HomeMy WebLinkAbout364 GRENOBLE LN - Building Permits,
(714) 754-5273 • Faz (774) 754-4856 • �wiw.ci.costa-mesa.cBaI.IILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 364 GRENOBLE LN
Suite:
Vicinity: GARAGE ONLY
Parcel Number: 43914127
Applicant: HANSEN, DUKE
Address: 260 E. ALTON AVE
SANTA ANA, CA
Owner: BACKBAY GARDENS HOA
Address 960 CALLE AMANCER
SAN CLEMENTE, CA
Contrector. ROSS & BARROWS INC.
Address: 260 E. ALTON AVE
SANTA ANA, CA
Zip: 92707
Arch :
Atldress:
Zoning:
Phone: (714) 557-7440
Zip: 92707
Phone: (949) 498-7129
Zip: 92673
Phone: (714) 557-7440
License: 327802
Eng:
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: O6/26/2001
Issued: O6/26/2001
Phone:
Zip: License: License:
SCOPE OF PERMIT
REROOF GARAGE AREA FOR EXISTING CONDOMINIUM FOR "BACKBAY GARDENDS HOA" (4 SQ). TEAR OFF EXISTING
ROOFING & INSTALL NEW BUILT-UP ROOF SYSTEM.
Plan Check: $0.00
Permit: $57.05
SMIP Res: $0.00
SMIP Com: $0.50
Other: $0.00
Inspection: $0.00
Total: $57.55
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0- 0
PARKING Existinq: o
NOTES:
Rear 0-0
Rear 0-0
Required: 0
FEE SUMMARY
PLANNING & ZONING
LeN 0- 0
LeN 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0-0
$1,550.00
$1,550.00
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandonetl
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all
requlred Inepeetions end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2d4&68 (6q0)
WOPKERS' COMPENSATION DECLARATON:
I here6y ettirm un0er penalry of perjury one of tha tollowing deGaretions:
❑ I heve end wlll maintein a certificate o� consent lo self-Insure for workers' compensation, es provitlad for by section 3700 oi Ihe Labor Cotle, lor the paAortnence of the
work for whiCh this pertnit is fssued.
�,�I heve and will maintain workels' compensatlon Insurence, es raquired by section 3700 of the Labor Code, for the performance of the work for which this permit is issuetl.
My worker ' compensation Iniurence ar end policy number era:
r--"_" - .
Certier.—'� � Policy Number: �� -� 6 � � in % _
one huntlred dollers ($100) or Iess.J
❑ I certity Ihat in the pertormance of the work for which this permit is issued, I shall not employ any person in eny manner so es to bewme subject to Ihe workers'
compensallon laws oi a fomia, and ree thet II I should become sub�ect to the workere' compensation provisions of Sectlon 3700 of Ihe Lebor CaCe, I shell fotlhwith
mmply with t�ese pr si ns. /' /�
APolicant sipnamre: -� -- �--�� _ r-De�e:—,E�- 2 b � e�
WARNIN(3: FAILURE TO S E WOfl14ER5' GYkAPEN$ATION COVEMGE IS UMAWFLL AND SHALL SU6IECT AN EMPLOVER TO CR�MINAL PENALTIES AND CML FlNES UP TOONE HUNDRED
TMOUSAND OOLURE (510D,000), IN AD�RIIXJ TO TNE C0.ST OF COMPENSATION, DAA4IGES AS PROVI�ED FOR IN SECTION 37060F THE LABOR CODE, IMEPEST, AND ATTOqNE1^S FEES.
LICENSED CONTRACTORS DECLARATON:
I hareby attirm Ihat I am licensed unde�r provisions of Chapter 9(commencing with Section 7000) of Olvision 3 o}.I�e.Business and Professior�6 Code, and my license is in full
torceandenect. Lc A-7 � 7i�� - l S[�zi- � Class,k .f C'_'`j�j /�IlI'i L
Conlractor's Signet ru e: %--�--/-� � i- Dete: �_�� ,.,
' c
CONSTRUCTION LENDING AGENCY:
❑ I hereby eHirtn Ihat there is a G�s�ruction lending agenty lor Ihe peAormance ot the work tor which ihis pertnit is issued. (Sec. 3097, CiNI Cotle).
Lentlers Neme: LentleYs Atltlress:
Signature:
OWNER-BUILDER OECIARAT{ONS:
Date:
I �ereby ettirtn �het untler penalry ol pa�ury that I am EXEMPT FROM THE CONTfiAC70RS LICENSE LAW lor Ihe tollowing reason (Sec. 7031.5, Business and Protessions
Cotle: Any ciry or county w�ic� reqUires e pertnit to construct, el�er, improva, demolish, or re0eir eny slrucWre, pnor to its issuance, also requires t�e applicant for such permit
la file e signed statement that he or she is Iicensed pursuant to the pmvisions of Ihe Contractors License Law (Chepter 9(commencing with Section 7000) of Divislon 3 ai Ihe
Busineu entl Professions Code) or thet he or she is exempt therefrom and the basis lor Ihe elle8etl exemption. Any violation of Section 7037.5 by eny epplicant for a permit
subjects the epplicant to a civil penalty of not more then five hundred dollars ($500).):
❑ I, as owner ot Ihe property, or my employees wlih weges es iheir sole compensatlon, WILL DO THE WORK, and ihe struc�ure Is not Intended or oNered tor sele (Sec.
7044, Business and Professions Code: The Contrectors License Law does not epply to an owner of property who builds or improves Ihereon, and who dces such work
himsefl or hersetl or ihmugh his or her own employees, provided that such improvemenis ere nat intended or oHereO for sale. Ii, however, ihe building or impmvemant is
sold within one year oi completion, the owner�builder will have �he burden of proving that he or she did not build or improve foi purpose ot sale.).
❑ I, as owner of t�e D�operty, am EXCLUSIVELV CONTRACTNG WITH LICENSED GONTRACTORS to construct ihe project (Sec. 7044, 6usiness end Professions
Cotle: The comracrors License Lew Eoes not ap01y to en owner ol property who builtls or Improves thereon, antl who contracts lor such project with e contraaor(s)
licensa pursuant to the Contractors License Laws.).
❑ I em exempt under sac. Busineu antl Professions Code lor this reason:
Signature: Date:
Owner ID venfied by drivers license. ❑ Ves ❑ No Drivefs License No.
VenlicaUon ot Ownership by (rype of document, i.e. - properry ta: bill or deed):
E:pires:
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFIGATION:
❑ I hereby cetlity thet no excavalion five (5) or more feet In depth into which a pereon is raquired Io tlescend, will be made In connection wi�h work euthorizetl by this
permil, and that no building siructure, scalloltling, falsework, or demolition or dismentling ihereof, will be more ihan thirty-slx (36) feet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Titla 8, Celitomia Adminis«ative Cotle).
❑ As ownerv6uiltler, I will not emp�oy anyone to do work which woultl require e permil from ihe Division of Indusiriel Safery, as noretl ebove, unless such person has e
permit to do such work from tha division.
SignaWre: Date:
Division of Industrial Safery Pertnit Number:
CERTIFlCATE OF COMPUANCE AND AUTHORVA710N OF ENTRV: I certity under penalry ol perjury ihat I have reatl t�is application an0 state ihat the infortnation given is
correct. I egree to comply with ell state laws end city ordinences releting to building consiructlon, and authonze representatives of the City of Costa Mesa to enter upon the
ebove-tlescribed property tor inspedion purposes. I egree not to occupy or allow occupency ol eny builtling authorized by this permit until finel inspection.
CODE �, INSiECT10NTYPE
1816 Fixed System Finel Fire Pre�entlon
1266
200
201
202
203
Poal Spa Final
Flnel Re-Roof
Flnal BIocWRetaining Wall
Finel Fectory Fire Place
Finel Sign
20a Finel Demolition
.1IIf .
� ,, n,,,,
COOE� NISPECTIONTYPE
206 Finel Mechanical
20B Finel Plum6ing
210 Finel Electrical
212
220
Flnal Fire Preventlon
Final Planning Approval
222 Final Site
250 Finel Building/Occupancy
Q� INTlIU�S
�
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PNOJECTAOOHESS: 36� GRENOBLE LN
OWNEN'SNPME: COOPER.c..MITH HENRY J
aooxess: 364 GRENOBL� LN
COSTA MESA,CA 92627
FNCHIENGINEEfl: 6 5 �— J 5 5 Z
noosess:
NEG.NO.:
UNIT:
uxir:
PEflMITTEE: HOUDREAUX GLASS CO (714)630-7753
aooRess: qQ�S E LA PALMA
ANAHEIM CA 92807
uCENSEo CONiPACTOfl OECIABATION: I hereoy affirm that I am IicenseA under pwvisions ol Chapter 9(commencing with Section
7000) ol Orvision 3 oi t�e Business an0 Pmtessions Coae, antl my license is in full forca and ellect.
CI7Y LIC.: STATE LIC.: SS: �7
44522�/�_ C-1y.� EXP;
�ate: ._(� ^ ��_�_ Signaiure'. �j— Q. / /
WOflRENS' COMPENSRTION OECIABATION: I �ereby affirm Ihat I have a riificate o consent to seli-insure or a certi�icate a� Workers'
Campensalion Insurance. or a ceriifiee copy �hereof (Sec�ion 3800. Lab. C�.
POLICY NO.: EXP. URTE:
, COMPpNY:
� Cer�i�iea copY is hereby fumishetl. ❑ Certi�ietl topy is �ilea wi�h ��e tiry BuiltlinB Division.
Daie'. Applicant:
E%EMPTION FROM WOXREBS'COMPENSATION OECLAflRTION: (Thisseclion need noi6e comp@�etli�tAe permiiisio�one �unAretl(S1W)orless�.
I cerlify Ihai in Ihe oetlormance of Ihe work �or which this permii is issued. I shall no� e any person in any manner so as lo become
sublec� io Ihe Workers' Compensalion Laws of Calitor� �
oaie: �o-6—�t�{ s�9�am�
NOTICE: If. afier making �his declaralion, you should DB r�su - �o Ihe Workers' Compensation pmvisions ol �Ae Labor
Code. you mu5i forthwith comply wi�h suc� pmvisions or �his permi� 5hall be deemetl revaked.
CONSTBUCTION LENOING AGENCY: I hereby aitirm �ha� Ihere is a ConSlrUttion IendinA agenty for the pedormante ot �he wotk fOr
w�ich I�is permi� is issued (Seciion 3W7, Civ. C).
LENOEN:
ADOflESS:
OWNEP BUILOEB DECIABATION: I nerehy aflirm ��at I am exemp� Imm ihe Contractors' S�a�e License Law �or Ihe followinA �eason
(Seqion 7031.5 Business and Professiona� CoOe: Any cily ol counry w�ich reQuires a permit �o con5imct. alter. impmve, demalis�, or
repair any slmciure. prior �o i�s issuance. also requires the applicanl br such permii �o lile a signetl s�atement IAa� he/she is licensetl
pursuam to I�e pmvisions oi Ihe ConVaclors' Slale License Law (ChaO�e� 9 Rommencing with Section 7000) at �ivision 3 of �he Business
antl Pm�essions Cotle) or Ihai hehhe I5 exemp� ��erelmm antl Ihe basis lor Ihe allegeU e�emption. Hny violalion of $ection 7031.5 hy
any appl¢am for a permi� suDlec�s ��e applicam to a civil penalry ol nol more than �ive �undred dollare (5500�.
I, as owner ot I�e pro0erty or my employees with wages as Iheif 5oie compensation, will do �Ae work, and IAe
❑ strucwreis notintentletl orotferetliorsale (Seclion 7044, Business and Professional Cotle'. The Coniractors' State License Law
tloes not apply lo an ownerof a D�openy who builds orimproves thereon, and who tloes sucn woM himself/herseif orlhrough
his or her own employees, proviAetl that such impmvemenis are not intended or ofleretl lor sale. If, �owever lhe huil0inp or
impmvement is soltl wiihin one year ol compleiion. �he owne� will have ��e burJen oi pmuing helshe ditl nol build ot imD�ove
tor Ihe Durpose ol sale).
I, as owner ot ihe propetly, am exclusivety con�rocting with licensed conVacbrs �o constmc� �he pmject (Sec�ion 7044, Business
❑ antl Pm�essions CoOe: TAe Comracmrs' State License law Eoes noi aDPly lo an owner at D�opeM who 6uilUs or impmves ihereon
and who contrac�s �or such prole��s with a contractoqs)license pur5uan�io the ConVactors' State License Law),I am aware
1ha� pmol ol �heir Warker'S Compensation insurance shoultl be pmvidetl Io me.
� I am exemp� under Seciion: B. 8 P. C.
�o! thi5 f¢d5on'.
Da�e�. Ownec
I tlo Aereby cenily Iha� I am aware a� and untlerstana t�e requiremen�s o� Cali�omia Heali� and $a�ety Code Seciions 25505, 25533, antl
25534 antl �hat I or any �uWre building occupan� wllllwlll not (circle one) neatl lo compty with said s�a�e cotles antl �he requirements tor a
permit for cons�mction or ma0ilicaiion imm Ihe Air Ouali�y Managemen� Uistric�. flesidential consimction applicalions are exemp� irom
�h¢52 P�Ovi5i0�5.
�ale: ApplicanP.
I hereby [eiiifythal I have reatllAiS apPhw�ion antl sta�eihal�he above in�ormation is correcL I agree to compty with all ci�y and coun�y
orUinancesands�alelawsrela�ingio�uildingconstmc� rebyaN�orizerepresenta�ive hisciry�oenleruDon�hea�ove�mentmnetl
pmpeny fur 7nspecilon purposes. �
Oaie'. `v—b—� Signaii ' ��
Orivefs License or Social Secun�y a:
t6Gt�d6 Whne—Builtling; Green—CoOe EnlorcemenL Canary—Applicanl: Pmk—Revenue: Goltlenrotl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT FERM NO: B 069163
PERMIT NO; b 069163 PLAN CHECK NO: 03765-94 S GOVT: N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; OTH
JOB DESCRIPTION ; REPLACE HALCONY DOOR W/GLASS WINDOW SQ FT; 5J0
CLAIM VALUE: 535.00 CALC—VALUE: 530.00 GROUP OCC: R-3 /
COMMENTS: REPLACE DOOR W/WINDOW ZN THE SAME FRAME
*�r�t*?����rx�x���r�r*�r�*t�*+�*�***�r**�***�x��x*�r�t*�rx�**�r�r�#�r�****�r�*�**�*�r�*�***?�*�r*��x�r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT I1+1 RGHT; FT IN
FARKING REQ • PROC�: PARCEL: 43914127 ZNE; REF NO;
PLAP�NING N6TES>
i
iE iE i!!f !E 1! # 1t iE iE iE iE 1f !E i.' dE 1! iF �f iF fE fE fE ic 1E iF iE if 1f if iF iE iF iE if k iclf iE iE if if jf fE ic iE jF jf if iE 1F if if 1E iE if iElE fE if iElE iE it 1EiE 1FlF 4F 1E it 3F iE iE iF ik #'- * 3E
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 D1 E N T S
2vNING APPROVED HY PATE; "
BUILDING APPROVED BY ; PATE:
APPLICATION ISSUED BY; DATE: �� � 4�
ifiliElflflElFlElEiflFlFf(�1flElkififlFiEjflEiFitSF�it3F��t3Fit3F3Filit"�3FiF'.kTtifiFi'Fif�f3f �ititif'�`i'FiFiliF�?f�ftifiFiElEiffEi!?E�'iFiFi!1F
iE iE it iE 1f if')k i! 7f iF 1f iF iF if i!� iE fE k iF iE it if fE 1E iF if iE i! iE ic it 3E iF iF if iP iE iE # iE iF iE iE iE iEltlE'lE if� iE if �)f �1! iE tE tE 1F iE if 1E iE iE iF 9! iE iE 1k �E i! IF iE i!� if it!! iE!! if iF
LEGALIZATZON;N F E E S U M M A R Y STRUCTURAL SEGME3JT:Y
BLPG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 17,00 ,SQ
ShtIP/NON—RES
PLAN 11,05
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DCTE
TOTALS----> 17,50 0.00 11,05 28.5� 28,55 .00
REVENUE DZVISION TOTALS--> COLLECTED; 2A,5� OVER/5fIOAT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
17.00 ,50 11.05
if iF �lh it 1(� �1F it il� iE if !E if iE iF if iE if ik if iE iF iE'lE iE iE 1E iE iE iE iElf ff iF lE * iElE iE i!!E if if iE if iF it if !f ih it �)f 1E �f if if if �If iFlt iF iE iE i: iE fE �lf if if ?E iE # iE'lE # iFlE'rt!E 3f
I N D Z V I D U A L F E E B R E A K D O W P]
TYPE �iTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 530 ALTER BY VALUE RESIDENTIAL NUZONE 1,00
END OF FEES
530,00
ill DU16S083—OO1b9Q85 7 GT 28.`
6NiE: 26/OS/94 Tf�lE� 11%39
CGPJS RUCTION AND PLANNWG POG . SPA ; '
APPROVALS Permit#'"r Oate Inspector APPROVALS Permit# Date I�spector
1. Tempolary Elec.rical Service or Pole 52. Poo1 & Equipmeai Location
2. Soil pipe�Undryrnd. 53. S[eel Reinforceme�t
3. E72ctrical Conduit Utility-Untirgrnd. 54. Forms
4. Electrical Condu;t-Undrgrnd. 55. Electrical Bonding �
5. $teel Reinforcement 56. Rough Ptumi�ing & Pressiire Test 1
6. Electrical UFER G�nd. 57. APPROVAL TO COVeR�GUNlTE
7. Footings 58. Elec:rical Cor,duit-Undrgrnd.
8. Foundation 59. Gas Pipe, 17 Untlrgrnd., Test
i
S. Nlater Fipe-Undrgmd. -- 60. 8ackwash Lines, P-Trap, C� U»drymd.
1Q. Struciural Ploor SYst?m � � _.�' 67. APPROVALTO DECK
�
11. PropertY Sewer �ine & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap , 63. Neater & Vent�Finai
13. Roof D�alns 54. Pfumbing System - Fina�
74. Rough Plumbing 65. Electricai-Finai I
15. Rough Electrical-Conduft 66. Solar SYstem-Final y�
t fi. Rough Electric YViring 67. Fencing & Access Approva! � �
l7. Rough Wiring Sign 88. APPflOVED FOR PLASTERihG
18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEP�S FINAL
19. Rough Hea:ing & Air Conditioning fiRE DEP7. REQUIREMENT
' 20. Rough Factory Firepiace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, `✓eniilating 71. Product Piping O Gas ❑ Oii
� 23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Underyrnd. Storaye Tank C Gas ❑ Oil
� 25. Roof Sheathing 74. Ovefiead Hydro
� 26. T�Bar Ceiling IStructuralf & Monocoat 75. Dry Chemica! �
27. Frame and Flashing 76. Dry Standpipe I
28. Lathing & Siding 77. FIXED SYSTEM FINA�
29. Insulation 78. FIRE PREV. fINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
3L Pl;ster Bro�nm Coat 72 FINAL INSPECTiON
( 32. Ele.ctnoai Power Meter�F�nal 80. FOOD CERTIFICATE ISSUED
33. Flnal Eiectrtc Notes:
34. Final Heat(ng & Air Condition�ng
35. Final Gas Pipe-Test
� 36 Hood or Canopy
37. Flnal FactorY Fireplace
38. Final Piumbing
39. Water Se��ice�Fi�a�
40. Gas Service-Fina�
A5. Soiar pomestic-Fina{
�
42. BackfioW P�eventer " I
43. Backflow Irrigation
44. landscaPe trripation SYstem
45. Sound Attenuation
46. Handicap Regutations
47. FINAL STRUCTURE & BUILDWG !� y�(� /.(,v�.
C�
48. PINAL P�ANNING
49. Electric Release to Edison
50. Gas Release to Southem Catifornia Gas Co
51. CEiiTIFICATE OP OCCUPANCY
No, Dace �
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.
°� 1'�� ' �--
� �Ro�1' � \ �� ,
� • C o�.�S tQ �. � �
S�'�C�o � , - .
DMSION OF BUII.DING SAFETY
CITY OF COSTA MESA
,
• � �
. ae
' of plans and specifkatlons MUST be kept an Ihis job at 1 \
' unlawtut to make azry changes or atteration on same witFro . w � `
bn hom the Divisbn ot Building and Safery, City of Costa M
. ping af this phn and sD��h�aons SHALL N0T be held t t
' a. fo an approvat of the violation of any provisions of any City t st
, • - M inance andlor Slate iaw. !L � r,� l�
1" l `
TI es ans and permit shall expire by Ilmitation and bec e null an id I �XS�1 r�q
, th b iI Ng or work is not commenced antl maintainetl active per UE C 30 —� �
;d w lhi 180 tlays of issuancc. � O o f
F�
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f� '��NEqg;ti�� COOPERs'M3THB�HENRY J
aooxess: 364 GRENUBL� LI�
CUSTA MESA,CA
650-SSd2
��
uxir:
92627 � M 8�68
ABCH/ENGINEEfl: � HEG.NO.:
AD�flESS: UNIT:
PEflMITTEE: CUOPERSMITK, HENRY "( 714 ) 650-5552
ADDNESS: jG� GREIVOBLE
C,K CA 92627
LICENSED CONTHFCTOfl OECIANATION: 1 �ere�y ai�irm �hat I am licensee un�er D�ovisions o� Chapter 9(commencing with $ection
7000� ol Oiv�sion 3 0l Ihe B�siness and Prolessions Code. anG my license is in full force antl eifec�.
CITY LIC.: STATE LIC.: CU15S:
Oate SignaWre:
WOBNEBS' COMPENSATION OECU1PqTI0N: I herehyaifirm �hai I have a cehi�ica�e of conseni Io sel4insure or a cerii�ica�e at Workers'
Compensatmn Insurance, or a cenified capY ��ereoi (Seaion 380Q Lab. C).
POLICY NO.: EXP. OAiE:
cornraxv:
� Certilietl coOY is herehy fumished. ❑ Cetli�ied capy is �iletl with Ihe ciry Building Oivision.
vale: ApDliCant:
E%EMPTION iPOM WOFREflS' LOMPENSRTION DECLAflRTION: (Thi5 s ion neetl n l mpl d iI t�e permit i5 �or one huntlre4 �51 W) or less�.
I cehity Ihal in �he per�ormance o1 �he work for which �his per s i eq I not e oy any person in an eie-Uecome
subjeq to t�e Workers' Compensation Laws af Califom�
Oal¢: =�J �yZ Signa
NOTICE: Ii, aiter making Ihis declaration, you shoul e 5 mkers' ompensalion pmvisions o� �he Labor
CoOe. you must lohhwi�h camply wiih such pmvi ans r thi it shall be dee revoke0.
CONSTBUCTION LENOING RGENCY: I �¢reby a��irm �Aa� Iher con9mclion lend agency for Ihe pedormance af t�e wark for
which t�is permil is issued (Sec[ion 3097. Civ. C�.
LENOEP:
aoopess:
OWNEB BUILOEN OECLABRTION: I hereby aflirm Iha� I am exempt from Ihe Conlraciors' Sia�e License Law for the �allowing reason
�Section 7031.5 Business antl Pmtessional Cotle: Fny ci�y oi counry which requires a Oermi[ to cons�mct, al�er. impmve, Oemolish, or
repair any stmcNre, prior to iis issuance, also requires I�e applicant for such permit �o lile a 5igne0 s�atement �hai he/she is licensetl
pursuani m Ihe provisions oi �he Comracmrs' Sta�e License law (C�apter 9(commencing with Section 7000) ol Division 3 0� the Business
an0 Pro�essions Code� or thal he/she is exemp� Ihereimm ana ihe basis lor the allegetl exemption. Any violation al Section 7031.5 Oy
any applican� �or a permi� subjecfs ihe apPlican� to a civil penalty of noi more Ihan �ive hundretl tlollars ($500�.
I, as owner oi the property or my employees vntA wages as iheir sole comoansation, will Do the woM, anU ihe
❑ stmcture is nat inten0etl or oifered for sale (Section 70a4, Business antl Professional Cotle: The Coniractors' Sta�e License Law
tloes not apply to an owner ot a pmperty who builCs or impmves ihereon, antl who Ooes such work himself/herself or thmugh
�is or �er own empioyees. pmvidetl Ihai suc� impmvements are no� inlended o� oife�eJ for sale. Ii, however �he LuildinA or
impmvement is sold within one year of completioq the owner will have �he bur0en oi pmving he/she ditl not 6uild or impmve
br ihe Durpose ol sale).
I, as owner ol ihe pmperty. am exclusively coNracling wilh licensea caniramars m cans�mc� �he pmlect (Sec�ion 7044, Business
❑ antl P�olessions Cotle: The ConVaclors' S�ale LiCense Law doe5 not apply Io an mmer ol pmperiy who huilds or improves ��ereon
and w�o conVac�s lor suc� D�ole��s wilh a comrac�or(s) license pursuantm the ConVacfors' Siat ' nse Law),I am aware
Iha� pmo� of �heir Worker'S Compensa�ion insurance should be pmvi0ea Io
�f] � am eremp� unaer Section: B P% O�I 4 e. s P. c
mr mis reaso�. AI�L WORK BY OWNF�
Da�e'. � /� /4� Ownec �
I do hereo ceni y that I am aware nf antl untlerstanA �he requirements ol C or " e Safety Code ctions 25505, 25533, antl
2553a antl �hat I or any fu�ure buil0ing occupan� willlwill no� (circle one) neetl to com it saia state co antl �he requirements lor a
permi� lor con5lmciion or modi�ication imm Ihe Air Ouality Management District. R en�ial constmcti apPlica�ions are exempi imm
Ihese pmvisians.
�a�e: Npplicanf _
I hareby certilylhai I have reaa ihls apDllcallon and Slaie t�ai
ortlinances ane s�alelawsrelatinglo �uilaing cons�mclion an
pmperty lor jAspection 0urposes. �
.oa�ee����G,� ` _ Signawre:
omersiicense or 5ociai Securiry a: _�
t6aFa6 WNte—Bulitlmq; Green—Cotle Enlorcemem:
Comply wilh all tily and
enierupon�he a�ove-m[
Pink—qevenue: Golaenroa—Ac�essor
CITY OF COSTA MESA - HUILDING PERMIT �nxr� iv�: r. �0 7
PERMIT NO; E OSfi092 PLAN CFIECK NO: N i: . u r: i�
CON�TRUCTION TYPE; V-N PERMIT T'YPE; ELE PIIRPOSE: OTH
JUB llESCRTPTION : ELECTRICAL FOR WASHER & DRYER S(j F'C:
CLAIM VALUfi: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: SMOKE DETECT'OR RE�UIRED IN THE HOME
if#if3EiEifiFi'r3EiFiF3f�*iEiFiEiEifiEifiEifiEfi�aF%iE ifiEiE#-iFiEifibi'rifiElFifiFi'r�lFifiE3EiFififiE3EfEiFli�3EiF3EiEiFiF3E3E]FiEifiE#if��lE�fifiE#iEM�*if�i
Z O N I iV GS ERTEBQAUCIKRSE M E N T 5
------------ N.AIN BUZLDING ---------- --------- ACCaSSORY BUILDTNG ---------
FRNT: F'C IN REAR; FT IN FRNT; FT IN RnAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGFIT; FT IN
PARKING REp • PROV: PARCEL: 4391412'7 ZNE:: REF NO:
PLANNING N(3TF,S� � ���� ����y C�� •�o�,
iEiFiFlf�lfiE3E�%kii�lf-1fiF3F�1F3f1E7F3f3EiEiEtc3fi[��1E3fiE3FiF 3E1fdEiF.ff^lEIF�IFjF�1F3EiE3E�lE##N�IEi���l(�-IEiFiP�-3f#��14�iE�1FIhiE�lfieiflFiEihi'r!E*ifiFifii�i'r3F
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
, CwiQ ��
ZONING APPROVED BY ; �c��l��4J=�2F-- DATE:
BiJILDING APPkOVEP BY : �,/' DATE;
APPLICATION I5SQED HY:
��*���*�**��*�����,�.*� C
�r��*********u**x���**x�*�a�
LEGALIZATION;Y
BLDG PMT PL,UMBING
PERMIT
PL�
ISSUE FEE
-�- DATE: �7�fZ�
r. -Rh'lChi%')t '.�M.�if�(��%')FiEji'ti%ifaE�-h'�t ' : i(�1E
,r�cn� lE3fiFifjFlf 1EificiFiEiEjb�E�EjEi(�lEiEiEif3i3EjhihlE!siE�fdFiEiF�f1Fi(��i3E3E�f�EiEie�Eie
F� S T" M N A R Y STRUCTURAL SSGNiENT;1.
ELECTRIC MECHANIC FIRE SMIP/RES GRADING
3'_00
;r.0 % SMTP /AION-RES
i
1J:��
HUILDING-DTV-> PERMIT ISSUE PLAN-CHECK TOTAL PAiD DUE
TOTALS----> 3,00 15,00 0.00 18.00 18.OD .00
REVENUE DIVISION TOTALS--> COLLECI'ED: 18,00 OVER/SHORT: 00
BLDG PMT fiLUMBING ELECT�tIC MECFiANIC FIRE SMIP/TOT GRADING PLAN-CHECK
LQ,�Q /L
1f 3F iF ii� �E iE iE-IE jF 7E iE i(� iE ff iE �i- !F ii� iF iF ib'1E iE iE IF iE 3F �k !f if af 1f iF iE 3i�.3E i�4E IE 1E 3f iE iF 3F-1(� iE 3f iE iE 1f iE # iE 1f �E K� iE 3E 3E M� if !f jf iF+� 1f 3F i k iP%i4 ic iF x If iE i� iE
I i�] D I V I D U A' I, • F E E B R E A St t D O W N
TYPE QTY ll E S C R I P T I O N; UN7.T COST TOTAL COST
EI,E 2 RECEPT/UUTLET ;-1� w'P� p/@Q.� D/ hµ1. /� �• 75 1, 50
�3 `rJ F-�4� �
FEB ._ � ��sz �
�.� oF cosra rn�s�
.
�j� POOI "� SPA �
CONSTRUCTION AND PLANNING � Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Pe. .,c #
��3. Temporary ElectriGai Service or Pole 52. Pool & Equipment Locatlon ,
�2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement -
3. Eiectriazt Conduit Utility-Undrgmd. 54. Forms
4. Electriwl Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel iteinforcement 56. Rough Plumhing & Pressure Test
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Electricai Conduit-Undrgrnd.
8. Foundation i 59. Gas Pipe, � Undrgrnd., Test . �
9. Water Pipe-Undr9rnd. ' � 60. Backwash Lines, P-Trap, O Undrgrnd. '
10. Structurai Roor SYstem ' � 61. APPROVAL TO DECK • .
t t. Property Sewer Line & House Connection . �' 62. Backwash & ReceptorFinai _ �
12. Sewer Cap - 63. Heater & Ve�rFinal .
13. Roof Orains 64. Plumbing SYstem - Final �
14. Rough}'lumbing 65. Electrical�Final .. •
75.�N9ugh Electrical-Conduit � 66. Soiar System-Finai � �'
16. Rough Electric Wi�ing � 67. Fencing & Access Approvai .,�
17. Rough Wiring Sign � 66. -APPROVED POR PLASTERIN�'i
18. R�gh Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceilin9 (Svuctural) & Monocoat 75. Dry Chemical
27. Frameand Flashi�g - 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation � � 78. FIRE PflEV. FINAI
.i
30. Drywali Nailing . . . HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ;: ' � 79. FINAL INSPECTION
32. Electrical Power Meter�Final ,� 80. FOOD CERTIFICATE ISSUED
33. Final Electric .' g.� Notes: s-2 �-Ct3 ���� (,`�-o ;
34. Pinal Heating & Air Conditioning •; � . �;,� � �['._O �/ i ,.,,. /� _
�� Z 7 �.c.i.j
35. Final Gas Pipe�Test ; �; � � ' .
36. Hood or Ca�opy �:i� ' � ' '
37. Final Factory Fireplace � �
i �
38. Final Piumbing - " _
39. Water Service•Final ,,; .�
40. Gas Service-Final I ;
41. Solar pomestioFinal •
��. --� .
42. Backflow Preventer �
43. Backflow Irrigation �
44. Landscape Irriqation System
45. Sound Attenuation .
46. Handicap Regulations
47. FINAL STRUCTURE & BUI�DING �
48. FINALPLANNING ���
49. Electrie Release to Edison ��
50. Gas Release to Southem California Gas Co �
51. CERTIPICATE OF OCCUPANCY �
N0. Date
69 GRENOBLE LN
�OOPERSMITH HENRY J
`I�. 64 GRENOBL� LN
COSTA MESA,CA 92627
650-5552
AHCHIENGINEEfl: BEG.NO.:
ADOHESS:
uxir: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05265
PERMIT NO: P 052653 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU PURPOSE: OTH
UNIT:
PEPMITTEE: NOCK PLUMBING ( 714 ) 895-1296
aooness: 11610 SEABOARD CIR
STANTON CA 90680
LICENSEO CONTBACTOB UEClABl1TI0N: I nereby alfirm Ihal I am licensetl untler provisions ol C�ap�er 9(commencing with Seclion
7000� of �ivision 3 0l Ihe Business antl Pmfessions Code. and my license is in full force anG elfect.
c�Truc.: 050386 STATELIC.: SiL9%S cws� 1'
Oa�e. %` ��' � � SignaWre�. � _ _
WONKEBS' COMPENSR710N OECLABATION: I hereby aliirm Iha� I �ave a rerli�¢ate 0 consenl Io selbinsure or a cetlilicaie ol Workers'
Compensation Insurance or a cenilietl copy thereo� (Section 3800 I,ab C.
voucvxo.: 116799290 exr.oarE: a3/O1/92
comeaNr: STATE
� Cetlifietl [oDY is �ere��yy tumi5�e0. � Cehi�ied copy is � ith Ihe ciry u ing �ivisioi��
Da�e� �� ��— ( / Fpplican�
E%EM�IONFPOMWOBNEXS'COMPENSATIONDECLAHATION: (Thi55eClionn¢etln0ihelompl¢I¢Ail�hCpermiiisbran¢hunCre0�5700)Orle55�.
I cetlify ihat in ihe petlormance of ihe work for which ihis Dermil is issue0, I shall not employ any person in any manner so as lo become
5u01et1 �o ih¢ Workers' Compen5aiion laws ai Caldomia.
�ale', Signature', '
NOTICE: If. a�ter making this tleclaration, you shaulA become suhleci �o Ihe Workef5' Campensa�ian provisions ol �he Labor
Catle. you must tonhw�th compty witn sucn pmvisions at inis permit shall 6e UeemeA revoked.
CONSTflUCTION LENOING AGENCY: I Aere6y a�firm I�at Ihere is a ton5lmtiion IEnAing aAenCy lor �he DeMOfmanCe oi Ihe work fot
which Nis permilis issuetl (Section 9097, Civ. C).
LENOEN:
AO�NESS:
JOB DESCRIPTION : CHANGE OUT WATER HEATER SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: SMOKE DETECTOR RE�UIRED IN THE HOME
**�t*+�**�*�r***�*�*****�t**�*�r **�r**�t*�r*�**��**�t+r�*x�+�*�**+��x**�t+t+r�t�c**�*�r*�r*�r�rt�r+t�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 43914127 2NE: REF NO:
PLANNING NfST'ES>
i
***�**+r�t**�t*�t*�***��r�**�*�r�t�t,r�t+t*******�e�**�r�r**�t**+t�e�r�*x��t*******�*�*�r*�r�r*�r+t�**�r
D E V E L O P M E N T 5 E R V I C E S.. R E Q D I R E M E N T S
ZONING APPROVED HY . ' DATE:
BUILDING APPROVED HY
APPLICATION ISSUED B
iE �f M iF if if if iF iF aF iF If iF iF if �1E k k iF If
if it k iE if iE iF ii iE ik k iF iF k iF iE iE iF iF fE
LEGALIZATION:N
OWNEB BUILOEB UECLAflATION: I here0y allirm t�a� I am evemp� imm Ne Canlrac�ors' S�ate License Law for tne Imiowinp reason B LDG PMT
�Senion 7031.5 Business antl Protessional Coae: Any ciry a� coumy w�ic� reQuires a permii to constmct, alier, impmve, Oemolish, or pERM I T
r¢pair any s�mclure. prmr lo iis i55uance. al5o repuire5 Ihe ap0liCant fof 5uch p¢rmil lo lile a Sign¢tl Sta�emenl t�ai �els�e is liC¢nsetl
pursuant Io the umvisions of the Con�raclors' State License Law �Chapi¢r 9(commencing �tA Section 7000) ot Oivision 7 oi �he Business
ane Pwlessions Code) or Ihai �eh�e is eaempi t�erelmm anG the Dasis lor I�e alleye0 eeemplion. Any violation ol S¢clion 7031.5 by PLAN
any applicanl Por a permit subjec�s lhe appiicant lo a ciNl penalty ol nol moa Ihan live hundrea Gollars (5500�. ISSUE FE
i. as owner oi me o�ooeny a� my employees wiin wages as meir sole wmpensation, witl Eo ine wanc, ana ine BUILDING
❑ simcture is nol inten0etl ar alfereU lor sale (Section 7Wa, Byyness anG Pmlessioiul CaUe: The Coniracmrs' State License Law TOTALS--
Does not ap01y to an owner o� a O�oPeny w�o GuilEs or imp�aves I�ereon, antl wlw aoes suc� work Aimsell/Aersel� ar I�mugh
E
—DIV—>
__>
iFikifiEif 1tiEiElE�F1Fi6
F E E 'S U M
PLUMBING ELECTRIC�14�
Z,�O
2si
3.00 -
PERMZT ISSUE P,LAN—CHECK
2.00 3.00 - 0.00
DATE:
DATE: `�
�A����t�r*��r�t�r+r+�� " **
M iF iE k�F if �f If IF iE �E �k if if iFlF iF ii IE ik fE M 1E iF iF K iF iF if �F 1E iE iE 3F
A R Y STRUCTURAL SEGMENT;N
ANIC FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
5,00 5.00 ,00
� his ar ner own employees. provitletl ihat sucA impwvemenls are nol intentletl ai oiferetl br sate. 11, hawever ihe huilainp or REVENUE D I V I S ION TOTALS— —> COLLECTED • S, � 0 OVER /SHORT • 0 0
impm�emepnt is soitl wimin one year oi wmplelion, the own¢r vnu have ihe OurOen of proving ne/sne aie not euila or impmve BLDG PMT PLUMB ING ELECTRIC �MECHANIC FIRE $P� IP /T�T GRAD ING PLAN—CHECK
far ine o�� ose ai sale .
I. as owner of ihe pmpeny, am eeclusively comraming wiih licensea contraciors io conslmct Ihe Dmject (Section 7044, Business � S. OO �;
❑ ana Pm�essrons Coae: t�e Contracmrs' Sta�e License Law Oces irot apdY �o an owner ol propeM who Omlas or imprwes Nereon )
an�w�Otonlratl5torsuc�Oraietl5wilharonVatlor(S�IiCenSepur5wntlolhefAnirat�OrS'StaleLittnleLaw�.lamaware iFifik�EikiFlfififlFlE1E±F1FiElElfiF1ElEIE7EfFlFifiEifikifiFififlF3FikffiFiFlF�EiE1fIF1FIfIflEiflFlflfiEiFif*1flfiEiElEMiFiffFlFIE�EifIflEif*ifIF1EM�IffE1F
ihai D��� af ��ei� Worker'S Compensa�ion insurance stwultl �e Dmvide0 lo me. I N D I V 1 D U A��. F E E B R E A K D 0 W N
� I am eeempt untler Seclion: B. 8 P. g.
ro�misreason: TYPE QTY D E S C R I P T I'.O N UNIT COST TOTAL COST
oaie: a+�e� PLU 1 WATER HEATER AND /OR VENT 2, 00 2. 00 /
i eo nereby cend� thai i am aware ai:na unoerstano me requirements oi caommia Heaun ana Saiery Cade secuans 25505. 255�, ano .$ND OF FEES ./
25574 antl ��a� I or any fulure Uuiltlmg occupan� vnNvnll nol (circle one� neeG lo comply wii� said Slaie mCes an0 ihe reQuiremenis �or a V
pe�mil for con5imc�ion or modification �mm t�e Air Ouahly Managemen� DisVic�. flesi4eniial cons�mction aDDlita�ions are exempt Irom
�nese pmvisiorts. '�
Daie: AOPlitani:
1 �ereby cetlily Ihai I have reatl W5 ap0�italion and slale Ilwi I�¢ abp�e inloirtuiwn is tarrecl. 1 a0�ee lo tOmpty wilh all tiiy antl wun�y
ominancesanOSlatelavrsrelalinglaGuiltlingcorrslmclionanA�ere ppr¢¢repres I liu¢5o11hi5u/ip to¢n[tej.� IheabOve�m¢ntione0
pmpetly for inspeciian purposes. t/^�����/�,%'' _
i731¢'�"' �� I' � Si9naiure: ` Cu v
1 i
oriveiS L¢ense or Social Securiiy a:
t6aLc6 Wbne-9wltlmg: Green—Cotle Enlorcemem: Canary�qpplicant: Pink—Rgvenoo: GolCemoE—Assessor
r. i �
.' �\���v. ., ._ _ :
/
,
CON$TRUCTION AND PLANNING � P��'PA �
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
T"iporary Electric2l ServiCe or Pole 52. Pool & Equipment Location
�oil Pipe�Undrgrnd. -r_ � 53. Steel Reinforcement
� tiElectryFal Condait'Utility-t7ndrgrn� �� 54. Forms
. '�,�}:•-Electrical Conduit-Uodrgmd. 1� 55. Electrical Bonding
�= 5�.�'5feel Reinforceme:it� 56. Rough Plumbing & Pressure Test
T,'" i n+
''r��;EfectricalUFE�jt�irnd. -,.., 57. APPftOVALTOCOVER-GUNITE ��
�i� 7:.�Y,00tings S�L � 58. Electrical Conduit�Undrgrnd. `-
`'��...Foundation � � 59. Gas Pipe, O Undrgrnd., Test o;
5.$. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. -
�
1�0. Structural Floor System 61. APPROVAL TO DECK
1 L �roperty Sewer Lir{e�& House Conngction 62. Backwash & ReceptorFinal .
12. 9eWer Cap T ;� 63. Heater & Vent-Final
,.
13. Roof Drains 64. Plumbing System � Finai
14. Fough Plumbing �% 65. Electrical-Fina�
15. Rough E�ectriFBJ-Conduit . 66. Solar System�Final .
76. Rough ElectricWiring 67. Fencing & Access ApProval
17. Rough Wiring $ign � 68. APPROVED FOR PLASTERING
18. Rough Electrieal-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT '
20;riioagh Factory FirsPlace :C!+; Q� � :. '*: - APP "'. rr:- F :+. - -
RQVAi,�.�.: Permit #��
- �. r. � ,-
21 !Ducts, ia Str,Sictu�.Cr ,. , � � .� - c ' 4 ' =70. [Indeigr;ounc� HXdro ; •�
22. Ducls, VentFlating� , , �� S L�s >.77. ProducF�ping G.!Qas OOiI
�
23=Gas'PipezRo}gh & �est ' '� � � , J 2 �- s � � 72. Undergio�infl Fltsh: ' -
24,1fioo,j F aming �=f , ; . �:"ryu ;� � x x 73�xUndergrr�.Storaye-Tank+OGas ❑C3il
�
25. RoQf SfZgathing ?;� �, �'' T � r.� ��7q^Overhead�'Hydro-.� �
26",T�Bar Ceiling �SLuGtural) &�vlonocoat ,s �:�. - in� F 75.rDry Chemical v +- ,,, 3
27 =Fra^ e a�d FlasFiian� L, �- y rn > y�: Y 76': Dry Stant�DLPe C7 �, 7' =`; F
� 28"Lat(�iny� Siding_:; �_ ��'�,��, r� * y� . ..'� � 77:.' FIXED SYSTEM F.tNAN, v ~
>29. Insulatron �C� ::, .. .. j ;. ;r . f � ._ „ .:..... y . .. :�,
- � � y 78s FIRE PREV. FINAL �.� y;y
=30. Drywal�iVailing r�,t ' � ' � �'r ^;`.� ".,bEALfFi,�JEPT.REQUIR6MENT '
�31. Plaster BrowQ CoaY�' ,;_ ; ._ �, ' � � �4 _79��FINAL I��pECTf�N r*. � �7 r
' v: r. t�-= � r F�� �-
:-32_ Electri�l Power{Nele�-Final,' �-,; �, 80,�FOOD CER�IF�f��TE IS.bOED �'
�. _ - . _ , _ . , .
33?:Final Elhktr'c ?� • � ' Cv ' � �" ^N' es:Q
:. r � --a rr S �.b s. � p�l�q� KoohlEHom�G�l-Gqao-�
:;:34,,Fir�lHeatin�'&xi�ConditibrlSng; �; � Z ( , ' ;� � .r.�' '. .
a S r y S ��
�35 rFirtal Ge8 Pipe-Tasn � � S• - _ +. ^ 't� .:S • S =
�to -r w - _,�
�36rHo� o�CanoPY�,» `. � � , .n. : ;i �. v ,'_` ; ••f' v :,+ .
, �•
~37�: Fin81 Factory Fifeplace , :Si• 2 r i� ' . ; - • -. �*, . �.
- r a a - Q Cd Y. .1: �1' !
_38. Fina! Plumbing � � t �� �� � �4 !� �(�.�� Z ' `r ,� , -
� \ e-, v A
:39. WaIer Service�Finak ' , r f. !' p? � u
+ r ' t. : .
� 40. Gas Service-Final ' ° i^ �� �' ' �� '^
s y ^ .LP .�' � r � .I ♦ C'`� C7N
�-41. Solar pomesticFinah � •• i ;�t ,r .� e*o " x �
. � y. �� ,; � � x
�42 =8ackflow Preventef � �' � " -' � ' � S
- -t , �.� : .� a -_ �
43. Backflow Irugation �z` •, � .r t � �.K�' � .7 ' .,
,-. , .� .�
.`�44. Landsc�pe hfipatiQn SYsterry_';i� t� -'r, - - �w i :L�, ?. 3 :, o
� 45�Sound AttaQuatio� • �'.1 � � '` f � �-�t � i- " t�,� .c 'i. ` �
�- t ;ny�..r. �� E� r.�� � Y I
546: Handica;n Regulatidns `-� ^ `� �^ •' ' '� �= � ' �i� ••�-
.. , v cC \ CO � .
J47;;FIRj�L STFiiJCTURE & BU�LDING �. ' � � w _ v N ' I
:. . � - . �
`48.',PIId�AL PLANNINC,, . � `.'��� " ' * + �� 'X = '. _
+ I -r �. r z �� x.
� 49 TElectric Release to�Edison � �. ' I ^'r z; " i r _
4 ,r
: 50.,Gas�Release to So athem California Gas Co ' I ,�° - Y'r ' -. �
- � •J
' 51. CERTIFICATE OFOCCUPA C ti�� �r , •' J
No Date
PFO.jfCT RUOflESS: � E1 �% GRENOfl I. E LN
OWNEP:SNAME: COOFERSNIITH HENRY J
:'l,boxess: 3Ei4 GRcNOHL� LN
COSTA MESA,CA 926.�.7
650-5552
RPCN/ENGINEEfl:
NEG.NO.:
UNIT:
AODHE55: lIN1T:
PEPMITTEE: COOPERSMSTH HENRY ( 714 ) 650-5552
aooeess: 369 GRENO�LE
CM CA 97.62'7
LICENSEO CONTHACTOfl OECIABATION: I hereby alfirm thal I am Iicense0 un0er pmvisions o� Chapier 9(commencing with Sec�ion
1000) nl �ivision 3 of ��e Business antl Pro�essions Cotle, and my license is in lull force anU eflect.
CITY UC.: STFTE UC.: CU55:
�aie: Siqnature:
WOflREflS' COMPENSFiION OECU�flATION: I �ereby a��irm Iha� I have a cerlificate of consenl �o self-in5ure or a cehilicaie ol Workers'
Gompensatlon Insu2nca. or a certified coDY �hereo� Sec�ion 3600, Lab. C�.
POLICY NO.: E%P. DATE:
COMPPNY:
❑ Ceriitied copy is herehy Wmishetl. ❑ C¢rli�ied capy is filetl wi�� ��e ciiy Building Division.
Daie: Ap0licani: _
E%EMPTION FflOM WOHNEXS' COMPENSATION DECLi1flRTI0N:
I cetlity Iha� in �he petlormance oi the work for which this
sublec� Io I C Wor rs' ComDensa�ion Laws ai Calit a.
Dare 5' ure� _
N ICE:) . after making Ihis declara�ion. you 5hould
Cotle. you must fotlhwi�� comply with such pmvi
CONSTNUC710N LENOING AGENCY: I here�y afti al
wnich Ihis permn is issued �Sec�ion 3097. Civ. C). /
LENOEN:
aooxess:
,dermit sTiall 6e
a consimaion.
one hundrea (5100) or less�.
� manner so as lo become
Compensaiion pmvisions of Ne Labar
i revaketl.
agency for �he petlormance of the work ior
OWNEP BUILOEN �ECIANRiION: I hereby allirm that I am exempi imm Ihe Contraclors' Staie License Law �or �he following reason
(Section 7031.5 Business antl Protessional Code: Any ci�y oi county which requires a permi� lo cons�mct, al�er, impmve, Oemolish, or
repair any s�mcture, prior �o i�5 issuance. also repuires Ihe aDPlicanl for such permi� to �ile a signed sta�emeni that helshe is licensed
' CITY OF COSTA N,ESA — BUILDTNG PERMIT r�GriM NV; Y u�ov7c
' -t
PERIfIT NO; F U56093 PLAN CHECK NO: N t, v:: iv 5ur•r�; rv
CONSTRUCTION TYPE; V—N PERMST TYPE: PLU PC7RFOSE; OTH
JOB DESCRIFTION ; FLUNBING F'OR WASHER SQ FT:
CLAIM \7ALUE; CALC—VALUE; GROUP OCC; R-3 /
COMMENTS; SMOKE DETECTOR RE�UIRED IN THE HUME
iF ie 1E 3F iE it iE iE-%iP �7F iE �1E iF 3f IE iE if �%� �E iE ib �lk iE lE iF 9E '- iE iE if j(� iE 1FYr iE'% iE 3F if 1i� IF ie ic ic iF iE 3E iE %if iE ie �If iE if iE ii� k iF IE 9F �lE K�1e 3E iE # iF aE #� 3f 3e Y� k iF iE i'r 3R
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BliILDING --�-------- -------- ACCE�SORY BUILDING --------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN ftGIiT; FT IN LEFT; FT IN kGHT; FT SN
PARKING REO; PROV; PARCEL; 43914127 7,NE; r�EF NO:
PLANNTNG Ni3'I'ES� �.� L���� ��iS77�A%/�j P.Os�/D/�•G�or/)
i•�
-kiEitiFlEiilF7!�!(1Fk1FX�iEifif�ifii�#iiifiF 1kif�iFifiE-)Fi(�3S�iFi:l6iFiE�k�lFlf�lili�ii'3fif�ii�iP36ti��IeiFih3F}:�iE1f31S�iER7f34iFifk�1(ii�iFih7fieliii�N•if#3P3f#..y.
D E V E L O P M E N T S/ E R V I C E Sp� R E Q U I R E M E N T S
20NING APPRUVED HY ;��/_J�'� DATE:
f
BUILDING APPROVED BY ; � DATE:
APPLICt?TIGN ISSOED B� � UATE: ��
�tE*3E;E�F;(-iE�Ex�iF�F�tEiE�E*iE��E�i3�iE�F xn�xkx �� � £i^�k3���h��F*�(-i!��1�+'r�ic��F*��Q x'3t� ��r
iE if i'r aE �� ih �lE 1F iE � jE iF if iE iE iF �1(• 1E iF 3E iE iE iF 3f �lE # iE �(� �k 1F �E i(� 3F iE �IF iF �lF ii Y�c iF #E k� R 3E R 3E ie-N-3E �lc iFji 3e K� if iE iE �f� )t iF �JE i(� V.� iE �1F 3(� �K� �(- 3E iF # ii� lE 1E 1e ik if
LEGALIZATION;Y F E E S J M M A.R Y STRTICtURAL SEG,�ENT:N "
bLDG PMT PLUMBING ELECTR_C MECHANIC. FIRE SMiP/RES GAADING
PERMIT 4.00 .' �„ ,
pursuan� to the pmvisions ot the Contractors' Slale License Law (Chapter 9(commencing wi�h Seclion 7000� o� Oivision 3 oi the Business z 5 g -. .: SN I P/NON—RES
antl Pmfessions Code) or �hal helshe is exempl thereimm anU I�e Dasis for the allegetl exemplion. Any viola�ion o� Sec�ion 7031.5 Dy �' LAN '� •..; �,
any a00�icant lor a Dermit sublecis the applicani Io a civil penalty o� not more fhan live huntlred tlollars �5500�. I SSUE FEE 3. 0 0 � �
BUILDING—D N—> PERMIT ISSUE PLAN=GHE�CK ,, , TOTAL PAID D"JE
i, as owner oi ine pmpeny or my empioyees wim wages as meir soie compensation, win tlo ihe work, and ihe TOTALS----> 4, OQ 3, DO '=:0. 0'0 � t %, �0 J, �� , �Q
❑ slmclure is nai inten0etl or o�feretl �or sale (Sec�ion 704d. Business antl Pro�essional COAe: The ConVaciors' State License Law �
does not appiy to an owner ol a D�operly who builtls orimD�ovesihereon, antl who does such work �imsell/�ersetf orihmugh � � 'W ,
nis or her own empioyees, provmetl ma� sucn impmuements are not mtenaetl or onerea for sale. u, however me huiitling or R$V$NUE DI VIS ION TOTA%S--> C�L"L,ECTED •' + 7, 00 QVER /SHORT • 00
imvmvementissomwiininoneyearo�compietion,ineownerwiilnavemeourdenoiprovinqnelshedidnotbuiloorimprove BLDG PM"I' PLI�MBING ELECTRIC NyECAAN•7C ^ FZRE SM1P/TOT GRP.DITIG PLAN—LHECK
lor tne purpose of sale�.
I, as owner of ��e DmDehy, am extlusiuely conUaC�ing wilh litensetl contraclors �o Cons�md th¢ pf01e�� ($eclion 7044, Busine55
❑ an0 Pmfessions Code: The Conirac�ors' S�ate License Law does no[ appty to an owner a petly who �m1Q5 or impmves �hefeon
and who comrac�s �or such D�ojects with a contracioqs) license pursuanl �e C ract s' Sia�e License law). I am aware
tha� pmof of their Warker's Compensalion insurance 5hou10 be provi a
�:j i am exem t�under Section� BP�TO �! 4 B. 8 P. C.
mr tms � aso�, ALL WORK BY O
Oate: � � Owne
1 do Aereb enify) al I am aware oi anA untlerstana the requiremem I ' a an ery CoOe Sec�ions 25505. 25533, antl
25534 a t�ai I or any �Wure buil0ing occupant will/will not (circle a e) ne comply wiih i state codes antl the requiremenis for a
permil � r conslmclion ar modilica�ion irom Ihe Air Oualily Management ' ricL BesitlenY ns�mction applications are exempt �mm
Ihese provisions.
oa�e: noPr�am:
I hereby ceriily Iha1 I �av¢ reatl�his aDPliCaiion ana S�aIE
ordlnances antl s�ate laws relating lo �wltlmg cons�me'
properry �ar i pec�i n Ourposes.
�aie' naWre:
�river' ice e or Socia� Securi�y a:
16ei�G6 Whne—Buildmg; Green—Cotle Enlorceme
I agree la comD�Y �th all ciry and coun�y
this ciry to emer upon t�e above�memione�
Pink—Revenue: Goldenrod—Assessor
� 7.00 _ . ,
**x�*����**�v�*������r***���*�*��**����**�*x�**����**��*�*�r�*x***�����c**����****
2 N D S V S D U A%i, . F E'E B R�E A K D O W N
TYPE C,�TY D E S C R S P T I O N•'? ;: UNIT COST TUTA� COST
PL[J 1 LAI7NDRY TUB OR idAS�ND (�F k'£ES � i z��� °� `" ^-� �}
�. , ,- � /,_ =-. : _, �.:.:�, �1 !'' �,
,- � ' '
� � ^
� . 3 �_ 1�3?
. , � Fr ..
.. .y � _ �, _� ' � .v�il
� - �- C{TY G: � . . ..
—�. ., l
v��n� C6�'1( 6� ��mN""
�
. , „ , -
ONSTRUC7IQN AND PLANNING POOL & SPA �. �
` APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
�
1� Temporary Electrical Service or Pole ' 52. Pooi & Equipment Location -
2. Soil Pipe-Undrgmd. ' 53. Steel Reinforcement �� �
3. Electricai Conduit Utility-Undrgrnd. 54. Forms
4. Electricai ConduibUndrgrnd. 55. Electrical Bond�ng
5. Steei Reiniorcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Footings . 58. Electrical Conduit-U�drgmd. �.
8. Fo�ndation o " 59. Gas Pipe, O Undrgrnd., Test •
9. Water Pipe-Undrgmd. • �i � 60. Backwash Lines, P�Trap, O Undrgmd.
10. Structural Floor $ystem ' 61. APPfiOVAL 70 DECK ��-
1 t. Property SeWer Line & House Connection - -� 62. Backwash & Receptor�Final '
12. Sewer Cap ��- ' 63. Heater & Vent-Final
� 13. Roof Drains � F 64. Plumbing System � Final _
i
14. Rough Plumbing . 65. Electrical-Fina� �
75. Rough Electrical-Conduit , 66. Solar System�Final
16. Rough EleMric Wiring 67. Fencing & Access Approval
77. Rough Wiring Sign -•� 68. APPROVED FOR PIASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �
20. Rough Factory Fireplace APPROVALS Permit # -
21. DuCts, in Structure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Svucturaq & Monocoat :f 75. Dry Chemical
27. Frame and Flashing � 76. Dry Standpipe
28. Lathing & S�ding 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywall Nail�ng �, HEALTH DEPT. REQUIREMENT
31. �Pidster Brown Coat � �� 79, FINAL INSPECTION
32. Electrical PoWer Meter�Final -' ���' S0. FOOD CERTIFICATE ISSUED
33. Final Electric " !' Notes: 7�y���fZ �YO oK,E l�Oh'iE •LEl�7'G4RlJ'L� �
�
34. Final Heating & Air Conditioning , {'��
;' ,f 3-�J'-�tz �loa�r� FFonr�-G�GrC.�.to-LED
35. Finai Gas Pipe-Test . �' 'i � .'��/-/Fi' Qt r(O OMQ. �.Fo�+v1c.- LiEf-�'Gq20-GE�D
36. Hood or Canopy . I�`� S"�S'4Z- G�P.ii� P�hWa.. NOYK.fL- C.�� �
37. Final FactorY F�replace , �� ,'
38. Final Plumbin9 .`�('jl'� � S//y�ltL �•�fRPjJGQC.. C`�ryE(� 't%O
� • u.
39. Water Service-final . � /y��Iq.L �K'DU�T G}5 �6fPiF.I� ��iFi6�
40. Gas Service-Final
41. Solarpomestic-Final �� ;�
42. Backflow Preventer ��
43. Backfiow irrigation
44,. Landscape Irripation System
45. Sound Attenuation
46. Handicap Regulations •
47. FINAL STRUCTURE & BUILDING � �
48. FINAL PLANNING .
49. Electric RelOase to Edison • . . �
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
HENRY J. COOPERSMITH
home: 364 Grenoble Lane, Costa Mesa, CA 92627 (714/650-5552) -
work: 1200 N.' Main St. Suite 800 ,
Santa Ana, CA 92701 ^
(714/834-1171) hours 8:3U am. to 5:�0 pm
September 15, 1992 '
Mr. David Hartke, Building Inspector
CITY OF COSTA ME5A
PO Box 1200
Costa Mesa, CA 92628-1200
RE: Permit Number E 56092 for Electrical
Dear Mr. Hartke:
I am responding to a note left in my mail box dated
Septembez 4, 1992 regarding my residence 364 Grenoble Lane and
the above permit. I had a full insgection of the property, and
it was signed off.
A building insgector came by to inspect the plumbing and
electrical work, and signed off on everything. If you check your
files you will see this took place several months ago.
If you have any questions please feel free to call as stated
above.
Very truly youcs,
�� �
�j ^ � �_
/`
c�owt T nn...�r.,.n.._+,�,.-.
�I g�' -^
�°';o`� ��� �r'�
� �F ����� � . ;
HBNRY J. COOPERSMITH ,
home: 364 Grenoble Lane, Costa Mesa, CA 92627 (714/650-5552)
work; 1200 N. Main St. Suite 800 _ �
Santa Ana, CA 92701
(714/834-1171) hours 8:30 am. to 5:00 pm
October 2, 1992
Mr. George Edmiston
CITY OF COSTA MESA BUILDING SAFETY DIV.
77 Fair Drive
Costa Mesa, CA 92658-7270
RE: Permit No. P52653 •
Dear Mr. Edmiston:
In my letter of September 16, 1992 I informed you that I
have called repeatedly the number set forth on your Notice, 754-
5626 and 7, and to date my letter and calls have had no response.
I would greatly appreciate hearing from you so I can discuss
this matter.
Please call or write at your very earliest convenience.
HJC:ds
� �
HENRYJ.COOPERSMITH
i200 N. Main St. SUITE 8D0
SanYa Ana, CA 92701
December 1, 1992
Mr. David Hartke, Building Inspector
CTTY OF COSTA MESA
PO Box 1200
Costa Mesa, CA 92628-1200
RE; Permit E-56092 for electrical
Dear Mr. Hartke:
It is my understanding that all the work has been done on
364 Grenoble Lane. Would you please contact Terry MCPrang, the
general contractor, so he can go over any remaining questions
regarding the electrical work, if you require any additional work
to be done.
I would like to get this matter finally resolved.
Very truly yours,
� ^ �C��� CL.I(�� 7� � � 3 J II � �
', �j%,`- ���t�✓
t
/ � - �
� � fU/r'�r t� �i � � �' -� �aJ n / —
0
MA�,� 5�2��c� ,
.�.—.�v s�%��._,���A�P :
0
0
' %. I
. . . . . v �� � Con �/�C"e ' " � "
Q� A�.2NS?R_Y � i� `,� i� C��;Ga�
_ �O�tLE�� �'�' � I� .
� Ex;s-�;� � �o,��--� c'_ �ti�, c�� t-z.
. d r ye,� � �e4' ��o,� �a �•,d �Y . .
��� Ir �� Z09M� , ,
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8
_ _._.__ - - -►. . . .
,. ,.. ,;
� . . � -I� C►;G�,t�tii � �o � txist-ttiiX'
, �����5 � i2�
u
ti�r�'�'s' �o�
—. _ �—
a
GFj 3
� �
' _ 3 G 4 G�w�at��
Cos A 1`�l,Es�
Es���Z
0
ApPllcant [o tlll In all spaces axcept t�ose wit�i� �eavy borCer Iines antl sign all appropriate tleelaratlons.
CITY OF COSTA MESA .
CONSTRUCTION PERMIT
Pioject Addre�� ',/ £G ��/� � � �
Applicant's Mailin Address ; �Z2 C✓"•"'�JLS
Owner'sName n Phone��—ss
Address ��'f
Arch/Eng. "� License No.
Address
Contractor's Nam � U Phone `� n0�
Addresslmailing) Zy�22�1�'� ( � 7
City License No. �� � �J
LICENSED CONTRACT00. DECLARATION
I heraby affirm that 1 am Ilcensetl untler provislons o} Charter 9(commencing
wlth secilon 7000) of Dlvision 3 of the Busine55 antl Prote55ion5 Cotle, anC
my Ilcense i5 in�u11 �$e an0 effect. /t L/rGYi
Date�/U/x�� Slqnature L1�c-h ��"4..�
•xORI(ERS' COMPENSATION DECLARATION
'-�4ereDy affirm that I have a certificata of consent to self-Insure or a cartiflcate
Rp�-�e� Workers' Companutlon Insuranca, or a certltietl copy the (Sectlon
3�800, Lab. C.) —
Polity No. � Company
Certitietl copy is hereby furnishetl.
is 111eC with tha slon
Data Applicant �
EXEM TI N FROM WORKERS' COMPENSATION DECLARATION
(This saction nee0 not be complatetl If [ne Oermit is for one huntlratl (S10v or
iess).
I certify that In the perform ce of the work for whlch this perm� ' I55 tl1 I
Shdll OO[ ¢TOIOV NIY 081�0 d�Y Td��BI 50 d5 LO}1�COTB S fBC O tf18
NOTICE: If,iSiter Ing this tleclaratlon, you shoultl bacome subject ro the
Workerz' Compensa lon provlsions oi tha Labor Cotle, you must Porthwilh
com0ly with such Orovisions or tnis Oermit snall be tleemeU revoked.
CONSTRUCTION IENDING AGENCV
I heraby affirm tnat there Is a constructlon lentling agency for the pertormance
at the work for which this permlt is , IssueA (Sactlon 3097 Civ. C.)
Lentler's Name
Lentler•5 Atltlre55
OWNER BUILDER DECLARATION
I M1ereby affirm that I am exempt irom tha Conlractor's License Law for the
followina reason' ISectlan 7031.5 Business antl Professlonal Cotle: Any clty or
':-315 �y any appuGani to� a permi[ sun�ecis ma appncanc co a. avn
�enalty of not more [han flve huntlretl tlollarz ($500).
I,'as'owner of the Oroperty or�my employeas with wages as [hoir sole
compensation wlll tlo tne work, antl the structure is not Intentletl or otteretl
for sale (Sec4lon 7044, Buslness antl Profe55ional Cotle: The Contrac[or'S
license law tloes not apPly to an owner ot a proparty who builtlz or improves
tnaraon, antl wno tloes zucn work hlmself/hertelf or throu9� his or �er own
employ eas, provitletl that such improvements are not Intentlatl or offeretl for
sale. I/, nowever, tne Eulltling or improvemant Is soltl wlthln one year of com-
pletlon, the owner'wlll �ave the burtlen o1 proving he/5he Cltl not bulltl or im-
�rove�for the purpose of sale).
I, as owner of the property, am exclusivaly tontracting wlth Ilcensetl con-
tractorsto constructthe projett (Sectlon 7044, Business antl Pro/ezsions Cotle:
The Contractor's License Law doe5 not apply to an owner ot properly who
bullas or improves tM1ereon, antl who contracts (or sucn projects with a con-
tractor(s) Ilcensa pursuant to the Contrattor's License Lawl.
❑ 1 am ezempi untler Sactlon B. 6 P. C. for this reason
Date Owner
certlry that I have reaA thls applicatlon antl stata that lhe abova
m I5 corroct. I agree to comply wlth all city antl county ortllnances
laws relating to bulltling constructl n, antl heraby authorize repre-
of tnb city [o enp' upon t abova-mentlonetl pr par �fp
P � C
TYPE OF CONSTRUCTION LI NEW LI ADD C�J ALTERATION �INiEPAIR �
❑ CONVERSION ❑ OEMO I$H ❑ OTHER q,p, #
DESCRIPTION OF WORK ��G%✓16/N.l /"��
—�� S Main Building:
TVPEOFPERMIT GRADING�--� �FOUNDATION STRUCTURAL T Front
❑ TENANT ❑ ELECTRICAL 6SPLVMBING ❑ MECHANICAL B Reaf
❑ OTHER A
PHOJEC7 DESCRIPTION 5a. FT. oCCUaANCv f �% C Right
K
CONSTRUCTIONTVPE VALUATIONS S Left
ZONE GRADING CU. VDS. ACRES ping. Ref. #
Remarks: Parking Req./Provi�
Use of euilding:
PLUMBING FEES Planning Notes:
Sink
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks �
Gas Service�
Interceptars
Kitchen Sink
Lavatories�
P—Trap
Roof Diains
Outlets
a
Reinspeetion Fee � � $25
Boiler •
Duct - Under Ground ,
Duct - Structural
Duct - Ventilating _.
Exhaust System � Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0.100,000 BTU �t00,0008T
Signature Date _ I I
Drivars' e e or 55 � Reinspec[ion Fee
CMF 0865-46 rev. 12/B3 White - Bui101n9; Canary - AOPliwnt; Plnk - Accounting; GolGenrotl - Assessor
$25
Showers
Service Sink
Sewer Cap
Sewer ConnectiOn
Solar Collecmrs
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
, ' Issue Fee ": $ 3
iANICAL � FEE
Hootlar Typel ❑ ' .
Canopy Typell ❑
Refrigeration System
❑0-t00,0006TU �100,OOOBTU
System Repair/Alteration
Isua Fee I E 3
Automatic washei
Construction Pole.
Cooking Unit .
Dishwasher .
Dryers ❑Gas ❑
Fan
F.A.U.
Fiztures
Device Bozes
Outlets
Garbage Disposal
Generator�d5 KW
4248 2/14/84
IZone
Accessory Building:
Park.Fees
ELECTRICAL
Transformer ❑ 75-50 KW
❑ 50+ KW
Meter �up co 100 amps
Meter pover 100amps
KW
Sub Panel � �
Motors �0-1 HP �1 %- 8 '
Inc.Solar �9-15 HP �16-15+
Microwave
Pole Light •
Range �
Sign
Standing Sections
Trash Compactor .
I Rainspection Fee . I$25' �ssue Fee
PUBLIC SERVICES REQUIREMENTS:
2oning Approved By � Date
Building Approved By Date
Aoolifation Issued Bv � oate
FEES
3•
SUMMARV OF FEES �
BUILDING PERMIT $ SMIP' $ �
PLAN CHECK $ �' ,� PERMIT
PLUMBING § �L_ ISSUANCE $
PLAN CHECK 25% •$ - ENERGY P.C. $
ELECTRICAL $ GRADING $ '
PLANCHECK 50% $ MICROFILM $ /— y
MECHANICAL $ TOTALFEE $ `� � ��1
PLAN CHECK 25% $ � . , _ .
O
N
I
N
G
R
R
E
N
E
N
T
7
CONSTRUCTION AND PLANNING _ POOI 'PA . � . -
APPROVALS Permit# P1��5 �• Date Inspector . AppROVALS PermiT# r �Date - Inspector _
� 1. Temporary Electrical Service or Pole �• 52, Pool &,Equipment Location - - � ' �
. 2. Soil Pipe-Undrgmd. , ` . 53. Steel Reinforcement ' � � - �
3? Electrical Conduit Utility-Undrgrnd. . �54. Forms � � � � � . - � �
" 4. Electrical Conduit-Undrgmd. '� .55r Electrical Bonding. . � ' ` -, �i � z
5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test � '
6. Elecirical UFER Gmd. �� . 57-, qPPROVAL TO'.COVER-GUNITE � ., i.
7. Footings � .� ' . 58. ElectricafConduit-Undrgmd. ' _ � '� '
8. Foundation -59. Gas Pipe, O�Undrgrnd ; Test = ' - 1
9. Water Pipe-Undrgmd. . 60. Backwash Lines, P-Trap, � Undrgmd.: .' -
10. Strucwral Floor System ' �� 61. APPROVAL TO DECK ' . _
11. Property Sewer Line & House Connection � 62. Backwash & ReceptorFinal� . ' �
12. Sewer Cap �� 63. Heater & Vent-Final � . . "
73. Roof Drains • � � 64. Plumbing System - Final . - ,
14. Rough Plumbing . `65. Electrical-Final' ' � - ' '
15. Rough Electrical-Conduit 66. Solar System-Firial -, - '"' " '-
16. Rough Elec[ric Wiring- 67. Fencing & Access Approval �- - � "� '. " -
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING i-
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS.FINAL , ,
19. Rough Heating & Air Conditioning FIRE DEPT.,REQUIREMENT � �
i
20. Rough Factory Fireplace APPROVALS Permit # , 1
21. Ducts, in Structure , 70. Underground Hydro �
22. Ducts, Ventilating �77. Product Piping O Gas � Oil �
23. Gas Pipe-Rough & Test �72. Underground Flush • � �
24. Roof Framing 73. Undergind.5torageTank OGas ❑Oil � �
25. Roof Sheathing � � J4. Overhead Hydro .� � . �
26. T-Bar Ceiling (Structural) & Monocoat ,� 75. Dry Chemical - � , �
27. Frame and Flashing � �76. Dry Standpipe . ' . • _ �
28. Lathing & Siding , 77. FIXED SYSTEM F,INAL `' - �, �' �
29. Insulation 78. FIRE PREV. FINAL � ' i `
30. Drywall Nailing HEALTH DEPT. REQUIREMENT � �
31. Plaster Brown Coat 79.� FINAL INSPECTION �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � ' �
33. Final Electric Notes:
34. Final Heating & Air Conditioning ' ' � -
35. Final Gas Pipe-Test . • , - , .
36. Hood or Canopy � . ! - � . � .
�
37. Final Factory Fireplace � ' . � � � � _ . �
38. Final Plumbing oi�f ��(� ' j- :.�
39. Water Service-Final ' � . ' ' ' �_ -
�'.
40. Gas Service-Final • � � �, �� � ' '
41. Solar pomestic-Final . - • � � .
42. Backflow Preventer � _ ' _ _ � • �
43. Backflow Irrigation ' , ' • � �
44. .Landscape Irrigation System ' �
45. Sound Attenuation� ; � : j �', � � � � � -
46. Handicap Regulations �' � , ' ' � ' . I � � • - ' �
47. FINALSTRUCTURE&BUILDING � � � � ' . �
48. Special Requirements Completed - , � � � '
i'
49. Electric Release to Edison ' - � � �. - �� �� - � � � � � '
50. Gas Release to Southem Califomia Gas Co ' . ��, ' �'�
51. CERTIFICATEOFOCCUPANCY - - - - �
No. � � Date _- _ . ' _ � . � - _ : . . � . . . .
:ITY OF COSTA ME�.�
CALIFORNIA 92628-1200 P.O BOX 7200
DEVELOPMEN7 SERVICES DEPARTMENT
September 21, 1994
Mr. Henry Coopersmith
364 Grenoble Lane
Costa Mesa, CA 92627
RE: 364 Grenoble Lane
Dear Mr. Coopersmith:
Please find a
permits have
inspectors.
copy of all permits for the above address. All
been finalized and signed by their respective
Should you have any questions, please contact me Monday-Friday
7:00-7:30 a.m. (714) 754-5231. If you cannot contact me in the
early morning hours, please leave a message on my voice mail.
/ /
�� � � � �
� ► :
RANDY BUCK
Electrical Inspector
RB:mm
Builtling Drvision (714) 75a-5273
77 FAIR DRIVE
Code Enforcement (774) 75a-5623 •
FA% (]14) 556�7508 • TDD (714) 756-5264
Planning Divis�on (71a) 754-5245
�cC�1����9�L
�RY J. COOPERSMITH
home: 364 Grenoble Lane, Costa Mesa, CA 92627 (714/650-5552)
work: 1200 N. Main Street, Suite 800, Santa Ana, CA 92701
(714/834-1171) hours 8:30 am. to 5:00 pm
September 16, 1991
Mr. George Edmist'on
CITY OF COSTA MESA BUILDING SAFETY DIV.
77 Fair Drive
Costa Mesa, CA
RE: Permit No. P52653
Dear Mr. Edmiston:
I have called repeatedly the number set forth on your
Notice, 754-5626 and 7 to leave a message during the inspector's
telephone hours, and I have yet to have my calls returned. I
would like to discuss the note, and what can be done about it.
In order to explain everything more fully, approximately five
years ago, on moving into the home, I found the plumbing was
defective and the house was replumbed. I was told a permit was
obtained at that time.
The water heater was reinstalled at that time. Then the
water heater was replaced and a permit was obtained. The water
heater was placed at approximately the same location as the
previous one.
I am not sure what'to do now that I have received this
Notice. Therefore, I would like to discuss this with you.,
Ver�,�t'fu�y yours,
TH
�_�G�q/
�-��,�,...�� �
�„ �a�iorr�,,,,1•�
� �
7ye�ua c�alva�� �ti as7•��a�! ��Y
�j ��a-G.Z.+-ti ��
�� �
�QGd�Y�- � , �'�� /I7%
f��i
HSNRY J. COOPBRSMITH
home: 364 Grenoble Lane, Costa Mesa, CA 92627 (714/650-5552)
1 (714/834-1171) hours 8:30 am. to 5:00 pm
January 24, 1992
Mr. George Edmiston, Chief Plumbing Inspector
CITY OF COSTA MESA
PO Box 1200
Costa Mesa, CA 92628-1200
RE: Imnprovements to residence 364 Grenoble Lane, CM
Dedr Mr. Edmiston:
This letter will confirm my appointment on February 5, 1992
at 1:00 p.m, to meet with you at my condominium at 364 Grenoble
Lane, CM regarding the problem with previous permits.
Very truly yours,
HJC:ds
December 3, 1991
�:ITY OF COSTA MESA
CALIFORNIA 92628-1200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPAR7MENT
Mr. Henry Coopersmith
364 Grenoble Lane
Costa Mesa, CA 92627
RE: IMPROVEMENTS TO RES=DENCE
364 GRENOBLE LANE, COSTA MESA
Dear Mr. Coopersmith:
First, please allow me to apologize for letting this matter lapse
for the past two months. I have conducted some further research
and have discovered the following.
The 3rgr�vad fl^^r pi3P._ FOr �,�••r rQs��eroA a.r.a ce*�ta.ined vith�.n
City records. These floor plans show the washer and dryer as well
as the water heater contained within the kitchen area of the
residence. As you noted, there was a buildinq permit issued for
repiping your unit. However, this repiping was not for the
relocation of the water heater, washer and dryer into the qarage,
as evidenced by the illegal penetration through the required one-
hour fire wall between the residence and the garage.
Additionally, these floor plans show each unit provided with a two
car garage. Under current standards, these garages are non-
conforming; a 20' by 20' clear interior dimension is now required;
the plans show an approximately 19� by 19' dimension.
The result of the above research is that the water heater, washer
and dryer need to be placed back into the house again, under the
direction of the Building Division. Of course, as noted within
youi 3e�tEr of Sep�e�r.be_ 20, '_941, a Vari3nc� can be appZied for.
However, it will take the completion of the included paperwork, the
submittal of plans and a notification packet as well as a$450.00,
non-refundable filing fee. Staff will be unable to recommend
approval of this Variance because the findings per State law cannot
be made.
To allow resolution of this matter as soon as possible, some type
of action must be taken by yourself prior to December 31, 1991.
77 FAIR DRIVE
Building Division (776) 754-5626 • Code EnforcementlBusiness License (714) 754-5234 • Planning Division (714) 75a-5245
FA% (714) 5567508
364 GRENOBLE LANE, COSTA MESA
PAGE TWO
i'm sorry I could not forward better news. If I can be of any
assistance, please call me between 8:00 a.m. and 12 noon at 754-
5153. I can also be reached at the counter during those times.
� 4 L-
Sincerely, /,, �,�'
N"
2�N v��',
"�` � i
�
WZLLA BOUWENS-KILLEEN
Senior Planner
Enclosure
WBK(IOLTRI ��
cc: George Edminston, Chief Plumbing Znspector �
January 20, 1992
CITY OF COSTA MESA
CALIFORNIA 92628�1200 P.O. BO% 1200
DEVELOPMENT SERVICES DEPARTMENi
� � ��
� .9� �" �►,
� � yV � �� � ,�""�
� � � J /
^` � i�
� � P �✓
� �� � q� � � �� �,iti
Mr. Aenry Coopersmith � �3" � , ,��
364 Grenoble Lane �)
Costa Mesa, Ca 92627 � �
�
RE: IMPROVEMENT6 TO REBIDENCE �� � � ,
364 GRENOBLE LANE, C06TA MESA `�
Dear Mr. Coopersmith:
This letter is in response to your letter of December 9, 1991,
appealing Planning Staff's decision requiring the Variance for the
encroachment of the water heater, washer and dryer in required
garage area. Per your request, we discussed your matter with the
Director of Development Services.
As it is difficult to ascertain exactly what the history is behind
the relocation of the three appliances (in light of the replumbing
and other plumbing permits for the residence), the Director of
Development Services has approved the location of the three
appliances in your garage. However, this approval is contingent
upon clearing any pending building code violations (for example,
the penetration of plumbing through the fire wall between the
residence and the garage).
Please contact George Edmiston at 754-5290 as soon as possible so
this matter can be resolved.
Sincerely,
` , ,' ' Ut�.�
�Gl.�"'-
���
LLA BOUWENS-ICILLEEN
Senior Planner
WBKpOLTR118)
cc: George Edmiston, Chief Plumbing Inspector
77 FAIR DRIVE
Building Division (714) 754�5626 • Code EnforcemanUBusiness License (!14) 754-5234 • Planning Division (714) 754-5245
FAX (714) SSG7508
HENRY J. COOPERSMITH
home: 364 Grenoble Lane, Costa Mesa, CA 92627 (714/650-5552)
work: 1200 N. Main St. Suite 800
Santa Ana, CA 92701
(714/834-1171) hours 8:30 am. to 5:00 pm
June 9, 1992
Tony C'De Baca, Asst. Dev. Services Dir.
CITY OF COSTA MESA
PO Box 1200
Costa Mesa, CA 92628-1200
Dear Mc. C'De Baca:
I am responding to your extension dated 6-4-92, a copy of
which is enclosed. Please be advised that when I originally
submitted my furnace with the water heater for inspection, it was
determined that additional work was needed. I was required to
obtain a building permit of which I have an approved copy signed
by the Department.
Would you please check my file and send me a written notice
that this matter has now been resolved. If for some reason you
have determined there is still some failure to comply, please let
me know in writing immediately what the alleged noncompliance is
and what is further required. Based upon my discussions and the
inspection held on May 14, 1992, I understood that everything was
now in comliance.
HJC:ds
encl.
CITY OF COSTA MESA
CALIFORNIA 9262&1200 P.O. BOX 1200
DEVELOPMENT SERVICES DEPARTMENT
Dear Costa Mesa Property Owner:
In reviewing past permits, we fi that work has been done on your
prope,j� y located at 3lo��2E�UoRLE , Permit
No. /' SZ-�o S3 for �:�1Prr�E�C hF,4h�i �/L- The
permit has passed expiration per Section 303(d) of the 1988 Uniform
Building Code, but we are offering you 10 days from receipt of this
letter to reactivate the above permit. Should we not hear from you
within the 10 day oeriod; your permit �aill be eYpired and
additional fees will be required to finalize the permit. Failure
to final a Building Permit could possibly impact the future sale
of your property.
To activate the above permit, please follow these steps:
1.
2.
3.
4.
Telephone (714) 'I54-5626 or (714) 754-5627.
Request an inspection; state address, permit no.,
and type of inspection.
Be sure you have a working smoke detector as required
per Section 1210(a) of the 1988 Uniform Building Code.
Have an adult present at the property at the time of
inspection to provide us access.
Thank you for your cooperation.
Sincerely,
.�^, ��iLC�(�^
Inspector '
TONY C'DE BACA
Costa Mesa Building and Safety
Asst. Development Services Director
Building and Code Enforcement
TCDB:mm
(OLDPERMT.LTR)
�1��9z-
Date
77 FAIR DRIVE
o,.:u:..� n:..:..:,._ n..� -.c..�e�c . ...._ �""""".,o..""" � """ ,...., ��.
B���iding Valuation I'ata
Aitherequestofnumerousbuldmgofticials, .�dingStandardsoNersihelollo��ingbuildingvaluationaatarepresen�inga�eragrcozlslo�mos�build�nF�.
Becausr residential buildingc a�e Ihi• most common for manp[itiee, Mro general rlacses zre considered for �hese.one lo� "averaFr' conctmclion and Ihe othrr
(or ��good.•' Ad�ustments should br made !or spec lal a�chlteaural or stru�wral (eatures and ihe locailon o`. �he projrc i. H�ghei o� lo��ri unit cosis ma� ai��n
fe5ull.
The unii cos�s are intended to tomply w�ith the de(inition o('valuation" in $eclion 4�3 o(the Uni(orm BuildingCodeTM and �hus include archi�ectural, struc-
tural, elecuicai, plumbing and mechanical worl„ e>cept as specificall�� lis�ed beloK. The unit tosls alw indude Ihe comranor's profit, which ihould not be
omined.
The delermination of plan check fees for projecis reviewed bythe International Conference of Building OHitials will be based on valua�ion compu�ed from
these flgures N�hlch were �ompiled in April 7992.
c«, a, ca� �� c�n �, ca� ��
fqwrr foot, fyutrt fool, fqurt foo�, iq�+rr fooi.
Octvpanry �rd Typr Averasr a�w�� ,�a r� Averajr Octvpann ard 7�p An�a6r Ocevpanr� ud Trye Arer�6r
7. APARTMENT HOUSES: 7. DK'EIlINGS: 13. IAILS: Type 111-N ............. . 26.J0
•� Type I or 11 F.R.• ....... S 71.50 Type V-Masonry ....... 60.80 Type 1 or tl F.R. .........128.60 Type V-1-Hour ........ 23.1 U
(Good) f87.00 IGood) f78.00 Typelll-l-Hour........116.90 Tp,RESTAURANTS:
Type V-Masonry Type V-Wood Frame ... 52.30 Type V-1-Hour ........ 84.00 7ype III-1-Houi ....... 74.80
lor Type Ilq .......... 56.80 (Goodl 574.00 1{. LIBRARIES: T III-N 71.70
YPe ............
IGood) 570.80 Basements- Type I or II F.R. ......... 9420 � Type V-1-Hour........ 66.30
Type V-Wood Frame ... 50.60 Semi-Finished ......... 76.20 Type II-1-Hour ........ 65.90 Type V-h ............ 63.10
(Good) 563.90 (Goodl SiB.50 TYpe II-N ............: 62.50 2l. SCHOOLS:
Type 1-Basement Garage 29.90 Unfinished ............. 12.20 7yPp �p-1-Hour........ 71J0 7ypP � or U F.R. ......... 9D.00
, 2. AUDITORIUMS: (Good) f 14.30 TYpp III-N ............ 68.20 7Ype II-1-Hour ........ 64.20
Type I or II ER. ......... 83.80 8. FIRE STATIONS: Type V-1-Hour ........ 6410 7y� pl-l-Hour ....... 64J0
TYpe I I-1-Hour . . . . . . . . 59.50 Type I or I� ER. . . .. . ... . 91.H0 TyFe V-N .. . .... . . .... 61.20 Type II I-N . . . . . . . . . . . . 61.30
Type II-N ............ 56.50 Type II-7-Hour ...... ,. 59.SD �5. MEDICAL OFFICES: T��pe V-7-Hour ........ 59.20
7YPe III-1-Hour ....... 63.60 Type II-N ............. 56.50 TYPe I or II F.R.• ........ 9G.20 Type V-N � 56.00
............
Type III-N ............ 6070 7ype 111-i-Hour ........ 66.20 Type II-7-Hour ........ 71.60 22. SERVICE STATIONS:
Type V-1-Hour ....... 58.40 Type 111-N ............ 62.80 T II-N ............. 68.20 �
Type V-h ........... YPE' Type li-� ............ 53.40
. 55.50 TypeV-l-Hour ........ 59.10 Typelll-l-Hour........ 7830 lYPelli-t-Hour ....... 53bU
3. BANKS: � Type V-N ............. 56.20 Type 111-N ............ 74J0 T�•pe V-1-Hour ........ 47J 0
Type I or II ER.• ..... ,.. 120D0 9. HOMES FOR THE ELDERLY: Type V-1-Hour ........ 72.90 Canopies .............. 20.60
Type 11-t-Hour .. ... ,.. 86.20 Type I or II F.R. ......... 82.80 Type V-N ............. 68.90 23. STORES:
7ype 11-N ............ b2.10 Type 11-7-Hour ........ 66 40 16. OFFICES":
Type III-t-Hour .... ,.. 97.)0 Type 11-N 63.�0 T I or II F.R.• 8610 Type I or II F.R.• ...... .. 67 40
............. yPe ........ T II-1-Hour........ 40.60
Type III-N .........,.. 9330 Type III-7-Hour ........ 69.20 Type II-1-Hour ........ 55.80 7Y� II-N 39.80
. 86.20 T e tll-h 66.20 """"""
Type V-t-Hour ...... Y
T1'Pe V-h YP .. ..... ..... TYpe II-N ............. 5320 TYpe III-1-Hour ..... .. 49.60
�........... 82.00 Type \'-1-Hour ........ 66.00 Type III-1-Hour........ 61.40 T e III-N 16.80
0. BON'LING ALLEYS: Tppe V-N ............. 62J0 YP '
)P ............ 58.60 T�pcV-l-Hour........ 39.60
T- elll-N
Type II-1-Hour ........ 40J0 10. HOSPITALS: Type \'-7-Hour ........ 56.A0 Tqpe \'-n' ............ 37.10
l��pa li-'.� ............ 3830 ippr i or II f.F.' ........ 131.50 Typr \'-N ............. 54.20
2i. iHfATfRS:
7qG�' III-1-Hour ....... 4-0.00 i��pe III-1-Hwr ....... 705.40 77. PRI�'ATE GARAGES: l�p�� I ni II F.F. ........ . 8' H(�
h;�m ill-�' ... _....... 41 9p 7��u. V-1-Hom ....... tOL50 11bud ( ramr .... _. 1 Hou� ....... bl 60
i�-pe\'-7-Hour ....... 375G .... 18b0 qp,�lli-1�
11. HOTELS A!JD MOTElS: A1asonr� .. _........... 22A0 Typ,� III-1�' ............ 60.60
S CNURCMES: 7pp: I or II F.F..' ......... E?10 Open Carpnh! ......... 7330 T��pa \'-1-Hcw� ........ Si ali
ippr I or li F.F. ......... 79.?0 lqPe III-1-Hour ........ 71.00 18. PUBLIC BUILDINGS: lyp�- 1'-1.' ............ 54.ft0
Type II-1-Hour ........ 59.2G l�pc III-1�' 67.60 7ti•P�. � or II f.R.• ....... lOQ4D 25. N'AREHOUSES'•':
............
iype II-N .......... _ 56.20 Type V-i.Hour ........ 67.90 TVPe II-i-Hour ........ 74.9D TYPe I or II F.R_ ... ...... 39.90
YPe III-1-Hour ....... 63.50 Type \'-n� ............. 59J0 TYpe II-N ......... .. 71.60 7
Type III-N ............ 60.50 " 1'Pe II or V-1-How .... 23.60
i' ....... 57.80 12' �NDUSTRIAL FUNTS: Type 111-1-Hout........ 83.80 7 p II or V-N ........ 22.T0
)pe V-1-Hour YP
Type V-N ............ 55.00 T��pe 1 or il F.R. ......... 45.60 Type 111-1: ............ B0.10 Type III-1-Hour ....... IJ.IU
Type II-1-Hour ........ 31.10 Type V-1-Hour ........ 74.10 7YPe III-1.' ............ 25.9D
6. CONVALESCENT HOSPITALS: Type II-N (Siock) ....... 29.40 Type V-N ............. 71.10
TVPF I or 11 F.R.' ........ 712.30 Type III-1-Hour ........ 3430 �9. PUBIIC GARAGES: EQUIPMENT
Tqpe II-1 �Hour ......... 94.20 Type III-IJ ............ 32.80 7ypF I or II f.R.' ........ 39.60 AIR CONDITIONING:
Type III-1-Hour ....... B0.10 Tih-up ................. 23.iD Type I or tl Open Pa�king' 31 np Commercial ......... 3.45`
T1'Pe V-1-Hour ....... 71-10 7ype V-1-Hour ........ 37.00 TYPe II-IJ ............. 2320 Residemial .......... 2.R?
Tqpe V-N ............. 29.?0 Typc III-t-Hour ........ 27.90 SPRI�1'Kt ER SYSTEM$ ... 1.6i
'Add 0.5 perwnt to total tosi (or each sio-� ove� three. ••Dedua 20 oercent io� shell-onl� buildincs. ••'Deduc i 11 u���cFni fnr mfn�..,�a,rh����«��
REGIONAL MODIFlERS
The follo�ving modifiers are recommended ior use in conjun[tion N•ilh the building ��aluaiion data. In addi�ion, cenain bcal condilions may requirr further
modificatfons. To use these modifiers, merely muhiplp the listed cos� per square foo� b�� �he appiopriate regional modi(ier. For eaample, to adjust Ihe cosi of
a Type III-1-Hour hofel building of average construnion for the lowa area, select Regional Modi(ier 0.80 and unit cost from valuation data, 569.90.
0.80 x)1.00 = 556.8D ladjusted cosi per squarelootl
Eastem U.S. Modifier Easiern U.S. (coni.) Modiler CeMral U.S. Modifier K'es�ern U.S. Modifier
Connecticut ............. 0.95 Pennsylvania Kentucky ............... 077 Arizona ..............., 0.82
Dela�+•ate _ .............0.84 Phladelphla .......... 0.9b louisiana............... O78 CaGfornia
Diq�ic�o(Columbia ...... O.A7 Other ................ 0.83 Alichigan............... 0.84 LocAngeles .......... 1.00
Flprida .................. 0J4 Rhode Island ............ 0.94 Minnesoia .. _.......... 0.86 San f rancisco ......... 7.13
Georgia ................. 0.68 South Carolina .......... 0.70 Mississippi .............. 0.77 Other ................ 0.94
Maine ........... 0.87 Vermont ................ 0.80 Missouri................ 0.78 Colorado ............... 0.81
Maryland ............... 0.79 Virginia ................. 0.73 Nebraska ............... 0.75 HaH�aii 7.7q
Massachusetts ........... 0.94 West Yrginia ............ 0.82 Norih Dal,o�a 0.80 Idaho .................. 0.80
...........
Nev,�Hampshire ........- 0.82 �eniralU.S. Ohio ................... 0.80 Montana
............... 0.79
Ne�� Jersey ............... 0.91 Alabama ................ 0.72 Oklahoma .............. 0.71 Nevada 0.89
................
eN� or � Arkansas .. . . . ........... OJD �uth Dakota ........... O78 NeN� Mecico .. ......... . 0J6
New� Yorl, City ......... 1.16 Illinois .................. 0.8? Tennessee .............. 0.72 Oregon ................ 0.83
Oiher ................. 0.87 Indiana ................. OB2 Texas ... .............. 0J4 Utah................... OJi
NonhCarolina...........0J0 �oK�a 0.80 �`�sconsin .............. OBS Nas�fnglon O.Bft
................... ' ............
Kansas 0.74 Alasl.a ................. 1.30 Vdyoming --............ O.BO
GENERAL
I'
S
DOYLE & SHIELDS
Forms
Co.
DATE
DATE b-3-b;i
BUILDING PERMIT N0.
VALUE S 19. 17.00
SUBCONTRACTOR
�
- �� iss�s
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOI �I] C09TA M88p, CALIFORNIA
For Applicanf ►o Fill In Complafaly
TYPE OR PRINT
B°��o�Na 36ti- C�� r-�.
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COSTA MESA, CALIFORNIA
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DESCRIPTION OF WORK
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SIZE
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1 HEqEBY ACKNOWL¢DOi TNAT 1 XAV6 READ TXI6 APPLIC�TION
�NO 9TATE THAT THH ABOVB IY COqRHC'( ANO AOqBE TO COM•
PLY WITH FLL CITY OR�INANCHD AND BTAT[ UW9 R6GULATING
Bl11LDIN6CON8TftU ION. (((ry w/ n n
SIGNATUREO�Q,��1���Z_ ,�Y/�" �
PERMITTEF ' f IU �/ K.
AUTHORIZEOAGENT �fY • fILLVI f���� 1
FIRE
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APPROVED
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FEE RECEIVED
�✓ JUN 3 1963
� FINANCE DEP1.
APPLICAT23N F� G� MESA
BUILDING
For Office Use Only
P6C61'T NO, p 0.
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NO.OP � U980PN8L,VJ�
PLAN9 OUILOINO
Lo �" � 7 /r� � 37
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JE OVERHAN6 SHALL BE LE88 THAN
YARD9APPROVED
MAIN BUIL�ING
VAR. #
TXE AMOUNT
PURPOSH O�
s�g� �f/�v�
YAFD9APPROVED
ACCESSORY BUILDIN6
BET. MAIN 8
AGCESS. BLI
OATB
APPROVED
nerr ��
V�LUATION IB FOR TNE
Tw PERMIT FEfi ONLY.
_ / l V-