HomeMy WebLinkAbout2726 DRAKE AVE - Building PermitsCITY OF COSTA MESA
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B!/ILDING DIVISION
i � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-0856 • www.ci.costa-mesa.ca.us
°.�� . � FOR INSPECTIONS CALL: (714) 754•5626 �
PERMIT NUMBER P07-00396
PERMIT TYPE
JOB ADDRESS:
Vicinity:
PLUM
2726 D
SCOPE OF WORK: REPIPE��S:F.
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OWNER: BRODRICK,yFLORENC
PHONE: t
APPLICANT: ANTHONY-;��PAT �- -
PHONE: 714-758-7725 ��
CONTRACTOR: PACIFIC GOAST�.
Address: � 1556SANAHEIM���.E
City/State: ANAHEIM CA �_ "�
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PLUMBING PERMIT FEE_SU
PLAN CHECK FEE:
PERMIT FEE: $33.30 ��i,
TOTAL FEES: $33.30
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PLUMBING.
STATUS:
ISSUED:
3UED BY:
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nddress:, ,, ;2726
. �.^•City/StatelLp�:'e. ;CO;
Address: "' 155f
City/State/zZip: ANF
'ER�REP,IPE�COMPANY -. - � Cicense No -A��'66
STE�Fe °� ` �_r F ..,_ �. �_'_PHONE:=.'��!714
2ipCode 92805 �:. " CELI.: .�.
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ISSUED
06/06/2007
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NOTICE: The work authorized �by this permit shall comply with all applicable handicap access requirements under California statules and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.'
INSPECTIONS:� In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval musl be obtained. Failure to obtain inspections and final approval will result in the expiretion of this permit.
COOE i. INSPECiIOXTYPE
161fi Fixed System Final Fire Prevention
1266 Pool Spa Final �
200 Final Re-Roof � �
207 -Fina1 Black/Retaining Wall
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
on� ixnna�s oet IN$YEC110NiYPE
206 Final Mechanical
208 Final Plumbing
210 Final Elecincal
272 Final Fire Prevention
' � 220 Final Planning Approval
222 Final Site
' 250 Final BuildingiOccupancy
DATE INTITIAL
WORKERS' COMPENSATION DECLARATION:
I hereby aHirm under penalty of peryury one of the t�._ ..�ng declarations:
❑ I have antl vrill mainlain a certificate of wnsent to selElnsure (or workers'
compensation, as provided for by section 3700 0( Ne Labor Cotle, for [he
e rmance of the work for which this pertnit is issuetl. �
I have antl v.ill maintain v,nrkers' compensation insurance, as required by
� fan 9700 of ihe Labor Code, fw the pertormance of the work for which this
permit is issued. My vrorkers' wmpensation Insurance cartier antl policy
number are: �/�, �/J
Cartier:.. � ��Y� �/7 C%l'
` /Thisseamn noteemnpeteodmep�cvnirtisreWetlarmehurWredeonars(Sf00)aless)
Policy Number._ - � ��7 '7
❑ I certi(y [hat in the peKormance o( the work for which this permit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation lawsy � ifomia, and agree that if I should
become subject to th orkers' �mpens f1�e provisions of Section 3700 ot
the Labor Code, I s II f rth rit omply ' t se provisions.
_ . _ !y �O`1i.�0�
�_ pptiwnfs SignaWre � L Date_ _ - .�
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby af6rm that I am licensed under pmvisions of Chapter 9(commencing
with Seclion 7000) of Division 3 of ihe Business and Professions Code, and
my license is in full force antl eHect. /�
-Lic_# J Gl`�el f7' class #-�% C� -� 6
/-(�� J
nor s Dale._ —�
�-. _ _ .
CONSTRUCTION LENDING AGENCY:
� I hereby aHtrm lhat lhere is a consWction lending agency for the
peAortnance o( ihe work for which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name:
Lentler's Address:
SignaWre
OW NER-BUILDER DECLARATIONS:
I hereby aKrtn that unGer penalty of perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Pmfessions Code: Any ciry or counry which requires a permit lo
consiruct, alter, impmve, tlemolish, or repair any structure, pnor lo its
issuance, also requires the applicant for such pertnit to file a signed statement
that he or she is licensed pursuaN to the pmvisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the
Business anA Professions Code) or that he or she is exempt therefrom and
ihe basis for the alleged ezemption. Any violalion of Sec[ion 7031.5 by any
applicant for a pertnit subjects the applicant to a civil penalty of not more than
Ove hundred dollars ($500).):
❑ I, as ovmer of the pmperty, or my employees with wages as their sole
compensation, WILL DO THE WORK, and lhe structure is not intended or
offerea for sale (Sec. 7044, Business and Professions Code: The Contractors
License Law does not apply to an ovmer of property who builds or improves
thereon, and who does such vrork himselt or herself or through his or her own
employees, provided that such improvements are not intended or oftered for
sale. If, however, the buildinq or improvement is sold within one year of
completion, the ovmeo-builtler will have the burden of proving that he�or she
ditl not build or improve for purpose of sale.). �
❑ I, as ovmer of the propeAy, am EXCLUSIVEIY CONTRACTING WI7H
LICENSED CONTRAC70RS lo consWct the project (Sec. 7044, Business and
Pmfessbns Code: The cont2ctors License Law dces not apply to an ovmer ot
propeny wno buiids or improves thereon, and who cont2cts for such project with
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for [his reason:
Signalure Dale
305]-a6�J�0])
Owner ID ven(ed by drive ise. ❑ Yes ❑ No
Oriver s License No. Expires:
Verification of Ownership by (rype of document, i.e. - property tax bill or tleed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: � �
❑ I hereby certify tha[ no excavation frve (5) or mwe feet in tlepth into which a
person is required to descend, will be made in connectbn with woAc authorized
by this permit, and that no building siructure, scaHdding, false�wrk, or demolition
or dismanUing thereof, will be more than thirty-sa (36) feet higR (Chap. 32, Grp
2, M 2, Sec. 347, Tlle 8, Califomia Administ2tive Code).
❑ As owner-builder, I will not employ anyone to tlo work which would
require a permit from the Division of Industrial Safety, as noted above, unless
such person has a pertnit [o do such work (rom [he tlivision.
AOPlicanfs Signalure
Division of Industrial Safety Permit Number. _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant neetl to Ne and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Califomia Health and Safety Code requires, with some
ezceptions, that a Business Plan be filetl with the Costa Mesa Fire
DepaAment by every business which has at any one time during a reDortetl
year a quantity ot hazardous marenals equal to or greater than a weigM of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperaWre antl pressure).
2. Does or vnll the applicant or present or fuNre builtling occupant need to file
a regis[ration torm for acutely hazardous materials? ❑ Ves ❑ No
(Section 25533 of the Califomia Health and Safety Code, with some
ezceptions, requires registration vn[h the Cosla Mesa Fire Department by
each business which al any one lime has on hantl a quanlity of acu[ely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standard
tempera[ure antl pressure).
3. Does or will the applicant or present or future building occupant neetl to
prepare an RMPP (Risk Management and Prevenlion Program for acu[ely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Cali(omia Health and Safery Code pmvides that the
Costa Mesa Fire Department may require the preparatioq certifcation antl
filing with the Fire Department of an RMPP by businesses whith are required
to register acutely hazardous materials with the Fire Depatlment.
4. If an RMPP is presently required, has Section 25534 of the Cali(omia
Heal[h and Safety Code been fully complietl vnth? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupant require for
ihe work which is the subjec[ of this application a permit for suc� conSWction
or modification from Ihe Soulh Coast Air Quality Management District or from
any other air polNtion control tlistnc[ or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Califomia Govemment Code requires that the requested
infortna[ion be fumishetl on applications fa nomresidential building pertnits).
6. Will any part of the facility [o be constructed under t�is pertnil be wilhin
1000 feet from the outer boundanes of a school? ❑ Yes ❑ No
(If yes", the faciliry must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safety Code).
7. If a permit from the South Coast Air Quality Management Disirict or other
air pollulion control tlisMct or agency is required for the vrork which is Ihe
subject of this application, have all of the disclosures prescribed by Califomia
Health and Safety Code Section 42303 been matle? ❑ Yes ❑ No
8. pf'yes", attach certificate of compliance from ihe appropriate air pollution
control officer).
CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the
information given above is correct. I agree to comply with all state lavrs and
city ordinances regarding Hazartlous Materials and Emissions. �
Signalure Date
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read this appliwtion and state that
the intormation given is correcl I agree to comply wiih all state laws and city
ordinances relating to building conslruction, and authonze representatives of
the Ciry of Cosla Mesa to enter upon the above-0escribetl property for
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized by this permit until final i ction.
Signalur 1 L i eqs) Oate
G G' D 7
A/o o zeOApPli�ant J �_Date.._..,
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PflOJECTADORESS: 2�]z( DRAICH P,V
owHee�sxaMe: BRODERICK
nooxess: SAME AS AHOVE
uxir:
714-/537-1229 �
IRCNIENGINEEfl: � RE6.X0.:
�OORESS: , , , . UNR:
' PEpMiTTEE: ZEMKE ROOFING ( 714 ) 537-1229
� �ooeess: g852 ANTHONY �
+ GARDEN'GROVE CA 92641
110ENSEO CON7MCTOB OECUMTIOX: I AereEy allirm tAat I am IicenseU unAer pmdsians of CAapter 9(commencing with Section
7000) af �ivision 3 of the Business antl Pmlessions Cade, an0 my license is in full force an0 aflecL �
cirvuc.:051529 srnr�uc.:436436 cuss:C—�9
� Date: ��� g �7R � SiAnature: �'��•�F�/ �
�i WOBKEBS' COMPENSATION OECIAM7ION: I here0y aRirm that l havi cetlificate at consent ro sell-insure ar a cetlifiwte oi Workers'
�mpensatian Insurance, ar a certilietl capY ��eaof (Section 3800, La6. C�.
.icr no.: exr. oare:
COMPINY: � �
I❑ Cehife0 coOY �s hereby fumiShaE. � � Certilie0 caDY is filetl with [he ciry Buil0in0 Division.
Date: ApDlicant:
,
E%EMPTION FBOM V/OBIIEBS' COMPENSATIOX DECUIUTION: Rhis sec0on need not Ge completeE i� �he permtt is �or one hunE2A (5100� or less�.
I ceniy that in the pedormance at the work for whic� [his permit is issue0, I shall not employ any person in any manner so as ta Uecome
suhlect to the WOMers' Compenution Caws of Calilomia.
Date: � 3 ��q� Sipnamre: ' �--- 'Z�� � �
NOTICE: B, aher maldng Nis Oeclaration, you s�oultl be� I�e Warkers' Compensatlon pmNsions of tha La�or
Code, you must tortAwith camply with such Dmvisians or ihis Oermit s�all Oe tleeme0 revoked.
CONSTBUCTION IENUINO �GENCY: I Aere6y aflirm that ther¢ is a consimction lentling aAency for Ihe Oenarmance oi Ihe woB far
w�ich I�is Oermii is i55ue0 (Section 3097, Civ. C�.
LENOEH:
nooxess: -
� •
OWNEB BUILOEP OECUMTION: � I heieDy attirm that I am exempt irom the Coniractors' State License Law for the followin0 �eason
(Section 7031.5 Business an0 Pmtessional CoUe: My ciry ol counry wAich reQuires a permfl ro construct, atter, improve, demolish. or
repair any stmcWre, Orror to its issuance, al4o rtQuires t�e applicant for such permd ta lile a signeA statement tAat �e/she is licenutl
t � �h � �h C t t' SI � C L Ch I 9 'Ih S I' 7000 i D" ' 3 f ih B'
' CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B �04929,1
PERMIT NO:�B 099291 �PLAN CHECK NO; N GOVT: N SUPP: N
CONSTRUCTION TYPE; . '� �.PERMIT TYPE; STR ' PURPOSE: ALT
. , ,
JOB DESCRIPTION : REROOF/COMP O/EXISTING WOOD SHINGLE ' SQ FT: ' 2;350
� "
CLAIM VALUE; 2,350.00 CALC—VALUE: � 2,350,00 GROUP OCC: R-3 /
COMMENTS: SMORE DETECTOR AEQUIRED � . ��
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. Z O N I N GS ERTEB�AUCIKRSE,M E N T S
------------ MAIN BUILDING ---------- -----�---- ACCESSORY BUILDING•------=—=
FRNT: FT IN REAR; FT IN FRNT: , FT IN REAR: ''FT � IN
LEFT: FT IN RGHT; FT IN-' LEFT:, FT IN RGHT: FT IN
PARKING REQ• PROV: � PARCEL: 14131203 ZNE: REF NO:� �
PLANNING NdTES> �
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D E V E L O P M E N T �S E R V I.0 E S R E Q U I�R E M E N T S •
if
ZONING APPROVED HY • ' DATE:
HUILDING APPROVED HY : DATE: ,f,�
APPLICATION ISSUED HY; DATE: �%�r O' .J' ��
ifkifiEif�fikit�kiF3F�tikiFMjklEikiEik3fiE it�FifiElFikiPiE*�F , iF
iE iE iF ik ik if Ik ik iE iE jt iE±E iF iP iE iE if iE 1E if if iE ik 1F �! iE iE iE iE i! 3k iE iE if dFlf iF iF iE iF iF iE IE iE �k ik ik 3F * 3k �E ik �k 1E iE iE 1E iF iE 9f ik iE if iE 1F ik iE iP'�k 1E af �1F iF it iE i! iE 1E
LEGALIZATION:N F E.E S U M M A�R Y STRUCTURAli SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE� SMIP/RES GRADING
PERMIT 54.00 � ,50
pursuan o e pmvisions o e an rac ors a e mense aw � aD er (commencinq wi ec ion � o rvison a e usiness pLAN '� ' ' �, SM I P/ NON —RES �
antl Prafessions CaOe) or t�at he/s�e is exempt tAereirom anE the bazis for ihe alleqe0 exemption. Any violation al Sectian 7031.5 hy _ � , , �
any applicant Por a permit su6jects Ne ap0��canl ro a civil penalry of not mora Ihan tNe hundr¢E Uollars (5500). I SSUE FEE - �
'�, I, as owner of ine orooen5' or my employees wim wapas ss meir sole compensation, wlll ao ine work, antl iha BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL , PAID ' , DUE
simcture is nol inten0e0 ar otteaA for sale (section 704n. Business ane Pmtessional Catle: The Contracrors' State Licenu Law TOTAL S �---> S 4. S 0 0, � 0 � �, � 0� S 4. S 0 S 4. S,� � , � �
s�p tloes not ap01y to an awner oi a Dmpetly wtro 6uAE5 or impmves tAereon, anE w�o Ooes such work himulf/Aersell or throup� ' • �
. hisorAerownemployeas,proviAed�ha�5uchimpmvemenisareno�inlenAeEoroflereAbr5aI0.It,haw8verl�eEuilAingar REVENUE DIVISZON TOTALS-->� '- COLLECTED• 54,50 OVER/SHORT•, ��
improvement i5 wIG wi�hin one year of completion, Ihe owner wiil have the burCen ot Omvinq he/5he EiE not builA or imD�ove ,
' �orurevurposeotu�e�. • HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
I, as owner oi the O�oVerty, am exclusively contractinp with IicenseA cantractars to canstmct tAe prolect (Section 7014, Business ' S 4, O O � � ' S O
❑ an0 Professians CaUe: The Controctors' SGte License Law Aces not aDOty ro an owner ai D�opeM �o hml�s or imD«s thereon
and wlio comracts for such pmjecis wii� a conlraclor(s) license Oursuan[ to [Ae Cantractors' State LicenSe.Law). I am awam
ihat Oroof of Iheir Worker's Compensa[ion insurance shoul0 be pravitle0 to me. ,
� I am exemD� unEei Sec�ion: B. 8 P. C. '
tor ��is reuon: . '
Date: Owner.
I tlo Aereby certiry t�a[ I am awara oi anE unGerstanG t�e apuirements ol Calitomia Healt� anA Safery Cade Sections 25505, 25533, anU
25534 anA that I or any /uWre builUing occupant will/will not (circle one) neetl to comDly with saitl state cotles antl the requirements for a
permit for wnsiruc[ion or mo0ifiwtion irom ihe Nr Oualiry Manaqemmt Distnce BesiAential conswctian apDlications are exemD� �mm
thesO,Dmvisions. ,
I. �ate: ApDlicant:
j I hereby certiry ihat I �ave reatl ihis a001ication and state ihat.the a0ove information is correct I a0ree to comply wft� all ciry an0 counry �
IorAinances and state laws relatinp to huildinp constmctlon anE hereby authonze represen[atives oi this ciry to enter upon the ahme-mentione0
proDertY �ar inspenion Duryoses. ^ 1
Date: �' � ��\� Si9nature: � v�
� onver's �icense or-5ocia� Secunry x:
1801�d6 W�i�e--BuilClig; Groan—Cotle Eniorcament; Canary—Applicant; Pink—Revenue: GOltlenroE—Pssessor
� . � '
if if 3f �f iF iF i! i! if ik iF 1F 1t ik 1F ik iF i! ik 3k ik i! iE if k iF 1F iF it jt fk if 3k 3! i! ik M k iE i! ik iF iF if �f dE iF ik iE 3k k ik ik if it iF iF �t �t i! f! iF iE±k if iE iF 1k 3t iE iE iE �E f! iF iE i! iE 1k
I N D I V I D O A,L F E E H R E A,K D O W N
TYPE QTY , D E S C,R �I-P T I O N UNIT COST, TOTAL COST
SFR 2350 REROOF BY VALUE RESIDENIAL NOZONE 1.00 � 2,350.00
, • END OF FEES
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CONSTRUCTION AND PLANNIN� � ' , � �` !=>L & SPA �
� Date Inspector ' Date Inspector
APPROVALS Permii #' _ APPROVALS�' Permit #
1. Temporary Electrical Service or Pole .- ' 52. Pool & Equipment Location� �
-2:USoil Pipe-Undrgrnd^,- "� � ' 53. Steet Rei�forcement
_;�3�Electrical Conduil�l�ltility-Undrgrnd. ' ' - 54. Forms � '
^-,r��4.-Electrical Condui[lUndrgmd. _ 55. Electrical Bonding
��5. Steel Reinforceme�(t? � 56. Rough Plumbing & Pressure Test �
,'T�. 6.z'Electiical UFER�G nd. ,=� 57. APPROVALTO COVER�GUNITE ��
,; 7=.Footings :'�%- -} � 58. Hearicaf ConduirUndrgrnd. =�
1 "�
8. Foundation 59. Gas Pipe, O Uniirgrnd.,.Test
9. Water Pipe•Undrgrnd. , � � 60. Backwash Lines; P,�Trap, O�Undrgrnd.
10. Structural Floor System '" � - 61..-APPROVAL T0, DECK �
i
11. Property Sewer Line:& Hduse Connection 62. Backwash & Receptor�Final r• �
t2. Sewer Cap �- -� •� � . 63. Heater & Veni-Final - ;
13. Roof Drains -, .„ 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
t7. Rough Wiring Sign ' 68.'APPROVED FOR PLASTERING �
18. Rough EleCtrica!-T Bar Ceiling 69. POOUSPA`SYSTEMS FINAL �
19.rRough Heacing &.Air Conditiol,Li¢g 7,r � �, w �.* � r,rFIRE_DEPT. REQUIREMENT N
,`, � � � . . . ,. � . .,. _ .. .,. -' ^.1i D'J C' # � 6'
20.:Rough Facto,ry Fj�eplace i S? c;� > S r-� ^.r. ?: �APPRQVA�CS;F-r-Permit # � "'
�' C� 'z� C H �f Y t `-� e" M b
/" ` �" X i •• H s i� $ C H � Y �-i ^ �' •J `� .T.
21.`Duct's, in�STructur�e.,. . c..� g .:� .� r�;: �: ti70. Undergi0uc�dHY�ro ;�;
22�Ducis, Ventilating; x ��G �x G �: O[�.X �¢71. Product'Piping ��Gas �Oil
.-,
23 Gas;Pipe�jiough $ T,est ' " �
_r � °* i [*�;T• O,O M r,�-�� �* : r,��2• Undergroirnd.Fl sh�y � �-��„ ,`t'�
24: �Roo`f Framing i � � `�" �, � " � .� ;--;a x '..73."Undergrnd. Storag�Sank �O Gas ❑ Oil
r� n r
25. Roof Sheathing `--�x � v 'y "- `-, � �X a `l7q 'O.�,verhead Hydro��^ x
26._-� � -, r, > � .:. .. ��, fi ,. �.- . � i n v
,T-Bar Ceiling (StrWciural) &'Morwcoat * �: ,r C* � 75�Dry Chemical F� x� r-t
27nFrame a'n'd Flashing== =� �� x � >' �M � 76. Dry Standpi�'e �"� �� � c'
r., •-. .. H rr r r r �, x x �a: e-� K C ;�. p
t. ~ r^ '� r. T. %_ ' i �"-. +. � L ••x ]; r-, t. U �� � i: ._
"28. Lathing:& SidJ^9G� �:� �i-� J #� � j � x. 77.yFIXED $YS7ENUF:INALa: H Ci
29. Insulation ' ' y -' ' � � � * 78�FIRE PREV. FI AL "' ^ �' /
�. � o w M< �: S I � �� �s � x
� � � * --' ,: i � .•; ti � � .�; �: -
`�30. DrywaIlLNailing �•r F- i k F- j � � _HEALTF{pEPT:;REQUIREMENT
L� _.
�37. Plaster BPnW�Coat* � � �" ' ! � * `79. FINAL INS�CTIdN � ^ =
r .)' 1 x: i I � a: _..J 'k i ('!
_ ��'. r� �: �; � a: ,- 7, �;
;32=ElectricAl.Power Meter-Final �� y; � � �y x 80.�fO0D CERTIFIC/lTE ISSUED:-� �
r33 `Finat Eleetri` y ,.,C'7 � H� 'C, � _ � i a: * � �No{es: " ;'^ < - O n7[-:
I i ��: � ,� ii r: � s
� :, r"�. �-s n t_ x:K :4 .�_"-. i:.... x _.��.
a34 �Find� Heating:& Air�Condrtioning R, .K � { � y: k p; �-; ; ; r� x ,:,
..�
35.['Final Gas:P�PrTestK �_� •• y �� i � f4 * D �o G^ +.c � :�M
* !n �^
!- � � ^ I L'n"y ti k:l 1 � 'r. $ S C%O i: ^��
J36.5Hood oryCdnoPY ��;n .i x � I'�',.�c * ;:� �o x r,
^37. �Final�Fa�ory FirePkacex � ;�' �-' ''� � � `'�� � " ` N �
t.- i •.� x Cil ( I � d: x c: G; :n a� S
: J i �.! Y �
"38. FinaCPlumbing r�a i O !: I � �: r, r� � ��� ��� .
�y39. Watei Se%vice,Finalx ;z; i � �� �K * � 4� �� S
:n �: � � ti::k F-.-� :g �- ;�
�`d0. Gas SerJite�Final K`r '``°`r s * t^ � � M U` "':`' '�
'� !1:-� c^ r1 K � � �* ',- • o i x t.�
-61. Solar pomesiicFinal " =r. � `�� y x ;- �-;c v� � ;. �
. ( � !: � �-. n i C'
42. Backflow Preventer' � �; '� ^ � , .` * `� �' � • fi o r�
�.� ,. ti� rJtiP, . 'x. x l�: ::±p,� x
...�_� . - _ -
43. Backflow I�rigation�. ;+ *.� +� �:ti i� r• v :' •
i• i ."1 0
�'44. Landsca'pe IriigatioQ SYstem:'`''•� �'`' "� `� ^ -''' `- `'; " ^Li" �� �' �'
i� �C... !T; + 4^ �G qW �✓ � t V Oc, r 5 F.
z45.;Sound Attenuation� ;� :. � .i� � tn !T; -^� ;: F � c� �-� • •'.' �
`c w^� r r, � i / ti:+J �N a:
� _ �, „ -y '� � i :k .� u: O C.` :� X'
�46..Handicap'pegulations _ � - _
c- •• Y': G, i� \:
-47.'FINAL STRUCTURE & BUI'CDING �-�-�� ,. ,: � �� � � r. i.
r .i �� n� c' x O
46.tFINAL PL"ANNING; �'� � "� � � � � w ;. ;� ;� � " � '.
`49. �Eleclric �Re�ease to Edison . ¢ '' �X ;. p; �:^ - � - .
� ../.�� . < �r � n
�50. `Gas Release to Soutliem Califorriia;Gas Co x •/ ;r a: � c t• � �7 �� J ^•
i � : ti t . _�J ! a' .� Q
'51. CERTIFICATE OF OCCUPANCY� - ' ` --� � � -
No. Date
Property Address
Owner �
Contractor _
; �k
,
CITY OF COSTA MESA
BUILDING DIVISION
ROOF COVERING CERTIFICATION
Zi �b
�
Permit No. S��a7
State Contractor License Number ���y7b Classification L39
I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the
above address in conformance with Chapter 32, and Section 1704 of the latest adopted edition of the Uniform Building
Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the
manufacturer.
❑ I further certify that I am the owner of the property. (Owner-Builder permittee only).
❑ I further certify that I am:
�Owner of sole proprietorship company
❑ Full partner of the company
❑ Limited partner of the company
❑ Officer of the corporation
I certify that as an authorized officer or agent of the company or corporation, I am empowered to make
this certification, which shall be binding on all successors or assigns of the company or corporation.
I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building
Division for acceptance.
Received by Building Division
By:
� �a l 3 /� �
�tial Date
0990�a6 W�ito-Building Div; Canary-Conira�yw; Pink-0wner
Ze..�,kc P.ea�'^�
Company o Corporate Name
84,sx p�l�, 6...J., �"•e 41c`i/
na �ess
��-,. �L9,..4 0 �f .� I Y 9 a
� nature Date
Ja�� ���
Printed or rypetl name
i
,
moeessacewiwm: 2726 DRAKE AV
wir+exswweiv�aww: BRODRICK FLORENCE K
. woxEss: 2726 DRAfCE AVE
COSTA MESA,CA 92626
557-2426
aw�. iwuxc �ooxEu
u�cxrtecTon�x�n:
uc. ta.:
uxr:
2� �
urcx ox uxi.•s �oo�ss: urn:
CONfXALT01Y5NAME: NOCK PLUMHING (719)895-1246
cam�croas�uuxo 11610 SEABOARD CIR
uoo�ss: STANTON CA �,�,; 707775
90680 �,R,
LICENSE� COHrNRCTORS DECLAflATION: I heraby ell'vm ueWer peneXy ol pa�jury thtl I em licerieed uMer povieiom o/ Chepter e
(eommendeq vnlh Seelbn 1000) d Drviaun 3 0l Ihe Buainaea end Pmfeaeiona Coda, vd my lioensa ie in lull Iwca eM eXed.
cmuc.No.:050386 uc.cuss: C-36 uc.No: 07775 EXP: 02/97
o�.: c�ireaa: �
OWNEN BIIILDER CLARATION: I Mmby elfirm under pe�uly d perlury �he� I em ezemq Imm �he Commaon Licensa Lew Iw tha
IdbwnO ��� (`�� »1.5 Busines ad Proleasbna COAe: AnY c1Y a�nry xfiitl� rpuirea e pe�mn io ooreWct. eller. impraro.
•md'o�, a repai eny sVunuro, pior �o ils'ewarim, abo reQui�ee IM epplksnt lor wch pamil to fib a epiwE afetement Met M a eM
IicanaeC Wn�e�t b ihe prwivona d Ne Coniretlas Licenae lew �Chepter 9(canmend�q wilh Sedion ]000) d Div6ion 3 d ihe
�ririe» eM Prdmeiona Code� ar Oat ha a ehe is axemq Iherehom vM �he bsvis fa iM eAeped ezempion. My violelon d Saeion
iO3t.5 by eny epDlirant for a permil wbjeae the epplicenl lo e dvil peneXy oi nd mwa ihen frva hundred dallen �S5W��.
� I.�ovmardthepopMY«myemply�aeex'vhwepeaeeiMiadammpense�ion.xilldotMxwk.eMlhasvudunum�imendeA
«aReraC I« eab (Seclion ]oM.6usron e�M PMesvme CaEe: The Canirmwa Liceme lawEms nol eODNto en ownera p'opeity
who Wide m inpemea tMrean. eM v.ho doan audi xak limroll a heneY a Ihraph he a har own employaea. pwidad ihm eueA
impwememe ara mt imeMed a dlerad fa eele. M, hawmar, tM buiNirp a'vnpwemeM ie sotl xilhin are yav d mmpk�nn, tlro
owner-0uiNer Mill have Iha buNen N provin0 he or ehe Cid nd builE or improve lar IM W�e ol eele).
� I. av owrer d iM propeny. em extluervey mnirmnB �h licenaed convacton �o conprw tlre peqea (Saeion ]011. Bue'uwae erd
Profesaione code: The Conlretlon licmm lew dam na eDPN �o en owner a O�W�Y wlw WJJ. « imG�'m ihaean arW vrtw
camrens 1« wM prqeea wnh e mmreaa(a) Icereee p��auem �o �ha Comreqon Licenea Lewl.
� I em axmmq uMer Seclion: 8. d PC., la ihc reswn:
Deta: �b�
I do Mieby aality Nel I em ewve d erd wEenteM iM 1epuiremenb d Celianie Haetlh eM Se/ely COEe Setlian P5505.2553J, aM
255J0. arM Nm I a e'ry hnuro Wikinp oaupen� vrill / wil rw� (acb wn) � lo comply wih eeid wa mdee ud ihe �aquinmeMa br
epertnXlormnaVuclionamadiR�ianhantMA'v e�i-6TI.%nepemeMDiatnd.Feskmlielconslrudioneppimliamerenaemqiram�hese
plOV1910119.
Dele: ApW�-
WOXKEN'S COMPENS�TION DEttAflATION: I Mreby elfirm uMer penelly d pa�jury an d iM Idbxi�p Exieretiom:
� I heve eM xil meintan e wnilicele d mneent io aell�inaure br warkere' campeme�bn, n prrnked for by Satlion 3100 of iM labar
Cade, in iM partameewe M Iha xak lor wlieh this peimX u i»ueE.
�] � neve ene wi� meio�e:� wohen� canv�� ��,�. n ba��ree M senim s�ao a u,. �en« cod.. a. me o«�«mei,u a ms
.�e«.n�m�,�na�,.�,ae.ey.�•G(�LDEN EAG E 'd���m�v E}CPIRES
c�e.:
Policy Number. 0 9/ 01 / 9 7
m;: secr� �a.d �w ea m,�dar.d r me v�x o ro� ore nu�eree ddbm (siool a bss.�
❑ i�n+r �nm m o,. a«iamerce a ine wak ro. w,�n mv �n n owea i na .mvM .m v� ��r m.�..o o io
bxome wbl� 1 tM v.vrkera' can0��ion lewe a Calilanu. en re hel / hauk Ecoma wM� to Ihe worFen•
campenxtion 0�' � one ol $ on 310U at the lebor Code, 1 ahall lo wil mp�y wlh�ih ae provevu.
ode: � nod�c
W�m/ip: F�Nun ro ucvn woilnn' compmutlon cov�rap� h unYwNl. �ntl shell �ub/�ct an xrplqw to cr/MNl pmtltlu �M
e1Nl Tros up b om �untlrW fhowantl tldNn (SfOq0001, M xM/tlon M fh� cwf of romperu+fbM1 danup� u prov/GM br In
9xtlon 3106 0l Ms LMorCOM, InMut, IM Immsy'� /wx
CONSTHUCTION LEN�INO AOENCY: I MreEy e1Fim uMer peneliy d perN�Y �� ��� �a e conatrudion bMinp epmcy for iM
p.d�eMe a me wo� r« wn�w me v�++ � a•�a (seaion aw�. ci.. cl.
LENDEH'S NAME:
LENDER'S AODpESS:
1 cenM �� I hew reed this epplicetian eM maie thet tM ebore iniametion ia rortetl. I eprea lo wmply wilh dl ory enA oouMy mdinv�cae
uM ate�e kwa reWiq to WiM'vp conffiWim eM hmeEy ei�har¢e repasen�alivea d thia ary to enlx upon IM ebv.a�memioned poDerly
�IaireV��on WrWs Qi� � CK
..` .. ......Pn Nem .... _ ..
� • . . ✓ Deta: ,_�
Sig�uredQmwr/RpenVAppicenVContraqa �
(5151<B WP) Whne-Buildiq 8 Seley: Greeo-Fb: Cenery-AppiceM; Rnk-Revanue; Gddenrob-Aaeeaor
� CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: P 081755 PLAN CHECK NO: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: PLU
PERM NO: P 08175
GOVT: N SUPP: N
PURPOSE: OTH
JOB DESCRIPTION : WATER HEATER CHANGE OUT SQ FT:
CLAZM VALUE: CALC—VALUE: GROUP OCC: R-3 /
COMMENTS: NO OTHER WORK AUTHORIZED BY THIS PERMIT
+�x�x*x�+r��x��r**x**x**x��*x �rxx*x�x�*x�*+r�x�*�r�rx�x�x�� *****xx�***xx�x�**�rxx***x**x*�ux**+r�x*�rx�
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 14131203 ZNE: REF NO:
PLANNING N6TES>
%
1Elf iE 1Elf if 1F 1E 1f-fE 1E 1E iE 1E iE 1E iF iF 1E 1f k iF 1E 1E'7F 1E 1F iE 1E 1ElE iElFlF'1F 1E iE 1E 1(' iE iE 1ElE �f' 1E iE 7PlE 1F 1E 1F iE 1i 1F 1f 1f fElElE fFlE 1E 1L'!! 1E iE 1e'lf 1F'le fE iE iF iF iE 1F 1E iE iF
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 .
BUILDING ApPROVED BY :
DATE:
DATE:
APPLICATION ISSUED BY; ��� DATE: Z Z—i—
1E1F1E1E�E�E1E1E1EfE1E1E1ElE7EiF1f1k741f1f1f��jf3f�f3F�'SF�FiF���f���FiF���F�f TF��if3F�FiF�F�F�FlE1EIE1EIE'N'fEiE1EfE 1Eik
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 11.00
25� SMIP/NON—RES
PLAN
ISSUE FEE 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 11.00 22.00 0,00 33.00 33,00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 33,00 OVER/SHORT; .00
BLDG PMT PLUMBSNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
33,00
if iE iE 1E iE IE fE 1E 1E 1E iE iE 1E fE iE iE IE iE iE iE 1E iE iE 1E 1E iE iE iF iF iF it it iE iE iE iF iF iE iE iF iF iE iE iF if iE 1E if rt iE 3E iE ii iE 1E �! iE iE iE iE iE 1E 41E iE iE iE iE 1E 1E iE iE 1E iE ff iE iF k iE
I N D I V I D U A L. F E E H R E A K D O W N
PLU
QTY D E S C R I P T I O N ONIT CO T TOTAL COST
1 WATER HEATER AND /OR VENT 11 . 00��,,,.-,,� 11 , 00
END OF FEES ;., q �
���T � � ��� F��',��. �99`�.
nt�i��� � ��'� � OF��S��� � �
�
CONSTRUCTION ANO PLANNING - . POOI 'PA
APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
� 1. Temporary EleGtriwl Service or Pole 52. Pool & Equipment location � '
Z. Soii Pipe�Undrgmd. - { � � 53. Steel Reinforcement - �
�.3. Electrical Condult Uti��tY-Undrgrqd. � . 54, Forms� ` � ,
4. Electrical Conduit-Undrgrrid. � � 55. Electrical Bonding "
" 5. Steel Reinforcement � � . � 56. Rough Plum6ing & Pressure'Test -
6.'ElectricalUPEf?�Gmd. � ' 57. APPROVAITOCOVER-GUNITE
• 7. Footings '� - �� ' 58. Electrical ConduitrUndrgrnd.
. 8: �Foundation '� • � ' S9. Gas Pipe, C Undrgrnd., Test .
- 9. Water Pipe-Und�9rnd. ` �.s �� 60. Backwash Lines; P:Trap, O Undrgmd. ,
10. Structural Floor System 61. APPROVAL TQ;DECK
11. Property Sewer line & House:Connection � � 62: Backwash & Receptor;�inal
12.-Sewer Cap ' '� , � �63. Heater & Vent�Final ' �
73. Root Drains � ' 64. Piumbing System -.Final � •
74. Fiough Plumbing ��� 65. Electrical-Pinal � � '
15. Rough Electric�bConduit �- � ' 66. Solar System-Finai �
16. Rough Electric Wiring '� 67. Fencing�& Access`Approval� �
�
17. Rough Wiring SiBn , 68. APPROVED FOR PLASTER�1NG '
18. Rpugh ElectricaP�T Bar Cei�ing . 69. POOUSPA SYSTEMS FINAL � �
79. Rough Heating & AirConditioning � � FIRE DEPT. fiEQU1REMENT �
wG. i� L
20. Rough Factory Fi�eplace - ' 4 _. -� � APP�OVqLS� � Peimit # r -
21.:�Ducts, in Strucfure'. . . = - . z � 70..-Undergrou�d Hydro � �
22. DuLts,Ventilatin9, � c . � - ''' � 77. Product=PipingGGas �OiI
23. ;Gas Pi erRou h &'Test � ' � ��� � -
P g � . n � �� � 72. Underyro�nd Flush �- .-
� 24. Roof Freming • -- • T �= 73. Undergrnd. Stord�e Tanfc O Gas O Oil
25. Roof Sheathing -. � � ` r � . � � 7,4. Overhead Nydro . .
26. T-Bar Ceiling (Structural) & Monocoat ' _ 75. Dry Chemical •- '
27.. Frame and Flashing� _ �.... ; Y r 76. Dry Standpipe �_ i'-. ,' �
28.'Lathing&Sidin9` r: • t .`' • • 7.7. FIXEDSYSTEMFINAL
- � `
29. Insulation : - � ' � � �� �. 78..FIRE FREV. FINAL �
30. Drywall�Nailing - � • • �. ��-HEALTNDEPT:REQUIREMENT
� 31. Plaster B[own Goat,� . .� � 79�.� FINA�L �NSPECTION r ^ a
32. Electrical Power MetenFinal ,._ , 80: FOOD CERTiFICATE ISSUEO
33. Final Electric � ' � " � � i Notes: _ .�_� _ . - , „
34.-Fin i Heating& Air,Conditioning., - � � „� -
: • - - - � C': �O dV' � /
35. Final Gas Pipe-Test.� _ � - . . •' _ �' _ _ : T _
- - GC��
36.'Hood oc'CanoPv , . - . � - �- .
37."FinaP Factory Fir�jace _. - � " � " ' ` � � " -
' - -
38. Final Plumbing .: , - � � - _
39. Water Service-F�rtelr � � • . '� � :
>- �
40. Gas Service-Fina� � �; 4,+�; _ ♦-^� r - e -
41. Solar pomestic�Fina1 .: ' •� � � _
_ �,. . .
' 42.=6ackflow Prevenrer, � `- - ' ` .c;'- � -
u _
43. Backflow Irrigatiom _ _ r �' � - - • � �
�. - �. :
44. Landscape Irriaation System�. � -� . - . �- � � - - ''" � '
- n
s45.'Sound Attenuatiom - - � - '. - �-- �"�- • s '
� ' �n
�46.�"HandicaPRegulatio�s _ - ' ' - � '--; �_ . ;�3 '
_ 'r'
47. FINAL STRUCTUR[ & BUILDING �' � ` - ' ' '' ` ;� j
�
48.�PINALPLANNING , ^ �' , _ � v" ��;.
49.'Electric Releass to Edison y ^ - : •�/�
80. Gas Release to Southern California Gas Co � : - -� -
51. CERSIFiCATE OP OCCUPANCY . " � ; -
No. Date
Aov�icant to till in all spaces ezcept tnose witnin neavY �ortler Iines ana si9n all
, CITYOF'cOS'raMEsa CONSTRUCTIONPERMIT '
T, Project�Address ,
� Applicant's Mailin I ddress �� � ^7
Owner's Name j�� �' � Phone� / i
Address
Arch/Eng. � _ License No.
Address
Contractor's Nam G / vhone �' �7G�,/�
Address Ima i"na1 �'� � l��% P.r� �� �' 4�
City License No. �2�7'45� '
LICENSED CONTRACTOR DECLARNTION
1 hereby affirm that I am licensetl untle� provisions of Cbarter 9(commencing
witM1 sec[ion ]000) of Division 3 ot the Business antl Professions Cotle, antl
my license is in tuU7� gantl effect. �, �\_"�
Licens4 C.,Wss �� � ic se N
Date / /f`'" : S'9n t r � � ,,,�/� /
� WORKERS' COMPENSATION DECLA0.ATION '
�I hereby affirm that 1 have a certiticate of consent to selt-Insure or a certificate
ot Workers' Compensation Inmrance, or a certifietl COpy thereof (SeCtion
� 900, Lab. C. / �,[� /�, r
� �IicY No. ���� "/7"-� ComPanY C��.N --//�/
� ertitietl copy is he�eby turnishetl. g �/
E�MPTION F�ROMIWORKERS' COM��SAT ONI�CL AT_ 10`N
Date Applicant
(Thissection neetl not be completetl it the permit is for one huntlretl ($100) or
less).
I certify [hat in [he performance o( the work fo� whlch this permk is issuetl, I
shall not employ any person in any manne� so as to become subject to the
Workers' Compensa[ion Laws af Calitornia.
Date Signature
NOTICE: If, after making this tleUara[ion, you shoultl betome subject to Ihe
Workers' Compensation provi5ions of the �abor Cotle, y0u must farthwi[h
comply with such p�ovisions o� this pe�mit sM1all be tleemed_�evoketl.
CONSTRUCTION LENDING AGENCV
I hereGy affirm that there is a mnstruction lentling a9ency tor the performance
of the work for which this permi[ is issuetl (Section 309�=-'Civ. Q)
Lentle�'s Name
LentleYs Atltlress - �
OWNER BUILDER �ECLARATION
I hereby affirm thai I am exemp[ from tlte ConVactor'S License Law for the
followin9 reason (Section ]031.5 Buslness antl Professional Cotle: Any city or
county which requires a Oermit to construct, alter. improve. tlemolish or repair
any sGucture, prior to its issuance, also requires the applicant tor such permit
to file a signetl staiement that he/she is licensetl pursuant [o the provisions of
the Contractor's License Law (Chapter 9(commencing witn Sectiom]000) of
Division�3 of the Business-antl Professions Cotle) or that he/she is exempt
therefrom antl the basis for the allegetl exemption. Any violation of Section
-'131.5 by any applicant tor a permit subjects the applicant to a clvil
�alty of not more than.five huntlretl tlollars ($500).
1, as owner ot the property or my employee5 with wa9es as thei� sole
eompensation, will tlo the wo�k, antl the s[ructure is nOt inientled or ofteretl
for sale (Section 7044, Busine55 antl Pro(essional Code: The Contractor'S
License Law does not appry to an owner of a properry who builtls or improves
thereon,-antl who tloes such work himself/herself or ihrough his or her own
employees, provltletl tnat such improvements are not intentletl or offeretl Por
sale. If, however,.the builtlin9 0� improvement is soltl within one year of com-
pletioq the owner will have the burtlen of proving he/she tlid not builtl or im-
'�rove for tne purpose of sale).
LI I, as owner of the property, am exclusively contracting with Ilcensetl con-
tractors to construct the praject (Section ]044, Business antl Protessions Cotle:
The Contractor's License Law tloes mt apply to an owner oi property who
builtls or improves Ihereon, antl who contracts for such projects with a con-
bactor(s) iicense pursuant to the Contractor's �icense Law). I am aware that
proof ot their WorkeYs Compensation insurance should be provitletl to me.
❑ I am exempt untlet Section B. & P. C. for this reason
Date � Owner
I hereby certify that I bave read this application and state that the above
information is correct. I agree to compry wrth all city antl county ortlinances
antl state laws relating'to builtlmq construction antl hereby authorize repre-
sentatives of this city to enter n the above-mentioneA property for
inspection pur es ����
Signature � - Date � c' �
Drivers' Li[en5e o $ ' '
; : I , UNIT NO'
TYPE OF CONSTRUCTION LJ NEW � U ADD LJ ALTERATION L�YREP
❑ CONVERSION' ❑ ,DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPEOFPERMIT GRADING FOUNDATION ❑ STRUCTURAL �
�� TENANT ❑ ELECTRIGAL�LUMBING ❑ MECHANICAL
!�.
❑ OTHER � _
PROJECT DESCRIPTION: SQ.Fr. ocCUPaNCv_
CONSTRUCTION TYPE VALUATION $
ZONE GRADINGCU.VDS. ACRES�
Remarks�^ � _�
Preventer
Irrigation
Drinking Fountains
Floor Drains
Floor Sinks
Gas Service Outlets
Interceptors �
Kitchen Sink '
lavatories
P—Trap
Roof Drains
Reinspectian Fee I $15
Duct- Under Ground
Duct - Svuccural
Duct - Ventilating
Exhaust System ❑ �Multiple
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑0-100,000 BTU �100,000
Reinspaction Fee � $15
CMF 0865-66, rev. 10/84 Wnite - Building; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor
0
Showers
Service Sink -
Sewer Cap
SewerConnection
$012I COIICCLOlS.
Solar Piping ' -
Solar Tank
Swimming Pool w/Spa
Urinal
Water Cloret
Water Heater
Water Service
Auto-Wash
Laundry Trays
Iwue Fee
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑o-i00000eru ❑ioo,000
System Repair/Alteration
Fire Dampers
Registers ,
Issue Fee
dCtldldL10115. _
AIR�
— A.P. �k -. � - .
S Main Building: �
— E ,.
T Front-
B Rear ,
A
— C Rightj:; � ' '
_ g left '�'� . ,
Ping. Ref. # �r„.� ,•
Planning Notes: ,.
$ 3
FEES
$ 3
Automatic Washer
Construction Pole Sub.
Cooking Unit
36G3 I/21/88
Accessory Building�
Parking Req./Provided
, i5,00 TL
i �
Zon�
ELECTRICAL -
Transformer ❑ 15-50 KW
❑ 50+KW
Fan
F.A.U.
Fixtures
Device Boxes -
Outlets
Switches ' '
Garbage Dispoul
Generator �0-5 KW �5-15 KW
Meter LJup to 100 amps
Meter ❑over100amps
Sub Panel ,
Mofors �0-1 HP � 1'/: - 8
IncSolar �9-15 HP 016�
Microwave �
Pole Light � �
Range
Sign
Standin9 Sections
Trash Compactor
Fee I$15 � � luue Fee
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved By
Buildin9 Approved By �
Aooliution Issued Bv
SUMMARV OF FEES .
BUILDING PERMIT $, SMIP .
PLAN CHECK $ —T^��_ �PERMIT
PLUMBING $ J VV ISSUANCE �
PLAN CHECK 25% $ ENERGV'P.C.
ELECTRICAL � $- GRADING
PLAN CHECK 50% $. � .MICROFILM
MECHANICAL $ TOTALFEE
PLAN'CHECI( 25% $
Z
O
N
I
N
, G
R
E
Q
M
T
S
EES
1
$ 3
CONSTRUCTION AND;PLANNING . . POOL & SPA �. .
APPROVALS Perfnit# 'Date Inspector qppROVALS Permit# Date Inspector
__ n �
t:'�em orar Electrical�Ser.vice or Pole � ' � ' ��� • '
p Y .. 52. Pool & Equipment Location���?
2. Soil Pipe-Undrgrnd. . ' 53. Steel Reinforcement ,� � '
3. Electrical Conduit Utility-Undrgrnd. ' : 54. Forms � -
4. Electrical Conduit-Undrgmd. � 55. Electrical Bonding x'"
c^'.� �
5. Steel Reinforcement ' . 56. Rough Flumbing & Pressur�est
6. Electrical UFER Gmd. 57. APPROVAL TO�COVER-Gt4NITE � �
7. Footings ._� � - 5S. Electrical Conduit-Undrgrnp� '� •
8. Foundation ; � , � � - 59.-GasPipe,-O Undrgmd., Tes� � �
9. Water Pipe-Undrgrnil: i� . 60. Backwash Lines, P-Trap, O Undrgrnd:
. 10. Structural Floor System � 61. APPROVAL TO DECK '
11. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final ,
12. Sewer Cap 63. �Heater & Vent-Final. - t
13. Roof Drains ' 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 ' � � APPROVALS � Permit #• �
� -
21�. DuCts, in Structure � 70. Underground Hydro - ' . �'-�
22. Ducts, Ventilating , 71. Product Piping OGas ❑Oil � - �
23�. Gas Pipe-Rough & Test 72. Underground Flush •� �
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil �
25. Roof Sheathing � 74. Overhead Hydro • �
�'
26. T-Bar Ceiling (Struciural) & Monocwt . 75. Dry Chemical . ,
27. Frame and Flashing � " 76. Dry, Standpipe _ � . _
28. Lathing & Siding 77. FIXED SYSTEM FINAL . � . .
��.
29: Insulation . ' 78. FIRE PREV. FINAL �
30. Drywall Nailing , ' � HEALTH DEPT. REQUIREMENT . ' r
31. Plaster Brown Coat 79. FINAL INSPECTION �`��=' '
- i:
32. Electrical Power Meter-Final � 80.� FOOD CERTIFICATE ISSUED
33. Final Electric � . Notes:� � �' r(�'� ,
34. Final Heating & Air Conditioning - � - � . _, • ' r?.
35. Final Gas Pipe�Test � �
36. Hood or Canopy
37. Final Factory Fireplace �. . �
38., Final Plumbing . �.�f�' -(j� �j� � ' , ��
39. Water Service-Final .
40. Gas.Service-Final - . - , , � �, .
41. Solar pomestic-Final . � . . �
'� P
'42. Backflow Preventer � ' _'
43. Backflow Irrigation . : ' , ,
. 44. Landscape Irrigation System - . � , : . � � _
45. Sound Attenuation , � , . • � , �
� . .
46.. Handicap Regulations � , � �
47. FINA�LSTRUCTURE&.BUILDING - � � � � . � � � .
48 �Special Requirements Completed - - � - � - �-
49. Electric Release to Edison . . � . ' _ � ,.
50. Gas Release to Southern Califomia Gas Co _ , � � _' - ' '
51. CERTIFICATEOFOCCUPANCY � -
No. ' Date - ' ' .' � . � ,
12�5�.
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 817 COBTA MEBA. CAL�FORNIA
For Applieanf fo Fill In Compleiely
TYPE OR PRINT
COSTA MESA. CALIFORNIA
■ qRCHirecr
ion
3800 E. Coast Hip
Corona del Mar
TEL.
sae 70 x 94 NO. OF BLD66. O
OF LOT - xOw oN Lor
USE OF
EXISTING BLDG.
88TBACK LINe PaOM
ceNTaw oP sineai 3 REAR YARD 3S
91DE VARD I LEFT S I RIGHi S
DESCRIPTIOM OF WORK
� BUILDING _ _ _ _ NO. OF
FEE RECEIVED
�� JUN 1 i' 1960
INANCE DEPT.
APPLICA�I ��(j�f�j�Sp
Lot � 18 BUILDING
Plan_� 3B
_ For Office Use Only
PEGEIPT NO. P
HECEIV6D BY �� OAlE ftECP.�IVED I��D.�TE 18511F�
COSTA MESA. CALIFORNIA
FIRE
ZONE
APPROVED
YONING
ZONE I NO. OF I USE OF NEW
PLANS Bu1tolNc
�ec�� / TTBCt � 3�
oescrsiwrioH
A. P. NO.
YARDS EVES
APPROVED ALLC
fG¢NTER 1.IN! BT.) �J
FRONT �'J FT.
R_ SIDE J� FT.
— / .
�;_ ...�_
Conatruct Single Family Reaidence
with attached garage
1 HER6BY ACKNOWLEDGE TXAT 1 HAVE fiEAD THI9 MPLIGTION qNE I�MOUM 9HOWN UN�ER VALUATION 19 FOR TH¢
ANO 9TATE THAT TH8 11 OVE IS COPRECi AND A E8 TO COM- pUPPOBE OF EBTRBLIBHING A PERM�T FEE ONLY.
PLY WITX ALL CIT' O NANCEB ANO BTATE lJ� R80ULATIN6
euiLDlNo coNBTRurn . VALUATION
SIGNATURE OF ^. PERMIT FEE $32�00
PERMI �v
$�..3 , 960.00 pLAN CHECK $ 16. Q�
Project Maneger
AUTHORIZED AGENT GB.00
TOTAL FEE
f
O
x