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Home My WebLink About630 JOANN ST - Building Permits{ ��p�� 630 JOANN ST �' ��'��F� LYNN, KEVIN ` �� LYNN JANET GUTHERIE i 630 `JOANN ST ux.Yu�wc,,00�s� COSTA MESA,CA 92626 ua�rtccT on Eiam�n: ue xo, uxx. an aae woxFss: mn: CONf"�CT0�8N�'� SHARP ROOFING (719)771-2225 `�"""C0""'""�'0 20062 FRANK ST "0°'�� ORANGE CA °GND'` 571575 92669 ""'' UCENSEO COMPKfOHS DECL�fl�TON: I I�maby � ivNx pe�Wy d I pa'v'vu cf Gheps p �mmmwsu .nn saaim ]aaol d oi.eun � d ms euamo ena Prtea ' u' rorc..ne artw. cmuc.No.: 66 uc.cuss: C-39 N P: 02/97 om.: �z�i�� .,a OWNER BUI�OEP DECIAR�AON: I Fseby elfirm ivMs pixly pajury tM I nn uemq hpn iM CapMan liowa l�w� la tla Idbwiq tmson (Setlbn ]W 1.5 &niwa� vd Prdeeuone Coda: �M' ciY a munh wAid� nV��w s V„�� o canbu[I. Nx. Ynpo.a. smd'sh. a rpw mry at�uUura. piw m n e�uenm. eho �pwm tM eppimq la ach penN to fiN e yyrd qtl�wq CW M w Nr . �b.,..e w�+ �o �� v�. a m. wn�eau. lxav. l.. wh.a« 9(mmma�o ..n swion r000) a oir:ian 9 a u. 8w'vwv md Fdm'an Codel n iMt M a Me b uanq IlrMmm W tM E�m ta tla YePa aaanNun. MY voW ion W Saian raiis M nv wdmv i« a o«mn wqw. m. evWrsm m. dw o.wiy a na mae mm rn. n�.d�.d eon.. �sswp. � I.eaaxrrd�MpapMYamY�dA'�x'vhweprotMidacomP�.wiOdoNov.aM.endlhotluMenolineNtl a oRsad b vb (Samon ]ou.8uuis�s enE Pmloaom Cob: Ths Caveepm L'oro� lew Eo» na WWYto � anwdV�WMY Mn W Wa a inG�+� �M1asan. rd wfio do� �ud� xM h'vnd u henN a C+wyi Ae u hs wn �VbM�. V�'� tM uM qnp�wwnM� ve nd ixrtlsE n dlrad la vele. tl. 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COM.Ia IM palamenca d IM vk t« wlirh Ne prmC's iousd. ❑ in....newm.ua.:�.w«.•mmw�.m'n�mw�.rc...snwo.dMs.a�a�aoam.ve«coe..urm.o��dm. X.�n ia.nKn a,m wm+ e�.a. Mv.w�.• �o� �.�o. �..w owr �e..�.: Oe1M �TA'T��'U�1D EXPIRES °a�""'""°` 2g�-g6H998-�� O1/Oi/97 �IhifeecTim�pHndbsou'IWM�sdi1MW^�l'oMansMUMMEWva/3100�a f � 1 Miy pW n tM1e pMmre�v d IM wwk Iw whM Nu pamt e inuaE. I ml mqvi�r p n Io Eecorts u�jw �o �M wAre' mipawtim Nw� d tlW 1 to �M wMs�' mmpriaeio! pwvuq+ d`J^dion ]]m al tM lebor Cods. I I py ' . oa.:J ci i c,��o �oa�.: � W�rrMiO: F�9u� ro rvn rolkr�'rnnp'�rCon cm'r�W l� . �M Mtll �WM« n wrD�oPM b cNr/rW W��r utl d�m nn.. w ro m. nu�a.e moww aorw. ltim,moA m.mden ro m. cou o� mrrnru.�nn ��w.. u c+ovw.e ar rn S�etlm 3ro6 0/ IM L�6or Cob, IMrw( uM �rtomry i ha. CONSTAIICIION LENqNO �OENCY: I IwaEy alfum wder psi�ly d psj.ry �IW iMn e e mu��uCion Wrtvp pan.y br Cr p.w�� a me � w�w ma o«m� m�.d lsw� x�. c:.. c�. LENDEN'S NMIE: LENDEN'S MUNE55: 1 MEY thm I hms iaeE Ihu eOD�i[eum bd Yela tMl Ns ebws'vdanWion e canatl. I ppw to m^D�Y xqM1 eA'YY eM owvaYdmunOs eM aWe lexs �aWiq b driM�q cwuvupion ud harab� awhor¢a npmen�etiwv diM ary w ems upon iM ebms�mpqionM popMy �a imaoeaion wro�as. OHN SKIRZYNSKI �p� m Wms S �(/ Dns: � 2' C��+ Sqrewm d /1pmVRppiren4Conlreea CITY OF COSTA MESA - BOILDING PERMIT PERMIT N0: H 080857 PLAN CHECK NO; N CONSTRUCTION TYPE: V-N PERMIT TYPE: STR JOB DESCRIPTION : T/OFF 6 REROOF W/COMP SHINGELS PERM NO: B 08085 GOVT: N SUPP: N PURPOSE: OTH SQ FT: 4,200 CLAIM VALUE; 4,200.00 CALC-VALUE: 4,200.00 GROUP OCC; R-3 /U-1 COMMENTS: REROOF 2800SF W/COMP SHINGLES �+��r�x x�**+t+��**��**�e**�*+r+t�r***� �+t��+�***�***�*��*�*�*+��rx ��***�**+�*x�*�*+�«�� **� Z O N i N G R E Q U 2 R E M E N T 5 S E T B A C K S ------------ t4A1N BUILDING ---------- --------- ACCESSORY BCIILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; fiT IN RGHT: ET IN LEFT; FT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 42215119 ZNE: REF NO: PLANNING NCS'I'ES> i ft fE it iE iE iE iE iE 1E if iE 1E k IE iE iE k 1E iE IE if iE iE fE iE iE iE iE iE 1E iE it 1! ik fE iE 4 iE 1E 1E iE if ik 1E 1E 1E iE k iE ff iE fE iE iE ir 1e if iE iE ii iE if if if 1E iF iE ie 1E � �E iE iE iF iElE iF if �IY 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 BY : DATE: APPLICATION ISSUED HY: DATE: 2 1�- `L1 1k1k1k1fiElEikilikiFiflkiElElEkfElEiFifikik 1EiklfiEiEikiEfElffE 1E3E LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 99.75 50 SMIP/NON-RES PLAN ISSUE FEE BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 100.25 0.00 0.00 100.25 100,25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 100.25 OVER/SHORT: .00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 99.75 ,50 1E fk 1f 1f if iE iE k 1F iElF 1ElF iE ik 1F If 1E 1E 1k iE 1E 1F 1E 1E iE 1E iE If if iE iE i6 if iE fE iE 1E iE i! k If iF iE if ik k k ff IE 1ElE iE i61t i! 1E fF 1E 1E iE iF it 1E 1E 7E 1E 7k 1E fk if iE 1E fE ff iE 1f 1E 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 SFR 4200 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 4,200.00 END OF FEES 01 �0220929-OQ22U930 T C+T IQt1.2` DATE: 22l12/95 TIItE: 15:?9 CONSTRUCTION AND PLANNING �^ 4 �� _ �POOL`RSPA' � "' ' " """'""' APPROVALS Permit,-P � Data �Inspector � APPROVALS Permiivr �°1� Insnecror �. Temporary Eleetrical Service or Pol� 52. Pool & EGufpmeni LuCSUoi� z, Soil�Pipe•U�tlrgrnd. � 53. Stce� Reinforcement 3. Electrical Conduit Utility�Undrgmd. 54. Forms • � 4. Electrlcai CondulrUndrgmd. 55. Elactrical Bonding 5. Steel Reinforcement 56. Rough Plumbiny � Pressure Test 6. Electricaf UFER Gr�d. � 5�. APPROVALTO COVER�GUNITE 7. Foo[Inys 58. Electrical Conduit-Undrgmd. 8. Pountlation 59. Gas PiPe, O Undrgmd., Test 9. Water Pipe�Undrgrnd. � ' 60. Backwash Lines. P�Trap, !� Undrgmd. 70. Struc[ural Floor SVstem 61. APPROVAL TO LECK 7 7, Propmry Sewei Line & House Connee[ion 62. Backwash & Receptor�final 72. Sewar Cap - 63. Heater & VenbFinal 13. Roof Diains � 64. Plumbing Syscem � Final 14. Rough Ptumbiny - 65. Electrical�Final 75. Rough Elec[rica6Condui[ 66. Solar SyStem�Fiaal 16. Rou�h Electric N'iriny - � 67. Fencing & Access Approval 17. Rough Wiring Sign ' � 6g, APpROVED POR PLASTEHING 18. Rough Electricai�T Bar Ceiliny 69. POOL/SPA SYSTEh4S FINAL 19, Rouyh Heating & Air Contli[ioniny . .- _ .• FIRE DEPT. REQUIREMENT ��• •• 20. Rough Factory Fireplace APPROVALS Permit � :1. DuCts,in Structure 70. Underqround Hydro 22. Ducts, Ventilatin9 77. Producc Piping �Gos OOii 23. Gas PIpa�Rouqh & Tcst 7Q, Undcr9round Flush 24, ftoof Framin� 73. Underyrnd.StorageTank L7Gas ❑OiV 25. Roof Sheathing Z� 6�� 7q, Overhead f-lydro 26. T-Bar Ceiling (Svuctural) & Monocoat 75. DrY Chernical 27, Frame and Flashing 76. Dry S[andpipz 28. lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PAEV. FINAL 30. Drywuil Nailing HEALTH DEPT. RE�UIREMENT 31. Plaster Brown Coat 79. PINAL INSPECI ION 37.. Electrical Power i\Aeter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Plpe-Test 36. Hood or Canopy 37. Final Factorv Fireplace i ' ~ I � - --' 38. F�nal Plumbing 39. Water Service-Final �� ' 40. Gas Service-f�nal 41. Solar pomes[io-Finai �' � � - . 42. Backflow Preventer r 43. dackflow Irrigation 44. Landscape Irripation Sys[em � 45. 5ound Attenuation 46. Nandicap Regulation: 47. F�INALSTRUCTURE&BWLDING �y Zj-Q7 �(,v�- 48. FINAL PLANNING - 49, Electric Release to Edison • 50. Gas Release [o Southern Californla Gas Co � 51. CERTIFICATE OF OCCOPANCY ' Nd. ' Date _ � ' { � � OFCOSTA.ME A CON TRUCTIONPE :t Address � � /� N � cant's Mailing Address� �vr �Q �3 S T Aoo�icant to fill in all spaces except tnase witnin neavY bo�tler lines antl sign all avProvriate aeclarations. � TVPE OFCONSTRUCTION 'LJ NEW� LJ ADD LI ALTERATION IJ✓REPAIR 3 ❑ CONVERSION ❑ �EMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. Address �'+v v�.�..� �-i"' Arch/Eng. License No. AAdress Contracmr'sNam��_ �� Q ¢ '�'/'��-�Phone2K ��S g Address (mailing) �G S`� Ss l�M•' 92 iz�— Ciry License Na � p G 7-� LICENSED CONTRNCTOR DECLARATION 1 hereby aifi�m inat I am licensetl untle� provislons ot Charte� 9(commencing with se<llon 1000) of DIvlSion 3 ot the Buslness antl Professions Cotle, antl my license is in full �farce3j�tl fiect. � Licens� C} �ss �` J LJ/�c�ennse No.4 3 �� DaleT/7�� $ignature_ e /��M�"'� WORKERS'COMGENSATION OECIARATION hCreby a/firT that 1 hdve a ce�tlticate of consent lo self-insu�e o� a certlficale '� Workers' Compensation �Insurante, or a cer[ifietl copy thereof (SecHon a800, Lab.�- ),c c�- �] ��(� • V y� Poliry No. 1N�_.p_v_LaJr_a{i_I Company '��k r -/^�� ' rilfietl copOY Is he�eby (umizhCtl. Certi/i co y 5 tile0 wAPpl tantY BujJpin9 D{yiyo{y� �w� Date �� K�j iGr�4.dXEl G r EXEMPTION FROM WORKERS' COMPENSATION DECLA0.ATION (ThiS section neetl not ba completetl if the pe�mit is for one huntl�ea ($300) or less). I certify thdt in Ih¢ Performance ot the wo�k fo� wnicn this pe�mi{ is issuetl I shall nol ¢mpl0y any po�son In any manner so ds to become Subjecl to t�¢ Workers' Compensatlon LawS of California. . Date Signature �NOTICE: I(, a(ter making this tleclaration, you shoultl become subject to'tno WorkCrs' Comp�nSaUon provlslons of th¢ Labor Cotle, you mu5t for(hwith � comply wlth sucn p�ovi5ions or tnis permil shall be tleemetl rnvoketl. CONSTRUCTION LENDING AGENCV - 1 hereby aftlrm inat lnere Is a construction lentlln9 agency for tne perlormance oi lhe work for which thiz permit is issuetl (SeCtion 309] Clv. 0.) Lenaer's Name i Lentler's Atltlress OWNERBUILDEH bECLARHTION 1 hereby atfirm that I am exemp[ from the Contractor's License Law for the following reason (Seclion 7031.5 Business antl Professional Cotle: Any ciry or county whicn requires a permlt to construct, alter, improve, aemolish or reoair- any structure, prbr to Its issuance, also requires the applicant for such permit to file a signetl statement Ihat he/sM1e Is IitenSetl pu�suant to the provlSlons o1 the ConVactor's License Law (Chapter 9(commencing with Section 7000) ot �ivision 3 of the BuSinesS antl Professions Cotle) or [hat he/She i3 exempt eretrom and Ihe basis for the allege0 exemptlon. Any violatlon oi Section J37.5 by any apo�icant for a permit zubjects the applicant t0 a civil �enalty of not more than five nuntlretl tlollars (5500). I, as owner ol thc Property or my employees witn wa9es as [heir solo com0ensation, will tlo the work, antl tha structure is not intentletl or offeretl for sale (Section 7044, Business antl Professianal Cotle: The Gontractor's License Law tloe5 nOt appty lo an owner Of a property who builtls or improves thereon, antl who tloes such work nimself/hersalf'or through his or her own employees, provltletl tnat zuch imorovements are not Intentlea or oHered tor sdle. It, bOweveq th¢ buil0ing or imp�ovemen[ I5 sold within one year Of com- pletion, ihe owner will have the burtlen of proving he/she tlitl not builtl or im- �rove for the purpose ol Sale). I, as Owne� of tbe prOperty, am excluzively co0t�dcting wlth licensea con- l�actors to comV uc[ [he pwject (SectiOn 7044, Business antl Professions Cotle: . The Contractor's License Law does not apPry to an owner ot property wha builtlz or improves tbereon, antl who mntracts for such projecl5 wl[n a con- [ractor(5 license pur5uant�to the Contractor'S License Law). I am aware fha[' proot o� [M1ei� WOtker's Compen5ation insuranGe ShOultl be provitletl to me. ❑ I am exempt untler Sectlon B. & P. C. to� thi5 rea5on Date Owner I hereby [er[ity tM1at I have reatl Ihis applicatlon antl sta[e that the above intormatlon is correct. I agree ta comply with all city antl munty ortlinancas and state laws rClating to builtling wnslruCtlon, antl hereby authoriie repre- sentativez of this city to entm upon the above-mentlonetl pro ert tor insve�tion our ses. /� � � � Signature ��Ll7l.� � Date �rivers' �Icense or 55 � ! TVPE OF PERMIT U GRADING �/LJ FOUNDATION Ll STRUCTURAL ❑ TENANT ❑ ELECTQq IC_AL 1=1 PLVMBING ❑ MECHANICAI ❑ -OTHER (1-�S � �tAl PROJECT DESCRIPTION 5�. FT. nrri ipnrycy_ CONSTRUCTIONTVVE ' VAIUATIONS ZONE GRADINGCU.YDS. AGRES_ Remarks: ' Sink Prevenrer Irrigation Dishwasher Drinking Fountains Floor Dreins Ploor Sinks Gas Service � Outlets Intercepmrs Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee I $15 oiier luct � Under Ground Duct-Ventilating � Exhaus[ System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating Sys[em & Ducting ❑ 0�100,000 BTU � 100,000 BT Reinspection Fee � $15 CMF OB65-46, rev. ]0/84 Wbite - Building; Canary - Applicant; Pink - Accouniin9; Goltlenrotl - AssesSor Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee Hood or Type I ❑ , Canopy Type I I ❑ Refrigeration System ❑o-ioo,000eTu ❑ioo,000sru System Repair/Alteration Fire Dampers � � Regis[ers Issue Fee $ 3 $ 3 A.P. # S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: dutomatic Washer � Construction Pole Sub. Cooking Unit r�:.w.._..�.... _ Dryers F,A.U. Fixtures Device Boxes �Uil¢25 Switches Garbage Disposal Gene�ator 065 KW Fee 27H5 4/09/i;6 Bui Parking Req:/Provided ,� . �� Zone ELECTRICAL Transformer ❑ 15�50 KW ' ❑ 50 + KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel ' Motors�0�1 HP Oi'/:-8 Inc.Solar 09�15 HP �16-15+ Microwave � Pole Light Range ; Standing Section: 5 KW Tmsh COmpactor 515 luue Fea FEES S 3 Z O N I N G. R E Q M T S DEVELOPMENTSERVICESRE�UIREMENTS: Zoning Approved By Date Building Approved By Date�_ Application Issued ey � Dat�a �� - ,SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PEfiMIT PLUMBING �$ �— ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAI $ GRADING $ PLAN CHECK 50% $ MICROFILM $ � MECHANICAL $ TOTALFEE $ 5.�� PLAN CHECK 25% $ � �RUCTION AND PLANNING '� APPROVALS Permit# Date Inspector 7. Temporary Electrical Service or Pole �� •� 2. Soil Pipe-Undrgrnd. � ' Undrgrnd. 0 5.`$i`eel Reinforcement r 6� Electrical UFER Grnd� :' 7. Qotings , � � , , 8. oundation � � ., 9. eter Pipe-Undrg�nd> 10. St�ucturat Fbor SYstem 11. Property Sewer Line & House CoMriect 12. Sewe'r'Cap ,� 13. Roof Drains '� 74. Rough'Plumbing � 15. Rough Electrical-Conduit i6. Rough Electric Wi�ing 17. Rough Wiring Sign 18. Rough Electrical-7 Bar Ceiling 19. Rough Heating & A�r Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structur6 22. Ducts, Ventilating 23. Gas Plpe-Rough & Test 24. Roof Framing �. 25. Roof Sheathing � 26. T-Bar Ceiling (Structural) & Monocoat 27. Frameand Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigati0n System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electrie Release to Edison 50. Gas Release to Southern California Gas 51. CERTIFICATE OF OCCUPANCY No. Date �� • POO iPA APPROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVALTODECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL ,�. FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: Date �Inspettor � Appllqnt to fill In all spaces except tnose wltNn heavy Dortler Iines ane sign a11 appwpriate aeclaratlons. CiTv OF COSTA MEsn COyN-STRUCTION PERMIT Pro{eclAddress � J��NN S� Appliwnt's Mail'n Add eis �C �`^ � a N� C /''� �7/ Owner's Name ��✓` /r 1/ Phnnw.J D�7 !` Address �a �� .�"o �}NN —ST • Arch/Eng. } License No. Address Contrector's Name�,,,� Phone -- Address Imniling) Vt1�Al G%hPiU � _._ CitY License No. �� LICENSED CONTRACTOR OECLARATION I �ereby alllrm t�at i am Iicensetl untler provisions of C�arter 9(commencing with seGliOn 7000) of Division 3 0l tne Busine55 antl Pro1¢SsiOnS Cotl¢, antl my Iicense is In tull force ana effect. LlGense Class LiCenSC NO. Date S�9�ature WORKERS'COMPENSATION DECLARATION I hereby attirm that I have a certiticate oi consent to 581f-Insure or a certificate ' Workers' Companution Insurance, or a carU(letl copY thereof (Settion 300, Lab. C.) Policy No. Company 8 CertilieC copy is hereby /umishetl. . Certl(letl cooY is tiletl with the tlty Builaing olvision. Dxtc APplicant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completeG if tba permil is tor one huntlretl (5300) or less). 1 certlfy that in the performance ot tlte work for whith this perin�t is issued 1 shall nol employ any pe�son in any mannCr so as [O become subject to t{�e Workers' Compensatlon Laws of Califomla. . Date Si9nalure • 'NOTICE: Ii, alte� mdking this tleclaratlon, you iboultl become Subject t0 Ih¢ Wo�kers' COmp¢n5ation proNsions ot the LabOr Cotle, y0u muzt forthwl�h comply with such orovisions or this permlt shall be aeemea �evokeC. CONSTRUCTION LENDING FGENCV 1 heruby alOrm tnat tnere is a constructlon Ienaing agency for the pertormance ol lhe work for which this permit IS ISsuBtl (SettlOn 3097 Civ. C.) LanEar'S Namo Lontler'S AEtlre55 OWNER BUILDER �ECIARATION I hureby allirm that I am exampt irom the Contractor4 Litenm Law for tna following reason (Section �031.5 Businass ana Pro/essional Coae: Any city or cnunty whlch roquire5 a pe�mit to con5trucl, alter, improve, tlemolizh Or repal� dny Structwe, prbr to I[s i55uanCe, also raqWwS the appllcanl IOr sucM1 permit [O /ile a signotl Statement thdt he/zhe Is IICOnsutl pursuant t0 MC Provi5ion5 of tM1e Contractor's'Liconse L�w (Chapler 9(commoncing wltb SecUon ]000) of DivlSion 3 0l the Busin855 anG ProfMsions Cotl¢) Or that he/she it lxempt �erelrom antl tne basis tor (he allegatl exemption. Any vb�ation ol Sectlon 31.5 by any dpplican[ IOr a permit subjocts lhe applicant lo d clvil �� Ity of not mOre lhan five huntlr¢tl tlollars (5500). '�l�Cl, as ownor ot lha property � � epmpewfalie�; will Eo Ihe work, antl the ilructu�a Is nol inl¢ntleC o� otf¢rBtl for sale (Section 7044, Business antl Protessional COOe: Tha Contractor's License Iaw tloos not apply to an owner ot a property who builtls o� Improves lbereon, antl wh0 tlo¢5 such wOrk himsell/herself or IM1rougM1 bis or her own employoes, provltletl Ihal suth ImprOvoments are nOl InlCndeU or oH¢re0 lo� sale. II, nowevlr, Ihe builtling or imprOVOmOnt IS soltl wlthin on¢ yea� of cOm- plelioq lhc Owne� will have tho burtlnn ol proving hc/sh0 ditl not bulltl or Im- �rova IOr the pur0o5G ot Sale). I, as owna� ol !he p�operty, am ezCluSively Conitactinq wilh Iitensetl COn- lractorslo conslrucllhe projec[ (SeciiOn 7044, Buslne55 antl PrOfessions Cotle: Tho Contractor's License law does not apply lo dn owner oi pwperty who builtls or improves enereon, antl wno contra<tz for such proje<ts witn a con- tractm�sl Ilcenso pursuant�m the GonVactor's L�canie Law). I am awaro tha( proo/ o� tM1elr Worker'S Cor�pensalion InsuranCO ihoWd be 0/ovitletl to me. ❑ I am exempt untler Seclion B. & P. C. Por thi5 reason Signature , Drivers' !i CMF O86 -46, fy that I have reatl correci. I agree to c �� r¢latlng to builtlmq tnis tity to enter n antl state that the above tlty antl county ortlinances and hereby au[norize repre- ve-QI¢ntionetl'proPe�ty for' �l /� / _ �ate 7 �O TYPE OF CONSTRUCTION LI NEW L.J ADD LJ ALTERATION LJ REPHIR ❑ CONVERSION ❑ DEMOLISH ❑ OT7 ER A p. � D CRIPTION OF WORKk�ffi$E- • /^' nn� �� T� S Main Buildi �}�� E TVPE OF PERMIT RADING FOUNOATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Reer ❑ -OTHER %� PROJECT DESCRIPTION 5�. FT. oCCUaANCV C Right K Left CONSTRUCTION TVPE VALUATION $ $ ZONE GRADING CU.v05. AC0.E5 p�ng. ReL # Remarks: Planning NOtes: Bar Sink Backflow Preventer Backflow Irrigation . Bathwbs Clarifiers Dishwdsher Drinking Fountains Floor OrainS ' Floor Sinks Gas Service Outlets Kitchen Sink Lavatories P—Trap Roof �rains Reinspection Fee $15 Boiler Duct- UnderGround Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/FacL Blt. ICBO # Heating System & Ducting ❑ ai oo,000 sru O i oo,oao Rains ction Fea =or55� - � � � 30/84 White - Builtling; Canary - Applicanh Pink - Acrounting; GOIdCnrOtl � Assessor $15 P Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Aufo�Wash Isue Fee Hood or Type t ❑ Canopy Type I I ❑ Re(rigeration System ❑aioo,000sru ❑ioo,000sru System Repair/Alteration Fire Dampen � Fegiste�s Iswe Fee FEES $ 3 5 3 Automatic Washer ConsVuction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generaror �0�5 KW 3776 4/?':/'i' Zone Bu ELECTRICAL Transformer ❑ 15-50 KW O 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Molors � 0.1 HP � 1 Y. - 8 Inc.Solar �9-15 HP 01615+ Microwave Pole Light 75 KW ; Standin9 Sections Trash Compactor FEES Z O N I N G H E � M T $ � Rainspection Fee �§15 � � Issue Fee � $ 3 � DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Date Building Approved By Data � Application laued By Dat� SUMMARV OF FEES BUILDING PERMIT � $ SMIP $ ' PLAN CHECK $ PERMIT . PLUMBING $ -ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. S ELECTRICAL § � GRADING 5 PLAN CHECK 50% $ MICFOFILM S g -�'� MECHANICAL 5 TOTALFEE $ r�v✓ PIAN CHECK 25% $ CO�STRUCTION ANDPLANNING POOL 'A APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector ' 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Elec[rical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Elec[rical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd, 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Foof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electriral-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 19. Rough Heating & Alr Conditloning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structu�all & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Finai . FOOD CERTIFICATE ISSUED 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 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. �Gas Release to Southern California Gas Co 57. 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. Attention 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 proposed property improvement. �Yes ❑ No 2. (hav signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name — Address — Phone ( � City 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 ( Contractor's Lic. City 5 I will provide some of the work but I have contracted (hired) the following persons to provide 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 personal knowledge, in compliance with this State law. Signed:- �• Date: '`� � a � Name: (Printed or Typed) C.D.L #or S.S. # CMF 1042-46 754-5273 .: W. AP. DATE BUILDING PERMIT NO. �!b VAL[1E $ lII DESCRIPTION OF WORR Sin�le Res. Att I' �ECTIONS I DATE I SUBCONTRACTOR I DATE P �RM1T8NUMBER i�ias :' . � � � �y�� COSTA MESA BUILDING DEPARTMENT P.O. BOX 31� - COSTA MESA. CALIFORNIA ING ss FOR APPLICANT TO FILL IN W. Joann St. COSTA MESA. CALIFORNIA MAIL �9 E. 17th St. ADDRE55 CITY �yyy�nQ$ �/�].. ARCHITECT � OR' 'NEER '� ebro� ADDRE55 Garden Vl��Ve LEGRL OESCR�PTION A.P. NO. USE OF E%ISTING B SEiaPCrc LIN NEW REPAIR E. 17th St. 6o x l00 TNil LIC. NO. fV LIG �� c.No. 8 TNO. �• PZZS9 BP TRACT ��`�'J ��. �F BLOGS. none [rM S�� REAR YARD 21� RIGHT 5� LEFT S� DESCRIPTION OF WORK ALTERATION ADDITION MOVING DEMOLiSH ��OSI1UROOMS� STORIES� WALL SYIICCO COOVERING CO� "' Single family residence � ivi.th attached garage. a-�� ECEiUED fl�3o Is� � � 'CE DEPt. GlIY OF C�iTA NEa�1 APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY �! RECEIpT NO. P `(� J RECEIVED BY OwTE RECEIVED OPTE ISSUE ✓X�7✓ �'1-3e -S SEP 2 n t COSTA MESA. CALIFORNIA Plan 130A I MEflEBY >CµNOWIEOGE TM>T I rypVE REFD THI$ FPPLIC4TION PNO STATE TH4T THE PBOVE IS CONFECT iNO iGREE TO COMPLV WITM iLL CITY OR�INFNCE$ FNO ST.� L�WS REGVL4TING BUILOING CONSTRUC� T�� VALUATION SIGNATURE OF PERMITTEE � � T,� s14, 526.00 AUTHORIZED AGENT M� & Colegrove yyyC CORRECTIONS PERMiT FEE S34�w PLAN CHECK $1/�W TOTAL FEE gS�'�OO �ry v M�