HomeMy WebLinkAbout3240 IOWA ST - Building PermitsCITY OF COSTA MESA
` ��p MF q BUILDING DIV/SION
F�� 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.wsla-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754•5626 v a}� d
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PERMIT NUMBER: BX11-00115
PERMIT TYPE B MISC STATUS: ISSUED
APN: 13910210 DATE ISSUED: 04/27/2011
Zoning: , ISSUED BY: KJB
JOB ADDRESS: 3240'�OWA.ST.CM--�-----� SuitelUnit
Viciniry: ROOF TO�'�� Primary Occ. Const Type :??
SQ. FT: 200 Valuation: 59,800.00
SCOPE OF WORK:
INSTALLATION OF A 10 PANEL - 2.8 KW ROOF MOUNTED PHOTOVOLTAIC SOLAR SYSTEM W ITH MISC EL EQUIP,
DICONNECTS AND 1 INVERTER. UPGARDE PANEL UP TO 200AMP
OWNER: SPENCER, ROSE E TR Address:: 3240 IOWA ST Unit
Cily/State: COSTA MESA, CA Zip Code: 92626
Phone: 714-522-2908
APPLICANT: KIMMIE,JENIFER
City/State:
Phone: 800-794-1972
CONTRACTOR:
Address:
Ciry/State:
Zip Code:
�ARCHITECT:
Phone
ENGINEER:
Phone
SUNBELT SOLAR SYSTEMS
26881 PRAIRIE DOG LANE
MORENO VALLEY, CA
92555
FEE SUMMARY
Building Plan Check:
Building Permit:
Electrical Permit:
SMIP Residential
SMIP Commercial
Bldg Std Admin Fund
Address:
Zip Code:
License No. 530809
Phane 1-800-794-1972
at 17.81
$181.25
^y124.25
$0.98
$0.00
$1.00
License No.
License No.
Unit:
�! :1
, Unih
Cell:
�':ii'.
�.!^ .
Ui �i!:
TOTAL FEES $425.29
HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3M8/2010 - PER CMMC Sec. 13-279 �.
.� Montlay thru Friday - 7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and fhe tollowing Federal Holidays:
= New Years Day, Memorial Day, Independence Day Labor Day Thanksgiving Day and Chnstmas Day
_. .
:i
NOTICE: The work authonzed by this permil shall comply with all applicable handicap access requirements under Califomia statutes and related
re9ulations. (Ord. No. 92-28, § 1, 72-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order (or the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approvat must be obtained. Failure lo obtain inspections and fnal approval will result in the expiration of this permit.
O�FO ,� INSPECTIONME O�T IN7I71RL5 OOEO INSPELiIONTYPE DPTE INPTIPLS
1818 Fixed System Final Fire Prevention 206 Final MechaniCal �� �
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 270 Final Elecirical S—Z ���
201 Final BIocWRetaining Wall 272 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Sile '
�204 Final Demolition 250 Final Building/Occupancy ' ��'��-� '� •` ��' �-��; �� �
. _ . _ _ .. ,---_._.J
WORKERS' COMPENSATION DECLARATION:
I hereby aPorm under penalry ol perjury one of the (ollowing declaration5:
❑ I have and will maintain a certificate of consent to self-Insure tor workers'
compensation, as provided for by section 3700 of Ihe Labor Code, for the
peAormance of t�e work for which this permit is issuetl.
❑ I have and will maintain v.orkers' compensation insurance, as required by
section 3700 0l the Labor Coae, tor the pedortnance of the wurk for which this
permitJyi ued. My workers' wmpensation Insurance carrier and policy
n�er-are
arner. Fi �
( secfimn eOndOecwnpefe0d/ft�ece�/a�isvaNetlatonenurMreOdalars(5�00)arbss.)
P icy Nu r WLOO�Q•1'�i�"/7
❑ I certify that in the peAormance o! the work for which this permit is
issuetl, I shall not em loy y person in any manner so as to become subject
lo the workers' com ens t n laws of Califomia, and agree that if I shoultl
bewme subject to th ers' compensation provisions of Section 3700 of
lhe Labor Cotle, 1 sha fo 'th comply with lhese provisions.
, �Aa pli e
WARNING: FAIL E S�CURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACT S �ECLARATION:
I hereby affrm thal I am li en d under provisions of Chapter 9(commencing
with Section 7000) o( Div io o! the Business-and Protessions Cotle, antl
mv license is in tull force a d ct. /J
a (I�I/
h
a�
CONSTRUCTION LE IN ,CGENCY:
❑ I hereby affirtn t there is a constructbn lending agency for the
peAortnance of the work fu wfiich this permit is issued. (Sec. 3097, Gvil Code).
Lender's Name:
Lentler's Adtlress:
OWNER•BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury Ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5,
Business and Professions Cotle: Any city or county which requires a permit to
consWct, alter, improve. demolish, or repair any sWCNre, prior lo its
issuance, also requires lhe applicant for such permil to file a signed slatemenl
lhat he or she is licensetl pursuant ro the pmvisions of the Contractors
LicenSe Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) Or that he or she is exempt there(rom antl
the basis for the alleged exemption. Any violation of Section 7037.5 by any
applicant for a permit subjects the applicant ro a civil penalry of not more than
fve hundretl tlollars (8500).):
❑ I, as ovmer o( the properry, or my employees with vrages as their sole
compensation, WILL DO THE WORK, and lhe slructure is not intended or
offered for sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law dces not apply to an ovmer of proDerty who builds or improves
thereon, and who does such vrork himself or herself or through his or her own
employees, provitled that such improvements are not intended or offeretl for
sale. If, however. Ihe building or improvement is sold within one year of
completion, the ovmer-builder will have the burtlen of pmving that he or she
did not builtl or improve lor purpose of sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
IJCENSED CONTRACTORS to construct Ihe project (Sec. 7044. Business anC
Protessions Code: The contractors License Law dces not apply to an o.�ner of
pro0erty who builds or improves thereon, antl who contracts for such project with
a contracta(s) license pursuan� to Ihe Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
ienaWre
3057.6( ]�
Owner ID verifed by tlnve� � license. ❑ Yes ❑ No
Driver's License No. Expires:
Verification o! Owners�ip by (type of tlocument, i.e. - property tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
� I hereby certily thal no eacavation frve (5) or more feet in depth into wfiich a
person is required lo descentl, will be made in connection with work authorizetl
Dy this permit, and Ihat no building stmcWre, scaffdding, falsework, a demolition
or dismantling Ihereof, will be more �han Ihiriy-su (36) feet high. (Chap. 3.2, Grp
2, Ni 2, $CC. 341, 711�C 8, i�.3�I�Off113 AAf111f115IfdIIVC CO(iC�.
❑ As owner-builder, I will not employ anyone to tlo work which would
require a permit fmm the Division of Industnal Safery, as noted above, unless
such person has a permit to do such work (rom the division.
AOWiwnl's SignaWre
Division o( Intlustrial Safety Pertnit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will ihe applicant or present or (uture builtling occupant need to (ile antl
ceAity a Business Plan for emergency response to release or threatenetl
release ol a hazardous material7 ❑ Yes ❑ No
(Seclion 25505 0l the Califomia Health and Safery Code requires, with some
exceptions, lhat a Business Plan De filetl vrith the Costa Mesa Fire
Oepanment by every business whic� has al any one time dunng a reported
year a quantity ol hazardous materials equal to or greater than a weighl o!
500 pounOs, or a volume of 55 gallons, or 200 cubic leet o( compressetl gas
al standard temperaNre and pressure�.
2. Does or will Ihe applicanl or present or fuNre building occupant need to fle
a registration form (or acutely hazartlous materials? ❑ Yes � No
(Section 25533 of the Califomia Health antl Safety Code. wim some
excep�ions, requires registra�ion with the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantiry ot acu�ely
hazardous matenals equal ro or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
IemperaNre and pressure).
3. Does or vnll the applicant or present or fuNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program (or awtely
hazardous materials)7 ❑ Yes ❑ No
(Section 25534 0l the California Health and Salery Cotle provides that lhe
Costa Mesa Fire Department may require the preparalion, certification antl
filing vrith the Fire DepaAment o( an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Departmenl.
4. If an RMPP is presently required, has Sec�ion 25534 0l the Calilomia
Health and Salety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fWure building otcupant require (or
the work which i5 the 5uhjetl 01 thi5 application a permit for such consWction
or modifcation from Ihe SoWh Coasl Air Quality Management Districl or from
any O�her air pollution wntrol tlistrict or agency? ❑ Yes ❑ No
(Section 65850.2 0l lhe Califamia Govemment Cotle requires tha� Ihe requestetl
infortnation be (umi5hed on applications for non-resitlential buil0ing permits).
6. Will any part o! the facility to be Gonstructed under Ihis permil be vrithin
7000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes", the faciliry must meet the requirement of Sections 25534 antl 42303
of the Cali(omia Health and Safety Cotle�.
7. If a permit from the South Coast Air Qualiry Management District or olher
air polNtion control district or agency is required for the work which is the
subject of this application, have all of the Cisclosures prescnbed by Califomia
Health antl Salety Code Section 42303 �een matle? ❑ Yes ❑ No
8. Q!'yes", altach certificate of compliance from the appropriate air pollution
wnhol officer).
CERTIFICATE OF COMPLIANCE: I certify Ihat under penalty of perjury the
infortnation given above is correcL I agree to wmply with all slate laws and
city ordinances regarding Hazartlous Materials and Emissions.
Signature Oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certity under penalty of perjury that I have read this application and state that
the in/ormation given is covect. I agree to comply with all state laws and city
ortlinances relating o building construction, and authorize represematives o(
the Ciry o( Costa Mes to enter upon the above-described property for
inspection purpose I a�ee not to occupy or allow occupancy of any building
authorized by this p rmi ntil final inspection.
O..ner(s) Daie
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Aoa,w�, c �- ;(��'�._
eooAessaem�ma: 3240 IOWA ST °Ni'
neas7�weiva�oxr+: SPENCER, ROSE E TR FLOOD: AH-38
- ADDPESS 3 2 4 0 I OWA S T
COSTA MESA,CA 92626
aw�. wutaa �noxess:
u�cxrtecT ox wow�x:
PCH OXENO.'SIDORE54:
uc. xo:
UNT:
�+�T�� COAST TECH SERVICES (714)589-6592
CQlIN1CTORSYYNp 14 SANTA CATRINA
aooxess RANCHO SANTA MARG CA ucno.: 355425
92688 uM:
LICp15E0 CONTflACTONS DECL1flATI0N: I Mreb/ Nim uMr qrely W peijury iM I em IiameE wMar proviaons d Chapa 9
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' raeaon (`�an ]W 1.5 Buaimn erd Rdeasion5 Code: Mry ciy a ooun7 �� �Vuiree e perm! lo comWcl. Mer. impare.
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work 1« whM ��n prmn b iaueE. MY wvMn' mmpenembn iruurarcs mnr vd pMv.y numbm ers:
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e v/l nrws �p o on. MnerW thous�rd dWNn (siP0,000A M���.bn ro tln cwt or nmpwetron �i+� u qov/tlM ror In
S�ctlon J106 0l M� LaEor COJs, Infenat, end �ttomry i Iwi.
CONSTIiUC'f10N LENDINO RGENCY: I In�aby a1Rm� imder pwiMy M perNry t1W tAxs u e miaewbn kMvq prcy for tM
pMamerce d iM xak Irc whitli Ihe D�Y e eweE (Setlion �09J. Cw. CI.
LENDEF'4 NAME
LENDEfl'4 1DDPESS:
I ceNh �� I heva reed Ne epplcetion eM qete thel Ne ebove iNamelbn b wned. I apise b camply x�lh all dy md mumy pdinviue
eM ele�e kwf rt�mp lo Wikip conab Wian eM Mreby aNMrixe iepaventefrvaa d thie tiry lo enler upon IM ebo+a-menloneE popeM
����M'��'�"� DON DEANGELbS
(5151�I6.WP) Mllw%EuilEiq 8 Salety.
— Deta: �
Pmk-Re�enue: GddanmFAasma
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: M 079833
PERMIT NO: M 079833 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: OTH
JOH DESCRIPTION : INSTALL NEW FURNACE 6 A/C UNIT SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: X
�r�t�t�rx��+�+t*x�***�x �x �r*�**�x �**��r*x *x�*******�t�t�r+t***********�t�r****�+t*�***�**�r�r�t*�r�e**
Z O N I N G R E Q U I R E M E N T 5
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: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41211209 ZNE: REF NO:
PLANNING NOTES>
i
ff 1F iE 1E if 1f 1E IElE if iF iF �F iE iE �E 1E iE iE 1E 1E iE 1E IE IElE 1E iE 3E 3E �F iE �E 1E iE iElE �E if 1f 1f iE iE if iE if iE 1E iElE iE 7E if iE if 1E 1f iE fE �E 3E ik fE fE IE iE 1E iE 1f iF 1E * iF iE �E 3f fE 1E iE
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 BY .
BUILDING APPROVED BY :
DATE;
DATE:
APPLICATION ISSUED BY: DATE: �
lhitifi(�i(�1EifiE1(�iEifiFiFIFlklfiFiEfFiFif�F ;F;F��3EiEKiEiEiEiEiEiFiE IEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GME T:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 13.25
25R SMIP/NON-RES
PLAN
ISSUE FEE 22.00
BUILDING-DIV-> PEAMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 13.25 22.00 0.00 35.25 35.25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 35.25 OVER/SHORT: .00
BLDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
35.25
1t 7k iE Ik if 1F 1E 1E 1E if Ik iF 1F ik IF if 1F if !E if if iE ik if 1E 1E if if if iE iE if ik ik iF ik If if 1E iE iE if iF if iE if 1E iF 1F 1E 1f iE ik if 1F if iE iF if 1F iE it 1E 1E 1E 1E 1E 1E iE fE f! iE iE �E i! iE �E IE fE
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
MEC
1 INST FORC—AIR/GRAV FURN <= 100 K HTO
END OF FEES
EXPIRED '^I
DATE � I �� �" "
13.25 13.25
O1 00216583-00216SE3 T Q T 35.25
GATE: 10/08/9` TINE: 09:55
r CONSTRUCTION AND PLANNING � POOI. & SPA '`
.,
APPROVALS Permit # - Date I�spector APPROVALS Permit # ' Date Inspector
1. Temporary Electrica� Service or Po3e 52. Pool & Equipment Location, •
2. Soil Pipe-Undrgrntl. � 53. Steol Reinforcement • � �
3. Electrical Conduit Utiliry�Undrgr�d. 54. Forms .
4. Electrical Conduit�Undrgrnd. � 55. Electrical Bonding �; j�' �
5, Steel Re�nforcement 56. Rough Plumbing & P�essure'�est ��
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
. 7. Footings 58. Electrical Conduit-Undrgmd.
�6. Foundation 59. Gas Pipe, C7 Undrgrnd., Test
9. Water Pipe�Undrgrnd. • 6�. Backwash lines, P�Trap, Q Undrgrnd.
10. Struaural Floor SYstem ' 61. APPROVAL 70 DECK t � �
17. Property Sewer Line & House Corinection 62. Backwash & Receptor•Final �
12. Sewer Cap , 63. Heater & Vent�Final ��� �
13. Roof Drains 64. Plumbing SYstem - Final � �
14. Rough Plumbing � 65. ElectricabFinal .'�
15. Rough Electrical-Condui2 66. Solar System�Final � .
16. Rough Electric Wiring ., 67. Fenciny & Access ApProval " �
77. Rough Wiring Sign 68. APPROVED FOR PLASTEfi NG •
18. Rough Electrica6T Bar Ceilir,§ 69. POOLISPA SYSTEMS PINlSL �
19, flough Heating & Air Contliuoni�g PIRE DEPT, REQUIREMENT
20. Rough Fattory Fireplace - ; APPROVALS _ Permit #
21. Duc[s, in.Strutture . , 70. .Underground Hydrp
22. Ducts, Ventilating . � �� 71. Product Piping O�Gas ❑ Oil -'
.-ti
23. Gas Pipe•Rough & Test � � _ 72. Underqrou�d Flush �� 'S
24. Roof Praming " - . 73. Undergrnd.SrorageTank �Gas DOiI �-•
25. Roof Sheathing - � .�� 7q, Overhead Hydro �
26. T-Bar Ceiling (Strucwrai) & Monocoat � � 75. Dry Chemical
D. FrameandPlashing _ _ 76. DryStarjdpipe - � �J
28. Lathing & Siding � . _ •� 77. FIXED SYSTEM'FINAL �
29. �nsulation . 78. FIRE PflEV. FIMAL
30. Drywall Nailing � HEALTH DEPT. REQUtR.EMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80: FOOD C�ERTIFICFlTE ISSUED
33. Final Eleciric ' ' Notes: �
34. Final Heating & Air Conditioning -� �-, -
35. Final Gas Pipe�Test ' ' - ' ' -
36. Hood or Canopy , �
� 37. Fina! FactorV Fireplace �
38. Pinal Plumbing � �, . ._ � .
39. VJater Service-Finai �
40. Gas Service-Pinal _ , " _ -
41. Solar pomestic-Finai . ' �
42. Backflow Preve�ter ' .. . _ � _
43. Backflow Irrigation " _ •. „ , ,
44. Landscape frripation System . - �
.45. Sound Attenuation • - -_ � - - ; -
46. Handicap Regulations - � � . - _
47. FINAL STRUCTURE & BUILDING -
48. PINAL PLANNING �
49. Electric Release to Edison �
50. Gas Release to Sou[hem Ca�itornia Gas CD
51. CERTIFICATE Of OCCUPANCY �
No. Date
,wowessorauiwK+: __ ' __"" _'
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APPL. YAIpNO ADURE54:
ANCMRECTONENtlNFFA:
JICN.ON EN0:4,1DOflES4:
cartx�crarsx�we: R C I kuOFIt3G
CONIPACTORSYNfING 317 CAbkILLi� ST
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LICENSED COMNACTONS OECU1fl�TI0N: 1 Mreby eflim pmely i
(mmmeranp wi11�56cWn]0101d DNnion 3 d Na epp Pmlariom
tm uC. NO.: V b 7 b/ ll uc. c1A55: � y UC. No.:
uHT: ClIY UY LVS1A MESA — bUiLLING YtHMll
PEkMI? NO: d "v8�b"v5 YLi:N CiiE�K NG: N
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UNT:
i714)65G-1079
CA ��_ iu9352
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UNT:
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OWNEP BUILDEH DECL�FATION: I hxeby affirm daly� r panel�/W perjury in gceFiq Imm I n�redae Licenae Lew la iM
Idbx+q ienwn (Sadion )IXi1.5 Biu�eaa vd PMssslpa COEe: AM �+Y �rf.nd� �w!�� . v� .u�. en�. �mpow.
demoln�, or repei eny s1�uc1ure. pw to us ewence. ebolaa�� � ehye a iwE el nt Net he w ehe
n IicenxC Wmant io ihe Pm'reims d tM Caureuon licema law I�bqer 91m�unenin0 w'v� Seam '' 3 W �he
Busima eM Prdesimu Godal a thet he a ahe u exemq thaalrwn vM ine bam Iw the dbpea a`amqbn. MY violeiion�Mipp
]0'Jt.S by vry eppliunt la a parmil suEpae �he eppican to e dW penelly at na mae iM1en (He hunEreE EaAen �SSOOp.
❑ �.mow,e.wn»o�w�r«mr�Mweee��vnwapesmme:sdecomo��..i4dou»wk.enaursNinureeiwimmdee
a ollared la aeb (Sec�on )Oa4. Birsum eed PrMazsiona Cade: The Comreeas lioenee lewEoea M eVdY loen owmr ol poDeM
W�10 W�e M RTp10M=��1BIBOf1. Bfld Yiq d0l4 flM�l MOf�[ hYllfpd V �IMl� IX �11fW�1 �IB IX �M! PMI BTGbRA. C�A'�d ��W B11CM1
impro+aments era not inieMed or dleieE Im eab. tl, lpwe.er, iha Wltliip a inpwemmt ie edd wilhin ma year d canpbtion, tM
owrim-0uiker xiA heve tM EUNm d Cw+�9 he or aha EA nd dili a imP� la �M wTaa d eebl.
❑ L o o.n« a ine o�w�v..m ..�v ���.a�ro •,m, ccam,a mwadas ro canm�c m. wqsc �seao� �ou. a�.me...�e
Prateaane CaEa: The Coruredae t"r.enx law tlaee ml eppy io en oxns W pvpMy who Wiltla w'unpmrw Iherson aM wlw
mmrecb br aidi pqxt+ Mnh a ca+emMn) fieemaE P�%uem m tte Caaeartus lieeme lawl.
� I em exemq uMm Sedon: 8.8 P.C., la Nu reeaon:
Dele: �
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WOPKER'S COMPENS�TION DECLANATION: I hsrsby Nfinn ivqx pwully d psjvy ans W Ne Idbw'up Eeduetam:
� I heve ad xil manlen e emN4e d mruaN lo utl�imum la Mvken' m�peeuuian. n pwiAed tn Ey Swlim 3)W d IM leCor
�iCdl. �M 1�I! V01�0ITYICB O� I�M MOfk �IX W�IIL�1 I�1O id�� O 19Uld.
� � nere.ne xi� meimen.ax..� mmo�on ms,reen.. n npuved M swvi a)oo a u.l.nor em.. w �ne wNa� d in.
work Iw wliich Ihis pe�mu ie 6sued. My waken' compen�etion inwrentt wrier erd pdicy numEs ara:
c�..:
Pdiry Number:
/mi m,�..dmrmcanderoeewn«m•em�o rwneeou roolndm.l
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becpne wbjae io tM MwMn' oompe m lewe d Cefdarve, eM hn i I Nwk Eecmie wbjw lo �M worken'
cwnoeiuetion Swion a] d iM leb« Code. I elull lonhw xan iMm p�m�wro.
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W�m/np: F�Nvn ro ucun rortwi n�vwu�tlon cov�rp� l� dil WhN Iryw ro ulMml pxvltlu �n0
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S�etlon J106 al M� LeDor Cotle. Inf uM �tromsyl /�u
CONSTi1Uf.TUN LENMNO AGENCY: I hraby elfum unCn pmeAy d psjvy �hm thxa b e oom�rudion inp q�niry br IM
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LENDEP'S NANE:
LENOEF'S �ODPE59:
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LEGALIZA7IUN:N F E E S M M A R Y 57RUCTUhAL sEi;MEN1:Y
nLLG PMT PLiiMfiING ELfiCIRIC MECi-iAiJZC FINE SMIriRES GRIwIivG
PEkMIT 3�.uu .Su
SMlY %NVIV—t(t,J
PLaN
ISSIIE FEE
biJIL'uIT3G-LIv-> PEkiNIT ISSUE FLAN-CHECK iu7AL rAIL uUE
TuTALS----� 32.�� �.Gu "v."v"v 32.5"v 32.�� ."v"v
kEtiENUE LIliISIGN I'OTALS--> COLLECTEu: 32.5"v Oti�,kisHGR7: ."vG
bLLG FMT PiJMBING ELECTkIC MECHANIC FIkE SMIPiTG7 GRALING FLAN-CHECK
32.GG .5"v
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11-84-1997/82:28 RN/532.58
RCPTq:�i-001SG87
F'ERMITe0856h9
CONSTRUCTION AND Pl'ANNING POOL & S°A .
!tF'R(.iVALS Permit # Date Inspector qpPROVAL$ Permlt-�# Date Inspettor
„ 7. Temporary Electrical Service o�Po1e 52. Pool & Equipmcnt Location
2. Soil Pipe�Urldrgrnd. 53, Steei Reinfqrcement "
3. Electricai Conduit lRilitY�Undrgrnd. 54. Forms �
4.,Electrical Conduit�Undrgmd. - 55. Electrical 8onding '
5. Steel Reinforcemenc ' 56. Rough Plumbing & Pressure Test
6. Etecvical UFER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings -�' 58. Electrical Conduit�Undrgmd.
8. Foundation - . 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. � � 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Struciural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & 4ouse Connection 62. Backwash & ReceptorFinal .
72. Sewer Cap , ' 63.� Heater & Vent-Final �
13. Roof Orains . . fKi, Plumhing System � Final .
74. Rough Plumbing �� 65. Electrical�Final �
75. Rough Electriwl�Conduit � 66. Solar SYstem�Final � �
ti.
16. Rough Elearic Wiring. 67. Fencing & Access ApP�oval �
77. Rough Wiring Sign �� ' 68. APPROVED FOR PLAS7ERING ��
c
18. Rough Electrical•T Bar Ceilinq 69. POOL/SPA SYSTEMS FMAL
19. Rough Heating & Air Conditioning FIRE OEPT. REQUIREMENT
- - - • ' ! -
20.�Rough FactoFy �ireplace � - �� - "' _ qPPROVALS Permit # ` � ,�
21.=Ducts, in Structuro� • � � � � . 70.'Undergrbond Hydro '
22. _Ducts, Ventilatin9 � . 77. Product Piping L3Gas �OOiI
23. �,Gas Pipe,Rou9h & Tesc � . 72, Underground Flush . �
24. Roof Framing *- ' : - � Z3. Undergmd.Stora9e7ar�k OGas ❑Oil
25. Roo( Sheathing • �'�� �7 C(/!�� 7q..Overhead HydPo °
26. T-Bar Ceiling (Structuraq &�Monocoac � ' 7,5.'Dry Chemical . ' �
2�.. Frame and Flashin� - . N� 76. Dry Standpipe � � ~
28. l.athing& Siding �' _ ' "' 77. FIXED SYSTEh1 FINAL
29. Insulation ; " �� . �� , �. 7$. FIRE PREV. FINAL �
' 30. DrywalPNaifing � ' � ' � HEALTH DEPT.'REQUIqEMENT
31. Plaster Brown Coat� _ � � �, ,.. 79. FINAL�FNSPECTION _" �,
32. Electrical Po�.ver trleterF�nal ' � •' 80. FOOD CERTIFICATE ISSUED _
� .
33..Final Electric. � . � � � Nptes. .- �
34. Final Heating & Air Conditioning- I . � '
�' �
35.. Final Gas Pipe�Te"st' . •. � � .
36. Hood or Canopy � � � �� • • , . .
37. Final Factory Fireplace , � ' " � - ,
38. Final Piumbing r � '
39. Water Service�Final' � - . ' � ` , -
40. Gas Service-Final .. _ , ,i �
47. Solar pomesiio-F(nal ' ' � , - ' ; ,
42:"Backflow Preventer � � �. . � � -i
43. Backfiow Irrigation � � ' � .
, 44. Landscape Irrigatiao System , . � ' � . �
45. Sound Attenuation ' ' . . ' '' `
,46�.,,Handicap Rflgulati4ns . � • � �
47. PINAL STRUCIURE & BUILDING � I�l►�.�% �" -
48,:FINAL PLANNING � � �
49. Electric Release co'Edison �
,
50. Gas Release ro Souihem Califamia Gas Co � �
51, CERTIFICATE OP OCCUPANCY "' .
No. Date
� �CI" �E��
AP. No.
INSPECTIONS
OCCUPANCY
Form 210—SM-11-59 5•B P
LOT
Vermont Ave. Land Co., Inc
CT jb40 FIAE ZONE
DATE I GROUP �
SUBCONTRACTOR
DATE t
BUILDING PERMIT NO. 7
VALUE $ 7
RIPTION OF WORK Res.ro
TYPE V ZONE
PERMITS ISSU
DATE NUI
' t''" "7 / �' .
c7 �J �
Y 4a �4 l4 v
12�95
.; �. �� F E� RECEIV ED �
COSTA MESA BUILDING-SAFETY D6PARTMENT g� .i�r� 21 �96�
P. O. BOX 917 COBTA MEBM CALIFORNIA F�NANCE DEPT•
For A 17eanf fo Fill In Com lefel nF(; OSTA MESA
PP P Y APPLICATION � PERFvtIT
TYPE OR PRINT
BUILDING
ADDRESS 3240 zo�va St.
GOSTA MESh CALIFORNIA For Offite Use Only
FlECEIPT NO, w qGgyC(/ryQ�
C Inc. 1fVlJ�JaJ
OWNEf2 9e ont Avenue I.and o..
MAIL � L+• ��}}� S1 • ' ' RECEIVED BY I OAlE RECEIVED al ���A�E� ����
A�ORESS 19 L pll p
cin Costa �sa No:I,ygu BUILDING
ADDRESS
ARCHITEG7 Cyr],SOTI S: 7E�. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
AD�RESS GaT'den Grove FIRE K
ZONE TVPE GROUP
CONTRACTOR D�ke & COZB rove IIIC• APPROVED
BY DATE
AD�RE55 47-9 E. 17th St. ZONI�VG a�
Z NO.OF VBE OP NEW /
CITY C r S �� vuHe ��auao�no
STATE TEL. �, g_1159 LBOAL
uc. No. 16729 NO. DEBCRIPTION Lot 1 Tr. 6 8
s�zE / xo. oF a�oanone
OF LOT VO X ZOO NOW ON LOT p, p, NO.
U8E OF YARDS EVES
EXIBTING BLDG none APpROVED ALLOWED
86TBACK LINE PROM fCENT¢R LIN! 8T.1 /�
ceHTaa Ov smaai � REAR YARD � FRONT ` V T. IN.
SIDE YARD I LEFT S� I RIGHT S� R. SIDE J T. IN.
DESCRIPTION OF WORK
l. SIDE FT. IN.
NEW I X II ALTERATION I II ADDITION I REAR r FT. IN.
REPAIR I IIMOVING I IIDEMOLISH I ByPROVED /
OATE �
S=EDING 1 6O SQ�ftROOMS % STORIE6 1
EXTERIOR WALL ROOF p� p /
COVERING St.UCCO COVERING C��• &�`UC ,3 � �—
U6E OP BUILDING AND WORK TO BE PERFORMED � � �_
a
Sin le familv residence rrith
ttached ara e. Plan 20AR
I HEqEBY ACKNOWLEDPB TMAT 1 MAV6 p6A0 THIB MPLIGTION }XE AMOUNT BHOWN UNDEH VALUATION IB FOP TH!
AND BTATE THAT TH6 �OVE IB CORREGT AND AORlG TO COM- pUIiPOS¢ OP EBTABLISMING A PERMIi FEE ONLv.
PLY WITX ALL CITY OR�INANCEH ANG HTATB L�W9 PEOULATING
9UILDINo CONeTAUGTION. VALUATION /
81GNATURE OF� PERMIT FEE $ 30•
PERMITTE o
� $ I.6 �.0�.• PLAN CHECK $ ZH•
Dike & le rove '
AUTHORIZED AGENT g � InC � C I �
TOTAL FEE J�i• LL
OWNER MOHAN. GEORGE DATE 6-6-69
JOB ADDRESS �l�p I�a Street BUILDING PERMIT N0. �0391
!`CAICOAI !'/lA1TDA('Tl10 r___� �_ r�_�_i____i___ IICC!'OIDTI/lAI _[WIIOV ��l__i_�_ �__ t�___.__tt r�_�
SUBCONTRACTOR
GAS
W AT
HOUSE CON.
ROUGH HEATING AND AIR CON�ITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUNO � POWER �
ROUGH WIRING
TRENCHES FORMS � STEEL REINF.
FLOOR SVSTEM
BOND BEAM � STEEL REINFORCE �
SHEATHING
FRAME AND FLASHING
LATHING — IN � i
PLASTER,BROWN COAT
PLUMBING, FINAL AN� GAS TEST
ELECTRIC, FINAL /{��
BUILOING. FINA , U��e.+ N�--
�i
.: � 3039 I
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. eOX 1200 COSTA MESA. CALIFORNIA 92626
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ForApplicant to Fillin Completely APPLICATION FOR BUILDING PERMIT
y^ �� � RECEI ED BV DATE RECEIV DA�E ISS_UEO
ADDFESS J�`�� � � �J CO
/nq PE IT
OWNER (i �M CleO IL A.P. NO.I� /�/O Z�/�
MAIL ^ BUILOING 3 Zyo SG'v� �%T
ADORESS S/VNL� ADDRESS
CITY ,�. NOL ��)� �V TFACT��o LOT !3I BLOCK
CONSTRUCTION W P
LENDEF
BRANCH MO���
OWNER � �
A�DRESS /�
�/nJ�J�, VALUS / / ���
ARCHITECT TEL. US Pi � ��V7
OR ENGINEEF N
FIRE # �
ADDRESS ZONE TV E GL10UP
APPROVED / 6�
CONTRACTOR (/L S 0/VfTIzuCT�� BV ATEp� �
ADORESS O d� �P�� ZOn� NO.OF USE OF NEW
CITV S./�/• NO. 5� /�•7fJ.� F't PLANS Z BUILDING �'��-
UC.NO. �-�}�c(7'1C� CITY ��c VARDSAPPROVED VAROSAPPROVED
LIC. NO. J MAIN BUILDING ACCESSORY BUILDING
SIZE NO.OFBLOGS. (FROMC/LSTREET)
.�
OF lOT NOW ON LOT FROfYT FT. FT.
USE OF
EXISTING BLD�� FT FT.
$IZE OF NO. OF
NEWBLOG. AOOMS STORIES 1.51DE FT. FT.
EXTERIOR WALL ROOF
COVERING COVERING REAR FT. FT.
USE OF BVI4DING AND WORK TO BE PERFORMED DI5TANCE BET. BET. MAIN &
MAIN BLIX'�S. ACCESS. BLDCS.
VAF.M6 DATE
ONB P� � WRGII % ��O C.U.P.�{'+ APPROVED q
FB�C� J�+ F N i �, f APPROVED 6�6 —� (
I hereby ackPowledBe t�at I have roatl this application end state
tha[ tha aboVe IntOrmatiDn I5 cortect and eB/ee �o comply with
all laws regulB[(ng builtlinp cOnstruction, antl I shall not amploy
any parson in violation of tha workman's compansatian laws ot
the Sleta ot Californla.
I hereby carti�Y �hot I em pro0arly licenzetl es e connector untler SQ. FT.
the 5[nm of California Business antl ProtBzsions Cotle, DivisiGn 3, TNE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, antl [hat such I(canws ere In tull torca ontl eitect, or I THE PURPp$E OF ESTAHLISHING A PERMIT FEE ONLV:
am exempt trom Me provislons of tha State of Cellfornie Business VAIUATION
antl Professions Code, Division 3, Chapter 9, ur PERMIT FEE 5 �
Sip^ature of , �
Parm(ttee tl//%/�� S�� s PLAN CMECK § �
V/ !��
Authoriza ABent � �/
70TAL GEE $