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HomeMy WebLinkAbout1780 PANAY CIR - Building Permits t a' ' . CITY OF COSTA MESA , ___ i9- BUILDING DIVISION ,� i DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT B02-01774 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDING PERMIT Job Address: 1780 PANAY CI Status: ISSUED Suite: Applied: 10/30/2002 Vicinity: Issued: 11/25/2002 Parcel Number: 13912216 Zoning: R1 R1 Applicant: WALDEN, DAVID L ISSUED BY: Address: 1780 PANAY CIR - - Phone: 714-979-8672 • COSTA MESA,CA Zip: 92626-2348 Owner: WALDEN, DAVID L TR Address - 1780 PANAY CIR Phone: 714-979-8672 _ ' COSTA MESA,CA Zip: 92626-2348 2��t Contractor: - r•y� Address: - Y 1./1-'r. D Phone: pA'� 1D ` lk Zip: License: , _ Arch : - Eng: Address: - Address: , Phone: - Phone: Zip: License: License: SCOPE OF PERMIT-. , - CONSTRUCT NEW 384 SQ. FT.DETACHED WORKSHOP. 176 SO FT.PORCH ATTAC ED,TO WORK SHOP. REF:MM-02-34.EXISTING-WORK SHOP TO BE DEMOLISHED UNDER SEPARATE PERMIT. ' YYY • FEE SUMMARY Plan Check: $145.11 - - Calc Valuation: $12,168.32 Permit: $223.25 Claim Valuation: $0.00 SMIP Res: $1.22 SMIP Corn: $0.00 Other. . $0.00 - Inspection: ' .$0.00 . Total: $369.58 . • . • . PLANNING&ZONING ,, . SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 10-0 • Rear 0-8 Left 44-0 Right 8-0 , PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. / 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 Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754.5626 2448-46(6/00) DECLARATIONS ii WORKERS'COMPENSATION DECLARATION: 1 I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed/f the permit is valued at one hundred dollars($100)or less.) :incertify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' —compensation la of California,ad agree at if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply.with.th provi l ffApplcanticant S - !A L ,Date:)) U/261112. `WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER'TO CR{MINAE PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: _ Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subE'ects the applicant to a civil penalty of not more than five hundred dollars($500).): ,— I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:Th:contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license;uant to the Contractors cense Laws.). ❑ l am.e tun•:r "/ i Business and Professions Code for this reason: .Omura: er Ir.. e ens.. Z7gExpires: •C-2( S Verification of Ownership by(type of doc : t,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY •ERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑Yes 0 No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes a No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPUANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I a to co ply with all state �fq@uws and city ordinances relating to building construction,and authorize representatives of e City of Costa Mesa to enter upon the above-d ' d pry flyl ' ct moms.I agree not to occupy or allow occupancy of any building authorized by this pel olll al inspection. 5G /`/ 2r 112. Signatuiee Of Legal Ownet(s) ate j And/Or Authorized Applicant Date LODE# INSPECTON TYPF QM ItRM81.6 CODE€ INSPECTION TYPE QAg INTmALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof — 210 Final Electrical 201 Final BIocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place _ 220 Final Planning Approval 203 Final Sign - 222 Final Site 204 Final Demolition 250 Final Building/Occupancy it 04 iltr OWNER-BUILDER VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. I. I personally plan to provide the major labor and materials for construction of the proposed property improvement.V Yes ❑ No 2. 16have n ) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (fimt) to provide the proposed construction: Name ra RfrM MOM/3 Address City Phone( ) Contractor's Lic. No. 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name Address . City Phone ( ) Contractor's Lie. No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 1042-46 REV,9/991 r U CITY OF COSTA MESA • BUILDING DIVISION o•,'ea- F • * I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4 PERMIT B02-01775 Nhvitimmose (714)754-5273 • Fax(714)754-4856 • www.cl.costa-mesa.cca.usING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 BUILDJob Address: 1780 PANAY CI Status: ISSUED Suite: Applied: 10/30/2002 Vicinity: Issued: 11/25/2002 Parcel Number: 13912216 Zoning: R1 R1 Applicant WALDEN, DAVID L TR ISSUED BY: Address: 1780 PANAY CIR Phone: 714-979-8672 COSTA MESA,CA Zip: 92626-2348 Owner WALDEN, DAVID LTR Address 1780 PANAY CIR Phone: P COSTA MESA,CA Zip: 92626-2348 '�4 Contractor OWNER-BUILDER �y�' O y2'"°� Address: $ ' ,,, j " Phone: 0� I�.IMU1 Zip: License: 000000 • Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT. DEMOLISH EXISTING 461 SQ.FT.SHOP BUILDING ON RESIDENTIAL PROPERTY. EXISITNG RESIDENCE AND GARAGE TO REMAIN. NEW SHOP BUILDING TO BE CONSTRUCTED.APPLICANT WILL CONTACT AQMD AND OBTAIN NECESSARY PERMITS(IF REQUIRED). APPLICANT WAS GIVEN THE AQMD FORM. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $1,000.00 Permit: $38.75 Claim Valuation: $1,000.00 SMIP Res: $0.50 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 • Total: $39.25 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codas, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of thisrpermit. FOR INSPECTIONS CALL: (714)754-5626 2446.46(6/00) // DECLARATIONS WORKERS'COMPENSATION DECLARATION: L. I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) • I certify that In the•:rformance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation le .I California,an gree tttt if I should become subject to the workers'compensation provisions of action 3700 of the Labor Code,I shall forthwith • comply with ih:j,. oWsi�1. `7't��� Applicant Signatur: p� / Date: / Zl/a— WARNING:FAILURE T.SECURE •- ERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO Rita PENALTIES AND CAVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,030),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECRON 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.N Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: _ Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business end Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a,signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business;and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I,as owner of the,property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement Is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license • rsuant to the Contractors License Laws.). ❑ I am - pt u s... Business and Professions Code for this reason: Signatur.. Lc. Jr At IL - Expires: S 025 Verification of Ownership by(type of doc ment,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes —121-NO---- (Section No(Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health end Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? (P Yes 0 No (Section 65850.2 of the California Govemment Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If'yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air(Duality Management District or other air pollution control district or agency Is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 1:1 Yes 0 No 8 (If"yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERf1FICATE•F COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agr:- o comply ps withallstate law and city ordinances relating to building construction,and authorize representativ s of the City of Costa Mesa to enter upon the above-des •:••prop r' Eon ores.I agree not to occupy or allow occupancy of any building authorized b��is r until final inspection. SignatureOf Legal Owner(s) 0-6Date And/Or Authorized Applicant Date ;ODE L INSPEODONTIPE PATE I1:OhlAI& CODE I INSPECTION TYPE RAIL Pmiw.S 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy J etre, 4 / diet ?ilea Fade" Vice:ltha. t , OWNER-BUILDER 1 1��,, x. VERIFICATION A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner-builder verification. Attention Property Owner: , • An 'owner-builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to pr vide the major labor and materials for construction of the proposed property improvement Yes ❑ No 2. 1hC9rhave not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firni) to provide the proposed construction: Name Address City Phone ( ) Contractor's Lic. No. 4. 1 plan to provide portions of the work, hut I have hired the following person to coordinate, supervise and provide the major work: Name Address City Phone ( ) Contractor's Lic. No. 5. 1 will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work 104246 (REV.9/98) (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 1780 PANAY CI SHOP 13912216 Applicant: WALDEN, DAVID L TR Address: 1780 PANAY CIR COSTA MESA, CA Owner: WALDEN, DAVID L TR Address 1780 PANAY CIR COSTA MESA, CA Contractor: OWNER -BUILDER Address: ISSUED BY: Phone: 714-979-8672 Zip: 92626-2348 Phone: Zip: 92626-2348 Phone: Zip: License: 000000 Status: ISSUED Applied: 11/25/2002 Issued: 11/25/2002 SCOPE OF PERMIT CONSTRUCT NEW 384 SO. FT. DETACHED WORK SHOP. 176 SO FT. PORCH ATTACHED TO WORK SHOP. REF: MM -02-34. EXISTING WORK SHOP TO BE DEMOLISHED UNDER SEPARATE PERMIT. ELECTRICAL TO INCLUDE: 11 OUTLETS AND 2 SWITCHES LOCATED IN THE NEW SHOP. REF.: B02-01774 03/24/03 REVISED: UPGRADE SERVICE TO 200 AMPS AND ADD A SUB -PANEL UP TO 200 AMPS. NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2"6-48(8/00) FEESUMMARY Quantity _ Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test $0.00 Busway /100 ft $0.00 0 Res. a/c package $0.00 Standing Section $0.00 0 New Res (1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res (3+units) $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 Lighting Fixts $0.00 0 .................up to 50 kva/kw $0.00 0 Recept Outlets $12.10 11 .................up to 100 kva/kw $0.00 0 Switches $2.20 2 ..................over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System / Ckt $0.00 0 Service to 200a $30.50 1 Misc. Conduit $0.00 0 Service to 1000a $0.00 0 Misc. Conductor $0.00 0 Service over 1000a $0.00 0 Circus ( gen or ride) $0.00 0 Motors to 1 hp $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2"6-48(8/00) WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are'. Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) I certify that in the erformance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation la f Cal' rola, tl gree that if hould hoc subject to the workers' compensation provisions of action 3700 of the Labor Code, I shall forthwith comply with th rovis' s. Applicant Signature Date: Q �. WARNING: FAILURES ( SECURE WARNERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL IDSUEUECTFOR I N EMPLOYER TOC INAL PENALTIES AND CIVIL FINES TO NEY'S HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3106 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: - I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. k Class a Contractoes Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license p uant t Contractors License Laws.). ❑ 1 am ex un a Business and Professions Code for this reason: Signature: Date: Owner ID ve led by drivers license. ❑Ves ❑ No Drivers License No. Expires: O Verification of ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .............................................................................................................................................................................................................................................................................................................................................................................I............ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..................................._..................................................................................................................................................................................................................................................................... _......................_...................................................... 3 Does or will the applicant or present or future building Occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..............................................res'..................................................ti"o*....................................................................................................................................................... ith-............. ............................................................................................ 4 If en RMPP is presently required, hes Section 25534 of the California Health antl Safety Code been fully complied with? ❑Ves ❑ No ..................................................piel............................................................ ildi........................................................................................................................................................................................................................................... difi................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject age of this a plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes L-1 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .......................................................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this pernit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). ....................................................................................................................................................................................................................................................-................................. .................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have an of the disclosures prescribed by California Health and Safety Code Section 42303 been made7 ❑ Yes ❑ No ..........................................................................................................................................................................................................................................................................................................-.............................................................................. 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree t comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above -describe operp in;;pec' u es. agree not to Occupy or allow occupancy of any building authorized by this permit ntil final inspection. Signature Of Legal Owner(s)—`Date And/Or Authorized Applicant Date CODE 0 IRELCQ11 TYPE DATE DIALCOQE#i INSPECTION TYPE 2AM IdjITAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Budding/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: 1780 PANAY CI SHOP 13912216 Applicant: WALDEN, DAVID L TR Address: 1780 PANAY CIR COSTA MESA, CA Owner: ` WALDEN, DAVID L TR Address 1780 PANAY CIR, Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 1 00h Communication drops Sub panel to 200a Pole Light Pkg COSTA MESA, CA OWNER -BUILDER Phone: 714-979-8672 Zip: 92626-2348 Phone: Zip: 92626-2348 Phone: Zip. License: 000000 Status: ISSUED Applied: 11/25/2002 Issued: 11/25/2002 ISSUED BY: SCOPE OF PERMIT -- ELECTRICAL TO INCLUDE: 11 OUTLETSAND 2 SWITCHES LOCATED IN THE NEW SHOP. REF.: B02-01774 I -" "" ' - -I -- - .n..- .. - $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 ��$0.00 $12.10 $2.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY Quantity I- 0' t SCOPE OF PERMIT -- ELECTRICAL TO INCLUDE: 11 OUTLETSAND 2 SWITCHES LOCATED IN THE NEW SHOP. REF.: B02-01774 I -" "" ' - -I -- - .n..- .. - $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 ��$0.00 $12.10 $2.20 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Quantity I- 0' Temp Dist System / Lighting 0 Busway /100 ft 0 Standing Section 0 Misc Electrical Equipment 0 Transformers up to 1 kva/kw 0 z . ",' . ...........:...:up to 10 kva/kw 0 .............::..up to'50 kva/kw •. 11, .................up to 100 kva/kw --, 2 ..................over 100 kva/kw " 0 Low Voltage Equipment - 0 Low Volt Wiring System / Ckt, , "0 Misc. Conduit - 0 Misc. Conductor 0 Circus ( gen or ride) ." 0 Circus (mech ride or lights) ' 0 Christmas Tree Stand 0 Fireworks Stand 0 Other Electrical Fee 0 0 Investigation Fee 0 Plan Check Fee 0 Reinspection Fee Quantity $0.00 0 0' $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 ' ' 0 $0.00 0 $0.00 0 $0.00- 0 $0.00 0 ,�- $0.00 0 $0.00 0 $0.00 0 ' $0.00 0 $0.00 0 $0.00' 0 $0.00 $0.00 $0.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7645626 % 244648(&00) DJECLARATIPINS WORKERS' COMPENSATION DECLARATION: r I hereby affirm under penalty of perjury ona of the following tlectarations. ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permft is valued at one hundred dollars ($100) or less.) I certify that in th ertormance of the work for hich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation I of California, rid agree t If I should become subject to the workers' compensation provisions of action 3700 of the Labor rode, I shall forthwith complywilh t12 routs Applicant Signatu Date: rr Z f WARNING: FAILURETVSECURE WODDITIO CO T E COS ON COVERAGEMPENS T UN, AWFULDAMAGES S A SHALL SUBJECT I N EMPLOYER TO C IMIHE ABOR CODE, I AND CIVIL AND AS OP DONE HUNDRED THOUSAND DOLIARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 31060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. # Class If Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit su jects the applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pur ant to the Contractors License Laws.). ❑ I am axe undo A n n Business and Professions Code for this reason: Signature: _ Date: Owner ID verified by differs license. Yes ❑ No Driver's License No. Expires: L_,_z- Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title B, California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). Does or will h a 11cant or resent or future 61din occupant need to file are istration form for hazardous materials? Yes No 2 t o pp p g p g cutely ❑ ❑ (Section 25533 of the Callfomla Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .. ..............................................................................................................................................................................................................................................................................................................................-....................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ............................................................................................................................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 o.. the California Health and Safety Code been fully complied with? El Yes ❑ No ...................................................................................................................................................................................................................................................................................................................................................................difi............... 5 Does or will the applicant or present or future building occupant require for the work which is the subject a(- of this a plication asP No for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? � Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ................................................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under Ihis permit be within 1000 feet tram the outer boundaries of a school? ❑Yes ❑ No (If ryes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................................................................................................................................................................................................... ................................................. ........................... ............ .c t 7 If a permit from the South Coast Air Quality Management District or other air pollution control district n agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety been Code Section 42303 bemade? [I Yes [:J No B (If ryes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree A comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the abovo-descrirope ti p es. I agree not to occupy or allow occupancy of any building authorized by this permityUntil Val inspection. // & Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE L INSPECTION TYPEun IEITA4$ CODED INSPECTION TYPE PAM INTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 PoolSpa Final 208 Final Plumbing 1 ' " 200 Final RB-Roof 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ffdfLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 ,lob Address: 1780 PANAY CI Suite: Vicinity: Parcel Number: 13912216 Applicant: MARTIN, GLENN Address: 130 N GILBERT ST FULLERTON, CA owner: WALDEN, DAVID L TR Address 1780 PANAY CIR Zoning: R1 R1 Phone: (714) 578-0090 Zip: 92633 Phone: COSTA MESA, CA Zip: 92626-2348 Contractor: RENAISSANCE DOORS AND WIN Address: 130 N GILBERT ST FULLERTON, CA Zip: 92633 Arch : Address: Phone: Phone:. (714)578-0090 License:- 490375 Eng: Address: ISSUED BY: Status: ISSUED Applied: 12/30/2002 Issued: 12/30/2002 Phone: Zip: License: License: SCOPE OF PERMIT_ CHANGE OUT 11 WINDOWS AND REPLACE 1 LAUNDRY ROOM DOOR. ALL BEDROOM WINDOWS TO MEET UBC EGRESS REQUIREMENTS. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $7,000.00 Permit: $139.25 Claim Valuation: $7,000.00 SMTP Res: $0.70 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.95 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. 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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 !64646(6/00) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby all under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the perfor manco of the work for which this permit is issued. ve and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Sectio 3700 0l a Labor Code, shell forthwith comply with these provisions. Applicant Signature.. Date: 0 02, WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (s1DD,ODo), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lia p Class M Contractors Signature: �Q+�- ��-� Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property. am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder. I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a Permit to do such work from the division. Signature: Date: Division of Industrial Solely Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight or 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .......................................... ..............................................................................................................................................................................................._.......................... 2 Does or will the applicant or present or future building Occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a welght of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ..........................................................................................................................._.............................................................................................................................................................................................................................................................. 3 Does or will true ;TIP or present Or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an DMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ........................................... ..............................,.................................................................................................................................. ............................ _....... .......................................................... ......_............... ._............._...............................__. 4 If en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied"with? ❑ Yes ❑ No ........................................... . ................................................................................................... ............................. ........................... ........................ _..................................................................................................................................i................ 5 Does or will the applicant or present or future building Occupant require for the work which Is the subject of this a plication apor mit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 8 Yes LJ No (Section 65650.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). —.................._..........................................................................................._................................_...........................__..................._............................................o................................................_................._.............._..................__..... 8 Will any part of the facility to be constructed under this permit be within 1000 lest from the outer boundaries of a school? ❑ Ves ❑ No (If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................................................................................................................... __ ................... I .............................. ­­­­ ....................................................................................................... .................................................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ...............___................................___._.......................................................................__....................__................_._....................._..__..-____.,....................___.......................__.............._..............._._.......... 8 (If yes', artach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Data: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. � ^ Signature Of Legal Owners) I ^ -�)o 6 7Date And/Or Authorized Applicant --I Date CODE t. INSPECTIDN TYPE 24H BRIDALS CODE I INSPECTION TYPE 2&11 ILLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BIocWRetaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �t 204 Final Demolition 250 Final Building/Occupancy '✓ CITY OF COSTA MESA CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMENT P.O. BOX 1200 MINOR MODIFICATION Reference No.: Status: Applied Date: Approved Date: Denied Date: MINOR MODIFICATION NO.: MM -02-34 Project Address: 1780 PANAY CI Suite: Parcel Number: 13912216 Project Applicant: WALDEN, DAVID LTR APPROVED 10-30-2002 10/30/2002 PROPOSED MINOR MODIFICATION: TO ALLOW CONSTRUCTION OF A 384 SQ.FT. SHOP BUIDLING WITH A 176 SQ.FT. OPEN PORCH 8 FT. AWAY FROM THE REAR PROPERTY LINE (10 REQUIRED). REAR YARD COVERAGE IS OK AND THE ADJOINING REAR PROPERTY OWNER HAS AGREED TO THE 2' REDUCTION IN THE REAR SETBACK. REQUIRED FINDINGS:Y The improvement will not be materially detrimental to the health, safety and general welfare of persons residing or working within the immediate vicinity of the project or to property and improvements within the neighborhood. Y The improvement is compatible and enhances the architecture and design of the existing and anticipated development in the vicinity. This includes the site planning, land coverage, landscaping, appearance, scale of structures, open space and any other applicable features relative to a compatible and attractive development. PROJECT PLANNER: LEE—M NOTES: 77 FAIR DRIVE Building Division (714) 754-5273 Code Enforcement (714) 754-5623 Planning Division (714) 754-5245 FAX (714) 754-4856 TDD (714) 754-5244 Applicant to fill in all spaces except those within heavy border lines andsign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address• /%t-() ApplicWgt aiIin"ddress Owner's Name rb L-'�i4 LpPN Phone�� i see Ct Address / 7 P,�k PA'�✓RY G/2. Arch/Eng. License No. Address Contractor's No - Pho a W_?, V Address (mailing) Pr�0aa ��I��D�25 2l I", =/f DO %tE+'1�%l� 0_9 City License No. flay % 9c'.t2K LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. L CenS CCllass� Llceris^ 3 Date «��iF Signature WORKERS' COMPENSATION DECLAR IO lereby affirm that 1 have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section ,800, Lab. C.) Policy No. !J9 -"�S%�'i� Company ffal/lE Li4ND RCertified copy is hereby furnished. Certified cop is filed with the city Building Division. DateNS/r Applicant E%E TIO FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter, Improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of livision 3 of the Business and Professions Code) or that he/she is exempt ierefrom and the basis for the alleged exemption. Any violation of Section ,031.5 by any applicant for a permit subjects the applicant to a civil Eenalty of not more than five hundred dollars ($500). L I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Levi, does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, Provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is Sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ I, aS owner of the property, am exclusively contracting with licensed con. tractors t6 construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who build$ or Improves thereon, and who contracts for such projects with a con- tractor(,1 license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have rea Information is correct. I agree to and slate laws relating to puller sentatives of this city to enter Signature Drivers' t 1 this application and slate that the above - comply with all city and county ordinances 9 construction, and hereby authorize repre- y�on the above-mentioned property for Date Z91 ,gr � TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION u REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P_# DESCRIPTION OF WORK/USE OF BLDG. A?-- )ZOO/' S Main Building: E TYPE OF PERMIT GRADING FOUNDATION LJ STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear OTHER /COOP/NG- A PROJECT DESCRIPTION SO. OCCUPANCY -7.— K Right CONSTRUCTION TYPE V VALUATION$ i OC)O• $ Left ZONE GRADINGCU.YDS. ACRES Ping. Ref. =0 Remarks: ,Planning Notes: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee 1 $15 Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG # Heating System & Ducting 110.100,000 BTU 0100,000 BT Reinspection Fee 1 $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink -- Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto -Wash Laundry Trays Issue Fee 1 $ 3 Hood or Type ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,000BTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee 1009 9/27/85 Zone Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washer Transformer ❑ 15.50,KW Construction Pole Sub. ❑ 50+ KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100amps Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00.1 HP 0.1'h - 8 F.A.U. Inc. Solar 09-15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range - Switches Sign Garbage Disposal ;Standing Sections Generator 00-5 KW 05-15 KW Trash Compactor 550:0 TL FEES Z O N I N G R E G M T. S ' FEES Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By Date Date Date BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUM ARV F FEES $ �• $ $ $ $ $ $ $ SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTALFEE $ $ $ $ S. $ �1 s SV 3 i $ 3 • • CONSTRUCTION AND PLANNING PO( SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Teiporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. El3ctrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement • 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation i. 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 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 67. Fencing &Access Approval ' 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil • :23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof 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 ISSUED 33. Final Electric Notes: g /%a� DORY, niT fo rcv�l/117� . dr 34:Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation - 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING p-I; kr 4C" j .48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. •Date - CITY OF COSTA MESA CALIFORNIA P.O. BOX �1200 FROM THE OFFICE OF THE PLANNING DEPARTMENT March 5, 1966 Claude Schoaert 1780 Panay Circle Costa I-7esa, California Dear Pool Owner: The Costa Mesa Planning Department has been notified of the completion of your swimming pool. So that your pool will be a safe one and for the purpose of advising you of your responsibility regarding the requirements of the Costa Mesa Municipal Code, we quote Section 9298.9: 1. No swimming pool shall be constructed closer than five (5) feet to any property lines, measured from water line of pool. 2. No swimming pool shall be constructed under any electric power lines or on any electric power easement. 3. No swimming pool shall be constructed unless the yard surrounding such pool is completely enclosed by a fence six (6) feet in height and has a self-closing and locking type gate or gates. This courtesy letter is directed to you so that you will be aware of our ordinances and can make a complete safety check of your pool area. Sincerely yours, William L. Dunn Director of Planning H. LAWMASTER & CO., INC. 0 7940 MAIN STREET — STANTON, CALIFORNIA 67CMS-186TT-002 828-8040 Field Data on Test Specimens Core Concrete eunXte Grout/Mortar— Project C. Schonert Pool Permit No. 27729 Project 1780 Panay y Circle Costa Mesa Contractor Anthony Poole Architect 2–#1 Shallow end Location in Structure 2-2 deep end 2–f/3 bond beam Engineer Adams Date Moylded 11/14/67 No of Specimens 6 Slump Specimens Marked Specified Strength at----2B—days 2000 P.S.I. Mix Designation Age to be tested_:Z--days 2ndays day's days nGAnv u1V MIA IT ACCnCI ATC C! I In/`C .._._. ...... ._.... ..__..__. .._ ___..__ I ivin$At.an 3842 3845 Weather Condition Fair cool 1 Yd. _Yd. Batch Cement Permanente Type I Cement, lbs. 151 eke --11121 Admix Sand 38 ton t; -Q7X1 Specimens made by Greaux #4 No further test ?R28.7.5 Data by #3 Ilrea rid E D-- 71,500 71,500 Delivered by #2 JILDING SAFETY DEPT. 2,529 Date Delivered # NOV 92 1967 REMARKSW/ Water, Gals. FM .IIO (1 Si a ✓.Et Lab. No. Date of Test Specimen Dimensions Area Ultimate Load Lbs. per sq. in. H/D Corrected Shallow end Deep end Bond beam FOR LABORATORY USE ONLY 3641 3844 3842 3845 3843 3846 Day Test I Day Test 7 Day Test Day Test --11121 11/21 t; -Q7X1 6.05XI3 No further test ?R28.7.5 Ilrea rid E D-- 71,500 71,500 66,000 78,500 B JILDING SAFETY DEPT. 2,529 2,334 2,776 NOV 92 1967 AM In FM .IIO (1 Si a ✓.Et n LCf (34UI u, .... -.. . . . . . _.. �i Ga 3 Claude C. Schonert GENERAL CONTRACTOR Costo Mesa, California Building Department Costa Mesa,California 1784 Panay Circle 5460094 7 i1 I Claude C.Schonert, owner of property located at 1780 Panay Circle, Lot 172, Tract 3363, Building permit nufaber 2684-7, acknowledge the drainage problem existing on this property. This situation will be corrected ( weather per- mitting ) within 20 days. Sincerely `Lours, Claude C.Schonert pDREssoFeaLaND: 1780 PANAY CI UNIT. CITY OF COSTA MESA — BUILDING PERMIT a98 - ooM6 INNERS NAME IF 10A1WN: WALDEN, DAVID L FPERM NO, B 087384 "°ORE'S' WALDEN NANCY L 1780 PANAY CIR PERMIT NO: B 087384 PLAN CHECK NO: 01066-98 S GOVT: N SUPP: N "pL MMura"DDREss: COSTA MESA, CA 92626 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH ARCHITECT OR ENGINEER: UC NO.: JOB DESCRIPTION 11OLF CITY STANDARD BLOCK WALL SQ FT: 110 ARCH OR ENO.'' ADDRESS: um. coNmAerarsP•••. TONY CONSTRUCTION (719) 972-8566 CLAIM VALUE: 2,200,00 CALC—VALUE: 2,200.00 GROUP OCC: R-3 / ca J11=01sMMING 420 S SPRUCE ST COMMENTS: CITY STANDARD BLOCK WALL wDma SANTA ANA CA 11CNO.: 692332*�' - -iF tE-)Ejt-)t 3E x-�(-at aE at at RE 9t iE 9E if jE at aEaE if aE jt it*iE)k it jt jt aE iF at K-atx-x-x-�Ex-tt jt SE 3t irk ar iE at iE iE*at iE 9t x-ifx-dt iE if 9E at 9E N-aE jt *jE iE it+E x-aEx 92703 UNIT. Z O N I N G R E Q U I R E M E N T S LICENSED CONTRACTORS DECLARATION: 1 hereby Nim under penury, a perjury Met I we licensed ender W.W. a Chep« 9 S E T B A C K S (axwom oN with Section 7000) a Duni.. 3 a IIu Bus— vM P":Z0, . my Lunw a lel Ml Most W N«a. CRY UC. NO.: - LID CLASS' .NO,1---------- ------ 59__8�Cy, C 2 6 EXP; 03/98 FRNT: ----FT MAIN BUILDING --- ACCESSORY BUILDING--------- Date: /��( g c r FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDIR DEC RATION: I hereby elfim under WAYp I. the Comred. Bowe Lew 1« the fa0owiIi meson (Semon 10315 Businae and Pnlewlom Code: Any My or county which le.ures a mesa to mmV W. N«, hngwe. demolish.. mom lig Immune. prior to n imumoe. emit remdlee lM awiown M« mNl panne to nue a signed ebtemem Ma he«end PARKING REQ: PROV: PARCEL: 13912216 ZNE: R1 REF NO: a licensed Mmuent 1. IM povislons of tM Contract.. Unum Law (Chagm9(oannuma, with Sedi.n 1000) ol Division 3 of the PLANNING NOTES> 110 LIN FEET OF 6 FT HIGH BLOCK WALL ON THE INTERIOR tOTLINE Susnew and Pralawmm Code] or thw M m she m wemp therahom and IM Mss 1« One aM9ed wwnpMn. Any violaan of Seoion > LOCATED 20 FEET FROM THE FRONT PROPERTY LINE, TJC 1031.5 by my mpium Im a pemul wNmA IM MPIX4t to A dd Pmullly a not men then fee hundred dollen ('SDOD. ❑ I,esowmajnsWoPmy«mywoloem,Min w'agesas their wile ampetemon.wlldothe o ,end One eMctunerheintendaO iEit k*REiEjEiElEirk9EiEirkiFRE3ERElk9E9EdF9EiFitRERFiERtihdi9tRt9ERtirkitdbytRkRiiE9E9E9EdtdEjEihiERkhEiE**RE 9EihiE*iElEk9EiEi dFREdidEdF*iEiFdkdhiEitiliE or offered lar we(Secl 704,1, Business and Prdesilons Code: TNe Cordoolon Lioeme Lew Com nol apply to on owner of popery 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 wM Wide m m,novem tMrean, end ehlo doss suds kdc Nmeeff or hoses# or,hr«Gh he or Mr own employees. Provided ter w 1, impr.w,neme web imaMed or d*dd Im sale. N. however, the Witlup «inProrm^sol m mad within one year of c.mpbtion. the ownerbuiLtm wRl M. One Laden of p,ovirq Ila or shs did not Wild «'vn,wwa for the peaposa of we). ZONING APPROVED BY D \[., DATE: -3, ❑ 1, e, neem, a,M mopeny. we esdwevdy o runctep wind Hommel co actom to oomm d Ms mole. (Sedan IOM, Business ere Prdewam Code: The Comracton L'cmue Lew does not ap*to apopmry whit tadkb «impwesthereon and vend BUILDING APPROVED BY : DATE: cmdracts 1« mdl projects wish a omenectorm) liowueE pun Con, a Lew). ❑ lam awn wMet s ion �' o.&E..C.. than APPLICATION ISSUED BY: DATE: Dab:1244_Owawr: *iF iE DIF iF iE aE iE iEib iE iF-1E DIE irih NFiFj(-ik Rt RE iFiFiF7FiFiFiF7fiFiF iF7F7F7F iF±FiF3F±FisisiFia 7aisiF3FiaisiF RE iF yEiEaE DIE iE 1l lElt��jF1(- LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y I do hereby :edify Met em eveane d end undemand the .Nui.m Cafoma Saay Code Sedum 25505. 25533, end A' 2553,1, and IMI I «any Mum W I&W covmm will I will not (dma one comply h said date codes and the .quinmena ler talc - epmdl«lqulNdlon«modifiwionhmnlM/vy awprmnt Digrkf. Raddenlid axtmnapn eppiwloroua ewmgMmnthew BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 74.75 .50 Date: Applicant: " ' SM I P / NON —R E S WORKER'S COMPENSATION DECLARATION: I hereby affirm vndm penalty of pmiury ane of the following dectanmiom: PLAN 48.59 �✓' ❑ 1haveendveil meintacacwffcaedC mnitoseff♦munlerwakma'compwwlon,mpro Mi«by S« 3100dthe Lebo, ISSUE FEE Code. 1«tMmdannaK.wlMw.kl«wnphMiapemni3 Issued, BUILDING—DIV—> PERMIT ISSUE PLAN—,CHECK TOTAL PAID DUE ❑ IMa«dwumemailw«kaAompwmmhwumn...asmquindbyswion37WaM.LwwCode.Mrthe pmbrmmbaoftM TOTALS ---- > 75,25 0,00 L,48,59 123,84 123.84 ,00 work (w which this peril is iwued. My waken' oompnwion I.... comer and polity number me: Carter: REVENUE DIVISION TOTALS--> COLLECTIED: 123,84 OVER/SHORT: 00 PolicyNumbm: BLDG PMT PLUMBING ELECTRIC MECHA IC FIRE SMIP/TOT GRADING PLAN—CHECK This'adroit need ndW comgefed / the prosk he roc ons hundred dellen I$IWI or low.) 74.75 �I 50 48 .59 cI omlty that in Me pedmmence of the wmk 1« whch Ihis prmh Is issue mqq in my manner eo m to ,- becomeeubjedorkm lolhewe'compenwl.n Inco' d CWoma, epr thatIeMuld be wbjed to the workers' DIE iE elk 9i iF*irk iE iE RE DIE iE irk Ri lir lE iF iE iFlFikfEiFlFiEfEik it iF 3(-lf hf-if iflEif if i(-Mif it iE if if lklf iEfEiilE7E i(-iE iE iElEiE iF hE iE iffEiF iE iF lEhE if-1FiL-)f 1EiE iF if iF iE ifM compwlwgoweNes d ion 3100 ol the Lab« Code. I shell N � Owe: io S Apgiwd. I N D I V I D U A L F E E- h 'B R E A K D O W N Wmnhv: Fal rso,ew. o*m,vwyFwwtlon pwerape /e un sHlf a,dlect an I romlMvlpwultlw arae TYPE QTY D E S C R I P T I 0 N ' UNIT COST TOTAL COST /// clvll Dens Iq ro pa huntlred 1NouMrd tlamn (SfOg000f, M atrll of ro R da/rle9se a ppvltlW ler In 3wtlpn 3ldSol MS Labor Cod, InbnaL antl ettomeyi/eeA SFR 110 RES—CONCRETE BLOCK WALL' FT. 20.00 2,200.00 CONSTRUCTION LENDING AGENCY: I hereby ahem under penalty of perpy tna Ther. Is . oamrualon lending aLlwy for Me END -OF FEES, pap emm<e of the wok ler which the perk m awed (Section 31191. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I cmurty Mm I Mve red this application and stele tMl the above id«m lion a const. I eine to c«nPly with an dry end county odMancw und sun new mi i g to With, ameouoeon and Namby eubmixe repreeenletives of this any 10 anter upon line shwa-IIIw1iNlBd popery i - 1«vspoion xnpotum. TAKAPU 03-19-1998/03:23 PNA123.84 I Name / Dam: PERMITe087384 Sc A9enVAppYpenlR.waradm WMe-wildim & Solely: Grwn-Fde: CuuryJupimn: Hnk-Rmwaw: Oddweod-Nsew« CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL N SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -' .53. Steel Reinforcement - 3.'Electrical Conduit Utility-Undrgind. 54. Forms - 4, Electrical Conduit-Undrgrnd. •% 55. Electrical Bonding ' 5. Steel Reinforcement ��- 6,ro* 56. Rough Plumbing & Pressure Test ' -6., Electrical OF ER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 3�W'.gp 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, ❑-Undrgrnd. 10. Structural Floor System .' + 61. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final- . 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 S 16. Rough Electric Wiring - 67. Fencing & Access Approval 17. Rough Wiring Sign 68, APPROVED FOR PLASTERING 18. Rough Electrical-7 Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating,& Air Conditioning, FIRE DEPT. REQUIREMENT APPROVALS ' Permit # 20. Rough Factory Fireplace 21. Q.uctsl in Structure • -_ -. - . 70. >Underground Hydro 22. Ducts, Ventilating _ 71, Product Piping OGas 00il 23. Gas Pipe-Rough &Test 72. Underground Flush _ 24. Roof Framing - 73. Undergrnd.StorageTank OGas OOil 25, Roof 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 ISSUED -33. Final Electric Notes: - 34. Final Heating &Air Conditioning' - 3 zo, ,24e,,Q_ 35. Final Gas Pipe-Test / 36. Hood or Canopy 37. Final Factory Fireplace ���------���- 38. Final, Plumbing 39. Water Service-Final 40. Gas Service-Final ' 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation -- - 44. Landscape Irrigation System- 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edson 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date ,v)LL-t 3301301*39 Y*1 W.m � 133M15 0'U ` oBLi "-9 3aM30133Y 30*30133Y =0301t3Y 2 DIVISION OF BUILDING SAFETY CITY OF COSTA MESA APPROVED "hssetof Date r:lako m'y or sID"Woations MUST be kept on this jobat ap l mas and d s unlaw4W to and Safety Cfij of Costa Mesa. ion on same w"" written Pa�lmis*ntrtram (he Divisian of B iklhg cfthen'vualgc!ton h'sptanandVecifiratiomSIHALLNOTbehoM� pe�or�bea °i P hal; e ns COSia Mesa Ordinance an approval R:asn plzri and permit shaCarpcz hp w;nijl„•'ep, y„d become DO and/or Slate law. andmditthebuiklsger �?07 !;t} w hin 130 days of is>unn; e, PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into this _/ q _ day of Rd RC H , /999 , by and between —"4V9N hereinafter referred to as "LANDOWNER," and //9/J hereinafter referred to as 'ADJACENT PROPERTY OWNER" It is hereby agreed that a party wall will be constructed on the property line between /'15'0 P,41V A ? elle C 4, h:- �o5r� mEs� CA_ in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Book , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. k LANDOWNER - (S azure) Nf!/✓C Y I-, Gu A U N Name (Typed or Printed) ADJACENT PROPERTY OWNER (Signature V. /J%RRJ D R/,e7 W!� t q Name (Typed or Printed) (Address) / (Address) NOTARIZATION REQUIRED anr•-my STATE OF CALIFORNIA COUNTY OF ORANGE 1 ss. 1 On March 19, 1998, before me, Elaine Steinhardt, a Notary Public, personally appeared V. Marjorie Williams and Nancy L. Walden proved to me to be the persons whose names are subscribed to the within instrument and acknowledged to me that they executed the same in their authorized capacity and that by their signature on the instrument the persons or the entities upon behalf of which the persons acted, executed the instrument. WITNESS my hand and official seal. (Seal) ADORESSOEBUILDING: 1780 PANAY CI MEWSNAMEIFKION11: WALDEN, DAVID L ADDRESS: WALDEN NANCY L A 1780 PAANAY CIR COSTA MESA,CA RK. fW UNG ADDRESS: t 11!!1 ECT OR ENGINEER: ARCH. OR ENG.'S ADDRE59: UNT: 92626 uc. MD.: UM: cwmxTcasNANE: RENAISSANCE (714)578-0090 CONm1CT0RS MAIUM 130 N. GILBERT AD911Ess: FULLERTON CA uc.ND.: 490375 92633 UNIT. UCENSEO CONTRACTORS DECLARATION: I h«eby elft. undo penalty of perjwy Mel I am Icensed under poveba of Chapter 9 (commending with Section ]000) of Division 3 of lha Business and Professions Code. and my Ikeue is in full face cod Mae. aOWR o.:0520006 uc.cLAss:B /UC..NO.: 490375 EXP: 11/97 ^�\—qn Cdamous �R^4tlay%..lp L.H yeftQ'v ILDER DECLARATION: 1hereby affirm under penalty d al tout I am oeenpl been the Cara t. License law f«the mon (Season ]031.5 flwives and Professions Coda: Am' city or ooumy offset mqu'ves a penes to oral upL slf«, imrov. raper any, aMatum. pror a M i sawn, sem mules IM applicant f« such pwmM to fib a t geed staemenl that he «she b licensed pungent to the Wayhoorw of the C«araa«s lioense law (Chaplet 9 (conmerhong weh Section ]000) of Derbion 3 of le Busies and Prdennorm Cods] or this ha «aha b exempt lheminse and the be,.. for the Waged! exemplion. Airy violation of SWion 7031.5 by any epplicam f« a perenM subjeea lha applicant to a oeil Penalty o1 out more than Me hundred dollen [MI). ❑ I, as mater dtha pmpeM« my emplryeea set wages an their see mmpavmicn,Wl do the work, and the avuclum is rel intended «dlaned for sats (Section 7044. Busiaa od Professions Code: The Commas Umwe law does not apphyte an dahwa pmpeny, who W Wer or inpnwes Ma non, and cote does ouch wk himself «basset or Mmtgh his «her oat employees, pmrided tet such subsen Baas are not intended «dlered for sets. O, bons., the Wiking or knpmvrneM is sold within one years camplaion, the ownerbuildw will neve the Madan of posing he «she dk rest Wik or impmee 1« this Damese of sets). ❑ I, as oat« of the ampany, am uduaisely cordmctig with ftonnaed ounmxtaa to oomaysG the «ojea (Swfion ]mea. BusMwe and PMeasiou Coda: The C recto s Liwnea law does " apply to 0 owns of poperry offD Wilda or impnwes Moment and ate, oonawts f« such pgedis and a comme«(s) Icemad mosuam to lha Comred«a LMwnee law). ❑ I am exempt end« Section: B. d P.C., for this reason: Dae: Oar, I do hereby cw* that I am aware of and undsmland the mpdmmems of caaomie Neebh and Safety Coda Swfion s 15505. 25533, and 2553x, and that I «any tofu. Wiking ocement will / wdl nd (sets one) need ro comply with eek sols codes and to mluinmenb for .P hf« construction« moddiimtion h«n IMAk ue y anpemenlD Adri Reaken rel mnaruct. apWaliou an Pt hose Moe Out.: Appitsant WORKER'S COMPENSATION DECLARATION: I hereby efinm under peneny of perjury one of the following deduatlons: ❑ Iode, endheberfrteeacondmled co,y,Nth eelfinsum Mwaken'wrnpenWion.npovidad l«bit Saaion 3]x0athe Lab« Code, f« the pedonaxe a Me work f« conger this perms a iaand. Cl I hum and coil maintain wodmncompensation u re ' npenen insure, required by Seel 3]00 d the Labor Code, for to peal«mance a the 7C' w«k f« which due penrit is issued. My wakens eumpeneaion wassam i tender end poW.y number am: carder: GOLDEN EAGLE EXPIRES Policy Numta: NWC�TLS6 &R E 07/31/98 (This section need nod be completed Ate premk is br one hundred ddlem /$1001 «bio.) ❑ coney Ma in the pMomwxe a ore area f« whtsh Ihie pa es s, sand a I ehdl t a1 shook! any pecan in any mother eo u m become abion b the wf Section n 37W ofti a labor G CaI shaft and ogres this X hese meronts subject to this vemAen' compenaaion pmviaiwre of Sad'wn 3]00 d the tenor Cade, 1�eha+l�lMhwh�h oompy with rhos pm—vieime. ter: 1 Applicant:bun Waml : Fegun ro axiom I'l us s ($100,M), s la uliMe. 1, and oust/ sublets sy eenon, Mora cdmine p inadu end nes up of con Labor Co , kwand dofbm ($irmsys ), M eddltlon ro the cwt of romponuerbn, damage ode provided for In $xtlmn 3]0$ o/ Me Labor Cods, /nfMsL and enorney'a /cos, CONSTRUCTION LENDING AGENCY: I hemby affirm under penalty a perjury that thane is a cmnamdlon ending ageney for the performance of the wok for west the paints is issued ($open 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I here mad this application and mute that the above inf«mution is correct. I i gene to comply with all City end county eminence and state leve relating to building conmmetim and hareby mahorl repreanmtiam athis oly to enter upon the above-menlimned ymperry I« mapeaion purWees. GLENN MARTIN Dae: —0�) (515146 WP) WhMs-Buildvg 8 Seery; Omem.Fle: Cotwy-AppYran; Pink -Revenue: Gddenmd-Aeaa« CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 086026 PERMIT NO: B 086026 PLAN CHECK NO: 05108-97 S GOVT: N SUPP: N CONSTRUCTION TYPE: V PERMIT TYPE: STR PURPOSE: 0TH JOB DESCRIPTION R & R EXIST, SLIDING DOOR & 2 WINDOWS SQ FT: 3,000 CLAIM VALUE: 3,000.00 CALL—VALUE: 3,000.00 GROUP OCC: R-3 / COMMENTS: INSTALL TEMPERED GLASS FRENCH DOOR" NO MSTRUCTURAL CHANGES" Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: -PROV: PARCEL: 13912216 ZNE: REF NO: �„ PLANNING NOTES> r 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 /mac ZONING APPROVED BY l DATE: BUILDING APPROVED BY_ DATE: APPLICATION ISSUED BY: DATE; +' # # ## ##### #### ## # ######3F3E'iFiFiFiF"iF'iFiFiF3F?F3F3t3F7F3 7F3F�F iF3fTFiFiFiF3iiFifiFiF# # ### # # # : # # # LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y PERMIT BLDG PMT 74.75 PLAN 48.59 ISSUE FEE PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING .50 SMIP/NON—RES BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 75,25 0.00 48.59 123.84 123.84 .00 REVENUE DIVISION TOTALS--> COLLECTED: 123.84 OVER/SHORT: .00 . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 74.75 ,50 48.59 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 3000 ALTER BY VALUE RESIDENTIAL NOZONE 1,00 3,000.00 END OF FEES 12-04-1997/10:3tl WV$123.84 RCPT4:01-0016354 PERMIT:086026 CONSTRUCTION AND PLAN NINGi APPROVALS Permit # Date Inspector POO, h SPA APPROVALS Permit # Date In{pector ,, e a 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location•-, a�R 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' t 3. Electrical Conduit Utility-Undrgrttd. 54. Forms 4. Electrical Conduit-Undrgrnd. .\ 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure'Test i 6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59, Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. ' 1 60. Backwash Lines, P-Trap, O':Ndrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK Ti-. Property Sewer Line & House CoAnection 62. Backwash & Receptor-Final j 12. Sewer Cap "'' 63. Heater & Vent-Final 13. Roof Drains - '4 64. Plumbing System - Final h Plumbing 14. Roug y t 65. Electrical-Final 1 15. Rough Electrical-Conduit - 66. Solar System-Final ll; • 'y 16. Rough Electric Wiring 67. Fencing & Access Approval _ 17. Rough Wiring Sign ft' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping El Gas OOii 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOii 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing `L��.� L�6ZAj0(--_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 ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy - 37. Final Factory Fireplace-• 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING /�Q L 48. FINAL PLANNING 49. Electric Release to Edison r a 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. __ Date -' `-' 1ie11nissnncr. - ` ' - . IJoors6•WinciJws � � '' '' 130 N. 11, CAI Shm2633 WSTOWER. ONI:II NAME' FUllorlon, cn rizcaa 1-------- (714) 570-0090 CONTRACTOR'S LICENSE 0490375 DIRIiCTI"NS: PHONE: 71 9Z2 -2G7 " AssrssoR's rnnc�---•----- [�I,q�r t�t,nr� t°:�ic_n.[;,t;_-ur(z.I�s ur•._trry� rt►ufl��•_t�t_u I. PILL OUT 'fill. STREET NAME 7.. SHOW SIZE OF UNIT G LOCA'T'ION OF MOONS IN THE HOUSE 3. SHADE Irl THE AREA OF NEN UNIT 44 IDENTIFY THE DISTANCE BETWEEN HOUSE AND PROPER'L'Y LINK IN ALL DIRECTIONS: FRONT, BACK, SIDE. 5. LABEL DISTANCE 11E'1'I.IEEN HAY F HON AND THE PROPERTY .LINE•. G. SHOW PON FAIL HAY b HON PROJECT OUT 7. GRAN A ROUC:N OUTLINE OF THE HOUSE CIT1T Y DMSI OF BiJZD1NG SAF= y OF COSTA McSA r APPROVED rn-c7a - Ccle 114 r: izc lact gar..^ c.J` C' c Y ` � d' � 0mfi � c7sJc5cf� G,r d� r ca d Cu.' 3 cnd Sc.e maw. �rr7tc v $�i ed c'' Lya cid bac' `arrt Sli! LL Ley cf C7 3 y �° Xo L- xi deny Crov ^tea d cnyt to xmY or. 3 r. # ix �.tl p."nr:Y clk.7 cmiro If c,n� cr syc+tc i; rtct comms' (� wiilt n 160 d&Y3 0l Lw ,� M4 End vo!d �_-fx3. P_r u;c r 'Ar f —2 S C) � N �_c:112 RGE'1' NAME OMAN I Nu NUT TO SCALE /D o k.0 6A S.C.L. Renaissance Doors & Windoi Corporate Offices and Factory 130 N. Gilbert, Fullerton 92633 (714)578-0090 Fax(714)578-0208 '= Showroom Locations &2—cl 1 18449 Brookhurst, Suite 11, Fountain Va. „ CA 92708 (714) 968-8866 • Fax (714) 968-4 090 23812-A Via Fabricante, Mission Viejo, CA 92691 (714) 380-9550 • Fax (714) 380-0106 1022 N. Tustin Avenue, Anaheim, CA 92807 (714) 632-8226 • Fax (714) 632-5198 385 Lemon Averwe,y'G" Walnut, CA 64J89yR09) 598A39 • Fax (909) 598-8896 Sales Person Address %% O ?Aea If City C % M . Map Q. 54�' of Home Phone (21� ) L94 -672 - Work Phone (__ ) Previous Customer Previous Customer Yes Exterior Swing Wall Thickness: Interior Swing 8' 7' 6'8' 2.1 Year Upstairs DownD 2 4' ns a cation: Glossary (25:'Screened A = Active X = Casement goes with # D = Dummy (2)Fixed 6' Y' 6' 9' to, Door Size: x R. O. " x WAATAER EXPOSURES ORIENTATION N "S (D W 5m (HRS) 2, 4, 6, 8, 10 Rain None Li Heavy Gutters- No Overhano ITY��\ No Size No Permit Renaissance Pe it Customers Permit Set On Countertop Tile Into Cut -Down CN -Down and Une-Up Bars Remove Kneewall Remove Post Remove Wall New Header_ x _ Shear Panel Build Wall Fill-in Opening Pick up by Customer Deliver by Renaissance 14' 15'1 16' Sidelite Size: x Wood Species Oak r BrassHardware IN Electrical Yes You are Levers Knobs Pull an le t w c for t co or z color s Color S Custom INTERIOR Pai Stain # of Plugs If of Wires looking Manufacturer Raised Panel A or B Glass /D (, , e 4 # of Switches #of ext. Lights at the 5' din Hinged Fixed P.O.# INT. MOL ING aint Stain # of can Lights drawing a e ded Thum or Key onI from the Window Fixed Garden EXTERIOR /Paint Stain Plumbin° Yes /11118108 4' Key to Customers Key? Yes' o of Key Alike? Yes No # of Keys Needed Reroute Vent Pipe only house 3' EXT.MOLDI aint Stain Height O Floor Hinges N.R.P. Butt 2.1 Year Upstairs DownD 2 4' ns a cation: Glossary (25:'Screened A = Active X = Casement goes with # D = Dummy (2)Fixed 6' Y' 6' 9' to, Door Size: x R. O. " x WAATAER EXPOSURES ORIENTATION N "S (D W 5m (HRS) 2, 4, 6, 8, 10 Rain None Li Heavy Gutters- No Overhano ITY��\ No Size No Permit Renaissance Pe it Customers Permit Set On Countertop Tile Into Cut -Down CN -Down and Une-Up Bars Remove Kneewall Remove Post Remove Wall New Header_ x _ Shear Panel Build Wall Fill-in Opening Pick up by Customer Deliver by Renaissance 14' 15'1 16' Sidelite Size: x Wood Species Oak r BrassHardware IN Electrical Yes Mahogany Other Levers Knobs Pull an le t w c for t co or z color s Color S Custom INTERIOR Pai Stain # of Plugs If of Wires DOOfS 13/8 // 3 '` Manufacturer Raised Panel A or B Glass /D (, , e 4 # of Switches #of ext. Lights Stock��jj��PP # l Deadbolt Ih7Lte/e din Hinged Fixed P.O.# INT. MOL ING aint Stain # of can Lights Sin I Double Cylinder a e ded Thum or Key onI Exterior Lights to be supplied by Customer Window Fixed Garden EXTERIOR /Paint Stain Plumbin° Yes Bay asement ding Key to Customers Key? Yes' o Bow Awning Stacked Key Alike? Yes No # of Keys Needed Reroute Vent Pipe only Does Eg ess Apply? Yes No EXT.MOLDI aint Stain Height O Floor Hinges N.R.P. Butt Floor Tvoe i Yes 4 x 4 Hinge r ncealed Hinge Standard Solid Brass Other OAK THRESHOLD COLOR Option s R7Aluminu '`jO'^ WndowTreatments None Finu Hardware finish -; Quarter Round to Shutters C ing flat Aluminum i ' Remove Shutters Permanently THRESHOLD NO THRESHOLD Pminum White ras Bronze Remove Mini -blinds ennanenlly PedarShing H drosill Interior SwinY ( g) mer to have w n tments G - Vz'8t/p' Handle Wingknobs (Interior Swing)G removed before inG- VAT1 ❑ Comments All AboveOak - All BelowSEEEL Standard rior Swing) O Inter or Exterior Baseboard �andard S Dnmil/Plaster Patch Yes tear Grey Bronze Other eveled La Drip Cap Yes No Sq. Ft. Color Insulated Triple Glazed em a Date P.O.# Stucco Patch Yes No OFFICE USE ONLY Screens e Single Gluechip Double Gluechip Sq. Ft. Color O.R. Yes No Special Fixed m Combo Yes No Stock Metal Frame Alam Yes Step Date P.O. # rey Mesh. Charcoal Mesh Renaissance to Prewire. Yes No Metal Flash Yes �No. Your door or window unit will be manufactured and installed (or delivered) according to the details, drawings, and information provided above. When altering the size of a door or window opening there may be additional plumbing or electrical lines hidden in the wall and not documented on these plans. There may be an extra charge for this work. On permitted jobs, any structural calculations or additional work required by local governments will be considered an extra. All extras must be approved by you before the work will be done. When removing existing doors and windows, Renaissance employees will be extremely careful, but cannot be responsible for any flooring, wallpaper, or countertop damage. Customer will s e hook-up with t it rm C m an . y /J ORIGINAL COPY Customer Approval �/L Date l� — L / S.C.L.#490375 Renaissance Doors "& Windok Corporate Offices and Factory 130 N. Gilbert, Fullerton 92633 (714) 578-0090 Fax (714) 578-0208 > Showroom Locations 18449 Brookhurst, Suite 11, Fountain Var, CA 92708 (714) 968-8866 • Fax (714).968-4090 23812-A Via Fabricante, Mission Viejo, CA 92691 (714) 380-9550 • Fax (714) 380-0106 1022 N. Tustin Avenue, Anaheim, CA 92807 (714) 632-8226 • Fax (714) 632-5198 385 Lemon Avenue, "G" Walnut, A 91789 (909) 598-3339 • Fax (909) 598.8896 Sales Person CustoGlossa Namemer d/� rri 6«cti �, �dFgES Address C// Screened S E W # � $jJ07(H 4,6, 8, 10 City 0^ 04 Map Q. -4- A = Activeg79- &72 Gtters Light Heavy Home Phone (�) _, °f X =Casement e No Work Phone (_) goes with # D = Dummy Overhand a No Previous Customer Yes Year F Fixed Size Exterior Interior Swing 8' 7' 6-8- 6. /You are looks g at the 5' drawing from the a1 BIOR 4' of house 3' r � 2' Upstairs nstairs 2' 4' Ins a ation location: /t 0-1 6' 7' 8' Customers Permit Prepared Opening Set On Countenop Tile Into Cut -Down Cdt-Down and Line -Up Bars Remove Kneewall Remove Post Remove Wall New Header_ x _ Shear Panel Build Wall Fill-in Opening Pick up by Customer Deliver by Renaissance 10' 11' 12' 13' 14' 15' 16' Door Size: x Sidelite Size: x Wood Species Oak FI Brass Hardware FINISHING INFO Electrical Yes Mahogany Other Le ers Knobs Pull Handles 1 C r t Color 2 Color 3 Color � Custom INTERIOR ai Stain /q'm ela;.' # of Plugs # of Wires of Switches # of ext. Lights 13/8 �/ Manufacturer /� FL_ Raised Panel A or B Style Glass Stock P.O. ## Udbo Sliding Hinged Fixed Date P.O.# INT. MOL ING aint Stain # of can Lights Exterior Lights to be supplied by Customer Single e Cylinder 1 sideey only Window Fixed Garden EXTERIOR aint Stain Plumbinc Yes �ff Reroute Vent Pipe only Bay Casement dl Bow Awning Stacked Key to Yes No Key AlYes No # of Ke HingesButt4 Standaid Brass Other X Does Egress Apply? Yes Height OH Floor x 4 Hinge or Concealed Hinge EXT. MOLDING Paint Stain OAK THRESH COLOR Yes Roof Options Window Treatments None Fat Aluminum Hardware idinHarchyare Quarter Round to Shutters Cro Moulding at AluminumRemove Pitche luminHOLD Pitched d hingle Glass top - ' & 1/2' Glass to - All ve Glass p - All Belo White Bronze Handle Wingknobs 0 T RESHOLD Hydrosi Inter wing) Oak (Inters wing) Standard xte Swin 9) Shutters Permanently Remove Mini -blinds permanently use a treatments e s ved before installa i Mouldin° SEE EL VATJO 4 ❑ Com Oth Interior Exterior Baseboard Standa (Slider) Drywall/Plaster Patch Yes ear Grey Bronze Other eveled Laminated Drip Cap Yes No Sq. Ft. Color Insulated Triple Glazed Tempered Date P.O.# Stucco Patch Yes ® OFFICE USE ONLY 5crep a a No Single Gluechip Double Gluech Sq. Ft. Color Q.R. Yes No Special Sliding Combo Yes No Alarm as _ Renaissance to Prewue? a No Stock Metal Frame t• re Charcoal Mesh iL Step # �No. Metal Flash Yes Date P.O. # Your door or window unit will be manufactured and installed (or delivered) according to the details, drawings, and information provided above. When altering the size of a door or window opening there may be additional plumbing or electrical lines hidden in the wall and not documented on these plans. There may be an extra charge for this work. On permitted jobs, any structural calculations or additional work required by local governments will be considered an extra. All extras must be approved by you before the work will be done. When removing existing doors and windows, Renaissance employees will be extremely careful, but cannot be responsible for any flooring, wallpaper, or countertop damage. Customer will sc dt a hook-up withtheir larm Co pany. // Customer Approval DaIeCl/_—_.=� ORIGINAL COPY S.C.L. #490375 Customer Name Renaissance Doors & Windot Corporate Offices and Factory 130 N. Gilbert, Fullerton 92633 (714)578-0090 Fax(714)578-0208 Address C/r cc. City i.�a5 AfeSzi Mao O. 35&G 6 Home Phone ('.) _979 —96 ;7L Work Phone(_) _S9,Me— . Previous Customer Yes ® Year Showroom Locations 18449 Brookhurst, Suite 11, Fountain Va,. CA 92708 (714) 968-8866 • Fax (744)968-0090 23812-A Via Fabricante, Mission Viejo, CA 92691 (714) 380-9550 • Fax (714) 380-0106 1022 N. Tustin Avenue, Anaheim, CA 92807 (714) 632-8226 • Fax (714) 632-5198 385 Lemon Avenue, "G" Walnut, CA 91789 (909) 598-3339 • Fax (909) 598-8896 Sales Person # 3 of goes with If Glossary (S�)iscreened WEATHER EXPOSURES ORIENTATION N S © W am (HRS) 2, 4 6, 8, 10 A = Active Rain None Lig Heavy X = Casement Le rs Knobs Pull Handl set Dummy Gutters No Overhang No — ixed Size Wood Species Oak Fi R. O. X No P Exterior Swing Mahogany Other Le rs Knobs Pull Handl set V011MC.101" 2color a color INTERIOR gin Stain r Wall Thickness: Renaissance Pemi Interior SwingCustomers Stock P.O. Style s B'. a c,C� C4^ Permit Sliding Hinged Fixed Date P.O.# INT. MOL NG Paint Stain # of can Lights Exterior Lights to be supplied by Customer Single Cylinder ouble Cylinder 1 sided Thumb rn or Key only Window Fixed Garden Straight Replacemen 7, Bay Casement � Key to Custo rs ey? Yes No 6'8• Key Alike? Yes No # of Keys eeded N.R.P. Butt repave pemng Reroute Vent Pipe only Does Egress Apply? Yes o Height Off Floor Set On Countertop g j Tile Into You are OAK THRESH OLD COLOR Cut -Down looking 5' S Q and at the Quarter Round to Shutters Line -Up B Bars drawingUne- uldi w/flat Aluminum Pinum Par Shin le G 1 1 2' All AboveGAll Below White ra Bronze Handle u Wingknobs from the NMR 4' // Remove Kneewall Remove Post of house Interior Exterior 4 Remove Wall 3, New Header_ x Baseboard Shear Panel 2' ea Grey Bronze Build Wall FII -in Opening 1' Drip Cap Yes No Pick up by Customer Insulated Triple Glazed Tempered Date P.O.# Deliver by Renaissance Upstairs ® No Single Gluechip Double Gluechip Sq. Ft. Color 2'4 6' 8' 10' 11' 12' 13' 14' 5' 16' o nstair Combo Yes No Installation location: C4� Door Size: x Sidelite Size: x Wood Species Oak Fi Electrical Yes Mahogany Other Le rs Knobs Pull Handl set V011MC.101" 2color a color INTERIOR gin Stain r # of PlugsSCustom # of Wires # of Switches Doors 1 13/a Manufacturer Raised Panel AGlasor Stock P.O. Style s Deadbolt a c,C� C4^ # of ext. Lights Sliding Hinged Fixed Date P.O.# INT. MOL NG Paint Stain # of can Lights Exterior Lights to be supplied by Customer Single Cylinder ouble Cylinder 1 sided Thumb rn or Key only Window Fixed Garden EXTERIOR, int Stain Plumbing Yes No Bay Casement � Key to Custo rs ey? Yes No Bow Awning Stacked Key Alike? Yes No # of Keys eeded N.R.P. Butt Reroute Vent Pipe only Does Egress Apply? Yes o Height Off Floor Paint Stain Floor Type Yes o 4 x 4 Hinge or Concealed Hinge Ste and Solid rass O at OAK THRESH OLD COLOR Options RXluminum Window Treatments None Fum Hardware fin' h Quarter Round to Shutters R SHOLD Xnte Swin9 g) ng)removed Swing) uldi w/flat Aluminum Pinum Par Shin le G 1 1 2' All AboveGAll Below White ra Bronze Handle u Wingknobs Remove Shutters Permanently Rem r '- iMtlsper nenfly ustomer to have w n t atments before installatiG Moulding SE EL VATIO I 0 Comments Other Interior Exterior 4 Baseboard Onmall/Plaster Patch Yes N ea Grey Bronze Other eveled Laminated Drip Cap Yes No Sq. Ft. Color Insulated Triple Glazed Tempered Date P.O.# Stucco Patch Yes ® OFFICE USE ONLY ® No Single Gluechip Double Gluechip Sq. Ft. Color Q.R. Yes No Special Sliding Combo Yes No Alarm a Renaissance to Prewire?kXeNo Stock Metal Frame y es . Charcoal Mesh Step Metal Flash Yes =No. Date P.O. # Your door or window unit will be manufactured and installed (or delivered) according to the details, drawings, and informa8on provided above. When altering the size of a door or window opening there may be additional plumbing or electrical lines hidden in the wall and not documented on these plans. There may be an extra charge for this work. On permitted jobs, any structural calculations or additional work required by local governments will be considered an extra. All extras must be approved by you before the work will be done. When removing existing doors and windows, Renaissance employees will be extremely careful, but cannot be responsible for any flooring, wallpaper, or countertop damage. Customer will s hedule hook-up with t ei[7AIa�Company. Customer Approval r�' Date &�_�?7 ORIGINAL COPY OWNERSUHUNI•;H'f ULAUDE U. DATE JOB ADDRESS 17 0 Panay Circle BUILDING PERMIT NO. 26845 )GENERAL CONTRACTOR owner DESCRIPTION OF WORK Hes W/aLL gar & QeL ga1 'AP No 149 -122 -lb LOT TRACT FIRE ZONE VALUE $ 4j ybg. VU INSPECTIONS Signature Date GROUP I&S TYPE , V ZONE Rl _ SoIlkb-I PERMITS ISSUED GasSUBCONTRACTOR 0-4 Date Number I Signature Water , r , 2 ;$t j - Plu bin Rough Plumbing -2G Prop. Swr. Line fZHause Con. __ Sprinkling Systei _Mi_s40]gile➢li a__ L.. ..-.n, g eating and Air on tiomn�s� Temporary Service or Pole Underground Power p •7 • b Rough Wiring 7 Ji. 67 Heating a d Vent. Trenches ZI Forms M Steel Reinf. ® /( 0 -17 Floor System Aju 6-;z9--4 Bond Beam ❑ Steel Reinforce p Sheathing Frame and Flashing B -i -F7 Lathing — In ® Out 0 Plaster, Brown Coat Structural, Final El 'c Heating, Vent., Refrig, andA.C., al _ Plumbing, Final and Gas Test - Electric, Final •2LC� Building, Final R/3G U • a%- 7 26845 �^ COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1290 COSTA MESA, CALIFORNIA 9262E ARCHITECT TEL I ENGINEER NO. SETBACK LINE FROM i t /L- - h.-)L_Li/L. . 147 . TEL NO. �) ) (� N0. or OLDa/. 1{ I/Jt NowoN LOrAIa _ REAR YAR �. DESCRIPTION OF WORK G,9lZI 1 H[IIEBY ACKNO' AND STATE THAT PLY WITH ALL Cl BUILDINO CONRT6 AUTHORIZED AGENT HAV[ READ THIS APPLICATION CORRECT AND AO33��[[ TO COY. AND STATE LAW/',e[QUpTINO HhR31-67PA7°001030" `195.75 APPLICATION FOR PERMIT BUILDING For Office Use Only II RECEIPT I PER T O. RKCKIvJUW IF DAT[ ECEIVED l - eTI pO ADDRQ1Ne PIRA ZONA wit OROU/ APPROVED l Li — J � BY, DATE/ ZONING ZO NO. OI PLAN[ � U[[OI NN/ OUILDINO //J L[OAL D[YcwImON A. P. NO. NOTE: NO EAVE OVERHANG SHALL BE LEEN THAN 80 -TO SIDE& REAR P.L EAVES ALLOWED (U. B.C. REQU IREMHNT) YARDS APPROVED YARDSAPPROVED MAIN BUILDING C RY BUILDING I FROM C/ eTjlH ) FRONT //'FT. /FT. R.QID L.210% ✓ FT. 6 PT. / RHAR'511PT. S/ FT. DISTANCE BET. BET. MAIN e MAIN SLOGS. ACCESS. 81-1308. VAR.* DATE C. U. P. APPROVED APPROVED / /y .5)/,My� DATE 3�S/ J- TH[ AMOUNT [NO" UNDER VALUATION IS FOR THE PURPOSE OF ■STABLISHING A PERMIT I= ONLY. VALUATION s yS/6.5� p C PHRMIT PEH 3L p�L5-.�7is_ TOTAL PEN II JOB ADDRESS 1780 Panav Circle BUILDING PERMIT N0. 27055 AP No. 139-122-16 LOT 172 TRACT 3363 FIRE ZONE VALUE$ 2,400.00 INSPECTIONS Signature Date GROUP T TYPE ZONE GAIL SUBCONTRACTOR PERMITS ISSUED Date Number Si nature GAS WATER ,. Plumbin ROUGH PLUMBING le -070- O PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING T UNDERGROUND POWER -L t. ROUGH WIRING '22•( Heat ng and Vent. TRENCHES Er FORMS ❑ STEEL REINF. -• linter sent FLOOR SYSTEM (p pWnu raeA W0 BOND BEAM E2' STEEL REINFORCE Y -� SHEATHING "s - FRAME AND FLASHING LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL, FINAL Electric HEATING, VENT., REFRIG. AND A.C., FINAL i PLUMBING, FINAL AND GAS TEST 22, ELECTRIC, FINAL BUILDING, FINAL r . -- 1 2-.,055 4 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS 1780 PANAY CIRCLE BUILDING COSTA MESA. CALIFORNIA OWNER CLAUDE C SHONERT MAIL ee 1884 PANAY CIRCLE ARCHITECT TEL 4NGINEER[ N . ADDRESS 5071 FIRESTONE BLVD• CONTRACTOR ADDRESS 5871 FIRESTONE BLVD. CITY S T STATE 190179 TFL • SP32210 LIC. NO. 9 NO. SIZE J5 V / .y NO. OF -L00/. OF LOT (((/// ^ 'X / NOW ON LOT USE OF res and ppar EXISTING BLDG. O SETBACK LIN[ PROM CENTER OF STREET 1 REAR YARD I SInEYARDI LEFT _ I OIOYT II Z 1 OF WORK M MAY 15.67FAsIaB?BOO 622* ****15.00 cw APPLICATION FOR PERMIT BUILDING For Office Use Only RBCHI" NO. I PERMIT NO. 1/SUED BY LSU ��/� .DATE S ZONING iON NO. OP w� USE OP NH ' / PLAN/ _/ HUILOINO �J' D[SCRIPF.0. /1 lam/ Q•/�--TT" �J`a*L �'�I A. P. NO. NOTE: NO SAVE OVERHANG SHALL BE LESS THAN 90' TO SIDE B REAR P. L. EAVES ALLOWED (U. B.C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING I FROM C/L$�SET) FRONT OOPT. FT. R. SIDE F FT. / FT. L. SIDE / FT. FT. . n VAR.# DATE ' EXTERRCOVER10 WALL ' COVERING I BYROOF APPROYED e� I DATE EJ -5--v7 USE OF B UI LOINS AND WORK TO BE PERFORMED I HEREBY ACHNOWLHObB THAT I HAVB READ TNIB APPLICATION ANO BTATB TNA B�ABOVH IB CORRECT AND O COM- PLY WITH AL ITS OROINANCHB ANO BTATB S q[O LATINO BUILDINOC STRURIO H. '' / 61GNAZU E 0 AUTHORIZED AGENT 9%= ,rliC;LAI{. REQUIREMENTS M 60. THE AMOUNT SHOWN UNDER VALUATION 18 FOR THE PURPOSE Of ESTABLISHINO A PERMIT FEE ONLY. 5 O LUATION � p 1-2- PERMITFEE S N G - 2400&00 PLAN CHECK S 0 VWNM_K .7I1V1Y1SI('1' 1F3ULLC V. Lt11G yv cv v�_ JOB ADDRESS 17 01iPanay Circle BUILDING PERMIT NO. 27729 GENERAL CONTRACTOR Anthony Pools DESCRIPTION OF WORK Pvt. Swim Pool Q AP No. 13,9-122-3 LOT TRACT FIRE ZONE VALUE $ 2, 67.00.00 INSPECTIONS I Signature Date GROUP J TYPE ITT ZONE R-1 Soil I SUBCONTRACTOR PERMITS ISSUED Gas Date I Number I Signature Water lumbing Rough Plumbing ' Prop. Swr. Line 0 House Con..[] Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole _ Underground 0 Power,0 Rough Wiring Heating and Vent. Trenches 0 Forms 0 Steel Reinf. 0 LRoor System Bond Beam 0 Steel Reinforce 0 Sheathing Frame and Flashing Lathing — In 0 Out 0 Plaster, Brown Coat Structural, Final Electric Heating, Vent., Refrig. and A.C., Final _ Plumbing, Final and Gas Test 0 Electric, Final Building, Final 27729 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92020 For Applicant to Fill In Completely TYPE OR PRINT wU,L.,N 1780 PANAY CIRCLE COSTA MESA. CALIFORNIA C SCHONERT 1785 PANAY ARCHITECT C ADAMS TEL 'ENGINEER NO. 5871 FIRESTONE BLVD. SO GI 5871 FIRESTONE BLVD. D 190179 3.1�T? SETBACIf LINA►ROM (.I1 x USE OF ND GAR REAR YARV 7161 RIGHT 61611 OF WORK POOL I NEREBV ACRNOWL[DGK,YNAT.I HAVE RRAD THIS APPLICATION AND STAT[ THAT'TH[ ABOVa .IS CORRECT ANO A [ TO COM. PLY WITH ALL'�CITY ORDI"= AND STAT[ UYW GYtATNG ( BUILDING CqNGYRUOy,ON. BIGNATU �/�ja4��� �/C�i•—�L-/ AUTHORIZED AGENT'v'�( Il/ PAP- CCT 20-67cf;-•0Q 91'5'- APPLICATION FOR PERMIT BUILDING For Office Use Only R[curT no. R ( I O REC[i [D BY DAT[REC[IVEO DAT[ISSU[D p_ , ESS PANAY CIRCLE ADD 1780 PIR[ /', XON[� TYP (r GROUPIJ APPROVED By, DAT[ IA )E ZONING : NO. OF i� u.a OP NEW _ PLANS BUILDING LEGAL 4o DESCRIRION a —/Z A. P. NO.131 NOTE: NO SAVE OVERHANG SHALL BE LEW THAN -20" TO SIDE& REAR F.L. EAVES ALLOWED (U. B. C. REQUIREMENT) YARDS APPROVED YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) I (I FRONT Fr, 3 FT. (1 . FL410% FT, FT. L. 811)11 FT. �I REAR FT. PT. DI STANCS BCT. BET. MAIN O MAIN BLDGS. ACCESS. BLDQS. VAR.* DATE C. APPROVED APPROVED DAT[ HnI 1) Fog SYcCIAL, REQUIRE ENTS G I LV SQ. FT. THE AMOUNT .MOWN UNDER VALUATION 16 FOR THE PYRPOB[ OF [STAOUGHING A PERMIT PER ONLY. VAL.UATLON / PERMIT FHB $PLAN CHECK S 4. 2600.00 TOTAL FEE