HomeMy WebLinkAbout301 HANOVER DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
PLUMBING PERMIT
Job Address: 301 HANOVER DR
Suite No
Vicinity:
Parcel Nunmber: 14138206
-- , ,
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Applicant: NOCK, TIM ��� %` -
Address: 11812 KNOTT,9T. " -
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;GARDEN GROVE, CA �' _ -
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0 �er:�/ QUACKENBUSH, JNELSON
�„� � : i
.Address EDWARp TR -' �
� , COSTA MESA, CA
� - ' � � 301 HANOVER DR
Bhonei (714)895-1246 "
� Zip: 92841 .. .
Phone:
Zip: 92626
Contractor: ' NOCK pLUMBING � '
Status: ISSUED
Applied: O6/11/2003
Issued: O6/11/2003
ISSUED BY: Ln �
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, Address: �11612 KNOTT ST- - - � " � - � - �
. ' ' " ' � Phone: (714)895-1246 � .
� � � , „��GARDEN GROVE, CA Zip: 92841
� � , - � � : License: 707775 \\ �
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� �Arch / Eng :" ,� _ - ' - -, . ' , . . - .' . . . . . . _ � y -
, Address:- � � --
�.. . . , , - � Phone: _ .
. . , .. . " Zip:" . . -.
� " ��� License: � �
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�z� �� i `, �� �, � � SCOPE OF PERMIT
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- , t �CHANGEOUT WATER HEATER
� � � � , „ . . . .. ..
•,,�. �- �,�.f-PEESUMM
'` ��� � - AMT_ ` � QTY
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ISSUEFEE,'��`�, � '$23.50,�� �^'��" LaundryTub/Washer
Backflow inigatibn- �$0;00 �'-0� . Landscape Irrigation�
Backflow Preveriter', $0.00 �0� . ' P-Trap
Bathtub ' �� $O.Ob . 0 ' Pressure Regulator
Clarifier System \��,�� $0.00 0, � Process Piping (per 10 ft)
Connect (Ice,Soda,etc) _ ,` $0.0p . 0 � - ' Receptors ' �-' ` '
Dental Units � $0.00 � �� �'0 , Septic'fank �
Dishwasher �'$0.00 � 0� - Sewer Cap for Demo
Drain, Floor $0:00� , 0 �' Sewer Connect
Drain, Rainwater $0.00 ' 0� Sewer Private Line -
Drain, Roof $0.00 0�. �' _�- Shower �
Drinking Fountain $0.00 0 -� Sink; bar -.
Ezpansion Tank $0.00 0 ��Sink, commercial ' '
Gas Earthquake Valve $0.00 0 Sink, Floor � '
tY ` �
AMT '.:QTY..�.�- �, . , ' , � AMT
$0.00 0� - '�'� � �;'" Sump,Pump _ $0.00
$0.00 0 " Swimming Pool . " � $0.00
$0.00 0 �Trap Primer � , � . � $0.00
$0.00 0 . Urinal � $0.00
$0.00 0 , Vacuum Brlir Bkflow(1-0) $0.00
$0.00 0 . Vacuum Brkr Bkflow(5+) $0.00
$0.00 0 - � Wash Basin, �" $0.00
$0.00 0 Wash Basin�Set $0.00
$0.00 0 Waste and Vent System $0.00
$0.00 �0� � Water Closet (Toilet) $0.00
$0.00 0 �WaterHeater/vent $12.30
$0.00„� 0""�� �-`""� Water Piping (Inst or Rep.) $0.00
�$0.00 -0 �� Water Re-pipe $0.00
$0.00 0 Water Service $0.00
QTY
0
0
0
0
0
0
0
0
0
0
1
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Cali(ornia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-g2)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 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 �
requlred Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. �
FOR INSPECTIONS CALL: (714) 7545626
saasas �s�oo�
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WORKERS'COMPENSAnON DELLARAnON: � ��
I hereby ettirm under penelry oi perjury one ot the following tleclarations:
❑ I have entl wlll maintain a cenilicete of conseni to selbinsure for workers' compensation, as provided for by section 3700 of tha Lflbor Gode, for the peAormance ol the
work for which this parmit Is issued.
� j I �ave an0 will mainiain workers' compensation insurance, as requiretl by section 3700 oi the Labor Code, for iha peAortnance of the work tor which this pertnit is issuetl.
work com en�sa1tion Insurance carrler and'9olic umbe re: �+ %O O O��� �p �
Ceriiei�_� C7V Cl�V� �i (�}'t� (P��Num6er.—.'�— ( �"ZJ
((hls sec(ion need not be comp/e(�il t� is valued at one und�ed dW/ars ($700) or less.) ��
❑ I ceRity that in the peAorm n f Ihe work for which this pertnit is issued, I shall not employ any pereon in any manner so as to become subject to the workers'
compensalion laws ot Cal' ar i a egree that if should become su6�ect to �he workers' compensation provisions of SectiOn 3700 of the Lebor Cotle, I shell iarthwith
compty with these provisi a. /' O
iApplicant Signeture: : D'ate:`� !n � � � �
WARNING: FAIWRE TO SECUPE 1 ORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALilES AND CIVIL MES UP TOONE HUNDRED
THOUSAND DOLLARE (5100,000�, � AD�ITIdJ TO T1E COST OF CAMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3lO60F THE UBOR CODE, IMEREST, AND A?TORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aRirm that I am licensed under provisions pL6hapter 9 c mm ncing with Section 7000) ot Division 3 of iha Business and Pr ssions Code, and my license is in tull
force antl ettect."Lic..p� CI` ess #+ G
Coniractor'e�Signetu� FDe�,a: –
CONSTRUCTION LENDING AGEN V:
❑ I hereby aHirtn that there is a w struction lending agency for the pertormance ot the work for which this pertnit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLAHA710NS:
I hereby aHirm Ihat under penelry of perjury that I am EXEMPT FROM TME CONTRAC70RS LICENSE LAW for ihe tollowing reeson (Sec. 7031.5, Businass entl Professions
Cotle: Any ciry or counry which.requires a permit to constmct, alter, improve, tlemolish, or repair any sirucNre, prior to its issuance, also requires the applicant for such pertnit
to file e signed statement Ihat he'or she Is licensed pursuant to the provlsions of ��e Contrectors License Law (Ghepter 9(commencing with Sedion 7000) of Division 3 oi the
Business and Professlons Code) or Ihat he or she is e:empt thereirom antl t�e besls for iha alleged esemption. Any violation oi Section 7031.5 by any applicant tor e pertnit
subjects the epplicant to a civil peaelty oi no� more ihan five hunared tlollars ($500).):
� I, as owner of the property, or my employees with wages as thelr sole compensation, WILL DO THE WORK, and Ihe sWCWre is not intended or ofrered for sele (Sec.
7044, Business and Protessions Coda: The Coniractors License Law aoes not apply m an owner ot property who builtls or improves thereon, antl who does such work
himseH or herseli or through his or her'own employees, provitled that such improvemems are not intentled or ottered tor sale. It, �owever, ihe building or improvemem is
sold within one year of completion, ihe owner-builder will �ave.the Durden ot proving that he or sha tlitl not Duiltl or improve for purpose oi sale.). �
❑ I, as owner oi the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sac. 7044, Business and Profeuions
Code: The comraaors Llcense Lew tloes not apply to en owner oi propeny who bullds or Impmves Ihereon, and who wntracts tor such projea with a contractor(s)
license pursuant to the Contractors License Wws.).
❑ 1 am exemp� under 58t. Business end Prof855i0n5 Code for ihi5 reason:
SignaWra: Date:
Owner ID verified by drivers license. �Ves � No DrivaYs License No. Expires:
Venfication ot Ownership by (lype of tlocument, i.e. - property tac bill or deetl):
DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION:
❑ I hereby cetliy ihat no excavation five (5) or more feet in depth into which a person Is required to descend, will be mede in connectlon with work euthorizetl by Ihis
permit, and that no builtling structure, scaflolding, falsework, or tlemolition or tlismantling thereof, will be more than ihirty-siz (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Title 8, Calilomia Adminisiretive Code).
❑ As owner-builtler, I will not amploy enyone to do work whic� would require e parmit irom the Division of Intlustrial Satety, as notetl aDove, unleu such person has e
permi� to tlo such work Irom the tlivision.
Signature: Date:
Division oi Indusirial Satery Pertnit Number:
HAZARDOUS MA7ERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or fuWre building occupant need to file antl certiy e Business Plan for emergency response to releese or threatenetl release of e hezerdous
matenel7 ❑ Ves ❑ No
(Section 25505 of the California Health and Safery Cotle requires, with some ezceptions, that a Business Plan be fitetl with the Costa Mesa Fire Depariment Dy every
business which has at any one time during a reportetl year a quantity ot hazardous matenals aqual to or greater then a weighl 01500 pounds, or a volume of 55 gallons,
or 200 cubic teet ot compressetl gas at standard temperaWre and pressure).
2 Does or will the applicant or present or future building occupant need to lile a regislration form for awtely hazardous materials9 �� Ves ❑ No
(Section 25533 oi the Calllornla Health entl Salety Cotle, with some exceptlons, requires re915tretion with Ihe Costa Mesa Fire Departmant by eech business which at any
one time has on hand e quantiry of acutely hazerdous materials equal to or greeter than e weight of 500 pountls, or e volume of 55 gallons, or 200 cubic teet of
compressed gas at stantlartl temperature end pressure).
........................................................................................................................................................................................................................................................................................................................................................................................
3 Does or will Iha applicant or present or tuture 6uilding occupant need to prepare an RMPP (Risk Management and Prevention Progrem for acutely hazardous meterials)7
❑ Yes ❑ No
(Section 25534 0l the Calibmia Health and Safery Code pwvides ihat ihe Cos�a Mesa Fire Department may require the preparetion, canification antl filing with the Fire
Department of en RMPP by busineues which are requiretl to register acutely hazertlous materials with the Fire Depanment.
4....–It an RMPP is Presently required,�has Section 25534 of the California Heelth and Satery Code been fully complied wit�7.....� �Yes............O.No ...............................................................
......__........_........._._........._ ...................................._................._................................................_....._......._....................................._..__......................................._........................................_........._............._.........................._..............
5 Does or will lhe aOD����� or presam or fuWre builtling occupant require tor the work which is Ihe subjacl of this a plication a Eertnit for such conscruction or moditicetion
fmm the South Coast Air Quality Manaqement Distdct or from any olher air pollution coniml district or agenc�? � Ves u No
(Section 658502 ot the Califomia Govemment Code requires ihat ihe raquestetl infortnetion be fumishetl on applications tor non-resitlential builtling pertnits).
6 Will any pan of the tacility to be constructed untler this pertnit be within 1000 feet from the outer bountlaries of a school? ❑ Ves ❑ No
Qf yes', the taciliry must meet the requiremenl ot Sections 25534 an0 42303 of Ihe Califomia Health antl Satery Code).
....._..........._..........._.........._ ..............................................................._._.........._..................................................................................................................._...._.......... ......................
7 If a pertnit trom Ihe Sout� Coast Air Oualiry Management DisMct or other eir pollution control distnct or egency is required lor ihe work which is ihe subject of ihis
epplication, have all 01 the disclasures prescnbetl by Calitornia Health antl Safery Code Section 42303 been matle? ❑ Yes ❑ No
........................................................................................................................................................................................................................................................................................................................................................................................
8 Qf yes', atlach certificate of compliance from the appropriate air pollution control otticer).
CERTIFICATE OF COMPLIANCE: I certiy ihat under penalry of perjury the inlormation given above is correct. I egree to comply with all state lews and ciry ortlinances
regartling Hazardous Matenals and Emissions.
Signawre: Date:
CERTIFlCATE OF COMPLJAN AUTHORQA71
correct I agree Io comply wi s te laws and ciry
ebove-described property fo i pe ion pu)poses. 1 ai
COOE 1, o"TE
1618 Fixetl System inal Fire Prevention
1266 Pool Spa Final
200 Final Ra-Root
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
ENTRY: I certify untler penalry of perjury that I have read thAs epD�����on and state ihat the information given is
ices relating to building construction, and authoriza represenietives of the Ciry of Cos�a Mesa to enter upon t�e
to occupy or ellow occupancy of any building authonzed by this pertnit unfil final inspection.
Data
/�n-fy�d�
�� [Date�
INTRIALS CODE� INSPECTIONTYPE
206 Final Mechanical
� 208 Final Plumbing
210 Final Electrical
212 Final Pire Prevention
220 Final Planning Approval
222 FinalSite
250 Final Building/Oaupancy
OpT� II�EL$
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�oonessoremiaxo: 301 HANOVER DR
°w"E"s"""EiFa�wr': QUACKETIBU5H, P7ELSOP7
���� EDWARD TR
301 HANOVER DR
:OSTA MESA,CA 92626595-2132
�vr�. uuimo �ooxess: .
ARCNRECT OR F1kiNEEX:
YILH ON FN0.'S dU0flE55:
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urrt:
uc. xo:
UNf:
caam�crarsruxE: NOCK PLUMBTNG (714)895-1246
COMAACLORSIWIPIO 1 1 6 1 2 KNOTT S T
�ooxess GARDEN GRO4rE CA �� 511971
92641 uxn 17
LICENSED COMXACTOFS OECIAF�TION: I M1eby e�'rm uMx panelly W pmj�ry Mm I em Icm�sd uMm prwie'nna d Cheqm 8
(oommmidip wilh Sec�ion )�00) ot Division � d iM Bu�ineea uM Pmbaaiona Code. eM mY lioenae w in lull face arM eHed.
cmuc.No.: 050386 uc.cuss: C-36 uc.No.: 51197 EXP: 02/96
o�,: � f a�/S � ���a: N oc� �u��tc3i �
OWNEH 6UILDEfl DECLANATION: I heeaby elfirtn under oenetY d par'ryry ihal I em exemq Imm Iha Comredas Liwme lew la Ihe
Idbw�p �enaon (Saqion J0�1.5 Buaiiesa eM RoteSeN�s Cada: AnY ciy w muMY �� �9uvee a peemil lo wqbuel, ellm, impo.e.
md'oh, u repai eny elNclure, qw lo ila bauarce, eba re0ui2e IM apd� �a vuc� pamN lo fib e epned atetement Met M a aM
'�iceneed puraueni to the O��eiona d �M Con�redofs Licenae Law �Chapter 9(cpnmend'p wn� Sedion ]OW) d Divoion 3 d �he
,4r�eav enE PrMeaeona Coda� or ihm he or ahe ia Memq tharehom enE ihe ba�ie Iw tha dlepad axemption. My videtbn d Sed'nn
,031.5 W eny epplirani far e permn subptla iM eppliceM b e cil penely d rwl maa Ihen Ma hundretl Edlen �SSW�).
❑ I. es ovmer d iM qope�Y a�M' �doY� �h weBas es Ihei sde mmpenaetion. xill do IM v.wk, vk �M nVucYure o ml iMeMad
or ollereE fa eele (SMion ]Oaa, Buanew eM Prdasaions Code: Tha ConVeUon Liceme Lew Eoae �wt eppM �a � owror d propeity
wM buids a m0� Ihmeon, eM xfio daee vueh xwk NmeeM or hene� or Nrouph he or her ovm amplvyen, peovided ihe� sueh
"mprv.einenn are nol imanEeE a dlemd I« mb. X. howmer. �hp Wiltliiq a inpravemenl ie edd wilhin omYevW mmplNion. Me
ownerbuiNx xill heva iM burden d provirq M Or sM EM nal buiW a impo.a lor iM WToae d eeb).
� I, av ox+wr W Ihe DropeM• � e�dueively mniredin0 �h licenaed conlrectae to consVua iM pmpa (Sedion ]014, Bueinma end
Pmtesaons CaEa: TM CoMreGae Licanee lnw doea mi xpqY to en owner d prapMy M1a WiNe a impov« �hereon eM who
emve�vs for wqi peqeda xnh e mmeaGor(s11ie0�sed Wnuent io the Comrepors Limms Lewl.
� I em axemp unEer Saclion: B. E P C., for Nia meson:
oax� Owner:
I do Mreby ceNly Nel l em ewere d ard undersiend IM �eVuirommn d CelLomu Hee11h eM Sefely Code Sed'ane 25505. 2553�. eM
2553C, arM that I a eiry iNure WiIEinO arupent xill / Will rwi (dreb wie) neaE lo comOH wAh aeiA pete oodee eM tM reyuiromenm tm
a pemN Iwmicewciion «modifiraianhomlMAis%Y���t Oietrie. Reaidm�iel'muruaion eppirstiwm uessmmq Imm thpe
wmdao�•.
Dma: Applzenl:
WOPKER'S COMPENSATION DKLAN�TION: I hereb/ eH under penelly d pajury ans d IM IOAowiiq Eetlere[una:
� I he�e vk wil meimain e cenJicele d mnsen� lo Oell-innure br wwkere' cwnpenWian, n prwided la by Seeun �]00 W Iha lebor
Code, lor tM pe�lamence d tM xvM1 for which I�is permit ie isauetl.
❑ I Mw ud xil maininn xwkare' mmV��ion inwrance. ro re9u"vad M Saeim �100 d ths Lebor Code. for �M O�o�marce d iM
wak la which I�o permX is i»ued. My woken' wmPenwion inwranca remer end pdiq numEa va:
ca.�,.: S'r'ATz EY,PIRES
Pdicy Numbec -� � F� q o �_ o� 0 3/ 01 / 9 6
his axlion need rwt be cwnWe�edY tM peiml 'p Iw �e hunCied Edlera /SfOJ/ w bas.J
� I eanM Ne� in tha perlormenea d IM woek lor Whwh ihie pa�mil is ieeued, I ehell na empby eny pa�mn in eny men�wr eo a+ lo
became wbjea io the v.orkare' eanpenmlian levn d Celilaena eprw ihel tl I dwuk bxpna wbjae �o iM waMero'
compenmtbn oru d Seppion �OU d tM Laba Code. I wilh comply wil�
Deie. ���i,�� � L � App�cem� Z �
Wam/ip: Fe/lun ro�ecuro woiksn'rompeiwtlon c�'erep� h un4wNl, endshsll aW/eet �n w+W/qw ro cqMrol psiWtlu �nJ
c/vll flnu up ro on� huntlrotl thoufarW oo/kn (S1P4�A In eddldon ro M� ro�t o/ rompsiwWr� Aemps� u pN�/tlN br In
Swtlon 8)O6 0l U�s La4or COM, Inhnaf, end ettorqsy4 IN�. .
CONSTIiUCT10N LENqNO ROENCY: I harebY eMh^ �^e^r peneliy o/ perN�Y Ihet iMre e a mna�ruaion kMiiq epawy br Ne
�n��e d me � �a.n�d� ma w�+ m esuee Isaac� xs�. ca. cl.
LENDEN'S NAME:
LENDEN'S ADDflE55:
� CBI�Ih/ 1�101 � hOVB fl81� Ihlf G�ICBIIM Blld q8101hBi 1�b BbWB III�MIW pll O COIIM. � q�R! 10 COT�' W11�1 G�� G1)' 811'� Mll1�Y OIdifIBMM
end eiela lews rele�inB �o buildinp con�ruqion � hereM eNhorae repeeentetivea d Ihn dly lo entar upon ihe ebove-men�nneE qopeM
forinspWy n vurV�s. `
Oale: � L �� �
(5151-CB.WPI W�e-Buik'vq 8 Selery:Orea�Fb: Cenery-AOG��t: Pink-RevemM: GalEenro�A%savor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO; P 07197U PLAN CHECK AdO: N
COT7STR[ICTION TYPE: PERMIT TYPE: PLU
JOB DESCRIPTION : WATER HEATER CHANGE—OUT
PERM PdO: P 071970
GOC'T : N SUPP : r7
SQ FT :
PUP,POSE; OTH
CLAIM VALUE: CALC—C�ALUE; GROOP OCC; R-3 1
CODIMENTS: NO OTHER WORF: AUTHORIZED BY THIS PERMIT
1f iE iF'lE'1F if if-If if 1�-if1E ik if�1f1F if iF if if iF�Lif if #F'1E i! +E it 1fjE if ii�Y iF 1EiE ffiF if Y'Y'-lf 1F iF�14 iL if iR�R Y-Y iL'Y�if J4 Y-iF i4'7f�iR �F aE iF iL iG y-if if iF-Y Y-N�iG.y+FaE iE�iL
Z O N I N G P. E Q U I R E M E N T S
5 E T B A C K S
------------ MAIPd BUILDING ---------- --------- ACCESSORY HUILDIA7G ---------
FRNT: FT Ir7 REAR: FT IP] FRNT: FT IP] REAR: FT IA7
LEFT: FT IN RGHT: FT IN LEFT: FT ZN P.GHT; FT IN
PARKIP]G REQ• PROV; PARCEL: 14138206 ZNE; REF NO:
PLAP]NING NO'tES>
� �-
af if if iE iG iF iF if ifif iF iF'iFY�if ii Y-iF if if if if-lfi�-if iE iG if �E k if iE if w 1f iFiE K if if if df K 1E iFif�if�'if if iR 1E iFYi4af if iF iE iE�If�If iE iF icaF if JI-Y if if if iE Y-i4 iF'N��h i�- iF
D E V E L O P M E N T S E R V I C E S:. R E Q 0 I R E M E N T S
ZONING APFROVED &Y "'_ DATE:
bUILDING APPRUVED BY ; DATE;
AFPLICATIOPI ISSUED BY: DATE;
*i(-�{f�ciF�r�N-i�-ac�tcjt-iF?t?tici�**aF*�v -�EacifiE iE*iR r�rt .i4*if��tjtaFiF-r� iF it-It*icacr�*�(-a(-xicacib*acrr-.y.+c�tt� �ac �)f.xa(.
LEGALIZATION;�I F E E S U M M A R Y STRUCTURAL SEGMPNT:N
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRAllING
PERMIT 7,00
25� SMIF/NON—P.ES
PLAr�
ISSUE FEE Z0.00
BUILDINC—DI��—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7,00 20.00 0.00 27.00 27.00 ,Qp
REt'ENUE DI��ISION TOTALS--: COLLECTED: 27.OQ OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC AIECHANIC FIRE SMIP/TOT GRADING PLAA7—CHECK
2%,��
'1f iF'lf #''1f'ff if tf i�- )h #�f k"Y.-'k ]fi('Jf iF-lf if k if'K'1E if l-if iF ih 1� �('4 if i�'�1F'N"M.'if'IF if Y�i�'i4 if iM ;E if ii�1E�f Y+F'7F af+f iR af'lf'jF {�'i�-i' i�-il-Y-ia iM1 iF if aF iF K if if af Y df i:
I N D I C' I D U A L F E E H P. E A K D O W N
TYPE �iTY U E S C P. I P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND!OR VENT
EA1D OF FEES
�.oe
oi cc:so��a-oniao�ib T#_tT
DA7E� 04l27.�96 7I;9E: 20%18
�.00
27. CiQ
� CONSTRUCTION ANDPLANNING POO� ,PA
APPROVALS Permit # Date inspector APPRQVALS Permit # Date Inspector
r_ _
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Und�9rnd. � ' 53. Steel Reinforcement • �
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. �. 55. Electrical Bonding �
5. Steei Reinforcement ` 56. Fough Plumbing & Pressure •Test -
6'. Electrlcal UFER Grnd. 57. APPROVAL TO GOVER�GUNI.TE
7. Footings � ' 58. Elecirical Conduit-Undrgrnd. � .'+
8. Foundation • 59. Gas Pipe, G Undrgrnd., Test '
9. Water Pipe-Undrgmd. - 60. Backwash Lines, P�Trap, n Und: grnd.
10. Structural Floor System r 61. APPROVAI TO DECK'
t t. Property Sewer Line & House Co`nneciion 62. Backwash & Receptor-Final"�
72. Sewer Cap _.. 63. Heater & Vent-Final � �
73. floof Drains � � 64. Plumbing SYstem - Final "
14. Rough Plumbing � 65. Electrical-Final ' �'
15. Rough Electrical�Conduit. � 66. Solar SYstem-Finai �
76. Rough Electric Wiring � : 67, Fencing & Access Approvai � '
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING -
18. Rough Electriwl�T Bar Ceiling 69�. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditio�ing FIRE DEPT. REQUIREMENT �
20. Rough FactorY Fireplace � APPROVALS � Peimit #
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 Framing -' " 73. Undergrnd. Storage Tank i7 Gas ❑ Oil
25. Roof Sheathing � � 74�. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat . . 75. Dry Chemicaf
27. Frame and FI05hing 76. Dry Standpipe
28. Lathing & Sidin9 ' _' . ' 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL � �
30. Drywall Nailing ' HEALTH DEPT. REQUIREMEN7
31. Plaster Brown Coat � 79. FINAI INSPECTION
32. Electrical Power MeterFinal � 80. FOOQ CERTtFICATE ISSUED �
33. Pinal Electric - , Notes: �
34. Final Heating & Air Conditioning � � � '
35. Final Gas Pipe=Test „ � '
36. Hood or CandPY
37. Final Factory Fireplace _ � - ,
- 38. Final Plumbing • ' '
39. Water Service�Finai . • � ' '
40. Gas Service�Final •� �
41. Solar pomesticFinal , . .
42. Backflow Prevencer
43. Backflow Irrigation
44. Landscape Ir�ipation System •
45. Sound Attenuation , � -
46. Handlcap Regulations � �
47. FINAL STRUC7URE & BUILDING �
48. FINAL PLANNING � �
49. Electric Retease to Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICA7E OF OCCUPANCY
No Date
nnonessae�niaxc: 301 HANOVER DR
°""Ea31'"°Ei"w""": QUACKENHUSH, NELSON
AD0"� EDWARD TR
301 HANOVER DR
�vr�.wuurw �oowess
COSTA MESA,CA 92626
MCXRECT Ofl ENtlNEER:
nxcx. on u+c.�s �ooxess:
uc. No.:
UNT:
1g ('�
UNT:
CONfXALTOR'SNAME: NOCK PLUMHING ( 714 ) 895-1246
CRrtPRCTOWSMNl1NG 11610 SEABOARD CIR
"���� STANTON CA �� 511971
90680 uNT:
LICENSED CONTPACTOHS DEC�ANATION: I heraby e%'vm uMm penely o/ perjury I�Po I em Ikaneed under praneionn M Chepter 9
(mmme�np wiih Saclion ]00p) d Divieion 3 d �he Buaina» enE Vrofeaeione Cab, eM my license o in full force end eHaq.
�c uc.no.:050386 uc.cuss: C-36 uc.No.: 11971 EXP: 02/96
�- vf — 9� �a�„�ao,: j�i oc�c Pu�.�IQ i�Uc-, ��/�
OWNEN BUILUEP DECLRNATION: I Mnby elfirm uMer penelly d perN�' �� I em eaemq Irom iM Convenae Liceree Lew Iw IM
Idbwig reawn (�ion ]031.5 Busneea vM Prdeeaiona Cade: AnY �AY a�+nry xfiieh eequirae a pertnil to mmvuei. eller. improva.
'•mole�, a repv eny swcwre, pior �o ne'sauence, elea requiree Ihe epplirant tm euch parmu m fib e egned alelament tlial M a ahe
icenaeC punuenl lo Ihe prwisiona d IM Conlreclore Licenee Lew �Cheplx 9(mmma�np wilh Sed'pn )000) M D'veion 3 M tta
rnea eM PrWe�uns Code� or �he� he or she is exemq thereimm anE ihe besia lor the elleped exemWion. My voleton d Sedion
. JJt.5 by enY eVW�t fa e permn wbjMs Iha epqicenl to a mil pereXy d M mare �hen tNe huiMreE ddlen I`3+WU�
� I, av avmer d the propenY a my empbyees wIh wepes av Ihei wla mmpenaetion, will Ao ihe vroM, eM tM siruciun's nd inlentled
or oilered br xle (Sec�ion 10aa, Bueireas end PMaeniona Coda: The Coniraztore Licenne law daea mt eppyto en ovmard properry
wlw WiEs or'unproves �hereon, eM who Eoan euch wM1 HmxM or haneX or throuph he a her own empbyeee, provided thm wch
improvameMs are nd inle�Wed a dleied for eele. tl. Mwever, IM buiNirq a'vnpwemenl is saltl wil�in ma yeet d compb�qry iM
ow�,-w�a., ..ui ne.� in� w�� a wo,ma na «� ed �a w�a a�mwo� i« ins wmo� a�1.
� I. es ox+rer ol �he propaM. em e.�cluaivety canireqip wnh IicenseC wnvectan �o conmrua �ha P�I� (Sedion 1014. Busir�ava eiM
Pro(evione Gode: Tha Con�radon Licen» Lew does � epply b en owner d prapenY �o buike w imqovee Ihereon end wfio
wntrern lor wtl� prqeas v.nh e oonirerfor�a) Icensad WA�t to ihe Coniredon license law�.
❑ I em axamq uMer Seclion: B. 8 P C.. br I�n ieewn:
Deie: Orvnar:
i eo n«ew �n�h mv i� e�a a�a ��B�,a ma �a����a a c�,om� �.nn .�a smmr cm, sae�, usos, usa�. �e
25539, eM IAet I«e�ry Mun Wikinp ampenl will l wil �pt (tircb are) nead to wmply w1h sak eble mdm aM iM iepuiremenK for
epermAformnaWef amotlArationhmmtheR'e e�y anepememDis�nd.ResiCentieleonmivaoneppfe�atiomenaremqlmmNeae
D�e�isiona.
W ORKEF'S COMPEN5ITION DECLAPATION: I hereby elfirm uiker penelty d pe�jury me M Me bllowiip detlerm'vru:
❑ I heve eM wil manien e cenAwa d mnaeni to naM-inaure br vroMare' canpenaeton, en pwided lor by Sepion 3�00 0l lhe labor
coaa i« ma rono�m�e a u..ron� i«.non m�. v�a n �.,�,e.
❑ I heve eM xil meinten worken' oompenseton insurarce. es reQuired by Saeim �]00 d �M Lebor COCa. la Ihe peRmmenm d iM
j[ work Iw which Ihis permit is isaued. My worke9 compensetbn imurence famer aM poliry numGer era:
c�er: S'TATR EKPIAES
va�N�mee,: ��Wr'321� �lA� 09/30/96
.iis sx�ion need rwt be comdeteE I tne pamrs is M one hundree ddbm (Stool w bss J
� I een'M �het in �ha perlormenee W iM woek i« whch this peimit is ias ell nM emd Pereon In eny menner w m to
n��a wqea m m, ..«�en comoa���� i=� w crn�� a ea� mm � i�.�qea m ina..on«„•
/NmOemelun povisum d Setlqn �)00 N ihe Lebor Cotle. I �onnwnn dr wni�n� //
" Weminp: Fallun ro axvro wodn�' campmueHon rovereys 4 unlewNl, entl shell aub/�cf anTmplaysr fo ctlmlro/0eru/tls� entl
c/vll flnss up ro ms hwErsO flwua�nd Jo/kn (S1DJ,000), M eJ�1/tlon b M� roat ol romps�uet/on, tlemep� es provltletl br In
SxHon 9106 0/ Ms Labor Cotle, Infenaf. anJ afromsy's /ws.
CONSTqUCTION LENDINO RGENCY: I hereby elfirm under penely o/ perryry the� ihare ia e mnet�udian IaMing agancy lor the
�no,m�� a ine.ro� ia wn�a, mm oa�� �s s�ea csaao� aaei, ca. c�.
LENOEq'S NMIE:
LENOER'S ADDNE55:
I canity ihm 1 heve reed ihis epplice�an enE stale ihet iha ebove iniammion ie cortee. I epree io comply wnh ell riry end munty oNinencea
vM aime lews releing to Wilding conYrWion eM hareby eu�lwr¢e reprasenteiives of ��e dly Io enter upon ihe ebv+e�mentior�ad pmpaM
Iainspatlion purposes.
�1 RON Q}9C�K /
Daie: / ` �
(S151d8 WP) While-Buikvq 8 Sefa�Y: OrearFb: Canery-APP��1: Pink-Revenue: GdEenro�Aesaeear
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 076090 PLAN CHECK NO; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU
JOB DESCRIPTION : C/O DISHWASHER
CLAIM VALUE: CALC—VALUE:
PERM NO: P 076090
GOVT: N SUPP: N
PURPOSE: OTH
S(,� FT :
GROUP OCC: R-3 /
COMMENTS: X
***�*x�**�***x**x***+r+r�***��*��*****��***��r��+�*��x****�**�*����x�x��**�r*���****�*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 14138206 ZNE: REF NO:
PLANNING N6TES>
� d
1E iE 7E ff 1E �E 1F iF iE 1E 18 iE 1E * iF 1F 1E i81E 1f 1E 1(� 1f if IE IE 1E 3F 1f 1E 1E 3E 1f 1E 1E iE fE iE iE iE iE 1E IE iE iE if iE �Eif 1E 1I� 1flF 1E 1F IE if if ik 1E 1E 3E iE IE!(� �E 1E iE'JE iE 1F if iE 3E 1E iE iE 1E ib
D E V E L O P M E N T S E R V I C E S,.r R E Q U I R E M E N T S
�
ZONING APPROVED BY .
BUILDING APPROVED HY :
APPLICATION ISSUED BY:
���x�*�*x�***�*�� *�r*�r�*�
LEGALIZATION;N
F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE
PEAMIT 7.00
25$
PLAN
ISSUE FEE 20.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 7.00 20.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
HLDG PMT PLUMHING ELECTRIC MECHANIC
27.00
DATE:
DATE:
DATE: ��
******�* ��
STRUCTUA SEGMENT:N
SMIP/RES GRADING
FSI�i���Ci7.II.l�
TOTAL PAID DUE
27.00 27.00 .00
27.00 OVER/SHOAT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
IE 1E iE IE iE 1F IE iE iE 1E 1E 1E 1E iF 1E 1E iE iF iF 1E if 1E iE iE iE iE iE 1E iF if 1E 1E iE if if 1E ib if iE iE i! iE iE iE ik ib if �)Eif if iE if iE 1t iE iE iE 1E 1E fE fE iE iF iE rt iE ik if iE ik �f rt iE rt iF iE iE 9E 1E
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
PLU 1 DISHWASHER 7.00 7,00
END OF FEES
G1 •`stl±99u37-t',�245d3? T�n� 2;.Ou
a�r�: c�.���,y5 rx�F: ra:��
' CONSTRUCTION ANO PIANNING � `_ � . PO�OL?°"�J�A '
� APPROVA4S Permit # � Date .Inspector qppROVAIS Permit # ' Date Inspector
1. Temporary Eiectrical Service or Pole , 52. Pooi & Equipment Location
2. Soil Pipe�U�drgrnd. ' 53. Steel Reinforcement � ' �
.3='Electricai Gonduitlltil+ty-Undigrnd. 54: Forms . �
-'��4� Elec(rical GonduTl7hdrgrnd. . 55. Electrical Bonding - �
��5f Steel Reinforcertieny=:, 56. Rough P�um6ing & Pressure Test ;�
>�y�Electrical UFEft`�'imd. � � 57. APPROVAI TO COVER�GUNITE
_�. �,
T 7. Fooiings �� '' � 58. Electrical Conduit-.Undrgmd.
^8. Eoundation .. �1 �= 59. Gas Pipe, O Untl�grnd., Test �
��9. Water Pipe-Undr9rnd. �, - 60. Backwasb lines, P-Trap, O Undrgrnd. �
t0. 52ructural Floor Svstem . - 61r APPROVAL TO DECK� � �
11. Property Sewer Line & House'Connection 62. Backwash & Rece{ifor-Finel � .
12. Sewer Cap �' 63. Heater & Vent-Final . c-r.
13. Roof Drains 64. Plumbing System � Final
14. Rough Piumbing_ � ` 65. Electrical-Finai `�
15. Rough Electrica�Lorrcluit .. 66. Solar System-FipaL
16. Rough Electric4C,�yrinf . � 67. Fencing & Access Approval
17. Rough Wiring Siga �L , 68. APPROVED F0�2 PLASTERING i
18. Rough Eleetrical,-`',.7. Bar Ceiling - 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning - �,Y - PIRE DEPT. REQUIR.EMENT
; .1xr- c
20. Fjougj�'Factory;;Fir€pj�ice '�� 4 ; � H �x;�APPRDVAi���Pe�mit#�-
21. Qucts�; i� 5truaTu�e�Y t -.. .. :�` y 5 C' � �,� 70. tlndergib�5� Hydro � ..
22. Q.utts: Veotilatin "'i� . _ � � 'r': �` '"�• ,� '�`�
� a 9':s ^C' r C Q r ;-�:�, ��71. ProducF;Riping OGas �Dil
23. Gas Pipe-8ougj & Test =_ 4�� � �C _ �� � 72, Underground Ftasfi� *' �
_ �
24. Roof�Fraitling.: x : �"�"' ^" `: �. � 'X � -� ` • .
y, ���, ,,, �,Y',73:,Undergrrifl.Stor_ag�Tank,,�DGas ❑Oil
25. ftoof Shes�hing :; ;; ' � :. ' j n; �- � � 74.": Overhead Hydra� �r
l: � G � R S .^ A' �-t _. C
26. T�Bar`Ceiling (StructSraq & (Vi�'bi�ptbat + ,.. ,.� �5,�:Dry Chemicai �,- �. ,.,
27. �r',ame.and�,Flashing �, �;�,- * � y p:'.+. 76. Dry StanO�'pe F=-- �� ��
. r, . �
�-28. �athing &-Siding �, °,� �='Q� �� _ •.� .•;� 7Z= FIXED �TEJy]�fiVAI; � ;� pj
� .., _ . .. � r. m " � �. '' c' c..
�29. InsulatioM • _ � *' a- 7&: FIRE RflEV. FINW'L
"30. Drywalil�iling �H i ?� S`'�� ,;ji�ALTtt�DEPT.REQUIREMENT
e. � :. . ,r ,�.�-. ��� .. �• _
'�37. Plaster 8rown;Coat � S -rr p � ;�' �79. FINAL IIySPECTf6N rt
- ._
�^32. Erectrical�RowQr MetAr�n�l � ' n' �,� �80;T'FOOD CERTIFl.G�TE I�St�lED�,
��
.. � � �� a r , r•- c ,.
�-33. Final Electric- �,; � � X ! �Nates: - -+.?l r -� = rr
�`34. Final:Heating & Air �onditionin'§� �" _ • _ - Y �� � � � ; �'
35. Final`Gas Pipe:Test K "� . ' ' ! ' � ` " ` � � ` '' �
: Cr x � :w .i.... C r�. -� '
-36. Hood>or Canopy « � �_ -' . : ' � c� � � .T
- x ^ o + [- r-
-37. Final`F,actory Fire lac ~^ , '��. " �. i� r� - � `.,
P i F+c- t.+ :K S r.;
-38. Final:Plumbing � tt: i a ' ���GJ'7 ' + -- � .� �-. ^ �r
- -1 � � �" I f [� :�' -C Fi C i:
39. WaterService-Final �: ` � ; � , � ' �'�'• ''''`
=�40. Gas Service-Final a: ?! �;:T'^ S �� [*: � �r ��t- -� .r �
-�. �, s.. r � F � �' Y c:
r S -� • • - • P � T
%41. $olar pomesticFinal�, ; ,� �� ;, ,.�, v _ _
"42. Backflow Preventer : .v = � ' x �" ; r x �"
�• _ _ ..- ;r,r.
43. Backflow Irrigation � '==• °. a_ x �h _ �
- � � .,. v. . .' "" �
44. Landscape Irripation�System ^':i:� � �* - N, N �� "� +t+ " r; �t � h -
45. SQund Att.enuation �; "x''" ''T � ' `� '..`".�;F � _ `,.J.' �t'" � :{
r
46. Handicap Regulations - x � � � S �:�c. �' �
• C T. (1 'l
47. FINA} STRUG'TURE & BUILDING �,` ' ^'� ` �' � ;
� �o- f. ��r � h r-.
48. FINAt PLANNING � -i- . q; � 'Fx : �r•, � : .
� i -
49. ElectFie Release to Ed'rson r ' ^ _ ' "�
G I ' Y • 1 4
50. Gas Release to Southern California Gas Co � � �F � - '
� � Y _
51. CERT�IFICATE OF OCCUPANCYc . * : .. - :< • . ..
No. Date
! _
OWNER � - COLLEGE-PARK � � � onre 3—]_Z-5%
JOBADDRESS 301 Hanover Drive BUILDINGPERMITNO. #(1((y],
GENERAL CONTRACTOF�-jypbOP C04SbTUC't�ri VALUE � 12�1y0n 00
� 70 BLOCK TRACT glbb Res. w/att. gar.
GROUP I& J TYP� V ZONE FIRE DISTRICT Li720
INSPECTIONS
Footing Trench �
Foundation Forms and Grade to G
Rough Framing
Piumbing, Rough to Slab �
Plumbing, Rough Complete �
Temporary Pole
Wiring, Rough
Heating, Rough
Heating, Final
�ewer Hnuse_CO.�L Sewer St.
Septic Tank or Cesspool
L-"��g, In Out �
I :ring f
Piumbing, Finat, Fixtures Complel
Plumbing, Fin.al Gas Test /�5"�
Wiring� Final
Occupancy
DATE
SUBCONTRACTOR
PERMITSISSUED
DATE � NUMBER
, 'I . _.. � ,l„_ .., _ . _
� - � � �� ��-�� � ���EE��}RECEIVED
� ����- . . �-���': �.. ^
y J'r- ('
� � •�fi � ,'� \�u�.7� .-.�� �' 1 i��
COSTA MESA BUILDING. DEPARTMENT>. �� % fINANCE Dfh�. �
COSTA MESA. CALIF.ORNIA � , '\ �' CITY OF COSiA MESA '
FOR APPLICqNT TO'FILL IN APPLICATION FOR PERMIT
ADDRE55 'Q� H%�iy `�R DR � v BUILDING
COSTA mEsn�`cnuForzNin .� FOR OFFICE USE ONLY
` ' \ • FECEIPT NO. PERMIT NO.
�acu�
CIT�
ARCHITECT
�ENGINEER
CONTRAQOR
ADDFE55
LEGnL LOT
OESCRIPTION NO.
A.P. NO.
USE OF
E%ISTING BLOG.
$ET04CK LINE FROM
TEL �
No- K I
LIG
NO.
r �c 62�
� NO
TEL {
N U.
� TRACT
NO.OF BLDGS.
�IOW ON LOT
EAR VARD Z
SIOE YARD RIGHT LEFT
DESCRIPTION OF WORK
'W X ALTERATION ADDITION
REPAIR MOVING DEMOLISH
BIJILDING NO.OF
SIZE �� I ROOMS STORiES
E%TERIOR WALL ROOF
COVERING � COVERING
9UELDFNGEW RESI OENCE B; ATTACHED
s - - r�aa z
` BUILfJING
ADORE55
�
� COSTA MESA. CALIFORNIA
FIRE •
ZONE
EONE NO.OF TVpE / GROU
�� I PLANS // �
U
� ', APPROVED �
� BV DATE
�
I HERE9Y ACKNOWLEOGE l
STl�TE TNAT THE ABOVE IS CORRECT PN� AGREE TO COMPLY WITN ALL j
CITY ORDIN<NCES ANO STATE L/�WS REGULFTING BUILUING CONSTPII�� �
T�oN. ' ' VALUATION
Z �
SIGNATUREOF COLLEGE PARK !
PERMITTEE �l
A
$'I2��.��•
� T
. . �1
CORRECTIONS
PERMIT FEE $
PLAN CHECK $
TOTAL FEE S