HomeMy WebLinkAbout554 JOANN ST - Building PermitsN
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� CITY OF COSTA MESA
�5`""'E B!/ILDING DIVISION �
F4�� 77 FAIR DRIVE, COSTA MESA, CA 92626 • i714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
° ` FOR INSPECTIONS CALL: (714) 754-5626
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PERMIT NUMBER: 609-00293
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 42216309 DATE ISSUED: 11/30I2009
ISSUED BY: BJK
JOB AQDRESS: 554 JOANN ST CM
Vicinity: APT BLDG -
Squares: 2500
Suite/Unit:
Valuation: $5,870.00
SCOPE OF WORK: REROOF APT BLDG: 1 LAYER 15# FELT OVER 1 LAYER 20-YEAR COMP ROOF, APPLY 20-YEAR COMP
SHINGLES. 25 SaUARES PITCH 4:12 �
OWNER: HENDRICKSON, WARREN JAMES Address: 2637 CIRCLE DR - Unit:
PHONE: Ciry/State/Zip: NEWPORT BEACH, CA
APPLICANT: ARROSAGARAYS, MARTIN Address: 2508 BOWDOIN PL Unit
PHONE: 714-556-8867 City/State/Zip: COSTA MESA, CA
CONTRACTOR: MARTIN ARROSAGARAYS ALL SEASONS ROOFING License No. 622480
Address: 2508 BOWDOIN PLUnit: PHONE: 714-556•8867 �
City/State/2ip: COSTA MESA, CA 92626 CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
TOTALPEES
$0.00
$125.25
$0.00
$1.00
$126.25
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relatetl
regulations. (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 for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in lhe expiration of this permit.
COOEN. INSPECTIONTVPE DATE INiITIALS GOOEp INSPELTIONTYPE �47E INTTAL
1616 Fix�d System Final Fire Prevention 206 Final Mechanical
1266 Poql Spa Final b 208 Final Plumbing
200 Fin�l Re-Roo� �-p� C� 210 Final Elechical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Finel Factory Fire Place 220 Final Planning Approval
203 FinglSign 222 Final Sile
204 Fingl Oemolilion 250 Final Building/Occupancy
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WORKERS' COMPENSATION DECLARATION:
I hereby a�rm untler penalry of perjury one of the (ollowing declarations:
❑ I have and will mainlain a Certifitale o( Consent to 5el(-InsUre fOr worker5'
compensation, as provitletl for Dy section 3700 of ihe Labor Code, for the
p ormance of the wvrk for which this permit is issued.
I have and will maintain vmrkers' compensation insurance, as required by
s bn 3700 of the Labor Code, for the peAortnance of the work (or which this
pertnit is issued. My workers' compens���¢¢¢on Insurance carner antl policy
number are:�� � Y � �
`Cartier: 2 �
(This sedion nee0 irot �gmmpete0 dtne pe�vdluetl al one nu�Wretl tlaMars (S I00) orless )
PolicyNumbar: �OS73 a
❑ I certify Nat in the peAormance o! Ihe work lor which this permit is
issued, I shall not employ any person in any manner so as to become subject
ro Ihe workers' compensation laws ot California, and agree that if I should
bewme subject ro the vrorkers' compensation provisions of Section 3700 of
the Lab r C e, I sh 1 rthvrith comply with Ihese provisions.
a� �(-,� l Ci
Appiwnl's SipnaWre Date�
WAF2NING FAILURE TO SECUR KERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
(5100,000). IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy aKrtn that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in full force nd effect.
Lic>#. �� ��� Class #- � � �
/(-3D -
Camract sSignayWre , Dale`
CONS7RUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a construction lending agency for the
peAortnance of the work for wfiich this permit is issued (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
OW NER-BUILDER DECLARATIONS:
I hereby affrm that under penalty of perjury lhat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5,
Business antl Professions Code: Any ciry or counry which requires a permit to
constmct, alter, improve, demolish, or repair any struclure, prior Io its
issuance, also requires lhe applicant for such permit lo file a signed statement
that he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapler 9(commencing with Section 7000) of Division 3 of the
Business antl Professions Cotle) or that he or she is exempt therelrom and
the basis for the alleged exemption. Any violalion of Section 7031.5 by any
applicant for a permit subjects Ihe applicaN to a civil penally of not more than
fve hundred dollars (5500).):
❑ I, as ovmer of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not inlended or
offered for sale (Sec. 1044, Business and Professions Code: 7he Comractors
License Law does not apply to an owner of propeAy who builds or improves
thereon, and who does such vrork himself or herself or t�rough his or her ovm
employees, provitled that such improvements are not intended or offeretl for
sale. If, however, the building or improvement is sold within one year of
wmplelion, the ovmer-builder will have the burtlen of proving that he or she
did not build or improve for puryose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTR/1C70RS to construct the projea (Sec. 7044, Business and
Professbns Code: The contractas License Law dces not apply to an owner of
property who builtls or improves thereon, and who contracts (w such project with
a cont2ctor(s) license pursuant to Ihe CoNractors License Laws.).
❑ I am exempt under sec.
Business antl Professions Code for this reason:
3U5]�a6�3/Ol)
�
Owner ID verified by driver�se. ❑ Ves ❑ No
Driver's License No. Expires:
Verification of Ownership by (type of tlocument, i.e. - propeny tax bill or deed�:
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certdy that no excavation (rve (5) w mwe feet in depth into which a
person is required lo descend, will be made in connection with vrork authorized
by Ihis pertnit, and Ihat no building slrucNre, scaHdtling, falsework, ar tlemolition
or disman0ing thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2, Art 2, Sec. 347, T�le 8, Cali(omia Adminis[2tive Cotle�.
❑ As ovmer-builtler, I will n0t employ anyone to tlo work which would
require a permi� (rom the Division of Indusirial Safety, as noted above, unless
such person has a permit to do such work (rom the division.
Appliwm's SignaWre
Division of Industrial Sa(ety Permit Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant need to file and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Sa(ety Cotle requires, v+iN some
exceptions, that a Business Plan be filetl with the Cosla Mesa Fire
Department by every business which has at any one [ime during a reported
year a quantiry of hazardous matenals equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet o( compressed gas
at standard temperature antl pressure).
2. Does or vnll the applicant or present or fuWre builtling occupaN need to file
a registration (ortn for acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the Califomia Heal[h and Sa(ety Code, with some
exceptions, requires registration with Ihe Cosla Mesa Fire DepaAment by
each business which at any one time has on hand a quantily of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume o( 55 gallons, or 200 cubic feet of compressed gas al standard
temperature and pressure).
3. Does or vnll the applicant or present or fuWre building occupant need lo
prepare an RMPP (Risk Management and Prevention Pmgram for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Cali(ornia Health and Safery Cotle provides thal the
Costa Mesa Fire Department may require Ihe prepara[ion, certification and
filing with the Fire Departmen[ of an RMPP by businesses which are required
to register acutely hazardous materials with lhe Fire Departmenl.
4. If an RMPP is presently required, has Sec[ion 25534 of the Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or tuture huilding occupant require for
1he work which is the subject of this application a permit (or such construction
or modifcation from lhe SOu[h CoaS[ Air Quali�y Management DislriCt or ffom
any other air polN[ion control district or agency7 ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Cotle requires that the requestetl
in(ortnation be fumished on applications fv non-residential building pertnits).
6. Will any part o( the faciliry �o be constmcled under this permil be within
1000 (eet from [he wter boundaries of a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requiremenl of Sections 25534 and 42303
oi the Califomia Healtn and Satety Code).
7. If a permit fmm ihe Sou[h Coast Air Quality Management DisMcl or other
air pollution conlrol disMct or agency is required for the work vfiich is the
subject of this applica[ion, have all of the disclosures prescnbetl Dy Califomia
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Q( yes", attach ceAifcate ot compliance from the appropriate air pollulion
control oKcer�.
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is wveU. I agree to comply with all state laws and
city ordinances reqarding Hazartlous Materials and Emissions.
oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury that I have read this application and state that
the infortnation given is correct I agree to comply wilh all state laws and ciry
ordinances relating lo builtling consUuction, and authorize representatives o(
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not lo occupy or allow occupancy of any building
authorized by this permit un[il fnal inspection.
i-�q � Si wre of gal wneqs Da�e_ r�
��� .SCI
Antl/orAulMnzeOAppliwnl �Oat¢.>
City of Costa Mesa
Building Safety DepaAmenf
P. O. Box 317
Costa Mesa, Californio
CERTIF.bCATE OF OCCUPANCY N� 1820 C
The Building located at ��� �t"�'�D�! F�- C�
has been inspected and found to comply with the Provisions of all City of Costa Mesa Ordinances applicable ihereto
for a Group � & +T Occ�pancy.
Use of Building • ��' ��'�'�� �'� �' � � �
Legal Descripiion ' �ti ��f ���� ���
_ (Sea ravarse sida for Metas and Bounds) -
Building Permit No. � Elecirical Permit No.�cet"f�� Plumbing Permit No. �
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
required under Sec. 2308� U. B. C. . required under Sec. 3301 (1) U. B. C.
17050. CERTIFICATE OF OCCUPANCY. (a) No aparimeni house, hotel, or lodging house shall be used or occ�pied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of aparimenis or guest rooms
3) Ownership
If Group H Occupancy, n�mber of apartments and/or guesf rooms as required under Sec. 17050.1 (d), California
Administrative Code, TiTle 8, Chapter 9, Article 8.
Number of apartmenfs—� and/or guest
ISSUED TO� � �
'�`��S'i:i,Y�L"����3.'".�S:�i�S"� �.`i^"a.:��
Building Official
by�� UG�
� Date �� �. � s7�'� �
7his Certificate of Occupancy SHALL BE posfed in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Cosfa Mesa under Sec. 306 (e) U.B.C. Fo�,,, svaa—iax—ii-r�ss r
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�oa��a���: 554 JOANN ST
av�asnu+EiF�,ox++: MCBRIEN, SUZANNE TR
�. nooxeu: 1812 ANTIGUA CIR
NEWPORT HEACH,CA 92660
642-1276
�vn. �,uww �ooxesa
IAPCNRECT ON FN�IEEN:
IqCH OP ENQ'S 100PES4:
CONiHACTdI'SNiWE:
cartn�croxs �uwa
�noxess:
UNT:
uc. xo:
urrt:
ue xo.:
uar:
LICENSED COHfP�CfOR9 DECLAPATION: I Mnby Mim under perie�y W pee'ryry tlw I em IcawE uMm pwiwns M Cheqx B
(oommmieiq xiiA Ssctpn ]OW) d Dimon ] d tha Buviren eM PMoeiona Cada, ud my lioenw n in lull lam eM aMed.
cm uc. No.: uc. cuss: uc. No.: EXP :
Oela� Conimtlor.
OWNEP BUILDEN DECLAPITION: I hereby elfirtn uMer peneYy al per'ryry �IW I em e�emq Irom Ihe Con�mfan Lken�e Lew lor Me
�bw'vp rea.on (�ion ]0�1.5 &n'v�esa eiM Pmlewbne Coda: �m eMv v mumy wfiidi epulras a paimn io aonewn. el�x. impove.
nnWuh, or ropei ury �liudura, prior lo ila's+uariw, eleo repuim �he epd�� �a eucA paimN lo fib e epiwE eletemenl Ilul M a ehe
. IieemW Wnuenl lo IM pwroiom d iM ConVadwa lieeme lew ICheqx 9(eommee�aiq v.i�� Satlon ]UW) d Orvebn � W �ha
Bu�inep eM Prolenun� Cade� or Ihel M a ehe n exemq ihereham eM iM be�ia tw IM ellepeE eaemqion. My vblmion d Satlun
]03�.5 by enY +OOliranl lor e parmn eubpae IM epplcent b e mil paneXy of � mas �han t'va hundrad dollen I`�I)�
� I, ea ownar d Iha D�openy or my empbyeee wvM1 wepea as the'r wla mmpeneetion, xill do tha Mak, end iM elmcluro n rwl InlenEed
or dlerad la eele (Sec�m )Oad, Bueiroa eM Prd»siona Cotle: The Caniredon Licenae lew daae rwt epyy io en owrwd propeny
who Wida ar'vnprova iMreon. end who doee euch wk h'uneMl or henell or Nraph hu a her own employsu, prwided ihm wch
impiv+emams ua mt intenEeE a oHrea ta �ele. tl.lwwawr, iM WiHirp a inpnnromeM u wid wilhin an yw d owndnun. Q+
�owror-0uildm wJl hew IM burden d pwi�p M a ehe d'd ea driN a impws Iw �he purywa al We).
I, m ormer d iM pW�Y. em vd��'M' mNretl'rq w4h fonaed conVacYon to canqrW Ns pGb 15eeion ]W. &n'uwe eM
Pmlea'via Code: TM ConlmCm Licen» lew Aom nd eDWY b an owwW pui�Y rAn brikh a inwa'u iheraon ud Wa
eonirem la aMi V�M�+ wuh e arurepale) �amed Wnuem m �M Cauearine lieame lawl.
❑ I em eaemq urWr Seclion: ( ( �B. b P.C., M tM reeaon: L1\
Dda: `- J Owner: � ( LO .. i- O 1\i� C f-�+y`
I do MraAy cMity YW I am ewua tl enE w enwd Na rpummerm d CelloT�t Vleeth anE Seluy Cade Setliom 25505. 255U. ud
PS.SI�. eM Aw I a enY hnun Wid'uq omipen� wdl / wa m� (ack ar) roeE to comNY wiA uid mts mdr enC iM �Wuiremanb br
�W�IaowWCUonamoGfrdionhom�MAi�y �en�D'Mriu.ReeNauwlmut�udianeiP�iwsenaxanqtromtlme
aa;.�,..
Dtla: Aod�
WOPKEF'S COMPENSATION DECLAR�TION: I MreW elfiim urdx penMy W psrjury one d ths Idbxirp AeW�vion�:
❑ I luw enE wil meinten s pnilirate d mnwn� to vaXimun la xohen' compenWion. n povided /a by Sedian 9)00 d Ihs Labar
Cade. for iM prlamance ol iM vurk la wlich ihn peimn n iuued.
� 1 Ma ud r.il meiMen xaken' mmpenaeiion insurerce, m ep�'ved Ey SWian 3]00 d iM lnb« Cade, b iM pMamenn d Ihe
wwk Iw whirh this peimA b inued. MY wvken' oompenaetbn iraurelrw ranx W pdicy numM ara:
c�..:
PWiry Number:
(Thie aenion nesE nof bs compb�ed A �hs pimd ie bi one hundred ddlen (S100j o� bsaJ
� I cen'M �het in t�e perlormenca M Ihe work Iw which thia peimn le i»ued, I ehdl �w amploy enY Oe� �� NY menner o u lo
Wcane �uWw to tM xwbn' wmpeneetbn lewe d Celilomie. W epne Net il I�houk becwns wb�eq to ih� waMen'
o nvon wwi.a,. d smion a�oo a m. lab« cw.. �.w mnnwnn oomcH wun uww
Dva: �'' .S Mdcvn: �t �A�t_OJ� .
Wem/np: F�Nu ��cun woMx�'rompmutlon mvereps li un4wlul,� �mp/oy�r ro eNMnl p�n�/tlu �nC
c�vl� nr�u yi ro on. n1nerW Hausud do/l�n litP0.000A ����n ro M. cwt ol ro��tror4 am�pw o provlWE ror In
9�ctlon �]06 0l M� LaDor COW, Infwt, �ntl etromeya Isu.
CONSTRUCTION LENDINO RaENCV: I Mroby �rtn ueMer paneAy d prNrv �� IMn 4 a wuvuabn bnNip eperiey la iM
pMormura d iM wark Ip whirA ihe permY la ewW (Setlion 3081. Crv. C).
LENOEN'S NRME:
LENOEN'9 �DOFESS:
I eantly ihm I hew nW Nu eppfiemian W nete iM Ihs abwe iNametion a mrtetl.l apees to eampty �mh eA rny enE mumy adiwiu�
eM eWe 4xe ralmiq io buiMuq canmudion e�d Mraby aWwr¢e �ep�menietivae d tks eryto aNr upon ihe ebow-mantionod pope�ry
�����P��O�� SUZANNE MC BRIEN
CPnM �(`'-�y[
V.�-��7 �I...O �C�-. Deb: � . Il7
ruwro d O«ner/ApenV�ppYcanVCaru aea
(5151�6a.WP) W�ilsBuildvq 8 Se1My; �reen-Fb: Cenery-AppFceM; Pink-Ravenue:OddanmC-rbwuor
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 073923
PERMIT NO: B 073923 PLAN CHECK N0: 03401-95 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: REP
JOH DESCRIPTION : REPAIR 20 SQ FT LANDING AT STAIRS SQ FT: 250
CLAIM VALUE: 250.00 CALC—VALUE: 250.00 GROOP OCC: R-1 /M-1
COMMENTS: REMOVE AND AEPLACE SHEATHING/ APPLY DECK COATING
�t*it������*��+�**��*��x*�**��if***��**at*x�**�*ie**x��**�x**+�+�**�**�*��**iF+�*it*�*�atatet*
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 ---------
FANT; 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: 42216309 ZNE: REF NO:
PLANNING NOTES> �'+'' i"
� `i
1E if iE iE if iE !F iE iE jE IE �E IE iE 3E 9E 1F iE if 1f 1E 1F iE IE IE 1E �F iE �E iE fE iE iE Ib 1F 1ElE iE iE if 1f ik 1F 1F iE iE 1E �E 1E iE If fE 1E 1E 1E IE �E 9E iE 1E fE iE 3E iE fF if aE iE iF if if 1f 1f if if 1E 3k iF 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
ZONING APPROVED HY ��� DATE: `
BUILDING APPROVED HY� : DATE: �
APPLICATION ISSUED &Y: � DATE:
iEiEiE9EiE�E3EififiElE*ifiEiElElEiEi[�lf�iliE�F�F3F�F�i�F3F±FiF��FiF�F7F�F3FifiFiF7fiF7F�F�F�F 7F�F�F�FiEiEiE1EiE1FiFifiFlf 1EiE
LEGALIZATION:N F E E S U M M A R Y STRUCTUR L SEGMENT:Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 15.00
PLAN 9.75
I55UE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 15.50 0.00 9.75
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
15.00
FIRE SMIP/RES GRADING
.50
SMIP/NON—RES
TOTAL PAID DUE
25,25 25.25 .00
25.25 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
.50 9,75
iF if 1E iE IE �E 9E iE 9E iE iE 1E fE �E 9E iE iF iE if iE if iE iE �E 3E iE Ik iE iE iE �E 3E 3E if if if iF iF 1E 1E �E �E 1F iE IE k IE aE k�E iE jE IE 1F 1E iE iE fE iE IE �f iE 3E iE iE 1E �E iE iE iE iF iE iF 1E jf 3E 1E �E IE
I N D Z V I D U A L F E E B A E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 250 ALTER HY VALUE RESIDENTIAL NOZONE 1.00 250.00
END OF FEES
O1 QL15886b—Gt1£8966 T « Y "3,Z5
DRTF: QSl:3/9S TIfiE: 15�29
�+•pNSTRUCTION ANO PLANNING ' PO� s SPA
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ApPROVALS Permit # Date lnspector qppROVALS Permit # Date Inspector
1. 7emporary Electricai Service or Pole 52. Pool & Equipment Locat�on
2. $oii Pipe-Undrgrnd. 53. Steel Reinfo�teme�t
3. Electrical Conduit Utility•Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. 55. Electricai Bonding
5. Sceel Reinforcement : 56. Rough P�umbing & Pressur¢ Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Eloctrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Structural floor System 61. APPROVAL TO DECK '
11. Pfoperty Sewer Line & House Connection � 62. Backwash & Receptor-Final -
12. Sewer Cap 63. Heater & VenaFinal
13. Roof Orains � � C4, Plumbing System � Final �
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical•Conduit 66. Solar SYstem-Final �
i6. Rough EleMric Wiring G7. Fencing & Access Approvai �
77. Rough Wiring Sign 68. APPROVED FOR PIASTEPiNG
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINA�
19. Rough Heating & Air Conditioning FIRE_DEPT. REQUIREMENT
20. Rough Factory Fireplace , APPROVALS' - Permit #
27. Ductr, in Structure •- � 70. Underground Hydro
22. DuMs, Ventilating 71, Produet Piping OGaz u0il
23. Gas Pipe-Rough & Test . 72. Underground Ftush-�
24. Roof Framing _ � �- � . 73. Underg.nd.StoregeTankOGas ❑b+l
25. floof Sheathing 74, Overhead HYdro
26. T�Bar Ceiling (Structural) & Monocoat ' �� 75. Dry Chemical -
27. Frame and Flashing �J�Lr.(,j',f�,l� 76. Dry Standpipe
7
28. Lathing & Siding '�� , 77, FIXED SYSTEM FINAL • ,
29. Insulation . - � 7$. �IRE PREV. FINAI.
�� 30. D�'Ywa�l Nailing ' . � HEALTH DEPT. RE�UIREMENT
37. Plaster Brown Coat � � � 79. FINAL INSPECTION � �
32. Electrical Power MOier�Pina� � 80. FDOD CERTIFICATE 155UED
33. Final Electric � � � Notes: � �
34. Final� Heating & Air Conditioning � �� �
35. Final Gas Plpe•Test - � _ ' �
36. Hood or CanoPv ' . '
37. Final Factory Fireplace �
38. Final Ptumbing ' , . - '
39. Water Service-final , �
40. Gas Service-Finai ' " _ . -
41. SOlar pomeSticFinal . -
42. Backflow Preventer � "
r
43. 88ckfVow Irrigation
44. �andscape Irrigation Sysrem ' , � � � � .
45. Sou�d Atten�ation . . .
46. Handicap Regulations '
47. FINAL STRUCTURE & BUILDING ,_?n- �(,�/ � .-
�
48. FINALPLANNING �
49. Eiectric Release to Edison �
50. Gas Release to Southern California-Gas Co �' _ .'
. 5l. CERTIFICATE OF OCCUPANCY '-
No. Date
CITY OF COSTA MESA
BUILDING DIVISION
OWNER-BUILDER VERIFICATION
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such
notice, and, as a condition precedent to issuing a building permit, require the completion and require the
return of. an owner-builder verification.
Att9ntion Property Owner:
An 'owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and return this information in the envelope provided at your earliest opportunity
to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued
until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the pro-
posed property improvement. O Yes i�No
2. I(have/have not)'�� - signed an application for a building permit for the
proposed work.
3. I have contracted with the
Name —
(firm) to provide the proposed construction:
Address ' �'-kV5 ���.�.1 J� �'�1� City a`�^-� `� d
�— i�- � %
Phone ('(1'� ��" ��� �� Contractor's Lic. No.�_
4. I plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name _
Address
Phone (
City
Contractor's Lic. No. ,
5. I will provide some of the work but I have contracted (hired) the following persons to pro-
vide the work indicated:
Name Address
Phone
Type of Work
I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State
of California Health and Safety Code and have completed the above information to the best of my per-
sonal knowledgGe�, in compliance with thi�s State law.
Signed: `>� �-�— � � 1 )�.. , Date: � �
Name: �19�R-N A� E TUl C��. f E I�
- (Printed or Typed)
C.q.L. # or S.S. #
754-5273
,o�:�
�� Ra6�-�
COSTA MESA BUILDING-SAFETY DEPARTMEPIT
P.O. 90X 317 COBTA MEHA. CALIPORNIA
For Applicanf fo Fill In Completely
TYPE OR PRINT
BUILDIN6 r�— �+ �
ADDRE55 cJ�d .f/ J/_
COSTA MESA, CALIFORNIA
s �
STATE TEL
LIG. NO. Np.
SIZE �9 � / NO. OP BLDOp.
OF LOT / I��Z 7���0 Now ON LOT
'"�
USE OF
EFT ��� I R16HT
DESCRIPTION OF WORK
sii�eO1N6 3000� Rooms 11 sr aies 2
EXTERIOR WALL ROOF �J-J
COVERING StC• COVERINO/C 6 G
U9fi OF BUILDING AND WOflKTO BE PERFORMHD
I HEHEBY �CI(NOWL8D08 THAT � HAV6 HGO THIB AppLICATION
ANO 6TATE THAT TX6 ABO 8 I6 CORNECT AND AOREE TO COM-
PLY WITH wLL CITY OR I� B O BTATt LAW9 q80ULATINO
BUILDINO CON9THUCTI
BIGNATURB OF
PERMITTEa .
AUTHORIZED A6ENT
FEE�,RE�E��ED
APPLICATIO PERMIT
FINAN�6����.
.,- G CIT`�K�F�(!4�{WNtESA+�r
116CHIr1' NO. �IV
FIPE
ZONE TYF
APPROVBD �
BY C
zf
ZOI Q _ � NO. OR ^
�una L
L80AL �' � T ?/
OEeCR1I1'ION� l�l�i `
�
A. P. NO. '�
NOTE: NOEAVEOVERHA
90' TO SIDE @ REAR P. L
EAVES
ALLOWED
YARO9 MPROVED
MAIN BUILDIN6
f FROM GL ^STREET)
FRONT S `�FT.
R. BIDH L�1 Ff.
L.HIDE ��-`,FT. `��
REAR J C/ p7, �
DISTANCE BET.
MAIN BLDG3.
VAR. SC
owTe�BsuEo
%J/
/ �-.i
Z� 3/ �/
SHALL BE LE93 THAN
(U.B.C.REQUIREMENTI
YAROSAPPROVED
ACGESSORY BUIL�IN6
G--LI �� 13
Y � ��;�4. �.l'�%.b �2t�/S/.3 �
THH AMOUNT eHOWN UNOBR VA UATION I8 FOH THE �
PUHPO88 Op HBTABLI8HIN0 A PERMIT PEE ONLY. p
VALUATION / m
�/ �/ PERMITFEE $/�SSQ �
$ � J • �� PLAN CHECK $ �'� p