2094 Marian Wav BUILDING PERMIT N0. 29813 �. LOT TRACT 2 FIRE ZONE VALUE ECTIONS Sianaeure Date GROUP I - TYPE i .,..o....�. � R....7^vR W ATER ROUGH PLUMBING PROP. SWR. LINE � HOUSE CON. ❑ SPRINKLING SVSTEM MISCELLANEOUS ROIIGH HEATING ANO AIR CONDITIONING TEMPORARV SERVICE OR POLE UNDERGROUNO � POWER � ROUGH WIRING TRENCHES Q^,�FORMS �j,i57EEL REINF. FLOOR SVSTEM BOND BEAM ❑ STEEL REINFORCE � SHEATHING FRAME ANO FLASHING LATHING — IN DUT ' P" `_R, BROWN COAT Si .TURqL, FINAL HEATING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST � ELECTRIC, FINAL � � 298 I 3 , COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Fo� Applicant to Fill in Completely BVILDING . __, // //� OWNER G( MAIL ADDRESS S CITV CONSTFVCTION LENDER BRANCH ADDRE55 ARCHITECT OR ENGINEER _ ADORESS CONTRA[70R nooRess y7 � n M�.tiSa =�T� � M. STATE �ic.No. �S'3c'7� SIZE OFLOT Gps[/2P USE OF EXISfING BIOG. S i;1�� LG � SI2E OF o 5/ NO. OF NEW BLDG� '— K � ROOM: EXTERIOR WP.LL ROOF COVERING ST4G COVEP USE OF BUI�DING AND WORK TO B TEL. TEL. NosYGL CITv LIC. NO. NO.OF BLDGS. NOW ON LOT C�TY �, �;:�a��; i�ESA f : 11 1��g aTIOf�LEOR BUILOING PERM A.P. NO.��Jj � �Q,_,'�} :'SYj IOI BUIIDING �jo (/ ��17/GC/U.C!/� ADDRESSp� 7 TRACT �a LOT W A OWNER '%/f�I� ��f USE(A/Il� ()L(A�Q �VALU$ FIRE �� 20NE TVPE� / GRC APPROVED ZON NO.OF � PLANS p VARDS APPROVED MAIN BUILDING (FROM C/L STEIEET) DIS7ANCE MAIN BLd V AR. # USE OF NEW p.�.v� BUILDING VARDSAPPROVED y f / F BET. MAIN & ACCESS. BLDG DATE APPROVED ...r� . '.i,. I hereby ack�owl¢dge that I have read this applicafion antl state ' Mat the abo�e intormation is correct entl aB�ee m comply with all laws reguleting buildln8 �onstruttion, and 1 shall not employ any perzon i� �iolation ot [he workman's compensation lews ot the State ot California. � I hereby cerrify that I am properly licensetl es e contractor untlar SQ. FT. O the State of Calitornia Businezs antl Protassions Cotle, Divisicn 3, THE AMOUNT SNOWN UNDER VALUATION IS FOR a Cnapxer 9, antl [ha[ svch licanses ere In full forca antl etfect, or I THE PURP�E OF ESTABLISMWG A PERMIT FEE ONIv: Q am exempt trom the provlsions ot the Stete of California Business VALUATION antl Protessions Cotle, Division 3, ChepYer 9. J j}� m PERMIT FEE S / v ✓ � J Signatureof � �/ ,�/�,� U �9_.�( m Permittee �Gf �� Sl,�/� � PLAN CHECK 5 • V V E 0 q�� LL Authorizetl PBent TOTAL FEE S V V ( � , � � I 7444 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 COBTA M66A. CALIPORNIA For Applicanf fo Fi11 In Complefely TYPE OR PRINT BUILDING ADDRES6 2 C057A ME6A CALIFORNIA � 1 MAIL IARC✓'TEGT � HHTBAGK LINB FROM TEL. FEE RECEIUFD JUL 3 1962 A��{NI�.�O�O�E��R PERMIT fi �n� CITY OFgC�TBi�f�A � �� For Office Use Only NECEIPT NO. /PERMIT N�O/. / 7v/�-{T N6CEIVHD qY DATB HECE�YED I D�TE ISSUED // I �/ D i A �l�iSt _/_�. FIRE MESA. CALIFORNIA +nort Blvd., ZONING �SA CCLLZF• �ONE NO.OF USE OF R�1 I PLANS 2 I BUILDI� TEL. LEOAL T^ 1� � NO. O69CRIPTION 1Nt �T• 4 INO. OF BLD09. .�� _ OF WORK �� NO. OF ROOMS STORIES / ��!/GC�rR.nv�FwiNr .T� .L l P_ I HEREBY ACKNOWLRD6H iHAT 1 HAV6 R6AU THI6 APPLIGTION AND BTATE THAT THQ ABO IB CORP6CT AND AGREB TO COM- PLY WITH ALL CIiY R INAN [8 AND BTATH LAWB Pfi6lILATINO BUILDINO CONB GTiOt�. SIGNATURE OF PERMITTE AUTHORIZED AGENT YARDS EVES APPROVED ALLOWED (CENTHR LINH !T4 FRONT S � FT. �� R. SIDE "/� FT. �. SIDE '✓ FT. __"_ �'y __ TH8 AMOUM SXOWN UNOER VALUATION IB PON TXE PUPPOBC OF EBTABLI9HINp A pERMIT FEE ONLY. VALUATION !�i PERMIT FEE $ � � /� ��3� a �_ S � PLAN CHECK $ TOTAL FEE S /�-