HomeMy WebLinkAbout1783 PANAY CIR - Building Permitss
CITY OF COSTA MESA
BUILDING DIVISION
F77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 •www. i.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (714) 754-5626
ly�,F
PERMIT NUMBER: BX08-00118
PERMIT TYPE B_MISC STATUS: ISSUED
APN: 13912246 DATE ISSUED: 04/18/2008
Zoning: R1, ISSUED BY: CAC
JOB ADDRESS: 1783 PANAY Cl CM Suite/Unit:
Vicinity: Primary Occ: - Const Type :??
SQ. FT: 0 Valuation: $7,000.00
SCOPE OF WORK:
REMOVE 3 SLIDING PATIO DOORS WITHN NEW ONES AT THE SAME LOCATION. NO CHANGE INSIZE
OWNER:
KOLANOSKI, THOMAS E TR' -
Address:: 1783 PANAY CIRCLE
City/State:
COSTA MESA, CA
Zip Code: ° '92626
Phone:
714.545.2629
APPLICANT:
STEVE JANOSIK
Address: 1621 E ST ANDREW PL
City/State:
SANTA ANA, CA
Zip Code: 92705
Phone:
714-259-5120
CONTRACTOR: DIAL ONE WINDOW REPLACEMENT SPECIALISTS
Address: 1621 EST ANDREW PL
City/State: SANTA ANA, CA
Zip Code: 92705 Phone
ARCHITECT: _
Phone
ENGINEER: .'
Phone
Building Plan Check:
Building Permit:
Electrical Permit:,.
SMIP Residential
SMIP Commercial
TOTALFEES
FEE SUMMARY
$90.51
$139.25
$0.00
$0.00
$0.00
$229.76
License No: ' 523043'
714-259-5120 - Cell:
License No.
License No.
Unit
Unit:
Unit:
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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 Inspection% and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
CODE 1. INSPECnoN TYPE pATENI MAL4 CODE S INSPECTON TYPE DATE INTMAL
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/Reteining 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
WORKER*' COMPENSATION DECLARATIC
I hereby affirm under penalty of perjury one of b.a rollowing 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.
t4v 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
num re:
Iiif seder need nor pe mmpNretl1 Me Perna 6 wNuedel we re✓rdred dOam(5100) xiewJ
Polic N
❑ I 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, and agree that if I should
become subject to the workers' compensation provisions of Section 3700 of
the Labor C de, I sh forthwith comply th these provisions.
�-
APpli m's ignatu Date
WARNING: FAILURE76 SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($10),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
m ntra
I' a is in full force and effect. pp
Z`7 _ Cla U
9 -08
Cot Sign re e
CONSTRUCTION LEN G 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
OWNER -BUILDER DECLARATIONS:
1 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 tele Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Signature
305716 (3108
Owner ID verified by d.
Drivers License No.
lir, ❑ Yes ❑ No
Expires:
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, All 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.
Applironfs Signature Dale
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 feel 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 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 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ 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 permit for such construction
or modification from the South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ 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 permit 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 California Health and Safety Cade).
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 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.
S19nawre 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 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.
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesaigULDING PERMIT
Job Address: 1783 PANAY CI
Suite:
Vicinity: ROOF
Primary Dec: R-3 Dwellings/ Cong Res <10 Type of Construction: V -N
Parcel Number: 13912246 Zoning: R1
Applicant: MCCARL, TIM
Address: 126 COMMERCIAL WY
Phone: 949-548-5569
COSTA MESA, CA Zip: 92627
Owner: KOLANOSKI, THOMAS E TR
Address 1783 PANAY CIRCLE
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/17/2006
Issued: 04/17/2006
ISSUED BY: 26"—I—
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 1 LAYER 30# FELT, 50 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS NEEDED.
5,400 S.F. INCLUDES ATTACHED GARAGE.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$391.25
$2.48
$0.00
$0.00
$0.00
$393.73
SETBACKS
Phone:
Front 0-0
COSTA MESA, CA
Zip: 92626
Contractor:
G L R ENTERPRISES INC --DBA CRANK BROTHERS ROOFIN
Address:
126 COMMERCIAL WY
Phone: 949-548-5569
COSTA MESA, CA
Zip:
92627
License: 828379
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 04/17/2006
Issued: 04/17/2006
ISSUED BY: 26"—I—
Arch : Eng:
Address: Address:
Phone: Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF EXISTING ROOF. INSTALL 1 LAYER 30# FELT, 50 YEAR COMPOSITION SHINGLES AND REPAIR/REPLACE SHEATHING AS NEEDED.
5,400 S.F. INCLUDES ATTACHED GARAGE.
Plan Check:
Permit:
SMIP Res:
SMIP Com:
Other:
Inspection:
Total
$0.00
$391.25
$2.48
$0.00
$0.00
$0.00
$393.73
SETBACKS
MAIN STRUCTURE
Front 0-0
ACCESSORY
Front 0-0
PARKING
Existing: 0
FEE SUMMARY
PLANNING & ZONING
Rear 0-0 Left 0-0
Rear 0-0 Left 0-0
Required: 0 Proposed: 0
Calc Valuation:
Claim Valuation:
Right 0.0
Right 0-0
$24,800.00
$24,800.00
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) 754-5626
DECLARATIONS
WORKERS' COMPENSATION DECLARATION: < i
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.
1_j3 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.
IIICCC My w ers' ompen_sa_tioqqqy Insurance carrier and policy number are: 11 /
-Carrier: r 1 rl YC 44 r St4g Y� Policy-Number:
'(Fhis section need not be completed if the permit is valued atone hundred Of /ars ($100) or less.)
❑ 1 certify that in the p rtormance 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 Ca jfc i , and agree that if I should become subject to the workers compensation provisions of Section 3700 of the Labor Code, I shall forthwith
Comply with thes vis' n . /
Applicant Signature
WARNING: FAILURE TO SE E WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PE TIES D GVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100 ), IN ADDITION TO THE COST OF COMPENSATION, DAh41GES AS PROVIDED FOR IN SECTION W06 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. Lfc. a IR 1Zamass N.
"Coniracto= nature: —Date:--
Let' I'7 196
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).
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 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 ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who build$ 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 pursuant to the Contractors License Laws.).
❑ 1 am exempt under sac. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
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, Ialsework, 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 ❑ 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 2DO cubic feet of compressed gas at standard temperature and pressure).
.... nt or or future
building
.. pant need to file..a.registration... . '...... ......'.............................................................
........................................................ .........................__......................................... .... ..... .......... .....
2 Does or will the appllce p u e bu d g Occup aform for acutely hazardous materials. ❑Yes ❑ No
(Section 25533 of the California Health and Safely 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 II an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑Ves ❑No
..........................................................................................................................................................................................................................................................................................................................................................................................
5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application 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 LJ No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits).
.......................................................................................................................................................................................................................................................... ..............1..................... .................................... I.................
6 Will any part of the facility to be constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑Yes ❑ No
(it 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
..................................................................................................................................................................................................................................................................................................................................-.......................................................
7 II 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'tyes 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: Dale:
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.
g t r Ot Le Owner( Date
P I 06
Or Authorized Applicant (I—Date -
CODE r. INSPECTION TYPE 2&M INMAL CODED INSPECTION TYPE gaff, INTITALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final - 208 Final Plumbing
200 Final Re-Roof �t (q �O -� 10 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
yl
ADDRESS M BUILDING: 1783 PANAY CI
WhER'SNAREI`IaavwKOLANOSKI, THOMAS E,TR
ODRE8410218 N CENTRAL AVE
PHOENIX, AZ 85020
968-3564
OR. RULING ADOBESA
ARCHITECT OR ENGNEER:
ABCK O8 END:8 ADORESS:
UNIT:
Iq D
uG ND:
UNIT:
L ACTapSNJUIM:LANDERS POOLS (714)722-7328
CONTBACTORSMMIAG 2569 ELDEN AV
C.M. CA mm, 256213
92627 UNIT: C-1
LICENSED CONTRACTORS DECLARATION: l hereby afkm urder penalty of perpuy Net l ml, fcaued under provisions of Cheater 9
(wmmendrp will, Section 70001 of Division 3 of Im Busimss mr Profmd«u Code, end my lice. is in IWI lace and e9ed.
MYuc.ND.O/yC66 UC.CLASS:C 53 uG . 256213 n�X�P/jr/4'-01/97
Date: i/- to — / G Cmumar: CLI/!-f� a -4—L W
of INNER BUILDER DECLARATION: I herebd
y afn. ur pof perjury II am ampl from IM Wrm
bCoon license Lew f« the
dwi,, reason (Sabaend ch im
waim 7031.5 Bs Prdesabm Code: AM city d ooumy which elf
a pmmi, to comuuct, ., kmprove,
S'smolah, err repair any rrmum, prior to Its lsauarhm, also Imi the appfirent for such psm8 to fib a signed sMte sent Nat M or she
Is licensed prsomo to the wovmons d the CoNrmaors L i.. Law [Chapter 9 (comd
momanng with Sion 7000) Divebn 3 of the
Business end Professions Co hal or thal he or she u aemp lhrelrom and the bans for the dlepd exemption. AM violation of Section
7031.5 Many apphosm for a perms a bieus the applicam to a cW pemlly of not rode Ihan We hundred dollen j350o1).
❑
1. Its ovnwr of the popsy« my, emMoyaes with wages as their say mmparusmicn. will do that work, ad the emlclu, n not k9ended
ordlerml for male (Semon 7(W1. B.1b. err PoA s. Cade: The Comrman Licensee Lawdom nit m*to ...d papny
who builds « improves Nieman, ad who doom such work limmB or herself «through his «her own amplo ows, provided the1 such
impwmmms ma nal imeMed «filmed for rale. 1. however. the Wildirq or :nlrwamm is add within one yam of completion, IM
owmr4mider will hew the When of pwil M or aha dr m W0d or bnpwe for the purpose d vale).
❑ I, as owmr of the popaM, am mdutively oomifookV wit, licensed contractors to carWrud Ne project (Smbn 70,M. Businses ad
Prof. Code: The C«armm licmm Law does not apply W an owner of plot" who WM. or impwm thaaan and who
owems for smh propels wish a comndor(s) hemseE Mrsuah to the C«arsdds Ldowle Lew).
❑ I am exempt urder Section: B. A P.C., I« that moron:
Dose: Owner:
I do hereby cent' Ihe1 I set swore d end hvdrsund Ne m OlUss m of Ce18«da Neelfh and SdMY Coda Sturm 95505. 25533, end
25531, end Net I «aM Man WiMtrq oozpm will I will m (cimb ens) need to comply wih said etme oodee and the rpu'vsmaw ler
A pmmh l«oomlruclbn« modification from he Ai y1fisy igamerl Dimia. Rssidmablomxrmion appicmiom en exempt from Nme
povfsima.
Dose: Applicant:
WORKER'S COMPENSATION DECLARATION: I hereby s firm itch peratpy of perjtsy oro of Ne Idbwing deWrataN:
❑ Ihave for Ise meima:he of
he for
wFjh tms peon ler wpkas'wrnpmetbn.m pwdd la by Section 3700dlha Labor
Code, la the pdomMws d the soak fa wlch th"v penin 6 issued.
❑ I have and w meihaen xnrkrv' oanpmatbn urourmhos. n resnued by Sadiron 3700 d Ihs lebp Cads. ler ins pedpmm�w d fns
work 1« whits Nis pamX ie nsaued. MY warken' oompenemicn inmrmhce rarrbr end policy number ma:
Canby:
Poky Number.
(M. sNshoh sed m M oompLNd d IM paint is M pie hundd dollen IS IMI or Ads.)
❑ I pnry Nm b Ne pdamwa d Ihe work ler wh"rJh tins pamE b iwusd. I sile0 nit errhPloy wary pJnon m aM melena w m to
came subjsd to the warmse wmpnsmdn Ira's of Cdilaend d epI shoal epee that coma eubjee l0 1M
bewoMers'
com`penwm tom of radion 37M d the Labor Cade, I forthwith comply x' 3ho rwiviom
Dose: Appfrem: 1
Wwming: F19urs Mer:un wodai campawdon ,ovrada la unlawNL Intl "I i -f a wthployar to cdMml yanaldw and
,lull Bps op to aN h;dmd tho omd dollen (SIOQ"A N edyldon or Im coat et' ronrpansacbra damps m provldd la, In
SWdon 3103 of Of LMPr Cods, IntsresL ml, mmmaY'A ION.
CONSTRUCTION LENDING AGENCY: 1 hereby mm underad
Rpmlfy perjury mi then b a omst odim lending agency ler the
pedmmhm dorthe work 1« which this Penni u lssud (Smion 3097, Civ. C). _
LENDER'S NAME: ,
LENDER'S ADDRESS: ✓
I cent' Nm I have mad this aplication arid pate that the abo r information at wad. I egret to comply with M dry and county odic m oss
ad pose W. relatsq to WBdag oanasuctim rd hereby euDa¢e reprmeNativm of his my to ma upon IM alx v mmtimml properly
for inspection purposes
CARS/Oh} YhANDER4'
I OR
fel _. .r1..
1 Owner/AgenUAppfcenheCantrma t h r
(5151-68.WP) Whne_Buildrg A Salary; Gmme hie: Camry-Appiran; Pink-Rmwnos: Gddenrod-At.
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: P 080336
PERMIT NO: P 080336 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION REDECK, RETILE 6 REPLASTER EXISTING POOL SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS: RELOCATE POOL EQYUIPMENT INSTALL DRAINS, PLUMB FOR POOL #B80334
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------
MAIN
BUILDING
-----------
---------
ACCESSORY BUILDING---------
FRNT:
FT IN
REAR:
FT IN
FRNT:
FT
IN REAR; FT IN
LEFT:
FT IN
RGHT:
FT IN
LEFT:
FT
IN RGHT: FT IN
PARKING
REQ:
PROV:
PARCEL:
13912246
ZNE:
REF NO:
PLANNING
NOTES>
>
###############################################################################
D
E V E L O
P M E N
T S E R V I
C E S R
E Q U
I R E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY
DATE:
DATE:
APPLICATION ISSUED BY: Fi
s DATE: F-(c--9AG
i(� dFi(���if3f;f�##########� ##
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTrRIC' MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.25
253 r" SMIP/NON-RES
PLAN
ISSUE FEE 22.00
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 54.25- 22.00 j 0.00 76.25 76.25 •00
REVENUE DIVISION TOTALS--> COLLEC,TED*: 76.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
76.25
I N D I V I D U A .,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'E r UNIT COST TOTAL COST
7
PLU 1 SWIMMING POOL 54.25 54.25
'END 'OF FEES
t `
01 00218659-00218689 TGT 76.25
<r• ) DATE: 11/06/95 TIME: 14:45
y�/
CONSTRUCTION AND PLANNING,._
APPROVALS Permit #
Date
_
Inspector
PC & 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-Undrgrnd.
54. Forms
4. Electrical Conduit-Und rgrnd.
55. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical UFER-Grnd.
57. APPROVAL TO COVER•GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
8, Foundation
59. Gas Pipe, O Undrgrnd., Test V-'
Z�
9- Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, Q Undrgrod.
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
Z% C
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
APPROVALS Permit #
20. Rough Factory Fireplace
21. Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping O Gas 0 Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank O Gas G Oil
25. Roof Sheathing
74. Overhead Hydro
26. T -Bar Ceiling IStructurall & 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: //-,-) (16-ool-
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
f�
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. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
�k
ADDRESSOPBMLDIND: 1783 PANAY CI
OmwsNIMEIPIDa'oN:KOLANOSKI THOMAS E TR
A^DRE5310218 N CkNTRAL AVE
PHOENIX,AZ 85020
968-3564
ADPL. Y/JM ADDRESS:
MNITECT OR EN@lHH:
ARGIL ON ENWS ADDRESS:
UNIT: CITY OF COSTA MESA – BUILDING PERMIT
PERM NO: E 080335
PERMIT NO: E 080335 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT
mw_- JOB DESCRIPTION REDECK, RETILE & REPLASTER EXISTING POOL SQ FT:
UNIT:
CLAIM VALUE: CALL—VALUE: GROUP OCC: R-3 /
cmucrarsNAME:LANDERS POOLS (714)722-7328
conA oR mm" 2569 ELDEN AV
MEEss:C.M. CA mmo_ 256213
•92627 mn: C-1
LICENSED CONTRACTORS DECLARATION: I hereby dkm u I peuWy of perpry tMI I em isoem E MYdar prOYdpw of Chapter B
(--ft wish Saction ]000) of Dwiskn D of tp A,Mk Pmlaaabm Code. and my spun b k M taca ark dlaa.
clrYuc.NO.066614 uC.CLA54:C 53 uc.No.:256213 E}/�P: 01/97
Data: �/— — 9G Camacta: C�e/E ' Y -f
OWNER BUILDER DECLARATION: I hereby dri uod pwMSy d Parley the 1 em .;t from tM Cameam Uaa as Law la tta
Sow n remora (Saab^ TDOt.S Buoiasa erd Proleadma Coda: Am coy or aouNy Wddu rerpum a permt to co souct, Ow, boprow,
mdbh, a raper any (M prig ro m Ccx ae, ebo rpu'vm IM epplibnt to arm panA to h a Sect.
7 awrbd Nio M a aM
Ga,aaed praW to IM pr j w t d tw Cots is ax pl t law )&Aper 9 (manerrag w d Section TOW) d DNion o 3 d ft
m
MISb end aptmkn Codal oa that la a aA a mamp therabarn and Of bme la tlue atlpad aew�plen. Am violtlkn d Section
TWI.s W am eDDSpnI la a pant ad>jom Ne epplrent b a as9 perrsSY a rad mm thn fw hushed da0ms (swop.
❑ I.npwbr d lM popery or my wVioYanwh wages as thew ade compepetol..0 do tu.ark. wk tta atu ait nal vuertdad
«Mred for sale (Section Toga, Busmen end Protsaaop Code: TM &odreram Hoene law does rad apply to an owwof property
wM WAAe err Ynprwea tle on, wk Ma don eauau wok Woven or h or trough No a tw own emWeas, pwkad tw each
imprwanrn we ort intndea a sled t« aeb. tl. howser. IM bldkbp a knpwanM b odd wthe one Yam tl oanpteaion, Ne
owuwbuiker win raw. IM anon d prwbc M «.he dk nor bak «improv• to tM purges a sob).
I, n ower a the poWty. am wohvny omni arq wth Bpnsed ca+n.am b mrnw tier project (Semon TOIa. ll a and
Pmteamons Code: TM Coutraam L as Lew door n.l appy b n arw d who o buikrw
a a imp.e Thereon erd wM
eon f« aa, Vqg . with a prareoa(a) liicenW puaure to tM Cmraaaa L'vne Law).
❑ 1 an arapt uMr section: B. A P.C., W the neaon:
Data: 1Amar:
1 do Mreby ceeM Iha I em ewers of aM urdwewk Na f"wremeda of Cayornia Nea ft and salary Code Sectip+P55o5. P55DD, artd
25!101, end tut I a ay Mm Wiking pmlpnl will I Al not (okab oia) need to am* w h eek elate codas and tM Mubemarn for
a pros l« ..t=i. or modKDation horn IM Aw0997W-ugamerY D'mrna. Raaidadolmmmakn epp4miaw as eaemplrom tMn
pavieions.
Det.: Applicant:
WORKER'S COMPENSATION DECORATION: I Mnby Ginn p porky of pa*" pas of to kOowbtp dedw'vM:
I hove auk wB meimee a caa'rata d aaww to aatlLw«s M worker ompruWbn, m popided I« by Sadion 0TW d tM lobar
Cade, la 1M pMormence d IM wak I« wldch thb permY a hued.
have end wit merles woexa'
lMy dion'vuuranca, n nauad oSaaim OTW d the Leo« Code. M tM paDmprtb d tM
wok a whidu this pant b baueel. ad. MY workm' axnpenaaion marenu mniar ark Ddiry «mubw w:
ca i :
Pully Number.
(T Nb saaion need nr M aompatad I tea pmol is b err hpkrW datwa ISrrpl a IrnJ
1 oetiy tut i tie p11,a ce d a as a aa which of perms b bard. I ahsb nal aI ew prep am
em meow n n to
becoin abject Ip IM wort e' mnpenwion law d CaMortiie. eM spree thm ! I ahwp a�bjso to IM worMre'
omyawatk/_n po�/n/m/a d Seakn DlOD d t» labor Cods, I gaMwan o�anWl `��' N/�i
Deb: App) :
WanWp: F.Dun ro Moria weds' d ara aJSI aorN.p b um0c. t aM.1 .1 coo on aarploYr ro cse .jpry W fiats
S.. 3 w of aunt.ab., Cd DM1 4 Al (v,,1W.pd, M aadlton ro M ro.r oI wrrperwton aanvpa n PreyWW ror In
S.D. OTIP OI M labor &ob. InMest and atomaya Yae.
CONSTRUCTION LENDING AGENCY: I hwaby alam uaMp
er petd t
y pwjwY at tMb bagertw p . conxtMion ncEn, M fta
ps papa a IM wank W whkA [Na psook b bad (Section W . ClI. C).
LENDER'S NAME:
LENDER'S ADDRESS:
1 W,a, I hen mad Nb apprcmion aM aws IW tM above hdamcfun R caned.I Wn to artily wth m «Y and county ad"nava
and ewe law mlaim to b idag ppnatufL0l1 wk Wr Yeuaharbs npsanlatNaa of t Nyta entw upon tM above-mwaiaied popsy
la aapenpn purpns.
CARS4 LANDERS
dalf"4 t Data: / f�
9qn e4 0crtarl nVAppiranLCaartla
(51511 mil) WMa-Buikeq A Saary: Grnn-Fle: Cavy-Appipm: Pok -Roams: Gokwlcxl seew
OL EQUIPMENT, INSTALL DRAINS. ELECT FOR POOL #880334
N-dE iE if dE iE♦E*dE*dE iElE JE iE dE♦EdF*N•dE dE dF dF dE dE*dE*df*dF iE*df dE dF**dF dE 181E*dE*dE df dk d(-dF iE dE dE*dF d(•
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------
MAIN
BUILDING
----------
---------
ACCESSORY BUILDING---------
FRNT:
FT IN
REAR:
FT IN
FRNT:
FT
IN REAR: FT IN
LEFT:
FT IN
RGHT:
FT IN
LEFT:
FT
IN RGHT: FT IN
PARKING
REQ:
PROV:
PARCEL:
13912246
ZNE:
REF NO:
PLANNING
NOTES>
>
dF * dE dE dE dE df dE
iE ♦E dE dE dE dE dE iE iL dE
k dE dE dE dE dE df dE dE * dE dE iE dE dE dE dE SE fE dE dE dE dE dE dE dE dE dE dE iE k 1E
k dE dE dE dE 1E if iE dE * dE dE dE dE ik if dE dE dE k iE dE dP dE if it dE dE df
D
E V E L O
P M E N
T S E, -R V I
C E S R
E Q U
I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE:
APPLICATION ISSUED BY:
dE df dE dE dE dF d(• dE df dk it dk k ♦F dE k dE dE ♦E * dE iE ��
LEGALIZATION:N F E E• S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 12.00
503
PLAN
ISSUE FEE 22.00
BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK
TOTALS ---- > 12,00 22.00 0,00
DATE: %1-10—
STRUCTURAL
1—b—
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON–RES
TOTAL PAID DUE
34.00 34.00 .00
DIVISION TOTALS--> COLLECTED: 34.00 OVER/SHORT: ,00
LDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN–CHECK
34,00
dE df**♦E iE iE dE*4dP dEk*il4iF*kdf dE dtkdE ik dt it df kdE dE iF dE dE lE iE dE dt df iE dE♦f ik lE dk dE dE dk if dF df dE*dE iE iE 1E ♦f dE dE dE iE dE it*MdE dF IE N•*dE
I N D I V I D U A L F E E B R E A K D O W N
QTY D E S C R I P T I O N UNIT COST TOTAL COST
I RECEPT/OUTLET 1 ST 20 EA. 1.00
1 MOTOR/POWR APPARATUS 1.1 – 10.0 HP 11.00
END OF FEES
1.00
11,00
01 00218690-00218690 TOT 34.00
DATE: 11/06/95 TIKE: 14:45
CONSTRUCTION AND PLANNING
APPROVALS Permit # Date
Inspector
POS '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-Undrgrnd.
4. Forms
4. Electrical Conduit-Undrgrnd.
�� 7 !
I
5. Electrical Bonding
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
•-
7. Footings
58, Electrical Conduit-Undrgrnd.
B. Foundation
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 FORPLASTERING
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 0Gas I-) Oil
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrod. 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
33. Final Electric
(� 410
FOOD CERTIFICATE ISSUED
es:
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 Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
--
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
BUILDING PERMIT LOG
EMPLOYEE: 7Z
l
ADDRESS: JZ 3 1' HNT9 CI q xaM -�
PERMIT NUMBER: E: 80 33J PE OF PERMIT:
VALUATION:J3�b.33 4 SQUARE FOOTAGE:
PERMIT FEES:
DATE: TIME IN TIME OUT ACTIVITY
ONLY ONE ADDRESS PER SHEET- TIME IS TO BE CACULATED TO THE NEAREST 15 MINUTES
PLEASE BE AS SPECIFIC AS POSSIBLE IN RECORDING ACTIVITIES
"30
ADURESS9i;I6 )INO: 1'183 PANAY CI
ONN 5NANEIPauwNKOLANOSKI, THOMAS E TR
+ MDRESS10218 N CENTRAL AVE
PHOENIX, AZ 85020
968-3564
AI+PL. MMuxo ADDREss
ARCHITECT OR ENGINEER:
ARCI .OR EN0.5 ADDRESS:
UC. MO.:
UHT:
UNIT:
DDWTRADTORS A 'LANDERS POOLS (714)722-7328
CONTRACTOR91w10N0 2569 ELDEN AV
AODRESS:C , M. CA uc-w- 256213
92627 DM: C-1
LICENSED CONTRACTcardreN d ury
ORS DECLARATION: I hereby of nn carder mpenthat I am fanee
sd und der prov d. Chapter 9
(o nuh.ncinl enM1 gam . TODD) of Divisum 3 d the Budmes and Profsador Code, real reit k. e at hA for. end aMct.
C"UC.No.066614 uacuss:C 53 uc 0.:25631/ EXP: O1/ 7
�A,/_Ao:>7 ��
OWNER BUILDER DECLARATION: I looby affirm under predly of perVry that I am tempt from the Comrraas Lioers law la the
foYowip ream (Semon 10315 Bueiws and Rdevabru Code: AM Cay or county whim reyu'vm a permit to oarsioni. after. inproye,
aodbh, «repair my elmct.w prior to le Yeuerae, also rpuiree the apptiomn for such prime to fib a sgrd stmemem that M or M
boomwed purrmn to IM provisions of the Com«e«a umm. I.A. (Chewer 9 (mmmviW with Sedan Toot)) of D:mion 3 of IM
aueber Arad P rhpta r Codel a Ihel M or ars b tempt Iherdmn ard the beds for the atleged reception. Ary violmun of Section
1031.5 by my applicant for a permit mbjecla IM applicant to a mil penally of nd more thm We hurdd dealers r50()j).
❑ 1, m owmr d IM property or my. 0o see wih wapm as Ihen cob oompemation. Wldo the work. ard the mrwurs b eel imerdad
or offered for sale (Section 10a4. Buweees and Pr.lessioes Coat: The Comodoo Licanse Law does rrol applyto m own« of property
wM bdda or inpmyes tMrsm, ard who dome such weak Nmself or Mrsei or through he or her own empkyre, provided that such
impovememe are not intended or o fed for sale. tl, however, the buibinl or improvement is soM within ore year of completion, the
ow.r uilcer w;S l.ve IM bumen d proving M «line did roe wird or impmw for the purpose d sale).
❑ I, r owoer d the proPeM, am axdmivdy oontrad l anh licensed Corarmnom to construct the project ISedion 70M Business and
Pwessi«o Code: Th. C Imot«s Ucemea Law does noi apply to an .weep d property mho wilds or Import.e 1Mr.m ern who
conuecls for suoh prolan. with a muactor(e) Iioenead Wouant to the Commct«a L arm.. Lew).
❑ 1 am exempt carder Soction: B. 6 P.C., for this reemn:
Data: 0.:
I do hamby candy that I am awme of ard undemrmd the reeuimmenb of CataDmia Ileefth and Safely Code Sectiom 255°5.25533. ard
25531, .rd dad I or any enure wiMelp ocagent will I will rat (acts ate) need to campy with add me Dodo end the r.Raremaras ler
e
Patera for caruHo,oion or modifiwb hon the AVMMYWy m_ noadl Diapid. ReeMemid oaneo n applications an asemq from ter.
law+uam.
Data: Applicant
WORKER'S COMPENSATION DECLARATION: I hereby Won order penafty of p qury one of the lodowirr9 declaral
❑ Ihm ern will manaaioeaadGled meent to rtlrrwrebwarkeo'carnpersmun,r prwid.d la by Samos 37o0dtM labor
cal.. b IM md.men.. d ue work t« wltn Ind. perms i, i,.u.d.
❑ I nam and W m i is in'.dmpermmion umrerae. r reR.ned Iry section 31W d m. labs code. b the mdaA+er+m a the
work la wfiim this
maem nn e ueoed. MY waken' campeneatb bmrance wrier end policy rmmber me:
Carrier:
Policy Number:
frda aeaAe head nit n eamplda i Arte pem f or for «e hard ed dcaear 151001 or leas)
❑ I certry Nat u the pedomerce d iM work for wh'rA tka permit b Hued, I MeU ret empty qpY Person kr erry mmrer r r to
Mane redject Io the wabn' oornpepsatian laws of Cefdorrie. arid al. DW d I eM,y becvm vApd to that wares'
companaat. pvrSection 3100 d IM Labor Cods. I tonhwih campy 6
Date: i/ - c —72 App mem:2 ri�c
Wamin9: Falcate m arum efodran' ponrpansadon rovargpa la unlmwftg and shell srllrrpf an amylo)wr m CdrrYrW panaltlr mrd
Cfdl Rree r4 to ore hardred IMurttl "Jars (SIM"A In edJlfloo to Ma toad of.omperuedon dermal r vovMed ler In
S.H. 3M of are Lror Cods, Inf eae4 and m aryl" It fro
CONSTRUC 10N LENDING AGENCY: I hereby affirm carder pemfty of perjury that there u e bndin9 apenoy ler the
parvo mouse of lM work ler whim the roma is caved (Section 3091, Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I oently that I hew read that epptiwien end maps two the shove information is oomed. I Alpert to campy vmh M dy oral coumy.rdbmrm.
apd owe laws olmin/ to wilding mnmudion ard hereby euHerae mpresemmivas of this my to enter upon the afar trmemioned property
I. irpection Wrpoer. i
CARSO4 LrANDERS
Prim N 7
.- t� Dose
S,,,W.6 of OwnerIA rdiAppiCenVConnedor
(51514e.WP) White-BuPMig b Safety; Green -FIs; Cmay-Appicam; Pink- rota; Goldenmd-Avseesa
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 080334
PERMIT NO: B 080334 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION REDECK, RETILE 5 REPLASTER EXISTING POOL SQ FT: 10,000
CLAIM VALUE: 10,000.00 CALC—VALUE: 10,000.00 GROUP OCC: R-3 /
COMMENTS: RELOCATE POOL EQUIPMENT, INSTALL DRAINS
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
--------
MAIN BUILDING
----------
---------
ACCESSORY
BUILDING ---------
FT
IN REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
FT
IN RGHT:
FT IN
LEFT:
FT IN
RGHT: FT IN
ING REQ:
PROV:
PARCEL:
13912246
ZNE: RI
REF NO:
WING NOTES>
SFR 10000
POOL
1.00
10,000,00
>
END OF
FEES
y
* if * i%iE if iE iE if * * ii iIt it dE iE iE iE iE iE 1E IE ii"IE iE 1E iE * if IE iE F'M if iE iE ♦f if iE * iE 9E iE'yE N' if
1f if if 1E * if if if if i%dt
iE if')E')f if iE'ii iE fE iE 9E iE iE ii' ii iE ii iE
D E V
E L O P M E N
T S E R V I
C E S R
E Q U I R
E M E N T S
ZONING APPROVED BY
DATE:
BUILDING APPROVED BY _ _ DATE:
APPLICATION ISSUED BY: _ DATE: alt-6—ci(
iE iE 1E iE 1E iE iE 1f jE * iE iE+E fE d(' iE 9E 3i'N' iE i! ♦E it) ♦E 1F iE k!E ii lE jk iE * iE iE iE 1E iE iE * iE 1E dE iE k irk iFiE iE iF 1E * 1E lE 1E ib dE 1i 1E iE *!E *!E dE iE dEiE iFi�i�i?-if ��Fi(- i(• 1k
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 162,25 1,00
SMIP/NON—RES
UE FEE
LDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
ALS ---- > 163.25 0.00 0.00 163.25 163.25 .00
REVENUE DIVISION TOTALS--> COLLECTED:
163,25 OVER/SHORT:
,00
BLDG PMT
PLUMBING
ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
162,25
1,00
*liif*lir iE 1E**ire if*iE iE**iE kiE iE iE iE IEfE♦E*♦E3E*1f**fir ii*1E 1E dE 1l kiE
iE iE if dE**di 1E*lirkiEklE dE dEfE di ii iE*iE dE jf �E irk iE jE jE*♦E jE*iE 3f dE 1f*
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 10000
POOL
1.00
10,000,00
END OF
FEES
01 00218691-00218692 T CET 163.25
DATE: 11/045/95 TIME: 14:46
CONSTRUCTION AND PLANNING
APPROVALS Permit # Date
Inspector
POC SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service or Pole
52. Pool & Equipment Location
'
2. Soil Pipe-Undrgrnd. i
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit -Und rgrnd.
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.
B. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. water Pipe-Undrgrnd. -
60. Backwash Lines, P -Trap, O 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 12-z�
-
�w)L1
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
16cw
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 0 Gas 00il
23. Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing
73. Undergrnd. Storage Tank OGas ❑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 Nailino
HEALTH DEPT. REQUIREMENT
31, Plaster Brown Coat
79. FINAL INSPECTION
32. Electrical Power Meter -Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe -Test
Notes:
G -7 17--C/dl/Yiy
t �- -
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 Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
`)
LAOTJ'E'P-5 Tc)oLS
2'S6 2C
X(s�
WA Ll. P.L tJoT- T -c) ScALig)
r= ,
NEW r EXIST Puoc,
SKIm� f'
!JC- W
C0U r I- KE-UC-crC-Rc-Ti�E
HIP ��` +1. %E r'! A5TE2 ilopL
3. Ave►OU I►Js TO
Tb)\
K01,AN 05 KI
Kr -S I► )F/Uc
PIVISION OF VUILDING SAFETY
W CITY O COSTA MESA
APPROVED S-
P,
-
This set of plans and sp tions MU$$LLbbe kept an ta' job at all tim�s
ar nlawtul to mak any changes orf& erat tAsh
i 2 83 �'A NA 4� C 1 �' C gym.Inc c Building and Safety, Ciry at osta Mesa
L� kTire stamping of this plan and specifications SHhLL NOT t held to permit
n -j'N I� [ S A to be en approval of the violation of any provisions of apy City of Costa
Mesa Ord�irarxe arWra Slate taw. Q'7 3-a�71 �J
These pLm and permit shag expire by kmitation and become null and vold 9
the bulldog or work is not commenced and maintained active per UBC §303
(d) within ISO days of issuance.
Qoff\ t7 wig y1M�CA 19a
July 5, 1974
Mr. Thomas Kolanoski
1783 Panay Circle
Costa Mesa, California 92626
Dear Sir: \\
A building permit has been issued to California Pools, Inc. to
construct a private swimming pool on your property.
In order that your pool wile a safe one and for the purpose of
advising you of your responsib ty regarding the requirements of
the Costa Mesa Municipal Code, we refer you to Section 81070 a
copy of which is attached.
This letter is di ed to you in order that you will be aware of
our ordinances and c make a complete safety check of your pool
area.
Sincerely yours,
RICHARD HANHART
Building Safety Director
RHtcb
2O Zs
TESTING
July 24, 1974
ininq Laboratories of S- out&7¢ 2 niefoz.Zia, _911a.
P.O. BOX 47 . 3310 AIRPORT WAY. LONG BEACH. CALIF. 908D . (213) 4263355 . 1213) 636-2386 . (714) 626-6432
PRANG OFFICES:
Isu.Dn-, He.w.snag Nen Oon..n
Sent. Ane, CsGfo.nle C7RW e'0 .n"• 7955 Redondo d.A.... V.,
O. 80. 47
L�]M5
IT H) 5. ��. ..� q Len, Be. h. CeGf, eD501 12131 63e 2311S
�Y.O{
Examination: SC74-3949
COMPRESSION TESTS ON GUNITE CYLINDERS
Mr. Errol F. Heesch
12921 Aspenwood
Lane
Garden Grove, California 92640
p
PROJECT
Swimming Pool for THOMAS
KOLANOSKI
ADDRESS
1783 Panay Circle,
Costa Mesa
SAMPLE FROM
Gunite Swimming Pool
ARCHITECT
CONTRACTOR
California Pools
ENGINEER
SUBCONTRACTOR
Grove Gunite Co.
"
SPECIFIED
MIX
4-1/2 to 1
STRENGTH
2,000 psi
DATE CAST
7-17-74
CYLINDER SIZE
DATE TESTED
7-24-74
7-24-74
7-24-74
4 "HOLD"
CYLINDER NO.
1
2
3
5 "HOLD"
6 "HOLD"
COMPRESSION
7 -Day
7-DaY
7 -Day
TOTAL LOAD, LBS.
95,000
81,000
104,000
POUNDS PER So. IN.
3,660
3,120
3,680
SIZE:
5-3/411 x 12-1/211
5-3/4" x 12-3/8"
611 x 12-1/21'
COMPLIANCE
7 -day test complies
with specifications.
MADE BY
DELIVERED BY
RECEIVED ON
CYLINDERS
Maleome
E. Heesch
7-18-74
DISTRIBUTION
Costa Mesa Bldg. Dept.
----__Trpve Gun ite Co.
E. F. Heesch - 2
... 4�.. e s .... s uo 'gyp .. ..r .. .. ✓e J.,i u.. Oe r. ['.•s ..... oa :...o •. iOc .i. ..K.•.O •. o. obn nc✓ona concLL 5�0 •.5 ou I.
.'s ,., .. ., � .. �. .�. ..... s �r sl .,,.:, eI o„ .. o ... .e•..o.,,,n.., a ,. r...< <.00 re e• ov .
a eue•. •s �T =uRue •.o o„�seurs
M
T
ADDFJ AW; 1783 PANAY CI UMT: ,
OINERSNAMEIEl01p/Ih KOLANOSKI, THOMAS E TR
eedppxess: 10218 N CENTRAL AVE
S PHOENIX, AZ 850201
968-3564
PPL. "LOAD ADOREM'
ARCNITECT OR ENGINEER: UC NO--
M11.
O:M11. OR ENO'S ADDRESS: UNIT.
CONIRACTOIES NMw: ANTHONY F PALOMBO CONSTRU ( 714) 968-3564
CoNmACTOR3MMUNU 21702 IMPALALN
ADDRESS: HUNTINGTON BEACH CA U,w.: 191801
926 6 UNIT:
LICENSED CONTRACTORS DECLARATION: I hereby Nom under of petj Icemed under wwlsons of Chapter S
(oommen iiq with Seclion 7") d Division 3 of the Businan And P as e is in full Nam end
CITY LIC. NO.: 0 6 710 LIC. cuss: B C. 1 1 • 3/97
de: —Y-16 Cmdaxa: ��
dNER BUILDER DECLARATION: I ImMy a under pmdty of panjdy the, I me ee mpl /nom IM Cavadas lar la pr
Idbwitp reason (Semon 7031.5 Staines and Pmfeadand Cade: Arty eby a nouety whcA nedins a peed to woman, abs. A ,,ey&.
darlolath, -= my Nucme, pia b of "nsuanoe, eoo Md. IM appE®n11a ouch peed to Ne ..typed tandems Chi he a she
u 4eemed pnedeN to the pwatem d IM Cwradeas Liomde Law jChps, 9 (aomms,tmp wuh Section 7ODD) d O,vecn 3 d IM
Btama se end Prefessime Coda] p that he a she is assmpt therdmn and the baso for rite al"ed exmpin. My vidman of Section
7031.5 by my applicant la a Wted s tbjede the epdipml Io a pmT Penland of M man then Tre hundred dollen ]S500D,
❑ 1. ... dthe penny e, M anpkpan nth Welles as lhm sole mmpemdion•rDl do lM xark. and the awdue is not W.odIad
e, Ns,ed for cele (Sectioo 70". Bunineo end Pnlaasials Cab: The C amaaors Limine Lardom cad Apply,. mawlwr of pnpmy
rho bolds or ao m Iharan, and who dead auM va h IimaN or haaeE or though he or has win amd"Ma. prodded that ach
imprommens we rot intended or offered for sale. If, however, IM Is icirp a Anppvemant I. aoal within dna year d em,pimm, the
owns,4uider wi0 leve the burden of busing he or she dal not build a knpoye la the puryme e, sad).
❑ I, as ohimr of the petpvy, all aadmivaly mntneoi g with%�I.
canatruct the
Is
Med (Section 70H ince and
Preleseim. Code: The Cmlraclae, license Law dose cad pomM who, Wilde a impwm I non end wbo
mntrm,a Ia such pgeda wish a mMrecsor(s) licensed Was Liana. Lew).
❑ ar11 mem Sed' ! B.'A P.C.:Dan. L 1J•Idoherebyoerdy01at Iamewvedendundasbnd0e needrend Nat I a my Move bdMa9 acmpw WI /w0 tq (d* win mid able.odea end that reads d.l. b
a perms Iamnemxfon a modifm,ianhan tM A.IIii yy7A—mepanerd Madrid. Residential mMndaim appNxtimaan asemp Inn bna
pwisidn..
Date: Applioaro:
WORKER'SCOMPENSATIONDECLARATION:IMreby MNi underpereydperjuyateddetotlowiydetl ism:
❑ Ihave andne mdntaaea of the,edaadmfto Marion is ound.t mrnperldatian,v provided to by Sed]a13700d1M lobar
Godo, to IM pManmanaa d IM won la wlrch Nb pamA o Mudd.
] I neva and hint nue pas is as' opmpamallen aedrmm. as taquinA by Ss,lcn 3 ndl policy
Labor cods. br tM partamatca d tM
work la witidl No llama b atsuad. MY workers' cornpemdion ilmnrenm cartia and pricy number vat:
cm er:
Paley Number:
!this udin need not es oanpbfed r fns pamd is M one AUMnqift ❑ I mn9y thin in IM pMormaKe d ,M wak fa when Ilia Po person In any me sat to
became subject to the wodnri wmpmmlian laws d Cabeta/yP/�,:! d �Cgd�gn 3700 d the Leber Code,Date: 6 nL/ ApplicW: AnWamlyployv ro elm' wand
o""0
Iq ro ono hdndrM Wowed ddbrs ($104"1 At scodden Is any dmf o7 mnlParrsatlo,t darn se As ",ked, An, In
S.I 37od of Ms labor Cods, Imaedt and Inerrtay's b
CONSTRUCTION LENDING ADEN YI I hereby alfrm mala penalty d pa}ry the then is a m9rwion WId'up patty lar One
palanenca of IM wak lar whirA that pant a iewed (S.dan 3097. CN. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I cenify, Ihd I have read No application And ride that the above indentation as caned. I pre ID Comply auh N dy and noddy oNAlvcas
anal stats 17 to Wtldap u�aslon And her.eby edhabe reprevenlatiw d the olty to ants, upm IM ebovsmemcned popMy
for inepedion dr aria HONY PALOM 0
Prin _z �!
�- Dine:
51 urs dl erfApenUApp nova
(5151) .WP)
Whle.-Bui-A Soley: Groep -We: uwy-Appimnt: Pink_Rweab: OoMauod_Asnyp
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 078833
PERMIT NO: B 078833 PLAN CHECK NO: 03089-96 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
JOB DESCRIPTION ; 66.5SF CLOSET EXTENSION, BATHROOM REMODL SQ FT: 5,067
CLAIM VALUE: 12,000.00 CALC—VALUE: 11,999. 3� CM"MT,TAO R
COMMENTS: 66.5SF CLOSET, BATHROOM REMODEL
1E 1E 1E 1E iE ♦f * 1E * dE 1E 16 * 161E 161E ♦E dE d6 iE * ♦E * 1E * 16161E 16 i6 i6 alt d6 * 16 dE dE 1E ♦E 1E dE 1E 1E N: 1E iE 1E iE 1E 161E 1E 1E 1E 1E 1E * ♦F 16 R6 dE iE 16 3E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQQ• PROV: PARCEL: 13912246 ZNE: R1 REF NO:
PLANNING NbTES> ADD 66'.5 SQ, FT. CLOSET TO REAR OF EXISTING HOUSE. NOT WITH
•> IN ANY'SETBACK AREAS.
1E 1E dE*169E dE 41E**1E 1F 1E*ii dE lE if dE 1E*1E4*iE'iE*dE 1616 aE dE 1E 1E 1E 1E 1E dE 1E***dE 1E*16♦E 1E 1E iE 961E 1E♦E if 9E 1E 1E*1E 1E 1E*♦E*1E 1E dE7E 1E 1E aE 1E 9E 1F*1E 1E
D E V E L O- P• M E' N T' S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE: o' 2-00ca
BUILDING APPROVED BY,
APPLICATION ISSUED'BY
* 161E 9E 161E iE 1E 1E 1E ♦E ♦E i6 ♦E 9E * iE 1E iF * N-1E3F'iF{F
LEGALIZATION:N
DATE: _
DATE:
iFiFTF�F7F7f3F�iFiFiF7fiF�i%iFiFiFif'�FiF7FDF iE if iE iE ik iE lE lE iE jE iE 1E
F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING
ELECTRIC MECHANIC FIRE SMIP/RES
GRADING
PERMIT 187,25
1.20
1 SMIP/NON—RES
PLAN 121.71
ISSUE FEE
BUILDING—DIV—> PERMIT ISSU
PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- > 188.45 0.0
121.71
310.16 310.16
•00
REVENUE DIVISION TOTALS-->
OLLECTED:'
310,16 OVER/SHORT:
.00
BLDG PMT PLUMBING ELECTRIC
MECHANIC'. .FIRE
;SMIP/TOT GRADING
PLAN—CHECK
187.25
1 1
7 1.20
121.71
1E ♦F 16 N:961E*1E 1E dE*1E*9E 9E 1E ♦E ♦E ♦E if *1E 1E dE 1E 1E**1E*161E
r '
9E ♦E♦E dE 9E 1E dE 1E 1E dE 1F iE 1E 1F iE 16169E 1E**1E 1E 1E 1E iE 1EiF iE 1616 ♦E 9E 1E 16rRE
1F*♦E 1E 1E ♦f aE 1E 9E
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 67 DWE—TYPE V—WOOD
SFR 6780 ALTER BY VALUE
FRAME —GOOD
RESIDENTIAL''.NOZONE
END OF FEES
77.90 5,219.30
1.00 6,780.00
CONSTRUCTION AND PLANNII
APPROVALS Permit #p
Date
Inspector
DL & SPA
APPROVALS Permit #
Date
Inspector
't Temporary Electrical Service or Pole
52. Pool &Equipment Location
'
♦ 2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement '
3. Electrical Conduit Uiility-Undrgrnd.
54. Forms
'
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
,p
5. Steel Reinforcement- X
6. Electrical LIFER Grnd. (/
L�-qV
�p V
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
i
7. Footings $-•��
GL
�Gv�
58. Electrical Conduit-Undrgrnd.
'
B. Foundation
9. Water Pipe-Undrgrnd.
/
tP rvV
_ /b/
59. Gas Pipe, 0 Undrgrnd., Test
60. Backwash Lines, P -Trap, p Undrgrnd.
'-
10. Structural Ftoor System
61. APPROVAL TO DECK(_
11. Property Sewer Line & House Connection
62. Backwash � Race tor+Fhfal
12. Sewer Cap
' "
63. Heater &Vent -Final i
13. f Drains �p.y, ,-fL'�t -, 1 r
L`� W
4J/ -LI
-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
APPROVALS Permit 4#-
#
20. Rough Factory Fireplace
21.
21. Ducts, in Structure,
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping OGas 000
23. Gas Pipe -Rough & Test
72. Underground Flush
24, Roof Framing
73. Undergrnd. Storage Tank D Gas D Oil
25. Roof Sheathing g
Z7 -C
74. Overhead Hydro
26. T -Bar Ceiling (Structural) & Monocoat
75. Dry Chemical -
27. Frame and Flashing•
76. Dry Standpipe - -
28. Lathing & Siding- 8L(O
77. FIXED SYSTEM FINAL
i
29. Insulation g
30. DrywalLNailFno /L�_(�
31. Plaster Brown Coat _� t_ t!O
32. Electrical Power Meter -Final -
�G(/�79.
78. FIRE PREY. FINAL
HEALTH DEPT. REQUIREMENT
FINAL INSPECTION _
80. FOOD CERTIFICATE ISSUED
33. Final Electric
Notes:
34. -Final Heating & Air Conditioning
35. Final Gas Pipe -Test,
/ 6_ 06 . .....
G GG
36. -Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing
/ _p
--
39. Water Service -Final
L -Z(�
40. Gas Service -Final
(.• _`Z
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 Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
City of Costa Mesa
California 92628-1200 P.O.Box 1200
Insulation Certificate
Number a d Street
e c
County
ROOF
Material
Thickness (inches)
Permit Number
City
Subdivision Lot Number
Description of Installation
EXTERIOR WALL
Material 5—: L
Thickness (inches)
CEILING
Batt or Blanket Type
Thickness (inches) a
Loose Fill Type
Contractor's minimum installed weight/ft2 Ib.
Brand Name .5�t t o SAL r�
Thermal Resistance (R -Value)
Brand Namek`'` L�01 W
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Brand Name
Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value)
RAISED FLOOR
Material
Thickness (inches)
SLAB FLOOR
Material ccilccQ�_
Thickness (inches)
Width (inches)
FOUNDATION WALL
Brand Name
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Material Brand Name
Thickness (inches) `r Thermal Resistance (R -Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
SIR (86 (
License Number
Ski �� (Ct
Date
(_`(_(_$61
License Number
�may" ``-
V\ \ Z-� L L Y+
190]-46
i
�AODR13sa RMLIKriO: 1783 PANAY CI UNIT:
OWNEWS NAME IF 1010w'N: KOLANOSKI THOMAS E TR
ADDRESS: 10218 N CLNTRAL AVE
PHOENIX, AZ 85020
968-3564
APPL. M U O AOWES&
ARCHITECT OR ENOMEER: UC. NO.:
LRCH.OR ENO: S ADOREW: uNT:.5 7 1 I G j
q q
E:
cD,nA,m,,,MANTHONY F PALOMBO CONSTRU (714)968-3564
`
cO AcmFrsmmUN, 21702 IMPALA LN
ADDRESS: HUNTINGTON BEACH CAS, 191801
t94 Ute.
UCENSEO CONTRACTORS DECIARATKIN: I Mreby ellD rPrmi(commednp wnn 5erMn )000) d Divla"vn 3 d IM 11atheC d d my looms la In hD face en Ntea.
cmuc.No.:0671 1 uc.cuss: H O1 EX 03 97
Dela: �v ` CmNNER BUILDER DECLARATION: I hedby affirm underhea I am IM Ca.redod Llama Law for Ow
Abwn9 reason (Seddn 70315 Bmkma and Pdlaaiam Code: Amy city or county N raluim a pamw ID corstmd, ell, hnpove,
demolish, or lapse any Wnwture. Prior 10 to beans, Woo repu'ves tM appficenl for such Moot to fib a w9nd statement tlW M or all
b loosened Wlosant to tM paisim of dw Coranmas License law (Chapter 9 (commend, with Section 7000) of Division 3 of IM
Steins and Noleaiore Calel or Ilea M a she it exempt thaelvn and IM Ims"is for De ".0d exemption. Arty yidetbn of Section
T091.5 by any appikant for a permit Wbj d IM apprr to a a paeDy of not more tfato We hundrd doter (Ss9DD,
❑ I. a meter of IM prepeny or my wnplWwa with wa9a as tMi sola compensmin. ad do Pe work. and Ow wnxune is not n4adad
a offered lar gab (Sawon TDM. suites end Pndeaaiona Code: TMCaurectare litems law does nd appy loan ownerd properly
who Mich a
we
not Whereon, r o Nm does ash cork Nona, l hereei a Wouph M a her own an one year
polled then each
oemmrnerd ma urate tended ie detect to, ,osis. r however, Dw iW o im a for tM pt b add within. Yer d drrlPld'nn, tle
mner-0uimm will haw IM Mrden d govinq M a site did rad MiM a impove la tM WNcaa d este).
❑ 1. as meter of IM pmpeM, am exduively mnarmn9 cath limred corereators to conmrud Na project (Section TOM, smites and
I'mi nor Cab: The Comrades Liam law dove nor apply to an mere of pMo." who bride or lapwa tMraon ad NIo
contracb for wool p lade w a oparacton.) licemed pmuwe to that Contactors license uW).
❑ I am mampl oder Sedb": B. A P.C., lar Nb reser:
Data: Owen
I do hereby cedf, then I am... of ad udwaad tM randrrnaa of C Womfa Heath ad Safely Code Sedum 25505. 25539. and
25590, and IMI I or any Mum buiNin, ocapent will /wit not (ddb one) need to comply cath said wale coda and IM neubamerds for
a More lortenstmobn or modif tion from tM Ai eanane9emem Dienes. ReidmlW amanxien e,Acw. ua eza pt 1. these
Data Applioam:
WORKER'S COMPENSATION DECLARATION: I Mraby affirm oder penMy of pelhay one of os f0moly ddemions:
❑ Whew end wit meimenacanib:.tad Wmmltoedalmnre fa wgkert colnDensmipn. ea pnwidd la by b'edlanl9]00d lM labor
Code, la tM pdamxu d caw work la xdidl nth pemW u ®ued.
(] Ihave adw theeworked'mo. My envie i!compe,aton numm, Section and dOs labor Core, larIM pedamencadIM
work la which Ihb pemd b laud. My waders opnpentdlan imurencs carrier end policy number are:
Cama:
Poky Number.
(]hie swoon meed nor be comp/etd I l a pami or for One hurdrsd I9t00) Am.
❑ I aafN Dena in ms penamerww d IM work b wh'rh Ihb laud. I d erry penan n any s° as to
become aubjed to tM workers' colnnpemmin laws d CNi a ere m hWd wosere'
w�enJyem,Ngn D7'�%�ism d Sed'mn 97M of IM leba Code. l o m prensve.
Applicant: C
Wamin9: Felled to axon woraxa' eonpxustlon rowrege 1. /,sand dell loyx to MWInal psneMss and
doll ff. w to one h ~ Ihcuad ddlsn (SIDq OOOA In We W M amt of anmpxuafbM1 deme9ea as pnoyMd lar In
9.0. 3706 01 tM Lebo, Cade, I.I.I. and.0omeye 1.
CONSTRUCTION LENDING AGENCY: I hereby affum oder penalty of perjury Ihm lines I. e canstnldin bndin0 a0aa:1' War Ne
o
pedn. of the w°Ik M whim this pallnt b issued (Section 3097. Civ. C).
LENDER'S NOME:
LENDER'S ADDRESS:
I ceniy then ave red Ihb eppfx:min ed coma ohm Dm above information b carted. I roles to campy omit M dy and axlmy odirencs
ad sola at I V l ra b buldM c lietnnd ewe
hereby lwnm inf rep ion is comet.
t. the my o .mer upn the eboand Weaned pdpany
Inv poem"°°� ja. ANTHONY PALOMBO /� �/
Dene: ` Z (—
re VA UCmnldtlor
(5151dd.WP) WMe-Buldiq d Salary: Gd Fde: Camry-Appica0: Pink -Reword: Gddenlod-Avaaaa
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 078834
PERMIT NO: E 078834 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION : 66.5SF CLOSET EXTENSION, BATHROOM REMODL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: 66.5SF CLOSET, BATHROOM REMODEL, RE:#B78833
�+1�*+�**1EiriElEdhxdrdfi(iiiEiflFHiilikiEiF101EifiEiElOik��*iE�iE9EiE**�***�E**/E**��**��P**�u�***�+E*+r*����E*�+E�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------
MAIN
BUILDING ----------
---------
ACCESSORY
BUILDING---------
FRNT:
FT IN
REAR:
FT IN
FRNT:
FT IN
REAR: FT IN
LEFT:
FT IN
RIGHT:
FT IN
LEFT:
FT IN
RIGHT: FT IN
PARKING
REQ
PROV:
PARCEL:
13912246
ZNE:
REF NO:
PLANNING
NbOTES>
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
>
ELE 6
FIXTURES, LIGHTING: 1 ST 20
EA, 1,00
6.00
ELE 6
iF 9E 9E iE iE Hf Hf ie
dE HF ii 9E iE ♦E 9E iE * iE
iE iE * * iE iE iE iE ♦E dE 9E iE 9E 9E iE * iE * iE iE iF 9E if iE * iE iE iE iE iE 9E *
iF iE 9E * 9E 9E iE iF iE iF
iE iE HE iE if iE 9E iE iE * ♦f iE iE iE dE iE * iE iE
D
E V E L O
P M E N T
S E R V I
C E S R
E Q U I R
E M E N T S
ZONING APPROVED BY
BUILDING APPROVED BY
APPLICATION ISSUED BY:
ik iF iE ii iE * iE 1E iE iE RE ih it i! iE it iF iP lit lit ♦E iP7F7FTFiF";f"iE"iFiF3F3FiFiFiFiFsi�fiFrF3FiF3F 7FiF
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 12,00
50t
DATE:
DATE:
DATE: 7 TLS
iE dE * * * iE iE iF ii ik
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
PLAN
ISSUE FEE
22.00
BUILDING -DIV->
PERMIT ISSUE PLAN -CHECK
TOTAL PAID
DUE
TOTALS ---- >
12,00 22,00 0,00
34,00 34,00
.00
REVENUE DIVISION TOTALS--> COLLECTED:
34,00 OVER/SHORT:
.00
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN -CHECK
34,00
iE iE * iF iE iE iE * * iE iE ♦E iE iE iE K iE * * if iE iE * * iE * dE dF iF iE ♦E 9E 9E iE iF 9E if df 9F iF 1F iE RE iE iE
iE 9E iE iE iE if iE 9E ik 9F 9h iF 4 * HE iE if * iE 1E iE iE H! iE iE iE iE iE iE i6 iE iF iF HE
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
ELE 6
FIXTURES, LIGHTING: 1 ST 20
EA, 1,00
6.00
ELE 6
RECEPT/SWITCH 1 ST 20
EA, 1.00
6,00
"END OF FEES
CGNSTRUCTION AND PLANNINI
APPROVALS .Permit #
Date
Inspector
L & SPA
APPROVALS Permit #
Date
nsp;ctor
l.'1-emporary Electrical Service or Pole
+
52. Pool & Equipment Location
r 2. Soil Pipe-Undrgrnd,
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit•Undrgrnd.
55. Electrical Bonding -
5. Steel Reinforcement
56. Rough Plumbing & Pressure Test
a
6. Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
. B. Foundation
59. Gas Pipe, O Undrgrnd., Test
' 9. Water Pipe-Undrgrnd. _
60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System
61. APPROVAL TO DECK f
11. Property Sewer. Line & H6use.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
I& Rough Electric Wiring
17. Rough Wiring Sign
jj
��� 6
66. Solar System-Final
67. Fencing & Access Appr6val
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 OGas rO Oil
23. Gas Pipe-Rough &•Tgst
72. Underground Flush _
24. Roof Framing
73. Undergrnd. Storage Tank O Gas O Qil
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 PREY. FINAL
30. Drywall Nailing
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coag
79. FINALINSPECTION
32. Electrical Polder Meter-Final
33. 'Final Electric -
80, FOOD CERT', 'CATE ISSUED
Notes:
_ 1 3 Y 7TCv o.)
34. Final Heating:& Air,Conditioning-
1 `
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 Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
ADDRESS Oi BUILDING: 1783 PANAY Cl UNIT:
01YNERB MAINE IF IDIOIRE KOLANOSKI THOMAS E TR
ADDRESS: 10218 N CLNTRAL AVE
PHOENIX, AZ 85020
968-3564
APPL. MCUNIQ ADORERS:
ARCNIfECTOREMQINEER: LIC W.:
ANCK OR ENG.'S ADDRESS: UNT:
c ACTOIR`lma : ANTHONY F PALOMBO CONSTRU (714)968-3564
cOhYRACTORSMMui0 21702 IMPALA LN
ADDRESS: HUNTINGTON BEACH CA utero:_ 191801
"61� UNIT:
LICENSED CONTRACTORS DECLARATION: 1 hereby Nim licensed under proveions d Chapter 9
(arm oe NwithSacUom]000)dDivision3dNeSusi scmLIC.NO.: 06 101 I .cuss: B1 / 9Data: § ConumC—
NNER BUILDER OECLARATIDN: I hereby alfum under petsly d perj ry IMI I am exempt hen rhe corweadas liowa law la the
UowwN reason (Section 7031.5 Buis. and Pmleeao. Code: AM cay or aanty which dies a permB 1. aamWd. Nen, impros.
damdeh, or repa r any auuduro. p/lor w m Balance, alae raluir03 the appf la such pemW to file a ®prod atatement Nat M Maine
e licensed pumuent to the a viawm d tle Coal.. Liunaa Law (Chaprar 9 (cmmmendN with Salon ]000) of Diveion 3 of the
Btsinaea and Prdeaiom Codel a that M or ahe Is exempt therehom anal the Mae la Os ~ exemption. Am violation of Section
7031.5 by Fey •.Plicas for a permit wbjede the appliram to a civil penalty of rod man that two hundred ddlare ISSDOD.
❑ 1,moaahardthe popes«my amdgees with aage, astheiadsmmPersemn. aindo Oswork,end Os amwuro is intendnd
a dtenae br edit (Saxon 70X4. Butiroaa ad Prolpai«s Cade: The Cesare r. License lewdose nit epplyroan owrord propd,
who Mics or knpwvp tMtam, and and does such wak boreal a herself or Wagh he or Mr oan wr to n ea, prodded that each
i op arws we not intended or fibred for sae. 1, lawgiver, the Mild w or inl.memaa a sold archin one year of ornpbron, dee
owror-0uiker will haw the Mrden d pwvintl M or she did nal Mind or impmw la the purpose of acts).
❑ I, p
darner or the prapeny, an udewly, oarwrodaq oath tiwaaed rano- suer. w o«stme Na .*d (safion 70X4, Buai Bas and
Pmle.ons Code: The Contredon lien. Law does not apply w an .surer of poppy who Miles or ohprwas that. and whe
contrecu la such pgada wah a o ntredpR.) fcrosed ppoarw to the Camottoore Liwma Lew).
❑ 1 are exampl under Sedion: B. & P.C., lar des
Data: Gander
I do hereby dalY dol I an... of and and rda cl de raaufnmads of CaMada N end Salary Code Seats 25505. 25533, ad
25534, and Inst I or any hours MikiW ae]man will I wB not (cine as) need to comply with eek "a edea and the rpuinmaMs for
e permalao«strucdonatrwdifiution horn Onelirhetet engTemem Diacid. Reak«aul mrhrtrudion eppfw[ioreare eaempltmnlMea
yrovhnm..
Date: Applicant:
WORKER'S COMPENSATION DECLARATION: 1 hereby aKrm miler perohy of perjury are d Os dlowhq dWarations:
❑ `new and ail maidaih acenddedoorsptloeNuhwn ror corkers'mrripentWkn,ppovidsd labySedon 3700drhe labor
Code, la IM pdarmpu d the work t« wlich MM Ferrell a Wund.
❑ I hew end wil meintdh avrkete aanpenwon ipuraeo, p hopuaed by Section 3700 d Os Lobar Code, ha IM pdampca d the
work la chid Oro pamd'o issued. My w«ken' compen,Nion insurance carrier ad policy number aro:
Career:
Policy Number:
(ibis eadion need rotW oanpbnd I the permit or b aro fancied' dolers Isiml or WSJ
❑ 1 omly sup in the pad« of the wok lar ahoh the a es d, 1 hdl npby am Fenton o any In
mp n to
becoe subject to IM waken' mmpeaealian le. C aper a the d alouk become Feb t xodwe' _
can ion hop d Section 3]00 d the lobar Code. n RII and � cee 'sb C4�
Appli doe.
W.mhp: FSNum at areun harkens' eompereetlan «warapa b w wed, and alWI,rOHd p snLRloyen ro «IMrW panrltlp srW
doll .r oy Io ons ar di Coda,
Infers ddbn ll... 0 f M rdl/tlon ro Mr rosf of romprnpfbn, ane., p provkNd roe In
Saotlm 3706 0/ tlts Le6or Cade, Infwss4 and srromay� Ips.
CONSTRUCTION LENDING AGENCY: I hereby alf under panahy of perjm flet then is a condadion wall' gpn , M the
pdarmance of the aork for whirl the Fermi is awed (sadion 309]. Civ. C).
LENDER'S NAME:
LENDER'S ADDRESS:
I caddy that 14tree reed the appli sum ad dal. that the above vdamaioneconed. la tocomplywhhOdya ourwyadipnces
a�Aqq.weM Iati, to Mildetl canmudion gird herebyeW ate repeeens as d the dry w oma ups the ab«ro memorod property
IP I ° `p9'°': ANTHONY PALOMBO
Dae:
(515146.WP) Whaa- ikitl6 Safety; Gr.mRla; Cena"ppidi Fnk-Raven.: Gokitra�Aaaa.ar
CITY OF COSTA MESA – BUILDING PERMIT
PERM NO: P 0788351
PERMIT NO: P 078835 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ADD
JOB DESCRIPTION : 66.5SF CLOSET EXTENSION, BATHROOM REMODL SQ FT:
CLAIM VALUE: CALC–VALUE: GROUP OCC: R-3 /
COMMENTS: 66.5SF CLOSET, BATHROOM REMODEL, RE:*B78833
1E * 1E 1E 1E 1E 9F 1F 1E if 1E dE 1E 1E ♦f iE N -1E iE iE * ♦E k 1E * 1E 1E R61E 1E 1E 1E 1E 1E 1t 1E * 1E RE 161E * 1E 1E 1E 1E 1E ♦F k 1E * dE * 1E 1E d61F RE * ♦E 1F dE dE SE dE iE 1E 1E ♦E 1E 9E 1E RE 1E 1E 1E 1E RE 1E
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN
PARKING REQ: PROV: PARCEL: 13912246 ZNE: REF NO:
PLANNING NOTES>
dE 1E dE 1E 1k 1E 1E 1F iE dE 1f ♦E df 1E 1E 1F 1E * 1E 1E 1E 1E dE iE 1E 1E 1E 1E dE 1E 1E 1E RE RF 9E 9E 1F 1E 1E iE 1E RE 1E 1E 1E iE"1E'dE dE 1E 1E 1E iE 1E ie 1E 1E iE 1E 1E iE 1F 1E iE RE iE iE dE * 461E iE dE Rf 1E iF * iE dE
D E V E L O P M E N T S E R V I C E Sal R E Q U I R E M E N T S
ZONING APPROVED BY – DATE:
BUILDING APPROVED BY DATE:
APPLICATION ISSUED BY: DATE: 5, 101c
1E 1E dE 1E 9E 1E 1E 1E RE 1t iE 1E if 1f RE SE 1E 1E iE 1E*ik�3f�3f�3FiF�f3f����-��Sf��-����3f�� 3f����iF��dl ik iE iE ff lE 11 lE SE 3E iE 3E
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC,– MECHANIC FIRE SMIP/RES GRADING
PERMIT 35.00
253 SMIP/NON–RES
PLAN
ISSUE FEE 22.00
BUILDING–DIV–> PERMIT ISSUE PLAN–CHECK TOTAL PAID DUE
TOTALS ---- > 35,00 22.00 .0.00 57.00 57.00 .00
REVENUE DIVISION TOTALS--> COLLECTED -.f-.– 57.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC— FIRE SMIP/TOT GRADING PLAN–CHECK
57.00
dE RE 1t*1E i6 iE 1S SE 1E1E1ERE iE 1f iF RE dE*1E 1E 1E RE 1E dE RE RE*1E if♦E dE RE SE IE RE IE****�1E 1E 1E 1E 111E SE*iE♦E♦F*1E 1E 1E*RE1E♦E**K1F dE 1F 1E 1E 1E 1E*1E 1E 1E 1F ♦E ♦F ♦E
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
PLU
1 BATHTUB
8,75
8.75
PLU
1 SHOWER
8.75
8.75
PLU
} HASH BASIN (SFT)
8.75
8,75
PLU
1 HATER CLOSET
``TOILET)
8.75
8,75
END OF FEES
1
S.
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
1 - & SPA
APPROVALS Permit #
Date
Inspector
1. 'temporary Electrical Service or Pole
52. Pool & Equipment Location
i
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
i
4. Electrical Conduit-Undrgrnd.
55. Electrical Bonding
S. -Steel Reinforcement
56. Rough Plumbing & Pressure Test
6, Electrical UFER Grnd.
57. APPROVAL TO COVER-GUNITE
I
7. Footings
58. Electrical Conduit-Undrgrnd.
'
8. Foundation
59. Gas Pipe, 0 Undrgrnd., Test
9. Water Pipe-Un&grnd.
60. Backwash Lines, P-Trap, El Uhdrgrnd.
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 - I
13. Roof Drains
64, Plumbing System - Final
14. Rough Plumbing UNpER $,LAO
)p-ta o�6
g�/
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 Ceiliag • d
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 0Gas 0O0
23. Gas Pipe-Rough & Test
-
72• Underground Flush -
24, Roof Framing
73. Undergrnd. Storage Tank 0 Gas 00il
25. Roof Sheathing -
74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat
75. Dry Chemical "
27, Frame and Flashing-
76. Dry Staodpipe
28. Lathing &Siding- •" -
77. FIXED SYSTEM FINAL
29. Insulation
78. FIRE PREY. FINAL
30. Drywall Nailing -�
_ HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
79. FINAL I-NSPECTION
32. Electrical Power Meter-Final
80. FOOD CERTIFICATE ISSUED
33. Final Electric
yy QQ
Notes:Ii4)�VG(� PiUmQl/1G Q/� U�
1.1 -46 Wft7FR SuPP>•Y O K Q
34. Final Heating & Air,Conditioning
35. Final Gas Pipe-Tett
36. Hood or-Canopy
37. Final Factory Fireplace
7
Final Plumbing
/a-�_CT `1
{Z n•/ _
_ .
39. Water Service-Final-
40. Gas Ser¢ice-Final
41. Solar Domestic-Final
"
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
-
.45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUfLDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
,
51. CERTIFICATE OF OCCUPANCY
No. Date
JOB SITE
DIVISION OF BUILDING SAFETY
CITY OF COSTA MESA
APPROVED
of
Tlis set of plans and specifications MUST be kept on this job at as We and it is otw411 O
ab airy charges oralterations on same wiw wrillen permission tram the Diveim of &WM
and Safety. City of Costa Mesa.
TIN stamping of this plan and specifications SHALL NOT be held to perms or to be an MP"
of the violation of any provisions of any City of Costa Mesa Ordinance and/or Stab Ica.
Tmse pians and permit shall expire by limitation and became null and void it the buildup or
VIA iand oamltnced and Maintained active per CBC Sec.105.5 within 180 days of isslerroa.
Window & Door Change Outs
1 The Following Locations Require Tempered Glass
A. Glass In Doors
B. Glass In Windows Within 24' From Doors And <Than 60' High
C. Glazing Within 5 Feet From Pool Or Spa
D. Glazing In Windows At Shower Or Bathtub & Stair Landings
< Than 60" Above Floor
2 All Construction Shall Comply With The 2007 California Building Codo.(CBC)
All Windows Are Rated And Certified For 20 lbsisf Of Wind Load.
All Windows Meet IBC sec. 2406 For Safety Glazing.
All Windows Meet tBC sec. 1203 For Light And Venlilation.0.08 & 0.04
All Windows Meet 2005 Energy Code Requirements .
U Factor = 0.67 Or Less
Solar Heat Gain Coefficient = 0.40 Or Less
3 Smoke Alarms In All Bedrooms.
4 Egress
All Bedrooms Must Have At Least One Window / Door Opeliing Directly
To The Exterior _ It Must Meet The Following Criteria:
Min Clear Width =20' Min.Ciear Height = 24"
Min. Area = 5.7 Sq. Ft Max. Sill Height = 44'
5 Does Any Door Swing Out 7 YES NO
The Outsvdng Door Must Open Over A Landing Not More Than 1" Below
Interior Floor Surface
The' Ing Must Be At Least As Wide As The Door(s) And Extend
Out f om The Threshhold The Distance Of The Doors Outswinging Arc
51U0001ASt" TUCKED UP
BMND WATERMDAPPA E'
A MINIMUM OF I'
ANDERSEN
ACCEPT fIW5HINGTRIM
ANDERSEN I35PRT WINDOW
APPROVED ANDEK5EN IN5EKT. WINDOW
ANDER5EN PATIO DOOR DETAIL
26'
.k.
--
- ---
------ .--- P/L--- .----- .------------- ._.-.__._
26'
Renewal By Anders
SCHEDULE
lj�
- - - - - - -----
------
---- PANAY CIRCLE -- -- --- -- - -- --- ---
L
7
Name
Renewal By Anders
SCHEDULE
DOOR
WINDOW ROOM
EXISTING SIZE NEW SIZE
1
FAM
118 X 79 ALUM PATIO DOOR 118 X 79 RBA PATIO DOOR - TEMPERED
2
BED
95 X 79 ALUM PATIO DOOR 95 X 79 RBA PATIO DOOR - TEMPERED
3
ATRIUM
70 X 79 ALUM PATIO DOOR 70 X 79 RBA PATIO DOOR - TEMPERED
ALL NEW
WINDOWS HAVE DUAL GLAZE, LOW E4 HP GLASS UNLESS OTHERWISE NOTED
Name
THOMAS KOLANOSKI
Dial One WRS
Adress
1783 PANAY CIRCLE
1621 E. St. Andrew Place
City, Zip
COSTA MESA, 92626
Santa Ana, 92705
Phone
714-545-2629
714-259-5210
Drawn By:
Steve Janosik
ALL NEW
WINDOWS HAVE DUAL GLAZE, LOW E4 HP GLASS UNLESS OTHERWISE NOTED
JOB:19720 mb
LEGEND:
XX
SLIDER, SLIDER
XO
SLIDER, FIXED
GW
GARDEN WINDOW
CST
CASEMENT
PIX
PICTURE WINDOW
AWN
AWNING WINDOW
DH
DOUBLE HUNG
SH
SINGLE HUNG
RBA
Renewal By Andersen
PD
PATIO DOOR SLIDER
SCOPE of WORK:
REPLACE 3 PATIO DOOR SLIDERS WITH ANDERSEN RENEWAL PATIO DOOR SLIDERS INTO
EXISTING OPENINGS
NO HEADER CHANGES
lie
o
wPndour Rrplsca+nant SparJaeafia
UWNtK SHERTZER LARRY & BARBARA DATE 6-20-68
JOB ADDRESS 178-_Panav Circle BUILDING PERMIT NO. 28677
AP ND. LOT 168 TRACT 3363 FIRE ZONE . VALUE $ 44 206.00
INSPECTIONS
Si nature Date
GROUP I & j
TYPE {/ ZONE R-1
SOIL
SUBCONTRACTOR
PERMITS ISSUED
GAS
Dote Number Signature
WATERu
Plumbi
ROUGH P UMBING
PROP. SWR. LINE HOUSE CON.
SPRINKLING SYSTEM
61
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MISCELLANEOUS
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TEMPORARY SERVICE OR POLE
6G'
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ROUGH WIRING
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CES FORMS STEEL REINF.
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FLOOR SYSTEM
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STRUCTURAL, FINAL
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ELECTRIC, FINAL
BUILDING, FINAL
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286.7-7
COSTA MESA B_UILDINGSAFETY DEPARTMENT
P.O. BOX 1290 COSTA MESA, CALIFORNIA 9=H1
For Applicant to Fill In Completely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
MAIL
STATE
NO. OF
USE OF
GETBACK LINE
DESCRIPTION OF WORK
BUILDING
EXTERIOR WALL
u
1 HEREBY ACKNOWLEOOE THAT 1 HAVE READ THIS APPLICATION
AND STATE THAT THE AQOVJ[IE CORRECT AND AGREE TO COM.
PLY WITH ALL CITY OR !A tl AND STAT LAWQ REGULATING
BUILDING CON
SIGNATUR
PERMITTED-���A��''r
AUTHORIZED AG[
JUN 13 x;00 865* *** 192.00
APPLICATION FOR PERMIT
BUILDING
For Office Use Only
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DATE RQQQJV[D-
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�UTVNLN SHERTZER, LARRY DATE 12-1-69
JOB ADDRESS 1783 Panay Circle BUILDING PERMIT NO. 31149
GENERAL CONTRACTOR Owner -Builder DESCRIPTION of WORK Private Block Wall
AP No. 139-122-12 LOT 168 TRACT 6 FIRE ZONE VALUE $ 500,00
INSPECTIONS Sianatu re Date GROUP J TYPE III ZONE R-1
SOIL PERMITS ISSUED
�GAS JVOIVI� 1 RXIIOR
Date Number Sian azure
PROP. SWR. LINE LJ HOUSE CON. Lj
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER
ROUGH WIRING Heatin and Vent.
TRENCHES 8L- FORMS Lj STEEL REINF.
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN OUT
PLASTER, BROWN COAT
STRUCTURAL, FINAL El.ct,ic
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST (-1
3 1149%/170
DEC -1-600 tos n*****5.00
COSTA MESA BUILDING -SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATION FOR BUILDING PERMIT
For Applicant t5,F4U49 Completely
RECEIVED BV DATE RECE�Ep DAT f�S J/
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ADDRESS
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hereby acknowledge that I have read this application and state
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the State of California.
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I hereby certify that I am properly licensed as a contractor under
SQ. FT.
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THE AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Divisicn 3,
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THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY.
2
m exempt from the p dGi`efons of the State of ifornia Business
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VALUATION
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Signature
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Authorized Agent
TOTAL FEE
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�yAPNo.1 X122-12 LOT TRACT
\ INSPECTIONS Si u
Pool Location
Forms
Main Drain
Steel Reinforce
Elec. Bond
Approval to Cover
Underground Electric
Gas Piping Test
Filtering System Lines
Backwash Lines and Recep.
Electrical Final
Heater and Vent Final
Filter System Final
Backwash and Recep. Final
Fanrinn Final
DATE
FIRE ZONE VALUE
GROUP TYPE
SUBCONTRACTOR
//-7¢'j Electric
Plumbing
7-1-74
PERMIT NO.
3862
COSTA MESA BUILDING -SAFETY DEPARTMENT
P,O,BOX1200 COSTA MESA, CALIFORNIA 92626
For BUILDINGApplicant to Fill in Completely
ADDRESS 1 L a� 1: ANAL/ ` {Q
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I hereby certify that I am properly licensed as a contractor under
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Chapter 9, and that such licenses are in full force and affect, or I
am exempt from the provisions of the State of California Business
and Professbna C11.Jpivislon 3, Chapter 9.
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Signature of
Permittee r
Authorized Agent
1.11 -1-71 fr ' 00 Dol' : 3 "0
APPLICATION FOR BUILDING PERMIT
RECgIyED BY
PY/O.
D=� REC VED
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NO. 3l-IZ-- 2BUILDINGADDRESS
PA.P.
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OWNER /14
VALUE
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BY DATE
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NO.OF
PLANS 2
USE OF NE
BUILDING `��
YARDS APPROVED
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YARDS APPROVED
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REAR FT.
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DISTANCE BET.
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VAR. siE
C.U.P.#
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THE AMOUNT SHOWN UNDER VALUATION IS FOR
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$ a O ^
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PLAN CHECK $ a Q
TOTAL FEE $ N