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Home My WebLink About1207 PARNELL PL - Building Permitss' CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT c j PERMIT PERMIT NUMBER �°b a E98-00768 (714) 754-5273 • Fax (714) 754-4656 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1207 PARNELL PL Suite No Vicinity: Parcel Nunmber: 14104610 Applicant: GANEY, KAREN Address: Owner: Address HUN' Contractor:i ._ i Address:// LO, CARL %,• � fir;, ,;. ELECTRICAL PERMIT Phone: 714-751.8224, Zip: Phone:-� Zip: 92649 I; - Phone,'' -; r ,Zip: _ \ - i, � :License: _ SCOPE OF PERMIT 'REF B98-01 113, INST 2 RECPT, 1 DISHWSHR, 1 KIT SINK, 1 GAS PIPE OF 2 OUTLETS, 1 ' REPAIR DRAINNENT PIPING i ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) '\ Pool / Spa, , ' Lighting Fixts Recept Outlets Switches Non Res Appl•,��, Res Appl Service to 200a Service to 1000a ' Service over 1000a Motors to 1 hp - Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole FEE SUMMARY Quantity , - - - 1' i $22.00 $0.00 $0.00 $0.00 0 $0.00 0 $0.00 0 '`$0.00 0 \$2.00 2 $0.00 0 $0.001. 0 -x$0.00,-0 "x,$0.00-, 0 $0.00 0 $0.00 0 $0.00 0 _ $0.00 0 '$0.00 0 $0.00 0 $0.00 - 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 _Temp Dist System / Lighting Busway /100 ftp Standing Section Misc Electrical Equipment Transformers up.to 1 kva/kw ................up to 10 kva/kw ......... to 50 kva/kw .......::........up to 100 kva/kw .........-..........over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt 'Misc.-Conduit Misc. Conductor - _ Circus (gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Status: ISSUED Applied: 07/20/1998 Issued: 07/20/1998 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00' 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES $24.00 COMMENTS / SPECIAL CONDITIONS u 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 authodzed under this permit to be considered legal, such work must comply with all applicable codes,,,aand all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this ppefmit FOR INSPECTIONS CALL: (714) 754.5626 V y DECLARATIONS T&TRIM 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: Cartier: Policy Number. (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this pemlit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply With these provisions. Applicant Signature: Data: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,00)), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full lone and effect. Lic. M Class fl Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 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 contract s License Law does noy apply to an owner of property who bullds or Improves thereon, and who contracts for such project with a conlractor(s) license pursuant to a Contractors Licen a Ws.). I am axe S4CA iness and Professions Code for This reason: ignature: Date: t^l— Owner ID verified by rivers license. es ❑ No Drivels 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 certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, 1 will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 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 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). ........................................................................................................................................................... i*s.k'.......a, ge,.......................e-nti.......rogr...............utel.......................aterials ? 3 Does or will the applicant or present or future building occupant need to prepare en RMPP (Risk Management end Prevention Program for acutely hazardous matenals)7 ❑ Year ❑ 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 requiretl, has Section 25534 of the California Health and Safety Cada 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 as plication a ermt for such construction or modification from the South Coast Air Quality Management DlstdCt or from any other air pollution control district or agency? Yes NO (Section 65650.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 WIII any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it '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 application, have all o1 the disclosures prescribed by California Health and Safety Code Section 42303 been made ❑Vas ❑ No .................................................................................................................................................................................................................................................................................... 8 (if "yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFlCATE O COMPLIANCE AND AL�RI7ATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is corect. I agree o comply with all stale. laws end city ordinances relating to building construction, and authorize representatives of the Clry of Costa Mesa to enter upon the above -des bd roperty for inspedi p p sea. I gree not to occupy or allow occupancy of any building authorized by InITI.I until final inspection. Sifrifildrig Of Legal Ow r(s) Dale And/Or Authorized Applicant Date CODE 0. INSPECTION TYPE Cdg 9i1111A65 CODE 1 INSPECTION TYPE gAIE I611DSL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing _ /J A 200 Final Re -Roof 210 Final Electrical Z Z 2 201 Final Block/Fletaining 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 2"6.46 (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1207 PARNELL PL Suite No Vicinity: MASTER BEDROOM/BATH Parcel Nunmber: 14104610 Applicant: GANEY, RICK Address: 1207 PARNELL PL COSTA MESA, CA PLUMBING PERMIT Phone: 714-751-8224 Zip: 92626-2737 Owner: GANEY, RICHARD L & KAREN M Address 1207 PARNELL PL Phone: COSTA MESA, CA Zip: 92626-2737 Contractor: OWNER -BUILDER Address: Arch / Eng : Address: Phone: Zip: License: 0 Phone: Zip: License: SCOPE OF PERMIT 136 SF EXTENSION OF A MASTER BEDROOM/BATH IN AN EXISTING SFR. I BATHTUB, 1 WASH BASIN, 1 WATER CLOSET. REF: B01-00610 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 Status: ISSUED Applied: 05/04/2001 Issued: 05/04/2001 ISSUED BY: QTY AMT FEESUMMARY 0 AMT QTY 0 AMT ISSUE FEE $23.50 - " . Laundry Tub / Washer $0.00 Backflow irrigation $0.00 0 - Landscape Irrigation $0.00 Backflow Preventer $0.00 0 P -Trap $0.00 Bathtub $9.80 1 Pressure Regulator $0.00 Clarifier System $0.00 0 Process Piping (per 10 ft) $0.00 Connect (Ice,Soda,etc) $0.00 0 Receptors $0.00 Dental Units $0.00 0 Septic Tank $0.00 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 Drain, Floor $0.00 0 Sewer Connect $0.00 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 - Drain, Roof $0.00 0 Shower $0.00 Drinking Fountain $0.00 0 Sink, bar $0.00 Expansion Tank $0.00 0 Sink, commercial $0.00 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 Gas (14 outlets) $0.00 0 Sink, kitchen $0.00 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 Gas Service $0.00 0 Spa (public) $0.00 Interceptors (Grease, Oil) $0.00 0 Interceptors (Sand Auto ) $0.00 0 Status: ISSUED Applied: 05/04/2001 Issued: 05/04/2001 ISSUED BY: QTY AMT QTY 0 _ - , Sump Pump $0.00 0 0 - Swimming Pool , $0.00 0 0 Trap Primer $0.00 0 0 Urinal $0.00 0 0 Vacuum Brkr Bkflow(1-4) $0.00 0 0 Vacuum Brkr Bkflow(5+) $0.00 0 0 Wash Basin $9.80 1 0 Wash Basin Set $0.00 0 0 Waste and Vent System $0.00 0 0 Water Closet (Toilet) $9.80 1 0 Water Heater / vent $0.00 0 0 Water Piping (Inst or Rep.) $0.00 0 0 Water Re -pipe $0.00 0 0 Water Service $0.00 0 0 Water Softener $0.00 0 0 OTHER $0.00 0 VIOLATION $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 0 TOTAL CALCULATED FEES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if w for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply, required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result In FOR INSPECTIONS CALL: (714) 754.5626 2446.66(&00) and related orabandoned ith all applicable codes, and all the expiration of this permit. C 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 workerscompensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Cade, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carder: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars (5100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Cade, I shall forthwith comply with these provislons. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. q Class 8 Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her Own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law deas not apply to an owner of property who builds a( Improves thereon, and who contracts for such project with a contractor($) license pursuant to the Contractors License Laws.). ❑-�I am exempt d sec.�— Business and Professions Code for this reason: signature:+Date: S-4� Of O neclD verified by driver's license. ❑ Yes ❑ No Driver`l�Ocense,No. _Expires: Verification of Ownership by (type of(document, i.e. - property tax bill or deed): J - 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 Cade 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 pro ssure). ....................................................................................................................ildi.............................................fits........................................................................................... ......teri...... ......... ........................................................... .............................. 2 Does or will the applicant or present or future builtling 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 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 a�plication apermit for such construction or modification from the South Coast Air Ouality Management District or from any other air pollution control district or agency? LJ Yes LJ NO (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........................................................................................................................................................................................................................................................................................................................................................................................ 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Vas ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ........................................................................................................................................................................................................................................................................................................the.............................................................................. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district n agency is requiretl 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 ...........................................................................................ce.......-...........................-ria.................................................................................... ............................ ........... ............... .......... ....... ................................ ............. ...................................... 8 (If "yes", attach certificate 01 compliance Irom 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 co with all state laws and city ordinances relating to building construction, and authorize representatives of the City Of Costa Mesa to enter upon the above-described pr for ins tion purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. K__ Signature—Of Legal Owner(s)1 1r^� �— DateJ AndlOr Authorized Applicant \ \\' Date CODE 1. INSPECTION TYPE PATE IBTUJ IAL@ CODER INSPECTION TYPINTRIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Well 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 1207 PARNELL PL MASTER BEDROOM/BATH 14104610 GANEY, RICK 1207 PARNELL PL COSTA MESA, CA Phone: 714-751-8224 Zip: 92626-2737 Owner: GANEY, RICHARD L & KAREN M Address 1207 PARNELL PL Phone: Contractor: Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole COSTA MESA, CA OWNER -BUILDER Zip: 92626-2737 Phone: Zip: License: 0 SCOPE OF PERMIT. 136 SF EXTENSION OF A MASTER BEGDROOM/BATH IN AN EXISTING SER. 6 RECEIPT OUTLETS, 2 SWITCHES 1 4 iCU Ti REF: 801-00610 $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 54.40 $6.60 $2.20 $0.00 $000," $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 MIX) $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 0 0 0 4 6 2 0, . 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway /100 It Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ..........:.....up to* 10 kva/kw .................up to 50 kva/kw - ................. up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment " Low Volt Wiring System /"Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (meth ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 05/04/2001 Issued: 05/04/2001 ISSUED BY: Quantity, - $0.00 0 $0.00 0, $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 ; 0 $0.00 0 - $0:00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 $36.70 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is susl for a period of 180 days. J/� INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with ail �-appl required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiral FOR INSPECTIONS CALL: (714) 754-5626 and related or abandoned de codes, and all of this permit. I DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: ~ (This section need not be completed if the permit is valued at one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, 1 shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. N Class k Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affix i that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). jI; 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 contractors) license pursuant to the Contractors License Laws.). n R/I am axe t der sec Business and Professions Code for this reason: ,Signature, —,r fi Deter— 4 t9/ y "Owner ID verified by driver's license. �f,Ves ❑ No Drivers License No. � Expires: Verification of Ownership by (type oidocument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 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). ........................................................................ .......................................................... .... ......................... 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 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................................................................................................................................................................................................................................................................................................................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this implication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 ofthe California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........................................................................................................................................................................................................................................................................................................................................................... 6 Will any part of the facility to be constructed under this permit be within 1000 foot from the outer boundaries of a school?..... chool? E]Yes ElNo (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ...............................................................................................................................................................................................................................................................................................................................................................................I............ 7 It a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes [:1 No ...........................................-..........................................................................................................................................._........................................ ........................................................................................... ............. .................................................. 8 (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the Information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comp) wi all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described proonspecti rposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. l_7 —T -- Signature Signature O1 Legal Owners) Date And/Or Authorized Applicant Date CODE E. INSPECTION TYPE DATE IWITIRLS CODE ♦ INSPECTION TYPE 2AX INITIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing n �n 200 Final Re -Roof 210 Final Electrical �cf �,1 V� RN6 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy CITY OF COSTA MESA 4 BUILDING DIVISION t � DEVELOPMENT SERVICES DEPARTMENT �� PERMIT PERMIT NUMBER P98-00577 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 1207 PARNELL PL Suite No Vicinity: Parcel Nunmber: 14104610 Status: ISSUED Applied: 07/20/1998 Issued: 07/20/1998 Applicant: GANEY, KAREN Address:- r;��..� -Phone: 714-751-8224 Zip' - Owner:PALAZZOLO, ARL CARL- Address Address1,16449�LAZARE' i Phone: -HUNTINGTON.BEACH,CA Zip: 92649 ,Address J ' y' Y_ I Zip: \ - i• , /", - - License` ,. ,. Ar'chIEng : Address: Phone , ' -Zip ...,. _._.. , License: 'kOPE OF PERMIT '. REF B98-01113, INST 2 RECPT, 1 DISHWSHR, 1 KIT SINK, 11bAS PIPE OF 2 OUTLETS, 1 -" REPAIR DRAINNENT PIPING FEE SUMMARY - A �� \/AMT QTY AMT QTY AMT QTY ISSUE FEE,",, `, / $22;00, Laundry Tub! Washer $0.00 0 Sump Pump x$0.00 0 Backfow irrigation $0.0011, 0 Landscape Irrigation - $0.00 0 Swimming Pool $0.00 0 Backflow Preventer -, $0.001 V`.0 P -Trap„ ��- < <..r ,- '$0.00 0 Trap Primer - '$0.00 0 Bathtub A" `�� $O=X0� '0}s-..,. � � - Pressure Re - d -' .,$0.00 - 0 . - ' � -Urinal $0.00 0 Clarifier System.? \ $0.00. 0: z(�' Process 'Piping.(per 10 ft),;, $0.00- 0 _ - Vacuum Brkr Bkftow(1=4) $0.00 0 Connect (Ice,Soda;etc), C$0.00 Receptors t ,_ ,_ $0.00 0 Vacuum Brkr Bkftow(5+) $0.00 0 Dental Units . ,. $0.00 %/.0_ - Septic Tank- -' $0.00_ _ 0' - Wash Basin $0.00 0 Dishwasher , $8.75. 1 -� �, Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 .0 , Sewer Connect .. $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater ' $0.00,., '0, Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Drain, Roof $0.00-,, 0 Shower ., $0.00 0 Water Heater/vent $0.00 0 Drinking Fountain $0.00., 0 ' : Sink, bar $0.000 Water Piping (Inst or Rep.) $8.75 1 Expansion Tank $0.00 Sink, commercial', $0.00 '0 Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor,. , .$0.00 0/ Water Service $0.00 0 Gas (1-4 outlets) $5.50 1 Sink, kitchen $8.75 1 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: $53.75 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 perm 7 FOR INSPECTIONS CALL: (714) 754-5626 1 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. ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Cartier: Policy Number: (This section need not be completed i/ the permit is valued at one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($t00,OW), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3/06 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Uc. N Class a Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Data: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects .applicant to a civil penalty of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contrqctors License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pureuan o the Contractors LJc ns Laws.). ❑ lam exam t r ec Business and Professions Code for this reason: igneture Expires: Verification of Ow ership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, Califomla Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic teat of compressed gas at standard temperature and pressure), .. ................................................................................. I .............................................................................................................. 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? []Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ................................. ......................................................................................................................................... .......................................................................................................... 3 Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ......................................................................................................................................................................................................................................................... 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Cade 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 plication apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 8 Yes 8 No (Section 65850.2 of the California Government Code requires that the requested information be fumished on applications for non-residential building permits). .................................................................................................................................................................................................................................................................................... 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ 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 Ouality Management District or other air pollution control district or agency is reqquired 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 ❑Vas ❑ No .................................................................................................................................................................................................................................................................................... 8 (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 F COMPLIANCE AND ORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I ogre to comply with all stat I I sand city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above -de cn d lo� for inspec fi rposes. I agree not to occupy or allow occupancy of any building authorized by this permit til final inspection. "n-aRfire-Cfi Legal Ow ris) Date And/Or Authorized Applicant Date C92LL INSPECTION TYPEDATE ILRIDALS CODE l INSPECTIONTYPE MATE RQmAIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 71 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 . Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 244646 y ADDRESSOPBUILDIRG: 1207 PARNELL PL OWNER'SNAMEIEIOKIWN: PALAZZOLO, CARL ADDRESS 1207 PARNELL PL COSTA MESA,CA ADPL. MAII.NG ADDRESS: ARCNWECTORENNNEER: ARCIL OR ENI ADDRESS: 92649 UNIT: FLOOD: X 46 UC. NG: CONTRACTOR'S HI ME: CONIRACTOWSMUUNG AOORES3: M. NO.: UNIT: UNIT: LICENSED CONTRACTORS DECLARATION: I hereby aRim under penalty of perjury Ihat I am licensed under provisions of Chapters (wermerwrst Win Section )000) of Division 3 of the Bumirw. and PMmsionm Code, and my litems is in full force end effect. CITY LIC. NO.: LIC. CLASS: LIC. NO.: EXP: Deli. Connector: OWNER BUILDER DECLARATION: I hereby affirm under pemly d parjury that I am exemq from the Conimctae license Law for the idowing reason (Section 7031.5 Summa and Professors Code: Any city or county Which reforms a permit to construct, after, improv", iemol'sh, or rapes any struclure, prior to its Issuance, also require" the applicant for such puma to Rb a signed mmmm m that he or end licensed pursuant to the prossions d the Contractors License Law (Chapter 9 (commencirq with Section 7000) of I inion 3 of the ,users. and Professions Cada) or the M or she ls eaemq theratrom and the basin for the alleged exemption. My violation of Setlon 7034.5 by any applicant fa a Perms subjects the appfranl to a civil partalry of rest more hum We hundred seats ISS001). I, m owner of the property or my employees win wages as their site compensdim, dll do IM work, and the structure Is net intended or offered for sale (Section 70,14, Business and Proimstons Code: The Cwtrmm License Law dose nit wptylow bwrerd propemy win builds or in fcs thereon, and who doer such iewk himself w to hell m through he or her own employees, provided that such imprwem mm are M intended or offered for sale. ff, however, the building or recommitment is cold within are year of complai m, the owmrbuider Will haurdd pr ve the ben ovirp M ey site did nit Wo ind irruptions d se prove la the purpose c). I, m owner of the property, are exdmivdy contracting with licensed contractors to construct the project (Section 7000, Business and Professions Code: The Contr"cian _cense Law does cot appy to an owner of property who Wilds or imptovm thereon and who contracts for saw projects With a ooMrmo(m) licensed punumt to the Contractors License L.W. 1 and exemq under Section: B. & PC., for this reason: Date: Cher I do hereby certify that I an aware of and understand dm requirements of Csttlomla )matlh and Salary Code Sections 25505, 25533. and 25530, end that 1 or any Mum Wildim oosrpent will f wit not (circle one) need to comply with said stele codes and the requraments for a permit fes construction or modification train the Air u�ty emgement Disinct. eeidenlial construction applications are exemq icons these Data 4' v - f ✓ ApgiaM: WORKER'S COMPENSATION DECLARATION: I thereby affirm under parody of perjury aro of the to"Iixi ng dwaraton Ihereandwillm Mstnaconifiratadwn.nitoseff4nwmfmW m'compansellon,m Wov foby Sedan3700dtMLabor Cada, for the pedomance of the Work for W ri this pemN is issued. I have and ail mailman waken' ed. My W ion insurance, m required ny cane 3)00 xi Ues Labor Cade, ler tM pedamanca d tM we* for which this pests o issued. My waken compensation insurance career end policy number an: Carrier: Policy Number. (This motion need net M completed f the perms is h, one hundred dollars /$tool or fa..) I cantly that in the pedormence of the work M which this perms to issued, I mall nit employ my person in any manner so at to become subject to the Wmrkera' compensation laws of Caldonia. sural agree Uul ff I should becerna subject to the WOMts' wmparead. provisos of Section 37M of the Lobo Code.1 most forthwsh comply with dose provnimw. Dale: AptAicam Werelesi Fellum As secure wormns compamedon covecege Is unlawful, and pull tus t an amployec to cdm'na/penadiss and ofd/ dress W m ono hundred thousand ddlare (SIOGOW), M adddlen le the east et rompansetfen danwp"a As prey/dad ler In Settlor 37M of Me LeEor Code, Interest, and attorneys Amass CONSTRUCTION LENDING AGENCY: I Mreby aXsm undo penalty of perjury Ihat there he a construction lending agency ler the perform. ofthe Worn for Which the permit Is issued (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy test I ave rand this apgesmion and mate that the above information Is coned, l agree to campy With all city and county ordineresee vd men laWiyat iM to WiMip cormm�dion and Mroby authorize repr.entstivea of he city to enter upon the ebova mentioned property for inspectror/gdNIases. 1.0— r% — q -, I `r I Simmina of CmedAgmUAppp5&nVConlmctor // I (515146.WP) Whits -Buildup 8 Sdery; OmrmFle; Conary -Applicant; Pink -Revenue; Gaelmd -As. CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 072696 PERMIT NO: B 072696 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : INSTALL VINYL SIDING ICBO#NER102 SQ FT: 2,500 CLAIM VALUE: 2,500,00 CALL—VALUE: 2,500.00 GROUP OCC: R-3 / COMMENTS: SMOKE DETECTORS REQUIRED PER 91UBC dE if iE dE iE dE dE lE dE dE iE dE dE dE dF dF lF It lE dF df*�*SIE iE iE kiE iE dE iF iE did ih iE iE AE StiE �r�aE�r �E itkiE�SEx�t iE�EiE iE��E�E �r ie�Eitat�Sr��PiE�E�E �P �E*iEiEiF Z 0 N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 14104610 ZNE: REF NO: PLANNING NOTES> > * 1E 1E * * * iE dE 1E dE dE * * dE 1E dE iE 1E lE dE iE 1E iE ♦E 4 * dE 1k %df * dE dE dE dE iE iE dE iF iE * If iE dF ib iE IE dE * dE dE iE 1E iE * iE dE iE dE * dE iE iE iE iE iE dE * iE dE oft dE iE iE iE dE iE if 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY BUILDING APPROVED BY ICAT DATE: DATE: 0XV0 iF dF * iF oft dF iF iF 4 fi 1F dF R eF iF dF ie iF iF rt ib eh ih dE dE eb eF ib iE iE iE iE iF iF * iFiF iF iF iF * dF iE * iE M * iE iE IF * if-iF iF if3f iFiE iF IE iE IE iE ifs ii 1F iE��{F1h ih LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 54.00 .50 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 54.50 0.00 0.00 54.50 54.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 54,50 OVER/SHOAT:00 BLDG P00 PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOO GRADING PLAN—CHECK **dEdl ii ib iEkklEkklFkkdFk*IE if if klE if iE iF dE*did*dF dE dE db iElE iE df dE dF did iE dE dE dE dE lFkklFkiFdE*4dt dE lE dflflE dF iP dE iE fir dE ilk dE dl dE dE lE IE dEk dE dE d! 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 2500 ALTER BY VALUE RESIDENTIAL .NOZONE 1,00 2,500.00 END OF FEES til 0101335?2-00183593 'TrIT 54.50 OA7E: 06136/95 ilfiE: 09:54 s CONSTRUCTION AND PLANNINGPOO, - iPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement '<I 'Electrical Conduit Utility-Undrgrnd, 54. Forms _�4:"�iectrical Conduit -Undrgrnd, 55, Electrical Bonding 5t'Steel Reinforcement 56. Rough Plumbing & Pressure Test ;Electrical UFER Grnd, 57. APPROVAL TO COVERGUNITE ,,,-.7-. Footings 58, Electrical Conduit-Undrgrnd. ' Foundation 59. Gas Pipe, 17 Undrgrnd., Test ' 9 Water Pi e-Undr, rnd. P 9 p, ❑ Undrgrnd. 60. Backwash Lines, P -Trap, ' 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 11 63. Heater & Vent -Final .1.3. Roof Drains 64. Plumbing System - Final U:4. 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. POOL/SPA SYSTEMS FINAL 19. Rough Heating &Air Conditioning FIRE, EPT.,,REQUIREMENT -Q APPfOV,ALS,h Permit # 20. ,Rough Factory Fireplace ':_ r. r - '' 21. in=Strdcture '• " `" - '? ''' 70.'Undergrougd F}ydro' _Ducts, ,- � ,-, C, 22. .Ducts, Vientilaiing,� is s _ `L. ;, 71. Produe ,Piping QlpasQil 23. Gas Piper_Rough & Test :Ta t� t-! y: - 72, Underground Flus"h� ' T� 24. RooFFriimng•' F'= .. -'� l �; `. 73, Undergmd.Storage.Tank0Gas ❑Oil _ ,r 25. Roof Sheathing _ 74' 'Overhead Hydr6 •' r 26. T -Bar Ceiling (Struofural) & M6nocoat .y 75: Dry Chemical �- '" -• '!' 27. -frame and Flashing. pv•z' 76. Dry Stan`dpipeF-'-^ .m ' 28. Lathing & Siding,^ �. - .�u,,; -. ". "y 77. FIXEDSYSTEM,FINAL, 5--+-} 29. Insulation - _' •• _ * 78: FIRE PREV. FINAL �• 30. Drywall Nailing �• - : HEALTH DEPT.."REQUIgEMENT ,,� ,;, : 31. Plaster Brown Coa., .- r.- I + t 79. FINAL INSPECTION . . ' 32. electrical Power Mefei-Final " n' s • 86.', FOOD CERTIFICATE I$§UED 33.±ina4;E1ectric> ;-t M t Notes: 11 :n 34. _FinalHeating'_& Ail Cditioning`= 35..FinaT Gas Pipe;Tesf _. 36. Hood or Canopy- - •r'7 •-" = t� I - _ 37.'F.inal".Factory Fireplace ,. F.'r-r- c+ ^ j =� 38. Final Plumbin� - - - �, ! ' , F x cr ' 39. WaterService. Final ,' _ I �. ; t n_ ; '' •� y t 40. Gas Service -Final r" �_ _r tr j 't "' <• '^` r - 41. Solar Domestic -Final - - T1 ' a ,`-.•. - 42. -8ackfiow Preventer 43. Backflow Irrigation nz :44.Landscape Irrigation System.^.:• - T cf u^ s - S• _ 1 Cr. -45. •Sound Attehuation'' "'-' r_� F+4' r ~ t1 `>:7•y 46. Handicap Regulations i• * �. �" _ 47. FINAL STRUCTURE & BUILDING 48. VEINAL PLANNING• - . t i" r -• 49, 'Electric Release to Edison - 50. Gas Release to Southern California Gas Co w - � 51. CERTIFICATE OF OCCUPANCY - No. Date 0 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. IF CITY VF COSTA MESA CTST" PERMIT PERMIT NO. - _ TRACT NO. LOT NO. UNIT NO Project Address ` r�N �% I Applicant's Mailing Address Owner's Name _5�94j,l_ Address Arch/Eng. License No. Address Contractor's Name Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby, affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class ce s o. Date Signature If�tons.re WORKERS'COMP NSATIONDEChereby affirm that I have a certifica cocertificate ah Workers' Compensation Insurance, or af (Section 3800, Lab. C.) Policy No.Company BCertified copy is hereby furnished. C rtifletl py' filed with the city Building Division. Date Applicant -EXEMPT PIKERS' FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one Ir of ed ($100) or less). r11 I certify that in the performance of the work for wlaichghis p it is issued, I Laws comply with such provisions orthis•ptipabt snail bemeq revoked. CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction leptling agenq for he performance of the work for which this permit is iso uetl, (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of 'he Contractor's License Law (Chapter 9 (commencing with Section 7000) of Jvision 3 of the Business and Professions Code) or that he/she is exempt nerefrom 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 Eof not more than five hundred dollars ($500). LJI, as owner of the property or my employees with wages as their Sale compensation, will do the work, and the structure is not intended Or offered for sale (Section 7044, Business and Professional Cotle: The Contractor's 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 com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale).. I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property. who builds or improves thereon, and who contracts for such projects with a con- tractors license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ ].am exempt under Section B. & P. C. for this reason Data Signature Drivers' L CMF 0865- have read this 4/84 White- Building; Canary that the ai mtv ordina TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OT HE A.P. DESCRIPTION OF WORK/USE OF BLDG. da2 C \ut Ai S Main Building: TYPE OF PERMIT Ll GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION SQ. FT. �tS _ OCCUPANCY C Right K' CONSTRUCTION TYPE ' VALUATION $ 'J+ 7-0 $ Left ZONE GRADING CU.YDS. ACRES ping. Ref. # Remarks: .Y t ._t_ n.- nl .� Planninq Notes: '{ Sink Irrigation Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service 'Outlets I nterceptors� Kitchen Sink Lavatories Roof Drains Reinspection Fee I $15 FEES Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee I $ 3 9479 10/04/84 - 17.00 .Tl — I r7 I Zone —I Accessory Bui I Parking Req./Provided Z O N I N G R E O M T S. u N I_T tit oT- _Tr� SUMMARY OF FEES L-F-FP'1^ F67e"r" ELECTRICALL-* I FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50+ KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Electric !Sub Panel Fan Motors E10 HP 01%; B F.A:U. Ina Solar 09-15 HP ❑76-15+ Fixtures- Microwave - Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 00-5 KW 115-15 KW Trash Compactor =-== I I Reinspection Fee Pink - Accounting; Goldenrod - Assessor $15 Issue Fee 1 $ 3 Reinspection Fee I $15 DEVELOPMENT SERVICES REOI Zoning Approved By_(�iyz. �I Building Approved By Application Issued By Issue Fee REMENTS: $ 3 Iio -11- Boiler SUMMARY OF FEES Hood or Type I ❑ Canopy Type ❑ BUILDING PERMIT $ 10.00 Duct- Under Ground $ �3SL Duct -Structural $ Refrigeration System ❑0-100,0008TU ❑100,000BTU PERMIT PLUMBING Duct -Ventilating ISSUANCE Exhaust System ❑ Multiple ❑ PLAN CHECK 25% System Repair/Alteration ENERGY P.C. $ Firepl/Fact. Bit. ICBO # $ GRADING $ PLAN CHECK 50% Heating System & Ducting ❑ o- 100,000 BTU ❑ 100,000 BT MICROFILM $ MECHANICAL $ TOTAL FEE $ =-== I I Reinspection Fee Pink - Accounting; Goldenrod - Assessor $15 Issue Fee 1 $ 3 Reinspection Fee I $15 DEVELOPMENT SERVICES REOI Zoning Approved By_(�iyz. �I Building Approved By Application Issued By Issue Fee REMENTS: $ 3 Iio -11- PLAN CHECK 25% $ SUMMARY OF FEES BUILDING PERMIT $ 10.00 SMIP $ �3SL PLAN CHECK $ Sid PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ • CONSTRUCTION AND PLANNING ,*APPROVALS Permit - Date Inspector POL .a SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd, 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7..Footings o Gam- 58. Electrical Conduit-Undrgrnd. 8. 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 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 OGas ❑Oil 23. •Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas O Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final - 40. Gas Service -Final ' 41. Solar Domestic -Final 42. Backflow Preventer ' 43. Backflow Irrigation _ 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations , 47. FINAL STRUCTURE & BUILDING �o - 48. Special Requirements Completed 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date TYPICAL 11 Cement Coping Optional — Channel Block With One 4/800 Horizontal Top of all, Y' Fences For Fences 5' or Less Vert. Bars 3/8'0 at 4' -0" O.C. For Fences Higher Than 5' — Vert. Ban 3/8'0 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 16 " or to Code NATURAL GRADE 1o0 TWO 718" BARSOCONTINUOUS TOP & BOTTOMe 6" CONCRETE BLOCK FENCE — WIOT SEE Ch BELOW ING REQUIREMENTS GENERAL- NOTES MORTAR: One Part Plastic Cement, and Three Parts Sand GROUT: - One Part Cement Three and One Half Parts Sand COPING: One Part Cement, Three Parts Sand CONCRETE: Well Mixed I: 2% : 3%2 Max. of 71/,z Gallons of Water Per Sack of Cement GROUT MAY BE POURED FROM THE TOP OF THE FENCE CELLS AND AREAS OF HORIZONTAL REIN- FORCEMENT SHALL BE CLEAR, CLEAN & FREE OF ALL MORTAR DEBRIS, ETC. BONDS SHALL BE PROVIDED BY LAYING BLOCKS IN STRETCHER COURSES SO THAT VERTICAL JOINTS ALTERNATE IN EACH COURSE. IH OF EARTHTCOTH 1/3 THE HEIGTH OF FENCE BELOW BOTTOM OF FOOTING. SCALE: 1/2"= I' WALL HEIGHT 6 5' 1 14' 1 13' WIDTH OF FOOTING 14' 14" 12" 12" THICKNESS OF FOOTING 10" 10" 8" 8" DEPTH OF EARTHTOOTH 2d' 20"''- 16" 12" SPACING OF EARTHTOOTH 12' 14' 16' 16' City of Costa Mesa, California OWNERS NAME: _ _ JOB ADDRESS: _ _ _ — _ _ _ _ _ _ _ _ _ _ _ — _ — — _ _ _ — — _ _ Building Department MUCTURAL APPROVAL OIV1l , SEPARATE PERMITS ARE �EWUNREd FOR ELECTRICAL, P10 51ru HEATING, VENTII_ATiiiS 'W REFRIGERATfON Wow. Permit # JD1 S5 3 I THIS NUMBCR RUST ACCOINUT ALL INSPECTION REI;tBM3 FOR BUIL MNGS t: c :_ FL�2S!II+S.AiETiD BE EMPLOYED, WE S:;S! zST THAIr TxiE STATE OF UPASKIN OF INDUSTRIAL S. FLT"' nE ; (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ccaUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 1207 PARNELL PL Suite: Vicinity: MASTER BEDROOM Parcel Number: 14104610 Zoning: R1 R1 Applicant: GANEY, RICK 05/04/2001 Address: 1207 PARNELL PL Other: $0.00 Phone: 714-751-6224 COSTA MESA, CA Zip: 92626-2737 owner: GANEY, RICHARD L & KAREN M Address 1207 PARNELL PL COSTA MESA, CA Contractor: OWNER -BUILDER Address: Zip: Phone: Zip: 92626-2737 Phone: License: 0 Arch Eng: Address: Address: ISSUED BY: Status: ISSUED Applied: 05/0312001 Issued: 05/04/2001 Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT 136 SF (8' X 1T) EXTENSION TO AN EXISTING MASTER BEDROOM/BATHROOM IN A SINGLE FAMILY RESIDENCE, NUMBER OF BEDROOMS WILL NOT BE EXPANDED. Plan Check: $136.01 Permit: $209.25 SMIP Res: $1.16 SMTP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $346.42 SETBACKS MAIN STRUCTURE Front _. 0-0 ACCESSORY Front 0-0 \ PARKING Existing: 0 NOTES: _. FEE SUMMARY Calc Valuation: $11,628.00 Claim Valuation: $0.00 PLANNING & ZONING Rear 55-0 Left 43-0 Right 5-0 Rear 0-0 Left 0-0 - Right 0-0 Required: 0 Proposed: 0 I NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related. regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abancloned 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 I 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 Cade, for the Performance of the work for which this permit Is Issued. My workers' compensation Insurance Carder and policy number are: _ Carder: Policy Number (This section need not be Completed if the permit is valued at one hundred dollars ($100) or less.) ❑ I certity 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 became subject to the workers' compensation laws of California. and agree that If I should become subject to the workers' Compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060E THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Lic. # Class # Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 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 Contr I; ors License Laws.). ❑'11 am exam sec. Business and Professions Code for this reason: (Signature: ._.rr CDate: Owner.ID verified by driver'l license. P(Yes ❑ No Driver's License No. CF-x'pires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person Is required to descend, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Cade). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building Occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires. with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................................................................................................ ........................ ..........................._.................................................................................................................... ........... I............ ............... 2 Does or will the applicant or present or future building occupant need to lite a registration form for acutely hazardous materials? ❑Ves ❑ 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 II en RMPP i5 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 plication a ff rmit for such construction or modification from the South Coast Air Quality Management District or from any Other air pollution Control district or agency? 13 Yes LJ NO (Section 65850.2 of the California Government Cade requires that the requested information be furnished on applications for non-residential building permits). . ......... ........................ ._.......................-._.... ...... ....................... ........................................ _........ ........................ ....................................................................._.___........_........_..........................................-......-........................................... 6 Will any part of the facility to be Constructed under this permit be within 1000 feel from the outer boundaries of a school? ❑ Ves ❑ No (If yes-, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..................................................................................................................................................................................................................................................................................................................................... 7 It a permit from the South Coast Air duality Management District or other air pollution control district or agency is required tar the work which is the subject of this application, . have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ......................................................... ,.........................-...................................................................................................................................................................................................................................................................... 8 (If yes", attach certificate of compliance from the appropriate air pollution Control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. 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 cop�p 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-descdbed prd"o6Rv'lor in c n purposes. I agree not to Occupy or allow Occupancy of any building authorized by this permit until final inspection. 1 g�a 'Ot Legal.OvmerS) And/OT Authorized Applicant —Date CODE It INSPECTION TYPE 2AIE INTRIALS CODE? INSPECTION TYPE PAIS INTRIALS 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 r 4 CITY OF COSTA MESA BUILDING DIVISION /B98-01113 DEVELOPMENT SERVICES DEPARTMENT PERMIT PERMIT NUMBER (714) 754-5273 Fax (714) 754-4856 BUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 .lob Address: 1207 PARNELLPL Status: ISSUED Suite: Applied: 06/23/1998 Vicinity: KITCHEN AREA Issued: 06/23/1998 Parcel Nunmber: 14104610 Zoning: R1 R1 Applicant: GANEY, KAREN Address: Phone: ZIP: Owner: PALAZZOLO, CARL,:, Address 16449 LAZARE Phone: HUNTINGTON_BEACH,CA� Zip: �' 92849-1,�;, Contractor: Address Phone:,>\;-�.� ZAP: i � License: Arch / Eng/'//1"F iAddress: ✓ r ` ./! Phone License r� i SCOPE OF PERMIT 1 'r 102'sf addition to existing kitchen in the front of the house. Plan Check: Permit: SMIP, Res: 'SMIP Com:. Other: Inspection: v.Total: FEE SUMMARY $81.09 $124.75 /'- $0.65 7/ $0.00 $0.00 - — $206:49 n _ Calc Valuation: $6,500.00 Claimed Valuation: $6,500.00 PLANNING &"ZONING SETBACKS, MAIN STRUCTURE Front 27-0Rear 10- 0"' ` Left' .13-Q', Right 0-0 ACCESSORY Front 0-0',Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0. Required: o: Proposed: 0 NOTES: 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 rmB. c,_ FOR INSPECTIONS CALL: (714)754-5626 1W. IF Is DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is Issued. ve and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. y workers'mpensetlon Insurance carder and policy number ere: Ca ' r. Policy Number. (lir settlor ed not fN7 if the permit is valued of one hundred dollars ($100) or less.) I co that In 1 Dario nce of the work for Which this permit is Issued, I shall not employ any person in any manner so as to become subject to the workers' co satlo we of Call mla, and a r f I should become subject to the workers' compensation provisions o1 Section 3700 of the Labor Cade, I shall forthwith ase of s. D nt SI um Dale ING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBIECT AN EMPLOYERTQC WNAL PENALTIES AND CML FINES UP TO ONE HUNORED 0 DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY -S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. Lic. If Class 1! Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 hereby aHkm that there Is a construction lending agency for the performance of the work for which this permit Is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, Improve, demolish, or repair any structure, prior to Its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors Lloense 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. 11, however, the building or Improvement Is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of p perry who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws,). I am xempt under sec. Busin d P essians Code for this reason: tura: Owner ID verified by drivers license. ❑ Y ❑ No Driv s 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 cortity 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, TIt1e 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). .................................................................................................................................................................................................................................................................................... 2 Dces or will the epplicent or present or hrture bulldinp ocapant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Cole, with some exceptlons, requires registration with the Costo 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 Dces 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 Masa Fire Department me 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 F re Department. .................................................................................................................................................................................................................................................................................... 4 If an RMPP Is presently required, hes Section 25534 of the Celifomia Heelih end 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_ppplicatlon a permit for such constructlon or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Cole 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 (It yes', the facility must meet the requirement o1 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 required for the work which Is the subject of this applfcetlon, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been madecy ❑ Yes ❑ No ....................................................... ................................................................................................................................................................................................................... 6 (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. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not topy or allow occupancy of any building authorized by this permit until final inspection. oc Si g�Owner(s Date — /AnTOr Authbrized p Icant CODE L INMECrONTYPE 9M INTRIAL$ CODE z iNSPECDONTYPE DAM Itd0AL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final - 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval . 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Bullding/Occupency 2N 46 s 1207 PARNELL PL' NAME: RICHARD & KARREN GANEY ADORy9G- 1207 PARNELL PL 10111" C,M,92626 714) 557-5782 ARCH/ENGINEER: ADDRESS: REG.NO.: UNIT: UNIT: PERMITTEE: KARREN GANEY (714)557-5782 ADDRESS: 1207 PARNELL PL C.M CA 92626 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 license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Dale: Signature: WORKERS' COMPENSATION DECLARATION: I hereby allirm that I have a cenificate of consent to sell -insure or a cenificate of Workers' Compensation Insurance. or a certitieo copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: Climbed copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not completed d the pertrtil is fornepundred (S7e0) or less). I earthly that in the performance of the work for which this permit is issued. shall not employ any person in a neer 0 as to become suy�,'pCC' to the lySykers,�J ampensaCJl/on Laws of Califomu. MIA ,7,r �/�7z1 n' ae�l ✓✓'S� / Signature:—� /A//ii// l // I NOTICE: II. alter making this tledaralion, you should become 5 ject to the Workers' Compensation provisions o the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work lot which this permit is issued (Section 3097, Liv, Q. 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 the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation. will do the work, and the El structure is not intended or offered far sale (section 7044, Business and Professional Code: The Contractors' Stale License Law does not apply to an owner of a property he builds or improves thereon, and who does such work himselUherself or through his or her own employees. provided that Such improvements are not intended at 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 exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The ContractorsState License Law does not apply to 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 proof of their Worker's Compensation insurance should be provided to me. ® I am exempl under Section: B P 7 0 4 4 B. 8 P. C. 0 mr this re n: ER �U�LDER owner `/�/�'�� do hereby comply that I am aware of and understand the requirements of Wlifdm a ealth and Safety Code Sections 25505, 25 . and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have mad this application and state that ordinances and state laws relating to building construction and h property fori�cnspecttiioon purposes, Grte�f `` r l Signature: information is correct. I agree to comply wrt II city and i)ze reprosentalives of this city to enter upon eabove me diver's License or Social Security x: 1641-46 Whne—Building; Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 067306 PERMIT NO: B 067306 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION : T/OFF RESHEATH & REROFF W/COMP, SHINGLES SQ FT: 3,500 CLAIM VALUE: 3,500,00 CALC—VALUE: 3,500,00 GROUP OCC: R-3 /M-1 COMMENTS: SMOKE DETECTORS ARE REQUIRED IN EVERY BEDROOM & HALLWAY, 1991 UHC BE aF jE if if ih if 9E 1E 9e ie aE iE*lEfi*K#iE iE*9F 9E aE nE 9E*if if-iF ie if iF aE 9f ae 9'.****ar 9E iF iH 9F of aE 4L iE iF 9f 9E aE 7FfE*ac iE if 9e iF aE**fE iE ae iE #iF iF ie if iP 9f 9:K Z O N I N G S E T B A C K S R E Q U I R 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: 14104610 ZNE: REF NO: PLANNING NOTES> iE iF iE*iEle if s6 iE a6lfif***fE**iL 1E iE iE fE iE lE le iE iF iH iE it iE if iE fE ie****9f iE iF if iF*1e*1E iE 4 iF kif iEM*96 fh if lE iF iEk iH if aE 9E it BE foie *if le lE lR*ik 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: ZS iH fE of 1E 1E 1E*ie iF iE ie lE ik if Bt•IE ff iE iE iE eE iE�F��E��it �F3FiF'iF'iFi:{��. {(. 1FTf ��'jf�{—F�i�7��{F {E lE lE ie iE iE iE iE it if iE it iE iE iE iE ik ie if iE iH iH 9E iE aE aE lE iF iR iE if ie !! if ie iE iE fE 1e if iE eF iF iH k ie 1f iF l6lH iE iH 4E 1E 1F iH if if 1E if 1E if iE ie 9e aE fF if * iE ff is if of iE iE ie 9E if iE iE Bf M Ie if ie YF iF lE iF iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 63,00 .50 PLAN SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 63,50 0,00 0,00 63,50 63,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 63,50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 63,00 .50 1E iE iF iE iE iE Bf 1E iE iF iR iE lE if iE %if iE iF 4E iE 1E 9t iE iF 9E iE ie iF 1e iE iE iE 9E 1E lE iF if it iE iF * i4 iE if !E i( if iH iE if ie if iE fF jE iF aE iE ie iE ff iE iE * if ie ie iE * a6 iE iE fE iF aH iF if k 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 3500 REROOF BY VALUE RESIDENTIAL NOZONE 1,00 3,500,00 END OF FEES SMOKE DETECTOR REQUIRED 01 00161089-00161090 TOT ' 63.50 ,,, DATE: 05/25/94 TIME: 09:10 'RUCTION AND PLANNING PO. y SPA VALS Permit �` I Date lospector APPROVALS Permit;;- Date Insp,ctor I I mporary Electrical Seance or Pole 52. Pool & Eou'r'm2nt LuC-1 r 2f So,i Pipe Undrgrnd. 3 Elnctrica: Condu.t Ut4h'-J-dr9r1:. 4 Electrical Condu t_Undrg-_ .d. - S. Slee; Re.nforeement �- Euctrica LIFER Grnd 7. Footings 8. Foundation 9. l'vater Pipe Undrgrrd. - - 10. Structural Floor System 11, Property Sewer Line & House Connection 12. Sewer Cap 13 Roof Orans 14. Rough Plumbing 15, Rough Eactrlcal-Coidurt 16. Rough Electric Curing 17 Rr::O ;4 rmg Sign 18 Rough Electrical -T Bar Ceiling 19, REl_h Hr.ting & Ar Co,d. ,2,.ng 20. Rough Factory Fireplace 21. Ducts, i- Strixturr, 22. Ducts, Vcntilating 23. G._s Pipe Rough & T est 24. Roof Framing 25Hrof Sncat'mng 26. T Bar Ceiling (St & 7.�onacoat '--- - - - 27_ Fame ecd Flash,, g 23. La ,g ;> S'.d ny 29 Insulat or. 30 Or Iiia 11-:,7iling 31 ':.. �t: r Brov,n Coat l 32 EILLCSr.eal Pa6er lar -F-•a: 33. Fir61 Electric 34. Fin;.: Heating & Air C012rronicg 35. rmcl Ga; Pipe -Test 36. Heed or Car•opy -- �37. F,ncl Fcctory F.rep_ace _- 38. F, nn; Plumb. �g ^39. ':;ulcr &:rvice-Fin;•. 43. Gds Serrce-Fral 41. Solar Domestic F. rtl '2. 3acisf, ol" Preven%r 43. Backflow Irrigation 44. - L..ndsca Qe l:nga ion Syste.r 45. Sound Attenuation =6. Ha'•dicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to �d.son 50. Gas Release to Southern Cahfo,nia Gas 51. CERTIFICATE OF OCCUPANCY No. Date 53, Steel Reinforcemei,i 1 54. Forms --- -- _-- _- 55. Electrical Bovdrrg 56 Routh ? umh r ; 1ST t'r.- .: r_ 57. APPROVAL. 10COVFH G.- 58. Eiect•.cal Cordu • v,.r . .. i 59. Gas Pipe, C1 Urdrgri.i!., T.st I 60. Bada':ash L:I,:,. P - rLp, '.. L 61, APPROVAL TO DECK - I -- 62. Back..u-h & Rrcc•,:.. ,:,.-� -----�----, 63. Heater & Veni-sinal 64. ?:umaiy Sys -_m F , 65. Electrical -Final - ---I- 6 Salar Sys;emp �, ---- - -- � - - -- -- 67. Fencing & Acsss Apra. ,I I E3. APPRCVED FDR PI i:STEP:%'�3 69. POOL/SPA SYS ", FiNAL-- FIRE DEPT. REQUIREr.'.F',T APPROVALS PUr.,11t 70. urriProduct au^.d Fi; a Il -_-- 72. Product Rpinq_ G.is O_I- 72. Undx,grounc...•r• -- 773 U d S'n - - -�-.. 1; D --e_ , -- -- - - j I 7a. Dw Ci-,.-n.ca I Ste ,c,-------- - - - -- - - -. -- 77. F'Xc0 SYS'L - - ---'- I i8. FARE FREV. F.\i.l - - -----'--- ' --- --- - i--- -S „_A LT'1 DEPT. REQ L'IR_..: i 7P. FINAL X80. FOODi:LFT;r',':.•'-,'tL[^ `r OWNERr,AxTrnr>.n czprp 3S DATE 8-3-61 GENERAL CONTRACTOR Anthony Pools VALUE $ 2,500.00 AP No. 113-306-10 LOT 'TRACT FIRE ZONE DESCRIPTION OF WORK Pvt.swim pool INSPECTIONS Signature DATE GROUP TYPE ZONE SUBCONTRACTOR ISSUED Gm Water _DATERMIT5NUMBER Rough Cam. Refrig. ❑ Air Coed. ❑ Rough Heating Rough Plumbing R �-. Miscellaneous FieC� Prep. Prop. Swr. Line ❑ House Con. O St- Swr. ❑ _ -.-26+O "` �_(�q� `7� v. _U - �- _g_�f� $-2="�O v 10—Til Sprinkling System Construction Po e Underground ❑ Power ❑ /�A, Rou •h Wirin _p_w. — $_ZY_ - _ _- Trenches ❑ Forms Steel JReinf. Floor System Bond Beam ❑ Steel Reinforce ❑ Sheathing Frame and Flashing Lathing - In ❑ Out ❑ Plaster, brown coat ❑ A-iriCond. ❑ Final Final Plumbing Fixtures, Finalf Final Gas Test Electric Fixtures, Final_ r r Building, Final _ Q. OCCUPANCY FORM BU4 - 5M - 7.61 15O62 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA. CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT BUILDING ADDRESS 1207 PARNELL COSTA MESA CALIFORNIA rtt KLULIVED AUG 2 1°81 FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only STEPHEN GANDOLFO RECEIPT NO. P8�[.1OIT�D. OWNER MAIL RECE D BY D R8C61VH T88U¢�/1 ADDRESS SAME I I NO. BUILDING 1207 PARNELL CITY /lf�s� ADDRESS ARCHITECT / TEL. COSTA MESA. CALIFORNIA OR ENGINEER /' NO. ADDRESS FIRE ZONE TYPE GROUP / APPRO DATE , - (P _ CONTRACTOR ANTHONY POOLS . 5871 FIRESTONE BLVD. ZONING ADDRESS :DN NO.OF USE OF NEW P Z—I I P_L®AHB BUILDING LEGAL r �— / �( B. / CITY SOUTH GATE +'� ` ? 6TArNO. 3 a it c LIC. /�/ _7 NO. . ! Z 7 DESCRIPTION - Y'� '1 4 A. 1. NO. 113 �'• O 6 ( 6 SIZE /Z., kv� I NO. OF BLDOB. / OF LOT "'aaa"' r NOW ON L'T USE OF YARDS EVES EXISTING BLDG APPROVED ALLOWED SETBACK LINE FROM (CENTER LINE ST.) _ CENTER OF STREET REAR YARD FRONT f FT. IN. SIDE YARD ILEFT (RIGHT �j R.SIDE +��- FT. / IN. DESCRIPTION OF WORK L. SIDE F IN. . NEW I II ALTERATION I I ADDITION I X X REAR FT. IN. REPAIR I MOVING I DEMOLISH I 6 Z APPROVED cin [T DATE LT G BB BUILDING zL'7 ANO. OF SIZE ROOMS STORIES EXTERIOR WALL ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED SWIM POOL PRIVATE ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS POR THE THA OVE IB CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. A CITY ORD NANCES AND ST W LAW REGULATING VALUATION E O '�' p J LA PERMIT FEE S{�2500.00 PLAN CHECK SED AGENT TOTAL FEE OWNER (LOLLEGE MESA COMPANY DATE 10 -ll -56 JOBADDRESS -1297-Parnell-Place BU I LD ING PERMIT NO. #3827 GENERAL CONTRACTOR The Hale Co. VALUE$ n, 368,.o0 L 1%1 BLOCK TRACT 2671 Single dw i +n x/.,_gaz. GROUP 1 & J TYPE V ZONE Rh FIRE DISTRICT 3857 INSPECTIONS DATE SUBCONTRACTOR PERMITS ISS ED DATE NUMBER Footing Trenchr Foundation Forms and Grade to Garage �' I Rough Framing C / Plumbing, Rough to Slab (ori ip..�.y�r_n�.j -Nb.-J- /d -e -4 �o %a 326 Plumbing, Rough Complete yme,S L,�9,sf, u Temporary Pole Wiring, Rough Heating, Rough ivi. C'S f A B•�6�5 //"a76'S� 3G Heating, Final Mid S -S -S7 ..�i"/Coir ✓ 3°. /"I -/J - ._ % f i> /: ✓ 2!w -.r, House Ly Sewer, St.)%# Seotic Tank or Cesspool i ng, In� Outx Plastering ' _ 1„ - As- • J Plumbing, Final, Fixtures Complete 1'1 IfS G JS �Si 4P Plumbing, Final Gas Test/S- 1WH44-5*—s'% /�'ir /��_•�l_ I `�� Wiring, Final y 2 B Occunancv .. __ ,flesa Building Department ^ �yAPPLICATION FOR PERMIT Ill EAST 2Gth STR 430STA MESA, CALIFOERNIA �2R� C BU D D I N G FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY I Receipt No. I Permit No. p� O Bullring Address 1207 Parnell Place Costa Mesa, CaMornia Received by Date Redd. /"% —� Date Issued NearestI Cross St. Loren Lane Building Address Owner College Mesa Company Costa Mesa, California Mail Address 1777 W. Lincoln Avenue Nearest Cross St. Tel City Anaheim Y 3-3161 Zone No. of Plans Type Group I 1R' Architect or Lic. Engineer Davis & Quigley No. C-1790 Approved IV oy Date Address43 Malaga Cove Plaza,Palos Verdes CORRECTIONS City Lic. Contractor The Hale COmpany No. 3422 Address 1777 W Lincoln Ave. Anaheim Legal Description Lot I No. 171 I Block I Tract 2671 (Attach Metes and Bounds) No. of Bldgs. Size of Lot 66 X 110 Now on Lot None O Use of No.of No. of Existing Bldg. I Families I Rooms 70 Setback Line from Rear Yard bUZ Center of Street 50 Side Yard $ y DESCRIPTION OF WORK New I X I Alteration I I Addition Repair I I Moving I Demolish Building No. of Size 1321 Rooms 6 Stories 1 Exterior Wall Covering Stucco I Roof overing Shake APPROVALS Use of New Building Sinele family dwelling with Foundation Location Forms, Materials, Under -Pinning Inspector Date detached garage Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply with all City Ordinances and State Laws regulating building construction. Signature of Permittee THE HALE COMPANY Authorized Agt. "�_ _ }�� Lath. Int. Lath. Ext. Plaster, Int. Plaster, Ext. p Valuation Permit Fee $ 28.00 Plan Check $ 14. 00 $ 11,368 Total Fee $ 42.00 Masonry Reinforced Bond Beam FINAL cm FORM 204 S -BP 2M 6-55 �UWNtK tsuutvis, nuts 15. acne UAIt JOB ADDRESS BUILDING PERMIT NO. a GENERAL CONTRACTORowner- DESCRIPTION of WORK Ijioc Wall '�'S A"''o. LOT TRACT 2b7l FIRE ZONE VALUE $ 160 • OU II cCTIONS Si nature Date GROUP J TYPE ZONE SOIL SUBCONTRACTOR PERMITS ISS ED \' GAS Date ANumber Si nature WATER Plumbin ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND E POWER ❑ ROUGH WIRING Heating and Vent. TRENCHES 16fl FORMS n STEEL REINF. U(I SHEATHING FRAME AND FLA: LATHING — IN f PLASTER, BNOWt S' TURAL„ FII HE. dG, VENT., PLUMBING, FINAI ELECTRIC, FINAL RIIII DING. FINAL HING 1 OUT REFRIG. AND A. AND GAS TEST Z aU Z Z_Q ON am J J to Q W to J J to Q Uin Za W CC aW Lu Z JO mZ J � W W O= Z I - WO n IL �O 81812 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 HAY —7-74� 00 270 * *5.00 PPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely JADDRtESSA2,9 RECEIVED f DATE ISSUED LDING �sDATE ADDRESS ZI r / PERMIT NO. OWNER 6�i b /D MAIL y n ADDRESS i2 0 N TEL CITY (� !ri NO..sy6 -7Sh / TRACT 6 LOT BLOCK _4a CONSTRUCTION W A ALTER LENDER BRANCH OWNER ADDRESS 6 V LUE S Y! $ Q ARCHITECT TEL.USE(/ OR ENGINEER FIRE ADDRESS ZONE TYPE /7'17GROUP APPROVED o CONTRACTOR ` BY DATE ADDRESS TEL. ZONE NO. OF USE OF NEW CITY NO. PLANS BUILDING STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO. OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. �rJ Z Qti�� SIDE FT, SIZE OF NO. OF NEW BLDG. ROOMS STORIES L. SIDE FT. EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& // MAIN BLOBS. ACCESS. BLDGS. VAR.+ DATE LC)aW C.U.P. iW APPROVED APPROVED (LS-- DATE _ 70 II 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 0 the State of Colif orn ie. � I hereby certify that I am properly licensed as a contractor under SO. FT. O THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: 2 am exempt from the provisions of the State of California Business and Professions Code, Division 3, Chapter 9. VALUATION m PERMIT FEE $ N Signature of o �`- '1n (� D m Porm lttoe % i v $�/D •� PLAN CHECK $ E LL Authorized Agent TOTAL FEE $ �7