HomeMy WebLinkAbout3261 OREGON AVE - Building Permits,�noxessaem�w+c: ��b1 VKbVVN Aii uM:
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AfICXIfECi OH QltlNEEP:
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corrmacrarswu� I3pCK PLUMHING ( 719 ) 895-12db
CONfNACT0A5MNUN0 1 1 6 1 2 KNU7I' SI
moxEEss: GARLEN lakOVE t:A uc.xo.: 7G7775
92641 uxr: 17
LICENSEU CONfRACTOflS OECL�HATION: I hereby ellim unEar penelly d perjury Ihel l em IcenseE uMx pwimona M Cheqw 9
(cammmaip wilh Seclion 1000) ol Drvison 3 W �ha Businau enE Prdaeaiona Code, eM my Ibanae is in lull brce end aHen.
c r+o.:UjUjb" uc.cuss:L_jp uc.No.: 7vi7i7 EXF; G[iy8
me: �
'f C�_ comreaor. ���"�
OWNEN ILOEX DECUINRTION: I hereby elfiim under penety d parjury Ihet I am examq Imm IM Conlredwe �m�iiF�i w�la Ihe
tdbxi� on (Swion ]03t.5 &m�ress enE Rdessbns Code: MY cIy n muntY �� �9uiree a pa�mn to owuwn. Mr. imqws.
de h. or repei eny svucwre, prbr lo ib ewieMe, a6o repuiree ihe epplicent /a w¢h pa'mil lo fib e sipmE atalemant tlet M a oM
' rcensed W9uan1 lo the povieiona d Ne Conlren«e Limree lew �Chap> 8(comme��q wilh 3ednn )000) d Div'vion 3 d Ihe •
Buaineae eM Roleaeions COCej or thet M a eha is eicemp ihereimm eM IM beeie lor iha ellepeE ezemWian. My videlon d Sedan
)031.5 by enY aGP��� la e permG wbjw� �he eppli�am io e wil pereliy d rwi more ihen I'ne huekreA Edlen 135001).
� I,eaoxrard�MpropenywmyempbyeeawYhwepaemtheiedeoompanwion,wlldotMMwk.eMNeavui.YunenaimeMeA
a oflered Im+eb (Seaion 10M, Buvmea eM Pmleaeiona Coda: Tha Conlredon limnae lewtloea mt npplyto en owror d popery
wM bulds a inprovea �hereon, eM who does auch wak Mmstl or MrseC or ihrwqh he a her own employeea, provided Ihel wch
�mww,meni, are nw m�a�dad a one�ee ia seie. u, nowav«. me w�u��re o, Mww�a�� � aaa wnnm a» yeer d oomWmon, m.
owrrorLUJdr xill heva IM WNan d parirp he « eM did m� buik a impova ta tMWT�a d vebl.
� 1. ea ovmar d IM V��M. em ssdwiveN ooMretlM wnh IbemeE cannectae w conavua tlre O�M� (Seaion )0�1. Busmma erd
Proteavions CaCa: The CantreeoA Lieenae law Eoea iwl epply b en owner of popeM � buikb a impeoves iMreon a�M who
ronirecm tw eud� O�M�s �h a wmredorta) leenaed pureuent ia the Conlredon licerree Lew).
❑ I an memp uMm Section: 8. 8 P C.. (« �hb rmvon:
De�e: Owner
i ao n«eW cemb uw i em e..,e a m�d ��ee�n.�a me rea����n d c�a�y Hmnn .�a sdar wes sm�,. uws, nsaa. ene
?5531. eM Mel I a em/ INum Wikirp m�pent vrill / wil ml (dreb�pq) naep Io tanph/ W h aek stals mEm eM �M repui�emenb b
e Garmn lamnabuciion a rtadifiutionhan iMAi�e�apemem Oimiid. Readauid mnmruaun ePV�iaroere memp ham iMw
,.�,�sa�,.
oa.: �pqiceiv
WOFKEH'S COMPENS�TION DECIAX�TION: I Mreby elrum uMer penelry d psijury ona d tM bllowi�q Aetleretoru:.
❑ I heva eM xiX meintein a cenJicme d mneanl to eeX�inwm fa workers compeneetbn, m povideE lor Ey Setlion 3]00 ot iM LeEar
coae. r« �ne weormeno. a �ne won �« wnion ml. w�d f. n.uea.
�] in�.oe�;��m�wnw.•�v�oo��re�oe.m�a���abrs.e�aiaoam.�s«caa.r«mero���am.
work Iw xhidi thie peimil ia hsued. MY ��' �Ge�� iruurarce cerr'nr vd pdiry numbar ere:
c�a�: GGI.UEN EAGLE EXYIRES
rwKVN�mc�, �, � ut "v9/G1/58
(iM1is eeGion neeC �rot be mndeteCT tM w�l "u M are huMred ddWa l3'faJl w/m.)
❑ ily �hel in IM peAorme�we d iM wak fa whkh thia pem�� ia iswed. I ahell iwl employ e�ry pe�eon in eiry menner eo m to
bx a subl� ta tM wwkers' campanmtian lavn ol Celilamie. eM eprae Ihet X I etwuld become eubjatl b Ihe wo�ke�e'
�" mm �iw� �„ d' ls a>oo w�n. i.m coee, i.wi �onn..'rn �.nn m '�sr�vion .
a: ' `7 � % nPdiram: b^'�i
Inp: FaAun ro axuro workxi corqvmutlon cm�rq� b �nbwNl, mtl �lull aub/�cf m�mployw ro ctlMiul pxuMw md
Iv/I flnu �g lo one huitlrad thouuM GWNn (SfOqOqDJ, M aJE/tlon b M� cwt of rompmuetbn, demeps� u provlAsd br In
�. SOCIIM J%i�5 0/ IM LIEO( LOCJ� III(MYL NE IIIOTI�'! INI.
CONSTHUCTION LENDINO AOENCY: I hsreby elfirm uMer pendy N parjury iM1el lhem u e mnn�ueion IaiMinp epe�wy br Iha
perlormarKe IN Ihe xwk lor whidi Ihm pamG n osued ($eUun 308), CN. C).
LENDEP'S NM1E
LENDEH'3 �DDRESS:
I canily Ihet I hew roed thb epplicelion eM e�ele �hat the ebove iniwme�ion ia wrted. I egree b canply wnh ell tlty aM counry ardinencm
erd slete lewa relmiq to buildinp conetruclbn end hereby eulhorixe reprecenimivm d ihis oiy io enter upon ihe ebove�mentioned popeM
la insqeion W�Wses.
hi�N tvuCF
o�e: C � L
(St51de.WP) While-Buildiq 8 Sdery: G�eemFb: Canery-AOW^��: Pink-Havenua; GddenraC-Aseessa
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FEtcMII Nu; F oasaso PLAN CHECri Nv:
CVN52kUCIIvN TYPE: V-N PERMII TYFE: FLU
J�b LESc:RIPYIGi3 : uIsHWASHnR CAANGE uUT
N
9 7�000
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CGMMENTS: NG UTHEh WOAK ASSUCIAIEU WIIH IHIS FEkMII
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PLANNII3G NG7E5>
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AFYiICA'IION ISSuEL aY: LAI'S: �
iiifiiiiii'sfiPiFieiiiPiiieieieieieiiii�if'seiFwsewie�eieae ws' srse�ese�e t werw se i'eiFwieiiiFiFiiiFif se +e sesrse i'i'e
LEGAiIZA7IGTi:N F b E. 5 U M A n.Y . STkUCTlinAI, SnGMENI:N
!lLLla rMi FiuHn3tvG �LEC3kIC HECriANIC FIkE SMIFik�,s Gk[iuING
PEkMI? 8.75
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PLAN
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bUiLLING-LIV-> FEkMII ISSU� PLAN-CHECK. TvIAL FAIL UUE
2GTAL5----> 8.75 22."vG G.G"v 30.75 3G.75 .Gp
REVENUE LIVISIGN I'GTALS--> COLLEC'IEL: 3�.75 GVEkiSHGkT: ,V�
bLLG PMT PI.UM&ING ELECI'RIC MECHANIC FIAE SMIFiTGZ GkPiLIiVG PLAN-t,HECri
3�.75
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� I N L I V I U U A L F E E b k E A K L u W hi
IYPE {j►Y u E 5 C h I F T I �:r N D'NI? CGSi 7GIIw CGSi
PLu 1 LISHWAsfith 8.7� 8,75
fiNL uF FEES
EXPIRED
DATE / � Oj�
11-24-1997/08:49 A�rf3�.75
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FEkMIT:08NggFy
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' � CONSTRUCTION AND PLANNWG ���` `� SPA � �
" � � Date . inspector ' Dace Inspector
APPROVALS Permit # - APPROVALS Permit;# � ,
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 1 .
_ - c
2. Soi� Pipe=Undrgrnd. � _ :; � � 53. Steel'Reinforcement ,_ �
�� - -
� !3 3.���ctrical Condajt�+lity-UnCi9md. - ' � - 54. Forms ' . � � ,�S , �'�
�. ,N,.,. . .: . .
4. EleCtricaf ConduivUndrgrnd._ ' . 55. Electrical Bonding - -�i
�.
' '��5.���ei Reinforce'q-ibSc� � � 56. Aough Plum6ing & Pressure_Test !�' •
i } 6_:�tectrical UPE �nQd. ' 57. APPROVAL TO COVER-GUNITE , :�
' �^7.� Footings �� �'% � ' � , . 58�. Electrica� Con �-Undrgmd. . �
:-i �x nr„ i.� �� . ��'
� yB.jFoundation �� `� ' . 59. Gas Plpe, O Ur,y�igmd., Test
'9. Water Pipe�Undrgmd.�'� • ', - "60. Backwash LineySt.;f?-Trap, Q Undrgrnd.
� 10. STructural Floor SYstem �; � 61. APPROVAL T. .�ECK. - '
11. Property Sewer Line^& HouseConnection 62. Backwash & R�ejator-Fi�iil �� -
12. Se�✓er Cap �("; •� ' 63. Heater & VenDFinal ,� i��; � �
� I� 3. fioof Drains ^ . 64. Plumbing System � Final i � .
,J4. RoughPlumbiri$ � !,'�� I� _ ' , � 65. Electrical-Final � � � � � •��
' �;15. Rough Electricaf,-CoDduit .. `,,_ . . ; - � , �"
� 66. Solar SYstem-Fw�l
ti:
�`I6. Rough ElectricSNir���� . �� , � � • . � ' fi7, fencin & Acc'�.' � 1 - �
g q�Ss�Approval
�,77. Rough Wiring Si.gn : � 68. APPROVED Ft9.R PLASTERING - r�� „
_ � 78. flough Electric.�'+T Bar Ceiling � 69. POOL/SPA�SYST�MS^FINAL � "
39.i.btou� M,ga2i�g &�A� Conditipnin� ;T:r �: �� �� ,G r� �; Fl��1-E�.1&PT�REQUIREMEIV�T rT 1
!❑ '71U:7:� i*1 't i :r `7
20.��fiou�}h Prttocy F6e�lace � ;SI* �^�i �r -.S �-� - �r r r' APP�O�ti3'��" ,�e,.rmit # �« .. ��"�-'��' �? -
,-� : ,.,�-, :�s � �_ �� � � � sJ'7�2
I ir R I •• •• I-1. � . '_ H. � H • • .
21.�]}ucys, iqTStr u�;k i ,5�� ,�_ �� �� i; r i 70!-Undergreuud Fb�dro :t
22.�.�ucf3, U�htilffiingiS:'r. �_,�j :r �7 ^: i� ��:k Jt. Prod�f�'ipin.y�as i�] Oil _
23. Tias'Rip ��to�h B�T�St � in;s :r in �r �_ � :k �-� � i �, !� (
�� � � rrlr :�:] :k �z iT ;:K � 72. Underg�a�lnd ush :k .N
24. �Roo� Framing ��t �� � i*t :K �� :� x i�'K �• 7�. Undergrnd. Sto'Ya�e Tar,i� O Gas ❑ OiI
1 �t• 'k 1. I. iU i. : Ht
25. Aoo�Sheathing x:t H ��,K ,� � j'��j ��-�� 74. Overhead Hyd,�ir :k
26.iJ-Bau Cei/ing (Strccpturall & � �t�oat �a �� ;r '_ �Y i8. Dry Ch� ical �-�� , �� � '-' -
27.'�ranie ai� Fiashi�� ���^�r k ir :" �p'� 76. Dr Sta�Di ay �� K�� �v ;�
v � Y HIT�IJ IT :K :�:k Y RP �-i •
j.: 28. Latliing� Siding;c.i: �7': i� �� .v f � 7p. FIXEdS`FST'�iV1�FIN '� ;�� •v
� �.
.
.. 29. InsWati d:r ,S •• � K �1 r, :!: � � !r�
°71 �J:t S �� .�- S e: �•aFIR6XREV. �u1M1y4L �t
i � . ,.
30. Dryevall!Mailing �].i �-� i �r t� �K :Si�i,� ��ivH£ALTH DERT.�iEQUIREMENT
i
' 31. Plaster Bcpw � 1.." •S ''"�° .� k� .r
01Co�.x � ,��_ :r }k 79. FINAL',�PECI�ON .r ;� ��
�, 32.�=Electricaf�Power I�sei-Final i v � C� � 8� FOOD CERTI�CATE ,M'YSS2JED�
-f I*f ! '� 'K � "� '7 '7i*7 ��� "J �7 1*i "
�� 33.��inE�Ele�trtc' �'r �r, 1 i�i'-1 �x k�r, r N.Qtes: � I*7�1 �t :S 'd
ti
� 34.��'in Heajing- f�i;�Cctnditioning i�j �k � k! i�-+ �i I�d: .r �� J �,
�- - � �c � �n �,
. 35.;�FinaiGas'Pipe•Test�+'�'y .. :K''' K; - :�o '=�'' �'` i'' � .
.� �� �-.�t r' .r Y�• �n . ••�l K M
, i 36..Hoo�or CanoPY H K��i � t��In �s .% � r in ;Co e tn �n (�
� . C . . ... � . . : . � :. :r �
� 37. Pinai'Factory Fir�q�c��Y � ;� '� •" ,y :K �v '
r �v :e iV � � K �T' �.i
38. FineyPlumbin9 '� t i�7 '� i �� ��. � � �* � ; � 'r :k _ � �
39. Water Service-Finai i F.. � �K'x �: " �
i .K r �-..� • .p �r,
1 f 40. Gas Service�Finai ~'r �'� "'"�n �/ ' ' ' ". � -
�t n�-.�-. jr, �r k �-� iV� ��f �
i i 41. Solar pomesticFinaN � IT' :' ' f �:' '7n� iT :t :� :7
� . 'Y k -� ::1 I J .-� ��! !. .5
42. Backflow Pre�enter° �� �� � � ` � " �� - � '�
� t'li .�1-fl-I .R e-i k li ITJ�) 'F I�
�`43. Backflow Irri�tion � �"�� �'^ .A � iv k ;a �� ,�
i� i
� • �k iA:<7: �K 'r IO
... ��4.,-Landsca'p�a Ir�ipatio4 SYstem,�•I�Z i.: ��: � �2 2.F� ,- :E �� :.; �'x :: :S i�
., }_ 45. 5ound FVCtenaation+ .'" ..'.• .� ~ M �*f �*l.t i� �^ 7 �a: � ,-.� �.x
�r �-r :-. � t '-I 'c i tTt ••'.Y � .. i �.a(i ••H :r
.. ��{ i� .! -' . .� 'J� ,� .
� , `�6. Handicap'Re9'ulatio;r�s � .. g ;S � �k a m �� :� �x
� �47. FINkL STRUCTURE & BUIl01NG � ;� K .i �r � -
' � .�. : � � I I.-1' 't I'- C . !^ � 7 k ��
' 46.;fIN�AL PLANNINGp j'-`'� j`� �-- -- t� ri S e: :�;
. -,
-: �A9. Iecfric Release to 6dison i K � +�_ }(R i* i •;'� 't
� - r . �7 ��;� .+ n ,b
- ;�0.�$as��ieleasetoSout.�ernCaliforalaGasCo -` � ---' �: � �' ' � � ' '' �
+ '<' Jp �`l r n.}
'bi. CERTIFICATE OF OCCUPANCY � " "
No. Date
CITY OF COSTA MESA
suno►Na o►v►s►oN
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
E98-00728
PERMIT NUMBER
(714) 754-5273 • Fa�c (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAI PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
3261 OREGON AV
13905405
DEWAYNE NEUFELA
Phone:
�,/7�r%�~ (� �
.--"�� I t
NEUFELD;DEWAYNE' �
- -�'�'/✓ ;�'�. � _ �
New Re§ (1=2 units)
New Res`�.x(3lunits)�
Pool % S`pa � .
Recept O`utlets r'•
Switches,�� r\�\ �, \
NonResApp\� \V�
Res Appl \ ��, �'
Service to 200a�
Service to t000a\
Service ove� 1000a��
Motorstolhp ��;
Motors to 10hp �
Motors to 50hp
Motore to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Pole light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
.,` �
$22.00
so.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
� $0.00
0
0
0
0
0
0
1
0
pr.
��
cr
�-t
status: ISSUED
Applied: 07/13/1998
Issued: 07/13/1998
�--._' ._�� ..,. �
�� (�/�\
, .
; ;�\ \��� ��
�� �`'�.�<,'�� ^��
_�����' � ��
�����
v
Busway /100 ft
.......... . up to�10 kva/kw
........ :*�-up.to 50 kva/kw
............c-,u'{' p o�,100 kva/kw
......over 100 kva/kw
LowtVoltage Equipment
Low�Volt Wiring System / Ckt
nr u � -,
Ii, `�1
:?J'1�', �� ; 'U
;-
Quantity
$0.00 0 �,
$0.00 0 '
$0.00 0 �i�
$0.00 0 �%
$0.00 0 f
$0.00 0'1
au.w u '`.,."�c�...� v[ner�eiecRncarree� \t ��au.oi
: �.$0.00 J �� � 0� '�_� �- - = =�'''� \\L��r� .
: '$0,00 �v�f OC�"� ? Investigation Fee � �- ,� � $O.Oi
`$0.00�� LOl C� � �"} r'�.�PIan.Check�Fee�`� \1 $O.OI
$0:00 � 0 `ti � ! �-- Reinspection Fe� 1�-J ,.�$OAi
so.00� �'";o�� � �.�' �\;[r� � +�l '=
�,.�.
$0.00 `'"�0 �`%=.`��:�.�,� TOTALCALCULATED�FEES 54925
$0.00 01''.��,��'X".��r�=: ��=��'"`�-
COMMENTS / SPECIAL CONDITIONS
EXPIRATION: This permit shall automatically expire and become void if xrork is not commenced within 180 days, or if work is suspended or abandoned
for a pedod oT 180 days. .
INSPECTiONS: In order for the work aulhorized under this permit to be considered legal, such work must comply with all applicable codes, and all
Irequlred inapeetlone end flnal epprovat must be ob�eined. Failure to obtain inspections and final approval will resutt in the expiration of this pertnit.
FOR INSPECTIONS CaLL: pt4) 7545826
•- a
WORKERS' COMPENSATION DECLARAY�ON: - • . �
I hereby etfirtn unCer penalry ot pe�ury one 0� the tollovring declaratians: . ... � � � � .
❑ I have end will maintein a cerllficete ot consent ta self-Insure for workers' compensetlon, es provitlad for by section 3700 oi ihe Lebor Cotle, for the peAortnence of the
work for which this pertnit Is luued. "
❑ I have and will meintain workers' compensetlon insurence, az requiretl by section 3700 of the Lebor CoOe, for �he pertwmance of ihe work for which this partnit is issuetl.
My workers' campensation Insurence Gertier end policy number ere: � �
Cartier. Pdicy Number.
(Thls sectlar need not be completed i/ the pB��t is ve/ued et one huntlred tlollars ($100) or less.)
❑ I certily that in the padortnence of the work for which Ihis pertnit is issuad, I shall not employ any person in any manner so es to became sublect to the workero'
compensetlon laws of Califomie, entl ag�ee that i1 I shauld bewme suC�ed to the workers' compensatlon proNslons af Sectlon 3700 ot the Lahor Code, I shell forthwith
comply wNh Ihese provisions. .
Appllcen� Signature: Dete:
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATIqJ COVERAGE IS UNIAWFUL PND SFULL SUBJECT PN EMPLOYER TO CRIMINAL PENALTIES AND GVI� FlNES UP TO IXJE HUNDREO
THIXISAND DOLIARE (5100,000), IN ADDfTION TO TNE COST OF O�.IPENSFTION, OAMAGES PS PROVIDED FOR IN SECTON 3]Ofi OF THE LABOR CODE, INfEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATItlN: .
I hereby etfirtn that I am licensed under prov�slons of Chepter 9(commencing with Sedion 7000) at Division 3 of the Business entl Professions Cade, end my license is in full
force and eflecL Lic. H Class N
ConVectofs Signature: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby affirtn thet there Is a wnslruc0on lentling aqenty for Ihe perfortnance of the work for whic� Nis pertnit is issuetl. (Sec. 3097, Civil Code). ..
Lendefs Neme: Lentlels Atltlress:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eXirtn thet under penalry oi perjury fiet I em EICEMPT FROM 7HE CONTRACTORS LICENSE LAW for t�e following reason (Sec. 7031.5, Businass end Profeulons
Catle: My ciry or counry which requires a pB��� �a construct, eller, Improve, damolish, or repair eny struclure, prior to its issuence, elso requires the applicent for such permlt
to flle e signetl statament that he ar she Is licensed pursuant ro Me provisions of ihe Contrectars License Lew (Chepter 9(commencing with Sectlon 7000) oF Division 3 of the
Business and Professions Code) or thfl� he or s�e is exempt iherefrom and the basis tor Ne alleged exemption. Any violation of Section 7031.5 by any epplicanllor e permit
sub)ects Me epplicant to e civil penalry ot not more Man five huntlretl tlollars ($500).): �
❑ I, as ownar of Ihe property, or my employees wilh wages as iheir sole compensation, WILL DO THE WORK, end the structure Is not Intendetl or oMered tor sale (Sec.
7044. eusiness and Pratessions Code� The Contrectors License Lew does not apply to an owner of property wha builds or Improves thereon, and who tloes such work
himself or herselt or through �is or her own employees, provltletl ihet such Improvements are not Intended or oHeretl for sele. If, however, ihe bullaing or Impravement is
soltl wit�in ona year of completloq Ihe �+'�er-builtler will have the burden of proving that he or she did not builtl or imD�ove for puryose ai sale.). -
�I, es owner of the properry, em E%C4USIVELY CON7RACTNG WRM LICENSED GON7RACTORS to cronsiruct ihe D�al� (Sec. 7044, Businass end Protessions
Code: The contrectors License Law daes not eppy to an owner of property who bulltls or improves thereon, and who contrects for such project with e wntractoqs)
� pursuent to the Contradors License Laws.).
I exe t under sec. Business flnd Prafessians Cotle tor thls reason:
at e:
/ Expires: / Z/ b-� S
� edflcetion of Ownerehip by (rype of tlocumant, i.e. - property tac bill or deed): �
DIVISION OF INDUSTRIAL SAFETY PEPMR CERTIFICATION: '
❑ I hereby certtly thet no excavatlon five (5) or more feet in tlept� into which a person Is required to descentl, will De mede In connectlon with work authorized by t�is
pertniL antl Ihat no Duiltling structure, scattalding, talsework, or tlemolitlon or dismentling ihereof, will De more t�en thirty-six (36) feet hlg�. (Chep. 3.2, Gry 2, Atl 2, Sec.
341, 7111a B, Celitomie AtlmiMstretive Cada). .
❑ As owner-builder, I wlll not employ enyone to tlo work which would require e pertnit iram Ne Division of Industnel Safety, es notetl ebove, unless such person hes e
pertnit to do�syfh work from Ihe divisiq�. ���
Signature:
Division of InOustrial Safery
Numbar:
Date:
1 Will Ihe applicant or present or tuture hulltling occupant need to fila entl certity a Business Plan tor emergency response to release or Ihreatened release ot a hazerCous
matedel? ❑ Yes ❑ No . -
(Section 25505 oi tha Californie Healtl+ and Satery Code requires, with soma exceptions, thet a Business Plan be filed with the Costa Mese Fire Depertment by every
business which �as at any one time du��9 a reported year a quantiry of hazardous matenels equal to or greeter Ihan e welght of 500 pountls, or e volume of 55 gallons,
2 Does or will the eDDlicent or present or iuWre Dulltling occupflM neetl to Tile a regisiratlon fortn for ecutely hezardous metenals? ❑ Ves ❑ No
(Section 25533 of the Celifomie Heelth end Sefery Code, with some exceptions, requires regisiretion with the Coste Mese Fire Depanment by eech business which et any
one time hes on hand a quentiry o1 acutely hazerdous materiels equel to or greater then e welght oi 500 pountls, or e volume ot 55 gallons, or 200 cubic leet oi
compressed gas at stenderd temperetu�e end pressure).
..................... . . ... .........................................................................................................................................................................................................................................
3 Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Manegement and Preventlon Program for acutely hezarCous metenels)?
❑ Ves � No
(Section 25534 of the Califomia Health entl Sefely Code proNdes that ihe Coste Mese Fire Depatlment may require the preparation, certiflcation entl flling with' Ihe Fire
bepartment of an RMPP by businesses which are required to registar ecutely hazerCous materiels with ihe Fire Depenment.
............. . . .... ....................................................................................................................................................................... ................
a It en RAAPP Is�presentty required, has 5ectlon 25534 of the Calitomia Healih antl Safery Code been fully complied with9 ❑ Yes ❑ No ���������� �� ��������������
..................................................................................................................................................................................................................................................................................
5 Does or wlll the applicam or present or+uture DuIlGing occupant require tor the work which is ihe subjact of this a plication epertnit for such consiruction or modificatlon
from Ihe South Coast Air Oualiry Management District or irom any oNer air pollutlon conirol disinct or egancy? � Yes L] No
(Seclion 658502 of the Califomia Govemment Cotla requires that the requested intortnation be fumished on epplications for non-resitlential bull0ing pertnits).
..................................................................... ..................................................................................................................................... ................. ................................................
6 WIII eny part of Ihe fecillry to be consinicted under Ihis pertnit be wit�in 10001eet irom the outer boundaries of e school7 ❑ Yes ❑ No
pf yes', the faciliry must meet the requirement of Seccions 25534 end d2303 oi the Califomie Healt� and SafaN Cotlal.
7
8 (If yes', ettflch certificete oi complience trom tne appropneta e
CERTIFICATE OF COMPLIANCE: I ceNi�y thet under penalty
regarding Hazardous Matarials and Emissions.
Signature:
or agency is reGulretl for ihe work which is the
en metle7 ❑ Ves ❑ No
�o u ion con m o cer . �
.___...._........
perjury the information given ebove is correct I egree to comply with all stete lews antl city artlinances
Dete:
CEHTIFlCATE OF COMPLIANCE AND AUTMOR¢ATION OF ENTRV: I certity under penelry of perjury that I heve �ead this applicatlon entl stete that the Information given is
correct. I agree to comply with all state IaWs antl ciry ordinances relating to buil0ing construdion, end authorize representetives ot the Ciry of Costa Mesa to enter upon Ihe
above-CescnbeQB{�erty tor inspadion puf �ses. I agree not to occupy or ullow occupancy of eny building authorized by ihis pertnit until final inspeqion. . �
� ,���-�.��c i — 7 —/ ?— S/
�ignaNre 6iC Dete ��
And/Or Autho�aed Applicant - Oete
t00E �. INSPECTION TYVE
1676 Fixed System Finel Fire Preventlan
12fi6 Pool Spe Final � '
200 � Flnel Re-Rooi . � �
201 Final BIocWReteining Wall
202 Final Factory Flre Plece
203 Final Sign
204 Final Demolition
COOE � INSPECiION TYPE
206 Final Mechenical
20B FlrielPlumbing' '
i.
210 �Finel Eledricel
212 Final Fire Prevention
220 Flnel Pleoning Approval .
222 Final Site
250 Final Bullding/Occupancy �
2446�d8 . • .
a
i .:�=�
�
/
PHQIECT RODBESS: 3 � (� j. CJREGUN .a.L� . � .. ( , .. � . ... .. UNI7: � .
owNes�sxen+e:.STLIRVEVANT � , � �
�ooxess: � 2 6.1' OREGON A�i E .
: C:nS'TA.MESA ' "'; :. e' '
�. CA 9?.626
't ( 11�? ). 546-7636 ; '
�RRCH/F�GINEE�'`• . � � . ,� .BEG.NO. . .. �
� �ooeess: , �' ' ; ' uxiT: � .
, . (i : � - ' '.
PEAMinEE:FAIRWF.'ATIIER.ROO,FING � (714')f332-5:357'
nooeess: �;�5 S: ,PASAIiENA. ' ; ' ' '
TUS'TIN CA 9268Q i .
LICEXSED CONTMC70R UEClAM710N: 1 here�y affirm ihat I am licensed untler pmvisions af Chapter 9(commencing with Section �
7000) ot Oivision 3bf the Business antl Pmfessions COAe, antl my license is in fu117orce and effect.. �
' ciTr u� 4 7 8� sure uc.:515 ]. 2 5 cuss: C— 3 9 ".' —
o e: . '' Sipnatu2: fL/f��5 ' � . ' . <'
�
WNINEBS'COMPEXSRTIONOECUMTION: IAerehyaifirmihatlAaveacetlificateoiconsenitosell-insuraoracenificateotWorkers' �
Compensation Insurance, or a certified copY ��ereollSection 3800, La�. C). ' � �
roucr xo:: 10.4 2 G 0 0'— fi 9 i E%P. O�TE: L O/ O 1/ 9 O �
coMv�xr:STATE FUND ; , � ,
� CetlifieD copy,is hereby tumis�eA. � Cetli/ietl copy /is� Ne0 wit� the c BuAOinA Division. . � .
oate: 12� 5 �/q�� �7/v�i _" ' ; �
Applicant:
IXEMVfION FNOM WOPKENS' COMPENSIITION OECUMTION: �TAis section neeA not �e wmplete0 il Ihe pe�mit is im ane huntlrea (5100) or less�.
I certity that in the De�ormance of ihe work for which t�is Oe�mit is issue4 I shall not employ any person in any manner so as ta Oecome
suhject to tAe Warkers' CompensatiomLaws oi California. . •
Oate: " Signature: - � ' - � - - � —
NOTiCE: II, atter makinA �his tleclaration, you shoultl Uecome subject to the Workers' ComOensation pwvisions of tAe Lahor
Code, you musifortAvnth camply witA such D�ovisions ucthis Dermi[ shall be tleeme0 revoke0.
CONSTpUCT10N tFN�ING �GFNCY: I hereby aflirm ihat tAere is a consimction lenaing agency for the pedormance oi the wark for
w�ich this permft is is5ued (Seciion 3097, Civ: C). � ' ,
� IFNDEH: . . . . . .
. _. -ROORE33: . . . . . . — � ,-
OWNEB BUILDEB OFCUMTION: I hereGy affirm ihat I am exempt Imm t�e Contracrors' Stata License Law br t�e lollowin9 �eason ,
(Sedion 7031.5 Business an0 Professonal'Catle: Pny ciry ot counry which requires i pe�mit ro construc6 �alter, imDrove, tlemolish, o�
repair any stmcNre, D�or,ro ifs issuance, also'reQuires t�e apDlicant for such'permit to file a signed stattmem tAat he/sAe is licensea
pursuant to tAe pmNsions of the Cantactors' State License Law (Chapter 9(commencinA with Sectian 7000) al Uivision 3 at t�e Buslness
antl Pmfesaons'Cotle) or that he/s�e is exempl t�erefrom ana Ihe Oasis br t�e allepeU exemption. Any nolation ot Section 7031.5 Dy
any apDlicanitor a,peimit sublects t11B aDPlicant to a civil penalry af not mare ihan five huntlretl Jollars (5500). , • �. �
� I, as owner of tAe pmDedy or my employees with waqes xs their sale compensation, will tla the work, anC ihe
❑ stNciure is not intendetl or oHeretl tor Sale (Sectlon 7044, 9usiness anU Pmtessional CAtle: Tne Coniractors'� State License Law
Oces nat aDOy ro_ an owner af a pmDeM who 6uilOs or improves t�ereon, and who Uces such wark himselflhersell or ihmuph
�his or her own emplayees, D�a�a� t�at such impmvements are nat inten0e0 ur o(lerea for sele. II, hoxrever the 6uilAinp ar
impmvement is solU wRhin one year o/ completion, ihe owner will have ihe GurGen of pmvinA h�she diJ not huild or impmve
lor Ihe Ourpase of sale). ' '
I, az awner,ot the O�operry. am excluslvely�coniracting with Iiunse0 coniractors to constiuct Ne Drole�� (,�ction 704d, Business
❑ and Pmfeuions COGe: The Contactors State Licenu Law tloes not apply to an owner ai pmpeM who UmIUs or imD�� ��reon
antl who contracls lor such D�ojects with a coniradoqs) license pursuant to the Contractors' State License, Law�. I am awa�e
t�at D�ooi o1 tAelr Warkei s Compensation insuronce shoultl Oe pmnaeE to�me � . ,
� I am exempt un0er Section: � � 8. 8 P. C. .
for this reason: � � . • . .. ,
Oate: � - � Owner.
I tlo heahy certiry �hat I am aware of and understantl ihe requiraments of Califomia Mealth anA Safery COAe Sections 25505, 25533, and
25534 anG t�at I or any tuNre huildinq occupant will/wlll not (circle one) neeE lo comply with saitl state coEes and the requirements lor a
permtt lor connmction or mo0ilicatian fmm the Air Oualiry Management District. Nesidential consimction applications a2 exemD� �mm
� inese Orovisions. � • . � ,
Date: Applicant
I hereby certiry that I have rea0 ihis apDlication�antl state t�at the ahove information is correct. I agree to comD�Y ��� all ciry anJ wunry
ortlinances anU state lavrs relatinq m GuilOinq tonstrucfion anE here0y authonre 2DR�ntalives of Ihis ciry to enter upon Ne aDove�mentionea
D�oDeM �or inspection purpases. � . � ��9
Date� ������'� SlqnaNre: � � � il4f.-- � �
onver s License�or Sociai Securiry x: � � � ' �.
1641 A6
Eniorcemenp Canary—Applicant; Pink—Revenue: GolOenraE—Assessor
', � ' CITY. OP COSTA MHSA =�ROII,DING. PERMIT � PERM NO�: L�, 'U45290
PERMIT' NO; �B, �`095290 PLAN CHECK NO: .� N �GOVT;� N S"UPYc' N
CpNSTRUCTION: TYPF: 5-N' ;� PEFtMIT TYPE; STR � ' PURPOSE : AI�T.
�JOE3 DESCRIPTIOD] � ; RE-SHEATH ( 1 /2"CDX ), RE-ROQF FIFlGLS �SH • � ; SQ FTa � • . 7, 600 .
CLAZM VALUE: `� ' '3, 600. 00:. � CALC-VAI,UE': � -J, 600.�0'0 � GROLIP OCC: R �_ ./ ,
COMMENTS: SMOKE DF.TECTOR REQi7IREll IN HOME. • ' � �" ,
���x+�x u*x��u�*****�+�**.*�� �c-��r�r�r���****��r+�*����**x��**�**�*�*�'�*x��**�***���r�r��**-xi��
' i , �� � Z O N I N G R E� Q.0 7. `R E M E N T S, �
� , � S E T A A C K�S . , .
-----� ---�- MAIN F3U7LDING -=--=----- --=------ ,ACCESSORY'BU.T.LDING_ --------'
�FRNT: ' FT IN REAR: FT IN FRNT.: �FT IN REAR: FT ^ IN '
-LEPT: • FT ' IN RGHT: FT IN LEFT: FT IN RCHT: 'r,FT ' T.N
y ' `
PARKING RE�i • PROV: ' PARCEL: 1J9(75405 ZNE: HEF NO: � ��
PLANNING'NdTE$> � ' ' � . � '
- . i .. � �. . . .. __ : .. . _ . . . _ . . . . . , . � ., . .
iE iP iE �k it it tE iE �lE 1E K� it K iE � 3E k ik !F iE i6 it iE it IE iE 3E i! i( iE �E ik iE iE it iE iE �)E iE if sE f6iE if i6 dt �%it 3E it iE It it iF i6 ib �E it ttlE 3F it iE �t it i6 it?6 # iF if jE iE iE ae iP 3k if iE
D E V E��L O P M E N T �5 F. R V I C E S R'E (,� I] I., R E M e N T',S ;
' " ' f' •
20NING'.APPROVED=BY.� _ __ ___ ' •DATE: _
BCIILDING.APFRGVED HY c ' � � DATE: � �
: t , . ' . . _ �/J . . . .
APPLICATTON ISSCJEll BY: ,tES���������iF � ' DATE: /.2=��^�
iEik3tX-�1EiE�%iEiEiEiE1EjEX�*ifiE�IEiE�Jkit�lf?F��iF 3FCiF��iF�1f,3Eil�)EiE�IEiE�1EiEiF�k�FiF��� %��f
iE3EiEjEiE�EiEiE�E�EiElEifiEiFifiEiEjEiFjEiEjEitiEiE�iEiEiEiE�E1F�EiE1Eff%iFifiFifiFfFi iEiEif�E�)(-9EiE1EiEiEiEiEik#dEiEiEiEiEi(�iE3E3EafiEiEiFiEiE3Eif�EjfiF
LEGAI�IZATION:N , "� F;E F', S: U M M A' R Y STRUCTUF<AI;' SEGMENT;.y
BLllG FM7 FLUMAING ,SLECTRIC 'MF.CHANI:C FIRE� ,SMIP/,RES. GRADING
PERMIT' _ 69.OQ .a i.�r50 ;
• � . . , � . . SMIR•fTION-RE:S'
PLAN - , ' ;.. �� ,
_ISSUE FEE � .. ' v . ' " ';�.' % .
BUILDING-D7V-> r PERMIT ISSUF - PI�AN-CIiECK ' TUTAL "':+PA3D DUI;
T01'ALS----> 63'. SO 0. 00 , U. 00 - , f 3. 50 ; " 6�3 i 50 . , 00
' ' . , . . . , .. � � . �
REVENUE DIVISIODI TOTALS--> ' COI�LECTED: , 63. 50, OVF.R/SH�R'C?.= � . 00
BLDG PM'I' PLUMHING•L•:LECTRIC MECHANIC FTRE SMIP/TOT ";GRADi'NG PLAN-CHEC};
63.'00 . .50 �� ;', ;
, ,�; ,
f5 �.�;
'�� �'� �E �X- i' jf it 1E Y.- iF iE iE iE iE i:-ik iE if iE 3E i! if it �l' iF ik iE �1(-iE iE iE iE iE k 3E aE 3E 9f iF K-iE dk iE ih iE i' if iF �E iE if iE iE iF iE Y-iE iE iE 3E jf iE if�1E it iF'iF.k if if iE jE # iE % iC� �E if IE %
' '� S N D I. V I- I7 U A L� F E E II R G A' K D O W N.;:i ;
' . � . �: . . ( :
TYPE ` QTY D F S C R 2 P T I.;O N , UNIT COST, � TO'1'AL CO5T
SFR 3600 REROOF DY NALU�: RESIDEi�1TAL TdOZONB �"�"i..00 ^•^'�, f�00.00
i '�� FND OF 'FPF�
�C .. . . . . . " '
EXPI.RED; . �
I�icomplete Inspections. �
� ��ate _` ` . � SiB -- N��\ ,
1 �, . . ' • � . . �� ' , i , �1 .
'� ',
01 00049122-00049123 T �� T
DATE: 12lOb/89 TItlE: 13:16
'
03.50
CONSTttUCT10N AND PLANNING ° . . - POO. SPA � � � . .
Date Inspector ' Date
. APPROVALS Permif # ; ' . _ .. _ - , APPROVALS Permit # '
�5. Tempo�ary Electricat Service o� Pole � .� • � 52. Pool & Equipment Location; �
2.. Soil Pi �Undrgrnd. _- '� 53. Steel Reinforcement ' �
- 3.-Elect�'fal Conduit UtilitY-Undrgrnd. T � 54. -Forms" � . � �
'4. Electiical ConduibUndrgrnd. _ 55.�Electrical Bonding � ' �
' 5. �Steel Reinforcement ' . - � 56.'Rough Plumbing�& Pressure Test -
� .'6.: Electrical UFER,Grnd: - _ � . � 57.�APPROVAL TO COVER-GUNITE
7. Footings . ��� � 58. Electrical Conduit-Undrgmd.
� 8. Foundation ' ' , �� 59. Gas PiPe, O Undrgrnd., Test � ..
9. �Water Pipe-Undrgrnd. � 60.'Backwash Lines, P�Trap, � Undrgrnd.
10. Str�ctural Floor System � ' 67.�APPROVALTO DECK .
11. PropertY Sewer Line;& House Connection - 62. Backwash & ReceptorFinal •
12. Se�Ber Cap - � � - . ' � 63. Heater & Vent-Final - '
� 13. Roof Orains ' � . � 64. P4umbing System - Fina1
14. Rough Plumbing , _ . ' 65. Electrical�Final
15. Rough Electrical-Conduit � ,_.' 66: Solar System-F,inal -
�� 16. Rough Electric Wiring� ' . 67. Fencing & Access Approval _ �
, 17. Rough Wiring Siga . � 68. APPROVED FOR PIASTER4NG
18. Rough.Electrical-TBarCeiling � � � 69.=POOL/SPASYSTEMS�FfNAL
�79. Rough Heating & Air Conditioning ; � . , . � . FIRE DEPT. REQUIREMENT ,
20. Rough Factory Fireplace � ' � � _ � APPROVALS � ' Permit #
21.'Ducts, ��,Structure' ' ' = ; � � �` , 70. Undergro�nd Hydro � ' .
22. Ducts, Ventilating � _ �,' ;. 71, Product P.iping O Gas ❑Oil �
23. Gas PiPe;Rough & Test ', � __ � 72. Underground Flu"sh �
24. Roof Fiaming J • ,,, ; 73. Undergmd. Storage_Tank O Gas ❑ Oil •�
25: Roo4 $heathi�g Z$� 7q. ,Overhead Hydro : �' '
26: �T-Bar Cei�ing (Structuraq & Monocoat . ' 75� Dry Chemical . �i ' �. - � .y;
27.. Frame and Flashing, . - � ` � ! 76. Dry Standpipe " . . ' ;:�
_28. Laihing & Siding,.,_ ' .. ' � i � 77, FIXED SYSTEM,FINAL -• - � G ci
29. Insulation • _ ._ � . ,;; �:' 78.`•FIRE PREV. FINAL - ��
�,
�30. Drywa���Nailing �,�, _ _ � �.`. � ; � HEALTH DEPT. REQUIREMENT
'..31. PlasterBrownCoat� - �" ' ' ���� 79.jFINALINSPECTION � _ -
'�32. Electrical Power Meter'-Final �. ' .'•�'-, ; 80. �FOOD CERTIFICATE ISSUED. ,
; ti• .
_ 33. Final Efectric - - . jy � Notes: � �� ' ' - ' ' ' .
' 34: Final Heating�& Air Conditioning• _ " � • 7 �� - - �
� \'"
� 35 Final Gas Pi�pe-Test+ � ��
� 36.. Hood or Canopy � - ' '� ' �
-37. FinalFaMory�Firepface�, . ' • c
38. Final Plumbing ' ,
"39. Water Service-Final. � _ � . �
.40. Gas Service-Final � " - - •
41. Solar pome'siirFinal - ' �
42. Backflow Preventei ' ,� ,
43. Backflow Iriigation �- .-
' 44. LandScape I�rigation SYstem ' ' �� � �� �
" ,��
� 45�.=So�nd Attenuation � .
46. HandicaP�Regulations ^' ._ �
47: fINAL STRUCTURE & BUILDING .
48. FINAL PLANNING "
49:=Elect�ic Release to�Edison
� 50'. Gas Release to Souyhem California Gas Co
51. CER7IFICATE OF OCCUPANCY
No. Date
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COSTA MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 9f7 COBTA MEBA. CALIFORNIA
For Applicanf io Fill In Compleiely
TYPE OR PRINT
6UILDING 3261 Oregon Avenue
ADDRE65
COSTA MESA.-CALIFORNIA .
OWNER �erst Development Co.
;"^;,e«� 1533 Baker St.
carlson
CONTRACTOR Dike & ColegI'ove� InC.
ADDRE6S 1533 Baker Sti•
�,,,. Costa rlesa� Calif.
� � No. 16 293 No: KI 9-ll51
SIZE - �Z X loo I NO. OR 0LDG6Y]QI]
OF LOT Now oH LOi
USE OF none
EXISTING BL�G.
861'BACK LINE FROM � Q2 �
CeNTen Ov eTxeET � REAR YARD J
SIDEYARDILEFT S� IRIGHT >�
DESCRIPTIOPI OF WORK
..�..; �:c �� ., .�e.,,,.., � �� ..,.,,,..,.., �
$�=E��Nc'].SbO 3Cl. ftROOMS � STORIES �'
EXTERIOR WALL ROOF
COVERING St.11CCO COVERING WOOC� Skllllg.
� USE OF BUILDING AND WORK TO BE PERFORMED
Single family residence with
attached garage. Plan 21BR
1 MER¢9Y �CKNOWL¢DOe THAT � HAVE R6AO TX18 APPLIWTION
ANO BTATE THAT TXE ABOVE IB CORIiECT AND AGREE TO COM-
PLY WITH ALL CITY OPD�NANCEe ANn BTATE tAWB IiBGULATNG
9u1Lo1No coNeTR�UC/i10aN.�/ /,���
81GNATURE OF %�L//�-Q(��/�- �
FIRE
ZONE
APPROVED
BY
ZONE
R-1
LEGAL
APPROVED
- FEE R�CEiVED
" � OCT 181960
� FINANCE DEPT:
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
Fo� Offiee Use Only
a,
OATE 199UEO
acr � s �sso
COSTA MESA, CALIFORNIA
ZONING
NO. OP I U88 OF NEW
PLAN9 2 BUIIDIN6
eT.l
YF
THE AMOUNT BHOWN UNDER VALUATION �8 FOR THE
PUPP08E OP EBTF9L18XING A PEHMIT FEE ONLY.
VALUA710N I
Y"`"�"" 16,101. 18.
- $ PLAN CHECK $ �'{�
AUTNORIZE� AGENT 1�11 & Cole�rove, ZI1C� � Jµ•
s