HomeMy WebLinkAbout3468 FUCHSIA ST - Building Permits1
AUDFESSOFBUILqNG: 3[��jS FOCHSIA ST UNT:
owr+Easr+"NEiF�a"": FftEMUNT, JANA CUMMINGS TR FLOOD: AH-38
��� . . AUDNESS 3968 FUSHIA ST
- COSTA MESA,CA 92626
�av�. uuuxc woeEss:
�RCNRECT OP FNtlNFFR: IlC NO.:
JiCX.OX FNG.'S ADUHE55: YNT:
CONTHACTORSNAIIE GWENS ROOFING ( 714 ) 978-2075
cartx�croas�uuxo y 3�9 2 MOLOKAI
�p� HUNTINGTON BEACH CA �.�.: 6009G2
92646 uxr:
LICENSED CONfPACTONS DECLAPATION: I hereby eflim uMer peneXy d pe�ury Ihat I em licer�ead urdx yovisiana d Gheqs B
(wmme�ng xilh Sectian lW0) oi Divieion 3 d Ihe Businam enE Profesaiona Coda, eM my licenae ie in �ull brce vM eHecl.
cmuc.No.:O 1 74 uc.cuss: C 39 N� 600402 � EXP: 01/98
�
om D 9� ���o,: �-
OWNEH BUILDEP ECLAHATION: I Mreby ffiFrm unEar penery d parNrY �� � em eumq fmm �he Comreqwe Umroe Lew fa ihe
tdlow'vg reeson (SeUion )0.1t.5 Buanms ard Pmtavaior�a Code: Any cYy or muny whidi iapu'vee e permil to omaVucY, eller, impraro,
yemoleh, or rapei eny awcture, pna lo ils ov�erce, abo reQuirea �he epdirsnl lor euch permil to fib a eg�nd neiemeni Hw he w vM
� k� licemed pursueni io �he provisions d ine Canvenns Licerua law �Chepter a(oommentl�p vrith Ssebn )tqo) d D'xubn a d �hs
q0
}'��� ineo eM Prolessbns Cade� or thet he a she ia eaemp �herehom eM the beas I« the dbped azempion. My vbWion of Sedion
E' iIXit.S by enY eGPlirem fa a permil wbjeqa the eppl'rant ta e rnil penelry ot M moro then fNe huMred EdWe �55001I. .
� I. m oxner attM O�PanY a mY �GbYeeH wah wepea m �hei ede mmpenselion. wJl do the xak. and tM avunun a m� in�eMed
or oflered br seb (Seclion )WO. Buarresa eM PMesabna Code: Tha GoMredon lioense Lewtloes rwt eppyto en ownmd propeM
who buida «'vnporee thereon, eM wtw tloas euch work Mmmll or hener or thrwqh hi a her own emWvyeea, pwidatl ihet wch
impovemerus are mt �meMed n dlereE la sele. ll. Mwever. iM WiMirp a"vnpm�emeni ie edd xi�hin aie Y� d oompbtion. the
axmer-0uiMer Mill heve iha WNen d pwin0 he or ahe d'd M build w improve la tM WT�e d eeb�.
� I. m ovmer d Iha qapery. em eKtlusrvay coniredip wilh IicenseE convedaee ro wnaUud Iha pojed (�� ]ON. Bwi�wee erM
Profenims Coda: The Contreeon license lew Ews iwl epply lo en ovmar d popMy xiw builde w impwm ihaean eM who
wnvecia M sutli pqecls wAh a mmfmar�s) Icereed W�uent lo ihe ConVetlon lioanse lew).
❑ i,� ,=amq ��da, s«��a,: e. a P c.. �« uo �.o�,: ,
Dale: Ownx:
i m na�nv �v �nm i� ew�a a�a �a,Bw�d ma rea��rem�m a c��o�oe N..nn �a s.�r cma s.a�. uws, usa3, .�e
u53s. eM mm �«em' Mure Wikina oauv�� will / wil na (riich wie) naed �o wmoN win eeid alele codec eM �he nGuinmame ror
ePartnniamnsViwlionamaEArmionhwn�heA'r�y areea��tDislritl.flmkenlmlconsliutlonMP�browewemAhdnlhess
w�.
ome: nnd�c
WOFKEP'S COMPENSATION DKLAXATION: I hareby aiNm uMx peneM1y d psjury ma d Ne Idb�ieq dedumiom:
� I here ud Mil meininn e canifute d mroent to satl�muia b wkan' wmpenmlon, m prwided la by Setlion 3]00 d iM lebor
c�. r« ma �no�,�a d�.ax r« w�m m� �e a a.�a.
�i neve end xi� meimen woMere• comc�un ireu,erce. e. �.c��rea M seain, aloo a Ne Lebor cme. ror �n. ro�«menm a �n.
wark lar whiM Ihis pmnd ia esueA. MY ��' �mpeiue�ion irceurenca urtier vd pofx.y numbar ue:
c��: STAT£. FDND EXPIRES
aa:.yN�mna: 7AS—l5MO7qq 01/O1/98
.;s .,«r�m �aee �a ae canvbree �� v�e a ro, o�. n�,n,ad ddre„ Is,00l o. �.1
�] I ceniy tlw in Ne V�amence d �na wwk tor wncn �nia Pa�mn in iswea. I enell nd emMW �Y V� In enY menrw w n to
exome a,Naa m �ne xo ro cano��^ �e�re a celilanie. em w�.. �nm e � enouM exane «i4a m �n. .oM1.e•
ompe�uetf v� - bre d eelon aroo a ihe laba cod.. � wu n N�h i wa�..
�e: 6 � 47 a�,: .��T�
amliy: Fequn secun rollrsri romperuatlon covenps Is unlewNl, entl Ms/l sW/ect en enprloysr M plmlrW p�neltlu aiM
nM� n�.. w ro m. nu,dree mou,.ro edrr. (Stoa,000A m.eeirron ro m. co.� o� rorrqw.rron wm.w. u povie.e ro. �n
Sxtlon 3]P6 al Me Lebor Cotls, iMaul, uM attomsy i lesa
coNsrnucnoN ��rnr�c �oeNcr: i n�w me� �. re�n d w�i�r �nm m.s m a�oonNa� �a�a m�v eo, m.
paAormarKe d �M hwk fa v.hiUi ihb pmmY w asueC (SeGion 309]. Cv. CI.
LENDER'S NAYE:
LENDEq'S ADDHESS:
I cenilY Ihat I have reaE ihm eGW'ratian enJ 9me ihe� Ma ebove iMormeiun u conaa. I prea to canW wilh dl UV ud couniY ad'mv�oee
eiM slma laxs �elmiq to buitlig conNumon e�d hereEy a4harae rqxeaen�etiws d Ihb dly to enlm upon IM ebwe.mentoned pope�ty
la impmbn puepoms.
BRENT C�WENS
M l0 � �i
D�e:
• Sgiatura dDxnar/ApenVAppFanU mtredor
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(StSt-,B.WP) WhAe-Buikipd5efery:GreemFb;Cerwy-Appicent;Rnk-Rewnue;GoMemoJ-Nseaav
CITY OF COSTA MESA — BUILDING FERMIT
PERM NO: H 084991
PERMIT NO: H 084991 PLAN CHECK NO: N GOVT; N SUPY: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: UTH
JOB DESCRIPTION ; T/OFF RESHEATH & REROOF W/COMP. SQ FT: b,500
CLAZM VALUE: 0,500.00 CALC—VALUE: b,500.00 GROUP OCC: R-3 /
COMMENTS: SMOKE UETECTURS ARE REQUIRED.
**x �:******���**�r*��r�r�r** �����r*x��*+�**x�**�********;��x�******i�*a��+��r��**;�;�� ��;�*�* � �;�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILLING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: . PRC�V: PARCEL: 412173G3 ZNE: REF NO:
PLANNING NOTES,> �,�
>. s�
iF iE iE iE i@ iE iE iE iE iE'1E if if iF iE it 9t 9F if iE iE ih * iF iE iE 3t if 1E ii iE iE if if iF if if ii R iE iE'1E iF iF iE iE �1F iF iF iE iF iF if iF ie ih if �k iF iE iF if �E it if iE'%3F iE iF iF �F iE if i't ie ir if ie
U E V E L t� P M E N T S E R V I C E S R E Q U Z R E M E N�T S
ZONING AP�ROVED�HY . DATE: i,
HUILUING APF�ROVEL BY :
APPLICP.TION ISSUEL BY:
*�r�;�*iE*��r�at*�t*****it**it�'3�'3�'iF
LEGALIZATZON:N
BLDG PMT PLUMbING
PERMIT 124.75
F E E S U M M A R Y
ELECTRIC MECHANIC FIRE
DATE: ` '
LATE: � %`, �
*��t*�c;�;t;� � ��1
STRUCTURAL S "'ME T:Y
SMIP/RES GRADING
,b5
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHE�K TOTAL PAID DUE
TOTALS----> 125.90 0.00 0:00 125.40 125.40 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 125.90 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRi�DING PLAN—CHECK
124,75 .65
iF 3F iF 1k ik if iE iE iF iP iF iF ii it if iE iF iE iE iE i! iE i! iE iE iE * iE iE iF 1E if 3F iE i! 3F iF 1t iE if iE iF iF if if if iF if if if iE �w if iE iE 3E fk iE iF�iF if iF if if iE iE it iE ik iE if if �E iE iE iE iE iE i�
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT CGST TOTAL CUST
SFR 6500 REROOF BY VALUE RESIDENTIAL NOZUNE 1,00 b,500.00
END OF FEES
18�'1]Jl�le:Ja A1If�CJ.70
RCDT#:81�13171
PERMIT:984991
. -
�'y� CONSTRUCTION AND PLANNING • � _ - . - ' _ P��� PA �" ' �
APPROVALS Permit # Date Inspector . APPROVAIS - Permit # - � Date inspector
i. Temporary Electrical Service or Poie ' 52: Pool & Equipment Location -' - '
2. Soil Pipe•Undrgrnd. . ' � 53. Steel Reinforcement � � - � ' -
.�
.'^3: Electrical Condvit:Utility-Undrg[nd. � • - � 54, Forms ` � ��� • .
-�-4�. E)ectrical Conduit-Untlrgmd. � . � � 55. Electrical Bonding . � � � �_ '-.
� 5- Steel Reinforcemenf= � 56: Rough Piumbing & Pressure Test � '
� 6� Electrica! UFER-G;nd. � 57. APPROVAL TO COVER-GUNITE- _('�,�
�,
: �:7'" Footinge - � � � -_ 58. Electricai Co'nduii_Undrgrnd: � � � � � '
� ~8:� Foundation � _ + ' . _ . 59: Gas Pipe, �7 Undrgmd., Test � � . � . �
,'9. Water Pipe-Undrgrnd�. L _ i � ' � 60. Backwash �ines�P:Trap,,�^, Undrgrnd.. ' '
10. Structural Floor Svstem ' _ - ' 61.. APPROVAL TO;D�ECK �� M' �• • -.
,1]. Property Sewer Line & House�Connection . � •62. Backwash & Receptor.Fina� - - ' ',
12. Sewer Cap � - • � 63: Heater & Vent-Final � . . � �
. -,
13. Roof Drains _ �' - - ''64. Plumbing System - Finai �? � � � � �
14. Rough Plumbing ; . - - �65. Electnical�Final - � ' n � � ,. '
. i
15. Rough Electricai=Coridu"it � -- " '. ;- j � _ �.66. Soiar SY3tenrFlnal . ,. , �. "
t16. Rough Electric Wiririg r � ; . � - "` - ` � � " � , � � � ' ' - ' - �
, . . .�y-, '`67c Pencing & Access-Approval � � �
77. Rough Wirinq Sign � � ��� � � - . �'. , '68� APPROVED POyR�PLASTERING . ; '
s,.
18. Rough�EleMrical.TBarCeiling ! � � � � ' -`69. POOL/SPASYSTE��1S'FINAL' - � ' �
1'9. RougFi-Heating,& Air Conditioning -,-T. "`j . " - ' �, , FIRE,REPT.^�2EQUIREMENT �i - .�. � _
20. Etough Factor,Y Fireplace , " �f� � � k= APPROVAL'S,�;:' Peimit# - -
- = - I
27. Ducts,inStructure � • �'� ' �� - ''i ' 70.`Undergrou�tl Hydro M1
22. Ducts, V¢ntilating F � ' � r f'j �': y�, 77. ProductiPiping J�Gas �Oil
23. Gas Pipe�Raugh & Test � !7`. +• ,_; ^' '1: � i � � 7y, Underground FtUsh'' ' '�'
�. �Y ✓ T
' _
24. Roof-Framing" �� � �"� " ' ' ' - r ,.� , : 73: Undergriid. Stor,age Tank�� Gas :=i ail
25. Roof•Sheathing �ry: c ;• J? r7 ��, 74�.°�Overhead Hydr2,r '
26. x�B�i•Ceiling fStruc�urall & Mo�ocoat i, ,-, ' ��' � 75 ;�Dry Chetaicai �� r ' „
2�..Frameand Fla;hing�c != t,�J' ! -' r -+t � � �
76. Dry Standdipe � u' k '`
- - � -
- 26. Lathin SiSid�n ""��^ k .� ; �. ..
g g j,t "' r_,�, , ,." ��� � ��;+ 7Z, FIXED�SY�STEfi9rINAL .
., ,. , -, . ., .�
29. Insulation � :�;�F :S .. + ' '+. �$'. FiRE PREV. FI�J`QL t" =• -. '
� �� � �
' 30. Drywall Nailina . �_ � � (j " '�HEALTH DEPT.�REQUIR.EMENT
� 37. Plaster Brawrt�Coat �� ; ,� �r �i � � �. :,- 7g`, FINAL tCJSPECT�ON �
- �� �
,� 32. �ElectricaLPower �vt�{er-�Fi,�al � "�'•L � � f�. " 80� POOD CERTIFICATE ISSUED
. .� J * � . o� , . i. �.. . . ..
� 33. F,inaf;Electric-_ ��! �. . � , Noter ti • � �
- ' r
: 34. Fina4=Heafing_& Ai� Conditiod�ng= ~ � T 4 4 � .
. � c „ r
r� Y 4•� � i �.k � i � `� 1; .
" � � r � � . '
35. .Finai Gas ?�Pe,Test : . • � I + . � ; _: _'.�, �- -
1 y
36. Hood or�Canopy * � � � � � - i � ��# r � � ' ' .,
•r * -,
37. F.inaLFac'�ory Fireplece �r , - , .� c �� ' --' ,:; . '
_ I : ` i .. ,.
� 38. Final�•Alumbing � ' _ � � '" _ � � ° ' � ' �-� �
•�I4
39. Watei�Selvice�Finai ' _` ' '- .r t � I� .� .' ' �+ '
- 1 h`. �
.� 40. Gas Service-Final � �+' ,� F .'� ' � !:; t�
= � �� '=
, 4i. Solar pomestic�Finaf '� K ` i ' ;` "_ �
4 k r
42. Backflow Preventer � " i { l, ,' >p... • . . .
� �;r .,,� .
�43. Backftow Irrigation" r' •� + �.. ���:_ ' . � -. .
44; Landscape IrrSgation System " " �� �' _ ' � � t '� � � :�, - . ., _
- .� - , .5 � , . .r .. �
• . , . ,. . . r ... . , . -^ r. , . .: � i.
45.'Sound Attenuationy: . , , , -- ;,; .Y =�'�. ,_ �
- 'a'` P
46.HandicapRegulations �� ' '�= •`' C"�' = '- - �i� �'.
r : •- • - ' �-7� � � c tx( :� -_ ''l r: � ,� t`.�
4T. FINA''L STRUCTURE & BUfL'DING x ' � "` _ � � "
/�D'�J R �'
. ' Q_:_�7'!`/'/� �, _ .' 'a
48. F,INAL PLANNING, _ l _.l�_ ;�1 ., _ • ';?',.
49. Electric Release to Edison ` •- ��� _ �' �� ; u���
- ,
�50. Gas Release to Southern Califomia�Gas Co r � •�'� - • " ' -' . "`�G.i
'- .L+ - i��w 1
511. CERTIFICATE OP OCCUPANCY � ' • ` _ �,;+�,,,.,
No. Date
7
�
PflOJECT PU�BESS: 3 q 6 H FUCHS I A S T UNIT:
OWNEN'SNAME: FREP'�ONT, JANA COMMZNGS TR FLOOU; AH-38
aooxess: 3968 FUSHIA ST
COSTA MESA,CA 92626
979-0431
RXCM/ENCINEEfl: BEG.NO.:
aooRess: uxiT:
PEflMITTEE: KENNIHAP.I PLUMBING ( 714 ) 548-0229
aooxess: q18 TUSTIN AV
NEWFORT BEACH CA 92663
LICENSEO CONTFACTOfl UECLAflATIUN: I hereby aHirm Iha� I am IicenseJ unaer D�ovisions ot Chapter 9(commencing wi�� Section
7000) ol �ivision J o� ihe Business an0 Prolessions Cotle. an0 my license is in full force an0 eifeci.
ciTvuc.:0 4°80 srnreuc.:61958 �SS 36 EXP; 11/95
Daie'. �. `J�Vj���'j'� �'� Sigw�ure: _ � � /-,
WONREflS' OMPE SATIOR N OECIAHATION: I hereby a��i IId�II1dvC d L2h1�ILd�C O�COIISEfIl�O 521�-I050(C Of d CCrtlliCdlE O�WO(kEfS�
Compensa�ion Insurance. or a cemhea copY �hereot �Section 3800. Lab. C�.
POLICY NO.: E%P. OATE:
CaMPANY:
r] Certilietl copy is hereUy lumished. ❑ Certdietl capy is filed with I�e city Builtling Oivision.
Daie' Applicanl:
EXEMPTION FflOM WOHREflS' COMPENSN710N OECLi7PBT10N: (This section neetl not 6e comDleteO if the De�mit is for one huntlretl ($100) or less�.
I ceni�y Ihal in �he performance ol Ihe work for which this permit is issued. I shall no� employ any person in y manne.ap r so as �0 6ecome
sublec� m the Wor Jrs' Compensation laws of Califomia.� 0 ��}`�
Daie: � Signamre��.�
NOTICF il, after making ihis declaration, you shoultl come su�lect m the Workers' Compensation provisions of the La6or
Catle. you mus� fotlhwi�h comply with such pmvisi s or �his permii shall be OeemeU revoke0.
CONSTFUCTION LENOING AGENCY: I �ereby alfirm �ha� Ihere is a constmction lentling agency �or �he De�o�mance of Ihe work for
which this permii i5 issued �Section 3097. Civ. C).
LENUEH:
FDDPE55:
OWNEP BUILUEB DECIABATION: I �ere0y allirm thaf I am eKemp� �mm Ihe Conlraciars' S�a�e License Law for �he follovnng reason
�Section 7031.5 Business antl Pm�essional Code: Any ciiy ol coun�y whic� repuires a permit m conslmci, alter, imD�ove, Aemolish, or
repair any slmcWre, prior lo ils issuance. also reqmres ihe applicant tor such permit to file a signed statement that he/she is licensetl
pursuam m Ihe pmvisians ol the ConVaclors' S�ale License Law (Chap�er 9(commencing wilh Seciion 7000) af Division 3 of Ihe Business
antl Pmlessions Cotle) or Iha� he/she is exemp� �herefrom antl the basis �or �he allegetl exemp�iaa Hny violation of Section 7031.5 hy
any applicani for a permil suble��s �he apDlicant �o a civil penal�y o� no� more �han �ive hundred Aolla�s (E5110�.
I, as owner oi the pmpeny or my employees with wages as iheir sole compensation, will do ihe work, antl Ihe
❑ slmc�ure is no� imenaea ar oHereO for sale (Sec�ion 7044, Business ana Pmfessional Cotle: The Contractors' S�a�e License Law
tloes nai apply �o an owner o� a pmDetly who huilOs or improves �hereon, antl w�a tloes such work himself/hersel� or IhmuAh
his or her own employees, provitled ihal such imD�ovemenls are not intenUetl or offerea for sale. If, �owever Ihe builaing or
impwvement is SoIA wi�hin one year ol completion. Ihe owner vnll �ave the Ourtlen o� proving he/s�e Eitl not �uiltl or impmve
br ihe purpose of sale).
I, as owner o� �ne pmperty, am exclusively contracting wit� licensetl con�ractors ta constmci �he projec� �Sec�ion 7044, Business
❑ antl Pmlessions Code: The ConVacbrs' State License Law tlaes not aDPly m an owner oi OroDenY who 6uild5 or improves Ihereon
and who canVac�s br suc� pmlects with a contractor�s) license pursuant �o Ihe Coniractars' Slate License Law),I am awaie
�ha� pmo� at �hert Worker's Compensation insurance ShaNa be pmvitletl to me.
� I am eMemp� uneer Section: B. 8 P. C.
�ar IhiS �easan:
Date: Ownec
I tlo hereby cenily thai I am aware o( an0 unAerstana the requiremenis of Califomia Health an0 Safety CoAe Sections 25505, 25533, ana
25534 antl ihat I or any lulure building accupant will/will no� (circie one) neea �o comply with saitl state cotles ana Ihe requiremenis �or a
permit �or cons�mction or motlilication Irom Ihe Air �ualily Managemenl �iSVicL Residenlial constmciion applica�ions are exempt tmm
�hes¢ provi5i0n5.
Oaie: Applicanl:
I nereby cetlify Iha� I have read this application antl stale ihat ihe above inbrmalion is correct. I agreeto comOty with all city and counly
ortlinances anA 51aie laws relaling �o builtlmg cons�mction antl �ere�y auU rize represeni ives ol this ciry � e ter upon Ihe above-mentioned
pfOp¢fty IOIinSp¢C�100 UUlp05¢5. �
Da�e: �� Signamre
Driver's License or Sonal Securi�y
t641-a6 White—Builtling�, Green—Gotle Enbrcemem�, Canary—Applicant Plnk—Revenue: Goltlenroa—Assessor
CITY UF COSTA MESA — BUILDING PERMIT
PERAIIT NO: P 071Q76 PLAN CHECK NO: N
CONSTRUCTION TYPE; PERMIT TYI�E; PLU
JOB DESCRIPTIUN ; WATER REPIPE
PERM NO; P 0'1076
GOVT: N SUPP: N
PURPOSE: UTH
SQ FT;
CLAIM C'ALUE; CALC—C'ALUE: GRUUP OCC: R-3 /
COMMENTS; NO 'BLDG,' PERMIT INVOLVED.
**��-�rr-�t�c*�t*-�t**�cr�t-*****�c�tat�t-x��tr-�***�c�t+E*-�t�t�t�t���r���s*-���+r�v�cr�t-x�*�+E+e�*at�µ*x-�:+�r-atu-x*a�at�*-�r��-
Z O N I N G R E,2 U I R E M E N T S
S E T B A C f: S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN AEAR: FT IN
LEFT: FT IN RGHT: FT ZN LEFT; FT IN AGHT: FT IN
PARKING REC�• PROV; PARCEL; 41217303 ZNE; P,EF NO;
PLANNING NCS'I'ES>
> [.
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D E V E L O P M E N T S E R V I C E S� R E Q U I P. E M E Pi T S
ZONING AP�ROVED BY ' DATE:
bUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY; DATE: 2— I���i7�
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LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
&LDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 21,00
25; SMIP/NON—RES
PLAN �
ISSUE FEE 20,00
BUILDING—DI��—> PERMIT ISSUE PLAN—CHECK TOTAL PASD DUE
TOTALS----> 21,00 20,00 0.00 41,00 91,00 ,00
REVENIIE DIVISION TOTALS--> CQLLECTED; 91.OQ OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
91.00
iF if i! ik M ik if if sf i! iF iF jE af if ?f :f if jF if it iF 1f �f rt iE #E ir if if M k iF if+f if iE if i! �S if M if 1t iF �f 1f iE �E 41f �! iE iE if iE k iE aE af if i' iE �E+t #� 1! it iE ir if t 4 if k iE #?f %
2 N D I V I D U A L F E E B R E A K D O W N
TYPE QTY U E S C R I P T I O A7 UNIT COST TOTAL COST
PLU 1 WATER HEATER AND:OR VENT 7.OQ 7,00
PLU 1 WP.TER SEAVICE 7.00 7,00
PLU 1 WATER RE—PIPE - 7.00 7.00
END UF FEE5
� 71 071?5479—G�1?547E T�7 T 41.t1fl
: fiATEt G3/fQ!?r 7I!'�c': :Q:`g
CONSTRUCTION AND PLANNWG POO� oPA
APPROVALS Permit# Date Inspector qppROVALS Permit�k Date Inspector
� 1. Temporary Electriral Service or Pole � 52. Poo( & Equipment Location �
2. $oil Pipe-Undrgrnd. � 53. Steei Reinforcement �
3. E{sar+cai Conduit Utility-Undsgrnd. 54. Focros
4. Electrical Conduit�Undrgmd. 55. Electrical Bonding
5. Sceel Reinforcement 56. Rough Plumbing & Pressure Tzst
6. Electrical UFER Gmd. 57. APFROVAL 70 COVER�GUNITE
7. Footings 58. Etectrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, C� UnUryrnd., Test
9. VJater Pfpe�Undrgrnd. i � 60. Backwash Lines, P�Trap, � Undrgrnd.
10. Structural Floor System 67. APPROVAL 70 DECK
1 t. PrOPerty Sewer �ine & House Connection 62. Backwash & Recepior-Final
12. Sewer Cap ' 63. Heater & Vent-Final
73. Roof Drains 64. Piumbing System - Final �
74. Ro�gh Plumbing 65. Efectrical-Final �
15. Rough Electrical�Conduit 66. Solar SVstem-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
77. Raugh Wiring Sign 68. APPROVED FOR P�ASTERING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTED.IS FINAL
19. Rough Heating & Ai� Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firep�ace - _ , APPROVALS � Permit g
27. Oucts, in St�ucture � . 70. Under9rourid Hydro
22. Ducts. Ventitating _ 77. Product Piping � Gas ❑ Oii
23. Gas Pipe�Rough & Test �;' , , ' 72. Underground Flush
24. Roof Framing ' . , 73...Undergrnd.Smra9eTank QGas �Oil
25. Roof Sheathing � � 74. Overhead Hvdro
26. T�9ar Ceilir.g (Structural) & Monocoat ' 75. Dry Chemicai
27. Frame and Flashing :�rr . 76. Dry Standpipe
28. Lathing & Siding � 7<��' " 77. - FIXEO SYSTEM PtNA�
n�t:, n ,
29. Insulation �� � g�� 78. FIRE PREV. FINAL
30. Drywall Naiiing + � ' H,EALTH DEPT. REQUIREMENT
31. P�aster 8row� Coat � � � J9. FINAL INSPECTlON �
32. Electrical Power Meter=Finai ' 80. FOOD CERTIFICATE ISSUED
33. Final Electric �� Notes. ��_ �r i.;-� ��,+F ��rZ� �
�J
34. Finai Heating & Air Conditioni�g �
35. F(nal Gas Pipe-Test , � � �
36. Hood or CanopY
37. Final Factory Fireplzce ' . �
38. Final Plumbing � 'Z'`!1-t� ,(�/ . --'
39, Water Service�Final ' � , ,
40. Gas Service-Final �
41. Solar �omesticFinal - ,
42. Backflow Preventer . � . - .
43. Batkflow Irrigation � ,
44. LandscaDe Irriqation System . ' ' '
45. Sound Attenuation -. . _
46. Handicap Regulations .
47. FINA�L STflUCTURE & BUILDiNG .
48. FINAL PLANNING ,
49. Etectric Release to Edison �
50. Gas Release to Southern California Gas Co ��
51. CERTIFICATE OF OCCUPANCY
No. Dace
C�Y OF COSTA MES,_
GIJFORNIA L2626 � P.O. BOX 1200
FROM TME OFFICE OF TME DIRECTOR OF BUILDIN6 SAFETV
Project Address �G%� � J.C�r,��� � � ��
Project Name
Owners Name ���14�, ( = ��Sa ,�,.�
Raners Address � 3� �� � �.�',,,�_�� � ���_ 7�0�_
O+mers Telephone �j'� y - � �j�/
F�cmit #
FlT�',.�
City Use Only
I�`� �/' �jfj�,.,�� as Owner, Contractor, Agent (strike out all
ex�e¢t one) do hereby attest that e�loyment of any person, or persons, is not
anticipated at the time of seeking the above-referenced permit. In the event that
any person, or persons, are e�loyed under the pravisions of this permit, I shall
imrediately cause a valid Certificate of Worlanens Compensation to be filed with the
Costa Mesa Building Division.
I agree to defend at my own wst, arcl to indemnify and hold harmless,, the City,
its officers, agents and/or e�nployees, fran and against, any and all liability,
damage, costs, losses, claims and e�cpenses, hv,ascever caused, resulting directly
or indirectly fran, or connected with the improvement under this permit.
I further state that I have read and fully imderstand the implications and re-
sponsibilities of the above statelrents, and will canply with all provisions of the
Contractors State License Law found under the Business and Professions Code,
Division 3, CS�apter 9, of the State of California.
��1NA l. �R�NIoN�
Print Name
� �„i'�
G� Signature
CMF 0777-46
� � iy��
Ik3te
. . � . . .. .� _ . ...�.. _ _ .�:� �..__.___ �....
CIl_ OF COSTA ?tESA R.c.QliEST r0R OCCL....QCY
�
a
�RACT �0. ( • � (�
DATE�Q��
The developer of the a�ove er.titled tract desires to sell the above set
forth lot prior to the time that the tract has been comoleted and its streets
�ccepted by the City of Costa Mesa.
T4e undersigned, by executir.g this agreement, acknowledges that
���-^�-they) (rcar-es were)�� advised that this tract has
ao_ oeen given f{ a1 iaspection nor has it been accepted by the City of Costa Mesa
as aavi^g carplied with the coaditioas of aoproval which were imposed by the City
�t :ne ti-ae the final tract mao „as approved.
The City assa�es no liability for the enforcement of the conditions
;ecessary for approval other th2n those conditions protected 'oy surety bond.
T:ze undersigaed agrees to inda-�nify ar.d hold the City haa-aless fro�
tn} clain resultir.g in dz:.age er persor.al. injuzp to tne uadersignec by reason
of the a£oreir,entiened unco�plet=d co:di�ioa.
BY �
srchaser
RECEIVED
C�TY OF COSTA MESA
::� �iNni;n�C 11FPT
�%�� 1ly/.�
AM QM `
: �8�y�4�,. .. ,.y d�4,5�ti
�
_--- � -�
EY '� •
��s�—,�_i ���:�".-tl��c"�l
Developer and/or 2uthorized
re�resenta[ive
BY ���
�»,��.�/'�, 1�����.
Lender
PPLICATION FOR A BUILDING P( IT
�/ BUILDINGPERMITNO. Eiectr�wi W
Tract l� 8 Block Lot l Permlt No. �.
Builtling
Plumbing a
AtlGr¢zs 2� � G � O��/ Permit No. D
✓
Cf055 MechanlCdl C
Area SVeet Fermit No. a
m
Owner G LC -'T Type ot Project: ❑ New ❑ Altar Atltlition �
Atltlress 3 8 -�% ❑ Repair ❑ Convert ❑ Demo ❑ Occupancy Pmt.
'� Sup. Oist./
CItY COS � P Ph A.P. InSP. Area
ArcMlect/ Zone SPI. PmL No.
Designer License No.
Setbatk5 P/L Front C/L SL Street Witlth
Atltlress
Vartls Le t Right ear
CItY ZiP Phone
ave �o�. e ig . .
r .Engineer License No. .
� Park n9 SPaces equ ra rovi e overe
p, AtlCress
m City Zip Phone Struct No.o( No.oi
Hei9ht Stories Family
� LICENSED CONTRACTOR'S DECLARATION Park Fees Ves Fee
�° ReoWretl No GT. Receipt
m I heroby aftirm that 1 am licensed untler provisions of Chapter 9
L (commencing with Seciion 7000 of Division 3 of the Business and Zoning ApProvetl BY: Date
�. �Professions Cotle, and my license is in full forca and effect�.
r2 License pas � License Number
T Date_. —Conttactor Misc.
E Atltlress Proposetl Use
ot Structure
ji Cily antl Zip Phone
v� CONSTRUCTIONLENDINGAGENCV
y ! hereby affirm thnt there is a consvuction lentling a9ency tor the
a pnrfarmance at the work for which this permit is issuatl (Sec. 3097, Occ. Typ¢ Cotle
' Civ. C.1. Class ConsL Year
C Lendor's Name USE/OCCUPANCV SIZE S�. FT.
Lendor's Address
� OWNER-BUILDER DECLARATION
y 1.
I hereby affirm that I am exempt trom the Contractor's Licanse Law
� ior the follawing reason:
� ❑ I, as owner of the prOparry, or my employaes with wages as theit 2� '
sole compensation, will do the work, and the structure is not
r intentled or ottereA ro�sale. -
� ❑ I, ns bwner ot the property, am exclusively contmciing with 3'
licensad contreciors to conrt�uct the projacT.
r ❑ I am ezempt under Sec. , B&PC tor this reamn 4�
m
a Det __Ownar
E WOLiKERS' COMPENSATION DECLARATION Total Valuation
I hereby affirm thac I �ave a certificexa ot confent io self-inwre, � No
or a cartiiicate of Worke�s' Compensation Insurance, or a certifi¢d EncroatBment Permit P.equiretl ❑ Ves
C copy thereof. Gratling Vmt. GraCing
� Policy No.— Company ReQulretl ❑ Ves ❑ No Pmt. No.
� ❑ rtified cooY �s hareby furnishetl.
� ,�,� Rough Gratling 9
¢ Il7 Gertified cop is /iled with (i�apy��eu M� m
Q Approvetl by: oate
Datc — Applicant «�� 3
CERTIFICATE OF EXEMPTION
FROM WORKERS'COMPENSATIONINSURANCE Z
(This ssction need nat bu completetl it pe�mit is for $100 or less). �
I certity ihat in [he perto�manca of the work tor which this permit is �
issuetl, I shall n0: employ any pe�son in any manner so as ro become i
subJect to the Workeri Compansation Laws of Calitornia. PERMIT FEES
Data Applicant
NOTICE TO APPLICANT: It, after making this Certiticate of Struttural b Plan Check $
Exemption, you should become subject to the Workers' Compensation
provisions of the Labor CoAe, yuu mun torthwith comply wixh such SPecial
ElectNfal 5 Invest. S
provisions or this permit shall be deemed revoked.
ICERTIfVTHATIHAVEREADTHISAPPLICATIONAN�STATE �
THAT THE ABOVE INFOflMAT10N IS CORFECT. 1 AGREE TO P�umbing E
COMPLV WITH ALL COUNTv ORDINANCES AND STATE LAWS
FELATING TO BUIIDING CONSTRUCTION, AND HEREBV AUTH- Methanlcal S
ORIZE REPRESENTATIVES OF THIS COUNTV TO ENTER UPON
THE ABOVE MENTIONED PROPEFTV FOfl INSPECTION PUR- pre-Gratle
P/OS�/$'' / / /� �i /Z_�O Inspectlon 5 �
ry �C���S �.� /� Pr¢-Gtatle Permi[
Si nature oi Applicant or Agant Oata Rea No. a Issue $
.4G�.�oN •dg��� ►
Print Applicent's/Agent's Name
All s aces within this hox must be completed to rocess Plan Issuance
P P CheGk By: Approvetl:
�mr uaao�uo �eu-en� rev. einu
OWNER T�ARG7TN Rn
JOB ADDRESS ql�$ ;
�ENERAL CONTRACTOR
A� LOT
I' TIONS
s�
GAS
WATER
ROUGH PLUMBING
PROP. SWR. LIN HOUSE CON.
SPRINKLING SY El.A
MISCELLANEOUS
ROUGH HEATING ANO AIR CONOITIONING
TEMPORARY SERVICE OR POLE
UN�ERGROUNO � POWER �
ROUGH WIRING �
TPENCHES FORMS � ' STEEL RE
FLOOR SVSTEM
BON� BEAM � STEEL REINFORCE �
SHEATHING
FRAME ANO FLASHING
LATHING - IN - OUT ¢�_
PLASTER. 9ROWN COAT
ST'
HE
REFR
DATE
FIRE ZONE VALU
SUBCONTRACTOR
NG PE
. 36=� I �
, � sPR 1 i-7=��:���`� 613 `'"�-`� i�-1.34
3�1 gR��poTeoxEt2o0 UCOs�7�arGut SAFCALI OHNAIA9 626 T .
� - � A L ATION FOR BUILDING PERMIT
ForApplicant to Fill in Completely - R i ev D TE RECEIVED nAr�iSSV�p,
BUILDING . `.,) � � ppR o tsr3
ADDRESS GC/
� PERfWTP�O. �
OWNER in outhe n California lnc. A'P' ND' JO`f I i
BUILDING ij i //� �C/�f/� �
� MAIL ADDRESS,.� "7 c rv
Z ADDRESS 1 2 entura Bou�levard
d U CITV Encino California No��986-8890 TRACT ]]]$ LOT].91 BLOCK
�z
O V~) �N�ERCTION W A D
h n California
am •
�� BqANCH 16255 Ventura Boulevard
J N OWNER �
m � ADDRESS Encino California �
Jm ARCHITECT TEL S ST�C
a ORENGINEER 1+3YC41R S. Calif. N.'273-4464
U � FIRE
W� ADDFESS 9100 Wilshire Blvd. Bev. Hills ZONE
aw
J O APPROVED
CONTRACTOR Larwin Southern California B�
m Z
�¢ ADDFiESS 16255 Ventura Boulevard
.SO � L
w�w � TEL. Z�NE NO.OF USE OF NEWS/ �«>
ZF cirv ncino alifornia N� 986"-8890 —� P"'"Si/ gUILDING�f7'T��Q
�� STATE � qTY � YAADSAPPROVED YAADSAPPROVED
(p � ua No. 191311 LIC. NO. B�1 MAIN BUIL�ING ACCESSpRV BUIIDII
� O (FROM C/LSTqI
SIZE ' . . NO.OFBIDGS.
OF l0T (�Q X 100 . "' NOW ON LOT Q fRONT 1
USE OF'
EXISTING BIOG. �
� SIZE OF 1987 NO. OF ], L. SIDE S I
ZQ NEW BLDG. . FOOMS STORIES '
U EXTERIOR WALL ROOF
COVERING StllCCO COVERING WOOd shin�le flEAR I
J USE OF BUfIDING AND WORK TO BE PERFORMED DISTANCE BET.
a' � MAIN BLDGS.
a
Q' vna. �
O C.U.P. #
~ ' APPROVED/' 7
v� i.ri
z ' ; HOLD FOR
0
V� I hereby acknowledge ihat I have read this application antl state
� thai the above information is correct antl agree to comply with
� all laws regulating building construction, antl 1 shall not employ
F„ any persOn in violation of the workman's compensation laws of
(A Me State of Calitornia. ' '
zI hereby certify ffiat I am properly licensetl as a contracior under SQ•
the State ot California Business antl Protessions Code, Divisicn 3, THE MOUN
Chapter 9, antl that svch licenses are in tull forca antl effect, or I THE PURPOSE
em exempi from the provisions ot the State of California B�siness VA�UATION
antl Professions Cotle, Division 3, Chapter 9.
Sipnature � �
Permlttee���(�-'�� D DOTiTIS '$ �9�8��
' Authorizetl ABent
FT
BET. MAIN &
ACCESS. BLDGS.
DATE
APPROVED
�/_ 9.
0
�
�
V �
e
FT. o
T S W UNDER VAlUAT10N IS FOF �
OF ABLISHING A PERMIT FEE ONLV: m
¢
PERMIT FEE $ lOI.. SO N
�
PLAN CHECK $ SO. %S E
`o
152.25 "
TOTAL FEE $'
OWNER F�
JOB ADDRE55 346
GENERAL CONTRA(
! 412-173-0
IN��ECTIONS
501 L
G/5
W ATER
HOUGM PLUMBING
PROP. SWR. LINE rI NC
ROUGH MEATING RND PIR CONDIT�ONING
TEMPORARV SEAVICE OR POLE
UNDERGROUND �I POWER �
,�J ROUGH WIRING
4% TRENCHES FORMS STEEL FE
� FLOOR SVSTEM
yBONO 6EAM � STEEL REINFORCE [
� SHERTHING
•r-1 FRAME AND FLASMING
N LRTHING - IN I� OUT n
�PI "-'ER, BROWN COAT
5 :UR4L, FINAL
a HEni ING. VENT., REFRIG. ANO A.
PLUMBING, FINAL NNO GAS TEST
ELECTRIC, FINAL
DATE
BUILDI
�IPTION oi WORK pat
ZONE VALUE
PE V-N GROUf
SUBCONTRACTOR
1
.� COSTA MESA BUILDINGSAFETY DEPARTMENT APPLICATION�OR'STRUCTURACPERMIT-20�
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 -
RECEIVE V PERMIT N° 50971 �
For Applicant to Fill in Completely — Use Ink Only
BUIIDING � A.P. NO.
ADDRE55
B UI LDI NG
OWNEROR 6 � A�DRE55
TENANT
UNIT OR
MAILING . SPACEN�
ADDRE55 5�A E
TR.NO. LOT BLK.
^ TEL. �
CITY CQS T/V �J�%� EW ADD LTER EPAI MOVING DEMOLISH
CANSTflUCiION ��
LENOER .
BRANCH �
OWNER Q �/ �
ADDRESS ✓ • '/ VALUE 9/
ARCHITECT TEL. USE �(, �O CO Ue' I $ l� /V'
OF ENGINEER N
l�
ADDRESS ZON TVP GROUP
CONTRACTOR�—� /i�� APP OVE
�GR/c/�sEC,�� BV DATE ._ O
ADDRESS�� N T/� E y .
��T� .o ,o F � �92�
STATE CITY APPROVE TBAC S
LIC. NO. 3� D � LIC. NO. -
SIZE NO.OF BLDGS. (FROM /L R �
OF LOT NOW ON LOT � RONT
USE OF
EXIS"fING BIOG. S� F
Separate permits are required for L. SIDE FT ��
electric, plumbing and heating work: / !/ .
REAR FT
USE OF BUILDING AND WORK TO BE PERFORMED PLP.NNINC� ACTION
,d T/D -
///G � Z APPROVED
APP
� ��
I hereby acknowledge that 1 have reatl this application end state
ihat the above information is corract and ag�ee to comply with
all laws regulating builtlin0 consttuction, antl I shall not employ
any person in violetion of the workman'S compensation lews of
the State ot California.
I hereby certify that I am proparly licensed as a contrector untlar �
Z SQ. FT.
the State of Califo�nla Business antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chaptar 9, antl that such licansas are in full force antl effact, or I. THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV:
am ezempt from the Drovisions of the State of Calitornia Business VALUATION PERMIT FEE $
antl Professions Code, Division 3, Chaptar 9. � •�
�j PLAN CHECK E
sienatura o (� I O / . �
Permittee f�� �:tip! � S iaq�.� TAX E �, c
Auffiorizetl ABent Date ��' �2 � U Q >�
TOTALPAID $ O� �
00 TL