HomeMy WebLinkAbout3025 GARFIELD AVE - Building Permits,
.
• CITY OF COSTA MESA . .. �
BIIILDING DIVISION �
, 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax p14) 754-4856 • www ci wsta-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
� ��� PERMIT NUMBER: E08-00388
PERMITTYPE ELEC �� � �1� ��v� STATUS: ISSUED
APN: 14113429 O�// DATE ISSUED: 10/OS/2008
ISSUED BY: YH
JOB ADDRESS:
Vicinity:
3025 GARFIELD AV CM
Suite/Unit:
SCOPE OF WORK: ELECT. FOR EXTERIOR FRONT YARD LANDSCAPING - 5 FIXTURES, 2 RECEPT/OUTLETS & t SWITCH.
OWNER: ZAVELION, MARK
PHONE:
APPLICANT: ZAVELION, MARK
PHONE: 714 210-9044
CONTRACTOR:
Address: Unit ; �
City/State:
PHONE:
ZipCode:
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee:. . , $0.00
Electrical Permit Fee: $32.30
Reinspection Fee ` $0.00
TOTAL FEES $32.30
Address: 3025 GARFIELD AVE Unit:
City/Slate/Zip: COSTAMESA,.CA
Address: 3025 GARFIELD AVE Unit: .
City/State/zZip: COSTA MESA, CA , �
License No.
CELL:
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NOTICE: The work authonzed by this permit shall comply with all applicable handirap access requiremenls under Califomia statutes and related
regulations. (Ord. No. 92-28. § 1, 12-21-92) '
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. , .
INSPECTIpNS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
400E �. �NssernoN rrve o� �xnM�s � �r+sPEcnox rne ➢� ' �N7I71pLS
1816 Fixed System Final Fire Prevention 206 Final Mechaniwl
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 210 Final Elecincal
201 Final Block/ReWining Wall 272 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Fi�al Demolition 250 Final Building�Occupancy
WORKERS' COMPENSAT�ON DECVIRATION:
I hereby aHirtn under pena�.j of perjury one of the following tleclarations:
� I have an0 will main[ain a ceRifi�ata o( consent lo sel(•Insure !or workers'
compensation, as provitletl for by section 3700 ot the Labor Code, for the
peAormance of the work for which this permit is issued.
❑ I have and will maintain workers' compensation insurance, as requiretl by
sectbn 3700 of Ihe Labor Code, tw the pedortnance of the v.ork for which this
pertnit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier.
(Thi� saclar nee0 not Ge cwndete0d (heQ��Q � �aluetl a1 one hv�retl W'lais (Sf00) a less )
Policy Number:
❑ I ceAity that in the peAormance ot the work tor which this permit is
issued, I shall not employ any person in any manner so as to hecome subject
lo the workers' compensation laws o( Califomia, and agree that if I should
bacome subject to the vrorkers' compensation provisions of Sec�ion 3700 0(
the Labor Cotle, I shall forthwith comply with these provisions.
Appliwnfs SignaWre �ale
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&1ECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVII FINES UP TO ONE HUNDRED THOUSAND DOILARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 PF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm Ihat I am licensetl under provisions o! Chapter 9(commencing
with Section 7000) of Division 3 of tpe Business and Professions Code, and
my license is in (ull (orce and eftec[.
Lic. # Class #
CAmratlor's SignaWre Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn that there is a construction lending agency fw the
peAortnance of ihe woAc for wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender s Name:
Lender's Atltlress:
Signalure
�
OWNER•BUILDER DECLARATIONS� n,
I hereby aKrm thal under penally of perjury lhal I am EXEMPT•FROM THE
CONTRACTORS LICENSE LAW for the (ollowing� reason (Sec. 7037.5,
Business antl Professions Code: Any ciry or county which requires a permit to
conslmct, alter, impmve, tlemolish, or repair any strucWre, prior to.i�s
issuance, also requires �he applicant for such permit to file a signed statement
that he or she is licensetl pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing wtth Section 7000) of Division 3 of the
Business and Professions Code) or [hat he or she is exempt therefrom and
the hasis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjects the applicant to a civil penalry of not more than
five hundretl dollars ($500).):
❑ I, as owner o( Ihe property, or my employees with wages as their sole
compensa[ion, WILL DO THE WORK, and the SUucNre is not intended or
offered for sale �Sec. 7044. Business and Professions Code: The Contrac[ors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himsel( or herself or through his or her ovm
employees, provided lhat such impro�ements are not iNended or oHered (or
sale. If, however, �he building or improvement i5 sold within one year of
completion, the owner-builder will have the burden of provirig thal he or she
did not build or improve tor purpose of saleJ. ,
T
❑- I, as owner o( the property, am EXCLUSIVELY �CONTRACTING WITH
�LICENSED CONTRAC70RS to constNct Ihe project (Sec. 7044, Business and
Protessions Code: The contractas License Law dces not apply to an rnmer of
property who builds or improves thereon, and who contracts for such project with
a contract«(s) license pursuant to the Gontractors License Laws.).
�.I am exempt under sec.
Business and Professions Code !or this reason:
/�. �e�, c�a�
' ( SignaWre � � , . Date ,
905]�a6 (3/0]) \ �
/ '
Ovmer ID veri(etl by AriAvc. _.�cense., � Yes ❑ No
-Dnver's License No. � Expirb'3: I�"�6 � J
Verifcation of Ownership by (type of document, i.e. - property tax bili�r deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT GER7IFICATION: '
❑ I hereby certdy that no excavation frve (5) or more feet in depth in�o wfiich a
person is required to descend, will be matle in connection vrith work autFarized
by this permi�, and �hat no building slructure, scaRdding, falsework, v demolilion
or dismantling Ihereof, will be more than thirty-six (36) feet higR (Chap. 32, Gry
2. M 2. Sec. 341. Ttle 8. Cali(wnia AdminisiraWe Cotle�.
❑ As owner-builder, I will not employ anyone to do work which woultl
require a permit from ihe Division o( Industrial Sa(e1y, as noted above, unfess
such person has a permii to do such vrork from the division.
Appl¢anl's SignaNre Date
Division of Induslrial Safety Permit Numbec
HAZARDOUS MATERIALS AND EMISSIONS GERTIFICATION:
1. Will the applicant or present or WWre builtlinq occupant need to file and
certi(y a Business Plan for emergency response lo release or Ihreatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Cotle requires, with some
exceptions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one time during a reportetl
year a quanlity of hazardous matenals equal t0 or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas
at standartl temperaWre and pressure).
2. Does or will Ihe applica�l or present or tuNre 6uilding occupant need to file
a registration form (or acu[ely hazardous matenals? ❑ Yes ❑ No
(Section 25533 of the Calilomia Health and Satety Code, with some
exceptions, requires registration wi[h the Costa Mesa Fire DepaAmenl by
each business which at any one lime has on hand a quanlity of acutely
hazartlous materials equal to or greater than a weight ol 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standartl
temperalure an0 piessure).
3. Does or will the applicant or present or fu[ure builtling occupant need to
prepare an RMPP (Risk Managemen[ and Pre�ention Pmgram lor aw[ely
hazardous materials)7 ❑ Yes ❑ No
(Sec�ion 25534 of the Califomia Health and Sa�ety Code provides Ihat the
Costa Mesa Fire Depanment may require the preparation, certification and
filing with the Fire Department of an RMPP Dy businesses which are required
to register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presenUy required, has Section 25534 0( the California
Health antl Sa(ety Cotle been fully wmplietl with? ❑ Yes ❑ No
5. Does or vnll �he applicant or present or future building occupaN require for
the work which is the subjecl of this application a permit lor such construclion
or modifcation from the Soulh Coast Air Quality Management Distnct or !mm
any other air polWtion control tlistrict or agency? ❑ Yes � No
(Section 658502 of the Califomia Govemment Cotle requires Ihat the requested
intortnation be fumished on applications ta rron-residential builtling pertnits�.
6. Will any part of the tacility to be consWcted under this permit be within
1000 (ee[ from the outer boundaries of a school? ❑ Yes ❑ No
pt yes", the lacilily must meet the requirement of Sections 25534 and 42303
of the California Healih antl Safery Cotle).
7. If a pertnit from Ihe South Coast Air Qualiry Management Dislrict or other
air polWtion control district or agency is required for the work which is the
subjecl o( this application, have all ot ihe disclosures prescribed by Califomia
Health and Safety Code Section 42303 been made? ❑ Yes 0 No
8. Qf 'yes", attach certificale of compliance from the ap'propnate air-pollution
tontroloffcer�. � � •
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ihe
infoimation given above is correcL I agree to compty with all slate laws and
city.ordinances re9arding Hazardous�Materials and Emissions.
SignaWre Oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this apPlication and slate that
the information given is correcL I agree to comply with all slate laws antl city
ordinances relating to building conslruction, and authonze representatives of
the City of CosW Mesa to e upon Ihe above-described properry for
inspection purpo� I agr o[ occupy or allow occupancy of any building
aulhorizetl b permit u lil al inspection. � / A
/ � p �d F�
Ip
� $iyNWr Cg310vTerls) C Ddle
Ana/orAul�onzeOApd���n1 Ddle
Address
r' �
�„"'�' 4� ��QQ.�CL ��� �Ap:l� �Gl�GdGdyt
OWNER—BUILDER
� VERIFIC�TION i� c7�— (��� �
�� ) �Jlil.0 �'(i l, ly� Permit #:�� — `
A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as
a condition precedent ro issuing a building pennit, requirc the completion and require the retum af, an owner-
builder verification.
Attention Property Owner:
An 'owner-builder' building pemiit has been applied for in your name and bearing your signature.
Please complete and retum this infomiation in lhe envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building perniit. No building pemiit will be issued until this
verification is received.
l. 1 personally plan to provide the major labor and materials for consmiction of the proposed
property improvement. ❑ Yes ❑ No
2. (have ave not) siened an application for a building permit for
the proposed work.
� have contracted with the following person (firm) to provide the proposed construction:
\ame �U7 �'i �C`�Ti7
Address
Phone (
City _
Contractor's Lic. No.
4. 1 plan to provide ponions of the ���ork, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Yamc
�
10C2a6 (Rev. ttl6s)
Address
Phonc (
City _
Conlractor's Lic. No.
1�aill provide some of the w�ork but 1 have contracted (hired) the following persons to
provide the ���ork indicated:
Address
Phonc "1'ypc of Work
PERMIT TYPE
CITY OF COST6t MESA
' BUILDING DIVIS/ON
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 7%-5626
ELEC
JOB ADDRESS: 3025 GARFIELD AV CM
Vicinity: GAftAGE
PERMIT NUMBER: E07-00687
STATUS: ISSUED
DATE ISSUED: 07124/2007
ISSUED BY: RMD
Suite/Unit:
SCOPE OF WORK: PERMIT REVISED ON 08I07/07 TO ADD 14 LIGHT FIXTS AND 2 ADDITIONAL OUTLETS.
ELECTRICAL PERMIT TO LEGALIZE WORK DONE WITHOUT PERMITS IN GARAGE. WORK TO INCLUDE 2 NEW OUTLETS. C07-001289
OWNER: ZAVELION, MARK
PHONE:
APPLICANT: ZAVELION, MARK
PHONE: 714•210-9044
CONTRACTOR: OW NER-BUILDER
Address: Unit: PHONE:
City/State: ZipCode:
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00
Electrical Permit Fee: $43.30
Reinspection Fee $0.00
TOTAL FEES $43.30
Address: 3025 GARFIELD AVE Unit:
Ciry/State2ip: COSTA MESA, CA
Address: 3025GARFIELDAVE Unit:
City/State/zZip: COSTA MESA, CA
License No. 000000
CELL:
NOTICE: The vrork aulhonzetl by this permit shall comply with all applicable handicap access requirements under Cali(omia sfatutes and related
regulalions. (Ord. No. 92-28, § 7, 12-27-g2)
EXPIRATION: PERMIT EXPIRES 180 OAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, antl all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
OC DE/. INSPECTIONTYPE D� NI ifi1RL5 OU / INSPECiIONTYPE pF�i �Nnn��s
1618 Fixed System Final Fire Prevention 206 Final Mechanical
7266 Pool Spa Final 208 Final Plumbing
Z00 FinalRe-Root 210 FinalElectrical �%�/(-0% �7Y�i
201 Final BIocWReWining'Nall 212 Final Fire Prevention J
202 Final Factory Fire Place 220 Final Planning Appro�al
203 � Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSqTION DECLARATION: .
I hereby affirtn under penalty of peryury one ot the following declarations:
❑ I have and vrill maintain a cenifiwte of consen[ to self-Insure for workers'
compensalion, as providetl lor by section 3700 of t�e Labor Code, tor the
peAormance of the work �or which this permit is issued.
❑ I have and will maintain workers' compensatan insurance, as required by
section 3700 ot the Labor �pUe. fa the peRormance of the vrork fw which this
permit is issuetl. My workers' compensation Insurance carrier and policy
number are:
Cartier.
(TNs seGon neetl irol oe ampletetl Alne peimrt 6 valuetl et one nunEietl da9ars (3f00) oNessJ
Policy Number:
GI� I-c'ertify Ihat in t�e pedortnance of the work (or which this permil is
issued, I shall no employ any person in any manner so as to become subject
to the vrorke compensation laws of Califomia, and agree that il I should
become s ct to the worker ' lion provisions af Section 3700 0l
Ihe La r otla, I shall fotthvn com 'th these provisions.
�8.-O%. �%
Fppptanl's5qp�awre ' `--- Oa1e '
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNlAWFUL AND SHALL SUBJEC7 AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FWES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS
PROVIDED FOR IN SEC710N 3706 OF THE LABOR CADE. INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions ot Chapter 9(commencing
with Section 7000) ol Division 3 of the Business antl Professions Code, antl
my license is in full farce 8nd eHecl.
Lic. # Class #
Comroc�or's Signature Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby atfum th2t there is a constmction lending agency tor the
pedortnance of Ihe v.ork fpr v,fiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Address:
Da�e
OWNER-BUILDER DECLARATIONS:
I hereby aKrm thal un0er penalty ol perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Prolessions Code: Any city or county which requires a permit lo
constmct, alter, improve, demolish, or repair any sWCWre, prior to iis
issuance, also requires the applicant lor such permit ro(le a si9netl statemem
that he or she is IicenSed pursuant to Ihe provisions of the Contractors
�icense Law (Chapter 9(commancing vrim Seclion 7000) 01 Division 3 Of lhe
Business and Professions Cotle) or lhat he or she is exemp� therefrom antl
the basis tor the alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit suqjects Ihe aDPlicant to a civil penalry o( not more than
five hundretl tlollare (5500�.�:
�I,—as owner ol the propetly, or my employees vrith wages as their sole
compensation, WILL D4 THE WORK, antl the stmclure is not intended or
oHered for sale (Sec. 7044, Business and Pmfessions Code: The Comractors
License Law does not apply to an owner of property who builtls or improves
thereort, and who does suth work himself or herself or througb his or her ovm
employeas. pmvided t�at such impmvements are not intended or offered tor
sale. If, however, the Guilding or improvement is so10 wilhin one year of
completion, Ihe owner-builder will have Ihe burden of proving that he�or she
ditl not build or improve for purpose ol sale.).
❑ I, as ovmer of lhe property, am EXCLUSIVELY CONTRACTING WITM
LICENSED CONTRACTORS to consWct fhe projecl (Sec. 7044. Business and
Professions Code: The cpntractor5 License Law dces not appty to an Ovmer o(
propeAy who builds or improves thereon, and v.ho contracts fw such project with
a contracta(s) license pursuant to the Contraclors license Laws.�.
❑ I am exempt under sec.
Business and Professions Cotle for this reason:
�' . �7 0�
�ignaWre" — '� (_Da�e
305)-a6�]IO]� � �
C'�mer ID verifietl by drive, ,nse. ❑ Yres ❑ No
tDriver's_License No. � Expires: Z6' %t�
Verification o( Ownership by (rype of document, i.e. - pmperty lax bill or tlee0):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation frve (5) or more feet m depth into which a
person is requiretl Io descen4 vnll 6e matle in wnnection with work auttqrized
by thi5 permit, and that no building strucWre, scaf(dding, falsework, or tlemolition
or dismantling �hereol, will be more than thirty-six (36) feei high. (C�ap. 32, Grp
2, Art 2, Sec. 341, Ttle 8, Califomia Administ2tive Code).
❑ As ovmer-builder, I will not employ anyone to do work which would
require a permit from lhe Division of Industrial Safety, as notetl above, unless
such person has a permit to tlo such work from the tlivision.
A�d�����s $iB�aWre
Division of Indusirial Safety Pertnit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or (uture buildin9 occupant need lo file antl
certily a Business Plan for emergency response to release or threatene0
release ol a hazartlous material? ❑ Yes ❑ No
(Seclion 25505 0( the Califomia Health and Safery CoCe requires. with some
exceptions, that a Business Plan be filetl with the Cosla Mesa Fire
Department by every business which has at any one time tlunng a reported
year a quaNiry of hazardous matenals equal ro or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feel of wmpressetl gas
at standard temperaWre antl pressure).
2. Does or will the applicant or present or fWure building cecupaN need to file
a registration form tor acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the Cali(omia Health and Safety Code, vriN some
exceptions. requires regishation with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantiry of acutely
hazardous materials equal to or greater than a weight ot 500 pounds, or a
volume o! 55 gallons, or 200 cubic feet o( compressed gas at stanaarA
temperature ana pressura). �
3. Does or will the applicant or present or future building;o�ccupant need to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous matenals)7 ❑ Ves ❑ No
(Section 25534 0( the Califomia Heal[h and Safet C e provitles that lhe
Costa Mesa fire Departmen[ may require Ihe preparation, certifcation and
fling with Ihe Fire Department of an RMPP by�businesses which are required
to register awtely hazardous materials withihe�Fire Department.
4. If an RMPP is presently required; 7�a's Section 25534���ne Calitomia
Health and Safery Code been fully complied�with7 ❑ Yea ❑ No
5. Does or will the applicant or present w�(uWre builCing.oc v\t�require for
the work which is the subject of Ihis'application a pertnit lor�suih conSWction
or modification from Ihe Soulh Coasl Air Quality Managemenl Districl or from
any other air polNtion control districbor agency?^��Yes'% ❑ No
(Sec�bn 658502 of Ihe Califomia Govemment Code requ'ves that tha requested
inlormation ba tumished�on�applications lor roo-residentlal building permits).
� � �� �. /�\ i/ �
6. Will any part of Ihe facilM1y to be con5lmctetl'under this permit be vrithin
1000 (eel (rom Ihe ouler boundaries�o(�e school? "❑ Yes ❑ No
�A I1 A�/"
(If yes", Ihe lacility musl meet Ihe requirement�of Seclions 25534 and 42303
of Ihe:CalitomiarHeallh�and Safery Gode�.��
7, If a�perm��rorti the SoWh Coast Air �uality Management DisMct or other
air pollutlon contiol district or agency is required for the vrork which is the
subject ol,this application, have all of the disclosures prescnbed by California
Health and�Safety Code Seclion 42303 been made? ❑ Ves � No
8. (If "yes", attach certifiwte of compliance from lhe appropnata air polNtion
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury Ne
information given above is cortecL I agree lo comply vrith all slate laws and
city ordinances regarding Hazardous Matenals and Emissions.
Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and sUte that
the infortnation given is correct I agree to comply with all state laws and ciry
ortlinances relating to building conswction, antl authorire represeniatives of
the City of C Mesa to enter upon the above�escribed property for
inspection ses. I a n o occupy or allow occupancy ot any building
authon t' permit mal inspection. �
8..�7.0
SlBnamreolLeBalOwner(s) Daie -!
An0/or AOIM1onzeG Appliwn�
� ,
CITY OF COSTp MESA
BDILDING D/V/S/ON
77 FAIR DRIVE, COS7A MESA. CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa•mesa.w.us
. FOR INSPECTIONS CALL: (714) 754•5626
EI,EC
�
PERMIT NUMBER: E07-00687
STATUS: ISSUED
DATE ISSUED: 07I2412007
ISSUED BY: RMD
JOB ADDRESS: 3025 GARFIELD AV CM Suite/Unit:
Viciniry: GARAGE
. I � ��Y'u.�/
SCOPE OF WORK: ELECTRICAL PERMIT TO LEGALIZE WORK DONE WITHOUT PERMITS. RK TO INCLUDE 2 NEW OUTLETS.
C07-001289 � � � �
OWNER: ZAVELION, MqRK
PHONE:
APPLICANT: ZAVELION, MARK
PHONE: 714-210-9044
CONTRACTOR: OWNER-BUILDER
Address: Unit: . �
City/State:
PHONE:
ZipCode:
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: $0.00 �
Electrical Permit Fee: . 325.70 �
Reinspection Fee . , $0.00
TOTAL FEES ' ` $25.70
Address: 3025 GARFIELD AVE Unit:
City/State2ip: COSTA MESA, CA
Address: 3025 GARFIELD AVE Unit:
Ciry/State/zZip: COSTA MESA, CA
License No. 000000
CELL:
0
NOTICE: The work authorized by this permit shall compty with all applicable handicap access requirements under Califomia sututes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAVS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPEC710NS: In order For the work aulhorized under this permit to be considered legal, such work must comply with �all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspeclions and final approval will result in the expi2tion of this permit.
40oE �. INSPEC710NTYPE
1618 Fixed System Final Fire Prevention
7266 � Poof Spa Final �
200 final Re-Roof
201 Final Block/Retaining Wall
202 Final Factory Fire Place �
203 FinalSign
204 Final Demolition
gR¢ IN R j`Qy�j INSPECTIONTYPE
208 Fi al Mecha ' .
20/$� inal Pfu ing
10 Final Elect cal
212 Final Fire Pr vemion
220 Fin arrnl Approva!—
222 Final ' e
250 Final8uil0inglOccupancy
0� IN 1L5
WORKERS' COMPENSATION DECLARA710N:
I hereby a(firm under penalry ot perjury one of tne Io��wnng decla2tions: �
❑ I have antl will maintain a certificate o( wnsent to self-Insure for v.orkers'
compensation, as providetl for by seclion 3700 0! the Labor Code, for the
peAormance of Ihe wnrk for which this permit is issuetl.
❑ I have and will mainlain workers' compensation insurance, as required by
section 3700 of the Labor Code, for the peAortnance of the wnrk (or which this
pertnit is issued. My wo�lcers' compensation Insurance cartier and policy
number are:
Cartier:
(iNs sedion neeC nof Ge mnpetetllfha pemv rs vaMtl al are nuMiMMlars (tf 00) a leu )
Polity Number:
��—I-certify that in lhe pertortnance of lhe �+ork for which this pertnit is
issued, I shall not employ any person in any manner so as to bewme subject
to the vrorkers' compensatio of Califomia, antl agree thal il I should
become subjeyt- the vi0rker5' mpensation provisions of Section 3700 0l
the Labor Co , I shall forth ' comply with these provisions.
/ _ _ __Y_ .z_z y. �
�ApP�����'sSignaWre `Oata...;
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF h1E LABOR CADE. IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o( Division 3 of the Business and Professions CoEe, and
my license is in full force and effect.
Lic. # Class #
Convacmr's Signawre Da�e
CONSTRUCTION LENDING AGENCV:
❑ I hereby affum that there is a crostniction lending agency tor me
pertortnance of the v.ork fa v.fiich tNs pertnit is asued. (Sec. 3097, Civil Code�.
Lentler's Name:
Lentler's AtlCress:
OWNER•BUILDER DECLARATIONS:
I hereby affirm that under penalry of perjury Nal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe (ollowinq rea5on (Set. 7031.5.
Businass and Prolessions Code: Any ciry or county which requires a parmit to
conslruct, alter, improve, tlemolish, or repair any strucWre. prior to its
issuance, also requires the applicant for such permit to file a signed slatement
Iha� he or she is licensed pursuaN to the provisions o( �he Contractors
License Law (Chapler 9(commencing with Section 7000) of Division 3 of the
Business and Professions Cotle) or Ihat he Or 5h8 i5 exemp[ Iherefrom antl
the basis lor Ihe alleged exemption. Any violation of Section 7037.5 by any
appliwm for a permit subjects lhe applicaN to a civil penalry of not more than
fve hundred dollars ($500).):
�„I, as owner of ihe property, or my employees with vlages as Iheir sole
compensalion, WILL DO THE WORK, and tha structure is not intended or
ofleretl lor sale (Sec. 7044. Business and Professions Cotle: The Contractors
License Law tices not appty to an owner ol property who builEs or improves
thereon, and who dces such work himself or hersell or through his or her ovm
employees, provided that such improvements are not intended or oflered for
sale. If, however, the 6uilding or improvement is sold vrithin one year of
completion, the ownerbuilder vnll have the burtlen of proving lhat he or. she
tlitl t build or improve for purpose of sale.).
I, as owner of the� property, am EXCLUSIVELY CONTRACTING WITH
SED CONTRACTORS to constmct the project (Sec. 7044, Business and
rolessions Code: The contractors License Law dces not apply to an ovmer of
propeny who builds or improves thereon, and wh0 tontract5 !w such projeCt wilh
a cmtractw�s) license pursuaN to the Contractors License Laws.�.
❑ I am�exempt under sec.
Business and Professip�ns Cotle for Nis reason:
j
- �.zy�
r59^eMe�a-'-'r `Oate.,,.._�_�:`x'
305]-46(3/0]) �
Owner ID veri(etl by drivi .ise. es ❑ No • I O a� Iv
D��er.'S�License_ No. Explres:
Venficalion of Ownershi by ( ype o document, i.e. - property taa bill or tleed):
DIVISION�OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �
❑ I hereby cetlify that no excavation frve (5) or mae feet in tlepth into wfiic0 a
person is requiretl to descend, will be made in connectbn with wnrk aultarized
by this permit, and Ihat no building struclure, scaffdding, false�wrk, a tlemolition
or dismantling thereol, will be more than thirty-sbc (36) feet high. (Chap. 32, Grp
2, M 2. Sec. 341, Tlle 8, Califomia Adminisl2tive Code).
❑ As ovmerbuilder, I will not employ anyona to tlo work which would
require a permil from Ihe Division of Intlustrial Safety, as noted above, unless
such person has a permit to do such work (rom Ne division.
Appl¢anfs SlgnpWre Wle
Division of InCushial Safely Permit Numher.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neetl to file antl
cenify a Business Plan tor emergency response to release or threatened
release of a hazardous malerial7 ❑ Yes ❑ No
(Section 25505 of the Cali(ornia Health and Sa(ely Code requires, with some
eaceptions, that a Business Plan be filetl wiN the Cosla Mesa Fire
Department by every business which has at any one time tluring a reported
year a quantity of hazardous matenals equal to or greater than a weight ot
500 pounds, or a volume of 55 gallons, or 200 cubic feet ot compressed gas
al stantlartl temperaWre and pressure).
2. Does or vnll Ihe applicanl or present or (uture building occupant need to file
a registration (orm for aately hazartlous materials? ❑ Yes ❑ No
(Section 25533 of the California Health anC Safery Code, vriN some
exceptions, requires reqistration with the Costa Mesa Fire Depariment by
each business which at any one time has on hand a quantily ol acutely
hazartlous materials equal to or grealer than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet ot compressetl gas at standard
lemperalure and pressure).
3. Does or will the applicant or present or future building occupant neetl to
prepare an RMPP (Risk Management and Prevention Prog2m for acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Code provides that the
Costa Mesa Fire Department may require the preparation, certification antl
filing with the Fire Department of an RMPP by businesses which are required
ro register acutety hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the Califomia
Health and Sa(ety Code been tully complieG vrith? ❑ Yes ❑ No
5. Does or will the applicanl or present or (uiure builCing occupant require for
the work whith is the subject o! this aOP�ication a permit lor such wnstruction
or motlification from ihe South Coast Air Qualiry Management District or trom
any other air pollution control district or agency? ❑ Yes ❑ No
(Section fi5850.2 0l the Califomia Govemment Cotle requires that Ihe requestetl
information be tumished on applications fa rron-residential building pertnits).
6. Will any part of the facility to be constructed under Ihis permil be within
1000 leet from t�e outer bountlaries of a school7 ❑ Yes ❑ No
(If yes". Ihe tacility must meet the requirement ol Seclions 25534 antl 42303
o( I�e Calilornia Healih and Safely Code).
7. If a permit from the South Coas� Air Oualiry Management District or other
air pollution control dislricl or agency is requireC tor the v+ork which is the
subject ol this applicatioq have all o! the discbsures prescribed by Califomia
Health antl Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'Yjes", attach certificata of compliance from Ihe appmpriata air pollution
comrol oKcer). ,
CERTIFICATE OF. COMPLIANCE: I certify that under penalty ot perjury the
information given above is conecL� I agree to wmply with all sWte laws and
city ordinances regarding Hazardous Malenals and Emissions.
Slgwwre
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the information given ' correct. I agree to comply with all state lavrs and ciry
ordinances relatin building wnstruction, and authorize represenlatives ot
the Cily of Co esa to pon the above�described properry for
inspeclion pu es. I agree not to cupy or allow occupancy of any building
auihorizetl is p rmit until fi in pection.
%. 2 y 7
SipnalureuCCegalOwneqs)._. - . -Wte-�-
_- _ _ �
AntllOr AWbwizetl AOPIi W nt
� . .
.aaa��s�_
�
. ,. , -., . , . . ,
OWNER-BUILDER
VERtFICATION
Permit #:
A city or county, which is required to give notice pursuant to Section 19830, shall at[ach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-
builder verification.
Attention Property Owner:
An `owner-builder' building permit has been applied for in your name and bearing your signature.
Please complete and retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildine peRni[ will be issued until this
verification is received.
��1'personally plan to provide the major labor and materials for construction of the proposed
property improvement. ❑ Yes ❑ No
�'1 (have/have not) signed an applica[ion for a building permit for
the proposed wark.
�3 = I fiave contracted wi[h the following person (firm) to provid the proposed construction:
Name J 2ET ����
Address _
Phone ( )
City —
Contractor's Lic. No.
4. I plan to provide portions of the work, but I have hired the following person ro coordinate,
supervise and provide the major work:
Name
Address _
Phone ( )
City —
Contractor's Lic. No.
5. 1 will provide some of the work but I have contracted (hired) the Following persons ro
provide the work indicated:
Name
10a216 (Rev.ltl0a)
Address
Phone T}�pe of �Vork
CITY OF COSTA MESA
61IILDING DIVISION
F � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� FOR INSPECTIONS CALL: (714) 754•5626
'�+'a..� �' .
PERMIT NUMBER: P08-00219
PERMIT TYpE PLUM STATUS: ISSUED
APN: 14113429 DATE ISSUED: 10I08/2008
ISSUED BY: YH
JOB ADDRESS: 3025 GARFIELD AV CM
Vicinity: ' ' � �"
Suite/Unit:
SCOPE OF WORK: IRRIGATION SYSTEM FOR EXTERIOR FRONT YARD LANDSCAPING.
OWNER: ZAVELION, MARK � Address: 3025 GARFIELD AVE
PHONE: . � CitylState/Zip: COSTA MESA, CA
APPLICANT: ZAVELION, MARK - Address: 3025 GARFIELD AVE :
PHONE: 714 210-9044 � ' � City/State/zZip: COSTA MESA, CA
CONTRACTOR: ' License No.
Address: _ PHONE:
City/State: , � ZipCode: CELL:
ARCHITECT:
ENGINEER:
License No. - PHONE:
License No. PHONE: '
PLUMBING PERMIT FEE SUMMARY �
�
PLAN CHECK FEE: $0.00
PERMIT, FEE: $38.30
TOTAL FEES:
$38.30
�
NOitCE: 7he work authonzed by this permif sfiali comply with ali appiicabte handicap access requirements under Calitomia statutes and retated
regulations. (Ord. No. 92-28, § 1, 12-21-92) '
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in lhe expiralion of this permit.
CODE /, wsaecnox rne on� i �� yg� iNsvecnox rrre p� iN7IlUL5
1816 Fized System Final Fire Prevention 206 Final Mechanical �
1266 Pool Spa Final 208 Final Plumbing lO_f.3�0� 5.��
200 Final Re-Roof 210 Final Elecincal
201 Final BIaklRetaining Wall 212 Final Fire Prevention
202 Final Feclory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
i �ere6y affirm under penalty of perjury one of the follovring declarations:,
❑ I have and will maintain a certifcate of consent to self-Insure tor workers'
compensalion, as provided for by sectlon 3700.of tha Labor Code, for the
peAormance o( the work for vfiich lhls permit is i55ued.
❑ I have and will maiMain v.nrkers' compensation insurence, as required by
section 3700 of the Labor Cotle, tor the peAortnance ot the work for which Ihis
pertnil is issued. My workers' compensalion Insurance carner antl policy
number are:
Cartier.
(This section nee0 nd be mmpefM d t�e pennAa ealueAat one huMrtd MOars (5100) a less.)
Policy Number:
❑ I certify that in the peRormance tl� lhe work for which this permit is
issued, I shall no[ employ any person in any manner so as to become subjecl
to the vrorkers' compensation laws of California, and agree that if I shoultl
become subjecl to the workers' compensalion provisions of Section 3700 of
�he Labor Code, I shall forthwith comply wil� �hese pmvisions.
AOOliranCs SignaWre Dale
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERP,GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF 7HE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARA710N:
I hereby aKrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Pro(essions Code. and
my license is in full force antl effect.
Lic. # Class #
Cont2<�or's Si9nawre
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a construction � lending agency for the
pedormance of the work fa which this pertnit is.issuetl. (Sec. 3W7, Civil Code).
Lender's Name:
Lender's Address:
SignaWre� Da�e
OWNER-BUILDER DECLARATIONS:
I hereby aKrm iha[ under penalry of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW lor the following reason (Sec. 703L5,
Business and Professions Code: Any city or counry which requires a permit to
constmct, alter,'improve, tlemolish, or repair any s�rucWre, prior to its
issuance, also requires �he applicant for such pertnit to fle a signed statement
thal he or she is licensed pursuanl lo the provisions of the Conlractors
License Law (Chapter 9(commencing vnth Seclion 7000) o! Division 3 of the
Business and Professions Code) or ihat he or she is exempt therefmm and
the basis for the alleged exemption. Any �iolation of Seclion 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty o( not more than
five hundred dollars ($500).):
❑ I, as ovmer of Ihe property, or my Employees with wages as their sole
compensation, WILL DO THE WORK, and the strucNre is not intentletl or
oftered for sale (Sec. 7044, Business and Protessions Code: The Contractors
License Law dces not apply to an owner of property who builds or improves
lhereon, antl who tloes such work�himself or herself or lhrough his or her own
employees, provided that such improvements are not intendetl or oftered for
sale. If, however, the building or improvement is sold within one year of
completion, Ihe ovmer-builder will have tpe burden of proving that he or she
did nol builtl or improve for purpose of sale.).
i❑ � 1� as ovmer of the propeAy, am EXCLUSIVELY CONTRACTING WITH
�-LICENSED CONTRACTORS to construct lhe project (Sec. 7044, Business and
Profe55ions Code: The tontrattors License Law dces not apply to an ownef o�
property wfio builds or impmves thereon, and who contracts for such project with
a contraclor�s) license pursuant to ihe Conl�ctas License laws.�.
❑ I am ezempt under sec.
Business and Professions Cotle for this reason:
l °. Od°. •l �
l--S�gnator ' '-Dale I
J059�a6 �3/Ol)
Ovmer ID verified by Ariyv�e� .. ncense. YyE s ❑ No
Drivers,Litense No. � �" Fxpires:. �j� �� �V
Verifcation of Ownership by (type of document, i.e. - propeRy tax bill or deetl�;
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ��
❑ I hereby certAy Ihat no excava[ion (rve (5) or more feet in depth into which a
person is required lo descend. will be made in connedion with v.ork au�tqrizetl
by this permit, and Ihat no building slrucWre, scaNdding, false�wrk, a demolilion
or dismantling Ihereol, vrill be more [han �hirty-six (36) fee� high. (Chap. 3.2, Grp
2. M 2, Set. 341, Tille 8, Califomia Adminisl2We Code).
❑ As ovmer-builtler, I will not employ anyone to tlo work which would
require a permit from the Division o( Industrial Sa(ety, as noted above, unless
such person has a permil to tlo such work from Ihe division.
AOPbwnl's Signalore Date
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicaN or present or tuture building occupaN need to file and
certify a Business Plan for emergency response [o release or Ihreatenetl
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Calitornia Health antl Safely Code requires, with some
exceptions, that a Business Plan be fled with the Cos[a Mesa Fire
Department by every business which has at any one time during a reportetl
year a quantiry o( hazartlous matenals equal to or greater [han a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic (eet of compressed gas
at standard temperature and pressure�.
2. Does or will Ihe applicant or present or tuNre building occupant need b fle
a regis[ration form for awtely hazardous matenals? ❑ Yes ❑ No
(Seclion 25533 of the California Heallh and Sa(ety Code, witn some
exceptions, requires regisfralion vrilh lhe Cosla Mesa Fire Department by
each business v+hich al any one time has on hand a quantity of acutely
hazardous materials equal ro or greater than a weight of 500 pounds, or a
volume o! 55 gallons, or 200 cubic feet of compressed gas al stantlard
femperaWre and pressure).
3. Does or vnll the applican� or present or fuWre building occupant need lo
prepare an RMPP (Risk Management and Preven[ion Pro9ram (or acutely
hazardous malerials)? ❑ Yes ❑ No
(Section 25534 of the Calitomia Health antl Safely Code provitles that the
Costa Mesa Fire Department may require Ihe preparation, certification antl
fling with the Fire Department o( an RMPP by businesses which are requiretl
to register acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safery Code been fully complie0 with7 ❑ Yes ❑ No
5. Does or will Ihe applicant or present or fWure building occupanl require !or
the work which is Ihe subject of this application a permit for such cons[rvclion
or modification (rom the South Coast Air �uality Management Disirict or Gom
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires [hal the requested
informalion be fumished on appliwtions far nornresi0ential building permits).
6. Will any part of the faciliry to be constructed under Ihis permil be within
1000 feet from the outer boundanes o( a school? ❑ Yes ❑ No
Qf "yes", the taciliry must meel lhe requirement oF Sections 25534 and 42303
of the Cali(omia Health antl Safety Code).
7. I( a pertnit from the South Coast Air Qualiry Management District or other
air pollution conhol distrid or agency is requiretl (or Ihe work which is ihe
subject of this application, have all of the disclosures prescribed by Califomia
Health antl Safery Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'j�es", attach certificate of wmpliance from the appropriate air pollution
control oKcer). � `
CERTIFICATE OF COMPLIANCE: I�certify that under"penalty of perjury the
infortnation qiven above is correcl I agree to wmply with aIl,State laws antl
city ordinances regarding Hazardous Materials and Emissions. �'
SignaWre '
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penally of perjury that I have read lhis appliwtion and state that
the information given is correcl. I aqree to comply wth all state laws and city
ordinances relating to building construclion, and authorize representatives of
the Ci1y of Costa ea m enter upon the above-descnbed pmperty for
inspection purpos agree no1 to upy or allow occupancy of any building
authorized by ' ermit umil fi ' pection. . �
/o Od°, ba'
&�alureolLegalOvmerls) ,"-�a�e '•
Ana/O� Aul�Oni2tl ApOLGinI
�
�
1DOPESSOiBUILqN�: ] V L J bHitt 1GLL HV
avxursn.�eiviu�axx: DOHERTY, WILLIAM J
�ooxEss 1402 PEACOCK HILL
SANTA ANA,CA 92705
544-7779
�Ptt. WIIII10 �OOPESS:
�pCNRECT ONf1M�NFFA:
UNT:
FLUOD; X 47
uura_
a3-�.
ACH Oli FNq.S AD�FE53: UM:
coNmuTowsru� HARTNETT ROOFING ( 714 ) 573-9887
cwm�croas�u�wa 17461 IRVINE HL
,��,: TUSTIN 92680 CA uc.ra.: 535605
uxr: Q
LICENSED CONfP�ROXS DECUF�TION: I Mreby tllim inkr puWy tlet I I' udr po.iame d Cheqs 9
(mmmemi�q wilh Seciion ]OW) d Drv'sion J d iM Budnev eM Pmlm ' . xd IuA Iwce enE Mlatl.
cmuc.n :0 31 / uc.cuss: C-39 uc.No 35 EXP: 00/00
Dme: I �� Can4etln:
OWNEfl BIII EX CL�RATION: I hreb� tllum uMs pe'Wy d per'ryry ihel I em ersmq Imn IM CaLLrotlm Licmme lew la iM
Idbx'vq �mmn (�bn ]m1.5 &viwa eM Adeaabne Code: MYW a awmY xAirh �wun+ a penni m meo-uq. e!>. inwwe.
'�md'eh, ar npei ury evupure, pior lo Oa eweza, e6o rpuiros iAe epplvant lu wch parmtl to fJs e eqneE eletemem tlm M a eM
IicmeaC W��� lo �M yaiuona d Ne Coniredwe Limma lnw ICheqx 91�m«dnp wnh Sed'nn ]000) d Owebn 9 d tb
.usr�e�s vtl Rdmiuu COMI a iNt Ir a ehe u e�emq IMrelmn uM Ihe Eme lor Ihe e0e0� ezemNion. MY vuletion d Sedion
�wis W env eao� �«. v� w4ea+me wW�+m. aa v.�r a m ma.e m.� a. n�w.d em.n �ssmp.
� I. m o�.nar W tlw popeny m my emqryem xih wapee u iMi vob mmpmimiion. will do tM wark, eM tM ewnun u� imaMeA
a dlaesd lor aeb (Seeibn �Ou. Bmiru uM PMmdms CoCe: The CanlradweLieanae Lev Eom nol NGNtoan owror W pWMY
.ro wim «mwo... ma,�..oe..+b aoe..�m.,on� �.w «na.a «w�n ne «n. ow� «oo�w.d. wwu�e iw.�
�nw�«w v. �w wwea «weAd ia..b. u. no.,�c ros w�dmu «mn�am e.aa �.nnn �. w+� a oomo�o�,. me
awner-0uAdar will lave ihe buNen W povinp M w she did m� huJd a impws la IM WNwe d vlel.
❑ I, m ownar W iM V WaM. em utluwW mnirmiq wdh Iicen�eE canuecbn m muVurl IM p9� (Setlun ]OM. &m'uw� and
aa.�on. caae: The commeoie l�n+. �e. me. m mW a m, o.ner a aroMv wno wiw « v�pm+« nwea, .na wno
cmvena 1« aM piqees xnh e mMredor(e) liwmed pvewm to iM CaNrepan Lisne lew�.
� I am examq uMer Sec1ion: B. 8 P C.. In ihb reewn:
Dale: O�+br.
I do hateby cerlM �� �� ewera W uW uMemlenE Ihe repuiremenle d Geliomie HseAh vd 3eMy Cade Satlbna 25505, 2551i, enE
2553�, vM tlw I a ury Mum Wik'vp arvpaM will / wil rwl (emb aw) neeE to mnpy wth uid Ye�e cada uM �M isyuiremeMs tor
eGa�lamuvueionamodRWianhamtMAr�y a�emem0ipr'vf.RaeNau�lm'WiutlionePO�ioroarsexemqhamllwm
wa;.a�..
om.: nodc.m:
WOPKEN'S COMPENSATION DECLAHATION: 1 Mraby elfirm uMx penelly ol prjury ane a11M Idbxi�p Esderatiom:
❑ I haw entl wil maimein e tt�Xicala W mneont to eeX�ineure Iw wuAen' compemelion, ea 0��� �m by Sedion 3]W ol lhe Lebor
Cada, iw the qrloimeiwe d IM xwk lor wHch I�is pa�mB n lauetl.
❑ � n.�. w.a meime:, womm�• oomw�won mw.eme. m r.a��ba M swim amo d m. �en« cod.. �« me w�«meme a in.
work 1a which Ihie permn ie ivueE. My wake�e' wnpenution ineurarwe femer eM poliry numbx are:
c�.,:
Pdiy Number.
y.,.is mcfion need rro� bs comdMe.i l Ne D�d ia M one �vMroE dollen (Y100. a 1w
ZJ I mr1YY � in tM periwmarice d tM xroA M whch Ihb p�mil b u�uetl, a� iM emp Y�f V�n in vry memr o m �o
n�o� wqaa �o in. won«.� �w�.m� mw. a ca�,e. e. ro Net ' I o IC ame eubjeq �o tM worYen'
comqnWion n d eaion �)00 d iM lebor Coda, I ehall ihr' mp! m � s miau.
Dela: Applicanl:
W�mlip: F� n h �cun woKen'romp�nutlon ror�rep l� �nhMul, �iM �/M �rr emp/oyr fo p1MNl peruftlu nM
GNI flnu �q ro m henJrod fhouaud tiv/l�n (t10qP00A ��Itlon b tli� ewl ol rompxueWM1 0am�ps� u prorltlW br In
9�ctlon 908 0l Ms L�Oor COW, InNnst, an0 attomWl Iwi.
CONSTIIUCTION LENqN(i �OENCY: I hereEy elfi�m ��,e« oe'wiv a o«'.y md inae 4 e w�.�aw, wwq w.rv ro. e,s
penamence a �ne wvk �v wnitl� ine wm�� ro emnd Isaeon wn�. cN. cl.
LEN�EN'S NI1ME:
LENDEfl'S MDPE55:
I canitythet I lim�e reaE No epplicetbn vd mma ihe� �In ebove iMame�ion u mnM. I epise �o campy xitA M cey uM wuMy oN'vwioee
eM ete�e lex'e reletip to buik'vq conWutlion end Mnby aullarixa npeemte�nw W Ihit tily b m�s upon IM ebo.e�memionaA p�opery
�°`"SpBtl10"""0°°°''STEVE AARTNET'�
Dme:
Sqnetum d Oxner/Apeirt/AppimNCmireqa
(5151�6.WP) M�e-�q85elety:Gnm-Fb:Cvwy-Appimu:Pink-Rewmie:�akenmd-A�meaor
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: P 080818
PERMIT NO; P 080816 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
SOH DESCRIPTION : WATER HEATEA SEISMIC STRAPS 6 TP VALC�E SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1
COMMENTS: REF B-80817
**�r**�rftitit�tir�e+r�*�+rat*�at*****�*�r�atat���r�ititar+�ie+t+rit�rit�r�r�r* ***�tx �atat�rat**itat�t� it �t�at*��tie*+�*+�*
Z O N I N GS ERTEB�AUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV; PARCEL: 14113429 ZNE: REF NO:
PLANNING N TES>
i
iElE 1f IflE iE 1ElF iF ik iE IE 1E 1! 1E fE iE iE 1E IE f! 1! 4 fE fE iE fE fE fE if 4 k 1t k 1E 41! iE fE fE k 1E iE 1f 1f 1E iF if 1f 1E 1k 1ElE if 1F if iE 1E iE 1E 1F IF IElElE If 1F 1k �E 1f iE fE iE if Ik 1! ff 1F fE
D E V E L O P M E N T S E A V I C E S-. R E Q U Z R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY ; DATE: /
APPLICATION ISSUED BY: ������ DATE: Z� l! —
iE1ffE1E�E1EiE1EiEifiEiflFiElFiE1E1E�E1E%ikiF�FiF�{FR3FiFiFiFiFif�'3�if7EiF 7f �iF3F{F3F�FiEiElEiElflfifiFlEif IFiF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 11.00
25t SMIP/NON—RE5
PLAN '
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PI,AN—CAECK TOTAL PAID DUE
TOTALS----> 11.00 22.00 0,00 33,00 33.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT; ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.00
iE 1F 1E 1E 1E iF 1f 1E 1E 1E 1E 1E iE 1E 1f 1E 1E 1k 4 iE i! 1E 1F 1f iE if if if 1ElE 1E 1E IE 1E iE i! iE iE 1E 41E 1E iE iE fE 1E 1E 1f IE iE fE 1E 1F iE fE 1E ff� ff fE fElE 1E iE iE iE iE fE M 1E IE IF fE fE 1t �E fE 1FlF �f
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU . 1 WATER HEATER AND/OR VENT 11.00 11.00
END OF FEES
01 0022Q811-00220E11 Tt7 T 33.00
DATE: 12/±1l9� TIIfE: 13�23
�
CONSiRUCTION AND PLANNING P��� SPA
APpROVALS Permit�h Date Inspedor qpPROVALS Pc��nit# Date Inspector
1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. •. 53. Steel Reinforcemeni
3. Electrical Conduit UtilityUndrgrnd. 54. forms .
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Elettrical UFER Gmd. 57. APPROVAL 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, f� Undrgmd.
10. Structural Floor System I 61. APPROVAL TO DECK �
t t. Property Sewer Line & House Connection 62. Backwash & Receptor�Finai •.
12. Sewer Cap - 63. Heater & VenbFinal
13. Roof Drains � 64. Plumbing System - Fina� ��
14. Rough Plumbirtg - � 65. Electrica4-Fina1 �
15. Rough Electrical-Conduit 66. Solar System-Flnai
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough 4Viring Sign ' 68. APPROVED FOR PLASTERING
78. Rough Electrical�T Bar CeUing 69. POOUSPA SYSTEMS FINAL
79. Rough Heatinq & Air Conditioning PIqE DEPT. REQUIREMENT
20. Rough Factory Fireplace . -� APPROVALS Permit #
21. Oucts, in Structure -� 70. Underground Hydro
22. Ducts, Ventilacing � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test �- - - 72. Underground Fiush
24. Roof Framing - 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing -- 74. Overhead Hydro
26. T-Bar Ceiling (Siructural� &�Monocoat 75. Dry Chemicai
27. Freme and Flashing 76. Dry Standpipe
28. Lathin9 & Siding 77. FIXED SYSTEM FINAL
29. Insulation � 78.. FIRE PAEV. FINAL �
30. Drywall Nailing HEALTH DEPT. RE�UIREMENT
37. Plasrer Brown Coat 79. FINAL�INSPECT�ON �
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Eiectric Notes:�a'�!d'9� F��Aj,I zL�
34. Final Heating & Air Conditioning r n�7�w��%C�,� ���;���T
' �� ' ` l.r i! VJ�i
35. Final Gas Pipe•Test � . -
36. Hood or Canopy �
37. Final Factory Fireplace
39. Final Plumbing •� • N
39. Water Service-Final
. 40. Gas Service-Ftnal � -
41. Solar pomestic-Final , ,
42. Backflow Preventer �
43. Backflow irrigation -�
44. Landscape Irripation System � _
45. Sound Attenuation .
46. Handicap Regulations
47. FINAL STRtICTURE & 9UILDING -
48. FINAL PLANNING �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
, wonEssa em�nmo: � v t 7
Od0
2WNEfi9NN1EIFqIVNN: n��;ER
1DDf1E34: 1 4 � 2
SANTA
544-7
�rr�. �uiwa .00xFss:
u�cxrtEcr on u+ooi�n:
urcx. ox exa•s �noxcss:
V
J
���g� HARTNETT ROOFING
�WfpAC10R5�N�p�p 17461 IRVINE BL
��Sg TUSTIN
92680
UMT:
FLOOD: X 47
92705
uc w,
uur:
(714)573-9887
CA ��, 535605
uMr: �
110EN4ED COMP�ROHS OECUHATION: I IwaDy dlim iaNx p�Wy a q'ury Ntl I am fp d ivd� pwu'va N Cheqw 9
(cpnmwviM wAA Sapion ]0001 d Dire"v� � d Na Buvew entl PNmdm . and a i m M1A bm ud oflaq.
cmuc.wo.:0 31 � uc.cuss: C-39 uc.No 5 EXP: 00/00
Detm t � Cmtreem.
OWNEP BUIL N CLAN�TION: I lwsby el(rm uMm pvWy d paejvy �NI I wmq Imm �he Caaream Liowa lew ta Ne
IoOow+q reemn (Swion 1W I.S &mir�a eM Prafwaav COM: MYW a cwwy Midi �p�vae e O�G lo canhup. atler.'vnRow.
Wndeh, a repei eiry �Wciwe: pnor b m uaena, eho npium iM epp4rem lor urt� penM to fJe e dpned qtlemem tlW M a Me
lioenaed punuent to IM pwmma d Ns ComMors lioeroe few' �CMqr 9(mmmwup wLh Sedion 1000) d Oi+eian J d Ilr
,uv�en ene Poam.ion. coeel «um �. u,ne e e.mna �nsshan md ue ma �« ne aOepeE ssemaoa A�n vdmun a seabn
1Vl1.5 by eny eppfrcaiu la a pemu wbpaa Ilw eppfrem �o e tivi peneRy d na mon ihen Ms hivMietl AaOe'a �SSW�.
'❑ i.a.omwamsn�ramr�w..+..nw�...ub:.d.�,ro�+..�aeoub.wM.m,ams.aw�.emw.�e.e
. «onasak.edalsaaon�ou.9udnmeneriamdwucua.:mecwmaa.U�+.l.wdomnaeooN�oenowiwap�opany
wM buiM « inpwse ihaeon. eM wno dom �urh v.ak FbnnE a henN «Nraph he a hx wm anWvlw. V�'� tM ach
impewemmA ae nU imrded a Warad la eeb. tl. howawr.IM dild'up a inpwanatl w wtl w4h'v� wrYw d mmpletcn. tM
owrierbuitler wiA Mve IM WNen d pwinp he w ehe d'd ia ddd or imprma lu tM WTas d mle).
� I. m oww d IM pW�Y. em mAivM/ mmmaiq hVh 6mmeE cmveclon ro mnmw ihe pel� (Saeun ]01.. &ninre enE
Profee�im� Code: TM Comretlm li.' wus lew Em nal µ�pry b an ow'w d papMy who buiFb o'e�ovw ilweon ud wlw
wnvecta In wM pqec�s xiih e mmmtlor(e) Icemed punuw to the Caureeae lioema la�.
� I em exmmq uMar Ser�ion: B. 8 P.G.. br Nw �waan:
Dela: �
I Eo hemby cenM � I em awua d vd urEanwd tha �apuiremws d Cd'fomie Ibelh enE Selny Code Sediam Y5505. 255�3. ud
25591. enC IM� I a enY Muro dultivq ompenl will / wil rw (crcb one) � b canply wih uM mte ooEu enE IM npu'vemsN la
a Oermn Iw coneiruclian w modi�ratianhom iMAi�Tiy . enWemm� Dipnd. RmidamW mMiudion WV�iwvenacamq ham Nma
a��.
Deb: �DV���
WONI(ER'S COMPENSATIqI DECIANATON: I hsrab/ Nkm inda pwWy d pajwy wr d the blow"vp detlem�um:
� I hm aM W mmiuen e ttNiula d memm �o uparwn br Yu�kan' mips�utian. o pwided la by Semon J]ro d �M lebar
CaEe, la iM pMamercs d IM xM lu wlic� Nu pamG's iouaE.
❑ �nn.wxi�meim.n.iawen•mmo��uuv.�v..,nm+:.dbvswionmodm.Len«caG..a�n.pal«mem.a�n.
WOf% �IX W� 1�1Y p!!IM 4�IMd. �.h' MIY1bI�� N11VM�W1011 �1Y1IB11CO QIMf YY� V�Y IYllbll M:
c�.�:
Pd'c/ Number:
� uaion mN MW mrol�nd! tlw 0�� u b ar MnM�C JaOen ISIWI n Im1
� I unry Ihel m Ihs pMoimerca d �M �mM la wM1c1+ Uw vami o umu . I NG m ry pen n n ury mems w n m
Eecmw wEj i to IM xarMSY mnpan+mian bw� M Cefdomie. en • N I�� ew eiEjee to tM wMaY
�o«� tc P o�y/ Setl'v� JIW d �h lebor Cods. I tluG 10 m'w'
Oma: .� � V MD�'�+:
{YIT/IIp: U1� IN'1/I�IF/kM�LVI1�YlY1�MLP'M�p�l1P�1�IQ1/IQIb�I10�ICItlIM1��0yrlOCN/I�/Y�pNYbp1/IQ
cnn nnu w ro an nu�dr.e �nouum earr. ltialaooA m.emaon ro m. co.r o� mnv«u.wn d�w o wn�e.a ror �n
s.�cw' arzE e� m. Veo, coa., �m.n.t w.m,.�.r. �..
eonsrnucnoN ��ara naee+cr: i n..W .ir.�,� „m e�r a o�iw �nr w«e o. wmNu� r�ro wkr w m.
peAamence d IM xak la xf�N Ihe psml u'sweA (Safun �OY]. CM. C�.
LENDEP'S NMIE:
LENOEN'S �DOFE59:
I cenilv thW I hew reM Ne epd� end qma ihet IM eEwe'vdwmLLian b wrtW.l epns lo wmply wuh e0 cry md mvay advwiow
xaxTNs�'
otl, � /1 �
(5151�OB.WP) While-BuiWvq d Se1my:OreerFb: CvxmAppfrani; Fnk-Revanue; (3oldenmd-/uamaar
CITY OF COSTA MESA - BUILDiNG PERMT.T
PERM NO: 8 080817
PEAMIT' NO; B 080817 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: STA PURPOSE: ALT
JOB DESCRIPTION : COMP OVER 1LAYER COMP/ REF H-69984 SQ FT: 2,500
CLAIM VALUE: 2,500.00 CALC-VALUE: 2,600.00 GROUP OCC; R-3 /U-1
COMMENTS: DRYWALL REPAIR IN GARAGE /
iF if ik fF if if 1F lE iF% M iE IE IF IE If ff % iE iE if i! iE k ik iF 3E iE jE jk if iE �f iF �f IE 3E fF 1! iE k�f 4 ff 1f 1f if iE iE k IE k iE iE iE iE �f IE IE iE 1f 3E 1E ik iE 7k 1E iE lE fE �E 3E IE 1f iE dFiE 3E aE
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 HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 14113429 ZNE: REF NO:
PLANNING NbTES>
i
1E iE k!E 1ElE 1E iE iE iE iE 1f k iE if iE �f iE 1f iE 1f if if 1E iE 1E 1E if 1FlE iElE 1E IE if iE fE 1E iElE 1f 1E ik fF 1f iE iF 1E if iE if 7t ik ff k!k iE M 1f 7E fE iE fE iElE 161f if iE iE ff i! iE 3E iE iE fE aE IF
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 BY:
LEGALIZATION;N
' BLDG PMT
IPEAMIT 74.75
�������;�1w�y�����
PLUMBING ELECTRIC MECHANIC
_ DATE;
DATE: IZ"' /(' /�
��iE 1E * 1Elk 1E 1E iI� 1k ik���if it
STRUCTURAL SEGMENT:Y
FIRE SMIP/RES GRADING
50
SMIP/NON—RES
PLAN
ISSUE FEE
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 75.25 0,00 0.00 75.25 75,25 .00
REVENUE DIVISION TOTALS--> COLLECTED: 75,25 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
74.75 .50
if ik 1E iE 1E iElE k 1f iF ff 1f 4 k!f k 1E 1E iE fE ik fk iE IE ik 1E 1k ik iE 1E iE if iE 1E �E 1E f! fk iE 1E iE iE iE k iE iE iE �f k if fE 1E fk iF It if 1E 1k 1f 1k 1k fE IF ik iF ik 1F ik 1k if iE fk 1E iE f! 1t 1E 1F 1E
I N D I V I D U A L F E E B R E A K D O W N
TYPE
SFR
QTY
2600
D E S C R I P T I O N
ALTER BY VALUE RESIDENTIAL NOZONE
END OF FEES
UNIT COST TOTAL COST
1.00 2,600.00
0! OQ2?OE09-00220El0 T O T 75.25
DATE: 12/11/9g TI11E: 13�27
�
' CONSTRUGTION AND PLANNING PO01 ' SPA
APPROVALS Permit# Date laspector qpPROVALS Pt,�nit'# Date inspecror
t. Temporary Electrical Service or Pole 52. Pool & Equipment Locatiotn
2. Soil Pipe-U�drgrnd. 53. Steel Reinforcement � .
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Elecirical ConduibUndrgrnd. ' 55. Electrical Bonding �
5. Steel Reinforcemenf 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•Undrgrnd. 60. Backwash Lines, P•Trap, O Undrgrnd.
10. Structural floor Svstem 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. Efectrical•Final
15. Rough Ele�trical-Conduit 66. Solar SYstem�Finai .
16. Rough EleCtric Wiring 67. Fencing & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING
18. Rough Electrica�-T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, in Siruaure 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gat ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Cefling (Strucwraq & Monocoat 75. Dry Chemical
27. Frame and Flashing . 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insu�ation 78. FIRE PREV. FINAL
30. Drywall Nailing HEA�TH DEPT. REQUIREMENT
31. Plasrer BroWn Coat _ 79. FINAL INSPECTION
32. Electrical Power Meter-Final S0. FOOD CERTIFICATE I�SSUED
33. Final Etectr�c Notes: �.�a-q�F�N� � � z �_ p 1.1 �'7�
34. Final Heating & Air Conditioning
35. Final Gas PiPe�Test
36. Hood or Cenopy
37. Final Factn�Y Fireplace
38. Final Plumbing _
39. Water Service-Final '
40. Gas Service-Final �
41. Solar pomdstic-Final
42. 8ackflow Preventer
43. Backflow Irrigation
44. Landscape Irripation System -
45. Sound Attenuation
46. Handiwp Regulations
47. FINAL STRUCTUfiE & BUILDING ra�►a 9
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Cn
51. CERTIFICATE OF OCCUPANCY
No. Date
.��flOJECi AOOBESS: j� 2� GAR F I ELD AV
owNensxame: DOHERTY [^lILLIAM J
;moeess: 1402 PES.COCK HILL
SANTA ANA,CA 92705
594-7779
AflCHIENGINEER:
aooness:
IINIT:
FLOOD: X 47
flEG.NO.:
uxrt:
eenminee: HARTNETT ROOFING ( 719 ) 573-9887
aoosess: 17461 ZP.VINE HL Q
TUSTZN CA 92680
LILENSEO CONiPPCIDB OEGNNpTION: I he�e0y aHirm �ha� I am IicenSeE unJer Omvisions of Chapler 9(commenung with Section
7000) of DiWSion J a�lhe Business antl Pwfessions COEe, and my license is in Nllforce and eflec�.
ciTruc.:n63�5 sTaTeuc.:535605,��°SSC-39 EXP: 09/95
,Ba� ��—� Y SignaWre: _��I�6�,�
WO EPS' COMPENSATION DECLANATION: I Oereby a��irm ��al I have a cerliliCaie ot tonsen� to sell�in5ure of a tetlitita�e o� Warker5'
I —
Densalion Inw�ance, oi a cetlilied coOY �hereol (Sec�ion 3800, La�. C�.
PO�ICY NO.: E%P. DRTE:
COMPANY:
� Ce�iiietl topy i5 hereby lurnished. ❑ Cerlilie0 topy i5 liletl with Itle ti�y Builaing Oivi5i0n.
Oa�e: Applicanc
E%EMPTION FPOM WOBKEPS'COMPENSATION UECLAPRTION: (Thi eciion n n0ihe tom IeteOi�the p¢rmi�isfOronehuntlre0(51(q)Orless�.
I[etlify Inal in Ihe petlormance ol Ihe work for w�ic01hi5 Oermi� i iss I I no� e ploy any person in any manner so as to Gecome
5 Io iho/)york/ers' Compen5aiign Laws af Cali�omia.
Date' �,.1—{ ' �� SignaWre'. �
NO7ICE: II, alier makinp ihis tleclaraiion, you shoultl become subiect to �he workers' Compensation pmvisions oi ihe La�or
' Coae. you musl fotlhwitA compty wilh su[� pmvisions or Ihis permi� shall Ce deemed revoketl.
CONSTPUCiION LENOING RGENCY: I �er¢by alfirm Iha� I�er¢ is a conslruc�ion lenaing agency �o� ihe pertormance ol Ihe wark la�
whic� Ihis permii is issuetl (Section 3W7. Ci¢ C�.
LENOEH:
FUDPE55:
OWNEfl BUILOEH OECLAPATION: I �ereby affirm �Aat I am exempl Imm Ihe Contraciort S�a�e License Law tor ��e �allowin8 �eason
(Seclion 7031.5 Business an0 Pmfessional Catle: Any ety ai counry whicA repuires a De�mit m construct, alter, improve, Oemolish, or
repait any slmciure. prior lo ils issuance, also reduires ihe aDP�icanl for suc� permit to Iiie a signeC s�atement that heh�e is Iicense0
pursuanl to Ihe pmvisions ol Ihe ConVactors' State License law (C�apier 9(commencing with Sectian 7000� af �iNsion 3 0l ihe Business
ana Pmiessions Cotle) or I�al helshe is exempt t�erelmm anU I�e Uasis lor t�e allegetl exemD�ion. Fny vialatian of Section 7031.5 by
any apPliCani br a p¢rmi� Suhle��s Ihe apD�itan� Io a tivil Oenal�y oI nof more lhan five �undretl tl011ars �E500�.
I. as owner ol i�e pmpeny or my employees wiih wages as t�eir sole camDensatbn, vri0 do tAe work. antl ihe
❑ stmcmre is not intentlee or aBeretl for sale (Secuon 70a4, Business an0 Pwtessional CoOe: T�e Coniracrors' State License Law
tloes nol aDDly �o an owner o� a pmDetly w�o Ouiltls or impmves lhereon, antl who does sucA wo�k himsell/�erS¢I� Or IAmugh
his or �er own employees, proviGed t�ai suc� impwvemenis are nol inlen4eE or oflered tor sale. Ii, however lhe Guilding or
impmvement is solA wiihin one year ol complelion, the owner will have Ine DurCen of pmvinp Ae/she did not 6uiIE o� imprwe
for ine vurvose ot sale).
I. as owner ol �Ae pmpetly. am e�clusively conVac�ing wilh licensetl coniractors lo constmct Ihe pmleci (Seclion 7060, Business
❑ a�b Pmlessirns CoGe: The Contratmrs' State License Law Goes not apDN �o an owner of pmpeM � �uilAs or impmvu t�ereon
antl who contracis lor such D�%etls wit� a wniracior�s) licens¢ pur5uani lo Ihe Contractors' $iate Li[en5e Law�. I am aware
Ihat Or00� 01 i�eir WOrklrs Compen5dii0n inSutdOC¢ Sf1001tl Ge pfOvlded IO m¢.
� I am e�empt unaer Setlion: B. 8 P. C.
for ��is reason:
Date: Ownec
I Eo hereby cenily Iha� I am aware ol an0 untlerSlanC Ihe repuiremen�s of Calibmia Heallh and Safery Code Senions 25505, 25533, anA
2553d andihalloranyfulure builEing occupanivnlVvnllnot(circle one� nee4to campry wit� SaiG slate codes antlt�e requirementsfor a
permil tor conAmciion or m00ifitation Irom I�e Air Ouality Managemenl USlnci. FesiCenlial constmction aDD����ions are eMempt irom
t�ese piovisions.
Oaie: pOPlitanl:
I �ereGy cer�ilyt�ai I �avereae��is application antl statetha� I�e a�ove intarmalion is co�reclJ agree lo compty with aliciiy an0 couniy
ortlinancesantlsiatelawsrelatingloDWldingconsimc�ianan0herebya presentalivesof�hiscilyioenierupon�heabove�mentionetl
pmpeiiy for inSDe��ion �pur,p(o�ses. �;
at : ��-%� 7 Signalure: � Vy/
ve�'s License or Social Securiiy a� ��, �
16aLa6 White-Bvileing: Green-Cotle Enbrcemanl: Canary-ApPlicanl; Pink-Revenue: Goltlenrotl-Assessor
CITY OF COSTA MESA - BUILDIPJG PERMZT PERM NO: B OE998�
PERMIT r10; B U69984 PLAN CHECY. NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION ; ROOF W/COMP E 30LB FELT OVER EXIST, COMP SQ FT: 2,500
CLAIM C'ALUE; 2,500.00 CALC-C'ALUE: 2,500,00 GROUP OCC: R-3 /M-1
COMMENTS: SMOKE DETECTORS ARE REQUIP.ED IN EVERY BEDROOM 6 HALL4IAY
+t�+r**i�i�+���k�rx*yx�+r+rraK�*.e+rr+r;�*r*��r�t�fi:r+t«x+r�r+r,rs�-r�r�r�r+�.,r�r*�*r+r*r+r+��.-�r**.«x�y+�**r
Z O N I N G R E Q U I R E N E D! T S
sETar,cxs
------------ MRIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT; FT IN REAP,; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
FARKING REQ: PROV; PARCEL: 14113429 ZNE; REF NO;
PLANNZAIG NOTES>
>
if ifih M if 1f if �f'1fM if iF % ifiFY 1F 1F iF 1f'M'If if i�"IFih'lh'IF ifif'lE 1liE if if if ififiElf if if if iL�1F 1f !fifiE 1f 1F iF1F�)f M-f #ifiE *Jf'If JF 1i iE 4 if M-M-if if iE')FiF af..iF iFiE Y
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 AFPROVED $Y ; DATE;
APPLICATION ZSSUED BY: � DATE:
�lcifaEMifiRifififjfi4ifafiFi:iFiFifil�MiEif3F�$1T�if�if�c�$�iF��.'iL i e+�..i 1F� ���i�r�F�iFiFiTTf$FS�ifjfifiEiEjF1F�tEM�k Its•. + iL��
iFiFifiFifififitltifikififiFififlFifitMififjEitifY-1EifiEif#�iE+(��EitiEififlfif+fiFifiFrtifit�fiFiEiF!tififiFii�ififlEificififlFifititlEilaF�tiEifYiE �+faE{f
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGA4ENT:Y
BLDG PMT FLUMBID7G ELECTRIC MECHANIC
PERMIT 59.U0
pt,Ar�
ISSUE FEE
fiUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 54.50 0.00 0,00
FIRE SMIP/RES GRADING
50
SMIP/NON—RES
TOTAL PAID DUE
54.50 . 54.50 .OQ
REVENUE DIVISION TOTALS--> COLLECTED: 54.50 OVER/SHORT: .00
HLDG PMT PLUMBZAIG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECY.
54,Q0 ,50
if if if if t' � if iF4iF M 1f M 4 �f ft iF af iF if iF if iF if ifif if if 1f if ±f if i! �f iF1%k iF if if +fit ff iE iF if if 1�tF M if iFif 4� M it iF if Y if?f Kif if if iFM if if if tFif iE iF if iF ��)f
I T] D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 2500 REROOF HY VALUE RESIDENTZAL NOZONE 1.00 2,500.00
ED1D OF FEES
CXPIRE�t��
Inc ,p�erA lrspe
� ����� � L/
�
��OKE �ETECTOR �
����I�{,�C✓71957-00171958 TOT 54.5�
DA7E:-12lt8/S'{s ithE: lO:Si
/'
ti`", ,CONSTRUCT�ON AND PLANNWG POO( ',PA
APPROVALS Permit# Date Inspector APpROVAIS Permit# Daie Inspector
t� Temporary EleCtrica{ Servict�Or Pole 52. Pooi & Equipment Location
y, $oil Pipe�Undrgmd. '^� 53. Steel Reinforcement ,
3. Efectricaf Conduit Utitity-t5ri8rgrnd. 54. Forms
4. Electrical Conduit-Undrqrnd. 55. E�ectrical Bonding
5. Steel Reinforcemen: 56. Rough Plumbing & P�essure Tzst
6. Electrical U�ER Gmd. 57. APPflOVAL TO COVER�GUNVTE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. FOundation : j 59. Gas Pipe, O Untlryrnd., Test
ti
9. Water Pipe-Undrgsnd. ' . 60. 8ackwash lines, P�TraP, C� UixiTymd. - �
10. St�uciural Floor System �� ' 61. APPROVAL TO DECK ��
17. Property Sewer Line & House'�onnection � 62. Backwash & Receptor�Final
i
t2. Sewer Cap ' 63. Heater & Vent-FinaY "'
13. ROof Drains � 64. Piumbing Sysrem - Pinai
I
14. ROugh Plumbing � 65. Electrical-Finai
15. ftough Electricat�Condu�t 66. Solar System-F'inal .
76. ROugh Electric Wiring 67. Fencing & Access Approval
17. Raugh Wiring Sign 68. APPROVED FOR PLASTERING
18. FPugh Electricat�T Sar Ceiting 69. POOL,'SPA SYSTEMS FiNAL
19. ROugh Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Pactory Firepiace APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping OGas ❑O�i
23. Gts Pipe�Rough & Teet 72. Underground Flush __
2A, ROof Framin9 73. Undergmd.StorageTank OGas ❑011
25. Roof Sheathing 74. Overhead HVdro
i
26. T�Bar Ceiling (Struaural) & Monocoat 75. Dry Chemica�
27. Frame and Flashing 76. Dry Standpipe -�
28. L2thing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL j
30. DrY�vall Naling HEALTH DEPT. REQUIRENIENT
37. PlBsier BroK�n Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final S0. FOOD CER1"IFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Cond�tioning
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 pomestic-Fina� •
42. Backflow Preventer ,,,,� `�R(�` B-� � L'� �- �.
43. Backflow Irrigation �?�-Cil1 .
44. lendscape irrigation Sysiem %I•"Z"�'• % C,�,� � =uilH "�
45. Sound Atte�uation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING .
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Da[e
LoT 75 rRncr 42 2
• �r �.-�.a
v7•.�v7�t_
COSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX 917 COBTA MBBA. CALIRORNIA
For Applieanf fo Fill In Complefely
TYp OR PRINT �`���'P"'L'
BUILDING �-.. , �Jln ..i _ /1 . � . . " –
COSTA MESA. CALIFORNIA
IM.A,:.e��� 1555 P�A�eNrin AVENUE
FEE REGEIIIED
�SEP Z71961'
INANCE DEPT.
CITY OF COSTA MESA
APPL�CATION FOR PERMIT
BUILDING
For Office Use Only '
REClIPT NO. PBRMIT NO.
BY
N No_------- COSTA MESA. CALIFORNIA
'_"'_"__'_"'_""_"_"
FIRE
ZONE TYPE GROUP�
�. �� v_.. APPROVED
6���r', NO. MI 6�227 '�e0n�
�
NO. OF BLD68.
t .. 1 /1l11 I .._.." __. . __ /�
ZONING
NO. OF ^J US8 OF NHW S/�
PUN9 G BUILOINO (y���
Q�- '7,y� Tir �1 z 3 L
E[TlAGK L1N[ PROM �� «MT�R L1N6 BTJ
C6NTeN ov eTNeeT O� REAR YARD � � Z FRONT � /
81OE YARD I LEFT O� O" I RIGHT �� '1 R. BIDE `�
DESCRIPTION OF WORK �
n L. 81 DE
NEW I IIALTERATIONI IIA�DITION I pgaQ �
NO. OF
�OO SQ. FT• ROOMS 7 5T041ES �
wwl� IRooF COMPOKfSH-INGLE
STUCCD COVERING
i1LDING AND WORK TO BE PERFORMED
� GARAGE
� Herteer wuWowLeooe YH�r i x�ve aawo rx�e MPYGTION
AND BTAT! TXAT THE ABO� �8 COPRER AtID AGRC6 TO COM-
PLY WITM ALL GITY OXOINAMGEB AND BTATE LAWB R86UUTINO
elllldlNO CON9iRUCT10N. -
SIGNATURE OF �j� (�, fJ �
PERMITTEF 1�—fs
AU7HORIZBD AGENT
7
2
TXH AMOUM SHOWN UNDER VALl1AT10N IB POR TXe
PUNPO88 OF EBTAB48XING A PERMIT FE6 ONIY.
YALUATION �j
��� ��' PERMIT PEE $ , `I. �i �
S PLAN CHECK S � /.-S'
Y
,