HomeMy WebLinkAbout3107 GINGER AVE - Building PermitsJob Addresg:
Suite Np
Vicinity:
Parcel Nunmber:
Applicant:
Address:
Owner:
Address
3�07 GINGERAV
SIDE YARD
13956308
DECKER,KENNETH
1551 BAKER ST
APT A
COSTA MESA, CA
CARROLL, WILLIAM J
2785 BUNTING CIR
�COSTA MESA, CA
Phone: 714-269-2845
Zip 92626
Phone: 714-549-3285
Zip: 92626-4744
status: I SS U ED
Applied: 01252007
Issued: 01252007
ISSUED Y:
\
Contredar. OWNER-BUILDER ���� �,� � � Y W�
Address'. � � ��
Phone:
" Zip: (((+++��,
. , License:00000 , � �(] �"'
.,� �
� SCOPE OF PERMIT
. ELECTRICAL PERNIIT TO LEGALIZE AND EXISTING ABOVE GROUND SPA FOR AN APARTMENT
- COMPLEX, LOCATED AT THE FRONT SIDE YARD.
FEESUMMARY
. i " Quantlty�• , � � " - - -' • - Quantity
ISSUE FEE $23.50 -. � . ' Temp Dist System'/ Lighting $0.00 0
Temp service test $0.00 Busway M00 ft $0.00 0
Res. a/c package $0.00 , Slanding Seclion $0.00 0
New Res (1-2 units) $0.00 0.. Misc Electrical Equipment $0.00 0
New Res (3+units) $0.00 � � 0 - .> Transformers up to 1�kva/kw $0.00 0
Pool / Spa $0.00 . 0 � - . . . .............:..up to'10 kva/kw $0.00 0 �
Lighling Fi#s � ` ' � $0.00 '" �0 � ` � .................up �0 50 kva/kw $0.00 0 r
Recept Outlets $0.00 0 ..............:i.up to 100 kva/kw $0.00 0
Switches $0.00 0 ..........:.....:.over 100 kva/kw $0.00 0.�
Non Res Appl , � $0.00 0 Low Vollaga Equipment $0.00 0
Res Appl , $0.00 0 Low Vol� Wiring System / Ckt $0.00 0 ,
Service to 200a . $0.00 0 - � � =Misa Conduit $7820 � " 1
Service to t000a ; $0.00 0 . � Misc. Conductor $78.20 � t
Service over 1000a ��� �$0.00 0 -' � Circus ( gen or ride) $0.00 0
Motors to 1 hp � ��$4]5 . 1� �� Circus (mech ride or lights) $0.00 0
Motors to 10hp. � $0.00, �- 0 Christmas Tree Stand $0.00 0
Motors l0 50hp � �. 50.00: - 0 - Fireworks Stand $0.00 0
Motors to 100hp � g0.00 �� , 0� Other Electrical Fee $0.00 .
Motors over 100hp . �. � ' 30.00 � ; -.0- . , � � � - � . � .
Communication drops , $0.00 � _ 0 - � Investigalion Fee " $0.00 ,
Sub panel to 200a � $0.00 0 � �Plan Check Fee 50.00
Pole Light Pkg . .$0.00 " 0' Reinspection Fee , $0.00
Sign Circuits � � $0.00 � . . 0 . -
Temp Avr Pole � $0.00- ' 0 . , � � TOTAL CALCULATED FEES §64.65 , - -
Intermed Pole $0.00� �0 '
` COMMENTS / SPECIAL CONDITIONS
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: Thi& permit shall automatically expire and become void ii work is not commenced within 780 days, or il work is suspended or abandoned
for a period of 180 tlays.
INSPECTIONS: In order for the work authonzed under ihis permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlone and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaas�se (sroo)
WORKERS'COMPENSAnONDECLARAnON:
I here6y aHirm untler penalty di perjury one ot the following tleclarations:
❑ I have antl will maintain a�nificate of consent to sel4lnsure br workers' compensation, es provided for by section 3700 of the Labor Cotle, for Ihe pedortnance of the
work tor which thi5 permil is issuetl.
❑ 1 have and will main[ain Workers' oompensation insurance, as requiretl by section 3700 of t�e Labor Cotle, lor ihe pertortnance of Ihe work for which this permit is issuetl.
My workers' compensalion Insurance carner and policy number ere:
Carrier: Po�icy Number:
(Triis section need no( be comp�etetl it fhe permif Is valuetl af one hundred dollars ($100) or less.)
I certity that in the peAorRiance ot t�e work br which Ihis permit Is issued, I shallgpt.employ any person in eny manner so as to become suDject to ihe workers'
compensation laws W C9litomia, antl agre t et it I shoultl become su6 QtF wolners' compensation provislons ot SecCion 3700 0l the Wbor Code, 1 shall lorthwith
comply with thesa provisians. //
anbSignature:. v � Date: "^ O� — L,S —U �
ING:�FAICUR O SECURE WOPo( COMPENSATION COVEPAGE IS UNLAWFUL AND SHALL SUflIECT AN EMP�VEP i0 CRIMINAL PENALTIES RND CIVIL FlNES UP TOONE HUNDFED
irW D OOILARE (5100,000�, IN NDDRION TO THE WST OF COMPENSATION, DAMAGES AS PROVIDED FOP IN SECTIQV 3]O6 OF THE LABOq COOE, IMEREST, AND ATTORNEY'S FEES.
� LICENSED CONTRACTORS PECLARA710N:
I hereby effirm ihat I am licensetl untler provisions of Chepter 9(commencing with Section 7000) of Division 3 of the Business and Prolessions Code, and my license is in full
larce entl eflect. Lic. N Cless a
Contrector's Signature: Date:
CONSTRUCTION LENDING AGENCV:
❑ I hereby attirm Uat there is a construc�ion lending egency for the peAormaoce of the woAc tor which this permil is issuetl. (Sec.3�97, Civil Gotle).
Lentlels Neme: LendaYs Adtlress:
Signature: Date:
OWNER-BUILDER DECLARAnONS:
I hereby attirm that under pena�ry oi perjury Ihet I em EXEMP7 FROM TME CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business and Protessions
Cotle: Any ciry or wunry whicF requires a permit lo consiruct, alter, improve, demolish, or repair any strudura, prior to its issuance, also requires lhe applicant for such pertnit
b tile a signed stetement thei �e or she is licensed pursuant to the pmvisions ot the Contractors License Law (Chapter 9(commencing with Section 7000) ot Division 3 oi the
Business end Profassions Code) or that he or she is exempt Iherelrom and the basis for Ihe alleged axemption. Any violation oi Section 7037.5 by any ap0�icant for e pertnit
sublects the applicant to a civil penalry of not more than tive hundred dollars (5500).):
❑ I, as owner ot Ihe property. or my employees with wages es their sole compensation, WILL DO THE WORK, and ihe siructure is not inrended or oHered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law dces noi apply to an owner of propeny who builds or improves Ihereon, and who dces such work
himseH or herself or throtlgh his or her own employees, providetl Nat such impmvements are not intentletl or oHered for sale. If, however, the building or improvement is
sold within one year of cOmpletion, the owner-6uiltler will have ihe burden of proving ihat he or she did not builtl or improve for purpose of sale.).
❑ 1, as owner ot the pcoperry• am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC7�RS to constmct the projecl (Sec. 7�44, Business and Professions
Cotle: The coniractors Licensa Law does not apply to an owner of property who Duilds or impmves thereon, and who coniracts for such prolect wit� a contracror(s)
license pursuanl to ihe Con�rec�ors License taws.).
❑ I em exemp� under sec.
Signature:
Owner ID verilied by drivers IiGense. ❑ Ves ❑ No
eusiness entl Professions Code for this reason:
Varification oi Ownership by (type o/ tlocumem, i.e. - pmperty tez bill or tlaetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
Driver's Litense No.
Date:
Expires:
❑ I hereby cenity Ihat no eX�evation five (5) or more feet in depth into which a person is requireE to descend, will be made in connection with work authonzed by Ihis
pertnit, and that no building structure, scafloltling, lelsework, or demolition or tlismantling ihereol, will 6e more ihan thirty-six (36) feet hiqh. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomia Administretive Code).
❑ As owner-builder, I will not employ anyone to do work which would reQuire e permit fmm the Division of Industrial Sefety, as noted above, unless such person hes a
permit to tlo suc� work trom Ne 6lvision.
Signawre: Dale:
Division ol Industrial Safery Pef�nit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I cenity under penalty of perjury that I have reatl Mis applicalion and state ihet �he informatlon given is
correct. I agree m comply with sll state laws and ciry ordinances relating to building consiruction, and eWhorize representatives ol the Ciry ol Costa Mesa to enter upon tha
ebove-described properry for inspection purposes. I agree not to occupy or allow occupancy of eny building authorized by �his permit umil tinal inspeciion.
CODE�. INSVECTIONTYPE �
1616 Fixed System Flnat Fifa Prevention
1266 Pool Spe Final
200 Final Re-Roof
PdIE IMmnLS
CODE 1 INSPECTION iYPE
2�6 Final Mnchanical
208 Final Plumbing
2/0 Finel ElectriGal
201 Final BIocWRetaining W ell 212 Flnel Pire Prevention
, ..v.�.�y.�_ ii.. � .. r'v "" ' �'�. •••�• �u ....� -�r �.o'�u.i: �...i r�� .•. .:�� . y �.i; .-��;' lL LIL\.I l'1I111C T'UW :1'll i�.l I�JL`IU Ill GYIIiIIJJYGV!�
. . .. � ... .. . . _
202 y�.,�Final Fectory.Fire'�:PIaGe,�il ry� � �p�, r;�. �-..-. -�� ��-, pp. -.'.�-_' _��, �;, �:,. ,22Q�':, Final Planning Approval.n.•Olacq lanl` `..' "-'""- `
_ �,..,.... _ _..____.,30� -"' ,-_'
203 Fin21 Sign 222 Final Site 3S�d-i�2C (di i} ..,.w„ o,,.,� �,�3� u��� nv-i
� . . ,
3 j d � �/`1G��- '�''�
��.5�� ��s� �
�Z6z�
18.5' 9.0' 18.5'
STOR-
0 2 CAR AGE 2 CAR -=:
GARAGE GARAGE
in WASHER 46.0'
n DRYER
�0.�� _� ....- ..:.._" " ,
in
.. . . n, tn ..
N -
�,ppROVED
CITY OF COSTA MESA
PLANNING DIVISION
SUBJECTTO BLDG. DEPT. REG.
NOTE: APDITIONS, DELETIONS, UNIT A;
OR CORRECTIONS SHALI. I�G "'
APPROVED BY THE PLANNING lll .
/A /1 iL�'/, ' � C ,-, n-rr.. � I %.Y Q
_ �
� �/ �' � / 1 •,//
.. _N 8.5' �
- I. �
o �
�
.d 1•
ENTRY "1
5.5'
- ` �
0' 13.0' ` 8.5'
. .. .. _. .. : 4 _
�
�xISTI� S��E��"LlL �,
l�
DECLARATION OF AUTHORITY
FOR AGENTS OF PROPERTY OWNER
TO APPLY FOR PERMITS
Bldg. Permit #
This Permit #
StreetAddress: �.J/v � //��/lU/�— �7�'�'/u��� APNumber.
1. I(we), ��//��fl� �J � ///¢i�-%l� // , deciare that I am the Owner of Title of the above
referenced real property, and that I(we) hereby authorize:
5 // �, //� / �
Name: /� ��G^�/� Telephone NumbeK �/ `7/ �v � � �/ 1\�
l
Street Address: � J��� /�/��Y�— �l�Gy%l/c ��
Ciry. Ci"U � ///��'� State: Zip: __ %���
to obtain permits in my behalf, as owner/builder, for
at the above referenced property.
2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Worker's
Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa
Mesa, as required by State of California laws.
3. As owner/builder in fact, 1 understand and accept that my responsibilities do not transfer to any other person, company or
corporation.
4. I agree to indemnify and hold the Ciry of Costa Mesa and its employees or officers harmless from any claim resulting in damage or
personal injury to myself or any other paRies as a result of work authorized by the permits from the City of Costa Mesa.
5. I declare under the penalty of perjury that the foregoing is true and correct. .
Executed this /" NJ day of h Ari- 20 �, at cf �� �' 1� , California.
Print Name: �f�r'�� �f� �i l-% . � �/�%1'O� �
Signature:
Date: �,li��L�j �al, , G��Q%
Note: This author¢ation does not grant authorization to perfortn the work as ovmer,
it solely provides for limded power of attomey to secure this permit in any behal(.
0]99<6 (rev.t f/00)
JobAddress: 31Oi GINGERAV
Suite No
Vicinity: LAUNDRY ROOM
Parcel Nunmber: 13956308
Applicant ROBERT JONES
Address: P O BOX 7813
NEWPORT BEACH, CA
owner: CfiRROLL, WILLIAM J
Address , ,2785 BUNTING CIR , � .
. COSTA MESA, CA . �
Convactor: ROBERT JONES
Address:- P O BOX 7813
NEWPORT BEACH, CA
' '
Phone: 949 642-3575.
Zip� 92660
Phone:
Zip: 92626-4744
Phone: 949 6423575
Zip: 92660
� �License: 600049
` SCOPE OF PERMIT
WATEfi HEATER CHANGE OUT (SAME LOCATION).
,aMr
ISSUE FEE - $23.50
Backflow irrigation $0.00
Backflow Preventer $0.00
BathWb $0.00
Clarifier System $0.00
Connect (Ice,Soda,etc) $0.00
Dental Units � $0.00
Dishwasher $0.00
Drain, Floor $0.00
Drain, Rainwater � $0.00
Drain, Roof $0.00
Drinking Fountain $0.00
ExpansionTank " .�$0.00
Gas Earthquake Valve 50.00
Gas (1-4 ouUels) � $0.00� �
Gas (Over 4 outlets) $0.00
Gas Repipe $0.00 '
Gas Service ' � $0.00
Interceptors (Giease, Oip , $0.00�
Inlerceptors (Sand Auto ) $0.00 �
.�
L �
0
0
0
0
0 .
0
0
0
0
0
0
0
0
0
0
0
0- <
p <
o ,.
FEE SUMMARY
- . AMT
LaundryTub/Washer - �$0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping (per 10 ft) $0.00
- Receptors - �$0,00,
�SepticTank- - $0.00
Sewer Cap for Demo $0.00
SewerConned 50.00
Sewer Private Line $0.00
Shower 50.00
Sink, bar - � $0.00
Sink, commercial 50.00
Sink, Floor "$0.00
Sink, kitchen $0.00
� Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
gN
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
Status: ISSUED
Applied: 01/78/2007
Issued: 01/18/2007
ISSUED BY:
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash 8asin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater / vent
Water Piping Qnst or RepJ
Water Re-pipe
Water Service
Water Softener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION -
TOTAL CALCULATED FEES:
AMT
50.00
50.00
50.00
$0.00
so.00
$0.00
$0.00
50.00
50.00
so.00
512.30
50.00
50.00
$0.00
50.00
$0.00
30.00
$0.00
50.00
535.80
QTY
0
0
0
0
0
0
0
0
0
0
t
0
0
0
0
0
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, 72-21-92)
EXPIRATION: This permit shall automatically ezpire and become void ii work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPEC710NS: In order for the Work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inapectlone and Iinal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaas�ac la'aoI
WORKERS'COMPENSAnON DECLARAnON:
I hereby affirm under penalry oi perjury one oi Ihe following declarations: '
❑ I have antl will maintain a cedificete al consent to self-Insure for workers' compensation, as pmvitletl for by section 3700 0l the Labor Coda, lor the peAormance of ihe
work tor which lhis partait is issusA.
❑ I hava and will maintain workers' compensation insurance, as required by section 3700 of Ihe LeDor Cotle, for Ihe peAormance of ihe work lor w�ich Ihis permit is issued.
My wo�ers' compensation Insurance carrier end policy number are:
Cerrier: Policy Numher:
(This secNon neetl nof be completed il the permi( is valued af one hundred dollars ($700) or IessJ
��I,certiry Ihat in ihe pertormance of the work lor which this pertnit is issued, I shall not employ eny person in any manner so es to become sublect to the workers'
��crompB�sellon lews of C ie, and eggg[[[ggge �hat II I shoultl become subject to t�e workers' compensation provisions ol Sectlon 3700 0l Ihe Labor Code, I shall lorihwi�h
rnmpty with Ihese prov' i . / 1 .� �
AP�enl Si9^eluie:'� � �� rnate."`�� ^ � `ry �
6�
`/�(ARNINO�'FAILURE TO SECURE WORK ' PENSATION COVEMGE IS UNL4WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FMES UP TOONE HUNpRED
TFqUSAND O���RE (5100,000), IN ADD�TION TO THE COST OF CAMPENSNTION, OAMAGES AS PROVIDED FOR IN SECTION 3]O60F THE LABOR COOE, IMEREST, AND ATTORNEV'$ FEES.
LICENSED CONTRACTORS DECLApATION:
I hereby aflirm Ihat I am licensed under provisions of Chepter 9(crommencing with Section 7000) ot Division 3 0� �siness aa6 Prolessiory5 Cotle, and my license is in full
force�erMeHact.-Lic..k � s.p ('— � lo �
'Cbntrac� Signature: � j �-- �ate:'—"�''_ � � 7 �
-r' 1 ��
F
CONSTRUCnON LEN�ING AGENCV:
❑ I hereby ettirm thAt there is a consfmction lending egency for the peAormance ol Ihe work for which this permit is issuetl. (Sec. 3097, Civil Code).
Lenders Nama: Lentlers Address:
Signature:
Date:
OWNER-BUILDER DECLARA710NS:
I here6y eNifm Ihat under penalty ot perjury Ihet 1 em EXEMPT FROM 7ME CONTRAC70RS LICENSE LAW for the following reeson (Sec. 7031.5, Business end Professions
Cotle: Any Ury er counry which requires a permit to construct, elter, improve, demolish, or repair eny sWCNre, pnor to its issuance, also requires the appliwnt for such permil
to tile e signetl statement that he or sha is licensed pursuent ro the provisions of the Contractors License Law (Chapter 9(commencing with SecOon 7000) of Division 3 of the
Business and Prolessions Cotla) o� lhat �e or she is ezempt therefrom antl the besis lor the ellegetl e:emption. Any violatian of Section 7031.5 Dy any appliwnt for a permit
subjects ihe ep0licant to a civil penalry of not more than five huntlred dollars (5500).J:
❑ I, as ownar ol the properry, or my employees with wages as their sole compensalion, WILL DO TME WORK, and ihe structure Is not intended or oHeretl lor sale (Sec.
7044, 9usiness and Professions Coda: The Conirac�ors License Law does not apply lo en owner of property who 6uilds or improves ihereon, and who does such work
himselt or herself or through his or her own employees, provitletl that such improvemeMs are not imentled or oHeretl tor sale. N, howaver, the boifding or improvement Is
sold wi�hin one year ot completioq the owner��uilder will have the burden of proving Ihat �e or she did not build or improve br purpose of sale.).
❑ I, as ownar of ihe property, am E%CWSIVELV CONTRACTING WITM LICENSED CONTRACTORS to constmct ihe projact (Sac. 7044, Business and Professlons
Cotle: The contracbrs License Law tloes noi epPly Io an ownar of property who builtls or Improves Iheraon, antl who toniracts lor suc� pmject with a contrector(s)
license pursuant to the Contractors License Lews.).
❑ I am eXempt under sec.
Signature:
Owner ID venfied by tlrivers license. ❑ Ye5 ❑ No
Business and Prolessions Code for this reason:
Vedticallon tlti �+'nership by (type oi document, i.e. � properry tax bill or tleatl):
DIVISION OF INDUSTHIAL SAFETV PERMIT CERTIFICATION:
Drivefs Ucense No.
Date:
Ezpires:
❑ I hereby certify �ha� no excavation five (5) or more leet in depth into which a person is requiretl �o descend, wili be mede in connection with work authorizetl by this
permii, end Ihai no Duilding simcture, scaHolding, falsework, or demolition or dismantling theraof, will be more t�an Ihiny-six (36) fae� high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ti��e e, Calibmia Administre�ive Code).
❑ As owPer-builder, I will not employ anyone to do work which would require a permit from the Division of Intlusirial Safery, as notetl above, unless such person hes a
parmit to do sucfi work from ihe division.
SignaNre: Date:
Division oi Industnal Safery Pertnit Num6er:
CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF EMRV: I certity untler penalty of perjury thai I have read this application end stare ihat the information given is
correct I egree to compty with all state laws end ciry ordinances relating to building construction, and euthorize representatives of the Ciry of Costa Mesa to enter upon the
above-descriPetl pmperry for inspection purposes. I egree noi to occupy or allow acupancy of any building amhonzed by ihis permit until tinel inspection.
Legal
COpEI, xSPECt10NTYPE QLiL � RL
1616 Fizetl System Final Fire Pre�ention
1266
200
pooi Spa Final
Final Fe-Roof
201 Final BIocWRetaining Well
2Q2 Final Factory Fire Place
203 Final Sign
20C Fina� Demolition
y00E� INSGECTIONTYFE
206 Final Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 FinalBuilding/Occupancy
D� INIITIALg
il
�
noonessoremiaxc: 31U7 GINGER AV
avxexsruweir�u�owr/: NELSON, ELMER
dDDAESS 3107—A GINGER
COSTA MESA,CA
(719)595-9177
�vv�. �u�n+o,�oo�ss:
IIMXRECT OP FlN�lFFN:
ARCH.OPEN0:5 �DDXE55:
92626
uc. ra.:
GoG-
uNr: A�$�C
UNT:
coxrn�crarsruue: SHARP ROOFING ( 714 ) 771-0118
CONfBACTOR5YNIING 20062 FRANK ST
,�oowEss ORANGE PARK ACRES CA uc.xo: 571575
92669 urn:
LICENSE� COMNACTOflS DECLhHATION: I MreW eflirm uMer penetly d perjury �he� I fcen pwiuma ol Cheqar 9
(oommeridrp wnh Seubn 1000) d Drvision 3 d Na &wmu eM Pmleaaions , enE I' ' 1 I face vk eHap.
cmuc.No.:048266 uc.cuss:C 39 u o 571` ; 02/98
o�<: y -1 S— �i � �em�a:
OW NER BUILOEX DECL�HATION: 1 hareby eifilm �Mm pane�y d Fuy ihet I am uemq Irom ihe Gon�repon Limrua Lew la ihe
��Ibwing reeeon (Setlim ]0315 Buamma end PMa�ione Code: My ciy a munry whidi reQuiiea e pe'mil io conahucl, eller, imqwa,
iemolah. or repeir eny ewciure, prior �o no asuenca, eHo reyuiree ihe epplirant fin euch permil lo fib e siB�� %�eman� ihel he a ehe
is IiceneeE W�suem lo �M povi5bm d �he Canlretlne Lioenie lew jCAeplx 9(commazidip wilh Setlun ]000) W Oirvsbn 3 d Iha
Businem arM Prdeaiona COCe� m thm ha or sha ia azemq thxehom end ihe b�e la Uw dleped awempion. My vidmion d Seaion
]031.5 by vry applicent for e permit subppa the epplicent lo e cnil perieMy d not mae than IHe hurkretl Edlers I5500�.
� I. aa owner d �M propeny a my empbyaea wih wepes av Ihx ede mmpanaetbn. vAll do iM xoA. eM iM siriMum e rw1 inteMed
or oXared M eale �Section ]00<, Buainess end Proleeaions Cade: The Conireqwa Licensa Lewdoea nm eppyto en ownerd pope'ly
wlw dWde « inprovea Ihereon, vM xM dme such wwk NmseM a henetl a Nraqh he a har own amployeee. prv+ided thm euch
impavemmta are not inleMed a Wered for ceb. X. Iawever, tM Euikirp a'vnpwemen� o eok wilhin aro yeer d mmpbton, tM
ownerWildar xill heva ihe buMen W qovin0 � or ahe dk nd Wik w improve Iw tha WR�e d sele�.
� I. a+ownr d �he V�WeM. em ssduwaA' oonlraavq wilh IicenaeE conVeMas lo m�MrW iM MqaN (Setlun )061. &ui`me erd
Pmfeaime Cada: TM Contrepon lsame Law tloes nd epply lo en owner d qoperlY'� �iNa a impwm �Mreon eM who
conlrecta (a vuW projees wnh e mMreeor(e) licenaed W�� to the Comreuws Limne lew).
� I em eaempt unEer Seciian: 8. 8 P.C., M Nn reeaon:
De�e: �
I do hereby canity the� I em ewere d ard uMerslarM iha repuiromenro d CelAoma Nml�h eM SeiMy Code Sedione T5505.255�, eM
zss.v. �,e inm i«em nn�re nu�umo «wo�� m�i i wm �a I�b �.1 �d m�dr wn.dd mme om.. e�d me �eauiremenu ror
epaminlwwnsvuaionwmodfie�ationhantMAY u3efily.T�epemenlDisind.RaskeMielwnatrutloneppieetimauemcamqhamtheae
prwisions.
oe�e: nvWKem.
WORKEP'S COMPENSATION OECLAN�TION: I heraby dfirtn uMx penehy d parjury ma ol iha IaOowiiq dedere�ima:
.� I heva vM witl meinlen e cenNieia d coneent lo aett-ineure for xoAere compeneetbn, m providetl lor by Seaion 3)0o d tha lebor
i Code, fa tM pe�lamierce N Ne wak far wNch �hu permn is iaueE. .
I�I nave end wil mantein vroekere mmpensetun insurerce. av reQuired by Setlim �10� d IM Lebor CoCe. br iM perlormenu d IM
wwk Iw whirh tha pertnil ie usued. My wvken eompereelion ineurenee e�artier aed poliry number ere:
c�a STATE FUND EXPIRES
. Poliry Number: ++ — O 1/ 01 / 9 9
Rnh ee�.viun need nor ae �onda.e � rne o�� Q ro, on. nwn,ad ddwels,aol a�.�
� I cenily ihm in Ne pa�lomance d Ihe xroik lor whch thie permil ie isau I ehell rat doy p eon in eny meniwr eo u lo
becama wbjetl lo �M1e v.vrkne' compe�ee�ion kwe d Celilwn" , �rea N i l ehoW be �me wbjeN lo IM xoNere'
C0111pBf19011q1 �IOVI9U19 OI SBGIM �JJCO W IM1B IAEM COEB. I 8� i Y�n �0 6 pN BI�
ova y—� S— 5� a��:
Wem/n0� F�llun ro swun woM1�n' compsrueHon roverep� li u�wlul, md sMll wb/�cf m xnployu roWMml p�nel0o �M
c/vll flnu ,p ro ms h,.ntlrM tMvuM oo/Nn (S/aO,GW), In /tlon ro M� cw! ol romp�nutbn, tlenxp� sa qoWds! br /n
3xHon 3]P6 0l tlis Labm COW, Intwu( enJ ettamsy i/wa.
CONSTNUCTION �ENDINO AGENC�: 1 hereby effirtn �Mx parelry d perjNry ihet iM�e u e mnmivaion brdieq epercy br ihe
paAormama d �M hoM1 la whidi �h'v permi is beuatl (�� �). Civ. GI.
LENDEN'S NM1E:
LENUEH'S AODFE55:
I eMiry thel I liew reed Nu epplira�ion eM sleta �Iw tM ebwa iniwme�ion ia wrtaq. I eprea Io eanply wrth dl ay eed oounry adinences
ends�eielewerebivqloWilErtqcnnsVudion MrebyeWwrrserepesemmrvesdthotl�yloenleruponiheaEme-memionedpopeny
�����s°���PurD�SJOHN S RZYNSKI
�"� —15f7�
Dma'
SiB�eWm of OwnetlApanVApplicenVContreda
(SiS�ie.WP) Whne-Build'vp 8 Safery: Grean-Fle; Cenery-Appira�t: Pink-Ra+anue; GOldenioC-Aasavor
CITY OF CUSTA MESA — BUILUING PERMIT
�IO —@ �O �
PERM NO: B 087738
PERMIT NO: B 087738 PLAN CHECK NO; N GOVT: N SOPP; N
CONSTRUCTION TY�E: V—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION ; T/OFF,RESHEATH W/1/2"OSB,REROOF GAF COMP SQ FT: 12,000
CLAIM VALUE: 12,000,00 CALC—VALIIE: 12,000.00 GROUP OCC: R-1 /
COMMENTS: APPLY NEW "TZMBERLINE" GAF COMPO OVER NEW 1/2"OSB BOARD SHEATHING
�****��e�� *�r� �**x � ***�r+��rt�r��r��*�*x ���****�**��r*x��*���**�r*�**�+��t� �x *��r�+�*�*#****�
Z O N I N G R E Q 0 I R E M E N T S
S E T B A C K S
------------ MAIN BIIZLDING ---------- --------- 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 REp� PROV: PARCEL: 13956308 ZNE: REF NO:
PLANNING NZ3TES>
i
fE 1E iE i! iE jf jE iE 1E �)i iE iE �E if iElElE 3f iE iE iF fE iE 1F if 1f iE iE if 1E iE iE �E iE iF 3E fE iF �E 1E �E if �E iE if jE iE 1f 3E iE �f 1k 3f iF fElE iElf iE iElE �f 1E �E �t iE �E if df jE �E 7E i'c iF 1E iF jf 1E jf
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 .
BUIL➢ING APPROVED HY ;
APPLZCATION ISSUED
iFifif �f iE if iE iE iFiEifiE ifif iE iE �f �f
LEGALIZATION:N
BLDG PMT
F E E S, U M Y�1 A R Y.
PLUMBING ELECTRIC MECHANIC FIRE
PERMIT 187.25 •
PLAN � -
ISSUE FEE � •
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 188.95 0,00 0.00
�r �
REVENUE DIVISION TOTALS--> COL�,ECTEb;
HLDG PMT PLUMBZNG ELECTRIC MECHANIC
187.25
DATE:
DATE:
DATE; � �<S �
iEiEiEiEikdEiffEdE �EiE
STRUCTURAL SEGMENT:Y
SMIP/RES GRADING
1.20
SMIP/NON—RES
TOTAL PAID DUE
188.45 188.45 ,00
188,45 OVER/SHORT: 00
r'IRE SMIP/TOT GRADING PLAN—CHECK
1.20
1E 3E if' �f iE iE iF �1F iE iE'IF fE iE'1E iE fE iE iE'1F iE # iF 3E iE'IE iE if 1E iE IE if 1E jE jk ii 1E'� iE if if iE iE'1E iE iE iE iF 1E iF if jE iE 9E �%fF if if iE 1f if iF �1F * if ii 3E df if iE jF iE iE iE 3f 1E'1E iE fE jE
I N D I V I D U A I; Y F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O,N UNIT COST TOTAL COST
SFR 12000 ALTER BY VALUE RES.IUENTIAL NOZONE 1.00 12,000,00
E1JD OF FEES
EXp D
UxTE 6 � 04-I5-1398/�3:0? Gfl/t168.45
.�
ncvrn:ai a2224A8
F'ERPIIT : �B773g
CONSTRUCTION AND PLANNING � P� �' SPA
APPROVALS Permit� � Date Inspector APPROVALS Permit;i` Da2e inspector
t. Temporarv Electricai Service or Pole 52. Pool & Equipment Location� ,
2. Soii Pipe�llndrgmd. 53. Steel Reinforcement �
3. Electrical Conduit Utilitv�-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgmd. - 55. Electricai Bonding � .
5. Steel Reinforcement 56. flough Plumbing & Pressure Test
6. Electricai UFER Gmd. � 57. APPROVAI TO COVER•GUMTE -
7. Footings - 58. Electrical ConduiFUndrgmd.
8, Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pip¢-Undrgmd. 60. Backwash Li�es, P�Trap,�t7 Undrgrnd.
10. Structural Fioo� System 61. APPROVAL TO DECK ,
i t. PropertY 5ewer Line & House Connection 62. Backwaah & Receptor-Pi�al �
12. Sewer Cap � • 63. Heater & Vent-Final -
13. floof Dreins + . - 64. Plumbing SYstem � Final
14. Rough Plumbing ( 65. Electrical-Final
r
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough HectricLViring 67. Fe�cing & Rccess ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling ' . 69. POOL/SPA SYSTEMS FINAL '
79. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Oucts, in 5tructure J0. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas PiRe-Fough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oii
25. Roof Sheathing 74, Overfiead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing ' 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEAA FINAL
29. tnsulation ' � 78. FIRE PREV. FINAL
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL WSPECTION
32. Electrical Power Meter-Final ,r 80. FOOD CEflTIFICATE ISSUED
9-16 -? S S af/� ,.
33. Final Eiectric � . Notes: ` �� � � ,�
34. Final Heating & Air Conditioning -� . /�� � � �
� 4�r/'
35. Final Gas P�Pe-Test . � �
36. Hood or Canopy �� �
37. Final Factory Fireplace � � '° �
38. Final Plumbing •
39. Water Service�Final �
40. Gas Service-Final �
' 41. Soiar pomesticFinal
42. Backflow Preventer '
43. Backfiow ��rigation _ �
44, l.andscape irrigation System
45. Sound Attenuation �
46. Handicap Regulations
47. FiNAL S7RUCTURE & BUILDING ^
48. FINALP4ANNING •-
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co '
51. CERTIFIGATE OF OCCUPANCY
No Date
.-�
AOV�icant to /ill in all spaces except those wit�in �eavy Do�tler lines antl sign all appropriate Eeclarations.
CITY oF COSTA nnESA CONSTRUCTION PERMIT
Project Pddress
}....--
ApplicanYs Mailing Address -
Owner's Name �-�� �e'✓'� Phone �2'A
Address �aiQ7��l���(j �S�
Arch/Eng. � Licenu No.
Address �j
ConVactor's Name A�Y� H'�l10lL�9J�/6es,G2 Phone�S'�/G/
Addresslmailingl ��,aia—��+`%ilc� Q' ����an.l�}
City License No. Z4 � 1
LICENSEp CONTRACTOR DECLARATION
I hereby aftiim Ihat I am licensetl untler provisions of CM1arter 9(commencing
with section �000) o� Division 3 of the Business antl Professions Cotle, and
my license is in f II force and ei ecl.
a
License Class License No.
Date � Si9nature -
WORKERS'COMPENSATION �ECLARATION
' hereby affirm that I have a certificate of conseni to self-insure or a certifiwte
Workers' Compensation Insurance, or a certiti2tl mpy the�eof (Section
d00, lab. C.)_ �� !'J /� y.w rN
Po' y No. � a Company �7 /t�� ��N�.
Certifietl copy I5 hereby (urnishetl.
CerYtietl copy is letly� ith the city Bui yin ivislon.
Date�p_!� �4� Applicant
EXEMPTION FROM WORKE(35' GOMPENSATION DECLARATION
(Tfiissection naed no[ be wmple[ed if Ne permit is far one huntlretl (5300
lesz). -
I certify thal in the performance of the work tor wnlch ihis oerm�t is issuetl, I
shall not emplOy any person in any manner so as to become SubjeGt to the
Workers' Compensation Laws of California.
, Date Signature
'NOTICE: If, atter making this declaration, you snoultl become subject to Yhe
Workers' Compensation provisions of tM1e Labor Cotle, you must forthwith
comply with such p�ovisions or Ihis permi[ shall be tleemetl �evoketl.
CONSTRUCTION.LENDING AGENCV
1 herety atiirm that there is a cons(ruction lentlin9 a9ency for the perPormance
of [he work tor which this Oermit is issuetl (Section 309] Civ. C.)
Lentler's Name
Lentler'S Atltlress
OWNERBUIL�ER �ECLARATION
I hereby af(irm that I am exempt from the Contractor's License Law tor the
following reason (Section ]031.5 Business antl Professional Cotle: Any city or
county wM1ich requires a permit to construct, alter, improve, tlemolish or repair
any st�ucture, prio� to its issuanc¢, alw requires the applicant for SUCh pe�mit
to file a signetl statement that he/she is licensetl pu�suant to the provisions of
the Contrac(or'S LitenSe Law (Chap[er 9(commencln9 with Section 7000) of
'livision 3 of lne Business antl Professions Code) o� that he/She is exempt
=refrom antl the basis for the alle9etl exemption. Any violation of Section
31.5 by any applicant tor a pe�mit subjects the applicant to a civil
enalty ot not more than five hundretl tlollars ($500�.
b I, as owner of the property or my employees with wages as their sole
mmpensation, will tlo the work, antl the structure is not intentletl or offeretl
for sale (Section ]044, Business antl Professional Cotle: The Contractor's
License Law tlo¢5 not applY to an owne� of a p�ope�ly who builtls or imProves
thereon, antl who tloes such wo�k himself/he�self or through his o� her own •
empioyees, provitletl that such improvements are not intentletl or offeretl to� '
sale. It, however, the builtling or improvement I5 soltl within on2 year of com-
pletioq the owner will' have the burtlen ot proving he/she ditl nol builtl or im-
�rove tor the purpose of sale).
I, as owner of the property, am exUusively <ontracting with IicenSetl con-
t�actorsio conitruct the project (Section ]044, Business antl Professians Cotle:
The Contractor's License Law does mt apply to an owne� of property who �
builtls or improves ihereon, antl who wnYratts for sucb project5 wlth a con-
Vactor(s} license pursuant to Ihe Cont�acto�'S License Law). 1 am aware that
proot ot their Worker's Compensation insurance shoultl be provitletl to me.
❑ 1 am ezemp[ untler Section B. & P. C. fo� thi5 reason
Date Owner
I hereby certiry tnat I have rea
information is correct. I a9ree to
antl state laws relatinq to builtlir
520IdiIV25 O} L�1�5 C��y IO COICf
inspection pu ose /
j� Si9nature ��
Drivers' License or SS � �
th
the above
ortlinances
�S— /938� I t�zc�c� I r 5 �
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG. I�C"�-'� ���'a'�"' �
TVPEOFPERMIT � GRAOING FOUN�ATION STRUCTURAL
❑ TENANT ❑ ELECTRICAI ❑ PLUMBING ❑ MECNANICAL '
❑ oTHER
PROJECT DESCRIPTION 5a. F7. occUaA�� �/�_�
CON STRUCTION TYPE VALUATION $ � .L �_
ZONE GRADINGCU.VDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irri9ation
Bathtubs
Clarifiers
�rinking Fountains
=loor Drains '
Floor Sinks
�as Service Outlets
Interceprors
Kitchen Sink
Lavatories '
P—Trap
Roof Drains
Reinspection Fee $15
Boiler
Duct- Under Ground
Duct - Structurel
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU 0100,0008T
Date �O^ Z'— � .
Reinspac[ion Fee $75
i�
CMF OB65-46, rev. 30/B4 White - Bulltling; Canary - Applicant; Pink - Accounting: Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/$pa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash �
Laundry Trays
Issue Fee
Hood or Typel O
Canopy Type I I ❑
Refrigeration Sys[em
❑0-100,OOOBTU ❑100,000
System Repair/Altera[ion
Fire Dampers
Registers ,
Issue Fee
FEES
$ 3
$ 3
A.P. # ���'J "
S Main Building:
TFront p�U �
6 Rear ��
A
C Right Q
S Left �(�'
Ping. Ref. #
PlanningNotes: ,J.,
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Oryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal '
Generator �0.5 KW C
Fee
4764 6/12/95
�
— Zone
Accessory Building:
Parking Req./Provided
ELECTRICAL .
Transformer�� 15-50,KW '
❑50+KW ,
Me[er ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors �0-7 HP �1'/:�- 8
Inc.Solar �9-15 HP �i6-75+
Microwave '
Pole Light
Range '
; Standing Sections
5 KW Trash Compactor
$15 Issue Fee
IleOu �TL
FEES
$ 3
Z
O
N
I
N
C�i
R
E
Q
M
T
S
DEVELOPMENT SER VICES REQUIREMENT^S:
Zoning Approved By '�✓� �� A-� Date i� �TC
Building Approved By � Date
Application Issued By �w �/a� Date
SU ARV OF FEES
BUI�DING PERMIT $ .00 SMIP $ ���a
PLAN CHECK $ •SD pERM1T
PLUMBING $ � ISSUANCE $ ,
PLAN CHECK '25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ /
MECHANICAL $ TOTAL FEE $ • �O
PLAN CHECK 25% $
r.
CONSTRUCTION AND PLANNING P�� 'PA '
AP.PROVALS Permit # aate I Inspector _ APPROVALS Permit # Date Inspector
1. `R"empora �y Electrical Service or Pole , 52. Pool & Equipment Location ,
2. Soil Pipe-Undrgrnd. ,' ' 53. Steel Reinforcement �
-3. �lectri:cal Conduit;Utility-Undrgrnd i � � 54. Forms � �
4. Electrical.Conduit�Und�grnd. - � 55. Electrical Bonding
�5. Steel Reinforcement �,' .. •�� � 56. Rough Plumbing & Pressure Test
� .
6. �EleFtrical UFER Grnii. • 57. APPROVAL TO COVER-GUNITE
i
� 7. Fodtidgs � ; i ' �3 , �S' 58. Elebtrical Conduit-Undrgmd.
8. �o4ndation ; � ' ; � 59. Gas Pipe, � Undrgmd., Test �'
9. VJat�er Pipe-Undrgr'nd. � � � 60. Backwash Lines, P-Trap, O Undrqrnd. �'
�
10. Str4cwral Floor System � . 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal
12. Sewer'Cap � � � 63. Heater & Vent-Final '
� .
13. Roof drafns � 64. Plumbing System - Final
i� i i
14. Rough Plumbing � � 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final '
�16.� Rough Elec[ric Wiring 67. Fencing & Access Approval
17.. Rough Wiring Sign 68. APPROVED FOR PLASTERING
78!Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19�: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20:� Rough Factory Fireplace APPROVALS Permit #
• 21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil
- 23. �Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank �Gas, OOiI
25. Roof Sheathing 74, Overhead Hydro
26. T-Bar �eiling (Structural) & Monocoat 75. Dry Chemical
27. Frame knd �Flashing 76. Dry Standpipe
28. Lathing &�Siding 77. FIXED SYSTEM FINAL
� �
� 29. Insulation 78. FIRE PREV. FINAL
i
30. Drywall Nailing '�- � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat'- 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing �
39. Water Service-Final !
40. Gas Service-Final ,
41. Solar pomestic-Final � .
42. Backflow Preventer � . �
43. Backflow Irrigation , '
44. .Landscape Irrigation System � �
45. Sound Attenuation �
46. Handicap Regulations i
47. FINALSTRUCTURE & BUILDING g' / 8� �,N-
48. Special Requirements Completed
49. Electrie Release to Edison I
. 50. Gas Release to Southern California Gas Co � � " .
51. CERTIFICATE OF OCCUPANCY ' �
:�
No. Date �
STRUCTURAL APPRQ`JAl O�NLY
SEPARA7E PERMITS AflE P.cQUIFElI
F�JR ELEi:TRICAL. PLUMBIN6.
HEG1Ti'�G. \%�N i I! AiihlG AM1JO
REiF!"uFA%T1Cu�1 t�'CP,Y
����-;; ���s. �-8_�iq3�6 a
!�
�_'_f �Fi�a�, �..1'i�lt.`.:,� . . .. . �.4i..r . .'�'� i
.�}�iak.._._"_.',- ,``_�Wr,.._._.__i
i �
L�
FOR Gi;lu;:;:;; , h�::: �'.RS�hc r.s� . t;;c
Ehif-LUYE4':rL i;d"urpS' :Ha( (HE : ;:t�-;i �JF
�Alf=Ofii�!;� ::jvf�iu;d ^% ;'�Ci;STHlat 51: ETY
BE CUf!S::�L�Eu r�9�:7 AuDITi019AL
�
4
W
W
R
►.
N
II[fIDEMC[
i � � '� `
1� r�:
i
Ci1y of Cos�u Mesa Buiidina Dept
THESE PLANS MUST BE ON J08 AT ALL TIMES
MAKE NO CtiANGES WITHQUT PRIOR APPROVAI'
C�F DEPf.
THE ISSUANCE Oft GRANTING OF A PERNJT OR APPRO4AL
CF PLAyS FND SPLCIRLFTfONS SHFLC NOi P£ CONSTROED
TO 6E A P[RN,I? fOR. OR FN F,PPROYAL 6F, kNY VIC:JifION
OF l,NY OF TNE PROVK'IO�S C�f THIS CJDE. P10 fERNt�' PRE•
$IX�71NG TO GlVE RUiHORITY 70 1401AT IXi CAyCEL THE
PROVtS70NS OF iHiS CODE °fWLL �BE"G�3.� ���`'T IN SO
fARASjHEYi0fi1(ORUSEM'HICH ILAUTHORI2ES7S-CA'NFUL
TRE 1'SSUfJJCE OF A PERN!7 6ASED UPC.`I FLANS AND
SPEC�CARL�`SSHALL hOf PRNEY.T THE f!'IL�I�:, 0(�ICIPL
FR6C7 T�iEf3Ef+fTlft REQUIRING 1HE fOfiRE�TI�N CF E,idOdS
Ip SN9 �� Si'ECIFICATfO":i C,7 fR_,VI PRC4EN(INu
BI71107AM'i i�i{&TiL�1�6 Fti�A& fARR7ED OY THEREUNCER WNCtI
Id Y!D{ATiE�ftl� i►u5 �E ort oF arav or�t�a o;a�i,va:;c�
■t61D[NC[
•ElIDEMCE
�P���D =
OF COSTp MESA
pL1A1NIfYG DEpi,
��S1ECT i0 ELDG. DEPT, �p,
ey�,)..,fhC �U/,� CQ B
�� O/ liANNiNO
3 I o� Gi i� i4Y�
STREET � _
tli
�
W
W
�
N
TYPICAL
Cement Coping Optional �
Channel Block With o� �8u�
Horizontal Top of all �
Fences -. � �.
Fo� Fences 5' or Less
Vert. Bars 3/8'� at 4' -0" O.C. Y
For Fences Higher Than 5'. �
Vert. Ban 3/8'� at 32" O.C.' �
Fill Cells Solid With Grout �
Where Steel Ocsurs �
Reinforcing Steel:Shall • -
Conform to Sec.A•15�39
A.S.T.M.
All Steel to be Lapped
i6 " or to Code
NATURALGRADE
TWO 3/8" BARS '
CONTINUOUS TOP
& BOTTOM
6�� CONCRETE BLOCK FENCE
�.eo
r. .o `o �
D
�0 � F�--WIDT
p SEE Ch
p BELOW
O�
�'-°-i
�
WALL HEIGHT
WIDTH �F FO01'�NG
THICKNESS aF FDOTfNG
DEPTH OF EARTHTOOTH
SPACING OF EARTHTOC
City of Costa Mesa;
Building Department
7-G-84
REQUIREMENTS
14'� 14" 12"
I 0'� 10" B "
24° 20" 16°
12' 14� 16
,.
GENERAL- NOTES
MORTAR: p�e part Plastic Cement, and
Three Parts Sond
GROUT: One Part Cement Three and
One Half Parts S�and
COPING: One Pari Cement, Three
Parts Sand
CONCRETE: Welt Mired I: 2� : 3%2
Max. of 7%2 Galle�s ot
YVater Per Sack of Cement
GROUT MAV BE POURED FROM THE TOP
OFTHEFENCE
CELLS AND AREAS OF HORI20NTAL PEIN�
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF AlL MORTAR DEBRIS, ETC.
BONDSSHAILBEPROVIOED BV LAVING
BLOCKS IN STRE7CHER COURSES SO THAT
VERTICALJOINTSALTERNATEIN EACH
COURSE.
-H OF EARTHTCOTH
I/3 THE HEIGTH OF FENCE
��LOW BOTTOM OF FOGTING.
SCALE: I/2��= I'
12
8„
12"
16'
/t I OWNERS N4ME: _ _ ,_ _ _ _ _ _ _ _
II OI �IC� 'JOB ADDRESSI _ _ _ _ _ _ _ _ _ _ _ _ _ _
Applicant to till in all soaces except those within neavy boraer lines ana sign a11 aDDrovriate Oeclarations.
CITY OF COSTA SA CO%�Q� STRUCTION� yPERMIT PERMI N2 _ —_ . TRACT NO. LOT NO. uNIT Nn
Project Address �V� gv , `�� ( � j� •
ypplicanYsMailingAddress �2�D� �?��YYaO.r Q-�.}eG`} �lP} (�
Owner'sName �e-`��r � Phone�-,5�f�-7�
Address ���_1 G� nQ�'Y Q �-
Arch/Eng. � License No.
Address
Contractor's NameS�������.'��� �,� �—Phon '
Address (mailingl!"-�l_�1_l�___I`�"•'
City License No. �� c��� g'tR
LICENSED CONTRAGTOR DECLARATION
I M1ereby affi�m that I am licensetl untler provi51on5 ot Charte� 9(commencin9
with section 7000) 01 Oivision 3 0( th Buslness antl Professlons Code, antl
my license is in lun f rce tl e�fecL ,Z 1�
License Class i<ense
Date � Si9nature
WORKERS' COMPENSATION DECLARATI
+.reDy atfi�m inal I have a C¢rlifiwte o1 co s lo selbinsure o� a certificaf¢
Workers' Compensation InSuranc¢, or a co�tlfied copy the�eot (Section
,JO, Lab.AC1.)��� ml � L ..��('_ �
PolicY No."�yxa+EF 7�V1 COmPanY �U 'YD
�fi ertifietl copy is here�y fumishetl.
LYCer[ifie(�mpy �zfi�ep wilh tha ci ing_I�,ivbwQ� _�
E%EMPTION FROM WORKEFS' CO Ai' N
(Thi55ection neetl not be completetl if e , i h �'
iessl.
I certify [Ital in the performance ol t k for whl h erm�t is iszuetl, 1
shall not employ any pe�son In any manner so a5 become subjec[ to the
Workers' Compensation Laws of Calitomia.,
Dace Signature
NOTICE: If, atter makinq lhis decla�alion, y0u Shoultl be<ome subject to Ihe
Wo�kers' COmpenSa[ion provision5 of the I.ebor CoOe, you musl fortnwith
comply wilh SucM1 provi5ion5 or this Oe�mit snall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby affirm that there is a consVuctlon lentling a9enty for the pertormance
of the work for wM1icb this permit is issuetl (Section 309],SCiv. C.)
lRntle�'S Name
Lentler's Atltlress
OWNER BUILDEH UECLHRATION
I hereby affirm that I am ezempt from the ConlraCtor'S License Law fOr the
f'ollowing reason (Section ]031.5 Business antl Protessional Cotle: Any city or
county wM1ith requires a permit [o conStruC[, alteq improv¢, tlemolishro� repal�
any structure, prior to its issuance, also requires the applicant tor such permit
to file a signetl slatement lhat he/slte is IicenSetl pu�suant lo [he provlsions of
[he Contractor'z License Law (Cnapter 9(commencing with Section ]000) of
��vision 3 of the Businezs an0 Professions Cotle) or [ha[ M1e/she is exempl
vefrom antl the basis for the alle9etl exemption. Any vlolation oi Seclion
31.5 by any applicant for a permit sub�ects lhe appliwnl to a civll
„enalty of not more than frve M1untlretl tlollars (E500).
,❑ I, as owner of the property or my employees witn wa9es as thelr sole
mmoensation, will tlo the work, and the structure is not intenaetl or oHeretl
�OI Shc2 ($CC�IOl1 JOA4� BU510255 dlld PYOfQ55100d1 Cotle: The Contractor's
Licenw Law aoes not apply to an owner of a property who builtls or Improves
thereon, antl wM10 tloes such wo�k himsclf/herself or [hruugh his or her own
employees, provitletl tha[ such improvements are not Intentletl o� offeretl far
sale. If, howeveq lhe bulitlin9 or Imp�ovemenl i5 Soltl withln one year ot com�
pletioq [M1e owner will have lhe burtlen of proving he/she tlitl mt builtl or im-
�rove tor Ihe purpose of sale).
I, as owner of the pro0erty, am ezclusively contracting with Iicensetl con-
l�actors to conslruct the pro�eci (Section 7044, Busine55 antl Protessions Cotle:
The Contra<tor's License Law aoes not apply [o an owner of praper[y who
� builtls or improves thereon, antl wno contracts for such projects with a con-
Vactor(s) i�cense pursuanl to the ConVactor's Li<ense �aw). I am aware that
proof of their Worker'S Compensation insu�ance Shoultl ba provl0etl to me.
❑ I am exempt untler Section B. & P. C. tor tnis reason
Date Owner _
I hereby certify that I have reatl [his
information is cor�qct. 1 agree to comp
or 55
tlon antl state [ha[ the above
all city antl county ortlinances .
CMF 0865-46, rev. 30/84 Whi[e - Builtling; Canary - Applicant; Pink
TVPE OFCONSTRUCTION LJ NEW LJ aDD�ERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRA�ING L1 F UNDATION LJ STRVCTURAL
❑ TENANT ❑ EIECTRICA�.�C 1MBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq.FT, ocCVParvcV
CONSTRUCTION TVPE VALUATION $ _
ZONE�� GRADI� CU.VDS. ACRES_
qemarks: A /1 i /
Sink
Preventer
Irrigation
Dishwasher ,�'
D�inking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavamries
P-Trep
Roof Drains
Reinspection.Fee � $15
Boiler
Duct - Under Ground
Duct - SVuctural
Duct � Ventilating
Exhaust System ❑ Multiple
FirepVFact Blt. ICBO #
Heating System & Ducting
❑ a-i ao,000 aru O i oo,000
IRainspeccion Fee I $15
Goltlenrod - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w)Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑o-ioo,000eru ❑ioo,000
System Repair/Alteration
Fire Dampers
Regisiers
laue Fee
FEES
A.P. ,ie
$ Main Building:
E
T Front
B Rear
A
C Right
SLeft
Ping. Ref. #
Plannin9 Notes:
0585 �5/16/E:
Zone
Accessory Building:
Parking fteq./Provided
ELECTRICAL
Amomatic Washer Transformer � 75-50 KW
ConstructionPoleSub. � ❑50+KW
Cooking Unit Meter �up [o t00amps
Dishwasher Meter ❑overi00amps
�ryers ❑Gas ❑Electric Sub Panel -
Fan Momrs �0-1 HP �1'/: - 8
F.A.U. Inc.Solar 09�15 HP �16-15+
Fixtures Microwave
Device Boxes Pole Light
Outlets Range
Switches Si9n •
Garbage Dispoul Standing Sections
Generator �0�5 KW �5-15 KW Trash Compacmr
$ 3
Reinspection Fee $15 Issue Fee
FEES
�DEVELOPMEN7 SERVICES REQUIREMENTS:
Zoning Approved 6y �
Building Approved By �
Appliwtion Issued Bv
$ 3
50^" Tl
FEE$
$ 3
Z
O
N
I
N
G
R
E
�
M
T
S
SUMMARV OF FEES -
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT _-z1Y
PLUMBING $ �D ISSUANCE $ S
PLAN CHECK 25% $ ENEFGV P.C. $
ELECTRICAL $ GRADING $
PLAN CHECK 50%� $ MICROFILM 5��(�__
MECHANICAL $ TOTAL FEE $ S�
PLAN CHECK 25% $
CONSTRUCTION AND;PLANNING POOL & SPA
F.' Date Inspector Date Inspector
APPROVALS, PermiY� APPROVALS Permit #
1. Temporery Electrical $ervice or Pole 52. Pool & Equipment Location
1
2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms � -
4. Elecirical Conduit-Undrgrnd. 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.
8. Foundation �- - 59. Gas Pipe, � Undrgrnd., Test
r,...
9. Water Pipe-Undrgrnd:� � 60. Backwash Lines, P-Trap, � Undrgrnd.
�
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Une & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap . 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing . 65. Electrical-Final
15. Rough Electrical•Condui[ 66. Solar SYstem-Final
i 6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. PO L/SPA SYSTEMS FINAL �
19. Rough Heating & Air Conditioning "FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit# _
21. Ducts, in Structure 70. Underground Hydro
22. Ducts,Ventilating 71. ProductPipingOGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank C] Gas ❑ Oil �
25. Roof Sheathing 74. Overhead HYdro
26. T-Bar Ceiling (Structura0 & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe . �
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation . 78. FIRE PREV. FINAL
30. Drywall Nailing <i' HEALTH DEPT. REQUIREMENT ^<-��
31. Plaster Brown Coat 79. FINAL INSPECTION �'��
32. Electrical Power Meter-Final 80. FOOD CERTIF�CATE ISSUED '
33. Final Electric Notes: '
.�
34. Final Heating & Air Conditioning "
35. Final Gas Pipe-Test
36. Hood or Canopy
�37. Final Factory Fireplace
38. Final Plumbing 6 2 i��f �iQ .
39. Water Service-Final - '
40. Gas Service-Final '
41. Solar pomestic-Final '
• 42. Backflow Preventer
43.� Backflow Irrigation
44. Landscape Irrigation System
45: Sound Attenuation
46. Handlcap Regulatlons
�47. FINALSTRUCTURE&BUILDING �
48 �Special Requirements Completed '
� 49. Electric Release t0 Edison
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
31 � I Applicant to /ill in all spaces exce0� those witnin �eavy Oo�Oer Iines anE Slgn all approD/iate Eeclarations. � '�
CITY OF COSTA MESA CONSTRUCT N PERMIT ERMIT NO. T ACT NO. LO UNIT NO. _ .� -
ProjectAddress ��� ����T� _
�3 3q o� 3 p A.P. # �o�a
T A licant's Mailin rAd'dress �5'`�Md� ���� �-/�� p�.�
TYPE OF CONSTRUCTION NEW ADD ALT RATION REPAI R S Main Building: Acce55ory BUilding:
E
PP 9G`MCfP ���%G�S /'t'S�C"iPhone�7 � GONVERSION ❑ DEMOLISH � OTHER P19' ID CO(%E�L-- ' 7g FrOnt .�� N
Owner'zName f�, DESCRIPTIONOFWORK/USEOFBLDG. A Rear �� �
Address �l �l � � S�trJG�$+� Cd�',yr YVL6� i ! ( N
Arch/Eng. License No. TYPE OF PERMIT GRADING FOUNDATION STRVCTURAL � C Right
Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S� Left ' ���� R
Coniractor's Nam Phone ❑�oTtiER _ � Ping. Ref. •# Parking Req./Provided E
PROJECT DESCRIPTION 5� FT 7 � nrcuvANCv n
Address fmailingl f /��{ r�. Pla�ning No[es: ti M
CONSTRUCTIpNTVPF / VGI_IIGTION$ �AAN�� T
City Lic¢OSC NO. 20NE GRADING CU. VDS. ACRES 5
LICENSED CONTRACTOR DECLARATION
1 hereby affirm that I am li�ensetl untler provisions of Charter 9(commencing Remarks: �� �-L O C0�
with section ]000) of DiviSion 3 of tne Business antl Prot¢Ssions Cotle, antl ,
my license is in t W I torce antl ettect. '
ELECTRICAL FEES
License Class Li<ense No.
Date Signature PL MBING FEES Automatic Wash¢r Trans/ormer ❑ 15-50 KW
WORKERS' COMPENSATION DECLARATION ConstruttiOn PoleSUb. � 50+KW
'eby ailirm that I nave a certiticate of consent to self-Inzure or a certiflcate Bar Sink Showers
/orkers' Compensation Insurance, or a certifietl coDY thereot (Section Backflow Preventer Service Sink Cooking Uni[ Meter ❑Up to 100 amp5
,0, Lab. C.)
Policy No. Comoany Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps
eCertifietl cooY �s nereby fumishetl. � Dryers �Gas ❑Electric Sub Panel
Certitietl copy is tiletl wi�M1 the city Builtling Divislon. Bathtubs Sewer Connection
oate Applicant Fan Motors OO-1 HP O7 X- 8
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION Clefifi¢�5 SOIa� COIIECl0�5
(Thissectlon neetl not be completetl if the permlt Is ior one huntlretl (5100) or Dishw3sher Solar Piping F�P'�U� Ina Solar �9-15 HP �16�15+
less).
I cxrtify lhat in tbe pertortpanCe of [he wo�k f0/ wltich th15 p¢rm�t Is Issuetl, I FIXtu�ES
shall not employ any person in any manner so as to become subject to the Drinking FOunteins Solar Tank Microwav¢
Workers' Compensation Laws of California. Devic¢ Boxes
Date 5iqnature Floor Drains Swimming PooPw/Spa Pole Light
NOTICE: It, after making this tleclaration, you shoultl become subject to the Outlets Range
Workers' Compensation Orovisions of the Ldbor Cotle, you must torthwitn Floor Sinks Urinal
comply with suCh provislons o� thi5 p¢rmlt shall b0 tleemetl revoketl.
CONSTRUCTION LENDING AGENCV GaSServiC2 Outlet5 WatCfCloSet SWItCheS Slgn
1 bereby atfl�m that Ihe�e is a const�uction 1¢ntling agenCy 1or the pert0/mance -
ot the wo�k for wbich this permit is Issuetl (Section 3097 Civ. C.) Int¢fC¢pt0�5 Water Heater Garbage Disposal $[dnding SEC[i005
Lentler's Name
Lentler's Atltlress Kitchen Sink Water Service Generator �0.5 KW �5-15 KW Trash Compactor
OWNER BUILOEft DECLARATION
I hereby ailirm lha[ I am exempt (rom the Contractor's l.icense LAw tor the Lavaiories Auto-Wash
/ollowing reason (Section 7031.5 Business antl Profeszional Cotle: Any <ity or
county which repuir¢s a pBrmit to wnst�uct, al[¢r, imprOve, tlemOl6h or repal� P-Trap L2u0dry TfeyS
any structure, prior to itz fssuance, also requires the applicanl (or such permit
lo file a signetl Slatemen[ that he/She is licensetl OurSuanl to the provisions ot qOOf Df3if15
Ihe Contractor'S License Ldw (Chapter 9(commencin9 V+��h $ection �000) of
�ision 3 ot the Busine56 antl Profess�onz Cotle) or that he/she is exempt Reinspection Fee $15 luue Fee $ 3
efrom antl lh¢ ba5i5 �Or the allegetl exempliOn. Any viOlation of Section
-1.5 by any applicant for a permit subjects the applicant to a civil
alty oi not more than five hundred tloliarz (E500). DEVELOCMENT SEflVICES REQUI{/�7 �MENTS: /
c�I, as owner of the property or my employees with wages as lheir sola Reinipection Fee $15 Issue Fee $ 3 Zaning Approved By `��" Date �.fCZ 2�
p¢nsation, will tlo the �york, antl the S(ructure IS not Intentletl or otferetl
for sa{e (Section 7044, 6usiness anG Professional Cotle: The Contractor's MECHANICAL FEES Building Approved By Dat�
License Luw tloes nol apply to an owne� ot a Property who bWltls o� improve5
litereon, antl who tloes Sucn work himself/h¢rs¢It ot throu9M1 hls or her own AppllWtiO� ISGUBd By 4' Det
. employees, pwvitletl that Such improvements are not intentletl or offeretl for BOiI¢� HOOd O� Typ¢ 1 ❑
I sale. If, howevM, the Guilq�ng or improvement is soltl witnin one year of com- Cdnopy Type II ❑ , �JM A Vp F fEES , f1'
pletion, lhe owner wlll haye lhe bu�den of p�oving he/she tlid not bui10 or im- DuCt - �lnd¢� i�i�OUnd C+ , V
nrove'.orcher�urposeotsaie�. BUILDINGPERMIT� - SMIP $ � -
'I ❑ I, as owner of the property, am exclusively contractln9 wifh Ilcensetl con- Duct-Structural Refrigeration System PLAN CHECK � PERMIT
t�actors to cons�ruct the project (Section ]044, Husiness antl P�ofesslons Cotle:
The Contractor� License �w tloes not apply to an owner of property who Duct - Ventilating ❑0-100,0008TU ❑100,000 BTU PLUMBING $ �SSUANCE $
builtls or imD+n es thereon, antl who conVacts fo� such orOi¢Cts wltb a ron-
tractor(sl hcense pursuant m me ConVactors License Law). i am aware thai Exhaust System ❑ Multiple ❑ System RepaidAlteration PLAN CHECK 25% $ ENEfiGY P.C. $
proof of their worker's Compensation insurance shoum De provltletl m me. ELECTRICAL $ GRADING $
i� I am exempt untler Sec(ion B. S P. C. tor Ihis reason Firepl/FacL Blt. �CBO dk Fire Dampers MICROPILM $�
PLAN CHECK 50% $
Dat ��� � �/-1 ' Heating System & Ducting Registers
-�-�� ❑Q10p,0008TU 0100,0006T MECHANICAL $ TOTAL FEE $
I hereDy tertify that I nave reatl tnis apPlication antl stat¢ tnat ihe above �
. •in(ormation is correct. I ayree to comply wiM all tlty antl county orAinances PLAN CHECK 25% $
. antl state laws relating to buileinq construction, antl hereby authorize repre-
Sentatives of IhiS ciry IO ente� upon the above-mentionetl pro0e�ty fOr
inspection pur . . � �/
Si9na[ure , .-�1/✓ ti- DateS�4_� ..- _p^a�"y'r-��,:r �'.
`�. =
Reinspection Fee $75 Isxue Fee $ 3 JHTc: Od • 1
Drivers' License or 55 � — " ' �
i�3; :a�.*I;�_. ..:i;
0865-46, rev. 5/88 White - Builtling: Canary - ApP���an�; pink - Accounting; Goltlenrotl - Asiesso�
CONSTRUCTION ANDPLANNING POO SPA �
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspecto[
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • .�
� �.
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ..
3.,Electrical Conduit Utility-Undrgrnd. , 54. Forms .
�.
4"'Electrical Conduit-Undrgrnd. 55. Electrlcal Bonding �
5''Steel Reinforcement 56. Rough Plumbing & Pressure Test '� �;
6._ Electrical UFER Grnd_ 57. APPROVAL TO COVER-GUNITE �
7:�.Footings � D(Z,'� 58. Electrical Conduit-Undrgmd.
8." Foundation 59. Gas Pipe, O 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 ,
12. Sewer Cap 63. Heater & Vent-Final � •'
13. Roof'Drains 64. Plumbing System - Final �-
14. Rough Plumbing 65. Electrical-Final (i'�
15. Rough Electriral-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace , • APPROVALS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & T.est 72. Underground Flush
24� Roof Framing �' 73. Undergrnd.Storage Tank O Gas ❑ Oil
25. Roof Sheathing • 74. Overhead Hydro
26. T-Bar Ceiling (Structurap &'Monocoat 75. Dry Chemical
27;'�Frameand FfasF�iag- • , 7O7 76. Dry Standpipe
�28. Lathing & Siding ' 77. FIXED SYSTEM FINAL
29. Insulation :� 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coatr • 79. FINAL INSPECTION
32. Electrical Power Mete'r-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric ` Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
;l36. Hood or Canopy
��37. Firial Factory Fireplace .
,-38. Final Plumbing ' �
�•
`�39. Water Service-Final,
•40. Gas Service-Final �
�41. Solar pomestic-Final .- .
42. Backflow Preventer '
43. Backflow Irrigation�' ! I ,
44. Landscape Irrigation System �
45. Sound Attenuation
46. Handicap Regulations
� 47. FINALSTRUCTURE&BUILDING pT�Z� Sp? 01L
48. Special Requirements Completed �'
49. �lectric Release to Edison ' �
•50. Gas Release to Southem California Gas Co . , � _
57. CERTIFICATE OF OCCUPANCY' . � �
No. Date �y _ � '
LIMITED ST,ATEMENT OF RESPONSIBILITY
TO WHOM IT MAY CONCERN:
t
�� �U � C.'' / �✓ � � � �! Ur
Slreel Address
Bldg. Permit #
This Permit lf
ia,a.�zn
/
I, ���yu:-✓ ��t� , as Owner in Title of the above referenced
property, do hereby authorize:
F�sn/..
,�;' �.c nl�Z' � n/�
�''%F-
si,Bai
cs<f'�_,fC%a
7elephone No.
�-
to obtain permits in my behalf, as ownedbuilder, for iaA� / O (� o t�� /Z
at the above referenced property.
Should anv oerson become an Pm �ov engaged in the improvement of the property, I shali
immediately provide Worker's Compensation Insurance coverage and cause a certificate of that coverage
to be filed with the Building Division of the City of Costa Mesa, as required by State of Calitornia laws.
As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other per-
son, company or corporation. ,
I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any
claim resulting in damage or personal injury to myself or any other parties.
�'Li � r/� ti�CJ�iI/
Printed Name
����- 5�-1-���
Sig ature
O]]9.45, rav. NB]
�'�st y /C /�/� i
Date
'�r
4'-�" �k- �Ai,�
�F'�oP�z-TY
t-i11E —
; g�P�.ovEn,�
� a7 o co
� OF C STA MESA
PIANNING DEPT.
, wuecr To uoc. oerr. eea
+tl'��� DAT� 6' �'B�% r.
— — — � — — � -- ---- . — —
� � � �y o if � �J
City of Costa Mesa Buildirr Dept.
BY / ''
, r -,ree K S � ;, �,el
THESE PLA�JS �J��iST RE ON J:�$ A7 ,1! L Tf.b1ES h1A,K,c
NO CHqNGES \'QNITHCqUi r'fiiOR ;;i'7;t.;,V.q! p= DEPi.
PLANS SSLANCE OR GgqN7'NpOF F F�!N,.., .�F Ao.qrn,,:.l np .
PERM:i FN� �v�:!��IC4TION; SFIAII NC r g4 r. �;:,,fv:.�_li h:: n[�.�
iHEPk �R. Ok t,\ APPRO'JAL GF.:.N`.' YIO�n+�C•.:J,_.P n:� I
AUTHpFIN IONS i�F 74!5 Cv^E. ;�10 0�:;. •+.;- �. '��F i
iL' vlOt/�?: n4 Cn; �� ,�ih.•. , �i'.. � C
GQOE StiAl! E. V.di; . � C''" ; �. '..`c .
WHICH li �• `J,Cr.?i I.v 5(: tA; q. .•.• :" v�: �:C L
'I�Uiii0a12F.ti1SiviYFi.'L ""q.�n:(�:.Fi�E: F
—�D�OS 1% T1+�r�S�JnNCE , a
- p � SP ICATlON: SHPdL NOTrPkr.VE��::'c'f�� �pOn r.�.,�a �
fA{I� �/ �S ID PiAI'£.'.?'iCd kEG�UiRING TNE CliRnS�'r:�,,.,., _-'"'�:\l I�
BUILDING WE A110NS: �IFIC:411UN5 C^ ::��ia� P..y Jq5 !i�! l
w vio: � a_in•c c�aeieo er• r__ , -'�-�Ne y
. TH� IiY.'ON OF h115 Ci70C Cr n:. .. .. ., `6l:i•'.�:�i R�vHE�' y
. ' � G ;"L'r ANCE O' 1
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SUBJECTTO MEASURE G
Q/�TE�'13� q INITIA!
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DDITI S, DELETIONS, OR CORRECTIONS SHALL
B APPROVED BY THE PLANNING DEPARTMENT
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I}.lEi OF �lE� I
�.T� �v� ��P �d��� I
City of Cost�/vi��'a�uiff?.� De;�i. �
BY ��R Qpc�^�
�' �Z.�)r,:.�_.___'"_.�
�THESE'r.ANS!✓�t.i5"f f}E QN i^E ?? nLL TI!.5'S l.4A�
NC CH,9NG�5 \'✓i7i10UT r';iUR F•i"ri::VA! OF DEF
a
_, '_"� _ _ " . PEfiL@iP��.C`4`N,s.°PRO`JAIOF.:,;.oJbIU'�;.�'�Ci:J,:p`' j�c
SHE°Rk��� ` )F (`c:.' i •.P,.• -�� P.�.
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ee�<<.;.ue ,„ .e;.. ���._�F,. ,i�. .c_<�..
THE 1�57nN.E' :JP A ::c•v,� �,.. .•r_�. . U?O:� . ` �-• f .
SP`eCIFICAiiiiNS SM4lf :JQI.?kr.Vi .. '�,r fili'r- .`.�.L .
FROM [v� . '> r;C4riRiNG J`�c t :. _ . ., . :� b� (�
'SA�d ii "<::6 :.FD /�j . iCn;v.:NS. i:R .� ;. .-vP.a�p.y- �
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+ ,� (
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iiHESE PLA:J� 1•'..icT �i ... , ;., . :.!: �I:. _$ M �
NO CHAN:;CS N`!`::;CUi i'n.Ort :�'F;YI�iA! O` D. P(�.
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C�ty of Costa Mesa Bui9d:�9 nepi. .
C A : i= _.�-- 19-�
SY _�--""'""_'_._--, �. J aT . i i. Acc., h',AY.'• �
iHESLPIAN.;h..'.-3`- �BipPi.t''rf+'.,.._�FD'cPl
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Applicant lo fill in all s0aces except those wilhin heavy GorCer lines antl sign a1l aporooriate Oeclarations.
CiTv oF EOSTA MESq CONS-T4RUCTION PERMIT
Projecl Address �� ��N�
� �� ,
Ap�icant's Mailing ddress � �� ��' ` �"
Owner's Name ��y` � Phone �#?`�1�7
Address .��� � �� G�
Arch/Eng. — -- License No.
Address ^
Contrector's Na � � Phon ro�
Address (mailing) �3�__ �
Ciry License No. —����, �
LICENSED CONTRACTOR DECLARATION
1 h¢reby aftirm that I arry licensetl untl¢ R ovisi o1 Charler 9(commencing�
witn seclion 1000) of qivislon 3 oi e isi esz antl Professions Gotle, antl
my license is in full fo�ce antl i t ��O
LicenSe a s ice N .
Dale� Signature �
WORKE ' C MPENSATION DECLARA ION
ereby aHirm Ihat I hav¢ a CerlNicate of mnsent to selbinsure or a certiticate
Workers' Compenwtion I s}�ran/ce ' �r a c ietl copY t reaf (Section
..800� Lab. ��['�/� . ^/`%�'t�l / 1 .... �.� � �RT m.. � a.Y
�G��L''�CFfiGY��i i�f►��
EXEMPTIOt! FROM WORKERS' COMP�FISATION DECLARATION '
(Thissection neetl not be Campleletl if the permit is for OnC hundred ($300) or '
less).
1 cerlity Ihat in the pertormance oi tbe work fo� which this permlt is issuetl I
sM1all not employ any p@rson In any manner so as to become subject to t�e`
Workerz' ComOensation ��v5 of Calitomla.
Date Si9naturc
NOTICE: If, after making (hi5 tlecla�ation, you sltoultl b¢cOme subject to th¢
Wo�kers' Compensation provl5ion5 ot [he La�o� Cotle, y0u must forthwith
�comply wilh SucM1 pro�{slons or [his pe�mit Shall be tleemetl revoketl.
CONSTRUCTION LENbING AGENCV
� I hereby at�irm that the�8 is a conrt�uction lentlinq agency for the Oe�fo�mance
ol the work for whiCh Ihis permi[ is issuetl (Section 309] Civ. CJ
� Lentler's Name —
�entler's Atltlress
OWNER BUILDEH �ECLARHTION
� I hereby affirm that I am exempt irom Ne ConVactor's Ucense Law for the
followin9 reason (Section �031.5 Business antl Professional Cotle: Any city or
^ county whiCh requile5 d pefmit f0 construci, alter, implOve, tlemolish or repair
�`I , anY sVucture, prior to its Issuance, also requires Ihe applicant for such permit
to file a siqnetl slatemeq[ that ne/she I5 licrnsetl pursuant lo lhe provisions ot
the Contractor•s License �w (Chapter 9(commencing witn Sectlon ]000) ot
�ivisiOn 3 of the Busiqess and Protessions Cotle) o� [hal he/she is exempt
e�el�om antl the baSiS for IhC allegetl exemption. Any viOlation ot Seclion
J31.5 by any applicdnt fo� a permit subjecls Ibe aDPlicant to a civil
�enalty ot not more tnan tivc nuntlretl tlonars (5500).
I, as owner oi the prooerty or my employees with wa9es as their sole
compensation, wi11 tlo the work, antl the structure is not Intentletl or oiterea
/Of SdIC ($CC�IOl1 ]044, BU51�¢SS dOd P(OfQ551011d1 COffC: 7hC Contractor'S
License 12w does not apply lo an owner o( a property wM10 builtls or improves
thermn, antl who tlaes such wo�k himself/he�seli or lltrougn his or her own
employces, pwvitletl tM1BI such improvements are mt intentletl or offe�etl for
sdle. H, howevet, th¢ bUiltlin9 or Improvement is soltl wi[hin on¢ yea� o! com-
ple[ion, the owner will have lna bu�tlen of proving he/she tlitl not builtl or im-
pwva lot lhe pu�pose oi sale).
❑ 1, as owne� of the p�operty, am exclusively contractlnq wlth Iicense0 con-
l/dCtOR t0 COnSt�utf Ne p�OjBCt ($2C110l1 ��44. BIISIfIC55 dlld Professions Cotle:
The Con[ractoYs License !aw does nof apply to an owner oi properiy who
buibs or impwves Mereon, antl who conVacts fo� suGh projects witb a con-
tractor�sl imense pursuant to the ntractor's �icense 1_yw), I am aware that
pwo/ of their Worker's Com sat on insurance shoultl �e provitletl to me.
� I am ex er 5¢cti 8. & P. C. fo� this reason
1� �
TYPE OF CONSTRUCTION LJ NEW LJ ADD LYALT ATION
; ❑ CONVERSION ❑ DEMOLISH ❑ OTH
DESCRIPTION OF W09K/USEAF,94DG. _
TVPE OF PERMIT IJ GRADING LJ FOUNDnTIorv u STaUCTUaAL
Q TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT• DESCRIPTION
CON STRUCTION TY
ZONE
-Remarks: �f� Q't.�
. wn`-'�
Bar Sink
88ckflow Preventer
� Backflow Irtigation .
Jrinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Lavatories
P—Trap
Roof Drains
Reinspection Fee
3! .'S ��OCCUPANCY
VALUATION S _
GRADINGCU.YOS. ACRES_
$15
Boiler
Duci - Under Ground
Duct - Structural
Ducc - Ventilating
Exhaust System ❑ Mul[iple
FirepVFact. BIL ICBO #
Heating System & Ducting
❑6100,000 BTU 0100,000
Drivers' License or � ''� I I Reinspection Fee I $15
CMF 0865�46, rev. 30/84 White - Bulltlin9: Canary - Appllcant: Pink - Accoun[ing; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auro-Wash
Issue Fee
Hood or Typel ❑
Canopy Type II ❑
Refrigeration System
❑aioo,aoosru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers
luue Fee
8981 4/19/Br '5�1'�
E� —
A.P.9W S Zone
S Main Building: �Accessory Building:
T Front 'F ZQ � p
B Fear � -�j N
p I
C Right � � N
L_ S Left / G
R
Ping. ReL # Parking Req./Provided E
Q
�L Planning Notes: (� M
� S
FEES
$ 3
S 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator O65 KW 05-'
ELECTRICAI �
Transformer ❑ 75�SOKW,
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors�0-1 HP�iN,-8
Inc.Solar 09�15 HP �1615+
Microwave
Pole Light �
Range
Standing Sections
5 KW Trash Compactor
FEES
� Reinspaction Fee I$15 � I Issue Fee � S 3 �
DEVELOPMENTSERVICESREQU EMENTS: C
Zoning Approved By � Date � � �C
Building Approved By Date
Appliwtion Issued By Date
SUMM/�V OF FEES �p
BUILDING PERMIT $ L�� �C' SMIP $ D'�
PLAN CHECK $ —I�-d— PERMIT
PLUMBING $ ISSUANCE S'
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $ _�_
MECHANICAL S TOTAL FEE S 3�-�—
PLAN CHECK 25% $
' ' � POO L & SPA
CONSTRUCTION AND PLANNING
Date Inspector , Date I�spector
APPROVALS Permit# ! APPROVALS Permit# `� ��
�
1�: Temporary Electrical Service�or Pole 52. Pool & Equipment Location� ' ) `
�.
2. Soil Pipe-Undrgrnd. , � 53. Steel Reinforcement I( `'� �,•� )� �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms � - -
4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding t� �
,
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -�
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE !
7: Footings J� �� 58. Electrical Conduit-Undrgrnd.;�, �1,i
8. Foundation • 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, O Undrgrnd. Y
10. Strucwrol Floor System 61. APPROVAL TO DECK �'- '
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 4��
12. Sewer Cap 63. Heater & Vent-Final �" i. ;,�
13. Roof Drains 64. Plumbing System - Final ` ,
'i � r
14. Rough Plumbing 65. Electrical-Final :. . � � ' + �
15. Rough Electrical-Conduit 66. Solar System-Final ,
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' �
19. Rough Heati�g & Air Conditioning FIRE DEPT. REQUIREMENT �� �
t •
20. Rough Factory Fireplace APPROVALS Permit # ,
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil -
23. Gas Pipe-Rough & TeSt 72. Underground Flush � �� ��'
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil ', /
25. Roof Sheathing � 74. Overhead Hydro . ,"
26. T-Bar Ceiling (Structural) & Monocoat 75. DrY Chemical � ��,
27. Frame and Flashing 76. DrY Standpipe , �`' � :"
28. Lathing & Siding 77. FIXED SYSTEM FINAL `' . I •��.
29. Insulation 78. FIRE PREV. FINAL �
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION ;, I ._
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED �
33: Final ElecVic . Notes: 20 ��f ��.
34. Final Heating & Air Conditioning ' 21 � �
35. Final Gas Pipe-Test .� � -a "
�
36. Hood or Canopy
37. Final Factory FireplaGe �
�
38. Final Plumbing , I � ' •
39. Water Service-Final , �- - ., . -
40. Gas Service-Final '
� I
41. Solar pomestic-Final � ' � _ "
42. Backflow Preventer � • , ' , •
43. �ackflow Irrigation y � � ' i
44. �Landscape Irrigation 5ystem � , � '
' 45. Sopnd Attenuation . '� .. ; �
46. Handicap fiegulations � ' , �
47. FINALSTRUCTURE&BUILDING - � � - , � - � I �
I ' I I
48. Special Requirements Completed , , � � ' '
I
49. Electric Release to Edison ,. ,
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY '
No. C ��'��_ Date � �
w
i �
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G crrr�o�n Me`sa w
PLANNING DEPT.
auuEcr ro e�nc. o�r. rtEa.
PY•..... � DATE1
01lCCT OP FlANNINO
�
4.
W
¢
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NOTE
ADDITIONS, DELETIONS, OR CORRECTIONS SHALL
BE APPROVED BY THE PLANNING DEPAR7MEN7
xcaiocwcc
•csiocMce
REBIOEMCE
�j107
CI ����L�
STREET �
61t/+r�7
8 �-
A���Q11ED
� Ci+,y of �osta Mesc 8vil� ing Dept.
gy �.�T�^DATE�.191�8
��?h+E:E PiA�•i, ;d:;.",i'':E vPi JOB AT ALL TEMES N�GKc
NO CHANG�S Vvfi H�JU"f F':(Gk F�Pi'i:OVAL O"r ;c-T
� �3 33 i 3
'� iHEt:55'u'APeGi� (i? _;:,ANT't7':L :Jr 6�c c!.17'f OR APP@'J`Lll O
�PIANS FN: 5�'c:'+= CF �'0••� i`�A.! �!7? (S;: COPISTI:IkD'.O f
PECidli f05� G't,`:�: dii�i:OvAL (if pM'i `�I•`)lP.?ION OF (�NY ,
7Y.EP%GV�S:C::-Or'���tOD'c ��07::',1FIi G�ESU6:WG f0C `'
f 4UiN051'!Y .D `.iO..vi�: OR CA;aCEI l:iiE ::'O`/Ii:JNS OP 7 -
1 COCE SF!�! L 95 YA! ID. EXC[PT IN 50 FT6 n5 Thi`_ N/OG: OR l:.
WHICH IT AU7H05:2e> 15 Ln\'%'rUl.
TNE 153�inN.=E C: A?ER;riiT EASED UPOtd PIANi !�D .
S?ECIFlCATD:•NS SH�iL t. `.c "_'�L1 TNc 9l:ILDWG O''�ilA ,
F�QM I��Et-1�!:.'.f 4E'��.�:nl(VIsL �-: C;iFv�'(IICi: OY F�Ql7k� �I.
541� ?lAnS F,n�� 'fEC:IHCk7�0��5 J" fRO:+� PREVEr�7M�: �
BUIIDING GFEP,:ifONS EE!NG C�noIEU ON T4E8F.U, vCeP. W�:N • }-
W VIOIAitON Of TH.^_� CODE�7h OF ANY 071IFH ORDI�v�WGeCF .
THE Cltt. ,
Wf D I
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RElfOEMt[
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Cement Coping Optional —'
Chanrrel8bek With 1•3J8�
Horizontal Top of all
Fences
Po� Fences 5' or Less
Vert. Bars 3/8" � at 4' -0" O.C.
Fo� Fences Higher Than 5'
Vert. Ban 3!8"� at 32" O.C.
Fill Celh Solid With G�out
WAere Steel Oeeuro
Reinforeing Steel Shall
Conform to See.A-15-39
A.S.T.M.
All Steel to be Lapped
24" of to Code
NATURALGRADE
TW0�3/8"� BARS �
CONTINUOUSTOP
& BOTTOM - " �
310RIZ.STEEl MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTItlN.
TYPICAL 6�� CONCRETE BLOCK FENCE
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�INIDTH
p� � SEE CHl+
9 BELOW
o' I 'Q.
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FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: pne Port Plostic Cement, and
GROUT; Three Parts Sond
One Port Cement Three and
�e Half Parts S�and
COPING: pne Part Cement, Three
Paris Sand
C�NCRETE: Wett Mixed l:2-ll2:3-I12
MaY. of 7- I/2 Gallons of
Water Per Sack of Cement
GROUT MAY BE POUHED FROM THE TOP
OF THE FENCE IN CELLS WHERE'STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL 9E CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS. ETC.
H OF EARTH7COTH
I/3 THE HEIGTH OF FENCE
�6ECOW �QOTTOM OF FOOTING.
SCALE: I/2�� = I'
� rr'+�� nuvm o D ' y 'r J'1'.
WIDTH . 14'� . . . . . . . . . . . 14�� . . , .. . . . . . . f. 12". . � 12��. z
- ---
� THICKNESS - .>;. . . . _ . . . . .10'�. . . . . . . . . . . .10" 8""__ . . . . . . . . . 8 �r .
DEPTH OF EARTHTOOTH . . . 24�� . . . . . . . . . . .20�� _ . _ . . . . . . . . 16". . . . . . 12�.
SPACING OF EARTHTOOTH. . 12' . . . . ...:.. . . . .14� . . . . . . . . . . . 16�. . . . . .'. . 16�
City. of Costa Mesa, California
�Building Department
ip::a r..a•,_r�_�_,.: 2EV154P NOV.82
OWNERS E�1�
JOB DRESS�.� 3
FERM T NUMBER;_
SIGNA URE:
/• • N• ? 71
Zi-IIS AQ2EEMENT, made ard enterer3 intn this � Z. day of
A'� "— , 198�, by and between 1�—Lr�
hereinafter referred to as "I.t�IU 0�^d�1ER", and �S�C_L�
hereinafter referred to as "AD,7ACENT PROPEI7IY OWNER".
It is hereby agreed that a
property line between �j,
vrall will be constructed on the
J���
� �t�uucc� vi rv���ii�i�n� riv�+ci�ic��
C� � � �-�—
in the City of Ccsta Mesa, Coimty of Orange, State of California, as per map
recocded in Book , Page of Miscellanecus Maps, in the office of the
Coimty Recorder of said Coimty. The party wall shall be pezmitted to encroach
IN WI'INESS Yd-IEREOF, the parties ha�e entered into this Agreement the
day and year first above written.
IAND (�1NER ,-��.s�„J
���r� � �� %� %�, �� �
(Signature)
�r��-r�e e.s 1� �
Name (�i�xd or Printed�)
� I� 7 C��t�, C�-w. L. 7ii
(Address)
AA7ACENT PROPEKPI' Qv7NER 2us3c.�z<�
/�/���,.� GC/ ��y��
(Signature)
l,�j!//!pm /,�J. KuSs�LL-
Name (Typed or Printed)
3/// ���s-� ��
(Address)
�,y� o� .�,___ ^*�ry's statemen.t.l.�
City of Costa Mesa
B�ilding Safety Department
P. O. Box 317
Cof�a Meta, Californio
CERTIFICATE OF OCCUPANCY N� 2596 C
The Building located at �S+�QRCQP AVEAtIfl A-D
has been inspected and fovnd to comply with fhe provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group � 1h T Occupancy.
Use of Buildin9 � 1$3iL �$ $'d�i8g-��*i� �'tfl^-i#'.��� anA ]atmAwv
Legal Description ��Q� ��0 � a5
(See reveno �ide for Metet and Boundt)
Building Permit No. -, Electrical Permit No. �� Plumbing Permit No.��y.�yQ-
Floor Load Signs have been installed as Room Capacity Signs have been instaled as
req�ired under Sec. 2306 U. B. C. . required under Sec. 3301 (1) U. B. C. _
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied
until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency.
(b) A new certificate of occupancy shall be obtained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of apartments or guesf rooms
3) Ownership
If Group H Occ�pancy, number of apartmenfs and/or guesf rooms as required under Sec. 17050.1 (d), California
Adminisfrative Code, Tifle 8, Chapter 9, Article 8.
Number of apartments_� and/or guest rooms
ISSUED YO: Building Official �
L1R�'ApR RA�9{'� bY= ���.e,fj'L, �� 7''� �. C
Date— 1� R�1�
This Certificate of Occupancy SNALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed
except by the Building OfFicial of the City of Costa Mesa under Sec. 306 (e) U.B.C. r�,,, avs�im—»-e�sa a
}� OWNER HOPSON. TOM
�JOB ADDRESS 3107 Ginger
��GENERAL CONTRACTOR o�
o D �. LOT 15
II._ cCT10N5
� SOIL
� GAS
W ATER
ROUGH PLUMBING
PROP. SWR. LINE � HOUSE CON. �
SPRINKLING SVSTEM
MISCELLANEOUS
ROUGM HEATING AND AIR CONOITIONING
UNOERGROUND U POWER U
0.0UGH WIRING
TRENCHES � FORMS � STEELI
F100R SYSTEM
BONO BEAM � STEEL ftEINFORCE
SHEATHING
FRAME AN� FLASHING
LATHING - IN I-I OOT n
PlP
51
:NT., REFRIG. AND A.C., FINAL
FINAL ANO GAS TEST I-I
DATE 11-4-69
BUILDING PERMIT N0. 31062
DESCRIPTION of WORK Conm. BLock Wall
�T 6260 FIRE ZONE VALUE $ 250.00
ature Date GROUP TYPE ZONE
SUBCONTRACTOR PERMITS ISSU
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CO5TA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant fo FiIJ in Completely
BVILDING /
ADDRESS J'�O % - /d/G/.F'/C-
OWNEP O /P-���
MAIL
ADDRE55
/1 TEL.
GIT Y C 1„' iLY /��f% NO. �}'/-/Z �
BRANGh
ADDRESS
ARCHITECT
CONTflACTOR O/P/�/,� �
ADDRESS
CITV
STATE ��-
LIC. F10.
SIZE
OF LO7
USE OK
EXISfING BLDG. 7�L S
$IZE OF NO. OF
TEL.�
TEL.
NO.
CITV
LIC. NO.
INO.OF BL�DGS.
NOW ON LOT I
EXTERIPR WALL IROOF
COVER�NG COVERING
USE OF BUILDING AND WORK TO BE PERFORMED
R
BVILDING
ADDRESS
F
uov—u-6�00 079 �*tr*"*5.00
4TION FOR BUILDING PERMIT
V OATE EC VED nnr iaci
0
PERMIT
VALVE
20 NO.OF USE OF NENY +'
PIAN$ � BUILDING
VARDSAPPROVEO VARDSAPPROVED
MAIN BUIIDING ACCESSORY BUIIDI
(FROMC/LSTREET) . . n
VAR. siE
'' .ix � !d' G ,.,y� APPROVED
-/ L" Y/ �' x S�- o'� U!p
I hereby acknowlatlge tha[ 1 have reatl thls application entl sta[a
that the ebove intormaiion is correct antl agree to comply wich
ell laws reg�lating builtling construction, antl I s�ell not employ
eny perSon in violation of the workman's compensetion lews ot
che State of California.
I hereby certity Mut I am properly Ileenutl as e cantractor under SQ. fT.
Me Stete of California Buciness entl Professiona Cotle, Dlvlsicn 3, THE AMOUNT SH
Chnpter 9, antl thot such licanses ara in full torca antl effect, or I THE PURPOSE OF I
am exen�P� from the provisions of [he Stero of California Busineis VALUATION
antl Professtons Cotle, 7vision 3, ChoDie 9, �
SIB^etare i
Parmittee - 5
AUNoriied Agent ��
�
BET. MAIN &
�
b
O
ER VALUATION IS FOR �
VG A PERMIT FEE ONLV: m
¢
./' 0 m
FEE S � c'
�
m
iECK 5 E
- � `o
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� . •' ?95�8
COSTA MESA BUILDING-SAFETY DEPARTMEM
P.O. BOX 1200 CO8TA MESA, CALIFORNIA Y2026
l�' For App/icanf ro FIII In Completaly
TYPE OR PRINT
BUILDINO � ) �
ADDR6£8 1 Vl. (/ .
COSTA MESA, RN
�
owrie
MAIL d y J
ADORgID9
CITY Y NO. /��l
. -_...�..� � i P' � _L ��. .__ �
)�la -6-64�H���O 118n �^* �15.L`_
PLICA710N FOR PERMR
BUILDING
r0� �]C8 �if0 �/lh/
11[cqITHO. /'�• nuT(�\1
"��� /. 1 1
qi V8D DA 198U[D
�' -� /� 3/-
9 fj �� -D
TYPE OROUP �
fffATB T`L, •/ ,�3 3 nvr¢: no uve �+v�rcnwn� anw�.� oe �eaa � nwn
LIC. N• N � DO' TO BIDQ Ei RBAR P. L
swvea
6IZE NOAI �LDo4y _ n� ALLOW6D �U. B. C. REQUIRHMENTI
OFLOY Now H ��O YAROBMPROVHO YARD9APPROVED
EXIST Na BlDO, b%%�C/ MAIN BUILDIN6 ACGEA80RY BUILDING
� iPROM WrLGTR6[T) /J �
Y6TpACK LIX[ IROM rRONTJ � PT /iC�l2•. PT.
earmw o� oineei �� RBAR Y D � D �}
&IOIYA DI LQPT p�pM' R.HIDQ / FT.
DES � PTION OR WORK �. oin vr. rr.
Tuwsi N ADD�T{ „ Run J rr. Rr.
DIiTANC[!R. B6T. MAIN Q
RHPAIR O IN 6M Ll8 MAIN BLD ACCESII.BLUOB.
BUILDINO / U NO.OF V�•# __ DATB
812E v O ROOMB � nST RI Iv C. U. P. '. / MPROVED
lXTERIOR WA� ROOr // _ J MPROV[G_ W�L� �� �/
COVERINQ COVERINO ��'�U[i er C.I.C%� DATE �o
U98 OF �UILDINp AfrO WORK TO B6 PiRrORM[D a
W
IO �
, *�BGo �.�.� aa� �
0
1 X BY ACKNO pOt }ry�AT 1 XI�VI RGAD THIB APPLIGTION TM� AYOUMT BMOWN UNOCp VALU/.TOX le FOR TH6 �
ANO 9TAT8 TMAT 6 �GOV6 IY CORR6R�AN0 AORBL TO COM• �URPo88 O� L9TABLIBNINO A PHqMIT P88 ONLY.
PLY WIYH ALL CITY ORDINANCC/ AND RAT[ U1WY R[OYIATINO VALUATION /' l^ S� �
BUIL�INO CON9TRYGTION. � L ��
P6RM^ITT6 E�P � PERMIT FEH S/ i v. �
�- ��' '-�`�� 93� - - � �
AUTHORIZ¢DAGtfiT \ J�
TOTAL FEB 1