HomeMy WebLinkAbout341 NASSAU RD - Building Permitsnoon�sso�eunawa: 341 NASSAU RD uNT:
owhi�rcsruxeiva:.�m: DWAIN PAUTSCH
• r wu�ss 341 NASSAU RD
,1 COSTA MESA
;. A 97626 (714)557-8087
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UCENSED CONTXACTOfl4 DECIAHRTION: I hareby aH'vm urMer pera�y af pe�ury thtl I em licemetl unEar proviaiore A Cheqer 8
(commend�g v.nh SxMion ]000) ot Drvisun � d �he Businam end PMeaeiona Goda, eM my license o in full bRe eM eked.
cm uc. No.: uc. cuss: um No.: E X P:
Dme: Comraaor.
OWNEH BUIL�EF OECLAPATION: I Mreby ffifirm ueNer paneXy d per'ryry the� I em evamp Irom iM COMredae Limme Lew fa tl�e
folbwinp �eeaon (Sectian 1031.5 Buei�eas end Praleasiona Code: Any cRy a munly which req�iren a parmil �o wrewn, ellx, improve,
demol'sh, or repei vry ewcture, prior b ib'eweMe. also reyuirea �M applicant for ach parmn to fib e ag�red alelement Net M a eM
ie IimnaeC punwnl �o the provizona d IM Cmtrecloro License law �Chepter 9(mmme�rq wi�h Sed'on ]000) d 0'v6bn 3 d ihe
Businesa eM Prdesenm Gode� w thet M a she ia ezemq thaalrwn end the beeie la the elleped axemqion. My violetion of Sedion
1031.5 by eny applicenl for e pertnit subjMa �ha epplicaM lo e crvil peneXy d ml more ihen Me hundrad dollen �5500�).
� I, es o�mar d Iha prope�y w my empbyeea w1h weges es Ihei sda mmpenselion, will do IM wak, end �he avunure e nd'mleMed
a oRered lor sele (Sectian'lOM. Busirese end PMassiona Coda: The Comredore License Lew Aoea �wt epplyto en owrerN propMy
wno n�wa a mo��� ��re�. �d wno aoea sucn � �:m�r a, na�ax «m.«�an ne or ner own emWwea+. w�eea mm.�n
imprwements ere not in�eiMad or oHereE for sele. H, howaver, the buiNifq or impmvemaM is eold wilhin aw yeer d mmWe�ion, IM
owner-0uiker will heva iha burden d proving he or she Ek mt WiIE or imprare fa IM W�a d ade�.
� I. m owrier M iM propeM. em e*dusivey coniraqiq v.nh licenaed contrecwn to conalrutl IM piojetl (�� ]ON. Buair�e mM
Pm/eaiona Code: The Contreeon license Lew doee rw� epply w en owner of popeM � buika a impwea ihaieon vM wla
y/. mntreeb br wd� PrW�s with a mmeeaor(s) Icensed Ounuant to �lia Contredora Limnsa Lex�.
{� I em exempt �nEer Sect'wn: �2 '4 B. E P.C., for Nia reason: R
Dele: Ow�ar.
i do na.eW cenav mm i� a.are a ena u�d.9�ene me rea��rem<oa w ce�aom�e tieenn �a sm�r cme seaia,s uws, us�.a, ena
zss3a. �a mm i or enr nn�re a,�ame �o�� mn i.ai �m (a,ua on.l oeea m canvN wm mia e�me codm and me ma��em. m.
apeimitlmconsvunianormadifiratbnhantheAi ueSlilyl.ranapementDniatnd.Reaidantialmnm a'vneppiratbmeneromqhomUms
wW 15��� "7 I18 �rlb X lEc.1C�- ��cF�.d3'G�
Dele: Applrent
WOflKEfl'S COMPENSPTION DECL/�PATION: I Mreby elfi�m uMs penel�y d pe�ury me d ihe Idlowiip Eedare�bm:
� IheveaMxiNmanteinacenificeleMconeenttoaeH-inarebrxaken'campenaetbn,eaprovided(abySedian3)OOdtheleEor
coae, io. �n� oarto��a a�n� won� i«.n��n m�a ��n �. ��a.
� I heve end wil meiMan wwke�e' mmpemelion inaurence, ea required by Seabn 3)00 ot tlw Lebor Code, br iM pMormaru� d IM
wwk Iw which iM1ie permX is issued. My workers mmpaneation ineurance ramer eed poliey numbar ere:
c�a�:
Pdiry Number:
�nr: aecrron ��d,wr ne candarad s rn. ro�a �s ro. o,re nu�a,ad dwa,s Isiool w r.�.�
� I canly thel in Ihe perlamiv�ce d IM wwk Iw whch thia parmil is isaueE. 1 shell mt empby ary penon in enY men�rer ao es to
becoma aubgd io Ihe woMere' cwnpenselion lewn N Cel'dmnie, end ro� thm N I ahauM becoma euEjeO to iha xwken'
eompanxtion pmviauna d Sedion 3)OU W tha labor Catla. I shell forlhwilh eampy wnh tham peoviaiom.
Dele: ApplkeM:
Wam/ng: FeNun b secvro xrorken'rompxuetlon rovsreps I� un/ewlul, end�Nll subJscf an employsr ro alMrol peMMu eM
elvll flns� up ro vns hundroJ tMuaantl dulHn f5f00.000), M etltl/tlan ro fhs ewt ol romywatbry Cemepu u pov/tled br In
Sxtlon 9]06 0/ tlro La6orCods, Inbn�f, antl ettomsy's /esx
CONSTPIICTION LENdNO AGENCY: I hereby eifi�m under penelly oi perN�' �� thare o e mnalruapn bMirp pency M tM
parlorme�e N �he xnM lor xfiich tha peiml is eeued (Sedion J09). Civ. C�.
LENDEfl'S NRME:
LENOEX'S10�RE%:
I cenily Ihet I have reaE �hu epplke�im end mete Ihet the ebove iniamelion is corted. I egree to wmply wnh ell rey and couMy aEineMea
eiM Mete lewa relmiq to builE'vg conslrudan ard hereEy aulhorixa repreeentmivec W th� ory to enler upon iM ebova-memionad papeM
fofioape°�°°v°`D°�°' DWAIN PAUTSCH
� �'Cc.0 vYCz,l� ome:'1 �`/�o
s�a���,e d o�neae�vnovu�ucooi�aao�
(5151�d8.WP) While-Buildvp 8 Selery: GraeMFle'. Cenery-AppFcaM: Pink-Ravenue: (3oldenmFAasessa
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO; B 078659
PERMIT NO; B 078659 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE; STA PURPOSE: OTH
JOB DESCRZPTION : T/OFF 6 REROOF W/COMP SHINGLES SQ FT: 3,500
CLAIM VALUE: 3,500.00 CALC—VALUE: 3,500.00 GROUP OCC: R-3 /U-1
COMMENTS: REROOF 2400SF RESIDENCE W/COMP SHINGLES
�atitatatetatit��*+r��*it�*it*iEit�iE�+�ie*+r+�+�**�ritit+rieu���ir+�+t+�*�ieit**��****�r****ieie+r*itieitat*******ieir
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGiIT; FT IN LEFT; FT IN RGHT: FT IN
PAAKING AEQ; , PRdV: PARCEL: 14144204 ZNE: REF NO:
PLANNING NOTES>
t.�
iE 1E �F 1f �E iElE 1E iE 1F fE 1E IE fE 1E if iE 1E iE iE 1F 1E 1f 1E 1E 1E 1E 1E fE 1E 1E iE'!E �E 1E 1E i(' �E i("IE 1E'Ih 1E fElE 1F iE fF 1E fi� 1E iElE iE 1E 1ElF'lE 1ElElE 1E 1ElE if 1f iFlE 1E,�E iE iE fE 1E 1E iElF �lE iE
D E V E�L Q P M E N T S E R V I C E S R E Q U I R E M E N'T.S
ZONING APPROVED HY DATE:�� �
BUILDING APPROC�ED BY : DATE: �
APPLICATION ISSUED BY: � DATE: %I��S °l
fElElE1E1E'N'iEiE1E�EiE1ElEfFlEiElflFl4lflFiF3f3F�'iFiFiF3F3Fif7F�fE'iF3FTFTfTF�if�TF�F3F'fF 3F3FiFiF3FiF�if�F7F3F1E1FiE'1E1EiEiF1f1ElE� �1E1E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE�' SMIP/RES GRADING
PERMIT 87.25 , 50
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDZNG—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK
87,75. 0,00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
8�.25
TOTAL %• PAID DUE
87.75 irr 87.75 .00
1
87.75 OVER/SHORT: .00
FIRE SMIP/TOT; GRADING PLAN—CHECK
, 50:��
if 1E 1E �IE 1E 1ElE iE 1E iE'1E 1El4 iE iF IF 1E 1f iElf IElE iFl4lE ik 1k if 1E iE 1E 1F 1f iF ik'k iE iF iE 1F 1F k iElk iElF iElF 1f iFlF 1k 1f 161E 1E1E iE 1E 1E 1E fE'7(' 1E iF 1E 1F iF iE 1ElF 1E 1E 1F 1F 1E 1E iE fE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 3500 REROOF BY VALUE RESIDENTIAL NOZONE 1".00 3,500.00
END OF FEES ��'
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CONSTRUCTlON AND PLANNlNG . POOL & SPA
� ARPROVALS Permit # � _Date Inspector' APPROVALS Permit # Qate; T inspector
t:�emporary Electrica! Service or Pole 52. Pool & Equipment �ocation -
• 2. So�i7 Pipe�Undrgmd. - 53. Steel Reinforcement � �
'�
3. �Elecirica! Cond�it Util:ty-Undrgmd. 54. For�ms - � '
�;4 �Electrical Conduit�Undrgrnd. . � 55. Eiectrica! Bondin� - � '
_ . �
J& Steel ReinSorcement . � 56. Rough Plumbing & Pressure Test �
� F6�`,:Electtical U�ER Grnd. � 57. APPROVA� TO COVER�GUNITE �
.-.7. Poatings �, 58. Eiectricai Conduit�Urdrgrnd. �
`8. Foundation 59. Gas Pipe, � Undrgrnd., Test ,
9. VJa2er Pipe-Ur.drgrr,d. �� 6Q. Baakwash t�ines, R7rap, L� Unclrgrnd.
70. SirucTurai Floar Systen: . 61. APPROVAL TO DECK
13. Property Sewer Line & HouseConnectlon �=� g2, Backv�ash & Reczp�Q,-Pinal
..
72. 5ewer Cap � � 63. Heater & Vent-Final
73. Roof Drains � :� 64. Plumbing System - Flnal
14. Raugh Piumb:na 65. Electricai�Fina! (
-t -
75. Ro�fgfl Electricai-CQr,duit �.:. � 66, Solar System-Finai :
16. Rough itectricbViring � 67. Fedcing & Access AnP=avai � �
17. ftough 4Viring Sign . _ 68. APPRQVED FOR F�ASTERING �
18. Rough Eiectrical-F 6ar Ceiling 68. FOOI.ISPA SYSTEhIIS FINAL
i9. Rongh Heating & Rir Conditioning FIftE DEPF. ftEQUtREMENT
20.-Rough Factory Firaplace ��.;�, r� - - �• .� APPROVAIS'��= Permit ��� i
,,
2L=Ducts, irtStructure , �.. ; _ - ' �, , 70.tiUndergrouhd Hydro Y '
� _ _ +.
22.`�Ducts, VenYYanng,x ., � -. -: 71. F'roduct:PlPin��G7Ges fl Oil
23.�Gas-Pipe�Rough &'Test _ _ ; . -.� ' ` �� 72. Undergmund Fiush_ _
24. Roof�Fr2ming: _ T� = �: . � � a = 7+3. Undergrnd�Sior�c%�Tank'�Gaz � J:Oi! �
25. Rooi Sheathing -� � "�',�,r�� �i,..,1i 74.. Overhead NYd'rci=�"� ;,
' � _'.'V77�� .,. �,�_�
26. T�Bar Ceiliny {guuc"Lvr�O &•PAo�ncaai� . `: ?5. Dry Chemicai - +� -- _ �
27."�rame and Fiashirigr �, Y` _ . y, 78:'-Dry Sta. t+piPe'. ;�` r= -
28. `tatViing:& aidirn}" R . -:�``; . ,,, �.* 77. FiXEB-SYSTEM:FINAL '
- 29. Insulatio'n =- ; x r ' � � . - ��;, 7$. FIRE PiiEV. FltwaL � . . . '
� 30. Drywzli Nal'yno �i '" '� . � i �c �-HEAL7+;i DEP„T��REQUIR�EMEN7
, 37. P�a;ter Bzown C�ai�... ' r„ � �+` � 7�. FINALINSPEC'I�ON ` f-� �
32.-Electricat�Powe! IU.eter-rinal `��' . r: �# �: II0�_ FOOD CERTIFiCATE IS5UE6 ^�-'___T-_�'_�
33__Finaf Electric �` - � . �� ` I<t"ntes: '�z �� _ 'r � 1
-.� . �re r . - c ,r ,',im !
_ _ __ (
s: 3A.,-Pin�t Hea?ing'& Rir"�C'o�uirtioriiag_: �.-� ' �� rs . - ' . „�'
35.•-Fina4 Gas:Pipe-TeSf �� v u _ .. � - - � .; _ _ -�
. - .. -, . - �. _ `_. � - � � . � � r _--�
: 36. Hoo�; or,CanopY�,. -- ` _ :. - », -; . - :.r � , . 'a �
��� 37.'Fir,ai;FactorV Fireplace( - . ` - �`•. �- � �- ` _ -----�j
- - r � ,: r.
� � - �. � ��: e� --- _ --- -- --�
38. Finai Plumbing .' y ' .. . . .. . � ' �* � - "' �� -
_ ^ ��: � ._ _ . �
39. Water Service-Fi�a�ii: -.. .� � -. : _
) y'
40. Gas Serv�ce-Fina! #: ry - - :. � , �`. r,:' ' � �
r#. ,3 � `
41. Solar pomesticFina! -, - ,.- �. . -. ' �Y '�� •-
- - �
42.`Back`IowPrevente;�''r -' "� '�' - '�� �
_ m _ . t _ - i
43. Backf!ow Irrigatiom: - _. _ � � _ � z 3- ��.��. / � _ ?�� /i S��
�, �..� [c{� , Q�
44. Landscape I�rir<tion SYstem� , �- - " �� ' ' .-:�, ; _' : /'��i�
'-� ' a`
=45.%Sound Attenuation '�- �-r f� �. ._:. - � �. v.Q i -- -----�
_ ... : , w - . � ' - _ ':
-AB.•Wandicap'Regvl�tin�s � - ..'r - - � ..�, *
. . . --�- y/ / � - . � - �
A7. FiNAI STRUCYU�E & BUf'i_DING ^ �/��� [�/ � � � _ I _
� �� �Z� -
48.;,F1N.4L PLANNING; .`� " ' _ " _.
>
-49. Eiectric�ReleasetoEdison , � _ �� � -- �
.�; _
50..,Gas Release to S�uthern Caiifomra Gas Ca ; � ` i;. � - - , ; : �;, ; �- .
'57. CERSIFICATE OP'OCCUi'ANCY ; ;. � ; , . _ „ , _
No. paze
1
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CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-buitder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the major labor and materiats for construction of the pro-
posed property improvement. O Yes C�lo
2. I av° ave not) signed an appiication for a building permit for the
proposed work.
3. I have contracted W`ith the following /p!erson (firm) to prorvide the proposed construction:
Name �f'nCN S%t�CUC.�-/ �oo'I�^�ri ,.y�
Address 9� �• �� � � City SA,.i e(2..c v�
Phone'Q<<() �gZ��7�� Contractor's Lic. No. s25`r°78
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
City
Contractor's Lic. No. _
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name
Address
Phone Type of Work
I hereby aHirm that I have received a copy of the information set forth in Section 19830 of the State
of California Health and Satety Code and have completed the above information to the best of my per-
sonal knowiedge, i mpliance with this S�t te' la/w.
Signed: � �—� �n�.0 (/d'Ll�. Date: ��t a /��
Name: �� � -� r�
(Printed or�ed)
C.D.L. # or S.S. k �� "�
754-5273
,062-GB
1.,
Je .
oo.ir �r iuc o�:iy NAA 714 z4tl tl976 ALLERGAN SLS OPS IQ 003
y, _ ,
, - CITYOFCOSTAMESA �.J�l'- 32.Bech�atPowerAkmr-Find �
BUILDiNG SAFETT DIV�ION �{. � p�
POST IN CONSPICUOUS PLACE �. � s��c�c
�N THE JOB �. ���-T�
-noncf �e. r�d«
vou must fumis� PERMIi NUMBER entl tM JOB ADORESS FOR �. � F F�
EACM RESPECIIVE �NSPECTION. CALL 7'udSB47. APPROV�
PI.ANS SHAl1 BE ON JOB AT ALL 71ME5. �w�n 38. F9W Pblm6i
' A 0. PA. WTF 1. e5 1_. �. �MB�Bf SBI'lML9 • FdIBI
�
uBEF /i _ /1 �� � _ �
POOL � SPA
APPtW1lAiS Peemq•
F�unra saera �— R�
-- SiCe Yd. L� R-- Rear�y
� CONSTpIKTt01tApDPLANNIl10 Dur nqaa
APYIIOYAtB P�nN1•
1. T�y Elxttkel Serviia a PoM
2. Sa1 P'ipa • IMdoqro�mE � .
3. EJactrkel Conddt UUIY • UMBrymaA
. d. EIBCIIkYCadult•UM�ouM
5. SteN ReinMrcemerd
6. �ectrical UFEii Gmd,
7.
8. FwrMaliOns
B. WaterPipe-
10. Structn2l Fbor Nmmn -
15. Hou FJeWtr� • CaMui1 FIf1E Dlv�. REOIAFBAENT
18. Nau� BaLit Wa6q APPROVAl.3 PMmh I_
17. Rouah VNrino Sim� 87. UrdeiomeM Hvdo
�ooi.
� ALLERGAN
Fax Transmission
TO: LF�N R- I%� � DATE:
FAX NO: � �[.� — 7S�-�� ��5�
FROM: DW� /•v /'� �SC �
Numbez ot Pages,� (including cover sheet)
If al1 pages are not received, please contact ��'`� `�' ^� at :
714/246� For return fax, ou� num6er is 714/246-6976.
PflOJECT A�ONESS: 3 Q S NASSAU RD
OWNEB'S NAME: DWAIN PAUTSCH-
aonxess: 391 NASSAU RD
COSTA MESA
CA 92626
(7141557-8087
FflCHIENGINEEH:
ROOflE55:
uxit:
flEG.NO.:
UNIT:
PEflMITTEE: DWAIN PAUTSCH ( 714 ) 557-8087
aooAcss: 341 NASSAU RD
COSTA MESA CA 92626
LICENSEO CONTHpCTOB OELIAflATION: I �ereby allirm �Aa� I am IicenSeU unCer pmvisians o� C�apter 9(commencing with Sec�ion
7000) oi Division 3 0l Ue Business and Pmlessons CoGe. and my licen5e is in lull force ancl efler,t.
CITY UC.: $TRTE LIC.: ClASS:
Da1e: Signamre:
WOpNEflS' COMPENSA710N OECIANATION: I �ereby aflirm t�at 1 have a cenificale ol consenl to self-insure or a cetlilica�e ol Worker5'
Compensa�ion Insurance. or a cerUlietl copy ihereol (Section 3800. La�. C).
POLICY NO.: EXP. UATE:
COMPANY:
❑ Cetlilied ropy is here0y lumis�ea. ❑ Certilietl copy is filed wiN Ihe ciry Building Division.
�ate: Fpplicant:
EREMPTION FflOM WOPNEBS' C�MPENSATION OECIABATION: Qhis section neee no� be completetl ii ihe permit is br ane huntlretl (5100) ar less).
I cetlily Ihal in ihe pedormance ol I�e work �ar whic� �his Dermil is issuetl, I s�all na� employ any De�son in any manner so as to became
subjecl to I�e Workers' CompenSalion Laws ol Caldomia.
�ate: SipnaWre:
NOTICE: Ii, aller makinp ihis aeclaralion. you snould Decome subiect to ihe workers' CAmpensalion provisions of ihe LaWr
Code. you must lonhwn� campry witA such O�ovisions or this permit shall be tleeme0 rewked.
LONSTPUCTION LENOING RGENCY: I �er¢�y a��irm Owi Ihere fs a cOns[mCiiOn lending agenty for ��e OeAOrmante ol I�e wark for
wnich I�is permn i5 �ssued (Seclion J097, Gv. q.
LENOEX:
aoosess:
OWNEP BUIlOEB OECIABRTION: I �ereby ailirm ihat I am exempt imm ihe Contracmrs' State License Law lor i�e lollowing reason
(Seclion 7031.5 Business and Pmlessional COAe: Any city o� coumy whic� repuires a Oe�mii Io conslmcl, aller, im0�ove, tlemoliSR or
�eDair any Sirutlute. Orio� lo ils issuante. als0 r¢puires �he apD���an� tor SUCh p¢rmii Io lile a SigneO S�ai¢meni Ihai �e/5he i5 IitenS¢tl
pursuanl to i�e O�ovisions ol lne CW Iraciors' Slale license law (Chap@r 9(cammencing wilh Section 7qq) ol Division J ol t�e BuSiness
ana Pmlessions Code) or thal ne/she is ehemo� tAeretmm antl the Easis for ine allegeA exemption. Nny violation ol Section 7031.5 by
any apDlicani lar a permit SUGjttiS I�e apD�iWni to a civil penalry of noi rtrore lhdn live �untlred dollars (f500�.
I. as owner of ��e pmDeny or my emVloyees xith wages as their wle compen5dtion. wiil Co t�e woM, ana the
❑ vmcmre is not imenaea or ollerea for sale �SecUon 70aa. Business an0 Pwtessional Code: The Coniractors' Slate License Law
tloe5 n01 apDly Io an owner ol a pmperiy who OuiltlS ar impmve5 i�ereon, antl w�o tloes SUCh work Aimselllhers¢Ii or t�rough
his ot her own emD�oyees, provitled t�at such impmvements are not inlended or offeretl for sale. II, however t�e builtling or
improvement is sola wil�in one year ol complelion, ��e owner vnll have ihe UurOen ol proving Aels�e aid nai Uui10 or impmve
for ihe purpose ol salel.
I, as ownef ol the propetly, am exclusively conVac�ing wi�h Iicense0 conlraciors to cons�mc� the prolecl (Sec�ion 7044, Business
❑ antl Pm�essions Cotle: fie COniraClors' S�a�e License Law Ooes no� apDly lo an owner o� pmpeny who 6wI0s or improves thereon
ane wno coniracis lor such pmiecis wilh a conlractor(s)license pursuanito ihe Coniractors' Stale License Law�. I am aware
ihal pioo� ol Iheir Woiker's Compensation insurance shauld be Dmvi4eA Io me.
� i ein e.emP� unaer Section: HP%QQ Q B. 8 P. C.
mn/nis�easqo�:p ApI,L WORK BY OWNER�/� /J /
Date: _(O' X, d— 7� Uvner� /�!N � l .��G�
I tla �ereUy certily Nal I am aware ol antl untlerstan� tAe reQuiremenis ol Calilomia Heall antl Salety Code Sections 25505. 25533, antl
25534 and Iha� I or any lulure Ouiltling occupanl willlwill nat (circle one) need to com0ly wilh 5ai0 s�a�e wtles antl Ihe iequiremenis for a
permil lor constmction or mo0ilication Imm I�e Air Ouali�y Managemeni OiSlricL Resiaen�ial con5�mciion applications are eMempi Imm
inese o�ovisions. �
Date: ppDlicanc
I �ereUy certily I�at I have reatl ihis aOVlication and state ihat t�e above inlormation is torrect. I ag�ee to wmply wit� all ciry anA county
orCinanc¢5 antl staie lav5 relating ta Emlding conArut�ion and heteGy aNtqr¢e repre5¢nlaiiv¢s of �his tiiy Io enier upOn i�e a00ve-men�im¢a
O�aOeriy /lor mspeqion purposes. � �f�,. ��� /�/
�ale: (O �a�- 9� Signamre: _�/� � ` ' �
Onvee'S License a� Social Securily .: �/
t6a1-46 Whne—Bmltling; Green—Co�c Enlorcemem; Canary—Appl¢am: Pink—Revenue: GOldenro0—Assmw�
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 05257
PERMIT NO: P 052579 PLAN CHECK NO:� N GOVT: N SUPP; N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION ; RELOCATE WATER HEATER, WASHER 6 DRYER SQ FT:
CLAIH VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
COMMENTS: RELOCATE APPLIANCES TO TAE GARAGE.
**�t*****��+�*�r**�r�*x��r�t***�r�c*�t*�r�t*+�*�r**�r�r��r�r�*�**�r*�c�**+r+t�r*��r****+r*+��r**�c+t*******
2 O N I N Gs ERTEB�AUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING --------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 19144204 ZNE; R1 REF NO•
PLANNING Ni51'ES> RELOCATE WASHER AND DRYER INTO EXISTING GARAGE, MUST
> MAINTAIN A 20'X 20' INTERIOR GARAGE DIMENSION.
*�r�r�r�e**�r�*�r**�r*�r*�***�r�**+�r�r******+r**�r**�r+�*�*r��r�r***�r****��r*��r*�r+�+r***+�*****�r*�r J
D E V E L O P M E N T S E R V; I C E S �. R E(J U I R E M E N T S /
20NING APPROVED HY `! DATE; �=
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: '2p` �
kiFkkiFkiEit�E�Elfif�FiFffkifififiEifiE ifiFiflkaEififiFaFaf Mjf
kjfiFlF�IklfififlE�EifiElk3kiElFififMifkiFififififitiflfifikiElE�lEififafilk�F�fitKifiFfkiFif 1fiflf�fiFififkiE�E�fiflfiFiEiFif3FiFiEiEMlf3E3f�f�fif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 6�52 SMIP/NON—RES
PLAN .
ISSUE FEE 3.00 -'�
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 6.00 3.00 , 0.00 9.00 9,00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 9.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
9.00 -•
k if if iF if if ik iE �1f �IElF iE �f �f if �E k if if �f if iF if if iF iF k iF N 1E iF iE iE if aF if iE iE iE iF iE k iF �E i! iF it iE k iE 3t if iE K iE if If iFiF aE iF if iF iF iE k iF iF iF 3F iF if iF iF �E �E iE if iE
I N D I V I D U A;.L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I b N UNIT COST TOTAL COST
PLD 1 LAUNDRY TUH OR WASHER 2.00 2,00
PLU 1 WATER HEATER AND/OR VENT 2.00 2,00
PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 2.00 2,00
'END OF FEES
�
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CONSTRUCTION AND PLANNING � POOL & SPA i
APPROVALS Permit # Date Inspector AppROVALS Permit #
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
. 'y.'��trPcal Condalt,�iility-Undrgrnd. 54. Forms
ua �-� .. �, ,
-�,�}: jl�cuical Condgu.Undrgrnd: 55. Electrical Bonding �-, �
�;'V6.:�i�Q R�inforc'e�f7+a T 56. Rough Plumbing & Pressure TFs"�
���;�i: ctoccal UF�&���y+d. 57. APPROVAL TO COVER-GUf�I,�E
:=[7nFootitigs :�:% 58. Electrical Conduit�Undrgrnd. m
r
`K-, 8. Foundation � s 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Unc�jrnd.
10. Structurel Floor System 61. APPROVAL TO DECK �"
11. Propeity Sewer Liqq & House Connection 62. Backwash & Receptor-Final •
12. S;wer Cap 63. Heater & Vent�Final
��
13. Roof Drains .� 64. Plumbing System - Final �
14. Fbugh Plumbing '� . 65. Electrical-Final �
. 15. Rough Electri�i�Conduit 66. Solar System-Final �
16. Rough ElectriC-Wiring 67. Fencing & Access ApProval ��
17. Rough Wiring�Sjgn 68. APPROVED FOR PLASTERING ��•
18. Rough Electri�l-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20� �Ruggh �acto[y �place � x n ��y * � Ct ? � PP r~� � � `�- �� ±
flOVFtl1S;�OPermit# -
� s' rn�� Y� ,.��. y
r � t _ �
21�Dt{�5, icStwCt�e' �`'"�" :s a: S.` Hx �` ;70. �Ind�rg�n�d H�ro x '�
22. Dutts, �ntiiatin � i � s a `
9 . ✓:`�' Q� ��:71. ProduaFe'iping �6as QOiI
23%GaS�ipc�Rqtigh di'�est ; ��.M1. � ^ `T ^ r•F' -; ;72. Underjib�n� FtQ;sk; R '�
N I C*5 �k !*l tr rC O:K .x ,
tv � � d': Ja� v ' ,
24v-+Rogf Framing ,,}:: i____. ..�,._. . � p�"'.� .. ; 73Y- Undergrrt:f. Stonaqo'Tank� Gas � Oi!-�
25. Rqof Sf�Cathing `= ; � ni * h+ tr,*1 : i .il x x;: �� Overhead�fiydrOj`' x�
a� ."1., v• Y� j C_:r r, 's
26>,�T��'rir Ceiling (St ctural) &SiNpnocoat� . 4 � rn O m�� �t- 75r Dry Chemical '�� �- 7 �� „
�
27`�Frameand Flashin� u' '=� �`� �^`' �' 7g"Dr Stan,�j� pe �? Y-, =" �''
v ? :� .^ Y 4�� r' Y CC"ru '-•Q1:L < Si�.
i I r ^y �-r?7(, '�. �' :r }+x :e �v.. :
�28"�a,f(iin¢�Siding,-.e:c. •:y,q �.C� rS. •-xx 77�:� FIXED ;STE��iNAL* c; �+
29. Insulat`�'n ��''� .� .••• : �';� -:i: p7 i 'r �r. x. fq�,
�'� ' I tr� Y �� FIRE PREV. FIN(�L * �„�,
' r.y - :F !O W ' ~ +
.30. DrywaldrfJailing;=.: �� �'*,� 1 � � � w �-; •v� •rbEAL�M;DEPTr.;E?�EQUIR �ED
�37. PlasrerB own C3b. .� � %� • .�• r �. 79��1'NAL�FitS ECT� N `. - s �'
. � - rr:r - i: i *' • � � U^, 3
E-� ' 'I. 'J,: Y - / ' �k F� ''
_32; Electrical Po`�, er�jeter�Fina;'u` x;o �:r ; 8q��F00D C�EA`fIFi�TE ISSl7E[{� ��7
33;'�Fin.el Electr;c -;� � � �'�� �' m I I , r t N� es: '7/a"fq � OIf�_i�t�!±Y�
Y r k.. P7�
`3a,.F�n`�.'� Heati'n"`g_ &�F?3. E`o��ti¢r�3"� ^ � - * K � � . � 'c s n•v � ; !��
35r�Firiel Gas Pij2•T�69t� a `:}' �7/`pla� (�j�. x� .. .� r c x-� �
.� .� . � ' Q ^ -� ! �--'-
A3B.''Hdy{i or"CanoP�:� ;�� � n..... ,��.0 a n � �F +. I- s na .•n ;`a U
-37�Fi�l FSctory FirePlace � ��T' `-'S� � ^� i � * . � . '
.. K �+ t c. -- a. � . : ;Y ' ' ` :f. O
38' Fi yal Pl�Imbin a, tK f.. .. �p *• - e•„ �, [*' v .y
}, 9 :M �J i �n - x� �i li�:%r- :� S :U
'�39. W�tar Service�Final � i =i•x t /'7 �r � � (� n .w tt; • te7
- x y ♦ i-
' 40. Gas Ser�:ice-Final �' �'Np i �. x H • > r7 .
.J e::i] �Y,[*'rr �Sf- %: CT! I a .. :j� OfJ :�.
-41. Solar D,omesticFina� 1� •�5 x' '_ I f � x� yo r: ��
r o c ^'
"42?Backflo'w Prevente -`' n� '�^`• �. � r: �� 'i �.`'. �
� N -+CJ �i r. cK ? F � �
�� .,-
43. Backflow Ircigation � �S i '.`.. r� x x. ' iKi- � O ���+��
.� �. 7
�'.44. Lands � e l�ripati`n SYste '^ ^ '�� � x: .� :' c�� :�� '' �� ��"��
n SP A '�tn:a c;ca t m u o:.. »�• ro o� �r., x ca aco
, - .. .
-.45;,Sound Att�uation �-+(Ce-� h' ?" � F '� !-- * � `-+ 'sq, �;� v .
n .r .,. � F r, x
� .. .. V �- - .
�4�`�HandicanF�e'ulati, ns G S� x a� •• ••x y.• i i -!o .•a-� >:
9 � �; o^ » ���- � s o:� s �
��47;�F1(�4L STfi{ICT � E & B � .LDING �+.-�. y ._ i i �.'�. * s. • N S �✓ .X
y4�'�FI�L PLAYVNIN� i p,�_, r. "� "� �� ' -
:r :,� �: t n1 •S
�49,:, Elgqtric Release to�Edison � a: `i `. x. �- x�� i :k '=+
i r .�
,�5Q�,Gas,Release,�o Sot7�Them Cal�for�a Gas Co � � I ���'� ;. ,' ti ._ �� F �"�+`;
'51. CE�TIFICATE OQ OCCUP� � ; � �; ��, _ ,� ��"
No. Date
Date Inspector
�
S
4
,�
/2
�r ��� ��
�
-OWNER R��+aara Tk+�._ Cn_ DATE $-29-Si.. .
lOB ADARESS 34l NASCAI] RA _ _ . .. • ' BIIdDING PEI�3IT NO. �. �. .7i67- � `
GENERALCONTRACTOR I7i.ke &'Cole�rove. IIIC. VALLISS 13,919.00 �
AP. No. LOT �j TRA
GROfIP I & J 1'ypE
INS
Twt
coat
:IC' •
ZONE
DATE I SUBCONTRACTOR
PLAN
s. w/att. garage
PERMITSISSUED
..�.:,-_:.� '%�3d'7`?'
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
Nassau Road
COSTA MESA. CALIFORNIA
ADDRE55�9 �'+• 17th SU•
CITV COnSt+$ "'"�$g� �!�
ARCHITECT V$i�� broo
OR ENGINEER
ADDRE55 Garden �OQe
St
LEGAL
oescniPrior+
A.P. NO.
SIZE
OF LOT 7� x
USE OF
E%ISTING BLOG.
SET64CH L�NE FFOM
cErvrEa oF srR[[r SO� REAR YARD 3�
SIDE YARD RIGHT ZO� LEFT lO�
DESCRIPTION OF WORK
NEW � ALTERATION. I ADDITION
REPAIR IIMOVING I IOEMOLISH
5 ZELDING 1365 8• 1UROOMS 6 STORIES
E%TERIOR WALL ROOF
cnVFRiNr, Stl1CCO COVERING CO�•
TNOL�.• �11J�
LIC.
NO.
QTV LIC. n"
NO.
T,��d.. 5-1159
TRACT �[.754
NO.OF 0LOG5.
NOW ON LOT IIOIIB
USE OF NEW
) '_ r�
�= �= 6'���,�a �—;; ;
AU� 27 I958 �� �
. FI{1',"P�CE DEPi:
. . n�..-.i f'-�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO
r:.p i
RECEIVEO 9v O/�TE RECEIVEO DATE-ISSVE
�� �
ILDING
COSTA MESA. CALIFORNIA
FIRE
ZONE
ZONE/� '
�Z-�-
APPROVE�
BV
I MERE9Y TCKNOWLE�GE THPT I MIS APPlIC�1TION PIJO
STATE TMPT THE F00VE IS [ FECT RNO FGREE TO COMPLY WITH ALL
CITT OROINpNCES PND ST (F ♦WS GULiTIN UILUING CONSTPl1C�
TiON. VALUATI ON
SIGNATURE OF
PERMITTEE
� � $13,919.00
AUTHORIZED AGENT —�"e & Colegrove, 1.LyC•
CORRECTIONS
PERMIT FEE S 32��
P�AN CHECK s 16�VV
TOTAL FEE S I}H�O�
VOMf