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HomeMy WebLinkAbout1087 GLEN CIR - Building Permits(714)754-5 273 • Fax (714) 754-4856 • www.d.costa-mesa. t3UILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1087 GLEN Cl Suite: Vicinity: 2ND FLOOR Parcel Number: 42203146 Zoning: Status: ISSUED Applied: 07/01/2003 Issued: 09/09/2003 Applicant: VOGEL, LORI ANN ISSUED BY: Address: 1087 GLEN Cl --� - — - -- - i '% j-; Phone: 949 -645 -6826 - COSTA MESA;. CA"�;��,. - Zip: 92627 FEE SUMMARY" - al %Plan Check: ' $326.85 �r - - Calc Valuation: Owner: VOGEL;, ROBERTA AND LORI ANN Claim Valuation: ',, Address /1087 GLEN CIR ,g / I (�.. - Phone. V �� A �•' COSTA MESA; CAS Zip 92627 ��� inspection:` $0:00 Contractor: / Address:. /. > n/I Phone:" V•.�; = ' < �` ,� � -Zip: �'"' 'License:- icenser+Arch,: Arch,: _ " Eng: EDMUND FORESTEL" ` i .Address: -- � ,' � - � - "� - - � � Address: 2377 S EL CAMINO REAL- _ �;__. Phone: - -. SAN 'CLEMENTEii `, Phone: X818=964-0014 s - STE 200 Zip: .� License: 92672 License: X957 i v SCOPE OF PERMIT, r-: - , ` 387,2ND STO,RYADD'ITION. SCOPE OF WORK,TO INCLUDE: EXTENSION OF 2, EXISTING BEDROOMS AND A NEW OFFICE AREA.'REF; ZA- '. 03-34. ,.i:- _. -- ._r.- _. _- - --, . .--...I . I - i '% `. NO ADDITIONAL BATHROOMS OR BEDROOMS. FEE SUMMARY" - al %Plan Check: ' $326.85 �r - - Calc Valuation: $35,758.80 .,� ,Permit:'.:, $502.85 Claim Valuation: ',, S0100 , SMIP Res: " , $3.58 ,g / I SMIP Com �;. $0.00— �._�.` Other. : $0.00 inspection:` $0:00 > n/I Total. ✓'1833 28 SETBACKS ,\"'`'\ - MAIN STRUCTURE -Front, 20- 0 .' Rear 24-0 ACCESSORY Front ',�0--0 -'Rear _0-.0 PARKING Existing: 4 Required: 4 PLANNING & ZONING Left 5-0 - Right %4= 0 Left, 0-'0 Right 0,0,,E Proposed: 4 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 180 days, or if work is suspended or abandoned for a period of 180 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 required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 244646 (6=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to salt-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars ($100) or less.) 1 codify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provislons of Section 3700 of the Labor Code, I shall forthwith comply with [hese Drov±sions. �7 Date . '� / ` ! O Applicant Signature`--? �1��4 Y r (WARNING: FAILURE TO SECURE WORKERSTION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION SOS OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Uc. Y Class Y Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirn that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professlons Code) or that he or she is exempt therefrom and the bass, for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is _ sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). - "� I;as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions /Code: The contractors Llconse Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I em exam t at sec.. Business and Professions Code for this reason: Signature: IrF�cpires:— d Verification of Ownership M (type of docum , i.e. - property tax bill or deed): -' DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, This 6, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials?❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic fast of compressed gas at standard temperature and pressure). ................................................................._.....................................................__.... __.... _............................................................................. _..................... _._.._._....................... .._.._................................. _.............................. ........................... 3 Does or will the aeppplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mese Fire Department may require the preparation, cedification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..._..................................................'tiy.........u"Ir.................................................................'—"anSafety Code fully c...............................�............................................ _..................._....... ........................... 4 If en RMPP is presently required, has Section 25534. the California Health end Code been fully complied with? ❑Yes ❑ No 5 Does or will the applicant Air or present or future builtling occupant y cher for the work which Is the sublets c this exe�plication apermit for such construction or modification from from the South Coast Air Quality Management District or from any other air pollution control district or agency? Byes LJ No (Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will ...._....__............._.....art o...thef...cili_.................._...................................................................................................................................................................._............................. y part of the facility to be constructed under this permit he within 1000 feet from the outer boundaries of a school? ❑Ves ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................... _............ _........................__...... _._............ .__....... _............................................................................ _..... __.._... _............................ -............................................................................................. 7 If a pe(mit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which Is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .- ......................_............._....................._._.._......._.._____..._......_....__..._..................................................................................................._..........._................................................................................................... 6 (Ii yes", attach ranificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I codify that under penalty of perjury the information given above is correct. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: 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 is Correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costo Mese to enter upon the above-described prope�opOf Inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. '310 3 Signature, Owner(s)__ - Date y And/Or Authorized Applicant Date CODE J. INSPECTIONTYPE PATE INTMA SRLF1 INSPECTIONTYPINTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing -. 200 Final Re-Roof 210 Final Electrical 201 Final BlocklRetalning Wall 212 Final Fire Prevented 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuiWing/OccuPancy p 1z1..OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return 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 return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification ig received. 1. 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. Yes �4 No 2. 1 (have/have not) hove signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name To r)e r::oy) dc rl - Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work IW2-a6 (REV. MS) May 19, 2005 W CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT BUILDING DIVISION NOTICE OF PERMIT EXPIRATION Bret McCarroll & Patricia Colagrossi 1087 Glen Cir. Costa Mesa, CA 92627-3908 PERMIT NUMBERS: B03-01118 FOR: Addition PROJECT ADDRESS: 1087 Glen Cir., Costa Mesa Our records indicate the above listed permits were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project and additional fees may be required to finalize expired permits. According to our records, the permits listed above have not had an inspection for a period exceeding 180 days. If -you have a signed inspection card indicating an inspectionwas conducted within 180 days from the date of this letter, please contact this office so we may correct our records. If you need to request an inspection please call our Inspection Request Line at 714-754-5626. 1 you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you do not have an approved final inspection, your permits will expire on June 3, 2005. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, Mary Jane Weidenkeller Office Specialist II Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245 FAX (714) 754-4856 • TDD (714) 754-5244 • n ci.cosfa-mesa.ca.us June 19, 2003 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT Bob Vogel 1087 Glen Ci. Costa Mesa, CA 92627 RE: MINOR DESIGN REVIEW ZA-03-34 1087 GLEN CIRCLE, COSTA MESA Dear Mr. Vogel: The minor design review for the above -referenced project has been completed. The application has been approved, based on the following project description and findings, subject to the conditions set forth below: PROJECT DESCRIPTION The applicant requests a minor design review to expand the second floor area of an existing, two-story, single-family residence. The existing residence consists of a living room, dining room, kitchen, den and a 2 -car garage on the first floor and 3 bedrooms on the second floor. Proposed is a 387 sq. ft. expansion that includes extension of 2 of the bedrooms and an open office area. No construction is proposed on the first floor. ANALYSIS A minor design review is required for any two-story construction in the R2 -MD (Multiple -Family Residential, Medium Density) zone to ensure proper design consideration and compatibility with surrounding properties. With exception of the legal, nonconforming lot width and lot area, the proposed construction meets all development standards and the intent of the residential design guidelines. The proposed second floor area is 106% of the first floor area (1,359 sq. ft./1 ,288 sq. ft.), however, the second floor extension is proposed at the front of the residence, which is offset from the first floor and incorporates architectural articulation for an interesting building mass as viewed from the street. Building Division (714) 754-5273 • Code Enforcement (714) 754-5623 • Planning Division (714) 754-5245 FAX (714) 754-0856 • TDD (714) 754-5244 • w .ci.costa-mesa.ca.us ZA-03-34 June 19, 2003 Page 2 The proposed addition is well integrated with the existing first and second floor configuration. It also incorporates variation in roof forms, orientation and pitch. Staff has conducted a site inspection and determined that the addition would not negatively impact the surrounding properties or aesthetics of the neighborhood. There are many two-story homes in the vicinity that are similar in mass and scale. The proposed second floor windows do not line up with any windows on the adjacent residences so no privacy impacts are anticipated. The proposal meets single-family parking standards with the existing, attached 2 - car garage and 2 open parking spaces on the driveway. Although it is zoned R2 - MD, the property is limited to 1 unit because of the small lot size. FINDINGS The information presented substantially complies with Section 13-29(e) and 13-29(g)(14) of the Costa Mesa Municipal Code in that: a. The proposed development and use is compatible and harmonious with uses on-site as well as those on the surrounding properties. The proposed construction meets or exceeds all residential development standards and intent of the design guidelines. b. Safety and compatibility of the design of the buildings, parking areas, landscaping, luminaries, and other site features including functional aspects of the site development such as automobile and pedestrian circulation have been considered. C. The project is consistent with the General Plan. d. The planning application is for a project -specific case and does not establish a precedent for future development. e. The proposed development is substantially compatible and harmonious with existing and/or anticipated development on surrounding properties. This includes site planning, landscaping, appearance, scale of structures, location of windows, and any other applicable features relative to a compatible and attractive development. 2. The project has been reviewed for compliance with the California Environmental Quality Act (CEQA), the CEQA Guidelines, and the City environmental procedures, and has been found to be exempt from CEQA. 3. The project is exempt from Chapter XII, Article 3 Transportation System ZA-03-34 June 19, 2003 Page 3 Management, of Title 13 of the Costa Mesa Municipal Code. CONDITIONS OF APPROVAL Ping. 1. Street address shall be displayed on the fascia adjacent to the main entrance or front door in a manner visible from the public street. Numerals shall be a minimum 6" in height with not less than Y�" stroke and shall contrast sharply with the background. 2. The conditions of approval and ordinance or code provisions of minor design review ZA-03-34 shall be blueprinted on the face of the site plan as part of the plan check submittal package. 3. The applicant shall contact the Planning Division to arrange for a Planning inspection of the site prior to the release of occupancy/utilities. This inspection is to confirm that the conditions of approval and code requirements have been satisfied. Eng. 4. Maintain the public right of way in a "wet -down" condition to prevent excessive dust and remove any spillage from the public right of way by sweeping or sprinkling. CODE REQUIREMENTS The following list of federal, state and local laws applicable to the project has been compiled by staff for the applicant's reference. Any reference to "City" pertains to the City of Costa Mesa. Ping. 1. Approval of the Zoning Action is valid for one (1) year and will expire at the end of that period unless building permits are obtained or the applicant applies for and is granted an extension of time. 2. All contractors and subcontractors must have valid business licenses to do business in the City of Costa Mesa. Final inspections will not be granted until all such licenses have been obtained. 3. Existing mature trees shall be retained wherever possible. Should it be necessary to remove existing trees, the applicant shall submit a written request and justification to the Planning Division. A report from a California licensed arborist may be required as part of the justification. Replacement trees shall be of a size consistent with trees to be removed and may be required on a 1:1 basis. This condition shall be completed under the direction of the Planning Division. Eng. 4. At the time of development submit for approval an off-site plan to the Engineering Division and grading plan to the Building Division that shows sewer, water, existing parkway improvements and the limits of work on the site, both prepared by a civil engineer or architect. Construction access approval must be obtained prior to building or engineering permits being issued by the City of Costa Mesa. Pay offsite plan check fee to ZA-03-34 June 19, 2003 Page 4 the Engineering Division. An approved offsite plan and fee shall be required prior to engineering/utility permits being issued by the City. 5. A construction access permit and deposit of $350 for street sweeping will be required by the Engineering Division prior to the start of any on - or off-site work. 6. Submit required cash deposit or surety bond to guarantee construction of offsite street improvements at time of permit per Costa Mesa Municipal Code Section 15-32, and as approved by City engineer. Cash deposit or surety bond amount to be determined by the City Engineer. Bldg. 7. Comply with the requirements of the Uniform Building Code as to design and construction. Fire 8. Provide approved smoke detectors to be installed in accordance with the 1997 Edition of the Uniform Fire Code. SPECIAL DISTRICT REQUIREMENTS The requirements of the following special districts are hereby forwarded to the applicant: Sani. 1. Applicant shall pay all current sanitary district sewer connection charges. Upon receipt of this letter, your project has been approved, subject to the above - listed conditions. A copy of the conceptually -approved site plan is enclosed. The decision will become final at 5:00 p.m. on June 26, 2003, unless appealed by an affected party or a member of the Planning Commission or City Council, including filing of the necessary application and payment of the appropriate fee. If you have any questions regarding this letter, please feel free to contact the project planner, Wendy Shih at 714-754-5136 between the hours of 1 p.m. and 5 p.m., Monday through Friday. Sincerely, �. PERRY ALANTINE Zoning Administrator Enclosure: Conceptually -approved plans cc: Engineering/Development Services Chris Foerstel Fire Protection Analyst 915 A. Calle Amanecer Water District San Clemente, CA 92672 Building Division ZA-03-34 June 19, 2003 Page 5 PLANNING APPLICATION SUMMARY Location: 1087 Glen Circle Application: ZA-03-34 Request: A minor design review for a second story addition to a single-family residence. SUBJECT PROPERTY: SURROUNDING PROPERTY: Zone: R2 -MD North: R2 -MD General Plan: Medium Density Residential South: R2 -MD Lot Dimensions: 36' x 103' East: R2 -MD Lot Area: 3,708 sq.ft. West: R2 -MD Existing Development: Single family residence with an attached 2 -car garage. DEVELOPMENT STANDARD COMPARISON Development Standard Required/Allowed Proposed/Provided Lot Size: Lot Width 100 ft. 36 ft.* Lot Area 12,000 sq. ft. 3,708 sq.ft.* Density: Zone 1 du/3,630 sq.k. 1/3,708 sq.ft. General Plan 1 du/3,630 sq.ft. 1/3,708 sq.ft. Building Covera e: Buildings NA 35% (1,288 sq.ft.) Pavia NA 9% (320 sq.ft.) Open Space 40% (1,483 sq.ft.) 56% 2n° floor/1" floor ratio: 80% 106% (1,359 sq.ft./1,288 sq.ft.) Floor Area Ratio: N/A 71 % (2,647 sq.ft./3,708 sq.ft.) Building Height: 2 stories/27 ft. (max.) 2 stories/22.5 ft. max. Setbacks (house): Front 20 ft. 20 ft. Side (left/right) 5 ft. 5 ft./4ft. Rear 20 ft. 24 ft. Parking: Covered 2 2 Open 2 2 Guest N/A NIA TOTAL 4 4 Driveway Width: 10 ft. 16 ft. NA = Not Applicable or No Requirement CEQA Status Categorical Exemption: Class 3 Final Action Zoning Administrator * Existing, nonconforming lot width and lot area. (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.usNG PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1087 GLEN Cl Suite: Vicinity: HOUSE & ATTACHED GARAGE Parcel Number: 42203146 Applicant: BURR, STEVE Address: 711 WEELO DR COSTA MESA, CA owner: VOGEL, ROBERT A Address 1087 GLEN CIR Zoning: Phone: (714) 548-2965 Zip: 92626 ISSUED BY: Status: ISSUED Applied: 06/06/2001 Issued: 06/06/2001 , '' SCOPE OF REROOF EXISTING SINGLE FAMILY RESIDENCE &-ATTACHED RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 30# FELT UNDERLAYMENT AND TIMBERLINE SHINGLES. Plan Check: $0.00 Phone: $139.25 SMIP-Res: COSTA MESA, CA Zip: 92627 Contractor: STEVE BURR Inspection: $0.00: Address: 711 WEELO DR -�PLANNING Phone:- (714)548-2965 COSTA MESA, CA Zip: " 92626 License: 635586 - Arch _ Eng: Address: ACCESSORY Address:" " -, •Rear 0-0 Phone: Righty 0-0 Phone: Zip: - License: Proposed:. License: , '' SCOPE OF REROOF EXISTING SINGLE FAMILY RESIDENCE &-ATTACHED RESHEATH WITH 1/2" CDX PLYWOOD. INSTALL 30# FELT UNDERLAYMENT AND TIMBERLINE SHINGLES. Plan Check: $0.00 Permit: $139.25 SMIP-Res: $0.62 SMTP Com: $0.00 Other: $0.00 Inspection: $0.00: PERMIT G_ ARAGE•(24 SO). TEAR OFF EXISTING SHAKES & _ REROOF WITH 30 YEAR GAF —FEE SUMMARY Calc Valuation: $6,200.00 Claim Valuation:,` $6,200.00 Total: $139.87 �& ZONING% -�PLANNING SETBACKS MAIN STRUCTURE Front 0-0 Rear'- 0-0 Left 0-0 Right_ 0 0;, ACCESSORY Front 0-0 -, •Rear 0-0 Left 0-0� Righty 0-0 PARKING Existing: 0 Required: 0 Proposed:. ,0: NOTES: 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 180 days, or if work is suspended or abandoned for a period of 180 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 required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754.5626 2446-46 (6/00) F" WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 CE—Ihave and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Wo rs/' compe/nsation Insure on corner a policy number are: -Carriec '/�lA�-lM �y Policy Number: -D-7 _(This secfion Mbd rTofbd completed i1 he permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation law Ce' mla, antl e t if I should become subject to the workers' compensation provisions of Section 3700 of the Lab r Code, I shall forthwith comply with theC/0 rro / P _Applicant Signature:/ A . _WARNING: FAILURE TO SEC E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100.000),jhlADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirn that am.licen der r s P�Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ofe o Code, and my license is in full force and effect. Lic. fl S X� .Class M Contractors SlgJnature: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yet; ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code 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 reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................................................................................................................................................................................................................................................................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................... _......._........................................................................_........................................................................................................................................ ....................................................................... ................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .......................................... _.. ...................................................................................................................................-................................................................................................................................. 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Ves ❑ No ..................................................................................................................... ildi........................................................................................................................................................................................................................................... difi................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this byes aggernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control distract or agency? LJ No (Section 65850.2 of the California Goverment Code requires that the requested Information be furnished on applications for non-residential building permits). ............................................................................................................................................................ithi........................................................................................a's,......m''1............................................................................................................. 6 Will any part of the facility to be constructed untler this permit be within '10,60 feet from the outer boundaries of a school? ❑Ves ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...................................................................................................................................................................................................................................................................................................... 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all 01 the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .......................................................................... ................ -............... .....-.......... ............................................................................................................................... ..................... .............. ............. ............................... ............. ...................... _............. 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: 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 is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 5 fur Of Legal Ow er(s An I onzed ApPll ---- r—Data---, CODE t. INSPECTION TYPE 4rlIE INTRIALS CODE INSPECTION TYPE 0M INTmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root -' 2 "�' "� 210 Final Electrical 201 Final Slock/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ;YDDRESS OF BMLOMG: 1087 GLEN CI V4. q ZJ - Z6 L um. UYNENSh EIFIOlU6N: VOGEL, ROBERT A 'i ADDRESS 1087 GLEN CIR 11 �oaS-' Gg26 COSTA MESA,CA 52627 ••4 APPL�IWUUi AOORE55: 'ARCHITECT ORENGREER: ROBERT THURNTON UcxD: 024186 ARCH. OR ENG.'S ADDRESS: 1085 GLEN CI Ugh C.M. CA 92626 CONTRACTOR'S RUNE CONTRACTONSMALING ADDRESS: I.C. NO.: OMT: LICENSED CONTRACTORS DECLARATION: I hereby Nim under penalty of perjury mat I am licensed under rosison. d Chapter 9 (commmdre with Section ]000) d Dv®un 3 of the Susi. and professors Cade, and my license b In Nil face and affect. CITY LIC. NO.: LIC. CLASS: LIC. No.: EXP: Done: Contractor: OWNER BUILDER DECLARATION: I hereby affirm under penalty of penury that I are exempt from the Contredons License Lew for the _ fdbwing reason (Section 7001.5 &»mesa and PMeseione Code: Arty city or county which routines a cannot to construct, Mer. imyrows. -` "molbh, or repair my structure. prior to its issuance, also mutase the aplNkanl for such pemd to fib a signed western MMM or sic i �,'jcsnsedproment to the provisions of the Connectors License Lew ]Chapter 9 (commmong with Sedbn 7") of Division 3 of the h' = wnma sh and Prdaasiau Codel or that M or e is exempt thorehm oand the basin for the alleged exemption. My vd solution Section -1031.5 by arty applicant for a permil subjects the applicant to a cnM penalty of std more Then No hundred "I. j5500]). Ei I, m owner of the property or my employees wish wages m thea sob com,madion, will do the work, and Ma muchas is rot inewel d or offered for sale (Section 7Gu, Business and Pmfassio s Code: The Cmdrectore License Law does net apply tom owner of property who builds or kmprny m meson, and who does audit work himself os himself or through he or her own empkyw o, provided that much improvements ane not intended or offered for sale. H: howayer, the building or knprevemeM is sold within we year of completer, the owowrLuiban will have the Widen of msiW he or she did not build or Improper forthe Wrpow of safe). I I as owner of the m am wd contracting with licensed contractors to construct the project Section 7W0 Bummers and Profeaeions Coder Contractors Uurea law dose net appy to m o who bwMr a "un es pension and who contract. M such projects with a contraxor(r) licased PureueN to the Co Law). -�-I,mryDltynpt and int: a Dir nor Ihi. /� " I do hereby can* Ihat I are aware d ala understood the ntauiremend of Celt— ord9elftyAme Sediom 2�0'y.'�533. end 2SS3C, end (hat I a any enure building occupied will I will ml (dmb mel reed con wit stale codes and the reudsama as ler ammkformnslsdimamodificetion IhOA, u �enegamenl Dindd. idesllsl wnatredion eppicatkweareaxempllsmthece provision.. Date: Applicant WORKER'S COMPENSATION DECLARATION: I treasury afrom mass panepy of perjury ore of the folkrwcg dedereliom: I have are will mortician a owifcate of consent to eMimum M workers' compenealbn, m proyaed for by Section 37M of the Labor Code, for the performance of the wok for which this perms in; issued. ❑ 1 hat end will maintain wnrf e e compere a insurance, ® repaired by Section 3700 of the labor Code. M tic performance of the work for which this perms is issued. My workerecompensation insurance comer and policy number we: Camar, Policy Number .s section need nor be completed I tic peon b Mone hundred dollars I51OOj or /m.) I candythat in the pedomance d the work for witch (hie perms ls based, I Moll std employ any Prion in any mmnar w m io ,stoma subeci to the workari consen.ation tawe of Cddamia, and a0ree mel H I Mould Eeroore subject to the amours' compeo.aron provisions of Boom 37M of the Labor Code, I Moll forthwith comply with those provisions. Dere: Applicant: Wombp: FelfMs is amount wouken'rompewtlpn rovrntps Is unMwNl, andisls11 subject an employer b, eNMuel pmeltlw end clvlf power up to me hundred thousand "Ions (d100000A In satfidw M Me cwt of rompenseffan, da.Va, u mov had far In Swtlm 3706 of Me (dbot Code, Interest and aMo 's lase CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction WMiw nos cy M tic performance of the work Its which the permit is acted (Secan 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I neva reed this eppticmrtm and none that dna above Information or coned. lapse to canny with all dry and county odimncee and nate leasre ng to Wi1dNg construction and notably horse repmantaf ives d this my to enter upon the ebovs mwdioned properly Iainspamon;6sea — - - (5151-46.WP) WhRe-BuiMic a Solelf. Green -Fu.; Conery-Appicam; Pink-Rosenue; (ioldemod-Asaeuor 7 CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; B 084617 PLAN CHECK NO; i CONSTRUCTION TYPE; PERMIT TYPE: ti JOB DESCRIPTION 15SF RESIDENTIAL ADDITION 02633-97 S STR PERM NO: B 08461•, GOVT: N SUPP: N PURPOSE: ADD SQ FT: 315 CLAIM VALUE: 1,500,00 CALL -VALUE: 1,522.50 GROUP'OCC: R-3 / COMMENTS': KITCHEN EXTENTION, WINDOW RELOCATION ii;E***ii***is*riic iE**iE iE?EiE*if is**HE*#tc iEk�e****iF;e iff**ifs(-ii iE jtt mix*if is iE it i(-iE iP iv t -it +F iefiia �F ie iE ix*z**if*jt it ie ilk* 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 BUILDING--------- FRNT: FT IN REAR: 24 FT IN FRNT: FT IN REAR; FT IN LEFT; 5 FT IN RIGHT: 23 FT IN LEFT: FT IN RGHT: FT IN PARKING REQ; PROV: PARCEL: 42203146 ZNE: R2—M REF NO: PLANNING NOTESi ADD A 3' BY 5' ADDITION TO THE REAR OF AN EXISTING SINGLE FAM( FAMILY_ ,E'SIDENCE. /y xiE*if ifxie if**fiiF>r if ii *ifY'F ix iF�iF iE*if is iexsit is**rixif if if***it if'rtriiE %fit *if if if rif iE if if it if if**if iE. nif #'iE tf iFtif* D E V E L G PQM'; 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: l.? BUILDING APPROVED BY %��. _ DATE:/), .Y. APPLICATION ISSUED BY;: : eft( /d�� DATA.: if 1i. /y * #dEICAT itis• x*te* ac%***ac:ttcxsttc*tFacxsc+cr.*atxtteaenriEiF ific-kifiFicie..//-x**�{'�"-.i LEGALIZATION:N :' F E E S U M M A R Y STRU&UR�Ai SEGMENT:Y BLDG PMT PLUMBING ELECTtIC MECHANIC FIRE SMIIRES GRADING PERMIT 51,25 i' .V60 SMzPI/NON—RES PLAN 33.31 ISSUE FEE 4., BUILDING—DIV—.> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS----; 51,75 0,00 ,'� 33.31 85,06 85.06 .00 REVENUE DIVISION TOTALS--;� COLLEgTED: 51,75 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING FLAN—CHECK 51,25 ? 5v '!E'IE df 1I'*Fcs**lf]t***1('**Jt*)tt"lt}t}j(•***]E*<}E9E'R*-1^iCf1l•9E'R<'1.'T*]t .r J'. Jct*]F'RT**9E ]!:T F'T'R'l. Y: ]19E F91'!: 'F *'I :C 1I'T'RK*Jt 1C I N D I V I D U A' L E E B R E A K D O W N .x"F, I ./ TYPE QTY D E S C R I P T I. O N UNIT COST TOTAL COST SFR 15 DWE-TYPE V -WOOD FRAME{ -GOOD 81.50 1,222.50 SFR 300 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 300,00 END, OF FEES �f 09-09-19971©1:25 P't1f551.75 RCPT4:C31-3fi12Eu7 PERMIT:084617 t ' CONSTRUCTION AND PLANNING ' Date _APPkOVALS Permit# Inspector - POO;PA APPROVALS Permit# Date -- Inspector 1. T4mporary Electrical Service or Pole ,-C 52. Pool & Equipment Location 4 2. Soil Pipe-Undrgrnd. .�" ^ 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 1 . 4, Electrical Conduit-Undrgrnd. 55: Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test f• 6. Electrical UFER Grind. - ,57. APPROVAL TO COVER;GUNITE 7. Footings 58. Electrical ConduidUndrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., ,Test 9. Water Pipe-Undrgrnd. 60. Backwash- Lines, P -Trap, 0 Undrgrnd. }. . 10. Structural Floor Systems 61: APPROVAL TO DECK -; { 11. Property Sewer Line & House Connection + 62. Backwash & Receptor -Final 12. Sewer Cap . ` r63. Heater & Vent -Final .f• 13. Roof Drains64. Plumbing System - Final - 14. Rough Plumbing -65. Electrical -Final 15. Rough Electrical -Conduit, - 66: Solar System -Final 16. Rough Electric Wiring 1.67. Fencing & Access Approval - -r 17. Rough Wiring Sign - `•68'. APPROVED FOR PLASTERING - - 18. Rough Electrical -T Bar Ceiling -69: POOL/SPA SYSTEMS FINAL - - 79. Rough Heating & Air Conditioriing - FIRE DEPT. REQUIREMENT APPROVALS, Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑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 & Siding77. FIXED SYSTEM FINAL 29. Insulation 30. Drywall Nailing Q_ _%> (9-�y-�YF-I. 78. FIRE PREY. FINAL HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 33. Final Electric 80. FOOD CERTIFICATE IS ✓dED Notes:-jG-+�7 `�1� `-fG� ; 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 7 � � c� ����c/r�• 36. Hood or Canopy 37, Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40, Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer -43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation -- 48. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison t 50. Gas Release to Southern California Gas Co 51,, CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA BUILDING DIVISION OWNER -BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return 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 return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. 1 personally plan to provide the major labor and materials for construction of the pro- posed property improvementX( Yes ❑ No 2. 1 (have/have not) haut, signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction: Name _ Address Phone ( City Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to 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 to pro- vide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Heal and Safety Code and have completed the above information to the best of my per- sonal knowledgen co pli ce with this State law. Signed: ` ' Date: ` I Name: J C.D.L. # or S.S. # ,N: � 754-5273 A' JUL-Z9-1%', M75 DEUELMIENT SVS P.02 DECLARATION OF AUTHORITY stclg, Permit N FOR AGEt4S8 OF PROPERTY OWNER Thla Permit e , _ TO APMY FOR PEjRMITS —J0_E?, .« adaea AP Numbs � L amiate that, am the Owner of Tide of lite above rafreartwo Mal property, and Thal I (we) hcteby authorize; _ALJ,l RrName v Teleplwm No to obtain permtta in my behaff, as ownerlbuilder at the above «tferanced property. zW 67" for Z. Should any person become an employee engaged in the improvement of the property, I (wo) shall Im­ medlstely provide Worker's Compensation Insurance coverage and cause a carthicate of that coverage to be filed with the Building Division of the City of Coate Mesa, as required by State of California laws. a. As owner/buPoor in fact, I understand and accept that my responsibilities do not transfer to any Other per- son, wmpany or corporation - 4. 1 agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim reau" m damage of personal Injury to myself or any other panes as a result of work authorized by the permits ban the City of Oasts Masa. S. I declare under the penalty of perjury that the toragofng N true and correct. Executed thiod�� day vi 19-al-J��. , California. prmle4 Name NOM TMs authorization dose not grant authorization to perform the work as owner, It solely provides for limited power of attorney to secure thle permit In any behaif- NOTMIZATION REQ134RE0 TOTAL P,o2 ADDRESSOFaHLMNO: 1087 GLEN CI UNIT: MEWS NAME IF IDIONN: VOGEL, ROBERT A ARMIES&, 1087 GLEN CIR COSTA MESA,CA 92627 APDL. AILING ADDRESS: ARCNRECT OR ENGINEER: LIC. NO.: WN. OR END'S ADDRESS: UNIT: CONTNACTOWSNAME: NOCK PLUMBING (714)895-1246 coNTRAcrows Arum 11612 KNOTT ST ADDRESS: GARDEN GROVE CA ucw, 707775 92841 1 ural: 17 LICENSED CONTRACTORS DECLARATION: I hereby, Mum under Penalty of perryry now I am licensed uder provisions of Chapter 9 (commendng with Section 711(w) of Division 3 of the Business and Professions Code, end my license is in full tiros end offers. CITYLIC.NO.: 050386 "CLASS: C-36 uc.NO.: 707775 EXP: 02/98 ate: Domrersw pLc�i39A1' W! BUILDER DECLARATION: hereby affirm under pmolty d parlury Mat I am exempt from the Cmtradae License Law for the 1 ving rescan (Saosion 7031.5 Business and Pmleaacm Cade: Any cily or county Whist requires a Inns to dnawd, Nwo. Lmgote, smolah, to repair any stdolure, prior to its awmw, also requires IM «plicent for such perthO to No a sgnsd statement Met M or eM lioensed Punuanl to the provisions of the Contradas Lies. Law [Chapter 9 (oommmctng with Section 7000) of Drvaon 3 of the Juanasa and PMeseions Code[ or that M or she i3 «ethpt therefrom and the bees for the alleged exemption. My violation of Sedion 7031.5 by any applicant for a perp t subjects the applicant to a viol penalty of IM more than fee hudnse dollen [S500]). I. «ovmar dthe property or thy employees om wapns re; their sole camltatetion, will do Ma work end the structure is not "ended or Blase M sale (Section 7011, Buanessed Proessions Cade: The Ct dredars License Law does net applyto an osmoof property who builds «knPro. Hereon, ad also dose such sock Nmsed or herself or Mmatph he or her own employees, providse that such imprwementa ere not idaMed or dleretl for sale. U, hewewr, the buiMin9 or knprovemwot a sold wkhin one year of wmportion. the owrwrbutlder will Ave the burden of pro'ringi M or she do rot Mild or imprwe for the Impose of sale). 0 I. m ownsr of IM unpent. are «dlnivwy codretlnp with Trensad convection m mnslrW the projad (Section 7011. Bnsiod M ins an Prolessions Code: TConhadan Ism« Lew dted dose not apply to an ownsr property atlo lowest a imps« Utlthereon and who conlrate for suN propos With a a mactro(s) loereed queued to IM Cadrersan License E] I am exempt uroer Section: B. & P.C., la Ma reason: Dai Owner: I do hereby candy Mat I am ewere, of wool odarsad Me nab immeds of California Health ad Safety Code Setons 25.505.25533, and 25531, ad that I or my, Mum builww omaent sill / Mi roll (circle woe) need to comply mh said state codes atd the requiremmis ler a peond la construction or modifiration both IM Airy . ans9emenl Didrirs. Readrnial o nsento'on applications areexempt from them promons. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm oder penalty of peryry one of the Ulovaq dedaatom: I haw awl mi moisten a cendrae of oonsal 10 s frinsum for awkwos' aanpawaton. as provider! far by Salion 3700 of the Labor Cole, for the padamaaa of that aamk for which this past is erase. [ ] I bow al air matntan worker' comlnsation heaenro. «required by Section 3700 of the Labor Cade. for 1M penlormenca of the ][ wank /a whits [hie pemt a Gaud. MY waMre oanpensaton insurenca carrier ed po0c/ number ars: Carrico GOLDEN FA EXPIRES Policy Number. NWC '32114101 09/01/97 1 This section meed nd be canpolse % the permM b M cos buoyed dWars /41001 a ked.) I seedy Out in the pMortnaae d the wodc tion whoh thio Imlt a lssuse, I Nell rat empty my person in amy mmna m «1p subject to the osx n' corwarerrion was d California, wool of. Mat if I shwM beano [bpd to the awkan' c pen ei tion pyriaione d Spine 37M d He Labor Cade. l ehallAwilh con�Per1W.Q oae pry isotu. �[W«fma: F.Rr/a ro sxunMren• fompausam r:«sops 1. u�ewN( «dsMn n empmyer ro snero«.nd 11 or cop to ons hundred thouserof dollen (Se0D.0DML M Mdlt/on M the east of sampansatlnw, 4tlapss as mNon 3706 of Me Labor Cods, Interest, amf ettomey's I. CONSTRUCTION LENDING AGENCY: I hereby eMm1 uder penalty d paltry thus there IS A conataction lednp agal ler the pedomarre of the wak for which the pemi is issued (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I have react this a,,Ikmoo and date that the above idamation is coma. I spree to campy mh At city use county on irmoss and state laws relal to building sonNudion and hereby authorize representatives of this city to enter upon the above-memionse proDaty for inspodorn Irpone s. RON NOCK oPrint Noma Dae signature ar�r�: . (5151-46.WP) Who"WidiN 8 Safety; Green -File; Canery-Applicant: Pink -Revenue; Goldenrod-Aossssor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 08395" PERMIT NO: P 083957 PLAN CHECK NO: N GOVT:.N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH JOB DESCRIPTION ; DISHWASHER CHANGE OUT SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK ASSOCIATED WITH THIS PERMIT 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 ---------- TOTAL PAID --------- 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 REQ• PROV: PARCEL: 42203146 ZNE: REF NO: PLANNING N TES> TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST LP 1 > 8.75 8.75 *Mif>k**M**aft aft****M*k****irk dF**dE aft*irk dE iF dE*dF dF*RF 1E dE dE if aft iE dF RE*iE iF RE*Rt dF df iE**dE***df dM 9E Rt 9E iE NE dE dE dF RE RP iE RE it Ri at 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: APPLICATION ISSUED BY: DATE: aft 9t**kkrrit*it*MdE iE dE dEiF 1E RE dE df iFiFiF iF �FiF iF7fiiiFiF7Fdt*iE NF ih 9E**** LEGALIZATION:N F E E S U M M A R Y STRUCTURAL GMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 8.75 25% PLAN ISSUE FEE 22.00 SMIP/NON—RES BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 8.75 22.00 0.00 30.75 30.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30,75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 30.75 dk*df dF dF lF dk#iF*dF*dk>k*df kRE Rk irk d!*RF nth df*dF dE dE*dE df*dE dFiE dhiE aft dE*9h iF dE iF dE dE RE*iE dE dE dE iFdF*dE dEiE aft*�l9t dE ih iE*irk*df d!**dE*nth*iEi! 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 LP 1 DISHWASHER 8.75 8.75 END OF FEES EXPIRED DATE 3' ZZ qg eb 07-30-1997118:21 AM338.75 RCPT8:01-0009906 PERMIT:083957 CONSTRUCTION AND PLANNING"'t _ P9.0 SPA . _-- APPROVALS Permit # ' i Date Inspector APPROVALS Permit #r, J' Date Inspector - 1. Temporary Electrical Service or Pole 1 52. Pool & Equipment Location - 2. Soil Pipe•Undrgrnd. '-' `• 53. Steel Reinforcement- _=3':Electrical Condvit.Utility-Unrjrgrnd. 1 54: Forms alr4r Electrical Cond6iVUFdrgrnd. 55. Electrical Bonding � 'EP Steel Reinforcement" 56.- Rough Plumbing & Pressure Test .6'�.Electrical UFl R_.Gind. 57. APPROVAL TO COVER_-GUNITE ti7? Footings '-' 58. Electrical ContJii Undrgrnd. 1 r. _ 8. Foundation - n 59. Gas Pipe, C Untf-grnd., Test ~9. T. J Water Pipe-Undrgrnd. 60. Backwash Liness P_'Trap, u Undrgrnd. 10. Structural Floor System _ 61. APPROVAL TO;DECK t' - 11. Property Sewer Line HousetConnection 62. Backwash &-Receptor -Final {� ,& 12. Sewer Cap '`- 63. Heater &Vent-Final 13. Roof Drains _ _ 64. Plumbing System - Final 14. Rough Plumbing. •r, ,65. Electrical-Final t 15. Rough Electrical•Conduit' - 66. Solar'S,stem-Final 16. Rough Electric Wiring,y: --! 67•. Fencing:& Acceesss.Approval '1 17. Rough Wiring Sign 68. APPROVED FPR'PLASTERING , 18. Rough Electrical-T Bar Ceiling ` w - - 69. POOL/SPA SYSTtEMS-FINAL . 19. Rough Heating & Air Conditioning - •-- FIRE DEPT.-REQUIREMENT. ' r 7 t-1'S 1. S is APPEtOVAtSD5*1 Per' r 20.'Roug't} Factorx Fireplace i•= Y1 -t'= =' D ='+" 21.;Dueis,in-Strq_gture! .... ,-,�- i - C -.;;. 70.' UnclergroL`nd Hydro i _ 22. . V"enol ing-i� y �? r ._; ;1 r 71. Prod uct,Pi ping'�Rias It] Oil •Quci ;�y 23. Gas Pipe-.Rough &•Test ;f t*! 1=, _t 72. Underground F-wSh n t- 24. RooPFraming•' �' "''- -'`•" 'O a 73: Under rnd.Sto 40Gas a�Tz1❑Oil 9 K: r > 25. Roof.Sheathing11 l[ w v r v t y 1.C' > i''s 74] Overhead Hydro'. 26.17-Bar,Ceiling (Str U_cFura l) & Mbnocoat r� cc! '�' 79' Dry Cha,�ical 27. tame and flashing; _x- + ;, mr 76. DryStarn]pipe6-�o t: 28. Lathing &Siding "� 77 FIXEDSX$TEF!afJNA� - 29. Insulation; ca: �• •• a: 1 1 �t 78: FIRE-P.REV. FINAL 4: m_ 30. Drywall Nailing V f � , �� i�;� DEPT 'REQUIREMENT _. ._;-HEALTID n: -; 31. Plaster Biown•C.t„ oa� .,. r. r :+- j. R 79, •,. FINAL IVSPECTsON ; j . 32.'ElectricaGPovJgr Meter.:Final ! ou }` I 807 FOOD CERTIFrI•?GATE I S�.IEQ ;y r - 33.1in Ir, ,� g j I �V Notes: ly yn %y 1 th- .; 34..Final.Heating-� Air Conditioniq::: ; +' i t�: rs: - 1'i:^ k S O - '�' -1 r l ITt _ T '4 ^r I t•� rt :.i I Lr � t: ; _ 35. •�inal'Gas�Pipe.TesP 1. 'i ( I _ - t •, c- a > r. T. _ .+ 36. 'HooWor Canopy '- :D 1 T'� � Ll t• ' Y. i�t T '1 ' 37. Final_'Factory FirerPlace- + 38. FinatrPlumbing '*' + �. �� -i + •- i 'Ti * :' --- 39. Water Service-Fina I j 40. Gas Service-Final - . ry s- : a rn I i po-ro e - 41. Solar Domestic-Final: - 42.'Backtlow Preventer 43. Backflow Irrigation A ? ^ .A k ^F 44. Landscape Irr"igation System,:::m1 1 r ' C t'J n_S -45..tound A�ttentiation,' ''- t " ;! ` '' z; ^`'' • .. M. J T .46. Handicap. Regulations Alc tr 5 =w k i FINAL STRUCTURE & BUICDING t47i. 48. 'FINAL PLANNINGt 49'.'Electric Release to Edison r •"` la '_ `� - 50. Gas Release to Southern California-Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 1 `-- ' 200RESS OP (jML0P10: IV 0 1 VLL1V i.l aMNERS NAME1P gI0ylN: VOGEL, ROBERT A ADDRESS: 1087 GLEN CIR COSTA MESA,CA APPL. MAIUND ADDRESS ARCNITECTORENfdIEFR: ROBERT THURNTON M. OR Ehl ADDRESS: 1085 GLEN CI C.M. UNIT: CITY" OF COSTA MESA - BUILDING PERMIT 92,627 PERMIT NO: E 084618 PLAN CHECK NO: CONSTRUCTION TYPE: V -N PERMIT TYPE: ELE UC.Il 024186 JOB DESCRIPTION : 15SF RESIDENTIAL ADDITION CA 92626 0 NI 1 CLAIM VALUE: CALL -VALUE: CONTRACTORS NAME: CONRIACTORS MA RIO ADDRESS UC NO.: UNIT: LICENSED CONTRACTORS DECLARATION: 1 hereby a fbm under pasty of parjay that I are licensed under provisoes of Chapter 9 (cammmon, with Section 7009) of Division 3 of the Rusirme and Prdeaeions Code, and my license a in lull more sed affect. CITY LIC. NO, LIC. CLASS: UC. NO.: EXP: Date: - Cortins. OWNER BUILDER DECLARATION: I hereby affirm order penalty d perjury that 1 ern exempt fran the Cmtredo s Licenee Law for the Idow r,, reason (Sernion 7031.5 Bosiiess and Profeuions Code: Any cry or county which recuinea a parmn to zonal after, improve, demolish, or repair any stmdure, prior to or sauterne, also requires the applinant for such permit to file a a fined statement that he or abet Is licemed W moan to the provisions of the Contrapms Uoeme Law [Chapter 9 (oanmenanp with Section 7000) of Division 3 d Ihe Susine® ars) Professions Coda] or that he or she is exempt thireborn and the basis Its the Wal uamption. My videtion of Section 7031.5 by any apphoers for a perms subpes the applicant to a diff peraky of not mons than two hundred dodan [S=)D.. © I. as owner of the property or my empoysu with wsi as that sole mmpenaetio r, will do line wonk, and line structure a net intended or offered for safe (Section 70N, Bu inee t and Professions Code: The Contractom License Law does not apply to an owner of property who bolds or inpecom theneoro and who does such work Nmsoff m herself m thro t h his or her own empoyeee, provided that such impmvemeers are not imerded or offered for sale. I. howesx, the buir in0 or knpmverneM is sok within one year of oornplatim. the owrwrLuiker will have the leaden d proving he or she dk not bulk or improve for the puryose of sale). ❑ I, as owner of the propeM, am exclusively mntradi, with hostraed contreaon to construe She project (Section 7011, Bossiness and proteins.. Code: The Comra emir License Law dose not apply to an owner�ymwho builds or improves thereon and who Pontrads far such projects with a comnador(e) Icensnd pureuam to the Cant a Law). ❑ Sem exCwplynder Section:_ .. I B. & P.C., ler t�b / reesm:/// a Code Sections 25505.25533. and to codes and the raparemanu ler eppintbe are aasmpr from these Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of piney one of fire fdow'oR dadarmiaa: ❑ I have ens) wit maintao a certffcate d omsont to sel4re m b caw 'sompensalon, n provknd fm by Seeon 3700 d iha Labs Code, for the performance of The work for which this permit is issued. ❑I have end wit maintain workers' work TMy canon insurance, u required by Section 3700 d the Labor Cade, b The performerwe d the er whidr the perms u issued. Ay werken' rompenaelian insonnu mrtiar end policy camber we: Cerner: Policy Number. (This sod/on retest not be nonolered a the parrot is for ora hundred dollars, /$1001 or Nee) ❑ I cantly that in the lost nate of line work b which this short a ivuad. I "I sot employ my person In any menner iso as to Date: _ Apploard Wam1W. FeNon W aeon wodrera' mmperaedon em'wepe Is urifew?uA and shill nlpct an employer Is cdMnel penaltlaa and ely l fine. tat 0 one hundred thouurzd dolls. ($/00,00% he aWlffon W the coat of romperwffort dameli as provided for In Secffm 3706 of the Labor Cods, Interest, end momeyl leu. CONSTRUCTION LENDING AGENCY: I hereby affirm under panelly d perjury that them is a conmumon kMinp af, a ,r for the pedormence d the work Ion which this perm$ a eaued (Section 3097. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I certify Iss l rd this application end date that the above information Is tuned, l agree to campy wfth all ay end owmry ardinerrus ardatatela rel to Wikrg cmand haul anstruon eereby horizenapneaentativu of the cy to enter upoon thealrs Mkied properly lotins n s..1 --t , - /" - (5151 <6 WP) Whhe-Buikie 8 Satety: Gaamn 1`110: Caray-APp5cant: Pink4laaenoa; Gokenmd-Aeauw N PERM NO: E 08.361£ GOVT: N SUPP: N PURPOSE: ADD SQ FT: GROUP OCC: R-3 / COMMENTS: KITCHEN EXTENTION, WINDOW RELOCATION 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 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 REQ: PROV: PARCEL: 42203146 ZNE: REF NO: PLANNING NOTES> > ##if r. #xh is}tEiE#####a. r#if R.x ccxx#aicTxir#ss#ic irx#########ii if #+f it xiF is cc###ix#x"##ic .. icx##ie iftifE###r' D E V E L O P M E N T S E.'R V I E -S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; r., DATE: �vPP1ICATION ISSUED _ BY: _ DATE: Q 7f'.T#it]Cx##^t##F#'R#ft <ft'!C -R'Ifxxx�xxx.. 7c) x x�.xT.�xxxx7C a�T�xl�x'R'lZxxhff'/th+fxxjt'/c %t 7xxnYt ltRxT'Yt ie'h' LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 7.00 50% PLAN ISSUE FEE 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTALS ---- > 7.00 22.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 29.00 I N D I V I D U A L. F E E TYPE QTY D E S C R I P T I O N ELE 5 FIXTURES, LIGHTING;_' 1 ST 20 ELE 2 RECEPT/SWITCH 1 ST 20 END OF FEES FIRE SMIP/RES GRADING SMIP/NON-RES TOTAL PAID DUE 29.00 29.00 .00 29,00 OVER/SHORT: 00. FIRE SMIP/TOT GRADING PLAN -CHECK #�f is if#if if ie if tie is ie####riE###tit is x-##iEt;i#ic B R E A K D O W N UNIT COST TOTAL COST EA. 1,00 5.00 EA. 1.00 2.00 09-09-1997/01:227 PM/$29,00 RCPT#:01-0012008 PERMIT: 084618 0 A ++ .CONSTRUCTION AND PLANNING ' 1_ APPROVALS Permit # `. Date - Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ` } 2, Soil Pipe-Undrgrnd. - _. -yf X53. Steel Reinforcement ;;• 3. Electrical Conduit Utility-Undrgrnd. n 54. Forms - - 4: Electrical Conduit-Undrgrnd. ''i 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test' - 6. Electrical UFER Grnd.- .` 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. "- a 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. _ 60. Backwash Lines, P -Trap, 0 Undrgrnd. ' 10. Structural Floor System ': 61. APPROVAL TO DECK - > ,- 11. Property Sewer Line & House Connection- ,'. `62: Backwash &Receptor -Final - r 12. Sewer Cap - 63. Heater & Vent -Final. - 13. Roof Drains 64. Plumbing System -,Final, . 14. Rough Plumbing (, -h '65. Electrical -Final 15. Rough Electrical -Conduit - =66 - Solar System -Final • . `,_` 16. Rough Electric Wiring ` 't 67,: Fencing:& Access Approval 17. Rough Wiring Sign r • 68. APPROVED FOR PLASTERING ` +'.•, 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning- FIRE 6EPT. REQUIREMENT APPROVALS Permit # t -J 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing - 73. Undergrnd. Stot age Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26, T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 26. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY- FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31, Plaster Brown Coat -' 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD., ERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36v Ado Canopy 37. Final Factory Fireplace '-t. 38. Final Plumbing ' 39. Water Service -Final 40. Gas Service -Final f 41. Solar Domestic -Final t 42. Backflow Preventer - --43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations , 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date - (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: -2200 HARBOR BL Suite No Vicinity: Parcel Nunmber: 41903107 Applicant: AMBURGEY, ORV Address: Owner: Address CA ELECTRICAL PERMIT FAR -00630 PERMIT NUMBER 77 FAIR DRIVE, COSTA MESA, CA 92626 status: ISSUEDg6 . • Applied: 06/26/1998 ao Issued: 06/26/1998 Phone: 714-979-2311 ILY� L -Zip 92627 ELECTRIC �\ uC 4� "SCOPE OF PERMIT rty �� ; }/ �''� t N, I FIREWORKS:STAND.� _�'] VA,�,�• i, FEESUMMARY�,,oJ j� J .A� iA�, _'_ _, r , Quantity = - - - � � _...:- � Quantity ISSUE FEE )�'I��1 I $22.00 \ Temp Dist System /.Lighting $0.00 0, Temp service test I = $0.00 ^^ Busway /100 it $0.00 0 Rest a/c package ti `? � $0.00 iz `�. _ `: ' Standing Section `'�� r,' $0.00 00. ' % � ♦ i! New Res (1'-2 units) t•,i $0.00 L,:aO - - -- -rr--Mise Electrical- Equipment ') $0.00 0 ` New Re'st(3+units) �1�, $0.00 �� 0-'- "'-"` _-- Transformers up�to 1 kva/kw I $0.00 1) �� � - � V Pool %Spa, �� �\.,t\ $0.00 0 ................up to�10 kva/kw $0.00 0 =�=f j Li htin F.1 1 J $0.00 0 ............T u to 50 kva/kw i''� $0.00 0, 9 9 .. ��\ �_ P i f Ir, rA Recepl Outlets C, ��\�l $0.00 (l 0 ...............-up to.100 kva/kw : $0.00 /0,,' Switches,' ���. $0.00 0 - ..................over 100 kva/kw $0.00 r' 0", Non Res Appl\ 1✓r; \$0.00 0 i Low,Voltage Equipment1$0.00� �0 Res Appl \'> > % $0.00 0 j I Low Volt Wmng System / Ckt $0 OO,q� 0 t ! Service to 200a?� $000 i 0 (-' ,t� \\\Misc.Condwt4 $0.00;1 0_! Service to 1000a i ` .Z $0.00 �i� 0 �r rf Misc. Conduct& /$0:00 0, �' f/• \ r X17 t�.� - fY='� Service over 100\a� - j $0 00\\0' { ' G `} C rc s (meth �iiie or ghts): $0 OQ.�) 0 Motors to 1 hp Motors to 10hp ` r��$0.00 0�'� Christmas Tree Stand '// $0:00 0 Motors to 50hp �- $0.00�0\��6 5 "Fireworks Stand $11:00 1,��`� Motors to 100hp $0.00J ,Oth'-e-r- E--lec V_ica.tFde C�$`0:000 - Motors over 100hp 0 Sub paneCommunication toO i200a PS $0.00 $0;00; C Investigation� 'Plan-Che$0.00- k Fee -1 ` `' ` V Aol:00� Pole Light Pkg$0.00:- -_ 0 _ - i Reinspection Fee -,-$0.00 Sign Circuits $0.00 0.- Temp Pwr Pole $0.00 - 0.; !:rr.re„-, ,TOTAL CALCULATED,FEES $33.00 Intermed Pole $0.00 0 - - - COMMENTS / SPECIAL CONDITIONS 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 period of 180 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 required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5525 I DECLARATIONS WORKERS' COMPENSATION DECLARATION: 1 hereby affirm under penalty of perjury one of the following declarations:. ❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance o1 the work for which this permit Is issued. 1 have and w10 maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My r ' co ansa on 1-1% works 1ce came and policy number are: Cartier. 1�1 Policy Number: / (This section need not be completed if the pe it is valued atone hundred dollars ($100) or less.)' ❑ 1 certify that in the perfornance of a work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws fomie 0 gree th I should become sub' t to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these v I s. Applicant Signature: c Date: WARNING: FAILURE TO S RE WORKERS' OOMPENCOVE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED SA THOUSAND DOLLARE($100,ODo), IN ADDITION TO THE OF comPOIISAnoN, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provision of C ter 9 cing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Lic. # Class # Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as Owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year Of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, I.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work allthohZed by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code 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 reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................................................................................................................................................................................................................ ... ..................................... ... ... ...... 2 Does or will the applicant or present or future building Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ............................................................................................................................r'e.p........................................................................ -.-.................................................. -..................... 3 Does or will the applicant or present or future building occupant neetl to prepare an RMPP (Risk Management end Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .................................................................................................................................................................................................................................................................................... 4 If an RMPP Is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ..................................................................................................... u.p.a.................fo'r.................................................f.1'h.'s........................................... ........................................ il'on.. 5 Does or will the applicant or present or future building occupant require far the work which is the subject c this a plication apemtit far such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 65850.2 of the Califomla Government Code requires that the requested information be furnished on applications for non-residential building permits). ................. ... ........................................ ........................................................................................................................................................................................................................ 6 WII any par o1 the faGliry to be constructed under this permit be within 1000 feet from the outer bounded" of a school? ❑ Yes ❑ No (if 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................................................................................................................................................................................................................................................................................... 7 If appeemlit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................... B (It yes", affach certificate of compliance tram the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and stale that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signa ure Of ner(s)^2 '�f�a's !WAnd/Or uth 'zed Applicant (• ((Date j=LL INSPECTION TYPE DALE ItL1mAl5 CODE# INSPECTIONWPE Deg Id11llA� 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ' 200 Final Re-Root 210 Final Electrical 201 Final BlocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Buliding/Occupancy - 2446.46 C._ Y OF COSTA MESA CALIFORNIA 92626 P.O. BOX 1200 FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY December 21, 1977 Mr. Barry D. McClean 3855 South Main Street Santa Ana, California RE: Pool Construction at 1087 Glen Circle, Costa Mesa Dear Mr. McClean: This is to notify your poo company that the construction of the pool at the above address m st stop until adequate permits has been taken out including a business license. The permits are in Finance Department awaiting Business License application completion; therefore, no permits have been processed. Immediate attention is warranted before further action is taken. Please contact us if any questions remain. Thank You, WILLIAM B. KUMER Assistant Building Director WBK/ajr Certified Mail cc: Harry M. Knotts Zuma Constructors 1835 Whittier Ave., IIF -3 Costa Mesa, CA 92627 L TRACT NO. IAT NO. OF COSTA MESA REQUEST FOR OC. ANCY DATE The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that (h she they) was or were) .G(�ie advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were imposed by the City at the time the final tract map was .approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason o.f the aforementioned uncompleted condition. RECEIVED CRY Of COSTA MESA PLANNfN„ DR -r MG 2 9 ]9)7 71819110111112111-2i3i4j 6 tfrc ser / �. Developer and/or—authorize BY � }� �p`q I! �` ,(� !4f /j 2�W �� $V41 (�ila�YWa YLilalp®:ll:Cltanes UI G7oNC fVi ellrlfUS,zla' J,7C, Vi PO. BOX 41 3310 AIRPORT WAY LONG BEACH. CALIF. 90801 17171 4263355 . (2111636-2186 714I B786431 e.nNcr orricn: TESTING n�..n ND„s N.,,., s.,... � Nc, o.✓,..,... r.,,.y P�•1 ui-vas � d lo., w.<F cda, .olol Rnl ele nae - December 13, 1977 [[AMINATION: 77--7126 GUNITB COMPRESSION TESTS ON)VbhXXXK%E CYLINDERS Bob Henderson 17817 San Rafael ,%u,,Laiu—valley, caii YoTnia 90708 r SWIMMING POOI. PROJECT ADDRESS 1087 Glen Circle, Costa Mesa, California SAMPLE FROM 1-2-3 from Spa 4-5-6 shallow end off beam ARCNIT[CT ON.,.... J. W. Regan MIX DATE CAST DATE TESTED CYLINDER NO. COMPRESSION .. TOTAL LOAD. LOS. I'. POUNDS PER SO. IN. ,II , COMPLIANCE (a. CYLINDERS CONTRACTOR Barry D. Mclean SUBCONTRACTOR J 6 J Gunite SPECIFIED 4.0 per ton STRENGTH 12/6/77 SLUMP 12/13/77 12/13/77 2 4 7 days 7 days 142,000 110,000 5,025 3,890 7 day average: 4,458 7 day tests comply with specifications. ., BNTRIBp TIBN:. Bob Henderson - 2 Costa Mesa Bldg. Dept. 2,000 oauvaRaB Br Rccaivco oN Henderson 12/7/77 ,II , (a. . ' .o ..., ..., . a.. a. . . M O T,,.I. .. oT. <Twc To cuc..T.. —.—..o oo....—S. Laboratories of sOU0MTn eafifax2;.F I.O. BOX 41 . 3310 AIRPORT WAY . LONG BEACH. CALIF. 90801 . 12131 4263355 . 1213) 6363386 . 17141 828.6A32 {RANCH OFFICES: IH40 NMF M.ryr SNwr Nw D..O.[rb. I.[tp L.N Aw. GEIW.:. tt10) ONE "SS R.d.16. AT... IO. BSI L1 171.1 ULRNS lap A.d. GLI. pDR01 II UI OHbR December 13, 1977 BIIAM IMAT,ON: 77-7126 GUNITEY COMPRESSION TESTS ON)VURN YE CYLINDERS Bob Henderson 17817 San Rafael Fountain Valley, California 90708 PROJECT SWIF2-11iftG FOOL ADDRESS 1087 Glen Circle, Costa Mesa, California SAMPLE FROM 1-2-3 from Spa 4-5-6 shallow end off beam ARCNITBCT CONTRACTOR Barry D. Mclean BNOINRBR SUBCONTRACTOR J. W. Regan J b J Gunite SPECIFIED MI)( 4.0 per ton STRENGTH 2,000 DATE CAST 12/6/77 SLUMP DATE TESTED 12/13/77 12/13/77 CYLINDER NO. 2 4 COMPRESSION 7 days 7 days TOTAL LOAD, LBS. 142,000 110,000 POUNDS PER SO. IN. 5,025 3,890 7 day average: 4,458 COMPLIANCE 7 day tests comply with specifications. y MAOK BY OBUVKRKD BY 5 CYLINDERS Allen Henderson DISTRIBUTION: Bob Henderson - 2 Costa Mesa Bldg. Dept, dji'i'jQryE RIECE1VEO ON 12/7/77 ALL be•obT• .1. • MITTED .. I.S eoHaORHTUL IRO•RRTY OR CLIRNTS. . .OR r SIIIAII..4.rOUw REP MC�LO.I.OM YI /O - T4ACT% IM OM ON NECANOINO TRAM 16 R SMOVRD •.NOINO OUR WRITTEN APPROVAL AS A MUTUAL PROTECTION TO CLI.NT., THC IY Y LIC .Mb oUwS.LVLS. CITY OF COSTA MESA BUILDING SAFETY DEPARTMENT Registered Deputy Building Inspector — Certificate of Compliance Date of this Certificate 1Z -E " 77 Building Add Owner Contractor Permit No. •7U t'�; cV - Date Issued To the Director of Building Safety: I hereby certify that the following portions'of work on the buildings at the above address which required continuous inspection and which I was employed to inspect, were inspected by me and comply with the provi- sions of the Building Code applicable thereto. [ ] Concrete [ ] Masonry [ ] Welding [ ] Reinforced Gypsum [ ] Special Cases i Swimming Pool Size .3 06n [ unite ( ] Hand Pack Sacks of Cement I -le, Tons of Sand t3 •5' Approximate percent of water in aggregate This report covers work completed during week ending REMARKS: 11 Registered Deputy Building Inspector >11 :2zZ--'� Name Address 24r 7 z' �r � Laboratory Telephone--,-�.j 5 3 FU CMF 0406-46 (BU 6) OWNER R & W Development DATE 12-7-76 JOB ADDRESS 1087 Glen Circle BUILDING PERMIT NO. 427' 'ID• .115-661-29 LOT 15 TRACT 9105 FIRE ZONE VALUE $ 43.6 sono XTIONS Si nature DateTYPE V GROUP I & J ZONE R2 -CP s`- 2'1 SUBCONTRACTOR Date ISS Number Si, i nature GAS % WATER 20-749 Plumbin ROUGH PLU GING' • [• 1i%. iGo 7dg) PROP. SWR. LINE Q HOUSE CON. h SPRINKLING SYSTEM A1fmC't'R11f'_005 %i ROUGH HEATING A D AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND POWER E3 ROUGH WIRING TRENCHES FORMS STEEL REIN F. L Heeti ant. FLOOR SYSTEM C BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING d LATHING IN OUT — PLASTER, BROWN COAT 7TURAL, FINAL I NG, VENT., REFRIG. AND A.C., FINAL L PLUMBING, FINAL AND GAS TEST 71V T J 45 ELECTRIC, FINAL BUILDING, FINAL 51 n 4/Q76-77 o6r . COSTA MESA BUILDIN -SAF TY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Cylmpletely — Use Ink Only BUILDING/O1.4 ADDRESS / CITU OWNER LIC. NO. MAIL ADDRESS BUILDING ADDRESS CITY TEL. NO. CONSTRUCTION LENDER NOW ON LOT BRANCH OWNERioili ADDRESS FIRE ZONE TYPE GROUP ARCHITECT OR ENGINEER TEL. NO. ADDRESS NO.OF PLANS CONTRACTOR A ADDRESS (FROM C/L STREET) RONT FT. CITY TEL. NO. STATE CITU LIC. NO. LIC. NO. SIZE BUILDING ADDRESS NO. OF BLOCS. OF LOT NOW ON LOT USE OF OWNERioili EXISTING BLDG. FIRE ZONE TYPE GROUP Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. Signature of Permittee Authorized Agent APPLICATION FOR STRUCTURAL PERMIT RECEIVED BV I DATE RSCEIVED VAR.* A.P. NO. C.U.P.* BUILDING ADDRESS TRACT�01 OWNERioili EfSE FIRE ZONE TYPE GROUP APPROVED BY DATE ZONE NO.OF PLANS USE OF NEW BUILDING YARDS APPROVED MAIN BUILDING YARDS APPROVED ACCESSORY BUILDING (FROM C/L STREET) RONT FT. FT. R. SIDE FT FT L. SIDE FT. FT. DISTANCE BET. MAIN BLDGS. BET. MAIN ACCESS. BL VAR.* DATE C.U.P.* APPROVED APPROVED THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERM. FEE ONLY: VALUATION PERMIT FEE $ s PLAN CHECK E $ /(/ TAX $ / TOTALPAID E s J IT NO. _46182 'AP Na. 422-031-46 LOT 19 TRACT ging FIRE ZONE - VALUE$ 7,000.UU _ Main Drain Steel Reinforce Elec. Bond Approval to Cover Underground Electric Gas Piping Test Filtering System Lines _ Backwash Lines and Recap. Electrical Final Heater and Vent Final Filter System Final wash and Recep. Final Fencing Final Approval for Finish SUBCONTRACTOR Electric /)-- Dryl !CT _2 1 Plumbing -h_.. D1:01. I C [ I`l - W r✓ 40182 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Coo,m/pletelwy ,— Use /Ink �Only BUILDING ADDRESS /D// / V�E<I!/GC-LG r2761'6%�78 APPLICATION FOR STRUCTURAL PERMIT OWNER Ni« or_V ts.r.ry __ MAIL ADDRESS BUILDING I ADDRESS TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEW ADD ALTER FREPAIR LENDER BRANCH OWNER ADDRESS VALUE ARCHITECT TEL. USE $ OR ENGINEER NO. FIRE Tt ADDRESS ZONE TYPE GROUP -APPROVED CONTRACTOR Q -f1--' By DATE IV ADDRES 7 / `pZONE CITY NO. NO`�ya /�� NO.OF PLAPS USE OF N BUILDING21 STATE G CITY LIC. NO. 3��j a �Q LIC. NO. ARDS APPROVED MAIN BUILDING YARDS APPROVED CCESSORV BUILDING W SIZE NO. OF BLDGS. (FROM C/L S EET) 0. OF LOT NOW ON LOT FRONT FffT. T. a .�.� USE OF EXISTING BLDG. r if I T. FT. w FSeparate permits are required for electric, plumbing and heating work. r ry L. SIDE FT-(lFT:' REAR /FT C/ FT. W F QMAIN USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE 4ET. BLDGS. BET. MAIN & ACCESS. SLOGS. ar VAR. * C.U.P.4s DATE APPROVED a 7 APPROV r a Ix w 0 6: 6 1 hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and I shall not employ N � Z Zthe 3 any person in violation of the workman's compensation laws of State of California. 1 hereby certify that I am properly licensed as a contractor under the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are In full force and effect, or I m m N m — SQ. FT. THE AMOUNT SHOWN UNDER VAL THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. Signature of .p - D Permittee /X /-At -L(i �% „� y J� o u. VALUATION 9 $7400, 7400 PERMIT FEE $ 1640,00 PLAN CHECK $ 20r ad TAX $ �O Authorized Agent U TOTAL PAID $ /00.6,01 9105 : 15.27�. :. f 1717 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O.BOX1200 COSTA MESA, CALIFORNIA 92626 F. CA 'IF4' �', f�•�Zri-'�,O17n 11#1 i4" v"n: �h i-�7'7.'vi i�J For Applicant to Fill in Completely — Use Ink Only UCATION FOR STRUCTURAL PERMIT I V BV t 3 TE RECEIVJGROUPT- �BUILDING ` p ADDRESS (OS Lew GR' R & W Development A.P. NO.MAIL .OWNER ADDRESS 188 E. 17th St. BUILDING ADDRESS (o &.CITY Costa Mesa, Ca. No!642-4210 TRACTL740: LLOODER�Otal• Fed. Savings & Loan AD BRANCH 5670 Wilshire,Blvd. OWNER�E ,ADDRESS LOS An ales Ca. 90036 USE 143A ARCHITECT DMA Assoc. TE L731-216t�qrrAVALOR ENGINEER1 FIREADDRESS17621 zoNE TVP Irvine B1vd,Tustin,Ca. J. Ra COnstructlonCO. CONTRACTOR Y CONTRACTOR APPROVEDU)SaL BV DATE ADDRESS188 E. 17th St. CITY Costa Mesa, Ca. rO. TEL642-421 E �� NO.OF PLAP6 Z USE OF N W BUILDINSTAG LIC. NO. 126426 LICVARDS NO. CITAPPROVED BUILDING ACCESSORY BUILDING SIZE OF LOT36 X 103 I NO. OF BLOGS. NOW ON LOT O (FROMC/LSSFEET) NT 5 FT. FT. USE OF EXISTING BLDG. O R. SIDE FT, FT Separate permits are required for electric, plumbing and heating work. L SIDE FT. FT. REAR Z FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. MAIN BLOCS. BET. MAIN & ACCESS. BLOCS. ;,..yin, "'-`-.-_)Sin le FamilyDwellin VAR. sW �J G'�? C.U.P.6/s (O^ DATE /' APPROVED Lei w/ Attached Double Garage APPROVED nATP VOR r/� ��)) HOLD t"V'I`� ryry pp++,2'' ii_rr�1 �� Sa�".GUI7i4F�1::.t.l. eby acknowledge that 1 have read this application and state the above information Is correct and agree to comply with ws regulating building construction, and I shall not employ erson in violation of the workman's compensation laws of tets of California. by certify that I em properly licensed as a contractor under tate of California Business and Professions Code, Division 3, ter 9, antl that suc licensee are In full force and effect, or 1 empt from t p vJelons of the State)) California Business rofessions C de Itlon 3, Che ter�9' ture of ( ittee rAuthorfiie'd —' SO. FT. 4400 THE A OUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: VALUATION ('�/ $ % �/� PERMIT FEE E PLAN CHECK E TAX E 3,06 r zed Agent TOTAL PAID E