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Home My WebLink About2023 PHALAROPE CT - Building PermitsCITY �F WSTA M/�J$F(�) ST H ,/.I�U-� Project Address "�-/ 2� � I, �/�� Applicani's Mailing ddress 2t%�L7 �1/4 Owner's Name�,�� v Address Arch/Eng. Licenv Address Contractor's Name � u` Address (mailingl Ciry License No. LICENSED CONTRACTOR DECLARATION I hereby aftirm inat I am licensetl untler provisions of with section 7000], of Dlvislon 3 of Ihe Buziness ani my license is in I�f}Ptp�lepitl eHec}r\ �� / No. 9 (commencin �,lons Cotle. anc Applicant to fill In all spaces exceo� enose witnin neavY DorCer Ilnes and sign all aDGroDriate aeclaratians. PERf�jT�. �/� �7 TRACT NO. LOT NO. - UNIT NO. TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � q.p, �6 DESCRIPTION OF WORK/USE OF BIDG. S Main Building: E - , TYPEOFPERMIT GRADING FOUNDATION STHUCTURAL T Ffont ❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL A Reaf S❑ OTHER C Right PROJECT DESCRIPTION 5a. Fr. OCCUPnrvcv K ' CONSTRUCTIONTVPE VALUATION$ g Left � ZONE GRADWG CU. VDS. ACRES p�ng. Ref. # 9 Remarks: /, , � `y q � � ��h'/.� � / � �� j(_ Planning Notes: � Signature ' i�rf'OR ERS COMPENSATION D LA ATION .�-lereby a/flrm tha[ 1 bave a certi ¢at of consent to f-insure or a certificate ^'-.if Workers' Compensation Ins r e, or a certif' tl copy thereof (Section 3800, Lab. C.) Pollcy No. Company eCerti/ietl coOY it h¢reby fumisM1etl. Certifletl copy is filetl with the city Builtling Division. Da[e Applicant ion neetl nol be COmple[ 1 t0e ermrt �5 ror nunarea �yiuu ar Ihat in the pertOrmanc O( the w fo his pe�m�t suetl, 1 Oate ��ture �' - ' NOTICE?'(t, al{er �Faki th s tleciar tion, u sh be me tubject to tne Workers' Compensation pIOVI510I15 f the bo� Cotle, ou must torthwith cOmpty witb such provi5ion5 0� this p rmit shall e Oeemed revoketl. CONSTRUCTION LENDING A NCV 1 M1e�eCy aifirm tha[ IhGr¢ Is a con5 �ucti lentlin9 agency for t�e perbrman<o o/ the work tOr w�ich this erm' is I55ueC (Section 309] Civ. C.) Lentler's Name Lentler's Atltlress � � OWNER BUIIDEN �ECLFRATION I hereby a/tirm that I am exempt trom the Contractor's License Law /or tne foilowing reason (Section 7031.5 Business antl Professional Cotle: Any city or county wnich r¢quires a permit to construct, alter, improve, tlemolish or repalr any structure, prior to its issuance, also requires Ihe applicant for suth permlt to ti�e a si9neC slatement tbat he/zhe is licensetl pursuant to the provisions of '.e Coniractor's License Law (CnaDter 9,(commenong with Section 7000) of Wsion 3 of the Businass antl Profe55wn5 Cotle) o� that he/she is exemp[ ierefrom antl the basis for the allegetl ¢xemp[ion. Any violaHon o/ Sectlon 7031.5 by any applicant fo� a permlt subjects the applican[ to a civil �enalty ot not more Ihan five huntlretl tlollars (5500). LJ I, as owner of the property o� my ¢mployees with wages as thei� sole compensation, will tlo tne work, antl the structure is not intentletl or otfereC tor sale (Sec[ion 7044, Busine55 antl Prote55ional Cotle: The ConlractOr'S License 12w tloes not aOPly to an own¢r of a properry who builtls or im0�ove5 tM1e�eon, antl wM10 tlaes Such work himself/herself o� throuqh his o� M1er own employees, plovitletl Nat 5ucF1 Improvements are not intentlatl Of oHeretl tor sdl¢. If, �owever, the DuIltling or Imp�ovement I5 soltl within One year of com- pletion, tne owner will have the burtlen of oroving he/she tlitl not builtl or im- prove tor the purpose Of sale). ❑ I, a5 owner ol the property, am exclusivety contractlng with licensetl con- Vactors to mnslruct the O�oject (Section ]044. Business antl Profeszions Cotle: The Contractor's License Law does not appty to an Owner Of O�op¢rly wha builtls or improves thereon, anA who contracts tor sucn projects with a con- tractar(s i�cense pursuanVto the Contractor's License Law). I am aware ehat proot o� thei� Wo�ke�ComPensation insurance shOultl be ProvlE¢tl [o me. ❑ I am exempt unUer clion B. & P. C. for Lhis reason Date — I hereby i iMormatio antl state sentatives inipection Signature . Drivers' LI 1F OB65�46, _ Owner have rda� � � Wnite Sink Preventer Irrigation Drinkin9 Fountains Floor Drains Floor Sinks Gas Service Outlets I nrerceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee � $15 Duct - Under Ground Duct - Svuctural Duct - Ventilating ExhaustSystem ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 67 00,000 BTU � 100,000 Reinspection Fee � $15 Canary - Applicant; Pink - Accountln9; Goltlenrotl - AssesSor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash N Issue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,000 BTU ❑100,000 BT System Repair/Alteretion Fire Dampers Registers Issue Fee G $ 3 $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec' Fan F.A.U. Fixtures Device Boxes Outlets � Switches Garbage Disposal Generaror DO-5 KW [ 5079 2/16/88 Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter L�up to 100 amps Meter ❑over 100 amps Sub Panel Morors � 0-1 HP � 1 X- 8 Inc.Solar �9�15 HP �16-75+ Microwave Pole Light Range Standing Sections 5 KW Trash Compactor I Reinspectian fae I$15 I I luue Fee '+� � DEVELOPMENTSERVICESRE�UIREMENTS: 2oning ApOroved By 8uilding Approved By Appliption Issued By t 2300.� TL FEES $ � Z O N 1 N G R E Q M T S SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING 5 �• OD �SSUANCE $ PLAN CHECK 25% 3 ENERGY P.C. $ ELECTRICAL $ � GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL 5 TOTALFEE $ � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING - ' POOL & SPA ' ' APPROVALS Perrf'iit # 4 Date Inspector qppROVALS Permit # Date Inspector 11^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. APPROVAL TO COVER-GUNITE 7. Footi'hgs' ; `' � 58. Electrical Conduit-Undrgrnd. 8. Foundatiori 59. Gas Pipe, O Undrgrnd., Test 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 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 �1 � 19. Rough Heating & Air Conditioning FIRE'DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21: Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL : 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �- 31. Plaster 8rown Coat ' 79. FINAL�INSPECTION >. 32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED �+ 33. Final Electric Notes: � � i� 34. Final Heating & Air Conditioning • � 35„ Final Gas Pipe-Test . � 36: Hood or Canopy - 37: Final Factory Fireplace � ' � 38' Final Plumbing � ' . � : �1 39.- Water Service-Final � :�� • " � i_ � 40. Gas Service-Final / � ' t ' � � 41. Solar pomestic-Final � � � -/ ' . ' � 42. Backflow Preventer �! � � ✓. -43. Backflow Irrigation . � • � - r• 44. Landscape Irrigation System . . 45. Sound Attenuation • � - � �i ,. • 46. liandicap Regulations � � � • �, 47. FINALSTRUCTURE&BUILDING t� l „�_r . . , 48. Special Requirements Completed ' _ � -� 49: Electric Release to Edison - � 50. Gas Release to Southern California Gas Co � ,t �� /, 51. CERTIFICATE OF OCCUPANCY No. Date -� • ' � ApP��ant to fill in all spaces ezcept �hose wi�hin heavy bor0er lines antl si9n ali apPropriate Eeclarations. ciTY oF COS7A MESA C ST T N PERMIT Proiecc Address � �� Applicant's Mailing Address -, �+fc/1�� ry Owner'sName rT�� -Phone��—��/' Address ��?� � � Arch/Eng. icenu No. 'd�'�✓ Address I � Contrector'sNa �� dqe¢ � Address Imailing s�p �� City License No. N!� i� LICENSEO CONTRACTOR DECLARATION 1 hereby aHbm that I am Ilcensetl antler,provi5l n5 0l Chart¢r 9(comm¢n<ing with section �000) of pivi5ion 3 Of the Busi 55 antl Profe55ion5 Co�e, antl my license is in (ull torce an�i^ec� O� Liren Cla •Y License o.�3 3 Oate ' Signature WORKEHS'COMPENSATION DECLAR TION hereby afflrm that I have a certificate o con5¢nt to 5¢It-insure or a cerliflcate 1 Workers' Compenza[ion InSurancC. or a certitietl copY ��e/eof (5�� J800. Lab. !C�) G l/ Policy No. /_��0� 2� (Gompany � �� O� ❑ Certifietl copy is hereby fumishea. ��I Cer Itiea apy�j' Jetl with the city Builtling �Date �' � �9� Applicant E%EMPTION FROM WORKERS' GOMPENSAT ECLARATION (This section neetl not be completetl if [ne perml is or One huntlretl ($100) or less). I cerlify tna[ in the performance o( the work tor whlch this perm�t i5 i55uetl, I shall not employ any per5on in any manner so as to become subject to the Workers' Compensa[ion Laws ot Californla. Date � Signature NOTICE: If, after making this tleclara��on, you zM1oultl become subject to the Workers' Compensation provisions o� [he labo� Cotle, you must Porthwith Comply wittt Such provisions or �his pe�mit snall be 0¢em¢tl��evoketl. CONSTRUCTION LENDING AGENCV 1 hereby a/tirm that tbere is a conStruG��o� lentling agency fo� the pei(o�mance of ine work 1or whirn this perm�� z issuetl (Section 309]aCiv. C.) Lentler's Name Lentler's Atltlress _ OWNER BUILDEN �ECLARATION I hereby atfirm that I am exampt irOm the Contractor's Ucense Law tor the /ollowing reason (Section ]031.5 Business antl Professional Cotle: Any city or county which require5 a permlt to const�uct, aller, improve, tlemoliih or re0ai� any 5[ruclure, prior [o its Issuance, a�so requires the applicant tor sucn permit t0 flle a siqnetl statement Ihat h¢/ShQ is IiGensetl pu�suant to the 0/ovi5ion5 ot tne Contractor's Li<en5e Law (Chaptsr 9(commencing wltn Section 7000) of '�vision 3 of the Bu5in855 antl Prolessions CoOe) o� tttat �e/she is azempt eretrom antl IhE baSiS fOr Ihe alle0etl exem0tion. Any viOlaUOn Of Section J31.5 by any ap011cant Por a p9rmit SubjeC[s the applican[ lo a civil �enalty of not more [han five huntlretl tlollars (y500). 1, as owne� 07 thc proPerty Or my employees wi[h wages as [heir sole compensation, will tlo the work, antl the SVucture is not in[en0etl or offeretl tor sale (Section 7044, Business antl Professional Gotle: The Contractor•s License ldw Coes not dpply to an oWne� ot a property who builtls o� Impwves thereon, antl who tloes such work h�mself/herself or tM1rough nis or �er own ¢mployees, provi0etl that such ImprtivCments are not intentled or otferetl f0/ sal¢. 11, howeveq [he builtling or imp�ovament is soltl within Ona yea� ot com- pletioq tne owner will hav¢ the burden ot pvovinq he/she ditl noi bWltl or Im- prove for the purpose ot sale). ❑ I, as owner of tne property, am 6xclusively contracUng with licensetl mn- . tractors to construct the project (Sect�on 7044, Business antl Professlons COCe: Tne ConVactor's License I�w does �ot apP�Y to an owner of Oroper[y who builtls or ImOroves tbereon, antl whP conVact5lor Such prOjectz with a con- Iractor(s ❑cense pursuant to [he Co�baCtor'S License �aw). I am aware that p�oof o� [heir Worker's Compensation insu�anca shoultl be provitletl [o me. ❑ I am exempt untle� $eclion B. & P. C. to� IhiS reason Date Owner I hereby certify that I have reatl tn�s application antl ztate that the above inPormation is corr¢ct. I agree to comoly wit� an city antl counry ortlinances antl state laws relating to builtlinq cPnstructlOn, and hereby autho�Iie re0re- sentatives o/ t�is city to enter upon the above-mentionetl property for inspection purposes. Signature Date TVPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMpL15H ❑ OTHER q.p.# DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL T Front ❑ TENHNT ❑ ELECTRICAL PLUMBING ❑ MECHHNICAL 6 Reaf ❑ OTHER A PROJECT DESCRIPTION 5(i. FT. oCCuaANC3 C Right K Left CONSTRUCTIONTVPE VALUATIONS S � ZONE GRADING CU.YDS. ACRE$ Ping, Ref. # Remalks: PldlIOlnJ NOt¢5:. Sink Preventer Irri9ation Drinking Fountains Floor Drains ' � Floor Sinks GasService Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof �rains ReinspeMion fea � $15 Boiler Duct - Under Ground Duct - Structural Duct � Ventilating Exhaust System ❑ MWtiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0.100,000 BTU 0100,OOOBT� ,� Driverz' License or 55 � I I Reinipection Fee 'MF 08fi5-46, rev. 10/84 Wnite - Build��9: Canary - Ap011cant; Pink - Accountinq; Goldenrotl - Assessor $75 PLUMBING Showers Service Sink Sewer Cap Sewer Connection lar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Cbset Water Heater Water Service Auto-Wash Wundry Trays laue Fea Hoodor Typel ❑ Canopy Type II ❑ Refrigeration System ❑0-100,000BTU ❑100,000 System Repair/Alteration Fire Dampers Registers , Issue Fea FEES $ 3 $ 3 Automatic Washer Constructian Pole Sub. Cookin9 Unit Dishwasher ' Dryers ❑Gas ❑Electr Fan P.A.U. FIX[IIfCS Device Boxes Outlets $WIiCh25 Garbage Disposal ' Generator O0.5 KW O' � 2791 � 14/�OB/86 2on8 Accessory Building: ETLECTRICAI I I Transformer ❑ 15-50 KW J_J O 50 + KW 5KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Momrs OO-1 HP O1'f, - 8 Inc. Solar �9�15 HP 016-15+ Microwave � Pole Light Range Slgn Standing Sections Trash Compactor 5.00 TL FEES Z O N 1 N G R E Q M T S ' Reinspectian Fee I$15 I � Issue Fee I $ 3 I DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Date Building Approved 6y Date��'J��y��/ ��/ Application Issued By � Date�L_QLQ1l2_ SUMMAFV OF FEES � BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ � �SSUANCE $ PLAN CHECK 25% $ ENERGY P.C. S ELECTRICAL $ GRADING S PLAN CHECK 50% $ MICROFILM S MECHANICAL S TOTALFEE $ � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL & SPA _ APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Electrical Corlduit Utility-Undrgrnd. 54. Forms . , 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - 5. Steel ReinforCement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVA� 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, � Undrgrnd. 10. Structurel Floor System 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 9„��L `�j 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 76. 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 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPflOVALS Permit# � 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71 . Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frameand Flashing 76. D�y�Standpipe 28. Lathing & Sitling 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 I;,�p�{. {'rj„Q � � � i 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System � � 45. Sound Attenuation , ' 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING , ' 48. Special Requirements Completed , � � 49. Electric Relegse to Edison 50. Gas Release to Southern California Gas Co 51. CEftTiFICATE OF OCCUPANCY No. Date i,00nessocaunnwc LVLJ YliHLEiliVYfi l.l °M' U�NERSN.WEIGqqNN: riANCGCri, iriUNiAS l, tLVVL: HE.—Gb �oox[ss: L V L J YliAL[�it(VYt l. 1 CusiA MESA,CI. yL'bLb 'I.SJSL'LV �vr�. u�nmc wo�ss AxcxrtEcr aa ENm1EFn: APCN.OX QM.'S ADONESS: uc. xo.: UNf: c«,m.cransr,u�:A FLJS SEHVICES INCiA FLi.i i7i4i775-i947 CWIP�CLORSY4ldl0 11231 SLA1F.tc AV �ooxrss FVUNIAIN VAi,Lr:Y �A uc.ra.: b7�241 yL%V� uHr: 4CENSED COMXACTOflS DECUPATION: I Mreby Nim uMs penely d pajury Net 1 em IcermE wMr porinans d Cheqx B (mmma�rp xilh Senian ]000) d Oiv'vun 9 d Ihe &nimu uM Pmlme' COAs. ud mY �� e in IUA taw mM eMed. cmuc.No.:voGL%6d7Q� uc.cuss: L 3y uc.N p75241 /f'.. JyFX- OiiSfi Dme: II � I ! � / � Camrarfu: .P�/ /I�'"�'� OWNEN BUILDEfl DECLAflATON: I hxeby dfirm urMer penellY d perjury Ihel I em emmq Irom �M CoMraqm L.iceeua law lor tM lolbwip memn (`�� t 3&»iims md Rdm+ians Cade: Airy cty a caunry Miid� �puM e pemi's to mmTw1. Mer. impraue. demafoh, or rpei eery evunuro, prior io m oweMe, ebo requim iM eppli�anl la arh permY to fJe e sqmd �tetm�ml �hel M a�M ie licenead W��e�� lo �M qa'vwns d Ne COMredas Limnae lew jCheqs 9(canme�p v.'uh Setlion ]000) d DH'wion J of th� Busineae eeM Pedeaons COEeI a thet M v ehe ia emmq tMreimm eM IM bese la Ne elbpetl mcmmqion. My vidmun of Setlion ]ro1.5 by ury epptirenl lw a pemN wbpce Ihe epd� b e crvil pene„y ol M more Ihen Ma hwWred da0e�a �SSOOU. � I.avowmrdtMPrWa�YamYemoM�eM�weO�mlheiedecvmGe^aetian.wiOdoJ�ewoek.e�MtMevununbmlmleMed w oflered br seb (Sx�im )OM. Busrba eM ProleasionsCoae: TM ContreGae Liroma LewEom � epptytoen ownerd propMy wlw buida rc inproves �Mraon. md wM10 Eom aucl� xoA MmsaM «hene� a tivwqh he a her mm emplvyeee, pwidaE ihm wch impo.emmua ve nd Weidad a WertA Iw eeb. tl, howevar, �he buitlirq a inpovaenem u eoltl wtlAin one yeer d comWaon, Uw owror WYEx will heve tM burEm d poviiq M a ehe CiE nd WiW a impeow la Ne puryme d eeb). � I. ea owror tl �he W W�Y. em eztluei+aN mnirmiq wiN licenaed wnheMas w conaUW Ne pqed (SW un )O�d. Bwiroee eM ww.da,. coee: rne wu,eaon �we�.. law aoe. nd eooN m en ow�wr a wwu�r wno auw. a impwe. me,em ena wno canvecb �n wM p9�+ wan e mnme«le) tiun.od wnuem �o �ha Corueemn liosvs leW. � I em eKemp uMer `wnian: 0. 8 P C., Iw Nia reaeon: Dele: Owner: i eo nxeM �r mm i.m ..m. a w wd..i.�e me namr«n«w a ceuon�e wew, ene s.�w coa s.ac�. nws. zsssa. ana p5i1�. aM tM� I v e�ry Mive MiMinp oovryeM xill / wll iw (drtb ar) nsed ro mmWy wih md mte ooAu W iM myu'uemenb br eMrmelammWctonnrtaEi(otionhamiAaAi u�y eneOemeMO'mtritl.ReekeNWconqvfioneppicetiweuse�mmpimmiheva prwiaiom. Dme� Aod��' W OPKEP'S COYPENS�TION UECLAP�TION: I Mrsby alfirm uMer peiWly d pajW me d Na Idbxieq dativmiom: � IhmerdWmeintenecenActledowmntioeaM.ineurebrwakme'campmelian.mprwideOlabySacion3)00dtMleEa cod.. i« me c.rt�. a m...on� i« wnon ma ro�n re re.�,ee. .[] i n... ene w me�mu�.aw.� oanw�.mion i�n„eMe. m na��e W seem a�ao a m. Lebar coa.. mr �ne waamv�m d m. rs work lor whirli iA'u Fs^^n u rmueE. MY worke�e wmVenwian imurenca ranier ud P�Y m�mEer me: Ga�.: 51�11F. tUNU t.)lYlttt.S Pd'ryNumbec /tS]— /1tlIV ll� I1 V1/UI/771 ��e.� �»oa,a ns �dar<a r rna ro+�� a m. o,. n�,�dree dwa.lsroo ,, x�.� ❑ I cendy Nm in tha Darlmnerce d �he work la whch ihu pertnn u iw ,1 eheA erc� penon m eny men�r eo e+ to weom. weiee io �Ae v.wwn� wmpensation bw, d ce4lanie. w,ee A � k�bjeq�io ine w'xn.• mmpenaNion IXqGsians d Stlion 3J00 d �M lebo� Cab, I ahell l Milh mm vAh // Wamllp: F dun ro iecun Morkon'rompwuetlon rov�rap� l� unNwhd, �M �IWI ubNcl �n amployw ro u/MrW pmeMs� �ne e/vll IIMs W h aro hlnLreJ Hnuurd oo/Nn (J��.�A M sAf/tlon b tlw emf ol rompwuafbM1 Mmep� �� provWH br In S�ctlm ]M6 0/ M� Lebor Cod�, /nnnap enC ettomsy i M�. CONSTHUC110N LENDINO 1OENCY: I Iwreby eHim uMer perely d perjury iAm �hen a e conmuaion bndirq epenq �or ine perlormeMe d iM wk la xhirh �h'v pe'm1 b ewatl (�+� ��. C'v. CI. 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'rEkM37 i49,75 YLHN ' iSsUE FEE t1itY. $MlY%IttJ � l.it(71L17V1� .87 sMIFiNGiV-RES t1UlLUlNI>—L1L—> 2'tttMll 1SJUt PLAN-CriECk 707AL YA1U . 11UY� 1V1ALS----> LJV.bG V.VU ' V.VV 1�V.bL L�U.bL .VV tCtVtIVUt. 1J1V1S1VN 1V1}1LS--> I.ULLGI.lt.11: I�U.bL VVttC%JfiVt(1: � ,VV liLLl� 1'M1 1'LI./MUlNI� t.Lt.l.lt(ll MECH:iivlC tlltt SM1Y%TV1 GtCHLlIVI� 1'LEl1V—l..titl.tl 149.i� .87 +� x sc ar x ae x�e x x sc �c �c �c+e �e x�i �i ae ii �i �i �E ir i� ie ic iE iF iF ic x�c ii ie ii ii� ie iF if iE ic ii� ic iv ic ii� ie ii� ie ic i' ic iE iE ii� iE i� ic i' ic ii ii iE ic i'r w ic ie ic ii� iE ie iE ic ii ie+e 1 N L 1 V 1 L U A L t t t t1 lt F. H ll L V W N lYYt QiY li E 5 C k I r 7 I u N uNli Ci�ST iGiAi C057 SFR 6i"vv k�.nO�F bY VAL"uE t(tJ1UtN11l�L iVGZGNE i.uu B,i'vv."uv tNL Vt' tF,t,S 11-19-1997/�1:37 PN/5150.62 RCPT�:01-6a15672 PEkMIT:08581'3 � CONSTRUCTION AND PIANNING Pa�- $ SPa APPROVALS Permit# � Date Inspector qppROVALS Permit# Date inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � � 3. .E�ectrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding 5. Steel Reinforcement 56. flough Plumbing & Pressure Test , 6; Efectriwl UPER Grnd. 57. APPROVAL TO 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 Undrqrnd. 10. Struaural Floor System ' 61. APPROVAL TO DECK 7 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final . 12. Sewer Cap , � 63. Heater & Vent•Final � 13. Roof Drains � 64. Plumbing SYstem � Finai ,� 14. Rou9h Plumbing 65. Electrical-Final � 15. Rough Electriwl�Conduit � 66. Solar System-Final ' 76. flough Efectric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. flough Factory Fireplace �� APPqOVALS Permit # 21. Ducts, in Strutture , � � 70. Underground Hydro 22. Oucts, Ventiiating 71. Product Piping OGas ❑Oil 23. Gas Pipe•Rouqh & Test �� , � 7Z, Underground Flush 24. Roof Framing 73. Undergrnd. Stora9e Tank O Gas ❑ Oil 25. Roof Sheathing / �`� 74..Overhead Hydro 26. T•Bar Ceiling (Structurap & Monocoat 75. Dry Chemical 27. Frame and Flashing , 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. InsuVation 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 ISS ED 33. Final Eiectric . Notes:y� .� ��, �� 34. Fina� Heating & Air�Conditianing 35. Final Gas Pipe-Test' , 36. Hood or Canopy � 37. Finai Factory Fireplace ' 38. Fi�al Plumbing � 39. Water Service-Final 40. Gas Service-Final 41. Solar pomesticFinai � ' 42. Backflow Preventer 43. Backflow Irriqation 44. Landscape Irrigation System 45. Sound Atcenuation - 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING l 17 / ` �/+ cl� GA"� � , 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date OWNER p�',� S[iRnl{TIDERS� DATE p�!{._� JOB ADDRESS 9(1?'� Phalamne Crn�rt BUILDING PF.RMIT NO. ?52�5 SUBCONTRACTOR Tr, 549:3 Lot 65 'COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX H77 COBTA MEBA. CALIFORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT ADDRESS 2023 Phalarope Court COSTA MESA, CALIFORNIA OWNER Pemba Subdividers,Inc. ;'�;,o�Qa 2$50 Mesa Verde Drive 823 E, 17th St.SantaAna Pemba Subdividers,Inc. 2850 Mesa Verde Drive 187318 No 5I49-0395 67 x 105 I "° �"°`°°°. 0 I NpW ON LOT bcgle Family Residence � hNOM G!1 r�c /i EFT 9 I R�QHT - 8 DESCRIPTION OF WORK E�INa 2404 "ao' Ms 11 r rt�ea 2 fER10R WA pppp lllg' eS VERING 1CC0 COVERIN6 Q]7 ]{PS B OF BUILOINC �NO WORK T[e HE wFRF[1wMwn 1 HEPEBY ACKryOWL8D0[ TXAT I HAVB PBAD TH18 APPL�GTION AND 8TAT8 TryAT TH6 ABOV6 IB COqqECT ANO AOqEB TO COM. PLY WITH ALL CITY OROINANCHB ANO BTATi LAWB RGOULI�T�NO BUILOINO CONgTqUClION. SIGNATURE pp PERMITTE � � AUTMORIZHD A6E C9Tli OF GsST�, fd9E�A FEB 2 1966 sr ZONING � NO.OP U88 _ � �una � emi YARD9APpROVED MAIN BUILDING �I vwn.# 169UEO BNALL BE LES9 THAN YARDSAPPROVED :CESSORYBUILDING owre APPROVED �.re i i� --� TNE �MOUNT eHOWN UNDHH VALUATION IB POp THE PURPOOH OP 88TABLIBXINO A PERMIT PE8 ONLY. VALUATION ` PERMITFEE J $ � � I ��0 TOTAL FEE " / �