HomeMy WebLinkAbout3041 GRANT AVE - Building PermitsJobAddress: 304'I GRANTAV
Suite:
Vicinity:
Primary Occ: R3 Dwellings/ Cong Res <10
Parcel Number. 14113311
Applicant: SCOTT JOHNSON
Address:
Type of Consiruction: V-N
Zoning:
Owner. SATURENSKY, GEORGE TR
Address 3041 GRANT AVE
COSTA MESA, CA � -
Contractor: � PLATINUM BEST VALUE ROOFING CC
Address: 22365 EL TORO RD � -
� , SUI7E 297 , � '
LAKE FOREST, CA �
Phone: 949-770-7663
Zip:
Phone.
Zip: 92626
Phone: 949-770-7663
� ' Zip: 92630 , � License: 753512
Arch :
Address:
Zip:
Phone:
License:
Eng:
Address:
SCOPE OF PERMIT
T/OFF AND RERqOF 2000SF RESIDENCE W/COMP SHINGLES
FEESUMMARY
Plan Check: $0.00
Permit $97.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $97.75
SETBACKS-
MAIN STRUCTURE front � 0-0 Rear, - 0-0
ACCESSORY Front 0-0 ' - ' 'Rear 0-0
PARKING Existin : , 0 ' . �Reauired: 0
PLANNING & ZONING
Left 0- 0
Lek 0- 0
,Pr000sed: 0
Status: ISSUED
Applied: 12I26I2006
Issued: 12l26/2006
ISSUED BY: S 1 �—
Calc Valuation:
Claim Valuation
Right 0-0
RigM 0-0
Phone:
License:
$a,oao.00
Sa,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. Q2-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
tor a period of 180 days. �• .
INSPECTIONS: In order for the work authorized under �his permit �o be considered legal, such work must comply with all applicable codes, and all
requlred inspectlona and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CqLL: (714) 7545626
'aa6-a6la�aa)
c�
WORKERS'COMPENSAnON DECLARAnON: � � �
I hereby aftirm under penalty of perjury one of Ihe following tleclaretions:
❑ I heve and will mainleln a certilicate ot consent to self-Insure for workers' compensation, as provitletl for hy saction 3700 of the Lebor Code, for the pertortnance of Iha
wO�k fof whiCh IhiS permit is 155uetl.
� I heve and will maintain workers' compensation insurance, as required by section 3700 of ihe Lebor Code, for the pertortnance ol Ihe work Por which Ihis pertnit is Issuetl.
My worker ' co�j ensation Insurance carner antl policy number ere: �-7 ,�
Cemier. S� 'TL/ /' Policy Number: � / � � � �
(This section need not be completetl iI tlie permit is valued e! one hundred dollars ($100) or /ess.)
❑ I Cetlify Ihet in Ihe peAortnanca of t�e work tor which ihi5 pertnil is issued, I Shell not employ any pereon in eny manner so as to become w6�ect Io Iha workers'
compensatlon laws oi Calitor and egrae thet if I shoultl become subJecl to ihe work rs' compensation provisions of Sectlon 3700 of the Labor Coda, I shall forthwith
comply with t�ese provisio
APplicaniSignaWre: �` �� � � Dete: ���Z. ���' �
�
WARNINO: FAILURE TO SECURE WORKERS' CAMPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED
THOUSAND OOLL4FE ($100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3]O6 OF THE LABOR CADE, IMEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirtn �hat I am licen5ed undar provisions of Chapter 9(commencing with Section 7000) of Division 3 ot ihe Business
lorce and eflect. Llc. # %.i��\`� / 2— � Cless # C
Coniractofs Signawre: �— % Date: / `<
Code, antl my license is in full
CONSTRUCTION LENDING AGENCV:
❑ 1 hereby aMirtn that there is a construc�ion lentling agency for Ihe pedormance oi the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
', Signature: Date:
OWNER-BUILDER DECLARATIONS:
I he�eby eHirm the� under penalty of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business antl Professions
Code: Any city or county which requires a permit to consimct, eltar, improve, demolish, or repair any stmcWre, prior to its issuance, also requires Ihe applicant for such permit
to file a signetl statement thet he or she is Ilcensed pursuant to the provisions of the Contradors LJcensa Lew (Chapter 9(commencing with Section 7000) oi Division 3 ot Ihe
Business end Professions Code) or that he or she is exempl therefrom and the 6asis for ihe ellegetl exemption. Any violation of Seqion 7037.5 by any epplicant tor a permit
subjects the applicant to a clvil penelty c� not more then five hundred dollars ($500).): �
❑ I, as owner of the property, or my employees with wages es thelr sole compensation, WILL DO THE WORK, and ihe struqure is not intendad or o%eretl for sale (Sac.
7044, Business and Professions Code: The Contractors License Law tloes not apply to an owner of property who builds or improves thereon, and who does such work
himseN or herself or ihrough his or her own employees, providetl ihat such improvements ere not iNendetl or oNered for sale. If, however, ihe building or improvement is
sold wilhin one year of compietion, the owner-builder will heve the burden of proving that he or 5he did not build or improve fot purpose ot sale.).
❑ I, as owner ol the property, em EXCLUSIVELV CONTRACTING WITH LICENSE� CONTRACTORS to conslruct the project (Sec. 7044, Business and Professions
Code: The contraaors License Law does not epply to an owner of propeny who 6uiltls or Improves ihereon, antl who coniracts for suc� project with a coniractoqs)
license pursuant to ihe Contractors License Laws.).
❑ I am ezempt under sec. Business and Professions Code for ihis reason:
Signature: Date:
Owner ID veniietl by tlriver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verification ot Ownership by (type ol document, i.e. - properry tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cenity thet no excavetion fiva (5) or more teet in depih into which e person is required to descend, wlll be made in connection with work authorizetl by �his
permit, and ihat no bullding structure, scaflolding, talsework, or demolition or dismantling ihereoi, will be more than thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Ttle 8, Celifomia AdmiNsirative Gotle).
❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit from the Division of Indusirial Safery, es notatl above, unless such person has e
permlt to do such work trom ihe division.
SignaNre: Date:
Division ot Industnal Satety Permit Number:
CERTiFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTAY: I cehify under penalty ot perjury that 1 have reatl this application antl state t�at the intortnation given is
correct I egrea to comply wlth ell sta�e laws and city ordinances relating to 6uilding constmction, end euthorize representetives of the City of Coste Mese to enter upon Ihe
ebove-descdbed prop for inspection puryoses. I egree not to occupy or allow occupancy ot eny buiiding authorized by this permil until tinal inspection.
��
ture Of Legal Owner(s) /2/�/ � 1 Date /
�P e
v� And/Or Authorized Applicant � � � Date
COOE I. INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final
200 Final Re-Roof
201 FInaI BIocWRetaining Wall
202 Final Fectory Fire Place
203 Finel Sign
204 Final Demolition '
�� �
COUEt INSPECTONTVGE
206 Final Mechanical
20B Final Plumbing
210 Final Electrical
212 Final Fire Preven�ion
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
29g I[�Lfl
CITY OF COSTA MESA
BYILDING DIVISION
F� � 77 FAIR ORIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • www.ci.costa-mesa.ca.us
�, FOR INSPECTIONS CALL: (714) 754-5626
�nrvi A•:
PERMIT NUMBER E08-00113
PERM17 TYPE ELEC
APN: 14113311
STATUS: ISSUED
DATE ISSUED: 04/0112008
ISSUED BY:
JOB ADDRESS: 3041 GRANT AV, CM ' Suite/Unit: .
ViCinity: ,r �;%S';-�..`�. - . -
, `ti . - _ - - �--'�'-
SCOPE OF WORK: UPGRADE EXISTING SERVICE�TO 100 AMP. - SAME LOCATION. � � ,
OWNER:
PHONE:
APPLICANT:
PHONE:
SATURENSKY,GEORGETR
ISAZA, ERUBEY .
CONTRACTOR: KEY ELECTRIC INC ' �
Address: 12611 HIDDENCREEK WYUnit SUITE G
City/State: CERRITOS, CA ZipCode: 90703-2147
ELECTRICAL PERMIT FEES
Electrical Plan Check Fee: _ $0.00
Electrical Permit Fee: $54.00
Reinspection Fee $0.00
TOTA� FEES $54.00
Address: 3041 GRANTAVE UniC -
City/SWte/Zip: COSTA MESA, CA �
Address: Unit: -
Ciry/State/zZip: - , , _ ., ' � ..
License No. 678113 ��� .
PHONE: . 562,404-1508 � '
CELL: � '. � . .
�
NOTICE; 7he work authonzed by this permit shal7 comply with aN applicable hand+cap access requiremenis under Cali�omia statutes and related
regulations. (Ord. No. 92-28. § 1. 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all
required inspeetions and Tinal approval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
C0� INSPEC7IONTYPE ORiE IN7I11A15 COOER INSPECPONiYVE ORiuF INIIMlS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
7268 pool Spa Final . 208 Final Plumbing n
200 Final Re-Roof 210 Final Electriwl 6 V
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition _ ,,, 250 Final Buibing�Occupancy
WORKERS' COMPENSATION DECLARATION:
I �ereby aHirm under penalty of peryury one of Ihe tollowing tleclarations:
❑ 1 have anA will maintain a certificatB of wnsent to sel(-InSUre (of workers'
compensation, as provided for by section 3700 of the LaDor Code, for I�e
p Aormance of Ihe work (or which this pertnil is issuetl.
I have anG will maintain workers' compensation insurance, as required by
s tion 3700 of Ihe Labor Code, fw ihe pedormance of the work for which this
pertnit is issuetl. My workers' compen ation Insurance carrier and policy
�umber ar/a//y�� n �% ����,,,����
arrier: Ln iinti QLt (�./A.+ � T �_��+i"i�
(rwseaw�neea,roraewm�p/'�nree 2me awraWede�m{nLnd'ie�cio,Mars(Ef00)aless)
Policy Number. � �A (�. J / Z
❑ I certi(y ihat in the peRormance of Ihe work (or which this pertnit is
issued, I s�all not employ any person in any manner so as to become subjecl
to the workers' compensation laws of Calitomia, and agree t�at if I shoultl
bec m83e ject to the wo cers' compensation provisions of S tion 00 of
t bor C de„I shall fo vnth comply with Ihese provisi s. � Q�
AOpliwnf Sig re Da�
WARNING: FAILUR TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSEO CONTRACTORS DECLARATION:
I hereGy aHirtn that I am licensed under provisions of Chapter 9(commencing
with Section 7000) o� Division 3 0( I�e Business and Professions Code, antl
my license is in full rce e e . S D
�J �%%
�ic. # ( Clas� `�
Z
Conlraclor's5i aWre Date
CONSTRUCTION LENDING AGENCV:
❑ I hereby affmn lhat there is a consWctbn lending agency for the
peAortnance of the v.vrk fa which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Name:
Lender's Address:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of perjury thal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the (ollowing reason (Sec. 7031.5.
Business antl Professions Cotle: Any city or counly which requires a permit to
construcl, alter, impmve, tlemolish, or repair any strucNre, prior lo its
issuance, also requires the applicant for such permit to file a signed statement
Ihat he or she is licensetl pursuant ro Ihe provisions o( Ihe Contractors
License law (Chapter 9(wmmencing wilh Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempl [herefrom anC
the Dasis for Ihe alleged exemplion. Any violalion of Section 7031.5 by any
applicant for a pertnit subjects the applicaN to a civil penalty of not more than
five huntlretl dollars ($500).):
❑ I, as owner of the property, or my employees with wdges as their sole
compensation, WILL DO THE WORK, and the slructure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an owner of properry who builds or improves
Ihereon, and who dces such work himself or herself or through his or her ovm
employees, providetl that such improvements are not intenAetl or oRered for
sale. If, however, the building or improvement is sold within one year of
completion, ihe ovmer-builder will have the burden of proving that he or she
did not build or improve for purpose of sale.).
� I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to conslrucl the projecl (Sec. 7044, Business and
Pro(essions Code: The contractors License Law tices not appy to an owner of
pmperty who builds or impmves thereon, and who coniracts for such project with
a contracta(s) license pursuant ro the Contraclas License Laws.).
❑ I am exempt under sec. �
Business and Pro(essions Code for �his reason:
Owner ID venfietl by driver's licen J Ves ❑ No
Dnver's License No. � Expires:
Verifiwtion of Ownership by (type of document, i.e. - property lax bill or tleed):
OIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certdy that no excavation (rve (5) or more feet in tlepth into wTiich �a
person is requiretl �o descend. vnll be made in connection with work authonzetl
by this pertnit, and Ihat no building structure, scaffdding, talsevrork, v demolition
or tlismantling thereof, will be more than thirty-six (36) (eet hiqh. (Chap. 3.2, Grp
2, M 2, Sec. 341, Title 8, Califomia Administratrve Cotle).
❑ As ovmer-builder, I will not employ anyone to tlo vroB which woultl
require a permit from the Division of Industrial Safery, as notetl above, unless
such person has a permit to tlo such work (rom ihe division.
Applicam's SignaWre
Division of Industrial Safery Permil Number _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or tuture building occupant need to fle antl
certify a Business Plan tor emergency response to release or Ihreatenetl
release of a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safe[y Cotle requires, with some
exceptions, ihat a Business Plan be filetl with the Costa Mesa Fire
DeDartment by every business which has at any one time dunng a reportetl
year a quantily of hazardous malenals equal to or greater than a weight ot
500 pounds, or a volume of 55 gallons, or 200 cubic feet ot compressed gas
at standard temperature and pressure).
2. Does or will the applicant or present or future building occupant need to file
a registration form tor acutely hazartlous materials? ❑ Yes ❑ No
(Seclion 25533 0( the Califomia Health and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Depanment by
each business which at any one time has on hand a quantiry of acutely
hazardous malenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standartl
temperaWre antl pressure�.
3. Does or will the appliwnt or present or future building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for aculely
hazartlous materials)? ❑ Yes ❑ No
(Section 25534 of Ihe Califomia Heallh antl Safery Code provitles lhat lhe
Costa Mesa Fire Department may require the preparation, certifcation and
fling with the Fire Depanment of an RMPP by businesses which are requirad
to register acutely hazardous materials vnth the Fire Department.
4. If an RMPP is presently required, has Section 25534 of Ihe Califomia
Health and Safely Code been fully complietl with? ❑ Yes ❑ No
5. Does or will ihe applicant or present or (uture builtling occupant require for
Ihe work which is the subject of this application a permit for such construclion
or modi6cation from the South Coast Air Quality Management Districl or fmm
any other air polNtion wntrol Oistnct or agency? ❑ Yes ❑ No
(Section 65850.2 of tha Calilomia Govemment Code requires �hat the requestetl
infortnation be fumishetl on applications fa non-residential building pertnits).
6. Will any part of the facility to be consWctetl under this permit be within
1000 (eet from the outer boundanes of a school? ❑ Yes ❑ No
pf yes", the faciliry must meet the requirement of Sections 25534 antl 42303
of the Califomia Health and Safety Code).
7. If a permit from the South Coast Air �uality Management District or other
air polWtion control district or agency is required for the work which is the
subject ot this application, have all of Ihe disclosures prescribed by Calitomia
Health antl Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. pf 'yes', attach certificate of compliance from Ihe appropriate air polWtion
contml offcer).
CERTIFICATE OF COMPLIANCE: I certify that under penalry of perjury the
information given above is cortect. I agree to comply wilh all sWte laws and
ciry ordinances regarding Hazartlous Materials and Emissions.
SiB�aWre Dale
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this applicalion and stale that
the in(ormation given is correcL I agree to comply with all state laws and city
ordinances relating to building consiruction, and authonze representatives of
the Ciry o( Costa Mesa to enter upon the above-descnbeC pmperty for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this pertnit until final inspection.
Sigrissure of L Ovmeqs) Da1 ^
SignaWre Da1e Z �/7�
Jil9-06(�/0]) ME/IXAuIl10 CdAV �G]nl � Dll< f.�r�
ADPi�eant to till In all iDaces exceD< <hosa wH�in �eavy borOar Iines ana slgn all ap0�oorlate Coclaratians.
CITY OF COSTA MESA �' �� . � PE MI NO. � TRACT NO. LOT NJ. BL ,
CONSTRUCTION PERMIT, . , ' " • ���� -
AppflCenYSMellingAddfeA ~� V`e ' iVPEOFCONSTRUCTION ' NEW ADD �ALTERATION REPAIR �- �
PrOjEtt Add/Bss � V`i � �=' �` � N � ❑ CONVERSION ❑ DEMOLISH ❑ OTHER
Owner a Name � -S A T U Y2 C'..N 5,� G hane 5S7''��6�' �DESCRIPTION OF WORK ,
Address �J� O � G f2- F1 N� ' - � . . .
� TVPE OF PERMIT GRnoiNG m- �F OAl
Arch/Eng. � � Licensa No. �❑ TENANT ❑ ELECTRICAL PL� LUMBIN6
, �_ r. , �
Addr255� _ :�OTNER ' ' '
,� �; + jh Y'S9-q�7o PqQ1ECTDESCRIPTION� S�.F7. . .
CqntrettO�:SNBm �S�I V�D .�lo`�P�' , ' CONSTRUCTIONTYVF ' �
Address Imsiling) . .
.�' j � S1 G' / ; ZON� " ' � GRADING CU. VDS.
License No.
LICENSED CONTRACTOR DECLARATION • ' Ramarki: , y . .,
I hareby aHirm l�at 1 am IlcenseE untler provliloni oT Charter 9(commancing . .
with sectlon 7000) of Divislon 3 of the Business antl ProfeSslons Cotle, anC • � �
my Ilcense.is in /ull force effect. � 1 _p-/
Llcense Ci6u � � � � Lice a lo.� •� � � � �� 9' ^ . � - � � , PLUMBING
Date'� "'� ��X Signature - � � �
'"��RKERS' COMPENSATION DEC ATION � . . Bef Sink � $awef CBp
eoy'aftirm tnat 1 hava a certlfltete oi consent to self-insure oi a c¢rtltlWte �I ' gackfloW.Freventer SeWBr Coni
Norkars"Compensation Insurance,�or a`certlfietl�copy theeof (Sectlon� � - - � � -
380o,'LSb. C.) q � � ; Backflow Irrigation 1 Solar Colle<
Policy No. �S/� Company � ' ' " -
BCertl}IeA�copy li here�y turnishetl. � ' ' f ' � � ' Bethtubs ' ' $olar Pipin{
Certiiletl copy Ii fl eC wit� t�e city Bui `tl'ny�oi��s��. ' � .
�...e .i -aY .S' � n�..u�:..r � � �.K� /n /? �.l�l�� - Clarifiers . • ' . Solar Tank
EXEMPTIONFROM WORRENSCVMYGMMTIOIV UGGLHIiqIIVIO
(ThlsSectlon neaa not De comoletee if tna permlt is tor one hunEree (5100) or '
less)�. . ' ' � •
I<erUfy�t�at In the Der/ormtnce ot t�e work tor which this permR iz IssueU I•
snall' not employ any person in any mannar so as to become suEject. to t�a �
WorkerT' Compenutlon. Laws oT CalitOrnia.: � t � �
Date - ti9natme - � ' ' '
NOTICE:.If, altar. makipg t�is OeclaraSion, yoqz�oultl become zuUject to� Me i
Workers' ComOenutlon' provlslons of the laboi Cotle, you musl fort�with .
comOb w��h, suc� 'proWilons: on tniS..Dermlt `s�all be ; tleametl� revoketl.i
CONSTRUCTION LENDING�AGENCV �• - '
I h0reby a/tirm thdt [hera Is a'constructlon Ientling a9ency for thG�perfOrTanCB
af tha work for which.� this Darmit ii' issuetl (Se<pou� 3087 Civ. C.J- �
LenEer's� Name- � ' ' "
tanCer'S AGOress � � � � " � -
OWNER BUILDER OECLARATIONI � � - � ' ' "
I herabY affirm that I am.exemoti (fom i�e'Contractor'S' Litenie Law Tor the
for a
e hun
as
a
a
Drinking Fountairis '
Floor Drains � � •
Floor Sinks - �
Gas SerJice ' Outlets � ��
Interceptors �+ '
KitchenlSink' ' .
La'vatories � I -
Drains. .. .. • .- ;
:r's -
�e Sink � . j �
�
LJ STRUCTURAL
MECHANICAL
_OCCUPANCV
iqTION $ `
— ACRES
Water qoset� �
Water Heater.
'WaterService V" �- �
. � � . �
� � 1 , �
. . . � .. .l .)
ia. r. sr�
PLNG. REF
LEFTSIDE VARD
PKG.SPACE REQ.
�STREET WIDTH�
SVECIAL CONDITIONS:
Construction Pole�"
Cooking Unit -
�IShVld$�ICf �
� - Dryers -❑Gas•��Electi
Fan�
, F.A.U. ` � ,
D Fixtures �.
Device Boxes , �
Outlets '
Switches � �
' � Garbe9e Disposel ,
. y. . �
� � • Reinspaction�Fee , $15
�'^� , � Isue Fee � � ' $ 3
- MECHANICAL . � ' .
- Refrigeration System
❑a,100,0008TU ❑tO0,00087U� �
, i
pieuon, me own¢riwm nave me ouraen or provm9 ne/sne oia noi owia o� im-
' �Ove /o� tne pu�po5e of� 5a18). • � � . - . i � . Dutt - Structurel ' : Sy
� I, ai owner ot Iha D�operty, arn ex<lusively contracting.with,llcensetl con- � .
. lldCfORfO <OOS[�uCt t118�pfO�BCt (Section 7044, eusinezs antl Pro(essions Cotle: . Duct - Ventilating � � �
The Contractor's�licen3e �Law doas not apply to an owner�of property who -� - '
builtls or improves tharaon, antl who contracts for such pro�ects wilh a con- � ExhauSt SyStEm ❑ Multiple ��
tractor(5) Iicense pursuant to tne Contractor's License Law). � •
❑'1'am enempt untler Saction _ � B. & P. C. for this reason Firepl/F2Ct. BIt. ICBO # ; �
Date � owner � ' � Heating System & Ducting :
I hereby cer[Hy that, I•have reaC this applicatlon antl state that Ihe.aDove ❑a100,000.87U �100,000BT
irvformatlon is correct.'I agree to comply with alf Gty.antl county ortlinancei �. � � � '
an0 state laws relating lo bulltlln9 construction, antl hereby authorize repre- Hood o� T e I ❑. �
'senPatives o! this�<Ity'to e tar� pon tha above-mentionetl prop�y,or� � YP .
ins ection purooses.n y p Jj Cano T e II ❑�
Signature ✓,(✓ �/ �J�� • Oate O � � • �
/y Re isters !
' Drivers' Ll�•^� ^• CS q� �%/ � ' _ 9 �
CMF 0865-46 rev: 12/82 �"Whita - Bulltling; Gnary - Applicant; Plnk - Atcountln9;'Goltlenrotl -'Assessor ' "-" ^" "'�
a
� j Reinspection;Fee{ S75 �
i�
� + laue Fea . $ 3 ��
. . . 423', :t�j,:.s% . ,' , TI.
' _'flEAfl VARD (TO P/L) . ' �
RIGHTSIDE VARD � ' ' '
' PROVIDED '" � '� . �
a � .PARK FEE S " � `
� r `
` r � .' � ' 1 '` j
ELECTRICAL • � � -
�Meter �over100amps' �
. � ;Sub Panel .• • , �
, �
� Sub Pole � : . �
� -Motors �0-1 HP ❑1X� � � '
� �ilnaSolarf�09-15'HP 01645+ �� "'
� 'Microwave �
. �Pole�Light � , �
. 'Range . . .j .
� Sian i . . � .
0
KW
Standing Sections �
Tresh Compactor ' I
� , � + 1
�-�
I i rensrormer t_175-50 KW ' � ' '� ; '
❑5U+KW' i �'ReinapeaionFee � $15�
, � �
Meter �up to 100'ampi �:laue Fae' ' i I'$ 3
Zoning Approved BY i �'.Date �
�
Application Approved By � �Data ' � 1 -
' � : G ' � � , 9-�3�
Applimtion Issued By Date
� � ' , �, � SUMMARVOFPEES�,n �� � y _'.fiLf�
�BUILDING PERMIT $ ; � ` SMIP ;�YL.� $ � �+'��
�PLANCHECK, � $, pPERM1.T� yyy���///���'''�"lll�' ��',I/Y
�PLUMBING . $' ��f�SSUANCE4�•b'f,�
�PLAN CHECK� $� ' • GRADING $'�
,ELECTRICAI � $ � . ' � ' $ •
�PLAN CHECK 1 MICfiOFILM � $ ,
$ � � i 1 .
�MECHANICAL i $ � � ' ' TOTAL PEE ' $ �
�PLAN CHECK� i $' ' { ' .. qD ANCED PC � $ C� �
' j ' • ' , FINAL FEE $ ?r1�.�
� � CONSTRUCT.ION AND PLAN� G � � �•, � . • � - - ", ' �C SPA . � � * � � � !
o:
� ' - ' ..; -; "�'�'� : Date ' � Inspector ' � . � � . Date Inspeitor� ,
_ AP,PROVALS`. •.Permit# . �APPROVALS - Permit�'
r. ., .
_ ��1. Tempoiary E�ectrical Seivice,or Pole �� :� . � , �,. � >;- ' _c ,"�52.` Pool�&:Equipment Location' � . . - �
: ,2.' Soil Pipe-Undrgrnd. ` � `` ;.� : .. :; ' . _ � 53.� Steel;Reinforcement - � ' �
i 20� , �
. t3. Electrical Conduit UtilitviUndrgrnd. � a �' � �';54.��Forms� � - ' "�_ � � ' �
4.�'Electrical Conduit-Undrgrnd = �_ }1 . ��; � �� � : 55. Electrical Bonding � � - � _ - �
' 5.��Steel Reinforcement , ;' = ' ;; ;1 _ �� ; ' ' : � �-. 56.- Rougti Plumbing�& Pressure Test '
6• Electrical UFER Grnd: -` , �- � � ' - � . _57.�APPROVALTO COVER-GUNITE � ,
7.-Footings . �_ � �'�;:' � .� �•� _ �58."Elec[rical�pnduit-Undror�d. . . �
6.�•Foundation �' � ,�! � � - _ � •': - - _ _ � � 59. Gas Pipe,'� Undrgmd., Test . �. �
9.�Water Pipe-Ui�drgrnd:'. : ' � ' �� _ ' , 'gp.'-gackwaeh�Lines; P-Trap, O Undrgrnd. � �
10.iStructural,floor�System , � . - � � � .61.�APPROVALTODECK• _
11. Property Sewer Line ffi House Connection� , �. " '. 62. �Backwash & Receptor-Final' __� - �
12.�,Sewer Cap � � � � �� , " 63..Heater & Vent-Final .
13., Roof Drains i I = , . . 64..Plumbing System •'Final � : . - . .
14. RougN Plumbing • � �� � ' '- 65.'Electrical-Final
� 15., Rough' Electrical-Conduii " �'- � �' �' �� �'" ' �' � - : 66. Solar Sy4tem-Final � �� � �- � '
�16. Rough, Electric Wiiing � '� E , " �'� i .�'i -: . � , • , 67. Fencing &�Access Approval =� •- �- � - '
_ 17.��Rough Wiriny,Sign � � - � ; . `;�' � � � •`� - : ( • a gg. AFPROVEO FOR PLASTERING' � .
18.� Rough Electrical-T'.88r Geiling �i !� ! q! "� �� 69. POOUSPA SYSTEMS FINAL
. 19. Rough Heating &�Qi �Conditio�ing ,� �: j:'. � � �_: � i � � t FIRE,DEPT. REQUIREMENT ;. ' .'
�0. Fiough Factory Fireplace ; �, I � � � '' � �'APPROVALS � Permit � �
21: Ducts; irnStructure '� � ' �j i � � � � 70. Underground Hydro � - �
` 22.�Ducts, Ventilating. � ._ � ' � ; � i I ' � �71. Produc[�Piping,OGas ❑Oil �
523. Gas Pipe-Rqugh & Test,; � � ; �'� i I � ' I � ' ' 72. Underground Flush � � � .
� 24: Roof Framing � ; i � � � ,i;y ' ,> � , � � � I � ' � , � , , � 73. Undergrnd. Storage Tank O�Gas ❑�Oil
:�
� 25.,, Roof Sheathing + � , �. � �;,; � � � �, � „ � j �_ � - ; 74. Overhead Hydro � _
• �26.�T-Bar Ceiling��Struaural����& Monocoat � � � ' T "i ' �j 75. Dry Chemical � .
i �� i' �
� � 27. � Frame�.and`•Flashing 'l ; � '� � . i I i � ' ; � 76. Dry Standpipe- - • - � . �
� 28. Lathing & Siding �� „ , i i ," �� � � � � � � � : 77�. FIXED SYSTEM FINAL. � ' � �
•� 1 1 !
29: Insulation' ; i" � j � � �� � ( � j� 78. FIRE PREV. FINAL ,
r
�- 30.�Drywalt Nailing ; � I .r � ' 7 ; i � ' I ; Notes: � i ' . , .
- - � . .� .. , .
'31.�Plaster Brown Coat � .. ' � i - - � � '--� . - �� --; , . .
� , �i � � � � i ; i �, � .
� ^ 32. Electrical Power Meter-Final � ii , � � ' . ,
33., Final Electric � j � �� � � _ � � ' ' � �
.._
34. FinalJHeating&Air�Conditioningy�;; � � � � ! � � �� - '
�,. � � '
35.FinalGasPipe-Te;tr x,�i _� � ' ��-°j��.�, . '- . �.'� � .
7 .�,I��:�-, ir, ,'I,i' - -
36. Hood�or Canopy'�� � ` ' -� � � ; � � ' � - . ' � '
- - r � .i I �
37. Pinal Fac[or.y Fiieplece= �� - � ��i �� � � �- j ' I i � �' , I � �� � � -
38. Final:Plumtiing� ' ; � � . �� � , � � � �� ' .
39. Water. Service-Final ' � .. i �i � •
�
40. Gas Service-Final � � � , � . ' ' � - � � , . �
� � i 'i
' 41. SolarAomesticFina� � � ' � ', �__ _ � _.� '_ L;__ '_ _ _' _ � �
42. Backflow Preventer � , � i r. , t � � j ,� i • _ � � � "
' - - -- , i , - r . _.
43. Backflow Irrigation � � r i � � : � ! - �
'i , . _ - - . _. .
44. Landscape Irrigation System � �;f'- � I � , � � . . ' . •
... _ -. .�. i i � i i r � � n i - � .
45. Sound 'Attenuation', �;' � e i i °� I s^ . � " � e - ' ' ' � � � � , �
�
46. Handica`p Regulations� � �� i � ' � .� i � . ' - � ' � '" • ' . .
�� � �
47. FINAI STflUCTUREi& BUILDINGI �` � �' � ' ! ' I .
I i �
48. Special Requirements;Completed , � � � , �, , ' ' , ' - . . - �
� � i �
,. , , ; . . . .. .
49. Electnc �;Release toi Edison � � _ � _ � ___ _ _ _ _ __ _ ' �
50. Gas Release�to Southern Califomia Gas �Co � i � � � ; � I � , � ' ' • � . � '
51. CERTIP�ICATE OF OCCCIPANCY � _ ' Y_ ;. _. y. � ; _ . _
i {`
No " � Date ' � ° � , ' � � ! • i � . �
.,_
�or 56 rRA�T 4z z
��t-���
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 317 COSTA MESA. CALIFORNIA
fOR APPUCANT TO f/LC /N COMPLETELY
TYPE O PRINT C`� r�"�
BUILDING ��a
ADDRESS I
COSTA MESA. CALIFORNIA
OWNER K S�. K DEVELOPMENTKCO. INC.
MAIL j555 PLACENTIA AVENUE
AOORESS
crrv NEWPORT KBEACH TNO.MI E)�Z[
1 CONTRAGTOR K.W. Ko�� L C NO.
1555 Pu ceNria AVENUE
A.P. NO.
SIZE (� NO.OF BLOGS.
OFLOT 7O� X�`f��� IRRIG NOWONLOTO
USE OF
EXISTING BLDG. NONE
SETBACK LINE FROM
CENTER OF 9TflEET � REAR YARD �
SIDE YARD ILEFf � IRIGHT � ��
DESCRIPTION OF WORK
NFV I X II ALTERATION I II ADDITION I
BUILDING 1, NO.OF
SIZE �y� SQ.FTBOOMS 7 STORIF
EXTERIOR WALL ROOF Om�
COVERING ICOVERING SHINGLE
USE OF BUILDING AND WORK TO BE PERF ED
SINGLE FAMILY RESIDENCE AN YTAC
GARAGE
1 HEPEBY ACKNOWLEOGE THAT I NAVE REAO TXIS /�PPLICATION
ANO 6TATE TXAT THE ABOVE IS CORflECT RNO AGREE TO COM�
pLY WITH ALL GTY OFDINANCES NND STRTE LAWS REGOLATING
BUILOING CONSTRUCTION.
SIGNATURE OF �� .. L/ v w.7D
/AUTHORIZED AGENT
�
FEE RECEIVED
,�/ SEP 271961
. � fINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR Off/CE USE ONLY
I RECEIPT NO. I PERMr�NO�'
f � G
IVjD�HY � DAZCTiECE�VED .I. DATE ISSUED
BUILDING
COSTA MESA, CALIFORNIA
APPROVED
ZONING
ZONE NO. OF UBE OF NEW S/.t.
R�/ IPLANS � IBUILDING��/'-�%
ty
qPPROVED / l7/
LU'h�sn.� neTr / Z�o
THE AMOUNT 6HOWN UNDER VALUhT10N �5 FOR TNE
PURP08E OF ESTAOLISHING A PERMIT FEE ONIY.
VALUATION
PERMIT FEE S �'�S
$ /�3�/�/ PLAN CHECK $ � 7j ��
l
TOTAL FEE $ ��. S�