HomeMy WebLinkAbout292 PACIFIC CREST DR - Building PermitsInsulation Certificate
..ity of Costa Mesa -
California 92628-1200 P.O.Box 1200
PermitNumber W ooS�I�
2323 SPNTA An�A A��. V►��T �
( 242 au{ cc- Cce-s� Di'�uP� C osr A MFSfl
Number and Street City
o�,��_� f �S ►S I
Coun�y Subtlivision ' Loi Number
ROOF
Material
Thickness (inches)
EXTERIOR WALL
Material
Thickness (inches)
N/A
BATT
3 5/
Description of Installation
Brand Name
Thermal Resistance (R-Value)
Brand Name �VILLE
Thermal Resistance (R-Value) R-
CEILING
Batt or Blanket Type BATT Brand Name �1VILi.E
' Thickness (inches) 11�� Thermal Resistance (�-AValue) R-30
Loose Fill Type N�A Brand Name �
Contractor's minimum installed weight/ftz_ Ib. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) _
RAISED FLOOR
Material
Thickness (inches)
SLAB FLOOR
Material
Thickness (inches)
Width (inches) _
FOUNDATION WALL
Material
Thickness (inches)
N/A
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
Califofnia Adminstrative Code.
Slgnature antl(�itle
WESTERN INSULASION, INC.
$ub-Comractor Qnsulation Insialler) �
�j�,�����RODUCTION MANAGER
•� �j � Signature antl Title
190] d6
License Number
31L�Iti¢
Date
481278
License NumDer
03/24/94
Date
; : _. . _______ _ �..
- ..
�. .....-- : -
Project ,�ddress: _
I.ot \umber:
FI\AL GRA�ING CERTIFICATIO\�
292 Pacific Crest
#1 of Tract No. 14815
Permit \umber. $ 06501t�
By Civil Engineer:
ve�
I cenify ro the satisfactory completion of grading in accordance u•ith the appro��ed p]ans,
specifications, locai and state codes. All drainage devices required b�� the gradin� permit,
gradin� plan and 2radins ordinznce ha��e been installed. Adequaie pro��isions ha�e been made
for drainzse of surface w•ater from each building site.
7�he r,�inimums zre:
�/i Fail from S?iLClUf25 µ'lihia 5 feei f;e„i exterior �ti�a�)5.
]� F2ll for asp;�'t surfaces ar.d landscaped zrezs.
�.�/� F2�� f0i iOilCi2i2 Sl:ricC25 to zprro��ed disposa� ci22S.
T}7� f1:12� TOfiL'�TiCiiiS c5 Sh0'�t�� O;1 iii:. recor�ed if2C[ ff12�'.�'Zi2 S'.I. .�i�� �iicl �rzding e1e��z-
ll0ii5 c:'.' U'li!i7� _]�]� Oi [i:2 C��SI^ned e?e��ations.
S��per�•isine Civil En=i�zer i1 Re_. No. 31720
� . (Si_nswrrJ
DZ;A 4/20/94
QPOF ESS/pN
�Q,�`,�0��� B. y,q,y9l�,2c�
c� � ���n z
w m
� m
E�P i190 �
* *
�'y CIVII. ��Q'
J�
TFOF CAL1F�/
.+-•^.. - . : . . STa•.fD anA CTl�i
August 6, 1993
To:
CiTY OF COSTA MESA
CALIFORNIA 92628-1200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPARTMENT
Building Safety Division
Code En£orcement
Communications
Copley-CoYony of �osta Mesa
County Administration Office
County Clerk/Bd. of Supervisors
County Registrax 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 Heights Water Company
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:
QLD ADDRESS
2323 Santa Ana Avenue
NEW ADDRESS
292 Pacific
288 Pacific
284 Pacific
280 Pacific
276 Pacific
Crest Drive
Crest Drive
Crest Drive
Crest Drive
Crest Drive
Your cooperation in this matter is appreciated.
Sincerely,
• C� �i.C�.f Vh--
GABRIEL ELLIOTT
Associate Planner
(2323SNTA.ADD) C-75
cc: Kerry Smith
Harbinger Homes Inc.
375 Promontory Drive West
Ne��port Beach CA 92660
A.P. NO.
119-133-19
77 FAIR DRNE
8uiltlmg Division p14) 75a-5273 • Cotle EnforcemeN (714) 754-5623 • Planning Division (714) 754-5245
FA% p14) 556-7508
a
�
• r
�
276 `�
o_
2aa s
� �
MiN 288 �
, � *1
1-� ,�„�`
vE sn�ar -
�
292 �
n�
�,—..
.. ,• ,
23?3 S�tNT/� /�N� AVENUS
PACIF�C CRE'ST
HARBINGER HOMES ��
�YNTH�A
Cou�
��• —
WIlKIN50_N
ASSOCIATFS
l�ae.cw.
!Yn-,Mp
�nqau nr
�mo.ww�cwoc
MR44�w
o���m ir,�.u{�.c, ��r� Vr'.
PPUJECT POUHESS: �`� UNIT: 1
owN[ssxame: HARBINGER HOMES
AUDPESS: 3"]S PROMONTOAY DR WEST
N.B., CA
675-6653 �'
ANCH/ENGINEER: WILKINSON �iss�C flEG.NO.: C9HZ9
aooness: 1fS002 SKYPARK CI uxir:
IRVINE CA 92714
PEpmiTTEE: HARBINGER HOMES ( 714 ) 675-6653
aoon[ss: 375 PROMENTORY DR WEST
NEWPORT BEACH CA 92660
IICENSED CONTFACTOB OECUIflFTION: I hereby aifirm Ihat 1 am licensea un0er pmvision5 al ChaD�er 9(commencing wiih Section
7000� ol Dlvision 3 of iho Business antl Pmtessions Cotle, antl my Ilcense is in full torce antl eftect.
CITY UC : $TpTE LIC.: CUISS:
�a�e: SigreNre:
WOXNEPS' COMPENSRTION OECIAPPTION: I here6y affirm �hat I have a cenitica�e of consent to selbinsure or a certi�icate o� Workers'
Compensa�ion Insurance. or a cerU�ied copY Ihereo� �Set�iOn 3800. Lab. C).
POLICY NO.: E%P. DPTE:
COMPANY:
❑ Certilied capy is �ere6y Wmishetl. ❑ Cetlifietl copy is filetl with the ciry Building Division.
�aie'. APPlicanP.
EREMYrION FAOM WOHREBS' COMPENSATION �ECUflATION: (ThiS Section need no� be Compl¢Ied il lhe permii is lar ane hunOretl (5700) or less�.
I c al in �he petlormance of �he work lor w�ich �hi5 Oermii is iss� I shal ot ¢mploy anY person in any manner SD as �o become
jeci � I�e Warkers' Compensa�ion Laws ol Calilomia. �//
Oa�e: ' � Signamre:
—o --H
OTICE: If. afier making Ihis tleclaration, you shoultl become subject to Ihe Workers' Compensaiion provisions o� t�e Labor
Code. you mus� lor�hwi�h comply wi�h such provisions ar this Oermit s�all be tleemetl revoke0.
CONSTflUCTION LENOING PGENCY: 1 Aereby allirm thal there is a cons�mction IenAing aqency �ar t�e pedormance o� lhe work lor
which Ihis Dermit is issued (Seciion 3097. Civ. C).
LENOEN:
PDOPESS:
OWNEP BUILDEB OECLABATION: I hereby afiirm �hat I am exempt Irom the ConVac�ors' S�ale License law �or the �ollowing reason
(Sec�ion 703L5 Business an0 Pro�essional Code: Any ary o� counry which requires a permi� �o conslmci, aller, improve, Oemolish, ar
repair anys�mqure. prior lo iis issuance, also repuires Ihe apDlican� br such permit �o lile a signee s�atement �hat he/she is licensetl
pursuam Io Ihe pmvisions of I�e Gomracmrs' S�ale Licenre Law �Chapter 9(commencing with Sec�ion 7000) of Oivision 3 0l �he Business
antl Pm�essions Cotle) or thai he/she is exempt �hereimm an0 �he basis �or �he alleged exemption. Any violalion al Sec�ion 7031.5 6y
any apP�icanl for a Oe�mi� SuUlec�s Ihe apPlican� to a civil Oenalty ol no� more �han five hunere0 tlollars (5500).
I. as owner o� �he O�opetlY or my employees wi�h wages a5 their sole com0ensa�ion, will do Ihe work, antl �he
❑ stmcmre is no� intenUeA or oflered for sale (Seaion 70a4, Business ana Pmlessional Code: The Coniracmrs' State License Law
tloes not ap01y lo an owner of a pwpetly who builds or impmves Ihereon, antl who Ooes such work himsel�/he�seA or �hrough
his or Aer own employees, pmvi4e0 �ha� suc� impmvemenis are not in�entled or oflereA for sale. II, however �he building or
impmvement is soltl wiihin one year ol completion, �he owner will have the burtlen af pmving he/she tlitl nol buila or impmve
lor �he purpose ol sale).
I, as owner o� Ihe pmperty, am exclusively con�rac�ing wilh licensetl coniraclors �o cons�mc� ihe pmjec� (Section 7044, Business
� antl Pmlessions Code: The Coniraclors' Sta�e License Law tloes not aOPry to an owner ol DmOetly w�o bmlas or impmves I�ereon
antl w�o coniracis lar such pmle��s wi�A a contracim�s� license pursuant�o the ConlraclorY Slate License Law�.l am aware
I�al pmof oi Iheir Worker's Compensallon lnsurance 5hou10 be providetl �o me.
� I am exempi untler Section: B. 8 P. C. /�
lor this reason: ' / D . //
�'c,� Q�( .1 9•�'
Oa �J� Ownec � "(�'b1.•'\'� 1
I tl hereby cetlily ihat I am aware oi antl undersiantl Ihe requiremenis o� Cahbmia Health antl Satery Cade Seclions 25505, 25533, antl
2 34 and �hal I or any �uiure builtling occuDanl wilVwill not (ci¢le one� neea to comply with sai0 slate cotles and the requiremen�s for a
ermii lor con9mc�ion or mo0ihcation imm Ihe Nir Ouality Managemen� Oisiric�. flesitlenlial constmc�ion applications are ezempl imm
Ihese pmvisioni
Oa�¢. Applicani:
I �ereby cerlityihatl �ave reatl t�is application and sla�e IhatUe a�ovelntorma�ionis ca rec� comply with all cily and coun�y
ortlinance5anO51atelawsrelatinglobuddmgconslmctionandherebyaNhorizerepresenta�i 5o�thi5ciiy en�eruponiheabove�men�ioned
� lar inspec�ion purposes. �
Oaie: r�J Signaiure:
ori� . s License or 5ociai Securny a:
t6Gbnfi Whue—Bulltling�, Green—Cotle Eniorcement; Canary—AOPlicanf. Pink—Pevenue�. Goldenro�—Hssessor
CITY OF COSTA MESA - BUILDING PEAMIT PERM NO; M 06583
PERMIT NO: M 065835 PLAN CHECK NO: N GOVT: N SUPP: N
C�NSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: NEW
JOB DESCRIPTION ; 957SF 1ST FL, 907SF 2ND FL, 461SF GARAGE SQ FT:
CLAIM VALUE:
CALC-VALUE;
GROUP OCC: R-3 /M-1
COMMENTS: REF: B-65010
� �**�***�*��*x *� �r�t**� *�r�****�r*��t**�r*+t�+t�r+t******�**�r�**� ***�r*x+�*�t��*+�**x *��***+�*
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 REAA; FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 11913319 ZNE: REF NO;
PLANNING NOTES>
>
•+t**�t*+t+t���itir+t�tx�ititfe*ft*it*itit�t�t�r+t*+Eitx�x�atit�t*+t**�tit*ieit�*it**�r+r�r**r**�r*�t**�**�tit*�t�ti[�**+�-�-ic�it�
, 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: �` - DATE:
�FiEfE1E1Fk�1Eff�Eif7EiE1f1flf�ElfiEitifdklfiFiF3f3F3F3F�f�F�F�f3F3F � �F3f3F3FiF�3F�F'�F7'FiF3F�F�i�iEihiEiElEififiElEih lE3E
ikikifiEiFiEiFlfifiEif�EiE�EiEfFiEfEiEiEiEiEiEiEiFitifiFiFititiEiEiflfk3EfE�fiEifiEiFiEiFifdEifiEiflFifiEiEiE�)fitiEifiEiEiE3FiE�E9EiE9Eit iEifiF ifiEiEiFif
LEGALIZATION:N F E E S O,M M A R Y STRUCTURAL SEGMENT;N
l
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 12,00
252 SMIP/NON-RES
PLAN . �
ISSUE FEE i 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 12,00 15.00 0,00 �2--7�.�00 27,00 .00
REVENUE DIVISION TOTALS--> COLLECTED;' 2// 7.OQ% OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANIC ;' FI�-�S`MIP/TOT GRADING PLAN-CHECK
2i,�� -
. '�
k iE iE iE IE iE 3f if iE iE 3E %fE if 1E iE if iE iF 16 iE it * if if if if it ik iE iE ff iE 1f iE �E �E iE iE i! if iE ik if ih iE iE if if IF iF iE iE fE �E jE if iE if �E iF iE iF iE if it iE it iE df jE iF �%iF if iF jE if iF
I N D I V I D U A L F'E E- B R E A K D O W N
i
TYPE
MEC
MEC
QTY D E S C R I P T I O N -
1 INST FORC-AIR/GRAV FURN.<=,100 K BTU
1 GAS PIPING SYS 1- 4 OUTLET.S
END OF F'EES
UNIT COST TOTAL COST
9,00 9.00
3.00 3.00
L? Q�1:Y:`.i7—�1Q�`4�.`+7 �1�� �I.�Ju
PATE: UL'2u/�4 TI{1E: 16�05
/_
CONSTFlUCTION AND P�ANNlNG
� APPRpVALS Permit,�",-.- Date lnspector
� 7. Tempora�v Electricai Service or Pole
2. So.! PiPe�Undrgrrtd.
3. Hect�ica' Condu;t Ut'lity•Undrgrr.d.
4 E!ectncal Co^du.t-Undrg-nd. �
; t-- �-'
', � �. $tee H�.rfn�Czrr:en[
"�t 6. Elc�t�.c �, . ' :R v*:�.d.
.�� -'--
. f 7. Foot.ng� .
:' H. FountlaUon
9. Water P�ne�Undrgm:t.
�� 10.�5u�ctural Flcor System
�- it. Frope�ly SE:�.^,r Line & Fiouse ConnecLon
�' 12. Seo�i:;r Cap
�. 73. Roof O�ains
� 14. RougF� PI�mUinp
�- -- - --
� i5. Ro�yh �;ectrical�Condu�t
~ 16. Rough Eicctric W�ring
17. Raugh 1N�nng S�gn
78. Rouyh E'ee!rical�T Bar Cei���9
79 Rovgh I'car�^.g & A�r Co�ditionh�g
_ -�-. �--..
2C 9ci:;�- F�c'ory Firaplace . .
27. l�_� s. ��. 5?n�ctc-:
22. D_.'s.'Je^.•:'at�ny _
23. Gr.' � �.�4e.�h t5 T?st
rJ[, 4a�r c.;m�.g .- ..-
r?5.Roo' S`,:ath.ng
I -�_ �_- -.�
� �E. t-E.� Cr�i�n; (Stiuctu•al� L [r.c^ocoet
�. --a; �.; i'�,as'i ne --
� . .
' °8. :atn n� iY S tl���0 . _
�------ -
� i�. inSUld`.iun .
3�7. Dry�^;all Uailing
31. P�aste� ilro�.�.�n Coat _ _
32�ElErtnC11 PO�a'Bt iyi2l2/�Fi!)dl
� 33. Firdl ElecUic
I 34. Final t-� -�i�ny & Ait Contlitiordn�-
j 35. {�� •S! G��s PiGe-Test ,
�3u. Hood o� Car�opy �
37. F�n.�� Fpt!or�• FveplaCe �
38 F�rr.; Picmb�ng •- �
39. \!�a:er °�.rvic��Final �
�. �i0. Gas Ser��ca�Final �
r 41 Salar Oc.nubcF��a: � �
�;<. caccflo�.: ?reventer
43. 3ad�fic;. �r��.7aUor.
H4. Lall(JSC�FPI�Lq3LOr$}'S[NR� -
�:D :AJI C� ..C(J.ludiiCf� ,
Ju". H�ndicao Re�ula!ions
:--
� 47. f�iVAL Si9UCT1SRE & dUIIDING
48 f-INAL PIARNI�VG
� 49. Electrlc Retease to Etlison
50. Gas Releasc to Southem C���fnrnia Gas
�ate
POI. .n SPA �
APPROVALS Permii # ( Date � Inspector
52. Pool & Equipment Locat�on
�,
1 53. Steel Re�nfarcement
5G. For�ns
55. Electricai Bond�ng
5E Rouyn Plumb�ng & Przssure Tes[
57. AFPROVAI_?C COVFR�GUNiTE
58. "c,ecincai Cond�'�t�Undrgmtl.
59. Gas P�Fe, C7 Und�grnd.. Test
60. $aekwash Lmes, P�Trap, � Undrgmd
61. APPROVALTODECK
62. 6ackwesh � ReceptorF�nal
63. Heater & VenbPinal
64, Plumbing System � F�_al
65. El�ctrical-Fir,al
6&. Solar 5Y5tem�Fina1
67. 'enc�ng & Access Approval
fi8. APPROVED FOR PLASTERI�'G
69. POOUSPASYSTEiv;SFiNAL
FIRE DEPT. REQUIREMENT
APPROVR4S Pcrmit #
70. U^de�g�tz�.nd Hyoru
1'.. Protivct P pinq :�: G,.; _s Oi�
72. Ur;:��p�ou��d Fics"
73. Underri�ntl. Sroragc Tan'a r: G.�: .� 7.
�
� , �, �----,
1•:. Oterh�ao Hvdrr, I �
" _ , _ _-_ _'_ �___ . _-h-- _ _-.I._ __ __
•' __ j 75. Dr� Gl��cm�c.ai _--------- 1- -- � ._.
. . I 76. Jry Sta^.dciPo . I .
- ,- --- 1---- -- -- - - ----- ��- ---
� I i:-. FiXE^ SYSTF'�S F�NAL I ,
--J--=--_ -'
� 78, FIHE FREV. FIN;\L I _1 __
- -�-�---------- --
�_�-I ---_ _._ '_-- ___ _' - . -'__ __ _ '"' ,.
1-'EALTH D�PT. FEQUIFEl.Ic'")T
r79, FiNi�L IN�PECTIDN i -}�
^ I ~-� 80. �OOU Ct;iTIF IGA"("t ISyUEiJ- _ - - L -- L - -- '
__,._' _'____ i
_ � � IVoies--_ _-' _____ ' ___. _. _'__
Q . � _.I _ _ _'�
� c ; . % 3i -� cc�lnxzz-cc� 'r�^c`rc - - ---;
� - _� - . -� 2 -�_ =�f - -- -rZ°z%c�r-- - �Y - --
�_��,_-c� �i�-- ��-���� y - - -
i
_-___"_________ ___ . ___�
- --------- ---- --� -'
11
,♦
PBOJECT POUflESS �
OWNEfl'S NAME: H
ADOHESS' 3
N
DR WEST
uwT: 1
675-6653
AHCHIENGINEEH: WILKINSON 6 ASSOC flEG.NO.: C9BZ9
aooAess: 18002 SKYPARK CI uNir:
ZRVINE CA 92714
PEPMITTEE: HERNER ELECTRIC, INC. (714)734-3171
aooxess: 75 E, GRAND HLVD.
CORONA CA 91719
UCENSE� CqNTFJq OECSpflRTION: I hereby allirm that I am licensetl under pmvisions oi Chapter 9(commencing with Sec�ion
]0001 0l DiJxSf �7 e�ess antl Pmfessions Cotle. ana my license is in �ullforce and efiect.
CITY LICJ v't.1 sTnTe uc.: 4 8 5 3 2 2 � 1�
a�y; � SignaNre' _ _ .
EFS' MPE SBTION OECli1BATI0N: I hereby ' �hal I have a ce dical o� con5eni Io sel �insure or a certificate af Workers'
omuensaoon I�sU+ agcej g+ §cfn�i� �nov �hereo� �Sec�ion 38a0. �ao. �)2 � 1 S/ 9 4
POLICY NO.: E%P. OATE:
comvnxr: CNA I N5
�Ce itied copy is heJ eby Wmishetl. � Cerldiea c,opy is f%ile0� � Ue.`"� Atli Division
/ / , �i/ //YL . .. � / . %�il'/� .- r
ION FflONWONHEBS' COMPENSPTION OECLlF97NM: (ihis sedian need
T
lessl.
I cetlify ��a� in �he petlormance ot �he work for w�ic this permil is isSueQ I sh3lfno� employ any person m any manne ,so as �o oecome
sublect lo ihe Workers' Compen5aiion Laws of Calilomia.
l :.
�aie: SignaNre: r
NOTICE: Ii. a�ter making Ihis tleclaralion. you shoula �ecome suble�� to ihe Worker5' Compensaiion pmvisians o( Ihe Labor
Code. you musi Iorihwi�� comply wiih such pmvisions or Ihis De�mi� shall �e deeme0 revoketl. !
CONSTBUCTION LEN�INC RGENCY: I here�y a��irm I�a� there is a conslmc�ion lending agency �or the Oe�ormance ol ��e woB �or
w�ich t�is permit is issued �Section 3�97. Civ. C�. .�
LENOEfl: �
I AOOflESS: �
OWNEP BUILOEF OECLANATION: I hereby allirm t�ai I am exempi hom t�e CanVacior5' Slale License Law for the following reason
(Seclion 703L5 9usiness ane Pm�essional Cotle'. Any ciiy o� coun�y which reQuires a permi� ta can5imc�, al�et, improve, tlemolish, or
repair any stmc�ure. prior �o i1s issuance. also requires Ihe apDlicant for such permi� �o lile a signetl s�a�emen� tha� he/she is licensetl
pursuant lo �he provisions ol ihe Comracmrs' Siale License Law (Chapter 9(commencing wilh Seclion 7000� al Division 3 of Ihe Business
antl Pmlessions Cotle) or Ihai he/she is exempt Iherefmm an0 �he basis �or lhe alleged exemption. Any violatian ol Seclion 7031.5 by
any applicanl for a permit sublects ��e applicant �o a civil penalry ol not more than live huntlretl dollars (5500�.
❑ I, as owner o� Ihe DmOeriy or my employees with wage5 as �heir sole compensaiion, will tlo the work, and �he
slmcWre is not inten0ed or offered for sale (Seclion 7044, Business and Professional Cotle: The Conlrac�ors' Slate License law
�oes nol apDly b an owner ol a D�oPerty who huilOs or improves ihereon. and w�o tloes such work himselflherself or Nmug�
his or �er own employees, pmvide0 Ihai SucA impmvemenis are no� intended or offeretl br sale. II, however tAe �uiltling or
impmvemeni is soltl withm one year of completion. �he owner will have �he burtlen oi proving he/s�e aitl no� build or imDmve
for ihe purvose ol salel.
I, as owner o� Ihe pmpetly, am exclusrvely contrac�ing with licensetl conVacto�s �o cons�mct the pmlect (Sec�ion 7044. Business
❑ antl PmIe55ion5 Cade: ihe Contrac�ors' State License Law tloes no� apply lo an owner ol propetly who bwlAs or imD�oves lhereon
antl who conlracis �ar such pmlecls with a contracior(5) license pursuan� lo Ihe CoNrac�ors' State License Law). � am aware
iha� D�oof ol �heir Worker's Compensalion insurance 5houlA be pmmdetl lo me.
i� I am exemp� under Section: 8. 8 P. C.
�or I�is reason:
Daie: Owner
I tlo hereby cerlAy Ihai I am aware ol an� un�erslantl Ihe requiremen�s o� California Heallh antl Sa�e�y Code Sec�ions 25505. 25533, antl
2553a antl ihat I or any fuW�e builtlmg occupanl willlwill not (circle one) nee0 ta comply wiih 5ai0 s�a�e wdes antl ��e requiremeNs for a
permil br cons�mctmn or moddication �mm ��e Air �uahty Managemen� DiStricL Residen�ial cons�mclion appl¢a�ions are exempl imm
theSe pmvisi0n5.
Date: Applicant:
I hereby cetlify I�at I have reatl Ihis applicalion antl siale
ardinances antl siate laws relaling �o buil0ing con9mcuon �
prOp¢i�V lof inyp¢t�iary{Iurp05¢5.
�r's License ar Social Securiiy a:
is carrecL I agree b compl i1h all cily and
nlaliveSo�IhiScitvt�Enter ooniheabove�mE
164t�e6 Whne—Builtling'. Green—Coae n orcemenC Canary—Applicam; Pink—Revenue:
�ITY,OF COSTA MESA - HUILDING PERMIT PERM NO; E 065721
PERMIT NO: E 065721 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: NEW
JOH DESCRIPTION : 957SF iST FL, 907SF 2ND FL, 461SF GARAGE SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1
COMMENTS: REE: B-65010
�r��r*�r�*�r***�***+t*�x�*x+�+r+rit�r*it�*�rx��it*�*+��rx ****�r***�r*�*� �r*��*irrt+�*�*�**�x��r�*�****�*
Z O N I N G A E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSOAY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; ET IN RGHT; FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ; PROV: PARCEL: 11913319 ZNE: REF NO;
PLANNING NOTES>
>
�r�rit�rir�r�r*atitft*�rx�rit+�+�**itititit*it�r��**�r�t*t�*it*�r**ititit**at*�***it*it**���***�r**�r*iE***x*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
ZONING APPROVED HY � DATE:
BUILDING APPROVED HY :
APPLICATION ISSUED BY:
LEGALI2ATION:N
HLDG PMT
PERMIT
PLUMBING
- DATE:
� �•'� DATE; � �
lflflEifititiEiEiFfF IEiE
iEifiE�lEiEiE1E1k�F1EiflEitifit�EjF�flfiflfififiEltfElEiFlEifiEiFlEiklEklFitiFiEif itiflEiEiE�EiEaE
F E E S U M M A R Y STRUCTURAL SEGMENT:N
ELECTRIC MECHANIC FIRE SMIP/RES GRADING
18,50
502 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 18.50 15.00 0.00 33.50 33.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 33.50 OVEA/SfiORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
33.50
it i! 1E iE ik iElE if iE fF �E iE �E iE iE it iF iE if iE iF fE if if iE 1i iE if iE iE iF ik ik iE �f iE if 1E iE 1E iF iE it iE iE if 1f iF iElF iF iF iE iE iE iE iE if iF iE if if M IE iF iF iE �E 3F iE it it ik iE iE iE iF iE i4
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
r
ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18.50
END OF FEES
01 q01`3;7fi-07i53771 Ti�'T 3..?p
":aTE: 0:11;('vt TIM�: 11:5[
l. '�
I CONSTRUCTIOR�ANQPLAMNING
�
APPROVRLS Permit � -�_
� 1. 7empora�y Electrical Secy�ce or Po�e
' --
� 2. So�! Pine Undrgrnd. • ,
"_ ��� -�, Electrc^.I Conduit L't�lijy��Ur.drgn-.d.
���) <'Electr'cal Cc.c�',;bU�dryrrd. '��
.. r----'' '.
I 5' Sta� R,��-,'orcement
�" b_ C'.�:cv,c,: ..��=: Gr;�d. �
_ � 7 Foonncs ' `
:' ��_.,`- -
8. Po�ndat��•,
. ���---
9. Vdater ?ine-Untlrgrnd.
'�
�.�I 1C: Struct��a� Floo: SYstem
,, 11. Property Sr-r,zr Lme & Housc Connectian
`�� - � Z. Sewer C�p . .
i13. Ftoof D�ains
r-i5 Raug�4 PWmbing . --�
L_ _
+ i5 Rn�yh�'ectrica��Condurt
'-- -- - --- -
� 16. Rou9h liect��cL�'iring
i, 17. Rot:�h 4'Jrma Siyn
18. Rouyh Eleci�ign��T 8ar Cei�my
i�J Rcu�h Healinc L�� Air Co�d�honing
2��. Ro�..h �.,ectY Fir@Place �. . "
_- _ '- TT
2! 'Duct; v 5?��,cT�te
22�Ds.t_.�.^t�at�ny .-
23. G.i.�'-�pL'.io.gh ti: ;r.5. .
2�' F,u� Fnm ^g .
25 Ra• �: _a'h,ng �`
I 26. T :v p. „S;r�ttu�ai; 8::�.:0:-�coat
I Z;i�P,zne.�-c f-lar:�ng ----
�-•'------ --__.__._..-
� ?8. _�:h��.r. c S.a..,� ' ' '
�
r'O. Insula��on �
30 Drywa�i?dn,;inn •
I 37. Pi�ste� ^,�c:.n Gont �
i- ------�-" - ---
32- Hcctnc+ Po�.ver i.?nter Final
� 33. F�„a� El::a��c
� 34. Fi�al H:2t.nr� A�r Co�:: i�vnina.-
35. r�nal r��f P��pe-lrst ~
3fi. �Hn�d c� .^a^oP;' - �_
3��ina� Fc��tor�, c�repia:z
3€ F�n-' � �siU�ng �-�
39. :'Je.rr � �rvira�F��,a� -�s
�_-. Y -_____.._��
I 40. Gas Ser.ic^ F�n;:i
�41. Saiar CoT.c;ticP�nsl
( �:2. 9�c�af�orr Preventer .
3 �. c! fto.�� infgatior . .. ..�.
' i.4. Lznusccoc Irriqation System .i ,
45, Sound A!tcnvation �
46. Handicap RegulaYions ��
47. FII�AL S7RUC7Ui�E & nU1lD1NG �
48. FIRiAL PLANNING
49. Eir:ctnc Release tc Edison
50. Gas Ralease to Southem Califomia Gas
Dat&
Dace
Inspector
POOL & SPA
APPROVALS Permit � Date Inspector
52. Pool & Equipment Location
53. Stee1 Reinforcement �
54. Fnrms
. 55. Electr:cal Bnnd�ng �
56. R�mbing & Pressure Test --� �
. i
5; 7. APPA0�I�LTOCOVER-GUNiTE �- ,
58. Elcctrical Conduit�Undrgrnd. '
�
j 59. Gas P�pe, O Undrqrnd., Test
t i
� 60. Backwash Lines, P�Trap, O Und�grnd. '
� 61. APPROVAL TO DECK I
--I
62. Sackv�ash & Receptor-Final I
63. Neater & Vent-Final i,
_ �
64. PlumOing System - Final I
65. Electrical-Finai �
66 Solar 5ystem-Final �
r67. f-encing & Access Approval �
- -'--�
68. APPRDVED FOR PLASTERING
69. POOL/SPA SYSTE'�,SS f iNAL � �'
_�
FIfiE DEPT. REQUIREMEU7 !
A:'PR'�VA;i� Pcmiit� �-I ��
?0. kfh[ier,3�G�_nJ Fiv(Jro �
_ 71, ProductPip:c9l�G.�s u0i1 ��
T -- --'
72. Unde�G�ou�id F:ush
i --
73„Ur.de. �rrd. Stcr2yc Tank � Gas �'� 0''�
C74. Oucnc�ad HYdro_ � �
- -- � - , 1-- -- ---
I 75: Dry C'iern�,.cl
+-----. . -�- -- -�
�76. Dry Stand:.ipc � . I - -'
77�� FIXEO $VSTEAh E�'�'Al' , -�--- �
- --i i
� 78.�F�REPREV.FIVnL • _L �__ �
!-_�- __-..-. r-- _'
� HEAI_TF1 DC-PT'. REQUIRE�!%iE��T �
t79. PINnL IMt'aECTi�N ----- -- - � ----- � --_._
� BD _ FOOD CERTiF ICnTE ISSUED �
--- -- -- -�--- � -�-----
�,- . :
� �IU4,:tli - . _"-_ '____ .._ -
�_� ._-' -- . ,
�------ ----r - .-� --- --- --- - 1
�-'- - � --- `--- ------- - -
:...'._ z. __
�-- -
�
-
%I
_I
�T`p00PE5S U�. �.y HN S_'`• IV .V(.G1J� �isLl T UNIT: 1
�r�€�sxnmE: HARBINGER HOMES �
aooeEss: 375 PROMONTORY DR WEST
N.B„ CA
675-6653
APCHIENCINEEN: W I L K I NSON �i$JrQC pEc.xo.: C 9 Q� 9
noosEss: 18002 SKYPARK CI u"iT.
PENMITTEE: IRVINE CA 92714
aooness: BILL HELFEA PLUMBZNG (714)248-0$45
27522 SILVER CREEK DR
SAN JUAN CAPISTRANO CA 92675
LICENSEU CONTflqCTOB UECNBATION: I hereby affirm I�a� I am lit¢n5etl Untler provisions Of Chapl¢r 9(commenting with Set�ion
700U) ol Division 3 0l Ihe Business an0 Prolessions Code, an0 my license is in tull lorce antl effec�.
cirr uc: sTnre uc.: y y 3 9 � � cu�ss � 6
Date: ��-y3 -g�� Signalure: _%�'' _
WONNEHS'COMPENSRTIONOFLIAflPTION: I�er¢�ya�lirml�ail�aveacerii�it olconsenttoseu�insureoracenilicatealworkers'
CamDensalion Insurance. or a cenilietl copy t�ereol �Seciion 3800. Lab. C�.
POLICY NO.: E%P. ORTE:
COMPANY:
❑ Cetlili¢A t00Y i5 �ere0y �umished. ❑ CenilieE copY ¢ liletl with,ihe city Builtling Division.
•�- ��
Date: Applicani:
E%EMVfIONiPOMWOBKEPS'COMPENSpTIONOELLAflRTION: �iliissetlionneednolUecompl¢tedifthepermit6laroneAunGreG�5100�wless�.
1 ceNfy ��al fn the pedormance ol I�e wark for whic� Ihis Oermil is issued. I 5hail nol e loy any Oe�son in any manner so as ia become
5u01etl �o IAe Wor4ers' ComOensElioi� Laws ol Calilornia. .
.�
Da�e'. �/� �'� %% - Signature: '
NOTICE: Ii, afle� making Ihis tleGlaration. you shoula Oecame subjetl to �he Bers' Compensa�ion pmvisions ol the labor
Cotle. you must �atl�wil� complV wilh such pmvisions or �his permi� shal e tleeme� revokea.
CONSTflUCTION LENUING RGENCY: I here�y al�irm Ihai Ihere is aYwstr ion lenaing apency lor ��e'p¢dormance o� ihe woB for
wnicn inis oermit is:�suee (Setlion 3�7. Civ. C�. `
LENDEP: '
AOUNESS:
OwNEB BUILOEN oECufl�7lON: I hereey aflirm Inal I am exempt 1mm Ine Conlractors' State License Law for tne following reason
�Seclion 7031.5 Business ana Prolessional Cotle: Any ci�y ol county whic� requires a Oe�mil �o conslmc4 aller, impmve. Oemolish, or
repair any slmc�ure, prior to its issuance, also re0uire5 ihe apDlicanl for such permil Io lile a 5igne0 s�alement ihat helshe is licensea
pursuanl �o ihe pmvisians ol the Canlraciars' Slale Lirense Law (C�apter 9([ommencing with Seclion 7000) o� Division 3 of lhe Business
anU Pmlessions Code) or Ihal helshe is exemp� �herelrom and Ihe Dasis br Ihe alleqeU e�emption. Any viola�ion oi Se[Iion 7031.5 6y
any aU0licanl �or a permil subjec�s tM1e applicanl to a civil penaliy a� nat more t�an hv¢ huntlrea tlollars (E500�.
I, as owner ol ine propenY or my employees vnih wages as iheir sole campensdtion, will ao Ine wark, ana tne
❑ simcmre is not intenaea or al�erea for sale �Secuon 70a4. Busineu and Pmlessional COAe: The Contractors' State License Law
aces not apDty �o an awner o� a pmperty wlp builES ar impmves I�ereon, anG w�o Eoes such wOrk himS¢IVhersell or lhroug�
�is or hei awn em0loyees. pfoviaetl �hat such imprOvemen�s are no� ini¢ndeC Or alleretl �or sale. II, howev¢r ihe Ouileing or
im0�ovemen� is sold wi��in o0e year o� complelion, the owner will �ave Ihe burden of pmving �e/she tlitl not builU or improve
for t�e purpose ol sale�.
I, as awner o� Ihe pmperly, am exclusively conlraciing with IicenseJ coniractor5 to constmct the pmlect (Seclion 7044, Business
❑ ana Professions C0a¢: IDe fAniractors' Sla�¢ Li[ense Law Qoes no� apPty Io an owner o� pmperty who Cuiltls or imOmves therean
and who conVatls lor suc� p�ojects vn�� a contracbqs�license pursuanlio ihe Coniractors' S�a�e License Law�.l am aware
��a� pmol ol �heir Worker'S Gompensa�ion insurance shoula be pmvided Io me.
� I am erempt un0ei Stttion: B. 8 P. C.
br lhis reason:
�a1e: Ownec
I tlo hereby cenily Ihai I am aware oi antl unders�and I�e requiremems o� Cali�ornia Healih and Sa�ery Cotle Sections 25505, 25533, anA
2553d and Ihat lor anyfulure �uilUing occupaniwill/wilinol(circle one) neeA lo comply with saitl itale codes and Ihe requiremen�slor a
permit lor conslmction ar mo0ificalioP ��om the Air Ouably Management DiSiricl. Resiaenlial consimction apPlicalions are exemp� Imm
these D�ovisions.
Oate: ADPlicanl:
I �e�e�y cetlity I�a� I have rea� I�is aOPlication an0 s�ate Ilut ��e abwe iniormalion is correcl. I agr¢e ro wmpty wit� all ci�y antl counly
or0inances antl slatelawsrelaiingto budding consVuclion an0 �erehy au�horilereD�esentalives ol�Ais ciryloenleruponlheaUOve-mentione0
pmperiy lor inspeclion 0urposes.
�a�e'. �f1=l�- Signaiure'. �
Oriver's Llcense oi Sonal Securny a:
■
i6nLa6 Wnite-BuilCing: Green-�e Enlo¢emenl: Canary-qppliwn�; Pink-Ravenue: Goltlenrotl-Assessar
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 065039
PERMIT NO; P 065039 PLAN CHECK NO: N GOVT; N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE; PLU PURPOSE: NEW
JOH DESCRIPTION : 957SF 1ST FL, 90?SF 2ND FL, 4615F GARAGE SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1
COMMENTS: NEW SFR, PLAN #1, RE:#H65010,
*****�:***�-**************�+r*+r*�*+�***�r�*'+��r+�*+r******x��u*+�*�+���****u**�***�u�+�****�u+�
Z O N I N GS ERTEBQAUCZKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BOILDING ---------
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: 11913319 2NE: REF NO;
PLANNING NOTES>
>
if if if jE iE iF iE 1F if if if if iE if i! 3E >E if if if if !E �! �E jf if !E 1E it 1f 1F iE iE f6 if �1E if iE !E'1t 1F 1f if fE if iF'1F 1E 1E iE iF if if fE iF if if iF iE if af �f aE if if jE if jf iE 1f iF iF *!E fE iF 14 iF iF
D E V E L O P M E N T S E R V I C E S R E.Q 0 I R E M E N T S
ZONZNG APPROVED BY � DATE:
BUILDING APPROVED BY ; � DATE:
APPLICATION ISSUED BY: �q- f A DATE: `��i.3���
�,, " ti
')f'�'�'**�"x"�*'x'i�'�'�'x'iex'**r'ir'x'�' . Fi'�'iF'R�Faf'�ir**iF'Kifi�'i�F1F�ie"ir�F3€iFiE'x'
iE if �f it it if K if it 1E iF 1E if iE iE �E ff if k iF if if �f iF jE if aE iE if if iE iE iE iE �f iE if jf if 1E if it if if iE iE i4 iE ii it if 1F 1E iE if iE iE �le if if 1E jt i: if ## iF iE ic N iF �c {4 {F 3c { f jr- i. if
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUM6ING ELECTFZIC MECHANIC FZRE SMIP/RES GRAPING
PERMZT 112.00
ZSR SMIP/NON-RES
PLAN .
ISSUE FEE 20,OU
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK - TOTAL PAID DOE
TOTALS----> 112.00 20,00 0.00 132.00 132,00 .00
REVENUE DIVISION TOTALS--> COLLECTED: ' 132.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC ��FIRE SMIP/TOT GRADING PLAN-CHECK
132.00 �,
1f iF iF iF if iE iF #' iElf � 1E ik iE iE jf if �f ff �f �f if iF iE 4 iE jE #' if if iE M 1f if iF iE iE it if if fE jE iE if ff iE if if �k if jE iF iE iF 1E?E 1E jf if i6 iE iF iE iE 3E iE if if if ��f if iE * aE iE if if iF
I N D I V I D U A L ",F E E � B R E A K D O W N
• _ i/
TYPE QTY D E S C R 2 P T I O N ," UNIT COST TOTAL COST
PLU Z BATHTUB 7,00 14.00
PLU 1 DISHWA5HER �^�� 7,00 7.00
PLU 1 LAUNDRY TUB OR WASHER - 7.00 7.00
PLU 1 SHOWER � �' ' 7,00 7.00
PLU 1 SINK, KITCHEN . 7,00 7.00
PLU 9 WASH BASIN v;,`' 7.00 28.00
PLU 3 SdATER CLOSET (TOILET) ;� 7.00 21.00
PLU 1 WATER HEATER AND/OR VEN`P,',-=- �' - ` 7.00 7.00
PLU 1 GAS 'PIPING SYS OF 1 TCj'A" OUTLETS 5.00 5.00
PLU 2 GAS PIPING SYS 5+ OUTL-PER OUTLET 1 00 2.pQ
PLU 1 GAS SERVICE �; �,�'i`7�;'Q(}; �1`.1214 �:?3 7. b0- '"�
_-�t- L. . _ '''1"i�` i'� ..'
ONSTRUCTION AND PLANNING
"APPROVALS Permit #
c
t. Tempora�Y Electricai Service or Pole
2. Soil Pipe�Undrgrnd.
3. Electrical Conduit Ut�Iity�Undrgrnd.
( 4. Electrical Condwt•Undrgrnd.
! 5. Sieel Reinforcement
� 6. Electricai UFER Grnd
� 7. Footings
, 8. Foundati0�
} 9. Water Plpe-Untlrgrnd.
/.
10. Structural Ploor System �
tt. Property Sewer Line & Hoase Connection
12. Sewer Cap .
73. Roof Draint
74. Rough P1umG�ng
15. Ro�gh 6ectricai•Condwt
i6. RaughElectricWiring
17. Rough Wiring Sign
16. Rough EI¢ctrical-T Bar Ceiling
19. Rough Haaung & Air Cor.ditio��ng
20. Rough Facmry Fireplace
27. Ducts, in Structuro
22. Duas, Ventilating
23. Gas Pipe-Rough � Tes[
24. Roof Frami�9
25. Roof Sheathing
26. T�Bar Ce�ling (Structuraq & ^i'or.ocoat
27. Frame and Flashing
28. tathing & Siding
29. Insulation
30. Drywall Nailing
31. Piaster Bro�vn Coat
32. Electncal Power Meter-Final
33. Finel Eleciric
34. Final Heating & Air Conditionirg
35. Pinal Gas Pipe�Test
36. Hood or Ganopy
37. Final Factory Fireplace
38. Final PIuR�bing
39. �Vater Serv�ce•Finaf
40. Gas Serv�ce-Final
47. Solai DomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINA�PLANNtNG
49. Electric Release to Ed(son
50. Gas Release to Southern California Gas Q
51. CERTIFICATE OF OCCUPANCY
Date
Date
POOL & SPA
Inspector APPROVALS Permit � Date
52. Pool & Equlpment Locat�on
�� 53. Steel Reinforceme�t
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNITE
58. Eiectrical Conduit�Undrgrnd. �
59. Gas Pipe, O Urdrgmd., Test �-
� L� 60. Backr:ash Lines, P�TraG. C1 Undrgmd I
f 67. APPROVAL TO DECK
�� 62. Backwash & Receptor Final
63. Heater & VenbFinal
64. Piumbinq SYstem � Final
1� 65. Ele�tricabF�na�
66. Solar System�Final
67. Fencing & Access Appruval
68. APPROVED FOR PLASTERING
69. POOUSPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT i
APPROVALS Permrt ir
70. Undergraund Hyri•o
71. Prociuct P'p�n� :: Gas f_' Oil
72. Undergro�nd Flush
73. Undcrgmd. Sroraye fank O Gas � Oi:
74. Oaertaad Hy�ro
75. Dry Chem:cal
76. Dry Star.ep,pe
77. FIXED SYSTEi45 FIRAL
Inspecmr I
--
78. FIRE PREV. FINAL ! � _�
HEALTH DEPT. REQUIREMEh�T
- �-1
79. FINAL INSPECTION �
80. FOODGERTIFICATEISSUED � �_�
I
Notes:
/ �,;�t ,c%4 /��_ �, `?�7 -�
-!-` �- _ �7_U�f�T_G[*Y_`f-- r�G�'- -
. �.. , � � r _ � I
�WNEfl'S NpME:
POOflESS:
AflCHIENGINEEP:
ROOFE55:
PEflMITTEE:
aooAess:
NEG.NO.:
UNIT:
PERMIT NO: P 065039 PLAN CHECK NO: 04614-93 N PAGE: 2
*****�rirx��r�r***�r**�r*�*rt�r*�r*��r�rr*+�*�r*�t*�r**�ex�x��r*�e*�r�*+�*+�**�r�r�c*�c*x�*+r*�r��rx-****�rf�r*-x#
uNir: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
� UCENSE� CONTFRCTOR OECNNATION: I here6y allirm IAaI I am Iicense0 un0er pmvisions of Chap�er 9(commencing wiih Seciion
70001 oi �ivision 3 of Ne 6u5iness antl Pmlessions Cotle, ana my license is in full brce antl efiecl.
CITY LIC.: STATE LIC.: CNSS:
�ale: Signature:
WOPNEFS' COMPENSATION OECIAHATION: I hereby allirm Ihal I �ave a cetlifica�e oi consenl Io sell�insure or a certilica�e ai Workers'
Campensaiion Insurance. or a cenified copy ��ereol (Section 3800. Lab. C�.
POLICY NO.: E%P. DRTE:
COMPANY:
❑ CeNIieE copy is hereGy fumiSAeA. ❑ Cenilie0 wpY a filed with the ciry BuilOing Oivision.
Da�e: Appiicant
EXEMPTIONFpOMWOBREBS'LOMPENSATIONOECUNATION: (TN55ec0onnee0notbecompkieAilNeperm�blorone�unUred�S100�or1e55�.
I certily IAaI in t�e Dedormance of l�e work for which ihis permi� is issced. I s�all no� employ any person in any manne� so as �o become
subjeci io ��e Workers' Compensation Laws ol Califomia.
Oate: SipnaNre:
NOTICE: Ii, a�ier making Ihis UeClaraiion, you S�oWa UeCOme Suble�� l0 Ihe Wofkefs' COmDen5ali0n pmvi5ion5 oi I�e Labor
Cotle. y0u musl fOtlhwiih tOmply wi�h Such Omvisi0n5 or IhiS permil Shall be AeemeO reuoketl.
COkSTNUCTION LENOING FGENCY: I here�y a��irm t�at Ihere i5 a constmc�ian lending agency �or IAe pedormance ol t�e wOrk lor
which Ihis pe�mii is i=sued (Seciion 3097. Civ. C�.
LENOEN:
AOOflE$5:
OWNEN BWLOEN OECLAFRTIDN: I here0y a�lirm IAaI I am eeemp� �mm the ConVactors' Sta�e License Law for �he followinp reason
�Seciion 70315 Business and Pmie55ional Coae: Airy ciry OI touniy wAich r¢quir¢5 a permii Ia tOn5imtl, aller, impmve. Aem0liSh, ar
reDair any SlmcWre. prior to itSlssuance, alsa reQuires ��e applican� br such permi� to �ile a signetl s�a�¢ment tlwl he/s�e is licensetl
oursuam to t�e Drovisions of i�e Coniracmrs' State License Law (Cnap�er 9(commencing with Section 7000) oi Oivision 3 af the Business
an0 Pwlessions Code) or that he/s�e is exempi ��eielwm antl I�e basis for the aliegetl exemption. Any Nola�ion o� Seciion 7031.5 Dy
any applicanl �ar a permi� su�lects Ihe ap0liwn� lo a civil p¢nalry ol noi more Nan �ive huntlreA Eollar5 (55f10�.
I. as own¢r ol t�e pmperty or my employees wi�A waAes ai Iheir sole cOmpensation, will GO t�e work, an0 t�e
❑ simcture is not imeneetl or oflerea �or sale (Seclion 70aa. Business and Pmfessional COGe: T�e ComratloR' Siate License Law
does nol aOPly to an owner ol a property who builtls or impmves thereon, antl who does such work himSelllAersell or I�mugA
Ais or her own em0�oyees, pmvitle0 t�al suc� im0�ovemenis are not intentleU or oflereU lot sale. II, however ihe huil0ing or
imDmvement is solA wilhin one year ot completion, Ihe owner will �ave ihe burden of pwving he/she Oia nol 6uild or impmve
�or IAe purpose 0� Sale�.
I. as owner o1 tAe pmpeny, am eKclusiuely conVac�ing with licensed contractors b cons�rucl lhe pmjecl (Seclion 7044, Business
❑ an0 Pmlessions Co�e: The ConVactors' Stale License Law does nol apply to an owner ol prope�y who �uilAs ar improves Ihereon
and w�o coniracts for such prolecls wil� a conlracioqs) license pursuan� �o �he Conirac�ors' Sta�e License Law�. I am aware
Ihat pma� o� Iheir Worker'S Compen5aiion insurance s�oultl �e pmvi0etl to me.
� I am exempl unaer Seciion: B. 8 P. C.
foi Ihis reason:
Dale: Ownec
I do n¢re0y cetlity Ihal I am aware o� ane under5lan0 I�e requiremenis o� Caliiomia Nealt� anU Salery CqEe $eCli0n5 25505. 25533. an0
2553d antl t�a� I oi any INure Oviltling occupant wilVvnll not (cirUe one� nee0lo comply vnl� 5ai0 s�ate ca�es an0 Ihe repuiremenls lor a
permit lor consimc�ion ar modilication Imm Ihe Air Ovalily Managemeni Oistnq. He5i0ential conSlruciion aDDlicaiions are eKempi �mm
�nese pwv4ions.
Uale: Applitant:
I �ereby cetlify IAaI I have reatl ��is apOhtation and Slale IAaI I�e a0ove inbrmalion is CorreCl. I agree lo tOmply wilA all ti�y and cauniy
ordinanres an0 Slale lav5 relaling lo building consimction antl �ereby aWhorrze representatives ol IN5 ury to enier upon Ihe a0ove-men�ione0
properly Im inspec�ion pur005e5.
Dalcl Signalure:
Onvefs License or Soci�l Security p.
i6at�n6 WnM1e—Bwldmg; Green—Coae Enlorcamen�; Canary—Applicant; Pink—Revenue', Goltlanrotl—Assessor
END OF FEES
't'il/ V �� �L. 1 u -'.A") 4 � t^"'� �: £. T i ' •� =^.
jl (1(,?=,1_'r'��i_•t�i� i 41� �d..��'
UH�t.: LI�.2Yi43 rrME: .fi.��
�
�ONSTRUCTION ANDPLANNING
,Y. APPROVALS Permit �
� i. Temporary Electncal Service or Pole
2. S��I Pipe�Undrgrnd. ,
'- 3 E.�.:_!r�c�� Cc^.duit Ut:�ity-Undrgrr.d. '
I4 E.c,.L c,i Condurt-Undrgrnd. J
r_ -'-
s'
` 5. Sc . 7emtorcement
`6 EI-Ct� c:' UFER Gmd.
� -- -
� J. Foot�rgs
�--
iB. Foundation
, 9. !�+ater P�pe-Undrgrnd.
� 70. Sauctural Floor System ~
, 7 7. Praperty Sevder l.ine & House Conne�twn
; 12. Ser:er Gp
� --- -
'�3. FoitOra��rs
�- - -
' 14. io��h Vlurnbing
75. Rou�h Electrical-Condwt
� 7G. Rough Electric Wiring
� 17. Rou9h Winng Sign
18. Ro�gh Eiectrical-T Bar Ce�l�ng
�9. RC�..;`� Hetting $t Air ConditiOning
�20. tc.-,n Facmry Fireplace
2i. �uC'S, �n $trUCtufC
�99. D�cts, Vent�'ating
Gas ?�pe-kough & Tesi
�-- -
24. 9oa.' Framing
25_Hoot Sheathing y-
� 26. T�Bar Cediny (Structural) & MonocUat
� z7, Frame and Flashing
i
28. Lath�ng & Siding
29. Insuia[�on
30. Dryv.all Nailmg
31. Piaster Bro�vn Coat
32. Elec;rical Power M1teter�Pinal
� 33. Final EleMnt _
34. Final Heating & Air Condrtioning
35. Final Gas Pipe�Test
36. Hood or Canopy
37. F�nai Factorv Fireplace
38. Final Plumbing
3S. lVater Sarvice-Finai
� 40. Gas Service-F�nal
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. l.andscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
� 47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING
49. Electric Reiease to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Dote
POOL & SPA
Inspector qppROVAIS Permit #
52. Pool & Equipment Location
53. Steal Reinforcement
54. (orms
55. Electrical Bonding
56. Rough Plumbing & Presswe Test
57. APPROVAL TO COVER-GUNi7E
. 58. Electrical Conduli�Undrgrnd.
59. Gas Rpe, CJ Undrgrnd., Test
� 60. Backwash Lines, P�Trap, O Undrgrnd.
61. APPROVAL TO DECK
- 67.. Backc:asii & Reeepwr�Final
63. Heater & Vent�Finai
64. Plumbing SYstem - Flnal I
65. Electrical-Final
66. Salar System�Final
67. Fencing & Access APproval
68. APPROVED FOR PLASTERING
69. POOUSPASYST&b7SFINAL
FIRE DEPT. RE�UIREMENT �
APPROVALS Pe�mit � -�
70. Undergrourd Hydra
71. Product Pipirc C', G.is � Oil _ �_
72. Under�round Flush
73. Undergmd. Srorayc Tank �� Gas ❑ 0.'
74. Overhead Hydro
75. Dry Chemical
76. Dry Standplpe
77. FIXEO SYSTEI1 FINAL
78. FIRE PREV. FINAI �_
HEALTH DEPT. REQUIREN'�EVT
79, FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
Date � inspector
__�
---i
i
Pfl0.1EtT RODFESS: Z 3 z 3 SANTA ANA AV ux��: 1
owecnsxame: HARBINGER H0�1ES
nooness: 375 PROMONTORY DR WEST
N.B., CA
675-6653
AflCH1ENGINEEH: WILKINSON �iJCs�C REG.NO.: C(j87(3
nooR¢ss: 18002 SKYPARH CI uxir:
IRVIN£ CA 92714
PEpmiTTEE: HARH ZNGER HOMES ! 714 ) 675-6653
RDOPE55: 3']S PROMENTORY DR WEST
NEWPORT BEACH CA 92660
LILENSEO CONTPACTOF UECNBATION: I �ere�y alfirm Ihai I am licensetl un0er pmvisions of C�aD�er 9(commencing wii� Seclion
7000) ol �ivision 3 of Ihe Business and Pmlessions Code, and my license is in full �orce antl eflect.
CITY LIC.: STATE LIC.: CIASS:
Daie: Signature:
WONRENS' LOMPENSRtION OECIAHPTION: 1 �ereGy aHirm tlw� I �ave a renifiwte of consent ro sell�insure ar a cenifiwte al Workers'
Compen5ati0n Insurance. o� a certili¢G Copy �herea� (Section 3800. Lab. q.
POLICY NO.: E%P. OATE:
COMPANY:
❑ Cerlilied topy i5 here0y lumis�ed. ❑ Certilie0 tODY �5 liletl wi�h Ihe tily Builtlin9 �ivi5ion.
oate: AODlicant: �
E%EMPTIUNFflOMWOPRENS'COMPENSpTIONOECIABATIUN: (ihi55etiionne¢0noi�etnmpl¢fe0ifihepermi�iSloronehUnareO�$1W�orle55�.
I cetlii Ihat in Ihe petlormance ol �Ae woB lor whicA �his permi� is' ed s�all noi .em/p/qy any perwn in any manner so as to become
, �let ,�I�e WOrkers' Campen5ali00 LaxS oI Califomia. ---- i�� j�'—^
�✓ 12-16-� '
Signature: �
NOTICE:II, ailer making I�iS dedaralion, y0u ShoWd betome SuDjetl�o Ihe Workefs' fAmDenSaiion O��Si0n5 a�ihe LabOr
Cotle, you must forihwilA compry wilh such pmvisians or t�is permil shall �e deemetl revoketl.
CONSTHOCTION LENOING /7GENCY: I here6y al�irm thai there is a conSlmction,lenAing agency for Ihe perlormance ol ��e work lor
which Ihis permil is issuetl (Section 3�7. Civ. C�. J
IENOEN:
ROONESS:
OWNEfl BUIWEB OECIAHRTION: I hereby allirm Iha� I am exem0� Iwm Ihe Coniracto�s' S�a�e license Law lor �he following reason
(Section 7031.5 Business and Prolessional fAOe: Any city ol caunry whit� r¢puires a Dermil �o con5imct. alter. impmve, aemoli5�, or
repair any simclure. O�ior Ioits i55uaPce. alSo reQuires t�e apP�icanl lor suc� permi� �a tile a signetl Slatemeni tha� he/s�e is licensee
pursuant la Ih¢ pmvisions ai the Conir9cloi5' Slate License Law (C�apter 9(commencing wit� Section 7000) ol �ivision 3 ai Ue eusiness
antl Professions CAAe) or thal ne/sne is exempl lheretrom ane ine �asis for ihe allegea exemplion. Any violation af Seclion 7031.5 by
any applicanl lor a permi� su�lec�s Ihe ap0licant lo a civil penally ol nol more t�an live huntlree Dollars (5500�.
I. as owner o� ihe pmpetlY or my employees with wages as �heir sole compensalion, will tlo ��e work, an0 the
❑ 51mcWre is nat intentletl or olle�etl lor sale (Section 7044, Business an0 Pwfessional Cotle: T�e ConVactors' $�a�e License Law
Ooes nol apO�Y ta an mvner ol a O�oDeny who builds or im0�oves Ihereon, antl who tloes sucA work himself/heRelf or ihmugh
his Ot ner own em0loyee5, prOvidetl lAai Suth impmvemeni5 are not inlenOeA or offereA lar sale. IL Mwever I�e OuilCing Or
imprmement is sW0 vni�in one year ol com0�eiion, the awner will have I�e �urden o� O�ovinq he/she did no� Guild or imprwe
for Ine purpose of sale�.
I, as owner of the property, am exclusively contracling wilh Iicense0 con�ractors l0 cans�mci Ihe pmle�� (5ec�ion 7044, Business
� ana Piolessions Code: The COniracmrs' State License Law does not aOPty to an owner ol pro0eny w�a �uilds or impmves iherton
and w�o coniracls far suc� pfolecis with a conVaclor�s) license pursuant to ihe Coniractors' Slate License Law�. I am aware
Ihal pioal 0� Iheir Worker'S COmpensalion insurance ShOul� pe DroviOetl Io me.
� I am exempt unaer Seaion: B. a P. C.
�lor @is re on' j/ ?
�—(,b � �J Owner.
I Oo nereey cenify inal I am aware oi ina unaerstantl ine requiremenis oi Californu Healin ana Salely Coae Sections 25505, 25533, antl
2A34 ane IAaI loranylulure EuilUing occupanlvnlVvnllno��ci¢le one) n¢eG to comply vrith saitl s�at¢ cotles antliherepuiremenis lor a
permi� loi con9mclion or modi�icalion Imm Ne Air Ouality Managemenl �isiricl. Resitlen�ial construclion applications are erempt imm
mese nrovisions.
Date'. Applicanl�.
I hereby cenily��at I have�eaG this ap0lication antl statet�atihe aDove inlormaiionis correct. lagreeto campty vn�� ail city anA counly
o�0inancesandstalelawsrelalingloOUl�d�ngconslruciionan4�erebyaulMr¢ r resenlalivesaf�hi�ciiyt Ierupon�heabave�memioneA
pmpetly �a� mspe[Iion purp0l¢5.
Dale: IZ—I—Lv� SignaWre:
- Dd�ers ucense or Sociai Secudiy .:
16ab46 Wlnie—Bvilding: Groun—Goee Enlorcement; Canary—Apphcanl: Pmk—Revenue; Goldanrotl—Assessar
\
CITY OF COSTA MESA — BUILDING PERMZT PER'ri NO: P 06536:
PERMZT NO: P 065363 PLAN CHECK NO: N GO�'T: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: NEW
JOB DESCRIPTION ; 957SF 1ST FL, 907SF 2ND FL, 461SF' GARAGE SQ FT:
CLAIM VALUE: CALC—VALUE: GROUF OCC: R-3 /M-1
COMMENTS: REF: B-65010
**���*r*�#+��**#*****#*******����t*�*-�c�*�r***�****�c*�c�**��*�:*�*x�+�**�t*t��c**�r#***�****
Z O N I N G R E Q U I R E M E N T S
S E T b A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN
PARKING REQ; PROV: PARCEL: 11913319 ZNE: REF NO;
PLANNING NOTES>
>
# il�lf # it 1t ft # iE if # if if # 1E �f if # 1F ## il� 1F i(� iE iE # i! �E if # iF i4 if if if jE i4 fE �lf 1f 1F fE 1f !E if 1f �If iE iE if If �)f jE # if i4 fF # if ff i: # 1E f4 if iE ih iE �1F df �If %aF iF ff if 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:
BUILDING APPROL'ED BY : DATE:
APPLICATION ISSUED BY: DATE: � Z 4-I U' ��
�*�t*�r*�r***�t*x�*i�ft*�r**�t*�r er*�3FiF'ir.. . �. .. ��****+�****#3Fi�.��t�F'S�i2�'��r�
if iE �lE 1E iE iE iF it� if iE fE #` iE # iE �E iE it iE �lE iE iE if �lf iE ik iE ik iE iE iE i4 if if * if- if if if iF iE iE iE fE if iE if �N-ik if if iE if iE iE iF if # iE i4 ## iF if ##�It;E it if ## iE �f ih if iE �1[� #
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 30.00
25S SMZP/NON—RES
PLAN
ISSUE FEE 20.00
SUILDING—DIV—> FERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 30.00 20.00 0,00 �0.00 50.00 .UU
REVENUE DIVISION TOTALS--> COLLECTED: 50.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
5�.�0
iF iE iE if if if if # if !E iF if if it # if ik iE �IF if if if if 3E if� ft if iF iE if !t ik i! if # iE �IE �f ff 1E iE if if if� iE iF iF iE iE i4 iE iE if # iE � iE # fF lE �)E if !f iF iF iE dh tf iE iE if iF iF �F �1! fF if iE �Y
I N D I V I D 0 A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 S£WER, BUILDING / TRAZLER 15.00 15.00
PLU 1 SEWER, CONNECTION TO BUILDING EACH 15.00 15.00
END OF FEES
Of 0015240?-00152402 T.� Y 5C.�C
�i,TE: 12''.6'9;, TInE: pg:5$ �
�
/ �
r �
CONSTRUCTION AND PLANNING
APPROVALS Permit;`-
i. Temporary Elettrical Serv�ce or Pote
2, Soil Pipe-Undrgrnd.
3. Elect�icai Conduit UU4ty•Und�gmd.
4. Electr;ca� Condwt�Undrg�r.d.
5. Steei Remforcement
6. E:ectncal UFER Gmd
7. Faotings
8. Faundation
9. ';:a!er P�pe-Undrgrno,
70. Svuctural Floor Svstem
71. Praperry Sewer Line & Hause Connection
12. Sewcr Cap
13. Roof Drains
14. Rough Plumbing
15. Rough Eiectrical�Conduit
16. Rough ElectricN.�iring
77. Rough Winng Sign
18. Rough Electrical-T Bar Ceil�ng
19. Rough lieating & A.r Cord�t.onmg
Z0. Fough Factory Fireplace
21. Ducts, in Structure
22. Dutts, Ventilating
23. Gas Pipe-Rough � Tes[
24. Roaf Framing
25. Root Sheathing
26. T•Bar Ceiling (S[ructurall & Monocoat
27. Frame and F�ash�ng
28. Lathing & Siding
29. Insulation
30. Dry�vall Naihng
37. Plastcr Brown Coat
32. Electncal Po�ver 1r'feter F�nal
33. Findl Eleciric
34. Final Heating & Air Cor.ditioning
35. Pinal Gas Pipe-Test
36. Hoad or Canopy
37. F�nai Fattory Fveplace
38. Final Plumbing
39. VJater Service-Final
40. Gas Service-Final
47. Solar pomescioF�nal
42. Backflow Preventar
43. Backflow Irrigation
44. Landscape irripation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUI!_DING
48. F(NAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas 4
51. CERTIFICATE OF OCCUPANCY
Jo. Date
Date' j Inspector
POI._ & SPA
APPROVALS Permit ��
52. Pool & Equlpm:nt Locat�on
53. Steel Reinforcement
54. Fo�ms �
55. Electrical Bor�dmg
56. Rou9h Piumh�rg & Pressure Test
57. APPROVAL 1"O COVER-GUV�TE �
58. Electncal CordwhUndrgrnd. ��
59. Gas Pipe, I� Ur��a�rd . Test
fi0. Baclo.vash L'^.r,. P�Tra�, _^. ':�.dr,�.��
67. APPROVAI TO UFCK
62.-Back�.ash & Rcczvtor�F�r.a�
63. Heater & Vent�Fins;
G4. P!umbing SYstem � F�nat
65. Electrical-F,na'�
66. Solar System�Fin,.l '
6�. Fencing & Accr.ss Approval
- , --
Date I inspeccor �
- �-- -- --- ;
� --
68. APPROVED FOR PLP5TER1\G � ''
I �
69. POOUSPA SYSTE��'S FINAL
--- -- --�'- - �--
FIRE DEPT. REQUI�Et:'L-f��T I
APPROVALS � rr,nit -ir' ( I �
70. Underground HYdro �
71. ProtluctP;p.nq'_Gas 70�1 �
--{-
72. Undergrounu F P�t � _ �
73. Undergmc. S!nr;,nc -�n!� � Gas :-' :i .
74. Overhead Hyd�n
75. Dry Chemica�
76. Dry StandF'c�
77. FIXED SYSTE':S FINAL
78. FIRE PREV. F!".:P,L �_
HEALTH DEPT. REQUIRENIERT '
79. F�NAL INSPCCTION ',
90. FOODCEHTIF��ATEiSSUED �
____ - __.1_- __ _ _ .
Notes:
-- - ----- -- -- - �
- - -- �
- -1
�
n
7
�
PFOJECT AOUflESS:
OWNEB'S NRME:
AUOflESS:
DR WEST
uxir: 1
675-6653
AfltH/ENGINEEfl: WILKINSON �1SSOC qEG.NO.: C9Si9
aooxess: 18002 SKYPARK CI uxiT:
IRVINE CA 92714
PERmmEE:HARBINGER HOMES (714)675-G653
noonEss: 375 PROMENTORY DR WEST
NEWPORT HEACH CA 92660
LICENSEO CONTBACTON OECLIBATION: I hereby alfirm thal I am licensed un0ef Drovisions ot Chaptef 9(commencing wi�h Sec�ion
7000) of Division 3 0� I�e Business antl Professions Code, an0 my license is in lull force antl eifeci.
CITY IIC.: STATE LIt.: CUISS:
�aie: Signa�ure:
WOflNEBS' COMPENSATION OECLABATION: I hereby aifirm �hal I Aave a cenificate of con5eni Io self-insure or a certificate of Workers'
Compensation Insurance, or a cenilie0 copy Ihereol (Seclion 3800. Lab. C�.
POLICY NO.: EXP. DATE:
COMPNNY:
❑ Cetlilied copY is hereby Wmishetl. ❑ Cehifiea copy is filetl with ��e ciry Building Oivision.
Date: PpDlicani:
E%EMPTIONFflOMWOflNEBS'COMPFNSATIONOECIAflATI�N: Qhi55edmnn¢¢Ono�beCamDleletlil�hepermi�iS�OroneAunOr¢tl�Ellq)Orless�.
I cer�ity I�al in Ihe pedormance oi Ihe work tor which �his permi� is i55ueQ I shall no� empl�ny person i�manner so as to become
suble�t lo ��e Workers' Compensa�ion Laws o� Calilornia. '/
Oaie:' � .' � I — 7 �J � � Signa�ure: 1� ��
NOTICE: I�, af�er making I�is 4eclaraiion, you shoultl become subject �o the Workers' Compensation pmvisions o� the La6or
Cotle. you mu5i lanhwi�h compty wi�h suc� pwvisions or �his permi� shall be OeemeO revaked.
CONSTBOCTION LENDING AGENCY: I here6y affirm tha� there is a conStNtlion lending agency �or the pedofmance of �he work for
which I�is Permil is i<suetl (Section 3W7. Gv. C).
LENOEN:
aooRess:
OWNEF BIIILUEB OELLABATION: I �ereby a��irm I�a� I am eaemD� ��om Ihe ConVactors' State License law �or Ihe �ollowing reason
(Section 7031.5 Business ana Pmtessional Code: Nny cily of counry which reQuires a Dermi� to constmct, atleL impmve, Eemolish, or
repau any s�mcNre, prior �o lts issuance, also repulres �he applicant for such permit ta file a 5igne0 6�a�ement Ihat he/she Ia licenaetl
pursuanl to �he provisians a� �he Con�racmrs' S�a�e License Law (Chap�er 9(commencing with Section 7000) oi Oivision 3 0� Ihe Business
antl Pmte55ions Code) or �hat he/5he i5 exempl Ihere�mm and I�e basis br lhe alleged eMemption Any viola�ion oi Sec�ion 7031.5 by
, any aDPlicanl lor a permit sublects ��e applican� �o a civil penalry ot not more I�an five �untlree dollars �5500).
I, as owner of the pmpeny or my employees wilh wages as their sole compensation, wiil Oo the work, and ihe
❑ simcture is nol inlentled or oHereO for sale (Section 704a, Business antl Pmfessional Cotle'. The Conirac�ors' State License Law
does no� apply to an owner ol a praperty who builtls or impmves ��ereon, and who Ooes suc� work himseltl�erself or ihmugh
�is or her own em0loyees. providetl t�al such improvements are na� in�ended or oiferetl for sale. II, however ��e �uiltling or
impmvemeni is sold within one year o� comple�ion, Ihe owner vnll have the burden of Dmdng he/she Jid no� Uui10 or impmve
lor ��e purpose ol sale�.
� I, as owner o� Ihe property, am exclusively con�racting with licensed contraciors lo consimc� �he pmlec� (Seclion 7044, Business
❑ and Pmfessions Code: The Conlrac�ors' S�a�e Lirense Law Uoes nol appry to an owner ol pmperry who 6wIUs or improves �hereon
antl who conlmcls far such pmjects wi�h a canVacmqs) license pursuant m �he Contrac�ors' Staie License Law�. I am aware
Ihai pmo� oi I�eir Worker's Compensalion insurance shoultl 6e D�ovitletl �o me.
� I am exempl under Seclian: B. 8 P. G � /�
�ur Ihis ieasun: ��1 a�
Oa�e: � �' ZZ � � Owner: <.SN^�� �
I Oo hereby certiry Ihat I am aware of antl unUerstantl ihe requirements oi Califomia Health and Safery Cotle Sections 25505, 25533. antl
2553a antl iha�l oranylu�ure builUing occupan�will/will no� (circle one) neetl�o comply with said s�a�e coaes and �he requiremen�s�or a
permi� for conslmclion or mo0ilicalion �mm Ihe Nir Oualiry Management DiSVicL Resi�eniial conslmc�ion apDlicaiions are exem0� f�om
these pmvisions. `
�I
�ale'. Applicani:
I hereby cerlity thal I have reatl ihis applicaiion and 51aIe Iha� �he ahove intormalion is correcl. I agree ta compty with all city antl counry
ortlinances ana sla�elaw5relalingio building constmc�ion and here�y aulharizerepresen�atives o�lhis -yto enieruponthe aEove�meniioned
pmpetly lor inipection purpases.
111�jZ \
Oate'. `� ` ��� ~ L,.� Signalure'.
onver's License or Socia� Securiry p:
164La6 Wlme—Builtlmg: Green—Gotle Enlorcemem: Canary—Applmanl; Pink—Revenue; Goltlenro�—Assessor
CITY OF COSTA MESA - BUILDING FERMIT
PERMIT NO: H 065010 PLAN CAECK NO: 03391-93 A
CONSTRUCTION TYPE: V-N
PERMIT TYPE; STR
rtx ��v; et vo�viu
bVVl: IV JUYY; IV
PURPOSE: NEW
JOH DESCRIPTION : 957SF 1ST FL, 907SF 2ND FL, 961SF GARAGE SQ FT: 2,325
CLAIM VALUE: 110,000.00 CALC-�'ALUE: 196,510.60 GROUP OCC: R-3 ;M-1
COMMENTS: NEW SFR, PLAN Jtl
*****����r*+c��c--x****���**�r**-�***�f**��c-�-*�-**;�**�***�c�*�+r+�******�c�z�**�c*s**�****�c**�*-�
' 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 HUILDING ---------
FRNT; 20 FT IN REAR; 20 FT IN FRNT; FT IN REAR: FT IN
LEFT: 5 FT IN RGHT; 49 FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ: � 2 PROV: 2 PARCEL: 11913319 ZNE; R1 - REF NO: VT-14815
PLANNING NOTES> SINGLE-FAMILY.HOME (292 PACIFIC C$EST DRIVE) PART OF A
> SUBPIG'ISION (TRACT 14815). LOT'1.
�ir�-***iE*i�i�*�c�ritla�t**�t***�t�F*�t+r�t�E*it**it*�r�E�f���rfr�x-�-�ri�i�**+t�ti�***�f*�t*�r**�*�t*�c-*�t*******+r�r+r
D E l,' 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. ;•' C� � � DATE: ��I1-L��13_
BUILDING APPROC�ED BY : DATE:
APPLICATION ISSUED BY: ' � �lC�� S�'" DATE: �(_��"-( S-J
*�-��*****�i�***�t�t***;t�**�t*�**�**�-******�:***r **x*���*�**�*+�**�:�c**�c*���r*�*?�� �F�*�u
#� iF if ii iE iF iF 3E iF if iE iE iP 1f iE jE iE iF 9i� iE if �iF iF if 3E iE iE 9i if iE if jE iF iE iF * it 3E iE if iE ii iE 3E if 3E �E 3f:E iE aF iE aF jE if if 9E it aE iF ic� if iE iF i4 iE jE aE iE af i� �)f 1F 9F iF jE iE iE iE
LEGALI2ATION;N F E E S U M M A R Y STRUCTUAAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
FERMIT 804.00 • 14.65
SMIP/NON-RES
PLAN 170,65 �
ISSUE FEE
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 818.65 0.00 130.65 949:30 949.30 .001
REVENUE DIVISION TOTALS--> COLLECTED: 818.65 OVER/SHORT; ,00
BLDG PMT PLUMHING ELECTRIC ME.CHANIC FIRE SMIP/TOT GRADING PLAN-CAECK
804.00 14.65
1E iE iE iF iF i! 1E if �f if if iE i6 iE �lf iF dE iF it� 1E 1E iE iE iE it if if it iE iF if iM1 if iE if if iE df iE if if iE iE jE �M iM1 iF if iE i(� it iFiE ih �lE iF iF if iF 1E �lk iF if iF �IF # iE i(� jF iP if iF iE iF iF iF iE #-Y
I N D I Cr 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 UNIT COST TOTAL COST
SFR 1864 DWE-TYPE V-WOOP FRAME -GOOD 74,00 137,936.00
SFR 461 RES-GARAGES TYPE V 18.60 8,574.60
END OF FEES ?
S
Qi OGS`�i1U5-0:�1`1107 �'L+-i :t3,E`
"vaTE� ti!2:,ly3 F.t?E: ?a:�1
��--
CONSTRUCT�ON AND PLANNING PaO� & SPA
+'
APPROVALS Permit # Date laspector p�ppROVALS Permit # Date laspector I
i. Temporary Elec2rical Service or Pole 52. Pooi & Equipment Location I
2. Soil Pipe�Und�grnd. 53. Steel Reinforcement
3. Electricaf Conduit Utility-Undrgr�d. 54. Forms
4. EleGtrical Conduit-Undrgrnd. 55. Electrical Bonding � �'
� 5. Steel Reinforcemenc 56. Rough Plumhin9 & Pressure Tzst (
6. Electr.cal UPER Grnd. 57. APPROVAL TO COVER-GUNITE i
7. Footings /(aQ,(�s 58. Electrical ConduirUndrgrnd. �
( �
r 8. Foundation ,t��6� 59. Gas Pipe, O Undrgmd., Tesc
�L �
. 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, C; Undrgmd.
70. Structural Floor SYstem 61. APPROVAL TO DECK
':11. P�operty Sewer �i�e & House Connection 62. Backwash & Recepior�Final
, 12. Sewer Cap 63. Heater & Vent�Final
,
13. Roof Drains 64. Plumbing System - Final
74. RoU9h Plumbing ' 65. Electrical-Final �
15. Ro�9h Elec!rical�Conduit 66. Solar Svstem-Final
76. Rough Electric Wlring 67. Fencing & Access Approvai
17. Rough Wi�ing Sign 68. APPROVED FOR P�qSTEftING �
18. Rough Electricai-T Bar Ceiling 69, POOL/SPA SYSTEAIS FINAL �
19. Rough Heating & Air Conditionin9 FIRE DEPT. REQUIREMENT I
20. Rough Factory Fireptace APPROVALS Permit # I
21. Ducts, in Structure 70. Under9round HYdro
22. Ducts, Ventilatinq 71. Product Piping �Gas ❑Oil
23. Ga: Pipe�Rough & Tesi 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing �...�g_qe� 6e„� 74. Overhead Hydro
26. T�B�r Ceiling IStructural) & Monocoat 75. Dry Chemical I
27. Frame and Flashing 2...�Y.�qG� 76. Dry Standpipe I
28. Lathing& Siding 2�-��-� �c.(pF 77. FIXED SYSTEM FINAL
29. Insu�ation 2--22�(.f 78. FIRE PREV. FINAL �7-R�( W� ,,,
30. Drywali Nailing � z�-qY (,�..� HEALTH DEPT. REQUIREMENT 6�.;
37. Piaster Brown Coat 3 �G� �pCudL_ 79. FINAL INSPECTION �
32. ElectricalPowerMeterFinal k'��q.yy R�Qy��B(. FOODCERTIFICATEISSUED
33. Fina� Etectric .L�„e�,�'(( �(, Q�t � otes: 2... �_Gl tr_rh`� �i'a �„1ijy,� ����
!7 �-
34. Finai Heating & Air Conditioning !t"���qY �
35. Fina� Gas PiDe-Test 3�Y_qY �
36. Hood or Canopy
� ^ `
37. Pina� FactorY Fireplace `' l
38. Final Plumbing y!S q(` � 1
39. Wat¢r Service-Final _z _�
40. Gas Se�vice-Final Y-is-q�i �,� ���
41. Solar pomes[ic-Fina�
42. Backtlow Preventer
43. 8ackflow irrigation
44. Landscape Irripation Syscem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUIIDING ^.Z�_L' 6'Cc.�/
48. FINALPLANNING .3?../�'y (,�E �� ir�.�y
49. Electrie Refease to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCV
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. ❑ Yes ❑ No
2. I (have/have not)
proposed work.
signed an application for a building permit for the
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone (
City
Contractor's Lic. No..
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
City
Contracror's Lic. No..
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Address Phone Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19630 of the State
of Calitornia Health and Safety Co e and have completed the above information to the best of my per-
sonal knowledge, in mpliance th this ate law.
��
Signed: Date: �/-2 Z s'(,�
Name: �
(Printed or Typed)
C.D.L. N or S.S. N� ��
754-5273
,o�:�
TO:
Applicant:
Address:
NE"'�ORT-MESA UNIFIED SCHOOL DIS' �T
1095
r �
CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES
PURSUANT TO AB 1600 AND AB 181
�) City of Costa Mesa District Receipt No. —��=��
( ) City of Newport Beach
( ) County of Orange Plan Check No.
Telephone Number: �� 4� �' j S-� CS,3
TracUP rcel and Lot Number(s): �`t ��S �@TS � ���4� s
Location of Project: 2�3 S�m1TA Ri.i /� QVk%JU �
10, Sol t� n1E�J
Number of Square Feet of — 2� 37 � I�f �L.�
Residential Space Z3 x$1.65 Total � �3� ��2 •�S
Residential /
Sr. Citizen Space
Commercial and
Industrial Space
R & D Space
Warehouse Space
Commercial / Industrial Project is: (Check One)
Warehouses
R&D
Movie Theater
Mini-storage
Heavy Industrial
Regional Shops
Light Industrial
This project is exempt because
x $ .27
x $ .27
x $ .2652
x $ 2253
Motel
Bank
Neighborhood Shops
Racquet / Health
Hotel
Medical Office
Office Park
Total
Total
Total
Total
Preschool
_ Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government
Code Sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now
be issued by your jurisdiction.
Checks are to be made payable to Newport-Mesa Unified
�
The above representation as to square footage is true. Applicant agrees that if it is later determined that such
representations are not true then this certificate shall automatically terminate and the appropriate Ciry/County shall be
notified.
Date: l I — I �'93 `�
Applicant
PH6IECT POOflESS:
OWNEfl'S NAME:
aooeess:
R WEST
uNir: 1
675-6653
PflLH1ENGINEER: WILKINSON A$$�C flEG.ND.:C9SZ9
auosess: 18002 SKYPARK CI uxiT:
IRVINE CA 92714
renmince: HARBINGER HOMES ( 714 ) 675-6653
aooncss: 375 PROMENTORY DR WEST
NEWPORT BEACH CA 92660
LICENSEO CONTPACTON OECIAPATION: I �ere0y allirm I�at I am IitenSeA un0er Omvisions o� Chapter 9(commencinp wii� Seclion
7000) at Drvivon 3 0l I�e Bu5ine55 aM Pmiessqns Catle, anG my license is in I W force an0 eilecl.
CITY LIC.: STRTE 11C.: LLASS:
Dale: Siqnamre:
WOflHEPS' COMPENSATION oECUHRTION: I nereUy anirm ihat I nave a ceniiiwte of cansenl to sell-insure or a cenilicate of Workers'
Comoensatbn inswance. or a mndie0 caoY tnereoi �Section 3800. 1a0. CI.
POLICV NO.: E%P. ORTE:
COMPRNY:
❑ Cendie0 cooY �s nereoy fum¢Aea. ❑ Certifiea copy is fil¢� �ith iry Birildn � v ion.
L
- ai . AODlicanl: F�
EXfyl ION iflOM WOflNEflS' COMPENSRTION OECIAHRTION: (ilus secfion neM roi be campleteG il Ne permt is iw one hunOrM �510D) or less�.
—rertily ��at in ��e pedormance ai Ihe work br wNch I�is perrttii is issuetl. I ShaN not emplay any person in any manner so as to become
suojecl lo Ine workers' CAmpenSation LawS of Cdlifomu.
oa�e: Synature:
NOTICE: t�, alier making this tleclaration, y0u slwula Oecome suGlect Io l�e Wotkers Compensa�on provi5ion5 a� t�e La�or
Coee. you mu9 Ion�x�i� comply wit� suc� provi9ons or iNs permit shall Ue deeme0 revoke0.
LONSTflUCT10N LENOING RGENCY: I her¢by atlirm Itul I�ere is a canstmt6on IeMing agency fOr Ihe periarmante Of lhe work lor
wn�cn m�s oermn is issuetl ISeaion 3097. Civ. C�.
LENOEfl:
AOONE55:
OWNEB BUILDEB OECWHA710N: I �ereby allirm Rut I am e�empi Imm �he Conirac�ors' S` te License Law lor t�e Pollowing reason
(Sec�ion 703L5 Business an0 Pwlessiorul COEe: Any dry al munry whic� repuires a Dermit to consirucl. alter, imprwe, tlemolR�, or
repair any stmcture. prior to its i55uance, also repuires the appli[ant for suc� Dermil Io lile a 5i9neG s�a�ement Ihat �e/she is licensetl
pursuam Io Ine O�ovisions ol the tontractors' State Licenu Law ICnao�er 91�mmencing wi�h Senion 7000� ol Oivision 3 0l tne eusiness
antl Pmlessions Cotle) or Inal he/sne is evemD� Iherefrom ana ihe Uavs lor ine atleqee exemption. Any violation ol Seclion 7031.5 by
any aoD�icanllor a permit suoieCis ine apv��nt to a tivil oenalry ol not more ttun Iive nunarea Aallars (5500).
1, as owner ol Ine D�operty or rtry emyl0yees witn wages as �neir SOIe compen5ation, will tlo Ihe work, antl ine
❑ slNcture is nol inlenCetl ar olleretl lor Sale �S¢clbn 71Wd. Business antl Prote55ional CoOe: The Caniractors' State License Law
Ooes nol apO�Y �o an owner ol a pmp¢tlY � �uilEs or imprOves tAereon, anJ wtio tloes suth woM1 �imselV�ersetf or IhmuAh
M1i5 or h¢r own emDloyees. D�od�e0 Iha� SUch imptovemenis are n0i inlenata or Offete� lor Sale. II, �owev¢r I�e Ouilding or
� impmvemenl is solG vnl0in one year of complelian, I�e owner will �ave t�e Ourtlen ol OrovinA he/she Uitl not Ouiltl or imOmve
br ihe ourpose ol sale�.
� I, as owner ol l�e DmOerty, am exclusively ConVattinB ��h IiCenSeA mniraClOrs lo cOnSVUd I�e O�ojett (SeC1i0n 71WE, Business
anE Pmiessions Cade: T�e Contractors' State L'¢ense Law Ooes not appN �o an ovmer ol pmperty who Cuil0.s or improves tAereon
antl who conlratls br such pmjecis witn a conlraclorlsllicense Oursuant�o �he ConVactors' Slate License Law1. I am aware
��al pmol of Iheir WorkeYs Compen5afi0n in5urante 5tqu10 6e Drovi�eE Io me.
� exe.m0� unCer Section: B. 8 P. C. ��
r Ihis reason:
iDal �1z q4 Owner.
tlo hereby cenily Iha� I am aware ol antl untler51an01he repuiremems a� Calilomia Healih antl Salely Coae Sec�ions 25505. 25533, and
25530 ana t�at I or any IUWre �uil0ing oaupant wilUrrill not (tirtle one� neetl �a comDN'�'��� �iE s�ate to0es antl ��e �epuiremen�s for a
uermil lor conslruclion or motlilicalion Imm ��e Nir Oualrty Managemeni �isVict. Fesi�ential cons�mc�ion apDlicalions are e�empl Irom
IhCS¢ prOvi5i0ns.
Oate: Npplicant:
I here0y [erlilyl�al I have read I�is applicalion antl 51alelAali�e abavelniormali0ni5 torr¢tl.lagree ro comply wii� all tity anA Couniy
artlinances antl stat-law5 reWling lo Ouiltlmg cons�mction anG �ereb/ authonie re0� 5enlaiive5 ot,h�qCily �o en�er upon ihe above�men�ionetl
pro ¢tly for mspeciion purposes. '� � �
1 ;IR
Ie: Z` SignaWre: 1`�
,
riv s License ar Socia� Secunry +:
16a1�46 wnpe—Bwldmg; Green—Coae Enlorcemenl; Canary—AOPlicanC Pinx—Revenue; Golaenma—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: M 065682 PLAN C[iECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC
JOB DESCRIPTION : ADD FACTORU FIRE PLACE
CLAIM VALUE:
CALC—VALUE:
PERM NO: M 06568"
GOVT: N SUPP: N
PURPOSE: NEW
SQ FT:
GROUP OCC: R-3 /M-1
COMMENTS: REF: B-65010
**+�**�ex�**+�x�+rr**r***�r+t*+r�r**ir+r+e*+r�r*�r�r*�rx�*�**x�**�r*+�+rx�+r+r***�*r+r�-*****�xw**�*«****+r+r
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY 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: 11913319 ZNE: REF NO:
PLANNING NOTES>
>
if 1f 7f ff fE 1f dE iF fE fF ff iE 1E 1E 1E %iE fE 1f fF if 4 fF 1E 1f !f !E 1E if tf iF if itlF fE iE if if if !f If it iF if iE ff �E M if iE 3f it 1f 1f M if k iE 1E %fE ff !F if if It iE iF 1E �E iF fE ft �f iE iE iE iF iE
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY; DATE: �,�F��
1Eik1fiElfMifiEiEM1E1Fif1E1E1tfEM1l1f1Eif iElflfiflFMifif%iE iEiF
�t+t*�t�t+tit�tirit�r�t**�r**it******it****r**�r*�t*ic****�t�t�r****it�r**r*r***+t**+t**+t�t*�t**jt ***�t***
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
PERMIT BLDG PMT PLUMBING ELECTRIC MECH6NSC� FIRE SMIP/RES GRADING
252 SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDING—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
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GKADING PLAN—CHECK
21.50
1t if if M i1 M M if �F f!!! if f! ft 1E ff ft iE 1f iF 4 if iElf tt it itlf k if 1! i! 1P iF if iF 1f it k it iE i! it it if it iF if M iF 1f iF ik M ff if M�E fE iE iF if 1t 1f 1E 1F 1f 1! 1E iF if if iF if 1f 1E if fE 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
MEC 1
D E S C A I P T I O N
FACTORY FIREPLACE
END OF FEES
UNIT COST TOTAL COST
6.50 6.50
QI Q02.5�d3�;-�0=253L3v ����- , ��
G.3Tt: U��i?,'6r TIii.: �— -i.��
14: ,� �
CORS7RUCTIOA' AND PI.AN{LInG
APPROVALS Permit � .
�
InspectOr �
POO E & SPA
APPROVkLS Permtt ::
- - --I - - - - -I
�
Date � inspector �.
T �
1. Tempmaiy Electncal S.:�v�ce or Poi� 52. Pool & Equipmeni lucaY.un , I--; .
� ' ? Co i P��e-U�drp•^;. � 53. Stecl Rcinf�rcemvnt ' ' I �
rt:. ---- --- -- ---- --�'--- -------f -j-"--
' E e�'.'�.i. ' CJ' �...t ,i.'rty.l..'. rg� .G. ' � 64. For.nS _ _� _
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?��i:�; ��e��ncel C;: d�.,.t-l�nd,-a�;-n. - � 55. Eleciricai Bond�n� �, � '
r o,,. . � •,�....-. ._�� _ _ -_ __ � _-_�_-� 5f, Rauah Plwnbing U P.essu. c T,S� -'_ j_ _ _ � -_-.
ir__ _ __ ._.-_- _ �-___ _ - -'� __-_;-__ _,
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i-{�- - - - - - --- - ---� ---' -�-- '- - --- - - ^- - - - - -'
. i {! f-ool�� i � ' � � � 58. Eloctncal COndui(�Untl�gmd, i i
� � f -- -- - ---- i ---�---- ---- - - - - - - -�.
. I • $. Fou.CeU^• -�. . 53. GaxPipu, LI Undry•,J..7r�; � �. �
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; �. '.. 1�., �' p..l,�7rr.md. -�T- � E�. �3C:���Sh '..��1c5. P''i;.p, � .. .u...ti�r.i, ��
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_____"'._ "._ _'.._1_ __ __
�� i 10. Structu�ui �'oor SYstem � I i 6L APPRQVAL TO DtCI< I � ,
;"' 11 , �.m•'V 5� r i_��r & �'n..�c Cc�„�Pc��on - -'}-----=�- - i - - ----. --,- -- .`-"_- --;
67. eac;v�e;h Ci Rei��'����F.n�! 1
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_ -___�___.�-' _ _ _____ __� __-__I_.'__♦
,%', 72. 5: �.c. a? .�--I 63. Healcr & Vuni�Fina� 'j- L--- --
� 13. Hoo* Dra�n,--___ --_�- � 6A. Plumbing SYstem � F��n:�l -�-'i ---� I
', '4. qc._n'�-_�^��nn -.______�-y�- r '.__--�,--7
� u5. G_cLicab� mnl �
� 15. Fo,..7'�� c'.cct� ca'� Cond�...: I- --- --' -� -i
� - - - 66. Sol�r SYstem�:-r�o� -- - -i- -- � - �
16. Rc�gn �iectnell'iring 67. Fendn� & Ac�ecs Approe.�l _�� �
� 17. Rough!V����gS:an I &8. ,qPPROVEC FOR?LASIERI�ZG ! .
�
18. Ro��1 Elect�ica6T Bar Cei� na
1�J. R��.�h yeat���.3 & A�r Co^c�tioning
?C _'��,U� r'.�_*o�� i �� s,�c - ---..
69. POQUSPASYSTE;,;SFiNAL
FIRE OEPT. REQUIREMENT
,�PPf;bV,4�_S Per�it
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71. Prouuci P.,�in�� I l.'., ' Gi' ,
l� __ -�.� ___ � ____-._- ___ __ - --�
___ __--____-_ _�______i.__
II i3. S:: ° p._.5o_:{h ii� l'cs' �-'_ f_ -_ I.77. :ir.c,� �. �o.. �ri 'i�..,. . � I
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� � , �. 73. Undcrgmd.Stora��� �a�,a " G�a . � p . .
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38. Fina� P'umu•�ni ' I . .
39. lYater SernerFinal^- ' � , -_ �-�------- -�-�-
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50. Gas Pele�s^ to Southem CzP'c�n�� Gas Cn� - i � �
51. CEflTI' C,' E OF OCCU?0.'QCY I r-- ---�---- ---- -- -�---�-�----
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