HomeMy WebLinkAbout3323 MARYLAND CIR - Building Permits��
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��s MBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
,lobnddress: 3323. MARYLAND CI
Suite No
Vicinity:
Parcel Nunmber: 13961129
Applicant:
Address:
Owner:
Address
SPALDING, JASON
17390 MT CLIFFORD CI
FOUNTAIN VALLEY, CA
MUNSELL, GREGG M
3323 MARYLAND CIR
COSTA MESA, CA
Phone: 714-241-1414
Zip: 92708
Phone:
Zip: 92626
ISSUED BY:
�
Contrector: COAST ROOTER PLUMBING HTG AND AC
Address: 17390 MT CLIFFWOOD , ,
, Phone: 71
FOUNTAIN VALLEY � Zip: 92
� License: 529727
SCOPE OF PERMIT
CHANGE OUT (E) WATER HEATER FOR SFD.
ISSUE FEE
Backflow irrigation
BackBow Preventer
Balhtub
Clarifer System
Connect Qce,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
$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
50.00
$0.00
so.00
$0.00
�
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY
AMT
LaundryTub/Washer � $0.00
Landscape Irrigation � - 50.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
Receptors $0.00
SepticTank � $0.00
Sewer Cap for Demo $0.00
Sewer Connect , �$0.00
Sewer Private Line � . $0.00
Shower - $0.00
Sink, bar ' ' ' - $0.00
Sink, commercial '' "- . $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) � 50.00
Spa (public) - , $0.00
QN
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0 �
0
0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 10/03/2006
Issued: 10/03/2006
Sump Pump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-0)
Vacuum Brkr Bkflow(5+)
Wash Basin - .
Wash Basin Set
Waste andYenfSystem
Water Closet (Toilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Waler Ser4ice
Water Softener
OTHER
VIOLATION
PLAN CHECK ,
- REINSPECTION
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES: 535.80
Qrv
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
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, 12-27-92)
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 180 days.
INSPECTIONS: In order for ihe work authorized under �his permit to be considered legal, such work must comply with all applicable codes, and all
required inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of this pertnit.
FOR INSPECTIONS CALL: (774) 7545626
xaa�av fu�ao)
WORKERS'COMPENSAnON DECLARATION: -
I hereby efllrm under penelty of pehury one of the following declarations:
❑ I heve and wlll melnteln e certiticete of consent to self-Insure for workers' compensatlon, es proWtlad for by section 3700 oi the Lebor Code, for the performance of the
work tor which this permit is issued.
workers' compensation insurence, as requiretl by section 3700 of the Labor Code, for ihe pedortnance ot the work for which this pertnit is issued.
tion Insurence carrier antl policy number are: ,�--�—t.. .�. Lq,,,,f
� CP,olicy�Number-(�'�� iOC.VS
npleted iI the permit is valued at one hundred dollare ($100) or IessJ �
❑ I certity ihat in ihe performance of ihe work tor which Ihis permit is issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of Califomia, antl agree that if I should become subjact to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
comply with ihese provisions. q
Appl�nt SignaWre: ��I�. r'� te s"' i�� '.7"d�
WARNING.'FAILURETO UREWOFKERS'G MPENSA I NCOVERAGEISUNLAWFULANDSHALLSUBIECTANEMPLOVERTOCRIMINALPENALTIESANDCIVILFWESUPTOONEHUNDRED
TMOUSAND DOLLARE ($1 ,000), IN ADDITIIXJ TO THE CA OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIQV 3]O60F THE L400R CADE, II TEREST, AND ATTOPNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
provisions of Chapter 9(commencing with Section 7000) of Division 3 nt the,Business and Professions Cotle, and my license is in full
� C��,� a , c 3��.
� �� oa�e: ' :r��� -2 - u!,
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm ihat Ihere is a consWction lending agency for iha performance of the work tor which Ihis F�ermit is issued. (Sec. 3097, Civil Cotle).
LendeYs Name: Lenders Address:
Signature:
OWNER-BUILDER DECLARATIONS:
Data:
I hereby aHirm thet under.penalry oi perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW ror ihe following reason (Sec. 7031.5, Business and Professions
Code: Any ciry or county which requires a permi(_k'coFlsimct, alter, improve, demolish, or repair any stmcWre, prior to its issuance, also requires ihe applicant for such permit
to file a signed statement ihat he or she is licensetl puisuant to the provisions oi the Contractors License Law (Chaptar 9(commencing with Section 7000) of Division 3 of the
Business and Protessions Code) or ihal he or she is exempt therefrom and the hasis For the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit
subjecis ihe applicant to a civil penalry c� not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, antl the structure is not intended or ottered tor sale (Sec.
7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of propi;rty who builds or improves Ihareon, and who tloes such work
himsalf or herself or through his or her own employees, provided that such improvements are not intended or oHered tor sale. If, however, the building or improvement is
soltl within one year ot completioq ihe owner-Duiltler will �ave ihe burden of proving that he or she tlid not 6uild or improve for purpose ot sale.).
❑ I, as owner of the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business and Protessions
Cotle: The contractors License Law tloes not apply to an owner of propeny who builtls or improves ihereon, and who coniracts for such project with e coniractor(s)
license pursuant to ihe Contrectors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID venfietl by driver's license. ❑ Yes ❑ No Driver's License No.
Verification of Ownership by (type of dxument, i.e. - propetly tex bill or deed):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
Expires:
❑ I hereby cetlity that no axcavation tive (5) or more feat in depih into which a person is required to descend, will be made in conneclion with work authonzetl by this
permit, and that no building sirucNre, scaHolding, falsework, or demolition or dismantling ihereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, California Atlministretive Code).
❑ As owner-builtler, I will not employ anyone m do work which would require a permit from the Division of Indusirial Safery, as noted above, unless such person has a
permit to do such work fmm ihe division.
SignaWre: Date:
Division ot Industrial Safery Permit Number:
CEpTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certify under penalty of perjury Ihat I have read this application end state Ihat ihe information given is
wrrect. I agree lo comply with all state laws and city ordinances relating to 6uilding constructioq and authorize representatives of ihe Ciry ot Costa Mesa to enter upon the
above-described propeAy tor inspection puryoses. I agree nm to occupy or allow ocapancy of any building authorized 6y this permit until final inspection.
CODE I. INSPECTION TYPE
1616
1266
200
„ Signature Of Legal Owner(s)
Fized System Finai Fire Prevention
Pool Spa Final
Final Re-Raof
201 Finel BIocWRetaining Wall
202 Final Factory Fire Place
203 FinalSign
204 Final Demolition
tjejg INTR
cooe� 7y5PE�.11)NttPE
206 Final Mi:chanical
208 Final Plumbing -
210 Final Eli3ctrical
212 Final Fiia Prevantion
220 Final P1�3nning Approval
222 Finai Sile ' '
250 FinalBuilding/Occupancy �
p� nmtu�s
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RDONESSOGBUILpNG: 33z _� MARYLANL CI
ONNERSWYEIFIQAWN: (�SHOr{N, TIMOTHY, R
���� 3323 MARYLAND CIR
COSTA MESA,CA
�vv�. uuuxc nooness:
AIICXRECTOPFNtlNFEX:
APCII ON ENO.'S �DDRESS:
92026
UNT:
FLuOD; AE-37
uc. ea.:
IINT:
corim�crarsru�: KEMNITZ A/C & HEATING ( 714 ) 453-8500
CQAFACTOASMNIMO 188 TECHNULOGY
�opE�: IRVINE CA uc.xo: 695879
92718 urar: C
LICENSED COMRACTORS DECL�NATION: I Mreby ellnn uMer pera�y d perjury thet 1 em Icrued uMm poiuima d CMqs 9
(mmmenarq wilh Section ]000) d Oiveion 3 d iha Buarea aM PMeavma Cada, ard my liunae u in lull tace vd Mea.
cmuc.r+o.:063 9 uc.cuss: C_20 uc.no.: 69 874 EXP: 10/97
o�a. O ��,�
NEF BUIL D LAXATION: I hereby e/fi�m undar penely d perjury t I em eKemp t � I �nlretlae lirome lew /a Iha
IdlawFp rees ( ion )0�1.5 Buaires+enE Proleseions Coda: Any ciry a counry which e pa�m� to m�reVucl, aXer, impova,
� demoleh, or epei eny slrudure, prior to As bwenca, elso requires �ha epdie�ant br euch ! lo fib e aqned eletement thm he or ehe
i IicenseE W�%�^� to Ihe peovivma d �M Conlreqore Licenee law jCheqar 8(�mmviq xiih Sedion )000) d D'veion 3 d Or
,usirie� eed Prdeabns Codel a i1W he « ahe u examq thareimn ark iM bea lor tha elb0ed memqbn. MY videtion d SarJion
�mi s M enr eod�� �a a oem�n .�,4+� �ne aoWcem �o a d�i oe,�e�y a na mae �nen r e nu�k�ed ddivs �ssao�).
� I, es owner d ihe propeity or my empbyms vAh wapea m �he'v eole oompeneetion, will Co �he wak. end �he elnwYure w nd inleMed
w oRered fw eele (Secwn l0<4, Bueinese arM Prokssbns COEe: TM Comrectare Lirenae lew doea nm epplyto en owner ol propeity
wlio budde w'vnprow Iherean, end w}w Eree euM xvk IimeaX w hareeY a IMaph h6 a her own amplvyeee, pwided �hm such
impwemema are not iniaMed a WueE (or+eb. M, however, tM buJdi�q a'vnprv.emam u sold xnhm ma yw d mmpM�un, Me
owmr-0uiNm xiil heva iM WrEen d pwirp M a eha Eid nal EuiM a impv.e ta iM qvpoee N seb�.
� 1. ee mmer W �he propaM. � extlusrvely mnirenmp wuh licensad wnvectwe ro conmua tlro pmjea (Swion ]016. Bue'vms eM
PrWaeniona Coda�. The Conirenae Licenae Lew doea na epply �a en owner d propeM �o buiNa w imqww thereon eM v.fio
conVeas I« wrh v�s wnh e mm tor(sl IicenxE W�uem to ihe Comrea«e license Lewl.
� 1 un eumq wMm Saction: B. 8 P.C., b Nu �eamn:
Dero: Owner.
I do hereby ceMy ihet I em ewera d eM uMe�slerM iM repuiremeM� d CalAomie HaeXh enA Selely COEe SeGiam 25505, 25533, eM
2553a, erd ihm I w eny tNure buikiip oaupeM wiil / wil rw (vicb ane) naed to comqy wih aeid mma mdm md iha reQuiramann lur
epermnlpmuWc�unamodifimtionhantM�i�y a�pemenlD'¢fiitl.RmidenlielmMrutlbnappf�iamenmamqliomNete
a��,s.
De�e: Appliunc
W OPKER'S COMPENSqTON DECLAFATION: I Mreby dfirm uMr peneXy d psjivy aw d �M blbxi�q deduetiom:
p in�d,a.�;��m�e�r�.a�iio.�n:�.m.�n��o«�+dm...wo.�ee«ers,�,a�aoam.i.nQ
coae. r« me o�rto�a a�� iw �m m� oe�u m m.�d.
�I heve end xitl meintein xoM1en' mmpenminn insurerce, ea reQuirad by $aclion 9]W ol Ihe Lebor Code, b iha peAwmerim d�he
work lor whiM Nie parmN ia i»ueE. My wnkan' wmpenxlion insurariea remer aed pdiq numEer are:
c�, �p LIF COMP EXPIRES
Pdicy Number: c: ��S'��iS�— 0 Z/ O 1/ 9 8
�his sMiwr need na be wmpbfeJ! tM pemirt is la are hvnCieJ dd/ers (S1W/ a bu.)
�I � 1 wnly ihe� in ihe pe�ameza d iM xroh �« v.hch ihu permn ie i�uad, I ehell irot emdW enY Pa�� �� Nv menner eo n m
�bewme wbpa �o t' v.oh a' canpensetion le� d CelAomb. eiM epme thel ! I ehouk bacome eubptl �o iM xvken'
,���smim ww� � �s a e'� a>oo d ma iena, cma. i wu iunn.nn �pr �� mae � o�u
iJf
�_�"_ RPWi�aM: \ l��
�u�e�/y1,�enCaNllsWfecte ysiMralMnslpsnellluard
Mlltlon b fM cwt o/ ro r5 tlemq�s� �� poHtlM br In
Sxtlon Jl[I66/ tlrs Lebor Cotls, Infw�s4 ana emmeY'i ��u. (/
CONSTPUCTION LENOING AOENCY: I Mraby eifirm uMn penelry d perpiry 1l�et �M1em u e conatrutlion bMiip epem.y far tlro
peel«menm d tha xvM fa which Iho pafmi ia ivsueE (Seaon 909), CW. C).
LENDEH'S NCME:
LENDER'S ADOFE55:
I caMiN �het I heve reaE Ihia epqir.aiion vd mele �M1et Ue ebave inlamelion e co�rep. I eprae to mmply x±l� aA cry aM counN �invKee
eM slate lexe relmiip �o building canslrudion erd hereby author¢e repasenletivea M thu rny to enter upon Ihe ebova�mentioneE popa�ly
br inspociian purpoeas.
ROBERTA STENTZ / /
�
(5151de.WP) WhAe-BuiNiq 8
Rnk-Revenue:
�.
CITY OF CGSTA MESA — bUILLING PERMIT
PERMIT Nt�: M 084975 PLAN CHECK NG; N
CGNSTRUCTION TYPE:
JOH DESCRIPTION ,
CLAIM VALUE:
V—N PERMIT TYPE: MEC
INSTALL 1-91,000 bTU FURNACE
CALC—VALUE:
—Dop
PERM NO: M 084975
GOVT: N SOPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: X
1h 3F ik iE ik'1F iE iE iE �f �F'1F �E i(� iE iF 1E iE iF iF if iE if iF iE iF 1f if iE 3F ik iF if'1E'k� if iF iF iF i! if ih if iE iE if iE iF 1E 3F if �E iF if iF iF if if'!f if ih ih �E'lF iE'1E 3f iF iE if iF iF i@ iE if' iE 3F if ie
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGFiT: FT IN
PARKING REQ; PROV: PARCEL: 13961129 ZNE: REF NO:
PLANNING NOTES>
i
M iE if 1E iF iF 1F 3k iF iF if iF ik iF iF i! if iF iFlk if if iE �lE iE �E iE if �lf iE iE iE �E iE 9f iE aE iF jF �f iF if %if if iE iF if 3f iF if iE 1F i6 if iF if if jE iE iE if if iF if i't i6 iF iE 3E iE iF 3E iE iE i't if if ie
D E V E L O P M E N T S E R�V I C E S R E Q U I R E M E N T 5
ZONING APF+ROVED HY "A DATE:
HUILDING APPROVED BY : %i�J/l_ .r DATE:
APPLICATION ISSUEU BY
if iE iE iE if if 1E 1F �E if M �E iE jE if if jf iF 3! iE it
LEGALIZATION:N
PEftMIT
Pt,aN
ISSUE FEE
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC
MECHANIC
13.25
25R
22.0�
iEif-iilfiEiEii1E34ifiE'lfif E�Fi��iFiF�iF�iF1f
STRUCTURAL SEGMENT;N
FIRE SMIP/RES GR.z.DING
SMIP/NON—RES
BUILDING—DIV—> YERMIT ISSUE PLAN—CHECK TOTAL PAZD DIIE
TOTALS----> 13.25 22.00 0,00 35.25 35,25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: .00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
35.25
if iF iE if !f if ik 3! jF * ik if 3F iE jf iF jf 1E 1k 3f 3t ik �t if iF iF iF iF �k iE i! iE dF iE iF iE ik 3F if if 1k it it if iF 1F ik jf iE it 1F �F iF dF if it �E ik iFt iF iE 3k iE �E iE iE iE * iE 1E iE �f dE iE iE 1f ik ik if
I N D I V I D U A L F E E H R E A K D O W N
TYF�E QTY D E S C R I Y T Z O N UNIT COST TOTAL COST
MEC 1 INST FORC—AZR/GRAV FURN <= 100 IC BTU 13.25 13.25
END OF FEES
.� D
1lv � ie-ei-iss�iei:z� wvs�s.�s
�A.� o RCATis81�813128
PERMITe084975
� CONSTRUCTION AND PLANNING POOI ,PA
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
i. 7emporary Electrical Service or Poie 52. Pool & Equipment Location
2. 5oil Pipe•Undrgrnd. � 53. Steol Reinforcement
.3. Electrical Conduit Utility-Undrgrnd. 54. Porms �
4. �lecirical Conduit�Undrgmd. 55. Electrical 3rnding '
'.5: Steel Reinforcement 56. Rough Plumbing & Pressure Test
6: Electrical UFER Grnd. 9. APPROVAL TO COVER�GUNITE
"`-7: �ootings 58. Electricai Conduic�Undrgrnd.
_ - --r-
8, Foundation " � 59. Gas Pipe, (7 Undrgrnd„ Test
' 9, Wate� Pipe-Undrgmd. . 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural FloorSvstem ' 67. APPROVAL TO DECK
il. Piopercy Sewer Line & 4ouse�Connection 62. Backwash & Recep,tor�Finaf ,
�2. 5°We� �P - � 63. Heater & \�ent•Final
13. Roof Drains _ ' 64. Plumbing ;;ystem - final ,
14. flough Plumbing. 65. Electrica6Final �
15. Rough Electrical•Conduit - 66. Solar SYstem�Final �
.i 6. Rough Electric Wiring 6�. Fencing & Access ApProval
17, qough Wiring Sign - 68. APPROVED FdR�PLASTERING .
78. Rough ElectricaGT Bar Ceiling 69. POOUSPP, SYSTEMS FINAL �
79. Rough Heating & Air Cbnditioning FIRE DLPT. REQUIREMENT
- - 3 - • � -
20. qough Fac[ory Fire�lace '� r?; ; � �., r'� APPROVAlS_. �-, Permit # t -
21, Oucts, in Structure i • �� - _ = -• * 70. 'C.Inderground t{Ydro `
�
22. fJucts, Ventilating,_ i . ��"+ � 7l. Produet Piping O��as OiV
23. Gas Pipe�Rough & Tesc � -. '� 72. Underground Ftush
Y i
24. Roof�Framing t ' �� ;: - - _ 73� Undergrn'd.Stara9eTank C�Gas ❑Oil
25. Roof Sheathin9 • � ` '_� � ' � 74. Overhead Flydrq ,
26. T-Bar Ceiling (Strucfural) & Moqocoat � y � �'_: i 7�, Dry Chemical _. - �"
27, Prame and Flashing : _ . - � . •� :� ? 76. Dry Starid�ipe -� �
,
28. Lathing&;Siding � - - . . � '� " "�," 7Z, FIXED,SYSTE�t;FiNA��., -
; ... _ ,
29. Insulation + � ^ � i �+� 78, FIRE PRE`J. FI(�fAL � - '
30. �rywal� Nailing � ,. � � Jr, � .NEALTH DEPY.REQUIifiEMENT
31. Plaster BrDwrrCoat : •• � � k� 79. PINAL INSPECT'tDN '
- - �
32. Electrica�Power Me�er-Fi�al t' � :� 807 FOOD CERTIFICATE t�S�IED, �
- 33. Fi�a4 E4ectric � � Notes: - : � .
34. Final Heating'& Air Conditioning"• y,q_.�_�� (�,�� T� ` � � -
d u
35. Final Gas Pipe-Test ; . . , . � �� - _. . � � ^
36. Hood or CanoPY ' , � � _ ' � � '¢
;; - , .�
� � . , � , . � � . , i . .---r-q-, .
37. Final Pactory Fireplace- - � � � � e � �
� _�
38. Pinal Plumbing - ' ' � . - , ' _ �'u ---
� � �
39. Water Service�Final ; . , - ' � " " ' '
i �
40. Gas Service-Final + � �� � ; • -. , - ` .
41. Solar pomes[icFinal _ � , ' , �, ; =.� _ y x -
42. Backtlow Preventer � e - � � � + �% �
:
-43. Backflow Irrigation ` ' , ..� � � � -
q4, l,andscape Irrigation Sys2em � ' - � - � ' � - � - ' ' �
r
45. Sound Attenuation! ; „ ' � '' . , ;� } , ", � , � - . � =r
46. Handicap Regulations . ' +' " �� _ ' _ ' ,��,,,�
i r Y
47. FINAL S7RUCTURE & 8U1lD1NG � ' ; . � "
m �
48. FINAL PIANNING -� � � ' • "� ' ;;���
�4g', Electiic Release to Edison ' �, ; ' ..- � . . ���,,1
5Q. Gas Release to Southem Califomia Gas Co � ' ` • �� ' - � ' ':.` li
; en u+ �
51. CERTIPICA7EOFOCCUPANCY * - . " ,
No. Date
�
Avo���ant to fill in al1 soaces exceD� those wit�in �eavy Eortler Iines anE sign all avvroo/�ate tleclarations.
OF COSTA MESA CONSTRUCTION PERMIT •
. rojectAddress ��3�3 Y�iAiC�l.Ki'I1� e (�.C,�S.•
Applicant's Mailing Address �- \
Owner's Name T �'M S�� /v Phone
�Addreu � ia'%Y� �
Arch/Eng. Licenu No.
Addreu /� ,,� (�
Contractoi s Nam�' 1_-YL p�"�- XOS�i1—�+one �`L
Addresslmailing) �� �
Ciry License No: z � �� -
LICENSED CONTRACTOR DECLARATION
1 hereby aftirm t�ai I am Iicensetl untle� proy{sion5 01 Chart¢� 9(commancing
with section ]000) of Divlslon 3 of the BuSinesS antl Prof¢sslons Cotle, antl
my license is in fu11 orce tl fect. f'�� T
_License CI s � � Licenze No. � / � �L/�
Date ,���� �p5i9 t � ���
WORKERS'COMPENSATION OE ARATION
I hereby afflrm that I have a certiflcate of consent to self-insure or a<ertlticate
' Workers' Compensation Insurance, or a certilietl copy thereof (Sectlon
;00. Lab. [.�� 1'�^�i1/ ComPariy� 1�' Sil�nV1 ("fI
r'olicy No. C � � � �.k �'
Certifietl �copy is heroby fumishetl.
Certifi tl ca y 6 illetl with the cit B ��^D������lvisi�on.,,,...
�ale�t�. APPllca��
EXEMPTION FR WORKERS' MPENSATION DECL RATION
(Tnis section neetl not be comple[etl It tne peYmit is for one hunGretl (E100) or
less).
I cerlify [hat in the pe�fo�manGe O/ the wo�k tor whith this pCrm�t is Issuetl, I
snall not emo�oy any person in any manner so as to become subjett to Ihe
Workers' Campensa[lon Laws ot Calitornia.
Date Si9nature
'NOTICE: If, after making t�is tle<laration, you shoultl become subject ta [ne
Worke�s' Compen5ation Orovi5ion5 of the �bor Cotle, you must forthwilh
como�Y �+��h sucn provisions or this permii snall be tleemetl rovoketl.
CONSTRVCTION IENDING AGENCV
I M1ereGy affitm that thero I5 a con5truction lerytling agency for the perfo�mance
of the work for whicn thi5 permit is issuetl (Section 3097 Clv. CJ
LRntler's Name '
LentleYs Atltlress
OWNER BUILDER OECLARATIOfJ
I hereby atfirm that I am ezempt from the ConVactor4 License Law for tne
following reason (Sectlon 7031.5 Business antl Professional Cotle: Any city or
county whicn requires a permit to con5truct, alter, improve, demolish or repair
any structure, pr(or lo fts issuance, also req�ires the aoP�icant Tor sucn parmit
to file a Signetl sta[ement that ha/sM1e i5 licensetl pursuant to lhe proviSions ot
the Contractor's License Law (Cnapter 9(commencinq witn Section 7000) of
Division 3 of [he Buslne55 and Professions Cotle) or that he/sh¢ is exampt
therefrom antl tite basis for the allegetl exemption. Any violatlon of Soc[ion
'031.5 by any applicant (or a permit subjects [he applicant [o a civil
enalty of not more tnan /ive huntlre0 Oollars (5500�. .
L7 I, as owner of the property or my employees with wa9es as thair zole
mmoensation, will tlo the work, antl the structure is not intentletl or otteretl
ior sale ($ection 7094, Business antl Professional Cotle: The Con(ractor's
LicenSe Law tloes nol apDly to an owner of a property wno bulltls or Improves
thereon, antl who aoes sucn work himselt/herself or tnrough hls or her own
employees, provitletl that such improvemen�s ate not in[entled or OHeretl fo�
sale. It, however, the builtlin9 or Improvemen( is zoltl within one year o1 com-
pletlOn, the owner will have Ine burtlen oi provin9 �e/sne tlltl not bulltl or im-
ptOve fo� the purpose Ot sale).
❑ I, as own¢r Of tM1e property, am extluslo¢�y tontraGting wilh Iicensetl mn-
tractorsto construct the project (Seciion ].0¢4, Business antl Protessions Cotle:
The ConVactor'z Licanze Law does mt a0ply to an owne� of property who
builtls ar ImD�oves thereon, antl who contracts for such projects with a con-
t�atto�(5 Ilcense pursuant to the Cont�acto�'s License Law). I am aware that
proof o� thelr Worke�'s Compensation inSUrance shoultl be provldetl to me.
❑ I am exempt untlor Section 8. & P. C. for thls reason
Date
I hereby c¢rtify that
intormation it torrect
dOtl Stdt¢ IdWi !¢Idtlfl
sGn[ative5 Of this cit
inspection purpases
Signature �
Drivers' license or 5
_ Owner
1 have reatl tnis appiication antl statn that the above
. I agree t0 comDly with all clty antl county ortlinance5
7 to bulltling wns[ru¢tion, antl hereDy authoriza repre-
y f enter upm the above-mentionetl' vI�9 Pert for
Date�l_�
f
�
Pink - Acmunting; Goltlenrotl - Assessor
$hOW¢f5
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal '
Wacer Closet
Water Heater
Water Service
Auto-Wash
Isue Fee
iANICAL
Hood or Typel ❑
Canopy Type II ❑
Retrigeration System
�4700,OOOBTU ❑700,000
SVstem RA�pair/Alteration
T
FireDampers E
Registers ���R��
✓C�\P. a_-mc-
laua Fee .
$ 3
§ 3
Automatic Washer
Construction Pole Su6,
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW 05-'
>
��7072 II%12/86.
Zone ,
Accessory Building:
Parking Req./Provided -
ELECTRICAL
Trensformer ❑ 15-50 KW
❑ 50+KW
5 KW
Meter LJup to 100 amps
Meter ❑over 100amps
Suh Panel
Mowrs�0.1 HP �tYh-8
Inc. Solar �9-15 HP �16-15+
Microwave
Pole Light �
Range
Sign
Standing Sections '
Trasb Compactor ,
m
I Reinspection Fee I$15 ' I I�sue Fee
DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved By �
Building Approved By n
Aoolication laued Bv ✓ �
22:50 TL
FEES
$ 3
SUMMA V OE FEES c
BUtLDING PERMIT $ ��-DU SMIP $ � V �
PLANCHECK $� PERMIT
PLUMBING � $� ISSUANCE $
PIAN CHECK 25% $ ENERGV P.C. $
E�ECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ �'�
PLdiV CHECK 25% $ ,
Z
O
N
1,
N
G
R
E
Q
M
T
S
ONSTRUCTION qND PLANNING
APPROVALS Permit#
- 1.:Temporary•Electrical Service or Pole
'2.-_Soil Pipe-Undrgrntl.
3. Electrical Conduit Utility-Undrgrnd.
4. Etectricat Conduit-Undrgrnd.
5. Steel Reinforcement
�6. Electrical UFER Grnd.
7. Footings
8, Foundation
9. Water Pipe-Undrgrnd. �
i
10. Structurel Floor System
11. Property Sewer Line & House Connection
12. Sewer Cap • '
13. Roof Drains
14. Rough Plumbing
15...Rough Electrical-Conduit
� � 16.� Rough Electric Wiring
17. Rough Wiring Sign
'18.. Rough Electrical-T Bar Ceiling
79. Rough Heating & qir Conditioning
20. Rough Factory Fireplace -
21. Ducts,�in StructurE �
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test .
24. Roof Framing
25. Roof Sheathing
26.�T-Bar Ceiling (Structurap & 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. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final
42. Backflow Preventer ,
43. Backflow'Irrigation _
44: Landscape Irrigation System
45' Sound Attenuatiqn �
46- Handicap Regulations .
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
� 49. Electric Release tq Edison'
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY �
Date
Date
POO L 'A
Inspector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reiniorcement
54. Forms
55. Electrical E3onding
56. Rough Plumbing &� Pressure Test
57. APPROVPLTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, C] Undrgrnd., Test
60. Backwash I_ines, P-Trap, O Undrgrnd.
61. APPROVAL TO DECK .
62. Backwash fi Receptor-Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical-Final .
66. Solar Systein-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping OGas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hvdro
75�. Dry Chemical
76. Dry Standpipe -
77. FIXED SYf�TEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
' ' 79. FINAL INSPECTION -
80: FOOD CERTIFICATE ISSUED
Notes:
�
PIRED
Date I Inspector I,
CITY OF COSTA MESA REQUEST FOR OCCLrANCY
TRACT N0. .�.�� DATE �J Z 9- ��L
IAT N0. 2�
�
ADDRESS
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 agreement, acknowledges that
(he-she-they) (was or were} 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 conditions 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 agrees to indemnify and hold the City harmless from
any claim resulting in damage or personal injury to the undersigned by reason
of the aforementioned uncompleted condition.
RECEIVED
CITY OF COSTA MESA
Pl'+MNING DF:Pi.
P:IAY 15 1972.
Ah1 PM
7i8i9;10�]lii2i1i2�3�4i5i6
�
BY � ���,�5��.�
Purch er
BY �
Developer and/or ho zed
representative
BY
Lender
�
�I
ONNERS NWE IF IQIOVIN:
woxess:
APVL.WJIRlG 100FE55:
ANCIIRECT Ofl ENtlNFFR:
�PCN.OH FN4'S AUUNE55:
23 MARYLAND CI_
ORN TIMOTHY R
3 MARYLAND CIR
TA MESA,CA
—1381
uxT: _ ___ _ CZTY OF COSTA MESA.— BUILDING PERMIT
PLOOD: AE-37 _ _
92626 PERMIT NO: P 086227 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU
—oD g
PERM NO: P 086227
GOVT: N SUPP: N
PURPOSE: ADD
��.�.: IJOH DESCRIPTION ; DISAWASHER CHANGE—OUT SQ FT:
YNT:
calm�crarswu� APPLIANCE INSTALLERS, INC ( 562 ) 986-5511
coxm�cronsxuwa 3299 E HILL
�oo�ss SIGNAL AILL CA uc.no: 594282
90804 uHr: 306
110EN5EU COMNACTONS UECLAP�TION: 1 hareby ellim under panely d parjury Mm I un licerued uMx praisims d CMqx 9
(mmmenti�p wil� Seciion ]000) d Drvvion 3 W tlro Bum�wsa vd Profeesiwp Code, uM mY liuroa u in lull brce eM etlad.
cmuc.No.: uc.cuss:C 36 uc.No.: 594282 EXP:
oda: ``2.—\ o —�7 com.�a: �R�: d,1.1c��Sl�ca�l�s ,f.r_ .
OWNEfl BUILDEP UECLRflAT10N: I hareby alfirm undx panely d perN�Y �� I om exemq Irom iM COMredon Licenae Law la tlr
lollowinp reeaon (SeGion 1031.5 Bueneea eM PMeeeiom Code: Riry c1y a caunty wfiich rayuiree a peimu �o mmWM, eller, improve,
damd'oh, or repei eny evunure, qia lo m uwarim. ebo requirea ihe epplicanl Iw wch pem�X lo file e sipmE etelement Ihel M or eM
is licenead W�a�� �o iha provisions ol tha COMredwa limnae Lew jChepter 9(commmviq vmh Setlion ]OW) d Divebn 9 d iha
Businesv eM Prd%nvn+ Cudel a that he a she u azemq �hsel�wn erd tM bavia t« the elbpeA uemqion. Nry videiion d Sedun
)031.5 Oy eny epplimnt Iw a permil vubjxts �ha epplcem b e dvY pmelry d M mae �han � e huMrad ddlen �5500��.
� I. ee axnar d IM popenY a mY empbyeaa w!h wepes av Ihei eole mmpametion. will do ihe wwk. vM the et�umre e ral intendeE
a ollered Iw eele (SeMian 101d, Buaness end Proleseims Cab: TM Contreaon L'wense lawCwa �at epplyto en owner W popeM
wM Wids w inpwu iherean, eM Ww dom cuch xwk Nmeatt a MmeY ar �hraqh hi «her oxn empbyeee, prwkeE Ihet wch
imqovamm4 us rwi imenEetl a WxeE iw eeb. tl, lrowewr, �M buiWirq «inqmanem u edd wnhin aw ymr d comqetion. �he
awror-0�iltler wiil Mw IM WNm d Vw'��0 M a ehe Ak ml Wik a imNb'e la �M WNaa W�le).
� I, m ovmer M �he popMy, em eRtlusrvey mnomnq xi�h licenaed contreclas m crostrud �ha pqed (Sepion ]WC, Busi�e arM
PIOIB�W119 CWB: TM1B Caf1�1BCOf8 LEMBB LBW a�. �a oroM w� ow�� a v�weny wno w�ba « �mwo�.� me� �d wno
conlrecis I« aurh prqeds wM e cvmrerloHe) Icenead punueM to tM Camrapore liceme law�.
� I em azemq wdm Sermn: B. b P.C.. br �he �eawn:
Date: �>
I do Mroby eenity tliet I em ewera d vM uMeniend the requiramem� ot CelLwnle Hael�h eM Se1Ny COEe Sepiom 25505.25533, eed
255J1. end Ihet I a eny Mure W iWi�q ocapeM will / wY1 nd (arcb�aw) neatl b compFy wih veid mme mAw eM �M reyuiroments br
epem�nl«mrehuclionamodifmbnhamiM1eA'� ue�iy enepementD'nt�.Residanlielmmtnpionnppfu�iomvessemplromNeae
pwisiona.
Dele: Rpplicent
W OHKEN'S CONPENSATION DECUNATION: I Mreby eifirm uMer penehy d pajury ar d Ne Idlowi�p Aetlareaioru:
� I heve eM wil meinian a ceMkele W mreent io vapinwm tar Mvkers oomW�ian. n pwided Iv M.`•en'v� 3)00 d �he leba
COEe. tor the peAamerce ot Ihe xwk Iw wlvch i�n pemN ie iaueE.
� I heva end wil main�en woAen' oompammon ineurarKe, m reyuired by Seaim 9]UO d ihe Lebor Coda, br �M peilarmariw af tM
work for wh'rh Mie permil ia iaaued. My warkert companamion imurarica umer uM pdi�y number ere:
c�: GOLDEN EAGLE EXPIRES
va�N�mc« — — 01/30/98
(inis senion neee na ee canWeree I the w�md 'a ro. one n�Mmd dollere f3fool o. bu.)
� I eenty iha� in ihe pa�laeme�we d �M work br whieh thn pe�mn u iaued, I ehell ml empby eny paean in eiry menner eo aa ta
becwne subptl to iM1e xvMxs' canpensetion kvn d Celibmie, erk epree Nm A I ehouW berome wbptl to the Mwkan'
�omo�� w�o� d saa� e�oo d me �na. .�m inob vo+�+.
oa,. �-�—�R-9� ��,: .��_�
WaminO� FeUun ro sxun woilreri romperuetlon coverap� l� unkwN( antl Nsll �ub/scf �n xnploysr ro cr/M�u/ psiwltlu en0
clvll flrros �g N on� h�ntlrstl tlpuunC tla/Nn (SfOry000), In eddltlon b M� ewt o! rompNuetbn, demep� u proNdeC br In
Sxtlon 9]O6 0l MeWorCob, Inlenst +� ettomsy's /su.
CON4TFUCTION LENDING AQENCY: I Mreby elfirtn umbr penelly d per'ryry Ihet �here'v e mnm�wfion WMirp egercy br iM
perlwmarKe N iha walc br which tM1e pmii is oaued (Sedion �arl, Cir. C).
LENDEH'S NAME:
LQlOEP'S AD�flE55:
I cenih thet I have raeC �hia epplketian uM mete tl�el Ne abwa inlpmelun is oortad. I epree to campy wuh ell uryarM counry ordinenme
enE e�ele lev.s releling lo WiMng conwutlun aM hareby eutlwriza represemalrvae M Iho dly to enter upon tha ebova-meniionad pmpaM
fwinspedion purpasee.
DANE MCNEALY
�m riema
, o�e:12-18 �
� s�a���aao..,,�ineaminvor�,vca,vm«
(St51d6 WP) WAde-Buikip d SeMy: Green-Fb; Cenery-Appicent: Pink-Ra+enue; Oddenm�Meeawr
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED HY THIS PERMIT
�***�tx�+t*�****��c*�***�x ******�*�e***x�*+t*+t*+r+t�t*�**�r�r**�**+�x�+r*��c�*���x�****�t*�*�t�r**+r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN AEAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN AGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 13961129 2NE: REF NO:
PLANNING NfSTES>
i
�F 1F 1f k i4 iE iF iE if iF 1k k 1F iE If M If iE iE if if ik iE iF iE iE 1f 1k iE 1E 1E iF iE if if If iE 1F 1E �lE 1F iE 1f If fk M ik ik.M ik iF iF 1f if if ik iF If fF fFiF iE iF if iE iF iE iF iF 3F iE iE iF iE ik if ik Ik 1E
D E V E L O P M E N T S E R V I C E S� A E Q U I R E M E N T S
ZONING APPROVED HY ° DATE;
BUILDING APPROVED HY : ` DATE:
APPLICATION ISSUED HY: DATE: `2 ���
ifkifikikl(�iEiEfE1FMMlFiEitiFiFkiEM1f1F iFlflfikiflflfikiEiEiFiFi 1fi('
LEGALIZATION:N F E E S�U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 8.75
25i SMIP/NON—RES
PLAN
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 8.75 22.00 ,0.00 30.75 30.75 .00
REVENUE DIVISION TOTALS--> COLLECTED; 30.75 OVER/SHORT; ,00
BLDG PMT PI;UMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30,75
�E 1E fhlF if iE if 3k �f M iF M iF'k IF M 1(' iFiF %1E if iE iE 1E iE 1F �E 1i iFlf 1ElE if k if %iF 1F if'M 1F M iE iE iF iE iFif iF iE 3F 1@3h 1E'1F Kik if K ik M if iE il� iE ik ikif� iF if iF iF N if If M if'Ik
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
`����
D E S C R I P T I O N UNIT COST TOTAL COST
1 DZSHWASHER 8.75 8.75
END OF FEES
12-18-1397/ln':44 pn/538.7�
RLPT�:�1-��ir]cr
F'EB2t'1IT: H85�� f
CONSTRUCTION ANO PLANNING POOI & SPA
APPROVAIS Permit # - Date Inspector APPROVAI.S Permit # Date Inspector
7. Temporary Electricai Service or Pole 52. Pool & Ec,uipment Location
2. �il Pipe-Undrgrnd,_ 53. Steel Reinforcement
`��3�riF,yectrical Conduii7}ylity-Undrgrnd. 54. Forms �
- �4.=Efectrical Condvif+lJNdrgrnd. 55. Electrical Bonding
� S'
��::Si�,el Reinforcetil�x � 56. Rough Phimbing & Pressure Test :�
-+fc �.Electrical UPER G�i. 57. APPROV�4L TO COVER•GUNITE . aj
-1T✓' !1 r1^
'����Eootings �7 4, 58. EloctricaiCondu�t-Undrgrnd. �'
.�8:`Foundation ¢ 0 59. Gas Pipe, � Undrgmd., Test
"`9� Wa[er Pipe•Un� md.a 60. Backwash Line,�.�'P-Trap, O Undrgrnd.
70. Structural FIo��SYsiem v 61. APPROVAL T, §1ECK
11.=Rroperty Sewer LinE'& Hous�Connection 62. Backwash & R�eptor-Final �
12.'S,,'ewer Cap �� u: 63. Heater &`Jent�Finai
C13. Roof Drains �^ 64. PluMbing System � Final
14. Rough Plumbing � :t 65. Electrical-Final
`75. Rough Electrical-C�duit .. 66. Solar System-Fitia'4 �
� 6. Rough Electric'VJiri,� 67. Fencing & Acc�ss;Approval
.J7. RoughWiringSign V 68. APPROVEDF�RPLASTERING � i
��
18. Rough ElectricaFT Bar Ceiling 69. POOUSPN SYS'I'EMS F�NAL
19.�Rough H,gatirg &;,¢�r Conditiaai� .ro. x � y�;;T .7 c RhI�iE'�6PT!.y3EQUI�tEMEN�T N
C�7 ^.N��O :�1 * i+ '-!
20.'�ioJ`h P3'ctof" FTse lace � S:T' sG x S' H�,^'� ;� APP O f" P`ermit #� J' �
� ;� .X r�' . �-. �s M H ti 7x � � ��.E r� '�
�,/ . . 1 .. .. � y V . . I
21.,c.�uc�s, irir�truau_ x � S= CJ -+ ;l.< � 70.E-Undergrat�lOd FSydro �
22.=Ducis, U'�entif6;tingJ:� i ^'� x r? 'C �� E"x 71. Prod�;�i�ing_[11'..,as .T`r70i1
F-. " . 9; 1 F.' k H'r. � V rJ'
23. Gas,�ipa`�iouc�h &-. #est ' C'"•S r m c� i�: r-� � tii. -�
�,N. i mcr O;G h� � a S;� _ 72. Undergrsund F,jush * j,
� � -
2A.�Roof Framing * u k T ` � j� � 7�• Undergrr�d.Stq��eTan� C�Gas ❑Oii
Y /X
25.-vRod�;Sh'e'athing x� � � � .; `' M ,�x u �4. Overhead Hydm=+ »
26.�d•Bar Ceiling (Strricturaq & MSnScoat � O . �� y�, Dry CheT ical F� *� � ^
+< ^t �r w ('J
27.:'Rra e a Flash','�. * 7'^- *'� �' m.`: � "` �. `"''Do r� s
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" `"51. CE IFtCATE 0F OCCUPANCY
No. Date
OWNER MODULAR Technolo�y� Inc. DATE 7_15_71
JOB ADDRESS ��24 Marvland Circle BUILDING PERMIT N0. ����i
P" "o, LOT Q
L _CTIONS
SOIL
GAS
WATER
ROUGH pLUMBING
PROP. 5`MA. LINE � HOUSE CON. ❑
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGH NEATING AN� AIR CON�ITIONING
UN�ERGROUND � POWER �
ROUGH WIRING
TRENCNES FORMS � STEEL REI
FLOOR SYSTEM
BONO BEAM U STEEL REINFORCE U
SHEATHING
FRAME AND FLASHING
LATHING - IN 2}� OUT
PLASTER,BROWN COAT
"TURAL,fINAL
h iNG, VENT., REFRIG. AN� A.C., FINAL
PLUM9IHG, FINAL ANO GAS TEST �_
ELECTRI�, FINAL
DESCRIPTION of WORK
FIRE ZONE VAL
E'P�=Zi�1J�.;�L�t�n
z .
a cwj
Z
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ON
am
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33271
PA70 �
1U1.20-7lcrisr��1709<' ' � �SEi.C�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFOHNIA 92626
APPLICATION FOR BUILDING PERMIT
ForApplicant to Fillin Completety REce�veD BY DATE RECEI� o
DAT ISSUED
ao�o ess 3323 Ma land Circle d�� �Y ��_7 ��
P
OWNEfl Modular Technology, IT1C. A.P. NO.
MA I L BUI LDING
nooRess 1104 E. 17th Street ADDFESS 3323 Ma land Circle
cirv Santa Ana No`547-g673 TRACT 6 82 �oT 2 e�ocK
CANSTRUCTION W ADD A TE P
LENDER �r
BRANCH
OWNEF Modular echnolo y. n ,,,
AODRESS � '
residence � va�u
ARCHITECT TEL SE $
oaENciNEea Kermit Dorius AIA No. 644- ili "
FIFE %
ADDRESS 3111 2nd Ave., Corona Del Mar ZONE TVP GROUPI �
APPROVED U
CONTRACTOR Owner BV DATE
ADDFESS 58IIlE
TEL. Z�NERl NO.OF 2 USE OF NEW Res/w
CITV S3ii78 NO. P�� BUILDING
� C No. 252549 °;��No. i690 vMAIDN BUILDING ACCESSORY BVILDING
SIZE NO.OF BLIX'aS. (FROM C/L $TfiEET)
/
OF LOT 6O X HO NOW ON LOT RONT FT. FT.
USE Of
EXISTING eLDG. — S E FT. FT.
NEWBLOG.21OO S.F. ROOMS 'I STOflIES 2 L.SIDE FT. � � L� FT.
EMERIOR WALL Per ROOF WOO
COVERING 13i1S COVERING shin ].E REAR O FT. FT.
USE OF BUI�DING AND WORK TO BE PERFORMED DI5TANCE BET. BET. MAIN &
MAIN BLDGS. ACCE55. BLO(SS.
Construct new residence with C URP 3W —�' �(�� APPROVED `✓ '�aj
attached gara,ge APPROVED � � � /
F.NT. S
I hereby acknowledge that I have read this application antl state MOLD F�� S
that the abave information is correct antl agree to comply with
all laws regulating builtling consttuciion, antl 1 shall not employ
any person in vialation of ffie workman's compensaiion laws oi
Me State of Califomia. ���/�� �� f
I hereby cer2ity that I am property licenutl as a contrector under SQ. FT. ��
tne State of California Business antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNOEq ALVATION IS FOR
Chap[er 9, antl that such licenses are in full forca antl eftect, or I THE PUFPOSE OF ESTABLISHING A PEflMIT FEE ONLY:
am ezempi trom the o isions of the State of Calitornia Business
antl Professions Cotl ,'vision 3, haptQ VALUATION / O =
/ PERMIT FEE $ /
f
Signatureof ` + �1 %��.
Permittee i $ [j�� \ry p�qN CHECK $ � �� �
Authorized Agent ��J " �/ . �
- TOTAL FEE (D
ro
7
m
`o
LL /
C