HomeMy WebLinkAbout418 OGLE CIR - Building Permits' CITY OF COSTA MESA
BUILDING DIVISION
/
77 FAIR DR�VE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci,costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT 7YPE: B COMBO
Sub Type: RES_RRIP
�oe aooRess: 418 OGLE CI CM
APN: 42574318
Vicinity:
Const Type: V-B
Zoning: , ,
SQ. FT: 227
PERMIT NUMBER: BC08-00561
STATUS: ISSUED
DATE ISSUED: 02/0212009
ISSUED BY: RMD
Suite/Unit:
Primary Occ: R-3
Valuation: $125,516.10
SCOPE OF WORK: ADD 227 SQ FT TO AN EXISTING GARAGE. 197 SQ FT OF EXISTING GARAGE WILL BE CONVERTED TO
KITCHEN qREA. KITCHEN REMODEL AND MASTER BATH REMODEL. LAUNDRY ROOM IS BEING RELOCATED INTO THE
GARAGE CONVERSION AREA ALSO. 1 REPAIR/ALTER COOLING/HEAT, 1 MECH GAS PIPE, 1 HOOD W/DUCT, 16 LIGHT FIXTS,
16
OUTLETS, 8 SWITCHE$, t SVCS TO 200 A, 1 DISHWASHER, 1 GAS OUTLETS (1-4), 1 LAUNDRY TUB/WAHSER, 1 WATER
HEATER, 1 WATER PIPING INST/REP, 2 WASH BASIN, 2 WATER CLOSETS, 1 KITCHEN SINK. TOTAL GARAGE SQUARE
FOOTAG� WILL BE 462 SQ. FT. .
OWNER: RIMMER,HAROLDTTR
Phone:
APPLICAN7: CIRALLI, DOUG
Phone: 949-548-9884
CONTRAC70R: CIRALLIENTERPRISESINC
Phone: 949-548-9884
Cell:
ARCHITECT: -
ENGINEER; AXCESS ENGINEERING
Address: 418 OGLE CIR
City/State/Zip: COSTA MESA, CA
Address: .
City/State/zZip:
License No. 698771
Address: 735 FARAD STUnit:
City/Stale: COSTA MESA, CA
License No. -
License No.61751
COMBINqTION PERMIT FEE SUMMARY
Building Plan Check: 5740.58
Building Fees: $1,139.35
Electrical Fees: $67.50
Mechanical Fees: $54.00
Plumbing Fees: $9825
SMIP Residential: $12.55
SMIP Commercial: $0.00
Bldg Std Admin Fund ??
TOTAL FEES: $2,118.23
"Refer to fee receip[s for all fees paid (or project
Unit:
Unit :
ZipCode 92627
PHONE:
PHONE:714-881-1084
r'`���
��
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be oblained. Failure to obtain inspections and final approval will result in the expiration of this pertnit.
COOE /, INSPECTIONTYPE
1676 Fixed System Final Pire Preven6on
1266 Popl Spa Final
200 Final Re-Roof
207 Final Block/Re�aining Wall
202 Final Factory Fire Place
203
�
Final Sign
Final Demolition
QpiF IN7I7IRLS �QO�f INSFECT14N PYE
206 Final Mechaniwl
208 Final PlumOing
210 Final Electriwl
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
� �NifilAtS
WORKERS' COMPENSATION DECLARATIOI�:�
I hereDy aKrtn under penalry of perjury one of the following declarations: .
❑ I have antl will mainlain a certificate of consent to self-Insure for workers'
compensation, as provided for by seclion 3700 of the Labor Code, for the
peAortnance of ihe xork for which this permit is issuetl.
I have antl will maintain workers' compensation insurance, as required by
� n 3700 of lhe Labor Code, fa the peAortnance of the wvrk fa vfiich this
pertnit is issued. My workers' compensalion Insurance carrier and policy
number are: �%' \
tCamer.i S�{.1� '$ 1 V I'J-I-�
(Thk seUun neea nof pe mmpkletl`atlie peemrt ¢ vaM1IM at orre nuntlrtd tlotars (Sf 0p) «Iess )
Policy Number: �1C7C1 �3b' ��
❑/I certify ihat in the pB�ormance of the work for which this permit is
issued, 1 shall nol employ any person in any manner so as to become subject
to the vrorkers' compensation laws of Califomia, and agree that if I shoultl
6ecome subjecl o R8�wo[!c ers' compensation provisions of Section 3700 of
the Labor Cotle, I s I forth�lt comply with these pmvisi ns.
� a5
liranl'sSignalur D�le j
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLL4RS
($100,QQ0), IN ADDITION TQ THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm thal I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Divisi0n 3 of the Business and Professions Cotle, and
my license is in full (orce and effect. '�
r Lic. # ' 4 � Class #
�
nVaIXOr's SiB ure `Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a conswction lending agency fw the
perfortnance of the work ta which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Adtlress:
SignaWre Date
OWNER-BUILDER DECLARATIONS:
I hereby aH,'�J�d tJ� der pAnalty of perjury tha[ I am EXEMPT FROM THE
CONTRAG_TO�S �U,�E¢¢ U1W lor t�e ollowing reason (Sec. 7031.5,
Business �fd I�,�f8 ( Ssi ^9 : A iry ounry �ARich requires a permit to
construct, alterimp����� lis r �air an�s ture, pnor to its
issuance, also re uires [Fe nt erm �t� a si r�tl stat ment
that he or she is licensed pur t r n the CQi[
License Law (Chapter 9(commencing o 00)'of Di i� 3 e
9 9
Business antl Profe55ions Code or thal he or she e m 1 er Fr �
the basis for ihe alleged ez�mption.,Ariy violation of Se�ion �31. y
applicant for a permil subjecls;the applicant to a civil'�penalty of not more n
fve huntlred dollars ($500).): �
❑ 1, as owner of the property, or my employees with wages as their sole
wmpensation, WILL DO THE WORK, antl the structure is not intended or
oflered for sale (Sec. 7044, 6usiness and Professions Code: The Contractors
license Law dces not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himself or herself or Ihrough his or her own
employees, provided that suth impmvements are not intended or ottered (or
sale. If, however, Ihe building or improvement is sold within one year of
wmpletion, the ovmer-builtle� �II have the burden o/ proving that he or she
did not build or improve for purpose of sale.). .
� I, as owner o( Ihe property, am EXCLUSIVELY CONTRAC7ING WITH
LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business an0
Protessbns CoCe: Tlie contraclors Licensa Law dces not apply to an ovmer of
property wfio builds or improvBs thereon, and who contracts �a such project with
a conlfacl0r(5) license pursua0� lo Ifle Coniractors License LawS.).
❑ I am exempt untler sec.
Business and Professions Code for this reason:
Si8^a�ure Date
305]<6 (]/0])
f
Ovmer ID verifletl by dn cense. ❑ Yes ❑ No
Driver's License No. Expires:
Verilcation o( Ov+nership by (type of Cocument, i.e. - property taa bill or tleed)i�
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby cetldy thal no excavalion frve (5) or more teel in deplh into wfiich a
person is required lo descend, will be made in connection with work author¢etl
by �his pertnit, antl �hat no building stnicture, scaHdtling, falsework, a demolition
or dismantling thereof, will be more than Ihitly-s& (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, TiUe B, Califomia Administrative Code).
❑ As owner-builder, I will noI employ anyone to do work which would
require a permit from the Division of Industrial Safery, as noted above, unless
such person has a permit ro do such vrork Irom the division.
Appliwnl's Si8^��ure
Division o( Indus[rial Safety Permit Number. _
MAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. Will the applicant or present or future building occupant need to (le antl
ceAify a Business Plan for emergency response to release or threatenetl
release of a hazardous matenall ❑ Yes ❑ No
(Section 255�5 0( the California Health antl Sa(ety Cotle requires, with some
excep[ions, that a Business Plan be filed vrith the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quanlity o( hazardous ma�erials equal to or greater [han a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas
at standartl temperalure antl pressure).
2. Does or will the applicant or present or (uNre building occupant neetl to (le
a registretion lorm for acutely hazardous materials? ❑ Yes ❑ No
(Seclion 25533 of the Califomia Health and Sa(ery Cotle, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on �and a quantity of acutely
hazardous materials equal to or grealer than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
temperature antl pressure).
3. Does or will ihe appliwN or present or fuWre building occupant neetl W
prepare an RMPP (Risk Management and Prevention Program (or acutely
hazartlous materials)? ❑ Ves ❑ No
(Section 25534 of Ihe Cali(omia Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certifiwtion and
fling wi�h Ihe Fire Department of an RMPP by businesses which are required
to regis[er acutely hazardous materials with the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of Ihe Cali/omia
Health antl Safery Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or presen[ or fuWre building occupant require for
the work which is the subject of Ihis appliwtion a pertnit /or such mnstruction
or modi(wtion (rom lhe South Coast Air Quality Management District or from
any other air pollution contml tlistriU or agency? ❑ Ves ❑ No
(Seclion 65850.2 of the Cali(omia Govemment Cotle requires thal the requested
infortnation be (umished on applicalions (a non-residential building pertnits).
6. Will any part ot the facility to be constructed un0er this pertnit be within
1000 feel from the outer bountlaries of a schooll ❑ Yes ❑ No
Qf "yes", the lacility must meet the requirement of Sections 25534 and 42303
of the California Health and Safety Code).
7. If a permit from Ihe Soulh Coast Air Quality Management Distric� or other
air polWtion control district or agency is requiretl for the work which is the
subjecl of this application, have all of the disclosures prescribed by Calitomia
Health and Safety Code Seclion 42303 been matle? ❑ Yes ❑ No
8. pf'yes", attach certificate of`compliance from the appropriate air pollution
control officer). �
CERTIFICATE OF COMPLIANCE: I'certify lhal untler pena�ty of perjury Ihe
infortnation given above is wvecL I agree to comply with all state laws and
city oMina�ces regarding Hazardous Materials aad Emissions. ,
Signalure . pale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state that
the information given is cortect. I agree to comply vrith all state laws and ciry
ordinances relating lo building wnsWction, antl authorize representatives ot
the City of CosW Mesa to enter upon Ihe abovedescribed property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorize0 by this permit until final inspection.
Sie� ure o eg. eqs) D e
- .0
AnOlorAURbrize _pplicanl / . pate
• r��
_ �-09- �' �
�� ( �� �,291.� i ,-�� ���s
�CD g —od�� I
_
/���'' � ��v� � �€�
/� ( S l��'� � �<��<�
� S� /%%r.� �'-
�z6z �
���- ��( - 5 �E� �_-c�-�.�
� � �-( - � ( _ 2-� � 7 _ c� ��
From: ❑ Finance
� Building Safety
� Planning
� Public Services
❑ Community Services
� Other
CITY OF COSTA MESA
REFUND REQUEST FORM
Vendar #:
Permit#: ��Q —Q�s� �
Amount: $ �Q
Date:
Department Signature
To�t'a..Q �`ro �f4,G$
Name and address of applicant: �( �'�'� {�(.�J�Y� M��
4l FT �-lil,� C lL��, c
('� s-� /I?�s� �'r , 4 z 6� 7
Phone:
REASON FOR REFUND:
�`fR'G�E6-7 S� o -���- �t_�1vr7 c�c�
� � ���r-� y
i nYs Signature Date
�l �/''' l7%�-v/� �/�! .;��CT t% �-C � z�
n ,,( ,�i��i'it ,✓ /�' �> /L� /N�%�C Zrn•�S
//20U� � t (/ � �i"r
�/L .FJ�y Ctiv/�- ��/��'•�MG'r� .
APPROVALS:
Finance:
City Manager: _
2a01-22 MW ONLINE
,� y ..rn- pIO� r�.��iY _d f 4 r N � ti��4 r���. ��� in�*frI i��- �� � ��T�'�^ z'�:�
- � t' , t }. ,� � "" � � FILING FEE _ , � """'' (
) � yCITY OF����5�,T,A�jME�5A i ks� �;,Fa, �S PD�iT�69: +��eYS,(�Q'i
' v41 �s t JI"'+i+". . Y 1 Rr YA :" }v 'lii - i+ i,. t S `5 S
�6+t'e O �CALIFOfiN1A:� "�-.Na BO%..317 �y�VAR1ANC8NOi . :.i; .�
j� � � ��` -� o"�` � 9 yS t - .�.a 4 � cr . : o �� '. � Y �'F t - ! .
r: _..c,.-� �!r `v" . ��3 : s ` # 2 �` e� ,�'.'"�+: , � ta � t - r � i o �+,'- T � i �� �� �.,.
— _ � '�
"'`� �a4,,..�' qPPLICATION�FOR'VARIANCE to�fhe''CITY'OF`.COSTA`MESA, p:
,4
�."'r � 'T. ;a� � ,�,.ii�,S."'. ,;,^+��'L"`' . ;'�� `�;uo '"!.6'l�: �,y"�;n"�; ,. � yri . � '� t .. C. � i
4 .. . �f .. ! `�i. �, .. 1� .. .
OQ . a A . o .. . . ' .
' " [ r h�� �� .... .� . �i.yi s u . -.
D i _' . 4h . _ ,-
��L .`• '. - « . Y- .,. r'. '.
r�?'�.NOTEr Yvl m A1 �p�on. Attu�� fhe,iet� at Plnm or dnwlnp�on p�Pa� } j WhcrYe �pKlnl P�blem� exLt noto 6elow und cxplein.,
}�. Y,-vra.idre. ; C�. ' a ;- d . -,s o - � S �on back of torm o . . , o • '
.'T7--. i ,� .y �y �� y � !^tr�«ri e�inr �- ����,o �� y;'� �,.Dulldln3—='� _•� � . '.L/ f �i;:
>. .' �' c - �-{�' i 1" � ' a . Q
fc7t � QiQitii $o�v. �: nV'.'RQu � , q i . ♦
�..,aNafric y"'��"". , -i���r -�uflv .,, Hioo • iFlrt �—,-
ry.' �u • . �. ._. _ r�,: . � . � .. .
rti L . e : -, � -, ..� . , �'.p, �,.
�
�2b 9e orL vd? UavporL Pench�_Ce�.lforula�, rouce >. . .- " ' , �,
�l+ddrc YP � � ._J . �.. n u t �.v � n �,. . ..,�Y� ,s, . . .
'� � w.�� ..�,. tn ��r"'1.J 0 �on
� ' " U ��7 "�' � , n � `En¢Inecring�
� 4'. Q �,n., � � . y , ,�'r`-r'."'"� '"'� }�.,
i y GI '.t' o _ .., .
.. �TclePhonc No:-4r1o1d3 6G00� , : �.. . � — • �„ :' . '�, ,Dninu¢a . .. . . : .. •+
' • �wu� - t y la i � . p � . , � i 1 � , �
� i. � .- . o oi' � r'� � r � ' a �III¢hl ot Wdy /•` / /' l� .
( n o .� .
�C r . a �� �`-eacroneffieats into hoaL s.� , .,,n ;, �
4R��atln Varlqn�c�' ��� � � , .. �� �
'- yn�Qe oi o e 1-� b^�-H and'I� ot:l4ect 5776 �;Gsim� 'o � .
�- �Ben aptechad Plat Dlam. ; -�- .. a . a - � �
�� .. . . - : : . �t�r�8ewe � ;, �, t u!
:r �'� ' -� .. Lote i,_5, 6,_T, ��� �
%uyal �/ iptlon/Parcc I,�m r. r . Vtumc .. . , ,,,,, ..
j; yt w� � ` � I - �w� [l vR - �.`, .
/ . } : r � F�� , �; '� , b j I'.
�7'i'6eL 1'�6.� � Plannln ��,'"' .
Y � . , n . ' � ' •, t - .' � . . �
� InF ,lon� O,�le� o� betvcrn Alieo-ead 1Vstiu Ave . wai�t " .. - _.
r -.1� � v� :�.a
� a ak `
� � :' � . j (� �� � ..• V �' � � %Zone _�ta�ter Pln = ;
y, t . . .... . . . '". _ "'
.� o. vow�r� ru�v.i•-„ r. o���, ,.
APPiJCAY'fS 1IU9Y�FILL OGT CO`fPLPYF:I.Y1 • _ I�� o _. ` . , �ry «
�.i. . -.,..�'U �.' , . ./j�� , O . . . - , : ' . , f
V clrcumatnnccy'or condlUone„np�ly.to thia pro�ertyY ,.. , '!
'' . (I) ;Whnt excepUonal"or extruo�dlnn�y, . . . -. .. � , � � - �t ti
�'� yot shnpee and•Lype ot comtruetion caueee.�ucroacLroent.into;ironY�nnC renr,yardn�. .
. . . - � . . o �� ., r o-
' r, ry _..,.�. � _, . " -; ' •. '. :. _ � ', ' , rlt . ' , ' . . '
�
�(p); Why ls this variance neces.aary lor the preservatlon nnd en)oyment ot substunqnl propertY rl6�ita4' ; .;
� +
�,;_- lypu of devcl,aymeat md PTiee,of homes nod land co�t.prohibit��m�isller�homea.. ,. •. , °�''���'
� .;�. . ' � o .'- . . , .�. - ..`4'
�-T,.-.1':'.e. ... .�.i., _
.�(3), Thc �'nnting o( this vdrinticc�wlll not bc-matcrlally detrlmentnl'to thq public .�GdCnrc or fnlurfous to property.. �
. i"<In the same zo`Ing distdct Ixcnuse: , „ , . . '. _. ' -3 . ,.
o'
:} - Thie Sd.Lo be._a contained unit and e47?�ent to amcrjn yreacrit dapelopmenL�to �theJecuth.• .,
_ . � 7r n - - "� - ` . � _ . .. - .
(4)' �Thc 6ranUn6.ot Ih:s ymiunec wlll not bc contrary to lhc ob�ectives',of thc hinvlcr Plnn becnusc:' �
� for addiLional ualtu� oaly iroat�aod reer�Yazd�ecexroaclimeate:, .
Wuer is no9' mlcin8 . . . .. . � , . � , �
x. (," • , . . . -.. �,
: ,.' . � � _ - . . ; ' ' a : . � , - , .
- " � . J�J . � � � �'� � Thc PlnnnlnQ �Dr.Pnrtment ncknowleB6es thnt,
Signatu'^ --- ��� �,�� - :, ����y, pPp���ntion hos bcen duly exa�tnined and ��
�, . . ... �. . if � � � " .
' /.�.�� is comPletc: o �r
a'
.SlHnnlu—=.�.i�_ .r�C' �_.�. � �_...�.. - ;qiy' ...; ' _ ;�
- . . �l �v .o. , _ , . _
'' Ik . .•�- � 1� ��r� xeaa�odaa eyprovnl ,
� ?b26 �_rt Blvd � 3lcvporL Sench� , Calit Dp,� o �Pl�t�1g �fi�4ibni- . , _ .
r naa,�s_ G^ , �� ,' � ' ..;... -- —�,.. �„ v
w••• � . ' �ee r�quenied� -
o � „
' `� . . . . . .. o .
� $�6nIILLtC � �� �r o .�� - .."' .�._�_ �•. ' G�y COUf1C���6E !OO �
��0 1
�261�i��` �1`� x or Seach .� n fhe'Plm�nin8 Caaniedon. $i .8
� Addm=^ art vd.,,._ c�T.;. E.. ,. oiifornia 't7
w.�, � . .�.. a n
J - , l" � � .
d ,oa 4 '����I� . j , a
, '�r d J ._.. � o
� Telepfione�No ' N.;��.. . . ,,; . . . . ,
i �. ,
� ok�- � at�d . ,o � � '- : � � .
� I l' - f �� �'i � _ . , , v
�f _ - . . _ � . ...�' .
O id) j��'� 0 � � �..� Y f> �c t W,,. _r .
� 6 _. a i-. f/,ijk: ._ ., � • • �,� ' b-p '.' �.. _; ���:,
''.YARiAYM.'I9 T�S 7RASBPERA6LF. -�VAItIANCL IS NUI.LrABD tO1D IP�NOTlu9[n�'1TIrtNR�EAit
_..__ �
� ' } -� r�. � .�+ '�,��,�t-4 - :i.:` �.I+r � . " ,�.,i „� '.� � �A ,+�:�y Y y,y. o, > ao � '.d' i.+4i - � s,..
',�' i:��, C,�a+�e�9 '�.j{r Ji 1 ,� ��..y n�. ��� A. ..� iip .�� V
y. , ' ;y y d F�� � o i� �. i� ' � . i� 7� .. o� .
i -b0'� '� � .'Q r � � , � � ' ,, ` ; k d. -C� r x . .
G - , , 9 � � . � �' , - . � o � . ,
t � �; m%'r -. , ' � .. .lk . • �' . .il• � ; , P S p � F Fr i f H' . 'e � .� ..
a. - '�12 ♦ ,�, i :� to� � ,p '�_
� 6 . � l�'�i:� � . O, t� �•u . o ., - . � • o'.
, '� , , �,� �- , o ,. , � , ,.: s, a � '-D P a �� �� c
.t.. ;�' . �
�'� --- ------ is l. is •� y_ s. o o� -i
�°�.,a .I - � ' — 'ro -leT-�S¢u•-_ ,o� .y.� i�"-'v"-r ':< 'i
r5 �.^ �
. . 1 4''`n 4 .: .'i t a�D p . �� .�.Y�4 iM1 �`' V 1YIf L �+p .,ry .��-'C'o : • ` .. I
ji � . ' �� . � `� �
, ! � : • Y I � I-• '� . .�r t"! ..M)�F �. . �.�N . _,� - 1
'� ' � . . �/ �� ' �' r � � �I
` ( �i ' 'i " , ..i
a. i` { /
��v �'� ,; �IN � //�J. .0 SB��. u ��-���! ,?�! �Sf�r�,iQ� �.'r � _i
" f .y: o .2 b � . r�, - . O. ` I 1' i � ;' . ! o-b`- �a.vO . . . { �'1 ST .. I
' � . V'_ w e� . p 7 • `7 i �� /' - . :�r �
• .o��a \ C� ' • Z U . ,,Q ' r ' �. i / t.'� � I .�(1• '
u , � � ♦ •�'„`� 'I 6 . � ' ' � ((( _'"'� ' ' �` r .,._,- � .-'.- �
L �
/����) � � ) A Y ( � �
U " � . `
.o'rv�.�. ,I , �� � ,tf-y , 1,0 5-S. "
. , :� io:o�' � - . .; . � . e �. _ --
' ���-•� � �, i; �/ - �. , �' , j , - .. ' �
-.o' ot . ., _ i � _✓ •, . , _o �.� , ., i ;; ,�` ,O� G L`EJ
, � i , ;,;,•
� .� , . ._ �
�•.. L . a '.I � _. . � • ��-� ��,.o. . �.
� . . . .. t� •n � f] Q o \' • v . , .
� 41' � ,y � , � I' ��n .,. -
,�,
�� � I ' G ,� ' ' �
,ory�. ,o , . '� • ��� �. _ ,� ,.,
o . ., �
- -� , � ' ° , . o, . o � . , .
� -• . . � � �, . . . . � jj Olj�ti'�'�'� I' --�ti. •o
. , . . p o�. .�Q �,b ' . ' �,��- . I � , o o. 'v
- � • � .0
- ' �ol . o !� 0 . \ I
o � ,
� b �I , ., ' ' � „` 0 �. . i' 'I. � �_ . l 'i: p :
' �, �� �--,I 1 r50
�, . ` .' �� _ . � � ' . \ c o � ••�
. .i' I o. Q y o � \• i`.4 0, ' p,i
o� ° `
<• ' o i �q: o� ._� �� IA , � .�'. , � ,
i — S , �� .. _ - �''
,� ' � �- ' � � �1;' �-*�-3 ' r "
, ' � ' . ' . —:" (' �r� ' . ' .
� . . 8 0l',� � 6 � , �� � �9 . ` � '�i
� � . . ' ' . . ' � .
. . _ _ �_ _ o <0 ' �n h � n ` .
C ..... .._...A........._. _ __ _ ' �.i��i5�_�_"�__ ___ _'___�} ,BS �Qi _ __.4.___. _
. . . , '•. _ . ... .�. . . , � . �H
. • . �/ �.� 6 •, o'� ' .0'6'e � � c
. .� . . .> .. . ` � , . /�� • v • o � ��1 ,. ,, � ' .. �- .- .. �
. 0 ' ' _0. ., • '�� / . ' ., , ' . ' _
. o � � 9., . ' 'u .
� .v . . . .. G . . . _ Qo ..
- .. . . . , o ' � r . , c o C, .
�n . . e . � .. � , ' 'J . , ` ' . ' . O . ' . . C � � . ' .
o . . v . ' ' 1 , . •• .. L .i .
e 1 .
.,
AFAc, C}V�;D o � , � � ' : � ;.. � • .
. `". , CPfY Or CC.L�Pn I.tESA ' o , � o .
���:..�:�,:;;,�:��,�. �' R`.:".:A �:C
�.
' . - ' tiU(fl.'.r,i tU bLU�J. DEFT. REO, a � � J ��
s � ' �
' /�� ^ �
_ n .. , , ' ISYI(.:��L�1 o,,re,� �� -- � .. . �, ,. � ��:-R;,E
� ��a�� ,. �, � � � >
. � , <
u, � � � - G � .
o � a � , � ' � `a o � �� � . �
, .20 � o � , a .
� � ,
� � . � '������{ri- j•� ( � � � " v ° o; 0 90 ' , � ' " • ��. ; o
„ � „ . dd L ��., . .
'� �J� � o
' - . �i, � �� .`fl �: �', �' � o �° � �
- ' ` .�."�'sw ' i3O; '.q-'-`� ' � ' ;.✓- _• .- . . TT � .
urr: ,- �.•.,
��` ��� . �� ' :8 -
v,,u. r;� nrr��icvec :6'�s:� ,�
, , D? c ��u�^+
<�o � a � _' T _-�dia.�„�-.�1:
. , ,; � . .
'
. . itd� :r\ \ ..Vn�. . ��... . .�-..r�r . - .„.,�,^ry:
i �y pti.I'
, � r U�- /.,V•t%+ �'Y.ilY�i'%� V %li�/T( 'E�.lf%lFHT ..
z"- .i,
'�'�`� r. -.t �:_ �� t a o�6�Q�.. o a � a o• 6 0�
�; k..- - ""�--- --'—._t�' --------s — --
� . .'J �..: <. w 1
_ � yv . I
i s �� � . I
�o. � o
� tx �~-i.i c ";,ti' . 7; b. � � ►6, � �
�� � ' � q �.�, r�t � .,
' ,.� - ! i I
-
� �� . �N}
• { �� � `� � . �J • � I 1
J � `\ 1
; . • o � - � • .V ' .�
�
c 6 _ (p' � ' "
y � ;:.4 . _-� , J�' ��.
i �
., , �J- �u�
-. , 0'4 ' . O p �� � , ! o�. � �
aa.� '� 7� �%�\ \Q� . � � �,, /C � ' ' ',l`i�
�.' �.. �� \• • . �' � �L7 i � .
� � . � � C --,-a '
� �� �, � � '
j ! ,� o .; . _ -o^ N � �
. I l
, � � � o " � ' ,� . .� � . r„ , � 23: p�(: � .I
-�;.
1?3�0'=� a.d , ��� �.\ . o- (
—'1 / , � 1
�y ( � �• � - . i . , �` � , � ^ j r , 1 �
� " t . '� . '. ./� . . � 4
� ! 6 � 0 � ;' o ,' � % `. \ ' p, �
� . . � ' . .
1 � '��' � � �, 1
� m a, ' , ti
� ) �- . �� ;,." � , , � • \ � ;
I , ,. ^
1 ( ��./r e, 'w. . - ' � . �� ' r.
� , � \ �
I ! ' /� . . ' ' • � . ' � ~\ � (
� i "
� , -.—_' .-- '...._ ..- . ---- ---__-. la.a� -"-_.."' '- ,. i7:�.1
�/� i� r.
` �� W '�"' � ' . A � �
o� � � -� tf � . �J� 0,-. �' . I`r
O� � . �� � �� � . „ � � � 'q
I ^' � . ' � :, w . CL ; � . r'�'�:( 1. �A . � .i / , i ' 4 .
!1 ' 27�,f •C;.?�� lV�VIA' L✓ . ' ` 1 � a
f� � �
�� � ':;r� . � . . � ' c�
� ' • + .�
� , � "�D . . . `O- . . . ,,.'
' � .. o
, � � b
� , � � � �
, �
� .. � . � �, Q,
� , w f- ...,
I� 1- ,r� �._.•...� id: p"� �'., � fi ,,; . a , i n"
� t �
. � a;�o��.
I �`� ' .
� i � � � ". � , �` . re: n• .
._ . ._, �.� •.
x Bx� � �r,�
_. K
_ � � `1
599' 5o i4 q'�
�?- � ��"'-- -� '
e wo �Ch -
� �En�
.`_�� 1L ^�.. -~ _ _ �ScMc�r
r T: ._ -_ 4�' �.`
-i;;' - t
,i�: . � ,
�.�_ ,
"i~ -'i •.
,..}_•� Lt _ ". ` � . t;
� Li � � �p� •�.. --�._ " .
, .� ' Cf, `Y�O ""' /f
�
-' �. �� � � , _. �
' � r'IIG..
. � -- �BN��^
j- � �.c
� . '�' r`_`` . �:. . �
. . . ' � � , IG�011 ` . � ` .. . .
� . oNE ilNg � � , , ' � . • .
, � , ' _ R�o �RY � � - - � . . . � .
- ' . . � -��H_E_ e , .. -
. �
, �
� �
/
�� � ,\
,
,. EX �i� K
,�
,��ScqpEp �.Co i„Wpo�p� O
. "'-,-.\ nft,yE1,�{y�r . , � t( E!`10E 8 '
� � . . . ' , ,../��'-�_�-�__ •,
� " Z
i -�_:-_ �
, • . ,
J , �
� _-'.- l; ��,� R, 4_ � T�
�,
�<IMMER, HAROLD T
RIN'�1ER, SALLY K
418 OGLE CIR
COSTA MESA,CA
AYPL.WJIIMG ADDRE55:
LRLXRECT Ofl E1NiNEEP:
wcx a+u+o.•s woness:
92626
coxmacrarswu�; MIKE DIAMOND PLUMBING
CONiPALtt1flSNY1JNfi 3022 N HESPERIAN
moncss: SANTA ANA
92706
LJCENSE� LOMHRCTOPS DECLAN�TION: I Mreby ellim uMx perely d parjur
(commenarp xiih SeMion )000) d Oiviaion 3 d iM Buainms eM Pmleavma Code,
crnuc.No.:0647.99 uacuss: C 36 uc.No, 43
UNi:
uc. ra.:
uxt:
(714)541-9753
�A uc.xo.: 432734
uxr:
thm I em licanaed uMer pemmv d Cheps 9
M my licanae ia in lull lace aM allw.
!,734 EXP: 04 /97
"f W F BUILOEH DEC�AHRTION: I hereby elfirtn under panelryN perMT �hm I em eremp Irom iM COMreaon licenae law lar tM
'I ' reasm (Sedion 1031.5 Bue'�resa end Pmieasiona Coda: Any cily a rounly xfiich requiree e pa�mil to consVuct, ellm, improve,
moleh, or repsi eny evuciure, prior lo ib bauence, e6o rx�uiroa �he eppli�xnt lar mr.h permn �o fib e spnad etelemeM tlW hs a she
a i�o�a w�� �o �n, a�,. a ine co�vae«. ua�sa i.. ICheqm B loommmd^Y xdn Sadion )000) d Diveion 3 d IM
e�� �d cramsw coeel « md na « d,e n�ema �nereimm ene me nea �« me d�ed .:emaun. an •wmon a seav,
)031.5 b/ enY ��t la e permil wbqps ihe epd�l to e ci�nl penMy d iwl mae iMn (ve huMrtE Edlan �ISOOn.
�,, � I. ee ovmar dthe peopeny«my empbyees wRh wegee m �hen ede rompenealion, will Eo �ha wak. end �he elnwwn w ml iMended
or ollared br aeb (Section ]Oas, Buunesaend Professions COEe: TM Conlreaon Lkeme lewdoes iwt eppyto en owiwr d popeity
wro a�u. «mwW� �na,aoo. �e .+w e�.�d� .An� �bn a n�ar «�n��ron no «ns, o� �dm+e., w� �nm.�e,
impwammia are rot iniaMed a oXmad I« aele. tl, however, �M buiNi(q a inqoveinem u edd xnhm pr yw d mmpla�un, the
ohmarbuaCer vnll heve IM1a buNm d qaviiq M a she tliC ml Euik a impove lor IM WN�e W eab).
� I. ea ownx ot tM O�M. � eaduervey cantreain9 �h liceneed convecton �a cmatrua ihe pmjerl (Seaion ]oa. &ni�roee eM
Profeaeima coEe: Tna comraaon Licensa Lew doea na eppN �o en own.r a v�M �+�+o buiNs m impova inereon eM who
wnvecb la wM pmjee% wnh e coMreclor�a) IcensaG W���� to �ha Gonireclan Licenae Lew�.
� I em uemp �mCer Seclion: B. d P.C., for Ne �eamn:
o�e: o.,�a.
I Eo hereby carlily Uw I em ewere W uM uMerstend ihe reQuiremente W GalYomu Fleellh aM Sefety Coda Seqiom 25505.255J3. vd
255J0, vM thm I or eny lulure WiMirq oowpent will / wYl nd (dmb me) neeE b canply wYh eeid mle mEee enC iM npuiremanta br
epermelawuvuclunamodifrelnnhamlMA'r�ueC�y enegamen�Diuiie.Radde�aialmmrwbnappiratiomvamemphanNus
a�apro.
Dele: Applicaril:
WOFKEfl'S COMFEN4�TION DECLAPRTON: I MreEy effirm ueqer panelly d px"ryry one d Ne toYoxinp Eetleret"vo:
❑ � nma ene wi� meime:i e cenaKme d mrean �o..n;im,m �« won�na• canw�.mion, o wo.+a.e e« M s.mm a�ao a m. �ee«
Code. lar IM parlorme�we d iM1e xwk la which thia peimil u iaeued.
�11///������..,,,(((///��� I heva end wil meintein xnikeA compameiion inaurenm. ea required by Sedim 3]00 0l �M Lebor Code. br the pe�lormenw d tM
\ work ta r.fiidi thie pamin ia ioued. My warkere' mmpenae�ion ineurence urrbr enE pdicy number ere:
GOLDEN EAGLE EXPIRES
ra� �mn� 01 / 01 / 9 7
�ih,a ,enr� ��d �or a. canvbroe i me va�x o ro. �a n��d�d dw� /siaol w x.a./
� I mnN that in IAa perloimenca ol iha wak Iw whkh ihia pamil b issueE. I ehell iwl employ enY 0a� M�Y maniwr n m �o
becoma wbjm to tM woMne' wmpenaeiion lewv d CeIE«nu, prea Nm �ittlfI yd,.�au.My b�erome wbjwa ro iM v.oMn'
compenseur 'ao 1 Seaion 3100 d �M Lebw Code. �MII �.;mn wm°y�C' /��
�vW�. w.vCc/
lig: Fellun ro s�euro workeri romps�wtlon eowraps I,7 nkwlul, �ntl Mell wsJ�et nn�empioy.. ro�nm�w �.ro., ma
c/vll llnu uy ro w� M1unOrM (houunOOall+n (f100,000). M�tlelfbn ro th� cwf ol rompNwt/on, denupu u provlNtl lor In
Sxtlon ]l05 0/ tl�s Lebor Coee, Infaut, entl ettomey'a Isss.
CONSTpUCTON LENDING A6ENCY: I MreEy �rm �nde� peneM1y d pxNN �� �� u e wnairuamn bMirp epeMy br IM
parlormeMe d �he waA la wfiidi Iho pa'm4 is uaued (Seqion 309J, CN. C).
LENDEN'S NAME:
LENUEN'S AUUflE55:
I ceniy Ihet I nere raed �nia ePVlcetim arM qme Ihei tM ebove inlorme�ion is cana. I wrea lo wmON Mi1h ell ceY ene muny ardire�x,s
end eteie lexs releling lo build'mg wnsvucnon aM MreEy eNhor¢e repreeentmiree N ihis dry la entx upon tha ebove�meMianed pioperly
�°`�°'P°'�°°o°`D°'°' FERNANDOMORENO
��'St51<B.WP) —_ W�no-Buildvq
Oele:y��'y��
/
Pink-Ravenue: Aoldenm�Reauwr
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 080822
PERMIT NO; P 080822 PLAN CHECK NO: N GOVT; N SOPP: Y
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : SUPPLEMENTAK TO f10446 SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
if if !E iE 1tlf 1F 1f 1f fE iE iE fE fk k if iE 3F ik 1E� ik 1E 1E iE iE iE iE 1f iE ik iklk �E if iE 1E 1F iE iE 1E i! iF iFlE if 1k ff iF 1f 1f 1f ff 1E if 1FlE 1k fE 1E iF 1E 1F iklE �7! 1f 1E iE �E �f iElE iF fE fE if iE IE iE
Z O N I N G R E Q U T A E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42514318 ZNE: REF NO:
PLANNING NOTES>
i
if if iE if iE ik iE'IE 1E 1E IE fE fE iE i! iE 1E iE'lI-iI' 9F iE iE iE iE 1l' ik il' iF i%ih iE ii' �f 1E if 1l' iE iE 1E iE iI' iE iI' if if it iF 1E if' 14 iE iE �E iF iE if iF if' 1%i%iE ih ih'K' ih iPlE'1E iE'If if iF iE if iE if if 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;
1ElE'1f-'lEiElEfEfE1F1E�ElEiEiEiElEiEfE1EiE�EfEiF3Fi�F{��iFiFi�iFiFiF�7F�iF�FYh�F'(fTfi�iE�FiFifTf�F�f3fiFiFikiEikiklf�iElE1E 1E�
LEGALIZATION:N F E E S U M M A R Y STRUCTURA SEGME T:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 11.00
25x SMIP/NON—RES
PLAN /�
ISSUE FEE 6.50
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL PAID DUE
TOTALS----> 11.00 6.50 ,. 0,00 17.50 17.50 .00
7
REVENUE DIVISZON TOTALS--> COLliECTED: 17.50 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHF.CK
17.50 •,''
.,,/
', IfiEffif�fiElf3ffEiElffFiEjFlElfifiEfElkiflk�EiElfiElflEiE1E1E7E1E�EiEiElFltiflfiliElEiEiElE1ElEIElFififltiflEiflEiEfE9ElEiE1E1EiE1FiF1EiEiEiEiE1F1F1fdEiflffE
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 Z P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 11.00 11.00
,END OF FEES
�.
v
;� i
•::r �
01 00220E1S-00220ESS TO T 17.50
DATE: 121�1/�5 TItiE: 14:23
\
CONSTRUCTION AND P4ANNING P� �& SPA :
API'ROVALS Permit # pate iospectar APPROVALS � Permit # pate inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location�;�
� Soil Pipe-Undrgrnd. 53. Steel Reinforcement � �
�Electrical Conduit Utilitv-Undrgrntl. 54. Forms �,
. -� -.
4�,Electrical Co�duit�Undrgrnd. y' S5. Electricai Bonding .; ".
5. Steel Reinforcemeat 56. Rough Plumbing & Preswre Test � �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE - �
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test -
9. Wa2er Pipe�Undrgrnd. �, • 60. Backwash Lines, P�Trap, �,Undrgmd.
10. Structural Floor SYstem 67. APPROVAL TO CECK � '
t t. Property Sewer Line & House Connection 62. Backwash & Receptor•Finai
,
12. Sewer Cap � . 63. Heater & Vent�Final .
13. Roof Drains 64. Piumbing SYstem - Final
14. Rough Ptumbing � - 65. Etectrica!-Finai ..
15. Rough Electrica6Condurt 66. Solar System-Finai �'
16. Rough Etectric 61'iring � 67. Fencing & Access AnProval '
17. Rough 4Viring Sign 68. APPROVED FOR PLASTERING •' S
18. Rough Electrica!-T Bar Ce��ing 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT
20. Rough Factory Fireplace � ' " APPROVALS Permit # �
21. Ducts, in Structure . 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping O Gas G pil
23. Gas Pipe-Rough & Test � . 72. Underground F Wsh _
24, Roof Framing .- - 73. Undergrnd.Storag2Tank UGas OOiI
25. Roof Sheathing � 74. Overhead Hydro �
26. T�Bar Ceiling (Structural} & Monocoat 75. Dry Chemical � -
27. Frame and Flashing _ 76. Dry Standpipe
28. Lathing & Siding- � - 77. FIXED-SYSTEM FINAL
29. Insulation . � 78. FIRE PREV. FINAL .
30. Drywall Nailino � . - HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FWAL INSPECTION
32. Electriral Power Meter�Final � 80. FOOD CERTIFICATE ISSUED .
33. Finai Eleciric � ' • Notes: ���� _ �C � ���_ _ �
34. Final Neating & Air Conditioning- � ' - - - � _-
35. Final Gas Pipe-Test ` - _ ' ' -
36. Hood or CanopY � - �
37. Final Factory Fireplace � . � ��
38. Finai P�umbing - � ', _
39. Water Service-�inal �
4Q. Gas Service-Ftnai . - -
4t. Solar pomestio-Final ' �
42. Backfiow Preventer �
43. Backflow Irrigation � - _ � .
44. Landscape Irrigation Sys[em� . . -
45. Sound Attenuation f � -
46. Handicap Regulations • �� _
47. FINALSTPUCTURE&BUILDING , ` „
4&. FINALP�ANNING -
49. Electric Release to Edison -
50. Gas Release to Southern Catifornia Gas Co �
51. CERTIFICATE OF OCCUPANCY .
No. Date
�OONF55
�. yuiwc �ooxcss:
vVLL l.l
, HAROLD T
SALLY K
����t��
92626
urn:
APCIIRECT OP FNfd1EfA: 11C. N0:
�qCll qi BIR'4 �DURE54: UM:
c��Tarsw� M3022DNHESPERIANBING (714)541-9753
cam�crons � SANTA ANA CA ��, 432734
9 2 7 0 6 ,,,�,,
LICENSEU COMFACTOfl4 OECUNATIOH; ��py ¢�'� �r pmy�y d peepvy tlim 1 em fcameE ivdv povu"vu W Cheqx 9
(wm Tq w4h Senun )OW) d Dnnion 3 d tha Buvrem end Pmf»siom Code. eM mY 4oems u in IW laca rd Mtetl.
c uc. 0.:064799 uc.cuss: C 36 uc.no.: 932734 EXP: 04/97
/D e: CaNrea��.��.i �
s
H BUILO DECLANATION: I ha�eby �� undm pmely d per'µy Ihtl I em acamp Imn tM CmtreGm Lioen�s lew la Ihe
' rmmn (Setlbn ]0�1.5 Buainae mq qWaeaima Code: MY �'fi' a�nry wfiirh repuiree a permG �o cwawc�. elis. impro.e.
.�ndnh, n ropei any ev�ciuro, p'v lo ile eWywe, ebo rayuirea IM epplimrY �a mch pxmn to fib a eqrcd etetameM Mel M a�M
'n fcrosed purnient lo Ihe pvmbm d IM C,onireeon licenx Lew ICMqm 9(�menonp wuh Seqipi )ppp) ol Oivebn 9 af �M
Buznev vM Prdeuuna COEe� or �hN he a eM is eaemq �hereliam vM Ihe besa tw Na ellepeE eMemqion. My voWbn d 6equn
]03t.5 by eiry ep0liranl �w a permn wEjacle Ihe oppliram to e dvil penelry d ml mare ihen IHe hundretl dd4n �55007).
� I, ee owrwr M t�e properly a my amployone wnh wegea es iM'r eole mmpenaelion, will Ao Na xrork, and �ha ewnure b nW iMeMed
a ollered br We (Sociwn )OIa, Buuiwq ¢�d profeesiona Code: The Conlrepore lrcanae lewdoea nd epplyto en oxnerd popeiry
who buida ar inqwm Ihmaon, arM wlw doee euM wak NmeeX a henetl ar Waph hi a Mr oxn pnpbyae�. pwNeE tNl ach
impewemeNa ere nd imeeded a dlsiatl lor eele, p. howmror, the WiNiip a'vnpwamem u�old rmhin ms ym d eomWYun, tlq
owrwrbuiNx xill lave IM buNen d ppvirq M a dre d"d nd buJd a imqv.e M tM WN�e d aeb).
� I. n oxmr d IM V�WsM. em uduwrMy oontretliq xqh Goenaed contrMae ro m�mua Ms pMad (Seuun ]Ou. Bw'vws eM
Roleasions Code: TM Canlrepm �icanee Lew Eom ml apWy ro en owiw d popny x1a dulde a Ynpmie� tlwson md Mn
contrem M wW pqem wnh e mpreqy(e) Icaivad W�� to tM Contretlaa Liceme Lewl.
� I am manq uMu Section: B. b P.C., M thia mmm:
I tlo hxeM ��N tlW 1 un awvs dW �dsivwM tM n9w�emeNa d Cellmue Ibell� uH SdW Code Swiom 45505.2551'1. end
]SSv. enE Nm I a erry Mws WiNuq omryanl xio I wil m� (acb ar) rced to minply wlh �eid uele mEee end �M npivsina�ro br
� w� la mmuutlbn w moddrmion ham tM �i�axmaw4 Ou�rin. MsdeNil m�aa�ue un �ppf ratiom an axemq hom tlra
a�.
Dme: Rppfraeu:
WOPKER'9 COMPENSITION UECLAA�TION: I MnW df uMv px�eliyd pxj�vy me d IM IdbNinp Aedvtlbp:
� hewudxilme'viienaanLkmedo0neent�oaatlimunlawaken'mnpemaim.eV�ovidadlaMSatlion�lWdlMleEa
Goda. tu �M O�rcmence W Ne xak In w1ic� Nu Da� o'vsusd.
I Mw ud wJ meiNen.aken' aomMnwion hwvae. m nT� W Saaion 3100 d tlr lebv Code. br iM P��ri d �Ir
1,.��«.+:nw.c.�em�.e.Mv.pn.�.'a�%ii�`�:`P.�L`�'�°°a`v�ea.n EXPIAES
c�«:
ca;�, N„me,,: O 1/ O 1/ 9 7
(This mcfiwr need nd be romph�eJ l fM1s psnnt h M one �vndm0 Cdlen (fi00) w ho.)
❑ I mrliy Nm in ths pMormence M iM Wpk fa xfich thu parmn N iseued. I ahell M employ enY pa� in vry menner so m to
/�become wdeq� o-i�oAiM x�o/Ms�en' canVenwion kvn d CeNaw. eYme Nm J I tlauk becme abled �o iM wrYrs'
A\��nl� 1/� /�/ �9 / 9)0o a �ne len« coaa. � ennu � wiln oomoy�.� ��. l
// //
m .anm�
ro alMnl p�n�Ma.rM
mpi u prov/ew ror In
CONSTRUCTION LENDINO A6ENCY: I hq�ayy ¢ryi� under perelry W pmjury ihel Ihen ie e eanaeuaun Nntliip e{�em.y 1a Ne
parlormarre ol �he xak la xfiich �M16 peiml ie awed (�� �l. CN. CI.
LENOEN'S NRNE:
LENDEH'S ADDPE53:
I eenily thet I hew read i�u epplieeiim and nme ihet IM ebv+e infpmelion o eo�reef. I�ne lo eomply wilh ell ary eM ooumyoNvu��
eM atals lexe mleiiq to Wik'vq cmnruuion aM Mreby eNhorce iepeeenlelivea dihe ary b omx upon tM ebo.e-meMiwd p�apvry
�°""'pBd10"°"r°°'°' FERNANDOMORENO
. ., _.
(s,s,+e.wa�
Dtle: /� /�
ameMFle: CenM'-ACPk'��: Rnk-Rewnw: OOldenmA-,Weav
CITY OF COSTA MESA — BUILDING PERMIT
N��iKit�' fdf�E ki dtt�t�2j E'LAN t'H��'K NO: N
CONSTRUCTION TYPE; PERMIT TYPE: MEC
JOB DESCRIPTION : F.A.U.
CLAIM VALUE: CALC—VALUE:
PERM NO: M 080823
GOVT; N SUPP: N
PURPOSE: OTH
S(j FT:
GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
**�r****�t�**�r****�t�t#***�*****r�r**�t**+t******+�i�+�*x�*�***«*�rx�********x�x���**�t�t***�**
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ: PAOV: PARCEL: 42514318 ZNE: REF NO;
PLANNING NOTES>
i
if 1E iE iE �ElE iElE iE 1f iE iF iE 1E 1E iE 1E jE 1E iE 1ElE 1ElE 1E �E 1E 1E i! it if IE it iE iE 1E ik 1E 1E iE k fE 1E 1l� if 1E iE fE * 1f iE it iE iFlE if ik if if 1E 1E iE 1E iE iE 1E ik iE iE fE 1E 1E iE 1E 1E iE if 1E 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
BUILDING APPROVED BY ;
APPLICATION ISSUED HY:
iE1EiEif1f1E1FfE1E�E1EfE�EfEifiE1f1E1E1fff1f3f�fi�iF�iF������ff �F
LEGALIZATION;N F E E S U M A R Y
BLDG PMT PLUMHING ELECTRIC MECHANIC
PERMIT 1325g
DATE:
DATE: �
DATE: /
7FiFiffEfEiElfiE1E1f1E1E1E if
STRUCTURAL EGM T:N
FIRE SMIP/RES GRADING
SMIP/NON—RES
PLAN ...
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE P�,AN—CHECK TOTAL PAID DUE
TOTALS----> 13.25 22,00 ,,, 0,00 35.25 35.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
35.25
1t iE 1k iF iE iE iE iF fE 1E 1E 1E iE 1E 1E iF 1F fE if 1E 1E 1E 1E 1F �E iE iE k 1E IE iF 1F 1E 1E 1f IF 1k ik 1E if iE 1F 1F 1E iE k!F iElE fE 1f iF iE k fE 1E iF iE 1E 1E 1E 1f ik 1E iF iE 1E if 1E 1F iF fE iE 1F 1k iE IE k 1E
I N D I V I D U A'L F E E B R E A K D O W N
TYPE (JTY D E S C R I P T I�O N UNIT COST TOTAL COST
MEC 1 INST FORC—ATR/GRAV FURN <= 100 R BTU 13,25 13.25
.END OF FEES
, i:
D1 DO?20E1d-00220E16 T U T 35,?,�,
DATE: 12/11/95 TIhE: 14:14
CONSTFiUCTiON AND PLANNING P� �& SPA �
APPROVALS Permit # Date I�spector qppROVAIS rermit # Date ir�spector
7, Temporary Electrical Service or Pole 52. Pool & Equipment l.oca6on ,
2. Soil Pipe�Undrgrnd. '� 53. Steel Reinforcement 'i`
�. Electric8l Conduit Utility-Undrgt d: 54. Forms `%' ' •
G. ElectricalConduit�Undrgmd. (•�5 55. Electrical8onding � ` '
5. Steei Rsinforcement 56. Rough Plumbing & Pressure 7est
4.
6. Electricai UFER Grnd. 57. APPROVALTO COVEA�GUNfTE ,
7. Footings 58. Electrical CAndui[-Undrgrnd.
8. Foundat�on 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undr9rnd. , � 60. Backwash lines, P�Trap, O Ltndr9md.
10. StructWal Floor Svstem , 61. APPROVAL TO DECK f �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Pinal
12. Sewer Cap � 63. Heater & Vent-Finat � .
13. Roof Drains 64. Plumbing System - Final ,:
14. Rough 7�umbing _ 65. Electrical�Final ,`�
15. Rough Electrical-Conduit �66. Solar System-Pinal %r�
16. Rough Electric Wiring - 67. Fencing & Access AnProval -� �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �'
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL °
19. Rough Weating & Air Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough factory Fireplace APPROVAIS Permit #
21. Duas, in� Struc[ure . 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipin� OG.s ❑Oil
23. Gas"Pipe:Rough & Test . . 72, Undergrouad Flush
24. Roof Framing �- - 73. Undergrnd. Storage Tank O Gas O Oii
25. Roof Sheathing _ - 74. Overhead Hydro
26. T�Bar Ceiling (Structura0 & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Laxhing & Siding . • 77. FIXED SYSTEM FINAL
29. Insulation � � :' 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final • � S0. FOOD CERTIFICATE ISSUED \
33. FinalElecvic . � Notes: _`G_G����e��.�s
t
34. Final H¢ating & Air Conditioning
35. Finai Gas Pipe•Test � '
3fi. Hood or Canopy _ �
37. Final Factory Firep�ace
. �
38. Final Plqmbing � �� .
39. Water Service-Final �
40. Gas Service�Final . .� •
41. Solar pomesticFinal -
42.� Backflow Preventer , . ,
43. Backflow Irrigation � .
44. LandscaPe Irrigation Svstem - - �
45. Sound Attenuation ' -
46. Handiwp Regulations . .
47. FINAL STRUCTURE & BUILDING '
48. FINAL PIANNiNG - �
.49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY �
No Date
�nonEcsaeu�mic: 418 OGLE CI
5 wmexsruxeira�a+m:RIMMEA, HAROLD�,,T
� wowess RIMMER, SF�;LY :�,
418 OGLE CIR
COSTA MESA,CA 9'1626
1PPl. YAl1IIlG iWOPESS
IMCHITECTOP F11tlNFFR:
ARCX.ON ENG5.1WNE55:
uwr:
�—V
11C.1q.:
urrt:
coamncTarswu�MIKE DIAMOND PLUMBING (714)541-9753
CONIIiACTORSYYt1NG 3022 N HESPERIAN
wo�ss:SANTA ANA CA ucxo, 432734
92706 urar:
IICEN5E0 COMNRCTOHS UECLAflATION: I hareby � m wMu penely d pwjury ihm I em licemed uMm prvrisma d Cheqa 9
(oommeMin6 wilh Sactian ]UW) d Oirision 3 d Ma Buv�n erd VMesaivn COEe. end mY liomw o in IUA lace end eltetl.
No.:064799 uc.cuss:C 36 uc.No.: q32734 EXP: 04/97
,c,: — r N- �����: �.-i; be. 7; A-v�nn.��Q �PI µc�.
'i R BIIIL�ER �ECLARATION: I hareby elfimi uMer panely d parjury ihet I em memq Irom �M Comraqon Lioame Lew la
" 9�aeson (Setlian ]W 1.5 &niwsa vM Rdeavona Cade: /�M ciY n cvuniY xfiidi reVwree e D�C to mreMxY. eller. imYove.
..emd"a�, a repei any avucture, prior W As iauerca, aho requirea iM applirent lor euch permil to fib a eqmd etatemmt tlW M a vAe
ia licenved Wn�e�l to IM yomiona d iM Conireaas Licerue Lew ICheqer 91����0 �h SeUion ]000) d Divwion 3 d the
�9up�ss eM Rdmaiw�v COEe� or Ihei he ar she is ezemq Iharehom eM iM besb fa ihe dbped ezemqion. My vidmion d Setlun
)031.5 by enY e00�irsnl �w a pmmn aubptls Ihe eppli�anl lo e wi perieM1y d ml mora Ihen Me �uMreE Adlen �5500�.
❑ i.�a.�,�erainev�vwmranWureas�..n�aa.�in«.dammro�.m�..uieoin.won�.enemen�un�ueemimenaee
«ollered for wa (Secwn ]044.6uareaeM Pmleasiau CaEe: The CaqY�on licrose Lew daea ml eooNtoen owwrd qopem/
who buids or inpovea therean, aM wfio dmn euch work lim Wt or Mnatl or thraq� hc or her ovm empbm�, qwided thm euch
improvemeMs ere rot imeMed or dlered /or aeb. X, however. IM buitli�q ar inprovemeM u wid xil�in one yev d mmWe�ion, IM
owrer-buiker will lave iM buNen ol pwirp he or ahe d'd m� buik w impwe f« the W�s d eeb).
� I. m ownx d the P�PoM. em exdiurveN oonlredM wilh IicenseE wnVMaa ro canaVup the pNaa (3oqun )01/. Bwinme enE
PMe.mona Code: The Conlreda+ t'seme law Caee �wl npply ro en owner W pope�y who builda a impovae tAraon erd x1a
mnvecta i« wM pqeee wiM e coMmtlortn) Icemad quauent to �M Com�edaa Limma lew).
� I em exemq �ider Senbn: B. 8 P.C., br Ihia mawn:
De�a: O�mer.
I do hereby ca�lity Ihat I em ewere d arM uMeialuM tha �aquiremmb W Cdiwnie HeeXh e�d Salny CaEe Sedima 25505. 2SSJ3. uk
T553a, eM thm I a eny M1nure Wiki�p orsvpent will / wil nd (dicb one) need to comply wIh eaid qma codu ud tM nyuiremaMs M
epxmnlawnsVuct'anwmodifiratonham�heM�6w y�enepamemDim�ia.ReaNentielmnetiudionxppfu�iaroene�omqhanNua
a���.
Data: Applioaril:
WONKEP'S COMPENS�TION DECLAN�TON: I Mreby elfiim uMer penetly al pajury aro d Na fdloni�q dWeiuuona:
� I heve vM xil meintain e cenilcele d mnsent lo aellimurt la xorken' compenmtion. ro povidad la by Seeion ]]00 d �M leEn
coea, rw ma �no,�w m ma � rw w�n m�n oe�n re��e.
'�I hew end x�tl meimen woMen' compenamion insureMe, es required by SeUian 3]UO d the Lebor Cods, br IM pAormvwe d IM
��m,wn�a,m����n�.�.�,se.n+y.�.��GO�DEN�EAG E '��"�m��� EXPIRES
c�.,:
Policy Number: � 1� � 1� y 7
(mis seaion neea �a ea mmWerea r rna w�x is ro. o�e n�m�ee aarers /siaol or ress.)
� I ce�ily ihd in tha pMormerce d iha woA br whch t�ia pmmil ie imued. I ehell iwl emplvy any pemn in eny menner m o b
becane subl� lo iha xvrkera' compenvtan lewe W CelNanie, enE epree Nel il I ehouk Decome wbjaa lo iM xwkan'
compenseiion P�90119Q� ol Ihe Lebwle� , I ahel��� ���
e:
em/ng: e/lun ro wc�ro woh»' compwwtlon covxep� l� �n/awNl, ene �hell aubHc! en ernp/oysi to eNMNI pm�ltlu �rM
Ivn nr�s up ro ons hunCrotl tMuasid CWlen /f�u0.�A �� ���� ro�s eost ol romvwa�rort tlamsp� o provltled br In
xf/o ]OS ol tl�s LMor Cooe, Infers,t, entl ettamsyl lesw
CONSTHUCTION LENDINC AGENCY: I hareby elfirm unEer penelry oi perN'Y �hm t�en ie e canel�ud'wn IeMiip eperKy lur �M
�IBI�IXTBIICB O� �h0 MUf�( �Of MiIC�I �h6 %�TI 19 BBYBj (SMY 113091. riN. Ci�.
LENDEH'3 NAME:
LENDEN'S RDDRE55:
I cerlity ihel I heve reaE Ihia epWicelion eM me�e ihel Iha ebava inlormPobn is mrrw. I epme to mmply xith ell tlry eM muMy oNineMae
eM atete lexe relmng �a buildinB construdian vd hareby eNhorrte represanie4vea W thia My to enbr upon ihe ebova�mamioned pmperry
mr ios�aioo v�r�s. F ERNAND OMOR ENO
o�e / / �,�
(St5t�46.WP� Whno-Buildinp 8 Sefely. Greert-Fle; Cenery-Rpplicenl; Rnk-Revenue; Oddenro�Aeeeaeor
CITY OF COSTA MESA — HUILDING PERMI"P
PERM NO: P 080446
PERMIT NO: P 080446 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : REPLACE WATER HEATER SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AOTHORIZED BY THIS PERMIT
1E if 1E 1E if 1f iE ik iE iE if if if 1f iE 1E iE iE iF 1E 1E iE aF 1f iE IE 1E k 3E ik k 1Elf �E iF 3! IE 1f ik ik if iE If �E 1f 1F 1E �F iE 1E fE 1E iE 1ElE if 1f fE 1f iE iE iE if 1F fE iF 1E 1E fE �E �)E iE 3E fE i6 iE 1E iF aF
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 BUILD'ING ---------- ---------- ACCESSORY BUILDING ---- ----
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN AGHT: FT IN
PARKING REQ: PROV: PARCEL: 42514318 ZNE: REF NO:
PLANNING NOTES>
i '
iE fE ik 1F ik if iE 1f if iE iE iF iE jE iE iE IE IF IE 1E iE �E if �E �E 3! if fE iE iE if if if 1E iF iE 1E if if !E If !E IE iE if !E �)E 1f 1E iF IE if iE jE 1E iE fE if iE iE 3f if iElE iE 1E iF 1E iE if iE jF iE if iE iE iF �lE� 3E
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 .
BUILDING APPROVED BY : __
APPLICATION ISSUED BY; / A<�.
iF fE �E iE if 1E if if IE 1ElE iE 1E iE �E iE iE �E k 3E iE fE�� if ik if�FiFiF"iF��iE
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 11z5�
PLAN
ISSUE FEE 22.00
HOILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TQTAL5----:� 11.�1�) i�.�Jt7 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMRING ELECTRIC MECHANIC
33,00
DATE:
DATE:
DATE: L b
i� � * �t * �x-* u-�FlF� 1d ���* �c
STRUCTURAL SEGMENT:N
SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
0 33,04 ,0�]
33.00 OVER/SHORT: 00
F1 E P/TOT GRADING PLAN—CAECK
ik iE iE iE if !f iE 1Elk 1E if �1F iE 1F �IE fE iE 1f fE 1! if If 1F iE 1f �t iF 1f if iE if 1F it if' 1E iF iE 9F 1k ik i(-iE 1t 1F �E 1F IE 1E ik iE �k 1f 1E ff 1k iF 1E 1E iE �E iE iE fE iE 1F iElFlE 1E iE iE if'%# 1E iE jE if 1f
I N D T 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
PLU 1 WATER HEATER AND/OI2.VENT 11.00 11.00
END OF FEES
�2 00219i82-00219182 T�7 T 33.00
DATE: I1/14/95 TIIfE: 13=53
-- - -
CON5TRUCTION AND PLANNING � Q� �� & SPA
qPpROVALS Permit # � Date inspector APPROVALS' Permit # ' Oate Inspector
1. Temporary Electrical Service or Pole � 52. Pooi & Equ�pment l.ocauon ;'
2. Soil PiRe-Undrgrnd. 53. Steei Reinforcement .
3. Electricat Conduit Utility�Undrgrnd. 54. Forms - �
4. Electrical Conduit�Undrgmd. ' 55. Electricai Bonding � �
i
5. Steel Reinforcement 58. Rough Ptumbing & Pressure Tezt
6. Electrital UFER Grnd. 57. APPROVAL TO COVEF�GUNITE
i� Footings 58. Electricai Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �
-=�i+
9. Wate� PiPe�Undrgrnd. ' 60. Backwash Lines, P-Trap, � U�ndrgmd.
10. Structural Floor System �� 61. RPPROVAL TO DECK �
1 t. Property Sewer Line & House Con ection 62. Backwash & Receptor�Pinal'
12. Sewer Cap .. 63. Heater & Vent-Final �
73. Roof Drains � 64. Plumbing System � Finai -
74. Rough Piumbing ; 65. Electrical-Final �
15. Rough Electricai•Conduit � 66. Solar System-Final .
16. Rou�h Electric Wiring 67. Fencing & Aceess Approval .
17. Rouyh lNiring Sign 68, APPROVED FOR- PLASTERING
78. Rouyh Electrical-7 Bar Ceiling . 69. POOL;SPA SYSTEMS FINAL
79. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fi�eplace APPROVAIS Pe+mit #
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping � G. s❑ Oil
23. Gas Pipe�Rough & TeSt 72. UndergrOund Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling �Siructural) & Monocoat 75. Dry Chemicai
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding . � 97.� fIXED SYSTEM PINAL
29. Insulation 78. FIRE PREV. FiNAL
30. Drywall Nailing HEAL7H DEPT. REQUIREMENT
31. Plaste� Brown Coat . 79. FINAL INSPECTION
32. EIeM��c�l Power Meter-Final 80. FQOD CERTIFICATE ISSUED
33. F�nal Electric Noces: _e? �S4RQk�I�O�( �Q� ���-�iy
34. Final Heating & Air Conditioning
35, Final Gas Pipe•Test �
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing 1 �
39. VJater Service-Finai
40. Gas Service-Pinal
41. Soiar pomestioFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem �
45. Sound Attenuation
46. Handiwp Regulations
47. FINAI STRUCTURE & BUILDING ,
48. FINAL PLANNING
49. Electric Release to Edison .
50. Gas Release to Southern California Gas Co _
51. CER7IFICATE OF OCCUPANCY
No. Date
i pppJECT�00flES5: 4 1 8 UGL E C j�. •
OWNEN'S N�MF: TIM R IMMER
noow�`ss: SAME
UNIT:
encn�excixecn: � 14 ) 8 3 9- 8 6 0 5 pEG.NO.:
eooeess: ' ; uNrt:
PENMITTEE: �HE.PPARD MASONRY ( 71.4 ) 839-8605
nooeess: 17587 MEAD ST
FV CA 92708
UCENSEU CONIMCTOP OECUMTION: I �ereEy aflirm ihat I am IicenseE untler D�oNsions ol C�apter 9(wmmencinA �+�� �Cion
70W) 01 Ohdsion 3 0l tAe Business antl Pmtessiws Cotle, an0 my license k in tull loru an0 ettect.
cmuc.:0�933FS sTareuc.:564877 cu%�:C-29
Uate: Sipnature: �
V0KEB5' fAMPENSRTtON OELUXIITION: I �erebp allirm tAat I have a cetlitiwte al cansent ta ull-insura or a ttrtificate of Workers'
in0enution Insurance, or a cenilieA copy tAereol (Sectlon 3800, Lao. C)
�oucr xa.: F�f8o�9 ucr. o�re: �{�28�89
COMPRNY: ,,.,/
❑ CertifieE copy is Aere�y IumisheA. L71 CertifieE copy il A'Ih t�e ciry BuilUing OiN, a. �___ �� _
✓ /
' Date: �2/��/8t Nppliwnt: , ` '
IXEM7fI0N FflOM WOflNEH3' COMPENSIITION OECIAWITION: ,(Ilus sectlan ne 1 he complele0 if tlw permn is for one hurMreE �5700) or kss�.
I certity thal in the performance ol ihe work for wMc� Ihis permit is issue0, I II not employ any Derson in any manner so as to bewme
sublect to tAe Workers' Compenutlan Laws oi Calitomu: .
Oate: Sipnammi � '
NOTICE: If, aiter maMnO this declaratian, you shoultl Oecome suEject ta the WOBers' CamOensaiion provisions oi tha Lahor
CoOe, you must Iorlhwii� comply vnlh such pmvisions or t�is permit sAall 6e tleemeE revoketl.
CONSTPUCTION LENOINO �GENCV: 1 Aerehy affirm that IAere is a wnstmction IenOinp apency lar the Detlormanu ol Ihe work far
whicn inb permit is iuuM I�Uon 3097. Civ. CI. .
lENOEN: .
ROORE85: -
OWNEP BUILDEB DECUMTION: I here6y attirm t�at I am e�empt irom the Contractors' State License Law br Ihe lollowinp reasan
(Section 7031.5 Business and Pmfessional CoEe: Pny ciry of counry which r¢quires a permit ro constmct, alter, impmve, Oemolish, ar
re0air any simcWre, pnor ro its issuance, also'requires Iha apDlicant lor SucA permit ta file a sipnetl stalameni ihat h¢/5Ae i5license0
pursuant to Ihe pmvisions af IAe Contracrors' State License Law (Chepter 9(commancinp wit� Sectlon 7000) ol Dlvislon 3 ot ihe Business
anG Professbris CoOe) ar tlut he/s�e Ls exempt t�erelrom and tha Easis Por ihe alle0etl exemption, My violation of Section 7031.5 by
any applium for a Dermit su01e«5 Ihe aDO�iwnt lo a civil penalry ot not mom I�an /ive hunCreE Collars (5500�.
I, az owner of Ihe propeM or my employees wltA wapes as tAeir sole com0ensation, will do the woB, anA Ne
❑ s�mcWre is no� intanGeE or afleretl for sale (SBC�ion 71144, Busln¢55 antl Pm�essional C040: .The ConiraCtors' Sta�e Lit8nS0 LaW
aoes not aODly to an owner al a D�operty who EuilOs or improves tAerean, antl who Ooes such work �imself/hersell or thmuph
his or her own emDloyees. pmNtleO that suc� Impmvements are not intenAeO or oiferetl lor saie. If, �owever the Euildinq or
•impmvement is solU vnihm one year ol completion, Ihe ownar vnll have Ihe �urtlen of proving he/she tli0 not CuiIE or imDmve
for the puryose oi sale�. , -
- I, as owner al ihe Oroperry, am exclusively contractin0 wilh licensetl contractors to constmct the D�olect (Sectlon 7044, Business
0 and Pmfestians Coae: Tha Coniractors' State Licenu Law Oces not apply ro an owner of Dmpefry wha �mlds or imDmvu IAereon
an0 wh0 COn�ratls la! SUCh prOlCttS wIR1 a COntratl0r(5) lit¢n58 pulSuani �o t�e fAnt2cbr5' $�aie UCln52 LaW). I am awaf¢
Ihal prooi of IAeir Workei 5 Camp¢nsation insurante SAONE be O�a�Oetl ro me.
� I am eKempt untler Seciion: B. 8 P. C.
. for tAis reason:
Oate: Owner:
I tlo nereby certiry that I am aware a1 antl untlerstanE tAe reQuimments ol CatiPomia Hea1tA an0 Safery CoOe Sections 25505, 25533, anA
25534'anU t�at I or any fumre CuilOinp occuDant will/vnll not (circle one) neetl to comp�y wii� saiU stata codes antl t�e requirements tor a
permit lor conStNCI'wn Or modilication Imm t�e N'r dualiry ManapEmtnt DiSIntl. HeSiEmtial COnitmGtian aDWlCati0n5 ar¢ exemD� ��om
these Drovisions. ' �/� N
Date: /Z �� 8 ApDlicani: .�-��/'�„��
I �er¢�y C¢Nty Ihat I �ave reatl [�i5 ap0liWlion an0 5Ial0ItWi �he aGOv! in10 on is tOfreti. I a0f¢e la Wmply vn�h ail [iry an0 County
orUinances an0 state laws 2lannq to EaWinp wncwctim anE hereEy autAorire resenUtires ol IN5 dry ro enter upon tAe aUove�mentane0
propeM �w inspecf fpsurymes. ^ �j�.
oate: �2 I r — SiAnature'Q7�(�G� �-/�'�"�%���
oriver's Licenu ar Saciai Securiry
164/J6 W�ita—BuiMieg; Greon—CaCe Enloreemenq Canary—ApO���^�� Pink—Ravenue; GdEenroA—Ass¢sgpr
CITY. OF CU5"fA MESA - BO'CT,DINC> PERMIT
PF.RMIT NO: B 045407 PLAN CHEC(< NO: 01953-II9 5
CONSTRUCTION TYPE: PF.RMIT TYPF: S7R
PERM NO: ➢ 04�407
GOVT: N SUPP: N
PURPO'.iE•:: NGW
JOB DESCRIPTION : STD BLOCK WALL ' SQ FT: 144'
CLAIM VALUE: 3,0OO.OU CALC-VALUE: 2,OII0.00 GROUP OCC: M-1 /
COMMENTS: STU BI,OCK WALL
��c-�����*��*��***�+����r�**���***��****�r�r�r�c�*���**��*�r�******^��*�x*�x*����***�c�� x�r��
7. O N 1 N G k E Q O I R E M E N T S
S E T B A C K S
--------- -- h1AIN BUILDING ---------- ----- -- ACCE;SORY DUILllIDIG -- -----�
FRNT: FT IA1 REAR: rT IN FRNT; FT IN REAR: FT, Irl
LEFT: ET IN RGHT: I•'T IN LEFT: FT IN RGHT: FT IN
PARKING R�n: PROV: PARCBL: 4251.4318 ZNE: R1 REF NO: ,
PLANNING NOT�S> APPROVAL TO CONSTRUCT �.44 LINEAR FEET OF SIX FOOT BLOCK
% WALL ON REAR AND RIGHT FROPERTY LINES.
iE iE iE iE �f iE �%3E'f 3f fE iE iE �lE iE # iE iE 3t !t �f �)E iElE Ik iE IElE �E iFlE if it iF if �lf� �/' if if iE i' iE iE if iE jE �%# dE 9f if iE �1E if iF if M� �lE fE �E K 1h iE iE 7f i' iE Ik iF if # fE iF iE i(� iF 341E �k
D E V E L O P M E N T 5 E R V 2 C E S R E O U I R E M E N T:3
ZONING APPROVED BY ___ _� _ DATE: __�2—I /��
AUILDING APPROVEC� BY :____,_ ________�___ DATE: I2l/�/��
APPLICATZON IS'SUEQ BY: DATE: /2�l`7�/v -�
x�ie�r.-at*3t-n**�**ir�*x���*�c�**3F"iF'iF'iFi��i€�i'r';riv3F,e�- . . . �-��c��***rt?�*"�'.�.FiF-i�•x�+t
�**�x*it**��iE�*��**�:������ciEiEitifx�r��r*it*rt+�x��it+tx�ie#itx�*�**it***xitit**x*iF��it**�r*��***x**at '
I�EGALIZAT70N:N F E E 5 U M M A R Y' fiTRUCTURAL S13GMF.NT:Y
BLDG PMT PLUMBING ELECTRIC MGCi{ANIC FIRE S'MIPlR£•.S GRADSNG
PERMI'T 54.00 � .50
. sMZPiNori-u�:s
YLP.N l5. 10
ISSUE FEE
HUSLDING-DTV-> PERMI.T I.'"iSUE PI:AN-CHL:CK
TOTALS-----> 54..50 0.00 75,10
REVENUF.: riIVISIGN TOTALS--> COLI,CCTED:
fILDG PMT ]?LUMB7NG fiLECTRIC MGCIIANIC
54.00
TOTAL PAID DUE
09.60 89.60 .00
t19.60 OL'ER/SHOF2T: .00
FIRE SMIP/TOT GRADING PLAN-CIiP:CFC
.50 35.10
if IE 3E jE �E �lE 9E 3:- i(--Y.- # iE :E ?i )F iE 3E 3E IE If iE if if iE 3E ik iE 1E iF if i4 if iE )F 3E 1f i4 if 3E iE iF iE if fE iE iF !E iE 3E jE 3E if ih'F 3(� 1E iE �E iE fE ��lE?E iF 3E 3E iE iE K;E � 4f !f iE iE 3' iE # if
I N D 1' V.T. U U A L P G E B R E A K P O W N
'PYPE QTY D L•' S C R T Y T I O N UNIT COST TO'fAL COST
SFR 14h RGS-CONCRETE �[�OCF<' WP.Li, <O,UO 2,800.OU
� snin or• FE�:s •
\1.
01 00049775-00049777 TC7Y 89.50
DATE: 12/14/89 TItIE: 16:14
CCINSTRUCTION ANO PLANNINd � POOL & SPA � `�
APPROVALS Permit # Date Inspector pppROVALS Permit # Date inspector
�'lTemporary Electriwl Serviceor Pol�r.. �+ 52. Pool & Equipment Location �•? -
�
! .
2. Soil Pipe-Undrgrnd. }• 53. Steel Reinforcement .i'
3.. Electrical Conduit Utiliry-Undrgma� C 54. Forms � � �
4. Electrical Conduit-Undrgrnd. �� 55. Electrical Bonding � �l
5. Steel Reinforcement 56. Rough Plumbing & Presture Test
6. Electrical UFER Grnd. �� 57. APPROVAL TO COVER-GUNITE
7. Footings - �. �• 58. Electrical Conduit-Undrgrnd. �'�
� 8. Foundation _ 59. Gas Pipe, 0 Undrgrnd., Test , "
9. Water Pipe�Undrgrnd. � �.'�'. 60. Backwash Lines, P�Trap, O Undrgmd. �� �
10. Structural Floor System j ,� � 67. APPROVAL TO DECK , �.; -�
11. Property Sewer Line & House Conn'ection� ;� 62. Backwash & Receptor-Final � `
12. Sewer Cap , N . r/ 63. Heater & VenbFinal ; - j� �
13. Roof Drains ��' x 64. Plumbing SYstem � Final � i � '�
14. Rough Plumbing . e�' � 65. Electrical-Final - �"
ti
15. Rough Electrica6Conduit i:.y 66. Solar SYstem-Final � �� �
16. Rough Electric Wiring ��t 67. Fencing & Access ApProval .� )
77. 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, iri Structure 70. Underground Hydro
22. Ducts, Ventilating . 71. Procluct Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing - 73. Undergrnd. Storage Tank O Gas O Oil
25. Roof Sheathing 7q. Overhead Hydro .
26. T-Bar Ceiling (Structural) & Monocoat 75. �Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing�& Siding 77. FIXED SYSTEM FINAL
29. Insulation 78, FIRE PREV. FINAL �
30. Drywall Nailing ' HEALTH DEPT. RE�UIREMENT .�
37. Plaster Brown Coat 79. FINAL INSPECTION -
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: R� b�L �
34. Final Heating & Air Conditioning � ��`�
r,�,
35. Final Gas Pipe-Test . � � •
36. Hood o� CanopY •
37. Final Factory Fireplace
38. Final Plumbing -
39. Water Service-Final �
40. Gas Service-Final
41. Solar pomesticFinal � -
42. Backfiow Preventer � �
43. Backflow Irrigation ,
44. Landscape Irripation System
45. Sound Attenuation . '
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING � �� �
✓.
48. FINAL PLANNING _-� � ; �
49. Electric Release to Edison -" j^�
50. Gas Release to $outhern Calitornia Gas Co _�`
���.
51. CERTIFICATE OF OCCUPANCY .
No. Date .
;-,-..
�.'r-
. ., , �,• �� ��
Ct l�
� �}ILS AC3tEF?�S7T. made and entered inta this J � day of
teCPru �a— ��7 �/ . � � bY and heb+een k // !�'/ //i%/!'/E��
hereinafter referred to as 'LAAID aFt�R•, and
hereinafter referze�i to as •AATA(�S.T F�FKPEei 3 6JNFR'.
It is hereb� egreed tAat e party vall vill be constructed m the
prcperty line beri+een
T
in the City of Costa tSese, Co�nty of Orarxle, State of California, as per mnp
cecor3ed in Bodc � , Page_ of't7iscellanews Ftaps,, in the office o� Lhe
:ounty Aecorder id Co�nty. Tt�e parLy ti+all ahall be pezmitted ta encrxd�
�� O
_3 ����.� � � gl�h�, ,a��,���4, . ���
�i� o� si�-� � ..� 4 ��S
�
,,
G'r
TN WI�T7FS5 1+t�REOF, the psrties have entered inta this Agreenent the
Ia�+ ard year first abwe ti+ritten.
:4ND a7;�Tt
x �
,SignaUse) !
�`�cr� � /t i fi .r,E/L
iai� (i}'ped OZ Pf1�tECf) .
�`��sr D�� �,e��
:Address)
� � • �a • -w • •a • a-
/
/ � , ��,
_ � .
� , r
.
r�e czypea or arintea� J
�a ���--
'` � �'.��n�,e�v6E' �2«�
(Address)
u
i-7�:.�`.�1�lf�e , aa.�a..
�
��
9iL5 AC�tEE�NI'. tosde ard entered into this � � day of
�2.ribP` /`7S� , �, by and bee+eenj( � iL.irYlm�`".2
hereinafter referred tn as •LAt�ID aFt�Et', and h ,�/L—`,��01� �. �'E'E'�ES�
hereinafter tefeTted to ds •1►ATACiN!' PR('PE+23 Q1NfIt'.
It is herebi agreed that a party vall vill be constn�cted on Lhe
property line be�+een
r
in the City of Casta Asesa, Co�nty of Orange, State of California, as per mnp
recorded in Bodc " , Page_ of Niscellanecus Fiaps, in Lhe office c� the
:ou�ty 7�corder of sai.d Cou,ty. Tbe party wall shall be permitted to encrxd�
IN WITT1F55 W�REOF, the parties have entered intn this Aqreerrent the
!ay ar�d year ficst above r+ritten.
11ND 67i�R
x uv�� � ^
;5 gnaLse)
��9.�UL� � /Li✓YI/r+E/�
ta�ne (TYped or Prant )
� �fi� ��s�E G'i,ecL�
;t�ess)
AAIAC�?.T PR�EKIY d+R�IFR
X . `�7i�'�.ch✓ r,� ,� i��c.�c�/
(SignaUse ) r
x �/�io�✓ s ���
Nane ( or Prin )
� ��� �cStE �21�E
(Address)
.
i
, _-_.� � ..-v. •r�.,
,.+
:,
s`
.�.
�
1" J
�
v
�-
' =J^C_3�d . �O�L-�=^ '�E� �_�nC_"'
vFC:4T Cc :?SSP�C:IC:I :. hascr.r7 �J ,' S'r=orro�_.�c � ?
Gunite ( j Reinforcing St�=_ i)
II�l1L TO
4ddress
GYHER
PltOJELT: C-�. Report No.
—v--�
Address: �$ �;,�p Q� Permit No. �y��J
Architect: �j�,��p� �y� Contractor: Al�6�d�YL �C��S
Address
Address:
Engineer: 3.�.,(�ry_�y'ny Subconcractor: ��,�, V�,(�,��
(Gunite)
Address: Masonry or
Concrete)
Inspector:/Y'�ax ��2 Address:
'(� . � 345� �:I l�a �
n:x us�a�{,�,_�
sl�mp, fncnes-�
Admixture:$
Designed Strength, P51(a�-�
J
OATES
�a�
�o
Cu.Yds. No. of
Placed CYIs•
�� 3
Remarks
— J' /
� xzr.I�,o,J.�.M-,� n� k� U� � `},�� ,�G,,; �
:ooies of Repo�ts [o: (Indicate which Bldg. Dept. E furnish address of any noc listed)
', Pfl0.1ECT ROUflESS: 4 �. H 1:,L E C 1'. - uxiT:
•( . OWNEN'SNRME: TTM'RI�ER . . . ..
• nooeess: 41 i� OGLE C I
� CA9262�E3A
(77.9') 646-5540
flC�/:HGINEEN: �� RNARD �i�i%'�S xec.xo.: � p y g g
�� , eooeess: 11.022 ACACIA CA 9'J.643 uxit:
j G.G.
�"PEflMITfFF: AMBASSAIiOR POOLS 6 REPLAS ( 71.4 ) 775-7114
� �oosess: FS575 TULE RZVER GIRCLE
'' FOUNTAIN V}�LLEY CA 92708 -
LICENSEO CONTMCTOH OECIAP11t10N: I here�y.zlfirm ihat I am licensetl�untler provisions of Chapter 9(commencln0 wrth Se ian
7000) o� Oivision 3 o� Ihe Business and Protessions'Cotle, antl my license is in lull force an0 effeci.
ciTruc.:p4940-�5fl2541n�_,� ?� -� L/�-W�
� �Da�e:' SiAnaNre: � o-o�� ���
WONNE S'COMPENSRTIONOECUM710N: IherebyaflirmihaUhaveaceni/icateotcansenitoself-insuraoracenifiwteofWo�Cers'
Compensation Insurance, or a certifieA copy IAereof (Section 3800, Lab. C�.� '
POLICY NO.: � EXP. 01TE: •
COMPRNY:
� CetlifieU caDY is hereby lumishetl. ❑ Certifie0 copy.is filed,wi[h Iha iiry BuilGinp DiNsion. �
Oate: Applicant: ' ' '
E%EMPTION FPOM WOHKEXS' COMPENSl�TIOX OECUNITION: (This seccion need not tie complete0 ii the permit is for one hunAred (5700) or less�.
I cetliry that in tAe Derformpnce ol Ne work for which this permd is issue0, I shall not employ any person in any manner so as to become
Subj¢t� [0 Ihe Workers' COmpenSa�ion Laws Of Cali�omia. � -
Dare: - SiOnaluie: � �
NOTICE: It, aher maltlnp ihis Oeclaration, you shoWd become subject to the Workers' Compensaiion pwvisions of the Labor
CoEe, you must tortAwiN comply with such D�ovLsions or ihis permit shall be OeemeO revoke0.
CONSTPUCTION 1FN01NG �GENCY: I h¢reEy attirm t�at there is a construction IenOing agency for the petlarmance af tAe wark for
w�ich 1�i5 permitis issued ($ection 3097, Gv. C�. .
IFNUEfl: . .' ' . . .
ROUflESB: ' ' -
�
OWNEB BUILOEB UECUMTI�N: I hereby affirm that I am exemD� hom the Contractors' State License Law for ihe followinA reason
(Section 7031.5 Business antl Pmfessional Cotle: Any ciry oi counry which reQuires a permit ro constmct, alter, imDmve, Aemolish, or
reDair any simcture, pnor to its issuance, alm requires Ne ap0licant for such Dermit to file a signetl statement that he/she is licensetl
pursuant to t�e pmvisions oi the Contactors' Stata License Law (Chapter 9(commencinA with Section 7000) oi Division 3 0l ihe Business
an0 Pmieuions CaOe) or t�at �e/s�e is exem0� �herefrom ana t�e basis for I�e alle0e4 exemption. My Nolaiion of Section 7031.5 hy
any aDP�icant for a permit suEle� ��e aDPlicant to a civil penalry af not more ihan frve hunOretl tlollars (5500).
I, as owner of ihe Omperty ar my employees with wa0es as Iheir sole compensation,' will tlo Ihe wo�c, and tfie
❑� stmcWre is not inten0ed or ofieretl lor sale (Sectian 70C4, 9usineu anA Pmlessional Cotle: T�e Conlraciors' State License Law
does not apply to an ovmer ol a D�aOeM who builAs or imDroves thereon, an0 who Ooes such work himself/�erseli or t�rough
Ais or her own employees, prwi0ed tAat such impmvements are not intendetl or ottered for sale. It, however the 6uilding or
. impmvement is sold within one year of completion, tAe owner vnll have Ihe Uurtlen oi provinA he/she Uitl not build oi imOrove
�or Ihe Ourpose oi sale�. • .
I, as owner oi ihe pmperty, am exclusively coniractinp with licensed contracrors ro conshuct ihe D�olect (Section 7044, Business
❑ an0 Professions Code: The Contractors' State License Law does not aDPly to an owner of properry who hmtOs or improves ihereon
and who contrac[s for such pmlects with a contrattor(s) license Dursuant to �he Conlraciors' S�aie License law�. I am aware
t�ai proof of their WorkeCs Compensation in5uranc¢ shoultl be OroviCetl Io me.
� I am exempt unGer Section: , 8. 8 P. C. � �
for Itlis redson:
Oaie: ' Owner
I Eo here0y certiry tAat I am aware of an0 un0erstantl the requirements of Califomia Healih an0 Safery CoOe Sections 25505, 25533, and
25534 antl that I or any tuNre huil0ing occupant will/will not (circle one) neetl to comply with saitl s�ate co0es antl the requirements foca
permit for consimIXwn or modification imm the Fir �ualiry Management DisiricL FesiOential consimction aDPlications are exem0� (ru� •
t�ese D�ovisions:. � - �
_ ' ' __ "' v; " ..
Oate: Hpplicant: ` ' ��
I hereby certity that i have reaU tAis aDPlication and state that the abo informaiion is correcL I agree ro comply witti all ary a ry
orainan ntl state laws relating to Cuiltlinp con5lruciion an0 here0 onze representaiiv oi ��is cHy t�o �enter upon the abuve- �en�io etl
pm ctian Durpas % /-i��-� . `/ � "_ _ , \�.:
Oat . Signamre: �
oriver's �icense or socia� secunry '
16C1-48 W�i�e'-BuilEing; Green-COEe Enbrcement; Canary-Ppplicen�; Pink-Revanue; GOltlanroE-Assessor �
�' CITY. O}.' COSTA MESA - HUZLUING P�RMIT PERM NU: DP;P 09S3t31
PERMIT NO: HEP 095381 � PLAN CIiEC:1C .NO: 0,1929-89 S GOVTc N SCJPPe' D]
CONSTRUCTI:ON TYPE: 5 . PERMI'C�_7'YPE: FLE FLU STR � PLIRPOSE: NEW
<4'h
JOA UESCRIPTION : NEW GUNITE SPA � "�4�"�j5(}�:FT::�� ,�, 500
CLA1.M VALUE: 8, 500.00- CALC-VALOE: II, 500.00 'r R P�OCC:���R C:)'t7��,/,�
COMMENTS: SPA BEING ADDED TO EXIST. GUN/FOOL.. � DE�'I� � ,
�*x*t�����*��r**�xx*+�+�+��***x��*�*���***�#-x*��r+�x�x�**�*�*#�� �******�*��iP�*,*_ *��*�c
Z O N I N GS ERTE�QAt1CIKRSE M E N T�jf ; Cii'-',�,d�� ��Sq�
----------- MAIId DUILllING --------- , --------- ACCESSORY BUILDINC. -------='
FRNT: FT � IT] REAR: FT IN FANT: ET IN REAR: FT IN
LEFT: FT IN RGHT': FT IN LEET: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42514_17.8 ZNE: R1 REF NO:
PLANNING NOTES> APPROVAL TO INSTALL A SPA
y _ _ .. .
�+�*�r����r*�r****�x****+�*���*x�**��*+�*�**+���x�*�r*�rx��*����*x�*��*��**��*�***;���*��**
D L V E L U P M E N T S E R V I C E S R E� U I k E M E N T; .
70NING APPROVED BY :_�- _ � DATE: %a-'�i�--f8�
BOILDING APpRUVErJ BY. : � DATE: /�yl �
APPLICATION I55UED DY: ����� �� DATE: /a-.�jZ g" ^-
iEiEjFiEfEiCiEifiEiEiFiEiEiEitiEiEiFit�i(�iE � �� iFiF ifiEiF�EiE�3FiEiEiEif�i�F�1F., ftiE � '
-0tiEifififfkKi(�iEiEiEiEififitiFiEifdEiEiflEiEiE3EiFiFiflfififibiElFiEiE�EiEiE�1(�ikiElkiEiEiEiEif iEiEif3Ei61(-#iEifiEifiEiE-N�1EiE�EiEjE*��ifif�E]fiEiEi�
LEGALIZATION:N � F,E E. S U M M A R Y ' STRUCTURAL SEGMFNT':Y
HLllG PMT PLUMEI7NG ELECTRIC MECHANIC FI11E SMIP/RES GRADING
PERMIT ]US.00 2.00' . :10.00 .60
' 258 SOg SMIP/NON-RES
PLAN 70.20 '
ISSUC FEE 3.00 15.00
BUILDING-DIV-� P6RMIT ISSUE 'PLAN-CHECK TQTAL PATD DUE
TOTALS----? t46.60 18.00 70,20 228.80' 228.80 .00
i2EVENUE DIV:[SION TOTALS--> COLLE(.'1'�D; 22t3.80' OVER/SHORT': .00
BLDG PMT PLUMBING ELECTRSC MECHADIIC FIRE SMIP/TOT GRADiDIG PLAN-CHECR
].UB..OU 5.00 4S.OQ .b0 70.20
iE if if 3t �� jf it iE iF 1E �lF �lE fE !(� �)f IF �%� iE IE �IE �If #)f je �lE # 1f iE �7( �f if iE iE * iE �lE iE-1F-IEik �1F 1f ik �1E �)E i(� dE iE iE �lE �1F 3E IE iE 1E �IP M�IFif ie lE1E iE �E i! iE iE # i@ IE iE � if if # iF?E ��iE
I N D I V T. D 0 A L F� E B R E A K D O W N
TYPE QTY D E a C R I P T I O N U�IIT COaT' TOTPL COST
iFR 8500 AI�TER HY VALU[: RESiDEN'.CIAL NOZONE
L'f,F. 1 SW:LMMIt•IG POOL - ID] GRUUND - tdEW PA
PLU 1 SW.T.Mh1ItdG POOL, -
•.
Eri� or• r• r:rs
1,00 8.500.00
30.Op 30.00
�.00 � 2.00
. (f
�UGriON AND PLANNING
� APPROVALS - Permit # -
s'
1. Teyaporary Electrical Service or Pole
r2.:Soil Pipe-Undrgrnd.- ^ �""
�3.�Electrical.Conduit Utility-Undrgmd. �
,4.'�Electrical' Conduit�Undrgmd'�'
Date
�: �Steel Reinforcement�
-�"6. Electrical UFER Grnd. ..
-+ 7. Footings� � � _
�8. Foundation � 7�" ��
,j
9. Water Pipe-Undrgrnd. �
10. Struttural Flooy Svstem �
S
11. Property SeweryLine & House Connection
�
12. Sewer CaP =•,-3- � '- �
�:
13. Roof Drains;,,� � ' �
�
14. Rough Plumbing „ I
15. Rough Electrical-Conduit -_,
16. Rough Electrii Wiring �
17. RoughWiring$ign i
- , -`
18. Rough Electrical-T Bar Ceiling
�19. Rough Heating &�Air Conditioning _
20> Rough Factory Fireplace - - =�
21f �Duc,ts, in Structure. "' --
� -
22_ Ducts, Ventilating : - -+
23t Gas-Pipa=Rough & Test = __ �
' 24:;.Roof Framing � �- "
25. Roof Sh�eathing " � - `
26;` T-Bar Ceiling (Structural) &-Monocoat:.,
27..�FrameandFlashing -^;�' '
' 28` Lathing�& Siding , � ' � ' `:'"' -' "'
r ' 'd
� 29. Insulati�on ' �_ i� � ^
� -
�30. Drywall-Nail'ng ,`�� �' ,_. � �
`�37. Plaster�Brown Coatx �. - c; I
: 32�Electriral Power,MeterFinal 6 _ ' '
^_33:yFinal Electric � ' . !Q = ��
x34` Final Heating &.Aii ConBitioning� �' "=�
35.•Final Gas Pipe-Test � � • -
` 36.�Hood or Canopy' _ ' �' �'� - �
t; �- _�
� 37.:.Final Factory Fireplace . . ;- - � �
/,•
�38�Final Plumbing -,: � " - /
'39,';Water Service�Final�, �; �' _
�40 Gas=Service=Final �K'-• �T •� �
41. Solar pome'sticFinal -
42. Backflow Preventer
43. Backflow Irrigation '
44. Landscapelrriga[ionSystem , �,
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. PINAL PLANNING
49. Electric fielease to,Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
� � POO � .. SPA .
Inspector qPPROVALS Permit # Date
. 52. Pool & Equipment Location �1,
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE �7
. 58. Electrical Conduit-Undrgrnd. ` zQ,
59. Gas Pipe, Undrgrnd., Test ��
60. Backwash Lines, P-Trap, O Undrgrnd.
67. APPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent-Final -
64. Plumbing System � Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING 'j
69. POOL/SPASYSTEMSFINAL
� � r_r ,: _ ,_FIRE DEPT. REQUtREMENT
_ . � APPROVALS:,`..Permit# - -
• Y _ J
}. - � 70. Underground HYdro �
c. _ � .,�. �v �71. Product-Piping O�Gas ❑��Oil
.'72. Underground Flush� � - _
- � ' �'73:Undergrnd.Storage�T:ank��Gas ❑Oil
. - _ � 74: Overhead Hydro �.
�,,. , 75� Dry Chemical - � - �- -
>' �= � � 76. Dry Standpipe ��=' . _ _
>>:•. _
� • ,� �• 77.�� FIXED SYSTEM'FINAC.._ , - -
I�y,I,,�. ,.� �; 78�: FIRE PREV. FINAL '
� �'�,�i . : ..;,HEALTH DEPT�. REQUIREME�NT
� �'�
� �� � , "79. FINALINSPECTION -'
/;� � .. �SO:,FOOD CERTIFICATE ISSUED_Y .
��Notes: - - - ' - �-
;�
�;r� -�.. : _ r;� _ -�
:✓ ��' � .. __C .., - _' " -
�� � --
�.:
,r} 1.1 .._ . ' -
�
c.::. �
c� . Y . _
�_ s
_ "- 2� �s ?wrni� Laboratories �f ��u�� ea�:fo�, .��.
2��� �°�. �,oa�nWaY
, , (g� �,y . �— ' Lpg Beach, CA 90808
' � - Mail: P.O. Box 47. 90801
, , (213) 426-3355 �
. � . TESTING � � � (71<) 828-8432 FAX (213) 426-6424
CUSTOMER: Sitter, Max
Compression Test on Gunite
P. 0. Box 3454
Fullerton, CA 92631
JOB NAME: VARIOUS PROJECTS (Sitter)
See "Sampled From" for
ADDRESS: Sob Name & Address
ARCHITECT:
HNGINBBR:
B.C.Adams
SAMPLE FROM:
MIX: 4.2-1
DATE TESTED
SPECZMEN NO
AGE (DAYS)
TOTAL LOAD (LBSj
LBS PER SQ IN
A
1514-D North Susen Street
Senta Ma, CA 92703
(714) 554-2665
fFJC (714) 5543960
a
HRAM HO: 90-1-611987
DATE:
JOB NO:
PERMZT N0:
OSH PD:
OSA AP i:
FILH t:
PAGE f:
.
OI/04/90
90616200
:
1
CONTRACTOR:
Ambassador Pools
SIIBCOIiTRACTOR:
Gunite Unlimited
--------------------------------------------------
SPA - 418 OGLE CR., COSTA MESA
SPEC. STR. (PSI): 2000 SLUMP: --- CAST: 12/26/89
----------------------------------------------------------
01/04/90
1
9
43000
2380
SPECIMEN SHAPE: Cylinder SIZH: 4.800 x 9.600 AREA/SQ IN: 18.10
--------------------------------------------------------------------------------
COMPLIANCE:
Cylinder #2 & ik3 (Held in Fieldj
SPECIMENS BY: Lou DELIVERED BY: Max RECEI�/HD ON: 01/03/90
--------------------------------------------------------------------------------
DISTRIBUTIONS:
Costa Mesa Dept. of Bldg. & SaPety, 1
Sitter, Max, 3
a�i��0�n�!
Mohammad Fakharpour
Laboratory Manager
LLL REVORTS PNE SUBMITTEO AS TME CONFIDENTIAL VROiERTY OF CLIENTS. AUTNOA�2GTION FOR VUB�ICRTION OF OUR REPORTS.'CONCLUSIONS..OR FkTP�CTS iROM OR
NEG4RDMG TMEM IS NESERVED PENDING OUP WNITTEN A✓PROVAI RS 4 MUTUAL VROTECTION TO CLIENTS, THE PUdLIC AND OUNSELVES.
1 �
Applicant [o fill in all spaces except tnosa wit�in heavY borGer lines antl si9n all apprapriate Oecla�alions.
CiTY OF cOSTA MESA /(j;ONSTR CTION PERMIT
ProjectAddress �L'.� ���/P.{,, �l/�P �E _
Applicant'sMailing-A�ddress '/�,pL3_3-�e{L �
Owner's Name r/^,r✓/ J/ //Yl �'J P,F Phone%y'^' «d
Address �,e�l,YJ �''
Arch/Eng. License No.
Address
Contrecror's tvame � - Phone�171'3 S�'ln'
Address (ma'1' g1/ T� 3- �(� �/r/i/L/ �.t/ '
City License No. ' .��3�T '
LICENSED CONTRACTOR DECLANATION
I.hereby attirm that 1 am licensetl untler provizlons oi Cnarter 9(commencing
with zection 7000) of Division 3 of (he Bu5ine55 antl P�ofessians Cotle, antl
my license is in �ull fors�e an t(ect. / �
Licen Class �� Lic se N � � ��
Dat� Signature
W00.KER5'COMPENSATION DECLARATION
here0y affirm that I have a certiticata of consent to self-insure or a terti/icate
�f Workers' compensation Insurance, or a certlfletl copy tnereoi (Section
3800, Lab. C.) /�(� T{{
PolicY No. � ` o �0 COmPanY'rlJ��Ve` �/�'S
�Certifietl copy is hereby furnished. �
Da[¢e��iei£op�'{sfiletlwAPPhCd^ity)g�tlA�Dlyisior,ye ��LQ/
/ J K' /� .eC_ .0
EXEMPTION FROM WORKERS' COMPENSFTION DECL'ARATION
(Thi55ection neetl not be completetl if the perml[ I5 to� one huntl�etl (5300) o�
Iess).
I certify tnat in the performance of the wo�k �o� which this pe�mi{ is Issuetl, I
shall no[ employ any person in any manner so as to become subject to the
Worke�s' Compensation Laws of California.
Oate Si9nature
`NOTICE: If, atter makin9 this tleclaration, you shoultl become subject to tne
Workers' Compensation provisions of the Ldbor Cotle, you must forthwitb -
com0ly with such provisions or tltis pe�mit shall be ,tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affi�m tbat tM1ere i5 a conztruction lentling a9enq for the perfOrmance
of Ihe work for which [his permit is issuetl (Sectlon 3097 Civ. CJ
Lenaer's Name
Lentler's Atltlress
OWNERBUILDER �ECLARATION ' �
I herebv affirm thal I am exempt from the Contractor's License Law for Ihe
3L5 Business antl.Professional Cotle: Any city or
tit to ConStruct, alteq ImO�ove, tlemolish o� �epal�
�ance, alm requires the applicant for such oermit
t he/sbe is IicenSetl pursuant to tM1e provisions of
(Chapter 9 (commencing with $ection 700�) ot
ntl ProfessiOns Code) o� that be/she is exempt
thereGom antl the ba5is for the all¢9etl exempUon. Any v101aLon of SecLon
]031.5 by any ap0��can[ for a pe�mit subjects the applicant to a civil
�nalty ot not more than five huntlretl tlollars ($500).
I, as owner o( the property or my employees with wa9es as tnel� sole
compensation, will tlo tne work, antl the structure is not intentletl or ofteretl
for sale (Section 7044, Business antl Professional Cotle:� The Contractor's
Licenze Law tloes not applY to an owner of a property wno Euiltlz or improves
tM1ereon, antl who tloes such work himsell/herself or through his or her own
emplovees, providetl that sucn improvements are not intentlea or otteretl /or
sdle. It, however, [he builtling or improvemenf Is soltl wilhin one year of wm-
pletioq [he owner will have Ihe burtlen ot proving he/she tlitl mt builtl or im-
prove for the purpose oi sale).
❑ I, as owner ot [he pro0erry, am exclusively Contracting with licensetl mn-
tractors to construct the project (Section 7044, Business antl Professions Cotle:
The Coniractor's Liwnse Law Eoez nOt aOPly to an owner ot property who
builtls or improves lhereon, antl who contracts to� such projects with a con-
Vactor(s) license pursuant'to the eontrac:or's License Law). I am aware thai
proof of their Worker's COmpensa[ion insurance shoultl be provitletl to me.
❑ 1 am exempt untler Se[[ion B. & P. C. for this reason
Date Owner
I nereby certity that I have reatl this application ana state Nat the above
intormation is correcL I aqree to comply witM1 all city antl Wunty ortlinances
antl state laws relaling to builtling cons[ruction antl hereby authorixe repre-
senta[ives ot �is city to enter ypon the above-mentione0 p�o0erty to�
insoection r ses. [ �r ���
Siqnature (� /.l /! '-��.^-o Date,9� � � 7�
DriverY License o 55 � �� •�
C�if�
TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION Ll REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ EI.ECTRIGAL PLUMBING ❑ MECHANICAL
❑ OTHER
PROJEC7 DESCRIPTION Sq. F7. oCCUPaNCV
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCU.YDS. ACRES
Remarkz:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
GasService Outlets
Interceptors
Kitchen Sink
Lavamries �
P—Trap
Roof Drains
Reinspection Fee � $15
Boiler
Duct - Under Ground
Duct - Sttuctural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
firepl/FacL Blt. ICBO #
Heating System & Ducting
❑P700,000 BTU 0100,OOOBT
ReinspeRion Fee � $15
CMF 0865-46, rev. 10/84 White - Builtlinq; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auro-Wash
Isue Fee
Hood or Type I ❑
Canopy Type I I ❑
Refrigeration System
❑0�100,OOOBTU ❑700,OOOBTU
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
$ 3
$ 3
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Ri9ht
K Left
S
Ping. Ref. #
7lanning Notes:
Automatic Washer
Cons[ruction Pole Sub.
Cooking Uni[
Dishwasher
Fan �.
F.A.U. �
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator 00.5KW
Fee
3574 5/24/BD
Accessory Building:
Parking Req./Provided
,
_ _ � n � _
Zone -. ■ �
ELECTqICAL
Transformer ❑ 75�SOKW �
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors 041 HP � 1 X- 8
Inc.Solar �9-15 HP �16-15+
Microwave - .
Pole Li9ht •
Range
; Standing Sections
S75 KW Trash Compactor
$15' Issue Fae
DEVELOPMENT SERVICES REQUIREMEN7S:
Zaning Approved By
Building Approvad By
$ 3
SUMMARV OF FEES ,
BUILDING PERMIT $ SMIP $
PLAN CHECK S ��(/'� PERMIT
PLUMBING $ �—�"' � ' � ISSUANCE , $ �
PLAN CHECK 25% $ ENERGV P.C. $�
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM 5
MECHANICAL $ TOTAL FEE $ � �
PLAN CHECK 25% $
� CONSTRUCTION AND PLANNING � PO�.. & SPA
- Date Inspector Date Inspecror
APPROVALS - Permit � APPROVALS Permit #
1. Temparary Electrical Service or Pole 52. Pool & Equipment Location .
2. -Soil Pipe-Undrgmd. . 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms �
4. Elec[rical 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 Conduif-Undrgrnd. . .
8r Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
71. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof,Drains � � 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical�Final
75. Rough Electrical-Conduit 66. Solar SYstem-Final . � �
16. Rough Electric Wiring ' 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 Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro "
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
27. FrameendFlashing 76. DryStandpipe
28. Lathinp & Siding 77. FIXED SYSTEM FINAL
29. Insulation � . 78. FIRE PREV. FINAL
30. Drywall Nailing � � � . HEALTH DEPT. REQUIREMENT .
31. Plaster Brown Coat � . 79. FINAL INSPECTION
32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric ' Notes:
34. FinaV Neating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbi�g � �
39. Water Service-Final
40. Gas Service-Final .
41. Solar pomestic-Final _
42. Backflow Preventer
43. Backflow Irrigation �'
44. .LandscBPe Irrigation SYstem .
45. Sound Attenuation ,
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed .
49. Electric Release to Edison �
�
50. Gas Release to Southern California Gas�Co i � �
51. CERTIFICATE OF OCCUPANCY �
No. Date .
� � ..
" 1635 WE6T GAYLORO ST�
P.O. BO% 9065
LONG 6EI.CH IO.CAIIFORH�A
NEn�oce 5-'1a93
NEvnOA 6-51'l6
Twinana
i. «:
Examination No.
�1�
Sample from
� �
october 23, 1958
GUNITE
REPORT OF TEST CYLINDER
58-3609
J. GIBIAN SWIM POOL
418 Ogle, Costa Mesa, Calif.
For Modern Pool Company
Architect
Contractor
Mix
�1'ater, gal./sk. cement
�; Slump
Date cast
Date tested
ModePn Pool Company
1-!}2 Gunite
9-25-58
io-2-5&
10-23-5e.
Cylinder No. 1 2
CO�IPRESSION TEST 7 D&ys 28 DBys
Total load to destruction, lbs 86 � 000 108 � 000
Pounds per square inch 3� Q(�Q � 3 82 }
Cylindermade�yl[ J, J. Eiff
under supv.
Cylinder delivered by J, J, EFiPf
Cylinder received on 9-26-58
Note� 2� day teat complies with specificationa.
cc: J, Gibian
Modern Pool Co.
Coata Mesa Bldg, Dept.
SA Lab
BRANCN O�IICC:
39815 N. 6iH St E45�
n.0. BOx 9�9
G.�LMDALE. C/�LlipqNll.
WlrvosOw 7-5911
p� � I/nl2
T�VWING LAIIOR TOI3IES F SO ERN CALIFORA'IA
� � ��
��� wwAr� �w[ suPM�r*[o �� rH[ con��own�� rwo'[wn or cu[nr�. �urwoMunow rell Ml�unar, w wl1 �[roRr�. cwlcw��or�t. o� u.
TMCT� /IIOM OI� 11[OIJ�OINO TNtM 1� 11{��RYtO �dDIN6 W II W I�ITfp NAqV/�L �� .� MVIVALlIIOTfGT10M Tp CLI[NTt. YM[ �Y�LIG NID W 1��LLV[�.
oz,Z,.�z
-OWNER �TRTAN� (;NART.Ffi F_ DATEq_10�5R _
108 ADDRESS i, o .._, _ c�___ -� BIIILDING PERMIT NO. 7ii67
AP. No. LOT 5 TRAC'1' 1776PIF2E ZONE
TYPE
INSPECTIONS
Ninal Gas Tut
$UBCONTRACTOR
PLAN NO.
17�1u'Ii�3b�311�7
• � '7�6`%
.� ..�-
COSTA MESA BUILDING DEPARTMENT
P.0.90X 31�
COSTA MESA. CALIFORNIA
eui�oiNc
4DDRE55
FOR APPLICANT TO FILL IN
�
COSTA MESA. CALIFORNIA
OWNERCI�/'��L``—S rp
MAIL ���A �
ADDRE55 ' 7 �
GITY �Cls T�y �S�
ARCHITECT
OR ENGINEER
AODRE55
LEGAL LOT
oescaianoN NO.
A.P. NO. I
USE OF ,
E%ISTING BLOG.
`34
TEL.
NO.
u C.
N o.
TEL.(�
� NU.\�G. i_i
BLOCK TRACT���
Q � �_
� No.or o�ocs.
X 1��• I�i NOw ON LOT I
�� �"�i
CENTER Oi $TREET � r�(l�JY�{(EAR YARD
SIDE YARD RIGHT / LEFT
DESCRIPTION OF WORK
NEW ALTERPTION ADOITION
REPAIF l IMOVING DEMOLISh
SIZIEOINGI� _/X 2.��e O.OF
(a e/T ROOMS STORII
EXTERIOR WALL ROOF
�=�� V�ECtd!l��i
9jz />�
FINANCE DEPT.
CITY OF COS?A MEc;
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
BIIILfJING ///� 'l j�� �
ADORESS wG L�� t
COSTA MESA. CALIFORNIA
FIRE
ZONF
ZONE
����C b OATE j�6
� i.
CORRECTIONS ..,,
CITY OF T.4 r�;ESA
L'.I+ 1: L r 1.
11BJECT TO BL G. DEPT. REG.
STni'E THwT TNE FBOVE IS COflRER arvD nGREE TO COMPLV WITN <LL
CITY OROINnrvCES /.NO ST4tE 1�W5 REGUL�TING BVILOING CONSiHUP
iioN. VALUATION
SIGNATURE OF OO PERMIT FEE 5 O`
PERMITTEE �
< � �%� PLAN CHECN S S
$ Q
�uT)r+oaizEo n�Er�r TOTAL FEE $ /., �
, /
�err
��
-- 6'751
' �' -
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COSTA MESA. CALIFORNIA
� FOR APPLICANT TO FILL IN
nooa°ess G.� g Ogle Ci rnl a
+• COSTA MESA. CALIFORNIA
OWNER
ARCHITECT �
OR ENGINEER
Koll -
ADDRE55 2826
�EcaL LOT
oesceiPiiorv No.
A.P. NO.
E%ISTING BLDG.
$ETBnCH LINE FROM
CENTEP OF STflEET
No: OR
. �jT—
LL �
�o. 6:
� W$N1
TY LIC.
�,0 8;
TEL. ....
NO.OF BlDGS.
NOW ON LOT
REAR YA12D
DESCRIPTIOIY OF WORK
NEW ALTERATION I AODITION
REPAIR MOVING DEMOLISH
BUILOING [� �tr� NO.OF
SIZE W]C F.l. A��MS STOFIES
EXTERIOR WAiL p- SbUCCO COVERING Shako
COVERING lS' <Y
USE OF NEW T,
BUILDING S1II�yB fa�u�.lY dWBlll� �
c- _ .2
�=�� ��C��'d�D
s �s-s� ��
FINANCE DEPT.
CI I � OF COSTA MrSA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. /�F.ryM�iNQ
ADORE55 //,{ OC//C C. /��
COSTA MESA. CA�IFORNIA
FIRE 3
ZONE
20NE NO.O: �— TVPE / GflOVi
PLsI
[ , �
APPROVE �' �
BY 0����' ATE
CORRECTIONS
CITY O^ .�`STFI ArtSA
—��ii -R:� .
SUOJECT TO ' DG. DEPT. REG.
r
STRTELTXFT TMEV>BOVE IS CORflECT^GNO FGREE TO COMPLY WITN >LL / ti
CITY OPOINFNCE$ PN� ST4TE L>WS REGUL<TING 6VILOING CONSTRUC-
iiOv. VALl1ATiON /
SIGNATURE OF PERMIT FEE S 3�B �
PERMITTEE �
. g// �D GJ PLAN CHECK S �� �
(O /
-{,��-�� TOTAL FEE S � `���
AUTHOFIZED AGENT L