HomeMy WebLinkAbout3044 GARFIELD AVE - Building PermitsPflOJECTADOHESS: ;�OQ�t G�RFIF.LD �:v
awNensNamE: SDHESKY, •705EPit
aooness: SDHESRY, SOPHIA
3044 GARFIci,D AVE:
CO5'PA MESA,CA 92626
27£1-?9]0
( RHCH/ENGINEEP: NEG.NO.:
aoosEss:
uxiT:
uxir:
PEflMITTEE: nURA BliILT CnNSTRUCTION ( 714 )[ 79-7910
aoonEss: �}
97,70.. MAGNOLIA Si' 4
RTVERSTDE CA 9�503
LILENSEU CONTBACTOP DECLRflATION: I hereby allirm ��at I am Iicense0 under pmvisions ot C�aple� 9(commencing wil� Section
7000) of �iv�sion 3 oi ihe Business and Pmfessions Code. antl my license is in full �orce and e�fecl.
c�rruc.:052656 STRTELIC �600'Z�) .��SS: �/� �— /
Uale: �Signa�ure: �.S-�S% `���e"'f��
'- WOflHENS' COMPENSpTION �ECIAflPTION: I hereby aflirm that I have a cenificate ot conseni m sell�insure or a certificate of Workers'
Compensa�ion Insurance. or a ceN�ietl copy �hereol (Section 3800. Lab. C�.
voucrNo.: IO4t305-90 exv.onTe: 10/09/9i
1 comrnxr: STATE
� Certitied capy is hereby Wmished � Cepitied copy is file with Ihe city Building Oivision.
// �
Date: (Applicant: �•-�--Q� '�-�+—� �
E%EMPTION FHOM WOflNENS' CaMPENSBTION OECLAHpTION: QhiS set�i0n neetl n0� b¢ tompleled i� [he permil is for one huntlre0 ($100) Or le ).
I certily ihat in Ihe pedormance ol �he work br whi�h t�is permil is issuetl, I shall not employ any pe�son in any manner so as �o become
SuDlac� �a the Workers' Campensation Laws of Calilomia.
�ale'. SignaWre:
NOTICE: II, ailer making Ihis tleclam�ion, you shoWd become su61ec1 �o Ihe Workers' Campensalion pmvisions ot �he labor
Coae. you mu511o�hwilA compty wiih such pmvisions or Ihis De�mi� shall be tleemed revoketl.
CONSTPUCTION LENUING FGENCY: I M1ereby aifirm ��al �here is a conslmciion IenOing agency tor t�e pedormance ol �Ae work tor
whith Ihis permil i5 i55u¢tl ($ettian 3097, Civ. C).
LENOEH:
aooeess: -
OWNEN BUILOFP DECLNBF710N: I hereby affirm IAat I am exempt imm ihe Contractors' State License Law 1or ��e following reason
(Seclion 7031.5 Business and Pmtessional Code. Any city ol cowry which reQuires a permit m constmct, alter, impmve, tlemolish, or
repair any StmcWre. prior lo ils issuance, also reQuires the applicant for such Oe�mil to �ile a 5igne0 ita�emen� Iha� he/she is licensed
pursuant m Ihe provisions ot I�e Contramors' S�ate License Law (C�apter 9(commencinp with Sec�ion 7000) of Division 3 of IAe Business
antl Pmiessons Cotle) or Iha� helshe is exempt �heretmm and Ihe basis �or Ihe allegetl exemption Any violation ol $ec�ion 7031.5 6y
any applican�lor a permit sublecis the applicant�o a civil penal�y of not more �han live �un4re0 Oollare (5500�.
I. as owner oi Ihe pmpetly or my employees wilh wages as Iheir sole compensation,.will tlo the work, antl �he
❑ stmqure is not inlen0e4 or ofleretl lor sale (Sec�ion 7�44, Busness antl Pmfessional Cotle'. The Contrac�ors' State License Law
� tloes not apDly lo an owner oi a pmperty who bui105 or impmves therean, and who Ooes suc� work himsel�/hersel� or �hmugh
his or her own employees, o�ovitled Nat such impwvements are not inten0e0 or oneretl lor sale. tl, however ihe builtling or
impmvemeni is soltl vnthin one year o� comple�ion, Ihe owner will have �he bmJen of pmving he/she tli0 no� build or impmve
^ �or �he purpase oi sale)
I. as owner o� the pmpeny, am exclusively conlrac�ing with Iicen5e0 con�rac�ors to constmct �he pmleci (Seciion 704d, Business
❑ and Professions Code: The Comracmrs' Slaie License law tloes no1 appry to an owner of pmpeny who builtls or imD�oves lhereon
antl who conlrac�s br such pmjec�s witA a contracioqs)license pursuant to Ihe Conttactors' S�ate License Law�. I am aware
Ihat proo� o� �heir Worker'S Compensation insuronce 5Aou10 be pmvitletl �o me.
� I am ewemp� under Section: B. 8 P. C.
lar ��is reasan:
�ate: Ownec
I tlo hereby cetlily Ihai I am aware of anA un0erstantl ��e requiremems of Calilomia Heallh antl Sa�ery Code Sec�ions 25505, 25533, antl
25534 antl Ihat I or any lulure builtling occupani will/will not (circle one) need Io campty wilh said stale codes antl Ihe requiremenls tor a
permil lor conslmciion or motlilication irom �he Pir Oualiry ManaAement OisVicL Resideniial conSVuction applica�ians are exempt imm
I�ese pmvisions.
�ate: Ap0licanl:
I here�y certAy Ihal I have rea� ��is applicatioq�antl slale �ha� �he above in�armation is carrecL I agree to comply wi�� all ciry an0 county
artlmances antl slale laws relating to butltling cdns�mction antl hereby auNorize represenlatives o� �his ciry to enler upon �he above�mentioned
properly �or inspec�ian purpo5es. � ''7 �^/ '�1
�aie: SignaWre��"`�`�� ��""""�
Drive�'s License or Social Securi�y q: $
t641�a6 WN�e—Builtling; Green—Code EnlorcamenC Canary—Appllcanl: Pink—Revenue: Goltlenmtl—Assessor
CZT'Y OF COSTA MESA - BUILDING P?RMIi
P�.RMIT NO: H (>51429 PLAN CHECK NO: 0079�-91 S
COI3STRUCTSON TYPE: V-N PERMIT TYPE: STR
SOB DESCRiPTION ; ADD SECOND STORY �OOMS
FERM NO: H Q519';?�
GOVT: N SUPP: N
PURPOSE: ADD
S�> fiT: 597
CI�AINi VAi,UE: � 28,000.00 CALC-VALUE; 38;985.00 GRUUP OCC: R-3 /
COMMENTS: ADti '�ND STORY TC1 SFll
iF �1E �IFif df �%�1F K N. 1f �%� �Y� fi-iF �}f?F �3E �3f �iE i(•-7E df �1c �Y.-�lf 3f �K �M �� iE iE ik�iF �M #dE if iE �%3E it iE if if �If X� M iE�IE?f iEaf # if dE iF �Y. df ii� �1E #�X �M �% iE �lE �!f #�4 �IE it �Jf iE if� �Sf �K �Y 3E 3f
I C) N I N G R E Q IJ I R E M E N T S
S E't II A C R S
----------- MAZN BiIILDINCs ---------- --------- ACCESSORY BIJIi,DING ---------
FRNT: 20 FT IN REAR: FT IN FRNT: rT IN REAR: FT IN
i,EFT: 16 F"I' IN RGI-IT; rl' IN LEtT: rT IN RG1iT: FT IN
PARKING RE�• P�OV: PARCEL• 14113301 ZNE; R1 REF NO:
PiANNING N TES> HEDftOOM �ATH G LIVING ROOM TO BE CON�TRUCTcD OVER EX GARAGr.
> NOT TO �E USED AS A ScPARAiE DNIT - MAk 1 UNIT C1N SI.Yn OK
*x�i**ii'r�+e*�t�x�rt�*�tY-*i��!�t��****x��:r�*acit?t*it*K�+tK}i��-�f��*�t�*x��r?t��i�*u�*x�r.���t*atx�v.-it;*�t?�a:•x�*k+Efr�
D E V E L O P M E N T S E R V I C E s' R E Q D I R E M E�N %T S
2073ZNG APPROVED dY �.S(,S�L DATL; �f��/�j_�__
_ � T�—T—
BUILDING APPROVL'D HY : DATt; , r.!
APPLTCATION ISSUED BY: DATE: ��[�j_�
ifibk3flfd'eiFiE?i�ieiEifiEifiFiEfF3EiEff1F'.k . . . . +if�klFiFR3f3fiF3?� . kiiiiFi'ruiP
�f if it 3F ic'1E iE'lE i'i' ie il'' aI' 3f'iE i� �(' iI' Y' 3f iF iE i%1f if ih 1f if k 1F iE jl' iM1 iF'1�' 3£' jf")f'JF M' i'E iE 3f 3F 1f if i�"k Y 1F iF if'A� iY 1a, 1f i4 3f ir 1f iE 3F i'f"14 � �f' �F IE iE i!� # if 3E # if �F i'r.?F ii'1F
LEGALI7.ATIUN:N F E E S U M M A R Y s'TRJCTi7RAi S•GNLNi.:Y
BLDG PMT PLUMBING ELECTRIC N:ECI3ANZC FiRE SMZP/RE5;J. �GRFiv'ING
PERMIT 343.00 �, 73;. • �
SMI�/NOti;RES `'
t"�LAN 2'1.2.95 � ^ ,� t
ZSSUE FEE ,�;,s,
BUILDING-DIC-> PcRMiT ISSUE PLAN-C:-TECK TOTAi.� PAID DUc.
TOTALS----> 345,'73 0,00 ,_271,95 568.6$ 56R,68 .,00
��' �i .
REVEA;UE DIVISION TO'PALS--> COLLECTED: 345,73 OVER/SHORT• `���,x
BLDG PMT PLUMHTNG ELECTRIC MECHANIC FIRE SMIP/iOT GRADZNG�PI,A'N-Cii�CK
393.00 '1..73 � -:. •�
�,; �
3F iF iE i!� K> �i iE le ie if �le fF �F 1E 1E i4 iE If ib iF iE �E �E iF �f if-iE iE i!� 3'r iE K- ii� if iF iE iF �IE #t IF iF �E iF M� if iE iF fE i'e iE iE k �F iE Y.� iE 3f iF � K iE+f iE �lY # 14 �1E ?F Y.-�If �� ir if iE 3e t iF
I N D I V I D iJ A L F E E � R E A K n O W N q' �
. ' �t
TYPE QTY D E S C R I P T I O N , UNI7' COST YOiAL;,COST
SFR 557 DWE-TYPE V-WOOI) FRAME -GOOD 69,00 "'�38,933,.00
SFR 90 Rc5-HAL,CONY, EXTERIOR STAZRWAY 13.80 '' S52.00
END,OF FanS ,L �
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9i �DCr31�_�-C�Q°"s?;S ;'t� ��,s' ' •- :., /
DATE. (13(21i:'l Tir;E: :.i:14''� (/
CONST UCTION ANDPLANNING r00. SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
' 3. �Electrical Conduit Utility-Undrgrnd. 54. Forms
� 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. �Footinqs 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Prope�ty 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 , i 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Dutts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test � 72. Underground FlusFi �
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil'� -
25. Roof Sheathing � 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe �
28. Lathing & Siding � 77. FIXED SYSTEM FINAL- -
29. Insulation 78. FIRE PREV. FINAI .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Nofes: '
34. Final Heating & Air Conditioning fjf,a,N, � � �/� ,� ,� �,j�y��� ,._, �,y�,�
35. Final Gas Pipe-Test ' � � ' '
36. Hood or Canopy . , ' , .
37. Final Factory Fireplace ' '
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer - � .
43. Backflow Irrigation
44. Landscape Irrigation System. � �
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �%�,f� ` - � . "' -
(vi 1„ Z e�- � c _ _
48. fINALPLANNING �
49. Electric Release to Edison • � - ~ �� ^ . . , 9
50. Gas Release to Southem California Gas Co � "- �
51. CERTIFICATE OF OCCUPANCY ��v� �
No. Date
CERTII'ICATE OF COMPLIANCE
PAYMENT OF SCHOOL FACILITY FEES
NENPORT—MESA UNIFI�D SCAOOL DISTRICT
Developer/Applicant: Dv�A - � �' ��
Address: % a% 0 2 {'�i/i fp n/ o�-r rr sr `� /C � l/en t'!p� C/�S1J o3
Telephone Number: %% r �� 5'- % l`�i �
Tract/Parcel and Lot Number(s):
Location of Project: � o iL�! �,.�J/��/ � �Q /� 7'J�J
Number of Square Feet of
Residential Space �� x$1.50 Total' �3S S�
Number of Square Feet of
Commercial and
Industrial Space
Commercial/Industrial Project is:
Mini-storage
Movie Theater
Racquet/Health
Warehouses
Heavy Industrial
Regional Shops
Light Industrial
x $0.25
(Check One)
Total
Motel
Banic
Neighborhood Shops
R & D
HnCel
Medical Office
Office Park
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
The provisions of Government Code Section 53080 are not applicable.
This certifies thac the above-named Developer/Applicant has paid school
facility fees in compliance with Government Code Sections 53080 and
65995.'
Checks are to be made payable to Ne�.�port-Mesa Unified School District.
^.
�.
Business Manager
Newport--Mesa Unified School District
The above representation as to square footage is true. Developer/
Applicant agrees that if it is later determined that such representa-
tions are not true then this certificate shall automatically terminate
and the appropriate City/County shall be notified.
D a t e : 1.3 - -�� � %/ � � �-- ��_ �
Developer/Applicant
c
�
�/ll �r,���0 �v
PflOJECT AODNESS: .3 O 4 4 �GARF I ET T) AV
OWNEX'SNAME: SUHESKY� SOSEPH
R�OHESS: SU2�t.SKY SOPAIA
3099 GA�FIcLD AVt
COSTA MaSA,CA
� 27R-7910
' aNCH/ENGINEEB:
RODPE55:
92626
HEG.NO.:
uNiT: CITY UF COSTA McSA - BOZLDING PERMZT PERM NO: ENP Q5143
PERMIT NO: ENP 051430 PLAN CHF..CY. NO; N GOVT: N SUPY: N
CON.r,TRJCTI01� TYPc: V-N PnRMIT TYPE: ELE MEC Pi.0 PURPOSE: ADD
�
UNIT: '
PEflMITTEE: �URA BUILT CONSTRUC'I'ION ( 714 )'1.79-7910
aoosess: i'1702 NiAC>NOLIA ST 4
RTVERSIDE CA 92503
LICENSEO CONTNACTOfl DECNPRTION: I �ereUy altinn Inal I am licensed un0er pmvisions ot C�apler 9 �commencinp wiih Set�ion
7000� ol Division 3 0l I�e Business antl Pwlessions Code, antl my I¢ense is in lull lorce antl etlea.
ci,vuc.:052656 STATELIC.:�(�00^�� pcu�ss: H /
Date' Signalure: �-'�^""—t-- — —
WONREPS' COMPENSRTION OECLABATION: I nerehy allirm Ihat I nave a cenilicale ol consent Io sell�insure or a cenilicate ol workers'
Compensation Insurance. ar a cendiea coDY �hereoi (Section 3800, Lab. C). '
i POLILYNO.: 1�413�rJ-9� E%P.OATE: LO`�OJ�9S
� COMPANY: S TATE
I❑ Ceriilied fApY �5 �¢r¢by �umished ��enilietl copy is file0 wi`� ihe ciry Building Oivisian. �
pale: 1 ADplicanC �X �����"—� �
E%EMF�ION FPOM WOPIIEflS' fAMPEN5ATI0N OECLAflATION: (ihis seclion neeA nat he completeE i� the permi ¢ lor o� huMretl (5100) ar less�.
I cerlity thai in t�e pedarmanc¢ of �he work lor which ihis permit is issued, 1 shall nal emplay any p¢rson in any manner so as ro become
subletl lo Ihe 4YorkeS' Comp¢nsation LawS af California.
Daie; Signa�ure:
NOTICE: If. alter making Ihis aeclaration, you snoultl become suDiect to ine Worker5' Compensaiion D�o�isions ol ihe Labor
Cotle. yau mu9 brt�wilh comOty wilh such pmvisions or Inis permit shall �e Geemed revoke0.
CONSTNUCTION LENOING �GENCY: I hereby al�irm that Ihere is a conslmc�ian lentling apency lor I�e Dedormance ol ��e work �or
wAich ihis permit is issu¢tl (Section 3037. Civ. C�.
LENOEfl:
AODNESS:
OWNEN BWLDEfl OECIABpTION: I h¢r¢�y al�irm Ihal I am ¢x¢mpt Imm �h2 ConiraClors' Stale License Law lor me lollowinp reason
(SeCtion 7031.5 BuSineiS ana Pmfesvonal Cotle: Any cily ol County whit� repUires 2 permii Io tonilfuC�, alter, imprOve, demolish, or
r¢pair any stmcture. pdor lo iis issuance. also repuires Ihe appliwnt for such DQ�mii Io file a signe0 statemeni Ihat heRhe is licensetl
pursuam ro Ine provisions ot �he Conlracbrs' SIa1e License Law (Chapler 9(cammencing wi�h $ection 7000� al �ivision 3 of ��e Business
ana Pmlessions Coae) oi Ihat he/she is exempi IAerelwm antl ine basis far the allege0 exemption. Any violation o1 Section 70.31.5 by
any applicanl �ar a pe(mil subl¢cts Ihe applican�to a civil penally ol noi mare lhan live huntlr¢E tlollars (E500).
I. as owner ol the pwperty or my emyloyees witn waees as their sole wmpensalian, will Aa �he work, antl �he
❑ stNclureis notinlen0etl orallereClorsale (Seciion 7044, Business and Prole55ionalCaEe: T�e ConiractorS' State License Law
does not app1Y �o an owner of a propeny who builtls or im0�o�es ihereon, ane w�o Goes such wnrk himself/hersell or ihmuAh
his or he� own employees. providetl �hat such impmvemen�s are nol inlen0etl or otlereG tor ule. It, �owever �he huiltlinA or
improvemenl is sola within one year ol completion, Ihe ov+ner will have the burtlen of proving he/she 4iA nat 6uild or imD�ove
, for �he purpose ol sale�.
I. as owner ol Ihe praperty, am exclusively conVac�ing wi�h licensed contractors lo conSlruci �Ae O�olec� (Sec�ion 7044, Business
❑ an0 Prolessions Coae: The ConVatlars' Sia�e License Law does nol apDly to an owner a� pmDeny who builas or impmves Ihereon
anE who coniratls for 5ut� O�olects with a ConVat�oqs�lic¢nse pur5uanllo Ihe Canttactors' Slaie LiCense Law�. I am aware
��ai pmol of Ih¢i� Worker'S Cumpensation insurance shoultl 6e pmviOeA �o me.
� I am eaempl untler Seclion: B. E P. C.
lor �his reason:
oaie: Ownec
I Ao nereey cendy Inal I am aware ol antl untlerslantl Ine requiremenis ol Caldomia Healln and Safely fAae Seciions 25505, 25533, ana
2553A and Ihal I o� anyluWre builaing occupanlwilllwill nol (circle one) neetlto comply with SaiC slate coees anEthe�equiremenislora
permi� lor cons�mclion or motli�iwtian irom �he Air �ualily Managemenl Oisiritl. fl¢sidenlial conslmc�ion apDliw�ions are eremp� imm
Nese pmvisions.
Oale: ��/AOPlicanl'.
I heieby t¢rliiy Ihdi ItWve read ihi5 aDPlitaiipn antl slaie�hat Ihe abaveintarma�ionis corr¢cl. lapre¢lo comply wi�h allcily and ca�iy
ortlinante5and5lalelawSrela�inglOCuil4in�F.onslmtlionanUherebyaulhorizerepre5enla�ive5ol1hi5Ciiy�oenl¢fUponlheaEOve�menit eU
O�oper�Y �orinspecimn purposes. I
Date' � Signalure�� � - = - ��
D�iver's License or Socfal Securily �: �
i64i <6 W�ite—BmlOing; Green—Cotle EnlorcemenP, Canary—Applicant; Pink—Revenue: Gddenrotl—Assessor
JOB DESCRTPTION ; ADD ScCOND S'TORY R\OOM , REFER TO kB51s'.29 SQ Fi:
CLAZN, VALUE; CALC-VAL�U"E; GROUP OCC; R-3 /
COMMENTS: ADD 2ND STORY TO SFD
if #�If iE.,v,.-IF if �IE i("k �)f iE 3b %' iE if f( iF �lE if. N iE if i(� �k �� jF iE if �lE-1f �JF �lE iE dF 3f if iE iF�1f iF if i(� if # i! �lE i�� if iE if #� if if ib if �)(� i(� �k # if �lE �%�KiE iE iF �lk dE iE if if if if -Y�Y.- # 3(�
Z O N I N G R E�[7 I R E N, E N T' S
S E T R A C K S
------------ MAIN H�iLDING ---------- --------- ACCESSORY HUZLDING ---------
rRNT: FT IN REAR; FT IN FRNT: FT SN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING RnG• PROV; PARCEL; 14113301 7.NE: REF NO:
Pi.ANNING NtSTcS>
>
�**����*+����*�**xx•*�itKr �*�*��+t*��c******x�*it**+��***+�*s��**��r*�***�t*����*+�ifv�*r'**+�*
D E V E L O P M a N T S E.k V I C E S'. R E Q 0 Z R E N, E N T S
ZONING APPROVnD BY � DATE:
BUILDING APPROVr.D BY : DATE:
APPLICATION ZSSUED bY: •` � /�-� DATE• �����,
iF ii� If i! �lf 3e ih iE ff iE iE 1E je )f Y if if !f 1F i!� if 1F i'tTf±FiF iriF3FiF3F iFiFit'F'TF fF t1'�fiFiFTF 3Fi�€iF if7iiFiF�7�-iF3f�� iE if if 1E iE i4 k iF i'r !'� � iE
�It M� af R 3k 1E * k� i!� if 1F iF iF 3t if fF i! �i�?e )F iP f4 N� �!E Y.-1f IF i!� ?!� 1k iF if� if 1i� IE iF if if i6 3F IF iE if 3F if 36 i41f Y.� iF !c i!� i(� IF iE i(� If 3E iE �i R If � 7F 161E IklE �ff Y.�+F L:� iE #b �%� i??P i!� i%
LEGALIZATZON:N F E E S U N, M A R Y STRUCTURAi. SEGMENT;N
HLDG PMT PLUMHING ELECTRIC NECHANIC FIRE SMIP/RES GRADING
PERMIT 6,00 15 00 9,00
25t .�iO3 25t SMIP/NON-rZES
PLAN
TSSUE FnE 3,00 15.00 i5,U0
BUZLDING-DIV-> PERNIT ISSUn PLAN-CHcCR TOTAL PAID DUn
T�TAi.,S----> 30,00 33.00 0,00 63.00 63,OQ ,00
REVENUE DIVISION TOTALS--> COLLECTED; 63.00 OVcR/SAORT; ,00
BLDG PMT �iUMBING Ei,ECTRIC MECHANLC FIRE SMZP/10T GRADIAiG PLAN-CiinCiC
9.00 30,00 24,DU
3FiE iF 1h 3f'7E IF 1E 1E il''if ii'#iE if iF iEiEit lf iE #'IFi! iE iI- i!�if 1! 1P 1F i6 iFdP 1: 1f iEiE 1h T:�if iE if if'i'f'if if K'1f'i!-if 1f 1f ii�lf iF 1I�'1f iE±fiF iE7E i:�1f i.�}'. �fie iE 3E Y'iE ?h IF1f ?F if-Y.�
I N D I V I D U A L F E E H R E A 3C D O W N
T'YPE QTY D F S C R I P'T I O N UNIi COST TOTAL COSi
EiE 9 FIXTiJRESt LIGHTING 1 ST 20 EA. ,75 3,00
ai.E 11 RECEPT/Ot7TI,E'P 1 ST 20 EA, ,75 8,25
ELE � RECEPT/SWITCH 1 ST �0 EA, ,75 3,75
MEC 1 INST FORC-AIR/GRAV FUf(N <= 100 Y; BTU 9.00 9,00
PLU 1 BATHTT7H 2,OQ ?.,00
PI�U 1 WASH BASIN 2.00 2,00
PI,U 1 WATER CLOSET (TOILET) 2,Q0 ;.',p0
FNn oF i' C.GJ
7� Q7�Fi-iS�'L'lJcr'i�t( 'r - _ . .. _ /
DATE: 03'i �; .1 TtiiF: i3s ii ✓
CON�%fHUCT10N AND PLANNING POOL .PA
APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole .52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
� 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding
5. Steel Re�nforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER G�nd. 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, � Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ,
12. Sewer Cap _ 63. Heater & Vent-Final
13. Roof Drains . 64. Plumbing System � Fina�
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Gonduii 66. Solar System-Final
16. Rough Electric Wi�ing 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTER�NG '
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Hea[ing & Air Conditioninq FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in StructurE 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing , 74.�Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashin9 '. 76. Dry Standpipe ,
28. Lathing & Siding � � � 77. FIXED SYSTEM FINAL '
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . 79. FINAL INSPECTION
32. Electrical Power Meter�Final � •80. FOOD CERTIFICATE ISSUED
33. Final Electric 7 f-�j Notes:
34. Final Heating & Air Conditioning ,- 7��t�l L�v -
35. Final Gas Pipe-Test ,
36. Hood�or Canopy . .
37. Final Factory FirePlace
38. Final Piumbinq 7! QC L�'
39. Water Service�Final '
40. Gas Service-Final �
-41. Solar pomestiaPinal �
42. Backflow Preventer . .
43. Backflow Irrigatio�
44. �andscape Irriqation System . .
45. Sound Attenuatidn
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING ,
48. FINAL PIANNING
49. Electric Release to Edison '
50. Gas Release to $outhern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
�
R
�
PflOJECT pODNESS: j O 4 9 GAFt FI ELD AV
OWNEN'S NFME: SUHES ;Y, ,:.9)SEPH TR
ADOPESS: 3044 GARFIELD
COSTA MESA.CA 92626
AflCHIENGINEEN:
AOOPESS:
NEG.NO.:
uxiT:
UNIT:
PENMIREE: JOSEPFi S SOPHIA SUHESKY (714)545-7323
aooaess: 3044 GARFIELD AVE
COSTA MESA CA 92626
LICENSEO LONTflACTOX OELIABATION: I hereCy aHirm I�al I am licensed unEer pmvisions of Chapter 9(commencinq with $eciion
7000� ol Division 7 0l Ue Business and Prolessions Coae. and my license is in �u0 Porce and ellect.
CITY LIC.: STATE UC.: C1A55:
Oate: Signa�ure:
WOPKEHS' COMPENSATION OELIANAiION: 1 nereby alfirm inal I have a cenilicale ol COnsent to sell-insure or a certiliWte ot Workers'
Compensation Insurance. or a cetlilie0 coDY �hereoi (Section 3800, La�. C).
, POUCY NO.: E%P. OATE:
COMPANV:
rJ Cetlili¢4 toDY i5 �¢r¢Ey �umish¢E. ❑ Cerli�ied copy is fileG wilA [he city Buiitling Oivision.
Oaie: Appliwni:
E%EMVTIONFXOMWOHREPS'COMPENSATIONOECIABATION: (Thi5seclionnee4iwlbecomple�Mi�t�epermilis�orone�unAre4�31W�orless�.
I cetlify thal in Ue pedormance o� I�e work for whicA Ihis permi� is issued, I shall not emDloy any person i any manne� so as to became
su�lect to t�¢ Wo/rk/ers' Comqpensation laws ol Califomia. �
• Date: �� — z— Y 3 Signalure: �
NOTICE: If, atler making ihis tleclaration. you should Decome hlect to t�e Worker5' Compensation pmvisiml f t�e Labor
Coae, yau musl fonhwilh comply with sucn pmvisions or tnis Dermit shall ee aeemed revoketl. '
CONSTNUCTION LENUING RGENCY: I here0y allirm ��at Ihere is a ConSimction lentling agency lor �he pertormance ol I�e work lor
which Ihis permii Is i=sued ISeaion 3097. Civ. C�.
LENOEfl:
aooeess:
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06476(
PERMIT NO: P 069760 PLAN CHECIt NO; N GOVT: N SUPP: N
CONSTRUCTION TYFE; C'—N PERMIT TYPE: PLU PURPOSE: OTH
JOH DESCRIPTION : i:_--=—�3+l� 51F1K �RSL SQ FT:
CLAIM VALUE: CALC—VALUE; CL�'j'�,1/���) GROUP OCC: R-3 /
COMMENTS: LEGALIZE SINK ON ROOM ON TOP OF GARAGE ���\
�r�-*�r**�r�r�r�r**�*#x�r*�**�r*�r***r*�r***+r�e+rx�f��*****i�u�*****�****i�**��rx�u��**x********�r+a*+r
Z O N I N G R E Q U I R E M E N T S���r" ., y
S E T B A C K S � �
------------ MA2N BUILDZNG ---------- --------- ACCESSORY BOILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ• PROV; PARCEL: 14113301 ZNE; REF NO:
PLANNING NC51'ES>
�
iF �E jE �E �f 1f i! #�E jf if 1E iE jf jE jF iE iE �E iE iE i! at if 1E 1E iE 1E iF if 1f jf jE iE 1f 1f ff if if iE iE if if if iF �: �E fE 1E iE 1E iE if 1f %if fE iE �)E if iF iE jf if if 1t ff iE K iF iE iE iF iE 1f �f ?F #� N�
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 APPROVEP BY DATE:
BUILDZNG APPROVED BY : DATE;
AF�PLICATION ISSUED BY: � DATE: 1 47
**********ir�f*�e+rkx��r***x� . ****x�**�r�r*�3F�F���' �,,F**
iE * iE iE if fF jf %!f if if +f if if * 3E iF if if af iE if iE 9E if �Y 9f iF iE if if 9E iF it if iF iF iF aE iE r iE iF iF iF �F 9F iF 3E iF jf �f i: it iE iE ic iE iE %iF if ic * iE if aE iE iF if n iF iF 1E ii iG iE jF �1f
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMEP7T:N
OwNEBBUILDENOECIAxRTION: IhereOyallirmtha�lamexempilmmiheComractors'StateLicenseLawforthetollowingreason HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 703t.5 Business an0 Pmtessional Coae; Any ciry oi county w�ich requires a Dermit to canstmct, alter, impmve, OemolisR or P ERM I T 7. 0 �
. repair any stmcmre. D�ior ta iis issuance. also reQuires �he applicant for such Dermi� to file a signeE statement ihat ne/she is IicenseA 2 S x SM I P/ NON—R ES
pursuanl lo Ihe pmvi5ion5 al ��e Conlratior5' Slaie License Law �C�apler 9(tommenting vnih Set�ion 7000) of DiviSion 3 oi ��e Business pLAN
ane ProleSSionS Co0¢� or Ihai ne/S�e is erempl I�er¢Irom anC Ihe GasiS tor Ihe allepeE eKem0�i0n. Any Nolali0n 0� $etli0n 7Q31.5 6y
any applicanl for a permi� SuUjec�s �he applican� �o a civil penaliy ol not more t�an hve hunOreO Oallars (E540�. I S SUE F EE 2 �, � �
I. as owner oi me o�openy or my emyiayees wim wapes as ineir soie campensation, will do ine work, antl ine BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
❑ Slmaure is no� ini¢nAetl or ot�ere0 �or sale �Section 7oaa. Business ana Professionai Caae: tne Contractors' State License �aw TO TAL S----> 7. 0 0 2 Q. 0 0 0. 0 0 2 7, 0 0 2 7, Q 0 . Q �
aaCS nol apD�Y lo an Owner of a pmp¢rty w�o OuilUs Or impmves Ihereon, anG wtio UoeS SUC� work �im5N1/AeReli Of lhmu0h
Ais or �er own employees. pwvitleE that sucA impmvemenis are not intendeG or oifereA lar sale. If, �owever [he builOinA or R EV ENUE D I V I S I ON TOTAL S--> COLL ECTED • 2 7, 0 0 OV ER / SHORT • . 0 �
impmvememissoltivniNnoneyearolcompletion,Ineownerwillhave�nebureenolpmvinqAe/she4itlnotGuildarimpmve $LDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CAECK
lor ihe DurDase ol sale�.
2%,��
I, as owner ol Ihe O�aDetly, am erclusrvely contratling wil� licensetl coniraciors �o con5imcl Ne pr01e�� (Sec�ion 7044, Busmess
❑ anC Prolessians CaOe: 7�e Contractors' State License Law Qoes not a041y to an owner oi pmpertp who Uuilds or im0��s ihereon
antl who conVatls �or such proletl5 wit� a contrac�or�s) license pursuan� Io I�e Coniracrors' S�a�e liten5e Law). I am aware
Ihai praol ol ��ei� Warker'S Compen5ation insu�ance ShoNU Oe pmvi0e4 lo me.
'� I am exempl untler Section�. B P% � Q Q B. 6 P. C.
mr ma reason: OWNER DOING OWN WORK
�ate'. Ownec
I Oo �ere0y ce�ify Iha� I am aware ol antl untlerStanE Ihe repuirements o� Califomia Heal�h antl Safety CoOe S¢c�ions 25505, 25533, anU
25534 ana t�al I or any �ulure building occupanl wilVwill no� (circle one) neetl �o compty wilh 5ai0 s�a�e co0e5 antl Ihe r24uiremenis for a
permi� loi consimction ar mo0ilication Imm Ine Pir �uab�y ManaAement �is�ricl. Residen�ial cons�mclion apDlications are eKempllmm
Inese provisions.
�ate: ApplicanP.
I �ereby cetldy I�at 1 have rea0 i�i5 ap0lica�ian ana slale ��ai t�e a�ove inbtma�ion is tarrecl 1 agree lo compty wii� all cily an0 couniy
oramances ana slatelaws mlaiinq�o �uilaing consimction ana nere�y aut�arize representatives olthis ciiy�o enterupon�he above�mentione0
prapetly �orinspetlion purpo5es
Daie' SignaWre:
oriver's ucense or Saiai Secunty n:
16aL46 Whne—Bmltling; Groen—Coae EnlorcemenL Canary—Applicant; Pink—Fevenoe: Gobenmtl—Assessor
if # if if ik if ?! if� iElk fh 1f 1! f! if 1! if 1E iE iE iE fE ff f! iE iF # fE if �)f if if !f V�lf if if if #! if 1f if 1f IE if jE it if if 1f ik 1E it if 11� 1E 1E iE i! if M if i4 # if if if it if ff iF # if if �f 1E if 4 ft
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 SINK, KITCAEN 7,00 7,00
END OF FEES
Ol OO1SD�6�—Op150±67 T�� T �7.Op
esre: �:;„isa zin�: i4:za
CONSTRUC710N AND PLANNING P��� 'PA
qPPROVALS Permit#"� Date Inspector APPROVALS Permit# Date Inspector
1. 7emporary Electrical Service or Pole 52. Poot & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steei Rzinforcemem
3. Electrical Conduic Utility-Undrgrnd. 54. Forms
4. Elecirical Conduit-Undrgmd. 55. Elecirical Bonding
:>
"5. 5teel Reinforcement 56. Raugh Plumbing & Pressure Test
f6. �lectrical UFER Gmd. 57. APPROVAL TQ COVER�GUNITE
7. Footings 58. Electricai Condwt�Undrgrnd.
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Strucwral Floor Syscem 67. APPROVAL TO DECK
17, property Sewer line & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap 63. Heater & Vent�Finai
73. Roof Drains 64, Plumbing System - Final
14. Rough Plumbing 65. Electrical�Finai
S5. Rough Electricat-Condult 66. Solar System-Final f
76. Rough Electric Wiring - 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVEO FOR PLASTERING
78. Fou9h Electrical-T Bar Ceiling 69. POOLISPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning PIRE DEPT. REnUIREMENT
20. Rough FactorY �ireplace APPftOVAIS Permit #
21. Ducts, in Structure 70. Underground HVdro
22. Ducts, Ventilating 77. Product Pfping � Gas � Oil
23. Gas Pipe�Rough & Tesc 72. Underground Flush
24, fioof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oii
25. Roof Sheathing 74. Overhead HYdro
26. T�Bar Ceiling (Structural) & RAonocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM FINP.!.
29. Insulation 78. FIRE PREV. FINAL
3p. DrywallNailing HEALTN DEPT. REQUIREMENT
31. Plaster Btown Coat 79. FINAL INSPECTION
32. Electri Power A4eter�Final 80. FOOD CERTIFiCATE ISSUED
33. Final E�eMric Notes:
3q. pinal Heating & Air Conditioning �,
35. Final Gas Pipe�Test
36. Hood or�CanopY .� _
37. Final Factory Fireplace
38. Pinal Plumbiag � !1'� /�.�
39. Water Service-Final
40. Gas Service-Final
41. SOlar pomestic-Finai
42. B�ckf�ow Preventer
43. Backflow Irriga2ion
44. Landscape Irrigation SYstem �
45. Sound Aitenuation
i
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING _�
48. FINAL PLANNING �
49. Electric Release to Edison i
50. Gas Release to Southem Ca�ifornia Gas Co .,.
51. C£RTfF4CA7E Of OCCUPANCY �"
No. Date
PROJECT AOOBESS: 3 O 4 4 GARF I ELD AV
OWNEN'SNRME: SUHES���� ;�SEPH TR
nooeess: 3044 GARFIELD
COSTA MESA,CA 92626
FNCHIENGINEEN:
ADOHESS:
flFG.NO.:
UNIT:
UNIT:
PENMITTEE: JOSEPH 6 SOPHIA SUFiESKY (719)545-7323
nooaess: 3044 GARFIELD AVE
COSTA MESA CA 92626
LICENSEO LONTPACTOB OECLANATION: I �ereEy allirm tha� I am licensed untler pmvisions oi ChaD�er 91�ommencing wilh Section
7000� ol Drvision 3 ot Ihe Busines5 ana Pmfessions Cade. ana my license is in tull force anA ellecl.
CITY LIC.: STPTE LIC.: CLASS:
Oate: Signam�e:
WONREBS' COMPENSP710N oECIAfiATION: I hereDy ailirm t�a� I Aave a cetlificate of consent m sell-insure or a cenilicate ol Workers'
Campensalion Insurance. or a ceridiea copy Ihereol (Seclion 3800, Lab, C�.
POIICY NO.: E%P. OPTE:
COMPRNY:
❑ CertilieE mpy is here�y fumished. ❑ Cetli�ietl topy i5 IileA wi�� I�2 tiiy Bu/il�i/ng DiNAs1'on. D
Wte: II'�y ' 9.�1 AV7licanti��/1[�� 7//N"�J�/��1
E%EMPTIONiPOMWOflHENS'fAMPENSATI0N0ECUBATION: Q� uc�ionnee0noib¢tompleleCilth¢permi� orone�un0�e0�5700�orless�.
I[etlily I�at in ��e pedormance ol �ne work lor which ��is permit is issued I s�all noi employ any De�son in any manner so as �o hecome
� sublect to �ne Workers' ComDensation Laws ot Calilornia.
�ate: Signa�ure:
NOiICE: If. alter makinB ���s aeclaration. you snoultl become suGjttt to Ihe Workers' fAmDensalion o�wisions ol lne Labor
Cade. you must lon�wil� comply wit� sucn O�ovisions or t�is permit shall be tleeme0 revuked.
CONSTflULTION LENOING �GENLY: I here0y a�lirm Ihai thefe IS a ConSimttion IenUing agenty �Or th¢ pedarmante al l�e wOrk br
w�ich Inis uermit is issued �Seciion 3097. Civ. C�.
LENOEfl:
aooeess:
OWNEP BUILOEB �ECLANRTION: I here6y allirm tAat I am exempt imm ihe Coniractors' State Lirense Law for I�e lollovnnq reasan
(Section 7031.5 Business an0 Pmlessional Cotle: Any ciry o� counry whic� requires a permil �o conslruct, alter, impmve. Oemolish, or
reDair any Stmtiure, prior �o iis i55uanCe. also repuir¢5 I�e applicani Ior 5ut� Oermil t0 �il¢ a Sipned 5ta�emen� �ha� he/S�e is liCensed
pursuant lo Ine pmvisions ot Itle Contractors' Slate License Law (ChaD�er 9 �commencinA ��� Section 7000) ol Division 3 al lhe Business
anU Prolessions Coae) or Ihal he/s�e is exempi iherefrom antl �he basis �or I�e alleqeE eKempiion. Any vioiation o� Settion 7031.5 Uy
, any aoPlicam for a oermit suGiems ��e aDPlicant Io a civil penalry of nol more tnan five Aun4re0 Oollars (55001.
I. as owner of t�e pmperty or my emplayees vnth waAes as Iheir sole comDenSation, will do t�e work, and the
❑ slmtWre is no� intentle0 or olterea for sale (Set�ion 70E4. Buslne55 antl Pr0lessional C04l: T�e ConUatlors' Stale License Law
Ooes not apply lo an owner of a propeny who builtls or improves t�erton, antl wtw Oces such wark himsell/hersell or thmugA
nis ar he� awn em0layees, provitle0 ihat sucA imo�ovemen�s are not intenAetl or onerea for ule. If, �owever ihe builCinp or
imD�ovemen� is Sold wii�in one year of compleiion, Ihe owner will �ave I�e burUen ol O�oving he/she 4iJ not huiltl or impwve
for ihe ourvose ot sale�.
� I, as owner ol t�e pmpeny. am eaclusively comracting wiih Iicense0 comracmrs lo cansimc� Ihe pwleci (Sectlon 704a. Business
❑ and Pmfessions Code: The Coniractors' S�a�e License Law does nol a07ry m an ovmer ol O�operty who GwIOs or imD�a�es lhereon
antl who caniracis lor such pmiec�s wil� a contractoqs) li[ense pur5uani to Ihe Conlractarz' Sta�e License Law�. I am aware
� ��al pmol of Iheir Worker'S Compensalion insurance s�ou10 Le D�oviGetl �o me.
� � I am exemD� unoer Section: B P 7 0 4 4 e. 8 P. C
ronnisreason: OWNER DOING OWN WORK
' �� �a1ef_�( ' H — '73 Ownec _�.��5�_:�3�LSaE�/�5'
I tlo hereDy cetlity iha� I am aware oi ana understantl I�e requiremenis ol Calilomia H Ih anE Sa�e�y Cotle Sec�ions 25505, 25 , and
2557a antl inat I or any tuture Guilaing occupant wilVwill nm �circle one) neetl to comDN ��h saiU slale mdes anG ihe rtquiremenis for a
pe�mil lar consimction or rtqCilitalion iwm t�e An Oualily Managemenl Disiricl. flesi0enlial constNction appliWtbns are eKempt �mm
�hese pmvisions.
Oal¢'. �� �' "/ 9� AppliCanl'. . .�/��1 \ .�
I hereUy cetlily Ihal I �ave reatl Ihis aDPlicalion and sla�e Ihat Ihe a ve information is corr�l agr¢e to comp ith all city antl counly
mtlinan[es antl 5taielawsrelatingto bwlaing can5imciion an0 hereby authorizereD�eseniatives otthis cily�o enter upon��e aEove�mentioned
Omperty lor inspec/tio'n purpanses. .
Oa�e: ��' `1 ' r� Signa�ure:
Driver's ticense oi Socia� Securi�y x:
i6�ba6 W�ile—Builtling�, Green—Cotle Enlorcemenl: Canary—Applicanl; Pink—Revenue; Goltl¢nrotl—AsSassor
CITY OF COSTA MESA — HUILDING PERMIT PERM NO: IP 06475�
PERD9IT NO: IP 06 59 PLAN CHECK NO: N GOVT: N SUPP: Y
CONSTRUCTION TY E V—N PERMIT TYPE: OTH PLU PURPOSE: OTH
JOB DESCRIPTIO, %�; REMOVE STOVE SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 /
COMMENTS: REMOV 'TOVE AND GAS LINE ATTACHED TO STOVE
�*�*��*��r�*�*�� � x+�x�***it�**�*+�**+r*�*�.****�r�c***�r+���*****+�****+��*�**�x*�c**x+t**
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 BUZLDZNG ---------
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: 14113301 ZNE: REF NO;
PLANNING NOTES>
>
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROC�ED BY : DATE:
APPLICATION ISSUED BY: �� DATE: ����� �
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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
30.00
25$
SMIP/NON—RES
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 30.00 0,00 ' 0,00 30.00 30.00 .00
,
REVENUE DIVZSION TOTALS--> COLLECTED; 30.00 OVER/SHORT: ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
30,00 .
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I N D I V I D U A I: 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
PLUMBING AE—INSPECTION FEE
END, OF FEES
/
0
30.00
91 QQi`01��—�015�1E8 Y �t7
D�i?E: li;�+:'/3 TItl�: 14:25
30.00
�U.�]
CONS7RUCTtON ANO PLANNING POOL �PA
APPROVALS Permit # Date i�spector p�ppROVALS Permit # Date inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgmd. 53. Steei Reinforcement
3. Electricai Conduit Utility-Undrgrnd. . 54. Forms
4. Electrical Conduit-Undr9rnd. 55. Electrical Bonding
•
`.�. Stee! Reinforcement 56. Rough Plumbing & Pressure Test
��. Electr�cal UFER Gmd. 57. APPROVAL TO COVER GUNITE
7. Pootings 58. Electrical Cond�irUndrymd.
8. Foundation 59. Gas P1pe, l� Undrgrnd., Teat
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. •
10. Structural Floor SYstem 67. APPROVA� TO DECK
17. Property Sewer Line & House Connection 62. Backwash & Receptor�Pinal
12. Sewer Cap 63, Heater & Vent�Final
13, Roof prains 64. Plumbin� System � Final
14. flough Piumbing 65. Elec[rical-Final
15. flough Electrical-Conduit 66. Solar SVstem-Fin21
16. Rough Electric Wiring 67. Fencing & Access Approval .
77. flougN Wiring Sign 68. APPROVED FOR PLASTERING
79. Rougb Electrical-T Bar Ceiling 69. POOUSPA SYSTEP,1S FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory rirep!ace APPROVALS Permit #
21. DuC.s, �n Structure �0. Under9round Hydro
22. Ducts, Ventilating 77. Product Piping OGas ❑Oil
23. Gas Pioe�Rough & Test 72. Underground Plush
24. Roof rraming 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structurali & Monocoat 75. Dry Chemical
27. Frame and Ftashiny 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulat�on 78. FIRE PREV. FINAL
30. Dry�va�� Naiiing HEALTH DEPT. REQUIREMENT
37. Plaster Brov,m Coat . 79. FINAL �NSPECTION
32. Electricai Power A9eterFina! 80. FOOD CERTIFICATE ISSUED
33. Finai �lectric � Notes:��j �� Ri �Euet. b/�
� � ��7 _ l str L.bT�
34. Finai Heai(ng & Air Conditioning Y ^ - � t �l �+
� [Li%_�e�'�ae��ts�4� ,L��
35. Final Gas Pipe-Test ..�
36. Hood or Canopy �
37. Finai Factory Fireplace
38. Final glumbing
39. Water Service�Final
40. Gas Servite-Final
47. Solar pomesticFi�ai
42. Backflow Preventer
43. Backilow Irrigation
44. �andscape irrigation SYstem
45. Sound Attenuation
46. HandiWP Regulations
47. FINA4 STRUCTURE & BUILDING �_
48. FINA4 PLANNING "`--.
49. Electric Release to Edison ��"' .
50. Gas RBlease [o Southern California Gas Co �,..
51. CEftTIPICATE OF OCCUPANCY `
No. Date
LOT 5H TRACT UZ Z
� �s���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
fOR APPL/CANT TO F/LL /N COMPCETE[Y
TYPE O PRINT �''' ��
BUILDING 3o v ''
ADDRESS
COSTA MESA, CALIFORNIA
OWNER K.�i.K. DEVELOPMENT CO., INC.
'EGT .. LIC.
! nee o�x�nu I LOT �D
un V
oF ior '71 _ 7� � X 100 � I NO.OF BLDOB.
NOW ON LOT
use oF �f�10NE
EXISTING 9LD
SETBACK LIN6 FROM
CENTER OF STHEET � REAR YAR
SIDE YARD ILEFT 1 IRIGHT �
DESCRIPTION OF WORK
REPAIR
BUILDING
EXTERIOR WALL ROOF
COVERING STUCCO COVERING R
USE OF BUILDING AND WORK TO BE PERI
INFLE FAMILY RESIDENCE AND
FEE RECEIVED
� SEP 271961�
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OfF/CE USE ONIY
' I RECEIPT NO. I �P A IT��
a�.;y
�y�D BY DAT�n ECEIVEO D TE I85UEC
/.l' I �'J�J<�/ SkP'L 7 1S
COSTA MESA, CALIFORNIA
ZONING
�� 7i ZONE NO.OF USE OF NEW � J•
r IPLANB Z I BUILDING 4 .J-
<LV
BYPROVED� /n Z//`
�i.(1 DATE d
Q VAROS EVES
REQIIIRED ALLOWED
fCENTEft L�NE 6TJ /
FRONT 6 FT. IN.
� 11
R.SIDE FT. iN.
L.SIDE /v/ FT. / / IN.
RFGF ` 1F FT / �N
I HENEBYACKNOWLEDGE THAT 1 HAVE NEAD THI6 APPLICATION
RND 6TRTE THAT THE RBOVE IS COPRECT AND AGREE TO COM� TNE AMOUNT 6HOWN 11NDER VALI1qT1pN IB FON TXE
PLY WITH /�LL CITY ORDIN�NCES ANO STRTE LAWS FEGULATINO PURPOSE OF E9TABL�SHING • PERMIT FEE ONLY.
am�n�He consinuRiON. VALUATION
SIGNATURE OF �� ,(J�. > y� PERMIT FEE $ 3�
PERMIITEE r� i-�
S f5/a�a � PLAN CHECK $ �� S
�
AUTHORIZED AGENT TOTAL FEE 5
5�._5'�