HomeMy WebLinkAbout3104 MCKINLEY WAY - Building Permits�
(714) 754-5273 • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Jobnddress: 31U4 MC KINLEY WY
Suite:
Vicinity: SIDE qND REAR OF PROPERTY
Parcel Number: 14165249
Applicant: MCGUIRE, SUSAN
Address: 3104 MCKINLEY WY
COSTq MESA, CA
Owner: MC GUIRE, fVlICHAEL L
Address 3104 MC KINLEY WAY
- = COSTA MESA, CA
Contractor: O W N ER-B U I LDER
Address:
Zip:
. , . Arch :
Address:
�
Phone:
License:
Zoning: R1 R1
" Phane: 714-641-8929
Zip: 92626
Phone: 714-641-8929
Zip: 92626
Phone:
License: 0
Eng:
Address:
StaWs: ISSUED
Applied: 07/11/2002
Issued: 07/11/2002
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Phone:
License:
SCOPE OF PERMIT
COMBINATION S�UMPSTONE COLUMNS AND 18" SLUMPSTONE WALL WITH WOOD FENCE. MAX 6' HIGH BLOCK COLUMNS
-- APPROX 62' ALONG REAR PROPERTY LINE, AND 77 LF' ALONG LEFT SIDE OF PROPERTY PER CITY STANDARDS.
Plan Check:
Permit:
` SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$90.51
$139.25
$0.00
$0.00
$0.00
$b.00
$zzs.�s
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front� 0-0
PARKING Existina: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: D
Calc Valuation:
Claim Valuation: .
Right 0-0
Right 0-0" �
m
s�,000.00
s�,000.00
'ICE: The work authorizetl by this permit shall comply with all applicable handicap access requirements under California statutes and related
ations. (Ord. No. 92-28, § 1, 1241-92)
RATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
�eriod of 1 BO days.
EC710NS: In order for the work authonzed under this vermit to be considered legal, such work must comply with all applicable codes, and all
ed inspections and ilnal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
ISPECTIONS CALL: (714) 7545626 _
Yw) � � � � � � �
WORKERS' COMPENSATION DECLARATION: . '
I hereby affirtn under penalry oi perjury one of the followinq tleclarations: �
❑ I heve end will maintain a certificate oi consent to self-Insure tor workers' compensation, as provided for by sedion 3700 of the Labor Code, tor the performance oi the
work for which this permit is issued. .
❑ 1 have enC will maintain workers' compensation insurance, as required by section 3700 of the La�or Cotle, tor ihe performance ot the work tor wNU Ihis pertnit is issuetl.
My workers' compensatlon Insurance carder antl policy number ara:
Carner. Policy Numbec
(Th�s se neetl nof be comp/eted ll fhe permit is velued af one hundred dollars ($100J or Ie55J
�I'cenily that in ihe peAormance of ihe work for which this pertnit is issued, I shall not employ any person in any manner so as to become subject to t�e workers'
compensation laws of Califomia, antl egree that it I should become subJea to Ihe workers' crompensation provisions of Section 3700 of the Lebor Cotle, I shell forthwith
compty with these pm 'sions.
' .
Appllwnt�Signetur� /�� _ �� Le;—
WMNING-FNLLRE TO SECURE WORKERS' WMPENSATION Q�VEMGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYEP TO C INAI PEP� IES AND G IL FWES UP TOONE HUNDRED
TlqUSANDDOl1ARE(5100.0OO�,INADDfiIONTOTHECO$TOFWMPENSATION,DAMAGESASPFOVIDEOWRINSECTION3)O60F ELABOR'a OE,IMEREST,ANDATTORNEY'SFEES.
LICENSED CONTRACTORS DECLARATON:
I hereby attirm ihat I am licensed under provisions of Chapter 9(crommencing wilh Section 7000) of Division 3 oF ihe Business antl Profassions Code, and my license is in lull
torce and eHect. Lic. a Class #
Coniractofs Signature: Date:
CONSTRUCTION LENDING AGENCV: �
❑ I hereby aHirtn that there is a construction lentling agency for ihe pertortnance oi Ihe work for which Ihis permii is issuetl. (Sec. 3097, Civil Cotle).
Lentler's Name: Lenders Address:
Signawre: Date:
I hereby eflirtn lhat urider:penelry of perjury,that I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end Profassions
Code: Any ciry w counry'whlch'reQuires a�pertnit to construct, alter, improve, demolish, or repair any siructure, pnor to its issuance, also requires Ihe applicant for such permit
to file a signetl statement thet he or she��is�.11censatl pursuant to the provislons of Ihe Conirectors License Lew (Chapter 9(commencing wit� Sectlon 7000) ol Dlvlsion 3 ot ihe
Business end Professions Cotle) or that he o7 3he is exempt therefrom entl the basis for the alleged axemption. Any violation oi Seaion 7031.5 by any epplicent for a permit
subjects the applicant to a cNil penalry of�not more ihan five hundred dollers ($500)J:
urr�r.,
❑ I, es owner ot the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the sWcture is not intentletl or otteretl tor sale (Sec.
7044, Business and Protessions Cotle: The Contractors License Lew tices not apply to an owner of propeny who huilds or improves ihereon, and who tloes such work
himself or hereelf or ihrough his or her ov.•n employees, provitled that such improvements are not intendad or ottered for sale. If, however, the builtling or impmvement is
sold within one yeer of completion, ihe owner-builder will heve the burden of proving Ihat he or she did not build or improve tor purpose ol sale.).
❑ I, as owner oi lhe proDerty, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe praject (Sec. 7044, Business antl Protessions
Cotle: TTe contrectors License Law tloes not eppty to an owner of proparty w�o builtls or improves thereon, and who contracts for such project wit� e contreaor(s)
ycense pursuant to ihe Coniractors License Wws.).
Owner ID verified by drivers license.
Verification of Ownership by (rype of
Business antl Professions Cotle for t�is reeson:
� G�ate:
`re:' ❑ No • o����rs,� .`.—.� ��-/�_
l�.e. - properry ta�c bill or dee�-
DIVISION OF INDUS7RIAL SAFE�S' PERMI7 CERTIFICATION:
❑ I hereby certify that no excavation fve (5) or more fee� in Oep�h Into which a person is required to descend, will be made in conneqion with work euthonzetl by ihis
permit, and that no building siructure, scaHolding, talsework, or tlemolition or tlismantiing thereof, will ba more than Ihirry-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Trtle 8, Califomia Administretiva Code).
❑ As owner-builder, I will not employ anyone to do work which would require e pertnit from the Oivision oi Indusirial Selery, es notetl above, unless such person has e
pertnit to do such work irom the division.
Signature:
Division o1 Indusirial Satery Pertnit Number:
3
Date:
Will the eppliwnt or present or future 6uilding occupant neetl b file and certiy a 8usiness Plan tor emergency response to releese ar Ihreatened release ot e hazardous
material? ❑ Yes ❑ No
(Section 25505 of ihe Calitomia Healih antl Safery Code requiras, with some exceptions, thet a Business Plan be filetl with the Costa Mesa Fire Depertment by every
business which has at any one time during a reportetl year e quantity of hazardous matenals equal to or greater Ihan a weighl 01500 pountls, or a volume of 55 gallons,
or 200 cubic teei of compressed gas ai stantlartl temperature and pressure).
..._............_ ........................._......................................_............................................_..._.....................................................................................................................................................................................................................................
Does or will ihe epplicant or present or fuNre building occupani need to file a regisiretion form tor aately hazardous meterials7 ❑ Yes ❑ No
(Section 25533 oi the Califomia Health entl Safery CoOe, with some ezceptions, requires registretion with the Costa Mese Fire Department by eech Dusiness whlch et any
one time hes on hantl a quantiry ot acutely haxardous metenals equel to or qreater than a weight of 500 pountls, or a volume of 55 gellons, or 200 cubic feet of
compreuetl gas et standard �emperaWre antl pressure).
'm
prepare an
lection 25534 of Ihe Califomia Health and Safety Code provides that the Casta Mesa Fire Depariment may require Ihe preparetion, certification and filing wiih �he Fire
eDahment of an RMPP by businesses which are requiretl to register ecutely hazerdous materlals with the Fire Depanment.
en �RMPP is presently required, has �SectiOn 25534 ot ihe Calitomia Heallh end Safery Code been tully com0lied wi�h7 �❑ Yes � ❑ No
uoes or ww me appncam or presem or romra ounamg occupant reqmre tor ina wonc wn¢n is me su�7ea m mis a F
trom the South Coast Air Oualiry Management District or from eny other eir pollution control tlistrict or agencyt
(Section 658502 ot lhe Califomia Govemment Code requires ihat ihe requestetl intortnation be tumishatl on epplica
...................................................................................................................................................................................................................................................,.....
Will any patl oi lhe faciliry to ba wnsiructed under this pertnit be within 1000 feet from Ihe ouler boundanes of a sch�
(II'jres", t�e taciliry musi meet Ihe requiremeni of Seclions 25534 and 42303 of the Califortua Healt� and Safery Cotl
.................................._.............................................._............................................................................................_........................................................................
tl e permit irom ihe South Coest Air Oueliry Management Disiria or other eir polWtion conirol disirict or agency
aooliwtion. �ave all of the disdosures prescnbetl by Califomia Health antl Satery Code Section 42303 been matle7
on a Permn ior sucn conswcuon or
�,J No
for non-resitlential building Oermits).
No
CERTIFICATE OF COMPLIANCE: I certify Ihat untler penalry oi perjury the intormation given aDove is correct. I agree to comply wit� all state Iaws and ciry orUinance
regarding Hazartlous Matenals antl Emissions.
SignaWre: �ate:
CERTiFlCATE OF COMPWWCE IWO AUTHORIZA710N OF ENTRY: I cenity under penalty of perjury that I have read this application end s�ate Ihet the information giver
correcL I agree to comply with all state laws antl ciry ordinances relating to building wnsiruction, end authonza representatives ot the Gty ol Costa Mese to enter upon �
ebova-de cribed p§ roperty �o� i� c� P�C_ ree not to occupy or allow awpancy of any building authonzetl by Ihi permit until finel inspection.
� �_ Zd2s L
,6t� sfqnatureOf�tegal�'Owner(s1' � . —Date– �
And/Or Aut�onzed Applicant Date
COOE �.
1616
1266
200
zoi
202
203
204
INSPECPON TYGE
Fiaetl System Final Fire Prevention
Paol Spa Final
Final Re-Rooi
Final Block/Retaining Wall
Final Factory Fire Place
Final Sign
Final Demolition
p�TE 1 igJi�g EQQ�( INSPEGTIONTYPE
206 Final Mechanical
20B
210
212
220
222
250
Final Plumbing
Final Electricel
Final Fire Prevention
Final Planning Approval
Final Site
Final 6uiltlinryOccupancy
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• iHI5 SI�TQ-I LS FOR INFORMATTONAL PURP06F5
ONLY. APPllCANf IS RFSPONSIELE FOR PROVIDING
AN ACNRATE REPRFSFNfA770N OF hh�i PROPER'IY
IN CASE iFff SI-IAPE AND SIZE DO NOT O�RRFSYOND
WLIH THE INFORMA170N PROVIDID ON T2�5 SF�EI.
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� aesoc.a u� t.`,t �ricS
• S011D WALLS/FQJCFS BEIWEIN 2'b' k 6' IN FIDCHT SHALL
BE SE7HAIX AT LEASf 10' FROM FRONP PROPERTY I.INE.
• SOLID WALIS/FFNaS SHALL NOrC IDC� 2' 6' IN FIDCHf
WIIt�1 ld OF TIiE FROM PROPER7Y IINE (NOT NRB LINf}.
• VERIFY D6TAN� FROM CURB TO PROPERIY LIIJE
AND SEiOW ON PLAN. VERQ�iG1]ON FROM THE QIYS
FNGINFEEtING DIV6ION 6 REQIJRED. 1) 75�534i
$4���,�'o+-���sA F�
APPRO�ED / (
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i
BLOCK WALL LAYOUT FOR BUILDING PERMIT
PLANNING DIVISION
1
Cement Coping Optional —r
Channel Bbck With 1�3/8� �
Horiaonfal Top o1 all
Fen[es
For Fences 5' or Less
Vert. Bars 3/8"¢ at 4' �0" O.C.
For Fences Higher Than 5'
Vert. Ban 3l8"� at 32" O.C. �
fill Cells Solid Wiih Grou�
Where Steel Occurs
Rrinl�rcinq S1Pei $hall
Conlorm to Sec.A-15�39
A.S.T.M.
All Steel to be Lapped
24" or to Cade
NATURAIGRADE�
� TWO]/B"OBARS
CONTINUOUSTOP
& BOTTOM
HOfI�3.STEE� MUST BE TIEO.IN
vLACE AT TIME OF TRENCM
INSPECTION. ;
TYPICAL 6�� CONCRETE BLOCK FENCE
�
0
a x
LL F
u
> w
a =
> Z
e
i '�
W O
u �-
z
w n
�
��
.n 'o� •' .� .'a .
.� --
D �
. �— K'IDTH 70 16� 0 C n'
p� � SEE CMART �
� BELOW"
o� .�
�c� o, �..
WIOTH ' . +
THICNNESS �
DEPTH OF EARTHT01
SPACING OF EARTH
14" ,
10'�
2 4"
� H. i2'
GENERAL- NOTES
MORTAR; pne Part Plastie Cement, and
Thret Parts Sand
GROUT; One Port Cement Ttvee ana
One Half Parts �and
COPING: One Parl Cemenl, T�ree
Parts Sand
CONCRETE: Weu M��ed 1:2-I/2:3-V2
Mati of 7- I/2 Gallcns ot
Water Per Sack ol Cement
GROVT MAV BE POUREO fROM THE TOV
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF NORIZONTAL REIN
FORCEMENT SHALL BE CLEAR, CLEAN 6
FREE OF ALL MORTAR DEBR15, ETC.
.
D T
♦
UFci�� (.�' C4PTnTCO7H
� I' V` TrIE HEiG7H O� �ENCE
L� ��LOW BOTTOM Of �OGTiNG
Z..' SCALE: I/2�� = I'
ING REQUIREMENTS CHART
5 4�
... ..14':. . .... 12�. ..
10" 9 "
20" 16"
.� 14' . . . 16' .
ING DIVISION
12"
8"
12"
i6'
ADP���ant to till in all spaces except ihose witnin heavy Goreer Itnes antl si9n ali a0o/opriate tleclaretians. �
� 1'.. . . . . . . _ . .
'�: ESA � ' pEFMIT NO. T ACT NO. LO�,� BL�G. . , . .
, CONSTRUCTION PERMIT . � .r � /' ' ' � ' ' � -
Project Address �' � �' ' TYPE OF CONSTRUCTION �NEW ADD - ALTERATION REPAIR '
App.liCant'S Mailing Addre55 �. ��E ' � ❑ CONVERSION ❑ OEMOLISH ❑ OTH�E-yR } A p # � �i� _ 2 — " •Zo�a ^'. '. ,� , , uo. iu T�.
OWnef'S,Name MIC �-L � L u�� /�� ap� �j DES�i IPTI NOFWORK��r��/� � �--/��Sl�'�' ' L�
�}(} =�- �� honesEL./—�-{< � �". � '��, � S MainBuilding: Accessory.Build� g: • �O
.�1��� � - �K POP/.�C—! ..F.aCG.STYf/^ ��Y tr,_�s�i T / /•� V� E
Address � TVPE OF P RMIT 'GRADING . FOIfNDA'�'SON STRUCT A� T Front . �� N
Arch/Eng.��'���-S L. �:i��!l� License^ No. ��_�? ❑ TENANT ❑,ELECTRICAL ❑ PLUMBING ❑ MECHANICA�y��7 • B Rear � �
AddfeSs �I 'R �I �'O�OTHER ....• : : � ��. • ' A � � N
Contractor's Name Phone �u . PROJECT DESCRIPTION 5(2. FT. oCCUPANCv � ' C Right ,. . G
Addre55�mailing�' CONSTRUCTIONTVPE �'�VALUATION$ ��7�.m g, Left R
E
� � ' 20NE GRADING CU. VDS. ACRES Ping. Ref: # �_ Park.Fees $� �
City License No.
U
LICENSED CONTRACTOR DECLARATION ' � Remarkz: ' ' ` � Parking Feq./Provided ' , �
1 hereby alfirm that 1 am IicenSetl untler provi5ion5 0/ Cha�ter 9(commencing R
with section ]000) of Division 3 of the Business antl Protessions Cotle, zntl � Use of Building: � E
my license is in tull torce an0 eftect. ' ' �
License Class � License No. PLUM8ING FEES Planning Notes: � � M
E
' Date Signature ' . -
� WORKERS' GOMPENSATION DECLARATION . � � Bar,Sink Showers . ' ' - � i N
+.reby affirm that I have a�certiticate of ConSen[ to Self-insure Or a <ertiticate ' - Byck110w P�Ev¢ptCl' ' ' '"SeiviCE Sink� ' -' - ' ' � " " ' " ' '$
JJorkers' Compen5ation Insu�ance, or a certitietl mpy thereof (Section
�o, Lab. c.) • � � , . � Backflow Irrigaiion . Sewer Cap , ' 1 . ELECTRICAL � ' FEES
PoiicY No. ' ComPanY � '• ;-�' J
eCertitiea copy is nereey furnisned. ' ' , , Bathtubs Sewer Connection � ' Automatic Washer Transformer ❑ 15-50 KW `
Certifietl copy is filetl with the city Builtling Division. . , ! � t ❑ 50+ KW
Date Appncant i � Clarifiers � � � Solar Collectors Construction Pole Sub. �
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION • DI511uYd5hC� SOId� Pi in
(Thissection neetl not be completed i( the permit is for;one huntlretl ($300) or ' P 9• CoOking Unit Meter ❑up to 100 amps � � r
Iessl. ' .� . ' � ,
1 c¢rtity that in the performdnce ot the work tOr which Ihis perm�t is is5uetl I � Drinking Pountains � Solar Tank ' Dishwasher � � Meter ❑OVE� 1002Tp5,' � �
shall not employ any person in any manner so as to become subject to t�e � . , .
Workerf�, C�ompe zatio Laws oi Califorr�py �= Floor Orains ' Swimming Pool w/Spa Dryers ❑Gas ❑Electric $ub Panel :`
Date ,u���' �Signature .w�t/1.0� � /e/�o.
NOTICE: I�making this tleclara�lon; you shoul�ecom��the Floo� Sinks �- � �� Urinal Fan � •" •"" Motors �0.1 HP �1 %- 6 -' '-
Workers'.Compensation provisions ot.the Labor Cotle, you must forthwith - ' - ��
comply with� such ,provi5ian5.orithi5 p¢rmit Shall be tle¢metl revokea., ' GasService: , Outleu , Water Closet �F.A.U. � InaSolar 09-15 HP �i6-15+
CONSTRUCTION;LENDING AGENCV '• � ' -'
� I hereby af(irm that there is a consiruction,lentling agericy�for the performance Interceptors � - Water Heater r.Fixtures � � Microwave •
of the �work for whl< is permit' is Issuetl -(Sec[ion .�3097 Civ. CJ � ' -
- Lentlei's� Name•. ��••• - - . � � _ �
p{O _ , Kitchen'Sink." Water Service Y . ( Device Boxes Pole Light �
Lentler's AdCress � ' � ' � � Cavatories � • '
OWNER�BUILDER DECLARATION' �' ' ' . - ' I ' ' � ' �� ' OUtletS ' ' �Rang¢ ' ' � '
I hereby'af/irm that I am exempt from the Contractor's License �aw tor the p_Tfa - �
followinq reason (Section,7031.5.Businessantl Profe55fonabCotle: Anycity or P - ' i� � ' ' ' ' �Switches ;Sign � �
county which reqWres a permit ro construct, alter, improve, tlemolish or repair .- ' .. ' .. '
� any structure, prior to its:issuance,�also requires the applicant for such permit � RoofDrains � �� :• i �� ' � ' ' Garbage Disposal Standing Sections . �
;to file a 5ignetl statement'that he/zhe is Iit¢nsetl pur5uant to the provi5iOn5 ot . , • ' ' �
�tne Contractor's License Law (Chapter 9(commencin9 with Section 7000) of � , ��� � , ' - ' : Generator �0.5 KW 05-15 KW T�ash Compactor
�
"'.Rion: 3-ot the'Business antl Professions Cotle), or that he/she ls exempf , - � � - � ;
�-;+�[�om antl the basis for the ailegetl exemption: Any. violation oGSection ' ' � � .
�:,,� 5 by any applicant tor a' permiC sub�ec[s'the • applicant [o, a' civil Reins etion Fee � � $ 3
'� 7ty of not more than five huntlretl tlollars ($500): '� i Pa �$25 , Issue Fee , ,
yy I; a5 owner ot the property Or my employees�with wages as.their sole . � ReinSpCctiDn F¢e - $25 155uB�F¢B, '$'3'
coTnpensatlon, wilL tlo the wbrk, antl tne structure is not intentletl or otteretl � ' ' -, MECHANICAL FEES
for saie' (5ection 7044', Business' antl, pro�essional Cotle: The. Contractor's � �, 1 _ . PUBLIC SERVICES REDUIREMENTS: � ' ' '
License Law tloes not apply to an �ownar of a property�wno builtls or improves ' goiler_ � Hood or i Type 1�❑ t' ' ' � � &.
the�eOn,�antl'who �tloes such wO�k himselt/herself�or Ihrough nis o� her own � -- ''� �' � Zoning App�OVed By Ddte
¢mployee5, p�ovidetl that su6h improv¢ments are not Intentlatl or otteretl f0/ � , CdnOpy � Typ¢ II ❑, � . � ^.�
sale. If, however, the builtling or improvement is soltl within one year of com- Duct -� Und2r Ground e - . Building Approved,By : �� Date �
pletion, the owner•will have the burden ot proving he/she Citl not builtl or im- . � �� + '' • . � ` i
�r ve for the purpose of sale�. � � ' , Duct - Structural � Refrigeretion System �� �� Application Issued By � Dat
I, as owner ot the prooerty, am exclusively contracting withlicensetl con- � ❑0.100,000 BSU ❑100,OOO�BTU p��p ~'
t a torstd,<onstruct the project (Section 7044, Business antl Professions Cotle:,... _ Duct - Ventllating ' • _ , � SU/y RV. OF FEES ' . 1 � ' •
Tha ContractoYs License Law does not apoly to an owner'of property who �� ,� � " BUILDING PEFIMIT $ ��• ��' SMIP' � �$ '� �
builtls or Improves thereon, antl who contracts tor such projects wlth a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration � � �. r ��
� tractor(s) Iicense pursuant to the Co tractor's Licerise Law). . � - + , . , � � PLAN CHECK $ � , ' 2� 7ERMIT • � � �'
❑ Lam exempt unaer�e ctlon B P. �, tor this reason Firepl/Fact.61L ICBO �k : '
�' OwN v� � PL'UMBING .$ ISSUANCE $ i �
• PLAN CHECK 25% $ ENERGV P.C. �$ �
Date Owner � - " ' • ' Heating;System & Ducting � . � '
•4'hareby certity that I have �iead thiz applicatlon antl st � thaf-the above -. -���P700;000 BTU 0100,OOOBT -� � • ' GRADING �$ '
Information is wrrect. I agree to compty wlth all clty antl county ortlinances , ' - - ELECTRICAL $ ' , r
antl state laws relating to builtling construction,�antl hereby authorize repre- • , � . , , , PLAN CHECK 50% $ ' MICROFICM �$ � � �
sentatives of t is tlty� to enter upon tha above-menHonetl� pro0erty for , � . ; . . � � • �
inspaction purp zes. C oJ • � ' ' " ' MECHANICAL $ � TOTAL PEE $ � � •�0
Si9nature - Date -3-�� �1 / � ' 1
Orivers' License or 55 � � � Reinspection Fee $Q5 ' 155ue Fee $'3 ,- PLAN CHECK 25% $ _
CMF 0865-46 rev. 12/83 Whke - Builtlinq; Canary - AP�Iicant; Pink - Accounting; Goltlenrotl - P.ssessor � � � � � . ' ' � - ` � - '� � ' ' � - '
. . . . . . . --_
_ _.�. ..� � � . ..�tir . . . .
CONSTRUCTION AND PLANNING ' - "� ., -. �: '" ,.�� ?OOL-' 'Ar�_ : �;� � _,_ ,�;:: f ra . � , � _�•�-��. �'�
` E I'
i'Date Inspecior � �'" - s� � t. � Date -� Inspector' �
�APPROVALS Permit# _ ' • �APPROVAI$,�.Permit# -
. . . ., i � < . ,
1� Tem orar Electrical Service or Pole � -' � . � , ' � �- - _ ' - ` �'' � �
P Y ;� '52.' Pool &�Equipmerit Loca4ion'` _ _ �o i;
- - � '�
2. Soil Pipe-Undrgrnd. . ' . . � - . � 53.' Steel Reinforc'ertient .. -� `-L% :°� ; � ��_« ; I >
�, . � n` ,r� ,_ '
- 3: Electrical Conduit Utility-Undrgrnd. �" '�54 � Forms 4 -_ - = �
;�q
4. Electrical ConduibUndrgrnd'. ' - 55.`. Electricaf.Bonding, � � - .3' _ _•� �
t= - -
. '56, Rough Plumbing.& Pressure Test : " . ' r + ' - �. '
5. Steel Reinforcement -" . � "'_ . �
6. Electrical UFER Grnd.� - - , -. � ��57.' APPROVALTO�COVER:GUNITE` ';5�, i�:,; � / �`"'
7. Footings �. _ _ _- " ' 58.' _ElectricaFCoriduit=Undrgrnii � _ _ +; (,'� .
` - � c
8. Foundation � - � � „ � 59. Gas�Pipe,�O Undrgrnd.-, Test' . �� , � -� ,;- �'
c,
. 9. Water Pipe-Undrgrnd. � - - _,; �, . 80. Backwasli Lines;.P.-Trap,'O�Uniirgrnd �- , .� y . ' _
10. Structural Floor System _ _ . � 61. APPROVALTO.DECK , � `��:,s-- . ��`;1.� `' ` : � -
�
11. Property Sewer Line & House Connection - . 62. Backwash & Receptor-Final �� -_ . � '
12. Sewer Cap - -� _ 63. Heater & Vent-Final '. � - - ` � '
- - '� �
13. Roof Drains . - , 64. Plumbing:SYstem,�Final+ . � - � � �����. �' I ;
14. Rough Plumbing 65. Electrical-Fina(' `� �' ` � _ ' ` �' �` � �
i,
15. Rough Electrical-Conduit • �; - - 'T : � 66. Solar�System-Firiaf � � '��' -' � � � �T -,-- ' ' -
i 6; • Rough Electric Wiring - � . ^ ` .67. Fencing &�Access Approval' � - _ � _'�; � - � i 8
17! Rough Wiring Sign . _ � �` 68.. APP.RO�VED FOR PLASTERING �' j� � ��.� �_ ' t�
� 18..:Rough Electriral-T Bar Ceiling, � - - j `; '69. POOL/SPA SYSTEMS:FINAL � �, ; :, j ; ` ; o
19. ,Rough Heating & Air Conditioning ' � . � ' 'FIRE DEPT.;REQUIREMENT- � .� i �� - ' = � •
I�.' ;
� 20.�Rough Factory Fireplace , � ' APPROVALS. I Peimif# - � � ' � • � i '
r �
21. Ducts, in Structure � � � 70. Unde�ground Hydro �� �� , �
22. Ducts, Ventilating i' � 71. Product Piping O Gas,�,�. � Oil � } : ,�_• t � , �'
i --� - -- -- `-�- ''':� -- -, - i" -i --r' - -t-
23. Gas Pipe-Rough & Test . � ' 72. Unde�ground Flush' .
24. Roof F�aming_ � _ .. . •: � � � , : 73. Undergrrid.Stor'ageTank ��Gas ❑Oil- '- � � � !
i
. 25. Roof Sheathing . . . . ' 74. Overhead Hydro � •�" � � • � � �
�
- �.,. . ; . , i
26. T-Bar Ceiling (Structural) & Monocoat �''' _ 75. Dry.Chemical ' � r � - - (' I.
�
27. Frame and Flashing _ �, � �76.� Dr,y Standpi'pe , i -� � ' � � � � � , � , �
i
28. Lathing & Siding _ , 77. FIXED SYSTEM FINAL '= � ^ ' ' I
�
29. Insulation � I � � •78. FIRE PREV. F�INAL '+ � `-' � G � � �
� .HEALTH DEPT. REQUIREMENT � i �
30. Drywall Nailing , .. � ' � � . , ' ; �
31. Plaster Brown;Coa't '� 99. FINAL INSPECTION.. � � ' . !
32. Electrical Power MeterFinal 80.� FOOD CERTIFICATE ISSUED � I t �
33. Final Electric � ' Notes�'7 � ' � � � � �
� 8w UNA �� '� y�-1 �GGG!SS_ _.__
34. Final Heating & Air Conditioning � � `,
FTt� c�,c' G�/�.
35. Final Gas �Pipe-Test . : : � � � � .' ' `% � - ,. �, ,�
f .
36. Hood or CanoPY , � ! - . . . � .• � , - , ; `' i�'.� . : L - - a _ . .
' ' - , , i � ' - �� 1 - " �
37. Final�Factory Fireplace - ' ' • � , , = % �� S.!'. , - ,,� � ,' - ���i�,
r m � ft
38. Final Plumbing � ' ' , � � � i � � � "� °� ��,i� ; � •� F : .
39. Water Service-Final � , � � � ' � _ '.. ,- I� --� � -
� _
40. Gas Service-Final� � � , � � ' , ��, "' � � � � � `�
41. Solar pomesticFinal ' • . . _ . -� .. - �'--- -. . .-.-� - - ��l�' 'fl • � .
42. Backflow Preventer , ... /� . - - ._�- ` - . . - - : - � �t i � � • i
•
43. Backflow Irrigation � ' . � � � . � � �. �� � ' ��� "�` � � � ' � �
'q� i
44. .Landscape Irrigation System . i ` 1 � � � ' , , . . `f,
�
- I ' ' ',i, � ' � m . ._
45. SounB Attenuation _ , e � , „ - � , , , _� �=
46. Handicap Regulations � � , ' - � �� , � � � , . � �� � ; ' � _ * �'
- 4
47. FINALSTRUCTURE&BUILDING G � � � � � + , � ;i ;�j � � "
48. Special Requirements Completed' � � � ' • • ' � '.. ' � '' '� " �' ` '
I � .� �
49. Electric Release to Edison � � '. ��"'� '� 't , � �` �-"�` � � : l� , i- ' i � :'.,^
50. Gas Release to Southern California Gas Co . ' � � t � ' � ' � - •• . t� � � � � :
, � . .. N• '!' � t
51. CERTIPICATE OF OCCUPANCY • • �- - '- -1- -'--�-- - � - - - - ; '�' I •
No. . . . Date - - � - .__ � _ _ . . �. ! _� _.�.._:__� ._ _. : -.,.� _..-z- _�_ ._. _
'l�ti°
UWNER DINGMAN.
� JOB ADDR.ESS 3101F N
� GENliRAL CONTRACTO:
a AH No,
,/� IP"'�ECTIONS
�J_ —
(� Gao
�Water
� Rough Com. Refl•ig. ❑
Rough Heating
Rough Plumbing
➢'Iiscellaneous
Prop. Swr. Line �p House i
Sprinkling System
Co�strucfion Pole
Undereround�fl Power
I.
P
DATE 4-2'i-64
BUILDING PLAMIT N0.
VALUE$ 7 0.00
FIRE 'LONE 3 DESCRIPTION OF WORK /
IGROUP J TYPE N ZONE
SUBCONTftACTOR
a�rn
�. �w t'tt KtI;tIVtU
22� �� 4Pfl 2 2 1964
Y�OSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE OEPT. A
P.O. BOX 91] COBTA MEBA. CALIFORNIA � CITY OF COSTA MESI1
For Applicanf To Fill In Complefefy '' APPLICATION FOR PERMR '
• TYPE OR PRINT . BUILDING
For Office Use Only
BUILDINO p � ' _ '
AOORES l. R8C61P� NO. PEqMIT NO.
� COSTA MESA, CALIFORNIA � ' � �O�
P8C81 DBY pAT8�C61V8p OAT6169U8�
OWNER /��f�
- _" BWLDIN6. �/n / / (,i /� [1/A_P
MAIL n� .. Ii �) �... I�I w�J ADDRESS D
TEL. �'I' � �R�
QTY NO. =ONE 9'YP8 ❑P
. ' MPROVE � '��
ARCHITECT `� - TEL. BY DATE ���
.ORENGINEER 'N .
ZONING
ADORESB � ZON NO.O[ U6EOFNEW � '
' :�PI./�NBa' �lUL IN6
CONTRACTOR
- ' - LEOAL � / D
DEBCRI D
ADDRH9S '
A. P. NO. .
CITY
NOTE: NO HAVE OVERHANG BHALL BE LESS THAN , �
STATE TEL. 90" TO SIDE @ REAR P..L. � �
LIC. NO. �NO. -O - I
EAVES
SIZE � �� - � � Q NO.OPeLD08. ALLOWED � (U. B. C. REqUIREME T)
OF LOT `O NOw oN tcT -
YAROSAPPROVED YARDSAPPROVED
USE OF " - MAIN BUILDINO ACCESSORY BUILDIN6
EXISTING BLD6. '
'. , (FROMC/L T EETI / .
BETBACK LIN6 FROM ' �-' � I �' /� FR N FT.
cErvTEx OF BTREET � ' � REM YARD d U . .
91DEYARDI LEFf ! ,� � I RIGHT� � �� R.SIDE FT. Ff. ..
DESCRIPTION OF WORK �. s�oE I T �.0 �� Fr.
NEW � ALTERATIQN _ AODITION REAR� Ff. � F7. -"�
DISTANCE BET. , BET. MAIN Q
MAIN BLDGS. ' ' ACCESS. BLpGS.
'-REPAIR MOVINO� � DEMOLISH.
BUILDIN6 � �/ INO.OF ' VAR.� . 'DATE
SIZE - -G � �i00MH BTORIE9 C.U.P.# APPROVED ` 1
EXTERIOR WALL I ROOF ' MP �_/ / -6 . , �
GOVERING � COVERIN(3 BY DATE 77`j� �
USE OF BUIL�ING D WORK TO Bfi PERFORM6D � � �
L � �
P oT — [6 '
- a �
8Q. �. o
1 HEREBY ACRNOWLE008 TXAT 1 XAVE READ THIB APPLIC�TION THE AMOUNT BHOWN UNDE ALWTION 18 POR TMH
ANO 8TAT8 THAT TX8 ABOVB I8 CORRE AND A EE TO COM- PURPO68 OP EBTNBLIBMIN A PERMIT FEfl ONLY. fi
O
PLY WITH ALL C/TY OROINANC68 8 LAW 80ULATINO yALUATION � •
BUILD�NO CONBTP�IGTION. � m
x
PERMIT FEE /
SIGNATURE OF r $�� /11 s� �, ¢
PERMITTE /l'�
AUTHORI2ED AGENT . � � , •
TOTALFEE ' %
�
`d ' I 8773
COSTA MESA BUILDING�SAFETY DEPARTMENT
P. O. BOX 917 C06TA MESA. CALIFORNIA
For Applieanf to Fill In Compleiely
TYPE OR PRINT
ADDRE85 �O� l�ICK�e °"a
COSTA MESA. CALIFORNIA
USE OF '
PJCI6TING BLDG.
BETBACK LINe RROM
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WALI.
NO. OF 6LD68.
�E ��C��V�D
EEB 1 9 1963
FINp?�f;F il��T,-
APPLICATION FOR PERMIT
CIIBUILDIIdG ��t�H
For Ofiice Use Oniy
RECEIPT NO. I PE M' II�.�/J
RECE�VED �ATE CEIVEDb DATE I8SUE0
I [td"�. � � Fk� 1 0 �a6's
BUILDING
ADDRESS
COSTA MESA. CALIFORNIA
APPROVE�
ZONING
ZONE NO.OF �j' US¢ OF NEW S;.'-
[I � � PLANB [� BUILOING � �.
.�
oesen�wr�nv LC%� �� TGc' �i� o
YARD6 EVES
APPROVEO ALLOWEO
n �f fCENTEp LINE 8TJ
REAR YARD �� /^�T�� FRONT Sr FT. �
IRIGHT �. ^ R. SIDE ,f� FT. --
OF WORK --
L. SIDE � FT.
1 I IIADDITION I gEAR � O FL ✓
- i 30
I HERBBY AGKNOWLEDGE TXAT I H/�VE READ TH�B APPLIWTION
ANO eTATE THAT TXE ABOVE IB GORPECT AN� AGHEE TO COM-
PLY WITH ALL CITY O INANCEe An'D STA�lAWB /PEGUL�SING
BUILDINO CON6'(R�N. / / //
� AUTHORIZED AGEWf
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,y-/97�"-�,i��6G �-�S6
TXE AMOUNT 6HOWN UN�ER VpLl1ATiON � FOH THE
PURPOSE OF EBTqBL19HING q pERMIT FEE ONLY.
VALUATION '/
PERMIT FEE $ `Y � �"'O
$ �// D�/L'� PLAN CHECK S ��'�Q
Y — A
TOTAL FEE � � �V