HomeMy WebLinkAbout3320 FLORIDA CIR - Building Permits(714) 754-5273 • Fa�c (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
�obAddress: 3320 FLORIDACI
Suite:
Viciniry: ROOF
Pnmary pcc:
Parcel Number: 13958202
Applicant: JAMES TIMOTHY MCCARL
Address: 126 COMMERCIAL WY �
COSTA MESA, CA
owner. BALLONE, JAMES "
Address 3320 FLORIDA CIR
TypeofConsWcUon: V-N
Zoning:
Phone: 949-548-5569
Zip: 92627
Phone:
COSTA MESA, CA � � Zip: 92626
Contractor: G L R ENTERPRISES INC/DBA CRANK BROTHERS ROOFING
Address: 126 COMMERCIAL WY
- � COSTA MESA, CA
Zip: 92627
Arch :
Address:
Phone: 949-54&5569
License: 828379
; " Eng:
- . Address:
Phone:
Status: ISSUED
Applied: 06/10/2005
Issued: O6/10/2005
ISSUED BY: "�J
Phone:
Zip: License: License:
` ' SCOPE OF PERMIT
REMOVE EIXISTING SHINGLES AND FLAT ROOF MATERIALS AND REPLACE WITH NEW 30 YEAR SHINLGES AND HOTMOP W/GRAVEL ON
FLAT ROOF. REPAIR AND REPIACE SHEATHING AS NEEDED.
Pian Ch�ck:
Permit:
SMIP Res:
SMIP Com:
Other: `
Inspection:
Total:
$0.00 :
$181.25
$0.95
$0.00
$0.00
$0.00
$182.20; . �..; -.. � .�
��. :�� i� � , _
. -� �
SETBACKS� � '
MAIN STRUCTURE, Front 0-�0 �" ' �-Rear 0- 0
ACCESSORY Front- 0- 0� Rear 0- 0
PARKING Existin : 0 Re uired: 0
,
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
�-
� -,,
Right 0- 0
Right 0-0' �
$9,459.00
$9,459.00
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)
EXPIRATION: This permit shall automatically expire and become void if work is not commencetl vrithin 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all appliceble codes, and all
required Inspeetiona and flnal approval must be obtainad. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2a648 (6�00)
WORKERS'COMPENSATON DECLARATON: ♦ . ,
I hereby eflirm un0er penalry of perjury one ot the tollowing tleclaratlons:
❑ I heve end wlll malntain e certiticate ol cansent to selhlnsure tor workers' wmpensation, es provided lor by section 3700 ot the Lebor Code, for Ihe peAormence oi the
�'yrork for which ihis permit is Issuetl.
have aritl
�o�
Insurflnce, as requiretl Dy section 3700 oi the LeDor Code, for Ne pertortnance of the work for which this pertnit k Lxwetl.
nd poliry num�er ere:
Policv,Number. �?7.�k92 -2ooS
ielued et ane hundred dd/ars (5100) or less.)
❑ 1 certity t�at In the Ded ie, c o tha wory.t�r which t�ls permit is issue0, I shall not employ eny person in eny manner so es to become subject to the workars'
compensetlon laws ot � m nd e(e at ii I s ulA beCome su��ect to Ihe workers' compensetion provisions af Sectlon 3700 01 lhe Labor Code, I shell forthwl(h
compywit these� 's
� �//,oI�S
A2p icant SignaNre� � ' Dat .
WAfiNING. AILURE TO S R ORKERS' COMPENSATIIXJ COVEM�E IS UNLAW FUl AND SNALL SUBIECT AN EMPLO T O C RIMINAL PE TIES MID GVIL FlNES UP TO ONE HUNDRED
TiIX15AND OOLLARE (Sl , IN ADDITION TO THE COST OF COMPENSATION, DPMAGES AS PROVIDED FOR IN SECiI 3]O60F THE LABOR CODE, INTEPEST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby effirm Ihat 1 em Iicensed under provislons of C�epter 9(cammencing with Section 7000) of Division 3 oi th_ .1 e! u�ss and Professions Code, and my license Is In lull
ta�ect. LIc. e ,/ /� Wess'+r—
r85�o 3ignah716! �'7`A Y7bI7 � �7� iC O��
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirm thel lhera is e consiruction lentling agency tor Ihe peAormance of iha work for which �his permil Is issued. (Sec. 3097, Civil Cotle),
Lentler's Neme: _ . _. .. Lendels Atltlress:
SignaNre:
OWNER•BUILDER DECLARATONS:
Date:
I hereby eNirtn Ihet under penelry at per�ury t�et I em EXEMPT FROM THE CON7RAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professlons
Cotle: Any ciry or counry which requires e pertnit to consWCl, alter, Improve, demolish, or repair any structure, pnor m its issuance, elsa requires ihe epplicent tor suc� permil
to tlle e signeA statement that he or ahe is Ilcensed pursuent ta the provlslons of the Cantrecrors License Lew (Chapter 9(commencing with Sectlan 7000) of Dlvlslon 3 of the
Business and Proiessions Code) or lhat �e or she Is exempt theretmm enE t�e besls br the alleged ezemptlon. Any violetion af Sedion 7031.5 by eny epplicent tor e permit
subleds ihe eppllcent to e civll penely af not more then flve hundred dollars ($500).):
❑ I, es owner ot Ihe pmpeM� or my employees wlth weges es iheir sole compensetion, WILL DO THE WORK, antl Ihe siructure Is not Intendetl or ottere0 for sele (Sec.
7044, Business end Professlons Code: The Contredors lJcense Lew daes not epply lo en owner of property who builds or Improves thereon, end who tloes such work
himsell or hersell or through his or her own em0�oyees, provided that such improvements ere not intendetl or oNered lor sele. If, howevar, the building or Improvement is
sold within one yeer ol complelion, the owner-builtler wlll have ihe burden of proving ihat he or she did not build or improve for purposa of sale.). '
❑ I, es owner ol the properry, em E%CLUSIVELY CONTiiACTNO WRH LICENSED CONTHACTORS to construct the proJect (Sec. 7044, Business and Protessions
Catle: The coniractore License Lew tloes not epply to en awner ot prapehy who bullds ar Impraves ihereon, enG wha cantracts for such prolect wifh a contrector(a)
liCense pursuant to the Coniredors License Lews.).
❑ I am exempt untler sec. Business end Professions Code for this reason:
Signatura: Date:
Owner ID verified by drtvers Iicense. ❑ Yes ❑ No Onvefs License No. F�pires:
Venficatlon ol Ownership by (type a� dacument, i.e. - praperty t� blll or deed):
DIVISION OF INDUSTHIAL SAFETY PERMR CERTIFICATION:
❑ I hereby certity that no excavetion five (5) or more leet In tlepth Into which e person Is requiretl to descend, will be mede in wnnectlon wlth work euthonzed by thls
pertnit, end ihat no building siructure, scettolding, lalsework, or tlemolition or dismantling thereoi, will be more Ihan thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Tltle 8, Celifomla Adminlstrallve Code).
❑ As owner-builder, I will not employ enyone to do work w�ich would requlre e partnit irom the Division of Intlustrial Safery, es noted above, unless suc� peraon hes e
permit to do such work irom the diWsion.
Signature: Date:
Division of Intlusirial Satery Permit NumDer.
CEH7IFlCATE OF COMPLUWCE AND AUTIiORIZATION OF EMRY: I certify under penelty of perjury that I hava read Ihls epplication and stete that the Infortnation given Is
cortecl I flgree to�Q mply wlth all stete lews and dry ortlinences relating ro building consiructlon, end au�hodte representetives of t�e Clry ot Cosla Mesa to enier upon the
above-describe�'prop�rty for InsDedion puryoses. I egree not to occupy or ellow occupancy of any Duilding euthonzed by this permi� until finel inspection.
COOE �. INSPEOIIONTYPE
7616 Fixed System Final Fire Preventlon
1266 Pool Spa Finel
200 Finel Re-Roof
201 Final8lock/Reteining Well
202 Final Fectary Fire Place
203 Finel Slpn
206 Flnel Demolltlon
PA� IMI��
t�
���
CODE� INSPEGfIONTYPE
206 Final Mechanical
208 Finel Plumbing
210 Final Electrical
212 Final Flre Prevenlion
220 Final Planning Approval
222 Finel Slte
250 Finel BUIIdIngiOccupency
PAffi U�dLi
ApPlicant to fill in all
GTY OF COSTA�MESA- aeRrnr
CONSTRUCTION PERMIT .g —
Address �
Arch/Eng.
Address
witM1in beavy bortler lines anC sign all appropriate tleclaration
TRACT NO. LOT NO. BLDG.NO.
�D "� r1�9.� �
� U TVPE OF COjJSTRUCTION •
Phone � C/ ❑ NEW `ADD ❑ ALTERATION -
��%� ❑ REPAIR ❑ CONVERSION ❑DEMOLISH
License No. ❑ o7hiER•
q�CRI�ION OF WQ[iK
Contractor � Phone TYPE OF PERMIT �,J
AddrMS ❑ GRADING ❑ FOUNDATION SlSTR
LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING�
1 hereby affirm that I am Iicensetl untler provisions ot Charter 9(com- � . f��� �'
mencing with sectiOn ]000) of DlvlsiOn 3 Ot th0 Business antl ❑ OTHER
arotessions Cotle, and my license is in fu❑ torte antl eftect.. pROJECTDESCRIPTION
Litense CIasS - License No. ' .-L � ' "
Date Sl9nature ' ' " SQ. FT.
WORKERS'COMPENSATION DECLARATION OCCUPANCV C NSTRUCTION TVPE _
I hereby affirm that I have a certificate of consent to self-insure or a e0
certificate of Workers' Compensation Insurance, or a certified copy VALVATION � ZONE
thereof (Sectlon 3800, Lab. C.). GRADING CU. VDS. ACRES —
�olicy No. Company
� Certifiee cOpy is hereby turnishetl. REMARKS:
.� Certl�ietl COpy is filetl with the city Builtling Oivision.
EXEMGTION FROM WORKERS' COMPENSATION DECLARATION
(This SeCtion neetl not be completetl if the permit is for one huntlretl
�$1��) OY IC55�.
,certify that in the performance oi e work tor which this permit is
issuetl, I shall nOt employ any pe� in any manne as to become PLUMBING�- ' PLAN CHECK "
subject to the Workers' Compensati Laws of Cali a. -
Date l—� �—R LSi9nature � � BATHTU65 � SHOWERS �
NOTICE: If after making [his tl aration, you shoultl become subject TOILETS URINALS ''
to the Work¢rs' Compensation provi5lons ot the LaCor Cotle, you must
forthwith comply with such provisions or this permit shall be tleemetl LAVATORIES DOUBLE LAVS
revoketl.
CONSTRUGTION LENOING HGENCV KIT. SINKS' ' "-'"'- DISHWASHERS
I hereby affirm that tM1ere is a constructlon lentlin9 aqency for the per- SERVICE SINKS � SUMaS
formance of the work for which this permit is issuetl (Section 3097
Civ. C.).' - " - - "' " - FLOOR SINKS " FLOOR DRAINS �
Lentler's Name
Lentler's Atltlress ORINKING FOUNTAINS" ' ' '
OWNER BUILDER DECLA0.ATION � -
I hereby affirm that 1 am exempt from the ConVacto�'S License Law tor
[he followin9 reason (Section 7031.5 Business antl Professions Cotle:
Any city or county wM1ich requires a permit to construcq alter,
�improve, tlemolisRor repair any�structure, prior to its issuance, also re-
quires the apFlicant for sucb pe�mit to tile a Signetl statement [hat he
is licensed�pursuanbto the provision5 of the ContraCtor's License Law
(Chapter 9(commencing wi[h SeGtion ]000) of Division 3 of the
�Buz" ess antl PrWEssions Cotle) or that he is exempt the�efrom antl the-
ba s r[he allegetl exemption. Any violation of Section ]�31.5 by
`�� litant for a permit subjects-[he applican[ [o a-<ivil penalty
'�''� a ore than f ve M1untlretl tlollarz (y500).
, as owner of the property; � '
will do the work, antl the structure is not inientletl
or offeretl for sale. (Section-7044, Business antl Professions Cotle: The-
Cont�actoYs License Law tloes no[ apply to an owner of a property
wh0 builtl5 or improves lhereon, antl who tloes such work himselt or
throu9h his own employees, provitletl Ihat such improvements are no[
intentled o� offe�etl for sale. If, however, the builtling or improvement
is soltl within onc year of completion, the owner will have tM1e burtlen
ot proving he tlitl not builtl or imp�ove tor the purpo5e of sale).
❑-I, �as owner-. ot the property,-am ezdusively contractinq with.
Ilcensetl contractors to construct Ihe prolect (Section �044, Business
antl Professions Cotle: The ContractoYS License Law tloes not apply to
an owner o( property who builtls ot Im0/oves tM1ereon, antl wM10 con-
t�acts from-such projecls with a contractor(5) lic¢zn¢tl pu�suant to
the Cont�aclo�'s License Law).
❑ I am exempt untler Section - "-B. & P. C. fo� thi5
12d5011 �
I hereby certitythat 1 have reatl tbis applitation antl State tha[ the above
nfo�mation is correct: I ag�ee-to <omply with all <ity and�county
prtlinances an�[ate laws relafing to con5truction, antl M1ereby autnorize
�epresentdtiv�5 bf tM1iS ci[y tp�nter 'uPon tM1e above. mentionetl
INTERCEPTORS CLARIFIERS�� -
SWIMMINGPOOL ' ' PTRAP ' "'
WATER"SERVICE 'ALTERATION-
GASSERVICE - ` OUTLETS "
WATER-HEATERS '"' BTU'OUTPVT -
SEWER'CONNECTIONS -- '
SOLAR'TANK -" COLLECTORS
SO�AR PIPING SVS. �
ISSUE FEE -- ' �
MECHANICAL PLAN CHECK
HEATING SVSTEM 0-100,000 BTU
AND�UCTING 100,000+BTU
REFRIGERATION 0-100,000 BTU
SVSTEM - - ' IOO,OOO+BTU
BOILERS BTV
SVSTEM REPAIR, ALTERATION
EXHAUST SYSTEM MULTIPLE
Signature "�""`� Date" �� � �/
Orivers' Li e e ar 55 � — `
ISSVEFEE ��
CMF 0865-46 Whit¢-Builtling; Canary-Applican[; Pink-Atcoun[ing; GOltlenrotl�Asse55ov
, ��. �. ,r
. ,'; ,.
A.P. �
ZONE
N
SETBACK
1CTVRAL 51p E VARD
❑MECHANICA LEFT
SIDE VA
th_C'i � ..RIGHT
--8370 6/IB/82
.: -, ..��;
ZONING�REGULATIONS
�—�R — cv
PLNG. REF. �,
REAR VARD (TO P/L)
` PKG. SPACE REQ.
STREET WI�TH
ZONI NG APPRO V ED B�
SPECIAL CONDITIONS:
ELECTRICAL - �
PROVIDED
: PARK FEE E
� c15.9D TLi
PLAN CHECK -
R7R,'E— _.
6ENERATOR 0-1 KW_1-30 KW _
TRANSFORMER
" '- ' APPL'IANCE ' 10-50KW_50+KW_
-- " ' MOTORS - 03 HP_1-30 HP _
_ (INC. SOLAR) 30-SO HP_SO + HP-=
FIXTURES ' OUTLETS' SWITCHES
" GASTUBE SIGNS — - -
-POLE LIGHTS ' '� '
POLES VV v METERED SUB -
" PANELS'- 'MAIN ' ' ' SUB
' ' '-SERVICE ' '- ' AMP
- ISSVEFEE "
APPLICATION APPROVED BV
SUMMARV OF FEES . � - �
BUILDING'
PERMIT $��:D� - ,SMIP. � ��$ D.So
PLANCHECK $ /�.�%n PERMIT ' .
� ISSUANGE E
PLUMBING $
- - GRADING $
PLANCHECK E �� : -
ELECTRICAL 8 � � � '�. " §
PLAN CHECK g - _ - MICROFILM $ �
MECHANICAL S TOTAL FEE $
PLAN CHECK E� �� �LE55 AD- '
VANCE PC "$ _'
_ . . I FINAL FEE E��.90
CONSTRUCTION AND PLANNING G POOL & SPA .�
APPROVALS Permit# I� Date Inspector pppROVALS ' Permit# � Date� . Inspector �
i. Temporary Electricai Service or Pole -� � 43. Pool & Equipme�t'Location � "' -
2. Soil ipe-Undrgrn 44. Steel Reinforcement � -
3. Electrical Cpnduit;Utility_Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn �-i �. 46. Electrical.6onding
. tee ein orce �� � 47. Rough Plumbin & Pressure Test '-
6. Electrical UFER Gm -- - • � 48. APPROVALTO COVER-GUNITE
� 7. Footin s- - �
9 49. Electrical Conduit-Undr rn
8. . Foundatioq - - 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe�Undrgrn ' 51. Backwash Lines P-Tra ❑ ndr rn
10. Structural loor System 52.��� AP.PROVALTO DECK
- 11.. Property Sa,wer,Line & House Connection � 53. � Backwash & Rece tor-Final �
12. Sireet SewCr Connection ' ' 54. Neater & Vent-Final
13. Rough Plumbing '
14. Rough E�ectric-Conduit �56. Electrical-Final
15. Rough Electric-Wiring - 57. Solar SYstem-Final
16. Rough Heating & Air Conditioning � Fencing & Access Approval �
17. Ducts, in Structure ' 59. APPROVED FOR PLASTERING - -
78. Ducts, Ventilating ' -� ' � � .
19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL �
20.- Roof Franming - � �
21. Roof Sheathin
22. Frame and Flashin - :7.7. ^L NOTES: �
23. Insulation ' -
24, l.athing & Siding - � � �
�25. Drywall Nailing - � � � � �
26. Plaster Brown Coat
27. Electrical Power Meter-Final � ' ' � � �
28. Final Electric -
29. Final Heating & Air Conditioning - - � -
30. Final Gas Pipe-Test '
31. Final Plumbing � � � _.....,--.-.- ..... ,..._.„,�..__. ._� .. ' '
r
32. Water Service-Final
33..� Gas Service-F.inal
�4. Solar pomestic-Final •
-�35.• `�Landsca e S rinklin S stem- '
36. Sound Attenuation • '
37. Handicap pegulations � �
38. FINALSTRUCTURE&BUILDING 7.'7. �
39. Special Requirements Completed � � �
40. Electric Reiease to Edison ' � � -
41. Gas Release to Southem Califomia Gas"Co. � -'
42. CERTIFICATE OF OCCUPANCY .
��� • 'iVo Date �
� ,,,,� . . :
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� �Of p�qyS HND SFECIFICATIONS 5
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� . - r- �---� - - -.- �_ _� � yT0_BE.A- ERMIi-FOR,-OR'AN' APF 07AL 6 , ANY VIOIAiION� �
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�i'fi'- "�THE-ISSUANCErOF q VERMIT BASED' PON PlANS A D
I I � ' � ' ����^/� ' SPECIFICAT10�5 SHALG ry0i PREVE
- � -1-- -*-- - i ,--? -�- ' - � - +- , ty �THE.B ILDING OFFIGAL- .+_ ..- .�-
I � 1 -t- � � ?� �� � ORREC ION � OF ERRORS �
�� _ � _, __ ! � �/ ` IN SAID PLqNS AND SPECIFICA710N- �OR �F M �PREVENiING ; --'
t r -�- � � I � / � � v - � - I � - � - PUIIDI'NC OPERAiIONS BEING CARRIE ON 7H REUNp � �
e . �-' t- * --r-- -i---J--1 � _INVfO_� ' i ERWHEN�....
� . '- , -+- .: -- � -. -- F- . J. I,ATIOY.OF;THIS�CODE-OR ;OF� NY 0 ER"OROINqNCE � � - '
_- � � i OF THE� CITY: ' .
� � i !
y -_ t . I - +_ � _ 't _ .� _" " " _ t __ t_' __ _ _� � '
���. I � . � � I , � � _ , , , ' _ _ . ' . � _ . a _ �
� . _ ♦ _ . ` _ a— ` —w ` � i J- }� � ..�_ —' � . _ ' � .
� }— ; __ _ _ _ __ _ _
.� - , _ , _ ��'3 ��_FG o'�� o.'A ' !'� �2.�•C�'�__ ' � _ �_ � � _ .
- � , � f- i - � � � � - -.
- � '. __ G�.OS.T��_'i'►7�S�f, � _'_ ',_'�
j -r -' � �- ' t , - �---�-F-r- � --.--� -� --,--r-----�- -+ ---- �
r-+ -t-+-_«-�-- _--__-y_.,_.i _�_,_-+. _ !-- -}--'_� _ �_ �_ �' _ .'_' , _ �' a _ r.��_�_� _4-�-_ -_
� I
�
I �
I � I � ��* :1_ 1 .r_� � I � � � � ` � I � ' i I �—f
I . � -1 _ +- 1 _ ' ♦ ♦ -r ' __ _ _ _ i_ I I � �_. __
_ _ _ " . _."_�' ' I � - I �
�J
PATIO COVER DETAIL - 7z/g/g� - NOT TO BE USED FOR SUNDECK, ETC.
STATE--��.,._^ �t,'�
SIZE SPACING SPAN ^ �
OVERMANCa _3 � Z 1z
,_' . RAFTERS: .�.�x Min. 1!4
STATE LENG SPAN �--� SLOPED FOR DRAIN
MAXIMUM /�
1
Z
�
i
z
i
4� %
�9EAM
�
STA7E SIZE
S�jg�x S�Lags 32°k �
Predrill Ledqer �
Predrill EKi�ti�q '/�-3 Daep
JOIST MANGER
or other app�oved methods
of euDPurt . tie.
ALL LUMB£N OOUCLAS f/R
3/�6 % 2��-T-ST RAP
� CONSTRUCTION GRADE FOR
TABLEN0.1
� 2 OR BETTER FOSi TABLE NO. 2
POST-BEAM
CONNECTION
` POST
■ �
S OW SIZE SHOW SPACING
SHOW LOCATION ON FEVERSE SIDE.
' DROP PATIO FL00
+— SLOPE 70 DRAIN— 2��max.@door
. ' °'��-- ��'3 ' � THICK SLAB a'�'o �
. .�,<
�� PUDDLED� SAND FILL�
.��� Remove G.acs And Weeds Down To Nofural Grode /
:�.. �.:� �.
' CONCRETE MIX 1:3�4 MAXIMUM WATER CONTENT
POST ANCHOR �I�.��..��.� 7� GALLONS PER SACK CEMENT.
For Pipe Post, Embed r12� Provide 26 Ga G.I. Flushing At Wood Floor Const.
Pipe in Footing to within 3" of Bottom, and
Provide detail of Flange or Weld Plate Screwed or Bolted to Frame.
CMF 0012-46 (BU 40) rev. 12/81
CONTINUOUS
LEDGER
TYPICAL JOIST ANCHOR
NOTE � USE REVERSE SIDE FOR PLOT PLAN.
No. 1 No. 2
UBC STD. TABLE UBC STD. TABLE
25-21 J-6 25-21-R•1
For open egg crete alumi• For solid sheathing.
num or plastic roof � Shingles or built up
covering. roofing.
MAXIMUMSPAN SIZE SPACING MAXIMUMSPAN
17' 2" 2•• x 6" @ 12 o.c. 12, 0„
15' 7" 2" x 6" @ 16 o.c. 10' 5"
13' 6" 2" x 6" @ 24 o.c. 8' 6"
10' 11•• 2,• x 4" @ 12 o.c. —
9'.11„ 2,• x 4" @ 16 o.c. —
8' 8" 2" x 4" @ 24 o.c. —
NOTE: FOR PROPOSEDOR FUTURE ROOM,OR WHERE PATIO WALLS
ARE TO BE BUI LT. USE NO. 2 CHART ONLV.
FOR PROPOSED OR FUTURE fl00M OR WHERE PATIO WALLS
ARE TO BE BUILT SUBMIT COMPLETE HOUSE AND ADDtTION
PLANS FOR APPROVAL.
�
CITY OF COSTA MESA REQUEST FOR OCCUPA\CY
TRACT NO „ � � DATE-���--� �
LOT N0. / •
ADDRESS��-� �
�^%�.
The developer of the above entitled tract desires to sell the
above set forth lot prior to the time that the tract has been
completed and its streets accepted by the City of Costa Mesa .
The undersigned, by executing this agreement, acknowledges
that �e-they) �c were) advised
that this tract has not been given final inspection nor has
it been accepted by th2 City of Costa Mesa as having complied
with the conditions of approval which were imposed by the city
at the time the final tract map was approved.
The city assumes no liability for the enforcement of the conditions
necessary for approval other than those conditions protected by
surety bondo
The undersigned agrees to indemnify and hold the city harmless
from any claim resulting in damage or personal injury to the
undersigned by Yeason of the aforementioned uncompleted cond�tion.
�
�
Developer an /or�a�uthorized
representat've
BY
L.ender
aaowess: g320 FLORIDA CI � 0N1T 000
i'S NAME: JIM VAI,T,ONE , `
POONESS: SAME AS AHOVE , .
RRLNIENGMEEfl: BEO.NO.: � '
aooness: uNR:
� PEflMITTEE: ACTION 1ST� ROOF CARF_ ( 714 ) 841-7663
RDONESS: 1 A 3 S Z GOTHARU
HUNTINGTON BEACH CA 92647
LICENSEO CONTMCTOfl OEClAMT10N: I �eaEy aHirm �Aat 1 am Iicense0 unEer pmvivons o� ChaO�er 9(commenCinp wilh 5¢ction
7000) of Oivision 3 af t�e Busineu antl Pmfeuions CoOe, antl my license is in lull tarce an0 alfect. .
cin uc.: 0 4 S 3 5 STATE LIC.:S O Z� O cuss: C— 3 9
Oate:��/� SIOnaNre•
�r—•
WONKEHS'COMPENSATIONOECIAMTION: IhereGyaffir ttu� aceniticateatconsenttasell-insureoracenifiwleolWorkers'
ComDenution Insuranc , r a e di d copy t�ereol (Section 3800, LaG. C
roucrxo.:104��0�6�9 rxr.o�re:0�9/O1/90
cornraxv:5TATE FUND
J Cetlilietl copy is herehy fumished. � CetlilieE coDY is fileA witA ihe ciry Builtlinq Divislon. ,
Date: � �� b �� ` AVVII n� . . ... .
IXFMPfION FIIOM VIONNFAS' COMPENS�TION OECIAMTION: (ilus sectian need rol Ee mmDleteO H Ne pemni ¢ lor ane �uMraE (5700) w less).
I cenity Nat in Ihe pedormante of t�e work lar wllich itlis Defmit 615Sue0, I stWll not empl0y any peROn in any manner m ds to betame
subjecl to t�e Workers' CompenSalion Laws ol Calilomia.
Date: ' SiOnature: �
NOTICE: II, atle� makinp t�is Eeclarztion, you shoultl become su0ject lo the Workers' CamDensation Drovisions of Ihe lahor
CoOe, you must fort�wit� compty wiN suc� Dravisions or t�is permit s�all he Aeemetl revake0.
CONBTROCTION 1FN01N611GEXCY: I here6y ailirm t�at the2 is a construction lendinq apency lor the pertormance of ihe woM1 for
w�ich �Ais Dermit is issue0 (Senion 3097, Civ. C�. �
LENDEN: •
RDOBE38: . �
OWNEN BUILDEH oECIAMTION: I AerebY aflirm Ihat I am exempt fmm the Coniractors' Stata License Law lor the I011awin0 �eason
(Section 7031.5 Business an0 Professional CoOe: My ciry oi county which reQuires a permil to constmct, alter, impmve, demolish. or
rtpair any s[mcNre, Drior to its issuance, also repuires t�e appliwnt for such permit to file a sipne0 5latement ttui he/sha I5 liunsee
pursuam ro tAe Drovisians al the ConVapors' State �icenu Law (Chapter 9(wmme�nq xi[� Seciian 7000) oi DivLsion 3 of the Business
aM Pmtessiau Catle) ar tlui AUs�e is exempt t0eretrom an0 [he Dasis br tM aOepeU exem0�on. My violafion ol Section 7031.5 Dy
any aDV��nt tor a permit sublects I�e apDlicant to a citil Oenalry a1 not more than iNe �unAad tlollars (5500�. '
I, az owner of tAe DroDerty ar my employees with wapes as their sole comDensation, will Eo tha work, an0 iha
❑ stmcNre is not inten0etl or ofleretl for saie (Section 7044, Busmess and Profassional Cade: The Contracrors' State License Law
Eces not appty ro an mmer af a proDerry wAa Euilas ar imD�oves Ihereon, an0 wlio Ooes suc� woM himselflhersetl ar tAmugh
his or Aer own emDloyees, Drovitletl that such imD�a�ements are not intenGeO or ofiereA lo� sale. Ii, �owever IAa Euildinp or
Impmvement is solC vnthin ane year ol completion, t�e awner will �ave t�e GurEen oi D�ng he/s�e tlid not OWO or Impmve
� for IM puryose ol utel. .
I, as owner oi tAe OmpeM. am exclusNeN contracting vrith IkenuE contactars ta wnsirup Iha pml�� (��on 7014, Busineu
❑ ane Proressions CaAe: rhe Comractors' 3tate Licenu Law Eces not apDty to an owner of Droce�y w�o 6mia5 or imDroves tAereon
antl who contracts for such Drolects with a contracror(s) license pursuant to ihe Contractars' SWte Licenu Law�. I am aware
I�ai D��� oi t�eir Worker's ComDensalion insurance SAoultl be prOviE¢0 to me.
� I am exempt untler Sectlon: � � • B. 8 P. C. �
far lhis reason: , '
CITY Of' COSTA MESA — BUILDING PERt4IT
PE:RMIT NO: B 0450J0 �� PLAN CHECK NO: � N
COr15TRUC'TION TYPF_: PERMIT TYPG: STR
JOD DESCRIPTION :.REROOF/30tt FELT fi.7.3 SQ OF SIIAKE
CI,AIM VAI,UE: ' 7,000.00 CALC--VALUE: 4,OU0.00
PERM �IOe B 045030
GOVT: N SUPP: N
SQ FT:
GRUUP OCC:
PURPOSE: NEW
4,000
R—J /
cor+MCN•rs : •
�«��*���*�**�***�*��*��*��,�****��;���,�����*�*�*��*��������*���������*�*�*�*��*�*
Z O N I N G R E Q 0 S R E M E N T S
S E T B A C K S. �
------ ------- MAIN BUILDING ----------- --------- ACCESSORY HUILbING ---------
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 RE(a: PROV:' PARCEL: ].3958143 'LNE: REF NO: '
PLANNING NOTES> �
� .
if it if ik if iE iF 3f 1f if if if iE iE 3flf iE if If iE 3t �t �f 3E �k it 3f iF iF if 3F 3k it ik if ik 1E iE 3E * if ik If 1k iE iE aE iE iE if iE 1E ik if if if iP 3E iF iE i(� iE �E iE if dF �E iE iE iE 3f if iE iE iE if iE iE if
D E V E;I� O P M E N T S E R V I C E S R E Q 0 I R E M E N Tr S
ZONING APPROVEU; BY _ DATE: _.
HUILDING APPROVED DY. ; DATE: ' '�
APPLICATION ISSUED BY: . DATE: G'�� �
iFifiEiFiEif3EiEiElf�t�EiEiFlEif3f3FiF3k�FiE iEifililff3E�EiF3t�� iEiE
!ElEiFlklElFdElE1F3f�fiE�EiflFifjfiEk�f�EiflkiEiEiEiEitikflfEiE1F1ElEiElEfEfF3flkiEiF�EiE1EiE ifdtiffFlElEiElElfiflEiEikiE�EfFlf3fifiEiE3fiFlE9f�Eik�lf�jEiEiE
LEGAI,IZATION:N F E E S U M M A R Y ;TRUCTURAL; SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT G3.00 .SO �
SMIP/NON—RES
PLAN
ISSUE.FEE
HUILDING—DIV—> PERMIT ISSOH PLAN—CHECK TOTAL PAZD DUE
TOTAL5----> 6J.50 0.00 0.00. 63,50 53.50 .00
REVENUE DIVI.SION TOTALS--> COLLECTED: 63.50 OVER/SHORT: .00
BLDG PMT PI,UMBING EI�ECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
63,00 .50
iE iE iE �F iE iE k 1E iE iE iE iE 1E iE iE if k k�E k 1E iE iF 1E ih 1E if 3f iE it it 3E if 3t iE iE if iF iF jE �E ik if d(� if K IP if iE if if�iE if iE iF iE 3E jf �F * iE iE iE if iE if 3E 3E iE 1f if 9E iE iE if iE iE 3E �E
I N ll I V I D U A L F E F. D R E A K D O W N
TYPE
Date: - �^ef� - I SFR
I Co �ereby urtity t�af I am awara oi an0 un0erstan0 t�e aqui2ments al Califamia HealtA antl Salery CoEe Seciions 25505, 25533, anE
25534 anOthailorany fuWre UuilUing occupanlwllUwill nai�circle ona�neeG b comply vnih SaiE s�a�e ca0es antl��erequirements tor a
permit for consWction or modlfication irom the A r Oualiry ManaAement �isiricl. Fesitlential conslmciion applications are exempf irom
these D�ovisions.
Date: NppGCznt:
I nereEy cenity that I have rea0 this ap0ucation anO state ihat tAe a6ove informatbn is corrttt 1 apae ta comDN �A all city arM counry
ortluwnces anE sure la�.s reWtl�p ta DuilOinp constructian an0 here auitro�iza reDR �t�M �a enter upon Ihe aGovamentione0
pmDeM' �'ar inspection pu oses.
Date: � � Sipnature:
�� i
onver's �icense ar Saia� Secunry t:
�
/ 18�1J8 White—BWltlinp: Green—CoOe Enloreament: Canarv—Aanlican�; Plnk—flevenue; Golpanratl—Asseaaor
QTY
4000
D E S C R I P T I O N
REROOF HY VAI�UE RESIDENIAL NQZONE
ENA OF FEES
ONIT COST
7.,00
_� •/ �.—i
��.�.�• .. ..l .
TOTAL COST
4,000.00
f
�' ' ' " -
�J[ '.
�� CONSTRUCTION AND PLANNING .
APPROVALS Permit � %� Date
1. Temporary Electrical Service�or Pole�
2: Soil Pipe-Undrgrndr, '1"� "_ ' � "
- 3.-Electrical Conduit Utility�Undrgrnd. _, - �
.4..,Electrical Conduit-Undr9rnd. •
' S. Steel Reinforcement '
6. Electrical UFER Grnd.
.
.' 7i-Footings � � "-
8. Founda[ion � :`,.
- �
. . 9. Water Pipe-Undrgmd. �' I
10. Structural Floor System � �• �
11. Property Sewer Line & House Connection � -
12. Sewer Cap -
13. Roof Drains _ �,
14. Rough Plumbing
15. Rough Electrical-Conduit
16. Rough ElectriaWiring .
_ 17. Rough Wiring Sign '
18. Rough Electrical-T Bar Ceiling
19 Rou h Heatin & Air Conditioning
L\
Pl , & SPA .
Inspector AppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical8onding
56. Rough Plum6ing & Pressure Test
57. APPROVAL TO COVER�GUNITE
58. Electrical Conduit-Undrgrnd.
• 59. Gas Pipe, O Undrgrnd., Test
60. Backwash Lines, P-Trap, O Undrgrnd.�
61. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing SYstem - Final
. 65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIREDEPT REQUIREMENT
_ 9 . 9 �. - - _� y . _ . .
20:, Rough Factory Fireplace _ - . �- _ - � ' '-'APPROVALSi=.;Permit #
21. DuCts, in Structure � ' ' .' 70 Undergiound Hydro
22: Ducts, Ventilating , - _
23. Gas Pipe�Rough & Test . - -�
24. Roof Framing � ' -
25. Roof Sheathing � '' Z a$ .(
26."T-Bar Ceiling (Structurall & Monocoat � -
27� Frame and Flashing ' "
� 28. Lathing & Siding � ' • - ' � �
29. Insulation ' � ' ' �
30. Drywall Nailing , � _,
. 31. Plas[er Brown Coai "'
`32. Electrical Power Meter�Final ' -
..33.:Final Electric ,
34. Final Heating & Air, Conditioning , ;
35. Final Gas Pipe�Test . �
� -36. .Hood or Canopy ' - . � '. � �
- 37. Final Faaory Fireplace� -
- 38. Final Plumbing � .� � � �
� 39. Water Service-Final, � : ,
�-�40. Gas Service�Final "� . . - �, x -•
' 41. Solar pomesticFinal' - - �
42. �Backflow Preventer
43. BacAflow Irrigation
• '. 71. Product Piping O Gas ❑ Oil
- ' 72. Underground Flush � ' ' "
- � •73: Undergrnd.StorageTank•QGas ❑Oil
" 74. Overhead Hydro-. �
.�, _ . .
• . 75.•DryChemical . �•
� � � 76. Dry Standpipe ' ' .
� '
�. 77:, FIXED SYSTEM `FINAL - �'
78:. FIRE PREV. FIN9l - '
��, ` ' FiEALTH'DEPT'. REQUIREMENT
� '79. FINAL INSPECTION '
� 80..FOOD CERTIFICATE ISSUED .
Notes: . X `� ' �
Y
♦ � 1
t fi � -, .. . . ..
� - .
� � _
T +' -
;, . . x. n .-i
A 'i' .
� � :, '
"44., Landscape Irripation SYstem� �, � ' � - ',
"45; Sound Attenuation � • �� ' " _ �
�46. Handicap Regulations .
i
_ 47.� FINAL STRUCTURE & BUILDING �
48.:FINALPLANNING - �
' 49: ,Electric Release to;Edison ,
�50:"Gas Release to Southem Califomia GasCo
•51. CERTIFICATE OF OCCUPANCY
Date
. � i
�
Date Inspector
�_
m
E'
0
CA
AOD���ant to fi11 in a11 spaces except those within heavy bortler Ilnes ane sign all appropria�e aeclarations.
CITv oP COSTA �^'' �� CON�.I:CTION PERMIT
ProjectAddress - )� FAOI'ICIQ C!'
ApplicanYs Mailing Address 1�� l�nmmarc iA.l WQY
Owner's Name �..l_lm Rn/ I nna �_ Phooe 751-6979
Address 3320 F�orida Cr.�, Costa Mesa 92626 � -
Arch/Eng. _ � License No.
Address �
Contrector's Name r/'ank B/'OS ROOf l/7Q Phone 548-5569
Addresslmailing119Fj �`pmmPrr`inl b/d� COSj'Q mesa 92627
City �icense No. �5993
_.. . ___._ . ., -. _...
LICENSED CONTf2ACTOR DECLARATION
I hereby affirm tM1at I am Iicensetl untler provi5ionz of Charter 9(commencin9
wltM1 sectlon 7000) o! Divislon 3 of the Busines4 antl Protesslons Cotle, antl
my Iicense Is in fu11 for antl ettect. 4�677
License Clas C—� LiGenSe o
Date � � Signature
WORKERS' COMPENSATION D LARATION
I h¢�eby aftirm that I have a c ' Icate of conseM to self-insure or a C¢rtificate
oi Workers' Compensation 1 surance, or a cerPiffetl copy thereof (Section
3800, l.ab. C.) � /-�ORlB %/)S.j
qcc.o�q,�rcy rvo. PWC1184462 comPanv �
IJ Ce�tif�tl��copY �s tilrebYuhrthehcltY tlin �Ivision.
Date � �Y����qPPlicant 'L�'
EXEMPTION FROM WORKERS' C PE SATION DECLARATION
�(This section neetl not be completetl" the permit is tor one huntlretl ($100) or
less). ' . , •
I cer[ity that in the performance of tne work tor Whlch this perm�t is issuetl, I
sha11 not •employ any person In any manner so 9s to'become subject to the
Worke�s' Compensatlon Laws o/ CdlifOrnia.
Daie Signature '
� NOTICE:,If, atte� making this tl¢Uaration, you shoultl become subject to tne
Workers' Compensation provisions of the Labor Coda, you must torthwith
comply with sucn p�ovisions or. thi5 permit Shall be tleemetl revoketl.
�CONSTRUCTION LENDING AGENGY � '. �� -
I hereby affirm that there is a conitruction lentling agency for the performance _
of [he work for which this permit is Issued �(Sectlon 3097 Civ. C.)
Lentler's ' Name � .
� LentleCs Atltlress .
OWNER BUILOER DECLARATION- � '
I hereby aftirm that I am exampt irom the ContractoYz License Law tor the
following reason (Section �031.5 Businesz antl Pro(esslonal Cotle: Any city or'
counTy which'requires a pe�mit to construct, alteY, improve, tlemolish o� �epai�
any st�ucture, p�io� to its i55uance, also �equire5 the applitant to� sucM1 permit
to file a signetl statement that he/she is licensetl pursuant to the provisions ot
�.-;he Contractor'S License�Law�(Chapter 9(commenong with Section 7000) of--
�^:��,Ivislon �3 of Ihe Business antl P�Ofessions Cotl&) or that he/she,is exempt
'�xherehom antl the basis tor the allegetl exemptinn�Any vlolation of Sectlon _
, 7031:5 by any appliGant for a permit'subjects the applicant to� a civll
�nalty of not more than five:huntlretl tlollars ($5P0). . - ; .
LJ I, as owner ot the property orroy employses"with wages�as their'sole
� tompensation, will tlo the work, antl'the structure is not intendetl or offeretl
for sale (Section 7044, Business�antl ProfessioPal Cotle:iThe�Contractor'S
License Law does not apply [o an owner of a property wM10 builtls or improves
thereon, antl who tloes such.work himselt/herselt or through his or her own
emplOyees, provitletl [hat such Improvements are,nOt intentletl o� offeretl fo�
sale. It, however, the builtling or improvement is soltl within one year of com-
pletlon, the owner will have the bu�tl¢n of p�ovin9 he/ihe tlltl not builtl ot Im-
prov0 f0/.[M1e purpoSe of.sale). ' —
� � I, as owner of the property, am exclusively cOntracting with licensed con-
fractors to construct the project (Section �044, BUsmess antl Professions Cotle:
, The Cbntractor's License Law does not apply t0 an owner of property who
builtls or, improves thereon, antl'who conVacts for such projetts with a con- :
tractor(si license pursuant to�tM1e Contractor's License Law). I am aware that �
� proof of thei� Worker's Compensation insuranc8 should be p�ovitletl to me. .
❑ 1 am exempt untler Sectlon . - B. & P. C. for this reason 1
Date Owner
I hereby certify that I have reatl this'applicatlon antl sta Ihat the-above -'
informatlon is corr ct. I'a9ree to comply with all UlY antl ounty ortlinances
antl siate laws rel$ ing [o bulltlin9 constructio nntl her y authorize repre-
sen[atives of thi"s city to en[er upOry[h ve-me onetl property for
inspection purpoi s. /1�/ ���
Signature '�V Date
i -
I I ReinSpectian Fee
IF 0865�46�v. 30/84 White - Bulltling; Canary - APPlicant: Gink - Accountln9; Goltlenrotl - Assessor
$15
FEES
leration System
00,000 BTU ❑ 100,000 BTU _
iSystem Repair
� Fire Dampers
� Registers
luue Fee �
$ 3
A.P. #
S Main Building:
E
T Front
ARear
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
DrYCrs ❑Gas ❑Elec
Fan
F.A.U.
Fixtutes '
Device Bozes �
Outlets ,
Switches
Garbage Disposal
Genereror �0.5 KW C
6378 I/24/85.
Zone
Accessory Building: •
Parking Req./Provided
ELEC7RICAL �
_� Transformer ❑ 15-50.KW �
❑ 50+KW
Meter Llup to 100 amps �
Meter ❑overi00amps '
Su6 Panel
Motors OO-1 HP O 1 X- 8
Inc.Solar �9-15 HP �i6-15+,
nn:,..,.,.,�„e ' . . .. _.
Pole Light � ' -
Range
Si9n
; Standing Sections
5 KW Trash CompactOr '
� �
Reinspection Fee • $15 Issue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved By — _ , T
Ioo�O TL
2
O
N
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G
R
E
Q
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S
� l SUMMIARV OP FEES ;s/\
BUILDING PERMIT '$ I lC �� � SMIP � � $ ' �J
PLAN CHECK $ � ' PERMIT � � , .
' PLUMBING $ � ISSUANCE ,$
PL'AN CHECK 25% $ ' � ENERGY P.C. ;$
ECECTRICAL $ GRADING� �$ �
PLAN CHECK 50% $ ' MICROFILM ,$ � 1-•
MECHANICAL , $ TOTALFEE $ ' (�I.sn
PLAN CHECK 25% $ � . . �
CONSTRUCTION AND PLANNING PO� _& SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location
2. SoiiPipe-Undrgrnd. _ 53. Steel Reinforcement
lectrical Conduit Utility-Undrgrnd. , 54. Forms � .
. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
,� Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE
. Footinqs � 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. " � 60. Backwssh Lines, P-Trap, O Undrgrnd.
10. Structural Floor SYstem � 61. APPROVAL TO DECK ' '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer (:ap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final _
14. Rough Plumbing 65. Electrical-Final
15. Rough Ele htrical-Conduit � 66. Solar SYstem-Final
16. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electriral-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .
19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Sfructure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.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. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Cbnditioning � �
35. Final Gas Pipe-Test
36. Hood or Canopy ' '
37. Final Factory Fireplace �, �
38. Final Plumbing , •
39. Water Service-Final '
40. Gas Service-Final . �
47. Solar pomestic-Final - � � � �
42. Backflow Preventer . . .
43. Backflow Irrigation ,
44. Landscape Irrigation System ' � -
45. Sound Attenuation �
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING a Sd5 �,� �
48. Special Requirements Completed �
49. Electrie Release to Edison � - ' '
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY '
No. Date •
GFNERAL CONTRACTOR Owner-Builder
lo. - LOT 7 TRACT
Ih>PECTIONS Si nofu
SOIL
GAS J
WATER
ROUGH PLUMBING
PROP. SWR. LINE OUSE COl�y,e�
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH MEATING AND AIR CpN�IT10NING
TEMPORARV SERVICE OR POLE
UNOERGROUND � POW�R �
ROUGH WIRING `. '
TRENCHES FORMS STEEL REINF. . � 'J -
FLOOR SVSTEM �
BONO 6EAM ❑ STEEL REINFORCE
SHEATHING /
FRAME AND FLASHING
LATHING - IN Q] OUT
P� 'ER, BROWN COAT
5� iURAL, FINAL
HEATING, VENT., REFRIG.
PLUMBING, FINAL ANO GAS
ELECTRIC, FINAL
9111LOING. FINAL
FIN
DESCRIPTION of WORK g
FIRE ZONE VALUE
SUBCONTRACTOR
g-z � ; 0088
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX1200 COSTAMESA,CALIFORNIA92626
For Applicant to Fill in Completely
BUILDING � � a, - �p�'`p `-' /' A� O,
onDRESS iv i �•
OwNER Hermes 1i8V. L'O.
ADPRESS 1104 S. 17th 9treat
TEL.
dT�' Ssnta Ana NO.
CONnAUCTION
LENDER United States Nationf
BRANCH 1$0 Broadway Avenua
ADPRESS San Die�o, CaliPornia
ARCHITECT _ . TEI.
CONTRACTOR qwner
ADORESS
TEL.
CITY NO.
STATE �5�5L^ CITV
LIC. NO. V�� LIC. NO.
r
OP I-�T IOO X� ' NOW ON LOT O
USE OF
EX15TING BLDG.
SI2E OF NO. OF
NEWBLDG.�LIOO 9tl• Ft.ROOMS STORIES
EXTERIOR WALL ROOF C�IDF10 O
COVERING 4t11CC0 COVERING WOO�
USE OF BUILDING AND WORK TO BE PEFFORME�
Residence w/attached FaraQe
APR 24-69Paj�OO1282�� *�<�' 152.25
cnsa
APPLICATION FOR BUILDING PERMIT
FECE� DA�FfELYE� pqT�SS�
d� r
J
BUILDING
AODRESS
3
OWNER
FIRE �_
ZONE �..
APPROVED
NE NO.'O�,F!�
/ P�"^� j
VAROS APPROVED
�
�
DISTANCE BET.
MAIN BLDGS.
VAR. ,$
c.u.P. # V—�
APPROVED I/ /i
�
DATE
VL
USE OF NEW
BUILDING
VARDSAPPROVED
ACCESSORV BUILDIN
BET. MAIN &
ACCESS. BLD('>S.
OATE
APPROVEO S—Zcr-6
nn-rc ����� '6
I hefeby acknowledge that � nave read mis aPp�ication ana state HOLD FOR SPECf,�L RE UIR£MENTS
ihat the above intormation is correct antl agree to comply with
all la`�'s regulating building construction, end I shall not employ
any person in violation of Me workman's compensstion laws ot
Me 5tate ot Califomia. � n �- m
Q'� S . FT. O� �
I hereby certify ffiat I am properly licensetl as a contractor under �
che 5iate of Calitornia Business antl Professions Cotle, Divisicn 3, THE AMOUNTSHOWN VNDEFi VALUATION IS FOR
Chapter 9, and that such licenses are in tull force and atfect, or I THE PURPOSE OF ESTqBLISHING A PERMIT FEE ONLV: m
am eKempt trom the provisions of the State of California Business �
VALUATION
and Arofessions Cod sio 3 apter 9. PEFMIT FEE S 0 �
Perm�ttee af $ P�AN CHECK §�(/ •�� E
� �9, �'D � L o
Auffiorized Agent TOTAL FEE ��. �� LL