HomeMy WebLinkAbout2799 FRANCIS LN - Building Permits�
PPOJECF.AUOflE55: Z% 9 9 FRANC I S LN
OWNEfl'S NAME: JAMES C. ROSENFELS
aooeess: 461 S GLASSEL
ORANGE CA 92666
714)532-5939
uxiT:
ANCNIENGINEEfl: XEG.NO.:
ROOflE55: UNIT:
PERMITTEE:• JAMES C. ROSENFELS ( 714 ) 532-5939
aooeess: 461 S GLASSELL
ORANGE CA 92666
IICENSEU CONTBRC70fl OECIAMTION: I �ert0y ailirm �hat I am lit¢n5M un0er prOvisions ol Clupter 9(commencinp wilh Seciion
7000) oi Oivision 3 ai �Ae Business an0 Pmle55ion5 CoOe, anG my li[¢nse is in IM �Orte an0 e�feci.
CITY LIC.: ST�TE LIC.: CUSS:
Da�e: SiBnaWre:
WOBI(ENS' COMPENSRTION OECIANaTION: I nereby atfirm �nat I tuve a cenilka�e ol wnsent ro sell�insure or a cenificate ol Workers'
CAmoensalion Insutance. or a ttnifiee wpy tnereal (�tbn 38011. LaD. C).
�`L1LY NO.: E%P. ORTE:
OMPRNY:
❑ Certilietl copy is �ere0y tumi5�e0. ❑ Certifietl copy is file0 with t�e ciry BuilAing Oivision.
Date: MD����
EXEMP�ION FflOM WOHKEflS' COMPENSRPON �FGAflAT1UN: (ilus ' roi bec �mp�l¢IeA if tlie pdfM 6 ta are huqreG (5100) M kss�.
I ceni�y that in ��e pedarmance af t�e vrork la wtiic� tlus permt' icwM, stwll not elnp' an erso ' an 5o a5 to �ecome
subjeci lo e Workers' Campensa�ion Laws o� tafdomia.
�. �ate: � Siqnawre:
NOTICE: If. alter making iMs aeclaration, you stloula Detame suoi¢CI ta tne wo rs Compen5a i n ons of Ihe LabOr
Lode. you must lanrnnin comoN �+�h wcn Drwisioas w tlrs permii snao be Ueemea rewked.
CONSTHUCTION LFNOING RCENCY: I �ereby atlirm tlul I�ere ¢ a construction IwNnq a0enty lOr I�e pedormance ol �he work IOr
w�ith IhiS permii is i55ue0 (Seciion 31197, Civ. C�.
tENOEfl:
RODflE55:
OWNEB BUILUEB OEClAfU710N: I here0y atlirm tlut I am e.empl imm �M Cantractars' Staie License Law lor ihe iqlowinp reason
�Seciqn 7037.5 Busineu and Protessional COUe: My dly of COunty wAi[� reyuirPs a permit to conslmcL alier, improve, Oemolish, or
reoai� any simclure. Orior lo ils issuance, also repui2s Itle apd�nt lot wf71 Oema� to lile a sipn¢G statement Iliat ne/s�e is IittnSeG
pursuant to ine prorisions of the Contracrori Swte Lrcense Law (CnaD�e� 9(wmmenpnp witn Section 7000) af Division 3 0l �he Business
an0 Proles9ons Coae) or Ilut nUshe R e*empt tnerefmm an0 ine GaSis lor ine all¢pea eYemO��on. Any Wolalion al Section 7031.5 Uy
any applicant for a permil sub�ttts t�e appfitdnl to a Civil pMalry of not more ttun Ine 11unAreO Oollars (5500�.
� I. as awner ol Ihe propeny or my em loyees xitn wa0es as ineir wla compensation, win do iha work, antl Ine
strucmre is not inteiMeE or ottereE for sale (��wn 70aa. Business aM Pmlessional CoOe: Tne Contractors' Stata License Law
GOeS n01 apply Io an ownet o� a O�op¢riy who Ouiltls Or impmve5 lM2on, an0 who tloes Sut� work him5ell/her5ell or I�muph
� �is ar �er own ¢mD�Wees, provi0¢O t�ai Suc� imprwements ar2 n01 intenECd o� ollereE lor Sa10. I�, howevel �he EuilCinp or
im0�ovement i5 SoIA wi1Nn one yW� al COmpletipl. t�e Pxner wi0 luve t�e hurAen of D��np hY/she Ui0 nol hui10 or imOrovc
lor ine ouroose a� salel.
I, as owner ol Ine propeny, am exGu9vely contractinp wit� IicenseE toniraclors Io fAnslmcllAe Droleci (Seclion 70Ca, Business
❑ an0 Piofessioiu CaOe: The Contraclors State Lkense law Gces no� apqy to an ovmer al prope wM OUACs or imOrw¢5 iAereon
u
ana wAo wniracts for sucli Drojecis with a cantractorls) licenu Oursuant to tne Contractors' tata Lmense Lawl. I am awam
inal D�ooi of Ihei� Worker's Compensation insurance sMula De 0«� �a e.
� � am exempi mMer Sec�ion: % O�I �I 8. 6 P. C. �
rormisreason: /B�EPC /�SEE CODE
Oale'. �l�/ � Owner. �
I
I do hereey cenity Inat I am aware of ana unUerstane ihe �epuirtmenls ol Califamia Hea�ih antl Salely fAde Seclions 25505, 25533, antl
25534 dOtlilldl 10� d0ylp10tE OIIi1Ai�A OCNpdtllvnlVWiII�O��GfCIC OfIG) IICBOIO COrtlply WIIIISdiO S�diE COQCS d041110 fCQNfCfI1CtIISi0f2
permil lo� constmtlion or rm0ilicaiion Irom tlu Air ualiiy ManaOemen� Oistricl. flev0ential conslmciion apDlicalions are eremp� Imm
mese omvisions.
Daie: Appl¢anl:
1 �erety cenity t�ai I have reaa i�is appl¢ation antl state t�al t a�ove in rmalion is correcl. I agree m camply 'IA )I i�y an0 county
ordinancesanOSWlelawsreW�inptobuilEingconsimc�ionantlneebyamMru represeniriive i,cilyl Ier 1(e ov� enlioned
pmperty ^lor inspeclion Durpose�s.j
Date: O /0 / (� Signalure:
Driver s �icense o� Sacia� Securi�y �:
r —�
��"��6 Whne—Buildina: Green—Catle Enlorc¢menC Canarv—Aoolicanl: Pink—Revenue: GolEenroE—Assossor
CITY OF COSTA MESA — BUILDING PERMIT rtx� NV: ltl ��ol
PERMIT NO: IB 056180 PLAN CHECK NO: N i: rv �ur :
CONSTRUCTION TYPE: PERMIT TYPE: OTH STR PURPOSE: OTH
JOH DESCRIPTION ; LEGALIZE ADDiTIONS SQ FT:
CLAIM VALUE: CALC—VALUE; GROIIP OCC: R-3 /
COMMENTS; RE:B46401/B45801/H38557/B38443
*+��*���**�***�x�*�*�*r***x�v*�c•******���*r�*�x**�x-x�c*xsc�*��x*x�*+�***K�c����x�t*��t*�e#
Z O N I N G R E Q U I R E M E N T S "
S E T B A C K S
------------ MAIN HUILDII�G ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: rT IN
LEFT: FT IN RGHT: FT 1N LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL; 14133111 ZNE: REF NO:
PLANNING Nt3TES>
)
iE if iE if �f jF iE ik iElF iF-1E iE iF if 1E iE aE iE ic iF # if iF iE 3t-i'r iE i!� iE iE iE+t 3F !E ii� 3e iF IE iF 1e ie if ih iE 3h 3E iP IF* 1F i!� iE iF if #E lf if *�1E i(• iE k� ii� 3E k 3f iF (F (E iE 1F If 1f ii� ii� if iF ak
D E V E L O P M E N T S E R V I C E 5 R E Q U I R E M E N T S
7,ONING APPROVED BY .
HUILDING APPROVED BY ;
APPLICATION ISSUEDis� ��
itiEiFIF3FjEaEiFiEklFielF3ciEific Lac 3
iF 1f �E If iF IF iE iE iE iF IE ff iF # IE if iE iE if IF iE if if iE ic if IE if 3E iE i(-if iE i(�
LEGALIZATION:Y F E E
HLDG PMT PLUMBING ELE
DATE;
DAT'E :
�E i6 iE iE iF if it iE iE if iE iF iE 3f 1E if )f ik IF K� if iE iF 1FiE if �F � iP %� 3E ii ik 3f i� R if A'� R ih
U M M A R Y STRUCTURAL SEGMENT:Y
MECHANIC FIRE SMIP/RES GRADING
PERMIT 30.00 �
SMIP/NON—RES
PI.AN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK 'TOTAL PAID DUE
TOTALS----> 30,00 0,00 0.00 30,00 30,00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 30,00 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30.00
�lt If iF iE 1F 9F iE ik 1E it iF !t IF iE 3f �E iF M� iF ie iE k iF if iEif 3f iF 3f if iE-%if 1E 3e iE fF iE IE if� iE 3F if 3P iF iE iE IE ii� if iFie f! �E it le iE k iF if K iE if �)t if iE iF 3(� k fe iF �e ii� iF li iF if N� iP
I N D I V I A 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 Z O N UNIT COST TOTAL COST
INS 1 BUILDING RE—TNSPECTION FEE 30.00 30.00
END OF cEES
��'A �1�. ���'.i'•f.����ri�._ ' '- . _ _
��
7ATE: . 'C, �.- ":,�'. .
• GONSTRUCTION AND PLANNIN6 � & SPA
" f qPPROVALS Permii # Date Inspector AppROVALS Permit # Date lnspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. $oil Pipe-Undrgmd. 53. Steel Reinforcement
3. Electrical Conduit UtilityUndrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reintorcement 56. Rough Plumbing & Pressure Tesi '
6. Electrical UFER Grnd, 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. 5tructural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ,
12. 5ewer Cap . 63. Heater & Vent•Final
73. Roof Drains 64. Plumbing System � Final �
14. Rough Plumbing 65. Electrical�Final
15. flough Electrical•Conduit � 66. Soiar SYstem�Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
�
78. Rough Electripl�T Bar Ceiling 69. POOL/SPA SYS7EMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ��
20. Rough Factory Fireplace APPROVAIS Permit #
21, pucts, in Structure 70. Underground Hydro
22, puas, Ven[ilating 71 . Product Piping O 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 IStructurall & Monocoat 75. Dry Chemical
27, Frame and Flashing 76. Dry Standpipe
28. Lathing & Sidinq 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Orywall Nailing � HEALTN DEPT. RE�UIREMENT
31. Plaster Brown Coat � 79. FINAL �NSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Pinal Electric � Notes:
34. Final Heating & Air Conditioning ' �
35. Final Gas Pipe�Test �
36. Hood or Canopy
37. Finai Factory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service•Final
41. 5olar pomestic-Final
42. 6ackflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem
45. SoUnd Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING � Q��
48. FINALPLANNING
49. Electric Release to 2dison
50. Gas Release to Southern California Gas Ca
51. CERTIFICATEOFOCCUPANCY
No. Date
�
Pfl0.1Et��PESS: �799 FRANCxS LN
� OWNEP'SNRME: JAMES C. ROS�NFE�S
aooaess: 461 S GLASS�L
ORANGE CA 92666
714)532-5939
AHLN/ENGINEEN:
RODPESS:
XEG.NO.:
UNIT:
UNIT:
PEHMITTEE: JAMES C. ROSENFEI.S ( 714 ) 532-5939
aoosess: 461 S GLASSELL
ORANGE CA 92666
❑CENSEO CONTflRCTOB OECIAMTION: I here0y atli�m Ilial I am li[enSeA urdEr prmi5i0n5 oi C�aD�er 9(cammencinp vni� Sectian
7000� of Divivon 3 of t�e Business an0 Pmlessims COE¢, an0 my littnu is in lull force anG elleci.
GTY LIC.: ST�TE UC.: ClA$S:
Daie: SiAnaturC:
WOAKEBS' COMPENSA7IDN UFCLAMTION: I �ereDy alfirm Wt I INve a ce�iliCdle ol t0.nsenl to ull�inwre a a cetlifiCdte ol Worker5'
�omvensalion Insurance. or a cenifieE copy inereol (&ction 3800, Lab. t).
1LICY NO.: EIP. O�TF:
COMPANV:
❑ CenifieA coDY �s hereDy fumisne0. ❑ Cenilied �py i� Ii1etl wt� tAe dty 0uiltlinp DNision.
Oare: ApDtiun�:
E%EMPTION FPOM WOflKEflS' COMPENSFTION OELIAPATIpN: (ilus ucLon nce0 mi Ee rnrdeted il Ne pertil6 ta ae h�qrW (5700) Or k55�.
I cerlily Ihai in lhe pedormance ol t�e work for wltiU �h{y perm ' G. I Stull ny em/pyl 4.)pny Oerson /i9/� nner 50 a5lo Decom¢
suUjea toJ e Wo�kers' Campensation Lavrs of Calilomu. �V // !/ ��
� .. /
oate: � Sipnaturp;
NO710E: II. after rtWkinq t1u5 eGaratbn, y0u ShoplE �Cto w�jett to �he orkC�S' m n prwi5ion5 o itle LabOr
CoGe. you mu5l Iwttrm�h comON *+�h Sut� prov�ipnt ur (tis permii slull EB GeemeO fewke0.
CONSTflUCTION LENOING RGENCY: 1 nere0y ailirm @u� inere �s a tanSWctiUn IetMinp apenq �or the ceMarmance ol Ne woA lar
wnicn �nis permit is issue0l�tion 3W7. Civ. tl.
LENOEN:
ROOflESS:
OWxEB BUILOEN OECIAMTION: I hereDy ailirm ina� I am exempt Irom ine Comracmri State license Law lor �he I011ovnnA �easan
(Seciqn 703t.5 Busineu anO Pmlessbnal CaEe: pny rity ol counry wNcti repuira a ce��i �o cori5vucl, atler, improve, aemolis4 ar
repair any struCNre. prior to its iuuarKe, als0 reduire3 tlre apWiant tm SUU pCrrtXt to file a SpneC sWtemenl Ihat liahhe is licensetl
pursuam m the o�ovisions ol I�e Cantracmri State Licenu Law (Ctupter 9(comme�np wit� Section 7000) ol 0ivision 7 0l ihe Business
anG Pmleuions COCe) oi Ibal MJs�e a e.empt I�eRirom azM Ihe Odss lor t�e aACpM evemption. My violati0n ol SEtI'qn 703L5 by
any apDlicant lo� a De�mit suUle��s I�e appliwnl �o a pivil penatiy al not mOre ttun IWe �unJreO Uo0ar5 (5500).
I, as owner ol ihe D�oDeny ar my empIOyees wit� wap¢5 as I�eir Sole fAmpensation, will Oo IOe work, an0 Ihe
� Slruclure is nol inl¢nEOE Or 0110r¢01o� sale (SeC�qn 70aa, Buvness anE Pmfessional CaUe: T�e Coniraciors' State License Law
tl005 nol a001y 10 an owner ol a prOperiy wlq builGS Or improves Ihe�¢on, an0 who Ao¢5 Sut� waA him5¢II/hCrsell Or Inmuph
nis or ner own emoloyees, pmvia¢G tAal sucn imprwemenis are nat intenOeO or ofleroa lor 5ale. II, nowevei ine Euilain0 or
improvemenl is sol0 wii�in one year al mmpletiw, t�e ovmer will have ��e DurOen a� Dmdnp hrJshe Oi0 not huilC or im0�ove
lo/ Ine puroose ol salel.
I, as owner ol Ihe pmpeny. am eKclusivery comractinq vril� IicmSeU coniracmrs lo canstmcl I�e pmlect (Seclion 7p44, Business
❑ anG Pmleuiore CaOe: The Contractars' State ��� �aw pces not appty to an oxner al properry x1n OmIOs or improues thereon
ana wlro conirac�s far suc� Omjec6 vfi� a canVaciar(5)license pursuan� to IbB ConVactors' Slate LicenSe Law�. I am aware
I�al pr001 01 I�eir Woder's COmp¢n5dli0n it6pranCC SMuIU Ge 0«4e0
'� � am eMempi ur�ee� 5ec�ion: % O 4�i B. 8 P. C.
mrinisreamn: BEPC i�P.6fi CODG
Oate: o`- — � � ^ /' � O.mer.
I eo nereey cenity Inal I am aware al an0 unaerslantl ihe requirements al Cdlifomia Heattn anE Salety COUe S¢ctions 25505, 255J3, anJ
� 2553C an0 ihal I Or any Iuiw¢ OuilCinq ocapani vnlUvnp �oi (tirtle one) neetl IO COmply vnih SaiE Slaie COJ¢5 antl lhe repUitemenls fOr a
Ipermit lor cansimclion or moatlication Imm Ihe Air Ouabry Manapemenl Dis�ncl. fle5i0enlial cansimttion applicalions are exempi Imm
�flese OrovlSians.
Daie: AO��icanl;
I here�y t¢tlityihal I hav¢ reaU I�is applitali0n antl Sla�eltwl I�e a einl ma�i0ni5 tOrre . eio Comply vn all '�y and touniy
orGinancesanOslalelavrsrNalingloOwWmgconslrucliaianGnere �au�lqr¢ re0�e5¢n�31N oilNsi yla Ierup ve�men�ionetl
pro0erry Ior inSpeclion purposes.
(� � /l �i1 //
Oate:� _���% � SignawrN: / T/ V
Driver's License or Sacial Securiiy tl: �
t6a�-46 Whne—Bviiainp; 6reen—Coae Enlorwmenl: Canary—Aoolicanl; Pink—Revenue: Goltlenrotl—Assxssnr
CITY OF COSTA MESA — HUILDING PERMIT txM NU: lY �oin,
PERMIT NO: IP 056182 PLAN CAECK NO: N � i: n Sui .
CONSTRUCTION TYPE: PERMIT TYPE: OTH PLi] PJRPOSE: OTH
SOH DESCRIPTION : LEGALZZE ADDZTIONS SQ FT;
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /
COMMF.NTS: RE;EP 45958
iF�lf iE iF �)f iE�IE iE�1f if IF�M iE # if iE 9E if 3c je�li if iF if �lf lF iFii� df if ��-lf i't iE 3F iE iE �lE iEiE �%� �IF �1f� iE iE jf iE iF dF rf If �ik �If iF �7F �lE�lf if �le 1F�k �If iE iE �1F iE �)f dF �1f iE iE iE #�N• �ikif 1i� � 1E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BTIILDING ---------- --------- ACCESSURY BUILDING ---------
FRNT: FT ZN REAR: FT ZN FRNT; FT iN REAR; FT IN
LEFT: FT IN RGHT: FT ZA1 LEFT: FT TN RGHT; FT ZN
PARKING REQ• PROV: PARCEL: 14133111 ZNE: REF NO:
PI,ANNING Nt7TES>
>
3F �1E �F?f ie i(� i! ji �F d'r if �f aF if •Y� V� R iE iE jE �1F iE iE iE iF iE iE � iF %� �lE 3(-1'r iE k�7(� iE 3'r iF if iF ii iE aE ii� iE if �IE 3E if 3't jF �.iF 36 3e if?f 1f if iE ii� iE iF iF i4 if li iF ii �R iF 3�: aF 3P �k iF 1E iF
D E V E L O P M E N T S E R V Z C E 5_ r� E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY ; DATE;
APPLICATION ISSi]ED DATE; ?i2�`�
#3fiElfiFiFiEiEiElFiEiEiFiflf�f3fiE iFif3E.. .. , xyrfr .. �if�fiFieaFie#�3Elf r. iFiE
i6iEfFiflF3EkiFiFiEiEiFjEiFlFiEi't1i* x �iEiEiFifiEiEiEiF3F1fiP1ki43fiFif' i(�ifiFik3eii�fihfh�lE�iEiEiF#'�fFif3Elf�iFiEiE1E�FiFifiEif3F3E�1'riFihiFlf3fiF
LEGALI2AT_TON;Y F E E S M M A R Y STRUCTURAL SEG,�ENT:N
BLDG PMT PLUMHING ELECTR7' MECHANIC FIRE SMIP/RES GRADING
PERMI't 60 , 00
253 SMSP/NON—RES
PLAN
I5SUE FEE
BUILD3NG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 60.00 0,00 O,OU 60.OU 60,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 60,00 OVER/SHORT: .00
BI.DG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
60.U0
iF i(� ik iE IF �1(• �N-iE-1F IE IF ielF iF ik if )F if if if iE iF if iE if iE iF iE iE iE 1ElE iE iF iF if 1E i6 af !'r 1!� fE iF iF iF ie 3f if iE iE iF it �]E i( i6 iE 3f if iF 1E 1k IE iF iE iE if 1f ie le !t!F!e i(� )f R iP 3b k� iE
I N D I V I D U A L F E E B R E A 3C D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 PLUMBING RE—INSPECTION FEE� 30,00 30,00
END OF FEES
oi aii�;e�a,.-,ri�,,�-s
aaTE: c2rlu/91 ,. �
� CONSTRUCTION AND PLANNIN�,
APPROVALS Permit#
i
P i. Temporary Electrical Service or Pole
2, Soil Pipe�Undrgrnd.
3. Electrical Conduit Utility-Undrgrnd.
4. Electrical Conduit-Undrgrnd.
5. Steel Reinforcemen:
6. Electrital UFER Grnd.
, 7. Footings
8. foundation
.9. Water Pipe-Undrgrnd.
10. Structural Floor System
11. Property Sewer Line & House Connection
12. Sewer Cap
13. Roof Drains
14. flough Plumbing
15. Rough Elettrica6Conduit
16. Rough Electric Wiring
17. Rough Wiring Sign
18. Rough Electriral�T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. DuMs, in Structure
22. Ducts, Ventilating
23. Gas Pipe�Rough & Test
24. Roof Framing
25. Roof Sheathing
26. T-Bar Ceiling (Structural) & Monocoat
27. Frame and Flashing
29. Lathing & S�ding
29. Insulation
30. Orywall Nailing
31. Piaster Brown Coat
32. E�ectriwl Power Meter�final
33. F�naf Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37, Final Factory Firepiace
38. Final Plum6ing
39. Water Service-Final
40. Gas Service-Final
41, $olarpomestic-Final
42. 6ackflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. 5ound Attenua[ion
46. Nandiwp Regutations
47. FINALSTRUCTURE&BUILDING
48. FINALPLANNING
49. �lectric Release to Edison
50. Gas Release to Southern California Gas Q
No. Oate
Date
A
�L & SPA
Inspector qppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reintorcement
54. Forms ,
' 55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER�GUNITE '
58. Electrica� ConduibUndrgmd.
. 59. Gas Pipe, � Undrgrnd., Test
60. Backwash Lines, P•Trap, O Undr9rnd.
61. APPROVALTO DECK
62. Backwash & Receptor-Fina�
63. Heater & Vent-Final
64. Plumbing System � Final �
65. Electrical�Final ,
66. Solar System-Final
67. Fencing & Access ApProval ,
68. APPROVED FOR PLASTERING �
69. POOVSPASYSTEMSFINAI
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. ProductPipin9OGas OOiI
72. Underground Flush
73. Undergrnci, Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENi
79. FINAL INSPECTION
� 80. FOOD CERTIFICATE ISSUED
Notes:
��'i
Date �Inspector
0
rnooncss: 27y9 FRANCI'.S LN
, 'SNAME: JAMES C. ROSENFELS
RDOPE55: 961 S GLASSEL
ORANGE CA y2666
714)532-5939
PflCH/ENGMEEP:
ROOHESS:
flEG.NO.:
UNIT:
UNIT:
PEPMITTEE: SAMES C. ROSENFELS f 714 ) 532-5939
aoosess: 461 S G1�ASSELL
ORANGE CA 92666
LICENSEo eOxTPPtTafl oEUABFr10N: I nereoy allirm inal I am licensea un0er orovisions ol GnaD�er 9(cammencinA `^'��� Settion
7000) ol Division 3 0� �he Business anA Prolessinns Coae, an0 my license is in full torce antl e��eci.
CITY Ut.: STATE LIC.: CUSS:
Date: Signature:
WONRFflS' COMPENSpiION OELLANATION: I n¢re�y alfirm that I have a cenilicate of tonsent to selbinsure or a certificate aI Wotkers'
Compensation Insurance, or a cenified coDY ��ereol �Section 3800, Lab. C).
7LICY NU.: EXP. ORTE:
COMPFNY:
❑ Cenifiea copY is hereby fumishe0. ❑ Canifie0 caDY is IileC with �he cily Builtling Division.
oale: APp�icant:
E%EMPTION FBOM WOHNEBS'COMPFNSATION UECLAqpTION: Qhis uctron neetl na�becompleteOi�tl�epermiiisfaone hunGrp �5100�orkss).
I ce�ity tha� in t�e pedorman[e o� the work for wpich Ihis permi� is ij5 �ed�. I s�all nol em I°P�7'Qerson in any n b as lo �ecome
5u01e�� �o he Worke 5' Co`pens ion Laws o� CaliPornia. / 1 � 1����
J� L-. J
�a�e' Signa�ure: d� SA
NOTICE: II, al�er making �his eclaralion, you Should become su lect lo lhe WOBers' Compensation pwvisions ot Ihe Labor
COtle. you mus� Iori�wit� [omply with such p�ovi5ion5 or tks permil stull be tleem¢E remke0.
LONSTNUCTION LENOING �GENCY: I �ereby affirm t�at t�ere is a constructwn lendinp agen�y lor IAe pedormance ot Ihe work lor
which t�is permil is issued (Section 3097, Civ. C�.
IEN�Efl:
nooaess:
��. OWNEfl BWLUEB OECLAflRTION: I hereby aflirm ��at I am exempl Imm l�e ConVactors' Slaie License law br lhe Poilowinp reason
�Section 7031.5 Business antl Pmfessianal Cotle: Any city ol caunty whic� rtauires a Oermil to wnicruct, aller, improve, Oemolish. or
�eoair any siNCWre. Drior ta i6 issuance. at5o rp0uires t�e applicdnl for such permit to lile a siBneO statement tllal �Pls�e a Iicen5e0
pursuant m I�e pwvisions of I�e Comraciors' State Lianse Law �Chapter 9(commencinp with Section 7000) of DNision 3 al IAe Buvness
anU Professions CoOe) ar Iha� he/she is exempl ��¢relmm and Ihe basis �or I�e allegeA exemp�ion. Nny viotalion ol $eclion 7031.5 Dy
any applicanifor a p¢rmi� suGjects Ne applican� to a civil penal�y of nol more �tWn five �untlreE dollars (f50J�.
I. as awner of t�e pmperty or my employees wit� wages as their mle wmpensation, vnll Oo Ihe work. anA the
7 s�mcWre is noi intenaed or otlere0lor sale (5¢ction 70ad. Business anU Pmiessional Cotle: T�e Contractars' State License Law
tloes nol apply �o an owner o� a pmpeny wlio builes or imD�oves I�ereon, and who Ooes suth work himselVhersell or I�roug�
his or �er own emDloyees. O��detl iha� such imprwemenis are not in�entleC or olfered lor Sale. I1, tWwever ihe builUing or
impmvement is wla vn�hin one year ot Compleiion, I�e owner vnll have �he Curtlen a� O�ovin0 hpJshe tliE noi hui10 or imprwe
for the purD�se of Saie1.
I, as owner o� the pmperly, am eeclusively �onlraciing wil� lit¢n5e0 Conlraclor5 io COnStNt� Ihe pmieti (SeC�ion 7044. Bu5ine55
❑ aM PrO�utions Coae: The CqntrattOrs' $�ale LicenSE Law AoeS nol appty fo an owTef at 0�ope�ty wh0 Ouil45 or imD�oveS iher¢On
and who cantratls for sucA D�ojects with a contractoqs) licenu Dursuant to t Comracmrs' Siate Li�¢m¢ Law�. I am aware
t�at proof af their Worker's Compensation insurance s�oulE be pmvi0etl t e.
� � am exemp� unaer 5ectian: 7 O 4 4 B. 8 P. C.
m�rtnisreason: BEPC SEE CODE
Uate: f,.� � i D � �a- �,e,:
I tlo nere�y cenily Inat I am aware of antl unaerslana Ihe reauiRmenis oi Calilomia Healih ana Salety fAtle Seclions 25505. 25533, antl
2553d antl t�al I or any fulure Duilding acupant VnlVwill not (tirGe one� neeE to compry with 5ai0 state COGeS an0 ihe r¢QuiRments lor a
p¢rmii for con5lmciion or moEilica�ion imm I�e Air Ouahry ManaAemenl USVici. BevCeniial conSlmciiun appliWiions ate eMempi iram
��ese pmvisions.
Uale: ADOliwnt:
I h¢reDy cerii�y t�a� I have reaU Ihis application antl ilate ttul ihe a� 'nbrma�ion is correc�. I aA�ee m comply wi�h all city an0 caunry
oitlmance5anO51a�elaw5�elaling�o0uiltlingcons��uclionana�ere auiho tereDreunla�iv¢sliflhiscii Ioenteruponl b -menlioneA
pmDerty for inspeclion DurD�ses.
Date: � � �� Siynamre:
od�ers uce�se a� sociai Secudty M: �
tbaba6 W�ae—Builaing; Green—GOEe EnlOrtemem: Canary—Ap0lkant; Pink—Revenue: oltlenroa—Assessor
CITY OF COSTA MESA — BUILDING PERMIT rttt nc�: l�. v�o ui
PERMIT NO: IE 056181 PLAN CHECK NO; N �� Sur�-Y
CON.S'TRUCTION TYPE: PERMIT TYPE: ELE OTH PURPOSE: OTH
JOB DESCRIPTION : LEGALIZE PJ)DITIONS SQ cT;
CLAIM VALUE: CALC—VALUE: GROUP OCC; R-3 /
COMMENTS: RE:E46244/ EP45958
�1( # �lf-�)f •lf if� if iEiE iF-1E d(� if �1E ih iF # 3f 4F 3( �IE if �� �lt �k iE �Jf #�1E i( �7F �1E��1h �lE �lE �7E if it �If �iFiE �lf jf-�7E �If �K� �lE-1E # IE if -0F �% IE �iE 1E 1E it K �X� 9f iE�1Edf-�lE K �lF �N �� IF �1F �1f # �k �k iklf �f dh
Z O N I N G R E Q U Z R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY B[JILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
I,EFT: FT YN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 14133111 ZNE: REF NO:
PI�ANNING NtSTE5>
)
if if 1E if iF ik )R �1F fE �1E iE fF iF 3f 3f 1M1 iF �f k R if if if• iF iE 1f IF f(� 1f �%iE iE if k�f ?E iE iE iE ff IE IE if ii• iF iE 1E 3f if iE iE iF IF if 1E if IF # k 3F',f�if if iF iP ii� 3f if iF iE ie iF 3f jE iF if iE # iE
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 DATn;
BUILDING APFROVED HY :
APPLICATION ISSUED
if iE if if )f iE k iF if iP if iE iE iE if ii i! .
iEiE�lE�flflfiEiFiEjfiff4iFifiejFieif � ifikiEiEiE�lEifiEjflfifi�
LEGALIZATION:Y F E E
HLDG PMT PLUMBZNG ELE
PERMZT i
DAiE;
DATE: ���'Z--
x,r ie+r 3EiE3F1Er.�iekiE3Elf ir x �k�R
iE iF �E 3F iE iF # IE iF if 3f 3E 3E iF if %� �E ii� M��C� IE iE iE If �E iE iF i� #� iF iF if iF iElf� A� �i ie i if
U M M A R Y STRUCTURAL SEGMENT;N
MECHANIC FIRE SMIP/RES GRADING
/ 503 SMIP/NON—RES
ISSUE FEE 1
BUILDING—UZV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 60,00 0,00 0,00 60.00 60,00 ,00
REVENIIE DIVISION TOTALS--> COLLECTED: 60,00 OVER/SHORT; .00
HLDG PMT PLUMBING ELECTRZC MECAANIC FIRE SMIP/TOT GRADING PLAN—CHECK
60,00
)E iF iF IF )F 3F if iE iE iE iE iF iE �7F 3f 3f #�76 iF iE iF iF if iF %� iE if 1E 3F if 1E i! iE 3E if k aF if iF iF lE fk if 1f ie ib if 3E if if iE IE 1E iE if iF iE 1E ie jF i:� ie if ! i!-?E iF 3F iE #E �F ih 3F iF 3e }:� 3F �li-�E
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 Z O N UNZT COST TOTAL COST
ELE 1 ELECTRICAL RE—INSPECTIOIJ FEE 30.00 30.00
END OF FEES
S:i ���._ �_.:-rn.,� _ ..
��T�: 6?�t: , .' _ ._
��
CONSTRUCTION AND PLANNIN6 - �' $ SPA
APPROVALS Permix # Date Inspector AppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & EQuipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrica� Conduit Utility-Undrgrnd. 54. Forms
4. Electrical ConduibUndrgrnd. _ 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electr�cal UFER Grnd. 57. APPROVAL TO COVER�GUNITE
` 7. Footings 58. Electrical Conduii-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgmd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor System 61. APPROVA� TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. $ewer Cap 63. Heater & Vent-Fina1
73. Roof prains � 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-final
15. Rough Electrical-Conduit 66. Solar System�Fina� �
16. Rough Eleciric Wiring '. 67. Fencing & Access Approval .
17. Rough Wiring Sign 68, qPpROVED FOR PLASTERING �
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL �
19. RougF+ 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 D Oi�
23. Gas PiPe•Rough & Test 72, Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (S[ructural) & Monocoat 75. Dry Chemical
27. Frame a� 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. Electriwl Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric 2,� � Notes:
34. Fi�al Neating & Air Conditioning
35. Finai Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Firepiace .
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final ,
41. Solar Oomestic-Final �`
42. Backttow Preventer � � �
43. Backfiow irriqation
44. Landscape Irriqation Svstem
45. Sound Attenuation
46. Handiiap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Souihern Caltfornia Gas Co �
51. CERTIFICATEOFOCCUPANCY
No. Date
Pfl0.1ECTR00NES5: 2-�9t3 FRANCIS LN
OWNEN'S'��ME: �7AMF_S� C. ROSENFEI.S
� aooxEss:451 S GLASSEL
OF7ANGG CA 92666 ,
1HCNIENCINEEN: � 1 4) 5 3 2— 5�� 9 ,
noneEss:
NEG.NO.:
uxir:
uxrt:
PEflMITTEE: f�„tES C. kOSENFIs'LS, (714)532-5939
RODflESS: Q(L S GLASSF'LL ' ' -
ORADIGE CA 326G6
LICENSEO CONTMCTON UECUIU710N: I �ere0y aKrm that I am Iicense0 unGer proMsions of Chapter 9(commencinB ��h Section
7000) of DNision 3 of the Business antl Prolessions Cotle. antl rtry licenu a in full lorce anA ellect.
cm uc.: srnre uc.: cuss:
Data: Sqnature:
WOPHEBS' COMPENSI1t10N OECIAMTIOX: I hereGy atlirm Vut I have a rxrtiBwte o/ consent ro self-insum or a certiticate of WOMers'
Compensation Insurance, ar a cetlilie0 copy IAereol (Section 3800, LaG. C�.
PoL�CY NO.: E%P. O�iE: ,
COMPRNY:
. e;.� CerlitieA wDY �s Aereby fumi5hed. ❑ CeN�etl coDY ���led with Ne dry BUIIdinO DivLsion.
�.�
:ate: Ap0licani:
IXEMPfION FlIOM WOHKEXS' COMPENSIITION OECUIUTION: (fWs un meE mi Ee mmDle�eO il Ne pempt i!
1 certiTy ihat in Ne De�ormance of ihe wnrk lar wNch this permi s issued, I shall not erpploy a erson in
suble� �o �he rkers' Comp n Wws oi Califomia. �,
C1
'Oate: � v SiqnaWre'
NOTICE: I, atter maWn t�is Geclaation, you sho c e suEjeq ro the Workers Compen ion
CoEe, yo must forihxit� comOh ��h such prm4sia tNs permit SAall Ae deeme0 mvoked.
CUNSTBUCTION LEN�INO RGENCY: I �ere0y aifirm lhat I�ere is a conslmciion lentlinp apency for Ihe
whic� Ihis permit is issue0 (Seciion 3W7, CN. C�. .
lfNOEfl: •
AODflE33:
Ihe Labar
oi ihe work lor
OWNFB BULLOEP DECIAMT10N: I hertDy affirm that I am exempt imm the Contracrors' State License Law for tAe followlnA �eason
�Section 7031.5 Business and Pmlessional CoUe: My ciry ol counry whic� requires a DermA to construct, alter, improve, Oemolisn, or
repair any itmcWre, D�or to I6 issuance, also requiru Ne aDD��� !ar suc� permit to lile a sipneE statement thai he/sAe is licenutl
pursuanl to t�e provisions ot tAe Cantracrors' Suta License Law (CAaD�er 9 �commencinq vnih Sedion 70W) af Division 3 ot the Businass`
anE Pmlessions Cotle) ar ttut Aels�e is eaempt tAemtmm an0 t�e Cass for I�e allepeG axempfion. My violation of Sectian 7031.5 by
any aDP���ani for a Dermit su0lects the aDPllwnt to a civil penalry of nat mom tlun hve �unGreG Gallars (5500�. '
I. az owner of tAe o�ove� or my employees wlt� wa0u az I�eir sole compensation, will Oo Iha work._and the
❑. simcNra is nat intenEeO ar ofleretl lor ule (Section 70M, Business anU Proteuional Cotle: T�e Conlractors' Stata Licensa Law
Aaes not aD71y to an owner al a D�oDeM �To Euilds or improves llrerean, a�M wM Ooes suc� wark himutf/hersell or NmupA
�is or Aer own employees, prwi0e4 l�at suc� impmvements are not intenAeO ar otlereA lor sale. I( �owever t�e buil0inp or
imDmvement is sold vntNn ane year ai wmpletian, I�e owner witl have Ne Eurden al proNnO ��sAe Oi0 not bui10 or improve
lor tAe Durpose of sale�. .
I, as owner of tAe property, am ercluvvely contractinp wit� licensed cantractoa to constmct the D�olect (Section 7044, Business '
❑ an0 Prafessions CaCe: The Contactors' State Lkenu Law Ooes not appty to an ovmer ol D�operty who CuAQs or improves t�ereon
and wAo contracLs lar suc� pmlects wit� a contractaqs)license Dursuant to t�e Conlraciors' Stata ' ense Law). I�q aware
that Omaf ol t�eir Worker's Campensation insurance shoula Ue DmviAeU ro me. / �
� I am exempt unEe� Sec�ion: 7 0 n n e. 8 P. C. �� V\r`
mrini reuon: pC SEE CODE
i c�� '
Date: � :
I do Aereby nity t�at I aware al an0 un0erstanE l�e reQuirements of Ca or ia Health an0 Safery CoOa Sections 25505, 25533, an0
25534 and that 1 or any f ture OuilJinA acupant vnlUvnll not (nrde ane) ne t comON �+�h saiC state coda anE Ne requirements tar a
permit lor constmction or ma0iliwtion Irom I�e tir Ouality Manapement Oi ct NesiAemial constmction aDD��ca[ians are eKempt imm
Ihese provisions.
Date: - Applicant:
I here�y ceniry t�at I Aave reaA Ihis apDlicatiomantl state Ihat t�e abwe inlarmaiion ¢ carrecL I aqree lo compty with all ciry and county
ortlinance5anO5iatelawsr¢lali IOOuilEinqConSlructianandAe b/aufMirzeLepreSenlativpsofi�, � loen[¢ruponlheaDove-mentioned
propeity for ins ection purya e �
' �ate: � Signam . —
Oriver's Lic se or Sai Secumy 1/`
1691-46 W�ite—BuilEing; Green—CoOe EnlorcemenryCanary—Pp0licent; Pink—Revenue: G IEenrotl—Assessor
CITY OP COSTA MESA — BUILDING PERMIT
P�RMIT Nc]: M 046242 PLAN CHECK NO: N
'CONSTRUCTION TYPE; PERM.LT TYPE: MEC
JOA DESCRIPTION : LEGALTZE ADDITIONS'
CT ATM VAI,OE: CALC�VALUE: .
P]�RM NO: M 046242
GOVT: N SUPP: N•
PORPOSEc OTli
Sf,� FT :
GROUP OCC: R-3 /
CUMMENTS: REI' B458U1
��-�r*iriE-����t�*�x��*aF�*+t�r�tarit**it*:K**�x�*at**it�*+t x�*it*�it*�+t*�****�*it��***�x�c�f�**xx x�r.�*
Z O N I N C R E Q 0 I R F•. M E N T S
� sE•r�Acxs
—'-------•--- MAIN RUILDING ----•-------- --�----•-- ACCESSORY QUILDING -----=---
ERNT: FT IN REAR: FT IN FRNT: ET' IN kEAR: FT IN
LEFT: I'T IN RGHT: F'P iN LEET: FT IN RGHT: C1' IN
PAkXING RGQ: i?ROV: PARCEL: 14133111 'I,NF.: RFF NO:
PLANNING NOTES> ,
�
**���r*��x��'���*x-**�r�e*�r�x�**x�x*�*��*�•i�*�**�*�+�*x�ru�-��*�r*�*�*�cxx��r�x�r*�r���+��**��*
D E V E L O P M E N T S E R V T C E S R E Q U I R�E P4 L• N T S
J_
ZONING APPROVED DY .
BUILDING APPftOVLD BY.:
�APPLTCATION ISSUED DY ��
itiE��t�x�itirit�i�ilit�-ifit-a�it+�x*itit3F'iriFiF'�F'iF��Fxx�ilie it
iElfiEiFiEiElEfEiEiElFiki!#itiElElFiEifiEiEiflEiflEiFikiFiFifiF3EiflEIE�IE ,, rt#
LEGALI2RTION:N F E G S U M
I3LDG PMT FLUMBING GC,LCT'RIC.
PERMIT
PLAN '
ISSUE FtiE
DATE:
DATL;
DATE:v/}—�� �(�.�J���Q/
'. 3Fi�1E�ii��iFiF�ii�F #� 3E iE iE �)E iF iE # iE 3F<{F�F �Fif If� 3hO�)h iE
!E jf IE fE it iF iE ik it iE iE iE iE �E If iF ik iF iE it iF k if iF if 1F jE iE iE jf IElk iElf jh
A R Y STRUCTURAL SEGtdENT:DI
HANIC FIRE SMIP/RES .GRADING
13.50
?.5$ SM'CP/NUN.rRES
15.U0
Bi7ILD.ING—UIV—> PERMIT ISSUF PLAN—CHHCK T01'AI. PAID DUti
TOTALS-- —> 13.50 15.00 0.00 28.50 2£S.>0 .' .00
REVENOE DIVISION TOTALS--> COLLECT6D: 28.50 O�BR/SIiORT: .00
B[,DG PMT PLUMDING ELECTRIC MECHANIC PIRE SMIP/TOT GRADING PLAW—CHECK
� � . 5 0
Y •
'J(�Y.- iE'll' 1:� ?E iE If')E if i!')f -N"M # 1f M' i!'K' ik 3F # 1E iE 1E if"!!- if iE if iE'N' iF ?E iE i%iE iF if iE if iE 1f iF If 1E if'N' i!-1E % iE iE?E k?f if if 1E ii' iE iE iE iE iE?E iF if if if iE X'iE # if'k if if Y
i N D I V I D U A L C L-' E F3 R E A K D 0 W N '
QTY D G S C R I P T Z O N
MEC 1 INSTALL EORC; AIR FURtd := 1U0 EC BTO/H
MEC 1 VB119'ILA1'ZOhI F'P.N COPIN TO SItJGLL DUC7'
En�n or• F•er:.s
UPIIT COST .,, YOTAL COST
J.U� 9.00
4.50 , n.50
:F,
r
O1 �0054E00-000548�0 �'f � T 2E.50
DATE: 02/23/90 TIItE: 16:12
0
0
. i _ ! ;
�DNSTRUCTION AND PLANNING � POOL ,PA -
APPROVALS Permit # Date Inspector AppROVALS � Permit # Date Inspector
{. Temporery Electrical Service or Pole 52. Pool & Equipment Location ' �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • -
3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms .
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6.` Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undr9rnd. 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 ' '
15. Rough Electrical-Conduit - . 66. Solar SYstem-Final • �
16. Rough Electric Wiring - 67. �Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Electricel�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning 3(p�lr0 (��{j FIRE DEPT. REQUIREMENT _ "
20. Rough Factory Fireplace _ APPROVALS Permit #
21. Ducts, in Struaure ' � 7p. Underground Hydro
22. Ducts, Ventilating _ 71. Product Piping OGas ❑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 �`�Cr1 L��. ,
!
35. Final Gas Pipe-Test - ,�� r
36. Hood or Canopy �� � � ,
37. Final Factory Fireplace �
38. Final Plumbing � �
39. Water Service-Final. �
40. Gas Service-Pinal - �
41. Solar pomesticFinal - - �
42. Backflow Preventer . �
43. Backflow Irrigation
44., Landscape Irrigation System ' '
45. Sound Attenuation _
46. Handicap Regulations ��
47. FINALSTRUCTURE&BUILDING '!� (P !r'� Q� _
46. FINAL PLANNING � ' �� (J ��
:; •�
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Co ��.
51. CERTIFICATE OF OCCUPANCY
No. Date
PBDIECT �OOflESS: z% 9 y FRANC I S LN
��OWNEfl'S�lRME: JAMES C. ROSENFELS
�„�, �DDflE53: Q(1 5 GLASSEL
ORANGE CA 9266G.
� 714 ) 532•-5939
RflC1UENCINEEfl:
�ooxEas:
PEO.NO.:
uxir:
uxrt:
PEHMITTFE: JAMT.J C. ROSENFELS ( 714 ) 572�-59 J9
FODHESS: QGL S GLASSELL
' ORANGE CA 92666
LICENSED CONTMLTOB OECIAMTION: I IiereCy aXUm tMt I am IlttnseE wGer ymisbns ol Gupter 9(commenUnO wllh Section
70110) at Oivisian 3 af t�e Bu5int55 anA PfotEssians CaCe, anG my fiterSE is in tull lorce aiM attBC1.
cm uc.: sr�re uc.: cuss:
Date: SiO�atum:
W08KEBS' COMPENSATION UELlAN1TI0N: I AeaEy aKrm tlut I have a cenil'cata of wnsent to ul4hiwre ar a certiliate al Workers'
ComOensatlon Lsurance, or a ceNfieO copy Uereol (��� �. LaD. C�.
POUCY NO.: FXP. OATE:
COMPRNY:
❑ Certifietl coDY is Aerehy tumis�e0. ❑ CeNfieO copy is f,/d�M with Ne city BuilOmq Division. 'l
� �//� .Si�J�/S 6 _I
.�e: pDVfitanl:
IXEMPf10N FlI M WOIIXEN� COMPFN&1TIUN OECUMTION: (fNs secmn reeE not Ee mrtqlete0 if Ihe pemit' fa me Awdr f10U� a Ips�.
1 teNly flial in Ne peAafmdnm oI NB wofk lot wNN Ilds pEmtll ¢ LSSueO, I shall noI empby any peROn' dnY ma��er W a5I0 hetame
suEject ro the Workers' Comce�tion Laws oi CaGlomu.
Date: SiqnaWre:
NOTItE: Ii, alter malanp tAis Uedaraqon. you stwul0 Eerome SUGja2 m the Workers' Compemation D��� a� t�e �a0or
CoOe, yau musi fOntrHith amDN �N 5Wi pro�ons a thh pttmil stull Oa EcemeO rewkM.
CONSTNIILTION IFNDING �CENLY: I IxreOy allirm tAat Nere is a constructlon IenEinO +Oency for t�e peAormance al Ne vro�k lor
wliicA Iha permii u issue0 (Se�1ion 3097, Civ. C�. �.
LENOEN: •
�ouness:
OWNEP BUIIDEX OECIAMTION: I heretr/ atlirm Nat 1 am e�empt from t�e Contraclori State License law lor the Idlowinp reawn
(Sectiw 70J7.5 Business aM Professional COUe: My uiy ol counry wltic0 requiru a perMt to consWct, alter, impmva. OemoGs�, or
repair any slmcNre. D�w ro its issmnce. also reQuirm ihe aDDGwnt lor such pemut m hle a slOneE Stalement rtut he/s�e is Ilcenu0
pursuani to t�e Ormtiam ol tte Convactwi State License Law (CMptu 9(commencinp xit� Sectlon 7000) of Divlsion 3 al l�e Business
an0 Protessions CoOe) ar ttut MJs�e is exem0� ��emlmm an0 Itrc Easit br �he allepeA axemptlon. My Wolatlon of Sectlon 7037.5 by
any a00licant lor a permi� suEi�s tne applkam m � civil penalry of not rtqm tlun fiva �wMrzO Oollars (`3.A01.
I, az owner of tna properry or my empioyees wit� wapes as tneir sole wmpenulbn, vnll ao Ina work, antl the
❑ structura B not NtenOM or oflereE lor sale (SecUon 70aa, Buvness an0 Protessbnal CoEe: TM Cantrzctars' Seate licensa Law
Eoes not aDDly to an ovmer ol a propeM1y w�o �u110.5 or Impmves IAeman, an0 wM Eoes suc� woM himsell/�ersell or throuph
his ar Aer own employau, prwiOM tAat sucA improvements art imt inte�eE or ofleaE iw sale. II, �owever I�a Oulldinp or
imDmvement is 5d0 witNn one year of comqe6an, Itro ovmer vNl tuva tAe OurEen of Drovinp AUs�e OiA not buil0 or impmve
for t�e Duryosa ai ule).
I, as owner oi the DmDerty. am axGusivety contractinp vnt� Ilcense0 wntrzctors to constmct t�e D�aled �Sedlon 7044, Business
L� anU Prolessians CaEe: The CantaRors' Suro Licemn Law Eces rol appN to an ovmer of properry wla Eu IEs ar improves Ineraon
and who mnir�cts lor such O�o�ects xiN a contractor(s) Ikense Dursuant to the Contoctor yyy' SUte UGCn50 12W�. I 21�1 dwdfe
t�at Droof of tAeir Warkar'S ComDenution insurarice stwuld Ue proviOeG to me. /� /, �
//; � a
� i am e�emot unaer Section: 7 Q Q Q B. 8 P. C. - 7
mrmisreason: HEPC S[iE CODE �— �
p � � ,��V �CLS
Uate: Zc'�� —_f O Owner
I tlo �ereGy certtly that I am aware of anA un0erstanC I�e repuirements of Calilomia Healt� anC Salery COAe Sections 25505, 25533, anA
'25534 anU I�at I or any luture UuilOinp occu0ant wiNwlll nm (cirUe ane) nee0 ro compty with saiU stala co0es anE t�e requirements lar a
permit lor consiructlan ar iroGiliution Imm t�e ar Ouahry Manapement Oistrict. He5i0enial constmction aDW���ions ara eKempt imm
ihese provisions.
Oate: ApD�icant:
I here0y cenity tAat I have read tAis aODliwtion anO state ttwt I�e aEmre intormatbn is correct. I a0ree to campty witA all cily anE counry
ordinances antl state laws reUtinq to OuilEinp construcuon anG hereCy aNtanze representatNu af tNs ciry to enter upon t�a above�mentione0
proDenY �orinspec�ion Durp05es.
Date: 2" r�(_(L sa�t��e:—��I7C`S C.����* �/S �yy�
onver's License or Sotlal Secunry �/
164146 W�ite--9uilEing; Green—CaOe Enbrcamant; Cenary—Ppplicam: P�nk—Revenue;
CITY OP COSTA MESA - BUIL�OING PL•RMIT
PERMIT NO: EP 04S95f1 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PLU
JOD DESCRIPTION : LEGF�LIZE ADDITIONS •
PERM NO: EP 0�5958
GOVT: N SUPP: N
..riQ FT:
PURPOSE: ADD
I:LAIM VALUE: CALC-VAI,UE: GROUP OCC: R J /
COMMCNTS: RE:B45001
��x xx**�*�r*��*� �r�**�**���***�*�r�r�x*��e�r*��*+���*r�*****�*�r*��r�*�*x+�+�**�x�*��*�**x*�
Z O N I N G R C Q U I R E M E N T S
S E T B A C K i
--------•---- MAIN BUILDING -------�--- --------- ACCESSORY DUTLDI.NG =--------
FRNT: L•'T IIJ REAR: FT IN FRNT: FT IN AEAR: 1'T IN
LBFT: FT IN RGHT: PT iN LEFT: FT IN RGIIT: FT IN
PARKING RF.Q: PROV: PARCEL: 14133111 'LNE: REF NO:
PLANNING NOTES>
1
�1f aF if if 3f � iF iE it iF if #�1E # iE iE-lE iE iE iE if iE iE iE iE 9F if iE k�If if IE iF jh if if iE � if iE iE i6 iF iE M K- it iF 1k k rt iE iE if k�k ik IE i! ik iE it iE iE it i! ir 1t if � it �k%iE if k iE k i!
^ ll E V E L O P M E N T S E R V I C E S� R E Q U I R F. M E N T S
ZONING APPROVED BY � DATF.:
DUILDING APPROVED BY : �;�������� DATE: __
APPLICATTON ISSUED BY: � �,���� DATE: �- S��
**�r�t***r***+�**rt�t*�t***+� e� E i �t'�. �� �F'iF3riF'i�'+F�r�r*�r�t�t**�t�rT�lF3F'3F3F iF
iEif�kikkiElEitifMiFiEifiEiElE1EiE1E�E1EiFfE3E3ElEif�EiFjEiEiEfF1FiF�fiElEifififitikit iFiP itiEitit3kkitkiEitiFlfiFiEMlfiFiEkMiti(�it%ifitiFiEitiE
LEGALIZATION:N F E E S U M M A R X STRUC'CURAL SEGM£.D]T:N
BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE S'MIP/RESi'` GRADING
P CRM T'I' 4. 0 0 . 15 '
258 502 � ' SMIP/NON-RES•
Pt.AN
ISSUE FEE 3.00 15.00
BUILDING-DIl'-> PERMIT ISSUE PLAN-CFIECK
TOTALS----> 4.75 1II.00 0.00
REVENUL•' DIVISLON TOTI{LS--> COLI.ECTED:
BLDG [�M1' PLUMHING ELECTRIC MECHADIIC
7.00 15.75
TOTAL PAID �� DOE
27_.75 22.%5 ' .00
. • 7
22.75 OVE.R/SHORT: ' .00
FIRE aMZF/TOT GRADING P'I.ADI-CHF.CK
S , �1
k IF M if if iF ik iE fE M N- iE k if k if N it it �f M iE k iE 9E i! k I(� k 1f iF if iE 3f M� IE if iE 1F IE if 1E i! IE k it If aE iE M 9F iP k ik If # iF iF i! if fE it iF if # iE iE it if it�lE 14 i(�.ik k iE if'.f� iE�
I N L I C� 1 D U A L I' E E B R� A K D U W �l ;�
�YPE QT'Y D E S C R I P T I O N UNIT CUST 'T,�OTAL COST
EL�E 1 FIX'TORES, LIGHTIAIG 1 ST 20 F.A. .'75 �. .75
I'L�IJ ] BATH'TUD '1.00 2.00
1?LU 1 WASH BAS]'.iJ 2.00 •' 2.00
GND OF FEES
t.'
? �i
�
D1 DQD53373-D0053372 -T d T
DATE: 02/OS/90 TIHE:'�14:15
22.7`
._v., . .
C°ONSTRUGTION AND PLANNING POOL � A .
Date Inspector Date Inspector
APPROVALS Permit#- , f APPROVALS Permit#
f. Temporary Electrical Service or Pole �.� 52. Pool & Equipment Location �'�
i �
2. ;Soil Pipe-Undrgrnd: 3(/�QO � 53. Steel Reinforcement r_ �
--'3.-Electriwl Conduit Utility-Undrgrnd. 54. Forms " �
r
��"4�'Electrical Conduit-Undrgrnd. 55. Etectrical Bonding -. ��� L�
'r 5"Steel Reinforcement 56. Rough Plumbing & Pressure Test .�
, -
�`6�'ElectricalUFER�Grnd. 57. APPROVALTOCOVER�GUNITE "
-:�-7�-Footings ��. 58. Electrical Conduit-Undrgrnd. "- _
�:8. Foundation =_ 59. Gas Pipe, O Undrgrnd., Test � ,-
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgmd. '
10. Structural Floor System 61. APPROVAL TO DECK ' ^
11. PropertY Sewer Line & House Connection .-- 62. Backwash & Receptor-Final - •
12. Sewer Cap - 63. Heater & VenbFinal - �� �
13. Roof Drains 64. Plumbing System - Pinal -.
14. RoughPlumbing -- 65. Electrical-Final ' _-
15. Rough Electrical�Conduit � - 66. Solar SYstem-Final . �- ; "
" 16. Rough Electric.Wiring ._ 67. Fencing & Access ApProval _ '_ � _
17. Rough Wiring Sign -• 68. APPROVED FOR PLASTERING - -'
�
18. Rough Electrical�T Bar Ceiling � 69.' POOUSPA SYSTEMS FINAL J �
19. Rough Heating &.Air Conditioning r_ ;� r .,FIRE DEPT. REQUIREMEN� ..
20-Rough Factory Fireplace - �2� __ - F � APPROVALS'., Permit # ' _ - +
21--' DuCts, in St�uceure ' ' . � ' ' ` '-70. Underground Hydro .
22:'Ducts,Ventilating`�_ % - _ . • ;,71, Product.PipingOGas ❑Oil
23rGas-Pip�Rough & Test ' . " ' _ + • - 7p, Underground Flush -
24�'Roof Framing '. , �� ��- � _ ::73 Undergmd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing _� �� ' `� ` � - ' } } 74. Overhead Hydro _ � �
26' T�Bar Ceiling (Structurap & �Mon"ocoat - � - �-� � 75f Dry Chemical _ , ' _ '
27r.FrameandFlashing - ' . 76. DryStand'pipe • - - ^-
"�28. Lathing:&Sidin9 - � .yprz a � ��� ' 77:� FIXEDSYSTEM�FINAL• _ - r--
� 29. Insulation - �' ` 78�.� FIRE PREV. FINAL - '
�30. DrywallfNailing �:� r ' �,�<.� ; ' ' ,��HEALTH.DEPT.RE�UIREMENT
: 31. Plaster Brow� Coar'-. ' ,' ti�. -- 7g, FINAL INSPECTION � -
T!'
' 32.� Electrical Power Meter-Final ' S.. �SO:FOOD CERTIFICATE ISSUED _ �
.33.�FinalElectric � :^ •.�.�.�, Notes: '"'� - _ "
� 34., Final Heati�g & Aii Conditioning� � � �� � � � � �' � �
; . ., _
35�'Final Gas Pipe�TesU � � � i - - _�c ' � -
' � Y - � `� '
� 36,_Ho`od or CanoPY ` � � y � '� t. :. ,,� , _ . -
.37�Final Factory Fireplacec r- � -. � � � �� - � � " ,
%i �'k" „
�38. Final Plumbin9 ', . � 21�( � � �
( al c:E9 °
39. Waier Service�Final- -.- - a_. '.,,-''^ y�� 1 �^
� '
40. Gas Service-Final " - �
- - - .n . .
�41. Solar pomestic-Final' � ' �, � r � � � _ .
42 Backflow Preventer ' ` i • -.
- e _ _' '
43. Backflow Irrigation ,' " ,. - . ' "
-� 44. Landscape �rrigation SYstem �„ � _ �' , � r _ - ._ � �
45. Sound Attenuation '.. � . � � � '
46. Handicap Regulations ; =. , � '
47. FINAL STRUCTU,RE & BUILDING • , � �,+� �
48. fINALPLANNING .- �� v
� 49,, Electric Release to Edison � ' .
50. Gas Release to Southern Califarnia Gas Co • ' "
.� •
' 51. CERTIFICATE OF OCCUPANCY •• � -
No. Date
PN6IECT AODPES3: �'J 9 9 FRANC I S tiN
�WNEP'S N�ME: JAMES C . ROSENFELS
,. aooeess: q61 S GLASStiL
:' ORANGE CA 92666
714)532-5939
• RflCHIENGINEEH:
a0DBE3S: ' � �
flE0.N0.:
UNIT:
UNIT:
PEflMITTEE: JAMES C. ROSENFEI,S ( 714 ) 532-5939
RDOHE58: Q(�], � GLASSE:LL ' � �
ORANGE CA 92666
LICENSED CONTMCTOP DECIAMTION: I here0y aKrm ihat I am IicenseG unCer O�oNsians ol C�aD�er 9(commencin0 ��� �ction
7qp) o� �ivision 3 of the Businew and Protqssions Cotle, anE rtry license is in fulllort0 and eflect.
CITY I1C.: , STR7F L1C.: CUSS:
Oate: SiOnaWre:
WOPKEBS' COMPENSRTION OECUMTION: I �ereEy allirm t�at I �ave a certificate of consem ro seli-insure ar a certificate of Workers'
Compensation Insurance, or a cenifietl copy ihereot (Section 3800, LaU. C). .
POLICY NO.: E%P. O�TE:
CaMPRNY:
i❑ Certified wpy is hemhy fumisheE. ❑ CetlifieE coOY �s filed with the tiry Buil�inA Division. � ,
. ApPlicani:
�wEMPf10N fIIOM WOflNEfl3' COMPENSATION OECIAMTION: (it� sec[
I cenity Ihat in �he DeM rmance o� ��e xrork �or wNc� this De�mit u i
suble�� �!o tjhe arker Com nsation Laws at Califomia�
Date: ✓ SipnaWre:
NOTICE: Ii, atte making tAis Aeclaation, you stroulG Gerome si
Code. you musi lort�wdh compy vn[h suc� proNsons ar INs p
CONSTBUCTION 1EN01NG �GENCV: I �erehy aKrm Ihat ��ere is a
which I�iS De�mit is i55ue0 (Set�ion 3097, Civ. C�.
LENOEP:
RODPESS:
br o�re hunEreO (5100) or less�.
anv uiawor m az ta become
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 046,406 FLAN CHECK NO: N
PERM �IO: B 04640G
GOV1': �l SUPP: N
CUNSTRUCTION 'tYPE: PERMIT TYPF.: STR PURPOSE: ALT'
JOD DESCRIPTION : REROOF 6 INSULATE SQ FT:' 6,000
C,LAIM VALUE: 6,000.00 CALC—VALUE: 6,000.00 GROUP OCC: R-3 /
COMMENTS: REROOF 6 INSULATE WITIi R-19
iFjFif iF iE iF iE lf if if it if iF iF 3f �E aE iF if iF it it iE if 3F iF i( if 3F it iEiE 1E if iE �E iEiE iF 1E If iE� if if it iF iE 1k �EK iE * if iF *if IEjF df iE iE iE iE �F iE %iE iF iF iE iE 1E iF iF �f iE fE X It
Z O N I N G R� Q U]: R E M E N T S
S E T B A C K S
------------ MAIN BUILDING --- — ---- --------- ACCESSORY HUILDING -------�--
FRNT: FT IN REAR: FT IN FRNT: FT IN REAFt: FT IN
LEFT: FT I�l RGiIT: F'T IN LEf'T: ['T IN RGHT:. FT IN
PARKING REQ: PROV: PARCEL: 14133111 'LN�: REF NO:
PLANNING NOTF.S>
1
3h 3E 7E 3E iF iE �E �f iF fF ik 1E 3f iE iE �k 3f If if if iF it iE iF iF iF k if iE 3f IE iE iE 3E iE �E fE 1E iE 1E if iElE iEiE 9F i(� iE ik iE iE 3E fF if iE if iE iF if iF iF if �F iE �F iE iF it iF iE iE if iE 3E M if k 3E 3E
, D E V L• L G P M E N T S E R V I C E S R E Q U I R E M F N T S
ZONING APPROVE.D BY .
Nar�ers'C oensationprmisionsoltheL or BUILDING APFROVED BY.
� OeemeE evokeA.
lentlin9 a0ency lor tne pedormance oi me work tor AP P L I CAT I UN I S S U ED B Y
, iE It if ik aF iE iF if iE IE iF iE iE iE 34 iE if iF 1(� �)E N
it if it ik iE if iE if if iE if jE iE if IE 3E iE iE if 3E iE
LEGALIZAT30N:N
OWNEB BUILOEB OFCLAMTION: I here0y aflirm that I am exempt Irom tAe Cantracrors' State Licensa law Por tAe followinA �eason '
(Section 7031.5 Business and Prolessional Cade: My ciry nf counry w�ic� reQuires a permil to constmct, alter, improve, Uemolish, or
mpair any strucNre, D�ior ro its iuuance, also reQuireS the appGwnt lar mc� permit to lile a siOneE slatameni that Ae/she Is licensetl
pursuant ro t�e DmNsions ol t�a ContractoK State License Law (Chapter 9 �commencinp with Sectian 7000) ol Oivision 3 of Ihe Business
anE Pmfeuions Coae) or that halshe ¢ exemp� I�erelrom aM �ha Dasis for Ure allepe0 eKemption. My violatlon ol Sectlon 7031.5 by
any aDP�icant far a permit su�jects ihe aDPlicant to a cidl cenalry of not mom Ihan five �untlretl Oollars �5500).'
I, as owner of t�e D�oDenY or my emyloyees with wapu as I�eir sole compensatlon, wlll Oa the work, antl the
❑ simctura is not intenOeA ar atteretl lor sata (S¢cuon 70Ed, Business anE Pmtessional Code: T�e Contracrors' State License Law
Oaes not aDPly to an owner of a D�operry wlio GUIIGs or ImOmves therean, antl w�o Ooes suc� work himsetl/herself or throu0h
, nis ar Aer own emDloyees, provitle0 Inat sucn improvements ara not intenAed ar aflereU lor sale. If, however the euiltlinp or
� ImDmvement is wld witAin ana year oi completian, t�e avmer will Aave Ne EurEen al O�odnO ��she UIO not Oui10 or improve
� lor tAe Durpose of sale). '
I, as owner of ine D�oOeey, am exdusively contractinp with IirenseE cantractors to constmct I�e project (Sectlon 7044, Business
ana Pmieuions CoOe: Tl�a Contrzctors' State Liume Law Gxs rwt apDN �o an owner al pmperty who bwlAs or improves I�ereon
antl who contracls lor such projects with a contractaqs) Ikense purwant to the Comracrors' State License Law�. I am awara
Ihat prool ol tAeir Worker's Compensation insurance sAou10 be OmhGeE o me.
� I am eKempl unGer Se �o�: � p q q B. 8 P. C. /� / �j�
mrmi:re;son„ ��C SEE CODE '�, (/l_ / �V/� IsI
Oate:
I do �¢reby ce N Iha� I�
25534 anE I�a I or any �u
permillotconSlmciion or
Ih¢S¢ pfOVISiOlIS.
Oaie:
I �ereDy cehity t�ayl havE
tAis
anU
ppD�icant:
n ana stan
of Califomi( Health an0 S�ly CoOe Se Y ns 25505, 25533, ana
� nee0 to compry xitn saiE state co0es a Ue requirements for a
m Disinct. ResiOenlial conslmction applications are exempt Irom .
is
all ci�y and
Date: V SipnaWre: � Y L L� ��� �
Dnver's Lice e or Sa ial5ecunry
Lenarv—AoolicanC Pink—F¢venue: GOIEenrod—Hssessor
F'E F. S U M M
BLDG PMT PI�UMBING ELECTAIC
PF.RMIT 81.00
PL.AN .
ISSUG EEE
DATG:
DATE:
�� ***D***�*�'�8 i�*�"
iF k 1E aE iE ik jt if ik If iE ik iE iE 1k 1f k 1E if 1E 3f 1E if 1E ik iF iE 1E IE �f �E 3E
R Y STRUCTURAL S'EGMENT:Y
IC FIRE SMIF/RES".�' GRADIDIG
. S �,� .
SMIP/NON-RES
r4
HUILDING-DIV-> PERMIT ISSUL• PLADI-CHECK TOTAL PAID . DUE
TOTALS----> 81.50 0.00 0.00 F31.50 81.50 ,, .00
REVENUE DIVISIOid TOTALS--> COLLECTED: 61.50 OVER/SH012T: "' f' .00
HI,DG PMT PLUMAZNG ELECTRTC MECHANIC FIR6 SMIP/TOT GRADING P.LAN-CHECK
8i..�� .5� h i �.
iF iF iE 3E k 1k if if it iE iF �E iE ik �E-if k iE k ik if iE iE N iE M i( 3! k if k iF if iF iF iE iF If iE ik dk ik Ik iE iE if 3F 1k iE 41k iF it iF dE ih if ik if if ik �f iE iE iE if IE iE iF i! �1t �F ik �k i! � iE ik 3F
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 Dl ' UNIT COST ,��T.01'AL COST
SFR 6000 REROOF BY VALUE RESIDGDIIAL NOZOME 1.00 1 6,OOp.00
END OF FEES
, ��`7 .
. �.
//z ��q� 01 00055698-OD055699 �i`if �.� Y
� DRTE: 03/OE/9D ?IME:' 12:40
SI.SQ
t
_ � i i
..:6�NSTRUCTION AND PLANNING POOL F ..
Date Inspector � � Date Inspector"
. APPROVALS Permit # � APPROVALS Permit # .
� , 't
� 1. Temporary Electrical Service or Pole -� �� 52. Pool & Equipment Location `�� %- �- -�
2._Soil Pipe-Undrgrnd. � : --� � 53. Sreel Reinforcement �•-' -.
- 73-Electrical Conduit Uti�ity-Undrgrnd. - 54. Foims �
4c�Electrical ConduiC-Undrgmd. 55. Electrical Bonding _';, _
�5:-:Steel Reinforcement � 56. Rough Plumbing & Pressure Test; '
=;6.^Electrical UFER`Gmd. 57. APPFOVAL TO COVER-GUNITE -
� -7:-Footings - . 58. Electrical Conduit-Undrgrnd. �-
'�8. Foundation „". , 59. Gas Pipe, O Undrgmd., Test - �
,9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. .-'
10. Structural Floor System . 61. APPROVAL TO DECK _
11. Property Sewer �ine & 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 . '-
15. Rough Electrical-Conduit �� 66.'Solar System-Final -� ,� "
16. Rough EleMric Wiring 'i�'� 67. Fencing & Access ApProval �
17. Rough Wiring Sign % 68. APPROVED FOR PLASTERINGij "
18. Rough Electric`al-T Bar Ceiling -'� 69. POOL/SPA SYSTEMS FINAL~ _' ��
79: Rough Heating & Air Conditioning � _ PIRE DEPT. REQUIREMENT`",
20.-Rough Factory Fireplace ` - - - ' ' AppROVALS= Permit# �
27 �Oucts, in St�ucture � - - - - � � � '• 70. Underg�ound Hydro '
- ' - . a
22.,-Ducts, Ventilating ` - j_ " =�, +77, Product Piping O Gas O,OiI
23 Gas-Pipe�Rough & Test = -. �, '- - �- 72. Underground Flush - ' - _
24. Roof Framing ' �- '. - � � ' 73. Undergrnd,StorageTankr�Gas ❑Oil
25. Roof Sheathing ` �. � _ ' • �� 7q; Overhead Hyd%, , ' , ' .
26= T�Bar Ceiling IStructural) &-Nlortocoat - 75. Dry Chemical _- �
27 �Frame and Flashing - � - - - 761Dry Standpipe - - "
• 28 Lathing & Siding� : _ ( �� " ` � �; 77,, FIXED SYSTEM'FINAL . ��
29. Insulation � ��. _ � , ��-+ r 7g;. FIRE PREV. FIN'AL - � '
30. Drywall'Nailing �.r � '�, : ;NEALTHDEPT,.REQUIREMENT
37. Plaster Brown Coat. - - Y�, v-79 FINAL INSPECTION � "
=.32.,Electrieal Power Meter-Final F'= ,�� k��60'rF00D CERTIFICATE ISSUED ..
' . a. A ' I .. Y. I . -1 _
- 33=Final Electric . i � ' Notes: - - - . �
'34, Finsl Heating& Air Conditioning � ` � , ' �,�_ . G �`� y4 ^ -
35 .Final Gas Pipe-Test; , � . • ' �-;"� :�- � � =�
'36�Hood or Canopy - - , "" - � r•r - - "�' ` l
- r i i� : �' � ,-
=37..Final Factory Fireplace� - � , �� � � �� ji. : _ x �
�38. FinalPlumbing _ ... ;,; )G':�'_' _ • ' -
39. Water Service-Fina�. r. 1 �. - "I � .� . .. . ' " _
i:
-:40. Gas Service�Final � . <^ -• - -. , �' �" � ' �
� C, r � � �
� 41. Solar pomesyic-FiRal- _ '� � � � ' .- �
. . •.� � r _ , .
42. Backflow Preventer � ' - - ' '
�_4-� 1 i--� �J 1{ f•. rl' ' T
43. Backflow Irrigation_ j,"" , 4 r; ' �' '
44. Landscape Irrigation System'''��� - -� �'r y �,� �� -
- r
- 45� Sound .Attenuation � ' . ' ' - : i� . � -- ✓ ^ ,- .
46: Handicap Regulations - - � � ' '-" _ _ _ = •
. ..av ;n c.,
47r FINAL STRUCTURE & BUILDING �' ` � ' ���: � "' y' � �
48: FINALPLANNING - �` � �?" "� � � �i(� ;G .
49.�EI'ectric�Release to'Edison � (f'' j ' - 4 • ,
_ 50: Gas Release to Southern California Gas Co > '• � ' - '�• '
C1�' ' 'C " �-.
51. CERTIFICATE OF OCCUPANCY ��' • � - � •
No. Date �
PHO'ECT R�OXESS: 1% y 9 FRANC I S LN
'oSE�ssName: JAMES C, ROSENFELS
AUOflESS: 4SI S GLAS5EL
ORANGE CA 92660
714)532-5939
FflCM/ENGMEEfl:
AOOflESS:
HEG.NO.:
UNIT:
UNIT:
PEflM1TTEE: SAMES C. RUSENFELS ( 714 ) 532-5939
aooncss: 461 S GLASSELL
ORANGE i.A 92666
LICENSEo CONTPACTOp �ECUINATION: I nereey allirm ihat I am licensea uneer provisions o� Chapter 9(cammencing with SecOon
7000) ol Div�sion 3 of Ihe Business and Pmfessions Cotle. and my license is in full lorce antl ef�ec�.
GTY LIL.: STRTE IIC.: LLASS:
Da�e: Signa�ure:
WOPNEflS' COMPENSAT�oN OELLAfIATION: I here�y allirm Nat I nave a certificate ol consem ro self-insure or a certilicaie ol Workers'
Compensation Insurance, or a cenifiee copy inereo115eclion 3800. LaU. C).
�9LICY ND.: E%P. 9RTE:
'OMPRNY:
L� Cenilietl copy is pere6y fumished. ❑ Cenifietl copy is IileG with i�e city Building Division.
Daie: Applican�:
E%EMPTION FNOM WOHKEPS' W MPENSpTION OECLABATIUN: (ihis seclion nee0 nol 0e camplete� if the permit is brone hunared (5100) or less�.
I cetlity I�ai in I�e OedO�mance ol Ihe work tor which �his permi� is issuetl, I shall not emD�oy any Derson in any manner so as �o become
sublecl lo ��e Workers �umpensalion Laws al Califomia.
Date: Signamre:
NO710E:11, afler making t�is aeclaration, you sAoultl Cecome suGle[� to t�e WorkeR' Compensation provisions olt�e La�ar
COtle. you must IO�hwiih CamDly with SUCh pmvi5ion5 or IhiS permi� Shail be tleeme0 revo5etl.
CONSTflUCTION LENUING AGENCY: I hereby aliirm Ihat �here is a consimction lending agency lor Ihe performance oi ihe work for
whith Nis pe�mi� is i55ueA �SeCiiOn 3097. Civ. C�.
LENUEH:
aooxess:
CITY OF COSTA MESA — BUILDING I�ERMIT PERM NU; 1M 7b1 _
PERMIT NO: IM 056179 PLAN CHECK NO: N GUV7'; N'�;
CONSTRUCTION TYPE: PEt'2MIT TYPE; MEC OTH PURPOSE: OTH
JOH DESCRIPTION : LEGALI7.E ADDITIONS SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: RE;M46247.
iE iE # �X� �)E it iF K if # K� �1E 9f iE IE iE �1E �1E �k %iE 9f lf �lE 44 �k iE )f �lE iFiE �)f� 3E if �IE�Y X..X..IE ��%�K �N # �lE x # �)f ��iEit �%�%�Y.� # �f �M� # # 1E�lE dFiF �lE if �1f�iE �1E 9f �I( iE # iF�lf �lf iE 3E iE iF
7. O N Z N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAZN HUIT.DZNG ---------- --------- ACCESSORY AUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT iN
i�EFT; FT IN RGHT: FT TN LEFT: FT ZN RGH7': FT IN
PARKIIVG REQ• PROV: PARCEL: 14133111 'I.NE; REF NO:
PLANNSNG NZSTES>
i
iF iF ikie iF iE IE if #'� iE if # k iE ic �IE i't iE if if iE iE 3!• ii� iF if 1i�lE 1E iF iE if if i(• fF if 1f iE if ib fE if if 3h ii� i(' 3E M� if iE iF if If if iP if -iE N� iE 3c �f iE 3'r lE �lE iElF iE iF iF iF 1F 1F 1F IF 1k i't k� �)f
D E V E L O P M E N T S E R'_"V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY , __ � DATE•
BUILDING APPROVED BY ;
APPLICATION ISSUED �
if iE fE aF iE iF iEiE If iE 3E 1E iF 3E 3f 3f # it iE ir
if iE if iF 3E iE aF iF �7E i61E ff iE iE iF if iE iF iF iE IE il
LEGALIZATION;Y
OWNEB BWLDEB OECIAApTiON: I hereDy affirm �hat 1 am exempt Imm t�e Contraciors' State License �aw lor the lollowinp reasan BLDG P�'i1' P LUMB I NG
(Sec�mn 7031.5 Business and Pmlessional Code: Any ci�y ol counry w�ich re0uires a permit m constmci, alter, improve, Oemolish, or pER%�i 1�
repair any siNcture. pdot Io i�s issuance, also repui�es ihe aODIiWn1 far sucn permit to lile a siAneA statement ihat he/she is licensetl
pursuam to t�e O�ovisions oi ihe Cantracmrs' Siale License Law �C�ap�er 9(commencinA m�� ���ion 7000) oi �ivision J o� the BuSin¢ss �T�AN
anE Prolessions Cotle� or iha� �e/s�e is e�emD� Ihereirom anA Ihe Dasis lor IM1e allegeG eKemption. My violaiion af Section 7031.5 Dy I$SUE F, eE
any aOVlicant br a p¢rmit subjecis �he apD�itan� to a civil Denalty oi no� more �han live hunEretl �ollar5 (5500�.
DATE:
. ��s�'��?t�'��****D�*�*�������x
1eiF3EiEiFiFIPif -ifiE�Eii�iFiiiElE�FiE3EifiE�fiF�fieleiflFiElEi6iE3f3eifiF�lF3ei'r3f�1'r�iiidjE3E3E1r�f
F E E S U M M A R Y STRi7CTURAL SEGMENT;N
ELF_TRZC N,ECHANIC FIRE SMIP/RES GRADING
60�SY SMZP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
i, as awner 0� Ihe ompeny ar my emproyees witn wages as ine�r mie campensation, wio 0o ine work, ana me TOTALS-----> 6 0, p 0 0, � � (� , 0 � 6 �, � � 6 �, � � , Q �
� strucWre is no� intenaea or oflered �or sale (Section 7044, 6usiness an0 Pmiessional Code: T�e Conirac�ms' State Licensa Law
tloes not aDDly to an owner ol a pmperty wtw builds or improves Ihereon, and who tloes such work himself/hersetl or thmugh
�is or her own employ¢e5. pmvitletl I�at suc� im0�ovemenls are not intendeG or oileBU for ule. II, however ��e buil0inp or REVENUE D I V I S TON TOTP.1.� $-- > COI L EC 1'� : (� 0, � � O VER /SHORT : 0 0
im0�ov¢men�iSsulEwit�inoneyearolcompietion.lheownervnll�avetheburtlenulprovinghe/SheGiGno�DuiltlorimD�Ove $LDG P�'�iT FLIIMBING ELECTRIC MECHANIC FIR$ $MIP/TOT GRADING I�LAN—CHECK
lor I�e purposE ol sale�. �
I, as owner of ihe D�oDeny. am exclusively coniracting wiih licensed coniractors m constmc� ihe pmlecl (Section 7044, Business 6�,��
❑ antlPro�ession5COAe: TheComraciors'Sta�eLicenseLawUoesnalaDON�oanmvnerofproperrywAo6uilasorimproveslhereon ********�*****�**********�***********�***�*��********�*******��********x**�*�*�
anA who coniracts far sucn pmieats witn a conimctor(sl license pursuanito Ihe Coniraclors' State License taw),I am aware
�hal prool ol ipeir Worker's Campenulion insurance s�oultl be pmvideC m me. I N D I V 1 jj U I� L F' E E B R E li K D � W id
'�.` i am e�emot under Sec�ion: 70 4 4 e. 3 a. c.
ionmsreason BEPC SEE CODE TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date: Owner.
I do here0y cenity Ihat I am aware oi antl un0erstan0lhe reQuiremems ol Calitomia Heallh and Safery Cotle Sections 25505, 25533, antl
2553< anC Ihalloranyluiure Uuilding o[cupanlvnlVwillnot�circle one�needlo comply vnth uiA s�a�e catles antlihe rtpuirementslor a
permii �or consimclion or modilica�ion imm t�e Air Ouabry Managemeni OiSiric�. FeSitlen�ial con5imctian applicaiions are exem0� ��Om
inese O�ovisions.
Dale: ApPlicanl:
I hereGy tenily�Aal I h��e reaa I�is application an0 Slaie��a� Ihe above informa�ion is tarreCi. I agree ro Comply wilh all ciry anG toUn�y
ordinances antl sta�e laws rela�ing lo Cuilding constmclion anA hereCy aN�or2e represen�alives oi �k5 ury to enler upon the above-menlionea
prop¢tly lo�inspeclion purposes.
- Da�e: Signamre:
Driver's �icense oi Socia� Securiiy x: $ � �
1641-a6 WM1ite—BmIA��9: Green—GaCe Enlorcemenl: Canary—Applicant: Pink—Fevenue: GolEanrotl—Assessor
MEC 1 MECHANICAL RE—INSPECTION FEE 30,00 30.00
END OF FEES
]) Q�10834',-�OU.i'�;L �: t..
9KYF: �2�';C;9i ''�1�� 1':�.;
�
!
(
� CONSTRUCTION AND PLANNING � -& SPA
�'APPROVALS Permit# Date Inspector qPPROVALS Permit# Date Inspector
7, Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Sieei Reinforcement 56. Rough P�umbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent•Final
73. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical�Final -
15. Rough Electriwl-Condui[ 66. Solar System-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
77. Rough Wiring Si9� 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Cond�tioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts,in Structure 70. Underground Hydro
22. DuMs, Ventilating 77. Product Piping �Gas OOiI
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas rJ Oil
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (Slructural) & 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. Piaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning 2/��/QL G�0
35. Final Gas Pipe-Test -
36. Hood or Canopy
37. Final Factory Fireplace
39. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final . ,, ._
42. Backflow Preventer �
43. Backflow Irrigation
44. Land:cape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAI.STRUCTURE&BUILDING -,
48, fINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PH0.IECT RD�flESS: ;i � y 9 F.k,�,NC S S L N
owxEe�s nnme: JAML•.'S� C. ROSENFELS
nooxess: 4�1 S. GLASSEL �
� ORANGE CA 92666
IIXCNIENGINEEP: � l 4) 5� 7— 5 9 3 9
�OUflESS: .
UNIT:
flEG.NO.:
UNIT:
PEflMI1TFF: SI,MF. i C, ROSENFELS ( 714 ) 532-5919
aooaess: q�l S GLASSELL
ORANGE CA 92666
LICENSED CONTMLfUP OECLAMiION: I hereGy aKrm tlwt I am IicenseU unEer provisbns ol Chapler 9(cammendnp witA Section
7000) of OiviSion 3 ai Ihe Business and Professions Catle, an0 my liceme ¢ in lullfarce anU eBect.
Cltt IJC.: STRTE L1C.: C1A83: •
�ate: SiOnature: .
WOPKEBS' COMPENSRTION OECUMTION: I Aereby alfirm that I have � cehificate ol consent ro sett�insure or a certilicate af Workers'
ComDenution Insurance, ar a cetlifietl copy thereaf (Sec[ion 3800, Lab. C). '
PoLICY NO.: E%P. O�TE:
COMPRNY:
'� CetlifieC copy is hereby tumiSheE. ❑ CetlifieE copy is fJed with Ne ciry BuilEing Division. �
.e: APOtiwnc �
IXEMPfION FliOM WOflNENS' COMPEN&1TION OEGAMTI01
I certiry that in t petlorma ce ol the work for wNch tNs
suble�� ro e orkers' SatjuLaws of Califomi;
/
Date: Sg�atu
NOTICE: If, alter m kinA ���s Geclaation, you s N
CoEe, you musl lo �wit� compty wit� sucA pro i�
CONSiNUCTiON LENOIN� �GENCY: I �ereEy attirm t�
wAich this Dermit is issueC (Section 3097, Gv. C). I
LENOEfl:
ROUflESS:
i1 tlIe permil ¢ lor one huMr¢d (S'.
�.ny persqn i= any prfnpe� w as
I Y��
me su6jecl to ihe Warkers' Como6nsation DfM�sians Af Ihe Labor
this permit shal� Oe aeemee revokeA. (
e is a conswction Ien4inB a0ency lor tAe OeAormance of I�e woA for
OWNEN BUIWEB OECLAMTION: I hereDy aflirm that I am exempi imm t�a Comractari State Licenu law lor t�a lollowing reason
(Section 7031.5 Business and Prolesilanal CaOe: My tiry ol counry whicA reQuires a permit ta construct, aller, imDrwe, Uemolish, or
repair any simcture, pnor m its issuanca, also requires t�e appliwni lor SucA Dermit to /ile a sipne0 slatement that Ae/she i5 licenseA
pursuam ro t�e pmvisians al t�e Cant2ctors' State License Law (Chapter 9(commencinq wit� Section 7000) al Oivision 3 of tha Business
anA Professions Code) or IAat he/sne is exemD< <herelrom an0 Iha oasis for tne alleOeA exemptlon. Any violation al Section 7031.5 Oy.
any applicant lar a permi( suEieCls tne appliWnt to a tivil p¢nalry of not mom tAan five �unOred tlollars 155001.
I, as ovmer ol ihe properry or rtry employees wit� w�pes as their sole mmpe�5ation, wi0 Aa ihe work, an0 t�a
❑ simcture is not ImenUeO or olferM tor sale (Section 7044, Business anE Praleuional CaOe: T�e Comactors' State License Law
Aces not appy to an ovmer ol a pmpeM � OuilEs ar imOmves thereon, anA who Uoes suc� wod himself/Aerself or ihrou0h
his or �er own emplayees, Drovidtd ttut suc� improvements are not inten0ed or otleretl 1m sate. II. however the �uiltlinp ar
ImD�avementis sa10 within ana year ol wmpleGon,tlre ownerwill have t�e burtlen oi D�ovinp �e/s�e E10 not huiltl arimprove
lor �Ae Ourpose ol sale�.
I, az awner ol t�e proDe�ty am exclusively wnVactlnp witA IicenuU coniractors to constmct Ne D�olect (Section 704A, Business
❑ anG Pm�essions COAe: The Contraci0rs' Stala License Law Ooes rqi apply IO an ovmer o� pro rty who b Ids or imDrovu theteon
antl wno contracts for sucn Dmi�� w��h a contmctor(s�license Dursuani ro tne Coniract State ' enSe Law). aware
tha� proof ol t�eir Warker's Compenutlon insurance sAoulE �e pmvi0e0lo me. /✓
� I am exempt unAer Sec�ion: -� � 4 q B. 8 P. C. �
fort" re on: A C$EL CODE �j
�ate: Z � C
I tlo �ereby cen' t�at I am wara of anG unCerstand the requiaments I ifo ia Health and Safery CoUa Sections 25505, 25533, and
25534 an0 that or any luture 6uiltlinp occuDant wiiVwill not (circle one) n lo ampH wii� said state codes anU Ihe reQuiramenis �or a
permii lor cons�mction or modilication Imm t�a Nr Oualiry ManaOement st' t. NesiAemial consiruction applications are exempt Imm
tAese Dmvisions.
Date: �lppliwnt:
i �ereby ce�iy I�ai I �ave 2a0l�is aD�licaiion anG staie IAat the e iniormation is correct. I aqree m camDly vn�h all ciiy anA
orainances an0 state lavrs relati p to ouildinp canstructian an0 he uthoiae represent ' � ciry to enter upon itre ov�ma
pmDeny for inspe ion purp es. � -�
. Date: SiqnaWrt: � �
Driver's Licen or Soci Securiry M: �
164/i6 W�ite—Builtlirg; Green—COCa EnforcemenC Canary—Applicant; Pi^k—Ravenue; GolOenrotl—Auesso�
ClTY OF COSTA.MESA - BUILDING PERMIT
P13RMIT NO: F. 046?.44 PI.ADI CH�CF< NO: N
PERM NU: � 04624A '
GOVT: M SUPP: Y
CONSTRUCTIUN 'PYFC: PERMIT TYPE: ELE FURPQSE: OTH
JOD DLSCRIPTION : LEGALIZE ADDIT'IONS' SQ FT:
CLATM VAL(7F..: CALC-VALUG: GROUP OCC: R-3. / .
COMMENTS: R6F �345801/EP45958 .
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'L O N I N G R F. Q U I R E M E DI T&
se•rr�Acxs
---- MATN BDILDING -------�---- -------- ACCES50RY BUILUING ----------
FRN1'; FT IN RfiAR: F'T IN h'RNT: ['T iN REA12: F'T TN
I�EFT'; FT IN RGHT; PT IN LEFT: F7' TN RGHT: FT IN
PARKING ItEQ: PftOV: ' P�:RCEL: 1413�1].1 ZNL": kEF NO: '
PLANNING NU'I'�5>
s �
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D L•'V E L O P M E N T i E R V't C E$ R E Q U I R E M H N T S
ZQN2NG AFPROVED BY ' _ __ DATE: _
DUILL"�INh A�'pFt�7�i�t? HY : DAT�:
P.PPLL(:ATIUN ISSUED E3Yc , � DATE: �'7 '�'��
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LFGALT7,ATIC7N:Pt ` F E E S f" M M A R Y STRUCTURAL SEGMfiDIT:Pd
BLL�G PtdT PLUMHING ELECTRIC �MECHANIC FIRE SMIP/RES; GRADI�JG
PERMIT _ 3.0 i��: '
: 50 >MIP/NON_-RE�
PLP,N � • . .:
ISSUE FEE '4.50 ' � �'
BUZLDING-DIV-> PERMIT ISSUE PIiAN=CHECK TQ'PAL PAID DUF.
'TOTALS----> 3.00 4.SU • ,'0-.00 7.SU 7.50 � .OU
�.
REVENUE L'iVISTON TOTALS--> Ct�LLECTED: 7.50 OVF.R/SHORT; "�'' 00
BL�DG PMT YLfJMHTNG ELECTRiC MECHANIC FIRE SMI TOT GRADING PLAN-CfIECK
).5Q . '
i( i; iF if 3( iE 3F 3E iE iE iE M iE �E il� �M��1f 1E M- iE jE jf �1E jE iE Y.� iF i( iF 1f 1(� jf M 1f 1E � iE if 3k �k iE M if iE ik if jE iE iE 1E%iE j' ik iF iE if �E iE iE 1E if if iE if iE iE iE iC 9t 3f i('�E iF iE iF 3f if 3E
� l: N A I V 1 D U A L: ��T' E F: A R G A' f< D O W N ��. �.
TYDE QTY D E S C' R I P T' I O:.N,^' '� UNIT COST TUTAL COST
ELE 1. MOT'OR/POWR AFPARnTUS (�.0 - 1.0 HP J.UO .'� i 3.00
EIdD OF FEES '
A
01`9054II01-00054801'"T[7�T 7,50
DATE: 02/23/90 TI11E:' 18:12 '
- , ,
CONSTRUCTION AND PLANNING POOL �A
APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
i. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' �
2, Soil Pipe-Undrgrnd. . 53. Steel Reinforcement �
3.�Electrical Conduit Utility-Undrgrnd. � 54. Forms
,4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
�5. S[eel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � ' 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Electrical Conduit�Undrgmd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash 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 Cap - 63. Heater & Vent-Final �
13. Roof Drains - 64. Plumbing System � Final, �
14. Rough Plumbing 65. Electrical-Final .
15. Ro�gh Electrical�Conduit �, 66. Solar SYstem-Final ,
i 6. Rough Electric Wiring '��r o� ,�, 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTEftING �
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. Oucts, in Structure ' 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas OOiI
23. Gas Pipe-fiough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead HYdro �
26. T�Bar Ceiling (Strucwral) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding ,� 77. FIXED SYSTEM FINAL
29. Insulation �� j' 78. FIRE PREV. FINAL
30. Drywall Nailing ''� HEALTH DEPT. REQUIREMENT
37. Plaster BroWn Coat � ,, 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � �� Notes: 3 O i' Q�o Y�
34. Final Heati�g & Air Conditioning . �' �
/
35. Final Gas Pipe�Test j,3� �� C�r�
' ,.
36. Hood or Canopy � • .
: � .
37. Final FactO�Y FireplaCe : ' �
38. Final Plumbing - .. '
39. Water Service-Final
40. Gas Service-Final �
41. Solar pomestic-Final _ ,
42. Backflow Preventer -
43. Backflow Irriqation
44. landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations ,1
47. FINAL STRUCTURE & BUILDING �;° �(�� �
48. FINAL PLANNING ^. � g ��'
49. Electric Re�ease to Edison • /
50. Gas Release to Southern California Gas Cv ,-�
51. CERTIFICATE OF OCCUPANCY
No. Date
PNOJECT RDONESS: Z�J 9 9 F'�i�,��C 1 ur 1.1�
OWNEH'SN�ME: JI�,T�ES C, ROSENFEl�a
eooxess: z7y.y �F;ANC7S liN
i�OSTP_ MF.SA
� �` CA 9�62(i
�NCHIENCINEEfl:
•� - FDOBE58:
nec.xo.:
UNIT:
UNR:
' PEPMITTEE:�]Q{�' MP_RFC P,tIILLIPS . (71�1)631-84tif3
�DOBESB: �79y FRAI�CZS LN . 0
COSTA ME5A CA 92G"l6
LICENSED CONTMCTOB DECLAMTION: I here0y affirm that 1 am IicenseA under D�ovisions oi Chapier 9(commencinp with Section
7000) oi Division 3 of tAe Business an0 Pmfessions Cotle, and my license is in lull force an0 effect.,
CITY L1C.: 8T11TE LIC.: C1A55: - �
Data: � - SiAnaNre: �
WOpKEflS' COMPENSRTION OECUMTION: i hereby aflirm that I have a certificate of conunt ta self-insure or a cenificate ot Workers'
ComDensation Insurance, or a certifiea coDY Ihereof (Section 3800, LaE. C).
POUCY NO.: ' EXP. D�TE: �
COMPANY:
�.,'� Certifie0 coDY is hereby fumished. ❑ Cerli�ie0 copy is �ile0 with ��a ciry BuilOing �ivision.
:5ate: Applicant _
E%EMPiION FNOM WOHNEBS' COMPENSRTION OECUMiION:
I cenity that in ihe Oe�o�mance of the work tor whic� this p
sublec� �a th Workers' Compen5aiion Law af Califomia.
Oate: Siqnamr�
NOtICE:`Ii, af14r making this Oeclamtion, you shoUM
CAJe, you must (oNlWlih fAmDly vnth suc� provisiort.
CONSTPUCTION LENOINC RGENCY: I AereUy atlirm I�at
wnicA this permit is issuetl (Sectian 3097, Gv. CI.
LENUFfl:
nooeess: - .
�. is iuue0, I shall�+n � not emplay any p�
me suDlect ta the Woikers' COMp�
lhis permit shall be deemed revoN
e is a constmction IendinA agency
i
t�
pr visions of �he Labor /
pedormance ol tAe work for
,
OWNEB BWL�EB UECLAMTION: I �ereCy affirm ihit I am exempt Iram iha Contracrors' State License Law lor Ihe followinA reason
(Section 7031.5 Business and Protessianal'Cotle: Any city oi counry which requires a Dermit to consimct, alter, imD�ove, Aemolish, or
repair any structure, O�or to its iuuance, aLso�rt puires the a p Dlicant tor sucA permit to file a siAneO stalement ttwt he/she is IicenseU
pursuant to t�e pmvisions ui the Coniractors' Sta�e License Law (CAapter 9 �commencing wii� Section 7000) of Division 3 of tAe Business
anU Pmfessions CoOe) or that helshe is'exempt t�eretmm an0 t�e basis tor the alleped exemption. Any Nolation of Sec[ion 7031.5 by
any aDPlicanifor a Dermit subjec[s t�e ap0liwm ro a citil Denalry oi not more ihan five AundreE Aollars �5500�. .
I, as awner ol Ihe Droperty or my employees wiN wa0es as Neir 5ote� compensation, will Ao the work, an0 the
❑ stmcture is not intenOeA or oiferetl lor sale (Section 70A4, Business antl Pmlessional Coda: The Contracrors' State License Law
tlaes not apDty ro an owner ol a Draperry who OuilJs or ImDmves thereon, antl who tloes such work himseli/herseli or ihrauAh
�is or her own employees, D�avideU that such imprwements are not intenUed or offere0�for sale. II, Aowever the builOinA or
improvement is sald within one year of completioq Ihe owner will have t0e bur0en of Droving he/she did noi tiuilA or imDmre
for Ine Ourpose ol sale�. �
I, as owner ot the pmperty. am exclusivel9 contractinA w��h licensed coniracrors to constmct tAe prolect (Section 7044, Business
0 . ana Professions COEe: The Contactors' State License Law dces not appty to an owner of pmpeM �0 6mitls or impmves Ihereon
and wAo contracts lor such D�ojects with a contracroqs)license pursuant ro�the Contractors' State License Law�.l am aware
Ihat oraof of tneir Woder's Compensation insurance 5nou10 Ue D�ovieed to me:
� 1 am exempt under Section: j{; B. 8 P. C. '
far th¢ reason %` ,Q q�. • � �% / ¢�/
Oate: � I2 I2' d � Owner N`�' nG'" f7 " � /
I tlo hereby cetliy t t I am ware of ana untlerstantl the reQuiremenis o R mia Healih an0 Safery Cotle Sectio s 255 , 5533, antl
25534 an0 that I or any future buil0inq acupant wilUwill not (circle one) ne camo�Y ��h sai0 state cades and e requiremenKfor a
permfl for constmction or modifica�ion trom t�e Air �ualiry Managemem D ict. BesiOential consimction aODlica ions are exempi irom
these provisions. � '
Oate:. FpO�icant:
I AereUy certiry Ihat I Aave reaOlhis appliwtion an0 state tAat tAe above information is correct. I
ordinance5 and siate laws relatinp to buiitlinp cons(mction and hereby aut�orize reD��nG�iv tl
pmpeM �or inspe ion pur/Pp,sfes�. /7
Date: 'Z' �Zl� SiAnaWre� T' n�
� �
odver's Licenu ar Socia� Securiry x:
16a1<6 ' Wfiita—BuilEina; Green—COCe
all
Pink—Revenue: GOICenrotl—Assessar
CITY' OP COSTA MGSA� — DOZLDI'A1G PE'Rt4IT
PERMIT NO: IA 045352 PLAN CHE�C;IC NU: ' N
CUIdSTRUCTIOtd 'TYPE: V�14 , PE:RMI7 TYPE: OTH STft
JOB DE�SCRIPT.T.OM : ADD E'AM _RM TO E.XIST SFD • S� F1':
CLAIM C�ALUi,: CALC—VALUE.: � CRqUF OCC:'R-3 /
`COMMEDITS: REiNSPECP TO EPALUATi•: EXPIR. PERM #38443 �
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2 O Id l: N G R E Q U 7 R E M E N T S �
S E T R A C K S
et:�2M nio: TFi oa5762
GOVT: D] S�OPY: Y
PURPuSE: AGP
MAIh] liUII,DING -------- ---------- ACCL•'SSUAY FiTJIL'UZNG -----�----
FRD1T: FT IAI REAR: rT IN FRNT; F.'T IN F.tF..AR: FT TN
LEFT': FT Iid RGIiT: FT 1'N LEP'T: FT IN RGHT: F'P IN
PARRING REQ: PHOV: PARCEL: 1413J1.7;1 7..NE: REF D10:
PLANNING NOTES> �
�
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' D� V L:I, O P M E N T S E R V I C E S R E� U I R E M E N T S
� ZONING APPROVF.L� BY .
BUZLDI.NG APPRUVGIS AY :
DATE:
DATF•_ :
APYL�ICA'LION ISSUGU BY.: L�����' DATE: �2—'—'�2 �'��
i��i�it�i[-i:�i(�3Ei[��:i��Eit�Mi�lf�5e**�i��fifi��"g�F'iF'3f' -rZ'Fi i�iF�k��'��T.FiFi� iF'iF'gi�'T�FiF�'�*i�*x�*�t#*iEiF'�F'�#i�"£�'iF"#. �x�
iE�tEiFiEi(�iF`%fEifiEiEiEiE�lEiEif��iEil�lEiEiki'iE#i:�3EiE*iFiFdE9E3FiEiEififkiEiFifiF#iFiE%iEiE�IEiE�ki;iEiE�%�lE#iFiE3eiE-IE%�1EifjfiE#dE?f3E�E%iE�H-iE� 3E
LEGALIZATION•N - F E F. S D
. M•M P� R Y S7'RUCTURAL SLGMENT:Y
I3LDG PMT i�LUMBZNG ELECTRIC MBCHANIC FIRE .SMIP/FtES' .GRADING
PERMIT, 30.00 . .-
SMIP%NON=RES
pt.Aro �. : � . ti
ISSUE FEE � 1=
nUII,DING—DIV—> PERMIT ISSUE ` PLADI—CHECK 'TO'PAL PAID "' .., DIIE
TOTA'LS----> ' 30.00 0.00 0.00 JO.UO. 30.00 � .00
REVF.NUE DIVISION TbTALS--: COLLECTEA: 30.00 UVEk/SHORT: �''~� .00
BLDG PMT. PLl7MBING ELECTRTC MECHANIC FIRE SMIP/TO'P GRADIDIG PLAD1—CHF•.CK
3n.n� ' , .. '
.�lE �� 1E 9f jc �E fE �lf dElE'E if iE iE K iE iE iE'h iE'.E'.E iE iE 1F-)F �N 3E i(- )f if iF iE iE iE ik if iE iE iE i! �E it !E �f iE iE df 3E iE �)E �f- if )E iF #�f k�M-iE .'E fE d(-!E �lE iE i't �E if iQ�if, ii: dt iE-ik �lE iE iE 3k
T N D I V I D U� A L £ F_ E B R E A K D O W Dl. r_._
TYPE '�TY D E S C R I P T. 'L O N ONIT COST ;20TAL CUST
� NS 1 BU7LDiNG RF,—INS}?ECTION FEE �0.00 • ,�,,, ]0.00
' EDID OF FEES .
� i' �
inry �
ne0 _
1
O1 U�D49527-0�044527 TC�T
DATE: 12/12/84 TIISE: 12:26
30.aQ
CONSTRUCTION AND PLANNING ' � � - . , - POOL .,PA � .
APPrtOVALS Permit#�� � Date ' Inspector pppROVAI.S Permit# Date Inspector
1. Temporary Electrical Service or Pole �-' �' 52.'Pool & Equipmen[ Location ' ���
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgmd. 54. Forms - - .�
� .
4. Electrical Conduii-Undrgrnd. . 55. Electrical Bonding ' �
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
�7. Footings � . � 56. Electrical Conduit�Undrgrnd. �
. 8. Foundation _ 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undr9rnd. 60. Backwash Lines, P�Trap, O Undrgrnd., _
10. Structural Ploor 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 - 'i �
15. Rough Electrical-Conduit 66. Solar System-Final � • -
> '--
16. Rough Electric Wiring ' 67. Fencing & Access Approval ', � �
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING �'� .
j':
18. Rough Electriral-T Bar Ceiling '; 69. POOUSPA SYSTEMS FINAL .� � ' �
19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT ; �•
20. Rough Factory Fireplace APPROVALS. Permit #
21. Ducts, in Structure ' '' 70. Under9round Hydro '
22. Ducts, Ventilating � � . 71. Product Piping � Gas ❑ Oil
23. Gaz�Pipe�Rough & Test . , 72, Under9round Flush '
24. Roof Framing . 73. Undergmd.StorageTank-OGas ❑Oil
25. Roof Sheathing - 74."Overhead Hydro •
26. T�Bar Ceiling (Structural) & Monocoat . 75. Dry Chemicai
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-Finat �� S0. FOOD CERTIFICATE ISSUED
33. Final Electric � � Notes: - �
34. Pinal Heating & Air Conditioning �� ' '
35. Final Gas Pipe-Test ' � .
� 36.-Hood or Canopy � ' -� �
37. Final Fac[ory Fireplace . . ,
38. Final Plumbing � , �,
39. Water Service-Final . .
40. Gas Service-Final - • �
� 41. Solar pomestiaFinal � �
42. Backflow Preventer - _ ' '
43. Backflow Irrigation " � � . �
44. Landscape Irrigation System � _ . � .
45. Sound Attenuation � , �
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING � � (?, _
48. FINALPLANNING " - 3 `/ (�a!� � G �
• 49. Electric Release to Edison � � . '
50. Gas Release to Southern California Gas Co ..
51. CERTIFICATE OF OCCUPANCY
No. Date . � �
�
Pfl0.1ECTRDOBESS: 'J7�)�j ['gANCIS LN
OWNER'SN�ME: ij�ES C. R65ENFELS
aooeess: ?�gg FRANCI.S' I,N
COSTA ME.SA
, CA 92.676
�PCN/ENCINEEH: '
AOUflESS: � � ' .
uxir:
flEG.NO.: ' .
UNIT:
PEflMITTEE: J(JN MARK PHILLIE'S ( 7:14 ) 631-8488
aooxess: 27gg �'HANCIS LN 0 -
COSTA MESA CA 926'l6
UCENSEO CONTMCTOB DECUMTION: I here6y atlirm ihat I am IicenseA unaer pmvision5 of Chapter 9(commenclnA ��h Section
7000� oi �ivision 3 of ��e Business anE Pmtessions COGe, antl my li�¢nse is in full force and eHec1.
CITY LIC.: STRTE IIC.: , C1A33: '
Date: Si9naNre:
WOBNERS' COMPENSRTION OECUIIATION: I �ere6y aBirm that I have a certiticate af consent ro sel/-insure or a certificate oi Workers'
� Campensation Insurance, or a certifietl copy thereoi (Sectian 3800, Lab. C). � '
PoUCY NQ.: EXP. O�TE: .
COMPRNY:
� Certified coOY �s Aere6y fumishetl. ❑ CertitieQ copy I5 fileA un(h ihe ciry BuilQinO �sian.
,,�e: Applicant:
E%EMPTION FBOM VNBKEPS' fAMPEN3RTI0N DECIA(WTION: Rhis section need nat he comDleteU if Ne permtt is for one hunOreO �5100) or lew�.
I cenity that in the peAormance oi tAe work far whicA ihis Dermit is iss etl, I shatl not emplp person in any m e� so 6 to beFome
suGject Io� -Ih7e larker ' JCompensation La af Califomia. � r 0^ 6 q/,
Daro: � �Z V - SignaNre: � � -J- � / �
NOTICE: , afle mald p this tleclaration, you shoul0 n tlbject to I�e Workea ComOensa[ion visians e LaGor
CaEe, you must tortMnt� comDly vnth such pravisions or t s permfl shall Oe Aeemetl revoked.
CONSTBIICTION LFN�ING RGENCY: I �ere6y a8irm tAat there is a �ansimction lendinp apency for Ih ertormance ai Ihe woB for
w�ic� ihis permit is issued (Sec�ion 3097, Civ. C). . , � •
LENOEH: ' � �
FDOHEBS: � '
OWNER BUIWER UECUM7IOX: I �ereEy atfirm that I am exempt ��om t�e Contracmrs' State License Law for the lollovnnp reason
(Section 7031.5 Business antl Profeuional Cotle: My ciry al counry wp{ch requires a permtl to cunsirud, al[er, improve. Eemolish, or '
repair any strucNre, pnor ta its issuance, also requires [he apDlicant for such Dermit to file a sipnetl statemeN that Ae/she is Iicense0'
pursuam ro tAe pmvisions ol t�e Contactors' State Licenu Law �Chapter 9(commencinA ��h Section 7W0) 01 �ivision 3 of the Business
and Pmhssions Code) ar that �e/she is exempt therefrom anA Ihe 6asis br t�e alleAetl eKemD��on. Any violatian of Section 7031.5 by
any apDlicant for a permit suhlects the apD�icant ta a civil penalry o� not mora than five huntlre0 dollars (5500).
I, az owner of iha D�aperty or my employees wii� waA¢s as their sole compensation, will tlo tha wark, an0 Ihe
❑ stmcture is not inlendaA or ofleretl lor saie (Section 7044, Buyiness anA Protessional CaOe: The Contracrors' State License Law
Aoes not aDO�Y �o an owner oi a DroOerty who builOs or impraves tAerean, an0 who Aoes such work himself/�erseli or ihraugh
' his or �er own employees, D�ovitle0 t�at suc� imD�ovemen[s are nat intentled or offered far ule. It, hawever Ihe buildinA or
impmvement is soltl wrt�in one year o( completion, Ihe awnEr will have the UwUen of DmvinA he/she Oid not OuiIG or impiove
9or Ine purpose a/ sale�.
I, as owner oi t�e Dmperry, am exclusively contractin0 ��h IicenseC contradors ro mnstmct t�e pmle� (,Secdon 704A, Business
�❑ an0 Professrons CaOe: The Contractors' SWte License Law tloes not appty to an owner of propeM �o hwl0s or improves Nereon
and who con[racts for such Dmlects witA a coniractor(5) license Dursuant m the Contractors' State License Law). I am aware
that proof oi [heir Worker's Comp¢nsation insurance sAOWA �e provitled to me. ,
� I am exempt un0er Sec�iore }( . 9. 8 P. C, ' �
tor this reason: •% 0 4 /�/ � ' �-
Dare:_—�2,_v�i� �wner' �
i Oo hereCy ceniry tlut I ar� aware 6i an0 unaerstana the repuirements of I omia Healin ana Satery aJe Sections 25j 5, J�ine-
25534 anC ihat I or any fuiure builtlinp occupan� wilVwill nm (circle one) n m com0ly vntA sai0 sWte coAes an0 t�e r/Quirements tor a
permit for canstmctian ar moGifiwtion Irom the Nr Quatiry Manapelryent � trict. Pesi4eniial consimction aDPlicationA2re exempt fmm
�hese pmvisions. /
Date: ' FApplicant: �
I here0y ceniry that I �ave read this aOVliwtion �anA state that the a6ove information is cortect. I apree ro comply with I�anO caunry
. DrEinances antl state Wws relatinp to huil0in0 conslruRion anG herehy aUthorize representatives of t�is ciry ro eSr upon t Go�-mentione�
. roperry tor inspecii n puryos 5. � �
Dale: 2 ( S�Anatur r/ � I � �
onver's License ar Sociai Secunry x: $
16C1-98 White—BuilOing; Green-CoOe Enb¢ement; Cenary�qpp�{cant; Pink—qevenue; oltlenrotl—Assessor
CITY OF COSTA MESA -- HUILLING PEkMIT
PERMIT NO: IB 045363 ' PLAN CHECR NU: D1
CONST'RCICTIODI TYPE: V-N L'ERM7T TYPE: GTH STR
PERM NO:'IB 645363
GOVT: N SUPP: Y
PURPOSE: AfJD
JOkI DESCRZPTI:(�N : AIiD FAM RM Tp EXIST SFD � SQ FTe '
CI�AIM C�ALUE^ CALC--VALUE: , , GROUP UCC: R-3 /.
COMMENTS: REINSPECT-TU EVALUATE EXPIR. PERM k38557
��**�********�t**x���**�**�t***r�-**��x****�-**?c-***�x-*�r;�+t�*�x��-#x�x�*x�*��t�-*+t**��i��t��.**�r�t-�t-�*
7. O N I N G R E Q U I R E M E N T 5
� . S E T B A C K S �
� .
-�---------- MAIN B[)SLDING ----------- ------ — ACCESSORY HUILL)IDIG ---------
FRNT: FT IN REAR: 'FT T.N FRNT: FT IN ktEAR: FT IN
LEFT: FT ZN RGHT: FT IN LEFTi FT IN RGHT: FT IN
PARK7NG RE�: PRUV: PARCEI,: 14133'111 2NE: REF NO:
FLANNING NOTES> . • _
. � . . . . • � r .�_
if iE iE if iE 1E i( 3F iE �� if iE �%df 3f ih iE iE iE 3E jF iE if if iE iE %� iE� 9E iE iE iF iE iF iE if it if if if if d(-if �1t ih if iE 9F iF �lE iE �lE iE iE iE iE�Y.� if iE 3f iE �lE iE iE i(� �1E iE �lE iE iE iE iF iF #�t iE jE iE #
D F. �V E L O P M E N T; S E R V I C r S R E Q U I Ft E M E N T.S
ZONING APPROVGD BY _ DATE: ____
�QUILDTNG APPROVED AY : _ � �� � � __ DATE: _ _ �
APPLICATION ISSLIED BY: �fN DATEi ���2.-'U°
it-KiEx�iEiEiE�:-*�iEiEit*�titiEiEiFiE�-iE'�'il��FTr�'R'�F����Fit��F3E � �c������iF*x�*,�*a�***a���F �'�'+r�'iF�"��**
�fb ik it ik if if i(-iE �F iE iE iE if # iF jE df ## if ik if i4 f!� iE if iE it i;� it ��'.F iE # if iE it it iE iE ik dt iF fF iE iE iE iE �Y.� iE if df if iE iF iE 3E �3E�ih iE i:� iE iE iE iE iE 3E lE �F jE �)E �lf 9E ih # 3E iE iF iE
LEC,ALI7.ATTON:N F E L" S U M M A R.'Y S'I'RUCTiIRAI, .''i[:GMLN'C:Y
BLDG PMT PLL)MBING ELECT.RIC MECHANIC FIRE SMZP/RES GRADING
PERMIT 30.00 .
SMIP/NON=RES
PLAN
ISSUE FEi' ,
EiUTI:DING-llIV-? PERMI7' ISSIJF PLAN-CHECK TUTAL PAID DUE
TOTALS=---> � 30.00 O.OU ,0.00 J0.00 30.00 �'.00
REVENIIE DIVZSION TOTAI�S--> ,COLLECTED: 30.00 OVERISHORT: �.00
ALDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRAL7.NG PLAN-CHECK
30.U0
dE i4 ik �k iF-%iE ?F jF 3E if iE iE �1F �If 1f 3k iE iE jf if fF iE iE iE iF 3E 1E it iF if iF ik if iE iE iE iE 9f j:-�1E 3E iE iE # dE jE iE jE 3E � 3E af �k iE!(-if 3E jE �E 9E �E iE �)F 3F dE iE �IP jf iE iE iE'�E.3k iE i(� iE lE iE
. I N D'f. V:f: D U A L' F F. E F3 R E A K D 6 W N .
T`,:VE QTY D E S C R I. P T I,O N UNIT COST `TOTAL COS1'
IA15 1. IiUILDIAIG RE-INSPECTlODI FEL•: 30.00 �' 30.00
- GND OF F'EES . ' :
0
tl
f;
OS OQ049526-OD049526 -;Tti!T 3t1.Ofi
� DATE:-12/!2/89 TIME:'12:25 �'
w �
. CONSTRUCTION AND PLANNING �- POOL rA
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector
1. Temporory Electrical Service or Pole -- " � 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement •
� 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � j�` -
4. Electrical Conduit�Undrgmd. 55. Electrical Bonding � _ � �.
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test , -
6. Electrical UFER Grnd. �� 57. APPROVALTO COVEfl�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundat�on � (, ,,� 59. Gas Pipe, O Undrgrnd., Test " ��
9. Water Pipe-Undrgrnd. - � 60. Backwash Lines, P�Trap, � Undrgrnd. .
10. Structurel Floor System 67. APPROVAL TO DECK '� -
� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � �=
' � 1 12. Sewer Cap - ' i-� 63. Heater & Vent-Final �� �,
13. Roof Drains ' 64. Plumbing System - Final� ' "S �- �
14. Rough Plumbing ,� 65. Etectrical-Final _"' y �' ,J
15. Rough Electrical-Conduit , � 66. Solar System-Final '
J�'`
16. Rough Electric Wiring � '� , 67. Fencing & Access ApProval ��% � �' �
17. Rough Wiring Sign � �3 � 68. APPROVED FOR P�ASTERING'�'�`:� �'� '
18. Rough Electrical-T Bar Ceiling - 69. POOUSPA SYSTEMS FINAL �� '� �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � �
20: Rough Factory Fireplace . � APPROVALS Permit #
21.Ducts,in�Structuie 70.UndergroundHYdro �
22. Ducts, Ventilating � 71. Product Pipin9 OGas OOiI
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 ffi Siding � � - 77. FIXED SYSTEM'FINAL
29. Insulation � �� 76. fIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes: -
34. Final Hesting & Air Conditioning , . � �
35. Final Gas Pipe-Test . � . �
'36. Hood or Canopy ' � � -
37. Final FaCtorV Fireplace V--
38. Final Plumbing � � . � �
39. Water Service�Final � .
� 40. Gas Service-Pinal -
41. Solar pomestic�Final �
42. Backflow P�eventer ' ' �
43. Backflow Irrigation �
44. Landscape Irrigation System � - - ,
45..Sound Attenuation � .
46.�Handicap Regulations � . .._
47. FINAL STRUCTURE & BUILDING ;. ` CJ`r
48. FINALPLANNING � � �� '
;
49. ,Electric Release to Edison �
50. Gas Release to Southern California Gas Co '- ,
51. CERTIF�CATE OF OCCUPANCY
No. Date
PflQ1ECT�ODNE33: Z']y9 FRANCI.''i LN
OWNEN'SN�ME:JOI�I MARK PHILLIPS
�OONESS: z'��9 FRANCIS LN
• COSTA MESA
CA 92626
�flLN/FNGINFEp:
�OOHESB:
UNIT:
e 1
HEO.NO.:
UNR:
. . PEflMITTEE:JON MARK P1�IILLIPS (714)631-•l34FlD
', RODflEBS: z] 9 C3 FRANC I S LN 0
COSTA MESA CA 92626
1lCENSEO CONTMCfOB OECtAMTION: I IrcreEy alilrm Itwt I am IicenseO unEer pmvisions al CIwD�er 9(commencln0 ��h Section
700U) at OiVision 3 0l Ne Business ana ProteulUns COEe, antl my Ikense is in lulllorca anA etlxl.
CITY 11C.: STRTE LIC.: CIASS:
Date: S�p�aNrc:
WOPNEBS' fAMPENSRTION OEIXAMT10N: I lrere atllrm tlut I luro a mNfirate of consent to ulNnwre or a ceniikate of Wo�ers'
�.OfI1pCn5d11011 IfLSUfdlltl. 0! d CEIL11ltl COPy IIKf201�$CCfqll 38011, Ld�. C�.
PoLJCY NO.: ' E%P. D11TE: '
fAMPRNY:
� Certifietl copy is hereby furnisheE. ❑ CertifieE copy ¢ fdeE with Ne tiry BWldinp Oirision.
.ie: Mclicant:
IXFIAPIION ff10M WOXIfENS' COMPENSl1TION OEpAHAT10N: (iAis ucrim n¢G not Oe campeRO il tic pemd b la aro IiWrtG (f10Pi or kss�. '
I certity Ihdl in the peAormaMe ol Ne wwk tW wNtll tllit pemYt R issue0. I Shall iqi empby any person in dny man�uf 5o az t0 Cerome
SIIbiEti l0 Ih0 WOfktfS �.DmpCM15dI1011 LdWS 01 �d(It011lld.
Oate: Sprowre:
NO710E: II, atter maAinp ttcs Eeclarztian, you stqulG Dewme suqecl to IM Workers' Compeivatron Oroviskm of tM LaUor
Code, you mus� IortMviN mmpy wiN suN DroW5ion5 or N's pemit s�aA Oe OeemM revakeE.
COXETHUCTION IFN�ING �CFNCY: I �ereEy affirm ttul Nere is a aistnrcibn IeMinq apency lor tM pertormanu al I�e work lor
wNch I�is permit is iswed 1��� �7. Civ. Cl.
LFNDEfl:
FODNESB:
OWNFR BUIIDEN OECIAMT10N: t �ere0y atlirm ttat I am e�em0� ��m t�e Coniractors' State Liceiva Law lor tha lollowinp reawn
(Section 7091.5 Business aM ProlesUanal CaOe: My dry ol counry Mtich 2pWra a pemut ta mnstruct, alter. improve. Oemolis�, ar
repair any strucWm, D�or to ib fsswnu, also repWas Ne �pptiant lar such permit to lila a 51pneG statement ttul he/slie is Ilcense0
pursuant �o t�e Orovisions ol Na Contractors' State License Law �Cluprer 9(mmmentinp with Section 7000) of Division 3 0l Iha Business
anG Pmfessions Cotle) ar tlWt treJs�e is exempl t�erotNm anC t�e Uasis for tM allepeE axemptiM. My violalion ol Sectian 7031.5 Oy
anY a0dicanl tor a Derrtut wbects tM applicant to a dvil penally of mt mom tlun INe hufMreE Eollars (3�1•,
1, as owner ol IAe pmpeny or my empbyees yriN wapes u meir sole wmpenuGan, vnll Eo Ina work. anA tAe
❑ simctureis notintenOeC araBereAlorsale(Se�ction 70Aa, Buvnpss anA Profes5ionalCoUe: T�a Caniractors' State Licansa Law
. tices �rot aDVN �o an ovmer ol a O�D�M � OWI0.t or Improves t�ereon, aM wtq Eoes suc� wark himsetl/�ersell or I�raup�
his or �er own emdN',tts, 0��� «� suc� imprwements are noI IntenOeO or ottereE lor sale. II, fawever I�e 6uiI41n0 or
imOmvement LS Soltl vninin one yeaz al fAmpletlon, tne owner will have the EurCen ol proNnp nUs�e 4iU nat Uuiltl ol ImD�ove
for ma ourpose a1 salel. .
� I, as owner ol Ihe pmperry. am aclusivety contracMp wlin Iicensed contractors to constmct tAe D�olect (Section I014, Businass
❑ and Pmfeuims CoOe: The Coniraclars State License Law Eces not apoN to an avmer ol pmp¢ity wM EuAds or improves thareon
anE wlia comracis lor SucA pmjects wit� a cont2ctoqs) license Dursuant to Iha Coniractors' 6uta License Law�. I am awam
Ihat Draof of thdr Worker's Campenutlon insurance sIpNE Oe D�� �o me. �
� I am exampt unOer SecliOn:}( B. d P. C. ,
lar tnis aazo�: '] � q q �n
Oate: � � �/ V / Owner: – " �
I Oo �ereDy certiry t�at I am awam al anU unUerstanE t�e reQuirements of Calif Heati� anG Salery CaUe Sections 25505, 25539, anE
25534 anG that I or any Wture GuilOinA acupant wllVwlll not (tirUe one) neeE to comDN ��� �a state caEes antl tha reQuirements lar a
permit for construction or rtw0i/iuuon trom I�e tir Oualiry Manapement Oisirkt. NeslOential consiructlon appliwtlons are eeemD� ��om
these pmvisions. '
Date: ApDlicani:
I hertby certiry that I have reaC ihis appliwtlon and state that tAe a6ove inlormation i correcL I a0ree lo comply witA all city and counry
or0inance5 anC stata lavrs relaGnp to EuilOinq wrrsimction an0 �ereby auc ' apres tatives oi t�is clry ta anter upon tM aEove-mantionatl
pmpeRy loi inspec ion purpases.
Oaro: _�� Si9nature: �
oriver's �icense ar Saciai Sewriry
i6a1�46 W�ita—BuiltliMl: GreerCOCe Eniwcemen4 Canarv—FOplicant: Pink—Ravanua; GdOanroE—Avesaar
CITY OF COSTA MESA — BUTLDITIG PF..RMIT PERM r10: IB 044695
P�RMZT NU: ID 044695 PLAN CIlECK NO: N GOVT: D1 SOPP: Y
CONSTRUCTION TYPE: V—N PERMIT TYPE:�OTIi STR FURPOSE: ALD
JOD DESCRIPTION : ADD PAM Rt4 TO EXIST SFD SQ FT:
CLAIM VALUE: CF�LC—VALUE: ' GROUP OCC: R-3 /
COMMENTS: RFINSPECT TO EVALOATE EXYIRED PGRMITS 3gyy�.3 �3sss,�
�r*x�x��c��*��r*at**x******x�**�**��-***x��rx�****���t-�t�x�*x��r*�r�r+t�r+t��r,r�r .r�* �-� ***+rv,�*��t� ��rx�x���ex�
Z O N I N G R E{� U I R E M E N T S
sET�Acxs
--------- — MAZN BUILDING --------- --------- ACCESSORY BUILDING ------ — --
FRNT; FT IN REAR: FT IN FRNT; PT IN AGAR: FT IN
LEFT: ' FT IN RGHT: PT IN LEFT: FT IN RGHT: FT IN
PARKING RCQUIRED: PARKING PROVIDED: PARCGL: ].41]3111 ZONE:
PLANNING NOTHS>
_ �.
x-�t-*�t�t�x�*+t�**�-*x�*�r*�*x-**��********�x�**x�i�*x�+e*x�****�c�***x�*+t*�t*****�t�t**x*****�t****rt**�
D E V E L O P M E N T S E R V I C E 5 R E Q 0 I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED BY : �
APPLICATION ISSUED DY: ����
iEiEiEi4ikitiFitiEik3EitiEihiEi:itiFiFititif�F3Fg3F 3F -��{�{E .
iEft�(-iflFfEfE�l(-�EfE�IEiEfEiF1Fl4�lEa(-iElfiFaEiE1E1ElEiEitiEiEiE�%iEfEfElFlkil�lklkiEiEiF?EiFIP�1E1fif�lk 1E�lE1Ei�
LEGALI'LATION:N F E E S U M M A R Y
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 60.00
PLAN ' �
ISSUE FEE - '
BUILDING—DIV—> PERMIT ISSUE PLAN'—CIiECK
TOTALS----> 60.00 0.00 0.00
FIRE
DATE:
DATE:
DATE: ����
If if iF iE iE 1E 1E iF iF �x
iE Ik iE iE iE iF iE iEdE iE iE iF iF ik iE iE iE k if iE jE
STRUCTURAL SEGMENT:Y
SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID llUE
60.00 60.00 •, .00
REVENUE DIVISION TOTAL'S--> COLLEC.TED: 60.00 OVER/SHORT: �' 00
DLDG PMT PLUMBING ELGCTRIC MECFiANIC FIRE SMIP/TOT GRADING'PLAN�-CHECK
60.00 , . �
�
iF k iE �f iE if IE iF iE 1E iF if if M iE iF 3E iE 3f fE iE �k dE i6 k if� iE M� iE �k if iE ik 1E 3E �IE �F iF k 1F.iE 1E ik it 1(-iE it iF N i(- K if� if i(-iF it �%1E ik iE iE # iE i6 iE if if N� if iEdE %IE af 3E IE if iF if
I N D I V I D U A I: '�' P,E � B R G A K D O W N •�• .
T'YPE QTY D E S C R I Y T I O! N. UNIT COST TOTAL COS1'
,INS :� BUILDING RE�-INSPECTION FE� J0.00 60.00
IEND ,OF PGES
0
'���.. _ '
�
'• 7' ,w
CONSTRUCTION AND PLANNING P��� �A
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
/
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location (
..
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement ''
3. Elec[rical Conduit Utility-Undrgrnd. ' 54. Forms i� �
4. Electrical Conduit�Undrgmd. 55: Electrical Bonding � ��
i
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test .
� 6. Electrical UFER Grnd. 57. APPflOVAL TO COVER�GUNITE
7. Footings -� 58. Electrical Conduit�Undrgrnd. �
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd. -�
� 10. Structural Floor System 61. APPflOVAL TO DECK �
1�1. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �
12. Sewer Cap 63, Heater & Vent•Final '
13. Roof Drains . 64. Plumbing System � Final �
1'4. Rough Plumbing 65. Electrical-Final � '
55. Rough Electrical-Conduit 66. Solar SVstem-Final ' �
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING� '
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT, ,_
20., Rough Factory Fireplace - � APPROVALS . Permit #
21. Ducts, in Structure -� 70. Underground Hydro �
22. Ducts, Ventilating � ' � .71. Product Piping OGas OOiI
23.•Gas Pipe�Rough & Test - � '72. Underground Flush -
24. Roof Framing .. � 73. Undergrnd. Smrage Tank O Gas ❑ Oil
25. � Roof Sheathing , . 74. Overhead Hydro_
��
26..T�8ar 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. qEQUIREMENT
" 31. Plaster Brown Coab �� � � �+ 79. FINAL INSPECTION .-
32. Electrical Power Meter�Final -. 80.'FOOD CERTIFICATE ISSUED
' 33. Final Eleciric . � Notes: O 3e- �f ,r/a6e£ TD
34. Final Heating & Air Conditi0ning � ' � yGIL� �T/Z!/GT7/?1"t_ /�v 2ES�%'�
% t .
35.'Final Gas Pipe•Test � D/n� �
_ 36. Hood or Canopy ; � "
- 37. Final Factory Fireplace .
-38. Final Plumbing � _ .
39. Water Service�Final : - - -
r...
' 40. Gas Service-Final� - . `�.'r � __ - � .�
41. Solar pomesticjnal � � � � �
42. Backflow Preveriter �
43. Backflow Irrigation .
� 44. Landscape Irripation System � •
�-
45: Sound Attenuation - � '
46.� Handicap Regulations . �
47. FINAL STRUCTURE & BU�LDING ', 3d3
48.� FINAL PLANNING ' � . F � .Lj
49. Electric Release to Edison '��
50. Gas Release to Southern California Gas Cu '
51. CERTIFICATE OF OCCUPANCY ;;i
No. Da[e
1\
�a4a� �
COSTA MESA BUILDING-SAFETY DEPARTML�.T
P.O. BOX 1200 COSTA MESA, CALIfORNIA 92G26
P LI ATION FOR BUILDING PERMIT
Fo� Applicant to Fil/ in Completely
flE [O � DATE /R�EACEIVE D TE ISSUEO
BUILDING �"' !Y( �.`�i � L(/ �—
ADORESS �, � _ ��,.a :I�iy 5t• s' �
OWNER •�CKK. �'`�tiL.� i S N.P.NO.� �SiI—I PER � J
J
ADDFESS � C�-�', eU1�DING n"'j� C �
ADDRE55 L' �
Z . � �_'1
0-U CITY �� NO�. TFACT�)-J� LOT � BLOCK
Z �
ZQ CONSTRIICTION N W ADD . ALiFR R PA M� r. c f
ON LE�'DEF •
a m
J � BRANCN /�
J N OWNER ►i L.L1
mJ ADORE55 VAWE
Jm ARCHITECT' � TEl t�-�' SE 5
Q OR ENGINEER . �4 N
�%N FIRE
wCL ADORESS � � � �T� �� ���' ZONE YPE . GROUP
p, W -
/ APPRO�I D
JO CONTRACTOfi '��J�� �(,L%. 4�j��;� BV DATE — -'
m Z '
J � �+DDRESS -
w W TEL. ZON� NO.OF USE OF NEW .l�
ZF CITv NO. PLAN$ Z BUIIDING �
w� STN7E CITY YARDSAPPROVEO YAAOSAPFROVED
N Q UC. NO. LIC. NO. MAIN eUILDING ACCESSORY BUILDING
7 O (f ROM Ul. STREET)
SIZE N�.aF HLOGS.
OF LOT ��' Y. I NOW ON LOT ` RON7 I FT. FT.
VSE OF / CL=�
E%ISTING BLDG. �! � V�` I � FT FT
F' $IZE OF �/ NO.OF ! �/' 4'
Z NEW BLDG. �� ��� ROOMS Sl ORIE$ L SIDE� FT. FT.
U EXTERIOF 1NALL ROOF /[� , ;1 � � ��
COVERING COVERINGLV�.. FEAR l'FT. FT.
J VSE OF B'ILDING AND WOFK TO BE PERFOR ED DISTANCE BET. gET. MAIN &
a MAIN BLDCS. ACC[SS.BLDGS.
a
Q VAfl.W� pqTE
o D iM1 8 �.�.�. * ,�Ro�Eo
~ APPROVED/ } i i'. � � ^L'Z �
tn V �^J
Z
O
UI nweby ackno�vletl8e that I have reatl Nis application antl state
� tha; the ebove i�tormation is rorrect antl ag�ee m comply veftp
� all la�vz regulatinB builtling consuuc[ion, antl 1 sha11 not employ ,
� any Oerson in violation of ffie workman's rompensrtipn laws of
� che State o` Calitomia. o . r �
z1 here�y certity that I am oroperly licensetl as a ronvactor untler J 54. FT. O
the Staic ot Celifomia Business antl Professions Cotle, Divisicn 3, THE AMOUNT SHOWN UNDER VAW4TION IS FOR !
Chapter 9, entl thet such liconses are in hll force and ettect, or I THE PURPOSE OF ESfABLiSHING A PEFh11T FEE ON�V: Q
am e•empt irom the provisio�s of the State of Cel'fornia Business V ALUATbN
antl 7rofessions Cqtle, D��ision 3�rer�9. ry
j PERMIT FEE 3 ]
Si nature o� }.. �y� �Y )�, . 4 f � � m
Permi�tee � w V �, � S�O /. /M PWN CHECK 5�� s� E
�Y l/ V p
Authoriied Ageni
LL
TOTAL FEE 5
Z .
a U
F- Z
Z Q
Om
J �
J �
Q W
a] J
J m
Q
UN
2a
W �
aw
W Z
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W W
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38557
COSTA MESA BUILDING-SAFETY DEPARTMENT
P_O. eox 7200 COSTA MESA. CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
forApplicant to Fill in Comple[ely
RECE E DATE RECEIVED E IS E
ADDRENS � I Ip G��f `N. ^� �
OWNER 1\ , q,p, NO. �� I-� J I- I I PERMIT N�
BVILDING I � `
AODRESS �+DDRESS� � � � C IS �--N '
QTV C, �`^. NOL TRACT 7��.�> - LOTC�2" BLOCK
GONSTFUCTION N-W ADD A'T P P \t '
LENDER Y
!\
BRANCH �L/I� (�
OWNER ��� � J
AODRE55
VALUE Q �
ARCNITECT 2 P � U NEL.p(��53 USE ��/ S
OR ENGINEER �J O
G FIRE
ADDRESS� DS � a e.R 3 20NE � TVPE GFOUP
nvaaoveo
CONTRACTOR nJ �I µ � BV D E- .��� ^�
C � � -� ` 3
ADDRESS Zpp{� NO.OF USE OF NEW �i.N
TEL. `1�' p�qryg BUILDING •nU��,J
CITY NO.
STATE CITV YAFDSAPPROVED VARDSAPPROVED
LIC.NO. LIC.NO. MAINBUILDING ACCESSORVBVILDING
SIZE .^� NO.OF BLOCS. (FROM GL S EET)
OF LOT / O � NOW ON LOT FROM I FT. FT.
USE OF �
E%ISfING BI.DG. A N 51 S FT. FT
SIZE OF NO.OF
NEWBLDG. ROOMS STORIES ( LSIDE �� FL� FT.
EXTERIOR WALL ROOF Q/ J.�
GOVEftING COVERING � G, REAR L] FT.7 FT.
USE OF BUI NG AND W017K TO BE PERFORMED DISTANCE BET. BET. MAIN &
MAIN BLOC'S. ACCFSS. BLDGS.
VAF.#` DATE
(y� �� GU.P.# APPR04Ef�
APPROVED�/ �� � / . /�� �
% L�
'' 1
I hereby acknowletlge thut 1 M1uve reatl chis applicetion antl stace /
that the ebove informetion is correct antl apree to comply wlth �
all laws regula[inB builtling consvunion, antl 1 s0all n0t employ i ♦ �
any pefsOn in viOlation ol Ih¢ wOlkman's compenSdtiOn lawi Of
[he Stare ot Calitomia. ` �hy �
I hereb certif that 1 am SQ. FT. ` _ �� p
y y praporly licensetl as a conbacmr untler
the State of California Business entl Professians Cotle, Divisicn 3, THE AMOUNT SHOWN UNDEF VALUATION IS FOR �
Chapter 9, antl tha� such licenses are in }ull forca antl etfect, or 1 THE GURPdSE Oi ESTABLISHING A PERMIT FEE ONLV:
am exempt from tt e Orovisions of tha State ot Califomla Business Q
antl Professions Coue, Division 3,`C�apter 9. VALUATION n� � �
1 PERMIT FEE $ ��
�
Sip^atura ot r m
Perminee �� �-� 5 2oDO PLAN CHECK 5 0 E
� o
ut orizetl Ageni �-
LL
TOTAL FEE 5
�✓
Ij
Z� 2 "
�,��``� ' � �```fo � Twininq
'�� ,0,' 2 =o s-n<�.>>=
TESTING
Laboratories ��f -��«��z=,� ���<<f�=,=«�, �,_�.
.. .�-• . .C.� PEP,� C _ "� 9=E_� . . . ,a lJvi . : 7 t?silfa . �'s; 828 ea3t
.. ." " � C.,
� -.� .a],-•• •i..=' .a. , e ., ^l..�
� . �i'... '.i�3:.-i�: . �. . __ i � e3. a� e
.��.
September 1], 1975 Examination: $CJS-4261
COMPRESSION iE5T5 ON GUNITE CYLINDERS
Mr. Errol F, tleesch
12921 Aspern+ood Lane
Garden Grove, Caltfornia 92640
PROJECT Poo1 for MARK PHILLIPS
ADDRESS 2799 Francis Lane, Costa Mesa
SAMPIE fROM Gunite Swlmming Pool
♦PCMrtfCi CONIPnCi09
Irvine Pools
ENG�NFFo SUOCONLq4CLOP
MIX
DATE CAS7
DATE TESTED
CYLINDER NO.
COMPRESSION
TOTAL LOAD, LBS.
POUNDS VER 50 IN
SIZE
COMPLIANCE
CYLINDERS
Grove Gunite Co.
SPECIFIED
�i—I/P LO � STRENGTH
9—j0-75 CYIINDER SIZE
9-17-75 9-17-75
� Z
7-Day 7-Day
90,000 89,000
3,185 3,010
6" x 12-3/4" 6-t/8" x 12-3/4"
7-day iest compltes wtth specificatlons.
MPDE er DEINEPEO BY
Skfp E. Heesch
oisicieuriou �Ei1��I�Bf.1 �"��C 1 1 DCY� �
Costa Mesa Bidg. Dept.
Grove Gunl te Co. S�i,�1 $�fJ7�
Irvine Pools `_�
E. Heesch - 2
2,000 psi
9-17-75
4 "HOLD"
3 5 "HOID"
6 "HOLD"
7-Oay
06,000
3,040
6" x 12-1/2"
MKEiVED ON
9-11-75
. ... ..... '.Y �wa . h� � , r ..�� o �e.~. nc ~osr�.�s
\
�
�
�
PXQIECT pO�FlESS: 2� tj cj FRANC I S I,N
OWNEB'SNAME:-JAMES C. ROSENFELS
nooxess: 461 S GLASSEL
ORANGE'CA 92666
' 719)532-5939
RXCHIENGINEEfl: , ,
� RDOPESS: i .
hxiT:
HEG.NO.:
uNrt:
PENMITfEE: SAMGS C. ROSENFELS .' ( 719 ) SJ2—S939
nooeess: q61 5 GLASSCLL
URANGE CA 92666
IICENSEU CONTBRCTOB OEClAM710N: 1 Aerehy attirm that I am Iicense0 un0er Drovisions ot C�apter 9(comm ncina with Section
7000) ol �ivisian 3 0� ��e Business anE Pm�essions Cotle, anA my license is in fuil torce and eflec�. O�
CITY LIC.: STATE IIC.: CUSS: /7L � � � � /
Date: � Siqnature�
L�
WOqNER3' C PENSpTI DECLAMTION: I herehy aifi �hat l have a cenificate of conseni ro selt�insure or a ertificate oi Workers'
ComOensatio Insurance, or a certified copY ihereof (Se i 3800, Lab. C). '
POUCY NO.: EXP. ORTE: -
COMPRNY: - �
❑ Certilie0 copy is �ereby tumisheU. ❑ Certifietl copy is IileJ wit� the ciry BuilOing Division.
le: Applicdni� .
cXEMPfION FPOM WOPHEBS' COMVENSPTION DECUMTION:, Qhis section neetl nat be completetl ii I�e permit is for ane hunAreO (5100) ar less�.
I certiTy that in the pertarmance oi the work for which this Dermit is iuueA, I s�all not amploy any person in any manner so as Io becoma
SuUlect Io lhe Workers' Campenution �aws of Califomia.
Date: - ' Sipnatura: � -� � � � -
NOTICE: II, aiter making this Oeclaration, you shoultl become su�ject to the Workers' Compensation pmvisions al tAe Labor
Code, you must forihwith com0ly with such pmvisions or t�is permit shall �e tleeme0 revoked.
CONSTBUCTION LENUING �GENCY: 1 hereby aflirm that there is a cons�mctiori IenAinq agency (or [he Oe�ormance oi ihe work for
which tAis permit is issuetl (Section 3097, Crv' C). .
i lFNOEfl: . . .
� R�ONESS: � � '
OWNEB BUILUEP OECUH11ttON: I here0y affirm that I am exempt imm the Contractors' Staie License Law lor tAe follovnnp reason
(Section 7031.5 Business anAPmfessional Cotle: Any ciry of counry w�ich requires a permit ro consimct; al[er, improve, tlemolish, or
repair any stmcWre, O�or ro its issuance, also requires ihe applicant for suc� permit to file a sipnetl statement that Ae/sAe is licensetl
pursuant to t�e provisions ai the Caniractars' State License Law (Chapter 9(commencinA m�h Sectian 7000) af Oivivon 3 a1lhe Business
an0 Pmlessions CoOe) or that he/s�e is exemD� �herefmm and t�a hasis lor ihe alleAed exemption.�Any violation of Section 7031.5 by
any aDDlicant tor a Dermit subhc[s t�e apD�icant to a civii penalry af not more thandive hundretl tlollars ($500).
I, as owner ol t�e pmDenY or my employees wit� waAes as t�eir sale compensation, wili Ao ihe work, antl the
❑ stmcture is not intenAetl or offeretl tor sala (Section 7044, Business and Pmfessional CoOe: The Coniradors' SWte License Law
does not appN �o an owner oi a pmperry wAo 6uilOs or impmves ihereon, anE w�o Aaes such work himseltl�erself or throuqh
-Ais or her own emDloyees, Drovitletl tAat such imDravemenls are not intenGed or oifered tor sale. Ii, however Ihe builtling or
imD�ovement is so10 within one year of completion, t�e owner will �ave I�e burden of DmvinB he/she 4iA not �ui10 or improva
tor ihe OurOose oi sale�.
I, as owner ol tAe proDetly, am exclusivety coniracting witA licensetl contractors to constmct ihe prolect (Section 7044, Business
J' an0 Pmfessions Cotle: T�e Contractors' State License Law Ooes not apph �o an owner of proper1y who 6mIAs or improves t�ereon
and who coniracis for such prolects with a coniractor�s) license pursuant ta the GoniracW rs' State Lig�nse Law�. 1�n aware
tAat pmof of iheir Worker's Compensation insurance shoulG be provitle0 to me. / / /' / � I 'm
� I am exempt uneer Section: � 0 4 4 8. d v. C. ' j c7r ��«� � v=%�
mr tnis r ason: b+ , pL SGF CODE �l�� � �� � /-
Date: �� � � � C� Owner bWr..��i �� � �� V'
I tlo Aerehy c riity Ihat I am aware o� antl understand �Ae requirements o� I' o nia Health an0 Safery Cotle Seclions 25505, 25533, anJ
25534 and that I or any lulure GuilEing occuDani vnlUwill nai (circle one) nee comply wi[h SaiA state co0e5 anA �Ae reQuiremen�s for a
permit for consimction or motlilication Irom the Air �ualiry Man�gement District^ResiOential constmction applications a{� exempt tmm
t�ese provisionb. �t / /1 � � � � I „
Date: � � J ADPlicant�
I hereby ce iry that I ha e reaa t�is application and sta[e
orAinances ana statelaws 2latinpto �uildingconsimc�ian;
propeRy �afinSDe��ion p rpOs/es�.
Daie: / U Sipnature:
oriver's ense ar S cial Securiry e:
I agree to
IM6 CiN �0
C�. %�.s �F�S
1641J6 White—BuilEing; Green—Cade Enlorcemen�; Canary—Applicanl; Pink—Revenue; GolOenrotl—qssessor
CITY UF COSTA,MESA - BOILDING PERMIT
� ,
PERMIT NO: B 045A01 PI,AN CHECK Nq: 021'72-90 S
CONSTRUCTION TYPE: PERMIT TYPE.: S'TR
; PERM NO: B U95801 �•
��. •
GOVT: N SUPP: TI
FURPOSE: ADD
JOII llESCRTPTION : LF.GAI,I'LE ADDITIONS • Sc,� FT: G9,4
CLAIM VALUE: 2U,000.00. CALC-VALUE: 47,OQ6.00 GROUP OCC: R-3. / I
COMMGNTS:
��******�t**�t*t�*�+��t� x ��*�c�c*�tx *�r*******�r**�t�t��tit *�r*�***�t*****�tit**��t**�r***a�**��r****
Z O N I N G ft F. Q U I R E M F•. N T u '
S E T H A C K S
------------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------=
FRNT: 29 F.T IN REAR: 49 FT IN FiiNT: FT IN RF.AR: FT , IN-
LEF'T: 5 FT IN RGHT: FT IN LEFT: PT' IN RGHT: F'I'. IN
YARKING REp: PROV: PARCEI.: 141J7111 ZNE: R1 REF NO:
PLANNING NO'TCS> ADD A CLOSFT AND A DATH TO AN EX HOUSE. CLOSET ADDED; TO LfiFT
> SIDF. OF RES; BATH WITIiIN EX PURCH ARF.A OF HOUSE. �
1E If 1E if iE iE iE iF iE �F if iE K� iE Ik fF iE -If 1ElF if 1F iF if iFlE iF 1E �t iE 3E iE iE 3E M iE �E iE if ff 1f 1F iE if fE iF 1E iE iE IE iF iF �If iF 1E iE 3E iE if iflF iE iE 3E fElF iE IE # iE iE 1f IE 3E i6 �E 9E if iE
D, E V E I, O P M E/'N JT' E V I C E S R E Q U I R E M E N T S /
ZONING APPROVEU BY : K/� DATE: V�'�3 `7 O
DUILDING :4PPROVED BY :�S : /l// DATE: /�a3 �'1l�
APPLICATION ISSUED BY;��F����. /� V DATE: �/�#�'��
iPih3EiflEifkiElEiEiF1F3E1FiEitiEiEit�lkitit F�"dF �'�'F�F �i�'k��****x�*arf�**�i .fF�3F *
ik9E3EiEiE3Ei6ifiEiFiFlkif3E�fif'if�%�f3E�IFiEiEfEifjEiElEIEiEfElEiFlEi6fF3k1fjEiF�ElE iE�EikifiFiE�EiklEjflE-0f3E1FiEifitkiE�EfEiEfEiflPiE�E�lkiFiEiEif�kif3f
LEGALIZATION:Y F E E�;,5 U M A R Y � STRUCTURAL SEGMENToY
BLDG PMT PLUMDING ELECTRIC� MECHANIC FIRE �SMIP/RES,..- GRADING
PERMIT 807.00 �;, 3.35_, ,.
PLAN 521.95 , SMIP/NON—R�S
ISSUE. FEE � • � ��` ��� �
BUILDING—UTtT-> PERMIT ISFiUE PLAN—CHECK TOTAI, PAID DUE
TOTALS----•> fS06.35 0.00 260:99 1067.37 10fi/.79 � .00
. - . .�. � , '� Y;
REVGNUE UTVISION TOTALS--> COLGECTED: t306,"JS' OVER/SHOR'f: • ..00
BLDG PMT FLUMBING ELECTRIC ML•'CHANIC � FIRE SMIP/TOT GRADING PLAN—CIIPCK
803. 00 . ... • { � 3. 35 •/ .,
if �( jE iE iE �E it �E iE iE jE iElE if iE iE if �t if 3E %1F iE !f iE if k iE 3f ik iE iF iE �)F jf lE jE it iF 3E'ff IE �E 1E iE !E IE �E if iE iE if !E iE if fE %iE iE if iE 3E iE �6 iE iE 1E ff iE iElp jf 3E j' iE if� iE �E 3E
I N D I V I D U A L' P%E F. B R E A K D O W N t:'
T'YPE QTY D E S C R I P'T I O N ' UDII'T COST TOT�AL COS'P
SFR 6i� PWE-TYPE V-F100D F'HAME -GOOD G9.00 r.`.A7�BU6,00
END Ofi FEES' ' '� ;,
N
i
�]
01 0005242Q—ODOS?421 �Tt3"i'
DATE: O1/23/90 TI17E: .lti:i3
0
&Ub.3�
CONSTRUCTION AND PLANNING � - � POOL & . .
APPROVALS Permit # ' � Date Inspector pppROVALS Permit # Date Inspector
1. Temporary Electrical Service orPole � 52. Pool & Equipment Location '
2.,So,il Pipe-Undrgr.nd:, . � 53. �Steel Reinforcement
_, 3; -Electrical Conduit Utility�Undrgmd. 54. Forms - � "' ' '
"4"'Electrical Conduit-Uridrgrnd. 55. Electrical Bonding -
�: 5:' Steel Reinforcement 56. Rough Plumbing & Pressure Test�.
�.
6.:.:ElectricalUFER`Gmd. 57. APPROVALTOCOVER�GUNITE '
"7.��Footings 58. Electrical Conduit�Undrgmd. "
� 8. Foundation � . ' 59. Gas Pipe, O Undrgmd., Test ' '
9: Water Pipe-Undcgrnd, � 60. Backwash 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 Cap � 63. Heater & VenbFinal .
13. Roof Dreins .. �- 64. Plumbing SYstem - Final '
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit , 66. Solar System-Final
i6. Rough Electric Wiring - . 67. Fencing & Access ApProval �
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING - '
18. Rough Electrical�T 8ar Ceiling 69. POOL/SPA SYSTEMS FINAL
� 19. Rough Heating & Air Conditioning �. �� � _ _FIRE DEPT. REQUIREMENT
20..Rough Facto_ry Fireplace - - - t= :�� t :; �APpROVALS �.. �-Permit #
21'Ducts,in,Structu7ey ' ' ;::`� ; ' � '', x J70. Underground:Hydro "
:�
22.�Ducts, Ventilating.. - , - _ � �:��; . �-77. Product-Piping OGas ❑�Oil
23. Gas'Pipe^fiough & Test a; -' 1�]_; ;� : 7Z, Underground Flush'� � '- ��
24.-Roof Framin . - � ' a
9 r - 73:-Undergrnd.Storage_Tank OGas ❑Oil
25. Roof SReathing � � . ' , �. 7q�pverhead Hydro'-_ . `
26.�T�Bai Ceiling (Structurall &'Monocoat � �;;, �� . - �-��; y 75.=-�Dry Chemical - � � -
27:�Frame and Plashing> _ � "v� " �� `r x 76. Dry Standpipe � �: "�
'28.`Lathing_&Siding , " -- �; ` �� ��„� °� 777FIXEDSYSTEM;F,INAL •- -
29. InSulation ' '� � '�"* _/�� !-, * fi 7$=FIRE PREV. FINAL
^30. Drywall Nailing � .. ��� ,. /, � -. r��: , HEALTH-DEPT-. REQUIREMENT
_�31. Plaster Biown Coat> -: ' "�> �: � � • . - " '79. FINAL INSPECTION r
�� �.- -
"�32._Electrical Power Meter�Final `" ' , �!a, � 'S0: FOOD CERTIFICATE ISSU.ED_ -.
n
E33:_Final Electric � �' ' � ' �� Notes: ^`. ' '-'
.: �-
`34._FinalHeating,&Air`Conditioning- �'`�� � 't `' `�� ' � ;. - '�"`
.. * -t•-•:: r l-Gl OR. -6N`_.
35.� Final Gas Pipe-Test. _ � -�• `:a ! . ' % :� Z -2 _ • D '_� � _
�36._Hood or Canopy k -� - - - . ', '' L _
- . `�.. '.w'
-37.��Final Factory Fireplace:; ��� .-�<c"', r.• .,i=t � � _
.�38`Final Plumbing � � - _; " ,`�;; ' i' ',, y S �- ;�' �
� 39._Water Service;Final:� -: - , �. � - � � . �� _
'40. �Gas Service-Final '" � �'- ' �' ' � �� ;k F ;•�. � � .
� :c
:'4L�Solai DomesticFinal - � a �' � � „ . . -- . - .
42. BackflowPreventer '� '�"���"�. �`, .__: � _ , �
43. Backflow Irriqationt . --' _ � ,� c, . � � a : �
'"44. Landscape lirigation Systerri�' "' r'� - -' -" _ = : '� '_ �
' � 1: Y � : �l �` �
`45.=�Sound Attenuation ���, ., = � -� ,��,. - , � � - _
46. Handicap Regulations �t, ^ _ ' - r = -- ` ' '
t ^t�
_47.=FINAL STRUCTURE & BUI�LDING _ ` "'' � ' - -
x - � 30
48:"FINAL PLANNING � ^ '� � � ' � � ,_ � �"
� ;' a
� 49: Electric`Release to :Edison '; 'T ; - " '�, , -
' 50.: Gas=Release to Southem Califomia Gas Co � F ' � !•-'K .. `I - \ � •
- - ; i ' s.
-51. CERTIFICATE OF'OCCUPANCY ' '" � - - ' "
No. Date .
�u4�.' PA'—"00 �6�n -� 4Z.50
; �qr, 26 7���;s: a.. ��,-
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
ForApplicanttoFillinCompletely ,P C TIONFORBUILDINGPERMIT
REC V D Y DATE RECEIVED DATE ISSUED
eUILOING t1'�l�' � � 1t^ � ��%�
ADDRESS JC.I V-J I-�
OWNER �' � 1� 1T�1� P`TI�IPS A.P. NO. �i3 � P IT
MAIL �-r� ,/y� BUILDING
ADDRESS � t�) � �� ADDRESS a�"� C S ` n
aU CITV �1 NOL��j TRACTJ 5� LO BLOCK
HZ
Z Q CONSTRU�'ION W A A R P
O N LENDER 1
am �^� 1 �y.�
J� BRANCH � OWNER 1� \ � lY���`--�
J �
Q w ADDRESS
p7 J AM/ VALU$ ��K .
J m ARCHITECT TEL $ � V✓��
a OR ENGINEER • � N
N FIRE �
W� ADORESS 20NE VPE 1•' GROUP �
d W '\ APPROVEO
J O CONTRACTOR �J � yS BY DATE ,S
m Z
J � ADDRESS �
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�= CITV � NO. P��� gU1LDING �
Z F
w0 STATE CITV �'ARDSAPPROVED VARDSAPPROVED
y� LI0. NO. 4 LIC. NO. MAIN BUILDING ACCESSORV BUILDING
�� SI2E NO.OF BLDCaS. (FROM C/L STREET)
OF LOT NOW ON LOT I ROM FT. O FT. �
USE OF
EXISTING BLDG. T. FT
� SIZE OF �` NO. OF ' L�
Z NEWBL ROOMS �� STORIES L.SIDE FT. FT.
U EMERIOF �M1'�+LL ROOF
GOVERING COVERING REAR _ FT. FT.
J USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BEf. MAIN &
a MAIN BLDCS. ACCESS. BLDCS.
a
Q M VAR. # OATE
O ��� 1/ W C.U.P.# � APPROVED
� HPPROVEf� � �( � S
y �r �O
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UI hereby aeknowledge ihat 1 have reatl Mis application antl state V�
� that the 6bove information is correct end apree to comply with
� all laws r9gulating builtlinB construction, entl I shall not employ
� any perw� in vlolaHon of tha workman'a compensation lews of
y the Staie of CaliforNe. .�� �
? I hareby certify that I am properly licensatl es a eontteeior untler SQ. FT. O
tha State ot California Business antl P�ofesslonz Code, Divislcn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR �
Chapter 9, antl thet s�ch licensas era in full force and affact, or I THE PURPOSE OF ESTABl6HING A PERMR FEE ONLY: Q
am exempi from the provisions of the S2ata of California Business VALUATION rJ'a
entl Professions Cotl ,�Division 3, Chapter 9. `. m
PERMIT FEE $ �
�
SIB^etur ` �,. /� [[����/� OU m
Permittae � � •���/ 5 �_1/ ) ) PLAN CHECK $ � E
``� �.�._.._.._' O
Authorizad Agant �Y LL
TOTAL FEE $
.F
PAI: , i��
• ' ';`i7?_-7�'�.—..r.Q� 929'% ..r:ii�2'.�...
' 38443 ,.�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COS7A MESA. CALIFORNIA 92G26
P LI ATION FOR BUILDIfdG PERMIT
For Applicant to Fill in Completely
FE D V DATERECEIVE pp7E'UED
BUILDING /j �y [ 22 f �
ADDRESS ( , —1 /� � :.I.� � � 'l.l.�� �� CO J � 7
OWNEF � Q.K!�- �l.l.�� (.-�, t S A.P. NO. � ��J� � I PER �
MAIL BUILDING /I"')Q C �
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AODRESS ( �'. �+DDRESS � ( �
d U GTV �� � NO�. TRACT�� LOT BLOCK
ZZ
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O N LENDER '
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JN OWNER A L�-I
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m J VALUE
m ARCHITECT'� TEL t h S S
J a OR ENGINEER �4� N •-��
U Q � FIRE
W� ADDRE55 ( S TB�� �'� ZONE VPE � GROUP
d w / APPRO� D
WZ CONTpACTOR �j[//� �.j� BV DATE � �
J Q
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J � ADDRESS
Z�TEL. ZON NO.OF � USE OF NEW�
� CITV NO. / P�� gU���' O
w� STATE CITV YAROSAPPROVED VARDSAPPROVED
y� LIC. NO. LIC. NO. MAIN BUI�DING ACCESSORY BVILDING
_� 512E NO.OFBLOGS. (FROMC/LSTREET)
OF LOT � V� NOW ON LOT ROIVT FT. FT.
USE OF p
EXISTINGBLDG .\ + �G�S �F . F
F SIZEOF "'�( � NO.OF 1 �'! .�
z NEWBLDG. ROOMS STORIES � L.SI F��. FT.
a EMERIOR WALL ROOF (` q
�%� COVERING COVERING�AJ/�'�,� � REAR SFT. '� FT.
J USE OF B ILDING AND WORK TO BE PERFOR ED DI5TANCE BET, BEf. MAIN &
d MAIN BLOGS. ACCESS. BLDGS.
a
Q D AM VAR.�{'+ OATE
O /y�/1 C.U.P.qy+ APPROVED
N APPR�VED i � � ^�'Z �
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� 1 herehY acknowletl8a that I have reatl ffiis appUcatioo end siete
� chat the ebove information iz correct antl aprea to comply with
� all laws reBulatinp builtling constr�ction, antl I s�ell not amploy
any pe�mn in violeUon ot the workman's compensatton lews af �
ythe Stata of Calitomla. a ,� �
zI haroby cartify that I am proparly licensetl es e contractor untlar SQ. FT. O
[he S[a[e of Calitornla Businexs antl Plotasslons Cotle, Dlvialtn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chepter 9, antl [ha[ such licensez are in full toreo ontl offact, or I TNE PURPp$E OF ESTABLISNING A PERMIT FEE ONLV: Q
om oxempt M1om the provisions ot Me State of Cel tornln Buslnass VALUATION
ane Profossiona C e, Divisio� 9�ter 9. ' m
D PERM�T FEE $ �
7
Sipnoturo ot �q, (�' J �� }j� E
Permittee � �U I .i �- � f ` ✓ $ /D � /►T _ P�qN CMECK $ ��
( l/ tJ a
LL
Au[horizetl Agent TOTAL FEE $ i
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38557
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant ro Fill in Completety
BUILDING �'iCi� ��1GIs. ��\•
ADDRESS � � 7J �V
OWNER
MAIL
CITV �..,,\ �' `.
CONSTRUCTION
LENOER
BRANCH
AODRESS ^�
ARCHITECT �q�-jP'
OR ENGWEEq ��� F
ADDRESS I DS' SIa
CONTRACTOR n w N E
A�OFESS
CITY
STATE
�IC. NO.
O'F LOT / O ^ � 3
Pl.IL
:�,,: � �-���.i�:00� ss2��� r::.�: :3�.50
APPLICATION FOR BUILDING PERMIT
:�E DATE RECEIVED � E�"'�
w� �
A. P. N O. �� I—�� �—�
BUILDING n
ADDRESS/�.
TEL. TRACT J pS
NO.
W AD
x
OWNER itl� j�
NOL CiZ. 03 S � �/
� 2 FIRE )
[��-+} —J ZONE TVPE �
' � � J � APPROVED
TEL.
NO.
CITV
LIC. NO.
NO. OF BLOGS.
NOW ON LOT
E ISTING BLpG. A�O1 TI�� {J
SIZE OF NO. OF ,
NEW BLDG. fi00MS
EXTERIOR WPLI ROOF
COVEFING COVERING �
USE OF BUIL 1G AND WORK TO BE PER
7�
♦ A .�. • .
� rvo.oF4
PLANS �
VARDS APPROVED
L SIDE � � FT. �
REAR U(FT.i� ��
DISTANCE 6ET.
MAIN BIOGS.
VAR. #
C.U.P. alE
0
LOT L
iti/��l tP1'
VALUE ���
4
USE OF NEW ��p
BUILOING �.D�
VARDS APPRO'
ACCESSORV BUI
BET.I
ACCE:
DATE
1 hereby acknOwletlg0 thet I have reatl [nis epDlicetion antl sta[e
[he[ the above info�mation is torrect and agrea to comply wi[h
afl faws reSu18i��$ builtli�g consvuccion, and 1 shatl aoc employ �
any person in violation o( tha workman's compenmtion laws of
Me State of Calitornia. •
I hereby cerNfy thet I am properly licensetl as a contracror untler S�. FT.
the State of California Business ond Professions Coda, Oivisicn 3, THE AMOUNT SHOWN UN�ER VI
Chapier 9, and that such licenses nre in (ull forca entl eftect, or I THE PURPpSE OF ESTABIISHING A I
am exempx trOm tPe Orovisions of the State of Callfomla Business VALVATION
and Professlons Cncie, Division 3,�Chaprer 9.
(((��� � PERMIT FEE
SIB^etura of �� \ J n n �
Permittee ��'�'���� g 2DDO PwN CHECK
c
Authorhetl Fgent
TOTAI FEE
FT.
�
b
0
IS FOR �
ONLY: m
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COSTS, MESA BUILDINGSAFETY DEPARTMENT �F w�� ,� i._`
r P. O. BO% 917 C08TA M88A. CALIFORNIA
�o � y�, OcA�d 3� �3 �
For Applieani fo Fill In Compleiely APPLICATION FOR PERMIT
TYPE OR PRINT ' BUILDING
BUILDING
ADDRE88
COSTA MESA CALIFORNIA For Offite Use Only
NHCHIPT NO. 'MSt.dLT N�. �
�Lt'
OWNER
MAIL M6CHN BY DATB HEC61V[D DATH 168U6D
ADDRE65 Q'F. ' i� /.� - 7'-Fr � �tp �
cirv Corona del Mat No:OR 34220 BUIWING •^ V �
ADDRES6 �
wRCHiiecr TE�. COSTA MESA. CALIFORNIA �
OR ENGINEER NO.O 3 ZO
ADDRESS 3800 E. C088C Hl Mi8 ZONE TVPE �/ GROUP `� �
CONTRACTOR APPROVED
BY DATE
ADDRESS 3800 E. Coast Aighway ZONING
zoNe no. oa use or Hew
CITY C0I008 del Mar vuxa auito�N
STATE p� TEL. ��L � � � „�_ _ �
LIC. NO. �fJ-- NO. OEeCxIrtION �—� w
SIZE /✓ � I NO. OP BLDO9.
�F l0T /l NOW ON tqT A.P.NO.
U6E OF ' YARDS
E%18TING BLOG APPROVED
BBTBACR LINB PROM � /1 / <C6NTeP LIMe OTJ
CaNTHR OP BTneei O' REAR VARO FRONi
/ � � �•
SIDE YARD LEFT RIGHT R.SIDE
DESCRIPTION OF WORK _.__ � ,
■ BUILDING NO. OF
�
�
EVES
XHRHBY�CKNOW�O[ iXAT 1 HAVB qeAD if119 APIYGTION TXG AMOUM 9NOWN UNDER VALLIATION 19 I011 TH8
AND @TA 6 THAT TNQ ABOVB IB CORflHGT AND AO 6 TO COM- pUIiP08H OP E9TAELIBNINO A PERMIT FEH ONLY.
PLY WITH ALL CIN O INAN�9 AND 9TATH LA R60ULATINO
eU�LOINo coNBTRUGs N. VALUATION
84GNATURB OF F PERMIT FEE $
PERMITTB '
� S I��) �. O• � PLAN CHECK $ J��Q
AUTNORIZED A6ENT '
TOTAL FEE
.. � '. . 1���0
, �-
C051°A MESA BUILDING•SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. CALIFOANIA
For Applieant fo Fill In Complefely
TYPE OR PRINT �
BUILDING
ADDRESS N a
COSTA MESA, CALIFORNIA
FEE RECE11lED
�OCT 171?61
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
For Office Use Onlv
/1 TEL. BUILDMG
CITV („�- i � NO. ADDRESS Ol lS ��
ARCHITEGT ,�� 7e�. COSTA MESA. CALIFORNIA
OR ENGINEER NO.
AODRESS FIRE
ZONE TVPE GROUP
CONTRACTOR Y APPROVED /Q
BY DATE' /
ADDRE55 ONING .
2 I NO. OF �tlBE OF NEW �� �^
CITY � PLANB q/IBUILDING o
�
STATE TEL. Lew� �� i J Y'�3
LIC. NO. NO. oescairrioN •) O,J
SIZE r-. /� NO. OF BLDGB.
OF LOT (/ I Now ON LOT A p N� -
USE OF YARDS EV65 �
EXISTING BLDG Q APPROVED ALLOWED
6HTBACK LIN6 PROM /� � / IC6NTEP LINe eT.) '1
CEMew Op eTligeT �/ REAR YARD �� FRONT FT T/ IN.
fiIDE YARO I4EPT / U/ IRIGHT I f / R.SIDE FT. IN.
D�SCRIPTION OF WORK � N
�. SIOE FT.
NEW I IIALTERATION I (IADDITION , qEAR ��FT. IN.
REPAIR ( IIMOYING I II�EMOLISH I BYPROVE� DATE I b'
BUILDING ��/ 'L � NO. OF � '
61ZE Y /'yT ROOMS "-" STO8IE5 � �
EXTERIOR WA4L I ROOF N /H u N'� ( {-
COVERING COVER 4� ' p�'
USE OF BUIL G�1ND� WORK TO BE PERFOR �
` 1`'.� � . 1
i v 'Z
� -,
I HEREBY ACNNO LEDO�,(�/ '�'HAT I/XAVE PEAD THI6 APPLIGTION THE AMOUNT BHOWN UNOeH V�LUATION 19 FOR THE
ANO BTATE THA�?HB I�OVE 8 CORRBCT AND AGNEH TO COM- pUPP09E OP EBTABLIBHING A PBRMIT F6E OMLY.
PLY WITX ALL LIlY�ORDINAN S3 �NO BTATE LAWB liSGUU�TING
eultnlNo coHB/rnurn - VALUATION pc
81GNATURE OF/ I �Q�'� � PERMIT FEE $
PERMITfE / % ,. j
, S � 9%, i PIAN CHECK $�
AUTHORIZED AGENT / ��
TOTAL FEE tl / /