HomeMy WebLinkAbout905 PEACE PL - Building PermitsCITY OF COSTA MESA
D�pMFs'q BYILDING DIVISION
F� � "i7 FAIR DRIVE, CQSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • wvrv+.ci.costa-mesa.ca.us
°. v^� BT FOR INSPECTIONS CALL• (714) 754-5626
�`°"°°°^°`" PERMIT NUMBER: P10-00159
PERMIT TYPE PLUM
APN: 41805305
JOB ADDRESS: 905 PEACE PL CM
vicinity:
SCOPE OF WORK: WATER HEqTER CHANGE OUT.
OWNER:
PHONE:
APPLICANT:
PHONE:
CHIARELLI, MARC TR
KENNETH BLOCK
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
ISSUED
1 2/0 912 01 0
KJB
Address: 905 PEACE PL
Cily/State/Zip: COSTA MESA, CA
Address:
City/State/zZip:
CONTRACTOR: ALL STAR WATER HEATERS INC License No. 812894
Address: 30300 PUERTO VALLERTA
PHONE: 800-727•0977
City/State: MENIFEE, CA ZipCode: 92584 � CELL:
ARCHITECT: License No. PHONE:
ENGINEER: License No. PHONE:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$35.80
$35.80
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 7, 72-21-g2)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and final approval will resWt in the expiration of this permit.
CODEp. INSPECTIONTYPE pATE INTIlIALS C,�OOEp INSPELiIONTYPE �ATE INPTIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 PooiSpaFinal 208 FinalPlumbing X 3-2y-II m�h��
200 Final Re-Roof 210 Final Electncal
201 Final BlocklRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Pianning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Fina� Building/OCCupancy
.. � ; � . �; � . ;.
WORKERS' COMPEiJ$ATION�DECLARATION: .
I hereby aKrm under penalty of perjury one o( Ihe following declara�ions: ,
❑ I have and will maintain a certi(cate of consent to self-Insure for workers'
compensation, as provitletl for hy section 3700 of the Labor Cotle, for the
rtorm nce of the vrork (or which ihis permil is issued. �
have and will maintain workers' compensation insurance, as requiretl by
se ion 3700 of the Labor Code, for the pedormance of the work for which this
ermit is issued. My workers' ompen tion Insurance carrier and policy
number are:
Carjer_. � Gni
(TM1ssectunneedipnl0emm J�/lhe�p(Jerm�RisvraWetlalone�h1un�tl�7edtl�dla�rs,(5100)orlessJ
P�d Y�mber: ( "%2-��F�/^/ / C �/ I'✓ —(/
❑ I certify [ha � ihe performance of Ihe work for which Ihis permit is
issued, 1 s not emp y any person in any manner so as to become subject
to Ih orkers' comp nsati law and agree that if I should
b me subject to t mpe � n- visions.of Section 3700 0!
e Labor Code s pl i ese provision .
�
alure �, atg�
WARNI � AILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS U FUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PE IES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAIiS
($ 0,000), 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 aKrm that I am licensed under provisions o( Chapter 9(commencing
with Sec[ion 7000) of Division 3 of the Business and Professions Cotle, antl
my license is in (ull f� �e %nd� eHec . �
�I:ic:-#�' v CClass #-- � � \
V
c 9na� �
NG AGENCY:
❑ 1 h y affrtn �hat Ihere is a construc[ion lending agency for ihe
peAortnance of the work for which this permit is issuetl. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
SignaWre Da�e
OWNER-BUILDER DECLARATIONS:
I hereby affrm that untler penalry of perjury lhal I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Pro(essions Cotle: Any city or counry which requires a permit ro
construct, alter, improve. demolish, or repair any stmcture, prior to its
issuance, also requires the applicant for such permit to file a signed statement
Ihat he or she is licensed pursuant b Ihe provisions of Ihe Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
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 applicaM to a civil penalty of not more than
fve hundretl tlollars ($500).):
❑ I, as ovmer of lhe property, or my employees with wages as iheir sole
compensation, WILL DO 7HE WORK, and the sWcture is not intended or
oftered for sale (Sec. 7044. Business and Professions Code: The Contractors
License Law does not appy to an owner of pioperty who builds or improves
lhereon, and who does such vrork himself or hersel( or [hrough his or her ovm
employees, provided that such impmvements are not intendetl or offered for
sale. If, however, ihe builtling or improvement is sold within one year of
completion, the owner-builder will have lhe burden of proving ihal he or she
did not build or improve for purpose of sale.).
❑ I, as owner of the pmperty, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Pmfessions Code: The contractas License Law dces not apply lo an owner o/
property who builds or improves Ihereon, and who contracts for such project with
a contractor(s) license pursuant [o the Contractors License Laws.).
❑, I am exempt under sec.
Business and Pro(essions Code for Ihis reason:
SgnaWre
J051-46�3I0])
Owner ID verified by tlrive•ense. ❑ Yes ❑ No
Driver's License No. Expires:
Verification of Ownership by (type o( tlocument, i_e. - property lax bill or deetl):
• . . r
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �
❑ I hereby certify that no excavalion five (5) or more (eet in depth into wfiich a
person is required to descentl, will be made in connection with work authonzed
by this permit, an0 ihat no building structure, scaffolding, falsework, a tlemolition
or dismantling thereof, will be more than Ihirty-six (36) feet high. (Chap. 32, Grp
2. Art 2, Sec. 341, Ttle 8, Cali(omia Administrative Code).
❑ As owner-builtler, I will not employ anyone to do work which vrould
require a permi� fmm the Division of Indus�rial Safery, as noted above, unless
such person has a permi[ ro do such work from [he division.
Rpplicanfs SignaWre Date
Division of Induslrial Sa(ety Permi[ Number
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or future builtlinq occupant need to file and
certify a Business Plan (or emergency response lo release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of [he Califomia Health and Safety Code requires, with some
excep�ions, tha[ a Business Plan be filed with Ihe Costa Mesa Fire
Depariment by every business which has at any one lime during a reportetl
year a quantiry of hazardous matedals equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas
a� standard temperature and pressure).
2. Does or will the applican� or present or future building occupant need to fle
a regisfration form (or acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Cali(omia Health and Safety Cotle, with some
exceptions, requires regisiration with Ihe Costa Mesa Fire Depariment by
each business which at any one time has on hand a quantity of acutely
hazardous matenals equal to or grea[er than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic (eet o( compressed gas at standard
temperature and pressure).
3. Does or will Ihe applicant or present or future builtling occupant need to
prepare an RMPP (Risk Management and Prevention Progrem tor acutely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Cali(omia Health and Safety Code provides that the
Cosla Mesa Fire Departmen� may require the preparation, certifcation and
filing with the Fire Department of an RMPP by businesses which are required
[o register acutely hazardous malerials with the Fire Department.
4. If an RMPP is presently requiretl, has Section 25534 of lhe Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicanl or present or fuWre builtling ocwpant require for
the work which is the subject of this application a permit for such construction
or modification from Ihe South Coast Air Quality Management District or from
any other air pollution control district or agency? ❑ Yes ❑ No
(Section 658502 of the Cali(omia Govemment Code requires that Ihe requested
informati0n be fumished on appliCalions far non-residential building permils�.
6. Will any part of the (acility to be constructed under this permit be vnthin
1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No
Q( "yes", Ihe facility mus[ meet Ihe requirement of Sections 25534 antl 42303
of the Califomia Health and Safery Cotle).
7. If a permit (rom the South Coast Air Quality Management Dishict or other
air polWtion control district or agency is required for the work which is Ihe
subject of this application, have all of the disclosures prescnbetl by Califomia
Health and Safety Code Seclion 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air polWtion
control oHicer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty o( perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
SignaWre Da�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
cerlify under penalry o( perjury that I have read this application and state thal
the information given is correcL I agree to comply with all state laws antl city
ordinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until fnal inspection.
' n ur Le er Dat `
J
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6
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Tag/ Assembly Name
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Fremin�
Material
Stnndard VeluesFrom JA4 7'able
Tliiclmess, Framed Continuous 7H4 � Yroposed
Spacing; U- ]HA 7able Cavip� ]nsulation Assemblp Assemblv
or Other' iacror' Numbei5 R-valu � R-Yalu�.' Cell Value" ' U-factor"
Caiimumrs Insuloiion R-valuc..cee
walfs nsr ihc
1. For Tng/ID indicaie the idenfi(ica�ion name ihar mmches �he building planr.
-'. bidicaie �he Aasemblr Nnme or qye: koof/Ceiline, W'alla, F/owa, Slabs. Crawl Spnce, Loo+a� and etc...l»dicate the Frome rype and Size: Fa�
Wood, Meial, Metal building,:, Moss, er�ier 2a4. 2xG, a� etc... see JA4.Jo�� o�her yossible {rame p�pe assemblies.
3. c`n�er !he Uuclmess,la' mass in inches or Suating berween,l�'aming members enier; ]G'or 29 "OC,- or Gthei:jw� all o�her assem6lv dea�cription
such ns Cmicreie Sandwich Pmie!, Spandre! Fane!, Log:, Strmv Bale Pmie! and e�c....
4. Dnsed on !he Climn�e 2air; emer the Siandm'd U fac�w _jrom Ta�le ].il-E, C or D for eucly dif/erem assemblp Name or nryc.
5. Emer rhr Tabtc num6er ihai clw�elr resembles �hr proua.xed assemblr.
(. L• n�er 1hc R-i�alue Iha� i.e being II15'14IICCI bi (I1C WGI� COVI/P or 6e�H,een Us lrnnnnp: olherwisc, enier "0,..
7. L•mer Ihr CaVinunus )nrula�iar R-vnlue fm� Ihc proposed ussembl�; olMerN�irc, emer "0".
J', E�ner !/re r�nr mrd cnlumn oflhc U-/aclor ��alue Ga.red o�i Coluntvr F Tcrble NumLer mxl en�er lJ�e ila�a�entblp L� fucfm� in Colunvr./
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Furrinp Su'ipa Consvuction Ta�le loi l�iass. V��aIL: Onh�
n �t c » r r I c t� I> > u L m
1'rn�msed l'ruperlies nf Matinnrl'swd Cuncrllr AdAed lnleriur ur �Xlci'iur lnsul:diuu
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?00$ Resideniiuf Cwnplimicc Porma Mor �UU9
J'rescrit�ti��r Ceriiiicate uf Cumuli.i. .. 7Lesideniinl
Jiesi[ientiai ALteratiuns�
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Cr�] Tt-AL"i'
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fIEl:S V�I(II�I CATJ Ol�' S U711MA7.�' Tirr erp7orcemenr �gener shuidd ym� snecial cmenuon in liic HL/LS hieaazu�c �. specilied m iiiie
checld�si belmr ri cornulcic�i nnd signed CF-4J� Fm�m Jnr <d! iiu mena�w�e.: syecilied shull Lc suunrmed rr, liv� uuilam� mspe�io;� Lefmr linoi
1luL'1 Set�lin� d Tesii���� HEI�� nerilicnuonisrcquu�ecll�� lhi.i mu�siirc.
❑ YLS ❑ 1V0 9ES Li Climuu "Luue:. _' nud 9-I G, if�morc than 4U line.0 ieei oi ne�v oi rcpincemeni [lucu. nrr ins�.iilcd ii� uncondi�iuneci
❑ 1 �S
❑ Y�5
spact, ll�e duclr w�e to b� se�iled pei v� �"l(b)]Lii and tht newh' ���slnlleU duca ure lti 6�i i�raui8md pei �•151(1�11(1.
❑ CXC�PTI(11�: Lxisting ducr s7.etems thai urc extended; Wl�iCh nre cuusu�ucLecL insulxted ur senictl i�•ith asbesws.
❑ I�U 1'E5: ]ii CLmam'Lonec ? and 9-] G, if the er.isiiu_� space-enndiiioniuo systen� (NVF,C equipmeni and ductingl i:, rpinced. [he
ductc are to 6c sealed pei §152(h)1Li.
❑ NO Y�&: Li Climatc "Lmies ° and 9J G, if the existinp HYHC equipin�ni is repluceJ iincludine tl�: replucemeni of thc air hundlei..
ou�door condensin�. nnii of a sphi systen��; couling or hantin� coil, or the iivnace lieai e>:eh�ngei7 the duct. nr= io L:
sealed per g152(b)lE.
��):C�PT10�: Luct systems thni are ducumented tu La��e been previuush� senled contirmed tlu'uurl� H�P.S
.beriiicntimi iu uccm�dance �vitli pcucedures in.thr7telerence kesidential Appendi>: I:h3.
❑ LXC�PTJO�;: Luu spatems with less fhnn 4U�linenr feet iu uncundiiiuned Spnce.
❑�XC�PTIOn: Lxistine duct si�stems cunstructed. insulated m� senled �vith aslrestns.
�2�Iri�E;ant Cha��e - Splli SyStem HERS verijicniion ia requireci.for �hi.e meastn�c.
❑ Y�5 ❑ NU YS�S: In Cli�nate Zones 2 anJ F-15, wl�en fne esisting HVAC equipmen� is replaced I»>clutiin� the replacameni oi the nir
handler, ontdoor condensing unit of e splii system A/C o� l�eat pump; coo]ing m� hsating coil; or [h= iurnnce hea�
exchaneeri a reineerent charee meesuremem sliall b� veri5ed ner (152fbllF.
Central Far� Inte�rated (CFI) Venfilation System and Fan V�'att Drah�
The ventilation renuirements oi F] 50(0l do not annlv to existinc� residential homes.
Ducted Splii 51�s[ems - Air Conditioners and Heat Yumps: AirfloH� HERS i�erif�caiion is reguired_fm� ihis measa�rc.
❑ 1�S ❑ NU ]'iS: ln Climate Zones 10 througli 1�, when the existing space-condi[ioning systsm (HYHC equipmani and ductingj is
reolaced. �he nidiw• and ian watt draw siiall be veriiietl oer § 152(b)1 Ci to meat the remiirements oi u 151(f17B.
Lncumentation
• ] cerHir that
Declaraiior Stztement
�
an[i
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li Anplicablc D Cr.A oi O CEPE
(Certificaiimi 1!):
' G'C�'14.;w. l�`�[ i<—cl � I W/ //i I' V l
l:espunsiblc I:uildinr Uesi� er's 7��claratinn Statement
•. 7 um eligiblr. undei Llvisimi .'� 01 the Culilornin Businec;: and 1'rotecsiom: Code to uccepi responsibility ioi thc bulldiug design iJentiGed mi
thi:�. CeniLcaa� of Campli;mce.
• ] ccnii�' thai Ihe cnergy leaiurc:::nul perlormancr speciiica�ion:. inr thr inill[Vim� tler,i�u idemiiied oi� ihis Cenifi;:atc of C:mnpliance ennlorm
tu lhcrequircmcros ufTitle 24, Pnn:. I nnd L nl the Calilurnin Cndr ofllegulmiun:;.
•'1'hr bnildmp desiEn leaturec IciemiGcd ou ihi:. Genilicxic oTCumplinnec;u�:.� cunsisiem vrilL th:: inimmnuui� pruvided w ducwuur, lhr.
builehn� desiEu oi� liir olher applicuble emnphane:. �lurm:.: wurl:shecu„ enlculilllUll:., �)Iilll:. �II(I 5�)L'CIIICHl1U11:. ;IiI�II11LlC� lb lI1C CIIIUtCC111C111
❑eencm iu� sonruvnl witL llu:� huildina ncnnii xnuliou�iun
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Itc��i.evmmn I�viniire:'
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(714) 754-5273 • Fax (714) 754-4856
Job Address: 905 PEACE PL
Suite No
Vicinity:
Parcel Nunmber: 41805305
Applicant: GLOVER, LORIE
Address: 2737 S. CRODDY
SUITE D
SqNTA ANA CA
Owner: CHIARELLI, MARK
Address
CITY OF COSTA MESA
BUILD/NG DIVISION
DEVELOPMENT SERVICES DEPARTMENT
PERMIT
PLUMBING PERMIT
Contractor: COAST PLUMBING & HEATING
Address: 2737 S. CRODDY
Arch I Eng :
Address:
SUITE D
SANTA ANA CA
WATER HEATER CHANGE OUT.
ISSUE FEE
Backflow irrigation
Backflow Preventer
Bathtub
Clarifier System
Connect pce,Soda,etc)
Dental Units
Dishwasher
Drein, Floor
Drain, Rainwater
Drain, Roof
Dnnking Fountain
Expansion Tank
Gas Earthquake VaNe
Gas (1-4 ouUets)
Gas (Over 4 outlets)
Gas Repipe
Gas Service
Interceptors (Grease, Oil)
Interceptors (Sand Auto )
AMT
szz.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
Qn
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
Phone: 714 241-1414
Zip: 92704
Phone:
Zip:
Phone: 714 241-1414
Zip: 92704
license: 529127
Phone:
Zip:
�icense:
SCOPE OF PERMIT
FEE SUMMARY _
AMT
Laundry Tub I Washer $0.00
Landscape Irrigation $0.00
P-Trap $0.00
Pressure Regulator $0.00
Process Piping�(per 10 ft) $0.00
Receptors $0.00
Septic Tank $0.00
Sewer Cap for Demo $0.00
Sewer Connect $0.00
Sewer Private Line $0.00
Shower � $0.00
Sink, bar $0.00
Sink, commercial $0.00
Sink, Floor $0.00
Sink, kitchen $0.00
Sink, service/mop $0.00
Spa (private) $0.00
Spa (public) $0.00
Qn
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
COMMENTS / SPECIAL CONDITIONS
�G�
PERMIT NUMBER
P99-00022 ✓
77 FAIR DRIVE, COSTA MESA, CA 92626
Status: ISSUED
Applied: 01/14I1999
Issued: Ot114l7999
SumpPump
Swimming Pool
Trap Primer
Urinal
Vacuum Brkr Bkflow(1-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
Waste and Vent System
Water Closet (Toilet)
Water Heater I vent
Water Piping (Inst or Rep.)
Water Re-pipe
Water Service
Water SoRener
OTHER
VIOLATION
PLAN CHECK
REINSPECTION
TOTAL CALCULATED FEES:
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
ai�.00
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$33.00
nrv
0
0
0
0
0
0
0
0
0
0
i
0
0
0
0
EXPIRA710N: This permit shall automatically ezpire and become void it work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 180 days. .
INSPECTIONS: In order tor the work authorized under this permit to be consitlered legal, such work must comply with all applicable codes, and all
required inapeetions end final approval must be obtained. Failure to obtain inspections and final approval will result in the ezpiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545628
WORKERS' COMPENSATION DECLARATION:
I hereby aftirm undar penalty of perjury one of the following declarations:
❑ I heva and will maintain a certificete of consent to self-Insure for workers' compensation, as provided for by section 3700 ot the Labor Code, for the paAormence ol tha
work for whiCh thi5 pertni� is i5sued.
❑ I heve an0 will maintein workers' compensetion insurence, as required by section 3700 0l Ne Labor Code, for the pedortnanca ol ihe work for which this pormit is issuetl.
My workers' compensation Insurance certier end policy number ere:
Cartier. Policy Number.
(This secfion nee0 not be completed il fhe permit is veluetl at one hundred dollars (S 100) or less.)
❑ I certity ihat In ihe pertormance of the work for which this pertnii is issuad, I shall nol employ any person in eny manner so es to become subjec� to lhe workers'
compansetion laws of California, entl egree that if I should 6ecome subject to t�e workers' compensation provisions of Sectlon 3700 of tha Lebor Code, I shell lorthwith
comply wit� Ihese provisions.
ApplicaniSigneture:. Date: ��y i �
WARNING FAILUFE TO SECURE WOPKERS' CAMPENSATION COVERAGE IS UNLAWFUL PNO SHALL SU&IECi AN EMPLOVER TO CRIMINAL PENALTIES ANO GVIL FINES UP TO ONE HUNDRED
THOUSANO DOLL4PE (E100.000), IN FDDITION TO THE COST OF COMPENSATION, OAMAGES AS PfiOVIOED FOR IN SELTION 3]O60F THE LABOR WDE, IMEREST, AND AITORNE`f5 FEES.
LICENSED CONTRACTOHS DECLARATION:
I hereDy eHirm that I em licensed under provisions ol Chaptar 9(commancing with Sactlon 7000) oi Division 3 of the Busineu and Professions Coda, and my license is in full
force end eflect. Lic. a Class a
Contractofs Signature: � Date: �/— r i'- $�-'
CONSTRUC710N LENDING AGENCV:
❑ I hereby aKrm t�at there is e construction lentling egency for the peAartnance of the work for which this pertnit is issuetl. (Sec. 3097, Civil Gode).
Lentler's Name: Lender'S Address:
Signeture: Date:
OWNER-BUILDER DECLARATIONS:
I hereby eflirm lhat under penalry of perjury lhet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reeson (SecJ031.5, 6usiness antl Professlons
Code: Any ciry or counry which raquires e pertnit ro consWct, alter, improve, demoll5h, or repelr Bny SiruCNre, prior to It5lssuenCa, also requiras tha appllcaN for 5uch permit
ro Nle e signetl stetement thet he or she Is Ilcensed pursuant to i�e provisions of the Contrectors License Law (Chapter 9(cammencing with Section 7000) ot Division 3 of the
Business end Pmfessions Code) or thet he or she is exempt Iherefrom and the besis tor the alleged exemption. Any violatlon of Section 7031.5 by any eppliceni tor e Oermit
subjecls Ihe aDDIiwN ro a civd penalty of not more than five hundred dollars ($500).):
❑ I, es owner of Ihe property, or my employees with weges as iheir sole campensatlon, WILL DO THE WORK, end ihe structure is not intentletl or otteretl for sale (Sec.
7044, Business entl Professions Code: The Contrectors License Law does not epply to en owner ot property w�o builtls or improves thareon, and who does suc� work
himself or herselt or Nroug� his ar har own employees, provided that such Improvemenis ere not intended or olferetl for sale. tl, however, ihe building or ImprovemeN is
sola within one year of complelion, t�e owner-6uilder will �ave the burtlen of Oroving ihet he or she did not builtl or improve lor purpose of sale.).
❑ I, es awner ol the properry, am EXCLUSIVELY LONTRACTNG WITFI LICENSED CONTRACTORS to consWc� tha project (Sec. 7044, Businass end Professions
Code: The contrectors License Lew aoes not epply to en owner of property who builds or Improvas ihereon, end who conirecis for such project with e comractor(s)
Ilcense pursuant to Ihe Contractors License Lews.).
❑ I am exempt untler sec.
Business and Professions Code tor ihis reason:
Signature:
Owner ID varifietl by tlriver's licensa. ❑ Yes ❑ No
Venlicetion ai Ownership by (type of tlaument, i.e. - properry tax bill ar deed):
DIVISION OF INUUS7RIAL SAFETV PERMR CERTIi1CATON:
Driver's License No.
Date:
Expires:
❑ I hereby certiy Ihat no excavation tive (5) or more teet in tlepth inro which e person is required to descand, wlll be mede in connection with work authodzed by this
permlt, entl thet no building structure, swNoltling, lalsework, or demolition or dismantling Ihereaf, will be more t�en thirty-six (36) feet high. (Ghap. 3.2, Grp 2, AR 2, Sec.
341, Title e, Celitomie Administwtive Cotle).
❑ As ownervbuilder, I will not emplay enyone to do work which would require e permit iram ihe Dlvision oi lndusirial Sefery, es noted ebove, unless such person hes a
pertnit to do such work from the tlivision. .
Signeture: Dete:
Division of Intlustrial Sefety Permit Numbar.
CERTiFlCATE OF COMPLL4NCE AND AIfTMOROATON OF ENTfiY: I cehify under penalry ot perjury that I have read this application and state that the infortnation given is
wrrect I eqree to wmply with all state laws and ciry oMinances relating to building consWction, end euthonze representatives of Ihe Ciry of Costa Mesa to enler upon the
above-descnbed properry for inspection purposes. I agree not to occupy or allow occupency of any building authorized by lhis pertnit until final inspedion.
� ' � giSl �I Owner(s) , Date
--�� �... /-/Y- �p
AnNOr Authorized ApD�icant Date
COUE 1 INaPECTIONTYVE
1616 Fixed System Finel Fire Prevention
1266 Pool Spe Final
200 Final Re-Root
201 Finel BIocWRetaining Wall
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolition
26C6-46
�II I��
�ppEl INSPECTIONTYPE
206 Finel Mechanicel
208 Finel Plumbing
270 Final Electncel
212 Finel Fire Pravention
220 Finel Planning Approvel
222 Final Siie
250 Final Building/Occupanty
DAIE Itf�EtS
��
�ooetss a em�xo: AL t k'
orm� sruvEiF�r,: CHIARELLI, MA
� �noness 905 PEACE PL
COSTA MESA,CA
�vri.�uuuxc �ooxcss:
ARCNffECTOfl ENCaNFER:
YRII.Ofl FHG.'S AOOXE55:
cartx�cToxsruuE: J.Z. CONSTRUCTION
cam�croRs�uiwo ANA16 W BROADWAY
"°o"Eu: 9 2 8 0 4
LICENSED COMHRCTOflS DECLAFATION: I hereby ell'vm u�ker
m uca o������ � uc. cuss: �� � vi
u
�„li -�"i'-14�—�'lG ��M.o,,,.�
92626
FLO(i�: X 47
�
uc ra.:
UNf:
(714)956-4618
CA 597408
uc.ra:
uKr:
� Nm I em liroeued uMm provitims d Cheqa 9
'�%�i��'�'° ""�m� "�° °�{ / 9 7
�W NE UILOEN UECLAflATION: I hareby eifirm untler pen�/W parjury 1Km I em va6iy�f(om tM Convetlae lice'ue lew for tM
�, (saa� �wis a�::�s d,a r�d,,,�o�s coes: nm �n «owmr wnw� rea��� a v�n io oa,.wn. en�. ��.
�--,'3emoloh, or repei eny ewnuro, pnor io im oeuence, elso requiree the epdicenl �a auch pa�mn ro file e aipned aietament Mei ha a vM
'n liceneed Wnuani ia tM Wavieima d Me Camreeoia Licenaa Lew IChequ 9(canmenaeq xnh Sedion ]000) d Diveion J d tha
Busineas arM PrNeuiam Cade� or thm ha a ehe ie ezemq Ihxehum eM tM beaie /or Iha elbpeE exemqion. My vialelian al Setlian
]O�t.s by arry epplicen� lar e permn wbjero iha epvlirant to a avJ parelry ol iw mwa �M1en Iwe hundred ddlue �55W]).
� I. ea owner olt�e propaM or mY �VbY� �h wepea es ihei eda mmpanm�bn, ll da ihe xwk. erd IM aowun u rd iruendeE
ar olimetl br eeb (Sectian ]Oaa, Buvrea end ProfessimsCOEe: The Conuetlas Licensa law tloea ml epplyto en ow�wrd qopeM�
who buiEa a inpm.ee iherean. eM who Aroa euN xork Ivmaetl «MneM m Mrouph hu a har own mmWqwa. pwided tAm euch
improvemenu ve rot in�aMed «ofleieC Ia aeb'H; hawm�er, tha buiNinp ar inpewamem ia sold wnhin om yev d eanqe�bn, �M
owrnrbuiNx vnll heva Iha WNan d pv.•i�p M w eM dk M bnW or improre lor IM purpwe d aele�.
� I. ea owner d Ihe propaM. � e�dusivety mnlredin0 �h lieensad wnvee�on W rmstrud the qqm (`�� ��. Busiewa eM
Profeaebns Coda: Tha Con�retlae Lieerua Lew dou nd WdV �o en owmr d pW�Y who buitle a'vnG�'s �hereon aed Wa
conlrecb fw wM prqeda xqh e mNraUot(e) IcensE punuanl lo Ihe Conlredon Licenee Lew).
� I em eaemp uMer Secnon: .�, B. 8 P.C.. la ihie reavon:
Dete: � �T�:
I do hemby canity �hel l em ewere d eM understeM iM rpuiremente d CelLanu Heellh eM Se/My CaEe Seqbne 25505.25533, uM
25531. eM Nel I a ury Mure bnMiiq ocapeni wiil / wil �(tircb are) need ro canply wih eeid aela mJn md �M ieq�memmN br
epe�mnlacanevuclbnormadifrceiionhanlMRi ue�7ny�ianepemmtDietnd.ReaidanlielconaVWioneppiceliomweaemqlmmthsee
„�r�,..
Dme: Avv�r�:
W OflKER'S COMPENSATION UECLRHITION: I heraby dfirtn uMer penelry d parjury are N tM lolbwi�p dedvmbm:
� � n.�re.�a wi� meima:i,c.na�me d oonsem io sen;�aA m..w�ke�e comv�on. a. nwded �« M s.�a� a�oo d me len«
Cade, la �he perloimenca W the work la which Mie pamin ie inued.
� I M�e arM wil meinlen xaAins' mmpemelion iroureMe, m repuired by Sedion �)00 M IM Lebor Code. br iM pa/amazim d IM
wak lor whi h �hia parmX ia iesued. My wvFe% canpensmion inwrence raner eid poliry number ere:
Cemer:
PWzy Numbar:
�s saction neeC rrot be romdered / �M P�R'v M vrre hurrdied ddkrsl3t0u1 w ba.1
I oMiy Ihel in Na pa�lormenca d Ihe work M whch thu paimn ia iawad, I 4WI m� empby eny peiwn N eiry memer eo m lo
became auMea lo iM xwken' wmD���ion lexw d cdHam' e�M Wres t1w d I elwuk became wbRd to tM waAmn'
omw�smion a�rieom o� seeion a�ao m me lenor coae, � el� onnwnn co�y wnn �noea wwiuw.
,� 9 - a y �G A�w���:
Ir
�minp: F�Nun ro sseuro woilrari rompawtlon eov nlawNl, an �NI �et �n �mplqer ro eNmlml pmeltl�� �iM
elvll fl�w W ro ms Funtlrod fMuiaM Ca/len (SfOq0001, In MtllHon b tlro ew eo�n.�.,em�, e,m.w. ., p.owe.a ro. i�
Sxtlon 3TM ol Ihs LaDar Cob, /nM1rsst, eM �ttomeY � lea.
CONSTNUCTON LENDINO AOENCY: I Mreby elfiim uMar peneXy d per'Wry Ihel �hera b e mr�ruaion bMiip apsicy lar Ne
peAarmeMa M IM MOM M whirh ihb pe'mi n eeued (SeGun 309'!. CN. CI.
LENOEN'S NMIE:
LENDEP'S 1UONE55:
I cenily iMl I he.e re� ihia epplicetion eM Wme ihel the ehwe iMormetbn b mrted. l eprea to comply wilh M dry mE courqy wd'va��e
enC et¢�s�pxs relelinB �a b�lldinp conmrudion aM hereby auNarize repreaen�etivea W thie ary to enter upon tM ebove�mentioneE poperly
DUe: � �� % �
W�ne-BuiIE'up d Sefery; OreamFle; Cenery-Appkcent; Pink-Revenue: Gddenmd-Asaema
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: B 079633 PLAN CHECK NO: 03909-96 L
CONSTRUCTION TYPE: PERMIT TYPE: STR
• �' . e
• � �.. �
PURPOSE: CON
JOB DESCRIPTION : REPAIR 30 FT BLOCK WALL SQ FT: 30
CLAIM VALUE: 700.00 CALC-VALUE: 600.00 GROUP OCC: U-2 /
COMMENTS: HLOCK WALL ONLY ON 905 PEACE PL
+���+�+��**����*�***+r�*�r**x��r�r**+r**�r*� ***��+�+r*��*�*x�**��*�+��+�***+�****�*�«��r+�+��r***��r*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HOILDING ---------- --------- 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: 41805305 ZNE: R1 REF NO:
PLANNING NdTES> REPAIR AND REPLACE E}tISTING HLOCK WALL IN EXACT LOCATION
> WITH SAME MATERIAL. •
�****��**�*���r***���**+�**� x x ��x *�r*x�*�x�*�r*****�*�r�**��**x+r+r*x **�**�r�r�r****x���*� �r�r
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 C� ., OC DATE: ^
� /
BUILDING APPROVED HY ; DATE: . � G
APPLICATION ISSUED BY: DATE:
�FiFiFiflEiflFiFlFffiFif3fIFlflEiElE1ElE1E1f 1E1EiF1E1EiE1E1F�E1E 1EiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL EGMENT:Y
PERMIT
BLDG PMT
23.75
PLAN 15.49
ISSUE FEE
PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
- . 50
- SMIP/NON-RES
/�
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 24.25 0.00 15.44 39.69 39.69 ,00
� i.
REVENUE DIVISION TOTALS--> COLLECTED: 39.69 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
23,75 ,50" 15.44
iflk k!f 1k 1E iF iF 1E 1E iE iE 1FlF dF iElE 1E 1E 1f �IF �f 1F iE iEiE iE fE 4 fE iE iE if iF 1k iF �lf !F iE 1E1f iF 161E fE iE IE iE 1E 1E fE 1E iE 1E 1h 1E IE iE 1E iE iE 1E 1f iF'lE iFlf �k if IE IE iE 9E'lE iF iF if iF 1E
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 30 RES-CONCRETE BLOCK WALL / FT
END OF FEES
207.00 600.00
i �
.V
'� �
t!
Of OQ2i5S97-00?l5S49 T O T 39.69
DA1E: 09/2ti19` 7IME: l4-S6
.
/ CONSTRUCTION AND PLANNING P� �` S� � -
`APPROVALS Permit# � � Date Inspectar qppROVAIS Permit# Date Inspector
i. Temporary Electrical Service or Pole 52. Pooi & Equipment Location � � s
2. Soil Pipe•Undrgrnd. ,"" 53. Steel Reinforcement '
-'3^Electrical Conduit Uiility-Undrgrnd. � 54. Forms � -
=:�4;`ElectricalCon86�-CJndrgrnd: - 55. ElectricaiBonding
��c5. Steel Reinforcement � Z� -� �(,,�[ 56. Rough Plumbing & Pressure Test - �
_ r6��Electrical UFER,,Gmd. 57. APPROVAL TO COVER�GUNITE ` )
r7�•Footings ��_ A GZ Zs'� /y� 58. Electrical Conduit-Undrgrnd. - �
; 8`.'�Foundation ' �� 59. Gas Pipe, � Undrgrnd., Test ' �
� 9. Water Pipe-Und�g`rnd: � ,' : 60. Backwash Lines, P-Trap, � l�ndrgmd.
10. Structural Pioor SvsYem � 67. APPiiOVAL TO DECK
1 i.. Property Sewer �ine & Hous� Connection 62. Backwash & ReceptorFinai %�
12[ Sewer Cap �. � - 63. Heater & Vant�Final ,
73. Roof Drains ' ' 64. Plumbiny System - Final �
.74. flough Plumbing 65. Electrica6Final '
�
�,75. Rough Electrical-QOnduit x 66. Solar SYstem-Finai � �
76. Rough Electric Wi�ing � 67. Fencing & Access AnProval ,
' 17. RoughWiring$iq�°" �- 68. APPROVEDFOR�PLASTERING
�.
18. Rough Electrirai�T Bar Ceiqng 69. POOUSPA SYSTE4�S FINAL �
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT •
20; Rough,Facto'ry Fireplace - a�.''-; :� '' �� p; APPR�VqLS� Rermix#-�
21�Ouc'ts, in Structure- - J� K �. 7 �'ti�, 70y� UndergraundCHydro �` "'
22~r �
Ducts, Ventilatiog„ �`� _ `� * v 71�Prodvct:Piping�('JGas :�OOiI
23'-Ga's Pip€Robgh &�Test - '"' .a, �� �; ^ 7z, UndergtoUnd_Flash. Y �
24; Roof �,�ming �=,; ' _. .. _ � - � - = 73. Undergmd.Siorage•Tank [�Gas E10ii
25. Rdof Sfieathing;� k �� y'" _ -- 74 30verhe'ad HycTro� � �`�
.
26'T-BarCelling{St�ucturap &=Monocoat--; � -� ,7�".Dry_Chemicaf��� � -. . a�
27:��Frameand Flashing _ - � '� �'� 96. Dry Sta'nc�pipe'� * � ' �'
,- F c
28` Lathing&Siding. `� _ - - - 7J. FIXEt3�S�,'ST�EM FWAL � �)
29. Ineulatfon -- � " -+ � � - =" ' • � � :78. FIRE PqEV. Fl.NAL } .
rt � ! c - .
r,
30. Drywall,NaiFino,�; '" '" `;� �„" , � ,..., � HEAL-7NDE4T.REQUIREMENT
31. Plaster Brown Coar � -- * � � 7�9. FINAI,n1NSPEC7'ION r, �
c - i r^ w
_ 32. Electrical Po`�rverzNl�ter-Final '` -` �� �,'� �,� � � i'�. .,� $0. FOOD C�RTIFICATE.ISSUED � �
33�LFiu�lEtactric r'fi . T=+-•?7 �i-;7 �Notes: �. -- .x -
« -i n . -�
� 34cFin`I FlEatir7g &"fiG Conditioiting '^'� • G ' �'� �' �`' r':'� " - -
, � .�. > . w. c s , � +' -' Q�-
35�Fina1 Ga Pi.pe-Teit =�, a i �� - '!-' K ""�C:
r,.- r
_, 3�Ho'od oi:CanoPY �� _ �y - : S � � i' ;t �.' < <"�� ..� ' ' �: --
�
37' Final Factory Pireplace � SiT " - � , - • � -
�- - -
- 38. Final Piumbing ; � �. " " -' ` �� , ,,; - � �` K. ,-- --_
F 39,:,.Water Servioe-Finai ��- . r, ! � �c � ....�- ?: r. ^
v r J �
`" 40?-�Gas Service%�inal y . �^ � � " '":- . ; y '
,r� < i;' T r. `- `r� r: �
� ^ '
^ 41-Solar pomestic•Pina�- -. � � � �-��c � -� �
= - - �r - -
J 42:�Backflow Prevente9 '- � - - � - ' Y --
_ - � _ . �. . � - 1
43. Backfiow Irr,'igation ;'_ -. _ - � : ��_�/ 'c-- � ; � .�', ���� I
- � . . _ +� � D ' �� 1
`44. Landscape tr)igati8n System. � _ `�` " - - `' - - w ` �� = � ' i
a� �� i� _
. `. .� ' ^r � y F ,1 �..; - .
�� 45. Sound 'Attenuation - , _ � g �, - ,
-�� � � �.r� * �
'= 46-Handicap Re�qulatiGns �- =- ' ���� "' '� r, [ �"'D _ : , ,
'J:' '% Y: ' C�4
�A7.-FINAL STRUCTURE & BUfLDING ^"' -
_ - _ �-��26 �cv` ,:�� ..
r ' - ' J
48_ FINAL PLANNING - � - ��- • ;� _; ,y � �
49�-Electric Release m'Edison i �,. �� E" ' .
- 50._Gas Release to So�tthem California GasCa '. ! ; � � ~ ' ` -
: �, y , ���;, .
-51. CERTIFICATEOF.00CUPANCY ; :,: r, � , �_ ,_
No. Date
��
TYPICAL 6�� CONCRETE BLOCK FENCE
Cement Coping Ootional �
Channel Block With�73/8�
Horizontal Top of all � �
Fences
For Fences 5' or Less
Vert. Bars 3/8"yS at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C. �
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall
Conform to Sec.A-15-39
A.S.T.M.
All Steel to be Lapped
24" pr to Code
NATURALGRADE
7W0 3/B"t5 BARS
CONTINUOUS TOP
& BOTTOM
.HOR7z.5TEEL MUST BE TIED IN
PLACE A7 TIME OF TRENCH
INSPECTION.
d
uA
D '
_
�
�
w
_
z
t�
—WIDTH
SEE CHl
BELOW
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: p�e part Plasfic Cement, and
Three Parfs Sand
GROUT; One Port Cemenf TAree and
O�e Half Parts S'and
COPING: One Part Cement, Three
Parfs Sand
CONCRETE: yyell Mixed 1;2-I/2:3-I/2
Max. of 7- I/2 Gollons of
�Nater Per Sack of Cement
GROUT MAV BE POURED FROM 7HE TOP
OF THE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS OF HORIZONTAL REIN-
FORCEMENTSHALLBECLEAR,CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H GF E4RTNTCOTH
�/3 iHE HE�GTH Of FENCE
�BELOW BOTTOM OF FOGTING.
SCALE: I/2�� = I'
WIOTH 14" . . . . . . . . . . .14" . . . . . . . . . ... 12". . . 12..
THICKNESS . . 10�� .
10" . . . . . 8 ". 8 ,�
DEPTH OF EARTHTOOTH .. . 24" 20'
16' . . . . 12
SPACING OF EARTHTOOTH. . 12� . . . . . . . . . . .14� . . . . . . . . . . . 16'. . . . . . . . 16�
City of Costa Mesa, California
Building Department
� . - . . ., . _. ... (,?E,vfSED Nov, e2
NEEIDEMCE
�
�
0
M
R[!ID[MCE
�J �
_ A"G�. STREET
R[SIDEMCC
o-
SURVEY OF LOT LINE
MAY BE REQUIRED
RESIOEMC[
JI
N
W
W
Q
�
N
�I
�ss , uaaxc: 905 PFACE 'PL
1F1°'01''"°CHIARELLI, MARC
�ooxess: g05 PEACE PL
COSTA MESA,CA
434-1206
�ar�. eww�c,�oonEss:
ARCXRECT OR FIItlNFFN:
NMH. OX ENG.'S AODNE55:
UNT:
FLOOD: X 47
92626
LIC. N0:
UNT:
coem�cTarsruue:S.Z. CONSTRUCTION (719)956-4618
LONfFACTORSM/J11N0 2016 W BROADWAY
aoo�ss:ANA CA uc.ra.: 597408
92804 uxt:
LICENSED COMPPCTONS �ECI.�RATION: I he�eby ellim uMer penely d perjury Ihm I em IbemeE uMer pwiabns d CMqm 9
(mm iendng wiiM1 Seciion ]000) d Division 3 W tha Busineas end PMesawne Coda, eM my licenee is in lull lorce eM eflecl.
u. . uc. cuss: H � 5 9 7 9 0 8 E�L�[s�
S=y9-96 -
me: '�--_ Comraew: �
/
WN UILUENNECLAN 10 : I hereby �rtn unCer pen parN e� I em evmq imm �M Coniradon licema Lew iw IM
..1 � 9 reawn (Seaion ] iess eM Pmlesvons � m� ciY a�nry xfiiM mquirea e permn �o owuvuci. elier. impme.
moleh, or repek eny etmewre, piar m na 6euaeKe, eLvo requime iha epolieent for wch permA tolla a eiB�� elelement I�et M or ehe
Y�Is IicemeE W��� �o Ihe pansioru d tln Contreqoro licenae Lew �Cheqer 9 �oommerciiq xilh $edion ]000) d DNeion 3 d Iha
Buaina� eM Prdmsions Codaj m ihm M a she is exemp,lhereimm enE ihe bavia fw ihe elleped examqvn. Riry vidaiion d Sedion
]0'lt.5 by eny epolirant Iw e perme eubjanv �he epvlicent io e wil penelry d�wl m«e Inen ira huMretl Eollere �550���.
❑ I. m wmer Mthe propMY a my emplvyaee xih wegea m ihei ade mmpansatbn. will do IM �wM. eM IM et�uclure e �wl in�eMeE
or ollereE lor seb (Section )04<, Busiiwss entl PrWesaions CoAe: The Con�renore Licema Lew does noi epplyto en owner oi qopery
wlw buida or inproves Inereon, vM who Eoee eudi MoM IimroM w henetl a �hrpph he a her own employeea, povideE Ihet wch
improvemenia ere mt inieMetl w oHered tw eale. X, Irowever, �ha buiNirq w mqwemem ia soM xilhin me yeer d mmplMon, �M
ow���w�us, �;n na.e ma b�m� a oro,me na o� sna a�e oa wna o� �mwo�* �« in� wmosa a.�a).
❑ i. � o.mer a ine v�wem�. em a:a�a:eh mmreams .nn r �sea �a�v�mn a c«�m�a me c�i«+ Iseao� �a.. e�a��se ena
Pmlessions COEe: The Comrenon Licenae Lew doee � epply�o en ownard prapany wha buiNe wimprwaeiM1ereon erM wM10
wnvecm t« axi� propda wnh e coniredor�sl IicanaeC punueni io IM1e ConireGan liceme Lew).
� I em eRemq unEar Senion: B. 8 PA., br this reeson:
i ao nereW <«iM u,m i� a..�e d ene u�emsw�d ina ma���amo a cae«nie Heenn ene smmr coee sm�ms uws, assaa, m,e
xssx, a�d mm i« a�y nn�re n�adma �+,oem w�n i win na Icircb one) �,eea io mmoh wan �e mme �aa. �e m. rea��.emama b,
epermAiwcauwnqnormoEifimlionhwniMAr-6u Gy�enepemeniDinna.qasitlmlidconslrud'anepD���erte[emptlromNme
poW:ro�a.
Daie: ADd��
WOflKER'S COMVEN4ITION DECLAPATION: I hereby eifi�m uMer psneXy d pa�ury wr d the IWbvnip decbmtone:
❑ � new e�d m� meimen e a.nnkme d mn.em m sarcJ�w,. m,..o�an comr,enwio�, es rw�aea �w M s«aian a�ao a me �ee«
Ci�O. �a! ��IB �IBf�OfTB11CB Oi �11B NVf�[ �O! Whlth I{119 PBTIII 1819911Bd.
❑ in��e���m.:,..o�ao��,ro����,,.�.nrec���acrsm�aiooams�e«cma.ro�inero��aina
woM br wTiM ihie pemin ie iaeued. My warke�e compeneation ineurar�ca ranar and poliry number era�.
c�,:
Policy Number:
�nia, �woe na o-n ca�Waree i rna w,ms u ro, o.,e n��d,ed dd� Isiool w Nu.l
9 I eeMty ihel in IM pe�lomunea M Ihe wark iw whkh Ihie paimil ie naued, I ehdl rot emdW �Y Pe� in eny menemm w u ia
e«a,b wbjw �o �ne �onen' cvnw�seibn lew. a c.4t epiee inm a enwa eemme wCjx+ w �ne v.wwen�
mpansetion pmviaione d Sedion 3100 ol�he LeborCode,le ellio hwnh mmON �� P�ebna.
.._ � � �> _ �,� .--�---. C� a� c� �-
�yY6mlrp: F�llun ro sxuro wailrx�'rompxwtlon eovxeps III.IkwNl, �iW iNll wb/�ef �Niip/oyx ro eNMru/ psnaMss �iM
c/rll flm� �,y ro ons ��nOrW fheuuM da/Mn (Sf00,000), NFflGIHon b M� ewt o/ romperwtbn, 0emsp� es pnvltlH br In
SxHon J)O6 0l Ms Lebor COM. Inbruq end ettornsY'a I�u.
CONSTHUCiION LENDINO AOENCT: I Meaby eifirm urMer panelry of pmlury ihet �hem is e conetivabn bMi�p egeney br iM
peAormenca M �M wrk fa which thu pxmY ia uauW (Sed'pn 309]. Cv. C).
lENOEP'S NAME:
LENDEP'S RDDRE59:
=
I cenity �hq I heve reeE Ihis epplketim end elete Ihet IM ebove in/ormeiion is coiree. I eprea lo comply wnh ell ciry uM oounty ordinencee
enE etele bws reblip lo builEvp wns4udim ard hereby ainhor¢e reprawn�etives d Ihn tlty lo enler upon Iha ebove�mentiomE pmperry
fainapeaian purposes. .
�E GUZMAN
Dete: 1 � �' / ��—�
(5�51d6 WP� Buildrq 8 Selely:OreairFlle; Cenery-Rpp4rant: Pink-Rerenue; Qoldanrod-�qseem
CITY OF COSTA MESA — BOILDING PERMIT
PERMIT N0: B 077896 PLAN CHECK NO: 02119-96 L
ERM NO: B 077E396
GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: CON
J08 DESCRIPTION : CONST. 6'HIGH BLOCK WALL 60LF SQ FT: 60
CLAIM VALUE: 2,200.00 CALC—VALUE: 1,200.00 GROUP OCC: U-2 /
COMMENTS: BLOCK WALL ONLY BETWEEN 905 PEACE PL & 904 LIARD
**��***�***�*�x*�**���***�*�**+��***�**��*�x���****���**��******��**+����*****�**�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------ MAIN BUILDING --------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 41805305 ZNE: R1 REF NO:
PLANNING NOTES> 6'HIGH HLOCK WALL SHARED WITH 904 LIARD AT REAR P/L. +'
i
3f 1E 1f !E!f if 1E 1f iF iF iE iE 1E iE if if �f 1k iE 1f !E 1k ik iF iE IE 1E 1E iElE 1E 1ElE ik iE fF fE iE jE iE if iE 1E �E �E fE fE 9E 1f 3Elf iE iE 1flf if iE 1f iElE 1E iE 1E 9E �E �E 1E iElE ik if 1E 3E iE iE if iE iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROC�ED BY T'C �\' DATE; /
BUILDING APPROVED BY : DATE: C�
APPLICATION ISSUED BY: DATE:
1FlE1EiEiEifiElEiEiF�EiEiEiEffiEiEiE1EiE1EiE lEIE3E1f1E1E1fiEiflE 1Eif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
HLDG PMT PLUMBING ELECTR-L,C MECHANIC FIRE SMIP/RES GRADING
PERMIT 40.25 .50
SMIP/NON—RES
PLAN 26.16 �
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN�CHECK
TOTALS----> 40.75 0,00 �,26,16
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
40.25 �
TOTAL PAID DUE
66.91 66.91 ,00
66.91 OVER/SHORT: .00
FIRE SMIP/TOT GRRDING PLAN—CIiECK
.SO 26.16
*�*����*�*�**��**,���**���*��*****����*�+�,�**��*�����*��**���***�**���***+�***�**�
I N D I V Z D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O NZ UNIT COST TOTAL COST
SFR 60 RES—CONCRETE BLOCK WALL / FT, 20.00 1,200.00
END ,OE FEES
�
�, - ..C'-, .-_ 25' ' . " -.
. ,_ .. _„ :�,
NSTRUCTION AND PLANNING ' PC y SPA1
� 7ROVALS Permii # � Oate Inspector AppROVAL$ Permit # Date i�spector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3: Electrical Co�duit Utility-Undrgrnd. 54. Forms
• 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Steel Reinforcement � 3A-N/_ �(�/� 56. Rough Plumbing & Pressure 7est
(Y
�6. Electricai UFER Gmd. 57. APPROVAL TO COVER-GUNITE
7.'Footings � S'��- [V� 58. Electrical Conduit�Undrgrnd.
8. Foundation _ ' 59. Gas Pipe, O Undrgrnd., Test '
9. 4Vater Pipe�Undigmd, 60. Backwash Lines, P•Trap, � Undrgrnd.
70. Structural �loor Sysrem 67. APPRpVAL TO DECK
11. Property Sewer �ine & HouseConnection 62. Backwash & ReceptonFinal
12. Sewer Cap , 63. Heater & Vant-Final
73. Roof Orains ' 64. Plumbing SYstem • Final _
14. Rough Plumbing � 65. Electrical�Final
1.5. Rough Electrical-Conduit .. 66. Solar SYstem•Final
t6. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sigrt 66. APPROVED FOR PLAS7ERING
18. Rough Elecirical-T Bar Ceiling 69. POOL/SPA SYSTEA4S FINAL
79. Rough Heating & Ai� Conditioning . , . -• pLr''tE DEPT. REQUIREMENT
20. Rough Factory Fireplace " • �ApppOVACS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22.Ducts,Ventilaung � � 71,ProductPipingOGas OOd
23. Gas Pipe-Bough & Test _ � , 7p. Underground Ftush�� �
24. Roof Freming � ' 73. Undergrnd. Storaqe Tank O Gas ❑ Oil
25. Roof'Sheathing - �. 74, pverhead Hydro
26. T-Bar Ceili�g (Structurap & INonocoat 75. Dry�hemical -
27. Freme and Flashing .. -� . . 76. Dry Standpipe �
28. lathing & 5�ding ' _ 77. fIXED SYSTEM FINAL �
29. Insulation -� - - - � 7�'. FIRE PREV. FINAL
30. Drywall Nai��ng r -- � _ HEALTH DEPT..REQUIfiEMENT
31. Plaster Brown Coar ,' . � 79. FINAL ENSPECTION "-
32 Hectricai Power MeterFinal 80. F000 CERTIFIC�ATE ISSUED '
33. Final Electric ' Notes: �
. 34. Final Heati�g & Air Conditioning i �y --��-�,�
_ . . - �'c�- �- cf�-a�-,
35.�Final Gas Pipe-Test�' . '� �. ' , /-�_
�P�
� 36. Hood or Canopy - . � - ' � � '
37. Final FactotY Fireplace � - ; � � _' �
38. PinalPlumb��9� ' -
39. Water Service-Final�' " ' .
40. Gas Service-Final ' � , r
41. Solar �omesticFinal -
42. Backflow P�eventer • . � • r. .
43. Backflow Irrigation � - ..
44. Landscape Irrigauon System , � � • -
45: Sound Atten�ation � - - ' • '
46. Handicap Regulations - •� .
49. PINAI STFIUCTUflE & BUILDING G�O -qG (IGUi��
48. FINAL P�ANNING . i '
49. Electric Release to Edison � ,
50. Gas Release to Southern California Gas Co � -
57. CERTIFICATE OF OCCUPANCY
No._ Date
�
o� o� c' o sP`� �� S'
�
��sl�,-��F ovEo SIa
AY�'R �a�'�
gt be kep� ��p
50�tf�ca�wi^ � aRefauM ���Y�f
�5 �� a, a�a�u ao myke anyof &��i� �'aS NOt ,
a� �� `S �n t;o;n �h° b`�S�on �dic2Uons St��pns of
�m,�s��on }, p�a� an No�an ot a�y P
ihe s�nmY,°0 �..a', a'� �� ate 1aW • at�d bec
� to'co .s� , e Gmda6 aNtiu�ed'
o �..r,.�<-' • p e;.Dt;e � a�d m
nAos� �' l -:.1 � plm2^.ce .'
" �;�' .u1C0
ihe50 4 :' �� � . ,. �a �� `a��e.
R�OUl10�,.QL � .col �w`
,d� w�m�;.
�
b
�
W
W
Q
�
N
Rd10tNCE
�
�b
G�Y °�'�
11LlID[MCL
Permit #�1� �� 6
THIS NUiviBFR MUST ACCOMPANY
_9ll_1NSPECTIOh; REQUtSTS
R[81DENC[
STREET �
Y� s ,��� i�� ,
SURVEY OF LOT LINE
MAY BE REC�liIRED
�s%�c�^�c� �
6. ������o�� 6c�
�Pi�OVED �,
CiiY OF COSTA M�SA
F1AN�IIvta D�T. �
suase;.; so caaa. ns�, u�,
u ,
%�� DA71�Sa���
Z � �
NE8IDEMC[
�
PARTY WALL AGREEMENT
THIS AGRE�MENT, made and entered into this S�/ ��9 1p day of
, by and between \�► O.� C� � ����
hereinafter referred to as "LANDOWNER;' and i n�.-�A � Vl � C�� l� 2" �
hereinafter referred to as "ADJACENT PROPERTY OWNER:'
It is hereby agreed that a party wall will be constructed on the property line
between
�5
of Adjoining
a� e Cos t� Mo_s�, C
in the City of Costa Mesa, County of Orange, State ot California, as per map recorded
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
/ . (Signa�/' ���
• ` � ��
�'. ��� M,�`�'�
Name (Typed o Printed)
ADJACENT PROPERTY OWNER
�i��CQ�j / ^ .
(SignaWre)
�res� � �iZ.r-��1 �
Name (Typed or Printed)
�
�c , � ��5 �' pl� ,��r 9��
ddre� � �� � � �,(yF (Address) ��G�
NOTARIZATION REQUIRED
isos as
AoO���ant to fill in all soaces exceo� ��ase within neavy bortler Ilnes ana sign all apv�opriate Oeclarations.
CITY.OF COSTA � CQ{�STRUCT}QN P-ERMIT _ _ P IT NO. TRACT NO. - LOT NO. - UNIT,NU. - '
Prolect Address _ .. �.� t� ��G �2 y�3 7 S�
ApplicanYs Maili ddre3s � - ' TYPE OP CONSTRUCTION� NEW ' ADD ALTERATION 'REPAIR� '
_ , / O - ❑ CONVERSION O DEMOLISH ❑ OTHER- Ap # �
Owner's Narne 'Pho td
Address $�'i't0
Arch/Eng. Licenu No.
Address
Contracto' N �n n�- PY � �
Addressim'I' 1 /�.� ' 'n1')Ll- �/.1nti. �
City License No. � ���
LICENSED CONTRACTOR DECLARATION
I�hereDy affi�m Ihat I am licensetl untl¢r provi5ions of Chdrt¢r 9(commencing
wlth section ]000) o� Division 3 of the Businesz antl Profez5lons Cotle, antl
my Iicense is iq tutl forrfpnqe�ct, n� �' Qh rf7
�IDa Si9na[ure /
WO RS' O NSATION DECL RA I N
� hereDy atfirm tha� 1 have a certificate oT consent to s t- sure or a certificate
�t Workers' Compevsation Insurance, or a certiti py tnerooi (Se[ ion
3800, Lab. �In I (�j1I
� Policy No. -� / Co any
Q Certitiea copy is/hereby famishetl. ` qI
.�'TTrxifieAcnnLldliledwithNeciiv 'zIM'.
E%EMPT/ON FROM WORKERS' COMPENSATION p�CLARATION
(This sec[ion neetl �ol be completetl if tne perml[ is f0r �ne huntlretl (E300) or
less). \ 1
I certify that in [M1e Perfo�mance of the wo�k fOr whit}Tthis oermR is izzuetl, I
shall not employ any person in any manner so as to become subject to the
Workers' Compensatlon laws ot Cali/ornia.
. Date - Si9nature
'NOTICE: It, after makin9 this tleclaration, you shoultl become subject to Na
Worker5' Comp¢n5atlon ptovisions of the Ldbor Cotle, you must forthwith
comply with such provi5ion5 or this D¢�mll shall be tleemetl revokeU.
CONSTqUCTION LENDING AGEPICV
I nereby alfi�m [ha� there is a construction lending agency for the performa�ce
of the work fo! which this permit is i55uetl (Section 3097 Civ. CJ
Lentler's Name
Lentler's HtltlreSs _
OWNER BUILDEM DECLARATION
I hereby atfirm tPat I am exempt from the COntracror's License Law for the
(ollowing reason (`.R�tion 7o31.5 Business anA Professional Cotle: Any citY or
couMy wM1icn �equires a pe�mit to construct, al�eq improve, tlemolish or Rpalr
any sl�ucture, priOr �o Its is5uanc¢, a150 reqWres Ihe applicant fOr such pe/ml[
to tile a signetl st?t¢ment that ne/she is licensetl pursuant to the provision5 of
the Contractor's V�ense Law (Chapter 9(commencing with Section ]000) ot
livision 3 of the Business antl Professions Cotle) or Ihat he/she is ezempt
aerefrom antl the basis tor the alle9etl exemptlon. Any violation of SecHon
/031.5 by any ePP��cant" for a permit sublects tlte applicant to a civll
�enalty of not more t�an tive huntlretl Collars (5500�.
I, as owner o� tne 0/operty or my emp�oYeeS with wa9e5 a5 lheir Solo
compensation, wiU tlo the work, antl [he structu�a is not in[entletl o� otteretl
fOr sal¢ (Section 7044, Business antl Profe55ional Cotle: The ContractOr's
License Law tloes �oi apply to an owner oi a property who Ouiltls or improves
thereon, and'who tloes such work nimseli/he�seH or through his or her own
employees, provide0 tnat such improvements are not in[entletl o� oHeretl fo�
' sdle. If, �owevGr, lhe builtling o� im0�ovement I5 soltl within one year of Com-
pletion, the owner,wlll have tne burtlen Of prOving h¢/she Oitl no[ builtl o� Im-
, prove for tne purpose of sale).
❑ I, as owner of the O�oOerty, am exclusivelY mntractlng with Iicensetl con-
�[racton to mns[N�4 tbe project (Section ]044, Busine55 antl Profe55ion5 Cotle:
TM1e Co�(�acto�'s License Law does nOt applY to an owne� ot 0/o0erty who
. builtls or improv65 thereon, antl who contraGts for Such prolects with-a con-
Vactor(sl license pursuant�to the Contrac[orY License Law�. I am aware that
proo/ af Iheir WGrker's CompenSaHon insurdnce shoultl De p�OvltleO to me.
' �] i am exempt untler Section B. & P. C. tor this reason
Date ' � ' Owner ' ' �
�I hereby.certlfy that av ,reatl [hiz application anC.State that.the_above_
In(otmalion iz [orrect I� to compl wiin all, city antl county o einances
antl state IawS rel ��n il ing ruction, antl hereby autho ze re re-
sentatives ot this to u h ove-mentionetl /pr e y,fqr
insoection ourVases. L rl l
' Signa[ure � Date �� VO
Drivers' Licensc o� 55 � ' Reinspec[ion Fea
BuilEing;-CSnary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
D IPT�j'N F W RK/US 0 BLD��� ` �
"r/ S Main Buildi
TVPE FPERMIT GRaDirvc FOu DATiOrv $TRUC7URAL - T Front
❑ TENANT EIECTRICFI ❑ PLUMBING ❑ MECHANICAI � B R¢d�
❑ �OTHER C Right
PROJECT DESCRIP710N Sq. F7. oCCUaANCV K.
CONSTRUCTION TVPE VALUATION $ g Left
ZONE GRADING CU. VDS. ACRES p�ng. Ref. �
Remarks: Planning Notes:
/
3ar Sink
3ackflow Preventer
3ackflow Irrigation
3athtuhs
�larifiers
]ishwasher
7rinking Fountains
=1oor Drains
Floor Sinks
iod5$CfVICC �l1LIQI5
Interceptors
Kitchen Sink
Lavatories
P-Trap
Roof Drains
Rainspection Fee §75
Boiler
Duct - Under Ground
Juct - Ventilad�g
2xhaust System ❑ Multiple ❑
FirepVFact Blt. ICBO #
�� ating System & Ducting
0.100,OOO.BTU �100,OOOBTI
._ C M F_ 0 8 65-4 6„r e,�. 3 0/ 8 4
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-Wash
Laundry Treys �
Isue Fee
Hood or Typel ❑
Canopy Typell� ❑
tefrigeration Sys[em ,
�8-1Q0,00�8TU ❑100.�00
System Repair/Alteration
Fire Dampers � ' �
Registers '
—j -_. -,_'� _J._ .
laue Fee � I
BT.0
_ " '_ ' " _ _ _�__ '� _�_�' __r'-_ _' _
:_ . � .�i 8539`: 6%3D-Y86= � :' ' � 16.00' TL
,` . . � . , s:�.t �.--_ � . --� - . , r.:
Automatic Washer
Construction Pole Sub.
Cooking Uni[
Dishwasher
Dryers ❑Gas ❑Elec�
Fan
F.A.U.
FixNres
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator �65 KW C
ic
Accesic
Parking
�ildJ
/Pro��dn
Zone - _ _
Z
-. �
- - N
- I
- N
G
R_
_ E
Q
M
T
S
ELECTRICAL
-' - Transtormer'❑ 15-50-KW--'
❑ 50+KW
Meter ❑up to 100 amps
Meter ❑over 100 amps
Sub Panel
Motors OO-1 HP ' - B
Inc.Solar 09-15 HP 016-15+
Microwave - " -
Pole Light
Range .
' I; Standing Sections
5-15 KW I Trash Compactor
$ 3
Reinspection Fee $15 luue Fee
FEES
�� DEVELOPMENT SERVICES REQUIREMENTS: •
Zoning APProved By
Building Approved By
$ 3
F.EES
--i-
$ 3
. � SUMMARV OF FEES � � �
. BUILDING PERMIT �$ ' SMIP $ ' ' �
PLAN CHECK $ � � PERMIT � �
, PLUMBING, $ � �SSUANCE ,$ ,
ENERGY P.C. �$ '
i PLANCHECK 25%�$ � � i .
� ELECTRICAL �$ � GRADING ,$ I i '
; � P�ANCHECK 50% �$ -�--� �� �i� -i MICROFILM �$ ,�/ � ,
; MECHANICAL � �.$ ���UU� TOTAtFEE �$ !�!D��
� PLAN CHECK 25% 'g � � � I �
'.CONSTRUCTION AND PLANNING �� �_ , PO�_ & SPA
� APPROVALS Permit# � Date Inspector qppROVALS Permit# Date Insp?ctnr i
i
.�7. Temporary Electriral Service or Pole . � - 52. Pool & Equipment Location
-2. Soil Pipe-Undrgrnd. � � � - '53. Steel Reinforcement -
%3�.. Electrical Conduit Utility-Undrgrnd. " • � 54. Forms �- -
�4. Electrical Condui[-Undrgmd. • 55. Electrical Bonding .
5. Steel� Reinforcement 56. Rough Plumbing & Pressure Test
' 6. Electrical UFER Grnd. � � 57. APPROVAL TO COVER-GUNITE
�-�7: Footings • + , _ 58. Electrical Conduit-Undrgrnd.
i
8. Foundation � " �". 59. Gas Pipe, O Undrgrnd., Test
9r Water Pipe-Undrgrnd. "� • i.r 60. Backwash Lines, P-Trap, � Undrgrnd.
�•10. St�uctural Floor SYstem ' � 61. APPROVAL�TO DECK
11. Properry Sewer �Line & House Connec[ion _ ._ 62. Backwash & ReceptorFinal
� 12. Sewer Cap ' , - 63. Heater & VenriFinal �
13. Roof Drains " • , 64.� Plumbing SYstem - Final
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical-Conduit , � 66. Solar System-Final
�t6. Rough Electric Wiring � - � 67. Fencing & Access Approval
77. Rough,Wiring Sign ' 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19: Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test � 72. Underground Flush
24. Roof Framing ' 73. Undergrnd.StorageTank OGas ❑Oil,
25. Roof Sheathing � 74. Overhead Hydro �
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat � 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric %�ii6 Geo Notes: 7-iy��g(o LF�- �'�,� ,�'j:vc� L.E•��
34. Final Heating & Air Conifitioning 7_cT,�(� �,�1
35. Final Gas Pipe-Test . � , ' �
36. Hood or Canopy �
37. Final Factory Fireplace .
38. Final Plumbing �
39. Water Service-Final '
40. Gas Service-Final
41. Solar pomestic-Final .
,42. �Backflow Preventer � � "
43. Backflow Irrigation . ' � .
44. Landscape Irripation System _
45. Sound Attenuation � � � . , � .
�•'
46. Handicap Regulations �
47. FINALSTRUCTURE & BUILDING . � . �
48. Special Requirements Completed � • ' Y
49. Electric Release�to Edison; ' ' • � � . � � .
50. Gas Release to Southern Califomia Gas Co � �
51. CERTIFICATEOFOCCUPANCY - � � - �� .
N�g,� Date � . ` - ' ' '' - . - .
\
�
�
v
AVD���nt to fill In all spacea a:cept �
CITY OF COSTA MESA � � . � Egaq iT n10. �
CONSTRUCTION PERMIT ,0/— S�%%S e
Applicant'aMeilingAddress `yO.T' rIACF_ ._5–Z� .-�L.
Rqect Address �O `T �'�A�'� �'L
Ownm's Nam�B, ��•' % T�`'� hones a-S'7G1
Address � `��J ar f�CiHL� � L .
Arc�/Eng. Licenm No.
Address '
Conbectai i Nam �RC �'r''� T.v_5'% ohona '��13`{�`j
Addrealmailing) �OS-// w' /�onia,�.a �
License No: `S `T
LICENSED CONTRACTOR DECLARATION
I'heroby afllrin that 1 am IlCenieO untlef provislonz of C�arter 9(commentln9
with section 7000) of Dlvlslon 3 of t�e Buslnass antl Vrofasslons COGe, antl
my Ilcensa Is In tull for n0 eff t: �/�
uceoie c�.0 - ��.�`Ic. uce�se No. �+GII
oate y'��-�� slgnature
7RKER5'COMPENSATION DECLARATION
ereCy attirm that 1 have e certificate of consent to selfanzura or a certHlwte
..� Workars' Compensatlon Iniurance, o� a certi/1etl copy/ tJheraot (Settion
3800. Lab. C.1.�O�I�O�� � • • /� li� . �'uSi
PoII<y No. ComDany Re� r
I�'y'I COrtlflatl-topy IS hBreEy lurnishatl. �/� '
LY'CertNleO�wpy Is flleE wlth the city Builtling Ivisiort�
Date � –a"U AOPlicant ( �. �%` � ���V
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(T�ISsaCtiOn nBeC not Ge COTpletatl if Iha Dermit is fOr One hUndretl (5300) or
lezs).
I certify thdt in t�B perl0rmanca Of the wOrk for which [hls Dermit IS ISSuetl I
s�alP not employ any person in any manner so as to betome sub�ect,to ti�a
Workers', Compansatlon Laws o1 Calitomla.
Date �ignature
NOTICE: If,-a/ter makin9 �hls tla<laratlon, you shoultl becoma subje<t lo the
Workers' Compensatlon Orovl5ion5 01 tne Labor Cotle, you must forthwit�
comply wilh such provisions or this �perrimlt s�all De Oeemetl revoketl.
CONSTRUCTION.LENDING AGENCV• �
1 hereDy affirm thal there Is a tonztrutUon Ien0ing agency for the perlormance
o( tne ,work for whlch tnis permlt is issuetl (Se<Hon 3oe7. Civ. C.)
Lontlar'S Name
�oaors naaro::. ' �
OWNER BUILDER OECLARATION � ' � • � � '
I M1erebv aHirm tM1at I am eYemot from the'ContractorY Llcensa Law fo� the
I, as
or
the basis for the alle9etl axemptlon. Any violatlon oT Sactlon
y aOP���ant tor a permit subjacts the applicant to a clvil .
more than five huutlretl tlollars (5500). , .
r of the property or my amployees wit� wa9es as thelr sole
witl Oo the work, antlrthe structure is not intentlatl or oHeretl '
on 7044, Buslness antl' Protessional Cotle: Tne Contractor's
oes not apply to'an owner ot a proparty who builtls or Improves
vho tloes Such�wo�k hIm5G1f/her5¢If Or ShrOugh hi5 O/ h0/ own
rvitlatl that su<h Improvements are not Intentle0 or offeratl for
eq the bulltling or Improvement is solE wi[hin one year ot com-
�ner-wlll have t�e burAen af proving he/she tlitl not builtl or Im-
urpose at sale). - � ,
❑ I, as ownei ot the property, am axclu5ively tontratting wlth.IlcenSeC con-
tractors co construct tne proJect (Se<Uon 7044, Business antl Pro/essions Cotle: ,
Tha Contractor•s Llcense Law does not apply to an owner of properry who
builtls or improves thereon, antl who contracts tor such pro7ects with a con- J
tractor(s)Iicense pursuantto the Conlractor's LI<ensa Law): �
❑ Pam exempt untler Sectlon , B. & P. C. for Nis reazon
Date Ownar �
nq cons
r� upon
Drivers' Llcense or SS 9p _
wit�ln
.
eoraer Ilnes ana sign all aovrooriate aaelantionf.
TYPE OF CONSTRUCTION IJ NEW LI ADD U ALTERATION LI REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHEq
OESCRIPTION OF WORK
TVPE OFPERMIT GRADING FOUNDATION STRUCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBIN6 ❑ MECHANICAI
❑ UTHER
PRQIECT DESCRIPTION 5�. FT. OCCUPANGV
CONSTRUCTION TVPF VAIUATION E-
ZONE 6RAOINOCU.VDS. ACRF�
Ramarkc:
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifi¢ts�
Dishwasher J '
Drinking Fountains
Floor Drains .
Floor Sinks � � . -
Gas SerJice Outlets
- P,–Trap, �
� Rdaf Drains �
Showers ' .
ServiceSink� -
SewerCap
$BNRf (�,OnnECtiOn
Solar Collettors �
Solar Piping
Solar Tank
� � Swimming Pooi w/Spa
Utinal
Water Gomt
We[er Heater
Water Service �
� �
Duct - Under Ground
Duct - Stmc[ural _
Duct:Ventilating _ _ .
Exhaust System ❑ Multiple ❑
Firepl/Fact. Blt. IC80 # '
Heating System & Ducting
❑6700,000 BTU 0100,OOOBT
i
Hoodor Typel ❑, �
Registers ��,
CMF 0865-46 r¢v. 12/82 White - Builtling: Canary - Appllwnt; Pink - Accounting; Goltlenrotl - A55essor
0
- , Reinspeetion Fee
Isue Fee . '
IANICAL
Refrigeration System
�oaoo,000aru ❑ioo,000eru
System Repeir/Alteration .
i
� � Beinspec[ion Fee'
Issue Fee
PLNG.REF.
LEFT SIDE YARD
PKG.SPACE REQ.
STREET WIOTH
Autometic Washer �
Construction Pole
Cooking Unit �
Dishwasher "
Dryers ❑Gas ❑Electric
Fan � '
F.A.U. _
Device Boxes
OUtI¢ts
Switches
Generator 00-5 KW O5�
• Transformer �15-50 KW
❑5U+KW
$15
Meter ❑up to 100 amps
$ 3 2onin9 APProved BY .
Application ApproVed By —
/�ppliotiOn Issued By _
0
$15
$ 3
BUILDING PERMIT
PLAN CHECK
PLUMBING
PLAN CHECK
ELECTRICAL
PLAN CHECK
MECHANICAL ,
PLAN CHECK
u
6105 9/p'/r�_i
REAR VARD (TO P/L)
RIGHTSIDE VARD
PROVIDED
PAHK FEE $
�Met2I lJovef 1 W BmpS
Sub Panel
Sub Pole
Motors �41 HP ❑ 1 X-8
Inc.Solar �9-75 HP �i6-15+
Microwave
,Pole Light -
Range _
�.7' T;
Trash COmpecror '
5KW
. , , Reinspaction Fee S1!
. � SUMMARV OF FEES
S SMIP
�
9�
$
$ PERMIT .�q�
g �� . 00. �SSUANCE $ S�
$ GFiADING • $ �
$ $ !
$ MICROFILM ' $ ,
$ TOTAL FEE; � $
$ - � LESS � , '
. ADVANCED PC � $ �
� � FINAL FEE � $ �
�OWNER RITTER� C.
]0$ ADDRESS 905 Peace P]
(=FNERAL CONTRACTOR Airflo
Vo.418-052-56 LOT
InSPECTI0N5
SOIL
GAS
N'ATEft
ROUGH PLI)MBING
PROP. SWR. LINE � HOUSE CON, �
SPFINKLING SySTEM
MISCEILANE0U5
ROt1GH HEATING AN� AIR CONOITIONING
TEMPOfiARY S�RVICE OR POLE
UNDERGROUNO � ppWER �
ROUGH WIRING
TFENCHES � FORMS � STEEL REINF
FLOOR SVSTEM
BONO BEAM � STEEL REINFORCE ❑
SMEATMING
FRAME AND F4ASHING
LATMING - IN n OUi �
ASTER, BROWN COAT
RUCTURAL, FINAL
HEATING, VENT., REFRIG. ANO A.C., FINAL
PLOM6ING, FINAL AN� GAS TEST �
EIECTRIC, FIryqL
DATE
PTION of WORK p�
�NE VALUE
SUBCONTRACTOR
_�L_
NIT N0.
�'��' �/�7 I U kPR'S'%�PAIDOO ob,� ��**�h.5c
�� CRSA
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
APPLICATtON FOR BUILDING PERMIT
For Applicant to Fill in Completely qECEI VED B� o TE RECEIVED
�ATEISSUED
BUILDING P � _ _ _s—_��
ADDRESS
/ PERMIT NO.
OWNER � � A.P. N . —
MAIL BUILDING
Z .
ADDFESS ADORESS -e
� U TEL. TRACT - �% LOT 7 BLOCK
CITY NO. : s
Z Q CONSTFUCTION W ADD A R P
ON LENDER x
J 7 BRANCH � q
- OWNER ` R �
� ADDRESS $�,Yt{{�,�• VALUE OU'
J m ARCHITECT TEL. SE $
a OF ENGINEER � N
U Q FIRE �
w 2 ADORESS �ZONE TVPE GfiOUP /1
dw APPROVED �,� �
w Z CONTRACTOR � BY DATE
J Q
m Z ,
J � ADDRES� � �
w W TEL. ZO NO.OF USE OF N W
�= CITV NO. � P�� BUILDIN
Z F —
w� STATE CITV �'ARDSAPPROVED YARDSAPPROVEO
N¢ L10. NO. LIQ NO. MAIN BUILDING ACCESSORV BUILDING
7O (FFOMGL TfjEFJI'I
SIZE NO.OF 8LDG5.
OF lOT NOW ON LOT ( FRONT FT FT.
USE OF i
EXISlING eLDG. $I E F. FT.
H SI2E OF NO.
Z NEW BLDG. ROOMS STORIES L.SIDE FT. � FT.
aEXTERIOR WALL ROOF
COVEFING COVERING REAR FL FT.
USE OF BUILDING ANO WORK TO BE PE:iFORMEO D�STANCE BET. BEf. MAIN &
a MAIN BLDGS. ACCE55. BLDGS.
Q � � VAR..1E DATE
O � C.U.P.qW APPROVED
F // � APPROVED _ /
N
Z
O
VI hereby acknowletlee chat I havo reud ffiis aDPlication antl staca
� thnt ffie above intormation is rorrect antl agree to comply wi[h
� all laws regulating builtlin8 co^svuction, antl I shall not employ
r any pe�son in violation ot the workman's compensation laws ot
m
y [he 52ate of Calitornia. �
zI he�eby ceriify that 1 am p�ope�ly licensetl as a contractor untler � SQ. FT. O
the State of California Business antl Professions Cotle, Divlzicn 3, THE AMOVNTSHOWN UNDER VALUATION IS FOR �
Chapter 9, antl that such licenses are in full force and ettect, or I THE PURPOSE OP ESiA8L5NING A PERMIT FEE ONLV: m
am exempt from the provisions ot the Staie of California Business �
antl Ptofessions Code; 'v' ion 3, Chapter 9. VALUATION � m
Q. PERMIT FEE S// �
SiB�ature of � �_ m
Permittae • S/� S_/ �'O. PLAN CHECK 5 0
b !� Q �y
V
AUNorized Age TOTAL FEE 5/ �
�� _,y �
'COSTA MESA BUILDINGSAFETY DEPARTMENT
P.O. BOX 12J0 C08TA MESA, CALIFORNIA 9R6Y6
For Applicant fo F711 In Compleroly
TYPE OR PRINT
ADDRE168 0 Peace Place
COSTA ME3A, CALIFORNIA
�u,NaA U.S. Financial
Rosalia, Stanton
� STAT6 . THL.
xo. or n.nos.
L[OAL
------- 5= P �.; tY�iJ�
��� � YG ��%�i��
MAR 23 1966
►or OHlce Use Only
ZONING
NO.O� UY[O!N[Wp (.l� `Q
�un� � emtoino )IG�r�
,Q,.� 7 `i'- ��. ��7�
� '
/R OV6RHAN0 BMALL �6 LH88 THAN
YAROD MPROV6D
MAIN BUILDINp
onnwcrc unc reor
cerrtsR O� �Tn[R � R[AR YA D � ��M
SIDBYAftDI L¢FT � RIOFIT 6� R.GID[� •
DESCRIPTION OF WORK �. ain '�
A_.. TQRATI N ADDITI N RlAR
DI6TANC[
MAIN BL��
REPAIR IN 8M L18
8 ZE�IN6 9 •� ROOMB VAR.�j
6 1 �. ,,. P.
L'XTHHIOR WALL � ROOP APPI10
WVERINO ]39t8 COV8RIN0 S�LLR ZC9 01
VARDSAPPROVHD
ACGEYHORY BUILUINO
DATB
06 PQRFORM[ •` v p'
np with A�tached �
I Nlq6BT ACKNOWL[D06 TNAT 1 NI1V[ R(Ap TX�B MPL�GTION
AND BTAT6 TXAT iH6 ApOV[ IY CORR6CT�AND AOR6[ T OY•
PLY WITH ALL CITY ORDIMANQI AND RI1T[ LAWG p[OY
eu��o�r�o conarnurnon. /J
SIGNATUREOP � s .�✓ �
�
�.� s �. �. � � �
0
ill[ AMOYHi OXOWM UNDHR VALUATON 10 IOR TH6 j
IURro![ OP [BTAOLIBNINO A PlRMIT PBB ONLY. 3
,vwt.uwnon � � �
PERMIT FE8
sl�s�s� /y� '' �
ITOTAL FEE Y /� � O