The URL can be used to link to this page

Home My WebLink About3484 QUEENS CT - Building Permitsa • R (714) 754-5273 • F3Jc (714) 754-4856 • YnVW.Ci.COs�a-mBS2��sCTRICAL PERMIT �� FAIR DRIVE, GOSIA MESA, GA 9'L626 .lob/+ddress: 3484 QUEENS CT Status: ISSUED Suite No Applied: 11/15I2006 Vicinity: Issued: 11/15I2006 Parcel Nunmber. 41204273 ApplicanC CANO, JASMINE Address: 202 E STEVENS P e: 9 79-5575 SANTA ANA, CA - ip 92 owner: MILLER, KENN TR Address 3484 �UEENS CT ' , , �,'� � Phone: . '�; ; � � �COSTA MESA,'CA - - . � �Zip: 92626 � �� Contracror '-COAST,AIRE. . � Atldress: 202 E'STEVENS � SANTA ANA, CA Phone: 949-279-5575 Zip: 92705 License: 355425 � - c . ; �. � , , SCOPE OF PERMIT REPIACE EXISTING CENTRAL AIR UNIT ELECTRICAL TO INCLUDE: 1 MOTOR TO 70 HP ISSUE FEE Temp service test � �Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets ' ' Swifches � � Non Res Appl � Res Appl � , , . Service to 200a Service to 1000a� Service over 1000a Molors to 1 hp , ` Motors to 10hp �' � Motors to SOhp Molors to 100hp � " Motors over 100hp ._ , � Communication drops.-� Sub panel to 200a ��, Pole Light Pkg . Sign Circuits Temp Pwr Pole Intermed Pole � 'Quantily-'� ; ' 523.50 Y •. �' - - . .. $0.00 $0.00 50.00 $0.00 $0.00 90.00 $0.00 $0.00 50.00 $0.00 $0.00 , 50.00 $0.00 $0.00 � , 512.30� ' $0.00 .\� � $0.00 50.00 � .i�$0.00'. � - '$O.00�.i�. 50.00 , $0.00 - �_.$0.00- . 50.00 �'.., 0 0 �0 0 0 0 0 0 0 0 0 0• _. i 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway/t00ft Standing Section Misc Electiical Equipment � Transtormers up to 1 kva/kw � . ................up�to 10 kva/kw .................up to 50 kva/kw .................up l0 100 kva/kw ..........�........over 100 kva/kw Low Voltage Equipment , Low Volt Wiring Syslem / Ckt ^ � `' �Misc. Conduit Misc. Conductor Cirws ( geri or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand � Ottier Electrical Fee Investigation Fee Plan Check Fee Reinspection Fee ISSUED BY: i o � A • /,L1 /I ,� Quantity $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 30.00 0 50.00 0 $0.00 $0.00 S0.00 50.00 � TOTAL CALCULATED FEES $35.80 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and relatad regulations. (Ord. No. 92•28, § 1, 12-21-92) EXPIRA710N: This permit shall automatirally expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a penod of 180 days. : , - � . . INSPECTIONS: In ortler for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections end final epproval must be obtained. Failure to obtain inspections and final approval will result in tha expiration of this permit. POR INSPECTIONS CALL: (714) 7545626 2446-46 (6/00) WORKERS' COMPENSATION DECLARATION: I hereby eMirm untler Denalty of porjury one oi the following declarations: � ❑ I have end will mainteln a certificate ot consent to sell-Insure for workers' compensetion, es provided for by section 3700 ot the Lebor Cotle, tor the peAortnance ot ihe work tor which this pertnit is Issuea. ^ a., � ave and wlll maintein workers' compensation insurance, es requiretl by section 3700 oi the Labor Code, for the perfortnance of the work tor which ihis partnit is Issued. �-My workere' compfe—n�sa�tion I urance wrriar antl policy number are: + // �/ LC2r e�`�"'�G�.� �t�l� 1n�' .- POIIcy.Number.r`�� Q 1 �� i) PIC. �J �2`-') � need not be complefed i/ the permit is valued et one hundred tlollars ($f 00) or less.) ❑ I certify that in ihe peAormance of the work for which this permit is issued, I shall not employ eny person in eny manner so as to become su6ject to Ihe workers' compensation laws ot Celifomia, and egree that i� I should become subJect to the workers' compensation provisions of Section 3700 of ihe Labor Code, I shell forthwith comply with these rovisions. � �a �p_IicanbSigneture'�'-=' ` . - F„Dete:j �F�l�I�� (L��Q�n WARNINO:;FAILURE T SE RE WORKERS' CAMPEN TION CAVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIM�LTIES AND CIVIL FINES UP TO ONE HUNDRE� TIqUSANDDOILARE�51 ,000),INADDITIONTOTHECQSTOFCOMPENSATION,DAMAGESASPROVIOEDFORINSECTIdJ3'1O60FTHELABORWDE,IfJ�EREST,ANDAITORNEI^SFEES. LICENSED CONTRACTORS DECLARATION: ot Chapter 9(commencing with Section 7000) of �ivislon 3,pbMeBus�s `s�and Pmfessions Cotle, and my license is in full CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm Ihat ihere is a consWction lending agency for the performance of Ihe work br which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lenders Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: � I hereby affirm thet untler�penalry of perjury thet I am EXEMPT FROM 7HE CON7RACTORS LICENSE LAW for ihe tollowing reason (Sec. 7031.5, Business and Protessions Cotle: Any cily or county'which�requires a permiLto consiruct, alter, improve, tlemolish, or repeir any siructure, prior to its issuance, also requires ihe appiicant tor such permit b file a signed stetement Ihet he�or she is Ilcensed pursuent to the pmvisions of the Contractors License Law (Chapter 9(wmmencing with Sectlon 7000) of Divislon 3 of the Business entl Professions Code) or Ihat he or sha is exempt thereirom and the basis lor the elleged eaemption. Any violetion oi Sectlon 7031.5 by any applicant tor a permit subjects ihe applicent to a civil penolry c� not more ihan five hundred dollars ($500).): ❑ I, as owner of ihe property, or my employees wlth wages as their sole compensation, WILL DO 7HE WORK, and Ihe structure is not intendatl or otteretl for sale (Sec. 7044, Business and Professions Code: 7tie Gontractors License Law does not apply to an owner ot pmperry who huilds or improves thereon, end who does such work himseN or herselt or �hrough his or her own employees, provided �ha� such improvemenis are not intendetl or oHeretl for sale. If, howaver, Ihe building or improvement is sold within one year oi completion, ihe owner-builder will have the burden of proving ihat he or she tlitl not build or Improve for purpose of sale.). ❑ 1, es ownar of tha properTy, am EXCLUSIVELV CONTRACTiNG WITH LICENSED CONTRACTORS to construct the projecl (Sec. 7044, Business and Professions Code: The contractors License Law tloes not epply to an owner of property who builtls or Improves thereon, and who conirects for such project with e contractor(s) license pursuan� �o �he Caniractors License Lews.). ❑ I am e:empt under sec. Signature: Owner ID verifietl by driver's license. ❑ Vas Vanfication ot Ownership by (rype of daument, i.e. Business antl Pmfessions Cotle tor this reason: ❑ No Driver's License No. property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PEflM1T CERTIFICATION: Date: Ezpires: ❑ I hereby cenify that no excavation five (5) or more feet in depth In�o which a person is required to descend, will ba mede in connection with work authodzed by this pertni6 and ihat no building sirucNra, scatFoltling, falsework, or demolition or dismantling thereoi, will be more than ihirry-sia (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calitomla Atlministrative Code). ❑ A5 owner-Duilder, I will not employ anyone to do work which would require a permit trom the Division oi Industriel Safety, as notetl above, unless such person has e permit to do such work from the division. Signature: Date: Division ot Intlustnal Satery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND Alff}10RVATON OF ENTRV: I certiy untler penalry of Deryury that I have read Ihis application antl state Ihet the information given is correct I agree to comply with all state laws antl city ordinances relating to building constmction, and euthonze representatives ot the Ciry oi Costa Mesa to enler upon the ebove-described property for inspection purposes. I agree not to occupy or allow ocapancy of any building authorized by this permit until final inspection. cooe �. iNsrwnonrrve 1616 Fi:ed System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Roof 201 Final Blak/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final'Demolition o� INi1TIRL5 COpE 1 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Final Fire Preventlon 220 �Final Planning Approval 222 Final Site 250 Final Building/Occupency PATE _ �/ INTffULS S� s-fc�. 5 qf -oca�ion � - , t--.�._. �� ' I APPRO` � C[TY OF COSTA PLANNING DI\ �' �� SUBJECT TO BLDG. I(SEPT. REG. NOTL: ADDITIONS,1�61_ETIONS, t OR CORRECTIONS SHAL.L E3E APYROVED BY THE PL'ANNING ll1V( � �f ! l�+/ , � IIY _�_ I?:`i�E: /iJ/-�C� � ! � �~`--- G`r'� loccr�`iv� __- -�-___�.�---____. f r/� Gh 9� pU F= Rp N T �,�t'� �R y ��,� �# sB G v�o �o _i�a � 78 00� �� G C � �, � �'u� '� r�o�c -� �c��3GR33�R3c� 3�� D 6 U tj e Lt t��o-_..., Nr Qv�-�,rs %I/]�118r QOnnq , 3u�y D��ee,�s cT �� C�sf� �.�es� ��t. ga�d �7�9��1--�1ra r� (714) 754-5273 • Fau (714) 754-4856 • wviw.ci.COsta-mesa.ta.us JobAddress: 3484 QUEENS CT Suite No Vicinily: Parcel Number: 41204273 Applicant CANO, JASMINE Address: 202 E STEVENS SANTA ANA, CA Owner ,MILLER, KENNETH M TR Address:� r3484 QUEENS CT _, - , , / , . COSTA MESA, CA Contractor COAST AIRE Address: 202 E STEVENS SANTA ANA, CA MECHANICAL PERMIT F � �� /��1 � � ` �� Phone: 949-279-5575 Zip: 92705 Phone: Zip: 92626 Phone: 949-279-5575 Zip: 92705 License: 355425 77 FAIR DRIVE, COSTA MESA, CA 92626 �� Status: ISSUED Applied: 11/15I2006 Issued: 11/15/2006 ISSUED BV: SCOPE OF PERMIT REPLACE EXISTING CENTRAL AIR UNIT. REF.: E06-01289 MECHANICAL TO INCLUDE: 1 FAU < 100 K BTU AND 1 COMPRESSOR/ABSORPTION SYSTEM 3 � TO 75 HP/100K BTU. ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <700 k BTU Refrig Sys >100 k BTU, Gas Piping Factory Fireplace Hood w/Mech Exhaust � VAV Box Vent Fan / Single Ducl Appliance . ' Fire Dampers. Smoke Dampers Inst or Relocate Appl Veni Air Handlers < t0000cfm , Air Handlers > t0000cfm Floor Fumace � Floor or Suspend Heater;A, � �Quantity $23.50 S�a.80 1 50.00 0 50.00 "0' $0.00 0 50.00 0 30.00 0 50.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 . ' ; -, 30.00 - 0 $0.00 0 50.00 0 50.00 0 ; �50.00 � --0�- _' � " , ' $0.00-. 0 � - � . , \ FEE SUMMARY Repair / Alt Absorbtion Unit Repair/Alt Reirigera�ion Unit Ventillation System Evaporative Cooler Commercial I ncinerator Domestic Incinerator Comoressors / Absorption Svstems Up to 3 hp / 100 k BTU 3 To 15 hp / 500 k BTU 15 To 30 hp / 1,000 k BTU , 30 To 50 hp / 1,750 k BTU � Over 50 hp I Over 1,750 BTU Boilers Up to 3 hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Invesligation Fee Plan Check Fee � Reinspection Fee TOTAL CALCULATED FEES �� COMMENTS / SPECIAL.CONDITIONS Quantity 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 50.00 0 i0.00 0 50.00 0 50.00 0 50.00 0 50.00 0 527.15 1 $0.00 0 50.00 0 50.00 0 $0.00 50.00 50.00 $65.45 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements unde� Calitornia statutes and related regulations. (Ortl. No. 92-28, § 7, 72-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlona and flnel approval musl be obtained. Failure to obtain Inspections and final epproval will result in the ezpiratlon of ihis permit. FOR INSPECTIONS CALL: (714) 7545628 zaaae (erool WORKERS'COMPENSAnON DECLARAnON: I hereby attirm under penalry of perjury one of the following tleclarations: � ❑ I heve end wlil meimain e certificeta ot consent to self-Insure for workers' compenseHon, es provided br by sectlon 3700 ot the Lebor Cotle, lor Ihe peAortnence o1 the work for which this partnit Is issuetl. � I have and wiil maintein workers' compensation inwrerqe, as requireA by section 3700 oi the Lebor Cotle, for the peAormance of the work for which this peimit is issue0. My w�o+rkers' compensatlon Insur nce certier antl policy num0er are: Q Certier \��,� � PolicyNumber: ��_I � �i� ( ) (Tlris secfion nee no( be completed i� the pertnif is velued et one hundred dollars ($100) or less.) ❑ I certify ihat in ihe peRormance of the work for w�ich t�is permil is issueQ I shall not employ any person in any menner so es to become subject to the workers' compensallon laws oi Celifomia, and agree that H I shoultl become sub�act to Ihe workers' compensation provisions oi Section 3700 oi the Lebor Code, � shall forthwith comply with t�ese pcIo^visions. '/ � Applicent Signature: Y—N aj TF`' Date: I �� G C WFRNINO: FAILURE TO RE WORKERS' COMPENSATION CWERAGE IS UNLAWFUL AND SHALL SUflIECT AN EMPLOVEF TO CRIMINAL PENALTIES FN� CIVIL FlNES UP TOONE MUNORED T71IX1SAND DOILARE (5100,000� IN ADDITION TO THE C06T OF CqAPENSATION, DAALIGES AS PROVIDED FOR IN SECTION 3/060F TME LABOR CODE, IMEREST, PNO ATTORNEV'S FEES. LICENSED CONTRACTORS OECLARATION: I �erehy aHirtn thet I em force end ettect Lic. k_ ContrectoYs Signelure: ot ChaO�er 9(commencing with Section 7000) ot Dlvision 3 of tha Busln�s,sZenOtl Professlons Code, entl my license is in lull Class q �-- n Da�e: � /� i r�.�y(;, CONSTRUCTION LENDING AGENCY: ❑ I here6y aHirtn t�ei there is a construciion lentling agency for the pertormance ol ihe woM for which ihis permit is issuetl. (Sec. 3097, Civil Code). Lenders Neme: Lenders Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aMirm ihat under penalry ol perjury Ihet I em EXEMP7 FROM 7HE CON7RAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business end Prafessions Code: Any ciry or counry which requires e permit to consiruct, alter, improve, demolish, or repair eny siructure, prior to its issuanca, also requires the epplicant tor such pertnit to file e signetl statement that he or sha Is Ilcensed pursuant to the provisions ot the Contrectors License Law (Chepter 9(commencing with Sectlon 7000) ol Division 3 of t�e Business end Professlons Code) or lhat he or she is e:empt iherefrom end Ihe basis for the ellegetl e:emption. Any violetion of Section 7031.5 by any applicant For a pertnit subjects the epplicant to e civil penalty c� not more ihan five huntlretl tlollars ($500).): � 1, as owner of ihe property, or my amployees with wages as their sole compensation, WILL DO 7HE WORK, and the structure is not Intended or oHered tor sale (Sec. 7044, Business end Professions Cotle: The Coniractors License Law dces not apply to en owner ot property who builds or improves ihereon, and who does such work himself o� herselt or through his or her own employees, provided ihat such improvements are not intended or oHered for sale. It, however, ihe building or improvement is sold within one year of completion, ihe ov+neabuilder will have ihe burdan ol proving that he or she tlitl not 6uild or improve lor purpose of sale.). ❑ I, as ownar of the pmperty, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the project (SecJ044, Business antl Protessions Cotle: The conirectors License Law does not appty to an owner of pmperiy who builds or improves Nereon, antl who contracts for such project with e contractor(s) license pursuant to the Contracbrs License Laws.). ❑ I am exampt untler sec. Business and Professions Code tor ihis reason: Signature: Date: Owner ID venfietl by dnvers license. ❑ Ves ❑ No Driver's License No. Expires: Vedfication of Ownership by (type of documem, i.e. - pwperry tac bill or daed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certity that no excevetion five (5) ar mare feet in depih into which e person is required Io descend, wlll be metle In connection with work aut�orized by this permit, end that no 6uilding structure, scaflolding, talsework, or demolition or dismantling ihereot, will 6e more then thiny-six (38) feet high. (Chep. 3.2, Grp 2, An 2, Sec. 341, Ttle B, Celifomia Adminisirative Coda). ❑ As awner-builder, I will not employ anyone to tlo work w�ich would require e permit from Ne Division of Intlustriel Sefety, es noted ebove, unless such person has e permit to do such work fmm the divlsion. Signature: Date: Divisian ot IndusMal Safery Permlt Number. CERTIFlCA7E OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certify under penelry of perjury tha� I �ave read this application entl state that tha infortnation given Is correcL I egree to compty with all stete laws end ciry ordinances relating to building wns�ruction, and authorize representatives ot the Ciry ot Coste Mesa to enter upon the ebove-descnbed property for inspection purposes. I agree not to occupy or allow occupency of eny 6uilding authorized by this permit until finel inspection. �� — gnature Ot Legal Owner(s) t+ �' /ZC/' O�Date 'C / And/Or Auihorized Applicant 3-F Date CQOE �. INSPECTIONTYPE 1616 Fixed System Final Fire Prevention 1286 Pool Spe Finel 200 Flnel fie-Rool 201 FIneI BIaWRetelning Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demalltion �jE �¢ �( INSPECTIONTYPE / ps¢, 206 Finel Mechenical Q�� ^'� 1 fc_if.«_� 208 210 212 220 222 250 Final Plumbing Final Eleciricel Finel Fire Prevention Finel Planning Approval Final Slle ' Final Building/Occupancy 1 r t � 0 Y -- J•�qmio'd� ��ia� �sa-sz�s • Fex pia) �sa-aess Job Address: Suite: Viciniry: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT 3484 QUEENS CT HOUSE & GARAGE Parcel Number: 41204273 Applicant: SELL ROOFING COMPANY Address: 17072 ROSEBUD YORBALINDACA--; /% '� _ :�, �- -'C-i Owner. MILLER; KENNETH (Vl TR ' Address 3484 QU�EENS,CT � � ' /�l� �� ' ��: �\ \ / ��fCOSTAMESA;CA _ ii/� � � ,�� .'/ �, Contractor:/ SELL . Adtlress: �17072 F �:�-� � � �,. /> / �'�"„ YORBA ; , +- ,' Zipi 92686� : ,, � � Arch _: � ' � �!� � �Address' �' ;� .'�/, " � . i� i t, i F- Zip: / , . . ��:� �. . CA BUILDING PERMIT Zoning: R1 R1 PERMIT NUMBER 1/6 9 9-0 1 41 8 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 09/07/1999 Issued: 09/07/1999 ISSUED BY: ; -Phone[- 714=9933328; -', . � 2ip: -92686 � - • `- < > ' � � � �� / �, \ Phone _ - — - _�` - � : V� _ � ", ' \. . - Zip: 92628� `�� _� �' '� " � �\ -i\ � �� •�_ �-�� , � - • � ��A��_ � �.! '��V" � �: `,: � � � i Phone: 714-993-3328 � �� '� �� Licensei� 323842 � ,'� - , � � � .:.. �- � .:' En9� ' � ` �. . ' i . _ Address: , � � '� -Phone:�" � --' � Phone:. . ,!�`i ' - ' ' _ t%� �" . . , . ' �. -_ -License: �=�j" � �( License: ' � �> . �: , � " �� " SCOPE OF PERMIT �V ` ' , � REROOF - T/O, INSTALL i/2" OSB BOARD, 2 LAYERS OP 30# FELT & NEW ICBO #4660 EAGLELITE LIGHT WEIGHT / TILE ROOF. �. _ . , . � . .. _. . . . . ... , . � „ .. � . ` FEE SUMMARY . � Plan Check:' $0.00 �� • Calc Valuation: � � PermiY. f $167.25 l„ �_,.a,..:,, --- ,�J,��'-� ✓l:•t: Claim Valuation: ` SMIP Res. . $0.89 _ . - , ,j 1 : . � SMIP Com: ` ,� $0.00 i j � � "Other �'�� $0.00 � _ __ _- �, �Inspection: � �,;��$0.00 � .. ._ - - � � �` % ,� . � '` Totai:` �$168.14 � � ' � � ' � � � `�� •� PLANNING & ZONING � � ' � � SETBACKS � �'>, � �! � � , . MAINSTRUCTURE Front 0-0 � �.-Rear 0-0�_ Lek� 0-0 ACCESSORY \��_Front-' 0=0 �i �Rear 0.0 �- � , .Left �0-�0 �- �� .. �' .. .._ � � PARKING Existing: \ 0�' ,. Required: o Proposed: o NOTES: - �- � " . �'. - �Right 0-0 � Right ,0- 0 �� ' v .5s,soo.ao $a,soo.00 � � �; 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. . ' INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work mus� comply with all applicable codes, and all requlred Inapectlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration ot this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of per�ury one o1 ihe tollowing tleclaratlons: ❑ I heve entl will melntain a cehificate ot consent to selt-Insure for workers' compensetion, es provitletl for by section 3700 of the Labor Cotle, tor the pertortnance of the work tor which this permit I5 issued. ❑ I have end II malntain workers' compenset insurance, as requiretl by sectlon 3700 of lhe Lebor Code, for the pedormance of the work for which Ihis pe �t is issued. My warker n 1r�F§nce cerr' and policy number are: /� �� / � �e«�a�: g,� PolicyNumber: 7 (Thls secf�on neetl nof be com /eted il Ihe perm/f is veluetl et ane hundred dollars ($100) or IessJ ❑ I certity thet In the peAormence of the work for which this permit Is issued, I shell not employ eny person in any menner so as to become subject to the workers' compensation laws ot Celifomia, gree ihat if I hould become subject to Ihe workere' compensation provisions oi Section 3700 of the Lebor Cotle, 1 shall fonhwith comply with these provisions. �^/ �� O Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEfiAQE IS UNLAWFUL ANO SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNORED THWSAND DqlARE ($100.000), IN ADDITION TO THE COST OF COMPENSATION, �AMAGES AS PROVIOED FOR IN SECiION 310fi OF THE LABOR COOE, IPREREST, AND ATTORNEV'S FEES. LICENSED CONTRAC70RS DECLARATION: I hereby aHirtn that I am licensed untler visic force and aflect. Lic. N_----------- E�F�-.c Coniractors SignaWra: (commencing with Section 7000) of Division 3 of ihe Business antl rotessionsc �Code, and my licensa is In full Class k � — �J / �- 9 Date: /�— �(—� CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm that there is e consiruction lending egency tor Ihe pedormence of the work tor which ihis permit is issuetl. (Sec. 3097, Civil Cotle). Lender'S Name: Lentlefs Atldr855: SignaNre: OWNER-BUILDER DECLARATIONS: Date: I here6y aftirtn ihat under penalry oi perjury t�et I am E%EMPT FROM THE CONTRACTORS LICENSE LAW tor �he tollowing reason (Sec. 7031.5, Business antl Protessions Code: Any ciry or counry which requires a permit to consWcL alter, improve, demolish, or repair any strucWre, Pnor to its issuance, also requires ihe applicant tor such permit to tile e signed statement ihat he or she Is licensed pursuent lo the provlsions ot ihe Comracrore LJcense Law (Chapter 9(commancinq with Section 7000) of Divislon 3 ot the Business antl Professions Cotla) or thet he or she Is exempt Iherelrom entl iho basis tor Ihe alleged exemption. Any violetion of Seccion 7031.5 by any eppliwnt for a pertnit sub�ects the applicent to e civll penalty of not more than Ilve hundred dollers ($500).): ❑ I, es owner of the property, or my employees with weges es t�eir sole compensation, WILL DO TME WORK, and the structure is not intended or otteretl for sale (Sec. 7044, Business and Professions Cotle: The Contreciors License Law tloes not apply to en owner ot properry who builtls or improves thereon, and who does such work himself or harsetl or through his or her own employees, proWtletl �he� such improvements are not intendad or oHeretl for sale. If, however, the building or improvement is sold within one year ol complation, the owner�bullder wlll have the burden oi proving thet he or she did not huild or improve for purpase of saleJ. � I, as owner of t�e property, am E7(CLUSIVELV CONTRAC7ING WIT}I LICENSED CONTRAC70R5 to consiruct iha project (Sec. 7044, Business antl Professions Code: Ttie contrectors License Lew does not epply to en ownar oi property who builds or improves Ihereon, and who coniracis for such project wi�h a coniractor(s) license pursuant to the Coniractors License Lews.). ❑ I am exempt under sec. Business end Professions Cotle far ihis reason: SignaWre: Date: Owner ID venfied by dnvefs liCense. ❑ Ves ❑ No Orivers License No. Expires: Venfication of Ownership by (type oi document, i.e. - property tex blll or deed): DIVISION OF INDUSTRIAL SAFETV PENMIT CERTIFICA710N: ❑ I �ereby certlfy thei no excevation five (5) or more taet In depih into which e pereon Is requlred to descentl, will 6e made in connection with work authonzed by this permit, end that no building structure, scettolding, felsework, or demolition or dismantling thereol, will De more than thirty-six (36) feei high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, California Administrative Code). ❑ As ownervbuiltler, I will not employ anyone to do work which would require a permit from the Division of Intlustrial Safety, as noted above, unless such person has a permit to do such work Irom Ihe division. SignaWre: Date: Division of Intlusirial Safety Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I certify under penelty of perjury that I have reatl Ihis application and state ihat ihe information given is correct. I agree to comply with all stete laws end ciry ortlinances releting to building construction, and authonza representatives of �he City of Costa Mesa to enter upon Iha above-described properry for inspection purposes. I egree nol to occupy or allow occupancy oi eny building authorizetl �y this permit until final inspection. S' a re/OLt Legal er(�v �_� Date rt� f� � j A Or uthonzed Applica t Date 40UE �. INSPECTIONTYPE 1616 Fi:ed System Final Fire Preventlon 7266 Poal Spa Finel 200 Final Re-Roof 207 Final BIacWRetaining Well 202 Finel Feclory Fire Place 203 Final Sign 20d Final Damolition 2448-48 QA�f. �$ COOEI INSPECTIONTYPE 206 Final Mechanical 20B Final Plumbing 210 Final Elecirical 212 Final Fire Prevention 220 Finel Planning Approval 222 Final Site 250 FinalBuilding/Occupancy P� IMITIALS � � PflOJECTR0UPE55: 34BA OUEENS CT u"iT: OWNEfl'SNFME: SANDERS, HURTON PARKER nooeess: SANDERS SHARON L 3489 QU�ENS CT COSTA MESA,CA 92626 APCN/ENGINEEP: L EONARD H EK EM EY ER REG.NO.: C O nooeess: Z1062 HROORHURST uxir: H.B. CA 92646 PEXMITTEE: LOREN WATI(INS ( 714 ) 841-2521 nooxess: 7891 ELLIS 1 NUNTINGTON BEACH CA 92648 LICENSEO CONTBACTOfl DECIABATION: 1 �ere0y a�hrm ItWI I am IiCenSeG unEe� pmN5ioR5 0l CIId Ier rtrencinp wii� Section 7000) ol Oivisian 3 ol ��e Bu5me55 anU Pmiessions Cotle. anJ my license i5 in full lorce an0 etfe . ciTxuc. 0560'�7 sTnreuc.:61633" �Ss B oare:_��_^.(�� signatu . _ _ _ _ � wOBNEHS'COMPENSaTI0N0ECtAMT10N: Inereoy Iirm�hatltwveacenilirateofconsenitosell�nsure rattrtilicateafWorkers' Compensalian Insurance. or a cendied copY ��areof �Settion 3800, LaG. t). POLICY NO.: EXP. ORTE: COMPFNY: I] Cenifie0 copy is Aereby Iurnis�eG. ❑ Cetlifietl copy ¢ filM with ihe ury BWIOmg Oivision. �a�e: Ap0licanC E7(EMFfION iflOM WOPKEHS' COMPENSRTION OECIAMTION: (ilus secnm mN rol0e mmpletd ii Ne pamt is �a are twn 0� a less�, I t¢Niy fhat in �he petlormance ol ��e wOrk �or wNtll tN5 permi� i5' eG, l'�lyall n0i employ any rs n i n an r �0 �etome su�l�� o� orkers' �D� n5aii �w7s 0�� Calitomu. oate: '/ LSiCnature: 1 , NOTICE: II. al�er maiting I�is 6 cWraiion, }rou shoul0 become 5u jttt �o tlre WaAers' Compensalwn Orovisions o Ihe Labor '� Cotle. y0u musl fanhwit� compty wit� sut� pra'nuons ot itos perrtut Shall Oe GeemeG revake0. LONSTNUCTION LFNOING AGENCY: I �ereGy allirm �Iw� there 6 a conSWcibn Ien0in0 aqency lor IAe petlarmance of lhe work lor wAic� Ihis permn is issue0 �Sectian 3W7. Gv. C�. LENOEN: POOflE53: OWNEB BUILUEB OFCLAMTION: I �ereEy aifirm ilwt I am exempt Imm the Coniractars' SWte License Law lar �he lollowing reason (Section 7031.5 Business ane Pmlessianal Cotle: Any cily al county wNcn reQuires a permit m consimct, alter. imo�ove, aemolisA, or rtDair any SVUCIme. Orior IO ils i55wnt0. a150 repuires �tre apqiWni br SuU perrtni �o lile a 5ipneG SlatBm¢ni Ilul Aals�e 6 Ik¢nutl pursuanl to I�e O�ovisions ol tne Conuatlors' Slate License Law (Ctwp�er 9(wmmencinq vni� Seclion 70W) ol Uivision 3 0l t�e Business an0 ProfeSsions Co0e) w tlWt h¢/sne ¢ aemp111Rrefrom ana tM Ea56 lor Ine aneqN eKempti0n. My vaWiiOn ol $ecibn 7031.5 Gy any applicanl for a permil suGlecis Ihe appliCant to a civil penatty ol nol more Ilun Irve IlunGreE Uollars (5500). I. as owner of ine O�ooeny or my employees wit� wa0� as t�eir sole campensation. will Oo Ihe work, an0 tAe ❑ strucwre is not intenEeE ar aflered for sale (SecUon 70aa. Businas an0 Pmteuional Cotle: The Contractori Siate Licensa Law Ooes nol aDDN �o an owner o� a Dropeny wlq buil0.5 or im0�oves Itleredl. dntl wlq OOes sucll wark 1limsell/lierull or t�wup� . his or �er awn employees. O�ovqed ilui suc� improvementt are no� intm0e0 w otlwe0 lor sale. II, hovrever iha OuilEinp or imD��'emem is solC wit�in one year ol comple�ion, t�e wmer wi0 luve t�e EUNen of provinp �Ushe EiE noi 6udA ar imprwa toi Ine purpose ol Satel. i. as owne� oi ine pmoeny, am e�Uusivery convaclin0 �� licensed wnlractors to constmct ihe O�oh�� 1Section 70G4, Business ❑ aiM Protessims CoGe: TAe Convactors' State licerue Law Gces mt apqy to an wmu al prope�IywM EWEs ar imprmes Nereon an0 wno contracts loi wcn projecis wiN a tAnVactorlsllicense pursuanito ine Cantraclors' State Ucense Law�.l am awam Ilui pr0ot ol tneir worker's COmce�� aMe SMWO Oe prOviEeO to me. I� I am exempt unCe� $etiion: B. 6 P. C. lo� IOis r¢ason: Da�e: Oanar. I CO �er¢Oy teridy Ihai I am awar¢ 0� an0 un0er5WnG I�e rCquirtmeni5 ot CalitOfNa HWtA an0 $al¢ry Coae $e[liai6 25505, 25533, an0 255� anG tlui 1 ar any WNre OuilOing OUupant vrilUwill no� (drde one) neM b Comph/ vn�� SaiG s�a�e mGes anC I�e repuirem¢nis for a permil lor consimtlion or mo0itiwlion �mm I�e Air Ouatny Managemenl GsVrci, fle5i0entul camiruc�ion appfiu�i0ns ar¢ eKempt IrOm inese omNSions. _ Oate: MWrcani: _ I �ereby ceilily Uu� I have reaE iNs aD0licaiion ana Sta�e IR or0uwrces anU sWie laxs rebiing to GuilEing mnSUu[iion aM pmper�y '��Specli0 Wrpose5. �a;e: � � � Sgnaiwe: _ Driver's Gcense a� Sacial Securi�y e: Io I6a1<6 Whi�e—Buibinp; Green—CaEe Entor[emenl Canarv—MdicanC Pmk—Revenue: GoWenrotl—Aceesurt < CITY OF COS'TA MfiSA — BUILDING P�RMIT PERMIT NO: B 059488 PLAN CHECK NO; 03954-92 A CONSTRUCTION TYPE; PERMIT TYPE; STR JOB DESCRIPTION : ADD 351SF LOFT OVER EXIST LIVING ROOM PERM NO; H 059468�` GOVT; N SUPP; N PURPOSE: ADD SQ FT: 351 CLAIM VALUE: 5,000.00 CAI,C—VALUE: 5,194.80 GROUP OCC: R-3 / COMMENTS; X �rx��r�*�r**#��r�r�r*rt�rx*x�x�r�r****x��t*ar�r*�e�r�r*�rx�*�tx��xx�� *�x##�r#x��**+�**xx+t*x**x**�rxx�**�u 2 O N I N G R E Q U I R E M E N T 5 5 E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- 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 REO• PROV: PARCEL: 41204273 ZNE; PDRL REF NO; PLANNING NZST'ES> CONVERT EXISTING CATHEDRAL CEILING ARcA ABOVE LIVING ROOM > INY�O A 2ND STORY LOFT, COMPLETELY INTERIOR WORK, **��r�r�t*�t+r�r+r�rx�*�r�r**�r�**�**x**��t*�r*********�r�+t*�r*�rx+��r***��*�r�t�r�x*�t*�r*�r*�r��***#� 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 APPROVEA HY %; �C� DATE: � o l',� �'�— BUILDING APPROVED BY : DATE: i� APPLICATION ISSUED BY; �-�' DATE: �0 3 � ifi(�ifitiFiElEiFifikklfkiFiEkifiEit�ifiE�3FiF3F3FiF7FTr�'t�iF�F+—F�3FiF'iFiF3F 3F3aTtiF3FiFi'+t+txiFkitikiEikiFikit#ft , �rf f r �r if *�*�rft�ritxx****�r**�itiF*�ft�*��r*#*�r�tx **�r**ititx***�x�*�it*##it�x�*at*it*�*�rx *+tit�ft�*�*****#x-* LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMI'T 81,00 ,52 SMIP/NON—RES PLAN 13.16 IS5UE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL — PAID DUE TOTALS----> 81.52 0.00 13.16 94.68 ��94,68 ,00 REVENUE DIVISION TO?'ALS--> COLLECTED; 81,52 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT�"GRADZNG PT.AN—CHECK Q1,�� ,52 �: 1f iE #!f 1E # iflE 1f if ff fk if iElf If� 1f i(� ff 1f iE iE 1E if ff ik 1f ih iE 1! 1l�ElE iE iE iE iE 1f # fE Ik iE f6 if 1! iE k!f ik M� IE ff fE �lf it ik iE if IE 3k!(� iEiE iE �1f- #!E 1! ff iE If 1E tE iF ## iE # 1f I N D Z V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 351 RES—BP�LCONY, EXTERIOR STAIRWAY 14,80�� 5,194,80 END OF FEES . q• [XPIRED irwomple!e lns;,ection, �H(C -- S�B ._ CONSTRUCTION AND PLANNING P�"' `& SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date inspector 1. Temporary Etectriwl Service ot Pofe !� 52. Pool & Equipment Location , `- 2. Soil Pipe-Undrgrnd. �� 53. Steel Reinforceme�t 3. Electrical Conduit Utility�Undrgrnd. �� 54. Forms � 4. Electriwl Conduit�Undrgrnd! , 55. Electrical Bonding � 5. Steel Reinforcement , 56. Rough Plumbing & Pressure Test F' 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE 7. Footings �' 58. Electrical Conduit•Undrgrnd. � � 8. Fouadauan �� • 59. Gas Pipe, � Undrgrad., Test ' 9. Water Pipe-Undrgrnd. s, '�� - 60. Backwash Lines, P�Trap, O Undrgrnd. y `1 10. Structural Floor System � ` 61. APPROVAL TO DECK � 11. property Sewer Line & House��onnection 62. Backwash & Receptor�Final � %a 12. Sewer Cap �' • 63. Heater & Vent-Final 73. Roof Drains >.�> `� � 64. Plumbing System � Pinal •' � 14. Rough Plumbing �?.-?'%' .�"� 65. Electrical•Final 15. flough Electrical-Con 't`�� ' 66. Solar System-Final � i� 76. Rough Electric Wiring � �' .;, 67. Fencing & Access ApProval 'S i,� 17. Rough Wiring Sign '`� 68. APPROVED FOR PLASTERING �� ' 18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Firepiace APPROVALS Permit # 21. Ducts, in Structure • 70. Underground Hydro 22. Ducts, Ven[ilating 77. Product Pipin9 O Gas � Oil 23. Gas Pipe•Rough 8i Tes[ 72. Underground Flush 24. ftoof Framing 73. Undergrnd.StorageTank �Gas OOiI 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling �Structurap & Monocoat 75. Dry Chemical 27. Frame and Flashing �_7'7�qL ��. �6. Dry Standpipc ��[ ( 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing �� L � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION 32. Electriwl Power Meter•Final t S0. FOOD CERTIFICATE ISSUED 33. Final Electric i � � Notes: 34. Final Heating & Air Conditioning I 35. Final Gas Pipe-Test � 36. Hood or Canopy � � 37. Final Factory Fireplace , • 38. Final Plumbing i i 39. Wate� Service-Final 40. Gas 5ervice-Final I � t' 41. So{ar pomeStic�FinaV � i � 42. Backflow Preventer � , E r p �� F p .' � r 43. Backflow Irrigation 'e r�SP�CY7W75 44. Landscape Irripation System �e -�( ��--��„� S�g 27'^ _ (�C 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING � f: 1 48. FINALPLANNING 49. Elect��c Release to Edison � � � 50. Gas Felease to Southern California Gas Co i 51. CERTIFICATE OF OCCUPANCY No. Date Pfl0.1ECTRDOflESS: 3459 pUEENS CT OWNEfl'SNRME: WILLIAhlS KEVIN L TR aooness: 3989 QUE�NS CT ' GOSTA MESA,CA 92626 ARCM/ENGINEEfl: 5 5 6— 4 4 8 a nooness: HEG.NO.: uxir: uxrt: PERMinEE' SANTIAGO A/C INC. f 714 ) 998-1600 aooeess: z31 W, BLU�RIDGE AVE. (�pj��jQ�` CA.42 6 LICENSEU CONTflACTOADECGFAT10N: I �ereby allirm t�at I am I ens unaer pronsions o hap er 9 �rommencing wi�h Section 7000) ol Oiuision 3 0� I�e Business ana Prolessions Cotle, and my li n s in full for[e anA efleci. arxuc.:00798� srnreuc.:269496 — 0 Dale- SiAnature: � — WOBK 0 PENSRTION OELLABRTION: I �ere�y aifirm ��at I have a ceniliwte of consent to selbinsure or a certifiwte ot Workers' Compensation Insurance. ar a cenilietl copy �Aereo� (Sectian 3800. �. q. eoucrNo.: W-9732051 EX" °"T'' 7JO1192 COMPANY: pAC STATES,CAS ❑ C¢nifietl copY is here�y Wmishetl. Ljt Certifietl coDY is with t� cit i'on. � Date: � � d Applicant: E%EMPt10N FPUM WORREPS'COMPENSATION OECIAPRTION: R stt�ion neeE no�EecomDleteaiithepermitisloronehunArea�5�00�arless�. I cerlify Ihat in IAe periormance ol t�e work lor wAich I�is pelmi� is iSSueJ. I stlall noi employ any person in any manner so as lo become �� subject to Ine workeri Comoensation Laws oi Calibmia. ' Da�e: Siqnamre: NOTItE: It, alter making Ihis tleclaration, you snouid became subiect lo ine Workers' Compensation pmvlsions of tAe La�or Code. you must lorthwil� comply wiih suc� pmvisions or ��is Dermi� s�all be 4eeme0 revoke0. CONSTBUCTION LENOING pGENCY: I hereby a��irm Iha� there is a cons�mction lending agency for the pedormance ol �he work for w�ich this Oermit is issuetl (Seciion 3097. Civ. C�. LENDEN: RUONE$$: OWNEB BUILUEB OEClABR710N: I hereby allirm Ihat I am exempt Iwm Ihe Coniractors' State license Law br Ihe following reasan ISemion 7P7t.5 Business and Professional Code: Any ciry o� wunry whicli requires a permit to consimct, aller, imDmve, Oemolish, or r¢pair any Slmtiure. prior �0 i�i ii5uante. ats0 repuire5 �he aDDlitani for SUth permil Io lile a Signetl Slalemeni Itw( he/S�e is licensetl pursuanl 10 I�e O�ovisians a� Ne Comratlors' Staie License Law (CAapter 9(commencinA ��h Section 7000) ol Uivision 3 0l the Business antl PmlesSioni Cotle) or Ihal �e/She i5 eXempl l�efelwm antl Ne ba5i5 lor Ihe alle0e4 e�emp�ian. Any nolali0n o� $eClion 7031.5 Cy any applicanl lor a Dermii sublects �he applicanl to a civil penalty ol no� more I�an �ive �undred dollars (E500�. I, as owner oi the proDehY or my emVloyees with wapes as iheir sale compensation, will do the work, and ihe ❑ strucmre is nat imenEeO or ouereU lor sale (Set�ion 7047. Busineu an0 Pm�e55ional CoOe: The COntraC(Ors' S�a�e License Law Eoes no� appty to an owner o� a pm0eriy wM builAS or impmves therean, anA wtq Ooes such work himself/hersel� or ��rouAh his ar h¢r Own employee5. pmviaeE Ihai 5ut� imp�ovemenls are not inlen0etl or Off¢re0 for sal¢. If, tpwev¢r Ihe builEing Or impmvemem is wltl xilNn ane y¢ar ol tompletion. the ovmer vrill have Ihe buMen o� O�oNnp �Ushe Oi0 noi DuiW or im0�a�e tor Ine ourpOse ol sale�. I, as owner ol the propetly, am exclusively contracimg wiih licensed contracmrs m consimct tAe D�olect (Section 7044, Business ❑ an0 Pmleuions COOe: The Conlraclors' Sta1e Liten<e Law Eoes not apply la an owner of D�openy who huilds or im0�oves ihereon and w�o comracts �or sucA O�ojects wit� a contracior(s� license pursuanl �o ��e Cantrac�ors' Slale License Law). I am aware t�al prool 01 Iheir Worker's ComDenialion in5urante S�oUltl Ue O��detl Io me. � I am exempt untler Setlion: B. 8 P. C, for Inis reason: Daie: Oe'ner. I Oa hereEy tendy Inat I am aware ol and unAersiana tne requiremenis of Californu Healih and Safery Ca�e SeCtions 25505, 25533. aM 2559A anG Uut I or any fuWre GuilJing o[cupani vnll/vnll noi (��«le one) neeG to compry vnth sai0 staie cOGes antl Ihe repuirements �or a permil br conslmction or motldica�ion �mm �he Air Oualiry ManaAement DisVitl. HeS�Gen�ial cons�mclion appliwtions ar¢ exemp� imm Ihese OroviSiont � Da�e: ADOlicanl: _ I here6y terlilylhai Ihave t¢aA I�is applitation anA S�a�e th� ordinances an0 slalelawsrela�ingto Ouilaing cons�mdion anA pr pe�y lorinspetlmn purpOs¢5. �� b�{� / Signamre: _ r er's License or Socul Securiiy r: �� t6aPa6 Whne—Builtlina�. Green—Cotlu correc� la comply wi�h allci�y an0 Cauniy uiv rstilyloemeruponlAea�ove�mentionea Canary—Hoolicant; Pink—Revenue: GOlaenraE—Auassar CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 05771 PERMIT NO: M 057718 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRDCTION TYPE: V—N PERMIT TYPE; MEC PURPOSE: NEW JOB DESCRIPTION ; INSTALL A 3 TON AC UNIT SQ FT; CLASM VALUE; CALC—VALUE: GROUP OCC: R-3 / COMMENTS: NO OTHER WORK PERMITTED ***�**+�+�**�ex�****+�+�*�r��******�r*�x �*�*****�*x*****x****��*�r*�**�r**�****x��r******** 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 S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- 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; 91204259 ZNE; REF NO: PLANNING NCSTES> i if �1F iE �E if IF iF iF iE if 1E 3k it jf if iF iE ik iF K if iE iE i!!! ik iF k k�)f �)f ik if IE iE iE if M iF k if iE if 1f iE �k �lf if �lE �k if �EiF af if ik if ik i! ik if iE �F 3F IF iF iF iFif 1f iE ik iFiFiE if ik �t �f D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : " DATE; APPLICATION ISSUED BY• %� DATE• ih iE 3E iE iF �E �E iE iF if i4 iF k k�E 1f if iE it �k iF k 1f i! k iE if if ik ff iF 3Eii�F��'$if if M ik iE �lk iF k�lE iF 3f ik if k iF k if iE M k if iF it k if �f fklf �! 3E IE if if iE if k k iE iF If if il�f iE k if if if if k if 3f if iF IE �f M iF if k If �E iF if �F�FiF 3F k jE iE if �f k iF �t * It M 1! k LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N PERMIT BLDG PMT PLUMBING ELECTRIC MECH9NI�C� FIRE SMIP/RES GRADING �252 SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID D[7E TOTALS----> 9,00 15,00 0.00 24,00 24,00 .00 REVENUE DIVISION TOTALS--> COLLECTED; 24.00 OVER/SHORT; 00 BLDG PMT PLIIMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECIC 29,00 k iFif iF iF �lF #if if M iE iE k�E k if k iE iE iE ik iF ik k 1! if �k 1E iE if k 1E iF if iF iE k if iE �F iE iE if iF if if iF IEk i! iF k 1t if �f if 1f 1E if 3E�E iF if iF if if if 3F if iF k fF IE af iF iF it �f 1E I N D I V I D U A L F E E B R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 INST FORC—ASR/GRAV FURN <= S00 K BTU 9,00 9,00 END OF FEES ��r;Si�, � . .' , . CONSTRUCTION AND PLANNING POO� & SPA APPROVALS Permit # Date Inspector qpPROVALS Permit # Date In:pector t. Temporary Electrical Service or Poleti 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. , � 53. Steel Reinforcement �`3. Eler,tricalConduiLUti�lity-Undrgmd� 54. Forms .�.4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding -S�Steel Reinforcement 56. Rough Plumbing & Pressure Test :5. Electrical UFER.Grnd. . 57. APPROVAL TO COVER�GUNITE . �� Eoatings 58. Electrical Conduit�Undrgrnd. ,$, �oundation �- � 59. Gas Pipe, O U�drgrnd., Test ' 9. Water Pipe-Undrgrnd. - �' � 60. Backwash Lines, P�Trap, O Undrgmd. 10.,Structural Ploor Sjcstem � ,� ' � 61. APPROVAL TO OECK . 11. Property Sewer Line & HoUse Connection - 62. Backwash & Receptor•Final . 12. Se�er Cap ' 63. Heater & Vent-Final 13. Roof Drains " 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Ftnal 15. Rough Electrical-Conduit 66. Solar System-Final i 6. Rough Electric Wiring 67. Fencing & Access ApProval 77. flaugh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough ElectricaFT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. qEQUIREMENT - _ - z 20. Rough Factory Ficeplace ��. �. - _ _ * APPR(}VAL'S';"'Permit # ! 4. _ _ 21. 'Ducts; in Strueturg � . ". � - � 20. Undergrpund �HYdco 22.Ducts,Ventil2ting - - • '- �•�' 77,ProductPipin;gOGas OOiI 23. Gas Pjpe�fiough & Tes[ , . � ,. 72, Undergroupd�Flush, , � 24. Roof-Framing ' - - � '93. _llndergmd�:StorageTank OGas ❑Oil 25. RootSheathing , � ' . `i4,�verheadHydro � 26. T-BarCeiling (Structural) & Monocoat . - ' 75. -Dry Chemical � - , 27. �Frame and Flashing .. . i; , � ',' 76. Dry Stand`p�p� '� �' n t 3 28. Lathing & Siding - . t�,r _ . • - � � 77, _FIXED SYS�EM F,kNA�- 29. Insulatiori . " "� , ., 78.:FIRE PREV. FINAL � • • it0. Drywali Nailing • � �+ � HEALTH �EPT.fiEQU1RENIENT 31. Plaster Brown�Coat ' �. � � F 79.'FINAL INSPECTION ,' ' � �32.�Electrical Power Meter'Final . , � I:;80. FOOD CERTIFICATE IS9UED � s. 33. Final Electric: ' � � � � �rNotes: _ �' ' � s � 34. Final Heating & Air Conditioning , /�/Z7/p�/, / (.: < �r , _ _ , .. V� �� Z ��c. .+ r 35. Fnai Gas Pipe-Test � � �K _, � . r .. . 36. Hootl.or Canopy ' _ , - `�c; �� •�- 37. FinaPFactory Fireplace . ` . � - ' 38. Final Plumbing � �. � � .> � �� 39. Water Service�Pinal � ' - � � ` 40. Gas Service-Final �. � . ' - � ` ' -- �. _ . +41. Solar pomesticFinal .S • � ' ' ! i� - - 42. Backfiow Preventer ' ' I i � - -� - � 43. Batkflow Irrigation � ' ' i '`' �+ � 44. Landscape Irriqation�System . • - s ... 45. �Sound Attenuation ' '-�� 46. Handicap,Regulations � � ' , " : . 47. FINAL STRUCTURE & BUILDING ' � - � 48.fINALPLANNING. � '" � - 49. �Electric Release to Edison - � ` ^ '�. �� " . r50. Gas Release to Southem Califomia Gas Co f � - ' ' 51. CER;TIFICATE OF OCCUPANCY • , .. � � , - No. Date OWNEfl'S NAME: aooeess: COSTA MESA,CA NHCHIENGINEEN: �'!'4�557—a�16 aooness: LEZGH 92626 NEG.NO.: �.- uNir: CITY OF COSTA MESA — BUTLDlNG PERMIT PERMIT NO: B 053275 PLAN CHECIC NO: 02432-91 L CONSTRUCTION TYPE: 5—�N PERyIT TYPE: STR uxir: PeAmirrec: KEVIN L. WIL.LTAMS ( 714 ) 557-8816 aoosess: z489 QUEENS COURT COSTA f3ESA CA 92626 tICENSEU CONTRACTOB OECLAHATION: I hereby affirm �hal I am licensetl under pmvisions ol ChaO�er 9(commencing wi�A Seclion 7000) of �ivision 3 0l ihe Business antl Pmfessions Code. anU my license is in full force anA effect. CITY LIC.: !STATE LIC.: CIASS: ' �ale. Signa�ure: WOFKENS' COM7ENSRTION OECLAHPTION: I herehy aifirm I�al I have a certilicate o� consenl Ia seli�insure or a certiticate o� Workers' ompensaiion Insuronce, or a cenified copy Ihereai (Sec�ion 3800, lab C) �LICV NO.: EXP. OATE: Ceriifietl copy is hereby luinishetl. ❑ Certilietl copy is �ilea with �he ciry BuAtling �ivision. �ate: Appiicanl: E%EMPTION FBOM WOPREB$'COMVENSATION OECLl�HATION: Qhi55e[tion neetliw�becomple�edilihe permili5loranehundre0�5100�orless). I certity Ihal in Ihe petlormance of �he work for which I�is permi� is i55ue4 I shall no� employ any person in any manner so as �o �ecome suhject Io Ihe Wo.kers' Compensalion Laws of Califomia. Da�e' Signaiure'. NOTICE: II, after making this tleclaration, yau s�ou10 6ecome suble�� o the Workers' Compensation provisions o� the Labor Cotle. you must Iorlhwii� compty'wl�h such pmvisions or Ihis permit s�all be�tleemed revoked. CONSTXIICTION LENOING BGENCY: I h¢reby allirm Ihal lhere i5 a Cons�mt�ion I ntling agency for �he Dedo�mante o� �he work �or which Ihis permit is Issuee (Section 3�97. Clv. C). ; LENDEfl: A�OXE55: � � i OWNEB BUILOEB OECLABATION: �bhere6y allirm �hai I am exempt �mm Ihe Conlractors' $lale License Law �or Ihe following reason 1 (Seqion 7031.5 BuSinesS and Professional Code: Any cily of counry which requires a permi� lo cons�mcl, alter. impmve, tlemolish. or � repau any slmclure. Orior lo iis issuance. also requires �he apPlicant for such permi� to �ile a signed s�atement �hai he/she is licensed pursuamtothe pmvisions ollhe ConVactors' Sta se Law(Chap�er9�commencing wi�h Section 7000)0l �ivision 3 o�the Business antl Pmiessions Cotle) or Ihat helshe is exem� 6a ' or ihe alle9etl exemPlion AnY violalion ot Section 7031.5 �y any applican� for a parmil sublec�s�he Applic ta a rv' ne f five hunOreO dollars ($500). I, as owner af Ihe pmpeny or m wi� ei ompensa�ion, will do the work, antl Ihe simcture is nai imendea or oifered �ar s i ,�Pw s nal Cade'. The ConVac�ors' State License law � does noI apPly la an owner oi a prope�y who bw p es Ihereon, who tloes such work himselUherseli o��hmuAh his oi her own employees. D�ovided tha� such impmvemen are no� in� a or ofleretl lor sale. If. hawever Ihe building or impmvemenl is soltl wiihin one yea� of completion. Ihe owner wi0 have I urtlen o� pmving helshe tlid not build or improve lor ��e purpose ol sale). I. as owner oi Ihe pioperty. am exclusivety conlracting wiih licensetl conVactars lo conslmci the prolec� (Section 70a4, Business � and PmIe55i0n5 C04e: The Coniraclors' Siale LicenSe Law tloes nOt apply �o an owner Oi Drop¢M1y who bullas onmpmves lhereon antl who coniracls for suc� pmle��s wit� a conlractoqs)license pursuant to ihe Coniractors' Slale License Law),I am aware tha� pmol ol Iheir Worker'S Compensation insuranre should be provided �o me. � I am exempi untler Sec�ion: ' B. 8 P. C. �or �his reason'. �^ pC� /� / Da� 'e �!'" 1/ � ! / � 0 ner: / 1�� / �� /./ , �� i °T— , I do hereby ceridy � I am aware of zntl un0ersiantl Ihe requirements oi Califomia Heal�� antl Sa�e�y CoOe Seciions 25505, 25533, antl 25534 antl Nal I or � ny Iuiure buil0ing occupant willlwill not (circle one) neetl Io comply wi�h said s�a�e cotles antl ihe requiremenis lor a permi� lor constmclion oi mo�ilicalion �mm �he Air Ouahly ManaBement �isMcL ResiAential conslmclian applications are exempt Imm ��ese ptOvi5i0n5. �a�e: AOPlicanL I hereby cetlity thai I �ave reatl this appl¢aiion and state that �he a�ove intormatian is correcl. I agree �o comply wilh a0 ci�y antl coun�y or�inances znA slaielawsrelatmgto builtling canstruciion antl hereby aulhorizerepre5entalive5 of��is citylo en�er upan�he above-men�ionea ^'�— .p�Opd�ly f0l IIISp¢C�iQp ppfp�5¢5. / l� l�ate: � / _ � � � 579na�ufe' ��'��,�/ i� � � i-� onvei�s �icense��l Sociai Securi�y y I�i64La6 Whne-6wltling: Green—Cotle EnlorcemenC Canary—Applican�; Pmk—Revenue: Goldenrotl—Assessor 1 PERM NO: H 053275 GOVT; N SUPP: N PURPGSE:� ADD JQB DESCRIPTION : EXTEND R7TCHEN (ADD BAY WINDOW) SQ FT: 40 CLAIM VALUE; CALC—VALOE; 2,760.00 GROUP OCC; R-3 /M-1 COMMENTS: SMORE DETECTOR(S) RE�UIRED IN HOME. ' ***x*��**��*�*#�**�*�r�**�*�*� *��**��***��**�x�****x****��*��*��+�-�***��*�**K* Z O N I N GS ERTEBQAUCII(RSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRN'T; 20 FT TN REAR; 23 FT 6 IiJ FRNT; FT IN REAR; FT TN LEFT: 5 FT IN RGHT: 5 FT IN LEFT; FT IN RGHT; FT IN PARICING REo � PRUV: PARCEL: 91204259 ZNE; PDRL REF NO: PLANNING NtSTES> 40rSQ, FT. ADDITION TO EXISTING RES. TO EXPAND KITCHEN Y 1F iE �lt� # jE jF 3e i43F 3t iF iE i/� aF 3f iF IF !F iF�t iF iF it it #�k itiE iE iE�](� iE 3E aE # 3k iEjE IE �lt if iE x��lE iF iPih if IE�1F iE k iE Mjt �Jf �F i6 �lt iF 1f �lc� N� 3f it * iF iF 3E fh# # if iF i6 ;F iF if it D E V E L O P M E N T 5 E R V I C E S R E Q+U I R E M E N T S ZONING APPROVED BY ;�`1 � �.� y DATE: �(yO�� I HUILDING APPROVED BY :_ � �) __ DATE; � APPLICATION ISSUED B ' s��,�� DATE: iFiE#iEiF�7FifiF1Flf1F7fiEiFlflFiFfE�1F'1FiF t �1E3(�#iEiFifiEiei(�if±l�'�'�F�if3FiF 9EiE�lFifiFiFiFiEiF#�IEkIE3E3ElEffiEaElEiFiFIFif#E�f#if�f#ikif�7FiF�lE�IF�lf�lf 3lM�if�aEl4iFiFiElElf#i4ifi4lF�lE#i(�.�Fif3E�EiFiFiFi!•#iE#�fif�)f�)(--1FiF#ie3fif LEGALIZATION;iJ F E E U M M A R Y STRUCTURAL SEGMEf3T;Y BLDG PMT PLUM$ING E CTRSC MECHANIC FIRE SMIP/RES GRADING PERMIT 54,00 50 . SMSP/NON—RES ISSUE FEE 35,10 BUSLDING—DIV—> PERMIT ISSUE PT.AN—CHECK 'TUTAL PA:ID ll0E TOTALS----> � 54.50 D.00 35.10 �89.60 89,60 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 89,60 OVER/SHURT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAiJ—CHnCK 54,00 .50 35.10 -1f iF 3t 3E iE 3E iF iE if if� 1E ik If ihif # iE iE iF # iFiE if iF iE if �lf i(� iE if if 1E'1F lE if iE iF1E if 3F 1f� iFiE iF#f' ii� iF if iF )k 1E i(� if iE it 3E if i( if iF iFiF �f if iE iF iF iF iE iF if iE 3F iF iE �7f �'. 3f� # I N D I V I D U A L F E E B R E A K D O W N 1'YPE QTY D E 5 C R I P T I O N UNIT CO�T TO,TAL COST SfiR 40 DWE—TYPE V—WOOD FRAME —GOOD nEND OF FEES f ` ✓` 1 � / / �� 69,00 2,760.U0 V DS 0�l194267-00094264 i+1'U' 84,60 DATE: QE/08/91 TIME: 11:32 I . � � �_ �=�s � s��, ��-� � �� n 3 � g_ 5 --�� .�: � � � -� z , � �_ �-�� -- �� .�:. �. , �� U��-�-- � � PBOJECi��3489 pUEENS CT OWNEfl'SNAME: WILLIAFIS KEVIN LEIGH aooxess: 3489 QUE�NS CT COSTA MESA,CA 92626 APCH/ENGINEEN: ( 714 � 557-8a16 nooeess: UNIT: � • NEG.NO.: uxir: , PEPMITTEE: NZCOLF. WILLIAMS ( 714 ) 557-8816 nooxess: 3G48,92� nM[.�UEENS COURT (7 LICENSEU CONTNRC70A�EC�f01TI0N: ��re�0y atlirm tlat I am Iicense0 unEef Ofovis'ro9n?uiC�iap r 9 �commencinq vnl� Seciion 70001 ot Oimson 3 0� i�e Business ana Pmtessians CoOe, anG my license is in �ull lo¢e anE eflec�. CITY LIL.: STRTE LIL.: ClASS: Oate: Signamrt: WOflNEBS' COMPFNSRTION oECIAMTION: I IrereOy affirm Ita111uve a ceriificate oI crosent m selbinsure or a certiliwie ol Workers' ' Comp¢nsaiion Insurance. or a cerlilieG coOY ��ereol (SeCtion 381p. La�. C). PoLICY NO.: E%P. ORTE: COMPANY: ❑ Cenihe0 capy is here0y tumi5Ae0. ❑ Certilie0 topy is tAeU wiU Itce pry BuilGing Oivision. Oate: ApplicanC E%EMPiION FflOM WOXIIEPS' COMPENSA710N oECIAMTiON: (i�¢ saWn meG not Ee mnnpeieE li Ne 7�i b �a are AuMreE �St00) a ku�. I te�ify �ha� in I�e perfotman[e ol ��e work for wl�k� tttis permi� is aweG, I SAall n0i employ any person in any mannet sa as la betome subletl io I�e Wor«er5' Comp¢nsalion Laws ot Ca4fomu. " ' Oate' Sgreiure: NOTICE: If. atler makinq Ws Eeclaration. you stwu'A GetOme su6ject lo t�e WorkeR' COmDe��on provisions al t�e LaOor Code. you must lorttrvntn compy witn sutn v�a'/��s w Uis ce�� stuil De aeemeE revoke0. CONSTflUCTION 1EN01NG RGENCY: I �ertGy attirm Ihai i�¢re 6 a cortttluclion 1¢n0inq apency �or Ilie petlarmanc¢ oi I�e vrork lor wnicn �nis vermn ¢ issuetl (Stttron 3097. Civ. tl. .,1 LENDEN: AD�PESS: OWNEN BUILDEB OECLAMTION: I �e¢Oy atlirm IIIai I am eaempi fmm IIR COnlratiors State Liume Law lor e�e IOAowinO �eamn (Senion 7031.5 Busineu an0 Pmlessional COAe: My city of county w1uc� repuires a permii to consvuci, alter, improve. Uemolish, or rtpai� a�ry sirucmre. prpr io its iswance. aho repuires ��e aDd�� o� wU perm� to lile a v0� slatemen� tlut �Ushe I5 licenutl pursuant io tne pmvisions al ihe Comraciori S�ate licenu Law (CAno�er 9(commencinp witn Section 7000� ol Division 3 of Ihe Business and P�ofessions Cotle) or t�a� Mls�e u wempt Neretrom aM t�e Oasis lar Ne aAepe7 aemD��. �Y �tbn ol Section 7031.5 6y any aodicant for a oermit suUiecls the appliWnt ta a dvil penalty ot not rtrort IAan live nuntlretl OdlarS (f500). �1. as owner ol tAe proDeny or rtry emdoyees with waqes az tAeir sole mrtroensaibn, xill aa me won�. ane me 9ruCture 6 notinlenEM oroffereEfotSale�Secibn 70Cd.&ISinpSS and Prol¢SSiOndlCuOe: Tne fAnuaztotS Slaie LifRnu Law aces no� apply lo an owner ol a D�oDeny wlp OmIGs or imprwes ihereon, aM w�0 GotS sut11 waA him5ell/hersell or InmuOh �is or �er own emDkYees, pmvbed thai such improvemenis am not intenOeO or oflerM for sale. II, however IM 6uilUinp ar impmvemem i5 Sd0 vnlhm one yCar ol tAmple�ion, t�e Owner wiU tuve IM OurOen ol prOvinp M/5�0 EiE noi EuiW or impmva lat Ihe purpo5e ol ulel. �I. az owner ol the propeny. am ercluvvery wniraclinp wil� Iicrose0 conVaclorz Io tonsimct I�e O�ojec� (Seciion 70C4, Busine55 aM Pro7essiorts CoOe: T�e Canlratiors SUte License Law Eces mi appy to an wmer ol vroperty vAq MnIEs or improues Inereon antl wno coniracis tor sucn prolects vni� a mmraclaqsl license vursuam to ine Camractari Sta1e license Law�. I am awam Ilidi pr00� 0� I�Er Wo�kei 5 fAmpen5d1i0�1 iM1Su�aMG SIwIG 0! p�NiGCd Io me. � I am erempt uMer S¢Ctian: B. 8 P. C. . tor Illis red5on: —�a�e: �� /_2R�_ ��1/� �� I eo nere� cenily inal I am xware al aiM un0erslana Ine repuirertrenis ai GhlorNa H¢alin an0 Salery CoCe SCctions 25NI5, 25533, an0 25534 anA Ihat I ar any lumre Ouiiding occupanl wilVwin nm �dNe one) neeE �o compM vnlh sai0 state ca0es anE ��e reQuiremems for a permit lor conslmclim or moOiliWlion Imm Ilre Air Wabty Manaqement USintl. fleSaenGal tonsimclqn aDD�ications are e�emD� Irom inese o�ovisions, Daie: MWwm: I here�y cerUlythatitwve reaG��is apD�itaiion and Slatelhat Ihe abovein�orma�ion is wrreci. lagmelo comply vn�h all ci�y anE county ordmances ana state laws rek�ing to budGirg matruction anE �ereDy autharize repreuntaGves ol Ris ary �o enter upon t�e ahave�mentioneU j O�oDerly�Orinspetlion purpOsei _ � ^ � _ , or Sa�ai Secunty ar t6<1 a6 WNte—Bmltling; Green—Coee En�orcemenC Canary—ApD�KanC Pink—Rovenue: GW4enroE—Assoswr CITY OF COSTA MESA — BUILDING FERMIT PERM NO: E U5573 PERMIT NO: E 055731 PLAN CHECK NO; N GOVT; N SUPP; N CONSTRUCTION TYPE; 5—N PERMIT TYPE: ELE PURPOSE: ADD JOB DESCRIPTION ; EXTEND KITCHEN (ADD HAY WINDOW) SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 COMMENTS: ELEC. TO KITCIiEN REF: B53275 itiFlf �f 1E it �f iE it iF iE 1E 1E if if iE iE if k iF 1f if if 1E if ik iEif if if iE it 3EiE iE if��E iE iFiE iE iE iEiFiE iE jE if if iE iE iF if if aE iF if if af iE iE if if iE if 3FiE iE iE if iE iE iE iF iE 1f iE iE 1E 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 S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; fiT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 41204259 ZNE: REF NO: PLANNING NiSTES> � � if ff if it �E M iP if iE if IE ik iE iE iF If iE if k �F 1E if if if i41F iE iE iE k iE if iE 1f IE 3f 3E iE if if IE ik jf iE IF 1ElF iE iE iF k iE iE if 1E iE iE if �E iE iE iE iE iE iF ik �E �f iE ik iE iE iF IE if 1E iF �k 3f 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 20NING ApPROVED BY ` DATE: BUILDING APPROVED HY : �,• DATE; APPLICATION ISSUED BY: DATE; — *�r��r*��*�r**�r�r�r��r�r��r* x�*�r�*��r+�*�r �* iFiFikiFififif3tifiFiEif3fikiEiFlEiFkififfFifjfifiEiEkiEiElElfiFif7EifiFiEaEifk3f ifiEifiEififikiEiflflElf�ElEiEifiE�lFiFiFilififiEikiEiffEifiF3EiEiFiE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N PERMIT BLDG PMT PLUMBING ELEC�R50 MECHANIC FIRE SMIP/RES GRADING SOY �/ SMIP/NON—RES PLAN d ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 7,50 15,00 0.00 22,50 22.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 22,50 OVER/SHORT; 00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC7{ Z2.5� If if iE k k k iE k iF ff �f k iF iF iE k iF M it iE �E �f fF iF iFlk If It it IE �E k k iF if k iE iE iE if if iE 3f if iE IF iE iE IE ik iF if 1E if iE iE IE jE if if �1E �E 3E iF 3E if if iF iF it ff if iF iE 3E if iE if iF I N D I V I D U A L F E E H R E A K D O W N TYPE QTY 'D E S C R I P T I O N UNIT COST TOTAL COST ELE 2 FIXTURES LIGHTING 1 ST 20 EA. ,75 1.50 ELE 3 RECEPT/OGTLET 1 ST 20 EA, ,75 2,25 ELE 1 RECEPT/SWITCH 1 ST 20 EA. 75 75 ELE 1 MOTOR/POWR APPARATUS 0,0 — 1,0 HP 3.00 3.00 „ END OF FEES / - -,r . I�' 1� _ . ld =� _ . ,_ �_ --T CONSTRUCTION AND PLANNING < � g` SPA ' j APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Loca[ion � Z, Soil Pipe-Undrgmd. 53. Steel Reinforcement 3. Electrical Conduit Ut�lity-Undrgrnd. 54. Forms - 4, Electrical Conduit-Undrgmd. 55. Electrical Bonding , ' 5. 5teel Reinforcement . 56. Rough Plumbing & Pressure Test ' - 6. Electrical UFER Grnd. 57. APPflOVAL TO COVER�GUNITE 7. Footmgs 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgmd. 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVA� TO DECK 17. Property Sewer Line & House Connection 62. Backwash & Receptor�Final •- 72. Sewer Cap 63. Heater & Vent-Final ' 13!floof Drains 64. Plumbing SYstem � Final 74. Rough Plumbin8 65. Electrical�Final • 15� Rough Efectriwl-Condurt 66. Solar SYstem�Final 1 G. Rough Eleciric Wiring �/a6� � 67. Fencing & Access ApP�oval 17. Rough Wiring Sign / 68. APPROVED FOR PLASTER�NG 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Fattory Ftreplace - . APPROVALS Permit # 21. Dutts, in Structure i0. Underground Hydro 22, DuMS, VenTila[ing ' ' 77. Produtt Piping �Gas OOiI 23. Gas Pipe�Rough & Test 72. Underground�Flush 24. Roof Framing ' ` 73. Undergrnd. Storage Tank O Gas rJ Oil 25. Roof Sheathing 74. Overhead Hydro 26. 7�Bar Ceiling (Structuraq & Monocoat - ' 75. Dry Chemical ' - 27. Frame and Flashing . 76. Dry Standpipe - 28. Wthing &$iding . : � 77. "FIXED SYSTEM FINAL 29. Insulation . 78.:FIRE PREV. FINAL � •� 30. Drywall Naili�g � HEALTH DEPT. REQUIREMENT 31, plaster Brown Coat . - 79. FINAL INSPECTION� 32. Electrical Power MeterFinal 80. FOOD CERTIFICATE ISSUED 33. Final Electric 8 5' 9Z � Notes: _ 34. Final Heating & Air Conditioning . - �� 35. Final Gas Pipe-Test � ' , ' 36. Hood or�Canopy � ' 37. �inal Factory Fireplace � 38. �inal Plumbing I . 39. Water Service�Final � 40. Gas Service-Final � 41. 5olar pomestic-Final 42. Backtlow Preventer � I 43. Backflow Irrigation � 44. �.andscape irripation System � . 45. Sound Attenuation ' , 46. Handicap Regulations ., 47. FINAL STRUCTURE & BUILDING - 48. FINAL PLANNING ; qg. Elearic Release to Edison 50. Gas Release to Southern California Gas Co i 51. CERTIFICATE OF OCCUPANCY No. Date `\ Applicant to /ill In all spaees axcept t�ose wilhin heavY GorCer Iines anE sign all apPropriate Eeclarations. CITV OF CCiSTA`' A ON RUCTION P MIT Project Addre`s� _ Applic�t'�Maili Add�ess �• �- ' Owner's Na e� � Phone : Address GseMEng. Licenu No. Address Contractor's Na� Phone Address (mailing) � • City License No. _�j-a,�j � LICENSED CONTRACTOR DECLARATION � I here�y attirm tha[ I am licensetl Yntler prOvislOnS ot Charte� 9(commtnUn9 with section ]000) of Divislon 3 of t e Business antl Profe55ions Cotle, antl � my Iicense is in tull a- ¢ffecL � ' �5 Class Li en o Si9nature .KERS' COMPENSATION DEC� TION !ereby affirm that 1 �ave a certificate 1 consen[ to self-insure or a certiticate Workers' CompensatiOn In5ura0c¢, r d cartifietl coDY thereof ($eCtl00 , 3800, Lab.�� )�v i (� _e - Policy No. ��'r �. �`� � � Co pany � ��lS , ❑,Certifietl CopY �s h¢r¢by furniShBtl. � �a CeJ� ietl cpp y i � with tne U�Y � G� vi lo Date✓��U�� AOPlicaht � EXEMPTION FROM WORKERS' CO P SATION DE A TION +(This section neetl noI be campleted �� h p¢rmit Is fo� ane nu r¢tl 300) O� lessj. 1 certity that in t�e per(ormance al tne ork /or w perm�t is iszuetl 1 sM1ail not emo�oy any person in apY m nn s to become zuDject to [�e Workers' Compensation Laws ot Ca�� . oate 51 NOTICE: If, after mal' is tleclBration, you shoultl become subject to tne Workers' Com on Orovisions of the Labor Cotle, you must forthwitb comply uG� provi5ion5 or thiz p¢rmit Shdll be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 M1ereby a/tirm Ihat there is a conztructlon lentlin9 a9ency for lhe pertormance of lh¢ work tor whiCh thi5 permit is ISSueU (SectlOn 309] Civ. C.) Lentler's Name LenOer's Atltlress OWNERBUILDER DECLARATION I hereby atiirm lhat I am exempl from the Contraclor's Licenze Law lhe fp¢owing reason (Sectlon 7031.5 Business antl Profezsional Cotle: Uty or .y which �equi�es a p<rmit [O ��nst�uct, aller, ITprove, tlem or repdi� _�, y�'; `Fruclure, O��o� to its i55uancer also �equir¢S lhe applican r SUGh pe�mit -_R_;: a signetl statemeni that he/4he i5 licensed pu�suant h0 prOvlslon5 Ot - �tractor's License Law (Chapter 9(commenting Sectlon 7000) ot lvisiol 3 of the Business antl P�oteSzions Catle) hat he/she is exempt �erefrom antl lhe baSiS fo� [ne aIIC9e0 exempti . Any viOld[Ion of 5¢CtlO� /031.5 by any applicant for a Permit sub' s the aOP��ant to a civil I�enalty ot not more tnan five huntlretl dollar E500�. LJ I. as owner of tne property Or m mployees with wa9es as their sole will tla on ]0� �es not n, me owner nave cne ou for lhe purp e of sale). `ne� the pw0erty, an� rtsto� lructlhe prOjecl 156� :on(r tor's License Law doe ' IfTpfOv¢5 tIl¢teOn, dOtl WI rt s) hcense pursuanc co me C ❑ I am exempt untler Date I hereby certifp iniormation is c antl stpte laws t sentatives o t1 inspection o o� Signature Drivers' License 0865-46, rev. 5/ . e ztructure is not mtentletl or otteretl I Professional Cotle: The Conirac[or's Er Of a propafty who bulltl5 or ImprOvtS nself/M1erself or tM1rou9h his or her own ements are not IntenGetl or ofleretl for ovement is soltl within one vear ot com- n of proving ne/she ditl not builtl or im- tlusively contrac[Ing wlth Ilcensetl con- �n 7044, Business anC Professlonz Coae: ot apply to an owner ot property who cOntrac[5 fo� Such oroieGts wlth a ton- :ractor's License Law). i am aware [ha[ n in5urance zhoultl be provl0e0 [o rtie. B. & P. C. io� thl5 rea5on ' _ Owner ,— that I have reatl thiz 'recl. I agre o P la[ing to b I n on � ci�y to nt r or that [ i. TYPE OF CONSTRUCTION LJ NEW�1 ADD LJ ALTERATION IJ REPAIR ❑ CONVERSION ❑ DEMOLISH U or� -a`- D�SCaIPTiL�N.OFV�{QRK/USE F�LOG. hd`7�• i�- E<�;�� K.0 �p�� . TVP O�MI GRADING LJ FOUNDATION TRUCTURAL ❑ TENANT�ELECTRICAL �LVMBING�,MECHANICAL ❑ -OTHER PROJECT DESCRIPTION 5 oCCUPANC CONSTRUCTIONTVPE VALUATION$ D O��' ZONE GRADING CU. VDS. ACRES Remarkf: ii/��ff' � /�/ _ a S Backflow Preventer Backflowlrrigaiion � Bathtubs • � � Clarifiers � ' Dishwasher Drinking Founiains , Floor Drains Floor Sinks Gas Service Outlets Interceptors Kimhen Sink Lavatories P—Trap Roof Drains Rainspection Fee $15 eoiier Duct � Untler GrounJ Duct - SVuc[ural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. iC80 d`- Heating System & Ducting ❑6100,000 BTU 0700,000 « � I I Reinspection Fee I $15 � _' White - Bulltlin9; Canary - APPllcant; Pink - qCCOunting; GoltlenrOtl - ASsesSor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash Issue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration Sys[em ❑o-iao,000aTu Oiao,000 System Repair/Alteration Fire Dampers Registers laue Fee A.P. # �- , S Main6uildin9: E T Front � ARear `? C Right g. Left S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers �Gas DElecl Fan F.A.U. Fixtures oevice Boxes Outlets $witCh¢5 Garbage Dispoul Generator 065 KW C 2one Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50 + KW Meter ❑up to 100amps Meter ❑over 100 amps � Sub Panel - � Motors �0.1 HP �tY. 8 Inc.Solar �9-15 HP �i6-' Microwave • Pole Li9ht . ' Si9n Standing Sections 15 KW � Tresh Compactor 1 ♦ Reinspection Fee .$15 S 3 ' VELOPMENTSERVICESRE�UIR laue Fee 5+ FEES 3 r. N I N G R E � M T S. FEES Building Approved 8� �� Date �-��a' Appliretion laued By .�x�- Date � -g�- � ; � ' � SUMMARV OF FEES � 'tBUILDINGPERMIT $ �Ol% SMIP $ �. 33 �PLAN CHECK $ PEFMIT PIUMBING $ ��_�_� ISSUANCE $ ( p;- PLAN CHECK 25% $'-�� ENERGV P.C. $ � ELECTRICAL � $ J`� � J+c7 GRADING $ 'PLAN CHECK 50% $ � MICROFILM $ � , 1 ^/ ,-MECHANICAL � $ �� TOTALFEE $ � PLAN CHECK 25% $ � . . 4� ��:' ..'`_.n:� �:.Y�6 .--.i_ . 'Jh'- �na�r,;U:,� �_1c' '_°..�;, - , — l =r �1 CONSTRUGTION AND PLAIVIVI APPROVALS Permit��_. =�. t., Te�nporary.Electrical Service or f r!i 2 �`Soil3PiPue��,ndrgrnd. 1 t` House I �:n 12-Se�� CaPi �! � I �.� ~ 13."Roo{�Dralns (�� i- s . �' �i 14. Rqu�i Plumbiny�% 15. Rough Electrical-Conduit . t16. Rough ElCctricWiring n. 7Z� Rough`WiringSign �� 1�� Rough Electrical-T Bar Ceiling .19f Rough'`eaT��yBSAir�Cond'%ning �On Rough Factory Fireplace_. � � -21.:Ducts�inStructure'i �. ilating •23. Gas Pipe�.Roygh &.Test 24,.4Roof Frami�ig � %� -25'� Roaf-She2ihing` � � 26. T-Ba�,�Ceiling (Str�ctural) . j27. Frame an�l � ashing ' 30. I Nailing, ��, ' � Br0`Nn Coat Q al Power�IVlpter-Final 33. Final Electric' "" � 34.. Firial Heating & Air 35. Final Gas Pipe-Test _36. Hood or Canopy 4 �}3$. Fin,'al��mbing ' t ;,39: Water. Seryice-FinaR� � „40. Gas Service-Final . �41. Solar porriestio-Final . .�� •.42. Backflow Preventer ; 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound �Attenuation 46. Handicap Regu ations 47. FINALS7RUCTURE&BUILDING 48. Special Requirements Completed ' :49. Electric RBlease to Edison . � �'�0. Gas Release to Southern California Gas Co � i ,51. CERTIFICATE OF OCCUPANCY i Date • � �.��,,., ...;� iSPA �'.i .�'.�., �1 � D e � I'nspector �e-�"�%y�y: ' ' _ n APPROVA'L*�� ;,Permit # � /52. Pool & Equipment..Location ,; y.s+` � ' n a � �q � 53. Steel Reinforcement d `,� � ' S4. Forms A` lu 55. Electrical Bonding � � � � ( 56. Rough Plumbing & Pressur�Tes[ � �_. 57. APPROVAL•TOCOVER.GUNITE . """-�'9""! '58. Electrical Conduit-Und grnd. �� f 59. Gas Pipe, � Undrgrnd., Test i �- 60. Backwash Lines, P Trap, � Undrgrnd. '�� 1 61. APPROVAL �0 DECK >a= . �H` � � 62. Backwash &�ReceptorFinal � � ' 63. Heater &�V�ent-Final � . �� ' ' 64. Plumbi�g System - Final �21 � L.�� 65. Electrical-Final � 66. Solar System-Final � 8 67. Fencing & Access Approval � � 68. APPROVED FOR PLASTERING ' � 69. POOL/SPA SYSTEMS FINA�L � . jf �(..�d) FIRE DEPT. REQUIREMENT 1 APPROVALS Permit# � 70. Underground Hydro 71. Product Piping O Gas ❑ Oit .7,2, Undergraund Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil - 74. Overhead Nydro � 75. Dry Chemical � � � • � 76. Dry Standpipe - �/r� 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL � HEALTH DEPT. REQUIREMENT 9/0 �9� fINAL INSPECTION .. � "80` FOOD�CERTIFICATE ISSUED � n� u I . Clr�s._ w!n m � { ` Da;e, , Inspector i' �-� •'��. '- i � �• � � i _ .; ;, .,; , � _�: �� . +1 7� `, ;,. , a ,, � � q �,�. a ',� . .. � .^ � r � APPlicant to fill In all s CITY'OF COSTA MESA P�RMIT3S CONSTRUCTION PERMIT 6 Addres Address Contracror License Na. Phone wit�ln heavy �ortler li[es antl si.3� all aDVropriate EeClarationi. TRACT NO. LOT N BLDG. NO. � O 27 2 � � TVP CONSTRUCTION NEW ❑ AOD ❑ ALTERATION f ❑ QEPAIR ❑ CONVERSION �DEMOLISH ' O OTHER DF$C{iIPTION OF WORK LICENSED CONTRACTOR DECLARATION '� I hereby affirm th:.t I am IlcenseG untler provislons of Charter 9(com- inancing wlth'section ]000) of , Division 3 of the Busine55 antl iProtessions Cotle, antl my Ilcense Is in tull torce antl efiect. License CI sz — Licen No. g Date�� iJ'� ci,.,..��.d - Oi�l�/� . ///✓ ' WORKERSr OMPENSATIOry��'p�} L A 1 hereby affirm thit 1 have a'Eertifi� f con5ent to self-lnsure or a �-^.tlfifzte o( WOrkerz'-CompenSaH n5urantt,-or a Certi(ietl Copy •eof (Section 3800, Lab. C.). �cy No. � Company - - - LJ Certifietl copy is h¢r¢�y furnish¢tl. ❑ Certlfietl cOpy is filetl with thC City Builtling Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This.Section neeA.not.be completetl it the permit is tor one huntlretl (E300) or Ies51. 'I. C¢rtiry that in the performance Of tne work tor whlch Ihis permit I5 issuetl, I Shdll nOl emplOy any p¢r5on in any mann¢r 50 as to b¢Come subject to ie W rkers' Compensati ws of Cal nia. �Dale -3 Signature NOTICE: If after making this e ratlo , u oW ecome subject to the Worker5' Compensatlon Ovisio f e Labor Cotle, you must fortnwi[h comply with such provislons or ihis permit shall be deemed r¢vOk¢tl. - _ _a . _ . _ _ _ _ .._ __ _ _ . _ 'CONSTRUCTION LENDING AGENCV I hereby aftirm that there is a construction lentling agency lor the per- fOrmance ot the work for wM1ich this permit is ISsuetl (SeCtion 3097 Civ.'C.):' '_' "_ ' " "' ' ' ' " �entler's Nam¢ Lentler's Atltlress � OWNER BUILDER OECLARATION' - ' ' ' "" 1 herebY affirm Ihat I aM exemDt f�om the Contractor'S License Law for TVPE OF PERMIT � ❑ GRADING I�FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL OPLUMBING ❑MECHAI ❑ OTHER PRO�ECT D RE�s�, �rr�oN. . SQ. FT. _ � �I�' OCCUPANC�CONSTRUCTION TVPE Jfi VAIUATION��ZONE GRADING CV: VDS. ACRES REMARKS: - . - _ . . BATHTUBS TOILETS LAVATORIES KIT.SINKS � SERVICE SINKS� FLOOR SINKS � DRINKING FOVNTA.INS INTERCEPTORS PLAN CHECK SHOWERS VRINALS DOUBIE LAVS� DISHWASFiERS $VMPS FLOOR DRAINS CLARIFIERS me ronow�ng reason'�xcuon' iusr:o tl11510255'dOO rroressionrcoae: SWIMMING�POOL P'TRAP � Any dty or county which �equire5 a permit to mn5truct, al[¢r, Improve, tlemolish or reDair any structure, prior to its Issuance, also re- - yyqTER SERV ICE ALTERATIO� qulre5 the ap�liWnt for sucb Oe�mit to (ile a Si9netl statem¢nl tha[ h¢ Is licensetl pursuant"to the provisions ot the Contra<tor's Ucense'Law GAS SERV ICE OUT�ETS '^hapter 9(commencing with Section 1000) Ot Division 3 ot the ��:'¢-�nezz antl'Prdesswns Cotle) or thai ne is exempt theretrom antl the yyqTER HEATERS BTV OUT�UT �- tor Ihe allegetl exemption. Any violatlon of Section ]031.5 by '�� permlt subjects�the applicant [o a civil penalty SEWER CONNECTIONS � W applipnt for a ot not mote than five huntlr¢tl tlolla�s (5500). ❑ I, as owner of tne property, or�my employee5 with wages as their� SOIAR TANK � ��COLLECTOR'. Sole compensation,.will tlo [he work, antl thC sVucturC is �oLintentletl _ or o(feretl for vle. (Section 7044, Business ana Profession5 Cotle: The SOLAR PIPING SYS. COntraCtoCs License law.tloes not.apply. to an Own¢r of a property. . . . who builtls or improves th¢reon, antl who tlOes such work himselt or �SSUE FEE t�mugM1.his OWO CrtlplOy¢e5, provl42tl thdt S�Ch.ITplOV¢rtl¢f1i5 dl¢ O0I . inlentletl or otferetl (or sale. If, howeveq [he builtlin9 or improvement MECHANICAL PLAN CHECK is soltl wi[hin one year oi completion, lhe owner will have the burtlen of proving he tlitl not builtl or imProve for the purpose of sale�. HEATING SVSTEM Od00,000 BTU_ ❑ 1,- az�owner ot the-property,-am excluzivety conVacting with� '�qNODUCTING� licensetl mntracto�s lo conSVUGt the project (Section 1044, BUSinesS 100,000�f BTU_ anU'Professions Cotle: The �Coniractor'rLicense Law tloes not apply to an owner of property wh0 builtls or imptoves thereon, antl who con- REFRIGERATION 0-300,000 BTU_ [racts from suth�projetts�with a �conlractor(s�-licesnetl pwsuant lo -SVSTEM " ' � ^ [he Contractor's License law). 100,000�i B7U_ ❑'I am ezempf untler Section B.�&�P. C. for thii BOILERS BTU reason ' ' ' - - '- ' Date� Owner SVSTEMREPAIR,ALTERATION I_h¢rebycertify[ha[J bave �eaa thi5 application antl state that t�e above E%HAUST SVSTEM MULTIPLE orainances Dat¢ �SSVEFEE ' � unverr�cense orXr� i j r � CMF 0865-46 White-Builtling; Canary-Appliwnt; Pink-Accountin9; GolAenrod-Assessor \ 5840 5/13/82 24.42 TL ; •� A.P. � 2 ZONE - SETBACK C/L STJ IpF VARD 5Ep R�IGHTA I REAR VARD (TO PKG. SPACE REO. ZONING APPROVED 8` SPECIqL CONDITIONS: ELECTRICAL REGULATIONS PLNGo. gR�EJF. � �0.0PE��TVNLINE 'L /'L _ ' !e AL • PROVIDED `_ PARK FEE S � DATE � PLAN CHECK . '" 'GENERATOR 0�1 KW_1-30 KW _ TRANSFORMER � �APPLIANCE 30-50 KW_50 � KW _ � - - MOTORS' ' �- '0�1 HP_1-10 HP _ ---- - � � �INC. SOLAR} 30-50 HP=50 rt{p _ �FIXTURES OUYLETS� SWITCHES � � GASTUBESIGNS � ' � " ' .POLE LIGHTS PANELS - MAIN �SUB � SERVICE ' AMP - - -_ ♦ - ' ' _ f ISSUE FEE � - - ".APPLICATION APPROVED BY ' i SUMMARV OF FEES � . ' � BVILDIfVG "' ��[ �j� __ IPERMIT E� _. SMIP. S �•�O � PLAN CHECK f _ , • �7 - • PERMIT � ' ISSUANCE E PLVMBING b , � �� GRADING � 8 ,PLANCHECK� b - � � � �ELECTRICAL §` � a - .PLANCHEEK� E ' " MICROFILM E . '�� TOTAL FEE S ' MECFIANICAL �E PLAN CHECK E - LE55 AD- ' VANCEPC S_ . - FINAL FEE $� �Z � CONSTRUCTIONAND�PLANN�I jG_� � - POOL&SPA � APPROVALS Permit #� Date I�spector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -� • � - 2. Soil ipe-Undrgrn 44. Steel Reinforcement �- -- 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn �,� � 46. Electrical Bonding - - . tee e�n orce i- 47. Rough Plumbin & Pressure �Test ' 6. Electrical UFER Grn ' ' 48. APPROVALTO COVER-GUNITE -�- � 7. Footings ' `' ' 49. Electrical Conduit-Undr rn ' - B. Foundation '� • 50. Gas Pipe, ❑ Undr m, Tett ' � 9. Water Pipe-Undrgrn � 51. Backwash Lines P-Tra 0 Undr rn - � 70. Structural Floor SYstem 52. APPROVALTO DECK ' -'- "' "� - "' " - "' ' 1�1:', Properfy Sewer L'ine &�House Connection 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-Wi"ring � ' " - � - � 57. Solar SYstem-Final ' � "� � ' 16. Rough Heating & Air Conditioning - - • encing & Access.Approval � 17. Ducts, in Structure � ' APPROVED FOF PLASTERING '� _ 18. Ducts, Ventilating - ' - __ __ , _ . .-_ 19. Gas Pipe-Rough &Test - - � 60. POOUSPA SYSTEMS FINAL � • _,� , � 20.. Roof Framing_ ' � � ' - ^ ° • � � � 21. Roof�Sheathin - � ' ' ' ' : 22. Frameand Flashin ' ' 1 NOTES: - ' ' , '.`, , . 23t Insulation _ � ' � 24. Lathing & Siding . ' ' ' - ^ , 25: Drywall Nailing _ ' . 26. Plaster Brown Coat. 27. Electrical Power Meter-Final � � � - � - - 26. Final Electric � � � 29. .Final'Heating & Air Conditioning ' 30. Final�Gas Pipe-Test � ' � � . 31. Final Plumbing - ' �� . 32. Water Service-Final � � ' : 33. 'Gas Ser.vice-Final_ - � ' 34. Solar pomesticFinal ' - � � � 35. • Landsca e S rinklin S stem � • � ' 36. Sound Attenuation ' � � � � � ' � � � , 37. Handicap Regulations � 38. FINAL s-j • � � ' � 39. Special Requirements Completed - ` � � 40. Electric Release to Edison ' � � - - �- - � ` 41. Gas Release to Southern California Gas Co: ' ' ' � 42. CERTIFICATE OF OCCUPANCY � - No Date . �.. 1 •�% r �' 1; .'' City of Coste Mesa Building DepT. i BT�-----�.�.._DATE.S/,�I3.._7 P Q _ r THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE NO CHANGES W�THOUT P0.10R APPROVAI OF DEPT. THE ISSUANCE OR GRANTING OF A PERMIT OR A➢PROVPL UF PLAdS HN� SPECIFICATIONS SNALL MOT BE CONSTRUE� TO BE A PEfiMiT FQR, QR AN APPROYAL OF. ANY VIOIATION OF ANY OF TNC PROVISIONS OF TNIS CODE. NO PERMIT PRE� SUM1N6 TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF THIS CODE SHPLL BE VAL10, EXCEPT !N SO I FAR A$ THE WORK OR USE WHICH IT PUTHORIZES IS 1AWFUL. THE ISSUANCE OF A PERMIT BASED UPON PLANS ANO SPECIFICATIONS SHALL NOT PREVENT THE BUIL�ING OFFICIAL fROM THEREAFTER REQUIRING iHE CQRRECTION OF ERROftS IiJ SAID PLANS kND SPECIfICATIONS OR FROM PREVENTING I�N'V OLATI�N OF7 �HIS CODE OR O�FDANY OTHER OR� Nf,NCE CF THE CITY, STRUCTURAL `ROVAL Q�LY SEPARATE PERMITS ARE REp!JlRED FOR ELECTRICAL, PWf:"ft�:lG, HEATI��!G, VEhTILATIP!G A:4D REfRIGERATION V�'CRK ��G'Q86fi$ # � � `��5 THIS idUh�6'R N';iS? ACCOiVIPANY _yALL IPlSPECTION f�QLfESTS ; F�ft Qi�lLDIf�GS �NHiRe ?ERSONS ARE TO III BE EKVlDYcD, bVE SL�SESi THAT iHE ; I STATE OF CALIFORVIA �]IVISiON OF I INDUSTRI.?L SAfETY BE C0;!SULTED FOR � + AODITIONAL REQUIREMENTS. ��.c�r/�'� CITY OF COSTA MESA PLAn;�!�IG DEPT. 61/:UECT TO 6?CG. DEPT. 0.E0. BY_K.�'�aT 6 3cSG� aiaFcr z oF v�;.�:ar�a r� PATIO COVER DETAIL - 12/9/81 - NOT TO BE USED FOR SUNDECK, ETC. �STATE—�--��, �°\ SIZE SPA� SPAN w U pVERHANG r-- • �' �E �— 12 _�„ RAFTERS: ��"6 Min. 114r __.�� cN(:TH s--�SLOPED FOR DRAIN Z � � z f BEA 2"K 3/i6X2° % POST-BEAM CONNECTION 5/g x 5 Lags 32% —� Predrill Ledqer � Predrill Eziatinq '/�-3 Deep JOIST HAN�ER or other approved methods of suppuH � tie. ALL LUMB£R OOU6LAS F/R CONSTRUCTION GRADE FOR TABLE N0.1 � 2 OR BETTER FOR TABLE NO. 2 `POST _ �x � � SHOW SIZE SHOW SPACING SHOW LOCATION ON REVERSE SIDE, � DROP PATIO FLOOR f— SLOPE TO DRAITJ— 2"max.@door � 6 �;. �..; ' ° :."..�3'�THICKSLABo:r� L4 ��: �' ` � � �PUDDLED • SAND � �FILL� � ' .,a. . Remove Gross And Weeds Down To Notural G.ode 12• •��"� CONCRETE MIX 1:3:4 MAXIMUM WATER CONTENT POST ANCHOR �I��... �� 7# GALLONS PER SACK CEMENT. Far Pips Posf, Embed r1z� Provide 26 Go G.I. Flashing At Wood Floor Co Pipe in Footing to within 3" of Bottom, and P�ovide detail of Flange or Weld Plate Screwed or Bolted to Frame. CMF 0012-46 (6U 40) rev. 12/Bl . =. CONTINUOU LEDGER �• = TYPICAL JOIST ANCHOR NOTE � USE REVERSE SIDE FOR PLOT PLAN. No. 1 No. 2 UBC STD. TABLE UBC STD. TABLE 25-21-J-6 25-21-R-1 Fo� open egg crate alumi- For wlid sheathing. num or plastic roof Shingles or built up covering. roafing. MAXIMUM SPAN SIZE SPACING MAXIMUM SPAN t7' 2" 2„ x 6" @ 12 o.c. 12• 0,• 75' 7" 2" x 6" @ 16 o.c. 10' S" 13, 8„ 2„ x 6" @ 24 o.c. 8, 6„ 10' 11„ 2„ x 4" @ 72 o.c. — 9' .11 „ 2„ x 4" @ 16 o.c. — 8' 6" 2" x 4" @ 24 o.c. — NOTE: FOR PROPOSED OR FUTURE ROOM, OR WHERE PATIO WALLS ARE TO BE BUILT. USE N0. 2 CHART ONLY. FOR PROPOSED OR FUTURE ROOM OR WHERE PATIO WALLS ARE TO BE BUILT SUBMIT COMPLETE HOUSE AND ADDITION � PLANS FOR APPROVAL. COSTA MESA BUILDING DEPT. 77 FAIR DRIVE I NSP E CT I O NS: 754-5627 '\ ADO��dnt to fill in all spaces exce0t those witM1in �eavy DorOer lines antl si9n a11 appropriate tleclarations. CiTY oF COSTA ME CO S RUCTION PE IT Project Address � . Applicant's M��r11/p,g Address � Owner's Namp,�I ��^,l- _ Phon Address !�� Arch/Eng. License No. . � Address Convactor's Nam P one Address (mailingl� — City License No. L IICENSED CONTRACTOR DECLAHATION 1 M1ereby aHirm that I am licensetl untler provisions of Charter 9(mmmencing wit� zection 7000 of DiviSiOn 3 0/ [h �7D'ne55 antl Profegsion�Coqe`antl my license is in f I,f ce anA eltect. �� T T f•(ri Licen�f lass S icen No. Date1, // � t'f/1 s t :reby af Ym tHat I have a certificate bf consent t f-insure or a certificate i Worke ' o pensation Insurance, or a cer tl cop h reof (Section 3600, L 1 /� u � Policy '"v Company /"�� Cer i ietl co y is hereby fumishetl. � C i i iletl witn the city guil � ate Applicant_ EXEM ION ROM WORKERS' COMPEN ATION DECLA TION (ThiS se tion neetl no[ be campletetl it the pe�mit is for one �ed ($100) or Iess). I c¢rtity that in the performance of th@ �yo�k for which this petmit is i55uetl, I shall not employ any person in any manner so as to become subject to the Workers' Com0en5dtiOn Laws of Califo�nia. Date Signature NOTICE: If, after making this tleclaration, you shoultl Cecome subject to the Workers' Compensation Orovisions of the Labor Cotle, you must torthwith comply wilh such provisions or this permit snall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV 1 hereby aifitm tha[ [here i5 a ronst�uctlon lentlin9 agency tOr the pe�fo�manG¢ of tne work for which this permit is issuetl (Se[tion 3097 Civ. G.) lentler's Name Lentler's Htltlress OWNER BUILDER DECLARATION � I hereby affirm Lhat I am exempt iror� the Contractor'S License Law for tM1e following reason (Section 7031.5 Buziness antl Professlonal Cotle: Any city or muMy which requir¢5 a Oermit [o con5t�uct, dlt¢r, imprave, tlemOlish o� repal� any slructure, prior to its issuarice, also requires the applicant for such permit � file a signetl statement [hat he/she is litensetl pursuant to the O�ovi5ion5 of � ConVactor's License Law (Chapter 9(commencing with Section ]000) of �ision 3 of tne Business antl Profe55iOn5 Cotle) o� that h¢/she is exempt .nerefrom antl the basis for the allegetl exemption. Any violation of Section ]031.5 by any applicant tor a permlt subjects the applicant to a civil endlty of not more than five huntlred tlollars (E500). � I, as owner of the property or my empioyees with wages as their sole com0ensation, will tlo the work, antl the structure is not intentletl or ofteretl tor sale (Se<tion ']044, Business anp Professional Cotle: The Contractor's License l.aw tloes not apply to an owner oi a property wno Cuiltls or impmves thereon, antl who Ooes such wo�k himself/herself or through hi5 ot her own employees, pwvitletl tha[ such improvements are not Intentletl o� off¢retl for Sale. If, howev¢r, the builtlin9 0� improvement is soltl within one Year Ot com- pletion, the owner will have the burtl@n ot proving he/she tlitl not builtl or im- prove for the purpose o( sale). ❑ I, as own¢� of the property, am ekclu5ively Cont�acting with lic¢nsed COn- tractms to construc[ tne project (Sectipn 7044, Business antl Protessions Cotle: The Contractor's License Law doez not apply to an owner of property who builtls or improves thereon. antl who contracts Por such oroiects witn a mn- tractor(s) Lcense pursuan[ m me Contractor's License Law). I am aware tnat proof ot thei� Worker'S Compensation insurance shoultl �e prOvlOetl [o m¢. ❑ 1 am exempi untler Seciion B. & P. C. for this reasan Date SiqnaWre — � Drivers' License or 55 � Owner _ rve reatl this iree to como that tne above 7VPE OF CO ❑ CONV DESCRIP" NEW LJ AD� l'J�ALTERATION LJ REPAIR SH ❑ OTHER %� �., TVPE OF PERMIT LJ (TRADING LJ FOUNDATIOj� STRVCTURAL ❑ TENANT ❑ ELECTRICAI ❑ PLUMBING � MECHANICAL ❑ OTHER PROJECT DESCRIPTION 5c1. FT. oCCUPANCv CONSTRUCTION TVPE `%� ✓ VALUATION $ ZONE GRADINGCU.VDS. ACRES Remarks: A%..� /� � /�„ !� Sink Preventer Irrigation Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outleis Interceptors Kitchen $ink Lavacories Roof Drains Reinspection Fee � $15 Boiler Duct - Under Ground Ouct - S[rucmral Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. iCBO # Heating System & Ducting ❑ o-i oo,000 eru � i oo,000 er� Reinspec[ion Fee � $15 0865-46, rev. 5/BB White - - Accountinq; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection $O�af COIIEC[Of5 Solar Piping Solar Tank Swimming Pool w/Spa Urinal W ter Closei Water Heater Water Service Auto-Wesh Leundrv Tra'vs Issue Fee Hood or Type I ❑ Canopy Type I I ❑ iefr� ratlon System 0-100,000 BTU. ❑100,000 BT System Repair/Alteretion Fire Dampers Registers laue Fee FEES A.P. # S Main Buildin9: E T Front A Rear C Right K Left S Ping. Ref. # Plannin9 Notes: Zone Accessory Buildin9: Parkin9 ReqJProvided ELECTRICAL - - Automatic Washer Transformer ❑ 15-50 KW Construction Pole Sub. � 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dr,yers ❑Gas ❑Electric Sub Panel Fan Momrs �0-7 HP 01 %- 8 F.A.U. InaSolar 09-15 HP �16-15+ Fixtures D'evice Boxes Outlets Switches Garbage Disposal Generetor 00.5 KW �5-15 KW Pole Light Range Standing Sections Trash Compactor Fee �$15 � � luue Fee $ 3 DEVELOPMEN7SERVICESREQUIREMENTS: Zoning Approved By FEES Building APProved By �R Appliration Issued BY BUILDING PEFMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ 33 • O� PLAN CHECK 25% $ O N I N G R E Q M T $. FEES $ 3 SMIP $ PERMIT ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ � • 9 6 o� 000ao35+-rco4o3a� �trtc� -- -,, �:i"k. D'3!".�/?9 T7rc; ls ,° �_.., ♦ -�� '� � . CONSTRUCTION AND PIANNING ~ P� $' SP'4 APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole� - �{; � 52. Pool & Equipment Location 2. Soil,Pipe-Undrgrnd. ' ' �� -_ 53. Steel Reinforcement ,r 3. Electrical Conduit�Utility-Undrgrnd. �-" 54. Forms . 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test / 6. Elect�ical UFER'Grncl.' / 57. APPROVALTO COVER-GUNITE _' 7. Footings .�� 58. Electrical Conduit-Undrgrnd. . 8. Foundation '� � '�� 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd, 10. Structural Floor System � 67. APPROVAL TO DECK 1].� Property Sewer Line�& HouseConnection ' 62. Backwash & Receptor-Final 12. SewenCap • � 63. Heater & Vent-Final � ' 13. Roof Drains � . � 64. Plumbing System - Final - .� 14. Rougfi 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 6S. APPROVED FOR PLASTERING 18.-Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19y Rough�Heating & Air Condi�ning FIRE DEPT. REQUIREMENT 20, Rough Factory Firepiace , APPROVALS Permit # t•i 21� Ducts, in Structure � 70. Underground Hydro 22. Ducts,�Ventilating , �l� 71. ProductPipingOGas ❑Oil 23. Gas Pipe-Rough & Test ' 72. Uniierground Flush i 24. Roof FFaming � 73.' Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing . 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical �' 27. �Frame and Flashing � 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing , HEALTH DEPT. REQUIREMENT 31. Plaster�Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ,, :'� 33. Final Electric Notes: ^ s� 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 3/6 4� L�iD 36. Hood or Canopy � 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final • 40. Gas Service-Final ;.�-� 41. Solar pomestic-Final / � i. 42. Backflow Preventer .� / �,��, t•; 43. Backflow Irrigation --- . /' � 44. Landscape Irripation SYstem � 45. Sound Attenuation �`ti f' k j� ' Y 46. Handicap Regulations ' 47. FINALSTRUCTURE&BUILDING � 48�. Special Requirements Completed 49. Electric Release to Edison �J 50. Gas Release to Southem California Gas Co -' `' 51. CERTIFICATEOFOCCUPANCY 'i ' No. Date " ~ ° � Applicant to fill in all sDaces except tnoza within heavy border lines antl sign all apvropriate Geclarations. cirv oF CosTa MES • C N RUCTION PERMITs�/ ProjectAddress -��ENS �^�ClieA/ Applicant's MailAiry�q ddres I�� T%��l�SG_ /`/�Q, Owner's Nam '/,•Q" �QSS -G��/i��.�o�e�5�d1 Addreu �7 �7 � �/!IiEG-C/�� G' �G�'Q % Arch/Eng. License No. Address /� - Contracto 's N)al1 v��-� � 'ec Ph e L/ ��"' Addresslmailin9lL� � �� T/E'�vOiP i �/✓i0�, City Licenu No. /� � � y LICENSED CONTRACTOR DECIARATION I hereby�affirm thal I am Iic¢ns¢tl untler provisions oi Charter 9(commencing with section 7000) oi OlviSion 3 0l the BuSiness anU ProfeSsions GoOe, antl my license is in full force.j�O eftect. — � y O 4cense la< - .•C� / icense N� Date � c � S9 t l�� WORKERS'COMPENSATION DECIARATION I h¢reby affi�m tha[ I have a certi/iCate Of consent to selftinsure o� a certiticate oi Workers'�GCJompensztion Insurancei.or a certlfiea copy thereof (Section Pol�'�c�Y No.WCW �% 3� ?ompanY `^ �'O _"_` sU�%� rtifieE opy is hereby furnishetl. Cert o ea wi[h [he ciry Builtlinq Division. �ale � � APPllcant EXEMPT ON ROM WORKERS' COMPENSATION DECLARATION (This section neetl no[ be completetl H[he pe�mlt is fOr One huntl�etl ($100) or less). I certify [hat in the pertormanCo of the wo�k for which thls pe�m�t is issuetl, I shall not employ any person in any manner so as to become subject to the WOrkers' Compen5alion Laws of Calito�� / 6` �/ Date � Si9nature L �¢ NOTICE: If, after making this tleclaratlon, you shoWtl become subject to the Workers' Compenwtion orovisions ot the Labor Cotle, you must forthwith comply with such p�ovi5ion5 0� this perml[ shall be tleem¢tl /evoketl. CONSTRUCTION IENDING AGENCV I hereby affirm that there IS a cons[�uction lentling agency tor the performance of the work for whith [his permit is 65uetl (Section 3097 Civ. C.) L.entler's Name LentleYs Atltlress _., � _ OWNER BUILOER DECLARIITION� I hereby atFlrm that I am exemPt from Ihe Contracto�'s Lic¢nse l_aw fo� the following reason (Section 7031.5 Business antl Professlonal Cotle: Any city or county whlcn requires a pCrmit lo Const�ucl, alter, improve, demolish or reDai� any struchre, prior to its issuance, also requires the applicant tor such oermit �. to file a signatl statemenl tha[ he/she i5 Iicensetl pursuan[ to Ihe provislons of �� the Con(ractor's Lfcense Law (Chapter 9(commencing with Section ]000) ot '. Division 3 of tbe Business antl ProfeSvons Cotle) o� that he/she is exempt "herefrom and the basis for the alle9etl exemp[ion. Any violation of Section 031.5 Dy any appliGan[ 1or a Pe�mit Subjects the applicant to a civil ,endlty of not more than tive hundretl tlollars (E500). ❑ I, as owner o� the 0/ope/ty or my employees wilh wa9e5 as Iheir sole compensation, will tlo lhe work, antl [ne structure is not intenCetl or offeretl for sale (Section 7044, Busin¢ss antl Protessional Cotle: The Contrac[or'S LiGense Law tloes not apply to en owne� of a property who bulltls or impmve5 thereon, an0 who does su<h work him5etl/hetSeH or [hrough his or h¢r own employaez, provitletl that such improvements are not intenUetl or offered tor sale. Il, however, the bull0ing c� improvement i5 Soltl within one year of com- pletiOn, Ine owner will nave tne bu�tlen of proving he/she tlitl no[ builtl or im- �ove tor Ihe purpose of sale). LI I, as owner o/ the oroperty, am exclusively contracting with li<ensetl con- Iractor5to con5truct the ptoject (Section 7044, Busin¢ss antl Professions CoOe: The Contractor's License Law tloes not aDPly to an owner oi oroperty who builds orimproves lhereon, antl who conlracts /or Such projects witn a mn-. tractor(Sl licenze pu�suant [o lhe Contraclo�'s License Law). I am aware tM1at proof o� Iheir Worker's CompenSaHon Insuranca shoultl be pwvitletl to me. ❑ 1 am exempt untler Section B. S P. C. for [his reason Date Owner 1 h¢reby certify that I have reatl this applicatlon antl state that the above information is correct. I a9ree lo comply with all Gry ana county ortlinances ana stat¢ lawz relating to builtling constructlon, antl hereby authorize repre- sentatives oi. this city to enter upon the above-mentlonetl property tpor inspectlon Purpo r: pat� //—C7�i Signature � Drivers' License or 55 � - CMF 0865-4fi, rev. 4/84 White - BUlltling; Canary - �.3 ,' �r.i-� ' - �TVPE OFCONSTRUCTION � ADO ALTERATION REPAIR ' ❑ CONVERSION ❑ DEMLlISH � OTHER DE$�CRIPT�OQNOF}yQRK,/�1SEVF8LDG. / /f/�' L�✓ �" TV�OFPERMIT GRHDING FOUNDATION STRUCTURAI ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL ❑ OTHER PROJEC7 DESCRIPTION 5Q. C O N ST RUCTI ON TV PE_ ZONE Remarks: Bar Sink Backflow Preventer Backflow Irrigation eathtubs Clarifiers Dishwdsher Drinking Fountains Floor Drains Floor Sinks GasService Outlets 'T�-L '� � OCCUP �- VAI.VATION 5 GRADING CV. VDS. A( Kitchen Sink Lavatories P-Trap Roof Drains Reinspection Fee $15 Boiler Duct-Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple � Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑ a� oo,000 eTu � i oo,000 sr Reinspac[ion Fee $15 Pink - Accounting: Goltlenrotl - Assessot Showers $ervice Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank $wimming Pool w/Spa Urinal Water Closet � Water Heater Water Service laue Fee Hood or Type I � Canopy Type I I ❑ Re(rigeration System ❑0�100,000 BTU ❑100,000 BTU SVstem Repair/Alteration � laue Fee FEES $ 3 A.P. �p S Main Buildi E T Front B Rear A C Right K Left $ Ping. Ref. # Planning Notes: Aummatic Washer Constructior Pole Sub. Cooking Unit D ishwasher Dryers �Gas OElec' Fan F.A.U. Fixtures Device Boxes Outlets SwiLcheS Garhage Disposal Generator O0.5 KW C � Reinspection Fee — DEVELOPMENTSER ZOning APProVed BY_ 'Building Approved By 0227 5/II/84 � 7 Accessory Building: Parkino Ren./Prnvir . 41 .75 Tl. Zone -- 1 ^ ELECTRICAL Transformer ❑ 75-SOKW ❑ 50+KW 5KW $15 v Meter ❑up to 100 amps Meter ❑over100amps Sub Panel� - Motors �0-t HP �1 % -�8 Inc.Solar 09-15 HP �76-15+ Microwave Pole Li9ht Range Sign Standing Sec[ions Trash Compactor Issue Fee S FEES $ 3 Z O N I N G R E � M T S. SU RV OF FEES BUILDING PERMIT $ �� SMIP $ O•�� PLAN CHECK $ � PERMIT PLUMBING $ ISSUANCE S PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50°,6 $ MICROFILM $ —/�,{�,/ /� MECHANICAL $ TOTAL FEE $ �_— PLAN CHECK 25% $ CONSTRUCTION AND PLANNING � POOI SPA APPROVALS Permit # - i Date Inspector qppROVALS Permit # - Date Inspector 1. 7emporary Electrical Service or Pole .� 52. Pool & Equipment Location � 2. Soil Pipe-Undrgmd. ' � � 53. Steel Reinforcement ; 3� �Electrica�l Conduit Utility:Undrgrnd. � � 54. Forms � 4. Electrical Conduit-Undrgrnd. �� ' 55. Electrical Bonding � i 5.' Steel Rerntorcement 56. Rough Plumbing & Pressure Tesi �- 6� �Electrical UFER Grnd. . �^ 57. �APPROVALTO COVER-GUNITE . 7. Footings �' � , 58. Electrical Conduit-Undrgrnd. i' 8. Foundatlon . . � 59. Gas Pipe, O Undrgrnd., Test i 9� Water Pipe�Undrgrnd. I � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � ! 61. APPROVAL TO DECK I' � • 71. Property Sewer Line'& House Connection ' 62. Backwash & Receptor-Final . 12. Sev�ec Cap �• 63. Heater & Vent-Final � � � 13..Roof,DrainS . � 64. Plumbing System - Final ' 14. Rough Plumbing' . 65. Electrical-Final 15. R�ou� 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 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, io $tructure 70. Underground Hyd�o 2� Ducffi, Ventilating 71. Product Piping �Gas ❑Oil 23. c Pipe-Rough &� est 72. Underground Flush 24. FoofFraming ' � 73. Undergmd.StorageTankOGas ❑Oil 25.: Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe . Z8 Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80: FOOD CERTIFICATE ISSUED 33. Final Electric ' . Notes: �G 5 .� 34. Final Heating & Air Conditioning � �. 35. Final Gas Pipe-Test '' . 36. Hood or Canopy � % � o 37. Final Factory Fireplace t �� 38. Final Plumbing ' 1 � � � 39. Water Service-Final ; 1 ; � � ' 40. Gas Serdice-Final ' � 41. Solat DomesticFinal � � 42. Back�flow Preventer � � " 43. Backflow Irri9ation � . � � � 44. .Landscape Irrigation Systerti . � 45. Sound Attenuation � � . � 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 5 � 48. Special Requirements Completed � 49. Eleciric Release to Edison �. 50. Gas Release to Southern California Gas Co ''• � . 51. CERTIFICATE OF OCCUPANCY . .' . No. � Date ' ' , �b�^_ t +i . n // ��_ � �� , �E. r<<1 '' �G� � '� °X�n "�a�.'.2, " F � „x.� �r�i�.:� �""_^--_- , ..----...._�._:_�-_ _-._ � :�,: �� , l� 0 S� . _.. _ / / ,.�_ _.. �s� �'b�`riy`. �: �,�•�it'�� ---- � j ' / � I �pp�° 0� of Sost� Mesa 6�; 5 MU �T BE ON JOE �-CHANGES WITHOUT PI IF_ � — ~ANCE OR I NTING OF A PE 1F- � 0'S:fdSD SFECIFSC TIONS SHALL N �0- E'A-:.PERMIT fOR, A AN APPRO`IAL 1 ;� 'OF'THE PROVI�O 5 Of THIS COD� iNNING TO GIVE AUTHO�2ITY TO VIOLAT =RC�YI IONS OF THIS COpE SHALL BE Vi 'AR A THE WORK OR US€ WHICH IT AUTF �� 4IE��SUANGE�pFIA�K�wi'/BFSEI iFE 1 ICA7l�N5 SHALLrN�T PREVENT THE f"� � HEREAfTER REdUI�tING THE CORR IN�AID FLANS ANO �P IFICATION3 OR fUl D NC OPERATIONS BE�NG CPRRIED ON IN I�LFTIC`l OF THIS C�DE OR OF ANY C' �H, CITY. _ __` f _I � I i ._ 1--'-----' �� I AlL TIMES APPROVAL OR APPROVNL � = CONSTRUED NY VIOLATION � PERMIT PRE. � � CANCEL THE! EXCFPT IN SO :S IS LAWFU4 IN PLANS AND� DING OFFICIAL' N Oc ERRORS, I \� � I i I ..�..-._.. ."_I....__.... _ i_,__ "' _" � _.._"_ "_ !.�3— :_..__. . j.. ..._..__..__. _ _ _ .- -- -- � -- - -,, -_._ - --- ------- -----�---------------__ _--- --------- _ ... _,_ - - - - �-- - _ _----- ------ - ----------------------- - ��-n'4.� � r>,,� ., ,....L--,,j;,a,-_., � , ti:_ :�% �� rii�c ��c.`_ ��.''%c%e:.�»�' iC%i;i? C':'-y".,.='_17 :��j'� `-%�.r..'' 1'r' ��; ,t=� �'��__.i'ia-.?y..`,'7 r . _ _9 "�'.�o "�G''i:�,ri=y�0/�iC=°c:�. ,. iVc�7��: , , � y_ � ,, y �,.,�� ,c- r ,,r-,,1;..c��r . j'�//�%k / i r/l./ �� i'��....i'l:..,� � i.-:_.. i�'!� .... /: �� t.'% C� �'Q "-,. '". w, '1 J 1 T L" � c^ / 1 i--a _..�. _ / r Y �„ . . .r � .� .`1- // C. !"' :1� L..� �: ;'% C:;;' !' : -:"r: ,.' VI 4. � =7 ��!�..J_T`�':.�-C././i 4.-^+..�_/�f.. �_L� .<�.�,�%�'r/1�" -G.�.CiN/ - c.`=�� ; �� r.'_------ .«'�,�� . �i�yT�oosess: 3484 pUEENS CT OWNEH'S NAME: SANDERS, BURTON PARKER nooness: SANDERS SHARON L 3484 QU�ENS CT COSTA MESA,CA 9267.6 APCH/ENCINEEN: LEONARD BEKEMEYER ADOHE55: 'ZIOG? BROOHHURST � � I �I uxiT: nec.xo.: CO UNIT: H.B. CA 92646 renminee: LOREN WATKINS ( 714 ) 841-2521 aooeess: �ggl ELLIS 1 HUNTINGTON BEACH CA 92648 UCENSEO CONTflACiOB OECIAflATION: I �ereby al�irm Ihai I am lit¢nseE under Omvisions a� C�apier 9(tamme ng Sec�ion 70W� ol Oivision 3 0l ��e Business antl Pro�essions Code, antl my lic nse is in �ull brce antl e��ect. � cin uc.: � S 5 0 3 7�,�!$^rE ��n 616 3 3 P CO�ss° B j � j/'� �a�e: � r I / � �"44i9naW _ �7�i.�C/ L�L� W —\— WOHNEPS`COMPENSpT10N DECLAPRYION: I �erehj,�fli�m Iha� I have a ceriilica�e of consent ta Selt-insure o� a cehilicatE ol Workers' Comp¢nsation Insurance. or a certilieA copy Ihereoi (Seclion 3800, Lab. C�. �OLICY NO.: E%P. ORTE: "OMPPNY: � Cerlilietl copy is here�y Iumi5he0. ❑ Ce�ilietl copy is lilea wii� Ihe ciry Builaing Divisian. Oate: �� / � AP�IicanP. �, � E%EMPfIONfPOMWOflNEflS'COMPENSATIUNOECIAPRTION: (TNs uo neeCr{�bewmplelWilNeperm�isl meh r �f100�a1ess�. I ceNfy I�al in ��e pedormance of �he wo�k lor whic� t�is permii' � 0. I shaltha� employ any rso in y ma as Io �ecame 5u01ect �o Ihe Workers' Campens ' n Laws ol Calilomia. J �ate: '` ' ignalure: N TILE: II, after making Ihis Ueclaration. you shoul ecome subject to ��e Workers' Compensa�ion pmvis 5 oft�e labar COUe. y0u must fonhwith tomply vnt� such pmvi9ons or tN5 permit shall De Ceem¢E rewkeA. , — CONSTflOtTION LENOING aCENtY: I nere�y aflirm ihat Inere is a consimction IenOing aAency br ihe pedormance ai ihe wark for wNch inis oe�miiis issuea (Section 3097. Gv. C�. ' LENOEfl: ! FDONESS: � OWNEB BUIWEB OECLABRTIDN: I here0y allirm Itut I am exempl imm �he Comracmrs' S�a�e License Law �or �he �ollowinp reason (Setlion 7031.5 Busines5 anU Prof¢55ional Cotle: pny ti�y al COunry w�ith r¢Quires a De�mii l0 tonSimCt, al�¢f, impmve, Cem01¢A, ar reoair any simcture, prior lo its issuance, also requires Ihe applicant lor such permit to file a signetl statement that Ae/slle is licensetl pursuanl Io Ihe pmvisions ol ihe ConVac�ors' Siale License law (Chapter 9 �commencing wit� Section 7000) of Division 3 oi ihe Business an0 Prolesvons CoOe) or tha� he/s�e is erempt iherelmm anA the 6avs for t�e allegeJ exemption. Any violation ol Section 7031.5 by any applicanl for a Dermi� Su0lec�s I�e applicant Io a civil Denalry of nol mOre ihan �ive hunUretl adlars (f500�. I. as owner af the OmDerty ar my employees with wages as their mle campenution, will ao �he work, an0 Ine ❑ simcmre is not intenaetl or olteree lor sale (Section 704a, Business an0 Pmfeuional Cotle: The Coniracrors State Liunse Law Ooes not apply lo an owner o� a propehy who builtls or impmves I�ereon, antl who does such work himselUhersel� or �hmuAh � hi5 ar her own empl0yee5, O�oviEeG IAaI Sut� impwvemenis are n01 intentletl Or Ott¢rea �Or Sale. Ii. however �he GuilAinO Or impmvemem is solA vnihin one year oi completion, Ihe owner wi0 �ave ��e bureen ol pmving he/sAe Uitl noi buila or imOmve loi Ine ourpose of Salel. I, as owner of t�e property, am eaclusivery coniracting with IicenseU caniractors to constNct l�e project (Sfttian 704d, Business ❑ antl Protessions CoOe: The Comramors' Sta�e License Law Ooes no1 apPly to an awner ol property who GuilJs or im0�o�es Ihereon antl who [onlratts lor Such pmled5 wilh a toniracim�5�licen5e pUrSUan�lo the ConiraC�ofs' S�a�e Litense Law�. I am aware t�al O�ool o� their Worker's Compensation insurance stwNA De D��OeO to me. � I am e�empl un0er 5¢ction: B. 8 P. C. i�i�reas^ / � r � Da�e: � � Owner. 1 tlo nerebvi cenily �nat I am aware ol antl uneersian0 ine requiremenis of Catilomia Nealth antl Sale�y Coae Sections 25505, 25533, an0 2553< anG Inat I or any IWure EuitAing occupan� wilVwill no1 �circle one� nee0 to compty wilh saitl s�a�e toEes anE IAe repuiremen�s �or a permil br conslmciion oi moGi�iwiion imm Ihe Air OuaOry Managemen� Ois�ncl. Besiden�ial cons�mction applicatpns are exemp� Irom ., Inese provisions. w . Date: Fpp�icanC IhereGy ttrlilythall have rea0t�i5 aDD�ication antl stati or0inaricesan4 slatelaxSreW�inglo Guilainq tonsvucli0n pmperty lo inspeclion pi po e^. oaie: � Signa� Oriver's License or Sacia� Security x: is carrect. I I6aL46 wni�e—Buildmg: Gmen—Coeo Enlorcement: Canary—npplicnm; Pink—Ravanue; Goltlenro0—Assassor and CITY OF COSTA MES:A — BUILDING PERMIT PERM NO; E 059489 PERMIT NO: E 059489 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE; ADD JOB DESCRIPTION : ADD 351Sr LOFT OVER EXIST LIVING ROOM SQ FT; CLAIM VALUE; CALC—VALUE; GROUP OCC; R-3 / COMMENTS; RE;#H59468 �******��rx**�r�rx**�r**�x�c�*�**#�rx**x��**x�r�t*�r+t*x�x�**x��r�*��r,t�r**�txx**i�+r*�*�c��t******� 2 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 BOILDING ---------- --------- ACCESSORY BUILUING --------- 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 RE • PROV: PARCEL; 41209273 2NE; REF NO: PLANNING N TES> i � �e��*��***��rxx**x,cx*��t��r***�u*x��Fx�F•xi��r***x�***�rf�x�**�e�x x*+�**�r**x�x��t� x��*#�*#�**�r D E V S 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 20NING APPkOVED HY , HUILDING APPROVED BY : DATE; DA2E; APPLICATION ISSUED BY• ' � DATE; �O I 1 itififitififififiEiFifiEifrtiEiE�lE-%3EitiE-%iFiFiFiFiFiFiFiFiFiFiFiF',fiF3F�f�F'iFiF3F iEiF7FiF3FiFiFiFiE3FiFifiEiF#1fiFiFi(�iEif r r e ir iE-1E iflf iE iF iF 1ElE #!E iF 1E If i! if it iF ik it i(� if iE it it ft ik 1f iF ik i(� iF iF if.# iE if iE ih iE fki! if fF iE If ik iF iF iE N� f6 iF �IF iE if iE iE # iE iE ft �E i! iEil� ii� fF !E fF if iE # it ff iF!!� �!E iE iFlt LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 31,95 508 SMIP/NON—RES PLAN ZSSUE FEE 15.00 BUILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 31.95 15.00 0.00 REVENUE DIVISION T'OTALS--> COLLECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC 46.95 TOTAL PAID DUE 46,95 46.95 .00 46.95 OVER/SHORT; .00 FIRE SMZP/TOT GRADING PLAN—CHECK # iE'lE iF if k!f # if iE �1E 1E if iE fF iE lf 1E fE k ik iF jE fE # iF iE i(� if iE 1F iE iE iE 1E iE iE iE 1E iE iE 1E iF fE iF # iE 1f IE 1E 1E IE iFiE if 3E If !(� iE 7klF iE 1E iE iE i(�!E!k if ik iElf iE iE 1E i(� Ik if iE I N D Z V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL CO5T ELE 20 FIX1'URES, LIGHTING i ST 20 EA, ,75 15,00 ELE 16 FIXTURES LIGH'PING ADDITIONAL EA. ,45 7,20 ELE 10 RECEPT/O{1TLET 1 ST 20 EA, ,75 7,50 ELE 3 RECEPT/SWITCH 1 ST 20 EA, .75 2,25 END OF FEES I CONSTRUCTION AND PLANNING , APPROVALS Permit # t. Temporary E�ectrical Serviac�'of Pole 2. Soil Pipe�Undrgrnd. � 3. Electrical Conduit Utility�Uqcl�grnd. 4. Electrical Conduit-Undrgm�.� 5. Steel Reinforcement 6. Elec:r:cal UFER GrrrJ. 7. Footing: � � 8. Poundation � � � 9. Wa[er Pipe-Undrgmd. �- � 10. Structural Floor SYstem ` ' 11. Property Sewer Line & House,Connection 12. Sewer Cap ' ..-r q 73. Roof Drains t 74. Rough Plumbing ` . � 15. Rough Electrical-Conduit�,,� 16. Rough Electrtc Wiring'• ,�`<, -a 77. Rough Wiring Sign�,.: � �, 18. Rough Electrical�T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts,in Structure 22. Ducts, Veniilating 23. Gas Pipe�Rough & Tesc 24. Roof Framing 25. Roof Sheathing 26. T�Bar Ceiling (Structuraq & Monocoat 27. Frameand flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power MeterFinai 33. Final Eleciric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service�Final 40. Gas Service�Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTUFE & BUIIpING 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southern Cal(fornia Gas G Date Date Inspector . r �� . i I � � - r Pl & SPA APPROVALS Permit # 52. Pool & Equipment Location � ,' 53. Steel Reinforcement � 54. Forms � 55. Electriwl Bonding " 56. Rough Plumbing & Pressure Test � � / 57. APPROVAL TO COVER�GUNITE-,� 58. Electrical Conduit-Undrgrnd. � 59. Gas Pipe, O Undrgrnd., Test 60. 8ackwash Lines, P-Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent�Final 64. Plumbing System - Final 65. Electrical�Final 66. Solar System-Final ,67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping � Gas � Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: Date inspector � . L� � 1 .� .:.; ., OWENS-CORNING . _Fiberglas �ianket Insulation The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carries the NAHB Research Foundation, Inc. label for assured thermal performance arid that the Blanket Insulation is in- stalled in conformance with current energy conservation regulations, California Administrative Code, Title 25, State of California, in the building located at: �3/l�'� �..o�'iy.� /�,nZii�T 9 /4� %s-. . Street Lot Number Tract Number Exterior Walls Owens-Corning Fiberqlas Blanket Insulation Ceilings Owens-Corning Fiberglas Blanket Insulation Floors Owens-Corning Fiberglas Blanket Insulation Foundation Walls Manutacturer General 3� �' 1/ Thickness R-Value _ �� / % a Thickness R-Value Thickness R-Value Type Thickness R-Value License No By Title Date (Signature�7 �/ �J � /�y� ,l Insulat ontr tor �!,/�/��/��J74/�7lLl�fcrn/,['-/�-.%License No. �.��1��/ By � li/��_��2,�.a� Title �/ P Date ��'�/d �'�/ ( gnaNre) Homeowner Copy. (White) State Copy (Yellow) . Builder Copy (Pink) Pub. NO 16�BL699SA Li��O in U$ F., July 19]] OWENS-CORNING FIBERGLAS CORP. Insulation Operating Division Fiberglas Tower, Toletlo. Ohio 43659 , , . , , OWENS-CORNING •--- �, ,.... ,.,,, �.., Fiberglas Blanket Insulation , The contractor named below certifies that the Owens-Corning Fiberglas Blanket Insulation used carriesthe NAHB Research Foundation, Inc. label for assured thermal performance and that the Blanket Insulation is in- stailed in conformance with current energy conservation regulations, California Administrative Code, Title 25, State of California, in the building located at: �� fio/iN�l �in�� 2.L' /l �'`/_h� `T Street Lo� Number �Tract Number Exterior Walls , � �, Owens-Corning Fiberglas Blanket Insulation �� /� Thickness R-Value Ceilings � ,� � Owens-Corning Fiberglas Blanket Insulation /o �� Thickness R-Value Floors Owens-Corning Fiberglas Blanket Insufation Foundation Walls General Thickness � R-Value Manufacturer Type Thickness R-Value License PJo. By � Title Date (Signature) Insulati ontractor��l�'"�-d � %��LicenseNo.13/f/i�.�i r 7,/� g /}' By— —��2� Title 1�,? Date� ��d wre� Homeowner Copy (White) State Copy (Yellow) , . Builder Copy (Pink)' OWENS-CORNING FIBERGLAS CORP. , , Insulation Opereting Division PvO. No. 16�BL6995-A ��cno �� us a.. dury isn � Fiberglas Tower, Toledo, Ohio 43659 F � � a ¢ � � S F C W F Q G .� Q > � a w a � C a Z � 2 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING 3489 Queens C011it ADDRESS OWNEROR Wimbledon p.SSOC. TENANT MAILING 1470 Jamboree Rd ADDRE55 CITV Newport Beach T�,o5•40-6800 CONSTRVCTION _ _ BRANCH paGa(�Pna ADDRESS � �+ T �lro Dc+e ApCHITECT Corbin/Yamafuji No5�49-7124 OF ENGINEER nooRess 17992 Mitchell So., Irvine CONTRACTOR MCLdin DeV. Co. ADDRESS 1470 Jamboree RCI CITV Newport Beach No�fi40-6800 �ic No. 2�38�5 �ic�No18873 SIZE NO.OF BLDGS O OF l0T NOW ON LOT USE OF Separate permits are required for electric, plumbing and heating work. USE OF BUIL�ING AND WORK TO BE PEFFOfl� PRD — New Construction Single-family dwelling I heraby acknowladpe that I hava raetl thla eppllcatlon entl stete thax tha above Informatian Is corrott nnd aprea to comply with ell laws rapulatlnB building constructlon, and I aholl not employ ony p¢rwn in violation of the workmnn's compensation lews of tha State ot Celitomla. i �areby certity that I am p�opeily licansetl as a cont�ecta� untle� the Stata ot CelHornie Businesa antl Professions Code, DIvlslon 3, Chapter 9, antl thai suc� lieanses are in full force end affect, or I am axampt from the O�ovisions of tha Stete of Calltornie Businass antl Profassions Coda, Dlvizlon 3, C ept 9. Signature ot Permittee / or Oi1 Authorizetl ABent Date �Z� APPLICATION FOR STRUCTURAL PERMIT RECEIVE BV P_. 1 / BI T�.�� N° �477�J - A.P. NO. . �/S� — D'7 � �� BUILDING ADDRE55 UNIT OR SPACENO.' 22 TR.NO. LOT BLK. 10275 22 NEW ADO ALTER REPAIR MOVING DEMOLISH x OWNER Wlm�leaon .9550C VALUE �� usE PRD �-5—rJ ZONE DPl—�U TVPE,V—N GROUP R� APPROVED BY DATE � 20 APPROVEDSETBACKS (FROMZ;7�L7'�'fKtEET1 L FROM o�-D FT. R. SIDE c'] FT. L SIDE � FT. REAR � / FT. PLANNING ACTION �— 75�� ROVED �—�/ nw ov � g ttOLD FOR SPECIAL REQ ENl P � ' O V � a sa. FT. � -�s � � T� AMOUNTSHO N VNDER VALUATION IS FOR m � THE PVRP�E OF ESTABLSHING A PERMIT FEE ONLY: � � VALUATION PERMIT FEE S �� q m � n PLAN CHECK 5 "� O LL 5�1� 3� TAX S g f� V TOTALPAID 5 (�' ` F �d a Q y y 5 F G w F Q 0 :� Q > } .� � w a � iY. L Z W 3 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For AppGcant to FHI in Completely — Use Ink Only AODRESS 3484 Queens C011rt OWNEROR Wimbledon ASSOC. TENANT ADDRE55 1470 Jamboree Rd. c�r� Newport Beach No`fi40-680 � oERC71O"'Imperial Savings & Loan BRANCH Pasadena ADDRESS 61 S. Lake Ave. ARCNITECT Corbin/Yamafu 1 TEL.S�}9-�IZZ OR ENGINEER � NO. ADDRESS 17992 Mitchell So.,Irvine CONTRACTORMCLd1I1 Dev. Co. ADDRESS 1470 Jamboree Rd. cirr Newport Beach No`640-6800 �ICTivo. z�38�5 uc r,o. 18873 SIZE NO.OF BLOGS. O OF LOT NOW ON LOT USE OF EXISTING BLDG. Separate permits are required for elec[ric, plumbing and heating work: USE OF BUILDING ANO WORK TO BE PEflFOflMED PRD — New Construction Single—family dwelling I hereby ecknowlatlge thet I have reatl this epplication entl stata Mat tha ebove Information Is correct antl apree to com0ly wlt� oll lewz reBuloHnB builtlin0 co^s[ruction, antl I shall not employ ony Oarmn in vlolatlon of the workman's compensallon laws oi Mo Stata ot Colifornia. I heroby cartify ihet I am properly licensetl as a conttactor untler the State of Celitornia Business end Protessions Code, D(vision 3, Chaptar 9, antl Net sueh Iicenses ere in i�ll torca and afieet, or I om ozempt fram Me provislons of t�e Stata ot Calitornia Business ontl Profassiona Coda, Divislon 3,.�ha ter / SIB^ature of j �` . Permlttae �« � or � Authorizatl Agant Date �� 6101 ��?I,/81 289.81 TL APPL[CATION FOR S'IRUCTURAL PERMIT 3 PERMIT *j0 4 7 7 8 3 1 �I A.P. NO. — �— BUILDING ADDRESS UNIT OR SPACE NO. iR.NO. LOT BLK. 10275 9 NEW ADD ALTER REPAIR MOVING DEMOLISH OWNER Wimbledon �i$$�C. vALUE � use pRD s7 , 5 APPROVED „P - 3 / �2v��/ APPROVEDSETBACKS PL PLANNING ACTION Z�' L ' OATE a�-7 APPROVED nav v �Q � ( �9�9 F9R SPECIAL REQ MENT� TMEAMOUNTSHOWN UNDER VALU THE PURP06E OF ESTABLISMING A PERI VALUATION PERMIT FEE E PLAN CHECK S g Qj�J/ � AA TA% S � ( �fJ TOTALPAID b � � 'm m ON 1 DR m r� V: � � -' N � m � n 0 i f �u �