HomeMy WebLinkAbout986 POST RD - Building Permits� - CITY OF COSTA MESA ' � � �
.
� BYILDING DIVISION
i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • vnvw.ci.costa-mesa.ca.us
� FOR tNSPEC710NS CALL: p14� 75d-5626 �
�ec.n�m'�
PERMIT NUMBER: B08-00187
PERMIT TYPE B_ROOF2
APN: 14123211
JOB ADDRESS: 986 POST RD CM
Vicinity: HOUSE AND GARAGE ROOF. �
Squares: 2800
STATUS:
DATEISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
06/2512008
RMD
$11,000.00
SCOPE OF WORK: TEAR OFF�'(E) ROOF-MATERIALS, INSTALI 1 LAYER OF 30# FELT ON A 4:12 PITCHED ROOF AND REROOF
WITH LIFETIME CERTAINTEED COMP SINGLES ON AN ATTACHED HOUSE AND GARAGE, APPROX 28 S�UARES.
REPAIR AND REPLACE SHEATHING AS NEEDED. ; , ,
OWNER: BARKER, KENNETH F ` �
PHONE: 714-545-7687
APPLICANT: MILES ABOVE ROOFING INC
A001
PHONE: 714-620-5916
CONTRACTOR: MILES ABOVE ROOFING INC
Address: 1346 LOGAN AVEUnit:
Ciry/State/Zip: COSTA MESA, CA �. 92626
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check:
Reroof Permit Fee:
Reinspection Fee:
TOTALFEES
$o:oo
$195.25
$0.00
$195.25
Address: 986 POST RD .
City/State/Zip: COSTA MESA, CA
Address: 1346 LOGAN AVE
Ciry/State/Zip: COSTA MESA, CA
SUITE A001
License No.
License No. �
License No. 880263
PHONE: 714-620-5916
CELL:
PHONE:
PHONE:
Unit:
Unit: :SUITE
NOTICE: The work authorized by this pertnit s�all comply with all applicable handicap access requiremenis under Califomia sWtutes and related
regulations. (Ord. No. 92-28. § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and'all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval vrill resWt in the expiretion of this permit.
COpEt. INSPECTIONTYPE UATE Nlfll L G�DF� INSPEGTIONTYVE , Q�TF, INTRULS
7818 Fixed System Final Fire Prevention 206 Final Machanical
1286 Pool SOa Final 208 Final PlumOing �
200 Final Re-Roof 7�/� _p� � 210 Final Electncal
201 Final Block/Retaining Wall � 212 Final Fire Prevention
202 Final Kactory Fire Place 220 Final Planning Approval
203 Final Sign 222 final Sile
204 Final pemolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby aHirtri under penalty of perjury one of Ne following declarations:
❑ I have anC will maintain a Certifica�e o( wn5ent to sel(-InSure for worliers'
compensation, as provitletl for by section 3700 of the Labor Code, tor the
pe ormance ot Ihe vrork for which this permit is issuetl.
I have and will maintain workers' compensation insurance, as required by
ection 3700 0( lhe Labor Code, for lhe peAormance of the work !w wfiich this
pertnil is issued. My workers' compensation Insurance carrier and policy
number aie:
Carrier:'
(Tha seGion neeE rpf De wmpetM ethe perm4 a valucd at one nundietl daMars (5100) orless )
P�olicy Num6er:
❑ I certily [hat in the peAormance of the work /or which Ihis permit is
issued, I shall not employ any person in any manner so as to become subject
to Ihe vrorkers' compensation laws of Califomia, and agree tha� if I should
become subject to the vrorkers' compensation provisions of Section 3700 of
the Labor Code hall lotlhwith comply with these provisions.
��-e s o
Appiwnl's SignaNre - te -
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT 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, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aKrm that I am licensed under provisions ot Chapter 9(commencing
vn[h Section 7000) of Division 3 of the Business and Professions Code, antl
my license is in full force antl eflect.
Lic; #,_�'rS'D.�o 3 . C�ass # C `3 �
��tll�f � �_'_ ". G ZSO�
�Conl2clor's Sgnalure rDate -
� ��
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn Ihat there is a construction lending agency for Ihe
peAortnance W Ihe work ta which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atltlress:
OWNER-BUILDER DECLARATIONS: '
I hereby aHirm that untler penaly of perjury that I am E7(EMPT FROM THE
CONTRACTORS LICENSE LAW for lhe follovring reason (Sec. 7031.5,
Business and Professions Cotle: Any city or counry which requires a permit t0
construct, alter, impmve, demolish, or repair any structure, prior to its
issuance, also requires Ihe applicanl (or such permit to file a signed slatement
that he or she is licensetl pursuant lo [he pmvisions of [he Contraclors
License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the
Business and Professions Cotle) or that he or she is exempt theretrom antl
the basis (or the alleged exemption. Any viola[ion of Seclion 7031.5 by any
applicant for a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of lhe property, or my employees with wages as their sole
compensation, WILL DO THE WORK, and�the strucNre is not intended or
offeretl for sale (Sec. 7044, Business antl Professions Cotle: The Contractors
License Law does not apply to an ovmer of property who builds or improves
lhereon, and vfio does such work himself or herself or.through his or her own
employees, provided Ihat such improvements are not intended or oftered for
sale. If, however, the building or improvement is sold within one year of
wmpletion, the ovmer-builder vrill have the burden of provinq that he onshe'
did not build or improve for purpose o( sale.). .
❑ I, as ovmer o( the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7644, Business and
Professions Code: The contractors License Law dces nol apply to an owner of
property wfio builds or improves Ihereon, and wfio wntracls (or such project with
a cmt2ctor(s) license pursuant to the Contractors License Laws.).
❑ I am exempl under sec.
Business and Professions Cotle for this reason:
Owner ID verified by drie, ,,;ense. ❑ Ves � No� � �
Driver s License No. Expires'.
Verification of Ownerehip by (rype of document, i.e. - pmpetly tax Dill or deetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: '
❑ I hereby certify �hat no excavation frve (5) or more feet in depth into which a
person is requiretl to descend, will be made in connectbn with v.ork authorizetl
by Ihis pertnit, and that no building struclure, scaffdding, falsev.ork, or demolilion
or dismantling lhereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2. M 2. Sec. 341, Ttle 8, Califomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit (mm the Division of Industrial Safery, as notetl above, unless
such person has a permit to tlo such work from the division.
ApP���nl's Signalure
Division of Intlus�rial Safety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicaN or present or fWure building cecupaN need to file and
certify a Business Plan for emergency response to release or Ihrealened
release of a hazardous malerial? ❑ Yes ❑ No
(Seclion 25505 of the Califomia Health antl Safety Code requires, vrith some
ezceplions, that a Business Plan be (led with the Costa Mesa Fire
Department by every husiness which has at any one time during a reportetl
year a quantiry of hazardous matenals equal to or greater than a weight of
500 pounds. or a volume of 55 gallons, or 200 cubic feet of wmpressed gas
at slandartl tempereNre and pressure).
2. Does or will the applicant or preseN or future building occupant need to file
a registration form for awtely hazartlous materials? ❑ Yes ❑ No
(Seclion 25533 of the Califomia Health and Safely Coae, with some
exceplions, requires registretion with lhe Cosla Mesa Fire DepaAment by
each business which at any one [ime has on hantl a quanti[y of acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feel of compressed gas al standard
lemperature antl pressure).
3. Does or will the applican[ or presen[ or (uNre building occupant neetl to
prepare an RMPP (Risk Management and Prevention Program !or acutely
hazardous matenals)? ❑ Yes ❑ No
(Seclion 25534 0! the Califomia Health and Sa(ety CoOe provides that the
Costa Mesa Fire Departmenl may require [he preparalion, certificalion and
filing with the Fire Department ot an RMPP by businesses which are requiretl
lo regisler awtely hazardous materials with the Fire Department.
4. If an RMPP is presently required, has Section 25534 0( [he Califomia
Health antl Safery Code been fully wmplietl with? ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupan[ require (or
the work which is the suDjec[ of this appliwtion a permi[ for such construclion
or modi�cation from the Sou[h Coast Air �uality Management District orlrom
any Olher air polWtion wntml distnct or agency? ❑ Ves ❑ No
(Sectbn 658502 0l ihe Cali(omia Govemment Code requires Ihat the requesled
intwmation be tumished on applicatans fa rron-residential buil0ing pertnits�.
6. Will any part of the faciliry to be constructed under [his pertnit be within
1000 (eet from the outer boundanes of a school? ❑ Ves ❑ No
(If'yes", the lacility must meel �he requirement of Sections 25534 and 42303
of the California Health antl Safery Code).
7. If a permil from the South Coast Air �ualiry Management Dis�rict or other
air pollution control tlistrict or agency is required for Ihe work which is the
subject of this application, have all ot the tlisclosures prescribed by Califomia
Heal�h and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", altach certificate of compliance from Ihe appropnale air polWtion
control oKcer). � - �
CERTIFICATE OF �COMPLIANCE: I certify Ihat �under penalty of perjury the
information given above is corcecL I agree to comply with all state laws and
ciry ordinances regarding Hazardous Matenals and Emissions.
S�gnalure Da�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penally of perjury tha[ I have read lhis application and state that
the information given is wmect. I agree to comply with all slate laws antl ciry
ordinances relating to building construction, and authorize representatives o(
the City of Costa Mesa to enter upon Ihe above-described property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by Ihis permit until final inspection. ,
9gnalur al O.vner s) Da1e ppy
Signaiure Date � � /_/��/O!y
]OS]46 (3/0]) !V / 6
�AotllO/AUR�Mze4ApPl¢ant rp��p� `
V��
: ,
CITY OF COSTA MESA
.
BUILDING DIVISION
F � 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754�856 • www.ci.costa-mesa.ca.us
�. FOR INSPECTIONS CALL: (7'14) 754-5626
!''°""°�� PERMIT NUMBER M08-00071
PERMIT TYPE MECH STATUS: ISSUED
APN: 14123211 DATE ISSUED: 05/15/2008
ISSUED BY: RMD
JOB ADDRESS: 986 POST RD CM. Suite/Uniti -.
Vicinity: REAR YARD " � ��. ' � " : � � . ' � -
SQ. FT: 0 ,
SCOPE OF WORK: 18 SEER��HVAC CHANGE�OUT (REFRIG > 100K BTU) SAME LOCATION, REAR YARD FOR A SFD.
OWNER: BARKER,KENNETH�F� � �Address: 986POST�RD Unit:�� '
PHONE: - . bity/State2ip: � COSTA MESA, CA �
APPLICANT: MCGONAGLE, JOHN .'' �� �� _ � Address: 801 S LAKEVIEW Unit:UNiT E
PHONE: 714-282-8178 _ _ � -. , - City/State/zZip: PLACENTIA, CA
CONTRACTOR: AIRCONCEPTS'��`' _� - LicenseNo. �534722 ��,
Address� 801 S�CAKEVIEWUnit' UNIT E � �PHONE: 714-282-8178 �� '
Ciry/State: PLACENTIA, CA" ' ZipCoder 92870' �� ' " . ' CELL: ' : � :� -� � �
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: ' ' ' $41.70
PLAN CHECK FEE: ' . _. . $0.00 ,
INVESTIGATION FEE: � • $0.00
REINSPECTION FEE: � ' � '- $0.00� -- � .
TOTAL FEES: $41.70
.... :'_y`Q _'�i��
. 4�,.': � r���,;�� /�/
!,.�;. �� :��
�
NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requiremenls under Califomia staWtes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
COOEf. INSPECTIONTYPE DRTE INTITIRL COOE/ INSPEL710NTYPE 0'� ' �l ' INIIML ^
"'/n7/., i)
1816 Fized System Final Fire Prevention 206 Final Mechanical P/{� 11JX11//A
/ .
1266 Pool Spa Final . 208 Final Plumbing
200 Final Re-Roof 210 Final Electrical "
201 Final Block/Retaining Wall 212 Final Fire Prevenfion �
202 Final Factory Fire Place 220 Final Planning Approval /�
r
203 Final Sign 222 Final Site
204 Final Demolilion 250 Final Builtling/Occupancy
.
WORKERS' COMPENSA710N DECLARA710�_
I hereby aKrtn under penally ol perjury one of the follovnng tleclaretions:
❑ I have and will mainlain a certifiwte o( consent to sel!-Insure for workers'
compensation, as provided br by section 3700 of the Labor Code, for the
peRormance of Ihe work for which this permit is issued.
� I have and will maintain workers' wmpensation insurance, as required by
secton 3700 of the Labor Code, fw lhe per(ortnance of the work for wfiich this
pertnit is issued. My vrorkers' compensation Insurance carner antl policy
number are: T
Carrier: �Gr /�-vnC/ii_o,., 1N4�L/�wiq�C Go.
(TMa seqion neeC rpt De mmqeltd Jthe peimU9 is valuetl af ine huntlietl Wllars (5100) w less )
'Polity Number: �� �3 3 %n p � /7
❑ I certify lhat in the performance of the work (or whic� this permil is
issuetl, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of California, and agree that if I should
become subject to the v.nrkers' compensation provisions of Seclion 3700 of
the Labor Code, I shall forthwit� wmply ' these provisions.
.S=iH'O�
; /Od����'s5ipraWre (Da�e ,
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLP,WFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS �ECLARATION:
I hereby aKrm Ihat I am licensed under provisions o( Chapler 9(commencing
with Section 7000) ol Division 3 of the Business antl Professions Code, and
my license is in full force and effect.
�Lic. # S3 � 7 ri a Class # % r� �
� ,p�/I/' /f�Y1/�,/ 5 - l �j -o S/
� Conl2clor'sSipnaWr D31e
CONSTRUCTION LENDING AGENCY:
❑ 1 hereby affvm lhat there is a constmctbn lentling agency lor Ihe
perfamance of the v,ork for which this pertnit is "ssued. (Sec. 3097, Civil Code).
Lender's Name:
Lender's Atltlress:
SignaWre �ate
OW NER•BUILDER DECLARATIONS:
I hereby affirtn that untler penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Pro(essions Cotle: Any city or coun[y which requires a permit �o
ConSWcl, alter. improve. demolish, or repair any strucWre, prior to ils
issuance, also requires the applicant for such permit to file a signed slatement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe
Business antl Professions Code) or that he or she is exempt therefrom and
Ihe basis for Ihe alleged exemption. Any violation of Sec�ion 7031.5 by any
appliwnt for a pertnit subjec[s ihe applicant to a civil penalry o( not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as iheir sole
compensation, WILL DO THE WORK, and Ihe s[ruclure is not intended or
offered for sale (Sec. 7044, Business and Professions Code: The Conlractors
License Law dces not apply to an owner of property who builds or improves
thereon, antl who does such work himself or hersel( or through his or her own
employees, provitled that suc� improvements are not inlended or offered for
sale. If, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have the burden ot proving that he or she
did nol build or improve (or purpose o( sale.).
❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to constNct lhe project (Sec. 7044, Business and
Professions Code: The contractps License Law dces not apply to an owner of
property who builds or improves thereon, and wfio contracls for such project with
a cmt2ctor(s) license pursuant to ihe Contractors License Laws.).
❑ 1 am ezempt under sec.
Business and Professions Code for this reason:
]OS]�a6 (10])
#
Owner ID verified by dr. lici ❑ Yes ❑ No
Driver's License No. Expires:
Verifiwtion of Ovmers�ip by (rype of document, i.e. - propeRy tax 6ill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certAy that no excavation frve (5) or mwe feet in depth into wfiich a
person is requiretl to tlescentl, will be matle in conneclion with wnrk aut�onzed
by lhis pertnit, antl thai no building struclure, scaf(dding, falsewnrk, p demolition
or dismantling thereof, will be more than thirty-six (36� feet high. (Chap. 3.2, Grp
2, M 2, Sea 341, Ttle 8, Califomia Adminislrative Code).
❑ As ovmer-builder, I will not employ anyone to do work which would
require a permit fmm the Division of Industrial Sa(ery, as no[ed above, unless
such person has a permit to tlo such vrork from the division.
Md����'s Signawre Da�e
Division of Industnal Safery Permit Number. __ .
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neeC ro file and
certify a Business Plan for emergency response lo release or threatened
release of a �azardous material? ❑ Yes ❑ No
(Section 25505 of Ihe Calilomia Health and Safety Code requires, with some
exceptions, that a Business Plan be (led with [he Cosla Mesa Fire
DepaAment by every Dusiness which has at any one time during a reported
year a quantity o/ hazartlous materials equal to or greater Ihan a weight o!
500 pounds, or a volume of 55 gallons, or 200 cubic feel ot compressetl gas
at standard tempereture and pressure).
2. Does or will the applicant or present or future building occupant need ro fle
a registra[ion form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 0( the Cali(omia Health and Safery Code, with some
exceptions, requires regisiration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal [o or greater than a weigh[ of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressed gas al stantlard
temperature and pressure).
3. Does or will the applicant or present or (uture building occupant need lo
prepare an RMPP (Risk Management and Prevention Program for awtely
hazardous malenals)? ❑ Yes ❑ No
(Seclion 25534 of the Cali(omia Health and Safery Cotle provides thal the
Costa Mesa Fire Departmenl may require lhe preparation, certification and
filing vnth [he Fire Department of an RMPP by businesses which are required
�o regisler acutely hazardous materials vnM the Fire Department.
4. It an RMPP is presently required, has Section 25534 of the Califomia
Heal[h and Safety Code been fully complietl with7 ❑ Yes ❑ No
5. Does or will the applicant or present or fuNre building occupant require tor
the work which is the subject o( this appliCation a permit lor such constfuclion
or modifcation from lhe South Coast Air Quality Management DisMct or from
any other air polWlion wntrol tlistrit� or agency? ❑ Yes ❑ No
(Section 658502 of lhe Cali(omia Govemment Cotle require5 [hat Ihe reques[ed
infortnation be (umished on appliwtbns fv ran-residential builtling permits).
6. Will any part of the (acility to be wnstructed under ihis pertnit be v+i�hin
1000 feet from ihe outer boundaries of a school7 ❑ Yes ❑ No
(If yes", Ihe faciliry musl meet the requirement of Sections 25534 antl 42303
o( ihe Cali(omia Health an0 Safery Cotle).
7. It a permit (rom the South Coast Air Quality Managemen[ DisMct or olher
air pollulion conhol disMct or agency is required for the v,ork which is lhe
subject of this application, have all o� the disclosures prescribed by California
Health and Safety Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air pollution
control oKcer).
CERTIFICATE OF COMPLIANCE: I certify that untler penalry of perjury Ihe
information given above is correct. I agree to comply with all staie laws and
city ordinances regardinq Hazardous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this application and state that
the in(ortnation given is wrrect. I agree to comply vrith all state laws antl ciry
ordinances relating to building consiroction, and authonze representatives ot
the Ciry of Costa Mesa to enter upon lhe above-described property for
inspection purposes. I agree not to occupy or allow occupancy o( any building
aulhonzed by Ihis permit until final inspeclion.
Sigiuwreo(LegalOwner(s� Date
S- /�-o�
nd/o m�onze pP � / .— Dale
` �v
CITY OF COSTA MESA �
BI/ILDING DIVISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBE . M08-00072
PERMIT TYPE MECH
APN: 14123211
STATUS: ISSUED
DATE ISSUED: 05/15I2008
ISSUED BY: RMD
JOB ADDRESS: 986 POST RD CM. Suite/Unit:.� -
Vicinity: ATTIC � � - -` .
SQ. FT: 0 �, ��. . , . � -. . . . _ : , . -
,� �,. �
SCOPE OF WORK: MECNANICAL'�PERMIT;,FOR AN FAU CHANGE (FAU >100 K BTU) OUT�SAME LOCATION (ATTIC) FOR A
SFD. � ``
(. K.
OWNER: BARKER, KENNETH F� ,:�� ,+� � . � � Address: �� 986 POST RD Untt:
PHONE: � � � - � City/State/Zip: COSTA MESA; CA` " -
APPLICANT: MCGONAGLE ,JOHN •= �' � � Address: 801 S LAKEVIEW UnikUNIT E
PHONE: 714-282-8176 �,:'�� " City/State/zZip: PL'ACENTIA;�CA `. „
l.'n ,�.., �.. , .. � .
CONTRACTOR: AIR CONCEPTS" � License No. 534722'
,
Address: 801 S,LAKEVIEWUnit: UNITE "�. ��� �� ' - '- ��� PHONE: 714-282-8178 --�
City/State: PLACENTIq, CA , ' ZipCode: 92870 CELL: � -- �-
�.t �
MECHANICAL PERMIT FEE SUMMARY
MECH ITEM FEE: ' ,_ � . - $41.70
PLAN CHECK FEE: , . ' � $0.00
INVESTIGATION FEE: � � � $0.00
REINSPECTION FEE: . � , �$0.00
TOTAL FEES: $41.70
NOTICE: The work authonzeq by this pertnit shall wmply vrith all applicable handicap access requirements under Califomia sfatutes 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 authonzed under this permit to be wnsidered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit.
CODE /.
1676
1266
200
201
202
203
204
INSPEC110N TYPE
Fixed System Final Fire Preyemion
Pool Spa Final .
Final Re-Roof
Final BIocWRetaining Wall
Final Faclory Fire Place
Final Sign
Final Demolition
ORT� INTRIRL COUEi INSPEL710NTYVE O5%a�/�8
206 Final Mechanical P/A
208 Final Plumbing
210 Final Eleclrical -.
212 Final Fire Prevention
220 Final Planning Approval
222 FinalSite
250 Final Building/Occupancy
,t'
WORKERS' COMPENSATION DECLARATIO�
1 hereby aKrm under penalty ot peryury one of the following tleclarations:
❑ I have and will maintain a certifcate of consent to self-Insure (or workers'
compensation, as providad for by section 3700 of tha Labor Code, for Ihe
performance o( the work for which ihis permi[ is issUed.
I have and will maintain workers' compensation insurance, as required by
sectbn 3700 of the Labor Code, for the peAortnance of the wnrk for which this
permit is issued. My workers' compensation Insurance carrier and policy
number are: �}
�Carner' �'G G �'TN�t✓'i�a„n ��nSU.��� �
(This sedqn nee0 nol0e complefetl �the permX rs valued af One huntlrM CWlars (5100) w less )
Policy.Numtier: L. �] S� 3 3�� �J 0
❑ I certify that in Ihe peAormance of the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of California, and agree that if I should
becOme Subjec[ to lhe workers' compen5ation provisions of Section 3700 of
the Labor Cotle, I shall forthwith compl_�Provisions.
` S�fy-o��
Applitanfs Signalure Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affirm [hat I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in (ull force and effect.
���#_� 3�7�a � ��a55� c_a«
, {'- ! ''1-O r�
Canlraclor's Sign � Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrm that there is a consiructbn lending agency for the
peAortnance of [he work for wfiich this pertnit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lenders ACdress:
OWNER•BUILDER UECLARATIONS: '
I hereby aKrm [hat under penalty of peryury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pro(essions Code: Any city or county which requires a permit to
consWct, alter, improve, tlemolish, or repair any strucNre, prior to its
issuance, also requires the applicant (or such permit to file a signed statement
Ihal he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Professions Code) or that he or she is exempt [herefmm and
ihe basis for ihe alleged exemption. Any violalion of Section 7031.5 by any
applicant for a permit subjects Ihe applicant lo a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their sole
comoensation, WILL DO THE WORK, an0 lhe siructure is not intended or
oRered for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an ovmer o( property who builds or improves
thereon, and who dces such work himself or herself or through his or her ovm
employees, provided that such improvements are not intended or oKered for
sale. If, however, the building or improvement is sold within one year o(
completion, ihe ovmer-builder will have the burden of provinq ihat he or she
did not build or improve for purpose o( sale.).
❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and
Professbns Code: The cont2ctors License Law dces not apply to an owner of
property who 6uilds or improves thereon, and wfio cont2cls for such project with
a contracta(s) license pursuant tothe Contraclars License Laws.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
Owner ID verifed by dr� �iu ❑ Ves ❑ No
Driver's License No. Expires:
Venfication of Ownership by (type of document, i.e. - p�operty tax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: �.
❑ I hereby certrfy that no excavation fve (5) or more (eet in dep[h into which a
person is required to descend. will be made in connection with work authorizetl
by this permit, and that no building strucWre, scaftolding, falsework, a demolition
or tlismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Gry
2, Art 2, Sec. 341, TiHe 8, Cali(omia Administra[ive Code).
❑ As owner-builder, I will not employ anyone to do work which would
require a permit from the Division of Induslrial Safety, as noted above, unless
such person has a permit to do such work from Ihe division.
Appliwnfs SgnaWre
Division of Industnal Safety Permi[ Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will �he applicant or present or fu[ure building occupanl need to file and
certify a Business Plan tor emergency response to release or threatened
release ot a hazardous matenal? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
exceptions, that a Business Plan be fled wilh the Cwta Mesa Fire
Department by every business which has at any one lime dunng a reportetl
year a quantily o( hazardous materials equal to or greater than a weight of
500 pounds, or a volume o/ 55 gallons, or 200 cubic feet of compressetl gas
at slantlard [emperature antl pressure).
2. Does or will the applican[ or present or Wlure building occupant neetl lo fle
a registra[ion form for awtely hazartlous materials? � Yes ❑ No
(Section 25533 0( ihe Calitomia Health and Safety Code, with some
excep[ions, requires regisUalion with the Cosla Mesa Fire Depariment by
each business which at any one time has on hand a quantity of acutely
hazardous materials equal to or greater Ihan a vreight of 500 pountls, or a
volume of 55 gallons, or 200 cubic feet of compressetl qas at standard
�emperature antl pressure).
3. Does or will the applicant or present or fuNre building occupant need to
prepare an RMPP (Risk Management and Prevention Program for acu[ely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Code provides Ihat lhe
Costa Mesa Fire DepaAment may require the preparation, certification and
filing with the Fire Department of an RMPP by businesses which are required
[o register acutely hazardous materials with Ihe Fire Department.
4. If an RMPP is presently required, has Section 25534 0( lhe Califomia
Health and Safety Code been fully complied with? ❑ Ves ❑ No
5. Does or will the applicant or present or future building occupant require for
the work which is the subject of [his application a permil (or such construction
or modification from the South Coast Air Quality Management District or from
any o�her air pollution control disMct or agency? ❑ Ves ❑ No
(Secibn 658502 of [he Califomia GovemmeN Code requires Ihat the requested
in(ormation be fumished on applications for noo-residential builtling pertnits).
6. Will any pad of ihe facility to be constructed under ihis permit be within
1000 feet from ihe outer boundaries of a school? O Yes ❑ No
pf yes", the facility must meel the requiremen[ of Seclions 25534 and 42303
of Ihe California Health antl Safery Code).
7. If a pertnit from the Sou[h Coast Air Quality Management DisMct or other
air polWtion control district or agency is requiretl for the work which is [he
subject ot this application, have all of the disclosures prescnbed by Califomia
Health and Safery Code Section 42303 been matle? ❑ Yes ❑ No
8. (If yes", attach certificate of compliance from lhe appropriate air pollution
wntrol oKcer). � _
CERTIFICATE OF COMPLIANCE: I certify lhat under penalty�of peryury Ihe
infortnation given above is corzect I agree to comply with all state laws antl
city ordinances regartling Hazardous Materials and Emissions.
SignaWre oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of peijury that I have read this application and state ihat
the information given is correCL 1 agree to comply with all state laws and city
ordinances relating to building construclion, and aulhonze represenWtives of
the Ciry of Costa Mesa to enter upon the above-descriDetl proDerty for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this pertnit until f nal inspection.
Signawre of Leclal er Dale
Signalure � Date ���� /��� �� �tw _� o�
3051-46(3/0]) T � 0
' Antl/o�AutM1onzptlApplica � Ddle
ADC�i�ant to (ill in all spaces exeeD< <�oze within heavY GorEer Iines anC si9n all aoo�ovriate aeciaratlons.
CITlV OF COSTA ESA CONSTR C I ON PERMIT PERfy�T N�9 a� TRACT NO. LOT NO. UNIT NO. A P,�y
�R� Pos� �� �
Project Address . {� S Mein Buildi
� 9XL ,��1�� TVPEOFCONSTRUCTION NEW ADD ALTERATION E�AIR E
Applicant's Mailing Address Front
Sit r� v �pb' /� ❑ CONVERSION ❑ DEMOLISH ❑ OTMER T
Owner's Na e �' S K'a"� Phone�� DESCRIPTION OF WORK/USE OF BLDG. I A Rear
�Qddress �� 6 �° S't
TVPE OF PERMIT GRADING FOVNDATION STRVCTURAL �I C Right
Arch/Eng. License No. K
Addre55 ❑ TENANT ❑ ELECTRtCAL ❑ PLUMBING ❑ MECHANICAL g LCft
Comractor's Nam 0`^� � � �� � � l Phone � oTHER � Ping, Ref. 51`-
Address (mailing) PROJECT DESCRIPTION SQ. FT..�; OOO OCCUPA,NCv O
CONSTRUCTION TVPE VALUATION $ �. �O� � P�anning NOtes:
City Licensc NO.
LICENSED CONTf2ACT00. DECLARATION
I bCreby allirm t�at I am licensetl untler provisions of Charter 9(<ommentlng
witM1 sec[ion 7000j o1 Dlvislon 3 0l the Bu5ine55 antl Proles5ions Cotle, antl
my license is in lull torce antl eHect.
Lic¢nze Class Licenze No.
Dale Si9nature
"'ORKERS• COMGENSATION OECLARATION
efeby allifm thal I bave d Certititd[e Of COnSCnt to SCIftin5ule Or d CertlfiCdte
Workers' Compensation Insurance, or a certitietl copy thereof (Section
3800, Lab. C.)
Policy No. Company
8 Cer[i(i¢tl topy is hereby (urni5hetl.
Certifietl copy is tiletl with the Uty Builain9 oivlsion.
Oate Applicant
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(T�is section ne¢tl not be compl<tetl it the perml[ is for one huntlretl (5100) or
less).
I c¢rlity thal in thC Pe�b�mance ol th¢ wOrk fOr which tnl5 Oe�m�t i5 iSSUGtl I
zhall no[ employ any Oerson in any manner so as to eco e subjecl [o t�e
Worke�s' Cpmpp,psation Laws of Califo ry
Date �e /L. �Y Si9nature
NOTICE: 11, a/ter making tnis tleclaration, you s ultl bec9 ie subject [o the
Workers' CompenSatiOn p�ovlsloni O( [hG Ldbo Cotle, ybu mu5t fOrt�wlth
comply witn sucn provislont or [his permit snall be tleemetl revoketl.
CONSTRVCTION LENDING AGENCV
I hereby aHirm tnat there Is a construction lentlin9 agency for the pertormance
of the work for wnich this permit is issuetl (Settion 3097 Civ. C.)
�entler's Name
Lender's AUtlress
OWNER BUILDER DECLARATION
I herebv altirm lhat I am exempt lrom Ne Contractor's License Law tor [he
a
also
o/ Inc Buvness ana �rmessions coae� or mai neisnv n
antl tha basis 1or the allegetl exemptlon. AnY ��olation ot
any applicant lor a permit SUDjects lho appllcant lo
not more than iive hunaretl tlollars (y500).
t, antl lh¢ StfucWle i5 nOt In[end¢O i
ess antl Professional Cotle: The Co
an Owner of a prope�ty who bulltls or
employ ee5, prOvitletl that such improvem¢n[s ate no[ in[¢naea or o*rerea �or
wle. I1, howeve�, lM1e bWltlln9 O/ ImprovOT¢nt IS SOItl wiNln O�¢ y¢dr Ot COT-
plotion, tne ownor wi11 nave the burtlen ot proving he/she tlitl not buila or Im-
prova lor th¢ purpose oi Sal¢).
❑ I, as owner o/ the property, am exUusively contractin9 with licensetl con-
ttactors Io Conslruct lhe projeGt ($ection 7044, Buslness antl PrOfession5 Cotle:
The Contractor's License law does not appry ro an owner ot property who
builtls or improves Mereon. antl wno conVacts �or such oroiects with a ron-
tractor(s hcense pursuan[ ro me Convac[or•s License Law). I am aware that
prool o� their Worker's Compensation insurance shoWtl be provlae0 to me.
❑ 1 am exempt untler Sectlon B. & P. C. for ihiz reason
natw �'/ " O i{r� .� r- i
1 nereby ttriity that I have reatl tnis avP���ation antl ztate Ihat the above
inlormation is correct. I agree to comply with all city antl county ortlinances
antl scate laws relating ro builtling cons[ruction, antl hereby authorize re0re-
sentatives of this city ta nter u n tbe above-mentionetl property for
inspection puEpp6eq.Ji �� �j
Si9na[ure �Si��w oate �—�L�%1",
Drivers' Llcense or 55 �`�� /�
Remarks:
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors
Kitchen Sink
Roof Drains
Reinspection Fea
GRADING CU. VDS. A(
$15
Boiler
Dutt� UnderGround
Duct - Structural
Duct - Ventilating
Exhaust Sysrem ❑ Multiple �
Firepl/Fact BIt. ICBO �k
Heating System & Ducting
❑ ai oo.000 sTu O i oo,000 sr
Reinspection Fee � $15
0865-46, rev. 5/88 White - Builtlin9: Ganary � Applicant; Pink � Accounting: Goltlenrotl - Assessor
Showers
Service Sink
Sewer Cap
S¢wet ConnectiOn
Solar Collectors
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Warer Closet
Wa2er Hea[er
Wa[er Service
Auto-Wesh
Laundry Trays
FEES Aucomacic Washer
ConStruction Pole Sub.
Cooking Unit
Dishvrasher
Dryers �Gas ❑Electric
Fan
F.A.U.
Fixtures
�2VIC2 BO%ES
DUL12I5
$wi[th¢5
Garbage Disposal
Generetor �0�5 KW O5�'
Zone
Accessory Building:
ReQ.IPravided
O
N
I
N
G
R
E
a
M
T
5.
ELECTHICAI
Transformer ❑ 15-50 KW
❑ 50+KW
Meter �up to 100 amps
Meter �over 100 amps
Sub Panel
Motars O0.1 HP O 1 h- 6
Inc.Soiar �9�75 HP 016-75+
Microwave
Pole Light
Renge
Standing Sections
5 KW Trash Compactor
Reinspection Fee $75 luue Fee
$ 3 DEVELOPMENTSERVICESREQUIFEMENTS:
Isue Fee Za�i�g qpproved By
FEES Buildinq ApProved By
Hood or Typal ❑
Canopy Type I I �
Refrigeration System
04100,000 BTU ❑ 100,000
System Repair/Alteration
Fire Dampers
Registers
Iwue Fee
$ 3
SUMMARV F FEES
BUILDINGPERMIT $ o�S-D� SMIP
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE
PLAN CHECK 25% $ ENERGV P.C.
ELECTRICAL $ GRAOING
PLAN CHECK 50% $ MICROFILM
MECHANICAL $ TOTAI FEE
PLAN CHECK 25% $
FEES
$ 3
$ .sa
_ '_ - .J:' _ " '"
.. � _ �'.. . ... . " '_
, CONSTRUCTION AND PLANNING PC i�A
� APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
il
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; Electrical UFER�Grnd. 57. APPROVAL TO COVER-GUNITE
�
7, Footings � �, 58. Electrical Conduit-Undrgrnd. '-
�
S. Foundation � 59. Gas Pipe, � Undrgrnd �, Test
�
'9. Water'Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection �l' 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heacer & Vent-Final II
13. Roof Drains 64. Plumbing SYstem - Final
14. Rough Plumbing 65. Electrical-Final . ��1
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
� 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
-13. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
2b. Rough Factory Fireplace APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil
23. Gas Pipe-Rough &/Test 72. Underground Flush
24. Roof Framing . 73. Undergrnd.StorageTank OGas ❑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 �i HEALTH DEBT. 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
.`
37. Final Factory Fireplace
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer �'-
43. Backflow Irrigation �
1
44. Landscape Irrigation System � .
45. Sound Attenua[ion
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING 3 � � ��-
48. Special Requirements Completed
49. Electric Release to Edison ?
50. Gas Release to Southern California Gas Co �� , •
5T. CERTIFICATE OF OCCUPANCY - � '
No. Date .
CERTIFICATE OF COMPLIANCE
PAYMENT OF SCROOL FACILITY FEES
NEWPORT-MESA UNIFIED SCROOL DISTRICT
.- �z �3.�
.
Developer/Applicant: $ ftol,Pv, .T %�.rb�i '
Address: /�(ri lpOSi /'� � `Dt�4 //�l%�'d4 l a C/Z�ztp
Telephone Number: (7/�J� 9(q(p `C%�/l�
Tract/Parcel and Lot
Location of Project:
Number of Square Feet
Residential Space
Number(s): % ,z �Q%{o L �O L�
`/��o Pos�- R�% �'�s�Q ��.�� �P �z6zb
of p��/
� x $1 .50 Total ��O /i �
Number of Square Feet of
Commercial and
Industrial Space
Commercial/Industrial Project is:
Mini-storage
Movie Theater
Racquet/Health
Warehouses
Heavy Industr�al
Regional Shops
Light Industrial
x $0.25
(Check One)
Total
Motel
Bank
Neighborhood Shops
R & D
Hotel
Medical Office
Office Park
Preschool
Auto Repair
Hospital
Large Office
Office Bldg.
Restaurant
Fast Food
The provisions of Government Code Section 53080 are not applicable.
„
This certifies that the above-named Developer/Applicant has paid school •
facility fees in compliance with Government Code Sections 53080 and
65995.
Checks are to be made payable to N
rt-Mesa Unified School District.
'd� /L. =k.�
Bu�i.ness Manager
Newport-Mesa Unified School District
The above representation as to square footage is true. Developer/
Applicant agrees that if it is later determined that such representa-
tions are not true then this certificate shall automatically terminate
and the appropriate City/County shall be notified.
D a t e: S',� -r� J �� !�•(���:/�.
Develop" er/ plican
S t P p 6 P,. S i�','r 6�
f TY OF COSTA MESP
CALIFORNIA 92628-7200 P.O.BOX1T00
Insulation Certificate ' ' � ,
98 � Pos f%� C Cos�q ,��s g
x�� �,a sv«� c�ty
n�9ti�a z8910 �5'
� county sabdivision Lotxumber
ROOF
Material '
'Ihicirness (inches)
EXTERIpR WALL
Material F, 6� � g! 5 s s
'Iliiclmess (inches) 3 %8
Description of Installation
Brand Name
'll�ertnal Resistance (R-Value)
Btand Name /J7 9.� v r//t
71�ertnal Resistance (R-Value) �- i/
CEILING
Batt or Blanket Type F� %r r 9( o S S Brand Name /N e� v e//C
'Ihiclrness (inches) � �z 'Ihermal Resistance (R-Value) �-l9
Loose Fill Type Brand Name
Convuccor's minimum installed weighUft Ib Minimum Ihiclrness inches
Manutacpuer's installed weight per square foot to acheive Thamal Resistance (R-Vatue)
RAISED FLOOR
Material
'Ihickness(inches)
SLAB FLOOR
Materiel
'ILiclmess (inches)
Width (inches) _
FOUNDA710N WALL
Brand Name
'Ihertnal Resistance (R-Value)
Brand Name
Thermal Resistance (R-Value)
Marerial Brand Name
'Itdckness (inches) 7liermal Resistance (R-Value)
Declaration
I hereby c¢rtify that the above insulation was installed in the building at the above locaUon in conformance with
the current Building Energy Efficiency Standards for new residential buildings contained in Tide 24 of the
Califomia Administrazive Code.
5 f'f/� �( li� r-{��
/� nefal Cyntrector (Builder) License Number
�,i�- o w <. . r- /- //- 90
(� S� a7d Tide Dam
SubContrncinr (Insulation Insteller)
Signenve ard Ti�e
Licrnse Number
9
/
•� I
Pfl0.1EtT RUONESS: 9(� ( POST RD
owxen•sxun�: STEPHEN & SHERRI KIRBY
. Aooxess: gg6POST RD
COSTA MESA
CA 92626
(714) 966-0814
• �flC111ENGINEEfl:
RDOflESS:
HEG.NO.:
uNrt:
uxrt:
PERMiTTEE: STEPIiEN & SHERRI }tIRHY ( 714 ) 966 —0814
' RODflES8:- �j $ ( POST RD
COSTA MESA CA 92626
IICENSEU CONTMCTOB OECUMTIOX: I �ereGy aflirm tAat I am Ilcensetl under provisions oi Chapter 9(cammencinq with Sectibn
70W) ot �ivision 3 af tha Business and Professions Cotla, anU my Ilcense is in full lorce and eifect.
CITY IIC.: STRTE IIC.: ClASS:
Date: SiOnature:
WOBKENS' COMPENSRTION OECIAiWTION: I herehy atlirm t�at I Adve a certifiwte of conseni to ui4insua or a unillate af Workers'
Compensation Insurance, or a certifie0 copy t�ereoi (Section 3800. LaE. C�. �'
'UCV NO.: ' ' E%P. O�TE:
JMPRNY:
L.) CertifieG capy 6 �eredy NrmstR�t. ❑ Certlficq copY n(i� wit� tire dN Builtlirry Unisiart. '
Date: pODlicanC '
E%EMPf10N FPOM WOflKEN3' COMPENSIITON DELtAMPON: (This sectfon nee0 not Oe completed il the permit is for one �unEreE (51 W� or less).
I Ceriity ihat in IAe De�o�mana of lhe woM1 lOr w�ic� this permi� IS i55u¢U, I 5�all nai emDlay any OersOn in any mannef so as to OecomO
suhlect to the WOIXers' Compensation laws af Calilamia.
Oaie: Sipnature:
NOTICE: II, atler making tAis tleclaratian, you s�oultl become s�hle�� ro the Warkers' ComOensation provisions ot t�e-Labor
Code, you must forlhwitA camply with sucA pmvisions or Ihis permit shall be Eeemed revoketl. .�'
CONSTBUCTION LENDING RCENCY: I �ereby affirm tAat there is a constmction IentlinA aAency for the pedorman�e o� IAe work for
wAich �his permit is issued (Sectlon 3097, Civ. C).
LENDEX: '
naoeess:
OWNEB BUILDEB OEClAMT10N: I here�y alfirm that I am exemD� �mm t�e Caniractors' State License Law lor t�e followinp reason
(Section 7031.5 Business an0 Pmlessional Cade: My ciry al counry whicA requires a permit to consimcf, atter, imDrme, Oemolish, or
repair any structure. D�or to its L55uance, also reqWres t�e apD�icant lor sucA permtl ro �le a signeG sutement that hNs�a e IicenSeE
pursuan� to t�e provisians al the Contanors' State License law (CAaOter 9(cammencinp »it� Sectlw 7000) of Oivision 3 0l IAe Business
anG Pmlessions CoOe) or that Ae/s�e is exempt theretmm an0 t�e Wsis for the a11e0eE exempiian. My violation al Section 7031.5 by
airy applicam lar a permit su0leps the aOPlicant to a cNil penalry ol noI moa ttun five huntlretl Eollars (5500�.
I, as owner of Ne proDerry or my employees with wayes as tAelr sale compensation, will tla tha work, an0 Ne
7 siructum is not intenUM or oifere0 for sale (Section 70A4, Busmess anA Prolessional Cade: The Contractors' Stata License Law
Oaes nat apply to an ovmer oi a pmOenY w� �uilOs or ImD�oves t�ereon, and wAo tloes such xrork himself/hersell ar Ihrouph
Ais ar her awn employees. pmvided ihat suc� imDmvementS are wt intenEed or ofiereA lor sale. II, Aowever I�e OuilEinp or
imD�a�ement is sold vnthin one year ol completion, IAe ownCr will have I�e Gurd¢n of provinp he/s�e UiG not builA or improve
for tAe Ourpose o� sale�. � ,
' I, as owner of the pmpetly, am exclusively contractinA witA lieensed contractors ta consimc[ the pmject (Section 7044, Business
❑ antl Pmleuions Coda: The Contractors' SIaIa License Law Uces nat appty to an owner of properry who builQs or impmves therean
anE wlio contracts lar such pml��s vnt� a wntractor�s) license Dursuant ro Ne Con[2ctors' Slate license Law�. l am awara
t�at D��� ol t�eir Worker's Compensatian insurance shoulU pe pmviEeE m me.
� I am aempt untler SecGon: B P'� � 4 4 B. 8 P. C. � �
�arinisrezso�: ALL WORK BY OWNER ,
oate: �� 1 � ' �% O Oxner.
I Oo �ereEy cenity tAat I am avrare of antl unEersunG t�e rtQuiremen�s ol Califor Heatih an0 Safe Ue Set�OnS 25505. 25533, an0
2553d anO 11ul I or any future WilGinp acupanl wilWnil wt girUO ane) neetl lo wmpry vnih sai0 state co0es an0 the repuirements for a
permit tor construction ar maOificaiion from t�e ar Uualiry ManaOement Disinct. Resitleniul constmction applications are exempt Irom
t�ese pmvisions. —7�/��
Oate: ' ` � �' �� Mpliwnt: '
I heaby certiry I�at I have rea0 t�is aDP�ication an0 state t�at t�e aE e iniormatian is corre . agree to compty vnth all ciry an0 counry
oNinairces anE state laws rtlatinp to UuilUing consimciion an0 here�y a�t�onie represenutivu af his ctty ta enter upon t�e aGove�mentione0
pmperry lor inspaclion purposes. /f ,
/ !D—�i0 �
'� Date: �{ - Sipnature: ��
Ion.rer's License ai Sociai Securiry
�186N8 W�ite—BuilEino: Green—Cotle Enbrcemant; CanarV—.qpo�icem; Pink—Ravenue: GOWenrad—Aasesmr
CITY OF COSTA MESA - HUSLDING PERMIT
PERMI'C NO: E 045676 PLAN CHECK NO; N
CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE
PERM NO: E 045676
GOVT: N SUPP: Y
PURPUSE: ADD
JOB DESCRIPTION : DINING ROOM ADDITION SQ FT:
CLAIM VALUE: CALC-VALUE: . � GROUP OCC: R-3 /'
COMMENTS: RE: BPEJ8J69 PRIMARY BI.DG. PERMIT. •
it if iE if 3F ik 1f �k 3E k i! 1f k k iE 1E if ik k fk iE iE iE If iE iF ft i! �t it M k IE IE iE k it ik iF iE iF 3! iE �E iE ik It IE if iE Mi!!f!E k!k it if k 1F 1E iE iE Ik Ik �E ik iE ih M Ik k if iF iE iE IE �t 1!
, Z O N I N G R E Q U I R E M E N T S '
S E T H A C K 5 •
----------- MAIN BUILDING ---------- --------- ACCESSORY 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: 14123211 ZNE: REF NO:
PLANNING NOTES> �
� �
if 1F iE fF iE iE if if iElf k!f !f !E if iE iE ff iE 1F 3E if !E iE 1F ft fk If k ib i61E if 1f iE')E If iE if !f k fF i! IE k fF k 1F M 1k M ik If IE IE iE IE ft i! iEfF * iE iE IF 3k iE �lk IE iE iF ik iE iF iE 4 �f IF�k
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 .
➢UILDING APPROVED HY :
APPLICATION ZSSUED }JY: �L. J . /U/Oi
if ff fE iE 3f iE IF iE iE if if iE 1f 1f iE iE �lE 1E 1E iE 1E if�'i��F��
ik fE fE i! IE iE 1! iE ft IF �F if 1Elf iE 1E fE 1E 1E iE iE �f iE iE iFlE f! iE iF If M iF iE 1E IE iE 1E 1E IE 1k 1! 1k 1! 1E
LEGALIZATION:N F E E" S U M M
' BLAG FMT FLUMBING
PERMIT
PLAN
ISSUE FEE
AUILDING-DIV-> PERMIT ISSUE
TOTALS----> 7.50 4.50
• DATE: — '"
—.
DATE:
�� � DATE: �O 9O
aeicxw�ciavrscxitikfElEiEfE1E1lIE1E SFiFiFiFiElf
fkk!lklkfliFiEikiEiEifiEiFltiE1F1l1t 1f i!ilftkfllElEiElEaFkif
R Y S"PRUCTURAL SEGMENT:N
$LECTRIC MECHANIC FIRE SMIP/RES GRADING
7,50
502 SMIP/NON-RES
•4.50
PLAN-CHECK TOTAL, PAID DUE
0.00 12.00 ' 12.00 .00
REVENUE DIVISION TOTALS--:> COLLECTED: 12.00 OVER/SHORT: .00
BLDG PMT PLUMHING F.LECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
' 12.�0 ,
' if IE iE 1E 3f ik fE fE iE fE 1f fE 1f iE If N�if iE M If iE 1E IE �k �E �E M iE if� if �F iF k k it it it iklE iE k!E �E i! 1E IE iE k ff iF M iE fE 1E fE iE IF �k iE 1E �E iF 1E k if ik iE iE ik ik ik ik iE iE �f �E iF iF iE
I N D I V I D U A L F E E B R E A K D O W N
TYPB QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 10 RECEPT/OUTLET 1 ST 20 F_A. .75 7.50
END OF FEES
O1 ODOSiS19-0005l519 T�]T
DATE: D1/]0/90 TIf1E: i1:09
e
a
wCONSI'RUGTION AND PLANNING h-� & SPA �
' APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
- 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location _ _
r2._ 8oil Pipe-U�drgrnd: 53. Scee1 Reinforcement � � '
- � ..
�[3�Electrical Conduit'Utility-Undrgrnd. 54. Forms �' -
'�:4.iElectrical Conduit�Undrgrnd. 55. Electrical Bonding
C 5� Steel Reinforcementl 56. Rough Plumbing & Pressure Testj -
'"n6"Electcical UFER-G nd. 57. APPROVAL TO COVER�GUNiTE 3�
�;;5. Footings .=±C 58. Electrical Conduit-Undrgrod. � '
�. Foundation 59. Gas Pipe, O Undrgrnd., Test ;z � � �
-9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undigmd. - ,� �
10. Structural Floo[ System 61. APPROVAL TO DECK ' � /'
1�1. Property Sewei �Line'.& House Connection 62. Backwash & Receptor-Final �' � �; �
� - ti
P �
12. Sewer Ca 63. Heater & VenbFinal -� � � "
13. Roof Drains _ ' 64. Plumbing System - Final � �'
14. Rough Plumbing 65. Electrical-Final - �
15. Rough EleCtrical�Conduit 66. Solar SYstem-Final
- 16. Rough EleGtric�Wiring �,� M% f 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Eleetrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19...Rough Heating &_Air Conditioning _ _FIRE REPT. REQUIREMEN7
,- r �k .� c: �: ,. - -- �' %
20��Rough Facto'ry F.ireplace � - �� " � ;y �,� X =APPROVALS�,�Pe mit# -
21`-Du'cts, i"n'Str`�uau7e^ . •. '-'S +' �' �' �: K � -: - �-� � - +� -
h � �..�, i, �: ,�. �70. Undergiound Hydro �,
i s' i:= Y � C%1 4•: �,-. �r c
22 �DuLts, Ventilating ,, �; -� �� r �_..,,� i• ; 71. Product-,�iping O�Gras ❑Oil
23.�Gas-Pipe�Rough & Test nS �s' . O^� ^7p, Under round FlusFi� `�• '-"-
.-. h. ' 1r > r 9
24��Roof F aming ;�� ' ` ".;i x ` - � -x r :.73=Undergrnd.Sror ga-Tank�OGas ^OOiI
25. Roof $heathing m Y �� ' y ^ � �.� R��� 7q;�p�erhead Hyd% _, i�
x
26`'T�Bar Ceiling (Struc'tural) &=Mon'ocoat Z r - � } K 75_Dry Chemical � � � .
27.�Frame and Flashing: _ -c a �- � .-.t.. + 76 Dry Stand'pipe `� �' • �
.r -... t -` +`1
'�'28l Lathing-`& Siding'"y' " J^:�; x r� " ', ', � 77�� FIXED SY�TEM;F;INAG; � F�
J 29. Insulation �''' J S� •' �` ' 78s�FIRE PREV. FINA�L r= t'-�
�. Y' '� i1 Y
�30. Drywall=Nailing �� , r' � ;, �`�. '� �HEALTH-�DEPTr; REQUIREMENT
, � �. .
=�31. Plaster Bro�✓n Coatr �' a�^ � ��•� x ��79. �FINAL I�1SP_ECTION• '!� �
:;
� 32�Electriwl PowerMeter-Final 1..=�� � r80;'FOOD CERTIFICATE ISSUED,
r33,=FinalElectric ;�x ;-: � a; �,�� ��� K �Notes: "'C�U,;B '� i�C�� e/
_, .J . !l - � �Y' �: c: • . � ; �C 4: _ �
34�FinalHeating&Ai1;C�oi�ditioning`- � � - �`�, �
c ' v (-7 M� � x s � � r., G :� c -
^ � i..r � _ + �� � .r . . . _ . '
35:�Final Gas Pi'pe-TesU i��� •� r. -� - �: _� � �J vT.c. v�-; • � '-'
4:. ` .
J36_Hood or CanoPY �,4 �-.n ��r a r:'i " ti: r: % g .'�c� t, �
{; ��a zc w -
�37.:�Firial Facto�Y Fireplacez y� ✓. K � � - �r r. �^� � ` �
_ �
538. Firiyl Plumbing ": �^ '' ' i �� x -- "� * '
Ki y
+: � ^' - � ✓, a. 1 � :
"39. Water Service�FinalK � , y -; � x * . � , -' r
� L � C i � M
^740. Gas Servics-Final '� -." � l'"T S *� �7 ' �� � O;-! =['� k
c. � ., _ �; ' :x +: �- ^ E e: �;
�41. Solar pomesticFiri�l�' r �� k�j �: y,, � j f; >�
� 42 Backflow 7reventer.' ! .^+ 'r � +: �" ', f-� :1. ._' ^
� � a� - �a � ^� t*i Q ,: 'r
" fi. r � ` ;, x .Y u. - • �_
43. Backflow irriyation; . ` * � * , i�� (; • -
_ ,_,
'144. Landscape IRipation System-�'-!�? � � '� �- O rn�c �� � -.� ;� * T r� n, .
.; � ,.� y� ' a• C e'.r. f -- x<� r
/'7 " � r. G: S-� !^ �t' 2: � c+ -� x � r• � �� � + .
`45�Sound Attenuatior� ... � , ,:3 �.yt * CJ� r��J �
'46.••Handicap Regulations - ^v " � z' x z• '� O;� `, *
ti t x'e� 1 ,ie� .K .1. i' ':J ,K
.. � � t. � � � c:: at . � � `"
,�47rFIM1tAL STRUCTURE & BUILDING � ,✓,.� t, .�. " `, �.� •
i
48'FINAL PLANNING • . - � �� i � ,'x � = `� x C .
a49�;Electric Release to;Edison , � ' `� ��: � I ``� "' � '-
. -, c, • �: �
"
�50?-Gas+Release to Sou�hem Califo�,r �a Gas Co x !� '�, K- %- �• J� � � �, '
Y. <' :� C :1
' 51. CERTIFICATE OF�OCCUPANCY � '' ^° = •• � �� - ' ^ `�
No. Date
Avp���anl to Iill in a11 sDaces eaceot tnose wlthin neavy Doreer Itnes antl sign all approo/�ale tleclantions.
CI?�.OF: OSTA MESA CONSTRUCTION PERMIT P•ERMIT NO. .� TRACT NQ. . LOj NO. UNIT NO. A P
P�ojea Address °18(0 -Pn�� Ri-i.
A�r, hcant's Mailing Addreu ���
Owner's Name �TEPi�EN � H R I 1{iR �o e"K�'�-���
Atldress 9'g n Pb�vT RS�, (�_. M. C�afi� �-1 Rlo o� ((',
Arch/Eng. License No.
Address
Conlract�r's Nam Phone
Address Imailingl
City LicenSe No.
LICENSED CONTRNCTOR DE LARATION
1 hereUy afflrm Uat I am licensetl untler provisions o/ Gharter 9(commencing
with sectlon 7000) ot DiviSion 3 ot tne 6u5iness antl Profassions Coae, anE
my license Is in full /orce antl eHect. �
License Class License No.
Datc Si9nature
'VORKERS' COMPENSATION DECLARATION
iereby aftirm that I nave a certi(itato ol consent to selttinsure or a certlticate
,t Workers' Compensa[ion Inwrance, or a c¢rtifietl copy t�ereof (Section
3800, Lab. C.) , ' �
Polity No. Company
BCertiiietl caoY is hereby tumishetl.
Certitle� copy Is filetl with tbe city BuilUing Oivision.
Date AOP�icant
E%EMPTION PROM WORKERS' COMPENSATION DECIARATION
(This section neetl not be completetl i1 the permit is for one huntlretl (y300) or
less). . ^
I cCrtity Ihal in tne Oertormance ot thG work fo� which Ihli pa�mR i5 ISSueG, I
sM1all not employ any person In any ma ner so s to bep�orye su�jec[ to Ihe
Workers' GioJnp nsation Laws of Calltor �`/// /
Date 'v � Si9natur ���� �^'�y
NOT CE: It, atter making this tleUaration, ou sho becom ubject to t�e
Wo�kers' Compensation Orovlsion5 OI Ihe 12bo� otle, you mu5t fO�thwith
comply wilh zuch provisions or tnis permil shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENGV
I hareby aliirm lhat Inere is a constructlon lentling agen<y tor the porformance
oi lM1a wark for which tnls permil is issuetl (Sec[ion 3097 Clv. CJ
Lentler's Name -
Lentler's Atltlress �
• OWNER BUILDER DECLARATION
1 her¢by a�l{rm lhat I am exempl 1rOm lhe COntra[to�'s LiGense Law tOr the
lollowing reawn (Se<tlon 7031.5 Buslness antl Professional COUe: Any clly or
COunty which requirGs a pe�mil IO COnst�utt, alt¢�, ImprOvO, demoll5h D� repal�
any sirucWre, pdor to iti issuance, also reqWres tha applicant for sucn permlt
to iile a SigneG SIdIC111Cf1I I:IdI IIC/SIIO i5 Iiconsetl pur5uant to thB ProviSio05 OI
'M1B COnl�at[Of'S LIcenS¢ Ldw (Chaptar 9(commen<Ing with Sectlon 7000) of
�ivl5io0 3 oi llle Busine55 antl Pro/e55ions Cotle) Or lhat he/Sha is axomp[
nerclrom antl the basis lor lhe alle9t0 oxemD��e�• /�ny violation o1 Soction
7031.5 by any aOPlitant for a pOrmlt Subjocts tne dpplicant to d civll
Q$�alty o1 not more than fiva huntlrna tlollars (5500).
UQ I, as ownm of the proparty o� my Cm0loyee5 with wagas a5 lhol� So10
CompCnsatlon, will tl0 the wOrk, antl lhC stluClure IS n0l Intentl¢tl Of oftefCtl
br salc (Settion 7044, Business antl Prolessional Cotle: Tho Contraclor's
License l., w aoes not apply to an owner oi a proparty who bulltls or improves
lhoreon, antl wM10 tl0ls sucb work hImSCH/her5eli or thrOu9h hI5 or h¢r own
empl0yee5, provitletl tnal Such imp�ov¢ments ar0 nOt Intentletl Or o1le�etl tor
sala. If, nowever, tne builtlin9 or imorovement iz soltl wit�in ono yoar of com-
picUon, the awncr wlli nave the burtlen ol provinq ne/she tlitl not builtl or im-
�rove lor the pur0ose ot Talej.
U I, as owner o/ the property, am oxclusfvely contracting with Ilcenso0 con-
tractors to <onstruc[ the project (Setlion 7044, Business anE Professions Cotle:
Tne Contractor's License Law tloes not apPty to an owner ot propur[y who
builds a� ImprOves the�eon. anE wh0 contracts tor such oroiects with d<on-
tractor(s Imense pursuam ro ene Contractor's License Law). I am awaro tha[
prool O� their Worker'S COmponsaUon InsuranG¢ Should be provitluU to me.
❑ I am exem0� untler Sectlorp--- B. & P. C. for th6 reazon
Date Z' � Owner
I hareby <erti(y that I nave reatl lhis apo�icatl n antl stale that tho above
Inlormalion is torrect. I agree to comply wlth all city an0 county ortlinances '
antl state laws relating to builtling construction, an0 hereby autnorize repre-
sen[ative5 of this city to enter upon tne above-mentionetl DroDerty for
InSpection Pprppse� /, � / �.
Si9nature R,4 /iK /% Date S Z��l
Drlvers'L �
TYPE OF CONSTRUCTION LJ NEW L�J ADD IJ ALTERATION
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCfiIPT10NOF WORK/USE OF BLDG.
TVPE OF PERMIT GRADING FOVNDATION T12UCTU
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ ECHANICAL
❑ OTHER
PROJECT DESCRIPTION 5�. F7. oCCUPAN�
CONSTRUCTION TVPE VALUATION 5 _d
ZONE GRADING CU. VDS. ACRES
Remarks:
c. '18t-84s-
Bar Sink
Back(low Preventer
Backflow Irrigation
Bathtubs
Clarifiers
7rinking Fountain5
'rloor Drains
Floor Sinks
3as Service
I nterceprors
Kitchen Sink
Lavatories
P-Trep
Roof Drains
Reinspaction Fee
ShoWers
Service Sink �
Sewer Cap -
SewerConnection. ' '
Solar Collectors
Solar Pipin9 � r
c,.�'" r__�" l . s
Swimming Pool w/Spa
Urinal
Outlets Water Closet
Water Heater
Water Service
Auto�Wesh
$15
Boiler
Duct-UnderGround
Duct - Strucwral
Duct - Ventilating
ExhauSt System ❑ Multiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ 0.100,000 BTU � 100,000 BT
Reinspection Fee � $75
0865-4fi, rev. 5/88 White - Buileing: Canary - Appliwnp Plnk - Accounting; Goltlenrotl - Assessor
Issue Fee
HooAor Typel ❑
Canopy Typell ❑
Refrigeratiori System
�4700,000 BTU ❑100,000 BTU
System Repair/Alteration
Fire Dampers
Registers
Issue Fee
—_ . . 9W —
S Main Buildi
REPAIR
T Front �i
8 Renr
A
I C Right
- K
'� g . Left � 1
� . Ping. Ref, dh
i� Planning Notes:
/
FEES P.utometic Washer
Constructian Pole Sub.
Cooking Unit
Dishwasher
Oryers �Gas �Electric
Fan �
F.A.U.
Fix[ures
i Device Boxes
Outlets
S 3
FEES
S 3
Garbage Disposal
Generntor �0.5
Fee
Zone
Actessory Buiiding:
—Park�ing Req./Provided
t t, /`Ec / �
ELECTRICAL
Trenstarmer ❑ 15-50 KW
❑50iKW
Meter LJup ro 700 amps
Meter ❑over 100 amps
Sub Panel
Motors 00�1 HP �1:4 - 8
Inc. Solar �9-15 HP �16-15+
Microwave _
Pole Light
Sign
Standing Sections
(W �5-15 KW Trash Compactor
i
$15 luue Fee
DEVELOPMENT.SER'
2oning Approved By�
Buildine APP�oved By
FEES
N
I
N
G
R
E
Q
M
T
S.
� SU pEFEES � � $
BUILDING PERMIT $ X� SMIP $ � •—
-PLAN CHECK S .PERMIT
PLUMBINGr ' S �-+ - ISSUANCE $
PLAN CHECK � 25% $ ENERG� P.C. $
ELECTRICAL � $ �� GR��%NG $ —
PLAN CHECKr 50% $ � ��1�{**"$
MECHANICAL S TOTALFEE
PLAN CHECK 25% $ I
C1 � n_ ���tYC' , �
� � _ a. �
��%�:�':����,�. ii� : ...� _-. �,
i
. a ,._.
�� C NSTRUCTION AND PLANNING' � PL & SPA
,�?�� Date Inspector �� Date Ins ector
� APFROVALS Permit # APPROVALS Permlt # P
�, Temporary Electiical Service or Pole " ^ 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. �� � � 53. Steel Reinforcement •
.•,Electrical Conduit Utility-Undrgrnd. 54. Forms � �
4.;Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5� Steel Reinforcement 56. Rough Plumbin� & Pressure Test �
6. Electrical UFER Grnd. �� `� p�! • 57. APPROVAL TO COVER-GUNITE
7. Footings 5��� 8q �� 58. Electrical ConduirUndrgrnd. .�
8.. Foundation � 59. Gas Pipe, O Undrgrnd., Test '
9.�Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor 5Ystem njj $9 fJ'd7J- 6i. APPROVAL TO DECK '
11. Properry 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
'.1;6. Rough Electric Wiring � � ' 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Elearical-7 Bar Ceilin9 69. POOL/SPA SYSTEMS FINAL '
�J18. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ,
20: Rough Factory Fireplace � � APPROVALS Permit #
� 2�7. 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. Undergmd.StorageTank OGas ❑Oil
.25. Roof Sheathing . � �-• -d � "� 74. Overhead Hydr'o � '- " � ' ' -
26. T-8ar Ceiling (S[ructural) & Monocoa[ 75. Dry Chemical
27.` Frame and Flashin9 . B � � 76. Dry Standpipe
28 Lathing & Siding �, ' /¢% 77. FIXED SYSTEM FINAL
29. Insulation • S�j � D 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 �' i '' . � �� Notes: 6
34. Final Heating & Air Conditioning , S� �a ��
35. Final Gas Pipe-Test . 6T� �
36. Hood or Canopy pZZ� ,�� o L
37. Final Factory,Fireplace
S c.� U �
38. Final�Plumbing � , �S'Cr� (�(�O
39. Water�Service�Fina; -. ,
40. Gas Service-Final •
41. Solar pomestic-Final_ '- ,
42. Backflow Preventei�; . � �
43. Backflow Irrigation .' i. -
44. Landscape Irrigation.System � � �; �.
45. Sound Attenuatio� . -
46. Handicap Regulations � , ,
�
�� 47. FINALSTRUCTURE&BUILDING '�y ' �
4A. Snecial Requiremerts Completed '+ '
49. Eleciric Release to Edison
, � '. �.�' 1,:'t.
_ .�
50: Gas Release to Southem Califomia Gas Co • � , � ��- :
51. CERTIFICATE OF OCCUPANCY • � � • . •
No. Date 't=�� d, ' �- , •:�i.�, ;�
... -I, - . . . �
� ��1�'� y
FERNAOLZ� JOE
r iitE
TE APR 2 9 19M
fILDING PERniIT N0. 22O 1
VALUE
su�coN2�secTox
220 I
CC,;.�'TA M�SA BUILDING-SAFETY DEPARTMENT
P. O. l:OX 9f] C09TA MEHA, CALIFORNIA
-
For Appllcanf fo FiII In Completely
TYPE OR PRINT �
BUILDIN6 �G '�OS �J/e
ADDRESS .
COSTA MESA, CALIFORNIA
OWNER �/DE / E��?D�Z
MAIL /)A� s'f_ _.-^ r-�r.
� TEL. ��
'STATE TEL
LI0. NO. NO.
ISIZE I no.oPa�.noe.
USE OF
EXISTINO BLDG.
SETBACK LINE PROM
DESCRIPTION OF WORK
WALL
ADD�Tio�V o �UEw Fi2E -
i,4CE
I HEREBY ACKNOWLED�B THAT � HAVE READ TXIB APPLICATION
ANO 6TATE TNAT THE P90VE 19 COqqECT ANO 6GFEH TO COM.
PLY WITH ALL CITY ORUINANCE9 ANO BTAT I.AWe H80ULATINO
9UILDINO CONBTFYCiION.
n
SIGNATURE OF
PERMITTE a.w�
.. ' //
AUTHORIZEDAGENT-� i� . l�
APPROVED
F�� R����V��
APR 2 9 1964
FINANCE UEPT.
CITY OF COSTA I�IESA
APPLICATION FOR PERM
BUILDING
For Offica Use Only
� R6C[I'l' NO. P[RMIT NO.
2'Z06/
OY DAT{ R[C[IVHC DAT6 �94UE0
u u� � �� 4 -�y� -�. ,
o a i � _--1 _
ZONING
no. o� uee
rune emi
y/ �5..�-G/ "�
EAVE OVERHANG SHALL BE LE THAN
EAVES
ALLOWED
YARD3 APPROVE�
MAIN BUILDIN6
��
VAR. #
YARDBAPPROVED
ACCESSORY BIIILDINB
DATE
N
6Q. FT. �
TX8 AMOIINT BHOWN YNDEP VALUATION IB FOR THE F
PURPOSE OR EBTABL�9HINO A pERMIT FE6 ONLY. �
VALUATION � N
do PERMITFEE j
_ m
$ �I. � PLAN CHECK $ �
�J V v
� i/' LL
OwNER �OMAS, C. F.
JOB ADDRESS
GENERAL CONT ACTOR Carroll
AP No. 1 1-232-ll LOT 4
INSPECTIONS
soa
GAS
1TER
��AOUGM PLUMBING
PROG. SWR. LINE HOUSECON.
SPRINKLING SYSTEM
MISCELL/.NEOUS
ROU6H NE�TING FND MR COND�TIOMING
TEMPOR�aY SERVICE OR POLE
YUNOEAGAOUNO � POWER
AOUGN WIRING
TRENCMES [ FORMS � STEEL REIMF.
FLOOR SvSTEM
BONO BE�M STEEL REINFORCE
SHE�TMING
FR�ME ANO F��SMING
LATNING - IN � OUT n
PL�STER.BROWN WRT
STRUCTUR�L, FIN�L
NF�TING VFMT. FFCRIG. 1N0 A.C.. FINAL
DATE
"' DING PERMIT N0.
SUBCONTRACTOR
F
�
W
O.
Q
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h
S
F
O
W
F
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0
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3
COSTA MESA BUILDING-SAFETY DEPART
� P.O.BOX 7200 COSTA MESA,CALIFORNIA 9
For Applicant to Fill in Completely — Use Ink
BUILDING � � (i/ `i Sr. �OA%%
AODFESS CT l// f�B
OWNER � /"/Q/YJfj � �, . `
MAI L 6�.
ADDRESS S//��/ �
oiT� Cds�r� �r�g.4 No.`SS�s=
CANSTRUCTION
BRANCH
AODRESS
ARCHITECT TEL.
CONTRACTOR L,AiYKOtil. /`C/�`f/f/R��
ADDRESS a�J7� �Q/»O�YR
CITY COSTA ��JR N�Ly�SO<
LIC. NO. ,3�'J S/� LICYNO.
OF LOT /VCI k (� I NOW ON LO S I
USE OF
EXISTING BLDG.��S � !7P N� �
Separate permits are required for
electric, plumbing and heating work.
._- iS Y // '
I �ereby acknowledge thet I have reatl this application entl state
that the above Info�mation is correct antl agree io camply with
all laws regulating builtling cOnstruction, antl I shell not employ
eny peroon in violation of the workman's compensation laws of
the State of Celifornia.
I he�eby certity that I am properly licensad as a conttactor under
the SSate of Calitornia Businass antl Professions Cotle, Division 3,
Chapter 9, antl ihat such Iicenses are in full force and effect, or I
am exempt from the provisions ot the Steie of CelltOrnia Business
antl PfOfe5510n5 COtle, Oivi i 3, Chapier .
Signature of �
Permittee
Authorizatl Agent
'39 ' 8/25/76
PL[ ,�I'10 4 FOR STRUCTURAL PERM[T
R CEI BV �ATE RECEIVED D E ISSUEC
-Z �
PERMIT NO.
A.P. NO. I �I � � J� � � �
BUILDING .-/�
nooaess 9 ��G �o a ( �o-ei
TRACT � D / N LOT � BLOCK
r\
F�RE
20NE
APPROVE
20NE �! NO.OF USE OF NEW C7�Q�-E
PLAN$ BUILDING (�j;' (.(.
VAR�SAPPPOVED VARDSAPPFOVED
MAIN BUILDING ACCESSOPV BUILDING
DISTANCE BET. BET. MAIN
MAIN BLOGS. ACCESS. BL
VAR.# DATE
C.U.P.� APPROVED
5.50 TL
��
n
m
'v
54. FT. w
THE AMOUNTSHOWN UNDEfl VALUATION IS FOR m
THE PUIiPOSE OF ESTABLISHING A PERMIT FEE ONLV:
e
VALUATION PERMIT FEE $ e
�� �
ro
PLAN CHECK $ ^�
///YJJJ���/\l 0
$ �+ (J TAX $ � LL
�
U
TOTALPAID q
OWNER ti7E[,(�.��"ii'6 H�i�$ ^ATE 5-18-56 � �
JOBADDHESS '�"POst �Oa� tlUILDINGPERMITNO. i07'J
GENERALCONTRACTOR WP�COIDe �i11PS VAWE $ .��7(O OO
.
LOT 6� BLOCK TRACT 2896 Single �3. W/att gar
GROUP I&'J TYPE V 20NE f� FIRE DISTRICT 3�-12
INSPECTIONS OATE SUBCONTRACTOR I PiRMITSISSUED
DATE NUMBER
i �
Formsand Gradeto
R
Plumbi
Wi
Sepnc ranK or �psspooi
Lathing, In Out �
Plastering
Plumbing, Fin�al, Fixtures Com
Plumbing, Fin,al Gas Test ���
Wiring, Final
Occupancy
FORM 210 3M 10�9�
J
i
�Iesa Building Department APPLICATION FOR PERMIT
P.O.Boz3�- 311�� BU'- DING '
COSTA MESA, CAL �2NIA
FOR OFFICE USE ONLY
'� FOR APPLICANT TO I'+II.L IN Receipt No. Permft No.
Builtling `
Address �Post Ro�, .� � % .�
Costa Mesa, California Receiv d bx Date Rec'd. Date pIssued
6l j �/ �—�� .S—/O �.��
Nearest Croftdnn �/
Cross St.
owner Tielcoire riomes, Ina.
Mail
nddress �8 tiYestminster �1ve.,
Tel.
city l�estminster No}rem. 5711
Arohitect or Lic.
concrecto��`elcoiro Homes, Inc.NpYLiC.I.o78
4�
AEdress �2$ tiVestaninster, Ave. ,
Legal Lot L1� I
Description No. �+-F I Block I Tract 2
(AtWch Metes and Bounda)
Size of Lot �xl�
4se of
Existing Bldg. NOrie
Setback Line from
Center of Street � Ft•
Repair
Building
X I AlSeralion
IMovina
No. of Bldgs NOriO
Now on Lot
No.of I No.of
Families Rooms
Addition
2rJ�4% Rooms 6 Stories 1
311 S,�a� I Covering W�d
Single fsmily residence and
car gar�ge attached. � �
I hereby ac}
and state th
with all Cii
building con
Signatureof
Permittee _
that I have read this Application
ve is correM a[�l agree to comply
Costa Mesa, California
Nearest
Cross St.
Zone CA Plans I TYvc V G
i i
Approved
by Date
CORRECTIONS
i � .
� � . . �
� .
r�
...., 12� _.
r.. ..
rJlr.. , �
APPROVALS
iundation Location InSpector
Forms, Materials,
Under-Pinning
�ame: Fire Stops,
Permk Fee $ p� � � Masonr
Plan Check $ � � '�
Bond B
Total J/
Fee $ J(� � FINAL
Int.
Ext.
i
Date
0
A
�
2
D
r
�
Jt'LVl YLA1V
Show loeatlon and distances from
property Ilne antl between buildinga
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