HomeMy WebLinkAbout2269 MINER ST - Building Permits�
PflOJECT POOPESS: Z Z 6 9 M I NER ST
OWNEN'SNPME: IWASAK�� IS]i�"�V
ADOXE55: IWASAICI M�Y
9652 Dqf�BRECK DR
HUNTINGTON HEACH,CA 92646
714 650-1086
UNIT: A
APCHIENGINEEP: flEG.NO.:
RUONE$$: UNIT:
PEflMITTEE: NOCK PI,UMBING (714)895-1246
aooRess: 11610 $EAHOARD CIR
STANTON CA 90680
I LICENSED CONTflACTOB OECLAflAT10N: � pereby allirm IIWt I am IicenSeE unGer prOvisions al C�apter 9 omme0cinp witA Seclion
7000) ol �rvismn 3 of i�e Business an0 Prolessions CoOe. ana my license is in tull force anC elleci.
c�Tv�ic1.:'0�502386 STATELIC.:SSS9%I cuss: C-36
IDaie: �L�1�0 Signamre: "�.�-��M— - _ . _
WOflKEPS' COMPENSR710N OECLABRTION: I �ereCy allirm IAdI l have a cenifirate ol consent to seli-irtsure or a cenilicate af Worker5'
I Comce�sation 151'6�79 9`2'9°� caov cnereoi ISecuan 7eoo. �ao. �' 3/ O 1/ J S
raucv No.: STATE E%P. O�TE:
COMPRNY:
r] Ceni�retl copy is here0y fumiSAeJ. � �¢nilieE coDY is �ile0 wrt the ciry BuilOinp Divisipn
ate: 1 �� � � � AODiicant: �� �L� �
EXEMPTION FflOM WOBHEPS' COMPENSATIDN OECNflATION: (ilns setuon nee0 no10e compRteC ii tAe perrtut is 1ar we �unOreE (57001 or less�.
I certily t�al in Ihe perlormance al the work far wAic� Ihis permii iS i55ue4 I ihall not ¢mpl0y anY Oerson in arry mann¢r 50 as lo �ewme
su�le�� �o I�e Workers Compensatian Ldws oi Catilamia.
Oate: Sigumre:
NOTILE: II. atler making I�is OeUardlian, you 5�oN0 Gemme SUGject lo tAe Workers Compensa�ron prwisions ot me LaUor
CoOe. y0u must IonMnl� tomoN Y^III suc� OrOvi5ion5 ot Ifis Oerrtti� ShaA be GeemeG revokeE.
CONSTflOCT10N IENUING RGENCY: I pereGy atfirm IIWI ��ere i5 a constmclion IenOinq apenry for ��e p¢dormance ol Ihe work for
wnicn inis oermn is issuea (Seaion 309>, Civ. C).
LENDEB:
ROOPESS:
OWNEfl BUILOEfl OECUBATION: 1 �eqpy attirm Iha� I am exem0� �rom I�e Cantraciars' Slale License Law lor the fallovnnB �eason
�Seciion 7031.5 Business anG Pmlessianal Code: Any ci�y ol coumy whic� repuires a permit to constmct, atter, imDmve. tlemolish, or
iepmr any sVucWre. prior lo �Is issuance, also reQuires ine aDD�icanl iw sucn oermit ta file a Aqnea statemenl inal ne/she is licensed
pursuant Io Ine Orovisions ol Ine Canlraa06' SIaR License law (C�aO�er 9(comm¢ntinp wil0 SetliOn 7000) al Oivisan 3 0l t�e Business
an0 PmIe55ion5 Coae) or Inal �e/5�e R exempl meRimm an0 Itrc EaSK �of the allepe0 eRemO�ion. My vioW�ion Oi Seclion 7031.5 �y
any applicant for a oe�mil suoiecis Ine applicant to a civil penaity ol 1rot more inan live nundretl �onars (55001.
I, as owner ol IAe D�apeny or my emp�ayees wit� wapes as lheir sole comDensaiion, wiA Go tAe wark, and ihe
❑ s�mmure is not intenAeO or otterep lor sale (Seciwn 7044, Business an0 Pmfessional CaOe: TAe Coniraciors' State License Law
tloes no� apPly to an owner ol a pw0eny wM10 GuilOs or imprwes ihereon. anA w�o Ooes mc� work Irimsell/�ersell or �hroup�
his or �er own employees, prov�0etl �hat such imD�ovemenls are not intenUetl or oflerea lar sale. Ii, however t�e 6uilAinA or
imOmvemem is sWE wiihin one yem ol completion. ��e awner vnll have t�e bur0en ol prpvin0 �e/she UiU not Ouil� or imp�ove
lor �ne purpo5! al Salel.
I, az axner ol me propeny, am eyUusively contnc�inp wim Iiceme0 canuactars ia mnsimct ine proiK� ISection 70aa. Business
❑ anG Pmtessions CaOe: i�e ContrM�ori State Lkense Law Eou not apply lo an wmer ol pmce�p wro emms or �mo�o�es mereo�
ana who wmracts mr sucn D�qects min a mmractor(sl Ivznse Dursuam to the Comoctors' State L¢ense Law�. i am awa�e
Ihat prool of Ineit wo�ker's fAmpensation inwrance sMuW oe O��ded ta me.
� t am exempt un0er Seclion: B. d P. C.
lor I�is ieeson:
�ate: Owner.
i aa Aere�y cenily �nai I am aware oi anq unaersianU t�e repuirements of Califomia Health anU Salety Code Sections 25505. 25537, antl
T5534 and Inai I or any iNure Omlding acupanl vnlVwiil not �Circle ane� neeE to wmDN "^�� saitl siate c04es and ��e reQuiremenis lor a
permil loe cons�mclmn o� mo4diW�ion trom I�e Air Oualiiy Managemeni Oi5lnci. PevGeniial conSVutlion aDP�icaiions are erempt �mm
Inese 0�ovisions.
Dale: ApDticanf
I �ere0y ceruly Ihat I �ave reatl I�is appb�auon anE 51aie I�at I�e abwe intormatian i5 mrreci. I apree to compty with all ciiy and counly
orNnancesan�slatelaw5relalinglobuil0ingcanstmctionantlhereDyaW�orizerepresenta�ivesol�Aiscilyioe ferupon�0ea�ove�menlioned
pmpetly �or ins0ecimn purpose5.
�ate'. _� 2 � 3 — �� Signaiure: _
DriveiS li�ense or Soual Secunry .:
164b46 Whue—Buibing: G�een—Co�e Enlorcement: Canary—AppLwnr. Pink—Revenue; Gdtlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT , `Oi2�
PERMIT NO; P 050123 PLAN CHECK NO: N , , I
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION : REPLACE WATER HEATER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: REPLACE WATER HEATER —+�*MAIL IN PERMIT�
**x�*�r*�r�r�t��t�r�r�t*�e***�r**�r�r*�txr�t�rr�t**�r****�rr+r�r�r�r*f�r�e�r�rx*�t�t�r�tr****�t**�t�r**�r�t�r*r*�e*�e�e
Z O N I N GS �RTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT ZN LEFT: FT IN RGHT; FT IN
PARKING REp • PROV: PARCEL: 42216212 ZNE: REF NO:
PLANNING NOTES>
�
iF 1k �f 1f 1f M M k if ikif �f if i! k1k ff fE if iE M M IF�E 1f N 1E%1f 1f ff M 1k li k if k M 1t 1f iF 1E �f 1f M�Ikif iE M If 1E IE if �F iElE iF iE k iF IE k if 1f IF Iflf iF fF Ik If k i! If M M iE 1f iE
D E V E L 0 P M E N T S E R V I C E S' R E Q U I R E M fi N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY ; DATE:
APPLICATION I55UED BY• _Yn` DATE: �a' � �
iF if if if M M M Ik If k li �t IE 1F �k if if M M if ik M ��F1f 1F 1f if If M M if ff If�aFiFif iF
1E1f1FiflfMMMMifikiEif�ElFlffllElf�fifMMiFMMifMIflEIfiEMMififK M1EifiEMififMifMMMlflfiFklkiEiElfNMkIfMMlfifikiflEikiFiFifffiElk1fM11
LEGALIZATION:N F E E' S U M M A R Y STRUCTURAL SEGMENT:N
PERMIT BLDG PMT PLUMZI00 ELECTRIC MECHANIC FIRE SMIP/RES GRADING
'15t SMIP/NON—RES
PLAN
ISSUE FEE 3.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 2.00 3.00 0.00 5.00 5,00 .00
REVENUE DIVISZON TOTALS--> COLLECTED; 5.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
5.�0
ifNk�fMifMlf3fklFifiFlEiflFlflfiflfifif�fMMKMkM1ElEiFM�fMiFifMMlfMMiklfiflkiFMiflfiflfMklEkifiEMMiflfifiFlf3FiEiFiF1EMIFifiEiFklfilik
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
PLU 1 WATER HEATER AND/OENDEOF FEES z•00 2.00
ACCUU;�T ;: ii�[?Ln;
17/0 /90CQ1 OUu?: ;;
C.K 7E�, _
Qi 0�7D7i533—OQ93553E ��1Z' S.G�
DATE: 12/04/90 TitiE: i2�4?
;
CONSTRUCTION AND PLANNING POOL�h .a
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
1. Temporary Electriwl Serf{fe or Po��.� 52. Pool & Equipment Location
2. Soil Pipe-U�dr rnd_ �^ '�'t 53. Steel Reinforcement
�3-.n:. - - v-.
-��3:_tf;c�ricalConc��'�(�tility�l7ndrgrn�'r 54. Forms
� •4i�Electrr2al Cond`uii�Undrgmd. �' 55. Electrical Bonding
a-�r- c�
s"�-3ieBj Feinforce�tt�ni 56. Rough Plumbing & Pressure Test �'
�.�6.�E7etit�al UFER.Grnd. 57. APPROVAL TO COVER�GUNITE W
n�.r..
:_77:,�,F,g-��js �� a 58. Electrical Conduit-Undrgrnd. n
. Foundation y 59. Gas Pipe, O Undrgrnd., Test •
9. Watei Pipe�Undr��nd. 60. Backwash Lines, P-Trap, O Undrgrnd.
70. Str ctural Floor Svstem � 61. APPROVAL TO DECK �
11. Property Sswer Li �& H6use ConnPction 62. Backwash & Receptor-Final
12. Seeityr Cap � :� � 63. Heater & Vent•Final
13. Roof Drains �� 64. Plumbing System � Final
.-. �r
14. Rou h Plumbi . �'
9 F�9 65. Electrical-Final
15. Rough Electri�al�Conduit 66. Solar System-Final
16. ftough ElectriCWiring 67. Fencing & Access ApProval
17. Rough Wiring Si.gn 68. APPROVED FOR PLASTERING
18. Rough Electric�I�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
._ �. . .. .. .... , -- - - � 7 C C',-.1 : C:
20 � Roli h FactoBy Eireplace : L:?" �t'"7 '} C: :% t'�i .; qppROVA�}i =-PeFriiit # �� > -
,z ;'� U z • � Str 7. .i .S r+ r�y '; .i. �..' :ur+i^ 7 -
.l. .. - u �� . I r+ � � q. L .>.... .. i
21.:Ducts,i��Str,tictuie, .... ,_S 5 J��x:� 770. UndergcoundHydro ��
22. DiCc_ts, Venti�tirig%� i C]S ;_ -'�[ 4d� i^71. p�oduc(�Pi� ng C7, s QOiI
23r',GaS.PiP�'Rou h & t• esc ' 'x �' '^ '�.r � � M i i o ' '' _
� f i �1S �r .n C d t�n .� 72. Undergroand Fkus�ii �r.
24'_•Ronf Piaming �M��� i FF ^l� �> rj r� �� ��� c7��Undergrnd Stor'd ':Tank'�OGas ❑QII
x y. tT '-1' ' % I � .�
25. R f Sheathin '��: i tiJ �� n; ��1 - -
Lj J-F Y v .-.(-. +
os. 9.-;;. .� �• :� � �:.� . 74:�Overhead HYdro� ..
26:_T�@ar Ceiling (Scraiotural) &SDAco ocoat y G c�i� ,� 7�;:,Dry Chem�cal �"7 °�, �, '=' �
27�,Frame apd Flashin , !n '' � '! ' `' '�` T � •" V'
.. i� _7�.[e: . i- �. a.:� �.. 7E Dry Stan��.Pe _s;.�, �.x .,;
_.28`. La,thing;& Sidin� � v �� ��:i�� ^ i s' �^ � t 77� FIXED 1'�TEM;6f AM� � ,T
�'29. Insulatio,n � `� -� �� '� :. �� �� � " 78� FIRE PREV. FIN .•L � �
�' �! � �� � :i A :�. p �^ C
i. •,. ��
* 30. Drywall Nailing -., �� ` r u � :f. � •..: ��HEALTFtPEPT. R'.E�HIWE'1NENT
�_�31. Plaster �ov(n Cpat� �: � .7,�� �. ' T �,79t.°F�}T�IAL`IN��ECTIdN ,Y � �~ C
u r ` ! r�t - � -
=32CElectrica) Po�er MeteGFinah �i� N � w n80:nFO0D CERTIFICtQUTE ISSUED V
�33¢Fin�� Ef�,ctriC " ' � "� ' ; `�Noi�s: c �� ' `-
; .� �'7 4 � r . 7iT + `� ��. .r�T
. . . .T. �1 �Z ' , _iti ` a�.. . '- � •�� . .+
i;34�Final Heating& Aic opditioRing; r, > � .�y :�; ; r, G >.-
rr r
'351J,�Final Ga's Pipe-Te3t� .'� ;7 � ` ! n �� ;cS .� V, �O
� .. r'� x, r� 'IIo -+ a E-!.,"
� � _ . .. >. . . . � �
�'36. Hoyd or Canopy� , i r,•� .. �-� � �'c� �� ' ,�
Y' ti
^3T.=Firia.l Factory Fif'eplAt4,,_, � S�'r �+ � :*7 k :r� �"i .b l�
- i ;-'-i T . �r � i. N
. ��..
`38. Final Plumb��g '� �� � '" " ;` ! `iY � S �-- x r;:
.�.39. WafOr Service�Fihal= �� i �+ ��� • i�� b� ? K
i. �� T � Y aT �' 1� a.
,�.40. Gas Service-Final ; �;� ��.,r 5 '� :;� '- , �r� pi; •� '
�41. Solar pomestioFinelS �'�� •• ?� O� �• ?� � - �� ✓
rr -.. . -, a• �70 ��' !: y
�"42�Backflow Preventet. H �" ��`" � �� ��' . `
ii ? r r i- 'I J
43. Backflow Irtigatiort �.�' ;' ' � �f-' • O ��
- �. , :r � :, ; . �� .
�. " .• a: C%: ' :! '• - to �
,.44. Landscape (riiUatiqn System,.r;� � ..� p �ti�:� �i p3 P. .LCn n; o
lJ - �
5�45::;Sound Atteouation �-� � . T �: � P-�� �! r - '�� ,•
' r ir zl�v N tT� L y.
.'46i ,Handicag R�9ulatiqns _ S �� ' � i r� "� �'�- `
J .e �.•. I �1: � 'vJ S
47:;FINAL STRi9CTlJf?E & BUiLDING 5> y i�i y �
� : : x C
a8'.';FINAL PLANNING � '� "� � � ' " ` ' � �'
.. �_ ' ' �r. OJ i. • ' n d' C-
49,-Electric Release to �Edison � . �
�50. Gas�Release to Sou�hem Califor,n;a Gas Co ;; ' ; ' `'�'- * - `�
S t. x � CiTi :f ��
'51. C FTIFICATE 0,OCCUPI�NCY �p � �; ; i'; i,�� x i. �� �
No. Dace
PHOJECT AOOBESS: � 2 6 tj M I NEk S T I I � uxiT:
OWNEP'SNAME: Ii"rA�AKI, ISA;4U
aooness: IWASAKI, F1ARY
9652 DUMBRECK DR
HUNTINGTON HEACH,�A 92646
FflCMIENGINEEH:
�OOflE55:
NEG.NO.:
UNIT:
`ja9
PEflMITTEE: NOCK PLUMBING ,,.-: i 695-1246
aooaess: 11610 SEABOARD CIR
STANTON CA 90680
LICENSEo CONTflAtTOB OEClABA710N: I hereCy atlirm tlWt I am IicertCG unaer prOvisians al Cluo�er 9(commencinp witn Section
7000� ol Orvision 3 0l t�e Business an0 Prolessions CaOe. anU my se n in tu0larte an0 ellect.
ciTruc.: OS 38F STRTELIC.:SSS9%% /!�`ss:l\_36 EXP: 02/95
Oaie: � SiAnamm: � —
WOfl8EP5'COMPENSR IONOECLAfUTION: Iherebyallirmtlut�IlavEdCenifMa contenitaselbinsureoratertificateolworker5'
Comoensalion Insurance. or a certitiea fApy inereal ISec�ion 3800. LaO. CI.
roucvxo.: 1167992-94 ezr.oaTe: 03/O1/95
comrnNr: S TAT E
❑ Ceniliea copY is Aereby lumis�etl. (;i: CenilieG copy is ed I�e cily i- g Division.
• a�e: O ppplicanL
EI(EMVTION FPUM WOBNEHS' LOMPENSP710N OECU11A710N: �Ttis sec6on ne[d rrot Ge completed ii Ne permt ¢ lor me hwMre 00) or less�.
I ce�i�y I�al in Ue petlOrmance OI i�e wOrk IOr wliic� �NS permit i5 iSSUEE. I SAdll n0i empl0y a0y Per50n in any manner 50 a5 �0 6¢cOme
su�le�� �o the Workeri Comoensation Laws ol Cali�omia.
oate: &qnamre:
NO710E: II. atler making t�6 declaraGon. you shoulU Eecome suEIK� �o t�e Worket5' fAmDertution D�%'i9ons of Ihe Labor
CoEe, you mu5t Iwt�vnl� tOmO�Y "^�� Sut� prmn5ion5 Or ItiS permii shall Oe Eeemed revakeC.
CONSTflOCTION LENOING RGENCY: I �ere�y allirm ttWt t�ere b a con5tnl[iqn IenGinq apenty lor itie pe�ormance af the work for
wnicn mis oermil is issuea (Section 3097, Civ. C1.
LENOEfl:
ADOXESS:
OWNEP BUILOEB �EClA8RTI0N: I �ert�y affirm ��a� I am e.empl Imm i�e Contractors' Stare L'cense Law tor t�e follovrinq reason
�Seclion 7031.5 Business an0 Prolessional CoOe: Any city ol COunry wNt� Rpuires a perrtut lo constNct, alier, imprOve, E¢molis�, or
moart any sirutture. prior to its issuance, also repuires Ine aoD�Kant far suCn perrtnt to lile a SigneO statement ihdt ANstie 6 IicenseU
pursuant to t�e D�ovisions ol t�e Contractors' Siate Lkenu Law �Clupter 9(cammencnp vnt� Section 7000) ot DNision J ol ��e Business
and Prolessians Cotle) or ihat he/slie is eRempt inerelmm anC the bdsi5 lor tne alleq¢E eKemptian. Any vidatqn of $ettion 7031.5 Uy
any aOV�itanl br a permil su0jetts Ne appliWnt lo a rivil penalry ol not more tlun Ilve hun4re0 AaIWrs (5500).
I, as owner 0� I�e pwperty or my employets wil� wa0e5 as their sole compensation, wiil Oo Ihe work, anG ��a
❑ slmclure is nal inlenUeO or ollereC lor sale (SettiOn 70aa. Busmess and Proleuionai Cotle: T�e Contracbrs' S�ate Licensa Law
tloe5 n01 ap01y lo an Owner ot a O�operty w�o GuiIES or imDmvlS l�ea0n, antl w�o Uoes Suc� work himSelfl�er5el� or tAwug�
his or her own employees. O�oviUetl I�al SUth improvemenls are nol inlEnAeO ar aHef¢a lar Saie. It, howBver I�8 Guildinp or
impmvement is sole wit�in one year ol complelion, Ihe Owner vnll Ilave IAe Durden ol DmvinA he/s�e tliA noi �uilU or impwva
lor IM1e purpose o� sale�.
I. as owner ol ine pmpeny. am e�clusively tonlratlin0 �^�� li[enSeO mnlra[lOrs �o fAnSimCi Ih2 pmlet� (Setlion 704E. BuSinC55
❑ antl Pmlessiws COEe: T�e Contracmrs' Sute License Law Ooes nol aODly lo an owner ol pmpeny w�o bwlas or impmves thereon
anC w�o coniracls lar such O�oletls wit� a conlrat10r�5) li[¢ns! OurSuani Io 1he ConVacio�s' State License Law). I am awarn
Ihat prool ol t�eir Worker'S ComOensation in5urante S�ouIG Oe O�oviGed lo me.
� I am exempi uMe� Section: B. 8 P. C.
br t�is r¢ason:
Oaie: Owner.
I tla nereby cenily Iha11 am aware ot ana untlers1an01�e reQuirements oi Calilornu Mealtn ana Safery CAae Seclions 2550.5, 25538. ana
255� an0 ihat I or any tuiure Duilamq occupant vnlVwill not (urU¢ one) neetl Io comply wiN 5ai0 Slate coEes anG ihe reQuir¢menl5lar a
permit lo� consliuctian o� mo0ilicalion Imm ��e An Ouab�y Ma(upement OiSirict. NevOeniial constru[lion applicali0n5 are e�empi �mm
In¢se provisions.
Oa�e: ADWicanl:
I hereGy certity ��a� I nave rea� t�is aoV�ication anG s�ate t�at t�e aUove inlormatian is mrrep. I aA�ee �o compy wit� all ciry antl Couniy
or4inancesanASlalelawsrelalingloWilCingconsimnionaM�ere or¢erepresentativeso�i_ I�dryloenteruponiheabove�menlionetl
pioperly Iar inSDetli Ourpose i �
c���d
Date: Q Signawre: —
miver's �¢ense or Sodai ecuriry a:
;6aP46 WM1ne—Bmltlmg: Green—Co�e EnlorcemenC Canary—Applicant; Pink—Revenue; GolEenrotl—Assessor
CITY UF COSTA PSESA — BUILDING PERMIT PER;A \O; P 06912:
FERMIT NO: P 069229 PLAN CHECK NO; IJ GOVT; N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOB DESCRIPTION ; WATER HEATER CHANGEOUT SQ FT;
CLAZM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMPIENTS: NO OTHER WORK AUTHORIZED BY TFIIS PERMIT
��x�*ir�r�r�*x��e?r�t#�**u*�ra�rx�+r#�rir#��r*#��r#�rx�r*�r�r�r�r�r�*x��r+r�rx�uu��#*x**��r�ir**?r##�rir#x*�r�r�,r�rs�
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 HUILDZNC ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT ZN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ; PROV; PARCEL: 42216212 ZNE: REF NO:
PLANNING NOTES>
i �
�r*�r�r*��r�r+ri��r�-*x�*x��*+�x**�x��r*�r*x�x�r+r�**�r****�r*�r*��t�r�r�e*�r�r+r***r+��r�-�r*#****�r#+���**�r�r*�r*
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 ; �' pATE: /�
APPLICATION ISS[IED BY: �� - DATE: �� I (/// �
1EiliFiEilil�lE!!lEiFiFif1ElElEiFiE4R1E'1l11� i FRit ii t! iC if i! ifit iF h ifiFiFl4ikilihifiFik��"iFiFiFiE�iF
i!ltkiElllEif#ihiflflE#fE1EtEiflflkiFik#IElE}!t •itif#i!iEifif#iFififiEifjEiEifiEl4ififlFiFiEiEik!liEitiEiEitff�EiEiEif�lFiEifiEitiE#iliE��iritiR#if#
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECI-IANIC FIRE SMIP/RES GRADZNG
PERMIT 7,00
258 , SMIP/NOP]—RES
PLAN
ISSUE FEE 20,00
BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 7.00 20.00 0.00 27.00 27.00 .00
r
REVENUE DICZ N -->
SIO TOTA . /
LS COLLECTED; 27,00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
2%.��
it iF iE 1E iE iE iE it if iE iE if i! iE iE f! iF it iE 1F 1E it if� iF iF it iF f! iE i! #!t iE iF iE ie i4 if it it?f 1h 7! if 75 df'k if iF if ±F it k iF if if k 1t iF 1! 1t if ik ft i! iF �! M iF # if it it # it i! it ##
I N P I C� 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
PLU 1 WATER HEATER AND/OR VENT 7,00 7,00
END OF FEE5-
Q1 OOLE9420-QQ269420 T O T
DAiE: 10/i2/?4 7iflE: 11:?6
27.Q0
CONSTRUCTION AND PLANNING
qPPROVALS Permit �4-`
1. TemPorary Electriwl Service or Pole
2. $oit Pipe�Undrgrnd. - - - -
3. Electrical Conduii Utiidy-Undrgrnd.
4. Elect�ical Conduit�Undrgrnd.
5. Sceel Reinforcement
6. Elscvical UFER Gmd.
7. Footings
8. Foundation
9. Vr'ater P�pe-Und.gmd.
10. Strucwral Floor System
71. ProPerty Sewer U�e & House Conneciion
1 Z. Sewer Cap
13. Roof Orains
14. Rough Plumping
15. Rouyh Electriwl•Conduit
16. Rough Electric Wiring
77. Rough �Viring Sign
78. Rough Electrical�T Bar Ceiling
19, Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ductz, in Structure
22. Ducts, Ventilacing
23. Gas P�Pe�Rouqh & Test
24. Root Framing
25. Roof Sheathing
26. T�Bar Ceiling IScrucwrail & Monocoat
27. Frameand Flashing
28. lathing & Siding
29. Insulation
30. Dry�vall Nailing
37. Plasier Brown Coat
32. Electrical Po�ver Meter�Final
33, Final Electric
34. Pinal Heating & Air Cond'rtioning
35. Final Gas Pipe-Test
36. HoOd or Canopy
37. Final Factory Fireplace
38. Findl Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Sola� Domestic-Final
42. Backfiow Preventer
43. Backflow irrigation
44. Landscape Irriqation Sys[em
45. Sound Attenuation
46. Handicap Reg�lations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Elettric Release to Edison
50. Gas Release to Southern Caiifornia Gas Q
51. CEflTIFICATE OF OCCUPANCY
No. Date
Date
POOI F .1
Inspector APPROVAIS Permit �
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUNiTE
56. EleCtric2l CAnduirUndrgmd.
59. Gas Pipe, � Untlrgm�., Test
60. Backwash Lines, P�Trep, :' Undrgr�d,
67. APPROVAL TO DECK
62. Backwash & Receptor�Fina�
63. Heater & Vent�Final
64. Plumbing System - Final
65. Electrica6Final
66. Solar System-Final
67. Fencing & Access ApP�oval
68. APPROVED FOR PLASTERING
69. POOLlSPASYSTEM11SFINAL
FIRE �EPT. RE�UIREMENT
APPROVALS Permit # I
70. Underground HYd�o
71. Product Piping O Gas ❑ Od
72. Underground Plush
73. Underyrnd. Sm�aye Tank Q Gas � 0�1
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
76. F�RE PREV. FINAL
' - HEALTH DEPT. REQUIREI4IENT
' '- 79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
�
,
Date ; Inspector
{
�
�
wr
a`
O
�
Y
�
�
/�OO���ant to fill in all spaces except t�ose wit�in �eavY �orGer lines anC sign all apprapriate Oeclaratians.
CITY QF COSTA M S NS Uy�TI PE IT%}' PF37MIT NO. _ TRACT NO. LOT NO. I INIT nln
Project � ddress � N � _
ApplicanYs Mailin ddr s
Owner's Name Phone � �
Address
Arch/Eng. Licenu No.
Atldress ( ,
Addresslmailing) '�Vv(i Iv - IGv •r i�7 � �V � iiyt�
--Z�':j
City License No. !/' /Q
LICENSED CONTRACTOR DECLARATI N
I hereby aftirm Iba[ I am licensetl untler D�ovision of Charter 9(mmmentlng
with section ]000) oi Division 3 of the Business antl Professionz Cotla antl
my Ilcense is In lull / ce eHecL a
Licens CI ss ' L c i s .
Date Signahre
WON RS' COMPENSATION DECL RATION
I her¢Dy atfirm that 1 have a certifica[e of consent to self-insure r a c¢rtiflwt¢
of Worken' eompen5ation Insurance, or a certifietl copy tn�t�5�tion
'900, l.ab.
n
licy o. Company �
tifietl copy is nereby furnishetl.
Certif tl c y is �il/° tl with the tity 8 I in Divi i_ q..
Date � �y�-- Applicant� ��
E%EMP I N ROtifWORKERS'COMPE SATIONDECLARATIO
(This section neetl no[ be comple[etl if the perml[ Is for one huntlreC $300) or
less).
I certify Ihdt in (he Performanc¢ Of the wo�k for whlch th15 pe�m�t is IsSueQ I
shall not employ any person In any manner so as to become subj¢ct to the
Workers' Compensation Laws of Califomia.
Dale Si9nature
NOTICE: 11, after makin9 this tleclaratlon, you shoWG become zubject to the
Workers' Compensation provisions of [he Labor Coee, you must forthwith
comply with sucn provisions or this permlt snall be deemea revoketl.
CONSTRUCTION LENDING AGENCV
I hereby a(firm Ihat [M1ere is a constructlon lentling agency ior [he periormance
ot tho work tor w0ich tnis permit is issuetl (Sec[ion 3097 Civ. C.)
LenEer's Name
�enCeYs AtlCre55
OWNER 9UIlDEN DECLARATION
I hereby atflrm that I am exempt from the Contractor's License Law for tn¢
followin9 reason (Saction 7031.5 Business antl Professional Cotle: Any city or
county wbich requires a pe�mit to con5truct, alte�, Improve, tlemolish o� �epair
any sVutture, prior to its issuance, also requires the applicant for suth permit
to file a Sign¢d itatement that he/she I5 IicenSetl pUrSUanl ro tbe provi5iOn5 of
the Contracior's License Law (Gnap[er 9(mmmencing with Section 7000) of
Division 3 of t�e Business and Professions Cotle) or that he/she is exempt
tM1erefrom anE tne basis for [he allegetl exemption. Any violation of $ection
�031.5 by any ap0���ant for a pe�mit SUCjectS the apP���dnt to a civil
'nalty of not more Ihan five huntlretl tlollars (5500).
, I, as owner ot the property or my employees with wages as their sole
._ompensation, will tlo tne work, antl the structure is not intentletl or offeretl
tor sale (Section 7044, Business antl Professional Cotle: Tne Contractor'S
License law tloes not apply to an owner of a property wno builtls or improves
thereon, antl who tloes such work himselt/herself or tnrough his or. her own
employees, prOvidetl ihal SUCh Improv¢ments are not inte0tl¢tl O/ o(fe�etl for
sale. It, however, the builaing or improvement Is soltl wlthin one year o( tom-
O�etlon, [ne owner wiu nave the burtlen ol provinq he/she tlitl not builtl or im-
nrova'for the purpose ot sale).
❑ I, as owner ot the orooerty, am exclusively contracting wlth Ilcensed con-
Vactors to wnstruct the p�Oj2CI (SCCIIOfI �064� BIISIOE55 dOC PlOIESSI005 COEB:
Tne ConVattoYs License Law tloes not apply to an owner of property who
builtls or ImOwves thereon. and who contraC[5 lo� suc� oroieCtS wit� a mn-
[raclor(sl Lcense pur5uam to �ne ConLraCforS l_Icense Law). I am aware tha[
o�ooi of their Worker's ComPenSation Insu�ance shoultl be O�ovitletl fo me.
❑ 1 am exCmpt untl¢r SeCtion B. & P. C. tor this reason
Date Owner _
I hereby certity that I have. reatl this
Information is correct. I agree [o comp
antl state laws relating to builtling con
sentatives of t z ity to en pp i
in5pectiOn purp �
Signature
Drivers' License r SS �
OB65-46, rev. 5/88 White -
- Ac<ounting; Goltlenrotl - Assessor
$15
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
SOlar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Tra'ys
laue Fee
Hood or Typel ❑
CanOpy Type II ❑
Refrig¢ration System
❑4100,OOOBTU ❑100,000
System Repair/Alteration
Fire Damperi '
Registers
Issue Fee
A.P. #
S Main 8uildi
E
T Front
6 Fear
A
C Right
g . Left
Ping. Ref. #
Planning Notes:
FEES P.uromatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
$ 3
FEES
$�
Electric
Fan
F.A.U.
Fixtures
Device Baxes
�Utl¢t5
Switches
Garbage Dispoul
Generator �65 KW
Zone
ELECTRICAL
Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors �0.1 HP � 1'h - 8
IncSoiar �9-15 HP �i6-15+
Pole,Li9ht
� I Standing Sections
15 KW Trash Compactor
� Reinspeaion Fee �$15 � � Issue Fee
DEVELOPMENT-SERVICES REQUIREMENTS:
Zonin9 Approved By
Building Approved By
� BUILDING PERMIT $
� PLAN CHECK $
PLUMBING $
PIAN CHECK 25% $
ELECTRICAL 5
PLAN CHECK 50% $
MECHANICAL �$
PLAN CHECK 25% $
/
N
I
N
G
R
E
Q
M
T
S.
FEES
$ 3
SMIP $
PERMIT
ISSUANCE $
ENERGV P.C. $
GRADING $
MICROFILM $ --��— ��/}
TOTALFEE $ �
o: ceo7z4�Q-0002297s �re�-r z�.;,o
�ar€: iziz�rsa iIfiE. es:z�
• \ ' Y •
COIVSTRUCTION AND PLANNING 7 POOL L a
1, APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole �� 52. Pool & Equipment Location
: Soil Pipe-Undrgrnd. � 53. Steel Reinforcement ;
3. Electrical Conduit�Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undrgmd. ' 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6.�ElectricalUFER-Grnd.- . 57. APPROVALTOCOVER-GUNITE , �
7. Footi�ngs • � . 58. Electrical Conduit-Undrgrnd. .�
�8�. FounBation '` - 59. Gas Pipe, 0 Undrgmd., Test . �
, 9. Water Pipe-Undrgmd. -' � - 60. Backwash Lines, P-Trap, O Undrgrnd. ",
tO..Structiiral Floor_System --�1 - 61. APPROVAL TO DECK
i;t. P.roperry Sewer Line & House Connection � 62. Backwash & Receptor-Final
12: Sewer Cap _ - 63. Heater & Vent-Final
,13. �Roof Drains 1 . 64. Plumbing System - Final
14. Rough Plumbing ,., 65. Electrical-Final �•�
15. Rough Electriral-Conduit 66. Solar System-Final
c� Rough Electric Wiring 67. Fencing & Access Approval •�
.]7. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
;19,. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
✓
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. D�cts, Ventilating. 77. Product Piping OGas OOiI
23.,�Gas Pipe-Rough & Test �- 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. ,Ovechead Hydro �
26. T-Bar Ceiling (Structurall & 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 j-
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �..� �,
33. Final Electric Notes: /-� �7 L��T C.o.¢v • 4e"•O
i
34. Final Heating & Air Conditioning � � (�(� _ _ ��
d •i
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace"
�.�
38. Final Plumbing n� , ��
39, Water Service-Final � � � ' ' _ _ _ �_ _. _ _ . _
- '3^ti7-_. . �-- - "- -- -- - - - - - � - - _. � s _ .
40. Gas Service-Final � � � �=� . ��
- .:t �
41. Solar pomestioFinal��� �=�^ ''
42. BackflowPreventer c;;,, ;` '�,� ,�
43. Backflow Irrigation -�� � �I "'��
44. Landscape Irrigation System ; _a ' �
45. Sound Attenuation , -��� �
46. Handicap Regulations��i
47. FINAL STRUCTURE & BUILDING
48. Soecial Requirements Completed .
49. Electric Release to Edison ,� �
50. Gas Release to Southern California Gas Co J-' �
�I.
51. CERTIPICATE OF OCCUPANCY '
,� �
No. Date �
E
P.{'�.IECT70c��ess: 2z69 MINER ST
owxee•sr�rne: IWASAKI, ISAMU
RODflESB: IWASAKI, MARY
9652 DUMBRECK DR
HUNTINGTON BEACH,CA 92646
962-6493
RflCHIENGINEEfl: NEO.NO.:
ADORESS:
uxrt:
UNIT:
PEPMITfEE: CRANIC BAOTHERS AOOFING ( 714 ) 548-5569
�ooness: 126 COMMERCIAL WAY
C.M, CA 92627
uCENSEO CONTMCTOB OECIAMTION: I hea�y atlirm that I am IicenseE unGer Orovisians al CAaOter 9(commenrinp vntA Sectlon
7000) of Divi4on 3 of t�e Business an0 Pmleuions Caea, antl my license is in full force anE eflect.
crtruc.:005993 sr�TEuc.:90867/7 ��'/��.Ass: 39 /n"
Oate: � `L� � �J SipnaWra: ( �/ ��C� `��
WONKEPS' LOMPENSATION OECUMTION: I hereEy aflirm that I luva a ceNliwte of wnsent ta sel4insum or a ceNliwte al Workers
^ampensation IusW3ecq e� 3 rqrUfietl copY tnereof (Sectlan 3800. LaO. G�1 / 0 1/ 9 1
�cvxo.: STATE97V E7(P.ORTF: l/
AMPUlY: ,5�
I � Cenifetl copy is hemEy /umishe0. C! Cenifietl copY is file0 m �e ciry B�'tlin0 DMsion.
e: � '�''L� '�� c� Applirant ��CJ� l��
� IXFMPfION FHOM WORNFAS' COMYENSITIXIN OEGAMTION: (iAit section nttU im� Oe mmpele0 il W pumil6 fa ane AutlrtE (5100) wl¢s).
I centry Wt in Itce pedormance af Ihe work lor w�ich this permil is issue0, I slull not emDbY afry person in anY �ner w az ta Oecome
w6ject to tha Workers' Compenutian Laws of Califomia.
Oate: SlpnaNre:
NOTICE: If, attu malanp I�is Oeclaatlon, you shoulU become SUEjact to iha Workers' Compensaibn proNSions o� the La�ar
CaOe, you must torllrvni� wmDN ��h such D�srons ar tks permit shall Oa EeemeO rawke0.
fAXSTPUC710N LENOING �GENCY: 1 �ereGy afArm that thera is a consiructbn IeMinp apency lor the peAormanw of tAe work for
wNch Ihis permit iv issue0 (SectlOn 3097, Civ. C�.
IFNOFR:
�onxess:
OWNEP BUILOEP DEUAMTION: I IrereEy aflirm that I am axempt Irom t�e Contactors State Lkense law lar IAe tMbwinp reason
(Sectan 7037.5 Business anA Pro7essional CoOe: My ciry of wunry wliicA repuires a permfl ro construct, aher, improva, tlemalah, or
repair any siructure, prior to i6 issuaixe, alm aduires ihe apD��cant for suc� permA ro file a sipned statement Ihat hNsha is Ilcensetl
pursuani to NB pmvaiore of lhe ConVaciori State License Law (CAapter 9(commencinp vni� Sation 7000) ol 0ivision 3 0l I�a Business
and Pmtessrons Catle) or tAat MlsAe is eKemD� tAemimm anE t�e Oasis br Ne alle0e0 exemD���� �Y �oWtion af Sectlon 7031.5 Ey
any apDlicant far a Dermit su0jec¢ IAe aDD�icam to a cNil penalry ol not moro ttun five hunUreO Oollars (5500).
. I, az oWner al the properiy or my efINIOyCeS Wlth wa�es as Illeir SOIe fAmpCnsatlon, will ao tne wafk, anU the
S[NLWRIS 001111IBOUEC 0! OHlf2d(Of 5318 (SCCI100 707d.BO5fIPS5 2110 Pf01E5510fIdIC00B: T110 COIIIfiGIOR� $I2IB LILE050 LdW
tices not apDN �a an ovmer ol a pmperry n1w GUJCs or ImD�oves tAereon, an0 who Ooes suc� work �imselt/Aarsell or thmup�
I � his or �er own employees, DroviOeE that suc� Impmvemen(s are not imenCeO or atleaE for sale. II, hoxrev¢r t�e OuilEinp or
imOrovement is sold wtthin one year ol completion, tAe owner will hava I�e GurEen ot O�oNnO he/she Ui0 not �uilO or ImD�%'e
lar ihe purpose af salel.
I, as owner of IAe D�aOeM• am excluSNeN coniractinp witA IicenSeA contrectars to construct the Drojecl (Section 704d, Business
I J anE Professians COAe: Tha Contractors' State License Law Oaes not appty to an owner of Oroperty who OUA0.s or imDroves therean
anE who contacts for suc� prol� zfU a contractor�s�license pursuanito the Contnctors' State Licensa Law),I am awam
ihat Drool oi tAeir Worker's Compens.twn msura(xe shoultl Ca DroviCetl to ma.
� I am exempi under Senion: B. 8 P. C.
lar Inis rea50n:
Dd�E: �W�Bf.
I Go �ereby certiry Ihat I am awaa oi anG unEarstan0 tAe repuirements of Calitomia Mealth anJ Salery CoOe Sections 25505, 25533, anG
25534 anG t�at I or any luture GuilEinq occu0ant wilVwill not (circle ane) neeE to comDly wlt� saiG state coGes and the reQuiremenis lor a
permit tar constmction or ma0ilicatian Irom t�e Air Qualiry Manapement Disfict. HesiUential consimction aDDlications are eeem0� ��am
Ihese pmNsions.
Oaie: ADPlicanC
I hereby certily tAat I have rea0 this applicatlon and state lhat Ihe aUova intormation Is correcL I a0rea to compty wIN all ciry an0 counry
or0inances anU state Wws relatinp ta builtlinp conslmciion anE herahy authorim �e0resentatyes ot Nis ary to enter upon iha aEmo-mentlone0
pmperry for inspe�ction puryous. // � ��
'Data: �_` ��, � SlOnature: � f«S'"—" ��
Dnver's �icense or socia� Seadry x: r
160118 Whiie—BuIlElnp; Oraen—Cotle EnlarcamenC Cenery—Applicant: Plnk—Ravanue; GWOanroE—Assaswr !
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 049225
PERMIT NO; B 099225 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE; STR PURPOSE: ALT
JOB DESCRIPTION ; T/OFF REROOF W BUILT UP SQ FT: 4,469
CLAIM VALUE: 4,469.00 CALC—VALUE: 4,469,00 GROUP OCC: R-1 /
COMMENTS; T/OFF REROOF W/ BUILT UP GRAVEL
*r*�rx*�r�***��*****�r*��r�rrx**�r*�r***��r�***��r**+r+r+r�+r�r**�r*�rr**�****r**r*��*******r�r�r
2 O N I N G A E Q U I R E M E N T S
ssrBAcxs
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN AGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42216212 ZNE: REF NO;
PLANNING NCS'fES>
>
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D E V E L O P M E N T S E A V I C E S R E Q U I R E M E N,T S
ZONING APPROVED BY .
BUILDING APPROVED HY :
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LEGALIZATION:N F E E
DATE;
DATE:
DATE : °�+ZS� U
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S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING EL TRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 72.00 .50
SMZP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 72,50 0.00 0,00 72,50 72,50 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 72,50 OVER/SHORT: 00
HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
72.00 ,50
k ik ik k k ik k ik 1! fk 1k if ik ff ik iE �f !f ik ik fk �! fk �F fk ff it 1f ft iF if if �f 1F iFlF iF if ik k 1f 1f if iF k if if fk M iF iF it Ik M ik iF ik 1t M iF 1E M M iF 1f if if ik 1E it iF M iF %if iF if M iE
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 4469 REROOF BY VALUE RESIDENIAL NOZONE 1.00 4,469,00
END OF FEES
O100D706S9-0007065p 'B"q.'o7'
GATE: 09/28/4� TI�iE: l0�44
CONSTRUCTION AND PLANNIN(a '� � �
APPROVALS Permit # Date Inspector APpROVALS Permit # Date Inspector
�1.7. Temporary �lectrical Service or PoleN 52. Pool & Equipment Location
n� �
.2.�Soil.Ripe�Undr9rnd-� � �E`z., 53. Steel Reinforcement
-"'-35iElec`-t'rical Con `ft'I'ltiliry-Undrgrnd: 54. Forms
'�' i.:1' air . Cq ^J
"y;4�Necir,�cal Condu {�Undrgrnd. " 55. Electrical Bonding
-� 5. �eei�Reinforcement %< 56. Rough Plumbing & Pressure Test ��
r..n n a �
�:6�EJEctrical UFE-�,`.,.Grnd. � 57. APPROVAL TO COVER�GUNITE �
c�?IyF.00tings :'^ !� 58. Electrical Conduit-Undrgrnd. ��
8. Foundation N,.'l.�j 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Un�rgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Flooc'System � 61. APPROVAL TO DECK
71. Pro`pjerty Sewe?'Line & House Conoection 62. Backwash & Receptor-Final
12. Sewer Cap =� � 63. Heater & Vent-Final
r"•�1 '--�
13. Roof Drains -� y ' 64. Plumbing SYstem � Final
14. Rough Plumbi�g 65. Electrical�Final '
75. Rough Electviral-Conduit 66. Solar System-Final
76. Rough Electric;Wiring , 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electr+ca4-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL
79;,,�Rough Heating Sc�F�ir Conditi �iny C,tr, * � p �(�: x,� a, FIRE,DEP,T. R�EQUIREMEN,� N
�,, � � •+..•, , . v .., v . 7 c�7 '7Cu: �i t,. x 7+ t'�^
20`�Rough �cto(Y Frceplace , SM �w. � S H Ma� 7� APPROVAI:S-�FPeCmit #�
L T'c' �-f C!"1� T % R'
21.^Du^ts,i�Struct'-« i•• •• �'S � S v �;i M' � r. cJ^� S ?�
�.,, � f1 �� i S�y * Cj r., Cl?; *,-�70• UPdergrqund Hy�ro *
225Dup"'ts, �entlatirigx i ��n ?: G �; CJ i•a x�E71, Produci+Fiping O(�as C�OiI
nn �
23.'Ga 'Pipe�-Rou h & �Test < i"•= � �T% a' 'Q �* * "'72, Under ro� � Flu h ` * F"' `'
� t�7� .-. x � tr!r C�O � � b' S n�� 9 P� S a �w ;; �
24. RoofF�ming Cg �' M* j ir ;..ixa: �73:7Undergrnd.Smr2��:l:ankrOGas ❑Oil
� � ..
25. Roof Sheathing'"�+� `C �`�x � � "' N� � 7q�pYerhead Hydr � �'
rn � k � ':1 �y: # aSC K
' A �'-11-1 # V [Ti R: h. • ' • . v
26,�`�T�83r Ceiling (St5'O�tural) &`Morwcoat �: p � v�: # 75.T_Dry Chemical F� �^ t*1
27=�Fr�'me and Rlashing; �a� ��' �' p* � 76. Dry StanM rpe `"'� �' c � �
n n � , n.« F. t++ n m � r* i �! 'S �--� x � N O
: � mW rn `7�2x � x? a: � r��,��
�'",',28. Lai�ling;& Siding �; V�r, p � ..� ..I� ,� x 77 ; FIXED S�YSTEM�F.INAC� �-+ C:
.�.
,�29. Insulati,pn Y' "' n _ * S I `� �, x 7g�FIRE PREV. FIiVA�L �� x�
[n u O 'Z'1: l; F H y n ✓
30. Drywal�Nailing �k� �.y � * � , � � � S r�EALTH•DEPTr. REQUIRE;MENT
`J31. Plaster Fiiow� C4at� S � �'"^ * I � � * • 79.^FINAL If,V�P£CT16N � ^ �
n' m .+ x i:.. t-. Y � K* . J H i: � F �7
' C "] :k CJ I # N I -t!: .Y �7 R] � -�: � x:
;�32 ;Electrical Power.MeterF,jnal; x � � „`K t 80-F000 CERTIFI§ATE ISSH£Dr+ �
�33YFiria] Efgctn�• + * !'� � � x � I � '�'�` � Noies: `� "7� � "� O nit�7
r-� � n v: m i., ti er � e i x� e-� t*1 Cl a: !-; S
r".k i 'C' {l ?: Y�� 5. ,> ( 1i .� '.Jv
�'�34rfirtal H�atin�& A+y;Condition�ngS � * ti I f ;'� q � �., � :,� *
� 35 ^Final Gas Pipe-TesPr O� .: � "� � ,' � * ' o "n � :�7 ¢�
�36.�Hond o�'CanoPv K �n � '„m-, � y * n I , I� �� � k ;� xo ? �; m
^37 �Final Factory Fire{flace� I Ft-� '-� * � • � � ' 1� _ � �'�
n � r^ ^_� x N I i fK # V,^ T` x S
i
�-38. Finrt3'f Plumbjn9 # �rN -y�. * � � ' � � !-i � x 'i�i
u39. Water Service�Finala � � * G � { �c ^ 'r * � S
..• � r x i � K c.•'v >: C�7 i9
r :tT CT�: S KT X V:ii fJ(U �
40. Gas Service-�tnal � n�� ,,, ,� I I � x r•�,i *,�
•.`,A7. Solar pomest��-Final'J ;r ic `� I � a t-� �:o �^ :� x ^
r-, I i �7 .. ��i � S
, 42. Backflow Pre.venter" N # � � f� � `- ='' � ' � ',�y
� � # (u O �-! �- � H x •: t*I �-1 J'J x .
�,.�.� -
43. Backflow Irrigationr ��� Y S ��� �� �� O o
�'44.,�Landsca�e Irrigation Systerrt�' �"" � *'`' G O G� r ^ 'o [ti � c> >+ ,u :�
T J¢.'�.. C^ � Q'Q.' �"-'.� -ti � � i C��-^. X• S
� _ �...�- � . c� � . . .. . . ..
� 45.;Sound Atte�uation� ••• r� [T: �+: [a* x c' d• E-r' x
i. c v � ..Y'i, i i HL ••H
�46.'Handica RegUlatio`ns �' � 'K � %� �` � ''� � `
p� c S .. r S I I f� > 4 inv0 C� x
, � . . _ .. � r
-47 `FINA.L STRUCTURE & BUtiLDING b:(C� pr + ti, �, K �
48=FINALP,LANNING` '''�' a '" • � � �' �' ", '. `"
c ,� !: I � �'•b: r� o n; s' � n;
� - - ' T ,. -
._49.:Electrio-Pelease to �Edison • .�; i � -' 4 �: ` 7:
� 1 �t Y� C r X J
� 50.�as`�ielease to Souihem California Gas Co ': �� �` " � `-� r' � � � '' " '
s ��.> �. �F F• S .7 O v C•i O
51. CERTIFICATEOF'OCCUPANCY ' '� •" " '
No. Date
City of Costa Mesa
9uilding Safety Deparfinenf
P. O. Box 317
Cmla Me�a, Califomio
CERTIFICATE OF OCCUPANCY rj� i�gg C
The Building located at �Y=S'� Z�=�"�' ���f�• A� D. 6e C
has been inspecred and found to comply with the provisions of all City of Costa Mesa Ordinances appiicable thereto
for a Group �* � T Occupancy.
Use of Building ''�i.n.�_i:x I:a�:i�lcr•co diCi� e�ttaclle� Caspost �� ^
Legal Description U�t �+ ' C• i's`��Ct' �9b
(Sea reverse aido fof Mote� ond Bound�)
Building Permit No. �� Electrical Permit No. ��'� _ Plumbing Permit No. ����
Floor Load Signs have been installed as Room Capacity Signs have been instaled os
rCquired under Sea 2308 U. B. C. . required under Sec. 3301 (7) U. 8. C. —
17050. CERTIFICATE OF OCGUPANCY. (a) No apanment 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 obfained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The n�mber of apartments or guest rooms
3) Ownership
If Group H Occupancy, number of apariments ond/or guest rooms as required under Sec. 17050.1 (d), California
Administrative Code, Title 8, Chapter 9, Article S.
Number of aparimenTs 3 and/or guest rooms
ISSUED TO: Building Official
._ F.wr��::�'1 (1, 4`i:ium3 by� `%�'f �' ��
' Date � �S � �
This Cerfifitate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. F�,,,, sv,,._.,u_,,.�,5_B p
� 20034
COSTA MESA BUILDING-SAFETY DEPARTMENi
P.O. BOX 81] COSTA MeBA, CALiFORNIA
For Appllcan/ ►o Fill In Complately
TYPE OR PRINT
BUILDINR •�l<�J�� ,/�I!//vC,� S�
ADDRESS L ��
COSTA MESA, CALIFORNIA
OWNER Csewell & Struve
ADDRH98 7900 Pacific Blvd.
�,TM H nti ton Park No Lo 617
OREN'GI EER D& E A86OC• NO.TO ZHi
�STATE .. TEL.
LI0. NO. NO.
ISIZE /'i /._�. I No. o�
EFT � I R16HT
DESCRIPTION OF WORK
FEE�r�{ t,RECw�E,��VED
liY I'v 2�J 1 �'U'
�IPIVA�BL! LD7PI�.PERMR
CIT��O WftH9TR�69EAi��r
P[C6�I� NO. PCpI
� "_ ��¢-.,�-/ � �u�
up �
% /s'-�'
�
'E: NO EAV E OVERHANf3 BHALL BE LE99 THAN
'TOSIDE@REARP.L
'ES
.OWED �U. B. C. REQUIREMENT'.
YARDSAPPROVED YARDSAPPROVED
MAIN BUIL�INO ACCESSORV BUILDIN6
RF, I I MOVINO I I DEMOLISH I O16fANCE BET. BET. MAIN B
MAIN BL�GS. ACCESS. BLOO9,
BUILDIN6 n � NO.OF V��# � DATE
SIZE YOOO ftOOM9 11 Sf RIBS 2 C. U. P. APPROVED
EXTERIOR WALL ROOF 9 MPROVi �
COVERING StC• COVERIN6 `�G� D 1'�✓� �AT '�'
USH OP BU ILDINC AND WORK TO B6 PfiRFORMBD
New t. Bl .�,oi ,¢ ,� HbLf� FOR PEC /
y-` ��/v.u%J. . —
N
O. �. �/ "
1 MEFEBY ACKNOWLHOOH TNAT I NAV6 HBAO TN19 APPLIGTION TXE AMOUNT BXOWN UNOBR VAL ION I6 pOq TH8 S
ANO 8TRT8 THAT TH8 AB 8 �9 CORNECT AND AOHBE TO COM. PUNP088 OP HBTABUBXINO A HMIT FEB ONLY, p
PLV WITM ALL CITY OHO ANCQB O BTAT[ LAW6 qi0U4TIN0 ypLUAT10N /%� '
BUILDINaCONBTNUCT pERMITFEE $ /"�/"� j
SIGNATUREOF �//J� . /��/l O1 N
PERMITT6 S ,3�� �J NCHECIC $ �/ p
AUTHORIZHD AGfiNT �`
TqTAl FEE ��S^ / �