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Home My WebLink About3465 PLUMERIA PL - Building Permits� CITY OF COSTA MESA � BU/LDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • vnwv.ci.costa-mesa.ca.us PERMIT TYPE APN: 41217321 Zoning: R1, FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B_MISC STATUS: DATE ISSUED: ISSUED BY: ' BX07-00151 ISSUED osnsnoo� bj k JOB ADDRESS: 3465 PLUMERIA PL CM ' _Swte/Unit: Vicinity: PrimaryOcc � `. .':_ ConstType :?? SQ. FT: 0 ,�r,-.�' .. . -Valuation:�: �. i � $8;120.00 SCOPE OF WORK: REPAIR/REPLACE WOOD DAMAGE TO'FASCIA DUE TERMITE DAMAGE. OWNER: City/State: Phone: APPLICANT: City/State: Phone: DARNALL, WILLIAM-H'� '" � Address:: 3465 PLUMERIA PL � i"" COSTA MESA, CA �� •, Zip Code:-`.'92626.-` � - DARNALL, WILLIAM ,� •� , �; Address „,3465 PCUMERIA PL �: � �' Uni4: . COSTA MESA, CA . ' "_ Zip.Code: .; 92626 �, ; � - , ._..,. ' ... : . .:, �. „ . :. - . -. - � � --�- 714-751-6007 � ; , ,. . . � CONTRACTOR: OWNER-BUILDER. � , License�No�•.�000000 �t Address: �., . _ � ;�� Unit: �� " City/State: :: ; i�a , � � .. .z. . . . . _ _ . ' _: =:_ ZipCode: , � . , � -� Phone � . � � ' --� Cell: ARCHITECT: Phone ENGINEER: Phone ,. � - � . License No. � � � +- - - � � License No. FEE SUMMARY Building Plan Check: ' $0.00 Building Permit: � � . �$167.25 Electrical Permit � $0.00 SMIP Residentiel -$0.00 - �. SMIP Commercial � $0�.00 7 � $O.00TOTAL FEES $167:25 Unit �� 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: 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 wnsidered legal, such work must wmply 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. ., COOE N. INSPECTION TYPE i616 Fiaed System Final Fire Prevention 1266 Pool Spa Final 200 FinalRe-Roof 201 Final BIocWReWining Wall 202 , Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE INTIiIRLS �O�EA INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 � Final Planning Approval 222 Final Site 250 Final Building/Oaupancy UATE INiIPAL 10 S �o'J � t �� WORKERS' COMPENSATION DECLARATIOI� I hereby aKrtn undei penal[y of perjury one of the following declarations: ' ❑ I have and will maintain a certifiw[e of consent lo self-lnsure for vioilcers' compensalion, as providetl for by section 3700 of Ihe LaDor Code, for Ihe per(ortnance of Ihe,vrork !or which this permit is issued. � ❑ I have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code, for the performance of lhe work' foi which this pertni[ is issued. My workers' compensation Insurance carrier and policy number are: . Cartier: (This sed.on neetl not be wmplefed dthe pe�mR is valuetl a( one hundretl0ollars (Ef00) orless ) Policy Number: �-�1 certify that in the peAormance of the vrork for which this permit is issued, I shall not employ any person in any manner so as lo become subject to the worker;l c ensation laws of Califomia, antl agree that if I shoultl become su fect workers' compensation provisions ot Section 3700 of the L od . all orthwith compl vnth these provi ons. A piranPs ignaWre � ate 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 DOLLAF2S ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND A7TORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensetl untler provisions of Chapter 9(commencing with Section 7000) of Division 3 0( the Business and Professions Code, and my license is in full (orce and effect. Lic. # qass # ConVatlar's Sie�alure Da�e CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that there is a construc[ion lending agency for the peAortnance of Ihe v.ork fa wfiich this pertni[ is issued. (Sec. 3097, Civil Code). Lender's Name: Lender's Address: Slgnalure �ate OW NER-BUILDER DECLARATIONS: I hereby aKrm that under penalry of perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5, Business and Professions Code: Any city or county which requires a permit to constroct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant tor such permit to file a signed statement that he or she is licensetl pursuant to the provisions of the Con[racrors License Law (Chapter 9(commencing wilh Section 7000) of Division 3 of the Bu5ine55 antl ProfessiOnS Code) or lha[ he or 5hB i5 exemp� lherefrom and the basis tor the alleged exemption. Any violation ot Section 7031.5 by any appliwnt for a permit su6jects the applicant [o a civil penalty o( not more lhan five hundred dollars ($500).): ❑ I, as ovmer of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such work himself or herselt or through his or her own employees, provided that such improvements are not intended or offered for sale. I(, however, the building or improvement is sold within one year of completion, the owner-builder will have ihe burden of proving that he or she tlitl not builtl or improve for purpose of sale.). � I, as ownei of the property, am EXCLUSIVELY CONTRACTING WITH LI NSED CONTRAC70R5 to construct the project (Sec. 7044, Business and Professbns Code: The coniractors License Law dces not apply to an owner of property who builds or improves Ihereon, and who contracts for such project with a contracta(s) license pursuant tothe Contractors License Lavrs.). ❑ I am ezempt under sec. Business and Professions Code for this reason: � � '1�� , --� - -� --. --.�, � Owner ID venfietl by dri�. � Yes ❑ No , �� Driver's License No. Expires: y" _/ �� Verification of Ownership by (ype of document, i.e. - property taz bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: -- ' ❑ I hereby certify that no excavation frve (5) or more feet in depth into �which a person is required to descentl, will be made in connection with vrork au[horized by this permit, and that no builtling strucWre, scaHdding, falsework, or demolition or dismantling thereof, will be more than thirty-six (36) fee[ high. (Chap. 32, Grp 2. Art 2, Sec. 341, Ttle 8, California Administrative Code). ❑ As owner-builder, I will not employ anyone [o do work which would require a permit from the Division oF Industrial Safety, as noted above, unless such person has a permit ro do such vrork from the division. AppliwnCs Sgnalure Division of Industnal Safety Permil Number: _ HAZHRDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuNre building occupant neetl to file and certify a Business Plan (or emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 of the Cali(ornia Healih and Safety Code requires, with some exceplions, lhat a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reportetl year a quan[ity of hazardous ma[erials equal [o or greater than a weight o! 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard IemperaNre and pressure). 2. Does or will the applicant or present or (uture building occupant neetl to file a registration torm for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of lhe Calitornia Heallh and Safety Cotle, with some exceptions, requires regis[ration with the Cos[a Mesa Fire Department by each business which at any one time has on hantl a quantity of aculely hazartlous matenals equal to or greater [han a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at slantlard temperaNre and pressure). 3. Does or will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazartlous materials)? ❑ Ves ❑ No (Section 25534 0/ Ihe Califomia Health and Safery Code provides �hat the Costa Mesa Fire Department may require the preparation, ceAification antl (ling wilh Ihe Fire Department of an RMPP by businesses which are requiretl to register acutely hazardous materials with [he Fire Departmen[. 4. If an RMPP is presently required, has Section 25534 0! Ihe California Health and Safety Code been fully complietl with? ❑ Yes ❑ No 5. Does or will the applicant or present or future building occupant require for the work which is the subject of �his appliwtion a permit for such conslmction or modification from Ihe South Coast Air �uality Management DisUict or from any other air pollution con[rol disiric[ or agency? ❑ Yes ❑ No (Section 658502 0( the Califomia Govemment Code requires that the requestetl infortnation be fumishetl on applications for nornresidential building pertnits). 6. Will any part o( the facility to be construc[ed under this permit be within 1000 feet fmm the ou[er boundaries of a school? ❑ Yes ❑ No Qf yes". [he faciliry must meet the requiremen[ of Sections 25534 and 42303 of Ihe Califomia Health and Salety Code). 7. If a permit from the South Coast Air �uality Management District or other air pollution control district or agency is required for the vrork which is the subject of this application, have all of the disclosures prescrihed by California Heal[h and Safety Cotle Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", atlach certifcate of compliance from the appropnate air polWtion control ofTicer). . - , CERTIFICATE OF COMPLIANCE: I certify,tha[ under penalty of perjury the information given above is correcL I agree to compty with all state laws and city ordinances regarding Hazardous Materials and�Emissions. - Signalure Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read �his application and state Ihat the information given is correct I agree to comply with all state laws and cily ordinances relating to building construction, and authorize representatives of [he City o( Costa�Mesa ro enter upon [he above-described propeRy for inspection ur s. agree not to occupy or allow occupa cy of a y builtling authQjn D ' per iit until final i ction. Signawre of Legal Ovmer�s) Dat � AnE/orAulhorize4Ap011can1 Date `: ��Q�T�T.991 °Termite" Terry PP�+ Control `�'� 1527 Harbor �Ivd, ; Costa Mesa, CA 9To2I � �� 0 949-637 73A8 Phone, 949 722-619D Fax �rFAAtI1ElEPQ+4 e-mail@lermiteterry.com PR4807 Address of Property: Inspection Date: Report M: Title Ca. b ESCrou N: WORK AUTHORIZATION CONTRACT 3465 Plumeria 8/31/2007 1853 ESCZOw H Costa Mesa CA 92626 7a,8a,9c,l0a,lla,lle Fumigation - 2450.00 without 9a - 2150.00 llb,lld,llf Wood Repair - G590.00 8b,8c,8e,9c,llc,9b: Owner to contact a licensed contractor. Further Inspection Item 8d: Unknown 9a Removal of Patio Cover - 1450.00 �' rrdt� <lll woo�% �o br Pi;.��d� P�,t.o We Authorized the Following Ilems to be Pertormed. I+'�Su��oh � ,��^1 Proposetl Cost: � � Total: � Page: 1 � NOTICE TO OWNERS: Under California Mechanics Lien Law any slrucWral pest conlrol company which contracts lo do work for you any contractor, subcontractor, laborer, supplier or other person who helps to improve your property bul is not paid (or his or her work or supplies has a right to enforce a claim against your propehy. This means tha�, after a court hearing, your properly could be so{d by the court otficer and the proceeds of the sale used to satisfy the Indebtedness. This can happen even if you ha�e paid your structural pest conlrol company in full, i( the subconiractor, laborer, or suppliei remains unpaid. To preserve Iheir right lo file a ctaim or lien against your property, certain claimants such as contractors or material suppliers are required �o provide you wilh a document entiUed'Preliminary Notice." A Preliminary Notice is not a lien against your property. Its purpose is to notify you o( persons who may have a right lo file a lien against your property it they are not paid. I have read this work authorization contract and WDO inpection report it refers to.SIGNED WORK AUTHORIZATION CONTRACT MUST BE RECEIVED BEFORE WORK WILL BE SCHEDULED.I have r a understand the terms f this work authorization contract and hereby agree to all 9�� (f 9-2�6� APPROVED AND 12EAD BY: DATE ACCEPTED FOR: DATE "TERMITE" TERRY PEST CONTROL pM a p o � t � : J �,'�..o.��'. CITY OF COSTA MESA BU/LDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ra.us PERMIT TYPE APN: 41217321 Zoning: R1, FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B_MISC STATUS: DATE ISSUED: ISSUED BY: V BX07-00145 ISSUED osizsnoo� SOK JOB ADDRESS: 3465 PLUMERIA PL'CM - , Suite/Unit: Viciniry�. :� Primary Occ: . , Const Type :?? SQ. FT: 0 � ., , Valuation�. �� $5,675.00/- , SCOPE OF WORK: REPAIRlREPLACE�WOOD.DECKING LOCATED OVER THE�ATTACHED GARAGE. OWNER: City/State: Phone: APPLICANT: CitylState�. Phone: ` - � . , � . � °z�q, DARNALL, WILLIAM H'`�� Address.. 3465 PLUMERIA PL�� COSTA MESA CA Zip Code 92626 DAN K�RTLAND � - Address: - 15 N � UniY.'- FOUNTAINVALLEY CA �� ZipCddv�'. �- � , 714-863-1645 QQQ___��- CONTRACTOR: DAN KIRTLAND �� --�..� ��' � Liceuse No. 693460 - Address: 17415 BANYAN ' -Umt ��e� . . � �. CitylState: FOUNTAIN VALLEY CA �- �� ; �`�" ' � � � . � � _ Zip Code: 92708 . � - . �,: . , Phone 714-863-1645 � �, Cell: ARCHITECT: Phone ENGINEER: Phone Building Plan Check Building Permit: . . Electrical Permit: SMIP Residential�� ', � � SMIP Commercial �.. � ` $O.00TOTAL FEES--. - - �icense No. ' License No. FEE SUMMARY ` $0.00 ": . � �-.$12525 " . . $0.00 � >$0.00 . , � '. - $0.00 .:-., .. . .$125.25..:: . �- ' 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: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPEC710NS: 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. FaiWre to obtain inspections and final approval will result in ihe expiretion of this permit. COUEN. INSPECTIONTYPE pATE INTITIpLS i676 Fized System Final Fire Prevention 1266 200 201 202 203 204 Pool Spa Final Final Re-Roo! Final Bbck/Retaining Wall Final Factory Fire Place FinalSign � Final Demolilion GOOEp INSPECTIONTYPE 206 Final Mechanical 208 Final Plum6ing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Fina�Building/Occupancy OATE INPTIALS , • h1� WORKERS' COMPENSATION DECLARATION: . I here6y aKrm under penalty of perjury one of Ihe following decla2tions: ❑ I have and will maintain a certifCate of consent to self-Insure for vrorkers' compensa[ion, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain vrorkers' compensa[ion insu2nce, as required by section 3700 of the Labor Code, for the perfortnance of the work for which ihis pertni[ is issued. My workers' compensation Insurance carrier and policy number are: Carrier (IDis secfion need no( be mmpleted Athe peimd is valued af one huntlred tlollars ($100) or less.) Policy Number: Q�I=certify tha[ in the performance o( the work for which ihis permit is issued, I shall not employ any person in any manner so as lo become subject to ihe workers' compensation laws of California, and agree Ihat if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall f rth 'E rt(ply wi[h these provisions. � y-.� /, -oJ �"ripf_ i- aWre�x% �- Date -� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TU ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE CQST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 pF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. . LICENSED CONTRACTORS DECLqRATION: � I hereby aKrm thal I am licensed untler provisions of Chap[er 9(commencing with Section 7000) of Division 3 of lhe Business and Professions Code, and my license /i§ in fu?ll force and effect. Cic.—# —:rlv �J � r'Class # �''�' � .o , ��- y �aG-U� la or's i ure -~^ Date ' :.::�-�---` '�^"--�.. CONSTRUCTION LENDING AGENCY: � I hereby aKrtn that [here is a construction lending agency for the peAormance of the wurk ta which this permit is issued. (Sec. 3W7, Civil Code). Lender's Name: Lender's Adtlress: SgnaWre Dale OW NER-BUILDER DECLARATIONS; I hereby aRrm that under penalty of perjury that I am EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 703'I.S, Business and Professions Code: Any city or county which requires a permi[ to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signetl statement that he or she is licensed pursuaryt to the provisions of the Contractors License Law (Chapter 9(commenciqg with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and [he basis for the alleged exemption. qny viola[ion o( Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalry of not more [han five hundred dollare ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and [he structure is not in[ended or offered for sale (Sec. 7044, BusinesY and Professions Code: The Contractors License law does not apply to an owner of property who builds or improves thereon, antl who does such work himself or herself or [hrough his or her own employees, provided that such imprbvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the ownerbuilder will have ihe burden of proving that he or she ditl not build or improve (or purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construd the project (Sec. 7044, Business and Professions Code: The contrac[ors License Law dces not apply ro an owner o! property who builds or improves lhereon, and who contracts for such project wi[h a contracta(s) license pursuant to the Cont2ctors license Laws.). ❑ I am ezempt untler sec. _ Business and Professions Code (or this reason: Owner ID venfietl by tlrive. nse. ❑ Yes ❑ No -Driver's License No. Expires: Verification of Ownership by (rype of document, i.e. - property tax bill or deed�: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation (ve (5) or more feet in depth into wfiich a person is required to descend, will be made in connection with work authonzed by Ihis pertnit, and tha[ no huilding structure, scaffolding, falsevrork, a demoli[ion or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle 8, Califomia Administ2[ive Code). ❑ As owner-builtler, I will no[ employ anyone to do work which woultl require a permit from the Division of Industrial Safety, as notetl above, unless such person has a permit to do such work from the division. SignaWre Date Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or future building occupant need to file and certi(y a Business Plan (or emergency response [o release or threatened release of a hazardous material? ❑ Yes ❑ No (Sec[ion 25505 of Ihe Califomia Health and Safety Code requires, with some exceptions, that a Business Plan be Ned with the Costa Mesa Fire Department by every business which has at any one time tluring a reportetl year a quantity of hazardous ma[erials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard �emperature and pressure). 2. Does or will the applicant or present or future building occupant need to f le a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health antl Safety Code, with some exceptions, requires registra[ion with the Costa Mesa Fire Departmen[ 6y each business which at any one time has on hand a quantiry of acutely hazardous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3. Does or will the applicant or presen[ or future building occupant need to prepare an RMPP (Risk Managemen[ and Preven[ion Program for awtely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the prepara[ion, certifcation and fling with the Fire Department of an RMPP by 6usinesses which are required �o register acutely hazardous ma[erials with [he Fire Departmen[. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Safety Code been fully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or fuWre building occupant require for the wo�k which is lhe subjec[ o/ this application a permil (or such constmction or modifca[ion from the South Coast Air Quality Management DisMct or fmm any other air polWtion control district or agency? ❑ Yes ❑ No (Section 658W 2 of Ihe Califomia Govemmen[ COde requires that the requested information be fumished on applications �a non-residential building pertnits). 6. Will any part of the facility to be cons[mc[ed under Ihis permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", Ihe facility must mee[ [he requirement of Sections 25534 and 42303 of [he California Heal[h antl Safety Code). 7. If a permit fmm the South Coast Air �uality Management Dis[rict or other air polWtion control district or agency is required for the work which is the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", attach certifcate of compliance from the appropriate air polWtion control o�cer). CERTIFICATE OF COMPLIANCE: I ceAify that under penalty of perjury Ihe information given above is comecL I agree [o comply with aN state iaws and city ordinances regarding Hazardous Materials and Emissions. SignaWre Date CERTIFICATE OF COMPLIANCE AND AU7HORIZATION OF ENTRY: I certify under penalty ot perjury that 1 have read ihis application and state that Ihe information given is correcL I agree to comply with all state laws antl city ordinances relating to building construction, and authorize representatives of the Ciry of Costa Mesa to enter upon the above-described properry for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until fnal inspection. SlgnaWreolLega — n-- ' D� � $ignaWre' � Date O� w�� 7 305]-46 (3I0]) � qnd� r Aul�onzed�i ppl cant �_,LL� �..' Date !� l� �._ . � �� t �t ;I� I- � � 1.♦ � � �_��' ' �� , � � , --- - -�--r�; --�- �-� _ �_ � i � j -� (- '' -t � ; � --i --� i - -� �� ' � I I � __ — _—. _'T` I � �_ — -r- T-- - , ' -; - ' � i � � _� - -�-- -I--i-;-- r - � � I ! i i � � � � � � --�--I--r-�-- � � I� I I � �-�-�--I - i - - �- -� - -l- - � �-- t - T--{-;--- - �--T- `- `_1_' _ �T 'i _ ' f "( . i � I � , I 1 �I I i I I �-_.�__ - 4, _ _ "_ � -�STRUCTU L-�AP-PROVAL-1-ONL-Y� �-- ' � � L._1__� � ��__. I � �SEP!-•------•••-- --...--- � �� ' f �; -� � I � , . ..� I �, � I I �_ r--r- --- i N IS ICODE! NO PERMIT P i CANCEI RL VaLIQ. CEPT IN ;'� a � � ,� � i ii ' � I i � , tn R � � i— , � � � ; ' i i i � L_ 1 �. � 0 � � , � ...- � � �, �- , � � IM:L'�� CITY vF COSTA MESA REQUES FOR OCCUP.,_.Y �7 � �w� l .k.. i��- ��y TRACT r'0. 75�� IAT ;10. � � ' �.�u� ADDRESS � Z� �.s—��fCN�� DATE /��% � ' The developez of the above entitled tract desires to sell the above set forth 2ot prior to the time that the tract has been completed and its streets accepted by the City of Costa Mesa. The undersigned, by executing this agreement, acknowledges that n (he-she-they) /..t_ (was or were) Zu�c.�' advised that this tract has not been given final inspection nor has it been accepted by the City of Costa Mesa as having complied with the conditions of approval which were impoaed by the City at the time the final tract map was approved. The City assumes no liability for the enforcement of the conditions necessary for approval other than those conditions protected by surety bond. The undersigned agrees to indemnify and hold the City harmless from any claim resulting in damage or personal injury to the undersigned by reason of the aforementioned uncompleted condition. Q BY �"�//�� c�. �%��c� Purchase� _� � \ � .�----- i BY /`--�„ �2 �.t �� '. GI�1� � Developer and/or authorized zepresenta�ive `�".- l /� �T'� BY � 2�.oz _/�,� L�nder � y,��'. ; �.:�;:, ; � CIN OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT (714) 754-5273 • Fax (774) 754-4H56 JobAddress: 3465 PLUMERIAPL Suite No Vicinity: ParcelNunmber: 41217321 Applicant: NOCK, RON Address: 11612 KNOTT ST GARDEN GROVE , CA Owner: DARNALL, WILLIAM H Address 3465 PLUMERIA PL COSTA MESA,CA Contractor, NOCK PLUMBING Address: 11612 KNOTT ST GARDEN GROVE , CA ArchlEng; Address; REPLACE WATER HEATER ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Conned pce,Soda,�tc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (GreasO, pil) Interceptors (Sand quto ) AMT szz.00 so.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $o.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Qn PLUMBING PERMIT Phone: 714 895-1246 Zip: 92841 Phone: Zip: 92626 Phone: 714 895-1246 Zip: 92841 License: 707775 Phone: Zip: License: SCOPE OF PERMIT FEESUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 fl) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect 50.00 Sewer Private Line - $0.00 Shower $0.00 Sink, bar $0.00 Sink, wmmercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS P�� PERMIT NUMBER P99-0007'I 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 07J0311999 Issued: 02/03/7999 SumpPump Swimming Pool Trap Primer Urinal Vacuum BrkrBkflow(1-0) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 ao.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $11.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $33.00 Qn 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 1 BO tlays. . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectiona and final approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTION$ CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby eNirm untler panalty of perjury one oi 1�e following declarations: ❑ I heve entl will ioeintaln a certificete ol consent to selF-Insure for workers' compensation, es provided tor by sectlon 3700 of the Lebor Code, for Ihe pertormence of the w for which ihis permit is issued. I have anE will maintain workers' compensation insurence, as requiretl by section 3700 ot Ihe Lebor Code, for the performance of ��e work tor whic� ihis permit is issuetl. My worker� mpensetion Insur ce ceMer entl palicy number ere: ��,Z �`�. rO � Carrier: �L"i��%�� G�� PolicyNumber: � �F� (TTis sectlon need not be cromp/eted i! fhe Oertnit is ve/ued al one hundrad dollars ($100) or less.) ❑ I certily that in lhe peAortnance of the work for whic� this pertnit is issued, I shall not employ eny person in any manner so as to become subject to the workers' compensation laws ot Celitomia, enC egree that If I shoultl become subject to the workers' compensatlon provislons oi Section 3700 ot t�e LeCor Code, I shell forthwit� comply with Ih85B prOvi5i0n5. C Applicant SlgneWre: ��—�� ' Dete: __ �— �_ / � WARNINO:FAILURETOSECUREWOFKERS'COMPENSATIONCOVERAGEISUNUWFULANDSHAILSUBJECTANEMPLOYERTOCRIMINALPENALTIESANDGVILFlNE UPTOONEHUNDRED TFIOUSAND DOLURE (EtOD,000). IN ADDITION TO TME COST OF COMPENSATION, DAMAGES A$ PROVIOED FOR IN SECTION 3]OB OF THE IABOF CODE, INiEHE5T, AND ATTORNEY'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby eMirtn that I am licensed under provisic force end eMect. Lic. # —% � Comractor's Signature: with Saction 7000) ol Divislon 3 of the Business entl Pratessiurs Code, and my license is in tull _ CIauN ��3-� l Dete: '� _— � —� C CONSTRUCTION LENDING AGENCV: ❑ I hereby elTirm that thare is a construction lending egency for the pertortnanca ol the work tor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lendefs Name: Lentler's Atltlress: Siqnature: Date: OWNER•BUILDER DECLARATIONS: I here6y aflirm thet under penalty of per�ury lhat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7037.5, Business antl Protessions Code: Any ciry or counry which raquires e permit to construct, alter, improve, tlemalish, or repair any swctura, pnor to its issuanca, elso requires the apD�icaN for such parmil to ille e signetl statement Ihet he or she Is Iicensed pursuant to ihe pmvislons oi the Contractore LJcense Lew (Chepter 9(commencing with Semion 7000) of Division 3 of the Business end Professions Code) or ihet he or she is e:empt therefrom anO t�e basis tor t�e allegetl exemp�ion. Any violation of Section 7031.5 by eny applicant for a pertnit sublects the epplicant to e civd penalry of not more than five hundred dollars (5500).): � I, es owner ot Ihe pmperty, or my employees with waqes as t�elr sole compensa�lon, WILL DO 7HE WORK, end Ihe strucNre is not intended or oHered tor ule (Sec. 7044, eusiness antl Protessions Cotle: 7Te Comractors License Lew does not eppty to an owner at pmperry who builds or Improves thereon, end who does such work himself or herself or through his or her own amployees, providetl that such Improvements ere not Intantled or offered for sale. If, however, the building or improvement Is sold within one year of completion, Ihe owner-builder will have the burden of proving ihat he or she did not bulltl or improve for puryose of sele.). ❑ I, es owner of the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the projecl (Sec. 7044, Business entl Protessions Cotle: The contracbrs License Law does noi epply to an owner of properry who builds or Improves thereon, antl who contrects tor such project with a contraqor(s) Ilcense pursuant to the Contractors License LawsJ. ❑ I am axempt untler sec. Business end Professions Code for ihis reeson: Signature: Date: Owner ID venfied by driver's license. ❑ Yes ❑ No Dnvers License No. Vedficatlon ot Ownership by (rype oi daument, i.e. - pmperty tae bill or tleetl): DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATION: Expires: ❑ I hereby certity that no excavetlon flve (5) or more teet in depth Into which a parson is requiretl lo tlescentl, wlll be matle in connectlon with work authodzad by ihis permlt, entl ihat no builtling strucNre, scaflolding, talsework, or tlemo0tlon or tlismantling ihereot, will be more then thirty-siz (36) teat high. (Chep. 32, Grp 2, Art 2, Sec. 341, 71t1e B, Califomia Administtetive Code). ❑ As owner-builder, I will not employ enyone to do work which would reQuire e pertnit irom ihe Divislon of Intlustriel Satery, as notetl above, unless such person hes a permit to do such wark fmm the divlsion. Signature: Data: Division ot IndusMal Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTNORVATON OF EMRY: I certify under penalry of perjury that I have read ihis application end stete thet ihe information given is correct. I egree to comply with all state laws end city ordinances relating to building construction, end euthonze representa�ives ot tha Ciry of Costa Mesa to enter uDon the above-described property for inspection purposas. I agree not Io occupy or allow occupancy ot any building authonzeC by this permit until finel Inspedion. ignetur OI Legal Owner s Dete �� , 2- '�-S � AnNOr u�horized Appliwni Date � COOE I. INSPECTIONTYPE Gdff It�9lS 1616 Fixetl System Final Fire PreveMion 1266 200 Pool Spa Final Final Re-Root 201 Finel BlocWfletaininq Wall 202 Finel Fectory Fire Plece 203 FinalSign 204 Final Demalition 2C4F46 CODEY wsveer�oxTrve 206 Finel Mechenical 208 210 212 220 Flnel Plum�ing Finel Electdcel Final Fira Prevention Final Planning Approval 222 Final Site 250 Flnal Building/Occupancy Q67F Iti�9lS • •� • • � � 1�pAE540FBVIL0ING: 346= PLUMERIA PL uxr: OIMERSNYIEIiqIUYlk DARNALL, WILLIAM H FLOOD: 11H-38 AD°"� 3965 PLUA9ERIA PL COSTA MESA,CA 92626 751-600? WPL. WUl1N0 AD�XE55: IPCNIIECT OX Ql�IffJi: uera: urrr: caam�crarswu� �LUMINUM ROOFIP]G SPEC ( 714 ) 558-0678 caxrn�croas�uiwc ? SQ3 MCFADDEN �o� SANTA ANA CA �N0 523043 92705 uxT: LICENSEO LONTflACTORS DECLAPATION; I hereby eRrm urMer penetly ot pa�ury thei l em Iceneed unEa prmieiona d CMqx 9 (commeewnp hilh Section ]000) M Dirnion 3 d the Buaimn end Prdmebne e, vd my Lcaiue i� in hll laca erd elletl. cmuc.No.:�F028Qr uc.cuss: C39 uc.No.: ��3043 EXP: 09/95 o�e: 7 c�,a OW N R BUILDEH OEClARA110N: I Mreby elfirm uMer pavly d perjury lat I em aRemp Imm IM Conlretlan Licanee Lew /a Me bCox*q ieawn (5eaion )0.'11 S Busins+ vd Rdaviau COEe: AnY c�y r couM' whirh n9uirea a Veeme �o mntrun. Ma.'vnVove. emd'eh, a rapai mry aWCWre, priar b Ya cauentt, ebo repwio �M mM fa wd� pen�W to Rk e epneC etmemenl tl�el M a she w ficamaE qirmwa to �he pva'vima d tM Cau�euoro Licmae lew �C Im 9(canmencnp with Seaqn ]000) tl Diveion J d Ib Bin'vbea erd Prdmbn Codel a Rm he a eM o ssomW �hashvm vd the ba,m la ths eOepeE mamqion. My videtbn af Seaion ]W 1.5 by erry epp4uru In e permp wEjatle Ihs applium lo e m�il penelry d nal maa ihen Me huMeed ddlen �SAO�). � I.eaowrorWlhepopenYamY�DMa+*x�hmqmniheiederompamelian.WlEONaxwk.endlMeWCWnurMinteMed a oXered la eda (Sectian l0aa, Buam» eM FrMwaionsCods: TM1e Comrepwa Licenae lew doea rai eppN �o en ownerd proparry who buide or inprv+ea ihaeeon, erd who daw euN wak Nmesll or Mne! or NrwpA he ar her own emqoyee�, pv+idad ihm wch improvemenb ere m� inteMed n aftnatl la sab. tl, Mwever. IM EuiNi�q a inprovemeM b sdtl wllhin wp yw d mmpbtion, Ne owror-0�ildar will heve iM W Nan d pav'up he w eha d'd mi buik w impo.a la the purpoea d�els�. � I. ea owner d iM MWMY. em utl�srva�y mnired'n0 vril� 4cenaW coniroc�we lo ton9�ut1 IM p%s115eQion )011. &pinafa eM Pmlaaione Coda: The Cantredan Licenae Lew Eoee nal epply lo en owner d prapMy w}ro buiNa a impv.•n tMreon end who <onlmcie Iw ac� propda xilh e mmratlar�e) licenaed punueni to tM Conireqare Li�na lewl. � I em eeemq uMer Seciion: � 8. 8 P.C., br I�ie reemn: DNe: � I do hareby cMdy thet I em ewue d end uideistaM Oie'eqidmmmb d Celiortiu IbeEh eM Sdery Gods SWuns T3505.?5593. ud 2S5JG. ud tlw I a enY Mum buiMvq omipeni will / wil m� (�6 wr) ��o minply wih uid mte mEm eM IM fpuirtmaNs tor eG�Glawni�uctionormodifimlionhantM�i u�y enepe^emDatrid.ReakeMalcaatiuquneGV�iwaeree*emqlmmNme a�. om.: roar�+: WOflKER'S CONPENS�TON DECLAF�TION: I Ineaby eMum uMr ps�Ny d pxpvy wn d tM IOYowinp EsduCom: � I hme vd wil memten a cenuictle d oomenl m�otlreuun lur xmks�s' canpenWion, m prmdded la Ey Seeion 3100 d Iha leEor Cotle, lw ihs pe�ormeze ol tM woA lor wM1icn ihie parmn u Inuad. � I hew vd xil meinlein xrorke�e cwnpen�elion imurence. n�puired by Sedim 3100 d Me Lebor Cods. W the pertormence d �M work Iw v.fiich M'v pemiit is inuad. MY �� Pe�� iruurence'errier uM pdicy numbor ue: Ce�eim: RTnTA �rir.ir, EXPIRE5 aaKyN�mn«: nnc_o�nn�TTn�� O1/Q1/96 (rn;s ,enion ne.e �a w mmd.roa r rne o�� ro roi on. nu�a.d adwe /Siwl a �w.l � I caMN � in �he pulmvrce d �M wak 1« xfiich Ihb pem�il b iauad. I ehell m� ampby erry pason M eiry menrwr eo n �o becaM wda :o IM xarMsa' mmpxueiion lexe W CNilarie. eM Wme Net J I Mwk bxvro nAjea io tM noM1en' cpnpmutlbn pwcim d`aion 3100 d IM lebor Code. l WA tyNr.rh mmpy�h Qnee piv+idvu. oa�e: �ccis.m: �I / Wem/np: Uun ro��cun �roKwi ronperu clvll Iln�� p ro on� hundivd tlauurd tldMi S�ctlon ]]O6 0l Ms LeborCotls, InronaL erk CONSTiIUCiION LENDINO �OENCY: I peAamuwe d iM v.ork la xfiich the p LEN�EN'S N E. L T LENDEN'S AUGH 5.9 I caniry R�ei I heve read inis eVpiwi mne erM elele lews rolelep lo Nvq mn IainspectianW�W�s� , 7 r�r�p� Is unYwN%'fM �IWI rbl� en Nn01Mw fo cNMiul PxultluW waA �n .m�rron ro m. co.t or rnrr�oxu.tron arr�pa .. povre.e ro• N �1 /w. ��MIG U B W119lIMIp1 �YId11N�N �i' �Of dM edin �OB). Cw.C�. CLAY TILE F A1A:! S^IEIG _ . w��ommWrwilnal�c�v.�wooumroNinenro. eulhw'vs npaeanlelivm d thie tiry to enlx upon IM eEv.e-meMiawC pivpery CITY OF COSTA MESA - BUILDIF7G FERMIT PERMIT P10: H 072507 PLP.N CHECF: NO: N PERM NO: 5 07250i GOVT: DI SUFP: N CONSTRUCTION TYPE: P-5 PEP,MIT TYPE: STR FDP.POSE: I�LT JU3 DESCRIPTIOP7 ; T/O SHEATH-REAOOF W/CLAY TILE ICBOk3523 SQ FT: 6,750 CLAIM VALUE: 6,750.00 CALC-VALUE: 6,750.00 GROUP OCC; R-3 ;M-1 COhiMENT5: REP,OOF 2300SF RESILEPICE, SMOKE DETECTORS AEQUIRED PER 41UBC if iF'lf'K iG i4 if�k if if 1Fi4 iEiF'-lf i4 iEif if if if Af-�f 1f iF �f i: IE i�iFiF ifin'1` i't iFi'�if iF if iF iicil rt iF-N-�F K�IR Y iF iE�1F i! Y if�1f�IF %� 'v4 iF iG if i� 4 Y-1f f /+ �Q Y 6 Z O Dl I T] G R E Q U I R E M E P] T�Sq /��"�� p��t/ S E T H A C K S �3e_. ------------- MAIN HUILDING --------- -------- ACCESSORY Fi�01JGs',3�'��-----�` FRP]T: FT IP] REAR: FT IP7 FRNT; FT IPE REAR: FT IAI LEFT: FT IN RGHT: FT IN LEFT; FT ZN RGHT; FT IA7 PARKING REQ: PROV: PARCEL: 912?7321 ZNE: REF C70: PLANP7IA7G NOTES> .� s 14 iF 1E iF 1t �f if iE iE 1P if if -u iE+r-at+F it iF t�E:t's iF s iE 1c ac+E ii�+f a4 a4 jr- 3: �Y ir� iE+t iF x- x ac an �f t+e+f ds if ic t'� * aF jf N� �rt �rt+'.. if ii� iF i� �� P+k a+F�3: p. aF s ii-�f jt r�1p x- D E �' E L O P M E PJ T S E R V I C E S R E Q U I R E M E N T S 20NING APFROVED BY , DATE; BUILDING APPROC�ED BY ; DATE; APPLICATIOPJ ZSSUED BY; ��",_ LATE: � 2- ��I � +r**r*r*rx-Ys�rx-��-***+�rra�TrTr�ir+sr.�+7tiz+.,.irx�r.F.(-�.*r��r,c��.++...i-�'�u.��*rxr+�cu<x} «n-<s +t+c� LEGALZZATION:N F E E S U M M A= Y STRUCTURAL SEGMET7T;Y bLDG e�D1T FLUf1BING ELECTRIC MECHANIC FIRE SMIP; RES GRADIAJG PERP9IT 9Q.00 ' , 58 SMIP!NOA7-RES PLAN ISSUE FEE � BOILDING-DIV-> PHRMIT ISSUE PLAN-CHECY, TOTALS----> 90.68 0.00 . Q.QO RrPENUE UIVIS'ION TOTALS--s COLi,ECTE�: BLDG PMT PLUMHING ELECTRIC MECNANIC 90.00 TOTAL FAID DUE °Q.68 90,68 .00 90,68 GVER/SHORT; ,OU FIRE SMIP/TOT GRADING PLAA7-CHECK .68 +f af'IF if+f')E1: V�iFif# +f'Y +f iF #'i t� �F if iL '4'If �f +Fir if iE iFit'Y 1E 1t af #'��iF if 1f 4Y 1f f k if iE tf a!'+hif-1f�Y iF ARY w i* �f�f if�lt if ic �f tf k:t# ic iL 4+' 1f ��! +fiE if 1F y- I N U I V I D U A L F c E H R E A K U O W P7 TYFE QTY U E 5 C R I P T I•U N UNIT COST TOTAL COST SFR 6750 RERUOr bY C�ALUE RESIDENTIAL NOZONE 1.00 6,750.00 END OF FEES � �- �-�D "`� ]i n01E27l7-ODiY27'_� iea�' 90.6u i� ( �,_ otle 'l C/S' DATE: �`J24%rS TIME: 55:43 !/ � �I � Si rodOwix/lpmVAppM�eryCmirmu (St51-aB.WP) W��-�+�M85deiv:Oroan-Fb:Ce�wy-�ppfram:Pink-Pevanue:GdEe'voF�erav � -=- CONSTRUCTION ANO PIANNING PO� � SPA qPPROVAIS Permit # Date Inspector A4'PROVAIS Permit # Date Inspector 1. temporary Electrical Service or Pole 52. Pool & Equipment Location " 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement ' 3. E�ectrical Conduit Utllity-Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding ` • 5. yteei Reinforcement 56. Rough Plumbing & Pressure Test �. 6. �lectrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7. Footings 58. Electrical Conduix-Undrgrnd. 8. Foundation 59. Gas Pipe, O Und�grnd., Test 9. Vvater Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. 5tructurai Ploor System 61. APPROVAL TO ��ECK 11. Property Sewer Line & House Conhection 62. Backwash & Receptor�Final � 12, 5ewer Cap 63. Heater & Vent�Final 13. ftoof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electrical-Final 15. aough Etearical-Conduit 66. Soiar SYstem•Final 76. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 18. pough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEhAS FINAL 19. Rough Heatin9 & Aii Conditioning FIRE DEPT. REQUIREMENT 20. Rough Fac;ory Fireplace APPROVALS Permft # 2L Ducts, in Structure 70. Underground Hydro 22.Ducts,Ventilating 71.ProductPipin90Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing �•�C�� 74. Overhead Hydro 26. 7�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical 27. �rame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ��slE�� j/aT 34. Final Heatinq & Air Conditioning � s 35. Final Gas Pipe-Tesi 36. Nood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. lNater Service•Final 40. Gas Serv(ce�Final 41. Solar pomestio-Final 42, Backflow Preventer 43. Backflow Irrigation 44. 4andscape Irrigation System 45. Sound Attenuation 46. Nandicap Regulations 47. FINAL STRUCTURE & BUILDING `/:�, 5'S� 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern Califomia Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all soaces except thase within heavy boraer lines ana sign ali aoPrapriate tleclarations. CITY OF COSTA MESA CO TRUCTION PE IT PERMIT NO. TRACT NO. LOT NO. UNIT NO. • P3d�.7o , Project Address Applicant's Mailing ddress �I � .-- TYPE OF CONSTRUCTION NEW AD� ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner'sName ��/n � Phone�S � DESCRIPTIONOFWORK/USEOFBLDG. Address ��Ar � � _.. . _ _ Arch/Eng. License No. Address Contracror's Name _Phone a F Addresslm�l'nal A � � CitY Licenca Nn l LICENSED CONTRACTOR DECLARATION I M1ereby affirm that I am licenzetl untler p�ovisions ot Charter 9(commencing with section �000) of Dlvision 3 of [he gusiness antl Protessions Cotle, antl my license is in ful o�r{ antl effect. � � Lice . n n ��yeenv9e N . �� Date� 5'9 t ,C � �� «` "OR ERS COMPENSATION DECLARqT10N ereby affirm that I have a certificate o( consent lo self-insure or a certiticate Workers' Compensation Insurance, or a certifietl co y thereoi (Sectio 3800, Lab. 'J�/%'J Policy No.�1�Gs /.� �� Cor�Pany n,�y.,�,ertifietl copy is hereby fu�nishetl. � O cer �'e y� til tl with the city By��^!�' pyq9-� Date APPlicant / ��/ /1�� . EXEMPTION-��RKERS' COMPErySATION DECLARATION (Thissectian neetl not b¢ completetl if [h@ p¢�mit is for one huntlretl ($100) or less). I certify that in [he perto�mance ot the Work fo� whlch this perm�t i5 issuetl, I shall not employ any person in any manner so as to become subject to the Workers' Compensa[ion Laws ot California. Dale Si9nature NOTICE: If, after making this tleclara[iop� you ShoulC become subject to [he Workers' Compensation Orovisions of tqe tabor Cotle, you mus[ fortnwith mmply with such provisions o� lhis permit shall be tleeme0 revoketl. CONSTRVCTION LENDING AGENCV I hereCy affirm that there is a consVuc[iop lentling agency for the performanw of the work for wbich tniz permit is issued (Section 309]�.'Civ. CJ Lentler'S Name Lentler'S Atltlress OWNER BUILDEH DECLARATION I tle�eby affirm that I am ezempt fwm {he Cantracto�'s Licenze Law for [he following reason (Section ]03L5 Business antl Protessional Cotle: Any ci[y o� county which requires a permit to construct, alter, improve, tlemolish or repair any structur¢, prior to its issuance, also requires the applicant for such permit to file a signetl statement that he/sbe is litensetl pursuant to the piovisions of `4e Contractor's License Law (Chapter 9(�ommencin9 witM1 Section-]000) of vision 3 o( the Business antl Profesvons Catle) or that he/she is exempt :refrom antl the basis for the alle9etl exemption. Any violation of Section . J3L5 by any applicant for a pe�mit subjects [he applicant to a civil pendlty of not move than five huntlred tlpllars ($500). ❑ 1,' as owner of the property or my employees with wages as their soie wmpensation, will tlo the work, antl tha structure is not intendetl or offeretl for sale (Section 7044, Business antl professlonal Cotle: The Contractor's License l2w aoes not aoP�Y to an owner of a pwperty wno builtls or improves thereon, anG who Ooes such wo�k himself/herself o� throu9h his or her own employees, provitletl [hat such improverhents are not intentletl nr otteretl tor sale. If, however, the builtling or imp�ov¢meni is soltl within one yea� of com- pleiion, the owner will M1ave the burtlen o{ proving he/she tlitl not builtl or im- prove for the purpose of sale). ❑ I, as ownev of Ihe property, am exclusively cont�acting with licensed cOn- Vactors[o construct the project (Section 7044. Business antl Professions Cotle: The Contracto�'s License Law tloes not apply to an owner of property who builas or improves thereon, antl who cpnGacts for such projects with a con- trattor(s) hcense pursuant to the Contractor'S License Law). I am awa�e that proot of ttleir Worker's Compensation insurance shoultl be provitletl to me. ❑ I am exempt untler Section , B. & P. C. for this reason Date Owner - I M1e�eby certify that I have reatl Ihis epplication antl state that the above information is correcL I aqree [o comply with all city antl county ortlinances antl state laws relating to bwltlin9 construction, antl hereby authorlie repre- sentatives of this ciry to en r upon the above-mentionetl property tor inspection pu�e�J/� //�/ /�_ � ,� Signa[ure �� !!lf ////!/((/ Date Drivers' License or SS'^ �"�� TVPE OF PERMIT LJ GH4.DIAG OUNOATION LJ STRVCTURAL ❑ TENANT ❑ ELECTRICAL PLVMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION S4.Fr. ocCuaANcv— CONSTRUCTION TYPE VAIUATION $ ZONE GRAOINGCU.VDS. ACRES_ Remarks: Sink Preventer Irrigation Dishwasher � Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets i ncercepmrs Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee ! $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple FirepHFacL Blt. ICBO # Heating SYstem & Ducting ❑0-100,000 BTU 0100,90Q Fee � $15 CMF 0865-46, rev. 10/84 White - Pink � Accounting; Goltlenrotl - Asse55or PLUMBING ' $FIOWEfS Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping ,Solar Tank Swimming Pool w/Spa Urinal Water Closet ' Water Heater Water Service Auto-Wash Laundry Trays Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeretion System ❑0-100,000 BTU� Registers luue Fee FEES A.P. # S Main Buildi E T Fronx B Rear A C Ri9ht K S Left Ping. Ref. # Planninq Notes: Automa[ic Washer Construction Pole Suh Cooking Unit Dishwasher Dryers ❑Gas ❑Ele� Fan F,A.U. Fixtures Device Boxes O utlets Swiiches Garbage Disposal Generamr �0- W � 7209 10/12/87 Zone Accessory Building: Parking Req,/Provided ELECTRICAL �� Trensformer M¢L¢Y LJ� Merer ❑� Sub Panel Motors ❑ Pole Light Range LJ 15-50 KW ❑ 50+KW to 100 amps r100am HP O1%-8 15 HP 076-15+ Standing Sections 5-15 KWT Trash Compactor $ 3 ' _—_ Reinspection Fee � $15 Issue Fee FEES �DEVELOPMENT SERVICES REQUIREMENTS: � Zoning Appraved By Buildin9 Approved By Application Issuad By $ 3 5oon n Z O N I N G R E Q M T S FEES $ 3 , ' SUMMARV OF FEES . � BUILDING PERMIT $ SMIP $ - PLAN CHECK � $ PERMIT PLUMBING $ � + O ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. 5 E�ECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ —('--}(�/-qV-� MECHANICAL $ TOTAL FEE $ �'� PLAN CHECK 25% $ CONSTRUCTION AND'PLANNING � 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� � � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test 6. ElectricalUFERGrnd.�, 57. APPROVALTOCOVER-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. , 70. Structural Floor SYstem ' - 67. 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 � 76. Rough Electric Wiring � 67. Fencing & Access Approval ,, 17. Rough Wiring Sign 68. APPROVED�FOR PLASTERING " �� 18. Rough Electrical-T Bar Ceiling ' - 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heatin9 & Air Conditioning � FIRE DEPT. REQUIREMENT i 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-Rou9h & Test 72. Underground Flush ' 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74, Overhead HYdro .� 26. T-Bar Ceiling (Structural) & Monocoat , 75. Dry Chemical . � 27. Frame and Flashing ' 76. Dry Standpipe . 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL � 30. Drywall Nailing � � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ' � - 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test . ..� 36. Hood or Canopy - i 37. final Factory Fireplace � , , 38. Final Plumbing � -(}�•�(( L ED I 39. Water Service-Final � . 40. Gas Service-Final � . , , 41. Solar pomestic-Final ' . � 42. Backflow Preventer � . 43. Backflow Irrigation " � : • . � �44. LandscapelrrigationSystem � -' ' � .� '45. Sound Attenuation ', . . . 46. Handicap Regulations � . , � 47. FINALSTRUCTURE&BUILDING - : � . . . 1 48.,Special Requirements Completed • � � � � , _ i. 49. Electric Release to Edison �` -, � � 50. Gas Release to Southern California Gas Co ' ' . 51. CERTIFICATE OF OCCUPANCY - - No. Date ' ' ` 4 . J Applican� �o fill In all s0a[es ezca0� t�ose wlt�in heavy Eortler lines anC si9n all approp�iale tlecla�alions. CITY OF COSTA MESA � � CONSTRUCTION PERM� , Project Addres5. _�r' Applicant's Mailin ddress, � Owner's Name Phor+h¢ ' S` Address ��<�-� � - Arch/Eng. License No. Address Contractor's Nam Phon��Z'3�� Addreu (mailing) � - � �' ' Ciry License No. - � LICENSED CONTRACTOR DECLARATION I hereby affirm Ihat I am Iicensetl under provisions ot Charter 9(commencing with� section 7000) oi �ivislon 3 of tne Busineit antl Professlons Cotle, dntl my Iicense is in f forc n eftect. cGI �/"2 License Class ��' Lic o-% / 5�� Date �-�� 5'g dt � G��p� � ORKERS'COMPENSATION OECLARATION . � �ereoy affirm that I have a certificate of wnsent to ulbinsure or a<ertlficate - of Worke�s' Compensation Insurance, or a cer tl' co y tnereof (Settlon 3600. Lab. �f.I)G2 �/!� " PoIiCy No..-p� �l W Company rtifietl copy Is hereby fumishetl. Cer fietl copy is filetl with the city 8 �ng i io!t� Date � ApPlicant �� A //CL✓QL�/ EXEMPTION FftOM WORKERS' COMPENSATION DECLARATION - - t (Thissection neetl not be Compl¢t¢tl if the permlt is for one huntlreE (5300) or less): 1 cerlify�that in the performdnce of the work for'which thii permR is ISsuetl I� shall not employ any person in any manner so as to betoma subject to�t�e � Workerz' Compensation Laws ot California. . Date Si9nature NOTICE: It; afte� making thl5 tle[IaratiOn, y0u S�OUItl becOme sub7ect to tne 'Woikers' Cortipensation provisianz of the labor Code, you must forthwilh comply with suc� provisions or thi5 permil shall be tleemetl revoke�. CONSTRUCTION LENDING 'AGENCV- . " . - I hereby at(irm t�a[ there is a construclion lentling agenty for the performance of the ,work far which this permi[ iz Issued (SecHon 3097 Civ. ,C.) L.entler's Name' lentler's Atltlress � � '�, OWNER BUILDER DECLARATION � I hereby atfirm lhat 1 dm exempt trom the Contractor's LI[¢nse L.aw 10/ tha following reason (Section 703L5 Buslness anG Pwfessional Catle: Any dry or county which requires a Permil to construct, alter, Improve, tlemoli5h or repair any structure, prbr to its'issuance, also requires the applicant for such permit 'o file a si9netl statement that he/she Is licensatl pursuant to the orovlsions of e Contra<tor's License Law (Chap[er 9(commenNn9 with Section 7000) of vision 3-ot the Business antl Professions Cotla) �or that he/she (5 exempt ierefrom antl the basis for the alleg¢tl exemption. Any vlolation of Section �031.5 by any applican[ for a permit sub�ects the dOP��ant to a civil . enalty of not more than five huntlretl tloltars (5500). ' � I,�dS Owner ot tne properly or my ¢mploy¢es�with wages as thBir sole . compensation, will tlo the work, antl the structure is not intentletl or offeretl for ule (Section 7044, Business antl Profeszlonal CoOe: The Contractor's � license Law tloes not apply to an owner of a Oroparty who bulltls or Improves thereon; antl wbo tloe5 Such work himselt/hersalf or through his or �er own employees, prOvitl¢tl tha[ such ImOrovBmentS dre nOt intentletl Or ofieretl f0/ sale. If, however, the builtling or improvement is TOItl wi[hin one year of com- pletion, the owner will,have the burtlen of proving he/she ditl not builtl or im- �rove for the purpose ot sale). I, as Owner of the property, aT exclusively COntracting wlth IlcenSetl con- tractors to construct the project (Section 7044, Buslness antl Professions Cotle: The Contractor's License Law- does-not apply to an owner of pro0erty who builtl5 or imprOves thereon, anU who cOnt�acts fo� such p�oj¢Ct5 with a con- tractor(s) license pursuan[ to the ContrattorY Licanse Law). ❑ 1 am exempt untler Section B. & P. C. for thls reason Date Owner — I h¢r¢by certify that I have �eatl th in(ormation is correct. I a9ree to con antl:state laws ralating to builaing c� sentatives of�tn city o enter up inspec[ion pur � y, Siqnature Drivers' �icense or 55 � the above TYPE OF CONSTRUCTION LJ NEW 1.1iADO LJ ALTERATION Ll REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER. . _ DESCRIPTION OF WORK TVPE OF PERMIT IJ GRADING L..I FOUN�ATION LI STRUCTURAL ❑ TENANT ❑ ELECTRICAL �PLUMBING ❑ MECHANICAL ❑ OTHER • PROJECT DESCRIPTION Sp. FT. OCCUPANCV_. CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.VDS. ACRES_ Remarks: . . _ _ _ .. / ! /:. _ivll. _ � .r� Bar Sink ' ' Backflow Preventer Backflow Irrigation eathtubs ('Iar'('�_ Diihwashe� � � O'"V Drinking FountaiAs Floor Oreins Floor Sinks GasService Outlets� Interceptors KitcFien Sink Lavatories P-Trap Roof Diains Reinspection Fee $25 Boiler Duct - Under Ground � Duct - Strucmral Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑ ai oo.000 aTu O � oo.000 sr Reinspaction Fae � $25 CMF 0865-46 rev. ]/83 ' White - BUIltling; Canary - Appliwnt; Pink - Accounting; Goltlenrotl - Assassor Showers Service Sink " Sewer Cap Sewer Connection Solar Collectors SOlar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Wa[er Service � IAue Fee . . iANICAL Hoodor Typel ❑ Canopy Typell� ❑ Refrigeracion System • ❑a�oo,000eru ❑ioo,000aT System Repair/Alteration � � laue Fee A.P. � S Main B� E T Front B Rear A C Right K Left S Ping. Ref. # Use of Building: FEES P�anning Notes: Automatic Washer Construction Pole Sub. Cooking Unit �IShW35hC! Oryers �Gas ❑E Fan F.A.U. Fixtures Device Boxes �UtIEtS . 3508 2/01/84 � 2one Park.Fees $ ELECTRICAL � Transformer ❑ 15-50 KW . ❑50+KW . ` - - Metei ❑up to 100 amps ' - ' Meter ❑over 100 amps i� Sub Panel Motors�0.1 HP�1�-8 Inc.Solar•�9-15 HP �16-15+ Microwave Pole Li9ht Range Garbage Oisposal ' I I Standing Sections Generator �0.5 KW �5-75 KW Trash Compactor $y� Rainspection Fee ' g25 ' laue Fee FEES PUBLIC SERVICES RE�UIREMENTS: Zoninp Approved By ApPliwtian APProved By Aooliption lauad Bv -� $ 3 BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL , PLAN CHECK MECHANICAL � PLAN CHECK 5.00 TL $ 3 .SUMMARV OF FEES . $ SMIP $ $ PERMIT $ � ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ ' $ MICROFILM $ $ TOTA�FEE $ �� $ ' Z O N I N G R E Q U 1 R E E N T CONSTRUCTION AND PLANNING ' � PO Y SPA APPROVALS Permit #� Q�� Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Electric8l Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgmd. � ' 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd.� 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding - 5. Steel Reinforcement , - 56. Rough Plumbing & Pressure Test 6� Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings ' 58. Electrical Conduit-Undrgrnd. B. Foundation � � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. � , 60. Backwash Lines, RTrap, 0 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 Plum6ing ' 65. Electrical-Final 15. Rough Electrical-Conduit , ' 66. Solar System-Final i6. Rough Electric Wiring � � 67. Fencing & Access Approval 17�. Rough Wiring Sigri � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T•Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - APPROVALS Permit # 21. Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating ' � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test � ' 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing . 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation � � � 78. FIRE PREV. FINAL 30. Drywall Nailing �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electriral Power Meter-Final , 80. FOOD CERTIFICATE ISSUED 33. Final Electric ' Notes: � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test . 36. Hood or Canopy 37. Final Factory Fireplace � 38. Final Plumbing 1.3-d'y r�`Lfl� - 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. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date� � OWNER �pRWIN So. Cal. JOB ADDRE55 34b5 Pludaeria Place GENFRAL CONTRACTOR same — AI LOT $6 TRACT INSYECTIONS Si natu SOIL GAS W ATER ROUGH PWMBING PROP. SWR. LINE OUSE CON. SPRINKLING SVSTEM h115CELLANE0U5 ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGftOUND � POWER � ROUGH WIRING TAENCXES FOPMS STEELiiE1NF. FLOOR SVSTEM BOND BEAM STEEL REINFORCE SHEATXING FRAME AND FLASMING LATHING - IN OUT PL -R, BROWN COAT Sl URAL, FINAL � DESCRIPTU FIRE ZONE DATE BUILDING PERMIT SUBCONTRACTOR / � � ,� .�b�� COSTA MESA BUILDING-SAFETY DEPARTMENT %OL CR P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 � For A��ic� (p�ill in Campletely� BUIIDING _ `,(07 2 . ww d U Z 2Q O v~i am J � J N Q W ¢] J J m Q U N Za W � aw WZ J Q m Z J � W w O= zF w� 70 H z Q U J a a ¢ 0 H N Z O F U � � �" N Z OWNER MAIL CITV Encino, California Nc CANSfRUc��,��n Southern California LENDER eaan,cN16255 Venlvra Boulevard nooaes¢ncino_ California 91�t16 ARCHITECT �� , ,. ,., �,,. TE CONTRACTOfi Larwin Southem Califomia ADDRE55 �6255 Ventura Boulevard TEL. ciTv Encino, California N�• 98! LIC. No. 191311 IICVNO. OF LOT rj$ X JI NOWONLOI VSE OF EXISTING BLDG. SIZE OF NO. OF NEWBLOG. 2.3S�F ROOMS STORI EXTERIOR WALL ROOF COVERING 5}UCCO COVERING w00(� cI VSE OF BUILDING AND WORK TO BE PERFO ED � � PArI q '°111-7:cr: 00 G33': '::*1�7.C��. � ��, � .��9 �� APPLICATION FOR BUILDING PERMIT ��'�� RECEIVE BV D�AITERECEIVED DATEISSUED n LL�/0�7� ..... � � ._'� A.P. NO. BUILDING /�iI ADDRESS �iT� TRACT %SS%-B LOT OWNER L�/'`L�I/� S FIRE 20NE T' APPROVEDJ„� / RV W � �G ONE NO.OF � > PLAN$ � VARDSAPPROVED MAIN BUILDING FROM GL STREET) 2 L. SIDE F1 REAR �StFI OISTANCE BET. MAIN BLDCS. VAii. #�+ C.U.P.�W APPROVED/.l - !/S/ NOLD FOR I hereby acknowletlge that I have reatl this application and stata that the ebove information is correct and eB/ee to comply with all laws raguloting builtling construction, and I shell not employ any person in violation of [he workman's compensation laws of the State of California. I hareby cartify that I am properly licensetl as e eonttactor untler [he Ste[o o( Calitornia Buzinass entl Professions Cotle, Division 3, Chapter 9, end that such licenses ere in full force antl effect, or I am ezempt from the provistons of Ne Srete of California Business antl Protossions �Cod�e, Division 3, Chapter 9. Signature��el�/y/ f _ _ti� n Permittae E%/,%//�l J� • Downs c�y`rr Authorizetl Apeni THE AMOUNT SI THE PURPOSE OF VALVATION s 35,600 L DATE �'��^ YARDS APPROVED DATE APPFOVED FT /0-73 / m [OO o UND VALVATION IS FOR ^ LIS G A PEFMIT FEE ONLV: � ¢ RMITFEE $ i16.SO � AN CHECK § SH. ZS E `o ITAL FEE $ 174.75 �` �JOB ADDRESS LL� W[fl• tt. 3465 Plumeria Place L2 BUI�DING PERMII -21 LOT TRACT FIRE ZONE VALUE S 1160.00 �GAS WATER ROUGH PLUM8ING �ROP. $WR. LINE [� HOUSE CON. � SPRINKLING SVSTEM MISCELLANEOUS ROUGH HEPTING ANO RIR CONDITIONING TEMPORARY SEfiVICE OR POLE UNDERGFOUNO � POWER � POUGH WIRING iRENCHES [ FORMS � STEEL RE FLOOR SVSTEM BONO BEAM � STEEL REINFORCE [ SHEAtHING FRAME ANO FLASHING PLn^—ER. BROWN COAT Sl UFAL, FINAL HENi iNG, VENT., REGRIG. ANO N. PLUMBING. FINAL AN� GAS TEST F INAL SUBCONTRACTOR �S • - � Nan " J��i�b ;'JB 13-74c;�«001173'� *=' =18.5C COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 AP I ATION FOR BUILDING PERMIT For Applicant ro Fill in Completely fl I � DATE RECEIVED pATE SSUED BUII.DIPJG ��1�" tit-%." � � _ j3 ADORESS F� v .r i PE N} T OWNER. ,� �� I7 ��_ • A.P. NO. — I '�. MA I L p BUILDING ADORESS J�'�1 �� ADDRESS �/` � Z ,�y a U CITV '� � �T ��', j� NOL TRACT , LOT BLOCK Z Q CANSTRUCTION � W A O� LENDER O��♦ d m J ' BRANCM ��] JN OWNER (J(Jm E m J ADDRESS 'UE J m ARCHITECT ls TEL. 5 d '�� $ � OR ENGINEER A `1 V FIRE /�'� w Q,' ADORESS �ONE VPE GROUP J aw . 2 J O CONTRACTO � �\ I (`]_T� BVPPOVE� DATE �' .J' Jz ADORESS��.11p �I � II(JV~%- �+1 W '(� /p �f 20 NO.OF USE OF N � x CITY F' � V.. NOL�j� !�`G • S P�� BUILDING �O Z �-- W O STATE �t CITV s 1 `�ARDS APPROVED VARDS APPROVED y a �IC. NO. �� '� � LI4 NO„��,y� MAIN BUILDING ACCESSORV BUIIDING '� SIZE (�,/� NO.OF BLDGS. (FROM C/L ET) OFLOT �J^ ��5 -�f� NOWONLOT qOM �� FT. FT. USE OF EXISTING BLDG. S �Q FT. F SIZE OF s NO. OF Z NEWBLOG. �� ROOMS STORIES L.SIDE S FT. FT. a EXTERI�R WAII RO�F / u �% COVERING COVER�NG REAF �� FT.(p FT. J USE O LDIN AND W K,�)TO BE P RFORMED DISTANCE BET. BEf. MAIN & a � %% MAIN BLDGS. ACCESS. BLDGS. a J �[ O C URP. �� / � �p APPROVED '��7 / z APPflOVED� f/ ^ � Q _'�3/ � � UI �ereby acknowletlBa Met I have reatl this epplication entl steta � � that the above informeNon is corract a�d aprea to comply with � all laws re8�lating building constructlon, antl I shall not employ �t . F eny person In violation of the workman's compensation lews of y tha State of Celitornie. B � ? I hereby certi�y that I am pro0erly licansetl as a contractor untlar SQ. FT, o the Stata of Celifornia Buziness antl Professions Cotla, Olvlslcn 3, THE AMOUNT SHOWN UNDER VALUATION I$ FOR '; Chapter 9, and that such licenses era in full force entl atfect, or I THE PURPOSE OF ESfABLISHING A PERMIT FEE ONLV: m em flxempt trom the proviclons Qf tha State of Cellfnrnia 8u¢inen ¢ end Protessions Cotle, D��sian � 0 apter 9. VA�UATION �_ m / PERMIT FEE $ � �r J Sipnature O( ��1 �.�� _ / � m Permittee � '�. �N $/�/^Q PLAN CMECK $ E � V% `p Authorizatl Agent � LL TOTAL FEE $ '