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Home My WebLink About3449 PLUMERIA PL - Building Permits(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.Ga.�.SCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 tL Job Address: Suite No Vicinily: Parcel Nunmber: 3449 PLUMERIA PL 41217317 Applicant SCHNIERER, STEVE Address: 2057 MANDARIN DR COSTA MESA, CA Phone: 714-719-1689 Zip: 92626 Owner: HEFNED, KRIS Address 3449 PLUMERIA PL Phone: COSTA MESA, CA Zip: 92626-1730 Contractor: ALLIED PLUMBING - HEATING - AIR CONDITIONING Adtlress: 422 JENKS CIR ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+unils) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over 1000a Molors to 1 hp Motors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a CORONA,CA Phone: 714-998-4300 Zip: 92880 License: 610780 Status: ISSUED Applied: 10/31/2003 Issued: 10/31/2003 ISSUED BY: � � . � ►�� .� i SCOPE OF PERMIT CHANGE OUT FAU ADD A/C UNIT IN BACK YARD. ELECTRICAL TO INCLUDE� 1 MOTOR AND MISC. CONDUIT FOR AC/ADDITION. $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $4.75 $12.30 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity FEE SUMMARY Temp Dist System / Lighting Busway/100 k Standing Seclion Misc ElecMcal Equipment Transformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring Sysiem / Ckt Misa Conduit Misc. Conductor Circus ( gen or ride) Circus (mech nde or lights) ChrisUnas Tree Stand Fireworks Stand Other Electrical Fee Investigation fee Plan Check Fee Quantity $0.00 0 50.00 0 $0.00 0 So.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 $0.00 0 $1820 1 $0.00 0 $0.00 0 So.00 0 $0.00 0 50.00 0 $0.00 $0.00 $0.00 6 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a periotl of 1 BO days. INSPECTIONS: In order for the work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections end finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 F3:CSei � �'�'. WORKERS'COMPENSATON DECLARATON: I here6y affirm under penalry of perJury one ot the following declarations: ❑ I have and will maintein e ceNlicate ol consent to self�lnsure tor workers' compensatlon, es provitletl for by section 3700 of the Lebor Code, for t�e peAormance oi Ihe tor whiCh Ihis permit Is issuetl. I �ave antl will meintain workers' compensation insurence, as required by section 3700 of Ihe Lebor Cotle, ior Ihe peAortnance of the work lor which Ihis pertnit Is 155ued. My workers' compens tion Insurence carrier end policy number are: cama�: Z��c�c.h�merico.�n PolicyNumber: �-%GZQ.�(py3—O� (This section need not be comp/eted il �he permit is ve/uetl at ane hundred dollars ($100) or less.) ❑ I certily Ihet in ihe perfortnance of the work for which Ihis pertnit is issuetl, I shall not employ eny person in eny manner so as to become subject to the workers' compensetlon lews of plitornla, and a rea at it l should become subject to Ihe workers' compensation provisions of Section 370 of tha Lebor Code, I shell fonhwith comply with these v � � _I �� Applicant Signature: Dete: �U WARNING FAILURE T ECURE WORK 5' COMPENSATION CAVERAGE IS UNLAWFUL PND SHALL SUBIEGT fW EMPLOVER TO CRIMINAI PENALTIE ANO GVIL FINES UP TOONE MUNDRED i1qUSPND DOLLARE (5100,000). IN AD�fiION TO THE COST OF COMPENSATIdJ, DAMAGES AS PROVIOED FOR IN SECTION 3]080F TME L4BOii CODE, IMEREST, ANO AiTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby afllrm �hei l em torca antl eNect. Lic. M_ Contractor's Signature: CONSTRUCTION LENDING AGENCV: oi Chapter9 (commencing wilh Section 7000) of Division 3 of the 8 Class x Date: _ Code, and my license Is in full ❑ I hareby aMirm Ihet Ihere is a consiruction lending agency lor iha pedormance ot Ihe work tor which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lendefs Address: Signature: OWNER-BUILDER DECLARA710NS: Data: I hereby aHirm Ihet untler penelty of perjury thet 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe lollowing raason (Sec. 7031.5, Business entl Professlons Cotle: Any city or counry which requires e permit to construct, alter, improve, tlemolish, or repair any strucNre, prior lo its issuance, also requires the epplicant for such permit to tlle e signed statement Ihat he or sha Is Ilcensed pursuant to the pwvisians al the Cantractors License Lew (Chapter 9(commencing wlth Sectlan 7000) ol Dlvislon 3 af the Business and Pmfesslons Code) or thet he or she is ezempt theretrom and Ihe besls tor the elleged e:emption. Any violetion of Sectlon 7031.5 hy any epplicant lar a pertnit subjects the epplicant to a civil penelry of not more than tive hundred dollare ($500).�: ❑ I, as owner ol ihe properry, or my employees with wages as iheir sole compensetion, WILL DO TNE WORK, antl Ihe structure is nat intentletl or oHeretl for sele (Sec. 7044, Business end Professions Code: The Contractors License Law tloes no� epply to en owner ot properry who builds or improves Ihereon, anC who does such work himself or herself or ihrough his or her own employees, provitled that such Improvemems ere not intentled or oNared tor sele. If, howevar, the builtling or Imp�ovement Is soltl within one yeer of complelion, the owner�builder will have tho burdon of proving thet he or she ditl not build or improve for purposa of sale.). � ❑ I, as owner of ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSEO CONTRACTORS to consimct the prolect (SacJ044, Business end Professions Cotla: Tlie contractor5 LlcenSe Lew d0es not epply to an owner of property who bulld5 Or Improves Ihereon, antl who contracts for such prolect with e contrector(5) license pursuant to the Contrectors license Laws.). ❑ I am exempt unAer sec. Business antl Pmfessions Codo tor lhis reeson: Signeture: Date: Owner ID venfietl by tlnvers license. ❑ Ves ❑ No Orivels License No. Verificetion oi Ownership by (lype ol dwument, i.e. - properry tax �ill or tleed): Expires: DIVISION OF INDUSTRIAL SAFETV PERMI7 CER7IFICATION: ❑ I hereby certlry that no excavation tive (5) or more teet in depth into w�lch a person is requirad to descen0, will be matle in connection with work authorized by this permit, entl that no building siructure, scaflolding, talsework, or demolitlon or Alsmantling thereol, will be mora t�en thiry-six (36) teet high. (Chap. 3.2, Grp 2, ArI 2, Sec. 341, 711e 8, CellfOrnia Atlmini5iretive Code). ❑ As owner�builder, I will not employ anyone to do work which would require a permit trom the Division ot Industnel Satery, as notetl aDove, unless such person has e pertnit to do such work irom the tlivision. Signature: Date: Division of Indusinal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZJITON OF ENfTiV: I cetlity under penalty of per�ury that I have read this application end state Ihat Ihe Informetlon given is correct. I agree to comply with ell stete lews end ciry ordlnences relating to bullGing consimction, end authorize representatives ot Ihe City ot Coste Mesa to enter upon ihe ebove-descnbed property for inspection purposes. I agree not to occupy or ellow occupency ol eny building euthonzed by this pertnit until finel inspection. 'gnetVla Of Legal Owner(s) � And/OrAuthonzed Applicant COOE t. INSVECTIONTYPE ps¢, ��$ 7616 Fiaetl System Final Fire Preventlon 1266 200 201 202 203 204 Pool Spa Finel Finel RB-Rool Finel BIocWRetaining Well Finel Factory Fire Placa Final Sign Final Demolltion CO�E I INSPECTIONTYVE 206 Final Mechanlcal 208 Final Plumbing 210 Final Electrical 212 Final Fire Preventian 220 Final Planning Approval 222 Final Site 250 Final Buildinq/Occupancy PAIE It�ELS October 13, 2006 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT S6RIVlIf80�F1fifMlMISION COURTESY NOTICE OF PERMIT EXPIRATION Kris & Mary Heftved 3449 Plumeria PI Costa Mesa CA 92626-1730 PERMIT NUMBERS: FOR: PROJECT ADDRESS: E03-01022, M03-00555 FAU & A/C 3449 Plumeria PI., Costa Mesa Our records indicate the above listed permits were obtained for property improvements or alterations at the above address. Per the i997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your Iast inspection for the project and additional fees will be required to finalize expired permits. According to our records, the permits listed above have not had an inspection for a period exceeding 180 days. If you have a signed inspection card indicating an inspection was conducted within 180 days from the date of this letter, please contact this office so we may correct our records. If you need to request an inspection please call our Inspection Request Line a1 714-754-5626. if you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you do not have an approved final inspection, your permits will expire on October 27, 2006. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your propeRy is our goal and we appreciate your working with us to resolve this matter. incerely, _ ��`��'_�%CJUL/ Mary Jane Weidenkeller Office Specialist II cc: Allied Plumbing-Heating-A/C 422 Jenks Ci Corona CA 92880 Buildirg Division (714) 7Si-5273 • CoOe Enforceme�l (714) 754-5823 • Planning Division (714) 754-5245 FAX p14) 754�a858 • TDD (714) 7%-5244 • www.ci.wsla-meu.ca.us �i (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Atldress: Suite No Vicinity: Parcel Number: Applicant Atldress: Owner: Address: 3449 PLUMERIA PL 41277317 SCHNIERER, STEVE 2057 MANDARIN DR COSTA MESA, CA HEFNED, KRIS 3449 PLUMERIA PL COSTA MESA, CA MECHANICAL PERMIT ISSUED BY: Phone: 714-719-1689 Zip: 92626 Phone: Zip: 92626-1730 Contractor: ALLIED PLUMBING - HEATING - AIR CONDITIONING Address: 422 JENKS CIR CORONA,CA Phone: 714-998-4300 Zip: 92880 License: 610780 SCOPE OF PERMIT CHANGE OUT FAU AND A/C UNIT IN REAR YARD. ISSUE FEE Inst FAU <100 k BTU � Inst FAU >700 k BTU Repair / Alt Cooling/Heat ' Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Retrig Sys >700 k BTU . Gas Piping Factory Fireplace Hood w/Mech Ezhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers lnst or Relocate Appl Vertt Air Handlers < t0000cfm AirHandlers> 70000cfm Floor Fumace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 30.00 $0.00 $0.00 Quentity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Repair / Alt Absorbtion Unit Repair I Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I nci nerator Domesiic Incinerator Comp�essors / Absorotion Svstems Upto3hp/100kBTU 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hP / 1,750 k BTU Over 50 hp / Over 1,750.BTU Boilers Upto3hp 3To15hp 15 to 30 hp 30 to 50 hp Over 50 hp ,. .. Other Mechanical Fee � Investigation Fee Plan Check Fee Reinspectian Fee Status: ISSUED Applied: 10/31/2003 Issued: 10131/2003 • ' � � II►.�! TOTAL CALCULATED FEES Quantity $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 514.70 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $53.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work Is suspended or abandoned fo/ 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 requlred Inepeetiona end final epproval must 6e obtained. Failure to obtain inspectlons and final approval will resul� in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 24dg-q8 (&00) WOR ERS' CPMPENSATON DECLARATION: � _ I her y aHirm untler penalry of perjury one of the following Oeclarations: ❑ I have entl wlll meintain a cetlificete of consent ro sel4lnsure for workers' compensatioq es provlded for by section 3700 0l Ihe L60or�Cotl�!`for tha pedormence of the work for which this permit is issued. .`� . I have end will mflintain workers�compensaLon insurance, as requi�etl by sectlon 3700 oi Ne Lebor Code, for Ne peAortnance of the work for which Nis pertnit is Issued. My workers' co1mpen/�ation Insurence cartier antl policy number ere: (� p Cerner.2U'f'�LN HYY1EYlC.(LY1 PolicyNumber i�GZ-13O�eN3'O� (This section nBed nat be camplefed i! the permi( is velued ef one hundred dollers (5/00) or less./ ❑ I ceniry that in �he perfortnance W the work for which t�is permit is issue0, I shell not employ eny peroon in eny menner so as to become subject to the workers' compensa��on lews o Calitomla, and a ee that if I shoultl become subject to the workers' compensetion provisions of Se tion 3700 f Ihe Lebor Code, I shall forthwith complywiihthese isi / Appliwnt Signa�ure: Date: O C WARNMG: FAILURE Tf�SECURE W ERS' COMPENSATION COVEMGE IS UNLAWFUL qND SHPiL SU9IECT AN EMPLOYER TO CRIMINAL PENALTIES AND NES UP TOONE HUNDREO TFKKISAND DOLURE (5100,000), IN ADDITION TO THE C0.ST OF COMPENSATION, DAMAGES AS PROVI�ED fOR IN SECiION 3]W OF THE LABOR CODE. IMEi7EST, AND ATfORNE1^S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I em larce and effect. ��c. # _ Contrectors Siqneture: of Chapter 9(commencing with Section 7000) of Division 3 of the B Class x Date: Code, entl my license is in full CONSTRUC710N LENDING AGENCV: ❑ I hereby attirm thet there is a construc�ion lending agency for Ihe pertormance of the work for which t�is permit is issuetl. (Sac. 3097, Civil Code). Lendefs Name: Lendefs Adtlress: Signature: OWNER-BUILOER DECLARA710NS: Date: I hereby aHirtn Nat unCer penelty of perjury ihet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Pmfesslons Cotle: Any ciry or county which requires e permit to consimct, alter, improve, demolish, or repair eny stmcture, pnor to its issuence, also requires Ihe epplicant for such permit lo lile a signetl S�etement that he or she Is Iicensed pursuent to the provisions oi the Contractors License Lew (Chapter 9(commencing with Section 7000) oi Division 3 of Ihe Busineu and P�ofessions Code) or tha� he or she is axempt therefrom and ihe basis for the alleged exemption. Any violation of Section 7031.5 by eny apD�icant for e pertnit sub�ects Ihe app��en� to e civil penalry of not more than five hundred tlollars ($500).): ❑ I, as owner o1 ihe p�openy, o� my emplqrees with wages as thair sole compensation, WILL DO THE WOAK, and the siructure Is not interitlea or otteretl 1ar sale (Sec. 7044, Business entl Professions Cotle: 7he Coniractors License Law does noi epply to an owner o� properry who builtls or improves ihereon, antl who does such work himself or herself or through his or her own employees, provided that such improvemems ere not Intended or oNered for sale. If, however, Iha building or improvement is soltl within one year oi completion, the owner-builder will have tho burden of proving ihat he or she tlid not build or impmve for purpose of sale.). � ❑ I, as owne� ol the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS lo construct the prolect (Sec. 7044, Business end Professions Cotle: The ��ectors License Lew does not appty to en owner of pmperty who builds or Improves ihereon, and who contracts lor such project with e contractor(s) license pulsuant to the Contractors License Laws.). ❑ I am exemp� under sec. Business anC Professions Code for this reason: Signature: Date: Owner ID verifietl by tlriver's licensa. ❑ Ves ❑ No Ddveis License No. Expires: Vedficetion at Ownership by (type of aaument, i.e. - pmpeny tax bill or Oeatl): DIVISION OF INDUSTRIAL SAFE7Y PERMI7 CER7IFICATON: ❑ I hereby c9hity Ihat no excavation five (5) or more feet In depih into which e person is required to tlescend, will be made in connec�ion with work authonzed by Ihis permit, and tha� no building structure, scaflolding, falsework, or demolition or tlismantling thereof, will be more than t�irty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8. California Adminisirative Gotle). ❑ As owner-bullder, I will not employ enyone �o do wolk which would require e permit irom ihe Division of Indusiriel Sefery, es notad ebove, unless such person hes a permit to do such work fmm �he division. Siqnature: Date: Division oF Indus�rial Safery Pertnit Number: CERTFICA7E OF COMPLIANCE AND AUTHORIZATON OF ENTFiV: I cenify under penalty oi perjury ihat I have read this epplication end state that ihe infortnation given is correct. I agree to comply with ali state lews antl ciry ortlinances relating to bullding constmction, and euthorize representetives of Ihe Clty of Coste Mesa to enter upon Ihe ebova-dascnbed property for inspection purpases. I agree not to occupY or ellow xcupancy ot eny building authorized by this permit until finel inspection. LagalOwner(s) / �� D� .7' .�A,�%_ ntl/Or Aut�onzed ADDlicant �� COOE I, INSPECTIONTYVE 1676 FixaO System Final Fire Prevention 1266 Pool Spa Finel 200 Final Ra-Rool 201 Final Blo�k�Retaining Wall 202 Ffnal Fa�iory Fire Place 203 Final Sig� 204 Final Demolition o�re INTRIAL9 COOE I INSPECTION TYPE 208 Finel Mechanical 20B Final Plumbing 210 Final Elecincal 212 Final Fire Prevenilon 220 Final Planning Approvaf 222 250 Final Sita Final Building/Occupancy 0� II�EL9 3�fy9 � lurn;.r�;��l. 0 c . . w � . .: StCee.�" �L ��`"�' C� ��'�� " ,r�� 3 (714) 754-5273 • Fau (714) 754-4856 • www.ci.costa-mesa€L�TRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 3449 PLUMERIA PL REAR OF PROPERTY 41217317 HEFNED, KRIS 3449 PLUMERIA PL COSTA MESA, CA Owner: HEFNED, KRIS � ` �, � Address 3449 PLUMERIA PL ' COSTA MESA, CA � �' � : �.'" Contractor � �OWNER-BUILDER �� Address: . � � ��3h - Phone: 714-540-6274 Zip- 9262&1730 ,.. _ - _ _ �` - - .,�;- Staws: ISSUED Applied: 09/01/2005 Issued: 09/01/2005 ISSUED BV: �v ,� � Phone ...� � � �Zip: 92626=7730 . a., Phone: Zip: License: 000000 �,, a -_ ., t . . >SCi� .CONSTRUCT 432 S.F. GUNITE-SWIMMIN PROPERTY. REF.:'BOS-01473 ELECTRICAL TO INC4.UDE: 1 POOUSPA. b i . � � �_� �, �,_ GUNITESPA'IOCATEDATREAR'OF �.- . �.a;�Fi - '�i'�.i , a :. � `+ � �FEE SUMMARY �" � ,� �� Quantiry�� _ ... - -7 , . -,. QuaMity�� ISSUE F,EE �?�� - S23 50 Temp Dist System'/ Lighhng �R�-� $0.00 0 ' Temp seryice test ' , $0;00 �� • �'� . Busway /100 ft $0.00 - '0 - �{" Res. a/dpackage °$0:00 � Sianding Section �� $0 00 •-:' 0 t.�; p NewRes(1-2units) 3".�� ^$0.00'� ��0�__ -�.�, Mis'c"ElectricafEquiprrient` � ,$0.00'-- 0--:, New Res (3+umts) -. - ,� $0.00 0 Transformers up to 1 kva/kw - $0.00 � - 0 . ` �� Pool / Spa m � - " g49.50 � `.l 1 ................up to'�10 kva/kw $0.00 � �- 0 Lighting Fixts • - . $0.00 �� 0 .................up to 50 kva/kw $0.00 �; ;N:O � Recept Outlets , ==- ��:. $0.00 ' 0 ...........::.:.:up to 100 kva/kw $Q00"�,'-s `0 -_� Switches - '-..,r= - , �. $O.00,r;� 0 ...................over100kva/kw '$0.00 .--0 - • - Non Res Appl �;$ODO -i 0 - , tow.Voltage Equipment $0 00._ ,d 0 Res Appl "$0.00 0 =,��.-. Low Volt Wiring System / Ckt $0 00'g�" 0 � �, r Service to 200a'.� .�� _,_ �$0.00 , ' 0 �� ' �,• Misc.-Cond"`uit'- .�_ $0.00' .0-; � Serviceto1000a "-- $0.00 � �r ;;0 �•r Misc,-Conductor,��. .$0.00 0-' , � Service over 1000a - , � $0.00� �-. �_ '0 - `Circus ( gen��or ride) � - $0.00,- 0- � Morors to 1 hp . '$0.00 0 -� Grcu's (mech ride or lights) � $0.00 � 0 x, � Motors to 70hp ,?a'"r ;� � $0.00 � 0 � °; '��"� � Chrislmas Tree:Stand _ $0.00 � 0 � Motors to SOhp $0.00� � 0-��:�� Fireworks Stand�-,�? � a$0100 0 Motorsto100hp ; $0.00 • 0 '„3 �OtliecElectrwafFee �. $0,00 Motors over 100hp $0 00" 0- ,�. _- �; - � � ^'`� Communication drops -$000 � 0��' Investigalion Fee=''P'�,� •''� $0.00 Sub panel to 200a $0.00 �: 0. _ - -, RIan�Gheck Fee;� , ,$0.00 Pole Light Pkg $0.00 �"', 0 " ` �_ �� ReinspedioneFee ". . , $0:00 SignCircuits $0.00 ,�0� �., •< � .., � Temp Pwr Pole $0.00 ��'� 0�. � .. TOTAL CALCULATED,FEESn E73.00 Intermed Pole $0.00 0 - „ • � COMMENTS / SPECIAL CONDITIONS NOTICE: 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: 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,�ali requlred inapectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expirationvof,th�permil. FOR INSPECTIONS CALL: (714) 7545626 zaae-as �sroo� WORKERS'COMPENSAnON DECLARAnON: I hereby aflirm under penalry ot perjury one o1 the following declaretions: ❑ I heve entl wlll maintain a certificete of consent to seN-Insure for workers' compensation, as provlded fo� by sec�ion 3700 ot the Labor Code, br ihe paAortnance of the work for which this permit is issuetl. . ❑—I.have and will maintain workers' compensation insurance, as required by saction 3700 ot ihe Labor Cotle, f r ihe perfortnance of the work for which this pertnit is issued. y workers' compensation Insurance carriar antl policy number ere: C n :� plity —�tie.= s., �is section need not be complefed il fhe permit is va/uetl at one huntlred dollars ($100) or less.) �'""-- — �I certity ihat in the pertortnanca ot Ihe work for which this pertnit is issued, I shell not employ any person in ny manner so as to become subjact to the workers' compensatlon laws ot Califom , end egree th f I e sub�ect to the workers' compensatlon provislons of Section 3700 of Ihe Labor CoAe, I shell fonhwit� comply with Ihese provisi Q / �pplicen� Signature: Dete: J � 6� � � WARNINO: FAILURE TO SECURE WORKERS' CAMPE TION CAVERAGE IS UNIAWFUL AND SHALI SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUN�RED THOUSANDDOLLAFE($100,000),INADDITIONTOTH CASTOFCOMPENSATIIXJ,DAMAGESASPROVIDEOFORINSECTION3]OBOFTHELABOFCODE,IPIrEREST,ANDATTORNE`fSFEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn ihat I am licensed under provisions ot Chapter 9(commencing with Section 7000) ot Division 3 of iha Business antl Professions Code, and my license is in full force ana enect. Lic. # cless a Contractofs SignaWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm that ihere is a constmction lending agency for the peRormance oi lhe work tor whic� ihis permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Signe�ure: Date: OWNER- • DECLARATIONS: �'-� � �': I hereDy ` al.untler penalry of perjury that I em EX�+ - OM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7W1.5, Business antl Protessions Cotle: Any � unry which requires�a�perrtul to co L r, improve, tlemolish, or repair any structure, pnor to its issuance, also requires the applicant for such permit to file e signed lement tl�f$Jie or stieJs Ilwiisetl pu nt t a provisions oi Ihe Coniredors License Lew (Cheptar 9(commencing with Sectlon 7000) ot Divislon 3 oi the eusiness entl P ssions C'ode) or thet he or she is exempt therefrom antl the basis for the allegatl exemption. Any violation of Seclion 7031.5 by any applicant tor a permit subjects the epplicant ro a civil penalry ot not more t�an five hundred dollers ($500).): ❑ I, es owner ot the property, o� my employees with wages as ihelr sole compensation, WILL DO THE WORK, and the structure is not intentletl or oflered for sale (Sec. 7044, Business and Professions Code: The Contractore License Law does not apply to an owner of property who builds or improves Ihereon, and who does such work himself or herself or ihrough his or her own employees, provitlad ihat such improvements are not intendetl or oifered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builtler will have ihe burden of proving that he or she did not build or improve for purpose of sele.). ' ❑ I, es owner of the properry, em E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Professions Cotle: Tha contractors License Lew does not epply to an owner ol property who builds or improves thereon, end who contracts for such prolect with a contrector(s) license pursuent to lhe Coniractors License Laws.). ❑ I em�empt nd sea _L;� Business and Professions Code for this reason: SignaW�e:'^ � !� �Ezplres::. � Verification oi Ownership by (type ot document, i.e. - properry taa bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICA710N: ❑ I hereby certify ihat no excavetion tive (5) or mora taet in depih imo w�ich e person is raquired to descend, will be matle in connecNon with work euthonzeC by ihis pertni6 and that no building siructure, scallolding, talsework, or demolition or dismantling Ihareot, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Ar12, Sec. 341, Title e, California Adminisirative Cotle). ❑ As owneo-builtler, I will not employ enyone to tlo work which would require a permit irom Ihe Division of Indusinal Safery, es noted above, unless such person has e pertnit to do such work irom ihe division. Signature: Date: Division oi Intlusinal Safery Pertnit Numbec CERTIFlCA7E OF COMPIJANCE AND AU7}10RVA110N OF E Y: I certity under penalty ot perjury that I have read ihis epplication end state that the informa�ion given is correct. I agree to comply with all state lews and ciry ordinanc releting to building constmction, end euthonze representatives ot the City of Costa Mesa to enter upon Ihe ebove-described D�operry for inspe purp/ose�j� . I gree cupy or allow occupancy ot eny building euthorized by this permit until fvine�l insp/ectioa r �,[..s-�✓�� - / - O `O 5 Slgnature�OtCeg � °ner(s)" CDate�_.__ AnNOr Authodzed Applicant Date COpE N, INSPECTIONTYPE �RL INTRIALS 1616 Fixetl System Final Fire Prevention 1266 200 201 202 203 Pool Spa Final Final Re-Root Final BIocWRetaining Well Final Factory Fire Place Finai Sign 204 Final Demolition LO�EN INSPELTIONTYVE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Preveniion 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy D�TE �^� PROJECTNAME: PROJECTA�OftE55: FERMIT NUMBER: TEST SPECIMEN AND COMPRESSIVE STRENGTH DATA SHEET H25VBl� INSPECTION FIRM OR CLIENT: 3449 Plumeria Place �NSPECTOR'S NAME: COSl2 ME52, CA INSPECTOR'S LICENSE NO.: B05-074 SET IDENTIFICATION NUMBER: Luiz Inspections Richard Luiz Accne.nir`:o CAST DATA (ATTACH DATA SHEET OF OTHERS WMEN AVAILABLE) LAST DATE 1�/21/0$ OESCRIPTION Lonc�ete Grou� Motlar S�olcre�e Masonry Pnsm Oi�ec GUNITF CONTFAG�OH PeterAnthanyPools SPECiF1EOF'c•P51 Z,OOO LEMENTIYFE V SUBCONTR4CTOR TII FOfCB CASTBY C0tl05 AOMIkTURE N/A ENGINEER B.C.Adams NO.OFSAMPLES 1 Wr1TERAD�ED N!A CONQ SUPPl1ER WA 10TAL Y0.5. PlACEO N/A SLUMP N/A PLANT WA T�GNETNUMBER N/A NIRCONTENT - MIX OESIGN N0. 4 7Q' 1 LAST TIME N/A AIIUCONG. TEMP. N/A �ocanoH iN e�oc.: Bottom 01 The Swimming Pool nores: NR = Not Reportetl Test specimens were 3-in. z 3-in. x 3-in, cube samples casl using wire mesh (no mold usedj. Resulis relate only to the testetl specimens. COMPRESSIVE STRENGTH D4TA DATESPECIMENSREGVD. 1T/S/05 EOIIIPMENTUSEO FOI�9 MLT REPORT�qTE 12/B/OS SNOFEOUIPMENT 04149 TECHNICIAN NAME J. FIOf85 CALIB, l RECFL. �PTE 9-OS / J-OS SPECIMEN AGEAT TEST TEST SPECIMENOIMENSIONSJN' AREA LOAD F�G BREnK IDENTIFICATION TEST OPTE TIME 1 3 3 � SO.IN. L65. PSI TYPE� NUM9EH DAYS 5 6 ) D �Nt) Eon5a6n a6 tv6/05 2:39am 3.618_ 3.601 3.622 3.605 13.04 35,065 2,688 c 3730 3728 3733 � 3J29 n.oa� 'Break rypa tlesignation per ASTM C79 Fgure 2: a=Cone, b=Cone and SpIH, c=Cone antl Shea�, O=Shea�, e=Columnar COMPLIANCE WITH SGECIFIED STRENGTN /CO NTS: Compliaa /, � �—� AUTM RIZED SIGI ATURE < i-0S V] ,. .•,.,�,'�f. ,:,;'i �i•r,y�� : , . ,.� 1 y t�-. � .�.d'/j�Xs,y4 �s� '•,w'�t,(��'7 �. �,� ;',ti. ��;� ��; ,�, .. . FICHARD LUIZ 5071LOYOLA AVENUE WESTMINSTER, CA 92683 Report of Special Inspection ➢: �� ,��b<< r�os- o t `1�3 !aspcctlon Typt(s) Gunite !nsp:ciion Datt(s) ��—Z��S [ J Periodic [ XXX ) Continuous Dcscribc inspec�ion Madc, including Locations: Inspec£ion of the swimmi .�� C�_the abov@ eddres,s on Vp—Zl'� _ ! :s: Tcs'.s .Madc: ��I �N l�[,� r. ?o�.=_I Inspcciion'iimc Each Day:, , Lls�, I�,cros Rcquiring Corrcciion, includc uncorrcc�cd ilcros prcviously lis�cd Co^imcais. �o ihc ocsi of my knowledge, lhe work inspected "�ss in accordance wi�h ihe Building Dcparimcn. z�pro��cd dcsign drawings, s�cciicalio and applicable workmanship provisions of ihc U.B C. ;xc:pi 2s no�cd abov . S{3r.cd: Date �0 "Z�j — �S I,C.B.O. # �;in�, Fvll ?�'amc: Richard T. Luiz Rtgistration No, 1075691-49 Concrece FORM SLOI ;C � (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.�tpLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 3449 PLUMERIAPL Suite: Vicinity: REAR OF PROPERTY Primary Occ: R3 Dwellings/ Cpng Res <10 Type of Construction: V-N ParcelNumber: 41217317 Zoning: R1 Applicant: HEFNED, KRIS Address: 3449 PLUMERIA PL COSTA MESA, CA owner: HEFNED, KRIS Address 3449 PLUMERIA PL Contractoc Address: Zip:` Arch : Address: COSTA MESA, CA OWNER-BUILbER " Phone: Phone: 714-540-6274 Zip: 92626-1730 Phone: Zip: 92626-1 Phone: License: 000000 Eng: Address: Status: ISSUED Applied: 09/01I2005 Issued: 09/012005 ISSUED BY: �IP t � ��i� Phone: " .Zip: `�' .. � � ' License: � . . � �License: � SCOPE OF PERMIT � CONSTRUCT 432 S.F. GUNITE SWIMMING POOL AND 64 S.F. GUNITE SPA IOCATED AT REAR OF PROPERTY. . , r �_. _.. FEE SUMMARY .,. _ '3 PlanCheck �r$320.29 � � , � " � ,�+ �� ', CalcValuation �� Sss,000:oo Permit e°�"$492.75 `.' Claim Valuation: r S35,000:00 �.SMIP Res: �� $3.50 SMIP Com: $0.00 Other � $0.00 �..., Inspechon. `�.��$0.00 � � � �� Total: $816.54 SETBACKS MAIN STRUCTURE --Front �0= 0��-� � Rear ';' 0= 0 ACCESSORY Front 0.0 . � Rear 0.0 PARKING ..--Existin : 0 �-: 'Reauired:-. , 0 PLANNING & ZONING '�`LeR 0-0�=": LeN 0- 0 � � Pr000sed: , 0 -,. e . ,�-.��_: .' , . Right 0- 0 Right 0-0 NOTICE: The work authorized 6y this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) // EXP�RATION: 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 tlays. INSPECTIONS: In ober for the work authorized under ihis permit to be considered legal, such work must comply witA all ap,plicable code� �W all required Inepectlons and tinal approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of�this permit. <S FOR INSPECTIONS CALL: (714) 754-5628 ewo�eo �aw7 WORKERS' COMPENSATON DECLARA710N: t � I hereby attirtn under penalry of perjury one ol Ne lollowing tleclarations: ❑ I have and will meintain e ceniticate of wnsent to selFlnsure br worke�s' compensation, es provided for by sedion 3700 of t�e Lebor Coae, for ihe peAormenca of Ihe ,,.work for which this permit is issued. � .e— �= 1 e antl will maintain workers' compensatlon insurence, es requiretl by section 3700 ot Ne Lebor Cotle, for the pert� work tor which Ihis pertnit Is issued. �workers' compansation Insurence carNer end policy number are: ! m �: Po Num r.� is section need nof be comp/efed!l Me permif is va/uetl e! one hundretl tlollars (Sf 00J or /ess.J I cenify that in Ihe peAortnence ot tha wark tor whlch Ihis pertnit is issued, I shall nat employ eny person in any menner so as to become subjed lo Ihe workers' compensetion lews of Califomi /Qntl egree �het II I ehou Decome suD�act to Ihe workers' compensation provisions of Section 3700 ot the Labor CoUe, I shell farthwith camply with these provision /� / � Applicant Signeture: Date: '7" b`� � WARNING: FAILURE TO SEWRE WOiiKERS' COMPEN54 COVEMGE IS UM.AWFUL AND SW1l15UB1ECi AN EMPLOYER TO CHIMINAL PENALTIES rWD CML FlNES UP TO ONE HUNORED TFKKISMID OOUARE (5100,000), IN PDOfTION TO THE T OF COMPENSNTIIXJ, DMMGES 0.5 PROVIDED FOH IN SECitIXJ 3]W OF THE LABOR CODE, INTEREST, AND FTTORNEI"5 fEE$. �, LICENSEO CONTRACTORS DECLARATION: II hereby attirm that I am Ilcensetl untler Drovisions oi Chapter 9(commencing with Section 7000) of Division 3 oi the Business and Professlons Code, anA my Ilcense Is In full tome and aHect. Lic. q Class M Coniractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I herehy ettirm thal there is a construction lending egency for the pertormance ot Ihe work for which ihis pertnit is issuetl. (Sec. 3097, qvil Code). Lenders Neme: Lander's Atldress: Signature: Date: �... .. _ � � if I hereby ettlrm ' t untler � alty of per�ury that I em EXEMPitPROM THE CONTRAC70RS LICENSE LAW for Ihe tollowing reason (Sec. 7031.5, Buslness entl Professions Code: Any ciry or county which requiros e parmit to con5liucl��Q�r, improva, demolish, or repair any sWCNre, pnor to Its issuance, elso requires the epplicant for such permit to file e signed stetement that he or she is Ilcensed pursuant to the provislons ot �he Gontractore License Lew (Chapter 9(commencing with Sectlon 7000) ol Divislon 3 of the Business and Prolessions Code) or thet he or she is exempt Iharefrom entl the besis for the ellegetl exemption. Any vloletlon of Sectlon 7031.5 by eny eppliceM tor e pertnit subjecis ihe eppllcant to a civil penelry of not more Ihen five hundred dollers ($500).): ❑ I, as owner ol the property, or my employees with wages es their sole compensation, WILL DO T1E WORK, and Iha structure I5 not IntentleC or otleretl for sale (Sec. 7044, Business and Professions Code: The Contractore License Law tloes not apply to an owner ot property who builds or ImprOves thereon, and who tloes such work himseN or herseN or through his or her own employees, provided ihat such improvements are not intended or oNered tor sele. If, however, Ihe builtling or Improvement Is sold within one year oi complation, tne owner�huilder will have ihe burden ot proving that he or she did not build or improve for purpose of sele.). • ❑ I, as owner ol the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Coda: The conirectors License Lew tloes not apply to en owner ol pmperty who builds or Improves thereon, and who wntracts lor suc� projed with a contractor(s) license pursuent to the Comrectors License Lews.). ❑ I em exemp�der seg,` �i Business and Professions Cotle for Ihis reason: _ Owner ID verifietl by drivar sJii�ense. ❑ Ves ❑ No �nver's�license`No. Ventication ol Owners�lp Dy (type of tlocument, i.e. - pmperry tex bill or daetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: � I hereby certity that no excavation five (5) or more leet in tlepih into which e person is requiratl to tlescend, will be made In connection wlt� work authorized by Ihis pertnit, end ihat no building siructure, sceHolding, lalsework, or demolition or dismantling thereoi, vnll be more ihan thirry-six (36) (eet high. (Chap. 32, Grp 2, Art 2, Sec. 341, T�le 8, Celifomia AAministrative Cotle). ❑ As ownerbuiltlar, I will not employ anyone to do work which would require a permit irom Ihe Division ot Indusiriel Sefery, as noled ebove, unleu such parson hes e pertnit to do such work irom Ihe division. Signature: Date: Division of Industrial Sefery Permit Number: CERTIFlCATE OF COMPIIANCE ANU AU7HORVATON OF ENTFiY: I certity under penalry of perjury ihat I have reatl this apDlication end steta that the infortnation given is correct. I agree to wmply with ell stete lews and ciry ordi nces relating to builGing construction, ana euthorize representatives oi the Ciry of Casta Mesa to enter upon iha ebove-described Dmp j for i ction pu s. I�t to occupy or allow occupancy of eny building authonzed by this pe � uNi�inel inspeCion. d dJ 'Signalu�ed� et'Owner(s) LDate�� And/Or Authorizad Applicant yQ�E �. INSiELTIONTYPE 1676 Fixetl System Flnal Fire Prevention 1268 Pool Spa Finel 200 Final Re-Rool � 201 Final Block/Retaining Wall 202 Final Fectory Fire Place 203 Final Slgn 204 Final Demolition PA� It�p45 � • AT I� COOE I INSPECTION TYPE 206 Final Mechanical 200 Final Plumbing 210 Final Electncel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy PAg. I�l� Job Address: Suite No Viciniry: 3449 PLUMERIA PL REAR OFPROPERTY , .� �.+�n unrvt, GUSTA MESA, CA 92626 MECHANICAL PERMIT i i i Sfatus: ISSUED Applietl: 09/07/2005 Issuetl: 09/01/2005 Parcel Number: 41277377 Applicant: HEFNED, KRIS ISSUEo BY: �--' Address: 344gpWMERIAPL - .� d �Phone 714-540 6D4- � . �� COSTA MESA, CA � . . �� Zip;. �� gZ626-1730 �� . . � Owner: HEFNED;''KRIS „� ,a Add25e 3449 P�IUMERIA PL _, ��' - � `,?. ' �. nPhone. . ,,.,: � � ,COSTAMESA�,CA Zip: 92626-1730 � �� .'-�_ � , , ,:> .. :.' ' : ' . t�_ contractor OWNER-BUILDER Atldress: ..: - ' � � . , . . - . . .� � > '& � _ Phone: -��- ZiP . ' , ' � � SCOPE OF P CONS7RUCP432 S.F..GUNI7E SWIMMING POOL-AN 'OFpROPERTY.REF.:;805-01473 MECHqNtCAC;7QINCCUDE: 1 INST FAU> 100K BTU. , ,� _ _.. _ - FEE Sl �t.t- �ti ,. �GUNITE SPA LOCATED AT REAR'' s f� � 'd,'. '�@ ` , � . a Fa, Quantiry r " ,� k `� a� N..' -� , ` ISSUE �FEE - � � - - - � "�� . � ' �^� , � � - ,' $2350 �� ` a " Quantity Inst FAU <100 k BTU � � $0.00 � 0 . Repav /Alt Absorbtion Unit `� _� $p � Q tnst FAU>100 k BTU � $182D �,_ Repair /Alt Refrigeration Unit =��# - Repair(Alt Cooling/Heat ' ' � _ --VenGllationSystem, y � -�� `�= $�'� 0 '-�-. Inst/Rep.RecessWallNh � �:-�$D.00-� 0 ; ,. . _� EyaporativeCooler -.�` - - -"�r.�� $0.00 0 , RefrigSys<100k�BTU . ��,z.� - $0.00 0:^ � � ,-Commerciallricinerator�.: ' "� $�'� 0 � Retrig Sys >100 k BTU . -- $0:00. 0 Domestic Incinerator � 50.00 0'� � Gas Piping • _ � $�� omoressors /qbsorofion Svstem - - - ,50.00 0 ." Factory Fireplace . 50.00 0 Up Jo 3 hp I 100 k BTU - Hood w/Mech Exhaust.: ;: �" -$0.00 0 3 To-15 hp / 500 k BTU VAV Box � , '�'$O.OQ 0 :. 15 To 30 hp / 1,000 k BTU Vent Fan / Sin le Duct �.$O.OQ 0 ,: ,� � =-30 To 50 hp / 1,750 k B7U 9.� , '$0.00 0 � . '" Appliance `,�' • � �'-�� ,_ $0.00 �. 0 � � , " � Over 50; bp / Over 1,)50 B7U ,_ _. Fire Dampers � . � .,$� QQ � �•Bo�leis' Smoke Dampers � � $0.00 0`"� � £�Up to 3 hp "�� InstorRelopteApplVent "�, $0.00 p a=.,.� � .��3'To15hp; �" , Air Handlers c 1000Qctm �$OAO 0',`+��' Air Handlers > 10000c(m �. _ <�$0.00 , 0 � � �� s. Floor Fumace h �'�$0.00 0 Floor or Suspend Neater � :-, _ $0.00 .; -, 0 � "�-x� � - . �: . < .,,n." �_ .., ��. . -. . . .�. �' � �.r,�.s <= � "� ' ?'�=' -� ,,:z � ` . - niwl Fee �, . Fee �;eey;� t � � Fee ' .-� $0.00 �0 $0.06 A $0.00 ' `0 ,--'$0.0,0 �0 $0.00°' 0 $0:00 p $0.00 0 $0.00 0 $0.00 p $O.DO 0 $0.00 $0.00 $0.00 � TOTAI CALCUl�,4TED FEES §q�.7p .. �'_'.s-',a... - N0710E: The work authorized by this permit shail comply with all applicable handicap access requirements under Califomia statutes antl related regutations. (Ord. No. 92-28, § 1, 72-2�-g2� EXPIpqTION: 7his permft shall automatically expire and become void It work is not commencad within 1 BO days, or it work is suspended or abandoned tor a penod of 780 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes,.an� required Inapeetlons and ffnal approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 zaaae �eroo� WOPKERS'COMPENSAnON DECLAAAnON: � I hereby affirtn under penelry of perjury one of tha tollowinq declarations: � ❑ I heve enC will maintain a certificate of consent to self-Insure for workers' compensetion, as providad for by section 3700 ot Ihe Lebor Code, for the performance of ihe work tor whiCh IhiS permit is issued. 0'�I.have antl will main�ain woMers' compensetion insurance, as required by section 3700 W the Lebor Code, or ihe peAortnance of the work tor which this pertnit is Issued. I�'My workers' campensation Insurence carrier end policy number are: a ' -" ,Poli um �� ,,,......,,, ///!s s tJon need nof be comp/eted il (he permif Is valued et one huntlretl dollers ($100) ar less.) .y- -'" �.y I certity that in Ihe pertortnance of `he work far which this permit is issued, I shell not employ any person in eny manner so es to become subject to Ihe workere' ]L. compensation laws of Califor ', a�d egree tha 'f I sho tl becoma subject to the workers' compensation provislons of Sectlon 3700 of tha Labor Cotle, I shall forlhwlth � comply with these provis'o . n /� �Applicent Signeture: Date: ' /' b' � S "WARNINO: FAILURE TO SECURE WORKEiiS� �MPEN$ ION COVEfiAGE IS UNL4WFUL AND SHALL SUflIECT AN EMPLOVER TO CRIMINAL PENALTIES AN� CIVIL FINES I1P TOONE HUNDRED TFIOUSAND DOLLARE (5100,000}, IN AWITI04TOTHE' ST OF COMPENSATION, DAMAGES AS PROVIDED FOR iN SECTION 3"/050f THE IABOR CADE, iMEREST, AND ATTORNEI"5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn Ihat I am licensed under P�o�sions of Chapter 9(commencing with Section 7000) oi Division 3 of tha Business and Protessions Code, and my license is in full force en0 eHeCt LiC. k Class q GontrectoYs Signature: Date: CONSTRUCTON LENDING AGENCY; ❑ I hereby aNirm ihat there is a construction lentling agency for Ihe performence of the work for which �his permit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Address: Signature: Dare: OWNER-BUILDER OECLARATIONS: I hereby aHirtn thet under penalry of peflury that I em EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7037.5, Businass and Professlons Code: Any city or counry which requires e Oerrnit to consiruct, alter, improve, demolish, or repair any SWCNre, pnor to its issuence, elso requires the applicant for such permit to file e signed statement that he or she is lic�e ed'pLrsuen[ to ihe provisions ot t�e Contrectors License law (Chaptar 9(commencing with Seclion 7000) of Division 3 af the Business and ProP�ions Code) or tha� he„Q� he.;'�s'exempt tlierefconi and the basis lor the alleged e:emption. Any violetion oi Section 7031.5 by flny applicant for e permit subjects tha applican(;l�a civil penalry o� �MSTiora'�9ian five hundredtlollers ($500).): ❑ I, as owner of Ihe properry, or my employees with wages as their sole compensation, WILL DO THE WORK, antl the siructure is not intentlea or oHered tor sale (Sec. 7044, Business antl Professions Code: The Coniractors License Law does not aDPly to an owner of properry who 6uilds or improves Ihereon, antl who does such work himseli or herself or through �is of her own employees, provided that such improvemenis are not intended or oflered tor sale. tl, however, iha builtling or improvement is sold within one year oi completion, tha ownerbuilder will have Ihe burden ol proving t�at �e or she did not build or improve for puryosa of sale.). ' ❑ I, es owner oi the property, am EXCIUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (Sec. 7044, Business antl Professions - Code: Tha contractors Licensa Law tloes not epply to an owner ot propeny who bullds or Improves thereon, and who contracis tor such project wit� a contractor(s) license pursuant to ihe Contractors License Laws.). ❑ I am evem t untl se . Business and Professions Code tor this reason: Signature:�- �� Date•-�.- •" Ownar ID verifietl by tlnver's licen . ❑ Yes ❑ No Driv{ eYs�l:icanse No. fi1 �� Expires:. d S Verification oi Ownership hy (rype of tlocument, i.e. - properry tax bill or deetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: ❑ I hereby certity ihat no exwvation �i�e (5) or more teet in depih into which a person is requiretl to descend, will be made in connec�ion with work au�honzed by ihis pertnii, and Ihal no building structura, scallolding, falsework, or demolllion or disrfianiGng Ihereot, witl be more ihen ihiriy-six (36) teet high. (Chap. 32, Gry 2, An 2, Sec. 341, Title 8, Calitornia Adminisirative Code). ❑. As owner-builder, I will not emplay enyone to tlo work which would require e permit from the Division ot Intlustriel Sefety, es noted abova, uNess such person has e permit to tlo such work from ihe di�ision. Signature: Date: Division ot Indusirial Safety Permit Number: CERTflCATE OF COMPLIANCE AND A�MORR.ATION OF ENTRV: I certify under penalty oi perjury that I have read this epplication and s�ate Ihat ihe Iniortnation given is correct. I agree to comp with all pstagt�e lews and a ordinances relating to builtling consiruction, and authonze represantatives ot ihe Ciry of Costa Mesa m enter upon ihe ebove-descnbed pr for inspe ti ��pos agree not to occupy or allow occupancy of any building authonzed by this permit untiql final inspection. !iC/ ! ��' 0 � ' Slgnat"- fCegalOwner(s) Date"' And�Or Authonzad Applicant Date COUEN, MSPECTIONTYPE P97E INTITIRLS 161fi Fi:ed System Final Fire Prevention 1266 200 201 Pool Spa Final Final Re-Root Final BIocWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition COpEN INSPECTIONTYPE 206 Final Mechanical 20B Final Plumhing 210 Final ElecMtal 212 Final Fire Prevention 220 Final Planning Approvel 222 Final Site 250 � Final Building/Otcupancy UATE --6-06 L (714) 754-5273 • Fax (714) 754•4856 • www.ci.costa•mesa��MBING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 ,lobAddress: 3449 PLUMERIAPL Suite No Vicinity: Parcel Nunmber: 41217317 Applicant: HEFNED, KRIS Address: 3449 PLUMERIA PL Owner: Address Phone: 714-540-6274 COSTA MESA, CA - � �Zip:. 92626,7730 . HEFNED KRIS ' 3449 PLUMERIA�PL � F . COSTA MESA, CA. - " �,.: � - - ' .. -: Contractori OWNER-BUILDER Address: - � -P.,hone .�-. ; :z�-Lp � 92626-1730 Phone:; Zip: � License: - 000000 - .� . SCOPE OF PEI �CONSTRUCT 432S.F. GUNITE SWIMMING POOL AND ;-�PROPERTY: REF,.: 605-01473 �;PLUMBINGTO.INCLUDE: 1 POOLAND 1 SPA.,,�, , _ Status: ISSUED Applied: 09/Ot/2005 Issued: 09/01l2005 ISSUED BY: �' L - 'MIT - i4 S.F. GUNITE SPA�LOOATED A � �` ` : � �: •= FEE SUMMARY ' � ' ' -�' ` � ' � = ` � - �� , <,; ' . �' ^ � ,.E - � AMT , �QTY AMT �T-Y � - AMT �'� QTY ISSUE FEE � �.� �. � $23 50 ' Laundry Tub / Washer $0.00 -0 � Sump Pump � � $0.00-'q 0 Backflow irrigation � � $0 00 0�� _ � � ��Candscape.lrrigation ' � � ,$0 00 ' ,0 - , , ��.�Swimming-Pool a°;�' . $60 75 ' 1 Backflow �Preventer � �' �$0 00 - 0`_ S� ; P Trap` ;, _- " '$0 00 �0 � : � �i ��Trap Primer $0 00 _� 0 Bathtub =` � �°z � �$0 00'' `� 0 ' � �"Pressure Regulator �-�`�� • $0 00 - 0 � � �� Urinal - . .r $0.00-- 0 Clarifier System., ,' , $0.00 ��. ,':.0 � Process Piping (per 10 ft) $0.00 ` 0 Vacuum'BikrBkFlow(t-4) � $0.00 0 Connect (Ice,Soda,etc) ,�$0.00 0. - Receptors $0.00 0 Vacuum Bikr�BkOow(5+) . $0.00 0 Dental Units" . '$0 00 0�.- Septic Tank -�$0.00 .-0 Wash Basin � . $0.00 0 Dishwasher'-� ,$0.00 �� -0"-.�-:- Sewer Cap for Demo $0.00 0 Wash Basin Set _. � $0.00 0 Drain, Floor $O.OD ` 0� �-- Sewer ConnecL ---r- -� $0.00 0 Wasle and Vent System $0.00 0 Drain,RainwateF, -�-- � $0.00 � 0,.. SewerPrivate�Line- -��$0:00 0 WaterCloset(Toilet) "$0.00 0 Drain,Roof �_:;�� $OA� _Oi..:"� Shower- ' -',5000� 0 WaterHeater/yent " $0.00 0 DrinkingFountam� - �$0.00 `0'�s- -,Sink^bar ;�'$000,,,._0 -.•.WaterPiping(InstorRep.) � $0.00 0 Expansion Tank $0.00 -� 0�' ` ;Sink commercial ;. $0 00 �" - --0 �� Water Re-pipe � . $0.00 0 GasEarthquakeValve-� $0:00 0� ,�_Sink�Floor � � ;:,;$000 �.0 ��.:WeteryService $0.00 0 , � Gas (1-4 outlats) ; $0 00 --,0_ �: �Sink, kitchen ,,. ' -� � $0 00 �;0_;� � ' Water S'oftener $0.00 0 Gas (Over 4 outlets) �a;` $0�00 ; �_ -0- �-� `"Sink service%mop ; ; .N ,� � $0 OOr�:F.O - - OTHER� - $0.00 Gas Repipe ' -, $0.00 � . � � 0 - Spa (prrvate) �,- - $30 25 ��.�;�1 - � VIOLATION � ,, $0.00 Gas Service �$0:00, � 0 :h.`Spa (public) :_ _ -.�;$0:00 - 0 � �PLAN CNECK�`� $0.00 Interceptors (Grease, Oiq $0.00: << 0 ; - - `z-_'. REINSPECTION $0.00 0 Interceptors (Sand Auto ) $O.OD � 0-, - � ,� ' �' � • :� �� i` , , TOTAL CALCULATED FEES: 5114.50 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 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� la I requlred Inspectiona end finel approval must be obtalned. Failure to obtain inspections and final approval will result in the expiration of this permtt� v FOR INSPECTIONS CALL: (714) 7545626 z+ne-ae �aroo� WORKERS' COMPENSATION DECLARATON: I hereCy ettirtn untler penalry of perjury one oi Ihe Following declaretions: ❑ I hava and will mainteln e certificete of consent to self-Insure tor workers' compensatlon, es proNtled br by section 3700 0l the Lebor CoEe, lor the pertormance of the wark for which Ihis pertnit Is issuetl. antl will maintain workers' compensation insurence, es required by section 3700 of the Lebor Cotl , for the erformance of the work for which this pertnit Is issued. Ikers' compensatlon Insurance carner entl policy numCei are: � P icY. r::�,, i need not be compleretl ll the permit is velued af one hundred dollars ($100) or less.) @-' I certity that in ihe pertormance of the work tor which this� rtnit is issueq I shell not employ eny person in eny menner so as to become subjact to ihe workers' I compensation laws of Celifomle d egrae that f I sh � becom .�subject to tha workers' compensetlon proWslons ot Sectlon 3700 ot the Lebor Cotle, I shell fort�wit� comply with these provision AppllcantSlgnaWre: ' Dete: �� WARNING: FAILURE TO SECURE WORKERS' COMPE TION COVEMOE IS UNIAWFUL AND SHRLL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUNDRED T/10USAND DOLI.ARE ($100,OW), IN ADOITIdJ TO THE COST OF CAMPENSATION, DAMAGES AS PROVIOEO FOR IN SECTION 3]OB OF THE LABOR COpE, IMEFEST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm thet I am Ilcensed under provisions oi Chapter 9(commencing with Section 7000) of Divislon 3 of ihe Business and Professions Code, and my Ilcense Is in full tOrce end eftecl. lia N CIa55 N Contracrors SignaWre: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that there is a consiruction lending agency for Ihe pedormance of the work for which ihis permit is Issued. (Sec. 3097, Civil Code). LentleYs Name: Lentlefs Adtlress: SigneW re: Dete: OWNER-BUILDER DECLARATIONS: I hereby ettirtn Ihet under penelry ot perjury thet I em E%EMPT FROM 7ME CONTRACTORS LICENSE LAW for the Iallowing reeson (Sec. 7031.5, Business end Profeuions Code: Any ciry or wunry which requires a Dermit to construc4 elter, impmve, demolish, or repeir eny sWciure, prior to its issuence, elso requlres the epplicant for such permit b file e signed stfltement that �e or she is Ilcense0 pursdant to the provisions oi Ihe Contractors License Lew (Chapter 9(commencing with Sectlon 7000) of DlWsion 3 ai the eusineu end Pmfessions Code) or thet he or she is exempt therefrom anA the besis for Ihe ellegeC enemption. Any vloletlon ol Section 7031.5 by eny epplicam for a permit subjects the epplicant to e civll penalry of not more ihan Hve hundred dollers ($500)J: ❑ I, es owner ot Ihe property, or my employees with weges es Iheir sole compensatlon, WILL DO TME WORK, and ihe structure is not intentletl or otteratl for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew does not apply to an owner ot properry who bullds or improves Ihereon, antl who does such work himselt or herseli or Ihrough his or her own employees, provided that such improvements are not Intendetl or oNered for sele. If, howevar, the building or improvement is sold within one year of completion, the owner-Duilder will heve ihe burdan ot proving ihal he or she did not �uild or Improve for purpose of sele.). ' ❑ I, es owner ot the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe pro�ecl (SeC. 7044, Busine5s entl ProfeSsions Code: The contracrors LJcense Law Aoes not epply to en owner of propany who bulltls or Improves thareon, entl who conirects for such project wlth e contractor(s) license pureuant ro re Contractars License LawsJ. ❑ I em exampt n sec. Business end Professions Cotle lor this reason: Sign �a ut e � w��. � _ __ Owner ID veritied by drivefs Ilcense. ❑ Ves � No Ddver's License No. � Venfication ot Ownership by (type oi document, i.e. - properry tex bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICA710N: ❑ I hereby certity that no excevetlon five (5) or more feat In depth into which e person is required to descenC, wlll be made In connection wilh work authorizetl Dy this permil, and that no building siructure, swNoltling, felsework, or demolilion or dismanlling thereof, will be more than �hirry-si: (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Tllle B, Califomia ACministwtive Code). ❑ As owner-builder, I will not employ enyone to do work which would require e pertnit irom the Division at Industrial Seley, as noted ebove, unless such pereon has a permit to tlo such work Irom the division. Signature: Date: Division of Industnal Safery Permit Numbar: CER71FlCA7E OF COMPLIANCE AND AUTHORIZATON OF EI Y!I certify under penalry of perjury that I �ave read ihis epplication and state ihat the intortnation given is correct. I agrea to comply with II stare laws entl ciry oidine�r o�relating to huilding constructlon, and authorize rep�esentetives of the City ai Costa Mesa to enter upon Ihe ahove-dascribed property to "�pection pu e4.1 agr � ov nr flllow occupancy of eny Guildiog authorized by this permit until final inspection. `j- 6-0> Slgn� eNre Of Owner(� Date-'--. ��__ AnNOr Authonzetl Applicant Date COOE I. INSVECTIONTYPE 1616 Fized System Final Pire Prevention 1266 Pool Spa Final 200 Final Re-Rooi , 201 Final BIocWRetaining Well I 202 Final Factory Fire Plece 203 204 Final Sign Final Demolition eeg u�eis cooe� iNsvecnoNnae 206 Final Mechanical 20B Final Plumbing 210 Finel Electrical 212 Final Fire Preventlon 220 Final Planning Approvel 222 Final Sita 250 FinalBuiltling/Occupancy PAIE INTff11L5 b� � (714)754-5273 • Fax(774)754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT , PERMIT JobAddress: 3449 PLUMERIA PL Suite: Vicinity: Parcel Number: 41217317 Applicant: MIRANDA,FRANK Address: 18193 MUIRWOOD CT CA F.V Owner: LE, TRI MINH Address 3449 PLUMERIA PL COSTA MESA, CA Contractor: ISLAND PACIFIC ROOFING Address: 18193 MUIRWOOD CT CA F.V Zip: 92708 Arch : Address: BUILDING PERMIT Zoning: R1 R1 Phone: (714) 557-6516 Zip: 92708 Phone: Zip: 92626 Phone: (714)557-6516 License: 631472 Eng: Address: ; PERMyNUMBER / ✓B00-00606 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 05IO2/2000 Issued: OS/02/2000 ISSUED BY: _�IYl'` Phone: Phone: Zip: License: License: SCOPE OF PERMIT T/O EXISTING WOOD SHAKE INSTALL 1/2" CDX, APPLY 30LBS FELT AND 30 YEAR COMP. SHINGLES. Plan Check: $0.00 Permit: $111.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $711.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Fron� 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Required: 0 FEE SUMMARY PLANNING & ZONING Lett 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0-0 Right 0- 0 as,000.00 $5,000.00 NOTICE: The work authorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) . EXPIRATION: This permit shall automatically expire and become void if work is noLcommenced within 180 days, or if work is suspended or abandoned for e period of 1 BO days. INSPECTIONS: In order for tha work authorized under lhis permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlona entl final epproval must be obtained. Failura to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKEFS'COMPENSAnON DECLAHAnON: 'o � � I hereby attirm untler penalry of perlury one of the tollowing tleclarations: ❑ I have entl will melntain e certlficate of consant to self-Insure for workers' compensation, es provided for by section 3700 ot ihe Labor Cotle, for the peAormance oi ihe ,,,GGG wark far which ihis permit i9 issued. 7� I have antl will mRapgintagin workers' compensa[ion insurance, as r ulretl by section 3700 of the Lebor Cotla, for the pertortnance ol Ne work for which this pertnit is issueatl. \MYW °�'L'. Y B/�i�� :�a� p�li�� e, ,B: . �✓G �—/ 9 --�i` —I/ Carner. � Policy Number. (This section need no( be comp/eted i! (he permi! i valued at one hundred dallers (5100J or Ie55J ❑ I certity t�et In the pertormance ol the work for which this parmit is Issued, I shall not employ eny person in any manner so es to becroma sub�ect to the workers' compensation laws ol Califomia, antl egr � if 1 s�oultl become s bject to the workers' compensation pmvisions of Section 370/0 oi the Labor Cotle, I shall totlhwith � °h °`s` �n s �/OD Applicant S' ure: �� i%/'/ Date: /N WARN : FAI RE TO SE E WORKERS' ODMPEN ATION OOVERAGE IS UNIAWFUL qND 5H4LL SUBIE TO CRIMINAL PENALTIES AND GVI� FlNES UP TO ONE HUNDRED TMW E(E100.000�,INADDIiIONTOTHECQSTOFGOMPENSATION,DAMAGESPSPHOVIOEDFORINSECfIQY�WOFTHELABORCODE,IMEREST,ANDATTORNEV'SFEES. aftirm thet I am i ettect Lic. a. Chapter 9(commencing wlih Sectlon 7000) of ' ision 3 of the E Class a �% ✓� L Dare: Code, nntl my license is in full CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm thet there is a consimction lending agency for the pedormance of ihe work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lenders Address: Signeture: OWNER-BUILDER DECLARA710NS: Date: I hereby attirm that under penalry of perjury Ihat I am EXEMVT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Cotle: Any ciry or counry which requires a pertnit m conslrucL alter, improva, tlemolish, or repair eny sWCNre, prior to its issuance, also requires the applicant br such pertnit lo file a signed siatemenl ihat he or sha is licensetl pursuant lo the provisions ot Ihe Conirectors IJcense Law (Chapter 9(commencing with Section 7000) of Divlsion 3 of the Business ana Professions Code) or thet he or she is ezempt therefrom entl tha besis for the allegetl enemption. Any violation of Sectlon 7031.5 by any epplicant for a pertnit sub�ecis Ihe appllceN to e civll penalry ot not more than five hundretl dollars ($500).): ❑ I, as owner of the propany, or my employees with wages as thair sole compensation, WILL DO THE WOHK, and the structure is not intentletl or ottered lor sale (Sec. 7044, Business end Professions Code: The Contractors License Lew does no� apply to an owner of property who builds or improves t�ereon, and who does such work himsell or herselt ar t�rough his or her own employees, provided tha� such improvements ere not intendetl or oNered for sale. If, however, the building or improvement is soltl within one year of campletion, ihe owner-builder will heve the burtlen oi Oroving ihat he or she did not build ar improva for purpose ot sale.). ❑ I, as owner of Ihe property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construci the projecl (Sac. 7044, Business entl Protessions Code: The conirectors License Lew does not apply to en owner oi propetly who builds or improves thereon, entl who contracis for such project wi�h e contracror(s) license pursuant to Ihe Conirectors License Laws.). ❑ I am exempt untler sec. Business and Professions Cotle for this reason: Signature: Date: Ownar ID verifiad by tlriver's license. ❑ Yes ❑ No Driver's License No. Venfication of Ownership by (rype oi daument, i.e. - propeny tex bill or tleed): DIVISION OF INDUS7RIAL SAFETV VERMIT CERTIFICA710N: Expires: ❑ I �ereby certlty ihat no excavation five (5) or more feet in depth into which a person Is requiretl to tlescend, will be made in connection with work authonzetl by ihis pertnit, entl that no building stmcNre, scaHolding, falsework, or demolition or dismantling theraoi, will be more than t�irty-six (36)leet high. (Chap. 3.2, Grp 2, Art 2, Sec. 347, 7�1e B, Californie Administrative Code). ❑ As owner-builtler, I will not employ enyone to do work which woultl requlre a permit from the Division of Industrial Safery, as notetl aDove, unless such parson has a pertnit ta tlo such work from the division. Signaiure: Da�e: Divisian oi Intlustrial Salery Pertnit Number: CERTFICATE OF COMPLIANCE AND AIfTHORIZATION OF ENTRV: 1 certity under penalty ot perjury ihat I have read this application and state that the intormation given is correct. I agree to comply wiih all state laws antl ci�y ortlinances relating to builtling constmction, entl authorize representatives oi the City ol Costa Mesa to enter upon the ebova-descnbed property for inspection purposes. I agree not �o occupy or allow acupancy oi any bulltlinq authorizetl by this permit un�il final Inspection. GOOE �, INSiELTIONTYiE 1616 FIxeO System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 20/ Final BIocWRetalning Wall 202 Final Fectory Fire Place 203 Finel Sign 204 Final Demolition 2448.68 4AIE INIIDaIS COOE1 INSPECTONTYPE 206 Final Mechanical mn 208 FinalPlumbing l% Ud 210 Final Electncal 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final BuildinglOccupancy P9IE INTRIRLS AVC��ant t� fi11 in all sDaces except thoze within neavy border lines antl sign all approvriate tleclarations. CITY 06 COSTA �M,EIS'AIn CO}N�S'TRUCTION PE�RjMIT PERMIT � �� TRACT NO. LOT NO. UNIT NO.. Projett Address �1�Z''L�'i�T( l� � � Applicant'sMailin�g/A-ddres` /��-��f� Owner's Name � ^�5��^ � �eP� Phone Address � � � Arch/Eng. License No. Address p� Cqntracmr's Nam : � - Pho e(�.1-� Address (mailing) )/� � - , LJ City Licen N \ "JI / �� LICENSED CONTRACTOR OEGLARATION 1 hereby at�irm [hat I am licensetl untler provi5ion5 ot Char[er 9(commencinq with section 1000) of Oivisbn 3 of the Business antl Professionz Cotle, antl my license is in ful�iprc and eHe<t. L .� � Llcense 'cePse • Datc � � - Signa�ure � � WORKEFS' COMPENSATItlN DECLA0.ATION I hereby afiirm that I have a certificate ot consent to Selt-insure or a certiflcate i Workers' Compensation Insurance, or a certitietl copy Ihe�eot (SeCtion )00, Lab. C.^i(� r+olicY No. �L�Jv1.7.�� ComPanY �� - �Certilietl copy is hereby Nrnishetl. /' e[dlieQ cop �Is tilea wilh the city tli �v/Hop //] �� / Date��/ �" �/ APPlicant �-�%'�( vU� ('� /v EXEMPTION FA�M W�RKERS' COMPENSATION �EGLARATION (Tnis sectlon neetl not be comP�etetl it the permit is tor one nunOratl (E300) or Icss). I ce�Ufy that in the performance of the work fo� which this pC/m�t i5 i55uetl, I shall not employ any DersoP in any manner so as to become sub7ect to the Workers' COmpensa[ion Laws of CaIlPomia. Date � - Si9nature NOTICE: 1t, after �making this tlecla�ation, you 5hou10 beGome SUbject to the Workers' Compenzatian pro��5ions Of the Labor Cotle, y0u mu5t forthwith comply with such O�ovisions or thi5 permit shall ba tleemetl ,�evoketl. CONSTRUCTION LENDING AGENCV I hereby a((Irm that there Is a�onstruction lenaing agency Por the oerformance of th0 work (or which thi5 perml[ Is issuetl (Sec[ion 309] Civ. C.) Lentler's Name �enaer'S Adaress - - OWNER BUILOER DECLARATION I herGby af/irm [hat I am e%empl from the ConVacto�'S License La'.v tor (h¢ following reason (Section 7031.5 Business antl Protessional Cotle: Any city or county wnicn requires a permit �o <on5truct, alt¢r, iTP�ove, tlemolish or �eDal� any StruCtur¢, prior to ils i55uance, also requires the applicant to� such Oe�mit to file a signetl statement that Ite/she Is licensetl pur5uant to the provi5ion5 of tne ConVactor's License Law (Chapter 9,(commencinq wltM1 SecHon 7000) of � Division 3 of [he Business antl Profesvons Cotle) or [ha[ he/sne is exempt 'herefrom antl the basis fOr the allegetl ezemOtion. Any vlolation of Section 131.5 by any applicant for a permit subjects the applicant [o a civil nalry ot not more tnan five huntlretl tlollars �($500). L� I, as owner ot lhe property or my employees wi[h wagas as their sole tompCnsation, will tlo ihe work, antl the siructure is not inlentletl or offeretl for sale (Section 7094; Business antl Professional Cotle: The Contractor's Litense l.aw tloes not apply to an owner of a property who builtls or improves th¢r¢On, antl who tloes SucP wo�k himselt/ne�selt or Ihrouqh his or hEr own employees, proviCeG [hat su�h Improvemen[sare noi intentlatl or ofteretl for sale. If, �oweve�, tM1e builtlin9 or improvemen[ is soltl wit�ln one Yla� ot com- oletlon, the owner will have Ihe buraen of o�oving he/sne tlitl not ouiltl or im- prove lor [he purpose oi sale). ❑ I, as owner of the property, am exclusively contracting wllh licensetl con- tractorsto const�uct tM1e p�o)ect (Settion ]044, Business antl Profe55ion5 Cotle: The Coniractor's License L➢v+ does not apply to an owner ot prope�ty who bulltls or Improves thereon, antl who conVacts for such proiects with'a con- tractor(51 iicense purmant tP tM1e ConVacror's License Law). I am aware that proof of their Worker's Compensatlon insurance shoultl bC Provitletl to me. I] I am exempt untler Sec[ion B. & P. C. Por this reason Data Ow�er I nereby certify t intormalion is con antl slate lawz .el; Signaturo Drivers' L upon a TYPE!OFCONSTRUCTION LJ NEW LJ ADD lJ ALTERATION Pd REPqIR �`CONVERSION ❑ DEMOLISH ❑ OTHER A p # DE CRIPTION OF WORK/USE OF BLDG. , S Main Buildi TVPEO � ERMIT GRADING �hOUNDATION STRVCTURAL T Front ❑ T HNT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear ❑ O HER A PROJECT DESCRIPTION 50. FT. OCCUPANCV C Right CONSTRUCTIONTVPE VALUATIONS g left ZONE'� GfiADING CU.YDS. ACRES Ping. R¢F. {� Remarks:, Planning Notes: Sink Preventer Irrigation Drinking Fountains Floor Drains � Floor Sinks Gas Service Outlets InterCeptOfs Kitchen Sink Lavatories P—Trap Roof Drains Reinspeetion Fee Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping . Solar Tank Swimming Pool w/Spa Urinal Wacer Closet Water Heater � Water Service Auto�Wash Laundry Trays $15 Issue Fee Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. B�t. ICBO # Heating System & Ducting ❑ 6100,000 BTU � 100,000 BT 55 � �� ' � '+� �� I I Aeinspac[ion Fee ..�- CMF OB65-46, rev. 10/84 White - BWltling; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor $15 Hood or �Typel Canopy �Type II Refrigeration Sys[em ❑0�700,OOOBTU ❑t00,000BTU System Repair/Alteration Fire Dampers � Registers - Issue Fee FEES 5120 3/31/B7 500+ - -- Zone ' Accessory Building: � 2 O N I N G R Parking Req./Provided E . Q M T _ _ S Auromatic Washer � Construction Pale Sub. Cooking Unit Dishwasher Dryers �Gas ❑Electric Fan F,A.U. Fixtures Device eozes Outlets Switches � Garbage Dispoul Generator �65�KW 05-15 ELECTRICAL Transformer � 15-50 KW ❑ SO+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel MororsOO-1 HP O1'h-S� - ' Inc..Solar �9�15 HP �16:15+ Microwave � Pole Light Sign Standing Sections Trash Compactor $� Reinspection Fee $15 Issue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By � Appliration luued By $ 3 FEES $ 3 � SUMMARY OF FEES BUILDING PERMIT $ � SMIP ' $� PLAN CHECK $ PERMIT PLUMBING � $ -�-+�CZ^� ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADWG $ PLAN CHECK 50% $ MICROFILM $ � MECHANICAL . $ TOTAL FEE $ PLAN CHECK 25% $ CONSTRUCTION ANDPLANNING POOL & SPA � APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms %?�i 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � r 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd�.,-TeSt 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK. 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final � 15. Rough Electrical-Conduii 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access.Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. RoofFraming 73. Undergrnd.StorageTankOGas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT .Q/ 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �0.�.g� �� ¢S P�E2 .7A�3 :Vf�. L� 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomestic-Final 42. Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations � � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Elearic Release to Edison 50. Gas Release to Southern California Gas Co ! 51. CERTIFICATE OF OCCUPANCY ' No. Date _ + � Cl2i OF COSTA MESA RcQliEST rOF OCCli�.�QCY TRACT ti0. � '✓ DATE � � � / The developer of the above entitled tract desires to sell the above sec forth lot prior to the tine that the tract has beer. co:�pleted aad its streets accented by the City of Costa Mesa. The ur.de�' by execut'_r.g tnis agre=:�ent, acknouledges that /�e�she-a%�ey-� (was .ar�x�),(.(l�_ advised that this tract has not Seen g_ven final i^spection nor has it been accepted 'oy the City of Costa Mesa 2.s hav�ng cc.nnlied wi[h the conditioas of 2pprovsl which were i�;posed by tite Citr at tnn_ time the final tract nap was approved. "'he City assumes no liability fo* tne enforce-�ent o` the cor.ditio.^,s r.ecessery for approval other than tnose coa3itions protected 'oy sutety bond. The uadersigned agrees to '_r.da�ni`y ar.d heid the C�ty ha r,�less `rer„ ,; cla_;� res�lting _n da�:age o: perse:;al ar.jury to t'r.e L:ndersigned b� :eason of the aforementioned uncom�Ieted cor.eitioa. RECEIVEp ��7Y OF COSTA MESA aIANNtNR pFp7' ��P 2? 1?;3 A �"f �� 7,8�9,I�� ;a.C..�,.��J�� BY � /'�" �Q�dILU//�I Yurchaser �% �� '""_/_ ^ `� BY �-�:�1"ec-�._ �3 �1�/%% .=C��' � Develoner a;.d/or authorized .epresentative �: , BY ,iv ��a�/'i_ �/j ��c� iender PflOJECTP�UHE55: '344(3 p�,UMERIA PL OWNEX'SNAME: LE, TRI MINH �t aooRess: TRAN, DIANE H i ' 3999 PLTJMERIA PL � �OqTA597SA�CA 92626 � pHCH/ENGINEEF: PEG.NO.: nooncss: UNIT: uxiT: PEHMITTEE: DIANE TRAN ( 714 ) 754-1597 aoosess: 3449 PLUMERIA PL C.M. CA 92626 LILENSEO LONTNACTOH OELLNflRTION: I hereby alti�m ��a� I am licensed untler D�ovisions ot Chapler 9(commencing wi�� Section 7000� ol �ivsion 3 0l Ihe Business antl Pmfessions CaOe, antl my license is in tull lorce antl e��en. CITY LIC.: STRTE UC.: CLASS: �ale: Signalure: WOBNENS' COMPENSAiION oECLAflFTION: I hereby }Iiirm inat I have a cenificate al consent to sell-insure or a tenihca@ of Workers' Compensation Insurance. or a cenilietl coDY ��ereo� (Seciion 3800, LaE. C�. POLICY NO.: E%P. DRTE: COMPFNV: r] Cenifietl coDY is here�y Iumishe0. ❑ Cenilie0 �oOY �s liletl with t�e city Builtling Oivision. Oa1e: Np0licanC E%EMPTIONFflOMWOflNEflS'COMPENSRTIONOECIAPPT10N: (ihi55eclionneeanolCecamDleteOillhe0e�m�i5loronehunAre4�S700�orless�. I ce�ity Ihat in ihe pedormance of �he work br whic� I�is Oermii is i55ueE. I 5�all noi em0loy any person in any manner w as �o become su�lec� lo �he Worke�s Compensation Laws ol Califorqia. �ate: SignaWrP: NDTICE: II, af�er making ihis tleclara�ion. you s�opld �ecome suble6� �o Ille Wofkers' Comp¢nsaiion pfavisions oi �he La�or Catle, you mu5i IOrlhwilA comply wii� 5uch pmviyions ar �his p¢rmii Shail be tleemea revoked. CONSTHOCTIDN LENOING AGENCY: 1 hereby affirm thai Ihere is a consimclion lending agency �or ihe pedormance ol the woB for which this permil is issued (Se[tion 3097. Civ. C). LENOEfl: ROUflE55: OWNEN BWLOEB oECIABFTION: I nereby ailirm ihal I am exempt imm tAe Comractors' State License Law for the following reason (Sectian 7031.5 Business antl Pro�essional Code: Any piiy al coun�y which repuires a permi� �o con5�mci, atler, improve, tlemolish, or repair any simcture, prior [o its issuance, also tequires �he applicani lor such permil �o �ile a signe0 s�a�ement �hai helshe is Ilcensetl pursuant lo Ihe pmvisions ol the ConVac�ors' $ta�e Liceqse Law (Chap�er 9(commencing with $ection 7000) oi Oivision 3 o� [he Business antl Pmiessions Gotle) or ��a� he/she is exemp� I�ereirom ana Ihe hasis br Ihe allegeA exemp�ion. Any viola�ion o� Seclion 7031.5 by any applicanl for a permil sublecis Ihe appliiant to a r,ivil Oenalty of not more ihan live hunOred tlallars (8500). n I, as awner oi �he pmpetly or my employees wiN waAes as their sole compensa�ion, will Oo Ihe work, antl the A simcture is not inlentled or oflere0 for sale (Sectian 70ad. Business antl Pmfessional Cotle: The ConiractorY Slate License Law . tlaes nal apDly �o an owner o� a pmpetly who builds or impmves �Aereon, and wha Ooes such work �imsel�lherself of �hroug� his or her own employees, pmvitled Ihai such improvements are no� in�endetl or o��ereA �or sale. Ii, however �he buil0ing or impmvemem is soltl within one year al comple�ion, ihe owner will have ihe bur0en o� pmving he/she Oitl no� �uild or impmve lar ihe purpose oi sale�. I, as owner of Ihe propeny. am exclusivel9 con�mcling with licensed coniracmrs m cons�mc� the pmle�� (Sec�ion 7044, Business ❑ antl Protessions Coae: ihe Comracmrs' Sla�e 4icense Law tlaes nol apDly �o an owner o� pmperty who builtls or impmves ��ereon and wha contrac�s for suc� pro�ec�s with a con��ac�or(5) license pursuant lo �he Contractor5' S�a�e License law�. I am aware Ihai pwol o� their Worker'S Compensaiion insi�rance S�oNd �e pmvide0 �o me. � I am exemp� untler Seciion: B. 8 P, C. lor IhiS reason'. Da�e'. � — — Ownec � I tlo hereby ceni�y ��at I a ware ol anA unders�and Ihe requiremems oi Califomia Healih e e Sections 2 O5, 25533, antl 2553a and Ihal I or any lu� e builtling accuD�ni willlwil nol (circle one) neetl �o comply wit saitl stale codes an0 i�e requiremen[s �or a permi� for wns�mqion or odihcation �mm Ihe Air �uab�y Managemenl Ois�ricL liesitleni al consimttion applica�ions are exemp� Imm Ihese pmvisions. �ale: I� I Applicanl�, I hereDy cetlify Ihat I have reatl ihis applita�ian antl state ��a� Ihe above infor at is correcL I agree to comply wi�h all ci�y an0 coun�y ortlinances zntl staie laws relating to builtling con9ruc0oq and hereby aN�oriz epr sentaiives ot this city Io enter upon ��e a6ove-men�ianetl , pmperry for inspection purposes. / �� f �ate: � � — Z� — �� Signature; Driver's License or Sociai Sewri�y ��' - 16ai a6 Whpe—Builtlmg: G�een—Cotle Eniorcement; Canary—ApPlicanC Pink—Revenue; GOltlenro0—Assessar ` _� CITY OF COSTA MESA — HUILDING PERMIT PERM NU: E 05462" PERMZT NO: E 054622 PLAN CHECK NO: N GOVT; N SUPP; N CON5TRUCTION TYPE: PERMIT TYPE: ELE PJRPOSE: OTH JOB UESCRIPTION : UNDERGROUND FOR A PORTAHLE SPA SQ FT: CLAIM VALUE: CALC—VALt3E: GROUP OCC: / COMMENTS: NO OTHER WORK PERMITTED *****x��*�*��*��*x�*�x*�*�*�**��*x�***�x�*�*��r�x�*�*�*��r��*h*�r-�x**x�*+�*�� 'L O N I N G R E Q U I R E M E N T S sETSAcxs ------------ MAIN HUiLDINV ---------- --------- ACCESSORY BUILDiNG --------- FRNT: FT ZN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEET: FT IN RGHT: FT iN PARKING REQ• PROV: PARCEL: 41217317 ZNE: REF NO: PLANNING NVTES> i if iE if iE K iE �1f 1E if �E iF 1E 1(� �f if iE iF ih iE af if 1Fjf iE 1E 1E 3E )F if iE if if iFiF'iE �7F if iFlf 1E if IE i/� �F if i(� iE �# 1E If if 3F If ii� i't lE iE 1e }'. �1(� iE iE 3e x R 3k if� Y lf �f iF iFif �P-1F iE iE iF D E V E L O P M E N T S-E:R V I C E S R E Q U I R E M E N T 5 20NING APPROC�ED BY DATE: HUILDING APPROVED BY ; DATE; APPLICATZON ISSUED BY: S DATE• �� iEiFiEiE3FiE�F�EiEif#iEiEiEif�ififiE3FiEiE1F . ifiEifif'�9F3EiEi43f7FiF'�!Fb�3hiE iF if iE 3f iF iE iE iE 1E 1E �E N� 3E {E {F if 3E 3f if if iF iE if if iF iE iF iF 1E iE iF if'jE iF iE iP if �F iF iE fE iF iE if iF iF if iF if if iP :tif �(� iE 3F iF3E it if iF if jE iE 3f i(� if iE lf ieiF RjF i' iF iF iE iF iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SSGM�.NT:N BLDG PMT PLUMBZNG ELECTRIC MECHANIC FIRE SMZP/RES GRADING PERMIT 11$�Og PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 11,00 15.00 0.00 REVENUE DIVTS'LON TOTALS--> COT.LECTED: BLDG PMT PLUMBING ELECTRIC MECAAiVIC 26.00 SMiP/NON—R£S TOTAL PAID IaUE 26.00 26,00 .00 26,00 OVER/SHORT; ,00 PIRE SMTP/TOT GRADING PiAN—CHECK ?f #F # iF if �IF �1e jF 3E JE iF � iF �FiF-lf 1F #�lE 3i� 3F �1F �)f jt iE iF if iF lE if-!E iEiF if fE �)E if jE 3f �E iE �1F iF iE ik * iF �lf 3F iF iF iF af IE aE iE if iF i4 ih iF �1E i(� iF i+,� 3f 14 iE iE iE �1F iE V.� 3�% 1F �lE 3f �1F I iv D I V I D U A L F E E 9 R E A K D O W N TYPE QTY D E S C R I P T I O N U1VST COST TOTAL COST EL�E 1 N,ZSC APPARATUS %10T LISTED REC2 PERMIT 11 , UO 11 , UO END OF FEES l',..1i __, . . ' . . � i.� , CONSTRUCTION AND PLANNING POOL ,PA .�vPPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Eiectrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. , � 53. Steel Reinforcement � � 3. Electrical Conduit Utility�Undrgrnd. 54. Forms �� 4. Electrical Conduit-Undrgmd. - 55. Electrical Bonding • '� 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVA� TO COVER�GUNITE� T. Footings 58. Electrical Cqnduit-Undrgrnd. � 8. Foundation ' 59. Gas Pipe, Q Undrgrnd., Tesc � 9. Water Pipe�Undrgmd. 60. 8ackwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains - 64. Plumbing System - Final ' 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System�Final - 16. Rough Electric Wiring 67. Fencing & Access ApP�oval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. ftouqh Heating & Air Conditioning F1RE DEPT. REQUIREMENT 20. Rough Factory Fireplace . � APPROVALS Permit # 21:�Ducts,inSiructu�e. . , 70. Underground.Hydro 22. DuctS,Ventilating 71. Product�PipingOGas ❑Oil 23. Gas Pipe`-'Rough & 7est � � ' 72. Underground Fiush 24. �Roof Framing - � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � ' � 74, Overhead Hydro � 26. T-Bar Ceiling (Structurall & Monocoat '• 75. Dry Chemical 27. Frame and Flashing, _ 76. Dry Stand'pipe �. ' ' 28. Lathing & Siding ' . ' • 77. - FIXED SYSTEM.F�INAL '29. Insulation � � � � � I �. 78. FIRE PREV. FINAL . - � � 30. Drywall Nailing � , HEALTH DEPT. REQUIREMENT �31. Plastsr Brown Coat' ' � ' 79. FINAL INSPECTION , 32..Electr�cal Power Meter�Final .. i f•.SO.�FOOD CERTIFICATE ISSUED 33. Final Electric ' � �l�,C� ' Notes: - . �34. Final Heating & Air Conditioniqg I I. . 35. Final Gas Pipe�Test I � �� - _ � 36. Hood or Canopy ' . � �� • � . � . � . � . 37.-Final Fac[ory Fireplace , ' ! '. 38. Final P�umbing - � � . 39. Water Setvice-Final � 40. Gas Service-Final � ., , � . � 41. Solar pomesticFinal . , � • � . 42. Backflow Preventer' ' ' . � 43. Backflow Irrigation � 44. Landscape Irrigation System , �, � . � � _ • . -� 45.'Sound Attenuation � • _ ' � r 46. Handicap Regulations - , ' _ , � 47.-FINAL STRUCTURE & BUILDING � . - 48. FINA� PLANNING , , �- . �. , , � 49. Electric Release to Edison , . i .50. Gas Release to Southem California Gas Co � � - ' ' i 51. CER7�FICATE OF OCCUPANCY , • No. Date OWNER �y�N So. Cal. DATE AP No. LOT cp IN tTIONS so,. Gas WATER ROUGH PLUMBING PROP. SWR. LINE OUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORARY SERVICE OR POLE UNOERGROUND � POWER � ROUGH WIRING TRENCMES FORMS STEEL REINF FLOOR SVSTEM 60ND BEAM � STEEL REINFORCE [-] SHEATHING FRAME AND FLASHING LATHING - IN �� OUT PLASTEF, BROWN COAT STHUCTURPL, FINAL HE '�, VENT., REFRIG. ANO A.C., FINAL PLI,. .,NG, FINAL AND GAS TEST E�ECTRIC, FINAL BUILDING, FINq� E ZONE SUBCONTRACTOR r 3b�29 COSTA MESA BUILDING-SAFETY DEPARTMENT 2�1 $ P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fi!l in Completely BUILDING `„a� ADDRE55 OWNER 7,a�in Southern California MAIL z . a U 2 ZF am J� J N Q W GI J J m Q U Q Z� W W a W2 J Q m Z J � W W O Z F w� � � F" z Q U J a a Q 0 H H Z 0 � U � � �"' N Z 16255 Ventura Blvd. TEL. ��¢.¢��i'�a,tt—�„ w.. 346q �un, • . � ��;,,-,:PA,�c� c3�=� �r��c5 cir� Encino, CaliYorniallo. 9S6-SSYU CONSTRUCTION LENDER Larwin Southern California BRANCH 16255 Ventura Blvd. ADDRESS Encino, California APCHITECT TEL ORENG�NEER Larwin S. Calif. No.'986-8890 ADDRE55 9100 Wilshire, Beverly Hiils CONTRACTOF Larwin Southern California AODRESS 16255 Ventura Blvd. TEL. cirv Encino, Calit, No. 986-8890 L C No. 191311 LICYNO. $—], oF ior 60 x 100 NOW ON LOOT�� 0 USE OF E%ISfING BLOG. SIZE OF NO. OF n,ewa��. 1436 qpOM$ STORIES 1 EXTERIOR WA�L ROOF COVERING SCllCCO COVERING WOO(1 shinQle USE OF BVILDING AND WORK TO BE PERFORMED APPLICATION FOR BUILDING PERMIT :EIVFp BV DATE RECEIVED nnrc �ccw A.P. NO. �� 6UILDING ADORESS TRACT%SS%-B W A ✓ OWNER LAry�/N s .SF S G� �S'. FIRE ZONE APPROVED eV ZON _/NO.OF � PLANS VARDS APPROV ED MAIN BUILDING (FFOM G'JL STREET) F:70NT 7 �FT. / �/ � Construction Single Family Residence ' CVRP� I hareby acknowlatlpe ihat I have read this epplication antl state Met the abova Informetion is corract antl eprae to comply wiih ell lews reBulatlnB builtlinp constr�ction, and I shall no2 employ eny perwn In violation of ihe workman'e compensation laws of tha Stete of Colifornla. I hereby cerNfy Nat I em properly Iicansetl as e conttactor untler [he S[n[a of Celifornia Bufinesa entl Proteuions Cotle, Divislon 3, Chepter 9, antl that s�eh Ilcenws ere In full force entl aftact, or I em axampt from the provisionz ot the State ot Celltomia Businesz entl Profes5ione Cotle, Divition 3, Cheptar 9. Sipnotura of J'� �/ Pormittee E/�/�J/ ��, DOWRS � Authorizetl Apent xoLn THE AMOUNT SI THE PURPOSE OF VALVATION $ 22,100 APR 10 PERMIj � m -%a - VARDSAPPROVED BET. MAIN & 1� m � 0 R VALUATION IS FOR ' u A PERMIT FEE ONLV: Q �fE S $3.�� =cK S E `o :e s124.50 �`