HomeMy WebLinkAbout3425 MEADOW BROOK - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
Parcel Nunmber.
Applicant:
Address:
Owner:
3425 MEADOW BROOK
93506057
GLOVER, LORIE
2737 S CRODDY
SANTA ANA, CA
PHILLIPS, ELIZABETH J
Address % WALKER, PAMELA E
COSTA MESA, CA
3425 MEADOW BROOK
PLUMBING PERMIT
Phone: (714)241-1414
Zip: 92704
Phone:
Zip: 92626
Contractor: COAST ROOTER PLUMING HEATING & AIR CONDITIONING
Address: 2737 S CRODDY �
Arch / Eng :
Address:
SANTA ANA, CA
1 WATER HEATER CHANGE-OUT.
SSUE FEE
3ackFlow irrigation
tackflow Preventer
athtub
larifer System
�nnect (Ice,Soda.etc)
antal Units
;hwa5her
3in, Floor
iin, Rainwater
in, Roof
iking Fountain
ansion Tank
EaRhquake Valve
(1-4 outlets)
(Over 4 outlets)
�epipe
>ervice
eptors (Grease, Oip
�ptors (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
$0.00
$0.00
$0.00
$0.00
�N
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Phone: (714)247-1414
Zip: 92704
License: 529127
Phone:
Zip:
License:
SCOPE OF PERMIT
FEE SUMMARY
AMT
Laundry Tub / Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 70 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 $0.00
Sink, bar ' $0.00
Sink, wmmercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
QTY
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: it/30/2000
Issued: 11/30/2000
ISSUED BY:
��, '
� �. �/�
�'
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-0)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (7oilet)
Water Heater / vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water SoKener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCULATED FEES:
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$o.00
$0.00
$12.30
$0.00
$0.00
80.00
$0.00
$0.00
$0.00
$0.00
$0.00
$35.80
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
� The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related
is. (Ord. No. 92-20, § 1, 12-21-92)
ION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abantloned
d of 1 BO days.
ONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
ispeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
:CTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON: �
I hereby eMirtn untler penalry oi perjury one of the following tleclarations:
❑ I have end will mainWin a certiticete oi consent to seN-Insure tor workers' compensation, as provided tor by seaion 3700 of the Labor Code, for the pertormence oi the
work lor whic� Ihis DBrmii is issUetl.
� I have and will maintain workers' compensatlon insurance, as required by section 3700 of the la�or Code, for the pertortnance of the work for which this permit is issueA.
My workryfl1rs,'� com en�sa7tion Ins1uranca carner and policy number are: n
Cartier. ,(/1��1�,�n'�M.� Policy Number. AIIJ� OR X g�9
(This sectlon neednof be compiete i/ the p rmit is valued et one hundred dollars ($100) or less.)
❑ I certity that in the peAormance of the work for which this permit is issue4 I s�all not employ any person in any manner so as lo become subject lo ihe workers'
compensation laws of Celitomla, and agree that It I should become sublect to Iha workers' compansation provislons oi Saction 3700 of t�e Lebor Code, I shell forthwlih
comply with these p,r�ovi�sions. �/
Applicant Slgneiure: a��i �� Dete: I ��� ��
WAPNING: FAILIIRE TO SECURE WORKERS' ODMPENSATION Q�VERAGE IS UNIAWFUL AND SHALL SUBIECi AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
TMOUSAND OOLLARE (5100.000),IN ADDRION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3106 OF THE IABOH CODE, INTEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aftirtn that I am licensed under provisions of ChaO�er 9(commencing with Section 7000) of Division 3 ot the Business and Professions Coae, entl my license is In tull
brce end ettect. Lic. M � a 1 Class M C. � i/1
Contractols SignaNre: _ ___ _ Q� Date: � ��'�I O.O
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirm Ihat there is a consiruction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby aNirtn Ihat under penalry of perjury thet I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business end Professions
Code: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repair eny swcWre, prior to its Issuance, also requires the epplicant tor such pertnit
ro file a signed statement that he or sha is licensetl pursuant to the provisions of the Contrectors License Lew (Chapter 9(commendng wlth Sectlon 7000) of DlWsion 3 oi the
Business and Professi6ns�Cade) or that he or she is azempt therefmm and the basis tor Ihe ellegetl exemption. Any violation af Section 7031.5 by eny applicent for e pertnit
subJects Ihe applicanito'a ci"vifpenalry.ot not more than five huntlred dollars ($500).):
�«X rn� n n �or_
❑ I, as owner of ihe properry,mr my employees with weges as their sole compensation, WILL DO THE WORK, and ihe struclure is not intentletl or ottered br sela (Sec.
7044, Business antl Professions Code:�The Contractors License Law does not apply to an owner of property who huiltls or improves ihereon, antl who tloes such work
himself or herseif or throu9h his or hei owii employees, provided that such improvemenis are not intended or oHeretl for sale. It, however, t�e 6uiltling or Improvement is
sold within one year of completion..the ownerbuilder will have the burden ot proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner ot the properry, am EXCLUSIVELY CONTRACTING WITH IICENSED GONTRACTORS to construct Iha project (Sec. 7044, Business antl Prolessions
Cotle: The contrectors License Lew does not apply to an owner ot proparry who bullds or impmves ihereon, antl who contraas for such pmject with a contractor(s)
license pursuant to tha Comractors License LawsJ.
❑ I am enempt under sec. Business and Professions Code for this reason:
Siqnawre: Date:
Owner ID veritietl 6y tlnveYs license. ❑ Yes ❑ No Drivers License No. Expires:
Venfication ol Ownership by (type ot tlocument, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAfETV PERMIT CER7IFICA710N:
❑ I hereby certity ihat no excavation tive (5) or more teei in depth into which e person is required to descend, will be matle in connectlon with work euthodzed by this
pertniL anC t�at no Duilding strucNre, scaflolding, falsework, or demolition or tlismantling thereof, will be more than Ihirry-six (36) feet high. (Chap. 3.2, Gry 2, Art 2, Sec.
341, Title e, Celitomia Atlminisirative Cade).
❑ As owner-builder, I will not employ anyone to tlo work which would require a pertnit from the Division of Industriel Sefery, es noted above, unless such person hes e
permit to do such work from the division.
Signature: Date:
Division of Industnal Safery Pertnit Number:
Will the applicant or present or tuture building wcupant need to lile end certity a Business Plan br emergency response ro release or threatened release oi a hazerdous
material7 ❑ Yes ❑ No
(Section 25505 oi Ihe Califomia Health and Safery Gode requires, with some exceD�ions, ihat a Business Plan be tiled with Ihe Costa Mesa Fire Oepariment Dy every
business which has at any one tima tluring a reportetl year a quantiry of hazardous materials equal to or greater than a weight of 500 pounds, or e volume of 55 gellons,
uoas or wm me appucant or presem or tuwre omiaing occupam neea to rne a registration rorm ror acutaly hazamous meterials7 LJ Ves U No
(Section 25533 of Ihe Celifomla Healih and Safety Code, with some exceptlons, requires reglstration with ihe Costa Mese Flre Depariment by eac� business which at an
one time has on hend a quentity of ecutely hazardous materials equal to or greater than e weight oi 500 pounds, or a volume ot 55 gellons, or 200 cublc feet �
CAmDfB55Bd qa5 B� 5�8ntl2rd IBmDBrBtUrB entl pr855urB).
or wm tne appucant or
an
(Section 25534 of Ihe Calitomia Healih antl Safery Cotle pmvides thai ihe Caste Mesa Fire Department may i
Department of an RMPP by businesses which ere required to register acutely hazardous materials with the Fire
........................................................................................._...................................................................................................................................................
H an RMPP is presenily required, has Section 25534 of ihe Celifomia Heallh antl Satery Catle been fully compli�
..................................................................._...................................................................................................................._...................................................
Does or will the epplicem or present or future building accupanl raquire for ihe work which is the subject oi thi.
vention Program for acutely hazartlous matedels)
the preparation, certitication end fiiing with Ihe F
ment.
..................................... ....................... _ .........................................
7 ❑ Yes ❑ No
........................................................................................................
ation a gertnit lor such construction or motlifica'
irom t�e South Coast Air �uality Manegement Distnq or trom any other air pollution conirol disMct or egency.� ❑ Ves u No
(Section 6585Q2 oi Ihe Califomia Government Code requires Ihat the raquested intormation be turnished on applications tor non-resitlential bi
...............................................................................................................................................................................................................................................................................................................
Will any part of the faciliry to 6e constructed under ihis pertnit De within 1000 feet trom the outer bountlanes of a sc�ool7 ❑ Yes ❑ No
(If yes , the fecility must meet the requirement of Sections 25534 and 42303 oi the CaliFomia Health antl Satery Cotle).
............................................................................................................._............................................................................................._......................._........_....................................................._......
If B permit fmm ihe South Coa51 Air �ualiry Menagement DisMct or o�her air pollution control tlislnd or agenty is requiretl tor lhe work
eppliwtloq have all ot ihe tlisclasures prescnbed by Galitomia Health antl Safery Code Section 42303 been made7 ❑ Ves ❑ No
0
CERTIFICATE OF COMPLIANCE: I certity that under penalry of perjury Ihe informalion given above is correct. I agree to comply with all state lews and cily ortlin
regarding Hazardous Matenals and Emissions.
Signamre: Date:
CERTIFlCATE OF COMPLJANCE AND AUIHORVJ1710N OF ENTRV: I cenify under penalty of perjury that I have reetl ihis application entl state t�et the infortnation �
correct. I egree to comply with all stete laws and city ordinances relating to building construction, end authonze representatives of ihe Ciry of Caste Mesa to enter u
ebove�tlescnbed property for inspection purposes. I egree not to occupy or allow occupancy of any building authonzed by this pertni� until tinal inspection.
�;r� Of Legal Owner(s) Date
�� � /J�3u�o�
Antl/Or Authorized Applicant Date
CODE I, INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spa Final
200 Final Re-Root
201 Final BIocWRataining Wall
202 Final Factory Fira Place
203 Final Sign
204 Final Demolition
QA�
INTIfI�LS COUE� INSPECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final ElecMcal
212 Finel Fire Prevention
220 Finel Planning Approvel
222 Final Site
250 Final BuildinryOccupency
PAIE
J:�l1�L J
PflOJECTROONESS: 3QZS MEADOW HR��K UNIT:
OWNEfl'SNAME: VILLAGE CREEK HOMEOWNERS
aoosess: ASSOCZATION '
3929 TIMBER LAKE -
CM VA'92626
ancn�excixees: CHESTER� CARVILLE aec.xo.: C18305
ADONESS: 'J j z 2 ARMOUR ST � u"�T:
• S.D. CA 9211�1 �
PEflMITTEE: 13HOENSX E131ERPRISES INC. (�7.13)690-9559
aooness: 411 COMERCIAL WAY
LA HABRA CA 90631
LICENSED CONTflFCTOfl OECLpBATION: I hereby atfirm that I am licen nAer p ovisions oi Chapter 9 mencing wilh Section
7000) o� Orvision 3 0� t�e Business and Pwlessians Catle, antl my lic e in fu' orce and eifeci;
ciTvuc.: 5 g Yeuc.:376639 /,I
Daie: ���`— Signamre' _ L�`/
WOBREBS' COMPENSA ION UECLANFTION: I herehy afhrm Ihal I have a cero cate 01 consent �o seli-insure or a certi�icaie ot Workers'
Compensation Insurance. or a certified copV Ihereol (Seaion 3800. Lab. C�.
`OIICYN0.:W7003S4 � E%P.ORTE: O%I �91
COMPNNY: CA COMP & FIRE
� Cetlilietl capy is hereby fumis�ed. ❑ Cetlilietl copy is hled wit Buil Divi'on. '
/L �
Dale' _( ��C �.� Applicanl:
E%EMPTION FBOM WOPREflS'COMPENSATION DECLAHATION: �ihissecuon neee nolDeca te0i�ihe permi�isforonehundre 1W)orless�. .
I certdy ��a� in the petlormance ol Ine work lor whic� �his permii is issued, I shall no� employ any person in anY manner so a5 to became
suhlect lo Ihe VJorkers' ComDensation Laws of Califomia.
Dale: SignaWre:
NOTICE: If, after making Ihis declaratioq you s�oultl become subject m ihe Warkers' Compensaiion Dmvisions o1 ihe LaOor
� Cotle. you musl �orihwilh camply wilh such pwvisians or Mis permit shall be �eeme0 revoked.
CONSTflUCiION LENOING RGENCY: I nereUy a�firm tnal �here is a cons�mction lentling agency for ihe pertormance a� t�e work tor
whith IhiS permi�is ic5ued (SettiOn 3097, Civ. C). .
LENDEfl: , , � '
aooxess:' '
OWNEN 6WLOEH DECLANATION: I hereby atlirm that I am exemp� irom �he Coniractors' Sta�e License Law for ihe �ollowing reason
(Seciion 7031.5 Business antl Pmiessianal Cotle: Any ci�y ol coun�y which requires a permit �o conSlmci, aller, impmve, �emolish, or
repair any S�mcNre. P�ior to i15lssuance. also requires Ihe aDPlicani for such De�mi� lo file a signed statement �hat he/she i5licen5e0
pursuanl Io Ihe pmvisions ol �he Contraaors' S�a1e License Law (ChaO�er 9(commencing with Semion 7000) a� �ivision 3 ot Ihe Business
and Professions Code) or I�at he/she is exempt iherefmm antl Ihe �asis lor ihe alleged e�emp�ion Any violalion of Section 703L5 by
any appl¢anlfor a permit suDjecis the aDP�icant to a civil penalty of not more than live hunUretl tlollars (5500).
I, as owner of Ihe Dropenv or my employees wilh wages as their sole comDensalian, will tlo ihe work, and ihe
stmcmre is not intenUed or ofleretl lor sale (Section 704a, Business antl Pmiessional Code: The Conlractors' S�ate Licenre Law
does not appty to an owner ol a D�operiy who builtls orimproves ihereon, and who tloes such work himself/h¢rsell or��mugA
�is o� her own employees, proviAeO thal such impwvemenis are no� mlendetl or ofleretl for sale. tl, hawever �he builtling o�
impmvemenl is Soltl wi��in one year ol completi00. �he Owner will have the buraen ol pwvinp �e/5he tlitl nol build or impmve
lor the purpose of sale). ' _
`� � I, as owner of [hc pmperiy, am exclusively conVading with licensetl contraclors to cons�mci fhe Orolec� (Section 7044, Business
-❑ an0 Pmiessions Code: The Contractors' Slale License Law tloes nol apply to an owner of pmpeM who �uilUs or improves lher¢on
I and who conVadsfor SucA prolec�s with a conlrac�or(s)license pursuant�o Ihe Conirac�ors' Slaie License Law�. I am aware .
tha� O�oof ol �heir Worker'S Compensalion insurance shaultl be pmvitletl to me.
� I am exemp� untler Sec�ian: B. 8 P. C
lor this reason:
Oa�e'. Ownec
I tlo hereby cetli�y tha� I am aware of antl untler5ian� ��e reQuirements o� Caltlomia Health antl Sa�ery Code Seclions 255Q5, 25533, antl
2553a and Iha1 I or any �uiute builtling occupanl willlwill not (circle one� neetl �o comDly wi�h saitl siate cotles and the reQuiremen�s for a
permii lor mnstmciion or matldication imm Ihe Pir �uality Management Oistrict. Fe5i0ential conslmciion applica�ions are exempt hom
Ihese pmvisions
Daie: Ap0licant _
I hereby certilylhai I have read Ihis application an0 slaie I�al �he
ortllnances antl stale laws relaling Io �uil0ing consimctlon antl herel
pmperiy loi inspec �u ase
Oaie'.���`— Signamrc�
�river's �icense or Socia� Securiiy x: �%$$
correcL I agree to com wi�h all ciry
i�ives ot ihis ciry io pon ��e abovi
t64�-a6 White—Builtling�, Green—Code Enlorcemenl: Canary—AOPllcant; Pink—Revenue',
��
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 050593
PERMIT NO: B 050593 ' FLAN CHECK NO: 00118-91 A GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSEi REF
JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: ' 143
CLAIM VALUE: 14,300.00 CALC—VALUE: , 14,300.00 GROUP OCC; R-3' /
COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION � ��
�*�***�r�*�*�*��x ***�**�****�********�*�*�t*+t*�t� �**���**�x�*�r**+�,+��t*�r�t�***x u *t��r�r•�*��
Z O N I N GS ERTEBQAUCIKRSE M,E N'T S �\.',
----------- MAIN BUILDING --- ------ --------- ACCESSORY HUILDING ----------
FRNT; FT IN REAR; FT IN 'FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN. LcFT; FT IN RGHT; FT IN
FARKING REp • PROV: PARCEL: 93506124 ZNE; R2 REF NU:
�ANNING N(7TES> FOUNDATON REPAIR.
. ) . . _ . . . , .
if iE ii if if �lE IE iE iE iF if if 1f iE iE iF IE iE 1E iE iE if�lk iE IE 1E �1E if lf iE 1E ff if 1E !E If !f )k 1E 1(� iF iE iE Ik 1E if 3f ik iE if if iE ib if !6 �14 i(� lE 1E 1h # iklE �1E IE 1(� if iE iF iE if 3E ie!(� if 1E �F if if
D E V E L O P M E /N T S E R V 1 C E S R E'Q U I R E M E N•T Fi
ZONING APPROVED BY C� �--�—�- DATE; b_'��l S`� J
' ��
BUILDING AFPROVED BY : w/�— DATE.; ��
i' �
APPLICATION ISSUED BY: DATE:
kiEiEiEif3EiEif3EiFlE%�lE3EjfiFlEiP1F3E�k1E� � e ��iFiFiF7F!(�lf�FiblFiFfF�IF�7F�1F�7Fi�iEif
ifiFiFifiElEfElfiFiflfiEifiElEielEiFlEiFlfiEiEiE1FIFififif�lEiE-1Fi E IFiFiEiEiFiEiElfifiFififlEififlE�lE�lfiEifiE�7F1E�1FiEik3EiF�lFlfifiEih3EiE1flEifiElf
LEGALIZATION;N F E E U M'M A R Y ,�,'TRUCTURAL SEGMENT;Y
HLDG PMT PLUMBING ELE RIC MECHANIC FZRE SMIP/RES GRADING
PERMIT 162:00 1.00
' SMIP/NON—RES
PLAN 26.33
ISSUE FEE -�
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR TOTAL I�AID �UE
TOTALS----> 163.00 0.00 26,33 189,33 189.33 .UO
REVENUE.DIVISION TOTALS--> COLLECTED; 189,33 OVER/SHORT; � ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECx
162.00 1.00 26.33
iF if �)E i(� iE # if �lE if if lE iE 1f iE IE if iF iF 1ElFlE !F �lk IE 1E 3E 3k ik iE iE iE 3E IE iF �1(- lF !f if 1E 3E If 3f if if if if If� iE iF IE iF iE iF iF if iE IF if 1E �1f fE if if IE �E lf if ff if iE iE �1E%iE iE %if if {(.
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 P O N UNIT COST TOTAL COSi
SFR 143 STRUCTURAL HY VALUE PER g100,00 1U0.00 14,300,00
END OF fiEE5
"_��__"� ' _
e
CONSTRUCTION AND PLANNWG � �I.�SPA,
APPROVALS Permit# Date Inspector qppROVALS Permit#
�
1. Temporary Electrical Service`or Pole. ' j _� _52. Pool & Equipment Location
� .
� 2: Soil Pipe-Undrgrnd. � ', ^ � r 53. Steel Reinforcement
3. Elec[rical Gonduit Utility-U�tlrgrnd. � 1 54. Forms -
4. Electrical Conduit-Undrgrnd.^� ^ 55. Electrical Bonding
�
� 5. Steel.Reinforcement 56. -Rough P�umbing & Pressure Test
6. Electrical UFER Grnd. � � 57. APPROVAL TO COVER-GUNITE
-7. Footings '� ` � 58. ElectricalConduit-Undrgrnd.
. 8. Foundation � � ���},� `. 59. Gas Pipe, � Undrgrnd., Test
� 9. Water Pipe-Undrgmd. �',�� f:i 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System! '�� �� ���� 61. APPROVAL TO DECK
11. Property Sewer �line & yous��onnection �•� 62. Backwash & Receptor-Final
12. Sewer Cap .� r"' �_�' �r 63. Heater & Vent-Final
13. Roof Drai�s - � �l 64. Plumbing System � Final
74. Rough Plumbing .�', ,� � 65. Electrical�Final �
15. Rough Electrical-CondLit �/�� ��� 66. Solar System-Final ,
16. Rough E�ectric;Wiring �� . i�� . 67. Fencing & Access�Approval
17. Rough Wiring Sign I, . �� 68. APPROVED FOR PLASTERING
�
18. Rough Electrica,l-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
� .� .
20. Rough Factory Fiieplace i• ' ��. � ; ' - �•� QPPROVALS; � �Permit #
21 .�DuMs, in 5irucluie .. � • J0. Underground. Hydro `
22. Ducts, VeOtilating �t _ 'Z� �` ',71. Product Piping O�Gas ❑Oil
23. Gas Pipe�Fough & 7est '' . - Y72, Underground Flush= . � � •
24. Roof Framing • � � '� � - �-'` �73.'�UndergrndCStorage�Tank �Gas'OOiI
i.
25. Roof Sh'eathing � ' � � � � ' . ,� '74 :Overhead Hydro , -
26. T-Bar Ceiling �Struci�ral) & Monocoat : • _ � � °' 75. Dry Chemical ' - •
e, -
27. Prame and Flashing' ' '� ;_ 76: Diy Standpipe , .� ' •
28. Lathing & Siding. . ,' ..�! � v � � 77. 'FIXED SYSTEM•FINAL
'29. Insulation � : � ��� � : . _I �. �� 78.; FIRE PREV. FINAL � �
30. Drywall Nailing ?'- - � � � HEALTH�DEPT� REQUIRE
31. Plaster Brown Coat' - � i; ;.�79.l�FINAL INSPECTION ', - '�
32..Electrical Power Meter-Final � .• � j i� ?- �80. FOOD CERTIFICATE ISSUED '
,33. Final Electric � � , ; � � � , ` ' ; . .
_ � ; j� Notes: _
34. FinalHeating:&AinConditioning�_ • � � �'
35. Final Gas PiPe-Test_ _- �' �
�
36. Hood or-Canopy . • . � , . �
37. Final Fanory Fireplace _ ' �� .�' i
38. FinaL Plumbing -. . i - �
39. Water Service�Final� ., � i
. i
.40.�Gas Service�Final � . � , - � �
41. Solar pomesticFinal �- � • - '
42. Backflow Preventer' . j
A3. Backflow Irrigation` -� � �
44. Landscape Irripation System , _ . � -
�45. Sou�d Attenuation � • � ' '
,
46. Handicap Regulations '_ . �
47. FINAL S7RUCTURE & BUILDING ✓ "
48.'FINALPLANNING � . _
� 49. Electric Re�ease to Edison �
50. Gas Release to Southern California Gas Co . �
'51. CERTIFICATEOF,OCCUPANCY' �
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Date � Inspector
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OWNER STATE-WIDE Develoners Inc DATE 4-28-76
JOB ADDRESS 4425 Meadow Brook BUILDiNG PERMIT N0. 41802 _ _
o. YE(7=(���=}i}r��OT iRACT ARSR FIRE ZONE
re
PROP. SWR. LINE U HOUSE CON. �
SPRINKLING SVSTEM
MISCELLPNEOUS
ROUGH MEqTING ANO AIR CONOITIONING
TEMPORARV SERVICE OR POLE
UNOERGROUNO � POWEfi �
ROUGH WIRING
TRENCHES �I FO Q�_ FPOI�f
BONO BEAM Lf STEEL REINFORCE
SHEATHING
FRAME ANO FLASHING �
— IN II% OUT
G. ANO A.C.
GAS TEST �
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 90X 1200 COSTA MESA. CALIFORNIA 92626
PAIC �. �
r;av �3-�c�,,�,tio0 �c�sx �265.08
APPLICATION FOR BUILDING PERMIT
For Applicant to Fill in Completely
RECEIVEDBY DATEPECEIVED D TEI S ED
BUILOING
ADDRESS �
OWNEFl State-Wide Developers, Inc. �'zs '°/OZ ., :PEFM��y�
A.P. NO. G-6 Z)< «
ADDRESS9`�V� GPllldldy ADORIEss .��iZ� �ir.il��noo;�
CITY Cypress No`.'826-4550 TRACT �� LOT BLOCK
CAN5TflUCTION �'�' A � ��
LENDER
BRANCH
OWNER
ADDRESS
ARCHITECT TEL 1 Res W�aLt aY' VALU$
onrt« iroeen� Lohrbach Pulaski No.826-4550
AooRess17848 SkyPark Blvd Irvine ZONE TVPE ROUP —
CONTRACTORStateW�de DEVe�OFIEPS� I�IC. eVPAOVED DATE
000Re5s9461 Grindlay
TEL. Z�NE NO.OF USE OF NEW /lJb L✓
cirv CypP@SS No.826-4550 22 �'i' P�+Ns Z BUILDING
STATE CITV VARDS APPROVED VARDS APPROV
UC.NO. ZZ47�O LIC.NO. MAINBUILDING ACCESSORVBVILDWG
SIZE NO.OF BLO(3S. (FROM C/L TREET) '
OF LOT 12.093 f]CY'e$ NOW ON LOT � ROfJT FT. FT.
VSE OF
E%ISfING,BLDG, 5 Z F � F
SIZE OF NO. OF �
NEW BLDG. ROOMS STORIES L. SIDE FT. FT.
EXTERIORWALLP�aStQ�" ROOF Shake FT. FT.
COVERING COVEfiING REAq ��
USE OF BUIIDING AND WONK TO BE PERFORMED p��{pNCE BET. BET. MAIN &
MAIN BLDGS. ACCESS. BLDGS. ��
�'i2W construction-Condominiums CURP #� 7� APPROVED !� ��
1 Residence w/att gar �ROVED�� � �_�G
HOLD FOR S -CIA REQUIREMENTS
I �ereby acknowledBe that I nave read this applicetion antl state
thet tha above information is correct and agree to comply with '�
all laws ragulating builtling consttuction, antl 1 shall not employ
any person in vlolation ot the workman's compenuHon laws of
tha State of California, m
1 hereby certity ihat 1 am proDerly licansetl es a conttactor under SQ, FT. � p
tha State of Californ(a B�siness antl Professions Cotle, Divisicn 3, THE AMOUNTSHOWN UNOER VAlUAT10N IS FOR
m
Chapter 9, and thet such licenses are in iull torce and affect, or 1 THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: ¢
am exempt from me prov(sion5 ot the $taYe ot Calitornia Busine55 VALUATION
antl Professions Cotle, Division 3, Chap(er 9. -w m
a��Q (q' PERMR FEE $ �
State-Wide Devel p s> Inc. " �,�-,- '
Sipnatur Q m
Pe�mlttee PLAN CHECK $ � E
Authorizedqgent Vice President Lw u
TOTALPEE $ �VD