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Home My WebLink About2345 ORANGE AVE - Building Permits. y t �� ` .► ,.�.'` .► (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c��ILDING PERMIT �� FAlfi DRIVE, COSTA MESA, CA 92626 JobAddress: 2345 ORANf3EAV Suite: Viciniry: RESIDENCE AND DETACHED GARAGE Parcel Number: 43926110 2oning: Applicant: HENNINGER, COREY Address: 12262 HESTER pL , . Phone; (714)534-7000 GARDEN GROV�, CA� Zip: 92841 , Owner: CROSS, MARY JO Address 23450RANGEqVE , - � _ . _ Phone: , � � -�COSTA MESA, CA - , Zip: 92627 Contractor: �ASSURED PftOFESSIONALS INC Address: 72262 IiESTER pL �, Phone: (714)534-7000 GARDEN GROVE, CA _ Zip: 92841 �. License: 760384 Arch : , � " � Eng: Address: � � � ' . Address: . . ' � Phone: Status: ISSUED Applied: 11/10/2003 Issued: 11/10/2003 ISSUED BY: � � �.� Phone: Zip: . License: , License: . - SCOPEOF PERMIT , REROOF RESIDENCE AND DETACHED GARAGE: T/0 EXISTING COMP ROOF,'REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER 30# ASTM FELT, APPLY "20 OR 30-YEAR COMP SHINGLES." 1500 SQ FT - � " Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $0.00 - $97.25 $0.50 $0.00 $0.00 $0.00 $97.75 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: 0 FEE SUMMARY Calc Valuation: Claim Valuafion: �,,r`�'� ' � � . Rear 0- 0 Rear 0- 0 Reauired: 0 PLANNING & ZONING Le(t ` 0- 0 Right 0- 0 Left 0- 0 Right 0- 0," Pr000sed: 0 : $3,163.00 , $3,163.00 i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIHATION: This permit shall automatically expire and become void if work is not commenced within 7 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all required Inspectlons and finel epprovel must be obtained. Failure to obtain inspections and (inal approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zaases �eroo� WORKERS' COMPENSATION DECLARATION: - �� I hereby eXirtn untler penalry oi perjury one oi t�e tollowin9 declarations: ❑ I heve antl will maintain a certificate of consent to self-Insure tor workers' crompensation, as provitletl for by seciion 3700 0l the Lebor Cotle, for the pertortnence of the work ior whith IhiS permii i5 issuetl. �fX ,I heve and will main[ain workers' compensetion insurance, as required by section 3700 oi the Labor Code, for Ihe peAormance of ihe work for which Ihis pertnit is issuetl. T My wos (com�oCsatioq Insuran carrier antl policy number are: / -'7 � 3 Carrier. �K� � 7 Policy Number. �6 � ! �� 6 - (This section need not be comp/efed i! (he pertnit is valued at one huntlred dollers ($f 00) or /essJ '� ❑ I certify t�at in the peAormance of the work for which this permit is issued, I shall not employ any person in any manner so es to become subject to lhe workers' compensation laws of Cell mia, antl agree that if I should become subjact to the workers' wmpensation provisions of Section 3700 of the Labor Cotle, I shall forihwit� comply with ihese vi s. //'l ApplicenlSignature: � � Date: /I�� 3 WARNINO: FAILURE TO SECURE WORKERS' CO�dP SA VERAGE IS UNLAWPUL AND SHALL SU8IECT AN EMPLOVER TO CRIMINAL PENALTIES AN� CIVIL FMES UP TOONE HUNDRED THOUSAND OqlAiiE (5100,000), IN ADOfiION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECiION 3lOfi OF THE LABOR CODE, IMEREST, AN� ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm Ihat I em brce end efted. Lic. �� Contractor's SlgnaNre: Chapter 9(commencing with Section 7000) of Division 3 of the Busines�n.tl�Proj.�ssions Code, entl my license is in full Class k '� �'! � Date: _ '— r� '� � � CONS7RUC710N LENDING AGENCY: ❑ I hereby aRirm that there is e construction lending agency for Ihe pedortnance of the work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lendels Neme: Signature: _ OWNER-BUILDER DECLARATIONS: Lender's Atldress: Date: I hereby aflirtn ihat under penalry ot perjury Ihat I am E%EMP7 FROM THE CONTFiACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also raquires the epplicant For such permit to file a signeC statement that he or she is licensed pureuent b the provisions of �he Conirectors License Lew (Chapter 9(commencing with Sedion 7000) oi Divlslon 3 oi the Business entl Professions Cotle) or that he or she is e:empt Iheretrom antl the basis for Ihe elleged ezemption. Any violation of Section 7031.5 by eny eOPlicenl for a pertnll subjects the applicant to a civil penalry of not more then five hundred dollars ($500).): ❑ I, as owner ol the property, or my employees with wages as their sola compensation, WILL DO THE WORK, and ihe structure is not intendetl or oNered 1or sale (Sec. 7044, Business and Professions Code: The Conirectors License Law tloes not apply to an owner of property who 6uilds or improves thereon, and who does such work himself or �erseN or through his or her own employees, provided ihat such improvements are not intended or ottered for sale. tl, however, the bullding or improvement is soltl within one year oi completioq the owneo-builtler will have Ihe burden ol proving that he or she did not build or improva for purpose of sale.). � ❑ I, as owner ai Ihe property, am EXCWSIVELY CON7RACTING WITH LICENSED CONTRACTORS to canswct the projed (SecJ04d, Business end Professions Cotle: The contracrors License Law tloes not appry to an owner ol pmpeny who builtls or improves t�ereon, end who contrects for suc� prolect wlih a contractor(s) license Dursuant to the Contractors License Laws.). ❑ I am e:empt untlar sec. Business and Professions Code for ihis reason: Signalure: Date: Owner ID verified by drivers license. ❑ Ves ❑ No Drivars License No. Expires: Venficatlon ol Ownership by (rype of documem, i.e. - propany taz bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICATION: ❑ I hereby ceriity that no excavation five (5) or more feet in depth into which e person is required to descend, will be made in connection wit� work euthorized by Ihis parmit, and ihat no building strucNre, scaftolding, falsework, or tlemolition or dismantling �hereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Calllomia Adminls�rative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permil Irom the Division of Industnal Selery, es notetl ebove, unless such person hes e permi� to do such work from tha division. Signature: Date: Division oi Intlusirial Satery Permit Number: CERTIFlCA7E OF COMPLIANCE AND AUTHORIZATON OF ENTRV: I certify under penalry of perjury that I have read this application and steta that the informetlon given is correc�. I egree to wmply with ell state laws end city ortlinences relating to building construction, antl authonze representatives oi the City of Casla Masa to en�er upon Ihe ebove-descnbed property tor inspection purposes. I agree not to occupy or allow occupancy of any builtling auihorized by this pertnit until finel insDection. COOE1, INSVECiIONTYVE 1616 Flxetl Sysiem Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Raot 201 Final Blcck/Retaining Well 202 Finel Fadory Fire Place 203 Finel Sign 204 Finel Demolition PdIE It�ALi // /� COUE� INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Pdg I�L� ��ia��sa-sz�a • Fax(774)754-4856 Job Address: Suite No Vicinily: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 2345 ORANGE AV Parcel Nunmber: 43926110 npp�icant: LORIE GLOVER Address: 2737 S CRODDY � SANTA ANA, CA PLUMBING PERMIT Phone: (714)241-1414 Zip: 92704 Owner: , ' CROSS, MARY JO � � � ' Address ' 2345 ORANGE AVE - Phone: COSTA MESA, CA Zip: 92627 Contractor: COAST ROOTER PLUMING HEATING & AIR CONDITIONING Address: 2737 S CRODDY , - , SANTA ANA, CA I . Arch / Eng : Address: ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect (Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Phone: (714)241-1414 � Zip: 92704 License: 529127 Phone: / ZiP; ._. � License: � � � SCOPE OF PERMIT ' WATER HEATER CHANGE OUT. AMT $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $a.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY QTY AMT Laundry Tub I Washer $0.00 0 Landscape Irrigation $0.00 0 P-Trap $0.00 0 � Pressure Regulator $0.00 0 Process Piping (per 10 k) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 0 Sewer Cap for Demo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $0.00 0 Sink, bar $0.00 0 Sink, commercial $0.00 0 Sink, Floor $0.00 0 Sink, kitchen $0.00 0 Sink, service/mop $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 03/10/2000 Issued: 03/10/2000 ISSUED BY: 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 (ToileQ Water Heater / vent Water Piping pnst or Rep.) Wa[er Re-pipe Water Service Water Softener OTHER AMT $0.00 $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 $0.00 $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 160 days. INSPECTIONS: In order for [he work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of �his permit. FOR INSPECTIONS CALL: (774) 754-5626 WORKERS'COMPENSAnON DECLARAnON: I herehy aHirm untler penalty of perjury one of ihe tollowing tleclarations: ❑ I have antl will maintain a certificate ot consenl lo self�lnsure tor workers' compensation, as provided for by section 3700 of Ihe Lebor Code, for lhe peAormenCe of the work tor which this permit is issued. � $ I have antl will mainiain workers' compensatlon insurance, as requiretl by section 3700 0l ihe Labor Code, for tha peAortnanca of the work tor which this permit Is issued. My w� ^ers' -copmpensation Insurance wrrier and policy number ere: y Carrier. 1 V 1� U � 4� �'1 M.i Policy Number: �DI O� R O O Cj (fhis section neetl nat be complefea i! (h permif is valued et one huntlred dollars ($100) or less.) � ❑ I cenify that in the pertormance 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' compensation laws of Califomia, antl agree ihat if I should become subject to Ihe workers' compensation provisions of Section 3700 of ihe Lebor Code, I shell lotlhwith comply with these prpvisions. � . Applicant SignaNre: �r! �L Date: �� 3 —�� WpRNING: fAILURE TO SECURE WORKERS' COMPENSATIIXJ fAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TOONE HUNORED THOUSAND DOLLARE (5100.000), IN ADDfiION TO iME COST OF �MPENSATION, DAMAGES AS PROVIDED FOF IN SECTION 31060F TME l4BOR CODE, INiEREST, AND AiTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aRirm that I am force and eflecL Lic. k_ ContraC�or'S Signature:, of Chapter 9(commencing with Section 7000) of Division 3 of ihe Busina�a3 �tessions Cotle, and my license is in tull Class M Date: Z� i^Cf.i CONSTRUCTION LENDING AGENCY: ❑ I hereby attirtn thai ihere is a construction lending agency for the peAortnance oi t�e work tor which this permit is issued. (Sec. 3097, Civil Code). Lenders Nama: Lendefs Adtlress: Signature: OWNER-BUILDER DECLAHATIONS: Date: I hereby aHirtn tha� untler penalry of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit m conswci, alter, improve, demolish, or repair any structure, prior �o iis issuance, also requires the applicant for such pertni� to tile a signetl statement ihat he or she is licensetl pursuani to the pmvisions of ihe Contraaors License Lew (Chapter 9(wmmencing with Saction 7000) ot Division 3 ot ihe Business antl Professions Cotle) or that he or she is exempt therefrom and ihe basis for ihe alleged eaemption. Any violation of Section 7037.5 by any applicant for e pertnit subjects the applicant to a civil panalry of not more than five hundred dollars ($500).): ❑ I, as owner oi ihe property, or my employees with wages as their sole compensation, WILL DO TME WORK, end ihe structure is not intentletl or offeratl tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who tloes such work himself or herself or ihrough his or her own employees, provided Ihat such improvemenis are not intentled or oNered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have tha Durtlen of proving t�at he or she ditl not build or improve for puryase of sala.). � I, as owner ot ihe pmperry, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to constmci ihe projeci (Sec. 7044, Business and Pmfessions Cotle: The coniractors License Law dces noi appty lo an owner ot properry who builds or improves ihereon, and who comracis for such project with a con�rador(s) license Oursuant ro the Contraciors License Laws.). ❑ I am ezempt untler sea Business and Professions Code for this reason: Signawre: Date: Owner ID verifietl by tlrivels licanse. ❑ Yes ❑ No Driver's License No. Verification ot Ownership by (rype of tlocument, i.e. - property taa bitl or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: E:pires: ❑ I hereby certify that no exwvalion five (5) or more teet in depih into which a person is requiretl to tlescen4 will he matle in connection with work authorizetl hy this permit, antl t�at no builtling sirucNre, scaffoltling, falsework, or demolition or dismantling thereot, will be more than ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Celitomia Adminisirative Code). ❑ As owner-builder, I will not employ anyone to do work whic� woultl require a permit irom Ihe Division of Intlusirial Safety, as noted above, unless such person hes a permit to tlo such work from ihe division. Signawre: Date: Division of Industnal Safety Permit Number: CERTFICATE OF COMPLIANCE AND AI7THORIZATION OF ENTRV: I certify under penalty of perjury that I have read this appliwtion and state lhat Ihe information given is correc�. I agree to comply with all state laws antl ciry ordinances relating to builtling constmction, and authorize representatives of the City of Costa Mesa to emer upon the above-describetl propeny for inspection purposes. I agree not to occupy or allow occupancy of any 6uilding authorized by this permit until linal inspection. �Sigru al Owner(s) � / �^ D� And/Or Authorized ApDlicant � Date OEy INSVECTIONTYPE 1616 Fizetl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Rooi 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition 2a66-<6 �pTE INTRIALS COUE 11 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electdcal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Bui�ding/Occupancy � INTRIALS \�_ ___ ..ApO�ica�t [o fill in all xpaces exee0t [hose within heavy Cortler lines anO.si9n.all appropriate tle i PER NO. ^� `' .TRACT NO. LOT NO. UN1T NO_ '; :Wv OF COSTA MEsa L/CONST{��%JCTION PERMIT � . ��rojFct�Address 2��75 • v��' — �v� •, � Applicant's Mailing Add ess' /� E�� /�� • Owner's Name �� t e SP��'J3t?� Address � �-' q -� Arch/Eng_ � � � License No. (= �� Address �� ' � ' ' Convactor's Nam � {,A � s�l ELF � i,e �h/p�ne' �y �' Address (mailingl ' y 2,/�'/O.�//�{A q� Q �++ T GT J� City Licenu No. ' -3 7 .��7. . � • , LICENSED CONTRACTOR DECLARATION � • ; I hereby a(firm that I am licensetl untle� provisions of Chartei 9(commencing with section ]000) of �Division 3 ot the Business antl Professlons Cotle, antl my license is in full forcf� ntlg( fec[. �f ' Licen CI s /'�U �_Lice e No. �� `' Date -�� Si9nature � G Q WORKERS'COMPENSATION EC RA - I M1ereby affirm that I have a certi ' te of consent to self-insure Or a certifiCdtE d Workers' Compensation:insurance,-or-a certlfietl copy�thereof.(Section l800, lab. C.) I ' � ' , i � ' . Poliry No. � Company BCertifietl ropy is hereby tumishe0. ' ' ' . � �Certifietl copy is filetl with the city Builtlin9 Dlvision. , Date Applicant EXEMPTION FROM WORKERS'�COMPENSATION-0EGLAftATION �- (Thissection neetl not be completetl if the permifis for one huntlretl ($100) or . less). � 1 certity that in tne performance of the work for, which this erm�t is'ssuetl, I shall not employ any pe�son in any manne� s as t0 be e sub'+ t to'the . Workers' m ens n I..aws ot Cali . ' . Date �� Signa[ure L" � 'NOTICE: If, after makin9 tM1is tlecla tion o sho tl b¢come Subj¢ct t0 the Workers' Compensation- provisions e La � otle, you must forthwith comOty with such p�ovi5ions or � thi5 � p¢rmit shall bet deemetl rewketl. ' CONSTRUCTION LENDING AGENCV •" •� ' 1 M1ereby a(firm that there is a construciion I¢ntling a9en[y fo� the performance ot tM1e ' work 'for wM1ich this permit is' issuetl ,(Section, 3091 Civ. �,C:) ttntler's Name � �ender's Adtlress ' � OWNER BUILDER DECLARATION - � I hereby affirm.that I am exempt from the Cont�acto�'S License Law for the following reason (Section 7031.5 Business antl Protessional Cotle: Any city or county which requires a permit to construct, alter, improve, tlemollsh or repair •any structure, prior to its issuance, also requires [he applicant for such permit ' �to file a si9netl slatement that he/She is licensetl pursuant to th¢ provisions of the.Contractor'S License Law (CnaOtei 9(commenting with Sec[ion 7000) of ' pivision 3 ot [he Business antl Professions Cotle) or thdt he/sh¢ is eaemp[ � �erefram-antl the basis for the allegetl exemption. Any viola�ion of Section : )31.5'by any applicant tora permit Subjects the.ap0licant to a civil enalty of not more than five huntlretl tlollarf(5500). � � I,. as owne� of the p�operty o� my�employees with wa9e5 as [hei� Sole compensation, will do the wo�k, antl the slruGture i5 no[ in[entletl o� offeretl for sale (Section ]044, Business antl Profezsional Cotle: The Contractar'S' License �aw'tloes mt apply [o an owne� of'a p�operty who builtls Or improves thereon, ana wno tices such work:himself/herselt or through his or her own ns. _ TYPE OF CONSTHUCTION IJ NEW ��L/J ApD U ALTERATION LJ REPAI R ❑ CONVERSION ❑ OEMOLISH LN OTHER ' A P; #- ' . , DESCFiIPTIONOF �9JS[US�OF$LDG ��'�✓� L � �� i /.c �F�J � S ' S Main Building: : TYPE OF PERMI.T GRADING ,FOUNDATION � STRUCTURAL - T Ffont - �� ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Rear�� ' � -❑ �oTtiER+ . . � . � A �iOJECT DESCRIP710N Sa. Fr. , oCCuaANCv C Right � - CONSTRUCT.ION;TVPE �VALUATION$ � ' �'g Left ' . ZONE �� - GRADING CU. V.DS. { ACRES Ping. Ref. #� � Remarks: � ' � , - . ' ' Planning Notes: � ' Bar Sink Backflow Preventer ' Backfiow Irrigation I Baffitubs ' Clarifiers � ' Dishwasher � � � Floor Drains � Floor Sinks � ' Gas Service � `.Outle� Interceptors � Kitchen Sink . . Lavatories . " -� � P-Trap , , . _ � Showers � � � ServiceSink� i � Sewer Cap� Sewer Connection i ' _ . SolanCollecrors . . . .. Solar Piping � � Solar Tank � Swimming Pool w/Spa. � � Urinal ' � �� s Water Closet • - � ' � Water Heater : � - Water Service. , � � � Roof �rains � � � ' 'Reinspection Fee� � $15 employees, provitletl that such� improvement5 ar¢ not mtentletl or offeretl for , � - sale. It, howeveq tM1e builtlin9 or improvertien[ is soltl wilhin One year of com- uV��c - pletion, tM1e owner will have the bu�tlen of pwving h¢/She tlitl not builtl o� Im- DuCt - Und¢� Ground prOVG for the pu�pose of sale). ' � ❑ I, as'owne� of the property, am exUusively cont�acting with IicenSetl <on-' Duct-St�uctu�dl ', tractors to construct the project (Sec[ion 7044, Business antl Professions Cotle: ' ' .-The. ContractoCs. License Law tloes_not apply to an'owner of'.proper[y who Duct - Ventilating - -- �-� builtls or improves thereon; antl who contracts fo� sach project5 with a con- tractor(s) license pursuant-m�the Contracror's License Law�. I am aware that � Exhaust System ❑ Multiple ❑ proof of their Wo�ker;s Compensation insurance Shoultl be provltletl to me., _ ❑.I am exempt untler Section B. & P. G fo� thi5 reason � FirepVFact. Blt. ICBO # ' Oate Owner � � Heating System & Ducting + f heretiy certity that I have iezd mis.application antl stzte ttiat Ihe above � i ❑0-100,000BTU �100,OOOBT' information is correct. I agree to comply with II clty antl county ortlinances ' . antl;sta[e laws relating o builtling cp}� Vuctio , antl he�eby autho�Iie repre- , � f sentatives of this.cit to enter u6nd bove-mentionetl property�for � inspection urposes. �--� , • _� . : � Signature � � y �, � ' Drivers" " ens or 5� _ Reiospection Fee ` i$15 CMF 0865-4 , ev. 10/84 White - Building; Canary - Applicant; Pink - Accountlng; Goltlenrotl - Assessor i Issue Fee Hood or, Type 1 ❑ � Canopy' Typell � Refrigeration System ❑0100,OOOBTU ❑10i System Repair/Alteratio Fire Dampers . : ; Issue Fee FEES � �� . ' $ 3 FEE: l 7 �00 BTU . - I � i , $ 3 , A312 5/02/96 � � - Zone Accessory Building: ' � � Parking Req:/Provided� - � l r r_ E Automatic Washer' , � Construction PoleSub. � ' Cooking Unit, . Dishwasher. _�. � ._.�.-..�. Dryers ❑Gas ❑Electric � Fan � � F.A.U. � . Device Boxes Garbage Dispoul � � Generator �0-5 KW 05-15 � Meter �.l 04 ' T� _ Z O N I ' N ," G R E m Q - M T� S . ,1 : ' FEES ❑ 15-50 KW ' ❑SO+KW � o700amps ' , 100 amps. . _ .- Sub�Panel ' � ' Motors OO-1 HP O1 % �8 Inc.�Solar 09-15 HP �16�1 � Microwave � � ' Pole Light � �, � aign ; Standing Sections TraSh Compactor , , � � Reinspection Fee ' $15 luue Fee $ 3 DEVELOPMENTSERVICESREQUIREMENTS: � � ' 2oning Approved By ' Date � Building Approved. By � Date Appliption luued ey � Dat z'�J'�-� � , � ' � SUMMARV OF FEES . , BUILDINGiPERMIT $ SMIP $ � � � � PLAN CHECK � ; $ � ,PERMIT ' � � PLUMBING � $ � �SSUANCE $ � PLANCHECK F25% $ ' ENERGY�P.C.� $ � ! ELECTRICAL � ' $ � GRADING � $ � PLANCHECK 50%; $ I �MICROFILM $ � , MECHANICAL, $ � TOTALPEE �, $ '1.�D _ PLAN CHECK Z5% $ � � � , , .. ;,� ,� , . . _ . '� I ,_-. � CGNSTRUCTION AND PLANNING � POOL PA Date Inspector Date Inspector (WPROVALS Permit # . APPROVALS � Permit # 1. Temporary Electrical Service or Pole� . ' 52. Pool & Equipment Location `2. Soil Pipe-Undrgrnd. � , 53. Steel Reinforcement � � 3. Electrical Conduit Utility-Undrgmd. . 54. Forms - - 4. Electrical Conduit-Undrgrnd. - ' 55. Electrical Bonding �, 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. � . - 57. APPROVAL TO COVER�GUNITE . 7. Footings � � � 58. Electrical Conduit-Undrgrnd. �.� 8. Foundation , _ 59. Gas Pipe, � Undrgrnd., Test � , 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ' � 61. APPROVAL TO DECK : 11. Property Sewer Line & House Connection �. 62. Backwash & Receptor-Final� � 12. Sewer Cap , 63. Heater & Vent-Final 73. Roof Drains . - 64. Plumbing System - Final . 14. Rough Plumbing ' 65. Electrical�Final � . . � • 15. Rough Electrical-Conduit 66. Solar System-Final - - 16. Rough Elearic Wiring _ . �6 � � 67. Fencing & Access Approval � � - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . � 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT� -, - 20. Rough Factory Fireplace ' � APPROVALS Permit #� ' 21. Ducts,in Strucwre 70. Underground Hydro -- 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test � 72. Underground Flush - 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing � 74. Overhead Hydro , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � � _ 27. frame and Flashing 76. Dry Standpipe i 28. Lathing & Siding 77. FIXED SYSTEM FINAL ' ' 29. Insulation � . � 78. F�RE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION �. 32. Electrical Power Meter-Final .� �i ��'_ 80. FOOD CERTIFICATE ISSUED �_ 33. Final Electric � Notes: ' �, 34. Final Heating & Air Conditioning' .a� � " j�� ' � r; 35. Final Gas Pipe-Test . - �. � � 36. Hood or Canopy � - . � 37. Final Factory Fireplace � 38. Final Plumbing � � _ � 39. Water Service-Final . ' - - - 40. Gas Service-Final . - . . 41. Solar pomestic-Final ' 42. Backflow Preventer / ' � 43. Backflow Irrigation . , - , 44. -Landscape Irrigation System � � , 45. Sound Attenuation � 46. Handicap Regulations � � 47. FINALSTRUCTURE&BUILDING ' , ' 48. Special'Requirements Completed � ' . ' .. . 49. Electrie Release to Edisdn � . - . �-- ' � ' 50. Gas Release to Southern California Gas Co 57. CERTIFICATEOFOCCUPANCY No. ' � Date . ' 1 i ' PR0.IECT �OOflE3S: z 3 Q�S ORANGE AV � owHeN•s xnMe: MAF2Y• JANE GORMAN . Iaooeess: gp,�,1E AS .ABUC�E � , . , , . ' , ��BCNIENGINEEfl: � . � . - ' ,-FUONESB:. • " , . UNIT: m HEG.NO.: � ` ' � .. • . ' , i ';UNIT:, � � PEPMIfTEE: (, � k R DRAINS, INC. `� �' ( 71"4 )�640-.2070 ; nooxess: . � � 2 5 MACARTHUR BLVD .' ,; COS:TA MESA ' CA 92626 '` ❑CENSEO CON7MCTOB DECUMTION: I �ere0y affirm that I am fcensed unEer pmvhlons oi Chapter 9(commencinp with Section 7000� of OiNsion 3 oi tAe Business anA Pmleaions Code, and my license is in full torce anG effect. ... - ciir uc.: p�.5 p j q. sTnTe uc.:5 317 4 6/f �cuss: C 3 6/.�� Date; �/ -> Z � —.�% SlpnaWre' Vi^-T� . 1- �___1'�i"+Ni '� �_' . .. WONKEBS' COMPENSATION DECIAMTION: I hereby ihat I have a cetliticate oi consem ro self-insure or a certifiwie af Workeri Campensation Insurance, or a.certifietl caOY �hereol (Section 3800, Lae. C). . voucv xo.: 10 S II 7 91 f3 9:, ezr. o�re: 0 2/ 01 / 9 0 , cornrnxv: S'TATE FUND � Certinee copy is nereby mmisned. � Certified wpy is tiled vnth IAe ciry, BUIIEinp Division. � Date: I �'� 7 /��a y ' ADPlicant /B'(ir✓ ' L— //�1�P� ..� . . E%EMPfION FPOM WOBKEBS' COMPEN&1TION UFCIAMTI :(This sec6on nee0 nol be complete0 if Ne parmit is for one AunErBG �5100) or les5). I cerliTy thai in tAe Dedormance ot the wod tor wAich this Dermit is issueA, I shall not employ any person in any manner so as to hecome suhlect to ihe Workers' Compensalion Laws of Calitomia. ' ( � , •Oate: ' " SignaNre: � - NOTICE: Ii, atter maldnA �his tleclaration, you should become subject ro Ihe Warkers' Campensation DroWsion3 oi [he Labor CaOe, you must tarthWith com0ly with such proVisions ur Ihis permit s�all 6e tleeme0 reJoked. , ' CONSTBUCTION LENOINC RGENCY: I herehy affirm t�at Nere is a constmction IenOing apency for the pertormance oi t�e woM for which Nis permit is issued (Section 3W7, Civ. C�. � , IFNOFR: • ' ' � � . -RUOBESS: " ' . . _ .. . � . ' ' .i �. OWNEB BUILDEB OECLAMTION: ,I hereby attirm ��at I am e.empt irom tAe Contactors' State License Law tor the followinA �asoo (Section 7IX11.5 Business antl Professional Cotle: My city of counry which requires a De�mit to consimct, atter, imD�ove, Oemolish, or � repair any stmcWre, D�or to its issuance, also requires the apDlican[ foi such permft to file a signed statemen[ that he/she is IicenseO �.. pursuant to ihe proNsions of the Coniracrors' State License Law (Chapter 9(commencinA'��h Section 7000) ot DiWsian 3 of t�e Business � an0 Pmiessions CoUe) or ihat Ae/sAe is exempt therehom anE t�e Gasis tor t�e atleped exemption. Any violation oi Section 7031.5 Gy I. any aDPlicant for a Dermit su�lects IAe applicant to a�civil Denalry oi not more than five �unEred dollars (5500).,- � ' I, u owner ai the Droperty �or- my employees witA wages ss �iheir sole compensation, will Uo t�a work, � antl Ihe ❑ simc[ure is not intenAeE or oHeretl tar ule (Sedion 70Ai, Business antl Professional Code: The Coniracrors' State Licensa Law Ooes not apDty,to an owner of a propeM �o huilUs or improves thereon, an0 who Coes such work himull/herulf or IDrouOh his or her own employees, pmvideE that SucA impmvemems are not intendeE or ottered tor sale. It, howevar the OuilUinq or .improvement is soltl within one year of campletion, the owner will have Ihe burden of provinq he/she Oia not UuilA or impmve for�he�0uryose�afsale). _ ' , -� ` � I, as owner of t�e O�operry, am exclusively contractinp wit� IicenSeC wmactors to constmct tAe pmject (Section 7044, Busineu ❑ an0 Pmleuions CaOe: The Cantractors' State Licensa Law Oces wt apply Io an owner of Omperty wAo 6utlE5 or impmves itiereon antl who conirecis forSucA pmlects witA a coniractor(s�license pursuant ro�the Cantractors' State License Law),I am aware IAatpmol ol ��el� Woder's Compensation insurance ShoWG Ee,pmviGeG to me. , . � I am exempt un0er Section: B. 8 P. C.' . � lof Ihis reazOn: . • �� ' , � ' �ate: � � Ownar I tlo �ereby certi/y Ihai I am awam ot antl understanA ihe requiamenis a� California HealtA and Safery CoUe Sections 255Q5, 25533, ana 2553C antl that I or any fmure Guiltling accupant wilU_II not (circle nne) neeG to comply vnth ui0 state cotles an0 t�e requirements tor a permii for construttwn afmotlification from the Air �ualiry ManaAement Disind. Fesitlential construction applications are exempt imm tnesa provisions , . ; . a � Oate: � � Fp0licant: I AereEy certity that I Aave'reaE t�is application anA state [hat the a0ove information is correct. I 5gree lo campty with all ciry an0 counry ' ortlinances anU state laws relatinq to builtling constmction aiN here�y autlronza representa[ives of t�is ciry to enter u0on the above-mentionetl pmperty for inspection Du�ryo}ses. , � � � - � Date:l��il—D� SipnaWre' ��AiJ�>f � Dnver's License or Socia� Security � - � 1841-48 W�ite—BuilOing; Grean—COEe Enlorcement: Cenery—Applicam; Pink—Pevenue; Goltlenrotl—Assessor ` CITY OL' COS"fA MESA;�- .HOILUING PERMIT P�RM NO: P� 045069 PERMIT,NOc P 045Qfi9 � PI,AN.CHECK NOc. _ N� GOVT: N SUPF?: N . - �•.. ' : , . CONSTRUCTION "I'YPF•.: ' . , . � � � PERMIT' TYPF. d '�P. L�U= � ' PURPOSE • NEW SOB DESCRZP�TION. ;.: . COP.PER I2F.PIPE TO. SFD ' • � S� ET: ' _ ' . . . . � . . . . : . . - � . , . , �CLATM VAI�UE; ; =` , . CAL�C--VALUE( � ' � � GROUP OCC:. - /„ � _ � , . , .. �COMMENTS: " ' - '�*�***��c*��*��+�***��*x�*******�*x****-�*�*��*�*****i��*�*+t*�*��r*at�r**+t**��r**� ' ' Z O N I N G R E� 0 I R E M E N T S � �', - , � S E T- F3 A C K S ' , � . . ---=-------- MAIN }3UILDING. ---------'- --------- ;ACCESSORY DQILDING. =-----=-�-. FRNT: F'L IN:RP:AR: ?!FT IN ' F'RNT: FT IN REAR: ' F.'T IN.� LEFT; FT IN RGH'P: ' F'T IN ` L�EFT:. kT� IN RGHT: ' rT T.N" . PARKING REQ': , �� PROV; . PARCEl�;. 00000000 2,NL: � REF NO: . PLANNING NOT.ES> , i. ' . . > - ._ . . - � ---.. if jE iP iE # iE IE �E �1f �)E �E jE IF 3f iE IE if it iE # iE it ik iF iF aE if K iE dE �%iF it 3F iE%,ik iF # iF 3E 1E 1E 3E iE iE iE fk lE �E �E 3E �E �f it # 1E iE 1E iFiE �)t 1E iE iE it 3E iE �lE iE iE af iE �X-iE iE ik 3E iE D E V E I� O P M E N T S fi R V I C E;;'. R E� U I; R E M E N T,S � • �.�' . a s �I ZONING APPROVED BY ' DATE: . � ,. .. . •.. . : . DUIliDING APPROVEU F7Y : , � ' ,DATEc APPLICATION ISSUED BY; ' � ;. ' DATE; -I Z �rf�at�*��r��**��x�**+r***�r*��F3�iFiFSFlE'iF3F�iF�� r*�r******�iF.��'�F3i�F� iE iE iE iE �1F iE k�)E iE iE �E �1E �N� iE �1E%ik �%�F 3E%if if if iE iE it iE 3E ik �1F 1E iE iE iE if 3E iE �1(� iF iE iE iE iE �E aE �E ih 3E iF iE,# iE iE �IE if iE if iE �E iE iF iE if X-�%�1E'�E if 3f if if if it �� i(- IE iF 1f LEGALIZATION: N �, .'F Ii G S; U' M- M'A R`Y . � ' ST,RUCTUR'AL � SEGMENT: N' . . DLDG PMT PI,UMBING ELECTRIC MECHANIC PPRE� SM.7.P/RES GRADING PERMTT 2. Oq .. ' , , - � � 25�" ' SMIP/NON-RGS �PliAN � ISSOE PEE ' , 7.00 . DU.T.I�DING ;DIV-> PERM'IT I,aUE , PLAN-CHECK TOTAL PAID DCIF•. TOTALS'----> . 2.00 � 3.00 0.00 5.00 5.00 ' .00 RGVFNUE DIVIiION TOTALS-->' COLLF.CTED: �5.00 OVER/SHORT: .00 ' i3LpG PMT F.>LUMDING'�LECTRIC MECHANIC FTRF SMIP/TOT GRADING PL'AN�CHI.CK ' . � ; � rJ.�O ' . , � ' 1E iE �!E 3E �E iE iE �1F dE fE �1F if iE iE iE if if 1E # dE iE k iE iE iE iF 1E k iE #�lE iE 1E iE iE iE iE iE iE iE iE k 3E aE iE 3E �IE iE iE iE if i(- )E # ih iE'ik iE iE � iE IE iE ih 3E iE �)E �k iE �lE �Y.- iE iE �Y iE IE'�If iF if I N D I�V I D U A L� F E E I� R E A K D O W N � ' . ` � . . , . - • ' ' , TYPE: (�'TY., D E S C R I.- P T I O N ' UNIT COST TOTAL �OST PL�U . 7 ' WATER` RE-F'ILaE • 2.00 , � 2.00 _ ,: ��1D OF FC•.ES . . � f P1 O6C�47Gc4-L«0-:-79ta -� p4- �.+Tc�:ll'2i.r'.a Txr= L,`:G+ �._ �. CONSTRUCTION AND PLANNING' �' � .� , POO ;PA . APPROVAL$ Permit# ' Date Inspector AppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole � �- - , � 52. Pool & Equipment Location . 2.- Soil Pipe-Undrgmd. ; � ; : _ � � � � 53. Steel Reinforcement . - �3�Electrical Conduit Utility-Undrgrndr � � -�� 54.� Forms . � • ' " 4.,Electrical Conduit�Undrgrnd.' ,: _ ' 55. Electrical Bonding • 5. Steel Reinforcement� � • ' 56. Rough Plumbing & Pressure Test ' ;.N � 6.• Elettrital UFER,Grnd. � � � � 57. APPROVAL TO COVER�GUNITE �'.7'�Footings - � .i ' . 58. Electrical Conduit�Undrgmd. _ � � ' `8. Foundation � � ' . � _ �: . - ' 59. Gas Pipe, O Undrgrnd., Test . � 9. Water Pipe-Undrgrnd. �� i 60. Batkwash Lines, P-Trap, O Undrgrnd. � 10. Strucwral Floor System. " �' ' � 67. APPROVAL TO DECK " 11. Property Sewer Line.& House�Connection ; � 62. Backwash & Receptor-Final � � 12. Sewer Cap � � � 63.. Heater & Vent-Final � 13. Roof Droins � � 64. Plumbing SYstem,� Final 74. RoughPlumbi�g �� ,� 65. Electrical-Final ' . i 15. Rough Electrical-Conduit .' �. - 66. Solar SYstem-Final . I 16. Rough Electric:Wiring �� 67. Fencing & Access ApP�oval � 17. Rough Wirinq Sign ' 68. -APPROVED,FOFi PLASTEF?ING 18. RoughElectrical�TBarCeiling 69.�POOUSPASYSTEMS�FINAL - 19. Rough Heatin9 &-Air�Conditioning _�,.. , � -.FIRE.DEP.T. REQUIREMENT -� 20rRough Factory Fi�eplace � • �• ; x • -APPROVALS --Permit # - , `� 21. Ducts, in Struaure , -� -� -'" '. _ _, � . _ 70. Underground Hydro 22; Ducts, Ventilating . � . ' , '�~ , .,71. Product"Riping OGas ❑Oil 23. Gas�Pipe-Rough�& Test _ �� •� . Y�. -�72, Underground Flush' r 24. Roof Framing • r � - .-+� ,. • 73"Undergmd. Storage Tank O Gas ❑ Oil 25. Roof SFieathing ` - '�"_, `' f i' 7q: Overhead Hydro- 26. T-Bar Ceiling (Structural) &�Monocoat ^ � .� � � 75 _Dry Chemical- ' . 27. Frame and Flashing - - ,� -' %' ; * * 76. Dry Standpipe "_ . ,. , ,. . 28. Lathing & Siding � � , ' ' .� ' : :a 77r- FIXED SYSTEM FINAL• ' 29. Insulation ' - �� 78::FIRE PREV. FINAL � 30. Orywall Nailing �� _ r-. � a - HEALTH DEPTe REQUIREMENT '31. Plaster Brown Coat '� �;�79. FINAL INSPECTION `� . 4 -�32. Electrical Power Mete�-Final � �: � SO;,FOOD CERTIFICATE ISSUED ��33. Final Electric- • � • Notes: _ =_ " � � �' � _ �. ,'34. �Final Heating & Air Conditioning � R i ` _ -�. 35: Final Gas Pipe-Test•' i. '' � ,+� x^ � ''36. Hood or CanoPY .. ' ' r + - {- ��: ` ' -, ' 37.� Final Factory Pireplace" - ^ � _ ,�'�� 1 � - _ ^ ='38. Final Plumbing . . ' �� y � (� .. . '39. Waier Service-Finali �, _ � � - .- ' ;40. Gas Service-Final ' • � . � - ' ' . ; ' - ' -41. Solar pomesticFinal' �.� � � + "-J. - - - 42. Backflow Preventer` - _ . , � .. � ' . _. � 43. Backflow Irrigation � �� : � � " " ' . _, � 44. Landscape Irripation SYstem' ' �1 y ` i ; �' . • _ `45i Sound Attenuation -. � � - � • � �'+ , �• . ' ' ' 46.' Handicap Regulations � . ' � - ' � i -�a7� FINAL STRUC7URE & BUI�LDING u =. , �" � � � � � • � 48.,FINALPLANNING ' � , �", � � � � � 49.� Electric Release to:Edison . - . 50. Gas Release to Southem Catifornia Gas Cn ' � <i = ; '. - .' ' �- 51. CERTIFICATE OF OCCUPANCY ' '' � " - No. Date OWNER McCA� JOB ADDRESS AP No.119-051-2o LOT INSPECTIONS Water F k OCCUPANCY TRACT � Signature DATE VALU� $ PIRE ZON� DGSCRIPTION DA� GROUP J TYPE I SUBCONTRACTOR 7.ONE B1ock wall � � �.�a�:"%�� . COS1�A MESA BUILDING-SAFETY DEPARTMENT P. O. BOX S17 COBTA MEBA. GLIFORNIA For Appiicanf fo Fill In Complefely 'I'YPE OR PRINT eui�o�Nc ' � ., , i .� . _' . .. . M MAIL ■ BIZE COSTA MESA: CAL'IFORNIA ��,�✓�2�P G��,..;�,�. s ��ls'�..�� —� TEL. �,�� ._,e Nodi�•t�rr CGT 7EL. INEER NO. 6 CTOR `� �, �_ S TEL. NO. ' ` / NO, OF BLUGS. q J U X /� I NOW ON LOT i� � BLDG /VO"�+/Z� � Gi/B�-Q��— LINE FROM rr srneer REAR YARD RD I LEFT I RIGHT DESCRIIPTIOtd OF WORK I M II ALTERATION I II AD�ITIDN I I II MOVING I II DEMOLISH I G NO. OF � RECEIVED � Nov •3 t�69 fII�ANCE DEPT. APPLICATIONIrFOIIFP��nT�r MESA BUILDING For Office Use Only RECEIPT NO. PgR IT NO. � : ��'3�� HEGEIVED BV DATE RECENEO DqTE BBUED FIRE ZONE APPROVED ZONE � LEGAL � I //—�- /./ I i`�� E /_ 23 yS O n,� /h� e, I;� � COSTA MESA. CALIFORNIA ZONING NO. OP I U6E OF NEW PLAN6 �i BUILDING �u� . ��. l 65 I�1— �5/—�- YARDS EVES APPROVED ICENT¢q L�NE 6TJ + EXTERIOR WALL IROOF COVERING COVERING USE OF UILDIN AND WORK TO HE PERFORM D , � /� ••�y .S'9 �� X 3 C �� L X S 'X /c+' �� .i� /n � f� ",{� �d "' i o ' I HERHBV .�CKNOWLEOde THAT 1 HAVE PEA� TH18 APPLIGTION THE AMOUNT BHOWN UNOEP VALUATION IB FOq THE wND BTATE THAT iHE ABOVE I6 CORRECT RND AGREE TO COM- PURP08E OF EBTABLIBHING A PERM�T FEE ONLY. PlY WITN ALL CITY OR�[NMICES AND eTATE lAWB REGUTATIN6 eURDiNa CONeTR oN. VALUATION r� � BIGNATURE O G �� /'/i�OC/ PERMIT FEE $ —_ PERMITTE $ / / /� PLAN CHECK $ AUTHORIZED AGENT I