HomeMy WebLinkAbout2489 PARMLEY LN - Building Permits��ia� �sa-sz�s • Fax (714) 754-4856 • www.ci.costa-mesa.�,�pLDING PERMIT n Fair+ uHive, cosra nnesn, ca szszs
Job Address: 2489 PARMLEY LN
Suite:
Vicinity: RESIDENCE AND ATTACHED GARAGE
Parcel Number: 43933332
App7icant: BRANNON, TOM
Address: 15161 LAFAYETTE ST
WESTMINSTER,CA
owner: HERRINGTON, WILLIAM F JR
Address 2489 PARMLEY LN
COSTA MESA, CA
Contractor: BRANNON'S ROOFING
Address: 15161 LAFAYETTE ST
WESTMINSTER,CA
Zip: 92683
Arch :
Address:
Zoning:
Phone: (714)897-8147
Zip: 92683
Phane:
Zip: 92627-1381
Phone: (714)897-8147
License: 609940
Eng:
Address:
Phone:
Slatus: ISSUED
Applied: 10/16/2003
Issued: 10/16/2003
ISSUED BY:
Phone:
Zip: License: License:
SCOPE OF PERMIT
TEAR OFF SHAKE AND ROCK ROOF. INSTALL FIRE FREE ON 18 SQ - ICBO 5075. 6.5 SQ. 40 YEAR COMP. REPAIR/REPLACE SHEATHING AS
NECESSARY. INCLUDES ATTACHED GARAGE.
Plan Check: $0.00
Permit: $125.25
SMIP Res: $0.60
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $125.85
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Ezistinq: o
Rear 0- 0
Rear 0- 0
Re uired: 0
FEE SUMMARY
PLANNING & ZONING
Left 0- 0
Left 0- 0
Proposed: 0
Calc Valuation:
Claim Valuation
Right 0- 0
Right 0- 0.
Ss,000.00
Ss,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commencetl within 180 days, or if work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepeetlona and finel epproval mus� be obtained. Failure lo obtain inspections and tinal approval will resul� in the expiratlon ot this permit.
FOR INSPECTIONS CALL: (714) 7545826
!a�as (erool
WORKERS'COMPENSAnON DECLARAnON: '
I here�y aHirm under penalry oi perjury one of t�e following declarations:
❑ 1 heva end wlll mai���ein a cenificate ot consent to sel/-Insure for workers' compensetion, as pmvidad for by section 3700 of the Lebor Code, for ihe peAortnance of the
rk tor whicn t�is permit is issuetl.
I have antl will meln�in workers' compensatlon insurance, as requiretl by sectlon 3700 0l lhe Lebor Catle, for the perfortnance of the watic lor which this permit is Issuetl.
My workers' compensation Insurance cerrier antl policy number ere:
Carner: ! Policy Number.
(This sectlon need not bB camplefed il the Oermi( is valued at one huntlred dollers (b 100) or IassJ
❑ 1 certity that in the peAormence ot the work lar w tct� this permit is issuetl, 1 shall not ampby any perspn in any manner so as to become subject to the workere'
compensetlon laws o� Cali ia, and agree that I I shoultl Decoma subject to the workers' compensation provisions oi S ction 3700 of Iha Lebor Code, I shall torthwith
comply with these pr ' ' ��� �
Applicant Signeture: Date:
WARNING: FAILURE TO SEGURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND 5lWLL SUBIECT AN EMPLOVEfl TO CRIMI PENALTIES AN� CIVIL FlNES UP TO dJE HUNDRED
TFKKAWJD OOLUqE (5100,�1.IN AODITION TO THE COST OF COMPENSATION, DAMnGES AS PROVIDED FOP IN SECiION 3]O60F THE LABOR CODE, INiEREST, AND ATiORNE1"S FEES.
LICENSED CONTRAC7PAS DECLARATION:
I hereby aflirm ihac I em licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business end Professions Cotle, ana my license is In full
force antl eHecL Lic. a Class #
Contractor's Slqnalure: ,� Date: I� I� r9 �Ya�
CONSTRUCTION LENDING AGENCY:
❑ 1 hareby attirm thet there is a consiruction lending egency ior Ihe pedormance of the work for which Ihis permit is issuetl. (Sec. 3097. Civil Code).
Lenders Neme: Lendefs Address:
Signature:
Date:
OWNER-BUILDER DECLANAT10N5:
I herehy ettirrti IhaPuntler penalry of perjury Ihat I am E%EMPT FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Buslness end ProFesslons
Coda: Any ciry or counry which requires a permit to construct, alter, improve, tlemolish, or repeir eny structure, pnor to its issuance, elsa requires tha applicant for such pertnit
to tile e signetl stateinent thet he or,she Is licensed pursuent Io the pmvisions of the Contractors Llcense Law (Chapter 9(commencing wlth Sectlon 7000) of Divislon 3 of the
Business end Profeuions Code) ar,thet he or she is ezempt iherefrom end the basis lor Ihe elleged exemption. Any violation of Sectian 7031.5 by eny applicant for e pertnit
subjects the epplicant to � civil penalry oi not more than live huntlretl dollars ($500).):
❑ 1, as owner ot the property, or my employees with wages as their sole compensation, W Ill DO Tl1E WORK, and the stn,cW re Is fwt Intendetl or ottered tor safe (Sec.
7044, Business end Professions Code: The Contrectors License Law does not apply to an owner of property who builds or improves ihereon, entl who does such work
himself or herself ot ihrough his oi her own employees, provided that such improvemenis are not intentled or offered for sale. If, however, Ihe huiltling or Improvement Is
sold within one yeat of completioq the owner-�uilder will have the 6urden of proving that he or she did not 6uild or improve tor purpose ol sale.). �
❑ I, B5 owner of the pfoperty, am E%CLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to construct Ihe projecl (Sec. 7044, BuSiness end Profeuion9
Cotle: The contractors License Law tloes not apply to en owner of property w�o bWltls or Improves thareon, and who contrects lor such project with e contracror(s)
license pursuant to �he Cornractors License LawsJ.
❑ I em exempt untler sec. Business antl Profeuions CoAe for this reason:
SignaWre: Data:
Owner ID verified by drivets license. ❑ Ves ❑ No DriveYs License No.
Verificetian oi Ownership by (rype ol document, I.e. - property tax blll or deed):
Ezpires:
DIVISION OF INDUSTRIA� SAFETV PERMI7 CER7IFICATION:
❑ I hereby certify Ihet no ezcavation five (5) or more feet in depth into which e person Is requirad to descend, will be made in connection with work euthorized by this
pertnit, end that no Puilding siructura, scaHOlGing, falsewoB, or demolition or dismentling thereof, will 6e more than ihirty-slx (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Celilornia AtlmiNsirative Code).
❑ As owner-builder, 1 will not employ anyone to do work whic� would require a permit irom the Division of Intlustrial Sefety, es notetl ebove, unless such person has a
permit to do such work from ihe tllvision.
Signawre: Date:
Division oi Indusirial Safary Permit Num6er:
CERTiFICATE OF COMPUANCE AND AUTHORIZATON OF ENTRV: I cenify under penalry ot pa�ory that I have read ihis applicafion and state lhst the intortnalion given is
wrrect. I agree to compty with all state laws antl ciry ortlinances relating ro building consiruction, entl euthonze representatives ot the Ciry ol Coste Mesa ro enter upon the
above-Oe�cnbetl� pe 10` I�specNoQ purposes. I aqree not to occupy or allow acupancy ot any building authonzed by this pertnit until final inspection.
�� �2„ ,va��
��re Pf Legel Owner�s) '� 'r D r-y�Dete
� \ � i '�
And/Or Authonzed ApDlicant ata
40DE r. INSPECTIONTYPE
1616 Fixetl System Final Fire Prevention
1266 Pool Spe Final
200 Fina1 Ra-Root
201 Final BIocWRetaining Well
202 Final Factory Fire P�ace
203 Final Sign
204 Final Demolition
PAg ItIDJT9L9
i
� , _� , /�/ %
COOE 1 INSPECTION TYiE
206 Final Mechanical
208 Final Plumbing
2t0 Final Efeclrical
212 Final Fire Preventlon
220 Finel Planning Approval
222 Final Site
250 Finel euilding/Occupancy
P�IE 1l1�Lfl
� AVo��eant ta (lll in all s0aees eattv� those ..in �eavy EorAer lines anG si9n all aporooriate Geclarations. \ I
• ,CITY OF COSTA MESA � � ' PE IT 0. -- TFiACT NO. LOT NO. � BL '
•. CONSTRUC:�da� PERMIT ' �,� 3�S � 4732 8/22/83 16.511 TL
—t —� " . , •
(y� Ap�litent'SMailin % 1'eSS� y� "�� t`�'Nf yJ7�� TVPEOFCONSTRUCTION % �NEW ADD ALTERATION REPAIR � . ' - .
1'1 PfojeCtAddlej5 ���� �r'CML@'v' _' i $'._ __ ❑ CONVERSION ❑ DEMOLqI5 /H..QOT qp..� . � � ' � . ' I � "
���(TI-IG[' /iG��./ � �C�J���x �S�:�SSL' DESCRIPTIONOFWORK i��v��Lk�- �'/��a/G�/ �Y//E _ . .
Owner's.Nam� PHone . Z IN R GUL TIO S
`� Addreu ��'t-L�� 1 � //1�[ . ' . � . _ . , .
r/(/ L�,� �_ j�� j TVPE OF PERMIT' GRADING , FOUNDATION STRUCTURAL A. P. 9W 1� ZONE 7�
[\ Arch/Eng. q C ,I/ `LiC¢ NO. ❑ TENANT �-ELECTRICAL I�`PLVMBING ❑ MECHANICAL � � . � BUILDING ` � � ' ' '
(�, %/�l�/ CO�-�/�l✓ �ZL/%l�� �Q.�OTHER -PLNG.flEF.# ,
` U � Addfess �/�q ?,�`� ' -' � ' TO BUILOING
, � /'G����'Y HVy�`i ��✓�' ��'MXf PFOJECT DESCRIPTION SQ. F � G' PR PERTV LINE REAR VARD (TO P/U ` - �
Contractoi s Nama P.houe OCCUaANCv� �� - . .
� Addresslmailingl ��� "r��� ����n'�" � CONSTRUCTIONTVPE - VALUATION$I�C�� -71��' LEFTSIDEVAqD RIGHTSIDEVAFD' � �
� ` . ��C�fy' � ' . ' ' ' � ZON� � GRAOINGCU.VDS. ACRES PKG.SPACEFEQ. ' PPOVIDED .
Licanse No. -
LICENSED CONTRACTOH DECLARATION � � . Remarks: -- � � ' � d . • STREET WIDTH � }- PARK FEE $ ' -
I hereDy�affirm that I am Iicensetl untler provislons of Charter 9(commencing
with sactlon 7000) oT Dlvljion 3 91 he usines �antl 7rotessions Coae, antl , ' � � �' � ' SPECIAL CONDITIONS: � ' ^ �
rtiy Ilcanse�li in �ull f antl effa�ct. / / � ' � / j�l// ; - .
LI<ense CI ss � � � � ' Lltense No. �� � I ' PLUMBING • � � '
Date�-1�L/ _ 519natur , ' . ,�-le1' �f . . : � . i
`RKERS' COMPENSATION DECLARATION . � 68i Sink i Sewer Cap _ ELECTRICAL '
.reby afiirrYl that I have a Certlticate of consenYto seli-Inzure or a certlilWte : ' ' Automatic Washer_ ! � ' Met2r r 100 amps
..� Workerz' Compansatton Insurance,. o% a certHietl, topy tnereof (SecUon ' Backflow Preventer - SeW2r ConneCtion �- --
3800, Lab. C,d n' / /� �" � / ' " - - ' , COnStrUCtion Pole' � ' SUb Penel ,
'/ Y� � Backflowlrrigation � SolarCollectors � �•
PoIICY No. /C�"���5�� LVC� ComPAnY/� � ' C'x ' ' ___ ' ' i .
� �Certifietl cbpy Is.nereby furnistietl O /, � i � i � Bathfubs ' . � i Solar Piping � - �. Cooking Uni[ . Sub Pole . �
,Certifiatl%cpPy I }Neawiththeci Ing 1 z'o����/� � � - Dishwasher ,' . ' Motors ❑0-i HP ❑1'h$ � '
�Date �^� ! ` �+�� AVPlicante , i' - . Clariffers � � � So11a� T9nk ' • �
EXEMPTION.FROM WORKERS' COM7E SATION DECLARATION � � - � - - � Or e�5 ❑Ga5' OElectric .- - ' '' - '
(Tnissactlon neetl not be comD�eted if tne peririit is tor, one hunarea (E10oj or � Dishwasher , � Swimming Pool w/Spa ' � Y InaSolar' �9-15 HP �1645+ �
I less)r . � • � . . 1 . , . . � e,� Fan, �. ;' iMicrowave . ' � �
I cerHty �that In the pertormance oi tne work tor'whic� this permk Is issuetl I � j Drinking Fountains Urinal . � )
'. shall noC employ any.parson In any manner so.as to become subjactto t�e ' � - � F.A.U. �.��� � Pole Li ht '
I NOTICE•�It, atter makinLtli s tleclar�alon'a �ou sh ' j Floor Diains I ; . ; � Water Oloset. ' y � ^ 9 '- �
P • ' �
� Date ' S1 natura ' � • : � � ' ;� � • �
. . . , . . � � ' Fixtures . �+`� �
. g y Oultl GecoTe subjec[ to�tha- -� Floor�Sinks - - -- � � �� - 7 �Water Heatei- -- -� �- - --- . . - . . ._ _ ., . _'._ _ .. �_ . � _. , Range_ � i
� Workers'� Compensatlon provislore�oi the Labor Code, you must forthwith� - . ,. � , , �„ � � . � _ Device Box¢5 ; � � ; ' t
tomO�Y �N'��h� such prOvl5lons:.or thlSnDermlt.5hall ba tleemetl revoketl. Gas$ENit2 Outlets� Water,SerSice' - �;�- , i Sign '
�CONSTRUCTION LENOING AGENCV ' ' • � ' ' ' - � � � . � �
I hereby affirm that there Is a construc[ton IenAing agency for the�performance- ��� i �ntErCeptors i '� r, � .,;., , Outlets � ' ' � , $t0nding $ections � � .
of the work for c6_ t� perm4b� is i atl • tlon' 3097', Civ C J ' - � .
' Leneer'r Name f �� � � �� t'�✓�'�'u r���� " � - Kitchen Sinki ' - ' � " � Switches . . � r Trash Compactor � � �
w
Lender•s AtlCres �C� �� � l�•`' `� ✓��� =� � �/Q"�'�' � ' Garba eDis osal ' ' ' '
OWNER BUILDER OECLARATION' � CavatOries• : � `'� � . � ' �- _ � � 9 P �
I hereby afflrm that I am �exempt from tha �Contractor'S LI<ense Law for the j� � � � �, . . � � Gene�atoc �0�5 KW �5-75 KW � � � �
following reaion (Sectlon 7031.5 Business antl Professlonal Cotle: Any city or P-Trsp. - - � � �
couney whl<h reqmres a permit to conslNtt', alter, imorove, tlemolish orrepair � -, _ ". , . - . . Transformer � 15�50 KW ' ' �
any structure, prlor to Its9ssuan<e,.also requires the'applican4.for such permit . ROof.Drains -" �� ' c.. � - - � - , � � :
�p tile a slgnetl statement that he/she I5 IlcenseA pursuant to [he provisions of - ' `� -� � � ❑5U+ KW' . � Rein c[ion Pee � 1
�t Contractor's License Law (C�apter 9 (commencing with'Sectlon 7000) of � � - ' ' " � ?Pe $15
islon �3 �of the BuSinesz' antl Professions Cotle)' or. that he/she ls exempt � Showe�s r � - � Reinspection Fee � $15 '
s��re(rom antl the, Easis tor the allegetl exemptlon:� Any violatlbd oT SecHon ,_. -. . , �' - Mete� ❑'up to 100'amps �IsSue Fee � ��$ 3 �
+/031.5 by,�any apPllcant for^a permit'subJects the applicant to a' civil , ' ' . . �
� lLenalty at not more than flve, huntlretl tlollars (§500). '" , '- . . ' ' Se�vme Sink , , laue Pee � $ 3 � - — � �
, . i Zonin9 APProved BY ' Date � -�
LJ I, as,owner ofi the property or my employees,with wages as their sole . -� , . .
, compensatlon will.tlo the work, antl the structure is noc intentletl or.ofteretl ' '� � " � •� MECHANICAL . . . ' qpp�imt�pn Approved By � ' Date '
; for sale (Secflon 7044, Business, antl � Protessional Lotle:: The Contractor's � .
� Licenu Law tloes not apply to�an owner of a proper[y who 9uiltls or improves � goi�e} ' � � � Fefrigeration System f . q,;�t;a„ ,A„� B',� t�i1,3 ;� .� zi—�3
the�eon, antl wM10 40¢5'SUCh wOrk hlrtiselt he�self o� th�ou h nis o� h¢� own '� � ' PP Y DetB
empioYees, provltletl tnat such,improvemerits ara not inientletl or offeretl tor � ❑0-100p000TU ❑100,OOOBTU
. sale. I/, howaveq the builtling or Improvement Is soltl withln one year of com- � Duct�- Under Giound ' . � � , SUMMAqV OF FEES : �� � '
pletion, the owner"will nave the Durtlen of proving he/she tlitl not bulltl or Im- ' � . . . • , , ,
:eromrortheburposeof,sale)�. � . , � �' ; � �� ,, Duct-Structural � Systemfiepair/AKeration �BUILDINGPERMIT $� �,SMIP ; ' .$ � �
LJ 1, as owner of t�e property, am exclu5ively contractlng.with�licensetl con- ' .
: tra<tors Oo constru<t the prqect (Sectlon 7044, Business anC Professions Cotle: ,' Duct - Ventilating _ ___ � _ ' _ _ �PLAN CHECK . $. � PERMIT � �
The Contractor's Litense Law does not apply to an owner of property who � ISSUANCE '. �$
� Euiltls or improves thereon, antl who contracts for zuch.projects wlth a con- � � ExhauSt System ❑ Multiple �' � ' � j . 'PLUMBING ' , $ .
� tractor(s) Ilcense pursuant to the Contrattor4 Llcense taw). � PLAN CHECK�� $,�' GRAD WG �$
� 0'I,am ezempt untlar Sectlon B. & P. C. for this reasbn Fiiepl/Fact. Blt. ICBO iR � ' � � � ,. � $, � . '�. ' � $ ; . ,
� Date. ' ' � - -� OJ.mer % � � � • ' Heating�Sysrem & Ducting � � ; - ELECTRICAL $ •
PLANCHECK � $� a.SD '. � MICROFILM � $ 1
' I heieEy��certify that,l ha� reaG this'application anrC state that the-above • -� �U700,000 BTU �100,OOOBT - '
Informatlon�is"cp�reR.Ji agree to como�Y with all city antl county ortlinances � ' � ' ' . . : . � ' �' TOTALFEE� �$ '
antl state 13ws relating tp byilCing construcSon, �nG hereby authorl e repSe- � Hood Or • � � + � �MECHANICAL �, $; � � � �
sentatives f�thls=<Ity t enter u on LKe abov -mentionetl pro erty�t or T�Pe � �� • peins eetion Feer $15 � � � LESS . '
�,Inspectlor�iLyr 6ses1 J !� � ����/' � Canop i T e II ❑� • P. , PLAN CHECK.- ; $' qDVANCED PC $ �
�-Signahre �� Da[e /� ' � �� � ; �
Drivers' Li� '«•�` ������- ' % Registers ! �. Issue Fea � � $ 3 C � . . � � FINAL PEE; � $ � �3�
CMF 0865-46 rev. 12/82� White - Builtlin9; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor � � - �
� . .
_ • CONSTRUCTIONAND.PLANNING � - '�� � � . : - �� =.:�C SPA . .
'" � �{�� lj ff �z � ' `Date ` 1 nspector. � � ` " - Date I nspector
-'_.APPROVALS,, Permit#- �-LSL! , ..rAPPROVALS : Permit# .
• 1��Temporary E�ectrical Service or-Pole - • ��_ ". ' 52: Pool & Equipment Lowtion
_ 2. �Soif Pipe-Undrgrnd. _� _ " � ' ' � . � � t53: Steel,Reinforcement ' � - , ' ,
3! � -iiral Conduit Utilitv-Undrgrnd. �. � � '�, - :54: `Forms ' �- � '
_ 4.�Electrical'Conduit-Undrgrnd. _- � . � _ • .[55J Electrical Bontling � �
�5: Steel Reinforcemen; _ � ;`. ;, - � ' ' _ � , - � ' ° � 56. Rough Plumbing &�Pressure Test - �
�
�6: ,Electrical UFER Grnd. �� � �� -� . .57. APPROVAL TO COVER-GUNITE . " �
7. Fooiings i . . � � � �- , i• �� '. 'Sg. Elearical��nduit-Undrar.,.f. . ' • �.
8. Foundafion �•; ' . . _ ' '' ^ ' � �- ��59. Gas�Pipe,�O Undrgmd.,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 &�.ReceptorFinal � � � -
.12. Sewer Cap , �`r' ' � � ,�� ' 63. Heater, & Vent-Final ' � •
,
13. Roof Drain's � ' - ; � ' � ' � � ' . 64. Plumbing''System - Final - - -
14. �Rough Plumbing f � ' `-� ' � ' � ''�65. Electrical-Final' - � � - -
- � 15. Rough Eleetrica6Conduit ,-',-" �^' �� - -*-�--T- ---�-- 7 66.� Solar System-Final ' � ' � � "-
� �1�6.Rough�ElectricWir�ing�„��a� � �-,-�:,j,`,�; � ;�',' "'67.�Fencing&�AccessApproval �. --. ��
.� 17. Rbugh Wiring Signi: =, •? 1 � � .� ',' � -��,_ ;C.�-'� ' '68� APPROVED F,OR PLASTERING � � '
, `.§-1� �
18. Rough-.Elec{rical=T Bai Ceiling� , � , ��,.�� � 169: P.00L/SPA SYSTEMS FINAI. ' �
19. �Rough,Heating & Air�Conditioning ,: ' � : � _ � � .FIRE DEPT. REQUIREMENT ' � _
20.,�Rough�FactoryFireplace, , , �� , � � � � � � pppROVALS, Permit# ,'
� I
i 21. �Ducts, in Structure � � •�' � f � � ;70. Undeiground Hydro - -
I
22. �Ducts, Ve'ntilating ._ �� � � � , � � � �7�, Product Piping O Gas ❑ Oil
��23. Gas Pipe-Rough & Test �: �` � �' I � I J2. Underground Flush '
��24. Roof Framing � � � I _ : , � � �� ' ' �� ! j73! Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing .. � ' ;. � � ' � � , ,� ,: F . �. i -' � 74: Overhead Hydro
_26. �T-Ba� Ceiiing ��Structural) & Monocoat ! � _ " ; � . 75. Dry Chemical - � �
,
27. Frame and Flashing •� ' 76: Dry Standpipe �' ..
28. ;Lathing & Siding' ' � • ' • . , ,77. FIXED SYSTEM FINAL ,
29._ Insulation - � ' � � ,� �. � � � �78. FIRE PREV. FINAL . .
-30. Drywall Nailing �� . � � ' j � Notes:� , , �
37. Plaster Brown Coat - ', i . � � � i .i � . _ . '. .. .. . .. . . - -
� 32. Electrical Power Meter-Final � � �i �� �,� � ' : - �
- ' 33.. Final Electric �� � AW�+«� ' ��-� ���.,.� . � . .
34. Final Heating & Air Conditioning � �. , .
35. Final Gas Pipe-Test- ' • , - �� ' - - � �. � -
, �..
36. Hood or�.CanovY''" . � ' ' ., - . ' - _ � � . - .
37. Final Factor}y Fireplace ' - � � , � ' _ � _ �
�
38. Final Piumbing � , _ ,� �
39. Water Service-Final ' ' ' � � ' ' � � -
40. Gas Service-Final � , „ �, , ' � � '
41. Solar pomestic�Final � . ' ' � �'
42. Backflow Preventer _ : � � •
43. Backflow Irriga4ion . ' � ' - ' '- � � � � ' ,
44. Landscape Irrigation-SYstem ' � ' � � �
45. Sound. dttenuation' . � . � � ` . � ' ' � � ' � � �. '
� � -
46. Handicap Regulationi� � � �. ' ' . I ' ' . � � ' .
47. FINALSTRUCTURE&BUILDING ; � -' � , � •
48. Special Requirements Completed ' ' � ; � � . � � -
�
49. Electric Releaselto�Edison' � � , _ i__ � � � _ _ _ __ � _ . . ' .
�
50. Gas Release to Southem California Gas Co '� � � , � , �
51. CERT.IFi;CATE OF� OCCUPANCiY __�_. _ _ ; ; _ . _ � _ ' '
No " ' � Date � � i � ,
,� .
' A�Vlieant to flll In all spaces ezcapt those witMn
CITY OF COSTA MESA � peq �nni7J� O. TRA��
CONSTRUCTION PERMIT . F— /.� i�I%O
ApplicanYs Mailing Addrea � h
Project Addrea a��9 Q4�'�+�� ��—�`9^ � �-=L��i'���'o1
Owner's Name �����am P ilO /NP.S�� - ohone 1.�.�-�-��
�, Address ��,��^,/ L' o�.,ns� �f� lii�'9.�27 / S�
ArchlEng. I� � f � � License No. n-//R'/
Addrew � t h/
Contrector's Nam hone .7'{� -�RSO
Address (meilingl -�� ^� �Q17 �. � U/ti� 9a S/ S�
Licente No. Q `� �U� �
LICENSED CONTRACTOR DECLARATION
I hereEy atlirm lha[ I am Ilcensetl untl r�provis Qni f Chartar 9(<ommencing
wlth sactlon 7000) of Dlvlsian �-o he usl exc antl Prota551on5 Cotle, antl
my Ilcanse is In /ull force an ef ect.
Llcense Class " n N �
Oate 'Y/���3 Si9natura
1RKER5'COMVENSATION D LA Tld
:re�y affirm t�ai I nava a cartif wta oT co p�nt to seltansure or a certifi�ate
..r Worka�s' Compen5ation In�u�r�9{ e, or 4 cartlfle c�oy y thareof Sectlon
3800, L.ab.��//{� � /%y //�,(�' ��f�y�n�.
POI1cY No. ��'L�. Co anY (.[%i. l�✓fJ ' �-i/
I certl/y l�at in the
shall not employ a�
WorkGri' COmDB�Sd�
Date
wlththetRy{B,bIJWhVfT✓E4GA.(7C/��(J- /�-h
- AOPlirant/ W(/[�[il '.(.!(i r-YCl y N
RKERS'C(SMPENSATION DECLARATION
completetl If the permit is for one huntlratl (E300) or
��Tdnce o! the wO�k f0/ whic� thiz 0¢rrtlit IS IsSUetl I
rson In any manner so as to become subject. to ti�e
dw5 01 Cd1lfOftlld. ,
CONSTRUCTION LENDINI
I nereGy a//irm that [here Is a
of tha work !or wh � �
LenEer's Name
L.entler's AGOress � �. //�/[
OWNER BUILDER OECLAF
I herebv a}tirm that I am ex
rom antl the basis tor the alle
5 by any aOP���ant for a p
y of not mOro than /Ive hunGr[
as owner of. Ihe property or
inSaUon wlll Eo Ihe work, ani
le (SecEion 7046, Business a
a Law tlaes not aOD�Y to an ov
m, antl wh0 UOes suth wo�k I
pu�posa
as
LI I�am exempt untler
Date
the Contractor's �Icense law for tha
iis antl Professlonal Cotle: Any clty or
rucq alter improve, tlemolish or repali
requlres t�e applicant for such permlt
Iltensetl pursuant to the proWslons ot
(commencing with Section 7000) ot
lons Cotle) or that �e/she is axempt
axemption: Any violation-of Sectlon
It suDjects [he appl(cant to a- clvil
Nlars (y500). ' '
amploy8C5 with waga5 ds thalr 5018
a structure is not intenaee or o/feretl
:n Improvemen[s are noi mcenaea or onerea lor
g or Improvement is zoltl within one year ot com-
tne burtlen ot proving he/she tlltl not bulltl or Im-
ty, am exclusivaly tontracting with Iicensetl con-
act (Section 7044,.Business antl Rofa551ons Cotle:
�w tloos not apply to an owner of property who
antl who contracts for such projetti with a con-
the Contractor's Llcense law):
n B, & P. C. for tnis reason
EorEer Ilnaf an0 sign all aOP�oDriate Eeelaratlonf.
TVPE OFCONSTRUCTION IaI NEW L� ADD LI ALTERATION LJ REPAIR -
❑ CONVERSION ❑ DEMOL`ISH ❑ OTNE
DESGRIPTIONOFWORK .,l�nl^������'� � r�S fHCP
TVPEOFPERMIT�p( GRADING FOVNDATION STRUCTVRAL A.P.qY+
❑ TENANT L�].ELECTRICAL ❑ PLUMBING ❑ MECHANICAL PLNG. REF. qp
❑ �OTHER � TO BUILDING
PROJECT DESCRIPTION SQ.FT. OCCVPANCV PR PE V INE
CONSTRVCTIONTVPE � VALUATION$ ��0� 3 � LEFTSIDE VARD
ZON� GRADINGCU.VDS. ACRES PKG.SPACERE�.
Rema�kr. �'6 STREET WIDTH
LOL` �p //�QC/ 1�6�Z . SPECIALCONDITI
Bar Sink
Backflow Preventer
Backflow Irrigatian
Bathtubs
Clarifiers
�rinking Fountains
°loor Drainz•
=1oor Sinks �
3esService C
Interceptars
Kitchen Sink '"
Lavacories� -
?-Trap
Roaf Drains �
Showers
Service Sink
Duct- Under Ground
Duct - Structural �
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
06100,000 BTU � 7 00,000 BT
Hood or Tvpe 1 ❑ �
o' es �ic eo S, �' -� I IRegisters
CMF 0865-46 rav. 12/B�l� White - Bulltling; Canary - Applicant; Pink - Accountin9: GolUenrod - Assessor
Sewer Cap
$BNYf (�.Onn
Solar Collec
Solar Piping
Solar Tank
Wete( CIOSEL.
Wa[er Heeter,
Water Service
n
Reinspection Fee
Isue Fee '
Retrigeretion System
❑o-ioo,000sru ❑ioo.000sru
System Repair/Alteration
i Reinspection Fee
Isue Fea
�
7430 4/I9/85
REAR VARD (TO P/L)
RIGHTSIDE VARD
PROVIDED
PARK FEE $
AutomaticWasher _ Meter uoverloUampS
Construction Pole Sub Panel '
Cooking Unit Sub Pole
Dishwasher . Motors �0-1 HP ❑1X-B
Dryers ❑Gas ❑Electric 'Inc.Solar �9-15HP �16-15+
, Fan Microwave � �
• F.A.U. .Pole Light •
, �3 Fixtures , . Range . .
Device Boxes Sign
Outlats � Stanc
Switches � � Trash
�
I9.5;, TL
Generator OO-5 KW �5-15 KW '
Transiormer ��5�SOKW
; ❑5U+KW �ReinipectionFee $15�
$15
Meter ❑up to 100amps laue Fea .'$ 3
S 3 2oning APPtoved BY � Data �
ApPliotion ApOroved BY ate 1 ,(�
APPlintion Isued BY ^ate ��
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT �
PLUMBING $ ' �SSUANCE $
� PLAN CHECK $ , GRADING $ �
ELECTRICAL $ � � $
PLAN CHECK ' $ s..<'ZJ MICROFILM $
MECHANICAL $ ' TOTAL FEE $
$15 pLAN CHECK $ ADVANCEDPC $ )�} Y•
$ 3 FINAL FEE , $ �/�.a�.S�
<. .; .. r �. - �\
' `-�CONSTRUCTIONAND:PLANNING ' � � ,. �- . ',; - � ,-- : _POC SPA : _ ' . ::
r - �p���� �7��� �-'Date �Inspector-� �� Date - �Inspector
.-APFROVALS . Permit#,,..�2Lrri .. �APPROVALS P.ermit# - � .
. l'.i 1 P'. .
^' iL, �emporary Electric$I SerJice or�Pole ' , � . � ��' � - �'52:- �Pool &�Equipinenf Location -
�„' . - - - - - - -
o �2! •Soil Pipe-Undrgrnd. _ � ' °• . � �'53�' Steel Reinforcement - --
` `.: , � _ , _ , . , - . .
� 3:�Electrical Conduii Utilitv-Undrgrnd. � � �, � -`� _ � 54��Forms'- . � ' - ,
�� 4 � Electr,ical Conduit-Uhdrgrnd, - _ ' ! � P : � �55L. Electricel Bonding ��. ' � , � '
� `�. .
5: Steel ;Reinforcement , i � `, : , :. � -` � a �.: ` 56.� Rougli Plumbing & Pressure Test -
�
6: ;Electrical UFER Grnd. ,' � � ; 57'.; APPROVALTO'COVER-GUNITE
7. Footings � � ^ ;. � F � • _ - = 58. ElectricaLCpnduit-Undrornr{. : � � �
8. Foundation ' , ' � � � ' " - � 59. Gas Pipe, O Uridrgrnd., Test . . _
_ � , _
9. Wa[er Pi�pe-Undrgrrid. i, "_ "; �. �-60. Backwash. Lines; P-Trap, � Undrgrnd. �
,
10. Stiuctural Floor Sy,stem �=� � 7 i�` � ��61. APPROVA�L�TO DECK -_
11. Property Sewer Line & House Connection �• -�- '.62. Backwash & ReceptorFinal� _ .
_ a
12. Sewer Cap , i , , � . ; ' � � - ' -'63. Heater & Vent-Final ' �
13. RooflDrsins ' i � ; � , � � _ • �64. Plumbing;SYstem - F,inal . . �
74. Rough Plumbing ' >� . - - � ' 65. Electrical-Final � � -
� -
; r_15: �Rough Elec[rical=Conduit ,� - -. +��' ' � 'j ; - ' �66., Solar System-Final , �� - ' � �
'rc16-�Rough Electcic Wiring, i ^ �i - Y - %'�6Z�.�Fencin & Acce"ss Approval - - - - �- �-
o .,, ,, ,3=�s3 =eC 9 �
.' �17:�Rough�Wiring'Sign ' . ' . ' . �" = ! � � � . �68.( APPROVED FOR�P.LASTER�NG � ' � � �
- ;,, � o i f i
�78C�Rough_Electrical-T'Bar� Ceiling�� ' i� - I : ' ` ' � - `. � - '69.� POOUSPA SYSTEMS FINAL ,-- � �
�' 78�Rough-Heating & Air Conclitioning : � :. � I � � , j FIRE DEPT.�REQUIREMENT . _ _
' �0. Rough�Factory Fireplace � � � � , � � I qPpROVALS Permit# - .
' 1 � i i
-�. �21. �Duc[s, in St�uctude � ' ' � � � � � � i '„ ' i
; � J,: � , � � � ,70.� Undeiground Hydro , .
o.� _.-� ' ' . . . . � ' � , - : '
F �,:22. ,Ducts, Ventilating , :i�: ; � � i � � , 7�, Product Piping OGas ❑Oil ' � � . �
- �23. �Gas Pipe-Rough & Test !. - T �', --. -, . - � '-- �. . . . .
, - � . 72. Underground Flush
24. �Root Framing � f� - � � i - 73. Unde{grnd. Sto �age Tank O Gas ❑ Oil �
� �� 25. Roof Sheattiing , � � � � .. r ' , . �,' = 1 ' i -' 7q,' Oyerhead Hydro � �
� i . -�
" �-26. ,T-Ba� Ceiling (Structural) & Monocoat � = � � � .; ` - I I %' ' �75. Dry Chemical ' � ' : � �
r � i
�.27. Frame and Flashing' - i �, , ; � � � - �76.- Dry Standpipe ' r � � ' � �
' 28. Cathing & Siding, � �.. , ; i � � 77. PIXED SY$TEM FINAL � • '
_ 29. Insulation ' � j , �� � � ; � � 78. FIRE PREV�. FINAL . ' �'. �
, �.'30..Drywall Nailing > � � � � 'I � i I � � ' �Notes: � � • � '
° 31. Plaster Brown Coat �' � � � � � ,
� ' I I
'32. Electrical Power MeterFinal ' - �� � � ' � ' - . ��
9.�-g� e�;
� 33. �Final Electric Rr fC Hrpu� . � q-q -$3 �� � , . .
' �34. Final Heating &�Air, Conditioning �� � ' ! , "� � I � � • . .
35. FinalGas,Pipe-Test ��. . ., s� . � �•._ - �T , - � � _ . . , .. -� . , - .
�
36. Hood or Canopy � ' - ' � - ' ' . �: ' � � ; . ' ` � . � _ - �
37. Final Factory Fireplace'' - . � � � ! ! ; y � - � � "
38. Final Plumbi�ng + ' i � ' - I _ � �
, .� i '
39. Water Service-Final� ' • ; �y� � � � � t ` . , ' • - . ,
i i i
40. Gas Service-Final �. ' ' , . � � � �
�, i
41. Solar pomesticFinal �� � � � � I ' ' � � : �.- . �F'�1� ' ,
42. Backflow Preventer . . i ^. i , .r-.+ � _ 1 - - --_ , � _ � t _�
43. Backflow Ir�igatyion; ,' � ' i ' i a � .; � , , � , � , ! ' ,
44. Landscape Irrigation System � ; ' � . - i � � ' � � -
� - �. : �� � i �
45. Sound'.Attenuation ; �:j - , _ i _ ' � _' . � � � -
I
46. Handicap.Regulations' ' ; , � " . � , '�� . • � .. " '
47. FINAL STRUCTURE & BUILD iNG , �� ; � '� i ' � � I � '
48. Special R�quirements Corhpleted . � � � � " ' � , � � �' � .
� � I
� 49. Electric Release;to Edison ; � _ _ _ .L _�_ _ _ _ _ - � '
fi
50. Gas Release to Southem California Gas Co � � � � � .�i, � , ' ' ' � -
I 51. CERTIFICATE OF OCCUPANCY _ '_ _ _ � , __ " � _' __ `' �
�� � ! Date I '! f ..i _ i - ;;� r , �?� � i '' �j ' ,p,
No ._�=' :?
�
.
': CITY OF COSTA MESA .
r--�ONST.R4ICTION PERMIT+
ApplicanYs Mailing Ad�dGre�sJs.
� Pioject Addreu� �-T 3 y P�
Owner's Ne�me��
Address .{����
Arch/Eng. -
Add'ress �/�
Contractor's Nama' �.lL/sf � �
Address Imailing) �� bO
License No. � 6
LICENSED CONTRACTOR DECLARAT
I+hereby'afflrm that 1� am Iicansatl untlar i
with section 7000) of Divlslon 3 01 tha
my Iicanse is In full torce A effe t. �
ucense ci � �" � '
Date Signature � _
'�;� iRK RS' C MPENSATION DECLARATION �
:a i�Eraby aHirm that I have a certlflwta ot consent to selt-insure or a certlllcata -
or a certi�U copy_thereof (Sactlon
. .."_" " "_ A
- � ,_
,� ✓.
L ��/�p�-1f
� ' honB iT1 pJ `�
/O �/� /d
LLicense No. G ���
hone LZC..2a�`
d� ✓/1v/iw//�.
i
of Cha�ta� 9 (commencinq
�'9!� \Profes5ions Cotle, antl
^[. NA ���0� 1
PoIICY No. /����✓ • � ComPanY�='-°-� �^�� ; cr4+r�^a
nµ,Certltletl copy I5 hareDy furnishetl. , '
Q�G���^�Jj flletl wiAtPpliwntY B� tllnA �visi� _P�' _�� p-
bate 5 ry�� TH�3� CSd
EXEMPTION'.FROM WORKERS'GOMPENSATION DECLARATION
Iss)5 seCtion n¢eC not Ee COTplatetl if the Oermit is for One huntlre0 (5100)�or
I certify that in the performanca oT tM1e work for whic� [his perm�t is Issuetl I
sball not amploy any person In any manner so'as to become subject. to t�a �
Worker5' Compensation l.aws of Callfornia.' i .
Date � �Ignature '
NOTICE: If, aftar making'thi5�deda�ation, you shoultl become suoject to'the -
Workers'. Compensation Orovisloni of the Labor CoEe, you must forthwRh
comply with such provlslons or ;,this Oarmit 'shall ba tlaemeU revokaC.' .
CONSTRUCTION IENDING ACENCV ' �
1 hereby afilrm that thera is a construction•IenOin9 agency for the erformanca
ot the work for/vfl�l h(�� oer� t Js•I35u�� (Se 1 n�� 7 Civ, C.);
Lentler'S� Name 5� / T�T�STJ977T /� a
12nOer•5 Atltlrei� ��r� � • ���dT.
OWNERBUILDER OECLANATION :' � .
I hereby affirm that I am exampt 7rom the Contractoi'S Llcense Law Tor the �
following reason (Section 7031.5 BuSlnest antl ProfeSSlonaPCoae: Any city or
county which requires a permit to construct, alter, Improve, tlemolish or rapalr
'any structure, prlor to Itslssuanca.'also rapui�es the'applicant'for such permit
tg file a signatl statement that ne/sne is Ilcensed pursuant to tne provisions ot
?`. ^. Contractor's�License Law,(Chapter 9(commenGng with,5ection 7000) of �
ision ,3 of the Business antl Professlons Cotle), or� that he she' is exempt
�reirom-anE t�e ba56 for the allegetl exemption. �Any ylola lon of Section �,
9031:5 by-.any aDPlicant for.alpermit suD�ects t�e•applicant to a' civll .
�enalty of not more [han five huntlreC tlollars ($500). � 1,- ' ,
�I, as owner ot Me'proparty or my amployees with wages�as thelr sole
tompensation will�tlo the work, antl the structure I5 not intentletl or offeretl '
(or sale (Secfion 7044, Buslnesz' antl Professional Cotle: The Contractor's ,
U6ense Law tloes not apply to an owner of a proper4y who �builtls or improves
the�eon,'antl wno'tloe5'such wo�k hlmselt/he�self o� Ih�ough hls or hBr Own '
employ ees, provi0ea thaf such improvements are not Intentletl or ofieretl tor
sale. If, M1owever, the bulltling or imp�ovement is soltl within one year of com- �
pletion, the owner,will hava tha Durtlan ot proving he/she tlltl not builtl o� Im- �
�rova for the purpose of sale). '
I, as ownev of [he property, am axclusively contractinqlwith�llcensetl <on- �
tra<torsto construct tha project.(Section 7044,.BuslneSYantl Professions Coae:_�
The Contractor'S License Law does not apply to an owner of property who '
Euilas or Improves theraon, antl who contracts for such projects with a con- ;
trattor(5)Iicense Dursuant to the ContractorY Llcense Law): � �. '
❑ I'am exempt untler Section B. & P. C. tor this reason ,
i �
Date Owner �.
I herebv �certlfv Shat I M1aoe reatl thls aoolicatlon anC state'thac ttie above -;
519na[ure � � � t `J � �'G't� �
� Drivers' L'te �Se o SS � � �
CMF 0865-46 rev. 12/82 Wbite - Bulltling; Canary - AppllwnQ Pink - Ac<ountin
to fill in all spaces ezeept thase wit�in heavy borEer Ilnes antl sign all a�
.. . . . . _.. .. .. . ...... . .. .
IMy��IT N.O�/. ���r . TRA�}C.T qNO. LOT NO. E
! Y � / ��Y � ��IS �C. ' . �� . � '.
tleelantians.
�
TYPE OFCONSTRUCTION NEW - ADD ALTERATION LJ REPAIR
• ❑ CONVERSION O DEMOLISH ❑ OTHER �
DESGRIPTION OF WORK S�/���-� F�'��L'� , ,
TVPEOFPERMIT. ,GRADING ' FOVNDATION STRUCTVRAI A.P.-�p
❑ TENANT ❑•ELECTRICAL C�KPLUMBING MECHANICAL.. � PLNG.REF.qW
- �:
❑��OTHER `' �' �' � ' . TO BUILDING
PRQIECTDESCRIPTION�SQ.FT.Z � ` OCCUPANCV LEFTSIDEVARD
CONSTRVCTION TYPE ' VALUATION $ ��0� S,Q'O .
' 20N� � � GRAO�NGCU.VOS. ACRES • ' ?KG.SPACE-REQ.
Remarkz: , � C '� STREETWIDTH �
. . � SPECIAL CONDITIOi
i PLUMBING � � �
� Bar Sink Sewer Cap � �
� Backfiow Preventer - Sewer Connection Automatic Washer
'. Backflow Irrigation . Solar Collectors • ' '� Construction Pole
� „__,__ ,__ . ., COokin9 Unit
ir Drains
rt Sinks
Service
Kitchen'Sink
Lavatories-
P—Trap
Roof Drains
Showers ' �
Service Sink '
Solar Pipmg
Salar Tank
Swimming Poal w
Urinal
Water Clout
�Water Heater � - �
Water Service :
- . ', Reinspection Fee
�. , , �- ; ; laue Fee ,_
Boiler � - , " � '
Duct � Under Ground �
Duct - Structurel .
Duct : Ventilating + _ _
Exhaust Sys(am�Multiple ❑
Firepl/Fact.8lt.IC80,# �
Heating System & Ducting �
�4100,OOO,BTU �100,OObBT
Hdod or Typel ❑ •
Canopy, -Tvoe I I �
Fiegirters �
enrotl -Assessor '
Oryer's �Gas � �E
Fan ,
F.A.U. � �
Fiztures f �'
Device Boxes
Outlets
• 97�5 .5/ I 6/83� .
. � . � ,BUILDING ' f
� ' S�TB/+_.G� cr'
REAIi VARD (TO P/L) _
RIGHTSIDE VARD
' ' PROVIDED � '
PARK FEE $
.Meter LJover100amps'
Suh Panel �
, , Sub Pole '
t
Motors ❑04 HP O1'b-8 �
� InaSolar�09-15HP 016-1
Microwave
Pole Light
Henge
' -57:50 TL
� awiicnes � Trash Compactor � . � �
' �� Garbage Disposal ' �
Generatar, �0-5 KW �5-15 KW ' ' � ' '
�
� . Transformer �75-50KW � � . . i �
❑5U+KW� ReinSpectionFae � $15'
$15 _
` � Meter ❑up to 100 ampi �Issue Fee � • ' $ 3
' a 3 Zoning APProved BY . Date
' ' Appliqtion Approved By �/y� ' �ata ' �
APPliration laued BY � �� �! � � Date `S ��' �
❑0.100,OOOBTU ❑100,OOOBTUI • . ,
V
� , �sue Fee
, , , SUMMAR OF FEES � � •
�-•BUIL�ING PERMIT $ � SMIP '. � $ .
' ; PLAN CHECK' � $ . PERMIT ' � '
' � ISSUANCE� $� �
. „� PLUMBING '�$ � - , ,
� '� PLAN CHECK � $ GRADiNG ' : $ '
ELECTRICA� � $ , � � - $ '
- ' PLAN CHECK� $ � MICROFILM -. $ . � '
� MECHANICAL � $ � , TOTAL FEE , $ ,,��j_ ✓
��$15 � PLAN CHECK• , $ �_� � LESS ' �
. ' ADVANCEDPC � $ �
' � ! '
S 3� i . ' � FINALFEE� , $'�
� �CONSTRUCTION�AND�Pt,q, NI G• � , . �.' - - � • � -. - . �0 SPA . .. -- - � �
' � �� ` ` ''/�' .`Date � Inspector� � -' ` � :-Date �� •Inspector �
%,PPROVALS :; Permit�r '� � , s, � �APPROVALS ,'Pe'rmit#'
-�� '
� d: Temporary�Electrical Service o� Pole'". � ��' n - 52.' Poo� & Equipment Locatibn �-� -
t f �, C
- F
�, 2% Soil Pipe-Uhdrgr�d:' • _ � _ •� -.; ' '�53��Steel Reinforcement- ' ' ' � � " �
_ 3: Electrical Conduii�Uiiftv-Undrgrnd. " � � ' r : � Y � i 54.� Forms � � :' ' � � � , � • �
- �-
� 4" Electrical Gonduit-Ondrgrnd' -' • ,� - � > :" � � • ,; 55� Electricsl,Bonding =� - . � - ;, � � ',
i i ;i..
5. Sfeel Reinforcem2nt' " ;�; ,. �;;�. � - _ • - E 56. Rougli Plumbing & Pressu�e Test �' •� ,a � � � � ��
s"�Elec'tricalUFER�Grnd.� x ' F� 57: APPROVALTOCOV.ER-GUNITE', . ; ',-
7. Footings - � �� � .�-' �; �` � - � � �.�58l� Electrical.�nduit=Undiar�d: ' . � •,
8. Foundation ` '"'t � - ' . . � �: `� � - '59. Gas iP.ipe �D�.�Uniirgrn8�., Tesf -' � � � ; _ �
9. !Nateh' Pipe,Undrgmil -'� , _ ' ' � - ._ "60. Backpvash Lines; P_Trep, O Undrgrnd.-` � - ' � , ; •
10. Siructural Floor System � , _„'_� " � �c ' � 61. APPROV,AL.TO�DECK ' � - , � - _ �
17. Property Sewer Line & House Connection' , ,�:� '� • . � �62. BackWash.&.Receptor-Final � � . - ., �
R
72. Sewer:Cap �'�,�'',��j . , �_,�! -� - ' 63. Weater&�VenbFinal _ � �
r
13. Roof Drains' � � � { - ' ' ' �,i ` � � �64. Plumbing SYstem - Final , � � -
14. RoughPlumbing •-�� i � � • �� ` 65. Elecfrical-Final � - - � ' �� - ��
:
- 15. Rough'Elect7ica6Conduit-�, -', --- �'- -1"° � .j '-" � - -66. Solar;Syst'em-Fi:nal- -- -� � � � -- •
16. ;Rough Electric Wiring: . � . - -' . - -- -'� � � "� . � ,67.; Fencing & Access Approva� ' � -
� -
"17. �Rough Wiring Sign_ � � . , { � �. ��. � : �. � '68.' APPROV.EO FOR P,�ASTERING � . - ' � � .
' 16.'Rougti Electrieal-TiBai Ceiling, ' � ' ' � � � ,69.� POOL/SPA SYSTEMS FINAL � '
0
19. Rough Heating &:Air Conditioning � 1 -, . i �'' I I FIRE DEPT.IREQUIREMENT _ � ,_
• - i i
�1 20. Rough Factory Fireplace � . � � ! �� � APPROVALS' ' Permif#
X'
21. �Ducts, in Structure- � r • � ' ! ' � 70.� Underground Hydro ' ' .
� �
� �22.� Duc[s,Nentilating �- � - } � � ; , � ,71. Product Piping OGas OOiI � ' . i
-23.`Gas Pi'pe-Rough ffi`T.est ? ! �� • r-� ' . � 72. Underground Flush � '
' 24. -Roof framing • ''' � � ' ' , � � � • �Z3. Undergmd. Storage Tank O Gas ❑ Oil . .
25. �Roof Sheathing � .- ,; f. � � � � � � !' � � 74.t Overhead Hydro ' � , �
26„ T-Bar Ceiling (Structurall. & Monocoat � ; � :� i = , " � � �75, Dry Chemicel � � � - '
� 27. Frame'and �Fla'shing, ^ ' , � ' � � , ;76. Dry Standpipe , ; • � .
- �
- � 28i ,Lathing & Siding �. � i i . . � 77i FIXED SYSTEM'FINAL • , -
29. .Insulatiori - � _ � , � � �78� FIRE PREV. FINA�L . �
'30. Drywall Nailing ' ,;, ' � . � , ' I ' iNotes: ' -
., : . , � . . - - - � - - ' .
31. Plaster Brown Coat�.:` � � � � � ���
32. Electrical.Power MeterFinal � , ;/�j : �� "�• ' �%
• 33. Finai Electric � � � y ; , i �
34. Final Heating & Air Gonditioning .' �j�)' _,8'3
�^
35. Final Gas Pipe�Test� ' � . � , O " ' � - • � �
36. Hood or�Canopy' `� ` � . � -� • , _ , � .
i i. i ' +
37. Final Factory Fireplace � - ' `' ' �_ ; � I - � � � �
- i � �
i . '
38. Final P�umbing � ' �� � � � i =. �' �,- '
. , � � �. � i - _ -
39. Water.Service-Final . ,� . , � � . , � �
40. Gas Service-Final � � , � � � � ! ' � ' � '
� •
� 41. Solar pomesticFinal ' ' � � I 1 _ ,',_ _ �, _, � � ' � -- + - . ' �
Y _ _ '� '
42. Backflow Preventer � � ' � ' - � - -! - _- _.- � . '
- �- �
, � � � i
43. Backflow Irrigation _ � � �' � , _: I', �. i' , � �� � � � � � , ,
44. Landscape Irrigation�System �� � .� �- �� I ` ; , � _ I � + � ,' - c ..
45. Sound Attenuation � � � i ' ' ' � . , � ' ' i ' � �
46. Handicap Regulations � � " � � '� '� � � "� � �
47. FINALSTRUCTURE&BUILDING" ' � � �LL � � � ' � �
I° i I� � � i
48. Special Requirements Completed � ' ' � � i Y i I � i � � � � ' � . - , -� .
i � ' . . � � `, ' . � , .
49. Electric Release,to Edison �, ,_ : +�_� .t _� - �_ --_-, -- -. '
' ;
50. Gas Release to $outhem Califorriia Gas Co ` ; � + � � � ! I � � � � .�'. � . ' . ' � •
51. CERTIFICATE OF OCCUPANCY " � � ' - I �� ' � . ,._ . . • ' .
�� , . . ' "7 i.,_-F l _I--r . � _i ` ` '" "' _ , ' , . .
No Date �. i _' ' � ' �
� AVP���ant to fill in all
CISY OF CASTA MESA � �ae�g iTp c
CONSTRUCTIONPERMIT I [5-(0�
� Address ,'-�,,��=r„
ArGh/Eng. ��f��S i
Address j 7/ �
Contractor ' � s ,/T",ij�
Address , 7/ �
LICENSED CONTR TOP
I neleby atfirm that am II�
ment�ng with sect n 700
ProfOssions tla, antl m7
LltePse Clas -
Date � Si9ne
WORKER ' CO P NSATIf
I hef¢by, ffir that9 nave
License No.
Phone
Within heavY boreer Ilnes ana sign aIl appropriate declarationf
j TRACT NO. LOT,NO. � BLDG. NO.
'�i ��C�' L �
c, `T=- TYPE OF CONSTRUCTION
r'7"f� xI.NEW ❑ ADD ❑ ALTERAT�ON
�� ❑REPHIR ❑CONVERStON ❑DEMOLISH
��5'/ ❑ OTHER
DESCRIPTION OF WORK
consent to self-insure or a
ance, or a cE�tifietl copy
TYPE OF PERMIT�(� /
❑ GRA�ING JTrOUNOATION �TRUCTURAL
❑ TENANT ❑ EIECTRICAL OPLUMBING ❑MECHAI
❑ OTHER
PROJECT DESCRIPTION
SQ. FT. _��� � � ���'"'
'OCCUPANCV�CONSTRUCTIONTYPE �.]LG—
VALUATION � 8 ZONE
GRADINGCV.VDS. ACRES
�YNo�/1�•n^ a, ComPa ��✓�.n:._� �+-!-iv�.
ertifietl coPy is hereby furnishetl ` qEMARKS: �
;tY Certifietl capy is filetl with the city Building Oivision.
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION
(This sectlon neetl not be campletetl it ihe permit is for one nuntlretl
SSL00) or Iess�. - � �
ce�tify that In th¢ pe�to�manCE Ot the woYk fo� whiGh this permit is
issuetl, I shall not employ any person in anY manner so as to become PLUMBING
subje« to the Worker5' Compensation Laws of California.
Date S�9�ature � - BATHTUBS
NOT�CE: It after maktng this tleclaration, you ihould hecome sub�ec( TOILETS .
to Ihe Workers' Compen5a[ion pwvi5ion5 0( [he Labo! Cotle, you must -
forth�+�th comply with sucM1 provis�ons or tM1is permit zhall be tleemetl �AVATORIES
revouetl. •
CONSTRUCTION LENDINGAGENCV KIT.SINKS - -
1�here0y a(firT that there is a construction I¢ntlinq agency to� ihe per- SERV ICE SINKS
(orm9�ce o( tne wor for which thi5 permit is i55uetl (Section 309]
Civ. C.). ��'� ,�����_ g� . FLOOR SINKS, _
Lentler's Name '
Lentler's Atltlres� �a��`N��-'/� �/ � S!`} � i - `�DRIfVKING FOUNTf
PLANCHECK
SHOWERS
URINHLS " ' ' '
DOUBLE LHVS
DISHVJASHERS'
R`D RA I NS'-
OWNER BUILDER DECLARATION INTERCEPTORS " "CLARIFIERS
I hereby aftirm thaYl�am exempt from the ContraCtor's Lic¢n5e Law for
the f011owing reason (Sectio� 7031.5 Business antl Profe55ion5 Code: SWIMMING POOL "' P TftAP
Any city o� tounty which requires a pe�mit to construct, alter,
impro�e, tlemolish or repair any structure, prior to its issuance, also re- yyqTER SERViCE ALTERATION
quire5 the applicant fo� such pe�mit to file a siqnetl Stdtement that M1e
ls IItR�seG pursuart to [ne provisions of the Contractor'S License Law GAS SERV ICE` -- OUTLETS
(Chapter 9(commencing with Sectlon�7000) ot Division 3 of Ihe
Bi��iness antl Professions Cotle),or that he is exempt therefrom antl [he WqTER HEATERS --BTU OUTPUT
Y for the allegetl'exemption. Auy violation of Section ]031.5 by
,pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - -
� �t mo�e than five hUntlretl tlollars ($500�.
❑ 1, as owner of.tM1e property,�or.my employees with wages as [heir � SOLAR�TANK '- COLLECTORS
sole compensation, will tlo the wo�k, antl the structure is not In[entletl
or offered.for ule. (Section 7�64, Business and-Professions Code: The 'SOLAR'PIPING SVS. -
Contrdctor'S License Law tloes not apply to an own¢� of a property
who puilds or�improves thereon, antl who does zuch work himsel( or- ' 'ISSUE FEE
ihrou9h hls own employ¢ez, provitletl that sUch improvement5 a�e not
intenAetl or.offa�etl.for sd�e. If, howeveq the builtling o� improvement MECHANICAL PLAN CHECK
is sold �+�lhin one year of rompletion, the owner will have t�e burtlen
of' O�oving he ❑itl not builtl or-imp�ove-far Ihe purpose of zale). HEATING SYSTEM Od00,000 BTV _
❑ I, as owner o} th¢ property, am exclusively mntractin9 with qND DUCTING -
licen:etl waVactors to mnstrutt the oroject (Section 7044, Business 100,0oo+gTU_
and P�ofessions Cotle: The Contracto�'S License Ldw tloes not appty to
an owner of property wno builtls or improves�thereon. antl wno con- REFRIGERATION 0-300,000 BTU_
tracts from such projects with a contractor(s) Ilcesnetl pursuant to SVSTEM
theCOntractor'SLicenseLaw)L' ' 100,000+BTU_
❑ I am exempt untler Section 9. & P. C. /or this gOILERS BTV �
reason
Oate O ner SVSTEMREPAIR,ALTERATION
I herePY�er at l.ryav reap this a licatio� antl state that tM1e ab ve EXHAUST SVSTEM MULTIPI.E
informati i borr,�r,t�aqtee9to co��y y�i�h all city a�tl co nty
orainan s an taJ�Jb �reYatin to co uyt�o antl hereb au� rize
Orive�S' Li�se�r 55�/j - �' � ` ISSUE FEE
CMF OB65�46 White�Bu�ltlin9; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor
`
/t!i0�1%/�� UCS�"6�
S�.r.�,�,��7 I/I�i/3.7 46C�2.7
S�kT'� ��ac- ¢— p/{//����
A.P �. if
ZONE
�'icHT..,.� 5,�„
REAR VARD (TO P/L)
PKG. SPACE REp. �
STREET WIDTH �'7r�V
CONDITI
ELECTRICAL
PLNG. REF. �
�n ��� �
-.�
{�(��/
) PROVIDE�� a,
� PARK FEE'$
�KG I.i� DATE
�1 W
� �
PLAN CHECK ,
- GENERATOR 0-1KW__1-lOKW_
TRANSFORMER
- APPLIANCE 10-50KW_SO+KW_
' ' " MOTOR$ - � 01 HP_7-10 HP _
- _ (INC.SOLAR� 1�-SpNP_S�+HP _
� ,FIXTURES OUTLETS SWITCHES
:'�j � �� • . GAS TUBE SIGNS �-
t - �POLE LIGHTS � � � � �
� ' PANELS MAIN . . �SVB �
SERVICE � AMP
._ _ • _ ""_ ' _. � � - i
; _ " _ ' ' ' _ . , �
ISSUE FEE
APPLICATION
� S/UMMAR�Y} OF FEES '• - -
PERMDIT G $ (OO.SiY .�SMIP '. S 'Z•.�� �
PIANCHECK $ PERMIT� ' � � �
ISSUANCE ,$
PLUMBING g
' GRADING S - �
�PLAN CHECK S � .
. $ t
ELECTRICAL $ _
PLANCHECK $ - MICROFILM 5
MECHANICA� g - '•' TOl"Al FEE $ - "
PLAN CHECK g 1.E55 AD- � -
VANCEPC S
FINAL FEE $ � ��+
L
CONSTRUCTION AND PLANNIN/ �. � -POOL'& SPA - ' . ' � � �'
APPROVALS Permit # -S��oY� Date Inspector APPROVALS � Permit #� � � ..�Date. � ,l _.Inspector
1. Temporary Electrical Service or Pole - 43. Pool & Equipment Loca�ion_ '� - -� ���
2. Soil ipe-Undrgm;. ., r .:" � � 44. Steel Reinforcement � � � , -
3. Electrical Conduit Utility-Undrgrn _45. Forms � � -� � � �"s�,'•
- - . >
4. Electrical Conduit-Undrgm _ 46.--Electrical Bonding - - � - � �� ��
. _ . ..... 9 ., : . .,
. tee em orce � 47. �Rau h Plumbin & PiessureTesi � � � � ` � � 1 �
6. Electrical UFER Grn '� 48. APPROVALTO COVER-GUNITE � � �� � �
7. Footings � ' � _�(„ } 49. ElectricaLConduit-Undr m ' ' - � �
� B. Foundation 50. , Gas Pipe, ❑�Undr rn, Test � _
9. Water Pipe-Undrgrn ' �51. _ Backwash� Lines P-T�a ❑ ndr rn �
10. Structurel Floor System 52. APPROVALTO DECK � '� - -
11. Property Sewer Line & House'Connection ' 53. � Backwash & Rece tor-Final . �� �
72. � Street Sewer Connection - � ' � � � - 54. � Heater & Vent-Finali � '
13. � Rough Blumbing � - ' • ' - � �
14.- Rough Electric-Conduit - � � � ��56.� Elecfrical-Final � � - .
15. Rough Electric-Wiring - ' � 57. Solar System-Final -
76. Rough Heating & Air Conditioning - • F.encing & Access-Approval • -
17. Ducts, in Structure � - 5. APPROVED FOR PLASTERING .
18. Ducts, Ventilating ' � - � - - � '
19. Gas Pipe-Rough & Test � � . 60.. POOL/SPA SYSTEMS FINAL�
20. Roof Framing - � - � -- �- � �
21. Roof Sheathin - - - � � . , . , , , - .
22. Frame and Flashin � �.2�, . . NOTES: ' . � . � � �
23. Insulation ' -( -� �p�,% it�o7` oc�i a� ko%.ar-�M/ w �
24. Lathing & Siding " - - � - "' " ' '�
25. � Drywall Nailing �- ,}i ' - � �
26. Plaster Brown Coat � � �
27. � Electrical Power Meter-Final � - ' � "
28. Final Electric - � � �
29. . Final Heating_& Air Conditioning - � ' � �
30. Final Gas Pipe-Test �
31. . Final Plumbing � ' ' .
32. � Water Service-Final ' - �
.33: � Gas Service-Final - - � ` �
34. Solar pomestic-Final � ' � � • - '
35�. '-Landsca e S rinklin S stem� �
36. Sound Attenuation ' ' ' - - � '
37. Handicap Regulations � - � � -
38. FINALSTRUCTURE&BUILDING � � �4
39. Special Requirements Completed �(a�33 G�fJ"
40. Electric Release to Edison �
41. Gas Release to Southern California Gas Co. -
42. CERTIFICATEOFOCCUPANCY �
. •No Date
�! AOplicant to lill in all spaces except those within �eavy Eortler lines anE si9n all a0V�o0riale Ceclarations.
CITY�F COSTA MESA CONSTRUCTION PERMIT PE TRACT NO. LOT NO. UNIT NO.
Project Address ��$
Applicant'sMailing�]dress � �������,���
Owner's Name S G Phone
Address ����-p�
Arch/Eng. License No.
Address
Contracmr's Nam� Php�e/
Addresslma'I� gl� � � �
Ciry Liceese Ne. _ -3�
LICENSED CONTRACTOR DECLARATION
I hereby affirm lhal I am licensetl untler provislons of GM1artar 9(commencing
wilM1 seclion J000) ot DIvi5lon 3 of tne Busine55 antl Prote55iOns Cotle, and
my license is in full t tl e(tecL p
Licens il ' e N
�ate Signature
WORKERS'COMPENSATION DEGLARATION
� hereby afti�m inat I have a Certifitat¢ of consent [o self-in5ure or a certiticat¢
d Workers' �C/%ompensation �Inys.uran[e, or a ce�tlfietl copy thereot- ($-e0ction
3800, lab. /N�/J � U- k' i �(•j� ��/(�
Policy No. �� Company :2/la( L
ertifietl copy is nereby furnishetl.
Cer[� 'itl py � filetl with the city i ing��y�jOn�� /
�ate �� Applicant -� � � �/�
EXEMP ION FROM WORKERS' GOM ATION ECl RA ON
(This section need not be mmpletetl il the permit is tor one huntlretl ($300) or
less).
I<ertily that in ttte perto�mance ot tM1e work fo� which thfs pe�mi{ is i55uetl, I
snall not employ any peRon in any manner so as to become subject to the
Workers' Compensation Laws o( California. '
oate Signature
NOTICE: If, after making this tleclara[ion, you shoultl become subject to the
Workers' Compensation provisions of the Labor Cotle, you must forthwith
comply wilh such provi5iOn5 or tltis pe�mit shall b¢ tle¢metl �evoketl.
CONSTRUCTION LENDING AGENCV
I nereby alfirm that there is a construction lentling a9ency tor the performance
ot ihc wark for whiGh thi5 Permi[ is issuetl (Settion 3097 Civ. G.)
Lentler's Name
�en0er's Atltlres5
OWNERBUILDER DECLARATION
I hereby affirm Lhat I am exempt trOm the Conlractor'S LlcenSe �aw for the
following'reason (Settion 7031.5 Business antl Professional Cotle: Any tlty or
Counly wnich requir¢5 a Dermit t0 cOnstrutt, dlter, improve, tlemolish or rCpair
any sVucturo, prlor to its issuance, also reqWres the applicant tor such permit
to tile d signetl Stdl¢ment thd[ he/she i5 licensetl puf5udnt [o the plovl510ns of
lne Contractor'S License Law (Chapter 9(commencing witn Secllon ]000) of
Division 3 ot the Business antl Protessions Code) or lhat he/she is exempt
Iwrefrom antl the basis for the allegetl ¢xCmption. Any viOlation ot Sectlon
]031.5 Dy any applicant for a permit subjecls Iha appllcant to a civil
�enalty of not more than five huntlretl tlollars (E500�.
LJ I, as owner oi the property or my employees wlth wa9es az thoir sole
CompenSation, will tlo th¢ wo�k, antl [ne SL�uCtU/¢ i5 not IntenGetl o� offe�¢tl
for saie (Section 7044, Business and Professional Cotle: The Contractor's
LiGense I.aw tloez nol aOP�Y to an owner of a property wno builtl5 Or improve5
thereon, antl who tloes SUCh work himselt/hCrsClf o� lltrough hi5 or he� own
employee5, proviGed thd[ such imprOvemen[5 ate nOt intentletl Or ofteletl for
sale. II, howaveq the UuIlEing or Improvement i5 Soltl within One year of cOT-
pletion, the owner will nave tne burtlen oi proving he/sne aia not builtl or Im-
nrove tor the purpose ot sale).
❑ �, as owner of the property, am exclusively con[racting with licensed con-
Vactorsto construc[the project (Section 7044, Business antl Profe55ions Code:
The Contractor's License 12w does mt apply [o an owner ot property who
builtls or improves thereon. antl who contracts for such oroiects with a r.on-
tractor(sl Lcense pursuanc to [ne ConVactor's License Law). i am aware that
prooi o� tneir Worker's Compenzatlon insurance shoW� be provitletl to me.
❑ I am ezempt untler Section B. & P. C. tor this reason
Oate Owner
I hereby certify that 1 have reatl this applicatlon antl state that the above
Information Is mrrecL I agree ro como�Y wrth all city antl county orainances
and state lawz relating to builtlin9 mns[�uction, antl he�eby au[horize repre-
Sen[atives ot this cily to enter upon Ihe abov¢�mentiOnetl prope�ty for
inspec[ion Ou 5.
Signature Date_Q_/.?7f�
Drivers' License ar 55 � �
�/ D � � /� A.P. #
T T
S Main Buildi
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR E
❑ CONVERSION ❑ DEMOLISH ❑ OTHER • T FrOnt
DESCRIPTION OF WORK/USE OF BLDG. A Rear
TVPEOFPERMIT GaADiNG�OUnonrlorv STRVCruaA� I C Right
❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL g left
❑ �OTHER � Ping. Ref. #
PROJECT DESCRIPTION 5(]. FT. OCCUP.aNCV pianning Notes:
CONSTRUCTION TVPE VALUATION 5
ZONE GRADING CU. VDS. ACRES
Remarks:
Bar Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
GasService Outlets
Kicchen Sink
Lavatories
P-Trap
Roof Drains
Reinspection Fea $75
M
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blc iC80 #
Heating System & Ducting
❑0-100,000 BTU �100,OOOBT
Reinspeetion Fee � $15
0865-46, rev. 5/88 Wnite - Builtling; Canary - Applicant; Pink - Acmunting; Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solac Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Issue Fea
Hood or Type I ❑
Canopy Typell ❑
Refrigeration System
❑0-100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
FEES Automatic Washer
Construc[ion Pole Sub.
Cooking Unit
Dishwasher �
Dryers ❑Gas• QElectric
Fan
F.A.U.
Fixtures '
Device Boxes
Ou[lets
Zone
Accessory
Parking Req./Provitled
ELECTRICAL
� Transformer ❑ 15-50 KW
❑ 50+KW
Garbage Disposal
Genereror �0.5 KW 05-15 KW
Meter ❑up to 700 amps
Meter ❑overi00amps
Sub Panel
Motors �0.1 HP 07 X- 8
Inc.Soiar �9-15 HP �i6-15+
Microwave
Pole Light
Range
Sign
Standing Sections
Trash Compactor
Fee �$15 � � luue Fee
S 3 DEVELOPMENTSERVICESRE�UIREMENTS:
2oning Approved By
FEES Building Approved By
�� APDlication Issued Bv_ �
$ 3
N
I
N
G
H
E
U
M
T
S.
FEES
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ ERMIT
PLUMBING $ — �D�SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRADING $
PLANCHECK 50% $ MICROFILM $
MECHANICAL $ 70TALFEE $ �
PLAN CHECK 25% $
�i CD^4?ZOb—it3�43^<9'> �:5� _
9�.TE: C7/�E;�° T�i9�c G;:;c
. ;
:,
CONSTRUCTION AND PL�ANNING ` PO(,, i SPA
Date Inspector Date Inspector
; APP�iOVALS Permit# APPROVALS Permit#
1. Temporery Electrical Service or Pole � 52. Pool &�Equipment Location
2. �Soil Pipe-Undrgrnd. - . 53. Steel Reinforcement
3.. Electrical Conduit Utility-Undrgmd. 54. Forms
<�4� Electrical Conduif-Undrgrnd. ��� 55. Electrical Bonding
5�.'Steel� Reinforcemeat� 56. Rough Plumbing & Pressure Tes[
i . �
6..•Electrical UFER,Grnd. 57. APPROVALTO COVER-GUNITE �
7..Footings , ' . � / 58. Electrical Conduit-Uncirgrnd.
B�Foundation �. '� ' 59. Gas Pipe, O Undr�rnd., Test
.
9.� Wa"ter Pipe-Undrgrnd.; • , 60. Backwash Lines, P-Trap, � Undrgrnd.
10. St�uctural 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 Sysrem - 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
.1'8. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
-1,9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ 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 e 77. FIXED SVSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37�Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes:
34. Final Heating & Air Conditioning �
35. Final Gas Pipe-Test �
36. Hood or Canopy
37. Final Factory Fireplace
38. Final Plumbing - 3 �Q (��
39. Water Service-Final '• ;
40. Gas Service-Final
41. Solar pomestic-Final: )
42. Backflow Preventer ,� : t�
43. Backflow Irri9ation ' \ .
44. Landscape Irrigation�System � •
45. Sound Attenuation ,'-� �
46. Handicap fiegulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison ,�;.,
50. Gas Release to Southern California Gas Co ��� ti i
51. CERTIFICATEOFOCCUPANCY / _
No. Date ,,� �
OWENS-CORNING
Fiber�las a��� �AP�
Build�ng Insulation � v���
The contractpr named below certifies that the Owens-Corning Fiberglas
Building Insulation used carries the NAHB Research Foundation, Inc.
label for assured thermal performance and that the Building Insulation is
installed in conformance with current energy conservation regulations,
California Administrative Code, Title 24, State of California, in the building
lo 'ed at:
%louTE l'O>rn I�IPsq GOT 8
Address City Trect Number
Exterior Walls
Owens-Corninq Fiberqlas Type3ATTS Insulation
Ceilin s
Owens-�orninq Fiberqlas Type�9'7� Insulation
f� �-15
Thickness R-Value
�z 2-� y
Thickness fi-Value
Floors
Owens-Corninq Fiberqlas Type Insulation
Thickness R-Value
F ndation Walls
Manufacturer Type Thickness R-Value
General Contractor License No.
By Title Date
�sls�awre / � /1
Insuletion ContraCtoi�� n��Po� �i^'� License No..�08�3 O
gy �-�"M �QQ�-- 7itle � Date� /� g3
Islam� e�
Homeowner Copy (White) �
State Copy (Yellow)
Builder Copy (Pi�k)
OWENS-CORNING FIBERGLAS CORP.
Pub. No. t&BL-8H85-B �nsulation Operating Division
iircro��us.�.,d.n.,�se,+ CupyrqmeeBezorerro-CorrmpFieerp�aatoro. Fibefg183TOwer,7oledo,O�io43659
OWENS-CORNING
Fiberglas
Building Insulation
The contractor named below certifies that the Owens-Corning Fiberglas
Building Insulation used carries the NAHB Research Foundation, Inc.
label for assured thermal performance and that the Building Insulation is
installed in conformance with current energy conservation regulations,
California Administrative Code, Title 24, State of California, in the building
lo� d at:
Mowr� ✓esrn L�asra i�ks,o ,(pT' �
Address Ciry Tract Number
Exterior Walls ,
Owens-Cornincl Fiberqlas Type_�A�SS__ Insulation �i/z �
Thickness R-Value
Ceilin s
Owens-�orninqFiberqlasType_�L'ilnsulation 6jz p.�
Thickness R-Velue
Floors
Owens-Corninp Fiberqlas Tvpe Insulation
Thickness R-Value
ndation Walls
Manufaclurer Type Thickness R-Value
General Contractor
ey
,s�s
Insulation Contractor
By
Homeowner Copy (White)
State Copy (Yellow)
Builder Copy (Pink)
No.
OWENS-CORNING FIBERGLAS CORP.
r�e. Ho. �e-e�-esss-e Insulation Operating Division
umo m us.�., a.�., isez coor�ro�� ���� ow.m-co�mny F�ee�eia� Co.n. FiDerglas Tower, Toledo, Ohio 43659