HomeMy WebLinkAbout2265 FOUNTAIN WAY - Building Permits�
� / �
� . CITY OF COSTA MESA
O MFS BI/ILDING DIVISION
i`� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • w�wv.ci.costa-mesa.ca.us
:
°. ` FOR INSPECTIONS CALL: (714) 754•5626
�''°�'�� PERMIT NUMBER: 610-00150
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 93074037 DATE ISSUED: 0 512 812 01 0
ISSUED BY: KJB
JOB ADDRESS
vicinity:
Squares: 200C
2265 E FOUNTAIN WY CM Suite/Unit:
Valuation: $5,000.00
SCOPE OF WORK: TEAR OFF EXISTING ROOF. RE-ROOF WITH BUILT UP ROOFING. INSTALL ALL NEW FLASHING. APPROX 2000
SQ FT.
OWNER: SCHROEDER WILSON ASSOCIATES Address: %GRIMMWAY MANAGEMENT CO Unit: SANTA
ANA, CA
PHONE: City/State/Zip: 1526 BROOKHOLLOW DR # 82
APPLICANT: GOODGAME, JACK
PHONE: 714-840•1626
CONTRACTOR: SIERRA ROOFING CO
Address: 5132 AUDREYUnit:
Ciry/Stale/Zip: HUNINGTON BEACH, CA 92649
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
Bldg Std Admin Fund
so.00
$111.25
$0.00
$1.00
Address: 5132 AUDREY Unit:
CirylSfate2ip: HUNINGTON BEACH, CA
License No.
License No.
PHONE:
License No. 511172
714-840-1626
CELL:
PHONE:
PHONE:
HOURS FOR CONSTRUCTION ACTIVITY; EFFEGTIVE 3I18I2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am lhru 6:00 pm. Prohibitied all hours - Sunday5 and lhe following Fetleral
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksoivino Dav and Christmas Dav
NO710E: The work authorized by this permit shall comply vnth all applicable handicap access requirements under California slatutes 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 this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
LOpEl, INSPECPONTYPE D�TE NTITIAL 400E1 INSPECIIONTYPE D�TE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa final �/�. 208 Final Plumbing
200 FinalRe-Roof �"i5"%a �kr7_t�w�., 270 FinalEiectrical
201 Final Block/Retaining Wall 272 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Pinal Demolition 250 Final Builaing/Occupancy
� 1 �
WORKERS' COMPENSATION DECLARATION:
I hereby affirm untler penalty o( perjury one of the following declarations:
❑ I have and will maintain a certificate o( consent to selFlnsure (or workers'
compensation, as provided tor by section 3700 0( the Labor Code, for the
e ormance of the work for which lhis pertnit is issuetl.
• I have and will maintain vAorkers' compensation insurance, as required by
sect n 3700 0l the Labor Code. for the peAormance of the waB la which this
pertnit is issuetl. My vrorkers' compensation Insurance wrrier and policy
number are:'�/' /-�
�er.—_� (//�j�J r'✓ �i%%�
I���SSCn.anneed�loemmde( emepemNurelueeolmenu�edtloaan(5�00)aless)
�.o��Y.P--�mee��oo�36�/3-��0o S
❑ I certify that in the peAormance o( the work lor which this permit is
issuetl, I shall not employ any person in any manner so as to 6ecome subject
to ihe workers' compensation laws o! Cali(omia, antl agree that if 1 should
become subject to the worker compensation provisions of Section 3700 0(
Labor Co . I sh II oAh � comply vrith these provisions.
�.-c� .�2�/0
_ 'c&p �e.r Oaie
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 DOLL4RS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
AiTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business antl Professions Cotle, antl
my license is in lull force and eKect.
��.�� -� Z ��� c. 3 y
s Z�-,o
Caima af�'y518���✓ �e--Y �
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a construcibn lending agency fw the
peAortnance of Ihe wurk fa which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
OWNER•BUILDER DECLARATIONS:
I hereby aHirm Ihat under penalty of perjury lhal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW 1or the following reason (Sec. 7037.5.
eusinass antl Professions Cotle: Any city or counry which requires a permit to
conslruct. alter, improve, tlemoiisn, or repair any strucWre. prior to its
issuance, also requires the aOPlicant for such permit to file a signe0 slatement
that he or sha is licensed pur5uanl t0 Ihe provisions o( Ihe Contraclors
License Law (Chapter 9(commencing vrilh Section 7000) of Divi5i0n 3 of the
Bu5ine55 and Pr0fe55ions Code) or that he or she is exempt therelrom and
the basis (or the alleged ezemption. Any violation of Section 7031.5 by any
applicant for a pertnil subjects the appliwN to a civil penalty of not more man
fve huntlretl tlollars ($500).):
❑ I, as owner of the property, or my employees wit� wages as Iheir sole
compensation, WILL DO THE WORK, antl Ihe struUure is not intendetl or
oflered for sale (Sec. 7044. Business and Professions Cotle: The Contrectors
License Law does not appty ro an ovmer of pmperty who builds or improves
thereon, an0 who dces such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or oKered !or
sale. If, however, the building or improvement is sold withln one year of
completion, lhe ovmer-builder will have Ihe burden of proving that he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRAC70RS ro construct the projecl (Sec. 7044. Business and
Professions Code: The contractors License Law dces noi apply to an owner ol
propetly vfio builds or improves thereon, and wfio conlracls (a such project with
a contracta(s) license pursuant to [he Contractors License Laws.).
❑ I am exempl under sec.
Business and Professions Code for this reason:
SignaWre Dare
905]-a6(3i07)
�
Owner ID verifietl by driver's license. � Yes ❑ Np �
Driver's License No. Expires:
Venfication of Ownership by (rype of tlocument, i.e. - property Wx bill or tleed):
DIVISION OF INDUS7RIAL SAFEN PERMIT CERTIFICATION:
❑ I hereDy certify that no excavation frve (5) w more feet in tlepth into which a
person is required to descend. will be made in Gonnection wil� work aulhorized
by this pertnit, and that no building sWCNre, sca((dtling, false�wrk, or tlemolition
or tlismantling thereof, will be more than thirty-sbc (36) feet high. (Chap. 32, Grp
2, M 2, Sec. 341, Title 8, Cali/omia AtlminiStraWe Code).
❑ As owner-builder, I will not employ anyone to do vrork which would
require a permit from the Division of Indusirial Safety, as noted above, unless
such person has a permit to do such work from the division.
Applicanl'S Signalure
Division o( Industrial Safety Pertnil Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICA710N:
1. Will the applicant or present or future builtling occupant neetl lo file and
certify a Business Plan (or emergency response lo release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Calilomia Health antl Salery Code requires, with some
eaceptions, Ihat a Business Plan be fletl vrith the Costa Mesa Fire
Departmenl by every business which has at any one time tluring a reported
year a quantity of hazardous 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 stantlar0 temperature and pressure).
2. Does or will the applicaN or present or fuWre builtling occupant neetl to file
a regislralion form for aately hazardous matenals? ❑ Yes ❑ No
(Section 25533 0! the Califomia Health and Safety Cotle, with some
eaceptions, requires registration with the Costa Mesa Fire Department Dy
each business vfiich at any one lime has on hand a quantity of acutely
hazardous materials equal to or greater than a weight of 500 pountls, or a
volume of 55 gallons, or 200 cubic (eet ot compressed gas at standard
tempereNre and pressure).
3. Does or will lhe applicant or present or luWre building occupant neetl to
prepare an RMPP (Risk Management antl Prevention Program (or acutely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 of the California Health and Safery Code provitles that the
Cos�a Mesa Fire Departmen� may require �he prepara[ion, certi(ca�ion and
filing with the Fire Department of an RMPP by businesses which are requiretl
to register acutely hazardous materials with lhe Fire Department.
4. It an RMPP is presently required, has Seclion 25534 0( lhe Calitomia
Health antl Satety Code been fully complied vnth? ❑ Yes ❑ No
5. Does or vnn the applicant or present or fuNre builtling occupaN require !or
the work which is the subject of this application a pertnit for such conSWction
or modifwtion from lhe South Coast Air Quality Mana9ement District or from
any other air polWtion control tlistrict or agency? ❑ Ye5 ❑ No
(Section 658502 of Ihe Califomia Govemment Code requires Ihat the requestetl
informalion be fumished on applications for non-resitlential builtling permits).
6. Will any part of the facility ro be constructetl under this pe�mit be within
1000 feet from the outer bountlaries of a school7 ❑ Yes ❑ No
Qf yes", the faciliry musl meet tha requirement of Sections 25534 and a2303
of Ihe Califomia Heallh and Safety Code).
7. If a permit trom the South Coast Air �ualiry Management District or olher
air pollution control district or agency is requiretl for the work vfiich is the
subject ol this application, have all ot Ihe disclosures prescribetl by Calitornia
Health and Safety Code Section 42303 been maCe? ❑ Yes ❑ No
8. pf yes", attach certificate of compliance from the appmpnate air polWtion
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that untler penalry ol perjury 1he
information given above is correcL I agree to comply wiih all state laws and
city ordinances regarding Hazardous Materials and Emissions.
CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have reatl this application and state that
the information given is correcL I agree to wmply vnth all state laws and city
ordinances relating to building consWction, and authorize representatives ol
the City of Costa Mesa to enter upon the above�escribed property for
inspeclion purposes. I agree not to otcupy or allow occupancy o( any building
authorized by this permit until final inspection.
Sign reo(L a Owne Da�e
a�.�.�o s • zd- id
�_llCle�` ullioneeE�App�ie nt_" ��Dete"^^'.
I'
1'ruject
c Certificate ot' Compiiance: Resi
Alterati�ins
��
�3 � n
,CI+-132-ALT
(Pu�e I oS5)
Clim:ite Zune i! /� � tt of S�ories
� C)o8aue SuCl�uce DetBiIS ror the lurred um�tiuned of Mass N'�Ils see Purriu� Strips Cansvuction 7'able below. �
Tag/ I Assembly Name
]D� orTvoe�
Nolc� For JurmAassem6lies,
Material
and Size'
Itl
U-
see
C'
Framed Continuous JA4 Proposed
]A47'able Cavity Insulation Assembly Assembly
Numbei' R-value� R-Value' Cell Velueb U-factory
use �he Mass ond
1. For' Tng/!D indicaie Ihe iden�ificalion nome �hat nmtches !he buildino plans.
3. Dtdimte �he Assemblt� Name or rype: Rooj/Ceiliig, Walls, Floors, Slaba�, Crawl Spare, Doors ond etc...lndica�e !he Frome rype and Size: For
Wood, Meial, Me�a/ Buildinga�, Mass, emer 2z9, 1x6, or etc... see JA4 for oiher passible,fi�ame rype assemb7ies.
3. $�uer 1he thickitess fa' mas3� iiv inchu a� Spacrno Genveen franring members enter,- JG "or 24 "OC; or 01her jar oll o�her assembl�+ dee�criptiwr
such as Cnncrete Sand�oich Panel, Sp4ndrel Panel, Logs, Strav,� Liale Panel and e�c....
4. 73ased on �he Climate Zane; enter tlre Siundard U facia� finm Table I51-Il, C or D Inr euch d ffereni assemhl�� Name ar type .
5. Enter die TaGle �wmber (ha� closelt� �'e.sembles d�e proposed assem6li�.
C. Ln�er !he R-ua(ue 1hn! is heing installed in the wull cai�in� or Le�weerr the (nming; mhenvise, erver "0 ".
7. Lrver the Cnnfinuaus lnsulniiou R-i�alue (or Ihc proposed ussemblp; olheiwise, enter "0".
b'. L•nier tlie rnw and cnlunm aJthe U-jacior valuc Lased on Colunm F 7'able Number aud enier �he As.sembl�� U-(ac�w� in Ca(umn J
). The Propnsed �1sa�embli� U fncior, Colmnn J, nmsi be eyunl lo or less ihan d+e S�rmdnrr/ U fucim� in Coluum E�o cnn�p/n �
Fuzrinp Strips Construction TaUlc for Mass Walls Onl��
n R C D C P G H 1 J IC L M
i'rnposcd 1'ruperties nf Mnsonn' :md Coneretc Added ln[crim� or Lxterim� Ins�d:iliun
Vd:dls rrum Itcicrence in Turring Sp:icc frum Iteierence
Jninf A ��cudix 7�alilr �1.3.5. 4.3.G. 43.7 Auint A� rendix 7'al�ic 4.313
U G �=t 1 ' U
u. �y G � 4 L. � v.
AxsCIDbl)� �_ U j G c` � F= F-� c y; o !, U v"y, jln8�
Mus> Name m� JA4 Table y= ", o= E rt o 't 2 0 0 " � Assembl%
Thickness� T s' Numhcr � �` - y - E ' ' � ` t ' "'�
� = m-' � � s �. r r U-facto� Cominem
�
� �
P.egisu'ulion Nlunber: Regis�raiio�v Uu�e/Tirne: HERS Prnvider:
20pb' Residentiu! Complicntcn Farnxr AzgnrsJ 7pp9
iptive Certific�tc ot' Comp,._nce: Residential CF-IR-ALT
ntial A[terntinns ' (Pa�e'3 uf 5)
N��mc: Climntc Zonc q � k of Stories
ROOP'ING PROPUCTS (COOL ROOFS) §151(p1.
When !he nren o%ex(crinr rnnfsrqjace (n bc repinced exceeds �nnre Ihan 5096 nf fLe rxisting ronjnren, or umre tl�an 1,ODO.ff, �vhichever i.a
less, Uie ne�r r�mfi�tg nren uu�sf ineel fhc rnofing producl "Cnn! Ronf'requirements oj,$152(bJ1Hi, 152(bflFlii, or 152(b)IHiii.
Cherk applicuble n(�ernntive or rseeption GeloN� if tde rooJa6era�ia� rs ecemp� fi�om �he roofing product "Coal Xoof' requirements. Note: /f any
nne oJUie afrerna�ives or exceprion beloN� is checked, �he Aged Solar ReJlecmnce m�d Thcrmal Emittance requiremems for roofing products in
§� 8(i) m'c nol appficable. Do noifi!! lab(e below.
Cool Roo(s Not Rcquircd in Climate Zones I-12, 14, and 1( wilh a LoH� Sloped. Less or 2:12 pi[ch.
❑Cool Roofs Not Required in Climate Zones I thmugh ) and I G with a Steep-Sloped Itoofs (pitCh grea[er Ihan 2:12) and product unit weignt less
than 516/ft�.
Alternntivec tn §]S2{b)1Hi and §152(b)Hii, S[eep-slopc roof (pitch> 1:72)
❑ Insulation with a Ihermal resistance of at least 0.85 hritZ�°PBtu or at lcast u 3/4 inch airvspacc is addcd to the roof deck '
over an attic; or
❑ Pxisting ducts in the attic are insulated and sealed according to § I51(�10; or . .
❑ In climate zones 10, 12 and 13, wi�h I fi''.of free ventilation area of attic ventilation for every I50 ft� of attic floor area, and
where al least 30 percent of the free ventilation area is within 2 feet venical distance ofthe roof ridge; or
❑ Building has at least R-30 ceiling insulation; or
❑ Building has radiant bartier in the anic meeting the requiremenis of §151(�2; or
❑ Building has no ducts in thc attic; or �
❑ In climate zones 10, 1 l, 13 and 14, R-3 or �earer roof deck insulation above vented attic.
�zception to §I52(b)1Hiii, Low-slope roof (pitclr 52:12)
❑ Building has no ducts in the attic.
Other Exceptions
.❑ Roofmg area covered by huilding integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria.
. O Roof constructions [hat have thermal mass over the roof inembrane with at least 25 IWft is exem t from the beluw Cool Roof criteria.
- Notc If no CRRC-1 label is available, this compliance method cannot 6e used, use the Performance Approach ro show compliance, otherwise,
Check the a licable box below if Exem t from the Roofin Pmducts "Cool RooP' Re uirement:
� Roof Slope Product W eight Product Aged Solar Thermal
CRRC Produci ID Number� � 2:12 > 2:12 < 516/ftz >_ 516/fr� T e2 Reflec[ance� ° Emit[ance SAIS
❑ ❑ ❑ ❑ p4
❑ ❑ ❑ ❑ p"
❑ ❑ ❑ ❑ pa
❑ ❑ ❑ ❑ p"
❑ ❑ ❑ ❑ p^
l. Tl�e CRRL' Producr !U Number con Le o6lnined fi�am die Coal RoofRuling Cwmcil's RaledYroducl Uir'eclmy a! ww�v.enolrnoCs.m'r/producn�/seard nGn
2. lndicale lhe qNc• ofproducl is heing useA_(nr Ihe roof mp, i.c. aingle-ply roof asphafl ronf, rnelol roof, elc.
. I%�he Aged Re/lec�ance ia' rm� availnLle in.die Coo( Roa(Rming Cow�cill� RaMd Producr Direcmrp J�en usr. �he /ni�ial Hef/ec�ance valuc fi�om (he snme
direcror�� aid �rse Ihe eq�m�im� (0.2+0.7(/1��������— 0.1J ro obiain n calcula�ed aged vafue. Wher'c p is �he Ini�iol Sofar ReJlecmn<c. .
4. G�eck Go.�� i(rhe Aged 2eQec�ance is n calculoied value using �he equatimr abave.
S. Cnlndaie Ihe SRl ualue Lr using tlie SIU- Worksheei oi lvrn�//wmu• enerp� cu env/litle24/und enier Ihc rextd�ing vnluc irt tlie SR/ Column aGone and anach ocopp nj
die SR!- IVarlcshee� in tlie CF-1R.
To apply Liquid Rield Applied Contings, the coating must be applied across the entire roof surface and meet the dry mil thickness or coverage
recOmmended by the coatings manufacturer and meet minimum performancc requirements listed in § I 18(i)4. Select the applicable coating:
❑ Aluminum-Pigmented Asphalt Roof Coaling ❑ Cement-Based Roof Coating ❑ Other
Repisu�ufion Namber: Registration Date/Time: HE2S Provider:
2008 Residential Compliunce Farmr � Augeesl ?009
cace ui' Cumulianee: Jtesidential
Alteratinn,s
CF-7 R-ALT
(Yu_�e � u1� 51
Yrujecl Nnnie: . . I Climatc "Lune �' I E' 01' 5tories
FIERS V�3:II�J CATI Ol� SUMA7AR�` The enjm-cernem ngener shoidd ynr speciul mie�vlar iv ihc HEIiS Aleusm�ea� specif�et! +r� 1Gia
chec/di.rr Gelrnr. ff comple�ed andsi�nedCF-4Ii Fmn� (or crl! Uir nren.��urea e/�eci/ied shtJl Ge suLmilred ro ii�c bi�ilding inspec�or Le/mr /in�d
v�Ct Setlline b 7�eSt1Rd HEItSverificniian is raquiredfur�hi.� maasnu�c.
❑ i'ES ❑ NO YCS: Li Climaie 2ones 2 and 9-I G, if more thau 411 linear feei of'new ur replaceniem ducts aire insiidled iu uncondi�ioned .
space, tl�e duc�s are to 6e sealed per {�152(b)IDii und the newly insmlled ducts ure to be insulated pei ¢151(i110,
❑ L'XCL�'1'TJON: Lxisting duct syslems th:n ar� extendnd, wltich xre cuustrucled, insulated ur scule[I �vith us6estos.
❑ li5 ❑ NO 1'LS. ]n Climate "Lones 2 �nd J-]6, if thc existiuE space-conditioning svstem (HVAC eGuipment and ductinai is repluced; thc
� ducts are io 6c sealed per �152(b)]Di. .-
❑ YES ❑ NO ]'LS: ]n Climate "Lones ° and 9-1 G, if [he existing HVAC equipment is repluced (including the replacemam o1� [hc air handler:
outdoor condensing unii of a splii sys�em; cooling or henting coil, or the furnace lieai er,changerJ [he ducts are to be
sealed pei §152(b)lE.
❑ LXC�PT10��. Duct s,ystems thst are ducumented tu hnve been previoush� senled confirmed thruugh H�P.S
� �' ' ' "' - ���- - � •'.veriiication iu accm�danee �vitli proce�ures in the Rei�erence Residential Appendia l�.S3.
.� . .__... . .. .— - .. . .
�� � ❑�L�XC�PTIO�: Duct systems with less than 4U linear feet in uncoudiiione� space. - ��'�"-�' �� �"
❑ EXC�PT10�: Existing duci svs[ems cons[ructed, insulated or sealed with asUesms.
Ref'rigerant Cherge - Split S}�stem HERS veriJicatia� rs reguirec�Ior �his measme.
❑ YL�S ❑ N 0 YCS: In Climate Zones 2 and F-1 i, wl�en the existing HVAC equipment is replaced Qncluding the replacemeni of the air
hzndler, outdoor condensing uni� of a spli� system A/C or heat pump, cooling or heating coil; or th� iumace heat
Centr�al Fan Inte;rated (CFI) Ventilafion S}°stem and Fan T�'att DraH�
The ventilation re�uirements of $I SD(ol do not aonlv tn existine residential homes.
Ducted Split Systems - Air Conditioners and Heat Pumps. Airilow HER:S,�erilica�ion is regui,-ec!/or rnis measurc.
❑ Y�S ❑ NO 1'�S: ln Climate Zones 10 t6rough 15, when the existing space-conditioning system (AVAC equipment and ductine) is
replaced. the airflora• and ian watt draw shal l be verifietl ner § 152(b)1 G to meet the remurements oT § I� I(f17S.
• I cerHfr th
Name.
Company'.
Hddress:
-L�'-( v
le � CEN or � CEPE
an il J
Responsible. Ruildine Pesigner's Ileciaration Statement � .
e J am eligible under Division � af the Culifornizi Business aud Professions Cude to uccept responsbility lor tl�e building design idenliUed on
thl� CcrliLcate of Coinpliancc.
�] certii)' lhai the energy fealw�eti and perlm�munee speeificaiion:c 1or the building dcsigu Identified on this Ceniilcaue of Cumplianec conl'onn
ln lhe mquiremems of 7�itic :�4,1'm��s ] und G of the California Cnde of ltegulations.
• Thc bullding desiEn lcn�ives idcntified on this Cenii��caw of Compli�incc are wnslsieni with lhu inlormatlun provided to duuun�ieni thls
buildino� d�.:sign on Ihe olher n��plicnblc compliunce lunn.;, wurl:shccis: �Ulcula�ions, pla�v; aud s��ecificauon;: subiniticd io thu ci�9vrccmeni
uecncv 1'or npnrov�il wilh this huildmp nermil appliculion.
IJaine
Hddi ess:
:.li�;'Sia�elZlp:
Signawrc:
Lic�nse:
TO!' [(.1'.PLPI(U�LC qi' (�tIL',ti110RS ]'C�lll'fIllt� ihc Encror Sumdtu�d.r, co»u�cr rl�r L•ncrgr HoUinc ru: J-80n-;;2-,31�0.
1(egisu'aban h'uuibcr" I(eg�.rvmmn Uaie/Timc: HER;' Froi�ider:
2UOi: Ieesiciemiul Cump(imicc Forms /eigtr.si 2p0J
ROBflES50FBUILqNG: ZZ6S E FOUNTAIN WY uxr:
owxeasras_Eiviwavx: SCHROEDER WILSON �
• , uooncss: ASSOCIATES
YSCHROEDER CO
2,��1.���o��AST HWY STE 300 CORONA DEL MAR,CA 9262
1NCXRECT OX ENtlNFEN:
ncx on e++a.�s,wo�ss:
uc. ra.:
uxr:
COMNACTq1'SNAME SUNSET ROOTER 6 PLUMBIG ( 800 ) 994-9906
CWfN1CTORSM110N0 5991 E. AV LA VIDA
A0°"�' ANA CA �GNO'` 656546
9z8�7 UNT:
UCENSED COHfN�CTON4 DECL�PATION: 1 heroby efl'vm uMx paeWy d psrjury Ihet I em lieenaetl uMm prwimana d Gheqx 9
(mmmeneiq xilh Section 1000) d Drvuion J d �ha Buaimu yb PMasmpu Cods. vN mY Ibenae b in lull laro uM eMetl.
C IJC. NO.: LI0. CLA89: LJC. N0:
lZ���SS C-39 656596 EXP:
/Dms: Gomronu:
� NER BUILDEP DECIAFRTION: I henby etfi'm uMer peeWy d perjury Ihal I em naamq Iran tM Contropae Limnaa Lew la tM
dbwiq reewn (`�� ]W 1.5 Bueiwse eM PMeaeione Co�y: Any cry a countY �� �9ui�ea e pemin �o mnatrucf. ellx. improva.
dama'nn, or rev� eny a��ucwre, o� to ila eweMe, abo reaairoe �he evpi�sni 1« wch v�n to fib a ebrieE et�emen� ihei ha «sM
ia licensed W�+�t lo IM pwivms d iM Canlredws Lioenae lew �Cheqm 9(�merviiq wnh Saeion "lOW) a�'eion � d the
6usriea eed Prdexiona Code� or ihel he a ehe n exemq il�yehom enE tM beaia tor Na elbpeE memqion. My videtion af Sedion
�mt s by a�y eod�,� �« e permF e�bjam ina epWicem io a rivi� pene�ry d nw m«e �nen iHe huMred ddbn I`�ll.
� I. es owmr oliM1a propanY w mY �VMaee w�h wepea a� i�yi ede mmpaneetion. will Eo IM woelc. eM �M sVuduro e ml in�aMed
a ofiered for seb (Saeiion l0sa. Bum�se arM Proleaaion> ��: The CoMretlon Lironx Lew doea ew eppytoen oxnxd propery
who Wids ar inpmvea iMrean. erd wM doea sudi xork IimaeM or hermetl a thraqh h's or her oxn empbyaea. pmviEed tlat wcn
imprwamenia ere m� in�eMed or oflered for ede. H, Mw�, tM WiMirq a'vnprovamam ia eok wnhin me yeer d mmplatun, the
owrierbuiMar will heva iM buNen d prorirp M or eM Qq � builtl or improve lor tM WT�e d eele).
� I, ee oxner d IM peopaily. em eRdufrvely oonlreqmp wilh IioenSeE mnVeelon �o eonaUup IM1e pqed (Sequn )Old, Busi�s enE
r�w�o„s coaa: rna ca�vmore u��.. �.. do� �a ww io � owKK d wwa�r ..no w�u. « �mwo+« ma�� �e wno
COIIIf9Cl9 /IX BW31 pfO�Bt19 W11h B WII�fBdOf(8) �CB11BBd Qy9YL11 ID IhB ri0lIIf0CIX8 �1MIISB �dW�.
� I em exemW uMer Seciion: B. 8 P.Q,1« �hie reeeon:
Dale: O.mar:
1 do hareby cenAy thel I em ewera d erd uMarslend iM reyui�mama d Wllomu HWh and Selaty Coda Sed'wns 25505. 25593. eM
2553C, enE ihet I a eny Mure W ikiip oawpent will / wPl nM �prcb one) neatl b compty w�h vaid etete mdee end the requiremenro tm
a permn iwmnatruclion or modifrationhanlhe Ak�6ueTyl.�enapament Dimria. Raaideniiel mnaiud'an eppYfelionsere uempt /rwn Naee
prwlsione.
o�a: aooiKam:
WOFKEP'S COMPENS�TION OECLANATION: I hereby elfi� uMer penetly M pe�jury o�ro o/ lhe IOlbwinB a�e��b^a:
� I heve end wil meinlein e canJiwe d mneenl lo eeH�insy�e /or xake�s' wmpenseiion, ea pro�ded for by SeCion 3]00 d ihe Lebor
Catle, iw thB peRO�mance ol the woA IOr which Ihin perr�q u uyUed.
r] i ne.� �,a m� m�m�:,.on�� �,ro���a� ��•����, m reaw�ad ny saa�o�, a�ao a me �mo� coee, ro� ma reno,m�� d ma
wwk (orwhichthis permitieiseued.My waka�e mmpe���ineurence rarriar vM poli�y number ere:
c�a,:
Policy Numbar:
(This sec(ion need nw be complefeC d the pim,i is lor are hu�dred Cdbrs (SIDJf w lesa.)
I eenity thet in �ha penoemenee d �ha wmk Iw wM1ch �hie parmn ia eaued, I ehdl �w employ eny penon in e�ry manner x av lo
becane subjed �o ihe workers' canpemetion lewe W Celilanie. anC epree Ihm il I ehould become aubjm �o �M wvikero
penselion piovisiona W� +Section 310U ol IM1e Lebar C�e, I ehell lonhwnh compy wnh IMx provisiona.
�oem: �Z���"—J � nodcem:
m/ng: Fallun ro�xuro worken' compmutlon coverp� l� unMwlul, end alull w6/wt en employsr ro ctlm/ni/ pen�Mu anC
clvll flMa up ro om I�untlM fMuunC tloll�r� (SI00,000J, In M1/tlon ro N� cwf o/ rompewfbrt d+mepu �+ pev/detl br /n
SxHon 3]P6 0l Ms L�bor COM, Inhnst, an0 attomeyY hsa.
CONSTFUCTION LENOINO A6ENC1: I Mreby �rm unEOr penelry d perNrv �� �hare u e wnatmabn bMinB W<^q �a tM
perlormerca d tM work for xfiidi �h"a perml u evued (Safo� 3pg�, CN. C�.
LENOEN'S NAME:
LENOEF'S ADDNE55:
1<enity �hel I heva reatl Ihia epWiceiwi eiM 9e�e ihet iM eEorp inlormei'an ia mrted. I ro� �o comply wn� all tlry eM caunry mdirer�ma
/� g�y 9�818 lews AIBIN910 WikNg C0119�utlion BM IKKBby eNlqryB 1B�MB90n18�ivB9 d 1116 OIY �O en�e1 uqm IM ebwB.mBnIYJ11Bd p10p0l1y
" IorinspatlqnWrpoees.
(5151<6.WP) W�ne-BuikiqdSelety:
Dete:
Rnk-Revenue; Golden seuor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 075561
PERMIT NO: P 075561 PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOH DESCRIPTION : LEGALIZE PLUMBING WORK " GAS LINES " SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 /M-1
COMMENTS: GAS REPIPE FROM MAIN TO RESIDENCE 6 REPIPE FIXTURES
x�**�f��tx��tft*x�x��t*x�x��tx�it*x�*�rx�*x��x�*�tit�tx��****�r*�r�*x�**�r*�t+e***�tx�ft�titf�***�****�**+t+tx�*+r***rt
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARRING REQ• PROV: PARCEL: 93079034 ZNE: REF NO:
PLANNING NdTES>
�
!k fE iE 1E 1E 1E 1E iE 1FlF ik 1k iE iE 1F 1E 1E 1E 1E iE 1E 1F 1F �f 1k 1f !f 1f k if ik if 1E 1! iE 1f 1E 1E 1E IE iF 1E 1f 1E If 1E if 1E iE 1F IF IE iE iF 1E IE iE 1E 1E1E 1E iE 1E 1E 1E fE fE 1E iF if ff iF if 1E If 1E 1E 1E �E
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;
HUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � DATE: Z Z rJ�
iFiEiEififlf�lE1E1E1E1EiEiEfElf1Ei41E1E1k1E14±FifiF�F�F3F7FiF7FiF�FiFiF 7f�FfFiFiFiF�iF�F{F3F{F7F(F1FIFlfifi6iEiEiEiFiE 1fiF
LEGALIZATION:Y F E E •S [3�M M,A R Y STRUCTURAL EGMENT:N
HLDG PMT PLUMHING ELECTR�IC,-,MEQHANIC FIRE SMIP/RES GRADING
PERMIT 24.00 ��
25Y ,�,: ; �'� �`. SMIP/NON—RES
PLAN ,.a} * �
ISSUE FEE 20.00 ' I'
BUILDING—DIV—> PERMIT ISSUE PL'`AN—CHECIC , TOTAL PAID DUE
TOTALS----> 24.00 20.00 0:00 � 44.00 44.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 44.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECH'ANI6� -FIRE SMIP/TOT GRADING PLAN—CHECK
a �i , o o � ' ',
if� iF 1E if iFlE ik ik iE ik fE 1! i! iE 1E fE If if ik if iF iP 1F ik 1E 1E Ik if iF fE 1E It 1E iE iE if if ik iE 1E iE if iE 1E 1E 1E 1E iE iF iFlf if iF 1E 1E 1E iF 1E1E 1E 1E IE 1E ik f! 1E fE 1E 1E i! iE 1E fE iE i! 1E 1E iF 1E
I N D I V I D U A L� F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O.N .' UNIT COST TOTAL COST
H � '
PLU 1 GAS PIPING SYS OF' 1 TO .4 OUTLETS 5.00 5,00
PLU 1 GAS RE—PIPE '� '"- 7.00 7.00
END OF:,FEES
EXP � �' .. �, �
DA�-�a � � � ��� , - �
/ � �� �
�/�� � V - _�1_�(li �Jr•�� _
` �� ajr /. f. ' _ � '�,• •' . • ._
i �
�CO�TRUCTION AND PLANNING ' . � P & SPA �
"' Date Inspector Date Inspector
, APPRDVA�S Permit # APPRQVAIS Permit #
't. TemPorary Electrical Service or Pole , 52. Pool & Equipment Loca[ion ,
2. Soia ipe-Undrgrnd. � 53. Steel Reinforcemeni
,;2::���e�ical Condui'�'�,iV�y-Undrgrnd. 54. Porms
�.zCCEi�'6A�ical Conduif,liedrgrnd. 55. Electrical Bonding
n•�-,-rc
r.5:�t�€�Reinforcementr 56. Rough P(umbing & P;essure Test �
r• 8t*22ctrical UFER Grnd. 57. APPROVRI TO COVER�GUNITE
,.,. �
�� FoQt�ngs �. '' � 58. Electricai Conduit-Undrgmd.
�.
�$i Foundation �C, a. _ 59. Gas Pipe, O Undrgrnd., Test
s 3 Wat'�e�{ P�pe-Undrg[nd: '0 60. 8ackwash Lines, P�Trap, O Undrgrnd.
10. Stt�{Ctural Floor S7�jst�m~ 61. APPROVAI TO DECK
11 . Property Sewer Ci�e &, House (rtoanectio� 62. 8ackwash & ReceptorFinaS
12. Sewei Cap "- " �,; 63. Heater & Vent�F'vnal
73. Roof Drains 64. Plumbinc� System � Final
74. Ra gh Plumbing � ,m, 65. Electrical-Finai '
75. Raugh Electricai-6ond.uit b 66. Solar System-Finai
�
16. Rough Electric 4Vging"� 67. Fencing & Access Approvai
i7. Rough N�iring $iqa 68. APPROVED FOR PLASTERING
78. Rau�h Electricai�g'Bar Ceiling 69. POOIiSPA SYSTEMS FINAL
19. Raugh Hea[ing & Air Conditioning FIRE DEPT. REQUIREMENT
.� � ._,y;-, .:. # F
20. fj�ugh,Fa��bry'-FirG�l"jce ' �M d;, y ? r,*'QPPRE�/A�S�itiFPer'mit#���
a x
21. Q:ucts�-in SlrucCGre-.'`'jr � .... �-�i�� 4 �= -':k ^*70. l�iiderg€Sf��HY�ro � ..
< r
22. DUccs'Venti4ac�g `,* : �* S `T` "�' S
i . � �'� � `� � F* �77. ProducU,Q;ping �C,as Q;�Oif
23. G�s P�pe-Rough�& Teg � ,��,y �;r, q j x.,72. Underground FltrstSd s r �
�
24. RdofF-faruing .: ��` `-'�-' _ R =' "' `S - 5 . �+c^ �
,v r k x��.73.: Alnder9rnd; StorageE7ank � Gas ❑ Oil ,�
25. Roof §�eaihing �;, f � � v t �� � N z 74,::Overhead HydroC r �� �' ~ �
i: .rJ ;.y'k _ t ^+ O :Ji ;'�\i
26. T Bar:Ceiling (StruQu'ra1) & M 'cftat 75 - ry Chem� ai �. .7.4 t�. �
,, -��. Y U Ck �
27. Framaand.Flashin�x� � x � r ���, �..e<� . .. ..
�!* :J�� +^.' � W� 76. DryStand�ipe Foa K^ �
-28. L2thifi'g &Biding �T'* %' "a;= Y `: � ..� 77 `-"FIXED S. STEtv!'�{�� x ; , _ r. � + .` :
�v: v � I '7 �� .J.J'J"`� r •
>. -� (7 M' � i H.. .. ,F Cr, I � ' : r '- V i
' 29. insulation�.. gc c r. � 78,£�ARE�PREV. FINIA*E M%' -� S�" t Y
�T30. Drywall Narling �* � ' ` `" '�` -�LTi-f',DEPT*FtEQI"11RF �NT �
."Y. � SC�t: ,.R•�`. X t1,
�31. PlBster Brown Croat� y�, � n-;,-• � � � �� rr79.��FlNAL If�tS2ECTI�N Y [u
_ _ � ��-
:-32. Et"ectrical Powe7Merzet--Fnal ' '� �� ; � R$0.�000 CERTIF�C�{ITE IS � D�, � �
� . f. . Y �t i, Y � ^{" J ��
ti � � . V * m ' � h �'! ` �
-33. F�al�fectx+c � rr� r� � �C � � Noxes: i_ �c*:
, - �-1_ �� ��-�z_���
�-
n34. F,ttaai t�feating �?Air.'�Condi2ioniny> S C'i +. J I� �9: I S i x � c
� -r .. 7 • , -y T. k �• ' 'K '/)������� � �
�35. �al`Gas P�,Pe•�Rstn; p.� -: r H �,fj� � r-i r�" ' =.
� r, , 2`��'g� (?i.�v<�"z�.3�-��ss:�-9�''
�s36. Hood:ar CanopY � � x •�, � .;, �, c„ M [� � f � '* s _�r - t_ �c%[� cLR � �• �n�
C T f T '�`.'I :�1 k. . .s.
'A N =L: :: �K I�: � R' oC7"��� .�
.-37. Fipalf�ctorYFirePU�,e z �E- � x. �� 'Z,jf !
: ' � : . '�.--�--�`�'�' � � C �7
� 38. Fina� Elunttiing x 1: � � �� � '� � j �x � S � '" * � "'
. -r � .�: G �-t T. Ys
�39. Water$ervtie•Finalc r � `�' .r S � ' � r " .,` �: F
=.40. Gas Service�yFinal mr ,- <:;-p^ _ +� t+7 I I ^� �-=� * ^
„ : ` r�. c � � Er
�47. So�ar pomestic�Fina� A 5 �; + C � 't�
�. X ( . t t*� 7o i^
� 42. Backflow Preventerf„� CV � � ' a' -� � F- � � '-+
�� � x [" t F
7'r � cr_ � �~ x c:- - i
43. Backflow Irrigaiion_,; �, ,; �• � �,y � * � . •
� . �•;.� ^ V
Lyndscap�trripationSyStem e7:?^ iT! �Wc; n� ti c N c.:..
-. �.A Y �-+. f � d � M *� 3 l�
4Fs. SQund At enuaiton � "^�' Y' £ c^ F:! i. r+ �-' Ca c',
F, fi '7 .. .. r � C' * F O' C cC • c� G �
� �. � `
4,fi �ndicap Regulations� - ✓ * r � �" e'o S *
,, •i �
' � ��: �J 1} j i'�
47, F1NA�STRUGTUR�'&BUILf9'ING �,.,, ,�. * E..,
48. F{�JA�.PLANNING +: �.- * �� � i� t' n � * F
� 1 -� w s � c
49". Ef�ctr�v fleleas@.to Ed�son � '' � �: �; �°: ,�.-. .,
��
5fj. Crat Release to Southern California 6as Co + � `�� x E� _ �'� `T * ;u v�
57- CER7IFICATE OF OCCUPANCY � -- �: ^� ' - �-
No. Date
�nonEssaam�ara: 2Z65 E FOUNTAIN WY uNr:
a""Eas"WEiFaawx: SCHROEDER WILSON
� �DDRES& ASSOCIATES
iSCHROEDER CO
2��1���o�.ST HWY STE 300 CORONA DEL MAR,CA 9262`
/JICNRECT ON FlANEEX:
JMII OX FNQ'4 AOOflE43:
uc wo.:
UNT:
�BTOf�s"'�` SUNSET AOOTER 6 PLOMBIG ( 800 ) 994-9906
eam.croirs�uiwa 5991 E. AV LA VIDA
�°°"�"' ANA CA �0'ND'` 656546
(�2807 UNT:
LJCENSED COMXACTOPS DECL�flAT10N: I M�eby tlfim uMx penNy d pmjury Ihet I em fKenroE uMer provi�ions ol Cheqx B
(mmmane�p wilh Ssction )OW) d Orvision 3 d ihs Bupiaa vd Pmfaaima CoJe, end my 4mma o In IW lorcs and sMed.
�C LIC. NO.: LIC. C1A43: IJC. NO:
�z_�Z_ sS C-39 656546 EXP:
Dme: ConveGa:
��NEfl BUILOEN DECURATION: I hemby effirtn uMm penely d per'µy tlai l em eKemq tmm IM Convedon Lioeme Law lu tM
�dbw'p reaeon ($eqi0n )091.5 9ueneat dd PrOfaaabna Code: A�ry NY d�nIY �� reGuine e patmtl lo oonsltucl. Met. imqove.
Aemdsh, or rapeir eiry si�unun, prior io ee uweMe, e6o rpuirae tM epd�� iw wch permil lo fib e aipneE etatemeM ihel �e or eM
'ienzed Wn� �o Ihe p�ovisbna d Ihe Conireetoes Lieenae Lew �Lheqer 9(oomma�iq wih Satlion i000) d Oveion 3 d ihe
'�,neae erd Prdeabna Cotle� w ihet he w ahe ie e�emp ihsehom e�M tM besia �w Ne dbpad eaemqion. My vbletion G Sedian
.t.s Ey eny epplirani Iw e permil wEjeda iho apdr�� �o e eivil penelry ol M mae tAan 1He hurdrad ddlaea �5500��.
� I.esowrerd�hapropenYormyemDWa+�hwegeaeaihxedammpenaeibn,WlEoihewwk.endtheewnureanaiinieMed
w dlered lor eele (Saciion )O<O. Buamea enE Prdeeaiona Gode: TM Contreaas Liceree law does not epply io en owner ol propany
wM WiO� w inpmwa iheroon, eM wl�o dwe euch wak himaell a haneY a Nrouph hu w M1er own ampbyws, pmvided ihm euch
imparemenb ue mi in�oMaE ar dlerod la eele. II, howavar, �he buiMiig w impwemenl o sok wil�in one yeer W mmpblun. IM
o�..w�wfx win ne�e in. w.ae� d ora,ina ne o. ene aia �wi nuim « �mv.are ia m. wm�. d.�el.
� I. av owner ol iha prope�Y. � eRCluniveN Pontreairp xnh limnaed conirecion b consVud iM1a projetl (Section ]04<. Buainese eM
Proleasone Code: TM Conlrncion licenae Lew daea not eppy io en owm� d properly wlw buitla w impoves IMreon enA wfa
canvena lar euN proled+ v.+ih a mnireaor�a) IicenaeC punuanl lo Ihe Con�aaas �iceroe law�.
� I em ezamq under Seciion: B. 8 P.C., Iw ihie reeaon:
Dem: Ow*ier.
I Eo Mreb/ cenity thei 1 em ewua d eM undorsteM I�e repuiremenu d CalLoma NaeXh end Selery Code Seeiom 25505, 255�3, vM
255�1, eiM ihei I a eny INure Wildnp omupeni will I wil nm (arcb «n) md �o comqy wiM1 ead dete cotlm eM IM repuiremenU la
e permn laoonslrutlion a modifiratianhan Ihe R'e�mn9amen� Dimncl. Pesidemial oma�utlion applretioruerauemq trom thme
prwisiaos.
oe�e: AvW��
WONKEH'S COYPFNS�TION OECLAF�TION: I Mraby alfirm wdr perelry d perjwy me d Iha idlorrirp Eatlarmom:
� I hms eM W meinien e ceM�s d con�enl lo �etlinwre /w xakero compemmion. m prwiEeE fa by Sefion ])00 d tM leGar
Code.la �he peAmnenca d tlr wak Iw wFic� �M1ia pemxi u i�suaC.
❑ i n�. �e M� meim.:� �a.• mmro��o� �na�,eMe. m�eau�ne M s«io� a�ao d o,. �ae« cme. ro, n» c«�m� d in.
wpk �or which Ihis petmA b e�ueE. MY wvFere' oompeme�bn inararica orr'wr ud po&y number ue:
c�.:
vdKrµ,me«: � .
Ns aeeion rieed na de mmde�ed I tM M+mR's br aro MmdrM ddlerslSiool n bsv.)
� I cenA' �� m� G^�a^e^�^ d iM work tor whih inie peimn b ieweE. 1 eheA m� empby eiy pa�n m ury manirer ro ea io
became cudeu to iM xoM1ero' canpenee�ion lew+ d Celil«na. vd epree iM1q J I ahauM become wbjeG Io IM woM1en'
penution qo.ia'vre a( �Seqion �]00 d the teEv Code. I ahell /onnwiln mmpy wilh tlrose pmrisian.
r�_._. �Z"�2'�I -r. e�w:..�r .
—�Inp: F�Ours ro�zuro woMx�'rompmutlan coverep� la unWwN( antl iIWI �ub/�cf an employa ro crlMns/ poneNw enC
dM� nnss w ro orrs nweroa �noua.�e eabr. (s�o0.00a). In wd�rron ro m. eo.r o� compe.wnon d+m.w. .. p�va.e ror �n
Sxtlon 9106 0l tlro LeDor COGs, Infsnat, ena ertomsy'i fsu.
CONSiNUCT10N LENUINO ROENCY: I MnEy �im unCer panelly d perjury that thera a e emarvaion b�qin0 e0em.y Im �M
pBfiOlIIId11M a 1�1! WOfk �IX NfiK111118 DBIT� 19 69UB4 ($Odq11:N3). CiN. Ci�.
LENDEN'S NAME:
LENDEP'S AOOPESS:
� cenM me� � neve naa mb evd'ce�ia, ene ade �nel mo eeovo I��ametion e mirea. � ea� �o oomdr.vnn el� wr ene coumr ordmd,cea
enC steie lewc rela�ip ia Wikirp oonsUupion vd hereby euihorae ropreaon�elives d ihis cny w en�er �pon Ihe ebove�mantioned properry
�wlnsveabo ouroosas.
,i-pAN RULICK ,i
Oaie:
(S151s8 WP) WAne-Buildvq d Selely: �rae Fle: Cenery-AvN��: Pink-Pavenue; GdtlanmE-nsana�r
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 075561
PERMIT NO: P 075561 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOH DESCRIPTION : LEGALIZE PLUMBING WORK " GAS LINES " SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-1 /M-1
COMMENTS: GAS REPIPE FROM MAIN TO AESIDENCE S REPIPE FIXTURES
r+rsr+rw�r�t�r�rx�x���rx **�r*x�rx**�r�r+t**+r*****etx x�+r+�+��r**+�*�r*�r**x�*x�+t�+r*�r***��c+t�r*�r�c**+�*�x�**�rx��r
Z O N Z N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARRING REQ• PROV: PARCEL: 93074034 ZNE: REF NO:
PLANNING NC7TE5>
�
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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
20NING APPROVED BY DATEc
HUILDING APPROVED BY : DATE:
APPLICATION ISSQED BY: DATE: ? 7 r��
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LEGALIZATION:Y F E E S U M M A A Y STRUCTURAL EGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 24.00
25� SMIP/NON—RES
PLAN
ISSUE FEE 20.00
HUZLDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 24,00 20.00 0.00 44,00 44.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 44.00 OVER/SHORT: .00 �
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK �
44.00 -
# 1f 1f ii if 1f 1f if 1f 1('iE 141f 1E 1F IF i(' if iE iE ik �)E 1E iE 1f' ih 1F 1f lkif'If iE iE'!F 1h1E 1F 1P i@ 1k 1F 1k iE 1f ii 1f ikiF Ik iF 1kiE IE if iE�f iF iF1E iE 1F ik 1k iE 1F1k 1E iE # 1E�E 1! IE iE 14ii i!� ##
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
PLU
D E S C R I P T I O N
1 GAS PIPING SYS OF 1 TO 4 OUTLETS
1 GAS RE—PIPE
END OF FEES
,
UNIT COST TOTAL COST �
5.�� 5,�� �
%,�Q %,��
01 0014b330-0019b330 T O T 44.00 V
DATE: 12/12/45 TiflE: 13�33
.."ab: �
�u�p�ssaeu�aw: 2265 E FOUNTAIN WY p1"
a+*+Eper,�EiFa+o"'": SCHROEDER WSLSON
�%% ASSOCIATES
tSCHROEDER CO
2411 E COAST HWY STE 300 CORONA DEL HAR,CA 9262`
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uc no:
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carm�crarswu�: SUNSET ROOTEA 5 PLUMBTG (800)994-9906
COMIq�Ci0R4YNNA 5991 E. AV LA VIDA
�s ANA CA ��o_ 656546
92807 unr:
LICENSED COMF�CTOR4 DECI�H�T10N: I Ireby Nim uMr pruly d pw'Wry Nm I em licer�eed uiMai proviums d Cheper B
((nTm �M xilh SMlql iC�) C/ DivifiMl'J d NG BUPIMO Yld Pf0100dd10 �.Ojf. 011d I�Y fiMt! 01t1 hA IOR! pd MIW.
c uc. io.: uccuss: C-39 �°�° 65654�'EXP:
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OWNE BIIILDER DECLARATION: I hxsby elfum wWar paWy d per'�vy Nel I am emmq tmn �M Comreeon liroma lew la Ms
Idlovn reewn (`�ion ]O�I S Buainea� eM Proleaawna Gada: �M cry a mumy r.hich npuiree e peimu �o awubucl. Mm. impme.
h. a repv eny tleucturo. p'v lo Cs eavWe. eleo iapuree iM epplimiY la euc� pemW lo fib e aqned ttabmaM tlW M p�M
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owner-0uikar wiP Mw iM Eu�den d qo:i�q M a eM did m� ddd a impaa Iw Na purywe d eeb�.
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WONKER'9 COYFENS�Iidl DK WIATION: I MrWy alfim �vtla prWy d papry ans d Ns bbw'vq detlnmim�:
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coa.. �« �m vMa�. a me .ak ea .1:M Nn w�C u muee.
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ian P�'ar d Swion YlUO d �M leEor Cod�. I lafh ' mmpy tluw pwe'vu�j
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CONST YCf10N LENqNO �dENCY: I Meeb/ etfum unMr psuW d per'r.ry tIW IMn u a cvnq�uCian Is+diq yricy tar Na
peAamuca d iM r.ak br whiN �Im G�� o ewE (`wqon 30H1. Cw. CI.
LENDEfl'S N�IIE:
LENDEH'9 A�DNE34:
I<eniN �hm I hew �aed Ne WW�rbion W aw tAm tM elow'vdamtlian b canw. I yne m mnW xVh eA M' md mwYadir�vae�
ud elqe 10Wf robllp b Wik1q Mffiuyl0ll Bib IKKlbl' aWIWCG A�bYatXbs d IhY Qly to oNY up]fl �M OdT!-TM�iC(1G� pOpM�y
IIX IMpO[11p1 p111pOMf. / \
DAN KULICK I I
(515�i8.WP) Whne-Bwldip85e1My;
Dme:
Hnk-Rerenue: OddemoA-A�eeaaor
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO; P 063879 PLAN CHECK NO:
CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU
�
PERM NO: P 083879
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION ; TO REPLACE EXPIRED P-75561 SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC; R-1 /U-1
COMMENTS: GAS REPIPE FROM MAIN TO RESIDENCE 6 REPIPE FIXTURES
�r�r**«w*****+r«*****r*«***r�r*******«*******«+r+r***«***�r********�****�r**.*�rr�e****+e*
Z O N I N G R E Q O I R E M E N T S
S E T H A C R S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FANT: FT IN REAA; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING AEQ: PROV: PARCEL: 93074034 ZNE; AEF NO:
PLANNING NOTES>
> `�'
3hiFMMMMMiFifMMkikMififMMMlfifMikklf/tMMMMMMMIF1fiFiklFiFitiFiFMi1%M'lFiFwfFifk�Mififi4ifil�ilitMiFiflEifMMlE�fiFafiFM3f3EifiFifik
D E V E L O P M E N T S E R V I C E Sr�: R E Q U I R E M E N T S
20NING APPROVED BY � DATE:
� �11� � � �� � �l�:�', � i � fi�l� � �� :�
APPLICATION ISSUED HY
MMMIFMMiFMiliflFifitifMiFMMMMM
LEGALIZATION;N
HLDG PMT
/.�
�
F E E S U M H A�R Y
PLUMBING ELECTRIC MECHANIC
PERMIT 14.25
25t
PLAN
ISSUE FEE 22,00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK
TOTALS----> 14,25 22,00 0,00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBZNG ELECTRIC MECHANIC
36.25
DATE:
DATE: /��
�ihMMiFNiEkMMM �if
STRUCTURAL S GMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
36.25 36.25 .00
36.25 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN-CHECK
ikMMMMMNMMMMMMMMMMIlMMikkifMMMMMMMNMitMkMM1FMMitfFifMMMMMM1FMMaFIFiFitM1lMMMkMNM1lMMMMMMMifMi4Mifit
Z N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 GAS PIPING SYS OF 1 TO 4 OUTLETS 5.50 5,50
PLU 1 GAS RE-PIPE 8.75 8,75
END OF FEES
07-24-1997/83:29 PM/536.25
RCDTq:BI-8809668
PERI'7I T : 083879
CONSTRUCTION AND PLANNING POO. ;PA
pPPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
1, Tertmporary Electrical Service or Pole 52. Pool & Equipmenc Location
2. Sojt FiPe-Undrgrnd. 53. $teel Reinforcement
�
u y..,. _
. (�3: Blectrical Conduit.U.filily-Undrgmd. 54. Forms
, �?�4,���Ig'ytrical Conduit�Undrgmd. 55. Electrical Bonding
�;p5r Steel Reinforcemeqt 5G. Rough Plumbing & Pressure Test -
��6�'.�E�ctrical UFEF{�G nd. 57. APPROVAI. TO COVER-GUNITE
''�,7' F,00iings � '' " 58. Electrica{ Conduit-Undrgrnd.
t'=8. Fo'Ondation �•t �v i 59. Gas Pipe, � Undrgrnd., Test �
�
'=9. Water Pipe�Undrgr'n,d. � _ 60. Backwash.Lines. P�Trap, O Undr9rnd.
' 10. St�uctural Floo�cS�stem 61. APPROVAL TO DECK
1 t. Prvperty Sewer'Line & House,Connection 62. Backwash & Receptor•Final ,
12. Sewer Cap " `� - 63. Heater & Veni-Final
13. Roof Drains _ 64. Plumbinc� System - Final
14. Rpugh Plumbing; ;n, 65. Electrical�Final
15. Rough Electricaf�Conduit 1 . 66. Solar System-Final
r r
16. Rough E�ectric Wiring 67. Fencinc� & Access ApProval .
17. Rough Wiring Slgn 68. APPROVED FOR P�ASTERING
18. R ugh ElectricaT�,T Bar Ceiling � 69. POOL/5PA SYSTEMS FINAL - �
79. Rough Heating & Air Conditioning FJ�RE�EPT REQUI EMENT
� .n --� . .., o� ,-. A r "s, � �-. �
20.,Rouq'�Facmi,yFie{�lace '�^T 'v ; O ' �x'`APPRI�V,A��Pb�iit# � � ��
�.. �. . :t �. - .-� 7'.i' �. r. F � -'t-'-�-�-
21. AucFs, in,3tr�turgl c ��•• •• �S r S^�• i. " 70.'"FJndergioi��i F£��dro x
.n e�. r n f, ^.i: -r, �
22. Ructe: Ventila`yiing )i. �� `:� ; ti ,� n �. y 77. Produn};P,iqing` as �Oil
� .
23. GasPipe:�ough& Test � �� � r a y O* 72, UndergroiiiAA Rtlt�4Ti # `-'
24.'�Roof F�aming" �Y r #� � �,- f.:i �3j Undergr�jd.Stn(��Tankk�Gas ❑Oil
25. RooJShqthing xy � � v r�" � � ]u�: 7¢ Overhead H d *
Y �n Y
26. ��Bar�Ceiling (StrG[t'Lraq & �C9�d6toat „ C � ` .
� m � i 7� Dry Chemical F..,p �; `a 7`_�
27. Frar�eandFlashiri0i� �xw �s " >' �� 76. OrySta�FipFpeh'bo � �
n „i -,
' 28. LatFu`�g $�,Siding :^ � '� �'?"' R " ••' ••' ••y 7� FIXED�,�Y�T�'1�QVA1.,� ;-� "m
.� 29. Insulatio�,�r � s� 5� J r , �* 7''f{REjPREV. FIf�P,L .� > s-r-"'
I n
' 30. Drywall bl�eiling =� � i• �, I ( {.� ���U �n}t�ALT� OEP�.`i'iE�11R�FIV�ENT
' 31. Plaster BPown'�� �:' r � !x ' 79. FINAL tDiSPECTION �^ v
' 32. �IectriwP`Dow"�r f� t�r�F'�ral • � �� � ,y - 80? FOOD CERTIF�i�ATE I��.lJE4r �
r�'. �" W I 1 Z ? F. � +' v
- 33. rina}�Elegtric. ;z.F m +.: ( �� NBtes: `7 ^!t�! �� ^ = m
� 34. Final:FfeaT�n�,& Ais #o,n�ditioniSgS *� � Ik ,,r, g �� Y S� O
35. F`inaY'GaSPip�Tes( � ry,� .: s..� � � y• �� YO J� 4 T
36.�Hoodrori2noPY �} �� � �- ��� � ly � xo *'- .i T
,37. .+na7.Fac2tory Fireqlace �- ; �;� y q �� r �' � .'+
- - ' '" , -'
-38. FinaCPlumbing G* !'J � c ' _ '-' .` x �
�' 39. Water Service�PinaT'' . � ��� ' :K ..-� "_x ' .
a 1 � i. �. �' � � x e'
�
40. Gas Service-Final r*: c:*1 QTT S �:�7 ' � ��'� ••�� +
r:.._ �r "s 1 �. F• • �v� ; 1
_a 41. Solar OomestiaFi�a� =' '' " �' -` '. `. - .
a � �'+i I*' "!�J �7' W.'C '�
�
42. 8�ackflow Prevente�•u � M '�� �: ^•F, # ~ �"+
n �- ✓ ^� � ..� v. ... a• 1t7 ?; � ti
43. Backflow Irrigatio� r ^`� :e � x . � .
.y >, ; � K'1 /
�. �!
;OA. LandscapelydgatiornSYstem=�.r � xtT1 o O rik�'• t� ;� O� Fi 1�
+�. rr �-.l^ T .". d'k'1 .c.. �r -
n
k5. S�ound Actenuation� �' E.. � � " F' '-,j m� : � "� � ,Q '. c� �
�6. FtandicaP Fegulatiom -� � - + .. �� .: S r��, S ��
� x � fJ
q7. FiN�L STRI�CTURE & BUILDING ��. �' n' � � �
� �
48. E1NF3L PLANNING �-`-� � 1 , �f !'• T� ~ t' �
, �: ti ti i T
d9. E1eci}�c Release to 2xlison P ' � , �, �,
i
50. Gas Releaseto-Southem CaliforniaGasCo i ' - w `• -' � • =? i ^ ' '
v p - � ,. (+i �� -
59, CERa'IFICATE OF OCCUPANCY. ' ` • � � • - �
No. Date �
.