HomeMy WebLinkAbout935 GOVERNOR ST - Building Permits1 •
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT �� FAIR DRIVE, GOSTA MESA, GA 92626
.lob Address: 935 GOVERNOR ST
Suile:
Vicinity;
Parce1 Number: 42242433
npplicant: BRENDA PENNINGTON
Address: 935 GOVERNOR ST
COSTA MESA, CA
Owner: BRENDA PENNINGTON
` Address 935 GOVERNOR ST
COSTA MESA, CA
.
ContraclOr.
Address:
Zip:
Arch :
Address:
Status: ISSUED
Applied: 09/15/2000
Issued: 09/15/2000
Zorting: �� �
ISSUED BY:
l%
Phone: 949-650-2667
Zip: 92627
Phone: 949-650-2667
Zip: 92627
Phone:
License:
Eng:
Address:
Phone:
� ' I
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,A�
1 �
•
Phone:
2ip: License: License:
SCOPE OF PERMIT
CONSTRUCT DETACHED 160SF STORAGE SHED.
Plan Check: $37.08
Permit: $57.05
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Totdl: $94.63
SETBACKS
MAINSTRUC7URE Front 0-0
ACCESSORY Front 0-0
PARKING Existinq: o
NOTES:
Rear 0- 0
Rear 0- 0
Required: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Lek 0- 0
Pr000sed: 0
Calc Valuation:
Claim Valuation:
Right 0-0
Right 0- 0
St,soo.00
$1,600.00
NOTICE: The work authorized by this permit shall comply whh ell applicable handicap access requirements under Califomia statutes and relateC
regulations. (Ord. No. 92-28, § 1. 12-21-92) ��
�_XPIRATION: This permit shall automatically expire and become void if work is �ot commenced within 1 BO days, or if wor!r.is suspen�d or abandoned
for a Penod of 180 days. �'� — -�-.__ __
'INSVECTIONS: In order for the work au�horized under this permit to be considered legal, such work must comply with all applicable cotles, and all
requlred Inspectlons and final approval must be obtained. Failure to obtain inspections antl final approva� will result in ihe expiratlon ot ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 �
zaa5�ae I�o) ,
WORKERS' COMPENSA71pN DECL �z'iiATION:
I hereby affirm under penalty ot perjury one ot ihe following tleclarations:
❑ I have and will maintain e certHicata of consent to self-Insure for workers' compensation, es provided tor by section 3700 of the Labor Code, for ihe pertormance ot Ihe
_/ work tor which ihis pertnit is issued.
�I have antl will maintain workers' compensetion insurance, as raquired by section 3700 of �he Lebor Code, tor the performance ot ihe work tor which this permit is issuetl.
My workers' compensation Insurance carner and policy number are:
t;arner: Policy Number:
(This sectlon need not be completed i! (he permif is valued et one huntlretl dollers ($f 00) or /ess.J
❑ I certily ihat in the peRortnance of Ihe work for which this pertnit is issued, I shall not employ any person in eny manner so as to bacome subject to the workers'
compansation laws oi Celifornia, antl agree that if I should bacoma subject to the workers' compen mvisions ot Section 3700 oi ihe Labor Cotle, I shell torthwi[h
c provisions.
plic nt Signatur Date:
WNPNING ET SECUREW KERS'CAMPENSATIONCOVERAGEISUNLAWFULANDSHALLSUBJEC EMPLOVE CRIMINALPENALTIESANDCIVILFWESUPTOIXJEHUNDRED
D DOLLA ($100,000�, IN A�DRIqJ TO THE COST OF CAMPENSATION, DAMAGES AS PqpVI�ED FOR IN 5�]W OF THE LABOR CADE, INiEREST, AND ATTORNEV'S FEES.
LICENSED
I hereby afli
torce epde
Signature:
pmvisions oi Chapier 9
3 oi the Business and Professions Code, and my license is in full
Da�e:
CUNSi�UCTION LENDING AGENCV: ��
❑ I reby aHirm that ihere is a constmction lending agency for Ihe pertormance of the work br which this permit is issued. (Sec. 3097, Civil Code).
Lande s Name: Lender's Adtlress:
SignaWre: Date:
OWNER-BUILDER DECLARATIONS:
�-�,
I hereby alfirm thet under penalty ot perjury �ha� I am EXEMPT FROM THE CONTRAC70RS IICENSE LAW for the following reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or county which requires a permit to constmct, eltar, improve, demolish, or repair any stmcWre, prior to its issuanca, also requires Ihe applicant lor such pertnit
to file a slgned statement ihat he or she is licensed pursuam m the prodsions of ihe Contrectors License Lew (Chapter 9(commencing with Section 7000) ot Divislon 3 of tha
Business end Professions Code)'oi:thet he or she is exempt iherefrom and tha �asis for the alleged ezemption. Any Nolation ol Section 7031.5 by any applicant tor e pertniti
subjects the applicant to a civil penalry of nol more ihan five hundred dollars ($500).):
�
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, antl ihe stmcWre is not intendetl or oHered for sale (Sec.
7044, Business and Professions Cotle: The Coniractors License Law does not apply to en owner of property who builds or improves thereon, antl who does such work
himself or herselt or through:his or her own employees, provided ihat such improvements are not intended or oflered for sele. If, however, ihe building or improvement is
sold within one year of compietion, the owner-builtler will have Ihe burden of proving ihat he or she did not huild or improve tor purpose of sale.).
❑ I, as owner ot ihe properry, am EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, eusiness and Professions
Coda: The contracmrs License Law does not apply to an owner of property who builds or Improves thereon, and who contracts tor such pmject with a contrector(s)
, license pursuant to �he ContraCtors License Laws.).
under
Ow7T� ID venfietl by drivers license.
Verification ot Ownership by (type of
Yes (W No
i.e. - propeny tax bill or
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
and Professions Code for this reason:
❑ I hareby certify ihat no excavation five (5) or more feet In depih into which e person is required to descend, will be made in connection with work authonzed by this
permit, antl that no 6uilding strucWre, scaHoldinq, talsework, or demolilion or dismantling thereot, will be more than thirry-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, California Adminisirative Code).
❑ As ownerbuilder, I will not employ enyone to do work which would require e permit from the Division of Industrial Sefety, as noted above, unless such person has e
permit to do such work from the division.
Signature: Date:
Division of Indusinal Salety Permit Number.
CERTIFICATE OF COMPLIANCE AND AUfHORIZATION OF EN7AY: I certity under penalry of perjury ihat I have read Ihis application and state that the infortnation given is I
correct I agree to comply with all state laws and ciry ordinances relatinq to building constmdion, antl authorize representatives of the City of Costa Mesa to enter upon the
ebove-/qescnbed property fo( in clion purposes_I grae not �o occupy or allow occupancy of eny building authorized by lhis permit unlil final inspection.
�l� ��d a� `��n�n.vn �a� � 9.//i.s,(� oaJ
Si�nature Of Leaa wner(sl "� Data
CODE t INSPECTIONTYPE
PAIE IHm1AL5
1676 Fixetl Sysiem Final Fire Prevention
7'I0R -�iioi:s�a.�inal
200 Final Re-Root � .
_ r .—.�.�__�
201 Final Block/Retaining Wali
202 Final Factory Fire Place
203 Flnal Sign
204 Final Demolition
COUE 1 INSPEGTION TYPE
206 Final MeChaniCal
208 Final PlumDing
210 Final Electdcal
212 Final Fire Prevention
220 Final Planning ApP�oval
222 Final Site
250 Final Builtling/Occupancy
I7�T€ L�48
�
e
6/97
�F'�_»_�
u N stotv or s�i�.DiN�g�£�.�i Y
CItY OF COSTA MESA
APPR V��
f��
i— Date � 4 �_ � j ----
4� ---_'
'il �s set pfPk�na find ePeCl�lca��otre �UST be kept on this jo�b e�'tim'�o p�i�� otBuild' �';
�:.i';oanyd�nQaeo�nlMrelbnan5emewfilwNwriitenpa QI-`%�
;ci;Sa}ety,GAj�0�C0�18M858. C� ro�Y
T�o stampmg oi this plan and spoc�ticaticrs SHAI. NOT o�� heWto pmm�� or lo Ae an ePP
;t th� v',:t�,n of any� isicn>,'� ar� C?Y o' Cogly µeaa Ordinan � andlor SIn10 lav.
. Y '' �
� , s"'" i , �sseanca
1'7�>e_I?.� ' • c?o��nlnAhr,1180cf:ys.d�
. ,.. . � :UI:`ittr. �dan�;,nq'.�+djr.;;�,:;�:«;,: ,. .
_o
q35. Lot��2no�
v no
Sr�� �. r
f'—�
�
���.���
CITY OF COSTA MESA
PLANNING DIV.
BJECT TO BLDG. DEPT. I
�o��
ADDITIONS, DELETIOP�S, OR CORRECTIONS SHALL
BE APPROVED BY THE PLANNING DIVISION
(�itry o6 (�oata �leaa �laK�urs� Dci�aioK
77 �adc Duue, eaata %iteaa, eali�ouria 92626
%le�a�re - (7141 754-5245
�,4x- 17141754-4856
4
�i��.� LI�ITED CONDITIOi�AL �ARRANTV
��►�E ■■
PItODiJCT�'
IYs Eary . . . IYs Handy
WARRANTY
Handy Home Products warrants ihe following:
L Ever� product is v+arranted for defects in workmanship and
manufacturing for 1 year.
2. AII hardware and metal components are warranted for 2 years.
3. Pine or SPF trim is warranted for 5 years.
4. Waferboard siding is warranted for 2 years.
s. Ultraside`"` sidiny is warranted for 5 years on all Marco senes
buildings and 10 years on all other buildings using panel sidings.
6. Mackinaw series buildings' siding and trim are warranted for 10
years.
7. Cedar lumber is warranted for i 5 years.
Handy Home Products will repair, replace or pay for the aftected part.
Installation is not included. All warraniies are from date of purchase. If
a cash refuntl is paid on an affected part, it will be prorated from the
date of purchase.
CONDITIONS
The warranT� is effective only when:
a) The unit has been erected in accordance with the assembly
instructions.
b) The unit has been properly shingled and painted or stained and
reasonably and regularly maintained thereafter.
c) The failure occurs when the unit is owned hy the original
purchaser.
d) Handy Home Products has received ihe warranry registration
card within ihirty (30) days of purchase and notification in
�vriting of the failure within the warranry period specified above.
e) Handy Home Products has had reasonable opportuniry during
the siuty (60) Cays following receipt of notification to inspect and
verify the failure prior to commencement of any repair work.
RE�UIREMENTS
To validate your warranry, it is necessary to properly maintain your
Handy Home Products unit; shingle the roof and paint or opaque stain
using 700% acrylic latex eMerior produci with a minimum of two (2)
coats within thirty (30) days of assembly; caulk above all doors and ail
horizontal antl vertical trim boards; paint and seal all exposed edges,
sides and faces of UlfrasideT" and waferboard siding to include all walls
and both sides and all edges for doors. Keep vegetation trimmed away
from building and make sure siding panels and trim do noi come in
contact with masonry or cement. The minimum ground clearance of
siding must be one half inch (1/2') from concrete slab or two and one
half inches (2-1/2') from the ground when building is on a treated
wood floor kit. Water from sprinklers must be kept off unit. In no event
will Handy Home Products be responsihle for any indirect, incidental,
consequential or special damages, or for failure(s) which are caused by
events, acts or omissions beyond our control including, but not limited
to, misuse or improper assembly, improper maintenance which
eventually leads to rot or decay, and acts of God. Handy Home
Products is not responsible for any labor costs incurred to construct
your unit. This warranty gives you certain specific rights which vary
from state to state.
CLAIM PROCEOURE
To make a claim under this warranry you can either call (800) 221-
1849, extension 208 and ask for customer service or prepare a letter.
Please have ready the informa[ion below when you call or include the
information when writing.
1) The model and size of the product.
2) A list of the part(s) for which the claim is made.
3) Proof of purchase of the Handy Home Products item, as shown
on the original invoice.
Mail the above information to:
Handy Home Products
Attn: Customer Service
6400 E. 71 Mile Road
Warren, MI 48091
IMPORTANT: THIS 15 YOUR WARRANTY CERTIFICATE. PLEASE COMPIEiE AND MAIL YOUfi WARRANTY CARD TO PROPERLY VALIDA7E YOUR WARRAMY.
3Z #16606
� ����� �3..,,Grr��.�Y.� ••- i' .. ��'',C$1^� .- .
. �v a,3^--�; ->:�' R � -
s•_ ��' *' ` - '� �"''�+
: y s� t a—"d' � `�`�'� � ,
+ 't'�?,��t,�k .. , . - � ?�;� �iy�_ .
�� „ � Revislon 060500,
Run# �060500,�
��DEU�i'S
fYs Eary. . . IYs Handy '
8400 East 71 Mi1e Road • • � � Also Inclutles
Warren, MI <ao9,_<,0, Riverside - 10 x ,°�x,2.
Tall-Ree 1-800-227 -1849 10' x 16'
■ First...
Read these instructions thoroughly before you begin
assembly. Assembly is easiest if you follow the steps in
the ordershown.
!n a drawing, a dotted line represents a part hidden from
view (like a part under a panel).
Lumber is graded from only one side. Check the part for
the most attractive lace and make sure to face it to the
outside.
■ Check all parts
Compare parts you have to the list on page 2. lf a part is
missing, circle the part in question in parts list and call
Always wear OSHA-APPROVED safety
glasses throughout assembly process
■ Tools required
❑ Hammer
❑ Phillips Screwdriver
O Level
❑ Step Ladder
❑ Pencil
O Tape Measure
O Adjustable Wrench
�s rou-��ee ar �-aoo-22�-�sas exr. zoa. � O^ptional tools
DI�ISi��N $7i_r ,-.,,,
❑ E(es1H �i�'I w1,d�.�h'iH�pS�vpcTl`
■ Assistance required '`�"'-{'uJ��+fviESq
❑ ChallALins� �g p a�; � �
We recommend that you assemble this building o�n level p Square q
ground in the location it will be used. Assistance is� 0 aiCPoUCh— "� Da�° � I._ �_� 1=
necessarytohandle,fiGandsecuresomecomponel�Ys:�P�n^sr::�1:,,,�cii;�;;w,,,�;;uSi�E;;�a � � ;
Twopeopleareneededlorsomesteps. �°"���'r��'.cescr:,�;eraticr.cr:;3ne;,p,t;��, a�;,���`'��`�`'�"��`�''`'��'ur!�;^+fWio
2C;1'G2.'�iur,;,. r � J'L'l:Ii.fQ?B6(Si'O:li'^Ri����'iyi£SNG}:Oi:'J.�110
, ; Q �i: iii PfESB. �
� S U8f Il '°� a�ciqgn`;!,is{;i�r,an c�r. s
s e d . i�.c�tiona,HA�LNpib:h�!dta
q e ess is very Importantd:mevic;a��or:cianYProsier,�;sc!zny�iqoi�;c;sA'a;zOrr'i.��d�crlohn.acsGPrval
Keeping all 90° come�s and 90° perpendiculars sq�are�: r,=�;,;�,�,;;:,,h�,�,,,,, ;,�,�, anc.,..,,.,,,, �.,,�r.
throughout the assembly ol this building will make each c. �a, ,"� ;1 �°° '� n`' � ° o�,t � Ui 'd r4 cr
- �3� �Fr„ J,' r:m�
succeeding step easier and is necessary to � '^�: �f ..,_,;._.
assure that all componenfs fi
properly.
i Check local zoni
'' Before starfing construction,
your local building code oflici
required permits, variances, �
,:� �'i;7�:. . � - -- -" -. _ � - .mm �+�a.�+dre
PRO1ELi RODRESB: 9 3 S GOVERNOR S T
OWNEfl'SN�ME: MARK GREEL£Y
�ODHESS: SAME AS AHOVE
714/549-8209
AHCH/ENCINEEH:
�ooeess:
XEO.xO.:
uxrt:
uxrt:
PENMITTFE:ELZTE PLUMHZNG (714)722-0374
�oosess: 1760 MONROVIA
CM CA 92626
LICENSEU CONTMCTOfl OECUMTION: I AereEy aflirm ttut 1 am IicenmG unEer pmNsions ol C�aO�er 9(commencinp wii� Seciion
7000� ol Division 3 of Ine Business anE Proleuians Coae, and my I" nm is in hAI Iorce anA lect.
cmuc.:0A6562 $TpTEuc.:539786 �u�;C-3
Oaie: SiqnaNre:
WOHKEBS 0 PENSF710 ECLAMTION: I hefehy a' m I 1uve a ceN`�wt N nt to ulbinsure or a certilicate al Warkers'
Comoensatian is�u�nc& 8 4niii o�py tnereo� (5 ��� ,�ao.��1 / 01 / 91
roucrr+o.: STATE FUND ��h
COMPRNY: ,L,
�] Certilieq,copy b nereby fumislieA. C] CerVfieO wpy is f�e0 xitl� N0 crty 9ulldinp D�n.
.ie:
MDlicant:
he comDMeE i� tice 7�'s fa ak AUMrN (f100) a larl.
mi empby a�ry person in arry manner 5o a5 to Detome
sublKt Io IM Workers' Campeiwtion Lavrs of CaLtwna. L/
Uaie: SlpilaNR:
ND710E: II, ahu mak4iq NLs OeGaation, yw slwuW Eecome wEject to Ne WorNers' ComDensation Drovisions ot Ne LaEor
CoOe. you must fonhvnN campy wiN sucli p�wis�ons or tlns pemtit stW 6e aeemeE arokeU.
fANBTHUtT10N LFND�NC �GENCY: I �erthy at(� �� Nere ¢ a mratruction IenOinp apenty for Ne DeAormanca al I�a wod lor
whicA t�is p¢rmit a iuueE (Seciion 3097, Civ. C),
LENOER:
�ooxess:
OWNEN BURDEP UELUMTION: I �ereDy atfirm ��� I am uem0� ��m tlre Contanors State �karise Law 10� ��e Idloxin0 reason
(Section 7031.5 Business aM Pr7essional CaOe: NiY �Y ot munry w�kh reqWres a perrtut to caawct. alter. improve. Eemdish. or
repair any siructure, 0� �o its issuance. also reawa ttro appBcant fm 5uc0 pemrit �o fJa a sipnW wtement ttut �NSM I5 IkenseE
Dursuanl Io Ue D��S ol tAe Contractors State �� Law (Clupter 9(mmmend�p wlt� Seclion 7000) ol OWidon 3 0l t�a Buslness
an0 Prolessiore COOe) w WI MJstie is eaertpt Neretrom anE W Dasis lor Ne alle0� ezemD�� �Y ��on al Sectlon 7031.5 Oy
any applkant lor a Dermit subl��s Ilu app6fant ro a cNil penalry of not more Uun Me huMred EWlars (f500�.
i. as owner of tlie o�DeM or my empioYees w1ro wapes az rtieir tda comce��. ��� eo the wnrk, ane �ne
❑ svucture is no� mce�ee or orcerea �a saie (��� ��. �as aM Prolesslonal Code: T�a Contacton' Sute Lkense Law
Ooes nat appry to �n owner oi a D�OeM �� or improves Ihermn, aM xTo Ooes such woh NmsUl/hersetl or t�rouph
Als ar �er own employees, pmviAW ttut 4� imD�%'emen6 are not mtenOeU or allemC tor sale. It, Mwever t�a OuilUinp or
ImD�a�ement is sol0 mt�m one year ol compiefion, Ihe ormer xill Iwve t�a EUNen ol pmWnO �sM Oia nat EuilO or improve
lor IM purpose oi ule).
I, as owner of Ne Droperty, am exUuslveN �vacWO ��� �� ��ctors ro mnstruct Na Droject �Section 70dd, Business
❑ enO Professlons CoOe: The ConVazlas' SW�e Lrtense law dors mt appty ro an owner al D�aperry wM Du IAs or ImDrove5lhereon
antl wlio cantrac6 tor suc� D�ale�� �d� 9 wnVacmr�s) ficense Dursuant to t�e Contractors' Sute Lice�se Law). I am awara
that Drool al tAeir Worker'S CompemiL'wi i�surarrce stauld Ea D�� to me.
� I am eeempl unEer Section: 8. 8 P. C.
fof lhis leason:
Data:
Ovmer.
I do Aereby certiry ttut I am awam o1 anU mNerstan0 the repuirtmentt ol Calitomia HealtA anE Safery CoAe Sectlons 25505, 25533, anE
25534 anA that I or any Mure OuiWinp ocapant vnlUNill not (drde one) neeE to wmpry vnih uiG sute coGes an0 ��e reyulrements for a
permit lor conitmdbn or mo0ificatlon Imm Ue N� Uw�N Manapemmt UstAct. Hesitlentlal wnstmction apD��c�tlons are exem0� ��om
tAesa provisions.
Dale: Appliwnt:
I heaby certiN that I have rea0 Uis apD��uon ari0 stare ttwt t�e ahove inforrtutlon isjw rec I a0�ee ta wmpry wlt� all ciry an0 counry
orUinances anG sute laws rtWtirq to baWinq construn� � �ere0y aNh rtra �ep[uee�ta'Wes W5 U er upon t�e abovo-mentloneA
proDetlY f specilon O�ses ��
Date: 6 SipnaWre:
onver's �icense ar Saia� nry x:
1801<6 W�ite—euiqirp: proe�Cotla
Pink—Rwenue; GdEenroO—Aaseasor
CITY OF COSTA MESA — HUILDZNG PERMIT PERM NO: P 048771
PERMIT NO: P 098771 PLAN CHECK NO: N GOVT; tJ SUPP; N
CONSTAUCTION TYPE: PERMIT TYPE: PLU PURPOSE; OTH
JOH DESCRIPTZON ; REPLACE GAS SERVICE SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC; /
COMMENTS: REPLACE GAS SERVICE
*��r**�r*+r�r#*� *�r�+r� ��r�����* **����*�� *x-****+�* �+� �*�r*� �*��r�r�r�r*-x �*����* �*�r*�r�*��e *+e*�r*
Z O N I N G R E Q U I R E M E N T S
S E T H 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 ZN LEFT: FT IN RGHT: FT IN
PARICING REQ• PROV; PARCEL: 42242410 ZNE: REF NO:
PLANNING N6TES>
�
iE iE iF iE it if iF iF it it ik ik iE iE iE iE i! iE iE �1! iE if iE it iE iE jF 1E iE iE iE iF iE iE iF iE i! aE iE iE if-iE iF k i! iE iE �E'�1F i4 ih it it iE ik if-iE 1F It iF iE iE 1f iE iE iF iE # iF it �E �t iE 1F iF iE iF iE iE
D E V E L O P M E N T S E R V'I• C E 5�' , R E Q U I R E M E N T S
20NING APPROVED BY ' DATE:
BUILDING APPROVED HY : , DATE:
APPLICATION ISSUED BY: � DATE; �oZ %/%(
iEi!lEiEkikif3tifitlFkiEititikikitiEikiFiE �.� iE1EiEiFifiFiE�li4if �'�iciFikiF
jF it it iE 1f it if 1k iE ik if iE it if M if iE i!!! it if iE iF iE iE ik �E jE fElk iE iE iE iF iE ikitlE k% iE aE iE iE if iF it 1! M i4 ik iE iE 1f fE if it it it iE ik %iE 7f iF if iE �E iF ik iF it %9E iE it iE i! jF
LEGALIZATZON;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 2,00
25�
PLAN
ISSUE FEE 3.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 2,00 3.00 0.00
AEVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
5.00
FIRE SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAZD DUE
5,00 5.00 .00
5.00 OVER/SHORT; 00
FIRE SMIP/TOT GAADING PLAN—CHECiC
if ik il� it 1k 1k ff if dt it k iF iF it iF k k M k iE # ik iE it it 1F ie ik iE fE ie iF iE ik 3F iE ik ik iE it ih 1! it iElF it if it iF if fk iE ik 1F iE iE dt it if iF iE if 1t fk iE it it it ik iE iE �E k!k iF ik iE i! 3f
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 GAS SERVICE 2.00 2.00
END OF FEES
��i �O�JE:Y�R—:! I]SuY�b ti �1� �^�
o�rt: w.�2�i>c ;irs: ia�n;
CONSTRUCTION AND PLANNING POOL 'A
APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reintorcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undr9�nd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor Svstem 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
72. Sewer Cap 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. flough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Oucts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Strucwral) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXEO SYSTEM FINAL
29. Insulation 76. FIRE PREV. FINAL
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 ��j (,�(i ��
36. Hood or Canopy `
37. Final Factory Fireplace
38. Final Plumbing �,�
39. Water Service�Final
40. Gas Service-Final
41. Solar pomestic•Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING �
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co �
i
51. CERTIFICATE OF OCCUPANCY .__
No. Date
�
PflOJECTF00flESS: rj3J GOVc`RNOR JCT
OWNEN'SNFME: GRE^LF.Y MARC L
aooeess: 1346 i.O�AN ••
UNIT H "
COSTA N.ESA, CA
549-8209
� RflCHIENGINEEN:
�� RODNE55:
HEG.NO.:
UNIT:
UNIT:
PEHMITTEE: �xS EiECTRIC ( 714 ) 641 -3550
AODNESS: 1315 EAST ST, ANDftEWS PI.ACE C
SANTA ANA CA 92705
UCENSED CONTBALTOP OECLAflATION: I �ereyy allirm �ha� I am Iicen5e0 uneer pmvisions o� Chapter 9(commencing wi�h Section
7000� of �rvisinn 3 0l the Business and Pmfessions CoOe. an laense is in lull force and ellect.
c�T^"!' ��� �(4 3 9�( STRTE LIC.: Q A O Z L S — CNSs: �� p
. r_l Si9nalure: _ _ �
WOBKEflS' COMPENSATION DECLABRTION: I �Qreby a��irm I�a� I �ave a certihcate of con5eni �o self-insure or a c ' aie arker5'
Comoensation Insurance. ar a certihee copy Ihereof (5ection 3800. LaU. C).
PoucrNo.: WP80540504 E%P.ORTE: IOIOSI92
comrnxr: r IREMANS Fi7ND
❑ Cenihetl co y is AereLy fumished. � Certifie0 CODY �s file ' t�e ciry Buil///Oi���ng Div�is7ion.
.taf������— ADDlicanL +�---d--
E%EMPTION flUMWONKEflS'LOMPENSAiIONDEtUpATION: (f�i55tttionnee0notbewmplete4illhepermi�blorOnehuMr �oriess�.
I cetlily Ina� in I�e per�ormance ol Ihe work for whic� Ihis permil is issuetl, I s�all nol employ any person in any manner o as to becom
suble�� �o Ihe Workers' Compensalion laws al Califomia.
I Oale: Signa�ure:
' NO710E: II. atter making tAis declaration, you shouitl �ecame su0lect to the Workers' Compensation D�ovisions ol t�e Lahor
Co�e. you musl forihwith comply wilh such pmvisions or �his permil shall Ae Oeemetl revoketl.
CONSTPUCTION LENOINC RGENCY: I �ereGy aifirm t�at t�ere is a constmction lending agency for the pedormance ol Ne work for
w�ic� I�is permit is issuetl (Seclion 3097. Civ. C�. �
LENOEH:
PDONESS:
OWNEfl BUILOEB OECLAflRTION: I here�y ailirm Ihal I am e�empi Imm t�e ConVaciars' Siate license law �or Ihe I011avinp reason
(Seciion 7031.5 Buvness an0 Professional fAae: Any ciiy of wunty which repuires a permit to con9rutL al�er, improve, Jemolis�. or
repair any simclure, orio� lo its issuance. also repurtes ihe applicanl lor suc� permit ro lile a signed statemenl t�at �Us�e $ IicenseE
pursuam to tne Omvisions of the Comractors State License law (Chapter 9(commencing wit� Semion 7W0� af Oivision 3 0l ihe Business
anU PmIe55ion5 fAae) ar Iha� �e/she is exempl IherelrOm anA I�e basis lor t�e alleged exemption. Any violdiion ol Section 7031.5 Gy
any ao0licant lor a permil subjecis ihe aoPlicanl �p a civil penalty oi not more than five huntlretl aollars (E500).
I. as owner of Ine propeny or my employees with wages as Iheir sole compensation, will Oa tne woB, and Ne
❑ stmcture is not imentletl or offered for sa�e (Section 70a4, Business anC Pmiessional Coae: The Commctors' Slate License Law
tloes not apply Io an owner o� a pmpetly who builtls or impmves ihereon, antl who does such work himsel�/hersetl or t�muAh
�is or her own emDloyees. pmvitled I�al suc� impmvemenis are no� intenaea or oHereO for sale. If, howevel �he buildirg or
impmvemenl is SoIU wi�hin one Year of completion. Ihe owner will have ��e burden oi pwving he/she tlid noi Ouild or impmve
loi Ine purpase of sale�.
� I, as owner ol ��e pmperty, am exclusively coniraclinp with licensea conirac�ors �o cons�mp the Dmlec� (Seclion 704a, Business
❑ and Prole55ion5 Cotle: The Conlractors' $�ate License Law Coes no� apply Io an owner o� pmperry who bw105 at improve5lhere0n
an0 who conirac�s for such pmjecis wit4 a conlraclor�s) license pur5uani Io Ihe Conlra[tors' Sia�e L�cense Law�. I am awar¢
Ihat prool ol iheii WorkeYs Compensati0n insurance shoultl be omvitlea to me.
� i am exemD� uneer Secuon: B. 8 P. C.
I. lor I�is reason:
Oa�e: Uvner:
I 00 �ere�y ceriify I�ai I am aware a� an0 underS�anG ��¢ repuiremem5 0� CalitOmia Heai�h anC Sa�¢ry Coae Seqions 25505, 25533, and
2557E and Ihat I or any �ulure buil0ing occupanl Willlwill no� (circle one) neetl la camply wiih saitl Slaie codes antl Ihe requiremen�s �or a
Oermil lor conslru[tion or modi�icaiion �mm �he qi� Oualiiy Manaqemeni OiSVic�. fl¢SiAenlial cons�mc�ion ap0lipalion5 are eeempi fmm
IhpSC pf0V1510115.
�ate: pOUI¢anl:
I hereby ceililY Ihai I �ave reae Ihis application and 5talel�ai ihe above inlormation is correci. I agree �o comply wil� all cily antl coun�y
o�tlinancesanesla�elawsmla�inglohuilOmgconslmc�ionanA�etC� ul�orizerepresenta�rvesollhisciryloenle�uponlheahove�menlionetl
prapariy �Oi inSpCciion purpO5e5,
-ere �' r^ s / �
Dnvei's License or Soaai Securiiy =: $ _ __
t6ai.a6 W�ile—Bmltling; Green—COGe Eniqrcemenl Canary—Applkam: Pink—Revenue;
v '
CITY OF COSTA MESA - BliILDING PER,"4IT PERN NO: � 054932
PiRMIT NO: E 054932 PLAN CHECIC h0; , N GOVT; Y SUPP: N
CONSTRUCTION TYFE: V-N PERMIT TYPE: ELz PURPOSE: OT:i
JOH DESCRIPTION : SERVIC£ CHANGz & CONI�ECTION SQ FT;
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: *�� CITY PROJECT NO. 91-07 ***
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Z O N I N GS ERTEBQAUCIKRSE M E N T S —___—
------------ MAIN BUILDING ---------- --------- ACC�SSORY HUiLnING ------ �
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; PT IN
LEFT: FT TN RGHT; FT IN LEFT: FT IN RGHT: �T IN
PARKZNG REG• PROV: PARCEL: 4224241U 2NE: REF NO:
PiANNING NOTES>
�
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D E V E L O P M E N T S`;E,k V I C E S R �. Q U I R£ M E N T S
ZONING APPROVED BY '' DATc;
BUILDING APPROVED BY :
APPLICATION ISSUED BY: Vl• /'(J�
ik3E�lF)f#�f3Ei(�1E1Ei6�FiF3Fi:iE1FiF�FlfiFif . . ..: ��r
+4±E �E !'r iF iF iE it iF iFi4 iF iF # iElb � ie iF 3F # If iF iF �E k i! if iF if iF i�'it'JPlE if 1c
LEGALI7ATION:N F�E'E� S
i -
BLDG PMT PLUMBING ELECTRIC
PERMiT 18.50
JOA
DATE:
DATE: G ^ (/�2_- '-
w . . jEi'?fiElfiEiea(-YIf3F'.tiF�Flf ��F�I:.iE
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M M A R Y STRUCTURAL SEGMENT;N
MEC'rIANIC FIRE SMZP/R�S GRADING
SMIP/NON-RES
PLAN
ZSSUE FEE 15.00
HUZLDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 0.00 O.QO 0.00 O.OU ,00 .00
REVENUE PIVISION TOTALS--> COLLECTEU; ,00 OVER/�HORT: .UO
BLDG PMT PLUMBING ELECTRIC NeECHANIC FIRE SMIP/TOT GRADING PLAN-CriECR
iE 3f 1f if 1E ii'?e iE jE fE #F iF if iE iF 3F 3f 3f iF iE # it?E ii iE } iE iF � if iF # 34 iF iF i4 iF #�?F if� �!e �)f iF iF 3F 3't M� ii �f if if � 3F if?f�iE 9F iE iE �lf iE If k iF �F if iF # IFle 3F �lE iF iF iF 3F iF iE 3f
Z h D I V I D[T A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N" i� UNIT COSi TOTAL COST
ELE 1 SERVICES BELOW 600 V& BELi3W 201 AMP 18.50 18.50
END OF cEES �_
,`j' .. . ' ' .
�. - .
Ir — _
: i/�!!��
C0IVSTRUi,TION AND PLANNING POOL 'A � -
APPROVALS PBrmit # Date Inspector qppROVALS Permit # Date Inspsctor
7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undigrnd. _ 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. � 55. Electrical 8onding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Eiectrical Conduit-Undrgrnd.
$. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd,
tO.,Structural F1oor Svstem 61. APPROVAL TO DECK
� 11. Property Sewer Line & HouseConnection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
7 3. Roof Drains 64. Plumbing System - Finat
74. Rough Plumbing 65. Etectrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & AcCess ApProval
17. Reugh Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
\
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory FirePlace APPROVALS Permit #
21. Dutts, in Structur6 70. Underground Hydro
22. Ducts, Ventilating _ 77. Product Piping OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structuraq & Monocoai 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL �
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat • . FINAL INSPECTION
32. Electrical Power Meter-Final ���/ / -- � s0. FOOD CERTIFICATE ISSUED
'I-/ � �- -
33. Final Electric �l� / � � Notes:
G
34. Final Heating & A�r Conditioning ,
35. Final Gas Pipe-Test
36. Hood or Canopy �
37. Final Factory FirePlace
38. Final Plumbing
39. Water Service�Finzl �
40: Gas Service-Final �
47. Solar pomesticFinal �
42, Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDWG �
48. FINAL PI_ANNING ' �
49. Electric Release to Edison '
50. Gas Release to Southern Califurnia Gas Co , , f,
51. CERTIFICATE OF OCCUPANCY �.�� ��
No. Date
1