HomeMy WebLinkAbout353 GRENOBLE LN - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa�DING PERMIT 77 FAIR DRIVE, COS7A MESA, CA 92626
JobAddress: $$$ GRENOBLE LN
Suite:
Vicinity:
Primary Occ: R-3 pwellings/ Cong Res <70 Type of Construction: V-N
Parcel Number: 43914117 Zoning:
Applicant: DEBORAH SIMMONS
Address:
Owner: BACK BAY GARDENS HOA
Address 17731 IRVINE BL
TUSTIN, CA
Contractor. HIRSCHMAN, RP & SONS INC
Address: 9582 HAMILTON AVE
SUITE 281
HUNTINGTON BEACH, CA
Zip: 92646
Arch :
Address:
Zip:
Phone:
License:
Phone: 714317-9705
Zip:
Phone:
Zip: 92780
Phone: 714-960-8329
License: 781923
Eng:
Address:
StaNs: ISSUED
Applied: 09I19/2005
Issued: 09/192005
ISSUED BY:
�
SCOPE OF PERMIT
T/OFF EXISITNG AND REROOF 3 CONDOS WlCOMP SHINGLES. ADDRESS INCLUDES 353-357 GRENOBLE LN
FEE SUMMARY
Plan Check: $0.00
Permit: $293.25
SMIP Res: $1.77/
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: 5295.02
PLANNING & ZONING
SETBACKS
MAINSTRUCTURE Front 0-0
ACCESSORY Pront 0-0
PARKING exist�: p
0
Rear 0-0
Rear 0-0
Reauired: 0
Left 0- 0
Left 0• 0
Pr000sed:
Phone:
License:
Calc Valuation: Sn,��e.sa
Claim Valuation: Sn,�is.sa
Right 0-0
ight �
0�
'
NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access raquiremenis under California statutes and related
regulations. (Ord. No. 92-28, § 1, 1241-g2]
EXPIRA710N: This permit shall automatically expire and become void Ii work is not commenced wflhin 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable cales, 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 CALL: (714) 7545626
zaaese�ava�
WORKERS'COMVENSAnON DECLAAArON:
I hereDy attirtn under penalry ol per�ury o�e oi Ihe lollowing declarations:
❑ I hava antl wlll maintaln a certiticete of con5eni lo sell-Insure tor workers' campensation, es provitletl for by section 3700 of the Labor Code, lor the pertortnanca at Ne
work lor whlCh thi9 pertnit is Lssued.
❑ I liave flnd will maintain workere' ca�pensatlon Insurence, es reQuiretl by sectlon 3700 of Na La6or Code, far the peAortnflnce of Ihe xrork lor wNch Ihis pertrtit is issued,
My workers'° sati nsuj� e ca r entl pollcy numbar ere: �^D� �— �
Cerrier: V'//�'�� %/%�� PollcyNumber. �3 �
(rn/s sectlon need not be canp/eted il the permit 75 velued e( one huntlred dollers ($1 . r less.) "
❑ I certity thet In the pertormence ol tho work tor w�ich ihis pertnit Is issued, I shell not employ any person in eny mennor so es lo become subject to lhe workers'
compenseNon lews of Cellfomle, e�7 eqree Ihat' I should become sub�ect to the workere' compensation provlslons of Sectlon 3700 W the Lebor CoEe, I shell lanhwith
comPly with Ihese����� A� n^' �� / �/� �/D� /
Applicanl Signeture: r i4�! //!4. Dete:
WARNINO: FAILUPE TO SECURE WORKERS' �aP �T�1 WVEM6E IS UNUWFUL AND SWLLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO IXJE Hl1NORED
THd1SM10 DOLLAPE (5100,000),IN ADOITICN TO TNE COST OF COMPENSATION, DAAWGES AS PiiOVIDED FOR IN SECTION 3]OB OF THE LABOR CO�E, IMEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eMirm thet 1 em Iicensed u�r�w'�sJpn,�s o�haptar 9(commendng with Section 7� f DlNslon 3 of the Business and
force end effecL Llc. p �/ �/ cless a
Comrenols SlgneWre: l�(��1� �Dete: �!.
CONSTRUCTION LENDING AGENCY:
❑ I hereby elfi'm ihat there is e construction IenOing apenty tor the peAormance ot the work tor which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lendefs Name: Lendefs Atltlreu:
Signature: Data:
Is in lull
OWNER-BUILDER DECLARATONS:
I hereby eHlrtn that under penelry ot per�ury that I em EXEMP7 FROM THE CONTRAC70RS LICENSE LAW tor Ihe I011owing reason (Sec. 70.31.5, Business entl Pratessions
Code: Any ciry w counry whkh ceputres e permit to construcl, alter, lmprove, demdish, or repair any structure, prior to its issuance, elso requires Ue applicant tor suU permit
ta tile a signed stetement thet he or s�e �s Iicensed pursuant to the pmvisions oi ihe Comrectors Llcense Lew (Chapter 9(commenUng wlth Secilon 7000) 01 Dfvlsion 3 af Ihe
Business end Profeulons Cade) or t�el he or she is e:empt therelrom and t�e Dasis for the alleged evemption. Any Woletlon of Sectlan 7031.5 by any epplicant for a pertnit
suh�eIXs the appllceni to e clvll penalry o� nat more than Me hundred dollars (5500).):
❑ I, es owner oi Ihe properry, or my Bmployees wilh wages es iheir sole compensation, WILL DO THE WORK, and Iha struc�ure is nat Intentletl or oflereC for ule (Sec.
704d, Business end Professions Cade: Tha Contrectors License Law does not apply to an owner of property who builds or improves thereon. and who does such wwk
himself or herself or thmugh his or her or,n employees, provided Ihai such improvemants ere not intendetl or offeretl for sale. If, however, Ihe builCing or improvement is
sold within one year o1 wmpletion, the owner-builder will have the burtlen ot pmving ihat �e or sha did not build or improve tor purpose of sale.). •
❑ 1, es owner ot tha property, am E%CWSIVELV CONTAACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sec. 7044, Business antl Professions
Code: The contrectors License Lew tloes nat apply to en owner oi property who �ullds or Improves thereon, end who contracts lor such pro�ect wlih e comractor(s)
license pursuant to ihe Conirector5 ��ense Laws.).
❑ I em e:empt untler sec. Business end Professions Cotle for ihis reeson:
Signeture: Date:
Owner ID venfied by dnvers license. ❑ Yes ❑ No Dnvers License No. Expires:
Vedflcetion of Ownership by (rype of Oaumenl, i.e. - pmperty tex bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMI7 CERTIFICATON:
❑ I hereby certlty t�at no excevetbn ��ve (5) or more leet tn Oepth into which a person is requiretl to descend, will be matle in con'rectlon with work enthoAzed 6y ihis
parmit, enC that no Dulltling siructure, stsHolding, falsework, or tlemolition or dismantling thereol, will be more �hen ihirty-six (38) leet high. (Chap. 32, Grp 2, Art 2, Sec.
341, T1Ile B, Cellfomia AdminislretWe Catle).
❑ As ov.ner-builder, I will not emplpJ enyone to tlo work whlch would requira a permit Irom Ihe Division of InOustrial Sefary, es notetl ebove, unless suc� person has e
permit to tlo such work Irom the tlMs�wi.
Signeture: Date:
Division of IndustAal Setery Pertnit NumUer.
CERTIFlCATE OF COMPLIANCE /WD A�ITMOROA710N OF ENiAV: I certity under penalry ot perjury t�et I hevo reeA �his ap0�ication and state Nat the infartnatian given is
corred. I egree to Compty wll� ell stete laws enA dry ortlinences relating to huiltling construction, entl authodze representetives of Ihe Ciry ol Costa Mesa to enter upon the
ebovadescnbed property tor Inspection purposes. I egree not to occupy or allow occupency ot eny building euthonzed by Ihis pertnit until final inspection.
/ � Sign�tura O� Lepel Owner�s) �
`,l�L�//�/.�f.L �l/ /)/11i7'l1/i"X.��
n�l�orized Applicant
COOE1, INSPECfIONTYPE
1618 Fixed System Flnal Fire Preven��on
1268 Pool Spa Finel
200 Finel Re-Roof
201 Finel BIocWRetelning Well
202 Finel Factory Fire Plete
203 Finel Sign
204 Finel Demolltion
PdtE nrtma�s
��
COUE� INSPECTIONTYVE
206 Finel Mechenical
208 Flnal Plumbing
210 Flnal Electdcal
212 Final Fire Preventlon
220 FinalPlann{ng Approvel
222 Final Site
250 Flnal Bullding/Occupency
PAIf. It�4
aoox�ssaem�pxo: jj} GRE.NVbLh LN
0{YNEP'SN.WEIFRlOWN: t(UYJt.R1S, GicbGURY ALLEN
�pE�' 3�3 GRt.iVV21LE LN
CG57A MESA,C� `�LbL%
�rv�. wuuNc �ooxess:
A1ICXRECT OP BNiNFER:
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AqCN.Ofl FNO.'S /i0DRE55:
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UNT:
uNT:
���T�g� K ti H AIk SYSTEMS ( 9u9 ) 736-1999
caxrx�croxswuuxo q057 lEMESCAL
�ooaess: Ni1"t2Cir LA uc.ra.: b89853
71 % b b �NT'
LICENSEU CONfRACTONS DECLAfl�TION: I Mreby dlim uMer panaly d pe��ry Net I em licerreed uMr po.tima W Cheqm 9
(mmmenti�q wilh SxYion 1000) M Oivision � d ihe Bwimm vM Pmlessbns COEe, erd my lironee o in hll brro eM aflec.
�`8 "o Vb5431 ��c.cuss: L—"LG ��c"o b84fi5�,3 �.XP: G3iy8
�' v- �-2i � % ��a:�,/�'..�-�,�--
OWN BUILUEN DECLAflATION: I Mreby dfiem under penelly W parjury �he� I em uemp Imm tM Comreuae lieense law la iM
�ollo B�aes� (�ian )031.5 Bueineee eM Proleseiom Code: Any cily a muMy whkh rtquiree e permA lo mnelrucl, aM1er, improve,
� oleh, or repei eny ei�ucture, pnor lo na oweMe, ebo repuiree the epd�� �or euch permn lo Rla e agirod etmament thel he a eha
IicenseE purnieni to IM qovisiona d the Conlredora Licanae Lnw �Chepter 9(commeiwiq wnh Seeion ]aW) d Divuion J d the
,�reay yd Prdwiwv� Godel or tAet M a eha is examq thaelrom ard tM beva In tha elbqed uempion. My videtion W Seaion
]03t.5 by enY eGd�^t Iw e permil wbjaee �he epd�t b e dvil penelly of �wl mae ihen Me �uMred ddlen (f500D.
� I, av ownar d Ihe pmpenyor my empbyeas wYh wepes as iMi eda mmpenae�ion, will Eo ihe work, enA iM eVuclure w nd inlended
or o%ered Im sele (Seclion )OCd, Bueiness enC Prolessiona Catle: Tha Contreqon Licenae Lew doee mt epply ioen ownerd propMy
who buiAs or inqw» thereon, eM xfio doea such wak himeell w Mnetl a ihraph h6 a her oxn empb�eee, pwided �het euch
impovemama va rat imeMaE «aHered fa eab. X. howevm, �M WiHiep a inprovemeM b sdtl wilhin an yw d mmpbtun. tM
o..,b.�wader :u nero ina eu�dm a o��m na o, ei» ea na d,ib or imw� ra me wmae a mel.
� I. ea ovmer d �he proparry. em e�dusrvety conirectmp wnh lioenead conVecmn W wnarua tM qqea (�� )�. �inese anE
Profeeaiona COCe: Tha Camreaon licensa Lew doea nd eppFy to en ownar d p�opany who buiNa or'unpovae tMroon enE x1a
mnvecb Iw au h prqetls wilh a wmredorls) IicenxE punuenl lo IM Coniredora lioenee lew).
� I em emmq uMm Saciion: B. d P.C.. M Nu raeaon:
Deie: Ovmar.
I Eo hereby cerlity Ihat I em ewere d eM uMe�siend tM requiremenie at CelAomie HeeXh eM Sefery COEe Sediona 25505, 25533, arM
255�4, eM �het I a eny tutura buildiip oavpeM vnll / wil na (o�cb ma) nead b comply wh seid mta mdn end tM reyu'vemeMa M
e rormn t«casVUCiana modifimlbnham�he�i�Lre�emw+� Oistrirl. ReeNmliel mmrupian WG�iamareexemq leom Nwa
pfOV19q119.
oma: nvWkam:
WONKEN'S COYPFHS�TION UECL�N�TION: I Mreby eMrm uMer penelly M pajury one M Ne lolbxi�p Mderetiom:
� 1 hna erd W meiman e ttrlificata G mnsant io veM�ireuro b hakers' campa�vmian. e� povNeE �a by Setlim 9lOD d iM laba
caaa. �« ma rono,m�a d ine � r« w�n mo oa�n �. ��,ee.
�I heve eM xitl meimem xroMert oompenaeton insurenm, m rpuireE bY �� �)� d �M leEw COEe. br �M paA«menm W tM
woM lor whiW ihie pa�mn n iwueE. My wakaie mmpenaeiim inwrence umer vd poliry numbar are:
c�er: t'AT.TF �:t�t.t� EXFIRES
aa�r+�mn..: l:4771ddidf� "v7/27/98
, ml::ectlon ,reed na ee oomvb�ee � tlm va^^x l: ro. orre nunerea eorlars R�ool w lesv./
� I cenity thet in Ihe perloimeue d iha work br whic� Ihie pe�mil ia iev�atl. I ehell ml amplvy anv O�+o� N�Y menner w m to
bacome subjad to tM workare' compenamion lexv d Celifanie. eM epree Mel il I ye� uM bxome abjed b �hs xakae'
oma / rj p-a� )% a � s�oo a ine �� �����-�E�JYfl7�"��.
minp: F�Ilun ro�.cun wrtsr�'rompe�ueHon roverap� h unNwNl, entlWll �ubj�ef en xnploysr b eMMnsl peneMu eM
u u nrw ,p ro ms nunaM mouw,d do/len (Sfoo,0001, M em/tlon ro tM ewt or rnmpemeHon d+� u povMw ror In
5 tlon3R16aItheLeDorCotle.Infwvs4���msYi/su.
CONSTtiUCT10N LENOING AGENCY: I hereEy a/firm uMx perWry d parN�Y �� �� a e conA�upion bM'up epeMry la tlre
�»name�,ce a me weM �o, .nia, ine pemi� is mauea (seaia, aos>, cw. c�.
LENDEP'S NAME:
LENDER'S ROUNESS:
I cerliN tl� I heve reed Ihis epd�ma^ ���e IM1et Na ebova inlormetion b ca�ea. I egrea lo canqy vrilh all ury aM mwry ardwrrm
eM ate�e lexe rele�in8 �o buildiq wneVuelion eed hereW eutlrorae �epreeen�etivx d Ihis ary lo enter upon iM ebove�menlianed qoparly
for impeGion Wrpoeea. .
_ liILL �AMMOtvS
oa�a: � �23��7
(S15t-d6.WP) WAna-Buikiq85elery:Oree�rFle:Cenery-App:renl:Rnk-Revmue:OdEenm�-Meevn
CITY OF CUSTA MESA - HIIiLiiINi; Yt.Y(M11
PfiRMI7 Nu; M G85387 YiAN CH�.CY: NU; N
CGNSTRUi7IuT3 TYPE: V-hi PERM3T I'YFE: MEi:
JGb LEsCRIPIIGN : CHANGb GUT FURNACE
CLAZM VALUE: CALC-tiALUE:
M 7 -00052
PEttM Nu; Ni Gn�36 i
�GUT; N SOrP: N
PUii'ru5�.; G'Iri
su r r:
GROUP Gi'C ; i't- 3 i
COMMENTS: X
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Z u N I N G� EkiB�i,�AiJ`Init��. M fi N T S
------------ MAIN bUILUING ---------- --------- ACCc�55uR3i YSI.IlLUlNla ---------
FRNT: FT IN REAR: FT IN tRNT: Fi IN REAk: Fi IN
LEFT: FT IN AGHT: FT IiV LEFI': b'i IN RGHi: FT TN
PelItKING RE�: PRdV: 'rAACEL: 4351tiI.i5 ZNE; kEF Nu:
PiANNING NOTES>
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L E J E L u F M E N i S� R ti I C� S k E{t O I R fi M E iV T S
�GNING AFPF2UVEU bY ,
LI�TE;
BiJILLING APPROi�EL BY : �!� LAI'E:
AF+PLICA7IuN ISSUEU bY: � LA7E; V�
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LEGALIZATIUN:N F E r. 5 U M M A R Y 57kUCIUiiAL S�;GMbNi:N
rLLG 'rM7 PLUMBING �,L�,CTRIC Mc.CHANI� FIRt SMIPiti�S Gitiu�ING
FERMI7 1:f,25
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PLAN
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bUILuING-LIV-> Fr.RMIr ISSUE FLAN-CHECri TOIAL YAlL LU�.
TUTALS----> 13.25 22.00 "v.00 35.25 3�.25 .0"v
REVENUE LIVISIUN I'GTALS--> CULLECTEL: 35.25 GV£RiSHGRT: .u'v
nLLG PMT FLUMbING ELECIRIC MECHANIC FiRfi SMIP/70T GRAuZNG YLAN—l',11G1:ri
35.25
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I N L I V I L U A i F E t b k E A K u � W N
IYPc� SjTY u c 5 i h I P 7 I U N uNIi i:(i�T iUTAL �u57
MEC 1 INST FukC—AIniGRAv Fi.iRN <= 1"v"v ri BTU 13,25 13,�5
ENL uF FEts
r EX� � � ED
� a 00
DATE 6
�i
18-�3-1997/81:27 PMlf35.25
RCPTN:81-8814388
PERMIT:085387
. -,
CONSTRUCTION AND PLANNING POG �PA
APPROVALS Permit # � Date Inspector AppROVALS Permit #- Date Inspector
1. Temporary Electrical Service or Pole ' 52. Pool & Equipment Loc�tion
2. Soii Pipe�Undrgrnd. - 53. Steel Reinforcement
�3��E�lectricaf Conduit Uti'tity-Undrgrnd. 54. Forms _
: zd.: Electrical Conduit�Unilrgrnd. 55. Electrical Bonding
� �5;Steel Relnforcement - 56. Rough Plumbing & Pressure Test � '
� 6:�' E�ectricai UFER`Gt,nd. 57. APPROVAL TO COVER-GUNITE _ �
- �.• _ -
��;�7:, Foot�ngs '; � 58. Electrical Conduit=Undrgrnd.
-=8.". Foundation - � 1 59. Gas Pipe, O Undrgrnd., Test
r .-
�� '9. Water Pipe•Undrgrnd. �. 60. Backwash Lines; E�7rap, L� Undrgrnd.
10. Structural Floor System . 67. APPROVAL TO.DECK
1�1. Property Sewer Line & Houee:Connection 62. Backwash & Receptor-Final _
12 Sewer Cap � ., 63. Heater & Vent-Finai
13. Roof Qrains . 64, Plumbing System - f�nal
14. Rough Piumbing 65. EleCtrical�Final
15. Rough Electrical�Conduit r 66. Solar Svstem-Fi�a�
76. Rough Electric �^Siring - ' 67. Fencing & Accees.Approval
17. Rough 4Niring S�gn - 68. APPROVED FOi'PLASTERING
78. fiough Electrica�iT Bar Ceiling' - 69. POOL/SPA SYSTEMS FINAL '
19. RoUgh Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - � i �r�
20. Rougb Fa<tory Fir�eplace "�" .� � � .�.' - ,Y � •.(App(�V�LS_'� Permit #T- '�__,__';
21. Ducts, in Structur� r , •• •� ,� _ * S '7 � � ' � 70. �NJnderJraur� Hydro �
22. Ructe Ventilatin ` � . '�=.' ' � `r � .,, ~ r�` ', ' ." ..
, 9'u �. p- .� x., 77. ProduGy P7Ring CI-'6as ❑ Oil
23. Gas Fipe;9ough & Test .� ' . n Y 72. Undeigraudd Flusla � -�
�
24. �Root=FrarJPiing•. �. � ' 'i. � ' � ' y+ '; 73 � Undergrr�d. Stor.a.g� Tank`G Gas ❑ 6i1
25. Roof.She3�thing � . �� � � �-�i ;> 74? Overhead Hydra�
26. T-Baa:Ceiling (51ructpraq & N'1ono�oat � ; :r '- �� ;, 75a. Dry Chemiwl ,� y R "' � ' `
27. Fiame and Flashing ,' - -� ti �� r: 76. Dry Stangpipe ��•x t -
- .�
�28. Lathing&•Siding �." '�r,= �Y " "k��`. 77� FIXED$,Y,STEIVI'fINA�� ,'� �`�
�� 29. Insulation � - S � •• t � � (�� 7$ FIRE PREV. F6NiaL +� > � "�
` 30.OrywaliNailing ` . R.� ' f! S ,HEALTt9'DEP�.AEQi11R�EMENT
= 31. Plaster Btown-Coat � - � . }. !. 79:� FINAL 1[JSPECT•t�N � - -�
� �.. - 5 �9 �g� �U9z,�
; 32 Electricaf-Pow�r Meter�Pin.ai #� � �� � BOy FOOD CERTIF�CATE i$SUE4.., �r I
y . ?' . �z /t Iq �, r ..
•33, f�inainElectric- ,,y a �� ! �i � Notes: y�r; � y _ ~.r
' 34. Finab:Heaiiog & Air Condiiioning >. F ir c. S ���% -� t _. __
:. r .> � r �
35. Final Gas Pipe .Test �. „ � �" ;' :. �7 � p ' ;:
,
, - ! - v n
r 36. Hood-or CanopY F � -' i r' _=
� - r r � (i . > n
c
,37. FinalYFactory Firepi�ce - ' . � � :` � �F� - + ~ - ---
�38. FinaiCPlumbing Y ' - • �� 1 't -. " � � � C �-+ --
K li: ...1' .7 t
'39. Water'5ervice�Final '� ` ' �x � • _ " ' �
i L � k+, j �. �
,40. GatService�Final • n . - :i ' �'. .�
�~ - �is r
41. Solar Oomestic-Pinalk iY ' .. Y iY K ^ �� r. '
� � F Y '�
42. 8ackflow Preventer � � P � - K-= -+
n- � ,
43. Backfiow Irrigation ! � , K } T� ' � ' •
44. Landscape Irripation'System r � - ' w �T. � '� +� � ' '= U ' '-` '= '�
w� ,f k T - -
45. Sound Attenu2tion r -� ; - - �: ;�' � � � r a �i ? �
.r 1 � -� .. .. c r z] �rl K S' ` - � _
48. Handicap.Regulations � � r� :: � 7 �• _ k .
,. . -,
47. FiNALSTRUGTURE&BUILDING �" _ i , '" ' ' ; � �
_i , "
48. FINA�L P:LANNWG �- x�. �'� r' _ �i C � � ..
c• j �•
49. Electric Release to Edison � i� � �` ' � �� � - ' " '
F�r • "t ' •
50. Gas Release to Southem Cafifomia-Gas Co t �% : _� _ ' •
-, � �,
57�. CER7IFICATE OF OCCUPANCY � ' � • .. �� = � K " - . '
No Date �
• l962g
-COSTA MESA BUILDINGSAFEfY DEPARTMENT
P.O. BOZ 91] COHTA ME9A, CALIFORNIA
For Applicant �o Fill In Comple�ely
TYPE OR PRINT
BUILDINO � (' 2 1^- \ y
ADDRESS J LT )'\..
�\ COSTA MESp, CALIFORNIA
OWNER Ie- �IC/ P✓ W
MAIL �/ n �.(
ennwwca�f 3� �n_ / hC_L PC/Ot.^ �
FEE RECEIV�i
JU F1 3 19fi3
� INANCE DEPT.
CI��PL1tA723i�f �FtSYt"PERMIT
BUIIDING
For Oifice Use Only
11iC[�'T NO. PERMIT NO. �
I �
�[rv[ er o re necerv o o�'r�� [o
s'= a�f-�3 �uN � �ss
)ING ���
ESS
AOORESS /� V p w / Wmlwor+wcc.q�R
ZO NO. O� I USE OF NE
^\ l PLAN6 El11LO1N0
CONTRACTOR J � H'�'Ci / T
LEOAL / . "� ' �JS ��
AOORE88 ��r./y/ L� oeecrslrnoN �-�a J
CITY �! A-(n. A. P. NO. �
�J NOTE: NO EAVE OVERHANG SHALL BE LE59 THAN
LIC.TNO. J I %-cJ_IJ' V NO. � �. d 30" TO SIDE 8 REAR P. L.
OFL0T.73 X����I% / I No.opeLDaey� ALLOWED (U.B.C.REQUIREMENT)
NOW ON LOT
YARDSAPPROVED YARD9APPROVED
USEOF -� MAIN BUILOING ACCESSORY BUILDIN6
EXISTWG BL06.
� . . (FROM C/LSTREET)
6ET9ACK LINE FROM
CENTER OP STREET �"`rD REAR YARD � FR NT FT. FT.
SIO6 YARD I LEFT •�--I R16HT ' R GIDH Q� FT. FT.
DESCRIPTION OF WORK L.61DH Fr. Fr.
NE ALTGFZpT10N AOOITION RfiAR Ff. � FT.
DISTANCE BET. BET. MAIN 8
MAIN BLDGS. ACGESS. BLD69.
ftEPA1R MOVINR DEMOLISH
BUILOING � �NO.OF V'�'R'# - OATE
SRE 33 xs3. sa ROOMS � bTOR1ES �1� C. U. P. APPROVED
EXTERIOR WAL I ROOF S H�N« G APP \ ��� �
COVERING ��v�C.0 COVERIN6 BY U' DATE J
U660 IIiGA DWORKTOBEP RFv RME
-' e ti ��. c fr7`!'��
u �. o d e/ �!�- -�
j�'33 s4. �. �'tD � � m
1 HEREBY ACNNOWL6DO8 TXAT 1 NAVB RGU THIB APPLICAT�ON THE AMOUNT 9H IINDER VALl1ATION �8 FOR THE F
ANo BTATE TXAT TH6 A90V6 �g CORflECT ANU AONEE TO COM- PUHP056 OF 88 LIBHIN� ♦ PERMIT FE6 ONLY, �
PLY WITH ALL CITY OqDINANCHB AXO eTAi[ LAWe REOULAT�NO yqLUATION /J 7 /y m
ew�o�NocoNSTxurnoN, � PERMITFEE $ Yv j
SIGNATURE OF
PERMITTE ^�C� F, /� m
$/�/ S yD � PLAN GHEGK $�� � o
rc
AUTHORIZEOA6ENT � S� '�
TOTAL FEE
^��
��
Pfl0.1ECfp�^DPESS: �'j] �gENOBLE LTl
OWNEWSN�ME: V�EG RUAERTS � � ' -
�ooeess: SAME �
RflCH/ENGINEEfl:
RDOflESS:
UNI7:
flE0.N0.: � �
UHIT:
PENMITTEE: ROSE SONLAU ( 719 ) 642-2475
. pDDBESB: ' 3SS GTtENOPLF. � � � '
c_M 'CA 92627
LICENSEO CONTMCTOB OECIANAT10N: I �ereby aHirm [hat I am licensed unAer provisions ai C�apter 9(cammencinq with Sectian
7000) of OiNsion 3 of �he Business antl Pmfessions CaUe, ana my license i5 in tull force an0 eflecL�
CITY I1C.: � ST�TE LIC.: LUSS: • ,
. a
Date: Sipnature:
WOBI(EBS' COMPENSRTION UECIAFUTION: I here6y attirm that I �ave a certificata of consent to seii-insu2 ar a certificate of Workers'
Campenutianinsurance, or a certifietl coOY ��e�eof �Section 3800, Lab. C).
POLICY NO.: E%P. D�TE:
COMP�NY:
❑ Certi/ieE copy is hereby fumis�e0. ❑ CertRetl coDY is filetl with t�e ciry BuilOinA Olvision. '
Date: ApDlicant: -
E%EMPfION FBOM WONKENS' fAMPENSRTION DECUMTION: ' LEfioli neetl r t �e iplete plhe permtt is far ane hunOretl (5100) ar leu).
I CeRity �hai in the p¢dormante f t�e wark br which ihis per � p u�0, I sh I not e�Dlo 6y person in any manner w as to become
Subj¢ct Io Ihe Workers' C D ' n Laws of Cali�omia." � �
Date: SipnaWre:
NOTICE: If, aft ma' g this eclaration, you shouM�become suhle�� �a Ne Workers' ComOensation provisions of the Labor
CoOe, yau musl fonAwit� comply witA suc� pmvis;ons or tAis permit shall be OeemeO revoke0.
CONSTBUCTION LENOING �GENCY: I hereby affirm ihat Ihere is a constmction IenAinA apency for tAe DeNormance of [he work for
which ihis Oermit is iss�e0 (Section 3097, Gv. C). � •
LENOEX: '
RDORESS: � �
OWNEB BUILDEB OECUMTION: I hereUy atlirm ihat I am exempt from the Contractors' State License Law far ihe followinp reasan
(Section 7031.5 Busineu an0 Professional Cotle: My ciry of iounry w�ich requires a permil to constmct, alter, imD�ove, Aemolis�, or
reDair any strucWre, Orior to its issuance, alsa requires t�e aODlicant tor such p¢rmit ro fite a signetl statement Ihat he/she is licensetl
pursuant to IAe pmyisions of the Coniraclors' State Licensa Law (ChaD�er 9(commencing with Section 7000) of �ivision 3 oi the Business
and Pmfessions CaCe� or ihai he/she is exemD� �hereirom and the Gasis br Ne alle0e0 exemD�ion. Any violation oi Seciion 7037.5 by
any applicant for a permit su0jects tAe aDDlicant to a�civil penalry oi not more tAan five AunAreU Aatlars (I500):
I, as owner oi the DmDeM or my employees with waAes as Iheir sole comDensa�ion, will do the work, anE Ne
❑ simcture is not imenAeA or a/ieretl for sale (Section 7044, Business antl Pmiessional Caae: The Contracmrs State License Law
Aoes not appry ro an owner ol a DmDertY who �uiitls or impmves t�erean, an0 wAo dow suc� wtiM himsetl/Aerselt or IhrouA�
' his or her own employees, D�ovi0e0 ihat suc� improvemenis are noi intendeA or offeretl lor sale. If, however I�e builtlinp or
imD�avement is sold mthin one year of completion, [he owner will have the 6urden oi provinA he/she tlitl nat Uui10 or improve
tor tAe purpase of sale�. , � -
I, as owner of the D�aDenY, am exclusively contracting with IicenseA contracrors ta consimct Ihe Dmlect (Section 7044, Business
�^] � ana Pmfessions CoOe: The Cant2ctors' State License Law tices not apply to an awner of propeRy who OwIUs or improves thereon
anE who coniracts for sucA prolects with a contractaqs�license pursuant to ihe Conirectors State �icense Law).1 am aware
tllat D�ool ol Iheir Worker's Compensatian insurance shoultl be provitle to me. �
� I am exempt unaer Sec'on: B. 8 P. C. '
lor ��is reuon� �
Oaie: � Ume .
I do �erehy cerliry �Aat I m awar oi an0 understand �Ae requiremen�s of Calitornia Health and Sa�ery Code Sections 25505, 25533, antl
25534 antl that I or any future builUinO occuDant wilVwill not (circle one) need to comply vnt� saiC state cotles antl the requirements for a
permit for consimction or moCifiWtion Imm tlle Air �ualiry Manapemeni Oisinct Resitlenliai ConstNc�ion appliCations are exempi trom
tAese D�a��sions. . ,
Date: � Applicant
I hereby cenity ihat I have rea0 ihis aDDlication and state that the v' ation is wrrect. 1 a ro comply with all city and counry
ar0inancesantlstatela relaf ptoGuilaingcanstructionantlher y o' presentativesoit' ' toenterupontheabove�menibnetl
prop¢rry tor in c'
Uate; � SignaNre: /�—�
Oriver's License or S ial Secunty x: .
1801�46 W�ite--BuiltlinA: G�een—Cotle En�orcemenC Canerv—AO�licenk Pink—Revenue: Goltlenrotl—ASsessor
CITY OF COSTA MESA - DUILDING PF.RMST
PERMI7' NO: 'B 0453:17 PLAN CHECK NO: O1'UA2.-f39 S
CONS'PRUCTION TYPE: PE.RMIT TYPL": STR
JOFi,DL•',5CRIPTICiN : STD LrLUCK WAI,L
PGRM NO: B, 045777
�GOVT: Dl SUPP: IJ
PURPGSF.: NEW
SQ FT: 1J
CLA.IM VALUE: 450.Q0 CALC-VAI,UE: 260.00 :GROUP QCC: M--1 /
COMMEhI'.I�S: CITY STD• BLOCFC WALL 13 PT
3t # 1E 3e iF k.H- 7E �k 7F lE 3E # 3E iE 3f 3f jE ie �!� 3E 3f JE iE iF iE ik iE iF # iE �lE �JtlE �)E?E it iE-lE�?t �If� 3F 9h if iF ;F �%iE i(� iE iE iE 3f iE # ih%iE il- iF �iE?E 1E dF iF iE iE 3f iE if jEdf If 3E iF IE 1E M� i4
`L O N:C N G. R E Q U T'R E M E N T S
S E T B A C.K S �
----------- MAIM BUII,DING ---------- --------- ACCESSORY BIIILDI�IG ---------'-
h'RNT: F'C IN RtiAR: , F'C IN E'RNTi FT IN REAR: FT IN
I,�FT: FT I:N RGFIT: FT ZN LEFT: FT IN RGFIT: '. FT IPI�
PALtK:i:NG N.�:Q: PROV: PAFtCEL: 4]914135 ZNE:: R1 �REF NO:
PLANNING NOTES> APYROVAL TO CONSTAUCT' 13 LINEAR FEET OF SIX F'OOT BLOCK WALL
> '
�F 3E iE �IE jE iE iE iE iE 3f j4 iE �E iE dE jE iE 1E if 3f dE ik 9E # iE 3E �F iE iF �lh i4 if if it it �1F iF iE iE %?E �1E �F iE iE 1E if iF if iE iE iE fE iE iE i(-�lk iF�1E �E if iE if IE iE jf iE ik jE jF iE jE iE #�lE iE 3E if iE
D E V E L O P M E N T S E R V I C E S R E Q U I R L; 'M E N'T ' S
ZONING AFPROVED BY ' DATE:
BUILD];P1G APPF.6VEU BY e
� DATE:
I�PPLICATLON ISSU£L� BY.: � DA'TE: �.%���[��J �
ifiEiE�1E3EiEiEjEfl�If�lt�(lEfElE'f,-�IEfE�1t�iEiFiE�'ffi� fe�t��3�� . i�iEE���E����EiE�i��ifiEiE�!-fE3(-IE�IfiE�� SFE-�3t ��EiE,TE.if
?EiEiEiElElEitiEk3E�7f�E'f,#iEii�j(-?Ek�lE3fiEi:�ltiE*jtfE3;#ifi'iF, '�IE3EiE if�lFiEiFiEdE9E1EiElE3EififiEiF3t�1EiR3EiEiFiEifiEiE�E%iEiE�M�1E3EiE3f�1E1EiF
LEGALI'LA7'IVN;N I? E E- S M M A R Y '�•�"`STROCTURAL,..SEGMENT:Y
F3LDG E�MT � PLIJMBING �LECTR :C � MECHANIC FIRE SMIPiGP,ES C>RAD'2NG
PERtdIT` 15. 00 �, ,, e�. 50
SMZP/NON-R�a
PiAn� ��.�s,. • ;: - :�
ISSUE FEF: , Ei. �'_•,: �
AUILDINC)-U.IV-? P�RMIT •ISaUE PLAN-CHECK 'TOTAL �"f� PAID � DUL
7'UTALS---> 15.50 0'.00 9:75 25.25 ,; ::25. 25 .00
, . . .,, f%,,
REVENOE DIV:[SION 'I'OTAL�Sr-> ' COLLECTL:D-i 25.<°, OVERfSfIORT� ' 00
BLI)G PMT P.LUMBING ELECTRTC MECHANI,C FIRE SMIP/TOT'v.GRAA��NG PLAN-CHECK
' 7 5. 00 , ..,0;,� -.: �;� 9.75
� � , � V:
_ iflE3fihiEiE�lt�f�lkiE3E1f#iEiEiEi(�3E#ifjf'kiEifd(#fElE#3f9("H-3fifiE3f)ElE�(-ifiElFifiE3E�E1E�f�EifiF#ifiE#�E1E3E1E�iEjF'1�'��E.�'3k3E3EifiE?EifiE�IE�C-iEiFiElE
I N D I V I L U A L F•E E ➢ R E A K D O Ydi N si�
TYPL' QI'Y D E S C• R I P'P T O N ` DNIT, COST ! TOTAI� COST
SFR l"J RES-CONCRETE BLOCK b�ALL �` 20.00 7_60.00
END Or F.ELS _.
fi�
♦
�,'�\ A
01 0004935�-00049352 T.OS , 25.2`
DATE: 12/OE/89 TItIE: 16:30
l �s '
� CONSTRUCTION AND PLANNING� POl . SPA
� APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
� 1-.- Temporary Electrical Service or Pole � �' 52. Pool & Equipment Location -' � �y":.
�2. Soil Pipe-Undrgrnd. ��' . 53. Steel Reinforcement ,-� ! '��"'
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �. ��
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding e/� -
5. Steel Reinforcement ' � 56. Rough Plumbing & Pressure Test
- 6. Electrical UFER Grnd. i 57. APPROVAL TO COVER-GUNITE
7. Footings � 58. Electrical Conduit-Undrgrnd. .
8. Foundation % 59. Gas Pipe, O Undrgrnd., Test �� .�
/ �i�
" 9. Water Pi e-Undr rnd. l! "� �
P 9 60. Backwash Lines, P�Trap, O Undrgrnd. �' �� �
. : ,,; i
10. Structural Floor System �..--, _� 61. APPROVAL TO DECK '_� j� ,
11. Property Sewer Line & House Connection �'� ��� 62. Backwash & Receptor-Final( /✓,-� - ,.
12. Sewer Cap �:� i 63. Heater & Vent-Final , , - '
13. Roof Drains 64. Plumbing SYstem - Final � +� � �
14. Rough Plumbing • 65. Electrical-Final �`�� �
15. Rough Electrical-Conduit 66. Solar System-Final .
16. Rough Electric Wiring 67. Fencing & Access Approval �
17. Rough Wiring $ign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL �
79. 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 OGas ❑Oil
23. Gas'Pipe-Rough & Test ' 72. Underground Flush
24. Roof Framing . ' 73. Undergrnd.StorageTank OGas ❑Oil
25. fioof Sheathing ' 74. Overhead Hydro
26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical . ,
27. Frame and Flashinq ' 76. Dry Standpipe '
28. Lathing & Siding ' ' , 77, FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL �
30. Drywail Nailing '. I: � FIEALTH DEPT. REQUIREMENT
31. Plaster Brown Coaf ' 79. FINAL INSPECTION
32. Electrical PowerMeterFinal �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 �: . �
i
39. Water Service�Final ��
40. Gas Service-Final � ,
� 41-. Solar pomesticFinal , _
42. Backflow Preventer � .. .... ..- ' - ���
43. Backflow Irrigation � p �� R E D '
> `v
44. Landscape Irrigation System - - � ��p p18 0 I�S p - '� -�
� 45. Sound Attenuation . - !� - �
, :.
46. Handicap Regulations � - , ����
47. FINALSTRUCTURE&BUILDING . ' /; ,. , �� �i �
48. FINAL PLANNING ' �
,_�
49. Electric Release to Edison �� . "
50. Gas Release to Southem California Gas Co � � ""'' -
51. CERTIFICATE OF OCCUPANCY
No. Date �