HomeMy WebLinkAbout3199 HAITI CIR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.�1lILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address:
Suite:
Vicinity:
- Primary Occ:
Parcel Number:
319g HAITI CI
R3 U1
13912235
Applicant: MORRIS, KATIE
Address: 3199 HAITI CI
Type ot Construction: V-N ED
Zoning: R1 EXPI
oA� � a �
COSTA MESA, CA . �
,
Ownec MQRRIS, KATIE%���� �- � �
Address 319g HAI7fCIR �%' ' �� �
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COSTA MESA, CA, . -• ' _ -
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Contracror < ;OWNER�BUILDERr ; �� �
Address. i. �' � - =' �
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r'nrcn :' 'PETERSEN DESIGN
Address�� �17582 FIESTA WAY -
Zip.
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�TUSTIN; CA � '
92780 . ' .
Status: ISSUED
Applied: 07/20/2006
Issued: 12/14/2006
Phone: 714-546-0902 ISSUED BY:
Zip: 92626
�"�. Phonei ��714-546-0902 . �- .' . �
� Zip ,_ 92626 , � .
Phone: 714-904-6720 �
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_License: % C28382� .` � �
Phone:
License:
Address:
. .,,;.� � ��y
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Phone:
License:
.. . . f - . .. _ -.' - , .
4 � �� . - - - SCOPE OF PERMIT '
,�''1,010SF NEW DETACHED.GARAGE�AND WORKSHOP W/2 STORY RECREATION ROOM, OFFICE AND STORAGE ROOM. 1ST FLOOR WORK TO �
, A 400SF DETACHED�GARAGE, AND A�160SF WORKSHOP AND 2ND FLOOR WORK TO CONSIST OF A 415SF RECREATION ROOM, OFFICE AND
;'� AREA�W/A �-; � ' .
35SFBALCONY.
, _ - ,-,. , -� � -�. -"- - :
�' CONDITION OF APPRQVAL: ALL FINISH�MATERIAL, COLOR, ARCHITECTURAL STYLE, WINDOW TREATMENTS, AND ROOF MATERIAL AND
�� �CO'LOR SHALL MATCH EXISTING RESIDENCE. � ' � � - �
�'�' , . . . �. - .
;,� . - _ ` v ,-,.` . �FEESUMMARY. ,. , _ �
".�,',PlanCheck:;,'r�, $463.94 =-- _-- �--; .� �- �-� CalcValuation: $eo,000.00
` Permik ' $71375 "" � ' ' " _ � ' Claim Valuation: $eo,000:oo
� ��� SMIP Res:�.`�,��- $6.00 �� � � �
���=SMIPCom: �'.`��'.$0.00 " � � �' �
'�`.��' '�Other`� ��```'$0.00 - . ..
' Inspection:, ��;'$0.00 =-r."`�' .
� � , .� , , �
��
� � �. � ,� ,, "- �
\�'Total: " � $1,183:69 . , � . "„ , �
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����'� BCANNING&ZONING �
SETBACKS;� ��` �:��D� _ � ,
� � � �
� 'v: ; :-'" � �:,.`'�.�: � � �, r . , .
MAIN STRUCTURE��Front /0-,OV �Rear - 0 0 �. Left � � 0-'0 --° ' - Right� '�0-'0 `" ' -` �
�. „� , r � ,� , .. ._ ,
�. . i , _ ` _ � , " ' -
ACCESSORY �Front� 0=0' % ,�1'� �Rear` 0=0 - � - Left 0-0 Right 0-0 � '
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. .. . , � ��, - . . -
PARKING Exi_stina,-, 0;-�, "Reauired: � 0'' Pr000sed: o
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S
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California
regulations. (Ord. No. 92-28, § t, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is sus�
for a period of 180 days.
related
orabandoned
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspeetiona end final epproval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
zaaaae �u�oo�
WORKERS'COMPENSAnON DECLARAnON: ' � ' •
I hereby enirtn under penelry of perJury one ot the tollowing tleclaretlons: -� � .
❑ I heve end wlll meinteln e certl8cete of consent to seli-Insure for workers' compensetlon, es pmvltleC for by Sectlon 3700 of the Lebor Code, far Ihe pertortnenca of ihe
work for which thls pertnit is IuueC. . '
❑ I hava end vrill malnUin workers' compensaGon insurance, es required by secUm 3700 of the Lahor Cotle, fw ihe perfortnance of t�e work for which Nis pertnit is issued.
My workers' compensatlon Insurance wrtier end policy number are:
Carrier: Policy Number:
(This secf/on need not be comp/eted U fhe permif is velued et ane hunOred tlollers ($100J or less.)
J 1 cently_that in lhe pertortnance oi the work tor wnich t�is pertnit i5 issued, I shall not employ any person in any manner so as to become subjed to Ne workere'
��compensatlon laws o1 Califomla, entl agrae Ihat if I should become subject to the workers' compensation provisions of Se tion 3700 of t�e Lebor Cotle, I shall fort�with
complywith�hes pr si s. —F 111 /
ApplicentSipneture����� Date:s�...l��i V7
WARMIN(1:'FAILURE TO SECU W ER ' COMPENSATION COVERAGE IS UNUW FUL AND SHALL SUBIECT AN EMPLOVER TO CFIMINAL ENAL ES D CNI FlNES UP TO ONE HUNDRED
T/IOUSAND OOl1ARE (5100,000), IN ADDRION TO THE �ST OF COMPENSATIqJ, DAMAGES AS PROVI�ED FOR IN SECTION 3)O60F THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES.
LICENSEDCONTRACTORSDECLARATION: �
I hereby effirtn that I am licensed under provisions of Chapter 9(commencing with Seciion 7000) of Division 3 of ihe Business antl Professions Coda, and my license is in full
force and eRecL Lic. M " Class x
Coniractors SlgnaNre: ' ' Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby attirtn that there is a construction lentling agency for the pertormance of the work for which this pertnit is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lender's Adtlress:
Signatura: Data:
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn that under penalry of perjury ihat I em EICEMPT FROM 7HE CON7RACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business antl Protessions
Code: Any ciry or counry which requires e permit to consirucL alter, impmve, demolish, or repeir any stmcture, prior to it5 issuance, elso requires the applicaN tor such pertnit
ro file a signetl stetement thet he or she is licensed pursuant to the provisions of the Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of the
eusiness entl Profeuions Code) or Ihet he or she is exempt therefrom antl the basis tor the alleged exemption. Any violetion ot Section 7031.5 by any epplicant for a pertnit
subjects the epplicant to a civil penelry M not more than five hundred dollars ($500).): '
'�� ner ot ihe pmperry, or my amployees wlth weges as their sole compensation, WILL DO THE WORK, antl the strucWre Is not intended or oHered for sale (Sec.
���7044, Business end Protessions Code: The Coniractors License Law tloes not apply to en owner of property who 6uilds or improvas thereon, and who tloes such work
himselt or herselt or Ihrough his or �er own employees, providad Ihat such improvemenis are not intendad or ofleretl for sale. If, however, ihe builtling or impmvement is
sold within one year oi completion, the awner-builtler will heve the burden ol proving that he or she tlid not build or improve for purpose oi sale.).
❑ I, as owner of ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Busineu antl Professions
Code: The contractors License Lew tloes not epply to an owner ot property who builtls or Improves ihereon, antl who contracis lor such pro�ect with a coNrector(5)
license pursuant to the Contracbre License Lews.).
❑ I am mp ndner��� Business and Prolessions Code for this reason:
SlgnaW �/1
�..�..._- " _';
Owner ID venfietl b dnvefs license. Yes ❑ No Orivafs License No:
Vedtication oi Ownership by (type oi document, i.e. - property tax hiil or deetl): ��
DIVISION OF INDUSTRIAL SAFETV PERMR CER71iICA710N:
❑ I hereby cenify thet no excavation tive (5) or more feet in tlepih in�o which e person is requiretl to tlescend, will be mada in connection wit� work euthonzetl by ihis
permit, end that no building siructure, scaftolding, falsework, or demolition or dismantling thereot, will be more ihan thirry-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec.
341, Title 8, Californla Administretive Code).
❑ As owner-builder, I will not employ enyone to do work which would require a permit from Ihe Division ot Intlustrial Safery, as notetl ebove, unless such person hes e
permit to do such work trom the division.
Signature: Date:
Division ot Industrial Safery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AUfHORIZAiION OF ENTAY: I certity untler penalry of perjury ihat I have reatl this application and state ihet the iniormation given is
correcL I a rae to comply with all te lews antl ciry ortlinances relating�to 6uilding constmction, antl euthotlza representaiives ot ihe City ot Coste Mesa to enter upon Ihe
de ribed prope for ins ec n pu es. I agree not to occupy or allow occupancy of eny buildinq authpnzed ty tl is permit unti�na�spection.
L 1� I 1'" � � �
f—Signature Of L`egal Owner(s)�._ y�� a e
l
And/Or Authorizetl Applicant Date
WpE I, INSPECTIONTYPE Q�. �¢
1616 Fixed System Final Fire Prevention
1266 Pool Spe Final �
200 Finel Re-Roof
201 Flnal8lxk/Retaining Well
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demalition ' �
COOE 1 INSPECTION TVPE
206 Final Mechanical
200 Final Plumbing
210 Final Electrical
212 Finel Fire Preventlon _
220 Final Planning Approval
222 Final Site ,
250 Final BuildinyOccupency
o�T� II�ALS
Address:= `"
y , r"t
L',it.�y °� L'�ta ��eda �'u�%�'dur y Dic�ia�
OWNER-BUILDER � -
VERIFICATION
Permit #:
A city or county, which is required to give notice pursuan[ to Sec[ion 19830, shall attach to such notice, and, as
a condition precedent to issuing a building permit, require the completion and require the retum of, an owner-
builder verification.
Attention PropeRy Owner.
An `owner-builder' building permit has been applied for in your name and bearing your signatuie.
Please complete and retum this information in the envelope provided at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No buildingpermit will be issued until this
venfication is received.
�I personally plan to provide the major labor and materials for construction of the proposed
property improvemenL � Yes ❑ No
�[� a/have not) signed an application for a building permit for
the roposed work.
3. I have contracted with Ihe following person (finn) to provide the proposed cons[ruction:
Name
Address
Phone(
City _
Contractor's Lic. No.
4. [ plan to provide portions of the work, but I have hired the following person to coordinate,
supervise and provide the major work:
Name
Address _
Phone ( )
City —
Contractor's Lic. No.
5. [ will provide some of the work but 1 have contracted (hired) the following persons to
provide the work indicated:
Name
IDA2-46 (Rev.ttroa) ,
Address
Phone Type of Work
CITY OF COSTA MESA
P.O. BOX 1200 • 77 FAIR DRNE • CALIFORNIA 92628-1200
OEVELOPMENT SERVICES DEPARTMENT
BUILDING DIVISION
COURTESY NOTICE OF PERMIT EXPIRATION
August 31, 2007
Katie & RobeR Morris
3199 Haiti Ci
Costa Mesa CA 92626-2345
PERMIT NUMBERS: 606-01205, E06-01456
FOR: New Garage
PROJECT ADDRESS: 3199 Haiti Ci., Costa Mesa
Our records indicate the above listed permits were obtained for property improvements or
alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4
Expiration, permits are valid for 180 days from the date of such permit, or the date of your
last inspection for the project.
Our records do not show an inspection for these permits within the last 180 days nor have
they had an approved final inspection. If you have a signed inspection card showing that an
inspection was made within 180 days, or that the final inspection was approved, please
contact this office so we may correct our records. If you do not have an approved final
inspection, your permits will expire on September 17, 2007. Additional fees will be required
to finalize expired permits.
Re uestin an ins ection—If you need to request an inspection, please call our Inspection
Request Line at 774-754-5626.
Re uestin an extension—If you wish to request an extension, requests must be made in
writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing
circumstances and listing an estimated date of completion.
If you have any questions, piease contact the Building Division at 714-754-5273, between
8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of
records affecting your property is our goal and we appreciate your working with us to resolve
this matter.
Sincerely,
k:�G�=e-c���k'J!X-��'
Ma Jane Weidenkeller
Office Specialist II
Building Division (714) 754-5273 • Code Entorcemen� (714) 754-5623 • Planning Division (71J) i54-5235
FAX (714) 754-a856 � TDD (714) 7545244 • v✓ww.ci costa-mesa.ca.us
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.G�1L�TRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
t t(i
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
�
3199 HAITI CI
DETACHED GARAGE AND WORKSHOP
13912235
npplicant: MORRIS, KATIE
Address: 3199 HAITI CIR
Status: ISSUED
� EX,�IRE� Assufed: 12/14/2006
DA'� �
Phone: 714-546-0902
COSTA MESA, CA � . ' , - ` Zip 92828 -
:i'= � � ` • ` ,
owner: MORRIS; KATIE ', , ,-� `. "
i ir. -�.\ - . . ,
Address 3199 HAI71 CIR -��� � - . . _ .
� �' ' � `, � ' .-- Phone: 714-546-0902 � �
\
u COSTA MESA �CA � - . Zip: 92626 �
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Contiactoc � OWNER=BUILDER
� Address: � � � -/" �
�
/ �` � /�/� /%;�� Phone:= �
!. ' � , i l':�;� zip �
" � - j Licen5e:000000
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' � . . / ' ' � � ` __ �..
, , ' � SCOPE OF
� ,, ; ELECTRICAL PERMIT A 1,010SF NEW DETACHED
. ; � ROOM, QFFICE AND�STORAGE ROOM.
___ REF#:BQ6-0 205
ISSUED BY:
C,z �
� ,r �",� ,
�
�
W/2 STORY RECREATION
, ', WORK TO INCLUDE:40,LIGHT-FIXTS;,1 SMOKE-0ETECTOR, 1 CEILING FAN, 1 GARAGE DOOR
� �� �-- OPENER, 16 OUTL'ETS,r10 SWITCHES,�1'PHONE JACK,-d SERVICE T0200A, 1 DEDICATED
CIRCUIT FOR FAU AND 1-GARAGE'DOOR OPENER: -� "" "
�'� „� � _ ,; FEESUMMARY � �
t � , � u Quantlty_ i - '', - �� . - __ �.. Quantlty ,
�- `\ISSUE FEE �� � - $23.50 � • - ' � - Semp Dlst System / Lighting $0.00 0 �
• �Temp service tesh � $0.00 ' Busway /100 fl $0.00 . 0 �
Res. a/c package. `�, , $0.00 � Standing Section $0.00 0�
New Res (1-2 units) $0.00 0 � Misc Electriral Equipment $0.00 0.-
New Res (3Funits) �, \'.'' � $0.00 �' 0 Transformers up to 1 kva/kw $0.00 : 0�
Pool / Spa -�, `.. -' ' ���;�>,- $0.00 ; 0 ; '�; .....:...........up to 10 kva/kw $0.00 0�
:_�N,
Lighting Fi�ds \ � ' ' : " 524.92 24 '� . . . ......... .....uP to 50 kva/kw $0.00 '� ` 0 .
. '� ;
`. ,�. � ,.�r.�. ; � ,�, . ...
Recept Outlets ��$17.60 � 16 ......:....up l0 100 kva/kw $0.00 - 0
.� ,.r ......
. ...-, .
Switches,� � � $11.00 10 ` � ...._ ...over.100kva/kw $0.00 0
Non Res Appl,,\ - $0.00, t 0": --Low Voltage Equipment ���� $0.00 0
Res Appl �`�. � �$0.00,A 0' Low Volt Wiring System / Ckt $0.00 0
Serviceto200a��� ��$3050�A�l� 1: � ' � Misc'Condui� - $0.00�. 0 -
Sernce to 1000a � � � � �$0.00�V0, ° �� � Misc Conductor � � ; $0.00 ' = i 0 �
Service over 1000a��� �' � �$0,00 j �0>��� -� � 'Circus ( gemor ride) � . .$OAO ���0 .' �
Motors to 10hp ��-�` � � �$0.00' ' �� / �0. � � � � - _ _ �=Chr stm a�T ee�Stand���g� $0.00 � -0 _
Motors to 50hp A';; $0.00 � `��.�,' 0 ; Fireworks Stand � - � $0.00 0
Motors to t00hp � $0.00 . ; 0 `- -�� � -, Other Eledrical Fee $0.00
Motors over 100hp ��$0.00��- � �011�-' - , ' ` � � , ' - "
Communicationdrops $O.00.:�Z.;;��0 ."i�,��Investigation.Fee �� ,. -50.00
Sub panel to 200a $0.00 ��'•0 ; _; - . _ Plan Check Fee � � � , � $0.00
Pole Light Pkg $0.00 �'0� " -. . � � -Reinspection Fee�', $0.00
SignCircuits $0.00 0 � - ._ �" _ � � -
Temo Pwr Pole $0.00 0 TOTAL CALCULATED FEES 5107.52
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremeMs under California
regulations. (Ord. No. 92-28, § 1, 1241-92) �
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is sus�
for a period of 180 days. . (/
and related
orabandoned
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mus� comply with all applicable codes, and all
required Inspeetions and tinal approval must be obtained. Failure to obtain inspections and tinal aAP�oval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
2446d8(8�W)
WORKEHS' COMPENSATION DECLARATION:
I hereby aHirtn under penalry of perJury one at the tollowing declareilons:
❑ I have entl will meinteln e certlflcate of consent ro self-Insure tor workers' compensetlon, es pmWded far by sedlan 3700 of the Lebor Code, tor the Oertortnance of the
work for which thls pertnit Is IssueC. . ,
❑ I have en0 wlll maintain workers' compensatbn insurance, as required by sectlon 3700 of the Labor Cotle, for the peAormence of the work for which this pertnit is issued.
My workera' compensation Insurance carner and palicy number ere:
Cerner. Policy Number:
(Thls section need nof be com0�efed I/ Me permif is ve/ued af one hundied dollars ($100) or less.)
I certity Ihat in Ue pertormence of the work tor which ihis permit is Issued, I shall not employ any person in any manner so as to become subiect to the workers'
compensetlon lews oi Calitomla, end agree that if I shoultl bewme subjea to Ihe workers' compensation provisions of Sectlon 3700 of the Labor Coda, I shall to�hwith
comply with �hese r sions
ant�SigneWr�� a�6, n MA Date: � f -�� l/]
__--
INO:'FAICURE TO SECUR WORKERS' COMPENSATION COVERAGE IS UNIAWNL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PENALTIE AND GVIL FlNES UP TOIXJE HUNDRED
3AND DOl1ARE (5100,000), IN ADDfrION TO THE COST OF COMPENSATIIXJ, DAMAGES AS PROVIDED WR IN SECTIIXJ 3]O60F iHE LABOR CODE, INiEFEST, AND ATTORNEI^S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm ihat I am licensed under provisions of Chapter 9(commencing with Sectlon 7000) of Division 3 ot the Business and Professions Code, and my license is in full
Porce end eftect. Llc. # � Glass N
Gon�rectofs Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby aflirtn thet there is e constmction lending egency for the pedormance of ihe work for which Ihis permit is issued. (Sec. 3097, Civil Cotle). � ��..
Lendefs Name: Lentler's Adtlress: '�
Signature: Date: ��
OWNER-BUILDER DECLARATIONS:
I hereby aHirm �het under penalry of perjury that I em E%EMPT FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professlons
Cale: Any city or county which requires a permit lo construct, alter, improve, demolish, or repair any structure, pnor to its issuance, elso raquires ihe epplicant for such permit
to file a signed slatement thet he or she is Iicensed purouant to ihe provislons of the Coniractors License Lew (Chepter 9(commendng with Section 7000) of Division 3 of the
Business and Professions Code) or Ihat he or she is exempt theretrom end the basis for the alleqed exemption. Any violation oi Section 7031.5 hy any epplicant for e pertnit
sub�ects the applicant to a civil penalry ci not more ihan five hundred dollars ($500).): '
f� owner ol the properry, or my employees with wages as ihelr sole compense�ion, WILL DO THE WORK, and ihe structure is not in�ended or otteretl for sela (Sec.
7044, Business antl Professions Cotle: The Contractors License Law tloes not epply to an owner of property who builds or improves thereon, end who tloes such work
himselt or hersetl or through his or her own employees, provitleC ihai such improvements are not intended or oHered for sale. If, however, tha building or improvement Is
sold within one year of completioq the owner-builder will have the burtlen of proving that he or she did not build or impmve tor purposa of sale.).
❑ I, as owner oi Ihe property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct tha project (Sec. 7044, Business end Protessions
Code: The contrectors License Ww does not,apply to an owner ol properry who builds or impmves thereon, and who comracis tor such project wlth e contrecior(s)
license pursuent to lhe Contwctors License�l.ews.).
� am,e nder se Business end Protessions Code tor �his reason:
SI`gneture.%���R� c� '
Owner ID verified b dnvefs license. Ves ❑ Na '� Dnvefs�IJcense N �
Vedtication of Owners�ip by (type of aocument, I.e. - pmperty tax hill or tleed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certity thet no excave�ion five (5) or more feet in depth Into which e person is requiretl �o tlescend, will be made in connection with work euthodzed by t�is
permit, and that no builCing struciure, scaHoltling, talsework, or tlemolition or dismantling ihereof, will De more ihen thirry-six (36) teet high. (Chap. 3.2, Gry 2, Art 2, Sec.
341, iitle B, Celifomia Atlministrative Code).
❑ As owner-builtler, I will not employ anyona to do work which would require e permit trom the Division ot Intlustriel Setery, as noted ebove, unless such person hes e
pertnit to do such work irom the tlivision.
SignaWre: Date:
Division of Intlusirial Safery Permit Number:
CERTIFlCA7E OF COMPLJANCE AND AUTHORVA710N OF EHTRY: I certify under penalry ot perjury Ihet I have read �his application and state Ihat the inibrmation given is
correct. I agree to comply with all stete laws and ciy ordinances relating to builtling consWction, antl euthonze representatives oi the Ciry ot Costa Mesa to anter upon Ihe
ebo scnb� prop4gIrry for inspecliq5� purposes. I egree not to occupy or allow occupency ot any building euthonzed bythis permit u til�al i�pection.
' �UVlV1�VU � '`�I /i�. �
�� �SignatureOf.Legal,Owner(s)t`�:.,_,,,_,� T� D'ate��---
�� . � '.NI�� �'
Q�IE INTITI� S
1616 Fizetl System Final Fire Prevention
1266 Pool Spa Final �
200 Finel Pe-Rooi
201 Finel BIocWRetaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Derimoliiion
COpEt INSPECTIONTVPE
206
20B
210
212
220
Final Mechanical
Final Plumbing
Final Elecincal
Finel Fire Preventlon
Final Planning Approval
222 Final Site
250 Final Building/Occupancy
p�
L�Lfl
o�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
BUILDING PERMIT
Job Address:
Suite:
Vicinity:
3199 HAITI CI
ROOF
Parcel Number: 13912235
Zoning: R1 R1
Applicant MORRIS, ROBERT - -
ISSUED BY:
Status: ISSUED
Applied: OS/19/2003
Issued: OS/19/2003
Address: 3199 HAITI CIR , i.; �- � -
� '.,r• . - �• . - . - _
- ' � - Phone: 714-546-0902
. ��.. ,"�- ,
COSTAMESAcCA-.--' ;i'�- , . Zip: 92626 � - ' , _
% ,-.' - , ' ,/ �-�
i ,
Owner MORRIS, KATIE . � � . ' � ��
Address /3199 HAITI CIR � i - � _ � -. , , - __ � �-� ���
/�l%'. � ' �Phone: 714-5460902 � ` �r - �
� ,�� , ; / A��
�� i jCOSTA MESA..CA � Zip: 92626 � . -� � � � ��.
,�!, .. : � � % � A: ` ; �, C � / ` � � ���
Co0tf8CtOf. : % ' .����� � ���
:. %� � � ♦
�, \
�Address: -,, j :\;�\ i� `,�
_..�� � ; % �,i Phone: :� .
, � � ' ��-, - \t,� � ' � � ' ' � � .
. . ' Zip:-' � � t License:- . . � - , ' . , �. - ��
� AfCh :
Address:
Zip:
- Eng:
� ' ` ' � � � Address: �
� �' Phone: -� �
i - - License:
� � � -. ."/ i,- , SCi
�. TEAR OFF EXISTING ROOF. WSTALL 30�YEAR, COMPOSITION
; FOR RESIDENCE ONLY. � �
; Plan Check: '� $0.00
� Permit> ` $97.25
� ��. SMIP- Res: ' �,'� $0.50
SMIP Com '� ;� $0.00
, ; ,', Other-. `� '�� ; $OAO
�� �
+I\spection:, '�$0:00
� `. �` :` .
�t �TotaL• � , $97.75,
�-�';`. � �> �;
��
A
� ��� Phone: -
� �� . ,
License:
0
tMIT ,
JD REPLAC,E SHEATHING AS NEEDED, 30# FELT. 2,000 S.F.
� FEESUMMARY; '
; _
%
R
Calc Valuation: Sa,000.00
Claim Valuation: ^ ; . Sa,000.00
�� _ , .
� ; ��'a���
_ ;%? _ '� .
- . ..;' : : r
+��-� . t ,
� : � '," � PI
SETBACKS�=�, " � � - � ��
MAIN STRUCTURE` Front � 0- 0, .' Rear --' 0- 0-��
�� �
� `. : .
ACCESSORY Front - 0- 0_ �' �' � Rear 0- 0
PARKING Existinq: � �0 � � Reauiredd ,0
�, . �
o �,
/ ���� , �
�
,�-, _
�en � a o � : R�gn� � . _a.o, , „ . .
\
Left 0= 0 ' Rlght• � 0-0 =,'�
, � Propased:t. 0 �"
y„ . • 'i' -
�I NOTICE: 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)
I EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
� for a penod of 180 days. �
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inspectlons and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
240646 (fl�W)
WORKERS' COMPENSATION DECLARATION: � �
1 hereby eflirm unAer penalty of perjury one N the tollowinq dedaretions:
r
❑ I heve entl will meintain a ceniticate of consent to self-Insure for workers' compensatlon, es provided for by sectlon 3700 ot the Lebor Gode, for the pertortnanrs o( ihe
work for whiCh thie pertni� Is issuetl. '
❑ I heve and will melntain workere' compensaYon insurance, as required by sectlan 3700 of Ne Lebor Code, for the peAortnance ot ihe work tor which Mis pertnit Is Issued.
My workers' compei�.5atlon Insurance carrier entl policy number ere: �
Carder. Policy Numbec
!s section need nof be comp/efed /l Me peimit Is ve/ued et one hundred dallers ($100) or /ess.)
�
,1 certity Ihat in the peAortnence of t wo for which t�is pertnit is issued, I shell not employ eny person in eny manner so es to become subject to the workers'
-� wmpensetion laws of Celifoml egr thet it I should become subject to t�e woMers' compensation provislons of Saclion 3700 of [he Lebor Code, I shall forthwith
com0ly.wit� ihese pmvisi p� /y
Appicel ntSigneWre:� Dete:��. kJr'J- � �"l ` �2i
, s
WARNINO: FAILURE TO SECUFE WORKE0.5' COMPENSATION COVEMGE IS UNLAWFUL PND SMALL SUBIECT AN EMPLOVER TO CRIMIN/L PENALTIES ANO CML FlNES UP TOONE HUNDPED
TFIOUSAND OOILARE (5100,OW�, IN ADDfTIIXJ TO THE COST OF COMPENSATION, DAMAOES AS PROVIDED FOR IN SECTION 31O60F THE LABOR WDE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hareby ettirtn Ihat I am licensetl under provisions of Chapter 9(commencing with Saction 7000) ot Division 3 of ihe Business and Professions Code, and my license is in full
larce end eHect Lic. p Class k
Comractors Slgna W re: Date:
CONSTRUCTON LENDING AGENCV:
I❑ I hereby aRirm that ihere is a consiruction lending egency for ihe pertormance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lenders Address:
Signature: Da�e:
OWNER•BUILDER DECLARATIONS:
I hereby atflrtn Ihat unGer penalry oi perjury thet I am EXEMPT PROM 7HE CONTFiACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Professions
Code: My ciry or wunry which requires a pertnit to construc�, alter, improve, tlemdish, or repair any strudure, prior to its issuance, also requires the applicant for such partnit
to file e sipned slatement Ihet he or she is licensed pursuent to the D�ovislons of the Contradors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 of ihe
Busineu entl Professions Code) or ihet he or she is exempt iherefmm and Ihe basis br Ihe alleged exemption. Any violation of Section 7031.5 by eny applicent for e pertnit
ubjects ihe epplicant to a civil penalry ot not more then five hundred dollars ($500).):
) I, as owner oi the property, or my employees with weges as iheir sole compensation, WILL DO 7HE WORK, anC ihe structure Is not Intendetl or oflered for sale (Sac.
.� 7044, Business and Professions Code: 7he Contractors License Law dces not apply to fln owner of property who 6uilds or improves ihereon, anC who tloes such work
himseN or herself ar ihrough his or her own employaes, provided that such Improvemenis are not In�entletl or oHered for sale. N, however, Ihe builtling or Improvement is
sold within one year ol completion, ihe owner-builder will have.the burden of proving that he or she ditl not builtl or improve for purpase of sale.). '
❑ I, es owner ol Ihe O�opeRy, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct iha proJect (Sec. 7044, Business end Professions
Code: The coniractars Llcense Lew does not epOh �o fln owner o1 properry who builds or Improves Ihereon, and who comrac�s for such project with e comrector(s)
license pursuant trylpe Gqrtractors License Laws.).
��em ezempt u A se �
Sipnature:�
Owner ID veritied by tlrivers Ilcense.
Verification of Ownership by (rype of
Business and Professions Code for ihis reason:
Yes ❑ No rDdvers license No.
14 i.e. - properry tac bill or deed):-�-�"'—r
DIVISION OF INDUS7RIAL SAFETY PERMIT CERTIFICATION:
(Exp�res:�
�--_'--`
❑ I hereby cetlity that no excavation five (5) or mora feet in tlepth into which a person Is required to descend, will be mede in connection with work euthorized by this
permit, and Ihat no building structure, swHoltling, falsework, or demolition or dismantling thereof, will be more Ihen thlrty-sla (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Tille 8, C8lifomla Atlmini5lrelive Cotle).
❑ As owner-builder, I will not employ enyone to tlo work which would require e permit trom t�e Division oi Intlustrial Satety, es notetl ebove, unless suc� pewon has e
permi� to do such wark Irom the Oivislon.
SignaWre: Date:
Division of InCustnal Safery Pertnit Number:
CERTIFlCATE OF COMPLIANCE AND AIJf}fORVATON OF ENTRY: I certify under penalry of perjury thet I have reatl this epplication end stete that the infortnetion given is
wrrect. I egree to comply with ell slate lews end city ortlinances relating to building consWdion, and authodze representetives of ihe Ciry of Costa Mesa to enter upon t�e
above-descnbed property lor inspedion purposes. I egree not to occuDY or allow occupency of eny building authonzed by �his permit until Tnal inspection.
CODE t. INSPECTIONTYPE
1678 Fixed System Final Fire Prevention
1266 Pool Spe Finel
200 Flnel Re-Roof
201 Finel8lacWReteining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolition '
pdg 1t�EL&
�� fy-=
Date
�s, i� - O�j c
�Date7
CODE� INSPECTONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Electricel
212 Finel Fire Prevention
220 Finel Planning Approval
222 Final Si1e
250 Finel Building�Occupanq
PAIE V�EL4
��
05/1S/2E��73 10�19 349-642-`�hl
tiNY- i�9-2��3 t10N i0 � 28 Ati C ME5A UEVEL6P SUCS
fOR' AGENTS OF PROPER7Y OWINER
YO aPPLY FOR PERMIT9
THOMSEN PROP=RiT' PAGE nl
FAH N0, ?14i ,6 � � ' � "P.' C1/03
'4: �u.,�-..-�� `)I4-1`7.ri�i-�{&5��
Bldg. Pefmil b ^ `„_ _-- I
Thiap6fn�illt ...�_�_..--.I
-� 1
Strqal Adtlress�, ��,�q�.�SG'��1.� �_,� A? Ni:mber�,
�n �
,. icwe�,Z(.,�d�`p<_1� l_C�.L�..—.
declare ihat I am ir,e Owner of TfUe o� Ihe ubave
fe�erercc9 �eal propefly, aod ltlat 1(wc) hareby aulhorize:
� / � /( �(�
Nnme: _ �_INY� , __,�_ TeleDhon� 1�'umGr+��1��-�_x.�
j�/�, ��,( �`
ulreel Adc•ress: . l! "/ �/ f,����C�✓ _✓l�Q �
'.Tr—r--j—
c��Y'• � Sl�__( ��/.�� _� Stata: G� ZW 1�� �
io oDlefn p�rcn�es In my behalf, aa ovincdbu�ider, for _� _. _ �_� ._,__���_��� ,
at Me abo�etelprenced G'operty.
2. Shoule uny porson become an amployeo engaged in ti+e Im,orovemenl ot the proGeny, i iwe) snau imm2eialely provide Workef'S
Cp�Tpg�yB!iofl IqSurancE tov0lBJe r7fltl C:IUSB 3[erllfiCale of Ih2t tOVE/B9c to br lilod with Ihe BVilAin9 Di✓i5i0n o! Ihe Cipj of CAStd
Mesa, as raquired by Slale of �aliforpia laws.
3. As owrredF,uilder lo lac�, I underst3nd and accept Ihai my responslbilit{es do nol !ran5ler to 2ny cther person, r,pmpnny or
corporetlon.
4, I eqree W ir,tlemnlfy and hold tho City of Cosla Mesa and its empluyeea a� otllce�s he�nHess tmm any cla�rn resuRing tn damage or
peisonal in)ury b mYseH or any other parties �s a resull 01 work a�ihorizea by the pormil� from the Ciry o! Cosla Mesa.
5. I tleclarp unJcr Ibe p ally o� perjury Na( Ihe lo�egoinfl Is lrue sntl CofIOr,L
°M�atlil�gd Ih;s .� day of __r�(� - 20 � J, al _� .CJ�1fLlil��__ , CAhfomi�.
� �_
p+)9.�d�n. ib:r,)
Pfinf N�m9: : ` ��_��O r ✓ / S __ _
Siqnaturc:�'��4'J-;5�.�_� ,
pale����'--�t-l—'�'�— �.._-.__.__.�.
Nole: This aNbo�zaton doos nol grant ouhod'.ation ta perlorm No vro6: ae o�mcr,
11 solrfy pm.ids�s 1or tlmiled powar of attamcy Io s¢tvrc 4iis pennit in orty BthflM,
�5/1S/2�F�3 10;19 949-64P-�'S1
THOMSEN PROPcRTJ�
tiAY-I�-?0�)3 "ON iD;28 qM CO:,... dESA DEVElO° S'JC5 FAK �0, ll4'�54. .�
;
PAGE �2
P, ��2��3
� °,� C�,eata. � 5�� Du.�k
O�.ER~�/��LLr�J{.��
�/ERI�ICAii��
,ti ciiy or cnoniy, which �s tequired �n giv¢ noiice pursuant �n Sa�ion 191i3U. shstl �ittach ta such �toti�a ���td,
.!'� n CnnQ11i0n prrccJcnt �u issuin�; a huilding permii, requiro tht cnrnplcUon �nd rcquiro ihc rc(�,m ni, xn
owncr�builJcr ��cnficaiio��.
Ai��nlion Propcny Owncr:
An 'ciwr,crbuilJ:r' 6uilding pMmil hua hcen applicd f�v in y��ur r.amc and bcuing yuut signatum.
Plc�::c cmnpletc �tnd rC�urn lhis infc�nnaiion in qre envcl�pc providcJ m y��ur tadimst opponunily �n nvoi;l
unnecessary dcluy in pn�as,ing an�l ixsuing your Guilding pcnnit. Na bgjldir�-permit will he iesur�f unti I�Is
v:[iljy':ISibq IS f[:CCj�f%
(/ 11 1 p[rsorolly plua lu prnvidc tM: a' r labnr .ind materials for coaalruclian of (he proQosid
� l,J pcnpcny �n,provic ent, ❑ Ycs No
(� I(havclhavc nol� _ s�gncJ en ;ippli:��tion f�rr � bUilding pcnni( f�r
ihc prupos�d work.
3. I h��c cnnirnctcJ wilh Uw fnllowing perspn (lirn;j io prpvidc ilm nioposcd cnn;lniclion:
N�mc-.,�—..���t`52.�1..�--IS�� T�y-��.�._—�._
Athlrcss �-�_. V.---. ,_ Clty - „-
Minne ( i_..�.�.J`^. Conlracluls I..ia Nn. ��
�. f pinn ln providc p��rionti o[ Ilfe work. bul 1 h:rvc bireJ Uic (qlluwing person in toonlinatc,
wFcrvisc �nJ prowde �lic major a�r:c
Nmne
AdJmSs
Phvnc (
_, Ciiy-
Cuntnclnr'z l,ic, No
5. I will prnvidc 5ome nt Ihs work bui I h�vc ronlracicd (11i1'td) Ihe tollow9ng pcnons tq
ptnvi:le �hc u•ork indi�mccl:
Namc
m+P AG fR';V. B�A91
Addrens
Phonc 1'pp¢ �f Wn�l�
Aov��canl to fill in all sDaces exceot those within neavy boraer
crfY'bF COSrA qmESA � CONSTRIICTION PERMIT
ProjectAddress _J+�� NH1 I 1 ' •
Applicant's Mailing Address n� ' �y� ,.,/
Owner'sName �S�11�yJ..� Phone��Tv��w
Address � �1IGCI [tAir� . , . .
Arch/Eng. License No.
Address � r-TT- � �
Convactor's Name �F Phon 7 .
Address(m��i���l I � �� T j �'1�,. �-(��/1'I�f �
City License No. � 39 Ji.� A
LICENSED CONTRACTOR OECLARATION
1 hereby atfirm that I am licensetl untler provi5ion5 of Cbarter 9(commencing
with section �OoO) ot Division 3 ot the Business antl Protessions cotle, and
my license is in full f0 e antl eftect. I'
License Class ' ' ense No. "19a �� ,
Da[e Signature
�.'�ORKERS'COMPENSATION OECLARATION '
�"aereby afiirm that I have a certiflcate of consent to seli-insure ov a certificate
.,;.. Workers' Compensation Insurance, or a certifietl copy thereot (Section
'a00, Lab. C.)
Policy No. Company
eCertifietl copY is hereby furnishetl. � ,
Certifietl copy is filetl witn [he city Builtling Division. ,
Date Applicant
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl not be completetl if the permit is tor one huntl�etl ($100) or
less).
I cer[ify that in [he perfo�mance ot the wo� for which thi5 0 Im�t is issuetl, I
shall not mploy any pe�son in any ma r so as t e su jeCt ta the
Worke ' pensation Laws o! Califo .
Date $i9nature ��
NOTIC : If, at[er making this tletlaratiOn, you shoultl come subjecFto tne
Workers' Compensa[ion provisions of the Labor Cotle, you must forthwith
comply with such p�ovisions o� this pe�mit shall be tleemed revoketl.
CONSTRUCTION LENDING AGENCV �
I hereby affirm lhat tFiere is a construction lentling agency for the performance
of th¢ work tor �which this permit is i55uetl (Section 3097 Civ. C.)
lPntler'S Name .
'Lentler's Atltlress
OWNER BUILDER�DECLARATION
I he�eby attirm thatSl•am exempt trom the Gont�actor'S LicCnse L.aw fo� the
followin9 reason (Section ]031.S�Busine55 and Prot¢Ssional COAe: Any City or
county whicb requi�es a permit to construct, alter, improve, demolish or repair
any st�ucture, P�ior to.its issuance, also requires the aOP�icant for such Oe�mit
to ti�e a signetl statement that he/she is licensetl pursuant to the p�ovisions o(
�he Contractor's License Law (chapter 9(commencing with Section ]000) of
'vision 3 ot the Business antl Professions Cotle) or fhat M1e/she is'exempt
refrom antl the basis for the allegetl exemptlon. Any vlolation of Section
31.5 by any ap0�icant for a permit subjects the applicant to a civil
enalty, of not more than five huntlretl tlollars ($500).
❑ I, as owner ot the property �or my ertiployees with wages as their sole
compensation, will tlo the work, antl the structure is noi intenEetl or otteretl
(OI Shc2 ($CCil00 �044� BI1510255 dlld PIOfC55100d1 Cotle: The Cantractor's
License Law tloes not aoPly to an owner of a property who builGs or improves
Ihereon, antl who tloes'Such work himselt/he�selt or through his or.her own
employees, p�ovitletl that such imp�ovement5 arE not intentletl or otfe�etl fo�
sale. If, �owever, the builGing or imprOvement is soltl within one year of com-
pletioq the owner will have Ihe burtlen ot proving he/She tlitl not builtl or im-
prove tor tne purpose of sa�e).
❑ I, as owner of the property, am exclusively cont�acting with licensetl con-
tractors td construct Ihe project (Section 7044, Business antl Professions Cotle: �
The Contractor's Litense Law-tices not apply to an owner of property who
builtls, ot impwves thereon, antl who mntracts for such projecl5 with a con-
tractor(5I ucense purouant to the Contractor'S License Law). I am aware ihat
,proof�of their Worker's Compensation insurance Shoultl be provitletl to me.
❑ I am exempt untler Settion B. & P. C. for�ihis reason
Date � � owner -
1 bereby certify that I nave reatl this application antl state that the above
information is correct. I a9ree to c ply with all city antl counry ordinances
antl state laws re ing to buil in construction, antl hereby author'ze r pre-
sentatives ot t city to � upon the above-mentionetl pro ert fo�
IfI50eCLlOf1 0�� 5 5.
Signature —� Date
Drivers' License or 55 � �— - —
��B3�2y �1.3, I ,,.3,�3I
TVPE'OF CONSTRUCTION rvEW u AOD
�•'❑ CONVERSION ❑ DEMOLISH ❑ OTHER
�,�DESCRIPTION OF WORK/USE OF BLDG. —
,
i
:z nntl sign all approDriate tleclarations.
-�a UNIT NO. _ '
ALTERATION REPAIR �
TVP.E OF PERMIT 'GRADING ❑ FOUNOATION LJ STRUCTURAL
� ❑ TENANT ❑ ELECTRICAL ❑�PLUMBING 0 MECHANICAL
�. O OTHER. ' ' . - -
PROJECT DESCRIPTION�S4.F ocCUPnNCV�
CONSTRUCTIONTYPE - VAWATION$�
ZONE GRADINGCU.VDS. � ACR 5—
Reinarks: �
Bar Sink
Backflow Preventer
eackfiow Irriaation
Drinking Fountains
Floor Drains '
Floor Sinks
Gas Service Oui
Interceptors
Kitchen $ink
Lavarories �
P—Trap
Roof Drains
Reinspection Fee
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Coliectors -
Solar. Piping
Solar Tank
imming Pool w/Spa
Urinal
Water Closet
' Water Heater'
� - Water Service
QU20-W35I1
LaundrY Trays
$15
Boiler
Duct- UnderGround
Duct - Structural
Duct - Ventilating
Ezhaust System' ❑ Multiple
Firepl/Fact. Blt. ICBO # ,
Heating System & Ducting
❑0-100,000 BTU, 0100,000
Reinspection Fee
CMF 0865-46, rev. 10/84 White - Builtling; Canary - Applicant: Pink - Accountin9; Goltlenrotl - Assessor
Isue Fee
Hood or TYPeI ❑
Canopy Type I I ❑
— A.P. # I � J o: cs: . �.•
S Main Building: �
E
T Front
A Rean
�C Righ
7 • .�G S
t
Ping. Ref. #
. Planning Notes: � ��,(,�,U
FEES
6297 3/OB/88 '
,S , z�
� Accessory Building:
5 '
v�
/
Parkin9 Req./Provided
���� . (.(.t(� J '� �
ELECTRICAL • , � ' �
Automatic Washe�
Consvuction Pole Sub.
Cooking Unit
' Dishwasher
' - � Dryers ❑Gas ❑Electric
Fan
P.A.U.
Fixtures
,Device Boxes _
O utlet5
Switch¢s
Garbage Dispou�
- Generamr �0.5 KW �5-15 KW
3e/figeration System
50-100,000 BTU ❑ 100,000 BTU
System Repair/Alteration �
Fire Dampers �
Issue Fee �� i
Meter
Meter
Sub P
❑ 15-50 KW
❑ 50 + KW
to 100 amps
rr 100 amps
Mo sO0-1 HP �1'/:-8
nc.Solar 09-15 HP O16d
Microwave - �
Pole Light
Range �
Sign
Standing Sections �
Trash Compactor �
$ 3
Reinspection Fee $15 Issue Fee
FEES
DEVELOPMENT SERVICES REQUIREMENTS:
� Zoning Approved 8y �
Building Approved By
Aoolidtion Issued Bv
$ 3
54.95 TL
' Z
O
, N
I
N
G
R
E.
Q.
� M
. T
S
FEES .
$ 3
YI�4
- SUMMARV OF FEES � � ' � '
BUILDINGPERMIT $ 33`UU SMIP $ -��
PLAN CHECK $ �'� `uS � pERMIT '
PLUMBING $ ISSUANCE- $
PLAN CHECK 25% $ ENERGY P.C. ,$
ELECTRICAL $ GRADING $� �
PLAN CHECK 50% $ � MICROFILM $� �/�'/
MECHANICAL � $ ' TOTALFEE ; $ .?'�_S=
PLAN CHECK 25% $
CONSTRUCTION AND PLANNING - � . _ ; POOL & SPA - ' � � '
APPROVALS !�Permi4# - .Date Inspecto� qppROVALS Permit# Date Inspector
. �
1.jTemporary Electrical Service or Pole 52. Pool & Equipment Location,f. • j
2. Soil Pipe-Undrgmd. �`��~� 53. Steel Reinforcement +� �
y
3. Electrical Conduit Utility-Undrgrnd. 54. Forms `; �
4. Elecvical Condult-Undrgrnd: 55. Electrical Bonding '
5. Steel Reinforcement j --� 56. Rough Plumbing & Pressure Test�
6. Electrical UFER Gmd:ya ��% 57. APPROVAL TO COVER-GUNITE., •��
i '
7. Footings �� %i - �� �? � $� . 58. Electrical Conduit-Undrgrnd- �
8. Foundation! !;j � ,.� ,, � �59. Gas Pipe, O Undrgrnd., TestY
9. Water Pipe-Undrgrnd':'��� - f 60. Backwash �Lines, P-Trap, � Undrgrnd.•
10: Structural Floor Systemj� . � � 67. APPROVAL TO DECK � _
11. PropertY Sewer Line,&�Fiouse Connection 62. Backwash & Receptor-Final ' �� '
� f
12. Sewer Cap � • � 63. Heater & Vent�Final - � %
13. Roof Drains 64. Plumbing System - Final - �� �
14. Rough Plumbing ,� 65. Electrical-Final �
i
15. Rough Electrical-Conduit � 66. Solar System-Final , -
16. Rough Electric Wiring . , 67. Fencing & Access Approval .
17. Rougli Wiring Sign ' 68. APPROVED FOR PLASTERING �, i
18. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL� �� !•' �
19. Rough Heating & Air Conditioning fIRE DEPT. REQUIREMENT i.�-'^
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 �%G' �
24. Roof Framing - - 73. Undergrnd. Storage Tank O Gas ❑ Oil .
25. Roof Sheathing � 74. Overhead Hydro � . '�j.
Y _
26. T-Bar Ceiling (Structural) & Monocoat �75. Dry Chemical ;'
27. Frame and Flasring / 76. Dry Standpipe '-� � ��.
28. Lathing & Siding / 77. FIXED SYSTEM FINAL t�f �
i
29. Insulation � � � 78. FIRE PREV. FINAL
30�. Drywall Nailing HEALTH DEPT. REQUIREMENT � r�`�
31. Plaster Brown�Coat 79. PINAL INSPECTION �
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � 1�
33. Final Elect�ic . Notes: � M
34. Final Hea;ing & Air.Conditioning , J'j. �O �'
35. Final Gas Pipe-Test � � �
36. Hood or Canopy � � �
37. Final Factory Fireplace � � � - ',
38: Final Plumbing . _ . • � ` � •
ti
39. Water Service-Final � � � - -
40. Gas Service-Final � .
41. Solar pomesticFinal' � ' - �
42. Backflow Preventer � . . �
� .
, 43. Backflow Irrigation . � . - '
� e�:
- 44: Landscape Irrigation SYstem � _,� _ ' . „
'.45. Sound Attenuation i' _
� 46. Handicap Regulations � ' � � � ,
47. FINALSTRUCTURE&BUI�OING � � 0�--, ' ' . � - '
48�Special RequirementsCompleted ,
49. Electric Release to Edison
•50. Gas Release to�Southem California Gas Co ' - - A
57. CERTIFICATE OF OCCUPANCY f-
No. � Date ' � j �
e
TYPICAL
Cement Coping Ootional —
Channel Block With 1-3/8�
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"� at 4' -b" O,C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C. �
Fill Cells Salid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-1539
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURALGRADE
TWO 3/8"� BARS oj
CONTINUOUSTOP I .
& BOTTOM � �_�
D
-HOR7ASTEEL MUS7 BE 71pD IN
PLACE AT TIME OF TRENCH
INSPECTION. p'
s
0
¢ x
��
u
Y W
�_
a
>Z
a
� o
a'p N
^ - _
a
1�— W I DT H
SEE CH/
7 BELOW
6" CONCRETE BLUCK FENCE
ING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: p�e part Plastic Cement, and
Three Paris Sand
GROUT; One Port Cement Three and
One Half Parts S�and
COPING: One Part Cement, Three
Paris Sand
CONCRETE: Well Mixed 1:2-I/2:3-I/2
Max. ot 7- I/2 Gallons of
Wofer Per Sack of Cement
GROUT MAY 8E POURED FHOM TME TOP
OF THE FENCE IN CELLS WMERE STEEL
OCCURS.
CELLS ANU AREAS OF HORI20NTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H OF E4RTNTCOTH
i/3 THE HEIGTH OF FENCE
�B�LOW �BOTTOM OF FOGTING.
SCALE: I/2��= I'
WIDTH . . . . i4" . . �. . . 14" . . . . . . . . . . !._12".. _: .: : _. 12„ .
THICKNESS . . . . . . 10��. . . 10" . . . . . . . . . . . g". . . . . . . . ... . 8„
DEPTH OF EARTHTOOTH . 24° . . . 20�� . . . 16��. . . . . . 12��
SPACING OF EARTHTOOTH. . 12� . 14� . . . . . . . . . . . 16�. . 16�
City of Costo Mesa; C�alifornia
Building Department
� ... , .. ...._._.. �'EVISED NOV.82
6
OWYERS NAME: �YIL.nLpi3� _ _ _ _ _ _ _
JOB ADDRESS: _3_���. ._ — ._ _ — _ __ __ _ _ _
FERMIT NUMBER:_ �'J� _.
SIGNA7URE: -�/�'J'�—" �� — �— — —
6V���
ADDITIONS, DELETIOyS, OR CORRECTIONS SHALL
BE APPROVED BY TNE PLANidlidG DEPARTh�ENT
� iR' ��i C� '' '
�-� � i 1 ;� .''.
City of Cc�sta 1�1esa Guilding Dept.
BY a�!'L,�. DA7E�.�19��.
THi:SE ?iANSl��At.- � SE OPt i08 /�f AL! TIMES MAKE
NO CH?,I�GEo 1N! i^ OUT PRIOR AP'r`?2U�?�L OF DEPT.
,B 3 �/ y
TNEI Ii:UM:CE :�k t�-.� !QTIN i C?F A^^iolli OR AFPROVAI Oi
PiAtJu n,Nfi 5';C�rIGh7'� 'J5 �HAli N�; "' •�r�:� Fp i0 BE A
FE@N'.1� Fb�. QR i�N i P� '7i:11. :;'. Ayl y(C7iA7;GN OF AN �r
'H:i Pf p"iSCN_ r,�}'�.�;, ��;1DK.. ;JO'�'i7 � �:ifiUMING tDGIYE
n:17'r',vRl'(y z,� • "� CX.' .:kN_' � ::titQN� OF 7HI5
C0685Hnif;:r.�,�a('L.i�<_.':Fr'n`!> " �,1:-�I'r!F.'daOAI:�RUSE
, � �
�NHI:H 17 AU7NOSI(c5 S !i��:?PU:.v
THE ISSiIq1.rE 07�P. pER1.1:S
SFECIR.'.hT!i;tih ;;ND.!1 hUT }�K:'•i4
fFCN� TIiE�F',:f.TER �:FC7 iiR��:G �:+.�
SAI� PLAN6 ANU�l::CIFICP.T10?
BUItDIidG O?ERAi7.),4� Pcl'dG CAR!
IN V,GLATiON OF TH:$ :OGE Oft Or
THE CITY.
�
Gti
N PLANS .AND
LDiN'v' L`�F:CtAL
J GF Eri@Ofl$ IN
��;1 PR6`/ENTING
REUNDER wHEM
qEqppy�� OF
V
NCOID�NCf
� �� ��.�
CI OF COSiA MES,q��'
PLANNING p�pt,
dU6lECT TO BLpG. DFAi. qQQ,
DS��� DATB- 3 (�`[YB
D��p � a�1MNIN0
N[a10EMCE
3 ��g
sraeer �
—�` _
AEtIDEMtt
d�
h
W
W
b
�
<-
REPC2T OF IPlSPECTION
� ro: G_,�+a i'11F�a
Address
vNNER:
Gunite \�" )
Masonry ( )
Concrete ( )
Post-T 'oned Concrete ( )
Firepr, ,ng ( )
Reinforcing Steel ( )
PROJECT: �,, ��r ti � y���j pSpJ Report 40.
Address: `�j\'�'� �-���j Permi c No.���� 3C�i`i%
Architect: 5—t-�"��ne�� �u,�� Concractor: 5�-�:.e�c_nE�.�,pt��s
Address:
Engineer:
Address:
Inspector
Address:
(�j.c.�oa:n5 Subconcraccor: \/-�N.� J�..�-�„_�/
(Guni[e)
Masonry or
Concre[e)
(Y�q,� rj;��;L Address:
• 'Pc. �x.'-�4SV F..l��chv
Mix Used:c�.�- �
$lump, inches:-O-
Admixture: �'
Designed Strength, P51:��
T�e folloNing inspection was performed in acc�rdance wi[h [he approved drawings:
Cu.Yds. No. of
pATES Placed CYIS• Remarks
IU ��vl _��a J S�lCf.i.T�`�GI�h.��C'�L'��l S�-CE.I. C�.P.]6J'�.Ldl \
jl.
y '_
Cooies of Repor[s to: (Indicate which Bidg. Oep L G furnish address of any not listed)
r�' % �
�,� F
�2��� raz T�rsninq Laborat�ri�: �f s�u��n �'ar�f���, ��.
� 73t0 ���oorr way / Mailing Atltlress P.O. Bo� s� / �ong BeacM. CA 90801 / 12t91 a26-3355 /(2�3) 636-2386 / p14� d26-6432
TESTING 9RnNCMOFFIGE: iS�a�ONonbSuaan5lrae� r sa��a.��a,cass�os i pi<issa-:s<s
October 30, 1987 Examination: SC87-11388
COMPFESSION TESTS ON �UNIT� CYLINDEPS
Max Sitter
°.0. BoX 345�
Eullerton, California 92537
PROJECT
ADDRESS
ARCHITECT
Stonecreek Pools
ENGINEER
B. C. Adams
SAMPLE FROM
MIX
DATE CAST
DATE TESTED
SPECIMEN NO.
COMPRESSION
TOTAL LOAD. IBS.
POUNDS PER S�. IN.
28-DAY AVERAGE, PSI
COMPLIANCE
SAECIMENS �
oiSrRieurioN:
Max Sitter - 3
('ieSZ3�Hesa 31dg. Dept.
SWIMMING POOL & SPA
3199 Haiti Circle, Costa Kesa
CONTRACTOR
Stonecreek Poo1s
SUBCONTRACTOR
Vern Anthony Gunite, Inc.
Shallow end
4.2-1
10-20-87 SLUMP _ _
10-29-87
1
9-Day
76,000
4,290
SPECIFIED
STRENGTH
SIZE
2 & 3 "HELD IN FIELD"
9—Day test complies with specified strength.
MAOE BY
Gary
DELIVERED 8Y
Max
2,000 p5i
4-3/4" x 12-3/4"
RECEIVED ON
10-26-87
/ qi k ,yyden
=LL ?EPOPTS aFE SUBMITTE� aS THE CONFIDpNTI:.I PROPEatV OF CLIENTS. aUiMORIZ?TION FOF Pl18LICTTION OF OUP fiEPORiS. GONC WSiONS, Oii E%TPAGiS:ROM
OR PEGAPCING iHEM IS RESERVEO PENOING GUR wiiITTEN aPP40�aL.:S.: �`nUTUAL �FOiECT10N TO CLIENLS, iME PUBLIG �NO OUASELVES.
130� � 2
, . �
- � _ _, - _. __ _ . . _ _� _ . _ _Apo�icant to fill in allspaces.except.thase within heavy portler lines anG.sign all approoriate aeclarations.� . _ _ _ __ , _ , .. _,_ _
l � � - PERMIT NO, . �. � TRACT NO. � �.LOT NO. UNIT NO: � �� ' �
� �CITV C� � COSTA MESA �CO� STRUCTION PERMIT. ' � � _ �. .- � � . . '.6839 � 10/p6/87' �'� �156.'77�� TL
�� . Piolect�ed,e�s �3i99 �1`,qiTi C;.P , i.� . � � P�PE 3t7 S°l'�7 ' � 33�63 'i 1. . . . . - . _ . .. _ .
�,a - ' '' ' " � TYPE OF CONSTRUCTION � NEW ADD ALTERATION' REPAIR - - � �
Np���ieant's Mailing Address T ' - - ' - �� . _ . - -
�P --v- ' w�p O � ❑ GONVERSION ❑ OEMOLISFI O OTHER q;p, # � � Zone " ,.
Owner'sName ,J-O_Pt �%/NnA//0� ��%iL /Y%��nrq� �090 � � � . ' � -�
i. �� � � DESCRIPSION OF, WORK/USE OF BLDG. _ -
Address �i % �Q��jg �%% � P � � � ' ' � � ' . ' � � - � E Main Building: Y - Accessory Building: '
Arch/En ' /1 ' - - • � Z
g,'�.17R/I75 �- License No.i���.�� TYPE OF PERMIT I' GRADING ' FOUNDATION STRUCTURAL T Front ^ � ' v� 1 p
Address fT G � ' ' , f ❑ TENANT ❑ ELECTRICAL ❑ PLUMBIyr ,G ❑ MECHANICAL - '6 Rear � � �- ' � N
Contractor's Nam � �P � � Phone 7 iYJ %A�1 � � � � 'OTHER - � �a m L �r. �S-oA �-!r"U A�/%2� � � '4 , . , , - �
� / PROJECT DESCRIPTION SQ. FL �'?�'3 �� ocCVaaNCv C Right I- � . G G
Addresslmailin9l�—YvA0/C� ' L/LiA ��t.� j��j./JrP_Tp � , . . . K . , � . . ._ .
City LicetISE NO. �%� /`� i � CON STRUCTION TYPE � VALUATION $/�� V70 � S ¢ft . f R
. , ZONE GRADING GU. VDS. ; ACRES � �- E' �
LICENSED CONT�RACTOR DECIARATION � � � • . Ping. Ref, # '� . • Parking Req.%Provided
I.hereb aifirm ihat `I am licensetl untler rovisions of Charter 9 commencin � a
Y P ( 9: Remarks: ��� i GO � b P.lanning Notes: � M
with Section .]000) �of Division 3 of [he Business antl Prof¢ssions Cotle, antl " ' �
my licenso-is in full �orce antl effect. . � `� '� �' / � 7 � /�_ 7 � ' ' T'
Licensg, CI�ss License �_�a.e��� � V � �� � � � "`S r pe�s�(c` .,y $ . , , S.
^ Date�� '� � � 5'g t rD._/t!. 1 nY����C�c/_ � � ' � PLUMBING ' FEES ' 1 � � ' • ' 1
�y WORKERS'COMGENSATIONDECLARATION� ' � � f BarSink ' j � Showers � � � � ' ELECTRICAL ' FEES
hereGy aifirm that I have a oertificate ot consent to selt-insure o� a certlticate � �
� ( Wotkers' Compensation ,Inzurance, o� a ce�tifietl -copy there0 �(Section' � "- - - • - * � - - � � - -- - - ' -
` 38oq �ab. � ' � Backflow Preventer � Service Sink Automatic Washer � . Tronsformer ❑ 15-50 KW
I Policy Nob ba ��{' Company ����� � Backflowlrrigation SewerCap� � ConstructionPoleSub. � ' ' � � 50+KW �
B Certifietl py is hereby furnish¢tl. . � . .
\Cer fietl rop /iletl with the'city ' tling �ivision. , { Bathtubs ' � Sewer Connection � Cooking Unit � Me[er ❑up ro 100 amps � �
Date � ��y-�% APPlicant � ' � � � . � � � � . . . ' .
EXEMPTIONFROMWORKERS',COMPENSATIONDECLARATI N--'� - Clarifiers'.._ ,�,_ � �_, _. ._SolarCollectors ,.._ .J. ._y,_.. _ Dishwasher _ _� _,. _., Meter ❑ov¢�1QOamps�___. ,�_ '
(Thissection neetl not be completetl if the permit�is tor one huntlre ($300 oi � - -
iess): 1 ' �: � � Dishwasher � Solar Piping� • Dryers ❑Gas ❑Electric � Sub Panel �
I certi(y that in the peifo�mance of the work to� which thi5 pe�mit Is issuetl, 1 i . .
shall not emptoy any person in �ny manner so as to become zubject to�the Drinking Founcains � Solar Tank � Fan . � � Motors �0-1 HP �i Ni - 8
Workers' Compensation Laws ot California: , , .
. oare 5ignawre � � Floor Drains � • Swimming Pool w/Spa . O0 F.A.U. � - 1 Ina Solar �9-15 HP �16-15+ � '
'NOTICE: If, after makin9 this tleclaratlon, you snoultl become subject to-the ' �
Workers' Compen5alion provisions of the Labor Code, you must'forthwith ' - FIoOfSinkS � " '� - �' ' Urioal �'� � � ' " "- ' '
compry witn such -provisions or,LthiS p¢rmit shall be tleemetl revoketl. Fixtu�¢5 , � -� Mi'crowave �
CONSTRVCTION LENDING..AGENCV �' ' � ' G25'S2rvicC OutlCts WaterCloset � ' ' ^ Deviceeozes� ' •
1 hereby affirm that there is a mnscrucHan lentling agency for [he performance j. Pole Light
of the'work for which this permit �is� issuetl"'(Section �3097 Civ. C.) InterceptOrs l . � Water H¢2t2r� ;. � � Outlets �� � ' Range � -
Leniler's Name� - '
� Lentler's AGdreds - ' ' ' � � - - Kitchen $ink : . ' Water Service;,, � ' � ' j, /' � .Switches . � Sign � � '
OWNER BUILDER �ECLARATION ' - � � � � � '
I hereby aifirm-that I am exempt trom the Contractor'S LicenSe:L`aw for tne � �avatories .,. ' � -.Auto-Wash � ' Garbage Disposal ' ", Standing Sections ' �
foilowin9 reason (Section �031.5 Business antl Pwfessional Cotle: Any city or " ' � `_ � �
.counry which requlres a permit to construct, alter, improve, Eemolish or repair � P=Trap ' ' � � Laundry Ttays_ ' _ - � '_' Genera[or �0-5 KW 05-15 KW . Trash Compactor '
any structure, prior to its. issuance, also.requires.tne applicant for Such permit ' ` . ' 1 �
to /ile a signetl statement that he/sne is'licensetl pursuant to the provisions oi ' ,Roof Drains ' ' ' � {' � J
the Contractor'S License Law (Chapier 9(commencing with Section 7000) of- � � ' � . (� . U�
�ivision 3 of ihe Business antl Professions Cotle).o� that be/she is eKempt , � � . . •
ieretrom antl the ba5i5 for.the alle9etl e�emption. Any violation. of Section � � ' � . , � � � , ',� ' • , .
03L5 �by any' appliCanhrfot A permit subjects'the ,applicant to'a civil /�
�nalty ot not more tM1an five M1unGretl tlollars ($500). . ' ' ' - " 1 Y ; � � . ' ' � < � . � � � '. , � ' ,
LJ I; as owner of tne property or my employees with wages as their sole � � Reinspeaion.Fee �$15 Issue Fee � $� 3-•� '^'
compen5ation, will Co the,wo/k, antl the SVucture�is not intenaetl o� offer¢tl ' ,, R9inspectiOn F¢¢ $15 IssuO F¢¢ ' $ 3
for sale (Section,7044, Business antl Profezsion'al Cotle: The Contractor's' . �' MECHANICAL � ' FEES �
License Law.tloes not apply to an owner of a Oroperty who builtls o� imp�oves ' ' - l ,
thereon, antl wno tloes suth work�himself/herseii'or throu9h nis or her own - � � - . ' � � � -DEVELOP,MENTSERVICESREQUIREMEf�F� /y�� ;� �
employees, providetl thdt+suGh imOrovements are not intentletl or offered fo� BOiI¢� i HOOd O� Type I i - , .
sale. If,�nowever, the tiuilding or Improvement is soltl within one year ot com- . Canopy Type 11 ❑� � � Zoning:App} ved By �"� � Data
pletion, the owne� will have the bu�tlen of proving'he/she tlitl not builtl or im-' DUct- Und2f G�OUOd � - '� � ��0� x�
rove tor the purpose o( sale). ' � � � - , Build `ng Approved By � „, Date L
� I, as' owner of4he proOertY, am exclusively cont�acting with licensetl con- � DUct- $L�uctu�dl � Refrigeration System ''' '�� ��Applit3tiOn.I55uBd By wl�ate �'V ���O 1
Vactors to construcl [M1e Project (Section ]044, Business antl Professions Cotle: , ' � � .
The Contracmr's License �aw tloes not'applr to an owner ot properry.who._ - puct�-�Veniilating .�- � �0�100,OOOBTU ❑100,OOOBTU � j' �` . R.� �SUMMARV OF FEES '
builtls or'.improves thereon, antl who•contracts for"such;projects wIM a con- -� . '
tractor(sy'Ocense oursuani to�,the Contractor;s; License Law)':';1 am aware,that Ezheust�5ystem ❑ MWtiple ❑ System Repair/Alteration BUILDING PERMIT' $ g�.s� SMIP � �$ �7V
proof of•their Wor�r's-COW pensation'insu�ence'Shoultli be,provitletl to me. .. .. -.. � ' SZ • 3 Z PERMIT � -
.r �- � . � � »� � � - � •'PLAN CHECK ' $ �
❑•I am ezempt �untler Section _r—� ' ��=.�6. &;P. C. �or this reason Firepl/Fact. Blt. ICBO #� Fire Dampers � . ' �� -� (o , O p ISSUANCE $ I
'- �.' J.--'- � - '. '� -� � 'PLUMBING $
Date � ` " � Owwer '6 ��i.'"`.Ff'� � L" �µ�.'�. " � � Hea[ing System & Ducting � Registers � i ' �;�' � � ; �ENERGV,P.C. $ ' �
� .. P.LAN CHECK �25%l $ �7 �
I hereby certify �thac�l-have reatl thisjapplicatlon xntl,.state tnat�the above �� �O�100,000BTU��t00,0006T ' � � ' ' 12 p,>�, GRADING $ �
iniormation Is correct.,l agree to'coinply.with,all City 5na cqunty ortlinances ' J i ELECTRICAL 5 , ,
antl.staYe laws relatin9 to•builtlin9 mnstruction; antl,hereby.autnorize repre- ; i7, '�� , . � � PLANICHECK 50Y $ � 4'.'So � 'MICROFILM $ � '�
sentatives :of this city [o enter up n�the�above-meniionetl'�prop¢rty� fo�-,r� " r � � , •
inspectionTpurp9��9. ��• �'+'- � ' t � � �� ' NIECHANIC/aL' � $ � 'TOTALFEE � $ � (�✓�•1�
Siqnature _ I_�_ � Datey��_�L i � ' ' - . � ' � � � � ,
Drivers'� License or 55 � Reinspeetion Fee � $75 , � Issue Fee $ 3� PLAN'CHECK ' 25% $
CMF 0865-46, rev,10/B4 Whit¢ - Builtling; Canary - Applicdnt; Pink - AGGounting; Goltlenrotl - AsSeSso�
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� �
' CONSTRUCTION AND PLANNING POO SPA .
}�- APPRCTI/ALS Permit # Date Inspettor AppROVALS Permit # Date Inspector
1. �emporary Electrical Service or Pole 52. Pool & Equipment Location �p �t p�}' �
2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement . •
3:.Electrical Condult Utility-Undrgrnd: 54. Forms , � "
4. Electrical'Conduit-Undrgrnd. 55. Electrical Bonding lQ 7 O'��
5. Steel Reinforcement ' ' 56. Rough Plum6ing & Pressure Test l �% 8 D� - '
6. Electrical UFER Grni1. . 57. APPROVALTO COVER-GUNITE �
7. Footings � � - 58. Electrical Conduit-Undrgmd. Z,r7 ��'
8. Foundation � • 59. Gas Pipe,�drgrnd., Test � �� p�
9. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, �Jdndrgrnd. p t4 Q�
•10. Structural Floor System � 61. APPROVAL TO DECK - Cp �
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final /' di• - 0�
12. 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 , n; . . 67. Fencing & Access Approval
17. Rough Wiring Sign �%' 68. APPROVED FOR PLASTERING
18. �Rough Electrical-T Bar�Ceiling ' , 69: POOL/SPA SYSTEMS FiNAL �p �6 FJ(g-
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.StorageTankOGas ❑Oil
�25. fioof Sheathing � � 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical �
27. Frame and Flashing �' 76. Dry Standpipe , -
' 28.. Lathing & Siding�� - , ' 77. FIXED SYSTEM FINAL
29. Insulation _. _' 78. FIRE PREV. FINAL .. -,. �
30. Drywall Nailing . HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat "_ 79. FINAL INSPECTION ' �
32. Electrical Power Meter-Final ~� 80. FOOD CERTIFICATE,ISSUEO
33. Final Electric � ' " Notes: r� �'tJ �
34. Final Heating & Air Conditioning iZ � ��
35. Final Gas Pipe-Test � _ � �,`
36. Hoo�.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 Irrigation System � '
45. Sound Attenuation - '
46. Handirap Regulations - �
47. FINAL STRUCTURE & BUILDING �
48. Special Requirements Completed � �
49. Electrie Release to Edison - - . • ' ,
50. Gas Release to Southern California Gas Co . �
51. CERTIFICATE OF OCCUPANCY '
No. - Date , , , -
COSTA
. �����
MESA BUILDING DEPARTMENT
P. O. BO% 31]
COSTA MESA, CALIFORNIA
.a� tlt��.l��.Eiis`�
AUG q 195g"
,.,v , �,,,-
!'!t �� _� �',r���-
FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT
9UILDING BUILDING �
AODRE55 Q
COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY
RE�E�P1 �o - p �y
. � .
OWNER T , p
^^""- 1555 Plaeentia REcci�r nnTe r+ec� eo A Gt'n1 issyI e
ADDRE55 "'�` � � "���
CITY TNO. ��� I. AOO EI55
AaCN�TECT ��c. COSTA MESA. CALIFORNIA
OR' VEER NO.
FIRE
A�DRE55 ' ' ZONE
j( VI• KO�� COIISL� ���E NO.OF T pE GROVP
CONTRACYbR CITY NIOC. �n.�n �/ P�nxs �� n _
G1 ! ��/
L` !
TEL. / n^�y BPPAOVED OATE
AD�RE55 NU.' [Y 4c./
�E�A� LOT 192 3363 CORRECTIONS
ocscaiviioN NO. BLOCK TRACT
A.P. NO. . p�• . . • •
OF LOTl�pg.i" �. I l-� YXO." �ow orv Lors O
USE OF
E%ISTING BLDG.
SEiBACH LINE FFOM �y •
cervleaorslACEi � o� REARVARO 3�3��
SIDE YARD RIGHT �� \^ /
f' LEFT I
DESCRIPTION OF WORK
NEW � ALTERATION I ADOITION
REPAIR MOVING DEMOLISH
SIZELDING �1fgEjg ROOMS "' STORIES ]_ '
EXTERIOR WALLS UCCO ROOF /S�A B �
COVERING `�r4C<.D COVERING SnpK,Q�
USEOFNEW �:1�^'T 4pQ,
BUIL�ING yl
I_K ,
I MEFE6V ACKNOWLEDGE TMAT I HAVE PEAO TMIS APPLICFTION tNO
STATE TNAT THE 4BOVE IS COflRECT nND nGREE TO COMPLV WITH nLL
CITY OROINANCES FNO STl�TE LA�NS REGULATING BIIILOING CONSTFUC� �
norv. VALUATION
% PERMiT FEE $ Y�—
PERMnITU E � �y/.���I `� r
� PLAN CHECK $ � ��
$
� TOTAL FEE 5 � %
AUTHORIZEO AGENT �J J �--
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