HomeMy WebLinkAbout280 PACIFIC CREST DR - Building PermitsAugust 6, 1993
To:
�:�TY OF COSTA MESIi
CALIFORNIA 926284200 P.O. BOX 1200
DEVELOPMENT SERVICES DEPARTMENT
Building Safety Division
Code Enforcement
Communications
Copley-Colony of Costa Mesa
County Administration Office
County Clerk/Bd. of Supervisors
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
Fire Admin.-Training Officer
Fire Prevention
File (2)
Newport-Mesa Un. School Dst. (2)
Pacific Bell
Police Dept. - Ping. & Research
Santa Ana Heiahts Water C�mpany
Sanitary District Engineer
Southern California Edison Co.
Southern California Gas Co.
State Board of Equalization
Street Division
U.S. Post Office - AIS
U.S.. Post Office, Adams Avenue
Mesa Consolidated Water Dist.
The City of Costa Mesa wishes to advise you that the following
address has been changed:
OLD ADDRESS
NEW ADDRESS
2323 Santa Ana Avenue 292 Pacific Crest Drive
288 Pacific Crest Drive
284 Pacific Crest Drive
280 Pacific Crest Drive
276 Pacific Crest Drive
Your cooperation in this matter is appreciated.
Sincerely,
C� �i.(�.T �"ti�.
GABRIEL ELLIOTT
Associate Planner
(23235NTA.ADD) C-15
cc: Kerry Smith
Harbinger Homes Inc.
375 Promontory Drive West
Newport Beach CA 92660
Builtlmg Division (71G� 754-52J3
77 PA1R DPoVE
Code Enforcemenl (71a) 754�5623
FAX (7t4) 556-7508
A.P. NO.
119-133-19
Planning Division (714) 75<�52d5
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-MINOR MODIFICATION APPLICATION
CASE NUMBER: �"r6� -bi� ' I I
PROJECT APPLICANT:
� l�nh n. IA r 7
� �
PROJECT ADDRESS:
�4sr�—��I9_ �rrr�-(�o <�i�-1- ��.
PROPOSED MINOR MODIFICATION:
i�l�.� ,�� �- �xlcn�in� o� �o i-1 (n��� l-,I�;rl�i�nl�
J
l)�l :l/� �(� �� L(`�P t.1L! r
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RE UIRED FINDINGS: (Y = yes, N= no)
Y_ N_ The improvement will not be materially detrimental to the health, safety and general
welfaze oFpersons residing or working within the immediate vicinity of the project or
to property and improvements within the neighborhood.
Y�/ The improvement is compatible and enhances the architecture and design of the
existing and anticipated development in the vicinity. This includes the site planning,
land coverage, landscaping, appeazance, scale of strvctures, open space and any other
applicable features relative to a compatible and attractive development.
_ Approved _ Denied
/ i
PROJECT PLANNER: I(1 ��/1 i/i �(t �n�fl��(' I I DATE: I� l
1
NOTES:
White - Cue File; Canary - Minor Modification File; Pink - Applicant
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PXOJELTFDOflE55: "Tr T T1T ZTV �(A�'f�L 'N'il ��y v��
OWNEfl'SNAME: HARBINGER H6ME5
aooeess: 375 PROMONTORY DR WEST
N,B., CA
675-6653
ANCHIENGINEEN: �"�ILKINSON E AS$�C nec.xo.: C9829
aoosess: 18002 SKYPARK CI uniT:
IRVINE CA 92714
reemineE: HAR&INGER HOMES ( 714 ) 675-665'_
nooRess: 375 PROMENTORY DR WEST
NEWPORT BEACH CA 92660
LICENSED CONTFACTOB DECU1flATI0N: I �ere�y a��irm Ihal I am licensetl un0er pmvisions of C�ap�er 9(commencing wit� Section
7000� ol OiNsion 7 0l Ihe Business and Pmtessians Cotle. an0 my license is in lull �o¢e ana eflect.
CITY LIC.: STRTE UC.: CLASS:
Oa�e: Signalure:
WOPNENS' COMPENSRTION UECIAflATION: I her¢by aflirm thal I have a certilitate o� con5ent b 5¢I4insuf¢ or a tertilitat¢ o� WOMefs'
Compensalion Insurance. or a cenihea coDY �nereoi (Section 3800. LaO. C).
;�OLICY NO.: EXP. �ATE:
:. +LOMPANY:
���L7 Cerlilietl copy Is �ere0y lumishatl. ❑ Cetlified coDY is tileG wii� lhe ciry Builtling �ivision.
yl
�
Date: Apvlicam:
E%EMPtION FpOM WORREBS' COMPENSATION OECLABRTION: Qhis semion nee0 not be comDleteA ilihe cermit is farone hunAreA (51W� or less).
I cenify Inal in ine oetlormance of the work tor whicn this permil is issued I snal not emDloy�n any manner so as to Oecome
Su0lect lo I�je orkers' ComDensalion Laws o� California. �
Date�. ( �—�—�� Signalure:
NOTICE: I1, af�er making I�is Oeclara�ion. you 5hou10 �ecome suDlect Io Ihe Workers' Compensation pmvisions oi Ihe LaOor
Code. you musl lotlhwil� comply wii� such pwvision5 0� this permit shall be EeemeO revokeG.
LONSTPUCTION 1EN01NG ACENCY: I here�y allirm Ua� Ihe�e is a con5�mciion lentling agency for �he petlormance o� Ihe work for
which Ihis permil is issuetl (Sec�ion 3097. Civ. C). "
LENOEfl:
aoosess:
OwNEB BUILOEB DECLABA710N: I hereby atlirm that I am exempt tmm the Contraclors' State license Law for �he 1ollowinA �eason
ISection 7031.5 Business antl Protessional Cotlel Nny ciry of coun�y which requires a permi� to conS�Nct, al�er, impmve, tlemolish, or
repair any siruclure. prior lo its issuance. also requires ine applicant far such permit to file a signed statement ihat ne/she is licensed
pursuant lo�he pmvisions ofihe Caniraclors' Slale license Law�Chapter9�commencing wi�h Section 7000)of0ivision 3 oithe Business
and Pmlessions Cade) or Ihal he/s�e is exempt therefmm and the �asis �or Ihe allege0 exemption. Any viala�ion of Seciion 7031.5 by
any applicanl tor a permi� suble��s the apPlicani Io a civil penal�y o� not more ��an five hundred Oallars ($500�.
I. as owner of ine owoetlY or my employees xtith waAes as iheir sole campen5ation, will tlo the work, anA ihe
❑ simcmre is no� imentletl or oifere0 for sale 15ection 70aa. Business and Pmtessional Code: 7he Contracmrs' State License Law
Daes nal apply Io an owner ol a pmDeny who builas or impmves Ihereon, antl who does such work himsel�/hersel/ o� ��mugh
his or her own emDloyees. pwvided thal such im0�ovemenl5 are not in�entletl or oflere0 for sale. II, however Ihe 6uiltlinp or
impmvemenl is solJ vn�hin one year a� comple�ion, tAe own¢r vnll have the bur�en of pmvin0 he/s�e tlitl not build or imD�ove
for ihe purpose af sale�.
'/ I, as owner o� the property, am erclusively conVactinA wilh Iicense0 contracrors m cons�mci ��e pwject (Section 7044. Business
� ana Prolessbns Cotle: The Coniractors' State License Law Uoes not a0�ly to an owner of pmPeM who GudEs or imD�a�es ��ereon
ana who conUads br sucn pmiects witA a coniracmqs)license pursuant m tne Comracmrs' State License Law�. I am aware
Iha� pmal of Iheir Worker'S Compensa�ion insurance shauld be OmviUetl �o me.
� I am eaempt un0er Seciion: B. 8 P. C. n
lor ihis reason: ��
oare: � �, —Z �S wme�: �
i tlo hereby cemty Ihat 1 am aware ol anU untlerstana ihe requirements ai Calilomia Healtn anA Safety Cotle Sections 25505, 25533, an0
25534 antl that I or any fulure Uuildmg occupanl will/will nol (circle one) neetl lo comply with saitl state co0e5 and the reQuiremen�s lor a
permii lor conslmciion or mo0dicatmn Imm �he Nir Ouahry Managemeni Oistric�. flesidential conslmciion apDlica�ions are exemp� Imm
inese O�ovisions.
Oa�e: NpplicanL
1 hereUy cerldyt�ai I havereaa Ihis ap0licatmn ana 51aie I�ai the a0ovein�ormalionis correct lagree b comply with all city and counry
ortlinances antl Slale laws relaiing �o building con5lmciion and hereby aWhoriz�resen��� ��is ' y to enter upon the above-men�ioned
pmper�y lor inspeciion purposes.
S Oate: � � —�2 1� Signature'.
� Orive�'s �icense o� Socia� Securiry x:
i64t-46 White—Bwltling; Green—Coee Enlorcemenl; Canary—Applicam: Pmk—Revenue; GaltlenroE—Nssessor
CITY OF COSTA MESA — BUILDING PERMIT YERM NO: !i Ub�vlc
PERMIT NO: B 065013 PLAN CHECK NO: 03394-93 A GOVT: N SUYP: N
CONSTRUCTION TYFE: PERMIT TYPE; STR PURPOSE: NEW
JOB DESCRIPTION : 1464SF 1ST FL, 1113SF 2ND FL, 4255F GARA SQ FT; 3,002
CLAIM VALUE: 120,000,00 CALC—VALUE: 198,603.00 GROUP OCC: R-3 /M-1
COMMENTS: NEW SFR, PLAN Ji2J
iE if if if ifif i� 1e iE if iF'N'!f i('iE')c'X'iF 1E'It'JE iE iE 1f if if ih'M'iE iE iE 1f iF1E1f if j('1i 1! IM1 if jf'iE ih iF if 1E 1f iE iF iE iEif IFi('if Y i�"N'IE i('Y iF 1f if ff'IF ff af if iF K if iFiE i( i4 i4 i�'
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; 41 FT IN REAR: 16 FT IN FRNT: FT IN REAR: FT IN
LEFT: 6 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ • 2.PROV: 2 PARCEL: 11913319 ZNE: R1 REF NO: VT-14815
PLANNING NCSTES> SINGLE—FAMILY HOME (280 PACIFIC CREST DRIVE) PART OF A
> SUHDIVISION (TRACT 14815) LOT 4. '
*�r�r*�t*�tat�-x�**itr'�+t*****�r*iri�**.*it�rri�*�t�tx-***x**it�-ar******u**at***�*�rir***ir*ria�tit**r.*�t*+t�e
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: \'_� 22��i
BUILDING APPROVED BY ; DATE:
APPLICATION ISSUED BY: W��'( �yA— DATE: �� I1-L��,�
itiEifififiE*lEiEifif�t�YiFiFiF9fiE�flE�ifiE ��RiFi'x . . .iFiFifiFK9Eif�iE�f7��'�afiF
if if % if if iE iF if if if 1E if af iE if iF it iE 3F jE if iE �F if if iE if if If�1E ff if if if iF iF 3f 3f if if if 1fiF i:�?} if if iEiF 1FiE if iF iF Yr iE iF iFiE* iF if�Y iE # iF iE 1F iF iFiF iFk ir. i: iFiR �c if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 986.00 19.86
SMIP/NON—RES
PLAN 160.23
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 1005.86 0.00 160,23 1166.09 1166.09 ,00
REVENUE DIVI5ION TOTALS--> COLLECTED: 1005.86 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR
986.00 19.86
iE iE 1E IE iE ik if iF if iF iE iF if if if iF if it if iE % if iE if if it iE if it iE ik if iE aF 1E if +f iF iF if iF it iF if iE iE if M iE if iF 1F iF iE if iE if 1E �7E iE if iF if 1F if if iE ik iE iE jf if if fE ic if i6 if af
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 2577 DWE—TYPE V—WOOD fRAME —GOOD 74,00 190,698.00
SFR 425 � RES—GARAGES TYPE V. 18.60 7,905.00
END OF FEES
o� oo:.i+.a,�-c�e�.,imi �-��� �oa:�.s�
�prE: 1..'r3,9"� T�hE: �g�:t
CONSTRUCTION AND PLANNING P� -& SPA
APPROVALS Permit# Date Inspector APPflOVAIS Permit# Date Inspector
1. Temporary EYectricai Service or Pole 52. Pool & Equipment Location
2. Soii Pipe�Undrgrnd. � 53. Steel Reinforcement ,
3. ElectriCal Conduit Uti�itY-Undrgmd. 54. Forms '
4. Electrical ConduirUndrgrnd. 55. Electrical Bonding -
5. Sceel Reinforcemenc 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVALTO COVER�GUNITE
7. Footings ��a f f's �� 58. Electrical Conduit-Undryrnd. �
- • B. Foundation �2,G � 59. Gas Pipe, O Undryrnd., Test
9. Water PiPe�Undrgrnd. . 60. Backwash Lines, P�Tiap, l Undryrnd.
� 70. Strucw�al Floor System � 61. APPROVAL TO 6`cCK �
1 7. Properrv Sewer line & House Connection 62. Backwash & Receptor�Final � -
12. Sewer Cap 63. Heater & Vent-Pinal '
':73. Roof Drains 64. PlumbingSystem-final
.14. flough Plumbing ' 65. Electrica6Fir,al
i
' 15. Rough Electricai�Conduit 66. Solar System-Fina!
76. Rough Electric Wiring 67. Pencing & Access Approvai
77. Rough Wiring Siyn 68. APPROVED FOR PLASTERING
� 18. Rough Electricai�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
' 19. Rough Heating & Air Condi[iontng FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hyclro
22. Ducts, Ventilating 77. Product Piping Gi Gas � Od
23. Gas Pipe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergmd. Storage Tank u Gas ❑ Oii
25. Roof Sheathing ���p_qy 6e,,,6e_. 7q, pVerhead Hydro �
26. T-Bar Geiling (Structural) & Monocoat 75. Dry Chemicai
27. Frame and Flashing �•�!� C� (F �� 76. Dry Scandpipe I
28. Laihing & Siding Z Z� �j'C� � 77. FIXED SYSTEM FINAL
29. insulation Z,-L�/_�Y �L�{L 78. FIRE PREV. FINAL L(-2 j-Q'�/ L./_f{-
30. DrySvall Nailing � 2.�(� �(�6L HEAITH OEPT. REQUIREI41ENT �„�, G'c..y
31. Plasrer 8rown Coat �-� (, 79. FINAL �NSPECTION
32. ElectriCa� Power MeterFinal • 80. FOOD CERTIF�CA7E ISSUED
33. Final Electrit Notez: 2 ���'L� �� p� �v���
34. Final Hea[ing & Air Conditioning --_
35. Final Gas Pipe•Test
36. Hood o� Canopy �
37. Final Factory Fireplace .
38. Final P��mbing
39. Water Service-Final
40. Gas Service�Final
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape irrigation System
45. Sound Aitenuation
46. Handicap iiegulations
47. FINA�STFiUCTURE&BUILDWG -3-CiY �.'411(
48. FINAL PLANNING Y Lz_q[� (y' L ��_
-•r
49. Electric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CEftTiF�CR7E OF OCCUPANCY
No. Date
PflOJECT ADOHESS: 2 8 O PAC I F I C CRES T DR uxir:
OWNEN'SNAME: HARBINGER HOMES
AODPESS: z8O PACIFIC CREST
C.M,
CA 92626
NHCH/ENGINEEfl: B ERNARD ��S NEG.NO.: C— L O 1 S 3
nooxEss: 11022 ACACIA PKWY �"�T E
G.G. CA 92640
PENMITTEE: C e c POOLs ( 909 ) 242-7665
anoeess: 11360 CARAIE LN
MORENO VALLEY CA 92555
LICENSEO CONTNACTOX DECLAPpTION: I �ere�y alli�m ihat I am licensetl unaer pmvis�ons ol Chapter 9 �commencing wilh Sec�ion
7000� o� Division 9 of the Business and Pto�essions Code, anU my license fs in lull lorce an0 etlec�.
�cirr u.: s re uc.: g q 7 c���ss: =_ 5�
�� cs-4 � �, �•��_�� �
e �,� Signamr� / "fi
ONKEFS' LOMPENSATION DELLARATION: I �ere�y aflirm I�ai I have a certitita�e o� tonsen� �o Sell-inSUre or a[ertifi[ate ol WOrkefs'
ComOensa�ion Insurance, or a certilied coDY ��e�eo� (5eciion 381p. La�. C).
POLICY NO.: E%P. ORTE:
COMPFNY:
❑ Certilied copY is hereGy Iumi5he0. ❑ Certifiea copy is filed vnt� Ihe ciiy BuilOing DiWsion.
Oale'. Applicani:
E%EMPiION FROM WONREPS' fAMPEN5ATI0N DEIXAMTION: (TNs 5ttiion nee� iwi be ampl¢tetl i� the permi� ii iw one hunAreU (310�) or less).
I ceriify that in �he pedormance oi the work lor which �his �1, �5 i5sue0. I s�all not emplo a y Derson in any manner so as to become
�sub�ed to he Workers Compe sat(ioJn Laws a� Califor ///j/'��� � �
� �� � /. Signatu�V //`�� � �
NOTICE: II, aiter making Ihis �eUaration. you snow become subietl to the Workers' CAmpensation pmvivons of tAe Labor
Code, you must fonhwith comoly with such D�ovisions or tNs permit sAall be Aeemetl Bvoketl.
CONS7BUCTION LENOING AGENLY:' I het¢�y ailirm Ihali�ere is a tOnS�rutii0n lending agenty lof Ne p¢hormant¢ ol �h¢ wOrk lOr
wAich ihis permii is issuea (Seclion 3097, Civ. C�.
LENOEP:
AOOflESS:
OWNEP BWLOEP OECIANATION: I �ere6y allirm Iha� I am eKempi Imm the Conirac�ors' $�a�e License Law lor Ihe lollowing reason
�SeCiion 70.31.5 Business anA Prolessional COtle: Any Cily ol Coun�y w�iCh repuires a permii �o cons�mtl, alter,impmue, aemolish, or
repair any SlmcWre. D�ior lo its issuance. alsa repuires t�e applicanl far such pe�mil to lile a sipnetl slaiemen� Inat he/she is licensetl
puRuanl to I�e provisions ol the ComractaR' Slale License Law �Chap�¢r 9(commencing wi1� Seclion 7000) ol �ivisian 3 0l I�e Business
antl Pmlessions Code) or I�al he/s�e is e+empt ihere�mm and t�e Dasis lor ihe allegeE erempiion. Any violalion of Sec�ion 7031.5 �y
any applicant for a permit sublecis ��e applicant �o a civil penally al no� more Ihan live hunAreO tlollars (5500).
I. as owner al ine pwoeny or my employees with wages as tneir sote comDensation, wiil tlo ihe work, and IAe
� strumure is not imen0e0 or ollereU for saie (Secuon 705a. Business and Pm�esSional Coae: The Contractors' S�a�e License Law
�oes not apply lo an owner ol a o�oDeny wlro builds or im0�oves ihereon, an0 who does sucA work himsell/hersell or thmugh
� his or her own em0�oyees. pwviGed rtlat such imprwemems are not inten4e0 or oflereG for sale. II, however t�e building or
improvemenl is so10 vnlhin one year o� comple�ion, Ihe owner vnll have Ihe burAen ol pwvinp he/SM1e AiA no1 6uiltl or improve
lor Ine purpose oi sale�.
I. as owner ol Ihe pr00etly. am e�clusively comracting wiih IicenseA wnlractors to cons�mc� �he Omleci (Seclion 7044, Business
❑ antl Pmlessions fAtle: The fAnVactors' Siate License Law OoeS nol apDly Io an owner ol propeny who butlds or impmves �hereon
antl w�o conlratis lor SUch pmleQS with a toNrattOr�s) licen5e pur5uani l0 I�e Conlfat�DrS' $lale License Law�. I am aware
I�al Orool ol ��eir Worker'S ComOensalion insuran[e shaulG Ce pmvitleG Io me.
� I am exempt under Seaion: B. 8 P. C.
lor �his reason:
Oa�e', Owner.
I tlo herebV �enity thai I am aware oi an0 unAentantl I�e re0uiremen�s ol Cahbmia Hea11� anJ Sa�e�y Cotle Seciions 25505, 25533, and
255� an�ihallaranyluture Ouiltling acupanlvnlUvnllnoi�circle one) nee0 lo comply vn�h saitl Slale coEes antl Ihe reQuiremen�s�ora
permii foi tonSlmtiion or madilitaiion Iwm I�e Pir Oualiiy ManagemeN DiSlriCi. fleSiAential ton5tmt�i0n application5 are eaem0� ��om
Ihese pmvisions.
Dale: AOP�icanl:
I here�y cer�ilythal I have read Ihis ap0lication antl slale I�alt�e aboveinbrmaiionis correct. I agree to comply with allcity an0 county
ordinancesaibslaielaws�ela�inglobuildingcon9mctian ere�yaWhorRer Iivesolthiscilyloen�erupon��eabove�menlioned
propetly lorinspection purposes.
�
Signaiu . �',� �� �
nver's License ar Sociai Securiry a:
t64na6 Whne—euiltlmg', Green—CoOe EnforcemenL Canary—Applicant Pink—Pevenue: Goltlenrotl—Assessor
CZTY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: E 066425 PLAN CHECK NO: N
CONSTRUCTION TYPE: V-5 PERMIT TYPE: ELE
JOH DESCRIPTION : CONSTRUCT GUNITE SPA
CLAIM VALUE:
CALC—VALUE:
PERM NO: E 06642`_
GOVT: N SUPP: N
PURPOSE: NEW
SQ FT:
GROUP OCC: R-3 /
COMMENTS: REF: B-66424
***�*******�***+�**+�*��**•�r***�******x-****x***�*i�*****+t�r*�r***r�x�*+r-�r**�r�r�r*+�x�*+�**#*
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
PARI(ING RE • PROV; PARCEL: 00000000 ZNE: REF NO:
PLANNING N TES>
>
iE iF 1E it iE iE �f 1E iE iE iE 9E iE # iE iF ic iE 3E 3E iclF iP iE iF tE iF iE if iE iE iE iE fE i� iE 1E if iE iE iF iE �E iE if iE iE iE iE iE �)E af iE iF iE �)f if if iE 3E if #: if iE iF-IE af if iE iE 9E iE if iE 7E iE 1E iE jE
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 APPROC'ED BY .
DATE:
BOILDING APPP.OVED BY : . DATE:
APPLICATION ISSUED BY: �� DATE: �_� 14' Q�
lfiElElEiEif��7EiEiFKiEiFiF%#iEiflfiFihifiF3F�'Z�'�iFRxiFir�t+'ic �3F3f�Fif�3FiFiF7:��F���ifiEiEiE�IFiFiFfEif:EiFiF riF�tx��iFzir
iF?F 9E iF 1f if i4 iE iE if iF iF iF iF %iE i: if if iE if iE iE 3E iF iF %3E 1E if 3f �If � iF iE jE if jE 1E iE if iF if iE �f iF ik iE i4 iF if 9f iF if 9f iF if K iF ik if iE iE±f iE iE iF if jf if 1E if 3F 1E at if 3f {E iF
LEGALIZATION:N F E E S U M M A R Y STRUCTORAL SEGMENT:N
BLDG PMT PLUMHING ELECTRZC MECHANIC FIRE SMIP/RES GRADING
PERMIT
30.00
50Y
SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 30.00 15.00 0.00 45.00 45.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: /� Y.0� OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRZC MECHANIC (FIRE nMIP/TOT GRADING PLAN—CFIECK
�i 5 , o o �---�
1E dE 9E 9E iE iE iE iF i! iE �F iE ihlE iE iE iE 1E iE 1(� 1k if 1E iF iE fElf iE fE iF iF i(-iE iF if if iF 1E iF ik iF if iE iF jE 1FlElE iE 1i 1f 9t �f if 1E if if �f �E iE iF 1E 1E if iE iE iE iF �f ?t jf �K iE 1f iF iF iF 3f iF
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
ELE 1 SWIMMING POOL — IN GROUND — NEW EA. 30.00 30,00
END OF FEES
01 OO1S7282—OO1S72E2 T�7 T 45.00
DA7E: 03/16J94 TIflE: 14:07
CONSTRUCTION AND PLANNING F `& SPA `
APPRPVALS Permit �� Date Inspector APPqOVALS Permit # Date Inspector
1. TemOorary Electricai Service or Pole 52. Pool & Equipment Location .
2. Soil Pipe•Undrgrnd. , 53. Steei Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. E�ect�ical Conduii�Undrgrnd. � �/-p`!/ 55. Electrical Bonding
!
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, � Undrgrnd., Test -.
9. Water Pipe•Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 67. APPROVAL TO DECK
11. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final '
12. Sawer CaR 63. Heater & Vent•Final
7 3. Roof Drains 64. Piumbing System - Final
14. Raugh Plumbing 65. Electrical-Finai
15. Ro�gh Eiectrical-Condulc 66. Solar System-Final
� 16. Rough Electric Wiring 67. Fencing & Access Anproval
77. Rougn4Viring5ign 68. APPROVEDFORPLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS F�NAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough fattory Fireplace APPROVALS Permit #
21. DuctS, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping OGas OOiI
23. Gas PiPe�Rough & Test 72. Underground Flush
24. Roof Framin9 73. Undergrnd. Storage Tank L� Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•8ar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Freme and Fiashing 76. Ory Sta�dpipe
28. Lathin9 & Siding 77, FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. RE�UIREMENT
37. Plaste� 8rown Coat 79. FINAL INSPECTION
32. Electrical Power Merer�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric S O/9 � Notes: �
34. Final Heating & Air Conditioning '
35. Final Gas Pipe�Test '��
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service�Final
41. So�ar pome:tic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irripation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINALPLANNING -' ` "
49. Elect��c Release to Edison �
50. Gas Release to Southern California Gas Co '-
51. CER7IFICATE OF OCCUPANCY
N0. Date
PflOJECiRU0flE55: 2$O PACIFIC CREST DR
OWNEP'SNPME: HAABINGER HOMES
nooeess: 280 PACIFIC CREST
C.M.
CA 92626
UNIT:
RflCH1ENGINEEX: BERNARD ADAMS nec.xo.: C-10183
aooaess: 11022 ACACIA PKWY 0N1Tt E
G.G. CA 92640
PEHMITTEE: C & C POOLS ( 909 ) 242-7665
aooxcss: 11360 CARRIE LN
MORENO VALLEY CA 92555
LILENSEO CONTNACT08 OFLUflATION: I hereEy a0irm Ilul I am IicenSeJ un0er provisions al CtuD�e� 9(rommencing wi�� S¢clion
7000� ol �rvision 3 ollAe Business ana Pmlessions CoOe, anG my li[ense is in lulllorce an0 etlecl.
ciTv i _ t s`�rnie uc.: 3 9 7 9^ �,. � �s: C/j_�.�`—_ y_
��i�i Y- Signamre W�•����v
WOflI(ENS' COMPENSRtION OECLANAiION: I nereey alhrm Iha1 I IWve a cenifitdle of consent Io setf-insure or a cenilicale ol workers'
Compenution Insurance. ar a cerufied copy t�ereol �Section 3800, la�. C�.
'OLICY NO.: EXP. ORTE:
comrnNr:
❑ Cetli�ie0 coOY �5 �ereEy �umisheE. ❑ Certilied w0Y u �ileG vet0 ihe city BWEing Oivaion.
�ate: ApDlicani:
E%EMPiION FHOM WOflKEPS' COMPENSRTIDN OECIAMTION: (iliit secuon nee0 not Ee mmpleleG il Ilie perm1 is tor On¢ �unEteG (5100) Or kss�.
I cerii�y ��al in t�e pedormante o� the wark lor wNc� lNs Oerrttiiyyy' yyy'ssueE. I 5tull n0i em.W.m any permn in any manner so as io �ecome
Su�^ lo t�e Workers' Compen5ation Laws ai Calilomia. ///� // f�
` :�
0 t � � ` � � � � $ignalure:
� CE: II. ailer making IluS Oetlaraiian, you Slioul0 me 5u01K� �o Ue Workers' fAmpenSdiion D«SionS o� �he LaEor
COUe. you mus� IotlAwit� comply wit� su[� prm%ions or �NS permit shall Oe OeemeO fevokeC.
CONSTNULTION LENOING AGENLY: I �e�e0y anirm t�ai ��ere is a cons�ruc�ion IenGing agency �or I�e per7ormance al ��e wOrk �or
whicn Ihis permit is 6suetl �Seciion 3091. Gv. C�.
IENUEP:
ROOPESS:
OWNEB BOILOEfl DECLABRTION: I Oer¢�y allirm Itwt I am exemp� �mm ttce Conttaciors $taie lic¢nse Law �or ��e I011wnng reason
(Section 7Q3L5 Business antl Proles5ianal CoEe: Any Gty al fAunty wnich repuires a cermil to consimct. alter, imorove, Oemalish, or
�2pdil 311y S�NLWR. 0�0f �0 I�5 ISSWfItl, d150 RQNlCS IIIC dppllCdll� IOf SULII PGfrtYI IO IAC d$IqOCE SIdICfIItOI IIWI IIHS�! IS IiCC11SCU
pursuanl to Ihe pmvisions ol ine fAninctors' Slate LicMse Law (Chapter 9lwmme�np with $ectian 7000) of Oivision 7 of Ine Busineu
ana Piolessions CoUe�ar I�al tle/s�e 5 exemp� ��erelrom anG Ille Gasis lor Ihe alleq¢O eeemplion. Fny violaiion of S¢c�ion 7031.5 by
any apWicani foi a perrtot suEl��s I�e apWicani to a pvil Denalry o� �wi more llun live �uMreG AWars (5500�.
� I. as owner ol ��e OmOerty or rtry emybyea wiN wages az t�eir sde wmpensation, vnll tlo �ne wark. anG t�e
slmmure is not inlen0ea or ollereU lo� sale (Secimn 70aa. 8usiness ana Proleuional LoGe: T�e Contractars' State License Law
aoes noi aDDN �o an ovmer ot a pmpeny wtn Ouiltls ar imprwes t�ereon, anE w1ro Oces wc� work Nmull/hersell or tAraug�
�i5 ar he� own em0loyee5, pi0vi0eE I�al 5ut� improv¢menis are nol inlenAeG ot oflere0 loi ule. I1, howev¢r l�e Ouilding ar
im0�ovement is sdU vnt�in one year ol comde�b^. �ne owner vriA have t�e �urGen al OrwinB ���e Ob �ro� Guik or impmve
' lor ihe purOOSe ol Saie�.
I. as owner ot ihe pwpeny. am excluvveIy wntracun0 ��� tittnse0 contractors to wnstmct t�e pmject (Section 704<, Business
❑ ana Professions CoOe: T�e Contractors State Lkense Law Eces ro� aODN �o an ovmer al praperty wlp WdGs or improves iheaw
ana w�o [Onlratis fOr SUC� prqetls wii� a wnUa[IoqS�li[enu Our5uanl�o Ihe ConVattors' $�a�e LicenSe Law�. I am aware
Iha� prool oi I�eii Worker'S Compen5aiian insurance 5�oultl De D�A+4� ro me.
� I am exem0� unaer Seciion: B. 8 P. C.
for inis ieasOn:
Oaie: Mmer.
I Oo nereoy cenily Ridt 1 am aware al an0 unaerstdnE the reQuiremen6 af Ca0lamu HWlin ana Sdtery CaOe SettiOns 25505, 25537, ana
2553i ana inal I or any luture owltling ocGupant vnlVwill nol (urGe one) neeA lo compry vnln Saia state coaes ana ihe reauiremenls lor a
permil lo� consimciion or moAilrca�ion tmm ��e !u� OuaLry Mmapemrnt Oi5tncl. ReSiUen�ul construciion appliwiions are eeempl imm
Ihese U�ovisians.
Da�e: Appliwm:
I �ere0y cetlily tlul I Iwve teaG I�R application antl state itutlM a0ove inlarmation 6[orrttt. I agre� to tOmpty vnl� all ciry antl county
orCinan[esand5lalelawsrelalingloDUAdingwn5tmciiona96�byauttqr¢er ntalivesall�isulylaemerupon��eaGov¢�meniionee
pmDe�iY lot insp¢cUon ourposes. �/ /�/ �� ��
zte: ` Signaim�/'�(/U%., �
nver'SLicenseor5aialSecurily,: �' ' -
164Fa6 Wnne—BuilCmg; Green—CoOe Enlo¢emenL Canary—qpplicam: Pink—Revenue: GolOenroC—Asseswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 06692E
PERMIT NO: M 066426 PLAN CHECK N0: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-5 PERMIT TYPE: MEC PURPOSE: NEW
JOB DESCRIPTION : CONSTRUCT GUNITE SPA SQ FT;
CLAIM VALUE: CALC—VALUE; GROOP OCC: R-3 /
COMMENTS: REF: B-66424
s*****�t�**#****+��*�r**�c***r+��rr******x-*�**��t*�x-***�*r**�***+�+r�c*�#�*r*#**�*x�***+t**
Z O N Z N G R E Q 0 Z R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSOAY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGiIT: FT IN
PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO;
PLANNING NOTES>
>
it if it if iE iE iE iE iE fE iF if # 1E {c iE 1E if if it iE iE iE i4 iE if iF+f it iF i! 1f+r. fE iE r# 1E iF it if # iE iE if 1E iE iF M iE iE if IE iE if iF 1E iF iE if tF # iE if iF 3E 1E iF iE if 1f iE �E iE M# if it 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 HY ,
BUILDING APPROVED BY :
DATE:
DATE:
***�****��*�r**isrx��»*B*���iF'i�""",�iF..4wxx ft*it+[��#iAi�iTt*ieatr-.I�P ��_
iFi3F Fi�Fiflk+E
if if i6 it iE it iE 1f iF ft iE iE iE it ic if if k it+E aE iE iE fE i4 fE fE it k iE iE iF K it iE i6 if it ik 1f iE if if 1E M if it iR iE iE iE iE iF 1t if it iE k k ir it iE iF iE it if it if iE �f iF if at iE iP iE it it iF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 3.00
25t SMIP/NON—RES
PLAN
ISSUE FEE 15.OU
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 3.00 15.00 0,00 18.00 18.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: v OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC F2R�—� MIP/TOT GRADING PLAN—CHECK
18.00
1f iE il� if iE if iE if iF iE IE 1F fF 161f i41f af iF if i4 ff if iF if # fE iM1 if 11� iE if ff jE 1f 1E if-K iE iE if �lE if� iE iM1 if if if �E %1f ik 1F �M iE ik 1f � 1E M if 1F iF if i(� iF iE �F iE iF # ff �E af iF iF iE+' #
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
MEC 1 GAS PIPING SYS 1— 4 OUTLETS 3.00 3.00
END OF FEES
01 ODiS7278-00157278 TO T 18.00
DATE: 03/16/94 7IttE: 14:06
C¢NSTRUCTION AND PLANNING � ` & SPA
APPROVALS Permit # Date � Inspector APpROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcemen[ �
3. Electrical Conduit Utihry�Undrgmd. 54. Forms
4. Electrical Conduii�Undrgrnd. 55. Electrital Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ✓��Z- y�
�
6. Electrical UFEF1 Grnd. 57. APPROVAL TO COVER-GUNITE ./
7. Footings 58. Electrical Conduit�Undrgrnd.
$. Foundation 59. Gas Pipe, � Undrgmd., Test ✓S�z.�jT �Q.
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P•Trap, O Undrgrnd. ✓_rZ �•#�
10. Structural Floor System • 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final ^� z,c:�
12. Sewer Cap ' 63. Heater & Vent-Final �
' y4_�/
13. Roof Drains 64. Plumbing System � Final ��...�� y�,,}
14. Rough Plumbing 65. Electrical�Final
15. Rough Electriwl-Condu�t 66. Solar SYstem-Final
16. Rough Electric W�ring 67. Fencing & Access ApProval I
17. Raugh Wiring Sign 68. qPPROVED FOR PLASTERING
18. Rough Electrica��T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rou9h Heating & Air Conditioning FiRE DEPT. RE�UIREMENT
20. Aough Factory Fireplace APPROVALS Permit #
27. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Produc2 Pipinc� �Gas ❑Oil
23. Gas Pipe�Rough & Test �2, Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �
26. T•Bar Ceiling IStr�cturall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Laihing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 7g, FIRE PREV. FINAL
30. Drywall Nailing NEALTH DEPT. REQUIREMENT
37. Plaster Brown CAat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Hea[ing & Air Conditioning � .
35. Final Gas Pipe-7est "-
36. Hood or Canopy j
37. Final Factory F�replace
_ _f
38. Final Plumbing �
39. Water Service-Final
40, Gas Se�vice-Find�
41. Solar pomestic-Final
42. Backfiow Preventer
43. Backflow Irrigat�on
44. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING ��
48. FINAL PLANNING � �
49. Electric Release to Edison �""'
50. Gas Release to 5outhern California Gas Co -�
51. CERTIFICATE OF OCCUPANCY
No. Date
PBOJECTAOONESS: Z8O PACIFIC CREST DR
ow�EesName: HARBINGER HOMES
:y nooAess: Zg0 PACIFIC CREST
% C,M.
CA 92626
UNIT:
NflCN/ENGINEEP: $ERNARD ADAMS PEG.NO.: C—Z O L S 3
AOOHE55: SIOZZ ACACIA PKWY 0N1T� E
G.G. CA 92690
PEBMITTEF. C & C POOLS ( 909 ) 242-7665
anoRess: 11360 CARRIE LN
MORENO VALLEY CA 92555
LICENSEO CONTBACTOfl DECLAflNTION: I here�y a�iirm ��at I am licensetl untler pmvisions ol C�apter 9(commencin0 wi�h Section
7000� oi �rvision 3 0l the Busine55 antl Pmiessions CoOe. anA my license is in fuli lorce antl elfect.
cirr � s rEuc.:3q7��, cuss •—�3
%� � � ' 1 s�9�a�� : _ �L_�-�¢�
' WOHKEPS' COMPENSRTION oECIAflFTION: I hereby aftirm that 1 have a cenificate of consent to setl-insure or a cehifitate of Worker5'
Compensation Insurance. or a certifietl copy ihereoi (Seciion 3800, Lab. C�.
I POIICY NO.: EXP. DATE:
COMPANY:
I ❑ Certiliea copy is hereby �umished. ❑ Certified copY is fileA with ��e city Builtling Division.
Oaie: NpplicanP.
EREMPTION FBOM WOflNEPS' fAM7ENSRTION OECLAPATION: (This sedmn neea no� be compleleA if ihe permit is for ane hundre0 ($100) ar less).
I cerlity Ihat in IDe pedormance ai Ihe work tor which Ihis p ' is issued. I shall no ', loy any person in any manner so as to become
su�le�-� ��e Workers' Com/p9e�nsation Laws ol Caliform
.,P P ~ f �� Z � Signatur
NOTICE: II, alter making this tleclaraiioq you s�oultl become SuGject to lhe Workers' Compensation provisions ot ihe Labor
Cotle. you mus� �otlhwilh compty wiih such pmvisians or �his permit s�all be tleemea revoked.
CONSTflI1CTI0N LENOING AGENCY: I �ereby affirm Iha� Ih¢re is a conslmCiion lending agency �or �Ae peAormanCe ol �he work �or
whlch �his permlt'q lssuetl (Semian 3097, Civ. C)-
LENOEfl:
FOOHESS:
OWNEH BUIlOEfl DECLABATION: I hereby aflirm thatl am exemp� Irom the Contractors' State License Law torthe Iollowin8 reason
(Seciion 7031.5 Business antl Pmlessional Code: Any city of county which requires a permit �o constmci. alter, impmve. Oemolish, or
repair any 51mcWre. prior ro i�s issuance, also repuires Ihe applicant br such permi� Io lile a 5igneU s�a�emen� �ha� �elshe is licensed
pur5uani lo Ihe pmvisions o� ��e Contracmrs' Slale License Law (Chapter 9(commencing wilh Section 7000) at �ivision 3 oi �he Business
antl Pro�essions Cotle) or I�ai he/s�e is exempi I�erelmm anA Ihe basis tor t�e allege0 exemption. Nny violatian ot Seciion 7031.5 by
any applmant �or e permit 6ubjecls the appllwnl �o a clvll penalry of no� more Ihan flve hunOred tlollars ($500�.
I, as awner of ihe prooeny ar my employees with wages as their sole compensalion, will do the work antl the
❑ Slmclure is nai in�enaetl or ���eretl �or sale (Seclion 7044, Business and Prolessional Code: The CanVac�ors' Slaie License Law
Ooes no� apply to an owner of a D�openy who builOs or improves �hereon, and w�o does such work himsel�/hersel� or Ihrough
his or her own employees, pmvi0etl thal sucn imvmvemenis are not intentlea or oflered for sale. If, however tne buileing or
improvement is sold wilhin ane year ot wmpletian. �he owner will have the Ourtlen of pmving he/5he Oid no� buila or impmve
for Ihe putpose of salel.
I.as owneroil�e propeny,am exclusively conirac�ing wiih licensed contrac�orsto cons�md [he D�ole��ISec�ion 7044, Business
❑ ana Pmlessions CoOe: The ConUactors' State License Law Ooes not apPly to an owner of D�opeM who builds or im0�oves ��ereon
and w�o conirads for suc� pmle��s wilh a contrac�or(s) license pmsuant lo �he ConVac�ors' Sia�e License Law). I am aware
Ina� pmo� o� Iheii Worker's Compensation in,urance should be pmvidetl to me.
� I am exempl untler Seclion: B. 8 P. C.
for Ihis reason'.
Da�e: Owner:
I tlo nere�y cenify inat I am aware ai and uneerstantl Ihe requiremenis of California Health and Safery Coee Sections 25505, 25533, anA
25594 antl t�a� I or any WWre builtling occupan� willlwill no� (circle one) need Io comply wi�� saitl siate codes and ihe requiremen�s �or a
permii for conslmciion or motlihcalion from��he Nu Ouality M2nagemen� Oi5lricL Fe5i0ential con5iruc�ion applica�ions are exemp� �mm
I�ese pmviSons. �
Date: ,� ApP�icanC
I heiehy [etlifythal I haverea0 IhiS application antl state�ha� Ihe aboveinlorma�ionis correct. I agreeio comply wilh all city antl counly
orainance5and5�alelaw5relatinglobuiltlingcons�mciionantlherebyautharizerep� Ialive5ofthiscilyioenteruponlheabove�menlionetl
pmpetly fai inspecllaFn purpases.' f y� �a'1�
� / e�—�_7 '� r � {
�� ' y5ignalure: � �`
164Le6 Wbi�e—Bwlding: Grecn—Cade Enlorremenl: Canary—ApplicanL Pmk—Revenue: Goltlenrad—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06642i
PERMIT NO: P 066427 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: C�-5 PERMIT TYPE: PLU PURPOSE: NEW
JOH DESCRIPTION ; CONSTRUCT GUNITE SPA SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: REF; B-66424
�-*x�x�*****�-****+�***x�x�x�*#*****+t********�r*****�t*�+�:��***+��t*�rf�*�rx�*+c�*�t�*+rx�****+t�t#*#*�
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 HUILDING ---------- --------- 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; 00000000 ZNE: REF NO;
PLANNING NaTES>
i
�r***+�+r***��t�**+c**x-**+�**+�********�x-+c�t�****+����*��r*+�**i��r*i�***x�*x��u*+r*i�*x-�t-***�r�t+�*�:?�**
D E V E L O P M E N T S E R C� I C E S R E Q U S R E M E N T S
ZONING APFROVEP BY .
DATE:
BUILDING APPROVEn BY : DATE: t p
APPLICATION ISSUED BY; DATE: � I'9� \�
if#iEiE3EiEjElEiFjf*iEiEK#iFiF9FdE3E#iE ;'�. H�.. . iEiE3c�lEifififiFiEifiFiie�iE3'-iF3F�F'-N�if
dF iF iF jE 3F iE?E if?E iF 1F 3E iE �E iF jF #' iE 1f if fF iE �E iF;ElElf �MlE i� 1R iE iF iF 3F iF if �f iE if iF i' 3E iE iE iE 9E jF iF if 1E K iE if 9E if 1E iE 9E 3E iE iF� it iE iF �7F :<3E iE �- iF iE iF af iF iE �1f-iF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLL�G PMT PLUMBING ELEGTRIC MECHANIC FIRE SMIP/RES GAAUING
PERMIT 7.00
25�
PLAN
ISSUE FEE 20.00
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 20,00 0,00 2�.00 "17,00 ,00
RE�ENUE DIVISION TOTALS--> COLLECTEU: �'i.�0 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANZC F"'."�SMIP/TOT GRADING PLAN—CHECK
2%,��
iE iE iE 1F iE 1f iE 1E dE if 9F 3E jF 3E iE?E iE �ElF 1f %1E �If iF aE 1E iE aE ik 1E 1E ik iE if iF jE �t i: iflf iE iE iE iE?E 1E iF j! if 1f if !E 9E If �E 9E 1E iF iF *�E iF iE-1f if df iE iF iE iE iF if if !E!F iE �F iE jt
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UAJIT COST TOTAL COST
PLO 1 SWIMMING POOL 7,00 7,00
END OF FEES
01 OO1S7277-00157277 T�� T 27.00
DATE: 03/16/94 TIttE: 14:�5
:� CONSTRUCTION AND PLANNING
POv� $ SPA �
M'.PPR4VALS Permit #_. Date � Inspector qPpROVAIS Permit # Date Inspector
1. Temporary Electricai Service,or Pole 52. Poo! & Equipment Location •
2. Soil Pipe-Undrgmd. ' S3. Stcel Reinforcement .
3. Electricai Conduit Utiiity-Undrgrnd. � 54. Forms
4. Electrical Conduit-Undrgrn'd. 55. Electrical Bonding �
5. Sieel Reinforcement 56. Rough Plumbing & Pressure Test �� � S�'� �Q�)
vrc�
6. Electrical UFER Gmd. 57. APPROVALTO COVER�GUNlTE
7. Footings 58. Electrical Conduit-Undrgrnd.
&. Foundation . � 59. Gas Pipe, _. U�drgrnd., Test ��Z-�.4. -f�y4{�
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C Undrgrnd, f1 Z, c�, l�
J
� 10. Structural Floor System � 61. APPROVAL TO DECK
�
, 11. Property Sewer line & Housg Connection 62. Backwash & Receptor-final •
12. Sewer Cap 63. Heater & VenFFinal
13. Roof Drains 64. Piumbing System - Final
14. Rough Piumbing 65. Elecirical-Final
75. Rough Etearicai-Condo�t 66. Soiar SYstem-Fina1
16. Rough EleMric Wiring 67. Fencing & Accese ApProval
� 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling 69. POO VSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning fIRE DEPT. REQUIREMENT
2C. Rou9h Factory rirepiace APPROVALS Permit #
21. Ducts, in Struciure 70. Underground Hydro
22. Oucts, Venfilating 77. Product Piping O Gas CI Oil
23. Gas Pipe�Rough & Test 72. Underground Fiush
24. Roof Frami�g 73. Undergrnd.StorageTank C�Gas OOii
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Ntonocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
2fi. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FhVAL
34. Drywali Nailing HEALTN DEPT. REQUIREMEN7
31. Plasrnr Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Finai Electric Notes:
34. Final Heating & Air Condhioning "_ �� ���4_ �
� /�� ., :
35. Final Gas Pipe�Test -
36. Hood or Canopy
37. Fir.al Factory Fireplace
38. Final Plumbing
39. Water Service-Finai
40. Gas Service�Pina� �
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backfiow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation �
46. Handicap Regulations -
� 47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING i .
49. Electric Release to Edison '-_
50. Gas Release to Southern California Gas Co
51. CERTlFICATE OP OCCUPANCY _ •
No. Date
PflOJEtT AOOHESS: O) b�V, �� �"v�(,l"�Vl,i,,. f�` VN � f . UNR: q
awNensNnme: HARBINGER HOMES
'A(IJHE55: 37S PROMONTORY DR WEST
N.B., CA
675-6653
,� ANCHIENGINEEH: WILKINSON $ .D,$S�C nEc.xo.: C9a�9
aooness: 18002 SKYPARK CI ""n'
PEHMITTEE: IRVINE CA 92714
� BILL HELFER PLUMBING (714)298-0845
� aooeess: 2�522 SILVER CREEK DR
SAN JUAN CAPISTRANO CA__92675
❑CENSEU CONTflALTOfl DECIAPATION: I here6y allirm �Aat I am licensed unAer pmnsions oi ChaD�er 9(commencing m�� SetliOn
1000� ol Oivision 3 0l ��e Busineu antl Prolessions CaGe, antl my license is in lull brte and ellecl.
CITY UC.: STRTE L1C.: 4 4 3 4 7 O �� ]�'�C�JSS� C 3 6
�Oaie' _`�2� ��� Signaiu�e: _�j/!'� -
WONREflS' COMPENSATION OECIAflATION: I �ere0y aliirm Iha� I have a[erlili[ale consenl �o sell�insure or a c¢rlilicate ol Workers'
Comoen5alion Insurance. or a certiliee copy Inereai ISection 3800. Lae. CI.
POLICY NO.: E%P. DATE:
COMPRNY:
❑ Cetlitietl copy is �ereGy lumis�ed. ❑ C¢rti�i¢E COpy i5 �il¢U vnl� Ihe ciiy Building Division.
Oate: Appliwnl:
E%EMPfION FPOM WOBKEHS' COMPENSATION DECUPPTION: (This secuddnee0 iw10e wmqelCd il tAe permil is for we hunOrea (5100) or kss�.
I ceNiy Ihal in Ihe pedormance ol Ihe work lor w�ich Ihis Oermil is i55ueC. I s�all nol emDloy any person in any manner so as to Oecome
subjec� to Ihe Worker5' Compensation Laws al Calilomia. �r��
� Oate: l/^ 2 3-S3 Signalure: �� ✓/'
NOTitE: il. alter maWng �his tletlaration, you s�ouid Uecome su�ject tO t�e Wor Compenution Drwisions ol t�e laDor
COUe. you must fotinmin compry with sucn prOvisions or Inis ce(mi� slull be emea retrokea.
CORSiNUCTION LENDING pGENCY: I �ere�y aliirm ihai ihere is a conslmcli entling ap¢nCy br the pedOrmanCe 01 Ihe wOrk lOr
wnich I�is oermn is issue0 (Sectian 3097. Gv. C�. �'Y
LENOEN� �
AUOPE55:
OWNEB BUILUEP DECLABRTION: 1 hereby atlirm Ihai I am exempl Irom Ihe CanVactors' Siate LicenST the followinp reason
(Sec�ion 7Q31.5 Buvne55 anA Pmiessional CaGe: Any cily ol cauniy w�ich reQuirzs a permil to conSim[I, ali¢r, i mv¢, demolish, or
repau any stmnure. prior �o ils issuan[e. also re0uires l�e applicani lor suc� permii Io lile a 5igneE statemenl ihal �rJshe is Iicen5e0
pursuam Io I�e provisions o� I�e Comracmrs' Slale License Law �Chapter 9(cammencing wit0 Sec�ion 7000) of �ivisi 3 0l tAe Business
anG Pmlessions Coae� or Ihal he/she is enempt IherelrOm anA Ihe ba45lor �he atlepetl eMemplion. Any violaiion Section 7031.5 by
any applicani lor a Oermii su0lects t�e applicani �a a civil penaliy ol not more Ihan Irve IlunAreA Oollars �5500�.
I, as owner ol Ihe propeny or my employees wilh wa9es as Iheir sole compensation, will Uo Ihe work, ane ine
❑ stmnure is no� inten0e0 ar offereE lor sale (Secbon 70aa. Business an0 Prolessional COAe: The Contractors' State license Law
Goes not appty to an axner of a D�apetly wlq �uiltls orimpmves t�ereon, antl who does such wofk himselV�ersetl orlhroug�
his or �er own employees, pmvidetl �hat suc� impmvemems are not inlenUetl or otlerea lor sale. II, however IAe buil4inA or
im0�ovement is sold wi�hin one year ol complelion. �he owner will have Ihe Uurtl¢n ol pmving he/sh¢ GiJ not �uila or impmve
�or Ihe pw0o3e oi Sale�.
I, as owner of Ihe pmpehy, am exclusively comraciing wil� Iicense0 conVacmrs m conslmcl the D�oleci (Section 7044, eusiness
❑ ana Pmfeuions Cade: T�e Cqniractors' Sfa�e Li[ense Law Uoes no� appiy ta an owner ol pmperiy w�a 6uild5 0! improves ��er¢on
antl w�o conVac�s lor such pmle��s vn�� a[ontracior(5) license Oursuant ta Ihe Coniractor5' State License Law�. I am aware
IAat pmof ot Iheir Workefs Compensa�ian insurance 5hou10 be pmvitletl to me.
� I am eRemp� un0er Seclion: B. 8 P. C.
Ia! IhiS lCd50R
Oale: Owner.
I tlo nemAy cenily ihat I am aware of antl un0erslantl Ihe reQuiremems ol Calilomia Healt� antl Saleiy Code Seciions 25505. 25533, antl
25534 anU Ihat I or any future builtling occupanl willlwill nol (circle one) nee0 b comply wilh said slale w0e5 antl ihe requiremenis lor a
permil loi conSlmciian or modi�icalion Irom �he Aii Ouaiiry Managemenl Disincl. Fesidenlial conslmclion applications are e�emp� �mm
IhQSC pfOV1510115.
Daie: NpP�icanC
I hereby ceriity Ihal I have rea0 ih'ts apphcaiinn and stula Ihal Iho abovo inlarmaiion is correel. I egreo In eomply wlih all elly antl counry
ortlinances ana 51alelaw5relalingio building canslmclion antl �ereby aulhorizerepie5enlaiive5 oi��is cityto enleruponthe above-mentionetl
pmpeny lar inspectian pwposes.
� Oate: ��� Signature:
Orivefs License or Social Seari�y x:
�641-a6 Whrte-Builtlmg: Green-Cotle Enlo¢emem; Canery-Ap ant; Pmk-Rovenue; Gol�enrod-Assessor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 065042
PERMIT NO; P 065042 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: NEW
JOB DESCRIPTION : 1464SF 1ST FL, 1113SF 2ND FL, 425SF GARA SQ FT:
CLAIM VALUE; CALC-VALUE: GROUP OCC: R-3 /M-1
COMMENTS: NEW SFR, PLAN #2J, RE:#B65013
*�r*�*+t*********�t�r**�-***+trt�***x��r*�+�x�***+�*i�+��*****�***+r***��c**��c�****�«.�***r�*�-r**
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDZNG ---------- --------- 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
PARFtING REQ: PROV: PARCEL; 11913319 ZNE: REF NO:
PLANNING NOTES>
> '
1E 1f if iE if M 1f ftlE iE iE iE if iE jE M jE aE iE af jE 1E iE %?E iE ff iE iE fE af iE iE �lf tf iF if ik fE iE if af ii iE fE if 1f 1f fE ff 1E iF iE if if iE iE if 1E iF if i4 fF if ii iE if * if iF if 1E x-iF iF if �K M if
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:
BUILDZNG APPROVED BY : DATE:
APPLICATION ISSUED BY: ��Pr- DATE: III�3l�l�i
jE af �f 3Fif iE ifiFiE if 1E it {f �E l�if if iF if iE ik iE �N�A��"R'iF 1fiF i4 3E if If 3E M 3f�it�rjf
iE iF1E iEiF�f 1E�Fif ff3f iE if if 1f �f if if 1f iE iE iE fFiEif iE if 3E iE i! if �E jf �f if if iE 1f iE !E iE iE iE iE if if if MiEitiF 1f �f if jE j: iP if iF If if If *if ff iF iE 1f iE If iF 1f K ikif�f iE iFiE
LEGALZZATION:N F E E S.0 M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECfiA.NIC FIRE SMIP/RES GRADING
PERMIT 140.00
25R SMIP/NON-RES
PLAN ,
ISSUE FEE 20.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 190.00 20.00 0.00 160.00 160.00 .00
REVENUE DIVISZON TOTALS--> COLLECTED;' 160.00 OVER/SHORT: .UO
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI�Pl/�T��'i`1G.p�,���11G P�L�CHEC� ��
160.OU C1pTE: :li?4/9� TIhfE: 1`:2�
!f iElE fE fE iE if iE if !f 1! 1ElE 1f if fE jE k it iE ik 1E it ik �E jF if 1E jE �E IE 1P jE 1E if iE 1f iE iE iF iE if if iE if iE k 4 if !f if if if 1Elf if iF iF if �1!K iE 14lf �f if 1f iFlk if iE if if if if if 9f i!?F iE
I N D I V I D 0 A L F E E� B R E A K D O W N
TYPE QTY
PLU
FLU
PLU
PLU
PLU
PLU
PLU
PLU
PLU
PLU
PLU
3
1
2
1
1
5
4
1
i
2
1
D E S C R I P T I O N
BATHTUB
DISHWASHER '
LAUNDRY TUB OR WASAER
SHOWER ��
SINK, KITCHEN
WASH BASIN �
WATER CLOSET (TOILET)
WATER HEATER AND/OR VENT
GAS PIPING SYS OF 1 TO 4 OUTLETS
GAS PIPING SYS 5+ OUTL-PER OUTLET
GAS SERVICE
UNIT COST
7.00
7.00
7.00
7,00
7,00
7.00
7,U0
7.00
5.00
1.00
7.00
TOTAL COST
21,00
%,00
14.00
7.00
7.00
35.00
28.00
7.00
5.00
2.00
7.00
�
,
CGiVSTRUCTION AND PLANNfNG
AF'PROVALS Permii r
_� �-
1,`Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. '
3. Electrical Conduit UnhtY�Undrgrnd.
4. Electrical Conduit�Undrgrnd.
5. Steel Reinforcement
�
6. Elecvicai UFER Grnd
7. Footings
� 8. Foundation
9. Water Pipe�Undrgrnd, �
10. Structurgl Floor System
11. Property Sewer Line & House'Connecti
12. Sewer Cap '
73. Roof Drains
14. Rough Plumbing
75. Rough Electriwl-Condu�t
76. Rough ElBctric4`:iring
17. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rou9h Heati�g & Air Condiuomng
20. Rough Factory Firep�ace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Tes[
24. Roaf Framing
25. Roof Sheathing
26. T�Bar Ceiling (Structurall & fdonocoat
27. Frame and Flashing
28. Laihing & Siding
29. Insulation �
30. Dryv�,�all Nailing
37. Plaster Bro�vn Coat
32. Electncal ?ow•er Meter�F�nal
33. Finai Electric
34. Final HeSting & Ah Conditioring
35. Final Ga5 Pipe-Test
36. Hood or Canopy
37. Fina� FaGtory Firepiace
38. Final Plumbing
39. Water Service-Final
40. Gas Serwce-Final
41. Solar pomestic-Final
42. Backfiow Preventer
43. Backflow �rrigation
44. l.andscape Irngation System
45. Sound A[tenua:ion
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48, FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas
Date
Date � Inspector
A
POOL & SPA
APPROVALS Permit �
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electricel Bard��rtg
56. Rough Plum6ing & Pressure Test
57. APPROUAL TO COVER-GUNITE
58. ElQctncai Conduit�Undrgmd.
59. Gas P�pe, O Urdrgmd., Te,t
60. Backwash L��nes, P-Trap,'� Undrgrnd.
67. APPROVAL TO DECK
62. 3ack�vash 7L RecepmrFrial
63. lieater & Vznt-Finai
64. Plum6ing SYsiem - Final
65. Electrical�F�nal
66. Solar SV;ten�.�Finai
67. Feccing & Accuss Apwuval
68. APPROVED FOR PLASTERING
69. POOL/SPqSYSTEPIISFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. UndergrounC Hvdro
77. Product P;n�ng � Gas ❑ Oil
72. Underground Flush
73. Undergrnd.StorageTank,�Gas :7G�1
74. Overhead Hvdro
75. Dry Chemical
I6. Dry Standpipe
77. F1XED SVSTE'•.1 FINAL
78. FIRE PREV. FI\AL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION_ _. l
80. FOOD CERTIFICATE ISSUED
Notes:
'T _
Date � Inspector
�
-�' - - I
I �
--'�
�
i
�-- 1
----�
Pfl0.1ECT RO�XESS:
OWNEP'S NAME:
liODNESS:
.
ANCH/ENGINEEH:
"' aooness:
1 PEflMITiEE:
\ aooness:
flEG.NO.:
UNIT:
UNIT:
LICENSED CONTNACTON oECIABATION: I hereby affirm ihat I am Iicense0 un�er Drovisions ot Chapter 9(commencinp wilh Seciion
7000� of �ivision 3 ot ihe Business ane Pmlessions Code. and my license is in lutl lorce an0 ellec�.
QTY UC.: STATE IIC.: CNSS:
�aie'. Signaiur¢:
WOBNEBS' COMPENSATION OELIAFPTION: I hereby aflirm �hai I have a cetli�iwt¢ ol consenl �o sell�insure or a cetlilicale ol WOBerS'
Compensauon Inmrance. or a certifiea copy t�ereof (Seclion 3800, La�. q.
POLICY NO.: E%P. OATE:
COMPpNY:
❑ Cenifi¢a capY is �ereby Wmis�etl. ❑ Ceni�ietl copY �s �ileU wi�h �he ciiy BuilUing Division.
�a�e: Ap0licanl:
E%EMPTION FflOM WOPNEBS' fAMPENSRTION OECUflATION: Qhis setlion nee0 noi Ge complelcd il ��e p¢rmit is �arone hunAred �E10D) or less�,
I cerlify Ihai in the pedormance o� �he work lor which IM1is Oermi� is issuetl, I SAall nol em0loy any Oerson in any manner so as lo become
suble�� �o �Ae Warkers' Compensalion Laws o� Califomia.
�ate: Signaiurt'.
NOTILE: tl, afler making IhiS tletlaralion, you s�oWd UetOme Su�letl IO IAe Warkers' CAmp¢n5diion provisions o� Ihe LaUor
Code. you mu51 fortOvnlh wmDly wi�h such pmvisions or this Dermi� shall be OeemeO revoke0.
CONSTPOCTION LENOING RGENLY: I �ereby afiirm Iha� ��ere is a COnSirutlion lending aqency for Ihe petlOrmante a� �he wOrk br
w�ich Nis permit is i=5vea (Seclion 3097. Crv. C�.
LENDEN:
ADOPESS:
OWNEB BWlOEB OECIANATION: I here�y allirm Ihal I am eKempt Imm Ihe Contracbrs' $Iale LicenSe Law lor Ihe lollowing reason
(Seclion 7031.5 Buvness ana Pmleuional Cotle: My city ol county whic� 2puire5 a Dermi� lo conSWct, alter, imprme, Eemoli5h, or
r¢pair any Slmtmre. O��or l0 i6 issuance. also requirei the aODlitani lor SUC� permit t01i1¢ a SigneA Slalemeni �ha� he/5h¢ is litens¢tl
pursuam to I�e pmvivons of Ihe Comractars' Stale License Law (Chapter 9(commencinp wi�� Setlion 7000) 0� DiviSion 9 oi Ihe Busineu
anC Piofessfons Coae� or ��a� �e/s�e is eeempl I�erelrom an0 ihe Easis lor t�e allepeE exempiion. Any tiolaiion al S¢clion 70JL5 Gy
any apP�icant for a permit 5ubjeci5 Ihe apPlicani lo a ciNl Oanalry ol noi more I�an five �undretl tlollars (5500�.
I. as owner o� I�e Dmpeny or my employees vnt� waAes as IAeir mle campensalio0. vnll tlo lhe xrork, anU t�e
❑ s�mtlUreiS nolin�entleA oro��ere0 br5ale (SettiOn 70E4, BuSineSS an0 Pm�¢55ionalCoAe: The ConVat�OrS' State License Law
Does not apply to an owner oi a pmpeny wtq builtls ar improves thereon, anE wlw does such work Aimsell/�ersell ar Ihrough
his or her own employees, pmviae0 Ihai suc� impmvements are noi intendetl or allereG lor sale. II, �owever the �NlAing or
impmvemenl is soltl wilhin one year ol completion, I�e ownei will have �he Ourtlen o� proving �e/she Ditl not �uild or impmve
tor t�e Durpose ot sale�.
� I. as owner ol the properly. am exclusively conlracUng wiih licensetl coniracmrs m conslmcl ihe D�alecl (Sec�ion 70d4. Business
I�, ❑ anC Profe55ions Code: Tne Caniractors' State LicenSe Law tices no� appry to an owner of propeM � DmIQt or ImprOveS inereon
'� and who coniracis for such pmle��s wi�� a coNraclor(s) license Dursuant lo Ihe Conlra[lors' $taie Lit¢n5¢ Law�. I am aware
Ihal D�ool ol their Worker'S Compensation insurance 5Aou10 be O�ovitletl �o me.
� I am exemp� untler Section: 8, d P. C.
for I�is reason:
�aie: Owner.
I do Aere�y tenily I�at I am aware ol and wders�antl I�e re0uirements ol Calilomia Hea�N ana Sdfe�y Cotle Sec�ions 25505, 255J3, and
25534 and Ihat I or any luture builaing occupani willlwill not (circle one� need to comply wi�� saitl stale codes and �he repuirem¢nis for a
permit for consim[tion or motlilica�ion imm Ih¢ pir Ouabry Management OiSirict. flesidential con5lruciion appli[alions are exempi Imm
ihese provisions.
Ua�e: FOV�icanl:
I herehy [er�ifyihal I have rea0 �his applicaiion antl slale I�at��e above inlormationis correcl. I aA�ee �o comDly wil� all ciry an0 counly
ordinances an0 s�ale laws relating Io building consuucuon and hereEy au1Mr@e r¢pre5enla�ive5 0l Ihis c�ty to enter upon Ihe a0ove-menlioneG
pmpetly lor inspeclion purpases.
Oa�e'. Signature:
Orivefs License oi Social Seari�y >:
i6aba6 Whi�e—Bmltllnq; Green—Cotle Enlorcemem: Canary—Pppllcam: Plnk—Rovanue: Goltlmrotl—Asseswr
PERMIT NO: P 065042 PLAN CHECK NO: 04617-93 N PAGE: 2
*+t+tir****�r*��*�rttx�-*�t***�t*x**�r+c�***+c-+�i�+t*+r*******+r**�**i��c****+r*********i�**i�****�r*��
TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST
END OF FEES
FDe..���y�.AT� Y�t4..�gF�Y"#
�r qUi �1Gt7-ii0161't?7 Y+:a� ;nJ:00
D(+7E: 11!24/43 rrnF: i:,:z;
CUiVSTRUCTION AND PLANNWG
APPRQVALS Permit �
_�,
i. Temporery Electricai Service or Poie
2. Soil Pipe-Undrgmd.
3. Electricai Conduit Utiliiy�Undrgmd.
4. Electrical Conduit-Undrgmd.
E. Steel Reinforcement
�� Electical UFER Grnd.
7. fooungs
(i. Fou^daUon
9. 6'�:ater Rpe�Untlrgrnd.
10. Struct�rai Floor System
11. Prope�ty Sevaer �ine & HouSe ConneCtion
72. Sea-er Cap
13 Roof Dra.ns
14. Houq� P'�mb�ng
15 Rough Electrlwl-Condurt
� tu. Ro�qh Electric'A�irin9
17. flou9h!Y�.ringSign
18. Ro�gh Electrica6T Bar Ceiling
79. Rouyh Heating & Air Conditioning
20. qo�gh Faaory Firep!ace
21. Ducts, in Structure
22. Ducts, Ventilatin9
23. Gas Pipe-Rough & Test
24. fioof Framing
25. Roof Sheathing
26. T•Bar CeJing {Struc±urall & Monocoat
27. Frame and Flashing
28. �athing & Siding
29. Insulaaon
30. Drywall Naihng
31. Piaster Brown Coat
32. Electnwl Power Meter�Finai
33. Finai Electnc
34. F��nai HeaUng & Air Condrtioning
35. Final Gas Pipe�Test
36. Nood or Cannpy
37. Final FactorY Fireplace
38. Final Piumbing
39. 1'Jater Service-Final
40. Gas Serv�ce-Final
47. Salar pomest�c-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landswpe Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUIL�ING
48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
\
POOL & SPA
Date Inspector APPROVALS Permit � Date Inspector
. 52. Pool & Equipment Location
� � 53. Steel Reinforcement
54. Forms
55. Electrical Bond�ng
56. Rough Plumbing & Pres�ure Test
57. APPROVAI. TO COVER GUNiTE
56. Electrical Condurt�Urtlrgmtl.
59. Gas P�pe, G Urdrgrnd.,lest
60. Bac;avash Linns, P-Trap, -: Ur,drg�^d
61. APPROVAL TO DECK
62. F1dck:rash & Rece�t�r-Pina!
63. Haater & VenbFinai
64. P�umbfng Systrin � F nal �
65. ElcctricaLFinal
66. Sfllar SyStcm�Findl
67. Fencing & Ar.cess Approval
68. APPROVED FOR PLASTERING
.69. POOL/SPASYSTEPr7SFINAL
FIRE DEPT. REQUIqEMENT
APPROVALS Permit i:�
70. Underground Hydro
71. Product Pipinc� C7 Gas ❑ Od
72. Undergrouncl Flust�
73. Undergrnd. Storage Tank O Gus ❑ O:i
74. Overhead Hydro
75. Dry Chemical �
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH OEPT, REQUIREPAENT
79. FINAL INSPECTION �
80. FOODCEHTIFiCATEISSUED
Noter. ._
-- -yI
- -- - 1
PHOJECT AOONESS: z 3 Z 3 SANTA ANA AV u"�T: 4
OWNEP'SNAME: HARBINGER HOMES
aoonEss: 375 PROMONTORY DR WEST
N,B., CA
675-6653
PPCMIENGINEEP: flEG.NO.:
nooxess: WILKINSON ASSOC C9uxii9
18002 SKYPARK CI
PENMIREE; IRVINE CA 92714
aooness: HARBINGER HOMES ( 714 ) 675-6653
375 PROMENTORY DR WEST
NEWPORT HEACH CA..92660
110EN5E0 CONTPRCTOB OECIAflATION: I hereDy allirm Ihal I am licensetl untler O�ovisions ol Chapter 9(commencing with Section
]000� ol Orv�sion 3 0l ��e Business ane Professians Code, an0 my license is in full lo¢e anA efieci.
CITY LIC.: $TATE LIC.: LU1SS:
Date: Signamre:
WONNEH$' COMPENSRTION DECUIPATION: I �ere�y allirm ��ai I have a ceriifica�e ai consenl to sell�insure or a certilicale o� Workers'
Compen5aiion Insurance. or a ttrlilieU copy ihereol �Seclion 3800, LaE. C�.
PO�ICY NO.: E%P. OATE:
COMPANY:
❑ CenilieG Copy i5 �ereUy �umi5he0. ❑ Certilied coOY is IileG vni� the city Builtling aNsion.
Dale: Appli[ani:
E%EMPTION FBOM WOBI(EPS' fAMPENSATION �ECIABATION: (This 5ec6an nee0 noI be completeE i� Ihe permil i51or one hunaie4 (E100) or 1e55�.
I[etlily I�al in Ih¢ DetlatmanCe ol l�e xrork bt whith I�is permi� i�ue0. I 11 not empio y permn in any manner so as to uecome
�/i5�t-wy��e Workers' Compeqns�ation Laws o� Caiilomia.
p t' e' �/_�� � i�— (= Signature:
�OTICE: II. alter making this Oeclaralion. you s�ould �ecome sublect �o Ihe Wotkers' Compensation Oiovisions of ��e Labor
otle, you musl Ionhvnih compty with sucn provisions ar ihis permit shall be Ueemee revakea.
CONSTPIIC710N LENOING RGENCY: I here�y aifirm t�at ihere is a constmction lending aAency br t�e pertormance ol t�e work lor
which Ihis permit is i55ueA (Seciion 3097. Civ. C�. ,��
LENDEH:
RUOPE$$:
OWNEN BUILOEB OECLRBATION: I here0y aifum tAa� I am exempl Imm �he Contraclors' State License Law for Ihe I011owinB reason
(Senian 703L5 Business an0 Pmlessional Code: Any ciiy ol counry whic� requires a De�mi� b cons�mc�, al�er, impmve. Oemolish, or
repair any SimcWre. prior lo i�s issuance, also requires t�¢ applicant for such permi� �o tile a signeU Slatement Nai hels�e is lic¢nsed
pursuanl Io Ihe pmvisions of �he Contraciors' Siate License Law (C�apter 9(commencing wi�h Sec�ion 7000) o� Oivision 3 oi Ihe Business
antl Prolessions Code) or ihat he/she is exempl ��erelrom and ihe basis lor the allegetl exemption. Nny violation of Section 7037.5 6y
any applicanl �or a permil suhlecis Ihe applicani to a civil penalry ot no� more Ihan live hundred tlollars (5500�.
I, as owner ol I�e D�oDeny or my employees wit� wages as iheir sole compensdlion, will tlo t�e woM1, antl ihe
❑ s�mclure is no� imenaeU or oifered for sale �Section 7044, Busness and Pmtessional Code: The Comractars' Slate License Law
Ooes nol apoly �o an awner ol a pmpeny who �uilds or imo�oves tnereon, anA who Ooes such work himself/herself or ihrouAh
�is or �er own em0loyee5, provitleC �hat SucA impmvemenis are no� in�enJetl or alfereU for sale. If, however the �uildinp or
impmvement is sold within one year of completion, ihe owner will have the burden o1 pwving nelshe aitl not Euild or impmve
lor Ihe purpose ol 5ate�.
I, as owner o� the prooetly. am excluvvely conVa[ting wiih Iicense0 coniractors �o cons�mcl lhe Dmjec� (Section 7044, 0usine55
C� ana vmiesvons Caae: tne Comractors' S�ate License Law aces not aODN �o an wmer of Dmpeny who �uilas or impmves t�ereon
ana who coniracis foi such pioleds wit� a coniractor�s) license pursuant to Ihe Coniractors' Stale L¢ense Law�. I am aware
��al prool 01 IAei� Worke�'S ComOanSaiion in5urante s�ould be pmvi0e0 �o me.
� I am exemD� un0er Seciion: B. 8 P. C.
Da�o� is �earw�n: / Q�7
�� L—'1,� — iJ Uvner. �
I Oo hereny cetlily Ihal I am aware ol and underSlanA Ihe reQuirements ol Calibmia Heal�h antl Salery CoOe Seclions 25505, 25533, antl
2557E and I�ai I or any Iuiure OuilEing occupant wilVmll noi (circle one) neea to comDN �^�h saitl s�ate cOCes antl the r¢puir¢men�5 �or a
permit Im mnsimc�ion or modilication irom the Fu Oualily Managemeni UisVici. FesiQeniial consimclian applications ar¢ exemp� Imm
I�ese Dmvisi0n5.
Da�e: FpPlicanl:
I �ere�y cer�ilyt�at I �avereatl I�is applicalion ana Sla�eihal��e aboveinformaiionis correct. I agree�a [omply witA alltiiy anG counly
ordinances antl slatelav�srelalingto builtlmg constmtlion anC hereby aul�orize represenia�ive Ithis cilyto enier upon Ne aDove�mentioned
p�n�y lor inspection pjurposes. � �
p e: ��'�b^� Signalure:
river's License oi Sociai Security +:
i6at�46 Whno—Bulltling�, Green—Code Enlomement�, Canary—A001¢anC Pink—Rwenue', Goltlonmtl—Assessor
z ��-94
CITY OF COSTA MESA — BUZLDING PERMIT PEAM NO: P 06536E
PERMIT NO: P 065366 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU PURPOSE: NEW
JOB DESCRIPTION : 9575F 15T FL, 907SF 2ND FL, 461SF GARAGE SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M—i
COMMENTS: REF: B-65013
**fr�r�*�r#�r*#*#�rir*�r��ru��*�r*�r#�e+rir+�+r+���rir�r�r**�*�r��#�r*�u�*�r*u#**+�*****+r*********�****
2 O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILPING ---------- --------- ACCESSORY BUILDING ---------
FRNT: £T IN REAR; FT IN FRNT: PT IN REAR; FT IN
LEFT: FT IN RGFiT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROI/; PARCEL: 11913319 ZNE: REF NO:
PLANNING NOTES>
>
iE iElk �If if if iF if it it iF if if IE if iE #?f 1F 1F iE # k 1f if !t 1f fE if if 1E # if� if iE iE f! i! 1E iF IE iE f4lt iF # ik iF fE if ## if iE if if ## iF iF 1E Y� �f # if ii 1F 1F if # if fF iE �N #*�f # M•
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
ZONING APPROVED BY _ DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; ��'� DATE: � Z�tr��
�fikiEifiFififlFifiEiEihiEiFfEiE�EiEiFfljElEiFi��FTF�i�3F'iF;f�F�iFiF i�F�#rt ;FTh3F�F�Fif�+3F'i�3ijF�1:1FiEiF#iEiFiFiE ��4 - iEK
if 3F jk iF #% iE iE iE ik jE iE iE i! �E K if �IE if -0f iE if if iE if iE iE ih iF iM1 if if jE jf # iE if �1E �1F if # if iF rt if # iE i� # iF aE iF iE if 1h if iE 1f iF iF �Ic 3F # iE if iF iE �lf if # iF # u�tc K K## K�
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGFSENT:N
BLPG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 15.00
25R SMIP/NON—RES
PLAN
ISSUE FEE 20,00
bUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.00 20.00 0.00 35.00 35.00 .00
REC�ENUE DIVISION TOTALS--> COLLECTED: 35,00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
35.00
if iE iE if iE i(�if ifiE if iFil�k iF iE iE iE ifiE iE# ik if if if�IE ifiFif iF1E if ih 1E 9E 3f�If�lE 1f if iE iE if if �f iF iF } iF iF 1f ?f iEif Yr 3f iE �E iF iE iE 1FiE iF�lf 3f fM1iF # if iE ii if il�# ih iF # if
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 Z O N UNIT COST TOTAL COST
PLU 1 S£WER, CONNECTION TO EUILDING EACH 15.00 15.00
END OF FEES
�1 rp15.;{n—�OiS?40h 1C+7 � 35.OG
UA'_. 1'i',E.4' fI",�� C`:0�
I CONSTRUCTION AND PLANNING
� APPROVALS Permit-i�
1, Temporary Electrical Service or Pole
2. So�l Pipe�Undrgrnd.
3. Elcctricai Conduit Ut;lity-Undrgrnd.
� 4. E�ectncal Conduit-Undrgmd.
I5. St�cl Relnfo.cement
6. Elcctnca' L+FER G:nd
' 7. f-oot�ngs
I8. Foundati0�
� 9. :�'ater Pipe�Untirgrnd.
�--
; 70. Structural Floor System
,} 7. Prope�ty Sewer f_ine & House Connenion
I 12. Se�vcr Cap
�- .. ._._ ._ _.. .........
I 13. Ro�f Drains
i ?4. Ro�gh ulumh�,ng
I 15 Raugn Eiectncai•Condwt
16. Fiough ElectricVViring
77. Rough lNiring Sign
18. Rough Electriral-T Bar Ce�lmg
19. Ro.:gh Hsaung & Alr Co�dinonmg
20. Roi.gr. Pactory Firepltce
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gxs PiRa-Rough & Test
24. Root Framieg
25. Roor Sheath�ing
26. T-Ber Ceiling (Structurall & Monocoat
27. Frameand�Flashing ��
28. Lath r.g & Sitlin3
29. I�;ulat�on
30. Dryv:all Nailing
31. Plaster Bro�vn Coat
32. EleclriWl Power M,eter Final
33. P'.nai Elactric
34. Final Heatmg & Air Contlrtioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Firal Factory Fireplace
38. Final Plumbing
39. Water Ser�ice-Final
40. Gas Sernu:e�Rnal
41. Solar pomestic•Final
42. Backflo�•; Preventer
---_.. _..__.
43. Backflow Irrigation
4C. Laodscape Irripation System
45. Sound Attenuation
4G. Hand�cap Regulations
47. FIR'AL STRUCTURE & BUILDING
48. FINALPLAtdtVI�VG
49. Electric Release [o Edison
50. Gas Release to Southern California Gas Cn
51. CERTIPICATE OF OCCUPANCY
Date
POOL & SPA
Date Inspector qppROVALS Permit #
52. Pool & E4u�pm¢nt locat�on
53. Steel Rn�Fo�cement �
54. Forms •'
_ - 55. Electrical Bnnding �
56. Rough Plumbing & Presswe Test
57. APPRQyA�. TO COVFR�GU�iTE
58. Electrical Conduit�Undrgmtl.
59. Gax PiRe, O Undrgrnd., Test
' 60. Backevash Lines, P�Trap, � Undrq.rd
� 61. APPROVAL TO DECK
�/�f/��� 62. Backr�as��.i 1L Recpnto�-F�na�
63. Heater & Vent-Fina�
64. Plumbing System - Final
65. Eiectrical�Final
66. So�ar Sy�tem�F�:nal
67. Fencing !4 Acc^r's Anproval
68. APPROVED FOR P�ASTERING
69. POOL/SPASYSTEti75PINAL
FIRE DEPT. REQUIREMEN f �
APPROVALS Permrt�F
70. Underg��ound Hydro
77. Product Piping C7 G�s � OJ
72. Underg�ound Fiush
73. Undergrntl. Storaoe Tank "Gac "�� 0.;
74. Ovenc�ad Hydro
75. Ory Chemiwl
76. Dry Star,dpiPe
77. FIXED SVSTEn7 FWAL
78. FIRE PREV. FINAL
ttEALTH DEP7. REQUIREh1ER�T
79. FINAL INSPECTIO'V -�
8D. r00U CERTIFICATE ISSUED
Notes:
Date � inspector
Pfl0.1ECT RODflESS: " � �' L'" - '' V
owxea�sname: HARBINGERTHOMES
aooness: 375 PROMONTORY DA WEST
N.B., CA
675-6653
AflLH/ENGINEEN: WILKINSON $ i�JCs�C
noowess: 18002 SKYPARK CI
uxir: q
HEG.NO.: C98z9
UNIT:
I IRVINE CA 92714
� PEPMITTEE: BERNER ELECTRIC� INC. (714)734-3171
aooeess: 75 E. GRAND BLVD.
CORONA CA 91719
CITY
POLICY NO.:
COMPFNY'
pLTDd���TION: I hereby alfirm Iha� I am licensetl untler pmvi5ions ot ChaO�e� 9(cOmmencing wi�� Seclion
tpiy�e�yrmess anG Pmiessions Code, and my license is in �ull torce and ¢tle[�.
� STFTE LIC.: 9 8 S 3 2 SS: C— I O —
Signaiure' —
ENS�TION 0 CIABRTION: 1 hereby ' �ha� I Iwve a cenili If-insure or a ce�ilicate al Workers'
yaqc� y�rgM1Jirb �npy tfiereof (Sec�ion 3800. lab. C)2 / 1 5/ 9 q
VA I NS 1��, exr. onTe: 1
❑ Cetlifietl [opY is hereGy fu nished. L'] Certifietl coOY is liletl �ii .U+ i y Builtling ivisio .
atif e: /// � � Applican�: ' !
E%EMPfIONFflUMWORKEB COMPENSRTIONOECIAPRTIO . rsstt�onnCe olGem ����e7� �S�OrmehuMreNd��S100�orless�.
I cerlify Ihat in ��e p¢�brmance ol lhe work for w�ich t�is permit is i55ueA. I sha no employ any person m y manner so as'ro become
sublec� to Ihe Work¢rs' Compensation Lavn al Calilamia.
:•
Oate: Signalure:
NOTICE: Il. ailer makinq ihis detlaration, you s�ouitl become subjetl to Ihe Wo�ke�3' Compensafion p�ovisions of the LaDOr
Code. you mus� �orlhwilh comply with suc� provi5ion5 or this permi� shall be tleemed revoked. �
CONSTBUCTION LENDING RGENLY: I here�y allirm ihat there is a consimction IenOing agency lor Ihe DeAorma�ce'fif ihe work lor
wAich Ihii permil i5 issued (SetliOn 3097. Civ. C�. «
�
LENOEH: �
aoonEss:
OWNEP BUILOEfl OECIAflATIDN: I here6y ailirm �hal � am exemp� imm I�e Contracmri State License Law �or the �ollowing reason
(Sec�mn 7031.5 Buslness and Pmlessional Cotle: Any city ol counly whic� reQuires a permi� to consimc�, alter, imOrove, tlemolis�, or
repair any s�mcture. P�ior Io its issuance, also requires the apD�icani lor such permii Io lile a signe0 slatemeni �hal helshe is licensed
Oursuant lo ihe provisions ol Ihe Conirac�ors' State license Law (Chap�er 91�ommencing wilh Sec�ion 7000) ol Oivision 3 0� �he 6usine55
and Pmlessions Coae� or that he/she is exempt therelrom and the hasis for tne allegeU exemption. Any vialation of Section 703t5 Uy
any applicanl for a permit sublecis ihe apDlicant lo a civil Oenalty ol not more I�an live huntlre0 dollars (5500).
I. as ovme� ol t�e pmpeny or my employees vnth wages as tAeir sole compensatan, wiA Oo the work, an0 tAe
❑ slmcWre is not inlentletl or ollerea lor sale (Section 70aa, Business an4 Vmiessional Cotle: The Coniracmrs' Staie License Law
Oo¢5 nol apOW �o an owner ol a pmpetly who builtls or improves l�ereon, antl who tloes su[� work himulf/herself or �hmu0h
his or Aer own emD�oyees, pmvl0¢U Ihal 5ut� impmvemenfs ar¢ noi in�¢nAeU Or offeretl br sale. It, haw¢vef lhe Ou�ltling ar
impmvement is 5o10 wilhin one year oi complelion, the owner will �ave Ih¢ 6urden ol pmvinp he/s�e Oid nol �ui10 or impmve
tor Ihe ouroose ol sale�.
I, as owner 0� the pmperty, am excWsively conl�acting wi�h licensed conlraclors ta cans�mc� the pmlecl (Section 7044, 6usine55
❑ an0 Pmlessipns CoUe: T�e Coniratlors' S�a�e License Law Ooes noi apDly to an owner ol pmpeny wM CuilCs or im0�ave5 thereon
antl wha coP��acis lor such pwlecls wi�� a contractor(s) license pursuanl lo �he ConVac�ors' Siate License Law�. I am aware
Ihat pr0ol o� ��eir Workei 5 Compensalion insuranre shoula be pmviJed to me.
� I am exemp� unaer Seaian: B. 8 P. C.
loi t�is reasa�:
Oate: Owner.
I ao �ereby cenily Iba1 I am aware ol an0 un0erstan0lhe requiremenis ol Caiilamia Health an0 Salery CoOe Sections 25505, 25533, and
25534 antl iha� I or 2nyfuture builAing occupanlwilllwill nol (circle one) neetlto comply wil� saitl s�a�e catles and the reQuirementslora
permit �o� con5lmciion or motlilica�ian Iwm I�e Air Ou2bty Managemenl Disiricl. FeSiEenlial con5imciion applica�ions are exemp� imm
I�ese pmvisions.
Uaie.- AppliCanl:
I�p120y CCIIVIVihdll�dvQ�Pd4 511i2 3ppliCdiiDO d110 SIdiC 111diih¢ diroV¢ip�q111311011K WrtCtl Id9 EID CMi1Ply w1 dN Clty d06
or0inances ana 5latelaw5ielaiingto OuilOing consim[tionan0 nereby au rize lives o�IAis iryla enterupa he above�me
prOperiy IofinSpCG�JOn purpo;LS A Q
�/ ry /N� Si9nalur '. _�_A_l�JC1
� «
Oriver's License or Social Secun�y +: ,
�64t-c6 wnne—emlaing: Green—Cotle Enlorcement; Canary—AOPlicanl: Pink—Revenue;
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 065718
PERMIT NO: E 065718 pLAN CHECK NO; N GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE; NEW
JOB DESCRIPTION : 9575F 1ST FL, 907SF 2ND FL, 461SF GARAGE SQ FT;
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /M-1
COMMENTS: REF: B-65013
x x�*+r**�*+r*�r�r*�*��r*�r�r*��rx�*�r*��r+��r�r�rx�*�r**�r+ex��r*x x�**x+r**�e+r+r��r+r�r*�r*�e��r*�r*x��r***��r*��r+�*
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT ZN RGHT; FT IN LEET: E'T IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 11913319 ZNE; REF NO;
PLANNING NOTES>
>
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D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY � DATE:
HUILDING APPROVED BY ; � DATE; �^
APPLICATION IS3UED BY• "� DATE• 'F� l�
1FifiEitiflfilMiFiFitifiElEiEkiflfiliflff! IE1f�fiFlfiEif4itif 1f1F
if if if iE iE if if 1f 1t iF iE i! 1E fElE iF if 1F 1E 1f 1f if if if if if IElf iE iE if iF iE fF iE it * k 1f iF iF if 1k 1f if iE if it k ff iE if �E 1E iF iE if df 1F i! if 1E iF fF iF iE fE M if iElE fk iF if iE if i! �f if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 18.50
SOR SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—DIV—> PEAMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 18.50 15.00 0.00 33.50 33.50 .00
AEVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVER/SHORT: .00
BLDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.50
it 1E iE ff ff f! �f 1F iE iE 1! �E 1E ff 1f 1f M iE 1! if iElf �f iE i! 1! fk if fE ff !f iFlf fE jF iE M iE 1E M 1F iF if iE 1E iF iE M iE ff iF iF iE ff 1E �f iF IF 1E iE 1t 1E 1E ih if if if iE If �f iF if iF 1E iF 1t iE 1f iF
I N D I V I D U A L F E E B R E A 4C D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
ELE i SERVZCES BELOW 600 V& BELOW 201 AMP 18.50 18.50
END OF FEES
�1 D��J�1/li'�� ��d'�Q �%iiT e�.°L
CpTE: 0't�14i9, T?I1G ll:d4
COlS' AUCTIOid ARD VLAIA:ING
A7PRObP.LS Permii=`
?emnorary E�ectrieal &cv�cr or Vole
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� 51 CERTIF,^,>icUi OCCUPA^lCY
Ii\'o _____ Date
L� - -- -
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PflOJEtT A0DHE55: ev1 �s�v—i.Ts.�'Tss'rm rii i n v IINI7: Q
awNexsxame: HARBINGER HOMES
aooaess: 375 PROMONTORY DR WEST
N.B., CA
675-6653
APCHIENGINEEN: WILKINSON I�.CJ$�C xec.xo.: C9829
nooeess: 18002 SKYPARK CI uxiT:
IRVINE CA 92714
PEPMITTEE: HARBINGER HOMES ( 714 ) 675-6653
aoonEss: 375 PROMENTORY DR WEST
NEWPORT HEACH CA 92660
UCENSED LONTBACTOB OECIABATION: I here0y af�irm IAaI I am licensea untler pmvisions ol Chapter 9 �commencinp wii� Seclion
7000� ol Oivision 9 al the Business ana Professions Cotle. anG my license is in full force antl ellecl.
CITV LIL.: STRTE LIC.: CLASS:
Dale: Signalufc'.
wOBxEAS' COMPEroSAT1oN DEClABA710N: 1 hereby aHi�m inai I nave a cerliticate ot conseni to sNt-inswe o� a ceniticate of Wo�keR'
Camoensa�ion Insurance. o� a cenihetl cooY thereol (Section 380U, La6. CI.
POLICY NO.: E%P. OATE:
LOMPRNY:
' 0 Cehilie0 co�y is �ereby fumished. ❑ CeNIieO coOY is �ile Ih � ciry Bui�tli Oivision.
'.i�. � � ! � Applicanl: �
E%EMPTIONIflOMWOBNEBS'COMPENSATIONOECIAPRT�ON: (ihi55ec1ionneeOnotUecampleleUil�hepermi�i5lorone�un4retl�5100�orless�.
I certify Ihai in Ihe peAormance o� the wark �ar which Nis permii is issued. I shall no� employ any person in any manner so as �o become
subleC� �o ihe Workers' CAmpensation Laws ol Caliloinia.
Daie; Signaiule:
NOTICE: II, al�er making Ihis Oeclaration, you sh�ultl become Subleci to the Workers' Compensation pwvisions o� Ihe Labar
Cotle, you mus� lort�with comply with such pmNsionS or ihis permi� shall be deemed revokea.
CONSTBUCTION IENUING AGENCY: I �ere�y aflirm Ihat there is a cansimction lending aAency lor �he petlormance o� �he wark lor
whic� I�is Oeimit is isiuea (Section 3097. Civ. C�.
LENDEfl:
nooRess:
OWNEH BWLOEH oECuflPTION: I nereby affirm 114�1 I am eaemo� ��om ihe CAniractors' State License Law tar ihe following reasOn
(Seclion 7031.5 Business and Professional Cotle: Any �ily ol couniy w�ic� reQutres a Oermit �o consimct, aller, impmve. Eemalis0, or
reoair any simc�ure, priar ta its issuance. also requires tne applicant 5or sucA permil to iile a siBned statemeM Ihat �elshe is licensetl
pursuam lo ihe provisions ol ihe ConVacrors' Slaie Licsnse Law (ChaO�er 9lcammencing with Seclion 7000) ol Division 3 0� I�e Business
ana Prolessions Code) or Inal he/she rs exempt iheref�om ana Ine oasis for ihe allege0 eremo��on. Any violalion of Section 703L5 by
any applicanifar a peimii subjects t�e applicant Io a civil Denally oi noi more �han live �untlrea dollars (5500�.
I. as owner ol Ihe pmpetly or my empIOYees wiih wages as I�eir sole compensation, will tlo �he waB, and Ihe
❑ slmclureis naiinlentletl oro�fered �orsale�Sec�ion 70a4, Busmess and ProfessionalCoeel The Coniraclars' S�ate License law
does not ap01y to an owner ol a propetly w�o builas or impmves therean, ana w�o tloes 5uch work himself/hersell or Ihrough
�is or her own emDloyees. pmvide0 tha� sucn improvemenis are not intended or oller¢d lor sate. I�, however ��e �uii0ing or
imOmvement is so10 vnthin one y¢ar ol completion, �he owner will have I�e 6urAen ol Dronng he/5Ae tli0 noi builA or impmve
lor ine purpose of salel.
� I, as owner 0� Ihe pmperty, am excWsively coni�aciinp with license� contracmrs m constmq the pmlect (Sectian 70aa, Business
an0 Pm�euions CoCe: The Comracmrs' Siate License Law does �wt appN to an avmer 01 propeny who Ouilds or impmves thereon
ana w�o wniracis lar suc� pmjects wi�� a cOnlracior(5) license pur5uani to ��e Contra[lors' $tate License Law). I am aware
Itwi pmol ol I�eir Worker'S Compensation insuranre s�oula Ue Orovitletl to me.
� I am eeempl untler Section: B. 8 P. C.
br I�is rcason', Q
��Bate �_� ��/ � Owner.
ereby certify Ihai I am aware ol and unaerslantl Ihe requiremenls of Calibmia Heallh anU Salery CoOe Sec�ions 25505, 25533, and
25534 antl Ihat I or any IUWre �uilding occupani willlwill nol (circle one) nee0lo comply wiih saitl state codes antl the requiremen�s for a
permil lor conslmclion or motlifica�ion �mm the Fir �Pabty Managemen� DisVici. Residenlial constmclion applica�ions aB exempt �mm
mese provisions.
�aie�, ApDlicanc
I hereEy cetlifyl�at I have reatlt�is applicatian and sla�e Ihat��e abovein�ormationis correcl. g�ee lo comply vnih allciiy and coun�y
ordinances an0 slale lavrs reWting Io DuilOing conslmcliM anC �ere0y aulMrixe presemames ol s ury to enter upon Ne a0we�men�onea
pm0etly loi inspecl1iorn�Ourposesd. (V
' �l` � 1 Signature: „
ori' .r's ��cense o� sociai secu�ny a: .
�6abu6 WOiie—Bulltling; Green—Cotle Enlo¢emenL Canary—Applicant: Pink—Ravenuo; Goldonro�—Assesso�
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO; M 065685 PLAN CHECK NO: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC
PERM NO; M 06568
GOVT: N SUPP: N
PURPOSE: NEW
JOB DESCRIPTION ; ADD FACTORU FIRE PLACE SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1
COMMENTS: REF: B-6Sm.LU.. � rJ O ��
***rtx�*�r*x�r*�-***�t�t*r*+r*�r* *�**+r *r+r*+�x�*****�x��t+r*r�rx�*******�c*****+t**+tr�*****r�xitx�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGtIT: FT ZN LEFT: FT IN RGHT: FT IN
PAAKING REQ: PROV; PARCEL: 11913319 ZNE: REF NO:
PLANNING NOTES>
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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 HY , DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; L� � DATE: C i, �.
if iliklf if iF 1f if lfff 1fltlf 1f 1f !f lfif ikif fllf ff !f iE 1E1F !E !E 1f 7f 1f fEfE
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LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 6.50
252 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 6,50 15,00 0.00 21,50 21.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 21.50 OVER/SHORT: .00
�T��1�3 �i93` fli,UM�gTN�3 ELECTRIC MECHANZC FIAE SMIP/TOT GRADING PLAN-CHECR
21,5�
1k it if if if i! if ft iF it if if it 1E i! it M 1f M ff k it it �k 1t k it it iE iE fE iE 7f if if iE 1E iE 1E iElE %�E M M it iE fE iF iF iE 1F iE iE ff 1f iE if iE if i! iE if ff iElf iE iF if iE iF if iE iE %if if iE �E
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
MEC 1 FACTORY FIREPLACE 6.50 6.50
END OF FEES
" QO':,'-.,,_�1r,,y3��I 'e oa �,' :1.5�'
fiPTe='ui%�::r�:�� �iIrIE; 14:59
I CONSTRUCTION A11D PLANNING
i
� APPROVALS Permii -.=
I 1. Temporary Electncal $ervice o� Poie
' � So�i Pipe�U�drqrnd.
3. Eiec'.'ri,oa'�Conc�uit`t7nlity�Undrgmd.
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';� , lO.Sructural Flaor System
Datc
--h� �L 2L SVI�
Inspector I Z�p�OVALS Per.�rc �.-_
52. ?uoi & Equ:pment Lor?�on
- i - - -,
OatP I Insp_r.t;�:
� 53. Stael 4;einforce-^rr,t � I � .
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54. Forms I 1 �
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_' iS Preperty Se�vr.'_Sn� R� House Conrec.^.on
. � 1 Z. Sr :�er Cap
✓ __ �
, ' �3. Roof Dra,n,
r_____-_-_ _
14. Pau�h Plumt,�ng
�� 15. Rough E.octrlwl-Cortl�rt "
I
i6. RoughEiectrclN+nnq
17. Ro,:3ti l'1�,•��g S�gn
� 78 Ro�gh Eleetricil�T R.�� Cei;.rq
9 �u..jhHc.t��,�R,A,('.�Btc^�-�g _-_
�2P. Rouyh Factory Firep'sce
�- ^ - -
' 27.,DuCs.inSn�.ctu-: '
22. Durts, Ventil,tti6q _
� 2J.Ge��.P�Pe�R��7n$.T�.;t .
24. Rwf Framinp � ! --
'S. ,.,��' Sh.�.,. .
26. '�Sir Ce�'�nq ;Str;,�:c. �,ii 3� 'J�c.�.oco,it..
27 r;;.•...c zru F�[.�^,•.7 __ _
I �2&. l.athing8:5,d�ng . , .. .
r
i .
�'7.9 I��a�:a!in---- I i 7;i �- . Rt'! �' --- -- --� -- ' -
� .37_J � � p:��-r`., --- --_---- - I -TI- --IiFO,LT`i10L1�-..-. REQUIRE�:i[1-'i-. .
� -. .� ..� Li�o .r C...' ---�-- ---�- � '� _.. . .:`"_..� h, . • _ -__
- - - - - - - -'- --- -1--�- ` �� - - - ' - �
i3? ��ec �-._.C�� P��_e lr., . F� .,.I __- � _ � 1�'' 90i f G:..� C�r� . � .. IS_� l "_.____ __ �L .
�' 3��5. F:n�; �'2C1' ' ' . � � � . � �iJt:S. . _
�,34. F�n�i He3t�Cg St A�r L,.,:�i;t�onmy -� 2;-- _ • � ,,��
f•�,�- --.-�_.x: ----- - -� �-I- � -c��. rZ'-�:� ----�%�G'G1 -�U2_tF?'JL�/Zrr'��t`-�� ..
, 3�.F�-aIGasP�p<-�.;�2 __� y . IS'Z�%¢"-�-- --r�4-i.�c'L- („�f� �--
f-_. _ _ __ __ __-. _ _�__ ' _
� 3� � -.*�d Or Car.' p � . • �i j - ��� .
?i�.alFar.tc�c T -•-�-"- -- -_-I--��-�t--- --�- -- - -- - ,- --
_- - _ �S_�-`�� --- -- - -
3e. ,_ , ; a.,:me,.., .
�3. Cic�t9r Scn�icc-Fi�,cl
� 40. Gas Sert•ico-Fna! .
� - --
� 41. Sola� Domest o-F�c;i
. t.i. 3.ccYa:: Prcrontc: . --___-_
I� _ �- _ _ �
�3. Bac:at!ow Inmat'o� ' -^
•'.t. _� osc:.Rc IN tat:o�. 5�: at� �
!,_ °�und At[anoancr. _ '-
...:E F'�nd'caoRcy�latiqr,
� 47,FIkALSTRUCTUR[iLBWLDING
, ,
-- ---�---- � �-�-- ' ------ ---- ---'i
-._
-- "-� ' --- ---'`-` --' -= - --- - -
- - �-- ---
I
._�__ -� -�L
' �$. F;��AL'LN1\d!I\G
� �9. Etactric Release to �d�son
i -
I EC. Ga; Release m Sou:he�n Ca��i`o�n�a Gas
51. CERTIPICATE OF. OCCUPANCY
\�o. _ �ate
n
�---- - ` ---- -
I � t
-I.-_.�� � ,_ - ..
�----) �--•--- •
--�---
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�
PFOJECTp00FES5: ��U� T`(���"`•s � • vr• UNIT: 4
owNen s Name: HARB INGER HOMES
aooxEss: 375 PROMONTORY DR WEST
N,B., CA
675-6653
ABCHIENGINEEfl: WZ LK I NSON � P.S�'J�C AEG.NO.: C(3p (3
AODPE55: l$OOi SKYPARK CI S��
IRVINE CA 92714
PEFMITTEE: HARBINGER HOMES ( 719 ) 675-6653
ADOPESS: j']S PROMENTORY DR WEST
NEWPORT BEACH CA 92660
IICENSEU CONTXRCTOB OECLAPATIDN: I �ere6y aifirm �hat I am licensed untler D�ovisions of C�apter 9(commencing wi�� Sectian
7000� ol �Ivisian 3 oi IDe Business an� Pmlessinns f.nAe. antl my 6cense is in lull torce antl effect.
ClW2fL^..1 STqTE LIC.: ClASS:
at Signalure:
NS' COMPENSpTION DECLAPATION: I hereby aftirm Ihat I have a cetlilicate ot con5en� to seli�insure or a ceriificate of Workers'
ompensaiion Insurance, or a cetldieA copY ��ereol (Seciion 3800. Lab. C�.
POLICY NO.: E%P. �RTE:
COMPANY:
� Cenihetl capy is hereby furnishee. ❑ Ceni�ied coDY is �iled with the cily BuilOing �ivision.
Daie'. Applicam:
E FflOM WOBREBS' COMPENSATION DECLANpTION: (This seciion ne n0i be tOmpl¢tetl itthe permit i5 forone hunOred ($100) or les5)
cetlily I�a in Ihe periormance ol Ihe work lor which this permi� is i e41 hall not empl y Derson in any manner so as lo become
sub�ect Io e Wohers' Compensalion Laws of Calitomia.
�6a�e: � � S� SignaWre:
ICE: II. aner making �his declara�ion. you should become sublect lo Ihe Workers' Compensaiion Dmvisions oi Ihe Labor
ode. you musi forthwi�h comply with such pmvisions ar Ihis permit shall Ue tleemetl revoked.
CONSTNUCTION LENUING RGENCY: I �ereby aliirm ��ai Ihere i5 a tonstmtlion lentling agenty for ��e p¢dormanCe Oi lhe work lor
which (his permit is i=sue0 (Se[lion 3097. Civ. C).
LENDEfl:
AO�PESS:
OWNEN BUILOEP DECLAFATION: I hereDy al�irm Ihal I am exempt hom Ihe ConVac�ors' S�aie License Law �or Ihe �ollowing reason
(Section 7037.5 Business an0 Pm�essianal Catle'. Nny city o� coumy which requires a permit m constmct, aller, improve, demolish, or
repair any slmc�ure. prior ta its issuance, also requires �he apDlican� lor such permit �o tile a signed Slalement �hat �elshe is licensee
pursuam ta Ihe pmvisions oi ihe Contracmrs' Slaie License Law �Chap�er 9(commencing wi�h Section 7000) oi Oivision 3 0l lhe 6usiness
anU Pmtessions Coae) or �ha� he/she is exempi Ihere�mm an0 �he basis lor I�e allegetl exemp�ion. Fny viola�ion o� Seciion 703L5 by
�� any apDlicani br a permit suhlecis I�e apDlicant �o a civil penalty o� not more Ihan �ive huntlretl Oollars (85011).
I, as owner oi ihe proDeny or my employees wilh wages as �heir sole compensation, will tlo ihe work, an0 ihe
❑ slmciure is noi mientletl or olfere0lor sale (Section 70G4. Business antl Pmtessional Cotle: The ConVac�ors' S�ate License Law
does not apply to an awner ol a pmperty who builtls or impmves Ihereon, and w�o tloes such wo�k �imsell/hersel� or t�mugh
�is or Aer own employees, pmvitletl t�ai such improvemems are nol inlen0etl or offerea �or sale. II, however Ihe builtlmg or
improvemen� is sold within one year o� campletion, the owner will have the burtlen o� pmving �e/she Oid not build or impmve
for Ihe purpose o� sale�.
I,as ownerofihe propetly.am exclusively conirac�ing withlicensetl conlrac�orsio constmct�he prolec��Seciian 7044, Business
� antl Pmtessions Coae: The Coniraclors' Slaie License Law Ooes not appty �o an owner of propeny who �uiltls or impmves thereon
and wAo conlracls �ar such pmjeds wilh a conirac�or(s)license pursuan�lo �he Contractors' Stale License Law),I am aware
Iha� pmof ol �heir Worker's ComDensalion msurance should 6e pwvitletl �o me.
I am exempl untler Seclion: B. 8 P. C. /�
or Ihis reaso � ' � � _ / /
i
Oa�e' Owner: �'�Inw�J\
o here0y cenity �ha� I am aware ol antl unders�antl Ihe reQuirements of Calilomia Heal�h and Satery Code Sections 25505, 25533, and
25534 antl �hat I ar any W�ure building occu0ani willlwtll nol (circle one) neetl lo comply with saitl s�aie coaes ana the reQmrements for a
permit lor consimclian or mo4ificaiion Imm Ihe Fir Oualiry Management �isiricL Residen�ial cons�mction applicaiions are exem0� ��om
I�CS¢ P�Ovi5i0n5
oate'. Apo�icanl
I nereby cerlityihal I have reatl Ihis applicaiion ane sta�e�hatthe above m�armalion is orre� comPly wi�� all ci�Y an0 counry
ordi ncesantls�atelawsrelalinglobuilAingconsimc�ionandhere�yaWharizerepresent vesolthisci enleruponiheabove�mentioned
oper orinspection purposei �
r
Oaie: � � � � � Signalure:
� s �icense or Socia� Securiry n:
t64L46 Wlme—Butltling: Green—Cotle Enlorcemenf, Canary—Applicanf, Plnk—Revenue; Goltlenwtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 06583
PERMIT NO: M 065831 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: NEW
JOB DESCRIPTZON : 1464SF 1ST FL, 11135F 2ND FL, 425SF GARA SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 !M-1
COMMENTS: REF: 65013
+�*+ei�***ir�rx��r*x�**�r�ie�t+r*+t+��c-+�-�*x�+rx��ri��-***+�*+�+r*�rx�****+tx��-*****�t****x�**+��r*�tr***�****�trt*
Z O N I N G R E Q 0 I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN AGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 11913319 ZNE: REF NO:
PLANNING NOTES>
>
+tx+t�t�t�ti�***�t+t*+t�r�t*�t+�x*i�i�*x-rx��r�****�t+�+t�*+t�r*ir***x�ir*+t+t�t*+�*+r*i�*��r***�t�t***********��x-**
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:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: G(\
fE1E1EilMif�flFifiEiFiEiEiEiEltiEiflElfiEif3F3FiF�F7F7FiF'7FiF F�iF3F�3FiF7fTF3f�F��lE�EfEiE1EiElfihiFiE jEi(-
iEiEifififikikiEitiPiEifiEifiEiliE�EiEiEiE�EiEitiFifitiE�EitifitititifiEjfifiElhifiFiFiElEiEiFiEiF3EitififiFiEiFifiFlEifil3fiEif�lFifiEiFif 3EitifififiEiEiEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 14.00
25t SMIP/NON—RES
PLAN
ISSUE FEE � 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 14.00 15.00 0.00 29�,-$Q\ 29.00 ,00
REVENUE DIVISION TOTALS--> COLLEQTED: 9.00 f�VER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FI �/TOT GRADING PLAN—CHECK
29.00
jE ff jE iE iE iE iF iE iE iE iE iE iE IF it iE iF iE iE if it ff iE iE iE it if 3f iE if iE 1E it iE iE if iE iE iElE M iE if if iF If ±F iE iE iE 1E iF ik i! ik iE �E 3E if iF iE �F �E iF IF IE i: �E iF IE if it iE iF if if if iE j4
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 , ONZT COST TOTAL COST
MEC 1 INST FORC—AIR/GRAV FURN > 100 K BTU
MEC 1 GAS PIPING SYS 1— 4 OUTLETS
END OF FEES
t
11,00 11,00
3.00 3.00
ul OO1S43`0-Q01543�0 T�? T 29.OD
��TE: �]1; %ni?4 T?tiE: 18:U4
_�
CONSTRUCTION AND PLANNI�G
. APPROVALS Permit 1r` '
i. Tempnrary Elecincal Serviw or Pole
2, Sod Pipe�Undrgrnd.
3 Eizc!rical Corwuit Utlity�Undrgrnd.
i 4. E�ectr,cat Condurt�Und�g�nd.
�----=-
' 5 s..��� a�:�Fcrc:mrnt
8. � ec�...e.:' JFER Gmd.
i - ----
?. i-ocUngs
,_ 6. Fouocetlo�,
'.! � y. 1�eatr P�pa�Untlrgmd. '�,
� .t---- - ,.
�' 10. S:�.ctu-a� Fioor SVstem '..
1�-
. 7S. �r�pc�cy Ser:er Lio� & NouseConnection�..
_.
�r 72. Sewer Cap
� 13. Huof prains �'��
r-- - 4 - - . .. ... _.. _
i 14. Po�c�� .m.i��n�
��5 G��o� �.,=.c!;�cal-Condu,t
���. ':la�..yr �r.:CbiG:�'ifin9
�7. Roo�'�::YnngS=gn -
�18. Ruunh t�ectdcabT Bar Ce�lmg
�9 ft��aF Nedrir,g & .4�r Co�•di;iening
2C. 3-� .-. ra�'ary F��ei,lace
7� D�Cs, �n Strtrctu�C
22. U..:��,\�Enti�,itmc� _
23. Ga. ?ipe-Ro�.gh E: Test �
�24. 9au� Frming �
25 Sn.� ea;hing
I2E ; � � C�'�ng �SVur,u�all �:;�1c^ocaat
r21. � :;,-.c ar! F!sshln9 --- -
�' ------- -
; � a �...ri, ,� � sr�i��g
� i i. . : u;�'.nr .._�
� 30 '• l��.a � ? �.L�c
r--- --
IS1. ?ia e� �.��::o:pz.t .
I 32. c'ef."�G. PC:'iC �1P[f'�Fir.d� - _
� 33 �in,l El��ctne
�
� .--- - --
i 5�.. � �al H':ating & pir Cordi[io�ing
� -.� _
35 �� '.�' G: � P�pe�Te;t J-
3u. No,U �� Ca�OPv --
37. �, ai F;,ctory Fvepiate �
'8 Fino' i'I���n6in�
39 \Vater �ervice��inal �
CC. Gns Sen��ce�F�nal
�_--
� �,i. Ss'ar Co.r,:st�oF�na:
- . Eac'.'�o:� �'ecantcr -_ .
�_ ___
��3. Baci.flo . �r;lgation �
a�! Lantlsc�.Ge !rriqauon SVs[em �
d5. So.:��,: � ttenuation
45. F!:^c'� z^ Reo�latio�s
r-___-__- -
47. Fl:c,�.:. S?RUCTURE R� EUILDI�iG
4E rIiZF\LP!_Af\NING _
49. EIeC; ic Rr,,ease to Edison
50 Ga� !?eiease to Southem Cali;o�nia Gas Q
51. CERTIFiCATE OF OCCU?P�i�CY
Date
Date
PO� t5 SPA
Inspector APPROVALS Permit,�
52. Pool & Equipment Location
53. 9tool fte��forceme�t
• 54. f-orms
55. Electrical Bondmg
56. Roc4h Plum.�ing & Prassure Test
57. APPROVALTOCOVER�GUMTE
58. Electrica! Condu�i�Ur.drgrnd.
59. Gas P�pe, C'i Undrgmd., Test
I 60. E?davash Lines, P-Trzp, �! U��drgrnd
i 61. APPROVAL TO DECK
62. 6aek�vash & Ree�ptor-F�nai
63. Hcater & Veni-Fm�l
64. Plumbing Systern - Fir�ai
� 65. Eiectrical-Final
66. Solar SVstem�Fr„!
67. f-enun9 & Attecs Appr�val
68. APPROVE6 FOfl PLASTEFING
G9. POOL(SPA SYSTENIS F WAL
_� F�fiE DEPT. REQUIREMENT`
1'
I AI'PRilVAl5 Pcrmrt ;r
� 70. Unde:giJu,^� F;�;Urc
I
.� 71. Prod�ct P�p:n; �: G.�, i. O��
; 72. UnUcrground Flu;h i
I
n
Date � Inspector
�
_� , � 73. Underamd.Stor�ve�Tan4C;Ge�s ❑0�. i 1� ,
-- --Y--- -�--,
.��--� 74. O.<rh¢ao Hvr'n � I
--i'--��I .�.----- --;----- -`----�-
- - I _,�_C'�em�ca' -- ------� �--- -----
- �� - -��- 7f. :rt Stz�cr .c , i '
--1--'^-- - - -------
� 77. FIXED SYSTtP'pF�R'AL - I--_--
-� � . .. �-----'-----_ - _a
I � 76. F!RE PREV. Fin.,;t
I _ _� I
� i -----N�t�,i.74 ��PT. RFQUIaEf._�. �i �
--'-�-'--i ---- . �.,• .._ -�- -- - - - --- -- �
, ]t'. r: �.H�_ . ,-l�. I.. . � ,
"' -_r_�__.- " .- _-'"' __ _ __'______ r" ..-i . _ .
�, �8G �: UGD GE7 -i'" I:'.-,�i � '�.SSLED � � - .
- - -- ------ - - ._ .�.- - -�--
'-�--- '-- - - - �' - .
' � i��otex: �
��¢+_ �3/, ��_�._ -----r -- ----� ':
� �� l" r-¢ -��i-u?s�Y�c-� - .��s�r ' ,,,-�
!
� _ .,
--- fi?J�� �i=� - rr-„-,;4� G�
._-'_�.�-1-T:�?S=-L�.. ___.�.!%�LA�-�_��� _._ __' ..
____--�__ _ _ __ _. __-_ _ __ 1
.,:ity of Costa Mesa
California 92628-1200 P.O.Box 1200
Insulation Certificate
23 Z3 SAaTcI Pvs A��� �i 1��T '�' Permit Number � O�� O I 3
i28o Q a� ic. _� c�,Je C d s'rrf M�iW
Number antl Sireet City
AOOF
Material
Thickness (inches)
EXTERIOR WALL
Material _
Thickness (inches)
A
BATT
�4 Is
� Subdivision
Description of installation
Brand Name
,Thermal Resistartce (R-Value)
Lat Number
Brand Name �NVILLE
Thermal Resistance (R-Value) _
CEILING
Batt or Blanket T e BATT Brand Name �1VILLE
Thickness (inches)P 11�� Thermal Resistance (R-Value) R-30
Loose Fill 7ype N�A Brand Name N/A
Contractor's minimum installed weight/ft2_ Ib. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Fiesistance (R-Value)
RAISED FLOOp
Material
Thickness (inches)
SLAB FLOOR
Material
Thickness (inches)
Width (inches) —
FOUNDATION WALL
Material
Thickness (inches)
n
A
N/A
Brand Name
Thermal Resistance (R-Value)
Brand Name
Thermal Resistance (R-Value)
Brand Name
Thermal Resistance (R-Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Adminstrative Code.
' SignaYure and Ti�le .
SNSULATZON, INC.
tContracmr (Insulation Installer)
,/YzE&AHllCTION MANAGER
�f Signature anG Titla
190]A6
6�33v�
License Number
31 �Y/y4
Date
481278
License Number
03/24/94
Date
FI\'AL GRAI`�ING CERTIFICATIO�\
Project Address: 280 Pacific Crest .Drive
Lot i�umber: #4 of Tract No. 14815
Permit �umber: pi 04,So�3
By Civil Eneineer.
I cenify to the sztisfzctory completion of grading in accordznce u•ith the appro��ed plans,
specifications, local and state codes. Ail draina�e devices required b}� the grading permit,
grading plan and erzdin� ordinance ha��e been instzlled. Adequate pro��isions ha�e been made
for drainaee ef surface �t•ater from each building site.
The n;ini;nums �re:
2�. F�il from s:ructures within 5 feet frem exterior Halls.
1� Fell for as.hah sur,�ces and landsczped areu.
0.� � Fa'.l t`er co�cre:: sur`2c:5 IO 2}'�rr0\'2d C'�1_rOS2I 2,-:�c.
Tf: finzl �TiOf:�_S:�ii;c gc sho�,;�n on t`� reco,-eed tract mzp �.�:r: s:i. ,A?1 finc� =f2C'�I:io e;e��a-
tions zre aithin — 1%10 oi t`e de iened ele��tions.
Supervising Ci�i1 En�in:er Ree. No. 31720
� . (Si_n-;cre)
p�;P 4/20/94
/�ROFESS/��
� � �\N 8. Hq '�1��
F�
� � N . N Z
w� f�C 20 R'
m
* E �, 6 �
`n>'y CIVII. ��Q'
\�F CAUE��
. :-s.__f:-�;;.. � . .. .. � C^��.Tv a,,.a c1r.,
PPOJE`aooq[ss: 280 PACIFIC CREST DR uxit: ''
owNdnseame: xARBINGER AOMES
aooness: 375 PROMONTORY DR WEST
N.B.
714) 675-6653
FflCNIENGMEEN: flEC.NO.: .
nooxess: uxiT:
PEXMITTEE: BAC LANDSCAF+ING INC, (719)851-1171
AOOHESS: 26(jl RICTHER AV 124
IR CA 92714
ULENSEO CONTFACTON OECLAHATION: I hereby alfirm ��a� I am licensetl untler provisions of CAap�e� 9(commencing wi�h Sec�ion
7000� o� Division 3 of the Bvsiness and Pmiessions Code, antl my license is in WII lorce ct.
��}'"'j'�' 055990 sraTeuc.:q11966 cuss:
f0ate� y— ze> � y 5�a�a���e: ��
b,�NEBS' LOMPENSPTION DELLABRTION: I here t�at I haue a cenilicate of consent to selbinsure or a certifiwte oi Workers'
Campensation Insurance, or a ceniliea coDY �� ection 3800. LaG. C�.
voucrNo.: 1079938 EXP.�ATE: O�%/ZS/99
carnradr: FARMERS INS
� Ceniliea copy is hereby fumishetl. �}t CertilieG copy i5 lile I �e ci N �on.
ojie: � Z G—' /� Y Ap0licanL �
�%EMPTION FNOM WOBKEPS' fAMPENSRTION DELUM : Qhis 5eciion nee0 nol be completetl i� ihe permil i51or on unAreO (5100) or less�.
I cetlify Ihat in t�e pertormance ol ��e work lo� which is permi� is is5ue0. 15hall nol em0loy any Dersan in any manner so a5 io Eecome
suDiect lo Ine workers' Compensalion Laws of Calitornia.
Uaie: Signawre:
NO710E: II. aiter making Ihis Eeclaraiion. you shoul0 become sublect to t�e Wo�ers Compensation O�ovisions ol tAe La�or
Cade. you musi �aM1hvnth comply wii� su[� D�ovisions or I�is permit slull Ce GeemeG revok¢d.
CONSTflUtTION LENOING RGENCY: I hereCy allirm ��ai t�¢re i5 a tonSlruciion lentlinp agenty lor lhe petlarmance Of t�e wark �or
wnicA Ihis Oermii is fssuetl (Sedion 3W7. Gv. C).
LENOEP:
ADONESS:
OWNEN BUIL�EP OECLABATION: I �ereby ailirm �hatl am exempllmm Ihe Canlractors' State License Law forihe following reason
�Section 703L5 Business antl Pro�essional CoOe: Any city oi counly w�ic� reQuires a permil Io constmcl, atler, improve, demolish, or
repair any stmcNre. prior to its issuance. also requires the applicanl for such permit to Iile a signe0 slatemem thai he/she is licensea
pursuam to �he pmvisions ot the Coniractors' Slate LicenSe Law (C�apl¢r 9(Commencing wiih SeCtion 7000) o� DiviSion 3 ot �he 9USine55
anA Pmfe55i0n5 COtle) o� Ihai he/She is ¢d¢mp� IAeretmm anU Ih¢ Uasis lor ��¢ alleOeA e�emp�i0n. Fny vi01ati0n o� SettiOn 7031.5 by
any applican� lor a Oermit Sublect5 i�e apDlicani to a civil penalry al no� more I�an �ive �untlreE tlollars (5500�.
1. as owner of ihe propeny or my employees with waAes as Iheir soie tompensation, will Eo ihe work, and the
❑ simaure is not imen0etl or onerea for sale �Section 70aa. Business antl Pmlessianal Coae: T�e Coniractors' State �icense Law
Uoes not aD01y to an owner of a prop¢tlY'nTo Euilas or improves iherton, an0 who Ooes suc� wark tlimsell/�erselt or throup�
�i5 or her own employees. provitle0 �ha� SUth impmv¢ments are n0i inlenOeA ar OHereU br Sale. Ii, �Oweve� ihe builUinq or
impmvemen� is sold wi�hin one year oi complelion, �he owner will have Ihe hur0en of pmvinA �e/she Uitl not build or imOrove
lor �he purpose a� sale�.
I, as owneroft�e pwpeny,am exclusively coniractinp withlicensetl coniractorsto consimctthe pmlect(Section 7044, Business
❑ and PrOtessions Cotle: IDe Contratlors' Siate LitenSe Law tices not apply Io an Owner o� pmperty w1�0 GmIaS Of improv¢S �h¢re0n
an0 who coniracts for suc� pmle��5 wi�� a contracior�s) license OurSuani lo Ihe Contra[tors' State License Law�. I am aware
' Ihal 0��� of their Workei 5 Comp¢nsation iniuranre S�oNA �e pwvitleG to me.
� I am exemp� unEer Sec�ion: B. 8 P. C.
lOr �his teason:
Daie: Ovmec
I Eo hereGy cetlity ��at I am aware ot ana unUerslanA Ihe requirtmenis ol Califomia MeaIIA and Safery CoOe $ec�ions 2
255Jd ane Iha� I or any future builtling occupant will/will no� (circle one) neeG 10 com0ly vn�h saia state coGes an0 i�e r
permil for con5imdion or modAication Imm Ihe Air Ouah�y Management �isirit�, qesitlential constmclion applications
Ihese pmvisions.
�ale'. AOPlicanC
Gy ceriily tha� I �ave reatlthis appliCation an� Slate Ihai I�e a�ov ' rmalionis
mcesandsia�elavrsrelannglobuilGingconslmc�ionandhere ih erepresent
r�y lo� inspec�ion purposes.
L% � — �� Signalure:
's License or Social Security n:
I6EL46 Wbi�e—Bulltlingl
5505, 25533, anE
equiremenis for a
are exempt imm
�Ty wth all ciiy an0 counly
upan�hea0ove�mentioned
Pink—Revenue; GOIEenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 06695
PERMIT NO: B 066952 PLAN CHECK NO: 01473-94 S GOVT: N SUPP: N
CONSTRUCTION TYPE: V-5 PERMIT TYPE: STR PURPOSE; NEW
JOB DESCRIPTION : CONSTRUCT 182SF OPEN TRELLIS PATZO SQ FT; 182
CLAIM VALUE: 1,500.00 CALC—VALUE: 2,693.60 GROUP OCC: R-3 /
COMMENTS: PERMITS TO COVER THE CONSTRUCTIONOF 1825F OPEN TRELLIS PATIO
x+�x-�r*�r***x�*********�r�r**�****+r*******+��r*�****�c**s****+��-*+�*************+�+r�r*�***+t*
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: 7 FT IN FRNT: FT IN REAA; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 11913319 ZNE: R1 REF NO: PA9420
PLANNING NOTES> LATTICE PATIO COVER, FOST SETBACK 7' FROM PROPERTY LINE, OVE
> RHANG TO WITHIN 6'
*�r*�r*rt*�*+rx��********�r********x-�rx�*x�**�r*�r****x��r***********x�******+�***�r***+�*�r�tir***
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
ZONING APPROVED BY �rSAT DATE: 2� �
BUILDING APPROVED BY : �'//�t DATE: 2� � G_
APPLICATION ISSUED BY: � DATE: 2� �? �
iE 1f iE iE i: if iE iE 1f IF iE iF iF iE iF iE If fE if if iF iE�iF��3F7�3Z�iF'iF'�f TF�Tf� if�iF�fiF�FiF �F�f3F�YTE7F iE jE i4 �1E iF iF ic if� iE iF . iE l.
iF IF *�f If if �E �E 9E 1E If if iF {F iF K iE aF aE iF iE iE iE if #k iF if 7F iF iF iE K if iF aE iE 1f x iF iF iF if iF aE if �E 9f if iElE iF if iF iF if iF ii # jf iE jE iE if if �f iE iE iF if �F IE 1E iF if iE iE iF aE if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 ,50
PLAN 35.10 SMIP/NON—RES
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 59,50 0,00 35.10 89.60 89,60 .00
REVENUE DIVISION TOTALS--> COLLECTED: 89.60 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK
54,00 .50 35.10
1E fF 1E iE iE if ff iE iF iF iF it if if iE iE iF if iE if iE iE K iE 3F iF iF iF M iE 1F iE 1F iE �E fE if if iE iE iE if iF 1f ff IE fF iE iFlE IE ff 9E 1E if iE if iE iF if iE iE if if iF iE iE fF �F iF �f iE �E iE 9f iE iF if iE
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 182 RES—PATIO COVER—POST 5 TRELLIS 14.80 2,693.60
END OF FEES
DI 0�359543—�D159`45 T GT 39.60
DATE: 04/?bJ94 TIME: 11:3?
�
�-
CONSTRUCTION AND PLANNING POO. SPA
♦
qPPROVALS Permit #� Oate laspector qppROVALS Permit # Oate Inspector
1. 7emporary Electrical Service o� Pole 52. Pool & Equipmen[ Location �
2. Soil Pipe�Undrgrnd. - 53. Steel Reintorcement
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Eiectrical Conduft-Undrqrnd. � 55. Electricaf Bonding
5. 5�ee1 Reinforcement 56. Rough Plumbing & Pressure Tesc
6. �Iectricai UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings yz�l,'Le�lf��,��( 58. ElectricalConduit�Undrgrnd.
8. �ountlation � 59. Gas Pipe. O Undrgmd., Test '
9. Water Pipe�Undrgrod, 60. Backwash Lines, P�Trap, C Undrgrnd.
10. Structurai Floor System . 67. APPROVAL TO DECK
17, property Sewer �ine & House Conner•ion 62. Backpyash & Receptor-Final �
12. Sewer Cap 63. Heater & Vent�Final
13. Fioof Drains '' 64. PIurY�bing System � Final
14, flough Plumbing � 65. Electrical-Final �
75. Rough Elec!riral�Conduit 66. Solar SYstem•Final
16. Rough Efectric Wiring 67. Fencing & Access ApProval
/7, qough Wiring Sign 68. APPROVED FOR PLASTERING
78. Rou9h Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19, pough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory �ireplace - APPROVALS Permit #
21. Quccs, in Structure � 70. Underground Hydro
22. Duas, Ventiiatin4 ' 77. Product Piping O Gas Q Oil
23. Gas Pipe�Ro�gh & Test 72. Underground Flush
24. Roof Framin5 � • ' 73. Undergrnd.StorayeTank OGas ❑Oil
25. floof Sheathing � 74. Overhead Hydro
26. T�Bar Ceiling (Structuraq & Monocoat 75. DryChemical ' .
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEhA FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. D�Ywail Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ' 79. PINAL INSPECTION
32. E�ectrical Po�vzr hlecerFi�a1 80. FOOD CERTIFICATE ISSUEO
33. Final Electric , - Notes:
34. Pinai Heating & Air Cond�tioning '� .
35. F�nal Gas Pipe-Test � � ,
36. Hood or Canopy
37. Final Faaory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service�Finai
41. Solar pomestic-Final
42. Backflow Preventer . •
43. Backflow frrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & 9UILDING l.lZ _g:y ��,/
LT
48. FINAL PLANNING
49. Electric Release to Edison �•, .
50. Gas Release to Southem California Gas Ca '-
51. CERTIFICATE OF OCCUPANCY (
No. Dace -� " I
1-Y� i�AL G��EN i��T TICt�
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D@ER08 CT PlAN4lt7G I
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j
PHOJECTROOflE55: 2$O PACIFIC CREST DR
owxexsxnMe: HARBINGER HOMES
nooeess: 200 PACIFIC CREST
C.M: ''
Ct: 92626
UNIT:
AflCM/ENGINEEH: BERNARD ��i%'iJ�' AEG.NO.: C—LOZA.3
AOOPESS: 11OZ1 ACACIA PKWY uNit: E
G.G. CA 92640
PEflMITTEE: C & C� PO�JLS ( 909 ) 242-7665
aooncss: 11360 CARRIE LN
MORENO VALLEY CA 92555
UCENSEO CONTNACTOB OECIAflATION: I hereby allirm tha� I am licensea untler pmvisions ol Chapter 9(commencing wit� Seclion
7000) ol �rvision 3 0l Ihe Business an0 Pmiessions Cotle. antl my lirense is in �uli �orce anJ eifeci.
cirv ic.: [.sTaTeuc.:347;i � ,cuyts: C-53
alc. � ��� I Signatu ' ���u�1..R�J
W Efl5' COMPENSATION OECLAflFTION: I here�y a�hrm ��at I have a ce�ificale o� conseni to self-insure or a ce�i�icaie ol WorNers'
omvensation Insurance. or a cetlilietl copy Ihereol (Section 3800. Lab. C�.
POLICY NO.: ' E%P. OATE:
COMPPNY:
❑ Cetlilietl copy is �ereby �umi5he0. ❑ Ceniliea copy is liletl with ihe ciry Building Oivision.
�aie: Npplicani:
EXEMPTION FflOM WOPREBS' COMFENSFTION OECLABRTION: Qhis seciion nee0 noi be compleietl i� I�e permit i5 �or One huntlr¢tl (E700) or les5).
I certif Ihat in Ne perloimance o� Ihe work for whic� this permii is issueQ I shall not employ any person in any manner 5o as lo become
su o l'.n{e Workers' Compensati Laws ol Calilom(ia�.(�`
a�e� J� �S� Signaturq � �L -� .� � �
NDTICE: II. a�ier making Ihis tleclaration. you Shoul�Beco e sublect Io Ne Wo�kers' Compensation pmvisions o� IAe Labo�
Coae. yau mu511or1�wiU comply with such provisions or Ihis permi� shall be Oeemetl revoketl.
CONSTBOC710N LENDINC AGENCY: I hereby a��irm t�ai there is a wnstruction IenOing agency br ��e pedormance ol I�e work for
whic� I�i3 Permit is i5sue0 (Section �097. Civ. C�.
LENOEfl:
FDOflESS:
OWNEfl BUILDEB OECIABATION: I �er¢Oy affirm Uut I am ezempt imm ��e fqntratlors' Slaie License Law br ��e tollovring reason
(Sec�ion 7031.5 Business and Pmlessi0nal Coae: Any ci�y o� counry which requires a permit �o wns�mci, alter, impmve, tlemoliSR or
reDair any 9mcwie. prior to ils issuance, also reQuires Ihe apDlicani br such permit �o tile a 5igneU statemen� iha� he/s�e i5licen5e0
pur5uantloi�e D�ovisions olihe Conlrac�ors'Slaie license Law(Chapier 9�commencing wi�� $ection 7000)0l Uivision 3 afthe Business
antl Pmlessians Code) or Itwl he/she is eeemp� therelmm an0 ��e basis for ��e allegeA exemD�ion. Any violaiion ot S¢ction 7031.5 6y
any applrtant �or a Oermil suCle��s ihe appliwntto a civil penalty o� noi more lhan �ive hunAr¢d tlollars (5500).
I, as owner ol iAe pwpetlY or my emyioyees wi�� wages as t�eir sole compensation, will tlo t�e work, anA the
I❑ slmciure is nol imenAeU or al�ereU lor sale (Sec�ion 70a4. Business antl Pmlessional Cotle: The Canlraciors' S�aie License Law
Uoes noi applY �o an awne� oi a DmDer1Y wfq builtls or im0�ove5 thereon, antl who JoeS such waM1 himsel�/hers¢I� Or I�mugh
�i5 or �ei own ¢mploy¢es. O��4e0 ��at suc� impmvemenis are not inlentleE ar oifered �or sale. II, however t�e builEinq or
impmvemenl is soltl wilhin one year oi compleiion. the owner vrill have t�e Ourtlen o� Dmving hpJs�e tliU no� OuiIG or imprwe
lar t�e Durpose of sale�.
1. as awn¢r ol �he pm0eriy, am excNsively conlrac�ing wit� licensetl conira[�ors to tonsirucl lhe pmlec� (Seclion 7044, Business
❑ anG Proleuions CoOe: The ConVacmrs' Siate License Law Coes not apDN �o an owner o� pmpeM w�o Uuilas or imD«s lhereon
an0 w�o wntracis br such pmle��s wit� a wnvacim�s) license pursuam to �he Cantractors' Staie LitenSe Law�. I am aware
��� O�oof al Iheir Worker'S CamOensation insurance 5twu10 be proviGetl to me.
� I am exempi under Senion: B. 8 P. C.
br I�is reason�.
Oare: Ownec
I tlo hereby cen0y Inat I am aware ol an0 uneerslana Ine requiremenis of Califomia Heallh anU Salely CoOe Sections 25505, 25537, antl
2553A antl ��at I or any IUWre building occupant will/will na� (circle one� neee to comply with saitl s�a�e cotles and Ihe requiremenis for a
Dermn tor consimclion or moaiticaiion imm Ihe,Air Oualiry Managemen� DislricL Fesidential cons�mction applica�ions are exemp� imm
III¢SC pf0VI5i0115.
�ale: ApPlican�'.
�
I Mreby cetlily t�at I have reaa Ihis applicalion and Sla�e ��allhe a�ave informalion is correci. I agr¢e Io comply wil� a0 ci�y an0 counry
orainancesantlstalelawsrelatinglobuiltlmgconslmpionandhpiepyaN��resenqert_pso�Wsulyloenterupon�heahove� enlione0
pmoeny lo� insoection purposes. �1' 1 y� ' �
a, 3--�"��L s�9�.���e � U c .
�rivefs License ar Sotial 5¢tunty N: % -
�\� 164P46 W�ile—Butl�ing', Green—Code Enlarcemem: Canary—Applicant: Pink—Revenue; Goltlenrotl—Assessor
_�
CITY OF COSTA MESA — HUILDZNG PERMIT PERM NO: B 06642�
PERMIT NO: B 066424 PLAN CHECK NO: 00924-94 S GOVT; N SUPP: N
CONSTROCTION TYPE: V—S PERMIT TYPE: STR PURPOSE: NEW
JOB DESCRIPTION : CONSTRUCT GUNITE SPA SQ FT: 10,000
CLAIM C�ALUE: 10,000.00 CALC—VALUE: 10,000.00 GROUP OCC: R-3 /
COMMENTS: WORKS ENVOLVES THE CONSTRUCTION OF GUNITE SPA ONLY
***x�**�*�*+�***�*x�*****�*�c�*�r�c���*******�***+t*+r x-+�**�c�*****�r****x��*#*+�*****�r***�c
Z O N I N G R E Q U Z R E M E N T S
S E T B A C K S
---------=-- MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN EiGFIT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REI,�: PROV; PARCEL: 00000000 ZNE: R1 REF NO:
PLANNING NOTES> IN—GROUND SPA IN REAR YARD, EQUIPMENT IN SIL1E YARD
>
if ib iE i! it iE if if iE iF �f ff N it i! iE iF 1E �c �E iF �E iE iE iE ik it iF iE iE iE iE iE iE 9E iF iE k iE �F 1E iF iE iE iE if if # if if iE iE iE i2 ff iE it if if 1f iF iF if iE if iF 1E iE �f iE if iF �If iF if iE if iE if
D E V E L O P M E tJ 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: �_I �' 1�
BUILDING APPROVED BY : C/�— DATE; �—IC�- Q�.
APPLICATION ISSUED BY: Ci{� DATE: �—I b�^� �
iEiEiElEiFiEiEifjEiEl4ifificifiFiEifiFitiEiE 1E . . iE!fiElEiEiFlEifihif��F'3FifiE
iF if �f-%�IF if �lE �1F iF ih ik iF � iF iE fF ff jE fF 1f iE if jf ff ik iElE iE 1E ih iF if 1E iF 9f fE iF i' 1E iE i! iF �)E iE 1f #�lf if ik iE iE If iE iE iF if if �1f if iE if� 1E iE iM1 if iF iE if ih iE iE i(� k-fE!!!!!E ik iE
LEGALIZATION:N F E E S U M M A R Y STRUCTORAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 117,00
SMIP/NON—RES
PLAN 76,05 2,10
ISSUE FEE
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 119,10 0.00 76.05 �t�_'S 195.15 .00
REVENUE DIVISION TOTALS--> COLLECTED: ( 195 : OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC i�,n SMIP/TOT GRADZNG PLAN—CHECK
117.00 2.10 76.05
if fE iE IE fF k 1E iE iF iE iE iE iE 1F 1E iE if if iF iFlf iE iE iE if iF iE if iE # 3F 9f iP jE iF iE if �)E iE iF if 3E 3f if iF if if jE iR iE if if iE iE i! iF if iE iE if fE if if iE if # 7f if iF i! iF iE 3E k iE � iE?E jE
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
SFC 10000 POOL 6 SPA 1.00 10,000.00
END OF FEES
O1 00157279-001572E1 TU T 195.15
DATE: 03/16/9S TItfE: 14:�7
c
CONSTRUCTION AND PLANNING POV� & SPA .
APPROVALS Permit # Date Inspector pppROVALS Permic # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Pough Plumbing & Pressure Test
6. Hearica� UFER Grnd. 57. APPROVAL TO COVER-GUNfTE (�(� _
7. Footings 58. Electrical Conduit�Undrgrnd. t
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structura� Floor System . 67. APPROVAL TO DECK
7 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap 63. Heater & Vent-Final
73. Roof DrOins • 64. Plumbing System � Final
14. Rough Plum6ing ' 65. Electrica6Pinal
15. Rough ElectricabCo�duit 66. Solar SVstem-Fina1 .
76. Rough E�ectric Wiri�g 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 5=�-9Y (�dL-
18. Rough E�ectricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �=2Y-qY ( 4-�
19. Rough Heating & Air Conditioning FIRE DEP7. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground HYdro
22. Ducis, Ventilating 71. Product Pipin9 O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof F�aming 73. Undergmd.Stora9el"ank �Gas ❑Oif
25. Roof Sheathing 74. Overhead Hydro �
26. T•Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashin9 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINA� '
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEAITH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. F000 CERTIFICATE ISSUED
33. Finat Efectric � Notes:
34. Final HeSting & Air Conditioning �-
35. Finai Gas Pipe-Test _ '
36. Hood or Canopy
37. Final faGtory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backifow Preventer � .
43. Backflow Irrigation -
44. Landscape irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL 5TRUCTURE & BUILDING • �
48. FINAL PLANNING � - -
49. Electric Release to Edison '
� 50. Gas Release to Southem Califomia Gas Cu ,
51. CERTIF�CATE OF OCCUPANCY
No. __. Date
: .. .
�, s �4- �i r�,� f{
CITY OF-�b�@N
DEVELOPMENT SERVICES DEPARTMENT
CERTIFICATE OF COMPLIANCE BY
REQI9TERED DEPUTY INBPECTOR
(IiJNITE FOR SWIMMINU POOL
Job AQdreeeagO Pcp�rF,c �reS�Permit No. �/ �
Oaner� � �, �qs•� .�.�.- ,�e� Centractor u 00%S
TO THE DIRECTOR OP BUILDI1Jai
I hereby certlfy that continuoue inepection wqa previded
by me during all placement of concrete in the eximming
pool under conetruction at the above addre6e, And that
aaid work compliee with the approved plane and aith al•1
applicable provioione of the Building Code.
-�— '/
Pool 91ze 3 8 3acke Cement �T � Tens 3and /�
Uunite � Hand Pack
Approx. �6 Water in Aggregate S �
Thie report covere work done from�te
Remarkas �r�v4i�� S�°?- S�3xelakr-�S 5��'e�
C90 or� jo�9
Signed C(j� � ��
�eg a ar,e Depu�c�3ing ,p�or
No._����
Orange Co . �9.
LA Co. �j
LA Clty p
Name �i��aard �aJ u�� � �
Addreas .�'>80 O� O� v( � yl�1 �i j
Da te •
1 ♦ . . �
INL�AND H�OIJNDATION ENGINL'[]2ING, INC.
1310 S. Santa Fe Avenue
P. O. Box 937
San Jacinto, California 92383
(909) 654-1555
CL17T7'P: Willard Gannawa,y Date: April 12, 1994
'L5780 Morgantown Way
Sun City, California 92586 Project No. G146-002
REYOR'P OF S'IRENGfEI TL�STS: Mortar () Grout () Concrete ()(�mite (X)
Project SPA Project Location 280 Pacific Crest
Costa Mesa, California
Contractor C& C Pools Arch.\�r. B.C. Adanvs
Location of Sample Floor Design Strength P.S.I. 2000
Max.Size Aggregate-Inches ---
Source of Concrete --- Admixture ---
Mix No. --- Ticket No. -- Percent Air
(1) Batch Size - �. Yds. ---
(2) sacks/1'ard ---
(3) Water Add.JoU-Cral. ---
(4) Water Add.Plant-Gal. ---
No. of �linders Molded 3
Specimen Size 6" x 12"
Water/Cement Ratio as Poured ---
S1�IrInches --- Sampled by: Willard Gannaway
Air Temp. -=Concrete Temp. -- Sul�mitted by: Willard Gannaway
I.F.�. Your
Lab.No. No.
5235 ---
DATE DATE DA'I'� IAAD AG� COMPItFSS
MOLDED RECENED TFSTED LAS. DAYS SI7tENGlli
0�1-05-94 04-05-94 04-OA%9'� 118,000 7 4175
� 3-�'�
This laboratory data indicstes confoi•mance
to the approveci Specifi.cations: YGS (X) NO O