HomeMy WebLinkAbout963 POST RD - Building Permits�oonsssaCw�axo: � 9b3 PVST RD
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CuS7A MESA,CA 92020
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coxm�crarsxu¢ CRANK BAOS A�FINt� CO ( 714 ) 54&-5569
C[MN�CIORSYNt➢q 12b CGMMERCIAL WAY
�zcCGSTA MESA CA ��= 408b77
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IJCENSEC COMN�CfOfl9 DECI�P�PON: I hxeby ellrtn udr prW y tl �srp�ry IM I em fcmveC uMx prwieuna d Cheqer 9
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WOPREP'S COYPFNSATION OECL�F�TION: I hereby eflmn uder prWy d prpry aw d tM Idbx4p tlsdvatbn:
� I hevs vW W meinten e caNiub d odumt lo setlinw�s b xakws' mnpendbn. m pwked la by Betlion �100 d IM labor
coes. �« in. c«��e a ne .oM �« wMn u,o v.� e��,.d.
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work la xhieh thb V�4 u iuueA. MV wwkn� _mmG��ion ieu�v�nea urr'w vd D�/ numbr ere:
c.�w: bTi�1E FUNL EXPIkES
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Deeonw �ubjetl ta iM w'brY mWauuion Nrn d Gafdande, ad aprw ihtl C I�hoWd Eeemw wEjW to iM xoeMn'
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CONSTIIUCIION LENpNO �OENCY: I!rW/ e1lum �vdr pdWy d perjry Na �Mn e a wWMion bM'vq epenvy lu Ns
peAormerce d IM v.ork tar whidi I�e pam�'s eaeC (�m �D41. Cw. C).
LENDEfl'S NYIE
LENDEF'S �OOPE53:
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erd �tme Wn nlet�V b heldiq w�utru9m md hereby aWvice �w�efA+� d IFb �Yf'4 emr upon tM ebws�rtemianetl popary
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(5151-68.WP) W�ne-BuiWiq85tlelY:O�wmFk:CenarWRppirani:FnkJiwanue:OdEen�od-Nnvaa
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CITY uF CuSTA MESA - HUILDING FEhMII'
PERMIT NG: b 085892 PLAN CHECIC NG: N
PEAM NO: fi "v85b52
GVVT: N SUPF: N
CGNSTRUCTIGN rYFE: V-N PERMIT TYPE: SI'R PUHPGSE: UTH
JGb LESCRIPTIuN : TiGFF s INSiAI,L CGMP. SQ FT: 5,10"v
CLAIM VALUE; S,1G"v.00 CALi.-VALUE: S,lOG.GG GRGiJF OC�: R-3 i
CUMMEN?S: T/G EXI57ING ANL RERGOF W/ CUMP. SHINGLE, SMGKt. LEIECTGRS REQ
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Z O N I N G R E Q U I R E M E N T 5
S E T B A C K S
------------ MAIN bUILLING ---------- --------- ACCESSuRY &LiILLING ---------
FRNT: FT IN REAA: FT IN FANT: FT IN AEAR: FT IN
LEFT: FT IN RGHI': FT IN LEFT: FT IN kGHT: FI' IN
PtlAKING AE(�• ` PROV; PARCEL: 426G7125 ZNE: REF NO:
PLANNING NVTES�� •'�
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CONSTRUCTION AND PLANNING POOL & SPA . I
qPPROVALS Permit # Date inspector qppROVALS Permit # Date Inspector
` 1. TemDorary Elecirical Servicenr Poie 52. Pooi & Equipment Locaxion
2: ,Soil Pipe-Undrgmd., �� 53. Steei Reinforcement _
."_
„j3.; IectricalCondut�.ltjlity-Un�grnd. 54. Forms s
�. ��4�-Electrical Condl7ii'Undrgmd. . 55. Elecirical Bonding -
r• �
. �5��teel Reinforcer�Se�� 56. Rough PYumbing & Pressure Test �
.
6:�_-Electrical UFER:GYntl. � 57. APPROVAL TO COVER�GUNITE
�
Im�J��ootings ;� .�, 'i 58. Eiectrical Con�ii,�Undrgrnd.
� j8. Foundation m�� _, 59. Gas Pipe, O UndcBrnd., Test
-'9. Water Pipe�Und€yr�d.�,} 60, Backwash LineJ'�-Trap, O Undrgrnd.
0. Structural FloorSvstem .a. 67. APPROVAL Y�t�ECK
11,�Aroperty Sewer Line�^& Housexonnection 62. Backwash & Receptor�Final
�a
12.-�ewer CaP �' .
�� �� 63. Heater & Vent-Final
13. Aoot Drains ' 64. Piumbing System • Fi�al
14. Rou h Plum6iri '�
9 8, a, ti 65. Electrical-Final
15. Rough Electrical:Conduit .. 66. Soiar System•P%�}iel
16. Rough Efearic'Wiri� ,:� 67. Fenciny & AcCesS�ApProval
17. Rough Wiring S�gn �:, 68. APPROVED PORPLASTERING .
16. ftough Eiectrica`i!T Bar Ceiling 69. POOUSPA SYS'�EMS FINAL
79.rRougr He�tirg & Air Conditipqwig r T � �� �„r � �r F1R-E�6PT,�iEQUIREMEfJ�T �v
� 'z7 "7•li:��;� :-1 k a+ ir�
20.,�ough F3Eto� FFeplace i s'^ �'S �+ �S '"' � r•� APW,�O�{NS'�" Pe3mit #` 'T r
' V �L M � �r�.� Y.S i. 1-i ��i �7 !' J�7 w -�-
�T .•.. H ! . 'J 1 ' 1'J �
21.�Duak,i�.truEturg� j ,�ti t ij �� ,1y•_ 70.'-UndergcaWdttydro %
22. pu�, Ventit3lingu� i � � F'7 '+`. �� ��r' 77, prod � i mg.CCi��s Oil
_ ,. ,- ,� � , y�'P �� � � �.
23.,Gas��peJ�oug� & T"�st ',;.,r.,, jj t�� �1 �r s+ , 72. UndergrouAd Fiushn e ;N o
24. Roof Framing � 4 � � �' �� � :? � �-� x • '��nderyr�d.StO�Yan1� OGas ❑Oil
,'� IV I '1 �V K J j nJ
25. Root,'Sheathing ,y # ^ � �'_�. 7q,,,Overhead Hydry�,
%! �'-q; � �
g � " '7 � 75:'Ory Ch��1Eal � � �i� +�1
26. T•Bar.Ceilin (Strnetural) & IVIff�6Loat � ��
� .-� i-..v n -� s 1. 'S �
27. frarr�e an� Fla}hiijg t �=x�^' `', ?' 'w t r ti �-:�� F�
� .,� _ r. ..ir,:7 T k ....r 76. Dry $tar�P�Pe�y.-� e �7 �U �7
, 28. Lath�ng $i Si�ng � !: � 7� ,�- ^ �� ,y I �F 7Z, FIXED'SYST�M�FINA� � '� �1
29. Insulatior} n+ g 'j k 5 �i 7�. FIRE PREV. FJfVAL y'l �; 'N
� ��
30. Orywall Wailing x!�-+ Y'- 'K ; •�FiEALTH DEPT. RE�UIfiEMENT
-� 31. Plaster 8:bwr;y�oa2 q 'S i '��" ,� � }* 79. FINAL 3AlSPEC�N � �- �� �
, 32. Electricat ower 9�ecer'Final � e � r $p; F000 CEiiTIF] ATE ISSCIED� ��
.• ' -• :. � *7 1 v. i. tK l !i 7 n �"] �_1 V*1
� � 33. �inal Electrics � y � � � k f�ptes: ,y �r., � Y .�,�
^ 34.,,�ina�HeSting�+ Ai{ �pt�ditioning' �r, k ;> � � k �t ;-i 'i i-:= k � � ,r1
.. i, :, r �
35.�Final GasPipe=Te= t,�,y .. `�"' K'- ��x: - 7.� r. '�`�r
�. � r. � r .� rm �-+
.. 36.'��ood�or CanoPY �c � -� � ;z.- ..i .« , � � I . ir +x �� .f ,*i �7 m
i - .- .. �� . �
� 37. pinat'Factory Firepl5c� r �" �� ��•� i � ft . ,� t 5�,
� 38. FinaLPlumbing j : -n ' � �n ! l �k : �-+ -+'� i Y %
�.n i^ � i
� 39. Water $ervice-fin2i �i E i r I �` .-' .'� : .S
�� , r -� t� e i� - • t i*] �r,
� � 40. Gas Service-Fiqal L e -" �'1i-!� .� F � K • •�� ` 'y
r
�- 41. 5olarpomest[cFi6af � S� �" "��� " `'e ��
r � ��ti - :� t �� . r.
42. 6ackflow Pre�v¢nte� F: � ?'�,� k� . :� �.,�.,_� r ,�
43. BackNow Irrigatiorf '. ` � * " � � .0 J � ,�; '� 7
1 .T1 } ii tf �, '. • . 'l J. � V V r
,�4. �l.andsca'p� Ir�gauon SYstem � ..,.r. ri s � �� �2 2 x ' � �7 �-: + = �
- .� -, - �
45. '�ound Attenuation+ '� .. .. � ` T7 ,n � t :- r,� �r a, i-�7 ,
' r r ' r rt .. �. �' i i-�L .. y r
46. HandicaPRegulatidr�2 �'- .. � � ..i t� .n�� � .v .� ..
� �.
97. �FINAL STRUCTItRf & BUILDING 1 7 �i � , � "
r�� � -f� i �e n s: ; r �1
48.;�,INALPLANNING� �� A � F �'� ? v � � '
�q9. Electaic Release to Edison , r I ±, i ? ._ 4 �,�
i r
'50. Oas ReleaSe to Soutl�em CalitorniaGasCo ; �: . � � -, i �"v
51. CERTIFIGATEOF CCUPANCY � �� �
No. Date
MUPESS OF BNLpNO: 9 b 3 PUS T RD
o,n,�asru�E�Fa+""": THOMPSON, EVERETT L
�o�K 963 POST RD
COSTA MESA_CA 9262b
�rv�. Yuur+c �oox�ss
I�flCHIfECTOREN�IEEN:
�RCII ON FNd'S 1WPE54:
UC N0.:
coNm�crars wu�:
carm�crons wuwa
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UNT:
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LICENSED COMfl�ttOPS DECL�R�TION: 1 hereb� tllim under psuly d pa�uy Nei l em lirometl uMs pwo'vu d Gheqr 9
(mmme�M hilh Section 1000) W D'me'vn ] d tM &ui�wee uk PMmeions Cods. eM mY lue�me u in IWl lace and s%ad.
cm uc. r+o.: uc. cuss: uc. No.: EX P;
Dme: CmUetla:
OW NEN BUILOEN UECLANATION: I heeWy e/fimi ivMs pere1Y d piWY thm I mn e�emp liam �M Caqrtlwa lbrua lew la the
IaOowvq immn (Seaion ]W 13 &minse eM Prolms'vn Cob: MYW a mwY Mudi �w�M a w�e w mmwl. ellr.'vnpwa.
demWch, a repv erry etulura, piu io Ie iwarce, ebo rWarm ihe epplimnl la wKh parmu �o fJs e eqroE MtemeM tlut ha a�he
o c�e w�+� �o me m�+• a u» com,mo.. uo�,s �+ Icn.p« e loomm.�aro .vn s.n�, �aaol a o'r+e� s a w
euaxsa .m craeaiona cue.l «�nm ro«ene u uemq insd.an .�d ins bem �or me •OeqaE ex«iabn. Mr �c�ncn a swion
]0]t.5 by enY eGC��^� lar e permu �ubptl� IM appfranl lo e dvY peroly d nal mas ihon fvs huMesd ddbn �SSW��.
❑ �.movme.ameww�v«mr«npw�••�n.vnpe+e.m:.d.00mo��.waronn.�ak.enem.mwunemw.neea
a MereE br seb ISecibn �Du. Bmmn eM PmtevaiansCode: The Wmreaas lioenee law Aoee na eDdYto en ow�w d puprry
M�ID �Ml�'! OfTpWM ��IVBpI. Mb Miq dOC� �W�I WIXk iY�Md IX �MRl� IX I�1IMI�1 b IX IIM O`MI MIIpC)!!L pIPI�� �� MCh
impwemema are M iNsdeE a aHaM la eeb. tl.lawewr.lhe WD]'up a inprv.anap o wN xlthm ane Y� d wmpMion. ihe
�owrorbuiWx xitl heva tM WNm d pwi'p M w ehe d'd m� buiM ar improvs tor tM WT�e d sela).
i..+o.�« w me o�v. ��a�.w ow�m:ro .an u�e oo��«w�. w wm�w m. o�i.e �swo� raa. e�,�,..�e
Pmlevans COJe: Tha Comretlm Liwnw law Eroe ml eVON to en owmr d pWMY x1a EuiIM a inWw'w �haison erd wfio
cmuects Iv vrh pM�� xdh e mmreCMs) Icawd R�uem to �M Cor¢radore L'crose Lex1.
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ceniry Ilut I em erve d vd
theila eny Mura Wikiiq a
Daie: ADP���
WORKEP'S COMiENSATION UKLAH�TION: I Mreby elfirtn unEx pnally d pajwy aw d Ns lolbwinp EWvalum:
� I Iwe ud wil maiMen e cenifraia d cansen� io vaMrrouro M workaii oompevNian, n prwidsd la by Sar�m ])110 N �M LeEw
cae.. �« �ne ronormenco a in. won �« wl:on mie w�n ie u.we.
❑ � n.�..m wi� meimen .�oM.i.• mmo�on imureM.. m.w���.d M saion amo a me �.n« coae. a. m. w�«�wiw a me
wak lor w1iiW �hie peimA is ipued. MY worFois ewnpeneelbn inwrence fenier vq poliry numEer ere:
c�.:
Polcy Numbor:
Rnr, .,eaan �eed �a es ca�Wwee r ms v�� o ro. m. w�e�.e ddie�s Riooi a iw.�
� 1 mrlry ihm in I�e pMormence M �M wak la whkh ihie permit u ieoued, I Nell � ampq e�ry paeon in ury mennx w o to
become eubjad io iM v.wkns' canpenu�ion lav.+ d CelRanu. enE q�rse IMt G I ahouM bacame euEjw �o IM xwken'
compamelan prwieione W Seeion 3]00 0l �ha lebar Gode, I ehdl lonhxnh mmpy wn� Ihwe pmmeione.
ode: �vpK.m:
Wem/n0� F�Ilun ro s�euro wortwi rompruetlon eovx�p� Is �nl�wNl, �ntlWll �dJ�el �n Nnp/oyr fo erlMrW pxultlu uW
clvll flro� up ro om huntlrM fhouund do/kn /SfOqOWA M Nk/ltlon b IM caf o/ ro�vrwfbM1 Ginps u povkMC br )n
Sxtlon 9106 0l Ms LeEor CoOs, Inbnal, end eMrnry'a /w.
CONSTPUCTION LENDINO A�ENCY: I Mreby dfirm uMx panelry d perjry ihm iMn ie e caMrudion bMi�p pa�x.y M iha
perlormerice dlne workla whiMthe perm� u ueued�Seclbn 30B].Ci+.C�.
LENOEN'S NAME:
LENOER'S ADUHE44:
I cenity Ihet I heva reed Ihis epplcetian and peb �MI tha ebwa iMormnbn ie mrtq. I epree to canply xiiA ell ury eM caunry adinvrea
eM steie lawa rolelip io buikvp wnnrWim eid Mreby eNhaixe repeoeNetivm d Ihis dlyto anlm upon tM eboue�mnuionaE poperly
lorirepeaion purpoaea.
EVEAETT THOMPSON
S Er' 97
�5t51de.WP) Whne-Bwbip 8 Sdery; �reen-Fb: Cenery-AppSmni: Fnk-Rv.anue; OOMmroFAermv
CITY OF COSTA MESA — HUILLING PERMIT
PERM NO: B 084839
PERMIT NO: B 084834 PLAN CHECK NO: 03b59-97 L GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE; ALT
JOB DESCRIPTION : CHANGE FROM FLAT ROOF TO GAHLED ROOF SQ FI'; 7,000
CLAIM VALUE: 7,000.00 CALC—VALUE: 7,000.00 GROUP OCC; R-3 /
COMMENTS: SMOKE DETECTORS ARE REQUIRED
rie***�at******;e**at*itie�r*�t*etat***�c�3t*�at*ieatit�r**;�it+r**��*�t*********�:***x �****itat��**�c��
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSGRY HUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT; FT IN
PARKING REQ: PROV: PARCEL: 14123125 ZNE: R1 REF NO:
PLANNING NUTES,>'CAANGE EXISTING FLAT ROOF TO GABLED ROOF ON EXISTING
> ADDZTION,
if 1f if 1k k iE if ff iE ik 3F if it iF ik M ih iF iF�if3F if i! i! iF �f k 1E if if k iF 1E 1F iF ih 1f �F iE iF iE if if iF if ik if if if �F iE 1f iFiE iF M iF if iE iF iF iM1 iE iE iE iE ih iF iE iE iF iE iF iE 3f if iF if iE
D E V E„L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED�BY�i�: DATE: ��
BUILDING APPROVED BY! : DATE: �� ZC3 ��`�
APPLICATION.ISSUED BY: DATE: '' 7/ / /
����������,«*����*�*.*�,� �:*�;��*���* � . �;��
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 124.75 70
SMIP/NON—RES
PLAN 81.09
ISSUE FEE
BUILDING—DIV—>
TOTALS---->
PERMIT ISSUE PLAN—CHECK TOTAL FAIU DUE
125.95 0.00 81.09 206.54 206.54 .00
REVENUE DIVISION TOTALS--> COLLECTED: 125.45 OVER/SHORT: ,00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
i2�i,%s .%o
'1F if 3F iF �f iF �F iF iF it �F if iF iF iF iE 3f if iE iE if it iF it iF if iE 1E �f iF ft iF 3t if iE iF iF iF 1E 1E if !E if iE K if 1E iF if if iE iE iF it if if if iE if if if iF if vf if iF iF if il� iF if iF if iEif R iF iF ii
I N D I V I D U A L F E E B R E A K D 0 W N
TYPE QTY U E 5 C R I P T I O N UNIT COST TOTAL COST
SFR 7000 ALTER BY VALUE RESIDENTIAL N020NE 1.00 7,OOt�,Ot�
END OF FEES
�9-�3-1937/�?:;.� -�:/'ei�a,�.�
4L✓Tk:el-�L'.C/.�!
��;.: �_Te e€a�,z�,
CONSTRUCTION AND PLANNING POOL & SPA
APPROVALS Permit�h Date Inspector APPROVALS ?ermic# Date Inspector
7. 7emporary Electrical Service or Pole � 52. Pool & Equipment Location
2, Soil Pipe-Undrgrnd. 53. Sieel Reinforcement
'.� �lectrical Conduit Utility�Undrgrnd. • 54. Forms �
' �?4.,'Electrical Conduit�Undrgrnd. _ 55. Electrical Bonding � .
�� , Steei Reintorcement 56. Rough Pl�mbing & Pressure Test
'�.. Electrical UFER Grnd. 57. APPROVAL 70 COVER•GUNITE "
� �7. �ootings 58. Electricai Conduit�Undrgmd. �
'T8. Poundation � � 59. Gas Pipe, O Undrgrnd., Test
r.
F 9. Water Pipe-Undrgrnd. t 60. Backwash Lines, P�Trap, Cl Unclrgrnd. "
1-0. Structural Floor SYstem 61. APPRqVAL TO DECK
11. Property Sewer Line & 4ouse Connection 62. Backwash & Receptor-Fina�
12, Sewer Cap 63, Heater & Vent-Final
13. i7oof Drains 64. Plumbing System � Final
74. Fough Plumbing , 65. Electrical�Final
15. Rough Electrical•Conduit "" 66. Solar SYstem-Final
16. Rough Electric Wiring � � 67. Fencinq & Access Anproval _
17. Fough Wiring Sign = -, 68. APPROVED FOA PLASTERING
18. Rough Electrical�T Bar Ceiling � - 69. POOL/SPA SYSTEMS FINAL �
19. ftouyN H� tiny & Afr Conditioning 1� " - FI�RE.j?EPT..REQUIF�EMENT ,
20. 8ou h Factor Fi+eqlace �:�Y 7 - -� . .
9 _ Y � Z �. :� K - APP�OVAL�Sr'_ '. Pbemit # . .
21, puctr, inStnPcturei � •• ^ �: w ��7 H k- 70. ;Llnde��rouiid Hpdro '
22. Ducts, Venti{ysin ° ' � �' , ~ 1" R , T � � •
„ 9i . � .-� � �� � y _ 71. Produn.��{�iping O�iaz �Oil
23. Gas Ripe�Rough & Test � rS �-: _ 2 C r: 7y, Undergreund Ftushz �. :y ��
24. fioof-FrB' in" � � •�' .• _• � > 7 �T � k � -r .> � -,�� � �
T 9 � k ' �� �: ; . 73; Undergri�d. S[or�ye TanK O Gas ❑�Oil
.. �'--- : � /}� ' .
25. RoofShr;�thing r i S ��_�^%/ ��[s � 7d'. �Ovc�fhead Hvdra,_ "
/ ��'• h
26. T-Bar'Ceilin (Str��'ura1) & a�fod'coat '�
• 9 ,�Q .Z � ;. ,7 .>, � n ti 7�, .Dry:Chemical ' � -• ..
27. �rame and Fl2shing : �;z r. .��r��� �� 76. DrY Stai�idipe • . � ` .
28. LatFi±ng & Sid(ng ' ' � r�� ;� '' �'., =` "� '" � 77�; FIXED SSySTE�Ur-FINq� , ,�
29. Insulation �• ' � � _ � r _� j �k 7� FIRE PREV. FItVAL +- " '�
30. Orywall i;Vailing •' Y � _ � � 4 � ry ' i}1EALTH DEP7.�E(SUIKfEPAENT
•. 31. Plaster Brpwn'Coat k.S '• 5 k ! � Fk 7g. PINAL I�.NSPECTtON � '
-: 32. E�ectriw[Power W4�Qr�F,inal ,� i'' i � �K ` 8p3 FOOD CERTIF�.CATE I$SUEQ,
- - � � -
33. �5�na(-EVectric> • � �lr ��� Nates - '_ . �^ �
�- 34. FinaRHea�ing"8& Ayt Co�ditionir�g-� � h � i � l ,� _ � � -. -
35. Final Gas-Pipe:Test . - - �� _ � � ' x �� � � � J
- - ,:
i �.r
= 36. Hootl�or EanoPY F ' � _ -"' � � �i �I ._4r ,- ' � , F i, r
� T
i 37. EinaLFactory Firepl9ce ; .� . ^� i i �
'38. Fina�Plumbing ' '1 . -. t �`: g . ' - --'
. i;� � ' i - .�
° 39. 1Nater Ser'-�ice��inal ° � ' • �` � � -
i
t E T: �. F '•� �� - . �
. 40. Gae Service-Ffnal 1- ��7 �;.'" T� � ` '� I t« � + �'C
., c � '
- 41. Solar OoroestibFinal, S ;,j i - j -' � � `' , _ � � � -
f i'. "
42. �ackflow Preventer �. - ' . �' �� C - • �� - -
� � � m r' -
- s . -.
43. Backflow Irri§ation r �y'" �� q. � ' � �
�
;q4. LandscaA.? lrrtipation System � ,?� � 'r '� ' .� .i � � + ' s ��� = - • .,� i
�
45. Sound Attendation' � k.^ ._ ` ' .� � - � "' - - �
�� r ,c �r .
�?F6. HandicapRegulations � _ � � ' ' A •� '"�' °
, v I :� - ,. '� ,
47. FINAL STRU�TURE & BUI�DING 1�_ip,� � ��L " � �-.
48..61Ni�. P�ANNING. - � ° ' ` . "
I . �F ., .. � I. '
49. E�eciric R�lease m Fdison r' i� � �! s�
�: �. , � .
50. Gas Release to Southem California�GasCo ' � � � �� - • � -' � - '
i
51i CERTIFICATE OF OCCUPANCY � ' � '
No. Date �
-` Applicant to fill in all s0aces wlt�in
O�Y.'OSTAMESA PEaMiTNg,_,O�
>TRt'-�TION PERMIT � 5
Address i s n.; .- .a,,.�,
Address %G' J 'f�(:P �Cl. �- , p/.
Arch/Eng. �,./,n�r LicenseNo.
Address S d � G( '/(� �� � ilNC�
Contracmr)=�/L��� (�y i PhonelJfjCi6t
Address �y/fC 7 � (°�.7; ✓t, /J//- �/1/Jw�7F� .
LICENSED CONTRAGTOR DECLA0.ATION
I nereby aHirm that I am Ilcensad untler provisions of Charter 9(com-
mencln9'wIN sectlon 7000) of ,Division 3 of the Business antl
Profes5ions Code, nd my Iltense Is in full force antl effett.
Llcense CI 55. � .Lic�nse No. � t �' G q
Date�.Zi � Si9nature,�°t^•�< <,
WORKERS' COMPENSATION DECLARATION �- � �
I h¢r¢by affirm that I have a certlficate of consen[ to self-Insure or a
C¢ttlfiwte of Work¢r5' CompensatlOn �Insurance, or a cerU(ietl Copy
tM1ereof (Section 3800, lab. CJ.
Policy No. � Company
❑ Certitie0 copy is hereby furnishetl. . __ _
�Certltietl copy is filetl wit� the city Builtling �ivision.
EXEMGTION iROM WORKERS' COMGENSATION DECLHFATION'
(This 5ection neetl not be completetl if Ihe permit is for one huntlred
(§l00) or less).
1 ttrtify that in the performance o( the work for which this permit is
issuetl, 1 shall not employ any person in any manner so as to become
Subject f0 the Workers' Compen5ation LawS of Gli(ornia. .
Date Si9nature
NOTICE: It after making tM1is tleclaration, you s�oultl become subject
to th¢ Wo�ke�s' Compensation p�ovl5ion5 ot the Labo� Cotle; you mu5t
forthwlth comply with sucM1 proviSlons or tltis pe�mit snall be Oeemetl
�¢vOketl. . .
CONSTRUCTION LENDING AGENCV
I hereby a/tirm Iha[ [here Is a constructlon lentlin9 agency tor the per-
formance of the w/ork for which tnis permlt is issueE (Section 3097
Civ. C.I: �10iN1 rt���. . .
Lender'S Name -
Lender�s Atldress �'/f''� �n �
OWNER BUILpER DECLARATION " " '
1 hereby atfbm that 1 am eaempt trom the Contractor's License Law for
the Pollowing reason (Section ]031.5 Buslness antl Profes5ions Cotle:
Any City Or COunty whiGh rGqWr¢s a pGrmit ta wnstruc[, alter,
Improve, demolish or repair any SVutture, prbr to its lssuance, also re-
qui�es the ap0���nt for SUGh p¢rmit l0 flle a 5iqnetl Stat¢ment thal he
I5 IlcenSeE pursuan[ to the provlsiOns Of the Contractor'S LlcenSe Law
antl P�INessions Cotlel oftnat ne
�r tho allegetl exempllon. Any vlolation of Sectlon ]031.5 by
ollUnC for a Oermit subfec[s Ihe applltant to a civil penalty
more [han five huntlretl tlollars (E500).
'� owner o/ the properiy, or my employees wlth wages as thelr
noensatlort wlll tlo the work. antl [he_ztrutture is no[ intentletl
bortler lines anE si9n all aOCropriate Eeclarations.
TRACT NO. LOT NO. BLDG. NO.
TVPE OF C,,O.,/NSTRUCTION
❑ NEW V9 ADD ❑ AITERATION
❑REPAIR ❑CONVERSION ❑DEMOLISH
❑ OTHER _
DESCRIPTION)OFWORK L'J ' tt�
Plr^N.I;i Xr(,tr,;..ut'.�.tl.:_, 7.i,/nr_•,u
TVPE OF PERMIT,�,/ ,,.,�
-OGRADING .L7FOUNDATION IETSTRUCTVRAL
❑ TENANT Q'�ECTRICAL C�}�UMBING �MECHANICP
❑ OTHER
PROJEC7 f�ESCRIPTION
5�. FT. +�'L1 i. /`�li Zo �J/�' %� L
�y'
OCCUPANCV� Q�TORUCTIONTV.GE' y
VALVATION d� ZONE
GRADING CV. VDS. ACRES
REMARKS:
PLUMBING PLANCNECK '
BATHTUBS SHOWERS
TOILETS � . URINAL$
LAVATORIE$ DOUBLE LAV$
KIT.SINKS ' DISHWASHEFS-,.
SERVICESINKS- SUMPS " "
FLOOR SINICS F.LOOR �RAINS
DRINKING FOUNTAINS
INTERCEPTORS CLARIFIERS
SWIMMINGPOOL - PTRAP .
WATERSERVICE� AITERATION �
GASSERVICE OUTLETS ,q 1�
WATER HEATERS BTU OUTPUT �
SEWERCONNECTIONS `
SOLARTANK COLLECTORS ,
SOLAR PIPING SVS.
ConVacto�'S Llcense Law DoeS no[ appiy [O.an owne� O�.a p�ODeny _
who builtl5 or improves Ihereon, antl who tloes such work himzelf or ISSUE FEE �
tM1rougM1 his own ¢TplOyees, provitletl ttlat Such improv¢m¢nls dr¢ not
In[entletl or of(eretl for sdle. If, howeveq the builtlin9 or Improvemen[ MECHANICAL PLAN CHECK
Is Sold wlthln one yGar.of completion, lhe Owner will Ilave the burden _
of' proving M1e tlitl not builtl or improve lor the purpoze o/ zale). NEATING SVSTEM 0-300,000 BTV _
❑ I, as owner af the propercy, am extlusivery contracting with qND DUCTING
Ilcensetl contractors to construct the project (Section ]044, Business 100,000 + BTU _
antl Profeszlons Cotle: Tne Contractor's License Law tloes not apply to
an own¢r ol property who builtls o� improv¢5 Iher¢On, antl wh0 <on- REFRIGERATION 0-100,000 BTV_
tratts from such prolec[s with a contractor(s) Iicesnetl pursuant to SVSTEM
the Con(ractor'S License Law�. 100,000 + BTU _
❑ I am exempl untler�5ec[ion B. 8 P. C. tOr this
BOILERS BTU
reason
Date - Owner SVSTEMREPAIR,ALT FATION
1 h¢reby certifythat I have reatl this apP����ion antl Slate thal ttte above EXHAUST SVSTEM MULTIPLE
In(ormation is corr¢cL I agree to Comply wi[h all City antl county
ortllnanCes antl Stdte Idws telatin9 to COnstruttion, antl her¢by authorize
�epresentatives Of this city to enter upon lne above msntionea
property fo�ins, pectipnib'�pses �/Z�/f�
Signature "�''�u•< <' Date �
Orivers' License or 55 �
� � � ISSUEFEE- -
CMF 0865-46 White-Builtling; Canary-APplicant: Pink-Accounting; Goltlenrotl-Assessor
�.S,l� ������Q�
,� � A
A.P. �F I�'I I���J I— 1I
20NE �_� PLNTGp. RUEF. p� �
SETBACKGLST. SO� PROPE�RTVNLIN
Li�E y�
SIDE vA �
RIGHT
REAR VARO (TO P/L) �Aj
PKG.SPACEREQ. � PROVIDED
STREET WIDTH -- PARK FEE
Al CONDITIONS:
; ' ..
PLAN
t.trvtNNIUN O-SKW_1-SOKW_
TRANSFORMER
` — APPLIANCE 30-50�KW_SO+KW _
� MOTORS Q-1 HP_I-10 HP _
(INC. SOLAR) 30-SO HP SO + HP _
FIXTURES OVTLETS SWITCHES
GAS TUBE SIGNS �
� POLE LIGHTS .
.�1F.Io';' � � �
'�,��QV PANElS MAIN SUB
,QO SERVICE " AMP �
0� _
ISSUE FEE �
3 A APPLICATION APPROVED BV DATE
SUMMARV OF FEES
PERMIT G S ������/'���
SMIP $_2,.�
PLAN CHECK E_l_Y.i"�L PERMIT
,OO ISSUANCE 8
PLUMBING $ � •
� GRADIfVG S
PLAN CHECK S qw
ELECTRICAL S�� $
PLHNCHECK g - MICROFILM $
0 TOTAL FEE E
MECHANICAI. $� � -
LE55 AD-
PLHNCHECK 5 VANCEPC $_
FINAI FEE b�
l
CONS7RUCTION AND PLANNING POOL & SPA �� � � '
APPROVALS Permit # � Date Inspector qppROVALS Permit # � Date �lnspect4r
1. Temporary Electrical Service or Pole 43. Pool &'Equipment Location
Soil ipe-Undrgrn 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms �
4. Electrical Conduit-Undrgm - ' 46. Electrical Bonding � �
. tee ein orce 47. Rough Plumbin & Pressure Test
6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE
7. Footings .Zs 49. Electrical Conduit-Undr rn
8. Foundation � 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn
10. Structural Floor System 52. -APPROVAL TO DECK '
11. Property Sewer Line &,House Connection S'�/P-9�' 53. Backwash & Rece tor-Final �
12. Street Sewer Connection 54. Heater & Vent-Final
13. Rough Plumbing °
14. Rough Electric-Conduit - �56. Electrical-Final
15. Rough Electric-Wiring � /. L' , 57. Solar System-Final �
16. Rough Neating & Air Conditioning • encing & Access Approval
17. Ducts in Structure APPROVED FOR PLASTERING
18. � Ducts, Ventilating - . ,
19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21, Roof Sheathin
22. Frameand Flashin - - NOTES:
23. Insulation ��.a2�3 � -+ uFc 2ou�H' '
24. Lathing & Siding � ' �
25. Drywall Nailing
26. Plaster Brown Coat 2
27.- Electrical Power Meter-Final '
28. � Final Electric � 3 =�ba- L°-
29. Final Heating & Air Conditioning , Z
30. Final Gas Pipe-Test �
31. Final Plumbing
32. Water Service-Final
33. Gas Service-Final -
34. Solar pomestic-Final �
35. Candsca e S rinklin S stein
36. Sound qttenuation - � � � �
37. Handicap Regulations � �
38. FINALSTRUCTURE&BUILDING , j0.
39. Special Requirements Completed
40. Electric Release to Edison -
41. Gas Release to Southern California Gas Co.
42. CERTIFICATEOFOCCUPANCY
No ' Date
e
INSULATiON CERTIFICATION
�� �'as+ Bea� . CoGta Maga n,�.�.,,.,,
NumDer antl S���ct Clly – ZoSr1Cy
Lpt N�mOer
DESCRIPTION OF INSTALLATION
ROOF
M�terid
Th�ckness (�nchesl
EXTERIOR WA�L
Materid __
�
� TAickness (inc�eel
CEILiNG
B�tt or Blanket Type_
TAic�neu (inc�nf
loose Filt Type
Minlmum Thickness Iinchesl
qrea Covered Ih=1
FLOOR,ELEVATED
Material
Tnicknns lincnesl
FLOOR,SLAB
�Ltrrial
Tnickness (inchrsl
W�dN (inches) '__
FOUNDATION WALL '
Ma�enal `
TAk4ness 6ncne:l
Brand Name Owens Cprning
Thermal Pec�stancc IR Vsluel R l}
BrsndName �WP.7'�S i'.nrnjsyo
TAerrru� Resistence IR V�iuel � R 1�j
BrandNamt Owens Corning
T�ermil qesisuncr (fi Va�uel
9rsnd Name
Number ot bs9s WeigAt per Oag ID
Thermai Resisinntt (R Vaiuel
9ranC M1im[
Tl+ermai Reu�Unce (R V�We)
1
'Brantl Aamt
Tnermai Res�sfance (R Vaiuel
Brand name
TAerma� Retbbnce (R Value)
DECLARATION
1 �ereb�� ttni1Y t�a[ the �hove' insulation rves instalietl m ihe Eu7idin9 +[ ihe above locatlo� im m�lorma�ce wrth �he
current regulations Ktting Enerpy Consrrostion Sisntla�tls ior new re�itlemul build��gs Uocatrtl in 7n1r 14 0( Inr
Cslifomia 40miniR�at v� e Cotle1.
�i
_Forcier Construction Companv S�7n�K
� G �� Connactor (8e�it�>) L�c<nse omu1T e. —
_ / /'�'!�' ,7ani,2�r�7 1,2r �S,i.��
S�g����re a�e Title 0+��
Sue �on�r�<IOr �In�uNLon ADD��u�OrJ_ Li[ep�e NumDer
S�qnatwe �ntl T�I�e
F�pu.r 4-1 E.�mDle o1 a eomOl,�nce eeniliu:r
4-9
APplitant to fill in all spaces within
CITY OF COSTA MESA PER
CONSTRUCTION PERMIT � :
Address �j (� 3 �nfT /zLY•
Arch/Eng. License No.
Address
Contractor Q,i�,/. ...��r Phone9y%o7,fZ
LICENSEO CONTRAGTOR OECLARATION
I hereby affirm that I am Ilttnsetl untl¢r provl5lon5 0( Chart¢r 9(Com-
mencing with s¢C[ion 7000) of Division 3 Oi tne Buziness antl
Professions Cotle, anztl m Ilcense is in tull forte ana ejfest.
License Class ,J `� License No, ��V � l�'I
Date Si9nature
WORKERS• COMPENSATION DECLARATION
I her¢by affirm that 1 have a certificata of Cons¢n[ t0 self-InSure Or a
certificate of Workers' Compensation Ins�u%rance, o/r� a certifie0 copy
Po1�ICY No. cSipnt39��^ �O�jComPanY / �� `� t(.
7
❑ Certlfietl copy is hereby furnishetl.
� Certlfietl Copy is filetl with the city Builtling Division.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(This section neetl no[ be completetl i( the pe�mit IS for one huntlrCtl
($100) or lesz).
I c¢rtify that �n [he pe�fo�manU of [he work to� which this permit is
I55ue0, I shall not ¢mplOy any person in any mann¢r 50 az to become
sublett to [he Workers' Compensation t2ws of Callfornia.
Oate Signature
NOTICE: If atte� making thi5 tleclaration, you shoultl become Subject
to the Workers' Compensalion provisions of tne Labor Cotl¢, you must
fOrthwi[h comply wlth Such provi5ion5 or this permit shall be deemetl
revoketl.
CONSTRUCTION LENDING AGENCV
I hGr¢by affl�m [nat the�e i5 a construttion lentlin9 aqency tot lhe per-
formance of the wo k for which [his permit is issuetl (Section 309]
civ. c.l. ��f `�`C
Lender's Name
Lentler'S Atltlress _;��� �� �'
OWNER BUILDER DECLARATION
I nereby affirm lhat I am exempt trom tM1e Coniractor's LicenSe Law for
[he following reason (Section 7031.5 Business and Prolessions Cotle:
Any city or COunty whlch requires a pe�mit lo COnS[ru[t, altG�,
ImprOv¢, tlemolish o� repair any Struclure, prior to ils issuance, al5o re-
qWres lhe appllwn[ for such p¢rmit to Iile a signetl statem¢n[ [hat he
is licensetl pur5uan[ to the provi5ion5 of the Contractor's Llcense Law
1Chapter 9(commencin9 with Section ]000) ot Division 3 of the
Business antl Prdessions Cotle) or that he is exempt [heretrom antl the
basis for the allegetl exemplion. Any vlolation of Sectlon �031.5 by
any applicanl tOr a p¢rmit subjects the dpplitdnt to a civil penal[y
of no[ mOre than five M1untlretl tlollars (§500).
❑ I, d5 Own¢r o( lhe property, or my ¢Tployees with wages a5 th¢Ir
sole compensation, will tlo th¢ work, antl the sVuclure is not in[endetl
or otfered fo� ule. (SeGliOn 704G, BU51ne55 antl Pr0/¢55Ion5 Cotle: The
Con�iactor'S License Law tloes not apply lo an owne� ot a properiy
wh0 bulltl5 Or ImprOves thereon, antl who tloes su[h work himsell Or
lhwugh his own employaes, provitletl thai such improvGments are not
Intfntl¢tl ov offe�etl fo� Sale. If, however, the bWltlmg or Improvement
Is sola within one year o( completlon, the owner will have tne burtlen
of proving h¢ tlitl not builtl or improve tor the purpos¢, oi sale).
❑ I, as owner Ot [hC prop¢rty, am ¢xcluslvely mnVdcting with
licensetl conlractorz to conslrucl [he project (Sectlon 7044, Business
antl P�ofessiOns Gotle: The Con[racto�'S LlcenS¢ Law tloes no[ appty to
an owner of property wh0 builtls or improves [hereon, antl who <On-
tracts hom such projects wiib a contractor(s) Iicesnetl pursuan[ to
tM1e Contractor's �icense Law�.
❑ I am exempt untler Section B. & P. C. for this
reason
Date Owner
I hereby certify that I have reaA this apPlication antl sta[e thal the above
Info�malion is CorrecL I agre2 to Comply wi[h all city antl county
ortlinances antl state laws relating to construction, and hereby au[horize
repr¢Seniatives of this city to en[er upon tne above en ronetl
property foJ� in p C purposes. �/
Signalure d >Oate
Drivers' License or 55 � �
bortler lines anC sign all apProO�iale tleclarations.
TRACT NO. LOT NO. BL�G. NO.
TYPE OF CO�RUCTION
❑ NEW ADD ❑ ALTERATION
❑ REPAIR ❑ CONVERSION ❑DEMOLISH
❑ OTHER
DESCRIPT19N OF WORK
TVPE OF PERMIY
❑ GRADING ❑ FOUNDAT�IO�N ❑ STRUCTURAL
❑ TENANT ❑ ELECTRICAL �ta�'LUMBING ❑MECHAI
❑ OTHER
PHO�ECT DESCRIPTION
SQ.FT.
OCCUPANCV_CONSTRUCTION TVPE
VALUATION ZONE
GRADING CU. VDS. ACRES
REMARKS:
PWMBING �
BATHTUBS
TOILETS
LAVATORIES
KIT. SINKS
SERVICE SINKS
FLOOR SINKS
DRINKING FOUNTAIN:
INTERCEPTORS
$WIMMING POOL �
WATER SERVICE
GAS SERV ICE
WATER HEATERS
SEWER CONNECTIONS
SOLARTANK
SOLAR PIPING SVS.
ISSUE FEE
MECHANICAL
PLANCHECK
SHOWERS
URINALS
OOUBLE LAV 5
DISHWASHER$
SUMPS
FLOOR DRAINS
CLARIFIERS
P TRAP
ALTEftATION
OVTLETS
BTV OUTPUT
COLLECTORS
PL/1N CHECK
HEATING SVSTEM 0-100,000 BTU
ANDDUCTING 100,000+BTU
REFRIGERATION 0-300,000 BTV
SVSTEM 100,0004 BTU
BOILERS BTV
SYSTEM REPAIR,ALTERATION
EXHAUSTSVSTEM MULTIPLE
ISSUE FEE
CMF 0865-46 White-Builtling; Canary-APplicanq Pink-Atcounling; Goltlenrod-AsSessor
3615 B/19/61
ZONE
0.EAR YARD (TO P/L)
PKG. SPACE RE�.
STREET WIDTH
ZONING APPROVED BV
SPECIAL CONDITIONS:
ELECTRICAL
PLNG. REF. �
PROVIDED
PARK FEE $
PLAN GHECK
GENERATOR 0-1 KW_ 1-30 KW
TRANSFORMER
APPLIANCE 30-SOKW_SO+KW
MOTORS 0-1 HP_1-30 HP
(INC.SOLAR) 10-50HP SO+HP
FI%TVRES OUTLETS SWITCHES
GAS TUBE SIGNS
POLE LIGHTS
POLES METERED SUB
PANELS MAIN SUB
SERVICE AMP
ISSVE FEE
APOLICATION HPPROVED BV DATE
SUMMARV OF FEES
BUILDING
PERMIT 5
PLAN CHECK E �
PLVMBING S�
PLAN CMECK 5
ELECTRICAL S
PLAN CHECK S
MECHANICAL S
PLAN CHECK $
SMIP
VERMIT
ISSUANCE
GRADING
S
S
8
5p�1
a
MICROFILM $
TOTAL FEE $
LE55 AD�
VANCEPC $_
�
FINHLFEE $�
CONSTRUCTION AND PLANNING POOL�& SPA>> ' � ` ..
APPROVALS Permit # Date Inspector qppROVALS Permit # ''\ Date Inspector
1. Temporary Electrical Service or Pole 43. Pool & Equipment Location
. Soi ipe-Undrgrn . 44. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrn 45. Forms
4. Electrical Conduit-Undrgrn 46. Electrical Bonding
. tee ein orce 47. Rough Plumbin & Pressure Test
6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE
7. Footings 49. Electrical Conduit-Undr rn '
8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test
9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn
10. Strucxural Floor System 52. APPROVAL TO DECK -
11. Property Sewer Line & House Connection 2^ -.f! �i' 53. Backwash & Rece tor-Final
12. Street Sewer Connection • 54. Heater & Vent-Final
13. Rough Plumbing
14. Rough Electric-Conduit �56. Electrical�Final
15. Rough Electric-Wiring 57. ' Solar System-Final
16. Rough Heating & Air Conditioning • Fencing & Access Approval
17. Ducts in Structure APPROVED FOR PLASTERING
18. Ducts, Ventilating �
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL
20. Roof Framing
21. Roof Sheathin � �
22. Frame and Flashin '� NOTES: �
23. Insulation
24. Lathing & Siding
25. Drywall Nailing '
26. Plaster Brown Coat
27, Electrical Power Meter-Final
28. Final Electric
29. Final Heating & Air Conditioning
30. Final Gas Pipe-Test ��
31. Final Plumbing �
32. Water Service-Final
33. GasService-Final �--� I
� 34. Solar pomestic-Final
35. Landsca e S rinklin S stem �
36. Sound Attenuation
37. Handicap Regulations
38. FINALSTRUCTURE&BUILDING
39. Special Requirements Completed
40. Electric Release to Edison
41. Gas Release to Southern California Gas Co.
42. CERTIFICATEOFOCCUPANCY
No. Date
AVP���ant to till in all spacas exeapt t�ose within heavv �ortler Ilnes antl si9n all aoorooriate Ceclarations.
CITY OF COSTA MESA � � P MIT NO. TRACT NO. . LOT NO. BLD . . O2B6 IO/J.6/84 I LoOO
CQNSTRUCTION PERMIT �
P�OjECt Add�¢55 TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR
AppliCenYsMeilingAdd�255r-��y � 1 ❑CONVERSION ❑�EMOLISH ❑OTHER , q,p,# Zone -
OWnef'S Name �C�� ^�'�� c.�.+� ��w�� Phon¢��s7'n�%7p DESCRIPTION OF WORK
�G � �\ [� "�T . Q��. n� � E Main Building: Accessory Building: Z
Address u�;��T �„ TYPE OF PERMIT GRADWG FOUNDATIorv SrRUCTV RAL T Front ry
Arch/Eng. LiC2n5C No. ��� ��� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAI B �
Address 3t�� ec���,�_�-`�1;7 C.•inl..$9� C4 � ❑�OTHER A Rear N
��.���cr.,..,1 .�. �Jabt� o�,,.�e _��1-L'AS�I PROJECT DESCRIPTION 5�. FT, OCCUaAnICv C Right ' � � G
Contractor's Nema - `� �\\ --- K Left R
Addresslmailingl��"�� ���`P�`� �� �-�'»����� CONSTRVCTIONTVPE VALUATION$ S E
City LiCense NO. �h��C�y ZONE GRADING CU. VDS. ACRES Ping. Ref. # Park.Fees $ �
U
LICENSED CONTRACTOR DECLARATION Remarks: �% _ Parking Req./Provided - �
I hereby affirm that I am lican5etl untler provislons of Charter 9(commencing R
with sectlon 7000) of olvislon 3 of the Business antl Professlons Cotle, antl Use of Building: ' E
my II<ense Is in full force antl'eftect. �
Llcense� Izss "� ' , uc e�! . 6 PLUMBING FEES PlanningNotes: ' - . M
Date Si9nature E
WORKERS' COMPENSATION DECLARATION � . BefSink ShOwe�s N
�I hereby aHirm that 1 have a certlfica[e of tonsent to self-Inzure or a ttrUficate - - T
oi Workers' Compansatlon Insurante, or a certifietl <ooY thereof (Settion BackflowPreventer ServiceSink S
3800, Lao. CJ Backflow Irrigation Sewer Cap ' ELECTRICAL :FEES
aoiicv No�UL65�.3b3cQA comaa��t-�i
eCertitietl covY Is hereby tumishetl. ' � Bathtubs Sewer Connection Automatic Washer Tramformer ❑ 15-50 KW
Certified copy Is tlletl with the city Bulltling DlviSion.
❑ 50+KW i
Date Appllcant Clarifiers • 2 Solar Collectors .(� Construction Pole Sub. �
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION DiShwashef � ' Solar Pi in
(This sa<tion neetl not be completetl it [he parmit is for one huntlratl (E300) or P 9 Z Cooking Unit Meter ❑up to 100 amps �
less)
I certiry that in the performance of the work for which thls permk is 155uetl 1 D�inking Founteins Solar Tank Dishwasher Meter ❑over 100 amps
shall not employ any parson in any manner so as to become subJect to tRe '
Workers' Compensatlon Laws of Callfornia. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric � Sub Panel
Date Si9nature '
NOTICE: It,�after making this tleUaratlon, you shoultl become subject to�the FIOOr SinkS Urinal � � Fan ' Motors �0.7-HP �1'/x�- 8
Workers' Compensatlon provl5ion5 of the Labor Cotle, you must forthwith
comply with such ptovlsions'or thls-permlt.shall be.tleemetl revoketl. G25Service� Outlets WaterCloset - - F.A.U. InaSolar�9-15HP�16-15+
CONSTRUCTION LENDING AGENCV
I hereby atfirm that there is a constru<tlon lentlin9 a9ency for the performance� Interceptors .. Water Heate� . �- Fixtures ' � Microwave � •
of che work for which this permlt is issuetl (Sectian 309� Clv. C.)
Lentler's Name ' Kitch2n�Sink Water Service ' � Device Boxes Pole Light
Lentler'S 'AtlCress . Lavatoried - �
OWNER BUILDER DECL'ARATION � ' " ' � � Outlets � .Range .
I hereby,attlrm that I am ezampt from tha,Contractor'S-License Law forthe p_Tte
following reason (Sectlon 7031.5 Buslness antl Protesslonal,Cotle: Any city or P ' ' • ` Switches Sign '
tounty which requires a permit to construct, alter, improve, tlemolish or repalr . .
any structure, prlor to Its.issuance, also requires the appliwnhtor sucn permit Roof Drains � - - ' Garbage Disposal . Standing Sections
to flle d Signetl StdtBmint thdt ne/s�e is Ilcensetl pur5uanl to the provl51on5 oi . '
tM1e Contractor's.�lcense L.aw (Chaptar 9(tommencing!with Se<Slon 7000) ot - ' ' �' Generato� �0.5 KW �5-15 KW T�ash Com actor �
Divlslon � 3 of the Buslness antl Pro(essions CoOe) or that he/she •is exempt - -• � P
therefrom antl tha basls for the allegetl ezemptlon. Any violation of Section , . � - .
7031.5 by any appllcant for a parmit� subjects the applicant to a civil � �qeins ction.Fee ' �
�nalty ot not more than iive huntlretl tlollars ($500). . � Pe $25 - � Issua Pee '. $ 3 '
I, as owner of Ihe Oroperty or my employees wRh wages as thelr sole MECHANICAL Reinspection Fee $25 Issue Fea ' $ 3
compen5atio� wlll tl0 LM1e wo�k, dntl th¢ St�UctU�e I5 n0[ intEntleA o� otte�etl - FEE$
for u1e (Sec�lon 7044, Business antl Protessional Cotla: The Contractor•s PUBLICSERVICESRE�UIREMENTS: ' �
Licensa law tloes not apply to an owner of a proparty who builtls or Improves � gpiler� " ' � Hood or Type I ❑ �
tbereon,.antl who,tloes such work nimselt/herself or through hl5 or her own � ' ' 2oning Approved By Date �
amployees, provltletl that such improvamentz are not In[antlatl or offeretl tor CdnOpy TypE I I ❑� .
ule. If, however, the Euiltlln or Improvement Is soltl wlthin one year of com- Duct - Untler G�ountl
9 , Building Approved 9y �
pletion, tne owner wlll have the burtlen o( proving he/she tlitl not bulld or im- � Date
�ove for tha purpose ot sale). , , , Duct - Strucmrel .. Refrigeration System : , Application Issued By Date 0 h
�J I, as owner of the p'roperty, am excluslvely contracting wlth Iicensetl con- ❑p.100,0008TU ❑100,000 BTU
tractors tb construct tha proiect (Sactlon 7044, Business antl Protesslons Coae: . Duct - Ventilating , , � SUMMARV OF FEES • , r
Tha Contractor'S LI<ense Law does not apply to an owner ot property who BUILDING PERMIT $ SMIP �
bulltls or improves thereon, antl who contracts tor such proje<ts witn a con- ' Exhaust SyStem ❑ Multiple ❑ System Repair/Alteration $
tractor(s) Ilcense oursuant to the Contractor's License Law1. . PLAN CHECK � $ � � j ' � PERMIT I '
❑ I am axempt untler Section , B. & P. C. tor this reason � Firepl/Fact. BIt. ICBO # PLUMBING � $ {.���%� ��UANCE $
Data � Ownar � - � Heating System & Oucting , � ENERGY P.C. $ �
PLAN CHECK 25% . $
I hereby certlry thatl have�reatl this appli<ation antl stata that the above �4100,OOO.BTU �100,OOOBT � '' + ELECTRICAL $ GRADING . $ '
Informatlon I5 cortecQ 1 agree to comply with all Uty antl county orElnances .
antl state laws relating to bulltlin9 constructlon, antl hereby authorize repre- � . PLAN CHECK 50% '$ MICROFILM $
SBntdtlVes o('thlS�City to enter,u On the dbOVe-mantlonetl property fOr � ��� �..,��
Inspectlon purpose ' MECHANICAL $ TOTAL FEE $�
Signatur Date� ` �
Drivers' License or 55 � Reinspection Fee �$25 � laue Fee $ 3 PLAN CHECK 25% $
CMF 0865•46 rev. 12/83 White • Bulltling; Canary • Appliwnt; Plnk - Accounting; GolOenrod - Assessor ' - ' �
' �CONSTRUCTION AND PLANNING - _ POOL & SPA . --•� - •,- - -
� � • ' Date Inspector - - Date '� Inspector�
APPROVALS Permit# APPROVALS Permit# . . �-. _-
' 1�. Temporary Electric8l Service or Pole . 52. Pool &�Equipment Location " _ �' ��,
� 2. Soil Pipe-Undrgrnd. � - 53.� Steel Reinforcement � - ..
3. Electrical.Conduit Utility-Undrgmd: 54. Forms.-� - ' . � ' - �
- 4. Electrical Conduit-UndrgFnd. 55. Electrical.Bonding ' , - � , . '
5: Steel Reinforcement. , ' 56. Rough Plumbing &�Pressure Test : ' - �<
6: Electrical UFER Grnd. '` � , 57. APPROVALTO COVER-GUN�TE" - ��
�
7. Footings . � 58. Electrical Conduit,-Undrgrnii.= _
. .. - = _ y: -- ; j
8. Foundation � �` 59. Gas Pipe, 0 Undrgrnd., Test- , � ..
:
9. Watei Pipe-Undrgrnd. ` 60. Backwash Lines, P-Trap, � Undrgrnd. � �� - '
10. Structural FloorSystem . „ . 61. APPROVALTO'DECK - - � - _�
11. Property Sewer L'ine & House Connection 62. Backwash & ReceptorFinal� _ �' -, •
12. Sewer Cap � � • 63. Heater & Vznt-Firial � � , ' �
13. Roof Drains ,. . � • .64. Plumbing System -,Final ,. �r
14. Rough�Plumbing '_ 65. Electrical-Final • - �" -
15. Rough Electrica6Conduit � � �' 66.. S61ar�Sysfem-Final � - , ' - � , -' '-
16. Rough Elec[ric Wiring . 67. F.encing & Access Approval �- � ' � ��- � -- � . "
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING . �
�
18. Rough Electrical-T Bar Ceiling � � 69. POOL/SPA SY$TEMS FINAL - . j. -�
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. RoofFraming 73. Undeigrnd.StorageTank�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 , ! r'
32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED � � '" �
33. Final Electric Notes, � � �
34. Final Heating & Air Conditioning j � �
35. Final Gas Pipe-Test � , � ' ' - I � _ - ,
36. Hood or Canopy - � � � � „ , - . .
37. Final Factory Fireplace . - ' _ � -� .. , �
38. Final Plumbing ' � . _ �
39. Water Service-Final . �' � . � � - '_ '
40. Gas Service-Final ' , . � � ` �
41. Solar pomestic-Final �d�� (�Q -
.
42. Backflow Preventer _ , _ .,. � � �
43. Backflow Irrigation - � � � - •
44. .Landscape Irrigation System , � ' �
45. Sound Aftenuation' � - ' i � � ' � � '
46. Handicap�Regulations ' � , �'� . � � � � � � ' ~� . ' �
47. FINALSTRUCTURE & BUILDING ' � � �• , � �
48. Special Requirements Completed ' - ' �
49. Electric Release to Edison , ' � � , � - � ' � � � �
_ ' _ ._. ._ . � �i i � I
50. Gas Release to Southern California Gas Co � , � ' �,� � � ' � • � ' �
57. CERTIFICATE OF OCCUPANCY - - - -, � --- � - - �
, �
No. Date . _, . .1 . ._ -- ,- _ . . _ .. __._ _ .-.
Name ������
Address Q� ��
c�cy �� �.��
Phone No. �5'>-O��\�
Truss ❑ Rafter �
Size of Members� "x � "
Centers \�o inches
Roof Span �, S u„P `X �S. �, c��a�feet
Roof Type �o�_'j�So,
Roof Pitch '�i.\�
NOTE: See attached Standard Plan for
Maximum Roof Span.
S
� �ED
�o�r c���A r����
!r/,�chanlcal Division
Building Department
FORM No. 5131 (10183 — 20M)
SERVAMATIC SOLAR SYSTEMS, INC.
Sb
PLOT PLAN
�
�.li�v�roa _ _
Date �<� �c6a
Installed by �l�.�lo�.xw.��� ,
-�\� s.r���s
Branch �o�-� ��y1
,-- - - � STRUC,' RAL AP��qe a��
---� _____
SEPAP,ATE PcR":917S ^PF q�Q�;��
FOft E�.ECTRi;'.;I � P'.{�;181Ta"G„
�Lij�j;'ji - ;,ry-+
� i.�i !!��
�i�' �Yi�',.,�,�. .�.�. �?7�
���:.__ . _..... I _(.-'
�� x"_. •' fr � ( J�O
, ---
�� , T�i�� i.. i"� I .'.: Phi�Y
� .
4 � -
r_ - �.. � ..
�� - _ �
. ,:.:z-. ��-_
j i{ ��:,r:.: �'/._�:. � c S
any existing roof problems before starting th� job and havq;th`��cu
have been made aware of them. ��v�USTHtAL SAFETY P
ADDiTiOiVAI RE�:�'-
ra:.cr � ..: -
omersign to acknowledge that
� �:.._
, ... „
�
ftOOF NS7ALLATION OtADELNES FOR SUN fLOw SOLAR i�YATER FfA7ER
! GIk[9�L
�. rai ��t:�:w Raas w[v[ s:a r�a nTtp N[�rr�s
1u 8! IM.iql[n SWLI BF YISu4ltr iKSvt(TCD er
TNL IFSTµItT�DM IO0.C�uN. "
..N, nntn. �k« �� tcc[s;tvt vc oa nu, vs��,iir
OPS[RVIP S�LL 9[ RfCORDC?. tf R[pU;qCD. � BRa(IrIL
:TSiiM IY� B[ 1MS14LEU IV 51R[MGTNCd T1q pMi Sr$T[!I,
, ir � a;nr IS DCTCpN1M[i� ro e[ nrrt[x rua� ro oi�ca,
��Tlp I`Siill�T1:M IOf�CNin SMAIL INSDICT TMC V4l'EP',IDE
a i�u s���rtua! wrRi un� !�eITS t0 E[ 1M5'eLIED.
wrtf �r.i� �E�[Ci�Y[ MEMSfv, Gi!rt�iTt:w Or ruTEalal, SIIE
M lNTERi�I OVE� Lll jNN AM1 SPo1(IMG, 6 fl I$ DCTCO-
M�11[� Tik1 YiQ fPLNlyfi SYSiEM Yl:l 11(�T $;iPDfN: TNC
.:ouirfonai toRns t�vos[n er T�a s�xw uu�n, ah [w�i-
MCCR[D BR�C1'� :rSIIM SN4Ll BE iNSTAIIED.
_ T�i rouai�c svans �no sow�w roF TNc io�s s�ovn
IS � Wi1DC TO D[T[RMin[ TK��tDC0.�4r p Is!E STRuCT1�RE,
lu Lif��pRi Si� �la' SOI� U�ITS, N(wMAllf i:1(WMTCR[D IH
iN[ MMt B':IlD1Ni, iKR!$TRT, FOF TWIC�I 3n574LUTIDN
DCT4115 SCC �. S•2. . ,
iNC [1i5TIMG R00� MCI�FRS�SUPPONTI�f TVS SOLAR UMITS ARC
�LSUM[D tU EC OhKi4i FIR IQ.2. �f � 1�50 Dsi, AEPCb
1ilr( MNfdp DESIGN ruu[s �f e[ �stD��roa � aa iqa[
. MCMf�I�; L��VfWf11G TXE S0.M IMI15. ..
I. . 95 pt�, E• 1.7 . 106.tsi:
, N�JTER ��D TRUSS Y�ttS NO SrA�1�5 WC 615ED OF
acaiarKMrs a uec i�ez coiTr:.r::
ai�_tiny tD'Y! Sp.N+ UNIT YEIel�'i1,iS OISRIl;IiED.ip [ACN
• ar r[p �ufCP Q�9T9�31L�1 AE 6/ � 09 =
'm
�
CITY �f C�yTI� Pa���
�;tachanicul Divi�icn
Buildiag Co�artment
AAProved ..�.._� � .�..._..
MAx/Mi/M SPANS FOR �Eo.�r RAFT£RJ
AN� /Pp�F 7R.:���5
DEJ/GN DATA
Rc70F'.'J� : ASPHALT
G? sVO.�D 3NAKE
�.7�N : 4 TD /7 D�'
p,�� G.?E�TER
� �
TR✓55 SP.SN ,�
�
OL s L7 0�
L L � /G %p'
wL * /5 y/c'
30LAR UN/7= 292`
�
T,etryS 3pAN
RGt�FiNy: TicE
P/TG N J � TO !1 AQ
4REATER
OL+/Cr/o�
LL • /� :/a�
i✓t = /5 r/a�
.Socq�e un�rT• t92s
AFjERS .�A`iN4 �7��
/6" ?4"
x4 q'O` 7=p'
2� b /5=6� /?=G
2 „ i6=6' ia=6`
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OWNER ZdEI,COME HOMES DATE S—lg—C�(�
JOBADDRESS
BUILDING PERMIT NO.
GENERALCONTRACTOR Welcome Homes VALUE $ 9�1(�O.00
�or 21 e�ocK TRACT 2896 Sinele Res, w/att gar
GROUP I& J TVPE V ZONE R�1 FIREDISTRICT i(1Fi9
I DATE I SUBCONTRACTOR I PERMITSISSUED
INSPECTION$ ,
Footing Trench
Foundation Forms and
Plumbin
_/L'3( I �7/� .�
House
In
Plumbing, Final, Fixtures
Plumbing, Fin.al Gas Test
Wiring, Final
Ocwpancy � e
FONM 210 9M 10�•v5
Costa Mesa Bnilding Department
� �� P. O. Box 3!7
- COSTA MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
Building
Address 963 Post xoad
Costa Mesa, California
Nearest
CrossSt T;i1bPo
owner Pfqlcone Hoiresz Inc.
Mall
Address �28 tii85tm.i_^.gter Ave. ,
Westrninster Te�.,
cicr No.'�ren. 5 �
Architect or Lic.
:�PPLICATION FOR PERbIIT
3Q6� BUILDING �
FOR OFFICE USE ONLY
_ I Receipt No. Permit No.
30 0� -�/
Receive y Date Rec'd. Date Issued
- � S�/� SG ,s, /8�56
Cross St.
11 Zone
contractorn'�loome Hores, Ino.NoY��y2%8
Address ��8 p�esia�nnster Ave.,
Legal Lot
Description No. 21 I Block I 7raet2&J6
Metes and
jb:ilOj � Nowon Lot '-�Orie
�:�� I No.ot I No.ot
Familles Rooms
trom Rear Vard+�:� i'�
Y. 5o Ft, ��.,..,�.., Ft
X � plteration � � Addition
rcepair � � moving � � Demolish I
Buildin9 � No. ot
Size 2rJx-i2 Rooms �j Stories 1
Exterior Wall Roof
Covering Stucco Covering lfood
Use oi New
suiidiny Sino� familV residonce dnd
two car ga ge attache d.
I hereby acknowledge that I have rend thls Applicutlon
and state that the above is correct and agree to comply
with all City Ordinances and State Laws regulating
building con���stru"""c��'tion.
Signature of� �
Permittee [
Valuation��'7'�-"^�`+�� Pe�mit Fee $ � � � Masonr
Pian Check $ � �
$ �� � � — Total Bond 6�
Fee $ 6 J FINAL
Costa Mesa, California
No.of I Type ,/
Plans �
CORRECTIONS
1
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APPROVALS
ion Location � Inspector
Int
Date
O
z
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2
a
r
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PLOT PLAN
6how locatlon and distances from
property Ilne a�tl between buildinga
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