HomeMy WebLinkAbout2058 MEADOW VIEW LN - Building PermitsPP0.IECTAODPESS: ZOSS MEADOW VIEW LN uxir:
�- OWNEN'SNAME: ANDERSON DALE L
nooaEss:2058 N.EA150WVIEW LN
� COSTA MESA,CA 92627
" 646-3689
li pflCHIENGMEEH:KEN RASHOFF xec.xo.:C12739
� aooaEss: z�536 PASEO VERANO uxir:
� SAN JUAN CAPISTRANO CA 92675
PENMITTEE:BRW ASSOC (714)694-2009
aooness: 1720 SANTA ANA AV A
C.M. CA 92627
I� UCENSEO CONTFRCTOB OECIABATION: I �ereDy a��irm �hal I am licensed wJer pmvisions oi ChaD�e� 9(commencing wi�h Section
�� 7000) of Division 3 0l Ihe Business antl Pmtesslons Cotle. anA my license is in full force antl eflect.
I c�rr uc.: 0 5 5 2 4 � $TATE LIC.' t� ] 6 1 1 cuss: H
IDaie'. � � � SignaNre'._�� ��.,�„0,� �
i WONNENS' COMPENSATI N DECIABATION: I here6y aifirm �hat I have a certi�icale of consent to selbinsure or a cetli�iwte o� Workers'
Campensa�ion Insurance. or a cenifie� coDY �hereoi (Sec�ion 3800, lab. C).
roucrNo.:1263564-91 E%P.URTE: O%�OZI92
� COMPANY: S TATE �
�� �] Ceni�ietl copy i9 heryby Iumishe0. � CehJk�capy is IileA wilh �he cl�y Bw�fing Oivision. �
.eie: �� - � APPlicanL LC./KJ V' v w��t /
E%EMPTION FHOM WONNE S' COMVENSATION ECLRNATION:,, Qhis section neeU iwt 6e complete0 il ihe permil is fa ane hunaretl (5100) or less�.
I certity Inat in Ihe oedormance of lhe work for which Ihis Dermit is issuetl, I shall noI employ any person in any manner so as lo Decame
sublet� lo Ihe Worker5' Compensation Laws ol CaliiUmia.
Oate: - SignaWre:
NOTICE: If, aiter making �his tleclara�ion, you s�oultl-0ecome su�lect to Ihe Workers' Campensation pmvisions ol �he La�or
Cotle. you must fonhwuh campry witn such pmv,isiuns�or Ihis permit shall be OeemeO rewke0.
CONSTBUCTION LENDING AGENCY: I hereby a�hrm�tha� there is a cons[mc�i0n lentling agency �ar lhe peAormance o� Ihe work �or
whicn �his permit is issueU 1Section 3097. Civ. C). 'f'
lFNOEfl: ,' f
ADOflE55:
OWNEP BUILUEB �ECLABATION: I hereby al�irm Iha� I am exempt �mm �he Conbactors' Stale License Law for �he �ollowinA �eason
(Seclion 7031.5 Business an� Pmfessional Code: Any cily ol county which fequires a De�mi� ta constmct, al�er, improv& demolish, or
repair any slmcNre, prior lo ils issuance. also requires the applicant for such permit to file a signed statement ihat he/she is licensetl
pursuant m the v�ovisions of tne Coniracmrs' State License Law (Chapter 9(commencing with Section 7000� of �ivision 3 0l tne eusiness
antl Professions Goae) or �ha� he/she is eaemp� �heretrom and Ihe basis �or ��e allegetl exempiion. Pny viola�ion o� Section 7031.5 by
any applicanl br a permit sub�ects the aOPlicam [o a ciNl penalry ol not more [han �ive hundred Aollars (5500�.
I, as owner of Ihe pmpetly or my emyloyees vnth wages as Iheir sole compensalion, will tlo the work, and �he
❑ slmcmre is noi imended or ofleretl tor sale (Sec�ion 7044, 9usine55 antl Pmlessional Cotle: ihe Contracbrs' State License Law
tloes nol apD�Y �o an owner of a pwpehy who 6uiltls or improves Ihereon, ana who Uoes such work himself/herself or ihmugh
his ar her Own employ¢es, pwviaed �hal Suth improuemen�5 are n01 inten0e4 Or OflereA fOt 5ale. tl, however Ne �UiltlinA 0�
impmvement is so10 wit�in one yea� of compleiion, ihe owner vnll have Ihe burUen o� pmving he/she OiA no� builA o� impmve
br ihe purpase of sale).
I, as owner af the propeny, am exclusively coniracting wilh licensed conlractors to consiNct ihe proie�� I,Section 7044, Business
❑ and Pmfessions CoOe: The Comracmrs' Slare License Law Joes nol apDly to an owner of D�oDeM �o bwltls or improves �hereon
antl who conVacis lor such D�ole��s wit� a conlrac�or(5� license pursuan� to the Contractors' SIaIe License Law),I am awa�e
Iha� pmot ol �heir Worker's ComDensation insurance s�oulA Oe provided m me.
� I am exempt under Section: B. 8 P. C.
for ihis reason'. '
oa�e. aV�e�:
I do hereby certily I�at I am aware o� antl untlerstantl ��e requiremen�s of Cali�omia Heallh antl Sa�ery CoOe Seciions 2550i 25533, antl
25534 and Ihai I or any INure builAing occupanl wilVwill nol (circle one) nee0 �o comply wiih sai0 state codes and �he requiremenis tor a
permit for con5imction or motlification i:om Ihe Air �ualiry Managemen� DisVicL Resideniial consiruc�ion applica�ions are exempt �mm
Ihese pmvisians. /
Oaie: Npplit /
I hereby cerlity thai I have reatl t�is applicalion e s�ale Ihai Ihe abave in�ormaiion is carreci I agree lo comply wi�h all ciry a counry
or0inancesanOslatelawsrelalingiobuildingco �mctionantlherebyauihorizerepresen�ativesotthisci�ytoen�erupantheabo �meniionetl
pmperly for inspection rposes. 1N n
p ,�
Date: � 2.6 2 Signamre: Q�y J �/�%O/1�
'�rivei s �icense oi Socia� Securiry x:
,.
Whpe—Bmltling', Green—Cotle EniorcemenC Canary—Applicam'. Pink—Revenue; Goltlenm�—Asessor
CITY OF COSTA MES U LIBA DTNG—Yh'nr�-�-.,--_����_
PERMIT NO: B 055850 PLAN CHECK NO: 00194-92 S GOVT; N SUPP U` "-
CUNSTRUCTION TYPE: PERMIT TYPE: STR PUkPGSE; ADU ,
JOB DESCRIPTION : 220SF 2ND 5TORY PATIO/DECK SQ FT; 220
CLAIM VALUE: 3,500.00 CALC-VALUE; 3,036.00 GROUP OCC: R-3 /
COMMENTS; ALSO 6" ABOVE GROUND REDWOOD DECK
**��***u**�*�*����r*��*x**�r*****+�*x�*�x****�*�*x+��r�*��**��r*+�*��r*��*�*�+�*�e�x��r*�**�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN EUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: 12 FT IN FANT; FT IN REAR; FT IN
LEFT: FT IN RGHT; 3 FT 6 IN — LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42201303 2NE; PDR- REF NO:
PLANNING Nt7TES> EXPAND AN EXISTING DECK• ADD EXTERIOR STAIRCASE; REPLACE AN
> EXISTING TUB SHOWER WIT{i TILED SHOWER, ;,..:
�t���t�r�r�*�**��*x **�r*x*�r**�**�t***+�*�**x �t+��e*�**�****�r*****x *+�****��***�*�.****x u �**
D E V E L O P M E N T S E R V I C E S A E Q U I R E M E..NrT S
20NING APPROVED BY �,��1�- DATE; '1�'l.0 ��t_
BUILDING APPROVED HY ; DATE;.
APPLICATION ISSUED BY: ��-/��� DATE: i' ,''
�kiFiFifiEiFi(�lFif��1FiF*ifiFiE�lfiflhiFiElFiEiF7FiFiFiziFiF3tiFiFiFiF3F3F7f�f�F�F FiFiF3FiFiF7'r{'riFiFitiFlE�lfiflEi!3EiFiEiEiE - � r c iFi(�
�E �lF if iE lE iE�k iE iF iE i4 # iF iE �E if �lE iE iE it it� iF 3E 3F-)E 3F l(-iF it i(� i4 �lE if iE iP 3E iF lE iE iF 7E iE �lE k 1E iE iE iF iF iE iE iF iF �)k iE if iE �f 3E �1E iF �F 3E�iE 1E iF it iF iE iE if if iE �E iF # iE lF �tE
LEGALIZATION:N F E E S U M M A R Y STRi7CTUitAL: SEGMENT;Y
'f -%
HLDG FMT PLUMBING ELECTRIC MECHANIC FIRE SI✓�IP/RES GRADING
PERMIT 63,00
PI,AN 40, 95 � {
ISSUE FEE r�,. -�,•"
BUZI,DING-DIV-> PERMIT ISSUE P�,AN-CHECK
TOTALS----> 63.50 O.OU !� ' � 40`.95
'at:
REVENUE DZVISION TOTALS--> COLLECT.ED�:
BLDG PMT PLUMBING Ei,ECTRIC MECHANIC
63,00 �J
r� ,
3f lE if ae )f iF if 1f �iE iE iE jf iF if 1F 1f iF IF iE # iE iE jF 3F 3E aF 3F �k iE 1f 3E �f jF �fiF iE �F iE jF iF4� 3E if
I N D I V I D U A� L E'' E^ E
TYPE QTY D E S C R I P T I O'NY��'�
� %, `" ✓.
SFR 220 Rfi5-BALCOA7Y, EXT.ERPOR'�STAIR
SMIP/
TOTAL PAID DUE
1.09,95 104.45 .00
109.45 OVER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN-CHECK
.50 90.95
iE if iF 1E If iElE ik �E aE iF 3E ii iE 3FiE iF ii IF iE iE �F �lE iE iE # �f 3F ik iF 3E iE # iE
B R E A K D O W N
UNI7' COST TOTAL COS1
Y 13,80 3,036,00
ill li�il��li',�inl.{}t%1� r3_:. -i
r,rF: G;�^_�i,,� �;�- ;t.^„
��
,
%� CONSTRUCTION ANDPLANNING:
APPROVR+3 Permit #
1. �Temrt�Pary Electrical Service or Pole
2. Soil Pipe�Undrgrnd. - � ` . �
.
. 3'. Electrical Conduit Utility-Undrgrnd;
4. ElectricaFConduit•Undrgrnd. '
.5. Steel Reinforcement
6. Electrical UFER Gmd.
7. FOotings
8. Foundation
9. Water Pipe�Undrgrnd.
10. Structural Floor System -
11. Property Sewer Line & House Connection
12. Sewer Cap , . . .
13. Roof Drains �
14. Rough Plumbing
75. Rough Electrical-Conduit
16. Rough Etectric Wiring
77. Rough Wiring Sign
18. Rough Electriwl�T Bar Ceiling
19. Rough Heating & Air Condttioning
20. Rough Factory Fireplace
27. Oucts, in Structure �
22. Ducts, Ventilating
23. Gas Pipe�Rough & Tesc �
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frameand Flashing '
28. Lathing & Siding
29. Insulation ' �
30. Drywa�l Nailing •
31. Plaster Brown Coat�
32. Electrical Power Meter�Final
33. Final Eleciric '
34. Final Heating & Air Conditioning �
�35. Final Gas Pipe-Test
'36. Hood or Canopy � ,
�37. Final Factory Fireplace
�38. Final Plumbing
' -
19. Water Service-Final
i
�A. Gas Service-Final ,
��7. Solar pomesticFinal
i
2. Backflow Preventer '
�
�. Backflow Irrigation
�. Landscape Irriqation System
ISound Attenuation
Handicap Requlations
`FINAL STRUCTURE & BUILDING
IFINAL PLANNING
Electric Release to Edison
i
ias Release to $outhern California Gas Co
SERTIFICATE OF OCCUI
� Date
`
Date
n
�
0
9
- _ POOL A
'Inspector qppROVALS Permit #
' 52. Pool &.Equipment Location
- - 53. Steel Reinforcement
- 54. forms �
55. Electrical Bonding
- 56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
J
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines, P�Trap, � Undrgrnd.
61. APPROVAL TO DECK
62.-Backwash & Receptor�Final �
63. HeSter & Vent-Final
64. -Plum�ing System - Final
65. Electrical�Final
66.-Sotar SYstem-Final
67. fencing & Access Approval
68. APPROVED FOR PLASTERING
69. PO�L/SPASYSTEMSFIIVA�
FIRE DEPT. REQUIREMENT -
� APPROVALS ' Permit #
� 70. Underground.Hydro
' 71. Product Piping �Gas �Oil
z
- 72. Underground Flush -
73. Underqrnd. Stora9e Tank O Gas ❑ Oil
� � 74.�Overhead Hydro
75.-Dry Chemical
, 76 `Dry Standpipe , � '
� • 77. FIXED SYSTEM-FINALj
� 76.,FIRE PREV. FINAL -
� HEALTH DEPT. REQUIREMENT
I� 79. FINAL INSPECTION
� 80. FOOD CERTIFICATE ISSUED�
' - Notes: �7G.. �/tY 1 �Pi10
91
0
:
Date I Inspector
9
/I
PFOJECT ROUflE55: z O S B MEADOW V I EW LN UNIT:
owNExsNnme: ANDERSON DALE L
aooness: z058 MEA150WVIEW LN
COSTA MESA,CA 92627
' r 646-3689
qp�11ENGINEEfl: t(ETj RASHOFF flEG.NO.: CS2i39
aoosess: z7536 PASEO VERANO uxir:
SAN JUAN CAPISTRANO CA 92675
PEPMITTEE: BRW A$SOC (714)644-2009
nooness: 172U SANTA ANA AV A
' C.M. CA 92627
� UCENSEO CONTFACTOfl DELIAPATION: I here�y aflirm that I am licensetl untler D�ovisions ol Chapter 9(commencing with Section
', 7000� ot �ivision 3 0l Ihe Business and Pmtes�si�ans Cade, and my license is in NII lorce an0 ef�ect.
Icirr uc.: 0= 5 2 4 5 STRTE LIC.: yq S 611 cas1s: B /
oate: � 20 �SignaNre: �.�—J� �
I WOBNEflS' COMPENSRTION DECNflFTION: I hereby aflirm tha� I �ave a ceni�icale ol consent �o seli-insure or a ceni�icale of Workers'
Gompensa�ion Insurance Or a certilied copy ��ereol (Section 3800. Lab CJ.
roucrHo.: 1263564-91 E%P.DFTE: O%IOSI92
camrnxr: STATE
� Cetli�ietl capy is ere6y lumishetl. �� dieJ coDY is liled with the ciry Builtlin �ivision. /
,a�e: i aPC Pr�,m: �LQi ��L�.0 �' �
EXEMPTION FNOM WO I(EBS' fAMPENSIITION UECLABRTION: (ThiS 5eciion n¢eA nol be com0le�etl ii the permi� is lor one hundrea �$11q) ar less�.
� I rerlity Iha� in I�e peAormance ol �he work for wAic� Ihis permi� is issuetl. I shall not employ any person in any manner 5o as �0 6ecome
� subject to �he Workers' Compensalion Laws oi Califomia.
� �ate: Signa�ure:
�, NOTICE: I�. a�ter making I�is declara�ion, you s�oultl became su�letl [o [he Workers' Compensa�ion pmvisions oi �he Labo�
�� Cotle. you musl fo��with comply wi�� such provisions or �his permit shall 6e deemetl revoketl.
', CONSTXOCTION LENOINC RGENCY: I hereby aHirm Ihal Ihere is a cons�mction lending agency for ��e Dertormance o� ��e wark im
�, whicA Ihis permit is issued (Sec�ian 3097. Qv. C�.
LENDEfl:
R�OPE55:
OwNEfl BWLOEH OECIAflRTIUN: I here�y aliirm ihat I am eeemD� ��om ine Conlractors' State License Law tor the iollowing reason
(Sec�ion 7031.5 Business antl Professional Cotle' Any ciiy of coun�y whic� requires a permi� m constmct, al�er, impmve, demolish, ar
repair any S�mtWre. prior �o i�s issuance. also requires �he applicani lOr SUCh permit to file a SigneO Sta�emen� lha� helshe is liten5¢tl
pursuam to Ihe pmvisions of t�e Contraclors' S�a�e License Law (Chap�er 9(commencing with Sec�ion 7000) o� Division 3 0� Ihe Business
and Pmlessions Co�e) or ��ai helshe is eKemp� �here�mm and the basis �or Ihe alleged exemption. Any violation ol Sec�ion 7031.5 by
any applicant for a permil suhiecis ihe applicant lo a civil penalty of not more than live huntlretl tlollars (5500).
I, as owner of �he pmpetly or my employees with wages as �heir sole compensa�ion, will Ao �Ae work. -antl Ihe
❑ s�mcWre is not imended or o��eretl �or sale (Section 7044, Business antl Pro�essional Cotle: The Conirac�ors' S�ate License Law
tlaes not apply to an owner of a pmpeny who builOs or Improves thereon, antl who aoes suc� work himsel�/hersel� or (hmugh
hrs ar her own employees. pmvitletl �ha� sucA impmvemenis are nol in�endetl ar oflered for sale. If, hawever �he builtling or
improvemenl is soltl wi�hin one year oi compleiion, fhe owner will �ave t�e burden oi DmvinA he/she ai0 not buila or improve
�or ihe OurOose o� sale�.
I, as owner of Ihe prope�y. am exclusivety contracting wilh licensed conlrac�ors �o conslNc� �Ae D�olec� (Section 7M4, Business
❑ antl Pmfessions Code: The Conimctors' State License law does nm apply ro an owner o� pmDeM �o builOs ar imD�oves �hereon
ar�d who tonVac�s �or Such pmleds wlth a ConiraC�of(5) litense pursUant�O ihe Contrac�ors' State Li[en5¢ Law�.i am awafe
Ihai D�ool of tAeir Worker's Compensalion insurance 5hou10 Ue D�o��4e0 to me.
� I am e�empl untler Sec�ion: B. 8 P. C.
lor Ihis rea5on'.
Dale: Ownec
I tlo hereby cenity Inal t am aware of anU unUerstane ihe reQuiremen�s of Cahfomia Health antl Safety Caoe 5ections 255a5, 25533, antl
25534 ane Ihai I or any luture builtling occupanl will/will nol (circle one) need fa comply with said sla�e cotles antl Ihe reQuiremen�s fot a
permi� �or conslmctmn or modifica�ion imm Ihe Air Ouabry Managemeni DiSinct. flesitlential conslmc�ion aD0lica�ion5 a�e eHempl imm
�he5e pmvisions.
Date: Ap01' n�', /
I hereby cetltly Nal I have read �his apPlication ntl stale t�a� �he above inbrma�ion is wrreci. I agree lo comply wi�h all ciiy ar� coun�y
ordinances and 5laielawsrelalingto building c Slmc�ion antl hereby aulhorite represenla�ives allhis ciry�o en�er upon�he abovertnenlione0
pmpetly �or i speclion pwposes. � /��
�ale: � 2� � 2- 9gnamre. —� N V �
onver's �kense or Socia� securi�y x:
164L<6 White-9uiloina: Green—Cotle EnlorcemenL Canary—Aoolicanl: Pink—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — BUIL�Y'NV r...__,_,_
`_i_---
PERi�IIT NO; E 055851 PLAN CHECK NO; N GOVT; N SUYN";—rv--_�
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTI(�N ; 220SF 2ND STORY PATIO/DECK, RE;iFB55850 SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: ALSO 6" ABOVE GROUND REDWOOD DECK ,
+�*�+c**+�***�*�***�***�*�****�***x*��*�***��****�*+�*x�********�*�*******�***��**�
Z O N I N G R E Q U I R E M E N T S
sETaAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT SN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 422U1303 ZNE: REF NO:
PLANNING NC�TES>
>
**********�r�r**�r*��t**�*�t�t��**+�t�****ir*�***���r��x*****�r****x**�***�t*�***��****u*�*
D E V E L O P M E N T S E':R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY , ��, DATE: _
BUILDING APPROVED bY ; �: DATE:
APPLICATION ISSUED BY; 'z �� DATE: � 'Lo � �
3EiF1F*iFiEiEikiF3fiEjfiFiElEifiF�lfiEififjE3f3'E�f3F7FiF�f�F7F'iF3Fib�F�ifiF3F'iF �iF?fiF7FiE3FPti'e7fiFiEiE3E1E1F�EiEiEif iEiE
if iE iE 1f iE iE ff 1f if iE iE jE 1E iF 1E if 1E iE If if iE iE iP * IF iF iE IF iE 3f aE �E �E 3E ik iF iE 3E k if iE iE iF �f �f iE iE 3E iF iE 3E 1E �f IE iE ah if iE jE iE IE iE �E IE IF �f if iE i't iE iF �f iE )F iP 3f iE �E 3f
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING �
PERMIT 4,50
503 SMIP/NON—RES
PLAN -
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 4,50 I5.00 0.00 19.50 19.50 .00
REVENUE DZVISION TOTALS--> COLLECTED; 19,50 OVER/SHORT: 00 I
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GitADING PLAN—CHECK
19,50
k ik iE 3F iE iE if dE iF �F 3ElFiE iF 1E iE i(� if if iF iE if if IE IflE �f iF iE �EiE #f iE iE iE iE 1F iE 1F iE iF iE 1f If iE if 3f iE iE iE iE iE jE iE �E iF 1E iE iE if iF iE if iE iF if IE iE iF 1F 1f 1E iE 1� fE 3f if �k jf
I N D I V I D U A L F E E B R E A R D O W N
TYPE QTY D E S C R I P T Z O N UNIT COST TOTAL COST
ELE 3 FIXTURES LIGHTING 1 ST 20 EA, ,75 2 25
ELE 2 RECEPT/OGTLET 1 ST 20 EA, .75 1.50
ELE 1 RECEPT/SWITCH i ST 20 EA, .75 .75
END OF FEES
�A l.���Qu�lo_�f���O�ls �4J4 'T �t.'� `!�
D"n7G: Ci.•'2Q/R2 ?I(i�: Si:l•i
CONSTRUCTION AND. PIANNING. _
� APPRDVP�.S ,.Permit# -
i. Temporary Electriwl Service or Pole
1�
2. Soil Pipe•Undrgrnd. - ' �
3. Electrical Conduit Utility•Und�grnd.
4. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
� 6. Electrical UFER Gmd. "
7. Footings
8. Foundation �
9. Water Pipe-Undrgrnd. •
10. Structural Floor SYstem
11. Property Sewer Line & House Cannection
72. Sewer Cap
73. Roof Drains
14. fiough Plumbing
75. Rough Electrical-Conduit
i6. RoughElectricWiring.
17. Rough Wi�ing Sign
18. Rough Electrica6T Bar Ceiling
19. Rough Heating & Air Conditioning '
20. Rough Factory Fireplace
21. Ducts, in Structure . . �
22. Dutts, Ventilating '
23. Gas Pipe-Fough & Test "-
24. Roof Framing
25. Roof Sheathing
26. T-Bar Cei�ing (Structural) & Monocoat
27. Frame and Flashing
'� 28. Lathing & Siding. .
�1
29. Insulatlon ' �
� 30. Drywall Nailin9
�
- 31. Plaster Brown Coat
32. Electriwl Power Meter�Final
` 33. -Final Electric
� 34:•Final Heating & Air Conditioning
I35. Final Gas Pipe-Tes[ '
`36. Hood or Canopy
�37. Final Factory Fireplace
38. Final Plumbing - .
5. Water Service-Final
i
0. Gas Service-Final . '_
i
I. Solar pomestic-Final
i
!. Backflow Preventer �
1�. 8ackflow Irrigation
�
� Landscape Irripation SYstem_
�Sound Attenuation
'�Handicap Regulations
�FINALSTRUCTURE&BUILDING �
i INAL PLANn�lnrc �
ilearic Release to Edison
�
�as Release to Southem Califom�a Gas Co
ERTIFICATE OF
Date
Da4e
POOL ?A �
Inspector APPROVALS Permit # Date Inspector
52. Pool & Equipment Location
53. Steel Reinforceriment .
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test ,
57. APPROVAL TO COVER�GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. 8ackwash Lines, P-Trap, rJ Undrgmd.
61. APPROVAL TO DECK -
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Final
65. Electrical�Final � -
66. Sotar System�Final
67. fencing & Access ApP�4oval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPRQVALS -. Permit #
• 70. Underground Hydro
71. Product Piping �Gaz ❑Oil
. 72. Underground Flush -
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical �
76. Dry Standpipe ' . � "
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL .
� HEAITH�DEPT:REQUIREMENT
79. FINAIINSP.ECTION,
.80. FOOD CEF2TIFICliTE ISSUED
� Notes: '. . � '
i
�
�
1
/
PflQIECTADOflESS: '�ps$ (ajr,��j�j VIEW LN UNIT:
OWNEfl'SNAME: /�NDERSON DALE L
aooeess: �058 MEA�OWVIEW LN
COSTA MESA,CA 97.627
646-3689
FNCH/ENGINEEN: KEN RASAOFF nec.xa.: C12739
noosess: 27536 PASEO VERANO uxit:
5AN JUAN CAPISTRANO CA 92675
PEflMITTEE: BRW ASSOC ( 714 ) 644-2009
aoonEss: 1720 SANTA ANA AV A
C.M. CA 92627
LICENSED CONTBACTOB UECLABATION: I �ere�y aflirm Iha� I am licensetl untler provisions o� Chap�er 9(commencing wi�h Section
7000� ol Oivision 3 0l Ihe Business ana Pmlessions Code, antl my license is in lull force antl ellecl.
cirr uc.: 0 5 5 2 4 5 STRTE LIC.: 3 4 I G 1 1 cuss:1 B�,I
D�te: � 2 Signature:—�..�1,/V . _
'VOflREflS' COMPENSFTI N OECIABAT10N: I hereby aftirm Ihat I have a certiliwte of consent m seli-msure or a certificale of Workers'
impensation ILsu�pce„ ]$c4 ire�cPov inereoi (Secuon 3s00, �an. �..� � O 1/ 9 7
OLICY NO.: S 1 ATE E%P. ORTE: -
COMPRNV:
❑ Cetli�ietl copy is h eby lurnishetl. '[] Cehi�ietl copy is fi^le0 with �he ciry Builtling ivision. �
'�e1e:- l APDlicanL [J � \NV�(/�'�/�'
E%EMPTION FHOM WOflNE 5'fAMPEN5ATI0N OECLABRTION: (Thisseclion neeA no�0ecompkteAi�Ue permitisforanehunOred(5100)orless�.
1 cerlily Iha� in Ihe pedormance oi Ihe work br which Ihis permit is issuetl, I shail not employ any De�son in any manner so as lo become
sublec� �o Ue Workers' Compensalian laws o� Calitomia.
�ate: Signa�ure:
NOTICE: If. afier making ihis declaration, you shoultl become sublect to the Workers' Compensation D�ovisions ol ihe Labor
COAe. you musl IOMwilh compiy wi�� such pwvisions or Nis permit shall 6e deeme0 revoke0. M
CONSTflOCiION LENOING PGENCY: I �ere0y a�firm Ihal lhere is a constmc�ion lentling agency br �he pedormance of t�e work lor •
whic� Ihis permit is issuetl (Sec�ian 3097. Civ. C�.
LENOEN:
aooness:
OWNEB BWlOEB DECLAflFTION: I her¢by af�irm t�at I am exempt imm �he Contractors' S�aie License Law fo� lhe following Bason
(Sec�ion 7031.5 Business antl Pro�essional Cotle: Any city o� counry which requires a De�mit �o cons�mcl, al�er, impmve, tlemolish, or
repair any simcture, prior lo its issuance, also requires t�e apDlicant for such permit to file a signetl statement that he/sAe is licensetl
pursuanl ta �he pmvisions oI l�e Comractors' Slate License Law (Chap�er 9(commencing with Seclion 7000) o� �ivision 3 0l ��e Business
antl Professions Cotle) or Ihat he/she is exemp[ �herefmm an0 �he hasis for Ihe allegea exemption. Any viola�ion o� Section 7031.5 by
any applicantior a permii suble��s ihe applicani �o a civil penally of not more �han tive hunArea Dollars (1500).
I, as owner ol Ihe pmpetly or my employees with wage5 as �heir sole com0ensa�ion, will tlo ihe woB, antl �he
I� s�mclure is nol imentle0 or offere0 for sale (Section 7044, Business an0 Pm�essional Catle: The Cantraztors' State License Law
tloes noi apply Io an owner ol a Dropetly who OuilOs or improves thereon, and who Ooes such wofk himself/hersel/ or throug�
his or �er own employees, pmviUeO ihal such impmvemenls are not intentletl or oifere0 for sale. Ii, �owever tAe building or
improvemen� is sold within one year of complelion, �he ownel will have ��e burtlen al pmving he/she did nol huild or impmve
lor Ihe purpose o� 5ale).
I. as owner of ihe pmpeny, am exclusively contracting wit� licensetl coniracbrs m consimm ihe Dmlect (Sec�ion 7044, Business
❑ antl Pm�eSsions CoOe: The Camracmrs' S�a�e License Law does na� aDDly lo an nwner ol pmpeM `�o hudJs ar imDmves thereon
an0 who conlrac�s for such Dmjec�s with a conVacim�s)license pursuani to �he Coniracbrs' $tate License law�.l am aware
Ihat proo� of Iheir Worker's Compensation insurance shoultl be pmvided lo me.
� I am exempl under Sectiore 8, 8 P. C.
lor �his reason:
Oale: Owner
I ao hereby certily Ihat I am aware of an0 un0erstane the requirements ni Calilomia Health antl Salety Code Sections 25505, 25533, and
25534 antl �hal I or any luture �uiltling occupan� will/will not (circle one) neetl �o comDly wi�h saitl state cotles antl lhe requi�ements �or a
permi� br conSVuclion or mo0ilication fmm Ihe Air Ouality Managemen� Dis�rict. Resiaen�ial canstmc�ion applications are exemD� ��om
I�ese pmvisians.
Date: Ap0licant:
I hereby ceN�y ��at I have reatl �his applicalion and 5�aie Ihai I�e a0ove information is correcL I agree Io compty wi�h all ciry an0 counry
ortlinances and stalelaws relating�o builtling constmctian and hereby aNhorizerepresental�/es otthis ciryto enter upon��e above�mentioned
pmperty far in pection urposes. /'�
� Signa[ure: �/� � �./ v ��
o�ivers �aense o� Sociai secudty a: $
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; � 7b
PERMIT NO; P 056003 PLAN CAECK NO; N GOV'T'; N 5 ; N
CONSTRT.JCTION TYFE; V—N PERMIT TYPE: PLU PURPOSE; �D
JOB DESCRIPTION ; REPLACE Ah EXISTING TUB W/TILE SF30WER SQ FT;
CLAIM VALUE: 1,200.00 CALC—VALUE; GROUP OCC: R-3 /
COMMENTS: REF; B56002
iE 1E iE 1f 3E K� ih 9F 3E iF iE iE �F if iE-}E 3F 3F iE iE iF 3E �E �IE iE ff iE �!f iE iF 3f if iE iF iF jF iF �F �E if fE i(� iE it iF �]c it iE 3f u�1F # IE iE lf iE �lF if if iF if iF iE �F it If iE iE �lE 3E �lt� iF iE 3E iE iE iE �7E 3E
2 O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILllING --------- --------- ACCESSORY BUILllING ---------
F'RP.T; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT: rT IN LEFT; rT IN RGHT: FT I13
PARKING REQ• PROV; PARCEL: 42201303 ZNE; RF.F NO;
PLANNING N15TE5>
? '
if i(� 3E 3E iF iE if �F iF iF �)f ib �l(� if� iE 3f 3E iE )f 3E if �E 3E iE iE-% iF iE 3(� �lf iE �IF iE 1f iE if if 1f �1( #P 3F IE �lF 3E fF K�.3E lE fF 3f iE # iE iE if �3Eif if 3F df �1F IE�f 3f-3F 34 iE iE if 36 if �F iE 3E 1E �1F �F #E 34
D E V E L O P M E N T S E R V I C E Sy: R E Q U I R E M E N T S
ZONING APPROVED BY ✓+ DATB;
BUILDING APPROVED BY ; '% DATE:;
APPLICATION ISSUED BY; ����� � DATE: � �l'—/�Z
IEiEiF1EiElfiEifiE�EiEiFiEifiElE3EiFiFiF3fjfiF3FiFiFiF�3FiFiF 7F ±F�E�Fgif�F'£'iFfr7FifiFif7f7FiF'lf'IFiF3EiFififiEif3E�'�Fit'7e£iE�lE
fF3E�1F1FiEitiEifiFiEiF�IFIFiFiE3fiEiFiE1F1f#;FifiFiElEitik3fiFiElf-kiFlfie�E IEiE�1F�FJFiEiE�It3h�1F�lE1EiFiFiEiEiE'.Eit�E�ififlF-IEiE�7f3EiEiFiRiFlEif9Fif1flFiEiE
LEGALI7.ATSON;N F E E 5 U M M A R Y STRUCTURAL SEGMENT;N
HI,DG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
FERMIT �a�5$ SMIF/NQN—RES
PLAN
ISSUE FEE 3,00
BLILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2.OQ 3.00 0.00 �.00 5,00 ,00
REVENIJE UIVISION TOTALS--> COLLECTED: 5,00 OVER/SHORT; UO `�
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/T07' GRADING PLAN—CHECK
5,��
3't 3FiF 3c iE fE iP fE iF iF iE�k if iE iE if ji if 3f �E 3F �F iE iE �%!F iE iF iE 1E iE iE 1E * if jF IF if jE �1E if ik if iF if iE 3E �klE iE iF�1F iF IF if �f * ie�1f iE �N� iE iE iE aF iE iP if iE M� #F it iE i'r �f !f -)f 3E iE
I N D I V I D U A L F E E B R E A K D O Tr1 N
TYPE QTY D E S C R I P T Z O N UNIT COS'C TOTAL COST
PLli 1 SHOWER 2.00 2,00
END OF FEES
�`
D1 QDi0;4a2—CGt4743: T �."k . ,
DATE: Gf/��,iq2 TII;c: �,<:3b .�G
1\ 1641�46 WN�e—Builtling; Green—Cotle Enlorcemen�', Canary—Applican�; Pink—Revenue; Goldenmtl—Assessor '
/ � .
CONSTRUCTION AND PLANN�Itvu - '
APPROVALS Permit# Date
1.� Temporary Electricai Serv�ce.or.Pole .
2. Soil Pipe-Undrgmd. � �
3. Electrical Conduit Utility-Undrgmd. • -
4. Electrical Conduit-Undrgrnd. ; '
5. Stee1 Reinforcement
6. Electrical UFER Grnd.
7. Footings
8. Fo�ndation '
9. Water Pipe-Undrgrnd. �
10. Structural Floor SYstem �
i t. Property Sewer Line & House Connection '
12. Sewer Cap
13. Roof Drains
14. Rough Plumbing . (l,,ji/��
15. Rough Electrical-Conduit
76. Rough Elearic Wiring
17. Rough Wiring Sign '
18. Rough Electriw6T Bar.Ceiling ,
19. Rough Heating & Air Conditioning
20. Rough Faciory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-RougFr,& Test
24. Roof Framing �
25. Roof Sheathing
26. T�Bar Ceiling {Structurall & Monocoat
27. frame and Flashing
28. Lathing & Siding
29. Insulation
`30. Drywall Nailing
�31. Plaster Brown Coat
,
32. Electrical Power Meter-Final
�
13. Final Eleciric
�1. Final Heating & Air Conditioning
�i. Final Gas Pipe�Test
�. Hood or Canopy
IFinal FaMory Fireplace
�,Final Plumbing �(Q�
IWater Service-Final
�Gas Service-Final
�
Solar pomestic-Final
i
lackflow Preventer
i
�ackflow �rrigation
�andscape Irrigation System
i
Iund Attenuation
�ndicap Regulations
�IAL STRUCTURE & 6UI�OING
i
IAL PLANNING
',tric Release to Edison
Release to Southern California Gas Co
Oate _ _
Inspector
GFc/1
�OL & SPA _
AP.PROVAIS Permit #
52. Pbol &�Equipment Location
53. Steel Reinforcement
54. Forms.
55. Electrical8onding '
56. Rough P4umbing & Pressute Test
57. APPROVALTOCOVER-GUNITE �
58. Electrical Conduii•Undrgmd. .
59. Gas Pipe, O Undrgrnd., Test
60. �Backwash Lines, P�Trap, b Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor�Final
63. Heater & Vent�Final
64. Plumbing System - Final �
65. Electrical�Final
66. Solar System-Final
67. Fencing & Access ApProval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAI
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank Q Gas O Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIPE PREV. FiNAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80.. F000 CERTIFICATE ISSUED
Notes:
n
Oate �Inspector
�
�
i
Cl'1'Y Ul� CUL1.. hi1;:;A 1<LtlUL'J'L' V�iL' �iCCUI�NICY
TRACT N0. ' I � � ( ) LJ�19'. � -S� ��
t,o�r �o. a�
' Annx�sa z1:5 8 '�Vl � c1r��i ,U �1 � c�� �-��/1-�-
Tho Qaveloyer O! tho abovo entitled traat fleeirea to se11 the above. sat forth
lOt pr1oY to tho time thst the tYact hae been completed snd ite atreate
acCepLod by tAo City of Coeta Meea.
The undereigned. by executing thie a�reement, acknowledgea that (he-ehe-they)
} . .
i (vae or vere) advised thdt thie tract has
��'
� ao0 Deaa given final Spepection nor has it been accepted by the City of Coata
�
j DleO� r�e hsviug complied vith the conditiona.of approval xhich were impoeed by
'� n
i�� tho olty at the time the finaT tract map v'ae approved.
�;:, ? '
+�' , •
�• Th@ eity maeumee no liability 'for the enforcement of the condltione naccaeary
r�
�, tor approvsl other than thoee conditions grotected by surety bond.
,. T11e�underalgaed egrmea to indemniry and hold the city harmlese fram az�y claim _
�;r� smoultlag in llemago or peraonal injury to the undersigned by reason o1 thm
'' 6fOT07¢antioaed IipcOmpleted condition. 1fi e undereigned acknowledgee that thie
€j
z•
� egreac�nt io aroda oolely for che benefit of [he city and doee not inure to
9. _
.� .
�. the Oenefit of thm uadereignad or any of ct�em.
�; _.. � n QD_. n�ti "_..
� RECEIVED
CIi'� ^P �ncrq h7ES.A
r'
�
,lU� g -1979
AM
718�ei�illiuili�i�i4i5 6
L
c
Developer efytj/os a
rnpranentet4've
GREAT WESTERN
eY � ' B�.LOAP�.ASf;6f#FFt@I
j'9#�?'�"/IlSHI!<E bOULCYARO�
. UtVL1ilY MILLS, CA�IF. 90211
.• . �✓ GCfCis 'L ,.
. `�.�I13.k. Yltl.olLwYb ''- '
Y
�
n
r
i
� :;',.ti QF7Y 0���7SfA'MESA:.:, ., ... . J
BUILDING 6AFETY DEPARTMEN'f=�•
POST 1N CONSP�CUOUS PLACE
ON THE `J08
A.v. No.
BUILDING ADORE55
NEW � ApD � ALTER � REPAIR � MOVING I DEMOLISH
USE
�FIAE ZONE - TVPE GROUP �
PDR—hID V I & J
HOLD FO[d SPFCi.Ai, iiEQUIl2li6iGN'f5
SETBACKS
Front Yd .�� Side Yd. R At� • L Att • Rear 2k ����
Side Yd. R L Rear
BUILDING INSPECTION RECORD
TO KEEP BUILDING PERMITS VALID. W�ORK MUST BE COM,
'MENCED WITHIN 60 DAYS WITH ROUTINE INSPECTIONS AT
LEAST EACH 120 DAYS THEFEAFTER UNTI L COMPLETED. .�
Trenchea C] Forms 0----•-------------
Fioor SVatem -"""""""""""""'"' � _
Steel Reinf.""""""""""""""' -[
Sheathin � .. �"
e""""""'"""':_""""'- / '
Frameend Flashing--------==------------- % -
Insuletion"""-"'-"'"" �"
' _ """"' _
LethinB""'""'""""""'""""""' / �
Dry Wall Neilin9"_""""'_""""_"' � .�' /Oy
Plaster,BrownCoa["-""'-"--"""-" - LY
SoundAttenuetion ........:.............. "'�—' �-
HendicapRegulation ...................... ^
FINAL �� �-
PLUMBING
Soil ----'---- �
Underpround Water - • �
�""""""""
RougA Plum6in9 ""',,,""""""""' ' - '
Prop. Sewer 4ine and House Conn. -... _.. _._ ��- IS�
StreetSewerConn.'----'---'------------ //-16=
WaterService """"""""""""" `3' '/
SPrinklinpSVstem """"""""""" --
GasTett """""'_""""""""" "` '
' FINAL .H.� �I-�'%
HEATING, AIR-COND. AND REFRIG
Refr.Linea,PrenureTert ................ -- —
Ductt. Undergraund"'""""""""""""'" � "
Ducts,in Structure ................._.._.. /Z O
Ducb.�VentilaHng .'+"""""""'--" " �'B'
RouBh Heating end A ir-Cond_ _ _ _ __ _ _ _ _ _ _ _ _ _ 0
FINAL iir�%�1/�% 3-9
ELECTRICAL
TemporaryServiceorPola•---..----..._.._ - —
Underp�ound ."""""""_c"'."'.' ' /O�T4�
Power Meter "" • " " - """"' _ "' _ "'
RouphWiring."""""""'_"'_"'_'_ //-S'
Do not occupy this project until finat insp�tion has
been made and occupancy ha�pprov9d
Final �7
NOTICE
24•hr. notitication required when the job is i' y foi i�speciiun. You
inust fu�nish PERMIT NUMBER and the JOB ADDRESS FOR EACH
RESPECT�VE INSPECTION. CA4,1_ 556-5273. ; ;,,;.;
APPfiqVED PI.AP�S SHA1�?. (4�F flhl,ln8 A7 ��,�_ TIMES
c�.:, . , �„ .. - . . .
�
PflOJECT ADUflE55: 2 O J� MEADOW . VI EW I,%] UNIT:
owxeR s Name: P.NDEftSON DAS.E L
noosess: 2058 MEAi)OWVIEW L�N
COSTA ME5A,CA 92627
646-3689
APCNIENGINEEN: YEN RASHOr F flFG.NO.: C S.�.7 3 9
ADDPESS: ,�.7536 PASEO VERANO UNIT:
SAN JUA� CAPZSTRANO CA 92675
PENMITTEE: BRW p.SS�C �%14%64Q—���9
noosess: 1720 SANTA ANA AV A
C.M. CA 92627
LICENSEU LONTNACTOH OECLAPATION: I hereby aHirm �hal I am licensed unGer pmvisions o� Chap�er 9(commencing wi�h Section
7000) ol Oivision 3 0� ihe Business and Professions Cotle. and my license is in lull lorce and eftect.
ciTr uc.: 55 4�5j sTnTe uc.: 3416 i i cuss: B
�ab. � 24 7 Z SignaNre: — _ '
�ORNEBS' COMPEN ATION OECIANAiION: I hereby af�irm �ha� I have a cetlilica�e o� cansenl �o sell-insure or a cehificate of Workers'
�mpensalion Ips oc caceJtifie GOpy ��ereo� (Section 3800, Lab.
�OLICYNO.: S�b��o�—�l E%P.DFTE: 7IOSI92
comvnxr: STATE
❑ Certihed opy is he e�y Wmished. Q Ceni�ietl copy is �ilea wi�h IAe ci�y BuilOi Oivision.
�,,,.. � 2 Q 1 Z' Applican�: �/�i V V
E%EMPTION FPOM WOBKEPS' COMPENSATION UECLABRTION: (i�is sttiion n¢e0 nai 6e tOmpkleU il Ihe permi� is lor ale hunOreO (5100) or 1e55�.
I cerlily Ihat in Ihe Dedormance of Ihe work for w�ich this permi� is i55ue0. I shall noi emDloy any person in any manner so as to become
su�lecl io Ihe Workers' Campensation Laws of Califomia.
Dale: Signature:
NOTICE: If, aller making �Ais Oeclaration, you shoul0 6ecome suble�� �o Ihe Workers' Compensatian Orovisions of t�e Labor
COde. you mus� Io�hwiih Comply wi�� 5uth pmvi5ion5 ar lhis Oermil S�all be tleemeE revoketl.
CONSTHOLTION 1EN01NG RGENLY: I hereby aifirm that ihere is a consimction lentling aAency for t�e De�ormance o1 the work for
which Ihis Dermil is issueA (Seclion 3097. Civ. C�.
LENOEfl:
aooxcss:
OWNEP BUILOEP DECLAflFTION: I hereby aifirm Ihat I am exemp! tmm Ihe Contractors' Sia�e License Law for the following reason
(Section 7031.5 Business antl Protessional Code: Any ciry oi counry w�ich repuires a permil to consimct, alter, improve, demolisq or
repair any s�mc�ure, prior �o ils issuance. also requires �he aODlicanl for such permi� lo file a signetl s�atemen� �ha� he/she is licensetl
pursuan� to ihe pmvisions of ihe Contracrors' State License Law (C�apter 9(cammencing with Section 7000) of �ivision 3 of Ihe Business
and Prolessions Code) or �hal he/she is exempt Ihere�mm and the basis lor �he allege0 exemption. Any violation of Section 7Q31.5 by
any apDlicant for a permit suhiecis ihe aDPlicant to a civil penalty o7 not more ihan live huntlre0 dollars (5500).
I. as owner of ihe propeny or my employees with wages as tAeir sole compensation, will Oo the work, antl ihe
❑ stmcWre is not intentletl or otfered for sale (Section 7044, Busness and Pmlessional CoOe: TAe Coniractors' State License Law
tloes nol apDly lo an owner of a pmperty who builtls or improves thereon, and who does such work himselflAerself or thmuAh
his or her own emDloyees, provitletl ��at such improvemenis are no� imentletl or o��eretl �or sale. If, however the 6uilding or
im0�ovemen� is so10 wi��in one year o� comple�ion, �Ae owner will have Ihe Uurden of proving he/she Aid no� huild or impmve
lor Ine ouroose of salel.
I, as owner ol ihe pmveny, am exclusively coniracting with IicenseA coniractors to conslNct tAe D�aie�� (Section 71M4, Business
❑ anU Pmieuions Coae: The Coniractors' State LiCense Law aoes noi appty Io an avmer 0� proDeM who bUilUs or impmve5lher¢on
and w�o tomraCis lor Suc� pmjects wi[h a canVac�oqs)license pursUan� Io �he ConVacmrs' S�a�e LiC¢nse Law). I am aware
t�ai pmo� o� Iheir Worker'S Campensation insurance shoultl �e pmvitle0 la me.
� I am eKempl un0er Section: B. 8 P. C.
for ihis reason:
Oate: Ownec
I Ao here�y cenily Ihal I am aware of antl undersland the requiremen�s ol Calilomia Healih antl Sa�ery Code Sections 25505, 25533, an0
25534 an4 iha� I or any fulure builtling occupan� willlwill no� (circle one) neetl �o comply with said slale cotles antl Ihe requirements lor a
p¢rmi� for conslmclion or modilicatmn �mm t�e Air Ouality Management �i5�ricL ReSiAenlial conslruc�ion applications are exem0� ��om
�h¢5¢ pfOVl5ipp5.
�ale: Applicanl'
I here6y cetlity Iha� I have read Ihis apPlication antl s�ate �ha� �he above in�ormalion is correci. I agree lo comply wi�h all ci�y antl counry
artlinances antl staielawsrelaling�o buildmg con5tmciion and herebY aut�orizerepre5enia�ives ofihis ciryto enter upon��e above-menlione0
pmpetly lOr ins(, t�ion pu 05pe5. ,� I �
at� ( �� LZ Signature: �,U,,v
on�er's ��cense o� sociai Secudty a:
.>>6at-� W�ile—Builtlinq; Green—Coae Enlorcemem: CanarV—Aoolicanl: Pink—Revenue: Goltlenrotl—Assessnr
� ---�i,�. .
CZTY OF COSTA MES� — BUILDING PERN,I'f PEk,+1 Nfl; B 76 .
PERMIT NO: 3 056002 PLAN CHECK NO: N �uvi; N surriTi
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ADD
JOB DESCRIPTION : REPLACE AN EXISTING TiIB W/TILE SHOWER SQ FT; 1,20U
CLAIM VALUE; 1,200,00 CALC—VALUE; 1,200,00 GROUF� GCC; R-3 /
COMMENTS: SMOKE DETECTOR RE�UIRED ZN THE HOME
*�*������x�*�r*#*x******�*��c .�*�**x**x�*�*�*x��c-�*�*x�**��**�c�*�r*�x�k***x*���x�*****�
7. O N I N G R E Q U I R E M E N i S
S E T B A C Y. S
------------ MAIN BUILDIVG ----------- -�------- ACCESSORY HUILDING ---------
FRNT; FT IN REAR• FT IN FRNT; FT IN REAit; F7' IN
LEFT; FT IN RGH7': FT IN LEFT; rT I�7 RGHT: FT IN
PARKING REp• PROV; PARCEL; 42201303 ZNE: REF NO:
PLANNING N01'ES�
�
it jf !E if 3F !F fE 7E iF if iE ib 1F 3F ik Ik 3E iE iF 3f it iE iF if 1E jF if if jt iE iF if if �f 3E 1E k-1f iE fE -Ik iE iF #F IE if ie �F if �M iF ik iE if iE iE 3f if iF iE 1E iE if ih *#f if iE 9E:3i�iE aE 1E iE iF if i!� if �
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 N, E^N�.T S
/�. .
ZONING APPROVED BY DATE; `r��
BUILDING APPROVED BY ; DATE:j�t,
APPLICATION ISSLED BY; • DATE�; ����p/ �y
+a it �c it x� i� i� x� i� �c ** i� �f� **�* i� *�x� it�7F iF iF'iFiF3F3F iF3FiF'iFi€'iF iF3FTr'iF iF5F3F X3F �Fif �F'xiF'iF 3F'fF iFiF iF3F k* �t� ie * 1F if+F iE �t��f�3FiF'SF� N� it
iF iF 1!� iE ik �IE jF 1f iE jE 3E �!E 3F iF JE jE 3E #iE iE iF �1F 1El: �E �F ik iE fk �f iE �F if iF 1f 1FlF iE iE �# iF �ElE # iE �1F iElf iF iE iE if �1E iE 3f !h 1f iblE �lE if �lE 3f #�F #E�f�� i(�iE �f �If !f i¢ �)f 1E �lElf
LEGAT,I7,ATION;N F E 6 S U M M A R Y STRUCTURAL SEGMENT;Y
t l"
ALDG PMT PLUMHING ELECTRIC N,ECHANT.0 FIRE SMIP/R"ES GRADZNG
PERMI'P 29.00 .50
SM IP /NON—r'tE5
PLAN
ISSGE FEE
BUILAING—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
29.50 0.00 0.00 29.50 29.50 .00 _,
REVENUE DIVISION TOTALS--> COLLECTED; 29,50 OVER/SHORT• 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRAD'ING PLAN—CHECK
29.00 .50
8F iE iF )( iF fF �7E if� If if• i(�'.f �IM1 jF iF 3f �(� 1E iF if )f iF 3F 3E #4 )F �E �Jk jE it 1E i4lF �1E fF 1E �lf if',4 �7F iF If if 7E �f 3E iE 1E it iE 1k �If �f !f iE iElf iF ih #! iE %if iE �1E±f if iE 3E tE 14 iE iE iE # 3E iF �1f !f
I N D I V Z 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
SFR 1200 ALTER BY VALUE RESIDENTIAL N020NE 1.00 1,200,00
END OF FEES
US 11'�1�]%k3?-u01L�b$'� ; ;: a :i°.;ll
DAT£: O1l7f/9� 'iTM�: Cv';,:
i ,,_
. - -- . ' - ! � � . JO L & SPA �
CONSTRUCTION AND�PLANNIh,�' • '. '
APPROVALS Permit # ' Date Inspector pppROVALS Permit # ��� - Date Inspector
t.'Temporary-E�ectrical Service-or Pole ' � - 52. Pool & Equipment Location � -
2. Soil Pipe-Undrgrnd. -- - � 53.:Steel Reinforcement '
3. Electrical Conduit UtilitY-Undrgcnd. .. � 54.' Forms ��
4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding . . �
5. Steel Reinforcement � �� 56. Rou9h Plumbing & Pressure Test
6• Electrical UFER Grnd. 57. APPROVAL TO COVEii�GUNITE
7. Footings '� � 58. Electrical Conduii•Undrgrnd.
8: Foundation -- � - 59. Gas Pipe, O Undrgmd., Test .-
9. Water Pipe�Undrgmd. � - 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor SYstem --' 61. APPROVAL TO DECK
11. Property Sewer Line & House�Connection 62. Backwash & RecepmrFinal
12. Sewer Cap 63. Heater & Vent-Final
l'
13. Roof Drains '� . , 64. Plumbing System � Final -� -
14. fiough Plumbing 65. Electrical-Final . �
15. Rough Electrica6Conduit 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 Ce�ling 69. POOUSPA SYSTEMS FINAL
19. fiough Heating & Air Conditioning �' " FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . APPROVALS Permit #
21. Dutts, in Structure 7Q. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank C�Gas ❑Oil
25. Roof Sheathin9 . ' 74. Overhead Hydro
26. T�Bar Ceiling IStructurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
� 29. Insulation � 78. PIRE PREV. FWAL
30. Drywall Nailin9 i HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ' 79. FINAL INSPECTION
32. Electrical Power Meter�Final , '' 80. FOOD CERTIFICATE ISSUED
i
33. Finai Electric � , �� Notes:
34. Final Heating & Air Conditfoning � � ,
i
35. Final Gas Pipe-Test �
36. Hood or Canopy %�� . '
�n
37. Final Factory Fireplace ; •
38. Final Plumbing
39. Water Service•Final -
�40. Gas Service-Finai '
41. Solar pomesticFinal -
42. Backflow Preventer
43. Backflow Irrigation .
44. Landscape Irrigation System � �
45. Sound Attenuation ,
46. Handicap Regulations
47. PINALSTRUCTURE&BUILDWG 3/�/OL �"
� t � �
48; FINALPLANNING �
� 49. Electric Release to Edison � �.
. 50i Gas Release to Southem California Gas Co ��' � i
51: CERTIFICATE OF.00CUPANCY �1
No. Date
� �*��48 .
COSTp MESA BUILDING-SAFETY DEPARTMENT
P,O, 90X 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
AODFESS
OWNER The Gregory �omapny
MAIL __,._. ,. .. __
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CITV C�S't'd lvlesa
CONSiRUCr�ON
BRANCH
ADDRESS
Ave.
NOL751-3
9 ��77 6Z30178 2B6'.93 -.TG -
�ii�37 5/30[78._: "286,93CKTQ
�t;als17�7 00004459 48 �� '� I Q""
APPLICATION-FO�R STRUCTURAL PERMIT
RECENED BV DATE RECEIVED ..�r� �ec���.�
A.P.NO.//J ���0''IZ I ri
BUILDING �
ADDRESS � (
TRACT ZOO�.S . LOT �LO
W A D A T R
X
OWNER The Gregorv �omF
3187-G Airway Ave• ZONE T
ADDfiESS
Gre OY� Construction Ci0 APPROVED
CONTRAGTOR g Y BY
ADDRE A' Ave•
cirv Costa Mesa No�� 751-3 _ �;°�Z
STATE 2g59g1 CITY o08179 YARDSAPPROVED
LIC. NO. LIC. NO. MAIN BUILDING
SI2E L�.Q7 � x99z' NO.OF BLDGS. (FROM GL ST ET)
OF LOT NOW ON LOT FFONT FT.
BLDG.
5eparate permits are required for
¢lectric, plumbing and heating work.
USE OF BV��DING AND WORK TO 8E PEFFOFMED
New condominium units with
attached �arage
I hareby acknowladge that I have reatl this applicaiion and staie
Shat ihe eba�a iniormation is correct antl agree to comply wIM
all laws regulatlnp buildinp construction, antl I shali not employ
any person �� ��olation of Me workman's compensation laws of
ihe State of California.
I hereby cettify that I am praperly Iicensed contractor untlar
Me State of California eusiness nC Pr e s Cotle. Dlvision 3,
Che tar 9 t t such lice s ar � force antl ettact, or 1
P
am exe pt from e provlsi s ot a ot California eusinaw
end Pr fassfons C e, jYi�Qs � 3, er 9.
�
VAR. #
C. V.P. #
u
USE OF N
BUILDING
VAFD:
FT
BET. MAIN &
ACCE�. BLIX3S.
DATE
APPROVED
HOLD FOR SPECIAL REQUixni�+�+�+� �
m
'
u
16 O SQ. FT. 1.2 ara B w
� 5 f �
THE AMOUNTSHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF E5TABLISNING A PEFMR FEE ONLV: �
VALUATION PERMIT FEE $ `�
n
m
� PLAN CHECK E ^�
/ ` O o
$ /DD� TAX S LL
� �
� U
TOTALPAID E �,