HomeMy WebLinkAbout2978 MILBRO ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 . www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 2978 MILBROST
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 14123405
Zaning:
Applirant: MARTIN, CID
Address: 14 BASCOM
- Phone: 949-289-9699
IRVINE,CA.� � � Zip: 92612
Owner. CAO, ALEX
Address 2978 MILBRO ST
Phone:
, COSTA MESq, CA � Zip: 92626�328
Contractor: CERT-A-ROOF OF SOUTH ORANGE
Address: 14 BASCOM
IRVINE, CA
Zip: 92612
Arch :
Address:
Phone: 949-289-9699
License: 733482
Eng:
Address:
Phone:
Stalus: ISSUED
Applied: 07l01/2003
Issued: 07/Ot/2003
ISSUED BY: __��
Phone:
Zip: � License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL FELT AND 40 YEAR COMP OVER EXISTING SHEATHING. INCLUDES RESIDENCE AND GARAGE.
FEE SUMMARY
Plan Check: $0.00
Permit: $83.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Totai: $83.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-0
PARKING Existin :, p
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation: $3,000.00
Claim Valuation: S3,000.00
Right 0- 0
Right 40
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Calitomia statutes and related
regulations. (Ortl. No. 92-28, § 1, 12-21-g2)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced wi�hin 780 days, or if work is suspended or ebandoned
tor a period of 180 days. �
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlretl inapections end finel approVal must be obtainetl. Failure to obtain Inspec�ions antl final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
2a4&68 (BI00)
WOFKERS'COMPENSAnON DECLARAnON: � �
I hereby ettirm under penalry ol perjury ona oi Ihe following declarations:
❑ I �ave end will meinlein e ceNticate of wnsent co seli-Insure for workers' compensa�lon, es proviCed for by seciion 3700 of ihe Lahor Code, lor the peAormance ot �he
work for which Ihis pertnli 15 ISsued.
❑ I have end will maintain workers' compensation insur nce, es reduired by section 3700 o�the LeDor Code, for the pertortnance ol [he work for which this permit is issuetl.
My workers' cotmpensa I r ce cer'er a d ic mber ere: •
Carrier. \ Policy Number:
ane hundreo' dollers ($700) ar less.)
I_Y1/ I certity that in the DeAormenca of the work Far which this permit is issued, I shell not employ any person in eny manner so es to become subject to t�e workers'
� compensatlon laws ol Celitomia, end egree that if I should bacoma sub�ect to the workers' compensatlon pmvisions of Section 3700 of ihe Lebor Cada, 1 s�all forthwith
comply wilh MeSe proNsio �-7 /
Applicant Signature: � � Date: / " I—(��
WMNING: FAILURE TO SECURE WOfiKERS' COMPENSATION COVEMGE IS UMAWFUL AN� SMALL SUBJECT AN EMPLOYER TO CflIMINr1L PENALTIES PND GVIL FlNES UP TOONE HUNDRED
TMOUSANO DOLIARE (5100.000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PROVIOEO FOR IN SECTIIXJ 31O60F THE LABOR CODE. IMEREST, M!D ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I em Ilcensed und�er provisions Chapter 9(commencing with Section 7000) of Divlsion 3 of ihe Business antl rofessions Code, end my Ilcense Is In full
�orce end ettect. Llc. a / 3� 1-(�.i Class N ��
Contrectofs SigneNre: F Date: `� — / -�
CONSTRUCTION LENDING AGENCY:
❑ I hereby aHirtn ihat Ihere is e construction lentling agency for Ihe peAormance of Ihe work tor which ihis permit is issued. (Sec. 3097, Civil Code).
Lenders Neme: Lender's Address:
Signeture: Date:
OWNER-BUILDER DECLARA710N5:
I hereby ettirm that under penelty ot perjury t�at I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu entl Professions
Cotla: Any ciry or counry which requires a pertnit to conswct, elter, impmve, demdish, or reDelr eny slructure, pnor ro its issuance, also requires the epplicaN br such permit
to file e signetl stetement Ihet he or she is licensed pursuant to Ihe provisions of ihe Contractore License Lew (Ghapter 9(commencing with Section 7000) of Division 3 of the
Business entl Professions Code) or that �e or she is exempt therefrom entl the Eesis for the allegetl exemption. Any violation of Section 7031.5 by eny applicent tor e pertnit
suh�ects the applicant to e clNl panalry of not more than five hundred dollers (5500).):
❑ I, as owner ot Ne properry, or my employees with wages es Iheir sole compensa�ion, WILL DO THE WORK, and the structure is not intentletl or offered lor sale (Sec.
7044, Business and Prolesslons Code: The Contractors License Law does not apply to en owner of property who builds or improves ihereon, entl who does such work
�imself or heroetl or ihrough his or her own employees, provided that such improvements ere not intended or oHered lor sale. It, however, the builtlinq or imp�ovement is
sold within one year ol completion, the ownervbuilder will havedhe burden oi proving that he or she ditl not build or improve lor purpose ol sele.). �
❑ I, as owner ol the propetly, em E%CLUSNELY CONTRACTING WITM LICENSED CONTRACTORS to constmct tha pmject (Sec. 7044, Business end Professians
Cotle: The contrectore Licanse Lew tloes not appty to en owner of propeny who bulltls or Improves thereon, and who contwas tor such pro�ect wlih e comractor(s)
license pursuant to ihe Contractors License Laws.).
❑ I em axempt under sec. Business antl Prolessions Coda for this reason:
Signeture: Date:
Owner ID venlied by driver's license. ❑ Yes ❑ No Dnvers LiCense No.
Vedfication ol Ownership by (type ol document, i.e. - property taz bill ar deed):
Eaplres:
DIVISION OF INDUSTRIAL SAFETY VERMIT CERTFICATION:
❑ I hereby certify ihat no excavation five (5) or more feet in tlepth into which a person Is requlred �o descend, will be made in connection with work euthonzetl by this
pertnii, antl �hat no building strucWre, scaflolding, falsework, or demolition or dismamling ihereof, will be more than thirty-si: (36) feet high. (Chep. 32, Grp 2, Atl 2, Sec.
341, Title 8, Celilamia Administretive Cotle).
❑ Ps owner�builder, I will not employ enyone to tlo work whic� woultl require e permit twm the Division of Industrial Sefery, as noted ebove, unless such person has e
pertnit ta tlo such work Irom Ihe division.
Signeture: Data:
Division at Industrial Salery Pertnit Number:
CERTFlCATE OF COMPUANCE AND AIfTHORIZATION OF EMRY: I cenify under penalry of perjury that I have read this epplication antl state Ihat Ihe intormetion given is
correct I egree to comply wlth ell state laws and ciry ordinences relating to tullding constructlon, end authorize representetives ot ihe Ciry oi Coste Mesa to enter upon ihe
ebove-described property tor inspection purposes. I agree not to occupy or ellow acupancy of eny building authorized by �his permit until finel inspection.
SJgrx,�lufgS�fl,@gal Owner(s) � I' - Datg, �
���1 U
And/Or Authonzed Applicant Date
CODE �. INSPECTIONTYPE
1616 Fi:etl System Final Fire Prevention
1266 Pool Spe Finel
200 Finel Re-Roof
201 Flnel BIocWRetaining Wall
202
203
204
Finel Factory Fire Place
Final Sign
Final Demolition
2Ag 1N��4
COOE� INSGECiIONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Eledrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupanq
Q�¢ IMRI�LS
(714)754-5273 • Fax(714)754-4856
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Appliwnt:
Address:
Owner:
Address
Contrador:
Address:
ISSUE FEE
Temp service test
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool I Spa
Lighting F�cts
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Molors to 1hp
Motors to 10hp
Morors to 50hp
Motors l0 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermetl Pole
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
2978 MILBRO ST
14123405
ALEX CAO
CAO, ALEX
2978 MILBRO ST
COSTA MESA,CA
ELECTRICAL PERMIT
Phane: 714-207-7790
Zip:
Phone:
Zip: 92626
Phone:
Zip:
License:
PERMI� /
✓
E98-01269
77 FAIR DRIVE, COSTA MESA, CA 92626
SCOPE OF PERMIT
UPGRADE ELECT SUBPANEL. NO OTHER WORK AUTHORIZED BY THIS PERMIT.
$22.00
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$27.25
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
1
0
0
0
0
FEE SUMMARY
Temp Dist System I Lighting
Busway /100 R
Standing Sedion
Misc Electrical Equipment
Transtormers up to 1 kva/kw
................up l0 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System I Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Christmas Tree Stand
Fireworks Stand
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
Status: ISSUED
Applied: 12/15I7998
Issued: 12/15/1998
Quantity
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
80.00
$0.00
TOTAL CALCULATED FEES E49.25
EXPIRATION: 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. .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred fnapections end tinal epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiretion of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS' COMPENSATION DECLARATION: -
I hereby aflirm untler penalry of De�ury one ot the tollowing tleclarations:
❑ I heve entl will maintain e certificete ot consent to self-Insure for workers' compensetion, es proviAed for by section 3700 0l Ihe Lebor Code, for t�e pertormence ol the
work tor which t�is permi� Is issuetl.
❑ I have and will maintain workers' compensaGon insurance, as required by section 3700 of the Labor Code, tor ihe perfortnance of ihe work tor which Ihis permit is issuad.
My workers' compensatlon Insurence wrtier end policy number are: .
Carner. Policy Num6er:
(This section need not be comp/eletl il the permil is valued ef one hundretl dollars ($100) or less.)
❑ I cetlily that in ihe pedormanca of the work for which this permit is issued, I shall not employ any person in any manner so as to become su6ject to ihe workers'
compensation laws ot Califomie, end agree lhet il I shoultl become subjact to the workers' compensetion provisions oi Section 3700 ot Ihe LeDor Code, 1 shell forthwith
comply with these provisions.
Applicant Signeture: Date:
WARNINO: FAILUflE TO SECURE WORKERS' CqMPENSATION COVERAGE IS UNUWFUL PND SHAl1 SU&IECT AN EMPLOYER TO CRIMINAL PENA�TIES AND CML FlNES UP TO ONE HUNDRED
TMOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF CQMPENSATION, DAMAGES AS PROVIDED F-0R IN SECfION 3]Ofi OF TNE LABOH CODE, IMEREST, AND FTTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eHirm that I am licensed under provisions of Chapter 9(commencing with Saction 7000) oi Division 3 of the Business end Professions Code, and my Ilcanse is in lull
larce and eflecL Lic. N Cless x
Contrector's Signature: Date:
CONSTRUCTION LENOING AGENCY: �
❑ I here6y aflirtn that ihere is a construction lending agancy for the perfortnance of the work for which ihis Dermit is issued. (Sec. 3097, Civil Cotla).
Lendels Nama: Lendefs Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby aHirm that untler penelty ol perJury ihat I am E%EMPT FROM TTIE CONTRACTORS LICENSE LAW tor the tollowing reeson (Sec. 7031.5, Business and Protessians
Code: Any ciry or counry which requires a Dermit to wnsiruct, elter, Impmve, demolish, or repair eny structure, pnor m Its issuance, elso reQuires the applicant for such permit
to file e signed stetement that he or she is Ilcensetl pureuent to the provisions of t�e Contractors License Ww (Chep�er 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt tharefrom and the hasis for the alleged e:emption. Any vlolation ot Section 7031.5 by eny ep0licant for e pertnit
sublecls Ihe epplicant to a civ�l penelry of not more Ihen five hundred dollars ($500).):
❑ I, es ownar of ihe property, or my emplayees with wages as their sole compensation, WILL DO 7HE WORK, end Ihe structure is not intendetl or olfered for sele (Sec.
7044, eusiness and Pmtessions Coda: The Coniractors License Lew dces not apply to an owner ot property who Dulltls or impmves thereon, end who tloes such work
himself or hersetl or through his or her own amployees, proNdaC that such improvements are not Intended or oflered for sala. If, however, the 6ulltling or improvement is
sold within one yeer af completlon, the owner-builder wlll heve the burden of proving that he or she did not build or improve for purpose af sale.).
❑ I, es owner of ihe property, em EXCLUSIVELY CONTRyCTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions
Code: The coMrectors License Law tloes not epplyto en owner of property who builds or improves ihereon, antl who contrects tor such pro�ect with a coMractor(s)
license pursuant to the Conirectors License Lew�"
❑ I em exempt under sec. Business and Pmfessions Code lor this
-_,g Signeture: � A.rfY1� .�� '
Owner ID venfied by dnvers license es ❑ No Dmers License No. _
Verification ot Ownership by (rype of tlocumeN, i.e. - properry tex bill ar deed):
DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFICATION:
❑ I hereby certily that no e:cavetlon tive (5) or more teet in tlept� into which e person Is reqWretl to tlescentl, wlll be mede in connectlon with work euthodzed by this
permit, end that no building siructure, scaHolding, felsework, or tlemolition or tlismentling Ihereoi, will be more then thirty-siz (36) feet hiqh. (Chep. 32, Grp 2, Atl 2, Sec.
341, Title B, Califamie Adminisiretive Code).
❑ As owner-builder, I will not employ anyone to tlo work which woultl require e permit Irom the Division of Industrial Sefery, es noted above, unlass such person has a
permit to tlo such work Iram the division.
Signature:
Division ot Industrial Safery Pertnit Number:
Date:
COOE 1. INSGECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Finel
200 Finel Re-Rooi
201 Final BIocWRetaining Wall
202
203
204
2A6fr96
Final Fec[ory Fire Plece
Final Sign
Final Demolition
Q� �{�
COQE� INSPECTONTYVE
206 Final Mechenical
208 Final PlumDing
210 Final ElecMcal
212 Final Pire Prevention
220 finel Plenning Approval
222 Final Site
250 Final Builtling/Occupancy
OAff U1fIDAl5
��'L'• d :+1�
AVV��cant to fill in all spaces except those within neavy bortler lines ana sign a11 aoaroo��ate tleclarations.
CiTY oF COSrn mE^SA�j �CJOQNSTRUCTION PERMIT
Project Address �N ` / a ���L'��o
ApplicanYs Mailing Addreis A ,��� ���,C
Owner'sName Lr�NM��i �i_7pirTT��� Phone�_7� f_f3[l
Address �0 �r "✓ �` � /��-.�j
Arch/Eng. �s%'i�� �Lvnl7 ��"L License No. +?� �12'
AAdress �' '
ConVacmr'sNameq '�-�%,�'���CVM � hon^e7���ZOb
Address (mailingl � ! � �= � �CG�V� �� �` v�
City License No.
LICENSED�CONTRACTOR DECLARATION
I nereby a(firm [hat 1 am Ilcensetl untle� provisions ot Cnarter 9(commencing
with section 7000) ot Division 3 ot the Business antl Protessions Cotle, antl
my license is in tull to�ce antl ffec[.
Licens Class ice se No
Da �� � � Siqnature
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certiticate ot consent ro self-insure or a certificate
�i N/orkers' Comoensation Insurance, or a certifietl mpy thereoi (Section
100, Lab. C.) ' '
olicy No. Company
eCertifietl coOY �5 hereby fu�nishe0. �
Certifietl copy is tiletl with the city Builtling Division.
Date APplicant
EXEMPTION F0.0M WORKERS' COMPENSATION DECIARATiON
(This sectlon neeC not b¢ completetl if the permit is (or one huntlretl ($300) or
less).
1 certily that in lhe performance of t�ork (or which this pen �f, is iSSuetl, I
shall not employ any person in any nn¢r�as to becom sulSject �he
Worker Co �p�ns�,tion Laws of Cal �a. /�
Date ��� �Y Si9natur Ln
NOTICE: If, a(te� making this tleclaration, you shoultl bec me subject to the
Workers' ComOensation prOvisions of the Labo� Cotle, you must fortM1witM1
comply with such provisions o� thi5 permit shall be tleemetl r¢voketl.
CONSTRUCTION LENOING AGENCV � � �
I hereby attirm that there is a�construction lentling agency for tne pertormance
of the work for wM1ich this permi[ is issuetl (Section 309] Civ. CJ
Lenaer's Name ' - '
Lentler's Atltlress
OWNER BUILDER DECLARATION �
I hereby aftirm that 1 am exemDt from the Contracto�'S License Law Por the
following reazon (Section 7031.5 Businesz antl Professional Cotle: Any city or
county which requires a permit to <onstruct, alter, improve, tlemoiisn or repair
any 5[ructu�e, prior fo its i55uance, also requires the applicant tor such permit
.to fiie a sianetl statement that he/she is licensetl oursuant to the Proviswns of
t eretrom antl the basis for the allegetl exemption. Any violation of Sectlon
E��31.5 by any applicant for a permlt subjects the applicant to a civil
y- alty o� no[ mo�e Ihan five huntlretl tlollars ($500�. 1
"_u� I, as owner ot the property or my employees with wages a5 their sole
� compensation, will do tne work, antl the sVucture is not iniendea or ofteretl
for sale (Section 7044, Business antl Profe55ional Cotle: The Contractor'S
License Law tloes not apoly to nn owner ot a property who builtls or improves
tnereon, antl who,tloes such work himself/herselt or throu9h his or her own
emplo ees, provitletl that such improvements are no[ intendetl or otferetl for
sale. IY howevet, [ne builtling cr improvement is zoltl within one yea� of com-
pletion, the owner will have the burtlen ot proving he/she tlitl not builtl o� im-
�rove forthe putpose of sale).
I, as own¢r ot the O�operty, am exclusively cont�actin9 with IicenSetl Con-
tractors to construct the project (Section 7044, Business antl Professions Cotle:
The Contractor's License Law tloes not appty to an owner of oroperty who
builtls or impwves�thereon, antl who coniracts Por such Droiects with a mn-
tractor(s1 license Oursuant�to the Contractor's License Law). I am aware that
proof of [heir Worker'S Compensation insuranGe shoWtl be provitletl to me.
❑ I am exempt untler Section B. & P. C. for tnis reason
Date Owner
I he�e0y certity [hat I have rea<
information is correcL I agree to
antl state laws elating to builtlin
sentatives of hi5 city to e er
inspection p p ses. /
Signature ��
Drivers' License or 55 � �
CMF 0865-46, rev. 4/84 White
[ion antl state that tM1e above
all city antl county ortlinances
i. antl herebv authorize reDre-
_�' �.3V�4 s I ....._. .-_. I -- ._ � .,,.,, ,....
TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION�OF WORK/USE OF BLDG.
TVPEOFPERMIT GRAo1rvG FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL .
❑ OTHER
PROJECT DESCRIPTION 5�. Fr. oCCUCANCv
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCU.VDS. ACRES —
Remarks: ' �
3ar Sink
3ackflow Preventer
3ackflow Irrigation
3athtubs
�larifiers
JIShWdS�ICf '
7rinking Fountains
Floor Drains '
Floor Sinks
3as Service
Intercepmrs
Kitchen Sink
Lavatories
P—Trap
Roof Orains,
Reinspection Fea
Showers
. Service Sink
Sewer Cap
Sewer Connection' �
Solar Collecrors
Solar Pipin9
' SolarTank
Swimming Pool w/Spa
Urinal
Outlets Water Closet
Water Heater
Water Service '
CAS ' � �P� �J G
$15
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating �
Exhaust System ❑ Multiple ❑
Firepl/Fact Bit. ICBO # .
Heating Sys[em & Ducting �
❑0.100,000 BTU 0700,000BT
peinspection Fee � � $75
- Applicanp Pink - Accounting; Goitlenrotl - Assessor
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System
❑0.100,OOOBTU ❑100,000
System Repair/Alteration
laue Fee
EES
A.P. #
S Main Building:
E
T Front
B Rear
A
C Right
K
g Left
Ping. Ref; #
Planning Notes:
I96� 6iI1i84 h�n�.
Zone
Accessory Building:
Z
O
N
I
N
G
R
. Parking,Req./Provided - E
Q
� M
T
S.
Automatic Washer �
Construction Pale Sub.
Cooking Unit
Dishwasher . �
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fiztures _ : . .
Device Boxes
Outlets
SWitches
Garbage Disposal
Generator �0-5 KW 05-15
ELECTRICAL
- Transformer ❑ 15-50 KW , ,
❑ 50+KW
Meter ❑up ro 100 amps �
Meter ❑over 100amps
Sub Panel
Motors �0-1 HP �1'/:-8
Inc.Solar �9-75 HP �16-15+
� Microwave . _
Pole Li9ht
Si9n
Standing Sections
Trash Compactor
FEES
$ 3 I
� Reinspection Fee $75 Issue Fee �$ 3
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By Date
Building Approved By Date
Appliption luued By Dat � �� �
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ S.OU �SSUANCE $
PLAN CHECK �25°6 $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTAL FEE $ � • OO
$ 3 PLAN CHECK 25%' $
CONSTRUCTION AND PLANNING POOL 'A �
Date Inspector . Date Inspector .
APPROVALS Permit # s' Y� �. APPROVALS Permit #
1, Temporery Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. i 53. Steel Reinforcement • �
.'
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms �
4..Electrical Conduit-Undrgrnd. �� . 55. Electrical Bo�ding �
�. 5'�Steel Reinforcement ' , 56. Rough Plumbing & Pressure Test
, 6. Elecvical UFER�Grnd. : ,� 57. APPROVALTOCOVER-GUNITE �
7: Footings :, � " ' 58. Electrical Conduit-Undrgrnd. �
ti
8, Foundation .� j � 59. Gas Pipe, � Undrgrnd., Test
" 9. Water Pipe-Undrgrnd. , � 60. Backwash Lines, P-Trap, O Undrgrnd. ���
-70. Structural Floor;System � ' 61. APPROVAL TO DECK
i t. Property Sewer Line & House Connection . 62. Backwash & Receptor-Final
. �. �. `
12. Sewer"Cap ,� -� 63. Heater & VenrFinal
13. Roof Drains ' r' 64. Plumbing System - Final .
14. Rough Plumbing 65. Electrical�Final �
15. Rough Electrical-Conduit " 66. Solar System-Final
�6. Rough Electric Wiring � 67. Fencing & Access Approval
17�. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
7,8. Rough Electrical-T Bar Celling � 69. POOL/SPA SYSTEMS FINAL
19_. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace , APPROVALS Permit #
21. DuCts, in Structure �� 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing ' 73. Underg�nd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro
26. T-Bar Ceiling (5tructural) & Monocoat � 75. Dry Chemical • -
27. Frame and�Flashing ' 76. Dry Standpipe� �
28. Lathing & Siding , 77. FIXED SYSTEM FINAL
. 29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT.
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final � ' 80. FOOD CERTIFICATE ISSUED
.,
33. Final Electric Notes: . �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test y��l��y (�j� .
36. Hood or Canopy � _
37. Final Factory Fireplace
38. Final'Plumbing (�/rZ�yl.� r"
39. Water Service-Final '
40. Gas Service-Final -
47. Solar pomesticFinal _
42. Backflow Preventer �
43. Backflow Irrigation ,. _ �
44. ,Landscape Irrigation System
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 �
51. CERTIFICATE OF OCCUPANCY •
No. Date
OWNER '�COME HOMES
a•• ia
JOBADDRES3 -�93� Milbro
i PERMIT NO.
GENERALCONTRAC70R [�JP��.nm< Anm..� VAWE $ 8)%C)O�OO
L' �� 3� BLOCK TRACT 2896 $ingla+ Res. w�att g�•
$
GROUP Z& J TVPE p ZONE ni FIRE DISTRICT 3078
PERMITS ISSUED
INSPECTIONS , I DATE I SUBCONTRACTOR
DATE I NUMBert
Footing Trench j'./a'./� 6 �
Foundation Forms and Grade to Garagq _ 8',
Rou
Heating, Final
ewer, House
Septic Tank or
Lath�ng,ln
PI: na
�a�-s
Plumhinq, Fin.al
OccupancY /JI [� ,�jy�-Jl� �a"d-/S"
FOflM 2�0 3M 10-•v3
�/S�S/_ SG/9—
a ��s- a 7s y—
' ' ^i � e O/ .�
O
�
Costa Mesa Building Department
�' " P. O. Box 3!7
' COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
B���d��9 . . df
nddress 2 Nilbro Street
Costa Mesa, California
Nearest Bsker
Cross St.
owner �'ie lco� Home s, Ino.
,nddress �8 Westminster Aoe. ,
c�t 1?estminster No�'Ffen. 5
Y
Architect or Lic.
Engineer No.
Address
City LiC.
ContractoilelcoirB $oII�s, Inc. ryo, �"
nadress �8 Westminster Ave.,
Legal Lot I
DescriDtion No. 3� Block I Tract
No. of Bltlg;
of Lot 58X1� Now on Lot
of N o. of
ting Bldg. NOne I Ramilles
ack Line from 0 Ft. Rear Vard
:erolSfrrs.t 5 RideVard
x
APPLICATION FOR PERMIT
30'78 BUiLDING '
FOR OFFICE USE ONLY
Receipt No. Permit No.
303�
�Rece by DatepRec/'d. Data iss�/ued
���0 �J 6 S� �Q _I
Building
Address
Costa Mesa, California
711
i • ��
' I Moving I I oemolish I
No. of
�5� Rooms 5 stories 1
$tiL1C00 Roof
r.��P���� ti9�od
Py- I Plans I Type, / Group.., y
v s
ved
Date
CORRECTIONS
�r \ • t 1
. . • 1
t — --
,...11 .L tl I::J') �
Gf '
2
^,1"' +', � '' , '.i D
� w. c c� ... .• 7 e r
APPROVALS
� -""� Forms, Material:
aisi �,v car �sra�_e at �aCf1z fI. Under-Pinning
3 Frame: Fire Stops,
Bracing, Bolts
I hereby acknowledge that I have read this Application
and state that the abme is correM and agree to comply Lath. Ini.
with all City Ordinances and State Laws regulating
building construction. ^ / Lath. Ex4
Slgnatureof9�'/� 7(�_ � .
Permittee �� K��4"�"�'� n __ Plaster, Int
Valuatlon r�'"�0 PermitFee $ � � �
� Plan Check $ � �
$ g l� o l To�� 33
�
Fee
Masonry Reiniarced
Bond Beam
6treet
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PLOT PLAN
Show locatlon and distances from � -.
property I(ne and between butldtnga
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ro�.. eoor.;;,,
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