HomeMy WebLinkAbout2970 MAUI PL - Building Permits(71a) �5a-5273 • Fax (71a) �si-4856 • w�wcci.costa-mesa.ca.us 77 FAIR OFiNE, GOSIA MtSA, GA 92ti2ti
Job Address: 2970 MAUI PL
Suite No
Vicinity:
Parcel Nunmber: 13925219
Applicant KEE, PAUL ROMAN TR
Address: 2970 MAUI PL
COSTA MESA, CA
Owner: KEE, PAUL ROMAN TR
Address 2970 MAUI PL
COSTA MESA, CA
Contractor. OWNER BUILDER
Address:
Arch / Eng :
Address:
PLUMBING PERMIT
Status: ISSUED
Applied: 02l75/2001
Issued: 02/15/2001
ISSUED BY: �
Phone:
Zip: 92626
Phone:
Zip: 92626
Phone:
Zip:
License: 000000
Phone:
Zip:
License:
SCOPE OF PERMIT
REMOVE EXISTING BATHTUB AND REPLACE WITH WHEELCHAIR ACCESSIBLE ROLL-IN SHOWER AND
SINK.
ISSUE FEE
Backflow irrigation
BackFlow Preventer
Bathtub
Clarifier System
Connect (Ice,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
523.50
$0.00
$D.00
50.00
50.00
50.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
50.00
$0.00
$0.00
30.00
$0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
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 50.00
Spa (private) 50.00
Spa (public) $0.00
an
0
0
0
0
0
0
0
0
0
0
7
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 Se[
Wasle and Vent System
Water Closet (Toilet)
Water Heater / veni
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water Sokener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
AMT
$0.00
50.00
$0.00
50.00
$0.00
$0.00
59.80
$0.00
$0.00
50.00
$0.00
50.00
50.00
$0.00
50.00
50.00
50.00
$0.00
$0.00
TOTAL CALCULATED'FEES: $43.10
Qn
0
0
0
0
0
0
1
0
0
0
0
0
0
0
0
NO710E: 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, 72-21-92)
EXPIRA710N: 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 7 BO days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cotles, and all
required Inepections antl final approvel must be obtainetl. Failure to obtain Inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2C4&d6(N00)
WORKERS' COMPENSATION DECLARATION:
I hereby ettirm under penalty of perjury one of Ihe following tleclarations: .
� I heve antl will malntain a certificate of consent to selbinsure for workers' compensation, as proWtletl for by sectlon 3700 ot the Labor Code, tor the pertortnance of the
work for which Ihis permit is issuetl.
❑ I have entl will maintain workers' cnmpensapon insurance, as required by section 3700 of the Labor Code, for ihe pedormance of the work for which this pertnit is issuetl.
My workers' compensation Insurance wrtier end policy number are:
Cerrier. Policy Number:
(This sectian need nof be comp/eted i! (he permit is veluetl ef one hundred dollars ($100) or less.)
❑ I cortily thet in Ihe pertormanca of the work lor which ihis pertnit is IssueQ I shall not employ any person in any manner so as to become suDjed to ihe workers'
compensation laws of Californla, antl egree ihat il I should �ecome subiecl to ihe workers' compensation provisions ot Sectlon 3700 oi Ihe Labor Co�e, I shell torthwith
comply with ihese provisions.
Applicent Signature: Date:
WARNING', FAILURE TO SECURE WORKERS' Q�AIPENSATION WVERAOE IS UNLAWFUL AND SHr1LL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNDFED
THOUSNND DOLUPE (5100,OD0), IN ADOITION TO TME COST OF COMPENSATION, DNMhGES AS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR fADE, INTEREST, M1D ATTORNEY'$ FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensetl untler provisions ot Chapler 9(commencing with Section 7000) al Division 3 of Ihe Business entl Professions Code, antl my licanse I5 in lull
force end eflecL LiC. N Class tl
Comrac�ors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there i5 a ton5�ruction lending agency for Ihe peAormance of the work for w�iCh �his permit i5 is5ued. (Sec. 3097. Civil Code).
Lendefs Name:
Signe�ure: _
OWNER-BUILDER DECLARATIONS:
Lentlefs Adtlress:
Date:
I hereby aflirtn thet under penalry of perjury ihat 1 am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5, Business end Professions
Code: Any ciry or counry which requires e permit to consiruct, alter, improve, tlemolish, or repair any sWcture, prior to its issuance, also requires the applicant for such pertnit
b file e signed statement ihat he or she is licensed pursuant to Ihe provisions ol Ihe Coniractors License Law (Chapter 9(commencing with Seclion 7000) of Division 3 of ihe
Business antl Professions Cotle) or that he or she is exempt theretrom antl the basis for the atleged exemption. Any violation of Section 7031.5 by any applicant for e parmit
subjects ihe applicant to a civil penalty of not more than five hundretl dollers ($500).):
❑ I, as owner of Ihe property, or my employees with weges as Iheir sole compensation, WILL DO TME WORK, and the siructure is not intentletl or oHered tor sale (Sec.
7044, Business and Pmfessions Code: The Contractors License Law does not apO�Y �o an owner of pmperry who builds or impmves theraon, and who tloes such work
himself or hersetl or through his or her own employees, provided that such improvements are not intendetl or ottered for sale. It, however, the builtling or improvement is
�d within one year of completion, ihe owner-builder will have ihe burden of pmving that he or she tlitl not build or improve for purpose of sale.J.
I, as owner oi the property, am EXCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRAC70RS to construct the prqect (Sec. 7044, 8usiness and Profeuions
Cotle: The contractors License Law tloes not appty to an owner of property who builtls or Improves thereon, and who contrac�s for such project with a contractor(s)
IicenseDurcyant to the Contractors License Wws.).
�am xempt nder sga eusiness antl Pmfessions Code for ihis reason:
Signature: ,h.dd.�-�--- _
Owner ID vari ed by nvefs license. ^es ❑ No Drivels License No. �
Venfication of Ownership by (type of tlwumem, i.e. - property tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Ezpir85:
❑ I hereby cetlify that no excavation five (5) or more leet in dep�h into which a person is required �o descend, will be mede in connection with work authonzetl by ihis
permit, and thal no buildinq struciure, scaHoltling, falsework, or demolition or tlisman�linq Ihereof, will be more then lhirty-siz (36) teei high. (Chap. 32, Gry 2, An 2, Sec.
347, Title 8, Califomia Administrative Code).
❑ As ownerbuiltler, I will not employ anyone to tlo work whic� woultl require e pertnit irom the Division of Industriel Salety, es noteA above, unless such person has e
permit lo tlo such work trom lhe division.
Signature: Data:
Division oi Industnal Safery Permit Number:
CERTFICA E OF COMPLJANCE ANO AUTHORVJITON OF ENTAY: I cenity under penalty of perjury ihat I have read ihis application antl state that the infortnation given is
wrrectri egra to comply wiN ell state laws end ciry ortlinances relating to building construction, and euthonze representatives ol the Ciry ol Costa Mesa to enier upon t�e
ebov �-describe proPerty fo; inspectio urpose�u 1 egree not to occupy or allow occupancy of eny building authorized by ihis permit until linel inspection.
� __ G�--�- �� / S / C� /
LSignaNre Oi Legal Owner(s) / —� Date
/
AnNOr Authorizetl Applicant Date
CQOE �. INSPECTIONTYPE QdL INfIiIALS
1616 Fixetl System Final Fire Preveniion
1266
200
201
202
Pool Spe Final
Finel Ra-Roof
Final BIocWRetaining Wall
Final Factory Fire Place
203 Finel Sign
204 Final Demolition
40oE� INSPECTONTYPE
206 Final Mechanical
20B Finel Plumbing
210 Finel Eiectrical
212 Finel Fire Pravemion
220 Final Plenning Approval
222 Final Sile
250 Final Builtling/Occupancy
��
_T � �
C� � L'� ��2eda �u�i'd� Du�iQca�
OWNER-BUILDER
VERIFICATION
A city or county, which is required to give no[ice pursuant to Section 19830, shall attach to such notice, and,
as a condition precedent to issuing a building permit, require the completion and require the re[urn of, an
ownervbuilder verification.
A[[en[ion PropeRy Owner.
An `owner-builder' building permit has been applied for in your name and bearing your signa[ure.
Please complete and return this infortnation in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permiL No buildine permit will be issued un[il [his
verification is received.
L I personally plan to prov,i�d the� major labor and materials for construction of the proposed
propeRy improveme �J'Xes ❑ No
2. 1(have/have not) signed an application for a building pertnit for
the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone ( )
City _
Contrac[or's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address _
Phone ( )
City —
Contractor's Lic. No.
5. I will provide some of the work but 1 have convacted (hired) the following persons to
provide the work indicated:
Name
1P12-46 (REV.9FJB)
Address
Phone Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of [he State
of California Heal[h and Safety Code and have completed the above information to the best of my personal
knowledge, in compliance with [his Sta[e law.
(Ynnha or �1 ypca)
�C.D.L. # OR S.S. #
[Date .2.�.i�//
For more information call City of Costa Mesa Building Division at (714) 754-5273.
1042�96 (REV. 998)
'" , 1 ADP��cant to fill in all spacei itM1in eavy Oortler lines antl si9n all appropriale tletlarations.
J'CITY OF COSTA'MESA ' PERMIT NO. TRACT NO.� - LOT NO. , 6LDG. NO. "-' , O6 I I I29I'� B�QO' �TL
CONSTRUCTION PERMIT �/J� ' .t 1. . .� . : . �.. ,
- Project Address 01 -� /k,U Le � TYPE OF CONSTRUCTION �, � � _ , � , �. ;� '
Ownef � L Phone�j, � � ❑ ryEW '� ADD ❑ ALTERATION � - -� � -- - - � ' -�- �
Address q - �� - -- _ . ❑ REPAIR ❑.CONVERSION ❑DEMOLISH _ _ � � � � _
. . ' ZONING REGULATIDNS � ,
Arch/Eng. - - � � - �license No. - - ❑ oTHER � .. _ . ' A:P. �.._ _. . „' ' _ -
� AddIe55' ' - - - - . _.._ . DESCRIPTION OF WORK - "
. . ' •. . " . �ZONE ' '-" " ' ". PLNG. REF. � �': - -" -' '
�� Contrecmr'� "�. � L '= 5t 1 �-RS�Phone �'3� -q'j� TYPE,OF PERMIT - � ' " ' -' ��" � - �- N - . To B�JILOING _.
' � 'SETBACK L T. PROPERTV�LINE' -
•Addfe55 �754i��A'N+koN -Ava. G�CT. . ' ❑�GRADING -,❑ FOUNDATION ❑STRUCTURAL� - .SIDEVARD � -- - --
,LICENSED GONTRACSOR DEC ARATION • � ' ' (��' •LEF �
❑'GENANT'�.ELECTRICAL ❑PWMBINGAJMECHANICA 5IDE-vA
d hereby aTfirm thtt I am licensed untler provisions of Charter 9(com-, -.- • . pr /\ ' FyIGHT - 1
� ,',
mentlng' with �section 7000) of }Division 3 of -the- Busine55 antl .❑ OT.HEIi � �
Professions Cotle antl y license is in full torce antl et�ec . - ; REAR VARD'(TO'P/L) " ' '� `- "'
• � '� �, -.� . �� '' PRO�ECT DESCRIPTION. , �
� i _ '__ _.
License Class ' enser o, li - � - � �'PKG. SPACE'RE�. -"" " - - ' -' oROV IOED: - - - • �
Date �1�A���ei.5i9nab�ro-1 �lPl�[" _.SQ.:FT. ' ...��� • ' ___'_ ' _ ' " '. '__ ' '
� STREEYWIDTH ' PARK'FEE'§' "
�WORKERS'-COMPENSATION DEC AR TION- - �OCCUPANCV "_CONSTRUCTION TVPE � ZONING APPROVED'BV - --- DATE �- -
.I hereby aifirm that I have a certificate of consent to self-insure or a , VALUAT.ION ' ZONE - 1
certitirvte of WOrkers' Compensatlon- Insurant¢, or a certifietl. topy. . - - _ _ � _ -._ __ _. - ' '•SPECIAL CONOITIONSi'
'�SSareof (Section 3800, L,ab. C.). � GRADING CV.,YDS. ACIiES ~
'�t.ry No. AD�q�ol�l 'ComPanY' �C.�� ' ' " ' � . . ... .. ._ .. .. . _.
��':'-�ertifieticopyis.hereby.furnishetl. �� �'REMARKS:.�u�' " � ,
�LI Certifietl copy is filetl with the city Bulltlin9 Division. i � - ' .'�..' ' ,- T
'EXEMPTION FROM WORKERS' COMPENSATION'OECL'qRATION ' " � - � � - � --
'(T.hls section nCetl.not be„cOmpletetl it the_permit i5 for one huntlre0 ' ' ' . i � � �. �'
(E300) or lessl. _ . _ . _ .. _ '_' _ "" � ' '. ' _ _ ' _ _ " ' . ' ' '. _' _" '
J_certify that in the performance of the work for which this pe�mlt Is ,,
issued, I shall not employ any pevson in any manner so as�to becbme PLUMBING -' -'� PLAN CHECK ' '- �ECECTRI L' "` PLAN CHECK •- �
'subj¢Ct [o the Worker5' Compen5ation Laws ot California. - '' .,
' ___.. ... �. ... � .
'Oate Signature � B7iTHTU65 `- - - SHOWERS- '" '" ' '- - - - - - - -- �
jNOTICE: I( after making thls tlecldration, you shOultl become subject TOILETS- , •.URINAl.S �"" - ' -�tiEN RATO - p-1 KW' '11'0 KW""' - '-
to the Workers' Compensation provisions Ot [he Labor Cotle, you mu5t' - � "��TRA FOR ER — �•. � . ; j
f0/thwith Compty with such provi5lon5 or this permit Shall be tleemeG LAVATORIES DOUBI'E-LAVS. ��-f'�9 -�%PPL NCE - 10-50 KW=50+�KW - -
revoketl..' '_�'_' " ...�.- _"__" __ _. ' _ 'KIT.SINKS .'-"____' DISH R5. _ .. .•. . - 1�MOTORS?-.. 0-1HP--_1d0�HP".-�..�.. . � � _ . r
'CONSTRUCTION LENDING AGENCY -- -
�I hereby affirm that there is a mnstruction lentlinq aqency for the per- SERV ICE SINKS -. �.�9 PS' � - -�„d��. SOLAR). . �0-50 HP 50 +. Hp, � ___ ___ (
formance of the work for whicn tM1is permi[ is issuetl (Section 309�
Civ.-C.I.."_ "_ _ " ' ' _. . �. - � . ... . , . ,
- � �� -- ' �'-- ' FLOOR SINKS' � �- ' LOOR' ' S" -" '" ' ' -" ?FIXTURES — OUTLETS - SWITCHES ' � '
'Lentler's Name � �
�Lentler's Atltlress - � -DRINKING FOUNTAI ' j ' • -'--�- ^- - 1GA5 TUBE - - � - - - - -- --- -
. - .. ."
OWNER BUILDER OECLARATION-� -' -"��-- '- -�- - - �NTERCEPTORS'�� �' CL IFIERS ""'� -" - �'P��- � 5'- " - --' � - -
�I heteby affirm that I am exempt from the ConVacto�'s �itens¢ Law fOr �
the following reason (Section 0031.5-Business antl Professions Cotle: - SWIMMING POOL' -- ' P'TRAP -� -� -� � I
�Any city or county which requires a permit to construct, alteq � POl.ES -- "- -METERED '" SUB� --'
improve, tlemolish or repair any structure,-prior to itrissuance,also re- yyATER SERVICE - ' 'LTE ION'- - ' PANELS --- -�MAIN- -SVB -
quires tite ap.licant for such permit to file a signetl statement that M1e � 1
is'llcensetl' pursuant to'the-provisions ot th¢ Cantractor's�License Law - GAS SERVICE - - � -'-- -"- "-' �SERVIGE - -- � — - - - - AMP- �- - - -
(Chapter 9(commencing with Section 7000) of Division 3 of the � - � �
@�s^�iness and Professions Code)-orthat he is exempt therefrom antl the y�ATER HEATERS '8 OUTPUT --- - - -- — - � •-- - -- � - -
�-!or lM1e allegetl exemption. Any vlolation ot Seclion 7031.5 by ' ' ^ : �'
'i,"i'aDPlicant for a-permit subje[Is the aOP���ant to a civiP penalty� 'SEWER CONNECTIONS "-� ' -' -- ^ ' ' -- - - - -- - - � - - � �- �- -� - � - -
'':mt more than five M1untlretl tlollars (g500). •
'0�1, as owne� ofthe �property, or my employees with wages as tM1eir ' SOLAR TANK "' " COLLECTORS - - - -- - � - - - - - -
sole compensation, will,tlo_the wo�k, antl the Structure is no[ Intentletl -
or offered for sale. (Section ]046, Business and Aofessiond Cotle: The SOLAR PIPING SVS. • � " ` ' ^ISSUE-FEE - -� - � � � ,
�Con[ractor•s_License Law.tloes not apply to_an owner of a property _� :�APPLICATION�APPROVEO BV ... _ _: OATE-
wh0 builtls o� improves tbereon, antl who tloes such work himself or ISSUE FEE -�' -� -" '-' "- " -
throu9h hii own employees,provitletl that such Improvements are no[ '
intentletl or offered for sale. If, however, the builGing or improvement MECHANICAL PLAN CHECK �� -� ` SUMMARY�OF FEES � - '
is sold:within.one year of corttple[ion, the owne� will have the burtlen � ,. 3,� �� AL
of prOvin9 he tlitl no[ builtl or improve Por the'purpose of sale). - --- - - .BUILDING ---- -. - - -,- --
.�-I,-as owner of the property, .am �exclusively contrac[inq with. HEATING SVSTEM 0400,000 8TU ' PERMIT E� , SMIP J E -
licensetl conlrattors to construct the ro'ect Section ]044, Busines5 -AND DVCTING- � -� � --- - - - �-- - � -. .
P 1 ( � 300,000? BTV �' d PLAN CHECK $ PERMIT ,��
antl Professions Cotle: The�Contracror's License Law tloes not apply.to- _ . _ _ ' ISSUANCE 8�'
an owner of property wno builtl5 or improves thereon, antl who Con- REFRIGERATION 0-300,000 BTU ' PWMBING 5 '
�Vac15 t�om such projects with a coniracto�(s) licesnetl pursuant. to. .SVSTEM --- �- - - - _ - - GRApING $ �
Ihe Contrattor's License Law). 100,000+gTU . PLAN CHECK E �- � �
�� I am exempt untler Section' - -� - B: & P. C. for thi5 " ''"' -- '' - ELECTRICAL $ E _ ' I
� BOILERS BTV
reazom - � 4pLANCHECK� �$- '�� "MICROFILM Y �—�_ �
SVSTEM REPAIR,AITERATION
'Date Owner �� O(3 )"� .TOTAL FEE $'
;I her¢by certify Ihat I have reatl this appiiCation antl State [ha[ [he above EXHAUST SVSTEM MULTIPLE � MECHANICAL E - -- -
mtormation is mrrecL I aqree to compty with all city ana munty PLAN�CHECK $' � ' LE55 AD-
VANCEPC $_ - �-
brtlinances antl state laws relating fo const�uction, antl he�eby authoriie , - . �
iepresentatives f Ihi to enter upon the" above mentionetl .. . `{}���,
'proper[y_for i ec' r.yno�se�s.� � FINALFEE 6� '�
�Si9nalure � "'�t��� Date ��'"a - /� OD - . "
Drivers' Lite e or 5� -' ISSUE FEE _. . _ a_. _ _ J __ _ ,
CMF 08fi5-�16 White-Builtling; Canary-Applicanq Pink-A<counting; Goltlenrotl-Assessor
CONSTRUCTION AND PLANNING POOL & SPA- " � . �
APPROVALS Permit# Date Inspector qppROVALS � ' Permit# Date Inspector
1. Temporary Electrical Serv(ce or Pole 43. Pool & Equipment Location -- � -
2. Soil Pipe-Undrgm '• ' 44. Steel Reinforcement - -- � - � •
3. Electrical.Conduit Utility-Undrgrn 45. Forms � - � �
-4.-. Electrical-Conduit-Undrgrn. . . 46.. Electrical Bonding � � � -- -
_ .. tee ein orce 47. Rough Plumbin & Pressure Test � '- �
6. -Electrical UFER.Grn _ 48. APPROVALTO COVER-GUNITE � � �
. 7. _Footings,. _ � � 49. Electrical Conduit-Undr rn ' � '
8: Fqundation - - - - �- . : ^ 50. � Gas Pipe, Q�Undr m, Test -
9. Water-Pipe-Undrgrn.. ,__ _ ' 51. Backwash Lines P-Tra ���ndr rn ' �' '
� 10. Structural Floor System � 52. APPROVALTO DECK '- ' -"" "'
�-it. Property�Sewer Line.& House Connection .,..._ 53. .Backwash & Rece torFinal �
12. Street Sewer-Connection .. - - - 54: Heater & VenbFinal : � �
13. Rough. Plumbing ' - � -
14. Rough ElectricConduit -�� - - � - � --�56. Electrical-Final � - ' '• .�� �
'. 15. Rough Electric-Wiring ' - 57. SolarSystem-Final . � ' "- . - �'
16.' Rough Heating &-Air Conditioning - - - • encing & Access Approval �
9. APPROVED�FOR PLASTERING � `
� 17. � Ducts, in Structure - � ' '
18: Ducts, Ventilating - . _ . . . ' _ _
19. GasPipe-Rough&Test .7 ��w � }.:-�' _ _ _ 60. POO.USPASYSTEMSFINAL, ' , ' � -',
' 20. Roof-Framin9 . - - - - r � � « - -' � . � .- - � . . .�. . '. .
: 21. Roof Sheathin " - - -. .': - ..- -- - -- ` ' . . .
22. Frame�and Flashing � � - - � ' - - -- - � - ,. s NOTES: ' � ' "� . � ' �� . " - ,
r r „
, 23. Insulation � � - -- - - - -_ _ .
24. Lathing & Sidin9 - � - - - - ' ' -- � - -- ' - ----- � -
25. Drywall Nailing � - _ -.. . - -.,:� }.. _ � •�;.� _ , . , - - -" •- �
26. - Plaster Brown Coat � - - -- - � -
` 27. Electrical Power Meter-Final - � --� - - -- � " � � ' 1 �'
. 28:- Final Electric - - - - -- � .-. . - -`'�. , . . � � - . .
29.-�-Final Heating & Air Conditioning � - - � � - - ' ' �� - - � � � � � � '
30. Final Gas Pipe-Test - ' -- - - ' � ��
31. Final Plumbing - - � ' - ' - ' � � ` � ' "
32. Water Service-Final - - - � ' ' � '
. '33. Gas Service-Final - � - - � ' � ' � -'
34. Solar pomesticFinal � � ' � ' � � ' � �
35. Landsca e S rinklin S stem � � � � ' � � ` ` � � ' ` � � � ' �
36. Sound Attenuation - � - � -� - � � � � - �
37. Handicap Regulations ' • - ' �- � '- �� - ' � ' ' �� r'� � �
, 38. FINALSTRUCTURE&BUILDING � � " �
' 39. S ecial- Requirements Completed �� -
40. Electric Release to Edison �� . � - � � -
41. Gas Release to Southem Califomia Gas Co. • � �
' 42. CERTIFICATE OF OCCUPANCY - �
i No - Date , - " - . .
�oonesswem�ou+a: z970 MAUI PL
GYNERSN�WEIFRlONM: xEE, PAUL ROMAN TR
moxEss: z 9 � 0 MAU I P L
COSTA MESA,CA 92626
�vn. Yuw+o woxrss:
1pClIRECLOPFNtlNffA:
wcx ax eic.�s �oo�ss:
uc. no:
uxr:
CITY OF COSTA MESA -&UILDING PERMIT
PERMIT NO: P 087546 PLAN CHECK NO:
CONSTRUCTION TYPE: V—N PEAMZT TYPE: PLU
�� JOB DESCRIPTION : ZNSTALL WATER HEATER
tONiqA10PSN�` NOCR PLUMHING ( 714 ) 895-1246
CON111AttOR4M4181G 11612 KNOTT ST
"DOfl� GARDEN GROVE CA °0'N0'` 7Q7775
u r:
110EN5E0 CONTfl4CTOq5 DECLAHATION: 1 MreEy eRFm ��pe�nely d pm'ryry Net I em licrosetl under pwiio 1 d Chaqer e
�mmmarinv wim seuim �000l d oMsio� a d �ne euau,w ene a�r..� coe.. am mr �ense u in ew io2a ene anea.
cm uc. No.: uc. cuss: uc. No �
0 3 6 C-36 �T�0 7 : 0 9
Dma: Contrador. C T
��
OWNER BUILU UEC P�TION: I lweby dfirm uMa pmety d perlNry ihet I em evemq Iran tM Comrmm licaue lew for IM
Idbwip reeaon (�� ]W I.5 &niiece uM Prolmiau Cade: MY ciY a caunh �✓� �Guvas e perm! lo dmbud. ellm. impove.
demWeh, or repei vry aVu[Iwe, por �o ilf bauerce, ebo repuim ihe epplimM Im ach permil to fib e eqrrod M�emcu ihe� M a eM
u IioemeE pu�m�W to tM pvAriwu al ihe COMredas Lican�e lew �Cheqs B(��q �h Setlian ]000) d OMeion � W Ihe
Buairov erM Vrdeubm Godel a ihm ne w eha ia wmq thael�wn vM �he beaia la Ne Meo� ezemqion. MY vulmun d Saeun
]031.5 by enY aDNiraru la e pemN wbjeae iM ePqceM lo e d.�d penelry d iat mwa Ihen INe huMred dollen �5500�.
� I. d ovmer d iM proqrtya my anployeea wlh wpm m Ihei ede oompeiueuon. xi11Eo Ne xark. eM Ne evuclun u nd imaMeA
«ort�d ror me Is«io� �aa. e�uiress �d a�d�m,.com: me caannas ��w.,. �. ma. �,amdv m.� �.,,.r d yopeny
who WiEa w inprovas tharaon, ud who Eoas su h wak NmseM a MneR or tMaph he a ha ovm empbyeee, pwkeE Il�p wch
'vnqmemema ere m� irveMeC a dlemd la eab. tl. howewr, tM Wiki�p a inpv.emeM b wld xil�in anY� a camG��. iM
ow�wrb�ildar will hew IM duden d poviip M a ehe did roi buJd « impo.a la IM WTde d eab).
� I. u oxiwr d Ilw WOVeM. em e�dumaW mntreeM �th ticaeueE conlrenae ro canmud Ne VpIM (SMion IOM. &ninme eM
PManione coda: The Camretlav Licenae lew Aose nal eDWY b en ohner d D�W�Y xfn buitle « imp�ws tM�son uW who
mniracp la wM paptla wM e mniretlar�s) licenaed punuW to ine CaMrrla� Limnea lnw�.
� I un aampl uMer Swion: 8. 8 P.C,. M Nn reewn:
Date: Ox+nr:
i eo n�er �n�v mm i� a� a�a ��a.Ria�a ma �m,���n a c�romm r�m d,e smm coee saao� zssas. zss�. d,e
usa�. �d mm �«a�v na�n nuwuno «wc.�� wi i..a �a �au. �) �o.d �o w�*pv.�n .dd .im. mde. w ma r�a��,u i«
e D�� lawuvuctiana moGfiW ionhan iM Ri�arepa^w^� Dielntl. fie�keNielaonpiutlion ePPimtiom e�e ezemV� Imm �hau
,. porisiom.
. Dete: �DV«�
�� W ORKEH'S COMVENSATIp1 OECIAX�TION: I Mraby alfvm urMer penetly d prjury ane M IM fdbxinp Aetlutlioro:
��. � I Iws eM vn1 meiruan e catJ'rele d cmwm to utli�uun M woeken' cpnpauaz'v�. o povided la Ey Seawn a]OD d �M Labor
��, coea. �o, �n� wn�w< a ub .�o�t i«.d:�m m� o� a m.�e.
'I ❑ �nev..newi�m.�man.akeia•eano«uda,i�wree�..,�w��.dMs.a�msmodm.les«coe..armecm+«menoeam.
�� wpk f« whirh Nis permn o mued. MY+'a�n �^D^^+da^ �^wrar�ce �anbr W pdwy wmber ue:
c""" 693,D�A� &AGT z' EXPIRES
°di�' ""'nbeC 0 9/ O 1/ 9 8
�rn;, .«rro� „aw �a e> canaeroa � rne w�x u ro. �e ��d,.d emisiaol 0.6.0.1
❑ � canN �nel m iM a ine w«k Ia .h:� Ws o+�a m Ivuea. � eheu na qw �r va� in �n menner eo ea to
becomo wbjee io aomparombn bwa d Cdiloenu. eM e Nm tl aiW ba;ame aEjea �o �M wwkwe'
rompenuli iom ol �M LeEor Cale. I eMA lon� '� py MiN Ua rowiom.
o.,.: roa�:
v—
Wam/ig: FaYu aacun +'oA'en' compeiu�tlon rovweys Is unkwNl, siM sIWI wD/M en srrp oysr ro u1Mrel psneltlss enJ
dWl flnu yv ro one h�nOrM Nouwd Coll�n (S10q000A N aJJltlon ro tl�s cw� ol mmpaueflort 4�W u proHCW br In
Ssctlon 9106 0l M� Le�orCoas. Infenst, siM ertormy� /su.
CONSTPUC110N LENDINO AQENCY: I hereby elfi�m �nEer penelry M perM'Y �� �� n a consliuUUim bnEirp epe�wy br tM
porlpmercn M ihe xM la whitl� t�e perme n'owed (Saeion ]W), Ci�. C�.
LEN�ER'9 NNIE:
LENUEP'S RDDPES4:
I ce�ity Il�et I heve rtaE Ihe eppficenan enE etete Ihet tM ehwe kdammion e cortq. I ep�ro lo comply �Ih ell dry erd caumy ordirier�cae
eed ele�e lexe'eleliq lo dukip mmVUCim ard hetebY aW�vrze �epeaenlalivef d Iho d�yb enlar upon IM ebwsmarYunad prope�ty
lor impecYion Wrposes.
xoN cx
Pnn� �
Dme:
pnetu�e a er RpenVAppYcaruK.orurada /
(5151 <B.W P) 'NMa-6uildM 8 5alery: OrteMFb: Cerary-ADW"�I: Rnk-Raxnue: C»benmtl-bwav
CLAIM VALUE:
CALC—VALUE:
��
I��I 7�/
�a•� .• �•�
•
•• •
SQ FT;
GROUP OCC: R-1 /
COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMZT
�r�r��r**�r*�**�**�*�r****��*x�**x�r****+r�***�*�*���+�*�r�****************��x+�**�*�*+�**
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
----------- MAZN BUILDING ------- — --------- ACCESSORY HUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT ZN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PAACEL: 13925219 ZNE: REF NO:
PLANNING NOTES>
> �:
iE iE iF if ik �k iF iF iF M iE k i@ if 1t ik iE iF it iE iF �F iE 1E iE 1E iE if 1f �f fE iE iE iElE iE iE iE iE iE iE ik iE iE if iPiF iEyif ik iE iF iE if iE iE 1k iF 1E � iE aE �1f 3E if iE iE iF �E �E if iF iE �1E fE iE if iF if
D E V E L O P M E N T S E R V Z C E S,�` R E Q U Z R E M E N T S
ZONING APPROVED BY y�" DATE:
/ .
BUILDING APPROVED BY ; i� •� DATE:
APPLICATION ISSUED BY; �� DATE:
iE')fiE'1hiEifiEikiEiFiFiEiEiFifklEiEiEiEif3f �f iE 1E 3FiEjEiEiE jF'1FiFiFifiFiE3EiEiEfk�EiF��iF1E
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECAANIC FIRE SMIP/RES GRADING
PERMIT
11.00
25t
SMIP/NON-RES
PLAN
ISSUE FEE 22,00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 11.00 22.00 0.00 33.00 33.OU .00
REVENUE DIVISZON TOTALS--> COLLECTED: 33.00 OVER/SHORT: .00
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
33.00
!k if ik iF if it iF ik �F iE iE ik 1E �k if 1k if if 3f �E ik iE 1f 1f jE �E iE iE �E fE iE if iE if iE iE 1f if if iF �E iF if iE iF iE if ik if 1F if if 3E 1f iE iE 1E iE iE �F aF �E iE iF aE �E iE �F 1FlE ik �1f iE iE iE �F iP iE 3f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 11.00 11.00
END OF FEES
84-02-1998/11:52 HH/533.B�
RCPTH:31-�0�1816
F'ERt'iIT:087546
CONSTRUCTION AND PLANNING POOL & SPA
APPROVRLS Permit # Date Inspector AppROVALS Permit # Date Inspector
i. TemDorery Electrical Service or Pole 52. Pool & Equipment Location
2. Soii Pip¢�Undrgrnd. 53. S[eel Reinforcement �
3. Electrical Conduii Utility-Undrgrnd. 54. Forms
4. Electrica� ConduibUndrgmd. 55. Electrical Bonding
5.. Steel ReintorcemeM 56. fiough Plumbing & Pressure Test •
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings � 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �
°. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Structura� Floor System 67. APPROVAL TO DECK
� 1 i. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Dra�ns 64. Plumbing System � Final
14. Rough Plumbing 65, Electricaf-Final
15. Rough Electricai-Conduit 66. Solar System�Final
76. Rough Electric Wiring 67. Fencing & Access AnProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough E�ectriwl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning , - � FIRE DEPT. REQUIREMENT
20. Rough Factory�Fireplace • APPROVAI�.S . Permit #
21. Dycts,��in Structure � � 70. Underqround Hydro
22. DLcts,Ventilating-' " ' 71. Product�PipingOGas OOiI
23. Gas Pipe-Rough & Test . 72. Underground Flush
24. RoofFraming ' 73. Undergrnd.StorageTankOGas ❑Oil
25. Roof Sheathing , � � . 74, Overhead Hydro_
26. T-Bar Ce�ling (Structurall & Monocaa[ � 75. Dry Chemical � �
27. Frame and Flashing � 76. Dry Standpipe T �
28. lathing & Siding � 77. FIXED SYSTEM FINAt � .
29. Insulation 78.� FIRE PREV. FINP,L
30. Orywall Nailing - WE�ALTH DEPT. REnUIREMENT
37. Platter Brown Coat - 79. FINAL INSPECT�ON �
32. Electrical Power Meter�Final �80. FOOD CERTIFICATE ISSUED
33. Final Electric , , ' Notes: ,
34. Finai Heating & Ai� Conditioning � ' - �
35. Final Gas Pipe�Test ,
36. Hood or Canopy . � � �
37. Finai Fa�tory Fireplace . . .
38. Final PlUmbing . �('O�
39. Water Service-Final /�_7 ,
�40. GasService-Final •
41. Solar pomestic-Final -
42. Backfiow Preventer � •
43. Backflow Irrigation
44. LandscaPe Irripation SYstem .
45. Sound Attenuation
46. Handicap Regulations
47. FINAL $TRUCTURE & BUI�DING '
.- 46. FINAI PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
�
�
�
PqWECT ADONE55: 2(j 7 O MAU Z PL
OWNEP'S NAME: KEE, PAUL
aooness: Zg�O MAUI PL
COSTA MESA,CA
AHCHIENGINEEfl:
aooeess:
uxir:
92626
flEG.NO.:
uxiT:
PEflMITTEE: QRANGE COUNTY SERVICES ( 719 ) 541-9753
aooncss: 3022 N. HESPERIAN WY 101
SANTA ANA CA_.92706
UCENSEO CONTflACTOP OECIABATION: I �ereby allirm iha� I am IicenseG unaer pmnsions ol ChaD�e� 9(commencing wi�� $ection
7000� ol Division 9 0� Ihe Business antl PmtesS�ons Code, antl my license is in lull forte anA eilec�.
cirruc�.:1'0605 B srnTeuc.:67 cuss �_�
�ate:0' Sign re:_
WOHKEflS' COMPENSRTION OECL�1flATI0N: I �ereEy irm illal l have a tertilicate ot ton5en 5eI6in5ure or a cetlitiCate o� Workers'
Compensation Insurance, or a cero�ied coOY Ihereof ( �ian 3800. Lab. C�.
roucrNo.: W991100990 E%P.UATE: OSIOL�9S
camvaxv: CA COMP .
� Cenilietl copy is hereby fumished. ❑ Cenifiea coDY is -'a 't� t�e city Buildin ivision
�ate:�5 -2--� �/ APDlicanL
ESEMPTIONFBOMWOBNEBS'COMPENSAiIONOELUIlATION: - 5ectionneeOnotDemmplete4ifNep ilislnronehunCretl�4100�oNus).
I certily t�at in ine peAormance ol ihe work lar which Ihis permit is is5ued. I shall noi employ any pe wn in any manner so as �0 6ecome
Subleci �o �he Workers' Compensa�ion Laws ol Gali�omia.
Date: Signa�ure:
NOTItE: II, aller making �Ais declara�ioq you should becOme su01e�� �o Ihe Workers' Compen5aiion pmvisions oi Ihe La6or
Code, you mus� lotl�vnl� comply wii� such O�ovisions or thi5 Dermi� shall Ue tleemeG revokeA.
CONSTflUC110N LENOING aGENCY: I her¢Gy a�firm I�al �here is a tonsW[Iion IenOing agenty lOr Ihe pedormance ol Ihe work �or
which Ihis permit is issue0 (Sec�ion 3097. Ci¢ C�.
LENOEfl:
AOOHESS:
OWNEP BUIWEN UECLABATION: I �ereby ailirm I�a� I am e�empl �mm Ihe Conlraciors' Slaie License Law for ��e lo�lowing reason
ISection 7031.5 BuSiness ana Pmfessional CoUe: Any city oi fAunty wnich reauires a permit �o constmct, alter, impmve, Aemolish, or
iepair any 5�mciure. O�ior to i�s issuance. also reQuireS i�e applicanl br such permit to lile a 5ipne0 stalemen� Ihat �elshe is licensetl
pursuanuo Ihe pmvisions ol Ine Comraciors' Slaie license Law (Cnapier 9 �commencing with Semion 7000) ol Division 3 oi Ihe 6usiness
. anA Pmlessions Code� or Iha� �e/she is eKempi ��erelmm antl ��e basis lor I�e allepe0 exemD��on. Nny violation ol Seciion 7031.5 by
'� any applicanl br a permi� subjec�s Ihe apDlicani lo a ciWl p¢nally ol nol more I�an five �unOred Dollars (5500�.
I, as awner of �he prop¢ny or my employees wit� wdges as iheir Sale compensation, will do ihe work, an0 ihe
❑ simcmre is not intende0 or olleretl lor sale �Secuon 70ad, Buvness and Pmfessional Cotle: The Contractors' State License Law
tloes nol apply �o an owner ol a OroOehy w�o �ui105 Or impmves l�ereon, and who tloe5 such work himselflherseli or Ihroug�
his or �er own employee5. pmvi4e0 I�al such impmvemen�s are noi inl¢ndeU or of�ereU lor sale. II, howeve� l�e building or
improvemenl is sola wilhin one year ol completion, t�e own¢r vrill M1ave Ihe Ourtlen ol pwving he/5he Ai0 noi �uilA or improve
lOr I�e DurpoSe ol 5ale�.
I, as nwner ol I�e Dmper�y, am eKclusivery comraciinp wi�� licensetl conVacmrs Io consimcl I�e O�ole�� (Sec�ion 704a, Business
❑ and Prolessions Code: �Oe ConUacwrs' State License Law does no� aoVN lo an mmer ol pmpetly w�o builtls or impmves Ihereon
antl who conVatls br suc� pmlecls wii� a conira[Ior(5�1i[ense Dursuanito ��e Camractors' Stale License Law�.l am aware
Ihat pmol al Iheir Worker'S Compensalion insuranre shoula Le OmviOetl to me.
� I am ehempi unaer Seaion: B. 8 P. C.
lor mis reason:
oa�e: Ownec
I Uo hereby cerlify Ihal I am aware o� an0 unaer5iand Ihe repuirements ol Cali�ornia Neallh and Salety Code Seciians 25505. 25533, and
25534 antl �hai I or any tulure building occu0ant wilVwili no� �circle one� nee0lo comply with said slale codes antl Ihe requiremenls for a
permi� �or conslmc�ion or motlilicalion Imm I�e Air Ouabty Managemenl DiSlrici. fleSiAeniial con5imc�mn ap0licalian5 are exempt �mm
IOcse orovisions.
�a�e' Applicani:
I �ereby cerlify Ihai I Aave rea01hi5 aD�lica�ion and slaie ihal Ihe above inbrma�ion is cor cL I agree to comply wi�h all ciiy and counly
or0inancesanastalelawsrelatmglo�uiltlingconsimctionantl norrzerepresemati� sotinis ilytoenteruponlheabove�menlioneA
pmpetly lar inspection pur0ose5.
Oale���` �y SignaW e:
�river's License or Social $ecun�y 9:
i5ni-a6 White-Builtling; Green-Cotle EnlorcemenL Canary-AOO��canl: Pink-Revenue: GoleenroC-Assessor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 067016 PLAN CHECK NO: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE
JOB DESCRIPTION : UPGRADE ELECTRICAL WORK IN RESIDENCE
CLAIM VALUE;
CALC-VALUE:
PERM NO: E 067016
GOVT: N SUPP; Y
PURPOSE: OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: ELECTRICAL WORK ONLY RE;itE66880
�����x�x �r**�x���r**+�+r�x ��r*****�r**4x�+r�******x�***�+r*��**�r+r�rx�r*****x�+r***+r**+r**x **�***
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY SUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGI-IT; FT IN LEFT: FT IN RGI-IT: FT IN
PARKING REQ: PROV: PARCEL; 93913222 ZNE: REF NO:
PLANNING NOTES>
i
*****+�**�r*****�r+r+�*x�*�-+tx-+�ir�*�r*�r�r+r+t+�*i�-*�t***�x*�-+�*****�*�*****�x�+c�*****�-*x��-�*�*�t****
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
�:
ZONING APPROVED HY DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: 'J� DATE: 3] z-
if 1E if if i(� 1E 1k if i� iF �E iF iE iE iE iE iF M iF if iF if'if3f iF�iFiFiFiF3FlF�fiF�iFif';FiF 1f if��F3F S�jE�fi�if�F�FjFjf�F�FjR �f �E iE iE if iF 3f iE iE7F iF�iF� if
it it if if if %it if it iE iE �E fE M iE 1E iF af r if iE 1E iE if iE K if if if !F iF iE iF iF 1E if iF iE if iF if iE iE iE 1t iE iE 3f iE iE iE iE 1f ik �E iE jE �t 9E �k iE iE if 1E iF iE iE if iE iE 1E �E if fE if if �F iE iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/RES GRADING
PERMIT 51.25
SOt SMIP/NON-RES
PLAN
ISSUE FEE 4.50
BUILDZNG-DIl7-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 51,25 4.50 0.00 55.75 55.75 .00
REVENUE DIVISION TOTALS--> COLLECTED: 55.75 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
55.75
fF �f fE iF 1E �E if if iE if * If iE if 1F ff K fF fF iF iE aE iF iE iF iE if if if if iE iE iF iF iE fF 1E iF 1F iF 1F if M if iE iP �E iE it 1E if ff if iE iF iF iE iF iE iE 1f !E 1E iE if 1E jF af if iF if iE iE jf if if jf fE iE
I N D I V I D U A L F E E H 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
ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. ,75 15.00
ELE 6 RECEPT/OUTLET i ST 20 EA. .75 4,50
ELE 1 RECEPT/SWITCH 1 ST 20 EA. .75 ,75
ELE 1 NON-RES APPLIANCE NOT OVER 1.0 HP 3.00 3.00
ELE 2 MOTOR/POWR APPARATUS 0.0 - 1.0 HP 3,00 6.00
ELE 2 MISC CONDUIT NOT LISTED REQ PERMIT 11,00 22.00
END OF FEES
O1 00154E42-OD159E42 Tr] T 55.75
DATE: OS/D2/9S TI11E: 1D-39
� CONSTftUCT10N AND PLANNING
APPROVALS Permit-ir
iL Temporary E�eCtncai Service or Pole
I 2. Soi' Pipe�U�drg.r.d.
I'�-------- -
� 3- E:tctnccl Conduit Ut�i�ty��ndrgrr.d.
�4 Eiecrnc:,1 Condurt�Undryn,d.
----- --
5. S!v��'� Rc.n+a,e=_ment
� G E'.^�L.u' UFEFl f'�^d
� 7. f-nuting: ------- -
�_.____ -
i 6. Poi�nC�t�on
�J. N�atcr P�pn��lnd�gmd.
I 10. S"t.ctu�a! Floor S�stc�^
i_- - ____
11, FTne'!y S�".?r :i�P & I�c: -c ConncCtio�
I� 1 �. 5: c C�p ---
, 1.3. h�uf Cra n, T
�14. Paugn f-��umbina
tE.. Rouyn Elecvlcal-Contl,.t
i lE. Rough Electr�c!4`iring
I___ _
i 7 7. Rough tYh mg Sign
18. Rough Electriw��T Bar C.�ii�ng
79 Rough Healing & A�r Cor.dition�ng
3C Ro�y" FaC�r„ F�reo'ace
?1. D�t'r. �� S.ruct�re
22. ��c;s, Vrn±;lat�ny
23. �o,�: Plp-.Rouah & Tesi
7�i. -"9oa Fram��,^3 -�-
75' �,�c+ Sh,at�lag -- -
� 2f,. T °.��- C:,f�cci {Strac;�:a'.1 E �'o'.ocoat
i 27. F.am: �•no r!ashina ----�-
r--- -- - -
� 2£S. �. �+n�nn S S�d-n7 _
� �3. .s�,� �,t r,n .
�0. J�ve. �„I ^:a�,4n9
31 r �J�iEr �10C.� CAui __--- --
� 32 :I�cr��c:�. Ja�..et G�¢ter�Fina'�.
� 33. , ^c' Elcn•�c--_ _ -.
�34. Fint�l Nr.c;�ry G�. A�r Co� h:t'ovrg
---- - -`-
35. F n�l Gas P�pe•Tesc
36. �;�od or Canopy
37. F�nai Fucto.v Firep�ace
38. Fnal P��„robing
39. �V.ter Service�Final
40. Gas Sen•�.ce�F�nal
I47. Sa dr pomc�.icFinal
42. 8���,r.'d�cti: P�eventer
�3. Facl I�o�v lrrraLon
�---- -
9�.. Landscape I�rigation Systam
45. So�nd A[tenuation �
QS. Hardieap Regulations ~
r47. �I�'AL STRUCTUFE & BUI:.D!�dG
48 f-II�qLPLANNI��G
A9. Eiec[r�c Releasc to Edison
50. Gas 9elease to Southem Californ�a Gas
51. CERTIFICATE OF OCCUPANCY
Date
�
� Poo� � sPa
Oate Insprctor � APPROVALS Permit i�
52. Pool & Equipment LocaYun
53. 5!eel Rc�nfortement
5�i. Forms
� 55. Electrical Bnnd�np
� 5E Ra�gh Plumbmg & P.essure T�St
l 57. APPROVAL TO COVFR-GUl;�TE
�- -- ------ -
5S. Electrical Cocd�a•Urdrgmd. '��
59. Gas Pipe, i� UnUigrnd., Tcst �
�
- -- -i
E0. Backcaash Lines. P-TrcP. C Unc��n�rd �
Gt. APPF!OVALTO'JECK
62. Bac;o;:a;h t4 Recep`or�Fi�al
53. Heater & Vem-Flnai ^
64. Plum6ing Sys[em � Finnl
G5. E;octrical-Final __ _
66. Solar System�Ph�ai
67. Fencin� Rl Att�ss Aupro:al
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEh`.SFINAL
FIRE DEPT. REQUlREMENT
.4?PROVALS Permit �
� . -I i0. Lnde�g�c,.nd HyGro � � �
-�-t- i----i •
� 71. Product Pipinq ilGos �Oil i _ � __ j
- �' - - �--
- � 72. UndergrOund Flu�h i' � '
-__} _-' _--__-� _ -_ i___.'- -'
i73. UnCergmd. Stcra��,,� Ta�.;< ^ G� -_. 0. � � ,
--� --- - - --- - -- -- - �- - - --
' 74 O�erhead Hydro � �
_-'_ __._'_ _ _ __ _ _---_ _---� _.__ _ '-__ _
� 75. Dry Chemical �
.�_' -___ -__ __ __ -___ , __-. _ ___-
� � 75. Ory Stantlpioc ' r
-�------�-77. FIXEDSV3TEM-Fi^.AL----- � - ---I--- �
, _" _.. __-'I _--J
_��,_-.____ _ _-__- I
78. FIHE PHEV. F!NAL
-' -- 7
IiEALTH DEP7. RE�UIRE��If_i11" �
��------------ ---- ---- '- ----- - ---------`
� I 79. F�NAL INSPF.CT�O'J i i '
'__- __'-_.+_ _'__"'".___.__ _-____ _`_ .. 't _ _.�
.' � 80. :�OOU CE��i?IPI('A'E �SSUCD � i
-1-n-�7--i{ _-__-_____.____i._._..__. ______�'
� � ���1•�� � Notes:
i nycr-
Qy: � �------ ----- - - - -- --
--- ----'------ �---+
--
------ - --------�--- -��
- ---- � - --� -- -- -�
- --- - -- --- �
Aoo��cant to till in all spaces exceot those within heavr boraer Iines ana sign all approDrlate tleclarations.
PE IT NO. � TRACT NO. LOT NO. UNIT . O3%9 4IO I IB5
CITv oF COSTA eM�ESa�7 CON TRUCTIO/}N-/PERMIT'' . � Z Z '; n.OG TL
. Project Address oC� /� ;rf �/� " . , • .
AppliCdnt"5 Mailin Addr¢55 -��e—Clf�++�" • ' TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
�c--7�c�.� ❑ CONVERSION ❑ DEMOLISH � OTHER qp # 20�8
Owner's Nam^e �._�.��__ Phone.�.11—�s% DESCRIPTION OF WORK/USE OF BLDG.
Address �`L�-�c ' ' S Main Building: Accessory Building:
� Z
Arch/Eng. � � License No.� TYPE OF PERMIT �. caaDirv FOurvoATION ❑ STRVCruaAL T Front ' . '" O
Add�¢55 � � ❑ TENANT ❑ ELECTRICAL PLUMBING MECHANIGAI B • , ' _ ' � N
Rear � ,
Contrecroi s Name Phone Oo ��OTHER � � � %A
PROJECT DESCRIPTION SQ. FT. OCCUPANCV C Right �- . - G
Address (mailing) � %� K ' �
, CONSTRUCTION TVPE '�' ' ' VALUATION $ g L¢ft R�
Ciry License No_ �� � � ZONE � GRADING CU.v05. � ACRES � Ping. Ref. # � Parking Req./Provided ' �� Q
LICENSED CONTRACTOR DECLARATION - -
I hereby a(firm that -I am licensetl untle� p�ovislons of'Charter 9(commencing Remarks: ' ' . ' Planning Notes: - ' ' ry�
with section 7000) ot Division 3 of the Buziness antl Professions Cotle, antl , ' , . T
my license is in tull force ancl eflecL ' ' O' ' ' � i .
Licenie Qass � � Licen o. � , S.
Date ;��R- Ac Signature � PLUMBING � FEES � '
WORKERS' COMPENSATION D CLARATION � Bd1 Sink ' ShOwE�S . ELECTRICAL ' FEES
I Itereby affi�m that I have a certificat¢ of consent to self-insure or a certificate
ot Workers' Compensation Insurance, or a cerliti - coOY ereot (Section Backflow Prevente� Service Sink ' � -
3800, �ao. C. Automatic Washer - Transformer � 15-50 KW
�icy No. �����y�0) Company Backflowlrrigation $ewerCa - , � � � '�50+KW
P Construccion Pole Su6.
Certiiietl coOY is hereby furnishetl. . �
Ce rtietl mpyJ �s filetl wirn the city Bwl Div io�J 8athtuhs Sewer Connection Cooking Unit Meter Dup to 100 amps
ate �"aQ'�2i� ADPlicant���'� •• '
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers � . Solar Collectors. Dishwasher � ' . Meter �Ov¢� 100 amps . _
(T�is section neetl not be completetl it the Dermit is for one huntlretl (E100) or � - �
less). � � Dishwaiher . - Solar Pipin9 Dryers ❑Gas �Electric Sub Panel
I certify�that,in the perlormance of the wo�k fo� which this perm�f i5�is5uetl, I .
shall not employ any person in any manner so as to become subject to the ' Drinking Pountains Solar Tank � Fan� C � Motors �0-1 HP O1'h- 6 . �
Workers' Compensation Laws of Califomia.
. Date Si9nature ' Floor Drains ' Swimming Pool w/Spa F.A.U. � Inc. Solar �9-15 HP 016-15+ '
'NOTIC : I, after making this tleclaration, you shoultl become subject to the
Wo�ke�s' Compensation provisions,of the Labor Cotle, you must forthwith FI00!$inks � . U�in21 '- '- '' Fi%tu�25' ' Microwav¢ �
comply .wi[h, such p�ovisions ov this permit shall be'tleemetl revoketl.
CONSTRUCTION LENDING AGENCV' '�' � Gas S2rviC2� ' OutICtS Water Closet . Device Boxes Pole Li9ht �
1 hereby affirm that there i5 a construction lentling agency to� the pertormance
of the work for which thi5 permlt,ll�iSSuetl (Section.3097 Civ. C.) Int¢rc¢pt0�5 �• Wate�H¢at¢� ' 2 Out12t5 Range
ltntler's Name= ����
Lentler's!qOdress ' ' � Kitchen Sink Water Service - � Switches Sign
OWNE0. BUILDER �ECLARATION ' .
1 hereby affirm that I am-exempt trom the Contractor's �icense Law for the Lavatories • Auto-Wash , Garbage Disposal ; Standing Sections .
. tollowing reason (Section �031.5 BuSiness antl�Protessional Cotle: Any city or .
county which requires a permit to construct, alter, improve, tlemolish or repair P-7rap . - Laundry Trays � - Generator �65 KW �5-15 KW Trash Compactor
any structure, p�io� to its issuance, al5o �equires tM1e aOP���ant for such pe�mit _
�to file a'signetl statement that he/she Is licensetl pursuant to Me provisionz oi Roof Drains ' ' � — �
th¢ ContractoYs License Law (Chapter 9(commencing with Section ]000) ot
Division 3 of the Business antl' Profe55ion5 Cotle) o� that he/she is exempt � - ._
there(rom antl the ba5is for the allegetl exemption. Any violation.oT Section �
703L5 by any applicant for. a, permit 5ubjects .the applicant'to a civil - ,
�enalty otinot more than five huntlretl tlollars ($500)., , ' ' ' , ' '
LJ 1, as, owner of the property or my employees with wa9es as their sole Reinspection �Fee , $15 Issue Fee $ 3
�Compensation, will Go the work, antl [he 5[�ucture is not intenGetl or otferetl Reinspection Fee $15 ISSu¢ F¢¢ $ 3
for sale (Section 7044, Business antl Professional Cotle: The Contractor's MECHANICAL' . FEES
License Law tloes no[ apply [o an owne� of a p�ope�ty who Guiltls or improves
thereon, antl who tloes such work himself/herself or through his or her own � � - DEVELOPMENT SERVICES REQUIREMENTS: �
employees, p�ovitletl that such improv¢ments are not Intentletl o� otfe�etl�tor BOil2� HOOd O� TypB I ❑ �
sale. If, however, the builtling or improvement is soltl within one year of com- '� . ' - � Canopy Type 11� 0�. Zonin9 Approved By Date
pletion, the owner will bave tM1e bu�tlen Of proving he/she tlitl not builtl o� im- DuCt-- UOd2�. G�oUnd ' � BUilding App�oved By Ddta
prove for the pu�pose o! sale). • � ,
❑ I, as owner ot the property, am exclusively contracting with licensetl con- Duct-Structural Refrigeration System ' Application Issued�By Dat �
tractors to construct the project (Section ]044, Business antl Professions Code: � ' � �,
The Contractor's License Law does not apply to an owner ot property who ' Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARV OF FEES '
builds or improves thereon, antl who contracts tor such pro)ecls with a con-
tractor(s) license pursuant to the Contractor's Ljc nze Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILOWG PERMIT $ SMIP $
proof of their WorkeYs Compensation insur shoultl be provitletl to.me. PLAN CHECK .$ PERMIT
❑ I am exempt untler Section B. B. R C. tor this reason Firepl/Fact. Blt. ICBO # Fire Dampers � PLUMBING' $ S-O� ISSUANCE $'
oate Owner ' ' Heating System & Ducting Re9isters ' pLqN CHECK 25%� $ ENERGV P.C. $
I nereby certity that I have read this ao ication antl state t�at tne above �4100,000 BTU 0100,0006T ' -� ELECTRICAL . $ GRADING $
information is correct. 1 agree to com0ly ith all cIty an counly ortlinances
ana state laws relating to bu"Itling constr ct n,.and y authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this city t ter upon abov ionetl property tor � . /r• R�
in5p¢Cti00 Ptllpo5¢5. p �p�
Signature Date��rJ ;,]Z MECHANICAL $ TOTAL FEE $�-L •�
Drivers' License Feinspection Fee $75 Issue Fee $ 3 PLAN CHECK 25% $
CMF OB65-46, rev. 30/84 White - Builtling; Canary - Applicant; Pink - Accountlng; Goltlenrotl - AsseSsor
\
� '�S
- CONSTRUCTION AND PLANNING . ' � . POOL & S°A• .
- APPROVALS Permit # Date Inspector I • APpROVALS Permit # Date Inspecc�r
1. Tempo�ary Electrical Service or PoVe ' _ 52. Pool & Equipmen4 Location •
i 2. Soil Pipe-Undrgrnd. - '. � 53. Steel Reinforcement -
3.'Electrical Conduit UtilitV-Undrgrnd. , 54. Forms -. -
4. Electrical Conduit-Undrgrnd. 55.� Elect�ical Bonding �
r 5. Steel Reinforcement ' � � � 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. � � 57. APPROVAL TO COVER-GUNITE
; � 7. Footings 58. Electrical Concluit-Undrgrnd. �
�8. Foundation - . ' � - 59. Gas Pipe, 0 Undrgrnd., Test - .
, 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural FloorSystem 61. APPROVA�TO.DECK
17. 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 Electriral-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 Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil �
23. Gas Pipe�Rough & Test 72.;�pderground Flush '
24. Roof Framing 73. Undergrnd. Storage Tank � 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 INSPECTION
32. Electrical Power Meter-Final - 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes: Y ��,E�" �Q� •(��p
34. Final Heating & Air Conditioning .
35. Final Gas Pipe-Test �
36. Hood or Canopy ' .
37. Final FactorY Fireplace � ,
38. Final Plumbing � �fl -
39. Water Se.rvice-Final
40. Gas Service-Final -
41. Solar DOmestic-Final � '
42. Backflow Prevenier � � � . � �
43. Backflow Irrigation ' .
44. LandscaPe Irrigation System ,
45. Sound Attenuation �
46. Handicap Regulations � �
47. FINALSTRUCTURE&BUILDING '
48. Special Fequiiements Completed �. .
49. Electric Release to Edison . � � - - �
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY � � � . � ,
No. - Date . '
Avgust 29� 1972
Afr. Paul Kee
2970 Maui Plece
Costa Idesa, CaliPornia
Dear 61r:
A building peaffit has Deen issued to B Haven Poola to
conetruct e private sNimaiag pooi on yrour property.
In order thet your pooi �K� sa4e one az►d tor the
purpose of advising you oY your sibility regerding the
requiremettte of the Costa Mesn cipal CoBe, sre reYer yrou
to Hectlon 8107� a copy of tlhich Se attacLed.
This ]atter is cted to you in order that yrou xtll be
avare oY our orflinences cea meke a co�lete_�eaYetyr check
of your pool area. ,
Sincerely youra,
�
RICHNRD HAHHART
Builfling-Safety Mrectos
RHiar
Ehcloa�ses
� 2
�= A � .
�_`� �o Twininq Laboratories �f ��U�E�,= euc�fo�.=ui, �.�.
W2 �♦ y P.O. 00X �1 . 7310 Al2POR.7 WAY . LONG BEACH, CA4F. 90801 . �213� �itr1355 . �717� 676�t386 • �714� 818�W72
pAnnC� OFFlCES:
TESTING �Si��DNennMnwrYua � Ne.�O�a•�.c•�wLo:.y
Sw���iuG:�em��ql0l �♦���K'• %SSo�Eenda�n v.Ob.�l
- PI�I Sl�dpS {�. i.. le•q 1�rtF. GGl KlO� I}Il) e)4.}]t6
1 �L `P
��
October 25, 1972 - Corrected Report
' COMPRESSION TESTS ON CUNITE
Joseph M. Henley
1913 Newport Bivd.
Costa Mesa, Callfornfa 92627
PROJECT
ADDRESS
SAMPLE FROM
ARCNITfCT
Lester Palley
ENOINEE0.
MIX
DATE CAST
DATE TESTED
CYLINDER NO.
COMPRESSION
TOTAL LOAD, LBS.
Examinarion: SC72-59�+�
tYIINDERS
��a ��U
15 x 40 Swim Pool for PAUL KEE
2970 Maul Ploca� Costa Mesa
2- 81 Bottom. 2- B2 Sidewall. 2-.93 Bond 8eam
CONTRACTOY
Dlue Havon Pools
SU6CONTRACTOR
Genturyr Gunite ,
SPEGFIED
STRENGTH y�000 p5i
9'1 �'%2 . SLUMP
9-1f3-)2 9-i8-72 9-18-72 10-24-72 10-24-72 ' 10-24-72
1 2 3 ia 2a 3n
7-Day 7-Day 7-Uay 43-Day 43-Day 43-Day
40,000 40,000 25,000 75,000 72,ODo 55,500
POUNDS PER SO.IN, j 51y0 j 6�Q 962 Z 8J� ' Z])2 2 �40
512E:
COMPIIANCE
CYLINDERS
DIfTRIW710N:
���� �sta Mesa
Blue Havan Pools
Centrury Gunite
. . � � .
5-3/4"xl2" 5-5/8"xt2" 5-3/4"x12" 5-3/4"x12" 5-3/4"xt2" 5-3/4"x12"
/MDf �1' DEIIVEYFD OT
Jos. M. Henley
�`�C/e�26'��
[ECEIVED OM
9-13-7z
,o. ;� S. " ;. .
�^ ? ^ ^'L
� � .. • ,.,
Jos. M. Hanlay '
. ' ' � �
•Ll 11EPORTS �RE SVBMITTEO �5 TNE CONf10ENTr�I vPOPEwTV Oi CLIENtS. �VTHORI2�TION FOR PUBIICnTION O� OUR REPDXT9, COHClUS1ON5. ON E�
iRACTS fNOM OR REG�RDING TNEM I$ PESEPVCD PENDIHG OUF Wfl1iTCN FpPROV�L �5 A MUTU.�L PFOTECTION TO CLI[NTB. TNL PJGLIC �NO OUXSEIVES
330�12
.
�
�
�
PPOJECT POOflE$S: Z 9% O �'i�iU 1 PL
A OWNEB'S NAME: KEE(, PAUL
, ROOflE$S: 29%V MAUI PL
COSTA MESA,CA
557-5327
AflCNIENGINEEB:
p00flESS:
UNIi;
92626
NEG.NO.:
UNIT:
vEeminee: RAZNPROOF ROOFING ( 714 ) 536-8702
aooeess: 369 P.O. BOX
HUNTINGTON BEACH CA 92648
IICENSEO CONTflpCTOfl OECIABATION: 1 �ereEy allirm Itwl I am Iicense0 unCer 0«Ons 01 C�apter 9(commencing witA Seciion
]000� ot pdvon 3 0l I�e BuYneu aM Pmfe55ions COAe. an0 my IiceRte is in IW force anE ellett.
ciTvuc.:04944l2 sr�reuc.:557494 euss: 39
Oate: ��� ��` Signamre: �-
WOPREBS'COMPENSR710NUECLABATION: I�erebyaHirmt tllwveacetli�ica alconse uosell+nsuawacertilkateoiWorkers'
Compenution I s a o ilie y t�er¢Of (Seclion 3800, Lab.
POLICY NO.: ���� ���— �� EXP. ORTE: 4� O 1 I 9 3
coMrnxr: STATE FUND
] Lenifiea copy is here0y furmS�eE. � CertifieE copy is IileO wt tAe ciry BuilUing Division. �
Daie: �— � � � � AppliWnC �
E%EMPIION fPOM WOflKEI1S' COMPENSRTION OECUIiA710N; (flis ' nxG nDI Ee mmpkteE il �he pdmi $ Iw me tunN¢d (570� or kss�.
I cetlity Itut in �h¢ OeAorman[e ol I�e work for w�ic� Itus permi 5 issued. I hall no� employ any perwn in y manne�az �o Decame
su6iect lo tne WorkeR' fAmpenSation laws ot CaGfomia. /
. � L
Daie: � � Sg�ature:
NOTILE: II, atter makinA I�is Eeclaraiion. you shoul0 Uecom uGjetl to t�e Work ' Compensaiion Drwisions ol t�e LaOor
CoOe. yau musl tanMnth Wmpty witn sutn 0«5 or It ptrmit StNA DB AeemeE rewkeA.
LORSTBIICTION LENOINC AGENCY: I �ere�y allum ��at tnere 6 a mmlruciion IenOinq agem.y for t0e peAarmance of ihe work for
wnicn ihis oermi� is issuM (Section 3097. Gv. C�.
LENOEX:
nooeess:
OWNEB BUILUEB OEClAMT10N: I �ere0y aflirm tlwi I am exem0� ��om t�e Contracmrs' State Lkense Law for t�e follawinp reasan
�Section 7031.5 Busineu an0 Pmleuional COGe: My rity ol county w0ic� repuircc a Dermit ta wintruct, alter, imprwe, Uemolis�, ar
repdi� am' siNCW�e. ptior to �6 i55ua�e. alio replluCS Ine a0d�� �or wtli ce�� to Ide a 9pn¢O Slntemenl tiul nUstle 6 licenutl
pursuant lo Ine Omvisi0rt5 0l the Coniracbt5' SWte Lkenu Law (Ctupter 9 �rAinmenGnq vAt� Settion 7000) ol 0ivision 9 of the Busines5
anA Proles5ions fAGe) ot I�at IK/s�e rs eeempl t�eRlmm anG IAe Edsis lor Ihe'aAEqeO exemptiM. Fny vioWtion al Setlion 7W7.5 by
any appGWn� bt a D�rmi1 suUjMs I�e applit2nt to a avil pdulry o� ro� more Ilun live �unGrM daAdrs (5500�.
I, as ovmer ol ifle v�ocenv ar my emyIoyea witn xapes u iheu wle wmpenution, vnT ao ine wark, ane tne
❑ s�mcWre is not intenGeA or olhre0lor sak (SeCtbn 70aa. Bus'u�ess antl Pmlesvonal Code: The Contractors' Slate Liunse Law
Ooes not aD01y to an owner o� a D�oOeny wtq OuilUs ar improves �tlereon, an0 wlw tloes suc� work �imsell/hersell or �hmugh
nis or IIEr awn employeCs, proviG¢G Itldi wcA imprOvemenis aR no1 intenGeE w allereE lar Sale. If, IqwCver ttlC EudEinp or
impmvemeni i5 sW0 wlihin one year ol complelion. I�e owner vnll luve t�e Emd¢n ol 0�%+nB ���e Oitl not builE or imprwe
lor ine ourvose ol satel.
I, as owne� ol IAe o�openy, am exclusivery contraclinp mt� IicensM cantractors to wnsimcl t�e pmjec� (Section 70Ad, Business
❑ an0 Praleisioni CoOe: Th! COntra[Iors Siale L'rceiae Law Oces noI apply lo an axml ol pmperty wM GudOs Or ImproveSlAereon
an0 wM contracis lai suUi prqects wit� a conir�ctor(s�lkeme pursuant ro the Canlractars' State License law�.l am aware
Ihat pmol ol ineir Wo�ker's Compenuti0n insurance snoul0 Oe provia¢E lo me.
� I am exempt un0er Section: 8. 8 P. C.
lor I�is reason:
Date: U�+ier.
I Uo AereOy ceNly I�al I am aware ot anG wGerslaM t�e tepuirements ol Cdlilomu Mealt� azItl Shcery COtle Setlions 25505. 25533, antl
25534 anE t�at I o� any luture Cui�Ainp acupant vnlVwi�l nOt (drUe one) neeE to wmDN ��� saiE state cotles antl t�e reQuiremenis lor a
permit lor conslmclion or modilication Immt�e Air �vabty ManaAement Oistrict. ResiUential wnsiruction aOP��calions are eeempt Imm
ihese provisions.
Oate' App6cant:
I hereDy cenily ��at I �ave read IAis appliwtion antl state rtui i�e a�ove inlormatian is correct. I agree D COmply wilh all Ciiy anU toUnty
ordinanCes an0 Stalelaw5relatingio �uilCing conSlmtiion an0 �ereby aWh nn�epre5enlaliue5o1111i5Gi1 o enlerUD�lhe a�ove�men�i0netl
pmDeny lor inspeclion Ourposes. ,/ /
c 1..� ///.
Daie: �� '� ' ( 2 Signaiure: �jT�'��
odve�'s ucense o� saiai Securiiy w:
t6ni�a6 W�ne—Builtling; Graen—Cotle Entorcemem; Canary—AOWicam; Pink—Revenue: GolOenroO—Assessar
CITY OF COSTA MESA — BUILDING PERMIT .
PERMIT NO: B 058522 PLAN CNECK NO: N , ,
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION : TEAR—OFF REROOF 30005F W/COMP SHINGLES SQ FT: 19,833
CLAIM VALUE: 14,833.00 CALC—VALUE: 19,833.00 GROUP OCC: R-3 /M-1
COMMENTS; INSTALL INSULATION 6 1/2" CDX PLYWOOD .' ����Y� �������
*�**�r�r**r**�r*�t*�r+r��e�rr�r�e�r�e�e��**�r*�e�e�r�e+t*�e�r�t�t�t**�r*�t+r*��*�t�r�r ��,�*-it
2 O N I N GS ERTEB�AUCIKRSE M E N T
REQUIRED
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV; PARCEL: 13925219 2NE; REF NO;
PLANNING NOTES>
��
ifiEiF�fiFkiflFififiFiFiFif1liFiFkif�Fkkkif,iF�llkifiFlFkiFiFifiF�fiF3!*�F3FiFiFlfiF�fkkiFifMikifiFiF�FMifif�FMififififiFk�EkiFiEkiFifiFkiliFlE
D E V E'•L O P M E�N T S E R V I C E S R E Q U I R E M E N. T S
ZONING APPROVED BY DATE:
HUILDING APPROVED BY : " DATE;
APPLICATION ISSUED BY: DATE: ,����
�EiFiEikkifMkiFifiFif%ikiFiFkifiFKMif iFkMitiFM3fiEiflt �f
MiFIFMM�FMkiFifiFifkiEifkkKlFifififif%MifKkiElFifMiflfifitifiFitififiFififMMMiFkMffMlfififlFlfMMifiFMMiFifM�f�fMkiEififififiF�FiEif
LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
_,:r�, ,
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT ., 162.00 1,48 ,
PL� SMIP/NON—RES �
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID =� DUE
TOTALS----> 163.48 0.00 0,00 163.48 163.48 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 163.48 OVER/SHORT: .00
BliD62p00 PLUMBING ELECTRIC MECHANIC FIRE SMIPiT08 GRADING PLAN—CHECK
1tiflfiF�IFiFiFakiFikk�fftiFMkMMifMif�tkMMif�fifit�fititiflFkifikitiFMififMlfMifM�flFifitikiF4kkafiFilMkkikiFMiEiFifikM�fifikik�kifiFiFif
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY
�14833
.�i . '
D E S C R I P T I O N UNIT COST
REROOF HY VALUE RESIDENTIAL NOZONE 1,00
END OF FEES
ci i� - ,
:.qT;- n' a., �-
TOTAL', COST
14,833,00
i� �
Y .�
(
�
� CONSTRUCTION AND PLANNING POC SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
7. Tempor8ry Electrical Serv�e ot Pole � 52. Pool & Equipment Location
W -
2. Soil Pipe•Undrgrnd, a 53. Steel Reinforcement
� ��:'Ef�ctEiSal CondUjj liiility-Undrgmd: ' 54. Forms
: 4. ElCctrical Conduit Undrgrnd. 55. Electrical Bonding
�,:�, �$jeel,f{'einforcement,' ' 56. Rough Plumbing & Pressure Test -
J 6. �tpctrical UP�R G�d, i. 57. APPROVAL 70 COVER�GUNITE �
" 7. �otinqs "'� ^� 58. Electrical Conduit•Undrgrnd. •
r � �n o,
8. Foundation ,� - " 59. Gas Pipe, O Undrgrnd., Test -
.e�5 -
9. Watxr Pipe�Unt1?grnd. 60. Backwash Lines, P�Trap, O Undrgmd. -�
10. Structural Floor System C 61. APPROVAL TO DECK
17. Pcoperty Sewer Line & HVnse Conrtection 62. Backwash & Receptor�Final '
1
12. SQwer Cap , ' � 63. Heater & Vent•Final �
l' :1 �✓
13. Roof Drains c � � 64. Plumbing System - Final
14. Rough Plumbip� '- 65. Electrical-Final
75. Rouah Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electrie Wiring 67. Fencing & Access Approval
17. Rough Wiring $ign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOVSPA SYSTEMS FINAL
19. Rough Neating & Air Contl�tioning FIRE DEPT. REQUIREMENT
- - � ]' { �J
2Q�Ro' h FBcto^y F�replace i'Xt*f 't'�; + _ � 'r'� - �qppRpVALS:'".Peitnit # "
.. �,., i �, , � .
21.'_�Ducis, i�Structu 0., , ... '.'' i `� • � ' ' ��. • . '
K �.5 * 1 - � 70. Undeigcqp � Hy�lro
22�DuMs, VBntiteting� • r �: 'C4 F f71' ProduCFP(ping CG�s d'Oil
23�Gas Pip��Rough &'jest i .,`'�� � . T ,y la , �;�72, Underground Plusli �� „ ' :,�
24*Roof Framing � c i-- �- �- a.:, � � �.�' � 73!�Under9rric�.StorageT�mk'f7Gas OO�I
25. Rao� Sheathing �:a �.� $�-�fj_L �� ° 74t=pverhead�-lydro- � �
c_/
26. •T�Bar Ceiling (Strueturaq &ivlenocoat � ^ _ � � . 75s Dry Chemical ' " P � + J s.
27''Framea�d F�ashincj ]�M a .r ,,,, �. 76:�Dry Stan�,i�e ��� y ' �' _
':28��L�t�ing�Siding.=� . ��y.: . 4?' ••' ••A + 77� FIXEDSYSTEM,6INAL' � � "
29. Insulation - t � ^ "''� �� ��- 1 , W�(�-= 7gj�FIRE PREV. FINA�L - ,� �,� ,.
� 30. Drywall�Naiting _�� � �� i � - HEALTF}DEPTe REQUIREMENT
:�
^.31. Plaster �ro�yq Co�ty � ! ,�, ,. ; h t ,.,79�FINA� IlOSPECT�N ! '� G' �
. .
i -
�32, Electrical Poyyer Met�-Final; � + �' �� + ,SOtrFOOD CE�RTIFIEATE ISSUED�
33`Fin�l ElectriC r� ' i ,,r� I N�tes: ? r C;°.,;
� � i � -.
-34,-Final F{e`�tirig&P.i4 opdition�g, n � �. �r a' ' �
35:'Final Ga¢ Pipp-TeSc n '7 ''� a .� - ;� . :_ .:C
� � a� . r
; 36F'Hoctl or Cano r ` , ` , . ' , - -
PY � � .�r � # .-. I � + - ^G
' .� -
��37.-�FinSl F$Etory Firydtac'�~ ' .� `� .., • - j '�
k i a. � *
�� . . .. - p � _ .y _
�38. Final PliFmbing �_ � : � 1 i :: r = '
-�39. Wai@r Se�vicr-Fina f T � v x,_ 1 �� � .� c�.� ' cC ..
C.40. Gas SerB�ce�Pinal � � • J� ,
, w . r��r•;� r ii. �� c .a
i
� 41. Solar D6mesticFineh. il� •• ' � ' +` �=�' � '
� �. r � �. n ^ ,
425BackfloFPrevente; � N � � .� '� , � - '.
'K 7 �
43. Backflow Iriigatiorr ,1:.-'� ' } " �S' - • t � . `
V A . c
' ]. .,-C'� ♦ � i. . � l'.
, 44. Landscape �r,npation Systers�,��q,� �J; :r �.� "z o� cu � ;s•; s t�• v
�`45._Sound Attenuation • �'�" " +� %• - - ^ � '" �� - � � -
+ •.+. v .T' .. �:,, r
c'46:, Handicep R'egulations - =' + m �� ��� . . :y-' ",�. �S �
�47.>FIa�.LSTRUCTURE&BWLDING .' �
-�,..(�J 'G�/�-� :
l
48"�FI�IAL P,LANNING � , � : ; � ,� t � •`
�49JEIeetricReleaseto�Ediion �♦ = � �� � �41�/�,��L,r C'�„��,.,'� �����
� �0 ( _ 7
,50. GaSRelhase.to SoJjhem Cal�fomiaGasCo , � � �j � , - _ . '�� ` . ., � ��/'
v---
:SLCERTIFICATEOFOCCUPANCV .. ; ,.� , � , �
No. Date
PH0.IECTPOOHESS: 2f3'�O MAUI PL
OWNEP'SNAME: KEE PAUL
nooaess: yg�b MAUI PL
COSTA MESA,CA
PflCHIENGINEEP:
nooxess:
uxiT:
92626
flEG.NO.:
ux�r:
PEflMITTEE: QRANGE COUNTY SERVICES (719 ) 591-9753 I
nooness: 3022 N. HESPERIAN WY 101
SANTA ANA CA 92706
LICENSED CONTflRLTOP oEClANR7lON: I nereEy allirm RWt I am liceniea uneer prOvi9ons al ChaDter 9(commenGnp wiln Section
'l000) al Orvision 7 0l I�e Business anE Pmlessions CoOe. an0 my license is in �ull lorce an0 etlact.
cirvuc.: 060568 sTnTeuc.:g�9g cuss - ����
ate �–� � Sipnaiure: _ . _ . {J/
w0 BS' COMPENSATION OECLANaT10N: I nereoy all inat 1 have a cenilicale al clh5ent to self-insure or a cenificate ol workers'
', Densation Insurance. o� a cenilied caoY ��ereot (Sec�un 3800. lao. C).
roucvxo.: W941100990 E%P.DATE: OS/O1/9S
comrnxr: CA COMP .
� Cenilied copy is nereby Wmisnetl. ❑ Cenified copy is 61 a with tne city Buil ' p Oivisio
a�e: ��Q Y pPPlitanl: /Y.LN 4f
E%E TIONFROMWOPREBS'COMPENSATIUNOECIAXIl710N: SetldnneeCro�G2compklMil epermtaloronenuMrM�5tU0)arleu�.
tlify Ihat in Ihe petlormantt ol Ihe work IOr w�it� t�is Derrttil b isSueE, I SAaII nol emDloy any perwn in any manner 5o a5lo b¢tome
5uble�� �o tAe Warkers' ComDensation Laws of Califomia.
Da1e: SipnaWre:
NOTICE: II, atler making i�is Ueclaraiion, you s�oulG �ecome mUlect lo t�a Warkeri ComOensation provisions ol �Ae Labor
Coae. you mUsl lan�m0 [omply wi(h SUt� prOvi5i0n5 af Ik5 permil Stull OE CeemtO revoketl.
CONSTNUCTION LENOING RGENCY: I �ertGy affirm Itut t�em is a wnsiruction IenOinq apency lor Ihe Derformance of tAe work for
which tnis permil is issuea ISection 3WZ Civ. CI.
�exoen:
noosEss:
OWNEP BWLUEN UEClAPA710N: I nereby aflirm t�ai I am exemD� ��om I�e Coniractors' State License Law lor Ihe followinA �eason
(Set�ion 7031.5 BUSin255 an0 PmIe5Si0nal C042: Any tily ol mun�y whith r¢pulrt5 a permil �0 COnSImCi, alief, imDmvO, demolis�, or
repair any slrucNre. prior �o its issuance. also requires Ine apolicani for sutn permit to lile a sipnetl statemenl tnal he/sne is Iicense0
pur5uant10t�e OrOvi5i0n5 olihe CAniraC10r5 StaIE License Law�Chapi¢r9�cOmmencinp wii� $ecti0n 7qI0�0101vision 3 ol��e Bu5ine5S
and Pmlessions Cotle) or ��at Ae/s�e is exempt Iheielmm ana t�e hasis for Ihe allepeE exemption. Any violatlon oi Sectian 7031.5 hy
any applicanl lor a permil su0lecls I�e a00�icani �o a tivil penally ol nol mOre tllan live �unAreU Oollars (5500�.
I, as awner ol I�e pmDeny or my emFloyees witA wages as I�eir sole compensation, will ao t�a work, anU Ihe
❑ stmcmre is noi imenaee o� ollereA lor sale 1Sepbn 70aa, Busineu anU Profeuianal COEe: The Caniractors' Siata license Law
Does nol ap01y to an owner ol a O�oDeny wlro Ouiltls orimDroves t�e�eon, an0 who Eoes such work Aimsell/hersell ort�rouph
�is or Aer own emD�oyees, prOviG¢0 I�al Sut� im0�w¢menis are nai inlenAeO Or OflBreG la� Saie. 11, �owev¢r l�e Cuiltlinp or
improvement is solA wi�nin one year ot comoletian, Ihe owner vnll have Ihe burOen ol provina ��she tli0 not Duila or Improve
Ior Ine purpose ol sale�.
I, as owner ol Ihe pmpert9. am exclusively comrominq wilh IicenseG tOmraclors �o cons�mct t�e pmleci {Sec�ion 7044, Business
❑ and Prolessions CaUe: 7he Contraciors' S�ate License Law Oces not appN �o an awner of Dmperry wtro EwIEs ar impmves tAereon
antl w�o contracis �ar suc� O�ole��s with a contractoqs) license pursuanuo ihe Convactors' State Licensa Law). I am aware
I�at Oraol olt�eir Worker'S Compensation in5urance s�outtl be provideG Io me.
� I am exempl untler Seclion: B. B P. C.
lor I�is ieason:
Uale: Qvmec
I tlo �ereby certily Ihat I am aware ol antl untlei5iantl I�e reQuirem¢nis af Calilornia Heallh an0 Sa�e�y COtle Sec�ions 25505, 25533, and
2557a antl indt I or any lulure Guilding octupant willlwill not �circle one� neeG lo comD�Y ��A said state catles antl t�e requiremenis lor a
permit lor consimciion or moGtlication Imm t�e Air Ouaiity ManaAemenl Oistrict. FeSiEemial constmction aDD��cations are e�empt Imm
mese o�avisions.
Date: pOD�icam:
I h¢reby C¢r�iiy I�a� I have reatl I�is ap0litali0n antl Slaie I�al Ih¢ aEOv¢ in�o(maiion is mrr¢tl. I a0ree Io COmpty wil0 all ti�y antl toUniy
ordinancesandsialelawsrelalingtoGuilEinBcwslmclionanC �au��orize�epresenlaYv�oenleru�onl�eaEove-memionea
properiy lor inspeClion pwpO5e5.
1 S/-t�--�v �.��.....
License or Sociai Security ?:
164ho6 Whna—Butltlmg; Greon—Code Enlorcomont: Canary—POOlican�; Pink—Pevenue: GOltlanro0—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06688
PERMIT NO: E 066880 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : UPGRADE TO 200 AMP SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: ELECTRICAL WORI{ ONLY
**x��r******+r***w�r�r�r��t�+r**�t+r*x�******�r�r�r+t+�+r�r�rir*�t+r*�r�r*+�*+rx�*�*�r***a�r*+r***�+�*+t*+�ar�r*+r
Z O N I N GS ERTEBQAUCIgRSE M E N T S
------------ MAIN BUZLDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: ET IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 43913222 ZNE: REF NO:
PLANNING NOTES>
>
if iF iE iE iE it it if it it 1t if iE i! iE iE iF iF if fF if if %if 1t if if if if iE %i! iE iE iE 1F 1E fE 1F fF 1E if if 1f if iE if if if 1E 1f 1f if 1ElE iE 1E 1t it it iE iF 1E it if iFlE if 1E iE �E if it iF iE if iE ik 1E
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPROVED BY ,
BUILDING APPROVED BY :
DATE:
DATE:
APPLICATION ISSUED BY: ���� DATE:
�tw+rfc�x��ti��t*�t�t***�t�t**�t**i�iFiF3FiFTFTF�F'iFif"iFi7�TE�F'iF'�F �F'iFiF3F3FiFiF'�tiF3F�+FSF***�t*�t*x��t* **
***+r�r**x-**�*�**�r***x�**�r�t�r�c**it**�at+t*+t**x�*�rat*�t**x�+�+t***�tr*****rt+rx�r�r**+r***�t x�*�r **at
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 18.'S0
� SO2 SMIP/NON—RF.S
PLAN
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ISSUE
18.50 15.00
1
'15.00
P,I,AN—CHECK
0.00
TOTAL PAID DUE
33.50 33.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVER/SAORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.50
iF iE 1f if iF 1f iF iF iF if iE %iE if if IE i! IElE iE iF iP rt 1E 1E IF 1E 4 iE iE if if iE iE �E'iE rt if af if iF if if iE iE if iE 1E M iF it 1E M i! i! if iE if iE it iF iF iE ff k 1E 1E iE iE fE if iE if it iE it iF iE 1E
I N D I V I D U A L F E E H 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
ELE 1 SERVICES BELOW 600��V 6 BELOW 201 AMP 18.50 18.50
END OF FEES
i,! 001�"24b—�0159246 T O T 33.SU
JATE: 04;20/94 TIHE: 11:48
CONSTRUCTION AND PLANNIN.G ^� POOI & SPA ~
DaTe Inspector Date Inspector
qppROVALS Permit # - APPROVALS Permit #
i. Temporary Elcttrical Service or Pole 52. Pool & Equipmen[ Loca[ion
2, $oil Pipe-Undrgrnd. 53. Steel Reinfo�cement
3. E{eccrlcat Conduft Utility-lSndrgrnd. . 54. Fosms
i �
. 4. E�ectrical Condurt-Undrgmd. 55. Electricai Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
8. Electrlcal UFER Grnd. 57. APPRQVAL Tp CQVER�GUNITE
� 7. footings 58. Electrical Conduit�Undrgrnd.
8. Foundation , � 59. Gas Pipe, 17 UnUrgrnd., 7est •
9. Wa�er Pipe-Undrgrnd. �' 6Q. Backwash l.ioes, P�Trap, O Undrgmd, _
70. Structural Floor SYstem ' 61. APPROVAL TO DECK
11. ProPerty Sewer Line & House Connection •, 62. Backwash & Receptor�Final
i
12. Sewer Cap - � 63, Heater & Vent�Final
13. Roo� Drains � • 64. Plumbing System � Fina� .
14. Rouc�h Plumbing 65. Electrical-Final
15. Rouyh Electrical-Cpnduit .� 66. Solar SVstem-Final
16. Rough Electric Wiring 6J. Fencing & Access Approval
77. Rough Wiring Sign 68. APPROVED FOR P�qS7ERING
78. Rough Electricai•T Bar Ceiling 69. POOUSPA SYSTEP1i5 F�NA�
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT I
20. Rougti Factory Firepiace � APPROVALS � Permit #
21. Dutts, in Structure „ 70. Underground Hydro
22. Ducts, Ventihaung� 77. Product Piping OGas OOiI
23. Gas PiPe•Rough & Test 72. Underground Flush
24. Roof Frnming . 73. Undergrnd. Storag2 Tank � Gas ❑ Oil
25. Roof Sheathinq 74. Overhead Hydro
26. T�Bar Ce��ing (S[ructural� & Monocoat 75. Dry Chemical
27. Frame and Flashing . - 76. Dry Standpipe
28. Laching & Siding � � • 77. FIXED SYSTEM FINAL
29. Insulation - - 78. FIRE PREV. FINAL
30. Dry�vall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat '.. 79. FINAL INSPECTION
32. Electrical Power Meter�Final (j n 80. FOOD CERTIFICATE ISSUED
33. FinalE�ectric y1���M I/ K!` Notes:/,jvZ��l�� ��� ����,(�p�l
� V f
34. F�nal Hzating & Air Conditioning ^,����_� �-� //y�P� .��
�L B{
35. Finai Gas Pipe•Test • .
36. Hood or Canopy , '�'
37. Finai Factory Fireplace . ,
38. Final Plumbing . � -
39. Water Service-Finai . '
40. Gas Service•Final
41. Solar pomestirFinal -
42. BaGkflow Preventer
43. BaGkflow Irrigation �
44. Landscape Irripation System -
45. Sound Attenuation
46. Handiwp Regulations "
47. FINAL STRUCTURE & BUILDING '
48. FINAL PLANNING . __ � ,
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY �
No. Dace
(714) 754-5273 • Fax (71 a) 754-4856
JobAddress: 2970 MAUI PL
Suite No
Vicinity:
ParcelNunmber: �39252'19
a
Applicant: LACROIX, JERRY
Address:
CITY OF COSTA MESA -�
BUILD/NG DIVIS/ON
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Owner: KEE, PAUL ROMAN TR
Address: 2970 MAUI PL
COSTA MESA,CA
Contractor. GRAHAM BROS INC
Address: 2952 Century pl
COSTA MESA, CA
ArchlEng: ,
Address:
ISSUE FEE
Inst FAU <700 k BTU
Inst FAU >700 k BTU
Repair I Alt CoolingMeat
Inst I Rep. Recess Wall Htr
Refrig Sys <100 k BTU
Refrig Sys >700 k BTU'
Gas Piping
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Dud
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Vent
Air Handlers < 10000cfm
AirHandlers> 10000cfm
Floor Furnace
Floor or Suspend Heater
MECHANICAL PERMIT
Phone: 714-546-1653
Zip:
Phone:
Zip: 92626
Phone: .546-1653
� Zip: 92626
License: 248604
Phone:
Zip:
License:
___1:.,:�
PERMIT NUMBER �
M98-00439
77 FAIR DRIVE, COSTA MESA, CA 92626
SCOPE OF PERMIT
INSTA/C SYSTEM FOR SFR, ALSO REF P98-00240 FOR NEW WATER HEATER.
$22.00
$0.00
$0.00
$0.00
$0.00
$13.25
$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
Quantity
FEE SUMMARY
Repair / Alt Absorbtion Unit
Repair I Alt Refrigeretion Unit
Ventillation System
Evaporative Cooler
Commercial I ncinerator
Domestic Incinerator
Comoressors I Absorption Svstems
Upto3hp/100k8TU
3 To 15 hp I 500 k BTU
15 To 30 hp I 1,000 k BTU
30 To 50 hp / 1,750 k BTU
Over 50 hp / Over 1,750 BTU
Boilers
Up to 3 hp
3To15hp
15 to 30 hp
30 to 50 hp
Over 50 hp
Other Mechanical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
TOTAL CALCULATED FEES
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 09I24I7998
Issued: 09/24I7998
Quantity
50.00 0
50.00 0
$0.00 0
E0.00 0
so.00 0
so.00 a
50.00 0
$0.00 0
50.00 0
50.00 0
$0.00 0
30.00 0
50.00 0
So.00 0
$0.00 0
50.00 0
$0.00
$0.00
50.00
535.25
EXPIRATION: This pertnit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
tor a period oi 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
required inepactlone and finel approval must be obtained. Failure to obtaln Inspections and final approval will result in the explratlon of ihis permit.
FOR INSPECTIONS CALL: (714) 7545826
WORKERS' COMVENSATION DECLARATION: �
I hereby eKrtn under penalry of perjury one at the following deGaretions:
❑ I have e will maintain e Cenificete ol consent to solt-Insure tor workers' compensetlon, as provitleA tor by section 3700 at the Lebor Cotle, tor the pertortnance ot the
wo r which this permit is �ssueA.
have flrM wIA melntain wo�kere' campensetion Insurence, es requireA by section 3700 of the lelwr Code, br lhe periwmence ot the woAc lor which NIs permit Is issuetl.
My warkeB' compen%°��oJ� /In� rence er poliry number ere: �/� /�---7 ��
Cerrier: ( // / -� � Policy NumDer. v � /
(m!s secrlar need not be comp�eted n the perm t ts ve�ued ar one nunared donars (5100) or �ess.)
❑ I certlly ihat In the pe� �anc ol Ihe wi rk fo which Ihis pertni� is issued, I shell not omploy any person in any manner so es ro become subject to Ihe workers'
compensatlon laws oi lit4�nia end e r e th f I shoultl bewme suDject to the workers' compensallon pravlsion9 of Sectlon333ZZZ 00 ot lhe Labar Catleee... I shell larthwith
' thes pr islons. � n �_ ��
Applitent Sign : Date: �
AILURE TO ECUFE Wtl <ERS' COMPENSATION COV{ GE IS UNL4WFUL AND SNALL SU&IECT AN EMPLOVER TO CFIM�WU. PENALTIES AND GVIL FlNES UP TOONE MUN�RED
TFNJUSPND OOLLFRE 100,000�, IN DITIIXJ TO THE COST OF COMPENSATION, DAhNGES AS PROVIDED FOR IN SEGTION 3]O60F THE LABOR CODE, IMEREST, M!D AT70RNEY'S FEES.
LICENSED LON7RACTORS DECLARATION:
I hereby aKrm thet I am lice sed under�fc i i of Cha ter 9(commencing with Section 7000) ot Division 3 oi the Business antl Professions Cotle, and my license is in full
' . M , y � Class #
aniracto 'gnatu -� � /�C.�' s"� Date: � - '
i
i e
� 7
— f
CONSTRUCTION LENDING AGENCV:
❑ I hereby eHirm that there is a constructlon lentling agency tor the petlortnance of the woB for which Ihis partnit is issued. (Sec. 3097, Civll Code).
Lentlers Nema: Lenders Atltlress:
Signature:
OWNER-BUILDER DECLARA7IONS:
Dete:
I hereby effirm t�al under penalry a� perJury Ihat I em E%EMPT FHOM THE CONTRACTORS LICENSE LAW for the tollowinq reason (Sec. 7031.5, Business entl Prolessions
CotlB: Any ciry or counry which rBGuires a pertnil ta canstrucl, elter, impmve, tlemolish, or rBDelr eny structure, prior Io its Lssuance, elso requires Ihe applicant for SUCh pertnil
ta Ille a slgnetl stetement Ihat he or she is Ilcensed pursuam to t�e provisions ol the Contractors License Lew (Chapter 9(commenGng with Sectlon 7000) ot DlNslon 3 0l lhe
Business and Professions Code) or Ihat he or she is exempt t�eratrom and Ihe hasb br Ua alleged exemption. My vidation o1 Section 7031.5 by eny applicant for e pertnit
sub�ects Iho epplicant ta e civil pe�alry of not more than frve hwAred dollars (5500).):
❑ I, es owner ot t�e property, or my employees with weges as iheir sole wmpensatlon, WILL DO 7HE WORK, antl the structure is not intentled or oHered for sale (Sec.
7044, Business antl Profes5�ons Code: The Contractore License Law does not appty to en owner oi property who builds or imprwes Ihereon, ana who tloes suc� work
�Imsetl or hersell or througP his or her own employees, provitletl that such improvements are not intended or otterad for sale. Ii, however, Ihe Duilding or impmvement is
soltl within one year of wmpletion, Ihe ownervbullder wlll have the burtlen of proving ihet he or she tlitl not build or im0�ove tor purpase of sale.).
❑ I, es owner oi ihe property. em EXCLUSIVELY CON7RAC71NG WfTH LICENSED CONTRACTORS to construct the pryect (Sec. 7044, Business entl Profeuions
Cotle: The contractors Lice�se Lew does not apply to an owner of pmperty who builtls or Improves thereon, antl who contrects tor such pmject with a contrector(s)
license pursuant to the Contrectors License Lews.).
❑ I am exempt untler sec. Business antl Pmfessions Code Por t�is reason:
SlgnaWre: Date:
Owner ID veAfled by tlrivefs license. ❑ Yes ❑ No Dnvefs Ucense No. E�cpires:
Veriticetlon ot Ownership by (rype a� dxumenl, i.e. - praperry tac Dill or deed):
DIVISION OF INDUSTRIAL SAFET' PERMR CERTIFICATION:
❑ I hereby certlty chet no exca�ation tNe (5) or more teet In tlepth Into which e person Is requlreC to descend, wlll be mede in connectlon with work authodzed by t�ls
permit, nnd that no builtling structure, scaHolding, felsework, ar tlemolitlon or dismentling thereof, will be more than tnirty-six (36) feet high. (Chep. 3.2, Grp 2, An 2, Sec.
341, Titla B, Calllamia AtlmiNstrelive Code).
❑ As owner-bullder, I wlll not employ enyone to Co work which would require e permit Irom iha Divisian al Intlusirlel Salery, as noted ehove, unless such person has e
pertnit to do such woAc irom the tlivision.
Slgnelure: Date:
DiWsion oi IndusMal Safary Permit Number.
CERfIFlCATE OF COMPLUWCE NND AUTHORIZATON OF EMRY: I certily unUer penalry of perjury thet I heve read Ihis epplication end slete Ihet Ihe infortnetion given is
cortect. 1 agree to compty with all stete laws end ciry ordinances relaUng to Guiltling cansiructlon, end authorize representetNes ot the Ciry o1 Coste Mesa to eNer upon the
eDove-tleuribed properry for inspeclion purposes. I epree not to acupy or ellow occupancy of any building authorizeC by this permit until final inspection.
cooe �. msveenoxmae .
1616 Fiaed Sysiem Final Pire P�evention
1268 Pool Spe Fnal
200 Flnal RaRoof
201 Finel BIocMRetaining We��
202 Fnal Feclory Fira Plece
203 Flnal Sign
204 Flnal Demoli6on
24a&48
Qe]( ��$ ZQp(� INSDECTIONTYPE
_ _ _ _ 206 Finel Mechenicel
208 Final Plumbing
210 Final Electnpl
212 Flnal Fire Prevention
220 Fnel Plenning Appro�al
222 FinalSile
250 Final Builtling/Occupency
� �./ e ( — //�
Date
OR'N�R 7(F;y� PpjJj, DATE 9-5-61
JOB ADDRESS 9g'70 Maui Pl ace BUILDING PERMIT NO. '1 Sfy�Q^
GENERAL CONTRACTOR Gaor�p Pot�s VALUE S __.Jy�Q,00
nP No. LOT 33 TRACT 3 80 PIRL' ZONE DESCRIPTION OF WORK Ret. wall
I*'^PGCTIONS I Signalure llATE GROUP TYP� 7.ONE _
`- PLRil�ITS ISSUED
�;� SUBCONTRACl'OR nAmF Nnnaur. ix
f
�_
. . `.; . . �s��o
� COSTA MESA BUILDING.SAFETY DEPARTMENT
P. O. BOX Dt7 COBTA MEHA. CALIFORNIA
For Applieani io Fill In Complefely
TYPE OR PRINT
GOSTA MESh CALIFORNIA
� MAIL
� ARCXITEGT
, 9HTBACK 4NC PNOM
TEL.
NO.
TEL.
TEL. 4
NO.
- (J INO.OI
DESCRIPTION OF WORK
BUILDING NO. O
812E ROOM
EXTERIOR WALL IROOF
COVER7NG WVF
USE OF.BUILDING AND WORK TO
zoNe
�eaw�
F�RECEIVED
SEP 5 196Y
FINANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
aeceirr rvo. 'nenn
COSTA MESA. CALIFORNIA
�NING "
Ho, ov use OP NEW
•uNs � I BVILDING
�
HNT[P LIN[ 9T.1 �jr� �' � j� (J�� J/N��'
:ONT /c/�`�T. Oi��—ac% q{
��77 -l. p,i
SIDE `FT. �IN ^
/o � ��"� �'� .�'
SIDE FT. �J'IN
'�7L�ct U..v,Ai/
AR FT. IN.
�PROVED /�/ �( /�. �l� _/
LY DA7E (p
G�"�-�
QY e"q
1 HBqEBV AC%NOWLEDOe iHAT i H/�VE READ TX18 APPLiWT10N THE AMOUM SHOWN UNDER VALUATION I9 POR TH¢
AN� 8TAT8 THAT THE ABOVE IB EORP6CT AND AGIiEE TO GOM- pURP09¢ OP EBTABLIBHING A PEftMIT FEE ONLY.
PLV WITN �LL CITY ORDINANCEe IWD BTAT¢ LAW9 q80ULATINO
euILDINo coN9�u VALUATION
SIGNATURE OF PERMIT FEE $ �/ �
PERMITfE '/ r
S iX J � LAN CHECK $�—
!
AUTHORIZED AGENT �
TOTAL FEE �
�JHB ADDRES�
GENERAL CO
� A° No. 139-
ECTIONS
s���
� GAS
W ATER
ftOUGH HEATING ANO Alfl CON
TEMPORqRY SERVICE OR POl
UN�ERGiypUN� � POWEft
ROUGH W�ftING
TRENCH�S ORMS �
FLOOR SyST ��—
BONO BEAM � STEEL RE
SHEATHING
FRAME qN0 F�ASHING
�AiHING — �N r] OUT �
PLASTEq, BROWN COAT
S- -�TURAL, FINAL
!. .JG, VENT., REFRIG. AN
PLUMBING, FINAL AND GAS T
ELECTRI�, FINAI
oiiu niur. ciuei
DATE 5-9-72
BUILDING PERMIT N
RIPTION of WORK o kwal
ZONE VALUE$ 495.00
7UP TYPE
SUBCONTRACTOR P�
.`L'/" /�i�'J� !C.fi�P ;B-G+cs��/'.Cc.<1/k"f-•✓��1�
CJ� ' j
/�r�"'-l�-i _-f�, �'t�ir�n:i .f-,*g-�.r�l��izr[c�r�[
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• '� - _ 34689 �,,P^��no s�z 5.04
- - ,a•, , �t ��� xtr
r.�:
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 '
APP ICATION FOR BUILDING PERMIT
For Applicant to Fill in Complerely
CEI E BV DATE RECEIVED DATE ISSUI
BVILDING �J—�^% � ��^� ,_�
AODRE55 /} r�/ /� ll �,1
/ A.P.NO. �%��v`Jd'/7 P.ZII�Ni7
OWNER � F/�
^ BUILDING �
MAIL �� • // ADDRESS
Z ADDRESS 7
W� U TEL.
CITV � NO. j -j TRACT
Z W A
Z Q CONSTRUCTION
O � LENDER GfJ � V
a m ��
J � 6RANCH
JN OWN AI
m J ADDRE55
J m ARCHITECT TEL. $ L�.Si
N OF ENGINEER
V Q FIRE
w CL ADDRESS ZONE
aw
W Z p APPROV D
J O CONTRACTOR fY�, G I` BV
m Z
J¢ AODRESS yn��p�� �,
♦
VALUE
DATE
W W ZO NO.OF USE OF NEW /°S/�C�
Z� CITV [� A.�EC NOL \� PIAN$p� BUILDING ��---
w � STATE CITV �'ARDS APPROVED VARDS APPROVED
y� LIC. NO. LIC. NO. MAIN BUILDING ACCESSOFV BUILDI
� O �FROM C/L STfiE T) �
512E NO.OF BLOGS. �
OF LOT NOW ON LOT RONT �T.
USE OF `
EXISTINGBLDG. ES fNCL. T. ^
F� $RE OF NO. OF �� �! f
Z NEWBLOG. ROOMS STORIES L.SIDE �' �
EXTERIOR WALL ROOF II .y�.
�% COVERING COVERING REAR •-0T. W ��
J USE OF BUILDING AND WOFK TO BE PERFOFiMED DLSTANCE BE�
a MAIN BLDGS.
a
O //�� �L OIJ OL/V CURP,yb
� aPr o
v� � . D S�es•
Z
O
UI horeby acknowledBe t�nt 1 havo rautl this npplicn[ion antl sta[e
� thpt tho ebova Information is correct ontl opree to comply with
� ell laws regulaNng builtlinq conztruction, nntl I shall not employ
F ony person in violation ot [he workman's compensetion iaws ot
y the State of Californla.
zI �ereby certify t�at 1 am properly liconsetl as a conttactor untler
tha State of California Business entl Protessions Code, Oivision 3, THE AMO
Chapttr 9, antl that such �icansez are in tull force antl affec[, or I THE PURP(
em ¢xampt from tl�e provizions of tha State ot Calitornia Businett VALUATION
and Prafessions Cqqe, Division 3, Chapt��
AuMorizetl
e
BEf. MAIN &
ACC�. BLDGS.
DATE
APPROVE�
� _ G_
R VA
3 A P
a
m
b
0
IS FOR j
ONLV: m
¢
� m
N
�
m
E
s
LL
�
OWNER
ESS 2970 Maui Place
nr nv. i.»-t
IN�oECTI0N5
G...
W ATER
ROUGH 7LUMBING
PROP. 5�M1'R. LINE
SPRINKLING SV51
ROUGH NEATING AND AIR CONOITIONING
TEMPORARY SERVICE OA POLE
UNOERGPOUNO � POWEft �
ROUGH WIRIN
TRENCHES �RMS � STEEL REINF.
FLOOR 5�STEM
BONo SEAM I� STEEL REINFORCE I I
NG
FRAME ANO FLASHING
LATHING — IN OUT
PLASTER,BROWN COAT
STRUCTURAL, FINAL
HF'-�NG, VENT., REFRIG. ANO A.C., FINAL
P ING. FINAL AND GAS TEST n
ELtCTRIC, FINNL �
BWLOING. FINAL
IEOI11flEMENTS
DATE �_2
BUILDING PE
of
SUBCONTRACTOR
.. �� ��PAi'
" � - - 34992 ��. �?��y25- A�++�39.28
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPL CATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
CE V BV DATE RECEIVED DATE ISSUED
BUILDING � � � Q �v ! .�{% 1 .��5 _
AOORESS � t--
OWNER v �� A.P. NO. � � L � V
MA�� ^ BUILOING j
Z . �]�} �j
A�DRESS - ` O � r �1DDRESS ��� � �
aU CITY �,' � � NOL�:� / VZ TRACT��j�p � L0T33 BLOCK
~ Z W A P
Z Q OONSTRUCTION � �
O N LENDER �
am
J7 BRANCH �„ G ���
J N OWNER
m J ADDRESS 1 VALVE
JQ ARCHITECT TEL. SE /L(P����� $
� OR ENGWEER N
V Q fIRE
w � ADDRESS ZONE TVP �GFOU �
�' w �n APPRO
JO CONTRACTOR Y`CI C BV E ��J' •
m Z
J� ADDRESS IQ S�(( � �
W w p. p / ZONE/ NO.OF USE OF NEW
Z� �� 1��A A: A NOL�� �JI7. �/ P��� BUILDING �
CIT V
y� LIC.NO. L� O��� LICVNO. Q yMADS6VIlDINGD ACCE SORV BU�ILDING
70 (PRpM /LSTREET)
512E O NO.OF BLDGS.
OF LOT � NOW ON LOT RONT 1� FT.
VSE OF �/�
EXISfING BLOG. I E✓`�-� T FT
F SI2E OF /' ,/ NO.OF
Z NEWBLOG. l� ^ 0 ROOMS �STOPIES L.SIDE FT. FT.
a EMERIOR WALL ROOF {, �
�% COVERING JCCp COVERING I�le � REAR FT. FT.
J USE OF BUILOING AND WORK TO BE PERFOIiMED DISTANCE BET. BET. MAIN &
a MAIN BLDGS. ACCESS. BLDGS.
a
Q VAF.� DATE
O ��N �I C.U.P.�W APPROVED
r APP OVE
v� . G S .�-
z
o -
UI hereby acknowletlge that I huve reatl this application antl state
� that che above information is correct and aBree to comply wiih
� all laws regulatine building consVuction, antl 1 shall not employ
F any person in violation of the workman's compensaiion laws of
y Me State oi California. m
z �
I �er¢by certity that I am properly licenud as a contracior under SQ. FT. T� o
the Stere of California Business entl Profassions Cotle, Divisicn 3, THE AMOUNT SNOWN UNDER VALUATION IS FOR �
C�apter 9, antl that such licensez are in foll force entl etfect, ar I THE PURPpSE OF FSTABLISHING A PERMIT FEE ONLV: m
am exempt from Me prOvisions ot Me Stete of Calitornla Businen ¢
entl Professlons Cotle, Division 3, Chap[er 9. VALUATION
PERMIT FEE $ •� �
� 7
Signature of � �,/� - (�"L� m
Permittee �✓L ��� �- �47wd'V a� $ ��y� PL.AN CHECK $ •' E
V
Auffiorizetl Ageni - c LL
TOTAL FEE $
OWNER. I�E Paul DATE g_2g_ 2 -
JOB ADDRESS 9 Maui ace BUILDING PERMIT N0. 35320
rGuconi rnurver-rno RInP uo.,o„ v.,.,i� �«,-.,��r�.,.� �„��.,� .ti_._.�_ ___. . .
TRACT 33tS0 FIR
ROUGH PLUMBING
PROP. SWR. LINE ❑ HOUSE CON.
SPRINKLING SVSTEM
MISCELLANEOUS - L�'H,-C
ROUGH HEATINC ANO AIR CONDITI
UN�ERGROIIND U POWER
ROUGH WIRING
FORMS IJQ STE6L REINF.
FLOOR SVSTEM
BONO BEAM �
SHEATHING
FRAME AN� FLASHING
LqTNING — IN �
PLASTER,6ROWN COA
STRUCTORAL, FINAL
H' 'G, VENT�, REFI
PL �ING, FINAL ANC
ELECTRIC, FINAL
anu mur. c�ua�
SUBCONTRACTOR
/o/a�/7a - ff.1� ,Zeer - a ffyP, �( 77�, d, /<fo�. s, i.
. ' 35320 ��nc�8'7ZPAIOOO�A�I�iF ,ra��
�,;5� 39.25
' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECrEJ'V,�.@ BV Df�T REC IVED ppT ISS D
BUIIDING� ✓�� � w Ol�• O O
ADDRE55 /
', n Cl P
OWNER � �C.t� -8.�%, A.P.NO. �'�-�aa(��
MAIL BUILDING � /
Z . ^�-g
ADDPESS ADDRESS ;�'9 GI �Q.G..G✓ �'�
� U TEL. �3[�O LOT✓J BLOCK
CITV NO. TRACT
Z
Z Q CONSTRUCTION W AD A
O N LENDEF
a ¢l `1 �-
J � BRANCM _' n
J � OWNER �.IX �—�
m J ADDRESS �oO � VALUE L/�rN_
J m AFCHITECT TEL. S C-Y.0 �
a OR ENGINEEF N
U � / F�RE
wa 20NE TVPE UP
Q ADDRESS
a W n ' APPROVED
W Z CONTRACTO [��Q 4D�1/ B�' DATE
J Q
m Z
J � ADDRESS /�`3-
w W T� ZONE NO.OF USE OF NEW S W III,F.�U
Z� CITV ��.Q fy� �� PLAN$ � BUILDING �Ov
� STATE CITY �'ARDSAPPROVED VARDSAPPROVED
? O LIC. NO. /`%�Y'3 LIC. NO. MAIN BUILDING ACCESSORV BUILDING
SI2E NO.OF BLDGS. (FROM GL STREET)
OF �OT NOW ON LOT FRONT FT. FT. v�
USE OF ��
E%ISfING BLDG. FT
F SIZE OF NO. OF
Z NEWBLDG. ROOMS STORIES L.SIDE FT. FT.
U EXTERIOR WALL ROOF
COVEFING COVERING REAF FT. n FT. -
J USE OF BUIL AND WORK TO BE PE RMED DI5TANCE BET. BEf. MAIN &
a MAIN BLOGS. ACCESS. BLOGS.
a
a � CUflP.�b APPROVED
OAPPROVE� rI ' d D
(/� �ll /`
z
O Siqr�
UI hereby acknowletlBe that I have reetl this application and state
� tha[ tha abOve info�mation is correct antl a0ree t0 comply with
� all laws ra9ulating builtling tonsttuction, antl I shall not employ �
� any person in violation ot the workman'z compensation laws of
m
� Na Stare of Califamia. �
z1 �ereby cartify thnt I am prOperly licensetl es a contractor untler SQ. FT. o
the Scote ot Celifornia Businass entl Professions CoCe, Divisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOfl �
Chapter 9, nntl thot such licenses ere in full forca antl utfect, or I THE PURP�E OF ESTABlISHING A PERMIT FEE ONLV: m
am ezampt from t a� provisions o( the Stote of Ca/lify rn/1� Businesz VALUATION ��J / ¢
entl Professions a, Division 3, CS�,�S�C't:`.c, " '�_` � w
PERMIT FEE 5 �
J
Sipnature o � m
Perm(nee —`� $� � PLAN CHECK $ /� E
0
AuNorized Agent — I' LL
TOTAL FEE 5 � �'�/
nn:n:, mr. ra�.0
JOB ADDRESS
GENERAL CONTRA OR Fox
APNo.139-25 -19 LOT
INeS,oECTI0N5
sr:�<.'-,y:-Y
GA'_-
W ATER
ROUGH PIUMBING
PROP. SWR. LINE HOUSE CON. �
SPRINKLING SVSTEM
MISCELL�NEOUS
ROOGH HEATING RN� AIR CONOITIONINi
TEMPOftARV SEAVICE OR POLE
IINDERGR0UN0 � POWER �
ROUGN WIRING
TRENCNES FORMS STEEI R
FLOOR $VSTEM
BONO BERM $TEEL REINFORCE
SNEATXING
FRRME nN� FLASNING
LATNING — IN n OUT n
PLnSTER, BROWH COAT
STRUCTURqL, FINRL
ME�"NG, VENi., REFRIG. AND A.C., F
PL NG, FINr1L /ND GAS TEST n
EIE��RIC, FINaL
BUILDING, FINAL
coc�'ie� ocniuocuCMTA
VNIC 11 GV-�}
BUILDING PERMIT N0.
SUBCONTRACTOR
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COSTA MESA BUILPING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applican[ to Fill in Completely
BVILDING �'1 q�7 O M �� ` �
ADDRESS O< � /
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CITV �-(rA. �I/L�%{A NO. SJ/�
CONSTRUCTION /� _ ...�
BRANCH
ADOFESS
ARCHITECT TEL.
CONTRACTOR �yc.-CIE/L ��Ifj �,
ADDRESS � (� �, �C�—UVLV ��[
_����iRJ\( � TEL.^'I �I��
CITY �� NO. J 1
LIC. NO. 2� 0 � CJ � LICYNO. �j�7
OFLOT 8O " I�,J' INOWONLOS
USE OF
E%ISTING BLDG.
SI2E OF NO. OF
NEW BLDG. ROOMS STORIES
EMEft�OF WALL :�OOF
COVERING COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
1 hereby acknowledge that I have reatl this application and siare
that tha above intormation is cortact and agree to comply wlth
all laws reBulating builtling consttuction, antl 1 shall not employ
any Oermn in violation of the workman's comp¢nsation laws ot
[he Stata of Calitornie.
I hereby cartity thot I am p�operly licensetl as a conttector untler
Me State of California Busf�ess antl Protessions Cotle, Divislcn 3,
Cnepxar 9, antl that such licansas are (n tull force an0 etfeet, or I
em ezamp� irom the provis�ons ot the Stata ot Celifomia eusiness
ontl Profezsions Cnua, �ivision 3, Ghepmr 9.
SlBnatura of �,n C.( C�. Il) _ !1 N
Permittee �� � "�� ��'�� ��
n�cno.�:ea nea�i
'u
BVILDING
ADDRESS
TRR
FIRE
20NI
APPF
^nV 75-7Jr�=:"00 915�` ft***24.50
cr�
ON FOR BUILDING PERMIT
)NE NO.OF
PLANS I'
VARDS APPROVED
MAIN BUILDING
ROM C/L STREET) �
BET
VAR. 9{'+
C.U.P.qW
VALUATION
S 1� iv�
/ lY
!
VALUE
USE OF NEW
BUILDINGy�� �l,��
YARDSAPPROVED
BET. MAIN &
ACCE$$.BLa
DATE
� �
b
T. o
SHOWN UNDER VAIUATION IS FOR j
IF ESTABLISHING A PERMIT fE ONLV: m
¢
PERMIT FEE 5 j
m
PLAN CHECK S E
q / 41!_ ,°
TOTAL FEE
1
.� �> s� +- - . ����.�o
tC�Si� MESA BUILDING•SAFETY DEPARTMENT
( P. O. BO% 917 C08TA MEBh CALiFORNIA
For Applicant to Fill In Complefely
� �3 TYPE OR PRINT
BUILDIN
ADDRESS
COSTA MESA, CALIFORNIA
I ARCHITECT i / / �
� STATE
��
I BEiBACK LINE FRON �n �
No:G<r po3y
T/ I NO. OP oL,DGB.
/ �
4EFT �l' RIGHT (//
DESCRIPTION OF WORK
ROOF
AN�
��� �E����'�I�
� �,�Ad "L 1 l�i�l
�' FINANCE DEPT.
CITY Of COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
MBCH�PT NO. ���n�il��
� �G IJ
flHC81 HD BY I O� R C.$1 �H� I �T8 188/E� /
J�♦ /I �
BUILDING
ADDRE6S
COSTA MESA. CALIFORNIA
FIRE
ZONING
20N6 ^ NO. OP U9E OP NE
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LEOAL . _� '7 '1 ��� �7 C
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BVPROVED �'� � 'oasF � '.
�
� HEPCBY �CKNOWL800H THAT I MAVB ReAU TH18 APPLICATION TM8 �MOUNT 9HOWN UND¢P V�LUATION 19 POR THE
ANO BTATe TH�T THH �00V8 IB CORRECT ANO /�OPEB TO COM- pUliP08E OP 88TAELIBXIN6 A PeRMIT PfiH ONLY.
PLY WITH ALL C�'n' ORD NANCHB ANO 8TAT8 WB Ii80 TINO
BuiLDINo CONBTn� ' VALUATION �
81GNATURE O PERMIT FEE $� Cr
PERMITTE ^' � $ /i( S /� / �'^ `
i
,7 C� �4 PLAN CHECK $ ��
AUTHORIZED A TOTAL FEE �L'—
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