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Home My WebLink About3424 PINE BROOK CIR - Building Permits{��a) �sa-sz�s • Fex (��a) �sa-asss Job Address: Suite No Viciniry: Parcel Nunmber: Applicant Address: Owner. Address Contractori Address: ISSUE FEE Temp service test Res. a/c package New Res (i-2 units) New Res (3+units) Pool / Spa Lighting Fizts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 3424 PINE BROOK 935060$6 SUZANNE MACENAS MACENAS,SUZANNE JOHN,GERALD COSTA MESA, CA 3424 PINE BROOK ELECTRICAL PERMIT Phone: 714-979-4446 Zip: Phone: 714-979-0446 Zip: 92626 Phone: Zip: License: PERMIT NUMBER E99-00311 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: status: ISSUED Applied: 04/16/1999 Issued: 04/16/1999 SCOPE OF PERMIT INSTALL NEW A/C UNIT. ELECT WORK INCIDENTAL TO MECH WORK, INSTALL NEW CIRCUIT, RE:M99-60178. � $22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.25 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Lighting Busway/t00ft Standing Section Misc Electrical Equipment Transformers up to 1 kva/kw ................up l0 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc.Condudor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES §28.25 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized hy this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced wifhin 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all required Inapectiona end tinal epprovel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby ettirm under penalry of perjury one of the following tleclaretlons: � ❑ I heve antl will malntain a certificate of consent to self-Insure for workers' compensatlon, es provided for by section 3700 of Ihe Labor Cotle, tor ihe pertortnance of the work for which t�is pertnit is issued. ❑ I have and will maintein workere' compensatlon insurance, as requiretl by section 3700 ot ihe Lebor Cotle, for the peAortnance of the work (or which this pertnit is issueU. My workers' compensetion Insurance cartier antl policy number ere: Carder: Policy Number. (lh/s section need not be wmp/eted il Ne permlt is veluetl at one huntlretl dollare ($100) or less.) ❑ I cenity ihat in ihe pertormance oi the work for which this parmlt Is issued, I shell not employ eny parson in any manner so as to become subJect to the workers' compensation laws of Celifornia, end egree ihet if I should become subject to the workers' compensetion provisions of Section 3700 of ihe Lebor Code, I shall forihwith comply with ihese pravisions. Applicent SignaNre: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAG'c IS UNLAW FUL AND SHALL SU&IEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,0OO�.IN PDDRION TO THE COST OF COMPENSATIIXJ, DMMGES AS PROVIDED WR IN SECTIdJ 3]OB OF THE LABOq CODE, INrEREST, AND ATTORNEI^S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby aNirm that I am Iicensed under provislons ot Chapter 9(commencing with Section 7000) oi Division 3 ot Ihe Business antl Professions Coda, antl my license is in full force and effecL Lic. N Class k Comractofs Signature: Date: CONSTRUCTON LENDING AGENCV: ❑ I hereby aHirtn that there is a consimction lending agancy for the pertormance oi t�e work for which ihis permit Is Issuetl. (Sec. 3097, Civil Cotle). , Lentler's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby afFirtn that under penalry of per�ury that I am EXEMPT FROM 7ME CONTRAC70RS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which requires a permi� �o construct, alter, improve, demolish, or repeir any simcture, prior to its issuance, elso requires ihe applicant tor such permit to file a signetl stetement ihat he or she is licensetl pursuant to the provisions of ihe Coniractors License Lew (Chepter 9(commencing wl�h Section 7000) of Divislon 3 of the Business and Professions Cotle) or that he or she is exempt therefrom and the basis for the allegetl exemptlon. Any violation of Section 7031.5 by any appllcant for a permit sub�ects the applicant to e civll penalry of not more ihen Tive huntlred tlollers ($500).): ❑ I, as owner ot the property, or my employees with wages es their sole compensatlon, WILL DO 7HE WORK, entl the siructure is not intentletl or ottered for sale (Sec. 7044, Business and Protessions Code: The Convacmre License Lew does not epply to en owner ot property who builds or improves thereon, end who tloes such work himseH or herself or Ihrough his or har own employees, proWded that such improvemenis are not intended or oHered for sala. If, however, ihe builtling or improvament is sold within one year ot completion, the owner-builder will have the burden of proving that he or she did not builtl or improve for purpose of sale.). � I, es owner oi the properry, am EXCLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Protessions Code: The contrectors License Law does not apply to an owner of property who builds or improves Ihereon, end who contracis for such projact with a contractor(s) license pursuant 19 �he Contrectors License Lews.). ❑ I am exempt �� Signature: Owner ID ven e Venfication ot Owi sec. Business and Professions Code for ihis reason: Date: Irs licensa. � ❑ Ves ❑ No Dnvels License No. � l expires: i-�o-Za: 3" by (type ot documenl, i.e. - property tax bill or deed): � � DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I here6y cenity thet no eacavetion ilve (5) or more feet in depth Into which a person Is required to descend, will be mede in connection with work euthorized by ihis permit, antl that no building siructure, sceHolding, falsework, or tlemolition or dismentling thereof, will be more than thirry-six (38) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Calitomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which woultl require a pertnit irom tha Division oi Intlusirial Satery, as noted ebove, unless such person has a permit to do such work from Ihe division. Signeture: Date: Division of Indusinal Safety Permit Number: CER7IFICATE OF C MPLIANCE AND AUTHORIZA710N OF ENiAY: I cetlity under penalry of perjury ihat I have reatl this application and state that the infortnation given is correcL I agree to omply with all state lews entl city ordinances releting to 6uiltling constmclion, and euthodze representatives of Ihe City of Coste Mesa to enter upon the above-descnbe ropetly for inspectio rposes. I aqree not to occupy or allow occupancy of eny builtling authodzetl by t�is permit umil final inspection. �...lR-.--.-c �-.:—,�.-- � '7�- /('• ��% Sianature Of Leoal Owner(sl � Date IAnd/OrAuthonzed Applicant Date I CQ�E �. ' INSPELTION TYPE . 1816 Fixetl System Final Fire Preven�ion 1266 Pool Spa Finel 200 Final Re-Roof 201 , Final BIocWRateining Wall 202 � Final Fectory Fire Place 203 Final Slgn 204 Final Demolition zaae as Q� INi111R COOE� INSPECTIONTYiE 206 FineIMBCheniWl 208 Final Plumhing 210 Final ElecMcal 212 Final Flre Prevention � 220 , Final Plenning Approval 222 Final Site 250 Final Building/Occupancy pRTE " lq a INTR (�ia� �sa-s2�a • Fax pia) �sa-aess CITY OF COSTA MESA ; BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 3424 PINEBROOK Suite No Vicinity: Parcel Number: 93506086 Applicant: SUZANNE MACENAS Address: Owner: MACENAS, SUZANNE Address: JOHN, GERALD COSTA MESA, CA 3424 PINE BROOK Contractor: Address: ArchlEng: Address: INSTALL NEW A/C UNIT. ISSUE FEE Inst FAU <100 k BTU Inst FAU >700 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm AirHandlers> 10000dm Floor Furnace Floor or Suspend Hea[er $22.00 $0.00 $0.00 $0.00 $0.00 $1325 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 quantity MECHANICAL PERMIT Phone: 714-979-0446 2ip: Phone: 714-979-4446 Zip: 92626 Phone: Zip: License: Phone: Zip: License: SCOPE OF PERMIT FEE SUMMARY PERMIT NUMBER M99-00178 � 77 FA�R DRIVE, COSTA MESA, CA 92626 ISSUED BY: Repair / Alt Absorblion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercia l I ncine rator Domestic Incinerator Compressors / Absorption Systems Up to 3 hp / 100 k BTU 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 7,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 04/16/1999 Issued: 04/16/1999 Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 535.25 NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 deys. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectiona end final approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545628 WORKERS'COMPENSAPON DECLANAnON: . I hereby aHirtn under penalry of perjury one ot the tollowing declarations: � ❑ I have end wlll meintain a certificete oF �nsent to self-Insure for workers' compensation, es provitled.tor by sectlon 3700 at the Lebar Catle, tor ihe pertormance of the work for which this pertnit is issued. ❑ I have and wlll maintain workers' compensation insurence, as required by sec6on 3700 of Ihe Lebor Code, for the peAortnance of ihe work for which this parmit is issued. My workars' compensation Insurance c�rtier and policy number are: Carrier: � � Policy�Number: (This section need not be comp/eted il the pe.mit is veluetl et one hundred dollers ($f 00) or less.) ❑ I certity thet In ihe performance oi Ihe work for whlch this permit is Issued, I shall not employ any person in eny manner so es to become sub�ect to ihe workers' compensation lews of CaliFomia, end agree ihet if I shoultl become su6ject to �he workers' compensetion provisions of Section 3700 of ihe Lebor Code, I shell fonhwith comply with ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' WMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOIXJE HUNDRED THOUSANO DOLLARE (5100,000), IN AODRION TOl}{E CQST OF COAIPENSATION, DAhL1GES AS PROVIDED FOR IN SECitON 3]O60F TME LABOR CODE, IMEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTOR5 DECLARATION: I hereby attirm that I em licensetl under proviaions of Chapter 9(commenclnq with Section 7000) of Division 3 of ihe Business and Professions Code, and my Ilcanse is in full force and eHect. Lic. k . Class H Contrectofs Signeture: . . . Date: CONSTRUCTION LENDING AGENCV: j❑ I hereby aflirm that Ihera is a consimctibn lending egency for ihe pedormence ot the work tor which this permit is issuetl. (Sac. 3097, Civil Code). ' Lender's Name: Lendets Address: Signature: Dete: OWNER-BUILDER DECLARA710NS: I hereby aHirm ihet under penalry ot perjury �hat I am EXEMPT FROM THE CONTRACTORS LICENSE lAW for �he tollowing reason (Sec. 7031.5, Buslness end Professions Code: Any ciry or county which requires a permit m construct, alter, improve, demolish, or repair any structure, pnor ro Its Issuance, also requires the applicant tor such permit to tile a signed statement ihat he or she is licensed pursuent to Ihe provisions ot the Con[racrors License law (Chapler 9(commencing with Section 7000) of Division 3 ot the Business and Protessions Code) or ihat he or she is esempt iheretrom end the basis tor the allegetl exemption. Any Nolation ot Section 7031.5 by any applicant tor a permit subjects iha applicant to e civil penalry of noi more than Ilve hundred dollers (5500).): ❑ I, as owner of the properry, or my employees with wages es iheir sole crompensation, WILL DO THE WORK, entl tha structure is not intended or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contrectors License Lew does not apply to en owner of property who builds or improves thereon, antl who tloes such work himseN or herself or through his or her own employees, provided that suc� Improvements are not imended or o%ered tor sale. If, however, Ihe building or improvamant is sold within one year ot completioq the owner-bullder will have the burden of proving Ihat he or she did not build or improve for purpose oi sale.). � I, as owner of the propeM, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the project (Sec. 7044, Business end Professions Code: The comrectors Licensa Lew does not apply to en owner ot pmperry who builtls or impmves thereon, end who contracis for such projact with a coMreclor(s) licensa pursuant to the Coniractors Lic9nse Lews.). ❑ lam Signature: Owner ID sec. license. ❑ Ves ❑ No Business antl Protessions Cotle for this reason: Veritication ot Ownership by (typa of dwument, i.e. - property tax bill or deed): � Date: �f —� Driver's License No. / � / DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATON: ❑ I �ereby certity ihat no excava�lon flve (5) or more feet in depih into which a person is required to descend, will be made in connac�ion with work authonzed by ihis permi4 end ihat no building stmcNre, scaRoltling, felsework, or demolition oi dismantling t�ereof, will 6a more than thirty-six (36) faet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califarnie Atlminisiretive Cade). ❑ As ownerbuiltler, I will not amploy any6ne to tlo work which would requlre a permit from the Division ot Indusirial Sefety, as notetl ebove, unless such person has a permit to tla such work from the division. Signature: Date: �ivision of Industrial Safery Pertnit Number: CERTFlCATE OF CQMPLJANCE AND AUTryORRATON OF ENTRV: I cartify under penaAy of perjury that I have reed Ihis application and state that Ihe information given is correct. I agree to dmply with all stele I iNs and ciry ordinances relating to building constmction, antl authonze representatives ot ihe Ciry oi Costa Mesa to enter upon the above-tlescnbe operty tor inspection rposes. I agree not to occupy or allow wcupanyr�f any bullding authodzed Dy this pertnit until tinal inspection. �_ f � "' ! /�/-/6-S`� � , Si9naWre01 agalOwner(s) Date And/Or Authoriped Applicant Dete CpDE l INSPEC710NTYPE 1676 Fixetl System Final Fire Prevention 1266 Poal Spa Finel 200 Final Re-Roof 201 ,Final BIocWFetaining Wall 202 Final Fectory Fire Place 203 204 244fi-06 Final Sign Final Demolition . PdIF IN f�Qp�( INSPECTIONTYPE � 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Flnal Fire Prevention 220 Final Planning Approval 222 Pinfll Site 25Q �,Final Building/Occupancy � ; , �, , ,. , ,., � , . , OWNER-BUILDER VERIFICATION A city or county, which is reyuired to give notice pursuant to Section 19830, shall a[tach to such notice, and, as a condition precedent to issuing a building permit, require [he comple[ion 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 retum this information in the envelope provided a[ your eadiest oppoRunity [o avoid unnecessary delay in processing and issuing your building permit. No building aemtit will be issued until this verification is received. I. I personally plan to provide the major labor and materials for construction of the proposed propeRy improvement. ❑ Yes � No 2. 1(have/have not) �i✓G signed an application for a building permit for the proposed work. 3. 1 have convacted with the following person (firm) to provide the proposed consWction: Name Address Phone ( City Contractor's Lic. No. �l ��(g 4. I plan to provide poRions of the work, but 1 have hired the following person to coordinate, supervise and provide [he major work: tvame �1 �� UEA � Ir�C, � A�2 CU� — DfZ� A� t��Jl-�P2T' Address �� 3 2 � Pl! �� g� City G%�� M� N IS��- Phone (41� )�(o- 5�o(P Contractor's Lic. No. '�� ( g� l� CCASS C- 20 5. 1 will provide some of [he work bu[ I have contracted (hired) [he following persons to provide the work indicated: Name Address Phone Type of Work 1062-46 (pEV.95B) :. . „ Village Creek Architectural Change Approval Procedure: Homeowner to submit a short written request of the change desired including a sketch or drawing. The sketch or drawing doesn't have to be to scale or at all elabora[e bu[ is mainly used to indicate exactly where on the building [he change will be located. 2. Architectural Committee to review the plan, consult with the Homeowner, and make up a Hold Harmless form for signature by the Homeowner. 3. Homeowner to sign the Hold Harmless form thereby agreeing to the conditions outlined on the form, but with d�e understanding that the change is not approved until the Doard has reviewed the request and signed the Hold Harmless form at a regular Association Boazd Meeting. 4. If the Board approves the request Equitable Management will notify the Homeowner by mail and return a copy of the completed Hold Harmless form. If the Board tums down the request Equitable wiil notify the Homeowner by mail. In accordance with our Association rules the Homeowner is to receive a response within 30 days of their submitting their request. 5. Equitable Management will maintain a file of these requests by address and will in- clude a copy with the other documents it copies for the Escrow company whenever a property in the complex is sold. �o� R � C �N `� l� � �.� �/�°�coN e� �Jt ��4 `��+-S� �e � t"J � Q.s ��but F'o�,-S �o ��' - S�-$ , PFOJECT AOOHESS: 3 4 Z 9 P I NE B ROOK uxiT: owNeesxnme: VILLAGE CREEK HOMEOWNERS aooeEss: ASSOCIATION 3429 TIMHER LAKE CM VA 92626 RFCH/ENGINEEP: CHESTER CARVILLE sec.xo.: C18305 FDDNE55: % J Z z p,RMOUR JrT I1NIT: S.D. CA 92111 PEflMITTEE: PxOENIX ENTERPRISES INC. ( 213 ) 690-9559 aooness: q i l COMERCIAL WAY LA HABRA CA 90631 LICENSEO CONTHPCTOB OECIAHATION: I hereby aliirm Iha� I am licensetl untl^ r is 5 of Chapter 9(commencing with Sec�ion 7000� oi Dirsion 3 0� Ihe 9usine55 antl Pwfessions Goae. antl my license is h or� nd ellect. cirruc.:0� Taeuc.:376639 �/ ��/// Oate: �� Signature'. _ - '�/1'��^l� WOflKEflS; COMPENSpTION OECLA RTION: I hereby a��irm ��a� I ave a cenilica�e of consent m seli-insure or a cenifi I WOrkers' , ComOensa�ion Insurance or a tetli�iea Copy Ihereal (Sec�ion 3800. Lab. C�. =o��crNo.: W700359 E%P.DRTE: U7/0 91 'coMaaxr: CA COMP 6 FIRE � Cetli�ietl oDY is ereby �or,nish ❑ Cetlifietl copy is file0 wilh c uildin uisi i Oa�e: � � ADplicanl: E%EMPTION FHOM WOflREflS'COMPENSATION DELLABATION: (Thissection neetl nolhe co � e0if�he Dermi isforone huntlre (S11q)orless). I certily I�al m the pedormance o� Ihe work lor which Ihis permit is issued. I shall not employ any person in any manner so as to �ecome suble�� lo Ihe VJorkers' Compensation Laws of Cahfomia. Date: Signamre: NOTICE: If. a�ter making this 4eclaratlon. you should become su�ject to the Workers' ComDenSatlon pwvisions o� the Labor Code, you must Iotlhwiih comply with such Omvisions ar this permil shall 6e Oeemed revoketl. CONSTBUCTION LENOING FGENCV: I hereby al�irm ihat there is a conSVuction lending agency for t�e petlormance ot Ihe work for whic� ��is permi� is i<sued �Section 3097. Civ. C�. �exoea: aooe[ss: OWNFfl BWLOEN �ECLABATION: I �ere0y aHirm IAai I am exempt imm the Coniraclors' State License Law �or �Ae follovnng reason �Section 703t5 Business and Pmfessional Cotle: Fny ciry oi counry which reQuires a permii to cons�mct, alter, impmve, demolish, or repair any slmcWre, prior Io its issuance, also requires the applicani �or such pe�mit �o file a signetl s�alemeni Ihal he/she is licensetl pursuant �a the provisions of the Coniracbrs' S�ate License Law (Chap�er 9(commencing wii� Sec�ion 7000) ot Division 3 0l Ihe Business and Professions Cade� or that he/she is exempt therelrom ana I�e �asis far ihe allegetl exemption. Any violation of Sec�ion 7031.5 by any applicant for a permil su6le��s I�e applicant Io a civil penaliy ai not more Ihan �ive huntlred Aollars (5500�. I, as owner o� ��e propeny or my emplayees wilh wages as t�eir sole cam0ensa�ion. will da the work, antl [he � simclure is not inten0ed or olleretl for sale �Section 7044. Business antl Pmlessional CoOe: The Conlraclors' S�ate License Law aoes not aOPly lo an owner ol a pmDe�Y w�o builtls or improves ihereon, antl who Eoes such work himself/herseli or tAmup� his or her own employee5, provide0 I�at su[h improvem¢nis are not in�enAetl or uflered br sale. I�, Aoweve� �he builtling or impmvemenl is sold within one year o� com0letion, �he owner will have Ihe Durden ai proving �e/s�e Gi0 noi huilU ot impmve lot ihe purpose of salel. I, as owner o� ihe pmpeny. am eeclusively contraming wiih licensed contraclors m conslmm the pmlecl (Seclion 7044, Business ❑ an0 Pmfessions Cotle: The Coniractors' S�a�e License Law Oces nol ap01y to an avmer ol pmperry who bmlds or impmves thereon and who coniracis lar such pmle��s wiN a wnVactor�s�license Dursuanl�o �he ConVac�ors' Sta�e License Law�. I am aware Ihai D�ool ol Iheir Warker'S Campensation insmance ihould be pmvided ta me. � I am exemD� under Secliare B 8 P. C. for ihis reason: oate: Owner 1 do hereby ceNty thal I am aware ol and understand Ihe reQuirement5 ot Califomia Health antl Safely Cotle $ec�ions 25505, 25533, and 25534 antl that I ar any future builtling occupant willlwill not (circle one) neetl to comply with saia state co0es and ihe requiremenls lor a permi� �or mnstmciion or modificaiion Irom ihe Air Oualiiy Management Oisiricl. Fesitlential constmtlion applicaiions are exemp� imm tnese pmvisions. . Date: Applicanl: _ I hereby cer�ity thal I have read Ihis aOVlica�ion and slale Iha� ��e oreinancesantlsta�elawsrela�ingtob IQingconsimctionandheret propetlV Ir inspec��on urpose� Date'. _ '�� SignaWre: _� oa�ers �ae�se or Sanai seadry ApPlicanl; Pink—Revenue: Goltlenrotl—Awessar CITY OF COSTA MESA — BUILDING FERNIT PERM NO; B 05052" PERMIT NO: B OSOS27 PLAN CHECK NO: 00161-91 A GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR � PURPOSE; REP JOB DESCRIPTION : REPAIR SETTLEMENT DAMAGE SQ FT: 143 CI.AIM VALUE: 14,300.00 CALC—VALUE; 14,300,00 GROUP OCC: R-3 / COMMENTS: BUILDING SETTLEMENT REPAIR/F'OUNDATION *�r�r�r*�r��**�r****�t**x�***��r***x*�****�txx��**�r+t�***�*��r�t**��******�r�***��r�r*��r*�r�r�x �, Z O N I N GS ERTEBQAUCIKRSE M E N T S ------------ MAIN BUILDZNG ----------' --------- 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 RE • PROV; PARCEL: 93506124 ZNE: R2 REF NO: PLANNING N 'I'ES> FOONDATION REPAIR. . � iE iE �f aF ik iF iF �F 3E 1ElE iE * 3E 3E if 3f 161f 3f if if ik 3E iE if if 3F iE 1E 3E if if iF iF if 1E iF �F if iF �E �E jE �E iF jf jE iE iEif iE If if If ik � �f if iE IE if �E IE jE 1f 1E if �F IE iF 1E # 3f �E af IE if i! D E V E L O P M E N T S E R V I C E S R E Q IJ Z R E M E N,T S ZONING APPAOVED HY � !�-� � � DATE: dI� IS'� I BUILDING APPROVED BY : � 1 L r� �. r� � DATE; �� APPLICATION ISSUED HY; DATE: � 3E aE if jF iF iE if ff iF iE 3E if iE if iE iFlE iF 3k 3klE if IE 3E if �F iE if if K if iF�iF7F3F iE ***�r**�t*�t*+t�t*�t*��tx�*�*+�*fr+��t**�t*�r�r+r*****i *��*��rx��*�r�e*�r*��t***�*�t*�t**�******** LEGALIZATION;N F E E S M M A R Y STRUCTURAL.SEGMENT:Y BLDG FMT PLUMBING ELECTR C MECHANIC FIRE SMIP/RES GRADING PERMIT 162.00 1.00 SMIP/NON—RES PLAN 26.33 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 163.00 0.00 26.33 189.33 189,33 .00 REVENUE DIVISION TOTALS--> COLLECTED: 189.33 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 162.00 1.00 26.33 ik 3E iF �f if 3E �lf if if 1E iF if iE iE iE 3f iE iE !f 3E� 3F af ik �1E )F iE iE iE 3f if iE 3E 3f� if ih iE if 3F If iF )E iE iE iFlF if iE 1F �E ff 3F iE if iF 1f 3k if 3E IF if if iF 3E if 1E Ik IF �ElE k iF �f iE±f iF iElF Ih �lE I N D I V I D U A L F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 143 STRUCTURAL BY VALUE PER 5100.00 END OF PEES 100.00 14,300.00 V ai o�c,,Eai-cu�iahb"o � o�� i=-.,.� oATe: o�i^�is� TICf� »:oa CONSTRUCTION AND PLANNING � ` �' SPA APPROVALS Permit # Date Inspector qpPROVALS Permit # Date Inspector � _. 7. TemporarY Electrical Service or Pole , 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. �� .�� 53. Steel Reinforcement -- . 3. Electrical Conduit Utility-Undrgmd. • �'� 54. Forms ' �y� 4. Electrical Conduit-Undrgmd.� � r, 55. Electrical Bonding � - 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �6. _.Electriwl,UFER Gmd. 57. APPROVAL TO COVER�GUNITE � 7. Footings' � 58. Electrical Conduit�Undrgrnd. -�8. Foundatio� , 59. Gas Pipe, O Undrgrnd., Test _.� � 9. Water Pips�Undr9md. :�� : �; 60. Backwash Lines, P-Trap, � Undrgmd. �'; �' 10. Struciural Floor System �� '. !�;� 67. APPROVAL TO DECK '��''� i 11. Property 5ewer line &�Noose-Connection '. � 62. Backwash & Receptor-Final . , � 72�. Sewer CaP . . .� '� . � � l V � 63. Heater & Vent�Final �/' �� 13. Roof Drains � � � �� ,� i-� 64. Plumbing System � Final �� 14. RoughPlumbi�g ,��' �� 65. Electrical�Final y�Y^� 15. Rough Electrical-Condurt �� '' 66. Solar System-Finai � /� 16. Rough Electric Wiring ' �`�� r� � 'fjr� 67. Fencing & Access ApProval /� 17. Rough Wiring Sign l: � ' 68. APPROVED FOR PLASTERING ' 18. Rough Electrical,-T Bar Ceiling V 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Coriditioning FIRE DEPT. REQUIREMENT 20. Rough FaGtocy Fireplace -� j • � • qPpROVALS� Permit # _ 21. Ducts, in StruMure. ' �. . - � - . � � � . 70. Underground.Hydro 22. Ducts, VeMilating • • _71. product'Piping OGas ❑Oil 23. Gas Pipe-pough & Test � '. . t 72. Underground Flusti � . 24: Roof Framing . . � � - .� �73. Undergmd: Storage;Tank O Gas ❑ Oil 25. Roof Sheathing ' ' _ ' ' �74, �Overhead Hydro: `� 26�T�Bar Ceiling (Structural) & Monocoat , u 75. Dry Chemical . ' � 27. Frame and Flashing; . . 76. Dry Standpipe � �� 28. Lathing & Siding - � 77. FIXED SYSTEM FINAL' 29. Insulation ', . ' � - � �. 78o_FIRE PREV. FINAL •30. Drywall.Nailing � j � HEALTH DEPT. REQUIREMENT 31. Plaster Bro`�`�n Coat" . � � � � ,' . 79. FINAL INSFECTION .� - 32. Electrical Power Meter-Final� � I �• - SO.�FOOD CERTIFICATE ISSUED ' 33. Final Electric ' ' I I � ' �Notes: , � , - 34. Final Heati�g & Air. Conditioning �� , i � ` . . - � , � 35.� Final Gas PiPe-Test _' � , �. . ' ` 36.�Hood or�Canopy �? , I I � �. - . ` . 37? Final Factory Fireplace � � I �, ; � "38. �Final Plumbing � � .. I � i. - � .+•. 39. Water Service�Final � , l ' �40. Gaz Service�Final . , i � ; � , � ' �41. Solar pomesticFinal � I � I ,-. . 42. Backflow Preventer � � � ' l. . ' , . i 43. Backflow Irrigation � , � ' , 44. Landscape Irriqation System � J� . ,, .' - �45. Sound Attenuation ' � "� - , 46. Handicap Requlations � ' . - � � 47. FINAL S7RUCTURE & BUfLDING ' � j -� 48. FINAL PLANfVING � ` � , • 49. Elecfric Release to Edison ( � � - . � 50. Gas.Release to $outhern Califomia Gas Cn , � I �� - ' 51. CERTIFICATE OF OCCUPANCY . , No. Date unnerc 5•rfu�-wt�: llevelopere,lnc. unit �..,........�.. �.n. ..e n...... ..��. AP No.`��fj_(j��,_}S}'u40T INSPECTIONS SOIL GAS WRTER ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROl1GH NEATING AND AIR CONDITIONING TEMPORARV SERVICE OR POLE UNOERGROUNO � POWEB � AOUGH wIRING TRENCHES FORMS � STEEL REINF FLOOR SVSTEM BONO BEFM [� $TEEL PEINFOliCE � SHEATHING FRAME ANO FLASJ—H—ING � � LRTHING — IN G/�6UT �� PLASTER,BROWN WAT STRUCTURnL, FINPL HEATING, VENT., REFRIG. AND A.C., FINRL PLUMBING, FINAL ANO GAS TEST 1-'! �i� ELECTRIC. FINnL TRACT AASR FIR SUBCONTRACTOR Z . aU Z ZQ ON am J7 J � Q W C1 J • (O J Q U N Z a W ¢ aW W Z J � m Z J � W w O z� w� (n 2 �O F Z Q U J a a Q O F- N Z O F- U � � H N Z � 4.1.864 COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicatlt ro Fill in Completely BVILDING 3424 Pine Brook ADDRESS OWNER State-Wide Developers, Inc. MAIL ,..�. „ . ... CITY BRANCH ADDRE55 ADDRESS 17A48 Sk CONTRACTOR StBYF AODRESS 9461 Gri c,r� Cypress LIC.NO. ZZQ7�O OFLOT 12.093 a SIZE OF NO. OF NEW BLDG. ROOMS EXTERIOR WALL a$ er ROOF COVERING COVERIN USE OF BUILDING AND WORK TO BE P No`.826-4550 CITV LIC. NO. NO.OF BLDGS. NOW ON LOT O I heraby acknowletlpa ihal � hova reatl this eDP��ation antl ste[e thot Na ebova informatlo� is correct entl aBrea to comply wiM all lows ragulatlnB bulltlin0 confttuction, ond i f�oll not employ any parwn in vlolation of the workmen's compansetlon laws of tha Sm[e of Celifomia. I hereby cenify Mat I em properly licancetl as a controctor under t�e Siate of Callfornia Buzi�ass entl Profeasione Cotle, Diviaicn 3, Chepmr 9, antl that such li�ensea ara In full forca anC effxt, or I am axampt trom t�e provi5�ons oi Ne Srote oi Cel(f nia Businea antl Professions Cotle, Oivision 3, Chapcer 9. State-Wide Develope " nc. Slp^etura o Parmittae Author{zaOApani Vice President '�HY �3"%��A[.]oO 7�rJ=' i:u}�Z�li.nO APPLICATION FOR BUILDING PERMIT A.P. NO. � BUIIDING ADDRESS�Z y TRACT �CYSB � OWNER FIRE ZONE APPROVED NE NO.OF USE OF NEW �Z'GP P�=� Z 9UIL�ING � YAqDSAPPROVED VARDSAf MAIN BUILDING ACCESSOR' DISTANCE BEf. MAIN BLDGS. VAR. �+ c.u.v.,w�—% HOLD FOR BET. MAIN & m W SQ. FT. O THE AMOUNTSHpWN UNDER VALUATION IS FOR j THE PURPOSE OF ESTABLLSHING A PERMIT FEE ONLV: m 2 LUATION m � O� GERMR FEE 5 / � m PLAN CHECK S � �O E `o w . 1� �e u TOTAL FEE $