HomeMy WebLinkAbout1787 PANAY CIR - Building Permitsa � ,
CITY OF COSTA MESA
BUILDING DIVISION ✓
� DEVELOPMENT SERVICES DEPARTMENT B98-00791
PERMIT PERMIT NUMBER
(714) 754-5273 Fax (714) 754.4856 BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
.lob Address:
1787 PANAY CI
Phone: 646-7686
Status:
ISSUED (/ I I .
Suite:
Zip: 92626
Applied:
04/30/1998" I U
Vicinity:
$957.25
Arch J,Eng :
Issued:
06/18/1998
Parcel Nunmber:
13912247
Zoning:
R1 R1
-
Applicant:
UNKNOWN
Address:
$0:00.
n
License:_ - - •�-).
' � ,
Phone:
r,
Zip:
Total:"
$968.60
Owner:
GRAY, ROBERT HTR --
Address
1787 PANAY CIR'����-
/,���i
Phone
COSTA MESA,CA A _ 1
92626
i
_Zip
Contractor:,
/,KENNEDYS'CONST_RUCTION
Address:
/%257, SANTA ISABEL /�/
SCOPE OF PERMIT
ADD 704 SQ. FT. 2ND STORY OVER EXISTING DEN/BEDROOM/BATHROOM AND 643 SO. FT. GAME ROOM OVER GARAGE W/ 146 SQ. FT. EXT.
STAIR, LINKED BY A 2ND STORY: BALCONY/CATWALK.-REFPC#1681-98A<<,.�,-,�;��,� ,� A
LUR REQUIRED
Phone: 646-7686
COSTA MESA; CA
Zip: 92626
Calc Valuation:
113,520.34
License�,324307�
$957.25
Arch J,Eng :
Claimed Valuation:
so.00,-,'
.Address:..
_
-
/,.'Phone:
x$0.00
;
$0:00.
n
License:_ - - •�-).
' � ,
r,
SCOPE OF PERMIT
ADD 704 SQ. FT. 2ND STORY OVER EXISTING DEN/BEDROOM/BATHROOM AND 643 SO. FT. GAME ROOM OVER GARAGE W/ 146 SQ. FT. EXT.
STAIR, LINKED BY A 2ND STORY: BALCONY/CATWALK.-REFPC#1681-98A<<,.�,-,�;��,� ,� A
LUR REQUIRED
PLANNING -&'ZONING_
SETBACKS
MAIN STRUCTURE Front 21-0, Rear 10-0 - - Left 8-0 Right 12-0-
ACCESSORY
2-0ACCESSORY Front 0-0 - Rear 0-0 Left. 0-0 ,-Right 0-0
PARKING Existing: 3 Required: 2 Proposed: o
NOTES: BOUWE W 5/8/1998 PLAN CHECK FEES PAID IN BIPS SYSTEM ON 4/30/98. REF. RECEIPT
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codas an all
required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of/ this
FOR INSPECTIONS CALL: (714) 754-5626 fig
- FEE SUMMARY
Plan Check:'
,$0.00
Calc Valuation:
113,520.34
Permit
$957.25
�_
Claimed Valuation:
so.00,-,'
SMIP Res.,,',
x$1.1.35
_
SMIP,Com:
x$0.00
`Other: "
$0:00.
Inspection: -
." $0.00"-."
Total:"
$968.60
PLANNING -&'ZONING_
SETBACKS
MAIN STRUCTURE Front 21-0, Rear 10-0 - - Left 8-0 Right 12-0-
ACCESSORY
2-0ACCESSORY Front 0-0 - Rear 0-0 Left. 0-0 ,-Right 0-0
PARKING Existing: 3 Required: 2 Proposed: o
NOTES: BOUWE W 5/8/1998 PLAN CHECK FEES PAID IN BIPS SYSTEM ON 4/30/98. REF. RECEIPT
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or If work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codas an all
required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of/ this
FOR INSPECTIONS CALL: (714) 754-5626 fig
I
I
DECLARATIOiVS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations: '
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and w0 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 caller and policy number are: Y
Cartier: �_TiYre �L`-✓"--:� Policy Number.
(This sect/ need not be completed If the permit is valued atone hundred dollars ($100) or less.)
❑ I certify that in the 'a&nm work for whi this eryrl Is Issued, I shell not employ any person In any manner so as to became subject to the workers'
compensation laws o1 Call ml d ree hat 11 1 this
e m subject to the workers' compensation provisions of Section 3700 of the labor Code, I shall forthwith
comply with these provisions.
Applicant Signature: L Date:
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAAND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATICN, D GES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby SHIM that I am licensed under provisions of Chapter 0 (commencing with Section 7000) of Division 3 of the Business erg Professions Code, and my license Is in full
force and effect. Lic. P Class N ��
Contractors Signature: Date:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code).
Lenders Name: Landers 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 o1 Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more Nen five hundred dollars ($500).):
❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or Improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contraclor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ 1 hereby certity 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 6, 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: Data:
Division of Industrial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 WIII the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight o1 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 builtling acwpent need to file a registration form for eatety hazardous materials? ❑Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Coate 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
..4....................Department.
..............................................................................................................................................................
....................................................................fa..MP.P .s
presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
5 Does ar will the applicant or present ar future building occupant require for the work which is the subject of this gpplication eppermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits).
............................................................................................................................................................................................................ ..................................................................
6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No
(If yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code).
....................................................................................................................................................................................................................................................................................
7 If apermit from the South Coast Air Quality Management District or other air pollution control district or agenIs roGulred 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 madecy ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
6 (It 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- cd property for In ction purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
gnature 01 Legal Owners) Date
And/Or razed Applicant ate
COOL L INSPECTION TYPE gAIE INTTM CODER INSPECTIONTYPE DATE INTmAW'
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 BlockfRetalning 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 lr=i=–sa-
2-+ 4e
A. -
SICIHIUILILIEIR
Residential Building Insulation
Installation Record
Batts & Blankets
Description of Area
Sq. Ft. of Insulation R -Value @ Thickness
Ceiling Roof ceiling area
R-30 11
Ceiling
Wall Exterior walls
R-13 3 5/8
Wall
Floor Between Floors and Garage
R-19
Title 24 Foam Caulking
If batt or blanket insulation has been installed in enclosed cavities, thosexavities are deep enough to allow insulation to
expand to the labeled thickness unless exceptions are noted above.
Blowing Wool in Ceilings -
Nominal Net Sq. Ft.
Bag Weight Insulated - - No.ofBags-
Minimum
_. . _..._...R -Value._ _. __ _ Required Thickness
Blowing wool, if used, has been installed in the ceiling in conformance with the manufacturer's requirements shown
on the bag.
Location
St. or Lot# 1787 Panay Circle
City Costa Mesa
Builder
Company Name
Signature
Date
Insulation Contractor
Company Name
Signature
_-.. _Date__11 /04/98
Schuller International, Inc.
Building Insulation Division
P.O. Box 5108
Denver, Colorado 80217.5108
CITY OF COSTA MESA
BUILDING DIVISION
DEVELOPMENT SERVICES DEPARTMENT
J
•� PERMIT PERMIT NUMBER
E98-00903 ✓
(714) 754-5273 • Fax (714) 764-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address
Suite No
Vicinity.
Parcel Nunmber
Applicant
Address
Owner:
Address
Contractor:
Address:
ELECTRICAL PERMIT
1787 PANAY CI
SECOND STORY ADDITION
`K1j`xzVA
PATRICK KENNEDY
257 SANTA ISABEL AVE.
CA
COSTA MESA
GRAY,;ROSERT.H TR
1787,PANAY.CIR
,COSTA MESA,CA _ `.
KENNEDYS CONSTRUCTION
Phone: 949.646.7686
Zip: 92627
Phone: 714.662.5746
Y i /
Zip: 92626
257 SANTA ISABEL
. ' Phone:: , 646-7686
Status: ISSUED e
Applied: 08/25/1998
Issued: 08/25/1998
COMMENTS / SPECIAL CONDITIONS
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) 754.5525
COSTA MESA, CA
• • Zip"_ 92626
� License: . 324307 _
SCOPE OF PERMIT
RE: B98-00791 / ELEC.PERMIT
FOR SECOND STORY ADDITION. 37 LHT,`FIXTURES, 51
"RECEPTACLES, 10 SWITCHES, 2 NON -RES. APPL. NOT OVER 1 HP, 1 SERVICE 600V BELOW
-1,000
'
'AMPS, 3 SUB -PANELS & 371HP. MOTORS.
FEE SUMMARY;;, f
Quantity
-- :--_ :_� :- ti-=�
Quantity
ISSUE FEE
$22.00
- -
-- -� TempDist Sy'slein / Lighting
$0.00
0:
Temp service test
$0.00
Busway /.100 It/
$0.00
0'
Res. a/c package
$0.00
Standing8ection
$0.00
.0 '
New Res (1-2 units)
$0.00
0
Misc Electrical Equipment
$0.00
-10
New Res (3+units)
$0.00
0
Transformers up to 1 kva/kw
$0.00
0 ,
Pool / Spa .
$0.00
0
.....:.......... up to 10 kva/kw
$0.00/1
0
Lighting Fixts
$31.05
37
........:.......up to 50 kva/kw
$0.00''
0
Recept Outlets
$40.15
51
•:.:.::..:. .:.:.up to 100 kva/kw
$0.00`
0
Switches
..
$10.00
10
.....`.........:..over 100 kva/kw
$0.00
0
Non Res Appl
$8.50
2
' Low Voltage Equipment
$0.00
0
Res Appl
$0.00
0 -
Low Volt Wiring System / Ckt
$0.00
0
Service to 200a
$0.00
0
'. ' Misc.,Conduit -
$0.00
0
Service to 1000a
- - $55.50
1
_
Misc. Conductdr -
$0.00
01
Service over 1000a
_ $0.00.
0
- " , Circus{ gen or ride)
_ _
$0.00
'0",/
Motors to 1 hp
" $12.75' ',
3
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 1 00h
$0.00
0
Communication drops
$0.00
0
Investigation Fee
$0.00
Sub panel to 200a
$81.75
3
Plan Check Fee
$0.00
Pole Light Pkg
$0.00
0
Reinspection Fee
$0.00
Sign Circuits
$0.00
0
Temp Pwr Pole
$0.00
0
TOTAL CALCULATED FEES
$261.70
Intermed Pole
$0.00
0
COMMENTS / SPECIAL CONDITIONS
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 754.5525
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit is issued.
❑ 1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workers' compensation Insurance carrier and policy number are:
Cameo Policy Number.
(This section need not be pr' tl it th rmit is valued of one hundred dollars ($ f 00) or less.)
❑ I certify that in th or ce f t work for which this permit is issued, I of employ any person In any manner so as to become subject to the workers'
compensation Is s all nis nod that if I should become sub a workers' compensation provisions o1 Section 3700 of the Labor Code, I shall forthwith
comply with t
Applicant Signature: - Date:
WARNING: FAILURE T SECURE WORKER ' MPENSATION COARAXIS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINALPENAL�'CIVIL FINES UP TOONE HUNDRED
THOUSAND DOLLARE($100,000), IN ADDITION TO THE COST OF NSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm that 1 a nsed 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. Li,. Class #
Contractor's Signatu f,
' Date: _
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affirm that there is a construction lending agency for a 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 affiml 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, prfor 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 Cade) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ I am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License NO. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation five (5) or more feet In depth into which a person is required to descend, will be made In connection with work authorized by this
permit, and that no building structure, scaffolding, 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 ❑ 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 hazardousmaterials 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? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of
compressed gas at standard temperature and pressure).
............................................................................................................................................................................................................................................
3 Does or will the applicant Or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
...................................................................................................................................................................................................................................................................................
4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Ves ❑ 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 a_kPemit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? Ll 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).
.........................................................................................................................00-0-.-feet......................................-e-a ................
........-....
.s.............-......................................
.............
6 Will any part of foe facility to be constructed under this permit be within 1000 feet from the outer Dountlanes of a school?[Yes ❑ 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 requlred for the work which Is the subject of this
appllcafion, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Ves ❑ No
.......................................................................................................co...............................................................................................:..................................................
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:
CERTIFIC P. CE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is
correct. agre I co ply ' h all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above- es re jlrry r inspection purposes. I Brea-Ret-tvoc p or allow occupancy of any building authorj;yd by this permit u �rl inspection.
\1 r-� 5 (LT/
Signature Legal Owner(s) Date
And/Or Authorized Applicant Date
LggEh INSPECTION TYPE LATE IBIm9fi CODEC INSPECTION TYPE LATE IHMAL$
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 BlocWRetaining 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
2446.46
� CITY OF COSTA MESA ,
BUILDING DIVISION r
F _ DEVELOPMENT SERVICES DEPARTMENT
�• PERMIT PERMIT NUMBER
- M98-00412 '1✓
(714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626
MECHANICAL PERMIT
Job Address: 1787 PANAY CI
Suite No
Vicinity:
Parcel Nunmber: 13912247
Applicant
Address
Owner
Address
Contractor:
Address:
Arch l Eng:
Address:
MOCKLER, SCOTT
HUNTINGTON BEACH CA
Phone: -
Zip: 92648"
-License: 575613
Phone:
Zip:
License:
Status: ISSUED
Applied: 09/10/1998
Issued: 09/10/1998
SCOPE OF PERMIT
REF B98-00791 INST /REPLACE EXIST HVAC SYSTEMS. AND WALL FURNACE.
Quantity
ISSUE FEE
Phone: 714-557-7717
Inst FAU <100 k BTU
Zip:
Inst FAU >100 k BTU
$0.00
Repair/ Alt Cooling/Heat
$0.00 0
GRAY, ROBERT -H TR
$13.25 1
178TPANAY CIR-
S26.50 2
Refdg Sys >100 k BTU
Phone:
COSTA MESA,CA, " '
Zip: 92626
CONTEMPORARY AIR CONTROL
$0.00 0
" 18685 MAIN STREET
$0.00 0
HUNTINGTON BEACH CA
Phone: -
Zip: 92648"
-License: 575613
Phone:
Zip:
License:
Status: ISSUED
Applied: 09/10/1998
Issued: 09/10/1998
SCOPE OF PERMIT
REF B98-00791 INST /REPLACE EXIST HVAC SYSTEMS. AND WALL FURNACE.
Quantity
ISSUE FEE
$22.00
Inst FAU <100 k BTU
$26.50
Inst FAU >100 k BTU
$0.00
Repair/ Alt Cooling/Heat
$0.00 0
Inst /Rep. Recess Wall Htr
$13.25 1
Refrig Sys <100 k BTU
S26.50 2
Refdg Sys >100 k BTU
" $0.00 0
Gas Piping
-$0.00 0
Factory Fireplace
$0.00 0
Hood w/Mech Exhaust
$0.00 0
VAV Box
$0.00 0
Vent Fan / Single Duct
$0.00 0
Appliance
$0.00 0
Fire Dampers
50.00 0
Smoke Dampers
50.00 0
Inst or Relocate Appl Vent
- $0.00 0
Air Handlers < 10000cfm
$0.00 0
Air Handlers> 10000cfm
$0.00 0
Floor Furnace
$0.00 0
Floor or Suspend Heater
$0.00 0
FEE SUMMARY
Quantity
Repair/ Alt Absorbtion Unit
$0.00
0
Repair /Alt Refrigeration Unit
$0.00
0
Ventillation:System -
$0.00
0
Evaporative Cooler
$0.00
0
Commercial incinerator
$0.00
0
Domestic Incinerator
$0.00
0
Compressors / Absorption Systems "-
"' Up to 3 hp / 100 k BTU
$0.00
0
3 To 15 hp / 500k BTU
$0.00
0
15 To 30 hp / 1,000 k BTU
$0.00
0
30 To 50 hp / 1,750 k BTU
$0.00
0
Over 50 hp / Over 1,750 BTU
$0.00
0
Boilers
"
Up to 3 hp
$0.00
0
3 To 15 hp
$0.00
0
15 to 30 hp
$0.00
0
30 to 50 hp
$0.00
0
Over 50 hp
$0.00
0
Other Mechanical Fee
Investigation Fee
$0.00
Plan Check Fee
$0.00
Reinspection Fee
$0.00
TOTAL CALCULATED FEES
$88.25
COMMENTS / SPECIAL CONDITIONS
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
�ip
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
for which this permit is Issued.
I have and will maintain workers' c mpensation insurance, es required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued,
My workers' compens n IS ce carver and policy number are:
Carrier: t Policy Number:
(This section need not be co late if the permit is valued at one hundred dollars ($100) or/ess.) .
❑ 1 certify that in the pe rim nce of the work for w c his permit is issued, I shall not employ any person In any manner so as to became subject to the workers'
compensation laws of all mi and agr a that If I uld become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
these provi i s
pplicant Signet IrkData:
RET RE ORKERS' 006EASATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED
THOUSANDDOLLARE($100,000),INADDm TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED POR IN SECTION Nos OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS D LA ATION:
I hereby effirn that I am license un ri Ypll f Chi or (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full
f t 5d . M / Class It
rectors nalur Date: lG—
CONSTRUCTION LENDING GENCY:
❑ 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code).
Lenders Name: Lender's Address:
Signature: Date:
OWNER-BUILDER DECLARATIONS:
I hereby affirm that under penalty of polury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit
to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License law (Chapter 9 (commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec.
7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work
himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is
sold within one year o1 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 tar such project with a contractor(s)
license pursuant to the Contractors License Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires:
Verification of Ownership by (type of document, i.e. - property tax bill or 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 B, Cafitomia 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
pernit to do such work from the division.
Signature: Data:
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 Pian for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Pian 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? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 2DO cubic feet of
compressed gas at standard temperature and pressure).
..........................................................................................................................................................................................................................................................I........................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)?
❑ Yes ❑ No
(Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire
Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department.
.................................................................................. _...............................................................................................................................................................................................
4 II en RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application a_EPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? uYes U No
(Section 65050.2 of the California Government Code requires that the requested intonation be furnished on applications for non-residential building permits).
...................................................................................................................................................................................................................................................................................
6 WIII any Dart of the fecllly to be constructed under this permit be within 1000 feet from the outer boundaries of a school? []Yes ❑ No
(If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety 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
appl teflon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ 9as ❑ No
....................................................................................................................................................................................................................................................................................
B (Ii'yes", edech 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 0 COM ANCE 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 o com ly 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-describ tl prop M for inspection purposes. I agre not to occupy or allow occupancy of any building authorized by this permit until final inspection.
nelu ,Lege r(s) D
A r Authonz nt Date
CODE I. IfthCTION TYPE 0M INTITAL4 CODE INSPECTIONTpE am ftA
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 Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
244648
I
r
CITY OF'COSTA MESA
BUILDING DIVISION
_ DEVELOPMENT SERVICES DEPARTMENT
PERMIT
(714)754-5273 • Fax(714)754-4856
PLUMBING PERMIT
Job Address: 1787 PANAY Cl
Suite No
Vicinity:
Parcel Nunmber: 13912247
PER IT NUMBER
P98-00592
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 07/29/1998
Issued: 07/29/1998
Applicant: KENNEDY, PAT
Address:-
-�
Phone: 714-646-7686
�9
Zip:
,
r
Owner: GR' PY,/R, BER T H TR"-
1787
Address PANAY CIR-
i
Phone:
'COSTA MES
Zip: 92626`.
CoContractor'-'/" KENNEDYS CONSTRUCTION
I,
Address:257 SANTA ISABEL-
i;,;f,_
Phone;
646-7686
�., I.
-- COSTA MESA, CA a
- -�-Zip: 92626
'
-�'
-
License:- 324307
Arch Eng: - _--
Address: f _
i
Phone:-,
Zip:,..-
- License:
. • SCOPE OF PERMIT
1,SHOWER, 2 WASH BASINS,
2 -WATER CLOSETS, 1 WATER HEATER, 1 GAS PIPING SYSTEM & 1
' FLOOR SINK, REF 898-00791
FEE SUMMARY
• " "."� AMT QTY
AMT
QTY
AMT
QTY
ISSUE FEE $22:00,
Laundry Tub / WAher"�., $0.00
0
Sump Pump
$0.00
0
Backflow irrigation $0.010:,, 0
Landscape Irrigation - $0.00
0
Swimming Pool.
r $0.00
0
Backflow Preventer _ $0.00\ �0
P Trap C' - $0.00
0
Trap Primer
$0.00
0
Bathtub `: - $000 \�0;, --
Pressure. Regulator_,,,$0.00`�'0
= Urinal =
$0.00
0
Clarifier Systeme $0.00
-Process Piping (per 10 ft) 7, $0.00
0
. Vacuum Brkr Bkflow(1-4)
$0.00
0
Connect (Ice,Soda,ete), x$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 '
$17.50
2
Dishwasher$0.00"//6-/,
Cap for Demo x,'$0.00
-0
Wash Basin Seth
$0.00
0
-Sewer
Drain, Floor �-7 $0.00 `- Ol! '
Connect
Sewer $0.00
0
Waste and Vent System
$0.00
0
Drain, Rainwater $0.00 O. -.
Sewer Private Line $0.00
0
Water Closet (Toilet)
$17.50
2
Drain, Roof $0.00 - 0 "�
Shower ". - $8.75
1
Water Heater / vent
$11.00
1
Drinking Fountain $0.00', -- 0:-
-
Sink, bar $0.00
0
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 „$8.75
1
Water Service
$0.00
0
Gas (1-4 outlets) $5.50 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: $91.00
COMMENTS I SPECIAL CONDITIONS
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
DECLARATIONS
WORKERS' COMPENSATION DECLARATION:
I hereby affiml under penalty of perjury one of the following declarations:
❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the
work for which this permit Is Issued.
I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
My workerscompensation Insurance carder and policy number are:
Caller: Policy Number.
(This section need not be completed If the permit is valued at one hundred dollars ($/00) or less.)
❑ 1 certify that In thepert �� o the we for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the workers'
compensation laws of all r 11, e d e e het Ii should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith
corn I a n . '
plicent Signetur �9
LURE TO SEC RE RN S'CON NSATION COVE EIS UNLAWFUL AND SMALL SUBJECT AN ERN'EfiYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED
THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF ODI PENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affil r a ensed u r ai ' of Chapter 9 (commencing with Section 7000) of Division mess Professions Code, and my license is in full
and effect. Uc. # Q Cla s #
Contractors Signatu Date:
If
CONSTRUCTION LE I A ENC
❑ 1 hereby affirm that there Is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code),
Lender's Name: 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 vidation 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).):
❑ 1, 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. It, however, the building or Improvement Is
sold within one year of completion, the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions
Code: The contractors License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractor(s)
license pursuant to the Contractors LJcense Laws.).
❑ 1 am exempt under sec. Business and Professions Code for this reason:
Signature: Date:
Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
Verification of Ownership by (type of document, Le. - property tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certity, that no excavation five (5) or more feet In depth Into which a person Is required to descend, will be made in connection with work authorized by this
permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, California Administrative Code).
❑ As owner-builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a
permit to do such work from the division.
Signature: Date:
Division of Industrial Safety Permit Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1 Will the applicant or present or future building occupant need to file and cenity a Business Plan for emergency response to release or threatened release of a hazardous
material? ❑ Yes ❑ No
(Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every
business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons,
or 200 cubic feet of compressed gas at standard temperature and pressure).
....................................................................................................................................................................................................................... ......................................................
2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any
one time has on hand a quantity o1 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).
..............................................
..........r'a...........................I*n'g...............................r'e.p...................................................................................................................................................
3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management end Prevention Program for acutely hazardous meterials)7
❑ Yes ❑ No
(Section 25534 of the Celifomle 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? ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this ,a,ppplication ePPermit for such construction or modification
from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes U No
(Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residenfial building permits).
................................................................................................................................................................................................................................................................................
8 Will any pert of the facility to be constmctetl
under this permit be within 1000 feet from the outer bounded" of a school? ❑ Yes ❑ 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 repulred for the work which Is the subject of this
application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
....................................................................................................................................................................................................................................................................................
8 attach certificate o1 compliance from the appropriate air palluaon 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 agJ� to co y wi tall st laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the
above-de Crib rop i o purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection.
gn a wner(s) Date
i
Or Authorized Applica t Data
CODE -y INSPECTION TYPE gATE IWTTTIA $ CODE INSPECTION TYPE gA¢ INTRIAL$
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final PlumbingY e 9e
200 Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Well 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
2416.46
PROJECT ADDRESS: 1787 PANAY CI UNIT:
OWNERS NAME: JARDINE JERRY L
ADDRESS: 1787 PANAY CIR
COSTA MESA,CA 92626
546-7050
ARCH/ENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: CASHA CONSTRUCTION CO. 1714)536-6205
ADDRESS: 1712 MAIN ST
HB CA 92648
LICENSED CONTRACTOR 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 lice ee is in lull force and effect.
CITY L//////IC�.yy�yy//JJJJJJ014928 sr ELIXc.:283884
Date. 9(/_ Signature: _ �consentt
WON ENS'COMPENSATION CLANATION: I hereby affirm that l naveacre or a candidate of Workers'
Compensation Insurance. or a certified copy thereof (Section 3000, Lab, ).
POLICY NO.: EXP. DATE:
COMPANY:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date:
EXEMPTION FROM WIN
I cenity that in the per
subject In he Warkm
Date: _ _'
N TICS: II. alter
Code. you most
CONSTRUCTION LEN
which this permit is i
LENDER:
ADDRESS:
• Applicant:
MPENSATION DECLARATION: (This section M not be completed it the perreat is for one hundred (StOl or lesst.
of the won for which this permit is 1,e1 hall not employjoypgrson in any manner so as to become
nsahon Zs of California, /1�1 / /
thisclaration, you ShoiAh!icome subject tKide Workers' Compensation provisions of the Labor
to•�ply with such provisions at this permit shall be deemed revoked.
IEN Y: I hereby affirm that there is a construction tending agency for the performance of the work for
action 3097, Civ. Q.
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B05010
PERMIT NO: B 050101 PLAN CHECK NO: 06035-90 S GOVT: N SU PO N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ADD
JOB DESCRIPTION : ADD 424SF HOBBY ROOM 6 106SF SUN ROOM SQ FT: 530
CLAIM VALUE: 36,570.00 CALL—VALUE: 36,570,00 GROUP OCC: R-3 /
COMMENTS: X
MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM
Z 0 N I N GS ERT EBQAUCIKRSE M E N -T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: 26 FT IN FRNT: FT IN REAR: FT IN
LEFT: 11 FT IN RIGHT: 5 FT 8 IN LEFT: FT IN RIGHT: FT IN
PARKING REQ• PROV: PARCEL: 13912247 ZNE: R1 REF NO:
PLANNING N TES> ADDITIONS TO SFR
>
M MMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T,S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED B DATE-
MMMMMMMMM141EMMMMMMMMMM MMMMMMMMMiF�7FiFiFiFifM
MMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMM MMMMMMMMMMMitMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OWNER BUILDER DECLARATION: Ihereby affirm that I am exempt :Tom the Contractors' State License Law for The following reason
BLDG PMT PLUMBING E CTRIC MECHANIC FIRE SMIP/RES GRADING
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, at
PERMIT 330.00
2.56
repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed
SMIP /NON—RES
pursuant to the provisions of the ContractorsState License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
PLAN 214.50
and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by
ISSUE FEE
any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTAL PAID DUE
I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the
❑ The Contractors'
TOTALS ---- > 332.56 0.00 214.50
547.06 547.06
structure i5 not imendedaroffered for sale (Section 7044, Business and Professional Code: State 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
.00
his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or
REVENUE DIVISION TOTALS--> COLLECTED •
3 32 . 56 --OVER /SHORT : 00
forthe perp is sold within one year of completion. the owner will have the Darden of proving he/she did not builtl or improve
for the purpose of sale).
BLDG PMT PLUMBING ELECTRIC MECHANIC
FIRE SMIP /TOT GRADING PLAN—CHECK
330.00
2.56
I, as owner of the properly. to construct the projecth
exclusivelyy contracting with licensed aot
❑
builds improves
Co pply to an s thereon
and Professions fall The projects with laic License Lawooes pursuant to the ontracmier of Probellate kens or imOroves aware
and who contracts for such projects with a contractors) Ikense pursuant to the Contractors' State License Law). I am aware
1tM 1t 1414 fE Mit It iFMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMMM
that proof of their Worker's Compensation insurance should be provided to me.
I N D I V I D U A L F E E
B R E A K D O W N
❑ I am exempt under Section: B, 8 P. C.
for this reason:
TYPE QTY D E S C R I P T I O N
UNIT COST TOTAL COST
Date: Owner
I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Ouality Management District, Residential construction applications are exempt from
These provisions.
Date: Applicant:
I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county
ordinances and state laws reining to b fling construction and hereby ride re resentat.ni •' city to enter upon the above-mentioned
property tar inspection purposes. �QJJ�J
Date:Signature:
Driver's License or Social Se.urity n:
1641 46 While—Behdmg', Green—Cotle Enforcement: Canary—Applicion Pink—Revenue: Goldenrod—ASST
SFR 530 DWE—TYPE V—WOOD FRAME —GOOD 69.00 36,570.00
END OF FEES
01 00075_08-000792017 Ti 3:
rVATE: 11/24/00 T;"nE: 14:32
CONSTRUCTION AND PLANNING
POOL & SPA
APPROVALS Permit #
Date
inspector
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Ser ice or Pole
-":t
52. Pool &Equipment Location
2. Soil Pipe-Undrgrnd•:• a.
Z
53. Steel Reinforcement
i
. 3: -Electrical Conduitklity`Untl'rgpd.
a
54. Forms
'
->4. Electrical ConduiYUndrgrnd.
55. Electrical Bonding
r �.ASteel Reinforcement
( Qp
'Q14
56. Rough Plumbing & Pressure Test
o
-ti!-6>Efectrical UFE_R'Grnd. x
57. APPROVAL TO COVER-GUNITE
_9.rFgotings cc 1U '_
�2 Qo
58. Electrical Conduit-Undrgrnd.
c
•8 }Foundation
59. Gas Pipe, ❑ Undrgrnd., Test
9. Water Pipe-Undrgrnd. �. r%
•t
60. Backwash Lines, P -Trap, ❑ Undrgrnd.
.
10. Structural Floor System ./
`f
!cp'd-
61. APPROVAL TO DECK
i
11. Property Sewer -Line & HaLse Connection
-!
-
62. Backwash &Receptor -Final
i;
12. Cap ap
u 7.•
63. Heater & Vent -Final
13. Roof Drains 'c
r
64. Plumbing System -Final
�'•
_
14. Rough Plumbing °"
, 'r
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough ElectrVViring
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
-APPROVAL'S GOPermit # ' " •T
20:r.Ro0gh Eactory Fireplace
21; in. Structupe, i .. .. �
<
�s
70. Ndergiotlnd Hydro
-Ducts, ,_
_
d
22, Ducts, Ventilating
_71 Producyfjping E1(5as Q•Oit
.l
L:R
23. s_Pipe=Rou h &' est r x
Ga '.7S
+' s
- t :�
- ;c 1 r - .
72. Undergro�ntl Flufi•,„_ a
!
R trs a
d ":a x
24.zRoof Framing F T•Y
ti Cr
Y '%:
-73F Undergrnd. Stora g rank-- Gas ❑Qil
-
25. Roof Sheathin u d ,r
r g d;
s. Zr to
.;
i:x..
j ,;.
S a• v -10 is
7150verfi ad Hydro"-
26JT-Bar Ceiling (Structural) &-,Monocoatd
•r
75'Dry Chemical
^•
27' Frame and Flashing -'
Q.
R -
�' `
^
76�DryStan_Pfpe
c.. _
r -
)j
Y S.� a-
• 28. Lathing:&Siding s. :�i .,�.
s?
r?
77:' FIXEDSYSTEM.FINAL= _J •v >_
_T
29. Insulati6nv
w O 5 Y ..i
-�
! .
;- F
78 FIRE PREV. FINAL
* 30. Drywall Nailing _ i-
.w a
I
,�
r, HEALTI -D EPT. REQUIREMENT
i
31. Plaster Brown Coat`
t
INSPECTION -
_ r ;�
r79FINAL
-32.7Electri6l Power Meter -Finale ' u;
+: ,L
;'i�r
:.80. -FOOD CERTIFICATE ISSUED y
ElectriF r e
.r: of I
s-
"Nuies:J r ,
u�
_33$Final
.r I d
t
i N 30 _Yes -
Z34 -Final Heating-& Af4Conditio ;g, -
''
Z; ' =,
35TFinal Gas Pipe-TestR
-•
r'y" + •s `t
r,LZ
l
z ,.
R :
J ire
,36THood or'CanopY ~ pd
,-37.-Final Factory Fire place, ! 5 �• c„
" "'
.- :`
.. r,
138. -.Final Plumbing
39r -::Nater ServicemFinah i
)
x
40. Gas Service -Final j . , S
£41^Solar Domestic-Final:__?�
-
-42.':Backflow Preventer f- It
43. Backflow Irrigation '9.S'L
-a #
r`-ro r. C' o•
44. Landscape Irrigation Systerr�,-z�
x
r
_
45' --Sound Attenuation - -
*
i-� t-�-• _
-- - e� ...r s
T
t
-7 f y
.46 -Handicap Regulations S.
_ 47. FINAL STRUCTURE & BUILDING •-
.
y.
a
- i+l•eS f
48rFINALPLANNING
!r x
49 -Electric Release to Edison
r
7'50._Gas,Release to Soufhern California Gas Co
51. CERTIFICATE OF,OCCUPANCY
No. Date
Insulation Certificate
Number and St at
��
County
ROOF
Material
Thickness (inches)
EXTERIOR WALL
Material
Thickness (inches) _ —
City of Costa Mesa
California 92628-1200 P.O.Box 1200
Permit Num r C. /D
City
Subdivision
Description of Installation
Brand Name
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Lot Number
CEILING
Batt or Blanket Type --Brand Name
Thickness (inches) _fR�Thermal Resistance (R -Value)
Loose Fill TypeBrand Name
Contractor's minimum installed weight/ft2 /!Fp Ib. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value)
RAISED FLOOR
Material
Thickness (inches)
SLAB FLOOR
Material — ^7
Thickness (inches) S
Width (inches)
FOUNDATION WALL
Material d—
Thickness (inches) 114
Brand Name
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Brand Name
Thermal Resistance (R -Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
Cal iforni Adminstrative Cod .
r
Genet tactor (Builder) License Nu bar
Signature an rtle. ate
Sub -Contractor (insulation Installer)
Signature and Title
1907-46
License Number
Dale
PROJECT ADDRESS: 1787 PANAY CI UNIT'
`OWNER'S NAME: ROBERT GRAY
ADDRESS: 299 PRINCETON
COSTA MESA,CA 92626
AHCHIENGINEER: 714 546-7050 REG.NO.:
ADDRESS: UNIT:
PERMITTEE: MONARCH MASONRY (714)753-1565
ADDRESS: 16 TECHNOLOGY 148
IRVINE 92718
LICENSED CONTRACTOR DECLARATION: hereby affirm that I m c nsed der provisions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Professions Code. an y c rise i in I force and effect.
xCITYLIC.: 522013 STATEuc.:52879 C C-29
Dale: �— { — C. ( Signature:
WORKERS' COMPENSATION DECLARATION: 1 hereby affirm that I have a certificate of consent to self -insure or a cool of Workers'
Compensation Insurance, or a certified copy thereat (Section 38 W,ah. C).
POLICYNO.:80O15200 EXP. D 0 01/92
COMPANY: TRANSAMERICA
1:1Certi�field copy is hereby furnished. Certified cop f e with I i Building Division.
Dale: L — ( Applicant'.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less).
1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor
Code, you must forthwith comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY: 1 hereby affirm that there is a construction lending agency for the performance of the work for
which this permit is issued (Section 3097, Civ. Q.
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: 1 hereby affirm that 1 am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any City of 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 Io file a signed statement that he/she is licensed
pursuant to the provisions 01 the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business
and Professions Code) or Thal 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 penally of not more than five hundred dollars 1$500).
S I, as owner of the property or my empDloyees with wages as their sole compensation, will do the work, and the
❑ structure is not intended or offered for sale(Secuon 7044, Business and Professional Code: The Contractors' State License Law
does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through
his or her own employees, provided that such improvements are not intended or offered lar Sale. It, however the building or
improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I. as owner at the properly, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business
ED and Professions Code: The Contractors Slate License Law does not apply to an owner of property who builds or improves thereon
and who contracts for such projects with a central license pursuant to the Contractors' Slate License Law),I am aware
that proof of their Worker '$ Compensation insurance should be provided to me.
❑ I am exempt under Section: a. 8 P. C.
for this reason:
Date: Owner:
I do hereby candy that I am aware of and understand the requirements o1 C
25534 and that I or any future building occupant will not (circle one) net
permit for construction or modification from the Air Costly Management
these provisions.
Date: Applicant:
hereby certify that I have read this application and State
ordinances and stale laws relating to building construction.
property for inspection purposes.
Date. =!i Signature.
Driver s License or Social Security Y:
and Safety Cade Sections 25505, 25533, and
h said state codes and the requirements for a
at construction applications are exempt from
I agree to comply with all city and county
this city to enter upon the above-mentioned
1641-46 While—Building; Green—Cade Enforcement. Canary—Applicant: Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05094
PERMIT NO: B 050942 PLAN CHECK NO: 00525-91 S GOVT: N SUPP: N
CONSTRUCTION TYPE: V -N PERMIT TY%5: STR PURPOSE: OTH
JOB DESCRIPTION CITY STD BLOCK WALL 43LF S'HIGH SQ FT: 23
CLAIM VALUEE: e 700.00 CALL -VALUE: 460,00 GROUP OCC: R-3 /
COMMENTS: 3� LINER FT 5'HIGH CITY STANDARD
Z O N I N GS E R T E B Q A U
C I K R S E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: 100 FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV: PARCEL: 13912247 ZNE: R1 REF NO:
PLANNING N TES> 23 LF OF 5 FT, HIGH BLOCK WALL TO SCREEN POOL EQUIPMENT,
iE iE iE If -1F iE 3E 3E if iE iP iE OP Bf * M 4f iE iE IE iE * 1E aE iE * * 3E k iE je BE iE if 1E 3F if iE BE 9EiF i6 iF dE iE if lE 1:4F iEiE if if 1F BK)f iE iE iE if * 4E iE 3f iE iE iE 9E 1F iF * 9e ie * iE 9F iF iE 9f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE:
BfBFBfBfiE*iEiFiE9E9eiFlE4Ef01EiElEIEBFiEiE IE #BEiPiEiENlEiEaF iE4E
1f * iE * iF 1E iE BE iF iE * 1E 3E * ie iE iE iF iE BE iE iF iE i(- iE * * * * rt * iE * * iE iE iE 1E iP iE if M aF * iE BE iP iE iE iF iE 9F * 16 iE aE ae 9E 3E )F?E if -!E BE iF iE iE BE iF if ah iF aF iF if iE * iE iE
LEGALIZATIl F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 15,00 SMIP/N.50
ON -RES
PLAN 9,75
ISSUE FEE
BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE
TOTALS ---- > 15.50 0,00 9,75 25,25 25,25 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 25,25 OVER/SHORT:00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK
15,00 ,50 9,75
iE BF iE )E 1E if 1E iE * Bf lE if'k IE if 1E !E !E iE iP lE iE fE iE lE !E it 1E it iE iE iE iE if BF * lE if iE.yE iE 1E iE BF iP ik 1e if 7E 9F fE iE 1f 1E if 9E iE 9E * aF �t 1E k iE iE of 3E iE ft !(' ie iE iF SF tf iE ie dE ie
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 23 RES -CONCRETE BLOCK WALL / FT, 20,00 460,00
END OF FEES
6r l
01 00088135-OQOSC.+13/'/' Ti rte"
DATE: 01/07/91 TIi16: 10.41 ;�"Z'
r, CONSTRUCTION AND PLANNING`
APPROVALS Permit #
Date
Inspector
POOL & SPA
APPROVALS Permit #
Date
Inspector
11. 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 LIFER 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, 0 Undrgrnd.
10. Structural Floor System ' '�
i
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
APPROVALS Permit #
20. Rough Factory Fireplace
21„ Ducts, in Structure
70. Underground Hydro
22. Ducts, Ventilating
71. Product Piping 0 Gas ❑'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 PREY. FINAL
30. Drywall Nailing
I
I'%�
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
I
I
79: FINAL INSPECTION
32. Electrical Power Meter-Final
I? /
80. FOOD CERTIFICATE ISSUED
33. Final Electric
I
Notes:
34, Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or'Canopy
I
I
i I
37: Final Factory Fireplace
'
38. Final Plumbing
39. Water Service-Final
1
40. Gas Service-Final
41. Solar Domestic-Final
i l
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Hand icap.Regulations ,
..
47. FINALSTRUCTURE & BUILDING
CV's j
Di
48. FINAL PLANNING
I
I•, 1
49., Electric Release to Edison
I Y
i
50. Gas, Release to Southern California Gas Co
I
A
-
51. CERTIFICATE OF OCCUPANCY
No. Date
APPROVED
N
r
City of Costa Mesa Building Dept. '`�(, GOA%&6QP
BY _ DATE % 199
$ LF \o�\S Q���\� 0 04
HF F. PI A t^�SR,){�t /'�
NO GI AI ' . t:I R 9i A?rAGVAL Gi !Er T. SOF 6y QTY Of COSTA
THE ISSUA!..CE CR CRANTU+G OF A PERMIT OR APPROVAL OF \ \'\\p�FO rymt!1 O : u%
I?LANS AND SFEC:FR1.i.ONS SHALL NO I uE CONF?RUED T CME A \\ QOO PQe� swum
PERMIT FOR CA A !?r FROVAI 0` . A\1 VIOLA C J - ANY OF
Tri OF THIS (=E -ND Pe'1'IiT PRFSUN vC 10 GIVE CJ6
r.;. H.., RIi . .....":C'_..-!. _R C .: CI:L ,.r PROb SONS OF IHM
.ODE SH;.:.' EE V'A!J." -',C`r '1 V4 TH.- WORK OR USE
:_. ; AN:,;: - A PL; -iii PAS'., J"ON riNANCE
SPE' r�i�'.LVS SHALL ?k)l r;<CJ .AT THE OUILDIFFICIAL
FR^• I 1 IEEE FTCR RE^UIRiNL'. THE COR^ECi ION OORS IN
I'ECI'rlCrA ,`11 OR FREk NTINGS 7 pogv"a � Cl r
SEikG CAF.;'CEU ON TAEREU1NHFNF LEAS CODE OR OF ANY v� HER OR OF L�
z3LF 5'
r
�5� �oo) ey��p{• I
i
0
0
I
I
Permit #Aq
THIS NUMBER MUST
`
ALL INP€tTIAN R
498109"m
1119SIDUCK
RKIIIIII)VICK
—
STREET d,
APPROVED
City of Costa Mesa Building Dept.
BY DATE
THS SE PLANS A KET BE ON J35 XF ALL TIMES MAKE
�vU� CHANGES P�:,, OF DEFT.
A P'AIT -.-P, APPROVAL OF
OGtri
ATWME
ND bNECIFF! A ONE
ShALL N%
C OM .-D 10 BE A
I L. EOR OP AN A,
0F, 1
:�OLAi ^' F ANY OF
1 TVS W-,,vn0l T OF P4E
GIVE
%'](d Cl
1 CAWAL WO
wonum OF rw
- , , C �v, 0., USE
1 �i� W l;,
lHF ISSUANCE UPM&F
KY
KAYC
W ON PLANS AND
1 AIM &OWNS SHALLI
A PRCWNF T
'E 5UTDbG GFRCAL
�,INC THk CORE
ECTIUN Or E�,,PORS IN
(,F
MOM PREVENTING
F7!�71
;,;G CA�,WED rp
IMPOW En MEN
co
EO.,�CFANY
THER ORDINANCE OF
r
TYPICAL 611 CONCRETE BLOCK FENCE
Cement Coping Optional
Channel Block With 1-3/8S6
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"� at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"q5 at 32" O.C.
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15-39
A.S.T.M.
All Steel to be Lapped
24" or to Code
NATURAL GRADE
TWO 3/8-0 BARS L--1
CONTINUOUS TOP
& BOTTOM -moi
H007 -STEEL MUST BE TIED IN
PLACE AT TIME OF TRENCH
INSPECTION.
w
0
1-
0
D I
F�—WIOTF
D SEE CH/
r BELOW
D I n
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR;
One Part Plastic Cement, and
.14"
Three Parts Sand
GROUT;
One Part Cement Three and
.10"
One Half Ports Srand
COPING:
One Part Cement, Three
DEPTH OF EARTHTOOTH
Parts Sand
CONCRETE:
Well Mixed 1:2-1/2:3-1/2
12"
Max. of 7-1/2 Gallons of
12'
Water Per Sack of Cement
GROUT MAY BE POURED FROM THE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H OF EARTHTCOTH
I/3 THE HEIGTH OF FENCE
MOW BOTTOM OF FOOTING
SCALE: 1/2"= I'
WIDTH
.14"
.14"
12°., .
12..
THICKNESS
.10"
. . . . . .10"
8.
8.,
DEPTH OF EARTHTOOTH
24"
20"
16"
12"
SPACING OF EARTHTOOTH.
12'
.14'
16'
16'
City of Costa Mesa, California
Building Department
F=Fv F-rD Nov. H2
PROJECT ADDRESS: 1787 PANAY CI UNIT:
OWNER'S NAME: JARDINE JERRY L
ADDRESS: 1787 PAhAY CIR
COSTA MESA,CA 92626
546-7050
ARCHIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: CASHA CONSTRUCTION CO. (714)536-6205
ADDRESS: 1712 MAIN ST
HB CA 92648
LICENSED CONTRACTOR 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 Coe, and my license is in lull force and effect.
CITY LIC.: 014928 STATE uc.:28388 cu
Date.. Signatu
WHO flS' COMPENSAT N OECUIRATION: I her um
RXEthat 1 IJa a temlicale Of consent to self -insure or a certificate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C).
POLICY NO.: EXP. DATE:
j COMPANY:
❑ Certified copy is hereby lu fished. ❑ Certified copy is I11;fI i m City Buddi .vision.
Dale: � AODlicant'_ 6ea o
EXEMPTION FROM COMPENSATION DECLARATION: (This Rech need not be Completed it the Permit is ler we hundred ($100) or less).
I certify that in the performance of the work for which this permit is issued, I mall not employ any person in any manner so as to become
subject to the WorkersCompensation Laws of California.
Date: Signature:
NOTICE: If. after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor
Code. you must forthwith comply with such provisions or this permit Shall be deemed (evoked.
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency lar the Performance of the work for
which this permit is issued (Section 3097. Cry. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
permit alt r im rove demolish or
An Il f county which requires a e I to ¢
n7 I. B in ntl ProfessionalCode. c o co
(Section 03 5 Businessy y YDP
repair any structure. iris Ip its issuance.s'SO requires the applicant for such permit to filo a signed statementofDi isio he/she a Business pursuant to the provisions of the /she is exempt
State License Law (Chapter 9 (commencing with Section 7000) of Division 3 0t. the Business
and applicant to Code) Or that he/she a exempt tho a civil
and the basis for the alleged exemption. Any violation 01 Section 7031.5 by
any applicant fora Dermil subjects the applicant to a civil penally of not more than live hundred dollars )5500).
I. as owner of the property or my em divides with wages as their sole compensation, will do the work, and the
❑ structure is not intended or offered for sale (Section 7044, Business and Prolessional Code: The Contractors' State 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 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 will have the burden of proving he/she did not build or improve
lot the purpose of sale).
1, as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business
Eland Professions Code' The Contractors' Stale License Law does not apply t.0 an owner of property who builds or improves thereon
and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware
that proal of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason'.
Dale: Owner
I d0 hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and
25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a
permit for construction or modification from the Air Ouahty Management District. Residential construction applications are exempt from
Mese provisions.
Date: Applicant:
I hereby certify that I have read this application and slate that the above information is correct. l agree to comply with all pity and county
ordinances and stale laws relating to bud 'ng construction and here by a 1 I e representatives o city to enter upon the above-mentioned
property fpr inspeclut pur0oses.
Dal,Signature:
Driver's License or Social Sec dty x:
1641 46 While—Building: Green—Code Enforcement. Canary—Applicant. Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: P 050361 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: ADD
JOB DESCRIPTION ; ADD 424SF HOBBY ROOM 6 106SF SUN ROOM SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: REF B5010i
iE 9E iE eEif iE 9E # iE 9E 686E iE df 9E Rf iF 9E iE iE *.N. BF 9E iE k 9e 9E Rt iE Bk Ok OE RE Re *+F * if Oe if tt 9f OFif .� 9E iE 9f If iF * 9E 4EDE JE 68.7E * jE .N. iF ia>E 9f iE )ERE iE 9F OE iF 9E 4F)E * ie 1E M
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------
MAIN BUILDING
----------
---------
ACCESSORY BUILDING---------
FRNT:
FT
IN REAR:
FT IN
FRNT:
FT
IN REAR: FT IN
LEFT:
FT
IN RIGHT:
FT IN
LEFT:
FT
IN RGHT: FT IN
PARKING
RE •
PROV:
PARCEL:
13912247
ZNE:
REF NO:
PLANNING
N TES>
,00
REVENUE DIVISION TOTALS-->
COLLECTED:
5,00 OVER/SHORT:
,00
BLDG PMT
>
ELECTRIC MECHANIC FIRE
SMIP/TOT GRADING PLAN—CHECK
5.00
iF iF M iF iE iF ie ie
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aE ie iF iE * iE JF iF * % IF 1F iF iE iE aH 1F IE iF 4e- * BE # RE iF # lE iE if
D
E V
E L O P M E N
T S E R V I
C E S, R
E Q
U I R E M E N T S
BUILDING APPROVED BY :
APPLICATION ISSUED BY
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IF )E of iE iE iE JE iH iF RE 1E JE BF * *!e iE iE i6 iF IE iF 3E iE IF k
LEGALIZATION:N F E E
DATE:
DATE: Z/
• F-�3F1F*iE iE IE iF iF iEBEK iF
iF fiEifiFee*1EMif*iEiE1E3EiEIflERFBEBEiEiE�fiEiFBEJeiEielEiElEBEiEiEJEiEkie
U M M A R Y STRUCTURAL SEGMENT:N
IC MECHANIC FIRE SMIP/RES GRADING
PERMIT
2,00
25%
SMTP/NON—RES
PLAN
ISSUE FEE
3 00
BUILDING—DIV—>
PERMIT
ISSUE PLAN—CHECK
TOTAL T PAID
DUE
TOTALS ---- >
2.00
3,00 0.00
5.00 5.00
,00
REVENUE DIVISION TOTALS-->
COLLECTED:
5,00 OVER/SHORT:
,00
BLDG PMT
PLUMBING
ELECTRIC MECHANIC FIRE
SMIP/TOT GRADING PLAN—CHECK
5.00
ieiEyHiEiFlF*Be if*1f*iE*%iEBERERF ifiFiEBEk*%RFiFaFBE3E*aFM3fieiEiEiEiEiFBe*BFiFiE1fKRE*iF1E*J(M9EiF#iFiF1FfE#IE*iEIFaETFiFMifiE3EiFiF±E*aE
I N D I
V I D U A L F E E B R
E A K D O W N
TYPE QTY
D E S C
R I P T I O N
UNIT COST TOTAL
COST
PLU rt.
WASH BASIN
2.00
2.00
END OF FEES
01 00076475-00076475 1-0T .U0
DI 1-2/18/10 TIME: 12:42
CONSTRUCTION AND PLANNING
APPROVALS Permit # Date
f
Inspector
POI, - & SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Service"or Pole
•-
-
52. Pool & Equipment Location
r�
2. Soil Pipe-Undrgrnd.
53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Conduit-Undrgrnd.
i
55. Electrical Bonding
5._ Steel .Reinforcem'ent
56. Rough Plumbing & Pressure Test
6. -Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
4•. Footings - -
58. Electrical Conduit-Undrgrnd.
•B�Foundation
59. Gas Pipe, 0 Undrgrnd., Test
'
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, 0 Undrgrnd.
'
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash & Receptor -Final
12. Sewer Cap
63. Heater & Vent -Final
'
13. Roof Drains
64. Plumbing System - Final
.'
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS - Permit #
20: Rough Factory Fireplace
V.
21. Ducts, in Structure, . -
70. Unde'rgiound Hydro +
22. Ducts, Ventilating • _
'S -
71. Product Piping 0 Gas 0 Oil
237 Gas Pipe -Rough & Test
72. Underground Flush
24. Roof Framing ••
73: Undergrnd. Storage Tank'❑ Gas 0 Oil
25. Roof Sheathing
` -
y ;
74-. Overhead Hydro
26. T -Bar Ceiling (Structural) &.Monocoat
-
75. Dry Chemical -
27,: Frame and Flashing + 1
76. Dry Standpipe
28. Lathing & Sidings _ ..
+ >
-: i
77. FIXED SYSTEM FINAL
- 29. Insulation:
;,
78: FIRE PREV. FINAL
- 30. DrywalLNailing
I' t fj, •
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat
I 1'
79.' FINAL -INSPECTION
32. Electrical Power Meter -Final
{
,I
- 80. FOOD CERTIFICATE ISSUED
33_ Final Electric
.•I{ '-_
Notes:
-, 34: Final Heating & Air Conditioning
I`
4
_
35.4 Final Gas Pipe -Test
4
36" Hood or Canopy r
it
37. Final Factory Fireplace
•'
-
38. Final Plumbing
(LiE,w
.
39. Water Service -Final
40. Gas Service -Final-
.- 41. Solar Domestic -Final
_ I
't
r
42. Backflow Preventer'
43. Backflow Irrigation
-
44. Landscape Irrigation System •:
_
_,-
45. Sound Attenuation
-
- -
46. Handicap Regulations
+ •
-- - ;
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
{
,
51. CERTIFICATE OF OCCUPANCY
No. Date
PROJECT ADDRESS: 1787 PANAY CI UNIT:
OWNER'S NAME: JARDINE, JERRY L
ADDRESS: 1787 PANAY CIR
COSTA MESA,CA 92626
546-7050
ARCHIENGINEER: REG.NO.:
ADDRESS: UNIT:
PERMITTEE: CASHA CONSTRUCTION CO, (714)536-6205
ADDRESS: 1712 MAIN ST
HB CA 92648
LICENSED CONTRACTOR DECLARATION: I hereby atfirm that I am licensed under provisions of Chapter 9 (commencing with Section
7000) of DiwSrn 3 0l the Business Professions Cotle, and my license is in full force and effect.
clTru T uc.:283884 CLASS: B
nature: /---- O L
WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a certificate of Workers'
Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C).
POLICY NO.: EK P. DATE:
COMPANY:
❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division.
Date: Applicant: /Z(� I'- l Q = 9 v
zRXM===
OANERS' COMPENSATION OECLAflATION: (This section need not be completed if the permit is for one hundred ($100) pr less),le erlormance of I r rk tar which this permit is issued, I shall not employ any person in any manner so as to becameo rip Int aws alilornia.gnature'.a1A making This declaration. you Should become subled to the Workers' Compensation provisions of the Labormull brthwith comply with such provisions or This permit shall he deemed revoked,
CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for
which his permit is issued (Section 3097, Civ. C).
LENDER:
ADDRESS:
OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason
(Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or
repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed
Pursuant to the provisions of he ContractorsState 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 he applicant to a civil penalty of not more than live hundred dollars (S5DO).
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 (Section 7044, Business and Professional Code: The Contractors' State License Law
1 does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through
his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or
improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve
for the purpose of sale).
I, as owner of the property, am exclusivelyy contracting with licensed contractors to construct the project (Section 7044, Business
Eland Professions Code: The Contractors' BIate License Law does not apply to an owner of property who builds or improves thereon
and who contracts lot such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware
that proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section: B. 8 P. C.
for this reason:
Date'. Owner:
I do hereby certify that Iam aware of and understand the requirements of California Health and Safety
25534 and that l or any future building occupant will/will not (circle one) need to comply with said stal
permit Ior construction or motlilication Irom the Air Quality Management District. Residential construe
these provisions
Code Sections 25505, 25533, and
e codes and the requirements lot a
lion applications are exempt from
Date: Applicant:
t hereby certify that I have read this application and state that the above information is correct. I agree to comply with all pity and county
ordinances and slate laws relating r building construction and hereb on = representative kfi. city to enter upon the above-mentioned
properly Ior inspection pumose
Date _ Signat��~r`'%/%
Driver's License or Sold I Security x:
1e4L46 White—Bmldmg: Green—Code Enforcement: Canary—Aoohcantt Pink—Revenue: Goldenrod—Assessor
CITY OF COSTA MESA — BUILDING PERMIT FIERM
PERMIT NO: E 050360 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTION ADD 424SF HOBBY ROOM 6 106SF SUN ROOM SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: REF B50101
k iE * iE 9E k k k k k 9c iE it k ik iF it k it1f-lEjf if 3EjE9E aEiE iEiE Jt IE 9E iF 9E jFiE jE jf Df iE 3E JF i4 3E iF )f of iE if -)F if tf iE df iF )E iE 1f iE jE-0E 3E if iE jE )E 9E iF-)f jF iE 9E iE if df lf iE if
Z O N I N GS E R T E B Q A U C I K R S E M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13912247 ZNE: REF NO:
PLANNING Ni
>
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY DATE:
APPLICATION ISSUE DATE:
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LEGALIZATION:N F E E U M M A R Y STRUCTURAL'SEGMENT:N
BLDG PMT PLUMBING EL TRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 18.75
503 SMIP/NON—RES
PLAN
ISSUE FEE
15,00
BUILDING—DIV—>
PERMIT ISSUE PLAN—CHECK
TOTAL PAID
DUE
TOTALS ---- >
18.75 15,00 0.00
33.75 33.75
.00
REVENUE DIVISION TOTALS--> COLLECTED:
33,75 OVER/SHORT:
,00
BLDG PMT
PLUMBING ELECTRIC MECHANIC
FIRE SMIP/TOT GRADING
PLAN—CHECK
33,75
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iEkkkkitkkkklEkkkskitk*itit iFk iF kitkkkkkkkikk
I.N D I V I D U A L F E E
B R E A K D O W N
TYPE QTY
D E S C R I P T I O N
UNIT COST
TOTAL COST
ELE 7
FIXTURES LIGHTING 1 ST 20
EA.
5.25
ELE 13
RECEPT/OGTLET 1 ST 20
.75
EA, .75
9.75
ELE 5
RECEPT/SWITCH 1 ST 20
EA. .75
3,75
END OF FEES
01 00076474-00076474 TOT av„'
DATE: 12/13/90 TIME: 12:4E
is
rl
I
CONSTRUCTION AND PLANNING
APPROVALS Permit #
Date
Inspector
POM SPA
APPROVALS Permit #
Date
Inspector
1. Temporary Electrical Sery e'pr Pole
52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd.
-
53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd.
54. Forms
4. Electrical Condtjit-Undrgrnd.'.
'
55. Electrical Bonding
5: Sieel Reinforcement %
56. Rough Plumbing & Pressure Test
6. Electrical LIFER Grnd.
57. APPROVAL TO COVER-GUNITE
7. Footings
58. Electrical Conduit-Undrgrnd.
"
B. Foundation
59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd.
60. Backwash Lines, P -Trap, O Undrgrnd.
-
10. Structural Floor System
61. APPROVAL TO DECK
11. Property Sewer Line & House Connection
62. Backwash &Receptor -Final
12. Sewer Cap '
63. Heater & Vent -Final
13. Roof Drains
64. Plumbing System - Final
,r
14. Rough Plumbing
65. Electrical -Final
15. Rough Electrical -Conduit
66. Solar System -Final
16. Rough Electric Wiring
67. Fencing & Access Approval
17. Rough Wiring Sign
68. APPROVED FOR PLASTERING
18. Rough Electrical -T Bar Ceiling
69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning
FIRE DEPT. REQUIREMENT
APPROVALS _Permit #
r
20: Rough Factory Fireplace
,..
21: Ducts, in Structure.70
' '
. Underground Hydro
22. Ducts, Ventilating
° ' -
-71. Product Piping ElGas ❑Oil
•
23: Gas Pipe -Rough &Test
72. Underground Flush
24 , Roof Framing
_
-73?Undergrnd. Storage Tank O Gas O Oil
25. Roof Sheathing t'
• 74.'Overhead Hydro
26. .T -Bar Ceiling (Structural) & Monocoat
-
75: Dry Chemical
27.. Frame and Flashing �.
76' Dry Standpipe
28. Lathin &Sidin
g. g
`
77. FIXED SYSTEM
' 29. Insulation
78: FIRE PREY. FINAL
30. Drywall Nailing -
j
i'
HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat.79.
FINAL INSPECTION, - -
32. Electrical Power Meter -Final
(
-80. FOOD CERTIFICATE ISSUED
33.' Final Electric
r
?
34. Final Heating & Ai'r Conditioning
35. Final Gas Pipe -Test
li- >
36. Hood or Canopy
I
3T'Final Factory Fireplace •
,
?
- "�
- 38. Final Plumbing -
- 39. Water Service-Finai,
1
a
40. Gas Service -Final
-'41. Solar Domestic -Final
42: Backflow Preventer.
43. Backflow Irrigation
-
r..
44. landscape Irrigation System .;1
- •
,i.
. 45. Sound Attenuation
-
46. Handicap Regulations
47: FINAL STRUCTURE & BUILDING
4&..FINAL PLANNING
49. Electric Release to Edison
i
-
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
OWNER Jardine, J. DATE 6/6/79
JOB ADDRESS 1787 Panay Circle BUILDING PERMIT N0. 48176
AP No. 139-122-47 LOT 1679 TRACT FIRE ZONE VALUES 500.00
INSPECTIONS Si nature Date
TYPE V GROUP j ZONE Rl
SOIL
SUBCONTRACTORHED
PErMl
GAS
Data Humber Si nature
WATER
Plumbin
ROUGH PLUMBING
PROP. SWR. LINE i_ HOUSE CON.
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND POWER Q,
ROUGH WIRING
Heatina and Vent.
TRENCHES (J FORMS M STEEL REINF. CD
FLOOR SYSTEM
BOND BEAM STEEL REINFORCE
SHEATHING
FRAME AND FLASHING
LATHING — IN I OUT
PLASTER. BROWN COAT
STRUCTURAL. FINAL '
HEATING, VENT., REFRIG. AND A.C., FINAL
PLUMBING, FINAL AND GAS TEST
ELECTRIC. FINAL
BUILDING, FINAL
COSTA MESA BUILDING -SAFETY DEPARTMENT
• ' P.O�BOX1200 COSTA MESA, CALIFORNIA 92626
9775 10.50 TLz
APPLICATIO WjfR6C�@PERMIT I,8-18 ,f6
RECEIVED BV PERMIT B
For Applicant to Fill in Completely — Use Ink Only
N 48176
BUILDING //
ADDRESS %
/�
A.P. NO. 22-/Z- L
OWNER OR �)'
TENANT G/
BUILDING/t'�
ADDRESS 7 6t /V
UNIT OR
SPACE NO.
MAILING i. )
ADD R ESS �jj/
TR LOT
BLK.
TEL.
CITY NO.
NEW ADD ALTER REPAIR
MOVING DEMOLISH
LENSiRUCiION
LENDER
BRANCH
J
OWNER
ADDRESS
VAL E
US E
ARCHITECT TEL.
OR ENGINEER
ZONE T E GROUP
ADDRESS
CONTRACTOR
APPROVED
BY UAJL DATE + +
ADDRESS
TEL.
CITY NO.
STATE CITY
LIC. NO. LIC. NO.
APPROVED SETBACKS
SIZE
OF LOT
NO.OF BLDGS.
NOW ON LOT
(FROM C/L STREET)
FRONT FT.
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
L. SIDE Z FT.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
DATE
APPROVED
APPRO� •
/ +7
o
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that I am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
am exempt from the provisions of the St a f California Business
and Professions Cotl , Division 3, Chap r
Signature of
Permittee •
SQ. FT.
THE AMOUNT SHOWN N ALUATION IS FOR
THE PURPOSE OF ESTA IS P IT FEE Y:
VALUATION �q
J V
$
D O
p IT EE S ��
PLAN CHECK E
TAX E
or �
Authorized A n Date
TOTAL PAID E
LW
976 90:84
w
iU
T
., COSTA MESA BUILDING-SAFETY DEPARTMENT AP CA ION F RIfP-7
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 5
REC I PER IT
For Applicant to Fill in Completely — Use Ink Only
BUILDING
A.P. NO. g— Z
ADDRESS
/ �� 7
OWNER /
T0 ENANTBUILDI
�/ ��I
ADORE S$
UNIT OR
SPACE NO.
MAILING ,� 7
ADDRESS//
TR.NO. LOT I ELK.
CITY NOL'„ga_l%�``
6
NEW ADD LTER REPAIR MOVING DEMOLISH
CONSTRUCTION
LENDER
BRANCH
OWNER
ADDRESS
�•s�
USEoaW
ARCHITECT TEL
OR ENGINEER
�}NJ
ADDRESS .s /�j' /! ,'�/'
ZONE E ROUP IT
APPROVED
)_
CONTRACTOR
BY
DATE GO
ADDRESS
TEL
CITY NO.�jO
F
STATE CITY
APPROVED SETBACKS
LIC. NO. LIC. NO.
W
SIZE
NO. OF BLDGS.
(FROM C/L STREET)
0.
OF LOT
NOW ON LOTFRONT
FT.
Q
USE OF
EXISTING BLDG.
y
FSeparate
permits are required for
/
L. SIDE 'FT.
!T.
electric, plumbing and heating work.
REAR
(W.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
Q
D
E�LDATE
APPROVED
a
APPROVnjoe
r
_
..1
W
I hereby acknowledge that I have read this application and state
y
that the above information Is correct and agree to comply with
0.
all laws regulating building construction, and I shall not employ
Z
any person In violation of the workman's compensation laws of
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THE AMOUNT SHOWN UN ER VALUATION IS FOR m
the State of California Business and Professions Code, Division 3,
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THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions oft S[ to of California Business
T
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VALUATION
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COSTA MESA BUILDING -SAFETY DEPARTMENT APPL ATION4FOR,STRUCTURALPERMIT57e59 Tl.
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 -
For Applicant to Fill in Completely — Use Ink Only
111111
RECLOIIKdBy PERMIT So ♦�
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BUILDING
1787 Panay Circle
ADDREBUILDING
p
A.P. NO. %'3/—/Z2 -y7
OWNER OR
TENANT J. Jardine
ADDRESS 1787 Panay Circle
UNIT OR
SPACE NO.
AMAILING DDRESS 1767 Panay Circle
TR.NO. LOT
169
BLK.
CITY Costa Mesa, TNO.EL 893-759
NEW ADD ALTER
REPAIR
MOVING DEMOLISH
CONSTRUCTION
LENDER cash by owner
X
BRANCH XX
R. Jardine
OWNER
ADDRESS
r i e VALUE J
USE E/lp ZSo
ARCHITECT
RENGINEER J. Smith Assoc. TE`'645-2110
ZONE TYPE GRODUP
ADDRESS 336 Reims Lane C M
Wayne Howard Contr.
CONTRACTOR Y
APBY DATE J
ADDRESS 1116 Harbor Blvd.
CITY Santa Ana, ND`• 531-6718
LIC. E . 351944 LICVNO.O7447
APPROVED SETBACKS
SIZE 2
OF LOT 18x111 triangle
NO.OF BLOW. 1
NOW ON LOT
(FROM C/L STREET)
FRONT oZQ FT. O
USEOF residence
EXISTING BLDG.
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Separate permits are required for
electric, plumbing and heating work:
L. SIDE Ot_
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED
PLANNING ACTION
24x26 addi.-& kitchen remodel
DATE
APPROVED
APPROVED 11_�
?
DATE �C
I hereby acknowledge that I have read this application and state
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of the workman's compensation laws of
the State of California.
I hereby certify that i am properly licensed as a contractor under
the State of California Business and Professions Code, Division 3,
Chapter 9, and that such licenses are in full force and effect, or I
am exempt from the provisions of the State of California Business
and Professions Code, Division 3, Chapter 9.
WaH / d o tr.
,
Signa ure of
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the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. o
Me State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR
Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE LV: a
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COSTA MESA BUILDING -SAFETY DEPAF
P.O.BOX1200 COSTA MESA, CALIFORNIA
For Applicant to Fill in Completely
BUILDING 1-73,7 3,7 C C�
ADDRESS D / O / T
OWNERMAIL
ADDRESS
TEL.
CITY M NO.
CONSTRUCTION
LENDER
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the State of California Business and Professions Code, Division 3,rVALUATION
SIZE OF
NEW BLDG.
NO. OF
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USE OF BUILDING AND WORK TO BE PERFORMED
i
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RECEIVEDDATE.RECEIVEO
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DISTANCE BET.
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SET.I
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VAR. %%
DATE
C.U.P. sf•
APPR(
APPROVED
s
I hereby acknowledge that I have read this application and state
, 0
that the above information is correct and agree to comply with
all laws regulating building construction, and I shall not employ
any person in violation of Me workman's compensation laws of
W
to
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the State of California.
I hereby certify that I am properly licensed as a contractor under
SQ. FT.
o
E AMOUNT SHOWN UNDER VALUATION IS FOR
the State of California Business and Professions Code, Division 3,rVALUATION
Chapter 9, and that such licenses are in full force and effect, or IE
am exempt from the provisions of the State of California Business
PURPOSE OF ESTABLISHING
A PERMIT FEE ONLY.
and Professions Code, Division 3, Chapter 9.
PERMIT FEE $ D ' N
PLAN CHECK $ • E
Signature of
Permittee
/ U% (}
Authorized Agent
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TOTAL FEE 9 V (�� LL
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,lardin
JOB ADDRESS 1787 Panay it l.P� BUILDING PERMIT N0, 48175
GENERAL CONTRACTOR ntat,or_R��; iao,- DESCRIPTION o f WORK Pvt_ Pool R SnA
NNSPECTIONS
Pool Location
Forms
Main Drain
Steel Reinforce
Elec. Bond
Approval to Cover
Underground Electric _
Gas Piping Test
Filtering System Lines —
Backwash Lines and Recep.
Electrical Final
Heater and Vent Final
Filter System Final
Backwash and Recep. Final
Fencing Final
TRACT 3363 FIRE ZONE VALUI
Si natv.e Date IGROUP TYPE
SUBCONTRACTOR
Electric
logc
L -(o
Plumbing
rf\
COSTA MESA BUILDING—SAFE? EPARTMENT^ ' 9` 6/06/79 12.00 TL
9770 6/06/79 1ReIGOC TO
✓ P.0. BOX 1200
9770 0000 I 6-,
Costa Meis, Calitornla
F110 a I s 1 1 i PERMIT IN
TRACT NO.::d�ti
REC D BY t J �jRj
ELECTRICIAN „��+l,�C LOT NO.;Y
ADDRESS /% `i%.% �s/..._ DATE ISSUED
BUILDING USE
CITY %41,* ,<L%I('
STATE LICENSE NO. CLASS.
BmlOwc
CITU LICENSE NO. ADDRESSle
NO.
111114
EACH
FRRS COSTA MESA, CALIFORNIA .�
DAM
TEMP. POLE
Dwelling, Sq. Ft.
3
NEAREST ( ,
CROSS ST.
UNDERGROUND CONDUIT
Q
Sub -Total Feu
J
FIXTURES r
_
Total FeetO
W
Garage, Sq. Ft.
- UTILITY CO. NOTIFIED I
FINAL
CMF 0313-46, rev. 7/75 . BLDGPERMIT NO.-}�S1%S
For items not listed refer to Fee Schedule _
r
Q
First 20 Outlets, each
MAIL
ADDRESS
_j
�(
Outlets, Additional
CITY TEL. NO.
First 20 Fidures, oath
I HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLI.
.r
CATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE
Fidures, Additional
TO COMPLY WITH All CITY ORDINANCES AND STATE LAWS REG.
ULATING ELECTRICAL WIRING.
LuDryer
1.l ? I CERTIFY THAT I POSSESS THE BO VALID STATE OF
Q
1. CALIFORNIA CLASSIFICATION CIR' I E LEGAL OWNER OF
Q.%'^
THE SINGLE FAMI RESIDENTIAL P PER DESCRIBED ABOVE.
0.
Fan
Healer
of
Lu
PERM171FF
FRMI77
Oven, Domatllc
1 ✓
No. ITIM EACH Piss
h
Pale, Construction .'.� -
Sign a L Trom. 2.00
aRang•..
Danestic
Tronsformere KW
W
Q
Mise.
n.
Motors (Soe Schedule)
His
N
HP
HP
Su a
APPROVALS
Meters, so.INSPRCToR
DAM
TEMP. POLE
Permit Fee . 1
3
UNDERGROUND CONDUIT
ROUGH �
Sub -Total Feu
J
FIXTURES r
_
Total FeetO
POWER
- UTILITY CO. NOTIFIED I
FINAL
CMF 0313-46, rev. 7/75 . BLDGPERMIT NO.-}�S1%S
For items not listed refer to Fee Schedule _
CGSTA MESA BUILDING—SAFieT DEPARTMENT ?- 6/06/79 9,
P.O. BOX y'. 6/05/79 9.0,
Costa Mesa, California 77i 090f.147.61'59 1A
CONTRACTOR
Address
City f "�
State License No.
City License No.
Zip Code
Class.
Tel. No.
FIXTURE OR ITEM
or
Heater and Vent
Tank
TRACT'
LOT N,
BUILDING USE
OAT, ISSUED
Mail
Address
FEE City �Qe7f, 1 Tel, No.
I hereby acknowledge that 1 have read this application and
state that the above is correct and agree to comply with all
City Ordinances and State laws regulating plumbing.
1 certify that I possess the above valid State of California classi-
fication or 1 am the legal owner of the residential property de-
scribed above.
1 certify that I have obtained a permit fro Slate Division of
Industrial Safety fore cavafions, other f n s imming pools, five
feet deep or deeper a mlo which a n required to descend.
Sigrtamre of _ `y V— .
INv[Ciow
^rmsena
'TOTAL FEE D 11J Plumbing
bing Ftinal
Utility Co. Notified I I
CMF 0450.46 BLDG, PERINIT NO.- L-1 FU2 S