HomeMy WebLinkAbout2426 ORANGE AVE - Building PermitsPXOJECT AUOFE55: L 4 Z 6 ORANGE AV
OWNEP'SNAME:gOSAN, WILLIAM 20LTAN TR
r :y�oeess: 18627 BROOKI-IURST 5T #213
"' FOUNTAIN VALLEY,CA 92708
AHCHIENGINEEfl:
aoosEss:
flEG.NO.:
UNIT:
uxiT:
PEFMITTEE:��S RFG ( 719 ) 965-0245
auoeess:z1382 DOCKSIDE CZ
HUNTINGTON BEACH CA 92446
LICENSE� CONTBACTOB UECLAHATION: I here0y afiirm Ihal I am licensed untler Dmvisions o C�ap�er 9(commencing wi�� Sec�ion
7000� of Oiv,sion 3 ot �he Business and Pmfessions Cotle. ana my license is in full force and eftect.
''c 0 4 22 sTaTeuc.:529341 ��'ss`Q' 39 E;{P: 10/95
�ale' � SignaWre'. "1 Q�t� ��
HNEBS' COMPENSATION OECLl�BRTION: I hereby aifirm that I �ave a cenificate of consent to self-insure ar a cetlificate of Workers
Compen5aiion Insurance. or a cetlifieA coOY �hereof (Sec�ion 3800, lab. C�.
POLICY NO.: E%P. OPTE:
COMPRNY:
� Cenifietl copy is hereAy �umishetl. ❑ Certifietl copy is �iletl wi�h Ihe ciry Building Division.
Da�e:
Applicant
E%EMPTION FflOM WONMEPS' COMPENSATION OECIAPATION: QhiS seclion neeA no� be complete0 if (he 0ermit is �ar one huntlretl �$100) or 1e55�.
cetlily Inal in Ihe perbrmance ol lhe work lor which �his permit is issued I sh)II not emplo ny person in any manner so a5 io become
I lo I�e orkers Compensaiion Laws of Califomia. �...� //�/�
/Daie: � 3� Signa�ure: (-./�"'�+� � v'
NOTICE: Ii, al�er makmg Ihis tleclara�ion. you s�au10 6ecome SuUjeci �o Ihe Workers' Compensation pmvisions o� t�e Labor
COAe. y0u musl IOrlhwi�h comply wii� suCh pmvisi0n5 or Ihis permil S�all be tleemed revokeG.
CONSTBUCiION LENOING FGENCY: I hereby a�hrm thal �here is a constmmion lending agency for �he petlormance of the work �or
whic� Nis permii is i55ue0 (Sectian 3097, Civ. C�.
LENOEH:
NOONESS:
OWNEB BWLOEP �EClABp710N: I hereby aHirm ihat I am exempl from the Comracrors' State License Law br Ihe followinA �eason
(Seclion 703L5 6usiness and Pmie55ianal Cotle: Any ciry o� county which requires a permi� to cons�mct, alter, im0�ove, tlemolis�, or
i r r ri r ii i uan I ir h li an � r uc� ermi� �0 lile a 5i neA S�a�emen� �hai he/She i5liCen5e0
repa r any st ucN e, p o lo s ss ce. a so reQu es t e app c t o s p 9
pursuamlo Ne pmvisions ofihe Comraaors' Siate License Law(Chapier9(commencing wil� Section 7000) o� �ivision 3 oilhe Business
and Pmiessions CoOe� or Ihat he/she is exempt therelmm anE ��e basis lor ��e allegeA exempiion. Any viola�ion ol Setlion 7031.5 6y
any apPlicanlfor a permil sublects ��e applican�io a civil Denafly of no� more than tive huntlred tlollars ($500).
I, as owner of ihe propeny or my emplayees with wages as �heir sole compensation, wi0 Ao the work, antl ine
❑ simc�ure is no� inlen0etl or olleretl for sale (Seclion 7044. Business antl Pmfessional Code: The Con�racbrs' S�a�e License Law
does not apply Io an owner of a pm0eny w�o builds or improves [hereon, antl who tloes such work Aimsel�/hetself of �hrough
�is or her own employees. pravide0 �ha� such impmvemen�s are not inten�e0 ar oif¢reU lor sale. II, however Ne buil0inp or
. improvemeni is soltl wi�hin one year of comple�ion, the awner will have �he hur0en of pmving he/she aid no� builU or imD�ove
for Ihe pur0ose ol sale�.
I, as owner ol the pmpetly, am exclusively con�raciing wi�h licensed conVaclors �o tonslmc� �he pmlect (Section 7044, Business
❑ antl Professions Cade: The Conlractors' Stale License Law tloes not aDDly to an owner of pmpeny who GwIAs or impmves t�ereon
an0 who conlracis br such pml¢C[5 wiih d COn��dt�0�(S�1iC¢ns¢ pw5uan� ta Ih¢ CO�I�dt�OfS' Sldt¢ LitenSC Ldw�. 12rn dwd�¢
Ihal proo� ol Iheir Worker's Compensa�ian insurance shoul0 Oe O�ovided lo me.
� I am exempl unAer Seclion'. B. 8 P. C.
, br I�is reason:
oaie: Ownec
I do �ereby ceniry I�ai t am aware of anG unaerstana Ihe reQuiremems ol Cali�amia Heatlh anA Salely COEe Sec�ions 255P5, 25533. antl
25534 and Ihat I or any fWure Omlding occupan� willlwill na� (circle one) neea to comply wi�h said s�a�e codes ana t�e requirements for a
permn lor con9mclion or mo0ilicalion Imm �he Nir Ouali�y Managemenl DiSUict. flesitleniial con5imclion applica�ians are exem0� ��om
IhCSe provisions.
Daie'. AppliCdnl'.
I hereby certAy Ihai I have read Ihis application antl stale Nai �he a0ove intorma�ion is corre I. I agree Io comply wilh all city and counry
or0inanwsanastalelaw5relalingloGuilAingconstmclianandhere�yau nzereD�esentatrv oit�iscirytoenteruDoncheabove�memione�
pm0er�y �or in5p ciio purposes.
�f> �� � S�
�Oa�e' �� � Slgna�ure:
Tlrrver's License or Social Security
Canary—Applicant Plnk—Revenue; Goltlenrotl—Assessor
CITY OF COSTA MESA — HUILDING PERMIT PERM rl0• B 07�948
PERMIT NO: B 07Q948 PLAN CHECY. NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: ALT
JOB DESCAIPTION ; REROOF OVER EXIXT. W/ONLY 1 LAYER COMP, SQ FT; 2,565
CLAIM ��ALUE: 2,565.00 CALC—VALUE; 2,565.00 GROUP OCC; R-3 /M'i
COMMENTS:. SMOKE DETECTORS ARE REQUZRED
�f r� ac iE iF+t3f �v- if �E �f �IE-�F if �f+r �lf aF .c �-�F-�!� x+t-tr� �E i� iE iF �If� �th+E it -tt x Y* i� at �7t af �It o.ac -v+t it * if iF r�+F+E �x-x it x �F *+t *�t �4 ar �x--�r *�kY� is �1L at v� * i��' -�' at�x
Z O N 2 N G R E Q U I R E M E P7 T S
S E T B A C K S
------------ MAIN bUILDING ---------- --------- ACCESSt�RY BUILDIP7G ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN P,EAR• FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGfiT: FT IN
PARY.ING REQ; PROV; PARCEL: 11910216 ZNE; AEF NO:
PLANNING NOTES> _
�
I rr*,r+t*+rw*****�r�**�r�rx+�r+r*+r+�*�r**�r+r***�r***�-*r*x**.�*+�****+�**�+r**i�*****r*�r�r***�*r�c-*
D E V E L t� F M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED HY ,
DATE:
HUILDING APPAOVED BY ; DATE;
APPLICATION ISSUED BY; � DATE; 1� I ��
iFiM1ifiEiflfkiliEiEiEk1E1f1E�fif%tiEififif�i���l�;E�iF���F��f7f�f�F�f �A-3�f{f�1t�l�}f�fi ififafafiEiEitif+tit iE iFjf
1f 1f M 1f if fF iE iF 1E if iE 1F iE it if 4 if jf fE ff M if af iF if 1f if if it 1f i! 1F if iE if �f iE if iE if if 4 iF if jE If if af �Y 9R M iE if iE iF 1f if K if it if 1f aF 1F if iF if if M M iF if iE iF iF if it �f iF
LEGALIZATION;N F E E S U M M A R Y �. S,TRUCTURAL SEGMENT;Y
HLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE •' SMIP/RES GRADING
PERMIT 54.00
— '!— -,'
� .50
T
—, .
C �
PLAN ����s_ �� � ���� � SMIP/NON—RES
I55UE FEE �g (g���� 1
BUILDING—DIV—> FERMIT ISSUE �,�A'AI:.rCifPfiEK� TOTAL PAID DUE
TOTALS----> 54.50 O,OQ 0.00 54.50 ?� 54.50 .00
IREl1ENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
54.00
54,50 OVEP./SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECY,
.'S0
�. �f1liEMifiElfif3FjfffiEfEfEifiElfiEifiFififi!%1Eif%i��fif9EffjFif�fEiflfififlfifiEiFiflfif�fkifififfEifYifiEifiFiEifiEaGlEiFitifiliFjfif�ifiRiflEiFiE�lEiEiE
I N D I V I D U A L F E E B R E A K�D,.• O W N
TYPE QTY D E S C R I P T I O N UNIT.COST TOTAL COST
SFR 2565 ALTER BY �'ALUE RESIDENTIAL NOZONE ' 1,00 2,565,00
END OF FEES �
• • .
��
, , , / � I
oa ��otis�4s--noi�sstia �r-�T s,.sa
G'�iE� �I!31i3S iIrEEa 11:a6
CG�VSTRUCTION AND PLANNWG �O SPA
A?PROVALS Permit #' Date Inspector APPROVAlS Permit .# Date InsPector
�
t. Temvorary Electriwl Service or Pole 52. Pool & Equipment Location
2, Soii Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Condutt Utility�Undrgrnd. 54. Forms
4. EleMrica� Conduit-Undrgrnd. 55. Electrica� Bonding
5. Steel Reinforcement- 56. Rough Plumbing & Pressure Tzst
6. Electricsl UFER Grnd, 57. APPROVAL TO COVER�GUNITE
l. Footing5 58. Electrical Conduit-Undrgmd.
8. Foundat�on - 59. Gas Pipe, CJ Undrgrnd., Tesc
i
9. Wacer PiPe-Undrgrnd. 60. Hackwash Lines, P�Trap, O Undrgmd.
10. Structural Floor Svstem 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finai
72. Seiver Cap . � 63. Heater & Vent�Final
73. Roof Drains . 64. Plumbing Sysiem - Final
l4. Rough Plumbing fi5. Electrical-Fi�al
15. Rough Electrlcal-Conduit � 66. Solar System�Final
16. Rough Electric Wiring . 67. Fencing & Accesc Approvai
17. Rough Wiring Sign 68. APPROVEO FOR P�ASTERING !
78. Rough E�ectrical-T Bar Ceiling 69. POOL/SPA SYSTEP;iS FINA4 �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREI41ENT_ I
20. Rough Factory Fireplace ' - ' : � APPROVALS .� Permit # � _
27. Duccs, in Structure � � •• � 70. Underground:Hydro ,
22. Ducts, Ventilating� ' • ' � , . ` 71. Product Piping OGas �.70ii �. � � ;-
23. Gas Pipe-Rough & Test �� �� • . ���72. Undergrou�d Flush I�; 4 �
24. Roof Framing ' ' " , , � 'Z3. UndergmdSStorageTank OGas ❑Oii [., `S
.�
25. Roof Sheathing � 74. Overhead HYdro • � I
�i ;
26. T-Bar'Ce�ling (Structural) & Monocoat 75. Dry Chemical ' : �
�y. • +
27. Frame and F(ashi�g , �.. " • 76. Dry Standpipe • � �< t 1
.'
28. Lathing & Siding :���' ' ' - ' � � ' ' ' 77, PIXED SYSTEM�FINAL �
29. Insulation � � �• � � � 78. FIRE PREV. FINAL -� •
30. Drywall Nailing • '. �� �� _ HEALTH DEPT. REQUIREINENT
�
+ ,
37. Plaster grow�n Coat � ... �' 79. FINAL INSPECTION
32. Electric5l-Powar MeterFinal '`' �� 80. FOOD CERTIFICATE ISSUED
33. Final'Electric � � � � Notes: � , �
34. Final Heating & Air Conditioning ' � � � ' , ' �' -
� ,
35_ Fina�Gas�Pipe=Test . , � ��- � _ � � ,
36. Hood oi Canopy � ' I -, � � ' �
,
37. Final.Fa�tory Fireplace � ' . � .
38. Final Plumbing � " � ' '
39. Water Service�Final . , � . � ' � -
. r
40. Gas Serv�ce-Fina1 • • ' � • ' • �
47. Solar DOmestic-Final � � ' � . .
42. Backflow�Preventer � ` � - � � � ^,
43. Backflow Irrigation ` ' - . . �� � Cwf�O� . �.1 �L �,[e- ���_
44. LandscaPe'�rri9ationSYstem '� � � �'� � " �
�.
45. Sound Attenuation' � . ' . . {D � �� � Z y ����
46. HandicaP Regulations � ' , � . '� - '�' �
47. FINAL STRUC7URE & BU/LDING � . � ,
48. FINAL PIANNING � � • , � '
49. Electric Reiease to Edison � . ��
50. Gas Reiease to Southern Caiifornia Gas Co _ � =��' �
51. CEIiTIFICATE OF OCCUPANCY �
No. Date
•
,`,
PflqIE jp00HESS: 7 d Z( piAtiG: AL�
OWNEH'SNFME:jjGvTAIV WI:,iIA^? 20i�Ati =R
AUOflE55: �'yf1L'uLl�..°t Z �C7JF�.�:
8852 BAYWCOD DR
tiiiNTStiGTO� ��AC'r",CA 92646
5487128
AflCHIENGINEEH: flEG.NO.:
aooeess:
uxir:
uxiT:
PEFMITTEE:PORIER Ei.ECTRIC (7i4)379-9436
nooRess: 6752 GARDEN GROVE B�
IdES?N.INSTER CA 925At
IICENSEO CONTBRCTOP UECLAFATION: I hereby af�irm Iha� I am licen5e� under provisions oi Chapter 9(commencing wit� Section
7p/p0) ol Div:sion 3 oi Ihe Business and Professions Code. antl my license is in WII lorce antl e�lec�. /) /%%JJJJJJ\^^��
I�ITY LIC.: q $TRTE LIC.:j Q? 9 1�� SS' _— 7 Q ��
Daie'. �� � � � L ,� Signature:
WaXNEHS' COMPENSaTION OECLANII7ION: I hereby alfirm inat I have a cenilicate of consent m self�insure or a certificate ol workers'
I Compensa�ion Insurance. ar a[erlihe0 copy Ihereof (Section 3800. Lab. C).
POLICY NO.: E%P. OATE:
COMPFNY:
❑ Certdied capY is hereby furnishetl. ❑ Cetlihetl copy is �iled wi�h �he ci�y Butltling Division.
Oale: Ppplicanl:
E%EMPTION FBOM WOBREFS' COMPENSpTION OECIAflPTION: (This section neea nol be cample�e0 if t�e Oermi� is �or one hunUred ($11p) or less�.
I certify Ihat in I�e petlormance of I�e woB lar whic� this permit is is ue4 I 5 all nol employ any person i any ma er so as �o become
�Sublecl �o Ihe Workers' CoQmpensalian Laws ai Califomia /9/_/_ `� (e
Da�e: �^ �7 — C � Signaiure�. ' ✓�'
NOTICE: II, afiei making �his declara�ion. you 5hou10 become sublec� to Ihe Workers' ComDensa�ion D�ovisions of the Labor
Cotle. you must �ort�wit� compty wiN such pmvisions or ihis permi� s�all be tleemed revokeA.
CONSTflUCTION LENOING AGENCY: I hereby aflirm Iha� Ihere i5 a con5imction lentling agenry for the DeAormance o� Ihe woB �or
which Ihis permit is i=.suetl (Semion 3097. Civ. C).
LENOEfl:
aooness:
OWNEB BUILOEP �ECIAHATION: I �ere0y atfirm Iha� I am exemp� tmm the Conlraciors' Siate License law �ar Ihe �allowing reason
(Seclion 7031.5 Business and Pmfessional Cotle: Nny ciry oi couniy which re0uires a permi� to canstmc�, alleL improve, tlemolish, or
repair any s�mc�ure. prior to iis issuance. also requires ��e applican� �or such permil lo fiie a 5igneA slatement t�al he/5Ae is licensetl
pursuani lo Ihe D�ovisions ol Ihe Conlrac�ors' Slaie License Law (Chapter 9 �commencing with Sec�ion 7000) oi Division 3 ot the Business
antl Pmiessions Cotle) ar �hat M1ehhe is exempt iheretmm antl Ne Gasis tor ��e allegea exemption. Fny viola�ion o� Section 7031.5 by
any aDPlicani for a Dermit suble��s �he apPlicant lo a civil penalty o� nat more than �ive �undretl tlollars (8500).
I. as awner of lhe pmpetly or my employees wi�h wages as Iheir sole compensation, will tlo ��e woB, and the
❑ slmcture is not inlendetl or oflered lor sale (Seclion 7044, Business anU Pmlessional CoUe: T�e Comractors' State License Law
tloes no� apply Io an owner o� a pmperty who Owltls or impmves lherean, ana w�o tloes suc� woB himselOherseA or �hmuAh
his or her own employees, pwvidetl ��at such impmvemenls are not intenaed or o�lereA lor sale. If, however �he 6uiltling or
impmvemenl is soltl wilhin one year o� compleiion. Ihe owner wtll have �he burtlen ol Omving �elshe tlitl not builtl or impmve
for the Durpose of saie�.
I, as owner ol I�e propeny, am exclusively contracting wi�� licensea conVacmrs to cons�mc� ��e prolect (Seclion 704d, Business
❑ antl Prolessions CoOe- The Contrac�ors' Slaie license Law does not apply �o an owner ol pmperry who Guilds or im0�oves Ihereon
and who conVac�s for suc� proiecls with a conlrac�or�s) license pursuan� ta Ihe Coniractor5' S�aie License Law�. I am aware
ihat pmol af Iheu Worker'S Compensation insurance shoNe be pmvitled �o me.
� I am exempt untler Seciion: B. 8 P. C.
�ar t�is reason'.
Daie'. Owner
I do here�y cenify Ihai I am aware o� antl untlersiand I�e reQuirements ai Califomia Healih and Safery Catle Sections 25505. 25533, antl
2559a and Ihat I or any tulure buil0ing occupant will/will nol (circle one) need lo comOty with saitl slaie co0e5 antl �he reQuiremen�s �or a
perma for conslmdian or ma4Jication Imm Ihe Air Ouabry Management DisVicL Fesitlential constmc�ion apDlica�ions are exempi lmm
�hCSC p�OviSi0�5.
Dale: APplicanl:
I here�y ceittlylAal I�avereatl��is applicaiion ane sla�e�hallhe a6ove iniorma�ion is correct. lagree�o compty wilh all ci�y antl coun�y
99rainances antl statelawsrela�ingto building cons�mc�ian ana �y a orize repre5enialives ollhi ciiylo enteru onl above-meniionetl
pmpeny lorinspecl9ion purpases.
/Da1e: �1� ( — ` � Signamre:�
orivers �icense ar Socia� Securny
164FC6 Whi�e—Bmlding; Green—CotlE Enbrcemenl Canary—Applicanq Pink—Rev2nue; Oltl¢nrotl—A55¢550�
� � � �
'''C'�T� Or CQS'.A ?� a - BJI..D�tiG rr-.::i. -�.-... .:G- � ---' -`I��n
P`.:-i�'::1 i4U: r �162�b4 t�1.i�:V �t'1FL�t �fV: T. (-(1�iT: �i c�f—'-�: :�:
Cu�S:�liCTION :YPc: V-N PER:!I; TYPE: EiE PURPOS'�; U.'r',
JOB DESCR_PiIUDI : RL�OCATE TRIr�LEX SERV�CE SV r�`:
C�AI?�3 VAL'JE: CAiC-VALiiE: GROUP UCr: �-3 /
C01�2�1EI�T5: RE�OCA.E SERVICES
if iEiP 3f iE if iE?E IE iF iEiE iF i(-jE iE if ii� �lh 9F �%#f iFi: �4' �Y. ### iF iE # sY # ie if' iP #+�f.' iE if if * 3f �• 3i if if 7E 9E # aY 9E �`.f .} `�{ #� 9i ####%'.E # iE Y i!� i i( x## lik #� Y'
Z O N 2 N r, R E Q U I?2 E M E,1 T S
$ � 1 � H C K $
------------ �a�r: au�t.�_r;c --------- --------- AccESSORY so-L��Nc ---------
�RNT: Fi iN REAR: Pi IN =R�T: =T IV REAR: =: IN
LcFT. .-F S\ RGHT: FT IN L�Fi: Fi IN RG�T. FT IN
PARKING ?tEO: PRUV; PARCt�; 119i0215 ZNE: R�r N��:
P�ANI�iING Ni5iE5:
J y�
?E ?f ?E:f f if 1f } iE i� i if {: ?E i ii iF iR?E 1c i� it� if 'r, t iF ?E #: i't j: iE �t�'r}t fc if i: � ii?E ie iE ic iE iF iE #!k !f #:< #'r: iF lE iE li iE iE ih?F iF � 3i iF i!� #�k iE �k # iE } iF }: if i� iF }}
D= V c L U:' N. � N i -'S �.E� �' V I C E:, R� Q U= R � M E N_ S
ZUNING A!'?RUCJ�J �Y . , � ��. UATE:
�� � L�,z`c a�-r�ov��, sY
I �i.'-!.'ie?'ififE}};?fiF?f'r.ifieifu�{?Fi:Eif-if#�EiF;}3fific�:f?E<
i��caL_za:.a�;:v r E �
a, nc �,y; PL'JN;3ING
N: .� �.Ul l !
Pi,AN
_SS�JE rF.E
�iiI�LING-JiV-> �=RMIT ISSuE
iGTALS----> 55.50 15.00
i�ar:.:
DATE: D o�
' xx r. irxu K n.x� xi!�iE�lE3E+:itie�kiE#��zic�iF'x�sit
E if jf-?E iE if�-%1E # 3f if 3ElF N 3f iE'�E?E iE #6?E!E IF ��l� 3f 3F #3E 3E 1E # iE t� iE i'r a}#*
G M M P. R Y STRi.iCTORn� SEG:!=NT;ti
N�CHA:viC FIRE u'MIP/RES GP.Ai.IIVG
U
8 5N:�P /NO:V-RES
55,00
P�r?N-CHECH
-- 0.00
R�VE�JU- i)I?TiSlON iGTAiS--> COLLtC2E�:
Bi,UG LMT P�UMBSNG E.LEC'i'RiC NsECt'.Ai�iC
%�.5�
iOTAL PAIU u=��
70.50 70.50 .OG
70.50 OVEB/SHORT: GG
ciRE SMIP/TGT GRAIZNG PiA�-CrECX
?e ie 3f ?f if 3E �: +E s{. ?i�?f ?F iE'r. ir if 3E �7E f iF �1F?F tE ?F x:{.?E'r IE ;i 'f, })f 3E ,r-u u iE iE # i4 �f iE �f # 3F #+E iE iE 3E;E iE # 3E �E iE �7f 3f iE �E #+� Ic ��1F 3f ?E �F iF iE 3E 32?� i4 iF i'r?f
I N D S V I D i.i A L r E E 3 R B A FC n r� W N
iYPE CiTY D E 5 C R; P Y I U N u�i:T CUST YOTAL COg;
��� 3 S��tVIC=:; y��uW 600 V 6 EE��Oid ZO1 A.�iP ? 8. 50 55, 50
=1vU OF = EES
01 �0139471-00139471 Tr] T 70.SQ
DATE: Q5/1�l93 TIItE: 1ti:09
��
CONSTRUCTION AND PLANNING �.
� APPROVALS Permit �
i._ Temporary Elec�rical Service or Pole
2.� Soil Pipe-Undrgmd. -
3. EYectrical CondU�t Ut�Iity-lSadrgrnd.
�
4. Etectrical CondwFUndrgrnd. .
5. Steel Reinforcement
6. Electr(cal UPEF Grnd. -
7. Footings
8. Foundation %
9. Water Pipe-Undtgrnd. .
10. Structural Floor Sysiem
11. Property Sewer Line & House Connectior
'l'
12. Sewer Cap _
i3. floof Draint
14. Rough Plumbing
75. Rough Electrical-Conduit ,
76. Rough Electric Wiring -
17. Rough 4Viring Sign �
18. Rovgh Electricai-T Bar Ceiling
19. Rough Heating & Air Conditi0ning
20. Rou9h Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Tesc
24. Roof Framing
.. 25. Root Sheathing
26. T�Bar Ceiling (Struetural) & Monocoat
;i 27. Frame and Flashing
�,, 28. (athing & Siding "
'r
, 29. Insulation
____ _
'�, 30. Dryv�all Nailing
I 37. Plaster Bro�vn Coat
'�� 32. Electrical Power Meter�Finaf
33. Fina� Electric
34, Final Heating & Air Conditioning
35. Final Gas Pipe�7est
36. Hood or Canopy
37. Finai Factory Fireplace
38. Final Plumbing
39. Water Service�Fina{
40. Gas Service-Fina�
' 41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irriga4ion
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regutations
47. FINAL STRUCTURE & BUILDING
48. PINALPLANNWG
49. Electric Release to Edison
50. Gas Release to Southern California Gas C
51. CERTIPICATE OF OCCUPANCY
Date
Date
X
.
POOL & SPA
�nspector ApPROVALS Permit # Date
52. Poo� & Equipment location
. 53. Sreei Reinforcement
54. Forms
55. Elect�ical8onding
56. Rough Piumbing & Pressure Test
57. APPROVAI TO COVER�GUNITE
56. Electrical ConduibUndrgmd.
_ 59. Gas Pipe, O Undrgrnd., Test
� 6Q. Backa4ash Li�ez, P-Tcap, L! Undrgmd.
61. APPROVALTODECK
62. Backwash & Recepior�Final
63. Heater & Vent-Finai
64. P�umbing System � Final
65. Electrical-fioal
66. Salar System-Final
67. Fencing & Access Appruvai
68. APPROVED FOR PLASTERING
69. POOLlSPASYSTEMSFINAL
FIRE DEPT. REQUIRER9ENT
APPROVALS Permit4`r
� 70. Underground Hydro
71. Product Piping CGas ❑Oil
72. Underground Flush
73. Undergrnd. Storage Tank L' Gas G Oil
74. Overhead Hydro
� 75. Dry Chemicai
� 76. Ory Standpipe
77. FIXED SYSTEbi FINAL ,
� 78. FIRE PREV. FIPJAL
HEALTH DEPT. REQUIREMENT
. 79. PINAL INSPECTION
� � 80. FO00 CERTIFICATE ISSUED
t
�� Notes:
�
�
Inspecmr
r
m
�
J j
PflOJECT AOOHESS: � q 2+ ORA�IGE AV
OWNEH'SNAME: SZMM�S LAVID R
FOOBESS: 1'SAJ M`INORCA llR
COSTA MESA,CA
AHCNIENGINEEH:
AOOflE55:
C��81`�A�6128 ��� uxir:
42626
NEG.NO.:
I1NIT:
PFflMITTEE: A—AMES PLUMBING 6 HEATING ( 714 ) 530-2440
nooeess: 10422 TRASK AVENUE '
GARDEN GROVE CA 92642
LICENSEO CONTBACTOH DECU1flATI0N: I here6y alfirm that I am licensetl untler Dmvisions of ChaD�er 9(commencin n
7000� ol DiNsion 3 0� Ihe Business an0 Pmfessions Code, antl my license is in full fome an0 effect.
cirruc.:006664 sTaTeuc.:250307 cuss:
�te� 7�— � / Signa�ure'. _ s� . _ _
WOflRE�MPENSFTION OELLAflFTION: � I �er um al I have a ceriitic o . Cnl Io selbins cetlih le ol Wor
Compensation I s ce r c rn ietl copY (Sec�ion 3800. Lab. � /
roucrNo.:���4��3�i Exv.onTe: �3/O1/92
comraNv: REPUHLIC
,] Cetlified cop is hereby �umi5hetl: � Certified capy is filetl wi�h ihe ciry Building ' sion. ,
� d � � Applicam: _
E%EMPTION FBOM WOPHEBS' COMPENSATION DECUflAT10 ' 155ec�ion nee Ot be c i tM1e 0ermit i510 ane hunOr¢a ($1
I cenily ��ai in �he peAo�mance of the vmrk br w�ich � permit is issueq I 5 . ploy any person in any manner so as to �ecome
sublect la Ihe Workers' Compensa�ion Laws ol Cali�amia.
Oa�e: Sigw�ure:
NOTICE: It. aller making Ihis declaralion. you shoultl become su�lect b ��e Workers' Campensalion pmvisions oi IAe Labor
Cotle. you must forthwilh campry wi�� such pmvisions or this permi� shall 6e deemed revake0.
CONSTNUCTION 1EN01NG RGENCY: I here�y allum �ha� ihere is a constmction lentling agency �ar �he pedormance of Ihe work far
whicn ihis permil is issuetl (Sec�ion 3097. Civ. C�.
LENUEH:
IIODflESS: - '
OWNEH BUILOEB �EClAXA7lON: I nereby affirm ihat I am exempl iwm ine Coniractors' State License Law for the tollowing reason
�Seciion 7031.5 Business antl Pro�essional Code: Nny city o� coumy which requires a permii to constmct, alter, impmve, aemolish, or
repair any S�mcWre, prior lo ils i55uant¢, also requires Ihe applitanLfor SUC� p¢rmii t0 file a Signetl 5�a�ement �hat �elshe i5 litensed
pursuant io �he pmvisions ol l�e ConVacmrs' S�a�e L¢ense Law (Chap�er 9 �commencing wi�h Sec�ian 7000) a� �ivision 3 oi �he Business
antl Pwlessions Code) oi Ihal he/s�e is exempi Iherelmm ane Ihe Dasis for Ihe allegetl exemplion. Fny viola�ion ot Section ]03L5 by
any applican� tor a permit 5u61eci5 Ihe applican� to a civil penalty of not more than �rve hundretl dollars �$500).
I. as owner oi Ihe D�operty or my employees with wages as ��eir sole compensalion,.will Oo the work, antl Ihe
❑ siNctureis nolinlen�ed oroffered Iorsale (Section 70E4, Business antl ProfessionalCotle: The Coniractors' State License Law
tloes noi apply Io an awner ol a pmperty w�o builds or impmves thereoq and who Aoes such work himselflherself ar ihmugh
his or her own employees, pmvideU Iha� such improvemenls are noi in�entled or oileretl for sale. I�, however the building or
impmvement is sola within one year of compleiion. �Ae owner will have Ihe huNen of proving he/she tlid no� 6uiltl or improve
for ��e purpose ol sale�. �
I, as owner oi Ihe pmperty, am exclusively contracting wi�h licensetl contractars �o consimc� �he pmjec� (Sec�ion 7044, Busine55
❑ anA Pmfessions CoOe: The Coniraciors' S�ate License Law does not appty �o an owner o� pmpeny who builas or impmves Ihereon
and who comracB lor suc� prolec�s wiih a con�ractoqs) license pursuantlo ihe Contractars' Sta�e License Law),I am aware
Iha� pmo� o� Iheir Worker's Compensation insurance shoultl be provi0etl Io me ,
� I am eKemD� unAer Section: B. 8 P. C.
for mis reason:
Oate: Ownec
I tlo herebY cenily Ihat I am aware of antl unaers�an� I�e requiremenls o� Calibmia Heal�h and Sa�ety Code Sections 25505. 25533, and
25534 anA �hat I or any iWure building occupanl will/will nai (circle one) neetl to compty with said Slale coaes and Ihe re0uiremenis tor a
permil lor conslmc�ian or modilica�ion �mm Ihe Fu �ualily Managemeni DiStricL Fesidentiat wnsimc�ion ap0licaiion5 are exempt imm
I�ese provisians. '
�a�e. NDOlicanl:
I herob tlity �hai I have reatl �hls appllcalion and slaie t�at the above informa�ion is correq I ag
i or ' nces antl stale laws relaling lo �uiltlmg con5lNctlon antl hereby auNoriie represen�ati �
iapeny Iorinspeqion purposes. � ,
Oaie: ���_,�� SignaNre'. E!—
DriveYs License or Social Securiry
i641-a6 Whne—Builtling�, Green—Code EnlorcemenL Canary—Applicam; Pink—Revenue:
wi�h
Gi
CITY OF COSTA MESA — HiJILDING PERMZT PERM.NO: P 05213
PERMIT NO: P 052136 PLAN CHECK NO: ��N GOVT: N SUPP: N.
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : REPLACE GAS WATER HEATER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
'EOMMENTS: SMOKE DETECTOR RE�UIRED 'IN THE HOME �'
*�**�****�r�r*�r��*�****a�*�*+r* �+��*�**�*�**�*�**��**+��r��**��*+�**�r*x��*+��**�c**�r±��r*�*
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 BLTILLIING ----�----
FRNT; FT IN REAR; FT IN FRNi; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN, LEFT; FT IN RGHT; FT' ' ZN
—PARKING REQ• PROV: �PARCEL; 13929504 ZNE: REF NO:
PLANNING Nf3TES> '
� . � . ..
iE it 3F iF aE 3f aE aE 9E iE iE #� iE iElE it if if �f iE iE iF iE iE IE M 1f IE it if iE 3f 1Fik if iE iE IE iE iP * IE �F aE?E iE IE?E jF iE if if jF if IE af N� 3E jE 3� 1F iE?E �E lE jF �F 3E 3E+E if iE jf iF �1b iE jE iE iE
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;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY: DATE:
+�a�*��r****�********�+��r* � ***�r***� �+� ��
MiEafiEiFjFiElf�lfiFiF�lEiEjE7FiEiFiE3FifiE�EjF1E?tiE3E�EiEiEiFiFiElEiFiEiF3E16jEafif �f 3FiP#IEiFiEifiF3fif#F1kaf1EiflfiF�fiF1E1F3F, 3fiFaEiPiEif3EiEaF3f
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
. •� �
'BLllG PMT PLUMHING ELECTRIC', MECHANIC FIRE SMiP/RES GR1:D'ING
PERMIT �Z�� • ' J �SMIP/NON—RES
PLAN �'%" � •
ISSUE FEE 3,00
BUILDING—DIV—> ' PERMIT ISSUE' PLAN=GHEGR TOTAL. PAID DUE
TOTALS----> 2,00 3.00 �;0.0.0 5,00 5.00 ,UO
REVENUE DIVISION TOTALS--> COLLECTED:``� S.OU OVER/SHORT: ,00�
BLDG PM7' PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
5,00
1F 36 af iF 3E if if i4 iF if !f if �lF �� iE 1E iF if iE �E �F � if if iE 3E iF iP �E iF iE 3f 3F 1E if fF 3F;iE iE if 1E 1E if iE i(� iE iE iE iE iF if if IF # aF iF If aF iF 1E 3� ibiE if 1E aE iF iF af af iE aF if 1f if iF IE iF iF
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 t UNIT COST , TOTAL COST
- .: i!
PLU 1 WATER HEATER A1JD/OR VENT 2,00 ' 2,00
END OF FEES
tl
!�
Gi 0!]C3u7�^3.�Dit4"ti?=' i i.:':
�!'��CC ilrii�:,���I iItix: :S�_•;-.
V
0
, � �
CONSTRUCTION AND PLANNING � POOL & SPA . �
! �Date Inspector Date -Inspector
APPROVALS Vermit #' , ' . ' APPROVALS Permit # �
1. Temporary Electrical Service•or Pole � 52. Pool & Equipment Location
�,
2. Soil Pipe-Undrgrnd. _ ' - 53. Steel Reinforcement �
3. Electrical Conduif 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 ' ,' j . ' 58. Electrical Conduit�Undrgrnd.
, 8. Foundation -� f� � 59. Gas Pipe, O Undrgmd., Test ' �
9. Water Pipe-U�drgrnd. � 60. Backwash lines, P��Trap, � Undrgr�d. .
�10. Structurol Floor System �/ . 1- 61. APPROVAL TO DECK . ��
11. Property Sewer'Line & House'Connection ''` � 62. Backwash & Receptor-Final ,
12. Sewer Cap , .� � „ • 1 63. Heater & Vent-Final ' .
13. Roof Drains ' � r' 64. Plumbing System - Final •
�-74. Rough Plumbing •- ' 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final
i 6. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign �� � 68. APPROVED FOR PLASTERING
18. Rough Eiectrical�-T Bar Ceiling �, 69. POOL/SPA SYSTEMS FINAL •
' 19. Rough Heating�& A�r Conditioning (� ` FIRE DEPT. REQUIREMENT �� � �
20. �Rough Factory Fireplace • • ?: r - - � _ � ` APPROVALS� � -Permit #
21.�Ducts,inStructuie � . .. '� � . -� 70. Under9round.Hydro � �
22. Dutts, Ventilating - '�` ' J -77. Product�Piping OGas ❑Oil
23. Gas Pipe�Rough & Test � -�� . � _ ' 7Q, Underground Flush _
24. Roof Framing � -- � � " J 73. �Undergrnd, Storage Tank O Gas ❑ Oil
25. Roof Sheathing „� � ' � . � - ', . �74,' Overhead Hydro .
26. T•Bar Ceiling (Structural) &�Monocoat - _ �� � ' 75. Dry Chemical ' ' - .
27: Frame and Flashing; ' � ;; , 76. Dry Standpipe � � �
ti � • •
� 28. Lathing.& Siding. � - - ' - - • ' 77, FIXED SYSTEM,FINAL' �
�'29. Insulation "'. � , � �� � �� . - 78: FIRE PREV. FINAL • � . ��
'30. Drywall Nailing '• � 1 ii ' '' HEALTH�DEPT: REQUIREMENT
-�, �.
31. Plaster Brown Coat _ � : � �`��` `,79. FINAL INSPECTION � .
i-
32. Electrical Power Meter-Final- •' I �'�� •�80. �FOOD CERTIFICATE ISSUED �
�
�33:;final Electric, ' � � 1 f� . �Notes:S�ZQ.(<// �{O /}pi• h✓m3;g,e � („ir'r�7
.34.-Final Heating�& A�r Conditioning� , � i + �'�', ,�':Z [%( �j'� 6Hi� �0�+7���£F.,-/_,._� G�iI�
� ._���ry
35._Final Gas Pi e-7e'st' : ' I���' ` `-
P f /o-�7-Y< 'P�e+»�r +��a,�.� � aee. u,3
' �, - �. •
.,36. Hood or.CanoPY +. .. , i". %V-.�pC� ;GF'p . '
i
37. Final Fattor Fireplace ' �' " ' �f � `
Y . i�\p .,
. . � -
38. final Plumbing , � � • ( � . � �
�39. Water Service�Final• ' � ! � • ° '
.40. Gas Service-Final . , �,�, p� ' - . - . - -,� . �
>41. Solar pomesticFinal � ' • � _ � � =
42.�Backflow Preventera " � i. '
43. Backflow Irrigation• • • � ` �� � . �
.�,� .
a •
44. Landscape Irripation System,�.:•, , _ - � � � . � ,,; -
45. Sound Attenuation ~ '� - ' � ' .� ' _: '
46.` Handicap Regulations . ' � � �� ,, -" � . ,
a7::FinlaL S7RUCTURE & BUILDING � � A�� y� ' ' � •
I I, �/' T
48. FINAL PLANNING � � .- I �/�I : ' ' �
49. �Elec[ric Release to Edison � .
I i �i.}l.
50. Gas Release to 5outhem California Gas Co � y�/j , �. . � - -�
�51. CERTIFICATE OF,OCCUPANCY , ' ! , , , , . , • � +
No. Oate �
ORANGE COUNTY BUILDING.DEPA�tTMENT APPLICATION FOR PERMIT �
, , 636 North Broadwoy � _ _ ..
SANTA ANA. GLIFORNIA • .• �-�.� � � � �- " '
� FOR AP.PLICANT TO FILL IN � ':- Fi1R OFFICE USE ONLY •'. ;. ,,.
' - -� RECEIPT NO. PERMIT NO. �
BUILDING s jJ�a� ^ /r//y/�'
AOORE55 �ii� qu A / � � / �
SCHOOI �IST. y� - ���7
OR TOWN //R�E�cCEIVED BY/ DATE REG'D.� DATE ISSIiED
NEAREST (�/I,✓V I//��J IJ� ���J �� •
CROSS ST. � �/N �� �
OWNER /�j'/ r 6x.If..AVC n AD RE' SG I �_ �
ADDRE55_.L, `�/ �JA � / l.lL//K3� �.4b�1 � ORHTOWN IST. / `� ��J
CITV /R� V JYII� 9�r// LI'l�+L. �NOL �l u'�/ �� CRO55 ST.� f' .�.�. � iO�L��
ARCHITECT OR /��.-n/�� LIC. /� ZO NO.OF TYPE GROUP .
ENGINEER y� �✓ NO. ✓///I`Ni�G f � ( I����5 I
ADORE55 qPpROVED�I �
�TRACTOR ///.�(/Y/ J� �' NO. BY ( 1 •�� DATE '
� 2 � � � n ���� CORRECTIONS �
ADDRE55 (� � � ,
DESCRIPTION I NOT BIOCK��I I TRACT.4�Fs� � ����� �i'C�W
' _ �
(ATTACH METES B BOI-UNDS) �. L.�� � .
�� N I�.S I NOW ON LOTS//!aJ'C.4� _ .
SIZE OF LOT '
C K
USE OF ��A�.�n NO. OF NO. OF - � � �
EXISTING BLDG. �/i�l�r Fnmiuee I ROOMS , „
SETBACK LINE FROM: / � REAR YARD 3 y�
CENTER OF STREET R � SIDE VARO i. � _�. , - - . _ ..
DESCRIPTION OF WORK V � �---� $
� NEW ` I�(�(�TLTERATION I I ADDITION I . „ � . , ' " �
Z
� . _ . y
REPAIfi I I MnOVING ! qI �EMOLISH pI `�..� •"^C.�" �., ���.,� . . r
BUILOING ^ �` O {� ROOMS -I.J STORIES iL � _ �
SIZE 1 / IT �-.s /� Y.,� , '
COV RING WAIL ' �A�IICOV�ERING"I]%'�Yti _ ' �
ILOINGEW f/�aS.�iC-T4-�--'� .� � �' � . •` . .. . . , , `
J '2- t
t .�— .- . ' ^^ .
✓� _ '
� � . APPROVALS , . �
FOUNDATION: LOCATION INSPECTOR � DATE�
I HEREBY ACKNOWLEDGE THP.T I d/A E READ THIS ' FORMS. MATERIALS, 1/y,rf �� �-'iC`�I..$
APPLICATION AND STATE THAT E A OV IS CORRECT ' UNDER-PINNING W D I� �
AND AGREE TO COMPLV WITH ALL COUNTY ORDINANCES FRAME: FIRE STOPS. �\`
BRACING, BOLTS . �I. - �
AND STATE LAWS REGULATING BUILDING CONSTRUCTION. .♦ -
LATH. INT. ' �w
����r.� � � _
SIGNATURE OF � LATH, EXT. W �\
PEFMITTE� A h QdQ�A.
' '✓ • PLASTER. IN'T.
AUTHOHI2ED AGT. PLASTER, EXT. � � (�(� 'yr
PERM�T FEE f� MASONRY REINFORCED
VALUATION S%� %�70. PLnN CNECK S ' �
� � �BOND BEAM
t./
r FEEA� 9RFiAL � ( ���
IOM ]-20-93 ! /
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I, � ` . � r. _ ' _ _ . � .
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STREET� . _ . ' _
� PLOT PLAN � - ..• - - - -
Show location and distances from �. _ _ _ _ _',-'•�= ^
properry line and between buildings. � , � _ .. , �' , .
�E /� �v o S�YrIY _' . _ � . : == , . - � ;: : �
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