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Home My WebLink About101 PINON TREE LN - Building Permits(714) 754-5273 " Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 101 PINON TREE LN Status: ISSUED Suite: Applied: 04/29/2002 Vicinity: 101 AND 103 PINION TREE Issued: 04/29/2002 Parcel Number: 43917201 Zoning: R3 R3 Applicant: MC COLLISTER, ELISE ISSUED BY: Address: 28816 CONEJO VIEW , Phone: 818-735-7876 AGOURA HILL, CA Zip: 91301 Owner: LAUREL POINT TOWN HOMES Address ,ASSN NEWPORT BEACH, CA Phone: 4631 TELLER AVE SUITE 130 Zip: 92660 Contractor: PRO -TECH WEATHERPROOFING Address:, 23261 DEL LAGO STE 5 Phone: (949) 583-1858 LAGUNA HILLS, CA Zip: 92653-1330 License: 620476 Arch.: Eng: - Address: - - Address:. Phone: Phone: Zip: License: License: SCOPE OF PERMIT REROOF 101 AND 103 PINON TREE (LAUREL POINT HOA): T/O EXISTING SHAKE ROOF, SHTG PER MFGR SPECS, 1 LAYER 30# FELT, APPLY "GAF GRAND SEQUOIA" SHINGLES. 25 SQUARES FEE SUMMARY Plan Check: $0.00 Calc Valuation: $5,300.00 Permit: $125.25 Claim Valuation: $5,300.00 SMTP Res: $0.53 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $125.78 _ •_ SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 NOTES: PLANNING & ZONING Left 0-0 Right 0-0 Left 0-0 Right 0-0 Proposed: 0 , NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. W-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 must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zub•oe (MO) DECLARA ONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: - ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for lhePerfortnence of the rk for which this permit Is issued. ) have and will maintain workers' compensallon Insurance, as required by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' com+rrnnensat,ipn Insurance carder an tl policy nI Carrier: 'l-enQ- C 0yKa.ak5at . umber are: Polity Number: 313 (This section need not be completed if ihe permit is valued at one hundred dollars (3100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of lifomia, and a re hotilH become to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these ns. Applicant Signature: Date: 0 z_ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO -1 -ARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code and my license is in full farce and effect. Lic. e CO 20 Lo 4 Class x C 39, %3, C . Contractors Signature: Y/ Date: —1`_201 CONSTRUCTION LENDING LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the 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 property who builds or Improves thereon, and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivels License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more feet in depth into which a person is required to descend, will be made In connection with work authorized by this permit, and that no building structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Administrative Code). ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during A reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ......................................-........................ ............................................................................................................................................... ................................... ... ......................... ..................................... .... _.............. __............. _................ _............ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). ........................................................................................................................................................................................................................................................................................................................................................................................... 3 Does or will theappplicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ Pl0 (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .._................_..............................ntly............................................................................................._.....e-alith............._...............die.....ae..._................................................................-...-O--No- ....-............................................_......................... 4 If an RMPP is presently required, has Section 25534 of the California Health antl Safety Cotle been fulty complied with? ❑Yes ❑ No 5 Does or will the applicant oru present or futureManagement building occupant require for the work which is the subject c this a plication a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency' � Yes � No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ......................................................................................................................................................................................................................................................................................... ...................... 8 Will an facility p ... ............................... ................ y pan of the facili to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (If 'yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ............................................................................................................ ....................................................................................................... ................................................................................................ .............. ..._.............. ._................................. _.. 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..................................................................... ............. ......................... ............................ ...... ..................................... ............................... ......................................................................................................................................... ............... _................. 8 (II yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to Occupy or allow occupancy of any building authorized by this permit until final inspection. ignature 0la nar(5n ^qDateO- i IF And/Or Authorized Applicant G Data CODE Y. INSPECTIONTYPE RAM INITHALS CODE# INSPECTION TYPE PATE Ifs 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final q 208 Final Plumbing 200 Final Re -Root (-f%Z 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition.. 250 Final Building/Occupancy PROJECT ADDRESS: 101 P I NON` TREt LN 19 P UNIT: OWNERS NAME: PETERSON, WILLIAM D / ADDRESS: PETERSON, CAROL J . 101 PINONTREE LN COSTA MESA CA 92627 714)631-73A3 ARCHIENGINEER: ANDY PARK ARCH. G ASSOC. REG.NO.: C-13967 ADDRESS: 9681 GARDEN GROVE UNIT: 201 I GARDEN GROVE CA 92644 ^9 PERMITTEE: UNITED CONSTRUCTION (714)534-3307 ADDRESS: 9931 CENTRAL 1 13 1 GARDEN GROVE CA 92644 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and elect. CITY LIC.: 060642 STATE uc.:6529666 /J CLASS: B Date: �Shen hereby ce ORNERS' COMPENSATION DECLARATION: hereby affirm that I have a cin nate of consent to Sethi sure or a cend¢ate of Workers' Compensation kis rlili py thereof (Section 3800. Lab POLICY NO.: 1�4 0 %T —1 EXP. DATE: 64/01 /94 COMPANY: STATE FUND J Certified copy is finery furnished.) M Certified copy is filed with the city Building ivis!on. ////J� Applicant: �T l\�/�.G(�J EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need notAcompleted it the permit is for one hundred ($100) on less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject to the WorkersCompensation provisions of the Labor Codeyou must lonhwith comply with such provisions or thus permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Cie C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prier to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Oivision 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 70.31.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the property, or my endlayers in wages as their sole compensation, will do the work, and the Elstructure is not intended or offered for sale (Section 7044. Business and Professional Code: The Contractors' Stale License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herselt or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sola within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7644, Business ❑ and Professions Code: The Contractors State License Law does not apply to an owner of proged who builds or improves thereon and who contracts to; such projects with a comracmr(s) license pursuant to the Contractors' $late License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: 6. & P. C. lot this reason: Dale. Owner: I do hereby Canty that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any Injure building occupant wilNwill not (circle one) need to comply with said state codes and Ire requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Dale: Applicant: I hereby certify that I have read this application and state that the above information is correct. l agree to comply with all city and county ordinances and state laws relating to building construction and hereby aul ooze presenounds of this city to enter upon the ab mentioned property for inspection purposes. Date: 1 Signature: Driver's License or Social ecunty n: 164146 Whine—Building Green—Code Enforcement, Canary—Applicant Pmk—Revenue: Goldenrod—Aeseesor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 06539 PERMIT NO: P 065398 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION : EXPAND KITCHEN AREA BY 42SF SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF: B-65253 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 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: 43917233 ZNE: REF NO: PLANNING N TES> T I O.N UNIT COST > PLU kMMM M MMM MMM M M M kM MMMMMk kMM kkk kM kkk kM k k k M k MMM M M Mk kk kk kkMkM M M kM M MMkM k k k M M M k MM kkM Mk 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: 7.00 p 'LJ APPLICATION ISSUED BY: DATE: 12, I3 k kkkMkkkkMkkkkMMkikkkkk kMkMMMMitMM Mk it Mik it It k it iF kik it ik it itk kit itM ik it it M it it kiFM itkMkkkkkkMkkkkkMMMMkMMkkkkMMMkMMMMkMkkkMMMMMMkkkMMM 1 LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 28.00 25% SMIP/NON—RES PLAN ISSUE FEE 20.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 28.00 20.00 -0,00 48.00 48.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 48.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 48.00 it it Mit itMMMMMMkkkkkMitMMMMMkkkkkkkkkkMMkMMMMMMMMMkMkkkkMkMMMMkMkkMMMMMMMkkMkkkkMkMk 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 PLU 1 DISHWASHER 7.00 7.00 PLU 1 SINK KITCHEN 7,00 7.00 PLU 1 GAS kE—PIPE 7.00 7,00 PLU 1 WATER RE—PIPE 7,00 7,00 END OF FEES 01 00152-:,:—,rQyti?.` T0 It CONSTRUCTION AND PLANNING PL ' &SPA i APPROVALS Permit ;; Date Inspector APPROVALS Permit Date Inspector ! 1. Temporary Electrical Ser%ce Yr Polev 52. Pool & Equipment Location 2_ 50^ Pi pe-Ugd.�Srnd. "L 53. Steel Reinforcement 3 lru� z` Ea l yl tiIity-b,drgr td?' 54. Forms +-=9 LIa "..ca I -El r2iTart tl3ndrgr n . - 55. Electrical Bonding 56. Rough Plumbing & Pres,ure Test -• 6. E1r4ir..carX1.F -Cnd to 57. APPROVAL TO COVER GUNITE t ! _1 7r' 58. Electrical Concu,T Undr Grnd. 1 r J I ---- :'FyurdatioP J 59. Gas Pipe, a lJr.,;rp•..d T•,c ," 70 --water Frp' UrWrgrnd. 60. Backwash Lines, P Trep, F, Lr0•emd T- • T0. Strucnnnl Floor System .J 61. APPROVAL TO DL CK 11. Prolbert.9 Sevier Li6e & Heuse Connection Fi.:.•! 62. Bacfc,.ash & Pecapl-:T. ! 12. Se�V'6 Cap 63. Heater & Vent -Fir,.' 13. Roof Dlaintr•. 64. Plumbing System _Fin.tl 14. Rough PluriiD�g 15. Rough' lectriial-Conduit 3 122�e�3 �-" ✓ely,!>- CJI 65, Electrical-Firal 66. Solar System -Fina' 67. Fencing & Access Appro.Il ---- - - - _ -- 16. Rough lectrit k%firing ----- 17. Rough l^JLing5ign 68. APPROVEOFOR ?'LPSTER'.�,G 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL FIRE DEPT. REQUIREMENT � 19. Rough Heating & Air Conditioning 207.Railgh Factt�y Eireplace . 0"•'1 if � r_% Z, l-`* t iAPPR-Q=:pD0 PdTinit , -.--rte, r^ :�.♦ 21 Duc?s, i» uCt}�{� ' '.' -' �{,�t'-5'�S`��\,'�iTl-__tri��-_ _y St 70. 4Jnderg any {gd u 22. Dw^.s,lrentllaiing� - +•� •� 71. Produping �-,A Ic , Oil -- 23;.Ga Pi a -Rod h $ Test a�py �(� g i N- �.z ,,R7 <- 2. Undergr&pt d F ,;5 tx. � 4. •. _ 2"Rdmf FYamirx� + : :71 ,.' y 7hli? Und ergrnd. Storjyy T;:•'X ='Gas 25. Rapt St:eathinq „ m r r '� 71� Overhead Hydrr 7`7 Dry Chemical �'� x " O dct•v= 26. T -Par Ceiling (Sttucturatl &-Altinocoat t .r,t '• 27,;Frahih _me d Flas{ ?jr : `P ; r .-, * r- .^. x x -i�'^ .r•:'a ` = to Nom_ '•`'' 7br Dry StarY>!r'�tPe 1-1 !28. L"rltinc:-& Siding- r :a -7< -r :: .. i- t 77: FIXED S�" TET,-4INA[ `L 29. Insula',n -. 7I9EF9EV Fsfn: :> �f[-� - -- -'.- - 30. Drywalt,Nailing r �. f: c -" •_ �• KEALTLti DEPT. REQUIREMBLH" 7d."' II'vAL IAS-15ECTtPN 11 " r' I 31. Plasterigro%vn Coat -- i �, t,, 31-ElectricAl Power Meter Fina; t 807 FOOD CERTIFLrCATE 195UED L _33- Finial Electric '� „T I e t'' I I t t Nies: i2 -,.7-1Y m 34:: FII FZ,jati &Ai[ wditipri3ng .� a. .. •+ S C - - I- ;l^, T. // i 35;; Fi^.al Gats Pfpe•Tesf ,tet^ • f* ��/^/{, Ho' or Canopy r - : rt a - y36: ,od » t s , g CIO x to r�37�Fihal FgiFtory Flreplacg, F'• �. Z�.S�,f fit. �. - -Jr " - 38. Fi, to PiumbinP. 39. We"r Service-Fina4 T H -i •i 4,r 40. Gas Service-Finat j :r; ,t,m �� -41. Solar Oomestic.Finat-: •• . •_.. n ¢:.> : > 42,.'Backflow Preventej ro it N t V R1 43. Backflow Ir otic, �> r F X"44. Landscape jt'rigation Svsterrxi ,., J -r 0, 174-- 45.. Sound Attabuatior. - - - ` i a • -:0 T ' 46„Handi6p R' olatigns- J -47,:FWALSTf,4JCTU:RE&Bk-5LDING 481-';FIF4LPLKNNINC ! i-.� v • : je - •.y Y -A ,49. Electric Release to»Edison I ! t T 50. Gas.Release to So ¢hern CalifQrn a Gas Co t - 0,1 _.-51. CERTIFICATE OF, OCCUP.pR*CY - Rte-" L• r-_ - - -� , No. _- _ Date PROJECT ADDRESS: UNIT: C!NER'S t.4l 101 PINON TREE LN ADDRESS: PETERSON, WILLIAM D PETERSON, CAROL J 101 PINONTREE LN COSTA MESA CA 92627 ARCHIENGINEER: 714)631-73A3 REG.NO.: ADDRESS: ANDY PARK ARCH. 6 ASSOC. C—;mW967 9681 GARDEN GROVE 201 PERMITTEE: GARDEN GROVE CA 92644 ADDRESS: WILLIAM PETERSON (714)631-7383 (('' MNA10 PINON TREE LN p (� (, '7 LICENSED CONTRACT05 OECCAAATION: I hereby affirm that I am licensed und,�Aisigs; C9pler 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self insure or a certificate of Workers' Compensation Insurance, or a certified copy thereat (Section 3800. Lab. C). POLICY NO.: 1 4 7 3 EXP. DATE: ,sM UN/i 4 COMPANY: $ E NDC a VNO �' ❑ Call copy is hereby furnished. ` Certified copy is Bled with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECUBATION: (Tris section need not be comp1fd3Lji permit is for one hundred (5700) or less). I Certify that in the performance of the work for which this permit is ii I anmay anyoursy in any manner so as to become subject to the Workers' Compensation Laws of California. j�� Y ale: 1 4 Signature: T. -----NOTICE: It. after making 16s; declaration, you should become subject to the WorkersCompensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTBUCTIDN LENDING AGENCY: I hereby affirm that there is a construction lending agency for the pertmmance of the work for which this permit is issued (Section 3097, Civ. Cl. _ LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a Civil penally of not more than live hundred dollars (5500). I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to Construct the project (Section 7044, Business and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proal of their Worker's Compensation insurance should be provided Io me, I am exempt under Section: B. S P. C. for (th%is reason: Q Dale: / E Jbn � Owner: if I do hereby certify that I am aware o and understand the requirements of California Health and Safety Code Sections 25505, 25533. and 25534 and that l or any future building occupant wiNwill not (circle one) need to comply with said state Codes and the requirements for a permit lot construction or modification from the An Grady Management District. Residential construction applications are exempt from these provisions. Date: Applicant: 77 I hereby certify that l have read this application and state that the above inform is cor cl. l a -ft to comply with all city and county ordinances and stale laws relating to building construction hereby au azer as aliv sol this cif men rupon the above mentioned Drop er)/Y for in puQrposes. Da /Q�! Signature. Drivers License or Social Security #: 1641-46 While—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldearon—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06576 PERMIT NO: E 065768 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION ; EXPAND KITCHEN AREA BY 42SF SQ FT: ::LAIM VALUE: CALL—VALUE: GROUP OCC: R-3 / -OMMENTS: AEF: B-65253, REF. E-65397 PERMIT IS PULLED BY OWNER IE IE 1e if * 1E iF 1e * iE it k k k ii 1E iE 9E fE ft fF fE iE aE fE 1F ff * 1E if 1t if ik 1E iE iE JE iB iE iE iE * * * ie 1E iE ie iE iE aE iE JF 1E ie Jk iE * lF 9E fE * IE 1e 1E if iE iE lE iE iE iF ie if iE ie 1E iE iF Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 43917233 ZNE: REF NO: PLANNING N TES> > IE*BE iE 49E aE 9E iE***7E iE*9E iF iE iF lE iE if'lElEif*lf 1E fE*ielE iE ie it iE if if**iE******iE*%4f***iE il'iF iF iF iE iE K JF***iE 9F JF if iE iF iE K iF iF iE lE ie D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: �APPLICATION ISSU+EBD*BY: �TB3FiF 3FiF�iFiF�F+�i�3FiFiF� +F�7FiF�FTE�3F3FiF3FiFiF*+t�E EDATE: ** aE 1E iE iE*iE aE iE 1E 1E iE 9E iE iE*lt ie%fE iE iE lF iE iliElf lE YE iE iE kE aF 9F iE k6 iE iF MiE 1E iE 1F*iE BF iF iE if**1f*4iE 1F iE 1E iE ie iF ie iF if iE iF *iF lE iE fE iE ie *iF iF ie iB LEGALIZATION:N F E E J S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING 'ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 3.00 50% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 3.00 15,00 0.00 18.00 18.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 18.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 18.00 *iE iE MtE BE iElE iE fE iE fe*iF 1F tE It ie iE iE 1Elf iE fE if lE iE ie**1E aE 1E*1e 1ElE iF iE iF**iE 1ElE iF BF RiE*fEk 9EeflE lE iF iE ik*if fE ae***iF iF ak if iE iE ie iE if if klE lE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY ELE 3 ELE 1 D E S C R I P T I O N FIXTURES, LIGHTING 1 ST 20 RECEPT/SWITCH I ST 20 END OF FEES UNIT COST TOTAL COST EA. ,75 2.75 01 0015.C")-003.54021! Ts --QT 18.0c) ATE: 0. L7P94rine: 14:3 POOL & SPA CONSTRUCTION AND PLANNING I - Date Inspector Date Impactor I APPROVALS Permit APPROVALS Permit ;,= - Ternpc ary Electrical Srrvice or Pole 52. Pcol & EGuIpment lucat.u,, 2. So:! Roe Undrgrnd. 53. Stead Reinforcement 3Cu«t;', J'1:tv. Unr,d'-d; i. 54. P,il- 4 Flecin Col Condu:t.Undrgrrd 55. Electrical Bonding - I I_ --- .. '...• `orr_ment 58. Ro- ,,i Pluir,hing & Pressurc Test- -I CFE. ,.r: y 57. QPPpCVr•I- TO COVFR GUNITE ' i_ root rn^-56. E', cct': cai CordutLr d,g: nil. F ca: :.: Lnd,F;•,..f —c.,t --j -- r ----'--I 9 ';,..ter PIna-Undrgrnd. 60. Bockwash Lines, P -Trap, ' Und'grn11 , -- _— I 10. S:•..et•r:.' F!aor SYstern - �. I Gl. A?P^^,OVAL TODECK i 11, Propc'!y `ewar Line & House Conneethon I 62. 61c6yre5h & Reca Final .2 f----�- —�---I -- - -- ------I H r & \'.nGF'ra L ^s V n c av,g c!Vem f n. I 65_ E".ct, ica! Fi"al-- 15 'in.;l S.�ct-,uI-Cend r, ,1 Sol;., System Pinel I I 6. flo..gh rie[Irc 1Virinq / / n' Fenc, ig & Access Approv.il ' "ng 5gn GB. APFROVC^ cOR I': ASTERIXG tFl. ;r- !'1 L'cctric . T Bar C,,I.ro - — _ -� 60. POO. /SPA 3YS7E:.'.S F'NAL ----- R .. '-at1^gr"". .Ar C:•..•ol.,c FIRE DEPT. RrUU'IHE.',:LUI" P•rory ,r �— � � rl'PRO ;/.4L5 Permit F22 I_' ,r 'o Strt Ct U! �- :'0, l,'•rcl,:p of:,J o '.Hyd. D;�.. 1:,cti'aT,rn ,�— —�i'' P,,. '._t G .O 23. I> >,r. 1t0yh E -- --- — -- —y--, U' •oro �n1 -- ---�------i-- 25 5o Y,- 1hirq %! 0..'rh.. ad Hydrn —� F 7" Pit ♦.e- ding ISt',IzU v ...]1J cod". (`) / I em -Ty 27, rc a Flashn l r— ?3. ;i. 30. :'Ia,ro HPA,LTH JI -FI". REOUIH�'v. : I 32 1 I t [ °o riot r al Ulr > U'L ?T rICATi i .4LE0� ,1 G'I ^❑ T _. _ _ _ _, - -�u _I at ter Sr'vlca-Fi ial I LZ �,2. LIcMjo;. Preranter -- — �`. lardsca Fe Irrigation Sy'Icm 47. t'i.A_ cT-,V.;CT LRE F. 3U!Di NGr4C F'NAL P1 ANNING !_ -- -- -- _ - --- - - --i 4S Cr.c Refecsc to Edison 30 (,L; 1;_I_ se to o,,,Fr rn Cai-fv-a,a Gas Ca 51. CER7IFCA TIE OF OCCUPA'ICY \o _ Oate - - - ---- PROJECT ADDRESS: 101 PINON TREE LN UNIT: 0PNER'S all PETERSON, WILLIAM D ADDRESS: PETERSON, CAROL J 101 PINONTREE LN COSTA MESA, CA 92627 714)631-7383 ARCMIENGINEER: ANDY PARK ARCH. 6 ASSOC, REG.ND.: C-13967 ADDRESS: 9681 GARDEN GROVE UNIT: 201 GARDEN GROVE CA 92644 PERMITTEE: UNITED CONSTRUCTION (714)534-3307 ADDRESS: 9931 CENTRAL 13 GARDEN GROVE CA 92644 LICENSED CONTRACTOR DECLARATION: I hereby affirm flat I am licensed under provisions of Chapter 9 (commencing with Section 76D01 at Division 3 of the Business and Professions Cotle, and my license is in full force and effect. y 060 4 STATE LIc.:652966 CLASS:B Dat / /a 17�Signature. ERS' COMPENSATION ECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' ompensalion n rkaooc r rtifi �o thereof (Section 3800. Lab. ) POLICY NO.: �7��—�SopY EXP. DATE: 4/O1/94 co r: STATE FUND e m d copy is Copy furnished. Certified copy is filed with the city Building Division. Applicant: R MWORI(E S' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Dale: Signature: NOTICE: Ifalter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ C). , LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish. or repair any structure, prior to its issuance. also requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7001) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mare than five hundred dollars (5500). I. as owner of the property or my employees with wages as their sole compensation. will do the work. and the ❑ structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for sale. It, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 11 and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am eeempt under Section. B. 8 P. C. for this reason: Date: Owner'. 1 do hereby cendy that I am aware of antl understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any Injure building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Drafty Management District. Residential construction applications are exempt Iron these provisions. Date. Applicant I hereby cendy that I have read this application and slate that the above information is correct. I agree to comply with all city and county tlmances ono slate laws relating to builtling consiructmn and hereby authorize representatives of this city to enter upon the above mentioned pr erfy for in peetion rpases. Signature Drivers License or Social Security a. 1641-46 White—Building', Green—Code Enforcemenn, Canary—Applicant, Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06570 PERMIT NO: E 065707 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION ; ADDITIONAL FIXTURES SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF: E-65397 6 B-65253 9E fE *+t lE iE if it lF * 1F if OE if 1E 4E 1f iF Of 1E iE iE lE ii if iE iE 1f iE lE 1F 1E 1E 1E iE 1E 1F iF iE if iE if if iE BF if if BE 7F if !E iE if iF iE 9f iE 1E 1E iE if iE 4E iE 4E iE of 9E iE 1F if iE iE lE 1E iE iE iE iE Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 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: 43917233 ZNE: REF NO: PLANNING NOTES> 12.00 fE ff if of 1f * fE 1E 1F lE lE 4 k if fF 1E iE 1E aE iE if 1F iE fE iE jE aE iE lF 4E if 1E lE if if iE if iE if ff if iE'lf if > I N D I V I D U A L F E E B R E A K D O W N iE if k * iE BE if if if 1E * if iE if !t 1E iE * if !E if iE 1E fE lE fE iE iE of ff k iE iE 1E 1f iE iE if 1E iE 1E iE 1E if iE iE iE iE of 1E iE 1E iE iF 1f 1F lE if 9E 1f 1E iE iE iE of 1f iE 1E if iE Bf if 1E iE 1E if if if iE D E V E L O P M E N T S ER 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: 1 APPLICATION ISSUED BY: i DATE: if ifiFfEiE1E1EiEiE1E1EOEiE1EiElEifiEiEiEfEfEiF3FiF3FifiFif�fiFiFiF�iF TF 3F� i€1FiF3FiF3F3FTF�FiFifiFiFiEfE1flEifiFfElFaEaE iEiE iEiE'lfiEiElEiEiflEfElEiElffElElEiEiEiEiEfEaEiEiEiEiElEaEiEiEJf*iEiE1flEfEfEif+tiEitiEiEiFifiEifiFiEeElfifiElEfEiEaEffiEeFlElEiEiEiEiEiEifif Elf 9ElEjEiElf*if LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 7,50 50Y SMIP/NON—RES PLAN ISSUE FEE 4,50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 7,50 4,50 0,00 12,00 12,00 ,00 REVENUE DIVISION TOTALS—> COLLECTED: 12,00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 12.00 fE ff if of 1f * fE 1E 1F lE lE 4 k if fF 1E iE 1E aE iE if 1F iE fE iE jE aE iE lF 4E if 1E lE if if iE if iE if ff if iE'lf if it if if of * k * ff 1E fE 1E Jf if iE *!E 1E if 1i OF jE 1E fE fE iE fE eE lE lE 1E 1E 1F iE'1E iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY ELE 3 ELE 3 ELE 4 D E S C R I P T I O N FIXTURES, LIGHTING 1 ST 20 RECEPT/OUTLET 1 ST 20 RECEPT/SWITCH 1 ST 20 END OF FEES UNIT COST TOTAL COST EA, 75 2,25 EA, ,75 2,25 EA, ,75 3.00 01 00153719•-00153719 T O -r 12.00 DATE: 01/17;'9; TIME: 13:55 CONSTRUCTION AND PLANNING POOL & SPA T f "APPROVALS Permit-;r Date Inspector APPROVALS Permit Date Inspector . Temporary Electr,cai Service or �7!c 52. Pool & Equ'pment Locaoon 2, Soil Pipe Undcgrnd- .J'- 53. Steel Relnfcrcerne,t 3. Elcctrica' Conduit GtilitY.GDGrgrn]. 54. roans 4. Electrical Conduit-Undrgrnd: 55. Electrical Bonding { 5.'Sjeel ReWorcement 56. Rough Plumb-ung & Pressure Test 6 Electrical UFER Gr nd. 57. APPROVAL TO COVER-Gl,'MiTE l }- 7..Fact, ngs 58. Electrical Conduit Ur di-imd r I fi r 8. Foundation '' 59. Gas Pipe, E, UrUpe,i d ,'r j 60. Bzrk•vash L'ne-,,P-'rap 9. \rale, Pipe-Undrgrnd, - 10. Structural Floor System 61. APPROVAL TO DECK --- 11. Property Sewer Line & House Connection - 62. Backr,ash & RaceptcrF,nal 12. Sewer Cap-63. Heater &Vent-Final 13. Roof Drains' I ' 64. Plumbing System Final ' 14. Rough Plumbing 65. Electrical-F'^al 15. Rough Electrical-Conduit6. Solar System-Fin„. 16, Rough ElectrictA+ring j I ,, 67 Fencing & Accass Anu•o,j' 17. Rough Mang Sign 68. APPROVED FOR PLASTERlt.G 18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTE„1S FINAL - 19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT APPROVALS P-rnut --- - - 20. Rough Factory Fireplace 21.: Ddc's, in Strycture ^- i 70. Undergfound liyu•a -- -�I----I} 22 Dints, Vzntilating` 71. Product P,ping 1, G•aC,' I 72. Under9rou" lust 23.-Gas Pipe Rough & Test _ I r----, --- 2425. Roof Framing 73. Undergmd.Sir_:..r i -_ :_Ga, 7 74. Overhead Hy. ;' ---_-�--- - - 75. Dry Cherr,ical _ Root Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27..; Frame and Flashing 76. Dry StarilCf..pe - 77. FIXEDSYSTc FINAi- -- --- -- 28 Lal�ng&S.ding -�---- -- - 29. lmulatDn r- -� I 78. FIREPREV.`i'-,..----- --- j -- -- ----------' -- ----1 -- '30 V^7'.al: Na4hng HEALTH CEP'. ;IEQUIREi-,i'V i ----� -- - f 31. P-asi' 310,m Co-_. 1 79. FIr.AI. ligSnECTIC'. - - -- -� - 18n 32. Electrical Pbvrer %getet-Final ' 000 CERTif-D' ;; F �"Su"D 31 3. Final ETP,ctric - 1g - .aoi�-t -I - _ __ 34. F,'r'. Heating & Air Corri.Uon,nn _ _ _ ___ _ _ ---�' - ----- _ ------ { 35_Fr,31GasPrpe.TesS ------'- -. -- -- - - -- - 30. Hpuo nr Canola --s 37. F. al Fceto-y Fneplace ` 38. F, 'j! Plumbing 39. W'rn?r Service-Final - 40. Gas Service Final _ ---- - -- -- _ -_ -- I - 41. Solar Domestic-Finaf. i�42. 6a Ucflow Preventer 43, B5ckilow Irrigation ------ - 4e, Undscape Irrigation System -- 45 Sound Attenuation - ---- -- --- - - ------ 46.aH ndicap Regulations 47. FINAL STRUCTURE & BUILDING ---. � • j 48. FINAL PLANNING 49. Elecnc Release to Edison , I 50. Gas Release to Southern California Gas Co 51 CERTIFICATE OF OCCUPANCY No. Date I- -_ - i PROJECT ADDRESS: 101 P I NON TREE LN UNIT: OWNER'S NAME: PETERSON,TWILLIAM D AD04SS: PETERSON, CAROL J 101 PINONTREE LN COSTA MESA CA 92627 714)631-73A3 ARCHIENGINEER: ANDY PARK ARCH. 6 ASSOC. REG.NO.: C-13967 ADDRESS: 9651 GARDEN GROVE UNIT: 201 GARDEN GROVE CA 92644 PERMITTEE: UNITED CONSTRUCTION (714)534-3307 ADDRESS: 9931 CENTRAL 13 GARDEN GROVE CA 92644 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000 -'ion 3 0l the Business and Professions Code, and my license is in full force and effect. TruG.:^ 0/642 S/TApTEuc.:652966� CLASS. B i!Ty' �—' yb —( 3 Signature: WORKERS' COMPENSATION DECLARATION: I hereby afirnflhat I have a cent care of consent t Insure ora cenilicate of Workers' Compensation Ytiw,Wc6 6 jcjrtifiel copy thereof (Section 3800, Lab. L)4 / O 1 / 9 4 POLICY NO.: STATE J79VFUNND3,�A EXP. DATE: O nihetl copy is hereby fu/rnis�hed�. L] Certified copy is filed with 1 city Building Oivjsion. Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Ts sectmn need not be completed it the permit is for one hundred (5100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the WorkersCompensation Laws of California. Date: Signature: NOTICE: If, atter making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. '• CONSTRUCTION LENDING AGENCY: I hereby alfirm that there is a construction lending agency for the performance of the work lot which this permit is issued (Section 3097. Civ. Q. LENDER: i ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing win Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered lot sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. Il, however the building or improvement is sold within one year of completion, the owner vdll have the burden of proving he/she did not build or improve for In, purpose of sale), I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who bunds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Ido hereby certify that l am aware of and understand the 25534 and that I or any future building occupant williwill permit for construction or modification from the Air Ouab mese provisions. Owner: requirements of California Health and Safety Code Sections 25505, 25533, and not (circle one)need to Comply with said state codes and the requirements fora ty Management Dlstdot. Residential construction applications are exempt from Date: Applicant: I hereby certify that have read this application and state that the above information is correct. I agree to comply wild all city and county ordinances and slate laws relating to building construction and hereby authorize representatives of In city to enter upon the above mentioned property for inspection purposes. Signature: i Driver's License or Social Security x: 1641-46 White—Building; Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenroo—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06539 PERMIT NO: E 065397 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT J�B DESCRIPTION ; EXPAND KITCHEN AREA BY 42SF SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / COMMENTS: REF: B-65253 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 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: 43917233 ZNE: REF NO: PLANNING NOTES> kk kk k k k k kkk k k k k k k kk k k k kk k k kkkk kk kkk kkkkkkkkkk k kkk kkkkk k k k kkk k k k k kkkkk kk k k k kk kitk 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 o' DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: Z p 13 k kkkkkkkkkkkkkkkkkkkkk kkkkkkkkkk kk k it it if iE it it k it it it it it it i1- k it k it it it i1- itk kkkit kit it k it k it kitkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 6.00 50% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> ' PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 6.00 15.00 0.00 21.00 21.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 21.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 21.00 k kkkiEkkkiE itkkkkkkit it it iEkkkkkiEMkkkkkkkkitkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 3 FIXTURES LIGHTING 1 ST 20 EA. 2.25 ELE 4 RECEPT/OGTLET 1 ST 20 .75 EA. .75 3.00 ELE 1 RECEPT/SWITCH 1 ST 20 EA. .75 .75 END OF FEES 0: Oui.; LO1`.2wi Ta -IT 21.00 0033E 12/20/93 ME: 10;19 ^l' _CONSTRUCTION AND PLANNING POOL & SPA ---, APPROVALS Permit :# ! Date Inspector APPROVALS Permit Date Inspector t, Temporary Electrical Service cr Poly d 52. Pool & Equipment Locat on SotfoUn�t P) r rn tj - 53. Steel Reinforcement 4 '3� •i `�F, H:3-El;ri.r-C�+au:: ^tt.nty-V 54. Forms h'-Z-:GafCcal'C�Yti<t'Indrgrnd. ' ' • 55. Electrical Bonding j r'o1:�oie ;r5 56. Rough Plumbing & Pressure Test .j ' �y+o, Q;E6R`O%rid. 57. APPROVAL TO COVER-GUMTE •' � 1:Fr7.'-`.'.hie:4C,. -1r VP)th� 7•-- ,v 58. Electrical Conduit-Undrgrnd. �•-£`_F�u^s.t,T3J 59. Gas Pipe, O Undrgrnd., Test - rn. 60. Backwash Lines, Trap,C Ur- idrgrrd. 61. APPROVAL TO DECK C. S:. uct-:�J, Floor System .a. J --y 71, P•'Ar5er;er Line & V{eiLsa Cu miectinn 62. Bacle.vash & Recepror-Final 12. S,ii.cr C p o, y �� 63. Heater & Vent -Final 13 Hoot Drainr- 64. Plumbing System Final j s.. a 1 14. Ruug Plunibl g 4 65• Electrical -Final ' 5 P, ".;h c;cct6cal-Gond u.t 116. Sala, System-F,nal 16. Hough fiectnlViring 61 reneing & Access.App,s;al 17. i,uLgh;(:JrgSign 68. APPROVED FOR PLASTERI\G 18. Rough Elect, id_ l -T Bar Ceihng 65%'0 3L/SPA SYSTE;.",S r!NAL 19 luugh L{cating & Air Conditioning ^"`" FIRE DEPT. REQUIREMENT 2Q'Ra ao CictPY F�r4place n'r'" n' APPFT?VA18 :Permit 21;. Dgcts, m SGC:t�re - 11 t. .j 70. Undergr3SUnd H4tlro n 2 C.r�� •. r:?'tcEc!r' S+ a X71. Produr{;� n. �?C„a O,I t `V 23: G.4 ' P '10 gh $�'1 est I s`_ � -, '=( i _ 6r vq 72. UndcrgidSlnrJ F!4. -,h ; r .� > ?1 c'r^, e- -, v • �<,'7 .oh Frem.^.y '7K Fi-+ .•,-' L. ittr '. 7P Undergrri .Storni•: Tar.A Gas (3if- r,z 25 ,...fit P`6eathtng � - s• •, : rt ra 74�, Overhead HydrC; 7g; Dry Cherp4cd " r�' .. •• 26.0T .17ar Ceiling IStnucturall €cSNe r,ocoat T t7 [*1' n zo �, _ 2T,Fra�mu a�.d FIiis 1ig. * _« 7e Dry Stanpi;lve�'-•i- --I, 3.; -- '28. LLI, nadr Sidin3-tr 77'.): FIXED ti r + F SYSTEM FINA+ .... ".. F 29. ,•sus!Rj^ * tr:D tp ; 7U.J FIRE PREV. FIv_?` 7 o. �_ -HEALTI4'DEPT . REMJIREr?�,'T I'�jk'.ECT:ij T 30. D yv-n.Ma0xg x _ .` i ^ �sttrtTro:tn Coa i �31. , _: t'm :0 9 f//1'� yr :n79 t ' ,'FINAL C:*)FOOD CERTiFfGA7t ISSUED` "Nq�es: Ur S- -1 3e 'Eicc:n �! PpyJer RSetFo-Finaii 33�Fi1 E Yctn 4^'a ,S � r. � jc134,nF. & Ait Cofdrticrut3 ^, . j !� > 35''1Fi,Fd1'Ga5 Pii� Ji. t m ---- �T I a36:�Hcsd or Caro PY D i c* a z :: r i .r _ -' f.011 �s _ 4 I. i Y •-• :7-� i .. ., A iii _ ,l - s :-� - r _' 1::37r F,rg F;2tory F:rejVJ&,, ' 'tr a, i- * Y x p I h 38. Final Plumbing r VJ •f•-:'-3 i a if 'i39. 1Va=3r Service -Fina!• -•, y i I# # • ' - c, tMrn l M40. Gas Service -Final � ¢tnb- »- ------------ RF -f- =41. So!ar Comestic-FiriSC: R •• t- G. I I �r �•_, - ^ .. `442c'Backflow Preventei to 43. 0: ckflc.v IrRgatiorY � .X44.Landsfaye5lgdti(dnSystem '-^ ,it _tYA, -moi ''45 Sound Atteuuatio; r,46`, Hard,cfa7y Regulations 47:_FlPtAL STRUCTURE & BLCtLDING 48�''FI sI•IrAL PLA�,NINLY- :49, •Electric Release to'Edison- 5CvGnRelease to Soujhern CalyfQrW Gas Co `51. CEgTIFICATE 05._OCCUPAa7CV No. Date 'P 01 101 P INON TREE LN C �+-•�� UNIT: OWN' E! PETERSON, WILLIAM D cvde, ADDRESS: PETERSON, CAROL J 101 PINONTREE LN COSTA MESA CA 92627 714)631-7393 ARCNfENGINEER: ANDY PARK ARCH, & ASSOC. REG.i C-11967 ADDRESS: 9681 GARDEN GROVE UNIT' 201 GARDEN GROVE CA 92644 PERMITTEE: UNITED CONSTRUCTION (714)534.-3307 ADDRESS: 9931 CENTRAL 13 GARDEN GROVE CA 92644 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full farce and effect. CITY uc.:060642 STATE uc.:652966 Signature'. /! WORKERS' COMPENSATION DEC RATION: I hereby affirm that I have a certificate of consent m self insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICYND.: 1354071-93 EXP. DATE: 04/01/94 COMPANY: STATE FUND 7 Codified copy is hereby furnished. Q Certified copy is filed with the city Building Division. -07:e. �� Applicant.��/�—s_ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not beeed not be c— ompleted it the permit is for one hundred ($100) or less). I cenity that in the performance of the work -for which this permit is issued, I shall not employ any person in any manner so as to became subject to the WorkersCompensation Laws of California. (, Date: Signature NOTICE: It, after making this declaration, you should. become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or mus permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that Imre is a construction lending agency for the performance of the work for which this permit is issued (Section 3097,,Civ. C). / �r LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby alfirm that I am exempt from the Contractors' Stale License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct. alter, improve. demolish, or repair any structure, prior toils issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions o1 the Contractors' State License Law (Chapter 9 (commencing with Section 70010) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I.as owner of the property or my employees with wages as their sole compensation. will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section'. 8. 8 P. C for this reason'. Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I a r comply with all city and county ordinances and state laws relating to budding construction and hereby aulhelps representahv mly to enter upon the above mentioned properly fhr inspection purposes. Signature. Driver's License Or Social Security ir: 164146 White—Building: Green—Code Enforcement; Canary—Applicant Pink—Revenue; Goldenrod—Assfssor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 065253 PLAN CHECK NO: 04748-93 A CONSTRUCTION TYPE: V -N PERMIT TYPE: STR JOB DESCRIPTION : EXPAND KITCHEN AREA BY 42SF PERM NO: B 06525'' GOVT: N SUPP: N PURPOSE: ALT SQ FT: 2,000 CLAIM VALUE: 2,000.00 CALC—VALUE: 2,000.00 GROUP OCC: R-3 / COMMENTS: SOKE DETECTORS ARE REQUIRED AS PER 1991 U.B.C. ############################################################################### Z O N I N G R E Q U I R E M E N T"S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 26 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: 43917233 ZNE: R3 REF NO; PLANNING NiEXPAND EXISTING KITCHEN BY PUSHING IT OUT 5'7" - SURROUNDED > ON ]�OTH SIDES AND THE TOP BY THE SAME UNIT. D E V E L O `P M E N' T S E R V I C E S R E Q U I R E M E N' -T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY-'. DATE: ############################################################################### LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 45.00 50 PLAN 7.31 SMIP/NON-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 45.50 0.00 1 7.31 52.81 52.81 .00 REVENUE DIVISION TOTALS--> COtt,ECTED: 45.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TGT GRADING PLAN -CHECK 45.00 .50 I N D I V I D U A I; 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 2000 ALTER BY VALUE RESIDENTIAL NOZONE 1.00 2,000.00 ,END OF FEES 01 00151963-00151964 Ti WE: 12/05/43 TIME: 14..C4•r 4s,.`.0 CONSTRUCTION AND PLANNING j APPROVALS Permit Date Inspector POC SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location + 2. Soil Pipe-Undrgrnd. I 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. , 55. Electrical Bonding 5. Steel Reinforcement `Z 4IF4v ( 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER GUNITE ' 7, Footings �,Z"�-`3i/ply� 58. Electrical Conduit.Undrgrnd. 8. Foundation /Z- L Q' 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe Undrgrnd. t 60. Backwash Lines, P -Trap, D Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11, P'ope-ty Sevirr Line & House Connection 62. Backwash & Receptor -Final d2. Sewer Cap 63. Heater & Vent -Final -13. Roof Dra,ns 64. Plumbing System Fnal L 14. Rough P:umbm9 65, Electrical -Final 15 Rough Electrical -Conduit I r 16. Rough Electric Wiring 66. Solar System -Final 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping D Gas 0Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank 0 Gas Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceding (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashingl(1 qc f` (Q�� 76. Dry Standpipe 28. Lathing &Siding Z_�? 16C.,4t 77. FIXED SYSTEM FINAL 29. Insulation ( Z6-`V4(WC 4_ 78. FIRE PREY. FINAL 30. Drywall Nailing I-26-'? '1 w4 HEALTH DEPT, REQUIREMENT_ 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 12 2- 34. Final Heating & Air Conditioning 34. 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38, Final Plumbing 39. Water Service -Final 40. Gas Serwce-Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow brig to lon.;�I 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date 723 I_ 0 PROJECT ADDRESS: 101 PINON TREE LN OWNER'S NAME: PETERSON, WILLIAM D ADDRESS: PETERSON CAROL J 101 PINOATREE LN COSTA MESA,CA 92627 ANCN7ENGINEER: ADDRESS: REG.NO.: UNIT: UNIT: PERMITTEE: EEL ELECTRIC (909)674-8765 ADDRESS: 33365 WINDING WY LAKE ELSINORE CA 92530 LICENSED CONTRACTOR DECLARATION: I hereby plump that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Cotle, and my license is in full force and effect. CITY LIC- 11 STATE LIC.: 6 5 8 3 3 6 `LASS: C 0 Date: 10 R:J% iQ2, Signature: 41.5.. WORKERS' COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to set sure) sure ote of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. Q. POLICY 11I EXP. DATE: COMPANY: Cenilied copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the Work for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, r` Date: Signature: � A••�W�%'�� DTICE: It. after making this declaration. you should become subject to the Workers Compensation g9visions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY:{ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code, Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing will Section 701 of Division 3 at the Business and Professions Code) or that he/she is exempt therefrom and the basis lot the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). I, as owner of the property or my employees with wages as their sale compensation, will do the work, and the ❑ structure is not intended or offered for sale(Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselflhersell or through his or her own employees, provided that such improvements are not intended or offered for sate. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale), I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business 1-1andProfessions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' Stale License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: O. S P. C, for this reason: Date: Applicanl: I hereby certify that I have read this application and state that the above information is correct. I agree to ordinances and stale laws relating to building construction and hereby authorize representatives of this city to property for inspection purposes. y/ Dale: J�gSignature. Driver's License o ocial Security x: With all city and county on the above mentioned 164146 While—Building: Goon—Code Enforcement: Canary—Anolil Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06369 PERMIT NO: E 063694 PLAN CHECK NO: N GOVT; N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: OTH JOB DESCRIPTION ; ELECTRICAL WORK FOR 2 SWINGING GATES SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: / COMMENTS: GATES ON SYCAMORE 6 EUCALYPTUS ENTRANCES. FIRE DEPT APPROV PENDIN RE*+t�Ear+E+t�rAE�t*rxAr�tae�r�r**��rx�E�rit**�P�E�t�ErE*�r�r*�tRr�t�r�E�r�r*�r*�r�P*x �P�r�t*�t�E*Se�E�r�E�E�r��r*�Er�E�E�ESr�E*�E�E*St Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: 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: 43917233 ZNE: REF NO: PLANNING N TES> REVENUE DIVISION TOTALS--> COLLECTED: 43,00 OVER/SHORT: .00 BLDG PMT > ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK kkkkkkMkMMMMMilMkMkkkikkkkkkkkkkkkkkkiEkkkkkkkkMkMMkkkMkMkMMMMMkMkkkkkkkkkkkkkkkkk 43.00 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 V I D U A L F E E B R E A K D O W N DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY DATE: 8 uo 1 M kkkkkkkkkkkkkkkMkkMMk kkkkkkkkkM kM k MkkkMMMkMMkkkkkkkkkkkkkkkkkMk kif Mkk HlkkkMkkkkkkkkkkkkkkkkMMkMkkkkMkkkkkkkk LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 28.00 50% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 28.00 15.00 0,00 43,00 43.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 43,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 43.00 k kkkkkkMkMkMMMkkMMMMMkkkkMMMMkkMMkkMMMMMMMMMMMkkkkkkkMkkkkkMMMkkkMkkkkkkkkkkkkk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 2 MOTOR/POWR APPARATUS 0.0 — 1.0 HP 3.00 6,00 ELE 2 MISC CONDUIT NOT LISTED REQ PERMIT 11,00 22.00 END OF FEES 01 00145337-00145937 T CET 43,00 DATE: 08/,:f6i93 TIME: 14:29 CONSTRUCTION AND PLANNING PO( SPA APPROVALS Permit:# Date Jnspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service;or Pole 52. Pool & Equipment Location •� •'� 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Und)grnd. 54. Forms .4, Electrical Conduit-Undrgrndn.-r+' ' I �H_�T'2. I n5. Electrical Bonding ' 5; Steel' Reinforcement' 56. Rough Plumbing & Pressure Test w 6., Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE V! Footings •• 58. Electrical Conduit-Undrgrnd. -8;'Foymdation 59. Gas Pipe, 0 Undrgrnd., Test 9.-Water Pipe-Undrgrnd. 11 ," 60. Backwash Lines, P-Trap, 0 Undrgrnd. 1Q. Structural Floor System 61, APPROVAL TO DECK '• 11. Property Sewer Ling & Hous Connection 62. Backwash & Receptor-Final ut 12. Sewef Cap 63. Heater & Vent-Final 13. Roof Drains '3v 64. Plumbing System - Final nr 14. Rough Plumbing+' 65. Electrical-Final t lv 15. Rough Electrica(�Conduit h 66. Solar System-Final 16. Rough Electriewiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT F. .n' APPROVALS,.' Permit # �' 20. ,Rough ractorp Ftl place i .: ' t '• Str•t ,.. 21.buc;,4 .. � i 70. U,ndergi•ou•n-Hdo 22.•Duce, t%entilatinp: r a+ 71. Product'Piping QGas OOiI y 23. Gas•Pipe•Rough &-rest rn i y2. Underground FIytSJi� 24.• Roof; Framing. E 4 ••i + +' .• O, a -737 Undergrnd. Storagd7fank O Gas 004 25. Roof'Sh ethin '�' C 9 ' x r'' l ; r' vt � - 74r-Overhead Xiydro, a , 26.-T-B�r, Ceiling (Stry ,t ural) &'Monocoat< u v - 75:-.Dry Chemical •'1 , _ 27.- Frame and Flashing.. ' 76� Dr Stand~ipe , 28. Lathing; Sidingti, n� ��y�i, n y,+ 77., FIXED S''YSTEMSFtNAL+ • - %29. Insulatiob �'+: 'D ' ""' ;, 78.• FIRE PREY. FlfSA� 30. Drywall Nailing rj. s , a HEA LT H DEPT, REQUIREMENT 5.31. Plaster Brown Coat; ; 'FINAL IN§yPECTION� . ,79. 32.-Electrica jPovver N(etertFinal i 80. FOOD CERTIFICATE ISSUED y33. Final'Electridd .9 i Not'es:. 34.Final Hgeting-& bk'trrConditiofling,: - - r' •. . -- "" .,_ _ r-;r 35.,�inePGasPipe-Tes1'r,�'y t I �" .••; „ . i•i _:Irit�1 36.' Hood or-Canopy 1 37, Final Factory Fireplace v. - ' '$8. Final Plumbing 39. Water Service-Final- , -40. Gas SerJice-Final 41. Solar Domestic-Final - 42.- Backflow Preventer' �J 4 43. Backflow Irrigation,- ' 44. Landscape il-,rlgafi6f System,,, A5. Sound Attenuation + .r ?46. Handicab Rdgulatiolhs ' '47. FINAL STRUCTURE & BUILDING ti 48. FINAL PLANNING_ ;49.. Electric Release to Edison ,i• -- r 50-. Gas Release to Sou{hern California Gas Co �I - '.51. CERTIFICATE OF+OCCUPANCY No. Date ale 1/\ TRACT NO. 10097 LOT NO. 47 CITY OF COSTA REQUEST FOR OCCUPANCY DATE: January 14, 1980 ,ADDS 101 Pinon Tree Lane, Costa Misa, CA 92627 The developer of the above entitled tract desires to sell the above set forth lot prior to the time that the tract has been obppleted and its streets accepted by the City of Costa Mesa. By executing this agreement, the undersigned acknowledges that he/she/they was/were advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having conplied with the conditions of approval which were imposed by the City at the time the Final Tract Map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condi BS R L SJ L V / V A C T„ BY (SigMUW of Developer and or authorized representative JAN 1 g, 1980 CALIFORN SAVINGS & LOAN ASSOCIATION Ph1 7ia,y,iu,u,u,l,u,�,4,5,s Y (rSignature of. Len Richard X. Gaunt, Assistan ice Presiden r��l��l 4/79