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Home My WebLink About3234 MONTANA AVE - Building Permits,tis�. • y�� :_:_::: ; ; � (714) 754-5273 • Feu (714) 754-4856 CITY OF COSTA MESA , BUILD/NG D/VISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 3234 MONTANA AV Suite: - Vicinity: REAR OF HOUSE ParcelNunmber: 13909103 Applicant: GUSSIN, ALLEN BUILDING PERMIT Zoning: PERMIT NUMBER � 699-00512 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/15/1999 Issued: OS/14/1999 ISSUED BY: Address: '.� ' � - . , . ,Phone: pi4)538-10W --`� � Zip: _ i, � owner: MC CORMACK, RICHARD A , ��," ' Address 3234 MONTANA AVE � '_ � � ' �Phone: � �-�`'-`C��2;-.:,`, . „ � COSTAMESA,CA � Zip: 92626 � �-�� .� '�� , \� , _ �- � � V�. �� . - Contraaor: WEST CARRIAGE CONSTRUCTION Address: 18512-1/2 SANTIAGO BL � � Phone:�� 714-538-1007 � � VILLA PARK, CA ' Zip: 92861 License: 627346 � : � � , � Arch : ' ,—i _ . , E�9: � . Address: '-' . � Addres's: ,. Phone: ' - � ., � �, Phone: Zip License: Zip: �- � � License: SCOPE OE PERMIT . , � 240 SF (15'Xi6') BEDROOM ADDITION TO EXISTING SFD. REMODEL EXISITING�BEDROOM TO CREATE HALLWAY. . . .. . . �. . , �. , . . . .. . . . REMODEL EXISTING DEN. 899-00512. � � � FEE SUMMARY .? ' �. + I''�%, Plan Check: $202.96 _ ` � = "' . , _j , <.•_ Calc Valuation: Permit: $312.25 — : � ( ' Claim Valuation: SMIP Res: $2.16 / j SMIP Com: $0.00 Other: $0.00 — � Inspection: $0.00 Total: $517.37 SETBACKS MAIN STRUCTURE Front 0. 0 ACCESSORY Front 0-0 PARKING ExiStinq: o NOTES: � � ;�i,- � �� - • - - � � � PLANNING & ZONING ��°�' ; ,� ;� , �„ Rear 18- 0 �' `'Lek � 40- 0- Right , 5- 0 Rear 0-; 0 Left � 0- 0 • Right 0- 0 Reouired: .0 , �� Pr000sed: 0 � � � � ; ' r , . .- ✓i'.�-'. , $21,560.00 $18,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 1241-92) EXPIHATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendad or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work musl comply wi�h all applicable codes, and all requlred Inspectlons antl final epproval must be obtained. Failure to obtain inspections and final apprnval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � "WOHKERS'COMPENSATION DECLARATON: — � I hereby eHirtn untler penelry ot pp�ury one oi the follawing daclaratlons: ,� ❑� � I'�eve end wlll mainteln e cBRificete of consent ta self-Insure for workers' compensetion, as provided for by section 3700 of the Lebor Cotle, far the pertormance of tha wark for whlCh this pertnit is �ssued. ❑ I have end wlll melnteln worKeB' compensatlon Insurance, es requireA by section 3700 of ihe Lebor Code, for Ihe peAortnanca of Ihe work far which Ihis pertnit is issuetl. My workers' crom ensetion Insurence carder end policy number ere: Cerrler. ST ��a � . Policy Number. Z�l, iIl- Y /� (Thls sectlon need not be wmpleretl i/ the permlt Is velued et one hundred dollars ($100J � less.) ❑ I certify Ihat in the peAormd�ce of the work tor which this permit is issued, I shall not employ any person In eny manner so es to become sub�ect to the workers' compensetion laws ot Celifomia, entl agree th II I shoultl become subject to the workers' compensatlon provisions ot Sedlon 3700 of the Lebor Cotle, I shall torthwith compty with Nese pro ' i q'. � Applicem Signeture: � Date: S/Y�9 9 '/ WFRNINO: FAILURE TO SECURE WOW OMPENShTION COVERACiE IS UMAW FIIL M1D SHALL SUBIECf AN EMPLOYER TO CRIAUWIL PENALTES AND CML FlNES UP TO ONE MUNpREO TF%)USAND DOILAfiE (5100,000), IN AD� TO TNE CO"uT OF OOMPENSATIIXJ, DAMAGES AS PRONIDED FOR IN SEGTION 3)O60F THE IABOR CODE, INfEREST, AND FTTORNEI"S FEES. LICENSED CONTRAC70RS DECLARATION: I hereby eXirm Ihet I em licensed under torce and eHect Lic. # 6`L'i J Y� � Conirectors Slgnatur� ot Chapter 9(commencing with SectiorY7000) ot Divislon 3 oi the Class p � Dete: _ entl Professions Coda, antl my Ilcense is in full CONSTRUCTON LENDING AGENCY: ❑ 1 hereby elfirtn that there is a�structlon lending egenry far t�e pertormance of ihe work lor which this permit is issuad. (Sec. 3097, Civll Code). Lentlers Name: Lentlefs Address: Signature: Date: OWNER-BUILDER DECLARA710N5: I �ereDy eNirm thet under penalry o� per�ury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7037.5, Business antl Professions Code: Any clry or counry which reGuires a pertnit to conslruct, alter, improve, demolish, or repair eny strudure, pnor to its i5suance, also requires ihe epplicant for such permit to file e signed stetemeni that he o� she Is licensetl pursuenl to Ihe D�ahslons ot ihe CanirflIXore License Law (Chflpter 9(tommencing with Sectlon 7000) of DlNslon 3 of �he Business entl Prolessions Cade) Dr ihet �e or s�e is exempt Iherelrom en0 the basis tor Me elleged eaemptlon. My dolatlon o1 Sectlon 7031.5 by eny epplicant for a permit sub�ects the epplicent to e civil penelry of not more then five �untlred dollers ($500).): ❑ I, es owner of the property, Or my employee5 with weges es t�elr sole campensetion, WILL DO THE WORK, end Ihe structure i5 not Intentled or oHeretl tor sale (Sac. 7044, Business entl Professlons Code: The Comrecmrs License law does not epply to en owner of property who builtls or Improves t�ereon, antl who does such work himself ar herself or through his or her own employees, pravitled ihet such improvements ere not intentled or oHered for sele. If, however, ihe builtling or Improvament Is sold within one year of complation, ihe owner-bulltler wlll heve tha burden oi proving Ihat he or s�e tlitl not builtl or improve for purpose of sela.). � I, es owner of ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, 8uslne55 antl Professions Code: The contrectors Licanse Lew does not epply to en owner of pmperty who bulltls or Improves thereon, and who contrecis for suc� pro�ect with a contracmr(s) Ilcense pursuant to the Convacmrs License LawsJ. ❑ I em exempt untler sec. Signature�. Owner ID verifietl by tlriver's license. ❑ Yes ❑ No Busineu end Professions Coda tor this reawn: Verification ot Ownership by (type a� documeN, i.e. - properry taz bill or deed): Drivers License No. Date. Expires: DIVISION OF INDUSTRIAL SAFE'�Y FERMIT CERTIFICATION: ❑ I hereby certlfy that no exce�atlon flve (5) or more teet In depth Into which a person Is requlred to tlescend, will be matle In connectlon wlih work euthorized by ihis permit, and that no builtling s��ucWre, scattolding, telsework, or Aemolition or tlismentling thereof, wlll be more than thirty-slx (38) feet hlgh. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle B, Californie Atlminlsiretive Code). ❑ As owner-builder, I will not emp�oy enyone to do work which woultl require a permit from the Divislon of Industnal Safety, as noted above, unless such person has a pertnit to do suc� work irom the tlivLsion. Signeture: Date: Division ol Industrial Satery Permit Number: CERTIFlCATE OF COMPUANCE M1D AUi}iORIZATION OF ENfAY: I certity under penalfy ot per�ury thet I have read this application flnd state Ihat the information given is cortect I egree ro comply with all 51ete laws and ciry ordinences relating to huilding constructlon, end euthonze representatives ot Iha Ciry oi Coste Mesa to entar upon the above-descdbeC pmperty for inspectlen purposes. I egree not to occupy or allow occupancy ol eny Dulltling authonzed by this pertnit untll final inspection. CO�E I, INSVECTIONTYPE QATP INTITIRLS 1616 Flxetl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Finel Finel Re-Fooi� Finel BIocWRelaining Well Final Fectary Fire Place Finel Sign 204 Finel Demolition Data � .r'/iy/sy � Date COpE� INSPECTIONTYPE QajE INnTIR�3 208 Final Machanical 208 Flnel Plumbing 210 Final Electncel 212 Finel Fire Prevention 220 Flnal Planning Approvel 222 Final Site 250 Final Building/Oaupa�cy � ,:;�:rr �, � q�� •.:._:� ; ; �, (714) 754-5273 • Fex (714) 7543856 CITY OF COSTA MESA BUILpING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT MECHANICAL PERMIT Job Address: 3234 MONTANA AV Suite No Vicinity: Parcel Number: 13909103 Applicant GUSSIN, ALLEN Address: Owner: MC CORMACK, RICHARD A Address: 3234 MONTANA AVE • Contrector: Address: ArchlEng: Address: COSTA MESA, CA � . .. : . Phone: � / -, . 2ip: / 1: � �- . ,._: ., _� Phone: �:�� Zip: 92626 WEST CARRIAGE CONSTRUCTION 18512-112 SANTIAGO BL Phone:� 714-538-1007 VILLA PARK, CA ... Zip:` 92861. -� License: 627346,', Phone: Zip: License: SCOPE OF PERMIT' � RESIDENTIALADDITION, RE:899-00512, EXTENDA/C�& HEATING. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Hir Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan I Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> t0000cfm Floor Furnace Floor or Suspend Heater Quantlty $22.00 $0.00 0 $0.00 0 $1225 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 . $0.00 0 80.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 PERI�IT NUMBER � �99-00231 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: � FEE�SUMMARY', � ,"% � . , . - �=�„ . - Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Venlillation System _ _ Evaporative Cooler � .. � � Commerciallncinerator - � -��Domesticlncineretor .� . '� Comoressors / Absorption Systems � -� Up to 3 hp I 700 k BTU � . ,��,3To15hp/500kBTU � 15 To 30 hp I 1,000 k BTU� , � -�".30 To 50 hp I 1,750 k BTU = _ � �Ovec50 hp / Over 1;750_BTU ' � -- � .• , Boilers� - � . � � � . , Up to 3'hp � . � 3To15hp i 5 l0 30 hp " � , - 30 to 50 hp Over 50 hp � . . , , , OtherMechanical Fee ' Investigation Fea��" � . , � , PIarc.Check Fee � � Reinspection Fee TOTAL CALCULATEO FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: OS/14/1999 Issued: 05114/1999 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 534.25 NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expiie and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized undar this permit to be conside�ed legal, such work must comply with all applicable codes, and all required inepeetlone end tinel approvel must be obtained. Failure to obtain inspections and final approvel will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS'COMPENSAnON DECLARAnON: � I �ereDy ettirtn unGer penalry of per�ury one of the following dederetlons: ❑ I have entl will mainteln e certiflcate at consem to self-Insure br workers' compensetlon, es provitletl for by sectlon 3700 of the Lebor COOe, far the pertortnance of tha work for whlch Nis pertnit Is issued. ❑ I have end will mainfeln workers' compensatian insurance, as requlretl by sectlon 3700 01 Ihe Lebor CoCe, tor Ne peAwmance of the work for wNch Ihis pertnl� Is issued. My workers' compensatlon Insurence carner and pollcy number ere: Cerrier. S% � �-� PolicyNumbar. �G93 �y (Thls sectlon need not be campleted ll the permit Is velued et ane huntlred dollers ($100J or less.) ❑ I certly thet in the peAormence ol the work for which Ihis permit is Issued, I shell not employ eny person In eny menner so es to become subJect to Ihe workers' compensetion laws of Cellfomi , entl egree Na ii I shoul ecome subject ro t�e workers' compensation provisions of Section 3700 of the Lebor Code, I shall fotlhwith compy with these proN � Applicant SlgnaNre: Date: �/b� % WARNINO: FFILURE TO SEW RE WORKE MPENSATION WVEMGE IS UM.AWFUL AND SHALL SUB1ECf AN EMPLOYER TO CRIMINA� PENALTIES AND CNIL FlNES UP TO ONE HUNDRED hKK15AND OOLUAE (5100.000), IN ADD I TO THE COSi OF COMPENSATION, DAhNGES AS PROVIOED FOR IN SECfIIXJ 3'/Ofi OF THE IABOR WDE, INTEREST, AND ATTORNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby eflirm that I am licensed under provlsq force end ettect. Lic. # 7 Comractols Signeture: CONSTRUCTION LENDING of Chepter 8(commencing with Section 7000) of Dlvlslon 3 af the Business end Professlons Coda, and my Ilcense is in full Cless A � Dete: 1'�/Y Yi ❑ I hereby affirtn Ihat ihere Is a consWctlon lending egancy for t�e peAormance ot Ihe work tor which this pertnit is Issued. (Sec. 3097, Civil Code). Lentlefs Name: Lendefs Adtlress: Slgneture: OWNER-BUILDER DECLARATONS: Date: I hereby eflirm that untler penalry of per�ury thet I em EXEMPT FROM 7HE CON7RAC70RS LICENSE LAW for the Following reeson (Sec. 7031.5, Business end Protassions Cotle: Any ciry or counry which requires e partnit to consWd, elter, Improve, demolish, or repelr any sirucWre, prior to ils Issuence, also requlres Ihe flpplicent tor such pertnit to flle e slgned statemem t�at he or she Is Iicensed pursuent to the provislons of the Conirectors License Lew (C�apter 9(cammencing wlth Sectlan 7000) of Dlvlsion 3 oi the 8usineu antl Professians Code) or ihel ha ar she is exempt t�erelrom end the basis for Ihe allegeE eaemption. Any violatlon oi Sectlon 7031.5 Dy eny epplicant tor e permit sub�ects t�e epplicant Io e ciNl penelty of not more than five hundred dollers ($500).): ❑ I, es owner ot Ihe property, or my employees with wages es I�eir sole compensetion, WILL DO TME WORK, end Ihe structure is not Intended ar aNereO for sale (Sac. 7044, Busineu and Professlons Code: The Contrectors License Lew tloes not appy to en owner oi property who bulltls or improves therean, antl who does suc� work himself or herself or through his or her own employees, pravitletl Ihel such improvements ere not intentletl or oNered for sale. If, however, ihe building or improvement is soltl within ane yeer ot completion, ihe owner-builder wlll have tha burden ot praving that �e or she did not build ar improve lor purposa at sale.). ❑ I, es owner of the properry. em E%CWSNELY CONTRACTING WI7H LICENSED CONTHACTORS to construct the pro�ecl (Sec. 7044, Business end Protassions Cotle: Tlie contractors Licensa Lew does not apply to en owner oi property who Duiltls or Improves thereon, entl who contrects for such project with a contrector(s) license pursuant ro the Contrectors License Lews.). ❑ I em ezempt under sec. Business end Protassians Cotle for �his reason: SlgnaNra: Da�e: Owner ID verlfied by tlrive(s license. ❑ Yes ❑ No Drivers License No. Venfication of Ownarship by (type of documeni, i.e. - properry tex blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Ezpires: ❑ I hereby certity thet no excavetion live (5) or more teet In depth Into whic� a person Is requlred to descen4 will �e meda In connection with work euthorizetl by this permlt, end that no builtling siructure, scafloltling, talsework, or demolitlon or dismentling thereof, wlll be more Ihen thlrty-slx (38) leet high. (Chap. 32, Grp 2, Art 2, Sec. 341, 71I1e 8, Califomia Adminlstretive Cotle). ❑ As owner-builder, I wlll not employ enyone to do work which would require a pertnit from the Divlslon of Industnel Selery, as notetl ebove, unless such person hes e permit to tlo such work fmm Ihe divislon. Signeture: Date: DlWsion of Industrial Safery Permit Number: CERTIFICATE OF COMPLIANCE AND AUTHORIZATON OF EMRY: I certity under penalry of per�ury that I have read this epplication end state that Ihe informe�ion given is wrrect I egree to comply with ell stete laws and ciry ordinences relatinp to builCing construdlon, end authonze representetives oi Ihe Ciry ot Caste Mese lo enter upon Ihe above-descrlDetl property for inspection purposes. I agree not to occupy or ellow occupancy ol any bullding euthonzed by this pertnit untll flnal Inspection. COUE �. INSGECTIONTYVE 1616 Fixed System Finel Fire Prevention 1268 Pool Spe Final 200 Final Re-Root 201 Final BIxWRetelning Wall 202 Final Feclory Fire Plece 203 Final Sign 204 Finel Demolition 2aa&a8 P�ff It{� Date t'/iv�9 % Date COOE I INSPECTION TYPE 208 Final Mechenical 200 Finel Plumbing 210 Final Electriwl 212 Finel Fire Prevention 220 Finel Planning Aoproval 222 Finel Site 250 Finel Building/Occupenry �: 1 .1111: ♦ � ♦ ; 0 a (714) 754-5273 • Fax (774) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PEFiMIT JobAddress: 3234 MONTANAAV Suite No Vicinity: Parcel Nunmber: 13909103 npplicant: GUSSIN, ALLEN Address: ELECTRICAL PERMIT PERMIT NUMBER �1/ E99-00407 77 FAIR DRIVE, COSTA MESA, CA 92626 SWtus: ISSUED Applied: 05/14/1999 Issued: OS/14/7999 ISSUED BY: CJ i , .r / i'.r- i _ i" , ; 'Phone: � . .. � � ... Zip: / � � . . � ;� -. . _- owner. MC CORMACK, RICHARD A _ , , � ,,: , � Address 3234MONTANAAVE . ` � � �1 � � �,�� ' Phone: �,A; ,�-- ' , . COSTAMESA,CA� Zip: 92626 ��.�;�� , „ � Contractor: WEST CARRIAGE CONSTRUCTION' Address: 78512-12 SANTIAGO BL � .... Phone: 714-538�1007 � VILLA PARK, CA %Zip: 92867 ;� . � � � � -Cicense: 627346 � ' - � - � . SCOPE OF PERMIT �_� '� RESIDENTIALADDITION, RE:899-00512, 12FIXTURES, 120UTLETS, 6SWITCHES. . ' ' ..'J'./` / . � ISSUE FEE Temp service tesl Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Motors to 1hp Molors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 522.00 $0.00 $0.00 $0.00 $0.00 $0.00 512.00 $72.00 $6.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 12 12 6 0 0 i, o � .. 0 0 ' ' � ., 0` . 0 0 0 , 0 0 0 0 0 0 � �. `; n'' Quantity �, . .' � Temp Dist System / Ughting. � $0.00 0 ,.-6usway/100�ft" '' -- - $0.00 0 - -- Standing Seilion '" - " $0.00 0 Misc Electrical-Equipment $0.00 0 Transformers�up to 1 kva/kw '.$0.00 0 ...._._`_-. _up fo:10 kva/kw � $0.00 0 ' - •- � .. . .................up to 50 kvalkw ! $0.00 0 ... ; %:•..i :................up l0 100 kva/kw �, � $0.00 0 . �•-,..'. -�.....:�.........over100kva/kw . $0.00-"�. 0 - � � Cow Voltage.Equipment � - $0.00 0 `Low Volt Wiring System / Ckt �.� �$0.00.- 0 � Misc: Conduit ��-,�.-: �. .,. � $0.00 0 , �Misc.,Condudor,, :% -� - $0.00 -' 0 ��'Circu;s ( gen or ride); ,-> � = � %" $0.00 � , 0 .- - -% 'Circus(mech�rideor�lights). � $0.00 �� 0 , - ` �Christmas Tree Stand � - " -' �- $0:00 0 ' '� ` Fireworks Stand � , , , . $0.00 � "0 OtherElectrical Fee � �$0.00 � � Investigation Fee � $0.00 . � PIan�Check Fee ' �$0.00 � ��-'Reinspeclion Fee ,� �� $0.00 �j!r �� *' %TOTAL'�CACCULATED FEES 552.00 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 deys. INSPECTIONS: In order for ihe work aWhorized under ihis permit to be considered legal, such work must comply wi�h all applicable codes, and all requlred Inepectlona antl final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS'COMPENSATON DECLAHAnON: � I hereby atfrtn untler penelry of per�ury o�e oi Ihe fallowing tleclaretlons: ❑ I have entl wlll meln�ain e certliicate of consent to selt-Insure for workers' campensetion, es provided tor Dy sec�ion 3700 of the Lebor Code, tor the peAormance af Ihe work for which Ihis pertnit Is Issued. ❑ I have antl will meintaln workers' cOmpensatbn trtsurence, as raquired by sectlon 3700 of the LeDor Cale, for Ne peAortnflnce of Ne work tor which this pertnit is iswed. My workere' compensetlon InSurence cerrier end poliry number ere: / Certier. �T �^'� / Pollty Number: y�yf t Y / (This section need not be comp/eted /! fhe permit !s velued e( one huntlretl tlW/ers ($100) ar less.) ❑ I cartity thet in the peAormence d�he work for which this permit is luued, I shall not amploy eny person in eny manner so as to become subject ro the workers' campensetlon lews af Cellfomia, and egrae Ihet it I should become subject to Ihe workere' campensetion provlsions of Section 3700 ot tne Lebor Cotle, I shall forthwlth wmplywiththe &r0nI s. AppllcantSignetur � -+-�\/ r.�.[_� � Dete: 'r/ y�9) � � WARNINO:FAILURETOSE ORKERS'�1PENS�ITIIXJWVERAGEISUNUWRILANDSHALLSUBJECTANEMPLOVERTOCRIMINALPENALTIESIWDCMLFINESUPTOONEHUNDPED THOUSAND DOl1ARE (51 ,�, IN ADDRION T0111E CC6T OF COMPENSA710N, OAAiAGES AS PROVIOED FOR IN SEGTION 3]OB OF THE LABOR CODE, INfEREST. AND ATTORNE`/'S FEES. LICENSED CONTRACTOHS DECLARAT�ON: I hereby aHlrm thet I em Ilcensed under provisions ot Chapter 8(commencing with Sectio�00) ot Dlvlslon 3 ot the Businass end Professlons Code, and my Ilcense is i� force antl ettect. Lic. a Z� 3 y 1 j Class a� � ComradolsSigneWre: Dete:_ /Y %5 � CONSTRUCTION LENDING AGENCY: ❑ I hereby eNirm lhet ihere Is a const�uctlon lending egancy for the pedortnanca of the work for which this permit is Issued. (Sac. 3097, Civll Code). Lendefs Name: Lendefs Address: --f Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm Ihe� untler penalry ol perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sac. 7037.5, Business and Professions Code: Any ciry or county which requlres 9 permit to construct, elter, improve, demolish, or repeir eny structure, pnor to Its issuence, elso requires the applicant tor such pertnit ta flle e signed statemem thet he or she is Iicensed pursuent to Ihe provisions of the Coniractors License Lew (Chepier 9(commencing wtlh Section 7000) ot DlNsion 3 ot the Business end Professions Code) or thet �e or s�e Is exempt t�erefrom and the �asis for Ihe elleped exemptlon. Any violetlon of SeMlon 7031.5 by any eppllcant }or e pertnit sub�ects the epplicent to e ciNl penalry ot �ot more then five hunAreC tlollars ($500).): ❑ I, as owner af Ihe property, or my Bmployees with wages es iheir sole compensation, WILL DO TFIE WORK, end the structure is not Intentled or oReretl for sale (Sec. 7044, Business end Professlons Coda: The Contrectors License Law tloes not apply to en owner ot properry who hullQq or improves thereon, end who does such work himselt or hersell or through his or Per own employees, provided that such Improvements ere not Intendetl or oNered tor sale. If, however, 1he bulltling or Improvement is sold within ona year of completion, Ihe owner-builder wlll have the burden of proving thal he or she did not build or Improve for purpose ol sale.). ❑ I, es owner of Ihe property, am EXCLUSIVELV CON7RACTING WITH IICENSED CONTRACTORS to construct the pro�ed (Sec. 7044, Business antl Professlons Cotle: The contrectore License Lew does not epD�Y �o en owner ot properry w�o bullds or improves thereon, end who conirects far such projea with a contractor(s) license pursuant to tha Contractars �cense Laws.). ❑ I am exempt untler sec. Business antl Professions Code for Ihis reason: Signeture: Date: Owner ID venfied by tlrlveYs license. ❑ �es ❑ No DAver's License No. Expires: Veritication of Owners�ip by (type of docUment, i.e. - property las 6ill or deetl): DIVISION OF INDUSTRIAL SAFETV PEAMI7 CER7IPICATION: � I herehy cenly Ihet no exwvetion ��e (5) or more leet In depth into which a Oerson is required to tlescend, wlll be matle in connectian with work authonzed by ihis permit, end lhet no DuilGing sWcture, scaflolding, felsework, or demolition or dlsmantling thereol, wlll he more than thlrty-slx (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle B, Cellbmia Adminisiretive Code). ❑ As awner-bullder, I will not employ anyone to do work which would require e permit from �he Divlslon ot Indusirlel Safery, as noted ebove, unless such person has a pertnit ta do such work from ihe tllvislon. Signature: Date: Divisian oi Industrial Sefery Permil Num6ar. CER7IFICATE OF COMPLIANCE AND AUTMORVATION OF ENTRV: I certily undar penelty ot per�ury Ihet I heve read ihis epplication end stete Ihat the informetion given Is correct. I agree to comply with all stete laws and ciry ordlnances relating to bullding consiructlon, end euthorize representetives of ihe Ciry ol Costa Mesa to enter upon tha ebova-describetl property 1or Inspectlon purpases. I agree not to occupy ar allow occupency ot any bullaing euthorized by this pertnit until finel Inspaqion. COOE I. INSFECTONttPE 1616 Fixetl System Finel Fire Prevendon 1266 Paol Spe Finel 200 Final Re-Rool � 201 Finel Blak/Releining Well 202 Finel Fectory Flre Place 203 Finel Sign 204 Finel Demolitlon 2MB-0s .��. •. / .r% COOE� INSPECTONTYVE 208 Final Mechanical 20B Finel Plumbing 210 Finel Eleciricel 212 Final Fire PrevBntion 220 Flnal Planning Approvel 222 Final Site 250 Flnal Building/Oaupancy PAIE INiIfIALS ��Ii ��G:' �I � ADDNESSOFBVIIpNti: 3234 MONTANA AV uxr: ONNERSIUYEIFpqMLMC CORMACR, RICHARD A FLOOD: X 37 "D°"�u' MC CORMACK, ELIZABETH A 3234 MONTANA AVE wv�. �uuwc �ooness: COSTA MESA,CA 92626 FPCNRECT OH ENtlNEFX: PCX. OH ENO.'S AO�PES: uc xo: UNT: C0N1"A0T0�""'� SENTRY ROOFING CO ( 714 ) 751-7663 caxm�croxswuura 3364 NEVADA ��w� COSTA MESA CA �� 678801 92626 u�: LICENSEO COIRPACTOqS DECIAPATION: I Mmby eflim uMm penely d pmjury Ihel I em licenxtl uMm pranaions d Cheqer 9 (commemiiq �tilh Section 1000� d prvieion 3 d ihe Busimu enE Profeasims COEe, enE my lioeme b in hA lorce enE eXed. cmuc.r+o.:060429 uc.cuss: C_39 uc.No.: 678 O1 XP: 10/95 o�,: �— S- 9�" ��,�a: .�� OWNEfl BUIL�EF UECLAHATION: I heraFy elfiim unEar penetly d par'ryry ihet I em uemq /rom tM CaNreGon Liceroe Lew la IM following reeson (Seclbn ]�J15 Bueiime enE Prolaeabns Code: Fny cily a counly wl�idi mquiree e permil �o mmlruct, eller, improva, �emd'oh, or repar ary ei�ucwre, D�a b Xa oauanm, e6o reyuiree tha eppliran� lor euch pamin ia fila e epmd etetemam thei M a eM +�.x licenead Wrsueni lo ihe Y�%�a d iM Ca4reewe Liceiue lew �CAeqx B(commendn6 wilh Sedion )000) d Diroion 3 d �he 'y.,;'usi�v ¢�y PrWeai,xu COEeI a �hm ha a aha n examq iherelnm ard the beais la ihe elbped axemqion. My violeton d 6edion ']031.5 tr/ erry epplicen� �w e parmn wbpaa the epplicent �o a crvil panelry ol nd mae ihen fHe huMred Cdlen �5500�). � I, m owner Mihe pmperry w my empbyeas wIh weg» av ihei wle mmpeneetion, will Eo Na xrork, enE IM eVuctum e nd inleMeC or Merad fn eeb (Secibn 10aa. B�eiriew eid Protasdons Code: The Comrenon licenae lnw doea mt eppty �o en ownard propeny wlw Wdds a mpwae �he�aon. eM Ww tlaee auch wark himeeH a M1enetl a �hraph �a w her own emplayaea, piovidatl thm wch impovemenU are rw imerdeA a dlereC fa seb. tl. hawever. tM huJdirq a inqwemeni b aold wilhin ma Yser d mmpdon. the o�.�w�u« w�n n� in� w� a ww��o na «� eb �a w�a a �mwa+�« ma wmow a�). � I. ea ox�wr d Ihe propeM. � extlusrvey oonlrednp xdh licaneed conVeclon lo conMruq IM pqed (Sequn )614. Buairims ard r�i.��oos coea�. rne com,�on u�� . eo� �m endr m,� o�a, a oroa�r •mo d,�ua «�mwo�� m„�� .�a .�,na conlrecla I« wtli prqeds wilh e comreaor(s) licemed Wnuenl to tM Conumas lioanse lewl. � I em exemp uMa Sec�ion: B. 8 P C.. b Nb reavon: Data: Owner i ao nereny o�y m.� i� ew�a a�e ��e�w�e ms �a��me��. d c�eomr wenn �d s�v code s��w,. zssos, usaa, .�a 25530. eed Ihe� I a enY Mure WiN'np oaupanl will / wYl M(d(cb ma) need b canply wIh veiA Yete codee enE IM eeQuiremenls fur eDeimillawnvunionamoEifi�ionhan�MAi ue�.y enepement0imrid.RuidentilmretvfionaGd�bmenazemNlmmtMu provisiona. Dete: Applrem: WONKEfl'S CONPENS�TION DECLRNATION: I Mroby eifiem uMm penelly d perjury aro d IM /olbvrirq dederazona: � I I�e.e aM xil meinten e cmlTcele d mnsent lo eellinw�e h wukers canpneetion, c prwiEeE (a by Seabn 3]00 d tM leEn coa. �« �M ronormeiwe d un .�wx �« wNcn inis v�il le rcauea. � I heve eM wil mvntem xoikert canpenaetion inwrence. es rtpuired by Seeim 3]00 M tha lebw Coda. b �ha pa�lamaMa d IM work la �MiM ihie permn is iesued. My wakert compensaiion inwrence arrbr eM policy number ue: c� va:.v N�mw.: his settion need rror be crompleteE X the pmm't is ror one h�nEred ddlers Rtool a Iesv.J ❑ I cerlN �het in Ihe perlom�ence d tM work br whbh Ihia permil ia iesued, I Mell ml empby e�ry peiem in eny mennar n u ta n«�e w4� �� ne wwen �w�.m� �w. a c�n��. �e mre. inm e i.ro�a �o� Mea �o �ns .aimrs wmpanu�/ion' �p-wis/iom7 d Safion 3100 d Ihe lebar Code, I e1Wl lath h oompy wn oea Oaie: �— l�' i� Rodseru' i�� WeminO� FeNun ro ixuro worka�' mmpuwtlon rovenps /� unNwNl, end Null wbfsef en xW/oys� ro eHMrol psneMu a�W c�vrr nns. w b� ��a�.d Mou,.ne aakr• (J�on,oaoA �� n ro m. co.r o� rorroauetron aamsy.. u povwa ror �n Sactlm 9)OS ol Ms Lebor Cotle, InroruL anJ ettomsy's Issa. � CONSTNUGfION LENqNO AOENCY: I hereby �im �Mer penalry d pmNrY �� ia e comlrudion bMirp epeM.y la tM paAarmen� W iM wo�k lor whidi iha peiml is osuad (SeGon 309'!. CH. C). LENDEH'S NRME: LFNDER'S ADDflE54: I cenity tAet I heve reeE Nia eppliration eM 9a�e ihe� tha ebove inlormetion ia wrim. I eprae to wmpM �h dl ory vM caunry adire�� enE eiele lewe rele�in8 �a buildinB ��dion erd Mreby eNhorae npmeentaii�m W this ary to enter upon Ihe abova�menlioned pmperly torinspepion Wrpovea. LARRY SWORD , De�e: � (515t<B WP) While-BuiNvq 8 Sffidy; OmamFle: Cenery-Appfranl; Rnk-Ra.enue; Ciddenmd-Rsaefaor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 073097 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR rPERM NO: B 07309 GOVT: N SUPP: N PURPOSE; OTH JOB DESCRIPTION : T/OFF RESHEATH 6 REROOF W/COMP SHINGLES SQ FT: 6,500 CLAIM VALUE: 6,500.00 CALC—VALUE: 6,500.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC, REROOF 2739SF RESIDENCE ��**��*�***��*�*,�*�****��*��**�*��***��*�*��*��*��i��*�*ETECTOR Z O N I N G R E Q U I R E M E N T ----------- MAIN BUILDING _____S_E—T B A_C K—S— _ ACCESSORY B��Y30�'� GD---- 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: 13909103 ZNE: REF NO; PLANNING NOTES> i !f if jE 1E iE 1E �E 1E �)E fE �f 3E 1E 1E �E 1E 1E 1E 1E 1f 1E 1E �f iE ik ff iE 1E ik ik iE iE iE iE 3f iE 1E �E 3E jf ff iE 3E jE �E iE 3E fElE fE jf �E 1E 1E �E 1E jE 1FlE iE 1F iE if 1k if if if !E �E jf 1E iE iE iF 1F 3F 1E ik ik 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: HUILDING APPROVED BY : DATE: APPLICATION ISSUED BY !f if !E fF ik ik fE fE jE k fE �E if 1k if 1F if !f if if ik LEGALIZATION:N 9f1E ifiEif 9E 1F3k IEjE IFiElkiEfE1E1E�E1F'IE��3ElE F E E 5 0 M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 90.00 65 SMIP/NON—RES PLAN ISSOE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 90.65 0.00 0.00 90.65 90.65 .00 REVENUE DIVISION TOTALS--> COLLECTED: 90.65 OVER/SHORT; .00 BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK 90.00 ,65 iE iE iE iE �t if iE iF iE iE ik iE if iF ik if 1f it iF it iF iE iE iE k ik fE 1E iE iE if iE iE 3E iF if iE iE if iE iE 1E fE iE jE 1F iE k iE iE iE iE if if iE iE iF iE it 1E iE iF 1E iE 1E iE if it iE aE iE if if iF 1f iE iE iF iE I N D I V I D U A L F E E B R E A K D 0 W N TYPE QTY D E S C R T P T I O N UNIT COST TOTAL COST SFR 6500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 6,500.00 END OF FEES �]! �Lik5Y3J-QO1E543i 'f c:�'S' 40.t5 �STE: L�]/D5�95 TiIiE: 14:3b �, r CONSTRUCTIQN AND PLANNING POO ;PA ; APPROVALS Permit �P Date laspector pppROVALS Permit # Date Inspector L Temporary Elearical Service or Pole 52. Pool & Equipment Location % 2. Soil Pipe�U�drgrnd. �' 53. Steel fteinforcement ; 3. Electrical Conduit UtiliTY-Undrgrnd. 54. Forms � � 4. Electricai Conduit�Undrgrnd. 55. Electricai Bonding �' 5. Steel Reinforcemen[ 56. Rough Plumbing & Pressure Test 6. Eiectrical UFEft Grnd. 57. APPROVAL TO COVER�GUNITE ` � 7. Footings 56. Electricai Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. � 60. Backwash �ines, P-Trap, �.� lindrgrr,d. 70. Structurai Floor System ' 67. APPROVA� TO DECK i t. Property Sewer Line & House Co ection �^ 62. Backwash & Receptor�Final � 12. Sewer Cap � 63. Heater & Vent-Final j 13. Roof Drains � 64. Plumbing System 'Fina� 14. Rough Piumbing 65. Electrica6Fina1 • . 15. Rough Electrica6Condult 66. Solar SYstem-Final " 7$ Rough Elacttic Wiring 67. Fencing & Access Approval , il. Rough Wiri�g Sign 68. APPROVED FOR PLASTERING ' 18. Rough Electrica?-T Bar Ceiling 69. POOL/SPA SY5TEMS FINA� 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Roagh Factory Fireplace - : APPftOVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping !� Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. �Roof Framin9 73. Undergrnd. Storage Tank i7 Gas ❑ OiI 25. Roof Sheathing %�r_q� � 74. Overhead Hydro � 26. T-Bar Cefiing fStructurap & Monocoat 75. Dry Chemical 27. Frame and Flashing . � 76. Dry Standpipe 28. Lathing & Siding � ' 77. FIXED SYSTEAA FINAL 29. Insulation ' 78. FIRE PREV. FINAL 30. DryHail Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Finai Electric Notes: � 34. Final Heating & Air Conditioning • 35. Finai Gas Pipe�Test . 36. Hood or Canopy 37. Pinai Factory Firepiace 38. Final Plumbing 39. Water Service�Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backfiow Preventer 43. Backflow Irrigation 44. Landscape Irripation SVstem - 45. Sound Attenuation 46. Handiwp Regulations ' ' 47. FINAL STRUCTURE & BUILDING � Z_� �wj,9 Y 48. FINAL PLANNING � . 49. ElectrEc Release to Edison `. 50. Gas Release to Southern California Gas Co 51. CERTtFICATE OF OCCUPANCY No. Date Aoplicant to fill in all spaces except those witnin neavY eortler lines ana sign all aoP�oo�iate aeclaratians. ci7voFCOSTAMESA CONSTRUCTIONPERMIT Project Address �B ry Applicant's Mailing Address nn ,�rn%��Q� ��/� �y�� Owner'sName ��1��J�Y/I' Phone�LX-LGL.L/� Address Arch/Eng. License No. Address n� � Contractor's Name_LY� u. Phone Address �mailing) _ /�/y Ciry Licenie No � (/ /� . � � ' LICENSED CONTRACTOR DECLARATION b hereby affirm [ha[ I' am licensetl untler provisions ot Charter 9(Cammencing . with Section ]000) of �ivision 3 ot the Business antl Prote55lons Cotle, and my license i5 in fW f� e antl effect. � License CI ss � Licen � No.� �.�� i Date� � Si9nature WORKE(i5'�COMPENSATION DECLA ATION � 1 hereby a(firm that I have a certificate of mnsent to selt-insure or a certifiCate N Workers' Compensation Insurance, or a certitied copy thereot (Section ;B00, l.ab. C. /'� . ' y� [ PnolicY No. �[ ,� ��% ComPanY �i-(�4�= IQ Ce�tifietl coPY is t�letlbwithrthehctlY B i i'sio .!/ �il A, /. Date ApPlicant ��V T `�� EXEMPTI N FROM WORKERS' COMPENSATION DECLARATION (This sec[ion neetl not be comple[etl if the permit is for One huntlr¢tl (§300) or less). 1 certify tM1at �in the perto�m5nce o( the work for which this permR i5 i55uetl, I -snall'not employ any person in any manner so as ta become subject to tne Workers' Compensation' Laws of California. � � Date Si9nature � � � ' 'NOTiCE: If, aiter making this'tleclaration, you shoultl become subject to the Wo�ke�s' Compensation provisions of the Labor Cotle, you must to�[bwith Comply .with such prOvisions or this pe�mit shall be �tleemed revoketl. CONSTRUCTION LENDING AGENCV� ' I hereby affirm that there I5 a coost�uction lentling agency for the pertOrmance of the work for � which thi5 permit is i55uetl .(Section 3097 Civ. C.) Lentler's Name � . Lentler's Atltlress � OWNER BUILDER DECLARATION � � � 1 hereby aftirm'that I am exefnPt trom the Cont�actor'S Lic¢nse �aw /o� the foilowing reason (Section �031.S,Business antl Professional Cotle: Any ci[y or counry which requires a permlLto construct, alter, improve, tlertiolish or re0air any stru<ture, prior to its Issuance, also requires tne applicant for such permit to (ile a sianetl statement that he/she is licensetl pwsuant to tM1e p�ovi5ion5 af 'herefrom antl the bazis fo� the alle9etl exemptlon. Any v101dLon ot SecUon 031.5 by any applicant for a permit subjects tne 'aOP�icant to a civil enalty ot not more than five huntlre8 tlollars ($500). .. L I, as owner of the. property �or.my emo�oYees with'wages as theii sole �compensation, will Go tM1e work, ana the structure is not intentletl or o/feretl �for sale (Section ]044, Business antl� Pwfessional Cotle: The Contractor's ' � Licenu Law tloes not apply to an owner of a property� wM10 builtl5 or improves thereon, anG who tloes sucn work himself/herself or through his or her own employces, provitletl [hat such improvemenls are not intentletl or offaretl for sale. If, howevet, lhe builtlinq or improvement i5 soltl within one year o( com- ' pletion, tM1e owner will have Itte burden of p�oving he/she tlitl not builtl o� im- �ova�for the pu�pose of Sale). ' � , , . , LI I, as owner of the p�oper[y, am exclusively contracting with licensetl Eon- � trac[orsto construtt the project (Section ]044, Business and Professions COCe: The Contractor's License law tloes not apply to. an owner of property who - builtls or improves thereon,�antl who contracts tor such projects witn a con- � trattor(51 license pursuant �to'the Contractor'S Licenze Law). I am aware that 'proof o( their Worker's Compen5ation insurance shoultl be p�bvitletl to me. ❑ I am exempt under Section 8. & P, C. for thii rea5on Date Owner � I hereby certify that I have read this'appiication antl state tnat She above , informatlon is correct. 1 agree to comply with all city antl county ortlinances � "� i TVPE OF COIVSTRUCTION NEW ADD ALTERATION ❑ CONVERSION�❑ DEMOLISH ❑ OTHER- DESCRIPTION OF WORK/U$E OF BLDG. ' REPAIR TVPE OF PERMIT . LI GRAOIfVG' �L/�F� OUNDATION LI STRUCTURAL ❑ TENANT ❑ ELECTRICAL I.� PLUMBING ❑ MECHANICAL O OTHER " BROJECT DESCRIPTION Sc3. Fr. � -� oCCUPANCv— � CONST,RUCTIONTYPE VALUATION$ '. ZONE � GRADINGGU.YDS. ACRES_ Rlmarks: Backflow Preventer Backflow Irrigation ishwasher � rinking Fountains loor Drains � , loor Sinks . • asService Outlets Lavatories , P—Trep • . Roof Drains � � : Reinspection Fee - $75 Boiler Duct - Under Grc Duct - Strucmrai Ezhaust SYstem ❑ Mul FirepVFact. Blt. ICBO # Heating System & Ductin ❑ 0.100,000 BTU 0100, antl state laws relating to builtlin9 construttion, antl hereby authorize repre- . Sentatives of' his <ity to enter upon the'above-mentionetl pro erty fo� inspe<tioh 0 os � - ' 1 Signalure _ Date ReinSpeRion Fee � Drivers' License or 55 � � 1 � CMF OB65-46, rev. 30/B4 White - Builtlin9: Canary - Appllcant; Pink - Accounting; Goltlenrotl - Assessor V1611VV . Showers ' ServiceSink � SewerCap Sewer Connection Solar Collecfors Solar Piping � SolarTank � Swimming Pool w/Spa Urinal Water Closet EES AutO-WeSh ' Laundry Trays � - Issue Fee $ 3 '�.ANICAL' FEE Hoodor Typel ❑ � . Canopy Type II ❑ , � Refrigeration System ❑0-1,00,OOOBTU ❑100,OOOBTU ❑ System Repair/Alteration ' FireDamoers� � $15 I I � Isue Fee $ 3 — A.P. # S Main Buildi E T Front B Rear A C Right K S Left, Ping. Ref. # Planning Notes: Automatic Washer: Construction PoleSu Cooking Unit i ' Dishwasher Dryers ❑Gas� ❑EI Fan � F.A.U. Fixtures Device Boxes Outlets $witCh25 Garbage Disposal Generator �0.5 KW fee 4837 •6/13/85 � Zone. Accessory Building: . Parking,Req./Provided ELECTRICAL Transformer ❑ 15-50KW� ❑ 50+ KW Meter LJup to 100'amps Meter �over 100 amps_ Sub Panel Motors�0-1 HP �1'/x-B Inc.Solar �9-15 HP �1�6 MicrowaJe " ' � � Pole Light ' � Range ' �, Standing SeCtions 5-15 KW Trash Compactor $15 Issue Fee � DEVELOPMENT SER VICES R EQUIREMENTS: Zoning Approved By � Building Appioved By _ _ . . ._ . f.�9lln� SUMMARV BUILDING PEFMIT $ � ' PLAN CHECK $ � PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL � $ P�AN CHECK 25% $ $ 3 FEES SMIP $ PERMIT . .ISSUANCE $ ' ' ENERGY P.C. $ ' � GRADING $ � MICROPILM $ � TOTALFEE $ � CONSTRUCTION ANDPLANNING POOL �PA APPROVALS Permit# Date Inspector AppROVALS Permit# Date InspPcror 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Foot�ngs � , . 58. Electrical Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgmd. � 10. StruGtural Floor System ' 61. APPROVAL TO DECK 11..Property Sewer Line�& House Corinection 62. Backwash & Receptor-Final 12. Sewer Cap � _ _ - 63. Heater & Vent=Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structurel) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. InsulBtion 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. �inaf Electric fdotes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing G L� 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. LandScape Irrigation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIfICATE OF OCCUPANCY . � Nn. Date Lor 37 - rR 40 , ��ti� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 3f7 CO9TA MEHA.�L�FORNIA For Applieanf fo Fill In Complefely TYPE OR PRINT BUILDING 3234 MONTANA AVENUE ADDRESS COSTA MESA. CALIFORNIA �MA��___ �555 PLACENTIA /iVENUE 1 SIZE TEL. K.W. KOLL CONSTRUCTION GO.�IN )R �555 PLACENTIA QVENUE _ NEWPORT BEACH 6tt95 No:Mi 6-3227 O�� Z I NO. OP BLD68. O � I LEFT 1� I RIGHi 5� DESCRIPTION OF WORK FEE RECEIVED r„� �pN 3 0 l�3`1 �y� FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only aece�wr wo. � J � �pr,,e. � I D/ �4 ,V C' I I �� DAT��3YJ. ADDRE6S f €B 7. 1969 COSTA MESA. CALIFORNIA FIRE � / �, � ZONE TYPE GROUP9 APPROVED ZONING �zo I NO. OP � I use oa n ._ 1 PLANB BUILDIN6 �t E �o�� •� n LINH 8T.1 EVES > 'BBZLDING .�/1�.755F ROOMS V STORIES V EX7eRIOH wa�� STUCCOIROOF WOOD SHAKES JI IVULG�1 MI�11 LI 1\GJ � VLIV GARAGE PLAN �-A I HER¢BY ACKNOWLED66 iXAT 1 HAVE REA� THI9 APPYWTION THg AMOUNT eHOWN UNDER VALUATION 18 FOR THH ANO BTATE THAT TH8 A90VE IB COPReCT AND AOPBB TO COM- PURPOBE OF EBTABLI6HING A PERMIT FEE ONLY. PLY WITH ALL CITY OPOINANCEB AND BTA'B uW9 R60ULATINO 0u1tDIN0 CONBTR�CTION �. VALUATION ��— SIGNATURE OF� r PERMIi FEE $ PERMITTE . $ /�/ .�/�,� '�" pLAN CHECK $ /� a AUTNORIZED AGENT A–L/ �.