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HomeMy WebLinkAbout2939 PEPPERTREE LN - Building Permits��ia��sa-sz�a • Fax��ia��sa-aess CITY OF COSTA MESA BUILpING DIVISION DEVELOPMENT SERVICES DEPAATMENT PERMIT JobAddress: 2939 PEPPERTREE LN Suite No Vicinity: Parcel Nunmber: 13920406 Applicant: LORIE Address: 2737 S ( ISSUEFEE� ` Backflow iriigation 1 � Backflow Preventer %' Bathtub � � � \ Clarifer System� � Connect pce,Soda etc) Dental Units ��� Dishwasher �Y Drain, Floor � Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) � Gas (Over 4 outlets) Gas Repipe Gas Service Interceprors (Grease, Oil) Interceptors (Sand Auto ) PLUMBING PERMIT PERMIT NUMBER � P00-00194 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 04/25/2000 Issued: 04/25/2000 ISSUED BY: _ --. _- s �r.r.._:. <T ��-� _ _ ..-s,�'l•- y�=._- � - � =r�.'-�; �-� /: ^/ �� �v�.� � rr� � r , '%' �` �� Y'' 4-� (- 1, � i I ! J"�.`'--''"\= ",`,� ` j` Phone: (714) 2� 1 1414� �������., 4��� V _Zip:-92704_. � / /� `-.�.\�.\�� . % � � �\` / � �� �i � ��- -✓"_-4�-�=`�'� �-.. \ \ .` \�� `\v `\ � lC���� � � ���,. ��/ ?� \�� �REE LN �- r � ��\� , � �` � Phone: � ����, ./' ' y� CA Zip::.n 92626 - !��� �'� �c�� � -- - ' \� \�%�, I'.%k-� • � i,"�`? "' ���. �1`��• �� �. � )TER PLUM�Ir,N-G. �H.EATING & AIR �CONDITIONING -. \� t\, � Y� �C ,�(j��F -,�"�� 1, ``�.� �l� �ti�� �- `f' , _ � U_ -�� � `n S �- ' Phone: (714) 241-7474 �2� �p .. .- ' /-_` `,.''' �ZAr. -.��A.� �� �, ^" Zip: 92704 '-�' yy�1T'' �\�+',!4t Llcense: 529127 � ���'�'`�� > ��i � �,� � , , ��� �� „ �� �� srv;r* 1'�li���Ci�'�� � d�� �n�� � ��.���,. �i I" 'oJlb �L�L.IL��'i� i t� �1�� C� �k i _ � �'+' I ��_-_ -�.._.:.Phone: ___ _._.;.�� � . ;f�,j� ''t'� ZID_ n /O. � IIIL� OUT. � �<< -J AMT QTY r �ii�sR _ l .'.G ' '�� I � Laundry�Tub"%�WaSher�r, , G �$0;00, 0 „ t '�\� 0 i � Landscape`linga6on ��j „$0 00 �, 0 \� ��0�� � =?��-Pressure Regulat i �'�'�%, �'-$0:00��,� 0 KT�' ., �0 �.y �� �Process Piping (Per`70 fl)`"C $0 00� p-0 �,,rJ ��;.-0 ��...`"��`Receptors,'a� �'y' �. i�- �$000 �- 0-� ��`"0� �SepticTank� - �; oC �$000 -�=0 i O���s � SewerCap.foiDemo-.'���$0:00.�'.--�0� - OC -,'Sewer Connect - �- "$0.00 0- � ��0`� f�� �SewePPrivatei ine_ ���$Or00; %0;��.`�ry � �'1 _i ;,Sump ��A '�� � `, � �r% � ��/ � � %f � r ` ��t'% � � . % �� ~ � i P � Pool � .: �l �; kr Bkflow(1�4) kr Bkflow(5+) n , �;� % i $0.00 , $0.00 '! $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 3u.uu�o„ ^�Shower � ( ) j �� � r � $0;00 `, -0� .-�j waterHeater / vent $12.30 $0.00 �V 0���� Sink, ba� �'� ff� J��' $0.00�`��0`' �Nlater Piping (Inst or Rep.) $0.00 $0.00 0'^�.�"„�Sink, commercial� `� �`� �' $0.00 0_- ��y .� Water Re-pipe $0.00 $0.00 0 \;Sink,-Floor ._$0.00' 0�' yz,.__._�. � !.i'"� WaterService $0.00 $0.00 0 Sink; kitchen-^�-'�%�'-3-=--�$0:00 ---r 0 Water Softener $0.00 $0.00 0 Sink, service%mo'p "� $0.00 0 OTHER $0.00 $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 $0.00 0 REINSPECTION $0.00 $0.00 0 TOTAL CALCULATED FEES: $35.80 COMMENTS I SPECIAL CONDITIONS QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 NOTICE: The work authorized by ihis 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 if work is not�commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mus� comply with all applicable codes, and all required Inspeetlone and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION OECLARATION: ' � �o I hereby aHirm untler penalry o1 perjury one of the tollowing declarations: � , ❑ I have antl will meintain e cetlificete ot consent to self�lnswe for workers' compensation, as provided for by section 3700 of the Labor Code, for the pertormance of ihe work for which this permit is issuad. . ' , � I have antl will maintain workers' compensation insurance, as requiretl by section 3700 of the Labor Cotle, for the peAormance ot the work for which ihis permit is issuetl. . My wor ers' compejn �ation Ins rance carrier antl policy number are: . • � Carrier: i i l" Q,4/` � , Policy Number: I�� ( t%�X R S O�) (This secfio need not 6e complefe i�Y fhe p mif is veluetl et ane hundred dollars ($100) or /ess J ' , ❑ I certity ihat in the performance of the work for which this pertnit is issuetl, I shell not employ eny person in any manner so as to become subjact to ihe workers' compensetion laws of Celi(omia, and agree that if I should become subject to Ihe workers' compensation provisions ot Section 3700 of the Labor Code, I shall forthwith comply with these provisions. /� ApplicaniSignaWre: i C ��— oe,a: y-a,-'-oa WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SU&IECT AN EMPLOVER TO CRIMINAL PENPLTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND OOLLAFE (5100,000), IN ADDITION TO THE COST OF CAMPENSATION, DAMAGES AS PROVIDED f-0R IN SECTION 3]O6 OF THE LABOR CODE, IMEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECIARATION: I hereby aHirm that I am licensetl under rovisions ot Chapter 9(commencing wi�h Section 7000) of Division 3 of the Business and Profassions Cotle, and my license is in full force antl eHect. Lic. # �o�� Class tt �.� % ContrectoYsSignaWre: Date: �a�-d� CONSTRUC710N LENDING AGENCY: � ❑ I hereby aHirm that there is a consimction lending agency for the pertormance oi ihe work for which ihis permit is issued. (Sec. 3097, Givil Code). � Lenders Name: Lender's Address: SignaNre: Date: OWNER-BUILDER DECLARATIONS: I hereby attirm ihat under penalty of perjury iha� I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business antl Professions Code: Any ciry or county which requires a permit to construct, alier, improve, demolish, or repair any sirucWre, pnor to its issuance, also requires the applicant for such permit to tile a signed statement Ihat he or she is licensetl pursuant to ihe provisions of ihe Comractore Licanse Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business and Professions Cotle) or thet he or she is azempt iherefrom and Ihe basis for the alleged exemption. Any violation of Section 7031.5 by eny applicanl for a permit sub�ects the applicent to e civil penalty of not more than five huntlretl dollars ($500).): _ ❑ I, as owner of the property, or my employees with wages as iheir sole compansation, WILL DO THE WORK, and the structure is not intentletl or oHered for sale (Sec. 7044, Business and Professions Code: The Contrectors License Law does not apply �o an owner of property who builtls or improves thereon, and who does such work himself or hersetl or ihrough his or her own employees, provided that such improvements are not intended or oflered tor sale. Ii, however, the builtling or improvement is sold within one year of completion, the owner-builder will have ihe burden of proving Ihet he or she did not builtl or improve tor purpose oi sale.). ❑ I, as owner of ihe property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors License Law does not apply to an owner of properry who builtls or impmves ihereon, end who coniracis for such project with a contractor(s) license pursuant to the Contrectors License Laws.). ❑ I am exempt untler sec. Business and Professions Code lor this reason: Signature: Date: Owner ID verified by dnver's license. ❑ Ves ❑ No Driver's License No. Expires: Venfication of Ownership by (type of tlocument, i.e. - properry tax bill or deed): � DIVISION OF INDUSTRIAL SAFETY PERMIT CEF7IFICA710N: ❑ I hereby certity that no excavation five (5) or more feet In depth into which a person is requiretl to descend, will be made in connection with work authonzetl by �his permit, and Ihat no building siructure, scattolding, falsework, or demolition or dismantling thereof, will be more Ihan ihirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title e, Celifornia Atlministretive Cotle). ❑ As owner-builder, I will not employ anyone to do work which would require a permit irom the Division ot Indusirial Safery, as noted a6ove, unless such person has a pertnit to tlo such work from Ihe division. Signawre: Date: Division of Intlustnal Safety Permit Num6er: CERTFICATE OF COMPUANCE AND AU7HORVATION OF ENTRY: I certity under penalty of parjury ihat I have read this application and state that the information given is correct. I agree to comply with all state laws and ciry ortlinances relating to building consiruction, and authonze representatives of the City oi Costa Mesa to enter upon the above-described propetly for inspection purposes. I agree not to occupy or allow occupancy of any building authorizetl 6y this permit until tinal inspection. ���Si e Of Lagal Owner(s) - Date �� �/�-as -oo l�nd/Or Authonzed Applicant Date CODE �. INSPECTIONTYVE 1676 Fi:ed System Pinal Fire Preventlon 1266 200 201 202 203 Pool Spa Final Final Re-Roof Finel BIocWRetaining Wall Final Factory Fire Place Final Sign 204 Final Demolition 2d46<6 . 1� ' INTRIRLS LOOE� INSGECTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fira Preventlon 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy Q�� NTI RIRLS �i / nooiiea�� to tin i� au saaces exceat tnose w_tnio nea�y noraer n�e: a�a siyo au auorooriate deciarauoos. � - ''�'"0229� 7�28� 86 25 � 50 ��\ _ � _ _ _ _ _ _ _ . _ . - -, - - -- - - � �,;;,._: , _ ; •. w _ _ A MESA 'CONST,RUCTION PERMIT � I~ �'� "^�j N �� j TRACT NO. ; �LOT�NO.i t^` UNIT N6I ~� t � � 3 ' ! '� � j ; � ^ I , I i ` � .{ 1 ' f' , pplicantde Mailing Address � ��� � � ZO TY❑ CONVERSION � ❑ DEMOLISFI TNER � ,�, � f � � , t � , ' { ' V ! 293zT /�� � , , , L � t � • � � � � � � �� � � I 'f ! � � ° j ! � OF CONSTRUCTION 1 NEW � ADD �ALTERATION REPAIR ' t ' � ' � � I � ' i ° � � � ' S � � � . ����, �"o _ .A P..#.' '� "'i .'._ ' . ' i � OwnersName. � Phone�q�_� f - - -�-��' �-»� �..__.�.� _r . �--a.-�_-.,. _ y.�_.;`__�-._;,.Zune_.��.. , `_ r q � �,.����.�+ ,� � �DESCRIP.TIONOF'�WORK/USEOFBLDG.' ' �Address z/ � s�/�r+��/�GG, ��(� • + � � , � , ' ' '. . ; : ; j � ; S Main Bwldmg' 'j 1 1 ; ; ;Accessory Bmlding-{ i � - Arch;Eny.' � � i LmenseNo. � 7VPEOFPERMIT `' GRADWG� ❑'FOUNDATION S7RUC7UaaL � T Front� �� I � � ��� I � ; j `y � O � Addres5 � � � � • � ' '❑ TENANT j❑ EIECTRICAL ❑ PLUMBING ❑ MECHANICAL _ ' � � B Rea� � ' �� � ' � � � t � - N Contiactor 5 Na+me. ' ' ' • i , o e ��I�?'/�- ❑ OTHER _. _ ! =� % ' i �. __ Y . �' .. _. � ; � A . . � ' Y 1 t :f I ' � . . i � t Address (m � ��� �� �� I ' :��j��':// �,f PROJECT DESCRIPTION' SQ. FT. � OCCUPANCv. � . _C Right - j . � '�'� (.. �:. _ �. j — i ._ _' � - � 'N. - � � r ' s ; � :CONSTRUCTIONTYPE } { � �VALUAT.ION$ S' Left � � s � : � 't � ' � ' � ( '( G � CitY License�Na. ' . ' 1. : : i � ; � .' I . ...� � . . . . . . . e R QONE iGRADINGCU.VDS � HCRES ��� ' t � 1 LICENSED CONTRACTOii DECLARATION� j.- � � 1 1 .{ .. i � � � �, _, Ping. Ref. # f � f. � �P2�king Req./ProvidEd � ; � E I he�eby affitm�. that� I am.licensetl untlerprovisions of Charte� 9(commencing Remarki: i � � i.y. � 1 ' ' �_ 1' y 1'- �'- Pldnniny NOL¢s:r �. � ��. � � �r �% "�,j � f i-.` M � with Section ]000) of Division 3 of the Business antl Professions Cotle, antl i mY license is in lull forGe antl ef(¢ct. ' � � -� � !_ � �' . 1 � � i-� � : t f � ' S. ; : � '� �.L r: I' ��� � 4� i� h� F. T License Class ' � > > � License No. , � ' � � ' ' ' - � - ' ' S. E 'Date' { � Siqnature f . : � � '., �.,i; �:� ' PLUMBING - �. . - i 'i .FEES i �: { � i ' � � .�- .� 1 '� � •� �� � WORKERS' GOMPENSATION� DECLARATION, ' � , � ' � � - • � , , Y LL •' � ' Bar Sink � �' � `" a i ' Showers i , ' � � ' ! ' - � + -m i '" ( - , '•ereby affirm tnat 1 have a ce'rtificate of consent to zelf-insure or a certiticate ' "' � : � �. ' i j. ' i �` �� � �, i .• i ' � � j ; ".' ELECTRICAL' -, ( .�„ � .� j � � �FEES �'• � Worker5' Compensation Insurante, Or a [ertifietl copy [hereof (Section ' - � - �, ,00, �ab. c.)j 1 � � '.. i �' • � } , Backflow�Preventer, ? �'- � ," ; jService;Sink � � -�- j � � r � � � AutomaticWasher`� ". � >> � ; Transformei-,0�75�50KW " _- � :' ? Poiicy No. � � ` i' � Company � � ' � � I Backflowirrigation � " � _ •Sewer Cap �- � ' � s � ��, Construcuon�PoleSub.t' 4 : � _ i ��� � � '��50+�KW.� ' {1 i ^ 'x� - � e CertifieG coOY is hereby furnishetl. j ' : 1 r . - ; . , ' ' � : - � ' � 1 . � { Certifietl copyis hletl witb the city Builtling Division! ) ! �� Bathtubs � , =, i � � � ; �' t ; �Sewer Conriection � . �'�.� � ��• � . � -Cooking,Uoit I : � > � � ,Me[er � ❑up to 700 amps ' � � Date'. i . .t i A�Plicant. � . � . i � � . l' . _ . . . ; .. . ; r � �. � h 1 .+ I � , .. , . . , t h J I �� . � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION • Clalifier5 � � � J � .. j $olar CollectOrS � � ? . �+ � L � � Dishwa5her. : � y � � >:; , 'Meter��over400am'ps'i � ' i � • (This section neetl not be completetl!it the permit is for one hUntlretl ($100) or y - '" ' " ^ -' ' �' � Iess). • F .. i : ! � 1 i • ' Dishwasher7 j _ ; + -� } , � � �Solai Pipmg! � T ' ; "' ! ' y -� ; Dryers �Gas. DElectnc' �' ' � �.Sub�Panet� ' ��� 'f ` h� �'� I ce�Hfy tn in t �pe�formance ohth¢ wor whictyH��� �t' issu I - � -�� - +�< < � r ��i' shall n e pp I¢¢ �qy person in any-mann ;so as teLOerb 8� Orinking Fountains� � �, i �Sola�,Tan "._ j � K' �_ � � Fan t � F�j 1 � � j Work op p��'��a�/��p� Laws ot Cal' i t X / � . .. �. � `^ '1 � f �r �> � � � 1 .• �:. �1 - Motors OO . P, Oi / 81 oate �����Z=,F , Si9uature CY _ ' � ' Floor Drains � ' � � ; jSwim ng Pool w/Spa , ^ � 1' � � � � F A.0 � � � i - �f Iria Sol 9 15 HP �16 75+ f _ _ . u .NOTI : It, a ter m5kmg;this��tleclarati ,�you oultl become subjeci to-the�-� ' ' ° •. � _ _ , _ _ . d Workers' Compensa[ion provisions:of the La or Cotle; you must fortM1with Floor Sinks -� '•' # .� inel • 1�. � �' ��' - • ,� � � comply with suth p�ovisions or'thi5 permit Shall be tleemetl revoketl. � � . ; F.iXtu!¢5 � � � � ! : `Mi wave �! - . �} CONSTRUCTION LENDING�AGENCV I i � � ' ' ! ' ' j e . • . . . - r . � � � Gas Service �Outlets , � �Water Cloret . ., � .� � � Device Boxes r " I � , ' I he�eby at}irm that there is a constructiOn lentling agency for�the performdnce � � _ � I j OI¢ Light � .� � � i _ fof tfie work��for iw�ich tnis permit;is �issuetl; (Section, 3097 Civ. CJ Interceptors � � � �Water HeatEr ' i � ' i ' 1 ( _ Lentler's IVzme' ' ' - � � . . � '. � Outlets i - -Lentle 's,Atldreis-. �+""-: . ' }. ' ' �' - -' 1 _- - ' ' _ _ .. __ _ � _. _ ` I Range, i ! , i . - - ' KitchemSink . -' - �-- •Water Service � - �-'- "�-� � ''- ' - `'� "'T . � Switches•- - �• OWNER BUILDER �ECLARHTION y ' �� � � � �, : � . ' � . - . 1 - . ' • � � � ' I 1 �uSlyn ���- � -Y��� --:t" ' � � j I hereby affirm that'I'em ezeinpt from the Contractor's License iLaw tor the Lavatories - � ( t � Auta-Wash� � i � � 1 � Garbage Disposal .Standin Sections followin9 reason (Sec[ion'7031.5 BuSiness antl Professional Cotle:,Any;city ar ' ' � • ' � � � . . I : 9 _ . ± �county which requi�es a permit to construct, alter,iimprove, tlemolizh or repai� P-T�2p I � � ' Laundr T�d 5 ' � � � � � � ' ' ' any structure, prior.to its.issuance,talso requires the applicant for�,sucn;permit � � '� ` t i V V � . � t : Generator �0-5�KW 5�15 KW � Trash Compacmr � • ; to tile a siqnetlistatem¢nt [haE he/she i5�litensetl pureuant to the provi5ion5 0/ ' I � �' �� ` I ' � ' - � the ConVactor's Licens¢•Law (Chapter 9�(commencing witM1 Section ]000) ot Roof Drains . � : � _ t � � 4 i � ! - ! .3 . � ' '?ivision' 3-of'the'Business'antl Professions'Code)'or'thaY he/she is'exempY.": , t � � . (( ' - - - �-- - - - = � � -- >refroin;antl'[he basis for Ihe alle9etl exemption. Any viola[ion of Section � t � � � '� • � `' � . ! p -�' ' ` ' t. _ f � � � y ��, 31:5-�by any applicant fo� a pe�mit' SubjeCts the� applicanl to a civil � � � 1 . `� ♦ : � 1 � �' : ( � d rof not more [han five huntl�ed tlollarsj$500). . ' � { i t i. • > i ; ' • . � � ` ' , � � , ` � „as'owner of the?oroperty � - ' � ' ' ' ' ReinspaMionyFee $15 � � t a jlssue Feej. ' � � � $ �3 � j � ' �- � - � ' ' ' ; ' � ` wiu tlo.the work, antl tne structure is not intentletl or ofteretl - ' ' �-' � �� ReinspacLon Fee - $15, � 15sue Fea ' � 1 j� �-.$ 3 . foq,sale� (Section;��o4a; IBusmess and Protessional Cotle: The Convactor's ��� r , r' , MECHANICAL j � J � FEES � � �' � � � �' 1 � LicenSe� Law tloes not apply to an owner;ot a property wM10 bulltls'o� improve5 � � - - - ihereon, antl who�tloes such work;himself/herselPor tnrough nis or her own _ � , � �- � . - � . . � DEVELOPMENT SERVICES REQUIREMENTS: � . f .% "' ' � � �;= employees, provitl¢tl that`such improvements are riot intentletl oi offeretl for Boilef -� � ; HoOA�or :Type I ❑ , } � , f , � ' _ # i �, % ' �. � sale': If, however,�the bwltling3or improvement Is soltl witnin,one year of com- ` ' � . � 'Canopy �Type I I ❑ , � r' �_ , Zoning Approved By , � � ' Date _ - _ -° ',pletlon,-lhe owneywill'have the bu�tlen of provinq he/She tli� not builtl o� im- DUCt ° UOd2� Ground � -` , < < � Building AppWV¢tl By �{ � }- � Data � { !ptove for the purpose of sale).� . - ; , ' � ' . , , _ ' ' ' ; ' � ' � , , � ❑,I,�asowner of the OroDe�ty, am' excWsively contracting with Ilcensetl-con- DuCf-StrUctU�al } Refri ¢fatiOn $ stem+ � =�� A lication ISSued B ��- �� �� trac[ors to'construct�.the project (Section 7044, Buziness antl Professions Cotle: ' ' � 1 1_ '-9: , Y i �-, i i , PP Y --' 1 � � Dat e� � € The Contractor'S4LicenSe Law does not apply to an•owner of.propertyiwho Duct - Ventila[ing . ' �� �_ 00.700,000 BTU. �100,000 BTU � e� � ' �.1. i SUryryry����ryryry���pp, RV 'FEES -� ' -�� � � bui1tls,or improves thereon; antl �who cont�acts�for such project5�with a con- � � � • �n � 1 " ;� � � • �, . ' /l _ ; tractor(s) iicense pursuant to the�Contractor's L'Icense Law). I' m aware_ttiat� - ' � ��' _ f !� , f ",. BUILDING�PERMIT �'';� {� t = S V �" . � ' ExhaustSysrem ��"Multiple:❑� z Syste epair/Alteratwn� � + $- SMIP,_ $ � . ; proof of [heir WorkerFs Compensabon in sh 'be r �itl to me.' - � h� � q - � - - � LS F � � �. j �L7 I'amiex ptu ersection� �� � �P sr on? - Fire VFact BIt.,IC60# � '� ' rteDampers ; ? � F � � ' . � ' ' P�N.CHECK ' $, ' � JPERMIT � -. j .~ _. � _ _ ^ P � I."..� , i - yl ' � : PLUMBING. . t I, ' $ . i . I ' r. �: - . . � _.' - .y � . .. . . . . T ISSUA'NCE � $ " �1 Date ! � � . O'wn ' ^ ; Heating System &'•Ducting� G , � �Registert � - � � � � _ � i � � j . t � ''. * ' ; ` � - � ; PLAN CHECK � 25% $= ENERGV PC � $ � I hereb certi mSt � a �ea is pp ion antl sti e that the.atio3e � '�' ❑0-100,000 BTU �1000 T '' ++ - �. ' � . � intormation is correc /p .to omply an ountyortlmances . ' � ' � t , � � ELECTRICAI '�' �� � GRADING � $ � - . � ��� '- _ 1 . ,,;, ! . _ • $ - � MICROF(LM � $ � . =i. 'antlstate laws relati buil ons on, er y,authorize repre- - -. � � � �! - _ � . � t ' • PLAN CHECK 50/ � �sentatrves-o i �to eY� po t ionetl er ,i7� r _ ; ; _: � " , , _. , � , �1T�� } � 1 '=, } i �, y�'$ � � . , � iinspecbo ur e �y � � ' - ' � � � MECHANICAL. $ � � -�� t :SiSnatu � -,• '� ' - Reinspection Fee � ! ✓$15r� � � ' rluue�Faei + 1 �' ! '$ 3= t � �. . P�AN CHECK 25% $ � � � , . � � �'1 g��Q�.. _—"- _' ",_' _.'_ _�r-' ' ___._' . ' _ "_' ____ " ' . '_ "_ .._ __.._.. ' __ .._ . . _ . . _ _. . _- . ' ' . _ _ _ CMF OB65-46, rev. 30/B4 White - Builtlinq; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor ' � - ' , ' , ' - ',: . ' I. � i � � , � � ; , : , POOL&SPA`_'�;.,, � . CONSTRUCTION'AND;P,L'ANNING , ' • • , � i � , � � '� � � `-'�'' N ,'�APPROVALS �Permif# � ����Date-��� Inspector;-'` "" `-�� ` ' - �'�� 'Date• Inspector � �, �f ^ , � � � APPROVALS Perinit�# .� ; �. i yry, � ' '- : � � � - ' � '�je1,�;jTemporary Electrical�Se�tvice or�,Pole � ! �, � . 1 � ' 52. Pool & Equipment Location' , � ' � e �� � ., � .� , 6, a � i 1 � � 2: Soil Pipe-Undrgrnd. ��� ' i � ' ' , .53. Steel Reinforcement� � ��� . , � , 3. Electrical Conduit Utilit� Undr md. i � ' � 54� ,Fo�ms' - -` � ' � � ! � ' Y' 9 1 � i , i�- t t ' � � �, - � � ,i � � �� , . ,. � 4-., Electrical Conduit-Undrgrnd. � I j . i �,55. Electrical Bonding R ' > t � �_ i � R � . .. , . . . �� � : � ; 5:. Steel'Reinforcement � � ' ; • � � � � 56! Rough�Plumbing�& Pressure�Test. � � � j (; � � � .6. Electiicel UFER Grnd., ' ' � � . � � ' - ' /57. 'APPROVAL TO�COVER-GUNITE ; ' � � R - , � � . � . .. � a . � � . i � tJ 7. Footings; i„S = •r � : �' _ � � ' � � ' �� i ._ � �/� _ 58�. Electrical Conduit-Undrgmd: ' � ' � j i ' ` . � /,' 1, ` 8. Foundation� �,�! rG.'�F' �. --- ' .. . � } . . 59.. Gas Pipe,.O-Undrgrnd., Test i ' -, � f - , -��- . r 9. Water Pipe-Undrgmd � �p? �� ,,, � ' w_ � _� _. _60. Backwash,Lines,�P-Trap,�O�Undrgr�nd.�' ' � � '� ' 10. Structural Floor Systeml .' ' , i .�� � �f � � 61. APPROVAL TO�DECK , � � � I � 'r 11. Property Sewer Line & House,Connection , � ; � � 62. Backwash & Receptor-Final � � � � 12. Sewer�Cap � � . " , , ` �,'�, , � � 63. Heater;& Vent-Final�ti � ' � � � ' � � � . 13.+Roof Dreins,. ��� . ' ' � �' � ; � � � � 64. Plumbing System - Final' ' � ,� � � � � � �14` Rough Plumbing � .- � ' '� ' � � 65. Electiical-Final, ; � � � � � ' �. , 15�. Rough �Electrical-Coniiuit � i � ! i � � , ' � - � � � � � . ' - I �� �, . _ 4 �� 66. Solar-System=Final � . , ti .• � 16. Rough Electric Wiring �� � -- � , �- . , - ; 67�.' Fencing &'Access-Approval � � 'r -` ��� - •� � � � - � Y 17a Rough�Wiring-Sign , - . • - - -� � �r � 68.'APPROVED �FOR PLASTERING�•' N"*° •-'•• ' - �' �". `. 1' � � '18:'RoughElectrical=TBar,Ceiling � - �" ' ' �--�j '69: POOUSPASYSTEMSFINAL��-��.i ,' '19: Rough Heating & Air Conditioning "' -. � � , FIRE DEPT. REQUIREMENT�. '�. y' : . . i � , . . . ' ;i,� � `�20: Rough Factory Fi�epla`ce " � � ' -" �� - i t'- ABPROVALS"; Pe�mit # , ' %�� _ � � �y � 21: Ducts; in �Structure � � � ' � � � � 70. Underground Hydro" , ' � , ' �'' �" •� -- i %. 22! Ducis, Ventilatirig- r - � ' � � 71. Product Piping O,Gas ❑Oil . � i a � �,n ? - i 23. Gas Pi e-Rou'h & Test: � - � , , � A ` � - � . P 9 _ - ' ; 72. Underground Plush , � � ` ' ' ?.?'- ". s; � �24! Roof Framing � _ �� � �� ,, « , ' :73�Undergind.StorageTank �'Gas; �OOiI � '= � � :n , M"' 25'. Roof SHeathin ' ' � ' ' �- � - �- 9 . :,�� , ' 7 � t74:, Overhead HYdr'o } `. �' . . . � . � �. 26: T-Bar Ceiling'1Structurall:&'Monocoat � � 1 75� Dry Chemical � ' +,�,;, ' , � � - �3 _, �- '27.��Freme�a�d�-Flashing. ; - ' � - - -- -'. '�' - r� �- 76. Dry StandPiPe'� - " ' � � � ` � _ , ;� . '. _ � 28. Lathing & Siding- � �. . . � _ �, � LL_'F ; - -77 FIXED SYSTEM FINAL ' � ,� � � ' �C •' �'� 29� Insulation i-.. � i � ' ' ' 78. FIRE P,REV. �FINAC , � , � � , � ' - ---�: o 30: Drywall,Nailing ; � � � � � � ' �� , � � t ; HEALT�H DEPT. REQUIREMENTr ., . �, ` ;� ^ . - ,' .. . " : , � - . � ; ' . . ' � � . , „�:." � 31,. Plaster Brown Coat�� Z . �� ,-'i �: , 79. FINAL'INSPECTION � � a �� f',.r/ ' y 32i Electriral'Power Meter'Final ', � � 80:'FOOD CERTIEICATE ISSUED � ' = "� �� 1 _ 33. Final Electric.- � -� � � ' � �, �, •Notes:-� � � - _ 1; � � � ;, _ � � � ;' � 34. Final Heating & Air Conditioning � , ' ' i ° � - '� � . ' . � , �- � �%�� i, - � i 35. Final Gas�Pipe-Test. � . � � ' ; � . , i � ' , . ' ': .. - 't!? -. p I 1� il I 5 q� �36: Hood or Canopy � - `" � ;-�'37. Final:'Factor.y Fireplace : -- �� ; � -� � � • � ''• '.��- �� ' �. � ' �38s"Final PIL'mbing . : � _ . � - . `✓' -J ' . ` ' ' - � '...� ,' . . . 4.i �/ �' : 39:.Water Seivice,Final � � � '"1 ' , � ',. � � � , �" � .,y. � - . .,'f .; . . ,- . "� . , . _ . .. �i40. Gas`Ser.vice-Final � a� � �'�� �; � ' '- �+ � � ', - _ �, x � . . . . „ � . ,,,- ' 41: �Solar pomesticF�inal . , - � � • � , '� F � .,�� . . , J% . , ��p. ��_ .. . .f � 42, Backflow Preventeri.: . - .. F . � - . �.. . , /� , -. � ', ..: � ,. ' . �, � � .. �` �� . � . �, z ;43. Backflow9rrigation ` $ , � �'� � : � .` . � � _ - Vj• ., , ' � 44:�'Candscape �Irrigation System�. ` : � � _ .- ' � � - � � � �„ ° ' • " -- v' � j . f 45. Sound.,Atten"uation:' � . .. - . - , _ ' � . ' �� - � � � ' ,�� . . - i` - .,_ - ;X46..Handicap Regulations � � � � - . , . _ � - � . . ` �� � • . - � � � - ' ; �'47:EINAL�STRUCTURE&"BUI�LDING�� ,�' � `' �". . ��' - _ t - .�X: :!..r'� " r �3 B� DlQ�� • - �,. � - �48.'Special�ReqLirements'Completed= , . - - - � � ' . � • -;' ;i;:� � r,' -,�. �% =. - :49.'-Electric Relea'se to Edison - , • �� ��'' � ' ' • - � ' - '-� �� _ - ' � F. �fi�� . _ . . , �t 50. Gas Relea"se to SoutFiern Califomia Gas Co � ' � � - ��,��,; � � ' , , . �t 'i'51.,CERTIFICATEOF.00CUPANCY` •� .,-.. • � y - . . � � No. � .. � Dzte ' �. `� - ., , . .. _°. . , . - . , ' , .��.. CITY Of COSTA MESA BUILDING DIVISION O�NNER-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. I personally plan to provide he major labor and materials for construction of the proposed property improvement. es ❑ No 2. � ave ave not) _� signed an application for a building permit for the p work. , 3. I have contracted with the following person (firm) to provide the proposed construction: Name — Address — Phone ( � Contractor's Lic. No. City 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: - Name Add ress City Phone ( � Contractor's Lic. No 5 I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone � Type of Work I hereby affirm that I have received a copy the information set forth in Section 19830 of the State of California Health fety Code and av co ete the above information to the best of my personal'kno e, in c ' nce w' t's St e � � � Signed. Date: Name: �• �C'�'� (P nted or Typed) C.D.L #or S.S. # �� ��� 754-5273 CMF 3042�46 • �.�/� b. nSo-.�-� � n . . . . . t-_,•- �.,...------.� �'.L�. ---.-i- �•�.�a.-�--_. �+'�!�,�AVVlicant to till in all,spatts except_tnose within.heavy bortler Iines,ana,sign all approDriate tleclarations. i . jjj?',:'� :_ �� � ' , � OF�COSTA M�j S Cnn�N-S�T1RUCTION PER,rM IT� ry�� i PER�N��y\ NO: I ! TRACT NO. �LOT�NOl E UNIT N6.r ' ( I � '( � ' � , ' '� 4 � ' '�.. K �1 .. ; �� i -I� ' .l � � Z"7 � �/"C�"%g��i�'� L.�./ J, . v � ; � � � - : . : 1 � 1 f � i f `t ` � � " t . � roject Address �• ` �� . �J. �� ' , . ! f � , i . . �� f � { ( � } 1 t { � f � ! ' a � ' ' ' ' � ' � TVPE OF,CONSTRUCTION I NEW� ADD� (ALTERASION REPAIRi � � � i � � � �Appl�cant'sMaili �Address I ' � � � - � � � : , � 1 ; i �/ r n � c ❑ CONVERSION.�� ❑ DEMOLISH_. OTH : j 1 . A.P.�# - '" -. --- �- I .. • " " � " L_�_ "'":_-- , Zone..l-- f �. - Owner's Name Q / - PhoneL���� �(•��w' Q� LYt�QQ ' ' � ' ' ' ��.� J'/ +DESCRIP.TION WO /USEOFBLDG. I Address � � � ' ��-�- �-✓�/� 1 . K� ��.-r•�� /�� � . . , � . . � r S Main Buildin9: i' ; � � W fAccessory, 8uiltlin9:1 � � � ; Arch/Eng.� ' ' t ' ' � ' LiCe eNo. � � � TVPEOF,:PERMIT. � GRA�ING ❑�FOUNDATION ' STRUCTURAL j � T Fiont! ' � � a � j � '� � � � ! O - Addfess ! � ' � � � � � ' �� TENANT �❑ ELECTRICAC �O PLUMBING ❑� MECHANICAL � � Rear � ' � �� ' ' � I �, �0 OTHER -i._.wi . I__� ___•_-�.a- - '--_J...--i- - '-_ . _.._ �_�. .A_ � � • I . , E'� ; , � N � i Contiactor� s N i : . , p � ' -i I -. . . . ; . - - � Ri9ht . � _ .'. , -, . � i f 1 r 1 � ? : N . � t �� ' r � ;� ' PROJECT DESCRIPTION��Sq.FT. �- ocCUParvcv �/.+ ��� ' Address Imailing - ' � � � i+'� •� - �� : ! i f � � � K Left � � � ' � � � � � ; G � � � ' � , � ! - � � CONSTRUCT,IONTVPE VALUATION$ -� $ ( � i , ; � ;. t. � � , � City License No. ' t � r � r ." ' ° . ' � ' - R � . . , � . §ZONE ' -`� �GRADINGCU.VDS.� �' � ACRES- , p�n Ref.# ' ' i LICENSED CONTRACTOR DECLARATIONi ' ! t � • l�b � 1 i � r i �� 9� , ' k , �Parking Req./Provided I � �� E � I M1e�¢by atfirm�that� I am licensetl untle�{provi5ion5 ot Charter 9(commencing Remarks:, � +. I � � � i �' � - � _` t - n 1 . i f � ' � . ! � -- 1 � � Planning Notes'i i . � , y C ; ' � M with section ]000) ot Dwision 3 of the Business antl Professlons Cotle, antl � � ' ' � ' • � • '� - ` � - my Iibense�is in.full force ana etfect. � • � � � - � s . ' ' � - ' . � r i . � j ' � - � -. I l3 � 1 ^ � � T f � f I ; ; � ! i � ° � � �'.�k,' �J: ,�Y ` ; i - . . � ;. t I . ? � ? t � i i r '_ ' ' 4 i r � � _ � i '. . I � ' S License Class License No. � Oate_ � Si9nature ' � I 1 � !�� Fy�j� i _ i . ' y j . PLUMBING- : ( i �' :FEES • • � `' ' � ? i �, 7 j ta: + . i i i �.^ � �R . � i "'ORKERS' COMPENSHTION DECLARATION ; � � � ' � � - - � + - c - �� �" Bai Sink � • - �Showers � 4 ' �� ' ; � : - � � �� � % - � r° ELECTRIC¢L� ' � ! T � ` ��'' � :reby afivm.that I have a certi/icate of consenc to self-insure or a certiticate .. � f• � '� � � • f�. ' � � � _ , j �a { i - FEES . �� workers' Compenwtion Inzurance, or a certifietl copykhereot (Section Backf�ow.Preventer� 4 � � �ServiceSmk' � � ' 1 ' - - . i ' - ' ' '' � i ti " � '3 - �"i aeoo Lab.�CJi, S i � j � -,-' � � � { �. � -. ..,, . . . . � _ � � - AutomavcWasher t '�, _�. .' .Transformer ��0 1550KW . ; � ,:, � Policy No' ' � �- � Company, � � Backf'low Irri ation. � � '- � "L % ' ' � �, 1. ' ' �. ! ,' � ���j50+�KW 1 .z : i .e . � py is nereby �urnisheH: 9 Sew2r"Cap ; ;� : _ i � ' ( � ; 'ConSlrucLon;Pole Sub.. Y ' ` 4 � ! F " . � + R Certitietl co . • f � ' : " • . ' � � i ! i. i .[G . I LJ-Certifietl copy is filetl witM1 the city Builtling Divislon. � Bathtubs.y �'� � i � .0 � � �Sewe��Connectwn ; � t I , "1 � , j � � y Cookmg,Unit ; .p . ; ' ' Meter- �up to'700 amps � ," v. � � � Oate � • AOPlicani t � . . ' I : , ' ��' . .- . _ _ - � . . .. . . . � ,. . . , .' EXEMPTION F�.ROM WORKERS' COMPENSATION DECLARATION � .1 Cl3niiC�S^ � i ',: i • � � , Solar Collectors:, J - ! _ � � : Dishwashen . { � � } �M2t¢���Ove��lO�dTpSj `- '� i r (Thissection neetl not be completetliif the permit isJor one hundretl (5100) ar: � � � � -- ' ' - ' " ' - " � - � less).? � y , � - . � Dishwasherr' � . Solar Pipmg ?. � . � j i f { Dr ers OGas� OElec[nc� � ' - � ' �" ' . �I certH tnat in the � � f � , � . , Y � � _ ' ', + � Sub Panel . • �. . y pe�fo�mance of the wor which S p � 'S e . . ' � , _ � ' • =' 1 V+- - �' : 't ! i shall n loy n erson in any mann o'az t e o Dnnking Fountains Solar Tank � 4 s ! � Fan. � ' ; � Worke og n Laws of c . � - : . � �. ' ' r � ' d - � I c { � i ,� . Momrs O41'NP O1/ -8�� ,� y„ � Date ' 4 Si9natur ' � � � � � - Floor Drams' � � ' ' 1 - �Swimmm Pool�wl5 a � � � -�' � - � r. "������a� . ' __ �_ ' _ ' _- - 9 P i _ _ 1 . F.A.0 .�; _i ._ .InaSolar �9-15.HP �16-15+ � i t 'NOTI :9t; e� making(thisAecla�atio ,-you houltl'become-subje �to tM1e-- ' - - - - � - . . . . ,— -- � Workers' Compensation.provisions�of the,Labor Cotle;.you must fortM1wrtn FIOOcSinkS � y� , ` Urindl • � � ' ( � ' � - � ' 2om I with such provhiOnS or [his� � � S �. j i i � Fixtu�25 , ! �Mic�owave �� t p y { � permit shall be tleemetl revoketl. � � 1 : ` . E . f { � �. . �. CONST0.UCTION LENDINGj�AGENCV . ' � � � j, � GaSSeNiCe f.- �OutletS � 1 �� ` � � DeviceBoxeS ' � � � WaterrCloset � � � 1 �, . j � � I Pole Li _ � _ � � � I hereby atfirm that there is a mnstruction lentlinq e9ency Por'the perPormance � 9h� : �� : o( tlie work .for which tbis permit`is issuetl! (Section� 3097 Civ. CJ ' �"-� � � ' . � � � . � � ' � , � � Interceptors .� ( � i Water_Heater • ; • .� � � Lentler's Name � � � ' � � �. . � - � - � 'I:entler's Atldresr =,_.�.._, _ � - '-� _ .. .� .. ....' -'-._...'- ' ' '-' Kitchen Sink'^� -^,"^�' ' . " ' � Outlets � ! Rang !' � _ i � i � s f , f 1 ' _ , � � -� ..I ..lWater;Service" ' �.._1--"i ' i ' � ' "Switches � r' r_,,; s- y Sgne . t_ _.'. _..�. .f _ ', � � OWNER BVILDEH.bECIARATION � - ,� .. ; � i + • j I her¢by afflrm that�l am exempt from.the Contrdctor's Lic¢nse,l.aw.fo� the LdVdtO�i¢5 ' � k� f ! Aut0-W85h �., ; �; Garbage Disposal � t _ ' Stdndm SCCbOnS- � ' t � F followin9 reason (Section ]W3.5 Businessantl Professional Cotle: Any-city or ' � �" � - , 1 . � . 9 - i ! . s � � county which �equi�e5 a permit to construct, alter; improve, tlemolish or repait P-T�a . � 1 ��' '� - � � '' - _ P j. � j � Laundry Trays' �� ' Generator �0-5 KW �5-15 KW • 1 any struclure, prior.to its issuancej also�requires the applicant foqsuchlpermit - I j. Trash�Compactoi ' �- � �O ill¢ 3 signetl'statement that he/she is�licensetl pursuant to the,provision5 of ' - � � �^ • � � � � � a ` � ;�,;jhe Contractor's,License Law,(Chapter,9!(mmmencing_ � Roof D�ains � rl, : � � _ � - �__ � with Section ]000 ot- + 1 I f-- 1 i � 1 F ; ;rvivon..3 of tbe Business antl Professmns Cotle)- or that he/she- is exempt�� . � , , . � y._ . . • ��- � �� `�' '-� `"t`� "`�" "' �' - -' '�' ' �"^erefrom:antl �th¢ ba5i5 Tor the.alleqetllexemption. Any,violatian of Section � � � ' i j i ' i }' � �' �i �� � � � � � � f � � t i.-'`b31.5��by any applicant foF'a pe�mit subjects the; applicant to �a civil -� . nalty of�not more�than five hundretl tlollarsq$500). � � �' ; ! - � � • � - � � � } � �,- $ 3 �, . f ,� . � �. i'i - � � ` •. 1 i . - � � � � I' as owner of the. property ' ' -' ReinspeMion!Pee % $15 ; ; � �Issue Fee� . � ' ' � � ' will tlo�[he work, antl the structure is not intentletl or ofiered " '' � �� �� �� Reins action Fee • � T > � i,$ �3 , � � , onsaie: (Section,7044„IBusiness antl Professional Cotle: The Contractor's � � MECHANICAL' �FEES � r P - � � � .... 515� � Issue,Fee . I _ � Li[ense)l2w tloes not 5pply to an owner of a properfy wM10 builtls�o� improves. � � �- � � � , . _ .. � �hereon; antl who.tloes. such work himself/herselhor through his or her own - � . � . � � , i � ., , i � : DEVELOPMENT SERVICES REQUIREMENTS: y �M � +. � � �" F } � � ' �employees, provitletl that'such improvements are not intentletl or otfe.ea tor Boiler � � Hood�or . Type I ❑ ,.� , � - � . . � ` � , � � '� .: i �� � - �!.sdl¢' If',howevet„the builtling•o� Improvement is Soltl withimone yea� of com- _� � , . CdnOpy 4Typg II. ❑ t' •� Zoning ApprovBd By. , DdtO '� � � �-pletlon,,the.owne� will have the burden of proving he/sne tliA noLbuiltl or im- Duct - Under'Ground � � � �� " ' � _prove tor the.purpose oi sale).' , �c � ; � 1 - �_ � -� .i' - ' � � ' • � � � ' .Buildin9 Approved By � � �� � - �� Fi�� � Date 7•2 J� � ! i �:I'�as'owner'of _ttie property, am exclusively contractin9 with.licensetl�con- Duct -Structural�' , � j Refrigeration System� � ' !' �w � - Application Issued By � ' ` � '�� � ' ' � Dat � ' � � 1 tractorsJo'construcfthe project (Section 7044, Business antl.Professions Cotle: ' - � '. ; ' � � The'Contractor'r:Cicense Caw tloes'not'apply`toan�owner�ofeproperty_who' • Duct-Ventilating ; � _ 00100,OOOBTU-.0100,OOOBTU � • �� � �-"_ I, � c;SUM A FFEES � .� ' � - - builtls o� improves thereon; antl.who contracts for such projects with a-mn-. � - � • ' ' ' � ' ' � � . - � � Y � - � �j • � � . •� tractor(s ilcense pursuant to.the contractor's License �aw). I am aware that' '- , ' '' ., i-. { . f BUILDING PERMIT ^$ �' `SMIP, ' I Oroot o� their'WOrker's Compensation �insurance Shoultl'be provitletl� to me:�'- Eiehaust System O� `MuILipIE O.. I. System�Repair/Alteretwn� �, _� � -,� , � G' �' $-� ' ! L7 �1 am exe �pt u tler�5ection � _ � B. & P C. tor this�reason . � Fire I/Fattf8lt.:ICBO # Fire Dampers � ' � ' ' - PLAN CHECK ' = $ � - � 3 � � PERMIT � � „ � � - j I .1. . . � . � � c . _ � . , P. . . . � � i ' t 1 �. . . PLUMBING � i ti $_ - i � ISSUANCE $ ` ' Date i owner � `� � � � Heatin System & Ducnn Re isters � ' F . � � - ' LL. � � � ` r� ' � s ^ j + " � � � _ � , . � � . � . - , . , '� 9 9' ' '. ; 9 . � . � PLAN CHECK 25%• $' > * :'"'ENERGV;P C.: $ � { . "^ ' i 1 hereb certi y thz .liave reatl th�s I�lication antll state that'the above �� -❑p-700,000 BTU 0100,OOOBT - . 3 �_ _ i z' ' • ' -� i iniormation is corre ? 9ree 'comp at antl county oramances ^ � � ' � ; � t - jGRADING , $ � ^_ � ,antl:state laws relat ' a b i - . . _ f ' ' ELECTRICAL � $ � _ � � ' � � �-sent5tives'o � � 9 co st cti , an hereby_autho ize re re-.;_ • 1 _ � yJto er,u entioned. � �pp - i � - � i " '.� ` r, � ;.7 ' i -� i , , PLAN�CHECK . 50%y$�- ., y,MICROFILM $ � {_ msPettion � ur e . �[�/ � ' � . � � ' � '7� ' � _Signatu're . ' f - � Date , �+�-. ��- .- ^ � � � � . . � _ � MECHANICAL T �$ _ ' ` TOTALFEE •. $ Y/a•�U •. j Driveis' License r 55 '.5� Reinspectian fee � 4�$15 �': Issue Fee �' '•• " � ,$ ��3 PLAN CHECK 25%" $'� 3 ' t =„ 865-46; rev. 30/04 White - Builtlinq; Canary - Applicant; Pink - Accountlng; Goltlenrotl - Assessor • ,. . , - � � � , . , ,., • CONSTRUCTION AND PLANNING ; I , � � ' ' }� � POOL &;SPA . � � „ , _ ' � ✓' • ' - �Date �� Inspectoi'�` "" r"' ` t ' 1" • "'�" "'Date- , Inspector ��APPROVALS ' Perrriit��# - ., � ( , APPROVALS Permit# ` :� i � � 1. Temporary Electric8l•SerJice o,�Pole � � � 52. ;Pool & Equipment Locatiori � j � y t'%: - 2. Soil Pipe-Und'rgrnd.`r '' � � � � 53. �Steel Reinforcement� � '� ' 3. Electrical Conduit Utility-Undrgrnd.. � - ' , � �.54. Forms .- � ° � . � � { ' , "` . i . 4. Elect�ical Conduit-Undrgrnd. '• f ' 4 � � �, ; 55: �Electrical�Bonding �. ' � . , t F y� � , 5. Steel Reinforcement � � ' b � � ' , '56. :Rough Plumbing & Pressure Test � = �� 6. Electrical UFER;G�nd. . ' . � i i � � - , . 57. �APP�ROVAL TO,COVER-GUNITE � _ � � � � 7. Footings '� .r, ,� . ., �i�� � f � ' .� ��-� �58. Electrical�Conduit=Undrgrnd. ` " ' � ;,� �. � . 8. Foundation _ � ` , ---i�- •59.-Ga's Pipe, O Undrgrnd.,�Test ' � . � � ! �� �` / _ � � 9. Water�Pipe-Undrgrnd', ;�'�'� � _t � � - ..�_. 60. �Backwash Lines; P-T�ap�O�Undrgrnd!� , �, . 70. Structural Floor System�� �� . 7 �` • � 61. ;APPROVAL!T0. DECK � I j � � � 11. Property �Sewer Line.& House Connection . . � ' 62. Backwash & ReceptorFinal � . � , ' c ' 12. Sewer Cap �, . ,� � , ' ' 63. ;Heater & Vent-Finab � � � � � � ' 13. Roof Drains- . �� - - ' � � � � -� � � � ' 0 64. �Plumbing System - F.inal, � . ' ' � ; ' t � ' � _74. Rbugh Plumbing � � � � ' � � ` ° 65. Electrical�Final � � ' � , . . � � `75' Rough Electrical-Conduit.� _ - ' - i � � ,66. �Solar System-Final � ' �� � � � - �. 16. Rough Electric Wiring ' _ � . j -; =• --' �- � 67."��Fencing�&'Access Approval� -� • � - ^ , ;�; � 17�. RoughWiringSign ,-- �-• `+��- - .' ' 68. APPROVEDFORPLASTERING���' " " - `"' - i 18."Rough Electrical-T BariCeiling'�, '-' �� ' � ' � � . - gg. POOUSPA SYSTEMS FINAL, � �% � ' 19. Rough Heating & Air Conditioning i � , , FIRE DEPT. REQUIREMENT �f � `S �� : , 1 - 1 � 20. Rough Factory Fireplace � � � ` ' � i � . � - . � APPROVALS , �Peimit,# , _ ' �I.. � � , . 27. Ducts, in;Structure ,� ' � 70. �Underground;Hydro� �� - ' � -- - 22. Ducts, Ventilating' , � � � 7.7, Product Piping �Gas ❑Oil . , � � `.� � 23. Gas Pipe;Rough & Test _ , , , { i 72. �Underground�Flush �1 ' ' ,- - � �i� - 24. Roof Framing ;. '� j� � � 73. Undergmd. Storage Tank O Gas -❑ Oil '. � �•� 25. Roof Sheathing ` . , � l.� 74. Overhead Hydro, ` � , " � - �� ' �' � .� 26. T-Bar Ceiling (Structural) & Monocoat � '_ 75. Dry Chemical. ., �' � r 1 • , �� 27: Frame and Flashing - � " ' �'� -� � � -' ' 1- '� ', � 76. Dry Standpipe ' � � � , ',� _- ., 28� Lathing & Siding �� i � � - � �, � f j � � 77. FIXED SYSTEM FI�NAL ' ' - " � �, � � � 29. Insulation � � � ' ' . 78.�FIREPREV.�FINAL .. ' . � �� �;,. 'i- 30. Drywall'Nailing� � � �� �� � � ; � ' ' HEALTH DEPT. REQUIREMENT j- "�� t�'! .'` ^ 31. Plaster Brown Coat . � � � � , . ', � � � ; 79. FINAL' INSPECTION � � � �, F�;•. _ 32. Electrical Power Meter-Final � � ��80.. FOOD;CERTIFICATE I SUED�� .� � '�, v�_� _ �i - �33. Final ElectricK � ' ' s � ' � i. Notes �g p,e� _ �- 34. Final-Heating'& Air Conditioning .` � . � � r � :.T � ���, � t • � � /ur 35. Final Gas Pipe-Test� ' ' ' � ' �< - � - , � �36. Hood or Canopy. , i" « � �-.37. Flnal Factory Fireplace � � � ' - -� ' � "' `%r ; -� ; � '�38: Final Blumbing - , . � , � - '� - - ,✓ �" - I � .. �'. , � � 39.�Water Service-Final ` • � . . *•' - 'i . u ' i . ' ,'�`, � . s ?.40. Gas Service-Final � � ' . , , , . ' �� {- � ,i � ' i 'i�41. Solar pomestio-Final. � - , � . F -� � . ' � � -{ n ' , � � � . 'l F_. �: " � , . . • . , ' ,ri, � . . - 42:�BackflowPreventer ' , ,� . . - f�, _ . ' , ,:'y' ' '/. L •' f � _ . . , r 43. Backflow Irrigation�,: ... . :.� �' ;�_ , : : ; �� _-. ' � , ' - , . • -' .Y,�. ��r, . . _ '. : , , , , , . . ,.i ,�'., � 44. �Landscape�lrrigation SYstem�' � � j _. , � . _ 4 � �� � ; � y r..45. Sound Attenua4ion� , - ,� - ' • . : - : � � :,� , % � - � '� :. '.� "46. Handicap Regulations �� _ "?��° . � � _ . � � � _' . " • t " '' � i�� -'47. FINALST��RUCTURE&BUIL•DING _ f"/ � � � � ' � ' �� � �. �I �' > - �6 £!9 P,r� � 48 � Special� Requirements Completed , . . - " � + �' . - r. � - , ; � � �.>�, ; - 49 � Electrie Release to Edison , : ; - , . � . �. ' - . : � � � ' , , , '50. Ga; Rel ase to SouthemyCalifornia Gas Co . . %ai. - ' � . .. ., � � , . `-'. � 51: CERTIFICATE OF OCCUPANCX� ;` - „ ' - - .. . , . � , No`. � ' ' � - �' Dafe' � . .. . . . � . _ .. . . . . _ . . . .._ . . __._ . . . . -- - . . . -+" . . _ . . .... ' . , � .- -r�-• . � . _. . ,. . .., CITY OF COSTA MESA � BUILDING DIVISION O�NNER-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. I personally plan to provi e e major labor and materials for construction of the proposed property improvement. �s ❑ No 2. I ave/ ave not) � signed an application for a building permit for the proposed work. , 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City ' Phone ( 1 Contractor's Lic. No. � 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work: Name - Address r Phone ( Contractor's Lic. City 5 I will provide some of the work but I have contracted (hired) the following persons to provide 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 Healt 'd,/5afety Code an�i�h ve c mpleted the above information to the best of my personal knowl in pnance his fa � Signed. � Date: � � �� � Name: � �� � �G (Printed or Typed) C.D.L. #or S.S. # � //� CMF 3042-46 7545273 GENERAL CONTRACTOR Ow AP. No. LOT INSPECTIONS OCCUPANCY S, VALUE $ U(3Y.C)U T1tACT 2822 FIRE ZONE DESCRIPTION OF WORK �lOCkW811 DATE I GROUP I TYPE ZONE R-1 — ---I SUBCONTRACTOR I PERMITSISSUED (I _ih— 4 v Form Y10-5M-11-59 5-B P " ; - - � -- -- ii654 ,� _ � ``� ::. i�.�s� � �EE REC�iVED � COSTA MESA BUILDING-SAFETY DEPARTMENT . P.O. BOX 31� COSTA MESA, GALIFORNIA . � ✓ � ��( �O V � � ' FINANCE DEPT. FOR APPL/CANT TO f/LL /N COMPLETELY APP�LICATION�[FOR$PERMIT TYPE OR PRINT ' BUILDING ADDRE55 ��3 ]— /Q ���L•,a ./^f jlC 3 r � . 1/ ' , COSTA M� q, CALIFORNIA ' ' - FOR OFFICE USG ONLJ r OWNER� r}1 n � • I RECEIPT NO. I ��yil'[�NO /� MAIL RECEIVEO Y OqTE RELEIV D � TE ISS�fVE ADDRE55 l'� � I � I � a.t CITY ARC 'C Oft V V •_�- �'I�C TEL. � � BUILDING �-+�-l�i NO. I J�'hl I pDDRESS � � ���' COSTA MESA. CALIFORNIA NO. FIRE ZONE CONTRACTOR �✓vi//L/"' �/��'LIG.NO. BYPROVED � DATE ADDRE55 ^ ZONING LEGqL I LOT � Q I I I K g�� ZONE I NO. OF USE OF NEW DESCFIPTION NO. I BLOCK TRACT PLANS BUILOING A.P. NO. - APPROV . � BY �` � ' � DATE I $IZE � � NO.OF BLOG6. - OF LOT O � � U� I How oN �oi REODU RED ALLOWED USE OF (CENTER IINE 9T.) EXISTING 6LOG. FRONT '�FT. SET9ACK LINE FftOM ceH1ER oF srReer REAR YARD R. SIDE FT. SI�E YARD I�EFT IR�GHT DESCRIPTION OF WORK NE� I� II ALTER4TION I II ADDITION REPAIR I IIAIOV�NG I. IIOEMOLISH EXTERIOR WALL ' ROOF COVERING COVE USE OF BUILDING AND WORK TO � I' •--. / .� W F'f. i / �� � ' �'.I M � r ,— ' / . .. I NEREBY ALKNOWLEDGE THAT 1 HAVE REAO TH19 APPLICATION 7HE AMOUNT 9HOWN IINOER VALUATION IS FOR TMF ANO STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COM� pUPPOSE OF ESTABLISNING p PERMIT FEE ONLY. PLY WITH ALL CITY OROINANCES ANU STATE LAWS REC LRTING BUIIOING CONSTRIICTION. VALUATION /, SIGNATURE OF - � � -- PERMIT FEE ' $ 7 � PERMIiTEE ��� � —_ $ PLAN CHECK $ AUTHORRED AGENT- _ TOTAL FEE $ I �� `1 , a ��ti� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPUCANT TO f/ll /N COMPLETECY � TYPE OR PRINT ADDRE15S 2939 Pe r Tree I.ane COSTA MESA,�.CALIFORNIA OWNER �YZCTIC• Ti1C� ` .=�� R�CtiVE� �. JUN i a ts59 . �� in �-:rir:�'tl�� ��E��. ' � �,.: _ �,�.' I„}`.... � j=�i APPLICATION FOR PERMIT BUILDWG - FOR OFf/CE USE ONLY I RECEIPT NO. I �MIT / ' RECEIVE� BY I�—I GECESEC/ I.�A—/� K\ we� '=_c7 Carlson & ���� COSTA MESA. CALIFORNIA Oi NEER NO. • — 1 e roo . FIRE ADDRE55 ZONE .CONTiiA�ibR& C�ZegrOVB� 111CLIC.No. 167293 p'PPROVED ' . BY DATE ADORESS 4�/ E� .17th St � Costa Mesa . � ZONING . LEGAL . I LOT q^ I I 2g�2 Z�NE /1 I NO. OF I USE OF NEW DESCFIPTION NO. <J� BLOCK TRAC �� PLANS BUILOING � APPROVED / A.P. NO. . . . BY � �� DATE F�/�� I SIZE OF LOT USE OF 'EXISTING BL�G. ' � NO.OF BLOGS.. serawcK �irue FaoM 56, REAR YARD �L9� CENTER OF STREET SIDE YARD ILEFT S� IRIGHT S� - DESCRIPTION OF WORK . � SIZ'E DING � 1�]bS RO M£ J attached garage. 1 HEREBY ACKNOWLEOGE THAT I HqVE HEAO THIS APPLICqT10N .7�{E AMOUNT 9HOWN UNDEfl VALUATION �9 FOR THE PND STATE THAT THE ABOVE IS CORRECT AND RGFEE TO COM- PLY WITH RLL-CITY OROINANCES AND.STATE LqWS REGULqTING PURPOSE OF ESTABLI6HING • PERMIT FEE ONLY. OUILOING CONSTRUCTION. VALUATION SIGNATURE OF �' � PERMIT FEE $ 'j'Z�� PERMITTEE ' ' ' . • $ 13�71�J . PLAN CHECK $ 16�00 AUTHORIZED AGENT D�.�Ce & C egrove� Inc. � � � TOTAL FEE $ � �