HomeMy WebLinkAbout912 HOLLOW BROOK CIR - Building PermitsPHOJECT AOUflE55: 9 1�,7 HOL LUW B ROOK
OWNEH'SNAME: VILLAGE CREEK HOMEOWNERS
nooaess: ASSOCIATIUN
3429 TIMBER LAKE
CM VA 97.67.6
UNIT:
AXCNIENGINEEF: CHESTER CARVILLE flEG.NO.: C183OS
RDDNESS: "J9'1'1 ARMOUR ST u"�T:
S.D. CA 92111
rexmiTree: pHOENIX ENTERPRISES INC . ( 21 3) 690-9559
AODPESS: 411 COMERCIAL WAY
LA HABRA CA 90631
LICENSED CONTBRCTOfl DECIABqTIUN: I �erehy allirm thal I am li[enSeU untler provisions ol ChaO�ar 9(commencing wiih SEciion
7000) oi DiNsion 3 0l ��e Busines3 anC Pmfessions Cotle. antl m se' in NII brce and ell ct.
ciTvuc.: 0788 sr,euc.:37663 ss: B
Da�e: � // — y�� Signamre: _ . —�
WaFNEflS' COMPENSATION OECtApp7lON: I nereby lirm ihat I na a cenificate of consent to selt-ins or a ceniticate oi workers'
Comoensation Insurance. or a cenilietl copy thereof (Sec�ion 3800. Lab. CI.
Poucrxo.:W700354 EXP.�ATE: O%�OSI9I
comraxr: CA COMP S FIRE
D Cetli�ie0 Fopy is hereby IUmiS�¢tl. ❑ Cetlilietl copy is hl ��e ciry Building �ivisian.� /�/
Oate: ' � ^ � � ADPlicani: � ���� l% <L�/
EXEMPTION FAOM WONREB$' COMPENSATION OECNflRTION: Qhi55eclion nee0 noI be comple�etl i1 �he De�mit is lor ane huntlre4 ($100) or less)
1 cerii�y (ha� in Ihe perlormance o11he work lo� wMch Ilus Aermil is is5ue0. I shall no� employ any person in any ma�ner so as to become
sublecl �o Ihe Warkers' Compen53tion Laws oi Calilornia.
Date: SignaWre�.
NOTICE: I�. afier making Ihis declara�ian, you shoultl become suhle�� �o �he Workers' ComDensa�ion pmvisions o� �he Labor
Coae. you must lotlhwilh tomply wit� such Drovisions ar this permi� shall be deemed revoketl.
CONSTHUCTION LENOING RGENCY: I hereby aflirm �ha� there is a canslmction lentling agency for Ihe pehormance at �he work for
which this permil is issued (Sec�iGn 3097. Civ. C�.
LENOEfl: `
ADONESS:
OWNEfl BUILOEN OECLAflATION: I hereby ailirm t�at I am exempi Imm t�e Contracmrs' State License Law for the �ollowing r¢ason
(Seclion 703L5 Business antl Pmf¢ssional COAe: Any ci�y of county which repuires a permit �o cons�mc�, alter, improve, tlemolish, or
repair any simclure, priar lo its issuance. also requires Ihe apPlicanl for such permil Ia tile a signea s�a�emeni tha� helshe is lic¢nsetl
pursuam m ��e Dmvisions ol the COn�raclors' Sta1e License Law (C�apler 9 �comm¢ncing with Sec�ion 7000) o� �ivision 3 oi ��e Business
antl Pmfessons Code) or I�al �elghe is exempt I�erefrom and Ihe �asis for the alleged exemptian. Any violatian of Section 7031.5 by ,
any applican� for a Oe�mi� Sublecl5 Ihe applicanl ta a civil penal�y oi noi more �han �ive �undred dollars ��5500).
I, as owner ot ine Oropeny or my employees witn wages as their sole comDensatioq will tlo ihe work, an0 the
❑ stmcNre is not intentleU or ollere0lor sale (Seclion 7044, Business antl Professional Code: The Coniractors' State License Law
tlaes nol apP�Y �o an ownNr ol a D�opetly who Uuilds or impmve5 ihereon, antl who does such work himself/herselt or Ihmugh
his or her own empioyees, pmviUetl tha� such imDmvemenis are nol intenAetl or oiferetl for sa�e. Ii, however ihe builtlmg or
impmvemeni is soltl wit�iq one year o� comD�e�ion. Ihe owner will have the burden of proving he/she did not huiltl or impwve
br ihe purpose ol sale�.
I, as owner of t�e D�openy, am exclusively comracting wi�h licensea contractors to constmct ihe D�olect (Section 7044, Busineu
❑ antl Pmiessions Coae: TAe Contrac�ors' Slaie License Law Coes not aDD�Y Io an awner of pmperry who builds or impmves Ihereon
antl who COnlratl5 lor suCb pmleCls wiih a conlraCior(S�lit¢nse pur5uani to ��e ConVactors' S�ate License Law�. I am aware
tha� pmof of Iheir Workefs Compensation insurance s�oultl be pmvitled Io me.
� I am exempt under Setlion� B. 8 P. C. �
for Ihis reason:
Date: Owner.
I tlo hereby ceniry tha� I am awara ol antl unaersland Ihe requiremems ol Cah�ornia Heallh antl Sa�ery CoOe Sec�ions 2550.5, 25533. and
2553G and�hal Ioranyluiure builtling occupan�will/will not(circle one) neeU lo compty with sai0 s�a�e cotles antl�he requirements�or a
permil �ar conslmqion or modi�¢alion Imm ��e Air Ouality Manag¢men� Dislrict. Fesitlen�ial con5tmction ap0lications are exemp� �mm
Ihese pmvisians.
Oale: Npplicanl: �I
I here�y terlify Ihai I havereatllhi5 aDPlitation an0 S�aie ihal I�e a9e0 1nl rmalion is wrrecL lagree b tomply wiih allciry antl tounry
ortlinancesands�alelawsrelalinglobuilainpconslmclionantlhereQ or;�repre5entaiivesof��cirytoen�erupontheabove-n one0
pmpeny f i pecuon purposes.
�ate: �R_� Signalure:
tfiat-a6 While—Builtllnq: Gree�—CoOe Enlorcement�. Canary—ApO�icanl; Pink—Revenue; Goltlenmtl—Assessor
, CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 04982
PERMIT NO: H 049828 PLAN CHECK NO; 06441-90 A GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP
JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143
CLAIM VALUE: 14,388.00 CALC—VALUE: 19,300.00 GROUP OCC: R-3 /
COMMENTS: BUILAING SETTLEMENT REPAIR/FOUNDATION
1f IF 1E �f if if jE if aE 3E jf ff iE 3E �f iF�F iE 7f iF iF k�F IFif �E if #F�EK if if iE )E �f �tlE 3F iFif 1P�iF #�f #F fF�E if # if if if �E #!f if �f iFif if iE 1E 1f �F �f 1E ff If if 1f iF if 1F iF 1F iE �E 3F *
2 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 HUILDING ---------- --------- ACCESSORY BOILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGFIT: FT IN
PARKING REQ• PROV• PARCEL; 93506124 ZNE: R2 REF NO:
PLANNING NtSTES> REPAIR E}CISTING FOUNDATION. HOLD FOR SPECIAL'RE�I��F�
i
���*�***�*�x*�*«****�*����*x���*�**�e****�r***��**�*��r*�*****�+��*�r******,�
ll 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 : � i1� � DATE: '1 / O� �l D
BUILDING APPROVEll BY ; �'�% <<- D s�-+J DATE: ��
APPLICATION ISSUED BY• DATE� ���
If k 1f 1F Ik if #�k if if i! If if iF iE M it it 3f iF if iE � 1E IF iF if it k 1E iE iF if��iFiFiFi4 �1F
iFlflfiFifififlk�tiFiklFkikiki4iFlkakik�kiElFiF1F1lIt�1FfF3E�fIFiEiFiF iFifififiF�fififlfiFiEiflElfiEkifif�F)flflfiEMiflEifiElf�IE�lfifiFifiFiEififiElEif�EiF
LEGA'LI7ATION:N F E S,U M M A A Y STRUCTURAL,SEGMENT:Y
BLDG PMT PLUMHING ECTRIC MECFiANIC EIRE SMIP/RES GRADING
PERMIT 162.00
SMTP/NON'—RES
PI,AN 26.33 2,,15
ISSUE Fk:E •
BUILDING—llIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID� DUE
��-iTALS----> 164.15 0.00 26.33 190.48 190.48 . ,00
REVENUE DZVISION TOTALS--> COLLECTED: 190,48 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
162.00 2.15 26.33
jk iF IE if k iF if 1E IE 1k iF if ik k iE ik if iE ik if IF iEiF 1E IF IF K* k K if iE if iF if iF ii iE iE jF if ikiE �F �F IE iE if iF it IE if !F iF IE iF IE iE af If 1E iE Ik iE fF iP if if iE 3F *�lf iE iE iE iF IF iE if
I N D I V I D U A L F E E B R E A K D O W N
F.�
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL`.COST
SFC 143 FOUNDATION BY VALUE PER $100 100.00 14,300.00
END OF FEES
o� oao�4Yoa-000a�4na -rn��- a��.:�
QATE; 11/IGl9U TIt1E: ?1:54
CONSTRUCTION AND PLANNING ' PO� SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Serv'fcB or Pole, _ �52. Pool & Equipment Location
2, Soil Pipe-Undrgrnd. �~ � 53. Steel Reinforceme�t
� .•
,,3';;Elecirical:Conduit�Utility�Undrgrnd._;�_ 54. Forms
- 4.•ElectiicaJ-COnduibUtidrgmd. 55. Electrical8onding
''' - "� � n
='S. Steel' Reinforceme�t; . 56. Rough Plumbing & Pressure 7est -
:�6.�_Ekctrital'UFER Grnd. 57. APPROVAL TO COVER�GUNITE
=7.i Footings�'�� , 58. Electrical Conduit-Undrgrnd.
= 8: Foundatio�� �: i . 59. Gas Pipe, O Undrgrnd., Test ��
_ 9, Water Pipe�Und�g� d. _ ' 60. Backwash Lines, P-Trap, O Undrgrnd.
�:. �
1Q. Structural Floor System . ' 61. APPROVAL TO DECK
1�1'. Property Sewer'Line-.& HoQse Connection 62. Backwash & Receptor-Final
d! �
t'2'. Sewer Cap .1 ' c� 63. Heater & Vent-Final
13. Roof Drain4 , "� 64. Plumbing System - Final
14. Rough Plumtiing � 65. Electrical�Finai
15. Rough Electrica"I-Conduit 66. Solar SYstem-Final
16. Rough E�,lectric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOfl PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - -. ' - - - - - -� . .c �, �i
20. �Rou`gh Factory Fireplace � �.�" �,+'`,.,{ ' �� c* •y ?APPROVALS- " Pecmit # } 'T'
-� - `' � .. , ^ • r - :-e '� A i ^ .r. r�'
21.�Ducts, inStr�cturQ:; . .. ' ;� :, - _;: y ;7p, Undeigrounii Hydro .,
22 �Ducts, Venti2ting_y ; ���� .� ,_ 1 '4^ �� -;77, producfRiping OGas O�OiI
23::Gas�Pip€Pough &'Test ; �'� ;; :,� _ �,a : .7Z, Undergrownd Flush� � '. i�' _
24 -Roof Framing �. , : . • -� _ _ � �. � s73r Undergmd. Siorag'e_Tank�O Gas O Oil
�� �-,�c n.>^
25. Roof SFieathin - s� �' '� "� �tl ' �
_ g _ � ',... �. .�x a ' 74;=Qverhead�Hydro-'� '"
26..-T�Bar Ceiling (Stryotural) &;Monocoat'�; *� � u� : !`l* � 75TDry Chemical ' • - i'
�- .
27F-Frame a,�d Flashfn¢� V�.� �'�' � r�.;, �� 76. Dry Standp'ipe -'�' �'`''
,_,r �
=28. Lathing�& $iding�:'r i �-�i.i �= t:, : Z • •+ R 77,- FIXED SYSTEM:EINAL• y �.
'29. Insulation ' j'i � a � � '..,�,-', �r � I ± x 78;- FIRE PREV. FINfkL � •s,
•r30. Drywall:Nailtr�g =:• � ��� S � � � , r. -HEALTF,kDEPT. R�E�I�IREMENT
�31. Plaster Binwo Co`at:',. r � '� ' ` x _73�FINAL INSPECTION "- � �"
� .� t :�'J" S a - .
.-�32._Electrical PovJer hJlreterFinali '^ � N;� ' �, . b rg0; �EDOD CERTIFICA�TE ISSUEDr
__ _ � f �
..33:SFin�l Elflctri� '�y ' s � � �' .�� ' � : �� ?Notes: - � : � �� .. " r�tn .
�- s- .� ,� s.= x i - . � . � . -
,,�34.-Fin�l Heating�& AicConditioning;, �^.= r, � �; x,� - � r�-
�35 _Final Gas` Pipe-Test;�� „kL �!-� ; i , ? x g� '
�.
� �-,r, � .5 �.• - � i x . n . . . .
.r36: Hood or-CanoPY�7 � t�' . '.�.`�.t x i � �' - r -
! il �f
; 37�Final Factory Fireplacel " ��`� '' �� `- ,"' � � ` � ' t �';-
- ..� � (_. ru b x � i �, : �
`�B..Final Plumbin9 - �tti; t •• .. - I I �` '� '� . �
:�39:-Wa[ei Service�Final• � � i �� �� I i I'� ' • �'T �° '-�
r . i. f' " i t' a
;�40.-Gas Service-Final ' _ i �� ' ='.'( '
x r'ir�. i r� �t 'r
�.41::Solar pomesticFinal ; :'i' ` -.. t c?' � i l� '- �r,� " . � ~
rn I � ;� �
'-42.�Backflow Preventer; -- :' � '� � �• �� � ��' `• • -• .
:� ( I h: �r_. . . p -
43. Backflow Irrigatiom � ��5' � • ' � �:'�'. _. 1 --
� Y 1• � .� �
- • �T,�Y r .v �i ,. � V
:44. Landscape lirigation System� , ;, � , y .� `. � _ i,- .� � . - N �;
� -.`. �. -' . -
%A5::Sound Attenuation -�: .' r � -� T - �- - � '� --� • - cC�Z �
�:- - �
��:46.~Handicap Re9ulations : '" c : r � � ',� ',
47 �FIf�AL STRUC7URE & BUYLDING J � D ' - ' _ _
L
- - ' � n * ti c. � . �-
• 48 i_ ' - -
` i_ .S. �� I. n 1r. i .
.�49.:ElectricfielBaseto.Ed on � '; � . > s: ; � _
� -
'r50.�Gas.Release to Sou{hem California Gas Co -.'r �-'I I `_' - _ , - '�'` �` � ,
Ct�: x J
:'51. CERSIFICATE OF;OCCUPANCY ;;; ; ; ,. - i�j; ;r�, ; � ; �
No. Date
�
�
�
APplicanl to lill in all spaces ezceDt ��ese wil�in �eavY borGer lines anA si9n all apPropriate Eeclarations.
CITY OF COSTA MESA CON TRU TION P�/ERMIT PERMLTNQ. TRACT NO. LOT NO. UNIT N(�
broject Address � �
Applicant's Mailing Address /
Owner's Name — Phone
Address
Arch/Eng. License No.
Address �
Conirecmr's Nam � 1 Phone _
Address Ima I"ngl /
City Licencr Nn �� �
LICENSED CONTRACTOR DECLARATION
1 h¢reby alfirm tbat I am licensetl untl¢r provisions of Cha�te� 9(comm¢nCing
with section ]000) oi Oivislon 3 oi the Business antl P�ofessions Cotle, anE
my license is in full rF ntl ei(ect. ///111
Licens la. Ljcerns% lo
Oate S'9 t (/U / /
"7HK RS' OMPENSATION DECLARATION
!reby aifirm Ihat I have a certiticate of ronsent to self-insure or a certlflcate
Worke�s' Compen5ation Insu�ance, o� a certifietl Copy thereof ($ection
3800, Lab. r� ,1 Q '���ry-p� _I
Pnolicy No.��IQ �� Y-u� Company � „'^ �
Cl� Cef,�t�lfietl m`0Y is fieeGbwithrthehcR/.��/g w��W/�n/g/�/py�y i�/��gn�/J/ /��,� �//
EXEMPTIO F�N PR�'RKERSaCOMFENSATIONDECLARATIO�_�
w
(Thisseclion neetl no[ be compl¢tetl i/ the permit is for one bundretl ($300) or
IC55).
I certify tha[ in the perfo�mance of tM1e work fo� whicit tnis Oe�m�t is i55uetl, I
shall not employ any person in any manne� so as to become subject to the
Workers' Compensation Laws ol California.
Date Signature -
NOTICE: It, after making this tleClaration, you shoultl become subject to [h¢
Workers' Compensalion provisions of the Labor Cotle, you must torthwitM1
compry with suGh provisions o� thi5 permlt shall be tleeme0 revoketl.
CONSTRUCTION LENDING AGENCV
I hereby atfirm that there is a mnztruttion lentling agency for the pertormance
of tne work for which this permit is issuetl (Section 3097^Civ. G.)
L.entler'S Name
Lentler's AOtlr¢55
OWNER BUIL�EH OECLARATION
I hereby atfirm that I am exemD� �/om lhe Cont�aclor'S License Law tor the
ioilowing reason (Section 7031.5 Business antl Protezsional Cotle: Any city or
county which requires a pe�mit to const�uct, alteq Improve, tlemolisM1 o� repair
any structure, prior to its izsuance, also requires the applicant for wch permit
to file a signetl Sldtement thal he/sh¢ is licensetl pursuant to the provlsions of
� Contractor's License Law (Chapter 9(commencing with Section 7000) o(
i5ion 3 ot Ihe Business antl Pro1e55ion5 Cotl2) ot that he/she is exempt
refrom antl the ba5i5 tor lhe allegetl exemp[ion. Any violation of Section
.a31.5 by any applican[ tor a permii sublec(5 Ihe ap0licant [o a civil
�enalty ot not more man five nuntlretl tlollars ($500).
LJ I, as owner o/ the property or my empioyees with wa9es as their sole
compensation, will tlo Ihe work, antl [he sVuctme is not intentletl or offeretl
tOr sale (Seciion ]044, Business antl Professional Cotle: The Contractor's
License Law tloes not apply to an owner of a property who buiitls or improves
thereon, antl wno tloes such work himselt/herself or throu9h his or her own
employees� provltletl LM1at such impravements are not intentletl or offe�etl for
sdl¢. If, nowevGr, lhe builtling or improvement is soltl within'one yea� of com-
pletion, [he owner will have [he burtlen Of proving he/She tlitl not builtl or im-
prova far tlte purpose of sale).
❑ I, as owner o/ [he properry, am exclusively <ont�acting with licensetl con-
tractors to construct the project (Section ]044, Business antl Professions Cotle:
� The ConVactor's License Law tloes not apply to an owner oi property who
bulltls or improves thereon, and who contracts (or such projects with a con-
� lraclor(51 u[ense pursuant to the Conlractor's Litense Law). I am aware that
I� proof of tM1eir Worker's Compensatlon insurance shoultl be provitletl to me.
'� ❑ I am exempl untler Section B. & P. C. for Ihis reason
Date Owncr
I nereby certify that I have reatl tnls application antl state that the above
information is correcL I agree to comply with all Gty antl county ortlinances
antl stale laws relating to builtling construction, antl nereby au[horize repre-
s¢ntatives of lhi5 City [O entcr upon Ihe above-mentionetl p�operty for
inspection o n (� n
Signature� Q y � T� Q Date v, �"�
TVPE OF CONSTRUCTION LI NEW U ADD LJ ALTERATION L7 REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p#
DESCRIPTION OF WORK/USE OF BLDG.
S Main Building:
TVPE OF PERMIT GaaDiNG OUNDATION ❑$TRVCTURAL T Front
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear
❑ OTHER %�
PROJECT DESCRIPTION Sp. FT. OCGUPHNCV C Right
K Left
CONSTRUCTIONTVPE VALUATIONS S
ZONE GRADING CU.YDS. ACRES ping. Ref. #
Remarks: ' Planning Notes:
Sink
Preventer
Irri9ation
fiers
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fee
$15
Duct - Under Ground
Duct � Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
FirepUFacc Blt. ICBO #
Heating System & Ducting
❑0�100,000 BTU 0100,OOOBT
I Drivers' L�cense or 55 � ,'�,� ' I Reinspec[ion Fee
CMF 0865-46, rev. 10/84 White - 8uiltling; Canary - Applicant: Pink - Accounting; Goltlenrotl � Assessor
$15
Showers
Service Sink
Sewer Cap '
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Trays
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
R efrigerat ion.System
❑o-ioo,aoosTu ❑ioo,000
System Repair/Alt¢ration
Fire Dampers
Registers
Isue Fee
FEES
$ 3
F
$ 3
Auromatic Washer
Construction Pole Sub.
Cooking Unii
D ishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generaror �0.5 KW C
Fee
5478 9/17/87
ZonB
Accessory Buildin9:
Parking Req./Provided
ELECTRICAL
Transformer ❑ 15�50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors � 0.1 HP 01 Yh � 8
Ina Solar �9-15 HP 016-15+
Microwave
Pole Light
Range
Standing Sections
5-15 KW Trash Compacmr
$15 Issue Fee
,DEVELOPMENTSERVICESREQUIREMENTS:
Zoning Approved 9y
Building Approved By �
Aoolication Issued Bv / /� �
SUMMARY OF FEES
BUILDING PERMIT $ SMIP
PLAN CHECK $ � PERMIT
PLUMBING $ .�J.tJ�/ ISSUANCE
PLAN CHECK 25% $ ENERG� P.C.
ELECTRICAL $ GRADING
PLAN CHECK 50% $ MICROFILM
MECHANICAL $ TOTAL FEE
PLAN CHECK 25% $
$
5s00 TL
FEES
$ 3
2
O
N
I
N
G
R
E
Q
M
T
S
CONSTRUCTION AND;PLANNING � POOL & SPA ,
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector •
r
1. Temporery Electrica4 Service or Pole � 52. Pool & Equipment Locatio'�'?
2. Soil Pipe-Undrgrnd. ��' 53. Steel Reinforcement ��
3. Electrical Conduit UtilitY-Undrgrnd. 54. Forms --
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ;,�;
5. Steel Reinforcement 56. Rough Plumbing & Pressu�eJest - -
�.
6. Electrical UFER Grnd. 57. APPROVA� TO COVER�fJNITE �
7. Footings � 1 /, , 58. Electrical Conduit-Undrgcmd. , . �
✓
8. Foundation ��� ,� 59. Gas Pipe, O Undrgrnd., T.eSt
9. Water Pipe=Undrgmd. 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64. Plumbing System - Final �
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign � - 68. APRROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � � "FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit# _ .
21. Ducts, in Structure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing � 74. O'verhead 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 HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED -
33. Final Electric Notes: � � � � -
34. Final Heating & Air Conditioning � •
35. Final Gas Pipe-Test .
36. Hood or Canopy
37. Final Factory Fireplace , �
38. Final Plumbing ,z.�..dy G�p � � i� I
39. Water Service-Final � ' ' � ' I
40. Gas Service-Final � ' � ,
, 41. Solar pomestic-Final ' � , '
�
42. Backflow Preventer � � � �
• i
� 43. Backflow Irrigation . � � .
�; 44. Landscape Irrigation System � , ' �
45. Sound Attenuation ' , ' � •
46. Handicap Regulations ; '� ,
47. FINALSTRUCTURE&BUILDING , ' i . � - , . .
i
48. Special Requirements Completed ' �
49. Electric Release to Edison '' " � .
50. Gas Release to Southern California Gas Co , ' '
51. CERTIFICATE OF OCCUPANCY
No. Date '
. ' v.:
IIIC.
JOB ADDRESS
P" 'SRAL C01
A .o. _
GAS
r
WATER
FOUGH PLUMBING
PROP. SWA. LINE � NOUSE CON.
SPRINNLING SYSTEM
MISCELLANEOUS
ROUGH NEATING ANO AIR CONDITIONING
TEMPORARV SERVICE OR POLE
UNDEPGROUNO j� POWEft n
BON� BEFM � STEEL REINFORCE
SHEATHING
FRAME AND FLFSHING
LPT4ING — IN � I
F ER, BFOWN COAT
SI�.eCTURAL FINRL
HEnTIN0. VENT„ REFRIG. ANO A.C., F
PLUMBING, FINAL ANO GAS TEST
ELECTRIC, FINAL
BOILOING. FINAL
BUILDING PE
DESCRIPTION of WORK =s,�
FIRE ZONE VALUE b 3!
TYPE GROUP
SUBCONTRACTOR
76
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' COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant ta Fill in Completely
BUILDING
onoAEss 912 Hollow Brook
OWNER
MAI l
9461 Grindl
ciTr Cy�ress
CpNSTRUCTION
LENDER
BRANCH
ADDRESS
ADOFESS � /,
CONTRACTOR
ADORESS 94
CIYv CV
STATE
110. NO. 22
size 12
OF LOT
USE OF
EXISTING BLDG.
SIZE OF
a
No�826-455�
TE
CITY
LIC. NO.
INO.OF LB�DG.S
NOW ON LO7 O
NO.OF
ROOMS STOF
er ROOF
COVEpING Shake
D WOftK TO BE PERFORMED
ar,ie
'�AY i 3-7Cc��,-. �0 647'% *'::'` 23�.Z�
APPL�CATION FOR BUILDING PERMIT
RECEIVEDBV DATEflECEIVED neTc�cciu
R
FIRE
20NE
APPROVED
DATE
ZONE P�� 2 BUILDING i
f� Z �/�
VAflDSAPPROVED VARDS
MAIN BUILDING ACCESSC
(FROM C/l$TREET)
DISTANCE BE7.
FOR
DATE
FT
e
I hereby acknowledpB ffiet I have reetl Mis aOP���ation entl state ?J /�
that the above informatlon is correct antl aprae to comply with ���
all laws reBuloHng builtllnp construction, antl I ahall not amploy
eny person in violation of Me workmen's companseHon laws oi
the Srote of Calitomla.
I �ereby cardty t�at I am pro0erly licansetl es e convactor untlar 5�. FT. —
the State of CalifornlE Businass antl Professions Code, Oivlsicn 3, THE AMOUNT SHOWN UNDEF VALUATION
Chepter 9, end that such litensas are in tuil forta antl effxt, o� } TNE PURP�E OF ESTAHlYSHING A PEAMTf FEE
am axompt trom the provisions of the Siate of Califo ia Businass VALUATIO
entl Protessio�s Cotla, Oivision 3, Chaptar 9. �/� O� � PEFiM1T FEE $ r
SiBnnturao te-Wide Develope nc. ��7y, �
Parmlttae � $�o+ PLANCHECK $
AuthorizedAOant Vice Pr,esident
TOTAL FEE $
�
0
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¢
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