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Home My WebLink About3290 GEORGIA PL - Building Permits(7ta) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIF DRNE, GOSIA MtSA, GA 92ti26 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicank Address: Owner: 3290 GEORGIA PL 13904105 MARTINEZ, ART 2517 TOWNSENp ST SANTA ANA, CA MARTINEZ, SAMUEL A TR Address 2517 TOWNSENp ST Contractor. Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixis Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over �OOOa Motors to 1hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over t00hp SANTA ANA, CA Phone: 714-5458646 Zip: 92704 Phone: Zip: 92704 Phone: Zip: License: Status: ISSUED Applied: 11/24/2003 Issued: 11/24/2003 ISSUED BY: � SCOPE OF PERMIT CONSTRUCT 355 SF ADDITION OF NEW FAMILY ROOM AND POWDER ROOM AT LEFf SIDE OF AN EXISTING SINGLE-STORY SFD.REF.:B03-01848 ELECTRICAL TO INCLUDE: 4 LIGHT FIXTURES, 5 OUTLETS, 4 SWITCHES AND RELOCATE 200 AMP SUB PANEI $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $4.40 $5.50 $4.40 $0.00 $0.00 $0.00 $0.00 So.00 $0.00 $0.00 $0.00 $0.00 30.00 Quantity FEESUMMARY Temp Dist System / Lighting . . Busway /100 ft Standing Section Misc ElecVical Equipment . Transformers up to 1 kva/kw � ................up to 10 kva/kw .................uP to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Volfage Equipment Low Volt Wiring System / Ckt Misa Conduit Misa ConduCtar Cirws ( gen or nde) Circus (mech nde or lights) Chrislmas Tree Stand Fireworks Stand Other ElecMcal Fee $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 Quantity 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 NO710E: Tha work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28. § 1, 12-27-92) EXPIRA710N: This permit shall automatic211y expire and become void if work is not commenced within 780 days, or if woAc is suspended or abandoned for a period of 180 days. INSPECTIONS: tn order tor the vrork authorized under this permit to be considered legal, such work must comply with all applicable codes, flnd atl requlred Inspections end final epproval must be obtained. Failure to obtain inspections and final approval will result in the explration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 zac<e �aroo) WORKERS'COMPENSATON DECLARATION: I hereby atlirm under penalry ol perjury one ot the following tleclareUons: ❑ I have end will meimaln e certificate ol consent ro self-Insure lor workers' compensetion, as provitled for by section 3700 0l Ihe Lebor Code, tor the pertortnance of the work far wnicn tnis vermit is issued. ❑ I have and will mainEain workers' compensatlon insurance, as requiretl by section 3700 of ihe La�or Code, for the peAortnance of t�e work lor which thls pertnit I5 Issued. My workers' compenlatlon Insurenca carriar entl policy number are: Carrier: r Policy Number. (This secfion need not be cromp/eted �� Me peimit is valued af one huntlred dWlars ($100) or less.) 4(] 1 certity that in tha peAormance oi the work for which Ihis permit is issuetl, I shall not employ any person in eny manner so as lo become sublect to tha workers' compensation laws Ilfomia, antl gr th if I should become sub�ect to the workere' compensation provislons ot Section 3700 ot the Labor Code, I shall forihwith comply wilh Ihese rovi ons. Applicant Signature: ��(�j Ei» Dete: Ou � ` O 3 WARNIN�: FAILURE TO SECURE WORKERS CAMPENSATION COVERAG IS UNLAWFOL ANO SHALL SU0.IECT AN EMPLOVER TO CRIMINA� PENALTIES AND GVIL FINES UP TOONE HUNORED THOUSAND DOLLARE (5100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATIIXJ, OAMAGES AS PROVIOED FOR IN SECTION 3'!OB OF THE UBOR CODE, IMEREST, PND ATTORNE`fS PEES. LICENSED CONTRACTORS DECLARATION: '� I harehy eNirm that I em licensetl untler provisions of Chapter 9(commencinq with Section 7000) oi Divislon 3 oi ihe Business end P�ofessions Cotle, end my license is in full torce entl ettect. Lic. k Class N Cantracta/s SigneNre: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby aNirm that ihere is e construction lentling agency tor Me pedormance of tha work br which Ihis pertnil is issued. (Sec. 3097, Civil Coda). Lender's Name: Lentler's Atltlress: SigneNre: Date: OWNER•BUILDER DECLARA710NS: I hereby eHirm thet under penelry of perjury �ha� I am EXEMP7 FROM THE CONTfiACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business anO Protessions Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair any strucWre, pnar m its issuance, also requires the applicant tor such permit to lile a signed stetement that he or she is licensea pursuent to the pmvisions ot the Contrectors lJcense Lew (Ghapter 9(cammendng wlih Sactlon 7000) ot D'Msian 3 oi the Business end Pmfessions Cotle) or tha� he or she is axempt therelrom and Ihe basis for t�e alleged exemption. Any violation of Section 7�31.5 by any epplicant for a pertnit subjacts the eppllcant to a civil penal�y o� not more ihen five huntlretl Aollars ($500).): ❑ I, as owner of �he properry, or iny employees with weges as their sole compensation, WILL DO THE WORK, end the structure I5 not Intentletl or otte�etl tor sale (Sec. 7044, Business and Professions Code: The Contractors License Law Ooes not apply to an owner of properry who builds or improves lheraon, entl who tloes such work himself or herselt or �hrough his or her own employees, providetl that suc� improvemenis are nat intentled or ottered lar sela. If, however, Ihe building ar improvement is sold within one year oi comple�ion, the owner-6uiltler will have ihe burden of proving that he or sha did not Oui10 or improve lor Duryose of sale.). ' � I, es owner ol Ihe ptoDerty, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to wnsirutt Ihe pralect (Sec. 7044, Business antl Professions Code: The contrectors Licensa L.ew does not epply to an owner of property who builtls or improves thareon, antl who contrects for such project wit� a wntrector(s) license W�suant to iheLonireC�ors License Laws.). ❑ lem Owner IDLeritiatl by tlnvers Iicense. Venfication of Owners�ip by (type of � Business and Professions Code for this ieeson: Date' Z 7/�0 is NO Dnvefs LiCen58 No. � Eapire5: � � � , i.a. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I here6y cenity thet no excavation five (5) or more faet in tlepth into which e person is required �o descend, wlll be metle In connection with work euthonzetl by Ihis permit, end ihat no building sirNcture, scaHolding, felsework, or demolition or dismentling thereof, will be more Ihen thlrty-six (36) taet high. (Chep. 32, Grp 2, An 2, Sec. 341, Title 8, Cellfomla Adminlstrative Code). ❑ As owneo-bulltler, I will nol employ enyona to do work which woultl require a permi� from the Division of Intlustrial Safe�y, as noted ebove, unless such person has e permit ta do such work trom tha division. SiqnaWre: Date: Division oi Indusirial Safey Pertnit Num�er: CERTIFlCATE OF COMPIJANCE AND AUTHORVATON OF EMRY: I certity under penalty of perjury thet I have read this applicetion end state that the infortnatlon given is correcl. I e e to comply with ell st9�e ws end ciiy ortlinances relating to builtling cons�mction, antl authodze representetives of the Gty of Cosia Mesa lo enier upon t�e above-de ri ed properry jqr In$pectio u ses.�not to occupy or ellow occupancy of eny building authorized by this permit until Mel inspection. // � �bl //� vr l✓i1�/ !—� lAC .�i SlgnaNre Oi Legal Owner(s) � Data And/Or Aut�anzetl Applicant COOE I. INSPEC710NTYPE 1676 Fi:etl SyStem Final Fire Pre�ention 1266 Paol Spe Final 200 Finel RB-Roof 201 Flnel Block/Retaining Weil 202 Final Fecrory Fira Place 203 Final Sign 204 Final Demolition QejE � �pp�� INSPECTONTYYE 206 Final Mechanical 208 Final Plum6ing 210 Finel EIBCMcaI 212 Final Fire Preventlon 220 Final Planning Approval 222 Finel Site 250 Finel BuilCingiOccupency �.1 .1111. . �%i .�� (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 hAIH UMIVt, GUS IA Mt.JA, l:A tl2ti2ti Job Address: 3290 GEORGIA PL Suite No Vicinity: Parcel Nunmber: 19904105 Applicant: MARTINEZ, ART Address: 2517 TOWNSEND ST SANTA ANA, CA Owner: MARTINEZ, SAMUEL A TR Address 2517 TOWNSEND ST SANTA ANA, CA Contractor. Address: ' Arch / Eng : Address: PLUMBING PERMIT ISSUED BY: Phone: 714-5458646 Zip: 92704 Phone: Zip: 92704 Phone: Zip: License: Phone: Zip: License: Status: ISSUED Applied: 7 7 /24/2003 Issued: 11124/2003 SCOPE OF PERMIT CONSTRUCT 355 SF ADDITION OF NEW FAMILY ROOM AND POWDER ROOM AT LEFf SIDE OF AN EXISTING SINGLE-STORY SFD. REF.: 803-01848 - PLUMBING TO INCLUDE: 1 WASH BASIN AND 1 WATER CLOSET. FEE SUMMARY AMT QTY AMT QTY � AMT QTY ISSUE FEE $23.50 Laundry Tub / Washer $0.00 0 Sump Pump $0.00 0 BackFlow irrigation 50.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer � $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0 . Urinal � $0.00 0 Clarifier System $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr BkFlow(1-0) $0.00 0 Connect (Ice,Soda,etc) 50.00 0 Receptors $0.00 0 Vacuum Brkr BkFlow(5+) 50.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $9.80 1 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor 50.00 0 Sewer Connect 50.00 0 Waste and Vent System 50.00 0 Drain. Rainwater $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $9.80 1 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater / vent $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord., No. 92-28, § 1, 12-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a penod of 1 BO days. /'� INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlons and flnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754562fi 2448d8(8N0) WORKERS'COMPENSATON DECLARAnON: I here0y attirm under penalty ol perjury one oi Ihe following tleclarations: ❑ I heve end will maintain e certiNwte of consent to self-Insure for workers' compensation, as provided far 6y section 3700 of iha LeDor Code, br the peAortnance of Ihe work lor which thi5 perrnit is issued. ❑ I heve end will maintain workers' compensatlon insurance, as requiretl by sectlon 3700 of Ne Labor Code, tor the peAortnance oi [he woM lor which this pertnit is Issued. My workers' compensallon Insurence certier end policy number are: Cerner. Policy Number. (This section neetl not be comp/etetl i! Me permit is velued af one huntlred dW/ers (5100) or IessJ �. I certily that in Ihe pertom�ance oi the work for which Ihis permit is issued, I shall not employ eny person in any manner so as to become subject to ihe warkers' compensation lews alifomia, na re hat if I sh uld become subJect to the workers' wmpensatlon proWsions of Section 3700 ot t�e Lebor Cotle, I shall fonhwith compty witR ihe ro 'S�s. . � I AppllcaniSigneture: ��%//l�l� �� Da�e: _ �OY �-�i%�+�3 � WARNING: FAILURE TO SECURE H'ORKERS' COMPENSATION COV iiAGE IS UNLAWFUL AN� SHFLL SU&IECT AN EMPLOVEH TO CRIMINAL PENALTIES AN� GVIL FlNES UP TOONE HUNDHED TFKKISAND OOLLARE (8100,000�, IN AODITION TO THE COST OF CAMPENSATION, DAMFGES AS PROVIDED FOR IN SECTION 3�O60F THE LABOR CAOE, IMERESi, AND ATTORNE`f5 FEES. LICENSED CONTRACTORS DECLARATION: � I hereby aHirtn Ihai I am licensed untler provisions oi Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Prolessions Code, entl my license is in full lorce end eflect. Lic. tl Cless q Coniractors SignaWre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby affirtn thal IherB is a construction lentling aqency lor Ihe peAormance of ihe work br which Ihis permit is issuetl. (Sec. 3097, Civil Cotla). Lender's Name: Lendels Atltlress: SigneNre: Date: OWNER-BUILDER DECLARAnONS: I hereby eHirtn lhet under pena�ry ol perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lar ihe tollowing reason (Sec. 7031.5, Business and Protesslons Cotle: Any ciry or counry which requires e pertnit to construct, alter, improva, tlemolish, or repair any structure, pnor to Its issuance, also requires Ihe applicant tor such permil ro lile e signetl stetement thet he or she is Ilcensed pursuent to t�e provlslons of I�e Conirectors License Lew (Chepter 9(commencing with Sectlon 7000) of Oivision 3 af the Business and Professions Coda) or thet he or she is exempt therefrom and ihe basis for the alleged exempNon. Any violation of Sectlon 7031.5 by any epplicant for e pertnit sublec�s �he applicam m a civil penelry of not more than fiva hundred dollers (5500).): ❑ I, es owner of the propeAy. o� my employees with weges as Iheir sole compensation, WILL DO THE WORK, and ihe siructure Is no� intendetl or oHered for sale (Sec. 7044, Business and Prolessions Code: The Contractors License Lew does no1 apply to an owner ot property who builds or improves thereon, antl who dces such work himsell or herselt or thmugh his or her own employees, pmvitled ihat such improvemenls ara not imentletl or oflerad fa sale. If, however, the 6uilding or improvement is soltl wiNin one year ot completion, ihe owner-builder wili have �he burden of proving iha� ha or she did not build or impmve for purpose ol sale.). � � I, es owner of Ihe propeRy. am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consima iha project (Sec. 704d, Business and Professions Coda�. 7�e contractors Lica�se Law tloes not appiy to an owner ol property who Cuiltls or Improves thereon, antl who contracts br such proiect wlth e contractor(s) license pursuant to the Gontractors License Lews.). ❑ I em e �pt under sej� Signawre: , ./� Owner ID erilied by drivefs liCense. Verificetlon of Ownership by (tyPe ol Business and Professions Code for ihis reason: is p No Dnvers License No. i.e. - property tax blll or tleed): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTFICA710N: oate: uav�-v�uo? Expires:Q�[_{�y_� ❑ I hereby certity that no ex�evetion five (5) or more faet in dep�h into which e person is requlred to descand, will 6e matle in connection wit� work euthorized by this permit, entl ihat no building structure, scaflolding, talsework, or demolitlon or dismantling thereof, will be more than Ihirly-six (38) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomla Adminlsiretive Cotle). ❑ As owner-builder, I will nat employ enyone to do work which woultl require a permit fram the Division of Industnel Safe�y, as noted ebove, unless such person hes e permit to do such work ftom tha division. Signeture: Date: Division of Industrial Safery Pe�ii Number: CERTIFICATE OF COMPLIANCE AND AU7HORIZATON OF ENTRV: I cenify under penalty of perjury thet I have reatl �his application antl s�ate that ihe intormation given is wrrecL I gree to wmply with ell s�a laws and ciry ordinances releting to buildinq construction, end euthodze represantatives of iha City ol Coste Mesa to en�er upon �he eDo��s Ded prope �o f{spe�oses. I pgree not to occupy or ellow occupancy ot any building authorized by this permit unlil finel inspection. L .��.t�, .; 1�;.�,`�q�-, ,�Co v z�/ zoo s gignaWre Of Legal ner ) Dace Antl/Or Authorizetl Applicant CO�E I. INSPECfIONttPE 1616 Fixetl System Final Fi�e Prevention 1266 Pool Spa Finel 200 Final Re-Roof 201 Final BIaWRetaining Wall 202 Final Factory Fire Plate 203 Final Sign 206 Finel Demoliiion DAre I[�LS CODE 1 INSPECTION TVPE 206 Final Mechenical 208 Final Plumbing 210 Flnal Electrical 212 Finel Fire P�evention 220 Final Planning Approval 222 Finel Sile 250 FinalBuildinglOccupancy pAg It�L9 .3-oi-o�! 4�L (714) 754-5273 • Fax (714) 754-4856 � wv+w.ci.costa-mesa.c��ILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Adtlress: 3290 GEORGIA P� Suile: Vicinity: FAMILY ROOM AND POWDER ROOM Parcel Number: 13904105 Applicant: MARTINEZ, ART Address: 2oning: ISSUED BY: Owner: MARTINEZ, SAMUEL A TR Address 2517TOWNSENDST SANTA ANA, CA Contractor: Address: Phone: 714-545-8646 Zip: Phone: Zip: 92704 Phane: Zip: License: Arch : MARTINEZ, SAMUEL ARTHUR Eng: Address: ' Address: Phone: 714-5458646 SWtus: ISSUED Applied: 10/22/2003 Issued: 11/24/2003 Phane: SANTA ANA, CA - Zip: License: C5012 �icense: SCOPE OF PERMIT CONSTRUCT 355 SF ADDITION OF NEW FAMILY ROOM AND POWDER ROOM AT LEFT SIDE OF AN EXISTING SINGLE-STORY SFD. Plan Check: Permit SMIP Res: SMIP Cam: Other: Inspection: Total: $307.16 $472.55 $3.28 $0.00 $0.00 $0.00 5782.99 SETBACKS MAIN STRUCTURE Front 20. 0 ACCESSORY Front 0-0 PARKING Existinq: 4 NOTES: Rear 74-0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left S 0 left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Ri9ht 6- 0 Right 0- 0 $32,802.00 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 1 BO days, or If work is suspended or abandoned for a period of 1 BO days. , / INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetlons and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiratlo(n o/f this permit. FOR INSPECTIONS CALL: (714) 7545626 v zaae�ae �voo) WORKERS' COMPENSATION DECLARATION: I hereby ettirm under penalry oi perjury one oi the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided tor by section 3700 of ihe Lebor Cotle, tortb� pertortnence of the work for whiCh this Oermil is issuetl. r ❑ I have end will mainfain workers' compensatlon insurance, es required by sectlon 3700 Of Ihe Labor Code, Por the peRortnence ot Ihe work for which Ihis pemut Is Issued. My workers' compensatlon Insurance carner antl policy num6er ara: Cerner: Policy Number: (This section need nof be campletetlll (he permif Is velued et one hundred tlallars ($f 00) or less.) I cenify t�at in the peAormance of the wwk lor which this permit is issued, I shall not employ any parson in any manner so as to become subject to Ihe workers' compensation law�alifomia, anc�ag�e Ih� If I shoulA become subject to the workere' compansation provislons of Sectlon 3700 of the Labor Code, I shall forthwiN Signeture: �� `/.�1! �.. .f� Dat�e: _�iUY � - � ?AU �$ FAILURE T SECURE WORKERS' CpAPEN$AT10N COVEMGE S UNIAWFUL M'� SHALL SU6IECT AN EMP�OYER TO CRIMIWIL PEN,LLTIES AND GVIL FlNES UP TOONE HUNDRED i OOLLARE ($100,000), IN ADDITIdJ TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECTIdJ 3]O6 OF THE LABOR CA�E, IIJrEREST, AND ATiORNEPS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm Ihat I am licensed undar provisions of Chaprer 9(commencing wit� Section 7000) of Division 3 of the Business and Prolessions Cotle, end my license is in full torce ena ettect. Llc. M Class q ContractoYs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirm thet there is e cansiruction lending egency for the peAormence of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lender'S Neme: Lender's Address: Signature: Date: OWNER-BUILDER OECLARATIONS: I hereby aHirm that under penelry ol perjury thet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for ihe tollowing raeson (Sec. 7031.5, Business entl Prafessions Code: Any ciry or counry which requires e pertnit to construct, elter, improve, tlemolish, or repair any strucWre, pnor to its issuance, also requires the eppliwnt for such pertnit to tile e signed stetement that he or she is licensed pursuem to ihe provisions ot the Contrectors License Lew (Chepter 9(commencing with Sectlon 7000) ot Division 3 oi Ne Business entl Professions Cotle) or t�et he or she is e:empt iherefrwn end Ihe basis br the elle9ed exemption. Any vialation of Section 7031.5 by eny epplicant far a permit sublects the applicflnt to a civil penelry of not more than five hundred dollars ($500).): ❑ I, as ownar of the properry, or my employees with wages as their sole compensation, WILL DO 7HE WORK, and ihe simcNre Is not intentlatl or oNeretl for sale (Sec. 7044, Business end Professions Code: The Contractors License Law does not apply to an owner ot proparty who builds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, pmdtled thet such improvements are not imendetl or oNered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builtler will hava the burden of proving ihat he or she did not builtl or impiove for purpose of sale.). • -�, I, as owner of Ihe properry, am EXCLUSIVELV CONTRAC7ING WI7H LICENSED CONTRACTOfiS to construct the prqect (Sec. 7044, Business and Professions �''�� Code: The contractors License Law does not appty to an owner of property who Duiltls or improves ihereon, end who con(racis br such pmjed with a coniractor(s) license pur uant to iha Comractors License Laws.). ❑ I am axe undar se Business and Professions Code for this reason: -Signa� LDate:_/�L6(� u(. ��nQi -OwnerlDv nfietlbytlnvefslicense. Ves ❑ DiivefsLicenseNo. � Explre,s:001 Ib/O+�' Verification ot Ownership by (type of docu e, i.e. � property tae 6ill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certlty that no ezcavation five (5) or more feet in tlepth Into which a person is required to descend, wlll ba metle in connection with work eu�horized by this permif, and Ihat no building siructure, scaHolding, falsework, or tlemolition or aismantling ihereof, will be more then ihirty�six (36) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, TiOe 8, Califomle Administrative Code). ❑ As owner-huilder, I will not employ enyone to tlo work which would require a permit from lhe Division of Industnal Safary, es notetl above, unless such person hes e permit lo do such work from Ihe division. SigneNre: Dale: Division of Indusirial Safety Permit Number: CERIiFlCATE OF COMPLIANCE AND AUiHOR¢A710N OF ENTAY: I cenity under penalry ot perjury that I have reatl ihis epDlication arW state that the infortnation given Is correct. I agre o comply wlih all te la end ciry or ances releting to builCing conswctlon, end authodze represantatives of the Gry of Casta Mesa to enter upon the above-desc' e pmperty lor' s n � o es. I agr ot to occupy or allow occupency ol any building euthorized by this permit until finel inspection. ��,� -i. - �%/lq .r, - Arn�F zv �_v.:7 � Signature Ot,Lagal.Owner(s � Date_._ And/OrAuthonzed Appliceni Date COOE �. INSVELTION TYPE 7618 Finetl System Finel Fire Prevention 1266 Pool Spe Finel 200 Finel Re-Roof 201 Final BIacWRetalning Well 202 Final Factory Fire Placa 203 Finel Sign 204 Finel Demolition p�, � �Qp[2 INSPECTIONTYPE 206 Finel Mechanical 20B Final Plumbing 210 Final Electricel 212 Finel Flre Prevention 220 222 250 Finel Planning Approval Finel Site Finel Builtling/Occupancy � —Z'D`( It�L$ C� � C''.oQta. ��leQa �u�r�� iv�� OWNER-BUILDER VERIFICATION A city or county. which is reyuired to give notice pursuan[ ro Sec[ion 19R30, shall a[[ach [o such notice, and, as a condition preceden[ to issuing a building permit, require the compietion and require the retum of, an owneo-builder verification. Attention PropeAy Owner. An 'owner-builder' building permit has bcen applied (or in your name and bearing your signature. Please complete and rewrn this information in lhe envelope provided at your earliest opportuniry to avoid unnecessary delay in processing and issuing your building permiL No buildingpermi[ will be issued until this verification is re�eived. I. I personally plan to provide the major labor and materials fbr cons[ruction of the proposed praperty improvement. ❑ Yes � No 2. 1(have/have nop �QYc— nt��_ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed conswction: Name Address Phone ( ) City _ Contrac[or's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise �nd provide the major work: Namc Address Phone ( City — Contractor's Lic. No. 5. I will provide some of the work but I i�ave contracted (hired) the following persons �o provide the work indicated: Name IOa2a6 (REv. s5e) Address Phonc Type of Work �ir� ............ . � � �.. JobAddress: 3290 GEORGIA PL Suite No Vicinity: Parcel Number: 13904705 npp�icant: ELLIS, E J Address: 3801 LENAWEEAV CUWER CITY. CA Owner: MARTINEZ, SAMUEL A TR Address: 2517 TOWNSEND ST SANTA ANA, CA MECHANICAL PERMIT. Phone: 310-83&0408 Zip: 90232 Phone: Zip: 92704 0 � . �. ' '�..x � -� ISSUED BV: Contracror. ALASKA AIR CONDITIONING HEATING SERVICES INC Address: 1407 N BPJ(TER ST ANAHEIM,CA Phone: 714-752-1250 Zip: 92806 License: 812494 SCOPE OF PERMIT FURNACE CHANGE OUT AND MISC DUCT WORK FOR AN EXISTING SFR. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocale Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Furnace Floor or Suspend Heater $23.50 314.80 50.00 313.70 $0.00 $0.00 $0.00 $0.00 $0.00 S0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 Quantity 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Comme rcial I nci n erator Domestic Incinerator Compressors / Absorotion SVstems Upto3hp/t00k8TU 3To15hp/500kBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15 to 30 hp 30 to 50 hp . . Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES Status: ISSUED Applied: 02/10/2004 Issued: 02/10/2004 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 30.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $52.00 � ...� ., `t , ;�w _ �.�\,_. '�1 /'-. r-.I � ._ � �. `' _A ` . � 1. NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1247-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned for a penod of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetions and final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646(NOO) WORKERS' COMPENSATION DECLAqATION: . I herehy eHirtn under penalty ot perjury one of the lollowing declaretions: ❑ I heve entl will meintain e certificetp ot consent to seli-Insure lor workers' compensation, es providetl for by section 3700 of the Lebor Cotle, far the pedarmance of the wark tor whiCh �his pormi� Is issuetl. I heve entl will meintain workers' compensetion insurenca, as required by section 3700 of Ihe Labor Code, for ihe pertortnance ot the work for which this pertnit is issuetl. My workers' compensellon InsurenCe carrler antl policy number ere: Carner: policy Number: (This secfion need nof be compleled i! the permit is valued al one hundred dollars (5100) or Iess.J ❑ I certily Ihat in ihe perlormance of Ihe work fo whi h ihis Derm�'N �issued, 1 shall not employ any Derson in any manner so as t become suhject to Ihe workers' compensation laws of Califqr�a greB�t�t' ultl ebom subject to the workers' compensation provisions � io 3� oof � e. L�DOCCotle, I shall forthwit� comply with ihese provisi� fis. O\/ Applicanl Signalure: Date: � WARNING: FAILURE TO SECURE WOfiNER �pENSATION COVERA IS UNL4WFUL M'D SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP i00NE HUNDRED TNOUSANDDOLLAAE�5f00,�),INA�DI7 TOTMECOSiOFCOM SATIQV,DAMkGESASPROVIDEOf-0RtNSECTKKJ3lWOFTHELABORCWE,IMEREST,aNDATTORNEI"SFEES. LICENSED CONTRACTORS DECLARqT10N: I hereby aNlrm Ihat I am Ilcensed er pro ' he (c mmencing with Section 7000) of Divislon 3 of the Business and Protessions Code, end my license Is in full force and effect. Lic. q Class M Comractors SignaWre: Da�e: CONSTRUCTION LENDING AGE CV: ❑ I hereby affirtn that there is a const�uction lending agency for the pedormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Atldress: Signeture: OWNER-BUILDER DECLARA710NS: �ate: I hereby etfirtn thet untler penalry of per�ury thet I em EXEMPT FROM 7HE CON7RAC70RS LICENSE LAW for the following reason (Sec. 7037.5, Buslness end Protesslons Cale; Any ciry or counry which requires a permit to consWct, alter, improve, tlemolish, or repeir eny stmcture, prior to its issuance, also requires the apDlicant for such permit fo file e signed siatemenf Ihel he or she (s Ifcensea pursuanl to the provisfons of ihe Conlrectors Llcense Lew (Chapler 9(commendng with Saclion 7000} of DFASion 3 of the Business antl Protesslons Code) ar thet he or she Is exem0� �heretrom and lhe basis for the alleged exemp�lon. Any vlolallon of Sectlon 7031.5 by eny epplicam far e pertnit suhjacts tha epplicant to e civil penally oi �ot more Ihen five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole wmpensation, WILL DO THE WORK, and the structure Is not intentletl or oHered for sele (Sec. 7044, Business and Profossions Catle: The Coniractors License Law does not apDly �o an owner of property who builds or improves thereon, antl who tloes such work himself or hersetl or through his or her own employees, provided ihat such improvements are not intentletl or oHered for sala. If, however, the buildinq or improvement is sold within one year oi wmpletion, the ownerbuilder will heve Ihe burtlen ot pmving ihat ha or she did not 6uild or improve for purpose of sale.). ' ❑ 1, as owner of the propeRy, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Pmfessi0n5 Cotle: Tlie contractors Licansa Lew does not epply to an owner ol property who builds or improves Ihereon, and who contracts for such project with e comracror(s) license pursuant to Ne Contrectors License Laws.). ❑ I em exempt under SeC. Signawre: Owner ID ventiad by driver's Ilcense. ❑ Ves ❑ No Business end Professions Code for thi5 reesOn: Ventication of Ownership by (type oi tlocVmenl, i.e. - property tax blll or deed): DIVISION OF INDUSTRIAL SAFETY P�pMR CERTFICATION: Driver's License No. Date: Expires: ❑ I hereby certity that no excevation five (5) or more feet in depth into which e person is required to descend, will be made in wnnection with work euthonzetl by this pertni[, antl that no building stmcture, scalfoltling, falsework, or demolition or dismantling Ihereof, wilf be more than Mirry-siz (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calitomia Administratiye Cotle). ❑ As owner-builder, I wiil not employ anyone to do work which woultl require a permil from ihe Division of Industnel Safery, as noted ebove, unless such person has e pertnil to do such work from �he tlivision. Signature: Date: Division at Industriel Sefety Permit Numher: CERTIFlCATE OF COMPLIANCE AND qUfHORIZATION OF ENTRY: I cartity untler penalry ol peryury that I have reatl this application antl sta�e �het the Information given is correct. I agrae to comply wlth ell state laws antl ciry ortlinances relating to building constructlon, end euthodze representatives of the Ciry of Costa Mesa to enter upon the ebove-described property for inspection purposes. I ag�not to ocwpy or ellow occupancy of any building aulhorized by this permit umil final inspection. CppE 1, INSPECTIONTYPE �/ Qdjg 161fi Fixetl System Final Fi�e Prevention 1266 Poal Spa Finel 200 Finel Re-Raol 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 FinalSign 20u Final Demolition I L CO�EI INSPECTIONTYGE 206 Finel Mechanicel 200 Finel Plumbing 210 Finel Electrical 212 Finel Fire Prevention 220 Final Plenning Approval 222 Final Site 250 Final Building/Occupency 3.a-oy l'1N rnaccTaooeess: 3290 GEORGIA PL owxee�sxune: MARTINEZ, SAMUEL ARTHUR aoowess: MARTINEZ SHIRLEE I 3290 GEO{tGIA PL COSTA MESA,CA 92626 545-8640 uxrt: RNCI4ENGINFER: REO.NO.: �ODflE33: UNR: PFflMITTEF: ORANGE COUNTY ROOFING INC ( 714 ) 771-0781 ROUflE33: P�1z�87 ORANGE CA 92669 ;ENSED CONTMCTOfl DELUMTION: I AereEy aflirm [hat 1 am ficeme0 unUer Dro�ns ol C�apter 9(commencinp with Section 001 of Divislan 3 nf the Business and Pmleuinns CaOe. alid mY lic.1: _'^ � I 1 rye and BfleCi. cm uc.: �� 1 f o f 87pTE UL.: �. WONNEN$iL`OM6FNSFTION OECUMTION: i �eaCy aflirm Nit I Aave a cenifmate oi mnsent to ulfansure ar a ceNticate a1 Workers '. Compenution ��`� e`d °ir�itl wev ucereoi �section aeoo. tab.��9 / � 1/ 9 1 � •^r xo.: STATE �P' °"�' eP�NY: .� fRfiifie0 CWY is hefeM Iu1R5t1eO. ❑ CeRifi � M1't71 BuilNnp Divisian Oate: � � �U Appliwn � E%EMPIIO FA M VIOBNEPE' COMPENSITION OECIAMTION: (flis sec6m �ueA m� Ea mmpleteA il IA8 pemii ¢ fa one �unErtC (f100) or less�, I cehity IAa[ in f�e peAorrlW�ce ol fAe work Iw wNCA Nis p¢rmit is iiwe0, I StWtl not empby dny pG(SM in any manner 50 az ta Cecome su�ject to t�e Workers' Compensatian Laxs of Calilomia. Oate: Slpnaiure: NOTICE: II, atler mabnp I�iS CeCW2ilon. you SMUM CeWrtre SuOjM to Iiro WofkEfs' Compenutlon O�sions ol me LaOor COE6. You «W5t �ortAMiIA LUmply vni� SUC� prpW5qn5 Or Ih5 pCrmii S�WII DB Eeem20 r¢vOk¢0. CONSTBUCTiON IEND�NG �GEXCY: 1 �ere0y aKrm [lut Ihere a a wnstructian IenUinp a0e��7 �or tAe peAormanca of tAe xroM lor wNc� this Permit is issu6� (Section 3097. Civ. CI. LENDEN: nooxess: OWNEP BUILOEP OEClAN1�TI0N: I AereDy amrm ttut I am exempt Imm ttn Contncrors' State Lke�e Ww for tAe Idloxinp reason (Section 7031.5 Businesz �O Pmfessinul Ca�e: My Ury ol wwh �«WUa a permit to co�swct, atter, imDmva. Eemolis�, or aDair any SlmcNre, pno� �o Its issuance, alw repuires t�e aDO��Unt lor suc� permit to lile a slqneE statement t�at �Uslre Is licensed pursuanl to Ne proMsians o� ��e Contnctors' S�te Liunse Law (CMpter 9(mmmencinp wli� SacGa� 7000) af DiWsWn 3 0l the Business an0 Pmlessians Cotle) or lhat he/she I5 eMampt I�emlmm anE tha Oasis lor I�e alleOeE axemptlon. Any Nolation ol Sectlon 7031.5 Dy any aDP��ant lor a Oermit subiects IAe aDDliwnt to a civil Denalty ol mt mom IWn IWe hunEreE Edlars (5500). � I, az awner at Na D�aO�ny or rtry empIoyees xiN �rapes as t�eir sole mmpenutlon. will Ao tAe woA, anE I�e simctum is not In�enUeO or atleaA br sale (Sectlon 70a4. Buvness en0 Protesslonal Cotle: T�e Contraciors' State Licensa Law Eoes not aODN �o N�er ol a Dropeny wM bWIEs or imD� ��, �� does sucA rmrk Nmsellmersell or NrouOn his ar �er ovm empioyees. DrwqeO tlut wch ImO�woments ue no1 IntmEeU or olfem0 �or sale. If, �owever t�e �wIAInO oi ' Improvemeni i5 s� �IMn one year o1 compleibn, tlw awner xitl IWve Ilie OurOen ol provin0 �� 4iE rqi Culq o� Improve lor Ihe Durpose a� sale). I, az ovmer of Ne Property� am exdusrrt1y conVactin0 �� acton to con5trucl Ne D�qep 1Sectan 701a, Busines4 ❑ ane Professfans C�e: The ConuacUrsrs' Siate lice�tte Law aoa not z00H'to an mmer al properry who eNY6s or ImDroves ttrereon anE wtro coniratts lor such DrojaU ��N a contracto�(5) Ikeme W�wan� ro IM CanUaRon' Sute License Law�. I am aware �nat praol al tntir warker's Compere:Fbn insuance staulU Oe praviaea to me. � I am exempt u�� : 8. 8 P. C. for Nis reason: �aie; Ownec I 0o IrcreOy tenity ��at I am aware ol and unEerslanG Ihe reQuiremen6 0� Glitamla Hwli� anE Sa�ery CaGe S¢clion5 25505. 25533, and 2553C an0 ttwt I or any tutura OUIIdInO �upant wlll/will not (c�rde one) nee0 to wmv�Y'M�� la suie wtles anOlhe reQuiremenro for a perrtut for construction o� �ifiwtion Irom Ita Nr liry Manapement District. NevEentlal wnsimction aDWications am eKemD� �mm inesa prmitiwu. Dare: nppfram: I �ere0y cefllry Ilut I luv6 teaJ INS dppGraliOn NO SI2te tllat Ihe iEm inf Wmalbn s cOrf[tt. I a0� �o tOmph/ xiN all tiry dnU wunry arAinancesanOSUtelawsreWtlnptoOWOinpwnslNc�o6Mrz0y�n'Gs+ep mufivnM�t�'¢�e eruponNeaEme�mentioned DroDeM'fw ins tion Ya�Doses. / � � �, v ,�� Oate: � � � � � Driver's icen e ar S«iai Sxuriry 4iT� 186b<6 W�ite—BuilEin91 Groen—CaEe Enlorcement: Canary—Applkant; Pink—Revenue; GOltlenraE—Asaeseor CITY OF COSTA MESA — BUILDING PERMIT PEAM NO: B 049396 PERMIT NO; B• �9396 PLAN CHECK NO; N GOVT; N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : T/OFF REROOF W/COMP SQ FT: 3,500 CLAIM VALllE; 3,500.00 CALC—VALUE; 3,500.00 GROUP OCC: R-3 / COMMENTS: T/ OFF REROOF W/ COMP *��**�r�r****�*��r�r**�*�r*�r�* �+r*�*�x *��*****+r*��***�***��*��r�r+r��*��r+r**�r�**��*� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY 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: 13904105 ZNE; REF NO: PLANNING NOTES> i it �F ik iE �! �F 3f M ik ik ik �! 4 iE if if if ik iE iE ff iE if iF i! if 3E k k it i! ik fElE if it ik 3E iE iE 3k �f 1f !E if it iE iElf iF iE ff it if i!!f �E if ik iF if iF iElE 1F iF iE If !E if 3E �E jE 3F iE iE iF iE iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE; ICATION ISSUED �k 3R �f iF iF 1k if if if jf if 1k iF iF 1k k if df it �k iklElE ik �E iE iE �E iE iF iF if 4 i�' LEGALIZATION:N F E E BLDG PMT PLUMBING ELECTR DATE: � if if 3f iE ik if3E if iF iE 1Fif !f iF 1 6 if !f 1f iFlElf �f iF * ff iE 3F fE f4lf iF iE If fk Ik iF * 1E iFlE IF �F iE iE IE if iF iF if 1E IE 1E S M M A R Y STRUCTURAL SEGMENT:Y MECHANIC FIRE SMIP/RES GRADING PERMIT 63.00 .SO SMIP/NON—RES PLAN ISSUE FEE " BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE TOTALS----> 63,50 0.00 ' 0.00 63.50 63.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 63.50 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 63.00 .50 if it 1t it 3k if i! if k k if ik if it jk it i! ih ik ik if it if it R ik ik if iF it k ik i! ik jf iF ik iE 1E i! ik it 1f if it k if ik if ik it 3t ik if if it ik it it M iF ii �t it it 3E iE iF iE it M iE it iE ik ik k iF it I N D I V I D U A L •F E E H R E A K D O W N TYPE gTY D E S C R Z P T I O N�� UNIT COST TOTAL COST SFR 3500 REROOF BY VALUE RESIDENIAL NOZONE 1.00 3,500.00 END O£ FEES n � . � =1 Oi OQ;.7:u73—G"R"15u� + �^- �'. � QR1E� ��'.'?/9C ?:iE: :•5 / ' t CONSTRUCTION AND PL'ANNING �" � '& SPA ��` Date Inspector Date Inspector APPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical Service or Pole� � 52. Pool & Equipment Location 2•.� Sail Pipe�Undrgmdt � 53. S[eel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms �� 4,�Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5�. Steel Reintarcement _ 56. Rough Plumbing & Pressure Tett � 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 Flooi System 67. APPROVAL TO DECK 11. Property Sewer line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap , - 63. Heater & Vent-Final 13. floof Drains . ' 64. Plumbing SYstem � Final 14. Rough Plumbing 65. Electrical�Final 15. Rough Electrical�Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.,Rough Heating & Air Conditionl�9 - FIRE DEPT.�REQUIREMENT. - \, . 20. Rough Facto,ry Fireplace , �, � � �,APPpOVALS� �Permit # r i 21. Ducts, iri Structure' �' ' �, " J �' 70. Underground Hydro � 22: Dutts, Ventilating � � � ' 7�. ProducYPiping O'Gas ❑Oil 23. Gas Pipe;Rough & Test - !' ` 72, Underground Flush' ' ` ?4. Roof Framing �- �� " J ��• �73. Undergrnd.Storage.Tank OGas OOiI i. Roof Sfieathing � � � � 74:' Overhead Hydro ` ; 2 _'.T�Bar Ceiling (Structurall &-Monocoat ' ; � . F�. 7g,� Dry Chemical ' , � 27: FrameandFlashing 'j�� - 76. DryStandpipe �� . 28. Lathing�& Siding '. = {- . ' , � 77.. PIXED SYSTENI'FINAL � 29. Insulation ' ' � - " � � � 78: FIRE PREV. FINqL , ' � � � 30. Drywall.Nailing _ _ �' . • - �H�ALTH DEPT. REQUIREMENT "31. Plaster Brown Coat '� "' ' '' 79. FINAL INSPECTION -, T �32. �Electriwl Power MeterFinal . � 'SO:iF00D CERTIFICATE ISSIiED � :33.'FinalElectric ' . � I � Notes: j-� � � �� 34. Pinal Heating & Air Conditioning� ' , .. �� ; . � � ^ c_.L _�:- H�i" �2 O"� � +35�. Final Gas Pipe-Test " � - � • ' _ ' �¢_, � e Gv �36.�Hood or CanoPY ' - -, � . . �t ,.•. ^ . 37. Final Factory Fireplace'. ' -- �� ' . , :'38. Final Piumbing •x• ; �.' - 39. Water Service�Final � - "'40. Gas Service-Final -� _ '-'c =- � � . � .,41. Solar pomesticFinal " , . ^ 42.�BackflowPreventer • � '. ' � 43. Backflow Irrigation •� - - � � � -04._ Landscape Ir'ripation Svstem,,.' t , , ' " v " ' , . , �_ _ . . '45i,Sound Attenuation �- - - . � ' � - � 46. �Handicap Regulations ' � . , ' ' _ 47.�FINAL STRUCTUFiE & BUILDING O_ 0 �.. �- .48. FINAL PLANNING � � � � 49.: Electric Release ro Edison _ - . _ 50. Gas Reiease to Southem Calitornia Gas Co � ' '' 51. CERTIFICATE OF OCCUPANCY � � No. Date __J .g�� COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BO% 917 C08TA M68A. CALIRORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT BUILDING �_,... _ _� COSTA MESA. CALIFORNIA MAIL iV19 Fi. I7t.}3 CJt.• AODRE55 C17Y Costa Mesa TEL. NO. � nacH�recr�arlson & Middlebroot��. Dike & Colegrove, Inc. 419 E. 17th St. Costa Mesa i67z93 No: � 8-1 [� yM NO. OP W AJv u..�. .. EXIBTING BLOG. 110R9 BBTBAGK IJNB PROM G6NTeR OP 9TN6Hi 7O� REAR YARD 1 SIDE YARD I LEFT !� I RIGHT S� DESCRIPTION OF WORK O♦ NO. OF 14� RO�MS Plan 20C I HHREBY ACI(NOWLEOOB THAT 1 XAVE RPAD THI9 MPLIGTION ANO BTATE THAT TN6 RBOV! IB CORAER ANO AOREB TO COM- PLY WITN ALL CIiY ORDINANCEB AN� 6TAT6 LAW! H80UUTINO BUIlDINO CONBTRUCTION. - ' SIGNATURE OF Dike & Colegrove� InC. PERMI'REF AUTHORI2ED AGENT / V ./� � '- �/� ," �EE RECEiVED ��- Mav i b ��o p. FlIVANCE DEPT. , C1TY OF COSTA MESA APPLICATION FOR PERM�T BUILDING • For Offiee Use Only REGEIPT NO. PBRMIT NO. .� �Df��1 er I oere aecervr� il o�te ieeuec COSTA MESA. CALIFORNIA eiae ZONE APPROVED ZONING SOtf�( � NO. OF I U88 OR i��l PLAN9 2 BUILDI! LHOAL � � �.� _ EVEB (CEMiR LIN6 6T.1 TH8 AMOUM BHOWN UNDHR VALUATION IS IOR TMC PUflP086 OP EBTABLIBHINp A PERMIT F6E ONLY. VALUATION _ PERMIT FEE $ 36�00 a $ 16��.�1 PLAN CHECK $ ZE�OO n iOTAL FEE 54��