HomeMy WebLinkAbout2742 FREMONT LN - Building PermitsPHOJECT ROOBESS: KNOX ? DAVIDNP, LN r7 I
OWNEB'S NFME: L 6
aoonEss: z�4z FREMONT LN
COSTA MESA,CA 92626
ABCMIENGINEEfl:
aooaess:
PEHMITTEE: PACIFIC COAST APPLIANCE
aoneess 139 W VICTORIA ST
[/J
flEG.NO.:
uNiT:
uxit:
(310)324-8476
GAADENA CA 90248
UCENSEO CONTPACTON DECLANATION: I here5y atfirm that I am licensetl under pmvisions oi Chap�er 9(commencing wi�� Section
7000 af �iv� i Ihe usiness ana Pmfe 5i n C tle nd m license is in fu0 torce and elfect.
,�u�:�� 1 S,aTEu�.:��i�2�a�z�yY� %��s�,s�: �j�j�
o �'i�-�l� s�9�am�e1'/�-����
�IOBREBS' COMPENSFTION UECLAflATION: I here0y aifirm I�a� I �ave a cerlifica�e oi conseni to seli-insure or a cenificate o� Wurkers'
amoensation �ncg q p��� copy thereol (Section 3800. Lab. � 8� � 1/ 9 4
nicvxo.: GOLDEN EAGLE E%P.OATE:
COMPANY: }[
❑ Certih¢tl wpy is hereby Nrnished. LJ C¢hifi¢4 topY is hletl wit h i�ry /BJuiltli ' Si i
E�Oa� �— � �y ApplicanC Q�
PTION PBaM WOHREflS' COMPENSATION UECIAPRTION �(1�is se[�ion need noi 6e compleletl il the permil is fo� one �un0�e0 (5700) or less�.
I cjtllly ihat in I�e pedarmance of �he work for whlch Ihis permit is issued I shall not employ any person In any manner so as to Decoma
.tQb�ecl to ihe Nlor4er5' Compensatmn Laws o� Calilomia.
Daie'. Signature:
NOTICE: II. ai�er making Ihis declaralion. you shoultl �ecome sublec� to Ihe WorkeK Compensation pmvision5 oi Ihe Labor
Cotle. you must fo�hwrth comply wi�h sucn pmvisions or lhis permil shall be tleemetl revoketl.
CONSTBOCTION LENOING NGENCY: I hereby affirm Ihat Ihere is a constmctian lending agency lor �he per�ormance oi ��e work for
which Ihis permil i5 i55ue0 (Seclion 3097. Civ. C).
LENOEfl:
nooness:
OWNEfl BUILOEN OELLNflATION: I here�y alfirm tha� I am e�emp� �mm t�e Comracmrs' Sta�e License Law for the lollowing reason
(Seclion 7031.5 Busmess antl Pmtessional CoOe: Any ciiy ot coun�y which repuires a permit to constmct, aller, impmve. demolis�. or
repair any slmclure. prior �o i15 issuance, also requires the applican� for such permit Io file a 5igneU s�alement iha� �elshe is licensetl
pursuani ta Ihe provisions ol �he Coniracrors' Slate License Law (Chapter 91�ommencing with Section 70(q) o� Oivision 3 oi I�e eusiness
antl Pro�essions Code) or Ihat he/she is exempl �herefmm and Ihe basis lor �he allege0 exemption. Any viola�ion o� Sec�ian 7031.5 by
any applicant for a permi� sublecls ihe applicant ta a civil Denal�y ol nol more �han five huntlred tlollars �5500).
I, as awner oi the pmpetly or my employees wilh wages as I�eir sole compensation, will tlo Ihe work, antl Ihe
� simmureis notintenAea oroi�eretllorsale(Sec�ion 7044. Business anJ Pmiessional CoOe: The Con�ractors' S�a�e License Law
, does no� appty ta an owner ol a propetly who bwltls or impmves Ihereon. and who does such work �imsell/�ersell or ��mugh
�is or her own employees, pmvitletl Ihat suc� impmvemen�s are noi intentletl or offere0 for sale. Ii, however Ihe bmltling ar
im0�ovemen� is sold wrthin one year of completion, the awner will have �he bur0en oi pmving �e/she tli0 not builtl or impmve
forlhe purpose ol sale).
I, as owner ol Ihe pmpetly, am exdusively contracting with licensetl coniractars �o con5imc� Ihe prole�� (Sec�mn 7044, Business
❑ antl Pmfessions COUe: The Contrac�ors' State License Law tloes not apply �o an owner ol pmDerty who builds or impmves thereon
and w�o conVaas lor such pmlems wi�h a conlractoqs�license pursuam m the CanVacmrs' Sta�e License Law) I am aware
Iha� pmol ai �heir Worker's Compensation insurance shoultl De D�ovitletl to me.
� I am exempt untler Seciion: B. 8 P C.
lor Ihis reason:
Date: Owner
I do hereby cenily Iha� I am aware o1 an0 under;mntl the reQuiremems ul Califomia Healih antl Safely Code Sections 25505. 25533, antl
25534 and Ihat I or any IUWre bmltlmg occupant will/will not (circle one� neetl to compty with sai0 siale co0e5 and Ihe reQuiremen�s lor a
permil lor constmc�ion or moddication Imm Ihe Air Ouali�y Management �istricL Resitlenlial constmction applications are e�empt �mm
Uese o�ovisions.
Oaie'. ApPlicam:
I hereby Ceriify Ihat I have read Nis applitali0n antl siale �hal ��e ahove inlOrmalion is corrett I agree �o Comply wi�� all tiry and toun�y
or ' ces ana staielawsrela�7nglo builtling consimclion antl hereb�P esen�a�ives a1 hi ' �a enler uPon�he a�ove-mentionetl
op¢r brinspection purposet �
aie: — �� Signaiure: �_
� i's �icense oi Sociai Sec�diy p:
White—Builamg; Green—Cotle Enlorcement�, Canary—Hpplicanf. Plnk—Revenue', Goltlenrod—Hssessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 065443 PLAN CHECK NO: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: PLU
JOH DESCRIPTION ; DISHWASHER CAANGE—OUT ,
CLAIM VALUE:
CALC—VALUE:
•o• �• �.
•� . �. .
PURPOSE: ALT
SQ FT:
GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
***�r�x�***�r*r**�r*�r****rr�r+r�r***�*�**+a+r�+cw�r******+r��***�r*�r�r��rr***+��r*�r�**�+��*�****�r*
Z O N I N G R E Q U I R E M E N T:S
S E T B A C K S ',
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: ET IN RGHT: FT IN
PARKING AEQ• PAOV; PARCEL: 14155202 ZNE: REF NO:
PLANNING NZSTES>
i
itlFlF 1f if M it iF it iE if 1F 1F 1t 1f M k k if 1t ik ik if 1! ik 1E 1f k f! if it it 1F iF IF ik ik iflF if 1t ft it 1k 1F if 1f iflf iE ik 1Flk 1f 1f 1! fE �k fE fk 1f 1E 1E 1f iFlk iklE it 1E iflE 1!!f 1E 1f iF it �lE
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 APPAOVED HY : DATE:
APPLICATION ISSUED BY: DATE; ����
iE iflf 1F it iF k k 1t iFlF it iE if iE 1Flk ik if if itlf ik iF iF 1E 1E fE if fE iFlF
fE it k if 1t 1E 1f 1E M ik 7F iF iE iE fF iE iF it iF iF 1f 1f ik if 7! iF 1f if iF k if k iF 1t 1Elt iE ik iE it iF iF iF /F 1F iE 1E iElE k 1E iE M 1f ff ff if !E iElklf iE if if fF if M!F 1F 1f 1f M 1E if iE if iElilE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
t /� • -
HLDG PMT PLUMHZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7.00 G
252 SMIP/NON-RES
PLAN �
ISSUE FEE 20.00 � '-
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 7,00 20,00 � 0.00 27,00 27,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED': 27.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
2%,0� � .
%� I
�` �` �i��#���t�FiF�r#��F�r#�� �r �F ## # iE#�tic�c�r**+r+r+r+r.*****+r*�****�x*�r*+t+r*+r****it*�r**�*it�r�rx�+r�r*�e*
�._�,. � I� I D U A L �F;E E H R E A K D O W N
! ^
TYPE QTY D E S C R I P T I O N=, . UNIT COST TOTAL COST
PLU � 1 DISHWASHER
� i
f END�OF, PEES
I
EXPIRED
��canRl�te Ir�spectians
• 1 ....� �
,� �
7,00
3t �J�±`31.?1-�11J753171 "�'LlT
fAT=: ]1/O;f94 Ti"IE= i4:31
e7.Q0
�
CONSTRUCTION ANO PLANNIN� .)L & SPA � , ,
APPROVALS Permii# Date iaspector pppROVALS Permit# Date InspectoF
1. Temporary Electrical Ser�ice or PQ!e� � 52.. Pool & Equipment Locacion
2. Soil Pipe-Undrgrnd. ��� �.'� 53. Stee� Reinfortement .
-�s^ �r
; 1.:-,'
•,i .�,;�iectricai Con�uit-`',1-71ti�ityVUndrgcrj�S 54. Forms
�+ 4. FJectncal Com?uztE*9ndrgrnd� ^ 55. Electrical Bondng
��- �~ �r
�.`.:'.�,Steel Reinforc2neirt :y?: 56. Rough Plumbing & Pressure Test �
,.�. .�-�
•-b`��lectrical UF�fi?.Grnd � � 57. APPROVALTO COVER�GUNITE
�r�-
� �s.1.' �otings �` '6 58. Electrical Conduit�Undrornd. ��
,� Foundation ti..� V� � 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Ufdr,�rnd. • 60. Back�vash Lines, P-Trap, O Undrgrnd. �
10. Structural FI 4i Svs?em � - � 61. APPROVAL TO DECK
11. Property Sew2r L'ffre & H�uSeCormection ' 62. Backevash & Receptor�Pinai
r..
t2. �ewer Cap y " ' y • 63. Heater & Vent-Fi�ai .
13. Roof Dcains �� 64. Piumbing SYstem - F�nai
� h
74. Rough Plumbthg ` � S5. Electrical-Finai �
75. Rough Electriral-Condwt 66. Solar SYstem-Final I
76. Rough Electr"r4Q Wiring 67. Fencing & Access Approval �
77. Rough Wiring§ign fi8. APPROVED FOR PLASTERING ,
18. Rough Electriy�ai-T Ba� Ceil�ng 69. POOL/SPA SYSTEfviS FINAL �
-- �
19. Rough Heating & A�r Conditiomng " FIRE DEPT. REQUtREMENT �
_ ' ' ' . �,s.; .s.,= . -�-� . , - _ ,� t E-. � �• p p-. r . '
2(T7 REugh;nac:nry�iRePlace i 5:,*' "; t� D c'a �APPR.L�VAIS%:. Pa!tnit# �: "H '� .
.. ;n :' . r 1 � C^ Q' := > � ^ a Cv .. �. : J H k- � ^ Y `^ -
nT �_`� i �. . - = -� S3'z3'3T�-`" . _ , �
Z�'i �V-'"S, S S��ct�.r� � .. .. ,.,5 s � .-�+ k -p 70.iJJnder9�u[inti F��ro �� . '
-'�-� ^' r-�--�'-i?s-�--+ - -•-p -. ,., '
22. DL�ts.'?YenD:at?^�•. i n.S � �... cC* r�-; 77. Produrt't�Ring����;as 4�Dit �
� � , � .r n . i r� • -� c��{
3 G� Pi�2•Rwgh�&'Test � M t rn ; x,_} 72. Under r�vnd F�.i.- - �:. - �
t � S � :-1 � O �.: x g Q : ,; " , �.
-�t-,Si--f-^Y^ „ . c-S�r-: "� . . ;r--�.r� _ " - -i
2�' R6bf Reemi�,g O r i F•F �- r J � ^ a i� & 7�'i �ndergrnd. S[o�^? Tar.k �� Gas ..r'lvd � i
s •:� • -� �. � Y: �3•: �
25. f; f eathin C i i: n. r m r� G n:: �: O F- - .i `-�
�� gt:,; ¢ v v x r i. ,� i s 7Fj Overhea�Hydrp m� �Y"
s-rx- r'; ' ._�""--�r-- l:� ,--" � "
Zfr T%�r Ce�ling ($:�;rt�ral; g{�ocoai h � J:^!� t. 7r�' Dry Chemical r�, o ti 4. .�`.,• . �
2�Fr� eand Fias�r� ;�< ' x x � � <]�-^• ��: cu "' j
.i� � �3 # ^' � : a+ •r. �. +; 76. Dry Sta . i�ype r �i :.- q .: F �, ;.
7-�tT'71'J . . •-�C�r -�-z�^.; � !1i ,T- J
, 28. LShing'& Sid.r�> co -^'2�: � . r .. . x* 7� F�XED•S•Y"oTE'?.=r�=UAL'; � i i
.., _. .. : �� - .-, v� �o .cr� -� , �? {
Y, � � ~
i' 29. Insular,jpn �k J �- .. .. - ; ( � K 7� FIRE�PREV. F��iAL a� ^ o� xi - �. � �
��- 34 � � �x'.5 � .J . . ._ � . : �=- .. --•
y::aSNa;hng��+ '' ; � * �-+ � •�1iEALT;�IDEPTv.�aEQU1REMENT I
'�.x,�. 4_ �"" � � [
��.-� i-
� 37. Piaster3roy:� Cyi{ ; i:'r, x i � i� *�, 79'.'FC(VAt�6_,rt?�EC'i�bN ;`� r• f r
�-C' .ti F-1 n r 3'_' � c-�--'r:,T-R'�-�' -- !
+ 3"c+ EleCtris&I F'avret�:lzt0'�Fina� F N � 1 .+ C 8f,�, FOOD CERTIF.'TCin7E I:#SUE� ' �
-t-�-mf-ru-� � �� -, �„- - "I
3�,� �,ct �c �y. i ", � ;,7 � N4i�es: c -�. .`
F���i � . m � s I �, �-; -�m �i r, n- _,
' 3� 4� FiZ91 � at�r�l 8�t\t C�dit9o`�^9 �� x�� I �� --%� -[�q ♦. r�^1't��/� `r!'y��,, =��,_.,- n - �
' �•-e-o Y "7 �. ,- ��i!_L_i! �4�•%V��--�`'1-7`a=%�/ _ "
3 Fifial �-as R=e.t :� m ^i : � I._�;�. r � �� <m �, -i
T 4 , / /��y�
;. �.� .. ;;.�F Ci.•` • f. -i � ��' f �� �_���,�f•�U-�_T�1�CF-+�• �
36� HCAd or CanoP{U:r p �"- `i r- C'� ( x; �'. r1v �`.�� r• 1
' � n � y - ! {�E f r �. ^� '4' _L1-" "'_ __ -_ �
� 3f-..�, Fii;al Faetory F,�e�'Fii`dL•P.,. �`;c, " '�" ! 1j- �ir-zi�- -i `.� � ��'-! �
38. Fi�el Plumbing��: � ,.... : : j 4' :- #: q _ H ;++t ___-_ __ I
.k
� 39. WSPxr Service•FSn�+ � ' _. .� fr , , :,�n . ,
` F '1 .. � v + x � � �
' 40. Gas Service-Final � � ° � � � � ` "
�� ., r.. .^, :•c_. � � rt1 i i �� .. ��:� L�2., .t
j _
. 41. Solar pomest�c-Fir.ab � •• ' G`- � {* � < % �•
.r .t , �. x : -
42' Backflow Prevent f `�" '� �� � ' L � � ' �
�t ;,.: .. � , f; ; � •_, � .
�
43. Backflow IrFigatio� � "r�� f :, � �a • T� .: � ; . -� �
:� �f� � A � • '.� �. . LI
44. landSGti,Pe�krigauon SYstet�py�' r• « Y �. �.. ,� p� �� �� • pJ J '
�-`J' "-:-t'} � ':' � ^m--'f <" - _�
jr4�Sound Att�uati6t� "'�F• ^ �' � `" �"'i" p � �+ a:� c:r * -' �
n = m m•--!� r c r F- � ,
�_ * m • . � , _, 3 -;
4� HendiqP R�gulati�ns ,., .. p �, � .- .. � ;� - �_ c. r F
" . 'y . .��.� �, ��
47.s Fi:�AL STFillCTURE E� Bl11LDiNG + � � � � � :� �' �
. > t-. � l�s � r c F
�n
4�;FI�AL PLi�,NNif`�`N i `,-.f-. t :� � � � :: r ;; �- � t 'rv�
49: It�tric Retease ta Edison � a� ' �� ,* *�: �r '7
' SG`S G�s Release to Souther� Californja Gas Cn s ; i-�' �; ,� ;�. 1:;: x '�
' S1. CFr�TIfICATE 0 OCCUPA'IVCY � , .._ : ;y ,r,r,� : � F.. o
No. Date
Applicant to fill in all s0aees except those wit�in heavy Goraer lines antl sign ail a0oropriate aeclarationz.
PERMIT NO. � TRACT NO. LOT NU.
CITY OF COSTA MESA CO�VSJ�� OI�LPERMIT , ' UNIT NO. A P�
'/ E - �35— 53
Project Address �17aZ � �fRe �o�T _ � E Main Building:
Sa,,,yte TVPEOFCONSTRUCTION NEW � ADD ALTERATION � REPAIR Front
Applicant'SMailing,�+dd�2u U � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T
Owner's Name UR✓� � fSnvk phone 3�a-3�a ' DESCRIPTION OF WORK/USE OF BLDG. B Rear
Address s��e ' ' � ' - - p`
Arch/Eng. _License No. � TVPE OF PERMIT GRAOING FOUrvDATIOrv STRUC7Uaa� I C Right
,�,.,/ K
Addre55 � / 7 ����� , ❑ TENANT u ELECTRICAL '❑ PLUMBING ❑ MECHANICAL _ I g� Left
Contrecm�'sNam /��e'1r e[ 2iL phone_�L4-3- ��oTHEa PIng.Ref.#
Address (ma����g� '��%9 w• «� S+• �' Co7rq {f�e/A PROJECT DESCRIPTION SC�. FT. oCCUPANCv
GONSTRUCTIONTVPE VALUATION$ PlanningNotes:
City License NO. � 3 d�� - -'
ZONE GRADINGCU.VDS. ACRES
LICENSED CONTRACTOR DECLARATION
I hereby af/irm that I am'licensetl untler provisions o( Charte� 9(tommencinq Remarks: �
witn seclion ]000) of Division 3 the Business ana Professions COCe, antl , }
my iicense is in full / rce antl ei/e /� p L-"O �
i.icense Cla s � jEense' ` i�v � �_ PWMBING � FEES
ite Si9nature
ORKERS' COMPENSATION DECLARATION BarSink Showers '
I nereby aitirm Ihat I have a certificate ot consent to self-insure or a certificate —
o/ Workers' Compensation Insurance, or a certitietl copy thereot (5ection , - gackflow Preventer Service Sink
3800, Lab. C.) '
Policy No. � Company BackfloW Irfigation SeWer Cap
BCertitietl copy is hereby fumishetl.
Certifietl copy i5 filetl with the tity Builtling Division. BathtUhs Sewef ConnectiOn
Date " Applicant - '
EXEMPTION�FROM WORKERS' COMPENSATION DECLARATION ' Cld�ifi¢R � 5013� COII¢ctOfS � • ' � _
-(Thissection neetl not be completetl if the permit is for ne huntlretl (5100) or Dishwasher '
less). Solar Piping _
1 certify thal in [h¢ pe�fo�mance of the w k � wt �cl this permk is IsSUetl, I �
shall not e oioy any person in any man r s to become ubject to the Drinking Fountains . Solar Tank �
Wo�ke� C tion Laws o! Californi L
Date Si9nature � ' ,� Floor Drains Swimming Pool w/Spa
NOTIC It tter making tnis tleclaratiOn, you shOUltl berome subjeCt t0 th¢ , �
Wofkels mpensation plovi5ion5 Of th¢ Ldbor COtle, y0u mu5t tOlthwith FIOOf SinkS _ Ufindl -
'comply with such provisions or this permit shall be tleemetl revoketl.' - �
CONSTRUCTION LENDING AGENCV � - ' � GaSSeNiCe 'OUtletS Wdt2�CIO5Et
I hereby affirm that there is a construction lentling aqency for the performance -
of tne work tor which this permit is issuetl (Section 3097 Civ. CJ Interceptors � � - Water Heater
Lentler'S Name —
�entler's ndtlress - � Kitchen Sink � Water Service
OWNER BVILDER DECIARATION
1 he�eby affirm lhat I am exempt irom the Cont�actor'S LlcenSe Law to� the L3VdtOfi25 � • AUtOdNdSh � �
following reason (Section 7031.5 Business antl Professional Cotle: Any city or � —
county which requires�a permit to conztruct, alter, improve, clemolish or repalr P—Trap � � Laundry Trays
--ny'S[ruc[ure, prior to it5 issuance, also requires the applicant for such�pnrmit —
� file a signetl statement thaC.he/sne is li<ensetl pursuant to ttte provisions o( ROOf Drains - � '
he Contractor's License Law (Chapter 9(commencing wlth Section 7000) of
Automatic Washer �
Construction Pole Sub. �
Cooking Unit �
Dishwasher � �
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes '
Outlets
Switches
Garbage Disposal .
Generetor O0.5 KW O5-�
Zone
Parking Req./Provided
ELECTRICAL �
� Transformer ❑ 15-50 KW �
• � 50+KW
Meter �up to 100 amps
Meter ❑over100.amps=-,
Su6 Panel !;�
Motors �0.1 HP � i X- 8
� InaSolar �9-75 HP �16-15+
' Microwave '�
� Pole Light �
Range
. Standing Sections
'KW Trash Compactor
Division 3' of the Business antl P�otessions Cotle) or that ne/sh¢ is exempt � . . . Reinspection Fee ,' $15 Issue Fee '
��therefrom antl .the basiz tor the allegetl.ezemption. Any violatlon oi Section - -
]031.5 by any appli<ant tor a permit subjects the apP���anY to a civil � " .
,penalty ot not more than five huntlretl aollars (5500): � . - , DEVELOPMENT SERYICES REQUIREMENTS:
'� I, as owner ot the property or my employees with wa9es as their sole Reinspection.�Fee $15 lesue Fee , ' $ 3 Zoning Approved By
compensation, will tlo the work, antl the structure is not intentletl or otferetl - .
for sale (Section 7044, eusiness anG Protessional Cotle: The Contractor's ' , - � .� MECHANICAL ' FEES Building Approved By �
License,Law tloes,not applyto an owner of a property who builtls or-improves. ,
thereon, antl' who tlaes such work himself/herself or through his or her own . APolication luued Bv
employees, provitletl tnat Such improvements aIe not intentleC or ofteretl fol BOiI¢f ' HOOd OI Typ21 ❑ • _
sdle. I(,�howeveq the builtling o� improvement is Soltl within on¢ year ot com- Cd�Opy. TypE.11 ❑' �
pletion, the owner will have the burtlen ot proving he/she ditl not builtl or im- Duct - Under Ground .
prove �or the purpose of sale). . ' .
❑ I, as owner of'the property, am exclusively contracting with Iicensetl wn-' Duct- St�uctural � RefrigeraGon Sys[em .
tractorsro construct tne oroject ISection ]064, Businezz antl Professions Cotle: - � '
Tne Contractor's License Law does not apply to an owner oi property who . Duct - Ventilating ' -❑0-100,000 BTU' �100,000 BTU
Cuilas or improves tnereon. antl who'contracls torsuch oroiects with a con- - - -
tractor(s1 hcense pursuanc m me ConVaciors Li<enie Ww). 1 am aware thai Exhaust System ❑ Multiple ❑ System Repair/Alteration .
proof o( their Wo�ke�'s Gompensation insu�ance shoultl be p�ovitletl to me. .
❑"I am'exempt untleu5ection B. & P. C. for this reason . • Firepl/Fact. BIL iCBO dk Pire Dampers .
Date ' owner � � Heating Sys[em & Ducting
" I hereby cer that 1 have�reatl-tnis application antl sta[e-tnat the above � ❑0-100;000 BTU �100,(
' information s co rect. I agree to comply with all city antl counry ortlinances : '
antl state la s rel ti t 6uiltl�ng construction, antl hereby authorize repre- ,
Sentatives Ihi �v �o enter b0on th¢ above-mentionetl prpperty for .
Inspectlon p poyE
Signature
Drivers' �icense or 55
0865-46, rev. 5/88
Reinspection Fee � , $15
White - Builtling; Canary - qpplicant; Pink - Accounting; Goltlenrotl - Assessor
Registers � ' ' �
luue Fae
SUMMARV OF FEES � ,
BUILDING PERMIT $ SMIP
PLAN CHECK $' PERMIT
PLUMBING $ �SSUANCE
PLAN CHECK 25% $ � ENERGY P.C.
ELECTRICAL $ 23•2� �GRADING
PLAN CHECK 50% $� MICROFILM
MECHANICAL� $ TOTAL FEE
PLAN CHECK 25% $ �
O
N
I�
N
G
R
E
Q
M
T
S.
�FEES
$ 3 oi 000�s?91-OOOi599S TCr7
DA;f: ,OtG�/°P 'TItiE: ?3:1v'
�3.?�
. , . .. , . .. ,�. , . . . ._
� CONSTRUCTION�ANDPLANNIN� JL&SPA
. APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service'or Pole r`' , 52. Pool & Equipment Location
,
2. Soil Pipe-Undrgrnd. ' '.� 53. Steel Reinforcement ; �
3.iElectrical Conduit U�tiliiy-Undrgrnd. 54. Forms - �
4.�Electiical Conduit-Undrgrnd. . 55. Electrical Bonding -" .
5. Steel'Reinforcement ' 56. Rough Plumbing & Pressure Test "�
6.� Electrical UFER Gcnd. � ' ' 57. APPflOVALTO COVER-GUNITE '-
�7.'Footings � ,-� � 58. Electrical Conduit-Undrgrnd.
8. Foundation . � ' � ' � � ' 59. Gas Pipe, O Undrgrnd., Test � �
9. Water Pipe-Undrgrnd. � � -�" 60. Backwash Lines, P-Trap, � Undrgrnd. -
10. Structural Floor Sysjem �'� �' 61. APPROVAL TO DECK �
11. Property Sewer Line & HouSeConnection t' 62. Backwash & Receptor-Final �
72.�Sewer Cap : � 63. Heater & Vent-Final .-��
13. Roof Drains . •'" 64. Plumbing System - Final �'�;
14. Rough Plumbing• _ 65. Electrical-Final � ,
15. Rough-Electrical-Conduit . 66. Solar System-Final
,1�6. 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 & Air CondiCioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace ��' APPROVALS Permit #
�
21. Ducts, in Structure %:� 70. Underground Hydro
22.-Ducts, Ventilating . 71. Product Piping OGas� �Oil
23. Gas Pipe-Rough & Test 72. Underground Flush -
� 24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil , ,
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical � �
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat " " 79. FINAL INSPECTION
32. Elecvical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric 3 J 0 Notes:
34. Final Heating & Air Conditi0ning ._ .1,, �
35. Final Gas Pipe-Test
36. Hood or Canopy � � • � - �
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final
40. GasService-Final '� � .
41. Solar pomestic-Final . '
42. Backflow Preventer ' - �
43. Backflow Irrigation
44. Landscape.lrriqation System ' � �
45. Sound Attenuation • �
46. Handicap Regulations , r' �
47.FINALSTRUCTURE&BUILDING 3� , •
48. Soecial Requirements Completed �
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co �� ' �
� 51. CERTIFICATE OF OCCUPANCY ' , , % `
No. Date � � i '
Applicant to fill in all ipaces exeept tho5e within heavy Oortler lines antl si9n all appro0riate tleclarations. _� JJSq _, U�� I.LBS ... - ��O;vO TL
_ _.' ' _ _ _ . . . _ . . T , : - _ ; -' _' ' ' j . I � n I . : �, � .
CITY OP COSTA MESA CONSTRUCTION PERMIT -- - ?ERMIT NO. TRACT NO. � LOT NO. ' ' UNI 0.,; ' i, • • � .� � , � • ., ' r � _
ProjectAddress %747 FTeflpIIt Lc1I12 ' - . � -'"',�.I����l � .. ._ � , - � . , . � _ � ,
ApplmanYSMailingAddre55 �jl}1'3 $,TA PalrtH AnaFipi�m�- .' TVPEOFCONS7RUC710N NEW � ADD ALTERATION REPAIR� ' � -
'❑ CONVERSION=O DEMOLISH ❑ OTHER � ' ' • � � ' ��
Owne7sName: Ml('ha 1& r;�nda `�`�ner-' vno�e'S56=4173 - Install Heat�& A C. A'P.# ' .� - Zone� `
- DESCRIPTION OF WORK/USE OF BLDG. -
Addiess, �74� FrPmon Tan ` � � ' ' � - ' � " � � �� ' � S Main Building: � ' � 'Accessory Building:._
Arch/Eng; ` � � ' �LicenseNo. ' � TYPEOFFERMIT GRADING FOUNoa710rv S7RUCTURAE, _ T Fiont �- � . ' - ' ' p
Addre55' � � ' . ' ., '❑ TENANT � ELECTRICAL ❑ PLVMBING � MECHANICAL , .' . B Reaf ' � � " - N
Contracror'stvame prn� HPafincr & AI�Y_ phone 714779-6H H �'OTHER'. . ' � � - � : � � /� - '. _ . � ,
Addresslmeilin9) 5413 �F'_ �Ta Palma-Anaheim � i � �PROJECTDESCRIPTION� sQ.Fr,� 1(70 � • � occuParvcv�Sin�a12__ K Right � . � "-' . - . .� G �
- ����� i i _ . CONSTRUCTIONTVPE ' - VAWATION$ ' S Left . � . � .
City Cicense No: _-+L6�L.+� � � � zONE �' - � GRAOING Cu.voS .ACRES ' pin9. Ref�. # � ' Parking�Req./Provided E `
LACENSED CONTRACTOR DECLAf3ATION ' ' - '� - � � 1 Q
I'h¢reby atfirin tha[ 1 am licensetl untler provisions of,Cha�ter 9(mmmencing Rema�ks: ��-;� _ � � ' . Pl2nniny NOt25: ' � � � M
wiih section ]000) oi Division 3 of the Busineds antl Professions Cotle, antl - � ,
my license'is in full force antl�effect. ' f .. ' . , � , � �^' T
,
� .---- ^•--- . r-7n �\ r.� � . .---._ .._ . 4F,9F,"�7 , . . . . � . � S �
�-''- Y;`+YORKERS' COMPENSATI N'bE 'ARATION . - '
�, " i hereby attirm that I have a mate of consent to self-insure or a certificate
� of Wo�ke�s' Compensation Insu�ance, _o� a certifietl� copy thereot (Section „
� 3800, Lab. Gj � � � -
�- voucy No. S�I—nF�A� � Company 'HOrt1PldnCl .IIIS. ,�
I��yI, Certifietl copy is her¢by furnishetl. ' �
y{ Certifietl cop i5 /iletl with tbe city Builtlin Divi;ion. � , '
Date 5���/#S qpplicant p1-n I-�Pat�na & Ai�r
EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION �
(Thissection neetl'not be campletetl if the permlYis for one huntl�etl (E100).0�
lessl. � � : � � : ; •
I certify 1M1at in Ihe performance ot the work for which this pe�mi{ is issuetl, I
shall �not, emPloy any pe�son in any manner so as [o become subject to the
Wo�kers'�Compensation'Laws of California.' �
. Date. - � Signafure • ' � '
�NOTICE: If, after making this tlecla�ation, you shoultl become subject to th¢
� Workers' Compensation p�ovisions ot the Labo�- Cotle, you must forthwith _,_
comply' with sucn provisions or -tliis permit �snall be tleemetl revoked. ��
CONSTRUCTIONILENDINGTAGENCV'' � -�
I hereby SHiim that tnere is'a'construction lentling agency (or the performance'. i
, of ttie work tor whith thi5 permit is i55uetl (Section 309] Civ. CJ
LPntler's Name - ; ` -
� Lentler's ACtlress�
OWNER BUILDER DECLARATION � "- �- �� '� ' " ' � i , -
I hereby aftl�rti'that I am�exempt trom thelCont�acto�'S1License L:aw tOr�the '
, fallowing reasom(Section ]031.5'BusinesiantlProtessional Cotle: Any city or
, county which r2quires a permit:to const�uct, alteq improve, tlemoliSM1 o� �epair ;
-any structure; prior to its"issuance, also requires [he applicant for such permit
�'k�'Io file a signed Statement that he/she is Ilcensetl pu�suant to.the provisions at
� ,`the Contractor'sLicense Law (Gnapter 9(commencin9 �+ith Section 7000) ofr �
. nivicinn i nf the Ruziness antl•Protessions Cotlel or that he/she is exemot
tbClQifOT df10 [OE Dd51
J03105 by any applic
�enalty of..noLmo�e tha
1, as�owner ot the
compensation, will tlo'
for sale (Section ]04�
LicenSe Law tloes uot a
thereon, antl�wno.doef
u i; as owner or me
L(dCI0I5I0 COfISf I11C1 I
The Contractor's Lic
builtls ot improves tl
tractor(') li<ense pue
proof of their WorkE
❑ I am exempt undei
• t:
Date �
1 hBr¢by certify. that
information is wrrect
antl state laws relatin
sentatives of'.this'cil
inspection purposes�
Signature
Drivers' License or 55
=.0865-46, rev. 10/84
r a pe
iuntlrei
rty or
rk, antl
ness ar
� an'ow
work h
�imprc
or imF
he bui[
v.amE
0
? PLUMBING
snawe�s
�r - �- Service Sink � --'
�n � � Sewer Cap- �
� � ' Sewer Connectiom
� . c,.i�, r,.ue,..,..� .
ms,
5 _
e . 'OutleCs � '.
irs �
inW � �
�n .
applicant_to a civil ' ' '
� ' _�
n wages�' as their sole � Reinspec[ion �Fee
t intentletl or ofieretl '
ie: �The Contractor'S � _ � '
_ ...� .,.. _,_.,...... . i . � .
�
�
�
j
Solar Piping '
Solar Tank
Swimming Pool w/Spa ;
'�if103� • ' • - '
' L
�Wate� Closet. .,p .
FEES
' � Automatic Washe� '
� ;i i ConstructionPoleSub.
' j "
, Cooking Unit , �
Auto,Wash � �' �
taundry Trays � ' � � �
5�.,� � � IaueFee' . ,
�emerits are nbt intentletl or oiferetl tor ' tloner '' ,�
ovement is�soltl within one year of com- � -' �
:n of proving he/she tlitl not builtl or im- Duct�- Under Giound ; �
eclusively contracting wiN licensetl con- Duct-StNctU�al .
on ]044, Business antl P�ofession5 Cotle:
�ot apply [o an owner o! property who � Duct - Ventilating �
�contractrfor such prolectswith�a con- - - - - --
tiactoi's License Law). I zm aware that ' Exhaust System ❑ Multiple C
�n insurance shoulE be provitletl to me.' __
B. & P. C. tor this reason FirepllFact. Blt. IC80 #
' ' ' Heating�System & Ducting
this application antl �state that the above-- -1 C}30-100,OOO�BTU 0100,OOOBI
omply with all city antl county ortlinantes �
Const�uction,'antl he�eby authoriie repre- � � .
upon ¢ above-mentionetl property for + � ' '
Date 5/22/85 �
- ' Reinspactian Fee $75
iltling; Canary�- qpp�{�ant; Pink - Accountin9; Goltlenrotl - AsSessor �
Hood or Type I ❑
Canopy Typell' ❑
Refrigeration System
�Jaioo,00asru C]i�
Sysfem Repair/Alterati
Fire Dampers_ �
iBT
I
� ' '_ "`"" �_
I
Issue Fee ' � $ 3
F.A.U. '
Fixwres ' "" - �
Device Boxes '
i
Outtets
ELECTRICAL � � , 1 FEE;
� � Transformer ❑ 1550 KW �1� ~ �
, � ❑ SO+KW � !
i I
� Meter ❑upto�100'amps, � �
� Meter ❑over 100 amps _ _ �
Sub Panel . � ' �
�MotorsOO-7HP�(]1X-8 � 1�
.� InaSolar'�9-15 HP �16-15+
,Pole Light
Ran9e '
Gar6age Disposal ! ; Standing Sections ,
Generamr �0-5 KW �5-15 KW Trash Compactor '
i
�Reinspection Fee $15 Issue Fee' �
DEVELOPMENTSERVICESREQUIREMENTS:� �
Zoning Approved By �
i ,
Building Approved By '
��
��
�
Appliwtion Issued By Dete__�/ 3 � i"
� � ' j SUMMARV OF FEES ' . ' �
BUILDING PERMIT '$ � � SMIP � �$ ''
! PLAN CHECK $ • PEFMIT ' �
PLUMBING+ ' $ � ISSUANCE • $ ; 6.00 I
PLAN CHECK 25°k $ � ENERGY P.C. � $ _ � �
ELECTRICAL �$ ���S���RADING $ �
PCANCHECK 50%�$�+ � N1�CROFILM ,$ - '
� MECHANICAL � `$ ' ��I�OLyOTALFEE '$ '16:50
PLAN CHECK 25% j$ � . . ' � .
DO
j
" 'CONSTRUCTION AND PLANNING X . . �..JL & SPA --
'" APPROVALS Permit# Date Inspector AppROVALS Permit# � Date Inspector I
-,i. Temporary Electrical Service or Pole - 52. Pool & Equipment Location
-2. Soil Pipe-Undrgrnd. : � 53. Steel.Reinforcement � �
r.3. Electrical Conduit Utility-Undrgrnd. - � ' - � �. 54. Forms '
.4. Electrical Conduit-Undrgrnd. - � �� 55. Electrical Bonding �
� 5. Steel Reinforcement � ' 56. Rough Plumbing & Pressure Test .;
�6. �Electrical UFERGrnd. - � � 57.-:APPROVALTOCOVER-GUNITE
_ ,.
_ 7. Footings � � .58: Electrical Conduit�Undrg'rnd. _ f
. 8. Foundation , 59. Gas Pipe, O Undrgmd., Test � � �
'.9. Water Pipe-Undrgmd�. � � 60. Backwash Lines, P-Trap, � Undrgmd' �,
'; 10. Structural Floor System p � 61. APPROVAL TO DECK .
� 11. Property Sewer Line & House Connection 62. Backwash & ReceptorFinal . " -'
12. Sewer Cap 63. Heater & Vent-Final '
73. Roof Drains 'y ' 64. Plumbing Sysiem - Final � - , -
14. Rough Plumbing 65. Electrical-Final � �
-15: Rough Electrical-Conduit , 66. Solar.System-Final '� � "
� 16. Rough Electric Wiring , " . - 67. Fencing & ,4ccess Approval • . ' ,
17. �Rough Wiring Sign� � . � .68. APPROVED FOR PLASTERING �
�18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � _
19. Rough Heating & Air CondiCioning FIRE DEPT. REQUIREMENT �
20. �Rough Factory Fireplace APPROVALS Permit #
21. Duc[s, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil �
23. Gas Pipe-Rough & Test 72. Underground Flush _
.24. Roof Freming � 73. Undergrnd. Storege Tank O Gas ❑ Oil t
25. Roof Sheathing � 74. Oyerhead Hydro
� 26. T-Bar Ceiling (Structural) & Monocoat �75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
�
28.'Lathing & Siding - 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
� 30. �Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
33. Final Electric %� G� Notes:
34. Final Heating & Air Conditioning �7 ��s-� ��O � �
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. Sotar pomesticFinal ' . _. . . -
42. Backflow'Preventer
,
43. Backflow Irrigation � � .
� -
44. .Landscape Irrigation System ' � ' � ,
45. Sound Attenuation ' • . �
46. Handicap Regulations � � � - -
47. FINAL STRUCTUFtE & BU�LDING `
�
48. Special Requirements Completed . � •• '
49. Electrie Release to Edison • � , , ' '- � � , ,
� �
�� 50. Gas Release to Southern Califomia Gas Co � � i �' � .
51. CERTIFICATEOPOCCUPANCY � i . . _ r. , �
.. _
Nn. � ' � Date � . .. .. . � � _ _ . . � . . ' -
' �.
FEE RE�tlVtu
r� j Lot b2� Tract 4285, Plan lt00 B SEp 6.?^,6Y'
1 .�,.
GOSTA MESA BUILDING-SAFETY DEPARTMENT � FINANCE DEFT.
P. o. Bo= s�� �o�� M��. �-���+�A • CITY OF COSTA MESA
For Applieanf io Fill In Complefely APPLICATION FOR PERMiT
TYPE OR PRINT
BUILDING BUILDING .
ADDRE68 271�2 Fremont L�e
COS7A MESA CALIFORNIA For Office Use Only
0.ECEIPT NO. PPRtlI�"NO:
OWNER Mesa Del Mar D velo ment Co: - :�.i'c..C''►. �'.'�
e�nnoe�� 38� .rS. COSSt H].p}7R3V aeceiv� ev I owp a��yve� I o�re iesum
S! Y A
MaCco
ss 3&� E• Coast' Higj�wa
Corona del- ar, Calif.
I81ZE ,6643 S
OF LO
No. oP
OR 22 pDD E168
OZ' 3�ZZ � COSTA MESA. CALIFORNIA
FIRE
ZONE TYPE � GROUP�
APPROVED
BY DA7E
ZONING '
. ZONE I NO. OP I U88 OF NEW� I
� � PLAN9 �� BUILDIN� L,)
'�ZZO LEGAL � w"J,�.� . L�.O !
OEBCRIPTION
�bt �P none YARDS EVES
EXI6TING BLDG APPROVED ALLOWEO
8lTBALK LINQ PROM 1� (CENT6R I.INE BT4
ceNTea oF eTR[eT 4S � REAR YARD 22 � FRONT s FL �—
81DE YARD I I.EFT' 7�- I RIGHT . � R. SIDE � FT. —�—
DESCRIPTION OF WORK - , _,,,_ � __ �
R�R Z Z
APPROVED � n'-
BV !J"
� NO_ OF
6/
w/attached garage Covered orch etc. 68 S F
1 HBRESY ACKNOWI.EDOB TMAT 1 HAVE HtAG iH18 APPLIGTION TryE AMOUNT eXOWN IINDER VALUATION 18 POR TX¢
AND BTATB THAT TH8 ADOVE �8 COHRBCT AND AOqHC TO COM-
PUPPOBH OF C9TABL18HING A PERMIT FEE ONLY.
PLY WITX ALL CITY ORCINANLH9 ANO BTATE LAWB NlOULATINO
euLLDINo CONBTRUC'�ION. � � VALUATION
SIGNATURE OF �sa Del �`ar Development Co. PERMIT FEE $ J��'
PERMITTE
- By ,/�/� //��oO � ZH�2�%�OO PLAN CHECK $ /��
.AUTHORRED -`r � C�y"�'�/'� 57��
iOTAL FEE
F
LL
25652 ' CfiY ii� �:S3A ���
� COSTA MESA BUILDING-SAFETY DEPARTMENT � p�qY 2 1g6fi
P.O. BOX 1200 CO$TA MESA, CALIFORNIA 9262!
' CITVv�F COSTA
PJOject Address -
�Applicani�' Mailir�
IySIR UCTI ON
IT
AVOlicanl to fill in all spatts exceD� thase wit�in neavy Oortle� lines ane sign all approoriate aeclanlions.
PFRMIT Nfl T CYWB� LO7 NO. I INIT f.lfl
Arch/Eng' � 1 WllIN2 License No. � .
�Address � � �
Contractor's Name N� Phone
Address.lm�'i��nl �
City License No. - .
LICENSED CONTRACTOR DECLARATIO�N '
I h¢reby affirm thal I em licensetl unde� provisions ot Charte� 9(commencing
with sec[ion 7000) ot Division 3 of the BuSiness antl Prot¢55ion5 Cotle, an0
my license is in full force antl effect.
LicenSe Class � Li<ense No.
'ate Signature .
JRKERS' COMPENSATION DECLARATION - � �
nereby affirm that I have a certificate o( consent to seli-insure or a certlfltate
ot Worker5' Compensation Insurance, or a certitietl coOY thereo( (Section
3800, Lab. CJ .a .� . -'
Policy No. COrtlpany �
8 Certifietl copy is hereby �urnishetl. --
Certitietl copy,is filetl with the city Builtlin9 Division.,_ �'�
�Date Applican[ � "= �%'
EXEMGTION FROM WORKERS• COMPENSATION DEGLARATION �
(Thissection need not be tompletetl�if the permit i5 tor one huntlretl ($300) or
less). . - .,•; .
I certify that in the performance of the w k �or whi` h this erm�t is issuetl, I
shall noy employ any Oe�son in any m n � SMas yO b e subjett t0 the
WorlSpryZC�i@Non Laws of Califorp , J)
NOTICE: 1f, after makin ration,-yoii shoultl become subject to tne
Workers' Compe provisions of the l.abor Cotle, you must forthwith
comply witb suc� provisions or tbis permit shall be tleemetl revoketl.'
CONSTRUCTION LENDING AGENCV '
I hereby atflrm that there is a construction�lentling agency for the performance
of Ihe work for which this p¢rmit is issuetl (Section 3097 Civ. CJ '
Lenaer's Name � �
Lentle?s Atltlress .
�OWNER BUILDER DECLARATION
I hereby atfirm that I am exempt trom the Gontractor'S License Law. for the
-following reason (Section 7031.5 Business antl Protessional Cotle: Any city or
county� which requires a permit to Construct, alter, improve, Oemolish or repair
'?ioy structure, prlor to its issuance, also requires Ihe applicant for such permit
"<;;?',tile a siqnetl statement that he/she is licensetl pu�suant to th¢ prOvisions of
:'n Contractor's LiCenS¢ Law (Chapter 9(commencing with Section 7000) of
+s7ivision 3 of the Business antl Professions Cotle){or that he/she is exempt
��-therefrom antl the basis for the alle9etl exemption. Any„violation of Section
�031.5 Dy any applicant for a permit subjects the applicant to a civil .
enalty ot not more lnan five huntlretl tlollars ($500).
I as owner of the property or my employees with wages as theiL sole
pensation,-will tlo the work, antl�the structure is not intentletl or-offeretl
for sale (Section 7044, Business antl Professional� Cotle:_ Tne Contrattor's
License Law tloes not apply to an owner of a property who builtl5 or improves
-thereon, antl who tloes such work nimselt/herselt or through his or her own
employees, provitletl that such improvements are not intentletl or o(teretl for
,saie, li; nowever, the builtling or improvement is soltl within one year of com-
pletion, the owner will have the burtlen of provin9 he/she tlitl not builtl or im-
erove for the purpose of sale).
LJ I, as owner oi the prbperty, am ezclusivety contracting with licensetl con-
fraCto�s to wn5truct the project ($ection 7044, Busine55 antl PrOfessions Cotle:
Tha ConVactor's License law tloes nol apply to an owner of prope�ty who
builas or-improves Ihereon. antl who contracts for such oroiects with a ron-
'tractor(51 Lcense pursuan[ ro�ne ConVactor•s License Law). 1 am awxre tbat
'proof o( theit Wo�ker's, Compen5ation insu�ance Shoultl be provitletl to me.
❑ I am exempt untler Secfion_—p�---_— B. §, P. C. �or this reason
Drivers' License or 55 �
0865-46, rev. 5/88
79 7
TYPE OF CONS7RUCTION" LJ NE\
❑ CONVERSION ❑ DEINOlISH
�. DESCRIPTION OF WORKNSE OF B
.TVPE OF PERMIT GRADING F
' ,' � TENANT,E❑ ELECTRICAL C
�. O �,OTH E R; '..
IfJ ADD LJ ALTERATION L1 REPAIR'
� OTFIER
DG� . _ /
.FOUNDATION STRVCTURAI ,
PLVMBING ❑ MECHANICAI �
PROJECT DESCRIPTION � 5a. F7. I rS �� ���" ""� �" � oCCUPI
�' CONSTRUCTION,TV.PE � � ' � '�VALUATION $,
' ZONE - �. GRADING CU. VDS. �AC
Remarks: �J�
Bar Sink
Backflow Preventer
Beckflow Irrigation
Bathtubs
Clarifiers •
Dishwasher �
Drinking Fountains
Floor Drains
Floor Sinks
GasService Outlets
Lavatories.
?—Trap
Roof Dreins - � �
Reinspection Fee - $75
Boiler . 1
Duct- Under Ground
Ouct-Structural �
Duct- VentilaUng
Exhaust System ❑ Multiple ❑
Firepl/Fact Blt. ICBO �k
Heating System & Ducting
❑ai oo,000 eru O i oo,000 sr
Reinspection Fee � $15
Canary - qppp�ant; Pink - Accountin9; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap ' '
Sewer Connection
Solar Collecrors . v
Solar Piping � �
SolarTank , �,
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Tra'vs
B
Issue Fee
Hood or . Type I ❑ '
Canopy � Type I I ❑
■
�
�
�
��
OB
Refrigeration System �
❑aioa,000sTu ❑too,000eT
System Repair/Alteration
�� Fire Dampers '
Registers '
Issue Fea
A.P. � /
S Main Building:
E
T Front
ARear Ct
C Right •
S. Left 2 �
Ping. Ref. # �
Planning�
Q_��.-_�
Accessory
ELECTRICAL
EES flutomatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher '
Dryers ❑Gas ❑Electric �
Fan
F.A.U. ' '
Fixtures
Device Boxes ,
Outl¢ts � � ,
Switchei
Garbage Disposal
Generator �65 KW �5-15 KW
Reinspection Fee
$ 3 DEVELOPMENTSER
� Zoning APProved BY-
FEES Buildin9 APProved By
. Appliption laued By_
I $ 3
$15
Zone
'Transformer 0 15-50KW
❑ 50+KW
Meter ❑up to 700 amps
�Meter ❑over100amps,,.•�"
.Sub Panel � y. �
Motors OP7 HP � 1 h",- 8
'Inc.Solar��9-75 HP �16-15
�Microwave �'/ ,
Pole Light . �
� Ranae . . � .
Sign
Standing Section5
Trash CompactQv
luue Fee
VICESREQUIREMENTS: _/_
X/A
O
N
1
N
� G
R
E
�
M
FEES
$ 3
SUMMARV OF FEES ,;l--'�'
BUILDING PERMIT $ � ��O SMIP. ;�: � $1 � �`Ql
PLANCHECK $ 7•%S PERMIT=� • .
ISSUANCE' I ; $:3 �
PLUMBING $ ,
PLAN CHECK 25% $ ENERGV P.C. .$=
ELECTRICAL $ GRADING ,$ �
PLAN CHECK 50% $ MICROFILM $ 2
MECHANICAL $ TOTAL FEE $� Z�J. S�
PLAN CHECK 25% $ . �. ' '
8
A
01 GUOli4�9-�OG114$1 �"Ll"$' �723.55
�arE; asrosies rtnG: �{a:z;
CONSTRUCTION AND PLANNING � � � _ �L & �PA �� .
��APPROYALS/' Perrpit# Date Inspector qppROVALS Permit# Date.' Inspector
A I
1. l'emporary Hectrical Service or Pole 52. Pool & Equipment Location � �. �
2. Soil Pipe-Undrgrnd. � 53..Steel Reinforcement � �
�
�.3'�Electiical�Conduit Utility-Undrgrnd. � 54.� Forms ,
4,•Electricel,Conduit-Undrgrnd. 55. Electrical Bonding `
. ` �
�5.( Steel Reinforcement � � 56. Rough Plumbing & Pressure Test
i ,� r
; 6: Electrical UFER Grnd. Qj (d j{ O�- % 57. APPROVAL TO COVER-GUNITE '� ' '�
r• ''i , I
.7. Footings ��Q 8�p � p.�: � � 58. Electrical Conduit-Undrgrnd. �' •
8. F�oundation � _�� 59. Gas Pipe, O Undrgrnd., Test , . �
9: Water, Pipe-Undrgmd. � .. • 60. Backwash Lines, P-Trap, � Undrgmd. �
10. Structural Floor System � IJ 8 O�� ' 61. APPROVAI TO DECK � ', �
11�.. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � �
12 Sewer Cap . 63. Heater & Vent-Final �
.:
13. Roof Drains , 64. Plumbing System - Final - ,.
74. Rough Plumbing ' 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final �
116. Rough Electric Wiring 67. Fencing & Access Approval
'1�7. Rough Wiring Sign 68. APPROVED FOR PLASTERING
Q.B. Rough Electrical-T Bar Ceiling . 69. POOUSPA SYSTEMS FINAL
�19. Rough Heating & Air Conditioning � ' FIRE DEPT. REQUIREMENT
1.
20. Rough Factory Fireplace 'I'� APPROVALS Permit # �
21. Ducts, in Structure. � •
�J 70. Underground Hydro
,r22. Ducts, Ventilating �'�' 71. Product Piping 0 Gas ❑ Oil
�
��23. Gas Pipe-Rough &�Test V� 72. Underground Flush
i 4 .!l
• 2,4. Roof Framing n' � Vnl 73. Undergrnd.StorageTank OGas ❑Oil
25: Roof Sheathing � � � ' � O(o g� � 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �
�7. Frame and Flashing C b$8 D- 76. Dry Standpipe
28. Lathing�i Siding �� / o y �i�- 77. FIXED SYSTEM FINAL
29. Insulation (o � 78. FIRE PREV. FINAL �
30. Drywall Nailing �"' (b p�� � HEALTH DEPT. REQUIREMENT
37. Plaster Brown Cdat �� � �D y d� � �9. FINAL INSPECTION
32. Electrical Power �vl'eter-Final �80. FOOD CERTIFICATE ISSUED
v
33. Final Electric Notes: � �
34. Final Heating & Air Conditioning .
35.. Final Gas Pipe-Test - � _. . � ,
36. Hood or Canopy . ' � �
/
=37. Final'Fac[oiy Fireplace 5� , p( U
�38. FinalPlumCi+g ��� � - � .�
�39. Waier:Service-Final;��
�40. Gas Service� Final � � ' .
0
(.�,41. Solar pomesticFinal _ _ _ " `=
� r;
.42. Backflow Preventer 2 . � • �; U' ; �,
_ ,.�
�3. Backflow Irrigation-� . - , , � . U N ;- �,�
�44. Landscape Irriqation System .T � ' � ? � � �
i
i
45. Sound Attenuation� ' . ' %f' � � �-
,;i x
46. Handirap Regulations - _ �� �.�.., � ` �:'
/_ .
47. FINAL STRUCTURE & BUILDING Q .� 7i�� ���j�,��j ��. F o
U J'
48. Special �Requirements Completed � �D 2. �p �L�'� �BC�� � � �'
.
�r49. Electric'Release to Edison - � ���` �� ` '� � �%' - � r" � a'!
4�n 1 .
50. Gas Release to Southem Califomia Gas Co � �. ,.l „: �' tJ �
51. CERTIFICATE OF OCCUPANCY � � " "�'� :�v !� � �,,
No. Date � ' ��� ' �d
�
o "'Fs9
t �
0
> _
�
V
.�� �
pia� �sa-sz�s • Fax (�ia) �sa-aese
CITY OF COSTA MESA
BUILDING DIYISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
Job Address; 2742 FREMONT LN
Suite:
Viciniry:
Parcel Nunmber; 14155202
Applicanp MC AFFEE � �J���
Address;
Owner; KNOX, PAMELA J
Address 2742 FREMONT LN
',COSTA MESA,CA
Contractor; TOPS ROOFING-CO
Address; 4144 RAMONA ST'
� „ ORANGE,CA
, Zip; 92865 -
Arch :
Address:
Zip:
Phone:
License:
BUILDING PERMIT
Zoning: R1 R1
Phone:
Zip:
Phone: , , � -
Zip: 92626 . - '
Phone: 283-1211
License: �� 745960
� Eng:
Address:
PERMIT NUMBEIa/
699-00186
77 FAIA DRIVE, COSTA MESA, CA 92626
Status: ISSUED ��
Applied: 02/09/1999
Issued: 02/09/1999
�
Phone:
License:
SCOPE OF PERMIT
T/O SHqKES ADN REROOF WITH 40 YR. PRESIDENTIAL FIBERGLASS SHINGLES. ROOF CERT ATTACHED TO PERMIT.
FEE SUMMARY
Plan Check; . $0.00 _ • , , , Calc Valuation: Se,saa.00
Permit $149.75 �� ,� — Claim Valuation: � $e,saa.00
SMIP Res: $0.86 � � '
SMIP Com; $0.00 ' �
Other; $0.00 . ,
Inspection; �$0.00 ,
Totel; $150.61
• r , �.
PLANNING 8 ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Front 0-.0
PARKING Existin : o
NOTES:
Rear 0. 0
Rear 0- 0
Reauired: 0
Left ��0- 0 Righl 0- 0
Left 0- 0� Right ' 0- 0
Proposed: 0 -
EXPIRATION: Thia permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 qays. .
INSPECTIONS: In order for the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all
required inapectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot ihis permit.
FOR INSPEC710NS CALL: (714) 7545626
WORKERS'COMPENSATON DECLARATION: �
I hereby eflirm untler penalry of perjury one ot Ihe following declarations: '
❑ I have and will melntain a cenificate ot consent to self-Insure tor workers' compensation, es providetl tor by section 3700 ot the Labor Code, tor the pertormence of the
work lor w�ich this pertnil i5 iuued.
❑ I have and will maintain workers' compensetion insurance, a5 reQuired by section 3700 ot the Labor Code, for ihe peAormance of ihe work for which Ihis permit is issued.
My workers' compensation Insurance certier end policy number ere:
Cerrier: Policy Number:
(Thls sec(ion nesd nat be comp/e(etl i! (6e permif is valuetl ef one hundred Oollars (5700) or less.)
❑ I cenify that in ihe peAortna� e of Iha work For which this ermii is issued, I shall not employ any person in eny manner so as lo become subject to the workers'
compp�eynsetion laws oi C I�I'�a, end agree Ihat i I shoul come subject to Ihe workers' compensetion provisions of Section 3700 oi lhe Lebor Code, 1 shell lonhwith
Applicafif"s/9 e'm�e:esev sw s� � y-9-�9
WARNING: FAILUfiE TO SECURE W KERS' COMPENSATION CO { GE IS UNLAWFUT AND SHALL SU&IECT AN EMPLOYER TO CFIMINAL PENAlilES ANO GVIL FINES UP TOONE HUNDRED
THOUSANDDOLL4RE(E100.000),INAD�ITIONTOTHECOSTOF PENSATION,DAMAGESASPFOVIDEDFORINSECTION3lO80FTHELABORCODE,INrEREST,ANDATTORNEV'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirm f�ai l em licensed und provisions of
(orce and eHect. Lic. a
Contractor S�I naWre:
with Section 7000) oF Division 3 of the Business entl Professions Code, and my license is in tull
Ctass tt
- � �� �
CONSTRUC710N LENDING AGENCY:
❑ I hereby aifirtn that Ihere is e construction lending agency for the perfortnance of the work For which Nis pertnit is isSued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: _
OWNER-BUILDER DECLARATIONS:
Date:
I hereby aNirm Ihat under penalry of parjury thet I em EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the fallowing reeson (Sec. 7031.5, 8usiness and Professions
Cotle: Any ciry or counry which raquires a Dermit to construct, alter, improve, demolish, or repelr any structure, pnor ro its issuanca, elso requires the epplicaM tor such permit
to ille a signetl statement that he or she is licensed pursuant to Ihe O�ovisions ot the CoNrectors License Lew (Chapter 9(commencing with Section 7000) of Division 3 of the
Business antl Protessions Gode) or t�at he or sha is exempt iherefmm and the basis for the elleged exemption. Any violation oi Section 7031.5 by any applicant for a pertnit
subjacis the epplicant to e civ�l penelry of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with weges as their sole compensation, WILL DO THE WORK, and ihe slmcNre is not intended or oftered for sale (Sec.
7044, Business end Professions Code: The Contractors License Lew does not apply to en owner ot property who builds or improves ihereon, end who does such work
himself or herselt or lhrough his or her own employees, provitletl ihat such Improvements are not intenCed ar otteretl for sale. It, however, tha bulltling or Improvement is
soltl within one yeer of completion, iha ownervbuiltler will have the burden of proving t�at he or she did not build or impwve tor purpose ot sale.).
❑ I, es owner of Ihe D�operty, em EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to conswct ihe project (Sec. 7044, Business antl Professions
GoOe: The contractors License Law does not apply to an owner of property who builds or improves thereon, antl who coniracis for suc� project with a coniractor(s)
license pursuaN ro tha Conirectors License Laws.).
❑ I am exempt under sec. Business and Professions Cotle tor this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Ves ❑ No Dnver's License No. Expires:
Venfication of Ownership by (rype of dwumeni, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICA710N:
❑ I hareby certity ihat no ezcavation tive (5) or more feat in de0�h into w�ich a person is required to descend, will be made in connection with work authorized by Ihis
permlt, end thet no builtling structure, scaXoltling, telsework, or demolition or dismantling thereof, will be more than ihirry-six (36) feet high. (Chep. 32, Grp 2, An 2, Sec.
341, Tltle B, Celltornia AdminlsVativa Code).
❑ As owner-builder, I will noi employ anyone to do work which would require a permit from I�e Division of Industrial Safery, as noted above, unless such person has a
pertnit to do such work irom the division.
Slgnature: �ate:
Division of InCusMal Safery Pertnit NumGec
CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF EMAV: I certity under penalry of perjury ihat I have read this application end state thet ihe infortnation given is
wrrect. I egree to comply with all state laws and ciry ordinences relating fo building construc�ion, end euthorize representatives of the City of Costa Mesa to enter upon the
above-dexribed prgperty for inspection purposes. l agree not to occupy or allow occupancy of any building authonzed by this pertnit until final inspedion.
CO�E I. INSGECTIONTYPE
1616 Fixed System Final Fire Pravention
1266 Pool Spa Pinal
200 Final Re-Rooi
201 Final BIaWRetaining Wall
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
2C46>6
�. I .1111. .
/
'��
�/
� Z _�ate 7� 7
Date
COOE� INSPECTIONTYPE
206 Finel Mechanicel
20B Final Plumbing
210 Final Electncel
212
220
Final Fire Prevention
Final Planning Approval
222 Final Site
250 Final Building/Occupancy
QAiE It1�Eta