HomeMy WebLinkAbout2688 PALA MESA CT - Building PermitsCITY OF, COSTA MESA
CALIFORNIA B262B4200 P.O. BOX 1200
DEVELOPMENT SER�ICES DEPARTMENT
September 17, 1990
To:
Building Safety Division
Code Enfc:-cement
Communications
Copley-Colony of Costa Mesa
County Administration Office
County Clerk/Bd. of Supervisors
County Registrar of Voters
County Tax Assessor
Engineering Division (2)
Fire Administration
Fire Prevention
Manager, MIS
Mesa Consolidated Water Dist.
Newport-Mesa Un. School Dst. (2)
Pacific Bell
Police Dept. - Ping. & Research
Santa Ana Height5 Water Company
Sanitary District Engineer
Southern California Edison Co.
Southern California Gas Co.
State Board of Equalization
Street Division
U.S. Post Office - AIS
U.S. Post Office, Adams Avenue
File (2)
The City of Costa Mesa wishes to advise you that the following
addresses have been changed or added:
OLD ADDRESS
161 "A" Mesa Drive
161 "B" Mesa Drive
161 "C" Mesa Drive
161 "D" Mesa Drive
161 "E" P:esa Drive
165 Mesa Drive
165 Mesa Drive
165 Mesa Drive
165 Mesa Drive
165 Mesa Drive
NEW ADDRESS
2689 Pala Mesa Court
2687 Pala Mesa Court
2685 Pala Mesa Court
2683 Pala Mesa Court
2681 Pala Mesa Court
2682 Pala Mesa Court
2684 Pala Mesa Court
2686 Pala Mesa Court
2688 Pala Mesa Court
2690 Pala Mesa Court
A.P. N0.
439-221-64
439-221-23
For your convenience we are listing the agencies above that we have
notified of the change. In addition to those listed, you are
advised to notify your correspondents of the change in order to
avoid any possible interruption of mail service.
77 FAIR DRNE
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DEVELOPMENTSEqVICES/BUJ.�4D.I/N G�SAFET�`Va_�
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Y� Building Permit �J.l�;,�
LS Cer �ficate of Occupancy
Elecyt '�al Release Form
L7' Gas ase Form �
Sani �on Fixture Form
Plumbing Permit # ��� � �-/
L�J Mechanical Permit �m/,/, �//,l�� J �D�
B�Electrical Permit -'` �T
❑ Reinspection Permit #
❑ Health Department Approval
❑ Roofing Certification
❑ Insulation Certification
❑ Dry Chemical System Certification
❑ Flame Spread Certifiwtion
❑ Fire Sprinkler Certification
❑ Soils Certifiption
❑ S al Insp ion Certificati n "
��: �s�86
All Required Documents Included " � �
Clerk
O.K.to Approve C.O.
Inspactor
O.K.to Release C.O.
B�Iltling O/flcial
CMF104630
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LICENSEO CONiflAC70fl OECLFBATION: I her � v'� •�a. r: GBr.seo uic o, 0. s of C�aO�'� 9�wr �e�cing •.iih $eclion
i0O01 ��'�90 3"u� � "' ,55 �'a ° 0 E55 C��S LOCP 'IS� i5 i '� C?`?C.
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WONHEFS COMPENSPl10N DECLANAl10N 1'�ere0y alhrm .nai l nav a, eniitaP�o� mnsent �0 5elf n re or a cenP ca�e of Workers
Comoensauon Insurance. c� a<er{il�ea co�Y �nerso� ISecuon 38�0. Laa C�. '
POLILY NO.: p i i\� i1: {% i i E%P. OAiE: l�% S I:�i �`� j
COMPANY: i'Ai I:MC1�` i
❑ Ceni'�iea woy ls ne�eoy :umisnea. l� Gendieo caoy �s, ;�hd v:�en ;ne c�ry Bcd ng Oivision.
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E%EMP710N FNDM WOBHFRS' LOMPENSAiION �ECLAPATION', :s SeF�0. ee4 noi [e C'�c=;3[ A t�e oerma fo� one ounare (5100) or less�.
� Wtidy i�nl�n IDC pEi101�= :2011M1¢ wOt+ 101 ,7hit1'� IiSiS P¢tmp �SSS511 0. I Sbdll n619fiC0'/ a0y pClSOFRI d0y T2MQ{ SD d5 i0 h¢COR1C
SUJIe�� l0 tr? S;or%?[5 L_�:in5a!ion Ld:S 0� C2hfo:nia
Oate'. Signawre
NOTILE: If_ aber maki�g this uetlaralion. you Snoultl oecom¢ SuO�eCt lo I�e C;��Y ers' Comp¢nsauon prov75ions ol the La�Or
Cooe. ��W TuS; ionn:.i r. comDl� vnID sucn pio�dsions o: ih{s oe�mR sna111e �eem¢C :evole6.
CONSTFUCTION LENUING AGFNLY: I ��erehy aHi�m I�al Ihero is a mnstmqion ia,�Cirg zGency for I�e pertormanre ot I�e work lor
::hiCh Ip15 patTll IS �SSUPG I$°C�1pp 3p97. GV. C�.
LENOEfl:
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OWNEfl BIILLOEB DECLAflATION: I hereby aLum ;na� I am exempi trom I�e Comracmri Slaie License Law lor Ine following reason
�Sedion i031.5 BuSness aac ��o�esAonxl CoDe. Am; cAy o� couniy w�icn repuires a oe:mii �o cons�mct. alteL improue. demolish. or
reoart any simclure. o��or :o ds Issuance. also re0wres Ihe ao0heant �o� such p¢rmil Io lile a signed slatemeni tnat he/she Is liGensed
pursuanl Io Ihe provi9ons 0� Ine Coniraclors Slate Lic¢nse Larv �Cnaoie/ 9lcommencing v.iin Seclion 70pp) ol Orvision 3 of Ihe 8usiness
ana Pmlessions Gone� or �-,z; ne�sne is ertmol Ine�efrom and ;�e Oasls far !he aliegea erem0��on. Any vlolanon ol Section 7031.5 by
any apPhca�,;for a Oermr saiec's ,ne apDuczm m a civA Oenalty ot not more Iha�� ,i:�e nuntlrea aollars 15500�.
L as owner o� ;ne o�o�eny or my ¢mp�oyees wn� wages as meir so�e comDensa�ion, will oo Ihe work, ana ihe
� SINCWI2 R �01 i0t¢n!?0 D� OHQfPd ��f 5d12 (52[Ii00 704<, BOSinC55 df10 P�01¢SSiOndl COdP: TIIP �Ofli�dCi0f5 $Idi¢ LILCOSE Ldw
aoes nol apoly to ov o:mer of a oroae ,ry une �uiles or improves inereon. 3nC xno eoes such work ni:�selflherself or thmugn
nis or ner own err.p'<vees. omviUed Inat suc� �momvemen�s are not Inlenoed o� otleretl for sale. It. nov,ever ihe building or
Imomvemenl ls so'C :.��hln one �lear ol complelAn. I�e owne: :•:ill �ave :�e 9ureen of proviny nels�e CiC nol �uild or improve
for me ourpos= o. s:�i.
I. as own¢� ol :he oroa°rty, am exduSNely conrtac�ing vni� hcense� contrac�or5 fa wns�mct fne O�olecl (Section 70d4, Business
❑ and Pro�e55fOn5 Lcc2 7he Coniradors' Siale LicenSe L2:i a9e5 ��oi apply lo z� ov:n¢r of proDert� nAo ]wl[5 0� improve5 ihereon
dn� :iha conV2c15 VT 5uch �roleQs wiih a coniraclodsl ht;nse pur5uani ;o Ihe ConlracfoR Slaie License Law�. I am aware
In�t proof ol tn?ir ".:. cefs Campensa0on insurance snoNa �e �rovidetl Ic me
� I zm e+empl untler >emon' B. 8 P C
10' ib15 �Bd50�
Da�e: Owner.
I do he�e�y tenRy inai I a� a:are of and unae¢lantl Te reaw�emenls o� Cahtomia Ho,alth an0 Saleiy Coae SeGiians 25505, 25533. and
25534 ane �n;t � o� anv �u;u�e 9uNoing ocaoant :sf��r.n_tl� nm k�,c�e on¢i ,veo :o comp�y v:f,n saic state mees zno fne requ7rements for a
�lermp lor cons�mctian o: ns�A¢alion trom ;ne Art OuaLP/ M1�ianagemen; t7islncL R?si�enlial conS.mc:ion aopbcaiions are exempl bom
f�ese provlsions
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r�R 37 FIRE EQUIP FEE (FiiGM hLDG JAL TABi.�:� :,GU �7,00
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CUSTA MESA,CA � .'2627 ����l�A��nl�'�
PFLMIENGINEEN. 5 5 3- H � 9 0 AEG.NO.:
aooAcss: TUDD SCHGULER C17327
500 N NEWP� �ftT u"�r 500
N.B. �=A �2700
PEpMiT'EE ;UM yOYER CO, t714)642-2931
ao�eEss: qq5 NEDLANDS
NEWPORT HEACH �A 92603
. UCENSEO CONiHACiOA OECLAFAiION: I ap:e5y affnm .ha, i am irte^= : c-_z; .�avisons cf Cnaoter 9(commencing �vnh SeUion
]OOOI e' _•. ::' 3 0: ;n¢ 9uiin¢SS anC ?�o:=s5ron5 Co,z ar,C .�y bt=.�."" ' c'orce _�C z::en.
Icirruc.:049070 sTareuc.5o690��'C-10
��a;e fQ���9_�__ S�gnaiure
VOHNEFS' COMPENSATION �ECLAFATION: I nereby a�hrm Inat I n e�Vh�:'e pt consem to SelFiasure or a cetlificaie of Workers'
.omee�s� �:'. ;-�surance o� a cenified cooy me,eof i5enion 380 .. Ci
POLILVNO:i13-]Q24—�� E%P.DATE:O4/O1I91
COM7ANY: j i ATE FUNDTq
❑ Ce^,��e; :t9y is nereoy Wmisneo. �y CerbSec co'Jy is'�' : r Ine O:) 3cileing �rvision.
DaIB' �.�/_L��v QOD�RdnS. �
E%EMPiION FflOM VlOFNERS'COMFENSAiION DECLABATION: �i�isset�mn r:e: c� _,p�:xCd;neJ°fm�1�5 brone�unC24�5100�OrIe551
I cev4; :-_ " 5 perloimaace ol ,�e �!�ork tor v�h¢� Ihis permn is Iss�°^ '... .: employ any Derson m any manner so as lo hecame
=_u01"-'� �%="- �����'��5' Com,on52bon La::�s o` Cahlorr,ia.
�ate Signaiure'.
NOTICF. ' atrer maling ��is declara�ion. you s�ou10 Uecome 5u�leci Ic I:�= C!c��?5 Compensation pmvisions ol the Labor
Coce .��. "us� ronhwnn coin�ry wnn sucn orovis7ons or mis oe�mil sna��:e c==mea revo.e0-
CONSTPUCTION LENDING AGENCV: I hereby afhrm mat ihere is a cansimction ip�dng agency for �he pedormance ol Ihe work for
�:�h¢h :�r- :e'-c rs¢sueC �Senion 309L Gv. CI.
LENDEN:
AOOPESS: �
OwNEF AUILOEH OELLFPPTION: I nereby afhrm ihal I am exemo� �mm th? ConVxctors' Slate L¢ense Law tor ine tollowing reason
ISec�io:. %97' i Busine55 ard P�olessional Code: Any city oI county vihicn reCui�s x �eonn ID tonstruct, aller, impmve, demolis�. or
:epair a:.) 5:"_c;�re. Orlor Io ils issuance. also requrtes the applicani lor mc� permii Io ftle a Signed 5taiemenl ihal he/she is licensed
oursuar; �,�'.-�z o�ovisions of ihe Comractors' State Ucense Law IChao!er 9 fcommencing :�nth Section 7000) of Orvision 3 0l t�e Business
aac P:;tfSi�:-5 COCeI o� Ihat �e/she is ?vemp� I�er^imm and Ihe 9asi5 �o: I�e a"ego7 e�empimn. Any violallon o� Section 7031.5 by
;rv; aoc�ca-:Ic� a permn subiecls tne apol¢antio a civil penalty ol not more ;nan :::e hunarea aollars I55001.
��� v;ner of I�e o�apeny ar my ?moloyees vnlh xages as I�eir Sol? compensation, wtll �o ��e work, and Ihe
'J ;r�:�me is not m�enaea o� oiferea br sale ISecuon 70<4. Busmess ane Pmlessional Loae- The Comractors' State license Law
a:P;'�G: aOPly Io an owner oi a pmperty who bmld5 or improves Ihereon. ana v�h0 aoes suc� wOM himSelOherSell Or ��mU9h
m; -� o; own emoioyees pmvitletl tnat suc� imOmvemenis a�e nm intendea ar olfere0 for sale_ If. �owever ihe huil0ing or
— =.^em 75 so10 a+il�in one year of com0leoon. Ih= o:��ner r.lil have cP? �ur�=n ol omving �ehhe dia nol 7uiltl or impmve
. . % :ur04se ot sale].
�l 1:= i:ner ol I�e p:opetly, am eeclusrvely [onUacting �:u;h h[=.r5?C can;reclor5 to cons�rutl Ihe Droled (Sedion 7044, 8usiness
LJ '- io55ion5 Cotle. The Conlratio6 Sla;e Li[ense La9 0o2s'�9t 2p0�': :0 ar J:. �er o� O�oG?hV'�:�o �uilds or improve5 �hereon
' n�9 conffacis for suc� pfoleCts vnlh d LOnffltiaf(s� 6c¢n<Q DURLanI 10 IEe GOnlydtl0l5 SldlE Lit¢n50 Law). I am dw3r¢
r3 :';o� o� Ihelr A7oikef5 Compensation Insuranc9 s�oulp Oe oron0etl ;o me
� �. e•z.np� uneer 5=aion: e B P. c.
_ : _'9d50f1
oate Oener.
I ao.+e�sz: c=':�:�� ihai I am a�vare oi an0 untlemana Ihe i¢amremens d Cxhtom�a Heali�, ane Sxfety Code Sections 25505. 25533, and
2553= r:'-:�" o� am� :uiure nuilGinq o¢uW n; c:illF.�ill nol (ci:tle on=1 a?ee ;o comob/ :a'n sxic S;ate coaos and ihe reQuiremenis lor a
Oe�mil b' c: =1�uc�ion or mo0dmalion imm �he Au Oualiiv Manapemen; ORinc;. ReSp¢N.ial con9rucimn applicalions are exemp� imm
�hese ��c.:; :-s
oate _ Aoohcant
i �pre��; :t"', 'a2t t nave �°aOlhis auphcxbon ana s��le ;�ai ine a0o:�= nfo:.n�u ^' orreG I 2;�ee to campty w7ih all �ity antl counP/
ormna-_ts°':s�Ll.u:sre'q�nq�obuJCmacon51�uc5onan4npre�;tCY-" ,25enixa•:�^-c�ryfo?nteruponlheabov=�meniionea
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CITY OF COSiA MESA - BUILDING PERNIT
PEP.MIT NO: E 049446 Pi.Aid CHECK NO;
CONSTkUCTION TYPE; 5-N � PERMIT TYPE: ELE
JOb UESCRIPTION :�NEW TkZPLEX W/ATTACHED GARAGE
N
PERM NO: E 099946
GUVT: N SL'•PP: N
PUkPOSE: OT}�
SQ FT: ��
CLAIM VALUE: CALC-��ALUE: / GROUP (�CC: R-1' /'�'M-1
COMMENTS: RE: B49331 PRIMARY HLDG. PERMIT, � '�
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Z O N I N G R E Q U I R E M E N T S
5 E T B A C K S
------------ MAIN HUILDING --------- ----- --- ACCESSOkY BUILDING -- ------
FRNT: FT IN REAR: FT IN FRNT: FT IN kEAR: �— IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN �iGHT: F1` IN
PARKING REQ • ROV: PARCEL: 43922123 ZNE: J REF NO;
PLANNING NCSTES> ` �
%
ik if')f iE ii'M k'k ik'k ifif if f4 �f 'IFikiti% if if if M iF'lh if'ik Mit'IF 1E iEit M i% if'16 �k ii i4 if if if iii! 3f iEiF K iF i(�'M ft'lf 3f'lf if 1f 1f if if if iF if ih �'!F i! aE iE IE K if +�F ik if ±F
D E V E 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
ZUNING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: � ��^� DATE: a/r
kififiF�kMkikifM�tiflFif�tfflFlkif�fikif 1 ���ii�EiEitMififlfiEi4k �%if�
iFdFMififMKjfffKitfkifiFififit�f�k�k�fMifiEM�FiF�fiflt�FifiFfkNitjF%ikiFif�EfEiF �FKifif%lfifififififififlEiflEifiFifiFiFiE%iFiFlfifaFi4iElfaFit
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 171.99
502 SMIP/NON-RES
PLAN
ISSUE FEE 15.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECR TOTAL PAID UUE
'�TOTALS----> 171.99 15.00 0.00 186.99 186.99 .00
REVENUE DIVISIUN TOTALS--> COLLECTED: 186.99 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
1E6.99
1t iE 1F'Y. l'e iE if if # fI'if 1f 1f if 1f if i� iI'IF ifif'If ii iF IE iF if iF �E iE K af if 1F if if if iF 1f iE')f if'1f�Y'M ik 'f 1f if i4 if if 1t 1F fi iF 1f if iE 1f 1f if if 1F i6 Y.'i6 iE �F'iR �E iE iF ie +' 1f 1f 1E if
I N D I V I D U A L F E E B R E A K D O W N
TYPE
ELE
QTY D E S C R I P T i O N
5733 NEW RES BLDG FOR 7+ UNITS / SQ FT
END OF FEES
UNIT CUST
03
TOTAL COS�
i71.99
PflOJECT AOOPE55: . �• ��� � y`��A '� �� �80 ".IZ L / � UNIT: �
OWNEfl'S NFME: 1 U J•` (�AL'V:t " �� �
:�.,�
aooness: �.OSi'A ...._:n,;_A 5;.;,�7
� i-$�'J:i
nflCH1ENGINEER'. -`—'''v : _:;+tU:, �t( pEG.NO.: C i / J � ]
PDOPESS: �.� �'�'` ,." :\C.:^t�'Vri: pN1T: �Uv
:4. . . ��i�'l� �l
' � : ' _ G r e 1 1 �i v ( 7 1 � ) � i . . .l ti V
PEFMITiEE: � �"' - •
AODflE55: J � v �. .i�'i ..t��_ i. . . �
�, 0.�.�iYii _n � 1 %i.0
LILENSEO CONTPqCiofl OECIAAATION' I-.��-�, 3;lu;n ;,^,a! I,�r, ce-5?de:.' ::ocuions ol CnaOter 9(commcne^c v:r.n See�cc
7000� o . s 3�t tca 8�s-,fss zn� 2 C� . �^ ^�� ,[ d '-_ t AO eNect.
CITV LIL � � � STA1E LIC j ' $ � /j � -
�J ��p i �J��( �
Cai�' � �/ / � ` �CFi/'L �C(/"-.i �
V�flNEPS COMP I SAl10N DECIAPATIDN ,� ��m r I nc p a ceM ... � con5enl io self lnsore or a c¢n rzt'� o` , or�= ;
„ompensz:ion i�s�','�FVa a rfitWec�co�: ;:>,r �S.;�o�-. 3000_ ��;. C�. i v:;_i y
�POLICY NO.. ;;.� y�;,�,� ` EXP. OATE:
LOMPANY:
t� C rt ��ec car� is ner J'� Wrr.ishea. � C^' ,eC caoy is iilee ;o ;�e r: dui ng �ivison
�a;e'. l `i l aaolca,c .�Ffi"ww�-��•�J
EMEMPTI�NFROMW RfftS'GOMPfNS4T�ONOECIARAiION: �ih55E:tF�nr,epi� sec.r,p'?le0dihepe�mf{5b�onehurA�sa15tC0)wlessl.
I(=,rtil'; :'31 ��: f�e pe::0:�man;o p� ;he vlor'�. �9r>.�i C� IP6 p?rmd i5 650=c. I iA �^0' cm010y dny per50� In any :tl3nner 50 a510 OE[Ome
�
suoiec, m Ire `.:�orFers' Compe�isa:mn Laus c: Caii:3'�ix �
�ae� Sicnx�ure- �
NOTILE: '�:, aher ma6iny ;nis 6edarz;io�. ;ou s�'+�aulC hemm? sual°f� �� �"�or'�?:5� Compensalion pwvisions oi ;Oe Labor
Coce �.ou :nus� ronmann como�y'��i�n sucn 9�ov�4ans ar ;his ;x-.n s.^.�.= c==_mea revoketl.
LONSTBUGTION LENOINC AGENCY: I ne�e�; 3`i'r .'�a: I�efe is 2 co�-svut n�emm�g agenty for I�e perfOrmance oi Lhe mOrk tor
::^�ch ns o_rma Is I=_suea f5eatron 3WZ C c Ci �
LENDEF:
AUDflESS: i
IOWNEfl BUILOEfl OELL4PNTION: I bereby afhrm Inal I am exem0� ��OT ;ne mractorS Sia�e License Law �or I�e follP�ving �eason
�Section iO3� 5 Busiress antl Professional Cod?. �n; oiy o� county w�icn rea es a Oermil Io conslmd. aller, impmve. Oemolis�, or
'Ppdv da/ 5:!utlu�2. pn0� IO I�5 i5511dOLP. 3150 �PCGi�PS IhQ dpOb�i�� �0� SLLh ;tlii IO �iIQ d Si9pP0 S�dICrtIPIIi Ihdt �C�SIIC IS IiCP�SPd
sursuam!o the promsions of Ihe Comranors' Sixte Lwense La:v (Chapter 9lcom nciny vti� Seelian 7000� ol Orvision 3 oi I�e 9usiness
enu P;o�essors Gonel m thai nels�e is eiempt ..".e:e�mm and Ine basis �or :h? IEgea e�emplion_ Any violation o� Seqion 7037.5 by
tny apo�¢am for a permu suble��s tne aop�icantic a cmil peaalty ol not.^A�e an hve nunorea aollars (5500).
�, as or:a?r ol Ine pmoeny or my empla/ees wiln waGes �s ���6 solt compensation, will ao [ne work, antl tne
I❑ S;mc:ure is noi inrenaeo or oL'ereG lor sale Beumr 70�4. Busne55 anC P fe55ionA Cotle: i�e Contrat�ors' Sia�e License Law
coes �oc apD�'i to an o'.vne� at a prap?qy v.�o 7utlds at im0'ovei Nereo a�C wh0 tloei such work himsetl/herself or Nroug�
nis o: n=r ov+n empioyees. proviaed that mc� improvemenis are no; inl De0 or olferea lor sale. If, however ihe 6uilaing or
impro•:e:neni is 5014 vutNn one year o� comC�eiion. Ihe o�.aner rnll ndve � �urden o� pmving he/s�e �id not �uila or improve
far me ouroase o� sa�.e�. `
i.as orvoe� at @e m��eRf. am exclusr:el•; mn.ractwg �n�th Acea;ec CoN:aeto¢ to constmcl the pmlect (Sec�wn704G, 6usi�e55
❑ 3nd Ff0�P55ian5 CUCe. iM1C COnVdtlOa' SIdiC liLPnS¢ L3'�/ 40E5'�013::11 m 2n Ow0¢� 0� ptOp2fiy wh0 OOd45 0� iI�O�Ov¢5 ��B�W�
xr�C >ho con;�act5 �or suc� pmlecis 'xiin a conPd[lorf5l hcense GCs:xnt�a ;he Conirac�ors' Slaie License �aw7. I am av�are
;nal o'ool ol Iheu ::br'eer's Compens2�on �nsu�ance SnOula oe orn+��;2� fo ma.
U I arr. zremp; untle� Seclion_ B. 8 P. C.
lor :nis :eason'.
Da�e O:a=r _
: tlo nei=ny t=:iiiy ;nai 1 am av�are of :mo unoeisiano tre �eauiremems ot Carr-:a Nealm an0 Saiery Cooe Seni�ns 255D5.25557, eno
25534 antl ONa; I or any:uiure �wlding occupani vn'.I'ulL�o; �GrGle onel neec :^ :oriryly �r.Rn said state Cotles an0 th¢ repWremen�s for a
oerinil �o� co�s�w<Imn or mooAicalran �rom ;n? 4rt Oua41y i�lanagemer.l 9ig;'�C qesio9�lial conslruciion ap0lica�ions are exempt tro�n
I�ogo p:9vi5�Occ
o� � ao����rm
i ae:eby ce:4:,' t?ai I have reae .nis aoo�iWuon ana 9aN_ �nal R•e aho:e n�lor:T2[ ci �s mrrect. I agtee �o comply wi�n all city ano coun:y
��QindnC¢Sd^C531EId:,>�Cl2{�ngI0bNI4i0gCOn5'utVD'Sr,GM1P':OV2�f�OntP2✓?3EtIhIrv250�fh6LityIOP�t_ C(UpOf���fdbOVE-meftli0"�9:
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<+E.�k#i!Ert�EhxFitrtiEiflEhr.�c'E,.!txkrtrtrtfFrt,c�tx±E4�f.�EkRxeE .iEM�+E+t<i-x#fE�kM�r. ettjt�xx�tlfx<x•rrcrt:ttr,�r��t?�
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i'UCALS----> �S,uU i�.00 0,00 �'�,6G ;9,UU ,U�
Rc'J'ctvun DIViSIUh '�'U;'Ai,5--> C��iLtC:'�:U: 69.00 Ulr:iic;HOrii; ,UO
diDG PMT =;..ii24d"1NG %LtC'!'itll: 'iECkinNil: r_iZ� �41i�/'i'07 Gi1AilING f I�H��-l:(G�_A
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`!�C 3 rdt;': =O�iC-Ai:t/� vi`:' h'J:t;v <- iuJ n d'iu �.00 ��.�„
�:�•� 3 �.ec�tivirtA'iLON SYSicL:�i <- �GU i. diU/H `,.UU �:-i,CU
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PFOJECi AOOFE55. �I'Ei�B�! �'`O `' Z��8' 'u'�� uxir: gLD(,`�'
OWNEfl'SNAME: W D,C DEV �A�A m�sg C'�
aooaess 1�i5 MESA DR
COSTA MESA,CA 92627
553-8090
AFCNIENGINEEF: TODD SCHOOLER ecc.so.: C17323
aooRess 500 N NEHPORT uNiT: 500
N.B. CA 92700
aesMirree. W.D.C. DEVELPOMENT (714)553-8090
aooRess: 2 CORPORATE PARK 202
IRVINE CA 92714
LICENSEO CONTFACTOfl OECLAAATION' ' a'Inm tAaa I am Utensetl un[e: �muno��5 e: C'a:L' 9 icuT.'n=nong vnih Se[lion
�_ '.>.
]OOOi o:'-i. iin� J o� !F.e Busm24 x:�C �"-.'ES�r'c L-]C? 3nC .'�'J hc¢n5e 6'in !ul::�:c� ,^a ?"Ecl
CITY LIC.: SiATE LIC.: ClASS'
�ate S�r.-atc= _ —
WOBNEPS' C�MPENSATION OECIAHAiION: I nor^oc aihrm Inat I have a CeGificate ol tonsent m 5?If-m5ure or a certihtai¢ 01 Worker5
Comoensz'.�:n ��sywp� � 7 w��t�=p;pov mere7 �Se�i�on 9800. tao. LI.� � � � � � �
aoucvea.. STATEla 71/ E%P.OATE. ��
LOMPPNY.
❑ Ger„��ec caoy is nerea� t��ahed. �L Cerehec ca�� i � YL���
�
oze •Z� � �9 � Aoa'�cxn; ^ �� - �
EMEMPiION FF@.I VlOflNEFl6' COMPENSAiION DEClABA710N�1'H55e[IiOn neeC no� Oe CG�'A'�e� 7ir= � n. �: is lor Oro nundre0 �SiW� or 1e551-
I t2^I!/'.? i^ '^ p4;:o,.T3n�o o� tn¢ e:o''� IF' ".hqn.�6AP1���115Is5ue4.I5�all nol ¢inol��p�. Q�Sor m an)' manner 5o a5 io beWme
SL�I°C 'S �'4 '::Od2=5� �0�0?052�i�0 L2:.5 9� Ldh�p��i✓
.
oa;o. s�9�zw;o
NOiILE: C, aG?r in&�ng Ihls Oeclaration. you 51IDu14 become sublect ta the Worlers' Compensa�on �mvismns of the Labar
Co;° �nu inus� icnnmm como�y �;.nn sucn provlsons ar mis oermn snall oe aeemea revo'�ec.
CONSTPUGTION LENOING AGENLV: I ne�?by aihrm tnat there Is a con9mc,ian lenaing agenci lor ,ne Oedormance ot Ine vmrk for
::m�n nr_ c�,,^�n �s issuec ISecuo� 709Z C�v CI.
LENOEF:
aooness:
OWNEfl BUILOEP OECLAFAiION: I Re:?9y aihrm Nz� I am exempi �rom ��e Coniractars' Slai? License Law for ��e followmg �eason
i5e�;ion �03;.5 9usine55 zntl Pmiessio�al Cotl=; An; ci;y ol counry whic� reQuires a permil to mnsfmct, alter, impmve, demolish, or
ieoar a'�.� s,`eciure. pnot Io iis iisuance. als0 reCuireS i�e aOD���an1 �or SUCh permii Io hle a S�gn¢C slaiement IAat h¢Ishe is liten5ed
pursua,;»;�e orowsion5 0l No Com:anors' Slale Liwnse Law IChap�er 9(commencing •r.im Seaion 7000) ol Division 3 ol the Business
dna P:�'e;nons GOCe� or ;�at nelsne is e*emp! �h:,eimm aod Ine Oasis lor ihe allegeC exe�T�pimn. Any violation of Section 7031.5 by
ar.y :Oti4ant to� a pe�mit sublecis Ihe a0�'icani Io a Gvil p¢nalty ol nol more th�n hve hun�red dollars (�+`�).
❑ i, as ov,ner ot ;ne omoer�) or my emoloyees ^�ilh wages as Iheir sole comp=nsalion, will Oo Ine work, an0 Ine
s;mcmre is not mtenaed or ollered lar sale (Secuon 7044. Bus�ness antl Pro�eSsional Co�e: The Comractors' Slaie License Law
caei nol apply Io an owner ot a proDef.y r.�ho Ouilas orimpr0`/e5 Ihereon, an0 v+ho doe5 Su[� work �im5elilher5el� Orihroug�
n6 9r her o':m emoloyeei p�ovided thal sucn ImDmvemeNS are noi 7ntenae0 or onereo lor sale. II. �oHever the 6uilding or
i�TG:ovemeol is so�tl'.vithin o��e y?a� o: mmo�=uan_ Ihe a�xner will nave �ne Oumen o� a'o'nng nelshe aid not oui10 or imOmve
'o: ;,= owaose o: sziel.
� i, as owne� of m¢ omoerty. am e�dusively can;rac,ing rn,n ficensed contracto�s lo cont:mcl t�e Dmlect �Seetion 7044, Business
dOC Pfole55i0n5 LO4E Tlle Conl;aCtorS Slale L'ic?nsf Law doEs nOIdpDIyIO 3n 0+%n¢r0� OfO�Efiy'.vAa Oud45 OtlmprOveS��eRon
anc aho conirecls for such prolecis +.'dh a con�¢tlOrfs� ficePse pursuanl�a �M1e Co�Va[tors Slaie License Law�. I am aware
:^31 orool ol :,",e�� 1Yorkei s Conoen5aiion msurance 51IDultl �e provi�etl lo me.
� i am e,emol unaer Soc[ion B& P_ Q /�— �
�o�:�,is:. so�� l � ���.
oa,� ����/ �� ow�� -- ��� � _�-
, J -
i co �e�a� a=_rnty mai I am ariare of ano unde�s;zaa .ne iepuiremeny5 0� Ca�' mia Nealth ano Saf=ig Loae xec;mns 25505. 25533, ana
2553-:::c :ral I a� an;� lulur= yuAnin, occcoao::vi4Nxtll not IcircL el n tl �o como�y �:'iln sale s:a�e coa45 xFa Ine iequiremenis lor a
permG :p; tens =utii0n oi ��oCd¢alio� I:om 1�? Art OuaN;� ldanag Oislnci. flesi�enlial con9ruCiion ap0litaii0n5 are eaempl Irom
inese ��c:�sons
Da;e Fppi¢an;
I ne�e_^':'e':� 4;nffi I nave �eda Inis apo`itSUon ane ;le�? Inaf fne a�ove m�o�ma.ion is correci I?;�_= Ie comoP� v;d� all Uiy and eouniy
o �" _- i .d : R.;,s �a g;o OuAdmr cons�.i o-e.�C ^ere� aW���� u�e<gn'ab ?s 7'< -- e�;?� uocn Ihe a�ove�mentlonea
)"�e '] clio� �U� .?5 /
/ �
�, p ¢..�zz�q� e � , � �! "��iL��'
� . _ . . - ;
,, .� -r - ._ ..�',--�,; , . a ._a..:. ._ :. . - :=s�.-
CITY OF COSTA MESA — BUILDING pERMZT
PERMIT NO: M 051121 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: MEC
PERM NO: M 051121
GOVT: N SUPP; Y
PURPOSE; UTH
JOB DESCRIPTION : ZNSTALL 3 FACTORY FIREPLACES SQ FT:
CLAZM VALUE; CALC—VALUE: GROUP OCC: R-1 /M-1
COMMENTS: RE: B49331 PRIMARY BLDG. PERMIT.
�*r*r*+r*�*�r*���*�*�r�rr�t***�r*�t�****��*r**�r��e�*�r*r�c�r*r***��*+e�x*x������***��e��e�e*�*
Z O N I N G R E Q U I R E M E N T S
5 E T B A C K S
------------ MAiN BUILDING ----------
FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN
--------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT ZN
PARKING REQ� PROV: PARCEL: 43922123 ZNE: REF NO:
PLANNING 13b'PES>
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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
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY: � DATE• 1L. Jt 1
iFfFik3FMiEiF1liflEKkMkififififlflEMik ffMiEiFMkifiElElf �t{f
iFiflFiflfifkMiFlfMkk4Mklfklfifif�FifiklflflfltiE ifMif M fIE kifKiFifif3fklFKMk�flfiF1k1f3fkiEiF1liE1fiElflFklElFiflt�fMifikkiEkif
LEGALIZATION:N F E U M M A R Y STRUCTURAL SEGMENT:N
BLDG PHT PLUMBZNG ELECTRIC MECHANIC FIRE SMIP/RES GRADINo�_
PERMIT 19,�St SMIP/NON—RES
PLAN
ISSUE FEE 4,50
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 19.50 4,50 0.00 24.00 24.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 24.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
24.00
IFlFMifkih�FlfiflEMkif�fkkif4ffk�FMitMif�{�/*�*ifiFifiEkii'Ik1fMMkifiEkMkkifMifififihk3kkififlfifiFifiFiflEiFMiFiflEiklfMlfif{EiFiFM
Z N D I V I D U 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 UNIT COST TOTAL COST
MEC 3 FACTORY FIREPLACE 6.50 19,50
END OF FEES
PXOJE�i AUDRESS:
OWNEP'S NAMF:
AOOqE55:
PflCNIENGINEEfl:
AOOPESS:
UCENSED CO MCTOp OECLAMTION: I ner¢oy aflirm Ihat I am licensed unCe: Omnsions
7000� ol Or+isia 7 of the Business ana Pmfessions Coae, antl my license is in !�il torce an0
CITY IIC.'. STATE LIL.: CUSS:
'�te: Signamre:
IqNENS' LOMPENS ION OECUNATION: I �ere�y attirm ��at I Aave a ceniticate o� co nt
�mpenSaVon Insurance or a certilied coOY ��ereo� (Seciion 3800, La6. C�.
.ICY NO.: EXP. O�TE:
60MPANY:
UNIT:
NEG.NO.:
IIXR:
ot Cnav� (commencinq wit� Senion
eNeci
to self�insure or a certificate oI WOAers'
' � CertdieQ moy 5 here�y mis�etl. ❑ CertilieE copy is NIeE with the ti BoiiGinq D�vision.
�� Daie: ApO���ant:
EMEMPfION FFOM WOflKEPS' COMPE TION DECUfU110N: (ihis sec0on not oe mmDk:[4 d Ih¢ perml is �w one �uMreA �5100) ar ku�.
I r,¢rtdy I�a; ir ;n> opdarmante o� Me' rk lor w�itA Ihis permit is issU , I Shall nc; em0�oy any perion In any manntf 50 aS IO Oecome
Su�leq to I�e `"or40rs' Compensa�lOn � 5 0l Call�omia.
Oate: S�gnature:
NOTICE: I'. aher making ihis aedd�alian,
Caae. you must foMwrt� wmpty with suc
CONSTBUCTION LENOING AGENLY: I �ereDy
w�icn ��is pe��^.n is issue0 (Section 3097. Civ.
LEN�EN:
ROONE38:
OWNEfl BWIUEP OECNMTION: I here�y
� �Senion 703t.5 Business and Pmtessional Q
i re0au any slNcture, pnor [o Bs iuuant0, al.
pursuant to t�e Dmvisions o� tAe Contracrors'
dnd Profe55i0�5 C04¢) Of f112i II¢IshO IE Bx¢t
ry applicant lor a Oermii suCjects Uk app-
I, as owne� of Ihe D�opeM i
� SINGIUl01511011��B11dE00lOflCf �0
does nol apDly to an owner of pm�
his or �er own emplayees, D� iaeU
imD�ovement is sold witnin e year
br t�e purpose of sal¢).
ulU Geto e Su�leti ro I�e Clorkers' Compen5ali0n pmvi5i0n5 of ��e �abOf
sians o Nis permit s�all �e aeemed reroke0.
t�at re is a canslruc�ion �endinp aAe�y ior tlre petlmmar¢e o� the woM �a
�at I am empt Irom the Comractors' State License Law for the fallowinA reasan
My ciry of nry which rea�ires a permd ro consimct, alter, imD�a�e. Oemali��, or
plure5 I�¢ app � � �of w[� permit 10 file a 5ipne0 Slaiement �Aat MJ511B i5 A�LenseO
�LicenuLaw�Ch er9(commencin0'�'��Sectlon7000�oIDivivon7oltheBusiness
ierefrom an0 t�e ha' tor the alleged exemption. My tiolatian o1 5tttion 7031.5 Ey
m a civY penalry a� more man 1rve nurMrM Oouars �5500).
�.m01oyM5 w�� waBeS Iheir SOIE [ompensa�On, will Aa �he M9d, a110 Iiie
nents aa nat ii
owner will Aave
I, as oxner Oi Ihe Orope , am eMtWSic¢Iy tonlfatlinq with IicenseC con[rattars tl
❑ and P:olesvons Coae'. e Canttacrors SWte License Law Oces not appty to an o.
anG xno roniracts br ch projec�s we� a coniractaqs) licens¢ pursuani m t�e
tnat omot ol ineir W ¢r's CompensaUon in5urance s�oWC Ge DroviOed to me.
� I am =.emD� under eaion�. B. 8 P. C.
bt �his renson'.
eG,nVactors StateLicenseLaw
i wnrk Aimutl/nerseli or IArouqA
Sale. Ii, however py �uilUinq or
i �e/sAe tli� not huilA or impmve
e projetl {Section 7674, Business
ry who OuilEs a improves t�ereon
Slate LiCenu Law),I am aware
Dare�. Ownec
7 40 �ereby Certih� (h f am awar¢ ol and Wdefstand th¢ requiremenfs Of Califomia Heatt� anG $a@Iy fAtle ion
25534 ana t�at I or y fuwre �uilGinq occuDant wAVwill nat (circle one) nee0 to compiy wit� sai0 state oo0es an
permit �ar [Onsim on or moadicauon Imm Ihe pir Ouahry ManaBemen� 04triCL Hesia¢mial cOns�mction aODli�a
Nex v�a��uons,
�aw�, qpplicanl:
I here0y c- Inat I have read [his aOGlitatmn antl Staie l�ai Ihe aGovP intormaii0n is forrttL I agree t0 wmply wi
oraina�c estareiawsrelaLngtoouiiaingconsimctionand�ere0yamhonrtrepresemativesoftl�cdytoenterapon
prope for msoeclian OUrpa5e5.
�a�e' S7gnaiurt
Un'.tf S'_�::-E'_ :i >JUdI 52Gutifl' •:
i505, 25533, anE
quimments br a
are ewemo� ��om
._.. ._ .-.e—a,a,.,�e r„non—C�ce Er.!orcemenC Ganary—Fpplicanf, Pmk—nevenue: GOldanr00—ASSessor
PEAMIT NO: P 04934b PLAN CHECK NO; 06098-90 N PAGE: 2
�FitaFikifi�kitikik�FilkkiflkitkkMikkifitililililjkif3fk�lit3kifikitltiFMiFMifihififkkjFifiFiti�3FitkkikikitftitififiFltiEikkkifMiFihkikitM
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 6 GAS PIPING SYS 5+ OUTL-PER OUTLET .50 3.00
PLU 3 GAS SERVICE 2.00 6.00
PLU 3 FLOOR DRAINS 2,00 6.00
END OF FEES
' ? � i . _ ' _ _ . -
�� '_ _
; '�.... . . . . . . • . .
IPB0.IECT AOOHE55: �A� �
OW�:ifl'SNAME: JIM WESHOFF
I aooness: #2 CORPORATE PARK
I it202
IRVINE CALIF.
714/55�3-8090
RHCNIENGINEEfl:
ADONESS:
�,c�, uxrt: BLDG4
/ �I�FG��f.y8
� � LQD
flEG.NO.:
UNR:
PEXMITfEE: HAYSHORE PLUMHING ( 714 ) 723-0806
nooness: 201 E HAY AVE
BALHOA CA 92661
UCENSEC CONTfiALTOfl OECIAMTIOH: I here0y aPorm ��at I am I¢ensec v�naer D�ovisions ot C�apter 9(commencing wit� Seclion
i000� o� ��nsor, 3 0l Ihe Business and Pmfessions Code ard my license is:n �ullforce and eRect.
CITYUC.:0513i7 STATELIC.:5847U2 --tU55:%,C)/—y�3��6//�
. Oate: �� �•. [.� Signawre: ���' �/LL `�-��K
:fleEflS' LOMPENSRTION OECUflATIDN: I here�y arfi �nal l �ave a centlicate at consen� to selM1insure or a ceriilicate of Workers'
,mpensalion s ili py t�ereof (Section 3800, La0
voucr Ha.: i iii0 �"/`3'—"� f9 exv. a�n: �7 / O 1/ 91
LOMPRNY: '�TATE FUND,y
❑ Certihea :aDY is nere�y furnishe�. L' 1 Cenifiea copy is HIeA wjiln� ine ciry Buildin0 Division.
�ate: /� � � (� AO�licant: '�"„ ���"�`
E%FMPfI0NFA0MW0RCEBS'LOMPENSRTION�FClAIW110M' (IDisuc9anr¢¢4nmkcanDk�MiflAepermiti5taaneAunGreG�E/Wlaleu�.
I ceniry Inat in InE pE�ormance ot ine work for wh¢h tnis oermil is iuueC. I snall oot emplay any Derson in any manner so az �o Gecome
su�lecl Io I�e'::cY�ers' Compensalion laws ol Califomi2. .
Oa!e: SignaNre:
HOTILE: R aner making this Oeclaration, you s�ould httome suElK��o t�e Workers' CompensaUan O�a'isians oithe La�or
Coez. 7ou nust b�Awn� comply wii� such O�oNsiOns ar ��is permrt sAali be UeemeO revokeU.
LONSTPUC710N 1EN01NG �GENCY: I here6y affirm 1�9� t�em is a consimction IenEinq apency lor IAe �petlormance ol tAe xroM for
wnich I�is �ermit is �ssue0 (Section 3097. Civ. C�. �
IEXDEH:
AOONESS:
OWNEH BUILOEP OECUf1ATI0N: I �ereby aHirm t�at I am exempt tmm IAe Contractors' State License Law for ��e follovrinq reason
{Sectwn 70.7� 5 8usiness ao0 Pm;essional Code�. My cRY ol counry wNcl� reQares a D�� �a ���. alter, impruve, demo4tA, or
re0air any stmcture, prior to rts issuanca, also requires tAe applican� iw suc� permi� to file a sqneE s[atement that hdSAe is licensed
Oursuant to I�e provisions of I�e Contractors' State License Law �ChaD�er 9(commencinp wii� SecGon 7000) oi ONision 3 of t�e Business
anU Pro�ess�ons COUe) or t�at he/she is exem0� ��erefmm anU the Uasis fw t�e alleged exemptqn. My Wolation al Section 70315 �y
�oy aoPlicanl tor a permit su0jects Ihe aDPlicant to a ciN� Genally ol not mort than five Auntlre0 Oollars (5500).
� i, as o+�ner of t�e pmperty or my employees wil� wages az ineir sole compensaoon, will do Ne wod, anA t�e
strucmrt is not imenCeO or oHeretl lor sale (Section 70M, Business ana Pro�essional CoEe: T�e Contracrors Stah License Law
. aoes not aOPty ro an owner a� a pmperty who 6uilEs or improves tAereon, anA wha Aoec sucA woM himull/hersetl or thmu9�
his or ner own em0loyees, pmvi0e� [�at suc� im7mvemenis are not intenOeE a oR¢re0 lor sale. If, however t�e UuilEinq a
imD�ovement is sold wiMin One yea! of tomple�i0n, me ownef will havB the Uurden M pmvinp �e/5�¢ tli0 na� UUIIO Of impmve
lor tE? ouroose of sale).
I, as oxner ot t�e pmDerry. am e.clusively contrattinq witA Iicense0 coniracrors to constmct ihe prolect �Section 7044. Business
❑ ane Pm�>ssions CoEe'. ihe Conlractors' S�ate Lice�se Law Oces noi apoh lo an owner ot Dmpeity who CuilCs a improves Nereon
anU wno COnlratls �or Suc� pmletls ;j:� a ConlratlOrlS� IitenS! DulSuani lo I�¢ ContncPoR' S�at! liC¢nse Law). I am awdre
Ihat proot o� Neir Worker'S Compensction inm�8nce 5�oulU De pmviGeOlo me,
� I am =�emo� under Seclion: B, d P. C.
for inis �eason:
�ate: Owner
i ao hereby remty Ihat I am aware oi anG wEerslanU [Ae repuiremeMs a� Gldomia Neali� and Safery CoGe Senions 25505, 25533, anE
2553a and tnat i or any tuture Uuilamg occuDant will/mll not �circle one) neeE ro comON'•'n� saiA stare cades and ihe requirements lor a
permi� tor consimc�ion or moGRication Imm �he Au Ouahry Managemen� pstnci. FesiOential constmction applications are exempt Imm
tneu Dmvlsions
oate: Applicant
I nereby amry ;nat I nave reaU this aoDlication anA state I�at ine above information is corretl. I a0�� �o comply wiih ali cRy an0 caunry
ar^„mances lnC st3t^ laws rela�ing to �vildinq consiruqion anG �ereUy auflpnze reD��nlative5 ot Ih¢ cM �o enter upon tAe aEovo-menliOnM
pmpe�y �arinsDetlion purp/os�es. //// ///�
�aie'. �V `� /(� Signatore:- ����''�'`'�'� .�/'[�(.L+L�e
. v.='s 1.,:=-s, .:' $acixl Securiry a; �
�o-�.+6 �� ,�._-3.:aemg; Gree�—Code Entorceman;', Canary—Apofcanf, Plnk—Ravenue; GolEenroC—Assessor
, zG �rez6�6 �Jo�`%�/
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT N0: P 049346 PLAN CHECK NO: N
PERM NO: P 099396
GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PORPOSE; OTH
JOH DESCRIPTION : PLUMHING FOR NEW TRIPLEX SQ FT:
CLAIM VALUE: CALC—VALUE; GROUP OCC: /
COMMENTS: _�- "—r° � ���,3,j/
�*�r��e***�**�**+�**�r** x�*�***�*»x*+�*x�*+r�r****��.**�r�**+��rx�+�**»�c�****�*+r*��*�c**��
Z O N I TI G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN 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: 43922123 ZNE: REF NO:
PLANNING NOTES>
>
fE 3k rtif iE M if iE M M if M!E k 1f if IE if it fF�f M k if if iE ik M if if if if M it if it it M it iF3f iE it % 7F 3f i£ M iE iFMM if If 3F if if iE iF iE if 3t iF if if if iE 3F if iF if if 3E if if if M* if
D E V E L 0 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
ZONING APPROVED HY DATE:
HUILDSNG APPROVED BY : DATE:
APPLICATION ISSUED BY; DATE• ii7 S �
kikifkiEifiEiF3fifiFMikif3tikiFiFifNik3f KkiFKiEiFiF%�Fif 1FiF
1t iF k ik if M �F jt ff if it M 1E iE iE �t it i! iF M it iE M iE j! k iE ik if M it iF if ik 1f iE jF iE !F 1t 1F if it iF iE M if 3t iE if M M iE M if IE k if ik iE if 3f iE if ff it % iF fE 1t iE 3t if IF if if 3E iE iE
LEGALIZATION:N F E E S U M M A R Y STRUCTUAAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 107,00
25i SMIP/NON—RES
PLAN
ISSUE FEE 3,00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 107,00 3,00 0,00 1]0.00 110.00 .00
REVENUE DIVISION TOTALS--> CULLECTED: 110,00 OVER/SHORT; .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
11�,0�
ik ik it k if i! ik lFiF if k iklf if it k k ik ff ik !! 1f k k!h if i! if i! if k ifif ik ft if iF if if if iF it iF �F k M k if k 1! k ifif iE ik k if M 14 fF M ik iF ff fE it !t iE ik if if 4 �t k fk fF ft 3t ik
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
PLU
PLU
PLU
PLU
PLU
PLU
PLU
PLU
PLU
PLO
PLU
6
3
3
3
3
6
4
9
3
3
3
D E S C R I P T I O N
BATHTUB
DISHWASAER
LAUNDRY TUB OR WASHER
SHOWER
SINR, KITCHEN
WASH BASIN
WASH BASIN (SET)
WATER CLOSET (TOILET)
WATER HEATER AND/OR VENT
WATER SERVICE \
GAS PIPING SYS OF 1 TO 4 OUTLETS
UNIT COST
2,�0
2.�0
2.00
Z.��
2.��
2.00
2,00
2.00
2.Pp�
''2.Ob
TOTAL COST
12,00
6.00
6.00
6.00
6.00
12,00
8,00
18,00
..6.00
� ` 6.00
6.00
;L Y[ F CI STA MESA ��,,UG---��
CALIFOHNIA 92628-1200 P.O. BOX 1I00
Insulation Certif cate
aG �� � � Se , �-- � �oz� i�a_._
� Numba nnd Svea C��Y
�/`/.�5�/ �-` �
Coun Subdivision Idt Numbcr
Description of Installation
ROOF
Material
7lticlrness (inches)
EXTERIOR WALL
Material a� �T
'Ihiclrness (inches) //L
CEILING
Batt or Blanket Type �.4 7r�-
'Riiclrness (inches) // ��
Loose Fill Type
Coovactor's minimum installed weighl/ft lb
Brand Name
'IT�em�al Ruistance (R-Value)
Brend Name /�/�,�/�//LLE
Thertnal Resistance (R-vaiue)�,T��*i �5 �;e. " ,3�
�f/GL %%�/2% `—�"/(
Brand Name /9it%✓/LL e
'It�em�al Resistana (R-Value) �1�tJH� Ti:�a/f .�--�j
Brand Narne
Minimum thiclrnest inches
Manutachaer's installed wei�t per square foot a acheive Thermal Resistance (R-Value)
RAISED FLOOR
Mattrial
'Ihiclrness (inches)
SLAB FLOOR
Ma�trial
'Ihidrness (inches)
Width (inches)
FOUNDAT[ON WALL
Material
Thicisess (inches)
Brand Narne
'Ihertnal Rcsistancc (R-Value)
Brand Narne
'Ihermal Resistance (R-Value)
Brand Narne
7Tiertna] Resistance (R-Vatue)
Declaration
I hereby certify that the abovt insiilaaon wu installed in the building at the above locadon in confortnance with
the curren[ Building Energy $fficiency S[andards for new residenaal buildings con[ained in TiAe 24 of the
Califomia Administrative Code. �
�7�,� �js.q �" L-r,
V Su6Convac�r 'on Installcr)
�1�J �i,� 1
$igneturc erd Ti�e
7 '7��8��/
��9%9�
.�
��i�� �
u��� 9,�,�
.3 � L/ �7'/
a�c
ara[cTnoor�ess +�;.���_�DR IZ uxrt:.�
OWNEF'SNAME: W,D,C DEV �(�' 8% �ZGPB•Z•If��
AODFE55: 1FjS MESA DR �(rs.y -�
COSTA MESA,CA �k« 92627 ��\\��Q
L
553-8090
ANCHIEr.GINEEfl: TODD SCHOOLER Rec.xo.:C17323
aooeess: S00 N NEWPORT uxrt:500
N.B. CA 92700
PEpMinEE: W.D.C, DEVELPOMENT (714)553-8090
aooeEss: 2 CORPORATE PARK 202
IRVINE CA 92714
LILENSEO CONTMCTOP OECIANAiION: I; er=oy aHum I�at I am IicenseG unaer provisions ot C�apter 9(commencinA ��� ��ion
?000� ol DrnSmn 3 01 t0e Business and Pm:=ssions Coae, and my license is in iWl torce and etteci.
CITY UL.: STRTE LIt.: CU53:
Oate: Signaiure:
W; H N E P S' C O M P E N S R T I O N O E C U M T I O N: I h e r e U y a fl i r m t h a l I h a v e a c e rt i fi c a t e o f c o n s e m � o s e l b i n s u re o r a c e r t i f i c a t e a i W O M e r s' ,
hm0ensauan In5 ranc r c rtifle opy I�ereal (Sec�ian 3800, LaE. �
�ucrxo.:1�2�1���—�b EXP.ORTE: 7�OSI91 �p_
cornr�xr: STATE \\
❑ CenifieC copY is hereby �urnis�ea. � Certified copy is Ii�eA witA the cM BuilCmg Division.
�ate: ADD�icant: 1
EYEMPTIONFBOMWOPI(Efl$'LOMPENSATION�ELWIA710N: (Thi55ectionneeGiwtAeromOkte0tllAepermi�¢IwonehuMreC(f100�orle
I ceniry �nat m ine oenormance o� fne woM for whic� t�is De�mit is issuea. I shall not emDloy any person in any mance� so as to Ueco
5u01eC lo I�e'Norkers' Compensatian Laws of Cali�omia.
Date: SignaWre.-
NO!ICE: II, atter making �nis declaration, you ShoNd become suhle� ro tAe Workers' Campenutian pmviuons ol the La�or
Coae. you musi fon�wit� camply wn� suc� provisions or this permd shall he 4eeme0 revoke0.
CONSTPUCTION IEN�ING AGENCY: I her¢Gy affirm tAM �Aefe i5 a tOnS�Nctmn IenAinp agen[y �or Itk peAormantt 0� the Wafk �of
wmch this oermit is issueE ISecnon 3097, Civ. C).
IFN�EH:
eooness:
OWNEX BUILOEH OECLAPATION: I hereby aifirm Nat I am evempt irom t�e Contraqors' State License Law far [lie IallawinA mason
�Secuon 703t.5 Businew and Pmhssional COAe: My ciry oi counry wNc� repwres a permit m constmp. atter, impmve. demoliSA, a
reWir any slrucWre, D�or to ils issuance, also reduires I�e apDlica(11 for suc11 pefmii to file a signeG Statement that Ae/she is licensed
pursuant m t�e pmvisions oi �he Contractors' State License Law (Chap[er 9(commencing wit� Section 7000) af Division 3 af ihe Business
and Prolessions CoOe) or that he/sne is exempt iherelmm and the Oas¢ lor tla alleqeE e�emption, My violatiUn ol 52Ction 7037.5 Ey
�ny aOPlicant for a permit su�lecis t�e aDPlicanl to a civil penalry ot not more tAan five �untlreU Gollars (5500�.
I, az owner at Ihe o�oDe�'Y or my employees wR� wa0es az tAe'rt sole comvensatlon, wi0 do tic work, an0 tM
stmcturt is noi inronAeO or ottere0 for sale (Section 7044, BuSiness anA Pmlessional CoOe: T�e Contractari Stah Licenu Law
Ooes not aODly to an owner of a pmperty w�o �uilds or impmves t�ereon, anU wha does such waM �imutt/�erself or I�muph
his or ner own emDioyees, D�oviOetl Inat such imo�ovements are not intenoeG or ottered for sale. Ii, however tAe EuiltlinA ar
imO�Ovement is Soltl wi��in one yeaf oi tomple�ion, Ihe owner will �ave Ih¢ OurOen Of O�aNnq hUShe Oid not build or impmvE
fo� 1ne Ouroose of sale).
I, as owner ol �he pmoertg am e�cWsvely conlractinA ��h licenua contradors ro conslmct Ine pmle� (.���on 704/. Business
L� ana Professions Cone: Tne Contracfors' State �icertse Law dces not appty to an owner ot property wAo EwIOs a improve5 Mereql
and ano comracts Por suc� pmjects with a mmnetoqs) license Dursuanl ro[�e Comractors' State Licenu Law). I am aware
t�a� orool ot their Rbrker'S Compensalion insurance s0oul4 be provided to me.
� I am evemp� untler Seclion'. B. 8 P. C.
for inis rea5on:
Oa�e'. �n — / LO Ow
I ao hereDy teroty ��at I am aware o� anG un0ers�anU [�e repuirtment 0� C mi Pal If n0 5 25505, 25533, anE
2553a ana tAat i�r any IUWre emlaing occuvant vnll/will nol (circle o e) n lo comply vnin uid state tlk repuirements for a
permit br constmction or motlifi�ation Imm t�e Air Oualiry Mana mem inct. ResiOential consim n a liwtions are exemD� �rom
I�ese O�on9ons.
�ale' Applican�'. '
I �ereGy cetlity I�at I �ave reae I�is ap0licalion an0 state tlmt tAe a�ove inlormation is correcC I aprtt to comDly wif� all ciry and counry
prilmance5anO5tllelaw5relatinqla0wl0ingmnslmc0onandher reun�aiiveso�lh¢ciryroenterupont�eaUave-mentioneG
e�oueny for �osoectlop ouroose��� � �<
'-'- —' �� 5gnawre� � ///, �
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tis---�"'" 1
� CITY OF COSTA MESA - 5UILDING PcRMIT PERM NO: B 049331
PERMIT NO: B 049331 PLAN CHECK NO; 06067-90 A GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; �IEW
4—
JOb DESCRIPTION ; BUILD #�'-3 UNITS, 5733SF LIV, 1395SF GAR SQ FT: 7 128
CLAIM VALUE: 120,000.00 CALC-VALUE: 381,320.10 GROUP OCC; R-1 /M-1
COMMENTS; X
x* x��r�����*���*�*�*�r��+r***u��r�r�r***ir+rft**��t****�t�*+���r*rr**�r*�*�*��rtr�r****�r**��t*�r**
Z O N I N GS ERTEH�AUCIKRSE M E N T S���R �� �U�F�ENiS
------------ MAIN PUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: 20 FT 8 IN REAR; 45 FT IN FRNT: FT IN REAR: FT IN
LEFT: 12 FT IN kGHT; 3 FT IN LEFT; FT IN RGHT; FT IN
PARKING REp • 13 PROV: 14 PARCEL; 43922123 ZNE: R2 REF NO: PA=90-31
PLANNING N6TES> CONSTRUCTION OF HUILDING 3, CONTAINING 3 UNITS.
>
ik it ie k if �f iE if k if if jF k if !E k itk ff iE �k k if iE k iE 7! ik i� if !F if if k�iE jf ff ff iE !f 1E % IE fE if k k if 1E it iF iF rt!f 1f Mk M if it if It iE1t %!f iF 7f iF if It iE it iE 1E if k iE k
D E V E L O P M E N T S 6' R U I C E'S R E Q U I R E M E N T,S
ZONING APPROVED BY , .� GO DATE; �n.
BUILDING APPROVED BY ; DATE;
APPLICATION ISSUED BY; � ' ��1�'` � � DATE: ����,��'�'
ifif if M if if iE �t iF %MifiE 3F iE iF ikif if ii�E if if M if iE K if IEIE if if if iF
MikitMitiFiFiFitiFitiFififkitifkiFifjfitkitit3kltMitit4i�Mit3kifiFi�itlFitMafiklEiliEitiFiFiklfitMiti6lFkiEklfkitMififiEiEifiEiFiFififiFltiFiRit
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE \SMIP/RES GRADENG
PERMIT 1,626.50 26.69
Sr1IP/NON—RES
PLAN 264.31
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK TOTAL '. PAID DUE
TOTALS----> 1653.19 0.00 264.31 1917.50 1917.50 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 1917.50 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1626.50 26.69 264.31
MitdfM3EMiFitftif3tkifiFiEikitilifiEiflEMikMMifitititM*iF%iFifikfEikMiFitiFitiE3FMlf�kltMifMif�f�fkkitltMlfifM3FiFifaFkiEiF3EiFkifjEit34iE
I N D I V I D U 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 UNIT COST TOTAL COST
SFR 5733 APT-TYPE V-WOOD FRAME -GOOD
SFR 1395 APT-TYPE I-BASEMENT GARAGE -AVER
END OFI�E
("'" : _ _._ '''1
� ��- OCT 4 1g90
1 1
�? �' ___._.
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CI�"i G� CO�TA MF.`;A
59.70 342,260.10
28.00 39,060.00