HomeMy WebLinkAbout3366 MARIGOLD CIR - Building Permits.00n�ssa�eN�owo: 3366_MARIGOLD CI u"T _
an+EasruuEiFp+a'^LTATE, RICHARD JA TR FLOOD:�P,H-38
��w� 3366 MARIGOLD CIR
COSTA MESA,CA 92626 ,L�'
557-6927
MPL. YNLW� �UDIiE54:
. . �
/iflCNREtt ON F.NtlHEFA: 11C. N0:
AIMX.OFl FNO.'S /iWflESS: UNf:
coxm�crarsruxE MC KENNA' S AIR SUPPLY ( 714 ) 879-4444
cwm.cToxswuwa 761 N RICHMAN AV
�uonesxFULLERTON CA uc.No_ 626029
92832� �MT:
LICENSEO COMPACfOPS DECLAfl�TION: I Irontr� ellnn indx pmely d per'ryry Ntl 1 un 4meed uMm pm'vim� al Cheqm 9
(commmxin0 �ilh Saction ]OW) d Oivcion 3 d Ne Budnen end Pmleadnu COCe. end mY 6ronm u in IW lau ud Mtatl.
uc.lo.:069721 ��.��:C 2p ��j."0:62602///�9-�;� �EX�P: 04/98
DaIB: � � — I �"—H Cammr. /1 �M/ % "�Uh"a✓��
N BUILDEH UECIAFATION: I Mnby elfirm wder penely d perjwy thel I em eremq irom iM CoMredaa Liroeus lew lar ihe
folbwiq rmwn (Saeion ]0]1.5 Buenma end Rdeabm Gade: Aery cry a couMy whid� reQuime a paimn io aonavucl. eller. imPrmre.
�emdsh, w rapei eny st�vure: pior b Ga aaieme. abo �eV�� the eppfrau lu eurh pamii� to fJe e sqind stetemaM Mm M a eM
Ike�med Wnuenl �o �M pmv'vn W Ne CntlMon licenx lew �ClaPar 9(omvnenen0 wtl� $edion ]000) d Dvvun 3 d IM
ldma arM Prolavioro Cadel n ihai he a sM b azemW tnadeom vd the bem fa Ma dkv� exempon. MY violetion W Smion
1031.5 by e'ry eppliranl lw e pamil aubptls �M epplksn� lo e dvY penelly d twl maro �hen fve hurdrad ddlan �SSOOj).
� I. es ow�wr d Ihe pWMY or mY a^VbYb+wYh weqes m �lai eob cam0��. Yiildo IM wh. eM Ne evunu�a e M'uNentleE
a oflared I« eeb (`��b� )a6. Butimsa eM Prdmmrre Code: TM Com�mon lirenae LewEme mi npply�o en owroro/ papem/
who W iEa a'vnpewea tMreon. eM who doea ewh xak Nmaelf a henell a Mraph he a her avm empbyaea. poviEeE Ihet euch
�mv�m�a ae ��i�e a ort..e io,.w. n. nowa«. me w�amo «mw�w o.w .an� o�. v� a oomv�oo. m.
w�.a�ud« wi n�. in. w,da, w o��ro no «.n. ed m wad o, �aa+e« ms ww�e a w�l.
� I. m oxmr d iM C�WeM. em ud��'dy mMrop^0 xM Gmroed wNraclm b m�mw tlr pM� (Seaion )OII. Bwmwa aM
PMeeeions Cab: TM Caqeaqwe liceme Lew dom nd WdY b en wniw d popr�y Ma WiKv a impwn iherean vd who
wmrecn M uWi p9�� wph e mMmnla) IceiwE WnueN to iM Canirodon L'vne le�vl.
❑ i,m �a ��e« s«uo�: e. a v.c.. ro� w�:
I do Irreby cMM tlW I em ewus W W �Mw�WM tln �W��rea d Cel/arrie IYeEh uM SeIMV COM Sad'pm 25505. 25Sti. ud
PSSI,. eM thet I ar eiry Mw builtliep omq�ni. vrill / wil nal (� �) � to camqy wih eeid um� mdm uM tM rtpuiremenN la
epertntllormnsWclionamodiRutbnhomlMA��uei�y enepement0elntl.RniAeMialoonp�ud'qnappira�iwrouaeumplromlhsee
,, woNsb�.. _
Deie: Mp��:
WONKEH'S COMPENSATON DECL�PAPON: 1 Mraby dfvm iudar pe�y d peepiry ans a11M Idbwi�q detlue�iona:
� I heve eM wil meinlen a canEwa d mneen� io �atlivun M wakere' mnpanaetian, m pwkeE Iw by Satlion 3)00 d tha lebw
coda i« me we��e d ine �x i«.+:rn inm v� e e.�e.
_ fl � new.nd wu mmmeo wonere wmro�on inw,a�m... r.a��,ea M sea:n aoo a N. �ec« cae. ror me wn«menn w m.
7� wak la whicM1 Mie wrmu ie ieeueE. MY waken' cam0e��ion mararce wrix eM Gdiw numbar ero:
c�«: FUND EXPIRES
Pdry Number: � — ], �� Q 1� 9 B
.iis aecfion neM rrd b m+npxed / tM pamit u br aro hvnL�eE daJbre �Si0V1 w bv.l
� I wl'1y Ne� in Ne pMmrerce d IM work lor whih ihu qeme o uauetl, I tM1etl ml ampb/ eiry penan in eiry merv�e� eo n �o
becpre eubpa io �he vrorkme' canpametim 4xs d Cdilamia. uM ep�as Nm il I e1wuN beowm �ubjae to t�a waM1an'
� mpenm�ian piwieum o/ Sedian �100 d �M Lebor CoEe. I�^y jonhxilh wmpy weA
�.: /1—�2 —97 noa�a: /1P!?�::1� �Cif.lti,c[r....c�
m/np: F�Nun ro��cun wortxi �o�ro«,..no� ow...o. a w��l..wt .�w,w�.�epa.n «roior« ro edm�.� n.�,.m...�e
dHl flnu ,q ro om hintliM rhouuM JdYn lSf00,ro0A ��l�n ro M� cwf ol rompwwtbM1 Gmsp� �� povMM br In
5«tlon 9105 0l tlrs L�borCode, Inroruf, �rW �ttomry'� l�q.
CONSTPUCTION LENdNO �DENCY: I limeby elfirtn uMer penely d perjury Ow iMn e e wmtfudion bMi�q eperu.y br iM
pprlameMG d IM Nqk IIX whch Ihc W�i e ee1Nd (^a+Un'JW]. Ci.•. C).
LENDER'S NMIE:
LENDEH'S �ODNESS:
I eeelGy ihN I M1eva raed Ne epplirsiion eM 9ma tha the ebova'uJmnaian e canae. I epree toeomyy wilh NI dry vd wuruy wdinenoe�
entl stele lews reklvp lo WJOvp cananwlion eM Mreby eiMa¢e rapeaeMe4vm d Ilu¢ drylo enter upon iM eEove.manlionetl popeM
tor inepection purpowa.
DONNA TERAANOVE
/�-�h-ri-n.� . �'i -�-. o�a� �'Y��' l
Sgnmure d Owbd a
�S151d6.WP) Whue-Buiki�p d Selery:Oreen-FJe: Ge�wy-Appirant: Pink-Ra.ann: GOldervo�Asaewar
__ _._._ _ .. _ _ �._ .-_ CITY OF COSTA MESA -_ BUILDING PERMIT...
_. - - _ — - _- - _ . . _. .__ . PERM NO: M 08615
PERMIT NO: M 086156 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE.:__V.-N__ PERMIT TYPE: MEC PURPOSE: OTH
JOH. DESCRIPTION . ..:..FAU .CHANGE-OUT .__. . _ . ._ __ SQ FT;
CLAIM VALUE: _.. .__._ CALC-VALUE:_. _ GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED HY THIS PEAMIT
r*****�r**+rr�rw*rr*r***r�*r�***r*******�r******r+r+�+r+�rx�+rr�r*+r+�+�***+t+r**�*�e+r�e**+rr�e�r�e�e�r
Z O N I N GS ERTEHaA CIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN AEAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT ZN RGHT: FT IN
PARRING AEQ• PROV: PARCEL: 41218227 ZNE: REF NO:
PLANNING NfSTES>
1
Ifif1FMM±F1�'kiFfFfFMfFffNiFlFIkkMMftlkkifffififkififfFikifiFMiflEiklkiklFlkM1ElFiFMMMifMMlEikMlfiFifkkifMMifikiEiFifMlFlEfE3F�kfElElkfE
D E V E L O P N 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:
HUILDING APPAOVED BY : DATE: ,.
APPLICATION ISSUED
�r*�e*�e*x�rrr***�r*r*�e+�
LEGALIZATION:N
BLDG PHT
PERMIT.__
PLUMBING
F E E S U_M M A R Y
ELECTRIC MECHANIC
13.25
25�
�s��r*��r+�it*w*r��*+r
_ STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
PLAN _ �
ISSUE FEE 22.00
BUILDING-DIV-i PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
iTOTALS----> . _ 1.3.25 22.00 0.00 35.25 35.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: 00
BLDG PMT,PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
35.25
iF1FilifMl4iFMlfNkMlfffMMMMkMiFMMMiFMNMMkitiFMMMMMMiF1kMiFlfiEikiEiFil�IkMiFiFilkiklfMiFMMifMiFMlEMikikifi!lkM3ffEMMiEiI'M
I N D I V I D U A L F E E B A E A K D O W N
TYPE_�_. QTY __ D E S C R I P T I O N UNIT COST TOTAL COST
MEC_.__-. 1__ INST FORC-AIR/GRAV FURN <= 100 K BTU 13.25 13.25
END OF FEES
12-I2-1337/12:42 pol43�.25
fiCRTq:61-8�16ii3
PERtiIT=086%56
CONSTRUC710N ANDPLANNING. PSO. SPA _
� Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
7. Temporary Electrical Service�r Pole 52. Pool & Equipment Location
�2.rSoil Pipe-Undr�dr � 53. Steel ftein4orcement
� C
c F�i�lacVical Condui lity•Undr9rnd. 54. Porms g
'4 �fe'Ltrical�Cond - drgmd. 55. Electrical Bonding K
cu
, H„:� .�I Reinfoicea� ,�'j 56. Rough Plumbing & Pressure Test �,- �
�=�'�lectrical UFEfL'6rnd. 57. APPROVAL TO COVER•GUNITE �
i, i
,�1'�.".�ootings ti� �� 58. ElectricalCon���Undrgrnd. Q
a8� Foundation � S u V 59. Gas Pipe, � Umiigmd., Test t�*f
t � .,-.i_ ^' '
''�� Water Pipe�Unc�,j�('id.� 60. Backwash Lin���-Trap, O Undrgrnd.
70. Structural Floor_lSystem �c � 61. APPROVAL TD�.BECK
i t.'rF�roperry Sewer Lin6�"& Hous�Connection 62. Backwash & Receptor-Final
12., ewer Cap �; 63. Heater & Vent�Finai
C�3. Roof Drains " 64. Plumbing System � Final
4. Rou h Plumbi .� �"
r� e 'L9. x 65. Electrical-Final
•15. Rough Electrica;.Conduit •• 66. Solar System-Fi1t^I
�6. Rough Electri�iri� `�
67. Fencing & Ac¢Te,sg�.'Approval
�1�. Rough Wiring Sian a� 68. APPROVED ROR PLASTERING
18. Rough ElectricSS�T Bar Ceiling 69. POOI/SPA SYS1�h9S FiNAL
79.�lough 1{p�tic,+� &d�y( ConditioRirx� ;.�- K c- m �a � C' P3'I�E�i6P7'AiEQUIREMEfd�T E
r•; ': Su D C i*! K :y b7
20.�0 � F'atto1�' F lace i S:< :d r� S H�'* � APP;$6�Q[��+ �'" Pe mit#'� �, n
� +'+ � i rF XS $ H '7 �� e.. S.�`..�`7'� � ��-
21.�u�, i, tru`aurg� � �r-; M � n t..i (t* 70E-UndergaeJdd Hydro �
22.SJucis, L�entil6kingu * t ^:J *� �� ri M� . 71�. Prod i in as Oil
� a �*`� � o.
23. Gas;TJipe�o�jh 8S'�est i,_,�, QO * r' ,,. tr SM 72. Undergqaund �iush x �
24. Roof Framing * y# >�'-+� � 7"y, Under r d.St 1�� Tanh OGas QOiI
x 'L' N # "J 9 � �� �t
25, o yShe�athing F"�` `e v:� M
� � .:...r --+ �c -� [*1 �# . Overhead Hyd�qtr+ *
26.rcT-BarCeitin9 (Strat;tvral) & M6h6coat � O � O* 7Y, Dry Ch�('yal FD % S
27."ararifea Flashi � �Sx *� �' mr �•-�. Fc� .
� ro � �-� �+n::J a' � �+r 76. Dry Sta�iWP�C�-+ � .'""i nJ ^
� 28. Lat�ng�iSidingx* `v."".F O * I i � . FIXED�3YST �yFINl�"'� n G
C* S .. x I � iry ��?
29. Insulati�A �* � � � � � 7�, fIRE PREV. FAId�4L .x i
� 30. OrywalldSlailing �x r+ � * i- � I � S tuFJEALTRI DEPT. E�UIR�EMENT
� 31. Plaster P�fr w�Co�x `-� ;_,'�'�', * � �`' 79. FINAL,ry'p,V�jPEC'�ON *� �, �
:, 32.�Electrica�PoNe � cer�Fihal ! *� I 89i FOOD CERTIEICATE tS91JE8' K
�� 33.�int�Electri�' * � ' G r- �ic .L1 � '�:;-7 � "; O ?7
�r m� a i:-::, a .� x � jY ��urtes: c, mn r ;�S
�• � _. _
. 34.;,,Fina`F,Heatinq� Air,iC�ditioning ��.- g .: H i E•a,v a ��
35.�Finyl Gas Pipe=Test*� � •• �'" -'�' C'"`�^ ' �"
� . ..n�� t [T7 n
, 36. �Floo¢ or Cano n� � � � � � �
PY x C1 � C".,'•'1 # � � c*7 �O # R1 t'I
_ X
- 37. Pinat'Factory Fir�t$�e � ��","' " �' x" :" r cf`�
�+. �. G; f• C X N I rt W c�l (*` r: O
39. Fin Plumbin9 -+z: Fn�� � u q: � � .�c.��v o �C � X
39. Water Service-Fi�a!'r E . *�� � � > v 4' ''
.".. .� x � i-�u • M.^•t F
: 40. Gas Service-Finai ;`'� ��� ,:.: *" H v v� x cC
�+ 41. Solar pomestio-Fina� �i � � j t*' "'�^� 'J' * x �
- r. x^ fy �/ � S
A2. Backflow Prev nter� ., -� � � � ' � "
,� �.1 :� r- N # H 'i �; F'! CJ F
43. Backflow Irri� tion� r' * x * i z C� •
W v, tL` :::3 .J :��
�, a� � ir; :7 V'. R lT. v • M • .�
�44.�.�andscabe IrYigatio2System��u �,y * �,� Q:g _ � � w O�� a 5 F
�
45.; und /,stten�atiom: ... ' { m cT� [T7-' cr y.;-�n x:
c %i: �•K / e-IV1 ••H M;
�46. }iar�jcap'Regulatio�s � � x S I [Ti G CJ ��
`}7. I L STRU TUf�f & BUfLDiNG � F � � � � c * `�
.y
48.�IN�LP�ANNINGt � F"F" * n' � �
� :. I ' r, iu s �: ¢
49. lecuic Release to fidison � � i r t* �q •f"� � ~ �+
t t-i o.i x i7 u
:�0. �as'F'f�elease to SouT�iem Califo�n� Gas Co ° � � , S -�p "� . j ;,�
81. CERTIFICATE OFUCCUPANCY ' "
No. Date
I
PPOJECTRO�XESS: 3366 MARIGOLD CI
OCVTIEH'$NAME: TATE, RICHARD JR TR
nooness: 3366 MARIGOLD CZR
COSTA MESA,CA 92626
pfltM/ENGINEEN:
ROOflFSS:
NEG.NO.:
UNIT:
PENMIiTEE: WALT' S ROOFING ( �14 ) 847-1558
nooeess: p,O.BOX 1635
H.B. CA,92647
LICENSEO CONTHRCTOfl OECUMTION: I �er¢Oy aflirm tlut I am ticertseC un0¢r D«uons ol Chapt¢r 9(commentin0 m�h S¢c�ion
70001 0l Drvision J o� t�e BuTine55 anU Prolessi0ns COGe. ana rtry license is in �WI lorce antl effeci.
c�rruc.:050 75 srnTeuc.:400226 i ]�S`1�
oate: � " Sronawre: —GtJ lJ _
WOflNEflS' COMPENSRiION OEClAflP710N: I �er¢Cy aflum WI I iwve a Cerlilicat2 0� Co�eni Io ull-utwre ar a Cetli�iwtE 01 Worker5'
Compensation Insurance. or a certiliee cooY ��ereof (S¢Clion 3BW. LaO. C�.
POLICY NO.: 1 Q Q Z Q 1 1— 9 2 E%P. ORTE: O�I I O S� 9 3
caMraxr: STATE FUND
� Cenifie0 wpy is IrereCy Iumishe0. `� Cerufie0 topy ¢ fileA m/i�h t/1�/r',ry p7WEi O�ivaion.
�a�e: � � / — � � FODlicant: " — i / �A, `^V / •'"'�"/!/ �l
FSEMPTION FflOM WOPKEXS' COMPENSATION OFCLAMTION: (Ra SttEon neeA not G! cOmpklM it IM pGml b la are hunOreG (510D) w IesS�.
I certily tlWi in I�e De�ormdn[e af I�e wwk �or w�itll thi5 pefmit is iSSueG, I Shall nol emD�%any peRon in any mann¢r 5o a510 �ecome
subl�� �o Ne Workers' CompensaGon Laws ol faGtomu.
�� Date: Sqiwwre:
NOTICE: I�, a�ter mditinp IN5 Uetlarati0n. you 5hould Eemme wbiKi l0 th¢ Warkef5' Campensa�ion provision5 0� tAe LaOor
Lotle. you must lonlrvntn compry wit� su[II 0«0�6 or Ik5 p¢rmit SIIaO UE OremeO revakeE.
CONSTNUCTION LENOING AGENCY: I �ereCy atlirm Ilui lhere is a coraVuclion I¢nEing aAe�R' �of lhe OerformanCe ol �he vrork for
whic� Ihis p¢rmit is i55ued �Sttiion 3097. Civ. C).
LENDEP:
nooRess:
OWNEN BUILDFfl OECIAPRTION: I �erz0y affum Ilut I am exempt Irom iha CAntractor5' Sta@ LKense Law lor ItK tollovnnq reason
(Semion 703t.5 Business an0 Pmlessio�ai Cotle: pny cily ol wunty w�icA repuires a permii to consimq, alter, impmve, tlemolish, or
�epair any simcmre. Onor to i�s iuuance. also repuires t�e a0d��� �or suc� perrtot to lile a SipneE statemenl ihat he/stre i5 licensed
pursuant to the omvisions ol Ine Contracmri $Iaie licen5e Law (Chapi¢r 9(tommentinq wiih Sedion 7000) 0� Oivision 3 0� Ihe Business
antl Professions Coae) or IIWI he/sne 6 eeempt ineretmm anA Ihe Ea5i5 lar ina alleOeE e�emo��M. MY �oWtion ol Settion 7031.5 �y
any apDlicanl lor a Oermii su61ec�5 Ihe applicanl Io a ciWl penaliy al no� mora Ihan live �unAreA tlolla6 (5500�.
I, as owner ol t�e Omperly or my employees xilh waAes as t�eir 5010 tompen5ation, will Oo Ihe work, and l�e
❑ simclure is nol inlendeE oi o�l¢reE lar sale �Section 76aa. Business anU Prolessional CoEe: The Comncmrs' State License Law
Goes no� aDO�Y �o an owner ol a pm0eny wtw UuilOs arimproves t�ereon, anA who tlaes suc� work �imsell/Aerself orihroup0
his or her own emO�oYees, pmd0¢G IAaI 5ut� imDrovem¢nis am nOt ini¢nd¢a or ollere0 for 5ale. II, howBver Ih0 buildinp ar
improvemeN is sol0 wilhin one year of comDletion, ine owner vnil luva Ine ourtlen of O�ovinB �e/she Oi0 noi build or impmve
forihe Durpose ol sale�.
I. as owner ol ihe DmDert , am exclusively coniractinp witn IicenseA wnlraciors to cans�mci t�e D�oleci (Section 7044, Business
❑ ann Professions COEe: TXe Contractors' Slate license Law Gces not appN �o an owner ol property w�o Dw1As or impmves tAereon
an0 w�o coniraclslor sucA pmlecls wrttl a conlracior(s)license DUBuam to tho CanVactors' Sla�e License Law),I am awam
Inal prool ol Nei� Worker's Comce�3��ion insurance shoWO Ee provi0¢0 lo me.
� I am e�empi untler Section: B. 8 P. C.
lor I�is reason:
Oate: Uxnec
I do here�y ceriily Ihal I am aware of anE unCerslantl I�e reQuiremmis ot Calilarnu Hea110 and Salety CoOe Sections 25505, 25539, and
2553A anA ihal I or any fuWre Uuiltlinp occupant wilUwill nol (circle one) neeA to comply wit� SaiG state co0es and ihe requiremenls lor a
permil lor consimction or modilicalion imm i�e Air Ouabry ManaAement Oisirict. FeYAenlial COnsiNction applicalions are exemD� �mm
�IICSC O�Ovi5i0�5.
Oate: MD�icant:
I h¢reby c¢riify I�all �avereatl t�is applita�ion an0 Slalellwtl�e abov¢info�malion is mrreti. Iaqree�0 tOmply wilh all tily and counly
orainances a� sta�e Wws rela�ing io DuiWing wulruc�ion aM OereUy auttarrze reD�e maiiues ol Ms dry m emer upan the above-mentione0
pmperty lar ins ection pur0oses. 1 — /�/�
�ate�. �� /� �� Si9nature: _"� - ' ' ``
odvers lfcense or Saiai Securny p: �
I6dt�06 W�ile—Builping: Green—Code EnlorcemenC Cenary—AppbranC Pink—Revenue; GoleenroC—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05799_
PERMIT NO: B OS'7999 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : REROOF WITH CLASS A COMP S� FT: 3,000
CLAIM VALUE: 3,000.00 CALC—VALUE; 3,000,00 GROUP OCC: R-3 /
COMMENTS: REROOF O/1 LAYER OF WOOD SHINGLES
�t+r�r�r*+t*�r���**�t*�r�r�r�r�x�r�*�x*��t+r�rr�r�r**rt�t�r*�r�r�r*�t*�r*�rx+r;����t�t***�r*x•*****�*�******�r#**
Z O N I N GS ERTEH�AUCIKRSE M E N T S
------------ MAZN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT ZN RGHT: FT IN
PARKING REQ• PROV; PARCEL; 41218227 2NE; REF NO:
PLANNING NOTES>
� � �._ .
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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�7�S
ZONING APPROVED HY DATE• '^
BUILDZNG APPROVED BY :_
APPLICATION ISSUED BY:
if if 1E iF iE 1E i! iE �E if 1E if iE ik k!E ik 3F iE iF iF ifiF'ii
3f iF 3! iE ik if iF aE iP iF if 3F iF jE iE if IE iE iFiE iE �E if �k
LEGALIZATION;N
IF if if if K 1f k ik ik 1f k�!
F E E S U
DATE: ,-. /
DATE: '—�( �
i�iF3FikififjF3F1Fi6iEiE1E . c rikit
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'A R Y ,STRUCTURAD SEGMENT;Y
. i
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE � SMIP/RES GRADING
PERMIT 54.00 ;,� .50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK
TOTALS----> 59.50 0,00 0.00
REVENUE DIVISZON TOTALS--> COLLECTED: 59
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE
54.00
TOTAL ' PAID DUE
54.50 54.50 ,00
,SO OVER/SHORT: .00
SMIP/TO'I'� GRADING PLAN—CHECK
. 5,�
if if 1E if IE 1E �1k iP IEik iE 1E 1F i4 if if If if 1k IF IE 1E if iF iE iF if iE aE iF iE 1t 1E ff if iE iF it if iE 1P �E �t jf k 3h iF 1f a(� it 96 #�)f iE if if �f� 1f if *�f �F iF iF if 1F 1E iF fE iF if iE iF iF iE iF jE �F IE
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T I O N UNZT.COST TOTAL COST
SFR 3000 REROOF HY VALUE RESIDENTIAL NOZONE 1.00 3,000.00
END OF FEES .
i
�� ' ' ' I
CONSTRUCTION AND PLANNING
1• qPPROVALS Permit#
1. Temporary Electrical Service or Pole
2, Sail Pipe-Undrgrnd.
3. Electrical Conduit Utiiiry-Undrgrnd.
4, Electrical ConduibUndrgrnd..
5. $t2el Reinforcement
6. Electrical UFER Grnd.
7, Footings
8. Foundation
9. Water Pipe-Undrgrnd.
10. Structural Floor System .
11. Property Sewer Line & House Connection
72. $ewer Cap
73. floof Drains
14. flough Plumbing
15. Rough Electrical-Conduit
76. RoughElectricWiring
77. Rough Wiring Sign
18. Rough Electrical�T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Firepiace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe•Rough & Tes[
24. Roof Freming
25. Root Sheathinq
26. 7•Bar Ceiling (Structurall & Monocoat
27. Frame and Flashing
28. Lathing & Siding .
29. Insulation
30. Drywall Nailing
31. plaster Brown Coat
32. Electrical Power Meter•Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or.Canopy
37. Finai Factory Fireplace
38. �inal Plumbing
39. Water Servite-Final
40. Gas Service�Finai
47. Solar pomesticFinal
42. Backflow Preventer
43. Backfiow Irrigation
44. �andscape Irrigation System �
45. 5ound Attenuation
46. Nandicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAI PLANNING
49. Electric Release to Edison
50. Gas Release to Sou[hern California Gas
51. CERTIFICATE OF OCCUPANCY
No. Date
Date � Inspector
0
I
POOL 'A
APPROVALS Permit #
52. Pool & Equiprnent Location
53. Steel ReinforcemeM
54. Forms
55. Electrica� Bonding
56. Rouc�h Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Electrical Cpnduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P�Trap, O Undrgmd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Hea[er & Vent•Final
64. Plumbing System - Final
65. Electric2l�Final
66. Solar SYstem-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Undeiground Hydro
71. Product Pipirig O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storaye Tank O Gas ❑ Oi�
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe ,
77. FIXED SYSTEM FINAL
Oate � Inspector
78. FIRE PREV. FINAL _�
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECT�ON
80. FOOD CERTIFICATE ISSUED
Notes:
Aoo���ant to till in all spaces except those witnin heavY eoraer lines antl sign all aoDroorlate Oeclarations.
cirv oF EOSTA aME� a/ O �j/R�UC��TI,O,/N PERM
Project Address ��___t��.I.d_�b_(S�L,L��i—
• �A.pplicanYs Maili �d.r/Qs-s�, ' ' `��p
Owner's Name /�4✓��j��� T�J� Phon� A21J
Address �fP'—(Y�Lt �L�aO �af `C. iL '
Arch/Eng. License No.
Address ��7��7��
Comraaor'sNam - Phone_(J,7.eect�i
Address (mailing) � �l / 4�
City License No. �._a_�7S 3 1
LICENSED CONTRACTOR �ECLARHTION
1 her¢by dffirm Nd� I am litensetl un0er provlsions oi Chartei 9(commencing
with section 7000) of Division 3 of the Business antl Grofessions Cotle, antl
my license is in f f e ntl effect. /
License C ss IC � o.
Date�` Si9nature �
WORKERS' COMPENSATION DECLARATION
I he�eby af9�m that I have a certiflCa[e of mnsent [o sel/-Insure or a certlficate
Workers' Compensation Insurance, or a rertiTietl cOpy thereof (Section
.0, Lab. CJ /J/� )/j / /� �%
olicy No. ___aL-=(_._(�fGL Company � �'�--+' �
�Certifietl mpy is hereby furnishetl.
Cer i ietl op �letl with [he city�tl�ng Di��/ �'�76�/
Date�� AOP��cant _r.eii���1
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thi55ec[ion neetl nat be completetl it the permit i5 for One huntlretl ($300) or
less).
I certify that in the Oerformance of tne wOrk for whlch thi5 perm�t i5 i55uetl, I
snall not employ any person in any manner so as to become subjec[ to [he
Workers' Compensation laws of California.
Date Signature
NOTICE: Ii, atter makin9 ihiz �eclaraUon, you snoultl become subject to the
Workers' Compen5ation pwvlsions ot the Labor Cotle, you mu5t forthwith
compry wilh such provi5ion5 or this permit Shall be tlGemeC•/evoke�.
CONSTRVCTION LENDING AGENCV •
I nereby at(irm thai there i5 a conztruction lentling agency tor tna Oerformance
of the work for which [his permit is Issuetl (SeCtion 309] .Civ. C.)
LCntler's Name
Le�der's Atltlrezs
OWNER BUILOEH �ECLARATION
I he�e0y afflrm that I am exempt trOm [he Cont�aclor's Lic¢nse Law for th¢
following rea50n (Seclion 7031.5 BuSinesS antl ProfeSsional Cotle: Any dry ot
munty whith requl�es a pCrmlt to construtt, alteq improve, tlemOlish or re0ai�
any structure, prior to its issuan<e, alm �eqW�es the applicant to� such permi[
to file a si9netl SWtement that he/5M1e is Ilcensetl pursuant to the provisions of
the ConVactor'z License Law (Chao�er 9(commencing with Section 7000) ol
Division 3 0( lhe Bu5ine55 antl Prof¢STIonS Cotlo) or that be/The Is exempt
'��efrom antl the ba5i5 for the alle9ca exemOtion. Any violatlon of Seclion
LS by any appllcan[ tor a pe�mit subjec[5 IM1e applicant [O d clvil
elty of not more than five huntlretl tloliars (E500).
LJ 1, as owner of tba OroPerty or my employees with wages as thelr sole
cortlpenSaUOn, will tlo the wolk, dntl [Fle situcture IS not Int¢nCetl oI off¢r¢tl
lor sale (Section 7044, Business anE Prote55ional Cotle: Tha Contractor's
License Law tloes nol appty to an owner ot a property who builtls or improves
ther¢On, antl who tloes such wOrk himself/her581f Or t�rough hi5 or her own
employees, prOvitletl that sutlt imOrovements are no[ intendetl o� ofteretl tor
sale. If, however, [he �uiltling or improvament is 5oltl wlthin ona year ol com-
pletion, [M1e own¢r wlll have tbe burtlen 0/ proving he/sne tlltl nol bulltl o� im-
prove for tne purpose ot sale).
❑ I, as owner of the property, am exclusively contracHn9 with Iicensetl con-
tractors to wnstruct the project (Section 7044, Business antl Professlons eotle:
The ConVactor'S Li<ense I..aw <loes mt apply fo an owner of property who
builtls or Improves thereon, antl who coneracts for such projects with a con-
tractor(sj litense pu�suant to fhe Cantracto�'s Llcense Lawj. I am aware tha[
proof of their Worker's Compensatlon insurante Shoultl b¢ provitl¢tl to m¢.
❑ 1 am exempt untler Sectlon B. & P. C. for this reason
Date Owner
I hereby certi(y that I nave rea
information is <orr¢ct..l agree t
antl sta[e laws relatin9 to bi' ir
sentatives of this ty nter
inspection pur s
Signature �
Drivers' mense or 55 �
TVPE OF CONSTRUCTION LI NEW I.J ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p �,
DESCRIPTION OF WO(iK/USE OF BLDG. S Main Building:
E
TVPEOFPERMIT GRADING FOUNDATION STRVCTURAI. T Front
❑ TENANT ❑ ELECTRICAI ❑ PLUMBING ❑ MECHHNICAL B Reel
❑ 07HER %�
C Right
PROJEC'�DESCRIPTION 54. FT. ocCUPaNCv K
CONSTftVCTION TYPE VALUATION $ S Left
ZONE GRADING CU.YDS. ACRES p��y, Ref, #
Remarks:� Planning Notes:
Backflow Irrigation
Clarifiers
Dishdcasher - �
Drinking Fountains '
Fioor Drains
Floor Sinks
Gas Service Outlets
<irehen Sink
Lavatories
'—Trap
Roof Drains
Reinspactlan Fee §15
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System �❑ Multiple ❑
Firepl/Fact Blt. ICBO #
Heating System & Ducting
❑0-100,000 BTU 0100,OOOBTi
Reinspection Fee � $15
CMF 0865-46, rev. 10/84 White - Huiltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assezsor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash
laue Fae
Hood or Typel ❑
Canopy Type II ❑
Retrigeration System
❑o-i ao,000 eru ❑ i oo,000
System Repair/Alteration
Fire Dampers
Fegisters
Is�e Fee
5 3
$ 3
Automatic Washer
Construction Pole Sub.
Cookin9 Unit
D ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0�5 KW C
Fee
2671 I/06/88
Zone
Actessory Building:
Parking Req./Preyi�qd 4Q�
ELECTRICAI
Transformer ❑ 15-50 KW
❑ 50 + KW
Meter ❑up to 700amps
Meter �over100amps
Sub Panel
Motors OO-7 HP �i'r4 - B
IncSolar �9-15 HP��16-15+
Microwave
Pole Light
Range
Standing Sections
5�15 KW Trash Compactor
$15 luue Fea
DEVELOPMEN7 SERVICES REQUIREMENTS:
2aning Approved By
Building APProved By
5000 TL
FEES
S 3
Z
O
N
I
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G
R
E
Q
M
T
5
SUMMARV OF FEES
BUILDING PERMIT $ SMIP S
PLAN CHECK $_� Q G PERMIT �
PLUMBING § ISSUANCE S
PLAN CHECK 25% $ ENERGY P.C. S
ELECTRICAL S _ GRADING S
PLAN CHECK 50% $ MICROFILM S
MECHANICAL $ TOTAL FEE $ �i..(�IIL
PLAN CHECK 25% $
CONSTRUCTION AND RLANNING POOL & SPA
APPROVALSi Permit:# Date Inspector AppROVALS Permit # Date Inspector
1.: Temporary �lectrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ' 53. Sieel Reinforcement �-� �
,..
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding t-s
5. Steel Reinforcement 56. Rough Plumbing & Pressure T.esi
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUrp11TE
7. Footings 58. Electrical Conduit-Undrgrnd_r=,r
8. Foundation 59. Gas Pipe, O Undrgrnd., Tesilj �
9. Water Pip¢= ndrgrnd.� ; 60. Backwash Lines, P-Trap, ��-.l.ndrgrnd.
r
70. Structural Floor System 61. APPROVAL TO DECK �
7 7. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final �
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar (;eiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heaiing & Air Condiiiorting FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test ' 72. Underground Flush
24. Roof 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 DEPT. REQUIREMENT •
31. Plaster Brown Coat 79. FINAL INSPFCTION �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Etectric Notes: •
34. Final Heating & Air COnditioning ' , -�
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing ,�p„� �j • �
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer • � ,
43. Backflow Irrigation '
44. Landscape Irrigation System
45. Sound Aitenuation '
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
,
50. Gas Release to Southern California Gas Co �
57. CERTIFICATE OF OCCUPANCY . '
No. Date �
t
CITY OF COSTA MESA REQUEST FOR OCCUPANCY
TRACT N0._� -( \ g Q DATE ,�,1-13
IpT N0. ���
ADDRESS 3'-� (o� C'\(�Q..�Ge�-h ���-•
The developer of the above entitled tract desires to sell the above set
forth lot prior to the time that the tract has been completed and its streets
accepted by the City of Costa Mesa.
The undersigned, by executing this agreemen:, acknowledges that
(�re-�she-t�e�-) �� (was -_ --___) ;,,�A� advised that this tract has
not been given final inspection nor has it been accepted by the City of Costa Mesa
as having complied with the conditione of approval which were imposed by the City
at the time the final tract map was approved.
The City assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by surety bond.
The undersigned agreea to'indemnify and hold the City harmless from
any claim resulting in damage or pereonal injury to the undersigned by reason
of the aforementioned uncompleted condition.
BY ��,.,r�,e . / '�,.,.a�C:Kci 7�. /GI/li.
Purchaser
aY lsy�.�--,.,.� � � � �.-�-���
Developer and/or authorized
Yepresentacive
BY ���[,G��(L lcJ/�e'cp�Cot✓
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35i�a
COSTA MESA BUILDING-SAFETV DEPARTMENT
3�ZAI�.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
�
For Applicanf to Fill in Completely
BUILDING
ADDRESS Mari old Circ�_
OWNER Larwin Southern California lnc
MAIL
aooREss 16255 Ventura Boulevard
c�Tv Encino, Califomia No`.986-8890
� � „vaioOO10£33* ��*15�i.34
0� 15-7ccnsn
4TION FOR BUILDING PERMIT
Y DATE FECEIVED nnTc isani
��/%�L �
��
TRACT
BRANCH 16ZJb V entura tSoulevara �
ADDPESS Encino, California �WNER
ApCHITECT LARWIN TE�.273-4q64 SE
ADDRE55 yi�� wiisnire �siva. nev. ni
CONTRACTOF Larwin Southem California,
nooaEss 16255 Ventura Boulevard
TEL.
CITV Encino, Califomia N�� 986-8
uc Tivo. 191311 uc No. B-1
O'F LOT 6O X ZOO I NOW ON LO S�
USE OF
EXISTING BLDG.
SIZE OF NO. OF
NEW BLDG.I9HJ qOOMS STORIES
COVEERINGALL StUCCO COV�ERING Wood Shin
USE OF BUILDING AND WORK TO BE PERFORMED
Construct $inctle
I hereby acknowledge that I have reatl this application antl state
ffiat the above information is mrrect antl agree to comply with
all laws regulatin8 builtling mnstruction, antl I shall not employ
any petson in violetion ot the wOrkman's compensation laws of
ffie State ot California.
I hereby certity ffiat I am properly licensetl as a conhactor untler
the State of Califomia Business antl Protessions Cotle, Divisicn 3,
Chapter 9, and that such licenses ere in full force antl etfect, or I
am exempt from the provisions of the Stace of Cali(ornia Business
antl Protessions Cotle, Division 3, Chapter 9.
Signature `__� � . Downs
Permitte Al..//L�S`-�
�
Authorizetl Aqant
FIRE
ZONE
APPR
ZONE �I INO.OF
PLANS
VAR�SAPPROVED
MAIN BUI�DING
(FROM C/L STFEET)
VAR..I�
C.U.P.�
APPROVED
THEAMOU�
THE PVRPOSf
VALVATION
$ zq�aa
VALUE
DATE /—
USE OF NEW��M1/ f'i(}
BUILDING �� a•�-7� �i
VARDS APPROVED
ACCESSORV BUILOING
eET. MAIN &
ACCESS. BLP
DATE
APPROVED
'�j m
% ' o
VA�UATION IS FOR �
A PERMIT FEE ONLV : ¢
E $ � �
]
%J� m
Kg � E
S LL
S
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