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Home My WebLink About341 RAMONA PL - Building Permits/ ��ia»sa-sz�a • Fax (�ia) �sa-aess Job Address: $41 RAMONA PL Suite: Vicinity: REAR OF PROPERTY Parcel N�mber: 42532110 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT Zoning: npp�icant: GOSSELIN, LAWRENCE JOSEPH Address: 341 RAMONA PL COSTA MESA, CA Phone: (949)722-2500 Zip: 92627 owner: GOSSELIN, LAWRENCE JOSEPH Address 341 RAMONA PL COSTA MESA, CA Contractor: O WN ER-B U I LD ER Address: Zip: Arch : LESTER KEPHART Address: 326 L STREET Phone: Zip: 92627 Phone: License: 0 Eng: Address: Phone: (949)675-2959 PERMIT NUMBER B99-01734 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 10/27/1999 Issued: 02/02/2000 ISSUED BY: � , � i� � •�I � V � � Phone: BALBOAISLAND,CA � Zip: 92661 License: License: SCOPE OF PERMIT CONSTRUCT NEW 346 SF FIRST FLOOR DINING/FAMILY ROOM AND 706 SF GARAGE WITH 591 SF MASTER BEDROOM & BATHROOM ABOVE GARAGE ON SECOND FLOOR . _ Plan Check: $627.74 Permit: $965.75 SMIP Res: $9.60 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,603.09 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0- 0 PARKING Existinq: o Rear 0- 0 Rear 0- 0 Required: 0 FEESUMMARY PLANNING & ZONING Left 0- 0 LeN 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $95,998.50 so.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or if work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for ihe work authonzed under this permit to be considered legal, such work must comply with all applicable codes, and all requlred InspecNone and final approval must 6e obtained. Failure to obtain inspections and final approval will result in the expiration of Ihis permit. FOR INSPECTIONS CALL: (714) 7545626 C� WORKERS' COMPENSATION DECLARATION: I herehy aHirtn untler penalry of perjury one ol ihe tollowing declaretions: ❑ I heve and will maintain a certificate ot consent to self-Insure for workers' compensation, as provided for by sectlon 3700 of the Labor Cotle. for ihe pertormance oi Ihe work for which this permit is issuetl. ❑ I have antl will maiNain workers' compensation insurance, as required hy saction 3700 ot Ihe Labor Cotle, for the paAortnance ot Ne work tor which Ihis pertnit is issued. My workers' compensation Insurance cartier antl policy number ere: Carrier: Policy Number. (ihis secfian need nat be cample(ed it the permit is veluetl af one hundred dollers ($100) or less.) ❑ I certity that in ihe pertormence of the work for which this permit is issueq I shall not employ any person in eny manner so as to became sublect to Ihe workere' compensation laws of Celifornie, entl agree Ihat it I s�oultl becoma subjeci b �he workers' compensalion pmvisions o} Section 3700 of the Lebor Code, I shall forthwith comply wiN these provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVEfiAGE IS UNLAWFUL NND SHALL SUflIEGT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED T/%)USAND OOLLARE (5100,000�, IN ADDITIIXJ TO THE COST OF COMPENSATION, OAMAGES AS PROVIDED FOR IN SECTION 37080F THE LABOR COOE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby effirm �hat I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code, antl my license is in full lorce and affecL Lic. u qass x Contrectofs Signature: Date: CONS7RUCTION LENDING AGENCY: ❑ I hereby attirm iha� ihere is a constmction lending agency for the pertormance of tha work for which this permit is issuetl. (Sec. 3097, Civil Cotle). Lender's Neme: Lender's Address: Signeture: Date: I hereby aflirtn ihat under penelry; o� perjury that I am EXEMP7 FROM TME CONTRACTORS LICENSE LAW for ihe following reason (Sec. 7031.5, Business and Professions Cotle: Any ciry or counry wtiich repuires'a pepntl to construct, alter, improva, demolish, or repair any siructure, pnor to its issuance, also requires ihe applicant for such pertnit b file e signetl statement t�a� he or sh@,is flcensed pursuant to the pmvisions ot Ihe Contractoro License Law (Chapter 9(wmmencing with Section 7000) of Division 3 of the Business end Pmfeuions Code) or ihat Ke�or she is exempt Iheretrom end the basis tor t�e alleged exemption. Any violation of Section 7031.5 6y any aOPlicant for a pertnit subJacts t�e applicant to a civil penalry ol no� more than fiva hundred dollars (5500).): i�. ❑ 11, es owner oi the property, or my employees with wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intended or oHeretl for sale (Sec. —704A, Business and Professions Cotle: The Coniractors License Law tloes not epply to an owner of property who builds or improves ihereon, end who tloes such work himself or herself or thmugh his or her own employees, provided thut such improvements are not intended or offered for sale. If, however, ihe building or improvemem is soltl within one year oi completion, the ownervbuiltler will have the burden oi proving thet he or she tlitl not build or impwve for purpose of sale.). ❑ I, as owner of the property, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Professions Cotle: The coniractors License Law tloes not apply to an owner of property who builds or impmves thereon, antl who comracis for such projact with e contractor(s) license pursuant to the Comractors License WwsJ. I am exempt untler sec. venfietl by tlrivers license. ❑ Ves ❑ No Business and Protessions Code for this reason: IDe�e:_ � Dnver's License No. � Expires: � � i Vedfication of Ownership by (type of documem, i.a. - pmperty tax bill or DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify Ihat no excavation five (5) or more feet In tlepih into which a person is requiretl to tlescend, will be made in connection with work authorized by this permit, antl that no builtling simcWre, scaHolding, falsework, or demolition or dismantling thereof, will be more ihan thirty-siz (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, TiOe 8, Califomia Admini5tretive Cotle). ❑ As owneo-builder, I will not employ anyone to tlo work which woultl require a permit irom the Division of Industnal Safery, as notetl above, unless such person has a permit ro do such work fmm ihe division. Siqne�ure: Daie: Division ol Indus�rial Safery Permit Number. CERTFICATE OF COMPLI CE AND AUh10Rl ION OF ENTRV: I certi}y under penalry of perjury that I have read ihis application and state that the information given is correct I egree to comply i all state laws an iry ordinances relating �o builtling constmction, and authorize representa�ives ot �he City of Costa Mesa �o enter upon the e6ove-tlescri6etl roperty inspection pur s. I egree no� �o occupy or allow occupancy of any builtling amhorizetl by this permit umil tinal inspection. � �— 3�--'�-�°b Signatu'e O Le( gal Owner(s),..��--! �Dale - ! ��— AnNOr Authorized Applican� Date CODE y, INSPECiIONTYPE 1616 Fixetl System Final Fire Prevention 1266 Pool Spa Final 200 Finel Fe-Roof 201 Final Block/Retaining Wall 202 203 204 24<&a8 Final Factory Fire Place Final Sign Final Demolition I�A� INTRIALS COOE I INSPECTION TYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fira Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling�Occupancy o"rE �NTRIALS To: NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 (x) City of Costa Mesa ( ) Ciry of NewpoR Beach ( ) County of Orange . ,� i 3321 ` District Receipt No. Plan Check No. �q9,-0173� Applicant LAv.tREh\CF T C70CSL1L\N Address: 3Q� RAMf1N� QL. Cf9C1% /`qES� i C 14 . 9 Z(o Z7 Telephone Number. �i9�9.��222" •ZrJO`� TracUParcel and Lot Number(s): �i2,'rJ —�2� — I � LocationofProject: 3q� �A-MON/4 Ql.., f'�C74 ML.�i�-. �'J�� 12-�Z1 Number of Square Feet of: Residential Space �Q� x $1.84 937 bF ►�e�t -►3� sF �va. = go� sF Commercial and Industrial Space Commercial/Industrial Project is: (Check One) _ Warehouse _ R8D _ Movie Theater _ Mini-storage _ Heavy Industrial _ Regional Shops _ Light Industrial This project is exempt because x$.30 Total ��.�13 �'-'� Total �,�,yp, ��'''`''�'� 1 _ Bank � j yJ � ' < '. _ Neighborhood 6�iqp��. (; � t!�n9 _ RacqueUHealtfi�'' Med cal 0(fice CI I!. Qf ��Si �` iit�� Office Park Preschool Auto Repair Hospital Large Office Office Bldg. Restaurant Fast Food This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code secdons 53080 and 65995. The Building Permils for this square footage in this proposed development may now be issued by your jurisdic5on. Checks are to be made payable to Newport-Mesa Unified School District. AWhorized The above representation as to square footage is Vue. Applicant agrees that if it is later determined that such representations are not true, then this certificate shall automatically terminate and the appropria�Ciry/County shall be notified. �--3 2-0�� Date: Appliwnt C�-�, b� ��ia �yV1�S�A {�y � �Nv� M � , ,i��-� �6�.-� �� usfi2s�ovv . ,Q/ v�sla � ,�1��--e �� ,�� s�,� ` �oa�,� �� .�� s�� r,vi�� ,ze /�� G/�� G:�,��-��o�. �" 9',�Nd �i�.e �� c��i-�(� p.s � ��,�� r � � � �� -� � ��q° �� p� �� e r�v � �,a� � ,�i� � -�u �e�� ri��j �s f�� -�`� �I� /Uvw � Go � �o'�✓ �;�up�bz� c�� -�� oC�a /r��- �� --� � o ��t 'r � .u- �� rn,.-G �� v� , / , � J �i �aSF-Cl� r� 7� � %� -�` A � � �- �. l399 -017 3 � � . � �op �- o00 3 � (G)i2i�t>p �DO� a� �_i � pc�o - o00 �.8 F� q� _ oDa a S� L,Aw�-e N� �o�s�G�.c� 3�fr ��o� p� , �as�� 1 ��r�L � 4�2�3a--Ila� ' �?l�, �71 � � �'7 � —�6"b FR�M : RESTRIIP.ANTS EXPRESS ?<'�.�'ie! i � ft�i,G%�S �in�''QV,. 359 Ramona Way Casta Mesa, CA 92fi27 949) 650-t f 88 FfiX ?1Z4NSr�VI � � /kL �DF�.ti! �'� essoo,e: FAX N0. : 7142559765 Dec. 31 2003 12:0aPM PI To: Plannuig DepL Name: Planner of property eddress: 341 Rertwna PI. CC: P�one: Fax: >ea� �Lo,wwCv� Dept., from: Nlezis Barton Date $ent 12-11-03 Number ot Pages:l t�� ✓�usbawJ. aV.d i purc4;ased. a house on r�cw�.owA wa� ;w Ntay � thi.< year awd we ha.ve �eaety ?wjou�ed c.�r �w �.ei.ghb�rh�od. wC h�ve v�eiahbors however ov� �avv.owa ?lace thac �ave had. a owgoCV„a, co�.scn.�c*Con.proiect. Maw� of our we�c+hbors ��ave saLd., `tha.� ttie COwStYUGt%On, hA5 90wC o�n. TDr rr2w� �ec!rs'? -r'ne bu��di.h.g thac si.ts e� �Ne bacl� o f`he%r lec i,s ver�u v�sib! e,—`ror�� our bac{z�a.rd. riie co�.structCow seenas to stap fov vu.aw� vkowths av�.d ��aw pCcizs kp aaAi.w ost ��r�ne bLue. we nave wowdered vu.awy� tCw es Cf there Cs a cer'ta�w aw�.ou,nt ef tivuz tne c�ty o-;'' cos�a n��ca a��ows a project ��o go owTor? we ave pl.awwC�.o a ✓�N.n,OGIE� 'PYOJec� C� �ne �a•r future a�.ct wa�x to g�ve our �.e�ahbors ever� cofsidevatCow iw �``eous�Gv�.y ourp'rof°et iv�. � tiw.el� na�wv�er. l�ne cowstn.cctiov� !�ca*i.ovL i.s: 341 R.uvu.o+ut vince Gosta MeSy3_ -�ne v�,aw;e owt�t�e ts: e�. �osse�tw t_auvewee'. (there Are wo o.d,dress wuw�bers v�si.bl,e froV� tne stveet so i caL!ed. ,ttleto fwuA ouc). i a�f� wot fa��.i.i ;ar w�th au tne e�.t� o f Costa Mesa's codes or vio�attow ol codes awd i wou�d app•recl�te C�se:ueon.e co��d. fo�l.ow ,�p wi.ti� vu.e ow tl�i.s v��cattev. 1�avii2 �ok, s��ex sa�toK y�9> 6.so-�ss. ,��/�3 p.��,�'� �.��. -rhaw� You �or Your rw.e, � � """" � � �.2.y�t� ,e��A� �� o s�llexis 3ar�ow � _ _ . n � `J �� ,/,, i.� � ,i�� / i 1"� � / � � CITY OF COSTA MESA �-j BUILDING DIYISION �� DEVELOPMENT SERVICES DEPARTMENT ` PERMIT (�ia) �sa-sz�s • Fax (>ia� �sa-aess Job Atldress: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address Contrector: Address: ELECTRICAL PERMIT 341 RAMONA PL DETACHED GARAGE 42532110 GOSSELIN, LAWRENCE JOSEPH 341 RAMONA Pl COSTA MESA, CA Phone: (949)722-2500 Zip:. 92627 GOSSELIN,LAWRENCEJOSEPH 341 RAMONA PL COSTA MESA, CA OWNER-BUILDER Phone: Zip: 92627 Phone: Zip: License: 0 PERMIT NUMBER E00-00038 77 FAIR DRNE, COSTA MESA, CA 92626 ISSUED BY: stams: ISSUED Applied: 01I14/2000 Issued: 02/02/2000 SCOPE OF PERMIT 38 LIGHTS, 26 OUTLETS, 15 SWITCHES AND 1 200 AMPS SUB-PANEL FOR NEW DETACHED GARAGE WITH SECOND STORY ABOVE. REF:B99-01734 ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t 000a Service over 1000a Motors to 1hp Motors to 70hp Motors to SOhp Motors to 100hp Motors over t00hp Communication drops $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $33.14 $24.38 $16.50 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 so.00 $0.00 $0.00 Quantity 0 0 0 38 26 15 0 0 0 0 0 0 0 0 0 0 0 FEESUMMARY Temp Dist System / Lighting Busway /100 ft Standing Section Misc Electrical Equipment Trensformers up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 700 kva/kw Low Voltage Equipment Low Volt Wiring System / Ckt Misc. Conduit Misc. Conductor Circus ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee Invesligation Fee Quantity $0.00 0 $0.00 0 $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 50.00 0 50.00 0 S0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 $0.00 V NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. � � INSPECTIONS: In ord@r for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspectlone ahd (Inal approval must be obtained. Failure to obtain inspections antl final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 , � � WORKERS'COMPENSAnON DECLARAnON: I hereby eflirtn untler penatry of perjury one oi the following declarations: ❑ I �eve entl will meintain a certiticata of consent to self-Insure for workere' compensation, es provitletl for Ey section 3700 ot the LaDor Code, lor Ihe performance of the work far which i�is permii is issued. ❑ I hava end wlll meintain wolkers' COmpensation in5u2nCe, a5 required by section 3700 of Ihe Lebor Code, for Ihe peAormence of Ihe work tw which this pertnit is issued. My workers' compensation Insurance carrier end policy number are: Cartier. PoliCy Number: (This secfion need not be comp/etetl i/ the permit is valued af one huntlretl tlollars ($100) or /ess.) ❑ I certify that In the pedormence of ihe work lor which this permit is issued, I shell not employ any person in any menner so as to become subject to the workers' compansation laws of Califomia, and agree Ihat if I shoultl become sublect to ihe workers' compensation provisions of Section 3700 of the Labor Cotle, I shall forthwith comply with these provisions. Applicent Signeture: Date: WARNING: FAILURE TO SECUFE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHFLL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOIIARE (5100,OW�, IN ADDITION TO THE COST OF WMPENSATION, OAMAGES AS PqOVIDED FOR IN SECTION 3JW OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: . I hereby attirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Profassions Code, antl my license is in full force antl eHect. Lic. # Class M Contraccors Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ I hareby aflirm Ihet ihere is a construction lending egency for iha pertormance of ihe work for which this permit is issued. (Sec. 3097, Civil Code). � Lender's Name: Lentlefs Address: Signature: Date: OWNER-BUILOERDECLARATIONS: � I here6y eHirtn that untler penalty ot perjury ��at I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Cotle: Any city or counry which repuires a permit to consiruct, elter, improve, demolish, or repair any sirucWre, prior to its issuance, also requires the applicenl for such parmit to file a signed statemen� ihat he or she is licensed pursuam ro the pmvisions ot the Contractors License Law (C�apter 9(commencing wlih Section 7000) ot Dlvision 3 of Ihe Business'antl�P,mfessions Cotle) or that he or she is exempt therelrom end the Dasis for the alleged exemption. Any violation ot Section 7031.5 by eny e001icent for a permit su6jects;the eppllcant to e ciWl penalty of not more than five hundred dollars ($500).): ❑ I`vn / r�. es owner.of.lha propeny, or my employees with wages as their sole compensation, WILL DO THE WORK, end the siructure is not intended or otteretl for sala (Sec. �7044, Busiriess,and Pwfessions Code: The Conirectors Ucense Law tloes not appty to an owner of property who builtls or improves [hereon, entl who tices such work himself or herSelf oi.�hrough his or her own employees, provided that such improvements are not inlended or oHered for sale. If, however, the building or impmvemem is sold wit�in ona yea'r olcompletion, the owner�builtler will have the burden of proving that he or she ditl not bui10 or improve for purpose of sale.). � I, as owner of e pmperty, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Protessions Code: Tlie co r ciors License Law does not apply to en owner ot property who builds or impmves lhereon, antl who contracts for such project wiN e contracror(s) license pursu n to the�Coniractors Licanse Lews.). i ❑ I em emp der Sec. Bu5ine55 and Professions Code tor Ihis reason: Sig a Bj Date;_ % � — '— Owner ID verifi by drivers licensa. ❑ Ves ❑ No Driver's License No. � E�tpires. _� Venfication ot nership by (type of document, i.e. - pmperty tax blll or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I herehy cenity ihat no excavation tive (5) or more feet in depih into which a person is requiretl to tlescend, will be made in connection with work authodzetl by this pertni�, entl that no builtling swcture, scaMoltling, telsework, or tlemolition or tlismamling thereof, will De more ihan thirty-siz (36) fee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle B, Calitornia Adminisiretive Coda). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit irom the Division of Industrial Safary, as noted above, unless such parson has a permit to do such work from che divisian. Signature: Date: Division ol Industnel Sefery Permit Number: CERTIFICA7E OF COMPLIANCE D AUTHORVJRION OF EMAY: I cenify under penalry ol perjury that I have read this application antl state ihat ihe information given is correct. I agree to comply with al ata laws and ciry ordinances relating to building construction, and eNhorize represematives of the City of Costa Mesa to emer upon the aDove-tlescribed property tor in ction pu es. I pree not Io occupy or allow occupanry ol any bullding aulhonzed by this pertnit until tinal inspecli0n. — � �--� 3— zoa ' na ure Ot Lepal.Owner(s)—� Late Antl/Or Authorized Applicam Date COOE y, INSPECTIONTYPE 1616 Fizotl System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof 201 Final BIxWRetaining Wall 202 Finel Factory Fire Place 203 Final Sign 204 Final Demoli�ion 2dC6 4fi QAjF NI TRIALS COOEN INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electnwl 212 Final Fire Prevemion 220 Final Plenning Approval 222 Final Site 250 FinalBuiltling/Occupancy 1HTSL4@ 4G��p M�s9 a, � ' -- p '.- a�� (714)754-5273 • Fax(714)754-4856 JobAddress: 341 RAMONAPL Suite: Vicinity: REAR OF PROPERTY Parcel Nunmber: 42532110 CITY OF COSTA MESA I BUILDING DIVISION o0 7� DEVELOPMENT SERVICES DEPARTMENT � I PERMIT GRADING PERMIT Zoning: Applicant: GOSSELIN, LAWRENCE JOSEPH Address: 347 R4MONA PL COSTA MESA, CA Phone: (949)722-2500 Zip: 92627 Owner: GOSSELIN, LAWRENCE JOSEPH Address 341 RAMONA PL COSTA MESA, CA Contractor: OWNER-BU ILDER Address: Zip: Eng: Address: , Phone: (949)722-2500 Zip: 92627 Phone: License: 0 Phone: PERMIT NUMBER I G99-00028 77 FAIR DRIVE, COSTA MESA, CA 92626 Siatus: ISSUED Applied: 10/27/1999 Issued: 02/03/2000 ISSUED BY: L r' l ,i � .' i J� Zip: - License: SCOPE OF PERMIT CUBIC YARDS � CONSTRUCT NEW 346 SF FIRST FLOOR DINING/FAMILY ROOM AND 706 SF GARAGE WITH 591 SF MASTER BEDROOM 8 BATHROOM ABOVE GAR4GE ON SECOND FLOOR . 48 Plan Check: $0.00 $0.00 Permit: $23.50 Other: $0.00 $0.00 Inspection: $0.00 $0.00 Total: NOTES: $23.50 � FEE SUMMARY PLANNING 8 ZONING Calc Valuation: $o.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) , EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requiretl Inspectiona and final approvel mus� be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 , WORKERS' COMPENSATION DECLARATION: I hereby aHirm untler penelty ot per�ury one ot �he tollowing tleclarations: ❑ I have and wiil maintein a certificate of consent ro self-Insure for workers' compensation, es providetl for by section 3700 oi the Labor Cotla, for ihe pertormance of the work for which this permit is issuetl. ❑ I have antl wlil mainlain workers' compensation insurance, as required hy section 3700 0l the Labor Code, for ihe pedormance of the work lor which this permit is issued. My workers' compensation Insurance carner entl policy number ere: Cartier. Policy Number. (This secfion need not be completetl i/ the peimit is velued et one hundred dollers ($100) or less.) ❑ I certiM1/ Ihat in the perfortnence of the work for which Ihis permit is issueQ I shall not employ eny person in any manner so as to become subject to the workers' compensation laws ol Califomia, and agrea that if I shoultl become sub�ec� to lhe workers' compensetion provisions of Section 3700 of the Lebor Code, I shall forthwith comply with these provisions. Applicant Signature: Date: WAFNING: FAILURE TO SECURE WORKERS' COMPENSATIQV CAVEMGE IS UNIAWFUL AND SHALL SU�ECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE MUNDRED TMOUSAND DOl1ARE �5100.0001, �N ADDITION TOTHE COST OF COMPENSATION, DMtAGES AS PROVIDED FOR IN SECTION 31O60F THE L4BOR COOE, INTEREST, M1D ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I em licensed untler provisions of Chapter 9(wmmendng with Section 7000) of Division 3 of Ihe Business and Professions Code, antl my license is in full force and ettect Lic. a Class # Contractor's Signamre: Date: CONS7RUCTION LENDING AGENCV: ❑ I hereby aflirm tha� �here is a construction lending agancy for ihe pertormance ol the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Neme: Lender's Atldress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aNirtn that untler penalry of perjury that I am E%EMPT FROM 7ME CONTRAC70RS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business antl Professions Code: Any city or counry w�ich requires a permit to constmct, alter, improve, demolish, or repair any strucWre, prior to its issuance, elso requires tha applicant for such permit to file a signetl statement t�et he or she is licensed pursuant to the provisions oi the Contractors License Ww (Chapter 9(commencing wlih Sectian 7000) of Division 3 ot ihe Busineu entl Prolessions Code) or Ihat he or she is e:empt Iherelrom and Ihe basis lor ihe elleged exemption. Any violation ol Section 7037.5 by eny applicant for a permit gu6je�ts t�e epplicant to e civil panelry of not more than five huntlretl tlollars ($500)J: �_I, es owner of the property, or my employees wilh wages as their sole compen5atlon, WILL DO THE WORK, and the strucWre i5 not intentletl or otteretl for sale (Sec. 7044, Business and',Professions Code: The Contractors License Law does not epply to an owner of pmperry who builds or improves thereon, antl who does such work himself or her5elf ot.�hrough;�is or her own employees, provided thal suth improvemenis are not intended or ottered for sale. If, however, the huilding or imOrovemen� is sold within one year of completion,-dhe owner-builtler will have the burden of proving that he or she did not build or improve for purpose of sale.). �� /� i ❑ I, as owner ol e pwperty`am E%CCUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to conswct the pwject (Sec. 7044, Business antl Pmfessions Cotle: The copir cbrs License Law°tloes�not apply to an owner of property who huilds or impmves thereon, and who contracts for such prolect with a contractor(s) licenso pur5ugnt o the Contractors Cicgnse'Laws.). Owner ID verifietl Verification of Ow Business antl Protessions Cotle for this reason: license. ❑ Ves� ❑ No document, i.e. - property taz bill or DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ❑ I hereby certily ihat no e:cavation five (5) or more feet in tlepth into which e parson is requiretl to descend, will be mada in connection with work authorizetl 6y this permi�, antl that no building siructure, scaHolding, falsework, or demolition or tlismantling t�ereof, will be more than Ihirry-six (36) feet high. (Chap. 3.2, Grp 2, An 2, Sec. 341, Title 8, Calibrnia Atlminisirative Code). ❑ A5 owner-6uiltler, I will not employ anyrone to do work which would require a permit from ihe Division of Intlusirial Sefety, es noted above, unless such person has a permit to do such work irom the division. Signature: Date: Division of Indusinal Safety Pertnit Number: COOE �. INSGELiIONTYPE 1616 Fixetl System Finel Fire Prevention 7266 Pool Spa Final 200 Final Re-Roof 201 Final8lock/Retaining Wall 202 Finel Fectory Fire Place 203 204 2b66 as Final Sign Final Demolition OAT �$ CODE♦ INSPECTIONTYiE 206 Final Mechanical 208 Final Plumbing 210 Final Elecincal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Sile 250 FinalBuiltling/Occupancy pATE INiITIPIJ 44��p M�s9 o, - � > _ r J "�.�.�m ^F ��ia� �sa-sz�a • Fa: (�ia) �sa-aess Job Address: Suite No Vicinity: Parcel Number: Applicant: Address: Owner: Address: Contractor: Address: Arch / Eng : Address: REF:899-01734 341 RAMONA PL DETACHED GARAGE 42532110 CITY OF COSTA MESA BIIILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT MECHANICAL PERMIT GOSSELIN, LAWRENCE JOSEPH 341 RAMONA PL COSTA MESA, CA Phone: (949)722-2500 Zip: 92627 GOSSELIN, LAWRENCE JOSEPH 341 RAMONA PL COSTA MESA, CA OWNER-BUILDER Phone: Zip: 92627 Phone: Zip: License: 0 \ Phone: Zip: License: � I3I � I PERMIT NUMBER M00-00026 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 01/t4/2000 Issued: 02/03/2000 ISSUED BY: L� SCOPE OF PERMIT 1 FAU AND 1 GAS PIPING, FOR NEW DETACHED GARAGE WITH SECOND STORY A80VE. ISSUE FEE Insl 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 wlMech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $6.15 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Comme rcia l I ncine retor Domestic Incineraror Compressors / Absomtion Systems Upto3hplt00kBTU 3To15hp/SOOkBTU 15To30hp/1,OOOkBTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Quantity $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 50.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 50.00 50.00 0 0 0 0 0 � � 1 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRA710N: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order tor the work authorized under Ihis permit to be considered legal, such work must comply with all applicable codes, and all raquired Inepeetiona antl flnal approval must be obtained. Failure to obtain inspections end final epproval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aflirm under penelry of perjury one of t�e following tleclarations: ❑ I have antl will maintein a certilicate af consent to self-Insure for workers' compenution, es provitletl For by section 3700 oi the Labor Cotle, tor ihe pertortnanca ot the wOrk for whiCh this perml� is issUetl. ❑ I hava and will maintain workers' compensation insurance, as requiretl by section 3700 0l the Lebor Cotle, for ihe peAortnance of tha work for which ihis permit is issued. My workers' compensation Insurance cerrier and policy number ara: Cerrier: Policy Num6er: (This section neetl not be comp/eted i� the permit is velued et one huntlretl dollers ($100J or less.) ❑ I certity Mat in the pertortnence oi the work for which this permit is issued, I 5hell not employ eny petson in eny manner so as to becoma su6jeCt to the workers' compensation lews of Celifornia, and egree ihat if I should become subject to Ihe workers' compensetion provisions of Section 3700 of the Labor Cotle, I shall fotlhwith comply with these pravisions. Applicant Signature: Date: WARNING FAILUPE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWfUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND QVIL FWES UP TOONE HUNDRED TTIOUSAND DOLLARE (5100,000�, IN ADOITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDEO F-0P IN SECTION 3]O6 OF THE LABOR CODE, IMEREST, ANO ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm ihat I em licensed under provisions ot Chapter 9(commencinq with Section 7000) of Division 3 of Ihe Business antl Professions Code, antl my license is in tull torce and eHecL Lic. a Class # ComractoYs Signature: Date: CONSTRUCTION LENDING AGENLV: ❑ I hereby aHirtn thal there is a consiruction lending agency for iha pedormance oi the work lor whic� this permit is issued. (Sec. 3097, Civil Cotla). Lender's Name: Lendefs Address: SignaWre: Date: OWNER-BUILDER DECLARATIONS: I hereby eNirm ihat under penalry of perjury ihat I am EXEMP7 FROM 7HE CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions Code: Any city or county which requires a parmit to construct, alter, improve, damotish, or repeir eny simcture, prior to its issuance, also requires the applicant tor such permit to file a signed stetement ihat he or she is licensed pursuant to the provisions of the Coniractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of �he Business and Professions Code) or that he or she is exempt t�erefmm end the basis for the allaged exemption. Any violation oi Section 7031.5 by eny applicant for e permit sub�ects the epplicent to e civll penalty of not more than five huntlretl tlollers ($500).): �-rl, as owner of the Oroperty, or my employees with wages as their sole compensetion, WILL DO THE WORK, antl the structure is not intended or oHeretl for sale (Sec. �7044, Business and Pmfessions Code: The Contractors License Law tloes not epply to en owner of pmperty who builds or improves thereon, antl who tloes such work himself or herself or Nrough his or her own employees, provided ihat such improvements ere nol intendetl or oflered for sale. If, however, the building or improvement is sold wilhin one yeer of completioq Ihe owner�6uildef will have the burtlen of proving that he or she did not build or impmve for purpose of sale.). ❑ I, as owner of the properry, am,EXCLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to wnstruct the project (Sec. 7044, Business and Pmfessions Code: The contrec�qrs License,Law-tloes not apply to an owner of property who builtls or impmves thereon, and who coniracts for such pmject with a coniractor(s) license pursuant ir/}he Conirectors'Li�rise.Laws.). p_I.�m exerhp �SignatGre: _ Owner ID venfied Venfication oi Ow sec. liCenSe. ' ❑ Yes by (type of document, i.e. Business and Professions Code for this reason: ordeed): No. DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICA710N: ❑ I �ereDy certily thet no excavation live (5) or more feet in tlepth into which e person is requiretl to tlescenQ will be matle in connection with work authorizetl by this permit, entl that no builtling sWcture, scaffolding, falsework, or tlemolition or tlismantling thereol, will be more than Ihirry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, Celifomia Atlminisirative Code). ❑ As ownerbuilder, I will not employ anyone to tlo work which would require a permit from Ihe Division of Indusirial Sefery, as noted above, unless such person hes a permit to tla such work Iwm iha division. Signe�ure: Date: Division ol Indusirial Safery Permit Number: CER7IFICATE OF COMPLIANCE� AUTHORIZATON OP EN7RY: I certify undar penalry of perjury that I have read this application and state that the informatlon given is cwrec�. 1 agree to comply with al s te laws and city ordinances relating to building consiruction, and euthorize representatives of Ihe Ciry of Coste Mesa to emer upon ihe above-descnbed pwpert lor in ction purposes. I agree not to occupy or allow occupancy of eny building authorized by t�is permit until linal inspection. � �-3- �� iqnei�u _re Of.Legel�Owner(s) IDateJ AnNOr Authorized Applirant Da�e CODE �. INSVECTIONTYPE 1616 Fixed Sys�em Final Fire Preven�ion 7266 Pool Spa Final 200 Final Re-Roof 201 Final BIaWRetaining Wall 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition zan5ss �A� I L 4QQ�� INSPECTIONTYGE 206 Final Mechanical 208 Final Plumbing 270 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy I�A � INiITIALS (714) 754-5273 • Fax (774) 754-4856 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: CITY OF COSTA MESA BUILDING DIVISION p�I�O� DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERNIIT . 341 RAMONA PL DETACHED GARAGE 42592110 GOSSELIN, LAWRENCE JOSEPH 341 RAMONA PL COSTA MESA, CA Phone: (949)722-2500 Zip: 92627 Owner: GOSSELIN. LAWRENCE JOSEPH Address 341 RAMONA PL COSTA MESA, CA Contractor: OWN ER-BU I LDE R Address: Arch / Eng : Address: Phone: Zip: 92627 Phone: Zip: License: 0 Phone: Zip: License: PERMIT NUMBER P00-00028 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 01/14/2000 Issued: 02/03I2000 ISSUED BY: L M SCOPE OF PERMIT 1 HOSE BIBB, 1 BATHTUB, 1 GAS UPTO 4 OUTLETS, 1 LAUNDRY TUB, 1 SHOWER, 2 WASH BASINS, 1 WATER CLOSETS AND 1 WATER HTR FOR NEW DETACHED GARAGE WITH SECOND STORY ABOVE. REF:B99-01734 ISSUE FEE Backflow irrigation BackFlow Preventer Bathtub Clarifier System Connecl Qce,Soda,etc) Dental Uniis Dishwasher Drein, Floor Drain, Rainwater Drain, Roof Drinking Fountain AMT $23.50 $0.00 $9.80 $9.80 $0.00 So.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEESUMMARY QTY AMT Laundry Tub / Washer $9.80 1 Landscape Irrigation $0.00 0 P-Trap � $0.00 1 Pressure Regulator $0.00 0 Process Piping (per 10 fl) $0.00 0 Receptors $0.00 0 Septic Tank $0.00 0 SewerCapforDemo $0.00 0 Sewer Connect $0.00 0 Sewer Private Line $0.00 0 Shower $9.80 0 Sink, bar $0.00 Qn 1 0 0 0 0 0 0 0 0 0 1 0 SumpPump Swimming Pool Trap Pnmer Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr BkFlow(5+) Wash Basin Wash Basin Set Waste antl Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) AMT $0.00 $0.00 50.00 $0.00 $0.00 $0.00 579.60 $0.00 $0.00 $9.80 $12.30 $0.00 QTY 0 0 0 0 0 0 2 0 0 1 1 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is no� commenced wi�hin 1 BO days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order for ihe work authorized under this permit to be considerad legal, such work must comply with all applicable codes, and all required inspections and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: I hereby eHirtn untler penalry of perjury one ol ihe following declarations: ❑ I have antl will maintain a certifiwte of consent to self-Insure tor workers' compensation, as provitletl for by section 3700 of the LaDor Code, lor Ihe peAormence ol ihe work for which Ihis permi� is issuetl. ❑ I have antl will maintain workers' compensation insurance, as required by section 3700 of Ihe Labor Code, for t�e peAormance of the work for which ihis permit is issuetl. My workars' compensaiion Insurance cerner entl policy number are: Carner. Policy Number. (7his section need nof 6e completed i! (he permit is velued et one hundred dallers ($100) or less.) ❑ I certity thet in the pertormance ot the work for which Ihis permit is issueQ I shall not employ any pereon in eny manner so as to become subled to the workers' compensation laws of California, antl egree Ihat if I should become subject to the woBers' compensalion pmvisions of Section 3700 oi the Lebor Code, I shall forthwith comply with ihese provisions. Applicant Signeture: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFIIL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAlPES AND CNIL FINES UP TO ONE HUNDRED TFIOUSAND OOLLARE (5100.000), IN ADDRION TO THE CGtST OF WMPENSATION, DMMGES AS PROVIDED FOR IN SECiION 3]O60F THE IABOfl CODE, IMEREST, AND ATiORNEY'S FEES. LICENSED CONTRACTORS DELLARATION: I hereby aNirm �hat I am licensed under provisions ol Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business and Professions Code, and my license is in full fome and ettect. Lia # Cless a Comractor's SignaWre: Date: CONSTRUCTION LENDMG AGENCY: ❑ I hereby aHirm ihat Ihere is a construction lentling agency for the pertormence oi Me work for which �his pertnit is issuetl. (Sec. 3097, Civil Code�. Lender's Name: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby aMirtn thet untler penalty ot perjury that 1 am EXEMPT FROM THE CONTRACTORS LICENSE LAW for lhe lollowing reason (Sec. 7031.5, Business antl Professions Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any sWcture, prior to its issuance, also requires the epplicaN for such permi� to fila a signed stetement that he or she is licensed pursuant to the provisions of ihe Comractors License Law (Chepter 9(commancing with Section 7000) ot Division 3 of ihe Business end Professions Code) or that ha or she is ezempt ihereirom antl tho basis for ihe allegetl ezemption. Any violation ot Section 7031.5 by eny epplicam for e permit .subjecis ihe applicant to a civil panalry of not more ihan five hundred dollars ($500).): ❑�as owner of ihe property, or my employees with wages as their sole compensation, WILL DO 7ME WORK, entl the structure is not intendetl or oHered for sale (Sec. ��7044, Businass and Professions Code: The Contractors Licensa Law does not apply to an owner of property who builtls or improves theraon, antl who tloes such work himself or herself or ihrough his or her own employees, provitletl that such improvements are not intended or oNerad for sele. If, however, the bullding or improvement is sold within one year of completion, the owner-builde� wiil have the burden of provinq that he or she tlid not build or improve for puryose of sale.). ❑ I, as owner of Ih roperty; am EXCLUSIVELV CONTRAC7ING WITH LICENSED CONTRACTORS to cnnstruct t�e pmject (Sec. 7044, Business end Professions Code: The coNr ct is License'�Liew.tloes not appty to an owner of property who builds or impmves thereon, and who contrects for such project with a coNracbr(s) license pursuan t Iie�C/C" tredors Clcense,Laws.). ❑ I em exemp er seY J�� VJh% // Buyness eatlAro�esiicns Code for �his reason: :.ti.— e.n va�n�i Lia (c tliC Cl/ _ _ i .. -� � Owner ID veritied nvers license. ❑ Ves�r 0 No Onvers Licensa Verification ot Own rs ip by (�ype ot document, i.e. - property taz bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATON: � I hereby certity that no excavation fiva (5) or more teet in tlepih into which a person Is required to descend, will be metle in connection with work authonzetl by Ihis permit, antl �hat no builtling struciure, scalloltling, falsework, or tlemolition or tlismantling thereof, will be more ihan thirty-siz (36) teet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Ttle B, California Adminisirative Code). ❑ As owner-builder, I will not employ anyone to tlo work which woultl require a permit Irom the Division of Indusirial Safery, as notetl above, unless such person has a permit to do such work from the division. Signa�ure: Daie: Division of Intlustrial Safery Permit Number. CERTIFICATE OF COMPLIANCE� AU7TIORVA710N OF ENTFiV: I certify under penalry of perjury that I heve reed ihis epplication antl state that the information given is correct. I agree to comply with ell i e laws antl ciry ordin ces relatinq to 6uiltling wnstmction, and authorize representatives ot tha City of Costa Mesa to enter upon the above-tlescribetl property for ins on purposes. I egree occupy or allow acupancy of any building authorized by this pertnit until final inspaction. �� `�� ,—� 2-3- �av �� aWre Of Legal Owner s)�" �Dete �� AnNOr Authorized Applicant Date COpE y, INSPECTIONTYPE 1616 Fixed System Final Fire Preventlon 1266 Pool Spa Final 200 Final Re-Roof 201 Final Block/Retaining Wall 202 Final Fectory Fire Place 203 20d 20d6<6 Final Sign Final Demolition pATE IN COOEX INSPELTIONTYVE 206 Final Mechanical 208 Final Plumhing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 250 Final Site Final Builtling�Occupancy �jE INTITIAL � �� (714) 754-5273 • Fax (714) 754-4856 • www.Ci.COSfa-me5'.�.Ce.Us 77 FAIH I7HIVE, GOSTA MESA, GA 92626 BUILDING PERMIT Job Address: 341 RAMONA PL Suite: Viciniry: Parcel Number: 42532110 Applicant: UNKNOWN Address: Zoning: Phone: Zip: Owner: GOSSELIN, LAWRENCE JOSEPH Address 341 RAMONA PL ConVactor: Address: Zip: Arch : Atldress: COSTA MESA, CA Phone: Zip: 92627 Phone: License: Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 08/16l2004 Issued: OB/16/2004 Phone: Zip: License: License: SCOPE OF PERMIT B' HIGH, 120 L.F. BLOCK WqLL ALONG THE REAR PROPERTY LINE. THE PROPERTY BACKS UP TO NEWPORT HEIGHTS SCHOOL AND THE ADDITIONAL HEIGHT HELPS TO REDUCE NOISE LEVELS. -- � � MM-04-33 FOR 8' HIGH WALL. PEF2 OWNER, EXISTING CHqIN LINK FENCE BEHIND HIS PROPERTY IS ON.SCHOOL PROPERTY. Plan Check: $54.11 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $137.86 SETBACKS MAIN STRUCTURE Front . 0- 0 ACCESSORY Front 0- 0 Rear 0. 0 Rear 0-0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Calc Valuation: Claim Valuation: % Right 0- 0 � ' Right 0- 0 $2,a00.o0 $O.00 NOTICE: The work authonzed by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period of 1 BO days. INSPEC710NS: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and all required Inspeetlona and final epproval must be obtained. Failure to obtain inspections and tinal approval will resufl in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2a+sse �aroo� WORKERS' COMPENSATION DECLARA710N: � I hereby ettlrm under penalry of Oer�ury one o� the following tleclarations: • ❑ I heve end will maintain e certllicate of consent to self-Insure lor workers' compensatlon, es provided for hy section 3700 of the labor Code, lar the pertortnance of the work for which this permit Is Issued. ❑ I heve antl will maintein workers' comp9nsation Insurance, es requiretl hy sectlon 3700 of ihe Lebor CoOe, for the pertormance oi the work for which Ihis pertnit is issued. My warker;' campeqsatlon Insurancp�wrn�nd policy number era: Cartier: Poliq Number: '� I certiry thai in the peAor ence of the work for which Ihis permit is issued, I shall not employ any pereon in any menner so es to become subjact to the workers' compensatlon laws of C fomia, antl egree ihet If I should become sublect to Ihe woAcers' compensetion provisions of Section 3700 of Ihe Lebor Cotle, I shall fonhwlth complywiththes prav �n5. �'/' /l\ r AOp�icanlSignature: Dete: T �� V `I WARNINO: FAILURE TO SECU WORNERS' COMPENSATION CAVERAGE I$ UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP OONE HUNDRED THOUSAND DOLLAFE (5100,000). IN ADDITIIXJ TO'R1E COST OF COMPENSATION, DPM4GE5 AS PROVIOED WR IN SECTION 3]O60F THE LABOR CODE, IMEREST, AND ATfORNEV'S FEES. LICENSED CONTRACTORS DECLARA71tlN: I hereby eHirtn that I am licensed untler protisions of Chapter e(commencing wit� Sectlon 7000) of Division 3 of the Business and Professlons Code, and my license Is in full af B B C�. k CI955 k C nt to'�i�e: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that ihere is a construction lending egency for the peAortnance of ihe work lor which ihis pertnit is issued. (Sec. 3097, Civil Code). Lender's Neme: Lenders Address: Signature: Date: OWNER•BUILDER DECLARATIONS: I �ereby eNirm the� untler penalry of perjury that I em EXEMP7 FROM THE CONTRAC70RS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Protesslons Code: Any ciry or county which requires a po�mit to construct, elter, improve, demolish, or repair eny structura, pnor to Its issuance, also reduires �he epplicant for such permit to iile e signetl statement that he or she I5 IlGensed pursuent to the provisions ol the Contractors License Law (Chapter 9(commencing with Section 7000) 01 Division 3 ot Ihe Business and Professlons Code) or that ha o� she Is exempl therelrom and tha 6esis lor the ellegatl exemption. Any vloletion of Sactlon 7031.5 by eny epplicant tor e pertnit suh� ihe applicant to e civll penelty of not more Ihan five hundretl dollars ($500).): I, as owner of �he properry, or my employees with wages es Iheir sole compensatlon, WILL DO 7HE WORK, antl ihe siructure is noI Intendetl or oflered for sele (Sec. 7044, Business and Professions Coda: me Contractors License Lew does not ap01y to an owner oi properry who Duilds or improves thereon, entl who does such work himself or herselt or through his or her own employees, provided that such improvements ere not intended or oNeretl tor sale. If, however, the 6uilding or improvement is sold within one year ol campletion, the owner-builtler will heva the burden at proving Ihat he or she did not build or improve lar purpose of sale.). ' ❑ I, es owner of ihe proparry, am EXCWSNELY CONTRACTNG WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professlons Cotle: The comractors Llcense Lew tloes not apply to an owner of propeny who builds or Improves thereon, antl who contracis tor such pra�ect wiih a coNrector(s) license purs nt to lhe Contractors License Laws.). ❑ I em eYemp der sec. Business and Professlons Code for this reason: SignaWre: / Date: Owner ID venfi � by tlriver's license. ❑ �es ❑ No Drivers License No. Expires: Vedticetion ot Ownership by (type of document, i.e. � property tae bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMI7 CER7IFILATION: ❑ I hereby certify ihat no excavation five (5) or more feet in depih into which e person is required to descentl, will be mede in wnnection with work euthonzetl by this pertnit, and Ihat no building siructure, s�ttolding, falsework, or tlamolition or dismantling t�ereof, will be more Ihen ��irry-six (36) feet �igh. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Tltle B, Californla Atlministretive Code). ❑ As awner-builder, I will not emplay enyane to tlo work which would repuira a permit irom the Divislon ot Intlustdal Sefery, as notetl ebove, unless such person hes a pertnit ro do such wark trom the divisian. Signature: Date: Division of Industrial Satery Pertnit Number: CERTIFlCATE OqjCOMPLIANCE AND AUTHORIZA710N OF ENTAY: I certity under penalry of perjury that I have reatl this application entl state that the information given is correct. I egree.(d comply with all state laws end city ordinences releting to building consimction, antl authodze represen atives of e Clty of Coste Mese to enter upon the ebov descg nbp(iproperry lor inspection purposes. I egree not to occupy or allow occupency of eny building authonzed b i ertnu /n�tiltlin� I inspection. ��i� / �� l /�Y Signature Of Legal Owner(s) 7— —r ete An[llOr Authon2atl Applicent Date COOE I. INSPECTIONTYPE 7616 1286 200 201 202 203 Fixed System Final Fire Prevention Pool Spa Final Final Re-Roof Final Block/Reteining Well Final Factory Fire Place Final Sign 204 Final Demolitian Q� �$ •� r � r!r � ' I�� CODE� INSVECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electricel 212 Finel Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency Q� IliIID�LS � s�rai o . �rruc ww ccuxen IIJ 7HE� ![1GY�N{�I�15(�`f JIIGGII� I r�.nr+iv SUBIECT TO BLDQY �T: REG. jl'p•� NOTE: ADDITIONS, DELETIONS, OR CORRECTIONS SHALL BE APPROVED BY THE PLANNING DIV. BY• • —�^W"�(,� 9 , i � • soun wN.�s/r�xa�s eenv�w r�• � 6• w rfftc.rrr�u.�. ee s�ac �r �wsr ia txoM r-xorrr eaon�xrr tu� • 90LID WAl1S/FFN�S SHALL NQf ID(� Y 6' IN Fff1GHT WIIHW IOOF'[f� FROM PROPkR7Y IAIE �IO?NRB IL�I�. • VEItII�Y D6TAN� FROM CURH 10 PROPFICLY [dJE ANDgiOWONPIAN. VFRQ�7G1iONFROM7'F�QIYS p�GWFERWGDN6ION6REQU[R�• CA1y171�)7�3� PDA Ra'ORMA'[ION. � �� FlM-� �� r"1 �__ __� I � � I�c.o: � � T�wN*y.na,,,._ . fi�ssetn�'='a�' `��. y,�„aar� sa � held �'z�';�'" •t�,sz. ��{p,llNOibe e°�'i + Gaa e� ., Finct lons °,� Gosta Mesa m2k c:: ^, S,,y , �.... S�yr J'�� t��Y �?•�Vlil Oc ot a"6m' aiwn andbeco � ol lh ��a � �cenc, sha6 :xpi�e �'I �e Pe� Uj1C 4�3 p�y� and F�� a� ,amta �ed a� C� � �� wmm� V �aacwa a�a � I � �� -----�----------- , �--- �-- - - H � , anaPPS0va1 � c� lo be :E and'o� State law. vo�d il the bu�1dN9� � I �� usmda � ---------------- , � STREET _ _ BLOCK WALL LAYOUT FOR BUILDING PERMIT PLANNING DIVISION u n 0 . , � �- _ � Cement LoPing Op`�bnal _ � cn,n��i.ew�k.w��n_i;3ie ¢ Hori�ontal Too of.'allc -- Fentes,' _ - �� . _ <_'- For FenCef 5'_or Leis ., — Vert: Bars 3/_8�"� a �4`0_-O.C. C' For Fences Higher T�han 5'� � Ven. Ban�3/8�� a[ 32_ O:C. — y .. _, f i{I.Cells SeGO W ith�Grou` WM1ere�SteelO�curi- _- - Rr.ininrcinq SI�N ShaIL _ � Conlormtr�Sec.A�5�79_ � A.S.T M. = . . � All Steel ro be Lapped ' . '2A" or to'Code"— ---. NATUAAI GFAUE �, 7WO 7/8"O BARS C�NTINUUUSTpP 6 B07TOM Ho01Z5TEEl MUST 9E t1E01N PLACE AT TiME OF iNENCN INAPECTION. ICAL n +A 'p N A — � D 1 F�KIDT � SEE C1 L BELOW o . ' WIOTH THIGKNESS OEPTH OF EARTHt00TH SPACING OF EARTHTOOTH 6" C 0 i I , 14 10" 24" i2' f a TE BLOCK FENCE ♦ �.� • �4X e • �L• 2��' FOOTING RE�UIREMENTS CHART 19 IO" 20" 14� BUILDING DIVISION GENERAL-- NOTES MORSAR; p�a part Ptastic Cement, and Th►et Parts Sond GROUT: One Part Cement .TMee anC One Half Po�ts S�and COPING: One POrt Cemenf, Three Porfs Sond L'ONCAETE: Weil M�aed 1:2-v2;3-i/2 Mati of 7-I/2 Gollons oY Wafer Per Sack of Cement GAOUT MAV BE POUFED FqOM TME TOP OF iME FENCE �NCELLS WHENE 57EE1 OCCURS. CELISAND /1REASOF MDR120NTAL pEIN FORCEMENT SMAII BE CIEAR, CLEAN 6 FREE OF AlL MOPTAR DEBR15, ETC. p[ot�� (,�' [4qTMiCO1H V! frlE HEiGTH Of fENCE BELOW BOTTOM Of �OG7iNG SCALE: i/2�� = I' B" 16" 16' 8" 12" i6' n PflQIECTRODflESS: 34S RAMONA PL owNex�sxnrne: LAWRENCE GOSSELIN �DDPESS: 3 4 S AAMOTIA PL COSTA MESA CA 92627 (714)722-2500 AflCHIENCINEEP: �DOflE53: flEG.NO.: UNIT: UNIT: PEflMITTEE: LAWRENCE G055ELIN (714)722-2500 noosess: 3q RAMONA PL COST ME5A CA 92617 LICENSEO CONTMLTOP OECUMTION: I hereby aHirm IDat I am Iicen5e0 unGe� D�avisions ol Chapter 9(commencing vntA Section 7000) af UNision 3 0l Ne Business anA Praleuwns Caae, anA my license is in NII lorca an0 effect. cm uc.: srare uc.: cuss: Oale: SignaNre: WOPKENS' COMPENSRTION OECUMTION: I �ereby attirm ��at I have a certi/icate of wnsent m selbinsure or a ceriifiwte of Warkers' Compensation Insurance, or a cetlified coDY ihereoi (Section 3800, LaO. C�. • POLICY NO.: E%P. D�TE: COMPRNV: o .] Certilietl capy is here�y fumiSheA. ❑ Certified copy is IileO vnt� the ciry BuilOing UiNsion. Date: Appliwnt: EIfEMPfION FlIOM WOBIIEPS' COMPENSITION OECUMTION: (ihis secuon neeC noi Ee compiete0 if the ce� is lar one hunOretl �5700) or kss�. I C¢riity tha� in �he petlormante oi l�¢ work la� whith I�is permi� i5 issuetl, I s�all no� employ any peRon in any manner So a5 io Detome sublect to I�e Workers' CamO��on Lavrs ot Califomia. Uate: Signature: NOTICE: It, atter making Ihis declaratioq you shoul0 Uecome,sublect to Ihe Workers' Compensation pmvisions at ihe Labor CaOe, you must farthvnt� comOty wit� suc� pmvisions or t�is permil s�all be GeemeO revoketl. CONSTNUCTION IFN�ING RGENCV: I herehy aBirm t�at t�ere is a constmction IentlinA agency for the petlarmanca oi the work for wMc� �his permii u issue0 �SeGion 3W7, CiV, C). ' �xoex: auosess: ` OWNEB BUIIDEB OECIAMTION: I hereGy ettirm tAat I am exempt from t�e Contracrors' State Licens¢ Law for t�e followinq reason �Section 7031.5 Business anE Pratessional Code: Any ciry oi caunry w�ic� requires a Oermit to constrbct, alter, impmve, Oemolish, or repair any slmcture, prior ro its issuance, also requires Ihe applicant for such permit ro file a sipne0 siatement that he/s�e i5license0 pursuanno t�e provisions ot tAe Coniractors' State �ic¢nse Law (CAeD�e� 9(�ommencinp vnth Section 7000) of Oivision 3 af ihe Business ana Pmlessions COAe) or t�at he/s�e is eKempl IAeretmm an0 t�e Dasis lor Ihe a�lepeC exemption. Any violation oi Section 7031.5 hy any applicanl lor a permit su0lects t�e aDO��cant ro a civil penalty of not more ihan five hunOreO Uollars (5500). I, az ovmer of t�e O�oDeRY a� my employees with wapes az lheir sole comDenution, will Eo Ne waM1. and Ne ❑ strucWre is not intendea ar atlere0lor �le (Section 7674, Businea anG Pmlessional CaAe: IDe Contracmrs' State Lirense Law tices nat apDM �o an ormer of a pmDetly wAo �uilOs or improves tAereon, anE wAo Aoes such woM1 Aimsell/Aerull or t�muph �is or her own employees, pmNdetl pu� sucA imDrovemenis are nat inten0e0 or oifere0 for sale. It, however ihe builtlinq or � improv¢ment is mld wilNn On! year ol completion, Ihe own¢r xill tuve lhe Ourtlen o� pmving hNs�! GIE noI huild or impmve far t�e purpose of sale�. I, as awner ot t�e pmperry, am eMclugively caniracting wiN IicenseU contractors ta constmct the pmlect (Section 7044, Busines ❑ an0 Protessions CoOe. The Cantrzctors' State License Law Eces naI appN �o an awner ol pmpeity wAa 6mIAs or impmves Nereon anA wpa contracts tar suc� O�ale«s with a contractor(s) license Dursuant to t�e Coniractors' State License Law�. I am aware tAat prool ol t�eir Worker's ComDenSation insurance s�oulE Ge providetl Ia me. � I am exemD� unoer Section: B p'] p 4 4 B. 8 P. C. mr mo reasare NO pEI+IPLOYEES Date: �9� i � Owner: 1 ^� I Eo Aereby certity t�at I am aware of an0 und¢rsWnE t�e require�eil�s ol Calit�ni Heatt antl Safery COEe SecLons 25505, 25533, an0 2553d anE 10a� I or any �Nure Duildinp atuDdm unlVwill not (cirda on ) nee0 to camply` ih saiE state co�es anO ltie reQuiremenis far a oermit for constmctwn or mo0ilication imm ihe Nr Uuatity Man ' e ent Disirict�esi0ential constmction ap0lications are eKempt imm IIIeSe D�avi5i0n5. Oaie: I _ � — �P qpplicani: � i I here0y ceriity IAa� I have reaC Ihis applicaliun an0 S�a�e [hat �A� a v inlormation is yorrect. I apree to comply witn all ciry ana counry orAinances an0 state laws relaun0 �o builtlinp cOnswction and her¢ry �u�ize represen Etives of Ihis ciry to enter upon t�e ahave�mentionetl propeny for inspection purposes. U / Date: � �� SiAnature: � ��—� oriver's �icense or Socia� Secunty 18qa8 Whiro—Buibing: Green—COCe �nlo¢ament; Canery—Applicanl: Pink—Revenue; GoWenroE—Assenwr CZTY OF CUSTA MESA — BUILDING PERMIT PERK� NO: BE 04G876 PEkMIT NO: BE 046876 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: S—N PERMIT TYPE: ELE STR PUAP05E: ALT JOB DESCR7PTIOi� : INCAEASE HEIGHT OF EXISTING GARAGE SQ FT: 200 CLAIM VALUE: CALC—VALUE: 3,460.00 GROUP OCC: M-1 / COMMENTS: PLANS WAZVED PER '8II UBC CHAP 3 SEC 302B **�****iE*�+�*itir�*irw*�r�eitit�+��*�*�eir*�e#�irx �*�*u#��•��tt��ttit#*st***#�*rt*******#*�r��+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 IIUILDING ---------- --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN ERNT: FT IN REAR: FT IN LEFT: FT IN RGF1T: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 92532110 ZNE: R1 REF NO: PLANNING NZSTES> RAISE ROOF OF EXZSTING GARAGE ATTACHED TO EXISTING RESIDENCE > HY APPROX. 3'. *�**�*r�+r��r�t**#�e�*�*r�+r+�#*�x��*#*#*��r�r*�t;��x�r�*�r*+r�ex �*�r�r<*�*tr***+�**#+r�r*�+�w� �#*n� D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY . DATE: HUILDING APPROVED BY APPLICATION ISSUED H �1f �f iF � 3F if if dF # 3f it it# �t �klf �f ik 3F# #**�**�****�r�r*#�**** LEGALIZATION:Y HLDG PMT PEAMIT 126.00 ��% DATE: fi��-3r�� DATE: y 3�'�a #3FiFiF 7f iF�F3EiFiFiF3i#iF�fiFiF'iFiFjT�lFif#it#if9f%iriF� if# #*�r��c*****k�*�+�x�***�r*�r*�rx**�r**�.�*�r��r#�r�*�r*#*��r#** F E E S U M M A R Y STRUCTURAL SEGMENT:Y PLUMHING ELECTRIC MECHANIC FIAE SMIP/RES GRADING i.S� S� S02 SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 128.00 15,00 0.00 143.00 143.U0 .00 REVENUE DIVISION TOTALS--> COLLECTED: 143.00 OVER/SHORT: 00 BLDG PMT PLUMHING ELECTRIC MEC3iANIC FIRE SMIP/TOT GRADING PLAN—CHECK. 126,.00 16.50 .SO iF 3f ilif iE 1k i! iE ik # if iF if ik ik iF iF # iF�lk iF ik�lE iFik ik # itlt iF if * 1f iE �ft ik # ik 1t �f M if it 1f iEif ik if #!! iF ##### if it if j! it i41f ik #�lk ik14 if # iF# �1F # 7Flf if ik it I N D Z V I D U A L F E E H k E A K D O W N� TYPE (JTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 200 RES—GARAGES TYPE V 17.30 3,460.00 ELE 1 RECEPT/OUTLET 1 ST 20 EA. .75 .75 END OF FEES �� oa�=�i5� ce.o�sis� �eo� DATE: 04/09/90 TIfiE: ZS:'4 14.i , C� � Aoo�icant lo �in in all SOdC05 CZCept 1t105! withl0 bl2vy EO�C[� �inlS d�E 31g0 ]II dOP�OD�iite CeCli�aBonf. �, C�A ME A 'j�J[`ONSTRUCT'`j�nN PERMIT PER IT NO. TRACT NO. LOT NO. UNIT NO. A P� - Za�� ro'ect Address _��I TViMiCi� 'y'{�,�,Qpq � � � / � I �' 1$' S Main Building: /lcceszory Building: Ap�licant'S Mailin Addr255 TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E FrOnt Z Owner's Na �N �� ].1 o�e Z- � �' � CONVERSION ❑ DEMOUSH ❑ OTHER T Ip DESCRIP710N0 WOFK/USEOFBLDG. ��"�� 'PL �� B Rear N Address � �flIYWf1A I. ��,�� Dn. �.r-,p fir,,,P �'A� Mn« y�,�i A � Arch/Eng. -- Litense No. TVPE OF PERMIT GRADING FOUNDATION STRVCTV RAL I K Right G AddresT ❑ TENANT jd ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g LEft Contracror'sName 4��`"�^'� '�'��^Ji`-� Phone ❑oTHER PIng.Ref.sW ParkingReq./Pravided E Address (mailingl PROJECT DESCRIPTION 5�. FT. OCCVVANCV Planning Notes: M CON STRVCTION TYPE VA WATION § Ciry license No. T ZONE GRADINGCU.YDS. ACRES S LICENSED CONTRACTOR OECLARqT10N I bc�eby alfirm Ibat I am licensetl untlqr provisions o1 Cba�ter 9 �commencing Remarks: 7 � �� witM1 se<tion ]000� of Division 3 0l lhe Business and Professions Co4e, anG my Iicense is in lull brce antl ellecL � �� 7� ELECTRICAL FEES � CIa55 LIC¢nie No. Si9nature PLUMBING FEES Automatic Washer Trans(ormer ❑ 75-50 KW KERS' COMPENSATION OECLAppTION COnSVuc[iOn POI¢ $ub. � 50 f KW tby alfirm that I nave a certilicate p/ conzent to selt�insure or a ttrtiticate Bar Sink Showers o Workers' Compenutian Insurance, or a certi/iea cooY ��ereof (Secuon Backflow Preventer Service Sink Cooking Unit Merer ❑up to 100 amps 3800, Lab. G) Dishwasher Meeer$over 700 amps Poiicy No. Comoany Backflow Irrigation Sewer Cap BCertilietl copy is nereoy turnizhed. Oryers ❑Gas ❑Elecvic Sub Panel Certifiea cooY �s filetl with tne city puiltling Division. Bathtubs Sewer Connettion Uate—_ Appiicant Fan Motors�Pl HP�iX-8 E%EMPTION FROM WORKERS' COMpENSATION DECLARATION Cld/ifi2�5 SOi�r C0112Ct0�5 icssjs section neea mt be completea if the permit is for one nuntlrea (S10o) or Dishwasher Solar Piping �� F�'4�U� Ina Solar �9-15 HP �16�15+ I cxrlily Mat ln tbe performanCe ot [h@�yprk fOr w�icn lnis Oer it is i55ueE, I . Fixture5 iball nof employ any OerSon in any MannT so ds to becom subje<t to the Drinking FounWins Solar Tank Microwdve Worgg� s'� omaq nsa�q�a ws of Calitor ia. ' � DaieY(_.]' L—p_LSi9na[ure Floor Dreins Swimming Pool wlSpa Device Boxes ght Pole Li NOTtCE: If, alter making �his tleclaratipn, you sboultl DlCOme subje t to lb workers' Compensation orovislons ot tne labor Coda, you must t rt Floor Sinks Urinal Outlets Range comply wilb sucb Provislons or thiz De/mIi Shall be tleemetl rev . CONSTRUCTION LEfJOING AGENCV (�idSS¢rvic¢ Dutl¢LS Wdt¢�CIOs2t $witCh¢5 Sj9� 1 hereby af/irm that tM1¢re is a conSVuctlon lentlin9 agency for lbe Oe�formance o� tno work �or whicn tnis perml� is issued (Section 309� Civ. C.) Interceptors Water Heater Garbage Disposal Swnding Sections �ender's rvamc � Lentler's Atlaress �� Kitchen $ink Water Service Generator 065 KW �5-15 KW Trash Compactor OWNER BUILDER OECIARATION I M1erOby a11lrm lhat I am axempt IrOR� Ihe ConVattOf's Llcenf¢ law for the Ldvd[Ofi2S AutO-WdSh �ollOwing r¢ason (Sec�ion ]031.5 Bu51ryes5 and PwleSsional Code: Any City or un:y wnicn reaui.es a oermit to conatru<t, alter, imo�o�e, demolisn or reoair P-Trap Laundry Trays y Sb1lClurQ PliO! !O ilT i55Udntl. d150 !¢qui!¢S lh8 dPpliCdOt /Of SUCh pBfTlt Iilc a siqnea ttatement that nc/sne {s licensea pursuaN to tne provisions of Roof Drains � Conbaaa�Y Liceme Law (GnaO�er 9��ommencing witn Sec:ion ]000) ot .ition 7 0l the BUSiness antl Pro�e65ions COUe) Or l�al he/zhe 6 exOmpt ReinSpeGtiOn Fe8 $15 ISSue PaB .�mrefiom antl Uie basis lor the a1lCgetl exemplion. AnY ��olation of Seciion ]031.5 by anY �PP�ican[ lo� a Pc�mi[ suble<ti lho applican[ [O a civil e alb ol not more tnan five huntlrutl tlollars (5500�. . DEVELOPMENT SERVICES RE�UIREMENTS: ��/ . I, at ownar oi tne prope�tv t ' Reinspaction Fee S75 laue Fae $ 3 ao-l�^ �•�^ 4, antl the svucture is no intentleE or offeretl 2oning Approved By Date ror wle (Se<iion ]oaa, Ou:inuss anq Professional Cotle: The Conerattor's MECHANICAL FEES Building Approved By Date License law tloes ml apPty to an owner o/ a proPerty who builds or improve5 /� � :ncreon, antl wno Coes sucM1 wOrk nimseit/nerzell or throug� his or her own Appliration Iiiued By 1� /��_Data_ •:muloyecs, provitle� that such imo�ovements are not intentlea or olieretl lor Roiler HooJ or Type I ❑ saie. I�, ho'+vever, the builtling or imprbvemenl ii To10 wilhin one year o( COm� Cd�Opy Typ¢ II ❑ pletlon, me owner will nave tnc buraen oi provin9 ne/sne aia not buila or im- Duc1 - Under Ground SUMMARV OF FEES orove �or tnc awpose ol saie). BUILDING PERMIT $ SMIP $ ❑ i, as owne. 01 me p�ooerty, am eaclusively convacting with iicensea con- Duct - Structural Fefrigerauon System PLAN CHECK S PERMIT tmctors to consLuct tne project (Sectipn 7044, Busin¢ss and Professions Cotlo: Tne Comractor'z License Law does not appry to an owner ol property who Duct - Ventilating ❑�-100,0006TU Ot00,000 BTU p�UMBING $ ISSUANCE $ builds or improves thereon. ana wno mnVacK /or sucn oroiects wlth a ron- Vacto.(s1 bcense pursuam co me Contractors Licanse Law�. I am aware tha[ Exhaust SyStem ❑ Multiple ❑ System Repair/Alteration PL.P.N CHECK 25% $ �5''� ENERG�' P.C. $ . D�oo1 0( tnei. wort�e.'s Comoensation insurance snowtl be provitletl to me. ELECTRICAL $ »•.� v GRADING S ❑ I am exempt untler Section B. 6 P. G. �or cnis reason Firepl/FatL BIL �CBO � Fire Dampers MICROFILM $ \ __ PLAN CHECK 50% $ Q � Da�e ' ' owner - aL,2�.� Heating System & Ducting Registen MECHANICAL � I nereby certiry that I nave read mis apo��aa;ion antl state u at tn e ❑0.100,000 BTU �100.0008T $ TOTAL FEE $ `��'s inl0rmaiion is tonec[. i a9r¢e lo comblY �+�tM1 all city ana coun4y or ncez PLAN CHECK 25% $ antl stale laws rela[ing (O buildip9 W45VuttiOn, dOtl tl!/Gby dUV10/It¢ reDr¢- S¢nId[iv¢5 i5 CLLy l0 ¢n B! UO�O tif¢ dbOVC-IIIBnli011l4 O�Opelty t0! Il1Sp¢CtiOn Utp SCS. ' Signaturc . Date 3'� . " i orivms• License or 55 /p _� _ Reinspection Fee $15 Issue Fee S 3 � . � , ' 0865�46, rCv. 5/88 Whi[e - Builtliryg; n - AOO�ican[; Pink - Atcountin9: Goldenrotl - Assessor j � � : � y N 0 � m w 0 m` . m m � m � 0 m a n v 3 v m �ry-Un �-Undrgmd. ��cemr.nt -cal UFER Gmd. �ot i ngs ��_ Date i � id��e t�.�Founda[ion 9. �Water Pipe-Undrgmd. 10: Structural Floor SVstr.m 11. Propertp Sewe� Line RI House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electrical-Conduit 18. Rough E�ectric Wiring 17. Rough Wiring Sign 78. Rough Elecvical�T Bar Ceiling 19; Rough Heating & Air Conditioning 20. Rough Fectory Fireplace 21. Ducts, in,Structure 22. Ducts, Ventilating 23 � Gas Pipe-Rough & Test 24. Roof Framing . -i 25. Roof Sheathing 26. T�Bar Ceiling (Structural) & Monocoat 27. Frame a�d Flashin9 � 28. Lathing & Siding � 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electriql Power Meter�Final 33. final Electric 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 Prevente� A3. Bar.kflow Irrigation A4. Landscape Irrin�tion System 45. Sound Attenuatien � 46. Handicap Re9ulat�ons 47. FINALSTRUCTURERBUILDING A8. SPecial Requirements Completed 49. Electric Release to Edison 50. Gas Relcase to Southem Caiifomia Gas Co 51. CERTIFICATE OF OCCUPANCY Date �L & SPA Inspector p�ppROVALS Permit # 52. Pool & EquiUment Location ' S3. Steel Reinforcement ' 54. forms � 55. Electrical8onding � 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE ' � 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, � Undrgrnd:, Test � 60. Backwash Lines, P�Trap, O Undrgmd. 61. APPROVAL TO DECK . 62. Backwash R 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 O Gas ❑ Oil 72. Underground Flush 73. Undergmd. 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 � �� Applicanl to fill in ail spaees excep� (�osa wliMln heavy OorOlt Iines anG tign all aOGroD��ate tleclaratians. PERMIT �rojeCtAddress _-�M i L�9nnpnti -yi{:EHt'F . �I Ap�licant's Mailin Addreas Owner•s Nam�� '+� K.2 D� //� 11 one Z' �� Address ..,`'.`� j 1�, ,._.a--��fllYl��,�l Arch/Eng, lice�se No. , Address I Conttacwr'sName �� N�'-�/�� Phooe Address (mailingl Ciry license No. LICENSEO COIVTftACTOp DECLAq0.T10N " I �ereby a/tirm tnat I am Iicensetl u�tle� p�Ovislon5 0l COar[ef 9(commenCing witn Yection ]000) of Divislon 3 of the Business antl Protessions Cotle, ane my Iicense is in /ull forte and eflect. !J<entt Clais �icense No. . / " Signature KERS' COMGENSATION DECUiRATION .e6y aifirm tnat 1 nave a certi/icate o1 consent to self-insure or a certiticate i of 'NOrkers' Compenwtion InsuranCe, Or a cetlilietl copy inereof (Section 3800, Lab. CJ �i PoliGy No. Comvany �Ce�;ilie� capy is hereDy turnisheQ Certiliea copy Is tiled witn tne city Builtling OWision. Date ADolican[ E%EMGTION FROM WORKERS' GOMPENSATIOfJ �ECLARATION (ThisSeGliOn neetl not be Completetl it t�e permit is ta� on0 huntlred (5100) ar 'es;). I carll(y (hat in the pertormance ol Ihe •.�ntk fOr whicb l�ls Oe h is issuetl, I shall bot emoloy any person In any rtfannT so ps to becom su0jec[ to Ihe Wor e s' �mpqnsa��}aws ol Calilor ia. Dat [_ 1�51gnature � YOTI�E: If, altCr making this EeCIa�aUon, you stloultl becomo subjE t l0 tM1e Workpri' CompCnsatian provi5ion5 Of Ine ldbo� Cotle, you must f rt comoly witn sucn provisions ar this parml[ shall ba eeemetl rev . CON$TRUCTION LENDING AGENCV I nereby al/lrm chat tnere is a<onstructlon IenEing a9ency lor tne Derformance � ot tqe work tor wbic� Ihis OcrTil IS i55uetl (SeCliOn 3097 Civ. C.) Le�tlar's Name LentlCr'S Atltlress �'�'— OwNER BUILDER OECIARATION 1 he�eby aili�m lhat I am exempl IrOm tha COnlractor'f LicenS¢ law for tne /plloWing rwson (Section 7031.5 Busfness antl Profeistonal Gotle: AnY ��Y o� counry wbicn requires a permit t0 con5lruct, allBq �mprova, tllmoliih O< <epai� a�y sVucture, p.ior to its issuance, also reqWres tha applicant for sucn permit ,,��y;filc a signatl slatement that tm/5h0 Is IlCensed pursuant t0 lne P�Ovisions of �(_�„ Conlractor's Li<enu law (ChaDler 9(commencing wlt� Saction 7000) of :�,aision 3 0l lhe Businass and PrOte55ions Cotla) o� lna[ ne/She is exempt �� fh2fCbOT d00 lhQ Ud515 (01 [b8 allegetl exompUon. AnY viotation Of $BCf10l1 ]031.5 by any ap0�icant lor a permit subjtGts Ihe appllGant t0 a civil e alty o/ nol more tban liva huntlratl tlollari (5500). I, as owner of the PropartY � pR"Cn1Y-tlOQ�'� ,..^,u antl the SVUGIura is no intenCetl or olterGtl �O� Salc (Soction 7049, BuSinefS dnU PrOteiSiOnal COtla: The COn[�a<to!'S License l..�w aoes nat aoP�Y �o an ownar of a property who bufltls or tmproves tner@on, and wbo 40e5 Sucn wa�k himiNf/hersall or Ihroug� nis or he� ow0 empiOYecs, OrovitlC� that sucn imo�ovemenls are nat intenaea or otferea for sal0. I f, boweveq [Ile Ouiltlin9 or iT0/ovament is SOItl within one year ol com- pietion, tne owncr will M1ave IM1G bueGen ol proving ne/fhC diC not builtl ar im- orove br lne pUrOote al Sale�. ❑�, as owner of t0a pro0erty, am eaUusiveiy coniraciing witn iicenseE con� tracl0lslo conSVuct Ihe Dr0)ec[ (SKlion 7046 Busin¢ss dnd Pro�essioni Cotle: ine Contractor's �icense Law tloes not appry to an owner o� P�o�erty who builUs or imoroves tnereon. antl who coneracts lor such aroiects witn a r.on- bactor(s1 hcense pursuan[ ro me Convactor•c Llcense Law). I am aware tha[ prool o( their WOrker'S CompenSdHon InSurdnCB ihoultl be OrO��tletl t0 me. ❑� am exempt untler $ecliOn 8. L P. C. for this reaso0 ' ' O �-...�� aLA1..1�9.,�-. I nereby certi/y cnat 1 have �ead cnis avo��catlon antl state t at th� informatmn iz correcL 1 a9ree ro como�Y �'��n all citY ane coun Y o�dh*rSnces antl state lawz relatin9 to builtlinq conSVuclion, and hereby authorize re0re- sentdtive5 . is uty to en er UDon the above-mentiOnad 1P�OPeripy t0� inspection urp ses.' � Da[eJ ,�S)� Signatu�e _ Drivo.s• �i 55 � E�.�n/a I ��I� I- TYPE OF CONSTRUCTION � NEW �/��U L.� ALTEFATION REPAIR ❑ CONVERS�ON ❑ DEMOLISH ❑ aTHER � DESCR,1p71pN O WORK/USE OF BLDG. ��'�^-+ �� PL,141 �_:�11L_�i. ' dn � An`'`P O `'M i1n.. �.�_ TVPE OF PERMIT�q GRAOING FOUNDATION STRUCTURAL ❑ TEIVANT yv ELECTRICAI ❑ PLUMBING ❑ MECHANICAL ❑ O7HER PROJECT DESCRIPTION Sa.FT. OCCUaAtaGY CONSTRUCTION TVPE VALVATION $ ZONE � GRADINGCU.�'OS. ACRES Remarks: Bar Sink Backflow Pre�enter Backflow Irrigation Bathtubs Clarifien Oishwasher Orinking Fountains Floor Orains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories P—Trap Roof Orains Reinspaction Fae $15 Boiler Dutt - Under Ground Ouct � S[ructural Duct - Ventilating E.haust System ❑ Multiple ❑ Firepl/Fact. Blt. �CBO # Heating System & DuCting ❑o-� oo,aao eru � i oo,000 er Reinspection Fae � S75 ^^^� ,e ..... emu syn�en . quiieino: n - APpli�anh Pink - q«ounting; Cc!^_enrOtl - Aszesm� ShOwen Service Sink Sewer Cap Sewer Connection Solar Collecmrs $olar Piping Solar Tank Swimming Pool w/Spa Urinal Wacer Closet Water Heater Water Service Auto-Wash Laundrv Trays Issue Fee Hood or Type � ❑ Canopy Type 11 ❑ Fefrigernuon Syztem ❑aioo,000eTu ❑ioo,000 Sysrem Repair/Alteration F�re Dampers Regiscers Issue Fee FE A.P. �WW S h7ain Buildi E T Front 8 Rear A C Righ[ K left $ Ping. fte(. � Planning Note�: Automa�'rt Washer Construction Pole Cooking Unit Dishwasher Oryers �Gaz ❑ Fan F.A.U. Fiamres Device Boxes OuUetS Garbage Disposal Genera[ar 065 KW �5-15 KW Buiitling: Req.�Provitled ELECTFiICAL 7rans(ormer � 7530KW ❑ SO+KW Meter �up to 100 amps Meter�over 100 amps Sub Panel Mo[ors �0.1 HP � 1 h- 8 Inc.Soiar 09-75 HP �1615t Microwave Pole Light Range Sign Standing Sections Trash Compactor � Reinspection Fee ' S15 ' � Iuue Fee 5 3 OEVEIOPMENTSERVICESRE�UIREMENTS: Zoning Approved By FEES euilding Approved By �_ $ 3 N I N G R E � M T $. fEES SUMMARV OF FEES BUII.DING PERMIT $ SMIP 5 PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE g PLAN CHECK 25% $ �-7�.—, ENERGY P.C. 5 ELECTqICAL § »•-7 � GRADING 5 PLAN CHECK SOo $ MICROPIIM $ Q MECNANICAL $ TOTALFEE 5 `� S PLAN CHECK Z5% $ . -'� y � � •'•' ,- = 1 .� 0mti �� ,� m'° ✓� �. o� � Y 1 � `O � 2 2 OP c� 0C p� a` `0 2�` 0� �J Q�y . ,r R �Grnd. s ,..[ing5' �.•Foundation 9. �Water Pipe-Undrgrnd. tO:;Structural Floor System 11�, propert9,Sewer Line & HouseConnection 12. SeWer Cap 13. Root Orai�s 14. Rough Plumbing 15. Rough Electrical-Conduit 18. Rou9h Electric Wiring � 17. Rou9h Wiring Sign , 18. Rough Electrical-T Bar Ceiling 19; Rough Heating & Air Conditioning 20. Rough Factory Fireplace • 21. Ducrs, in�Structure 27.. Ducts, Ventilating 23.' Gas Pine-Rough & Test 24. Root Framing ' . , 25. Roof Sheathing ��• �"' . 26. T•Bar Ceiling (Svuc[ural) & Monocoat z7. Framc'and Flashing • ?.8. Lathing & Siding � 29. Insulation 30. Drywall Nailing �1, Plaster Brow� Coat 32. Eler,trical Power Meter�Final 33. Final Stectric . • 34. Final Heating R Air Conditioning 35. Final Gas Pipe-Test $6. Hood or Canopy 37. Final Factory Firenlace 3S. Final Plumbing 39. Water Service-Final A0. Gas Service-Final A7. Solar DomesticFinal A2. 6ar.ktlow Preventer A3. Backflow Irrig�tion qA, Landscape Irripation SYstem 45. Sound Attenuation ^ q6. Handicap Regulations q7. FINAL STRUCTURE R BUI�DING J8. Specinl Requirements Completed 49. Electric Relense to Edison 50. Gas Release to Southern Cali(ornia Ges Co 51. CERTIFICA7E OF OCCUPANCY No. Date �,� -- - - 0 � • � POO L & SPA � ` APPROVALS Permit # 52. Pool & Equipment Location ` 53. Steel Rcinforcement � 54. Forms 55. Electrical8onding � 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE •1 58. Elecirical Conduit-Undrgrnd. • 59. Gas Pipe, O Undrgrnd:, Test - 60. Backwash Lines, P-Trap, O Undrgrnd. � 67. APPROVALTODECK . 62. Backwash & ReceptorFinal 63. Heater & Vent-Final , �' 64. Plumbing SYsiem - 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 OGas OOiI 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro � 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM F�NAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINALINSPECTION 80. FOOD CERTIFICATE ISSUED i s�i � Notes: Date Inspector �i I . ,. � 0 r, Pfl0.1ECT RODPESB: 3 Q 1 RAMONA PL owxee�sxaMe: LA4fRENCE G05SELIN RODflESS: 34 S RAMONA PL . COSTA MESA CA 92627 (714)722-2500 AflCN/ENGINEEfl: pDDAESS: flEC.NO.: uxiT: UNIT: PEflMITTEE: LAWRENCE GOSSELZN ( 714 ) 722-2500 • aooeess: 341 RAMONA PL COSTA MESA CA 92627 IICEN5E0 COHTMCTOR DECUNITION: I hea�y attirm ihai I am licensetl unUer pmvlsion5 0l Chapter 9(wmmenunq with Section 7000) ot Division 3 0l t�e Business anA Prolessions COGe, and my ticense ¢ in fullforca anE ettM. CITY ut.: ST�TE Ut.: CIASS: OatO: Sipnature: ��BKEPS' COMPENSATION UECIAPATION: 1 heiaDy afli�m iha� I have a cerlNicate M consent lo setl-msma o� a artilicate ot Wo�kers' �pensation Insura0ce, ar a certilie0 mpy tAereal (Section 3800, Lab. C). #.��ICY NO.: E%P. ��TE: COMP�NY: ' ' . ❑ CertifieU coOY is here6y fumis�e0. ❑ Certilietl wDY is f1eU with t�e ciry BuIlCinp Divislon. ' Oate: Applicant E%EMPfION FNOM WOPKEflS' LOMPENSATIOX OECUMTION: (�his section neeA not Ee comD�� il Ihe permh is tor ona hunUreA �5100) or less�. I mrtity ��at in Ihe peAwmanCe al Ih¢ xrork lor w�iC� IhiS Oe�mit i5 issue0, I 5�all not empby any person in any mannef m as �o EeGOme suGjttt to tne WorkeR Compensation Laws of Calilornu. • Uate: S�Onamre: NOTICE: II, atler �Wnp t�is declaration, you should Eecome SUEjep to Ihe�WOAers CamDe��ion D�oNsions ol I�e Labor CaOe, yrou must fonhwitA comply witA such provisions or t�is permit shall he EeemeO revoke0. � CONSTBUCTION LENPIN� AOENCY: I herehy affirm that Ihera is a constmction IentlinA aAency lor the pedormanca of ihe woM lor whic� t�is permit is issueE (Section 3097, Clv. C�. , ' lFNOER: nooxess: • OWNEN BUILDEH UECLAMTION: I here6y allirm tAat I am exemD� ��m the Coniractors' State License Law for the followinp reason (Section 7031.5 Business an0 Pralessional CoOe: Any ciry oi counry wNc� xpuires a Oe�mi� m construct, alter, improve, OemalisA, or repair any structure, prior ta tts luuance, alm'requireSIDe appllwnl tor such permil to tile a sipne0 statemem tha� �eisna is licensetl pursuant to Ihe provisians af Ihe Contractors' State License Law (Chapter 9(cainmencinp witA Section 7000) of DNision 3 of the Busineu antl Pralessions Code) or that helshe k exem0< <herelrom anE t�e Oasis lor t�e alle0e0 exemption. My violation of Section 7031.5 Oy ^+v aDD�icant tar a pt�mii SUEI�� e aDP��wm to a cNil penalry oi not more than Me hunared Aallars (5500�. I, az owner of tAe D�operty or my employees with waAes as t�eir sole compensation, vnll Oo Ne work, anE tAe . simcture is no� inrenAetl ar onere0lor sale (Sectlon 7044, Business ana Pmfessional Cotle: 7�e Contractars' State License Law Uoes not aOPly to an owner ol a O�operty wAo bmlds or imDraves IAereon, anG w�o Eoes such work himseli/herseli or Ihroup� his or �er own emDloyees, OroviUeO t�at sucA imDrovements are not intentletl or offeretl for sale. If, however IM1e builAinp ar improvement is soltl within one year al comple[ion, ihe owner vrill have the hurden ol pmving Ae/she tliU not 6ui10 ar impmva lor Ihe OurpoSe at sale). . � I, az owner oi ��e D�opertv. am exclusiveN contractinq wit� IicenseU contactors to construct the pmjeci (Secibn 7(k4. Busineu ❑ an0 Pmlessmns CaOe: The CanWctors State License Law Ooes not appty to an mmer of Dmperry w�o Dmltls or imD� �hereon an0 who cantracts for such pmjecis wit� a contractoqsllicense pursuant ro ine Cantractors' State L¢ense Law�.l am aware Ihat proof oi their WaBer's ComDensation insu�nce s�ou10 Oe Drovi�e0 to me.' /� � � am exempt unaer Section: gP'] � 4 4 B. s v. C. ronn�s reason: NOC �EMPLOYEES Date: � 9^— ( � Ownec I Uo �ereby certiry tAat I am aware of anA untlerstan0 ihe require of C 2553<ana t�at I or anY ��iure GuildinA occupant vnll/will not (circl on � nee permit lar consiruction or mo0ificafion from I�e AirOuali�y Man e enI Di inese provisions. oate: � �'%—�� Appliwnt: � I I �ere�y ceniTy tlut I Nve reaE this application anE state lhat v� oNinances antl state Ww's relatin0 �o Duil6np croswcUon anU FopeM /��or inspectio� purposes. Oate: % �9� �� . Sipnamre: oriver's lkense or Sodal Secunry E Satery Coae Sections 25505, 25533, ana �ai0 state cotles and t�e requirements for a con5imction applica�ions are exemD� ��om I apree to compy wi�� all eiiy an0 wunry tlus dry to enrer upon tAe ahove-mentionN /-/-.� ..��a_wn{�e—Bui�Oiiq; Green_____COEa Enlorcame�4 Ca�ry—Applicant; Pink—Pevenue: GolEanroO—Assessor .CITY OF�COSTA MESA — BUILDING PERMIT PER NO: BE� 046876 PERMIT NO: BE 046876 PLAN CHECK NO: N G�VT: N SUPP: N CONSTRUCTION TYPE: 5—N . PERMIT TYPE: ELE STR / PURPOSE; ALT ' JOB DESCRZPTION. ;.INCREASE HEIGHT OF EXISTING GARAGE� SQ FT: 200 CLAIM VALUE: CALC—VALUE: 3,460.00 GROUP OCC; M-1 % COMMENTS: PLANS WAIVED PEA '88 UBC CHAP 3 SEC 302H �+t�+�+� �*�*�**r**********x�r****�r*+t*****�r�rr*r�r*g�t***�rx*�r�**+r+r**** t71VIVP��1.i*1 Vfl Z O N I N G R E U I R E M,E N T S serBacxs ------------ MAIN BUILDING ---------- --------- ACCESSORY BUPL`D'INS`�'��ED___ 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: 42532110 ZNE: R1 REF NO: PLANNING NZ3TES> RAISE ROOF OF EXISTING GARAGE ATTACHED TO EXISTING RESIDENCE . > BY APPAOX. 3' *��*�e*r�r�exw��r�e*�t�r�*x******�r�r*Ar***�r�r��r****+t**��r*******r**r*******+a****�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 APPROVED HY � ' DATE: :� HUILDING APPROVED HY,: APPLICATION ISSUED !k if M 1f iF iF iF if %if 9k if M1k iF iE if ik % 1f3fitiEiFifKiflkMikMiFik%1EifMif LEGALI2ATZON:Y HLDG PMT PERMIT 126.00 PLAN ISSUE FEE NNMifitikMMiEitifififiFikMMMMNtifMiFitlfiEMMKMIkkitMMl1M F E E; S U M M A R Y PLUMHING ELECTRIC MECEIANIC FIRE 1.50 5�s 15.�� DATE: DATE • �� iFitifltiFi�ihit 7fitM� M M iF it iF ik k IE M if'if M iF if %iF iF If �f iF STRUCTUAAL SEGMENT:Y SMIP/RES : GRADING rj Q''� SMIP/NON—AES HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID � DUE TOTALS----> 128.00 15.00 0,00 143.00 143.00 ,00 REVENUE DIVISION TOTALS--> 60LLECTED: 143.00 OVER/SHORT: '-�� .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GAADING PLAN—CHECK 126.00 . 16.50 .50 ' 1f it �F �F 1F k iflf iklflf 1f k!f it iFiF it iF if M!F M M M ik k 1F k k iFiF if k iFlF M k ik iE 1klfltlf iflk iEikff ff M if fflF 1E if M �k M!t Mit M%!f!k iF M iF if M M!k if iF iE iF M if I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C A I P T I O�N UNIT COST ' TOTAL COST SFR 200 RES—GARAGES TYPE V 17.30 3,460,00 ELE 1 RECEPT/OUTLET 1 ST 20 EA. .75 ,75 END OF FEES 0 oi oaossiso-aeossis2 Ta-r DATE: 04/09/90 TIHE: 14:24 143.00 n _ r CONSTRUCTION AND PLANNf. �� ' OL & SPA ;� APPROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector � 1. Temporary Electrical Service or Pole � -' 52. Pool & Equipment Location '� � ', .2, Soil-�jpe�Undrgrnd-� � ' 53: Steel Reinforcement ' � '� i� v��BTectrical Cond-uii�l4tiliry-Undrgrnd. � 54. Forms �'' S . � "�'�Ctri�al Contt�i2-l7�hdrgrnd. _ . 55. Electrical Bonding . " � .�.. , , om-. �LtS ekdeinforcemet[t? � , 56. Rough Plumbing & Pressure T,esC� c � ��'4E`�ect��al UFEg��nd. 57. APPROVAL TO COVER�GUa�E ,o�' .�Footi�gs v 58. Electrical Conduit-Undrgrnd. M -��; `��. Foundation a,"� 59. Gas Pipe, O Undrgrnd., Test � ^� ' '9. Water Pipe�Un rgrnd. ' � . 60. Backwash Lines, P-Trap, O Undrgmd. �' 10. Structural Floor.Sysiem � -� 61: APPROVAL TO DECK 11. Property Sewer Lir%e'�'& HouseConnection �. - �62.� Backwash;&,Receptor-Final � 12. Sewer Cap a, , 63r �Heater & Vent-Final 13. Roof Drains l, � ' - � ' .,,� 64. Plumbing System � Final 14. Rough Plumbieg � . 65. Electrical-Final 75. Rough Electri✓�Conduit� � 66. Solar SYstem-Final 16. Rough Electri¢`�Wiring � - 67. Fencing & Access Approval 17. Rough Wiring Stgn � 68. APPROVED FOR PLASTERING 18. Rough Electricgl-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Ro�h-Heating & Air Conditionin PI �E EPT. EQUIR MENT m � a ,?� : r,+ c � vi � � x a �.-i�, r+ � �3. F N tT] 20``�RoO h ct�y FL�' �place � �`' �� '� � �* * ppR�lVA1��CPek�it # * � �"� b". I S C^ R' � h: i N T lc x„ � t+F -�t*i 21!-flu" s, in�StrTictUrP� i�•• •• r+S � S � H* x^70. UhdergTo'v�' Hy�ro * c, x i ^ F. � �!� x.� r .-� x �'� x 1 CJ S x S %K x i �7 , X 225Du�s, r2nt'I�atir�g'.,�. � � *� 6 � f.,,* �, *77. Produc �_� i�g C�b.as �.MOiI 23.�GarPipe+Rongh &�est i I+7S �[�t � O* * 7z, UndergroUntl FI'oifJ�+ * '-'� hn Yn 1 �n T i1l1 Ik .T X i i .-� V '1 ? 24dRo0Tf Fr�min `7%� I FF ••F �� O c' # M a1 � riT '^ q 9 4* ;,� ,�; � � ;..�*x •.73.yUndergrna.Stor�g��nk�]Gas ❑Uil 25. Roof Sh2athing pi* � v �� 7 > CJx x 74;jpyerhead Hydro=�� V * ^� T Y l� I� K 4 tr'. Y: CO C1 CC7� * C '7 * H O U'.� 26�T�Bar Ceiling (S(��turall &riJl��ocoat,� * 0 �, `* * -75g[�y Chemi.caJ r,� ;� �� 27;,Frarneaad Flasfppg ptCG n; �� rs � mx * 76. Dry Stan V�e F�7 *� � i['! :"28. LaMin SidinT� �^ y'Q"� � � � ..�'•` � K F � �* '7v:F OG � ..� ..( p� * 77�; FIXED ��E�,�jINAI'#,...� n �F y�29. Insulati� t+7� S ••O' x ( I!.* 7$EpIRE PREV. FIN �> �� `�30. Dr wali}Jailin * c ^ � * i # '" t��e LT P1KFi'EQOIRr�7,,� NT Y 9 _ * ,y i O * F � . � * S Nrt5' �� r �"`fc p31. Plaster BroNtn Coau S i t*�t+� � •x �= x 79.�fINAL INS9ECT10N� � �.^ _ 2_ : �-• '"32�Electric� Power�l�te��F�nali y* N I 'i:� x 80,.m.�F00D CERTIF�i1'F� IS��ED� � E33SFir�e,l Electr�� py i �F � .`� tes: �+^: '7m �+�-7 O r zf N34�Fir� Ffe'acif� &".qi�(�oadicibni:,cp ns x * Qu-.+ �•s nz � s v x �-1 J �Ck jT7, C�iC� k i I !- � k 3 !-1N0 O 1 F'C A: v i 35c�Final G� Pipe�Tesy p� •:C .K i..i ..x ` �,^.,o v'; x Nt* a36. Hoad o7.CanoPY�'� :' � I[�'-� nc� �(l �'� * E ^o rc [* � s c .os f� i ccm w� x �;�t * m ::o x,; :nm 1--I �� # M 1 J � IJ �F ' � -37...Fin Fpytory Fi�eplac� � E-.F �..�:+! � I " s -. K N : � �"�38. Fi'al PI^umbing w� N i �+�Q *^ ' FK * S ti M'+� .� � J w O Y: I •. F * I .'K � N --� C"., # c�39. Waier �vic�,�Fi`�� i �,Q r � i , .. x � � -, w � * m �40. Gat-6er.45ce-Fdnal * tT; �Q.Ty^ Sx * m j � x z �U oS �� H41. Solar pomes��LicFir�IS T j � I �� R. ,•;o C �: 7� � 42. Backflow Preventer. N �O k � * * ^ ' �F • � �7 H (�, HH Fti 1K �i 7i CT:O1% 'X F '"� 43. Backflow Irr+�jatior� '�x,SS X * rF �* �5 �� i x C� •• [�144. LandSCd� e iYripa[id'n Syster�T1CJ SN �[*] G t7 V� � N N � "'CJ � N Or., r'e n :k �' x x i F n Ci CC * S F �4 �Sound tte�n,uatio� ~�F :*ti � 2. F F f-�*? H �+ o'� � '� � ^� ^7 .. .. s � c*; m rn* x c� c� �¢ • 'ra x G46rHandicap Regulations �. O * � * * � •5 �o s * y �k N IV X m47SFIMAL STR'MCTU,�iE & BUYLDING N .,Ct` ,h0 %�, N�S , � `-. * �., N �� n ��4&'7FIf�174L PLANNIN6 � FF O t ru ' �•,� * L r V S Y eF„ w �49"?�EI�Ekric�iel�se to�dison i s� I I n/i� * Q ,�., * rp z�5Q5Gas�ftelease to Souihem Califo�rt�a Gas�Cn � � �=� � � � � �M * O ^• � + � t * M'K •• O ;l # N O� 51. CFRTIFICATE OF$OCCUPANCY � * * �� T�� "' � No. Date Aoo�icant to flll In all soaees excevt lhose witnin heavy boraer Iinas anG sign all avPropriate aeclarations. CITY �R COSTA ME$SS A ONSTRUCT PERMIT PER IT NO.rf TReCT NO. LOT NO. UNIT NO. A P,hy . Zone ' � � Fwject Address �g�0�� AP� � ! � , � -. �` TYPE OF CONSTRUCTION NEW ADD `ALTERATION REPAIR S Main Building: ACC255ory Building: Apnlicant's Mailing Address ' E Front Z Owner's Na � � � one 7-'�i D � �ONVERSION ❑ DEMOLISH ❑ OTHER T O �tp�� DESCRIRTIONO WORK/USEOFBLDG. ��`�^ti p`GU� B Rear N Address l ''—�1 L. �.� / �Ir._.( �_y�l,n � 1�IW�✓�� 7M �CYIn✓l—�fL%Cj—_ ' A I Arch/Eng. Licen52 No. TVPE OF PERMI7Tp� �J GRA�ING FOVNDATION STRUCTURAL � K Right G Addreis t� ❑ TENANT y6l ELECTRICAL ❑ PLUMBING ❑ MECHANICAL g Lef[ R .Contractor's Name IDQ�� N�'-��/ Phone ��o7HER Ping. Fief. # Parking Req./Provided E Address Imailing) PROJECT DESCRIPTION 5�. FT. oCCUPANCv Pianning Notez: M CONSTRVCTION TVPE VALUATION $ .� CityLiCen5eN0. ZONE GRADINGCU.YDS. ACRES - g, LICENSEO CONTRACTOR DECLARATION - I hereby a/(irm that I am licensetl untler prOvisiOns of Charlar 9(commancing Remarkr. wi[h Setlion 7000) of Divislon 3 ot the Busine55 dntl PrOfe55ions Cotl¢, antl my Ilcense is in iull (orce and eftect. ELECTRICAL FEES LicenSe Class LiGense No. Date Si9nature PLUMBING FEES /automaiic Washer Transformer ❑ 75-50 KW WORKERS' COMPENSATION DECLARATION Construclion Po125ub. � 50 t KW v¢�y attilm that I have a ctr[i}jcate ot consent f0 SGIf-Insule oI a ceftiticate Baf SIOk ShOW¢f5 Vorkers' Compensation Insurance, or a cerHfietl copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 700amps ,0, Lab. C.) ao�icy rvo. _ company Backflow Irrigation Sewer Cap Dishwasher Meter�over 100 amps 8 Certifiea copy is nereny turni:nea. Dryers ❑Gas ❑Electric Sub Panel Gertiiietl copy Is filed with thg city Builtlin9 Divislon. Bathtubs Sewer Connection Date Applicant Fan MotOrs �41 HP O 1 X- 8 E%EMVTION FROM WOPKERS' �OMPENSATION DECLARATION Clafifl¢f5 $Olaf COII¢Ct0l5 iess�ssection neea no[ be complet¢tl ii the permlt is for one hunaretl (5100) or Dishwasher SOlar Piping F.A.U, Inc.Solar 09-15 HP �i6-15+ I cBrlify lM1al in lhe pertormance ot the rk tOr wblch lhis pe� �t is IsSueU I , Fixt��¢5 snall not employ any person in any ann so @s to becom subject to the Drinkin9 Fountains Solar Tank Microwave �worge,/s�ompqnsa�qiTl.aws ot Calitor ia. Dala'oL L D� 5ignature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTI[E: If, after making this tle�laration, you should become subje t to the Workers' ComPensatlon provisions ot the Wbor Cotle, you must t r[t FloorSinkS U�inal Outlets Range <amply with such p�ovlsion5 or tltis pe�mit Shall be tleemetl �ev . CONSTRUCTION LENDING qGENCV GasSerVice OUtIEtS WetefCloSet SWitCheS $i9n 1 hereby alfirm that there Is a mnstructlon lending agency for the performance � of the work tor which this permit iz issuea (Section 3097 Civ. C.) Interceptors Wa[er Heater Garbage Disposal Standing Sections i.entler's Name Generator 00.5 KW �5-15 KW Trash Com actor Lentler's Aaaress �.�✓ Kitchen Sink Water Service P OWNER BUILDER DECLARAT�ON 1 hereby dtfi�m lhat I am exempt from the Contracto�'s LIC¢nse Law fo� th¢ L2vetO�i¢5 AptO-WeSh following reason (Seclion 7031.$ Business antl Protesslonal CoCe: Any clty or counry whicn requires a permit to construct, alter, improve, tlemolisn or repair P—Trap Leundry Trays any slructure, prlor lo its i55uance, also requires the dpPlicanl f0/ such permit to file a signetl statemenl that h¢/she Is licensea pursuanl to the orovisions of Roof Drains tne Coniractor's License Law (Chapter 9(commencing with Section 7000) ot r' '<ion 3 0/ the Business antl Professions Cotle) or that he/she is exempt Rainipaetion Fee $15 Iuue Fee from an0 the Dasis tor the allege0 exemption. AnY ��olation oi Section .5 by any appliGant for a pe�mil Subjects th0 applicant to a civil � aityotnotmoretnantivenuntlredtlouars(b5oo�. $ 3 DEVELOPMENTSERVICESREQUIflEMENTS: D�/ I, as owner of Ihe property t Reinspaction Fee $15 Issue Fea F�tlo-the�u'odc, antl the structure is no intentletl or otferetl Zoning Approved By Date tor sale (Section 7044, eusiness antl Professlonal Cotle: The Contractor's MECHANICAL FEES Building Approved By Date License Law tlo¢s not appty t0 an owner ot a O�operty who builtls or Imp�ove5 [M1e�eon, antl who tloes Such wOrk M1imself/her5¢If o� through nls or h0r own BOiIEf HOOd 01 TyPe l ❑ APP��tion Issued By Ddt employees, provitletl tM1at sucn improvements are not intentlatl or of(eretl for sale. II, however, tne bulltling or improvement is soltl within one Year of com- Canopy Type II ❑ SUMMARY OF FEES oletion, tne owner will have the burtlen ot proving hc/sho tlitl not buile pr im- Duc[ - Under Ground prove for the purpose oi sale). BUILDING PERMIT $ SMIP $ ❑ I, as owner o/ tne property, am exclusively contractin9 with licensetl wn- Duct -SVuctural Retrigeretion System PLAN CHECK $ PERMIT traclors to construct the Oroject (Section 7044. Business antl Professions Cotle: The ConVactor's Licenze Law tloes not apply ro an owner of property who Duct � Ventilating ❑0.700,000 BTU ❑100,000 BTU PWMBING � $ ISSUANCE $ builtls or imDroves tllereon. antl who conlfact5 for Such oroiec[5 wltM1 d ron- Vactor(s1 Lcense pursuane ro m¢ Contracior's License Law). 1 am aware tnat ExhauSt System ❑ MWtiple ❑ System Repair/Alteration P�N CHECK 25% $ � ENERGY P.C. $ proo( o( tneir Worker's Comoensation inturance shoum De provitletl to me. ELECTRICAL $ .7�•.� � GRADING 5 ❑ I am eacmpt untler Section— B. & P. C.1or this r¢ason Firepl/Fatt. BIL ICBO dk Fire Dampers MICROFILM S PLAN CHECK 50% S ¢ Date ' ' owner � Heating System & Ducting Registers MECHANICAL $ J S i nereby certity that I have reatl ihis appiication anO ztate t� at th e ❑Q100,000 BTU 0100,OOOBT TOTAL FEE $ iniormation Is correcL 1 agree to comply with all clty antl coun Y or nres PLAN CHECK 25% $ anO state laws relating to builtling construction, an0 nereby authoNze repre- sentatives Is city lo en er upon the above-mentionetl property for Insoecuon urp ses. � 1_n_4q 01 DOfl277-�3-0002?i73 }"I�21' ,, Signature �ate�� LSL4. . �f�� - Reinspection Fee $15 Issue Fae $ 3 DA7E: 7/89 TIfl�: i°:,i;] Ddvers' License or 55 $ 0865-46, rev. 5/80 Whi[e - Builtling; - Applicant; Pink - Accountin9; Goltlenrotl - Assessor .. s _M1 . . ..... . +. . , � . � CONSTRUCTION AND PLANNING � POOI °• SPA .�� APPROVALS Permit # Date Inspector qppROVALS P...��it # Date Inspector � 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Locajion _ '� 2. Soil Pipe-Undrgrnd. '' 53. Steel Reinforcement ', �_ • 3�Electrical Conduit Utility-Undrgmd. - 54. Forms ' . 4.'Electrical Conduit-Undrgrnd. 55. Electrical Bonding � � �5�.:Steel Reinforcement 56. Rough Plumbing & Pressure Test - , � E...ElectricalUFERGrnd. 57. APPROVALTOCOVER-GUNITE ' � jrFootings' � �.` 58. Electrical Conduit-Undigrnd. I �s 8. �Foundation , 59. Gas Pipe, O Undrgrnd�, Test . '� S; r 9.��Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. � tO�Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & ReceptorFinal ,. � 12. Sewer Cap '1 63. Heater & Vent-Final �� n 73. Roof Dcains ��. 64. Plumbing System - Final '. � � ' 14. Rough Plumbing � ( '65. Electrical-Final _ 15. Rough Electrical-Conduit � 66. Solar SYstem-Final - 16. Rough Electric Wiring 67. Fencing & Access 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 • APPROVAIS Permit # �� 21. Ducts, in�Structure , 70. Underground Hydro 22. Ducts, Ventilating ' 71. Product Piping �Gas ❑Oil 23.`Gas Pipe=Rough & Test ' 72, Underground Flush 24. Roof Framing /. 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof $heathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical 27. Frame'ar�d Flashing � - 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED SYSTEM FINAL i 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECT�ON 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � � Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 3S. Final Plumbing 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomestic-Final 42. Backflow Preventer � � � �, 43. Backflow Irrigation 44. Landscape Irrigation System =�� 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requiremenis Completed 49. Electric Release to Edison �� i 50. Gas Release to Southern Califomia Gas Co . ��" t� 51. CERTIFICATE OF OCCUPANCY '%; • .a � � No. Date ��" � LIMITED STATEMENT ..r RESPONSIBILITY TO WHOM IT MAY CONCERN: � �/ l �w v�, n�.�..a ��c.o Y.--a Street Address � Bldg. Permit # This Permit # AP NumDer I, l-�✓L-�`�' ��y� , as Owner in Title of the above referenced property, do hereby authorize: �l�or�c� I�►osQ�--��, '�zz- ocSG� Name Telephone No. AOOf055 V � to oblain permits in my beha�f, as owner/builder, for at the above refeFenced property. / L�b ��i-�,P" U riI� �� /� T(i—�c`v� V 1�) L�i�wWOw tl�'CbcN/ " JL V� �%� rj�� Should gpy oerson become an emolovee engaged in the improvement of the property, I shall immediately p!ovide Worker's Compensation Insurance coverege and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of Calitornia laws. As owner/buiider in fact, I understand and accept that my responsibilities do not transfer to any other per- son, company or corporation. I agree to indemniy and hold the City of Costa Mesa and its employees or otticers harmless from any claim resulting in damage or personal injury to myself or any other parties. L� � � . Printed Name Signawre 01�9<6, me. NB) � �v �� Date OWNER JAME$ H. PRICE ' DATE 9/11/59 JOB ADDftESS 3� R�any p'� BUILUING PERASIT NO. 1�Kg GF.NF.RAi.CONTRACTOR Owner builder VALUE $ iii_00 AP. No�l (—CCV—l5 LOT TRACT FIRE ZONE DESCRIPTION OF WORK INSPECTIONS DATE I GROUP TYPE Underground Soil U.G. Water _I I pERmil SUBCONTRACTOR � Form 410-3M--4-59 U ' 10�K� � '�, �'�� EE RECEIVE� , COSTA MESA BUILDING-SAFETY DEPARTMENT <7•_ �� _� P.O. BOX 31] COSTA MESA. CALIFORNIA fINANCE DEPT� ��` fOR APPI/CANT TO f/LL /N COMPLETfLY APPLICA'I[,W'rt�Oj�Sf��!`d�' TYPE OR PRINT BUILDING BUILDING' l' ADDRES� �7 r r V COSTA MESA. CALIFORNIA FOR OFFICG USG ONLJ ' I RECEIPT NO. I PEHMIT NO. OWNER MAIL ftECEjVE�'� O RECEjVEO CAiO ISSUED ADDRES Gj /�/I ��/ � —I�'" CITY TNO. �3 BUILDING 2�/ A__ ..-.. . �� ADDRESS ✓ ��'��'D /-T/' r ARCHITECT ��c. COSTA MESA, CALIFORNIA OR ENGINEER NO. � FIRE ADDRE55 ZONE TYPE GROUP �� CONTRACTOR O� �� e V ! STATE qPpqOVED LIC.NO. BY DATE ADDRES � ��%iq'J� ZONING y LEG�L I LOT ^ I I�. n I(J ZONE NO. OF USE OF NEW �� DESCRIPTION NO. d% BLOCK R��{ I PLqNS I BUILDING � A.P. NO. /— � O—I�' BYPROV I� / D� D9 E G ' '�%� SIZE �%� �� /J p p [jI-/yO. OF BLDGS. / yqRDS EV 5 OF LOT �I Ii• 6��%J TR�ow oN toi REQUIRED ALLOWED USE OF ICENTEN LINE ST.1 ['�7 EXISTING BLDG. FRONT J uFT. IN. - SETB4CK LINE FNOM O /� �� ceNTER OF STFEET REAR YARD R. SIDE FT. IN. // /l y SIDEYARD LEFT U RIGHT �4 L.SIDE Ff. OIN. DESCRIPTION OF WORK REAR FT. IN. NEW I/\ II AITERATION I II AD�ITION I � REPAIR I II MOVING I II DEMOLISH I BUILDING NO.OF , SIZE ROOMS STORIES EXTERIOR WALL IROOF COVERING COVERING USE OF BUILOING ANO WORK TO BE PERFORMED " � � vC a// en �aYn I � I HEREBY ACKNOWLEDGE THAT 1 HAVE FEAO THIS APPLICATION THE AMOUNT 9HOWN UNOER VALU/�TION IB FON TNE AND STATE THAT TME ABOVE IS CORPECT RNO AGflEE TO COM� PLY WITH ALL CITY OflU�NANCES AND STATE LNWS EGULATING PURPOSE OF ESTABLISHINC q PERMIT FEE ONLY. eui�oiHc cons'r ucriorv. 1 /1 � VALUATION SIGNATURE OF ti"� � PERMIT FEE $ ��-� PERMITTEE �� . $ � � pLAN CHECK $ � AUTHORIZED AGENT TOTAL FEE S � , - - .. _.-�- OWNER pIKE & COLEGROVE � DATE p_14_�� JOBADDRESS 341 Ramona Place BUILDINGPERMITNO. (�J�� GENERALCONTRACTOR Owner VALUE $ ti.riOO.00 � LOT 12 BLOCK TRACT 231� Single F''&Rl. Res. �� GROUP T T�'PE V ZONE RLL FIRE DISTRICT �j(7O PERMITS ISSUED INSPECTIONS TE SUBCONTRACTOR . � ,� __ � � _ DATE I NUMBER Fnu�datiu� to I� Sewer ` Seotic Tank or v.c � 3, r�ascermg �� i� -,�� Plumbing, Final, Fixtures Comp�et _� Plumbing, Final GasTest/ — 7/ LIS -.3� Wirino. Final LL ^.�i � Form YIO GH lbf 1:-68 ;� `�-� Costa Mesa Building Department APPLIHCATION FOR PERMIT ' (�"� COSTA ME AZOCAL F RNIA � -"��.�.Z� � �.D �Ii N_G_ .._ � FOR APPd.ICANT TO I� ILL IN �OR OFFICE USE ONLY � , � ReceiptNo. PermftNa. i Address 341 Ramona Pla ce j ''- �� rf µ � 5� 4� � Costa Diesa, Ca�lifornia Received;by I oate Re d. oate �ssued ' Nearest ; � � �V _ /� S�� c�oss sc. Santa An8 Avenue Building � Dike & C018gTove nddress , Owner ' � Ma.i Costa Mesa, California � Address 419 F+. 17tt1 Sti. Nearest � ' ! Te 9rty CrossSt. Gty i�iOStfl �889 No$� �j9 Zone '� I No.of I Type ,/ i Group � Architector Lic. ! Plans /' Engineer$ll�h G�bbS No. Approved • Address4¢I F,'. 19t Sti. I,UAg B6flCt1 �' Date � , � CORRECTIONS � Gty Lw. Contrector D�iCE&C019KT006 No. ' nddress419 E. 17th St. , COSta Me8& Legal Lot I _ Description I No. 12 I e�ock NOD9TractZ`31O (Attach Metes and Bounds) � — � ' No. of Bldgs. Size of Lot lfj$ e c�$�,_`j,O I Now on Lot NOIIB Use of I No. of I No. of Existing Bldg. Familfes Rooms Cn16�nL 1 i n f..n... Oe..� V�.wA .. _ of Street �J�J � New � Z I Alteration � Repair { . � Moving � Buiidin No. of Size �pl]_9_0 ATBH Rooms Exterior Wall � Rooi Use of New Buildina Addition Stories 1 jii( _ O �q.p�� q-S- }F�. [�— A _ _ Ul� I _1't IJJ'# � Z D " r F-1-:Vi�t/�Y7Y j�� .c�� . . . . ... . � • . APPROVALS Foundation Location I Inspector Forms, Materials, Lath.lnt. I hr.reby acknowlectqe that I have rcad this Application and state that the above is correct and agrce to comply Lath. Ext. with all City Ordinances and State Iaws regula[ing bttilding construction. Signature of Plaster, int. Permittee Valuation Pern (J �, (! � Plan $ b � �� Tota Fee ,_.._ ,n� r._n �Ar w_s, Plaster, Ext. }lasonry Retnforced 7 Bond Beam . ,---, -.->-, ��• ; Show,-�location; and distances from property line and between buildings. V ' f