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Home My WebLink About3350 NEVADA AVE - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3350 NEVADA AV Suite No Vicinity: Parcel Nunmber: 13957114 Applicant: NOCK, TIM Address: 11612 KNOTT ST GARDEN GROVH, CA Owner: NEWKIRK, MARY BETH Address 3350 NEVADA AVE EAST COSTA MESA, CA Contractor. NOCK PLUMBING Address: 11612 KNOTT ST . GARDEN GROV�, CA Arch / Eng : _ Address: ' ISSUE FEE . Backflow irrigation BackBow Preventer' Bathtub Clarifier System � . Connect (Ice,Soda,etc) Dental Uni4s Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earihquake Valve CHANGE OUT WATER HEATER AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY PLUMBING PERMIT Phone: (714) 8951246 Zip: 92841 Phone: Zip: 92626 Phone: (714) 8951246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY - AMT Laundry Tub / Washer $0.00 Landscape Irtigatlon $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 R) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0:00 Sink, commercial $0.00 Sink, Floor $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: O6/11/2003 Issued: O6/11/2003 ISSUEDBY: ��`� ��\ SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Pipin9 (Inst or Rep.) Water Re-pipe Water Service AMT 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by ihis pprmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wi�hin 180 days, or if work is suspended or abandonetl for a period of 1 BO 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 inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2a46d8 (B/00) WORKERS' COMPENSATION DECLARA710N: I hereby ettirtn under penalry oi perjury one oi the following declarations: ❑ I heve antl will meinteln a tertitiwte of ton5ent t0 selFlnSure for worker5' compen58li0n, es provided br by section 3700 of Ihe labor Code, for Ihe pedormence of ihe work lor which �his permit is iuuetl. .� �1 have end will maintain workers' compensation insurance, as repuired by section 3700 of Ihe Lebor Cade, for tha pertortnance of the work br which Ihis permit Is issued. My w'qh19(1sn' cwmIp'e�/nsetlan Insurence car er aF tl ruo number are: / % )Q m � Cartier��i(�lY �r� � /v� � POIfcyNum6gr: 1� [ �4�/ZW (ThIs sectlon need not be comp/efe il the permit is valued at one huntlred dollers ($100) or less.) � ❑ I certiy thet in the peAor enc of the work fo µhich ihis permit is issued, I shall not employ eny person in any manner so as to become subject to the workors' compensetlon lews oi C��lom , tl gree Ih i If I should become sub�ect to the workers' compansetlon provisions oi Section 3700 of tha Lebar Cotle, I shell lorthwlih comply with Ihese provi 1 ns. 7�^ �� r� � A licam Si neture:' O�ate: L� PP__9 WAPNING: FAILURE TO SECUR WORKERS' CAMPENSATION (`pVERAGE IS UNL4WFUl. AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND QVIL FlNES UP TOONE HUNDRED Tt10U$AN� DOLLAFE (5100,000) IN ADDITION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PPOVIDED f-0R IN SECTION 3'!OB OF TH� LAgpq CppE, INTEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm that I em licensed force entl ettect�lic, a � �ConiraC�5KJ09WfB (commencing with Section 7000) of Division 3 ol�he_Business entl Pro essions Code, end my license is in tull G899'k� 3 ,Detei ��- v CONSTRUCTON LENDING AGENCY: ❑ I hereby ettirm that there is e wnstruction lending agency for ihe pedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). Lentlefs Name: Signeture: _ OWNER-BUILDER DECLARATIONS: LentleYs Atltlress: Date: I heraby aHirtn thet untler penelty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business antl Professlons Cotle: Any ciry or counry which requires e permit to consiruct, alter, improve, demolish, or repair any strucWre, pdor to its issuance, also requires Ihe epplicant tor such permit to file e slgneC statement that he or she Is Ilcensed pursuant to the provisions ol the Contractors License Law (Chapter 9(crommencing with Section 7000) ot Didslon 3 of t�e Business end Professlons Code) or that he or she is exempt therefrom and the besis lor ihe alleged exemption. Any violation ot Section 7031.5 by any applicant tor e pertnit sub�ecis the appllcent to e civil penalry of not more then five hundred dollars ($500).): ❑ I, es owner ol the property, or my employees wlih wages as �heir sole compansation, WILL DO THE WORK, and ihe siructure is not intended or oHered tor sale (Sec. 7044, Business entl Professions Code: The Contracbrs License Law aoes not appty to an owner of pmperty who builds or impwves thereon, end who does such woAc himself or herself or ihrough his or her own employees, provided ihat such Improvemenis are not Intended or oNered for sale. Ii, however, ihe building or Improvement is sold within ono yeer ol complotioq the owner-builder wili have.the burden of proving that he or sho did not 6uild or improve for purpose of sale.). ' ❑ I, es owner ot t0e proDerty, em E%CLUSIVELY CONTRAC7ING WITH LICENSED GONTRACTORS to construct the pm�ect (Sac. 7044, Business end Pmtesslons Code: The conirectors Llcense Lew tloes not apply to an owner of property who builtls or improves thereon, end who contrects for such pmject with e coniractor(s) license pursuant to the CoMractors License Laws.). ❑ I am e:empt under sec. Business and Professions Code for this reason: SlgneNre: Date: Owner ID verifieE by Cnver's Ilcense. es ❑ No DriveYs License No. Expir05: Vedticeiion of Ownership by (lype of daument, i.a. - property tax blll or tlaetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certiy ihet no excavation five (5) or more leet in tlepth inio which e person is requiretl to tlescenq will be matle in connection with work authorizetl by this permil, and Ihat no building slructure, scaHolding, falsework, or demolition or dismantling Ihereol, will be more then ihirry-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Cellbmie Administretive Code). ❑ As owner-builder, I will not employ enyone to do work which would require e permit Irom the Dlvision of Intlustnal Safery, as notetl above, unless such person hes e pertnit to tlo suc� work irom the division. SignaNre: Date: Division ot Intlustnal Safery Permit Number: CERTFICATE OF COMPLIANCE AND AUTMORI ON OF ENTRY: I enity under penelry oi perjury Ihat I have read ihis epplication and state Ihat ihe information given Is correct. I agree to comply with ell stete lews en c y or nances rei ng to building consiruction, and euthorize represemetives of the City of Costa Mesa to enter upon the above-descnbed propeny for inspection purpos s. Aqr�not to yCc�or allow occupency of eny builtling authorized by this permit until finel inspection. C�L � CODE I. INSPELTIONTYPE 1, QAIE INTITIRLS V 1618 Fized System Final Fire Prevention 1266 200 201 202 Pool Spa Final Final Ro-Roof Finel BIocWRetaining Well Final Factory Fire Place COOE� INSPECTONTYVE 206 Final Mechaniral 20B 210 212 220 Finel Plumbing Finel EIBCIrical Finfll Fire Prevention Finel Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuiltlingiOcr.upancy Q�f. �� L � (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626 BUILDING PERMIT �obAddress: 3350 NEVADAAV Suite: Vicinity: PITCHED PORTION OF SFD Parcel Number: 13957114 npp�icant: MILLER, DALE Address: 13781 NEWHOPE ST GARDEN GROVE, CA Owner: NEWKIRK, MARY BETH Address 3350 NEVADA AVE EAST COSTA MESA, CA Contractor: DALE'S ROOFWG Address: 13781 NEWHOPE ST GARDEN GROVE, CA Zip: 92703 Arch : Address: Zoning: Phone: (714) 534-6398 Zip: 92703 Phone: Zip: 92626 Phone: (714) 534-6398 License: 503508 Eng: Address: Phone: Status: ISSUED Applied: 11/26/2001 Issued: 11/26/2001 �SSUED BY: � Phone: Zip: License: License: SCOPE OF PERMIT REROOF PITCHED PORTION ONLY: TIO EXISTING WOOD ROOF, 7l2" CDX PLYWOOD, 1 LAYER 30# FELT, INSTALL 25-YEAR "TIMBERLINE COMP SHINGLES." � 18 S�UARES � Plan Check: Permit: SMIP Res: SMIP Com: Other. I nspection: Total: $0.00 $111.25 $0.50 $0.00 $0.00 $0.00 $111.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: 0 NOTES: Rear 0-0 Rear 0-0 Re uired: 0 FEESUMMARY PLANNING & ZONING LeR 0- 0 LeR U- 0 Pro osed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0. 0 $4,300.00 $4,300.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and becoma void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considared legal, such work must comply with all applicable codes, and all requlretl Inspectlona and flnel approval must be obtained. Failura to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 � zmaae �eroo� WORKERS' COMPENSATION DECLARATION: - I hereby ettirtn under penalry of perjury one of the tollowing declerations: � ❑ have and will meintain a certificate ol consent ro self-Insure lar workers' compensatlon, es provitled for by sedlon 3700 0l the Lebor Code, for the peAormance of the work tor which ihis pertnit is issuetl. �I have and will main�ain workers' compens�tion insurance, es required by section 3700 of Ihe Lebor Code, for the peAortnence of the work for whic� this permit Is Issuetl. My workers' wmpensatlon In rance ce�Aer antl policy number ere: !/!/` / Carrier: �'��r �!/-�—i-/ Policy Number. ��fS ^/`7 7 h (7his section nee nat be completetl il fhe permit is veluetl et one huntlretl dollers ($ f 00) or /essJ ❑ I certify that in the pedormence of �e work for wh�ir,6� this permit is issued, I shall not employ any person in any manner so es to become subject�to tha workers' compensatlan lews ot ie, ntl egr a the Pl.�hould become su6�ect to the warkers' compensatlon proNslo Sectlon 700 0l the Lsbbr Cotle, I ahell forthwl�h comply with th85e pro i51on5. {,9 // ��/� Applicent SignaNre: LL� Date: � oVj � WARNING FAILLIRE i0 $ECIIRE WORKEFS' WMPENSATIqJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FINES UP TOONE HUNDRED TFqUSPND DOLLARE (5100,000). IN ADDITION TO T11E COST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECTION 3]OB OF THE LABOR CODE, INTEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em licensetl untler prqvisic force end eHecL Llc. q �� S ContrecroYs Signature: Chapter 9(commencing wi�h Sectlon 7000) of Dlvlsion 3 ot Ihe Business entl Pm ssions Cotle, end my license Is in full ClassM_ �—�� Dete: //—.R% — % CONSTRUCTON LENDING AGENCV: ❑ I hereby aHirtn that there is a consiruction lending agency for t�e pertormance of the work tor which this permit Is issued. (Saa 3097, Civil Cotle). Lender's Neme: Lender's Address: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby eHirtn thet under penelry ot perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Business end Profeulons Code: Any ciry or counry which reQuires e Oermit to consiruct, alter, improve, demolish, or repalr any structure, pnor m its iuuance, elsa requires ihe epplicant br such permil to file e signetl stetement thet he or she is Ilcensatl pursuent to tha provisions ol ihe Contractors Llcense Law (Chepter 9(wmmencing with Section 7000) ai Divlslon 3 of the Business end Pratessions Coda) or that he ar she is exempt therefrom and the besis for the alleged exemption. Any violatlon of Sectlon 7031.5 by eny ep011cent for a DertN' subjects the ap011cent to a dvll penalry of not more then tive hundred dollers ($500).): ❑ I, es owner ol Ihe properry, or my employees with weges es thelr sole compensatlon, WILL DO THE WORK, an0 the structure Is noI Intendetl ar aHeretl for sele (Sec. 7044, Business and Professions Code: The Contractors License Lew does not apply to an owner ol property who builds or Improves ihereon, end who tloes such work himself or herself or Ihrough his or her own employees, provided Ihat such improvements are not Intendea or oNered lor sele. If, however, the bullCing or Improvement Is sold within one year oi completion, iha owner-builder will have �he burden ot proving thet he or she did not builtl or improve for purpose oi sale.). ❑ I, as owner oi the Oroperty. em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business entl Professions Cale: 7Te cantractors Llcense Lew tlaes not epply to an owner ol property who hullds or Improves thereon, antl who camrects tor such project wlth e comrecbr(s) license pursuant to the Contractors Licanse Laws.). ❑ I em exempt under sec. Signalure: Owner ID verified by drivefs Ilcense. ❑ Ves ❑ No Business antl Professions Cotle for ihis.reeson: Venfication of Ownership by (rype of document, i.a. - proparty ta: hill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Dnvers License No. Dete: E:pires: ❑ I hereby certify Ihai no excevation fNe (5) or more teet in depih into which e person Is required to tlescenq will be made in connection with work euthonzed by Ihis pertnit, antl that no builtling swcture, scaflolding, felsework, or demolition or tlismentling iheraot, will be more than thirry-si: (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celifomia Administretive Code). ❑ As owner-6uilder, I will not employ enyone to do work which would require e pertnit trom t�e DlNsion of Indusirial Selery, es noted ebove, unless such pereon hes e pertnit to do such work irom the division. Signature: Dete: Division ot Intlusirial Safery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AIffHOR1ZA110N OF ENTRV: I cenity under penelry of perjury iha� I have reatl this epplication entl sta�e Ihet ihe informelion given is correct. I egree to comply wlih ell state laws end city ordinences relating to bullding construction, end euthodze representetives of the Gty oi Costa Mesa to enter upon Ihe ebove-descnbed properry for inspection purposes. I egrea not to occupy or ellow occupancy of eny building euthorized by this permit until final inspection. n ' Sip a Of Legal Owner(s) Data /I- .�--� And/Or Aut�orized Applicanl Date COUE 1. INSPEGTION TYYE 1618 FixeO System Final Flre Prevention 1266 Pool Spe Final 200 Final Re-Roof 201 Flnal BIotWRetaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolitlon � �s � � CODEt INSPECTIONTYPE 206 Finel Mechanical 20B Final Plumbing 210 Final Electrical 212 Finel Fire Prevention 220 Final Planning Approvel 222 FinelSi�e 250 Final Building/Oaupency ceie u�S (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDIN6 p1Y1S10N DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT JobAddress: 3350 N�VADAAV Suite: Vicinity: FLAT SECTION ON RESIDENCE ONLY. Parcel Nunmber: 13957114 Applicant: MILLER, DALE Address: 13787 NEWHOPE ST GARDEN GROVE CA _ Owner: NEWKIRK, M,4RY BETH Address 3350 NEVADA AVE EAST - ,� COSTA MESA, CA Contractor: -_ DALE'S ROOFING :Address: 13781,NEWHOPE ST l��> :� � i,�-/ _ .. , � . GARDEN GROVE CA , Zip: 92703 Arch : Address: PERMIT NUMBER ' 699-00752 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OS/261t 999 Issued: 05/26/1999 Zoning: � ISSUED BY: Phone: 714-534-6398 Zip: 92843 Phone: ' ' Zip: 92626 Phone:. 714-534-6398 License: 503508 Eng: - Address: � ' Phone: � � � ' Zip , License: Zip: , License: � ' � SCOPE OF PERMIT � , ,' REROOF: T/O ROCK ROOF; USE EXISTING SHTG; 4 LAYERS FIBERGLASS FELT; REROOF WITH NEW ROCK ROOF. 9 SQUARES. � � � . \ \. � ��; 1 ` � � . � A��` `, � �� Phone: ` Plan Check: ' Permit: SMIP Res: SMIP Com: Other: Inspection: � Sotal: $0.00 $62.25 $0.50 $0.00 $0.00 �0.00 $62.75 \ SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existin : o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY _ _ i PLANNING & ZONING LeR 0- 0 Lek 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: . $1,980.00 � s�,9e0.00 ', ,. � Right . 0. 0 : , ' Right 0- 0 NOTICE: The work authorized by this permit shell comply with all applicable handicap access requirements under California statutes and related ragulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall autometically expire and become void if work is not commenced within 7 BO days, or if work is suspended or abandoned for e peiiod of 180 days. INSPECTIONS: In order for the work eulhorized under lhis permit to be considered legal, such xrork must comply with ell applicable codes, and ell required Inapectiona entl flnal epproVel must be obtained. Failure to obtain inspections end final approval will result in the expiretion of ihis permit. FOR INSPECTIONS CALL: (�14) 754,5828 WORKERS' COMPENSATION DECLARATION: , I hereby etlirtn untler Denalty of Oerjury one ot the following decleretlons:, �. �' ,� ' i .., ❑ I heve anC wlil meintaln e certificate of consent to selt-Insure tor workers',CAmpensetlon,'es provided for by.section 3700 of the Lebor Code, tor ihe peAortnance of ihe rk tor which this permit Is issued. I have end will mainiain workers' canpansation insuranca, as requiretl by section 3700 oi the Labor Code, for the pertormance of tha work for which this permil is issuetl. My workers' compensation Insurance carner end poliry numbar ere: ' Carder. Policy Number. (Thls sectlon need not be crompleted i/ the permit ls velued et one hundred dollars ($100) or less.) � ' � ❑ I certiy t�et In tha eAortna e of the work f r which ihis pertnit is issued, I shall not employ eny person in any menner so es ta become suDject to Ihe workers' compensetlon lew o lit a, and a_ rea tl 1 shoultl become sub�ect lo Ihe workers' compensetion provisions oi Seclion 3700 at the Lebor Cotle, I shall forthwith Applicanrt S gnalWra es prohs o0 ��" oa�a: .s—aG — 9 9 WAFNINQ: FAILURE TO SECURE WORKERS' CAMPENSFTION CAVEPA�E IS UNLAWFUL ANO SHALL $UBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO IXJE HUNDRED THOUSANO OOLLARE (5100,000), IN ADDITIIXJ TO THE COST OF WMPENSATION, DAMAGES AS PROVIDEO F-0R IN SECTION 3]W OF THE LABOF WDE, IMEREST, AND AiTORNEYS FEES. LICENSED CONTRACTORS DECLARA710N: I hereby ettirm ihat I em IicayeeQ unjd�r provislon;pJ Chapter 9(commencing with Section 7000) of Dlvlslon 3 ot the Business and Pmfesslons Cotle, antl my Iicense is in tull torca end eHect Llc. p / I// /// Class u ComractofsSignawra:� � � Date: .S—�, —� CONSTRUCTION LENDING AGENCV: ❑ I hereby ettirm t�at �here Is a cnnsiruction lending agency for the performance oi the work for wNch this permlt is issued. (Sec. 3097, Civil Code). Lentler's Name: Lenders Atltlress: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby effirtn ihat untler penalry at perjury that I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business antl Protessions Cotle: Any ciry or counry which requires a pertnit to consWct alter, improve, demolish, or repair any structure, prior ro Its issuance, also requires the applicam tor such permit to file a slgnetl stetemeN ihat he or s�e is licer.setl pureuent to t�e provisions of ihe Contrectors License Lew (Chepter 9(commencing with SecHon 7000) ot DiNsion 3 of the Business end Professlons Code) or thet he or she Is exempt t�eretrom entl the besis for the allegetl ezemption. Any violation oi Section 7031.5 6y eny applicant for a permit sub�ecis the applicent to e civll panalty of not more Ihen five huntlretl dollars ($500).): ❑ I, es owner af t�e DroOerty, or my employees with weges es their sole compensation, WILL DO TME WORK, antl the siructure is not Intended or otfered for sale (Sec. 7044, 8usiness end Professions Code: The Contrectors Licensa Law tloes not epply to en owner of properry who builds or improves thereon, antl who tloes such work himself or hereelt or through his or har own employees, pravided ihat such improvements ere not Intended or oHered for sale. If, however, ihe Duiltling or improvement is soltl wlt�in one year oi completion, the owner-bulltler will have ihe hurtlen oF proving thet he or she did not build or improve for purpose ot sele.). ❑ I, es owner of the properry, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct lhe project (Sec. 7044, Business antl Professions Code: The coniractors License Lew does not epply to en owner of properry who builds or improves ihereon, antl who contracts tor suc� pro�ect with a comractor(s) license pursuent ro the Contrectors License Lews.). ❑ I am eaempt undar sac. Business and Professions Cotle for this reason: SignaNre: Date: Owner ID vanfietl by tlrivefs license. ❑ Ves ❑ No Dnvers Ucense No. Expires: Vanfication ot Ownership by (typa af document, i.e. - property taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y certlty that na ezcavation five (5) or mora feat in tlepth into which e person Is requlretl to tlescentl, will be matle In connection wlth work authonzed by this permit, antl ihat no builtling structure, scaHolding, falsework, or demolition or dismantling thereot, wlll be more Ihan thirty-sis (36) feet hlgh. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Californla Administretive Cotle). ❑ As owner-builtler, I will noi employ enyone to tlo work which would require a pertnit fram tha Division of Intlustnal Satery, es notea ebove, unless such person has a pertnit ta do such work trom the division. SigneWre: Date: Divisian af Indusinel Safery Permit Number: CERTIFlCATE OF COMPLJANCE IWD AUT110RVATON OF ENTRV: I certity under penalry ol per�ury that I have raad this application end state that the information given is correcl I egree to comply wlth all state laws end ciry ordinances relating to building consWction, end euthonza representatives ot ihe Ciry of Coste Mesa to enier upon �he flbove-tlescnbed praperry for inspection purposes. I agree not to occupy or allaw occupancy ol eny building authonzetl by this pertnit until Ilnal inspection. ' e Oi Legal Owner(s) ate � i -r S—��9 And/O Authonzad Applicant Dale COOE �' INSVECTIONTYPE � 1616 Fixed System Finel Fire Prevention 1268 Pool Spa Flnel 200 Final Re-Roof 201 FInaI BIocWRetaining Wall 202 Final Fectory Fire Place � 203 Final Sign 204 Final Demolition 244&68 pA7E I[�II1�L9 � � COOE 1 INSPECTION iYVE 208 Flnal Mechanical - 208 Final Plumbing 210 Final ElecMcal 212 Final Fire Prevention 220 Final Planning Approvel 222 Flnal Si�e 250 Final Building/Oaupancy �g INTRIALS nooncsswam�ar�c: TUNNICLIFFE, ALFRED L FLOOi�T: AE-37 °""Eas"nxEiFro+a"": TUNNICLIFFE, ANNE E a°o"Eu: 3350 NEVADA AVE 'OSTA MESA,CA 92626457-7027 AVPI. IW 11NG /i00flE55: I�PCXRECT OR FHtlNEEfl: LIC. NO.: /iNLX.OP ENQ'4 �OOXE55: UNT: CONff1ACTON'SNdNE NOCK PLUMBING ( 714 ) 895-1246 cam�croxa �uuxa 11610 S EAB OARD C I R STANTON CA 707775 AOD��' 90680 � uc.ra.: UNT: LICENSED CO�MpX$A�CyTpOnR�9ppOpE�CIAR�TION: I hembyyyMa'vqm quoMx paneXy M�,pqe�r�^ury �Ihtly�yI Jem IkeruW uynyd�,e�pr �pproWsloyna �N,Chepur B CRY LIC. N0, U] U J�Lf ba � C^ CUS4: Bl. � J Oe � ��Np�� ,/�/ /// i�nw b In t X L' � U L� 9% om•: � j1 // y� comreaorjV U� I�/"!'�3l� j/A� T OW NEF BUILDER DECLARATION: I Mntr/ elfirm uMar pan4y M perjury Ilw I un wmq hwn tM Corttretlon Lkanea Lew for ihs folbw'vip rwon (Sopion'l0�1.5 Bus'uwe� end Prdwiona Catls: Any cry v oounly whi[h isqulros e pe�mX to oon�Vucy, eller, Imparo, �demoleh, w np�ir eny etmauro, pnm w ile beueno, eho reQuira� Iha eppliunt lor euch permit m flle e sipneC eW ameM �hv M a the ie limneed punaenl w iM podeian d IM Commaon Liwme lew �Chapbr B(eommoMnp wl�h 9Mbn ]000) M DHbion � d Ihe B�einm enE PrMeaeione COEa� a Ihet hs a ehe ie uemp �herehom aM ihs Mau lor Na NIpeE mempion. My vioWion M 6Mion ]031.5 b/ eiry epplifan� Iw e pwmn wbpes �he eppliunt lo a pvil panely ol (w1 mwe ihen IHe huiMied tldlen �f500�). � 1,esownerdlhepropanyarmyempbyaec�tilhwepeauihe'vedewmpeneation,willdoihewak,and�heel'uclurtorwtintentleE improvemmb era M imeeMetl a oflemE fa eab. n.lwwever. IM W Ikinp a mpovamenl q eoN wtlNin vr Y� d mmplelcn. IM owner-0uiker will heve �M buMen d provirq M or eha did m� Wik w improve lar Ihe puryme d eele�. �, I, ea owner W �he pmpaM� em eMNuaivety mnlredinp wil� limnaed conlreclon to cantlrucl ihe prol� (Saqon ]OId, Buaimce eM Pmleasiom Code: The Conirvfae I.icenae Lew doea �wl eppy lo en owror d papeny who buiNa ar impavea �hereon end wlw contrens la wM prqeds wiU a mnveew(a) licemed Wnuent to �he Contredan l'xeree Lew�. � I em axmmq ueder Section: B. a P.C.. br Ihia mewn: oa<: o�.�a: i m na�nr �.nM �ne� i em ewere a ene u�mrsi�a ine �a��remmu a ca�comie Heenn ene se��r coee seaam uws. zssaa. e�w 2553a. eM �I�ei I«eny M1nure WiWieq ampent xill / wil � �arcb one) need io romply wdh sad deta cadee vM ihe reQuirementa for apa�mnlormnslruclionamoEilWionhomiheAir u-6TIre0emani�iatnd.Reaitlentielwnzlrudionepplicelionsereexampt/roml�eae proWsians. Dete: ApdceM: W OHKEH'S COMPENSATION DECLANATION: I hereby aifirtn unEer peneXy d perjury ora d the lollavnng dedereiiona: � I heve anA xil meinlen e cenilicele d mnseni io aeHrnwn br xakere cwnpense�ion, m Wa+�deE �or by Sedion �100 d �he Lebar Ci0'�B.�IXI�1B D>1�0I111811CB 0��118 MIXk�p W�1ICh1�19�Ie1111J b18lYBd. �] i ne� �e we m�m� waw�� o�re��, ��,�. ��a��a nr s<a�oo a�ao a ma �eo� coaa. w ma oerto��,� a ma .o� i�.,nKn m�a o�a m ��,aa. My .ax�re �'�,"�'iE'1'0°°'�A�'L°,�a wra ��mna, e,.: E X P I R E S c�a,: ��, a a, nn 09 /01 /96 catv N�me� (Tliis secfion neeE nm 6e rompbteJ / I�e pertnrt is ia orie hvMmd ddlers (SiOJ) or bss.) � I canLy Ihe� in Ine perlormenca N �ha wak ror whkh Ihie permit is ies�ed. I ahell nrn ampby eny pe�mn in ury mennar eo es to E%OIM BUMBtl �O IM1B WGI(Bf9 Cp11Pe�961W11 �9W9 O� Ci9�1�OR11B. Bfld 991BB �1191 1� � e�ldl� bB1:d11B &IbIBtl �O IM NOf�fBfH� compenalian pwisom an 3100 d IM leha Catle. I ehell ��^hyMipnpl/ xilM1yqge po+ieion. l/ � \ oeie: � Z7. `/ lo nnor e�c � l.,r. 1__.�f Wem/ny: Fellun ro swun woAren' compmsatlon covmaps b un/awNl, enJ sM/bub/scf en employer ro ctlMiul pe�u �nG� c/NI flroa ,q ro ons h�nGred fhouuntl dellan (5100,POOA �� sodltlon ro tl�s casf ol rompenut/on, Aameps es pnvllatl br /n SwNon 9]O6 0/ ihs Lebor Corb, Infersif, entl aMornsY'a �ns. CONSTBIlCT10N IENDM� AGENCY: I hereby aifirm unEer penalry of perNrv �hm �hem ia a mnatmqbn IenCirp egerwy Iw the perlormence d ihe wM la wl�iM Ih'v permi is ssued (Seeun 3091, Cv. C). LENDEH'S NAME: LENOEN'S AOOFESS: I ceniry �het I heva reeE Ihia epqicetim end pme �hm �he ebove inlormmbn u corieq. I epree lo wmply Milh all tlly enC county oNinenma aM s�a Wws mlei'vq to Wik'up consruclion aM Mreby eulhorae reqesamefnm d ihu dry m enter upon iM ebwa.mentioned propaM �°��^soatlion��. RON NOCK � Pnm Neme / Deie�%1% �� Signelure oi OxnerlAganVAppL�'anV onVetla (5151-,B.WP) W�ha-Buildiq 8 Sefely: Greerr-Fle: Cenery-Appireni: Fnk-fimenue: Gddenrod-Rsaeaor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 0769 1 PERMIT NO: P 076921 PLAN CHECK NO: N GOVT: N S . CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION : DISHWASHER C/O SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT �*************�****��*��+�*�*�*��**�***x*�**�x�**x******+��****+��****��*��**� 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 HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN I.EFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13957114 ZNE: REF NO; PLANNING NOTES> i 1E 1E iE iF ik iE fE iE 1E 1E 1E 9E fE fE 1E iE iE fE iE 1E if iE 1f 1ElE 9E 3E iE IE iE iE 1E iE 1E �E iE iE iElE �)F if !E iE iE ik ik if !k iE If iE * IE 3E 1F iElE Iflf ik iE iE 1F iElE iE iE iE �E if if dE jF if �E �f 3E iF if 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 HY ___________ DATE: BUILDING APPROVED HY : APPLZCATION ISSUED BY: I/vS� �� 1E'�1EiEiElEihiEiElE9E3E9E3EiElEiEiEfEdElEiE��f3F3Fi�iF3f�3f��FiE3fTF�F3f3f3f3F �fTF�3fTF�f� LEGALIZATION;N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMZT 7,00 258 DATE: DATE: r� iF iF iF 1E 1f iE iE iE iE iE iE fE iE iE 3E�E ib if �E jE � iE �IFiE 3E STRUCTURAL SEGMENT;N FIRE SMIP/RES GRADING SMIP/NON—RES PLAN ISSUE FEE 20.00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 7.00 20.00 0.00 27,00 27,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 27.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 2�%,�0 iE iE 1E iE iE iF i6 iE iE if iE 1E 1E iE 1E if �E �f iF if iE if iE ik if iE 1E 3E fE iE �E iE if 1f �E �E IE jE �E �F �E 3E 1F iE af 1E fE 3E 1E iE 1k 1E fE IE iE ff iE 3E if ff 1E iE ik jE 3f iElE �f �E fE 1E IE iE iE jf fE IE IE 3E I N D I V I D U A L F E E 8 R E A K D 0 W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 DISHWASHER 7.00 7,00 END OF FEES ei U0: �..�•_� -i 1.3ai. 'F- -- DiaTF. p.':.-r,�, . , j • r- .., �' CONSTRUCTION ANDPLANNING POC SPA APPROVALS Permit # Date Inspector pppROVALS . Permit # Date Inspector 7. Temporary Electriwl Service or Pole 52. Pool & Equipment Location � 2. $oil Pipe•Undrgrnd. ' 53, Steel Reinforcement �, � 3. Electrica� Conduit Utility-Undrgfnd. 54. Forms �. 4. Electrical Conduit�Undrgrnd. •. 55. Electrical Bonding - '5. Steei fieinforcement 56. Rough PWmbing & Pressure Test �� 6. Elec2rical UFER Grnd. 57. APPROVAL TO COVER-GUNITE , 7. Footings � 58, Electrical ConduirUndrgrnd. S. Foundation 59. Gas Pipe, O Undrgrnd., Test ' ! 9. Water Pipe-Undrgrnd. . 60. Backwash lines, P.�Trap, � Undrgrnd. 70. Structura� Floor Svstem 61. APPROVAL TO DECK . ' i 1. Property Sewer line & House Connection 62. Backwash & Receptor-Finai +. 12. Sewer Cap . , 63. Heater & Vent-Pinat 73. Roof Drains 64. Piumbing System � Finai 14. Rough Plumbing 65. Electricai�Finai ' ' 15, fiou h ElectricabConduit � 9 66. Solar System-Final 76. Rou9h E�ectric Wiring , , 6). Fencing & Access Approval !� 17. Rough Wiring Sign ,, 68. APPROVED FOR PLASTERIf+jG "18. Ro�gh ElectricabT Bar Ceiiing 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Cond�.ioning PIRE �EPT. REQUIREMENT 20.. Rough Factary Pireplace � . - APRROVALS Permit # 21 � Ducts, in Structure - 70: Underground Hydro � 22..O�tts,Ventifating , 71. ProductPiPing�LJGas OOii 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framin9 73. Undergmd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing �. � - 74. Overhead Hydro 26. T�Bas Ceiling (Structurall & Monocoat � 75. Dsy Chemicat 27. Frame and Flashing - 76. Dry Standpipe 28. Latfiing & Siding � 77. FIXED SYSTEf�� FINAL 29. Insulation - 78. FIRE PREV. FINAL - 30. Drywall Nailing ' . . ,.HEALTH DEPT. REQUIREMENT 37. Plaster 8rown Coat . �� 79. FINAL INSPECTION 32. Electrical Power MeterFina( � 80. FOOD CERTIF�CATE ISSUED 33. Finai Electric Notes: � 34. Finat HeSting & Air Conditioning �_ ; 35. Final Ga5 PiPe�Test . � � �� 36. Hood or Canopy , � 37. Finai Factory Fireplace 38. FinaiPlumb�ng p�.j�-}W�-jl/'��:,'� l�-/�l ��.j: t 39. Water Service-Finai • 40. Gas Service-Final : 41. Solar Oomestic•Final . 42. Backflow Preventer � � 43. Backflow Irrigation , 4G. Landscat�e irrigation System . � 45. Sou�d Attenuatio� 46. Handicap Regulations 47. FINAL STRUCTURf & BUILDWG , ., - 48. fINAL PIANNING �� ' 49. Electric Nelease to Edison ' 50. �Gas Release to $outhem Califomia Gas Co �° " 5i. CERTiFiCATE OF OCCUPANCY No Date CITY OF COSTA MESA REQUEST FOR OCCUPANCY TRACT N0. % LOT N0. � ADDRESS � � S� �%(.Pj2?�i� (�-C' � ��% `r":'� DATE / —��' — �� The developer o£ the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (he-she-they) was or were) advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the city at the time the final tract map was approved. The city assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the city harmless from any claim resulting in demage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. BY ' � � l/ • urchase B Developer and/ r horized representati e � ender OWNER ApOLLO DEVELOPMENT DATE 4-20-70 JOB ADDRESS 3350 Nevada Avenue BUILDING PERMIT N0. 31684 AP No. LOT IN""ECTIONS s GAS ROUGM PLUMBING MISCELLANEOUS ROUGH HEATING AN� AIR CONDITIONING TEMPORARV SERVICE OR POLE UN�ERGROUNO � POWER � ROUGH WIRING TRENCHES � FORMS � STEEL REINF. FLOOR SVSTEM BONO BEAM � STEEL REINFORCE � SHEATHING FRAME AND FLASHING v' PLASTER, BROWN H� P� E SUBCONTRACTOR e Z . d U HZ 2� O �n am �7 J N Q W p] J J m a U N za w� a w W Z J Q m Z J � W W 0 z� W � N � �O `� I 684 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.HOX 1200 COSTA MESA.CALIFORNIA 92626 Paio 141.Q0 �'PH 2?_-7Gcnse001296� **°' forApplicant to Fillin Completely APPLICATION FOR BUILDING PERMIT RECEI DAT RECEIVED DAT ISSUED BUILDING 3350 Nevada Ave. - �� -%d ADDRE55 PERMIT OWNER �i O�.LO Develo ent Cor . A.P. No. �'� I�.Q MAIL BVILDING ADORESS 110�# E, 1]CIl SY. ADDRESS 0 Ne ad A cirv Santa Ana No�' S47-9673 raacr 6694 �or 41 s�ocK L�ENDER�ION U S, National Bank W Main Office X BRANCH OWNER Apollo Development Corp. ADDRE55 190 S. Broadwa San Die o vn�u� ARCHITECT Kermit Dorius rE�675-1164 s Residence OR ENGINEEP �d '/ 3111 2nd Ave., Corona Del Maz ZONE TVPE ✓ GROUP � ADDRESS CONTRACTOA Apollo Development Corp. ByPROVED DATE AD�FESS 1104 E. 17th St. NE NO.OF USE OF N cirv Santa Ana No�47-9673 � Puns'� BUILDING STATE CITV YARDSAPPROVEO YARDSAPPROVE ��c. No. 252549 LIC. NO. 1690 MAIN BUILDING ACCESSORY BUILDING SI2E NO.OF BLDGS. (FROM G STi1EET) OF LOT SO X LOO NOW ON LOT —' RONT FT. FT. VSE OF �f EXISfING BLDG. � " FT NEWBLDG. �-]7O S.F.qQOMS 7 STORIES �- L.SIDE O FT. FT. EXTERIOR WALL er ROOF COVERING Plans COVERING WOOd Sh1R Le REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DSTANCE BET. BET. MAIN & MAIN BLOGS. ACCFSS. B�DGS. VAR.# OATE i.ORStLllCt RE'.W residence C.U.P.vys APPROVEO with attached gaYagej �ROVED � � I ho�aby ackPowlatlga tha[ I have �eatl thif eppllcation antl sta[e that the ebova Informallon h correct entl apree to comply with all lows reBulPting buildlnp consttuction, entl 1 shell not employ ony person in ��oletlon of the workmon'a companantion lawa of the Stete of Galitomle. � �J(y u I heraby certify that I am properly Iicensetl es n contractor untlar /�� SQ. FT. %C� � the Steta of Ce�Hornia B�sinass entl Profassiona Cotle, Dlvisicn 3, THE AMOUNT SN N UNDER VAIUATION IS FOR Chapter 9, end that sueh licensat ere In full force antl eftect, or 1 TME PURPOSE OF ESTABLSHING A PERMR FEE ONLV: � em azempt f�om [ha provlsions of t�e State of Ca�ifOrnla Buzlnau � antl Profeaslane Cotl Divislon 3, Cheptar 9. VALUATION / D� a 7EFMIT FEE S � Slpnotura ot ,/ / � �5 � Parmlttee „ 5 J/��D PLAN CHECK 5 � ��v i Gv lJ/ C� � Authorizatl Apo�i TOTAL FEE 5 ///�J O