HomeMy WebLinkAbout3016 GRANT AVE - Building Permitsm
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Pfl0.1ECTR00flE5S: 3OSG GRANT AV
'_OWNFfl'SN�ME: BELD, BARBARA J
nooeess: 3016 GRANT AVE
COSTA MESA,CA 92626
UNIT:
(714)557-4561
RpCH/ENGINEEX: 7ACHARY SFi�'i 5 AS50, xec.xo.: C-005009
�oonEss: 3001 RED HILL AVBLDG, 2 uNiT: 103
COSTA MESA CA 92626
rcnmineE: ZACHARY SHAM 6 ASSO, ( 719 ) 757 -2656
aooeess: 3001 RED HILL ;AV 2-103
COSTA MESA CA 92626
LICENSEU LONTBACTOP UECIABAT10N: 1 �¢reEy aliirm that I am IicenSeG unUer O�ovisions ol Chapter 9(commencing wii� Seclion
7000� ol Oirsim 3 al t�e Business an0 Prolessions COAe, an0 my license is in iW Iwce anG ettect.
cirrue.:04I2293 srnreuc.:q1063R euu: B �_�� � (�
Oate: �I [ I �-"F I �I 'L Siryamre: _ ' — ► �V �1
WOBI(F85'LOMp�PyENSqAgT,IONUEClABp710N: IhereUyalfirml�atllwveareniliwteaf nsen roselNnmreoracertilicateofWorkers'
POLICY N0. n b 1a4�1. ��ttrt�jed copy t�ereol (�I E%PO TEaO. SJ S I O S I 3
�J L V
coMraNr: STATE FUND
� Ceniliea copy is hereby fumis�eC. ❑ CenilieU copy is fileE vn1A the cily BuilOing Oivition. ^
�ll '.-I' / q'L '' ', ' =� .�:_ �� SA�^
Dale: � ApplicanL'•
EXEMPiIONfPOMWOflNEflS'COMPENS�TI0170ECLAMiION: ((tissec�mireetlmiDemmpin pemnisfameAwarMI5100�orkssl.
I cetlity Ihai in t�e Oe�armante o� th! wOrk for wAiU U45 p¢rrtut is iSsueE. I Stiall n0� employ p n in any manner m as �o become
su0lect ia i�e Warkers' Compensalion Ldra o� Calilomla.• Y,
Date: Siqnature:
NOTICE: II. alter indking Utis GMdraiidl. y0u SIpIdO�EeCOme su�iett ta Ilie Warkers' fAmp¢n5ation prm�'tsions al tlre LaGOr
COEe. you mu9 �ori�vn�� Comply wilA suc� O�ovisi0ns or tks permii s�all Oe tle¢m¢E revoke0.
CONSTfltILTION LENOING RGENCY: I tcereEy a�lirm Wt there�is a Wnstruciion IenUing aAenq lor I�e pedormance oi I�e work br
whicn tAis oermii is issuetl (�tlion 3097�Civ. C�. � !^
-rnvoex .IFv'Ci.lJ15ES 605F OFF' C ADD;
�o SITTING RM,BATH,BED RM
OWNEB BWLOEB OELLRPRTION: I hereGy allirm tlwt I am exempt Irom tAe Comraclors' Slate License Law for the lollowinp reason
(Seciion 7091.5 Buvness an0 Protessrowl CaOe: My city of camry wkN repuires a permit m consimct, atter, improve. Oemolish, or
reDair any stNtlure. prior to i6 issuance. a150 re0uves the aDW�nt for sutli Oermil lo IJe a 9qne0 statemenl tiut hPJshe is licensed
purswm to tne pmvisions af �he Contracmrs' Stare Luense Law (Ctupur 9(commexiiry witn Sectqn 70W) oi OHision 3 of tne Business
an0 Pmtesvons Coae) Or Ilui he/slie is eKempl NtRlmm mA Ih¢ bas's lor l�e all¢OeE evem0�an. My vioW�ion ol 5¢clion 7031.5 Oy
any iOVlicant lar a permit suGjMs Ilre appliUnt to a tivB pmaity al tqi rtqr! tllan live �unUreA tloAars (5500�.
I. as owner ol ine Drope�y or my empIoyeM with v2qes as tneit Sale tampensation, will Eo tne waA, antl Iho
❑ slmclure is no� in�ended ar oifere0 for sale (SeCtion 70aa. Buvneu �n0 Prolessional Cotle: ihe Coniractors' State Ucense Law
tloes na� apON �o an owner ol a O�oDeny wtn OuilEs arimprans tnerean, an0 wM Eoes suc� work �imselflhersalt or �hrouph
nis or ne� own emD�oyees. pmvidetl ItWt sucn improvemenis are not inlentle0 or ollered lor Shce. If, however ihe buildinp or
impmvemenl is 5oltl vnt�m on2 year ol tampletion, t�e awner vnil �ave I�e �ur0en 01 pmWnO �e/She UiU nol OUiltl or impmve
lor ihe DurOose ol Sale�.
I, as owner ol I�e OmpetlY. am eMclusively contracWp with Iicense0 coniractors to constmcl ��e pmject (Section 7U7<, Business
❑ an0 Pmleulons Code. The Contrxtws' SIatB Lkmu Law Gces rot appy Io an wmtr 010�up¢rty �Mn GmIQt or Impfwes l�ereon
ana w�o comracts for suc� prqects with a contractoqs) Gcense pursuam m ��e Coniractors' State Llcense Law). I am aware
tlu� Drool al ineir Worker's Compensatian insurarce 51wN0 Ee proviGeG ta me.
� I am eremD� unOer Section: B. d P. t.
lor Inis reatan:
Dale: M.+iec
I Qo hereDy cenily Ihai I am aware oi anG unCers�and ihe reduirements ot Calilornu Healt� anE Safery Coae Sections 25505, 25539, ana
2557E and I�ai I or any INure OuilAinp acupanl wiNvnll nol (tircle one) nee0lo comON'^��� �id slate co0e5 an0 t�e repuiremenls lor a
permit lor conslNclion or modilication irom t�e Air Oualily Management Oistrici. Resitlential consimction applications are exempl imm
I�CSQ O�OVI51001.
Dale: ApO�icanl:
I �ere0y ce�lily Ilwl I I�ave reatl t�6 applifatiM an0 stale Ilut I�e aOWe inlormation R COrr¢CL I agree to comDN `M�� aA Gty an0 tounty
orEinances and siate Wws reldting io UuBtlNq COnSVUCiiOn aM Ik�eby auitqriie re0���uIivPS oi lhi5 d�y to enkr upOn tlle BOWC�tMnli0ne0
prop¢riy IOr inspeclian puryoses. ^
�ale: � /� `� / � � Siqnaiure: ' �—��O � �
Driver's License ar Soua� 5earity x:
1641�a6 WNie-8wltlin9: Green—Co�e Entarcamem: anary—Applicenl Pink—Revenue; GOltlenroE—Assessor
CITY OF COSTA MESA - BUILAING PERMIT PERM NO; B 059055
PERMIT NO; B 059055 PLAN CHECK NO: 03009-92 L GOVT: N SUPP: N
CONSTRUCTZON TYPE: 5-N PERMIT TYPE; STR PURPOSE: ADD
JOB DESCRIPTION ; ADp 60iF OFC, NEW GARAGE S CONV,ORSG,GAR, SQ FT: �
CLAIM VALUE: CALC-VALUE: 19,79'7.40 GROUP OCC: R-3 /M-1
COMMENTS: CONVERT ORIG. GARAGE/BUILD NEW GARAGE
x�r*�r�+r�r�r+r�x**r�rx*rt*�r���r*x*�r���e*x��e�r*�e�r�x-�r�r�r��*+��**+r*+t******+r*#**�r+��*****�+�x�*��
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
------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; 21 FT 4 IN REAR: 25 FT 6 IN FRNT; FT ZN REAR; FT IN
LEFT; 10 FT 2 ZN AGHT; 5 FT IN LEFT; FT IN RGHT; FT IN
PARKING REp • PROV• PARCEL: 14113342 ZNE: R1 REF NO;
PLANNING Nf3TE5> CONVERTI1JGiEXISTING GARAGE TO LIVZNG AREA AND ADDING
> 2-CARiATTA�HED GARAGE, LAND USE REST, REpUIRED.
***�**�r���it��rft�Fitir*iE*+�it�c�*it*�it��t�-�ie �*ir�r*it***x�****rtit�r�t�r*it�x�ir�E*�-**�t*it��t�r�r�r*it���t��it*�e*
D E V E�L O'P M-E"�N7T ' S E R V S C E S R E Q U I R E M E N•T S
ZONING APPROV$I2 BY .,, :._SGC DATE: �/�Y/9z.
BUILDING APPRQVED B,Y ,: • ' .0 DATE: ;�_r�/-rl'/y.Z
APPLICATION ISSUED 9Y: DATE; _./
i!i!!FlFklE1Eltfkltffltitiklf�lklFififit!!ri(- . .e . .. IF1EiEiPlfaEifiFi[-1E � a iEjf
kikififfkikitlEitifiFkik�f�(-iEiE%ikifikiPi!l�iFiEifiEfEiElEiEifiEifj(�iE3f3f�M�iFiFit �it1ElEifitfFikif�iEiEikiFiEfE%1E1hiFN�iFif1VlE��jl�iFiEif�EiFifiEfEiF
LEGALIZATION;N F E E S U M��M A R Y STRUCTUfiAi,SSEGMENT;Y
i� �
HLDG PMT ALUMBING ELECTX?IC 'Nr�CiiANIC, FIR'E SMIP/RES GRADING
PERMIT 207,00 1,98
i:'% �'' , ' SMIP/NON-RES
PLAN 1 34 , 55 � ;,��
ISSUE FEE �, 't
HUILDING-DIV-> PERMZT ISSUE PLAN-CHECiCr-• TOTAL `� PAID DUE
TOTALS----> 208,98_- 0,00 ✓134.5��� 343.53 �� 343,53 ,00
1
REVENUE DIVISION TOTALS > COLLEC�TED;�� 208,98 UVER/SHORT: ,00
HLDG PMT PLUMHING cLECTRIC MECHANIC _ FIRE SMIP/TOT GRADING PLAN-CHECK
207.00 � � 1:98
/ � ' =1
+�**�r*�r���r�r*x�r******+r*****x�*x�***-x��t���r*+r****��+t�i***�*x�*�tx*��r*�t**�r�x***+t�x*�*�***x*
I N D I V I D U A L',� F E c. ��' B R' E� H D, O W�N
•rYPE
SFR
SFR
QTY D E S C R I P T I O N �. �-
60 DWE-TYPE V-WOOD FRANt � y��"GOOD
496 DWE-INT, ALTER TYPE �-WOOD FR��GOOD
431 RES-GARAGES TYPE V • ;i,.`
END; O�' FEES/ .
. ' ,`' J
r7 r �� •
/��
i, y
/ ��.
'Yi
UNIT COST
74-, 00
14;80
�,.18`; 60•
TOTAL COST
5,440.00
7,390.80
8.016.60
A
�� CONSTRUCTION AND PLANNING POOL _ �PA
., ARPROVALS Permit # Date Inspector •' p�ppROVALS Permit # Date Inspector
1. Temporary Electrical $ervice oi Pole - .� 52. Pool & Equipment Location
t
2. Soil Pipe�Undrgmd. � - 53. Steel Reinforcement .
3. ElecVical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical CAnduit�Undrgrnd_• .� 55. Electrical Bonding .
5. Steei ReinfO�cement q�a_c� 6!y� 56. Rouc�h Plumbing & Pressure Test
E. Elecv�cal UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footmgs '...{ g..cjZ �' Q,,,((J3: Electncal Conduit•Undrgrnd.
i v
_ 8. Foundation 5/� ' g u. ��� 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrgrnd. �v� 60. Backwash Lines, P�Trap, C7 Undrgmd. .
��. Structural Floor System 61. APPPOVAL TO DECK
11. Proper[y Sewer Line & House Connection � 62. Backwash & Receptor-Final � �
7?. Sewer Cap � 63. Heater & Vent•Final �
13. Roof Drains ' _
. 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical�Final '
15. Rough Eledriwl�Conduit � 66. Solar SYstem-Final '
7 G. Rough Electric Wiring 67. Fencing & Access ApProval
t i. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceilirig 69. POOL/SPA SYSTEMS FINAL �
79. Rough Heating & Air Cpnditioning FIRE �EPT. fiEQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
27. Ducts, in St�ucture 70. Underground Hydro
22. Ducts, Venti�ating 71. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test - 72. Underground Flush
24. Roof Framing . 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing `��(,j��'� �[_ 7q, Overhead Hydro
26. T�Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical
27. Frame and Flashing _` _ cL �6. Dry Standpipe
28. Lathing & 5iding �.,�=t ��„�,� 77, FIXED SYSTEM FINAL
29. Insulation � �J��-^� ,�j-' 76. FIRE PREV. FINAL _
30. Drywall Nailing � ��J��y 61c�/�iL HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ` /y.� � � 79. FINAL INSPECTION
9f r- -
32. Electrical Ppwer MeterFinal � � � 80. FOOD CERTIFICATE ISSUED
33. Final Elecir�c � � • Notes: �
34. Finai Heating & Air Conditioning i i. /�_13,�Y�_ ��--
L
35. Final Gas PiPe�Tesi � i �
36. Hood or Canopy ' j � % i. �,� �y�� �
./f./.-Lti! GK_l C�.:�/ _ _ f�!✓ �/lL��' �-m'.
37. Final Factory Fireplace �
: �llg� �� a✓_!_IO- _ �L'�
38. Final Plumbing � '
39. Water Service-Final ' ' � l� '-� ._ �.� � �_� O / ^�
!� w/
40. Gas Service�Final
' L � �j/.. f/��i� �i�.� �
41. Solar pomestic-Fina� �
42. Backf�ow Preventer � ` rc��
\ V
43. Backflow Irrigation �i` �-
44. Landscape IrriGation SYstem -�� --`�`,G y
l� a•-�
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �Z ��Q��__ i
1'
48. FINAL PLANNING ,
49-. Electric ReJease to Edison
50. Gas Release to Southem Califomia Gas Co �j '�
51. CERTIFICATE OF OCCUPANCY
No. Date
Insulation Certificate
3016 Grant Avemae
Number and Street
Orange
Coun�y
ROOF
Material _ByLts
Thickness (inches) _5.. "
EXTERIOR WALL
Material �LLS
Thickness (inches) 3.5"
City of Costa Mesa
Californie 92628-1200 P.O.Boa 1200
Permit Number
Costa Mesa, CA 92626
c��y
Subdivision
Description of Installation
Lot Number
Brand Name �nville
Thermal Resistance (R-Value) �1.9
Brand Name �nville
Thermal Resistance (R-Value) R-11
CEILING
Batt or Blanket Type Brand Name
Thickness (inches) Thermal Resistance (R-Value)
Loose Fill Type Brand Name
Contractor's minimum installed weight/ft2_ Ib. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR
Materiai
Thickness (inches)
SLAB FLOOR
Material
Thickness (inches)
Width (inches) _
FOUNDATION WALL
Material
Thickness (inches)
Brand Name
Thermal Resistance (R-Value)
Brand Name
Thermal Resistance (R-Value)
Brand Name
Thermal Resistance (R-Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 ot the
California Adminstrative Code.
ZaGiary J. Sham
— Ge ral Co tractor (Builder)
-l%� - ��Y.v--�� �u%�
Signature antl Title
Sub-Coniractor (Insulation Installer)
SignaWre and Title
19W-46
410638
License Number
12-11-92
Date
license Number
�ate
�
<�I
I PBOJECT RODflESS: 3 O S S GRANT �iV UNIT:
� OWNEH'SNAME: BELD, BARBARA J
aooRess: 3016 GRANT AVE
COSTA MESA,CA 92626
(714)557-4561
ABCH/ENGMEEfl: ZACHARY J�'i'i��'i Ei ASSU, NEG.NO.: C-OOSOUQ
aoosess: 3001 RED HILL AVBLDG, Z �"�T 103
COSTA MESA CA 92626
PEHMITTEE: GREG DESMET PLUMBING (714)969-9089
aooeess: ?1192 BINGHAMPTON CI
HUNTINGTON B£ACH CA 92646
LICENSEO CONTBACTOfl OELNflFTION: I he�eby a��irm ��al I am licensetl under provi5ian5 0l Clupier 9(commencing wi�� Semion
7000) ol Oivision 3 0l I�e Business antl Pmfessions Cade, antl my bcense i5 in lull lorte ana elittl.
ciTrucp.:042290 sraeuc.:498826 cuss:,Q3�,�
Date: / `1-5- 9L Signalure: _ C�
WONNEBS' COMPENS�TION OECUBATION: 1 her¢Gy at�irm Ihal I �ave a niliwte of consem m seli-inwre or a cenificate of workers'
Comoensation Insurance. or a cetlilietl cooY �hereol (Seclion 3800. . C�.
POLICY NO.: EXP. OATE:
COMPRNY:
� Cenifietl copy is hereby furnishea. ❑ Cehilietl copY is lilee with the ciry Building Uivision.
�I
Dale: Fpplicant:
E%EMPTION FBOM WOBKEPS' fAMPEN5RTI0N OECIABRTION: Q�is sec�ion need iwt be [o riplet¢tl i� Ne pumil is tor one hunGred �411q) ar less�.
I cetlily thai in t�e pedorman[e oi the work br which ihis permit is i55ueA, I SAall noCem � rsan in 3ny manner so as to become
sublect to tAe Warkert:Campensation Laws o� Caiifomia. /)�''�) =�
Dale: �� � S - � Sipnalure: � / -+�'/�
NOTILE: If. alier making Ihis Eeclaration. you should become subl o tAe Workers' ComOensatinn D��sions of Ihe LaOor
Coae, you must lanhvntn mmpy witn such pmvisions or tnis permn snall he deemed revokeU. !'
CONSTFUCTION LENOING RGENCY: I �ere�y a��irm Ihal there is a conSlmction lentling aqenry lar IAe DeMormance ol Ne work lor
whic� ihis Oermii is issuetl (Sec�ion 3W7. Giv. C�, �'
LENOEN:
RDONESS:
OWNEB BUIIDEN OECLANATION: I here6y afiirm Na� I am exempt Imm tAe Comractors' Slate License law lor ��e lollovnng reason
(Seclion 70J1,5 Business an0 Pmlessional COGe: Any city of counly whic� requires a permit to consiruct, aller. improve, tlemolish, or
repair any slmcWre. D��or lo its issuance, alm repuires 1he applicanl lor suc� Dermil Io lile a siqne0 slalement �ha� �e/s�e is licen5etl
pursuant lo ihe provisions ol the CanUactors' State License Law �ChaD�er 9 �commencing wit� Section 7000) of Division 3 of Ihe 8usiness
and PrOf¢ssions COAe) or Nat �e/she is e�empl l�erefrom anG ihe 6a5i5 for tAe alleA� exem0�ion. Any WOWtion ol Seciion 7031.5 6y
any apP�icanifar a oe�mit suGiecis Ihe apD�icantlo a civil penalty of not more inan five hunUreO donars 135001.
I, as owner ol Ihe pmperiy or my employees wi�h wage5 a5 IAeir 5ole campensa�ion, will tla Ihe work, and I�e
❑ simcmre ¢ no1 in�enGetl ar aflere0 for sale (Seclion 7044, 9usiness and Pm�euional Code: The ConVac�ars' S�a�e License law
Eoes not apPly to an owner af a pmperty who 6uiltl5 or improv¢5 thereon, anC who doe5 such xrork �imsell/�ersell or ��wuA�
his or her own ¢mployees, pmvided �ha� such improvemenis are not in[ended or aflereA fo� sate. Ii, however the builtling or
improvement is solU vnlhin one year of compietion, ihe owner will have I�e hurden of pmving Ae/she Uitl not 6ui10 or impwve
lor�he purpose of sale�.
I, as awner of tAe pm0erty. am exGusively conirac�ing wilh licensed contractors m constmci the pmjec� �Sec�ion 7044, Business
❑ and Pmfessmns CoCe: The Coniractors' State License Law tloes not aDDly lo an owner o� pmpeM who buil�s or imDroves I�ereon
antl who contracis �or such pmlecls wi�A a conlrac�or(s� license OurSuani lo Ihe Cantractors' Sta�e LiCenSe Law�. I am awafe
��al Drool oi iheir Worker's CamOensation insurance s�ouitl be Orodtled Io me.
� I am erempt un0er Section: B. 8 P. C.
lor IAis rea5on:
Oale: d'�+ner.
I Oo nere�y [enily Inal I am aware ol anG underslantl Ihe reQuirements ol Calibmia Healt� anE Sa�ery COAe Sections 25505, 2553�, antl
2553d antl �tWl I or any INure �uildinp occuDant will/will not Icircle onel need to com0ly with Saitl state cotles an0 Ihe reQuiremenls for a
permil lor con9mpion or mOGiliWtion Imm ihe Fir Ouah�y Managemen� Disiric�. fl¢9Aeniul constNclion aDPlications are eaempl �mm
Ihese pwvisions.
Da�e: Applicanl:
I �ereDy cer�ily Iha� Iluveieatl ihis applica�ion antl Sla�e Ihal Ihe abovein�a�ma�ionis wrr¢ci. lapreeto comply with all city and counry
ordinances an0 9ate lavrs relaiing Io Uuiltling conslmc�ion and herebY authorize reore5entafjYe5o4N6 Oiv �o enier v0on the a6ove-menlionetl
pmperry9 -lor inspection purposes.
�ate:/ - �S - % � Signa�ure:
�rive�'s Gcense or Social Secunty <:
t64�-46 W�ne-Boildin4: Green-Coae Enlorremenc Canary-Aoolicant; Pink-Revenue: Goltlenrod-As�aswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NU; P 059092
PERMIT NO: P 059092 PLAN CHECK NO: N GOVT; N SUPP; N
CONSTkUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE: ADD
JOB DESCRIPTION ; ADD 6U11 OFC, NEW GARAGE & CONV,ORIG,GAR, S� F"P;
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1
COMMENTS; RB:;ItB59055
IE iF iE �X� iE i41E lE IE iE 1! af i(� if iE iF ii� iE 3E jf itli� �)f� IF ih iF if ikif il• if iE �lF iE iF * ih ik if� �)f iF if iE iF �(� ik 1E iP iE iE 3e iE iE i(� if ih iE 3F if iF iE if if iF �lE �1F ik if jf i4lf IF IE 1k iF M� k!E �F
Z O N I N G R E Q U I R E M E N T 5
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN
LEFT; F7' IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARRING RE • PROV; PARCEL; 14113342 ZNE: REF NO;
PLANNZNG N 'I'ES>
>
3f iF iF iE iE iE jE iE iE if �E �1F iE iF iF iF iE 3k iEiE 3k IE iE if�-k iE 1E # i(� if iE �IE �IE iF if -IE K� if iE"�('lE iE �IF iE it ih N i(� K� 3f iEik i'r 3E iElf # if� iF iF if if� 3E if �Jf iE 3E �1f If iE �If iF iE 3E iF �1E iE if �1E
D E V E L O P M E N T 5 E R V'Y C E S'� R E Q U I R E M E N T S
ZONZNG APPROVED HY ��� DATE;
BUILDING APPROVED BY ; '' � DATE;
/,�,
APPLICATION ISSUED BY; DATE• �� L
itiE7EjkIFiE3fiEikiFifitiEiFiE%lEiki6iFM�ikititiC�T'iF�iF3�iF�iFTtf�iFifi'F1T�iF�F3FiF3FiF � �FiFSF3FiFiFiFiFi'FRikiflE%��llflF)fitif � iFiE
if iE 1E * it it iE it iElF ik k it fE iF iE iE iE i(� 1E ih ft iE ik iE 1t iE it ib )E if iE ik IE �E it fF iE iE �)E 3f !f !f 1E iE if� IF iE if iE 1E iElf if iE IE 1E k iE if 1E if if jf �F if iE !P ik if ff �E jE iF jf � aF iE �E
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PM'f PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PEkMIT 35,00
25t SMIP/NON—RES
PLAN
ISSUE FEE 20.00
BUILi)ING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DIJE
TOTALS----> 35,00 20.00 0.00 55,00 55,50 —.SO
REVENUE DIVISION TOTALS--> COLLECTED: 55,50 OVER/SHORT; 50
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
55,��
iE iFiE iF if if 1E iE iE iElE iFlE iF iE iE iE iE iE ik iE iF 3E iF if iE 1E 1ElElE iE 3(� 1E if 3F IE i(� iE if iF 3f iE If 1F 3E 1f if ih iE if if 1(� if if iE iE %� iE iE iF �1f� iFif iE iF-1E IE 1f 1(� ff iE if If iF ie i(� i'r if iE
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TQ7'AL COST
PLU 1 LAONDRY 7'UB OR WASHEk 7,00 7,00
PLU 1 SHOWER 7.00 7,00
PLU 1 SINK, KITCHEN 7,00 7,00
PLU 1 WASH HASIN '%,00 '7,00
PLU 1 WATER CLOSET (TOILET) 7,00 7,00
END OF FLLS
C
, _
� CONSTRUCTION AND PLANNING POG_ a SPA
APPROVALS Permit� � Date Inspector qppROVALS Permit# Oate Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ,
2. Soil Pipe�Undrgr�d. �y�Ox 53. Steel Reinforcement
L-�! I
3. Electrical Conduit UtilitV-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrqrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Piumbing & Pressure Test
6. Electrica� UFER Gmd. 57. APPROVAL TO COVER-GUNtTE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, � Undrgrnd.. Test
9. Water Pipe-Undrgrnd. � • 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. Structurel Floor System 61. APPROVAI TO DECK
11. Property Sewer Line & House Connection�/,./a�i�//` � 62. Backwash & Receptor�Final
!/(v/ 7
72. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final '
14. Rough Plumbing ' ��e�2�qL GEb 65. Electrical�Final �
15. Rough Electrical-Condulc 66. Solar SYstem-Finai
16. Rough Electric Wiring 67. Fencing & Access ApProval
77. Rou9h Wiring Sign 68. APPROVED FOR PLASTERING
18, Rough Electrical-T Bar Geiling 69. POOL/SPA SYSTEMS fINAL
19. Rough Heating & Air Condi;ioning FIRE DEPT. REnUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas � Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74, Overhead Hydro
26. T�Bar Ceiling (Structura�) & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe
28. Laxhing & Siding � � � 77. PIXED SYSTEM P1NAL .
29. Insulation � �
I j 78. FIRE PREV. FINAL
30. Drywall Nailing � � � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � � 79. FINAL INSPECTION
32. Eleccriral Power MeterFinal i 80. FOOD CERTIFICATE ISSUEO
33. Final Electric � Notes:
r
34. Final Heating & Air Conditioning I ,
t
35. Final Gas Pipe-Test � ,�
36. Hood or Canopy �
37. Final Factory Fireplace � . '
38. Final Plumbing �Zr Q
39. Water Service�Final
40. Gas Service�Final
41. Solar pomestic-Final
42. Backflow Preventer ;
43. Batkflow Irrigation
44. Landscape Irriqation System ,
45. Sound Attenua[ion
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48'. FINAL PLANNING
49. Elec[ric Release to Ediso❑ --
50. Gas Release to Southern California Gas Co i �
51. CERTIFICATE OF OCGUPANCY
No. Date
reaeeTaooeess: 3016 GRANT AV uNir:
OWNER'SNRME: Bt'LD, BARBARA J
�oosess: 3016 GRANT AVE
COSTA MESA,CA 92626
(714)557-4561
ZACHARY SHAM 6 ASSO. C-005004
AflLHIENGINEEN: 3OOS RED HILL AVBLDG. 2 pEG.NO.: IO3
�ooeess: COSTA MESA CA 92626 UNIT:
ZACHARY SHAM 6 ASSO. (714)751-2656
PEflMITTEE: 3OOS RED HILL AV 2-103
nooeEss: COSTA MESA CA 92626
110EN5ED CONiBACTOB UECLAflFTION: I nert�y allirm tlul I am Iicen5e0 untler pmvisions ol Chapte� 9(cammentinA wilh Sec�ion
7000� ai Div�i� � o� Ige�usines5 ana Prole�n�fBtlr� 5n0 my licenu is in I�I �orce and efiec�.
CITY LIC.: ST�iE LIC.: ClA : . � n�
o v ui.
Date: � � SiO�aWrt: iGl�
WOflKEflS' tdP, SR]I�t! OECLAPpT10N: Ih¢reEyalfir Iwllhavea enilicaI� oj cop nt�oullansure acertilicatealWorkers'
Compenuii0n ms�aic� E, i:cerMe4 coDY ��er¢ol (Setli n 3800, LaU. �1 / V 1/� j
roucr xo.: S TATE FUND E%P.OATE:
:COMPRNV:
�] Cenitiea DY �s ¢Dy �umishea. ❑ Cenilie0 copy is I' 0 vnth I�e city Builaing Divi io .
�ale: ADDlitant: •
E%EMPTION f OM WOBNENS' fAMPEN5ATI0N OELLAflATION: Aia seciion neeU no16e romple�eE il Ne permt is �o hwqreC �4100) or less�.
t certtly tnat in ine ve�ormance ol ihe work for wnicA ihis rmil is issue0, I shall not employ any per5on in a anner 5o as to Gecome
sublect Io ��e Warkers' Compensation Laws ol Califomia.
Oate: Signa�me:
NOTICE: It, alter makinp t�is tleclara�ion. yau s�oultl Uecome sublect io the Workers' Compensation prmdsians of ihe Labor
COGe. you musl IonAwith comply wit� suc� O�ovisions or I�is p¢rmil shali Ge Ae¢med revakeU.
CONSTNUC710N LENDING AGENCY: I hereGy atlirm t�at i�ere is a conslmction lenaing apency for i�e peAormance ol ihe wark lor
wNc� INS p¢rmi� is issi%��.°u�J�'SA°' R; OSF OFF' C ADD �
�"oE": SiTTING RM, BATH, BED kM
noonEss:
OWNEN BUILOEfl OECUBRTION: I �CreOy a�lirm itul I am ex¢m0� �mm �he ConlraCi0r5' State License �aw tor the loilowinp reason
(Section 70.3t.5 Buvneu anC Pmiessional Cotle: My city ol county wNCA repuires a permit to construct, alter, improve, tlemolish, ar
reDair any s�mclure. prior lo iis issuance. aiso repuire5 t�e apDliwnt for such Oermit to file a signeC statertrent ihat h¢ls�e is Iicense0
pursuant to i�e Orovisions ol t�e Comracmrs' 9ate License �aw (ttwpter 9(wmmencinp vnih Section 7000) ol Divisbn 3 of the Business
antl Prolessions CoOe) or tlui he/s�e is exempt t�er¢IrOm anG t�¢ Ea56 �or Ihe allege0 eRemption. My rolalion ol S¢ction 7031.5 hy
any applicant for a permt subieds t�e appliWnl Io a Civil penatty ol nol moa ihan five hunOretl tlollaR (5500).
I, as Owner of ine D�ooeny ot my em loy¢es witn wdpes d5 Ineir sole tompen5aii0n, wa 0o the wark, dnJ ihe
❑ snucwro ¢�w� inteneea ar olhre0lor sale I�tqn 70aa. Business and Pmlessional Cotle: The Coniractas' Slaie License Law
Oces no1 appty lo an owner ol a pmpeny wlq CuiIES ar imprWCS Ihereon, anE wha Oce5 sucll x9A �im5elt/hersel� or I�roup�
�¢ or �er own emDloyees, O�oviAed ItWt w[li improvements are not inten4eG or aHere0lar 5aie. II, haxever the huilding or
improvemen� 6 sol0 wi�hin one year ot wrtqletion. ine owner vrill luve �he oureen of Orovinp Mlslie aiA no� bui10 0� im0�ove
tor tlle Durp05e ol sale).
I, as Owner ol lne Dropen9. am exclu5ivlly toniracUnq wil� IkenSPA coniractors Io wn5iru[t t�e prqep ($ettbn 70CE, Bu9ness
❑ aM Rolesvms CoOe: The Conifatlai Slale L'[aae Law Ooes no� aDON IO an axn¢r of D�Ve�Iy wlq Dutl�s Or improve5 ihereon
an0 wno camrans for suc� pmlecis vnl� a mnirattor(5) lic¢nse pursuant 10 1M Camractars' Sia�e L'rcrnse law). I am aware
t�dl yo01 ot Ineii worker's fAmOenution insurance SMulO GE pwvide0 la me.
� I am e.em0� un0er Section: 8. 8 P. C.
lar INs rtason:
Uaie: Owner.
I aa here�y cenily �ha� I am aware ol anG un0erstan0 ��a repuirtments al Califomia Healih an0 Salery Coae Sectrons 25505, 25533, antl
255�E anG ihal I or any IWure buil0inp acupant wilUwill not (GrUe one) neeG Io comply witll 5aitl slate coaes and ihe re0uiremenis for a
p¢rmii lor constmclion or mo�ilicalion Iwm ihe Air Ouality Manapemenl UsMct. NesiOential calstmction aDP����i0n5 aR exempt from
inese D�ovisions.
Dale: Applicanl:_
I �ereby urutyt�all havereaGl�is ap0licalion an0 stale ttul I�e
ordindnCesanO slate Wwsrelaiinpla tutlQinp con9mciion an0 �erel
pmpetly lai mpOetii�" Durpose5.
Daie: —�J�I I ' � `
Oriver's License a Sacial Securiiy x:
i6CbG6 W�ito—Bwltling; Green—Cotle Enlorcemenl; Cenary—ApPI¢ani; Pink—Revenuel
lo comph/ wit� all dtY antl counry
ID e��erupOni�e above�mentioneA
CZTY OF COSTA MESA — BUILDING P6RMZT ^^^` • ^� ^^^
PERMZT NO: M OS9480 PLAN CHECK NO: N ^^ti�'"� �', �*t�r, �
CONSTRUCTION TYPE: 5—N PERMIT TYPE; MEC PURPOSn: ADD
JOB DESCRIPTION ; ADD 60# OFC, NEW GARAGE 6 CONV,ORIG,GAR. SQ FT;
CLAIM VALUE: CALC—VALUE: GROUF OCC: R-3 /M-1
COMMENTS: REF. B59055
*+r��r*�**±��*#�*��r*�#�*�+�*+�*+t#*��**�r**###�****#*�*�*�*��r*�,r+e#� #*��r##�� #*�*,r�+e��r#�
Z O N I N G R E Q U Z R E M E N T S
S E T B A C K S
------------�MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IN R6AR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 19113342 'LNE: REF NO;
PLANNING NtSTES>
i
�IE iE iflE iElE-1E iE iE 1E if # iE it ih IE # 1E # 141(� iE 1f if 1k �E if 1ElF %� ik # �klE iFlf iE.� # 1E # iF 1E # q� fE # iE iE # if �lE # 1f !(�%# iF fE if 1f ### it # if" # i(� 1k 1E 1E?E!F 1F 3F iE # ii
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 HY /,_ DATE;
,BUILDING APPROVED BY ; � DA'T�;
APPLICATION ISSUED BY: ' DATE; O^ �"
kifftitititk7EiEi4itifititiE%�iEiEititifrt . r. . F v e�f r re e i i 1 r e a��iri frR itiEfEitiEkikiF)kltafr r �rx��er rx itr
kifiEififi(�ikf4lfififiEi(�ltltiFiEit�EN�iEi(�iFiFlt..iElEif�% -lffkiFfElfiEiEi(-iEif3FlEi4fElfiF�EiEiFifiF�fil�1E1FltiklhiflE�fihiEi(�iEttititltiFifltlf#1F1Eff�f
LEGALIZATZON:N F E E S U M M A R Y STRUCT'URAL SEGMENI';N
PERMIT BLDG PMT PLUMBING ELECTHIC MECH9NI��C FIRE SMIP/RES GRADING
25Y SMIP/NON—RES
PLAN
ISSUE FEE 15,00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 9,00 15,00 0.00 24,00 24,00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 24,00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CHECR
24,00
!f iF iF iE 1E iFlk �lE if ±F if if� if 1f 1f 1f il�lE iF iE iE 1E iE 1F iF 1E iE 1E IF 1E 1E !E iE iF fF Ik iF 1E Ik iklE ik iE if f! 1f� iE !E if 1E iE 1E if 1F ik 3E if !f !F 1flf if iElE )F iE !f !f�lE 1f if !f iF # iE �k #!E #
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
MEC 1 INST/RELOC RECESSED WALL HEATER 9,00 9,00
END OF FEES
�CONSTRUCTION AND PLANNING POOL `A
APPROVALS Permit # Date Inspector AppROVALS Permit � Date Inspector
1. Temporary Electrical Service or Poie 52. Pool & Equipment Locat�on .
2. Soil PiPe�Undrgrnd. 53. Steel Reinforcement
3. Elect�ical Conduit Utility-Undrgrnd. 54. Forms
4. Electriwl Conduit-Undrgrnd. 55. Electrital Bonding
5: Steel Reinforcement 56. Rou9h Plumbing & Pressure Test
6. EIeM��cal UFER Gmd. 57. APPROVAL TO COVER�GUNITE
. �. Foot��gs 58. Elecirical COnduit-Undrgrnd.
8. Foundatbn 59. Gas Pipe, C] Undrgrnd., Test
9. 6Yater Pipe-Undr9rnd. . 60. Backwash Lines, P�Trap, i7 Undrgrnd.
10. Structural Floor SYstem ' � 61. APPROVAL TO DECK
1'.. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
7'<. Sewer Cap 63. Heater & Vent•Final
13. Roof Drains . 64. Plum�ing System - Final
�4. RoughPiumbing � 65. Electrica6Final
�i5. Rough Electrical-Conduit � 66. Solar System-Fina�
15. Rough Electric Wiring 67. Fencing & Access Approval
17. Rouqh Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electrical�T 8ar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. flough Heating & Air Condicioning ��,f�.�f� �� F1RE DEPT. REQUIREMENT
-1 :
20. .4ough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ 0�1
23. Gas pipe-Rough & Test 72. Underground Flush
24. R�of Framing 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T•9ar Ceiling (Structurall & Monocoat 75. �ry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding i 77. FIXED SYSTEM FINAL
29. Insulation ' I I 78. FIRE PREV. FINAL
30. Orywall Nailing ; �. HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat j 79. FINAL INSPECTION
32. Electrical Power Meter�Final � �• � 80. FOOD CERTIF�CATE �SSUED
33. Finai Electric � ���i Notes:
34. Final Heating & Air Conditioning ���p
����? ,
35. Final Gas Pipe�Test � � ,
36. Hood or Canopy I �
37. Finai FaMory Fireplace � �
38. Final Plumbing I � � �
39. Water Service-Final �
40. Gas Service�Final � �
41. Solar pomestic-Final �
42. Back{tow Preventer � ,
43. Backflovv Irrigation
44. Landscape IrriGation System
45. Sound Attenuation ,
46. Handicap Pegulations
47. FINAL STRUCTURE & BUILDING � �;.�
48. FINAL PLANNING � � �
I
49. Electric Refease to Edison � �
•I
50. Gas Release to Southern California Gas Co � ,�
57. CER7IFICATE OF OCCUPANCY
No. Daie
�
I �
I �i
PNOJECT�VOOflESS: -;016 VRANZ, AV
OWNEfl'SNRME: BELD, BARBARA J �
AODNESS: 3O1 G GRANT AVE
COSTA MESA,CA 97.626
(714)557-4561
UNIT:
AflCHIENGINEEN: LACI'IARY $HJ{l+l 6 ASSO. flEc.xo.: C—�^5004
noosess: uxrt:
3001 RED HILL AVBLDG, 2 ].03
PEpminEE: C.OSTA MESA CA 92626
aooness: WRIGHT ELECTRIC ( 714 ) 622-3958
PnMONASHERWOOD PL CA 91768
I LICENSED CON7flACTON OECIAflATIDN: I lie�eby a��irm lha� I am pcensea uMe� provisions 0� C�apter 9(commencinA wiU $eclion
7000� ol Oivisian 3 0l Ihe Business and Pmiessions Cotle, and my license is in lull force and ellect.
CITY LIC.: STRTE L�C.: CIASS:
SF375 G11878,i �� �_
�ate'. � %'— Signalure: L}�
WOflNEflS' COMPENSATION OECUPATION: 1 here�y a��irm I�ai I � e a cenificale ol co ent m selbinsure or a cenificate of Workers'
Compensaiion Insurance, ai a ceniliea coDY �nereoi (5ection 3800. La�. C).
� POLICY NO.: E%P. DRTE:
I COMPANY:
� CeNlietl copy is Oere�y IumisheC. ❑ CertilieE copy is IileE with the ciiy BuildinA �^'�3�on.
I / I
Dai¢: ApplicanL
E%EMPTIONiHOMWOPNEflS'fAMPENSNTIONOECUXATION: QhisseclionneeAnolbecompleteOiflAepermAislorone�uMreO(5700)orless�.
I Cetlity ��at in Ihe OedOrmante ol t�e work for whith lhi5 permii is i5Sue4 I Shall nai employ any p¢rwn in any mannei Su as lo becOme
subjec� Io �he WorkersQ' CAmpensalion Ldws ol Califomiai`,/���� .
Oa�e: �d '��/ d' Si9naiure: y p �� P-� ,
NO710E: 11. a0er m21Mp ihis OeclarytlM, you should become �ep to Ihe Worker CompensaGon Drovlsions9t ihe La�or
Code. you mu5i �otlhwii� comp�y wi�p such pmvisions or �his Oermit SAaII be AeemeC revokeE. .,,.
CONSTflOCTION 1EN01NG RGENCY: I here�y atlirm Ihai IAea is a tonsimttbn lending agenty �Or the peAormante o1 �he work lor
whicn ihis permil is issuetl (Section 3097, Civ. C).
aoo ss LNCL[7D6S 60SF OFF' C ADD, �
SITTING RM,BATH,BED RM
OWNEN BUILOEB OECUINRTION: I �ere�y atiirm tAat I am exempt imm ihe Contraciors' State License law far the followinA �eawn
(Section 7031.5 Business anE Pro�essiondlCotle: Any ciiy oi counly whic� repuires a Oermit�p rqnstmci, alier, impmve, demolis�, or
repair any stmc�ute. prior to i�s issuance, atso reQuires the applicant for such Dermii to lile a signed sWtement tlut �e/slle is licenud
pursuam lo �Ae pmvisions ol t�¢ ConlraclorS State License Law (C�aO�e� 9 kommencinp wilh Section 70110� o� Division 3 ol Ihe Business
an0 Pmlessions Catle) or Ihal �e/she is C�emp� Iherelmm and Ihe basis �or Ihe alleqed exempiion. Fny Nolation o� Seciion 7Q31.5 by
any applicant lor a permil su�ie��s ihe applicant to a civil penalty ol not more ihan five hunEred Oollars �55001.
I, as owner ol iAe pmperty or my emDloyees witn wages as their sole compensation, vnll tlo �ne work, anA the
❑ simcwre is nol imenOeU m olferetl for sale (Section 70a4, Business an0 Pmleuional Cotle: The Coniractors' S�ate License Law
tloes nal apply to an owner o� a pm0eny who builAs or impmves I�ereon, antl w�o tloes suc� wofrc himsell/�erself or I�mupA
his or her mvn employ¢¢5. pmvideU Iha� suCh impwvem¢n�s are not inlenU¢tl or Ofl¢�eC tor sale. Ii. how¢ver lhe EUiltlinp ar
impmvemenl is solC within one yeai ai comDleiion, ihe owner will Aave Ihe �urden o� pmving �e/she di0 nol �uiltl Or impmve
lor Ihe ourpose al salel.
I, as owne� ol Ihe D�OOehy, dm ¢y[IuSiv¢N coniracling vn�h IimnseE coniractors �o wnstmc� ihe prqeci (Sec�ion 7040, Busine5s
❑ anG Pmlessrons Catle: TAe Conlraclors' �laie License Law Eoes noi apply �o an owner al pmperry who OuilCs or impmve5 i�er¢on
an0 who coniracls for sucn D�ojec�s vntn a contractor(s) license Oursuant to ihe Coniractors' State Li[ense Law�. I am awdre
Iha� D��� ol ��eir WaM1¢i 5 Compensali0n insurante ShoulG G¢ pmvi0e4 io me.
� I am ¢rempi unaer Sec�ion: B. 8 P. C.
for I�is reason:
Date: P.vner
I do hereby cenify that 1 am aware ol antl untlersland ihe reQuiremenis ol Calibmia Heallh an0 Salery CoOe Sections 25505, 25533, and
25530 antl ihat I or any IUWre building occupant willlwill not (circle one) need to comply wilh saitl state coAes and ihe requiremenls for a
permil far conslmciion or mo0ilicalion Irom Ihe Air Oualiiy ManaAemenl Oisiricl. FesiOenlial cons�mciion appliwlions are e�emD� ��om
I�ese O�ov¢ions.
Dale' Applicam:
1 nere�y cerlilyi�al I�ave�ea0i�is a00�i�alion antl stateihat I�e a0ovein�ormalionis correci.lagree�o comply vnth allciiy antl counly
orEinao[es an� Slalelaw5relaiingto Euilding con5lrutli0n a�tl hereby aultqr¢erepreSenlaiiv¢5 ol�hi5 Cirylo enier uponl�e aEOve-menlione0
pfOPEfIy 10! Ip5pP/C11011 pcU/IpO5Q3. �� �
Da�e: �G — O —/ a' _. Signature: p/.�"'f� �=� �
v
Oriver's 6cense or Saul Secuniy x: � � �
16abe6 WM1i�e—BUAEmp: Green—Cope Entorcemem: Canary—Nooliwnt; Pink—Revenue: GOIEenrod—Asaxsxnr
CITY UF COSTA MESA — BUILDING BERMIT PERM NO: E 059378
PERMI'I' NO; E OS9378 PLAN CHECK NO: N GOVT: N SliPP: V
CONSTRUCTION TYPE; 7—N PEkMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION : ADD 6071 OFC, NEW GARAGE & CUNV,ORIG.GAR. SQ FT:
CLAIM VALUE: CAI�C—VALUE: GROUP OCC: R-3 /M-1
COMMENTS• CONV ORIG GARAGE/BUILll NEW GAR �IB59055
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Z O N I N G R E Q U I R E N, E N T S
S E T B A C H S
------------ MAIN BUILPING ---------- --------- ACCESSORY HUIlDING ---------
F'RNT: FT IN REAR; FT IN FRNT; FT ZN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: cT IN RGHT; FT IN
PARKING REQ • FROV: PARCEL: 14113342 ZNc: REF NO:
PLANNING NZSTES> � �
% /
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D E V E L O P M E N T S E R.V I C E S R'E � U I R E M E N T S
ZONING APPROVED BY PATE;
BUILDING APPROVED BY ; DATE:
APPLICATIt�N ISSOEll HY� � DATE; ��?��
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LEGALIZATION;N F E E 5 IJ M M A R Y STRUCTURA�, SEG��ENT:N
HLDG PMT PLUMBING ELECTRIC NECHANIC FIRE SMiP/RES GRADiNG
PERMIT 40.95
508 SMIP/NON—RES
PL,AN
ISSUE FEE 15,00
HUILD'iNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 40.95 15,00 0.00 55.95 55.95 ,00
REVENUE DIVISIUh TOTALS--> COLLECTED• 55,95 OVER/SHORT; ,00
HLDG PMT PLUMBZNG ELECTkIC MECHANIC FIRE SMIP/TOT GRADSNG PiAN—CHECK
55.95
iE if iE �IE 1E iE i(' it # ik # it iF it ftik iE 1F 1F ih ii� ** ik k It iE #!E 1! iF if iE iE iE 7f iE 3e if # f41E iF if iE # ik �lE ih iP 1E # Y� iF i!� iE if ## IF H� # M� # 34 iE iE if ii� 1E iF # iF I(� iE ic iE # iF
I N P I V I D U A L F E E B R E A X D O W N
TYPS
ELE
ELE
ELE
ELE
QTY D E S C R I P T I O N UNIT COST
1'7 FIXTJRES LIGHTING 1 ST 20 EA. .75
20 RECEPT/OfJTLET 1 ST 20 EA. .75
1 RECEPT/UUTLET ADDITIONAL EA. .45
17 RECEPT/SWITCH 1 ST 20 EA, ,'75
END OF FEES
TOTAL COSi'
1?_.75
1�:45
12.75
• CONSTRUCTION AND PLANNING PO( SPA
APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector
i
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 ContluibUndrgrnd. 55. Electrital Bond�ing
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrltal UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Cqnduit-Undrgrnd.
6. Foundation 59. Gas Pipe, � Undrgrnd., Test �
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor System 61. APPROVAL TO DECK
i 1. Property Sewer Line & House Connect�on � 62. Backwash & Receptor�Final
12. Sewer Cap .• 1 63. Heater & Vent-Final
13. Roof Drains � 64. Plumbing System - Pinal
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Condu�t 66. Solar System-Final
16. Rough Electric Wiring /o-�y� /P /(� 67. Fencing & Access ApProval
v�� -
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts,in Struct�re 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas OOiI
23. Gat Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74, pverhead Hydro
26. T�Bar Ceiling (StruGturalj & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding , 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTN DEPT. REQUIREMENT
31. Plaster Brown Coat '. i 79. FINAL INSPECTION
32. Electrical Power Meter�Final i , 80. FOOD CERTIFICATE ISSUED /
33. final Electric �� Zj - Notes: rl
�
34. Final Heatin9 & Air Conditioning . �
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Pfumbing ' '
39. Water Service�Final
40. Gas Service-Final
41. Solar pomeStic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Ha�dicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FINA�PLANNING
49. Elec[ric Release to Edison �
50. Gas Release to Southem Califomia Gas Co ' '
51. CEFTIfICATE OF OCCUPANCY
No. Date
0 42 TRACT 4� z �E� �'�CEIVED
"� r^���' �✓SEP271961
COSTA MESA BUILDING-SAFETY DEPARTMENT fINANCE DEPT,
P. O. BOX 917 COBTA MHBA. CALIFORNIA �ITY OF COSTA MESA
For Applicant io Fill In Comple+ely APPLICATION FOR PERMIT
TYPE OR PRINT `' �p
�.,,�- ..�,. BUILDIMG
BUILDING ^J �
ADDRESS J
COSTA MESA. CALIFORNIA � FOr, OffICB Use Only
NECEIPT NO. P6$MIT NO.
owNER K S� K DEVEL PMENT CO. INC. �i`�1:,_{�
MAIL RECE EO !Y OASE R CEIVEO DATE 186OEO
aDDRE65 � f LACENTIA AVE. I �—�,�j— :.+CP? % 19F�
TEL. BUILDING '
CITY N - ADORE56
ARCHITECT TE�� COSTA MESA, CALIFORNIA
OR ENGINEER NONE NO.
ADORE56 FIRE
ZONE TYPE GROUP
APPROVEO �
CONTRACTOR BV DATE
ADDRES6 �555 PLACENTIA AVE. . ZONING
ZONE ^ I NO. OF I USE OF NEW f� j't
ciry /{ .�� PLANS 2 BUILDING LV�
STATE TEL. �eaw� �_. y Z �"� Z3 Z
LIC. NO. NO. � DeeCRIPTION �^'!
SIZE I NO. OF ei.oas. p
OF LOT � � NOW ON LOT p, p, NO,
USE OF YARDS EVES
EXISTING BLDG. APPROVEO ALLOWED
BETBACK �IN¢ FROM O� REAR YARD� �4�� ���req ���e siJ
CENTex OP s'rnEei FRONT 5 I FT. IN.
SIDB YARO ILEFT 0�2�� IRIGHT � R.SIDE � FT. IN.
DESCRIPTION OF WORK L SIDE /o FT. Z ,N.
NEW I X II ALTERATION I II ADDI710N I e�.e '^ `� �r � ...
BUILDING NO. OF /�"'�
SIZE OOM6 STORIES '
EXTERIOR WA�� STUCCC� ROOF COMPO SH I NGLE
COVERING COVERWG
USE OF BUILDING ANO WORK TO BE PERFORMED .��
ATTATCHED GARAGE �
O.
� HEREBV ACKNOWLEU68 THAT I HAVE REAO THIB APP4GTION }XE AMO�INT 6HOWN UNOEH VALUATION 19 FOR THE
AND BTATE THAT THE ABOVB IS CORRECT AN� AGREE TO COM- pURP08¢ OP ESTABLIBHING A PERMIT PEE ONLv.
PLY WITH ALL QTY ORDINANCES AND 6TATE LAWB eE6ULATING
Bu1tDtNo coNaTRucT1oN. VALUATION
SIGNATURE OF u PERMIT FEE $�'T'^-
PERMITTH � L���/d� �/a
$ ��7� / PLAN CHECK $ / / �� �
AUTHORIZED AGENT 'Jl � .j�1
TOTAL FEE