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HomeMy WebLinkAbout1988 PELICAN PL - Building Permitsr. Appli4a r! to fill in all spaces witr.'n heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA p- RMI - .�— TRACT NO. LOT IN BLDG. NO. CONSTRUCTION PERMIT P�— �,��?>� 13173 _ 31P';1d(- TYPE OF CONSTRUCTION X NEW 0 ADD ❑-ALTERATION O REPAIR ❑ CONVERSION; ODEMOLISH 1:1 0 OTHER DESCRIPTION OF WORK vt 5 P11 ZONING REGULATIONS' E R., P NG. REF.Contractor Project Address �%� G+A/Y �- Wnel Phon 3d' Address Arth/Eng. S License No. a/ Address } (/ _ G,9 a< .O le %1�s Phone 3/-ffb TYPE OF PERMIT - ❑GRADIN FOUND T/{ lOfj4.igl{CTV RAL '0 TENANT ELECTRICAL✓fteLUMBING ❑MECHANICAE D BACK C L ST. - YARD V k TTppB�1/1ILpwGAddress PROPERTVLINE L� ,L v Fi/Y/s LICENSED CONTRACTOR DECLARATION hereby affirm that I am licensed under provisions o(Charter 9 (com- '❑ ��ttI HT V mencing' with -section 7000) of Division 3 of the Business and OTHER Professions Code, and my license is In full force an Ct. � REAR YARD (TO P/L) sof Cr PROJECT DESCRIPTION License C s License No!—�/.^' PKG. SPACE REQ. PROVIDED Date Signature SQ. FT. WORKE 5' COMPENSATION DECLARATION OCCUPANCY_/Q� CONSTR1l CTION TYPE STREET WIDTH PARK FEE $ I hereby affirm that I have a certificate of consent to self -insure ora ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE t' ^of (Sec'on 3;80 Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: • No. f�1TY rf2 Co he pany�"^�—'-"""'-"^ - - yy-ertiflei copy is hereby furnished. REMARKS: L� Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - (This section need not be completed if the permit is for one hundred - -- ($100) or less). - - -' - '- - Certify that In the performance of.the work for which this permit'is PLUMBING - - PLANCHECK _ ELECTRICAL PLAN CHECK issued, 1 shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. _ BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS„ URINALS - GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code, you must ._ -forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE L'AVS - _TRANSFORMER APPLIANCE 10-50 KW_50 + KW revoked. - KIT. SINKS - - DISHWASHERS - - _ MOTORS 0-1 HP -1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS '(INC. SOL'AR)" 10-50 HP_ 50 + HP formance of the work for which this permit is issued (Section 3097 Civ. C.). _ - _ - Lender's Name 'FLOOR SINKS —FLOOR DRAINS FIXTURES OUTLETS SW CHE -- --•- -' ^- Lender's gtltlress 'DRINKING FOUNTAINS' GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS 'POLE LIGHTS ' the following reason (section 7,031.5 Business and -Professions. Cotler. SWIMMING POOL R P _ ' POLES M B Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE - ALTERATION PANELS I SUB quires the applicant for such permit to fit¢ a signed statement that he - Is licensed pursuant to the provisions of the Contractor's License -Law GAS SERVICE - ' OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the P -•ess and Professions Code) or that -he is exempt therefrom and the -alleged WATEWHEATERS BTU OUTPUT • '— f for the exemption. Any violation of Section 7031.5 by _ SEWER CONNECTIONS - --- "- .optica nt for a permit Subjects the applicant to -a civil penalty m .,ot more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK -" - -COLLECTORS soil compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The _ _ _ SOLAR PIPING SVS. ISSUE FEE a Contractor's License L w does not apply to an owner of a property __ _ - ISSUE FEE - QD APPLICATION APPROVED BY DATE9 who builds or improves thereon, and -who does suchworkhimself or it through his own employees, Provided thatsuch improvements are not MECHANICAL PLAN CHECK - _SUMMARY OF FEES , ntended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden Of proving he -did not build or improve for thepurposeof sale). of '- HEATING SYSTEM 0-100,000 BTU _ BUILDING PERMIT QSD - - , .75 ❑ I, as owner of the property, exclusively contracting AND DUCTING -- '- $ SMIP.' $ licensed contractors to ce the project Busing s aw Business 100,000 +BTU PLAN CHECK PERMIT and Professions Contt d es not The Contractor's Licehse Law does not apply to Lce _$ ISSUANCE $ owner o5 property who builds or improves thereon, and who con- pert REFRIGERATION 0-100,000'B7U PLUMBING $ �0 Ir tracts from such projects with a contractor(s) IiCeaned pursuant to SYSTEM- - - - - GRADING $ - the Contractor's License law). �' 100,000+ BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this/07-00 $ reason BOILERS BTU ELECTRICAL $' PLAN CHECK $ MICROFILM $ - -- - Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE MECHANICAL $ TOTAL FEE $ LESS AD - AD - I hereby certify that 1 have read this application and state that the above information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorize representatives Of this city to enter upon the above mentioned property r inspection Pu— Signature" Date FINAL FEE $ Drivers' License or ISSUE FEE - - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # ` - ', POOL & f114_ 4 . Date -Inspector APPROVALS - - Permit_# Date Inspector 1. Temporary Electrical Service or Pole_ 43. Pool &Equipment Location '-" - 0-7�i --2.- Soil ipe-Undrgrn t .. 44. Steel Reinforcement - 3. -Electrical ConduiT'Utiiity.:Undr rn-- • _ _ _ 45. . Forms. --- 4. Electrical Conduit-Undrgrn - ='+ 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing'& Pressure Test -- t 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE---'- - -- 7. Footings - - - 49. Electrical Conduit-Undr rn.8. Foundation Foundation 50. Gas Pipe, ❑ Undr rn, Testi/ 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undr rn 10. Structural Floor System 52. _ APPROVAL TO DECK - 1• 1.:..P.roperty Sewer Line &'.House Connection 53.' Backwash & Receptor -Final' 12. 'Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit 56. Electrical -Final 15.- Rough Electric -Wiring - - -- - 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING - 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60. - POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing- Frame and Flashing - NOTES: 23. Insulation - - - - -- - - - - - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat - - 27. Electrical Power Meter -Final - - 28. Final Electric 29. , Final Heating & Air Conditioning 30. Final Gas Pipe -Test ' • 31. Final Plumbing - - ,32. Water Service -Final_ .33: Gas Service -Final 34. Solar Domestic -Final 35..' ndsca e Sprinkling System - 36. Sound Attenuation - - 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed- - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 142. .. CERTIFICATE OF OCCUPANCY No - Date - _ 1 Z(�z6 %dol✓ 1 </ 1� N /iS �Kv2i.�aTZ^i o A f. 4 .� w� L�"�s� Gow-,�-tom i TvtL '► �Cav'l AV)V2( T!D/� 4T �-41 AAb"I�T GANAHL CONSTRUCTION CORP. 13308 Verona Tustin, CA 92680 (714) 832-2889 Lic=ense #608117 City of Costa Mesa 77 Fair Drive P.O. Box 1200 Costa Mesa, CA 92628-1200 ATTN: Development Services RE: Permit #E-053370, & #E-053371 for 1988 Pelican P1. As of 9-23-1991 Ganahl Construction is no longer providing services to 1988 Pelican Pl.. As Ganahl is the Permittee on this project we would like to be removed as such. We are also cancelling our certificate of insurance as of 9-23-1991. We would also request a refund of our access permit deposit. Thankycu for your cooperation. T L,N- 1 1 - - T HU 1. 3 = r S HA1.4& :na.. 1011.4 F• -_-'-•__.__ __ CITY OF COSTA IVIES.. 32 EIPr:uirai I`ov,'zr r Final I t -' +3. proalFrecbic BOItOINGSAFETY DIVISION POS', 1N Cr0NSPI4:UVUS PLACEFinal Heating & 41r Conditioning VI9 THE 1V6 35. Final Gas Pipe -Test- -� - -- - NO I ICE --`-- - l 36. Hood or Canopy You mast Ilnni;h PERM]"! NUMBER and the JUB ADORES;FOR EACH IU%PF.CIIVE INSPECtION. CAH, 754.5627. 37, Fin„! Factory Fireplace APPROVED PLANS SHALL BE ON JOB AT ALL TiMF: 38. FinalPlinrbing -- A.r+, IJt�. GME r55!�Eb + .t. _.-...-_ 'in t.;y�, o.,.rce _F; .... TVP[ IG NFW PEPMirNO. 49. GasSaivice-Final 41, Solar Domestic+inal t _ _ 42. 5aC .,low Preventer Tr --- BLOCK - '--'- ---- -'� - 43. Backflow Irrigation rR nan t•rr+a nee -'OUST+-- 441, Landsczpe Isrigetioo System -.. - -- 45. Sound Attenuation 46. Handicap Regulptions -.---•=`,�,' \`� - 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING POOL & SPA 1 4 ._ H _-. ...-_--$C-7l`� A ^J �..f',_'�--. f�l, APPROVALS Fennit�---_-'-J... ------ � ----- C h.. 1 ; Frun Yd._ Side Yd.•.L r s.. -; ... 4n, Pool &=quipment Location ... Side Yd. L� _-H_.... ---.Rear_.- Start Reinforcement -- 'SONS7N11CilON AND PLAiJNiNCa :� 51. Forms ---_ pate !n<pec?ar A.PPRGVALS Permit -.- --- /' S2, Electrical Londing i, TI mporary Eieetri<;ai Ser.ic_ o- POie i ./ 53. Rough Pluming & P; es.sure Test 2. Sol!Pipe-Undtgrnd. J 5.7. APPROVAL TOCOVER-GUNIIL 3. Electrical Conti lot Utiii ty Undrgrnd. - ---_-T 55. Electrical Conduit Undrgrnd. 4. El;ctr Kcal Conduit-Undr end. 56. Gas PrF°, U Und; : n•1., Test 5. Steel R`inforcc�ment- U(4 57.Ba--kwish Lines, P - Trap, 0Undrr')IT S. Elp.cnd al UFER Ond. 58. APPROVAL TO DECK 7, Fooiing, 59. Backwash & Reeptor Final 6. Founci.uion 60. Heater R Vent -Final 9. Water Pipe-Undrgrnd. 61. Plumi>;ny System Final --� Fp, Structural Florin Sy -,tent T `V` t G2, I i. P!Uparty $elver Linc;,. House Connecticn 63. _Volar System -Final Q. aver Cap I 64.Fencing 3 Access Approval - 13. Roof gains I 65, APPROVED FOR PLASTERING _(1. Rogi' Plumbiny 68. POC71.!SPA SYSTEMS FINAL ---- 15. Rough Clecuieai Cnnduit FIRE DEVs. REQUIREMENT 16. Rough Electric W;rin--- -- et.n - \n y g O� C V' APPROVALS Per nit _ ��- 17. Reugh Wiring Sign, _'- _.. 67. Underground Hydro 18. Ro•.igh isr_t*i Cdl•7 Bar Ceiling --- - - -68, Fi_�4urt Pipin; UCias -UO;I y�I6 tl Rvugrrating 3: Air ^onrtltionin/t=7 G_ Undc S � i' ;' � ��-� 0 --� - }!1 'ground Flush 26. Rough Faclo,y Fireplace. 70, Undergtnd. Storage Tank UGas 13Oil 21. Ducts, in Structure 71. Overhead Hydro 22. LT'd Ventilating 72 Dry Chemical 23. Gas P tx Rough & Test 73, Dei Stzndpipe 4 i 24. Rvof Framing ,__ 7; f 74. FIXED SYSTEM FINAL --- 25. RoofShcithing ..7..�----�r7:R(r�ft,i/!_� 75. FIRE PREV.FINAL 26. T Bar l:eihng (Su::r.tr,ral) & PJnnvCvai � , 2'•/ Notes -("�_ ct�� ? i' - , 27. Frame andt Flashing ;(►�'�,jt -'. `� _ � '�y�' 28. L,atNn9 & S L1v,g - .... --- .... iI }_', i"7? / / -' - - 29. Insul?tion 7:,/✓ l % i✓� /. nI� 30. D; ywall Nailing 31. Plaster Brom Ccat ` ' (see reverse for additional notes) - - CMFOSSn-Ayr rev. t?DB2 ....__ ..... 7 -el � (/ �! '�.e"r f�(['rlr r'..� 4.:'.•• f< ,r �r= rl . Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. �N� 421 1 TY OF COSTA r1EaA CONSTRUCTION PERMIT "� 1�L` L 1 GMn% Project Address CS_ - Applicant's Mailing Address 5� 1M e I� c)N 1614A'W Phone � Z6&,6 Owner's Name SA'� Address PERMIT NO. TRACT NO. LOT NO. UNIT NO. S 0:21 A P soy — Zone S Main Building: Accessory Building: TYPE OF CONSTRUCTION LJ NEW ADD LJALTERATION LJ REPAIR ❑ CONVERSION 1:1 DEMOLISH 1:1 OTHER `af( Sf 5 �D DESCRIPTION OF WORK/USE OF BLDG. E T Front I Z O fo A Rear 1 V N Arch/Eng. License No. Address TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq. FT. OCCUPArvCY� CONSTRUCTION TYPE �„ N VALUATION$ 122_67-- 20NE GRADING CU.VDS. ACRES !!! C Right N K $ Left J G R Contractor's Name Phone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION Pln Ref. # 9 Parkin Re q./Provided E Planning Notes: 1 e s g Q M ` s� Iy ( T S. Remarks: O 122,$5- C I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect.�G (.' $� !! ELECTRICAL FEES License class license No. Date Signature WORKERS' COMPENSATION DECLARATION -eby affirm that 1 have a certificate of consent to self -insure or a certificate Vorkers' Compensation Insurance, or a certified copy thereof (Section __d0, Lab. C.) Policy No. Company BCertified copy is hereby furnished. Certified copy is filed with the city Building Division. PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. 13 50 + KW Bar Sink Showers Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps Backflow Irrigation Sewer Cap Dishwasher Meter ❑over 100 amps Bathtubs Sewer Connection Dryers []Gas❑Electric Sub Panel Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifiers Solar Collectors Fan Motors❑0.1 HP❑1%-8 (This section need not be completed if the permit Is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued IFixtures shall not employ any person in any manner so as to become subject to fife Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the perform of the work for which this permit is issued (Section 3097 Civ. .) Lender's Name Lender's Address Dishwasher S la F.A.U. Inc. Solar E19-15 HP 016-15+ Drinking Fountains o k Microwave Floor Drains wi of W/Spa Device Boxes Pole Light Floor Sinks nal Outlets R ane 9 Gas Ser a AS Water Closet $witches Sign a Writer Heater Garbage Disposal Standing Sections en Sink Water Service Generator E10-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for following reason (Section 7031.5 Business and Professional Code: Any city county which requires a permit t0 construct, alter, Improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/She is licensed pursuant to the provisions of t Contractor's License law (Chapter 9 (commencing with Section 7000) of ion 3 of the Business and Professions Code) or that he/she is exempt funand the basis for the alleged exemption. Any violation of Section 5 by any applicant for a permit subjects the applicant to a civil Icy of not more than five hundred dollars ($500). as owner of the property or my employees with wages as their sole pensation, will do the work, and the Structure is not intended or offered sale (Section 7044, Business and Professional Code; The Contractor's _,rise Law does not apply to an owner Of a property who builds Or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License law does not apply t0 an owner of property who builds or improves thereon. and who contracts for such cuoiects with a r -on- tractor(s) hcense pursuant to the Contractor's License Law). I am aware that proof o their Worker's Compensation insurance should be Provided to me. ❑ I am exempt under Section B. & P. C. for this reason Lavatories Auto -Wash P—Trap Laund4rrags Roof Drains 1OIN& ;20 Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Approved I nate it g Approved By Data tion Issued By Data Rein ction Fee Issue Fee $ 3 MECHANICAL FEES Iter Hood or Type I ❑ Canopy Type II CI - Under Ground BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES Q $ 8 / ' �� SMIP $ �' $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ $ MICROFILM $ $ TOTAL FEE $ $ 21 D t - Structural Refrigerate ,000 BTU DUgt - V¢ntil0ti0 Exhaust Syst Multiple $ ir/ teratiOn Firepl/Fact. BI O dk ampers Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances Heating System & tong ❑0-100,000 BTU L141MOBT egisters and stale laws relating t0 building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection purpdi� A _ Signature i �i''�^'^`'-'• Date4-1 Drivers' License or SS $ Reinspection Fee $15 Issue Fee $'3 0865-46, rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor I CONSTRUCTION AND PLANNING PO ,\ APPROVALS Permits Date Inspector APPROVALS rmit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. ,Soil Pipe-Undrgrnd. '53.:Steel Reinforcement 3-Electri6al Conduit Utility-Undrgrnd. 54. Forms ,.e'Electrical Conduit-Undrgrnd. 55. Electrical Bonding �' 5' -)Steel Reinforcement 56. Rough Plumbing & Pressure Test 6: Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final I, e : 15. Rough Electrical -Conduit "k Soa SYstem-Final 16. Rough Electric Wiring 67" Fencing & Access A proval•' 17. Rough Wiring Sign 68 APPkOVED FOR;PLASTERINGs 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Condioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ( QFPRQVA'L$ Permit # 21. Ducts, in Structure �y `d; w;40. Underground Hydros, + 22. Ducts, Ventilating �+ • v -N,.71. Product Piping L1 Gas .❑ Oil - 23. Gas & h Pipe-Rou Test .� 9 '"� � 72. Underground Flush �`+4+ti , ` � 24. Roof Framing ✓� R 73. Undergrnd. Storage Tank O Gas ❑ Oil .7 r'%�' 25./Roof Sheathing U A74 Cf 74. Overhead Hydro 26. T-Bar•TCeiling (Stci.Lural) &-Monocoat j 75. Dry Chemical•" a ,•'J 27: Fro e and Flashing r k'- 76. Dry Standpipe 28' Lathing & Siding ;� 77. FIXED SYSTEM FINAL 171 . 29. Insulation„ :c 78. FIRE PREV. FINAL r, 30. Drywall Nailing t - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ti( i 79. FINAL INSPECTION _ 32. Electrical Power'Meter-Final`, 80. FOOD CERTIFICATE ISSUED 33. Final Electric v Notes: •• 34. Final Heating & Air Conditioning ,t- �, 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final-Factory'Fireplace . 38. Final Plumbing '39. Water Service -Final 40. Gas Service -Final X41. Solar Domestic -Final �. 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation' - r 46. Handicap Regulations 47. FINAL/STRUCTURE & BUILDING 48..Special Requirements Completed r ,Electric Release to Edison •� rig. -50. Gas•Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1988 PELICAN PL UNIT: OWNER'S NAME: SHAW, RONALD DEAN ADDRESS: SHAW, JILL D 1988 PELICAN ST COSTA MESA,CA 92626 ARCNIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: COASTRIDGE ROOFING (714)557-6048 ADDRESS: 2480 FAIRVIEW RD CCA 92626 LICENSED CONTRACTOR DECLARATION: Ihereby athrm that) am licensed under provisions 01 Chapter 9 (commencing with Section 7000) of Division 3 0l the Business and Professions Code. and my, license is in lull force and effect. clrr LIC.: 4 g 912 STATE LIC.: 54 119 0 CLAS 39 Date: 30 _�— S ignature: _ WORKERS' COMPENSATION DECLARATION: I hereby affirm that a cend�a t consent to selbinsure certificate of Workers' Compensation Insurance. or a certified ropy thereof (Section 3800. Lab. Q. POLICY NO.: EXP. DATE: COMPANY: I Denuded copy is hereby fumishe i. ❑ Dumbed copy is filed win the city Building O vision. Date: Amundurt: EXEMPTION FROM WORT(ENS'COMPENSATION DECLARATION: (This Becton need not becomp2led it Ude permit Chfp Dile hundred DOOR or less). 1 cemly that in the performance of the work for Whl this permit is issued. I Stull not employ any person in any manner so as to become 5ublecI to the Workers' Compensation Laws of lilorma, sA �+ / Date: _ 30 Sipn:lure: _ — f� �� NOTICE: II, after making this declar ion. you should become suDjed to Ih¢ WOt s' 0 pensaUOn provisions f the Labor Code. you must fonhvAh comply with such provisions at 1115 permit sold be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction landbp agency for the performance of the work lot which this permit is issued (Section 3097. CN. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm Thal 1 am exempt from Ina Contractors' Slate License Law for the following reason (Section 7031.5 Business and Protessional Code: Any City 01 County which requires a permit to Compact, alter, improve, demolish, or repair any struclure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 Offing Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not =,a than live hundred dollars ($500). I, as owner of the property or rrry emloyees with wages as their sole Compensation, wiB do the work, and the ❑ struclure is not intended or offered for sale (faction 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and no does such work himself/herselt or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of Completion. the owner will have the burden of proving he/she did not build of improve far the purpose of sale). I. as owner of the properly, am exclusive contracting with licensed contractors to construct the project (SeCtion 7044, Business ❑ and Professions Code: Ale Contractors' $tate License Law does not apply to an Owner of propen who builds or improves thereon and who contracts for such projects with a conbaclOr(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker S Compensation insurance should be provided 10 me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Dale: Owner I do hereby certify that I am aware of and understand the requirements at California Health and Safely Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (Circle one)need to comply with said slate codes and the requirements for a permit for construction or modification from the Air Deadly Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have reaof This appI catim no stale that the above information is correct. I agree to comply with all city and Co Iy ordinances and stale lawsrelaung to nuifit goo Iruclideand hereby aumorae representatives of this city to enter upon the above -menti nee properly for inspection purposes. Date' �_3D `/ Signature: Driver's I irense m Social Security a: 1641 46 White—Building: Green—Cone Enforcement: Canary—ApplicanC Pink—Revenue. Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 054184 PERMIT NO: B 054184 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION T/OFF RESHT. REROOF W/TERRA COTA TILE SQ FT: 6,500 CLAIM VALUE: 6,500,00 CALL—VALUE: 6,500.00 GROUP OCC: R-3 /M-1 COMMENTS: REROOF 2800SF RESID 6 GARAGE 585LB/SQ T IGN,o#4 Zo 3 ie iF 1E4E 1Er a¢1E aE 9f KiE if ie aF BF R if aE aE 9F 9E iF if**1E***if iF k6 BE aE B¢iE 3l Bk SE iF**3E L¢44M M1f iF lE of %aL**>F34•ak*NIE iE****iE if 3E BE BP aE iE iE iE a¢ Z O N I N GS E R T E B Q A U C I K R S E M E N T S RNT: FT MAIINBUILDING REAR; FT IN FRNT: FTCESSOIP FP,,.-, Q' --- GRAN : LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGH EQ G 1N PARKING REQQ• PROV: PARCEL: 13947212 ZNE: REF NO: PLANNING NfSTES> i¢sE iE***B¢3F*iEa¢9Ei¢IE9E iE LE*BE*3E kaE iE***iE kiE 9¢iE if iF 9E*aE 9E*iti¢i¢***yE*B¢*if iE*IE9E ik*iE3¢**yP3¢iE 4A iE iF if BE li 1F %iE 3i 3f**iE aE* 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: qq APPLICATION ISSUED BY: DATE• I D iF 6E 1f*Be*k3E BFif iP lE iE lE ie *Bf if *3F 3F 3F 3E*if *iE iE 9f iE** 3F 1F *iF 4E BE iE*iE if iEiE*iE iE aE>E*N*IE3¢*i6 TE 3E iF i¢1t1¢iE 3f iE 9E**;E iE iE iE 9E iE iP iF**iEiEit♦E1¢iE iE iF*XEi¢aE Mie 3E iF*aE*3E #BE 1E 9¢IF*3f*iE*k3E *9E iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 90.0065 SMIP/NON—RES PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 90,65 0.00 0.00 90.65 90.65 .00 REVENUE DIVISION TOTALS—> COLLECTED: 90,65 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 90.00 ,65 if if * 3E iF iF iE 9E IP 9f * iE 1k i¢ * if if i¢ 1E iE * )F 3E OF BE * * iE 3E aE * * iE * * iF ir: * iF id 1E 3E aE 1E 1E iE IE fE IE iE iE 1F k if 3f iE iF7E IE 1E 3F aE iE ie iE iE 9E * IF iE if 3F if 3F iF 3e * * iF 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 6500 REROOF BY VALUE RESIDENTIAL NOZONE 1.00 6,500.00 END OF FEES OATS: 09!30/0; 'Ifi : i:"1 c CO�UCTIONANDPLANNING N,fF APPROVALS Permit # Date Inspector POC SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. •Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel. Reinforcement 56. Rough Plumbing & Pressure Test •6, Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12, Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final _ 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,APPROVALS Permit # - 20. Rough Factory Fireplace r � 21. Ducts, in Strycture .70. Underground' Hydro 22. Ducts, Ventilating r '• 71, Product'Piping 0 Gas 0Oil 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Roof Framing -73. Undergrnd.StorageTank OGas 0Oil 25. Roof Sheathing 26. T -Bar Ceiling (Structural) & Monocoat �Q..Z.�Q( _ '74.- Overhead Hydro ` 75. Dry Chemical 27. Frame and F)ashinj 76. D'ry Standpipe ' 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation 78R FIRE PREY. FINAL - 30. Drywall Nailing HEALTH DEPT, REQUIREMENT 31, Plaster Brown Coat' , 79. FINAL INSPECTION - 32. Electrical Power Meter -Final I 80., FOOD CERTIFICATE ISSUED 33. -Final Electric ' - Notes: ' 34. Final Heating & Air Conditioning I 35. Final Gas Pipe -Test 36. Hood or Canopy - 37. Final Factory Fireplace " .. .A •3, ' 38. Final Plumbing 39. Water Service;Final, 40. Gas Service -Final - 41. Solar Domestic -Final, ' 42. Backflow Preventer - 43. Backflow Irrigation r � , 44. Landscape Irrigation System 1 - ,, ,,• --, 45. Sound Attenuation .1. 46. Handicap Regulations - - - -, 47. FINAL STRUCTURE & BUILD. NG 48..FINAL PLANNING• 49. Electric Release to Edison �- - 50. Gas.Release to Southern California Gas Co 51. CERTIFICATE OF.OCCUPANCY No. Date PROJECT ADDRESS: 1388 PELICAN PL UNIT' OWNER'S NAVE:- SHAW, RONALD DEAN ADDRESS: SHAW, JILL D 1988 PELICAN ST COSTA MESA,CA 92626 ARCHIENGINEER: REG.NO.: t, ADDRESS: UNIT: PERMITTEE: RONALD SHAW (714)642-0660 ADDRESS: 1988 PRLICAN CM CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 0l the Business and Professions Code. and my license is in full force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to sel4insum or a certificate at Workers Compensation Insurance. or a certified copy thereof (Section 3800, Lab. Q. POLICY NO.: EXP. DATE: Certified Copy is hereby Wmished. ❑ Cendied copy is filed with the City Bantling Division. ate: Applicant: EXEMPTION FROM WORKERS'COMPENSATION DECLARATIDW—(Thssaccers neidilot be canpleed it the pemdlis turbine hundred(5100)or less). I codify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so AS to became Subject to the Workers' Compensation Laws of Cabfomia. Dale: Signature: NOTICE: H. after making this declandfin, you should become Subject to the Workers Compensation provisions of the Labor Cade. you must fonhwllh comply van such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby adults that there is'a construction lending agency tar the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECUBATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of counly which requires a permit to construct, alter. improve, demolish. or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the ContractorsState License Law (Chapter 9 (Commencing with Section 7000) of Division 3 0l the Business and Professions Code) or that he/she 15 exempt therefrom and the Oasis for the aneged exemption. Any violation of Section 7131.5 by any applicant lot a permit subjects the applicant to a ciW penalty of ad[ more than five hundred dollars (5500). I, as owner of the property or ray employees with wages as their sole Compensation, will do the work and the ❑ structure is not intended or offered for sale ( pion 7044, Business and Protessional Code: The Contractors' State License Law does trot apply to an met of a property he builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for Sale. If, however the building or improvement is sold within one year 01 completion, the owner will have the burden of playing he/she did not bu0d or improve for the purpose of sale(. I. as owner of the property. am exclusively contracting win licensed contractors to construct the project (Section 7044, Business and Prolessions Code: The Contractors State license Law does rpt appy to an owner of property who halos or improves thereon and who contracts for such projects with a contractogs) license pursuant to the Contractors' State License Law(. I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt moor Section: B d P. C lot this reason: y / Dale: 'Sled f �' — ( Owner' I do hereby teddy that 1 am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533. and 25534 and that I or any future building occupant wilUWll not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Analicarn: I hereby certlly that I have read this application d slate that the above information is correct. I agree to Comply with all city and county ordinances and Slate laws relating to building co trucaon aro hereby aulhorRe representatives of this city to enter upon the above-mentione properly for inspection pwposes. Date: !"', f- 2— i — ( Signature: �— Driver's License or Social Security .: 1641.46 Whine—Building: Green—Code Enforcemenl; Canary—Applicant; Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05904 PERMIT NO: B 054048 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: SIR PURPOSE: ADD JOB DESCRIPTION ADD TO SFD SQ FT: 284 CLAIM VALUE: 22,000.00 CALC—VALUE: 19,596,00 GROUP OCC: R-3 / COMMENTS: REF CANCELLED PMT R B53370 kkkkkkkkkkkkklEk kN kkkkkkkkkkkkkkkkkkkkkkkkkkkkk kiEkkkkxkkk.)Ekkkkkkkkkkkkkkkkkkkkkk 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: 21 FT IN REAR: 15 FT IN FRNT: FT IN REAR: FT IN LEFT: 53 FT IN RIGHT: 5 FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13947212 ZNE: R1 REF NO: PLANNING NOTES> 282 SQ. FT. SINGLE STORY ADDITION TO AN EXISTING RES. > k kkkkkkkkkkkk{69Ek kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk D E V..E•L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY: DATE: k kkkkkkkkkkkkk.k kkkkkkk kkkkkkkkkk ick kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkitkkkk kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC' MECHANIC FIRE SMIP/RES GRADING PERMIT 207,00 1.96 PLAN -'v SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 208.96 0.00 0.00 208.96 208.96 .00 REVENUE DIVISION TOTALS--> COLLECTED:'r' 208.96 OVER/SHORT:00 BLDG PMT PLUMBING ELECTRIC MECHANICp FIRE SMIP/T1.OTE GRADING PLAN—CHECK kkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkltkkkkkkkkk/iFkkkitkkkkiFkkkkitkkkkkkitkkkkiE kiE ltk kkkkiE kif 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 p UNIT COST TOTAL COST SFR 284 DWE—TYPE V—WOOD FRAME —GOOD 69.00 19,596.00 END OF FEES CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector PO ftPA APPROVALS Pes�,n,# Date Inspector - 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit, Utility-Undrgrnd. 54. Forms Electrical Condu`it•Undrgrnd. / 55. Electrical Bonding 5. Steel Reinforcement ". 56. Rough Plumbing & Pressure Test 6. Elecirical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. ,Footings 58. Electrical Conduit-Undrgrnd. $, Foundation 59. Gas Pipe, 0 Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains t 64. Plumbing System - Final 14. Rough Plumbing ' 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS' „Permit # 20. Rough Factory Fireplace - r -" 21: Duct s,inStructuie_ r =70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 113 Gas 00il ' 23:*GasPipe+Rough &'Test - i - r _ 72. Underground Flush 24. Roof Framing r - z -.73.• Undergrnd. Storage Tank O Gas 0 Oil 25. Roof Sheathing'" 4 `'74�O�erhead Hydro y 26. T•Bar Ceiling (Structural) & Monocoat / 75: Dry Chemical 27. Frame and Flashing " 76: Dfy Stan pipe ci ' 28. Lathing,§?Sicfmg; 77.: FIXED $'STEM FINAL 29. Insulation 78,'FIRE PREV. FINAL X30. Drywall Nailing HEALTH DEPT. REQUIREMENT -31. Plaster Brown Coat 79.-FINAL IN$•eECTIQN 32.-Electrical Power Meter-Final - I 80. FOOD CERTIFICATE ISSUED 33. Final Electric t - '' e ' Notes: -. 34, Final Heating & 35: Final Gas Pipe-Test' T36. Hood or Canopy 37.-Final Factory Fireplace ` - - - ' ' •" G�: -38. Final Plumbing`-- -39. Water Service-Final r- 40. Gas Service-Final - r ,41. Solar Domestic-Final , - .�:�• 42: Backflow Preventer` -�• ' 43. Backflow Irrjqation r �• X44. Landscape Irrigatign System L4 , s45. Sound Attenuation .46. Handicap Regulations 47-FINAL STRUCTURE & BUILDING 48: FINAL PLANNING .49. Electric Release to Edison 50.-Ga{,Release to Southern California Gas Co 1 „ 51. CERTIFICATE OF OCCUPANCY No. Date CITY OF COSTA MESA ' BUILDING DIVISION OWNER -BUILDER VERIFICATION ~ A city or county, which is required to give notice pursuant to Section 19830, shall attach to such notice, and, as a condition precedent to issuing a building permit, require the completion and require the return of, an owner -builder verification. Attention Property Owner: An 'owner -builder' building permit has been applied for in your name and bearing your signature. Please complete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. 1 personally plan to provide the major labor and materials for construction of the pro- posed property improvement.Zll Yes ❑ No 2. 1 (have/have not) /in ✓cl signed an application for a building permit for the proposed work. 3. 1 have contracted Name 5L5-Lf-- the t — the following person (firm) to provide the proposed construction: Address «_ City e_'" �— Phone h w) 657 o C. G o Contractor's Lic. No. 4. 1 plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name ' (5L -t " Address Phone ( City Contractor's Lic. No. S. I will provide some of the work but I have contracted (hired) the following persons to pro- vide the work indicated: Name Address Phone Type of Work I hereby affirm that I have received a copy of the information set forth in Section 19830 of the State of California Health and Safety Code and have completed the above information to the best of my per- sonal knowledge, in compliance with this State law. I e Signed: �' Date: S� 2 � 9 Name: ti S �-LA� (Printed or Typed) C.D.L. # or S.S. # 754-5273 1042-a Insulation Certificate .;ity of Costa Mesa California 92626.1200 P.C.Box 1200 Permit Number '14l� e 0: ("' �;-3 � l 5e @�Ll&A-,J C45q'/O,%45a� Number and Street City County Subdivision Description of Installation ROOF Material L4AW?- W,0j5'4VT rotVc, 77P-- Brand Name Thickness (inches) EXTERIOR WALL Material _.e,-rV9" 0(1�±fL Thickness (inches) CEILING Batt or Blanket Type_Smy k` Thickness (inches) Loose Fill Type Contractor's minimum installed weight/ft2 Ib. Thermal Resistance (R -Value) Lot Number Brand Name Thermal Resistance (R -Value) Brand Name tJZ24.lJGaeNI pini Thermal Resistance (R -Value) 9"330 Brand Name Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R -Value) RAISED FLOOR Material Thickness (inches) SLAB FLOOR Material ---i ©AJ Thickness (inches) Width (inches) FOUNDATION WALL Material Thickness (inches) Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Brand Name Thermal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location the current Building Energy Efficiency Standards for new residential buildings contained in California Adminstrative Code. li t,�,N 6x— Gen{{ital Contractor (Builder) License Number Signature and Title Date Sub -Contractor (Insulation Installer) and Title 190746 License Number Date in conformance with Title 24 of the PROJECT ADDRESS: • 19 8 8 PELICAN PL OWNEA'S NAME: SHAW,RONALD DEAN ADDRESS: SHAW, JILL D 1988 PELICAN ST COSTA MESA,CA 92626 ARCMIENGINEER: ADDRESS: RFG.NO.: UNIT: UNIT: PERMITTEE: GANAHL CONSTRUCTION (714)832-2889 ADDRESS. 1.3308 VERONA TUSTLN CA 92680 LICENSED CONTRACTOR DECLARATION: I hereby a0um that am license ceder pi i, ons of C 9 (cummencin Section 7000) of Dnision 3 of the Ouyness and Prpless Cotle. antl my lice rs - to or . and f ct. CITY LIC.: /I1t/(� FIE LIC ss:P Date: .�LVj l Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm at I have a ce ihcale of consent to selbN are or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Sectio 3900. Lab. Q. PDucYNO.:AE020807299 E .DATE: 11/20'91 COMPANY: AET NA Certified cop is herehjIrlded. [`a rCemcfiled city Buildi OiviDale: (�' EXEMPTION FROM WORKERS' COMPENSATION DEsection need not be completed if the permit is for ane undred($100) or less). I certify that in the Performance of the work for is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: ' Signature: NOTICE: If, after making this declarai you should become subject to the Workers' Compensation provisions of the Labor Cotleyou must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that'there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars (5500). CITY OF COSTA MESA — BUILDING PERMIT PERN, NO: B 053370 PERMIT NO: B 053370 PLAN CHECK NO; 02406-91 1. GOVT: N SUPP; N CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE: ADD JOB DESCRIPTION ADD TO SFD SQ FT: 284 CLAIM VALUE: 22,000.00 CALC—VALUE: 19,596.00 GROUP OCC: R-3 / COMMENTS: ADD TO SFD ###########ay##IF#'r.###X.* )E#i(##X##X###############-YK IE#ii#-)E#IF df#IE #3E df iE##:4 �1F#K.- IT X1E 7(.0 N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 21 FT IN REAR: 15 FT IN FRNT: FT IN REAR: FT IN LEFT: 53 FT IN RGHT: 5 FT IN LEFT: FT IN RGHT: FT IN PARKING REQQ• PROW PARCEL: 1.3947212 ZNE: R1 REF NO: PLANNING NOTES> 282 SQ. FT. ADDITION TO AN EXISTING RESIDENCE FOR A FIRST > STORY FAN.iLY ROOM, 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: 0 I BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: W DATE. I :"iFiFTrXiF iF sF'To3FiriF3F3lA###XXX ##F IE£'kTi iF rT-ir * =# ######IF#X#iF#############**XW. ###ii ######iF###X###!F#.##al # X LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE S,'lP/R'ES GRADING PERMIT 207,002.96- PLAN 134.55 SM ISSUE FEE j Date: Owner: I SFR I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future budding occupant will not (circle one) need to comply will Mid state codes and the requirements tot a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: AOPlitanC / hereby peony that I have read this application d slate that the above' r lip 'torr¢ agree fit n t all city and county ordinances and stale laws rq'a�gg W builtling t slrutlion and hereby Ire rep Ilii t ro on the shove -mentioned properly �cynspectiol�[P1. el/ Date:y ` \ Signature: :Driver's License of Social Security 1641-46 While—Rullding; Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor 284 DWE—TYPE V—WOOD FRAME —GOOD END OF FEES l 69.00 19,596.00 Y• 'i CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole t 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 1_- 53. Steel Reinforcement 3. Electrical Conduit Utility:Ur(drgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd"' 55. Electrical Bonding 5. Steel Reinforcement 6. Electrical LIFER Grnd. I Q,I (YLQ•( { S�� 56, Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System !� 61. APPROVAL TO DECK 11. Property Sewer Line & pious !t;onnectjion 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - ^•� 65. Electrical -Final 15. Rough Electrical -Conduit/ �' 66. Solar System -Final i 16. Rough Electric Wiring ,' / • 67. Fencing & Access Approval 17. Rough Wiring Sign ! 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas O Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing -q �6f,*L­ 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 j 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING t- J 7 40. FINAL PLANNING 49. Electric Release to Edison -I 50. Gas Release to Southern California Gas Co .. 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDQESS: 1 9 8 E PELICAN PL UNIT: OWNER'S NAME: SHAW,. RONALD DEAN agBREss: SHAW, JILL, D 1988 PELICAN ST COSTA MESA,CA 92626 ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: GANAHL CONSTRUCTION (714)832-2889 ADDRESS: 13308 VERONA 7MMN CA 92f�1 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licenRAGS: rovisions of liap er 9 (cam ending with Section 7000) of Division 3 of the Business and Professions my liceorce or. CITY LIC.: ��% In /$TATE LIC.: F 8117 Date: �' �' \ `-' 1 SI nature: _ WORKERS' COMPENSATION DECLARATION: I hereby all that I have a certificate of consent to selb nsure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Be ion 3800. Lab. C). POLICY NO.: AE020807199 EXP. DATE: T 1./^, /91 ,COMPANY: AETNA .11 l[I7 Certifid�egdY copy [iissdherepy furnished. 4' Com -copy is fi w the city unding n. Date: `�' _ I ` — g � ApplicanC EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: This section need nal be completed if the p rmit is for ane huntlretl ($100) or less) I certify that in the performance of the work for which this permit is issued. I shall not employ any per on in any in so as to become subject to the WorkersCompensation Laws of California. — Date: Signature: NOTICE: If, alter making this declaration, you should become subject to the Workers' Compensation provisions, 61 the Labor Cotle, you must forthvnth comply with such provisions or this permit shall be deemed revoked. rh.a CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500), I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Cotle'. The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through 1 his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or M improvement is sold within one year of completion, the owner will have the burden of Droving he/she did not build or improve tar the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 8, 8 P. C. for this reason: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 053371 PERMIT NO: E 053371 PLAN CHECK NO: / N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE; PURPOSE: ADD JOB DESCRIPTION : ADD TO SFD ,RE:#B53370 / SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: ADD TO SFA #K####XXoll E####4E#dE#'if%###%#%•%#Xdf####'###of ?E DE###Ye##if ?E X**X, %iEif#'#%9Ebc 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 —\ -- ---- F'RNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN — — ACCESSORY BUILDING --------- FRNT:FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN PLIRKING REQ: PROV: PARCEL; 13947212 ZINE: REF NO: ANNING NOTES> #•####'It i4#?(•##########x#######};#####df-###########Br####ier.i4######ie%##%'######}'}##Fi:#iE## D E V E I, 0 P M E N T S $*R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDING APPROVED BY DATE: _ APPLICATION ISSUED BY: fr DATE: ########X'iF###########if�F �'%;tTY'3fTr�rTriFn iEiF'Te 7FTrTe iFirie'TrlF iritTr3F'ir; it�FiERi't%3F*##9!###### I x x#%LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 29.75 50% SMIP/NON--RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 29.75 15.00 0,00 44.75 44,75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 44,75 OVER/SHORT; 00 BLDG PICT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 44,75 #####D('########RF####################aF##BE######'##iF?i######9:##3F of###Be iF#########'#4P 1i•i4'# 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 Date: Owner: = L E I do hereby cedily that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and ELE 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from E L E these provisions. ELE Date'. Appl' nt: 1 hereby certify that I have read this apphcatio nd state that the above Inform A s correct. I agree to comply wi y and coun ordinances and state laws relating to building c 1 truchon and hereby at re , natives of iCCliy �ab r 9 n the eve -menti etl property for inspection p(r�� 0s .are �'J _ ` • Signature'. Driver's License or Sao at SecurIly 1641.46 While—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor 5 FIXTURES LIGHTING 1 ST 20 EA, 3.75 6 RECEPT/OGTLET 1 ST 20 EA. ,75 ,75 4.50 4 RECEPT/SWITCH 1 ST 20 EA, .75 3.00 1 SERVICES BELOW 600 V & BELOW 207, AMP 18,50 18.50 END OF FEES 01 GX9e6E7-00014687 T rD 3 CGATE: 08; ;/97. TlnE: 12: N ►'"1 CONSTRUCTION AND PLANNINGP(.RPA APPROVALS Permit +_ Date Inspector APPROVALS Permit q#_ Date Inspector n t. Temporary Electrical Service `pr Pole ': - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility=Undrgrnd. 54. Forms-� - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - - 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer line &-Howse Connee2iori % 62. Backwash & Receptor -Final �- 12. Sewer Cap ;�'� ,��� 63. Heater & Vent -Final 13. Roof Drains i�. i .-__ 64. Plumbing System - Final I 14. Rough Plumbing .� �� 65. Electrical -Final 15. Rough Electrical-Conduii 16. Rough Electric Wiring - 17. Rough Wiring Sign q��alg� 66. Solar System -Final 67. Fencing & Access Approval ' 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas OOil 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 - 32. Electrical Power Meter -Final 79. FINAL INSPECTION i0. FOOD CERTIFICATE ISSUED 33. Final Electric_ 34. Final Heating & Air Conditioning ���LL` /,--, , Notes: 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47- FINAL STRUCTURE & 8UI LDING ' 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go ; 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: f 9 8 8 PELICAN PL OWNER'S NAME: SHAW, RONALD DEAN ADDRESS: SHAW, JILL D 1988 PELICAN ST COSTA MESA,CA 92626 ARCHIENGINEER: ADDRESS: REG.NO.: UNIT: UNIT: PERMITTEE: MAURI HELFFRICH (714)642-0660 ADDRESS: 1988 PRLICAN CM CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800 Lab. Q. POLICY NO.: EAP. DATE: COMPANY: ❑ Candied copy is hereby furnished, ❑ Certified Copy is filed with the city Building Division. Applicant: .,mMPT1ON FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner se as to became subject to the WorkersCompensation Laws of California. Date: Signature'. NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Prolessions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 8. 8 P. C for// r...00n — / �%/{/�; Date'. ^/" —&7 ) . Owner: `�' ' I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code SectioYs 9505, 25533, antl 25534 and that I or any future building occupant will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification tram m the Air Quality Management District. Residential construction applications are exempt fro these provisions. Date. Applicant. I hereby certify Iliad have read Ihis application state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to bu 16 9 c simplen and hereby authorize representatwes of this enter upon the above entione Date:proplyfor "I�sPlcti urpgsle� cm� 1 I .� Date: l Signature: `�"✓ 1liL' Driver's License or Social Security x: 1641-46 While—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 055136 PERMIT NO: E 055136 PLAN CHECK NO: N GOVT: N SUPP: N 7ONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD IOB DESCRIPTION ADD TO SFD ,RE:#B54048 SQ FT: =LAIM VALUE; CALL—VALUE: GROUP OCC: R-3 / �OMMENTS: REF CANCELLED PMT # B53370 IFiE DE BE it -1E BE Bt iEiE*iF***aF BE**iEif if iE aEiF*iE*BF **if iE 9E aF BFiE***of * **iEiE iE iE lH if iF**iEiE *iE lEif iFHE BF 9f* iE aEiF *iFiE*if BF iEiE*!F#dE Z O N I N GS E R I E B Q A U C I K R S E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 13947212 ZNE: REF NO: PLANNING NOTES> > k BE iE Bf Bt Bt 4F k iF BE iE if * * * iE HE iF k iE * BP iH Bk k BE BE BF BF BE k BF IF iP BF 1E #E Bt IE IE iE $F it it !E BE Bt lE BF if iF iPBF iP BP 1E k BF 9E 9E iF it * iA 9E Bt HE iF BE BE BE iE * Bf BE 9F iP * 9E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: li IE iE if kiF Blit Br k iEiFit**kiE iE it Ht**ifiFiFiFiFiiiF'iFiFiF'ifiFiF 3F�Aif iE iF Btit 9EiE iFit iE iE it k BF iFiE k 1F 9F iP BF BF if Bt BP it iH iE iE iE iE 9f k iP iP Bt if iF * ik * Bf * Bf iF * 9P iE * iF BE k it iE iE iEHt BE it k Bt * * N * iE iP ikiEi4 it BE iE Bt iE iE * iE BE lE BE iP iE 1E 3E ih�F iF BE lE BE LEGALIZATION:N F E E' S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 29 75 60$ SMIP/NON—RES PLAN ISSUE FEE A5.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 29,75 15,00 0.00 44,75 44.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 44,75 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 44,75 IF 1E ilRE Ik fE Bf iE BE 1f 1E BF M 1E IF BE iF iE if it * * Bt Bt;tt Bt 9E if iF BF 9E BE rt * iE it BE it BE it BF * iE Bt iE it at iF BF iE�(-iF iP BE iH Bt iP * iE iF * * * BE it it iE iE BE Be iFiE'1F iF if HH BF * if I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 5 FIXTURES LIGHTING 1 ST 20 EA, 3,75 ELE 6 RECEPT/OUTLET 1 ST 20 ,75 EA. ,75 4,50 ELE 4 RECEPT/SWITCH 1 ST 20 EA, ,75 3,00 ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18.50 18,50 END OF FEES IV CONSTRUCTION AND PLANNING PC E APPROVALS Permit # .ate Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' `,,, L� 0cal Condl' tyL�tilitY-Undrgrnd. 54. Forms L 0:4, y e'Otrical Conduit-Undrgrnd. 55. Electrical Bonding 5� Ste,eY Reinforcegief+t 56. Rough Plumbing & Pressure Test - T Efecgical UFE,gGrnd. 57. APPROVAL TO COVER-GUNITE <_ T.:F ob£rngs - 58. Electrical Conduit-Undrgrnd. Fpundation 59. Gas Pipe, 0 Undrgrnd., Test z 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing .r 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric -Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT S =APPROVAL& -).-Permit # = �• - 20._rRough Factory F$eplace - . - > 21._Ducfs, in_Structur:e. 70. Hyy ' VOderground 22. Ducts, Ventilating S < 't .'.71, Prod uct'PpIng MG'as 00d 23. -.Ga§ Pipe=Rough &'Test r " s ,. `. _,72. Underground Flusk. - S I. L Q. J ' 24,,rRoo1 Framing• rr,� - - - m ti r x. 'h 73l+Undergrnl:f. Storage Tank =:O Gas ❑ Oim " •- 25. f Ro4oSheathin 9 -` 74.= Overhead Hydrd.- 26. f-B'ar Ceiling (Structural) &-Monocoat t ti ;ZI tri w 75 Dry Chemical -• C t "•-:- ..'= 27. frame and FlashihTt. ; 76: Dry Stan{�gipe �`, 28Lating$ Siding 77.7 FIXED SY.STEM'F.INAL'� .'29. Insulationj.` = 7 ='t 7& FIRE PREV. FIjNR,L .30. Drywall. {Nailing < < �i . HEALT H-0EPT,. REQUIREMENT C31. Plaster Brown Coat" ! Y IN 2IECTIbN; . r.r r79:'FINAL '232_ -Electrical Poker MetegFinal, �; I F r80.,7FO0D CE1RTIFiG�7E ISSUED- .T33.inal Electric '�'� " n Y ,i 1- �/ /� �_' T ao' _ "' - • `� Final Heating.& D:ir Conditioning:- 110 ; .34. _ 35.;,F mal Ga3-Pipe-Test's - �'• I ,,: a - - c:^ th' v L' _ , ,36.'Hoad oi'CanopY - - •. < - t 'r z. �� -- a`r _` 37::.Final Factory Fireplace `- ''+ i ;,' ° `-38. Final Plumbing �_ i '. �• [V IIT - ``39. Water Service -Final, Q, „40. Gas Service -Final ' Al. Solar Domestic -Final 42.' -Backflow Preventers 43. Backflow Irrigation :r IS`.• - r 44. Landscape Ivr'igation Systemr •s :r. r. .`, - - ; G. ., s ` :-`; - .45._Sound Attenuation-�- -.-'s' - �r -_ - c.t .c-*. -46' ;Handicap., Regulatidns -, - ' ' •' - # '.� _„ ' 47. -FINAL STRUCTURE & BADING '46}_`.FINAL u r PLANNING I 1 r~ f ;} _u49.jEleetric Release to Edison _ 50 .,,Gas,Release to Souihern California Gas Co .51_. CERTIFICATE OF -OCCUPANCY No. Date i Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF STAMESA CONSTRUCTION PERMIT PERMIT NO. TRACT O. LOT N UNIT NO Project Address 111611?SL t 1a may. Applicant's Mailing 7Address 11%L/ 165 / 1e 2iiU1 Owner's Name x `QuZL'U 5771L,4W Phone;Ed- /G4I Address Arch/Eng. License No. Address Contractor's Name 1'A7 PJ44- U Phone Lia -13/5' Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full foffe an effect. License CI ss t, 2 Licen e Date:6 --7 S"g t �( "'ORKERS' COMPENSATION CEIELARATION ereby affirm that I have a certificate of consent to self -insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C. r+ rPr��licy No. 91 / 5'-`37 Company Sfdr4z Y(AA 4 (JJ Certified copy is hereby furnished. LL Cer ifi d c py Is filed with the city>,/ giin Divlsio Date _Z, u� Applicantl�£fJ_^_?*�� e_ Z1/111 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). all no that in the performance an the work for which this permit is t o t I shall not employ any person in any manner so as to become subject to the Workers' Compensation LawsCalifornia. Date -Signature NOTICE: If, after making this on, you should become subject to the Workers' Compensation provisionsions off the Labor Code, you must forthwith comply with such provisions or this permit shall b¢ deemed revoked. CONSTRUCTION LENDING AGENCY hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I'am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of -he Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision 3 of the Business and Professions Code) or that he/she is exempt arefrom and the.basis for the alleged exemption. Any violation of Section ,031.5 by any applicant for a permit subjects the applicant to a civil Enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered ,for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employyees, provided that such improvements are not intended or offered for sale. I/, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im. prove for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds. or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have r.ad this application and state that the above information is torr ct. I agree to comply with all city and county ordinances and state laws ng to but ld in co ruction, and hereby authorize repre- sentatives of Y city to ent -up he above-mentioned property for. inspection p rp ses, Signature 51 Date Drivers' Li ense or SS qp — 32.9-351 s2"1 TYPE OF CONSTRUCTION NEW ADD LJ ALTERATIONLJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ D t wOTHRI CcnCcR I PT3O[NOF k!UIUgf OF BLDG. 21 a;' L 1 14 Cp `J TYPE OF PERMIT LJ GRADING LJ FOUNDATION L$J STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq. FT. OCCUPANP_Y CONSTRUCTION TYPE VALUATION$ ZONE GRADINGCU.YDS. ACRES Remarks: 3ar Sink I IShowers S}�ckflow Preventer Service Sink 3ackFlb Irrigation Sewer Cap 3athtubs Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Ta Floor Drains Swi ing Pool w/Spa Floor Sinks final Sas Service Outlets Wate loser Interceptors Water Hea Kitchen Sink Water Service Lavatories Auto -Wash Roof Reinspection Fee I $15 ' I Issue Fee I $' 3 Boiler Hood or Type I ❑ Canopy Type I I ❑ Duct"FJ der Ground Duct - Structu Refrigeration Syste ❑0-100000 0100,000 Duct - Ventilating Exhaust System ❑ Multiple Syst epair/Alteration Firepl/Fact. Bit. ICED # Fire a ers Heating System &Ducting ❑o100,000 BTU ❑1 OOBT Registers . Fee 1 $15 1 1 Issue Fee CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor A.P. # S Main Buildi E T Front B Rear A - C Right K S Left Ping. Ref. # Planninq Notes: 7261 5/04/87 Building: Zone 83.83 TL Z O N I N G R E Q M T S - 'ELECTRICAL FEES utomatic Washer Con ctionPole Sub. Transformer ❑ 15-50 KW 050+KW Cooking "t Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amp Dryers ❑Gas ❑Ele is Sub Panel Fan Motors -1 HP E111/- 8 F.A.U. I olar 09-15 HP ❑16-15+ Fixtures rowave Device Boxes Pole ht Outlets Range Switches Sign Garbage Disp Standing Sections General O-5 KW 05-15 KW Trash Compactor FEES Reinspection Fee 1 $15 1 1 Issue Fee $ 3 DEV E LOPME NT BE R VI CES Zoning Approved BY— D L�r�T Building Approved By Application Issued By EQUI R EME NTS: I Date Date Date I BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ ro-50 SMTP $ $ .3 7 PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ S MICROFILM $ $ TOTAL FEE $ $ O�.SO F' 3 ` H $ 3 CONSTRUCTION AND PLANNING APPROVALS I Permit# Date Inspector POOL & SPA APPROVALS Permit =# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,..{ 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 7. Footings 6 p� 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line &_House Connection 62. Backwash & Receptor-Final . 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit +-- _21. 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0-Gas OOil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural)'& Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: , 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing . 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE &BUILDING B �� 48. Special Requirements Completed 49. Electric Releose to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date �• r TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional Channel Block With 1.3/895 Horizontal Top of all Fences For Fences W or Less > Vert. Ban 3/8"0 at 4' -0" O.C. o For Fences Higher Then 5' a 4 Vert. Ban 3/8"S6 at 32" O.C. > o: Fill Cells Solid With Grout > Nhere Steel Occurs > .14". .. a Reinforcing Steel Shall > Conform to Sec.A•15.39 IN M A.S.T.M. z All Steel to be Lapped W 4 24" or to Code NATURAL GRADE TWO 3ff'40 BARS ►"' CONTINUOUS TOP !� L BOTTOM ► SE HOMXSTEEL MUST BE TIED IN t BE PLACE AT TIME OF TRENCH I - INSPECTION. ►'L CHI FOOTING REQUIREMENTS CHART i GENERAL- NOTES MORTAR: One Part Plastic Cement, and GROUT; Three Parts Sand One Part Cement Thee and One Half Ports Stand COPING: One Part Cement, Three Parts Sand CONCRETE: Well Mixed 1:2-1/2:3-1/2 Max. of 7-1/2 Gallons of Water Per Sack of Cement GROUT MAY BE POURED FROM THE TOP OF THE FENCE IN CELLS WHERE STEEL OCCURS. CELLS AND AREAS OF HORIZONTAL REIN. FORCEMENT SHALL BE CLEAR, CLEAN A, FREE OF ALL MORTAR DEBRIS, ETC. I H OF EARTHTCOTH 1/3THE HEiGTH OF FENCE BELOW BOTTOM OF FOOTING, 1 SCALE: 1/2"s I' WIDTH ..- , .14". .. .. . _120._:..:: THICKNESS . . '. .. : :. . . . .10"... . . .. . ... .10" . . . . .. ..`. .. 8. . ... . .. .. . 8 • . DEPTH OF EARTHTOOTH .. 24" . . . 20" .... 16".. . . . . 12" SPACING OF EARTHTOOTH. 12' .. ... ... .14' .. . . . .. . ... 16'.... .. .' . . 16' OWNERS NAME: City of Costa Mesa: California JOB ADDRESS: Ly�i�caly �r - ^1 PERMIT NUMBER:_ _ _ _ Building Department ry� lent SIGNATURE: � ,�._ vv -'L_ 1 poo ' v"So NOV. eZ C Y Ikl CITY OF COSTA MESA p PLANNING DEPT. '/ SDBJECT TO BLDG. DEPT. REG Q �l I� � '� q near? 1 BY '� 3A� DAT S-4.oe� nnhl 7 N� lC, / J��0 I(Iw DIRECT` OF PLANNING w (,}% g �✓ ` -Al A II[W[MC[ ti W v �[nD[Lle[ N ' �y , �B Ni7i-TAY/ 28�i 1 s1REET d City of Costa Z.h-Kt $ova so Buildi g Dept. Q ~ DATE J/ I19-17 THE ISSUANCE OF A PE. 11T BASED UP ;; % "' -.ND .PECIFICATIONS SHALL NO7 REVENT THE .:IAL ROM THEREAFTER REOUiR )HE COT.S.ECT✓j^• O: IN _aivy riCAIIONS OR FR,'-?REWr4TING BUILDING OPERATIONS BEING CARP.IED ON TH REUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHEORDINANCE OF THE CITY. , lE PLANS MUST BE N JOB .AT A L TIMES MAK; HANGES WITH UT 5MOR APPR VA,L OF DEP'i, ., ISUANCE OR GRA !TIN OF A PERMIT bR APPP.OVAL OF f 4N UKI S SI ALL NCT Re CG ATRUED TO BE A FOR, OR AN APPR VAL OF, A^ Y V-Ok J .::N OF .A OF )VISIONS OF THIS ODE .!O PERM!`. LW �eU TG'�V/ PITY TO VIOIATF R C N<'EL THE ^dij aNS G^ THIS HALL BE VALID, E% :EP1 SO ,7AR A;,W THE ISSUANCE OF A PE. 11T BASED UP ;; % "' -.ND .PECIFICATIONS SHALL NO7 REVENT THE .:IAL ROM THEREAFTER REOUiR )HE COT.S.ECT✓j^• O: IN _aivy riCAIIONS OR FR,'-?REWr4TING BUILDING OPERATIONS BEING CARP.IED ON TH REUNDER WHEN IN VIOLATION OF THIS CODE OR OF ANY OTHEORDINANCE OF THE CITY. THIS AGREEMENT, made and entered into this �v day of 198, by and between k""- hereinafter w Lhereinafter referred to as "LAND OWNER", and hereinafter referred to as "ADJACENT PROPERTY OWNER". It is hereby agreed that a party wall will be construct on the property line between in the City of Creta Mesa, County of.Orange, State of 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 WI24ESS WMIEOF, the parties have entered into this Agreement the day and year first above written. 1F.IN �-RI�1a1;7 0(tvQE1 (S' ' ature) Name (Typed or Printed) ft P � L i nj eLAtIL (Address)C[�ST }� ALAS% CF1 (Signature) �1,�IS_� 5•, f�jDRTS Name (Typed or Printed) r i� THIS AGREEMENT, made and entered into this daylI of filly , 1983',�by and between � �Q jvi Cp Qom„ a � hereinafter referred to as "LAND cWNER", and hereinafter referred to as "ADJACENT: PROPERTY OWNER". It is hereby agreed that a party wall will be constructed on the property line between ft r �L1 ( N rd PL FSC L A14 I q 8'9 F t A w)je-c7 in the City of Costa Mesa, County of orange, State of 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. LAND OWNER ADJACENT PROPERTY OWNER �Y (Sign re) eg4nate) 61 Name (Typed or Printed) I Name (Typed or Printed) IGg� �Li CIAPJ PLKE (Address) Co5(A �l�sry CYt 9a4�c, (Address) Xp41?7 CITY OF COSTA MESA BUILDING SAFETY DEPARTMENT SI'LVIAL IN.SPI-XTOR INSPECTOR'S NAME - J /� /^ LABORATORY NAME /I/I . Gf7fu —Jo S ADDRESS TELEPHONE JOB ADESS_ OWNER'S Mt WORK PERFORMED — DATE // /�QZ— BUILDING PERMIT NO. K // NOTE: All special inspectors are to be registered with inspector's registrar at the office of the Building Safety Department. Inspectors shall furnish proof of affiliation with an approved testing agency; or, a state -licensed architect or engineer: or he shall be in the direct [tire, under state and federal payroll regulations, of the owner/developer of the proposed project. This proof shall be in the form of a signed letter front any one of the above three. REMARKS: CMF 0101-46 Address of Building Off -Site Fabricator Permit �` C� ?� CS? Number ___ __ L.- LL .J ,..._._. Year _..._(J... Cas 7�2 Mese. CITY OF DEPARTMENT OF BUILDING AND SAFETY BUILDING INSPECTION REGISTERED DEPUTY BUILDING INSPECTOR'S CERTIFIC/RE t9F COMPLIANCE TO THE SUPERINTENDENT OF BUILDING: I hereby certify that the following portions of the work at the above address which required continuous inspection, and which I was employed to inspect, were inspected by me and comply with the provisions of the Building Code applicable thereto: Type of inspection: ❑ "'sonry �eBar Placement ❑ Concrete or Mixer ❑ .Jing ❑ Concrete Placement LQ-6unite ❑ Ni -Ten Bolts ❑ Tendon Placement ❑ Other ------- _..._---- _- --- ----- Description and location of work completed: _________________-_-_________-__-__-_______- ---------- 1 �- -- ----- --- ------�'�D �e - -------------------- -------------------------------------------------------- --- -- ---------------- ------------------------------------------------------ --------------- ---------------------------------------------------------------- ------------- -------------------------------- --- Size of Structure ._ ...._. 3 2-- --- -- ---- Time Arrived ----- _._C �/ No. of Stories __- ------- .q. ...__..._ _ Time Left Job ______..cJ _ <a.__-..__.---_...._ .... __... Conc. Mix Design No. 1°- N_ .r. - Psi /`_( '�wimming Pool ---------- 4�7______-___._..__....__._ I had sufficient time to inspect all materials used and placed. I was not employed by the contractor, subcontractor or matepal vendor. Registration No. Employed By: Y;r;t—, Lab. ---------- ._._._.--_. `�e:?- 2 Regli�s�1tered De uty Building Inspector. B Se Be94den R2.7 i ,IL �' v a 1 P1 S� �� OWNy JOB ADDRESS 1288 Pelican Place BUILDING PFJ4IIT NO. 244b3 GENERAL CONTRACTOR J. Cittell DESCRIPTION OF WORK Block Wall— Comm. AP Wn TILT F.h• TRACT 97 O FIRR 7WNP VATAJVP $'P -to ()(1 IV- ECTIONS Signature Date GROUP J TYPE III ZONE R-1 5 SUBCONTRACTOR PERMITS ISSUED Gas I Date I Number j Signature Water Plumbing Rough Plumbing Prop. Swr. Line t] House Con.O. Sprinkling System Miscellaneous Rough Heating and Air Conditioning Temporary Service or Pole Underground ❑ Power ❑ Rough Wiring Heating and Vent. Trenches Z- Forms p Steel Reinf. py Floor System Bond Beam ❑ Steel Reinforce Q Sheathing Frame and Flashing Lathing — In ❑ Out p Plaster, Brown Coat Stmetural, Final Electric E lg, Vent., Refrig. and A.C., Final Pi...abing, Final and Gas Test ❑ Electric, Final Building, Final 2446,1 OSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 917 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT ADDRESSBUILDING //o I/�{ COSTA MESA, CALIFORNIA 1 ■ ART. CITY STATE i O 2 TEL. NO. OF BLOBS. USE OF , EXISTING BLDG. SETBACK LINE FROM - 1 DESCRIPTION OF WORK ■ BUILDING NO. OF SIZE ROOMS STOP EXTERIOR WALLI ROOF COVERING COVERING USE OF BUILDING AND WORK TO BE PERFORMED CITY OF COSTA MESA JUL 27 1965 NO. ZONING NO. OF USE DI NEW � I PLAN' 2� I USEO NO LEGAL tR DESCRIPTION /J_l! ( L{ a 'd" L A. P. NO. 11_1L NOTE: NO EAVE OVER ANG SHALL BE LESS THAN BOTTO SIDE & REAR P. L. EAVES ALLOWED (U.B.C. REQUIREMENT YARDSAPPROVED YARDSAPPROVED MAIN BUILDING ACCESSORY BUILDING DISTANCE BET. BET. MAINIII MAIN BLDGS. ACCESS. BLDGS. VAR. # DATE } I N SD. FT. � I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IB FOR THE F AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT PEE ONLY. O PLY WITH,ALL CITY ORDINANCES AND STATE LAWS REGULATING VALUATION �l m BUILDING CONSTRUCTION. (. PERMIT FEE SIGNATURE OF PERMITTE //�� AUTHORIZED AGENT $ � 66 AUTHORIZED PLAN CHECK � -200 COSTA MESA BUILDING -SAFETY DEPARTMENT P. O. BOX 317 COSTA MESA, CALIFORNIA For Applicant to Fill In Completely TYPE OR PRINT COSTA MESA, CALIFORNIA Pemba Subdividers, Inc. 2850 Mesa Verde Drive Cotta Mesa TL. 549039c fiRE. G. Kaltenbach Tr 5478046 1833 E. 17th St. , Santa Ana .__ owner— -<-n n .o l FEE RECEIVED YAH, 3-1-10k FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For Office Use Only BY BUILDING I RECEIPT NO. I rPIR, ' ZONING ZONE NO. OF I USEOFNEW Sine aID 'STATE .187318 TEL ` LIC. NO. NO. House 1 714 sq, ft. L� �/j� �'�V. NO. OF BLDQ O OF LOT / NOW ON LOTS. �T7�T�V USE OF THE AMOUNT SHOWN UND VALUATION IS FOR THE F PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G EXISTING BLDG. PERMIT SETBACK LINE FROM 50+ 351 CENTER OFSTREET REAR YARD -_-.• ^'^ ¢ 9L7 E 51 61 BIDE YARD LEFT RIGHT DESCRIPTION OF WORK SIZEDINGE 1139 NO. OF O' ROOMS 6 __STORIES 1 EXTERIOR WAIxLOI_ n6, L ROOF _. I .. LEGAL att none EAVE OVERHANG SHALL BE LESS THAN YARDS APPROVED I YARDS APPROVED MAIN BUILDING ACCESSORY BUILDING DISTANCE BET. I BET. MAIN Be MAIN BLDGS. ACCESS. BLDGS. VAR.# DATE 2o - l USEOF UI DINS NDWQ TO PE FO MED Sin e ami y wi a iac�ie� garage. ` House 1 714 sq, ft. Garage 425 sq. ft. Plan 41 -CR 7 AD R6BD. Fr. 1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS APPLICATION AND BTATE THAT THE ABOVE IB CORRECT AND AGREE TO COM. PLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING OUILOINO CONSTRUCTIO . SIGNATURE OF PERMITTE THE AMOUNT SHOWN UND VALUATION IS FOR THE F PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. G VALUATION r $� / PERMIT FEE $ G 3 .� X AUTHORIZED O NT _. -_-.• ^'^ ¢ 9L7 E Fir