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Home My WebLink About3260 IDAHO LN - Building Permits(714) 754-5273 • Fex (714) 754-4856 Job Address: 3260 I DAHO LN Suite No Vicinity: Parcel Number: �3906622 Applicant: MONTANO, DAVID Address: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT MECHANICAL PERMIT Phone: Zip: owner: HERRING, JACK Address: 3260 IDAHO LN Phone: COSTA MESA,CA Zip: 92626 Contractor: GEORGE BRAZIL PLUMBING, HTG. Address: 3801 LENAWEE AV ArchlEng: Address: CUWER CITY. CA FAU CHANGE-OUT. ISSUE FEE Inst FAU <700 k BTU Inst FAU >700 k BTU Repair I Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >700 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace � Floor or Suspend Heater 522.00 $13.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 so.00 $0.00 $0.00 Quantity Phone: 310-253-5229 Zip: 90232 License: 679898 Phone: Zip: License: SCOPE OF PERMIT FEESUMMARY NUMBER M99-00159 T7 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04I08I7999 Issued: 04I08I1999 ISSUED BY: � Repair I Alt Absorbtion Unit Repair / Alt Refrigeretion Unit Ventillation System Evaporative Cooler Commercial I nci nerator Domeslic Incineretor Compressors / Absorption Systems Upto3hp/100kBTU 3 To 15 hp / 500 k BTU 15 Ta 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up l0 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantity 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 so.00 0 $0.00 0 so.00 0 $0.00 0 Sa.Oo $0.00 50.00 535.25 NOTICE: The work aulhorized by this pertnit shall compty with ell applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with ell epplicable codes, and all requlred Inepectiona end final epprovel must be obtained. Feilure to obtain inspections and final epprovel will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5628 � WORKERS'COMPENSATON DECLARAnON: I hereby elfirtn under penalry o1 per�ury one ot the Idlaving Aedaratbns: � ❑ I heve and will malntain a ceNfkate oi coaaem ro selt-Insure for warkers' compensaUon, es providetl Por 6y aectlon 3700 of the Lebor Catle, for the pertortnance of the work far which this pertnit is Iswetl. ❑ I have antl will mBNtein wwkers' CornpBrtsalbn inwrance. requiretl by sectiM 3700 of the labor Cotle. iw Ne pBAortnerce of �he work fw whiC11 Ws pertNt Lt isweA. My workers' compensation Insurence carrler end polcy n r ere: ce��e�: CLA�NDa,J N,tr�o,uac S�lf. ceMnc_�,,rye,/ pollcyNumoer. �lL%KDO/iYd.� (Th/s sectlon neetl nof be cnmplefed 1! fhe perm/t!s ve/ued 1 one hundred ddlars ($100) or Iess.J ❑ I certify thet In the peAa the work for hich Ihis pertnll is issuetl, I shell noI employ eny person In eny menner so es to become sub�ect lo the workers' compensation laws ol Iloml gree Iha I s�oul0 become subject to Ihe workers' compensetlon provislons ol Section 3700 al lhe LeDor Code, I shall torthwith comply wlth these pr sions. �/ p Qa ApplicantSlgnaNre: Delo: /'o —/7 V WARNINO: FAILURE TO ECURE WORI S' COM °NSATION ODVEMOE IS UNUWFUL AND SMALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIES ANO CML FlNES UP TOONE MIINORED TFKKISAND OOLLARE 100,ODO�, IN ADDfiION TO TNE C46T OF COMPENSATIIXJ, �AAIhGES AS PROVIDED FOR IN SECTION 3'lO60F TME IABOR COOE, IMEREST, ANO ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I em tOrGe Bnd BfleCt. LIC. k_ � CantractofsSipneWre: ot C�ap4 (commendnp with SectlonJD00) of Dlvislon 3 of Ihe Business enC Professlons Cotle, antl my Iicense is In full � C1095 N � Date: — — CONSTRUCTON LENDINO AGENCY: ❑ I �ereby eMirtn thet thora Is e consiruIXion lentling egenry tor the peAortnance ot the work tor whic� this permit is Issued. (Sec. 3097, CNiI Cotle). Lentlefs Neme: Lsntlef5 Atltlress: . _ SignaNre: OWNER•BUILDER DECLARATIONS: Date: I hereby ettirm Ihet under penalry ot peQury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (Sec. 7031.5, Business anC Professions Code: My ciry or county which reduires a pertnit to conswct, elter, imprwe, demolish, or repair any strucWre, pnor to its Issuance, elso requires the appliwnt tor such pertnit to file e signed stetement ihat he or she Is ficensed pursuem to the prwisions of Ihe Contractors License Lew (Chepter 9(commencing wlih Sectlan 7000j oi DMsion 3 of the Business and Protessions Cotle) or that �e or she Is exempt Nerefrom and ihe basis lor the allegetl exemptlon. Any Ndatlon of Sectlon 7031.5 Dy eny epplicent tw a permit sub�ecis the epplicent to e ciNl penalry ot not more then Me hundred ddlars (5500)J: ❑ I, as owner af the Oroperry• or my employees vrith wages as their sde compensa6on, WILL DO THE WORK, antl Ihe siructure I5 not IntenOed or ottered for sale (Sec. 7044, Business end Professions Cotle: The Cantrectore License Lew does not apply to an owner ot property who Dulltls or improves therean, antl who does such work himsetl or herselt or through his or her own employees, pmvided that such improvements era not intended or aHeretl for sale. If, however, the building or improvement is soltl within ona year of completion, the owner-bullder will heve Ihe burden oi proving that he or she dld not bulld or improve lar purpase oi sale.). ❑ I, es owner of t�e properry, am EXCWSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to construct t�e prqect (Sec. 7044, Business and Pmfessions Code: The contrectors Ucense Ww tloes nat appty ro an owner ol Oroperty who bulltls or improves Ihereon, end who contrects for such pro�ect with a con[racror(s) license pursuent to the Contrectors License Lews.). ❑ I em eaempt untler sec. Business end Professions Code lor this reeson: SignaNre: Date: Owner ID verllietl by dAver's license. ❑ Yes � No Drivefs License No. Expires: Verificatlon of Ownerehip by (rype ol document, i.e. - properry tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION: ❑ I �ereby cenity lhet no excavetion Ove (5) or more leet In depth Into whic� e person Is requlretl to tlescentl, wlll be matle In connectlon with work euthonzed by this permll, and lhai no bullding slrucWre, scafloltling, talsework, or demolitlon or dlsmentling thereot, wlll be more then thirty-91: (38) leet hlgh. (C�ap. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomia Administrative Code). ❑ As ownerbulltler, l will not employ enyone to tlo work which would requlre e pertnll tmm Ihe DlWslon of Industrlel Satery, es noted ebove, unless such person hes e permit to da such work from the division. Signeture: Deta: Dlvislon of Industriel Sefery Pertnit Numher: CERTFlCATE OF COMPIIANCE AND AUTHORVATON OF EMRY: I certity under penalry of per�ury that I heve reed this applicatlon and state Ihat t�e information given is correct. I egree ta compty � all siete laws entl dry orainances relating �o buil7ing construction, end authoAze represenlatNes ol t�e Clry ot Cosu Mesa to enter upon tha ebove-descrJ4�dVrope or insDectlon puryoses. I agree not to oaupy or ellow occupancy ol eny 6uiltling authorizad by Ihis parmlt untll final inspection. 1616 1268 200 201 202 203 INSVECTION TYPE Fi:ed System Flnel Fire Prevenilon Paal Spe Finol Finel Re-Rool Finel BIocWReteininB Well Finel Feciory Flre Plece Finel Sipn 204 Finel Demolilion rz�:eca GlIE II�IS CODE 1 INSPECTION TYPE 208 Finel Mechanicel 20B Finel Plumbing 210 Finel Electrical 212 Final Flre Preventlon 220 Finel Plennlnp Approvel 222 Finel SIIe 250 Finel BuildinyOccupenry QATE Iti�Li !{/9 �99 � �I � � ADORESSOiBVILqNG: 3Z6O IDAHO LN ONNEH4NWEIFqqWN: SPACINSKY, SARAfi AODNESS ELIZABETH TR 3260 IDAHO LN =OSTA MESA,CA 92626546-9808 �av�. wuuxc �oo�ss: NCNRECTONENtlNFFA: '�.1RCN.ON FNO.'S /i00NE55: uc. xo.: u"T CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 083006 PLAN CHECK NG: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU UNT: wNm.crarsru� NOCK PLUMBING ( 714 ) 895-1246 CONIflACT01Y5MNIAlO 11612 KNOTT ST �op� GARDEN GROVE CA �� 707775 9zgq1 uNr. 17 110EN5EU CONTNACTONS DECL�NATION: I Mnby eflim �Mx penely ot perjury tlet I em IcenseE uMar prwieions d Cheqs 9 (rommeMing vrilh Seciion ]000) d Diviaion 3 d iM1e Buaineee vM Pmleeeiona COCe, eM my lioenae ia in full lace enE eHect. cmuc.No.: �� 38 uc.cuss: C-36 uc/.N/o/'�� 07�5 EXP; 02/98 Dele: � Cmvauor. / � �� C - b OWNEfl BUILDEN DECIAXRTION: I hereby dfirtn urder penely d per'µy thei l em eump tmn iM Cantrwors Liunsa lew la the Idbwvq renson ISeaun )W 1.5 &ninea eM Rdessiona CoGe: A�Y �fi' n oounry MM1itli n0u"vee e P�M lo corebua. eller. imprare. iemoleh, or repei eny eVucwre, prbr lo As eeaenm, al+a requiree ihe epplicenllw each permM1 lolle a eipned etetement ihet M or ehe i lironsed W��I lo �M prm+wme d �M ConVepwa Liceme lew jCMpim 9(commmdip xil� $etlun ]000) d Orveian 3 d IM luwrea erM Prolembu Coda� a ihel M n aha ia exemq tharalium end the beaa la tln dbped exemqion. My vulmbn d Sedbn 10�t.5 by eny epd�� lor e permn aubpee Ihe applicanl to a crvil panely d mt more tlan tHe hwEred ddlen �5500�). � I, av owner dtha propeM «my empbyaes �h xapes m Ihei ede mmpeersmian, will do tlro work, uM IM evucture c� inteMeA w oNered la sele �Seciion ]061. Busna» end PrdasvmaCode: The CoMredae Licenae Lewdoea rw1 epply �oen oxnx ol propery who WiEa a mYP'es �Mreon, aM xfio doee cuch xak Hmull a hanell or Mraqh he or Mr own emWWees. pm'ided ihrA wrJi improvemenle are m� inimCatl a dlaed la eab. X, Irowever.IM EuildinB a�0�'emeM ie ealtl xithin aro yeerW oompinion, tM owner-buiMer will neve tM WMen d D�'+ina M or eha eia na buik « imo� Iw the Wmae d eeb). � I. m ovmer d iM O�M. � exdusively wnlredip wuh IicenaeJ convMwe lo oo�rW Na pqed (Seclion ]Oa4. Bueimss eM Prolembna COEe: TM Cmtrmarn L'r.enx Law daee � xpWy �o en ovmer d pmperlY ��e a imqovm ihareon eM who con�recls la sdi p9�� wil� a mmrmMe) 4cemed WnueN to �he Comreewn Liranse law). ❑ i,m ��m �oe<, sa.v�o�: e. a a c., ia m�..,,�: De�e: Owner: i ea ne.eer �N u� i.m e�.e,e a ene u�dm.�.�e me nw��n d cdrome �eenn.�d s,fen cme s.c�,. nws. zssa3..m 2553C. entl thm I a eny INure buildino �V� �II / will nM (dreb ane) naeE lo compFy wlh uiA etale catlm eM IM reyuiremanb Im aWrmalnmroinKtionamod'ifi�ionhaniheRr u�y eeava��Dimria.ReaidemWmimiueioneppFatbmwmemqfromiMaa pfP/IS0119. Dete: AVd�� WONKEP'4 CONPENS�TION OECLMATION: I Mreby effim� uMx penally d per'ryry ons d Ne Idlowi�p Eetleretions: � I heve vd wil memten e cenEi�ate d cwvent lo setlinwn br xvken' canpenution, n provideE ta by Saeun ])00 d tM lebar Code,larihe pe�ormence oliM xnrkiw wlvch Nia permilieiaued. ❑ i n..<�e me me�mev� wonen� mmw�.mun ��,reMe. e, nawne M seaim a�ao d me i.mr coee. ro, me w�«meMe a me R wak fa wM1icM1 Mie peimn is isvueE. My wnFa�e campanwion inwrence certier arM poliq numbar are: o�,,: r.�r.nFN Fnc;r.F EXPIRES Pol'cy Number: [LWC 3� 11 d 1 � 1 0 9/ 01 / 9 7 �rnr: seaim �..d �a n. comderee i ure w�e u ro, a�a n�r�e�.e ea� R+oo/ a�.� � I cendy Ne� in Ihe paAoimence d tM work br whkh ihie pe�mil o bsuad, I ehell iwl empby eny penm in eny manner w m to becoma wM� �o woMeis' wmG�ion lewa d CeNmw. erd rae � dwuM bacome w4a io IM wksa' compenaetpnqrovi W 5 wn 9]00 0l lhe Lebor Code. I ehell 1 comp�y w�lh aae qwisione. /_ on.: �� AGd'raM: � Wem/np: FaNun ro iecuro wonta�'rompanutlon rowrep� I� unkwlu( �nd�hall su�Ncf en employsr ro MMiul pn�ltlu �rM c/H/ 1/nu'q ro on� huntlrM MouauM oelNn (SfOq0001. ln Mdltlon ro the cwf ol mmy�rwtbn, Mm�pp Is proNCed br In 9xtlon ]]O6 0l Ms LeborCOW, Infere�( enJ ettomsy'c Isss. CONSTqUCIION LENMN� AOENCY: I ha�eby eifi'm unEer panelry M par'ryry �he� iMn e e mnniud'wn bMinO egency br tM pertormaMe d ihe xoM1 br whidi the pertni ia ewed (Seaion �09I. Cir. C�. LENDER'S NAME: LENUEF'S ADpPES4: I cenity thm I heve reaE Ihis epplcetion eM ne�e ihel ihe abova inlorme�ion ia correa. I piee io wmpN �� I dly enE couMy oMinencea eiM stele lewa reW iq �o buikvq conavutlbn end hereby autMr¢e rapreaemmivea d Ihb ary io anter upon �M ebwe�memuned qapeny fwinapeaion Wrposes. , Noc.x P��, �< G �l� p � De�e: �SiB�aWre d Ownx/ApenVAppliranVConvecmr (S151d6 WP) WhCe-Buildvq 6 Selery: areerFle; Genery-Appicenl: Pink-fievenue; (3oldenro�Aevevor JOB DESCRIPTION : DISAWASHER CAANGE OUT CLAZM VALUE: CALC—VALUE: PERM NO: P 083006 GOVT: N SUPP: N PURPOSE: OTH SQ FT; GROUP OCC; R-3 / COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT *x*+�***�**��rx****�r*�****�r�+r�*+r*+�****�***�*x�***xx�r�*+��r��**t��u�#�x**t�t��e**��e***�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 BUILDING --------- --------- ACCESSORY BUILDING -- ----- ERNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING RE • PROV; PARCEL: 13906622 ZNE; REB NO; PLANNING N�TES> i iE iE 1E if iE if iE 1E fF iF 1E iE 1E fE 1E 1F 1E 1E iF 1F iE 1F iE iF iE if if iF iE iElE 1F iE iE 1E 1E 1E iF iE if iElE iF 1k if 1E if 1f iF if if ik 1E iE 1E iE tE iF iE iE if fE iE 1E iE �IE iF iE k�E 1F 1F ik iE It 1F iE 1f !E 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 DATE; BUILDING APPROVED HY ; DATE: APPLICATION ISSUED BY: �� DATE: C� Z3� � aEit�tiEatiEitiEiEiFiEiEit�tititiEiEifiE*iE3F7FiFif7F3FifiF�FiF3FiFiF3FiF�F3fiF3F3fiF3F7 T �FiFiFiEitit��taEit*it�Eif iEit� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/RES GRADING PERMIT 8,75 258 SMIP/NON-RES PLAN ISSUE FEE 22.00 HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> B.75 22,00 0,00 30.75 30.75 ,00 � REVENUE DIVISION TOTALS--> COLLECTED: 30,75 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30,75 , k 1E �f iE iE iE 3E If 3E if 1E �F �E 3f iE iE if if if iE fE 1f �f �E iE if 3f if if iE iE fF IF if fE IE 1E 1E iElE if if iE 3F If 3E �f iF jE IE IE IE iFlE iE iE k 1Elf 1E iE 1E iF if iE 1E iE iE iF iE �E 1k 1f iF iE iE iE if if _ I N D I V I D U A L F E E H 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 PLU 1 DISHWASHER ��'��ED DATE_�� Iu�\'�-� I � rl '�� END OF FEES C:�L.". 8,75 e�-e�-i�y�iio:aa a;,isaa.�s fiCGTq:ai-��a�az� �'�ftl'�IT o 083�F76 � CONSTRUCTION AND PLANNING POO. 3PA - APPROVALS Permit # -Date Inspector qPPROVALS Permit # Date. . inspector i. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrqrnd. 53. Steel ReinforcemenT ' � 3. ElecVical Conduit Utiiity-Undrgmd. 54. Forms � 4. Electrical Conduit�Undrgrnd. ' 55. Electricai Bonding 5. Steel Reinforcement - � 56. Rough Plumqing & Pressure Test � 6. Electrical UFER Grnd. � 57. APP.ROVALTO COVER-GUNITE 7. Footings - - 58. Electrical Conduit�Undrgmd. 8. Foundation 59. Gas Pipe, C Undrgrnd., Test 9. Water Pipe-Undr9rnd. 60. 8ackwash Lines, P�7rap, O Undrgrnd. � � 10. Structurai Fioor System , 61. APPROVAL TO DECK � � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final , 12. Sewer Cap ' 63. Neater & Vent-Final � t3. Root Drains 64. Plumbing SYstem - Fina� � 14. Rough Plumbing ' 65. Electrical-Fina� _ 75. Rough ElectricabConduit 66. Solar System-Final - � 1 76. Rough ElectricW�ring 67. Fencing & Access Approval _ 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 18. Rough Electrica6T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning PiRE OEPT. REQUIREMENT 20. Rough Factory Fireplace . APPROVALS Permit # 21, Ducts, in Structure • 70. Under9round Hydro 22. Ducts, Ventilating� 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test .. � � 72, Underground Fl�sh 24. Roof Framing 73. Undergrnd. Storaye Tank � Gas ❑ Oii 25. Roof.Sheathing . � . 74. Overhead Hydro "� E 26. T-Bar Ceiling �Structural) & Monocoat ' 75. Dry Chemicai 27. Frame and Ffashing . . 76. Dry Standpipe 28. lathing & Siding . 77. FIXED SYSTEM FINAL " a 29. Insulation � 78. FIRE PREV. FINAI. - •._..�` 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Piaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Pinal 80. FOOD CERTIFICATE ISSUED 33. Fina! Electric . Notes: 34. Final Heating & Air Conditioning • 35. Finai Gas Pipe-Test �� `� � 36. Hood or Canopy - 37. Final Factory Fireplace 38. Finai Plumbing 39. Water Service-Final 40. Gas Service-Finai 41. Solar pomesticFinal � ' 42. Backflow Preventer 43. Backflow Irrigation - A4. Landscape Irrigation SYstem 45. Sound Attenuation _ , ' 46. Handicap Regulations � - , 47. FINAL STRUCTUf;E & BUILD�NG 48. FINAL PLANNING . 49. Electrie Re�ease to Edison 5Q. Gas Release to Southem Califomia Gas Cn 51. CERTIFICATE OF OCCUPANCY No. Date �� /. Appllcant to fill in all spaces except tnose within heavY �ortler lines antl sign a11 apprapriate tleclarationz. �F COSTA MESA CONSTRUCTION PERMIT ProjectAddress 3Z6o /Dfi-ifCS � L/1,A/� Applicant's Mailin9 Address ��%' � �T F'7�2M�/�il� �L Owner'sName -S'/a/z/.7-LI �' S%�/aG/NSKV �honeS��—�O& Address .�7 G C� � A 47�ci-O �—/�+'� � QP<'S7'.�-Mf'%t) Arch/Eng. License No. Address -- Contractor's Nam �"tSUM(�2 S c�ei-uV CF�' .� ahone 754�/S Address Imailingl �7450 $ MT �`-f(S4Rni r7n/�/ Ciry License No. �� 2 r�� IICEN5E0 CONTRFCT�R DECLARqT10N -. I hereby affirm that I am IicenSeA untler provislonz of Cnarler 9(commencin9 with section 7000) ot Divislon 3 ot the Business antl Professions COGe, a�tl my license is in full force antl effeci. 34 9 License Class '• � Llcense N 4Z4 Date S �� 519nature � � WORKERS' COMPENSATION C RATION �' � ' hereby ai(irm lhat I have a cer itiy te ot consent to selbins re or a ceriificate Workers' Compensation Ins�Vbnce, or a cer[ifietl copy [hareof (Section .00, �ab. CJ " Palicy No. — Company � � eCerlifiCtl Copy is hereby fumishetl. t Certitiatl copy is tiletl with the ��LY Builtling Olvision: �ate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissectian neetl not Oe completCtl if [ne permi[ is for one huntlretl ($300) or less). — , I certity that in the Oe�fo�mance of tM1e wo�k for which this p¢r ' is issued, I shall not employ any pe�son In any ma a� so a5 t ecom bje�[t to [he Work¢rs' e 5 I.awS of Califor �� ate �Y��Sig�atU�e NOTICE: t, aft r makin9 this tlet�ar � n, you shoultl become �ect to the Workers' Compensation provisioe� of the LdbOr Cotle, you u forthwith comply wilh Such `provi5ions / is Oermit shall b! tlG¢ tl revoketl. CONSTRUCTION LENDING G CV I hereby affirm that there is a con ruction lentlin9 agency tor the pertormance of the work ror wblch thiz Permit is issuetl (Section 3097 Giv. G.) �entler's Name � � Lentler's Atltlress OWNER BVILOEN �ECLARATION I he by aftirm that I am exemp� from the Contractor's License L.aw for the follo 'n9 reason (Se<tion ]031.5 Business antl Professional Cotle: Any city or munt hich requiros a pe�mit to construct, aller, imprave, tlemOlish or �ePai� any st�u ure, prior to its issuanGe, also r¢quires Ihe applican[ fo� such pe�Tit to til¢ a si etl statemenl that hC/she is lictnsetl pu�suanl to the provi5ion5 ot the Contrac r's Li<enSC law (Chapter 9(commencing wilh SeC[ion 7000) of Oivisidn 3 o he Business antl Professions Cotle) or that he/ihe is exemp[ erefrom antl e basis for the allegetl exemplion. Any violation of Section l31.5 by any plicant for 0 permi[ subjec[s the applicant to a dvil �enalty of not mor han five huhtl�etl tlolla�s (b500). I, as owner of th prop¢rty Y em oyees with waqes as thei� sole comoensation, will tlo t work, �he utture is not Intentletl or ofteretl for sal¢ (Section ]044, siness an rotesslonal Cotle: The Contractor's License Law tloes not apply atl o e a properry wno bulltls or improves thereon, antl wM10 tlo¢z such � hi he�self or th�ough hi5 or h¢r o`N� employees, p�ovitletl tha[ such I rovemmib are not intontlatl or offeretl to� sale. It, however, [he bulltling or � rovement Is soltl within one yea� of cOm- pletlon, the owner will have the bur ot proving he/she tlitl not builtl or im- prov! fo� lhe purpose of sale). ❑ I, as owner of the property, am exclu ' ely Contracting with Ilcensetl con- tractors to consiruct the project (Section 70 Business and Professions Cotle: The ConVactor's License Law does mt dppl o an owner of Oroperty who builtlz or imD�oves thereon, antl who contracts r sucn projecfs with a con- Vactor(s) ucense pursuant to the Contracior's �ice e Law). I am aware thaf proof o( Neir Worker4 Compeqsation insuranGe sh Itl be provitletl to me. ❑ I am azempt untler Section B. . C. Por this reasan �ate — I hereby certi informatlon Is antl state laws sentatives oi inspectlon pur� Signaturc Drivar5' Lic s CMF 0065�46, r v_ Owner — have read tM1is a to r�33vys i i i �.� TYPE OFCONSTRUCTION NEW %�DD ALTERpqTION U REPA�R ❑ CONVERSION ❑ OEMOLISH O OTHER NFW "��F DESCRIPTION OF WO,RK/USE OF BLOG. „� TVPE OFPERMIT LJ GRAEING LJ FOUNDATION L1K��RUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PRQIECTDESCRIPTION Sa.FT.�oCCVaArv.�Cpy�.,� CONSTRVCTIONTVPE � VALUATION$� ZONE GRADINGCU.VDS. ACRES_ Remarks: Drinking Fountains Rnur �rain: Floor Sinks Gas Service Outleis Interceptors Kitchen Sink Lavatories P—Trap Foof Drains Reinspection Fee Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Water et Warer Heater Water Serv'ice Auto-Wasli� Laundry Trays :�. $75 laue Fee Bailer Duct-UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/FacL Blt. ICBO # Heating System & Ducting ❑ ai ao,000 sTu O i oo,000 � �-�—�'— I I Reinspection Fee I $15 55 # 34 White - Builtling� anary - Applicant: Pink - Accoun[in9; Goltlenrotl - Assessor Hood or Type I ❑ Canopy Type I I ❑ Fefrigeration Sys[em ❑o-ioo,oaoeTu �ioo,000 System Repair/Alteration Fire Dampers Registers Isue Fee A.P. $`- S Main Building: E T Front A Rear C R�9ht K Left S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole �pokiny Unit 0336 5/II/O�I 2one Accessory Buildin9: Parking Req./Provided ETLECTRICAL I I Trans(ormer ❑ 15-50 KW 1.J ❑ 50+KW Dryers as LJElecvic Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generator �65 KW �5�15 KW Meter ❑up to 100 amps Meter ❑over100amps Su6 Panel Motors DO-7 HP O7'F, - 8 1naSolar �9-15 HP �16 Microwave Pole Light Range Sign $tanding Sections Tr c�h Compactor $ 3 I �- Reinspection Fee $15 luue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By ' Building Approvad By Application luued Bv $ 3 SUMMARV OF FEI BUILDING PERMIT $ �GI C7G PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% S MECHANICAL 3 PLAN CHECK ZS% $ —� 5ao�a r�� Z O N I N G R E Q M T S FEES $ 3 SMIP $ .�� PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTALFEE $ S�%•'� �CONSTRUCTION AND; PLANNING POOL & SPA APPROVALS �Permit# Date Inspector AppROVALS Permit# Date Inspector / r,) 1i :Temporary Elettrical-Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � Y 53. Steel Reintorcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel ReinforcemenY�- 56. Rough Plumbing & Pressure Test 6. ElectricalUFERGrrid.� 57. APPROVALTOCOVER-GUNITE 7. Footings . .-�� - 58. Electrical Conduit-Undrgrnd. 8. Foundation i ,�• � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Unciigrnii�,% 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System ' �' 61. APPROVAL TO DECK � i i. 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 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I'•. 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 OGas ❑Oil '�'� 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing �8 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro I/ 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 �'� 1 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �� 31. Plaster Brown Coat 79. FINAL INSPECTION � � 32. Electrical Power Meter=Final 80. FOOD CERTIFICATE ISSUED �; Y 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 " " ' � ' � � , . 39.' Water Service-Final ` � Il � _ 40. Gas Service-Final � • �„ , 41i. Solar pomes[ic,-Final �. . i.; . `''v i 42. Backflow Prevenier '� - i. ' 43i Backflow Irrigation �� ,i� ' ° . ' ' �� ' � 44. Landscape Irrigation System ��' ��, , ' . " � ' � � �45�Sound Attenuation . ' ' , � I ' - '46. Handicap Regulations • ' '- 47: FWALSTRUCTURE&BUILDING 3 � ' " ' ' , '48. Special Requirements Completed y' ' � �49. Electric Release to Edison '- : � � "� i 50. Gas Release to Southern California Gas Co '1 , 51. CERTIFICATE OF OCCUPANCY No. ' Date OWNER SPACINSKY John JOB ADDRESS 32 0 Id&h0 GENERAL CONTRACTOR C� nP rro. i39-o66-02 LOT INSPECTIONS OCCUPANCY '(ICIA RIIA . LM _ TRACT FIRE 7.ONE � Signature� DATE GROUP� DnTE 9-7-62 NO. VALUE $ �S�•�-- DESCRIPTION OF WORK ( TYP� III�� ZONE SUBCONTRACTOR ` : � 17764 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX S17 COBTA MEBA. CA4IFORNIA For Applieant to Fill In Complefely TYPE OR PRINT BUILDING +2 � O ADDRE68 .� COSTA MESA. CALIFORNIA F— �� . c�. 1 —_ NO. __, i � SIZE I NO. OF 0LD09. OF L07 xow oN LOT 1 FEE RECEIV�D SEP 71�2 F�NaNCE OEPT. o �/`� CITY OF COSTA MESA APPLICATION FOR PERMIT � BUILDING For Office Use Only HHCHIPT NO. plBl REC V6O OY � OATE RECEIVEp DAi G � BUILDING 3� � a ADDRE66 � � G COSTA MESA. CALIFORNIA /� LEOAL ZONING INO. OF I U9E OF NEW nih PLANB z BUILDIN6 ➢ �'!-3 � TQ 3 7 z z /3% -O � � - O Z USE OF -�- YARDS EVES EXISTING BLDG. � APPftOVED SETBACK LINB FNOM <CENTBR IINE 8T.) DESCRIPTION OF WORK EXTERIOR W2LL �ROOF COVERING i–it%�4ERT� U8E OF BUILDING AND WORK TO BE �: o �^—�--- I HERBBY /�CNNOWL8��8 THAT I HAVE RE AND BTAT¢ THAT TN BOV IB COPR¢CT PLY WRH ALL CITY O IN CE9 ANp 8iA BUILOINO CONBTRU SIGNATURE OF r9 1 O ., i. � � APPROVED ,� " X G o' x lo' C�e-�vN.c�, ,�?�� (�O' X G � P�-s.�n.� _ TX6 AMOUNT BHOWN UNDEq VALUATION 19 POR THH PUPPOB¢ OP EBT.�BLI6N�NG A PEqMIT iEE ONLY. VALUATION � PERMIT FEE $ G� 5 � �Q � PLAN GHECK $ � ' AUTHORIZED AGENT � , r I TOTqL FEE 3 �/ GT/ I O Lo 3� Tr : '2 1,`Z�j�7[$ • '; +COSTA MESA BUILDING-SAFETY DEPARiMENT p, p. BOX 917 C06iA MHBA. CALIFORNIA- Fo� Applicanf to Fill In Complefely TYPE OR PRINT BUIL�ING 3260 Idaho Lane ADDRE58 COSTA �MESA. CALIFORNIA TEI. TEL. NO. TEL. NO: OR BlD6p. O BBTBAGK LINi �OM cSMea or eTnEei � REAR YARO � SIDE YARD I LEFT S� I R16Hi S* � pESCRIPTION OF WORK _ BUILDING -l�� NO. OF SIZE ROOMS STORIES EXTERIORWA�L IROOF WOOd ShiriglE' COVERING COVERING USE OF BUILDINC AND WORK TO�BE.FERFORMED 5in le F and Attached Garage Plan 1-B 1 HEREBY ACKNOWLED6¢ THAT 1 MAVB pBAD THIB APPLIGTION •ND 9TATE TMAT TME ABWe IB CORRlCT ANO AGR¢E TO GOM- PLY WITH A�-�- CITY OIiDINANCE9 AND BTATH lAWB REGULATING BUIlD�NO CONBTtUGR�ON. /� A IZEP AGENT FIRE ZONE APPRi BV ZONE � LEOAL APPROVED FEE RECEIVED p �-. �� a —� � fiNANC� �EpT.¢p APPLt��Tf�SN C�� IG11T BUILDfNG For Office Use Only IiECE�PT NO. PCRNIT NO. °" I io =i�°h e COSTA MESA. CALIFORNIA ZONING NO.OF U6E OF ! PUNB n BUILDINO 6T. ) n�e AMOUM SHOWN UNDER VALUATION 19 FOR TH! PUISOBE OF EBTABLIBX�NG A PERM�T PHE ONLY. $ /Y// IL •�O