HomeMy WebLinkAbout2313 HALF MOON LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address: 2313 HALF MOON LN
Suite:
Vicinity: L0T 7
Primary Occ: R3 Dwellings/ Cong Res <70 Type of Construction: V-N
Parcel Number: TPN00509 Zoning:
Applicant: WILLIAMS, GARY
Address: 1450 N. TUSTIN AVE
SANTA ANA, CA , ,
Owner. SHEA HOMES LTD
Address 603 SOUTH VALENCIA AVE
� BREA, CA � ' �
Contractor. �OWNER-BUICDER
Address: ' � �
Phone: 714-245-9760�X24
Zip: 92705
Phone: 714-985-1300 �-
Zip: 92823 � � �
� '.
�Status: ISSUED
Applied:. Ot/31/2005
Issued: 04/18/2005
ISSUED BY: �
. . � Phone: ' . ,
�
Zip: . . License: �000000 � � , ,
Arch : WILCIAM HEZMALHALCH Eng � ' '
,. Address: WILLIAM HEZMALHALCH ARCHITECTS INC �� Address:
SANTA ANA, CA " Phone: 949-250-0607 ' � Phone:
2850 REDHILL AV STE 200 � �
Zip: 92705-5543 License: C12920 � License: �
SCOPE OF PERMIT
LOT 7 � � � i -" � ' ' ; � , - � �
PLANS 2C - � - - - . _
CONSTRUCT 2560 SF 2-STORY SFD WITH 449 SF ATTACHED GARAGE AND 72 SF PATIO. FIRST FLOOR WILL BE 1225 SF WITH 1335 SF
SECOND FLOOR. A FIREPLACE MODEL #4236 (ANSI UL127) WILL BE INSTALLED IN THE FAMILY ROOM; THERE WILL BE A 2ND FLOOR
LAUNDRY ROOM. � -
REF: G04-000�0, PA-03-47, T-03-06 . � � ., '
SEE PA-03-47li-16600
Plan Check: $30527
Permit: $1,878.55
SMIP Res: $25:76
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00.
Total: $2,209.58
SETBACKS
MAINSTRUCTURE Front 6-0
. -`Rear 16-0
FEE SUMMARY �
Calc Valuation: 8z5�,5�5.3a
. , Claim Valuation: So.00
PLANNING & ZONING
_ . ,%;
� � Left 5-0 - Righ[ 5-0
NOTICE: The work authorized by this 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 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspectlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
29463fi (N00)
WORKERS' COMPENSATION DECLARATION: '
I hereby effrtn under penelry oi peljury one at t�e tollowing declaretlons:
❑ I have en0 will meintein e ce�ificete of conseN to self-Insure far warkers' compensatlon, es provided for by section 3700 of the Lebor Cotla, lor tha pertormence of the
work tor which ihi5 pertnil i5 i5sued.
❑ 1 have end vrill maintain workB�s' compensation Insursnce, es requirad by section 3700 of tha Lebor Code, lor ihe pertortnance ot the work for which this permit is issued.
My workers' compensation Ihsurence ceMer end policy number ere:
Cartier: Policy NumDer.
@�Is�lon need not be completed U the permit is veluetl et one hunOred dollars ($100) or Iess.J
i
�I certify Ihat in the pedortnence ol the work br wpich Ihis permit is issued, I shall nol employ eny person in any mannei so as to become sublect to the workr.rs'
compensation laws of C omia, anA egree h (t '�hould become subjac� �o Ihe workers' compensation prwisions of Sec�ion 3700 of �he Lebor Code, I shell fotlhwlth
���,,��.�d•y with these pm ' ons� �' /
Ap{i� �ant Signat : . Del� � � 8 ��
WARNING: FAIWR TO SECU WOR RS' COMPENSAiION VE UNLAWFUL AND SHALL SOBIECT AN EMP�OYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE MUNDRED
T}KK15ANODOLU 5100. ),INAp T�ONTOTHEO0.STOF S/TION,OAMAGESASPROVIPEDFOqINSECTIOfJ3lO60FTHELABORCODE,INTERESi,ANDATTORNEI^SFEES.
LICENSED CONTRACTORS DECLARATON:
I hereby affirtn that I am licensed under provisions of Chapler 9(crommencing with Section 7000) oi Division 3 of the Business end Professions Code, antl my license is in full
torce and eftect. lic. k Cless a
Coniractor s Signature: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirtn ihat there is a�nsiruction lending agency tor the pertarmanca of the work for which this permit is issuetl. (Sec. 3097, Civil Cotle).
Lender5 Name: Lendar's Address:
Signeture: Dale:
OWNER-BUILDER DECLARATONS:
I hereby aflirtn thet under penalry 0� Perjury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Cotle: Any ciry or county which retluires e permit to construct eller, improve, demolish, or repair eny stmcture, prior to its issuance, also requires ihe applicant for such pertnit
b tile e signed statement that he o� sha is Ilcensed pursuent to the pmvisions ol lhe Conlrectors License Lew (Chapter 9(commencing with Sectlon �000) of Division 3 of Ihe
Busineu enC Professions Cotle) tlr Ihat he or she is eaempt thereirom end c�e basis for the allegad examption. Any vidation of Section 7031.5 Dy any aOP�icant for a pertnit
subjetts the epplicani to e civil penelry of not mora Ihen five hundred tlollers ($500).):
��cl, es owner of t�e property, or my employees wlth wages es their sole compensation, WILL DO TME WORK, antl ihe stmqure is not intentle0 or ofleretl for sale (Sec.
-"'"70a4, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builtls or improves thereon. antl who does such work
himself or herself or through his or her own amployees, provided that such Improvements ere not inientletl or oXeretl for sale. If, however, ihe building or improvement is
wltl wit�in one year ol completion, the owner-builder will heve Ihe burden of proving t�at he or she di0 not build or improve �or purpose ot 5ale.).
❑ I, es owner of the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business and Pmfeuions
Code: 7Te contractors LicenSe Law tloes not epply to en owner ol pmperty who builtls or improves thereon, antl who coniracts tor such project with a contractor(s)
licensa pursuant to the Contractor�Liysnse Laws.).
❑ lem
m
sec.
licen56.
Verifiwtion ot OwnersNp by (type P�
Business end Prolessions Code for ihis reason:
,5/0 No
i.e. - property taz bill or tleed):
DIVISION OF INDUSTRIAL SAFE'n' PERMIT CERTIFICATION:
❑ I hereby canify Ihel no excavetion five (5) or more feet in depih into which e person is requirad to descenq will be made in connection with work aulhorized by Ihis
permil, antl ihat no Duiltling S�N�iure, ScaHdding, lalsework, or demolition or dismantling Ihereof, will be more ihan thirry-six (36) feat high. (Chap. 32, Grp 2, Art 2, Sec.
341, Trtle e, Califomia Atlministrative Code). ,
❑ As owner-builtlar, I will not employ enyone b ao work which would require e permit from the Division of Indusirial Safery, as noted above, unless such person has a
pertnit m do such work from the division.
Signature: � Date:
Di�nsion of InduS�rial Safety Permi� Number:
CERTIFlCATE OF COMPLJANCE AND AIJTHOR1ZA710N OF EN7RY: I cenify untler penelty of perjury thal I have read Ihis epplication and state ihat ihe information given is
wrrect. I agrea to omply with all bte�e yY� nd city ordinances relating to building conslmdion, antl authodze represen�atives of the City of Costa Mesa to enter upon �he
above�descdbe r perty for i spe� � �(foses. I grae not to occupy or allow occupancy ol any building aulhorizetl �y I�is per u until nel inspeclion.
��.�.., % - ylie�"os—
SIgn81u�e9 _eyQ�:Owner(s) T— l'Dele-a-�-��t'"
LODE I INSVECfIONTYPE
1616 Fixed System Final Fire Prevemion
1266 Pool Spe Final
200 Final Re-Roof
201 FIneI BIocWRetaining Wall
202 Final Fectory Fire Place
203 Final Sign
204 Final Demoli�ion
PAIE IH1IIJeLi
CO�E 1 INSPECTION TYPE
206 Final Mechanical
20B Final Plumbing
210 Final Beclrical
212 Final Flre Prevemion
22o Final Planning Approval
222 Final Site
250 Finel BuildinglOccupency
pATE
�$
�
�
(714) 754-5273 •• Fax (714) 754-4856 • www.ci.costa-mesa.ca.us �77�FAIR-DRIVE,_COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
2313 HALF MOON LN
HOUSE AND GARAGE
Parcel Nunmber: TPN00509
Status: ISSUED
Applied: 05/11/2005
Issued: OS/11/2005
Applicant: WILLIAMS,GARY — ' '_'�.-?'�� "�r- ISSUEDBY: W/i�
�' " _ ���'�,� � `-
Address: 1450NTUSTINAVENUE"`',�";-- -�� ^�-��`-`�-�^�"'�.
-�_ :
�f'`.t1�%/�
,. � i �,/
� � 7
/
l � �� �,
� Contractor: �
,
. Addres/s: I
ii 7�-.�/ /�
� t ._ � �/
� r,.l
,.� l�t%i
,
� �, t��/ �
n ,\. - ! f, �,' \'`
..-, . .
� ������ � '��. ,L0T7
' �-," , PLANS 2C4 � � ��
, �'"; 1-,� . .
. , F �' " ' �,� ELECTRICAL PERP
ti, t GARAGE AND 72 S
'"`f�'�� �`; ,1�'t=,FIXTS;3RECEPT(
� �, ,�,, i
�, .
�� i:, ,'�= � '�� REF: BOS00176 �
� , � .
!�i � / �� Phone: j ( ` �� 1����,� .
� �� � � .ti - f ���;��` ���
��� '� �� Zip.. 92705 i , ��� ��� . �� ; ' � . � .
i � r �*.� .C��".ti
� "'1 '", -_-- - . �. , ,e� -� ,__.�'�;-:,:
� %���_ _ . _:�� - ,-;-� , ��1 � n\: Ai.�
i ����
�/��-�!'I '- .� ���\ , \, , .� f \\���\
NCIA'AVE �_�V�.�� � ��.,�,�
�����:.
!� Phone: 714-985-1300 :�y�'�.,r��'� ',% ��`'
l �\�
Zip: 92823 �\����'�,� '� .
iN'
�
R.. �� ;,,,
�.��'�ho�� _
".�'f_,-"' � Zip: � . ,
{ _�-:
License: 000000
\ / '�
\.
� e^� �
.,` \\
.. ti \� ' � . _ .
,
' � `` �
�
j > >. i
,�` t i.. � � ,
iii.
' ,.- ��'t . - � ✓�' " !+—' � i . �, s '�
7 i�`�,Hi'� ,' � �
� :�; 1 t ��'��
, �, ,,,
,.
,.,�..r .4 , ,.: ; _ .
)� �� �� �SCOPEOFrPERMIT�f �� ,; _ � ,,�,5., � � '
_ -- . _ �_���.. ..._.-- �n..._..-c.. _ .�_ � �'. i. �� :_. " .�� �
� " t
, i i �
)RY SFD WITH 449 SF ATTACHED �`� � �,
SE �INSTALL 2 LIGHTING°u'q�; �.' � � t
D.OUTSIDE GARAGE ONLY jf` r�' Jr;' �
i ;
! ;;��/ r,-� , � : � r
�� �7%�� �, ��.,
r�� l!i�
t � � � � " � FEE SUMMARY �
� }..%� � � �
�'� ��. % � �. � � Quantity : i '1 , r-: , `tM ',
ISSUE��FEE r� �,�$23.50 Temp Dis(System / Lighhng :
Temp serJice test; � ` $0.00 . _ `Busway /�100,ft�?: ,� :.� � _ :
Res. a/c packar ' . � ,,,- . �" , _ �.t. -• �"'-"-� '
New Res (1-2�umts
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
Motors to 10hp
Motors to 50hp
$54.50�,; � .� � - rStandingSection�. �,- y�
� ��$143 36�.;, . 2560`-� , �Misc Electrical Eqwpment �,
��- .$0.00 � �.,,� �0 =_ ��a '�.�, Transformersaup to 1,kva/kw✓'
�L..%` $0.00� �'`:0��� � � , -, / uptot0,kva`/kw�
. ���, -.. $220 }�- ~2���..: . .`� �� �.up.to"SO�kvalkw
\� $330 � �3\\` � ��,.c .,��_�� __��--. i
�, ,� _ Y �`,� - - . ...:up to.100 kva/kw'1
� �.�:`.$1.10�,:�.'f;•�1� _.. � � ' � ....�.r.-....:..:.overJ00.kva/kw�1
� ���$0;00 � - ' i ,-0;,/ ��,�r , _-� ; _ �Low Voltage�Equipment
. � ' J �
`$0.00}�� ��� 0��� ^--s �� + y�"_ �'4tow Volt Wring Syste�in�/ Ckt
$0.00'-- �"��0 � .� ��MisaConduil�'",�'' � �
$0.00 �' � _ --.0�� - � - �' -'�Misc: Conductor ' '"
�! "��C= ' .
$0.00 "0� ��.�: j,_�--____Circus�(-gen:or-5ide)' �-�'�
$0.00 0 - - "-=�4-'Ciicus�(mecFi.ride�orlights)
' '�.--..__ �_.
� $0.00 0 ClSiistmas Tree Stand
$0.00 0 Fireworks Stand
��l'/ � � '� ��, t
,>� r� , ,�-�
3nhty ,,r � .,. ;
�p � �/)/i
0�-i ',;'�
0 ' � /
� J
)0 ,
�0/�j ; �
i ,
$0.00'/�%j�0
$0.00,' 0
30.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NOTICE: The�work authorized by this.permit.shall �comply with all.applicable handicap access requiremenis under Califomia statutes and related
regulations. (Ord. No.'92-28, § t, 12-21-92)
EXPIRATION: This permiCshall automatically.expire and become void if work is �not commenced within �180.days, or if work Is.suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized underthis permit.to be considered legal, such work must cromply with all applicable codes, and all
required Inepectiona and final approval must�be.obtained. Failure to obtain inspections and'final approval will result in the expiration of this permit.
'FOR.INSPECTIONS CALL: �.(714)�7545826 �
24CW8(fl�00)
WORKERS'COMPENSAnON DECLARAnON: � � .. � ' '
I hereby ettirm untler penalry of perjury one oi the followinq declarations: . � � , -, - � '
❑ I have end will maintein a certificate ot consent to seN-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the pedormanca of the
work tor whlch this permit is issued. � ' ''' � ' '
$
❑ I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Cade, for Ihe peAortnanca of the work for which this pertnit is issued. •
My workers' compensatlon Insurence carner and policy number are: �' .
Carrier: Polity Number: � �
(This section need not be crompleted i! fhe permit is veluetl al one hundred dollers ($f 00) or less.) •
�1
Idl�cenity that in Ihe peAorin nie of the.work fo w� icli tFis permit is issued, I shall not employ any person in eny menner so as to bacome subjecYto the"workers'
/ � compensation laws of Ca mia, antl egree I should b ome sub�ect to the workere' compensation provisions of Sectlo 370 oi the Labor Coda, I shall fonhwith
comply with Ihese r' 0 5. �
� p ican - ignatur . � � , ��� � �
AqNIN(3: FAIWRE O SECUR O ERS' COMPEN ION MGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLpYE RIMINAL PE TIES AN� CNIL FlNES UP TOIXJE HUNDRED
T/IOUSANDDOLLAR E100.00p) DITIONTOTHE WMPENSATION,DAMAGESPSPROVIDEOWRINSECTION31060FiHELABORCOOE,INiEREST,ANDATfORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
1 hereby aMirtn that I am IicenseC untler provisions ol Chapter 9(commencing with Section 7000) of Division 3 oF the Business and Protessions Code, end my license Is In tull
force and ettect. Lic. N Class M
Cantractols Slgneiure: Date:
CONSTRUCTION LENDING AGENCV: . �
❑ I hereDy attirtn that there is a consiruction lending agency for the peAormance of the work for w�ich this permit is issuetl. (Sec. 3097, Civil Coda).
Lentlers Name: Lentler's Adtlress:
Signature: Date:
OWNEH-BUILDER DECLARA710NS:
I hereby ettlrtn that under penelry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7037.5. Busineu and Protesslons
Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, elso requires Ihe applicant tor such permit
to tile e signed stetement ihet he or she is licensed pursuant to ihe provisions of the Conirectors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
Business end Professions Cade) or thet he or 5he 15 exempt lherefram antl the besis for ihe alleged exemption. Any violetion o� Section 7031.5 by eny applicant for e DBrtnit
sublecis ihe epplicent to a civll penalty of not more than five hundretl dollars ($500).):
❑ I, as owner of Ihe property, or my employees with wages es thair sole compensatlon, WILL DO TME WORK, and ihe siructure Is not Intanded or otferetl tor sale (Sec.
7044, Business anC Proteuions Cade: The Coniractors License Law dces not apply to an owner ot property who builds or improves thereon, and who tices such work
himsell or herself or through his or her own employees, pmvi0etl that such improvements are not intended or oHered tor sale. It, howaver, Me building or impmvement is
sold within one year of completion, ihe owner-builder wiil have �he burden oi proving that he or she did not build or improve for purpose of sale.). �
i�6 owner of Ihe proDerry. em EXCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
�"' �Clide: The con�ractors Llcense Law d�gs ot eppty to en owner ot propehy who builds or improves �hereon, and who conlracis for 5uch projec� wl�h a coNrac�or(s)
license pursuant Jp ihe Contractors Ljtb�j e Lews.). �
❑ lam
Owner
sec.
licen5e.
(type of
'/ Business and Professions Code tor this reason:
T oa�e: ,1, �� OS— .
No Drivels LiCense No. - � Expires: T�/ �T 9
pmperty tax 6ill or tleatl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify Ihat no axcavetion Five (5) or more tee� in depth into which a person is required to descend, will be made in connection with work authonzeC by ihls
permii, enC that no building siructure, scalloltling, talsework, or demolition or dismantling ihereof, will be more ihan ihirry-six (36) fee� high. (Chep. 32, Grp 2, Art 2, Sec.
341, 7tle B, Celitornie Adminis�rative Cotle).
❑ As ownervbuilder, 1 will not employ anyone to tlo work which would require a permit from ihe Division of IndusMel Safery, es notetl above, unless such person has e
permit to do such work irom the division.
SignaNre: Date:
Division ot Indusinal Satery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AIJi}fORIZATION OF ENTRY: I cehify under penalry of perjury that I have reatl this application and state tha� �he infortnation given is
correct. I agree lo comply wit� ell stete laws antl ciry ordinances relating ro building consiruc�ion, antl authorize represeniatives of Ihe Ciry of Costa Mesa to enter upon Ihe
ebove-descnbeC pmpetly lor inspection purpp$e;/1 agree not to occupy or allow occupancy ot any building authorized by Ihis permit until final inspection.
yyy�, INSPECTIONTYPE ' "' �� ' -
1616 FixeC System Final Fire Prevention
tt66 Pool Spe Final
200 Finel Re-Root � � �
201 Final Block/Retaining Well
202 Final Factory Fire Place � ��
203 Final Sign
204 Final Demolition
. , oere . . ixriru �
S
CODE� INSPECTIONTYPE
206 � Final Mechanicel
208 Final Plumbing
210 Final ElecMcal
212 Final Fire Prevention
220
222
250
Final Planning ADProval
Final Site
Final Building/Occupency
�.1 .1111. .
�
� i �_
(714) 754=5273-••Fau (714) 754-4856� ••www.ci.costa-mesa.ca.us 77 FAIR'DRIVE; COSTA MESA, CA 92626
Job Address:
Suite No
Vicinity:
2313 HALF MOON LN
HOUSE
ParcelNumber: TPN00509
Applicane WILLIAfv
..�
Address: 1450 N�,T,U
', '; ; -i
f r`'v G/41
,,;,: ..
-^; Contrector:` �
t . � , I
. f rAddress: f-
,
�t .. �i 1 �/
� j' ( }
ER-BUIL•DER
. r�
l �` �,
. _ i ��
� , ,. .. i r _•��..� ..
� �1
�� � 4U ` ` , �.r'.
,,;.' '4.� _ _, 1; ,
, ,..
�t�
�'.L0T7 .�-•�
, � ; �PLANS 2C k_-
'� ��J MECHANICAL PER
� �AT;TACHEDGARAG
"°"COOLING/HEAT, 2
-�� �� UP TO 3HP/100 K B�
�.f2EF: B05-00176
� '
ti� __ ,, AV� -
ISSUE FEE �� ��
Inst FAU <100 �k �BTU ` J
Inst FAU >100 k�BTU
Repair/Alt Cooling/Heat
Inst/ Rep. Recess�Wall H
Refrig Sys <100 k BTU? -
Refrig Sys >100 k BTU�`
Gas Piping�
Factory Fireplace
Hood w/Mech Exhaust
VAV Box
Vent Fan / Single Duct
Appliance
Fire Dampers
Smoke Dampers
Inst or Relocate Appl Ven
AVE
MECHANICAL PERMIT
Status: ISSUED
Applied: 05l11/2005
Issued: OS/11/2005
—. . - - `,�..--._._ Q in „^
.._-�.��: "�"� _`c''-=�='::_y-`�,� ISSUEDBY. /�vY1J
ii,_ _ - - - �..���� �
i. _ . _ � ,-._ _
� ` ' �' J.�`�r�� ``- _' � �
� � ! !� „ 1�i �s �� � �v��� c� •�
r !
1 .. ` � �
� ".�.Phone: - �',+ � •- � ```\''\-`� �
� �. —,�, �.
ti ;��
�`�` �Zip:' 92705 " . -' `� � \ J � . �' > � i,.
� � \ �
% ���\�.���: � ���
'�J� �: A� !% ^�`� i�
���`-;;.��"�r„ � 7 ����,�
V� � T . i, � ��v �
�'���,\���/ �1 �.
�`�t��.'.� � `� •.`.
Phone: 714-985-1300 , - .
Zip: �`92823 �` ��� � � � ,
� " �;;,>r,a„ �, 1\�, ', i :
� � 'C i �';�` ^•� ., . � i i r� �V � �-
� �_a� � �� _ `� ,- . . y , , ,, ��,
i Pr _ _.Phone � ':._. � _ ' %�1�� ��� � .
�
Zip: � '-�_�c.'� ' '��'' _
Llcense:000000 ' � �� ��''���
� ' a�' �,; ,'yv . .
,.. � , , •� SCOPE'OF.P.ERMIT `� - � `
l �f ��.t, i;.if%f' !1 � s� 'i I,. ..
--= -=-_ _'- --_-. ,..___.._ �—_._ :� _ -� . -" , ' .
MIT FOR THE CONSTRUCTION OF A 2560 SF 2 STORY SFD WITH 449 SF
E.AND 72 SF PATIO.,INSTAL'L"2 FAU,100'K�BTU ft.REPAIR)ALT =�
FACTORY_FIREPLACE,-6,VENT FAN/SINGhE�DUCT; 2�FIRE�DAMPERS AND
� FEESUMMARY
�� �
�;' Quantity '�-' �d� °.-�,�
� :
` ��'- , $23 50 _ o Repair /'Alt
; A�;$29 60 2 � - - ° `iRepair / Alt
.� �$000-�''"0=:;, �S�Ventillation
,�� $13�.70C�1 "z � . ' � i�� JEvaporativi
ti. f�„ !'� $000�.�.0��.,� � :�Comme�ci�
y+� `� �`$0 00 �0��`�`-'^ �; � 4_ `Comprelsslc
;�i2�.\v $0.00 0 - ', - -=_Up.to3:hp��
���� ;.,$21.30.'�2 �, �-�; � '"� ` 3 To 15 hp'
\.� ��$0.00- j0' � J '- Il�"-' '--� —15�To'30h�
�. $0.00.� 0 ��) � 1 "-"? � % . � � f �'�,30 To�50'h�
$43.50; -:'6- , - � > i "��;, ; _. Over��50 hp
$0.00�`.0^���`� ,- � � Boilers _
$14.50 2 � "��=ca.-=;'-----Uqto 3 hp`
$0.00 0 '- - ��_��'�`3?0�-15 hp
t $0.00 0 15 to 30 hp
Absarbtion Unit �
BTU
����j � !
! �L�".I ii_-'� �
;'i { , �- _.
,j -
`� _' � �
i
t� ,l}i r��.,�
2s..I'� (-
!t r.=
� ����� l. —.
r�� -�ti% �
' 1
�/' I`� �i l.�
�
„
� !>' � % ,f!�'
''�,, .� Quan�
$000 %��0,
� �: $0 00; 1%0
'' $000'�/0
' \ $0.00
v% � :$0.00
� �! � i
-"\ � f,t$0:00
''� ��l$29.40
����' $0.00
;�� �� $0.00
$0.00
$0.00
�
�
�
2
p.. .
0
0
0
$0.00 0
$0.00 0
$0.00 0
NOTICE:. The�work authorized��by-thispermit shall'.compty.with all:applica6le handicap�access>requiremenis-under Cati(omia�statutes�and related
regulations. (Ord.- No: 92-28; § 1, 12-27=92)
EXFIRATIONr This�:pertnit shall�automatically expire:and.become�.voidif work is.not commenced withln�180'days; oc if work�issuspended�ocabandoned
tor a period. of 180 days.
INSPECTIONS: In'oMertorthe.work-auUtorizedvnderthistpermit'.to.be:considered.legal, such.work��must'comply witk�,all'�applicable codes, an�ll
reqWred Inspections and flnel�approvel.must be obtained. Failure to obtain inspeclions�and final approval.wilLresult in the expiration of thisp�.
FOR'�INSPECTIONS�CACC:. (714) 75445626:
;rrar:i(:L�:9]
WORKERS' COMPENSATION DECLARATION: — -
I herehy eHirtn under Denelry oi perjury one oi the fallowing tleclarations:. � , • � �. , '
❑ I have entl will melmain a certifiwte ot consent b selbinsure tor workers' compensation, as provided for by section 3700 of Ihe Lebor Cotle, for t�e pertormence of tha
work for whiCh lhls pertnii is issuetl. ` � � '
❑ I �ave antl wlll maintein workere' compensation insurance, as required hy section 3700 ot the Labor Code, for tha peAortnance of Ne work for which this pertnit is issueC. �
My workars' compensation Insurance cerrier antl policy number are: • . .
Cerrier. Policy Numbec
(This secfion need not be comp/etetl i/ the permi( is valued et on hundred dollars ($700) or less.) �
certity Ihat in t�e pedortnanca o tha work for whicti M' mit i's issued, I shall not employ any person in aoy manner so es to 6ecome �subject Ib ihe workers' '
compensetlon lews ol Califomi and egree that if I s ecome bjact to the workers' compensation provisions oi SeGtio�700 oi the'Labor Code, I shall fonhwit�
comply with Ihese //
' ignat re: . . ��/ ��� �S
WqRNING: PAI�UFE SEC RE WO � RS' PENSATION E IS UNLNWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIIIAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TMOUSANDDIX.LAR (510p.000),IN DITI TOTHECG5T0 ENSATIIXJ,DAAMGESPSPROVIDEDFORINSECTION3lOfiOFTHEL400FCO0E,ItJrEREST,ANDATTORNEI"SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I em licensed untler provisions of Chapter 9(commencing with Seclion 7000) of Division 3 ot the Business and Professions Code, entl my license is in full
force and ettect. Lic. a ._._. ._ Class N
Comractofs SignaWre:
Date:
' CONSTRUCTION LENDING AGENCY: �
❑ I hereby attirm ihat there is a construction lending agency For the peAormance of the work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lentler's Name: Lenders Address:
Signetura: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirrn Ihat under penalry oi perjury thet I am EXEMPT FROM 7HE CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions
COGe: Any ciry or counry which requires e permit to consWct, alter, improve, tlemolish, or repair any swcWre, prior to its issuance, elso requires the applicant br such permit
to file e signed statement that �e or she Is Ilcensed pursuant m t�e provisions ot the Contractors License Law (Chepter 9(commencing with Section 7000) oi Division 3 oi the
Business end Professions Code) or that he or she is exempt therefrom and the basis lor the elleged exemption. Any violation of Section 7031.5 by eny applicant for a permit
sub�ects the epplicant to a civil penalry oi not more than tive hundred aollars ($500).):
❑ I, as ownar of Ihe properry. or my amployees with wages es their sole compensation, WILL DO TME WOPK, end ihe slructure is not intanded or oflered 1or sale (Sac.
7044, Business an0 Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, antl who tloes such work
himsetl or herselt or ihrough his or her own employees, provided Ihat such improvements are not intended or otfered for sale. If, howaver, tha building or improvement is
so within one year of completion, Ihe owner-builder will have the burden of proving that he or she did not build or improve tor purpose ot sale.).
s owner of the properry, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business entl Professions
Code: The conirectors License Law does not apply to en owner ol property who builds or Impmves thereon, antl w�o contracts for such prolect with e contracror(s)
license pursuant to the Coniractors�jciG�nse Wws.).
❑ lam<
Signelure:
Owner ID J
Vedticetion
sec.
iIs license.
6y (type ot
� Business antl Professions Code for ihis reason:
Data: 6f , /
❑ No Drivefs License No. � Expires: � ��
i.e. - properry tax hlll or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cetllty that no excavation five (5) or more teet in tlep�h inm which a person is required to descend, will be mede in connection with work euihorized by Ihis
pertnit, and �hat no building strucWre, scaXoltling, falsework, or demolition or dismantling thereof, will be more Ihan thirty-sia (38) teat high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Calilomia Administrative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which would require e pertnit from Ihe Oivision ot Intlustrial Safery, as noted above, unless such person hes e
permit to do such work trom the tlivision.
Signature: Date:
Division oi Industrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AUiHORVATiON OF EIITHV: I certify under penalry of perjury �ha� I hava read this application antl state that the informetion given is
correct. I agrae to comply with ell state laws and ciry ordinances relating to builtling consimction, and authorize representatives of the Ciry of Costa Mesa to anter upon ihe
ebove-descnbed propeny lor inspection purpose�WJl agree not to acupy or allow occupancy ot any building authonzed by this Dermit until fnal inspection.
CODE �.
1616
1266
200
201
202
203
INSPECTIONi1�VE "-'^ `
Fixetl System Final Fire Prevention
Pool Spa Finel
Final Re-Rool � �
�' - '2AIE I[4II1B65 � .
Final BIocWRetaining Wall
Final Faciory Fire Place � - ' �
Final Sign �
204 FinalOemolition
' �f pE t INSVECTION TYVE -
206 Final Mechanical
208 Final Plumbing
210 Final Eleciricel �
212 Final Flre Prevention
'� 220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
:..�-� g /o
.p.14)754-5273 •�Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 7TFAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 2313 HALF MOON LN
Suite No
Vicinity: HOUSE
Parcel Nunmber: TPN00509 � -
� ��if�r
Applicant: WILLIAMS;�GQRY��� �'
!n .�!-`% / f t
Address: 1450 N.TUSTIN�AVEN�UE�I �
� �,,�'��,J���� ��� 1 1
i^SANTA DND CG . � !'��. ��
�/(�, ,�
A,ti. / C,
:[„
,�/ `�
. ��
.\�
•.��)� � l
,.��, r'� 1
� ^ ' Contractor:
5lj
Address:'
y };
n� �,
� ` .
{ ~1 ij !
17
��
!�
ri•
,l/_� i d,
%t%;'. i F' `�4
I/ '
r1 � /
�.
,nve
I
�1�� r
; i�,�'� = =. .
� \. r; � -��.
�[�f��:.: "'
Status: ISSUED
Applied: OS/11/2005
Issued: OS/11/2005
, �:_� `�"=,-� =�_'"z�..''. ISSUED,BY:.��
_. - --- ..`-�- �
. � - � ' � .� ,'� �/ ~`."``� ,\ a
f�'f' ������'
Phone - - `„�. i\ J � � ��'��
��
;: Zip:_- 92705 .. .._1�, �..�`"� � f _�`.J �`�
.\� ;\\\`� r' /� �
�_< _ / ��A
_��:, ��.��, �� � ���
, ' �`\`�', ,_
Phone:��-714-985-1300
Zip.!%92823 ���\\'�� " ' .
�' �a ' - `'i�\' �� � .
- f. '�- �.��\ -y.
a�s�>r� ' , , � � ` \., .
�y.'sw { � �j� � ;' �,.�
Zt.J � �- 1 ui
�_��.� 3 ' ti � � �;�i'���, �� �
-'= v �- ...-. _ � , .�.
i �
Phone:
� � ti � ��
�4M'� e .
'. ;
. �.�_%�y..,
� > Zjp: � � ; �
/
.rrf f- � � -_ � - � --Cicense:=-000000-== == - - \
x, _ �
f"Y'7Rr" `F PP�'YI�) �"j"4 fl Y �i�'
��f� �1., i� �� �A �� � �� ll ;E �u � %fl �. . � � ��
" -- l� %' �,�SCOPE O
. - 1:,;'�on ." �,�. � .��., �
. , } � _ ". PLANS 2C - ti�,.,=.•--:
., i:5 �. � . +-'__„ _ ^-= j`
� � �� � '" ���-, �� PLUMBING PERMIT F'OR THE CONSTRUCTION
�, i'��`� ��� � '�GARAGE AND 72 SF PATIO.
�� INSTALL 3 BATHTUBS, 1 DISHWASHER, 1 GAS
" <� ��, LAUNDRY TUB/WASHER, 1 PRESSURE REGUL
1�,``�,` \\�/` � 151NK, SERVICE/MOP, 1 VACUUM BRKR BKFL
l / WASTE AND VENT SYSTEM, 4 WATER CL'OSE'
..\ '�,% r-
.\
.���
(INST,ORREP),1,WATERSERVICET��,:,• �- �
iti ����
�� -REF. 805-00
/�
\ l `f�, l
V �, j
i,�..ti :
ISSUE FEE
Backflow irrigation •
BackFlow Preventer
Balhtub
Clarifier System
Connect Qce,Soda,etc)
Dental Units '
Dishwasher
Drain, Floor
Drain, Rainwater
- _;`r� .
� �bf �
A�2560.SF 2-STORY SFD WITH 449 SF F
�y �.
OUTCETS),;3 GAS (OVER 4 OUTLETS),
iR; 1�SEWER�CONNECT, 3 SHOWER, 1 I
(1-4), 3 WASH BASIN, 1 WASH BASIN SI
)ILET), 1 WATER HEATERNENT, 1 WAT
/
��'.;��1� � %/!
�� - -
. \. y`
. ��i " " � in....
�`'r �'.� , .
u ��
�i � i i
��,r ��� ��',
� -� �i � _r. � ,
��ii
� {�! 1,' A _ �� �
1J.. ) ; ti
��',�i' , c , � .
1� 1 4 _..
r _
/i.�lf r ,� .
ACHED ` �-- � � �, ,
j��i� r"��..I ;'.
,; l 1.� '�� �(�'r
'.HENSINK;� �!i't
� � �� ��t 1
PIPING' �„�,
��, , i
ao . ' / _
' 0 1* I "
'- % .a�o .9 �'� ^o �-` �!7 ,.
: �;:. .'/'�C ` � L�" ` s�v.ie,y�j"�'i3°"! i� J�.
_ . �, . - . � � - —._ �3 � .. � � � � �
\���'�^../ .,
�AMT:�%tQTY '`,.`,�
/ �
l� �' �1
R
�23.50,.� �/� �auuwy-Juu�•wa>nei.�,._-_Yn.ou--'J= t� �.�aump�rwnp/.�v�
$000 �..0 �:/ �-Landsc`apelrtigahon `�'_.: $000''0 i\ Swimming.P,00/'
$0 00, � 0 ' / J P Trap; .,.., ` $0 00� (Ol�\ �,,Trap Primei/�
29-40 � z��3 �-` i� Pressure Regulator �/� ., �`�$g�80L-w 1� j Unnal'l� ;�'
$0 00� � �0 ' '� Process Fiping (per 10 ft) � . $0 00 <=-0.�-' - Vawum Brkr Bkflow(1-4)
/-. -
$0.00 0 �� ' � �- Receptors - - � '. � \� , l '..: $ODO' `� 0 - -� !' Vacuum Brkr BkFlow(5+)
$0.00 0 ��--SepticTank,_ _$0.00—;Oj/''�i" WashBasin
$9.80 1 "-Sewer Cap�for,Demo� _.=,;,$0.00''`.0= '� Wash Basin Set
$0.00 0 Sewer Connect�---- ----324:65� 1 Waste and Vent System
$0.00 0 Sewer Private Line $0.00 0 Water Closet (Toileq
AMT
$0.00
$0.00
$0.00
$0.00
$12.30
$0.00
$29.40
$9.80
$9.80
$39.20
QTY
0
0
0
0
1
0
3
1
1
4
NOTICE: The work authorized by this permit shall comply with all applicable handicap access iequirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This pertnit shall automatically expire and become void-if work is�not commenced wlthin 180 days, or if work-is suspended or abandoned
for a period of �190 days.
INSPECTIONS: In order for ihe work.authorized under this permit to be considered legal, such�work must comply with all,epplicable codes, and aN'
required Inspeetlons and final approval must be oblained. Failure to obtain inspections and final:approval will result in Ihe expiration of this pe '.
FOR INSPECTIONS.CALC: (714) 7545626
zaae�ae �s�oo�
WORKERS'COMPENSATON DECLARAnON: � ' � , -
I hereby eXirtn under penalry oi perjury one of the tollor.ing tleclarationsl= '; _ � ' �
❑. I heve and will maintain e certiticate oi consent to seN-Insure for workers' compensalion, as provided for by section 3700 of Ihe Labor Cotle, for t�e DertOrmance of the
work tor whic� this pertnit is issued. ' � �� ' ' ,
❑ I heve and will mflintain workers' compensatian insurance, as required by section 3700 of the Lebor Cade, for the peAortnance of ihe work For which this pertnil is issuetl.
My workers' wmpensation Insurance carner antl policy number ere: � , �
Carrier: Policy Numbec ' '
s secnon need not be cromplefed il (he permit is valuetl et one hundred dollars ($ f 00) or IessJ �
ify Ihat in the pedorma ce oi the woik foi �ic - this perrnit is issued, I shall not employ eny person in eny manner so as to 6ecoma subject b lha workers'
compensation laws of Cali ia, and egree t hould b ome subject to Iha workers' compensation pmvisions of Seclion 37 of the'Lebor Coda, I shall forthwlth
Comply with t ese provi ' n. �"�//� �
Wp at . �891 [��^iw. � v
ARNINO: FFIL E TO SECURE W FS' COMPE TION MGE IS UNUWFUL AND SHALL SUBJECT AN EM O ER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED
TMOUSPND E15100,0001, A DITIONTOTH OFCqMPENSATION,DPMAGESPSPROVIDEDFORINSECilIXJ3%O60FTMELABORCODE,INTEREST,ANDFTTOHNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirm t�at I am licensed under provisions ot C�apter 9(commencing with Section 7000) of Division 3 of tha Business and Professions Code, and my license is in full
lorce antl ettecL Lic. a Class # _.__ __
Contractofs SlqnaNre:
Date:
CONSTRUCTION LENDING AGENGY: �
❑ I hereby aftirtn thet there is e consWction lending agency for Ihe peAormance of the work for w�ich this permit is issued. (Sec. 3097, Givil Code).
Lentler's Name: Lender's Address:
Signature: Date:
OWNER•BUILDER DECLARATIONS:
I hereby ettirm thet untler penalry of perjury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business ana Protessions
Code: Any city or counry which requires a permii to wnsirucL alier, improve, demolish, or repair any structure, pnor to its issuance, also requires the epplicant for such permit
lo tile a slgnetl statement that he or she is licensetl pursuant ro the provisians of the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) ot Dlvision 3 at Ihe
Business and Protessions Cotle) or that he or she is exempt therefrom and iha basis lor the alleged exemption. Any violation of Section 7031.5 by any aDPlicant for e pertnil
subjects the epplicant to e civil penalry oi not more than tive hundred dollers ($500).):
❑ 1, es owner of the proDerry, or my employees with weges as their sole compensation, WILL UO 7HE WORK, and the structure Is not intended or otteretl tor sale (Sec.
7044, Business enC Professions Code: The Contractors License Law dces not apply m an owner oi properry who huiltls or improves thereon, and who does such work
himself or herself or Ihrough his or her own employees, provided that such improvemenis ere not iniended or oNereC tor sale. If, however, the building or improvement Is
soltl within one yeer oi completion, ihe owner-builder will have lhe burtlen of proving that he or she tlitl not builtl or improve for purpose of sale.). '
� wner oi lhe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business antl Profession5
Code: The contrectors License Ww dy�s9p t epply to en owner ol propeny who builds or Improves [hereon, and who contracts tor such project with a contractor(s)
license pursuanUo the ConiractorsJQEepye Laws.).
❑ I em exemp r sec.
Signa e:
Owne ID varified b dri fs license.
VeriFiw ership by (type of
� Busine55 and Prof855ions Code tor this reason:
� Expires: � / N O�
i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certiy thet no axcevetion five (5) or more feet in depth into which a parson is required to descend, will be made in connection wiih work authonzed by ihis
pertnit, and that no builtling siructure, scaHolding, falsework, or demoli�ion or dismantling thereof, will be more than thirry-six (36) faet high. (Chap. 32, Gry 2, Atl 2, Sec.
341, Ttle B, Califomia Atlministretive Cada). �
❑ As owner-builder, I will not employ anyone to do work which would require a permit irom ihe Division of Industnel Sefery, es noted above, unless such person has e
permit to do such work trom the division.
Signature: Date:
Division of Intlustnal Safery Permit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVA710N OF ENiRV: I cenify under penalty of perjury that I have read ihis application and state Ihat the infortnetion given is
correci. I agree to comply with ell atete laws and ciry ortlinances relating to building consiruction, end authorize representatives ot the City of Cosia Mesa to enter upon the
ebove-describetl properry lor inspeciion purposes. I aqree not to occupy or allow occupancy of any building authonzed by this pertnit umil final inspection.
INSPECTIONTYPE ' " "
1676 Fixed System Final Fire Prevention
12fi6 Pool Spa Finel
200 Finel fie-Rooi � ' �
201 Final BIocWRetaining Wall
202 Final Facto'ry Fire Place
203 Final Sign �
204 Final Demolition
CQOE♦ �INSVECTIONTYPE '
206 Final Machanical
208 Final Plumbing
210 Final Elecirical -
. ., .�g .. r..��
3-/-� �
212 Final Fire Prevention
220 Final Planning Approval "
222 Final Site � - � �
250 Final Builtling/Occupancy � " '
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administretive Code, Title 24, State of California, in the bullding located at
�p2� � 3 HALF MOON AN PHS-2-TRACT 16600-COSTA MESA
LOT-7
CEILINGS:
TYPE: Fiberglass Batts
WALLS:
TYPE: Fiberglass Batts
MANUFACTURER: Owens/Corning
MAN UFACTURER: Owens/Corning
GENERAL CONTRACTOR: SHEA HOMES
,i
TITLE:
THICKNESS: R-19 6-1/2"
THICKNESS: R-133 1/2"
LICENSE#
SCHMID INSULATION CONTRACTORS, INC. LICENSE #221517 C-2
BY: �C/� I J�/r TITLE: PRODUCTION ASSISTANT DATE: 02/07/2006
ANNETTE PATTERSON
INSULATION CERTIFICATE
This is to certify that insulation has been installed in conformance with the current energy
regulation, California Administrative Code, Title 24, State of California, in the building located at
HALF MOON LANE-PHS-2-TRACT 16600-COSTA MESA
LOT-7
CEILINGS:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Corning THICKNESS: R-19 6 1/2"
WAL�S:
TYPE: Fiberglass Batts MANUFACTURER: Owens/Coming
GEN�RAL CONTRACTOR: SHEA HOMES
BY: TITLE:
SCHMID INSULATION CONTRACTORS, INC.
THICKNESS: R-13 3 1/2"
LICENSE
LICENSE #221517 C-2
BY: �2vt�(i �/'�y� TITLE: PRODUCTION ASSISTANT DATE: 02/07/2006
ANNETTE PATTERSON
� ��r1:S7'i��i�;
!^�y`AIR CONDRIONMG INC.
Site Address
,___.atlation Certificate : Residentia] CF-6R
2373 HAI.F MOON T,,M(E Sldg: - Unih -%
l. BUILDER iPTFORMATION
Shea Homes
603 S. Valcncia Avem�e
Brea, CA 92823
INSTALLING CONTRACTOR
�. PROJECT INFORMATION
DIST'RIBLJ7ION TXPE
Flexible Ductnrork in
Attic and Bctwcrn Floors
PERNxI7' #
5LJBDMSION: Half Moon I,ane
CITY: COSTA MESA
COUNTX:ORANGE
WESTPAC A� CONDI'fIONJPIG
f1iL�11.1[fl:7 � I i N�C�3;�R��177�
Flexible Ducrivork Will have
a R-Value of 4.20 or Betteir
I, the undeisigned, verify that thc cquipmem listed in the category abovc my signature is the equipmrnt insralled and fhat the equipment
meets ar exceeds ti�e requimnenta of the Appliance Efficiency Standazds. In addition, I have verified that the equipment is equivalent to or
more efficient than the equipment speciticd on the Cerrificate o£ Connpliunco submitted m demonstrate complience with fBe Energy
Efficiency Standards for residcntial buildings.
3. HEATTNG iNFORMATIOPI
HEATING
POUIP.
Fumace-FAU 1
4. COOLAVG AVPORMATION
HEATING
LOAD
G CT COMPRESSOR A AL COOLING IJiP HEATING
EOUIP• NL1KE NIbbEL # SEER CAPACITY LOAD
Coil-FAU 1
A/GSTD HS26
A]lstyle
Lennox
LENNOX
ASFM60-18A31T+S
lOACC-048
EER
10
The building design heat loss and design l�eat gain rate have been determmed, using a method specifled in Section
150(h) of the Energy Efficiency Sffindazd,g, and are two of the criteria used foz equipment sizing and selecrion.
5. THERMOSTATIC EXPANSION VALVE (TXi�:
Tlxermostatic Expansaon Valve (or Commision appxoved equivalent) is installed and access is provided for inspectioa
6. SUliMI'I'1'CA BX:
WESTPAC AIR CONDITIONING
Signature Installing HVAC Con4actor
AC�airclCryslalRcpmta\PurchsninglC F6R_Rcpart.rp[
fobl7; 4RR9 i�t: 7 Bldg: - Unit: -
YES Q NO Q I3/A Q
6/30/2006
Date
See 190 23rd St. for add'I
paperwork covering entire tract.