HomeMy WebLinkAbout3447 HOLLOW BROOK CIR - Building PermitsPflOJECT AOUflESS: 3 Q Q% HOLLOW Bit�li
OWNEH'S NAME: VILLAGE CREEK HOMEOWNERS
anueess: ASSOCIATION
3929 TIMBER LAKE
CM vA 92625
UNIT:
AflCHIENGINEEP: (,HESTER CARViLLE NEG.NO.: CLA3OS
aooness: 7922 ARMOUR ST uxrt:
S.D. c'p 92111
PEflMITTEE: PHOENI}{ EN'tERPRISES INC. ( 213 ) 690-9559
aooxess: 411 COMERCIAL WAY
LA HABAA CA 90631
LICENSEO CONTFpCTOfl DECLRflFTIUN: I hereby aflirm that I am lice tl n0er pmvisions of Chapier 9(cammencing wi�h Sec�ion
7000) o� Oivision 3 of t�e Business antl Pmlessions Cotle. antl my I' i �ullimce antl eftect.
ciTv uc.: f 0788 srn.E uc.: 376639 , �
Date- O Signamre- _ _ _ —
WOFlNEflS' COMPENSATION OECIABATION: I hereby affir that I have a ceniticate of consent to sel4insure ar a c ificate oi WorkeK
Compensation Y�w�iwcp o( Ycu�iihed copy I�ereoi (Sectian 3800. Lab. 6�7 � O 1� 9 1
POLICY NO.: W��� �� �� 4 EXP. �ATE: V
�OMPFNY: CA COMP 6 FIAE
Cetlifietl coOY �5 hereby fumished. ❑ CertilieU cavY is lile �� ty Builtling Divis'
Oaie: ` / /�� (�� ADDlicanC
E%EMPTION FBOM WOflNEBS' COMPENSATION OECLAflATION: (This setiion n¢e not �e comple�etl ii the Oermit is fo ane huntlretl ($ID�) or less).
I cemty �ha� in Ne pedormance o� Ihe woB �or which �his permil is issued. I shall no� employ any person in any manner so as to become
subjec� Io Ihe Workers' Compensaiion Laws ol Cali�omia.
Date: Signawre:
NOTICE: II. afler making �M1is tleclaration, you should 6ecome suble�� �o the Workers' ComDensalion provisions of �Ae Labor
Code. you mus� �arthwiih comply wiN suc� pmvisions o� Ihis permit s�all he deemetl revoked.
CONSTflUCTION 1EN01NG RGENCY: I hereby al�irm Ihat there is a cons�mction lentling agency tor Ihe pedormance oi �he work �ar
which Ihis permii rs issuetl (Sectian 3097. Crv. C�.
LENOEP:
aooecss:
OWNEfl BWLOEN OEClAFa7lON: I hereby allirm ihat I am exempt lrom the Conlractors' Slate license Law for the following reason
(Seciion 7031.5 Business and Pmlessional CoOe: Nny ci�y oi counry which requires a permi� to consimc�, atler, improve, tlemolish, or
repair anY slmc�ure, prior to its issuance, also reQuires �he ap0licant lor such permit �o lile a signed sta�ement that he/she is licensed
pursuanl io I�e pwvisions ol Ihe Contraclors Slate license Law (C�apier 9(commencing wi�h Sec�ion 7000� of Division 3 0l Ihe Business
ana Pmtessions Code� or tha� he/she is eKempllherelrom antl the basis for the allegetl exemp�ion. Any viola�ion o� Seciion 7031.5 by
anY applicam tor a permi� sublecls Ihe applicanl to a civil penalry o� no� more than five hundred dollars ($500).
I, as owner o� �he pmperty or my employees with wages as �heir sole compen5alion, will do ��e wotk, and �he
❑ stmcwre is not intenEetl or oitered for sale �Section 7�a4. Business an0 Pmfessional Cotle�. The Coniracrors' State License Law
does no� apply �o an owner ot a pmpeny who builOs or improves ihereon, ana who tloes such work himsetl/hersell or ihmugh
his or her own employees, provitletl t0a1 suth improvemenls are not inlenaed or olfered br sale. If, �owever ihe 6uiltling or
improvemeni is so10 wiihin one year ol comple[ian. Ihe owner will have ��e 6urtlen o� pmving he/s�e Oitl nol build or impmve
lor I�e purpase o� sale�.
I. as owner of the pmperly, am exclusively conVac�ing with licensed conUac�ors to consimcl [he pmlect (Sec[ion 704A, Business
❑ antl Pmlessions Cotle'. The Contraciors' S�ale Litense Law aoes nol apply Io an awnef 0� propetly who builtls or impmves thereon
antl who conlracis lor such pmjec�s wilh a contmcloqs)license pursuan� to Ihe Contractors' S�aie License Law�.i am aware
ihat pmof of Iheir Worke(5 Compensalion in5urance ShoNE �e pmvided �o me.
� I am exemp� untler Section: B. 8 P. C.
br Ihis reasan:
Da�e: Owner
I tlo hereby cetlity Ihai 1 am aware o� ana untlerstana Ne requiremenls o� Cab�omia HeaVh and Salely Cotle Sec�ions 25505, 25533, an0
25534 and I�al I or any �uture �uiltling occu0anl willlwill not (circle one) need to compty with saitl 5�aie co0e5 antl �he requir¢ments for a
permi� for consimction ar motlification trom Ihe Pir Oualily Managemen� OiSUic�. Residenlial wns�mciion applicalions are eaempt �mm
ihese pravisions. �
�a�e'. Applicani'.
I hereby cerlilylhal I havereatl Ihis apPlica�ion antl slate Iha� I�e abo mf tionis correci lagree lo comply with all ciiy and counly
ortlinances antl slalelawsrelatingto building conslmclion and here�y- Ih r� pre5entaiives o�this citylo nteruponthe ahove�men�ione0
pmperly �or inspeclion purposes.
Oate: SgnaWre:
o�i�ers�aenseo�sociaiSewriiya� FOS207S8L
t64i�46 W�iie—Builtling�, Green—Cotle Eniorcemenl'. Canary—Applicant: Rnk—Revenue: Goltlenrad—Hssessor
CITY OF COSTA MESA — BUILDING PERMIT ,
PERMIT NO: B 049890 . PLAN CHECK NO: 06422-90 A , , .
CONST'RUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP
JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143
CI�AIM VALUE: 14,388.00 CALC—VALUE; 14,300.00 GROUP OCC; R-3 /
COMMENTS: BUILDING SETTLEMENT REPAIR/FOUNDATION •
�r*+�x*********��t***+�**��r*�r+���r��******�*�*��**�rx�**�t+r�r+��x��***x ��*�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
FRNT; FT MAIINHREARING --F------- --------- ACCESSORY BUILDING —=-------
T IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT - IN
PARItING REQ• PROV: PARCEL: 93506124 ZNE: R'l REF T30:
PLANNING Nt3'I'ES� REPAIR EXISTING FOUNDATION. HOLD FOR SPE.CIAL'REQUIREMEN75
iE 1E k iE if 3! �f iE �f if iF if 3E ik iF IF �E iF �E 4* 3f if 1E ikiE iE iE if M iF �1k k iE 4 ik iE iE 1E iE IE lf iElk iE 3E iF iE iF iE iE iE �E iE if 1E 4 iF 1f iE 1F iP iF iE * k iE ibik )f �F.iE 3E af aF 3f k 1f ik
D E V E L O P M E N T 5L E R V T C E S R E Q U I R E M& N T. 5
ZONING APPROVED BY l�D /� �? DATE: �-i O�°J a
BUILDING APPROVED BY : C�� tC, � P�� DATE: �
APPLICATION ISSUED HY: DATE:
IF 1F 1E fE iF if It N!F iE iF iF if Ih !E iFlE �k iF jf iF iF if if 1f jE iF aF iF 1F If if��7Fif �lE
1F1FfElkiflllFiklFifiEklfiElfifiElEiEiEfFfF�ElEltiFlfifikkiElElEiElPif IFifiEiflElfififlEiE�f1Elf�E�flflFiElkfflFlF�fjE3EiEiElFififk�FiP�EifiE�Eif�IfiFif�f
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL:SEGMENT;Y
BLDG PMT PLUMBING E CTRIC MECHANIC FIRE SMIP/RF..S GRADING
PERMIT 162.00 �
" SMIP/NON—RES
PLAN 26,33 2,15
ISSUE FEE
BUILDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 164,15 0,00 26.33 190.48 190.48 .00
REVENUE DIVISION TOTALS--> COLLECTED: 190,48 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE .SMIP,/TOT GRADING PLAN—CHECK
162.00 �. 2,15 26.33
jh k if fF iE ik if iE If if ik It k �E 1F IE �F iE a! iElf iF k i! !F!F iF k jE fF �! iF ik If �F 1f iF k!f IE IE 1f iF M iFlF 1E iE df if if iF 1P �F iF IE if 1f 1t it if iF �IF if IE iFif �f IF iE if if 1E iF k IF iFlE if
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
SFC 143 FOUNDATION HY VALUE PER $100 100.00 14,300.00
END OF FEES
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ry �a�r�: ii,�2��vn �:n�� rjs:c.�
CONSTRUCTION AND PLANNING • PO� . SPA
AP.PROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
�i. Temporary Electrical ServiCeor Pole,-; 52. Pooi & Equipment Location
2. Soil Pipe-Undrgrnd., ' � ^_� 53. Steel Reinforcement �
"3_�flectrical;Corid`uit Utility=Undrgmd,� - 54. Forms �
- 4:-Electrical GonduibUndrgmd. � 55. Electrical Bonding
:
'"�5: Steel Reinforcemeni �, 56. Rough Plumbing & Pressure Test "'
�S.^Electrical UFER Grnd. : �s 57. APPROVAL TO COVER�GUNITE -
'�-�. Footings''^ ��_ � 58. Electrical Conduit-Undrgrnd. �
�, 8. Eoundatiqn .i -_ " � 59. Gas Pipe, O Undrgmd., Test `
%%9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
;i:,�
1:0. Structural Floor System _ ,' 61. APPROVAL TO DECK .
11. Property Sewer_ Line & House Connection 62. Backwash & Receptor-Final
1�2. Sewer Cap , � 63. Heater & Vent-Final
13. Roof Drains�- - 64. Plumbing System - Final
14. Rough Plum[iing �' . 65. Electrical-Final
15. Rough Electrical-Conduit � 66. Solar System-Final
16. Rough Electri �Wiring - 67. Fencing & Access Approval
17. Raugh�Wiring $ign 68. APPROVED FOR P�ASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - ' - - tr l^r�i:..- - .. _ p�
20,�.Rough;Factory Fireplace m,�i <L � ' � � x� �'APPROVii'LS:�CPe�Ynit# "� �-
f i I'�r lt:e� .-'s., l: �^-,-. '� 2 '
2�'�;�UC�5�1`$t[uG[IIlB, � .. ';.� �• _ - y •` •'- _< r . m
s. = 70. ,Ondergiagnd Hyliro ,
22. Ducts, Ventilatin C�S ' c':! . c.
_ r. ;T 9' _ _ :r _ , 71. Product P.iping � Gas � Oil
�n
, : ' „_ �x. i: y �� . �. n '-�- ,
23. �Gas'Pipe. Rough & Test ' :n � , i: .r �--. , . � 72. Underground Flu{ti T t = .
24;'Roof Framing ^�� �--- '�� , i � ? � ':73? Undergrnd.Storage.Tank'OGas ❑Oil �
25. Roof Speathing �_ } � - , � �`' `� � �;; y ° ' 74 ,Overhead'Hydro�; �� ;
��
26aT�8ar Ceiling (Structural) �MonocoatC :i: _ � a 7g' Dry Chemical = _
27'�Frame and Flashin9 °L y , ;� .i T � „y � 76 'Dry'Stan�pipe :.y y S '� -
_ 28'' Lathing�•& Siding.'; ;. ��.rj�;: [;�c� . � ..7 :.� 77� FIXED SYSTEMcFINAL' .
i. -
`29. Insulation `�, ,�_�,'-• �•�•. ^;� i-`' � � r 78� FIRE PREV. FI�NAL ? r -
t;- `
� 30.,DrywaUCNaiting ^.-'J �� <� �, r � HEALTH DEPT.,REQUIREMENT
��
_, 31. Plaster��8ro�+tn CoaY .�. ;,�,.r. 'y ' r . 79� FINAL INSPECT ON - - a'
; 32-Electrical PowerlVleterFinal � �� _ ;� .I ._ � + t ; � BOr FOOD CERT FI�,fCATE ISSUED y
33''•Fi,n`al E.f@ctr.fc Q�T ' ' � - �'� •I � - " - Notes: - '' ' -
_ _ ` � i ef.'- i; n i 7i�'� x' :J ��,.
� 34: Fi�al Heatin`g &°Air G�onditiort; g ;-,; ��t "- � � � '�'� � ,,, j ^'' ,. „ -
i. -
35�FinalGa's Pipe-Te,st ,_�z .- ' ;-.e . : ( �^�h __.,:� • [' �1;'
s � t.L•rtf .�- t :� i
.36'.'HoQd o�CanoPY'��. _ ��' � ,_- a �_ ^ + _ - � - 9!
�
J37-Fin81 Factorv Fireplac�, ' �,;� _� ''� � ' Y.�, r c`
_ . .. _ 1, .. .. .L � - � �
- 38: Final Plumbing;' i� _ � �- � � 4� � :� �� ,..p
^ 39:�Water Service-Final � i � � ; ;r T : :� "+�:' - -
' 40[°Gas Service�inal � < _ 1 I ( ' � - `'� ' ���
i. •�'t j n'_ 1 r' z :� ' 7 ..
=4tcSolar pomestic-Firial-: •• _. I � r '. . � 1��
1 �� �r `-j¢'� .f :.' '.'7
42:'�Backflow Preventei - :� r3� R .l I ( �• �� - '•' � -� � '� �.
. ,., -
43. Backflow Ir¢igation �r,s-_- `�:=" ' '
: -
z.44. Landscape lirigation System;;�';r, � ~ _ a < < ` � .�?__ y _ ; `
; , - -
- 45_. Sound Attenuation - ^ [� • '^ � z � - -� f � � - - ' _ = •L + ��
- .,. :r _
`46' Handicap Regulations r; ;. "• " �'r ; ,„ _ . ,�,' " _ �
��47.�FINAL STRUCTURE & BUILDING� � , � �:-.. �� r
46: � - � � � .t . = n.
-.491-EI�ctric Release to�E ison � c- ' � � �1 - ��� � � �
� V � �{ � � 4• �� �
' 50, Gas Release to Southem Californ_ia Gas Co , I � (; ' ' ` "' ` ' - � �
� � . ri,: . . .
n ' i
= 51. CF�PTIFICATEOF OCCUPANCY � ; " ' � "' � . , ," ;,
- � � �r . t,� t'-. . i
No. Date
PR0.IECTADONE55: 3q4'� HOLLOW BROOK CI
owN�nsNnme: VILLAGE CAEEK Fi.O.A
aooeess: 3429 TIMBER LAKE
. COSTA MESA ,CA., 92626
553-1876
ABCHIENGINEEH:
AOOPE55:
flEG.NO.:
uxir: I CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 064527
PERMZT NO: B 064527 PLAN CHECK NO: N GOVT: N SUPP: N
uxiT:
PE"miT'EE: pETEASON ROOFING ( 714 ) 979-7111
ADONESS: 3006 ENTERPRISE
COSTA MESA CA 92628
LILENSEO LONTflPLTON OECLANATION: I hereby a��irm �ha� I am IicenSeA unAer provisions o� Chapter 9(commencinq wiih Seciion
7000� of Oivivon 3 0l tlie Business an0 Pmlessions Cotle. an0 my license is in full forco antl aifect.
citr uc.: 9 5 4 5 STqTE UC.: 6 O'� 8 7, LNS � 9
Da�e. Signa�ure fp
WOflN�OM��N OECLAflATION: I here�y a�lirm IOat I have a cerlilicaie consenl to seli-insure or a cenilicaie o� Workers'
Compen5aiion Insurance, or a cer�iliea copy Ihereol (Section 3800. Lab. C).
raucrNo.: 1021355-93 E%P.OATE: O9/OS/94
cornrnxv: STATE FUND
❑ Cem�i¢� wpy i5 �ere�y lumishetl. � CerlilieE copy i5 IileA wiih e tr�y AEm)�/p ivm o
Oare' �� AOO�icant �/ . �� � V
E%EMPTI FROM ONREPS'COMPENSRTION OECLABATION: (Thisseclion need no�becom IeOillhe permiiis�orone hun @ss�.
I ceriity thal in IAe pedormance o� Ne work lor whicA ��is permit is issuetl. I s�all not employ any person in any manner so a5 to Decome
su�led �o Ihe Workers' Compensalion LawS ol Calilomia.
Dale: Signa�ure:
NOTICE: If, alter making ihis Eeclaralion, you shoultl become sublect �o the Wo�kers' Compensalion pwvi5i0n5 0� tAe LaEor
CoOe. You must lotlhwilh comDly wi�� suc� pmvisians or this permii s�all �e OeemeA revokea.
CONSTBUC710N LENOING pGENCY: I here6y alfirm Inat inere is a constmction IenAinA aAency Ior Ihe performance ol �he work lor
which �his permil is issuetl �Section 3097, Civ. G�.
LENDEN:
FOUHESS:
CONSTRUCTION TYPE: V—N PERMIT TYPE; STR PURPOSE: OTFI
JOB DESCRIPTION : T/O RESAT & REROOF W/COMP. SAZNG SQ FT; 4,600
CLAIM 11ALUE: 9,600,00 CALC—VALUE: 4,600,00 GROUP OCC: R-1 /
COMMENTS: SMOKE DETECTORS REQ. ZNCLUDES 3445,3443,3441 HOLLOW BROOK CI
***�*�t********�r*�e*r�t�**�r****�t�t�ti�*�t******x��t***+�***r*+�***�**�+�*x�+��»x-*****�c***r�c*��-
2 O N I N GS ERTEH�AUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
FRNT; £T IN REAR: FT IN FANT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 93506117 2NE: AEF NO:
PLANNING Nt)TES>
�' �
iEk1liE�EfFififiEiElfikkiF,lFiEitifkiEltlfMififitiEkiE�E3E1ffE�EMM7fiEifitlkkkkiFiFifiFil�fiEffiEffif%iElEififlfifififff%ififiEiEiF1:M*i4fffFMiE
D E V E:L O P M E N T S E R V Z C E S R E Q U I R E M E N T S
ZONING APPROV�R BY DATE;
HUILDZNG APPROVED BY : DATE; �
APPLICATION ZSSUED BY: DATE: a 3
iEiEitiEiEitilitiElEiEifiElt�ltiEffifiEitikif jFiFififiEiEiElEiEif iFif
if ik iE if iE 1t it 1f it 1f 1f if 1E 1E if M if if if ik 1k ik 1f dtlt 1E 1ElE 1E jE 1ElE if 1f iE iF iE 1E iE i! 1f 1! 1f k iF iF it fE if 1E if !f if 1E fE fE �)E if if 1f 1t iF 1E 141f jE iF jf 1E iE 14 �)E iE ff 1f if iE if iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OWNFflBUIL0EB0ELUBATION: I�ereGyallirmt�a�lamevemD���omiheContratlors'S�aleLi[enSeLawlorlhelollowingreason BLDG PMT pL�7MBING ELECTRIC MECH�,NIC FIRE SMIP/RE$ GRP,I�INCi
(Section 7031.5 Busine5s an0 Protessional Cotle: Any ciry o� counry w�ich reQuires a permil �o con5lmci, alter, impmve, demolish, or p ERM I T % 2, Q �
re0air any Stmtlwe. prior �o i�i i55uance, also repuire5 I�e aOP�itan� Ior suc� permil ro lile a 5igneU Slalemeni Nai he/S�e is litens¢E , 5 �
pursuanl lo t�e Dmvisions ol l�e Conlratlors' Sla�e License Law (Chaprer 9 �commencing with Section 7000) ol0ivision 3 0l Ihe Busineu SM I P/ NON—RES
and Pmlessions Coae) or Ihal �e/s�e is exemD� Iherelrom antl ��e basis for �he allege0 exemp�ion. Any Wolalion o� $eclion 7031.5 by pLAN
any aO�Ocant lor a Oe�mit suble��s Ne applican� �o a cidl penally ot noi more ihan five huntlre0 tlollars (5500). 1 S SUE FEE
I, as owner ol me propeny o� rtry employees vnN wages as �Aeir mle compensa�ion, will Oo �ne work, ane me BUILDING—DIV—> PERMIT ISSUE PLAN—CHECI( Z'�TAL PAID DUE
❑ stmcwre is not intendetl or aflereC lo� sale (Section 70aa. Business ana Pmfessional CoOe: 7he Coniractors' State license �aw TOTAL 5---- > 7 2, 5 0 0, 0 0 0, � 0 7 2-, -5 0� % 2, 5 0 , 0 0
d0¢5 nol appty lo an owner ot a pmpetly wtq Duiltls or improves lhereon, and w�o Eoes Suth wotk Nmseli/hers¢Ii Or throUgh
�is or �¢r own ¢mpl0yee5. O�OviOea Ihai 5uth impmvemen�5 are nol intenEea or of�erea tor sale. I1. ipwevet Itre OUiltling or
im0�ovement is soltl vn�hin one year oi camD�etion, Ihe owner vnll have ihe GurEen ol O�oving he/s�e Aitl no� builtl ar improve RE V ET1TlE D Z V I S I �N T�TALS --> COLL ECTED : 7 2. 5 0 OV ER / SHORT : 0 0
m�meourpaseoisaiel. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner ot the property, am e�clusively contraming with IicenseU contracmrs lo conslmci IAe pmlecl (Seclion 70a4, Business 7 2. � � \ , 5 Q
❑ and Prolessions Cotle', The Coniractors' State License Law Uoes no� appry m an owner ol pmDeny wAo 6udUs or impmves theaon
antlw�oconlracl51or5uc�Drole��5wit�acontrac�or�s�licen5epur5uant�olheConVac�ors'SIaleLicenSeLaw�.lamaware *,N,�,*�,*„�*,�**,*�,**,M,*,k*!l�f,*ifif�,*i(,�f,1(,i(,!(,**,�*1f****if***iF*�f******{(.************{�{�*�.********�.
ihat pmol ol I�eir Worker'S Compensation insurance 5hoW4 be D�ovitletl to me.
� I am evemp� un0er Sec�ion: B. 8 P. C. I N D I V I D U A L F E E B R E A K D O W N
�ormisreason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Oa1e'. Owner'.
I do hereby cenily Ihai I am aware al antl untlers�ane me reQuiremems o� Califomia Healih and Sa�ety Cotle Seclions 25505, 25533, antl $ FR 4 6 0 0 REROOF B Y VALUE R ES ID ENT IAL NOZONE 1. � � Q�(� 0 �, Q �
25534 antl ��at I or any fWure building occu0am will/will noi �circle one) need m comply wi�� sai0 sla�e codes antl �he requiremenis for a END OF FEES
permit loi cons�mciion or modilication Imm Ihe Air �ualiry Managemeni OiSiricL Fesitlential conslmc�ion applicaiian5 are exemD� ��om
��ese pmvlsions.
�a�e: Applicani:
I here�y cetldy I�al I �ave rea� IhiS applicaiian antl slate��atihe abovein�orma�ion is correcL lagree lo comply wil� all [ity antl county
ordinances ana slate laws relaiing �o buildinp con5imcuon ane hereby aulhorite represenlalives o� �his ciry to enler upon Ihe above�mwtione0
propeny loi i speclio/nq pwposes,
oa�e: �O 74 //� Signa�ure: r` �"� �
r
/- Oriver's License ai So[ial Se[urily n:
16a1-a6 wnile—Builtling: Green—COda EnlorcemenL Canary—Applican�; Pink—Revenu¢ Goltlenrp�—Aues50r
SNiOKE uc � ��. � �� ,
w.�..... REQUIFiED �,.
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GAT�: :0/2C/93 7I11E: 14:00
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GC%JSTRUCTION AN6 PLANNING POOL & SPA
APPROVALS Permit # Date Inspector qppROVAIS Permic # Date inspector
t_
1. Temporary Electrical Service ar Poie 52. Pool & Equipment Location
2. Soil Pipe-Undrgmd. -• 53. Steel Reinforcement ' i
3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Sceel Reinforcemenc 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings . 58. Elec[rical Conduit•Undrgrnd. j
8. Foundation . � 59. Gas Pipe, O UnUrgrnd., Test .
9. Water Pipe�Undr9rnd. . 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Struciural Floor System . 61. APPROVAL TO DECK
1 i. Properry Sewer Line & HouseCo�nection 62. Backwash & Receptor-Final
12. Sewer Cap � 63. Heater & Vent�Final •
13. Roof Drains � l �� 64. Plumbing SYscem � F�nal
14. Ruugh Plumbin� ' 65. Eioctricel�Final
15. Rough Electricai-Conduit � 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17, Rough Wiring Siyn 68. APPftOVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS - Permit # I
21. Ducts,in Structure � �70, Underground Hydro
22. Ducts, Ventiiating� � 71. ProductPiping �Gas �70i1
23. Gas Pipe-Rough & Tast . 72. Underground Flush �
24. RoofFraming ' 73. Undergrnd.StorageTankOGas ❑Oil 1
25. Roof Sheathing �Q ZI�•�� (�w[T 74. Overhead Hydro �
26. T�Bar Ceiling (Structurall & Monocoa2 75. Dry Chemical �
27. Frame and Flashing , .. 76. Dry Standpipe .
28. Lathin9 & Siding . � 77. FIXED SYSTEM FINAL�
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIRENiENT �'
31. Plaster Brown Coat 79. FINAL INSPECTION I
32. Electrical Power Meter�Final . � -80. F000 CERTIFICATE ISSUED ';
33. Final Electric • . � Notes:
34. Final Heating & Air.Conditioning .
35. Final Gas Pipe•Test ' �
36. Hood or Canopy ' �
37. Final FactorY Firepiace . ' '
38. Final Plumbing � � ,
39. Wzter Service•final
40. Gas Service-Final
41. Solar pomettic-Final '
42. Backflow Preventar
43. Backflow Irrigation
44. �ndscape Irripation System .
45. Sound Attenuation •
46. Handicap Regulations ��
47. FINAL STRUCTURE & BUILDING 3 Z���� 6��/
48. FINAL PLANNING.
49. Ele.ctric Release to Edison �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER STATE—WIDE DEr
JOB ADDRESS 3b1i7 Ho1
GENERAL CONTR TOR Snmi
� AP No. _ _ +a�LOT
(� INSPECTIONS
SOiL
ry cns
WaTEN
1
� ROUGN PLUMBING
O PROP. SWR. LINE HOUSE CON.
}� SPFINNLING SYSTEM
�� MISCELLPNE005
` ROUGH HEATING ANO IR CON�ITIONING
�TEMPORARY SERVICE OR POLE
UNOERGROUNO � POWER �
ROUGH WIPING
�TRENCHES � FORMS � STEEL REINF.
FLOOR SYSTEM
BONO BEAM � STEEL REINFORCE �
SHEATHING
FRAME AND FLNSHING
LRTHING — IN �' OUT
PLASTER, BROWN COAT
$TRUCTURPL, FINAL
HEATING. VENT., REFRIG. RNU A.C., FINAL
PLUM9ING, FINAL FNO GAS TEST
ELECTRIC, FINAL
BUILOING. FIN4L
DATE
BUILDING PERMIT N0.
SUBCONTRACTOR
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COSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
BUII.DING
ADORESS
OWNER 5tate-wide Ve
;oopFss9461 Grindlay
CITV
LENDER
BRANCH
ADDRESS
AflCHITECT
coNTRAc,oRState-Wide Developers, Ihc.
ADORESS �j�jt
cirv CyF
STATE
LIC. NO. 22G
SIZE
OF LOT 1 Z
USE OF
EXISTING BIDG.
SIZE OF
NEW BLOG.
EJCiER10R WALI
COVEPING
USE OF BUILD
No '826-
CITY
LIC. NO.
NO. OF BLDGS.
NOW ON LOT
NO. OF
ROOMS STOF
��ter ROOF
COVERING ShakP
AND WOFK TO BE PERFORMED
I hereby acknowlatlge that I have raatl this appllcetion antl siate
thet the above information is correct e�tl agree to comply wlth
all lews �eBulaxing builtl�n8 �onnructlan, and I shell not employ
any Person I� viOlatia� of Me workman'a compensatlOn laws of
the Stato of Celifomie.
V
I hareby certi(y the[ I am properly licensed as e coniractaf under
the Stata ot California Businass antl Profeuionc Cotle, Dlvisien 3,
ChaPter 9, antl thax such licensas ere In iull forca antl affact, or I
am azampt irom Ma provkions of the Steta of Callfornla Businacs
antl P�ofessions Code, Division 3, Chaptar 9.
State-4Jide Develop s nc.
Sipneture
Permittea
AuthorizatlABent Vice President
't:�v 13-76��,-;`.'QO 639'= *�*765.68
APPLICATION FOR BUILDING PERMIT
:EIVEDBV DATERECEIVED D�I/�TE�ISS)UE
({� ��Jy I
BUILDING
ADDRESS
OF
L "^'1
VARDS
DISTANCE BET.
MAIN BLDGS.
VAR. #
C.U.P.�k � ',
USE OF NEW
BUILDING w
BET. MAIN
THE AMOUNTSHOWN UNDER VALUATION IS FOR
THE PURPd$E OF ESfABIISHING A PERMIT FEE ONLV:
VALUA.TION
y PERMIT FEE $ �
....+
S PLAN CHECK $ � S
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