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Home My WebLink About2816 NEVIS CIR - Building Permits4��p MF t o. T , .. . o t �6 � �.�� fi � , CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • v✓ww.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754•5626 PERMIT NUMBER: BC10-00341 PERMIT TYPE: B COMBO Sub Type: RES_ALT JOe ADDRESS: 2816"NEVt$-CPCM APN: 13943159y Vicinity: REAR OF PROPERTY Const Type: V-B SQ. FT: Zoning:R1, , 112 STATUS: ISSUED DATE ISSUED: 08/OS/2010 ISSUED BY: RMD Suite/Unit: Primary Occ: Valuation: $6,000.00 SCOPE OF WORK: CONSTRUCTION OF A 112 SF ATTACHED LATTICE PATIO COVER WITH BBQ AREA. GAS LINE AND ELECTRICAL CONDUIT TO GAS ELECTRICAL BBQ AREA. OWNER: PANCAKE, JAMES R TR Phone: 714-546-1959 APPLICANT: YBARRA, JASON Phone: 562d93-0429 CON7RACTOR: R K T DEVELOPMENT INC Phone: 562d93-0429 Cell: ARCHITECT: � ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund TOTAL FEES: Address: 2816 NEVIS CIR City/State/Zip: COSTA MESA, CA Address: City/State/zZip: License No. 819072 Address: PO BOX 508Unit: City/State: LOSALAMITIOS,CA License No. License No. $81.41 $125.25 $41.70 $0.00 $29.65 $0.60 $0.00 $1.00 $279.61 Unit: Unit: : ZipCode 907230 PHONE: PHONE: ^Reter to fee recei ts (or all fees altl for ro'ect HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Montlay thru Fritlay-7:00 am thru T.00 pm. Saturtlays-9:00 am thru 6:00 pm. Prohibited all hours - Sunday5 antl the following Fetlefal holitlay5: New YearS DaV. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksaivina Dav and Christmas Dav NOTICE: 7he work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28. § 1. 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. FaiWre to obtain inspections and fnal approval will result in the ezpiration of this permit. COUEi. INSPECTIONttGE DATE INTITIALS COOEp INSPECTIONTYPE OATE INTITIALS 1676 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpaFinal 208 FinalPlumbing x ��—�—��! ✓h� 200 Final Re-Roo( 210 Final Electrical . i�� ' 4�� V�� 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final $ign 222 Final Site L,� 204 Final Demolition 250 FinalBuilding/Occupanty �( �I �"7 � � U�� WORKERS' COMPENSATION DECLARATION: I hereby aRirm under penalry of perjury one of Ihe following declarations: ❑ I have and will maintain a certificate of consent to selt-Insure (or workers' compensation, as provided for by section 3700 of the Labor Cotle, for [he peAormance of the vrork for which this permil is issued. ❑ 1 have antl will maintain workers compensation insurance. as requiretl by sectbn 3700 of the Labor Code, for Ihe peRortnance of Ihe woAc for which this permit is issuetl. My workers' compensation Insurance carrier and policy number are: carrier7 e� �l ��•p L9 ti( l�R.. Lt. �2--. ��+�-S (This seIXbn need not be mmp@le(eC r1 fhe pe�md is valued af one huntlred dollars (5100) oi less ) PolicyNumber ��"�}2 % i�i-�s�-6/ ��%� ❑ 1 certi(y tha[ in the peAormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensa�ion laws of California, and agree lhat i( I should become subjecl to the vrorkers' compensation provisions of Section 3700 ot the 4e Code, I shall rthwith comply with these provisions. �-5-/D ` piiexM's5ignaWre Dat� e_ ��...�'7 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENA�TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that 1 am licensetl under provisions of Chapter 9(commencing with Sec[ion 7000) o( Division 3 of the Business and Professions Code, antl my license is in tull force and effect. !2 Lic-#--- _�C�ass•,#- !-� � � �d racta's�5tgnaWre ��e.-�-�' CONSTRUC710N LENDING AGENCY: ❑ I hereby affrtn ihat there is a constructbn lending agency for the peAortnance of Ihe v.vrk fa which Ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Dale OWNER-BUILDER DECLARATIONS: I hereby aNrm that under penalty of perjury [hat I am E%EMPT FROM THE CONTRAC70RS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permit to constmct, alter, improve, demolish, or repair any structure, prior to i�s issuance, also requires the applicant for such permit to fle a signed statement that he or she is licensetl pursuant to Ihe provisions of ihe Contrac[ors License Law (Chapter 9(commencing with Sec[ion 7000) of Division 3 of the Business and Professions Code) or tha[ he or she is exempt there(rom and lhe basis for the alleged exemption. Any violation o( Section 7031.5 by any applicant for a permit subjects the applicant [o a civil penalty of not more Ihan five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with vrages as Iheir sole compensation, WILL DO THE WORK, and the strucWre is not intended or oKered for sale (Sec. 7044, Business and Professions Code: 7he Conhactors License Law does not apply to an owner of property who builds or improves thereon, and who does such vrork himself or herself or through his or her own employees, provided that such improvements are not in�ended or offered for sale. If, however, the building or improvement is sold within one year of completion, the ovmer-builder will have the burden of proving lhat he or she did not builtl or impmve for purpose of sale.). , ❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITH UCENSED CONTRACTORS to consWct [he project (Sec. 7044, Business and Professions Code: The contractors License Law dces not apply to an owner of property who builds or improves thereon, and who conlracts for such project with a conl2c[or(s) license pursuant to the ConVactws license Laws.). ❑ I am exempt under sec. Business and Professions Code (or this reason: � Owner ID verified by drive� s license. ❑ Yes ❑ No Driver's License No. Expires: Verifcation o( Ownership by (type of document, i.e. - property tax bill or deed�: DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certify Ihat no ezcavation frve (5) or more feet in tlepth into wfiich a person is required to descend, will be made in connection with vrork autFrorized by lhis pertnit, and [hat no builtling structure, scaffolding, (alsewnrk, or demolition or dismantling thereof, will 6e more than thirty-six (36) (ee[ hiqh. (Chap. 32, Gry 2, M 2, Sec. 341, Title 8, California Administra[ive Code�. ❑ As owner-builtler, I will not employ anyone to tlo work which would require a permit from the Division of Indusirial Safety, as noted above, unless such person has a permit to tlo such vrork fmm [he division. ApP�iranfs SignaWre oale Division of Industrial Safety Permit Number _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant need to fle antl certify a Business Plan tor emergency response �o release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec�ion 25505 of the California Health and Safety Code requires, vnth some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time tluring a reported year a quantity of hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume ot 55 gallons, or 200 cubic feet of compressed gas at stantlar0 temperature and pressure). 2. Does or will ihe applicant or presen[ or fu[ure building occupant need [o (le a regisiretion form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 0( the California Health and Safery Code, with some exceptions, requires registra�ion with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely ha2artlou5 ma[erials eqUal to Or grea[er than a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard temperature and pressure). 3. Does or will the applicanl or present or fuNre building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely haZardou5 material5)? ❑ Yes ❑ No (Section 25534 of the Califomia Health and Safety Cotle pmvides ihat the Costa Mesa Fire Deparlment may require the preparation, certification and filing with the Fire Departmenl o( an RMPP by businesses which are required to register acu[ely hazardous malerials wi[h [he Fire Departmenl. 4. If an RMPP is presenlly required, has Section 25534 of the California Health and Safery Code been fully complied vrith? ❑ Yes ❑ No 5. Does or will the applicanl or Oresent or future buildin9 occupant require for the work which is the subjec[ of Ihis application a permit for such constmction or modifcation from the South Coast Air Quality Management District or from any other air pollution conlrol district or agency? ❑ Ves ❑ No (Section 658502 of ihe Califomia Govemment Code requires Ihat the requesled information be fumished on applications fa nornresidential building permits). 6. Will any part of Ihe facility to be constructed under ihis permit be within 1000 feet from the outer boundaries o( a school? ❑ Yes ❑ No Qf "yes", Ihe faciliry must meet the requirement of Sections 25534 and 42303 of lhe Califomia Health antl Safety Cotle). 7. If a permit fmm [he South Coasl Air Quality Management Dis[rict or o[her air polWlion con[r01 diStfiC[ of agenCy is required for the work whiCh i5 lhe subject of this application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes � No B. Qf "yes", attach certifcate of compliance from the appropriate air polWtion control offcer). CERTIFICATE OF COMPLIANCE: I certify lhat under penalry of perjury the information given above is correcL I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature oa�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry o( perjury thal I have read this application and state that the information given is correct. I agree lo comply with all state laws and ciry ordinances relating to building constmc[ion, and authorize representatives o( the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signawre of �e9al Ovmeqs) Da�e Signature �ate �� O 305]�46(3/0]) ntll AulM1wrzeO'AOObWnI 'Dale �8�� IBLG NEVIS CI �E��+�^T+ PANCAKE, JAM£S R �no�ss: z816 NEVIS CTR COSTA MESA,CA �VFL. Y/JlRlO IOORE54: 92626 UNi: ��Ta+�+� RODRIQ(lEZ ENGINEERS ��= C21639 ncx.on�as�oo�ss: 2816 E COAST HWY ��: D N.B. CA 92600 ca+m�crarawue: ULTRA LITE RQOFING ( 714 ) 895-4521 CONfRACTOP'SYNlINO 5082 BOLSA ST moxcss: H.B. CA ucao: 616679 92649 wn: 105 LJCENSEU CONTNRCTOPS DECLANATION: I MmW Nirt� uMm penelly d pujury tl� I em IicmneE under peaweim� d Cheqs B �commemi�Y xnA Seclion ]000) d OiJsion 3 W Ne Bueimn eM Pmimuom COEe. enE mY lioeime w in /uA /att aM Mlea. u r+o.:051082 uc.cuss: C_�9 uc.No.: 616679 EX�P�: 0.��3%/^/-97 I/,/et�e: �� Comraam �L7�LA-� � � �iY/ �^ v — tlW� BUILDEH DECLARATION: I hxeby dfrm uMa pa�yy d pe�juy ihtl I em e�emq hom tM Cav'anm lirom� Lew la Ihs �� Gro iae�on (5eac� ]m15 &�o. dd amtaaimn Code: �m cM s�Nv whi�n nauires a o�a �o amsm,a..ns.'vnpaa. \Nmdeh. p rapei em� NruUure. q'v b b iwvw. Wo reqwm tM epp4cem la wch pmme to fle e apid aatanrN tlW M a�M 34censed WnuerY lo Ihe Ywmons W ihe Caeq�ee«s lics�w lew ICMqs B(cammen�Y w9h Saaion ]000) d Dimian J d Ne Buriirn arA RWmaiom WCeI a itul Ir a ehe u e�emq Ihsehan aM ihe bue la the e1b0� naemqion. Nrv vuW un d 6wion ]0'J1.5 by vry epplirani lor a permn s�Ajea.r iM appfran� to e rivE peralry d M mae then fve hued�ed doAve �SSWU. � I.aiowrordihapmpe�ywmyempbyaeexihwepenbiMiwbmmpeneetion.vrillEoNexwk.eMNenruclunurwliMeMW w dlared lu �ele (Sect'an'l061. Businv erd PeMeasiay��: T�y Gorurepwa liwroe lewEoea nd epplyloan ownxd piape�y who buida w inpmvas Ihe�eon, eM who dom such xak timwX or M�se� or Nraqh he a Mr own empbyae�, povided IIW wM imqovememe ve eat inteMed ar dlaied la eele. M, however, ihe buiMiip a inpovemeM u voN xithin ma yaer W mmpbtion, the owrnr-0uiMm will M1eve �M WNm d po+iip he or Ma Dy �p WiM a imprwa la iM puepoae W eeb). � 1. m oxner G tM YWeM. am uduaiveM oonired�q WA IioneeE conVeclore ro cansl�ud Ne p9b (5aaion 101,. &n'vass ud Pmleaeime codo: TM Contrecwe l'rame lew don na eDON to en o�mer a O�WsM x1w Witla a imP�'w IMreon ud xho mnuec1a la wd� vr9�s �h e wmearfor(e) IkenseE p�nuem io ihe Convrfon lidiue lew). ❑ I em exemq unEer Sectim: B. 8 PC., la Ihb raeeon: Dete: �Tier: I do IweW cMM Net 1 em ewero d md uMe�abM iM �W�'vanam tl Cellomie HaeM end Se1MY Code SWiwu P5505. PS53J. end 3i4'N. md Net I a ur/ Mun drild'n0 ��_xiA / wW �(ertb one) meG b mnWY wih uid mts mMe mM IM iWW�ammb br •V�dlaaorowci'viamoECrmiontrwntMNsw yTi7��v�risu0iurie.RridM�mnlrWioneVD�'veenwmqhanNwe pweons. Dele: AOdkeM: WONKEA'9 CONFENS�TON OECLAP�TION: I Mreby elfi� uMer penelly W perpry me d Ms lolbwi�p Mtluticm: p �n.r..�dwmeiM.n.ceneisa.acon.em�o..n;nwr.�«.�axa:oomoapalian,..aovided�«Msemmslooa�n.leen, Cade. lu iM ps�mmerica of tM xvk fa which �hia pqmG e iauM. e�a.0 mev�ia:�.�en• mmv�� ,�. e+�.a�.a W s«i:n a�oo a me �eno, coe.. /« m. o.nw� d m. wark la which thn pmmil b uauod. My wake�J wmpq�umion i�uuruice far'w W pdicy r�umber vs: c� GO�gEN EAGLE EXPIRES PWiryNumber: iJGli7 — 06/13/97 (Thia se tion need nIN 6e complered i the pamrrt is Iw me hundreC dWlen /S10V) w baeJ 1 c ly Nel in Ihe pMameMe d IM wwk la Mfich ihia peimN i� iaeued, I ehdl m� ampby eiry permn in �ny menner n m to pe[� e wbjetl lo IM xdkare' canpenae�ian lev.+ d Cdilomie. rE eproe Nel il Mwld q tuEjW lo iM xqbn' co enutian roNeiaa Setlion �1a0 d iM lebar ��. I 1�h mmpy iMro pr � 1 onv. Deb: _ Md�unl: I minp: F�Y�n ro Neun woMwi rompwwtlon mr�r�p� I� unlawN4 �+�I a�!/cl m• lo r roWMrW pw�Wtlu uW clHr nnsi w ro on• hunerM MouaW Cdw. fJ100.P00J, m atle/tlan ro N. ewt o/ rompaueWn d+�W u provMW !or in �'ONSTfiUCTION LENOINO RdENtY: I Mreby elfirm wkyr pereXy d pnjvy thm then u e amn�uaon bnNiq epnrv.Y ��a pGf�q1110M! 0��1! NOf�l�O! YI�Y11(�1Y WITIIf ONBj�SBfJ�jI1'.109�i.CN.Ci�. IENUEP'S NAYE: LFNDEF'S �DOflE54: I cMily �hm I Mw ned �his eppliraiion eM pma �hel �he eEare iniwmetion 6 roma. I epne �o camply r.ith M dly eM mumy ad'vienu� eM etme lexe rslalinp b W iN�q wnsvueian eM hereby eut�¢s iepeeen�eiives d �hu my m enlx upon �M ebova�meMionM properly lorinapedan Durpoaea. ELDON ORGILL Pnm (7� A �c� ome:—J (5151�e WP) Whne-Buildip 8 Selely; areerFb: Cerory-Appirenl: RnkJie�enue; Cialdema�Mae�av ' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 079376 PERMIT NO: B 079376 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/O 6 REROOF W/HARDI SHAKE 3.OPSF SQ FT: 5,500 CLAIM VALUE: 5,500.00 CALC—VALUE: 5,500.00 GROOP OCC: R-3 /U-1 COMMENTS: X IE 1F IE iE 1E 1E iE iE 4 iF 1E 1E iE 1E 1E iE iE 1E 1E 1k ff 1F 1E 7E 1E IE iE Ik iElE 1E iF 1E iE if ii iF 1E 1E if 1E iF iE 1E iE if iE iE if iE 1f 1E 1k ik 1E 1f iE 1E 1E iE IE IE IE fE iE if if 1E 1E 1f 1f 1E iE �)E IE fE iE IE 1E 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 RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 13943159 ZNE: REF NO: PLANNING NdTES> - .% 1F 1f 1f 1E iF IF IE iE 1E iE I(� ff� 1E 1E 1E 1F 1F i! iE 1E IE 1E 1E'1E iE aE iE iF 1! ff if ik iF iF if ik if 1E 1E 1E 1E 1E IE iE iE iE fE iE iE i(� if iE iE iF if 1E if if i(� iF if if i(� iF iF iF 1E if iE.1E 161F 1E 1E iE 1E iE If 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N,�T S ZONING APPROVED BY DATE: HUILDING APPROVED BY : � DATE: (1 APPLICATION ISSUED HY: DATE: L ,��*�**�,�**�**�,�,�� *��*�***�* ��6 LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SE ENT:Y HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE -SMIP/RES GRADING PERMIT 112.25 55 SMIP/NON—RES PLAN , ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL�: �' P.AID DUE TOTALS----> 112.80 0,00 0.00 112.80 '"' 112.80 .00 REVENUE DIVISION TOTALS--> COLLECTED: 112.80 OVER/SH017T; .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT ,GRADING PLAN—CHECK 112.25 :55 • , �r��****x�*+��r+�+r+��r��x�*�xx�r�r�r*�+�+r***�r�***�******+�*x�e+�***x**��***x.x******�r**+��*��*� I N D I V I D U A L F E E H 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 5500 REROOF BY VALUE RESIDENTIAL NOZONE END OF FEES ' 1.00, 5,500,00 / � �.. �.� � 1 " ! / ��. �� f� SEP 3 19�6 , (',. � . �' -' --_,�.,.,..... CONSTRUCTION AND PLANNING- � � POOL & SPA . + � Date Inspector � � � Date Inspector 'APVROVALS Permit �h APPROVALSi PermiY# -'r ' V 7. Temporary Electrical Service or Pole 52. Pool & Eyyipment Location.. "� 2. Soi� Pipe�Undrgrnd. . 53. Steel Reinforcement � . 3. ElectricaF�Conduit_Utility�Undrgmd. 54. Forms ` . 4. Electrical-,Con�uit•Undrgrnd.' "�� 55. Electrical Bonding � ' '5;� Steei Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrica{.11FER Grnd. 57. APPROVAL TO COVER•GUNITE -' 7. Footings '� �. " 56. Eloctrical Conduit:Uodrgrnd. � � g, Foundation _' 59. Gas Pipe, O Undrgmd., Test � 9. Water Pipe�Undrgrnd. - � 60. Backwash Lines, P�Trap, [,� Undrgrnd. � � " 10. Svucturai Floor System 67. APPROVAL TO DECK "" 11, Property Sewer Line & House=Co`nnection 62. Backwash & Receptor�Final 72, Sewer Cap �" � � . 63. Heater & Vent-Finaf 73. Roof Drains � - 64. Plumbing System � Final 14, flough Plumbing _ - 65. Electrical�Final .-' 15. Rough Electrical-CoPdu�t . 66. Solar System�Final 16. Rough Efearic Wirirtg •• 67. Fencing & Access Approval � t7. Rough Wiring St9� �� -- 88. APPROVED POR PLASTERING � 18, Rough Electrical•T Bar Ceiling - 69. POOLlSPA SYSTEMS FINAL 79. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20..Rough Factory Fireplace -- ; - � . i� � APPROVALS_ ' Permit # � 21. Oucts, ir�5tructurE , '. . ' , ' - 70.- Undergrouad Fdydro 22, Ducts, Ventilating-. .. ' � : - 71. Product Piping'L] Gas O Oil 23. Gas Pipe-Rough &"Rst � .� 7z, Underground F1ush _ 24. Roof-Framing � - -- . - . 73. Undergrnd.StorageTank OGas ❑Ol 25. Roof Sheathing �' �^7.=R6. � 74. Overhead Hydro � 26. T�Bai Ceiling (Strucwral) & Monocoat - . � 75. Dry Chemicai � � -. � z7, Frame and Fiashing � ' ,_ 76: Ory Stand'pipe � ' ` 28. Lathing & Siding , - . •� s 77. FIXED-SYSTENLFINAi - 29. Insulation � � ' � � `• . 78. FIRE PREV. FINAL - -_ 30. Drywali Nailin9 � � � � -HEALTH DEPT. RE�U�REMENT 31. Plaster Browr�.Coat ' 79. PINAL INSPECTIDN � '� . 32. Electrical Powpr Meter�Final ^� ,„ .. -� 80: FOOD CERTIF�IQATE IS5UED 33.'Final Electric ' ` - � Notes: ._ � 34. Final=Heaiing-& Air �onditionin§._ - . - - _ , _ 35. F�nal-Gas Pipe•Test � ' .� '-' ' 36. �Hoo4i or.Canopy `' _ . ' _' ' ' ' r . ' ' _ . . . . ' 37. Finat Factory Pirepiace' -� '- � '. 38. Finai Plumbing � , � �� - � ; 39. Nlater Sar.vice�Final � � - , � ' 40. Gas Service-Final ; �, � , � 47. Solar pomestic-Final -: � . � � 42, Backfiow Preventer - ' - � . � � �/� _/' � ` �-�L - �� `'. f !IG Z �li 43. Backfiow Irrigation � ' - � � 44. Landscape Irci9atioqSVttem _ ' . • - - Gl�/L_�� y� � -,[ � �L�. l / (r=!/ 45. Sound Attenuation - ` - -- � �c = �c��- 46. HandicapFegulations _� _ ' " ' 47. FINAL STRUCTURE & BUILDING 9/�C�6 �'C.�j� . a ( � 48. fINALP�ANNING �, _ �--- , _ qg, Electrie Release to Edison � • � ` - . ; 50. Gas Release to Southern Califomia Gas Co -_- 51. CERTIFICATE OF OCCUPANCY - NO Date ' T PflOJECT ADOXESS: 2 8 1 6 NEVI S C I OWNEX'$ NRME: PANCAKE JAMES R aooness: Zg16 NEtIIS CIR COSTA MESA,CA RPCH/ENGINEEB: �O�flESS: 92626 flEC.NO.: uxir: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 06034 PERMIT NO; P 060346 PLAN CHECR NO; N GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE; PLU PURPOSE; OTH UNIT: PEflMITTEE: AAA SET ROOTER ( 714 ) 847-3445 A�OXESS: SGA%O BEACH BL 112 WESTMINSTER AV CA 92683 LICENSEO LONTpACTOB oECIANATION: 1 nereCy affirm tnat I am Iicensea under D�ovisions ot Cnapter 9lcommencing wilh Section ]000� ot Division 3 0l ��e Business an0 Prolossions Catle, antl my license is in tull brce and effect. c�,ruc.: �t/�� supTeuc.:649543///J cuss: C-36////� Daie: /� Nk� ` Z Sipnalure: _.(J'� � O�l� WOflKEflS' COMPENSRTION OECLABATION: I �ereGy affirm that I �ave a cenilicare ot wnsent m seif-insure or a certiliwie al Workers' CAmcensation Insurance, or a cenilie0 copy Inereol (5ectian 7800. LaE. C�. POIICY NO.: E%P. O�TE: COMPpNY: ❑ Ceniliea coOY is �ere0y fumis�eE. ❑ Ceniliea coDY is liletl vnih ihe ciq Builaing Division. � Oate: ADGlicani: �^ E%EMPTIONFNOMWOflNEPS'COMPfNSATI0N0ECLi1PRT10N: QhiSsec�ionneednolUeC6mDIe�eAilthepermi�i5foronehundr¢G�$100)orless�. I cetlity Ihal in Ihe periormance ol t�e work br which this permi� iy5 SueA. I shall no� employ any son in any manner so as to Uecome su0jeci lo Ihe Wo,ry(y/{s') �Com�pensaqliorn Laws ol Calilomia. (/ /) Q Date'. �� /�/ / � Sipnature: .6/� � �!{/'�✓�"' NOTICE: II. afler making IAis declaraiion, you shoulE become suDleci lo IAe Wo(kers' Compensa�ion pmvisions o� Ihe Labor CoGe. you mu51 lorthwi�� comDly wilh suc� pwvi5ion5 or Ihis permi� s�all be;tleemeA revoketl. CONSTPUCTION LENOING RGENCY: I �ereUy allirm Ihai Ih¢re is a cOnSlmciion lenaing agenCy lOr ��e OeMormante ol �he work �or whit� I�is permit is i55ue0 (Seclion 3097, Civ. C�. LENDEX: AUUflESS: OWNEN BUILUEB DECLAflATION: I hereby allirm Ihat I am exemp� �mm ihe ConVac�ors' State License Law lor �he lollowing reason (Section 7031.5 Business antl Prolessional Code: Any ci�y oi county which requires a permii to cons�mcl, al�er, impmve, tlemolis�, or repair any simpure. Drior lo iIs issuance, also reQuires ine applicant lor sucn oermit to file a signetl statement that he/she is licensed pursuanllolh¢ provisions ati�e Conlrati0r5' Slale License Law�Clupier 9�commenting vn�h SeCtiOn 7qp�ofDivi5i0n 3 Ofihe BuSiness anG Pmtesvons Co4e) ar t�ai �e/s�e is e+empi t�eceimm ana tAe ba4s lar t�e allege0 exemption. My violation ol S¢ction 703L5 Uy any aDD�itdnt loi a De�� suGl��s Ine appliWnt lo a civil penalry of no1 more Ihan five huntlrea aollars (S:d10). I. as ovmer of Ihe pmpetly or rtry employees xit� wd0es az t�eir 5ole tampensation, will Eo t�e wOrk, aM the ❑ s�mcmre ¢ not inlenOeA ar olfere0 �or sale (SeCiiOn 70E4, BuSiness an0 Protessianal CAde: The Con(ratlot5' S�ate LiC¢nse Law tloes not ap01y to an awner ol a propeny wlw 6UiIEs or impmves tllereon. and who does such vAd him5elf/herself or t�rough his ar her own emplayees. D�oviOeA t�al such imD�ovemenis are nat intended or oHereO for Sale. I1, however ihe buil0ing or im0�ovemen� is sola vni�in one year of comDlelion, I�e owner will have Ihe Curden oi proving he/she tli0 not builU or impmve far Ine ourpose af salel. I. as owner ol ihe properly, am eKdusively cOniracting wi�� licensetl camrac�ors to constmc� �he pmle�� (Seclion 7044, Business ❑ antl Pm�essions Code: The ConVatlors' S�afE Lit¢n5e Law Ooes no� apply �o an owner ot pmpeM who �uiIGS Or im0�m'e5 �Aefean an0 who contracis lo� SucA O�ol��s wit� a conlractor�s) license pursuan� to Ihe Contrac�ors $lale L¢ense Law�. I am awdre I�al O�oa� al t�eir Worker'S Gompensalion insurance shoul0 �e Dmd0e0 la me. � I am exempt under Sec�ian: B. 8 P. C. lo� Ihis r¢ason: JOB DESCRIPTION ; REPAIR SEWER LINE SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REPAIR SEWER LINE ONLY. NO 'B' PERMIT INVOLVED, ��e*�e+t+t�t**�r�*�r***��r�r******�e*�t***�t�t�t�t�t**�r*�r*�r��*�r+t****�t+r�****�r��***�****�r**�*�t** 2 O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING --------- FANT; 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: 13943159 2NE: REF NO: PLANNING Nt5'PES> i ,. *�r�r*�r�r*�r�r**�r�r�r�r�r�r�r�r�r�r��r�rxx�r�r�e�r��r�rx*****rt*�t***�t�r�r�r�rx��r**�r�r*x��r**�r�r�t��t+r�t*�r�r�r�r*��r D E V E L O P M E N T S E R V I C E S� R E Q U I R E M E N T S ZONING APPROVED BY r." DATE: BUILDING APPROVED BY : I DATE; —/ APPLICATION ISSUED HY: � [i�LQ�G/L�J DATE� /2�/�T79� if if 1f 1f 1f 7flE iF iE iE iEi! i! i! iE iE iE i! ik iF if if f! i! i! if i! if 1! ik if ik k if if �ElElF 1k iF ik if i! 1E i�f ikif fk ft iE �flFiF�! i! iE iF if 1E iE �f �t 1f k it 1E ih iF if iE k it iF 1t if if k if LEGALIZATION;N F E E S D M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTAIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15 00 '15t SMIP/NON—RES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 15.00 20.00 0.00 35.00 35.00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 35.00 OVER/SHORT: 00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR 35,00 if iF �f if if �f �flE i! i! iF ikit iFiFif if ik i! if fkit iF if if iE ik M k ik M i! ik If k!k iE ik iklf if k ik iF ikif �f if 1liE 1F it kilik ik k ik iF k 1f IEit 1k �f �E Ik fF!! ik!!!f �f iE IE IF �Elf M 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 Date: Uvner. PI.0 I Oo �ereGy ceriity I�al I am aware ol antl untlerstanE ��¢ requiremen�s ol Catifomia Neal�h antl Sa�ery Coae Seciions 255Q5, 25533, antl 25534 antl �hai I or any �ulure huilUing otCupan� willlwill nol (circle one) nee0lo Comply wiih Said Sla�e tode5 antl ihe requirem¢n�s tOr a permil for conslmc�ion or modilicalion irom Ihe Air Duality Management DisVicl. Resitleniial conslmction applicalions are eKemp� imm IneSe prOvisions. Oale: Npplicant: I �ereGy cetlily Ihai I have reatl Ihis aDPliCalion and 51aie Ihal ��e above in�armaiion is torreci. I agree l0 tomply wiih all tily anU COunry � ordinancesands�atelavrsrelatingmbuilEingconslmctionandhereDyaulhorizerepre5enialivesof��is' IoenleruDoniheabove�mentioneG ' pm0etly lOr inSDet�ion Dur0ose5. � 1 I �. Date: I�� _ Signature: � � ""'« �'� Driver's License o� Social Securily .: Aoolicant: Pmk—Revenue: Goltlenrotl—Asxxsmr 1 SEWER, BUILDING / TRAILER 15,00 15,00 END OF FEES CONSTRUCTION AND PLANNING POOL & SPA APPROVA45 Permit # Date Inspector qpPROVA�S Permit # Date Intpector 1. Temporary Electrical Service or Pole 52. Pool & Equ�pment 4ocation . 2. Soil Pipe-Undrgrnd., 53. Steel Reinforcement 4 i�� ,; 3;� Electrical GondiriF��Jtility-Und�grnd. 54. Forms 4. Elsctrical Conduit-Undrgrnd.,. 55. Electrical Bonding _ .� ,. � 5.:$t�el Reinforceme�t_ 56. Rough Piumbing & Pressure Test ` 6.. Electrical UFER�Gmd. � 57. APPROVAL TO COVER�GUNITE - i- i:� F:�btings • , 58. Electrical Conduit�Undrgrnd. „_ �8. Foundation � ' . 59. Gas Pipe, O Undrgrnd., Test '" 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�7rap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK � 11. P�aperty 5ewer Line & Hddse Connection ��ft��2 L� 62. Sackwash & Receptor�Finat T tz� �Y�'ef �P . �. 63. Heater & Vent-Final 13. Root Drains � � 64. Plum6ing SYstem - Final 14• qough Plumbing 65. Electrical-Final 15_ Rough Electrial-Conduit 66. Solar System-Final 16. Rough ElertricWiring 67. Fe�cing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough ElectriCal�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI 79. Rough HeSting & Air Conditioning FIRE DEPT. REQUIREMENT - . - o '��. - _ . _. 20:`RoughFactoFyFirEplace � - � �.� v • 'J" ��qPPRlQVA�$:-'-.Per�nit#� `� 21�_pubis, in 5iructuee . .. � ' . . ��_ -� �70. Undergr-0und Hydro � � 22. Du�Fs, Ventilatiri9'i •�r c �,; S� Y=71• Product:.PiQing QC}as C�OiI F'l: 1" y,l �J�, [ 'J. 23: �'ia{ Pipg`jiough & �est � . �, ,, �, ,, ; � ,7z, UndergroUnal Flush,� �e 24.7Rodf Framirrg i°�' •• * U tr _� x.73rUndergmcf.Stor9j�'7ank OGas ❑Oi1 25. f3oot Sheathing ;t � � � r � _ �"� � 74a Overhead Hydro�� . 26. -T-Bar Ceiling IStructural) &`Monocoat - 75i Dry Chemical � ' " � 27. Frame and Flashin§` �T, a.� Y., � 76:�Dry Standpipe � Y' ' r � `� 28. Lathing & Siding_� � . .� �- � ' � �� = 77. FIXED SY$'fEM�j�IQAL' ,_ ' � 29. Insulation � �� .. .� � 78sFIRE PREV. FINAL � � _ �30. DrywalWailinq .a . � - r HEALTH�DEPT. REQUIREMENT �-31. Plaster Bfiown Coat � � �x � ,.79`.`FifYAL''IfVSP�CTION .f �` '. 32�Etectricel PowerNleter�Finah �� - � u 80.-�FOOD CERTIFI�ATE ISSUED� �.33. •Firial Electric_ , , � - � � Notes: _ ,� �, - � 34.-final Heatinj.& Air Conditioning• � �i, - i-� �. . . , , 35. Final Gas Pipe•Test• L ' �' ' �� ' - ' � ' ' c' �_ _ 36. Hood or CanoPY_ ` - -� '< . � • .� ' '- . `37.^Final Factory Fir,eplace. � Y _ .` _38. Final Plum6ing . • . � � . .. _ r'f./f,�%G� " "' - � � � � -i c'39. Water Service�Fi�al � -'' ' � - • �' 40. Gas Service-Final� , . - � ,, . � "Al. Solar pomestic-Final . � ' • ' 42. 8ackftow P�event¢r ' . : . �; 43. Backflow Irrygation� � . � ; -� _ -, �44'. Landscape �rrigati0a System . -. . . ' .. ._ c �`45: Sound Attenua[ion ' � � - �� ' �46: Handicap Regulations ' � � �� . � -,_ � 47. fINAL S7RUCTURE & BUILDING � � � � � + 48...FINAL PLANNING i � . � .-49.. Electric Release to Edison I � �• ^ _ . r 50.,.Gas Release to Southem Calitomia Gas Cn . i � : ` .. ; 51. CERTIFICATEOF�OCCUPANCY .. • + � . No. Date � � l979� COSTA MESA BUILDING•SAFETY DEPARTMEPIT P.O. BOX 9f7 COBTA MHBA, CALIPORNIA Fo► Applicant fo Fill In Completely Tr. 4341( rrPe OR PRINT Lot 28 AD RE'SS �J' I \1 � `O�-'✓-1 \ .\' C COSTA MESA, CALIFORNIA OWNER Grove Park Construction, Inc., MAIL 1653 Minorca Drive ADDRESS arr Costa Mesa No • KI 9-( OR ENiGENEER E. G. Ka Itenbach No �772-3: ADDRESS 9772 Katella Ave.,Anaheim CONTRACTOR Mesa Verde Development Co. ADDRE38 1653 Minorca Drive ��n. Costa Mesa s`"Tv,. 181322 N�`�K19-0395 S'ZE 94 x 119 I NOW ONLAT O OF LOT USEOF ___ EXISTING BLDO. SETBACK LIMB PNOM � " � CBNTER OP BTRHBT 4'S REAR YARD Q SIOEYARDI LEFT b I R16HT � IO DESCRIPTION OF WORK ■ EXTERIOR WALL ft. RoomH 6 rrrnw�ra � WORK TO BE '1 HEREBY ACKNOWLBDaE TNAT 1 HAVB ReAD TNIB APPLICATION M1N� BTAT6 TXAT THH ABOVE 19 CORFECT ANO AOqE! TO COM- PLv WITH ALLiC11Y�OpO�NANC88 ANO 8TAT8 L11W8 RHOULATINO BUILDINOCOrbTROCYION. n ■ AUTHORIZED A6ENT r EE RECEIVED d� � 2 � 19@�° CITY 6F��j�Sl�EennR For Ofiica Usa Only REC81Pf NO. P Recarv ar wra aecerves re i eu fi� �-- -�- G; J i� sa BUILDIN6 (/�� a � ADDRES (J , (✓ .�v F7RE ZONE TYPE �� GROU APPROVED BY DATE ZONING r�.`� 2 8 NO. OP UeE OP N � PIl�NB OYILOIN — � � L60AL �J� � •� �� D88CqRT10N � � A.P.NO.� NOTE: NOEAVEOVERHANG6MALLBELESSTHAN YARDSAPPROVED MAIN BUILDINO :OM C/L STREET 1 / D19TANCE MAIN BLD� VAR. jC YARDSAPPROVED AGGESSORY BW LDING DATE ✓ � /� ZsaFr. S v�"� $ja!'nv��r n o THE �MOUNT�9HOWN UNOEH VALU�TION 19 FOR TX6 E PUHPOSH OF E8T/�BLIBHIN4 A PfiRMIT FE8 ONLY. � VALUATION / p.e m pERMITFEE $ G � � µ � 9 V d vV �/ �� O // � � ,' TOTAL FEE $ ��_�