HomeMy WebLinkAbout920 HOLLOW BROOK CIR - Building PermitsPPOJECT AOOHESS: 9 2 1 HOLLOW B ROOK UNIT:
OWNEH'SNAME: VILLAGE CREEK HOMEOWNERS �
aooaess: ASSOCIATION
3429 TIMBER LAKE
CM VA 92625
AHCHIENGINEEH: CHESTER CARVILLE flEG.NO.: C183OS
p0�HE55: % 9 z 7 ARMOUR ST uxir:
S.D. CA 92111
PEHMITTEE: PHOENIX ENTERPRISES INC. ( 213 ) 690-9559
aooeEss: 411 COMERCIA[, WAY
LA HABRA CA 90631
LICENSED CONTHpCTOfl UECIAflFTION: I hereby alfiim iha� I am licensed untler pmvision5 0l ChaD�er 9(commencing.wiih Sec�ion
7000) oi Oiv��sian 3 0l l�e Business and Pmfessians Gode. antl m se' in full Imce and ei�ect.
ciTr uc.: 5 78 � srare uc.:376639 ss: B�
Da1e: � Signature' �
WONREBS' COMPENSATION OECLI�HpiION: I hereby aifirm �hat I ha e a cenificate oi Consent to SelGin e or a certifitate ol Work¢rs'
comPensaoon �S+ u�� o� �crdmiea coPv tnereoi Isection seoo. �ab. �.� � O 1/ 91 '
eaucr eo.: CA COMP S F IRE E%P. �ATE:
�OMPANY:
Certitietl co y is hereby lumishetl. ❑ Certilied copY � wnh e ciry BuilOing Divi e
� �oate: ^ ApDlicanl'
E%EMPTION FHOM WOflREPS' COMPENSATION OECIABATION: (This sec�ion nee0 no� be comple�ea it the permit i or one hundred ($100) or less).
I certi�y that in Ihe pedormance ol ihe waB �ar whic� Nis permi� is i55ueQ I shall not employ any person in any manner so as �o become
sublecl to Ihe Wo�kers' Compensaiion Laws oi California. ,
�ate: Signalure: '
NOTICE: II, ailer making Ihis tleclamtioq you s�oula become sublec� to Ihe Wo�kers' Compensa�ion provisions oi �he Labor
Cotle. you mus� fatlhwith compty wi�h suc� provisions or �his permit shall he OeemeA revoketl.
CONSTHUCTION LENOING AGENCY: I Aereby alfirm Ihai lhere is a tOns�mttion lentling agenCy tOr the pedormanCe Oi Ne work lor
w�ich Ihis permil is issuetl (Section 3W7, Civ C�.
LENOEfl:
I poosess:
OWNEH BUILDEH DEClAflF110N: I here6y aifirm �ha� I am exempt fmm Ihe ConVactars' S�a�e License Law for ��e �allowing reason
(Seciion 703L5 Business an0 Pmiessional Cade: Fny ciry of coun�y which requires a Oermit to constmc�, alter, impmve, tlemolish, or
repair any stmciure, prior ta its issuance, also requires t�e applicani �ar such permii lo lile a signetl itatement Ihat he/she is licensetl
Oursuant to t�e pmvisions of Ihe Comracmrs' State License Law (ChaD�er 9(commencing with Section 7000) oi �ivision 3 of t�e Business
and Pm�essions CoOe) ar �hal helshe is exemp� Iherelrom antl ��e �asis �or ��e alleged exemp�ion. Any violation ol Section 703L5 by
any applicani lor a permit sublec�s �he applicant lo a civil penalry o� no� more lhan live hunOretl Oollars ($500�.
I. as owner of ihe pmpeny or my employees with wages as their sole compensalion, will tlo Ihe work, antl the
❑ simcWre is no� intendetl or ofteretl �or sale (Seclion 7044, Business antl Pm�essional Code: The ConVacbrs' S�ate License Law
tloes not apPly �o an owner o� a propetly who builds or impmves �hereon, antl who does such work himseltl�e�self or thmuAh
his or her own emDloyees, provitled �ha� such impmvemenis are noI in�endetl or o��ered �or sale. I�, however Ihe building or
improvement is sola within one year of compietion, ihe owner will have ihe buraen of pmving ne/she aid not builU or impmve
lor the purpose ol sale�. ,
I, as owner of Ihe pmpetly, am exclusivelp con�racting wi�h licensed con�rac�ors �o cons�ruc� �he pmle�� (Section 7044, Business
❑ and Pm�ession5 Code: The ConlmtloK S�a�e Litense Law does no� apply t0 an owner Ot propetly who bmlds or improves �h¢re0n
and who coniracls br such pmle��s wi�h a coniractoqs) license pursuant Io Ihe Conirac�ors' Sta�e License Law�. I am aware
that prooi oi �heir Worker's Compensatmn insurance shoultl be pmvitled ro me.
� I am exempt under Seclian'. B. 8 P. C.
br this reason:
�ale'. �v✓ne[
I tlo hereby cendy inat I am aware ol and unders�ana Ihe requirements oi Calilomia Health ana Safety Code Sedions 25505, 25533, and
25534 antl ihal I or any lulure bulltling occupani wiil/will noi (circle one) neetl �o comply wiih said state cotles antl ihe requiremenis �or a
permit lor consimction or moAilica�ian hom Ihe Air Ouali�y Manag¢men� Oi5Vic1. Residenlial conslmction applications are exemp� irom
these provisions.
Dale: Ap01¢anl:
I �ereby cer�ilytha� I have reatl Ihis application antl s�ate t�ai ihe aby� in maiion is correci. I agree Io comply wiih all ciry antl couniy
ortlinances9andsla�elawsrelaiing�obutltlingcons�mclionand�ere y ho repre5en�ative5o���oenlerupanlheabovGmentionetl
pmpeny i r inspection purposes
/�
oate: _F �_� Signalure'.
oriver s Lmense or Social Security a:
164n46 Whne—Builtlmg�, Green—Cotle Enbrcement Canary—AoolicanC Pink—Revenue: Goldenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT ,
PERMIT NO: B 099832 PLAN CHECK NO: 06434-90 A , ,
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP
JOH DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143
CLAIM VALUE: 19,388.00 CALC—VALUE: 14,300,00 GROUP OCC; R-3 /
COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION ,.
*�r**+�**�r��*�r*+�***�**�*************+r�r�r�***�r�**�********�r�**�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 HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; F7' I13 RGHT; F'T IN LEFT; FT IN RGHT: FT `ItJ
PARKING REQ� PROV: PARCEL: 93506124 ZNE: R2 REF NO: "
PLANNING N15TES>�REPAIR EXISTIN� FOUNDATION, p(�r� pp j��p��
� iF3F7�tit��F�#iF1E'ilMP4��P#Yf
9t it k it it iF �f �lt iE 3E iF M�IF �7E at k it it k iF if IF �k 3E M aEiP ib it iF 3E iP k if IF iE iE iF 3E 1E iE iE aE If iE it IE iE M if it it iF iF ft iF
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
7.ONING APPROVED HY :�/�-- � DATE: ',' D 8 D
BUILDING APPROVED BY : (� iLpfc.t�l DATE; •.I,I •O 8'�!O
APPLICATION ISSUED HY: DATEe L I� D��IO
1f iF k iF k iE 1F If 3F IE iE it 7E iE iE 1f±E �E 1E 1E iE iE
1EIF1kIf1EiFMik�IFlf�fM�iflEififiElf#FiF1EiElElfif� � iEl1� FIF iflfiEiE�EikikiElFiflfiflFitlklFikiFiE1E1E3FiEifiFlFlfiFif��lflFiE�7kiE1k1l�IEiElEjfik
LEGALIZATION:N F E E U M M A R Y STRUCTURAli SEGMENT:Y
BLDG PMT PLUMBING ELEC RSC MECHANIC FIRE SMIP/RES GRADING
PERMIT 162.00 .
SMIP/NON—RES
PLAN 26.33 2.15
ISSUE FEE
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 164.15 0,00 26.33 190.46 190.48 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 190.48 OVER/SHORT: 00
BLDG PMT PLUMHING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN-CHECK
162.00 2,15 26,33
iE if If jf IF ik ik iF ik ik k k* 3F iE iE �f If k 1f k 1i fF iF if iF 1F IF 1f ikiF 1f Ik �E 1F �F i! ff IE 3f 1t iE iF k ikif iF 1k iE M�lFik iE ik 1f �E �E1f 1F If It Iflf af iF ff iE 1F If If iE iF I! �f IE k iF iF �k
I N D I V I D U A L F E E B R E A R D O W N
TYPE �TY D E S C R I P T I O N ' UNIT COST TOTAL COST
SFC 143 FOUNDATION BY VALUE PEA $100 100,00 14,300,00
. END OF FEES
01 40074,±45—�L�CI%4395 'E d3';
CATE: ii/?6/40 TIFi£: 11��?
Z��.`*�
i�
CONSTRUCTION AND PLANNING x. PO� . SPA
APPROVAIS Permit # Date Inspector qppROVALS Permit # Date Inspector
t. Temporary Electrical Service or Pols � 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. :� ��� � 53. �Steel Reinforcement
. :� ,. .�', ' �.
� 3.';Electrical��ond`uit.Utility-Undrgrnd:'; 54. Forms
^+•4'Electrical Conduit=Undrgrnd. 55. Electrical Bonding
``S:TStee� Reinforcemerit �,, 56. Rough Plumbing & Pressure Test
�:i6.^Hectrical UFE:6'Gmd. � c; 57. APPROVAL TO COVEF�GUNITE �
=;j. Footings' ^ •� 58. Electrical Conduit�Undrgrnd.
�,;.a. Fsundation y` ` . 59. Gas Pipe, � Undrgmd., Test `
_%9. Water Pipe-Undi'girnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
lU. Structural Floor�System �.� 61. APPROVAL TO DECK
14. Property SeWerLinE & House Connection 62. Backwash & Receptor-Final
S N%� y
12. Sewer CaP , ' �
� 63. Heater & Vent-Final
13. Roof Drains � � 64. Plumbing Sysrem - Final
14. Rough Plurri6ing ` 65. Electrical-Final
75. Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough ,Elearic�Wiring 67. Fencing & Access ApProval
77. Rough VJiring,Sign 68. APPROVED FOR PLASTERING
18. Rough Electrica7-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- _ ' _ l'� U'�-a,U[.. �� . _ �,.
20?'Rough Eactory Fireplace ,�i;!-7 Q^. Cl = cr x;+qppRDVA'LS:��= Permit #' ''' 'T'
1 _ ' e. ...k- i ' ri.- - -
21"Duits,in�$tructu eF . •• , ��'� �'j - � , �?70. �Onde'rgroynd Hydro �
22. Dutts,Ventiatirty�� C�S j� _ S=�. �-77. Producz;P_%pingO�Gas �Oil
23; Ga's Pipe=Rough &:Test ' �5,..',�- ; �r � -�� ` : 7z, Under9round FI`u;li � � _ �.
24:r Roof Framing �... .. �- `.= a�� ;�; _ y! a: ; r 73_ Undergrn'd. Storage.Tank'O Gas ❑ Oil �
25. Ro f Sheathin ^x %� ''' ' �n �' - `" �" � � v �- --r
Q � 9 - y � . • r �,;�.. , ' 74=,,Over�head Hydrao-' .
26 T�Ber Ceiling (Structuraq &�Monocoat:C �x � _ ��': � 757 Dry Chemical ' *'-' �= r
27��-Frame and FlashlnJ �.�, r � r� .T p s`� � 76. Dry�Stan�pipe �'`' �`�
_ 28: Latfiin'g.,T'& Sitling,.: ;� -,a;�� rss: x: Z �;� 77:r FIXED SYSTEM`F.INAL
''29. Insulation x _�-z � '.� "" '�" ' �''' �� ' .� 78y, FIRE PREV. FINAL . 7 �;,
��•30. Drywall.Nailing r, ` �' �> J i �- �HEALTH'DEPf..REQUIREMENT
� ���.
, 31. Plaster�Brov¢n Coaf _ � � r _ � F��„79. FINAL INSPECTIDN ,;, � �'
� 32.-Electrical Power`Met�r-Final - ' � T ; �,;80::FOOD CERTIF,tCATE ISSUED �t
�33jFina,l El�ctric ��' ' -�.; "'-� ' r- � � N6tes: =,�- ^'
� �n i S _ -.r C ui;r,
' f '.3: . \' •./s, .�
=34- Pinal Heatiny &`Au Condition�n�; - (-�'� � . ; '�,-� S , ; ;, _
- I
35TFinal Ga"s PiPe-Test� -��w - - .� � ; x �. �"'- . �'- ^�
- � - r�, : ,-� 1i�� L �G�' - v
. 36THoo.d or CanoPY� � . ~ � L,• ] , s j . ! � z. 9�
-37-�Final Factory Fireplace , � t'•' "� ' �Y � � � �°
F_.� .-. i� '�
�38;Final Plum6ing ��; '�L �� � i ' . '� - M'
�39=WaierService�-Final � �+ � .. >>.� t'�
lC i Y T f
' 40.', Gas Service=Final � ` � " �Y � , �-"� " � '
�� ✓, �r�r' 1 : T � t L,Pj =('7
��41uSolarpomesticFinalS " � •• ��'� ' � ��--� `
i �' ., � - r -.
- 425-Backflow Preventei •- �i `r ;. '� � � j.. • is; ����. : � .
43. Backflow Ir�cigation =S'S: "'� � ^�'-'�� � =' -
i'
��44. Landscape Irrigation Syste `'KP; - ' _ �•' � " �-'
�;ir - .r �x � N iC �i:. C
� _ '
.45'.Sound Attehuation -.ai:- �_� .. � = � , - �- c'c• ��i =�
ra - � t + �_ a_'-.
_ 46-Handicap Regulations � r?4 �- " ";� x ; � J`' - •-:� :
C
��47,�FINALSTR�UCTUSRE&BI})LDING - ,._.
�T
48.'' - I`_ _ _ y ^ _ i _'
i' ' n �
-49=,Electric Release to.Edis n i - ; �•I , = Y � ;x ' . :
� ` .r c
Y�50�Gas, Release to Southem California Gas Co ": ' � �;. _ - , ��;;r`; "'
- ,I "
`'51. CERTIFICATE OF OCCUPANCY �} � `" , w;, ,-: i*ic :� �� �. �- �
No. Date
AOV���ant lo till in all spaces except those witnln heavy bortler Ilnes anO sign all aoP/oprlate aeclaratians.
�ITY OF COSTA MESA � PERMIT NO. TRACT NO. LOT NO. BLD . . �S%4 7/23/9.' ']oL" TI.
CONSTRUCTION PERMIT
Project Address f
Applicant's Mailing Address :
Owner's N�aime LOCV E RtJ%�n _ PhoneG9�—/o62
Address 7-2� %��LLDGJ /7nf7K
Arch/Eng. Licenu No.
Address
Contractor'sNam -- � • URP � Phone�9✓�'�2�
Address (mailing) ��S %O . �F� .80f1-/? 7� �� •
Ciry License No. -3C7,�'sZ.
IICENSED CONTRACTOR DECLARATION
I hereby atti�m l�at I am littnsetl untla� provi51on5 of Cha�ter 9(commCndng
wiih section 7000) ot Dlvision 3 ot [�e Buslness antl Professions Cotle, antl
my Ilcense is in (ull torce antl ettect,
License Class - llcense Nr. �h�'9��
"-•e�T SignaWre � �
iKERS'COMPENSATION DECLARATION
,reby afflrm that I hava a certHicate of consent to SelMnzura or a certiBwte
of workers' [ompensation Insurance, or a certitietl copy thereof (SecUon
3800, Lab. CJ '
Policy No. Company
Certifietl cooY is hereby turnishetl.
Certifietl copy is flleC with Iha tlty Builtlin9 Dlvislon.
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl n0[ be com0letetl it lhe permit is for one huntl�eC (E100) or
less)
I certify that in the performance of the work for whlch this oerm�t is issuetl I
shall not employ any person in any manner so as to become zubje t to t�e
workers' rt�pe tlo Laws ot California ,� ,
Date �� Signature '
NOTICE: If,iaf er making this tleclaratlon, you shoultl beco e�sub e<t [o the
Worker5' Gompensatlon prOvisions ot [he LabOr COtle, y0 muf[ torthwith
compry with such provisions or this permit shall oe tleemetl ravoketl.
CONSTRUCTION IENDING AGENCV
I bereby a((irm that ihere i5 a COnst�uction� lentlin9 agency fOr Ihe perto�mance,
of th¢ wark for which this Oermit i5 iz5ue❑ (Sectlon �309] Civ. C:) -
t_entler's Name . ,
�enEer's Aatlress
OWNER BUILDER DECLARATION �
I hereby affirm that I am exempt from tne Contractor'S License Law for the
tollowing reason (Sectlon 7031.5 Businezs an0 Professional Cotle: Any ciry or
county which �eqW�es a pe�mit [O const�uct, alteq ImO�ove�, EemoliSh o� �epair
any structure, prior to its issuance, also requiras tho applicant for such pormit
file a signetl s[atement that he/sh¢ I5 Iicensetl pu�suant [o the p�ovisions ot
Contrac(or's Llcense Law (Chapter 9(commenGng with Se<Uon ]000) of
ision.3 of the Business antl Professions Cotle�� or that he/5he is exemp[
.��ereirom antl the basis for�the allegetl exemption. Any violation ot Sactlon
7031.5 by-any applicant for a pormit sub)ects the applicant [o a civil
�enalty of not more than five hundretl tlollars'($500�. �
I, as owner oi the p�operty or my employees with wages as Iheir sole
compensation, will tlo the wo�k, antl the s[ructUre I5 n0[ IntenOetl o� offe�etl
(OY Shc2 ($EC�IOII %044� BI151lIE55 dOG. P�Of¢SSIO�dI Cotle: The COlII(dCI01'S
License Law tloes nol apply to an owner of a pro0erty who builtls or improves
ibereon, antl who tlnes such wo�k nlm5elf/h¢rs¢It or through his or her Own �
employees, providetl that such Improvaman[s are not intentletl or olferetl for
Shce. If, however, the bulltling or Improvement is soltl within ona year.of com-
pletlon, the owner wlll have,t�e burtlan ot proving �a/sne tlitl not builtl or Im- .
�rove-for tne purposa of sale). '
I, as owner O( the property, am exCluSively contraCting with Ilcensetl con-
Vactor5td construct lha project ISectlon 7044, Business antl Pro(e55ion5 Cotle:
The ConVactOr's License Law doas no[ apply to an owner of property who
builtlz o� Imp�oves Ihe�eon, antl who contract5 (Or tuch project5 with a Con-
Vactor(s) license pursuant to the Con[ractor's License Lawl.
❑ I am exempt untler 5ection B. 3 P. C. 1or thls rea50n
/ Date Owner' r
1 heraby wrtlfy that I hava rea0.thi5 avG��catlon antl state that the above
information is corract. I agree lo comply with all Nty antl county ortllnances ,
� antl stale laws relating to buil0ing constructlon, antl hereby authorize reDre-
a sentatives of thls cityi to enter upon tne above-mentionatl DI�� _'oj
Inspection purpos i. . �/( � jfG
Signature � Dat
Orivers' License ar,55 �
CMF OB65-06 rev. 12/83 White - Builtlln9: Canary • Appliwnl; Pink • Accountin
TYPE OF CONSTRUCTION LJ NEW LI ADD V.� ALTERATION IJ REPAIR —
❑ CONVERSION ❑ DEMOLISH ❑ OTHER � q,p,#
DESCR PTION OF WORK
C- L ' �r— S Main Building:
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front
❑ TENANT ❑ ELECTRICAL PLVMBWG ❑ MECHANICAL B Rea/
❑ OTHER %�
PROJECT DESCRIPTION 5Q. FT. ocCUPANCv C Right
K Left
CONSTRUCTION TVPE VALVATION $ $
ZONE GRADING CV. VDS. ACRES Ping, R2f. #
Remarks: � Parking Req./Provided
Use of Building:
PLUM8ING ' FFFC Plannin9 Notes:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Droins ,
Floor Sinks
Gas Service � Outlets
Interceptois
Kitchen Sink ' '
Lavatories � '
P-Trep
Roof Drains - �
1 A�?l3fl6� �SPOSRi
Rainspectian Fee ' $25
Boiler ' `, i
Duct - Under Ground '
Duct-Structural ,
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. BIL ICBO #
Heating System & Ducting �
❑ 0.100,000 BTU-� 100,000
� � Reinspec[ion Fee
Goltlenrotl - Assessor
$25
Showers
Service Sink
SewerCap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Issue Fee :
Hood or Typel ❑
Canopy Type II ❑
Refrigera{ion System : � �
❑o-ioo,000sTu ❑ioo,000eru
System Repair/Alteration
Issue Fee
2
$
$ 3
Automatic Washer
Construclion Pole Sub.
Cooking Unit
� ISh Wd5h2f
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0.5 KW �5-15
Zone
Park.Fees S
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter �up to 100 amps
Meter pover 100 amps
Sub Panel
' Motors O0.1 HP
Inc.Solar �9-15
Microwave
Pole Light
Range
Sign
Standing Section�
Trash Compactor
I'Reinspection Fee I $
PUBLIC SERVICES REQUIREMENTS:
2oning APProvad 8y
Building Approved ey
ApplidtiOn IssuBd BY C�
laue Fee
0
❑1X-8
HP �16-15+
z
O
N
I
N
G
R
E
Q
U
R
E
N
T
FEES
SUMMARY OF FEES � ,
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT � �
PLUMBING S•O� � ISSUANCE .$
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL � .$ GRADING $ �
PLAN CHECK 50% $ MICROFILM $ c�-
MECHANICAL $ TOTALFEE $ "1 Q �
PLAN CHECK 25% $ _ .
' CONSTRUCTION ANDPLANNING
�APPROVALS Permit#
1.. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd. �
. 3. Electrical Conduit Utility-Undrgrnd.
� 4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcement
6. Electrical UFER Grnd.
7. Footings � �
8. Foundation
9. Water Pipe-Undrgrnd.
10. Structural Floor System
17. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Droins
14. Rough Plumbing �
15. Rough Electrical-Conduit
16. Rough Electric Wiring
17. Rough Wiring $ign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning ,
20. Rough Factory Fireplace
21. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
28. Lathing & Siding �
29. Insulation
30. Drywall Nailing
31. Plaster Brown Coat ,
32. Electrical Power Meter-Final •
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final '
41. Solar pomestic-Final
42. Bac4cflow Preventer •
43. Backflow Irrigation
44. ,Landscape Irrigation System
45. Sound Attenuation
,46. Handicap Regulations �
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
� �\
PO' � $PA
Date Inspector - .-
n
APPROVALS Permit#
52. Pool & Equipment Location - �
53. Steel Reinforcement � �
54. Farms - - . - - �
b5. Electrical Bonding - . '
.
56. Rough Plumbing & Pressure Test
57.� APPROVAL l`0 COVER-GUNITE
58. Electrical Conduit-Undrgrnd.�' - - �_ -
59. Gas Pipe, O Undrgrndr, Test- -�. �
60. Backwash Lines, P-Trap; O Undrgmd. -. �
' 61. APPROVALTO�DECK - �--
62. Backwash & Receptor-Finai. . .
. 63. Heater & Vent-Final - .
64. Plumbing System - Final � �
65. Electrical-Final � - - - � -
66. Solar�.System-Final: � - � .
67. Fencing & Access-Approval --� ' - . -
68. FIPPROVED FOR PLASTERING , ,
69!POOL/SPASYSTEMSFINAL' '
FIRE DEPT. REQUIREMENT' -
APPROVALS Permit # �
�
70. Underground Hydro �
r
71. Product Piping O Gas ❑ Oil �
72. Underground Flush ��
73. Undergrnd. Storage Tank � Gas ❑ Oil
74. Overhead Hydro � " � � '
75. Dry Chemical -
76. Dry Standpipe � - ' -
77. FIXED SYSTEM FINAL ° ,
78. FIRE PREV. FiNAL �
HEALTH DEPT. REQUIREMENT
79. fINALINSPECTION
80. FOOD CERTIFICATE ISSUED
'Notes: E�///d��J �`/0 0/YE M%N�IE- Gf
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: �
Date, � Inspector
'' - .
- �-
. �
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OwNER STATE-WIDE Developers, Inc. DATE 4-28-76
JOB ADDRE55 920 Hollow Brook BUILDING PERMIT N0. at nz7
� �� "tEn`_h�4`_'hT`�`�T 7RACT qRSR FIRE
`,J� cns
M WATER
`= ROUGH PLUMBING
�O
d PFOP. SWR. LINE Q HOUSE CON.
-`J SPRINKLING SYSTEM
�MISCELLANEOUS
ROUGH MEnTING AND AIR CONOITIONING
�RVTEMPORaRY SERVICE OR POLE
N UNOERGROUNO � POWER �
�ROUGH WIRING
TRENCHES � FORMS ❑ STEEL REINF
FLOOR SVSTEM -
BON� BEAM � STEEL REINFORCE �
SHEATMING
FRAME ANO FLASHIN
LATHING — IN � OUT
PLeSTEP, BROWN COAT
TURPL. FINAL
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETY DEPAF
P.O. BOX 1200 COSTA MESA, CAL�FORNIP
For Applicant to Fill in Completely
FASO
"kY t�i-76�,;�.�Q 64'1.". �': *Z�O.RI
APPLICATION FOR BUILDING PERMIT
RECEIVED BV DATE RECEIVED nnrv iccn�
OWNER State-Wide Developers, InC. A.P.NO. �
MAIL BUILDING �
AooAess9461 Grind�ay nooAess ,
cirv Cypl'255 No`.826-4559 TRACT
BRANCH
coNTRAcroA Stat -Wide Developers. In
000REssg461 Grindlav
TEL.
CITY C�Inr'e$$ N�iii�i�4
STATE T CITV
LIC. NO. 'Z2471 � LIQ NO.
siz€ 12,093 acres INO.OFBLDGS.
OF 4�T NOW ON LOT
USE OF
EXIST�NG BIDG.
SIZE OF NO. OF
NEW BLDG. ROOMS STORIE'�
EXTEAIORWALL�1a�ter :�OOF
COVERING Op COVERING Shake
USE OF BUIIOING AND WORK TO BE PERFORMED
1 Resideace w/att gar
OWNER
FIRE
ZONE
APPROVED
c
0
LOT
NE NO.OF USE OF NE
� PLANS �'[, BUILDING
VAROSAPPROVED VARDS
VAR, qW
HOLD FOR UFf
1 haYeby acknowletlBa thet I heve reatl this e9P��cetion antl state
that ihe above Information ia corract antl ag�ea to eomply with
all laws regulatinp builtlin8 oonnroction, entl I ahall not employ
any person in violetlon of Me workman's compensetion laws of
the 5tate ot Celifornie.
I hereby cartity thet I em properly licansetl aa e eonbacror under SQ. FL
the 5iate of California Buainecz antl Protessions Cotle, Divisicn 3, THE AMOUNT Si
Chapter 9, antl thet such licenses are in tull torce and eftect, or I THE PURPOSE OF
am exempt from tha provlslons of the State of Calif rnia Business VALUATIO
entl Professions Cotla, Dlvision 3, Chapter 9. �� �
te-Wide Developer nc. ,,.,,
Signeture ot _
Parmittee $
AuthorizetlApent Vice President
BET. MAIN &
�ti
m
�
O
VA�UATION IS FOR ^
A GERMIT FEE ONLV: �
¢
m
E $ �
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