HomeMy WebLinkAbout2274 FOUNTAIN WAY - Building Permits..
B47II,DING SAFETY DEPAHTMENT N� 1394 L
R-O. Boa No. 317
Costa Mesa, California �
Date ��A � ? . � `�� n .
i i '
CITY OF COSTA MESA
CERTIFICATE OF OCCUPANCY
Building Permit No�A�%�Electrical Permit No Plumbing Permit No.
u� oe B�aa�g '� l��v r i ,�? 6� ;.'
� .a � cL -�i � � d., � ._ . _ _ 7� C�/u--�� Lc/�a_�.
77ie building tocated
Legal Descdption
(See reverse side for Metes and
,has been inspected and found to comply with the provisions of all City of Costa Mesa Ordin-
� applicable thereto for a Group �Occupancy.
ISSUED TO:
'� / City Building Ofiicial f
YAr�I. F. �nf^�.�TI"�Y.<na� f
(Owner of Building) BY� �'�
CC: ❑ Original—Owner lst co Gas Co. ❑ 2nd co ��
p py— py—Edison Co. ❑ 3rd copy—FIle
Form 206 SB P 1M 1-fi0
� � �. ,
CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRIVE. COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ewiw.ci.wsta-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: B10-00149
PERMIT TYPE B_ROOF2
APN: 93074014
JOB ADDRESS:
Vicinity:
Squares: 2000
STATUS:
DATE ISSUED:
ISSUED BY:
2274 W FOUNTAIN WY CM Suite/Unit:
Valuation:
ISSUED
05/2812010
KJB
$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: SCHROEDERWILSONASSOCIATES Address: %GRIMMWAYMANAGEMENTCO Unit: SANTA
ANA, CA
PHONE: City/State/Zip: 1526 BROOKHOLLOW DR # 82
APPLICANT: GOODGAME, JACK
PHONE: 714-640-1626
CONTRACTOR: SIERRA ROOFING CO
Address: 5132 AUDREYUnit:
City/State/Zip: HUNINGTON BEACH, CA 92649
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $111.25
Reinspection Fee: $0.00
Bldg Std Admin Fund $1.00
Address: 5132 AUDREY Unit: :
City/State/Zip: HUNINGTON BEACH, CA
License No.
License No.
PHONE:
License No. 511172
714-840-1626
CELL:
PHONE:
PHONE:
TOTAL FEES $112.25
HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2070 - PER CMMC Sac. 13-279
Monday thru Fritlay - 7:00 am thru 7:00 pm. Salurdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav. Lahor Dav. Thanksoivino Dav anA Chnsimas Dav
NOTICE: The work authorized by this permil shall comply with all applicable hantlicap access requiremenls under Califomia siatutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAVS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be oblained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
GOUE %. INSPELTION TYPE ORT INi1TIRL5 COD � INSPECiION TYPE DATE IN1111ALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof �j,1�p=_(,y Nm�` 270 Final Electrical
201 Final BIocWRelaining Wall J 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Buildincy0aupancy
WORKERS' COMPENSATION DECLARA710N:
I hereby affrm under penalty of perjury one of the following declarations:
❑ I have antl will maintain a certifcate of consent to self-Insure for workers'
compensalion, as provided for by section 3700 of the Labor Code, (or lhe
pey ance of Ihe work for which ihis permit is issued.
�j�, I have and will maintain workers' compensa�ion insurance, as required by
seclqn 3700 0( the Labor Code, for lhe performance of the work for which this
pertnit is issuetl. My vrorkers' compensation Insurence carrier and policy
number are: /�
aCCirie��/�� / l,�%/l
(This sMbn need not be mmpleted iI ne permrt is valveC at one hunere0 Collars (St00) or less )
or�a �N�b`D�J3�/,3-�ao/`'
❑ I certify that in the peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
�o the workers' compensation laws of Cali(omia, and agree that if I should
become subject to the workers' com ¢nsation provisions o( Section 3700 ot
t abor Co I shall rt'th co y with these provisions.
�-l�Lp S - 2d'�/U
�App�c'211(sSigneWre�j ,�03te��'
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARS
(5100,000), IN ADDITION TO THE COST OF WMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm Ihat I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions Code, and
my license is in full force and eRect. ��
��. 8 �� 7 Z �C asl s�#"�— 3,�
�--��-/o
{C_6n1F2ctoCSSignai� ."• ��Date-„"..
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn tha� there is a construclion lending agency for �he
pedortnance of Ihe v.ork fa which Ihis pertni[ is issuetl. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Adtlress:
OWNER-BUIL�ER DECLARATIONS:
I hereby aKrm that under penalty o( perjury ihat I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permii to
constmct, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires ihe applicant for such permit to fle a signed statement
that he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pmfessions Code) or that he or she is exempl therefrom and
Ihe basis for Ihe alleged exemption. Any violalion of Sec[ion 7031.5 by any
applicaM for a permi[ subjects [he applicanl to a civil penalry of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and the structure is not intended or
oKered for sale (Sec. 7G44, Business and Professions Code: The Contractors
License Law does not apply lo an owner of property who builds or improves
thereon, and who does such vrork himself or herself or through his or her own
employees, pmvided that such improvements are not intended or offeretl for
sale. If, hovrever, the building or improvement is sold within one year of
completion, the owner-builder will have the burden of proving [hat he or she
did not build or improve for purpose o( sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WI7H
LICENSED CONTRACTORS to constmct the projec[ (Sec. 7044, Business and
Pmfessbns Code: The cont2ctors License Law dces not apply to an ovmer o(
property who builds or improves thereon, and who cont2cts for such project with
a coniractw(s) license pursuant to Ihe Confractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature Oa�e
305]-46�3I0])
Owner ID verified by tlrive� � ucense. ❑ Yes ❑ No
Driver's License No. Expires:
Verificafion of Ownership by (type of document, i.e. - property 1ax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cedi(y that no excavation frve (5) or more feet in depth into which a
person is required to descentl, wilt be matle in connection with work authorized
by this permi�, and that no building sWcture, scaffdding, falsework, a demolition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sec. 341, Title 8, Cali(ornia Atlminislrative Code).
❑ As owner-builder, I will no� employ anyone to do work which would
require a permit (rom the Division of Industrial Safety, as no[ed ahove, unless
such person has a permit to do such work irom Ihe division.
Appli W n[s SignaWre �ale
Division o( Industrial Safety Permit Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to Lle and
certify a Business Plan for emergency response ro release or Nreatened
release of a hazardous material? � Ves ❑ No
(Section 25505 of the California Health and Safery Code requires, with some
exceptions, Iha[ a Business Plan be filed wilh the Costa Mesa Fire
Department by every business which has at any one time during a repo�etl
year a quantity o( hazardous materials equal to or grea[er than a weighf of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas
at standard femperaNre and pressure�.
2. Does or will Ihe appiicant or present or future builtling occupant need to file
a registration form for acutely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater than a weigh[ of 500 pounds, or a
volume o! 55 gallons, or 200 cubic teet of compressed gas at standard
temperalure antl pressure�.
3. Does or will Ihe applicant or present or fuNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program (or acutety
hazardous materials)? ❑ Ves ❑ No
(Section 25534 of the Califomia Health antl Satety Cotle pmvides that the
Cos[a MeSa Fire Department may require the prepafation, Certificati0n and
fling with Ihe Fire Departmen[ of an RMPP by businesses which are required
to register awtely hazardous materials with Ihe Fire Department.
4. If an RMPP is presen�ly required, has Section 25534 of the California
Health and Safety Code been fully complietl with? ❑ Yes ❑ No
5. Does or will the applicaM or preseN or fuWre builtling occupant require for
the woik which is the subject of this application a permit for such construction
or motlifcation trom the South Coas[ Air Qualiry Management District or from
any other air polNtion control district or agency? ❑ Ves ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requestetl
infortnation be fumished on applications (or non-residential building pertnits).
6. Will any part of the facility to be constructed under this permit be within
1000 feet (rom the outer poundaries of a school? ❑ Yes ❑ No
Qf "yes", the facility must meet the requirement of Sections 25534 and 42303
of [he Cali(omia Health and Safery Code).
7. If a permit from Ihe South Coas[ Air Quality Management Dis[rict or other
air pollution conhol dishict or agency is required for the work which is the
subject of ihis applicatioq have all of the disclosures piescribed by Califomia
Health and Sa(ely Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certifcate o( compliance from the appropriate air pollution
contml of(icer).
CERTIFICATE OF COMPLIANCE: I certify tha[ under penal[y oi perjury the
information given above is correct. I agree to comply with all s[ate laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read Ihis application and slate that
the information given is correcL I agree to comply with all state laws and ciry
ordinances relating fo building construction, and authorize representa[ives o(
the Ciry of Costa Mesa to enter upon the above-described propeAy for
inspection purposes. I agree not ro occupy or allow occupancy of any builtling
authorized by Ihis permit until fnal inspection.
Sig,p Wreo(, e IOw rs) Da1e
s - z �-/o
LAntlIw.ANhonzeGPGv� n�:...�."^ �D3t2.__,a:.�.•,a••
Certificatc uf
Prujeci Nnmc:
�3/r� o0
,z�s��,���c�;�i
Clim:�tc Zunc
CF-IR-ALT
,2'uL'e ] of 51
11 of S�ories
Gm�eral lnlin�ma�ion
Site Address:� ,� I linfurCemenl Agencl': I I)ntc: �„ O
Building Type � Single Family 1ulti Fni ' Circle the From Orientation: 1T, E, $, N', or degrees
Yrqjecl Type: ❑ Alterations ❑ Envelope O Fenestrntion ❑ 7toof O HVAC
Conditioned Flooi Areu (C�A): keplaeement or Chan �e Ow ❑ lluci Renlacemem ❑ Water Henter
N07Z: 77�is Jin�m is �mr m he uscr! J��r Nen�lr Conrrructed 6uifdings nr �Aditin��s
lnsufrt�im� I�ttlrres Fnr Opnq��rS'ru�rrces (Jar Fun�ing use !he Muss' und Furrrng S'n•ip.r Consu�uc�ion iable bel�wJ "
Assemb�)' Altcrntiun �
❑ Gpening of frameA cavitp ulone— A/ieraiions i6n� involve i6e opmiing ofdml�unied cavip, �f�i wu!l, ceiling, o�;nnor mu.v insia!l �he
ptGIlfIGi01)' mininuun ina�ulnrtar vnlue per,¢I SD./a� ihe nliered orsembh�. Fill in Colunvis d-C and emer niondamr�� insu(ution vofue in Column H.
❑ Repl.icement of cntire ussemblp- Replucemeni oJan en�irr wa/(, ceiling, orJloor asseniGlJ� reyuires �hr i�umf/ntion o%Componenr
Yuckn �e- D ii�suln�ion values in TaLle 151-C. Fi(1 in Column.f A- J.
L'C
"I�ag/ I Assembly 1Jame
ID� orTYpe�
Conslniction
the
Muterial
of Mass V�hdls sec
U-
Constnicliun 7'nble belo�r.
., .. � .... ..H...��.�. ..�
Vetues From JA4 Table
Framed Continuous JA4
lA4 Table Caviry Insulation Assembiy
Numbe�' R-value� R-Value� Cell Value
see Page JA4-3 and Egnwion 4-1.
use
t. ra� ingitu �nmcaie me meniyicauon name mm ma�cner me ouuamgpmna�. �
2. Lidica�e �fie Assem6h� Name or rype: Rooj/Ceiling, Wa(fs. Flnors, Slabst Crowl Space. Doars and e�c...lndicaie the Frame rype and Size: For
Wood, Meml, Meml Buildings, Mass, enier 3x4, 2x6, or eic... see JA4 (or other possible {rame rype assen;b(irs.
3. Enrer d�e �hichness for mass in ittches oi� Spacrna benveen_ framing members enter; I Gbr 24 "OC; or O�her jor a!! o�her assembly descriprian
such as Cnrtcrete Sandwich Pattel, Spandrel Pane(, Logs, Svaw Bale Pane! ond e�r.... .
4. Uased on the Clinmre Zone; enter7he S�midard U-(acrorfi�om Toble ]51-B, C or D jm� euch dif%renl assembl�� Name or rype.
5. Enter die TaGle num6er dm� closelp rea�emLles d�e proposed assernblr.
(. L•n�er Ihe R-i�alue llmi is heing inalulfed in �he wa(1 cavirn a' Letween die ('oming; olhenoise, enter "0 "".
7. 6n�ei� �he CrnrlLrx�oua Insufntinn R-valueJor 1bc propased cr.crem6l��; nlhe�wise, emer "0 ".
d'. Enicr (he rnN� and colunm o(rhe U-/acior value based ar Cn(urnn F TuGle Nvmber and enter �he dssem67p U facmr in Colunut.l
'). The Propnsed d.ssemG(r U'(iitlm', Cnlunm./. nrus� Gr. equal �n or les.v lhan Ihe Smndnrd U-fuc�nr in Co(unu� E in canpll�.
Purrin� StriPs Consvuction TaUle for Mass Wall^ Only
A lt C ll T P G 7�1 l .I 1S L M
Prupused Pruperlics uf M.ismv)' .md Cuncre�c Added Interim� or I?xterior lnsulatiun
1�r�alls i+rum Itefcrence iu Gurring Spnce irom }teferenee
.li�ini A��eudix'1'ablc 4.3.5, 4.3.G. 4.3J Jninl A�uidix 9'nblc 4.313
V •w j u � ' U
u. p G L ~
Asscmbly " j ° �� �' � � m�`v `� _ Final
L `._ V .p .. � G'u O..yi
Mux} Numc or JA4 Tnblc C a _ �� u= F � p '_ . C' �; Assemb�'
'���iickpCSS T e Numhcr' = w= � c G c, N N U-fLCL01" COI11R10p1
� — I _ .
I I I
f i I I
2egia�o�uiinn IJuml�er: /iegisiraiion Uaie/Time: FIEXS Provider:
2O08 Resideiuia! Cnmpliunce Fnrms �Iugu.s� 2009
of Comn.__.,�ce: Residential
Prnject Name:
(Pa�e 3 of
Climn(c 7amc tl �# of S[ories
T
ROORING PRODUCTS (COOL ROOI�S) §157(�12
When Oie nrea of rx�criar rnaJsrcrjare m he replaced rxceed,r inore thar� SOBS oJO�e crisfing rnojaren, or nmre lhan 1,000 jf, �vhiche�er is
laes, llre new rnnfing mrer� musf ineel (he rnofrng prodrrc� "Cao( Raof' �eqmirements nj§I52(bf IHi, 152(b)INir, ar 152(b)INiii.
Check 4pp/icaLle nl(enrative or eticepfio�i below if (he roaf olterotio�i rs exemp� fi�om (he rooftng produc/ "Con/llnof' requirements'. Note: !f ony
ane of (he olrernalives ar' excep�ia> belnw is checked, �he Aged Solar ReJlec�ance mid Therma! Lmi�mnce requirements jor roafrng products in
ure no! a�nlicable. Do noi fif! �able belaw.
�Cool Itoofs Not Required in Climate Zones I-12, 14, and IG witli a Low Sloped. Less or2:12 pitch.
❑Cool Roofs Not Reyuired in Climaie Zones I throu�h ) and 16 with a Steep-Sloped Itoofs (pitch grenter than 2:12) and product unit weight less
than SIb/ftZ.
Alternutive5 �u §752(b)I Hi nnd §!52(b)Hii, Steep-slnpe roof (pitch >?:I2J
❑ Ingulntion wilh a thertnal resistanec of at Ieasl0.85 hrft? °FBtti or at least a 3/4 inch airvspace is added to the roof deck
ovcr an attic; or
❑ Bxisting ducts in the attic are insulated and sealed according to §I51(�10; or �
��- 1n climnte.zones 10, 12 nnd I3, wi�h 1 R�.of free.ventilation area ofattic ventilotion for every I.SO lt�.ofattic Floor, area, antl
where ut Icast 30 pereent o(the free ventilation area is within 2 feet venical distance of the roof ridge; or ��
❑ Building has at least R-30 ceiling insulation; or
O Building hns rediant barrier in the attic meeting the requiremenu of §] 51(�2; or
O Building hes no ducts in tlic attic; or
❑ In climate zones 10, I I, 13 and 14, R3 or grearer mof deck insulation above vented atlic.
Exception [a §252(b)IHiii, Low-slape ruof (prtdr 5::12J
❑ Buildine has no ducts in the attic.
Other Exceptions
❑ Roofing area covered by building integrated; phorovoltaic panels and solar ihermal panels are exempt from Ihe below Cool Roof criteria.
❑ Roof constructions that have thermal mass over the roof inembrane with at least 25 Ib/ft= is exempt from [he below Cool Roof criteria.
Note: If no CRRC-1 label is available, this compliance method cannot be used, use the
Check the aoviicable box 6elow if Exemot from the Roofine Products "Cool Roof'
RoofSlope Product Weight
2:12 > 2:12 < 516/ftZ > Slb/ft�
PrnducllD Nmn6crcmr
Approach to shoe� compliance, oiherwise,
Product Aged tiolar Thecmal
T e' Reflectance" Emittance
0°
❑4
❑4
❑4
SRIS
Lidicaie Ihr. l��pe nfprnducl i.+ Leing used,(or J�c maf iop, i.e. single-p(�� roaf, uspfiall rnof, n�elol rnof, elc,
I(Ihe �ged'Hclleclorrce ia' nol avnilnble in.(he Cool Roo(Raling Cmnrcil's Rored Prnducl Direcior�� Ihen uxe Ilre Iniliul ReJlecmnre volue fi'ont (he same
dir'ecmr�� m�d use iGe eq�m�imi (0.?+p](�)���������— 0.2) ro obmin n mlcufa�ed nged vah�c. Where p is !he bti�inl So(ar ReJlecmnce.
Check Lo.�' i%ihe �ged Re/feclnnce is n culculmed nafue using the equaiiar aLove.
Culc�doic dic SRl value 1{v using tGc SlU� WorksHecl a hun'/hvw�r enerm� cu env/lillcl4/a�d emer Ihc ravdring vn6�c iu tlm SH! Colurnn abavc and auach acopy
d�e SR/- IVor•k.theer in (he CF-1 R.
� appiy Liquid rield Applied Cnntings, Ihe coating must be applied across the entire roof surFace and meet the dry mil thickness or coverage
commended by the coatings manufacturer and meet minimum performance requirements listed in §1 IS(i)4. Select Ihe applicable coating:
Aluminum-Pigmented Asphalt Roof Coating IO Cement-Based Roof Coating
Gther
Registrul iat Number: Regis�ra�ian Date//'ime: NE2S Pravider:
2008 Ree•iden�ia/ Compliunce Forms - August 2009
7'rescriotivr CerCiiicate oJ' Cumuli:uice:
Alterntians
Yrojecl I���mc:
enti.il
Clim�tr Zunc R
CF-7 R-ALT
(1'a��e � o1'i)
Ifi af Stories
H�RS ���IZIT1 CAT1 Ol�' SUMA4ARY Thv enJorcemenr �igencrrbbidd ym�sneciul uuemiou w Jhi HLItSMeqsures speciJied m ihie-
che•cir6s� belmr. �1 carnple�ed nnd si�iied CF-41f Fm�m lbr nll the maat��n'ex sy�eci/icd shnll Ge suLmiued io liie building inspec�or 6el���e finnf
DU Cl Scall�Pe S'1�CSt'lu� HL•IfS i�crificnlion is S�aquire�I��' �hi.+ mensarc. .
❑ S'�S O NO 1'CS: ln Climate Zunes' a�id )-16, if more thau 4U linear feet of ne�r ur replucemeN ducts �ire inst.dled in unconditioned �
, spaa, the ducic ure to be se;ilecl per �152(b)IDii und thc newll' inswlled ducts oTe tu be insulnled yei 1�151(1110.
-❑' EXCCJ'TJO�'. Lxistine duct systems th;�t m�e extended: which are cuustructed, invW.ued m� scitled with :isbestus.
❑ YES ❑ NO 1'P�S�. ln Clinmte "Lones 2 and J-1 b, if tlie ezistiug space-conditiqning svstem (HVAC equipment and ductino�.is repluced, the
ducts ure �o be sealed per �] 52(bp Di. �
❑)'�S ❑ NO YLS: lu Clinmm Zones 2 and 9J G, if the existing HVAC equipmem is repluced (including the replacemem of the air handler,
ouidoor condei�sing unil of a spli� system, cooling or henting coil, or the furnace heai exchanger) the ducts m�e ta be
sealed pei �152(b)IE.
❑ EXCE]'T10�: Duct sysiems tli�t are dncumented tu Y�s�ve Ueen previouslJ� sealed confirmed Uvuurh H�7t5
'" "_ - .. —� veriticatiou in �ccurdonce,�vith procedures in the Reierence kesidential Appendiz ItA3, _,
� � ❑�XC�7'T10�: Uuct systems witi� less than 40 lineur feet in uncondiiiuned spuce. � � "" -:"� .
❑�XC.GPT]OA: Esistin� duci svstems cunstructed, insulxted or sealed with asbescos. �
Re1�Cieet'xni Chdi�e - Sjlllt System H6RS verijica�iai is required.for �hi.r measurc.
❑ YLS ❑ NO YGS: in Climate Zones Z and F-I5, when the existing HVAC equipment is replaced (including [he replacement of [he air
handler, outdoor conde�sing uni� of a split system A/C or heat pump, cooli�g or heating coil; or the iumace heat
exr.hnnneri � refriveram r.harve mr.nsuremem shall be vedl�ed oer �I�Z(671F.
Centt•al Fan Inte;rated (CFI) Ventilation System and Fan R'att Dran�
- The ventilation remiirements of F150(o) do noi analv to existine residential homes.
Dneted Split S)'stems - Air Conditioners and Heat Pumps: Airf]ow HERS verilico�ion ia� reguired.for tnis n,easurc.
❑ Y�S ❑ NO�Y�S: In Climate Zones 7 U through 15, when Ihe existing space-conditioning system (HVAC equip�uent and ducting) is
renlaced. Ihe airflou� and iaa watt draw shall be veri5ed ne+' �152(b) I Ci to meet ihe renuirements of & I� 1lfl7B.
an�l
Name:
Company:
���
___ S-Z�-� v
If Applicable O CEH or O Cl
(Certification H):
Phone: / I Y% 7� 7'�
Respmisible Building Desi�ner's DecJaratiu+; Sz�tement �
� 1 am eligible under Division 3 of t6e Californi.i Business and 1'rofessions Codc iu uccepi responsibility Ior the building design identif"ieel un
this CcniLcate,of Compliance. �
• ] certiiy thai the eneig�• Icatures �md perfbrmanec speci5enliorc:: 1or the building desigi� Iden�iGed on this Certiiicaie' of Cmnpllanee cont'orm
tu �hc rcquircnieut:; ofTi�lc 2q, Pmts I and G of thu Culifumiu Codc o(7Zugulutiou�.
• Thc bulldin�; dcsign I�caun�es idcmiGcd on �hie. CertiLcnte o1�Compliance arc cunsislcni wilh thc iniormatiun provided tu ducumeni ihi��.
buildin� d�.:sigu on th� olher applicable cumpLuncc lunnc; woil:shce�s, calculations, plan:�, und specificaiiun�: subn�dticd tu thc enlin�eemenl
aeencv foi approv;il wilh this buildlm� permii application.
N�unc: Si�nawrc:
Comptiny:
Uate:
Licensr,
Phone-
Tor a.c.ci.stnncc or quc.slinn,c rc�,rurlin� ihc Lncrer S'tantGu�d,r, cnnlacl tLc L•nra�or Hotli�sc at: 1-B110_i72-33Db.
1<episu'«i7nn IduniLer' J(eg�svnuan Laia/Yimc: //G1tS l'roritier:
200t: Rc;idr:w7ir.J Cumpliancc Farm.s fic��ar.zi 3(1(1%
CITY OF COSTA MESA �
� '� BUILDING DIVISION
� � DEVELOPMENT SERVICES DEPARTMENT
� PERMIT
��
B98-0'1209 f�
PERMIT NUMBER
(714) 754-5273 • Fex (714) 7543&56 gUILDING PERMIT n FAIR DFIVE, COSTA MESA, CA 92626
Job nddress: 2274 W FOUNTAIN WY
Suite:
Vicinity:
Parcel Nunmber: 93074014
npp�iwnt: FONTAINE, JIM
Address:
,-, �
Ownec SCHROEDER-WICSON:
Address ASSOCIATES�� ��' � �"�
� .', '
2411 E-COAST_HWY STE-' �
%SCHROEDER CO�� �
/�/,� �� � ,�
�,
Contractor., �FONTAI N
Address: : %23015 DEL
/�r-/ �, `� ;
�'��•� LAGUNA-HI
i,�� � �
�',j �%%j ��%
Arch�l Eng :� /�j�;,
' �Adtlressi�-�� "��'"�
- � �/
,' , � ,
i
- , �„ i
. . � �
Stalus: ISSUED " D b
Applied: 07I07/1998
Issued: 07I07/1998
Zoning:
Phone:
.- �..ZiP:. . _
, � ��-_
��
Phone: _ � : � � , . ,.� �
-,Zip:_- 92625 i /A� ` �
ES` �+ -�` ��J` \\`�\� \\�
\ ��` �.A�_ �
��.�.���� , � i �,���,A
� - Phone: 714-598-8360 ���� �� ' , � � � `
� �,,, �.. .
; ..
A Zip: 92653 �'� `� �� �
�
License:� 708917 � ����� ��� `
i� �`\� . �
�y �
�L-'.� • ��-
, . . '�Phone:_ ��- �
�
� � � � Zip. �
i . S � . �.
' i �r . � License: �- -
�� .. . _ _ ' _ �. '
� �,
' ' ; '*� " SCOPE OF PERMIT •
M ; � �. - i�.. �
' i' ��. T/O AND REROOF�W! BUILT UP 2274, 2276, 2278, 2280 FOURPLEX. 2000SF.� '
� � ' " _ _ - �� .
� `
� .. , -� .. � ,.��"�-�i � � ^��,a ,�
� ' FEESUMMARY -- .
Plan Check: $0.00 - Calc Valuation: Ss,000.00
' Permit: $99.75 � ' i,'. Claimed Valuation: Ss,000.00
�SMIP Res: $0.50 , , . . _. ',r.-- �— . ,
�SMIP Com: $0.00 - - -- - - � � �
��', Other:�� �� $0.00 � � �
Inspection: - . � $0.00 � ._ '� � " ` _ �� � � �
.,
;�. , C��;,
� Total: � " $700.25 � � �
i �
�: , , . � , . � � �.. , �
,, ��_ .
\ \�.
SETBACKS�� ,-
MAIN STRUCTURE Front �- 0.�0�
ACCESSORY Front 0- 0
PARKING
NOTES:
�.rL111Y1Y11YU p LVIYIIYV ',
, ' ,_ iAi E� • �� . �/
.\ � )' � r� .. ' � �
_.�__ < �r �i,
��Rear �0.0�' � ; LeR' 0-0� . Right .0-'0,��, ��'�
�� �� . , ,
� - ` � � ,, : , _ . - � -': . �.A, , �
� Rear- --0 0-� ="� '-� �CeR - 0•0 - Right 0-0 - �
_ � j
�istinq: - 0� _ � ' Reauired: '_ 0- _,.. , - , , PropOsetl: - 0 � . ' .
. . \ . l , _. . . i .
EXPIRATION: ThIs permlt shall automat(cally expire and become void if work is not,commenced within 180 days, or If work is euspended or ebandoned
tor a perlod ot 7 80 days.
INSPECTONS: In order tor the work aulhorized under this permit to be considered legal, such xrork must comply with all epplicable codes, and all
requlred Inapectlone and flnel epproval must be obtainetl. Faiiure to obtain inspeclions and Mal epproval will result in ihe ezpiretion of this pertnit.
FOR INSPECTIONS CALL: (710) 754-5828
WORKERS' COMPENSATION DECLARATION: . � .
I hereby aHitm undar penalry of perJury one ot Ne fdlowing deGarations: �
❑ I heve end wlll meintein a certificete of consent ta setl-Insure for workera' compensatlon, es proNded for by aectlon 3700 of Ihe Labor Code, for the pertormence of Ihe
work for which this Dermit is issued.
❑ I heve anA will melnteln workers' wmpensatlon Insurence, es requlretl Dy section 3700 of the Lebor Code, for the peAortnence of I�e wwk far which Mis permi� Is issued,
My workers' compensetion Insurence certier enE pollty number are:
Cerrier: Pollcy Number:
(Thls sectlon neetl not be comp/eteO!/ Ne permlf !s valued et me hundred dollers ($100) or /ess.)
❑ I ceN1y Ihet In the pertortnance ot Ne woflc for which this pertnit is issued, I shell not employ any person in eny manner so as to Decome sub�ect to the warkera'
compensetlon laws ot Califomla, end egree that tl I shoultl 6ecome sub�ect to the workers' compensetlan provlslons oi Sectlon 3�00 of the Lebor Code, I shell falhwlU
compty vAth Ihese Provlslons. �7 /�� -�
Applicant SlgneWre: Dale: � � / � %�C
WARMNO: FNLURE TO SEWRE WORI�iS' C�OMPENSATION COVEMGE IS UMAWFUT AND SHALL SU6IECT AN EMPLOVER TO CRIMINAL PENALTIES NA CML FlNES UP TO ONE HUNDRED
THOUSRND OOLIARE (f100,00�, IN ADdT10N TO THE COSi OF C�OMPENSATION, DAMAOES AS PROVIDED FOR IN SECr10N 3708OF THE U180R C�ODE, INTEREST, N!D ATTORNEY5 FEES.
LICENSED COMAACTORS DECLARATION:
I �ereCy eMirm t�et 1 em Ilcensed untle�r� Igns oJ�C�ter 8(commendng with Sectlan 7000) ot Dlvlsion 3 oi the Buslness end Professions Catle, entl my Iicense is in full
force end eHact. Lic. p '! �S`� 1 C�ass a
�CoNrecrofa Signamre: Date: — � ^ J^�
CONSTRUCTION LENDING AGENCY:
❑ I hereby effirtn thet there is a conslruction lending egency tor tha pertortnence of the work for whlch I�Is permil is Issued. (Sec. 3097, Cihl Code).
Lenders Neme: Lentlers Address:
SlgnaWre: Date:
OWNER-BUILDER DECUIRATIONS:
I hereby eflirtn thet under penelry ot perjury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Business end Professions
Code: Any ciy or counry w�ich requires e permil to construct, alcer, improve, tlemolish, or repair any struaure, prior lo Its Issuance, also raqulres tha epplicent lor such permlt
to tile e signed stetement Ihat he w she is licensed Dursuent to Ihe provlslans ot Ne Contractors Llcense Lew (Chepter 8(commencing wiN Sectlon 7000) of DNL51on 3 ot the
Business end Pmtessions Code) or ihat he or she Is eaempt therelrom and Iha basis far the alleged exemptlon. My violatlon of Section 7031.5 by eny epplicant tor e pertnfl
sub�ects Ihe epplicant ta e dNl penalry ot not rtwre Ihan five �untlretl tlWlare ($500).):
❑ I, es owner of Iha properry, or my employees wit� wepes es f�eir sda compensation, WILL DO THE WORK, end the structure is not intentletl or offered for sele (Sec.
7044, Business entl Professions Cotle: The Coniractors lJcense Law tloes not apply to en owner ai properry who builds or improves ihereon, end who tloes such wark
�Imselt or herself ar through his or her own employees, proNded Ihet such Impravements ere not intanded or otteretl for sale. It, however, the building or improvement is
sold wlthin one year of completion, the owner-builder will have Ihe Ourtlen of proving that he or she ditl not Eulld or improve tor purpose oi sale.).
❑ 1, as owner ot the properry, em EXCLUSIVELY CONTRACTING WRH LICENSED COMAACTORS to construd the project (Sec. 704M1, Business end Prolessions
Code: The coniredors Llcensa Law does not eppty to en owner ol property who bulltls or Improves thereon, entl who coniracis for such DroJect wlth e contractor(s)
license pursuant to the ContreIXors license Lews.).
❑ I am exempt under sec. Business antl Pmfeuions Code far this reason:
Signetura: Date:
Owner ID vertlieO by tlrlvets license. ❑ Yes ❑ No Drivefs License No.
VenOcatlon o1 Ownership by (rype ot document, I.e. - proparry tez �III or tleed):
OIVISION OF INDUSTRIAL SAFETY PEHMR CERTIFlCATON:
Ezpires:
❑ I hereDy certlly Nat no ezcavetim frve (5) or rtwre leet In tle0� Into which e person is reQuired to descentl, wlll De made in connection wIN work euthorized by Ihls
portnit, entl t�at no Guiltling swcture, ScaXOIENg, lelSewMc, or Oomditlon or dlsmantling ihereof, will be mare then thirry-ela (38) feet high. (C�ap. 32, Grp 2, M 2, Sec.
361, Title 8, Celitomie AdminisVeWe Cotle).
❑ As owner-Duilder, I vAll not employ enyone to Co work whlch wauld require e pertnit irom Ihe DlviSion oi InOusirlel Selety, es notad ebove, unless such person �es e
pertnit to do such work Irom the diWsion.
SlgneWre: Dete:
Dlvlsion of Indusirlal Safery Permit Number.
CERTIFlCATE OF COMPLIMICE AND AIJTHOH¢A710N OF EMAY: I certity untler penalry of parjury thet I have read Uis epplicetian antl state that Ihe IMortnation given Is
correct. I egree to canply wiih all stale laws end dry ortlinances releting to building constructlon, enC authorize represenlatives of Ihe Ciry ot Coste Mese to enter upon the
ebovatlescribed propery for InspecGon purposes. I agree not to aapy or ellow occupanq ot any bulltling auUOAzed by this permit until tinal Inspection.
� Signetura Of Legel Owner(s) ^ D
�-�-i�-
AnNOr AuNoAzed Appllcent Date
�OOE L INSPECTIONTYPE
1618 Flzetl Syetam Final Fire PrevenUon
1268 Pool Spe Flnel
200 Flnel Re-Roof
201 Final Black/Reteining Well
202 Finel Fectory Flre Plece .
203
204
zasre
Finel $Ipn
Flnel Demditlon
� It��
� l�
COOEt INSPECTIONTYPE
208 Finel Mechenicel
208 Flnel Plumbing
210 Flnal EleCldcel
212
220
FInaIFlre Prevenilon
Finel Plenninp Approval
222 Final Slte
250 Finel Bulltling/OccuDency
�g ��
/
APG�icant to fill in a11 soaces except those within heavy boreer lines ana sign an apv�ooriate aeclarations.
CITY OF COSTA M�E�SA CONSTRUCTION PERMIT P�MIT�py . TRACT NO. LOT NO. UNIT NO.
. Projeci Address a��7i1176 2Z7 Sl,u•9D F`avnTnin V✓� ��5%
ApplicanYSMai�ingAd�drejn- �nQ-� ��! A��_�., ���- �
Owner'sName �/�---�[��n� Phone
Address
Arch/Eng. License No.
Address
Contractor'sName/�^-�`r��f �17�j(p�a,ip�hone�34z�
Addresslmailinglk',�j_�—�B�f-fi�—�6�. �
Ciry license No. _�� %Z�+�p
LICENSED CONTRACTOR DECLARATION
I hereby af�irm that I am licensetl untler provisions o( Charte� 9(commencing
witn section 7000) oi Division 3 oi the Business antl Professions Code, and
my license is in full torce ntl effect. �
License Class License N
DatelD�l�- r5iqnature �
WORKERS' COMPENSATION DECIARATION
,;}.hereby atfirm that I have a certili[ate of consent to Selhinsur¢ or a certificate
.,�::f Workers' Compensa[ion Insurance, Or a certifietl copy thereof (SeCtlon
`�800, Lab. C i ''j� � q�� �
�Policy No. �O `�' �-1— CompanySeC{�Q ��li�i�
�Ce�tifietl �aPy is hiledbwithr[henctl Itling D visio
�g�-�g� '�� ��y��� ° -^ -
� Date- Applicant �'Q(,� .
�� EXEMPTION FROM WOfiKERS' COMPENSATION DECLARATION
'� (This section neetl nat be mmpletetl if the permit is tor one huntlretl ($300) or
Iess).
I certify that In the performance of the work for wnich this perm�t is issued, I
shall not employ any person in any manner so as to become subject to Ihe
Wo�kets' Compensation Laws ot Califomia.
Date $ignature
NOTICE: If, a(ter making this tleUaration, you shouitl become subject to the
Workers' Compensation provisions ot the Labor Cotle, you mus[ fortnwith
comply with such Orovisions or this permit shall be tleemed revoketl.
CONSTRUCT�ON LENDING AGENCV -
I hereby affirm that there is a wnstruction lentlin9 agency tor the performance
of [he work for which this permit is � issuetl (Section .309] Civ. GJ
Lentler's Name
�entler2Atltlrezs .
OWNER 6UILDER DECLARATION
I hereby affirm Ihat 1 am exempt From the Contractor's Licenfe Law for tne
tollowing reason ($ection ]03L5 Business antl Professional Code: Any city or
county which requires a pe�mit to Const�uct, alter, improve, tlemolish or �epair
any structure, prior to its issuance, also requires the appllcant tor such permit '
to fi�e a signetl statement that he/slte is licensetl pursuant to the provisions of
the Contractor's LicenSe Law (Chapter 9(commenung witM1 Section �000) of
Division 3. of tne Business antl Protessions Coae) or that he/she is ezempt
`�erefrom antl tne basis tor the allegetl exempiion. Any violation of Sectlon
D31.5'by any aOPliCant for a permlt 5ubjeCts the applicant to a civil
�e�dlty of not more than five huntlretl tlollar5 (5500j.
LJ I, as owner of the property or my employee5 with wages as their Sole
compen5ation, will tlo the wo�k, antl the st�ucture i5 not intendetl or offeretl
� for sale (Section �044, Business antl Professional Cotle: The Gontractor's
License Ldw tloes not apply to an owner of a properry wM10 builtls or �mp�oves
thereon, antl who does sucn work himselt/herseit or throu9h his or her own
Cmployees, p�ovitletl [hat such Improvements are not intentl¢tl or otte�etl for
sale. If, how¢ver, the builtlinq cr improvement is soltl within one yea� of com-
pietion, the owner will have tne burtlen ot provin9 ne/she tlitl not builtl or im-
�rOve for the purpose of sale).
I, az owner of tM1e property, am exclusively <ontracting with licensetl con-
t�actorsto mnsVuct the projecl (Settion 7044, Business antl Protessions Cotle:
. The ConVactor's License Law tloes not apply to an owner oi property who
builtls or improves thereon, antl who contracts tor such projects with a con-
tractor(s) license pursuant�to�the Contractor's License Law). I am aware that
proo( of their Worker,'s Compen5ation insurance shoultl be provitletl to me.
❑ I am exemOt unCer $ection B. & P. C. for tnis reason
Date Owner —
I hereby certify that I'have read tM1is
infnimatinn IS GOf1¢CL 1 d�l¢E [O COrt1D
the
[ion antl state Ihat the above
all city antl county ortlinances
i, antl here�y authorize repre-
bove-men[ionetl orooertv fo�
Z
TYPE OFCONSTRUCTION LINEW U ADO LJ ALTERATION IJ REPAIR
❑ CONVERSION ❑ OEMOLISH ❑ OTHER
DESCRIPTION OF WORKNSE OF BLDG. �
TVPE OF PERMIT LJ GRAOING LJ FOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL '
❑ OTHER
PROJECT DESCRIPTION SQ. FT. OCCUPANCV_
CONSTRUCTION TVPE VAIUATION $
ZONE GRADINGCU.VDS. ACRES
Remarks:
Bar Sink
Backflow Preventer -
Backflow Irrigation
Bathiuhs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Kitchen Sink
Lavatories �
P-Trap
Roof Orains �
Reinspection Fea $15
Boiler
Duct - Under Ground
Duct-Structural �
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0-100,000 BTU � 100,000
Siqnature - �Date(•V_�"Q)]�
Drivers' Lice e o� 55 � Reinspec[ion Fee $15
GMF 0865-46, rev.4/84 White - Builtlin9: Canary - Applicant; Pink -Atcounting; Goltlenrotl -As5e55or
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Coilectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater �
WaterService f7en'
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refrigeration System .
❑o-ioo,000sru ❑ioo,000eT
System Repair/Alteration
Issue Fee
FEES
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
K Left
S
Ping. Fef. #
Planning Notes:
Automatic Washer
Construction POIpSub.
Cooking Unit '
Dishwasher
�ryers ❑Gas ❑Eler
Fan
F.A.U.
Fixtures --
Oevice Boxes
Outlets
Switches
Garbage �isposal
Generator �0-5 KW [
u
p42B 10/17/B4
Zone
Accessory Building:
Parking Req./Provided
ELECTFICAL
� Transformer ❑ 15-50 KW
❑ 50+KW
Meter �up m 100 amps
Meter �over100amps
Sub Panel
Motors �0-1 HP �1 %� B
Inc.Solar 09-15 HP �16-15+
Pole Light
Range
Sign
Standing Sections
15 KW Trash Compactor
$�— Reinspection Fee • $15
FEES
DEVELOPMENT SERVICES REQUIR
Zaning Approved By
Building Approved By _z
ApplicatiOn IssU¢d BV
$ 3
Issue Fee
FEES
$ 3
Z
O
N
I
N
G
R
E
Q
M
T
S.
� SUMMARV OF FEES
BUILDINGPERMI7 $ SMIP $
PLAN CHECK $ � PERMIT
PLUMBING g S'•d� �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ �.Q�
PLAN CHECK 25% $
%
CONSTRUCTION AND PLANNING POOL ,PA .
�
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Poie. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � � .�
3. •Electrical Cortduit Uiiliiy-Undrgrnd. . 54. Forms
4. Electrical Conduit-Undrgmd. :.a �-. 55. Electrical Bonding '
5. Steel Reinforcerhent :� 56. Rough Plumbing & Pressure Test .
,6. Electrical UFER Grnd. , 57. APPROVAL TO COVER-GUNITE .
7. Footings • ��� 58. Electrical Conduit-Undrgrnd. -
8. Foundation '� i � 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. -� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System • ' 67. APPROVAL 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 �
14. Rough Plumbing� � ` � � 65. Electrical-Final
75. Rough Electriral-Conduit 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
77. -Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20.�Rough Factory Fireplace . APPROVALS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 Conditioning
35. Final Gas Pipe-Test -
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing � Z � (,p�
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer ' '
43. Backflow Irrigation , . . �
44. •Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUC7URE & BUILDING
48. Special Requirements Completed � ' ,
49. Electric Release to Edison .
50. Gas Release to $outhern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
/ � ,9
'� . -. ���JL�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31� COSTA MESA. GALIFORNIA
, , �.
.. u-i .- . . - �'
,. � (� � ��( �� �
—��.,,o�rr_ I1f2-i_ �,`.t—
;'ll\��Iw� ••_"ir_C
_.- n��': \
FOR APPUCANT TO f/[[ /N COMPLETELY F�AFPLICATION FOR PERMIT
TYPE OR P 1 T ` Ct/ •/ l// BUILDING
BUILDINGa�1�JGi7 i � £�`�•4�-� •
AOORE55 t� V
COSTA MESA. CALIFORNIA FOR OFFICG USE ONC7 �
' I FECEIPT NO. �S l���NO.
OWNER P u U
MAIL RECE VE BY DATE HECEIVED�^ DATE I65UEU
AODftE55 � (�i r�/ �C�^IG�_S�
Te�. MIdway BUILDING
CITY Costa M 3 N�� ADDRESS
ARCHITECT ��c. COSTA MESA. CALIFORNIA
OR •INEER W. Jordan No.C-1449
ADDRE55 ]]1 W 1 kl S O ZONE TYPE� GROUP
CONTRACTH$lll E.ROt12ICSOR IRRC NO. ZWOGO BYPROVED � � DATE /D/S�S
�%
ADDRE55 771 W 19th St (�.08 8 M288 ZONING �
ZO I NO. OF I USE OF NEW
LEGAL I LOT 3417� ,
oescaivr�oN NO. 4 BLOCK TRAC P�ANS emwiHG
A.P.NO. ByPRO ED �/ OATE �J^
4n!
OF LOT GS x 135 .14 I How orv �ois REQUSRED rtl � ALLOWED
USE OF ILENTER LINE ST.)
E%ISTING BLDG. FRONT FT. IN.
SETBACK LINE FROM
c[rvrea oF s'racer �1.Z REAR YARD]2 6 R.SIDE '�'_O 0 Ff. IN.
SI�E YARD I LEFT S.O I RIGHT L. SIDE • V O FT. IN.
DESCRIPTION OF WORK
REAR FT. IN.
NE' I XII ALTERATION I II.4DDITION I
REPAIR � I II MOVING I II DEMOLISH I
SZ�EDING3•z X SS ROOMS y STORIES 2
EXTERIOR WAL ROOF
COVERING �Yl1CC0 ICOVERING bLlj.lt (3P '
USE OF BUILDING AND WORK TO BE PERFORMEO
1 HEREBY ACKNOWLE�GE THRT I HNVE READ TNIS PPPLICATION
AND STATE TNRT THE ABOVE IS CORFECT AND AGREE TO COM� THE RMOUNT BNOWN UNDER VALUATION 19 FOR THE
PLY WITH ALL CITY OROINpNCE9 ANO STATE LAWS NEGULATING PURPOSE OF E9TABL16HING A PEflMIT FEE ONLY.
euaoiHc CONSTaUcnOrv. VALUATION
SIGNATURE OF PERMIT FEE $ ��—
PERMITTEE � /' �// (Jl� w S
,J O
$O� �/ d PLAN CHECK $ � J '-�
AUTHORIZED AGE -7 �
TOTAL FEE 5 .3 �
� :. -. -. 1�:���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 31] COSTA MESA. CALIFORNIA
fOR APPL/CANT TO F/LC /N COMPLfTELY
TYPE OR PRINT
BUILDING�a% �.
ADORE55
COSTA MESA. CALIFORNIA
OWNER Paull S Robertson�Inc
MAIL ��X West'19th Steet
ADDRESS
' I_\ ] 1T��9
�LEGAL I LOT � I I�Ia�
DESCRIPTION NO. BLOCK A
A.P. NO.
SIZE _ _ . _ _ _ . I NO. OF eLOGb.
� USE OF
EXISTING BLDG.
SETBACK LME FNOM
CENTER OF STREET
SIDE VARD ILEFT O.p IRIGHT J
DESCRIPTION OF WORK
NEV I X II ALTERATION I II ADOITP
REPAIR I II MOVING I II DEMOL
S Z�E DING .L•L X GO ftOOMS STO.
PERFORMED
, ��".� a��hu�n 3 u�,t_�
�r�.-i t—�7
FIP�FiNCE DEPT. v ��
(�IT`! e`.' inST'�. P.'�«}'�
APPLICATION FOR PERMIT
BUILDING
FOR afFicF usF oNcy
I FECEIPT NO. I �P�qN� �
v a �
IVED BY O T RE IVED DATE ISSUE[
� T �, b--�- � L/� rL _
BUILDING
ADDRE55
COSTA MESA, CALIFORNIA
FIRE /1/
ZONE TYPE ✓ —, GROUP
ZO NO.OF
� PLANS
APPROVED �
BY
YARDS C
REpUIRED
(CENTER LINE ST.()�
FRONT �(�_
R. SIOE
L.SIDE
REAR �1
OATE /i
ING
IUSE OF NEW
BUILDING �
law
la+l
IICII
ff�l
1 XEREBY ACKNOWLEOGE THAT I HI��E PEAO THIS APPLICATION �
ANO STATE THAT THE RBOVE IS 6 T ANO RGREE TO COM� THE RMOUNT SHOWN UNOER VALl1ATION IS FOF.THE
PlY WITN RLL CITY OpDINANCES A TE LAWS REGULATING PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
9UILOING CONSTRUQION. �
VALUATION /'�
SIGNATURE OF 5��� ^_ PERMIT FEE $ `(i"�
PERMITTEE 1��
/
PLAN CHECK $' LJ
AUTHORIZED AGENT TOTAL FEE S �`�