HomeMy WebLinkAbout3441 PLUMERIA PL - Building Permits�f
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CITY OF COSTA MESA
BUILDING DIVISION
77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER: P09-00110
PERMIT TYPE PLUM
APN: 41217315
STATUS:
DATE ISSUED:
ISSUED BY:
ISSUED
08/31/2009
RMD
JOB ADDRESS: 3441 PLUMERIA PL CM Suite/Unit:'
Vicinity: THROUGH OUT HOUSE � � � � � ' � � � . � • _
SCOPE OF WORK: PLUMBING PERMIT:FOR A COPPER REPIPE THROUGH OUT HOUSE TO (E) FIXTURES AND WATER
SERVICE. PLUMBING FIXTURES WILL NOT BE CHANGED OUT. �- � �
OWNER: REYNOLDS, TERRY G� � „ , .
PHONE: 714-751-0056' � . „ -� ,
APPLICANT: EHINGER, GREG � . � � � �
PHONE: 877-547-9001 � � , � �
CONTRACTOR: AMERICAN EAGLE COPPER REPIPING
Address: 979 TROVITA DR � � ., � �
City/State: CORONA,:CA , ZipCode: 92881
ARCHITECT:
ENGINEER:
Address:
-City/State/Zip:
Address:
City/State/zZip:
License No.
License No.
3441 PLUMERIA PL
COSTA MESA, CA -
979 TROVITA DR : �
CORONA,CA �_
License No. 918998
PHONE: 877-547-9001
CELL:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$33.30
$33.30
PHONE:
PHONE:
NO710E: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92) -
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
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 fnal approval will result in the expiration of this permit.
CO�Ep. INSPEC110NTYPE DATE INTITIALS CO�EN INSPECTIONTYPE OATE IN11ML5
1616 Fixed System Final Fire Prevention 206 Final Mechanical p
1266 Pool Spa Final 208 Final Plumbing 1"�`� �__ ��
200 Final Re-Roof 210 Final Electrical
201 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Faclory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy _
WORKERS' COMPENSA710N DECLARATION:
I hereby affirm under penalry of perjury one of the follovnng tleclarations:
❑ I have and will maintain a certificate of consent to selbinsure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
performance of the vrork (or which lhis permit is issued.
[}� I have and will maintain wnrkers compensation insurance, as required by
section 3700 of the Labor Code, for the peAortnance of the work for which this
pertnit is issuetl. My workers' compensation Insurance cartier and policy
number are:
�C�. t,. .S'T/�"?�C Gz....o
arrier:
(Th8 secton neetl not be mmpletetl �the permR is valuetl al one hunpied Collars ($100J a less J
PorlioyNumber: DO� V jj9 S- 2.0�5
❑ I certity [ha[ in ihe peAormance of the vrork (or which [his permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of California, and agree that i/ I should
become subject to [he workers' compensa[ion provisions of Section 3700 of
the Labo Code, I sha o hwith compty with these provisions.
-�- �/ � o i
AppiPanfs gnaWre CDale
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 DOLLARS
($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 aKrm lhat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of ihe Business and Pmfessions Code, and
my license is in full force and ettect.
Li�`c. # Clas�s # � � � �
-�,il;-e�:�" : �%' 3/ � m �
ConVaclo igny re ✓"""'Dale'
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a constructbn lentling agency for the
peAortnance of the work fa wfiich Ihis pertnit is issued. (Sea 3097, Civil Code).
Lender's Name:
Lender's Address:
SignaWre
OWNER-BUILDER DECLARATIONS:
I hereDy aKrm that untler penalty o( perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pro(essions Code: Any ciry or county which requires a permit to
construcl, alter, improve, demolish, or repair any structure, prior to its
issuance, also requires the applicant tor such permit to fle a signed statement
lha[ he or 5he is liCenSetl pUrsuant lo the provisi0n5 Of the Contractors
�icense Law (Chapter 9(commencing with Section 7000) of Division 3 of the
8usiness 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 applicaM to a civil penalty o( not more than
fve hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
compensation, WILL DO THE WORK, antl ihe struclure is nol intended or
oftered for sale (Sec. 7044, Business antl Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
Ihereon, and who does such vrork himself or herself or ihrough his or her ovm
employees, provided that such improvements are not intended or offered for
sale. If, however, ihe builtling 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 lhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044. Business and
Professions Code: The cont2ctors License Law dces not apply to an ovmer of
pmpedy who builds or improves thereon, and who contracls for such project with
a cont2ctw(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business antl Professions Cotle for this reason:
3�5]-O6(JIO))
Ovmer ID venfied by tlriver's license. ❑ Yes ❑ No
Driver's License No. Expires:
Verifcation of Ovmership by (rype of document, i.e. - propetly tax bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby certity thal no excavation fve (5) or more feet in depth into wfiich a
person is required to descend, will be made in connection vnth work authorized
by this pertni[, antl that no building sWCWre, scaffolding, talsework, p demolition
or tlismantling Ihereo(, will be more (han Ihirty-six (36) (eet high. (Chap. 32, Grp
2, M 2, Sec. 341, TUe 8, Cali(ornia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Industrial Safery, as noted above, unless
such person has a permit to do such work from the division.
Applicanfs SgnaWre Date
Division of Indus[rial Safety Permi� Number:
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applican[ or present or fuWre building occupant neetl to fle and
certify a Business Plan for emergency response to release or threatened
release ot a hazartlous material? ❑ Yes ❑ No
(Section 25505 of [he Cali(ornia Heal�h and Sa(ety Code requires, with some
exceptions, that a Business Plan be filetl with [he Costa Mesa Fire
Department by every business which has at any one lime tluring a reported
year a quantiry of hazardous materials equal to or greater than a weight of
500 pounds, or a volume o( 55 gallons, or 200 cubic feet of compressetl gas
at stantlard remperaWre and pressure).
2. Does or will the applicant or present or fuWre building occupant need to fle
a regisiration (ortn for aculey hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Satety Code, with some
exceptions, requires registration wilh the Costa Mesa Fire Department by
each business which at any one time has on hantl a quantity of acutely
hazardous matenals equal to or greater Ihan a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of wmpressed gas at slantlard
temperemre and pressure�.
3. Does or will the applicant or present or future building occupant need to
prepare an RMPP (Risk Management antl Prevention Program for acutely
hazardous ma[erials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Sa(ery Code provides lhat [he
Costa Mesa Fiie Department may require the preparation, certifcation antl
fling with the Fire Department of an RMPP by businesses which are required
to register acutely hazartlous materials with Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 of the California
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of this application a permit for such construction
or modifcation from the South Coast Air �uality Manaqement District or from
any other air polWtion coNrol district or agency? ❑ Yes ❑ No
(Section 658502 of the Califomia Govemment Code requires that the requested
information be fumished on applications for non-resitlential building permits).
6. Will any part of [he facility to be conslructed under this permit be within
1000 feet from Ihe outer boundaries of a school? ❑ Yes ❑ No
Qf'yes", the facility must meet the requirement of Sections 25534 and 42303
Of lhe Cali(omia Health antl Safe[y Cotle).
7. If a permit from the South Coast Air �uality Management District or other
air polWtion control district or agency is required for the work which is the
subject of this application, have all of the tlisclosures prescribed by Califomia
Health and Sa(ety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf "yes", attach certifcate ot compliance from the appropriate air pollution
conirol officer).
CERTIFICATE OF COMPLIANCE: I certi(y that untler penalry of perjury the
information given above is correct. I agree to comply with all state laws and
city ordinances regarding Hazard0u5 Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify untler penalty of perjury that I have read this application and state that
the information given is correcL I agree to comply with all state laws and city
ordinances relating to building consUuction, and authorize representatives of
the Ciry o/ Costa Mesa to enter upon the above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorizetl by this permit until fnal inspection.
- f SignaWreof al ner(s) pate
���
��L.�. S� W3.i o 5
(MdocALlbo�i¢ed'Applicant Date
(714) 754•5273 • Fau (714) 754-4856 • www.ci.costa-mesa.��LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
JobAddress: 3441 PLUMERIAPL
Suite:
Vicinity:
Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Consiruction: V-N
Parcel Number: 41217315 Zoning: R1
Applicant: JOSEPH GILLIS
Address:
Owner: REYNOLDS, TERRY G
Address 3441 PLUMERIA PL - . -
COSTA MESA, CA ��
Contracror _ HOYT ROOFS �� `
Address: �� 1809 N OR4NGETFIORPE PK
ANAHEIM,_CA
�� Zip: -. 92801 <: � .
Arch : �' � �- -
Address:
�.
,. Zip:.. .-..
Phone:
License:
" -Phone:� 714-773-1820
" ZiP:-� ... -
- Phone: . � ..
� � -- Zip:, � 92626 . .
Phone: 714-773-1820 �
License: 606111
Eng: .
Address:
Stalus: ISSUED
Applied: it/14/2005
Issued: 11/14/2005
ISSUED BY: �---'
Phone:
License:
SCOPE OF PERMIT
�T/0FF SHEATH AND REROOF-2400SF RESIDENCE W/COMP SHINLGES , �
. _� FEE �SUMMARY — � ,
�.� Plan Check: ' $0.00 � � s. � �, Calc Valuation: � 5�,500.00
Permit: $153:25 Claim Valuation: 5�,soo.00
SMIP Res: $075_
SMIP Com �$0.00 � � � -
Other , $0.00 ,
' `� Inspection 6 � $0.00 � � � ` � � , �'
Total. � � �$154.00 � � � �� �
PLANNING & ZONING
SETBACKS
MAIN�STRUCTURE �Front ��0-0 Rear 0-0 " Left� 0�0 Right 0-A �
ACCESSORY Front 0- 0�' � �"°:"Rear 0-0 ^' Left ` 0- 0 �� -�Right- - 0- 0 -
PARKING � � �• � Ezistina:�, - � 0 -Reauired. -0 �� , �� �� Pro�osed. '0'�'�, ' _ , � .
� _ . � . � �a_ � , . � . _ `
NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
ragulations. (Ord. No. 92•28, § 1, 12•21•92)
EXPIRATION: This permit shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period ot 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 Inspectlone 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
�
WORKERS' CO'MPENSATION DECLARATION: ' ' . �
I hereby eflirm under penalty of perjury one of the foliowing declarations: � � - �
❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, es provided br by section 3700 oi �he Labor Cotle, for the peAortnance of the
work for which this permit Is issuetl. � , '
� I have antl will maintain workers' compensation InsuBnce, as requiretl by section 3700 ot the Lebor Code, for the perfortnance of t�e work for which this pertnit Is Issuetl.
My workers' compensation Insurance carner antl policy number ere: /� �
Carrier. ,�7i/�-zF �//1J[� / Policy Number: �%�i9!/�Y /
(This sectron need nof be completed i! fhe permit is valued ef one hundred dollars ( 00) or less.) , . ' /
❑ I certify that in ihe Dertormance ot ihe work for which ihis pe�mit is issued, I shall not employ any person in eny manner so as to become subject to the workers'
compensation laws oi Celifornie, antl egree that if I should become subject to ihe wo ers' compensation provislons ot Sectlon 3700 Ihe Labor Code, I shall forthwith
comply with ihese provis' �
Applicant Signam . Date: � �/ ' `� a'S �
WARNINO: FAILURE TO S RE l}�.2 (ERS' COMP �SATION COVERAGE IS UNLAWFOL AND SHALL SU&IECT AN EMPLOVER TO CflIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDFED
THOUSANDDOLLARE 0,000),IM1fADDITIQYTOTHECOSTOFCAMPENSATION,DAMhGESASPROVIDEDFORINSECTION3]O60FTHElABORCAOE,IMEREST,ANDATfORNEY'SFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aflirtn that I am license untler provisions of Chapter 9(commencing with Section 70001of Division 3 of the Business antl Professions Cotle, entl my license Is in tull
� force entl eNect Lic. a / Cless q�=.3 "^7 �
Contractofs SlgnaNre: �� Date: �/ �`/ O t'
i
CONSTRUCTION LE G AGENCY:
❑ I hereby aftirm ihat ihere is a construction lentling agency tor the performance ot the work for which ihis permit is issued. (Sec. 3097, Civil Coda).
Lenders Name: Lenders Adtlress:
SignaWre: Date:
OWNER•BUILDER DECLARATONS:
I hereby aHirtn thet untler penalry oi perlury thet I am EXEMPT FROM THE CON7RAC70RS LICENSE LAW tor the following reason (SecJ031.5, Business end Professlons
Code: Any ciry or counry which requires a pertnit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires tha epplicant for such pertnil
to file a slgned sletement that he or she is Ilcensetl pursuent m ihe provisions of Ihe Contractors License Lew (Chepter 9(commencing with Section 7000) oi Division 3 of the
Business end Professions Code) or Ihet he or she is exempt thereirom and the hesis for the elleged exemption. Any violation of Section 7031.5 by any applicant for e pertnit
subjects the apDliwnt to e civil penalry of not more ihan five hundred doilars ($500).):
❑ I, es owner ot ihe property, or my employees with wages as their sole compensa�ion, WILL DO THE WORK, and Ihe simcNre Is not intendad or oHered for sale (Sec.
7044, Business and Protessions Code: The Coniractors License Law tloes not apD�Y �o an owner of property who builds or improves ihereon, and who tloes such work
himseN or herselt or Ihrough his or her own employees, provided ihat such improvements are not intendetl or oHered for sale. Ii, however, Ihe building or improvement is
sold within one year of completion, ihe owner-builder will hava ihe burden of proving that he or she did not build or imp�ove for purpose of sale.). '
❑ 1, as owner oi the property. am E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS lo wnstruct the proJect (Sec. 7044, Business entl Professions
Code: The contractors Llcense Law tloes not epply to an owner of propehy who builds or Improves thereon, and who conireas lor such project with a contractor(5)
license Dursuant to ihe Coniractors License Laws.).
❑ I am e:empt under sec. Business antl Pmfessions Cotle for this reeson:
Signature: Date:
Ownar ID venfied by dnvets license. ❑ Ves ❑ No Orivets License No. Eapires:
Veritication ot Ownership by (type of document, i.e. - propeny tax bill or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I here6y cerlify Ihat no ezcavation tive (5) or more feet in depth into which a person is required to descenq will be made In wnneciion with work euthonzed by this
permit, and iha� no building simcWre, sceHolding, falsework, or demoli�ion or dismantling ihereot, will be more than thirry-si: (36) feet high. (Chep. 32, Grp 2, Ar12, Sec.
341, Titla B, Calitornia Adminisirative Gode).
❑ As owner-builder, I will not employ anyone to do work which would require e parmit from the Division of Indusinal Safery, as notetl above, unless such person hes e
pertnit �o tlo such work from the division.
Signature:
Division of Industrial Safary Permit Number:
Date:
HAZARDOUS MATERIALS AND EMISSIONS CEP7IFICA710N:
1 W ill the epplicant or present or fuWre builtling occupant neetl to file entl cartity a Business Plan tor emergency response to release or Ihreatened releese ot e hazardous
material7 ❑ Ves -❑ No � � . .,*q
(Section 25505 of the Califomia Health antl Satery Code;requires, with some ezceptions, ihat a Business Plan be file0 with the Costa Mesa Fire Depariment by every
business which has at any ona time during a reported year s quantity of hazardous matenals equel ro or greater than a waight o1500 pountls, or a volume of 55 gallons,
or 200 cubic feet ot compressed gas at standard tempereture antl pressure).
.......................................................................................................................................................................................................................................................................................................................................................................................
2 Does or will the applicant or present or tuture building occupant need to tile e registration form for acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of ihe Galifomia Health antl Safety Gotle, with some exceptions, requires registretion with ihe Costa Mesa Flre Department by each business which a1 any
one tima hes on hantl a quamiry of acutely hezeMous materlals equal to or greater Ihan e welght ot 500 pounds, or e volume ot 55 gellons, or 200 cubic feet of
compressed gas e� stantlartl temperatura antl pressure).
..........................................................................................._...........................................................................................................................................................................................................................................................................................
3 Does or will �he applicant or present or tuWre building occupant need to prepare en RMPP (Risk Manegemant and Pravention Program tor acutely hazerdous materials)?
❑ Ves ❑ No
(Section 25534 ot �he Calitornia Healih and Satety Code provides ihat the Costa Mesa Fire Depanment may require �he preparalion, certifica�ion and filing wi�h ihe Fire
Deperiment of an RMPP by businesses which ere required to register ecutely hazartlous materials with iha Fire Depenmem.
........................................................................................................................................................................................................................................................................................................................................................................................
4 It en RMPP is presently required, has Section 25534 ot the Celifornia Heelth and Safery Code bean lully complied with7 ❑ Yes ❑ No
5 Does or will �he applicenl or present or future building occupant requlre for �he work which is �he sublect ot Ihis a plica�ion e ermil for auch conswction or motlificetlon
irom the South Coasl Air Oualiry Managemen� Oistnct or from eny other eir polWtion contml disMct or eqency? � Yes � No
. (Section 658502 oi the Califomia Government Code requires ihet the requested iniormation be fumished on epplications tor noo-residentiel builtling pertnits).
................. ...................................................................................................................................................................................................................... ...........................................................................................
6 Will any pert of ihe tacility to be constructed under this permit be within 1000 feet irom �he outer boundanes oi a schooll ❑ Yes ❑ No
pf yes", the facility must meet the requlrement of Sections 25534 and 42303 ot the Califomia Healt� antl Satety Code).
........................................................................................................................................................................................................................................................................................................................................................................................
7 If e permit from Ihe South Coast Air Oueliry Menegement Disirict or other eir pollution conirol disirict or egency is requiretl tor Ihe work which is the subject of Ihis
application, have ell of Ihe disclosures prescnbed by Calibmia Healih end Satety Code Section 42303 been made7 ❑ Ves ❑ No
.................................................................................................................................. ........................................................................................................................................................................................................................
8 (tl "yes", attach cenificate oi compliance from the eppropriate air polWlion conirol oHicer).
CERTIFICATE OF COMPLIANCE: I certity thal under penalty oi perlury the infortnation given above is correct. I agree to wmpty with all state lews and ciry ordinances
regartling Hazardous Materials and Emissions.
Signature: Dete:
CER7IFICATE OF COMPLIANCE AND AUTHORVATON OF ENTRV: I certify under penalty of perjury thet I have read ihis applica�ion en0 state that the information given is
correcL I egrea to comply wlt� ell state laws end ciry ortlinances relating to building consWction, end authodze representatives of Ihe Ciry ot Gaste Mesa to enter upon Ihe
ebove-descnbed property tor inspection puryoses. I egree not to occupy or ellow acupancy ot any building authorized by ihis permit un�il final inspection.
COUE l INSPECTIONTYPE
1616 Fixed System Final Fire Prevention
1266 Pool Spa Final
200 Final RB-RoO�
201 Final BIocWRelaining Wall .
202 ' Final Fectory Fire Place �
203 Finel Sign
204 Final Demolition
ORTE
//��s�� s— � /
Data
COUE I INSPECTION TVGE
206 Finel MeChanical
20B Final Plumbing
210 Finel Electrical
212 Finel Fire Preventlon
220 Final Planning Approval
222
250
Final Site
Final Building/Occupancy
PdiF It�ALS
CIiY COS?A `;�SA 3:.Q'JEST' YCF, OCCU_'I
"�7r3--- =,,_ �e ,i
_D= '�0< !�/�. /�
����:.ss 3i6�/ /��/HGI'/c� C ; �%
DAT� �
/ `
_:e de•velo�er of t:�e eoc.� e^.ti=ied _ract cesires to seil t'r.e 2bove set
=OZ=.: _OL �,7<20= �O :fE ..�.^..0 �12� C:?? �.2C� �.°S �ee.^. CO^7�0ted a.^.G� itS st_eets
c.CCCy")=2C� J} t^8 C �V O: COStc vflS?..
:c?0 L•L1GE:5:.;4�IICG�, by execc_i^o t1iS c1$r@2IDCIIC� 2CiCIIOW1CG-^o0S i..^...�.L
(;-:�-�;�e-=:�e;;) � (was or ���ere) �G�-fc--O adv-�sen tiat �h'_s _zact :.�,.
^O: D�Ct": �iV2.^. -_^2_ '_^S?CCt�O.^, 40T A85 '_i. D�`�2:1 3CCCDtCQ bj� t�10 C.lt� 0: CCS=u ii�52
�..., ..�.�_.^:P C01:?_1C� ;i=t:: :flE.' CC.^.C'_�_O^S O� 2���OC2i 47:1iC❑ tvC.':C' .^..JOSCC: D} �^C C'_Cf
�_ _:-� t:.-.e �'.;e _`i^al tract .r.2� w2s z�oroved.
�:ne Czty :.sst:-�es ao 2:zb====y _`o: the ea_`o�ce::e.^,t of ,.'r.e co^.ditions
recess�.;y for a?proval ot:e= thaa ::ose co^.di�ions protectec by screty Sonc.
_;:e u^ders:g�ed a�r:es to :�d�-:^_`y ..r.d ho1C t;^e C'_ty ha^less =re:n
'� Ci..._... =�Sl.�.._.^.� iII G$^..2.�^.�8 0= �@2uC3.,^-.l _^jti�j� '.O �i:C 4^L�OISio^Cd ,�j� �^_2.^uOP
^_ _.:C L._OT�'f:�_'^.Lf`O^.C� ...^.CO:Il71fl�CC CO::_•' �_O :.'
R���rvEo
CITY OF �pSLi MESA
PI,aP:NIU^. �cn;
SEP 2� 1973
AM
'�i8�gi10i11i12i1i2i3i4i5 6
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Lender
MAAS, ChriGtian �^ ` 5-18-76
�JOB ADDRESS 3441 Plumeria Place BUILDING PERMIT N0. 42013
nvurn�i i-n�ito��rno nvcrmor�nu _twnov
�'y IN" �CTIONS
r�
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V WATER
�y ROl1GH PLUMBING
�VyPFOP. SWR. LINE � HOUSE CON. �
yySPRINKLING SYSTEM
� MISCELLRNEOUS
ROUGH HEPTING AN� AIR CONDITION
TEMPORARV SEPVICE OR POLE
IINDERGROUND � POWER �
ROUGH WIRING
TFENCHES ❑ FORMS STEEL
FL000. SVSTEM
BONO BEAM � STEEL REINFORC
SMEATMING
FRAME ANO FLASHING
LATHING — IN � OUT �
PLASTER. OROWN COAT
ST0.UCTURAL, FINAL
NF 'G. VENT., RE
PL �NG. FINAL A
ELECTRIC, FINAL
001LOING, FINAL
T
P
SUBCONTRACTOR
; 42013
� COSTA MESA BUILDINGSAFETY DEPARTMENT
.' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For AppGcant to Fill in Completely — Use Ink Only
ADDRESS 1T T 1 'F �.0 MEt��A "PL �
OWNER C�C��J���\v ��115
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CONSTRUCiION
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ADDRES:
ADDRESS
CONTRACTOR � �
ADORESS
CITV
STATE
U0. NO.
SIZE f � � `
OF LOT ��
A TE
NC
TEL.
TEI.
NO.
CITV
LIC. NO.
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
USE OF 6UILDING AND WOflK TO BE PERFOR�
aatu
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FOR STRUCI'URAL PERMIT
A.Y. rvV. / �
BUILDING
ADDRESS
TRACT"/��
W ADD AL
OWNE µ
S , WV1
FIRE
ZONE V
APPROVED
BV
ZO I NO.OF
PLAKS�
VARDSAPPROVED
MAIN BUILDING
(FROMC/LS EET)
RONT -
i� ii
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L SIDE F
REAR �FT.
DI5TANCE BET.
MAIN BLDGS.
VAR. �
PERM�T NO.
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LU /J L
LOT J BLOCK
J I'l J
^ VALU$ �-y�
v
GROUP
DATE� � lg�
USE OF N
BUILDING
VARDSAPPROVED
DATE
APPROVED
I hereby acknowletlge ihat I ha�e reed this applicaiion antl state
tha� the above information is oorract enA agree ta comply wlih
all laws ree�ia<i�e builtlin8 �onstrueiion, end I shatl not amploy
any person in violation of ihe workman's compensetion laws of
the Stata of California. �
I hereby cartify that I am prope�ly Ilcenzed as a conttactor undar SQ. FT.
the Stace of Californte Buciness antl Professions Code, Division,3,- THE AMOUNT SHOWN UNDER VALU
ChepSer 9, and�ffiat-cuch Ilcanses era in full force antl ef �or I THE PURPOSE Of ESTABLISHING A PERI
em exempt frorr��he provislons of the Steteyf Califor a Business VALUATION
entl Professions CodeJD�vis\ion 3, Chepter 9( PERMIT FEE E
T� �— $ �S� � TAX CHECK S
Sipnatura o� � —, /\� � � �
Permlttae �C XJ
Authorized Apent TOTAL PAID E
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GENERAL C0�
AP No.
IN :TIONS
soi.
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W ATER
ROUGH P�UMBING
PROP. $WR. LINE
SPRINKLING SYSI
MISCELLANEOUS
ROUGH HEATING AND AIR CONOITIONING
UNDERGROUND U POWEF
ROUGH WIRING
BONO BEAM U STEEL PEINFORCE
SMEATHING
FRAME ANO FLASHING
LATHING - IN 1
PLASTER, BPOWN COAT
NE i, VENT., R
PLOMBING, FINAL .
ELECTRIC, FINAL
BUILDING, FINAL
�
DATE
SUBCONTRACTOR
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�401
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364, ;
�FETY DEPARTMENT
i, CALIFORNIA 92626
in Comnletelu�_
BUILDING • •� • � � �/ %
ADDiiE55
OWNER Iarwin Southern California
ADDfiE55 16255 Ventura Blvd.
Z .
av cirv Encino Calif. No��986-889
�Z
Z Q CONSTRUCTION
o� LENDER Larwin Southern California
a m BRANCH 16255 Ventura Blvd.
m � ADDRESS Encino California
Ja ORENGINEER ��1R S. C211E. NEL.+ �
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w� nooAess 9100 Wilshire Blvd., Bev. Hills
aw
� � CONTflACTOR Larwin Southern California
mZ
w� nooRess 16255 Ventura Blvd.
w TEL.
Z� cirv Encino California No• 986-889
O
�o �ic No. 19131Z LlCYNO. $-1
SIZE NO.OF BLDGS.
OF LOT 6O X LOO I NOW ON LOT O
.�, �� q (�-C�-,�L�.���ae�c.
''; i 1-7 � �A:= 00 641 :,...:: l i!?.(�8
APPLICATION FOR BUILDING PERMIT
EIV BV D hTE RECEIy�q Dp �TE 1 SUED
C'� !f./o-7%1 AYR 1�0 1918
A.P. NO.
BUI IDING
ADDRESS
TRACT7SS%—B
FIR
20NE ' NO.OF
FLP'NS L
�'ARDS APPFOVED
MAIN BUILDING
r S12E OF NO. OF
z Newe�oc. 1784 ROOMS STORIES 1 L.SDE FT.
aEXTERIOR WA$lL SCUCCO ROOF WOOa shin le REAR FT.
COVERING COVERING P �
� VSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE eET.
a MAIN BIOCS.
� Construction Single Family Residence c�RP �
~ APPROVED
�
O HOLD FOR SI
Vi hereby acknowledBa Na[ I heve raetl this epplicatlon end rtate
� thot tha abave Information is correct antl eprae io comply wlth
� oll lews repulating buildinB consvucNon, nntl I shall not employ
F any penon in violatlon ot tha workmen's compansetion lows of
y the Stam of Celifornie.
zI hereby certify Mot I nm properly Ilcansetl as a eontractor untler SQ. FT.
i
Me State of CeNfom7a Businazs entl Profossions CoAa, OWhion 3, THE'AMOUNTSI
Chopter 9, nntl that such licenses nre in full torca enC atfact, or 1 7HE PURP�E OF
em azampt irom tha proviaions of tho Stnte of Celltornie BuSiness VALVATION
ontl Profosslore Cotlo, Divialon 3, Chepter 9.
Slgnetura ot /
Permittaa ��� 7d - I%. DO(JS15 s 26 900
s
Authorized Apent
LOT9z BLOCK
.. �q v
VALUE
A s L�G'
GROU �
DATE IV
USE OF NEW Y% .
BET
�3
YN UNDEF VALUATION I
'ABLISHING A PERMIT FEE
PERMIT FEE s 94.00
PLAN CHECK $ 4�.00
TOTAL FEE $ 141 .00
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OWNER ggyplOLDS, TERRY DATE 7-25-78
'JOB ADDRESS ZLlyl Plumeria P�ACA BUILDING PERMIT N0.
SUBCONTRACTOR
'ROUGM PLUMBiNG
PROP. SWR. LINE Q NOUSE CON. �
$PRINKLING $YSTEM
MISCELLANEOUS
ROUGN MEr1TING �ND nIR CONOITIONING �
TEMPORARV SEPVICE OR POI.E '
UNDERGROUNO � POWER �
ROUGM WIRiNG
TRENCMES FORMS STEEL AEINF.
FLOOR SVSTEM
BOND BEAM � SiEEL REINFORCE ❑
SXEATHIN6
FR�ME �ND FLRSMING
LATHING — IN � OUT n
PUSTER, BROWN COr1T
STR��CTUA�L, FIN�I
H G. VENT., REFRIG. RNO �.C., FINAL
PL�...dING. FINRL �NO WS TEST �I
,. ��452
�� COSTA MESA BUILDING-SAFETY DEPARTMENT
,� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
r For Applican[ to Fill in Completely — Use Ink Only
� BUILDING .-y�� ,� � _ � , .�.. .
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CONSTRUCTION
BRANCH
ADDflESS
AD�RESS
CONTRACTOR
ADDFESS
CITV
STATE
LIC. NO.
SIZE
OF LOT
TEL.
NO.
TEL.
NO.
CITV
LIC. NO.
INO.OF LB��GS
NOW ON LOT I
Separate permits are required for
electric, plumbing and heating work.
I hereby acknowletlBe that I have reatl ihis applicetion antl s[ate
that tha ebove information is corract antl agree to comply with
all laws reguleting builtlin8 conrtruction, antl 1 shall not employ
any person in vioiation of She warkman's compensaHon laws of
the State of Calitornle.
t hareby certify that I em properly Iicensed as e contractor untler
the Staie of Callfornie Busfnass antl Prof¢ssions Cotle, Divislon 3,
Chapter 9, antl thei zueh Iicenses are In full torce antl etfaci, or I
am axempt from the provlsions ot the State of California Business
end P�ofessions Cotla, Division 3, Chapter 9.
SIB�atura of �7"+� �n_� a �„ n� e
Permittee _I.,�,:�'7, Y(�/ �lal.t...I�.JLOL,
Authorizetl Agent
��
a�oe�> >i2eire
APPLICATION FOR STRUCTURAL PERMIT
BUILDING
AODRESS
OWNER
FIRE
20NE
APPROVED
I2' I%.�'���) PE
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ZONE� � IP�� q I gUILDING E�J- '
/i' (�ICP'
VARDSAPPROVED I VAROSAPPflOVED
MAIN BUILDING ACCESSORV BUILDING
DISTANCE BET. I BEf. MAIN
MAIN BLDGS. ACCEQ. BI
VAR.$'+ DATE
, I neTc �' eC��
THE AMOUNTSHOWN UNDER VALUATION IS F
THE PURPOSE OF ESTABLISNING A PERMR PEE ONI
VALUATION PERMIT FEE y �Q�
,^ � PLAN CHECK E �
$ �OV TAX $
/
TOTALPAID § � �
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