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Home My WebLink About3086 MOLOKAI PL - Building Permits�;,�.;�:r.��; r��' � .�.::: ; . 9�'.'� � CITY OF COSTA MESA � BIIILpIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT P98-00560 PERMIT NUMBER (714) 754-5273 • Fex (714) 754-4856 pLUMBING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3086 MOLOKAI PL Suite No Vicinity: Parcel Nunmber: 139183'I6 Applicant: NOCK, RON Address: Owner: Address -� 1'��INST�W.H. �� iit�, ti� 1 � � `�\ 1.��-'� \`;AMT ISSUE FEE _ i� ,$22.00 BackFlow Preventer-� � Bathtub ��L\\\... � Clarifer System{ Connect Qce,Soda;etc) ', Dental Units �,� Dishwasher \ � Drain, Floor �\ � Drain, Rainwater Drain, Roof � Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) � Z�P l I , 1,�L' Zip: 92626 NG Status: ISSUED Applied: 07/07/1998 Issued: 07/07/1998 r-�'�� i�\�-��, �� `��, =� �� C � ��\\\ �� \\\�\\\�Cj i��\\�' ST � � Phone:�714 895-1246 � ,z.--- IVE ..CA ' ::' Zip:/92847 ' : :' j �l. s' 1 � �- -�- :.�,� ' � ti .- �� yLicense �`7W775 ,� �"-iy � '� �.*e�a-. i� tS F r f �f`�� -�`t!-..�,%'� 'I�I �-�..� � i �. -^�._�.y„'l�,'�„F "'-�� r/ \J � Phone: - �� ==Zip'� / ��i!�, �J cL =L'icen'se�� +`? �Q'�J IOji�\ D �i �� ti�.,�� - �!��u� �-,��:,-,� , � /�`��+,�nSCOPE OF PERMIT ��j�� `� i � . , `f _ -'�-i�`�Y /l"�� C �t� ��4 �71`=."`�'.�1') 0 0 0 Laundry Tub / Washer Landscape Irrigation P-Trap � Pressure ReaulatoiktG $0.00 0 $0.00 0 $0.00 0 $0�001� 0 $O�UO%7 0 $0.00 �0�� , SepScjTank� �,��`-��' �$0 00 i( 0�,� $0 00�� 0� 4�Sewer Cap�for Demo� �,$0 00� �0"' $0.00 f> 0� 6ewer Conned ��i�,��$0 00��0 �S i �.' \, , , $0 00� � 0.,� �Sewe aPrivate Line �� ,n- SO 00 �.y- 0�-� �$000 �%0 �";_,� SFiowei�-�_-�,,--._,-� $OOOr=O--'�n $0 00 � 0 , / /rJ'� Sink tiar -' - __ �$0�00 0: , 5000\. OL� J �Smk commeraal $000--5�0�� $000 �0� Li�Smk�Floorj-`� '1 r`�$OOOC-�0�� $0.00 �0 �_z i Sink, kitchen � i �- 1! L� �$0.00 �= 0. -�' $0.00 0'� Sink,seriiee7mop^`��_;-"+�$0:00-"`Of� \\` ; `_ „ 50.00 0 -:SPa:(Private)....,.,...P...;��.�...•,.$0:00-,�0.7''. $0.00 0 Spa�(putilic)== �'i��y`�%$0.00�=-0'""� $0.00 0 _'-' _ - _-"-- $0.00 0 COMMENTS 1 SPECIAL CONDITIONS C�l \\ v �� <� ��\�� r..- � �';�. � � ' �, `,1, , 1 `_J -,�ti ! � t '• �,4 � ` " 1.,.-� n �, �� `, _ � �'`�;i�� - � '�� ; �- 1 f4�� j �, �� ;= ,r; � �� ;'� ;� � :' �n�; � �� ` � ,,, i �r�� ''1; �.-��i '.An �yl.'( i - l,l� Wasti Basm - 'i' $0.00 WashBasimSet ,�� $0.00 Waste and Vent System $0.00 Wate�Closet (Toiletj! $0.00 VJater Heater / vent $11.00 Water Piping�pnst or Rep.) $0.00 Water Re-pipe $0.00 Watei Service $0.00 Water"Softener $0.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK $0.00 REINSPECTION $0.00 TOTAL CALCULATED FEES: $33.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 EXPIRATION: � This pertnit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a pariod of 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all requlred Inapectlone and flnal epproval must be obtained. Failure to obtain inspections and final approvel wlll resutt in the expiration of this permit. POR INSPECTIONS CALL: (774) 7545826 WORKERS' COMPENSATION DECLARATION: — . , . — . I hereby etfirtn under penalry of peQury one o1 ihe tollowinp declaiatians: ,., „ - ' ' - ❑ I heve end will meinteln e ceNflcate of consent to sett-Insure for workers'�compensation, es proviAed for by sectlon 3700 of ihe Lebor Cotle, tor t�e pertortnance of Ihe �'''ork for which this pertni� Is issuea. �j I heve �end will melntein workers' compenseGon insurance, es required by secUon 3700 oi tl�e lelwr Code, tor the perfartnance of Ihe work for which Nis pefmit is issuetl. My workers' wi� nsetlo% Ins}�re�nce certle .dn0 policy number ere: � ? v� i _ Certier. (>'�) I�ilL� �� Q Pdicy NumDer. � � ��Qd" (Tn�s secuon need nor be completedlr fhe pelmlt rs vawedkr one nunarea ao��ars /3100) or �ess.) - ❑ I certity ihat in ihe pertortnence of Ihe work for which ihis pertnit Is issued, I shall nat amploy eny person in any manner so as to Decome subject to the workers' compen5etion laws of Calitomla, end egrae thet it I should become sub)ect to the workers' compensation provlslons ot Sectlon 3700 of the Lebor Cotle, I shell forthwith comply wIM these provisl� �i�' / Applicent Slgneture: �d "� � i Date: � � � — ' G� WARNINO: FAILURE TO SECURE WORKERS' COMPEN TION COVERAGE 6 H116M1�FULJJIR.Sue� c a ECT AN EMPLOVER TO CRIMINAL PENpLTES AND GViI FlNES UP TO ONE HUNDRED TlIOUSAND OOLLARE (5100,OW), IN ADORION TO THE C0.S� OF COMPENSATON, OAh1AGES AS PROVIDED FOR IN SECfION 31080F THE IABOR CODE, INTEREST, AND FTTORNEYS FEES. LICENSED CONTRAGTORS DECLARATON: I hereby eftirm that I am licensetl untl r pr vi 'a of pter 9(crommencing wlth Section 7000) of Division 3 of Ihe Business and Protessions CoCe, end my license Is in full force end eflect LJa k Class R Contrectors Signeture: Date: CONSTRUCTION LENDINC AGENCY: ❑ I hereby affirtn thflt ihere Is a consiruclion lending agency tor the pertartnance of the work for which ihis D i��s issued. (Sec. 3097, Civil CadeJ. LenGefs Name: Lentler's Address: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby effirtn that under penalry of perjury thet I em E%EMPT FROM TNE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Buslness end Professions Code: Any ciry or counry which requires e permlt ro wnstruct, alter, Impmve, demolish, or repalr eny structure, prior to Its issuence, elso reqWres the applicent for such permh to flle e signed slatement thet he or she Is licensed pureuant to the prodsions of the Coniractors License Lew (Chapter 9(commenGng wflh Sectlon 7000) of Division 3 of the Business en0 Professions Code) or thet he or she is exempt �herefrom and the basis for Ihe allegetl exemption. My violation of Section 7031.5 by eny eppliwnt tor e partni� subjecis Me epplicant to e civil penelry ot not more than five hundred dollare ($500).): ❑ I, es owner ot tha property, or my employees wlih wages as their sole compensadon, WILL DO THE WORK, and ihe structure is not Intended or olferetl for sale (Sec. 7044, Business antl Professions Code: The Contrectors Llcense lew does not epply to en owner of property who builds or improves Ihereon, and who does such work himselt or herself or through his or her own employees, proWded that suc� Improvements ere not intended or otteretl for sele. If, hawever, t�e bulltling or Improvement Is soltl wlthin one year o1 completion, tha owner-builtler wlll heve ihe burden ot proving Ihat he or she did not builtl or improve for purpose oi sele.). ❑ 1, es owner of ihe property, am EXCLUSIVELY CON7fiAC71NG WRH LICENSED CONTRACTORS to canstrud the project (Sec. 7044, Busineu and Profeulons Code: The contrecrors License Lew does no� appty to fln owner ot property who builds or Improves Ihereon, and who coNrecis tor such project wit� a contractor(s) license pursuent to the Caniractore License Lews.). ❑ I am exempt untler sac. Business and Prafessions Cotle for ihis reason: Signature: Data: Owner ID veAfietl by drivers license. ❑ Yes ❑ No Drivefs Llcense No. Expires: Verificetlon of Ownerehip by (lype oi dacument, I.e. - property taz bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certity ihet no excevetion five (5) or more feet in depth Into which a person is requlred to tlescenQ wlll be mede in connedlon with work authodzed by ihis permit, end Ihet no builtling structure, scaffolding, felsework, or Oemolition or dismantling thereof, witl be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Celifomle Atlminisirelive Cotle). ❑ As owner-bulltler, I wlll not employ anyone to do wark which wauld raquire e pertnit iram the DMsion at Industrifll Sefery, es noted ebove, unless such person hes e pertnit to do such work from the division. SipnaNre: Division of Industrial Sefery Pertnit Number: Date: �p�j, INSGEC110NTYFE 1616 Fized System Finel Fire Prevention 1286 200 201 202 203 ewo-ea �.f711�_i�nn77�, Podl Sps Flnal � � " . - � " Flnel Re-Roof � � -- � ' Final Block/Retaining Well Finel Fectory Fire Place � � Flnel Sign � Finel Demolltion jeQyFj INSPECTIONME 206 Finel Mechenical ' 208 Finel�Plumbing ' ' "210' Finel Electdcel � - 212 Final Fire Prevention 220 . Fnal Plenning Approvel 222 Final Site 250 Flnal BuildindOccuoeni �� . .- : (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 i JobAddress: 3086 MOLOKAI PL Suite: Vicinity: HOUSE & ATTACHED GARAGE Parcel Number: 13918316 ' Applicant: MARKHAM, GREG Address: 15201 PIPELINE LN #A �� , _-�� j,! HUNTINGTON'BEACH,:CA' � — i. i / owner: LOHRSTORFER, CHARLES Address ANTHONY-'�', � � COSTA�MESA,�CA �� .i. ' - '3086 MOLOKAI PL - � � � Contracror �CONSUMER SERVICES �Address:- 15201 PIPELINE LN #A Zip: Arch : Address: Zip: � HUNTINGTON BEACH, CA 92649 � - .� , .. ' .. � � �Phone:- �i � �� , �License: Zoning: R1 R1 Phone: Zip: (714) 936-5908'� ` - ISSUED BY: 92649 . % � ' _'\ Phone: Zip: 92626 Status: ISSUED Applied: 72/04/2001 Issued: 12/O4I2001 � - � ., ,/ , , . :r.`�-\._ .� � , � ,�� _ . -_ , ./ A.�� , \�\� � \ . . . , /. � � � ��.; �� :�,� ,./ l�V' _'\ „ `,�� Phone: (714) 936-5908 . � �` � ' � A �::� � % "� \� A \ f ` License: 676090 - _ �- , `- ` \ - A � , . t,-�, . � ,A ' Eng: . ' , , .\ ,. ; . �1 , Address; � _ ' `� � ` , - . - j; -� P.hone: , � ' - - ��)'�. •��,_ � �\ . ��. � � � �.Licehse: . ' � . , , i., � � . . . SGOPt Oh PtKMI l- . ' � , r} _.r_�..� /�.. . -, p -�.�� \ . � '� REROOF �EXISTING SINGLE FAMILV RESIDENCE & ATTACHED (27�SQ)sTEAR OFFLEXISTING, WSTALL 2 LAYERS OF � 15# FELT� UNDERLAYMENT, & REROOF WITH 40 YEAR�COMPOSITION SHINGLES. -_ �- �- - � _ , - �, � � �;'� FEESUMMARY."'�, ' ,i� ' � ; �� Plan Check: , � $0.00 - -- - — — � � . �'� = Calc Valuation. � '�; ' L- $e,000!oo ,- Permit'. ,. . $12525 � - Claim Valuation: 1�'! ' . -$s,000.00 ��`SMIP Res: -� � $0.60 /�;�� : =�- � � � �SMIP Corri: �' $0.00 � � � � � � Other:'. ;$0.00 �' . �i I nspection:.- ' . $0.00 � � �%� � , � � . � � r' : , �;,�, �V�: ;/, � � , '�TotaL• � � $125.85. , �_. r: .- ��; ' ' , � , • ", ��;=' � � - � PLANNING'& ZONING � , :�-;'; `- ; - ; .,i- SETBACKS�` " � � � ` ` � " MAIN STRUCTURE �Front ��0-� 0 . Rear 0- 0' LeN 0- 0 Right �� 0�0 � � �- , - . _ , ,� . ,�� _ ACCESSORY Fionh � �0-.0 � � � 'Rear � 0- 0 . LeN 0- 0 . Right ��' 0-.0�, % PARKING Existin :�� 0� _'� Re uired: 0 Pr000sed: o �� NOTES: - � ' � � � ` NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Cali�ornia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � • INSPECTIorus: In order for the work authorized under this permit to be considered legal, such work must comply with all applicabie cotles, and all raqulred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 754-5626 zans-aa ls�oo� � WORKERS' COMPENSATION DECLARATION: . I herehy aflirtn under penalry of perjury one of the following tleclarations: � I have and will maintain a certificate ot consent to self-Insure tor workers' compensation, es provitled for by section 3700 of Ihe Labor Code, for the peAormance of the work tor which ihis DeR^it is issued. ❑�I heve antl will maintain workers' compensation insurance, as required by section 3700 oi the La6or Cotla, tor the perfortnance oF the work for whlch this permit is issuetl. My workers' compensa�lon Insurance carder a policy number are: . J/ Carrier. ��-^C,�-A-��x� PolicyNumber.–'Q�k�–f�OO�—�p�o�/ (Thls section need not be comp�eted il fhe permif is velued et one huntlretl dollars ($700) or /ess.) ❑ I certity ihat in the perto�ance oi the work for which this permit is issueQ I shall not employ any person in any manner so as to ecome sublect to Ihe workers' compensation lews oi Galifomia, a agree thet if I shoultl become subjeq to ihe workers' compensation provisions oi Saction 00 o the Lahor Coda, I shall forthwlth comply with Ihese provisio t. (� � Applicant Signeture: � `^—�ate:� � � Z WARNING:�FAILURE TO SECUR RKERS' COMPENSATION CAVERAGE IS UNLAWFUL AND SHNLL SOBJECT AN EMPLOVEP TO CRIMINAL PEN LT1E AND CIVIL FINE$ UP TOONE HUNDRED TFIOUSANO DOILARE (5100,000�. IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTIqJ 3]O60F THE LABOR CODE, INTEFEST, AND ATfORNEY'S FEES. LICENSED CON7RACTOR5 DECLARATION: I hereby aHirm Ihat I am force antl ettect�Lic. # (commencing with Section 7000) oi Division and my Ilcense is in full CONSTRUC710N LENDING AGENCY: ❑ I hereby aflirm that there is a conslruction lending agency for the pedormance oi the work tor which this pe�mit is issued. (Sec. 3097, Civil Cotle). Lender's Name: LentleYs Atldress: Signawre: � Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalry of perjury thet I am EXEMP7 FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Buslneu end Protessions Cotla: Any ciry or counry which requires a permit to consWct, elter, improve, demolish, or repair any strucNre, pnor to iis issuance, also requires the applicant for such pertnit to tile e signed statament that he or she is licensetl pursuant to ihe provisions ot the Contradors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 oi Ihe Business and Professions Code) or that he or she is exempt iherefrom antl ihe 6esis for the allegetl examption. Any violation of Section 7031.5 by any epplicant for e parmit subjecis the apDlicant to e ciNl penalry of not more than five hundred dollars ($500).): ❑ I, es owner of the property. or my employees with wages as �heir sole compensation, WILL DO THE WORK, antl the siructure Is noi intended or oNered for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who tloes such work �imself or hereelt or thrPugh his or her'own employees, provitletl that such improvements are not intended or ottered for sale. If, however, Ihe building or improvemant is sold within one year of Completion, the owner-6uilder will have the burden ot proving that he or she did not builtl or improve for purpose of sale.). ❑ I, as owner of lhe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the prqect (Sec. 7044, Business and Professions Cotle�. The contractore Ucense Law tloes nat appty to an owner of property wtw builtls w improves thereon, a� w�o contracts tor such pro�ect with a comractor(s) license pursuant to ihe Coniractors Licensa Laws.). ❑ I am exempt untler sac. Business and Professions Cotle for this reason: Signature: Date: Owner ID venlied by dnvers license. ❑ Ves ❑ No DriveYs License No. Veritication of Ownership by (type of tlocument, i.a. - property tax bill or deetl): Expires: DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: ❑ I hareby certity that no �xcavetion five (5) or more feet in depth into which a person is required to descend, will be matle in connection with work euthorizetl by this permit, and that no building s(ructure, scaftolding, falsework, or demolition or dismantling Ihereof, will be more than thirty-six (36) teet high. (Chap. 3.2, Carp 2, Art 2, Sec. 341, Title 8, CalifOmia Adminislra�ive Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division of Industrial Sefety, es notetl e6ove, unlass such person hes e permit ro do such work <<om ihe division. Signature: Date: Division oi Indusirial Safery Pertnit Number. 4 CERTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF ENiTiY: I certify under penalry of perjury ihat I have read this appiication antl state thet ihe information given is cortect. I egree to comply with all s;ate laws antl city ordinances relating to building consWction, and euthonze rapresentatives ot ihe City of Costa Mese to enter upon ihe above-descnbed property for inspection puryoses. I egree not lo wcupy or allow occupancy of any building euthonzed by Ihis permit until finel inspection. 'gnature egalOwner(s) � nNOrAuthoriz iwnt� CQOE �. INSPECTONTYPE i616 FixeC System Final Fire Prevention 1266 Pool Spa Final 200 Finel Ra-Roof 201 Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Final Sign p�g ixmu�s �/� f cooe� ixsvecnoxTrae 206 Final Mechanical 20B 210 212 220 222 Final Plumbing Final Elec��cal Final Fire Prevenli0n Final Planning Approval Final Site �y /e / � Date P�IE II�L$ 204 Final Demolition 250 Final Building/Occupancy �;' c�Y �g : cwuForxNu azs2g STA b E5�_ P.O. BOX 1200 FROM THE OFFICE OF THE DIRECTOR OF BUILDIN6 SAFETV Project Address �d�� 01 p,�� , Project Name S-�� amers t�ame C- ,.�/ . r A� i�o v.� O4mers Address ,3v �(� ,C�d/�,Ciyc i /�L , Ownexs Telephone S'�f >� �- 7� � 3 � nermit # c�lo ��,//'/ '� d"bSN �YF� City Use Only I C,�. ��fG.�p� I�J as Owner, Contractor, Agent (strike out all except one) do hereby attest that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In the event that any person, or persons, are e�loyed under the prwisions of this permit, I shall inmiediately cause a valid Certificate of Worlarens Cwnpensation to be filed with the Costa Mesa Building Division. I agree to defend at my own mst, and to indemnify and hold haimless, the City, its officers, agents and/or e�loyees, fran arc3 against, any and all liability, damage, costs, losses, claims and expenses, haascever caused, resulting directly or indirectly fran, or connected with the improvement under this pernut. Z further state that I have read and fully imderstand the implications and re- sponsibilities of the above statements, and will canply with all provisions of the Contractors State License Iaw found under the Business ard Professions Code, Division 3, Chapter 9, of the State of California. C. (-f.. C�/>/_/r�(J U �"� . Print Na�re � fU � `; Signature CMF 0777-46 /D -�D -�'C� L13te Applicant to fill in all spaces except thase within heavy bortler lines anA sign all appropriate-Oeclarations. � � • • � • • � � • CITY OF COSTA MESA CO STRU TIQN P MIT Project Address � � Applicant's Mailing Addr ss � Owner's Name � Phon Address Arch/Eng; � License No. Address i � Contractor's Name � P pne Address Imailing) City License No. � LICENSED CONTRACTOR DECLARATION . I hereby aftirm that 1 am licensetl untle� provi5ion5 of Chart¢r 9(tammencinq wi[h section 1000) of DlviSion 3 of Ihe Business antl Profeszions Cotle, antl my license-is in full tl eftect. a �(J LJCElIf I 'C 5¢ O. Q Date Signature WORKERS' COMPENSATION DECLARATION `^�eby aHi�m [hat I hdve a certificdt¢ of ConSent to SEIf-in5we o� a certificate Norkers' Comp/e�nsation pInsurance, or a certitietl copy the��re/of� (Sac�tio/^/n 0. Lab..ij)/j�/lT �U'/1 O �� / ✓I //C�f volicy No. (� Company ertitietl copy is hereby fumishetl. CerYf'e py ' etl with the City/ g�/y��n �py Q� Date_.�� APPlican[1.c1y4'-u GIA EXEMPTION FROM WORKERS' COM7ENSATION DECLARATION (Tbissection neetl nohbe completetl if the permi[ is for one huntlretl ($300) or less). I certity [hat in Ihe performance of the work for which this permi� is issued, I shall not employ any pe�son in any manner So a5 to become Subject to the Workers' Compensation l.aw5 of CalifOrnia. Date Si9nature NOTICE: H, atter making this declaration, you shoultl become subject to the Workers' Compensation provisions of the Labor Cotle, you must torthwith comply with suth prOvi5ion5 or thi5 p¢rmit Shall be tl¢¢rnetl �evoketl.' CONSTRUCTION LENDING AGENCV I hereby affirm that the�e is a con5t�uction lentlin9 agency fo� the performanc¢ ot the work tor which thi5 permit i5 issuetl (Settion 3097 Civ. GJ Lentler's Name Lentler's Atlaress � OWNEfiBUILUER DECLA0.ATION I hereby atfirm lhat I am ex¢mpt from the Contractor'S License Law for the following reason (SecUon ]031.5 Business antl Professional Cotle: Any city 6r county which requires a permit to construct, alter, improve, Eemolish or repair any structure, prior to its issuance, also requires [he applicant for such permit 'to file a signetl statement that he/5he is IicenSetl pu�suant to the p�ovision5 of tne Contractor's License Law (cnapter 9(commencing with Section ]000) of �Wision 3 of Ne Business antl Professions Cotle) or that he/she is exempt :„ refrom antl the basi5 for the allegetl exemption. Any violdtion of Section ,;`31.5 by any applitant for a permit subjects the applicant to a civil ��-Lnalty of not more than five huntlretl tlollars'($500). �� 0 I, as owner of the property or my emoloyees with wa9es as their sole tompEnSa[ion, will tlo the work, antl [he structure is not intentletl o��otferetl tor sale (Section 7044, Business an0 Profezsional Cotle: TM1e Contractor's License Law tloes not apply to an owner ot a property who builtls or improves thereon, antl who tloes such work himself/hersel( or throU9h his or h¢� own employees, provitled that Such Imp�ovemenfs are not intentled o� offeretl for sale.'It, however, the builtling o� Imp�ovement is soltl within one year ot com- pletion, the owner will nave the buraen of proving he/she tlitl not builtl or im- prove for fhe purpose of sale). ❑ I, as owner o! the D/ooe�ty, am exclusively contractin9 with licensetl con- tractors to const�uct the project (Section �044, Business antl P�ofessions CotlE: The Contractor's License Law tloes not apply to an owner of Property who builtls ot improves thereon. antl who mntracts tor sucn oroiect5 with a mn- t�actor(51 Lcense pu�span[ [a tne Gont�acto�'s License Law). I am aware that proo( of Lh¢ir Work¢r'S Compensatlon insuranoe shoultl be provitletl to me. ❑ I am ex¢mpt untler Section B. & P. C. fo/ this reason � Date Owner I h¢reby certity [hat I have rea� iniormation is correct. I agree to Drivers' License oi 0865-46, rev. 5/BB J �03 TYPEOFCONSTRUCTION NEW ADD ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCFIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRAOING OUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5q. FT. oCCUPANCV— CONSTRUCTION TVPE VALUATION $ ZONE GRADING GU. VDS. ' ACRES_ Remarks: Sink Preventer Irrigation Dishm(asher , Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories ' P—Trep Roof Drains Reinspection Fee � $15 Boiler Duct- Under Ground Duct - Structurol Duct- Ventilating Exhaust System ❑ Multiple FirepVFacL BIL iC60 �k Heating System & Duccing ❑P100,000 BTU 0100,000 Reinspection Fee � $15 White - Builtling; Canary - Applicant; Pink - Accountin9: Goltlenrotl - Assessor Showers Service Sink . Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeratlon System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers laue Fee $ 3 $ 3 A.P. # S Main Building: E T FrOnt' ARear C Right 5 Left Ping. Ref. # Planning Notes: Auromatic Washer Construc[ion Pole Sub. Cooking Unit Dishwasher . �' Dryers ❑Gas ^�Elec Fan F.A.U. Fixtures ,�n Devic¢ BOx¢s - OUSIetS $WitChCS Garbage Disposal Generator �0-5 KW C Zone Accessory Building: Parking Req./Provided ELECTRICAL Trensformer ❑ 15-50 KW ❑ 50+KW - Meter ❑up to 100 amps � Meter ❑over 100 amps Sub Panel Motors �41 HP 01 X- 8 InaSolar 09-15 HP 076-15+ Microwave Pole Light Range I I Standing Sections 5-15 KW Trash Compactor � Reinspection Fae '$15 � � Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning APProved By Building Approved By _ .. _. . . _ i FEES $ 3 O N 1 N G R E Q M T SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT � PLUMBING $ �' ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ �'/�� MECHANICAL $ TOTALFEE $ �` PLqN CHECK 25% $ Ol �70021h79-DGD21b74 T��T S,pQ �ATE: 12/G9!°8 T7ME: 1?:?� ,� . C�NSTRUCTION AND PLANNING ' POQ SPA . . APPROVALS � Permit # Date . Inspector _ AppROVALS Permit # " Date Inspector ' .7. Temporary Electrical Service or Pole , 52. Pool & Equipment Location ,' � 2. Soil Pipe-Undrgrnd. � , 53. Steel Reinforcement ,; 3:•Electrical Conduii Utility-Undrgmd. ' �" 54. Forms . .- ' �, 4.�Electrical Conduit.Undrgrnd. �� 55. Electrical Bonding � • � 5. Steel Reinforcement ,• ,. _ 56. Rough Plumbing & Pressure Test �' � 6:,Elect}icaIUFER:Grn,'d: � 57. APPROVALTOCOVER-GUNITE ' �� 7.iFootings !� � ' � � 58. Electrical Conduit-Undrgmd. � ,i '� � 8. � Foundation �:. .� .. 59. Gas Pipe, � Undrgrnd., Test .� i i. ..9.�Water Pipe-Und grnii. •� � , 60. Backwash Lines, P-Trap, O Undrgrnd. 10.'Structural Floor System �� •�� 61. APPROVAL TO DECK 11..Property Sewer Lirie & House Connection • , 62. Backwash & Receptor-Final 12. Sewer Cap � " � � 63. Heater & Vent-Final � , � 13.:Roof'Drains �� 64. Plumbing System - Final . 14.iRoughPlumbing 65. Electrical-Final • , 15. Rough Electrical-Conduit , 66. Solar System-Final . � -. i 6. Rough Electric Wiring - - �- - � - � � - _ -- ;-:Y 67.- Fencing & Access Approval . . .�- '17. Rough Wiring Sign ' � 68. APPROVED FOR PLASTERING �'18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . .i 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT i• �20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush � � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil � 25. Roof Sheathing ' � 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat � 75'. Dry Chemical 27. Frameand Flashing � 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat " 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric , :� Notes: , 34. Final Heating & Air Conditioning 35: Final Gas Pipe-Test , � � i; 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � L� 39. Water Service-Final 40. Gas.Service-Final � �;� � . 41. Solar pomestic-Final ��; F 42. Backflow Preventer `�r � i � ';.: 43. Backflow Irrigation ' i 44. .Landscape Irrigation System t "":. 45. Sound�Attenuation � �`' 46. Handicap Regulations-� 47. FINAL STRUCTURE & BUILDING � " . 48. Special Requirements Completed . 49. Electric Release to Edison � " � . � 50. Gas Release to Southern California Gas Co : j `�� , �,� 51. CERTIFICATE OF OCCUPANCY , � ' .fC' - No. Date ' �'� OWNER CALHOUN, C.H. . APR 2 6 196R DATE 1-18-60 JOB ADDRESS 3086 MOlok3j. Pl � BUILDING PERMIT N0. � � �7n GENERAL CONTRACTOR pulner B1dT'. VALUE $ ��(7pp.np nr. No. 113-�32-16 LOT THACT FIRE ZONE DESCRIPTION OF WORK IN��ECTIONS DATE I GROUP TYPE ZONE i ground Soil U.G. Wal¢c PERMITS ISSUED _ ... ---I SUBCONTRAGTOR I _.__ . _.....___ L OCCUPANCY Form 210—SM-17-59 5-B P ,- �.1.�''%p COSfA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31� COSTq MESA. CALIFORNIA fOR APPL/CANT TO F/LL /N COMPLETE[Y TYPE OR pRINT BUILDING ADDRESS O O � COSTA MESA, CALIFORNIA b 1AR� '�CT OF NEER STATE IEGAL LOT �/ o[scrsiviion NO. BLOCK / TR/�C� A.P. NO. I �� J J,�1'— ( `� � SIZE NO.OF BLOG6. OF LOT '�� X I �T—f% I rvow orv �OT USE OF r EXISTING BLDG. SET9ACK LINE FROM CENTER OF 6TREET REAR YARD DESCRIPTION OF WORK 5 ZIE OING �� C� NO. OF O ROQMS STORII EXTERIOR WALL IROQF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED' 1 HEREBY RCNNOWLEOGE THAT I NAVE READ THIS �1PPLICATION ANO STATE THAT THE ABOVE IS CORPECT /�ND AGREE TO COM- PLY WITH AlL CITY OFOINANC£5 qNa STaTE LAWS REGULATING amLo�rvc cONSTfiUCTION. SIGNATURE OF y,_, _ /( d n_ o p_.. � � AUTHORIZED AGENT- � FEE RECEIVED � r i�-�n�. FINANCE O�PT. APPLI��C{K � I��u11T � BUILDING fOR Off/Cf USf ONLY I, RECEIPT NO. I PERMIT NO. � � � O IVEU GY I D�E REC�ViO �� A E SI�ED v;�/ I �o U :".� .� b �6 �G�i � CALIFORNIA APPROVED �.(Lj+OL DATE��, BY � %// /j% ZONING ZONE /� / I p�pNS ��BUEL�INOEW /T YARDS REQUIRED (CENTEH LINE ST.) n.� THE AMOIINT SHOWN UNOEN VALUATION IS FOR THE ' PURPO6E OF ESTABLISNING A PERMIT FEE ONLY. VALUATION . PERMIT FEE $ �i D — Or�o � $ / � PLAN CHECK $ �� TOTAL FEE $ � S OWNER DATE GENERALCONTRACTOR L. G. RObinSOR� VAL[IE $ 1S �195•00 AP. No. � LOT TRACT 311 F1RE ZONE DESCRIPTION OF WORK �s & At,t g3I' INSPECTIONS I DATE � SUBCONTRACTOR 19 coa[ P np Fiztu Pi�.,.. Gas Test �e � � .; CnSTA � 8219 MESA BUILDING DEPARTMENT P. O. BO% 31� COSTA MESA. CALIFORNIA -,:- ,._ , �- �;� r��.� �f � � OEC 9 l9�� w�^" F1P�r,�.CE DEPT. nn �..I I T U: F.r':: ::::iCJlt FOR APPLICANT TO FILL IN APPLICATION FOR PERM.\ a��o�N� BUILDING � nooaess 3086 Moloki Ave. COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY RECEIPT NO. PEFMIT O. OWNER Mesa Verde Estates � ".�/ MAIL AECEIVGO BY DPTE FECEIVED /ORTE � SUEDL AODRE55 �%Q� Gisler St• -� �� • r� ��'J aTr- COST& MOSFi TNO.KI :-175I nooeEss oRC��rE�eeR �• R. Shel ley N�0'C-ZI%O COSTA MESA. CALIFORNIA noor..,,s Long BeeCh GE 9-0908 zONE � CITV LIC. zorve poeN$ v? ceouv CONTRACTOR L• G. Robinson Np, I IL3 / T�� d. 1701 GislEr 51• TE�KI 5-1751 APPROVED AODRE55 NO. BV DATE `Ec"` O CORRECTIONS DESCwIPTON NOT V� BLOCK TRACT 3� �5 A.P. NO. SIZE NO.OF BLOGS. OF L.OT �OXIOO �IOW ON LOT None USE OF EXISTING BLDG. SET6ACN LINE FROM cErvi[n o� 5*vc[* SO'f REAR�YARD ZO+ SIDE YAR� RIGHT ' S�+ LEFT �J�+ DESCRIPTION OF WORK NEN X ALTERATION ADOITION REPAIM OVING OEMOLISH BUILDING NO.OF SIZE �J6O ROOMS Cj STORIES � ' EXTERIOR WALL ROOF COVEFING rJ}UGCO COVERING Rock & As �18�t USE OF NEW BUILOING �esidence & Attached Gara e HEREBY PCNNOWLEOGE THRT I HAVE REAp TryIS�.PPLIC TION ANO STPTE THAT THE RBOVE IS CORREGf PND FGREE TOfCOMP W!TN >LL CITY ORDINANCES FND $TATE L WS REGULFTING B�IIL� G CONSTPUC� T'�^'� VAWATION. i �Q SIGNATURE OF �_�,. . A,� � PERMIT FEE $��„ PERMITTEE ^ 1 �Yyt �'e��-✓` si� � . $ / � [(��'OD pLAN CHECK $ �,. AUTHORIZED AGENT r ' TOTAL FEE S�'� ,�.r .�°'"r