HomeMy WebLinkAbout2423 MISENO WAY - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
,lob nddress: 2423 MISENO WY
Suite:
Vicinity: ROOF
Parcel Number: 43914320
Applicank HANSEN, qUKE
Address: N6646636
Owner: LESTER, WILLIAM F
Address 2423 MISENO WAY
COSTA MESA, CA
Convactor: ROSS & BARROWS INC.
Address: 260 E ALTON AVE
SANTA ANA, CA
Zip: 92707
Ardi :
Address:
Zoning:
Phone:
Zip:
Phone:
Zip: 92627-1418
Phone: (714)557-7440
License: 327802
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 04/29I2002
Issued: 04/29/2002
' Phone: , - , Phone: -
Zip: � � License: � � License:
SCOPE OF PERMIT
REMOVE OlD B.U.R. AND INSTALL A NEW 4 PLY B.U.R. ON UPPER FLAT ROOF ONLY.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total:
$0.00
$83.25 -
$0.50
$0.00
$0.00
$0.00
583.75
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-b
PARKING Existin : 0
NOTES:
Rear 0. 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0• 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0
32,300.00
52,300.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if xrork is suspended or abandoned
for a period ot 780 days.
INSPECTIONS: In order for �he work authorized under this permit to be considered legal, such work must comply with all epplicable codes, and all
requlred Inapectlone end final epproval must be obtained. Fallure to obtain inspections antl final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
:wwo �aw7
WORKERS'COMPENSAnON DECLARAnON:
I �ereby ettirtn under penalry of perjury one ol the following tleGarallons: �
❑ I heve entl wlll maintein a certificate of consent to self-Insure lor workers' compensetlon, es provitled for by section 3700 of ihe Lebor Cotle, for Ihe peAartnence of Ihe
work for which I�iS permlt is issued.
fY_ 1 have end will maintain workers' compansetion Insurenco, es requiretl by section 3700 of �ho Lebor Code, for iho Dertormance ot tho work lor which t�is pertnll is issuetl.
T My workers' wmpensatlon Insurance carrler entl policy number are:
Cartler: 5� �- �P� .�.�J// policyNumoer b`16 ' �Z.Oa/O Fll�
((hls sectlon neotl nof be comp/eted Athe permlt is valuetl ef one huntlred dollers (5100) oi /ess.)
❑ I certify that in ihe pertormance of lhe work lor which ihis pertnit is issuetl, I shall not omploy eny person in eny manner so as to Eecome subject to the workers'
compensatian lews of Califamia, end egree thet II I should become subject to t�e workers' compenselion pmvisions ot Sectlon 3700 0l the Lebor Cotle, I s�sll forthwith
comply vrith these provisions.
ApplicaN SipneWre: Date:
WARNIN(3: FNLURE TO SECURE WORKERS' COMPENSATION WVERAGE IS UMAWFUL AN� SHPLL SUBIEGT Ml EMPLOYEfl TO CRIMIWIL PENALTIES PND CM� FlNES UP TO ONE HUNDRED
TFKKISAND DOl1ARE (5100,OW�, IN ADDITION TO THE WST OF COMPENSATION, DAMnGES AS PPOVIDED FOR IN SEGTION 3]O60F THE LABOR CODE, INTEREST, M1D ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirm ihat I am
rorce ena ettect. uc. x_
Conirector's SignaWre:
of C�apter 9(commencing with Seaion 7000) ol Division 3 oi lhe Business antl Professions Code, and my license is in tull
qass a C--.3 (
�e �— oate: �'/— )- �— o�
CONSTRUCTION LENDING AGENCY:
� I nereby eflirm tnat ihere is e consWcUon lentling agency tor Ne pedormance ot the work tor wnlch tnis permlt is iuued. (Sec. 3097, Civll Code).
Lenders Nema: Lender's Address:
Signature: � Data:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn ihat untler penalry of per�ury Ihet I am E%EMP7 FROM T11E CONTRACTORS LICENSE LAW for the tollov.ing reason (Sec. 703t.5, Business antl Professions
Code: Any ciry or counry which reduires e Dermit lo construct, elter, improve, demolis�, ar repair any strucNre, pnor lo its issuance, elso reduires the applicaN tor such permil
to tlle e signetl steiement that he or she is licensed pursuent to the provisions ol ihe Cantrectors License Lew (Chapter 9(commencing wIN SacUon 7000) of Division 3 of the
Business en0 Proleuions Catle) or that he or she is exempt therelrom end the Dasls for the elleged exemptlon. Any violatlon of Section 7031.5 Dy eny epplicent tor e pertnit
sub�ects tha appllcant to a civil penalry ot nol more ihan live hundred tlollars ($500).):
❑ I, es owner of Ihe properry, or my employees with weges as their sola compensetion, WILL DO THE WORK, and t�e strucNre Is not imendad or otteretl for sale (Sec.
7044, Business and ProFessions Code: The Coniractors License Lew does not epply to en owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided thai such improvements ere not Intended or oRered for sele. If, however, tha builtling or improvement is
sold within one year of completlon, the owner-builder will have t�e burden ol proving that he or she did not build or improve br purpose of sale.).
❑ I, as owner ot the properry, am E%LLUSIVELY CONTRACTING WITH LICENSEO CONTRACTORS to construct the project (Sec. 704d, Business and Protessions
Catle: The wmractars Licensa Lew does not apply to an owner oi property who bulids or improves Ihereon, antl who wmracts for such projaci with a comractor(s)
license pursuani to the Contractors License LewsJ.
❑ I am axempt under sec. Bu5ine55 and Prolessions Cotle tot �his reeson:
Signature: Date:
Owner ID verilietl Dy tlriveYs license. ❑ Ves ❑ No Drivefs Licenso No. Eapires:
Vedfication ol Ownership by (rype ot document, i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATON:
❑ I hereby cenlly that no eacavetion live (5) or more leet in tleplh into which e person Is requlred to descentl, will Ce made in connectlon with work euthorized by this
permlt, antl that no building structure, scaftolding, lelsework, or tlemolition or dismantling �hereol, will be more than t�irty-slx (3B) teel high. (Chep. 32, Grp 2, Art 2, Sec.
341, Title 8, Celilomia Administretive Code).
❑ As owneo-Dullder, I will noi amploy enyone to tlo work w�ich woultl require a pertnit Irom the Divislon of Industrial Safely, es noted ebove, unless such person has e
pertnit ta do such wark Imm ihe division.
Signature: Date:
Division oi Indusirial Safery Pertnit Number:
CER7IFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I certity unGer penalry ol perjury that 1 hava reatl �his ep0lication and state Ihat the infortnalion given is
wrrect. I egree to cwnpry with ell sate lews entl ciry ordinances rela6ng to bulltling conswctlon, and euthodze representatives ol the Ciry of Costa Mesa to enter upon I�e
ebovo-describetl property for inspection purposes. I agree not to accupy or elbw occupanty ol any Cuilding euthonzed by this pertnil until linel inspection.
�li�Signeture Ot Legal Owner;) Date
i �� y—Z (�' — � �
And�Or Authorized ApDlicant Date
COOE 1, INSPECTONTYPE
1616 Fixetl System Final Fire Preventlon
1266
200
201
202
20.3
204
Pool Spa Final
Finel RaRoot
Finel BIocWRetaining Well
Final FeCiory Fire Place
Final Sign
Final Demolition -
PAIE I[�LS
?-oz �
COOE 1 INSPECTION TYPE
206 Flnal Mechanical
20B Finel Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Flnal Planning ApD�a�al
222 Flnel Site
250 Flnal Buildiny0aupency
PdIF II�AL$
�
aooness: 2423 MISENO WY
iSNAME: KLOHS, JOHN W
aooxEss: zq�35�9ISEN0 WAY
COSTA MESA,CA
APCNIENGINEEB:
92627
NEG.NO.:
uxrt:
AOOFESS: UNIT:
PEXMITTEE: BRAI'IMA HERD (714?649-2976
aooxess: 28811 MODJESKA CYN RD
SILVERADO CA 92676
LICENSEO CONTPACTON OECIAHATION: I hereby allirm thai I am licensetl untler pmvisions oi ChaD�er 9(commencing wi�� Section
7000� of Division 3 ol Ihe Business antl Professions Cotle. and my license is in fullforce and eflect
ciTvuc.:061060 sTaTeuc.:601558 �,SS,C-39 XP• 12/99
�ale' � 2-` 2� — 1� SignaWre�$'� G�LiL—�—E�e�o—
REBS' COMPENSATION OECIABATION: I �erehy aflirm Ihai rnave a cenihcate of consent ia self-insure or a cenificate oi Workers'
Compensation Insurance. or a reriified copY Ihereol (Seciion 3800. LaO, C).
POLICY NO.: E%P. �PTE:
COMPpNY:
❑ Certifietl capY is hereby tumished. ❑ CenifieA copy is lilea with �he city Building �ivi ie
oaie I �L�Z%_ I � Applica��
MPTION FflOM WOBREBS' COMPENSRTION DECLABATION: (ihi55ecimn neetl not be comple�¢tl if �he Dermi� iSlor ane huntlretl �$100) of 1e55).
I cetli�y Ual in lhe peAormance of Ihe work for w�ich IM5 permi� is issued, I shall nol employ any person in any manner so as �o hecome
subleci to I�e Workers Campen5alion Laws af Calilomia.
Dale'. Signa�ure:
NOTICE: II. after making ihis declaration, you shoule become suhiect to ihe Worker5' Compensation pmvisions of the Labor
Co�e. you must forihwi�h comply wilh suc� pmvisions or Ihis permii 5hali be UeemeC revaked.
CONSiflULTION 1EN01NG AGENCY: I here0y afhrm Ihat there is a constmction lending agency tor the pedormance of Ihe work br
which Ihis permil is issuetl (Semian 3097, Civ. C).
LENOEH:
aooeess:
OWNEF BWLOEB OELLAflRTION: I here6y attirm �hat I am ¢xempt imm Ihe Con�ractors' Slaie License Law Pot �Ae following reason
�Seclian 7031.5 Busmess ana Pro�essional Cotle'. Any cily of counry whic� reQuires a permil �o cons�mc6 alter, improve, Oemolish, or
repair any s�mcture. prior �o ils issuance, also reQuires the applican� for such permi� lo file a signed s�atemen� Ihal he/she is licensed
pursuant Io Ihe pmvisions o� �he ConVacmrs' S�aie License Law (Chap�er 9(commencing wi�h Section 7000) ot Oivision 3 of ihe Business
antl Pmfessions Code� or Ihat �e/she is exempt therelmm ana ihe hasis for ihe alle0e4 exemptiort Any violation of Section 7031.5 Oy
any applicani �or a permit sublecis the apPlicant to a civil penalry of not more than live huntlred dollars ($500�.
I, as owner of ihe pmoeny or my employees with wages as their soie comDensatian, will do �ne woM1, antl ihe
❑ s�mcture is noi inlen0e0 or oifereU for sale �Sec�ion 7044, Business antl Pwfessional Cotle: The Con�racbrs' Slate �icense Law
Ooes no� apply Io an owner of a OmDeM1y who builtls or impmves ihereon, and who tloes such work himseli/herself or ihrough
his or her own employees, provided Iha� such impmvements are no� inlende0 or o��ered tor sale. Ii, however �he builtling or
impmvemeni is sol� wit�in one year of com0�e�ion, ihe owner wi�l �ave ihe burtlen ol pmving he/she Uitl no� build or impmve
�or Ihe purpose oi sale�.
I, as owner oi the pmperty. am exclusively convactinB wi�h licensetl contractors to conS�Nct ��e project (Section 7044, Business
..J anA Pmfessions Code: The Comrac�ors' S�a�e License Law tloes not apply �o an awner oi OmDerty who �uilOs or Impmves Nereon
and who conlracis br suc� pmlec�s with a conVactor�s�license pursuantlo the ConiractoR' Siate License Law�. I am aware
Ihal Droof ot Iheir Worker'S Compensaiion insurance should be providetl �o me.
� I am exempi under Seciion'. 0. 8 P. C.
lor I�is reason:
Date'. Ownec
I Eo hereby ceN�y ihat I am avrere o� anA undersland the requirements ol Cahlomia Heal�h antl $afery Cotle Sec�ions 25505, 25533, ana
25534 antl Iha� I or any lulure building occupan� willlwill not (circle one) neetl to comply wi�h saiA slaie codes and Ihe requiremen�s for a
permii for constmciion or modilicalion �mm Ihe Air Ouah�y Managemeni OislricL Resitlen�ial con5�mciion applica�ions are exemp� irom
��ese pmvisions.
Oate: Applicam:
I �ereby cetlily��al I nave reatl Ihis applica�ion antl 51alelhai the a0oveinlormation is correcl lagree Io comply with allci�y and couniy
orAinances antl state iaws relating io builemg constmction antl �ereby amhorize reD�esematives oi rois ciry to emer upon ihe above-mentione0
properry lo�inspecuon purposes.
SignaWre: _
�icense or Saciai Sewn�y a:�
�6aLa6 WM1ne—Builaing; Green—Cotle EnbrcemenL Canary—ApPlicant; Pink—Revenue: GolCanrotl—Assessor
CITY OF COSTA MESA — BUILDING PEAMIT PERM NO: H 070564
PERMIT NO; B 070564 PLAN CF[ECK NO; N GOVT; N SUPP; N
CONSTRUCTION TYPE: PEAMIT TYPE: STR PURPOSE: OTH
JOH DESCRIPTION ; T/OFF & REROOF W/BUR SQ FT; 800
CLAIM VALUE: 800,00 CALC—VALUE: 800.00 GROOP OCC: R-3 /
COMMENTS: SMORE DETECTORS RE(� PER 91UBC
*�t+e�e+r�r�r�r�r�r�r�r�r�r�r**�rir�r+r+r��r*�rjrr **�r�r+r*ir*x+r+r+t�r+r*�e�e+��er*x-k�+e**r�*+r�+�*�e+r�-�rx*+r*rr*r*�rir�r
Z O N I N G A E Q U Z R E M E N T S
ssrBacxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT ZN AGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV; PARCEL: 43914320 ZNE: REF NO;
PLANNING N6TES>
D
*rr*�r�r�r***�r**ir**+r�r*x*�rx�r*�r*�r*i�*kit*r***itirr****�r*****�x�r******�r**r*ir�rr+r*r�rx�t�r*�r+r�e
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 ISSUED BY; DATE; C/� ��p
�t�r�r*r�r*i�ir*�r**+t*�tritir*r�r *�e***ifir***7i"iFiE�iF�.fF�����f+t 1
ikMiFlfifiElflFifltifaklfkifMlFikitifif%%ftifltfFMiflfifaflfiflfifitM7f1fiF1liliEififlFitMifiF�IfiFifififlEMiEifif9fifMiFififlfiFiflfiflf IfififiE4
LEGALIZATION:N �F E E S U M M A R Y STRUCTURAL'SEGMENT;Y
HLDG PMT PLUMBZNG ELECTRIC MECAANIC FIRE SMIP/RES GRADING
PERMIT 21.00 ,SO
PLAN
ISSUE FEE
SMIP/NON—AES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 21.50 0.00 0.00 21,50 21.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
21,�0 ,5�
1lItMMfFlfffiFiFilififlFlFitltillFitMMitifiliFiFifMffilifiliFMiFififititititMkffffifMMMlfiffflfMitMM4MifKlfikfE%ifffMlfififif3fifrMlfiti!
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
SFA 800 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 800,00
END OF FEES /
�
Y
Of 00174??S—i}0174225 Tla j �Z,��
GATE: :2l29/;4 TlME: ;.=:QS
�CONSTRUCTION AND PLANNWG ' POOL & '
;�
APPROVAlS Permit #' �, Date inspector qppROVALS Permit # Date inspector
1. TemOorary Electrical Serb�,�'�ce or PoRe 52. Pool & Equipment Location
�
2. Soil Pipe-Und�rnd. :�� 53. Steel Rainforcement
�•����
:� ?3.�� � e`�trical Con ui� ti(it `-U�dr md. 54. Forms
' ]�i.4 d,.S�i Y 9
„�qiiElectrical ConBuif;Undrgrnd. � 55. Electrical Bondiog
��5_��$€ei Reinforce.r�r 56. Rough PWmpir.g & Pressure Test -
�`df3e:£tectricalUFQR-�rnd. � 57. AVPROVALTQCOVcR�GUNITE
�
- �7...F_aozings �i R� 58. Electrical Conduit�Unu'rgrnd. -
v'8�6bundation ` 59. Gas Pipe, O Undrgm6., Test ;
9. Vdater Pipa-Undr��'+tnd. 60. Backwash Lines, P�Trap, C� Undrgmd.
10. Structur;l Floor;Pystem 61. APPROVALTO DECK
i t. Property Sewer Li �& House Connection 62. Backwash & Rec2ptor-Final
12. SesG�r Cap u, c� 63. Heater & Vent-Final
73. Roof Drains ��� ' 64. Plumbing System � Fir.al
L
14. Rough Plumbipg �� „ 65. Electrical-Finai
55. ftough Etectricai�Condult-. 66. Solar SYstem-Final
76. Rough Electri(1'!Niring a; 67. Fencin� & Access Approval
17. Rough Wiringc�ign � 68. APPROVED FOR PLASTERING
78, Rou9h E(ectric�l-T Bar Ceiling 69. POOL(SPA SYSTEPdS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
' C : ti77�� z t.., �•
20'�Ro_ayh,E�cto'�y �replace �� 'Q"' ; L' =� �y '��APPi�V�"5�'�Pearmic?< ' >' �'
� ,� rs;•:; ,HE-- ''�_'€-^-N_
21.'`.,D��ctS, in St�ucture. j.. �. ,-+�a > _ t-,�. x� 70. �kJndery?:d-ilh�G� H�iiro ? �
22. Dupts. '�'ent'+�T�tiri,g � � �� J * ,� ,� ` n# r .'71. ProduC�,�p�ng F7�Cjus ..r"jOi;
r� a, c �:. * � •� � � �
23.:Ga�,Piqe;Ro�igh&'Jes, i ;,�� > n; � C•.�� y�,72. Undergr'a9��dFinsTt_� d -' z
- � a,_,;_� � - -
24.=%Roof Fiaming ��� � �^�' ''E" ` =� C'�' � =7��Underym�l.S[or'�^T.�nk'OGas Q�9'il
�� ('�: ,r .7~ �/' r-•: �t s-... i
25. Roo,f Sheathing ,`;j;, r, p�Z�Q y;; �, �.74;�fl4erhead Flyclrej� �
`
26�T-Bqr Ceiling (St�r.udtural) &.T�}Ohbcoat R � ?� '�' ^1` * 7��",'�rry Cherpical �,� '� �"' '�
Uo a
27�'Freme and Flashi"' �;'� �M � n' " • t' ' `:; �.: �_�.; ` " "' `�f �r--�
� f;4� �a7�:; r c� � a1 � Y 7B. �ry Standpipe �- A �j
-� �_
,28.YLa.hinq-& �diing� . '� �:, � �` � • 77," FlXED Syt�+r� E'�;INA, _� �
� y ..1„�' ��. � � �
'�29. Insulatio� `' �'s '� � .. •. : f `:� � �i .r 7� FIRE PREV. FLNtWL a ;> �; >�
"30. Drytvall Naitrlig �� � f � � �- � " 'HEALTFPDEPYY. REQ'UIREM[NT
�31. P�aster �rowq Go'a�t; < j ;,.;;. ; � y ;.79�FINAL I��S9EC'I"!�¢3h ��� ' '" ;j
. �; ..... .+-i-'=, . ":-
r32. Electricat PdWer�2A¢te�-Pinal' �^� � � (� � 7&0^?FQOD CERTIF�'&Tc I�I�,ED.� �;
�33 :f�tt511 EI ctri 1,, �, y� E' � r
.,^ , r b � C^ ! 1 � + ��7 '*t ' 1'
., ? s i �: � I r. Nw,es: 3 1j�� f1 7c*'�0�7 �G'.�,
�. �. i : � ^..
L34: iFi:t?I Heatingi& $tiaConditi�r�'4D9: Ci +� I•` 4 0; - ti �: > �� ..
_i.. _ i . .4 x + i i-�' i �y ��.
, 35f �Final G�s Pijie-Test; `x`'• •• , r, a � ' � :r:�� �)H • r� �;�
r. ... � , �---"i . ,�; -
.36. �Hood or CanoPY � "1 •s . � a r F :-,o • <;r.�
,� •; ,ao , v; -:n�
.".37.;'Firral FactorY Fireqace_. � E,�. :�• * ni I I � .ij ---� ---
�
-38. Final Plumbing i J�n; '-+ + ♦ ` � + �: ,.7
.r
��39. Waier Service�Pinal' , i `'' ; �: I I, ' �� "_;"� {", r"` `_� _
�;40. GasService-Final e;� �;,;,.m �g� «,,; ; �:. �. • �..;1: o�. �
�:, ..�
`41. Solar pomesffc-Pinai`-� C�, ^ ° =.+ j �e . .c'n� �� !
� ;r� t � x a b� "? ,� '�' = rC �
_ .,
�42.'Backfiow Preventer; � p� � I i ' t '�: ;>F • � J `-.
n• n i•.-i :
43. Backflow Ir�igation' °•$=; #` '} �:[-.., r C)
� a � � r .�
;,A4. Landscape I�rigation Systerm��i�� a: A �; rl c) r?+ * ,v ?; 1;: �:� i c�
.r .-�; r r a• s- <
'-05.-Sound ��:�itepuatiorf �"T•F' n� i. F i� F.- a ��-+ c•�� �'�: ,
� y . . � � s r,. � . E.. `i .
'',46:.Handicap Reguiations �� �� » � � � i = � ��; •�: '7c• ,: �
- .. . _, -�� 1 . ,�,.,�� �, .
47.=FIlYAL STRUCTURE & BU(�1.DING '� %(/q i ' " ' '��� r, ' �„
1: a' � .
48.-FINAL PL,4NNINCa i�-H .� I �» n '� ti;
ti � �,
=49.=EIeCtric Release to fdison � �*- � � � '-�"� • � ' ' `� ';
a i h I �_�' f. x 1 'c: ' � t
, .. .. j y
�SO.:Gzs-Rei�ase to Southem Cafi,fornia Gas Co .> �� �� r.� � �> ��, C? •
- ^ t. ..�_ ` i 13
-5L CER:TIFICATEOF-OCWPANCy + � �a . i> .��c •. ' • ��
No. Dace �
A0D"�0FB1pL0w° 2423 MISENO �WY
°'"'�s""""`� KLOHS, JOI{N W
�°o"Eu: KLOHS, DAWN M
� 2423 MISENO WAY
� ���� COSTA MESA, CA
IuxxrtECToxvxni�n:
YICN.OH EN6'810011ES4:
92627
uc ra.:
uxT: CITY OF COSTA MESA — BUILDING PERMIT
I� ' T PERMIT NO: P 079746 PLAN CHECK NO: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU
JOB DESCRIPTION ; WATER REPIPE 6 GAS BARBEQUE
UNT:
CLAIM VALUE: CALC—VALUE:
c«+m�ctaraxu� CAL—COAST REPIPING ( 714 ) 578-5090
CONIfUtiORSYYtIIlO 1 3 7 1 T I TAN WAY
��s% HREA CA ��= 636649
92621 uM:
LICENSED COHfH�CTOfl4 UECLAfl�TION: 1 hereby ellim uMer penaly W perjury Nal I am licenaetl undx prwivians d CMqm B
(mmmMc^Y x'vh Saclion )000) d Dimion J d Ne &mrow eM Pmbsauns Cotle. uM mY Gcenx e in IW ba uq eM�tl.
cmuc.Ho.:062453 �ic.cuss: C36 uc.No.: 636649 EXP: O1/97
Dela: Cmirapa:
OWNEH BIIILUEH DECLAHATION: 1 haeby dfirm uMer pe�Wy d qrjury ihet I am ezemq /mn tM Gomreqm liame lew Iv tlr
Idbw'vq �enwn (�ion )W 1.5 Buanee� enE Proleatione CoLe: Riry c1Y a oounry whiN nqui�ee e pemin io omabucl. eMr. imqwa.
Mmden. a rapv eny el�uvturo, priot b Ya ewvre, ebo epuim IM eppl'vanl fm ac� pe�mB Io fib e aqmE NelamaM tlW M a�M
: i��.a w�� �o ine wo.�,�. a n» comreao�. �e�.e u. �cnaaa e(oo�.�dro wan s.e� �000) d a.:� a a�ro
nimu eM Rdeubne Code� or ilw he a ehe ie eKemq iMohan eM �he bua la tM dleped uempion. My violetion d Sw'vn
9t.5 by vry epplvzm lar e permn eubjetla IM appl'rsni io e dvi peiutly d nol maa Ihen Me hurWed tldW� �SS�OD.
❑ I, m owisr W IM PAOenY or mY mmDbRe+wh weam v thei ede mmM�wion. wdI do Ne v.wk. eM IM �Vuctun w rio� imaMod
a dlmed I« We (Saciion )W�. Busrop eM Proleaeom Code: TM1e Conlreuon lioenas lewdoee nol epplyloan owmrd poprry
`M�p �f IX�11pfWM I�lOf0011. Y1d'N�q dOCf tW�l WCfk �YIIflM IX �1lACI Of UYOIid� b R �Mf OWII q11DbVM�. V�� I�ICYI�I
improvemeM� era nal imeMed a ollared I« veb. X. lawavar. �M E ldirq a inpv.ernem b sold wuhm an Yasr al mmplet'vn. tM
owner-WiNer will heva tM WMm d qwiip �e w she d'k �a Wiltl a impmva la iM WTae d eele�.
� I, m ownar d IM popMy. em vtlueivNy mnireeip wilh IvsiaW mnirecton ro cmmuq �As pqsf �Setlion JOM. Busvir� eM
Proleeeione Code: T�e Contreaon l'canaelew doee nd eppylo en ownard p�openy who WiNs orimpovm�heraan ud wM
mnVecY Ia wM projetla wiN a aoMrepar�e) Ica�wd WnueN lo IM Con�reGon Licanss lew�. �
� I em e�emq uMer Seclion'. B. 8 P.C.. la ihis reemn: J�
Dma: �:
1 Eo Mrsby canily ihet I em ewere d eM uMenwM IM rpuiremenb d Cellomie Hmph uM SeIMy CoEs Sedian� 25503.25.4U. end
?55�1. enE Ihtl I a ury Mun Wikirp oowpenl vAll / xill rql (rircb aw) nsed to cdnply wY� uid tltla oodu end IM npuinmaM b
aparmnfaoonel�uclianamodifiutionhwn�M�i e�iy e�apsmnt0imriq.RmidemWconprvpioneppiwiwnaroswemqhwnlAwe
wwieione.
Oele: Apqirant
WORKER'9 COYVENSATION DECL�N�TION: I Mraby Nfum wqr pmally W pxjury ar W IM Idbwinp Mtleitlbm:
� I luw uM xil meimen e cenJicete d mnwnt lo eeX-inwn Iw xvke�e' wmpan�etbn, u qovWeA far by Sedion 3]W d tM Lebar
cade, far �n. c«lamenc. d 0,. ww �« w+:cm m� wrmn ro u.�ee.
n I Mw eM wil meimen wwkere' oompenee�ion ineurarce, m reQuirod Ey Seeion ])00 d Ms lebar Coda. br iM pe�amenca d tM
)� waN lor whiM Ihie permil u wued. My workan canpenmtion inwrenu wnar end pdiry number ma:
c�«: rtiz TNS EXPIAES
PdiryNumber. 143818255 04 /27/97
xctian need rwt M cand�d / tM 0�! u la om hunJred Edlera RI00/ a Iw.J
....
I cenN �� in Ne pMormenca d IM wwk Iw wl�ch �his prmG I� ueueE, I e1Wl � empby ury perron In ury menrror o n to
�� becoms wbjed io iM xaMxe' canpenwion bwe d Ce41«Ma, ard pres ihn N I ehouk Eacmia vib�eq to tM w�bn'
mmpenwion ' d 6eaianu�.)00 d ihe lebo� Cade. 1 ehell I��� pmmm�q.
Deie: ��i�r ��/ 1�n AGdiram: � _ � �.F./
Weml F�llun ro axun woMx�' compwwtlon cowrp� b unbwN( me �lull �ub/�cf m�mp/opr roWMiul pxultlu nW
�� M+ w ro om nu,a..a �ro�,ud ddrn ls�actaoaA M.m�wn ro m• co.r o� rompm.eran �.w..+p+o� roi �n
�ctlon 9106 0l M� laEorCOJ�, Infw�f, an0 ettomsy'� Iws.
CON9TIIUC110N LENDINO AOENCY: I haeEy elfirm �Mm pe�uly d pajury ilw iMn fe e miut�uaion bnG�p �pmcy br iM
p,na�ne�m m �ne wonc �or wnkn mo romi� i, v.�ed (s.eo� sas�. cH. cl.
LENDEP'8 NMIE:
LENDEX'S AOONE55:
I canih �� I heve reaE Nn epplicelian ud uale IMI �he aEme inlammion u coned. I prea to oomply Milh M tlly anE couMy adirieMe�
eM etele lewe nletip to buikvp conmruaion arM haraby eNhwae �ep�aeantmivp oi ihia dry b enter upon iM ebove�mentioneA p�op«ry
m, i�oroaw� w�w,,,.
RICHARD EVINK
D,�e, O�Z-9,G
(5151-OB.WP) While-Build'vp 6 Sel&y; OreerrFb; Cenery-Rppiranl; Rnk-Revenw; (3oldenraFMeevor
PERM NO: P 079746
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT;
GROUP OCC: R-3 /
COMMENTS: X
*��r�r�x*****�rx*****�t�txx�**�****+t+��**�t�r**�t�r�t*�****�r�t**�*****�t�t*�t*x�*+tx***�x�***�t�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 HUILDING ---------
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; 43914320 ZNE: REF NO:
PLANNING NOTES>
i
1E IE 1E IE iE 1E IE 41E iE iE 1E IE 1F 1E iE iE iE fF 1E 1E 1E 1E 1E IE iE fF 1E iE 1E �! 1f iE 1f 1f 1E if 1F if IF 1F 1F iF 1E 1! fE ff i! 1E iE 1E IE ff iE if 1f IF if 1E ik iF �F 1E iE if k 1ElE iE 1E 1E iF 1E fE 1! iElf fF 1E
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
���**��t�r��*+�*+t+�****�t�t�
LEGALIZATION:N
F E E S U M M A R Y
DATE;
DATE: I�
STRUCTURAL S£GMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 130,25
25& -- SMIP/NON—RES
PLAN '_
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 130.25 22.00 , 0.00 152.25 152.25 .00
AEVENUE DIVISION TOTALS--> COLLECTED: 152.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
152.25 —
1EiE1E1EiE1EiElElEiFlFiFfflEiFiFiflF7EiElfikiE1E1f161FiF1fiE1fiElFiElEfEillEfflEiElEfEiE1f1E1EiElElFiFiFififlElfiE1ElF1E1ki61kiE1E1E�EifiElElEiFiEiFiFifiElfk •
I N D I V I D O 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
PLO 1 BATHTUH _ 8.75 8,75
PLU 1 DISHWASHER 8.75 8.75
PLU 1 SHOWER 8.75 8.75
PLU 1 SINK, KITCHEN 8,75 8.75
PLU 4 WASH BASIN � 8.75 35.00
PLU 3 WATER CLOSET (TOILHT) 8,75 26.25
PLU 1 WATER HEATER AND/OR VENT 11.00 11.00
PLU 1 GAS PIPING SYS OF_ 1 TO 4 OUTLETS 5.50 5.50
PLU 1 PIPE g 75� 8,75
PLU ♦ SET/TRAP W%PIPING 6 BACKFLOW O1 OOgZ6"��1-0 02 16 170 TOT $,7552.25
E��P� �' END OF FEES DATE: 1�/�s2/9` TIME: 09:33
(J � �'W�' ;,.-1
.'� POOL & ��A
'- CONSTRUCTION AND PLANNING .
' ApPROVAIS Permit# Jate Inspector qppROVALS Pen # � Date tnspector
1. 7emporary Electrical Service or Pole 52. Pool & Equipment location . .
2. $oil Pipe•Undrgrnd. - 53. Steel fleinforcement � '
3. �lectrical Conduit Utility�U�drgrnd. 54. Forms .
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding '
5. Steet Reinforcement 56. Rough Plumbing & Pressure Test •
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNtTE �
"7. Footings � " .� 58. Electrical CqnduibUndrgrnd.
-$. FoUndation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undtgrnd. 60. Backwash Lines,P-Trap, Ll Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK '
71, property Sewer �ine & House.Connection 62. Backwash & Receptor�Final �
�2• Se'^'e� Cap ' 63. Heater & Vent-final •
13. Roof Drains 64, Plumbing System � Final ;
14. Fough Plum6ing IO'3'e�6 � 65. Electrical�Final .
75. fiough Electrical:Condurt _ 66. Solar System�Pinal
16. Rough Electric Wiring 67. Fencing & Access x�pProvai '
17, flough Wiring Sign � , 68. APPROVEO FOR PLASTERING .
18. Rough Electrica�•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79, Rough Heating & Air Conditioning FIRE DEPT. REQUfREMENT
20. Rough Factory Pireplace � . _ � APPROVALS'. Permit # � ' ^
27. Oucts, in Struaure � . ' . ' 70. ,llndergrourid Hydro �
22, pucts, Ventilating + ' 77. Product Piping OG�s �Oil
23. Gas Pipe-Rough & Tesc _ - „ 72. Underground F14sh . � �l�
24, fioof-Framing - - �• - • � � � � 73: Undergrnd. Storage Tank O Gas ❑ Oif � � � -
�r
25. Foof ShGathing -. ' _ .� 74. Overhead Hydro •�
26. T-Bar Cefling (Structuraq & Monocoat 75: Dry Chemical ' � . . " -
27. Frame and Flashing ; _ _ �. 76. Dry Standpipe �`. ' - �
28. Lathing&Siding , �� � � • 77. FIXEDSYSTEM'FfNAL -'
29. Insula;ion � " - . 78,�FIREPREV.fINAL - �
30. Orywall Nailing � -� � . �-HEALTN DEPT.hiEQUIREMENT- - � �
31. Plasrer Brown,Coat _ ,. 79. FINAL CNSPECTION -
. 32. Electrical Pow�r MeV;r.Finat � • � � 80- FOOD CERTIFICATE ISSUED " -�
33. Final-EleGtric, � '. � ' � Notes: � �� �
. 10�3- Pc�uG11_P_1,umQ. oK �K
34. Finat-Heaiing�.& Air Conditioniag - - ' ' � - „- � - "
35. FinaV Gas Pipe-Te:t _ `� ' �' -,_ . _
36. Hood or CanopY ' - . _ �
37. Final Fac;ory Pirepf3ce ��`- _ - - „
. ,
38. Final Plumbin9 � .. .. . . � . ' e __ - --
39. Water Service�Finai = ' ' ' ' - • � � '
40. Gas Service�Final ' , - , _ . . ", � �
41. Solar pomesticPinal� _ � - ' � . ' .
42. Backflow Preventer � � � - � � � _ _ �
43. Backfiow Irrigation - : _ . " �� ' '
e .
44. Landscape Irrigation System - �- - -- - - � : � �� � � -_ . � �
45. Sound Attenuation - - � - �- " � - '
46. Handiwp Regulations = � � � - -, �� _ � �
47. FINq� STRUCTUi;E & BUILDING
,
48. EINALPLANNING - • •
49. Electrie Release ro Edison • � � ' " �
T •'
50. Gas Release to Southem Califomia Gas Co � " = �� � •
51. CERTIPICATE OF OCCUPANCY . -- -
No Date
� 43786
COSTA MESA BUILDING•SAFETV DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING
ADORESS L �
OWNER
MAI l
ADDPESS L S�//�
CITV //i90�A /A/�OlQ NOL.6C}/3/.L
BRANCM
0
ADDRESS
TEL.
CITY NO.
F STATE CITV
LIC. NO. LIC. NO.
� SIZE NO.OF BLDGS.
0. OF LOT NOW ON LOT
a USE OF
� EXI5TING 9LOG.
y
FSeparate pecmits are required for
� electric, plumbing and hea[in work.
c�. USE OF BUILDING AND WORK TO BE PERFORMED
�j , R
Q
�
�"
a
�
w
Q1 hereby ecknowlatl0o that I have roetl Nif eDP��ceNon antl stata �
y� Met the ebova Information ia corro<t en� aprea to comply with m
� ell lews reBuleiinp builtlin0 �onsiructlon, antl 1 shall not omploy
�Z any pnrson In violatlon of the workman'e compenseUon laws of d
� the Staie of Celitomie. -
3 I heraby certify Mat I am properly IlcansaG ea a conttector untlar SQ. FT, w
the Scata of Cellfornia Busineu end Profesalone Cotle, Dlvislon 3, THE AMOUNT SHOWN UNDER VALUATION IS fOfl m
Chepier 9, entl that euch Iicences aro In tull forca entl affoct, or I THE PURPOSE OF ESTABlISNING A PERMIT FEE ONLV: n
om ezampt from tha provlslons of the Stete of Californlo Business VALVATION PERMIT FEE S �/ a
entl Profeselona Coda, Diviflon 3, Chopmr 9. �'C� u+
�"G PLAN CHECK E m
Sipnotur of � m
0
�-�.�.) `- � LL
Permlttee 5 '� ////// TAX S f
�J '� " v p
AuthorizetlApant _ TOTALPAID E �r�
.,
n �_ r�: � �.r;:,f a
' l-, 77n•� OO 4?.7=' �Ii.S�
AP I A ION FOR STRUCTURAL PERMIT
REC I Y DATE RECEIVED DATE UE
_ �� P flMIT NO.
A.P. NO.
BUILDING
AODFiESS /�
TRACT LOT �Y BLOCK
W AD
OWNER �%�}'V�
y�f V/\WE ��
SE �' �U S
FIRE
ZONE VPE GROUP
APPROVED � ����
Bv DATE
YAF
MF
ROM
VAfi. #`
C.U.P.qW
APPROVED
iNO.OF �
PLANS `
APPROVED
3VI�OING
STREETI�
FT
USE OF N ���
BUILDING
VARDS APPqOVED
DATE
APGROVED
&
JOB ADDRESS
GEN&RAL COi
AP No.
Power
BUILDING PERIlIIT N0.
VALUE S 1.9. S1�n. (1()
DESCRIPTION OP WORK
SUBCONTI2ACTOR
19790
COSTA MESA BUILQING-SAFETY DEPARTMEM'
P. O. BO% 91] COSTA MHBA. CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
ADDRESS P'��� � WG,7-1
COSTA MESA, CALIFORNIA
TEL.
Same
LIC.TNO. 1 S I— Z S O—
OFLOT 33 x 53.
USE OF
EXISTING BLD6.
BPTe1cK LIN[ FROM
FEE RECE��ED
�INANCE DEPT.
APPLICABJ1l� Nc �T� MESA
For Office Use, Only
A�EI69 as�a37��
FIRE
ZONE TYPE G
APPROVED
BY DAT
ZONING
Z N NO. OF US¢ OP NI
PLAN BYILOINd
L80AL � _ . . .. � _
— YAR�9APPROVHD
MAIN BUILDiN6
= (FROMC/LSTREET)
�* ZO.SO� RHARYARD —
EFT � I R16HT ^ '
DESCRIPTION OF WORK
i� II ALTERaT�ow I I�ooir�ora I
VAR. �C
� EXTERIOR WALL
Model 42G
1833 so. Fr.
i XEqHBY ACKNOWLEO08 THAT 1 NAVO NBAO TH19 APPLICATION TH8 AMOUNT BH
AND BTAT6 THAT TM8 ABOVq �8 CORflHCT AND AORBH TO COM� PUPP09[ OF 6
PLY WITM ALL CITY ORUINAryCgp ANp BTAT[ LAWB PBGOLATINO
BUILOINO CONBTFUCTION. YALUA710N
PERMIITEE " /`� ` � �� � • yJ
AUTHORIZED AGHNT /11 I �1AL� iYrµ1 . S/� ��
6HALL BE LESS THAN
fI1.B.C.REpU1REMpNT1
YARDSAPPROVED
ACGESSORYeOlL�I#Q
DATE
:`��Qi
UNOEH VALUATION IB FOR TN8
16HIN0 A PEHMIT F6E ON�Y.
PERMITFEE $ f/� �
PLAN CHECK S �/ •�
_ R�t .S�