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Home My WebLink About1784 PANAY CIR - Building Permits CITY OF COSTA MESA , a BUILDING DIVISION F•" ,,,,, ,I DEVELOPMENT SERVICES DEPARTMENT PER IT NUMBER 4• 1 is PERMIT 6-07028 e (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ftus MBING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1784 PANAY CI Status: ISSUED Suite No Applied: 12/12/2006 Issued: 12/12/2006 Vicinity: - Parcel Nunmber: 13912215 .11111 Applicant: CARMICHAEL, JIM ISSUED BY: .//LL Address: 1784 PANAY CIR 7 Phone: 714-751-2181 COSTA MESA,CA . ' Zip: 92626-2348 , 410, Owner: CARMICHAEL LIVING TR Address ,1784 PANAY CIR " - Phone: COSTA MESA,CA Zip: 92626-2348 410re Contractor: OWNER-BUILDER ,' Address: Phone: ' Zip: License: 000000 SCOPE OF PERMIT INTERIOR REMODEL OF AN EXISTING SFD.SCOPE OF WORK TO INCLUDE:KITCHEN REMODEL REMOVAL OF INTERIOR WALL TO ENLARGE KITCHEN,REMODEL OF BATH#2,EXISTING 70 SQ FT _ POOL EQUIP ROOM(ATTACHED)TO BE CONVERTED TO AN OFFICE,REMODEL OF BATH#3. 'REF:B06-01915 1 BATHTUB, 1 DISHWASHER,1'GAS OUTLET(1-4);2 SHOWERS,3 BAR SINKS,3 WASH BASINS, 2 WATER CLOSETS,'1'WATER HEATERNENT(TANKLESS), 1 POOL/SPA EQUIPMENT(RELOCATION) • FEE SUMMARY' AMT QTY __ " i "AMT , QTY" AMT QTY ISSUE FEE $23.50 - ; Laundry Tub/Washer $0.00 0. Sump Pump $0.00 0 Backflow irrigation $0.00 0 , Landscape Irrigation $0.00 0 Swimming Pool $60.75 1 Backflow Preventer $0.00 0 P-Trap , $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1- ' Pressure Regulator $0.00 - 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) " $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0' Septic Tank -. _ , $0.00 0 Wash Basin $29.40 3 Dishwasher $9.80 1 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain,Floor - $0.00 . 0 • Sewer Connect $0.00 .0 Waste and Vent System $0.00 0 Drain,Rainwater $0.00 0 •Sewer Private Line $0.00 0 ' ' Water Closet(Toilet) $19.60 2 Drain,Roof $0.00 0 ' Shower $19.60 2 Water Heater/vent $12.30 1 Drinking Fountain'- $0.00 ' 0 - . Sink,bar $29.40 3 Water Piping(Inst or Rep.) $0.00 0 Expansion Tank , $0.00 0 Sink,commercial $0.00 0 , - Water Re-pipe, $0.00 0 Gas Earthquake Valve-' $0.00 -0 ; Sink,Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) \ .' ` $6.15' '1 - _ - 'Sink,,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) `, - $0.00 0 " Sink,service/mop $0.00 0 OTHER $0.00 Gas Repipe ' $0.00 0- Spa(private) - $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 . - .Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00_ 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 - 0 , TOTAL CALCULATED FEES: $220.30 COMMENTS/SPECIAL CONDITIONS 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 /'j 2446.46(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: 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 it the permit is valued at one hundred dollars($100)or less.) . 97 I certify that in the performance of the work for which this pe it is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laof California,and agree that if I shout b ome subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these ovisions. Applicant Signature: - Date: I vZ l I 104,0WARNING:FAILURE TO SE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100, ),IN ADDITION TO THE COSTOF COMPENSATION.DAMAGES AS PROVIDED FOR IN SECTION 3700 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.if Class a 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). 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 d within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve tor 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 ws.). ❑ I am =.mpt under sec. Business and Professions Code for this reason: Signature: - _ Date: )-a.'/ al Owner ID ver likd by driver's license. i Yes 0 No Driver's License No. Expires: 5/at 4 Verification of nership by(type of docum8n1,t,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: I 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 end 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 end 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 en 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 a plication appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes u No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (II'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 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is c rect. I agree to comply with ell ste e laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the a•• e-described mope..Norihsp: ti• purposes,I agree not to occupy or allow occupancy of- y building authorized by this permit until final inspection. li., I Si. . 'Ai4 Lai la I[7� ., Signature Of Legal owner(s) Date And/Or Authorized Applicant Date 90DE/ MENTION TYPE PATE• lNIMALS CODES INSPECTIONTYPE PATE INTmALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final _ 208 Final Plumbing 6 '`Ly"I _ 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 • t-��''`�' CITY OF COSTA MESA . BUILDING DIVISION >• ; ,1 DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER PERMIT 06-00824 %o.ns0 rR (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 1784 PANAY CI Status: ISSUED Suite No Applied: 12/12/2006 Issued: 12/12/2006 Vicinity: Er Parcel Number 13912215 ISSUED BY: _ Applicant: CARMICHAEL, JIM Address: 1784 PANAY CIR , Phone: 714-751-2181 COSTA MESA,CA Zip: 92626-2348 Owner CARMICHAEL LIVING TR 71111r Address:- 1784 PANAY CIR - . ip . Phone: . COSTA MESA,CA Zip: 92626-2348 Contractor: OWNER-BUILDER Address: - ' Phone: Zip: License:000000 SCOPE OF PERMIT INTERIOR REMODEL OF AN EXISTING SFD.SCOPE OF WORK TO INCLUDE:KITCHEN REMODEL REMOVAL OF INTERIOR WALL TO ENLARGE KITCHEN,REMODEL OF BATH#2,EXISTING 70 SO FT POOL EQUIP ROOM(ATTACHED)TO BE CONVERTED TO AN OFFICE,REMODEL OF BATH #3. REF:B06-01915 1 INST FAU<100K BTU, 1 INST FAU>100K BTU(RELOCATION OF POOL HEATER), 1 ' COMPRESSOR 3-15 HP/500K BTU(NC), 1 HOOD W/MECH EXHAUST,3 VENT FANS/SINGLE DUCT FEE SUMMARY . Quantity?- Quantity ISSUE FEE $23.50 ' - Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $18.20 1 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Ref rig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 - Compressors/Absorption Systems Gas Piping . ,, $0.00 0 - Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 . . 3 To 15 hp/500 k BTU $27.15 1 Hood w/Mech Exhaust '$10.65'-'1 , , 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box - $0.00 0 30 To 50 hp/1,750 k BTU $0.00. 0 Vent Fan/Single Duct $21.75' .3 •Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 '0 Boilers Fire Dampers N. , '$0.00 0' - .Up to 3hp - , $0.00 0 Smoke Dampers - $0.00 . 0 . - 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent .$0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm • $0.00 0 - 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 . 0. _ Investigation Fee $0.00 . Plan Check Fee - $0.00 Reinspection Fee $0.00 T/1T•I ('Al/Y„ ,•TCA COCO f„G INC 1 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 r 2446-48 WOO) /''- DECLARATIONS WORKERS'COMPENSATION DECLARATION: 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 tion need not be completed if the permit is valued at one hundred dollars($100)or less.) 1 certify that in the performance of the Work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation la s of California,and agre t if I sflou come subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with thes rovisions. b Applicant Signature: Date: II b WARNING:FAILURE TO$ RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLIARE(S1 ),IN ADDRION 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# 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). 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 ere 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) linens, •ursuant to the Contractors License La s.). ❑ I am e e pt under sec. Business and Professions Code for this reason: Signature: � -- Date: J a)1 je) Owner ID veil by driver's license. (, ,Yes 0 No Driver's License No. Expires: Cl�l I A8 Verification of ou nership 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, 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: I 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 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 0N (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 0 No 5 Does or win the applicant or present or future building occupant require for the work which Is the subject of this application epermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 011 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? 0 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 end 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 rrect. I agree to comply with all state I ws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the a ve-described prope r inspect'on urposes.1 agree not to occupy or allow occupancy any building authorized by this permit until final inspection. Signature Of Legal Owner(s) Date And/Or Authorized Applicant Date CODE s INSPECTION TYPE PATE INTIDALS CODES INSPECTION TYPE tat J�l� 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 /-11:1'- CITY OF COSTA MESA , 4 �, �D BUILDING DIVISION Y.�, ..a DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER 4. x+74 PERMIT t E06-01440 ban no (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa ffttsCTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1784 PANAY CI Status: ISSUED Suite No Applied: 12/12/2006 Vicinity: Issued: 12/12/2006 Parcel Nunmber: 13912215 Applicant: CARMICHAEL, JIM a Address: 1784 PANAY CIR �i ISSUED BY: Phone: 714-751-2181 i COSTA MESA,CA Zip 92626-2348 Owner CARMICHAEL LIVING TR Address 1784 PANAY CIR Phone: COSTA MESA,CA - Zip: 92626-2348iltirit Contractor: OWNER-BUILDER Address: Phone: 4IPP ' Zip: 411e)License:000000 SCOPE OF PERMIT INTERIOR REMODEL OF AN EXISTING SFD.SCOPE OF WORK TO INCLUDE:KITCHEN REMODEL REMOVAL OF INTERIOR WALL TO ENLARGE KITCHEN,REMODEL OF BATH#2,EXISTING 70 SQ FT POOL EQUIP ROOM(ATTACHED)TO BE CONVERTED TO AN OFFICE,REMODEL OF BATH#3. REF:1306-01915, 1 RES NC PKG,80 LIGHT FIXTURES,26 OUTLETS,22 SWITCHES,4 RES APPL(DOUBLE OVEN, KITCHEN HOOD,DISHWASHER,TANKLESS WATER HEATER),4 MOTORS TO 1 HP(SKYLIGHT MOTOR, 1 VENT FAN, 1 BATHTUB-JACUZZI), 1 POOL/SPA(RELOCATION OF EQUIPMENT),2 SUB PANELS (RELOCATION) "FEE SUMMARY_ 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 $54.50 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 $49.50 1 _ up to 10 kva/kw $0.00 0 Lighting Fixts ,$65.80 80 - -- up to 50 kva/kw $0.00 0 Recept Outlets ,$26.38 26 up to 100 kva/kw $0.00 0 Switches $23.46 - 22 : - over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $19.00; 4 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 . 0: Misc.Conduit $0.00 0 Service to 100044 $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 $19.00 4 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 Motors to 100hp -$0.00 0 , Other Electrical Fee $0.00 Motors over 100hp $0.00,- ' 0 ' Communication drops $0.00 .. 0' - Investigation Fee $0.00 Sub panel to 200a $61.00 ' 2 - Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $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 2446-46(MO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: 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 end policy number are: Cartier: Policy Number: (Thisissection need not be completed if the permit is valued at one hundred dollars($100)or less.) L7 )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 es to become subject to the workers' - compensation la s of California,and agree that If I M;10 id b•come subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with then revisions. Applicant Signature: •.-..-"' Date: I rrZ 11 31061 WARNING:FAILURE TO S RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TOONE HUNDRED THOUSAND DOLLARS(Sl ).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 end effect.Lie.# Class it 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 subjects the applicant to a civil penalty cf 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 him If 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 is 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.). 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 Lispns Laws.). ❑ I em e mpt under sec. Business and Professions Code for this reason: Signature: _ — Date: ' IP.,/I a C b Owner ID ve fie by driver's license. gyes ❑No Driver's license No. Expires: (1,/ai Jo Verification o 0 nership 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, 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 0 No (Section 25533 of the California Health end 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)?0 Yes aterials)?❑Yes 0 N (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 application a_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 Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan 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 COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is co ect.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 a e-described pr g rty for igsspectpn purposes.)agree not to occupy or allow occupann f any building authorized by this permit until final inspection. (1 _±J T `ML j{//r4/14Z,D�#Jf 1?- 1 06 Signature 01 Legal Owner 1?-.)Di ate Iif And/Or Authorized Applicant Date CODE A INSPECTION TYPE all INTRIAL3 CODE( INSPECTION TYPE WALE INTIRAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing _/ c� /�� 200 Final Re-Roof 210 Final Electrical 6_2(Me (✓.tom 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 ' . CITY OF COSTA MESA BUILDING DIVISION Fa; :tno ) 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us -.A.4fes. FOR INSPECTIONS CALL:(714)754-5626 PERMIT NUMBER BC07-00013 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: RES_ALT DATE ISSUED: 06/25/2007 - - ISSUED BY: JOB ADDRESS: 1784 PANAY CI CM ' , Suite/Unit : Vicinity: Primary Occ: Const Type: V-N SQ:;FT. ., . -617 Valuation:,..$20,000.00 SCOPE OF WORK: CONVERT EXISTING 617 S.F. STORAGE STRUCTURE TO A GAME ROOM. WORK INCLUDES:ADD A BATHROOM WITHIN EXISTING SQUARE.FOOTAGE 0. •4 LIGHTS 4 OUTLETS 3 SWITCHES. . -. 12 WALL HEATER .- ' ,1 1 SHOWER 1 SINK BAR:1 WASHBASINWATER'CLOSET.' >. :- -. I' • : `. REF:ZA-06-69 . OWNER: CARMICHAEL LIVING TR - - Address: - 1784 PANAY CIR Unit: PHONE: City/State/Zip: . COSTA MESA,CA APPLICANT: JEFF HACK Address:, . Unit PHONE: 714-231-7733 - . City/State/zZip: CONTRACTOR: JEFF F HACK i License No. -.536548 Address: P 0 BOX 26038Unit PHONE: 714-754-0151 City/State: SANTA ANA,CA ZipCode: 92799 CELL: ' 714-231-7733 "ARCHITECT: License No. - - PHONE: ENGINEER: License No. - PHONE: • COMBINTATION PERMIT FEE SUMMARY, .,';: > - " Building Plan Check: • $208.81 - - Building Fees: $321.25 . - - Electrical Fees: $35.60 - " -- Mechanical Fees: $37.20 Plumbing Fees: $62.70 SMIP Residential: $2.00 SMIP Commercial: $0.00 TOTAL FEES: $667.56 • "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections andfinal approval will result in the expiration of this permit. CODE S. INSPECTION TYPEIj Af IN1111AL$ CODES INSPECTION TYPE p1E ' TIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical A-aft- .Q As. 1266 Pool Spa Final 208 Final Plumbing - - -I!C AT` 200 Final Re-Roof 210 Final Electrical a. IC Z 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Signm 222 Final Site (0-01-6 t 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner ID verified by driv nse. ❑Yes ❑ No • I hereby affirm under penalty of perjury one of the timiuwing declarations: Driver's License No. Expires: O I have and will maintain a certificate of consent to self-Insure for workers'. Verification of Ownership by(type of document.i.e.-property tax bill or deed): 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 DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: - permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a num e: person is required to descend,will be made in connection with work authorized arri • 51-1K-23—CO P 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 (This section neednot be completed if thepermrt is valued of one hundred dollars(S100)or less) 2,Art 2,Sec.341,Title 8,California Administrative Cede). la 2-9 Gv 0 As owner-builder, I will not employ anyone to do work which would O I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. 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 Co.e,I shall forthwith comply with these provisions. Applicant's Signature Date ,/ .j_A aO / O7 Division of Industrial Safety Permit Number: igna re [ Idle HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. 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 LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons,or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is infull forceandeffect. a registration form for acutely hazardous materials? ❑Yes 0 No r,-.7-05349 5 cT Ua Class G� (Section 25533 of the California Health and Safety Code, with some 0/80 7 exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely oAr. 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). O I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: 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. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications for non-residential building permits). 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 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No 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 8. (If yes attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: 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. Si tur oI L g Owner 1e • Signature Dale • 4 3057-46(3107) V rzed OPIUn a _�b f _ r - CITY OF COSTA MESA BUILDING DIVISION • �r DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER PERMIT B06-01915 r1`' (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.SUfLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 1784 PANAY CI Status: ISSUED Suite: Applied: 11/14/2006 Vicinity: Issued: 12/12/2006 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: 13912215 Zoning: R1 Applicant: CARMICHAEL, JAMES H Address: 1784 PANAY CI Phone: 714-668-9559 l5% SUED BY: .A COSTA MESA,CA - Zip: 92626 Owner: CARMICH9ECLIVING TR Address 1784 PANAY CIR - - - Phone: `714-751-2181 4$1? COSTA MESA,CA, Zip:' 92626-2348 Contractor: OWNER-BUILDER Phone: Zip: - i - License: 000000 / Arch RANIERI, RANDY ALLEN Eng: AQX ENGINEERING Address:" 3141 LIMERICK LN Address: 1300 BRISTOL ST Phone: 714-296-5502 • STE 100 Phone: 949-261-7740 COSTA MESA,CA ` - _ NEWPORT BEACH,CA Zip: 92618, - License: -C24225 92612 License: C66510 SCOPE OF PERMIT INTERIOR REMODEL OF AN EXISTING SFD.SCOPE OF WORK TO INCLUDE:KITCHEN REMODEL REMOVAL OF INTERIOR WALL TO ENLARGE I REMODEL OF BATH#2,EXISTING 70 SQ FT POOL EQUIP ROOM(ATTACHED)TO BE CONVERTED TO AN OFFICE,REMODEL OF BATH#3. 2 BRISTOLITE(2'X 2')SKYLIGHTS WILL-BE INSTALLED BETWEEN RAFTERS(MASTER BATH SHOWER&BATH#2 SHOWER).ICC REPORT NER#2469 - � FEE SUMMARY Plan Check: ` $418.76 Calc Valuation: sso,000.00 Permit: , $644.25 Claim Valuation: $50,000.00 SMIP Res: $5.00 , SMIP Com:. , $0.00 Other $0.00 Inspection: , ." $0.00 Total: ' $1,068.01 SETBACKS . PLANNING &ZONING , MAIN STRUCTURE Front" 0-0 Rear- 0-0 Left 0-0 Right 0-0 ACCESSORY' -Front ,041,>) :'Rear 0-.0" - Left 7.0-0 - - "-Right- '0-0 PARKING Existinq: 0 ,Required: 0Proposed: 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 r" 244646(WOO) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: • - ❑ I have and will maintain a certificate o1 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: Carrier: Policy Number: (This tion need not be completed if the permit is valued at one hundred dollars($100)or less.) 232 t 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 I ws of California,and agree Met if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with the provisions. Applicaht Sighature: _ — ,'Date: 7 )0-,/ )a in(4 WARNING:FAILURE TO S RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS(St , ),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 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 end 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 sol ithin 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.). ,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 n t 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 a mpt under sec. -' Business and Professions Code for this reason: . Signature: ---— - 21 0, Expires: 7,11BE Verification of nership by(type of dodumiant,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation live(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 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 greeter 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? 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 apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes LJ 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 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 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 ate laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the ab've-described pro..rty for in pe.ion purposes.I a.ree not to occupy or allow occupanryof any building authorized by this permit until final inspection. i Signature Of Legal Owners) - - Date , And/Or Authorized Applicant Date CODE I INSPECTION TYPE PATE INTITIALS CODE! INSPECTION TYPEApET INTITIALS 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 ,�J 250 ' Final Building/Occupancy" 6-510e ZL - l 1 4 . "6 &4t4714442, 'a�K f tialdiaat "° OWNER-BUILDER VERIFICATION Address: 17 P t rde. <n-o cA ` �2P rmit#: goy 2/5 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 provid the major labor and materials for construction of the proposed property improvement. Yes ❑ No 2. l ;.v:/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person(firm)to provide the proposed construction: Name •—\--151 a 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 e4 Address City Phone ( ) Contractor's Lic. 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.11/04) LOytp4FS,� CITY OF COSTA MESA 4 4v" `'9 Cr P.O.BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 ;yl., la Fsi : L V yC 4 $ DEVELOPMENT SERVICES DEPARTMENT • January 18, 2007 Jim Carmichael 1784 Panay Circle Costa Mesa, CA 92626 RE: ZONING APPLICATION ZA-06-69 MINOR CONDITIONAL USE PERMIT FOR BATHROOM AND WETBAR IN ACCESSORY STRUCTURE 1784 PANAY CIRCLE, COSTA MESA Dear Mr. Carmichael: Review of the minor conditional use permit for the above-referenced project has been completed. The application, as described in the attached project description, has been approved, based on the findings and subject to the conditions of approval (attached). The decision will become final at 5 p.m. on January 25, 2007, unless appealed by an affected party (including filing of the necessary application and payment of the appropriate fee) or is called up for review by a member of the Planning Commission or City Council. If you have any questions regarding this letter, please feel free to contact the project planner, Hanh Nguyen, at (714) 754-5640. Sincerely, • pf 61/ ICHAEL ROBINSON, AICP Zsning Administrator Attachments: Project description • Findings Conditions of approval • Approved conceptual plans cc: Gary Wong, Engineering V Fire Protection Analyst Building Division Building Division(714)754-5273 • Code Enforcement(714)754-5623 • Planning Division(714)754-5245 FAX(714)7544856 • TDD(714)754-5244 • www.ci costa-mesa.ca.us zA-os-69 ' January 18,2007 Page 2 PROJECT DESCRIPTION • The applicant proposes to convert an existing, detached storage building into a recreation room. A minor conditional use permit is required because the applicant proposes to install a bathroom (toilet, sink, and shower) and a wet bar (dishwasher and refrigerator) in the storage building. The proposed fixtures are for convenience _ purposes when entertaining guests and/or using the swimming pool. • The accessory structure has nonconforming side and rear setbacks of two feet, and six feet, respectively; five-foot side and ten-foot rear setbacks required. Allowing the structure to convert from a storage room to a recreation room will not increase the nonconforming setbacks of the structure. The structure is located at the rear of the property where it is away from neighboring residences and adjacent to other recreation uses (pool in neighbor's property). • To minimize noise impacts to the adjoining neighbors, a condition has been included prohibiting any opening in the east and north walls of the structure; any existing doors or windows on these walls will be required to be replaced with a solid wall. • To minimize the possibility of conversion to a separate dwelling unit, a condition has been included requiring the property owner to record a land use restriction to inform future property owners that the accessory structure cannot be converted to, and/or used as, a dwelling unit. • The General Plan designation for the property is Low Density Residential, which allows a maximum density of one dwelling unit per 5,445 square-foot of lot area. The site contains one dwelling unit on a 13,977 square-foot lot, consistent with both the lot's General Plan and Zoning designations. FINDINGS A. The information presented complies with Costa Mesa Municipal Code section 13-29(g)(2) in that allowing a bathroom (toilet, sink, and shower) and a wet bar (dishwasher and refrigerator) in an accessory structure is compatible with developments in the same general area. Granting the minor conditional use permit will not be detrimental to the health, safety, and general welfare of the public or other properties or improvements within the immediate vicinity. Specifically, the wet bar and bathroom will be convenient for entertaining guests and when using the swimming pool. The structure is located at the rear of the property where it is away from neighboring residences and adjacent to other recreation uses. -A condition has been included prohibiting any opening in the east and north walls to minimize noise impacts to the adjoining neighbors. Another condition has also been included requiring the property owner to record a land use restriction to inform future property owners that the accessory structure (recreation room) cannot be converted to, and/or used as, a separate dwelling unit. Granting the minor conditional use permit will not allow a use, density, or intensity that is not in accordance with the general plan designation for the property. B. The proposed project complies with Costa Mesa Municipal Code Section 13-29(e) because: 1. The proposed use is compatible and harmonious with uses both on-site as well as those on surrounding properties. 2. Safety and compatibility of the design of the buildings, parking areas, landscaping, and other site features including functional aspects of the site zA-06-69 ' January 18, 2007 Page 3 development have been considered. 3. The project is consistent with both the General Plan and Zoning designations because only one dwelling unit exists on the lot. 4. The zoning application is for a project-specific case and does not establish a precedent for future development. C. The project has been reviewed for compliance with the California Environmental Quality Act (CEQA), the CEQA Guidelines, and the City environmental procedures, and has been found to be exempt from Section 15301, Existing Facilities, of CEQA. D. The project is exempt from Chapter XII, Article 3, Transportation System Management, • of Title 13 of the Costa Mesa Municipal Code. CONDITIONS OF APPROVAL Ping. 1. The existing, detached accessory structure (proposed recreation room) shall not be used as a separate dwelling unit. 2. The accessory structure shall not contain a bathtub, kitchen, or kitchenette without prior City approval. 3. The accessory structure shall be served from the same utility meters (electric, gas, and water) as the main dwelling unit on the property. 4. Any opening in the east or north walls of the accessory structure is prohibited to minimize noise impacts to the adjoining neighbors. 5. A land use restriction executed by and between the property owner and the City of Costa Mesa shall be recorded prior to the issuance of building permits. This land use restriction shall inform future property owners that the accessory structure shall not be used and/or sold as a separate dwelling unit. The applicant shall submit to the Planning Division a copy of the legal description for the property, and either a lot book report or current title report identifying the current legal property owner so that the document may be prepared. 6. All construction-related activity shall be limited to between the hours of 7 a.m. and 8 p.m., Monday through Friday, and 8 a.m. to 6 p.m. Saturday. Construction is prohibited on Sundays and federal holidays. Exceptions may be made for activities that will not generate noise audible from off-site, such as painting and other quiet interior work. 7. The conditions of approval;Code provisions, and special district requirements of Zoning Application ZA-06-69 shall be blueprinted on the face of the site plan as part of the plan check submittal package. • 8. The applicant shall contact the Planning Division to arrange for Planning inspection of the site prior to the release of utilities. This inspection is to confirm that the conditions of approval and Code requirements have been satisfied. CODE REQUIREMENTS The following list of federal, state, and local laws applicable to the project has been compiled by staff for the applicant's reference. Any reference to "City" pertains to the City of Costa Mesa. zA-06-6s ' January 18, 2007 Page 4 Ping. 1. Approval of the minor conditional use permit is valid for one (1) year and will expire at the end of that period (January 18, 2008) unless building permits are obtained and construction commences or the applicant applies for and is granted an extension of time. A written request for an extension of time must be received by Planning staff prior to the expiration of the minor conditional use permit. 2. Any mechanical equipment such as air-conditioning equipment and duct work shall be screened from view in a manner approved by the Planning Division. All roof-mounted equipment is prohibited. Bus. 3. All contractors and subcontractors must have valid business licenses to do Lic. business in the City of Costa Mesa. Final inspections, final occupancy, and utility releases will not be granted until all such licenses have been obtained. Bldg. 4. Comply with the requirements of the California Code of Regulations, Title 24, also known as the California Building Standards Code, as amended by the City of Costa Mesa. Eng. 5. A construction access permit and deposit of $560.00 for street sweeping will be required by the Engineering Division prior to the start of any on- or off-site work. 6. Revise the site plan to show a six-foot public utility easement. SPECIAL DISTRICT REQUIREMENTS The requirement of the following special district is hereby forwarded to the applicant: Sani. 1. It is recommended that the applicant contact the Costa Mesa Sanitary District at (949) 645-8400 for current district requirements. 05nli CITY OF COSTA MESA • BUILDING DIVISION %1 r.�,., ,( DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER J• PERMIT Arnoee B04-01639 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA, A 92626 BUILDING PERMIT Job Address: 1784 PANAY CI Status: ISSUED Suite: Applied: 09/21/2004 Vicinity: ROOF Issued: 09/21/2004 Parcel Number: 13912215 Zoning: R1 R1 Applicant: JORDAN ROOF COMPANY ISSUED BY: Address: 915 W COLLINS AV Phone: 714-744-6577 ORANGE,CA Zip: 92867 • Owner: PISANO, GEORGE P Address 1784 PANAY CIR Phone: COSTA MESA, CA Zip: 92626-2348 Contractor: JORDAN ROOF COMPANY Address: 915 W COLLINS AV Phone: 714-744-6577 ORANGE,CA Zip: 92867 License: 406783 Arch : Eng: Address: _ Address: Phone: - Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 1 BASE.SHEET,3 PLIES OF 11#FELT,AND WHITE ROCK BUILT UP ROOF.66 SQUARES INCLUDES ATTACHED GARAGE AND 9 SQUARES FOR DETACHED BOAT GARAGE. - FEE SUMMARY Plan Check: $0.00 Calc Valuation: $16,000.00 Permit: $265.25 - - - Claim Valuation: • $16,000.00 SMIP Res: $1.60 SMIP Corn: $0.00 Other: . $0.00 Inspection: . $0.00 • Total: $266.85 • 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 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 2446-46(6/00) • DECLARATIONS r7 WORKERS'COMPENSATION DECLARATION: • I hereby affirm under penalty of perjury one of the following declarations: ' 0 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. 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 11Lurance carrier and policy number are:r•'Ir V✓ v ":Poli Number: 2 / JVQ O'T/ (This section need not be completed the•ermit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of i work fo hich this permit is Issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C:ifomia,,gl a• ee I should become subject to the workers'compensation provisions of Section 300 1 the Labor Code,I shall forthwith comply (pese.provisi V'/ / 721 , plicarlli.ignssattuur—e:_' -� ` y/� Date: T WA�WNB. AIF LURE TO SECURE WORKERS COMP SATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN SAP TO CRIMINAL PE TIES AND OVIL FINES UP TO ONE HUNDRED h' 101 LSAND DOLLARE(5100,000),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 hereb afjtrn.that.Lam licensed u •Br provision o Chap:•9 ommencing with Section 7000)of Division 3 of the Business and Pppfeistsjons Code,and my license is in full orce-and effect..Lic. � .7 / / Gjass�'STII . Ci IJoml2tfo Signature�� minAz/ Date:' 77/��T MI 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 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(3500).): ❑ 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.). • O 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 driver's license. 0 Yes 0 No Drivers 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,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 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 0 No (Section 25533 of the Califomia 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? 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? LJ Yes U 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? 0 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 ❑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 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/spection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. �/`�� `•Jt al Owner(s) - g��/OSS Date Mn Or: �horized Applicant ` VDate CODE* INSPECTION TYPE, CATS RITIIIALS CODE! IIISPECTION TYPE , • . DATE IyTR1AL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final / y 208 Final Plumbing 200 Final Re-Roof /0 710 l 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 ^' ADDRESS OFWILDING: 1784 PANAY CI UMT: _ CITY OF COSTA MESA..,- BUILDING PERMIT. .. .. OWNER'SNAME U,WIOWN: BENNETT JOSEPH M _=" _ _. - " ' PERM NO: B 080676 • ADDRESS' B.EMNETT, 'DONNA, W ` _ - . 17,8E PANAY ...CIR. - _ PERMIT NO: B 080676 PLAN CHECK NO; 04979-96 L GOVT; N SUPP : N . COSTA MESA,CA 92626 APPL.IIA21NGALURE55: _ CONSTRUCTION TYPE: V-N PERMIT TYPE: STR - - PURPOSE; CON CHrTEcToRENGJlEEB: GREGORY CURD uaMO.: 36323 _ .. JOB. DESCRIPTION : INGROUND GUNITE SPA ONLY SQ FT: 5, 000 ARM OR ENG.'S ADDRESS: 1332 N. MILLER ST UMT: 201. ANA CA 92806 CLAIM VALUE: __5, 000 , 00 CALC-VALUE: 5, 000 . 00 GROUP OCC: R-3 / CONTRACTORS NAME: LAND ERS POOL ( 714 ) 309-7902 CIINTRACTORS MMLAO 2569 ELDEN AV COMMENTS; X ADDRESS: COS TA MESA CA up.NO.: 256213 *SEtESEit)E*at******yfr+f*********+Stip*rep****x-+t+t+r**M**Ma ***********+a+ *it*iE*****at*iEstit+t***dtitfE 92627 LINT: Cl - -_ .. _ ZONING R EQU I R EMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury thatl em licensed under provisions of Chapter 9 - SETBACK 5 (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my lice in full force and effect. CITY LIC.N IN RGHT:.:066614 uc.cuss: C 53 L o.: 256. 1 EXP:;201 / 7 . . . . _MAIN BUILDING ACCESSORY BUILDING ---- /� ate: 2/GIG �c l/J/ y FRNT: FT. IN REAR: F1'. FT IN FRNT; LEFT: FT IN REAR: FT IN LEFT: FT IN FT IN RGHT: FT IN / OWNERBUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt front the Contractors License Law for the ng reason(Section 7031.5 Business and Professions code:Any city or county which requires a permit to oonetmd,after,improve, PARKING REQ: P ROV: PARCEL: 13 912 215 Z NE: R1 REF NO: -noli,h,orrepair any stmcure,pndrtoisewance,also requires the applicanttorsuch permit lofile asgnedstatement that heorshe PLANNING NOTES> INSTALL A 6 ' DIAMETER, 33 S . F. SPA AT THE REAR OF SINGLE- conned pursuant to the provisions of the Contractors License Lew[Chapter 9(commenting with Section 7000)of Division 3 of the .sines and Professions Cade)or the he or she is exempt thereinxn and the basis for the aped exempon.Aro/vidmon of Sed'on _ > FAMILY RESIDENCE. SETBACKS O.K. ]031.5 by any applicant for a permit subjects the applicant to advil penalty d not more than five hundredn�f500)). ******************************************************************************* o as owner of the property or my employees with wages as their sole compensation,will do the sunk,end the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS or offered for sale(Section 7044.Business and Professions Cab:The Contractors License law does not appy to an owner d properly who builds a la inprovea thereon,and who does such work himself or or or horsedthroughemployees,he her own employees,provided then such improvements are not intended or offered for sefe.f,however,the building or improvement S sold within one year of completion,the ZONING APPROVED BY e DATE: owner-builder will have the burden d proving he or she did M build or improve ton the purpose of see). - /� / ❑ I.as ower of the property,ant exclusively contracting with licensed contractors to construct the project(Section 7044,Business end BUILDING APPROVED BY DATE; I�` (\//^ Professions Code:The Contractors License Law does not apply to an owner of propend who builds or improves thereon end who contracts ler such projects with a contrador(s)licensed pursuant to the Contractors License Law). ❑ I ern exempt under Section: B.A P.C..foe this reason: APPLICATION ISSUED BY: DATE: ************************************************************************ ****** Date: Owner LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;Y I do hereby certify that I am aware of and understand the requirements of Celaomia Health end Safety Code Sections 25505,25533,and ')6534,and that I or any future bribing occupant will/will no(circle one)need to comply with said date codes end the requirements for a permit f«eanawdionammD ly�ranu ificationfromtleAlagementdnid.Residenti m lndmdlonappl�iananexemptfromthese BLDG PMT PLUMBING ELECTRIC- —MECHANIC FIRE SNIP/RES GRADING provisions. PERMIT 99 . 75 Dale: Applicant: SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby aifem under penalty of perjury one d the following declarative: PLAN S 64 . 84 1 . 05 IS5UE FEE ❑ Ihave and MI maintain acertificate dconsent toself-insure for workers'compensation,sprovided for bYGect n3700dmeLabor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code.for the performance ofthe work fix which this permit eissued. TOTALS----> 100 . 80 0 .00 64 . 84 , 165 . 64 165 . 64 . 00 ❑ I have end 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 owner and policy number are: Carrier REVENUE DIVISION TOTALS--> COLLECTED; 165 . 64 OVER/SHORT: . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC . FIRE SMIP/TOT GRADING PLAN-CHECK dsec o need subs omWaradamaremkiaro one hundeedwba slwlaba l 99 . 75 • 1 . 05 64 . 84 Ligehat in workers'compensation lawsrforManCe ol the work for sidsGlifornia.rmit is lssued.I shall not employ and agree that x Il should +1 b manner so as to o he workers' ***3e**3e*************************************3e*te******le***3e, **************** e** �Warh //ion provisions of$M'�y3]00 of the Labor Code,IAIr$I Iathwnh comply with .:y..,r . ate: // oZ Y.A Apwisate4 /GO ' !J' /� I N D I V I D U A L p F E E' . B R E A K D O W N Mg:Failure to secure compensation coverage fa unlawfuL and slut/tt4r an employer to criminal penalties and TYPE .QTY DESCR IP T I O N, ' UNIT COST TOTAL COST • civil gnu up to one hundred thousand dollars($504000),In addition to the cwt of compensation,damages as provdad for In Section 3706olthe Labor Code,interest and altomey''s feet SFC 5000 SPA 1 . 00 5, 000 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that then is a construction lending agency fG the END OFFEES 09] performance of the work for which the permit is issued(Section 3 ,Civ.C). LENDER'S NAME: - • ' LENDER'S ADDRESS: !t • • I certify that I have read this application end time that the above information is correct.I agree to comply with all city end county ordinances end state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned properly ' mriwpedionpurpoaea.CARSON LANDERS Pri de, .� �.�.� //• JL/�iGJ� Date:,///J �y�f6�, , %r / Si9natureof•�^!-•=ntlAppkaen •onireaor _ 0100220032-00220034 TOT 165.64 DATE: 11/27/95 TIRE: 15:36 (5151-46.WP) White-Building&Safety;Green-File: mW-Applcant;Pink-Revenue;Goldenrod-Assessor ,, CONSTRUCTION AND PLANNING POO' SPA APPROVALS Permit# Date Inspector APPROVALS Pennil # Date Inspector 1 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location f •2. Skil Pipe-Undrgrnd. 53. Steel Reinforcement r-f ��p4i"�L • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms / 2--5-' ' . cxp� --4s Electrical Conduit-Undrgrnd. - 55. Electrical Bonding , 5. Steel Reinforcement 56. Rough Plumbing & Pressure test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER GUNITE ( -,2'(. d( 4,_ 7. Footings _ _ 58. Electrical Conduit-Undrgrnd. 8. 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 2126 C!� 1 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 2.1-2 C-117 ear 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 74-x- I-2 4-441 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. •Rough Factory Fireplace -• - - . APPROVALS- Permit # 21. Ducts,in Structure; z - 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe=Rough & Test ._ - 72. Underground Flush 24. Roof Framing - -t, 73. Undergrnd.Storage Tank 0 Gas O Oil 25. Roof Sheathing `.' 74. Overhead Hydrb - , 26. T-Bar Ceiling (Structural) & Monocoat - _• . . 75. Dry Chemical - -- 27. Frame and Flashing76. Dry Standpipe - 28. Lathing& Siding _ - 77. FIXED'SYSTEM FINAL - 29. Insulation - - _ : 78. FIRE PREY, FINAL 30. Drywall•NailingHEALTH 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= - - , g.r 2 -1,vit-tz .-1/7- �?t` & 35. Final Gas Pipe-Test - - .h `ii�� -� - 36. Rood or Canopy - Il 37. -Final Factory Fireplace - - Yr i-if 7 - ,te c- r,,A ,( .,fas_I44 Fitt - 38. Final Plumbing - ., - bw,-- 39. Water Service-Final - - 40. Gas Service-Final 41. Solar Domestic-Final -. • 42. Backflow Preventer t- - - 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 OP C S74 M A - DffiVEL0DMl;I1'I' PER VICES DEPARTMENT RECEIVED CITY OF COSTA MESA CERTIFICATE OP COMPLIAINCE DY Btienn r; rnv'c'^w RROISTE.n.gD DEPUTY IN5FECTOH �� 1 � 199Y OUNITE FOIl SWIMMING POOL, Job A!ldreoe 021 Np (ti-r; Permit Ho . 8t ..10 Ownor_ nom-EC— _ Centraotocnssonl L4N C\ e-&v TO THB DIRECTOR OF f1UILPJNOs J hereby certify that: continuous inspection wan provided by Me during nil pincement of concrete in the swimming pool under conntructien nt the above addroem, and that naid work complies with the approved plans and vith ill npplicabin provision° of the Building Cede . Fool Site ?)7/ — .Sacks Cement 247/ Tono Send Ounito itnnd Pack Approx. % Water in Aggregate_ j/ 5o_ • Thie report covers work done from /,L–/6 to flomarkos Pr.Iumtc„ Sea - 0047aS)Igo U `fignnd (J\a �na m ag ere epul Bu m i 4PCe _er No , z`/cif _—� Orange Co. 6s1 I.A Co. 0 TA City 'J name WIL.LAM GANNAHAY -�- 25780 MOR(UANTOWN - -' - AddronsSUN CITY, CA 97.5061 PIECEIVe CITY OF COSTA MESA INLAND FOUNDATION ENGINEERING, INC. 911! n,lin nib„c,nV 1310 S. Santa Fe Avenue P. o. Box 937 JAN 10199 San Jacinto, California 92583 (909) 654-1555 CLIENT: Willard Gannaway Date: January 3, 1997 25780 Morgantown Way Sun City, California 92586 Project No. G146-002 REPORT OF STRENGTH TESTS: Mortar ( ) Grout ( ) Concrete ( ) Gunite (X) Project SPA Project Location 1784 Panay Circle Costa Mesa, CA Contractor Carson Landers Arch.\Engr. Curd Location of Sample Floor Design Strength P.S.I. 2000 Max.Size Aggregate-Inches --- Source of Concrete --- Admixture --- Mix No. --- Ticket No. --- Percent Air --- (1) Batch Size - Cu. Yds. --- No. of Cylinders Molded 3 (2) Sacks/Yard --- Specimen Size 6” x 12" (3) Water Add.Job-Gal. --- Water/Cement Ratio as Poured --- (4) Water Add.Plant-Gal. --- Slump-Inches --- Sampled by: Willard Gannaway Air Temp. Concrete Temp._ Suhmitted by: Willard Gannaway I.F.E. Your DATE DATE DATE LOAD AGE CCHPRESSIVE Lab.No. No. MDLDED RECEIVED TESTED LBS. DAYS STRENGTH 7772 --- 12-16-96 12-18-96 01-03-97 91,000 18 3220 This laboratory data indicates conformance to the approved Specifications: YES (X) NO ( ) AtDREsstsBdL0IIC 1784 PANAY CI mt. CITY OF COSTA MESA - BUILDING PERMIT ONNERSNAMEIPIDIC,WN: BENNETT, JOSEPH M • PERM NO: P 080678 1 ADUREss BENNETT, DONNA W i .f' 1784 PANAY CIR ) % - Q PERMIT NO: P 080678 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA,CA 92626 APPL.7WLING ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU _ . PURPOSE : CON ARCHITECT ORBK?IaR: GREGORY CURD LIC.ND.: 36323 JOB DESCRIPTION : INGROUND GUNITE SPA ONLY SQ FT: ARCN.ONEra'sADOREss: 1332 N. MILLER ST urn: 201 ANA CA 92806 CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 / camucrowSNAMe LANDERS POOL ( 714 ) 309-7902 c1MRACTORS TIMING 2569 ELDEN AV COMMENTS: REF:B-80676 ADDREsa COSTA MESA CA LICNO_ .256213 +E*+t************+I'*{tit*so-*****+t** Est*******+rTtst************w******BW********BEW(**st***** 92627 urn: Cl ZONING REQUIREMENTS • LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Recto 7000)of Merron sol the Business and Professions Coda,and my' ' in lull force and wee. m cmo.:066614 uc.cuss: C 53 NO.: 256 1 XP : 1 /97 MAIN BUILDING ACCESSORY BUILDING —27-- 6 Contract O FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Data: LEFT: FT IN RGHT: FT IN LEFT: •FT IN RGHT: FT IN ER BUILDER DECLARATION:I hereby affirm under penaly of perjury that I am exempt from the Contractors License Law for Ihe wing reason(section 7031.5 Busbess and Professions Code:Any city or county whale requires a permit to construct arts',improve, PARKING REQ: P ROV: PARCEL: 13912215 Z N E: REF NO: , -.mash.or repair any structure.prior to its issuance.also requires the applicant for such permit to fib a signed statement that he or she PLANNING N V TE S> is licensed pursuant to the provisions d rhe Contractors License law[Chapter 9(cSectionnmerdng with Section 7000)d Dirlsan Sof the Business and Proleesione Code]or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 7051.5 by any applicant for a permeau4eda the applicant to a ave penally&nol mare than free hundred dola'ISSODD. ******************************************************************************* ❑ I.as owner of the progeny or my employees with wages as their sole compensation,MI do the work,and the shucture is not intended DEVELOPMENT SERVICES REQUIREMENTS or veered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to°Remit&of property who bulls or improves thereon.end who does such work lend or bene,or Sot *his or her own emplanes provided that arch improvements are not Wended ordlaed for sale.,,however,the building"inpwrnerf is sad within one yea of oomplelbn,the ZONING APPROVED BY : DATE: e-0 ownuilde will have the burden of proving he or she did not build the improve for purpose of sale). _. o I,esawrwdthegroper n"clusisw entre° amk�rwad"act" port°mthe n.' jed(S dian7O44.Buand BUILDING APPROVED BY : DATE: ProfessioCode:The Contractors License Law does not apply to an ownerof property who builds or improves thereon and who contracts for such projects with a coraeeor(s)tensed pursuant to the Contractors License Law). N❑ Iamexempt undrSection: B.&P.C..brthis reason: APPLICATION ISSUED BY: �. DATE: Fl*******************.....**************** *************************- . . -.y- • - '-- - ** Dat Owner: Me LEGALIZATION:N F E E SUMMARY STRUCTURAL SE• MENT:N I do hereby candy that Ian aware of and understand the requirements of California Hearth and Safely Code Sectin 25505.25533.end 255.94,and that l«any boon buildkp occupant win/veil ract(drob tna)need to comply wih said rota codes ad the reaarrnra4ler BLDG PMT PLUMBING ELECTR-IC MECHANIC FIRE SMIP/RES GRADING a penal fpr"nseuctiond modification Merl the Aa u3 fly anegemem District.Residential construction applications are exempt from these provisions. PERMIT 27 . 00 Date: Applicant 25% SMIP/NON-RES PLAN 11 11 WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one d the folw'ba°ti og dedons: ISSUE FEE 22 . 00 '1 ❑ I have and vril maintab a certificate of consent to self-insure foe workers'compensatim,as provided for by Section 3700 c4 the Lsdra BUILDING-DIV-> PERMIT ISSUE 'PLAN-CHECK TOTAL PAID DUE Code,for the performance of the work for which this permit is issued. sIll I have end sitm. worker,'compnsatininsurance,esmquiredbySection3700dmeLaborCode.fortheprromaaceoln. TOTALS > 27 . 00 22 . 00 �� 0 :00 49 . 00 49 . 00 . 00 • Web work for Mesh this permit is issued.My workers'compensation insurance canter end policy number are: • Caner; REVENUE DIVISION TOTALS--> COLLECTED: 49 . 00 OVER/SHORT: . 00 Policy Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK s section need not be completed I the coma is tor one hundred dollars($1001 or less.) 49 . 00aI . err eerily mat in the performance of the work for which this permit is issued,I shall rid employ any person in any manner so as 0 / • _ &Ned to toned 3703 nthe laws of CadomItondagree haw I s pr bjop to the workers' *************************************,****************************************** ;' '/y° p"" _ �'P� that � INDIVIDUAL 40 F E E BREAKDOWN Waning:Failure to secure wonlers'compeaadon coverage launlawfw,and shall subject an employee to criminal penalties and TYPE .QTY DESCRIPTIO N, UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($f00000),hi addition to the coat of compensation damages as provided ler In Section 3706olthe Labor Code.Interest,and attorneys lees. PLU 1 SPA (PRIVATE) 27 . 00 27. 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of Perjury mat there is a construction lending agency for the END OF FEES • performance of the work for which this permi is issued(Sedan 3097,Cir.C). LENDER'S NAME - LENDER'S ADDRESS: ,' 1 I candy that I have read this application end state that the above information is coned.I agree to comply with an thy and coaly ordinances /•''. and state laws relat,p to builders cormudion and hereby authorize representatives d this city to enter upon the ebove'memidrd propwy : for inspection paes pes.CARSON LA ERS - '`� Pnt , 9 DaW Signature of yAgenuAppitan z, 0i 00220035-00220035 TOT 49.00 DATE: 11/27/95 TIRE: 15:36 (5151.4 -Bu 6 WP) Whiteildb0&Safety;Green-Pb;Canary-Appicant;Pink-Revenue;Goldenrod-Assessor CONSTRUCTION AND PLANNING P & SPA_ r`, , • APpfOVALS Permit # ..Date Inspector APPROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' . ----s. 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. 'Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical"Conduit-Undrgrnd. 55. Electrical Bonding - r - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE r - 7. Footings_ - 58. Electrical Conduit-Undrgrnd. -1 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test r -\- 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 i 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. PlumbingSystem - Final i - r j3 a `I e 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 7 " 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing f .- - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical _ • • 27. Frame and Flashing' ., -. 76. Dry Standpipe _ 28. Lathing& Siding - - _ • 77•. FIXED SY..STEM-FINAL 29. Insulation • 78. FIRE PREY. FINAL _ 30. Drywall Nailing - - . - HEALTH DEPT -REQUIREMENT 31. Plaster Brown Coat _ 79. FINAL INSPECTION ' i 32. Electrical Power Meter-Final , - 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes: 'ate=/ -- 34. Final Heating& Air Conditioning: .3 (e 'f9 35. Final Gas Pipe-Test - J z / - 36.'Flood or Canopy - _- . 37. Final Factory Fireplace - - - ' 38. Final Plumbing - - _ - ' 39. Water Service-Final i 40, Gas Service-Final - 41. Solar Domestic-Final - - - 42. Backf low Preventer - - 43. Backf low Irrigation 44. Landscape Irrigation System 45. Sound Attenuation - j 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 - ` . ADD SOPmUILta10: 1784 PANAY CI MT: CITY OF COSTA MESA - BUILDING PERMIT x°'at .8N41EIFID1OYIN: BENNETT, JOSEPH M PERM NO: E 080677 .D t ORESS: BENNETT, DONNA W 1784 PANAY CIR PERMIT NO: E 080677 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 APDL.MARINO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: CON AIiCNRECTONEJaNEER: GREGORY CURD uC.NG: 36323 JOB DESCRIPTION INGROUND GUNITE SPA ONLY SQ FT: hRctLa1D+,'SADDBESS: 1332 N. MILLER ST on 201 ANA CA 92806 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 / cONTRACTafs Rear. LANDERS POOL ( 714 ) 309-7902 CCNncTowsuwq 2569 ELDEN AV COMMENTS : X ADDRESS: COSTA MESA CA Napa: 256213 ********'******************************+t***x*+E+r+r+ESE*****+E+E+ESE+ESE***+rx****+ESt*****+r*+E 92627 wt Cl Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 d the Business and Professions Code,end my license is in full force and effect. ."4066514.,, LJCLASS: C 53 NO�a'��z256 13 E P: /9 MAIN BUILDING ACCESSORY BUILDING ‘N•• //.� C.6 Contract FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN IWNER BUILDER DECLARATION:I hereby affirm under penalty d perjury that I am exempt from the Conlredon License Law for the ,dlowin9 reason(Serial 7031.5 Busneas and Professions Code:Any city or county which requires•Perms to One•MOd,after.'redcoat, PARKING REQ: PROV: PARCEL : 13912215 Z N E: REF NO: demolish,or repo any structure,prior to its issuance.also requires the applicant for such panne to file a signed statement that he or she is licensed pursuant to the provisions of the Contradors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the PLANNING NOTES> . • Business and Professions Code!or that he or she S exempt therefrom and the bans for the alleged exemption.My violation of Section > 7031.5by°nit'epWirant for a Permit subjects the applicant to a eel penalty d not more than free hundred doled P00p. ******************************************************************************* ❑ I,as owner of ihe property or my employees with wages as thee sole compensation,will do the work.and the structure is notinleded D E V E L O P M E N T S E R V I C E S REQUIREMENTS or offered ler sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property - who bolds or inproves thereon.and who does such work Smell or hadeg or through he or her own ernplofeee,provided that such 'unprwwmente re nal'wended ordered lor sale.1,however.the building or inpovemnt s said d mlo within as Yew mplen,the ZONING APPROVED BY I - DATE: owner-bi icer will have the burden of proving he or she did not bad or improve for the purpose of sale). ❑ I,as owner of the properly,eon exclusively contracting with licensed contractors to construct the project(Section 7044,Business end Professions Code:The Comredds Manse Law does not apply to an owner d property who bolds or improves thereon end who BUILD I NG APPROVED BY : DATE: contracts for such projects with a contractor(s)licensed pursuant to the Contractors license law). T ❑ Iammound under Section: B.&P.C..for this reason: APPLICATION ISSUED BY: :4 DATE: ************************************** ************************** • ** Date: Cheer. LEGALIZATION:N F E E SUMMARY STRUCTURAL .EGME1T: N I do hereby certify that I am aware of end understand the requirements of California Health and Safety Code Sections 25505,25533,and 25534,and that I or any Mud building occupant will/wit nor(circle one)need to comply with said state nodes and the requirements for e permitfawubudfmfrIhe iono modification ardgemdd District.ReeidentielMendel epp4atiam ed exempfmntMn BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING awistons. PERMIT 44 . 25 Date: Applicant: 504 SMIP/NON-RES • PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dduuoro: ISSUE FEE ' 22 . 00 ❑ I have end wig maintain a enthral.of consent la sell-insure for woken'compensation,as provided for by Section 3700 of the Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for the pettcrmance the work for atsichMepemiteeaged. TOTALS----> 44 . 25 22 . 00 0 . 00 66 . 25 66 . 25 . 00 ❑ I have and wig maintain workers'compensation insurance.es required by Section 3700 of the Labor Code,for the perlmman e of the work for which this Penn) ran is issued.My workers'compensation insurance ter and policy number are: • ' Carrier: REVENUE DIVISION TOTALS--> COLLECTED: 66 . 25 OVER/SHORT: . 00 Poky Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TTOTT GRADING PLAN-CHECK (Th' section need not be completed/the permit is for one hundred ddlarMOO/orbss.) 66 . 25 I caddy that in the performance d the work for which this permit is issued,I shall not employ any•.t^n any mender so es to become sublet to the workers'compensation laws d California. end agree that of . M . .v to the waldd' ******************************************************************************* compensation provisions o Geoctpct 3700 d the Labor Code,I sildorthwith comply with room. IND IVIDUA',L FEE BR EAKDO 14 N , // ^ Apptnt:(6tbtyIP . Warning:Failure to secure workers'compensation coverage Is unlawful,and shall subject employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil lines up to one hundred thousand dollars($104000),In addition to the cost of compensations demean as provided ler In Sedan 3T'O3 of the Labor Code,interest and attomers feet ELE ,1 SWIMMING POOL IN GROUND - NEW EA. _ 44 . 25 44 . 25 CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury that there is•construction lending agency for the _ END OF FEES performance of the work for which the (Sectionperm)is issued 3097,Civ.C). LENDER'S NAME: LENDER'S ADDRESS: . I certify that 1 have read this application and state that the above information is coned.I agree to comply with till thy and county ordinances and state taws relating to building construction and hereby authorize dgaermuMes of this thy to enter upon the above-mentioned property for inspection purpose. CARSON L' DERS •�%i aI . ..- Date: /yu��•� Signature• • .upent/A.. ... , lrmo • 01 00220031-00220031 TOT 66.25 DATE: -11/27/95 -T-IMI1-15:35 (5151.45.WP) White-Building d Safely:Green-Fit:Canary-Appian;Pink-Revenue;Goldenrod-Assessor 1 I b CONSTRUCTION AND PLANNINt_ L & SPA ! APPROVALS Permit# Inspector APPROVALS Permit# Date Inspector jDate 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-Undrgrnd. 55. Electrical Bonding 2-6 .`5. Steel Reinforcement. 56. Rough Plumbing & Pressure Test . 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 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 - t 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 O'Gas 0 Oil 23. Gas Pipe-Rough& Test • - Y- _ 72. Underground Flush 24. Roof Framing - - 73. Unde rgrnd.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 PREY. FINAL 30. Drywall Nailing . - . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final MI a 80. FOOD CERTIFICATE ISSUED 33. Final Electric r • p' 7 i Nptes: /2.-5----96 .GR' R1/ o Je� J_4,:f. 34. Final Heating & Air Conditioning. _ 1 35. Final Gas Pipe-Test 36. Canopy 7Hood or - _ �_ ® - 37. Final Factory Fireplace - i- 38. Final Plumbing , 39. Water Service-Final : • i - - • - 40. Gas Service-Final * -. - . 41. Solar Domestic-Final - - 42. Backflow Preventer _ 43. Backflow Irrigation , 44. Landscape Irrigation System . _ _ . _ , 45. Sound Attenuation • 1 - 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 I 451301,1:9( tjl ST �x;sT Q . N 61 1) m to. .1) _ ri'A "pvC AIR- SW. P ---CON;IN.Ous_B�a — — —- — — — — ,r'� . 0 • ! SSP ` �f(y." \n- --a/6 -� C1 '� ?O t CITE — — _ _ I LLD CoND- i — — — — I�Ez(sr'c'�a 7Je ) ' ,� IT it-SLED wits S 7012.- (� 5PA '-irE 1 N ( i lsq -PR vMv eRef°c.E e ; InES4 s®,gx 1 cLocK foIt LI1E5 1 Ni. 'I, r.1" .72.7vu[ ' :, i. rin P. (f!Q. gimp,. 823.8040 64 CMS – 016 = 002 as Field Date on Teit.Spccimans Core Concrete Gunite_ Grout/Mortar — Project Permit No 21294 Claude C. Schonert Shlmpool Project Location 1784 Panay Circle, Coate Mesa. Calif ' • Contractor Anthony Pools Inc: Atchitett Location in Structiira Bond beam North East Side cnpin1ar - Date Moulded 1364• No of Specimens Slump Specimens Marked Specified Strength at 28 days 2000 P.S.I. . Mix Designation Job Mia 1 – 44- Age to bn tested days • day' day days . READY MIX PLANT •AGGREGATE SOURCE •Rodeffor Industrie° ' SK Weather Condition Clear Mild 1 Yd, _l$E Batch.. Cement Permanente Type i Cement, lbs. 1 Admix None Sand ' 4. Specimens made by . Anthony Pools r$4 Data by Ceram • #3 Delivered by #2 Date Delivered # REMARKS: Specimens sacred from Water, Gals. 18 X 18 X 5 slab cast on plytrood FOR LABORATORY USE ONLY Lab. No, 8 Day Test Day Test • Day Test • Day Test Date of Test 2/1141 re/2 ...m,...... .../c add% Specimen Dimensions' 4 X 4 X 8 4 X 4X 8 rpm 11+14 �tCtri Area L16.0 96.0 E9BsUltimate Load 29,50040.,000 A j �� Mesa° ept. Lbs. per so,. in. 1,845 2,500Lit �•H/D Corrected -. . . i`-�\ 1 H. V. LAWMASTER & CO., INC. CITY OF COSTA MESA CALIFORNIA P.O. BOX 1200 FROM THE OFFICE OF THE PLANNING DEPARTMENT Mr. Claude Schonert October 15, 1964 1784 Pansy Circle, Costa Mesa, 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 have 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 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • MESA CONSTRUCTION PERMIT PE MIT NO. TRACT NO. LOT NO. UNIT NO. • CITY OF COSTA Project Address 1784 Panay Cir. P 3 Z�' - 27.57 I I /26/84 5.0D 71, Applicant's Mailing Address 10422 Trask Ave. TYPE OF CONSTRUCTION ❑ NEW 0 ADD LIALTERATION LI REPAIR Phone557-6277 ❑ CONVERSION 0 DEMOLISH ❑ OTHER A.P.# I Zone Owner's Name Foyer DESCRIPTION OF WORK/USE OF BLDG. . Address 1784 Panay Cir. - Replace Water Heater S Main Building: . Accessory Building: • Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING LI FOUNDATION El STRUCTURAL E Front • O Address ❑ TENANT ElELECTRICAL 0 PLUMBING IDMECHANICAL A Rear N Contractor's Name A-ames Plumbing-Heatinghone 530-2440 ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) 10422 Trask Ave. Garden Grove _ - K Left G 6664 CONSTRUCTION TYPE VALUATIONS 5 R City License No. ZONE GRADING CU.YDS. ACRES 1 LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E f•-) I hereby affirm that I am licensed •••r prows'. of Charter 9 c•mmencing Remarks: Planning Notes: Q (� with section 7000) of Division .f the Business .nd .i. s Code, and M my license is in lulyf-spp and elf: t. 030 S. License la T ll.• .7 GO License •• .� \.;., :'mate 11'�—• Slenatur'� ' - �- PLUMBING FEES I WORKERS' COMPENSATION • CLAR• •N Bar Sink Showers ELECTRICAL FEES -I hereby affirm that I have a ce tificate o '•nsent to self-insureor a certificate of Workers' Compensation In urance, or 4 certified copy thereof (SectionBackflow Preventer , 3800, Lab. C.)_ • Fremont ,s ®_■ , Automatic Washer _ Transformer 0 15-50 KW Policy No. W!' Company Construction Pole Sub. • 0 50+ KW BCertified copy is hereby furnished. Certified cyp I tiled with the city uilding Div n. Sewer Connection Cooking Unit Meter Duo to 100 amps Date 11—/—y8�i Applicant A-ames plumbing-Heating EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Solar DO lectors Dishwasher Meter Clover 100 amps (This section need not be completed if the Permit Is for one hundred ($100) or less). • Solar Piping Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains Solar Tank Fan Motors 00-1 HP 01'h-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: If,after making this declaration,You should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal . _ Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY • 'Water Closet Device Boxes Pole Light I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Intercepters Water Heater 2 01 Outlets Range Lender's Name • - • n g Lender's Address _ Water Service Switches OWNER BUILDER DECLARATION - Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Garbage Disposal 'Standing Sections following reason (Section 7031.5 Business end Professional Code: Any city or '�^��•�� county which requires a permit to construct,alter,improve,demolish or repair INSPECT EADY FOR r in Generator 00.5 KW 05-15 KW M Trash Compactor ■ any structure, prior to its issuance, also requires the applicant for such permit toh file a signedrcStatement that hapte is licensed pursuant to the provisions0 )of DrainsRoof I . MI 'toe Cona cnes License Law(Chapter sher s(commencing with hon of Division 3 of the Business and Professions Code) or that he/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). LJ I, as owner of the property or my employees with wages as their sole $Issue Fee 3 compensation, will do the work,and the structure is not intended or offered Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved •' te pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By _ •, rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System / tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con • - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration proof of their Worker's Compensation Insurance should be provided to me. PLAN CHECK .....§ PERMIT ❑ I am exempt under Section B.& P. C.for this reason Firepl/Fact.Bk. ICBG# • Y PLUMBING Date •caner System . ' • - PLAN CHECK 25% $ I hereby c— ify that I have ead this ppl'-.tion and state that the above 00-100,000 s ■ •5500 : GRADING informati• is correct. I agr: to • • h all city and county ordinances and stet- la s relatin• •uil. 5 ctlon, and hereby out orize repro- ■ ' • 0% MICROFILM Oinspectl, sentxtiv to ent • • the .•eve-mentionetl •• y T MECHANICAL $. purse _Signet f i1�s� Dab' i i Driv. s' icense or / CMF 5865.46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod'Assessor • r • CONSTRUCTION &SPA CONSTRUCTION AND PLANNING - . APPROVALS Permit#_• Date Inspector APPROVALS Permit # Date Inspector . 1. Temporary Electrical Service or Pole 'i 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrg'rnd. , 54. Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 5. Steel Reinforcement . • 56. Rough Plumbing & Pressure Test - - • 6. 'Electrical UFER Grnd. i.,' 57. APPROVAL TO COVER-GUNITE . " 7. Footings / 58. Electrical Conduit-Undrgrnd. • • 8.'Foundation 59. Gas Pipe, 0 Undrgrnd.,Test , 9. Water Pipe-Undrgrnd. - 'i - 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 ' r 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 i 72. Underground Flush 24. Roof Framing 73. Undergrn(lrStorageTank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead klydro 26. T-Bar Ceiling (Structural) & Monocoat ' 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED,StSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINALIN- SPECTION . 32. Electrical Power Meter-Final 80. FOOD CE- RTIFICATE ISSUED 33. Final Electric Notes:///2...gg4 te'-r 4-iao L.iriO 34. Final Heating & Air Conditioning 35. Final.Gas Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace ///3o4' tQ 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. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY \ No. Date II Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - CITY OF COSTA MESAy CQ�NSTRUCTION PERMIT I P MIT NO. TRACT NO. LOT NO. UNIT NO. 2512 6/19/814 5.0(3 TI • Project Address vv��<<ryry pt /� ' 3-/ 3 Z' r I Applicant's M Address 176 ✓`%QL« �A., . y` TYPE OF CONSTRUCTION Li NEW ❑ ADD U ALTERATION Li REPAIR • Owner's Name �yD EP _ •horyp J 7�F77 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Address ./725 /AA/+y9 elPe446 DESCRIPTION OF WORK/USE OF BLDG. S Main Building: Accessory Building: Arch/Eng. License No. _ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION T O ❑ STRUCTURAL Front r.(1 Address • 7� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N I Contractor's Nam- a a • r l.4 /. / .' one z„ ❑ OTHER • C Right N IPROJECT DESCRIPTION SQ. FT. OCCUPANCY K G Address(mailing)P01'7_,C1,-*A>,/4C Left 62 t'J CONSTRUCTION TYPE VALUATION $ § R City License No. !!!"` ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and - T my license is in fulljtA{e a O - feet. /a 9 S. License Class C... Icense o. C; (aate ..t Signature y- — - - PLUMBING FEES s • _ rVORKERS'COM•ENSATION DECLA-.•TION Bar Sink Showers ELECTRICAL ' FEES I hereby affirm that I have a certificate •f consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - 3800, Lab. T Automatic Washer Transformer 0 15-50 KW Policy No. -1T� An I �Dl-L) Com ny �i�� t 11 , Backflow Irrigation Sewer Cap Construction Pole Sub. • 0 50+KW 8 Certified copy is hereby furnished. Certified y is filed with the cit • ision � Bathtubs Sewer Connection Cooking Unit Meter Oup to 100 amps Date (Q Applica `_ - EXEMPTION ROM WORKERS COMP SATION DECLARATION Clarifiers • Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if t permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas OElec(ric Sub Panel ' 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 • Drinking Fountains Solar Tank Fan Workers' Compensation Laws of California. Motors❑0-1 HP 01'h-8 _ Date Signature Floor Drains Swimming Pool w/Spa i F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: If,after making this declaration, you should become subject to the Workers' Compensation- provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures - comply with such provisions or Phis permit shall be deemed revoked. - Microwave CONSTRUCTION LENDING -AGENCY' Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance �1 Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors / Water Heater Lender's Name vU Outlets Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Garbage Disposal - 'Standing Sections . following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Tra fr any structure, prior to'its issuance, also requires the applicant for such permit p - Generator 0.5 KW 5.15 KW Trash Compactor • to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains •' r the Contractor's License Law(Chapter 9 (commencing with Section 7000)of „ Division 3 of the Business and Professions Code) or that he/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). Ll I, as owner of the property or my employees with wages as their sole • Reinspection Fee I $15 Issue Fee $ 3 compensation, will qo the work,and the structure is not Intended or offered , • Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ Zoning Approved By Date sale. If, however, the building or improvement is sold within one year of com- Canopy Type I I 0 • pletion,.the owner will have the burden of proving he/she did not build or im- Duct-Under Ground j Building Approved By Date move for the purpose of sale). D I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Datit tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU - SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuat to the onracos License am awareBUILDING PERMIT $ SMTP $ ofnCttr' Law). I that Exhaust System ❑ Multiple❑ System Repair/Alteration proof their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.far this reason Firepl/Fact.Blt. ICBG 4 PLUMBING $ — 41 Op ISSUANCE $ Date Owner Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,00087E ELECTRICAL § GRADING $ information is correct. 1 agree to comply with all city and county ordinances and state laws r- ating to building co .truction, and hereby authorize repre- sentatives of % city to enc up• the above-mentioned property for Inspection p/.q : , / �f7`" MECHANICAL .0 Signature i. _ , .y ' .i� -.rt. _ Date /o • 7 $ TOTAL FEE $ O Drivers' License • SS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev..4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector 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-Undrgrnd. 55. Electrical Bonding. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER.Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. 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 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: 7//7/dy LEFT Ce/Le , 34. Final Heating & Air Conditioning 7/a3/89 Leer (SCA. care 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 7/�jj Leo 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. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date /'1 °,;I 64 dWNER • SCHONERT, CLAUDE DATE JAN 8 DU • lkJOB ADDRESS 1784 Panay Circle BUILDING PERMIT NO. 21294 - 1GENERAL CONTRACTOR Anthony Pools VALUE $ 2700.00 \ AP No139-122-15 LOT TRACT FIRE ZONE 3 DESCRIPTION OF WORKPVt. Swim Pool INSPECTIONS Signatur> , .DATE G'+UP J TYPE III ZONE El Soil _ ,-< .,- Srn - A: / PERMITS ISSUED _ Gas ,o _ . SUBCONTRACTOR DATE NUMBER Water Rough Com. Refrig. 0 Air Cond. 0 Rough Heating ,� ' Rough Plumbing 9-cert„ n•-F.-1- /-A /-Ai/-Gy C�,-2'I n.cj /tea , a /- t 1.6 rA �'-Li GP ? Miscellaneous ...dip- 4 a Len-9 ; I Prop. Swr. Line 0 House Con. 0 St Swr. 0 IA14, Sprinkling System 1-11) . ' Construction Pole V Underground 0 Power O - .MJ Rough Wiring �.� O'er -''JC1' .r of i Trenches Pte'- Forms Steel Reinf. f`/ft'"" /--...7.1%.7(.......7--7 ,h,/" ,.P / .`-.{ Floor System �/�py� 1111'4'' 0 " 1 Bond Beam,&-. Steel Reinforce �- �j� /J"- 3t]-l/ I`tr i Sheathing / \\ n--/ Frame and Flashing a V Lathing — In O Out O Plaster, brown coat Refrig. 0 Air Con. 0 Final Heating, Final ' Plumbing Fixtures, Final 9,/ /,.!5_ 7 Final Gas Test _/. Electric Fixtures, Final _ _ Building, Final ,��j�! / • OCCUPANCY ' Form BU4-5M-3-63-5-13 P unT.n FMR CPF.CTaT. RWIMIT'PWRIMA 21294 I - 21294 FEE RECEIVED JAN 8 1964 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPS(. P. O. BOX 917 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT - BUILDING BUILDING 1784 PANAY CIRCLE ADDRESS COSTA MESA. CALIFORNIA For Office Use Only OWNER CLAUDE SCHONERT 1 RECEIPT NO. (1.): M1120,7 41 RECE/Vt..13YADIL ADDRESS 2152 PUFTjST I 7r 7 rEc COSTA MESA ESA NEGLI 87901 BUILDING 1784 PANAY CIRCLE ADDRESS ARCENGINENO ER T LARSON . OR COSTA MESA. CALIFORNIA - ADDRESS 5871 FIRESTONE BLVD. FIRE ZONE TYPE GROUP CONTRACTOR ANTHONY IDOL S APPROVED BY DATE 5871 FIRESTONE BLVD. ZONING ADDRESS CITY SOUTH GATE E°K-I PLANS C... BUILDING EW f STATE TEL. LEGAL Lot 1 7/ 7R 33 63 LIC.NO. 190179 NO. DESCRIPTION F BLO S E OF A LOT 173X6 3%128X159 NONO.W ON LOTS /3 9 — / a a - /s A.P.NO. USE OF YARDS EVES EXISTING BLDG. CAR APPROVED ALLOWED SRES AND C /�7�'-,,� CENTER OF STREETACK LINE M 18' • REAR YARD 23' (CENTER LINEONT , R FT. �/li re". IN. SIDE YARD I LEFT 5' I RIGHT 10' R.SIDE / 0 FT. '(!e"W-.- IN. DESCRIPTION OF 'ryWORK L.SIDES FT. -f IN. NEW I X II ALTERATION I II ADDITION I REAR 2-3 I FT. IN./ REPAIR II MOVING I DEMOLISH BY (�/ � PROVED. / DATE / 7`Y ICN.-3 �R� BUILDING 557 NO. OF � SIZE ROOMS STORIES EXTERIOR WALL I ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED PRIVATE SWIM POOL I HERESY ACKNOWLEDOP THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT NL ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. PLY WITH ALL TY ORDINANCES AND (TATE LA B LATINO BUILDING C STRUCT N./ / VALUATION /' SIGNATUR OF (' .- / V A LI / PERMIT FEE $ / - N PERM1IITTEF — - m `C//f� CWT/__a $ PLAN CHECK $ �/`7 �' "'NN) I4 2700.00 f AUTkjORiZED AGENT • rc TOTAL FEE $ u OWNER SCHONERT, Claude C• / DATE 12-4-62 /JOB ADDRESS 1784 Panay Circle BUILDING PERMIT NO. 18180 ) GENERAL CONTRACTOR Owner•-Bldr. VALUE $ 45,44$.00 -AP No. 139-122-15LOT 1 1 TRACT 7 3363 FIRE ZONE DESCRIPTION OF WORK 4 1& • INSPECTIONS Signature DATE GROUP J TYPE v ZONEG Soil Loa, 2.-5--G3PERMITS ISSUEL Gas SUBCONTRACTOR DATE NUMBER Water -1�'r.., •?-/9-(s Rough Corn. Refrig. 0 Air Cond. 0 7 Rough Heating c(Prtrf. np/,S /0/5'(3 Rough Plumbing iza Ay-o-- , . t, • 7-7.4:4 374iL-f' Miscellaneous _ •- '7d- q_�_ GJ_3 Scat Prop.Swr.Line ease Con. t.Swr. 0 1,„„k..: k f'4 / a-c�L� k • �ZoZ/L Sprinkling System �' Construction Pole -. e:L��le!L`Gce/. r�-/�'4 Jam-— Underground" Power ❑ a ?-hy.� _ _ p—J¢� Rough Wiring 7(''/- 2, L/ L.LL.G(/f.GCCJ oq-/gt- - p'� Trenches ❑ Forms 0 Steel Reinf. 0 SYS; "4 •-G- $ Floor System Bond Beam 0 Steel Reinforce 0 Sheathing _ q Frame and Flashing r.. . i4p Lathing - In 0 Out ❑ A o Plaster, brown coat t b -39 -i, Refrig. 0 Air Cond. 0 Final ' Heating, Final ,i735,7;44,7 Plumbing Fixtures, Final ly _ Final Ga--.in J{l Electric Fixtures, Final le,OD �f, -CCE I Building, Final in-/-- , ,!?-C e -\,...\,,. 1 .t1.1 OCCUPANCY rnpM FII6.SM —. 7.AI -n,a.. 6 L7 IAI80 FEE E4 D NOV 7 1c62 COSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 317 COSTA MESA. CALIFORNIA CITY OF COSTA MESA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE OR PRINT BUILDING t0' DDRESS / 7gII PaAla y C'1 Atte COSTA MESA. CCALIFORI/4)IA For Office Use Only jj JG L0 /✓ ei RECEIPT NO. 771771° E(tMlr'QI y n OWNER �.J)aU `C % RZ� ,/n" 7 U MAIL BY GATE RECEIVED O]TT ISSUED ADDRESS "Z / Z„ U'eZ e !te /! 7- (y /_/_i�_6 �' CITY Gost,i Nese? NOii_7To7 Alma= DD lIIN / ARCHITECT TEL. OR ENGINEER -- NO. COSTA MESA. CALIFORNIA ADDRESS - FIRE /�/7� �!� ZONE TYPE GROUFj�� CONTRACTOR V ulIV eR. APPROVED BY DATE ADDRESS '-�� ZONING CITY ��.-- ZONE R. PLANSNO.OF BUILDINGUSE OF Ea Z fn.— STATE TEL - LEGAL ///� yp T�[`�/Q��[ d'#4 `�'L' LIC.NO. .-- NO. DESCRIPTIIIIt-��(}JS�-/ I 7/�]�/ F \I 'A OF / 3t 7A. ) I?st NOW ON LOTS C A.P.NO. ISS- , / 2- /S OF LOT O O USE OF ...-_ YARDS EVES EXISTING BLDG. APPROVED ALLOWED SETBACK LINE FROM Ce; 7 (CENTER LINE ST.) / �7✓ + CENTER OF STREET REAR YARD FRONT (Q / FT. ^ �� IN. kr SIDE YARD I LEFT RIGHT R.SIDE SFT. IN. DESCRIPTION OF WORK L.SIDE Sr. IN. NEW I x I ALTERATION I V ADDITION I LT. CC REAR REPAIR I II MOVING I V DEMOLISH I APPROVED//. 0 9 SIZE DING ,..NO. OF .•/`� SROOF ,T�O?RIES // iatt 430-04 B ((��(// '��y[iP/TE !a� (0 COVEREXTERIOR ING WALL`...mfr.,-/ "c I COVERING / , G c~ a % Q f / /� USE OF BUILDING AND WORK TO BE PERFORMED ( L D /IS 3 i -a f y4,99 /)es /%cce 9� r-/ �f,ea to 9.5- .. z/it e_01-. -'�`2Le � �0 27` yJ it RQ/9 P /Jre.e..e— /o/�- I HEREBY ACKNOWLEDGE THAT HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM PURPOSE OF ESTABLISH ING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND STATE LA REGULATIN BUILDING CONSTRUCTION. �l �f VALUATION /30,3 SIGNATURE Or.) (I •(j PERMIT FEE $ [^ 01 PERMITTEE /J .aSZ ${'� �J�/Q PLAN CHECK 5 (+/3-7.51 AUTHORIZED AGENT / �/ 7O TOTAL FEE $ // °