HomeMy WebLinkAbout215 PAULINE PL - Building Permits�
PHOJECTAODflE55: Z1S FAULINE PL
OWNEfl'SNRME: CIN�1 D'MICHAEL
aoosess: �AME
RNCHIENGINEEfl: � 1 4 � 6 9 5— 2 5 1 5
RUDflESS:
13� �
G
2'a�
flEG.NO.:
UNIT:
UNIT:
PENMITTEE: R P CONSTRUCTION ( 714 ) 669-1490
nooness: z65 PACIFIC STREET
TUSTIN CA 92680
LICENSED CONiflRLTOB OECLANATION: I �ereby allirm that I am licensetl untler D�ovisions ot ChaD�e� 91�ommencing with Senion
]000) ol Orvision 9 0� Ih¢ �u5ine55 ana Pmhssions Cotle. an0 my license is in full force antl eHect.
ciTruc.: 026682 sT^TEuc.:373323 cuss: A E�CP; 00/00
oate. SignaWre:
WOXNEBS' COMPENSRTION OECLABATION: I hereby afiirm ina� I have a ceniticate of consent to self-insure or a certiticate of Workers'
Compensaiion Insurance. or a cenifiea coDY ��ereof (Seclion 3800. Lab. C).
POLICY NO.: EXP. ORTE:
COMPpNY:
❑ Cetliliea capy is �ereby lumis�etl. � Certilietl copy is tileE wiih �he ciry BuilUing Uivision.
Date: Applicanf.
EXEMPTION FROM WOXKEPS' COMPFNSATION OECIABATION: (This nee0 no� be co pletetl i� �he permit' iy�� hunOretl (5100) or less).
I cenity Ihal in (he petlor�nce o� Ihe work for whicA Ihis per � iss d I shall no ploy any De�o 9qny ry3�s �o hecome
sy6je 1 to ihe WOBers' Compensalion laws ol Cali�omi� i� 1/
�ale Signalure
� NOT CE: I�,y er makinp this declaration. you s�oul become su�led �o Ihe Workers' Co pensation provisions of Ihe Labor
Cotle. you Rusi forihwlih tomply wi�h such pwvisions or Ihls permi� shall be tleemed revoked.
CO TflUCTION LENDING AGENCY: I here6y affirm �hat �here is a constmction IenOing aAency for the pedormance oi ihe work for
w ch Ihis permi� is issued �Sectian 3097. Civ. C�.
LENOEfl:
PDONESS:
OWNEfl BUILDEF OECLl�BRTION: I here�y aifirm ��a� I am exemp� imm IAe Contraclors' State License Law for ��e �ollowing reason
(Sec�ion 7031.5 6usiness anE Pmiessional Code: Any ciiy oi coun�y which reQuires a permii �o cons�mc�, alfer, improve, tlemolish, or
repair any stmc�ure. prior to its issuance, al5o repuires �he applicani for such pe�mit �o file a signetl statemen� Iha� he/s�e is licensetl
Dursuam lo Ihe pmvisions of Ihe Conirac�ors' State License Law �Chapter 9(commencing wi�h Sec�ion 7000) of �ivision 3 of �he Business
ana Pmfessions Cotle) or that he/she is exempt ��eretrom antl ihe basis for the allege0 exemption. Any violation oi Section 7031.5 by
any applican� �or a permi� subjec�s ��e applican� lo a civil penalty oi no� more than five hundred dolla¢ ($500).
I. as owner o� IAe D�oOerty or my employees wilh waAes as their sole compensa�ion, will do �he work, an0 ��e
❑ simcWre is not inten0ed or alleretl for sale (Secuon 704a, Business an0 Pwfessional Code: The Contracto5' State License Law
tloes no� appty �o an owner of a property w�o builds or impmves Ihereon, anU w�o tloes such work himseli/herselt or �AmuAh
his or �er own employe¢5. pmvideA Iha� such improvemenis are no� inten4eA or oifere0 for sale. I1, however Ihe huilAinA or
im0�ovemenl is soitl wi�hin one year ol complelion, ��e owner will �ave the burAen of pwving he/s�e aia not huild or imDmve
for Ihe Durpose of sale�.
I. as owner o� �he pmpeny. am exclusivery comrac�inp wiih Iicense0 cantracmrs m consimct the D�olect (Seciion 7044, Business
❑ an0 Pmlessions Coae: The ConVaclars' S�ate License Law Ooes nol apply �o an owner o� pmpeM wha huilOs ar improves I�ereon
antl w�o conVacts �or such pmlecis wi�� a conlrac�or�s�licen5e pursuan�to lhe Contractors' Sta[e License Law�. I am aware
thai O�oOi ollheir Worker's ComDensa�i0n insurante should De D�oviae0 to me.
� I am ecempi un0er Seclion: B. 8 P. C.
lor Ihis reason:
Date: Ownec
I tlo hereby cetlily Ihai I am aware ol antl unaer5lan0 ihe reQuiremenls o� California Health and Satery Cotle Sections 25505, 25533, and
2553A an4 iha� I or any �uWre building occupan� willlwill nol (circle one� need to comply wilh SaiU s�a�e cotles and �he reQuiremen�s for a
permii for cansimction ar mo0ilication imm �he Air �ualily Managemen� OiStricL Residen�ial con5imc�ion applications are exempt �mm
ihese pmvisions.
oate:
I nere
FpplicanP.
Ihal I Aave r¢ad IhiS appliCaiion and 51alelhali�e a ' lOrmati0n is reCL Iagree t0 C mpty wi�h allCi�y and Coun�y
51aIe laws relaling io 6uilding cons�mction anG her autho ze represen, ves o� �Ais ciry �, ter u� �� above-men�iane0
�yeao pu oses
r Signalure:
i5ocial5ecuritya:
t6ai-a6 Wlnte—Butlamg', Green—Co�e Enlorcemenl', Canary—Applicanl; Plnk—Revenue; Goldenmtl—Assessor
� CITY OF Ct�STA MESA — BUILDING PERMIT
PERMIT NO; P 069009 PLAN CFiECK NO; N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU
JOB DESCRIPTION ; SETdER CONNECTION TO BUILDING
CLAIM VALUE: CALC—VALUE:
PERM NO; P 069Q09
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT;
GROUP OCC: R-3 /
COMMENTS: FOR SEWER CONNECTION ONLY
**�***�r**�x-�e�r�r�r�c�x�z��x-�r�-+c-x*�r�-��t+t�r�t-�--��**�r-x--���**�x�*-��-�r�r�r*+r�r*�r*�r��rx-�r-��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 F� C IC S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILL�IA7G ---------
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: PROl7; PARCEL; 42614105 ZNE; REF NO:
PLANNING NOTES>
>
***it�**it*it*itiF�r*ir*x**it***+�it�*��i.**+�jt*�t**�+r*+�itx**��*�rx��r�+�**��**��ciE*x rt**�*�+�**�+r�*�t
D E V E L t� 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 HY DATE;
BOILDING APPROVED BY : DATE; �
APPLICATION ISSUED BY: DATE; ((((((��J
!filif 1(�if ihiE 9E iE # if if 'k it')E if 1E iE it 1E fp')E .+t .. �E iE if #'�1E iE iE iF !E iE ?R�i iF rt r L'�IE?' �
it iE iF iE -0F iF iE iF # If iE if� if� k iE iE iE iE jE iE iE iE iF it iE 1P iE iE iF iE iE iE iE iE iE iE iE iE iE iE iF iE iE iE if if %iE 1E if iF ic if iE �lf iE if iE �If 1E jE iE iE iE iE 9f �1F �1c �1E �1E ic if fE 3f 3E jc iE 3F iF
LEGALIZATION;N F E E ,S ❑ M M A R Y STRUCTURAL SEGbiENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC £IRE SMIP/RES GRADING
PERMIT 15.00 ,
25: SMIP/NON—RES
PLAN
ISSUE FEE 20,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 15,00 26.00 0.00 35,00 35,00 ,00
�
REVENUE DZVISION TOTALS--> COLLECTEP: 35.00 OVER/SHORT: ,00
BLLG PMT PLUMHZNG ELECTRIC MECHANI'C FIRE SMIP/TOT GRADING PLAN—CHECK
35.00 �
1f if !E iE iklf jF iE fE iE �! �ElF 1E 1E �E iE if 3E iE iE iE iE 1E ik iE 3E iE ik 1E �k fE 3E �E iE �ElE iF jE iE iE iE iF 1f i(- iE iF iE �Elf i6 if fk �E ff iE iF iE �f iE iE �)E iE iE iF ak?f�?E ii-+t iE iE-)E iE i� iE iE 3E jE
I N D I V I D U A L � F E E B R E A K D O W N
TYPE QTY P E S C R I P T I O N UNIT COST TOTAL COST
PLU 1 SEWER, CONNECTION TQ BUILDING EACH 15,OQ 15,00 �
ENU OF� FEES
. t, ,
` . �. .
r
� �
! �'
Of fl01b�42�—UD163429 T r_�T s`.QG
DAi'�: G9l2n/°4 TI!VE= 14:�,?
CONSTRUCTION AND PLANNING - PO� :SPA
APPROVALS Permit �`'� Date Mspector APPflOVALS Permit # Date , Inspector I
t. TemPorary Electricai Service or Pole 52. Pool & Equipmeni �ocation
2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Elecirical Conduit�Undrgrnd. 55. Electrical Bonding �
5. Steel Reinforcemenc 56. Rough Plum6i�g & Pressure Tzst
6. Electrical UFER Gsnd. 57. APPROVAL TO COVER-GUNITE �
7. Footings 58. Electrical Conduit Undrgrnd. _j
i
8. Foundation 59. Gas Pipe, � Undryrnd., Test �
9. WatEr Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, � Undryrnd.
10- Structural Pioor System 61. APPROVAL TO DGCK
i t. Property Sewfr �ine & House Connection 62. Backwash & ReCepter-Final
12. Sewer Cap 63. Heater & Vent�Finai �
73. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing : fi5. Electricai-Final _
15. Rouyh Electrical-Condu:t � 66. Solar System-Final
16. Rough Electric l�t�iring 67. Fencing & Access Approval � �
17. flough Wiring SIg� � 68. APPROVED FOft PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEi;•i5 FINAL
19. Rou9h Neating & Air Cenditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace • � APPROVALS Permii �
21. Ducxs, in Structure 70. Underground HYdro
22. Ducts, Ventilating � .• ' 71. Product Piping'-�7 Gas CI Oil
23. Gas P�Pe�Rough & Tes� 72. Underground Fiush
24. Roofi Framing 73. Underymd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ce�ling iStructurai; 8 Monocoat 75. Dry Chemical
27. F:ameand Flashing 76. Dry Standpipe � .
28. Lathing & Siding 77. FIXED SYSTEh9 FINAL
29. Insu�ation 78. FIRE PREV. FINAL
3Q. Drywall Nailing HEALTN DEPT. REQUfREMENT
31. Ptaster Bsown Coat 79. FINAL tNSPECTION
32. Electrical Power �t4eter�Final 80. FOOD CERTIFICATc ISSUED
33. fina� Eieciric � Notes:
34. Fina� Hzating & Air Concitioning Q Zd") �q� �� �g�����
� � .__(t
35. Fina� Gas Pipe�Tesi , � 3,c�l� �_ �,�
�_ -
36. Hood or Canopy �-. _ c;�,�.. _ ���'
_!��
37. Fina� Factorv Firepiace
38. Flnal Plumbing
39. Water Service�Finai
40. Gas Service-Finai .
41. Solar pomestioFinai �
%
42. Backflow Preventer • . .
43. Backflow Irrigation
44. Landscape Irriqation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. FiNAIPIANNiNG .. _
49. Electric Release to Edison '
50. Gas Release to Southern California Gas Cn �
51. CEflTIFICATE OP OCCUPANCV , .
No. Dare �
ADDPFSSOFBNIpNG: z1S PAULINE PL
qYNERSN.WEIFpqMN: DE MICHAEL GINA
�ooncu 215 PAULIN� PL
COSTA MESA,CA
MVL. WJl1N0 /�WFE55:
,�qCNrtECT OR ENfi11HA:
�PCN.OX FNG'S �DCNE53:
UNT:
92627
uc. Ho:
UNT:
cwmacrarswu� NOCK PLUMBING ( 714 ) 895-1246
CWfNACTOR5Y41NG 11612 KNOTT ST
woxess: GARDEN GROVE CA uew: 707775
92841 urr: 17
LICENSED COHfPACTOHS UECLINITION: I hereW eflim wdx panoYy d perjury Nel I am Icenaed uMer powdaa d Cluqx B
(mmmenaeq Milh Senion ]OW) d Diveion 9 d IM Butimm eM Pmleaaions Cade. W mY ��� w m IW latt aM aflaa.
nrr ic.No.:050386 uc.cuss: C-36 uc.No.: 70 775/� EXP: 02/98
e: � cam.aw: ��0� /��J%�%%�i�
BUILD X DECLAfl4 ION: I heMy effirtn uider penely d prjvy ilw I em ecamq Imn �M Caeieem liowm� lm+ la Ihs
bwM ieeaon (Seebn'lai15 &nnea� md Rdwbm COEa: My M' a mumY wNN nGwm e V�d to aorewn. W«. inpwa.
md'eh, > npv em� sVudue, pna w m eaerca, abo �u'vse tM epW'vnl la ach pxm4 �o Ns e eipned aeiemen Nn M a�M
e �ceved w�v �o �ne aw'viona a ur camreews �icenae law �cheq« 9(camm«dnu .an saaioo �000) d Oi.bian a a ��r
Busrwn ard Noteaiam Codel a �Aet Iw a ehe u xemq iharelmn ud iM bem la Ne elkWd exemqnn. My vuW un d Sed'on
)031.5 by vry epW'rent ta e pmmil ukpee �M epplicent to e dvY peroM1y d M mors IMn MslwM�ad ddlar� �SS00��.
❑ I.aaowiwMihePbG�Yam/emdMwewYhwepeaealheieobcamDemetian.vrillEOlMwvk.end�Aetl�upun'viMinteMtl
a MweE /w seb (Section ]oM. Butl�nee aM Pmlmume Cade: Tha Coruroaan Licerua lewdoae ra e00Nto en owner d p�ape�ry
M110 �f Q 111PT� IhMBGVI. B11d `M�p d0lf f W�I MIXk hI118GM Of �1lAN Of 1�1lWih hY IX �Mf PM1 M11GbRd. V�� 1� NC�1
imn�am me na imeneea «oHa.d �a ede. n. nowewr. �ne buiuinv «:npwem«a u.ai.nnin one rw a mmqwm. me
o.�wa��a« .w na.. m. w�d.� a nw��ro ro«.na ed �a wue « �ma� �o. � w�o�» a.w�.
❑ 6 u owre, a me vw«�v..m •.Jni�w mume:ro •qh 6romod cann.cla. b can.ow m. c�4ee (awnn roM. as:... w
Prafeaiae COEe: The Canratlm l"<ame Lew Eoea M eVaY b an axrier d pWMY Wa du1M a nWa'n Itwrem uM Ww
canlrxv br ad� Pel� wtl� a au+reqMe) GcamW pmuem m �he Camreaas Lbna Le'�i.
� I em mamq wHer Secrim: B. A P.C.. b Nu �mson:
Oeta: �:
i eo n�nr �ewr �nm i� ew� a�a wb..i.�a na Aa��rem�n a cv�ome w�an �a smav coee sw�. uws. zss.n..�a
?5590. eM tl� I a eery Mun Wikieq ooaWent xill / wil rwi (mcY wn) ��o camply wiA seid mts mdas enE iM npuimnaN br
epamnlacaat�uctianamotl�fiWionhwn�M�i i-6Tiyl.raiapemenlD'a1rip.Reudentielmmtiupioneppiratianvassemplmm�Mea
,.�;.�,..
Dete: ApW'ceex:
WOFKEP'S COMVEM4ATIX1 DECLAR�TION: 1 hersby elfmm imdx prupy d paj�vy ane W Ns b0ow"vq detlwioro:
� IhevaeMWme'v4anacenfinetlodueVlosapimuraMwkas'm�psWlian.nprwidadfaEy9W'v�J]OOANeIeEr
coe.. �« ihe wrtomarc. d m..oni �« Mrcn we wmm 4 4.w.
n I havs ud wil meiMan wM1re' mnV�ion'umranro. m�eN� h' Swion JIW W iM lebar CoEs. br IM VM�� d Ns
�C work fa xliich Mu P� u inueE. M' xvken' oomWrtmion inurancs fanir W D�Y wmber ero:
• c�«: GOLDEN EAGLE EXPIRES
Pd'ryNumber. Uti](' ii���� 09/O1/97
(This aectiwr neeE rrot 6e mmpbtee ] �hs prml "n la aro huM�ed ddlera �St0o1 w kaad
❑ I cql[y ihet in Ihe pMmnenca d IM wak M wM1ich �hie pe�mu is iaued. I emply� vry peison in em/ men�wr so m lo
becmre w4� to �M hoMe�e' romP�vion lewa W CelEanu. ree E M bevune cdjw io tM xoNen'
�mpemazbn pqvnm d Seywn 9100 d iM leb« Code. � fi', mmpy wM qwieiom. �
�nl : F�Ywiro ucun wo��ri rorrlpru�tlon roverap��InvIW, �ntl MYI �'Tnlrin rryloyr ro cMYIW pwltlu uW
nu tp b pH hYMrM fMuuM EWYn (SIQGOIXIf, bi W11lbn b tlw co�f OI ro�oxulWn Lam�pN U provMW M In
xtlon �)f16 0l Ms Le6ar Catls. /nferp4 N4 ��mry%� /ww
CONSTRUC110N LENpNO A6ENCY: I hseby dfi�m uMx penMy d perjury ihe� iMn u a amn�upian kMvq epenry M tlr
perlameMa d tM v.vk tor xfiitli tM1's p«mY ie ueued (Sedun �U9). Cia. CI.
LENDEN'3 N�UIE:
lENOER'S ADDflE55:
I ceniy �hm I have reed ihis epd�� � dete �he� tM ebove iMamalbn ia mrtea. I epna io camply xilh ell dly md cvuMy adimrcee
uM ewe lawe Metiq to buiM'vp wnetruqian eM Mreby einhorae �ayamntalives d INe d1Y lo mix upon iM ebwe.mantioneA pmperly
Iwinspedian purposer.
RON NJ.�K
Dme: _J�/
(5151d8 WP) Whno--Build'up 6 Selety:Oree i e; Cenery-Rppicent; Pink-Hewnue; OokenioFMeawr
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: P 08391
PERMIT NO: P 083917 PLAN CHECK NO: N GOVT: N SOPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH
JOH DESCRIPTION : WATER HEATE CHANGE OUT SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK ASSOCIATED WZTH THIS PERMIT
iE%KiFMiFMKiFiF�fKi('iMifMM1('�{'KiFifK1f1F1('KifKMififKafK'If±fififififMifMiFiFiFiEMlFifif�FiFfEMifif*if±flf�h±EifiFiFiFaFiiiFit�FiEiFififiFiF
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- 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
PARHZNG REQ: PROV: PARCEL: 41914213 ZNE: REF NO:
PLANNING NOTES>
�
iflfMMMlkM�t�fitif�llfM�F�fMM1k1f iFM1F'lkikiFMftMMMMiFifltiFiFiFiF�Fif IfiFifiFiF�EiEiflFiFif KififiFif 1FiFifif KiFkKlf if If iflFitKiFiF�FMifiFif
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: 9 q
APPLICATION ISSUED BY; DATE: Z 1,�1�
iliFifiFififMMififififiFiFlhMMitMiFif% iEitiFikiEiF3f3F3f1F iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL S GMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 11.00
25t SMIP/NON—RES
PLAN
ISSUE FEE 22.00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 11.00 22.00 0.00 33.00 33.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33.00
iFMitM1fMM�FNikKifiEikiFMMKM1fiFlEifitiFlFlFMMititMltiFKififkiEifilifiF%itK1F1Fi('i('iEfElfMit%KiF�FiFiFififlFiFKititlkiElFiF'k7fitititltiE
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 Z P T Z O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 11.00 11.00
END OF FEES
EXPIRED
DATE J'I2'qri�
87-32-1997/10:15 HNlf33.�8
RCPT�:A1-Ff889696
PERMIT:083917
CONSTRUC7ION AND PLANNING. P4 g SPA . ,
APPROVALS Permit # l Daie Inspector qppROVAIS Permit #� Date Inspector
1. 7emporary Eiectrical Service or Pole 52. Pool & Eq�ipment Location
2, Soil Pipe•Undrgrnd. 53. Steel Reinforcement
. y -
`,y3;'Electrical Condu}t-ltFjlity-Un�rgrnd. 54. Forms - � --
?-4.'Electrical ConduirUAdrqrnd. 55. Electrical Bonding
�'.,5L•5tee1 Reinfoccement' 56. flough Plum6ing & Pressure Test
'� -i6:..Electrical UfER�Gmd. 57. APPROVAL TO COVEfl•GUNITE -
'_ 7?���ootings �~� ',' 58. ElectricalCond�Yi�Undrgrnd.
,.J. • J. , I
•.-B�. Foundation --� .:. . 59. Gas Plpe, t7 Urttlrgmd., Test
�
��9. Water Pipe�Undrgmd.b � 60. Backwash line3'�;Trap, O Undrgrnd. .'
10. Structural Floor System �� - 67. APPROVALT0IDECK �
77. Property Sewer Line & House�Connection 62. Backwash & RecCptor-Final ,
72. Sewer Cap ` � 63. Heater & Vent�Final '
13. Roof Drains , 64. Plumbing System - Final
14. pough Plumbirig, � r�� 65. Electrical-Final �
15. Rough Electrica�l_Conduit 66. Solar Svstem-FiPa1 . ."
16. Rough ElectricYJiring _ . 67. Fencing & Acce�s,ApA�ovai
17. Rough Wiring Sign � �� � 68. APPROVED FOR"PLASTERING
_
18. F±ough Electrica jT Bar Ceilin� � � 69. POOL/SPA SYSTEMS'FINAL
19. Rough Heating & Air Conditioning ` FIRE DEPT. REQUIREMENT
' _ ' -� ... r.. � ti L�f t-� � �' F'
20.;�tough F��to� F��lace �r '=C � `�? =� � * �' APPk�bV%iLS^'� Pel'�nit # ���
21.�uc;ts, in_Structurei � '••`� �- � m ^ _ �A - 70.�Undergroifnd Fydro �
22. _Ducls, Ventila3ing" ^ ' c� « S `L t: - 71. Produ Pi ��n �Gas x
i ,J 1 k 7 � 7 F# �j;; P 9 �J Oil
23. �Gas �P1pe,1iough & T st � � � � � � ` �� `�
F ::7:� .t ,m, � �.4 ' 7y, Undergr6Lnd F+uSh ��� F
24.'=RooFFraming• ��� ��-'^ �*,= C' �!; 7� Undergrqd.StoGei�TanI�;OGas O'Uil
25. Rooj.She.�thing � K � :,• .� '�' _ j :; � 7q,� pverhead Hydrd � �
�-...
Z6. 7�Bar' Ceiling (St �lRtural) & JAona�oat .4� � � � 7�. 7� Dry Chemical r„y r`"' - �
27.: 'rame aq�d Flashiqg 4 ` a. r, �, � �'� " ' • ,z
� x �a � i: , rx 76. Dry Standpipe�.rr•-. : ti �
� 28. LatPring$� Sidingx.�. •: -=d.=' '" .i� >" .. •. ..* 7E FIXED.'�'YST6��, �- 3NAj: . �
„ -r♦ ;"�. .� �t Ir: .:"'Ji., ., �-i ;;
' 29. Insulation � K �` �' •• �� � ��. 78; -FIRE�P.REV. FINAL '�:= 'x 'C
" 30. ��Vw'alt Nailing �t �, � � ���;� �r7i�ALY'H DEP'�'REQUII�MENT
� � � � n 7g" INAL [iVSPECTJQN i -
� 31. Plaster BhowmCo�ay� � - .. i � C '
� 32. �E�ectricaJ Power MeteC•Final ' �; �� ! � �' • 80� POOD CERTIF�GATE i�$,�JEpH � �� �
. � � � 7 .t. �.y � �:. � rx7 �- - ,� : �� .
. 33.-Finat�EleCtriF. .i. , .S 1 � f�(otes: y ' i:*; '. "J 7 �: *�
t: 34.,Fin�Heaiing Air.Cond+tionitig5 �e i 1 �r x � ('�w: r ,... >O
+� rri .t `� � r -� -C, a ,:, .
I 35.i�inal GaJPip��,'TeSt � ~ i: � � �v � .�'"� _7� .e � r.r �
, 36.�NoodorCanoovs. = c X" � i � - s_ .'io - F., �
< , r •- M c 1 c : 7 «. .� r,
� � 37.CF.ina(.Pactory P�rep(�ce .t � - - a n � W �r �+ .-
- 38. FinaNPlumbing T7-• �' • �i�� "'
r `y � S �'L
-. , i. I ....T: .. Y
�' 39. Water Service-Finaf:t . -' t I J�+' � : � �-+t� .
. A : ' k' .^.. V " w '.
,�
� 40. Gas Service�Final ;:� - _ .r r�� � ,'� O.. �� k
41. Solar pomesticFina� S •• ' '� � �� `
.� 'a [*' ,�� �� X 7
42.-3ackflow Preventer � � :r: � � � t1 � �F �Y •= '-�
m rr,: .
�-43. Backflow Irrigation� .. x�S'= � ,� � , r" ;' � ` �
`� F � _
44. 4andscape Ir[igation System-. r A x r�*f ^ � 7 f- � :� �� a N�
,� � .... _ �, - x . -
35. _$ound Attenuation� - � ` . r : E �' �. � � '� -, �`z .
.. '� M : - �,' �'7 r
?36. �Handicap Regulacioris = _ � � x . z 5 ^ � � +
T � �
47�. FINALSTflUCTURE & BUILDWG ", c - ', �� -� �
, -
48.�FINALPLANNING� , - � r,. � -% m ` •
�
"4g, .�lecfric iielease to Edison � "' , �."�,�. � � � , ' �
50. -Gas Release to Sout�em Califocnia•Gas Co � � �"•'t � - • �� 4 �
.� � r
,51. CEF�TIFICATE OF OCCUPANCY __ _ ' ' x ' - �
No. Date ,
PF0.IECT AU�HESS: Z S S PAUL I NE PL
owNeRsr+ame: TIETGEN CHARLEY H
aooness: 509 29Tfi ST
NEWPORT BEACH,CA 92663
719) 7297929
APCHIENGINEEB: NEG.NO.:
AOOHESS:
UNIT:
UNIT:
reamiTTee: CHARLEY ( 714 ) 729-7429
aooness: 215 PAULINE PL
C.M. CA 92626
UCENSEO CONTflRCTOP UECIAflATION: I hereby allirm ��at I am Iicense0 under Orovisions ol C�apler 9(commencing wi�h Section
7000� ol Division 3 0l Ihe Business an� Pmlessions Cotle. anC Ty IILCfISC IS Ifl �IIII IOftE dI1G BIIBC�.
CITY UC.: STATE LIC.: ClASS:
�ate: SignaWre'.
WOHNEHS' COMPENSRTION UECLAPATION: I hereby a�firm ihal I �ave a cenifica�e of consent lo sell�insure or a cenilicate ot Workers'
Compensa�ion Insurance, ar a cer�i�ied copy ��ereo� (Sec�ion 38�0. Lab. C�.
POLICY NO.: EXP. OATE:
COMPANY:
� Certified coOY is �e�eDy fumishea. ❑ Cenified copY is fileU wiiA �he ciry Builtling �ivision.
Daie: ApPlicanC
E%EMPTION FflOM WOAKENS'COMPENSATION OECIANATI01
I cetlity Ihat in the podormanca of ihe work lor which Ihis
�NOTICE: II, after making Ihis Oeclara�ion, you should�come 5f
Code, you musi fari�with comply wit� suc� pmvisions or this p
CONSTBUCTION LENOING AGENCV: I �ere�y alfirm Iha� there is a
which Ihis permit is issued (Sec�ion 3097, Ciu. C).
LENDEP:
A�OPE$$:
IenAing agency tor�he pedormance o�ihe work for
OWNEfl BWL�EB OECIANATION: I herehy alfirm �ha� I am exempt tmm the Con(rac�ars' Slale License Law �or Ihe �ollowing �eason
(Seclion 7031.5 Business and Pmiessional Code: Any cily oi counry which requires a permii lo con5tmc�, al�er, impmve, tlemolis�, or
repair any Slmc�ure. Drior to �I5 issuance, also reQuires the applicant lor such permi� �o �ile a signetl statemen� ihal he/she is Iicen5e0
pursuam Io the pmvisians a� Ihe Coniractors' State License Law (Chapter 9(commencing wiih Section 700� ot Dlvlslon 3 of the Business
antl Pmtessions Gotle) ar tha� he/she is exem0� Ihcrelmm antl ��e basis lor Ihe allegetl exemp�ion. Any violatian ol Semion 7031.5 by
any ap0licantfor a permil sublects �he applicanllo a civil penaliy ol noi more Nan hve huntlretl tlollars ($500).
I, as owner of �Ae Oropeny or my employees wiih wages as �heir sole compensaiion, will tlo Ihe work, an0 Ihe
❑ stmclure is no1 inlenAeO or olferetl �or sale (Sec�ion 70Ga, Business anA Pmfessional Catle: T�e Contraclors' Slate License Law
tlaes na� apply lo an ownerof a pmDehy who 6uild5 orim0�ove5 Ihereon, and who Joes such wo�k himSelUherself or through
his or �er awn employees, pmvideA Ihai SucA impmvemen�s are not intentled or ofleretl lor sale. II, however the Duiltling or
impwvement is soltl within one year o� complelio4 �he owne� will �ave �he burden o� pmving helshe Oid no� bui10 or impwve
� lor ihe purpose ol sale)
I, as owner ol Ihe pmperty, am exclusivety contracting wi�h licensed contrac�ors �o conslmct the pmjec� (Sec�ian 7044, Business
❑ and Prolessions Code: T�e ConVacmrs' Slate License Law does not appry m an owner of pmpehy who builtls or improves �hereon
and who comracis for such pmlecis wilh a contractoqs) license pursuam m the Coniracmrs' S�a�e License Law),I am aware
�hai pmol ol Iheir Worker's Compensation insurance should �e Drovitletl to me.
� I am eeempt untler Sedmn� B P� 4 4 B. 3 P. G. �� /�—_
�ortnisreason�. OWNER— UILDER
I Oo hereby cerlify Ihat I am aware o� and understantl Ihe requiremen�s ol Cali�a Healih and $afety Cod¢5ec�ians 25505, 25533, and
25534 and Ihai I or any INure builaing occupant willlwill noI (circle one) need a compty wiih 5ai0 sia�e cf�es antl �he reqUirem¢n�s br a
permii for conslmclion or mo4Jica�ion Imm Ihe Air Ouah�y Managemenl DiSVici. liesaen�ial consimction applicaiions are eKempt tmm
Ih¢se pmvi5fOn5.
�a�e: AD�licant:
I here�y ceNty Ihat I have reatl Ihis appllcation and sia�e that �he)�ve in�orma'e6� correct. I a�ei�omplyyii�p,all ci�y end counry
or�mances antl siale laws relaiing �o butltlmg conslmction and e( ulhorize �sen�atives ol i ai e e�upo �ie above- en�ionetl
prOpetly �of in5p¢t�ian purpo5C5.
oaie � Signai re:
ori�er s �icense or Soc�ai Seanty a: �
I64L66 Whi�e—Builtling�, Green—Code EnlorcemenL Canary—Apphcanl; Pink—Revanue: Galdenrotl—Assassor
CITY OF COSTA MESA - HUILDING PERMIT PERM NO; M 06539
PEAMIT NO: M 065393 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: OTH
JOH DESCRIPTION : LEGALIZE FACTORY INSTALED FZREPLACE SQ FT:
CLAIM VALUE; 400.00 CALC-VALUE: GROUP OCC: R-3 /
COMMENTSs THIS PERMIT ONLY FOR THE LEGALIZATION OF THE FIRE PLACE
*x+r�r*�r�r�r�rx�***�+rx*r*�r��r*+r�e��r*��r�*x*��x*+r�r*+rxrx�x�**�r+r�r*+e+r+r�rx x *�r**��r*�r**�r�x+r+r�rx��r�rx�
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; 42614105 ZNE: REF NO:
PLANNING NOTES>
� r �
�rxftitetat�r�ritwet*�rx�t�r�*�r�r*itit�r**�ex*it�atitat��r�r**it�rit�rx_*it*atit�rx�*it****+r*ratit**itit�r**+t*itit�t�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
v-�.
'ZONING APPROVED BY �' DATE:
BUILDING APPROVED HY
APPLICATION ISSUED
if 1E if it itlflf iF M%iP if iF if it it iE if i!
!t i!!E if iElf iElE if 1E i!!f 1E 1E 1! M ik if M
LEGALIZATION:Y
HLDG PMT
PERMIT
PLAN
ISSUE FEE
�.� ,.
DATE:
• ✓-' DATE: �T
K' � ikiFif1F1E1FlFlFifif 9E1E
iE iE �t i! it i! 1! if 1! 1ElF 1F iE 7f if iF iF 7E 1E i!!E!E M!f iE iF 1Elf it if M 1E fF i! 7f 1F if 1E 1F IE iE 1E 1E iF iF iE iF iE IF if !F iE �E fF iF if iklE
F E E S U M M A R Y STRUCTURAL SEGMENT:N
PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
19.00
25Y SMIP/NON-RES
15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 19.00 I5.00 0,00 34.00 34.00 .00
REVENUE DIVISION TOTALS--> COLLECTED: 34.00 OVER/SHORT; .00
BLDG PMT PLUMBING ELECTAIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
34.00
iF it iE if iE iE fk M i! iE 1t iE 1E if iE iE iF if iE iE it iF iF.1E 1F iE iE it it iE iE Ik iE 1f iE 1f it if !E iF if iF M iE 1E 1F iE iE 1E iF iF M iE M M iE 1f 1E iF 1E 1E 1E 1F 7E iF iF 1f i! 1f 1E it iE 7E iE if if iF �f 1E
I N D Z V I 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 N UNIT COST TOTAL COST
MEC ' 1 �:GAS PIPING SYS 1- 4 OUTLETS
MEC 1 FACTORY FIREPLACE
END OF FEES
3.00
6.50
:.�1 QOtS1`3�-LOi`2`3"s Ta �T
DAi�: t.2'?Pi43 �IME: 16:2�
3.00
6,50
34.Q0
CONSTRUCTION AND PLANNIRIG
APPROVALS Permit #
1. Temporery Electrical Service or Pole
2. $Qil Pipe-Undrgrnd.�
� .> i
�� .
#v�ectrical Con�iiJ.;�-hiiity�Undrgrnd.
-.,�-+...._...
f,'E}ec;rical ConU���Undrgrnd.
'�clectrica! UF
nu. rounaat�on c�
M �y
9. Water ?�pe�Ur.tlrgmd. I�
10. Structurai Floor SYstem '��.
1 t. PP�Rerty Sewer �i�ia & No�se Conrecti0� �.
�
12. �ier GaP v
13. i�oof Drains �'
��
14. Rouah Piumb ng rt'
75. Rough Electrisal�Condua
-y
16. Rough clectri�'4Viring
17. Rough�;Vinng�ign
18. Rauyh electri�6T Sar Ceilin9
79. Rough Heacing & Air Condiuoning
---�-�--F.t---��
2Q'"�R�.�gh�Udct6}Y ��Piac2 : "'� �t
. . -c :.. �_x� i S�^ �
21:,Diici�'s, ir� St��ctv_`�r7e:�Tr.. ri
T---+=:�-t5 S-+
P06. . SPR ..
Date - Inspector APpROVALS Permit � Date inspector
52. Pool & Equipment Location �
53. Steel Reinforcement
54. Forms �
T 55. Electricat @onding S� �
rt ,
56. Rough Plumb�ng & Pressure'�s�'
57. APPROVAL TO COVER-GU�t�E I = i
58, Electrica! Condurt�Undrgmd. .= 1 =;
59. Gas Ripe, [� Undrgmd., Test .
� 60. Backwash Lines, P�Trap, :� Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Recep*or�Finai
63. Heater & Vent-Final
fi4. Plumbing SYstem � Finai
65. Electricai-Fina! �
66. Solar System�Fuial
67. Fencing $� Access Approval �
� 68. APPROVED FOR PLASTERING �
- 69. POOUSP.3SYSTEGISFINAL
� � FIRE DEP7. REQUlREMENT I
r* „""•_,-;� -
� rJ "'�' �a-�APPf�VA�:%��Pcpiiit;€ i �
22. D��s, aent8'dti�r!'. i � � S *
, :-�`.: ('�_` R, a$ � ("� * C: e,`
2�,Gz�Pi,�,,�=..Roygh��test � �.� yT �
=-r-t7•---t�x±--e-�- r-„-
2�=Rwf Fh_ming ^a' i:�i- vF O
4 � � X [T�
25. Ro�+,f S�athing'1}$ � `� ; M :j
-�-� -tf^-t. x�"f-
26'�T��ar Ceiling IS"^LEtural) 8;`1lApr�coat # �
� ax
� 2i? Frxyme a��� Fiash�c�' ``,�.,,, X �,
1"'p-- i•, :', .
i-�28. �_1SlFrt6�` :Fx1inQ 7" %^. '7a:T �'. ' �:
k si_�_.�.: :�� t � r.
r2J. !r.Sulati0n `: ,=y� �j � .••. ,� �
.J 30. Dryv✓a;:� �la iGng . . � K '
�
�37. Piaster,i3ro�y9 C�{, S i tr;*' �
(i�i�-X-.-�i��'�'�-_ .
�3�•Elect��Ael Pcs-yer„talitt€d-Final� ' r_ �
,. .- l. �,��u_
r�.3�,Fi,.�'YralE.�ctr�C t�'' �. � '' :�
I,�i34;-�Fir�� Heat�n �. _iX.C;oE•�litio�6�TT- .�, *' ^ I
��.. )
i 35�Firs�i �'S Pi9?��T�9i�. �s� _ �/e?I��
� ���������
.�3G.�Ho�d or CanoPYr.�� � •:--� %. x [l '�
z - _ .. _. - : -r .ij I : �,
,"�37�F��+.�i F ctory Firg�lace.,, ; F�-��i411Z�
�7
��38. Fi„I Piumbing � K " i �� :F
�39. tiNa1�r Service�FiaaF* T i { t, *. �
: I' Y � � n�i.
�. 40. Gas Ser��fice�fina� . � � �,-. �;.;
�"47. Solar 6�nestic-F1ii6I � '• �� " v�
�-, :r [*1 t
r'42SBackflow Prever�er H ,i '�, '�
43. Backfiow Irf�atiS;s �c�� *
r x
. T�
,;�45. Landscape �riqaiiqn System,;�� j q � �,
...-?J-Zx--'- 3�., n--"r
::45;:Sound AtteauatTon �'�cF r" �� % [ �
_ r i --- > � , . M
�46l�Handicag Re�ulations `� � y`'. '� ��
475F1 �� STRUCTURE & BUCLDING
� � x E�
48r�FII�k.A�PLANNIN4,T- ' �"'- '
. . �'-i. 3'G
o49u'Elextric Peloase to�Edison •
_50.,Gaf,Release to Sou�her� Cali�q� Gas Co Y
I�51. CE�TIPICATE OF,OCCUPAIVCY
No. Date
C.' x • +:+ -� z .:T.��._
+7�.' . .� '� �T'��T-�-�-
H k� 37p, EJndergro��rtl H�tdro �
F, ' ^ "
��g y '71. Pro�uc,��,�'�En9 E'��as C:OiI
- ' � • - r
� - ' 72. Undergri.Gind F{:s;�, .-
a'.. --v-S r-
H'; �` �7� Undergrn�. Stord'�.Tark� Gas � Oil
' � � � 7� Ory Chemjcal j � '• = ' :' I
a ^ -, �
mr � 75 DryStanti�? %�'�� � ' r� .�}��
-�, - �,-:a� Y'�'�-i
..� � 77?' FIXED$`i'�TE,LT��INA1� •-r ; � ;"„
7$��-, FIRE PREV. FINz�:L , _. �
. ... v-..---�-
� � HEALT�DEP�. i?EQi1�REN'EiVT
E
� `K �� .,79� FINAL I�ECT�N * G r �. • I
'�-'F� .'-Y--'sN--�'�-`'.._-_-•-
� I� } �780.'nF00D CERTIF�,"3'iTE IS5�,ED . �
--�--
� A � C •7% �? '
i �. x Nt�t'es:12'�i%Lt�S�C0+2/L'es,'T/iX(SNCpO
�� lC-�/jD 1l57_/NLj:�hS ✓%�-✓�-`il�de
�L � '.Chi-IJN�' � Z_O_iD2Y-L?7..._/wCh9L�t2,�%'_�
.! �� C i � � M': =< t� " �
t a:'
���. : --T:�-.+- �-•�-'"'-^---
j�'� ` C1G - .. �r ;'1 i
i/�/%. (1 ` z ?i
,r<< z � :�� ,
I�� , 'rv n �� ` �-1 :Y � __.__
T�� '�� � -T .�
��f � ]- R
f PT.
1 ..A 11 4 C ii i �.
' � - .�
� -�-- � � � „ �
( `k k ('� C" M "' �
� t. -:. r �`,Tx __-
� z ;� F
k .�' F •
y� ..' .
T Y �1 , l
-i p � : V (U . i :
� ._:�p x � �� ti �� « �.. � :
�r 'n- = c .r -S • �^r t
__T`�� T--:---"'ir- �+ •. .
1, s G S J �: �.
3 ��
.. S
-r��t ; � ..
l� tT. - + I
-�-__�'� � . :��
� I4 r -F-,� --�- a �
s e' �
', - -� � �c�..�, ;i `:
:�-= � -� '. _
00 �
�Y�/2u�o.NE�
_c� r�r_,,
" _'_-_�
_"_ 1'
JOB ADDRESS �--}}h—f]ran�y=
GENERAL CONTRACTOR Bd'
p�. 0110-02 LOT253 TRAC7
C"�UP I,Pl J TYPE V
IhoPECT10NS
coat
P'
E.
( � c���/!7 .��' /
lc�r� �
K�=/- . DATE 12-12-58
BIIILDING PERMIT NO.
VALUE S 9.2�%•00
H FIRE ZONE DESCRIPTION OF WORK R89 W
DATE
SUBCONTRACTOR
PERMITS ISSUED
, . `J- �
� � , 8��6 �� �� Ii31���0�9 �� �� a i2-
COSTA MESA BUILDING DEPARTMENT � I(a81� �
P.O. BOX 31]
COSTA MESA. CALIFORNIA 6I�`n1 CI� Af�•
�i 6 6iZ
FOR APPLICANT TO FILL IN � j�APP.L�ICA`�TION FOR PERMIT
a���o��� - _ BUILDING
A�DRE55 � t
`�� OSTA MESA. IF FOR OFFICE USE ONLY
ADDRE55 �� � � y2 ✓/L /7- � I 7 Y /T 6� •
CITV `�S T/y L " "`�� NO�� �Q�-7
ARCH„'cCT LIC.
OR f 'IEER NO.
�O%1�R`CTO� VY�S.T 'l�V/C�TY NO. �e �/
ADORES�^��I �C'�CSTiI///� /.�OC/'J AP
� BY
�[Gn� LOT 2 s;� y/���
oeScaiPnou NO. � U.LI W RAQ C'
A.P. NO. —` D � O �J
SRE �O� � X 7�j y' NO. OF BL�GS. Q
OF LOT •/ / � NOW ON lOT
SET9ACN LINE FFOM ��� I �� V� v�/`/'J
CENTER Oi SiREET d EAR VARD T� J.
i � i
SIOE YARD RIGHT S LcFT �// �
NEW
FEPAIR
�
DESCRIPTION OF WORK
ALTERATION ADDITION
MOVING DEMOLISH
�i O X �T'' ROOMS STORIES �
L�( G��L� CO�VERING/ �� �� C�G, I
i I N�i �� T��/» • l s� ��
e.
ORTE 199UE0
/�? - /�-�
GOSTA MESA. CALIFORNIA
^ NO.OF ?VpE
/ PLANS
1
OVF�
DATE
CORRECTIONS
i °� �
A�f \l
CITY OF ;STA MESA
LA�R' i'G U�P7'.
S JEC T "P'j,, REG
BY DAT —
�
ST�TE TH4 BOVE IS COMRECT N •GqEE TO COMPLY WITH nLL .
CITY Og NANC $ rD 5�TE LAWS REG L�TING BUILOING CONSTXUC�
nOn. . J /�„ • VALUATION ^
� ��^^ PERMiT FEE 5 �`, L�
SIGNATUR /v�������� �
PERMITT �{ ///��� � .�• . /
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