HomeMy WebLinkAbout2028 PHALAROPE CT - Building Permitsnooeess: " z028 PHALAAOPE CT '
i'SNRME: RAUL MARTINEZ
nooness: SAME AS , AHOVE
RNCH/ENOINEEfl: '
RODPESS:
flEG.NO.:
uxiT:
uxrt:
PEHM�TrEE: �UMINUM ROOFING SPEC ( 714 ) SSS-0678
aooxess: 1529 MCFADDEN
S.A. CA 92705
OCENSED CONTMCTOB DECLAM710N: I herehy aKrm tlut 1 am lic¢nse0 under provisions ai CAapter 9(commencinA ��h Section
7000) of Oivision 3 oi the Business and Protessians Cotle, an0 m�yIicCnse is in tullforce anE etted.
cinuc.:03372�3j s�p7Euc.� Sd3Dy3 cuss: C^39 � •
' Date: ��V ` 7 U SipnaNa: �,'�'`�� - ��
�.I� � �
WOBNEBS' COMPENSR710N OFClAM7I0N: I here6y aMirm Ib I haveAl a r¢nificate oi�r sent ro self-insure ar a certifiwie of Workers'
CamOenution Insurance, or a certilieE caDY �hereol (Section 3800, LdU. C).
roucrxo.:0662699-89 exv.oeTe; 04/0.1/91
coMr�xr: STATE . �
.� Cetlitie0 copY is �ereby lumishetl. � Cetlifie0 coOY u��led x1th the ciry BuilOinp Division.
Uate: �/U �n �lpplicant
ECEMPfION FBOM WOPKEfl3' COMPENS�TION DECLAMTION: �s secuon nee0 nol �e completeE ii Me permtt is far one hundre-0 �E100) or less).
I ceniTy that in the Oe�ormance of ihe work tor wAicA tAis pe mit is issu¢d, I sAall not employ any De�son in any manner so as to �ecome
suhlect to tAe Workers' Compensation Laws ol California.
Oate: � SiAnature: �
NOTICE: If, atler makinA ��is declaration, you shoultl become su�j¢�� to tha WorkeK ComDensa[ion pmvisions of tAe LaUor
CaAe, you must fort�with comDly with suc� Drovisions or t�is Oe�mit shall be tleemetl revoked.
CONSTBUCTION LFNDING RCENCY: I herehy affirm that Ihere is a eonstmction lendinq agency for Ihe pedormance of IAe wark /or
whic� t�is permit is issued (Sectian 3W7. Civ. C). ', �
LENUEB:,
aooaess: •
, , � .
OWNEB BUILAEB DECUMTION: I �ereDy affirm t�at I am exempt i�om t�e Contractors' State License Law tor tAe fallowing reason
(Section 7031.5 Business ana Professional Cotle: Nny city o� counry Which requires x Oermit to consimct, alter, impmve, demolish, or
reDair any stmcNre, prior to its issuance, also requires Ihe apDlicant for such Dermit to tile-a signetl statement that he/she is licensed
pursuant ta tAe provisions of iha Contractors' State.Licanse Law (CAaO�er 9(commencing wiih Section 7000) of Division 3 oi the Business
an0 Pmfessions Code) or tAat he/she is exempt tAeretmm and Iha 6atis for the alleged exemD�ion. Any violation oi Section 7031.5 by
any apDlicanifor a Dermit suUlecis ihe aODlicantto a civil Denalry of pa� mare ihan tiva AunAreU tlollars'�5500�.. _
I, as owner oi the DroOenY or my emVloyees wnh waAes as Iheir sole comDensation, will do t�e woM, an0 the
❑ stmcmre is noi intenAeU or offerea lor sale (Secuon 70a4, Business an0 Protessional Cotle: 7he Comracrors'�State License Law
does nat ap01y to an ovmer al a DroDeM who builas or improyes tAereon, anG who Aoes such work �imseli/herseil or through
his ar her own employees, proviEed tAat such impravemenis a2 not intentleE or oflere0 for sale. II, however tAe Uuii0in0 or
impmvement is wIC within ane year of campletion, t�e owner �II Aave the Eurden oi Droving he/she OiA not 6uilA or imD�ove
for tAe purpose oi ule). , ,
I, as owner ot t�e pmpeM, am e�clusiveN conlraclinp witA Iicense0 comracrors ro constmct Ihe Oroletl (Section 7074, Business
❑ and Profeuions CoOe: TAe Cant2ctor5 State License Law Eoes not aDDN �o an owner oi D�operry who Cmlds or improves t�ereon
anG who contracts lar suc� D�olecis vnth a contractoqs)licensa Dursuantta the Contracrors' State License law),I am aware
that pmof ol their Warker's Compensatiun insurance s�aultl h¢ pmvide0 to me.
� 1 am exempt unAer Sectian: B. 8 P. C. .�
�or Ihis reason: , '
Date: �'+nec
I Eo h¢reby teRity �Aa� I am aware ol anJ un0er5lanE the f¢Quir¢ment5 a� Cali�omia Heal[h anA Safe�y Cotle SeciiOns 25505, 25533. an0
2553< antl t�at I or any imure huil0ing occupant wilUwill not (circle one) neeG m comply with sai0 state co0es antl ihe reQuirements tor a
permit for constmctwn or motlifiwtion imm Ihe Air Oualiry Manaqement Disinct. Hesidential constmction applications are exemD� )mm
these provisions. �
Oaie: AppliwnC �
� I Ae2by certiry Ihat I have reaOlhis appliwtion an0 state Nat tAe abov¢ information is correct. I agree m comply with all city and counry
ortlinances anU state laws relatin0 �o huil0in0 eonstruction anE hereEy authodze reDresentatives of this ctty to enter uDon the a6ove-mentioned
propefiyf/o/r inSpeR�ion pu+moses. . . '
Date:7�J� 7�% � Signature: �-��� ���r
oriver's�icensearSociai5ecunryx:
Appliwnl: Pink—Revenue: Goltlenrotl—Assessor' ''
• CITY OF COSTA MESA — HUILDING PEAMIT PERM NO: B� 046893
PERMIT NO: B 046893 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: „ PEAMIT TYPE: STR P.URPOSE: ALT
JOH DESCAIPTION ; REROOF W/ALUM ROOF ICHO#3149 FOR SFD SQ FT: 6,000
CLAIM VALUE: 6,000.00 CALC—VALUE; 6,000.00 GROUP OCC: R-3 /
COMMENTS: REMAINDER OF ROOF W/FIBERGLASS BASE SAEE '
�r�r�r��r�**���****x�r+rx*�**�r*�****��r�rxx�rxr*�**�rx�r*�+r+t�e**�r�r�r****�r�r+r+r�r+r�r�*x�+r��*�r***�c
Z O N I N GS ERTEB�AUCIKRSE M E N T S '
------------ MAIN BUILDING ----=----- --------- ACCESSORY BUILDING ---------
FANT: FT IN REAR: FT . IN FRNT: FT IN REAR:' •FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ• ' PROV: PARCEL: 13957217 ZNE: REF NO:
PLANNING NCSTES>
� r,
M iF!! ik if ik �k if �ll� M M!f!F d! 1klklklFiF iF it iFiF if it iF ik iF iF 1t 1F 1k 4 iFi! �t M it it i! �F 1!!t iF k k 1k 1t if it M1k 1f if 1k 1k M!! 1F k!F!t {t 1k ik it if iF 1F 1k iE iFif ik iE 1k iF iE if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N�T;.S
, , •'
20NING APPROVED BY pATE:
BUILDING APPROVED BY': AATE; '
APPLICATION ISSUED BY: � DATE: .� a %�
ififMiFik�kitiFlFikiflkklFlkN�Fjkififitik 1klfiF�FiFiEMikikif ikik
!!!F iklk 1t it ik iF iF if iF M iF 1F M i! iF M If iF 1f iF if if ik 9k iE if if if if if iF iF iF iE iF if iE iF if iE iF iF M!F!F iFk iF k iF iF iF ik iF Mk M ik ik 1k if N!E iF iF it iF ik iF iE ik iF M�ll� 1k 9k it
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
' BLDG PMT �PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADING
PERMIT 81.00 . � .50
SMIP/NON—RES
PLAN �
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> . 81.50 0.00• 0.00 81.50 51.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 81.50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK
81.00 ,SO
!! ik 1k 1f 1f �k 1klFlF k iF,it iF iFlk Mit i! �flk �f 1k iFlF ik if !F!! if iFlklF iF if fk iF if ik it M iF if 4 if if if iF it %1F k if ik it ik itlk iFiE iF if k if !f 1f ik M!t ik �k ik 1t 1E jk iF 1k if 1E if
. I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N ' UNIT COST TOTAL COST
SFR 6000 REROOF BY VALUE RESIDENIAL NOZONE 1.00 6,000.00
END OF FEES
0
O1 �QOSR274-GDQ53274 "i nT
DflTE: Q4/lOJSO TItSE: 14:37
oi 000ss2�s-aooss2�� TC+T
DATE: 04/lii/90 TIt1E: 1:�37
B�.�Q
•�Q
1. . �
CONSTRUCTION ANP PLANNING � PO. _& SPA �
APPROVALS Permit#" Date Inspector AppROVALS Permit#
1. Temporary Electrical Service or Pole� : 52. Pool & Equipment Location
,�}uSoil Pipe-Undrgrndl; ;;,� yE�., . 53. Steel Reinforcement
o7�Electrical Con R�l9iility-Undrgrn� � � 54. Forms
��.`.Electrical Condyi��'-�Undrgrnd. p � 55. Electrical Bonding
_ �,:.
w�. Steel Reinforce'ment x � � . 56. Rough�Plumbing & Pressure Test
4��Electrical UFE�t�md.� �J � 57. APPROVALTO COVER-GUNITE
�js7��ootings ;; j7 k; 58. Electrical Conduit�Undrgrnd.
``� 8. Foundation S � ' 59. Gas Pipe, O Undrgrnd., Test
e.: 9. Water Pipe-Undtgrnd. � , � � 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural FIoo�System � � 61. APPROVALTO DECK
11. Property Sewer Lir�& House Conr�ction 62. Backwash & Receptor-Final
72. Sewer Cap o: _v , � i 63. Heater & Vent-Final
�� �i
13. Roof Drains ,j � � 64. Plumbing System � Final
14. Rough Plumbing y �- . ; 65. Electrical-Final
4
75. Rough Electric�1,-Conduit � 66. Solar SYstem�Final
� 16. Rough Electric�Viring 67. Fencing & Access ApProval
77. Rough Wiring $r'gn � 68. APPROVED FOR PLASTERING .
18. Rough Electri�-T Bar Ceiling 69.� POOL/SPA SYSTEMS FINAL
t9;,Rough Heati�g & Air Conditioni� FIRE EPT. QUIR MENT
:� a� n x � r� -i a� c r: r.� .v a x r .�.. � � t. cu
20ARo�h 'ct � lace � � � '" �+ ����C �' * �' '"
9� _Y �� i SIT' t�'S * S:� �* x-APPR;qVRtS;tir...Permrt#�a:.-x�
21 ^Du�s, ia�Str•uct T x i�•• ^ �-+S � S O �-+i -K 70. Qhdergib� Hydro '�'
;n `asg* � sN � n :, nx M � ... K
] * i [ S �X ac il 1 ^? w x
22S-0u�s, �ent�atiriiy y� i �-j *�y ¢ � p.,* � 71, productY , ing O Gps OtOil
23�Gas-Pip�Ro h & %est � mr [+iS � :�] _ �Q OM � 72, Undergroyncl Fl�sh�� * �"' o
L^ " IT1x � ;•t-• ••F x 7 O G^ # � � � r-�C� •
24. Roof Fryming �� M * ,> x i..��; �, ••73c�Undergm$.Stor2ge,sT�nk�7Gas ❑Oil
25. Ro2N Sfieathing �-+* �Z v t: � 'J > N� x: 7q�Jp�erhead Hydro'J� *
r-� x n x ... t" *
� COdt � � O ST:Y. W C^ '7 �: � O'+
26.�T-B�r Ceiling (S���tural) &'1v1or`� x� j,� C# ;K 75g.,Qry Chernjcal �� s �
27a:Frameand Fteshin� ��Q � v^ ��7� � 76. Dry Stan Ppe �"'� r O
r` Y' x �
"�"28. Lathin � �n '-* c^. '7'C= 'x * E �•x # C� ,,.t� yS, * [�
�` � 9* vcCc, J x •.� .•� . r 77-, FIXED S,��y E?✓�tr NALx H�n
� 29. InsulatiFin v OM S �• M � I � �� 7gMFIRE PREV. FI�I.� x> �>'
``�30. Drywall�',zNaifl'ng m� r� i * F �C * s �EALTH�EP'1� R�Q�IR�JVIENT
j 1 �J +
�J31. Plaster BroWr1 Coatx S i c^[" � *� 79, FINAL If¢S�fCTIt�N ��
r,Q_ .
�32'.�Y_jElectriqi Pawer�7l�ie�'-Fllnaii * � � I . * 'BO..myFOOD CERTIF�ATE IS�I�EDr., �
.. , ';' ; +c i : , � .•, • s.c {�,
s33SFirtsi EY2ctrCo r.K iv i � 1� ! � NoTes: '7 "'_tT1 *": O J:n
�^ r� ef u C
«�34nFirre� He'atir�q& ��C �itidnng � � � ,� I � ��� � � S nx a� s dC
tt x r-� .. � e+� m x � i:�w x i-+ F'� # ;n
i 35rjFinal Gai Pipo-Teat�: py �• r y � r. �� xo Gr+ +� .-itn
�36.�Ho`o o%,Canopy�* � ��y `" * n � � no x. yr�
a c� sx K« !n i:z m w x �* ;-� x o � ra tn
r+. .J t� t x i.a i' •�.
--37.•Fina Factory Firqplace.^. i f�t+ �v x a �i: n7
- ... ��x
�38. Fi�a� PliYmb��g �� �'1N i � � I ! GK *.. t$,' � M�A r�n
ti39. Wai r Servi�Fi�a� g i � W G + ' M s. ' *� 5
�40. Gas Service�6inal � tt% �;'� � �.*� d7 I � �' y C" "��} M
i`� c..' E. • o S ? xC
,_;41. Solar pome�cFinal� ; ; �� * , � * i„ .;�� • 4 * - �
42 Backflow Preventetk � N � � � i+� * � >�' �* � �'-�
� n.,;-� �=, x� m tvv^rv M
43. Backflow Ir� atio* �SS x +� � � ~-•
� �' �1 .�. T * �R J l y iC (i
n
t�'44. Landsce" e fdri4ati�n SYsterp`"��� � *� G C Ox' � n.; N "'CV s N o
n r: i tt ^ R: .k C 1� �. i E a� O CC *: S F
� Q i: Yt H S['� �� a". Z k-' ;-�:K r- r-i �� :+.
45ySound iQtte�Auatio� y .. .. �c ir; ;,7 ;r7s' * C� C� � • E-p �
�46.••Handicap Regulations ^+ O * � 1 ** tcr•S Co S �
�� n �
,z475FIAtAL STR�CICTU�iE & BUILDING . I �-'' * n'o � p, * c.
i � .+ n
48 �FIPfAL PLANfVINC� � �""" � �', � ' � . �"• 'C * �" `O
,, ,. � x �-, �k :: �7 r_ s z� � -
a49Q;Elec�,4,ric�iele"ase to'�dison � � � �.��' � ,., '^ .,-'� * o
� ' •i� : �
��50SGas=Release to Southern Califonrria Gas Co � I �,n �* � o• o,r, y: p�.
�, � � » x• 5 � o ^ x n: o
-�51. CERTIFICATE OFrOCCUPANCY * * * " �� T� '� �"
No. � Date
Date I Inspector �I �
;
�
0
U
2
L
CFADtlHES�S: `lOZa PHALAROPE CT uNiT: ��
owxEasxqme:MARTINEZ, RAUL B FLOOD: AE-46
� —nooREss:z028 PHALAROPE CT
� " COS'TA MESA,CA 92626
546-4630
APCHIENGINEEfl:ACTEC ENGINEERING AEG.NO.:OOOOOO
aooeess: 1 6 6 0 N MA I N S T uxiT:
ORANGE CA 92638
PEFMITTEE:KING KUSTOM BUILDF.RS (714)631-1921
POOflESS:lO]%2 P,Q, BQx
COSTA MESA CA 92627
IICENSED CONTHRLTOfl OECLAppTION: I �ere�y a��irm I�ai I am Iicense0 under provisions ol Chapter 9(cammencinA with Section
7000� ol Oivision 3 ofihe Business ana Pmlessions Cotle, anA my li[ense is ' lulllorce an0 eifect.
ciTruc.: 555 S STATE ic.9Cy1905 c s:B EXP; O1/95
.
al �' i gnaiure:_
H COMPENSATI UEC�N: I�eretyaifir Ilhavea[erlilitalealtOnSenitaSelFinSureoraterliliW�eO�Wofker5'
omDensationln5mpn�y pr� {PNlietl pOYY ��ereoi (5¢[li0n 3800, LabOC� � � 1� 9 5
Po�icr No. STATE FUIdD E%P. DRTE:
COMPANY:
] Cenibee py is ner by Iwnishea. �] Cenifiea coDY ���eG wit� t�e diy BuilainA �sion.
�ate � L Z poPlicant: �
PTIO flOM W KEBS' COMPENSATION OECUBATION: (T�is clion nee0 nol be cam �e0 il �he p¢rmil iS IOrone hunGreE �5100) at l¢55�.
I certily Ihal in Ihe Dedo�mance 01 I�e work lor w�ic� Ihis permil Is i55ue0, I shall noi employ any persan in any manntr so ds �o b¢came
SUbjetl Io I�e WOrkers' CampenSalion LawS 01 Calibmia.
Oate: Siqnamre:
NOTILE: If. al�er malting Inis Oeclaraiion, you 5�ou10 become SUGI�� �o ��e WOAeerS' Camp¢nsation prwisions o� �Ae Labor
CaAe. you must fonnwiih fqmo�Y ��� sucA o�ovisions ar iks oermit shall �e aeeme0 revokeE.
CONSTPUCTION LENOING FGEqCY: I �meby atlirm t�at tAere is a constmclbn IenGinp aAency lor t�e pedorma�e ol t�e work for
w�ic� Inis permitis issue0 (Seuion 3097. Civ. C�.'
LENDEN:
aooeEss:
DWNEP BUILOEP OECLAPR710N: I hereby ailirm t�ai I am exempt Imm ihe Contractors' Slate License Law for ihe following reason
�Section 7031.5 Business antl Prolessional Code: Any city oi county w�ich rpQuires a permil to constmct, alter, impmve, demolisR or
repair any structure. priur to its issuance, atso requires t0e applicant for such Oe�mit to fik a signetl statement t�at helshe is licensed
Dursuant to t�e pmvisions of I�e Comractors' Stale License Law (C�aD�er 9(wmmencinp with Sectian 7000) of �ivision 3 oi t�e 9usiness
anE Pmlessioni Code) or Ihal hy/shE is exem0� ��ere�mm and Ihe �asis �or ��e alleq¢0 eKemD�ion. Any violation ol Se[lion 7031.5 6y
any aDP�icant br a permil suEjetlS I�e applicant lo a civil Denalty o� nol more lhan live �unArea Gollars (55110).
I, as owner of ihe pmpeny or my emyloyees witn waAes as tneir sole campensation, will Ao Ine work, and ihe
❑ simcture is noi imen0ea or o�feretl for sale (Section 70a4, Business an0 Pwfessional Cotle: The Comractors' State License Law
aoes nol apply to an owner ol a prop¢tlY wA� Euiltls or im0�ove5 ihereon, anE who does suc� work �imsell/hersell or through
his Or �¢r own employees, proviaed Ihai SUt� impmvemen�s are n0i inientletl or oflereA lof Sale. II, AOwevef �he Ouiltling or
impmvemenl is sola wiUin one year ol complelion, �he owner will �ave Ihe burtlen o� pmvinA helshe Oitl nol huild o� impmve
lor I�e purpase of sale),
I. as owner of the pmperyy, am exclusively conUaciing wil� licensed coniraclors to cons�mct ihe pmleci (5¢c�ion 7044, Business
❑ antl Pmfessions Cotle: The ConlracPors' Staie License law tloes not apply io an awner of Dmpeny w�o builtls or impmves I�ereon
ane who coniracts for sucn pmiecls with a coniractor(s) license pursuanl to �he Contraclors' State License Law). I am aware
(hat proo� o� I�eir Wor4,e� 5 Compen5aiion insurance shoul0 be pmvitle0 to me,
� I am exempt untler Seqion: B. 8 P. C.
lor Ihis reason:
Date'. — Uwner.
I tlo hereby cenily ihat I am aware ol ana un4erstan0 ine reQuiremenis ol Calilomia Healih antl Safery Cotle Seclions 25505, 25533, antl
25534 and Inai I or any lu�ure builtling occuDanlwilllwill noi (circle one) neetl lo camply with sai0 staie codes antl Ihe reQuiremenisfora
permil lor conslmction or modilicalion Irom I�e Fir Oualiiy Management Oisiricl. flesitlenlial construc�ion applicaiions are exempi irom
inese pmvisions.
Uate: ADPI¢anP.
I hereby cer�ifyl�ai Ihave �¢atll�is applicalion anU Slaleihal Ihe ahaveinbtmation i5 Corfetl.Iagreet0 tomply vnlh ail City antl tounry
o�0inances antl slatelawsrela�ing�o Duilding cons�mtlion ana �ereDy aWlwr¢erepre5enlativesolihis ciryto en�er uponihe a0ove�mentioned
O�openy lor i s0eciia pwoose .
Ve ., Ii' Signalure: %" ✓ /' "' /�
er'S Li nse o Sonal Secy�
164ba6 While—Builtlmg: Green—CaEa EntorcemenL Canary—Applicanl; Pink—Ravenue; Goldenroa—Assessor
CI'fY OF COSTA MESA — BUILDING PERMIT PERM NO: B 070333
PERMiT NO: B 070333 PLAN CHECK NO; 04514-94 L GOV'T: N SUPP; N
CONSTRUCTION 'TYPE: PERMIT 'TYPE: STR PURPOSE: ADD
JOB DESCRIPTIOIJ : ADD 173SF KITCHEN S DININGROOM SQ FT: 15.000
CLAIM VALUE: 15.000.00 CALC—VALUE; 15.000.00 GROOP OCC: R-3 /
COMMEN'TS: ADD 173 SF KI'fCHEN 5 ROOM ADDITION
# iE iE iE iE �E if �E 9E iE iE iE 3E �f iE if jE iE iE iE �E iE iE 3f if if if iE �f if if if 1E iE iE iE 3E �E iE iE iE �iE iE �lE if if �lE iE if jE �E �f �E if iF �E iE �E iE iE 3E iE iE 1E jf if iE iE iF jf jE �% iE �`� iE if iE iE-IE
Z' O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: 24 FT IN FRNT: FT IN REAR: FT IN
LtiFT: FT IN RGHT: 6 FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 13953117 2NE: R1 REF NO:
PLANNIt�G NOTES> 173 SQ.FT, ADDI'TION TO REAR OF SFR
i
iEjE3EjEifiEiFiEjfifiE�M�lfifiFiE iEiEiEiFiEiEiEiFiEiFiEiE'lEifiE�7fiE�lfiEiEiE%iEiF�3EiEiFiEiE��jElfifiE�iEiFif%iEiEiF7EiE'IFiF��iEiE��7E#iFifiE�EiEiEiFiEif
D E V E O P M E N T, S E R V I C E S R E Q U I R E M E N T S
ZONING APP OVED BY _._�__�:�' DA'PE: _1L_ �— f�-�
BUILDING APPROVED BY :_____, �__.___ DATE; __�2=�_��
APPLICATION 3'S"SUED.BY: � ' DATE: �2—�2—��1
iE �f iE iE iF �� if iE'JE iE �E if jf iE iE iE iE if if iE if if'£�'�'1F3F7Fi�FiF3F7F�iF� iFiF£�f3F�FiF�3F�F9f iE jE 1E 3E jE �E jf iE if £�F�iFiFR�£�F�FiE iF
jE iE if iE if iE jE if � jE iE iE jE 1E jE jf iE if iE if iE iE 3E iE if if iE iE �E �lE iE if �� if �E iE iE iE 3E if if iE iE iE iE iE jE iE iE iE iE iE �E if iE iE iE �JF if jf �E 3E if jE 3E jf iE � iE iE �lf iE iE iE if jE iE if -)E
LEGALIZATION;N F E E S U M M A R Y S'TRUCTURAL SEGt+IEIJT:Y
BLDG PMT PLUtdBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 162.00 1.50
SMIP/NON—RES
PLAtJ 105 , 30
ISSU�: FE:E
BUILDING—DIV—> PERMIT ISSUE PLAN—C�iECK TOTAL PAZD DUE
TOTALS----> 163.50 0.00 5.30 268.80 262.80 ,00
REVENUE DIVISION 'f0'fALS--> COI,L CTED; — 163.50 OVER/SHORT: ,00
BLDG PidT PLUMBING ELEC'I'RIC M CHANIC FIRE S1dIP/TO'T GRADING PLAN—CHECK
162.00 1.50
'IE �7f iE X iE �%�% % iE �% �lf iE �3f �3f iE iE iE iE iE iE �lf jE jE iE iE if iE �� if if 1E iE iE iE iE �� iE X'7E �3E iE �E iE iE iE iE iE iE iE if iE iE iE if if iE if �� if iE iE iE 7E iE iE iE �7f if if iE 9E jE iE iE iE iE iE iE iE
I N D I V I D U A L F E E B R E A K D O W N
I TYf'�
ISFR
�TY tl � tl �: F! 2 p'F i El tJ
15000 ALTER BY VALUE REENDEOFIFEESNUZUNE
LiNf2 i;ri�fi �6J�t�i ( (_)��
1,00 15.OQ0,00
o� oo��32�4—+�01733E� Tt, r iaa.;a
DFTE: 12/f2/94 7If+F: IT:14
I CO�STRUCTION AND PLANNING
APPROVALS Permit #
�' .
L �'emporary Electrical Servic�br Pole
2. Soil ➢ipe�Undrgrnd. �
3. Electrical Conduit Utiiity-Undrg�nd.
4. Electrical Conduit�Undrgmd.�
5. Sceel Reinforcement � � �',
6. Electrical UFER Grnd. � �Z
7: Footings � k„
8, Foundation ' � �.
9. Water Pipe-Uodrgrnd.
10. Struc[urel Floor System �- �
i t. Property Sewer line & House Connection
12. Sewer Cap
i
13. Roof Drains �
14. Rough P4umbing
15. Rough Electrical-Conduit
16. Rough Elettric Wiring
17. Rough Wiring Sign
18. Rough Electrical�T Bar Ceiling
19, flough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ducts, in Siructure
22. pucts, ventilating �
23.�Gas Pipe-Rough & Test .
24. Roof Framing
25. Roof Sheathing
26. T�Bar Ceiling (Structurall & Mo�omat
27. Frame and Flashing
28. �athing & Siding ��_ � _ �
29. Insulation l
30. Drywall Nailin9 �.
31 . P�aster Broven Coat 2
32. Electrical Power Meter�Finai
33, finai Eiectric
34. Finai Heating & Air Conditioning
35. Final Gas PiOe�Test�
36. Nood or Canopy
37, Final Factory Fireplace
38. Final Plumbing
39. Water Service�Final
40. Gas Service-Final �
41, Solar Oomestic�Final
42, 9ackflow Preventer
43. 9ackflow t{�igation
44. Landscape Irriqation System .
45. Sound Attenuation '
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING (�
46. FiNAt PLANNING �
A9. Electric Release to Edison
50. Gas Release to Southern California Gas Q
51. CERTIFICATE OF OCCUPANCY
No. Dace
Date Inspector
�: -
i
.-ly-9N �w�J
-!k -q_y 4�.�E1
r �{ -� �(y�
-(K-4�( �v�
/ �-
:i
�
G'
i
6
PO t SPA
APPROVALS Permit �kk
52. Pool & Equfpment Location
53. Steel Reinforcement
54. Forms
55. Electrical8onding
56. Rough Plumbing & Pressure Test
57. APPflOVA�TOCOVER�GUNITE
58. Electrical Conduit�Undrgmd.
59. Gas Pipe, O Undrgrnd., Test
60. Sackwash �ines, P�Trap, � Undrgrnd.
61. APPROVALTODECK
62. Backwash & Receptor�Final
63. Heater & Vent�Final
64. Plumbiny System • Pinal
65. Nectrical�Fir,af
66. Solar System-Final
67. Fencing & Access ApProval
68. APPROVED FOR P�ASTEFING
69. POOLJSPA SYSTEMS FINAL
F1RE BEPT. itEQUIREMENT
APPROVALS Permit #
70. Undergrovnd Hyclro
77. ProducbP+pingOGas C70i1
72. Underqro�nd Flush �
73. Underyrnd. Stora9e Tank O Gas ❑ Oil
74. Overhead Hydro
75.�Di-y Chemicat
f
76. Dry Star.Cpipe
77. FIXED SYSTEA4 FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FiNAt 1�SPECTtON�
80. FOOD CERTIFICATE ISSUED
Notes:�Z'LS-9'r/ 0`C /G Lti✓� L�
�
Date Inspector
Insulation Certificate
City of Costa Mesa
California 92628-1200 P.O.Box 1200
Permit Number ( O � /�
�v2S _I rc�� � • �C9yt,c� �'�-P�J-e`
Number and Str Ciiy
� Cou � SuDaivision Lot Number
DPscri,�t's��� of Installation
ROOF -
Material �J:��'il-C1LA�5 ' .i�'�i1-5 -
r
Thickness (inches) 9 .
✓.
EXTERIOR WALL
Material �I�Eft�i95 (iq-iTS
i ^
Thickness (inches) � �i
Brand Name _QLC1_(/_Y�
Thermal Resistance (R-Value) _�.�.30
Brand Name L��—��✓ ✓l,_�v�
Thermal Resistance (R-Value) —j�=�_3
CEILING � T, ���� /��
Batt or Blanket Type_�1,?'fT Brand Name _l�w� � l�µ-'�^"� '
Thickness (inches) � Thermal Resistance (R-Value) _��C?
Loose Fill Type Brand Name
Contractor's minimum installed weighVft2_ Ib. Minimum thickness inches
Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value)
RAISED FLOOR �1
Material � /'+
Thickness (inches)
SLAB FLOOR /
Material h! / �
Thickness (inches) �
Brand Name
Thermal Resistance (R-Value}
Brand Name
Thermal Resistance (R-Value)
Width (inches)
FOUNDATION WALL
Material /V _� Brand Name
Thickness (inches) Thermal Resistance (R-Value)
Declaration
I hereby certify that the above insulation was installed in the building at the above location in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the
California Adminstrative Code.
��" �['ie�Etgf Con raLlo� �uTdei�IL-UERS—
P.O. BOX 10772
C a STA�; �FwS�,f,�AL.-9 2 6 2 7—
(714) 631-1921
sdc��d�i��MBmA�fa�i�05
e n i e �"/�
i9�]a8
License Number
Date
License Number
Date
��
PF0.IECTRODHESS: 'zOZS PHALAROPE C1 uNiT:
owxeR�sxnme:MARTINEZ, RAUL B FLOOD: AE-46
, . aooAEss:z�28 pHALAROPE CT
COS'TA MESA.CA 92626
;46-4630
AflCHIENGINEEfl:ACTEC ENGINEERING NEG.NO.:OOOQ�O
aooxess: 1660 N MAIt1 ST u�
ORANGE CA 92638
PEflMITTEE:KING KUSTOM BUILDERS (714 ) 631-1921
aooness:10772 P.O. BOX
COS'I'A MESA CA 9262 %
LICENSED CONTNAC70B OECIAPPTION: I liereby atlirm t�ai I am licensetl untler Drovisions ot ChaD�er 9(commencinp with S¢c�ion
7000� o� Oivision 3 of Ihe Business antl Professions Code. antl my license is In �ull lorce antl eifeci.
CITYLIC.:Q j� j$ srareuc.461905 ��S °R F.:XP: O1/95
ale. _ ,lt Signature: —
WOH �'�`EN TION OEC� I hereby allir at I �ave a certilicate ol consent io selbinsure or a cenificate of Workers'
pensalion Insurance, ar a certifietl copy �hereol (Section 3800. Lab. C�.
vaucrxo.:1.182634-94 E%P.OATE:OLIOS/9S
COMPpNY:STATE FUND
❑ Cenitietl copy is nereby fumishetl. $� Cetlifietl coOY is �ilea wiN �he ci,y Building Oivision.
�''Da�e .�T� Y Ppplicant:� ������7'�/"'��—
PTION BOM WO EflS' COMPENSATION OECfAflRTION: ( i57fi 5et�ion ne¢tl nol �e co npleietl i� Ue permi� is lor one AUMfeO (3100) Or lus�.
I cenily Ihat in Ine petlormance of Ine wotk for wnicn ihis permit is issuea, I shall not emoloy any person in any manner so as to eecome
su0lecllo Ihe 4Yorker5' Compen5aiion Laws o� Califomia.
Oaie: SignaWre:
NO710E: II, after making Ihis aeclaralion, you shoNd Eecome subject to Ihe Workers' Compensdtion O�ovisions of tAe La�or
Code. you mu5i forl�vnih campty wilA such pmv¢ions or Ihis Oermit s�all be GeemeO revokeC.
CONSTNUCTION LENOING AGENCY: I hereGy aifirm Ihat ihere is a construc�ion lentling agency lor Ihe D¢riormance ol Ihe work lor
w�ich Inis oe�mit is i<sue0 (Section 3097. Civ. G).
IENDEP:
AUGHESS:
OWNEP BUILOEF OECUNATION: I�¢re�y atlirm Ihatl am e�emplimm Ihe ConVactors' $tate Lkense Law lor��e �ollowinp r¢ason
�Seciion 703f.5 Business anE Pmlessional Coae: Fny city of coun�y which requires a Dermit ta constmct, alter, imDmve. Oemotis�, or
tepair any Slmciuie. prior toils issuance, aiso repuires lhe applicani for suc� permi� to �ile a 5ipne0 Slaiement l�al �¢/SAe is Iicenu0
pursuant m t�e Dmvisions ol t�e Canlractors' State License law (Chapter 9(commencing vnth Section 7000� of Divisian 3 07 t�e Business
anG Pmlessions Catle) or Iha� �e/s�e is exempi Nerefmm ana I�e basis lor �he alleqed eremption. Any KOWtion a� Section 70.31.5 Uy
any aODlicanl fOr a pe�mit suble��s I�e aD�licant la a civil penally of not mor¢ ��an Irve hundre0 tlollars (5500�.
I. as owner of the v�oDeny or my employees witA wages as their wle comDensdtion, will ao tAe work, an0 Ihe
❑ stmtlure is noi imenaed ar oi�ereE �or sale (Sec�ion 70aa. Business anU Pmfessional Code: The ConVactor5' Staie License Law
does nol appty Io an owner of a pmperiy who builtls or impmves Illereon, and who doe5 Such wotk tlimsell/�¢rsell or I�muph
�is ar her own emD�oyees. proviaetl t�at suc� imD�ovemems are nol imentletl or offereG for sate. II. Aowever ihe builEinq or
imD�ovemem is solU wi��in ane year oi compleiioq ihe owner will have IAe burtlen ol provin9 he/sAe diA nol 6ui10 or imprwe
lor Ne OurOose al sale�.
I. as owner of I�e propeny, am evclusively conVacting with licensetl cantraciars to cans�mct I�e pmleci (Seclion 70aa, Business
❑ ana Pmfessians Cotle: The Comractors' State License Law tloes not apply to an owner of Oraperry who DuilEs or impmves ihereon
antl who conlrac�s �or such pmjecis wilh a cantracror�s�license Dursuant to t�e Conlraclors' Staie License �aw�. I am aware
I�al proo� o� �M1elr Worker'S Compensation insurance 5�oulU 6e pmNUetl lo me.
� I am ezemp� unaer Section: B. 8 P. C.
lor Ihis reason:
Oale', �w�e��
10o her¢by tetliiy �nai I am aware o� anA Und¢rstanA Ihe requirem¢ms o� Cali�omia Healih and Sa�e�y Cotle SBCIi0n5 2550.5, 25533, antl
2553E and Iha� I or any lulure builtling occupanl will/will no� (circle one) neetl lo comply with saia state codes antl �he �eQuiremen�s lor a
Oermit for conslmdion or motli�icalion �mm Ihe Air Ouahry Managemen� DisMc�. flesitlen�ial conslmtlion applicaiions are eKemp� Imm
Ihese D�ovisions.
�ate'. AppliCanC
I hereby ceitify ihat I nave rea0 Ihis application an0 statet�al Ihe above infarmation is correcL I agreelo comply wil� all city an0 county
ordinantes antl 51a1elaw5relaiing�0 budaing conslmtiion ane h¢reby aNhOfizereD�esenlaiives o�lhis ciiyla ¢nt¢ruponthe abOve�men�i0ne�
p�Op¢f�y IOf IOSpI [_IiO� Jpyyy�� p01(5¢y5/
.p�E']��/�'''/ !_/ . , _— Signature: ____�����
� �
�o����Lmense or Socia� Secunty
164606 W�ile—Bwltling: Green—Gotle Eniorcemenl', Canary—Applicanl: Pink—Revenue: GolOenroE—Assessor
CITY OF COSTA MESA — BUSLDING PERMIT
PERMIT NO: P 070335 PLAN CHECK NO: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU
JOB DESCRIPTION ; ADD 173SF KITCHEN & DININGROOM
CLAIM VALUE:
CALC—VALUE:
PERM NO: P 0�0335
GOVT; tJ SUPP: N
PURPOSE: ADD
SQ FT;
GROUF OCC: R-3 /
COMMENTS: REF: B-70333
**�E*�*it**�x**�*��x**-���***�t�t*�*�E******!�*�t*���**�****�Ei�*��E*� � �***�*�*�E��*��t�#�*�**
Z O N I N G R E Q U I R E M E N T S
5 E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT I1J REAR: FT IN FRNT: FT IN REAR: FT IN
LE:FT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARICING REQ• PROV: PARCEL: 13953117 ZP7E: REF NO:
PLANNING Nb'I'ES>
i
*�***����**���*��*��******�*x�**�**,�*�*****�x����*****�*��**��***�x*�****�a��*x��
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
DATE:
BUILDING APPROVED BY : ___ __ DATE:
APFLICATION ISSUED BY: ���/�i�-------- DATE:����*,,��,/��,��F 7F i!
iE �1E iE if iE 3E # iE -)E iE iE x-lE �lE �lf lE jE 1f -lE jf iE jf 3F�^�F�f�FiF��F�'iF3F IF IF�3FiF�N�E'iE'iF'F�E �FiFiE iE iE �lE iE �lf jf iE �lE �A IE jE
iEiEiF�FiEifif�fiEifiElfjfif3EiEiEiE-1f��1EiEiEifiEiE�kiEjEiEiEifiElEjfjE�E1E�IfiE�fif�lEifiElEiE�f�EiEififjFiEif�Eif�fififiEiEiEififjf�3EifjE iEifiE iE��ififif
LEGALIZATION:N F E E S U M M A R Y STRUC'TURAL SEGMEIJT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 14.00
25% SMIP/NON—RES
PLAN •
ISSUE FEE 20.00
BUILDING—DIV—> PERtdIT ISSUE PLAN—CHECK
TOTALS---�-> 14,00 20.00 0.00
REVENGE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBIIdG ELECTRIC MECHANIC
34.00
TOTAL PAID DUE
34,00 34.00 ,00
-" 34.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
iEif if'� iE aE if iE* if jf if �if iE if iEiE � aE *�*aE �* if * iEiEif iF'� if * iE if if iE if * if iE � iE if iE�F *� iE1f if if if if � if if if iEif if iE * iFiEif *iEif if iE if iE � z if if
Z N D I V I D U A L F'.E E B R E A K D O W N
TYPE QTY D E 5 C R I P T I O N- UNIT COST TOTAL COST
PLU 1 DISHWASHER 7,00 7.00
FLU 1 SINR, KITCHEN 7.00 7.00
END'OF FEES
�1 OD1732E2—D02732E2 T�� T 34.0p
DATE: 12/+?/a4 TIt1E: 11:13
_ --��
f.ONSTRUCTION AND PLANNING POl . SPA
APPROVALS Permit # � ' Oate inspector AppROVALS Permit # - Date inspector'
7: Temporary �lectrical Service o�.Pole � �\ 52. Pool & Equipment Location •
2. Soil Pipe�Undrgmd. � ' za��. -"�.:�..-/1J%_{�,�L'V//, 53. Steei Reintorcement :
�
3. Elettrical Conduit Utiliry-Und�gmd. � 54. forms `
4. E�ectrical Conduit�Undrgrnd. 55. Electrital Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test (
6. Electriwl UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. ElocVical Condurt�Undrgmd.
8. Foundation . � 5�3. Gas Pipe, f� UndrgmU., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, L� Untirgrnd.
10. Structural Floor SYstem � 61. APPROVAL TO DECK '
17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �
12. Sewer Cap ��' 63. Heater & Vent�Final
1 J
13. Roof Drains , 64. Plumbing System - Final '
14. Rough Plumbing �,�1 �S T�.[��/ 65. Efectrical-Final �
-' 'C: �
15. Aough Electrical�Conduit 66. Solar System-Final �
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLP.STERING
78. ftough Electrical-7 Bar Ceiling 69. POOUSPA SYST6�11S FINAL
79, Rough Heating & Air Conditionin9 FIRE DEPT. REQVIREMENT
2�. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underyround HYdro
22. Ducts, Ventilating . ' 71. Product Pipin,y OGas ❑Oil
23. Gas Pipe�Rough & Test 72. Under9round Flush
24. Foof Framing � � 73. Underyrnd. Storaye Tank b 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. Lathinq & Siding � ' 77. FIXED SYSTEM F�NAL
29. Insulation � 78. FIRE PREV. FINAL
30. Drywali Nailing HEAL7H DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED
33. Final Etec;ric Notes:
34. Finai Heating & Ai� Conditioning
. jz-C3-�`� vKn�:s�.,e,� _
35. Final Gas Pipe�Test � q� ,.
�.�-" l�� a�:�-(�T1 l - - - -
36. Hood or CanopY - �� 2-"ZC-`!.7 l�Gk7Ci_
37. Final Factory FireP�ace
38. Final Plumbing ,�� y
39. Water Service�Fin81
40. Gas Service�Final
47. Solar pomestic-Final
A2, Backflow Prevent¢�
43. Backflow Irrigatio� .
44. Landscape Irri7ation System �
45. Sound Aitenuati0n �
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING "�
48. FINAL PLANNING i
49.-Electric Release to Edison •
/ .
50. Gas Release to Southern California Gas Cn �-
51. CERTIFICATEOFOCCUPANCY _..
No. _ Dace
PHOJECT AODflE55: Z O 2 8 P H A LAROPE C T uxir:
owxeeswam¢:[dARTINEZ_ RAUL H FLOOD: AE-46
, . aooness:z028 PHALAROPE CT
COSTA MESA.CA 92626
546-4630
AXCHIENGINEEP:ACTEC ENGINEERIIJG flEc.Na.:000000
noosess: 1 6 6 0 14 MA I N 5 T uxir:
ORANGE CA 92638
PENMITTEE:KIIJG KUSTOM BDILDERS (714)631-1921
aooxess:10772 P.O. BOH
COSTA MESA CA 92627
LICENSEO CONTNFLTOP OECIABBTION: I �ere�y af�irm Ihat I am Iicense0 un0er pmvisipns ai C�aO�er 9 �commencing wii� Section
7000� o� Drvision 3 0l t�e Busineu antl Pmiessions Code. and my license is in lull lo¢e an0 eBecl.
c uc..Q] SCy�g snTeuc.q6190�G�,�� �y B EXP: O1/95
e'!��(y Signamre;_ �/(/f�
KEHS' CO�PENSRTION UECLABATION: I hereby a�lir at I have a certificate al wnsent io self-insure or a cenificate of Workers'
I Comoensation Insurance. or a rertilieU copy ihereol (SecUon 3800. Lab. CI.
roucrNo.:1182634-94 E7(P.DRTE:OSIOSI9S
COMPFNY:STATE FUND
Cetli�ied W y is hereDy �umis�eE. :� Cettilietl copy is �iied wil the ci�y Building Oivision.
e; Appiicanl:
EREMPTION OMWO KENS'fAMPENSRTI0N0EQABRTION: (IDiSsectionneeUnol�ecampleteEif�hece�mli5�monehundre0(31W)orless).
I cetlify I�a� in ��e peAormance o� t�e work for w�ich t�is permi� is issued. I shall nat emplay any Derson in any manner so as �o become
suble�� �o t�e Workers' Compensalion Laws of Calilomia.
�a�e: $ignaWre'.
NOTICE: Ii. atter maWng ��is Declaration, you shoultl 6ecome subject to t�e Workers' Campensation D�ovisions o� he Labor
Cotle. you musl �on�with comply wi�h su[� provisions or Ihis permii shall Ue Oeemed revakeE.
CONSTPUCTION IENDING RGENCY: I nereUy allirm thauhere is a consimpion lending agency for the peAormance ol ihe work lor
wnich this oermit is issueU (Sec�ion 3097. Civ. CI. /
LENOEN:
aoosEss:
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 07033A
FERMZT NO: E 0%0334 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: ADD
JOB DESCRIPTIOW : ADD 173SF KITCHEN & DININGROOM
S() FT:
CLAIM VALUE: CALC—VALUE: GROOP OCC: R-3 /
COMMENTS: REF: 8-70333
*�f���***��*�t*****�f****��*�t*�E*x*�t*****i�x*� x *�*zf����t��*����**��****xi�x �E*�E**�t�#���t
Z O N I N G R E Q U I R E M E P! T S
S E T B A C K S
------------ MAIN BUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
— ACCESSORY BUILDING — —
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IIJ
PARKING REQ: PROV: PARCEL: 13953117 ZNE; REF NO:
P7,ANNING NOTES>
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D E V E L O P M E N T S E'R V 2 C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY• �1/Y�_ ' DATE• ! / ����
�E �E �E iE iE �E iE # iF iE iE iE �% �If iE it iE'k �E ��k iE#1EiF�F'*3FiE�C�7FiFiF .. . 3F£'iE�F'3E �f'�F�FiE iE iE �� *�� iE'7E �%iE'�F'�F3F3F��r iE iE
iEiE�3EififlE�lfiEiElEifiE�3fiEiEiEjEifiEiE�lfiE�ifiEjEif�%iEiEiEiEiE1E#��iEjEiEiEiE3EiElEiE�IEjE��iEiEiEjEiE�3EiEif3E%iEiEjEjFiEiFiEifiE�ffiEiEiEiE�3EiE� iEX��iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMEPdT:N
OwNEBBUILOENUECIAHRTION: IheieUyafiirmmatlamexemD���omtheConiracmrs'Sta�eLicenselawfonnefollowingreason BLDG PMT PLUMBING ELF.CTRIC MF.CHANIC FIRE SMIP/RES GRADING
(Seciion 7037.5 Business an0 Pmiessional Code: Any ciry ol county whic� repuires a permil to consimci, alter. impmve, aemolish, or p ERM I T 1 �. S �
re0aii any S�mclure. O�ior 10 ils issuance, also requires Ihe apPlicani lor such permii to lile a 5igne0 sta�ement tlut he/5he is licensed 5 0% SId I P/ NON—RES
pursuant Io I�e O�a�sions oi t�e Cantractors' Staie License Law (C�apler 9(commencing wiN Section 7000� oi Oivision 3 of ihe BuSiness
an0 Pmlessions CoUe� or t�a� ne/s�e is exempt therelmm and Ihe basis lor t�e alleg¢G exemD�ion. Any Wolaiion oi Section 7031.5 by P L A N
any appiicam ror a oermit suojecis me apoiicant �o a civil penany oi not more tnan five nunaren tlonars 155006 T S S U E FEE 1 S. 00
I, as owner o� �ne pmDeny or my empioyees witn waAes as �heir sole campensaiion, will eo tAe work, antl tne BUILDZNG—DIV—) FERMZ�I' IS$IJE PLAN—CHECK 'r�TAL PAID DU$
❑ slmcWre is nol intentlee or ofiere0 for sale (Sec�ion 70aa. Business an0 Pmlessional Co4e: T�e ConVactors' Staie License Law TOTALS ---- � 10 ,$ 0 1$, 0 � 0, 00 2 5. 50 2 5. 5 0 . � 0
Ooes nol apO�Y Io an ownei ol a DmDerty wha builtls or impmves Ihereon, antl w�o Goes 5uch wod himSelV�ersel� or thmugh
�is or her awn employees. pmviAeO that such impmvemenls are not in�entle0 or ofleretl lor sale. II, however t�e �uilding or R E V EN UE D I V I S I ON TOTALS --) COLLECPED • 2 5. 50 OV ER /SHOR T• . 0 0
impmv¢ment is 5old v�it�in one year ol comple�ion. the owner will have Ihe burtlen o� pmdng �e/she tlitl not �uiltl or impmve
ronneourPoseo�saie). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SIdIP/TOT GRADING P.LAN—CHECK
I, as awner of t�e pmpeny, am exclusively conimcting wi�h licensed comracmrs �o constmct Ihe D�oleci (Sec�ion 7044, Business 2 5. 5 0
❑ an0 Profeuiws Cade: The Coniracmrs' Sta�e License Law does not apDly la an owner ol pmDerry who UuilOs or impmves ihereon
ano wno contracis br sucn pmie[�s witn a coniractorls) I¢ense pursuant to ine Coniractars State L¢ense Law),I am aware
I�at pmal ol their Worker'S Campensatmn Inmrance shoultl be pmvi�etl to me.
� I am exempt undei Seclion: B. 8 P. C.
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I N D I V I D U A L F E E B R E A K D O W N
lor iMs reason: 'TYPE
� Date: Owner. ELE
I do here�y ceriily I�al I am aware ol antl unEerSiand I�e requiremenls ol Calilomia Heatlh antl Salely Code Se[Iians 25505, 25533, antl ELE
2553a and thal I or any lumre buiiaing occuoam willlwill nm (circle one) neee m com0ly vniA saiA s�a�e cotles antl �ne repuirements for a
permit for consimclion or motlilication Irom I�e Air Oualily Manapement Ois�ric�. flesiGen�ial con5tmciion applicaiions are exempl Imm
ihese pwvisions.
Date: NppliCanP.
I nereUy cer�i�yl�ail have rea01hi5 aOPlicaiion antl staie ihai Ihe abaveinformationis correci. IaAreeio camply wilh allciiy ana counry
ordinances an� slate laws iela�ing to Duilaing cansimclion and here�y auihorift re0�esentatives ol iN5 city to enter upon t�e above-menlione0
propeny Iorins0'/�"-��o� uu�poses. /
�/�7 � Signamre:
� � �
nver s �icense or Saia� Securi�y
t6at a6 Wni�e—BwlOing; Green—Cooe En�o¢emen�; Canary—Applicam; Pink—Revenue: GOltlenroE—Assessor
QTY D E S C R I P T I O N
6 FIX'fURES, LIGHTING 1 ST 20
8 RECEPT/OUTLET 1 ST 20
END OF FEES
UNIT COST TOTAL COST
EA. .75 4.50
EA. .75 6.00
oi o017�2�3-0o173?E3 3"+� T 25.5�
Da7E: 12/22/s4 rInE: 1�;1:3
CONSTRUCTION ANp PLANNING i �` ` SP'�' �
PPPROVALS Permit # - Date �nspector qPpROVALS Permit � Date Inspector
7, Temporary Electrical Service dr Poie � �' 52. Pool & Equipment Location
2. Soil Pipe�Undrgmd. ., � 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms �
4. E�ectrical Conduit�Undrgrnd: ' S5. ElecVical 8onding '
5. Steel Relnforcement 56. Rou9h Plumhing & Pressure Tesi
6. Eiectncai UFER Gmd. 57. APPROVAI TO COVER�GUMTE
7. Footings 58. Electrical Conduit�Undrgmd.
8. Foundation • � 59. Gas Pipe, � Undrgrnd., Test .
9. NJater P�pe�Undrgmd. �� 60. Backwash Lines, P-Trap, C Undrgmd. �
10. Structurat Floor Sys[em I 61. APPROVAL TO DECK '•
17. Prope�.v Sewer line & House;Connection r 62. Backwash & Receptor�F�n;l "
12. Sewer Cap � 63. Heater & Vent�FinaY
73. Roof Orains 64. Plumbing System � Final �
74. Rough Plumbing 65. Electrical•Final '
15. Rough Electrical-Condu�t /� 66. Solar SVstem-Final
16. Rough Electric Wiring /-6�� /�-' 67. Fencing & Access AnProval
17. Rough Wiring Sign r 68. APPROVED FOR P�qSTERING
78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEA•iS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REnUIREMENT
20. Rough Factory Fireplace APPROVALS Permit �
21. DuCts, in Strutture 70. Under9round Hydro
22. Ducts, Ventilating 71. Produc[ Piping OGas ❑Oi�
23. Gas PiPe�Rough & Tesc 72. Underground Flush
24. Roof Framing 73. Undergrnd. Siorage Tank O Gas ❑ Oii
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceding �Structurall & Monocoat 75. Dry Chemicai
27. Frame and FVashinq 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM PINAL
29. Insulation 78, FIRE PREV. FINAL
30. Drywa�l Nailing HEALTH DEPT. REQUIREMENT
31. Plaster BroKm Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal I J 0. FOOD CERTIFICATE ISSUED
33. FinalElectric . yH11Q�/{��,,,�Notes:
od� l �v � L
34. Final Heating & Air Conditioning �.
35. Final Gas PiDe-Test
36. Hood or Canopy .,
37. Final Factory Fireplace
38. Flna{ Piumbing
39. Water Service�Final
40. Gas Service�Final
41. Solar pomestic-Final
42. Backflow Preventer �
43. Backflow Irrigation
44. Land5�aoe Irriyation SYstem
45. Sound Aitenuation
46. HandicaP Regulations '
47. FINAL STRUCTURE & BUILDiNG
48. FINAL PIANNING -
49. Electric Release to Edison �.
50. Gas Refease to Southern California Gas Co ��
51. CER7IFICATE OF OCCUPANCY
No. Date
GENERAL CONT
A�
or
SEcel
c
BUILDING PERMIT
DESCE2PP7'iON OF WORK
FIRE ZONE VA
IGROUP TkT TYP
SUBCONTRACTOR
Tr.5493
Lot �s C 25243
COSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOZ 017 C09TA MEBA, CALIFORNIA
For Appllcan► to Fill In Completely
TYPE OR PRINT
ADD E'S9 2028 Phalaro e Court
COSTA MESA, CALIFORNIA
owNeR �mba Subdividers ' Inc.
MAIL 2850 Mesa Verde Drive
ADDRb98
c�n Costa Mesa Calif.T,o`549-039
oe TENEHR K1ltenbaCh rTio`.547-804
87318 N`o`.' 549-0395
6cJ X 10cJ I no.ore�noa0
NOW ON LDT
9ETBACK LIN[ INOM C/�
nvv+vensat��eT .)ll RR�RV�RIl26.75
� U860F
EFf 7 I RIOHT $
DESCRIPTION OF WORK
N6 2404 on�nva 11 crne�ra �+
,_5"L
I H6H6BY ACKNOWL8O08 TNAT 1 HAV6 ReAD THIB APPLICATION
AND BTATE THAT TXe ABOVH 18 COHqeCT �NO �GHHH TO COM.
PLY WITH �Ll C�TY OPD�NAHCiH ANO 9T�T{ LAW/ N[OULATING
OUIL�INO CON9TRURION. /^/
610NATUREOP i�_�_ �//"%�
� AUTHORIZBD
��rv o� ��sr� r�Esa
APPLIC�I�J ZOR��R
BUILDING
For Office Use Qa1Y
au��oiNo
ZONING
_ / NO.Of t1060PNHW ` `QI
PLANB a BU�LDIIIO� � �,./.G
lt
ii.,ioH �6.�i 7� - ,�i�2��t 5
NO. ��
': NOEAVEOVERHAN68HALLBELE83THAN
YARDSAPPROVEO
MAIN BUILDIN6 ,
DI6TANCE BET.
MAIN BLD68.
VAR. it
(U. B. C. REOUIREMENT'.
YARDSAPPROVED
ACCESSORY BUILDINO
DATE
TN8 AMOUNT BMOWN UNDBP VALUATION IB POH TH8
PtIpP088 OR 88TABL19HINO A PBpMIT P8H ONLY.
VALUATION �fJ �� .
PERMIT FEE $
$7j�� %�� � E� �'7
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