HomeMy WebLinkAbout811 PAULARINO AVE - Building Permits"� � ' ^ . CITY OF COSTA MESA � -
' BI/ILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax Qt4) 754-4856 • vnvw.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754-5626
1,^de�mw•�:
PERMIT NUMBER: E08-00340
PERMIT TYPE ELEC STATUS: ISSUED
APN: 41812123 DATE ISSUED: 08/21/2008
ISSUED BY: RMD
JOB ADDRESS: 811 PAULARINO AV CM
Vicinity: BUILDING G AND H
Suite/Unit:
SCOP� OF WORK: REVISION TO PERMIT ON 08/25/08 TOELECTRICAL PERMIT FOR AN APARTMENT BUI�DING G& H FOR FUTURE
WORK TO INSTALL 2 BRANCH CIRCUITS FOR A MOTORIZED GATE AND SENSOR LIGHTING. �
ELECTRICAL PERMIT TO INSTALL`A t00A SERVICE PANEL TO BE LOCATED AT APARTMENT BUILDINGS G AND H(ATTACHED BLDGS).
OWNER; FOLEY, NORMA J TR �
PHONE:
APPLICqNT: FOLEY, CYNTHIA
PHONE: 714-813-2343
CONTRACTOR: OWNER-BUILDER
Address; Unit: -
CirylState: - �
PHONE:
ZipCode:
ELEGTRICAL PERMIT FEES
ElectriCal Plan Check Fee: $0.00
ElectriCal Permit Fee: $90.40
Reinspection Fee $0.00
TOTAL FEES $90.40
Address: 6700 W OCEANFRONT Unit:
City/StatelZip: NEWPORT BEACH, CA
Address:
City/State/zZip:
Unit:
License No. 000000
CEL�:
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NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) '
EXPIRqTION: 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 inspecHons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiraGon of this permit.
COpE/, INSPECTIONTPE DAT INTITULS SOOE/ INSPEL110NTPE �j� IN717UL5
1818 FiaeO System Final Fire P2vention 208 Final Mechanical
1268 Pool Spa Final 208 Final Plumbing .1
20� Final Re-Roof 210 Final Electriwl � �v �^
201 Final BIocWRetaining Wall 212 Final Fire Prevenlion
202 Final FaUory Fire Place 220 Final Planning Approval
203 Final Si9n 222 Final Site
204 Final Demolition 250 Final Builtling/OCCuDancy
WORKERS' COMPEN5ATION DECLARATION:
1 hereby aKrm under penalry of perjury one of the following declarations:
❑ I have antl will maintain a certifica[e of consent lo self-Insure for workers'
compensation, as provitled tor by section 3700 of the Labor Code, for the
peAormance of the worl� �or which this permit is issued.
❑ I have and vrill maintain v.orkers' compensation insurance, as required by
sectbn 3700 0l the LabPr Code, for the peAormance of the v.ark fw which this
permit is issuetl. My �+orkers' compensation Insurance carrier antl policy
number are:
Carrier.
(ihk sectun need ipf be mmdeted d the permrt k valuatl al one hvMred aa'Wrs (3t0pJ w less )
P�o/liSH Numher:
;Ly I certi(y that in the pertormance of the vrork for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to I�e workers' compensation laws ot Califomia, and agree ihat it I should
becom ubjecl to the workers' compensation provisions of Section 3700 of
the l r tle I II f@�hwiN co ply with these proyi90n5. ���
G( � �l d
�Applifanl'S SignaWre ,Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aNirm that I am licensed under provisions of Chapter 9 �commencing
with Seclion 7000) of Di�ision 3 of the Business and Professions Code, and
my license is in full (orce and eftect.
Lic. # Class #
Conlrector's Sig�lure Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a constmctbn lending agency for the
pertormance o! the v.ork (or v.fiich IFus permil is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atldress:
Signawre Da�e
OWNER•BUILDER OECLARATIONS:
I hereby aKrtn thal under penalry o� perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW (or the (ollowing reason (Sec. 7031.5,
Business antl Pro(essions Cotle: Any city or GOunty whiGh fequires a pertni[ to
conslmct, alter, improve. demolish, or repair any structure, pnor to its
issuance, also requires ine applicant (or such permit to file a signed statement
that he or she is licensed pursuam to t�e provisions ol the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is ezempt Iheretrom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant lor a permit sublects the applicant lo a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner o! the property, or my employees with vrages as their sole
compensation, WILL DO THE WORK, antl the slrucWre is not intended or
oHered for sale (Sec. 70d4, Business and Pro(essions Code: The Contractors
License Law does not appty to an owner of property who builds or improves
thereon, and-who dces such work himself or herself or Ihrough his or, her own
employees, provided that such improvemenis are�not intended or offered for
sale. If, however, the 6uilding or improvement is sold within one year of
completion, the owner-bu�lder will have the burden of proving that he.or she�
did no uild or improve for purpose ot sale.). .. �. _
I; as owner of the property, am EXCLUSIVELY CON7RAC71NG WITH
LICENSED CON7RAC70R5 to conswct the project (Sec. 7044, Business and
Professbns Code: The contrectors License Law dces not apply to an owner of
property who builds or improves thereon, antl who contracts (or such project with
a cantracta(s) license pur�uant to the Contraclors License Lavrs.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
�•J�.�
�SignalUre Da�e
]OS]- (3/0]) ��
Owner ID verifetl by dr' er' __.,nse. es ❑.No ��` (/. �� ��
Driveis License No.� Expires: � _
Verification of Ownership by (rype of do ment, i.e. - property taz bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: �` •.
❑ I hereby certAy [hat no excavation (rve (5) or more feet in tlepth into vfiich a
person is required to descend, will be matle in connectbn with work authorized
by this permit, and that no builtling slrucime, scaffdding, faisev.ork, or Oemolllion
or tlismantling Ihereot, will be more than thirty-sa (36) leet high. (Chap. 3.2, Grp
2, Art 2. Sea 341. Ttle 8, Califomia AOministrative Cotle).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a permit to do such work from �he division.
ApWimnPs SiqnaNre
Division of IndusMal Safery Permi[ Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or (uture building occupanl neetl to file arW
certify a Business Plan for emergenq response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Cali(omia Healih and Safery Code requires, with some
exceptions, that a Business Plan be fled vrith the Costa Mesa Fire
Department by every business which has at any one time tluring a reported
year a quantiry of hazardous materials equal to or greater than a weight of
500 pountls, or a volume o/ 55 gallons, or 200 cubic feet of compressed ga5
at standartl temperaWre and pressure).
2. Does or vnll the applicant or preseM or future builtling occupant need to �le
a registration lorm tor acutely hazartlous ma�enals? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each 6usiness which at any one time has on hand a quanti[y o( acutely
hazardous matenals equal to or greater than a weight ot 500 pounds, or a
volume of 55 gallons, or 200 cubic feel o( compressed 9as at slantlard
temperature and pressure).
3. Does or will Ihe applicant or present or (uture building occupant need to
prepare an RMPP (Risk Management and Prevention Program for awtely
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Cali(ornia Health and Safety Code provitles that the
Costa Mesa Fire Department may require the preparation, certification and
fling wi�h Ihe Fire Departmen[ of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently required, ha5 Section 25534 of the California
Health antl Safery Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or W Wre builtling occupant require (or
the �+rork which is the subjecl o/ ihis application a pertnit for such COnSWc�ion
o� modifitalion fmm the South Coasl Air �ualiry Management DisMct or fmm
any other air pollution control distnct or agency? ❑ Yes ❑ No
(Section 65850.2 0( the Calilomia Govemment Code requires that the requested
informatbn he fumishetl on applications fv rwrnresi0ential builtling pertnit5).
6. Will any part of the facility to be constructed under this permit be vnthin
1000 feet hom the ou[er boundaries o( a school7 ❑ Yes ❑ No
pf'yes", the facility must meet the requirement of Sections 25534 an0 42303
of [he California Health and Safery Code).
7. If a permit from the South Coast Air �uality Managemen[ District or other
air polWtion wntrol district or agency is required ior the work which is the
subject of this application, have all of the disclosures prescribed by Calilornia
Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes', attach certificate�of'iompliance from Ihe appropriate air pollution
control officer). • � . � -
CERTIFICATE'OF COMPCIANCE: 1 certify Nat under.penalry�of peryury ihe
information given above is covecL I a9ree ro wmply with all sta[e laws and
ciry ordinances regartling Hazardous Materials.antl Emission3. '�
,. .i� .. . ..� . �
Signawre Date"' � '
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION-OF ENTRY: I
certity untler penafty of perjury thal t have read this application antl state ihat
the inlormation given is cortect I agiee to comply with all state laws and city
ordinances relating to building construction, and authorize representatives of
the Ciry ot Costa Mesa ro enter upon the above-descnbed property for
inspec'c�n purposes J agree nol} occupy or allow occupancy of any building
auth � y it ntil fifi s 'o ,���j� .
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SiqnalureotLegalOwner(s) Dace
Antl/or Au��onxetl AOOli�nt
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� CITY OF COSTA MESA
BIIILDING D/V/SION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • �wvw ci wsta-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT TYPE ELEC
APN: 41812123
JOB ADDRESS: 811 PAULARINO AV CM
Vicinity: BUILDING G AND H � �
PERMIT NUMBER: E08-00340
STATUS: tSSUED
DATE ISSUED: 0812112008
ISSUED BY: RMD
Suite/Unit:
SCOPE OF WORK: ELECTRICAL PERMIT TO INSTALL A 100A SERVICE PANEL TO BE LOCATED AT APARTMENT BUILDINGS G AND H
(ATTACHED BLDGS). � �
OWNER: FOLEY, NORMA J TR
PHONE:
APPLICANT: FOLEY, CYNTHIA
PHONE: 714-673-2343
CONTRACTOR: OWNER-BUILDER
Address: Unit: PHONE:
City/State: ZipCode:
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $54.00
ReinspeCtion Fee $0.00
TOTAL FEES $54.00
Address: 6700 W OCEANFRONT Unit:
City/State/Zip: NEWPORT BEACH, CA
Address: Unit:
City/StatelzZip:
license No. 000000
CELL:
NO710E: The work authorized by this permil shall comply with all applicable handicap access requiremenLs under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authonzed under [his permit to be wnsidered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure lo obtain inspections and final approval will result in [he ezpiration of this pertnit.
C U . INSpECTONTYPE
1816 Fixed System Final Fire Prevention
1268 Pppl Spa Final
200 Final Re-Roof
201 Final Block/Retaining W all
202 Firyal Factory Fire Place
203 Final Sign
204 FinalOemolition
�TE INTRIRL C9D_E1 �NSVEC710NTYPE
208 Final Mechanical
208 Final Plumbing
210 Final Electnwl
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
__ 250 FinalBuilding/Occupancy
� iNnnn�s
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ I have and vrill maintain a certificate of wnsent to sel4lnsure for workers'
compensation, as Drovitletl for by section 3700 of the Labor Cotle, for the
peAormance of the work for vrtiich this pe�it is issued.
❑ I have and will maintain wnrkers' cof�pensa[ion insurance, as requiretl by
5ection 3700 O( the Labor COde, (w lhe peKonnance o( the vArk (Or whiCh IhiS
permit is issuetl. My workers' compen5ation Insurance cartier and policy
number are:
Carrier:
(ihis seCiun needipf ce canpefetl athe perm4 u�1uetl at me huMretlOp�ars (St00) a less)
Policy Number. _
�I cenify ihat in the peAortnance o( lhe work for which this permit is
ed, I shall noI employ any person in any manner so as to become subjecl
[o the vrorkers' compensa6on laws of Caliiornia, antl agree thal if I should
become subject lo Ihe vrorkers' compensation provisions o( Section 3700 of
lhe la� Code, I h�l focthwith c iply with these provisio .
�a �
Apairam's Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPIOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO hIE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE. IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARAYION:
I hereDy affirm that I am licensetl under p�ovisions of Chapter 9(commencing
with Section 7000) o! Division 3 of the Business and Professions Cotle, and
my license is in full force and eHect.
Lic. # Class #
Conl2c�b 9 S�gnaWre
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn Ihat there is a construction lending agency for the
performance o( the work (or wfiich this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lentler's Address:
SignaWre Date
OWNER-BUILDER DECLARATIONS:
I hereby affirm Ihat under penalty of perjury [hat I am E7(EMPT FROM 7HE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business ana Professions Cotle: Any city or counry NTich requires a permit to
conslruct, alter, improve, damolish, or repair any sWcture, prior to its
issuance, also requires lhe applicanl for such permit lo fle a signed statemenl
that he or she is licensetl pursuan[ [o �he provisions of the COntraGlors
License law (Chapter 9(commencing vnth Section 7000) of Division 3 of Ihe
Business antl Professions Code) or that he or she is exempt therefrom antl
the basis lor the alleged eaemption. Any �iolation of Section 7031.5 by any
applican� (or a permit subjects the applicant lo a civil penalty of not more Ihan
fve hundred tlollars ($500).):
❑ I, as owner of the property, or my gmployees with wages as their solo
compensalion, WILL DO THE WORK, and the strucWre is not intended or
offered for sale (Sea 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of propeny who builds or improves
thereon, and who does such work himself or herself or ihrough his or her own
employees, provided Ihat such improvements are not intended or oRered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmervbuilder witl have the burden oP proving Ihat he or she
tlid not builtl or improve for pmpose of sale.). ..
� I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to cons[ruct the project (Sec. 7044, Business antl
Professions Code: The coniractas License Law dces not apply to an rnvner of
property who builds or improves thereon, and who wntracis for such projecl vrith
a Contractor(s) litense pursuart to ttle ConttaclorS licenSe l.dw5.).
❑ I am exempl under sec.
Business antl Professions Coae for this reason:
� � �'
` SignaWre Dale
305]3 /0])
Ovmer ID venfed by dnv 's .. � ri� e ❑ Yes ❑ 019� ����//a /�
Dnvers License No. �� / Expires:
Venfication of Ownership e. - property �aa bill or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: � '
❑ I hereby certAy lhat no excavation frve (5) w mwe feet in depth into which a
person is requiretl to descend, vAll be matle in connection wilh xork auihorized
by this pertnil, and that no building sWCWre, scaFldding, (alsework, or tlemolition
or dismantling thereot, will be more than thirty-siz (36) feel high. (Chap. 32, Grp
2. M 2, Sec. 347, Title 8, Califwnia AdministraWe Code�.
❑ As owner-builtler, I will not employ anyone to do work which would
require a permit (rom the Division of Industrial Sa(ety, as notetl above, unless
such person has a permil to do such vrork from the tlivision.
Applicanfs SignaWre Oale
Division o( Industrial Safery Permit Number
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or fuNre building occupant need to file and
certi(y a Business Plan for emergency response to release or threalened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the California Health and Satety Cotle requires, with some
exceptions, that a Business Plan be filetl with the GosU Mesa Fire
Department by every business v+hich has at any one time during a reported
year a quanti�y of hazardous materials equal to or grealer Ihan a weigh[ of
500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature an0 pressure�.
2. Does or will the applicant or present or tuWre builCing occupaN need to file
a registration lorm (or acurety hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Calitomia Health and Safery Code, with some
ezceptions, requires registration vrith the Costa Mesa Fira �epartme�l by
each business which a[ any one time has on hand a quantity o( acu[ely
hazartlous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressetl gas al standard
temperature and pressure).
3. Does or will Ihe applicant or present or fuNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program for acWely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code pmvides that the
Costa Mesa Fire Depanment may require the preparation, certification and
�ling with the Fire Department of an RMPP by businesses which are requiretl
to register acutely hazardous materials wilh lhe fire Department.
4. If an RMPP is presently required, has Seclion 25534 0! the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre builtling occupaN require (or
Ihe v.ork which is tne subject oi this application a permit lor such wnstruction
Or modif Wtion from the South Coast Air Qualily Management District or from
any other air polWtion control district or agency? ❑ Yes ❑ No
(Sectbn 658502 oi the Califomia Govemment Code requires that the requestetl
in(wmation be fumished on appliwtions lor rwn-resitlential building pertnits).
6. Will any part of the faciliry to be constructed under this pertnit be within
1000 feel from the outer bountlaries of a school? � Yes ❑ No
Qf'Yes", the facility musl meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safery Code).
7. If a permit from ihe South Coast Air �uality Managemenl DisMct or other
air pollution control district or agency is required for the vrork which is the
subject of Ihis application, have all ot the disclosures prescribed by California
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. Qf'yes", attach�certificate of coinpliance from the appropnate air polWtion
control oKcer). � ' � �
CERTIFICATE OF COMPLIANCE:d�certify that under.�.pena�ty of.perjury.ihe
information given above is correcL I agree to comply with all state laws.antl
city ordinances regarding.Hazardous Materials and Emissions:' ;' �:
' SignaWre ' Date .
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certily under penalty oi peryury that I have read this application and state Ihat
the information given is wrrecl I agree to comply with all st2te laws and city
ordinances relating to building construction, and authorize representatives of
the Ciry of Costa Mesa to enter upon the aDove-described property (or
inspec'on purposes. I agree no lo occupy or allovi occu ancy of any bui ing
auth b/y�Qim,U unf ', pectioa •� iQ� ,
%�%�� d� `
, SiB�alureolLegalOwner(s) Dale �
AnG/o�AulhonzeGAppl¢anl Dale
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PflOJELT AOOBESS: $ 1; pAULAR I NO AV
OWNEP'S NRMF. N yNEHEtZG BARBRRA H TR
ADOHE55: 2'� S' O CAR `ll I NAi DR
COSTA ;;ESA,CA 92626
963-21:1
PflCNIENGINEEF: flEG.NO.:
aoosess:
UNIT:
uxit:
PEflMITTEE:GE�^`H GARAGE DpOR CO (714)97.1-�2239
nooeess: 1759 N BA'!'AVTA
ORANGE CA 92665
UCENSEO CONTPACTOP OECIAPRTION: I �cre�y allirm Ihat I am licensetl un0er pmvi5ion5 ot C�aD�e� 9(commencing wiih Section
7000) ol �rvisian 3 ot IAe Business antl Pmfessions Cotle, antl my I¢ense is in full farce an0 e11ec1.
ciTv uc.: sraTe uc.: 314 4 8 6 cuss: C 61
Oa�e: � �— L— q 22 Signa�ure: � {�GLY��
WOPREXS' COMPENSATION OECIAflPTION: I here0y allirm t�a11 have a ceni cale ol consem to seli-insure or a cenilicale oI Workers'
Compensalion Insurance. or a cerUlied couy ��ereol (Section 3800. La�. C�.
POLICY NO.: E%P. DpTE:
i COMPANY:
� Cenihetl copy is Aereby lurnis�ed. ❑ Certified copy is filed wilh ihe city Building Divisron.
Date: ADPlicant:
E%EMPTIONFPOMWOPKEBS'COMPENSATIDNOECIAIiAiION: (Thi55ec�ionneetlnotbecomple�e0ilNepe�mi�i5foranehunOred�5100)arless�,
I certily Ihal in the perlormance of Ihe woB lar which Ihis permit is issueq I s�all not employ any p¢rson in any manner so a5 io become
suble�� �o I�e Warkeri Compensation Laws ol Califomia.
�aie: �� — 2-- 4 2-- Signawre: ��a�V �P�•
NOTICF. 1�, atter malting Ihis 0¢Uarati0n, y0u ShoUltl become subleCl ID I' Wofkers' Campensa[ion pmvisions o� �he LaDor
Coee. you mus� �on�wilA comply wit� 5uch provisions or I�is permii 5�all Ue OeemeO revoke0.
CONSTBUCTION LENOING RGENLv: I hereby allirm inat there is a constmction lending aAency for the oertormance al t�e wark lor
which t�is permit is issuea (Semion 3097. Civ. C).
LENDEH:
FOORESS:
OwNEP BUILOFfl OELLABATION: I nereoy allirm ihal I am eKempt trom ihe CAnlractorS' State Lkense Law br tne lollawing reason
�Seaion 7031.5 Business ana Pmfessionat Coae: Any city ol county which reQuires a permlt �o consiruct, alter, improve. tlemolish, or
repair any SiruClure. pri0r lo ils issuan[e. al5o reQUhes Ihe applicanl for 5uch Dermi� f0 lile a 5ipneA Sialem¢n� iha� helshe is litensed
pu�5uan110 t�e pmvisions o� �he Comraclors' Slale License Law (C�apler 9(cammencing with Seclion 7000) ol �ivision 3 of Ihe Business
ana Pmlessiqns Cotle) ar ihai he/she is exempt iherefrom ana ine oasis lor ihe allepee eMemD��on. Any violation ol Sec�ion 7031.5 Dy
any aODlitant lor a permit wEjecis t�e a001icant ta a civil penalty ol not more ihan live AunAred Oollars �5500).
I, as owner oi ihe Omperty or my employees with waAes as �heir sole com0ensa�ion, will tlo ihe work, and the
❑ slmclureis no�intenaea arolterealorsale(Section 7044, Business antl PmtessionalCade: ihe Coniractors' S�ate License Law
Ooes nol applY �o an awner o� a pmperty who builtls or impmves �hereon, and who tloes suc� work him5eii/her5ei� or through
�is or �er awn employees. prOvidetl ihat such impmvements are noi inlentle0 or onereG for sale. II, however t�e �uiltling or
impmvement is sold within one year of complelion, Ihe owner will have the 6urden ot pmving he/sne Oi0 not �uila or impmve
Ior t�e purpose ol sale�.
I. as owner o� ih¢ pmperty, am exclusively contracting wi�h licensetl cnntracrors to canSVuct t�e pmleci (Seclion 7044, 9usine55
❑ and Pm�eSSionS Cotle: The COnitat�Ors' State LicenSe Law 40¢5 not appty to an owner o� D�Op¢rry wtro builas or improves lhereon
antl w�o coniratls lor sut� pmjects wil� a conVacroqs) lic¢nse pursuant fo Ihe Cmlraciors' Slale license Law). I am aware
Ihat proot ol IAeir Warker's Campensation insurance shoultl be proviEetl ta me.
� I am exempl unaer Seaion: B. 8 P. C.
for Ihis reason:
Date: Owner.
I �o �ereUy cetlily IM1aI I am aware ol an0 untlerS�anC Ihe requiremenls ol Calilomia Nealth and $alely Cotle 5¢tlions 25505, 25533, and
2559a and t�a� I or any Imure builCing ocapant will/will nol (ci¢le one) neetl �o comply vnt� said state coaes an0 IAe repuirements lor a
permit lor conslNCUon or motlilication Imm Ne Air Oualiry Managemeni Oisinci. Re5i0enlial mn5imction applications are exemp� irom
IIICSC p�Ovi5i0115.
Oale: Applicani:
I hereGy cer�ilyl�al I �av¢ read Nis applicalion and slale lhal I�e aboveiniormationis correcl. lagreelo comply with allciry antl counry
ordinance5 an0 Slale la�n5 reW�ing Ia builaing tonSlmtiion an0 hereby autM1orae repre5enialive5 oi iNs tily lo enier upon Ne above�menli0netl
PmOehy lor insp¢tuon purp05es. _ . S �
(� � �� / ,, 1 /
Daie' _i�Z � Z— SignaWre:'%�"�^ �� A� u��� �'� L�CJ �
OriveiT License or Souai Securiiy •: 1 :
1646a6 '61M1ne—Bmltling; Green—Coae Enlorcement: Canary—Applicant Pink—Revenue:
CiTY OF COSTA N.ESA — BU1LD::UG PfiRM?T PrRv NO; d 0'�9787
PERMIT NO: H 059787 PLAN CHx'CK NO; 04�33-92 S GGG�, N SUPP; ,�
COWSTRUCTION TYPE: PERMIT TYPE; S7'R PUkPOSE; O�H
JOB DESCRIPTION ; INSTALL $OLF W,I, rENCF f. GATE:; 5() r'7'; 82
CLAZM VAL'JE: 900,00 CALC—VALUE; 820,00 GttUUP GCC; H-1 /
COMMENTS: GATES ON FtANDOI�PH F, i�AliI�ARINO
Y.� 1E # k iE �1F K i:-# �%# if if Ik x� )E iE � iE # i69! iE �Y.� �� 3E K#�Yc 1F lE 9( �lE �M if # if if �M� K�( Jf iE �1f �lh K 1E X%%# k iE � Y, �Y. Y' i[ Y. i( % i( !f )�% Ii Y. #�C i: �)F 1i i( Y. % if K IE ::
Z O N 1 N GS �RT�B�AUCIKRSE N E N: 5
------------ MAIN BUILDING ---------- -------- ACCESSORY B:iI:,DING ---------
FRNT: FT IN RtAR; FT IN FRNT; FT IN REAR; FT '�V
LEFT: FT IN RGHT: Fi I� I.EcT; F'." IN RGH':: FT IN
PARHING REQ; PkOV: PA't2CfiL: 41R17].23 7.Nc; R2 REF' NO;
PLANNZNG NZSTES> PROPOSED APPX. RO I,I,FT, WkOUGHT IRON ��NCE ALO,�G ENTi2Y
> OF THE COMPLEk VIA RANDOLPii/PAUI,ARiNO.
3e 1E if if iF iF �lf i/�3e 3E #E fE ## iE+i� it iF it ik ��1F iE A� ft� 3F # iF ## iE ik i't iE # if #�ff ###�1f ih N%if +r if it fF ## tf- # j( fE #### Sr 1F �# x K W tF it +t %## 1E j( it :: i6?E
D E V E L O P M E N T S E R V I C E S R E Q J I K E N E N'�' S
ZONII3G APPRO�7ED BY � I�� DATE: �?I 2)�i "�—
BUIiDING APPRO��ED BY ; DA;E: :.
�.
APPLICATION ISSUED BY: � DATE; .�l'��
#1FfF1F#?hif#iE�JF',E')f#!f?FiFi(�iEiEifi(•i(�1FY—FiF�iFlFiFhi�Fn���i4ir���i-Fl�Ff�FR,Fi�- �hrfTiefF#,�"X�iEitlf#'.tiE2tifiE#itil� %% #:'r.
# if %# #!E iE iE i( ?F fE 1E iE i( iE N if !E iFlE #'iE 1F iE 3E �1F iE if 1F #�lE 1k!f 1f 1f i! �f # fE i6# �)f a�f fh# �]E �E # A` # i( # IF # 1F ##%## k# lf if .Y %###!f lf i: 3E # iE K� S£ i(�
LEGALiZATION:N F E E S IJ M N, A R Y S:RGC'"TIRAL SEGMFN7;Y
BLDG PMT PLUMHING F.LECTRIC MECHANIC FIRF_ S2�'.=P/RES GRP,DItiG
PERMiT 23.00 ,�0
SMIF/NON-r2E5
PLAN 14,95
SSSUE F'EE
BUILDING—DIV—> PERMIT ISSUE PLAN—�HECK TOTAL PAIP DCF:
TOTALS----> 23.50 0.00 f4,95 38,45 38.45 ,00
REVENUE DZVZSIO,1 TOTALS--> COLLECTED; 38.45 OVF,R/SHORi; ,00
BLDG PN,3 PLUMBiNG E?,ECTRIC MHCHANIC FIRE SNiP/TOT GRADIfvG Pi�AN—CHr.Cn
23,00 ,SO 14,95
if ?f iE if )E -%i(-iF 1h?F #� if #!E if �1f 1f 1(� �)f iE IE 1F iP 1(� iE ## if iE 9E iF iE?E iE iE if #ltiE dF if # ih !@ #�Jf 1F K� if iE ## �( K?E i4 iF #%### i.� ih %jf iE 1'r # iF # jE iE N If :: #�
_ I N D S V I D U A L F E E H R E A K J O W N
TYF+E QTY D E S C R I P T I O N UNIT COST TO?AL COST
SFR 62 RES—W, IRON/CHAiN LINH FENCE / FT. 10.00 R?0.00
END OF rEES
r- �
CONSTRUCTION AND PLANNING ' PO� : SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipmeni Location '
2, $oil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Elect�ical Co�duit Utility-Undrgrnd. 54. Forms
4. E�ectrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Gr�d. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundatior 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P-Trap, � Undrgrnd.
10. Struttural Floor System 61. APPROVAL TO DECK .
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap , 63. Heater & Vent-Fina1
13. Roof Droins 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical-Final
15. Rough Efectrical�Cqnduit 66. Solar System-Finaf �
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Raugh Wiring Sign 68. APPROVED FOR PLASTERING
t8. Rough Etectrical-T Bar Ceiling 69. POOL/SPA SYSiEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS ' Permit #
21. Ducts, in Structuce 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof framing 73. Undergrnd.StorageTankOGas ❑011
25. Roof Sheathing 74. Overhead Hydro
26. TBar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding . 77. fIXED SYSTEM FINAL
29. Insulation � , 78. FIRE PREV. FINAL
30. Drywall Nailing �i 'i HEALTH DEPT. REQUIREMENT
31. Plaster Bwwn Coat ' 79. FINAL INSPECTION
32. Electricai Power Meter�Final � � 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric �. ' Notes:
34. Final Heating & F.ir 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. Backilow Preven[er
43. 89ckflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Hendicap Regulations
47. FINAL STRUCTURE & BUILDING z,��.72
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
N�
;_ . _
. " � ���' � � _L4. • - �
a�'� .._���
. . ���� . .F -� �
F
: . . . ; :-
S�. � S`''�''� •-C�s�-c'�."-
{= �- �� X' 7 L'o"'"�,'S-
_ . a_,_��. .
�j� j . �ar,� Cf-w�^�v �
P�...�-�
fi � n � rt �TE }
ADDITIONS, DELETIOt�S, OR CORRECTiONS SHALL
BE APPROVED BY iHE PLAW(JlNG DEPARTMEfti , _.
�--�; , r' �.rr E
� �L117f= 1�
-� :
PE�,��
U
..
►i Y" aa�.�. :' :. �.,
BY
C05'tA MESA FIAE OEPf.
Ai�E 9F FIFE PREYGNPIUN
Cus�'= �1ESa, CALIF.
� �' ��I� 1� 7ATE lIZ I�IZ.
� -- �Y� -�lQ0�m9r✓
A�p�� V�1 �{n�i F Aipp:wnl eppllee to pl�� ��.
'�� Y 1 Y\. ,����aa _n� i�,s roo�uuctioo itdiutn
CITY OF COSTA MESA �"�aun loate�letlon oa6jeet ee 1�n�i •
�a._. �... ... . .. ..... .. .. _ �
PLANNING DEPT. � ��1�E `��
£ TO 6W0. DEPT. 1E0.
�Y. - --._....DATE.II����l2-' a, ��«;�o -�;�u��ti�a
ot or nu+++iNo AI��SS ���� D�
�OoLP� �
ptio�vOs�t,o( 9�4 C+,►�.w' •��j �' �"` ' r� c�c�.
�� �� � /
C91'y S.TMi L?!5'�? fi'w 'c'� ;uL'+if.�1@P�� (�'�Y,.
�'
sar _ -�-- �,�y,� ll 2 7's.�_Z
fV0`S:t� i�u�S\'iii �i �� "�� �� � ,: R1Z �?�'k)s��E
• �`-�'��'1i 'c�K fd'E�T.
THE I (� , C `�
SSU.�•.CE Ofi GRAt:t� -. '�J��,��; �.•' j��F10�V�11 l�F
ANSAI�L'SPi:CmICAi!C:.i • . .Cp\;I��14'l)7JIiE,�
$ W.ifT FC3�. pH AN APPN��' . t^_ �. fii)N C3f AN�
'� Pp�"SI.d'�tili iF)k.\rol
UTFi!iR17Y i0 V1QLA7F�Cf: •t ,+-�'" '�nN:; G� IH15
'ODE SFL41(. L� VM.IC EY.CE:`� i�. .•. C� d� JN !1�
IiICH ITAUTNpRi-+c . .; IJ,: . � �
..: �
iHE �S3;UNr.E _'� `�,:�T [ . �
PEG.'1G1;10115 S7L:t1. 1:�_ .�;•�:.'� �:,� �.l���i N�D
f qOM THEF6lPTCi7 i2E'vi11:. ,} '::'�f 1:1 bPF:CiAL
,o ��KC:ir�rCt�:�t' t.:irt'�rSIN
� ..�� �� - , ''
ILOINGOP!t!'v�.-iICn;55:. "'7 ;•:ft.V£r:7R1G
'' �' 'F:' �'=i•"a EN WH(N
II' VIOIATIOH CF THiS CGCc :.F: i.r ::.,-: r' L�C.;3.q7r'CE Of
f rE C71'Y. . . •
�
�����i.,ti.....') �-
Gr� �
�v G�-rE
W��JC�)'
PR � +�s N � � ��
� �o cK � A-i�.-- 3S %r•t�a, 6(', o P� �u � �2
��
r�' • .
PXOJECT PODflESS �"�� 1 1 PAULAFt I NO AV UNIT:
OWNEfl'SRAME�I�tNEBERG BARBARA B TR
aooeess:2740 CAR�INAL DR
COSTA MESA,CA 92626
963-2117.
ANCHIENGINEEN: HEG.NO.:
ADONESS: UNIT:
reemiTrEe: ELF.CTRIC INSTALLATION ( 71 4) 636-6591
nooness:11676 SALINAZ H
GARDEN GROVE CA 92643
�ICENSEO CONTflhCTOP OECIAPAT10N: I �ereUy af�irm ��a� I am IitenS¢G unaer Omvisions of Chap�er 9(tommenCing wilh S¢tlion
7000� oi Oivision 3 0l t�e 6usine55 antl Pw�e55i0ns Code. an0 nry license is in lull brte anG ellect.
cirruc.:006791 srn,euc.:Z59408�J�J/J cu%srC�-1�""— /
�ate' _� �— 3 a � g 2— SignaWre: -/_"�l e/��I
WOPNE85' COMPENSATION OECUNF710N: I hereby atfirm iAat I twve a cenifiwte ol ronsem to self-insure or a cenilicate ol workers'
Compensation.lnwran�.�ra e'rWied copy Ihereo� (Section 3800. Lab �� � 0 5/ 9 3
POLICV NO.: t�� �'� E%P. ORTE:
'OMPpNY:REPUBLIC IN,y�DEM
_I Cetli�ied CaDY i5 h¢re�y �umish¢d. CJ Certifiea copy is file0 vn�h [he ciry BuilOing Uivision.
�., �
�� �ate: l�—�U^`7L :-` AODlicant �_z(/�'�'���
EKEMPTION FBOM WOBKEPS' fAMPEN5AT10N OECUPATION: (iNs seNon neeA noi 6e completeA il me permif is for one huntlretl (4100) or kss�.
I certity �hat in the petlorman[e ol �h'e�woB �ar which �M5 permit is issue0. I shall not employ any person in any manner so as �o became
subie�� �o Ne workers' Compensation Laws of Califomia.
r
Oale: SignaWre:
NOTICE: If, a��et making this tle9Iaraiion. you s�oultl become SuUject lo the Workers' Compensation provisions o� Ihe Labor
Cotle, you must lonhwi�� comply vrith 5uch O�ovisions or Ihis permi� s�all be Geemed revoke0.
CONSTBUCTION LENOING FGENCIG 1 hereey affirm that inere is a construclion lentling agency for ihe DeAormance oi ihe work for
whic� I�is permil is issued (Sectian:3097. Civ. C�.
LENOEfl:
aooeess:
•--- �
OWNEP BUILOEN DECIABATION: I �ere�y a��irm Ihai I am exempi Irom Ihe CONraC�ors' Sta�e license Law lor the tollowing reasan
(Section 7031.5 Business anA Prolessional Code: Any ciiy al county w�icA repuires a permit m conslmct, aller, improve, demolish, or
repair any s�maure. D�iot to its issuance, alw repuires ��e apDtiunt for suc� permit lo lile a siOneE statemem ihat he/s�e is licensetl
pursuant lo Ihe provisions of 1�e Comracmrs' State License Law (Chapler 9(commencing wit� Section 7000) ol Division 3 0l ��e Business
and Prolessions CoGe) or Iha� he/S�e is ee¢mpi I�ertimm ana I�e Oasis lor I�e alleAed eaemp�ion. Any violalion ol SediOn 7031.5 by
any aOVlicam for a Dermit subjects I�e applicant io a civil penalry ol not more than live �unOreE dollars (SSUO).
I, as owner oi me orooeny or my emylayees with wa➢e5 as tAeir sale compensation, will Do the wark, anU ��e
❑ slNtlure is not intendetl ar olleretl lor Sale (Section 7M4, Busine55 anG Profeuional Cotle: The Coniratlors' Slale License Law
OoeS nol apply lo an Owner ol a pm0e�y w�o �ui105 Or improve5 Iheteon, and who aoes Suth wark himsel�/her5¢II or IhrouAh
his or ner own em0loyees, provi�ea Ihat sutn improvemenis are no1 inieneeC or ollereA lor Shce. II, however ihe euilAinA or
improvement is soltl wilhin one year ol com0letion. Ih¢ owner will have Ihe buraen o� pmving �elshe ditl nol Guila or impmve
lor me purpose ol sa�e).
I, as owner ol t0¢ pmperty, am eKclusively coniracting wi�h licens¢0 coniractors lo consimcl lhe prolect (Seclion 7044, Business
❑ and Pmlessions Code: 7he Coniractors' State Licenu Law Oces not aOPN �o an owner of properry wiro huiltls or improves t�ereon
an0 w�a coniracis lor suc� pmjecls wt� a wmranor(s�license pursuantia t�e GonVactors' State L2ense Law�.l am aware
�hat prnol ol I�eir Worker'S ComOensalion insuran[e 5�ou10 Ue O�o��tleC �o me.
,� I am exemp� un0er Seclion: B. 8 R C.
i �or Ihis reason:
Date: Owner.
I do hereby cenily rtul l am awa�e al anG unaerstan0 t�e repuiremen6 al Calilornia Health anG Safery COAe Sections 25505, 25533, antl
25594 and �nal I or any fuWte Guilding occu0an� wilVwill no� (circle ane� neea �o com0ly wilh saitl slale cotles antl Ihe reQuiremen�s for a
permii lor consimc�ion or modilicalion Imm I�e Air Ouahly ManaAemenl DisVict. ResiOeniial constmc�ion ap0licalions are eKempl Imm
I�ese proviSiOns.
Oate: ADD�icant:
I here�y cerlitylhai I have rea0 this appli[ation an0 5laleihatt�e a�ove informa�ionis correct. I agree �o comply wi�h all ciry antl counly
ortlinances an0 9atelawsrelaling�o building consiruction antl �ere0y au�horize repreunlatNesollhis cilyloenierupon�he a0ove�men�ione4
pm0erty far inspec�ion purposes.
oaie: �—.�LO— rJ i— Signature: ��L���/
orivers Laense or Socul Security x:
164ndfi Whne-0uildmg; Green—Coee EnlorremenC Canary—ApO��cam: Pink—Revenue: Goltlenratl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT .
PERMIT NO: E 060105 PLAN CHECK NO; N . ,
CONSTRUCTION TYPE; PERMIT TYPE; ELE PURPOSE: OTH
JOB DESCRIPTION : INSTALL SOLF W,I. FENCE 6 GATES SQ FT;
CLAIM VALUE; CALC—VALUE; GROUP OCC: R-1 /
COMMENTS: GATES ON RANDOLPH 6 PAULARINO / RE: B59787
�*�*��r��e*�x��****�r�r�***�r�r+t�t******+r*�r*****�r�t�r*�rx �*�**�r��t*�*�t*��t**�r�r**�r*�r**�r**�r �x �
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 BUILDZNG ---------- --------- ACCESSORY BUZLDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 41812123 'LNE; REF NO:
PLANNING Ni31'ES>
i
�E if IF1E ik iE iF iF iFiE iFif �E IE iF k iE if �f iE IE if 1E iE iE �f iE �F i! iF if �f iF iEiE iF jE iF iE iE iE it i! iE iF iE �f 1f if 1E It iE it M k iE iE iF 3! iF 3kiF iF ik it iE iF it iE iF k iE k iF 1E if iE 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 BY .
DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY; � DATE; �2
ifiliFiFiFiEif1ElE1Eilil�llFlEiElEiFkiEikif iflF3fiEiElE1E1FiFiF i!j!
*rx�r�r�r�r�r�t*�t�r***�r�t�t�r�r�r*�r�t�t�t�t�t�t�t�r+tx��t�r**�r�r��t*�r�rx�*i i *�r�r**�t*�r�t�t��t�t***�r��rx�r*+tx�**�r*�t�
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
PERMIT HLDG PMT PLUMHING ELECqRSC� MECHANIC FIRE SMIP/RES GRADING
502 : SMIP/NON—RES
PLAN .
ISSUE FEE 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL . PAID DUE
TOTALS----> 9,50 15,00 0,00 19,50 " ^ 19.50 ,00
i•
REVENUE DZVISION TOTALS--> COLLECTED: 19,50 OVER%SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT, GRADING PLAN—CHECK
19.50 ' "
IE iF if ik ik i! if if if iE iE k ff ik iF iF iF 1F if if If 1E iF 1E 1E if if if ik iF if if iF �)k 3f 1E 1E k iE iE iklf it 1k 1F iF 1E if ik IE ik k ik if iFiF Ikif IF if iF ik iE 1E if if iE k�E 1E iFlf iF if ik if if iE at
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 IINIT COST
7
ELH 4 FIXTURE� LIGHTING 1 ST 20 (EA. '::7.5
ELE 2 RECEPT/O�JTLET 1 ST 20 EA. :75
E X�PR@��FEES
Incomple!e lnsp{'•ction�
B
veie �. - _ slg __.__.--._'�'
TOTAL COST
3.00
1.50
� �
CONSTRUCTION AND PLANNING PL $ SP'�'
APPROVALS Permit � Date Inspector p�ppROVALS Permit # Date Inspector
�' ' �
�i. Temporary Electrical Ser'VYce or Pole . 52. Poo� & Equipmen[ Location �
�2, Spil Pipe-Undrgmd✓ , � •� �-_ � 53. Steel Reinforcement �i'
��. E{ectricel Cone}viY Qti�ityUrttirgrnd,� : �'" 54. Forms '��
,
"4._Efectiical Conduif-l3ndr9rnd. ' '• �J 2.7 � 55. Electrical Bonding
�;�.,,`$tpel FeinforcenSgM ;�1 56. Rough Plumbing & Pressure Test
": 6-glectrical UFER QEnd. ' ^ 57. APPROVAL TO COVER�GUNITE
��;9:1�ootings :' �;t� ,: 58. Electrical Conduit•Undrgrnd.
� .
�•:BL�Foundation - , � 59. Gas Pipe, O Undrgrnd., Test i���
-� �
���. Water PiPe�Un�rgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. �,,.
10. Structural Floor System �� � 'y 67. APPROVAL TO DECK `�
1-0. P2ropertY Sewer Line & House"Contiection 62. Backwash & Receptor�Final �;
12. S�ewer Cap ''
�,, ', „ c� � / 63. Heater & Vent•Final
13. Root Drains = �' ' 64. Plumbing System - Final �
- 't
14. Rough Plumbin9 � ��� ��� 65. Electrical�Final �
15. Rough Electrical-Conduit ' 66. So�ar SYstem-Final
16. Rough Electri,CWiring 67. Fencing & Access ApProval �
1�. Rough Wiring $ign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
-- - rn�,:cp- .c .. -
20T�Rough'bactory F�iveplace -� ^ Q � _ �"� APPF�DV�C�;�� PeFmit# ` -" =
-1 l F �'T .0 w ^ �: : l : .l. -' 7 X r �
21'.'Duc[s,inStSuctuF� .... - ' -�� " '`'
=. s - u= - 70.:kJnderg[nLrid 114dro f
22.Duc�ts,Ventitatiirg� � •�? R ,:.;�= 7l. Produt�T, 'qingd�as C�OiI
2�;,Gai Pi &-Roa h 8i l"est "` ' '
P 9 i. r � pY .� i � 72. Undergi¢und F�fu7h „ �..
24: Ro2�f Freming < ' f-.- ���E- � 7 ' Jl •• : 7� UndergrA2i.Sto'[B � Tank`QGas ❑6fl'
25. RoQf Sti�athing ;•.,' ' `''� . � .`-' -' _" ` _ � - " " Y
o i v v. � +.r 74e Overhea�Hydrp�
26rT�8ar Ceiling (Sttuctural) &:Monocoat � ��F -� 7�j", Dry Chemical - • � �=
2Z� Frame and Flashin� ". z„ �` ^ L�� 76. Dry Stan�GlPe �" .�c �\ � f
- 26. Lathing & Siding..: v. Iz •' �� • 77-' F�XED SYSTEA?f INAL
�
� 29. Insulation � � �' � � �� " � `" 78; FIRE PREV. F�NAL � ,-. � � '
� 30. Drywall Nailing �� � •< r•. � HEALTM DEPTtREQUIREMENT
� 31. Plaster'Brown C�a[ � . ;, A 7�` FINAL I'NSQECT,fON ` ' � � �
32: Electrical Power_Meter-Final � . �.. 80; FOOD CERTIF��CAF.E ISSUED -
. 33� Firlal El�ctr�c � ' : - ; �� � �� Njites: _ �. ;. � ' _
i
,� 3�}, Final Heating & ."v ConditioRjng - � i � z �. ,, - � . � � _
� 35. Final Gbs Pi'pe-Test " _ " ,. ` �'`= ' "C- � � . _
�. L'J �- .C�
,.� . . .
, 36j Hood oP,Canopy�" - _ _ � . r •o , - '
37%Firfil Ffictory FiPePlac2. .>.' a : r �� . .� .. :� n . ..: � : �
= 38. Final Pli�mbing :v � i, _ � .. .. � � � .� . x � ; . -
Z 39. Water SCrvice-Fina1 _ - � -� i�'� s � � - �� r .
. 40. Gas Service-Fina� ' ` , -� � � ��. . .
,, .
' 41. Solar DOmesticFinal> � � .. � ` - ,
"42.' Backflow PreventeF � " ,� � � � - ' �I'ICOlI7 � �
A ete Ins tions
43. Backflow Irrigation � �'S - - x /( •-
Y - � _ � •_ � �i
' ' . u -���
,. 44. Landscape 1rrigation System ; ,� - - - > A , _ �
� 45: Sound Attenuation x � - - -b s C � ' +. : - ,
r r -
_ ... . i � x
r 46; Handicap Regulati�ns - - ., S� Jj ^�'S
47: FIf�SAL STRUCTURE & BUIIDING � � , '- > � .. �
v
48'FINAL PLANNIfY� ` � ;.� "` `
- � - � ' � Y
� 49r Electric Release to�:Edison i>� : c � � -
' S0. Gas Release to Southem California Gas Co '��' . ` � -. .
' 51 � CERTIFICATE OF OCCUPANCV - � ; , . - ; _- �
IVo. Date
OWNER DI p�IA�1ip DATE 12-17-79
JOB ADDRESS 811 Paularino BUILDING PERMIT N0.
A. o. n,o_ioi_'» LOT
SUBCONTRACTOR
ROUGH PLUMBING
PNOP. $WR.IINE
ROUGN NEnT�HG �NO �IR CONDITIONING
TEMPOFnRV SERVICE OA POLE
UNDERGFOUNO [� POwER �
AOUGN wIRiHG
TNENCHES IJ FOFMS STEEL REINF.
FLOOP SvSTEM
SHERTHING ' �
FRAME ANO RSMING
LFTNING — IN j � OUT '
P ER.BROWN COAT
51..,,LTJR4L FIN4L
HE�TiNG, vENT., REFRIG. ANO A.C., FIN�L '
PLUMBING.FIN>L AND GAS TEST
ELECTRIC, FIN4L �f�.
Bu1L01HG. FiH4L �� `� � x,_
�
�� 8658 12/17/79 66a50 TL�
COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR S'PRUCTURAL PERMIT
on onv �onn rneTn nncen rni �cnonun oocoa
.._. __.' "" "'......__... _.._.. _....... ""'
RECEIVED PERMIT NO 4936U
For Applicant to Fill in Completely — Use Ink Only Q
ADORE55 �II A'P'N '" — IZI �LJ
BUILOING I AVLA�1�vO
OWNER OR � J A�DRE55
TENANT
UNIT OR
MAILING � SPACENO.
ADDRE55 Pj �� Pia%/ �j � TR O. LOT BLK.
TEL. �Q.�( T{ �OY � 6
CITY lj ` P) NO.
NEW ADO LTER REPAIR MOVING DEMOLISH
CONSTFUCTION
LENDER
BRANCH
OWNER
ADDRESS� VALUE
AFCHITECT � TEL. USE E
OR ENGINEER
ADDFESS�/ ZONE RZ TVPE GROUP
CONTRACTOR /D, Jeu�s (� • � � B�' DATE � � �
ADDRESS �� � —
TEL
GTV (SiSO NO.
STATE {�_���,n CITV APPROVEDSETBACKS
LIC. NO. (/ �,yi LIC. NO.
�7 (FROM GLSTREET)
OF LOT/(%S , J�Q' NOW ON LO � ONT T
USE OF
EXISfING BIDG.
Separate permits are required (or L SIDE Fr.
electric, plumbing and heating work.
REAR FT.
VSE OF BUIIDING AND WORK TO BE PERFORMED PLqNNING ACTION
liy(�LL pLC.� /� APPROVED
APPROVEOCI .�Y I. ` "7
v� � �
I heraby ecknowledBe that I heve reatl this applicetion entl sum �
thet the abova Intormatlon iE correct antl epree to eomply with
all lews re0ulating buiftllnB �onsnucclon, antl 1 shall not amploy �
any person In violatlon of Ma workman'e compansation laws oi ?
the State Of Califom(a.
m
I �eroby certify that i em p�operly Iicenmtl aa a contrnctor �ntler SQ. FT. �`+
t�e SSata of California Buaineaa entl Protesslona Cotla, Divis{on 3, TME AMOUNT SHOWN UNDER VALUATION IS FOR m
Chepter 9, antl th such Ileentes ere In tull torea antl atieet, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: �
am exempt trom e provl 'ona of t�o State of Califprnle Businoss VALUATION PERMIT FEE b q
entl Professi0ns tle, Dlv ion 3, Chepter 9. � u+
n
PLAN CHECK E � QQ o
SiB�ature of � / LL
Permlttee 5�/� TAX E f
or 2 �Y � u
A�thorizotl Agen ate TOTAL PHID E 6