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Home My WebLink About3246 OREGON AVE - Building Permits�� (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3246 OREGON AV Suite No Vicinity: Parcel Nunmber: 13905308 Applicant NOCK, TIM Address: 11612 KNOTT ST GARDEN GROVE; CA Owner: MC CULLOUGH, DIANE L Address 3246 OREGON AVE COSTA MESA, CA Contractor: NOCK PLUMBING Address: 71612 KNOTT ST ' GARDEN GROVE, CA Arch / Eng : Address: ISSUE FEE Backflow irrigalion BackFlow Preventer Bathtub Clarifier System Connect pce,Soda,etc) Dental Units � Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve PLUMBING PERMIT Phone: (714)895-1246 Zip: 92841 Phone: 714-662-7654 Zip: 92626 Phone: (714)895-1246 Zip: 92841 License: 707775 � Phone: � � Zip: License: WATER HEATER CHANGE OUT AMT S23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 QTY SCOPE OF PERMIT � Laundry Tub / Washer Landscape Irrigation P-Trap . Pressure Regulabr Process Piping (per 10 ft) Receptors Septic Tank Sewer Cap for Demo � Sewer Connect Sewer Private Line Shower Sink, bar Sink, commercial Sink, Floor Status: ISSUED Applied: 02/27/2003 I ssued: 02/27/2003 ISSUED BY: � � ' • _ AMT QTY $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 AMT Sump Pump $0.00 Swimming Pool $0.00 Trap Primer $0.00 Urinal $0.00 Vacuum Brkr Bkflow(1-4) " $0.00 Vacuum Brkr BkFlow(5+) $0.00 Wash Basin $0.00 Wash Basin Set $0.00 Waste and Vent Syslem $0.00 Water Cbset (Toilet) $0.00 WaterHeater/vent $12.30 Water Piping (Inst or Rep.) $0.00 Water Re-pipe $0.00 Water Service $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wilh all applicable codes, antl all required Inspections and finel epproval must he obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2446�66(W00) WORKERS' COMPENSA710N DECLARATION: � . I hereby aHirm untler panalry ot perjury one ot ihe tollowing declarations: ' " . ❑ I have end will maintain a certiticate of consent to salf-Insure for workers' compensation, as provitletl tor by section 3700 of the Labor Cotle, for the pertormenca of the work tor which Ihis pertnit is issuetl. ' ' � I have antl wiil mflintain workers' compensation insurance, as requiretl by secNon 3700 oi the Labor Code, for the pertortnance of Ne work for whlch this pertnit is issued: My w.o{-rkerLs'•c'ompensatlon Insurance w�rn�e�r pa,ntl� �po`lic/y numDer are: '7 Cartier: J� � N CCii � Q� W'�w `I �✓� PoliCy Number. TC / O�qL� � (This section need nof be camp/eted i!!he p�et one hundred dollars ($100) or less.) . , ❑ I certity ihat in the pertormance of th ork for which this permit is issued, I shall not employ eny person in eny manner so as to become subject to Ihe workers' wmpensation lews oi C li� mia, an ree Ihat if I shoultl become su6�ect to Ihe workers' compensation provisions ot Sectlon 3700 of the Labor Catle, I shall fonhwith compty with these pr v ia s. �'� _ O� Appllcant Signature: —7�7-� i Date: WMNINO: FAILURE TO SECUREP✓ORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHP1L SUBIECT AN EMPLOVER TO CPIMINPL PENALTIES AND CNIL FlNES UP TOONE HUNDRED T/qUSAND DOLLARE (E100,000), IN AD�fTION TO THE COST OF COMPENSATION, DAMAGES AS PiiOVIOED f-0R IN SECTION 3]O60F iHE UBOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby ettirm lhat I am force antl eHect. Llc. a_ Contrectofs Signature: CONSTRUCTION LENDING I ❑ I hereby attirtn that there Lentler's Name: Signature: ChaD�er 9(commencing with Section 7000) ot Division 3 oi the Busin§Sg �y 9�ofessions Cotle, and my license is in full �i qass A �L 7b / Date: 2 - ! � � a consiruction lending aqency for ihe pedormance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lenders Address: Dete: OWNER-BUILDER DECLARATIONS: I hereby affirtn ihet under penfllry oi parjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor ihe tollowing reason (Sec. 7031.5, Business entl Professions Cale: Any ciry or counry which requires a pertnit to conSWct, alter, improve, tlemolish, or repair any SWcture, prior to its issuance, also requires Ihe epplicant for such permit to tile e signetl statemem that he or she is Iicensetl pursuant to tha pmvisions af ihe Comracrors License Lew (Chepter 9(commencing with Section 7000) of Division 3 oi the Business en0 Prolessions Code) or that he or she is exempt iherefrom and the basis for Ihe alle9ed axemption. Any violation oi Section 7031.5 by any applicant for e pertnit subjects ihe applicaM to e civil penalry ot not more lhan tive hundretl dollars ($500).): ❑ I, as owner oi lhe property, or my employees with wages es their sole compensation, WILL DO THE WORK, and lhe siructure is noi intentled or offered for sale (Sec. 7044, Business end Professions Code: The Contractors License Law does not apply to an owner of property who builtls or improves ihereon, an0 who does such work himseH or herself or through his or her own employees, provided Ihat such improvements are not intentletl or oNered for sale. II, howaver, Ihe building or improvement is sold within one year of completion, ihe owner�6uilder will have the burden of proving that he or she did not build or improve for purpose ot sale.). � ❑ I, as owner oi the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7046, Business and Professions Code: The contreciors License Law does not apply to an owner of property w�o builds or Impmves thereon, and who conirects tor such pro�ect with a contrector(s) license pursuant to ihe Coniractors License Laws.). ❑ I am exempt under sec. Signature: Owner ID vanlied by dnvers license. ❑ Yes Vedtiwtion oi Ownershi0 by (type of tlocumeni, i.e. Business and Pwfessions Code for this reason: ❑ No Dnvefs License No. property Iax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Date: Expires: ❑ I hereby certity ihet no excavation tive (5) or more teet in depth into which a person is requirea to Cescend, will be made in conneciion with work euthorized by Ihis permit, end ihat no building siructure, scaHolOing, falsework, or demolition or dismantling thereot, will be more than thirty-six (36) leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Califomia Administrative Coae). . ❑ As owneo-builder, I will not employ anyone to do work which would require e permit irom the Division of Industriel Satety, es notetl ebove, unless such pereon hes e permlt to tlo such work from the tlivision. Signature: oate: Division oi Industnel Safery Permit Number. CERTIFlCATE OF COMPLIANCE AND AIfTHORIZATON OF EMRV: I certity under penalry of perjury that I have reatl t�is application and state ihat lhe information given is correci. I egree to comply with ally �e laws and city ordi ces relating to building construction, and authonza representatives ot ihe Giry ot Gosta Mesa to enter upon iha ebove-described propeAy tor in Qe ion p oses. I egre n t to occupy or allow occupancy of any building authorized by this pertnit until tinal inspection. ignature 1 I wne � ,� ^ Qate U S And/Or A orized Applicant � Daie COOE t. INSPECTIONTYVE 1616 Fixed System Final Fire Prevention 1266 � Pool Spe Final 200 Final Re-Rooi 201 . Finel Block/Retaining W all � 202 ' Final Fectory Fire Place 203 Final Sign 204 ' Final Demolitian OAiE INTRIALS COOE 1 INSVECTION TYPE 206 Final MeChaniCal 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 � Final Planning ApProval' � 222 Final Site 250 � Final�Building/Occupanq �� § +� ✓ I� Pfl0.1ECT �OOHESS: QWN�P'8 NRME: pooness: �7 714/752-8000 UNR: �HCHIENGINEEN: ' � flEG.NO.: ' . '. AOORE88: ' � UNR: • ` � � CRANK BROTHERS ROOFING' (714)548-5569 � PEBMITTEE: ' 1z( COMMERCIAL WAY ! � aooxess: C.M. CA 92627 LICENSEO CONTMC70R DECLAMTION: I hereDy � 7000) o� oi�� 9��e�usiness and Pmt�� ciTr srere uc.: � Oa��__ Signat �ppenpa[io n1R90ral�l4r 9 Et�e4TcoDY IA heaf icreo.:STA E � LOMP►NY: I am Iicense0 my license is EXP. DR7E: � 9 (commentinp vn�h Seciion seli-insure ar a certificate oi Workers' ❑ CertitieA coDY is hereby lumishetl. ❑ Certified copy is vAth ciry BuilAinA O/ivisllon. / /(i{3fE:G��V Appliwnt�.G- �3��Z's! —`" � f E%EMFfION FPOM WOBKEPS' COMPENSATION DFCIANATIOX: QTis s¢�tion neeU not he compkle0 if ihe permit is for one hunAreE (5100) a less�. I certity thai in Ihe petlormanca of the work for which thi5 7ermit is issued, I shall not employ any perwn in any manner so as to hecoma suDlec� �o the Workers' Campensation Laws oi Califomia. �ate: Signature: NOTICE: If, atter makinp Ihis declaration, you ShoUld become sublect to the Workers' Compensation pmvisions of the Labor Cotle, you must fonhwith comDq with such provis�ons or this permit sAall he OeemeO ravokeA. CONSTPUCTION IENDINO �GENCY: I herehy aHirm I�at I�ere is a conslruciion lentlinq apency for t�e perlormance of Ihe xrork for wAicA Ihis permii is issu¢G �Seclion 3097, Civ. C). �xoeq: ROOHESS: ' ' • ' I hereEy attirm that I am exempt irom t�e Contractors' State License Law for the sianal Coae: Mv ciN of counry which re0uias a permit ro constmct, alter, imort repair any Slruciure, prior �o its issuance, a150 fequires �he aDO��ni IOFsuch p2rmit to �i10 a SigneE Slatemeni Ihai he/she is Ilc¢n5e0 pursuant ro the prov¢ions ot I�e Can[racrors' State License Law (ChaO�e� 9l�mmencing wit� Sectian 7000) al 0ivision 3 oi t�e Business antl Pmfessions CoOe) or that he/she is exempt iherairom antl tha �asis tor t�e allegeA exemption. Rny nola[ion ol Saction 7037.5 by any apDlicant tor a permi[ sublecis Iha aDP��cant to a civil penalry oi not more ihan five hundretl tlollars (5500�. I, as owner of Ihe pmOenY or my employees vnth wapu as iheir wle compensatlon, will tlo t�a woB, and Ihe stmcture is not inten0e0 or ottereE for sale (SecOon 7044, Business an0 Prolessional CaOe: The Caniracrors' Staro License Law Uoes not apDly to an owner oi a pmperry who bwltls or improves thereon, anA w�o Ooes such work hims¢Ii/Aerulf or ihroup� - � his or her own emDloyees, provi4eA that such �mpmvemenis are not intended or offeretl for sale. If, howaver Ihe buildinp or impiovement is wld witAin ane year ot comDletion, Ne awner will have t�e burden oi proving Ae/she tlid not �ui10 or impmve . for the purpose oi sale�. I, as owner of the D�oCerty. am eaclusively coniractinA with licensetl contractors to consiruct t�e pmlecf (Section 7047, Business ❑ and Vmfessions CoOe�. The Con[ractors' State License Law Uces not apply to an owner of Droperry who Omltls or imD�s Iharean an0 who con[actsfor SucA projeds with a contractoqs�license Dursuant to t�e Cantractors' State Licenu Law�.l am aware t�at prool oi Neir Worker's Campensation insu�nce shaultl be Orontletl ro me: � I am exempt un0er Section: B. 8 P. C. � , - for this reason: , . I Oate: � � Owner. I tlo hereby cetliry that I am aware of anA unOersWnE the requirements of Calitomia HealtA anG Safery Cotle Sections 25505, 25533, and 25531 antl that I or any tumre hullOinA occupant witl/will not (circle ane) need ta comply vnth saitl state coAes and tha requiremenis lor a permii for consimciwn or motlifiwtion imm I�e tir Uualiry ManaOement Disinq. Resitlential conslmction apDlicalions are exempt imm t�eu D�sions. . Oate: I here0y certity tAat I have rea0 t�is ap�li - orAinances anE sWtelax5 rtWtinOro 6uil0in pmOertYJor inspection Durposes. l�s�� C�/a !, Umer's License or Saial Secunry x: 184146 W�ita—Builtling; Green—CaEe S�a[E Io Cam wi[h al))l to po� %� � plicant; Pink—Ravenye; GolOanrod—Assasso� _ CITY OF COSTA MESA --,-HUILDING PERMIT- PERMIT NO: B i 049272 PLAN CHECK NO: N•� PERM NO: B � 04927,2• , GOVT; N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE:�STR ' ; ` PURPOSE: ALT � JOB DESCRIPTION ; REROOF W/ CLASS A FIHERGLASS SHINGLES SQ FT: 6,897, CLAIM VALUE: 6,897.00 CALC-VALUE: 6,897.00 GROUP OCC; R-3 /. COMMENTS: SMOKE DETECTOR REQUIRED � ' *+r*+r�r�r*x ****�*�x *�*�+r�r*+r�rx �r�**�x��r�r*�*�i�*�r*�r�*�r�r�r�**x �r*ir*�r�r�r�r****+r�r� **�e**�� +rx�*+�� Z O N I�N,GS ERTEB�AUCIKRSE M E N T S ------------ MAIN BOILDING —=-------- --------- ACCESSORY HUILDING --------- FRNT: � FT 'IN REAR: FT IN FRNT: FT IN REAR; FT IN'• LEET: FT IN RGAT: !FT IN LEFT: FT , IN RGHT:' � FT , IN PARKING REQ• PROV: PARCEL: 42514116 ZNE: REF NO: � PLANNING NaTES> , , � � . iF 1t M±E iE if fF ik iE iF if jF 1E ik ik 1E if ik 1f 1! it 1F if 1F 1F ik iE 1t k 1k if if i! iE 3E ik iE ik iE k iE it ik iF iF ft M iF iF it ik 1F iFfF iE±k iF if if ik ik 1E if dF ik aE ik it iE;iF iF 3E iE dk ik iE if if ib � 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-• 20NING APPROVED BY; ' DATE: " � HUILDING.APPROVED BY ; __ _' DATE: � DATE; � L_r/� if i! ik iE if 1k iE 1f �f iF iE iE it iE iE it 3F iF iF M!f if iF iE �k iF 3F ik �F 1F 3E iE if it fk iE it iF 1f iF iE iE iflF ik ik ik iF �E 1F iE if M if iklf if iF iE itlF 1F iF fk iE iF iE fF 3F if iE iflF iE 1f if iP iE iE LEGALIZATION;N F E E S U M M A R Y ' STRUCTURAL SEGMENT:Y BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/.RES GRADING PERMIT 90.00 ',SO . SMIPlNON—RES PLAN ' - ISSUE FEE• BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL� PAID � DUE TOTALS----> 90.50 0,00 0,00 90.50 90.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 90„50� OVER/SHORT: .00 HLDG PMT PLUMHING ELECTRIC MECHANIC FIAE SMIP/,TOT ;GRADING'PLAN—CFIECK �90.00 .50 if if ik iF i! iF if if ik if ft it ik 1t iF if iE iF ik ik Ik ik 1! i!!F �! if if ik iE±F iF iF if !E 1E if 1t iE±F if 1F iF iE iE it ik ik k ik ik,ik ff ik it k iE iF iF iE iE ik jE iF ik ik iF ik it if 1E iF 3k ik if iE ik iF 3t 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 6897 REROOF HY VALUE RESIDENIAL NOZONE 1.00 6,89'j,00 END OF FEES , � u � o� o�oa�97s-nna�44�9 -�e�-r � DpTE: 10/42/90 TT_ME: 2=:24 � I 1 r - � � , CONSTRUCTION AND PLA� Ih_ "� . )L & SPA ,. . Date Inspector Date Inspector �� APPROVALS Permit# _ APPROVALS Permit# . 1. Temporary Electrical Ser.vice or P.ole� .�� 52. Pool & Equipment Location. r.� / sG- p�2. Soil,Pipe-Undrgrnd. � � F �� 53. Steel Reinforcement = ��3. Electrical Ctipduit,Utility-Undrgriid. - 54. Forms ;% : rn `� `'�,4. Electrical ConduibUndrgrnd. `� � 55. Electrical Bonding 's i��5. Steel Reinfoick-ment :< . 56. Rough Plumbing & Pressure Test ' `�.% �; .:^ - r� r a � + -`�� Eleetrital U�ER Gmd. u . f 57. APPROVAL TO COVER-GUNITE n -?�7.�. Footings .L�+ t-- ��=�. � � � 58. Electrical Conduit-Undrgrnd. � a'-. ^.. _. _, = n 8. Foundation � `, : � ��• - . �i 59. Gas Pipe, O Undrgrnd., Test - :'-' � 9. Water Pipe-Undr.grnd. � � - 60. Backwash Lines, P-Trap, O Undrgmd, 10. Structural Floor System '�� '� 61. APPROVAL TO DECK � 11 . Property Sew"er �ine & House Connection � t � " 62. Backwash & Receptor�Final �� 12. Sewer Cap � `^ � y - 63. Heater & Vent-Final . �� 13. Roof Drains.�, u , _ ' 64. Plumbing System - Final , - f. 14. Rough Plum4ing � ' 65. Electrical-Final � � 15. Rough Elect�cal-Conduit 66. Solar System-Final ' ' '. � 16. Rough Electrit Wiring • �- 67. Fencing & Access ApProval �~ c 17. Rough Wiring�Sign � - . 68. APPROVED FOR PLASTERING 18. Rough Electdcal-T Bar Ceiling ' � 69. �POOL/SPA SYSTEMS FINAL 19. Rough Heating.&_Air Conditi n�ng,,,� F1R PT.REQUI . EMENT � :� ��, �;�-� o� ��x� T �� F ti V l ' . _.. l•� c.. V � ! f : � �T �'�ii� '-! * i� (1' 2b. RougFi�Factory,�Fireplace � Sr-. ,-..� - r. =�; * q App,BOV�jkLS;c, Permit#•• � c �--� Y� S �-. r-� Y M 21�. D,}jcts;�jn $-'fruC[ur'2 i'" �� n� *� 70:.]Jndeig��d Ftydro a: � 22. 6ncts;;Ventilatiny � �'n :: `. r,, � ��`..� z C 77. prodacYPiping C�Gas ��OOiI - -, 29. Gas Pipe-Fough 8i Test � t"S ��"- Q' �� *�" 7Z, Under r u d Ela'sFt' � '^ E� r i m [' x i�z� [^ ._xn t^. 5.k �: O 9..9 .i� J .k . G� 24. Roof �Fram'ing 4, < �" �,`^-.+, j ;-� i�� 73. Undergmd. Storage-Tank O Gas O Oil 25. Roof Sheathing�+,� � v v: C - �,� x x F� j4�'Overhead Hydro..,^ X �_ fi �• -.+ F+ i-� � ..�1 C' .K r '� v -� ac .-. v 26. T;Bar Ceiling (Siructurall'&,lNo�nocoat .: p„� p:� �: 7�.^_Dry Chemicat;_� * �c;. 27�. Frame�and:Flashing D ��C � ^' o* * 76.^Dry Sta�dpipe " ;' ,.., u �? � r r': c .+:-� �� t r. d,ti :k .� N O ` 28. Lathiri &-Sidin � ' ��" � � � ••* �: � "�� ^s � � F `9 9�. C.�;� p I � ix � 77�. FIXEQ-S.Y.STEM�FINRL� �: > :, -: :. .. , � . ^ . .. _. 29. Insulation • � " i � �� '� ?r8. FIRE PREV. �IBtAL �' "' ^ �" i C� h'r. C' f.`. i k s' X _ � 30. Drywall Nailing;; � � � ti I i f� � � .2 HEALTH DEP�TuREQUTA�EMENT � 31. Plastei Brown CoatS ^^ � � ��:• 79, FINAL�SPECF{ON x^ i� � c.. c.. � ti .e: O t-7'• •�• � ; ti � � � *� � . 32. Electr�ical P�wer;Meter`Final �; x 8(��y� FOOD CERTIE�I�ATE ISSUED _ � 33. Fanal Elecuic � � I x� * Notes: '"= `-�M * "� � ��h ✓ ' �" >' ^ C'] x �i S �' 34 F�nal Heating & 9irrCondi{ionmg � -; .� � � � * , � � ��: a; s o �,� � 1 t' G :v 35�. F nal Gas Pipe-Test � N � . I j �% mo �'^ K� � t* `-' 36. Ha'od or CanopY;�" �=r-; a : C'; � I � x g no �: ��n+ n ; x m �, . ;: � , y - o � :n n� `- �: 3i: Final F.actory FireplaCe i�4 � v� *� "' � :U � : n• I I�� x C �n k S ' ' � •,. t -^ �� • :F 5 ry x W ;i 38. Final Plumbing ., s;��`� .., � � ��; �: E., * � ' 3 � ' . .. � ... . .-. _ .. ._ � � 39. Water;Service-Final � � ` c, ! ' f� a: > o" x s ,. .� � r s� �. a� • m m �� 40. GasSe�vice=Final'`r 'e�T'^ �� "':'' � j�. fi �.^.c .,^c� .: � : ? e-� F i�; I � �k \: (^ • �. � :Y � ; 4 41. Solar pomestio-Final� ir �"� � � K+: ;r ;o a x� ;� � n ,; c 42. Backflow Preventer. J n-�.i � ^ � � �� X �'- �' � ''� .� k'-i W :aO'J `r' i-� '�. �.`l.0 h .., -i. . 43. Backflow Irrigation :.� ? c; * � c, ,. >; `� �i . i� Y c. I: i '] �. ,-. : ::i .. �7 _. •_�i. �n K iv Ci C7 C� i rJ :u T'C1 K i.l O 44. Landscape`-Irrigat;on System �� , � �.._ ?: r � � s � � � c�: � c� K = �- ' . :. _ N � i,. �, i, _ c : ' 45. SoundrAtienuation . .. g . -x W (- �`. :r= w Y `C / / 4J'. 1 '.j �) 46: HandicapRegUlations '�? '-� i � � � ,�.%� " �_�y Gc S � ;,aiPFiNaLSTRUCTURE&BUILDING { ��' j xr ��yil :� �, � , i' r r. x (l 48? F�NALPLANNING �`'`' �' i � ��;� � n � � � # t - ' 49.. Electric Release to. Edison . � � i�!� * ,r. � . � � = r� � � :i,5,: M.� i: . p-i { �. • ' 50: Ga^`s Release to Southem California Gas Co'� . - � ; � r. :r x . : �:� ;l S rd o � 51. CERTIFICATEOF OCCUPANCY ,. ` '� `^' " ' ' " No.'• Date � %�VOlicant to fill in all spaces exeept those wit�in heavy EorCer Iines an0 sign all apP�opriate tleelantions. CiTvoF COS7A MESA CONSTRUCTION PERMIT, - Project Qddr�s �_y(([__ Npplicant's Mailin9 A dre s' .Owner's Name Phone ��5 Address - - - Arch/Eng. � License No. Address Contrector's Nem �one �r Address (m 'I" gl p ? City License Nn . �// � J ' � LICENSED CONTRACTOR DECLARATION � I hereby af9tm Ihat I am licensetl untle� provi5ion5 ot Charte� 9(mmmencin9 �with section ]000)'ot Divislon 3 oi,the Business antl Professions Cotle, antl my license is in fu YfoR antl effect. '7 License Class � ' ence o � �te Si9nature ' IRKEFS COMPENSATION DECLARATION �ereby affirm that I have a certificate of <onsent to selt-insure or a certificate � ot Workers' Cortipensation Insurance, or. a.certitie copy tnereoi (Section , 3800, Lab. �} P�oli,cyy No. �� Company � � IO Certi(� eetlq�9c�oPY is.fi�letlbwithrthehctlY Bk�N� 9D� q� S}"�� / �are� Applicant �l�' �'��" —// / A� EXEM TI N FROM WORKERS' COMPENSATION DECLARATION ' (This section neetl not be com0letetl if the Oermit is tor one huntlretl ($100) or less). I certiry tnat �n the performance of the work tor which tnis permlt is i55ued, I 5hall not emPloy� any pe�son in any manner so as to become subjeGt to the Workers' ComPensation Lawz o( Calitornia. . Date Si9nature 'NOTICE: Ii, after making this tleclaration, you should become sueject to ihe Workers' Compensation provisions of the Labor Cotle, you must forthwitn comply wi[M1 such provisions or this permit shall b2 tleemetl �evoked. CONSTRUCTION LENDING AGENCV I hereby a(firm tM1at there is a construction lending agency for the oerfoimance � ot the wa�k for which this permit is issuetl (Section 309� Civ. C.) Lentler's Name Lentler's Atldress ' OWNER BUILDER �BCIARATION ' � 1 hereby aftirm chat I am exempt from the Contractor's License Law for the foilowing reason (Section �031.5 Business antl Professional Cotle: Any city or county which requires a permit to�construct, alteq improve, tlemolish or repair -ny structure, prior to Its issuance, also requires the'applicant for such permit file a si9n2tl statement that he/sne is Ilcensetl pur5udn[ to tM1e provi5ion5 ot ; Contraclor's License Law (Chapter 9(commenGinq,with Section 7000) ot .vi5ion 3 of the Busine55 antl Protes5ion5 Cotle) or tha[ he/she is exempt .nerefrom antl the basis for the allegetl exemptlon. Anyrvlolation of Section 7031.5 by any applicant, for a' permit subjects the� applicant to a civil �enalty ot not more than five huntlretl tlollars ($500�. LI I, as �op'ner ot the property or my employees with' wa9es aStheir sole� compensa��on, will tlo the work, antl the structure is not intentletl or ofteretl for sale (`�ction 7044, Business anE Protesional Cotle: TM1e Contractor's' LicenSe Ld�' tloe5 not apply to an owner of a property wM10 builtls or improve5 tbereon, antl who tloes such work'himself/herselt or through his or her own employees, P�ovitletl that Such improvements are�not Intentletl or ofteretl fo� sale. It, however, the builtlinq or improvement is soltl witM1in one year of com- pletion, l�he u�er will have the bu�tlen ot p�ovinq M1e/sne tlitl not builtl o� im- �rove for P Pose ot sale). • I, as owner of the property, am exUusively mntraGting with licensetl con- tractors ro construct the project (Sectlon 7044, Business antl Professions Cotlei The'ContractorY �.icense Law tloez not apply to an owner oi property who builtls or �mprovez thereon, antl wno conbacts for such projects'with a con- tracto�(5% license pureuan[ to the Contracto�'s License L.aw). I am aware tha[ p�oot o1 their Wo�ke�'s Compen5ation in5urance shoultl be providetl to me. ❑ I am exempt ontler Section � B. &'P. C. for this reason, Date owner P hereby, �ertity that�l have reatl�[his application antl state that the above�� informatmn is <orrect. I aqree to comply with all city antl county ortlinances antl state laws relating to builtling construction antl hereby authorize repre- s¢niatives o� this city to. enter upon t e above-mentlonetl pr perty for inspectlon p � Signature � � � Date Drivers' Licenu or 55 �_ _ 'TVPE OF CONSTRUCTION � LI NEW U ADD LI ALTERATION � REFAIR ' • Q CONVERSION. ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLOG. . � TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL . ❑ TENANT ❑ ELECTRICAL �PLUMBING ❑ MECHANICAL . ❑ OTHER - PROJECTDESCRIPTION Sc3.FT. ' oCCVaANCv CONSTRUCTIONTVPE ' � 'VALUATION$ ' ZONE GRADINGCU.YDS. ACRES Remarks: ' ' � ' M Sink � cflow Preventer . -r cflow Irrigation Drinking Fountains � Floor Drains Floor Sinks �� Gas Service - Outlets Inrerceptors Kitchen Sink Lavatories , P—Trap' Roof Dreins - Reinspection Fee Boiler $15 Duct - Under Ground � Duct-SVuctural � Duct = Ventilating . Exhaust System ❑ Multiple ❑ Firepl/Fact.8lt.IC80# , � Heating System & Ducting � � O7 00,000 BTU O 7 00,000 BT Reinspection Fee , $15 CMF 0865-46, rev. 30/84 White - Bulltling; Canary - Ap�licant; Plnk - Accountin9: Goltlenrotl - Assessor Showers ' � Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank � Swimming Pool w Water Closet Water Heater Water Service Auto-Wash Issue Fea # " . S Main Building E T Front . 6 Rear A' C Right K Left S Ping. Ref. # ,Planning Noies: , iiUtOfT2LIC W25f1Cf Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas OElec Fan � F.A.U. Fixtures Device Boxes Outlets � $WItC�125 Garbage Dispoul Generator 00.5 KW C $ 3 a , 6405'� 12/.26/85 . Accessory Building: ' 5AOt7 TL Zone `' • i .. 2 " O N I. N i G ' R iided E Q " M T S ELECTRICAL Transfo�mer ❑ 15-50 KW - ❑ 50+KW KW Meter ❑up Lo 100 amps Meter ❑over100amps Sub Panel Motors0U1 HP Oi'/:-8 Inc. Solar 09-15 HP �16-15+ Microwave � � Pole Light Range Sign Standing Sections Trash Compactor CHANICAL � FEES Reinspection Fee $15 luue Fee Hoodor Typel ❑ � DEVELOPMENTSERVICESREQUIREMENTS: Canopy Type I I ❑ Z�^�^9 APP�oved By ' Buildin9 APPraved BY, {1 Refrigeration System , ❑0.100,OOOBTU ❑100, System Repair/Alteration Fire Dampers Registers ' � � � Izwa Fee , FEES S 3 � SUMMARV OF FEES � BUILDING PERMIT $ � � SMIP � , $ � � PLAN CHECK $ PERMIT: 1 PLUMBING � $ � ,, ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $� ELECTRICAL. $� GRADING $• PLAN CHECK 50% $ MICROFILM • $ � g'�� MECHANICALI $ � , � TOTAL FEE $ . S�.ZLF�1—. PLAN CHECK , 25% $ . � ' , � � CO,�JSTRUCTION AND PLANNINI . . � I & SPA � � - � � .- Date Inspector �� Date Inspectoi APPROVALS Permit# � APPROVALS Permit# - � •� 1-Temporary Electrical Servics or Pole � 52. Pool & Equipment Location . • ;� 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement '� - 3. Electrical Conduit Utility-Uridrgmd.� � . �� 54. Forms , . ' ' ' 4. Electrical Conduit-Undrgrnd. . � ' 55. Electrical Bonding �' - , - . � , 5. Steel Reinforcement � � ' � � 56. Rough Plumbing & Rressure Test � .6�.Electrical UFER Gr�d. �� 57. APPROVAL�TO COVER-GUNITE ' 7. Footings , � , 58.'Electrical Conduit-Undrgrnd. . � 8. Foundation � 59. Gas Pipe, O Undrgrnil:, Test �- 9. Water Pipe-Undrgrnd. � . 60. Backwash Lines, P-Trap, O Undrgrnd. "� � 10. Structural Floor System � ' 61. APPROVAL TO DECK � .11. Prope�tY Sewer Line & House'Connection� 62. Backwash & Receptor-Final � 12. Sewer Cap . � 63. Heater & Vent-Final . 73. Roof Drains ' 64. Plumbing System - Final � � 14. Rough Plumbing . ' � 65. Electrical-Final � � � 15. Rough Electrical_Condu�t __ . � 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 Heatinj & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace + APPROVALS Permit# , � 21. Ducts,`in Structure 70. Underground Hydro � � � h22. Ducts,-Ventilating ` � , ' 71.� Product Piping OGas .00iI � � � . � 23. Gas Pipe-Rough & Test � " � � 72. Underground Flush - ' ` � � � ' � 24.'RoofFraming - - � � 73. Undergrnd.StorageTank�Gas��OOiI - ' �� 25. Roof Sheatliing ' � - �� 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 Nailing � ' � HEALTH DEPT. REQUIREMENT ' ' � � 31. Plaster Brown Coat � � -� 79. FINAL�INSPECTION --� � - ' �- 32. Electriral Power Meter-Final � � '' 80. FOOD CERTIFICATE ISSUED � � � 33. Final Electric • � � � � - ` Notes� - � ' � ' �� 34. Final-Heating & Air Conditioning� . � � '� ' �� 35. Final Ga's Pipe-Test� � � � � ,� , � " � � 36. Hood or Canopy� ' � � , " : � � - " ' � 37. Final Factory Fireplace � �_� , � ' - � � 38. Final Plumbing � ' �� c�-�7�6 L(cn -� 39. Water Service-Final 1'i� . �. 40. Gas Service-Final ' � � • 41. Solar pomestio-Final ' ' - � � i 42. Backflow,Preventer . � ' 43. Backflow;lrrigation "'" f ' , ' ' � � . � . 44. Lendscape Irrigation System , � : ' , � 45. Sound Attenuation �`' � - ' ' ' r..� ' . � 46. Handicap Regulations � � � � - ' � ` ' � - . - , 47. FINAL STRUCTURE & BUILDING � � - � • " - ' ' ' � i 48. Special Requirements Completed, " ' , .. . . 49. Electric Release to Edison ' - - ' � � � � - . . . - - � � - -- -- ' 50. Gas Release to Southern California Gas Co • � . ~� � � � � � 51. CERTIFICATE OF OCCUPANCY , - � � • ' � , , �1 .1.�_J . . ' _ . .. ' . . . . . No. � � Date . , � � , _� � $3�b� CCSSTA MESA BUILDING-SAFEN DEPARTMENT P. O. BOX 9f7 COBTA MEBA, CALIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT noo E�ss 321�6 Ore on Avenue COSTA MESA. CALIFORNIA , OWNER Amherst Deve'lopmeiit Co. ADDRE65 17 Baker Sti♦ TEL . _ _ _ �_ ■ ARCHITECT & Coleerove. Inc 8 � No. 1672 3 NEO. KI 9'� OF ELOT VO X 1W I vnOwOn � 6ETBACK LINB FROM I LEFT S� I RIGHT J� DESCRIPTION OF lNORK - F�E RECE(VED . ,1AN 1919691 � fINANCE OEPT. CITY UF COS7A NIESS APPLICATION FOR PERMIT BUILDING For Offiee Use Only necaiar do. 9 �11'�D'i ll� av I o/ '�c�rveg/ I,HI4 1 F Ui567' i « COSTA MESA. CALIFORNIA FIRE ZONING NO. OF (� uee on n PLANB ) BOILOINO LEOAL (ClNTER LIN6 BT.1 �� - 1L�65 sq� � ROOMS b sTo� IR WAL . ROOF �G B�UCCO COVERING WOOd BUILDING AND WORK TO BE PEftFORMED 1 HEREBY wCwHOWLEDGE TXAT I HAVE PEAD THI9 APPLIWTION AND BTATH THAT THE ABOV¢ i6 CORREGT AND AGREE TO WM- PLY WITH ALL CITY OPDINANLEe AND eTATE LAWe REOULATIN6 OUILDINO CONBTRUCi101. SIGNATURE O ` � PERMITTE APPROVED r THE AMOUNT BHOWN UND¢R VALUAT�ON IB POR THE PUPP08E OP EBTABLIBHIN� A PERMIT FEE ONLT. ,UATION � J • o0 PERMIT FEE $ y $ 15,139• PLAN CHECK $ 17��0 AUTHORIZED AGEN7 Dike ti[ Ci grove� �1C• C2•I�'O y 70TAL FEE � � 4