HomeMy WebLinkAbout3041 HARDING WAY - Building PermitsPfl0.1ECTR00flE35: 3OQS HARUING WY
owxex�sxeMe: PAGNINI, JOHN E
noneess:l'AGNINI, LYNNc^;TTE
3041 HARDING WAY
CO5TA MESA,CA 92627
� (7i9)662-7995
' AflCN/ENGINFEfl:
�DORESS:
UXIT:
NEG.NO.:
UNI7:
PEflMITTEE: JOHN PAGNINI ( 714 ) 662-7495
� AODflESS: 3041 HARDING WY
COSTA MESA CA 92626
LICENSEO CONTMCTOB DECUMTION: I here0y atlirm that I am licensed un0er pmvisions af CAapter 9(commencinA ��h Section
7001p o� Olvlslon 3 oi Ih¢ Business antl Pmtessions Catle, and my license is in lull lorca anG effect.
GTY LIC.: 57RTE LIC.: CUSS:
Oate: Siqnature: '
WONREPS' COMPENSATION OECLAMTION: I �ereby aHirm that I hava a certificate oi consent ta sell-insure or a urtilicate oi Workers'
Compensation Insurence, or a certified copy thereof (Section 3800, LaC. C�.
POLICY NO.: EXP. OATE:
NPANY:
�ertifie0 coDY is herehy fumi5he0. ❑ Cenifie0 copy is ftleA with t�e ciry Building Division.
�ate: ADD���ant:
E%EMFfION FBOM WOBKENS' fAMPENSITIOX DELIAN�710X: (This section nee0 not ha campleteA ii the permit is lor ane huMreG (5100) or less�.
I cenity that in t�e performanca oi the work for wAich this permit is issued, I shall not emDloy any person in any manner so as ro become
sublect ro tha Wo�rcers' ComDensation Laws of Califomia.
Oate: SiqnaNre:
NOTICE: 11, afler makinA �Ais Oeclaratian, you s�ould 6ecame sublect to Ihe Workers' Compensation OraNsions ol IAe Labor
Cotle, you must forthwith camDly with such pmvisions or this permit s�all be deemad revoke0.
CONSTNUCTION 1FN01NG AGENCY: I here0y aBirm t�at there is a constmction IenAinA aAency for IAe peAormance al tAe work far
wAich this Dermit is issueA (Sectian 3097, Civ. C�.
lENOEH:
nooxess:
CITY OF CUSTA �MESA - BUILDING PERMIT PERM NU: B 049012
PERMIT NO: b 049022 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; 5-N PERMIT TYPE: STR PURPOSE: ALT
JOH DESCRIPTION : RESTORE CONVERTED GARAGE BACK TO GARAGE SQ FT: 1,000
CLAIM VALUE; 1,000,00 CALC-VALUE: 1,000.00 GROUP OCC: R-3 /M-1
COMMENTS: LEGALIZATION PERMIT
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Z O N I N G R E Q U I R E M E N T S
S E T H 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: 14113323 ZNE: REF NO:
PLANNING NOTES>
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED HY : ____ ______ . DATE:
HUILDING APPROVED BY : n _� \_�J/J� DATE:
APPLICATION ISSUED HY: ���2yyG� DATE: C� —�
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LEGALZZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OWNEHBUILUEBUECIAMTION: Iherebyattlrmtha�lamexemptlromtheCaniractors'S[ateLicenseLawfort�efallowinA�e�on HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25.00
(Sec[ion 7031.5 Business antl Pmteuional CoOe: My ciry o/ counry which requires a Dermit ro constmct, al[er, improve, demolish, or 5 �
repair any stmciure, pnor to its issuance, also requires the apDlicant for such permit Io /ile a signeE statemem tAat he/she is licensetl SM I P/NON —R E S
pursuant to tAe Dmnsions ol t�e Cantractors' State License Law (Chapter 9(commencin0 ��h Section 7000) al �iWsion 3 of tAe Business P j, j�j�
anU Pmtessians Cotle) or that Ae/s�e is exempt thereimm an0 t�e basis for the allegeA exemption. My violation af Section 7031.5 hy I S S UE F' � E
anyap0licantfora0ermitsu0lectstheaDUlicantroaciviiDenalryolnotmorethaniivehunAreAO011ars�5500�. HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
I, as owner o� ine prooerry or my emplayees witn wapas as meir sale campensation, win tlo tha work, ana tne TOTAL S--- —> Z 5, 5 0 �. 0 � 0, 0 0 2$. S 0 i 5. S � ' . � 0
❑ stmcture is nat intentle0 or offered for sale (Section 704A, Business and Protessional Catle: TAe Coniractors' Stata Licensa Law .
Goes nol apDN �o an ovmer oi a propeM �o �uiltls or impmves IAereon, and who does sucA rmB �imselVherselt or I�muqA '
his or ner own emDloyees, pmvioed mat sucn impmvements are nat intenoeo or onere0 tor ule. u, however the Uvilaing or RE��ENUE D I V I S ION TOTAL S--> COLL EC TED ; i S,$ � OV ER / S HORT • � 0
� impmrementissolOwithinaneyearafcomplelion.NeawnerwillhavethebmUenoiproNnAhe/5�adi0natbuilUarimprove $LDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for t�e Durpose ai sale�. Z S 0 0
❑ and Protessions Cotle� TFe Cont2crors' �tate License Law Eoes not appN �o an owner of properry wAo builtls or impraves �hereon
and wha con[racts for such projects with a contractar(s) license pursuant ro t�e Coniracmrs' State License Law�. I am aware
that D��� of iheir Workei s Compensation insuance shoul0 be D�o�Oetl Io me.
� I am exempt un0er Sectiop: B F' 7 � 4 4 B. 8 P. C.
mrqthisreason: ALL WOR BY C>WNER
Date: / — � 7 � / � Owner.
I do hereby certity Ihat I am aware af an0 un0ersunC the requirements al C mia Healt� an0 Safery CoOe Sectians 25505. 25533, an0
25539 an0 tAat I ar any iNure builtlinp occupant vnll/will not (circle one) nee o comDh �t� sai0 state coGes and the reyvirtments for a
permit lor constmction or moAification from tAe Nr ualiry Management Distnd. Fesidential constmction aDPlications are axempt imm
Ihese provisions.
� Date: Appliwnt
� I �ereby certiry that I have rea0 t�is application an0 sWte I�at the aEove iniormation is correcL I aA�ee to wmpty wa� aIl ciry anJ counry
' Oftlinantes antl SIa[e lavrs relaGnq lo bUiltlinp canlNction antl her¢ aNtw' reunWtNes ol I�is tiry �o entef upon lhe above-m¢nti0ned
properry tarinspectian puryoses.
Date:� 9��7—�0 SignaNre:
oriver's �icenu or sacia� Secudry x:
169136 W�i�e—BuilCing; Graen—CaEe Enlorcement; Canary—Appliwn�; Pink—Revenue; Goltlenrotl—Assessor
. .50
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I N D Z 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
SFR 1000 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 1,000.00
END OF FEES
O1 OOD6971D-�OOqS71? Tr1 e
�aTe: ns�r�ico ttrE: ia:�a
CONSTRUCTION ANDPLANNING PC iSPA
APPROVALS Permit# � Date Inspector AppROVALS Permit# Date Inspector
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 Reinforoement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. - 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgmd. .
S. Foundation 59. Gas Pipe, d Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. -'-
10. Structural Floor System � 61. APPROVAL TO DECK j
11. Property Sew¢r Line & House Connection � 62. Backwash & Receptor-Final �-
12. Sewer Cap 63. Heater & Vent�Final ' t '
I
13. Roof Drains 64. Plumbing System - Final ' �
14. Rough Plumbin9 65. Electrical-Final ' i
15. Fough Electrica��Conduit ' 66. Solar SYstein-Final �
16. Rough Eiectric Wiring 67. Fencing & Access�Approval j �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING�
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rougfi Heating & Air Conditioning FtRE DEPT. REQUIREMENT
20. Rough FactorY Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing /.l HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal ,� 80. FOOD CERTIFICATE ISSUED
33. Final Electric `i Notes: .
34. Final Heating & Air Conditioning � � � _ �r,_ � ti � �� _
35. Final Gas Pipe�Test �'�
36. Hood or CanoPY
37. Final Factory Fireplace ,
38. Final Plumbin9 � -
39. Water Service�Final �
40. Gas Service-Final �
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUI�DING �..��.�/ 6�j./�
48. FINAL PLANNING '
49. Electric Release to Edison
>'
50. Gas Release to Southem California Gas Co f.
51. CERTIFICATE OF OCCUPANCY
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or counry, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of, an owner-builder verification.
Attention Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the m� labor and materials for construction of the pro-
pos property improvement. B'Yes � No
2. I hav have not) signed an application for a building permit for the
proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction:
Name
Address
Phone (
City
Contractor's Lic. No. _
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address
Phone (
City
Contractor's Lic. No..
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Address Phone Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State
of California Health and Satety Code and have completed the above information to the best ot my per-
sonal knowledge, i o iance with this State law. 9
Signed: �--� Date: -�� � �, ! �
Ti
Name: -�� �`� P� G (� , n �
(Printed or ped)
C.D.L.#orS.S.# �
SEP 1 7 1990
t�.�Q.fxk�
:
1
KG
KENNETH G. OSBORNE & ASSOCIATES
February 2, 1983
Mr. Donald Huebner
250 A East 16th Street
Costa Mesa, California 92627
Reference: Residential Addition
3041 Harding Way
Costa Mesa, California
Dear Mr. Auebner:
This letter presents the results of a cursory
inspection and field testing performed at the above
referenced address.
The work performed by this firm consisted of the
following:
1. A visual inspection of the interior and exterior
of the addition and the remainder of the residence.
2. Excavation o£ a single test pit adjacent to the
rear footing of the addition to allow determination of
the footing depth, density testing adjacent to the footing
and collection of a soil sample for laboratory testing.
3. Laboratory testing which consisted of determination
of the maximum density and optimum moisture content (A.S.T.M.
Test Method D-1557), expansion index (UBC Test Standard 29-2),
and soluble sulfate content of the soil (A.S.T.M. Test Method
D-516).
4. Preparation of this repert.
It is understood that the house in question is about
20 years old, and that the bar addition was constructed
about 8 years ago onto the rear of the house. The addition
is approximately 6 by 8�, feet in size.
VISUAL INSPECTION
pur visual inspection of the interior and exterior
superstructure of the house and the addition revealed no
Job NO. 3700-2
Page 1
GEOTECNNICAL ENGINEERING • 17741 MURPHV AVENUE • IRVINE, CALIFORNIA 82714 •(714) 540.2001
a
.;
` KENNETH G. OSBORNE & ASSOCIATES
Mr. Donald Huebner
February 2, 1983
evidence of substantial differential movement caused
either by settlement or expansion of the supporting soils.
The drywall interior walls and stucco exterior walls are
relatively sensitive to cracking caused by differential
movement. The lack of cracking is indicitive of insigni-
ficant differential movements.
FIELD OBSERVATIONS AND TESTING
The test pit excavated adjacent to the rear wall of
the addition revealed a concrete footing extending to a
depth of 12 inches below the adjacent exterior grade. The
results of a field density test at the footing level
indicated a moisture content of 1.9 percent above optimum
and a relative compaction of 91.8 percent. Density test
results are presen�`crd on the attached "Table of Test Results."
LABORATORY TESTING
The results of laboratory testing are as follows:
Sample Maximum Optimum Expansion BSoluble
Location Density Moisture Index Sulfates
Rear of Addition 119.Opcf 14.0� 41 0.063
CONCLUSIONS
Based on the apparent past stability, the excellent
soil compaction, the low expansion potential, and the
low soluble sulfate concentration of the soils, it is the
opinion of this engineer that the addition at the rear of the
subject house is suitable, from a soil and foundation stand-
point, for continued use as presently constructed.
The opportunity to be of service on this project is
appreciated. Please call if there are any questions.
JRC:rrk
Respectfully submitted,
G. OSBORNE & ASSOCIATES
James R. Coleman
R.C.E. 29929
Job No. 3700-6 Page 2
TEST
NO.
TEST
1� T�2/1
KENNETH G. OSDORNE G ASSOCIATES
TAaLE OF TEST RESULTS
ELEVATIONS
MOISD. I DEND I OPST. I DENS. I MAX. I RMKS.
00.0�15.9�109.2�14.0 �119.0�91.8
Job No. - Client 3700-6 Donald Huebner Location Costa Mesa
Test Type Code: S= Sand Cone, T= Drive Tube Cindy
Technician
REPORT OF INVESTIGATION
CM Q
Variances:_ Assigned to: Case No.: �� %
❑ Building Division G'�'K
C.U.P.'s: _ 0 Planning Division Assigned to: "3�
❑ Joint Investigation
Date: � ' a Fs "8'3
Received by: l�tl�� �'� d u c(' __ 3oy/ r�gA'a0iniq Guit �/
Complaint dress
�QM/,�/NNfY �fQ�V.ol� ��y9Z
Complainant
Telephone Number
Name oi Tenant (if applicablel
�/Fna �e C R- Lo, I s a�
Name of Property Owner Telephone
�dv� �f�F/1�in�g (,/iNy
Owner's Residen al Address
Nature of Complaint: ��/`PST�? ✓CTi a,cp o� �l �.H�f' /%v i�v �iXi"/��
�vo�7. S7`h��T���� �/�c7-.t�i«al , A9�vr�6i.ri4 -
Invesiigation by:
Inspector
Buitding Permit Files Reviewed:
Initial and Date
Assessor's Parcel No.
Violation of C.M.M.C. Section (s�:
Time of Day (if applicable)
Zoning Files Reviewed:
Map No.
Findings:
Ge �z 1` �-r�%eK 1- a �- S 3
NOTICES:
7st Given: 1 -a�' �3 e�K%
Date
2nd Notice:
Lao
Initial and Date ^
3
C�U.�I�I//rj ��'�
C �s� cl�s� 3��
Time Allotted for Correction __� , ���_,_..
maximum time
Certified letter advising that if violations are not corrected, the complaint and all supporting data will be forwarded
to the City Attorney's office with request for prosecution.
Date Mailed Dare Received 7-day recheck of site
Filesforwarded to City Attorney's office with request:
CMF 0829-30
Initial and Date
CITY OF COSTA MESA
CALIFORNIA 92626 P.O. BOX 7200
FRbM THE OFFICE OF THE DEVELOPMENT SERVICES DEPARTMENT/
BVILDING SAFETV DIVISION
January 28, ]983
Mr. James R. Wilson
3041 Harding Way
Costa Mesa, CA 92626
Co�liance
Site �,o�at
's Phone No.
«�•� a�� r•
i 7'!R 1N\ C 0.M7 'J : D! 1 Y7u.
No. 71492 �• 407
At your request,\inspection was made at the above-ref ced address on
Januarv 25 �483 ' , and the� ons shown on the reverse
side were observed.
You will be rcquired to correct the violations listed within fifteen (15)
days after receipt of this letter. Failure to c�xnply within the allotted
time will result in a cc��laint investigation being initiated for crmipliance
of the Codes.
If you need assistance, please contact the appropri.ate Inspectors listed
belaa:
Structural W. E. Cloud Phone 754- 5293
Electrical Bob Cochran Phone 754- 5230
Pl�nnb/Machanical �rge F�chniston phone 754- 5290
Vesy truly yours,
`�C�7.�CK! ! L�P� �
Y�IS.ACE E. CIAUD
Chief Building Inspector
cc: Inspectors
Property Owner:
as above
NOTE: SF� RE,'VERSE SIDE.
77 FAIR DRIVE �774) 7545273
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1
Site Location: 3041 Harding Way Date:
1. S'IRiJCTURAL
a) Framing walls (bar) and roof fr�ning to be exposed for inspection.
b) �ose footings for vesification. -
c) A structural �Y+++;t will be re��ired to legalize the illegal addition.
Z. F7,F'c'rRT�
a) Open all device boxes for inspection.
b) Ret�ove all exposed Rarex wiring in cabinets.
c) AZ1 wiring mast tesminate in an approved r�thod.
d) Use aoproved wire connectors at boxes.
e) Walls must be onened up to deteanine wiring method behind wall.
cn
2 f) Replace light fixture at rear sliding door and retrove extension cord to wood
o structure. -
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� 3
a
0
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W
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0
V
ula.M.=i_I�ZY\il
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4. PLUNIDING
a) Bar sink not installed oer oode. No �*m;t and no inspections.
ADP���ant to fill in all spaeas except thosa wftnin heavy borGer Iinas anC sign a11 aoD�oo��ate tleelarations.
CITY OF COSTA MESA ' �'. •..-_. . .� -. , •: , P . , TRACT NO. LOT NO. . BLD . . . . � . .. . . _... .
� CONSTRUCTION PERMIT ' ' — 6Z� � �'02 ' `� ' � . ' ' � � • � �
. . : ,. . 383�. I%3I/,UJ � le4.old T�
Appllcent'S M3iling Add(855 " � ryPE OF CONSTRUCTION' NEW ADD . ALTERATION REPAI R ' �- . = , � , .
ProjectAddress �� - ' � ' . " ' � � CONVERSION .❑ DEM LISH TFiER � . , ' , . , . , , i';
' /�� D CRIPTION O WORK � •
OwnersName2� ��1�`�' �L�p ho U � ��{,�1.�. �/• EX*7=�t��J S�d.�.r . Z NINGRE UpLATI NS." .
AOdress ��'1 �d TYPEOFPERMIT. GRADING FLJ OUNDATION STRUCTURAL A.P.yp -. ��,- � ZONE IL I -
^M AfCh/Eng - ; �^^ , • Lic8�32 No. ❑ TENANT � ELECTRICAL � PLUMBING ❑-MECHANICAL , , ' PLNG. REF.9p '�. � �BUILDING ; ' ,
{' Addf¢S5� . ..�� '. D��OTHER ' - _ . . � . . � TO BUILDING.. . ) �). . �.
� �lJ L�RN L�� �ha e '� PROJECT DESCRIPTION SQ. F OCCUPAN V' � PR PE V INE REAR VAflD (TO P/L)
Contrecto�'s Name—� . �
� ' /, ; �f � � � '� C� CONST CT ON TVPE � � VALUATION i- ' LEFT SIDE VARD � � RIGHT'SIDE VARD � �� k� � �
� Addreu (r�..^^' . � �, , �_ - . :
/` 20N��^� GRA�INGCU.YDS: �� RES PKG.SPACE,REQ. pRpVIDED
( � Cicense No. - : ' - � ; - . . � � .� . � • ' � �
� CICENSED CONTRACTO DECLARATIO.N ' � Remarks: ,�(�(JJ�C/��b%z,��NGC 'r � I 2 ��Z 00 STREET WIDTH � .�� ' PARK FEE $ '� � � ��
I nereby aTfl�m that I am IiCCnsetl' untler proviSlons Of �Charte� 9(com�nentlng ; , . , _
with'dectlon 7000) of Divlsion 3 of the Bustneu Antl Protesslons Cotle, antl ; ' ' � SPECIAL CONDITIONS: ' � '- '
my Iicense��is In tu rce antl ettect. ' ' � Z?� � / � ' ' ' ' ,
Licensel ��ass/' -n License o � �_-7 � - P�UMBING ` i ' • " ' ' � �
� Date�_L�:.L/ 519nature'�1FF[i! �lii.! ; . • , : � i. �
7� ��'T/o'-'� 1' BarSink ! I Se�verCap. i � ELECTRICAL `
' WORK'�RS� OMPENSATION DECLARATION' . � ; , ' � � ' � '� -- + ' - � ' �
i . �
` t hereby affirm that 1 have a.certificate of.conse�ti0 se�tinsura or a certfi{rate •-. ` ` .. .� _ . - �. _ : . _ � . _ Automanc Wasfier . . � . , �Meter,_Obver 100 am 5 _ _, � � ��: , _
-*'-- BacktlowPreventer—�- -+- SawerConnection'--�r- . P+ k
' of Workers' Compensatlon Insurance,�or a certifieC�copy the�eof (Section - � �
Construction Pole Sub Panel, � �
3800, tab. ) � � q • ' ��/� r�y±` � � Backflow Irrigation � � Solar Collectors � ' i " ' � '
X Pollcy No. � S �"-+ ��O�Compan �-�OC!!y U � Cooking Uni[ � ' ,Sub Pole � �j � �
�' ` B CerHtietl co f i { � Bathtubs � ; Solar Pi m � ' , � � , , �
OY �S hereby Lurnishetl. ' . � %f � P 9
� Cer i tl co ,�S Lletl with the Nty u m v SY�Zy = _ '. -� I . � . .. DiShwasher "`: i MOTOrs �0-1 HP ❑16-8 '� 1
� oate Applicant � i � Clarifiers SolarTank ,
. EXEM ION OM WORKER$' COMPENSATION DECLARATION ' ^ . DryerS ❑G85' �EI¢CtliC � J�InC.SOldf 09-.15 HP O164S+ ,
'� (TM1is section eetl not Ge completetl if the permit I5 �or one huntlretl (E100j or �� DiShwashe� Swimming Po01�w/Spa ,
� iess). � : , . . , � � . . , � - Fan � � Microwave . :
' 1 certify;that in the periormance ot Ihe work for wh�ch this pevmR is issued I I Orinking FOuntains Urinal � , �` I �
' shalf not employ 2ny perion in any manne� so �a9 to berome subject to tl�e ' ' . . - � , p.q.,�J, ��: : , ; pole�Li9ht � �
� Workers• Compensatlon:Laws of CalHornla.. . � . � � Floor Orains' � ' Water CIo52t' � � '
Date ' '9 SY nature ' Y , , � . �' � - � / - � ' �.
' � � g � '
Fixmres �
'-NOTICE:�If, after makin thi5-tleClaratlon, ou zlioultl�bewme Su0 e<t to the - - � Floof SinkS ! �- - --•- � � �-- -�Water•Heetef � � -� • - • - - �7 - - � - 'Ran9e _ . -
. Wofkefs} Comp¢nSdtiOn OrovisiOnSAf th¢ Ldbol, GOtle, ypu mu5t"fOfthwi[h, • � .. . - � � D2vIC2 BOx¢5 ' I ' � �
' comply wlth such 'provislons'oi � this,-permit iPall be tleemetl revoketl.. r Gas SErvice ' ;,Outlets . Water Service �� �� = Sign �
CONSTRUCTION LENDING AGENCV ` • � " � �'-� � ' ' ' � � . �
�'1 her2b affirm that there is a constru<tlon�lentlin a9ency tor the' erformanca , � .- � Outlets ' ' Standin Sections � 3 �
y 9 $ ,- I Interceptors � .� 9
of tfie work fOr which thi5 pevTit is issuetl (SeGtiOn :30 7� Civ: C.; � , . ,
� Switches � �Trash Com actor ' �
Lenaer's Name - Kitchen'Smk' . � � � .. - �' � � ' P �
, Lentler's Fltltlre<c . . • - - � , - . �vatories.. ' � ' .. ' - . r . Garbage Disposal '. ' . I l
. OWNER�BUILDER DECCARATION ; � � i , .- ' , .' ' - � , - �1 . • � - Y � ' !
I hereby aftirm that I am exempf trom the,Contrattor's�Llcense l.aw tor tne � 00-5 KW 05=15 KW .� � • � � t '
� followin9 reason-(Sectlon �031.5 Bhsiness antl Professlonal Cotle: Any city, or �-�?-T�ap. � _ ,� ^� :�� Generetor
. county which, requires a permit'to construct, alter Improve; tlemolisn orrepalr ' � i - ' � 1,! _ �E � � � � � Transformer ❑75-50 KW � � ' � ' �
any strutture, prlor to Ifs Issuance,'also requires t{�d applicant for such permit ; Roof�D�ains I . ' '. , • �
'.to tile a signetl statement Ihat he/sha Is IlcenseE oUrsuant to the:provisions of - ' � ❑5U+ �(W' f
'•the Contractor'z�License Law.(Cbapter 9 (commencln9 with'SectionJ000).of � � - ' r . �I -� ' '� ' � , ,� Reinspec[ion Fee � $75�
..Dlv6ton •3 ot the �BuSiness antl: Profe55ions Cotle) or, thaf he/she Is exempt ShOwerS r� r � � a � ReinSpectiomFee', $75 , , � �
tnerefrom anC tne{basis for the allegetl exemptlon{AnY ��olatiodot�SecUon . .:- '_ -, . '�' ' ' Met¢r ❑up t0 700'ampi ' �.�yYue Fee: $ 3 7
�a031.5 �Gy:any appli<ant for:-a.permiGsubjects�the�applicant to a-civil • � � � r • " , ,__ __ _ _ .
enalfy oi not more than five'huntlretl tlollars '' ' � � Service Sink ... • Issue Fee �i i $ ' -
(g5oo). , : n� i '.' ' . � . �. � �I 3 ' 2aning APProved BY � � -Date �
�; � I,`as�:ownar of; the.property ormy employee4 w�th wages as their sole , � • ' �, '
compensation' wiil.tlo the work, antl the,structura�is not intendetl or otieretl ' ��•., , � � MECHANICAC ', . I ' 1 qpp��mtion Approved By �� � • � ate '
. for sale�(Secfion 7044, Business.anE'Professional Cotle:•The ContractorY � , , � , � , � � .
�icenze Law Coes not apply to an owner of a prope(ty who bulltls or improves ' Boiler,. � � �' Refrigeration System ' q lication laued 6 J�
� [hareon, and who does such� work hlrtiseH/hersclt ocMrou9h his o� her own ' � ' � �� �� � PO Y � � � ! 1DetB ' ` � �
employees, provitletl that such Improvements are n4t IntenCetl or otteretl tor � ❑0.100;OOOBTU ❑100,OOOBTU . � . �
i wle. If, however, the Gulltlln or.im rovement is soitl within one ear of com- � . Duct - Under,GrOund .; , . ' � � !
• Oletlon,�the owner,will have the burEen ot proving he/she tlitl not bulltl or Im- � . � ' . � i ; � :� � , �S�UM�M.,�ARV OF FEES � r
�roveforthepurposeot,sale).- �� . ' , .� . �, .. ' Duct Strucmral , SystemRepair/Alteration ; QUILDINGPERMIT $ � � SMIP ', � $ � O•`��
I, as owner of the pro0erty, am e%clu5ivaly conlracHng'with'IlcenSetl cOn- � � ' �� �� , �
tractorsto construct the projact,(Seclion 7044,.Business antl Protesslons,Cotle: Duct _Ventilating _ i,_ � _ _ _ � � ' � � �;P�AN CHECK' - $; �.�. PERMIT ' ' �
The Contractor's Li<enie Law tloes not apPIY to 3n owner of property who - - - � � �'� p� ✓ ISSUANCE '$'
Euiltls or Improves. thereon, antl who contracSs tor su<h projacts with a con- Exhaus4 System ❑ MWtiple �' ' " ' � PLUMBING • $� � . �
tractor(s) Iicensa pursuant to the Contractor's LicenSe Law): • , ' � ' �PLAN CHECKI $� �`�j GRADING � �$
' � �I am exempt untler Sectlon � � ' B; & P. C. (or this reason � � Fiiepl/FaCt. BIt. IC80 # ° � � � . � � ' $, ' '
� oate ' � ' Owner � ' ' � ' ( Heeting System & Ducbng , - � _ � ' ; . � ELECTRICAL � $ � i .
PIAN CHECK � �,I MICROFILM � $
�I�hereby certiry�� hat I hava reaQ� is application antl�state thatthe abovo� ❑P100,OOOBTU•�100,0008 � - - - , - � �� �- ' $� � 1 •
intormatlon is correct. I agree to omo�Y �'�th all G�1Y antl county ortlinances . � : � � � TOTAL FEE
antl�state laws relatin9 to builtlin9 constructlon, aPd hereby authorize reore- � Hood or • . �MECHANICAL � $, , $' . .,
sentatives o( � � o anter upOn tha above-mantlonetl pro ert for Typ01 ❑� �� Reinspec[ioo Feej $75 � '� � . LESS ' � � � �� 1
� inspectlon pu se . ' ' I 7 ' •3 83 ' Ca"° ' _T � e I I �� � ,PLAN CHECK' $. • ' �
' Signature � 7 � oate � , . , � . , , , ' ADVANCED,PC' � $
� . . (iegisters . � Iswe Fee ' , $ 3 . . , i �IZ .� Q
� Drivers' Litense or 55 � � . FINAL FEE �$
CMF 0865-46 rev. 12/82 White - Builtlin9: Canary � APPliwnt; Pink - qccounting; Goltlenrotl - Asseszor .
_�. � �CONSTRUCTION AND PL Np1N . . . . � POOL & SPA - - �, . . �
-_ APPROVALS Permit # �` �'b�i Date Inspector qppROVAL.S Permit q� � Date � Inspeetor
,1. Temporary Electrical Service or Pole, ! � 52. Pool & Equipment Location • �-
�., -
�� 2. Soil Pipe-Undrgrnd. � � � � 53. Steel Reinforcement - - . _ , "
, , i
� 3. Electrical Conduil UtilitwUndrgrnd. " � �54. Forms � . -� ' i � .
•�� 4. Electrical Conduit-Undrgrnd. - . � � 55. Electrical Bonding . � � � . �. '
� �
5. St�el �Reinforcement '� � ,� 56. Rough Plumbing & Pressure Test - � Y; i
6. �Electrical UFER Grnd. � ' 57. APPROVAL TO�COVER-GUNITE ,, „� 1
7. Footings � � � , : ; - 58. Electrical�Conduit•Undromrl. �. . � �
�
8. Foundation ' � .�' � - 59. Gas Pipe, O Undrgrnd., Test . - � I'
9. �Water Pipe-Undrgrnd. , fi0. Backwash �Lines, P-Trap, O U�drgrnd.. � _ ��
�
10. �Stiuctural Floor System :.1 61. APPROVAL TO DECK � '�
11. Property Sewer Line &�House Connect,ion .62. Backwash & Receptor•Final - ,�
12. Sewer Cap � 63. Heater & Vent-Final � '�
13. Roof Drains � ' `� 64. Plumbing System - Final � - "
y 14. �Rough Plumbing � 65. Electrical-Final - ''
� 15. !Rough Electrical-Conduit � 66. Solar System-Final ' � �
,•76. Rough Electric Wiring z_.r_�� �� �r 67. Fencing & Access Approval � � �
�
1�.'Rough Wiring Sign 68. APPROVED FOR PLASTERING
18.'Rough�Etectrical-T Bar, Ceiling 69. POOUSPA SYSTEMS FINAL �� �.
19�'�Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ''
ti-
20. Rough Factory Fireplace . APPROVALS Permit #
� 21�."Duc[s, in Structure , .. � 70. Underground Hydro ';
' 22. �Ducts, �Ventilating � 71. Product Piping O Gas ❑ Oil �� .
� -� 23. Gas Pipe=Rough & Test ' �. � � � 72. Underground Flush � � .
-24..Roof Praming � ; . 2_�_gj uf��.j 73. Undergmd.StorageTank OGas ❑Oil ,
. 25. Roof Sheathing ' ' 74. Overhead Hydro ' � �
� 26. T-Bar Ceiling (Structural)� & Monocoat � 75. Dry Chemical ,.
" 27. Freme and Flashing • ' �./� j �,i���;- 76. Dry Standpipe � �
28..Lathing & Siding - � - 77. FIXED SYSTEM FINAL ' �
29..fnsulation ,� � � 78. FIRE PREV. FINAL .
�'� 30. Drywall Nailing .' � " • Notes: -
31. Piaster Brown Coat' i . i. �,:_ I-- '
32. Electrical Power Meter-Final'. . � �
:�'
33. Final Electric � �� i���3 . -
34. Final Heating & Air Conditioning ' .
35. Final Gas Pipe-Test , � � � � _ � �
36. Hood or Canopy . • . �. . " �
37. Final Factor�y Fireplace . - � � ' �
38. Final Plumbing �a y7� .
39. Water Serviae-Finab . �
40. Gas Service-Final • , ,
' 41. Solar pomesticFinal � � � � � ' �, �� 1 �..� �., .,
42. Backflow Preventer � .. ' . � �� �� , '
:', � i
43. Backflow Irrigation � . � �
44. Landscape Irrigation System � -
45. Sound Attenuation - - • _
46. Handicap Regulations , � . �
47. FINALSTRUCTURE:&BUILDING y�� '
48. Special Requirements Completed " %`� •
49. Electric Release to Edison� � _ � ' • ' ,/' '�
50. Gas Release to Southern California Gas Cn ,;
i
51. CERTIFICATE OF OCCUPANCY � . �; � . ' " ' � i
No Date � ^ -.
�oT 34 A 4z z
., :� ���5
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. HOX 917 COBTA M68A. CALIFORNIA
For Applieanf io Ffll In Complefely
TYPE OR PRI T .
ADD EiSS �7O I '
GOSTA MESA. CALIFORNIA
FEE RECEIVED
�✓ sEP z7 �set'
FINANCE DEPT.
C1TY Of COSTA MESA
APPLICATION FOR PERMIT
�� BUILDING
For Office Use Onlv
cirv NeVtpOrt Beach NoMi 6- 22 qDDRE55
ARCHiTeci 7E�. COSTA MESA. CALIFORNIA
OR ENGINEER NONE NO.
ADDRESS FIRE '/ �f //�
ZONE TVPE ✓ GROUP `-"' �
CONTRACTOR K VI .4PPROVED
BV DATE
ADDRESS 1 P 2 2 fl A e ZONIN6
ZONE NO. OP UBE OF NEW �� Jh
CITY D B H R�I I PLANB z I eu��nine e�
�C. NO. NO. _ �eaw� ��I— 3 y / j� s� Z 3�
OH9CRIPTION �7
BIZE I NO. OP BLOGB. Q
OF LOT � � I R R EG . Now oH LOT A p N� ��._
U6E OF YARDS EVES
EXISTING BLD APPROVED ALLOWED
OBTBACK LINB R80M )�t1 (CeMeH LINH 6TJ
CeNTep Ov eTrse6T T`� � REAR YARO 2 � FRONT �� FT. IN.
SIDE YARD I LE� � I RIGNT � �� �
R. SIDE / � FT. IN.
DESCRIPTION OF WORK �y --- .
L. SIDE / FT. IN.
NEW I IIALTERATION I IIAD�ITION I REAR Z� * FT. �— IN.
I II MOVING I II DEMOLISH I a�PROVED �/�� �erK 9/ZL/C/
REPAIR R
NO. OF p
FT. ROOMS U STORIES
IRooF COMPO SHINGLE
]O COVERING
ID WORK TO BE PERFORMED
I HHR6BY ACKNOWLEDGH THAT 1 NAVE HBAD THIB MPLIGTION TMg AMOUNT BHOWN IINOEH VALUATION IS FON TH8
•NO BTATH TXAT TXE ABOVB IB GORRCCT ANO A6RE6 TO COM-
PUPP09E OP 89TA0L19HINO A PERMIT FEE ONLY.
PLY WITX ALL CITY OFOINANCEB AN� BTAT¢ LAWB RHOULATINO
euiLDlNo CON9TRucT1oN. VqLUATiON t
BIGNATURE OF `��� /,� PERMIT FEE $ ./ � '""�
PERMITTE /�/ �/;Q _ /� �
$ 7 PLAN CHECK $ / �
AUTHORIZED AGEN7
TOTAL FEE � i_l�