HomeMy WebLinkAbout2729 DRAKE AVE - Building PermitsCITY OF COSTA MESA
��pMFSq BlIILDING DIVIS/ON � �
it ; 77 FAIR qRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (774) 754-4856 • �wiw.ci.costa-mesa.ca.us
�. � � FOR INSPECTIONS CALL: (714) 754-5626
�`°"�°`� PERMIT NUMBER: 611-00002
.
PERMIT TYPE B ROOF2 STATUS: ISSUED
APN: 14130212 � DATE ISSUED: 01/03/2011
ISSUED BY: RMD
JOB ADDRESS: 2729 DRAKE AV CM
Vicinity:
Squares: 2200
Suite/Unit:
Valuation: $7,600.00
SCOPE OF WORK: TEqR OFF EXISTING ROOF MATERIALS, INSTALL 1 LAYER OF 30# FELT ON A 4:74 PITCHED ROOF AND
REROOF WITH 30 YEAR COMP SHINGLES, APPROX 22 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED.
COMPLIANCE fORMS ATTqCHED JOB CARD AND CITY PERMIT.
OWNER: THOMAS, KqTHLEEN M
PHONE:
APPLICANT: DINES, BRIAN
PHONE: 562-682-9027
CONTRACTOR: TRC ROOFING �
Address: 3719 OLIVE AV�Unit:
City/State2ip: LONG BEACH, CA
ARCHITECT:
ENGINEER:
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $15325.
Reinspection Fee: $0.00
Bidg Std Admin Fund $1.00
Address: 2729 DRAKE AVE
City/Slate/Zip: COSTA MESA, CA
Address: " ' .
City/Slate/Zip:
PHONE:
90807
� License No.
License No.
License No. 712184
562•682-9027
CELL:
PHONE:
PHONE:
Unit:
Unit
�
TOTAL FEES $154.25
tiOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/16/2010 - PER CMMC Sec. 13-279
Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitietl all hours - Sundays and the following Federal
New Years Dav. Memorial Dav. Indeoendence Dav. Labor Dav. Thanksqivinq Dav and Christmas Dav
NOTICE: 7he work authorized by ihis permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit.
COOE r. INSPECPON TYPE UATE INTITIALS CODEk INSPECTION TYPE OpTE INTITIALS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
20o Final Re-Roof 210 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 Final Sign 222 Final Site
204 � Final Demolition 250 Final Building/Occupancy
WORKERS' COMPENSATION DECLARATION:
I hereby af(irm under penalty of perjury one of the (ollowing declarations:.
❑ I have antl will mainfain a certificate of consent to self-Insure for vmrkers'
compensation, as provided for by section 3700 of the Labor Cotle, for the
pedormance of the work for which this permit is issued. �
❑ I have antl will maintain vrorkers' compensation insurance, as required by
secl'an 3700 of the Labor Code, for the perfortnance of the work for which this
permit is issuetl. My workers' compensation Insurance carrier and policy
numberare: �� �
Carrfer.i
�(T�i55ec1ionneednot0ecompetetlAl�epeimrtisva etlalone�untlrMCWlars($100)wless)
Policy.Number: ��'QB R �
❑ I certify that in the performance of the work for which lhis pertnit is
issued, I shall not employ any person in any manner so as to become subject
to the vrorkers' compensation laws of Califomia, and agree that if I should
become subject to Ihe workers' compensation provisions of Section 3700 ot
the Labor Cod/� with c`ply with these rovisi�s- ���
qp� StgnaWre IDate„
�1
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
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 affrm that I am licensed under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Pro(essions Code, and
my license is in full force and effect. `
Lic�#. �� � �' C�lass�#a L/� �
�'4'. , �� —_� —
ontrano/sSignawre �'Da�e
CONSTRUCTION LENDING AGENCY:
❑ I hereby aRrm that there is a constructbn lentling agency for the
pedortnance of the v,ork fa v.tiich this pertnit is issued. (Sec. 3097. Civil Code).
Lender's Name:
Lender's Address:
SienaWre
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that untler penalty ot perjury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for the f011owing reason (Sec. 703L5,
Business and Professions Code: Any city or county which requires a permit to
cOnStruC�. alter, improve, demolish, or repair any strucNre, prior to its
issuance, also requires the applicant for such permit to f le a signed statement
that he or she is licensed pursuant to the provisions of the Contractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of ine
Business and Professions Code) or ihat he or she is exempt [here(rom and
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant for a pertnit subjects Ihe applicant to a civil penalry of not more than
fve hundretl dollars (5500).):
❑ I, as ovmer of lhe property, or my employees with �rages as their sole
compensation, WILL DO THE WORK, and the stmcWre is not intended or
oftered for sale (Sec. 7044, Business and Professions Code: 7he Contractors
License law tloes not apply to an owner of property who builds or improves
thereon, and who does such vrork himself or herself or thmugh his or her own
employees. provided that such improvements are not intended or offeretl for
sale. If, however, the building or improvement is soltl within one year of
completioq the owner-builtler will have the burden of proving that he or she
ditl not build or improve for purpose of sale.).
❑ I, as owner of the property, am EXCLUSIVELY CON7RACTING WITH
LICENSED CONTRACTORS to construct lhe projec[ (Sec. 7044, Business and
Pro(essbns Code: The contractors License Law dces not apply to an ovmer of
property who builds or improves thereon, and who cont2cis tor such pmject with
a cont2ctor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
Owner ID verifed by driver's license. ❑ Yes ❑ No �'���
Driver's License No. Expires:
Verification of Ownership Dy (rype of tlocumenl, i.e. - property lax bill or deed):
DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION:
❑ I hereby certify lhat no excavation (rve (5) w mwe feet in tlep[h into which a
person is required to descend, will be made in connecfron with work authonzed
by this permit, and that no building sWcture, scaHddinq, falsework, or tlemolition
or dismantling Ihereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Grp
2. M 2. Sec. 341, Title 8, Cali(omia Administrative Code).
❑ As owner-builaer, I will not employ anyone to do work which woultl
require a permit fmm the Division of Ind ' afety, as noted above, unless
such person has a permit to do such woB (rom the ivision.
ApOhwN's SignaWre Dale
Division of Industrial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will the applicaM or present or future building occupant neetl to fle and
certify a Business Plan (or emergency response lo release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of [he Califomia Health antl Safety Code requires, with some
exceptions, that a Business Plan be fled wilh lhe Costa Mesa Fire
Department by every business whic� has at any one time dunng a reported
year a quantity of hazardous matenals equal to or greater Ihan a weight of
500 pountls, or a volume of 55 gallons, or 200 cubic teet of compressed gas
at standard temperaWre and pressure).
2. Does or will �he applicant or present or fuWre building occupant need to file
a registration form for acutely hazardous materials? ❑ Yes ❑ No
(Section 25533 of the Califomia Health and Safery Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one time has on hand a quantity of awtely
hazardous materials equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feel of compressed gas at standard
temperawre and pressure).
3. Does or will Ihe applicant or present or future builtling occupanl need to
prepare an RMPP (Risk Managemenl antl PreveMion Program for acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Satety Code provides [hal the
Costa Mesa Fire Department may require lhe preparation, certifcation and
Sling with the Fire Departmen[ of an RMPP by businesses which are required
to register acutely hazardous materials with the Fire DepaAment.
4. If an RMPP is presently required, has Section 25534 0( the Califomia
Health and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or vnll the applicant or present or fuWre 6uilding occupanl require for
the work which is the subject of this application a permit for such consWction
or modifw[ion (rom the South Coast Air Qualiry Management District or irom
any other air pollution control disirict or agency? ❑ Yes ❑ No
(Section 658502 ot the Califomia Govemment Code requires Ihat the requested
infortnation be fumished on applications for rron-residential builtling pertnits).
6. Will any part of the faciliry to be conslructed untler [his permit be within
1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No
(If'yes". the faciliry mus� meet the requirement of Sections 25534 antl 42303
of the Califomia Health and Safety Code).
7. If a permit from the South Coast Air Quality Management District or other
air pollution control district or agency is requiretl for the vrork which is the
subject of this application, have all of the disclosures prescribed by California
Health and Salery Code Section 42303 been made? ❑ Yes ❑ No
8. pf "yes", attach certifcate of compliance from the appropriate air pollution
control oKcer�.
CERTIFICATE OF COMPLIANCE: I certify thal under penalty of perjury the
information given above is correct I agree to comply with all state laws and
city ordinances regartling Hazartlous Materials and Emissions.
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certify under penalry of perjury ihat I have read this application and state that
the information given is correct I agree to compty with all state laws and ciry
ortlinances relating lo building consWction, and authorize representatives of
the Ciry of Costa Mesa to eNer upon Ihe above-0escribed propeAy for
inspeciion purposes. I agree not to occupy or allow occupancy of any building
authorized by this pertnit until fnal inspection.
i le Owneqs) Date
Signatore Oate / —� — J �
305]-a6 (Y01) rq�l.Aut�oriz¢C AOPlirant ( —"Oale /
:
/
��
�
Pfl0.1ELT p00flE55: Z 7 2 9 DRt1KE AV
OWNEH'SNPME: THOMAS KATHLEEN M
aoosess: Z�Z9 D{2AKE AVE
COSTA MESA,CA 42626
ABCHIENGMEEB:
ADOflESS:
NEG.NO.:
uxrt:
PENMITTEE: S 6 S HEATING & AIR COND- (714)837-2000
aooncss: g q 3i� DARR,T�ELL
LICENSEO CONTHFCTOH �OECSLARAT�ON:MI� reby aHirm Ihal I am licensetl under oroisio9 of�h2p�er 9 �commencing wi�h Section
7000) ol �ivision 3 0l Ihe Business an0 Pmfessions Cotle, an0 my license is in �ull lorce anA elfeci.
ciTvuc.: 0177�8 sTareuc.: 39381 ��'�S' C-20 EXP: 12/99
Oam: .i—�LL� � SignaWre'. v - - -
WOHREHS' COMPENSFTION DECUBATION: I hereby affin at I �ave a ceni icate of consenl to selbinsure or a cenificate of Workeis'
ComOensalion Insurance, or a certifietl copy Ihereof (SectiOn 3000, Lab. C�.
PDLICY ND.: E%P. �ATE:
COMPRNY:
� Cenilietl coDY is hereby �umishetl. ❑ Cenilietl copY is �iled wi�h �he ciry Builtling �ivision.
Oaie'. ADDlicanC _
E%EMPTION FBOM WOBREBS' COMPENSATIDN OECIABATION: (T�is seclion neetl not be completetl ii the permit is tar one hundre0 (8100� ar less).
I cenify ihal in ine peAormance ol ine work for wnicn ihis permit is issue0. 1 shall not employ any person in any manner sa as lo become
sublec� to I�e WOBers' Compensalion Laws ol California� �
�ate'. —Lt—Si Signamre:
NO CE: If, al�er making �his tleclaration, yau shaultl become sublec� to Ihe Workers' ComOensation pmvisions of �he Labor
Cotle. you must Ionhwiln comply with such pmvision5 or inis permit shall be deemee revoketl.
CONSTBUCTION LENOING RGENCV: I hereby a�firm tha� there is a con5imction lentling agency for Ihe pedormance ol t�e work for
whiCh IhiS p¢rmil i5 i55uP0 �SCCIiOn 3�97, Civ. C).
LENOEfl:
RDOflE55:
OWNEfl BUILOEfl DECLRXPTION: I hereby affirm �hal I am exempt tmm t�e Caniracmrs' Stare License Law for Ihe followinp reason
(Sec�ion 7031.5 Business antl Professional Coae: Any ci�y o� counry which requires a Oermi� to cons�mcl, al�er, impmve, tlemolish, or
repair any simclwe. Drior to ils issuance. also requires ihe applicant br such permil ta file a signetl statement that helshe is ticensed
pursuant m ��e pmvisians oi Ihe Contracmrs' State License Law (Chap�er 9(commencing wi�� Sec�ion 7000) o� �ivision 3 0� the Business
antl Professions Code� or ihal he/she is exempl t�erelmm Bnd ihe basis for ihe allegeE eKemption. Any violation of Section 7031.5 �y
any aDPlican� for a permit sublecls ihe applican� Io a civil Penal�y of nat more t�an �ive huntlred dallars (8500�.
I. as owner ol �he pmDehY or my employees with wages as iheir sole compensa�ion, will do Ihe work, and Ihe
❑ stmcture is not inten0e0 or offered for sale (Section 7004. Business antl Pmiessional Code: The Contraciors' State License Law
tlaes na1 apply Io an owner oi a pmpeny w�o builAs or improves thereon, and who does suc� work himselAhersel� or �hmugh
his or her awn employees, pmvided Iha� suc� imp�ovemen�s are not intentled or o��ereJ �or sale. I�, however �Ae builOinA or
impmvement is sold within one year of compleiion. the owner will have ihe Ourden of pmving he/she did noi builJ or imOro�e
br Ihe purpose ai sale�.
I. as owner of Ine propehy, am eKclusively can�racting wi�h licensed conlrac�oR �o cons�Nc� �he D�ole�� (Sec�ion 7044, Business
❑ and Pmfessions Code: TAe Contracmrs' Sla�e License Law does n0i apply lo an awner o� pmDeM who Uuiltls or improves ther¢on
antl who conirac�s �or such pmleds wilh a contraG�m�s�license Dursuant to ��e Contractars' S�a�e License Law�. I am aware
Ihat pmo� o� Iheir WOBer's Compensa�ion insurance shoultl b¢ pmvi0ed la me.
� I am exempt untler Section: �. 8 P. C.
br ��is ieason'.
Da�e: Owner.
I ao hereby cendy ��at I am aware o� and untlerstantl ��e requiremems of Califomia Heal�� and Sa�ery CoGe Seciions 25505, 25533, ana
25534 antl I�at I or any lu�ure 6ullUing oGcupan� willlwill no (circle one) need ta comply wi�h SaIU stale cotles antl �he requlraments for a
permii for constmction or modilica�ion imm Ihe Air Dualiiy Management Distnc�. flesiden�ial conslNc�ion applicalions are exemp� imm
IIIESE PfON51005.
Date'. AVPlicant: _
I hereDy ceridy I�ai I �ave reatl �his apPlicalion antl state �Itai Ihe above inlormalion is correcL I agree to comply wi�h all ci�y anU counry
ortlinances and stalelawsrelating�o builtling conslmclion and herehy aulhorizerepresentatives ofihis cily�oenierupon�he aEove-mention¢d
pmperry �or inspection purposes. /��\ —�
Date: f '�- Z —�� Signa�ure:!✓ """ �'
Driver'S Gt¢nse or SOCial SeCurily x:
t6a1-a6 Wmte—Builtling, Green—Cotle Enlorcemem; Canary—Applicanl: Pink—Revenue; Gol�enmtl—Assessor
CITY OF COSTA MESA - BU?LDING PERMZT PERMI NO: M 06897"
PERMIT NO; M 068973 PLAN CHECK NO: N GOCTT; N SUPP: N
CONSTRUCTION TYPE: 5-N PERMIT TYPE; MEC PURPOSE: AL�D
SOH DESCRIPTION ; INSTALL NEW A/C ONIT S� FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /
COMMENTS; NO OTHER WORK AUTHORIZEP BY TAIS PERMIT
iE iE # iE iE it iE it iE iF iE if iE iF iF iF iE iE iE 3E iE if iE iE iE?E ir iE it 3E iE k iE 1E iE iE it it iE 3e if 1E?E iE if it it iE ib iE iE iE iE 1ElE # iE iE iF iE #` iE iE ik iE �lE ih iE iE if it 1t iF if it iE iE iF i!
Z O N I N G R E Q U 2 R E M E N T S
S E T b A C K S
------------ MAIN HUILL�ING ---------- --------- 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; 14130212 ZNE; REF NO:
FLANNING NOTES>
>
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D E V E L O P M E N T 5 E R V I C E S R E Q 0 I R E M E N T S
20NING APPRC�VEP BY DATE:
6UILDING APPROVELI HY ; L�ATE:
APPLICATION ISSUED BY; �- DATE; 22l �"1
ifiEiki('iEifiEiEiflfiflElE'1FiEiEjEiEiE1EiE#iFiF�F'��'iEiF�F.lF'r�f�'�F3F�f'�E�3f�Fll'iFiE��F��cYF�F��t��Fii�3FftiEiR{EiFiEiE1('iEiF?f i .1Ei('
iF ik i! # IF 1F iE iE iE if !E iElE iF iE if iF iE iE iE iE iE iE �ElE # 1(-fE iE f't if i! iE i4 jE iE fE iE �lk iE i6 iE # iE if If iE )E fE �lE iE iE if ii* ih �lE 1E 1P jf 1F 1ElE iE iF # it 1E iE 3E iE 1!�!E'rt if �f(� iE ik if ff
LEGALI2ATION;N E E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT : 9.00
-• -,- 25a SMIP/NON-RES
PLAN -- `
ISSUE FEE +" � .., 15 , 00
BUILDING-DIV-> PERMIT ISSUE P,liAN-CHECK TOTAL PAID DUE
TOTALS----> 9,00 15.00 -= ,0.00 24,00 24.00 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 24.0(x- OVER/SH[�RT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
� 24.00
:J,
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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 R I P T I O N UNIT COST TOTAL COST
MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9,00 9,00
Et3D OF FEES
y . . i
.JEXpIRE�, �;� �
►t�CW�Plet9 lnSP��twn� , �
,� �.1'C'� � � � . ,. � i�.��
'� t �J ' "
il? QO35E?23—OG±682Z3 TC:tT
6ATE� 09l;:2!94 7IME: 14.1E
CONS7RUCTION AND PLANNING POO� 3PA
APPROVAIS Permit # � Date ' Inspecto� pppROVALS Permit # Date Inspector
t. Temporary Electricai Service Or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgmd. -- 53. Steel Retnforcement
3. Elecirical Conduit Ut�lity-Undrgrnd. 54. Forms -
4. Electrical Conduii�Undrgmd. 55. Electricai Bonding
5. Steel Reinforcemenc 56. Rough Pium6ir.g & Pressure Tzst +
.6. Electrical UFER Gmd. 57. APPflOVAL TO COVER-GUNITE
7.. Foo[ings 58. Eiectrical Conduit-Undrgrnd. t
8. Foundation • 5S. Gas Pipe, O Undryrnd., Test - '
9. Wa[er P�pe-Undrgrnd. 60. Backwash Lines, P�Trap, �7 Undrgrnd. '
10. Svuctural Floor System _ i. � 67. APPROUAL TO DECK
17. Property Sewer Line & House Connection g2, Backwash & Recepmr�Final �
12. Sewer Cap � 1 63. Heater & Vent�Pinai
13. Roof prains i 64, Plumbing System - Final �
74. Rough Plumbin9 � 65. Electrical-Final
15. Rough Electrical-Condu�t 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval `
77. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. flough Electricai�T Bar Cei�ing 69. POOL{SPA SYSTEMS FINAL
19. Rougt+ Heating & Air Conditioning FIRE DEPT. REaUIREMENT (
20. Rough FactorV Fireplace . APPROVAIS Permit �
21. Ducts, in Structure ' 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping Ci Gas ❑ Oi1
23. Gas PiPe�Rough & Tes. 72. Underground Flush
24. Roof F*aming 73. Undergmd.Siorar,eTank L7Gas ❑011 �___ �
25. Roof Sheathing � � 74, Overhead Hydro - � __.,
26. T-Bar Ceiling (Structural) & Monocoat 75, pry Chamicai -� '
27. Prame and Flashing ' 76. Dry Standpipe � �
28. Lathing &.Siding • 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL '� �
30. Drytva�l Nail(ng � HEAITH DEPT. REQUIREMENT ,���•-'
i '
37. Plaster Brown Coa: '. � 79. FINAL INSPECTION �
32. Electrical Power MeterFinal . 80. FOOD CERTIFICATE ISSUED
33. Final Elec:ric , Notes:� ��5_ �� �r�,^�. � � W`
�� �
34. Final Heating & Air Cond�tioning �, _- ^ �-; _ �/�y -'_ _ r„f_n�, /�
C�y�.� 151.�7�1. ��c.,���»� �qv� '
35. Final Gas Pipe-Test
36. Hood or Canopy ;
37. Pinal Factory Fireplace '
.i
38. Final Piumbing - � ' - I "
39. Water Service-Final j'
40. Gas Sa�v�ce-Final
41, So1ar pomestic-Final ,'
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape Irrigation System .
45. Sound Attenuation
46. HandicaP Regulations
47. FfNAt STRUCTURE & BUILD4NG . .. �
46. FINAL PLANNING
49. Electric Release to Edison , -
50. Gas Reiease to Southem Caitfornia Gas Ca -
51. CERTiFlCATE OF OCCUPANCY
No. Date
Applicant [o fill in all spaces except those within �eavy Eartler linez antl sign all appro0riale tleelaratlons.
CiTv oP COSTA MESA CONSTRUCTION PERMIT -
ProjeCt AdzrMs � �� Ave. _
` Apnlicant's Mailing Address � 7 _ 1
Owner's Name ar ��1Qllds � Phone
Address S�f''
Arch/Eng. � License No.
Address
Contractor's Namo .�S �P�tu1� & Ei]S C.C7C1�hone 37— �
Address (mailingl 27324 C�l7s10 CzDistrano ��'157. La�ma
City License No. �27%5g NZQ�1+ �
LICENSED CONTRACTOR PECLARATION
I hereby affirm that I am-IicB�setl untler provisions of Charter 9(�ommencing
with 5etti�n �000) o� Division 3 oi ihe Business antl P�ofe55io�5 Cotle, antl
my license is in full force antl eftect.
License Clas - icense� nN/oI. 393818
Date Signature (Qy,��
WORKERS' COMPENSATION DECLAR ION
' he�eby affi�m [nat 1 have a C¢rtiticate ot consent to SeILInSure o� a certiticate
� Workers' Compensation Insurance, or a certifietl coOY thereot (Section
� )0, Lab. C. �l �,azY�R�iLlt
rolicy No. 3��3/ Com any
�Certifietl copy is hereby fUrnisheG. ,
Certifi�tl,cppy/izpletl wit�Me city B ling Divi n.
Date � I 1f75 q plicant � .
EXEMPTION FROM WORKERS' GOMPENSA lON OECLARATION
(This section neetl no[ be camP�etetl if Ihe permit is tor one huntlretl ($300) or
iess).
I tertify that in the pertormd��e o� the work fOr which this pe�m�t is i55ueQ I
shall not employ any person in any manner so as [o become subject to the -
Workers' Compensation LawS ot California. '
Date Signature
NOTICE: If, after making thi5 tleclaration, you shoultl become subject to the
Workers' Compenwtion orov�sions o( the Labor Cotle, you must (orthwith
compty with such provi5io�s o� [his pe�mit Shall b¢ tleemetl revoketl.
CONSTRUCTION LENDING AGENCV -
1 hereby affirm that there is a construction lentling aqenty for Ihe performance
ot lhe work for which Nis permit is issuetl (Section 309� Civ. C.)
Lentler's Name
Lentler'S Atltlre55
OWNER BUILDER DECLARATION , �
1 hereby affirm lhat I am exempt from the Contractor's License Law for the
followin9 reason (Section �031.5 Businass antl Professional Cotle: Any city or
county which requires a perrriit to construct, alter, improve, tlemolish or repair
a�� �r.���r��.a n �. r� �ec �ccuance. also reauires the aoolicant (or sucn permlt
a Si9netl statement [h9t'ne/stte is IicenSetl pur5uant to the
�the GonVactor's License Law l�^ap[er y(commencmg wrtn pacoun ivvo� o�
,!livision 3 0! the Business 9ntl P�o(essions Cotle) or Ihat he/sbe is exempt
--"�retrom antl the basis for the allegetl ezemption. Any violation of Section
yi
�'.&T��LS ,by any applicant for a permit subjects the applicant to a civil
'�:idlty of not more than tivB huntlr¢tl tlo11ar5 ($500). . �
�` l� I, as owner of the property or my employees wilh wages a5 thair sole
compensation, will Oo the work, antl the structure is not intentletl or.offeretl
for sale (Sectian ]046, BuSiness antl Pro(essional Cotle: The Contrac[or•5
Litense Law tloes not apply t0 an owne� of a prop¢r[y who builtl5 Or improves
thereon, antl who tloe5 SucB `Notk himsel�/herselt or through his or h¢� own
employee5, prOvitletl Mat SULh imOrovements a�e not Intentled o� otfe�eA for
Shce. If, however, the bulltlin9 or improvement is soltl wlthin one Year of com-
pletion, the owner will, have the burtlen of proving he/she tlitl not buiitl or im-
prove torthe Ourpose of sale). '
❑ I, az owner of the propertY, am exclusively contractin9 with Iicensea con-
tractorsto construct the project (Section 7044, Business antl Professions Cotle:
The ConVattor'S License Law tloe5 no[ apply to dn owner o( property who
builtls or imOroves tM1ereon. antl who cont�act5 �or such oroiect5 with a mn-
tractor(s) Lcense pursuant t0 ��e ConVaccor�s License Law). I am aware that
proo( ot their Worker's ComPensatlon insurance shoultl be provitletl to me.
❑ I am exempt untler Section B. & P. C. tor this reason
Date pwner
I hereby certily that I have reatl this application antl state that the above
information is CorrecL I agree to comply with all tlty antl county ortlinances
antl State laws reating to b iltling consVuction, antl hereby dutho�ize �epre-
Sentatives ot th' city to nte� upQn the abov¢-mentionetl prope�ty to�
inspection purpo 1'L�1�$$
5lqnature 1M oate
Drivers' Li e ze 55 `����� ��
TYPE OF CONSTRUCTION LJ NEW U A�D LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTIONOFWORK/USEOFBLDG. �5�11 �[le S22iS
TVPE OF PERMIT GRADING FOUNDATION STRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING �MECHANICAL
❑ OTHER
PROJECT DESCRIPTION S4.FT. � � oCCUPanCv
C O N ST RUCTION TV PE V ALUATION $'
ZONE GRADINGCU.VDS. ACRES
Remarks: '
Sink
<flow Preventer
<flow Irrigation
Drinking Foun[ains
Floor Drains
Floar Sinks
Gas Service ' Outlets
Intercepmrs �
Kitclien Sink
Lavatories
P—Trap
Roof Drains
Reinspection �Fee
$15
Boiler .
Duct - Under Ground
Duct - StructUral
Duct - Ventilating '
Exhaust System ❑ Multiple ❑
FirepUFact.8lt.iCBO# � �
Heating System & Ducting
�'7 P7 00,000 BTU O t 00,000 8T
Reinspection Fee � $15
0865-46, rev. 5/88 White - Builtling; Canary -�Applicant; Pink - Accounting: Goltlenratl - Assessor
snowers
Service Sink
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Piping
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto-WaSh
W undry Tra'ys
A.P. #
S Main Buildi
E
T Front
6 Rear
A
C Ri9ht
g Left
Ping. Ref. #
Planning Notes:
u
FEES P.utomatic Washer
Construction Pole Sub.
Cooking Unit
Dishwasher
Dryers ❑Gas ❑Electric
Fan
F.A.U.
Fixtures
Device Boxes
OULIeSS
Garbage Disposal
Generator �0.5 KW �5-15 KW
2one
Accessory
Parking Req./Provided
Transformer ❑ 15-50 KW
❑ SO+KW
Meter ❑up to 100 amps
Meter ❑over100amps
Sub Panel
Motors �41 HP �1 X- 8
InaSolar �9-75 HP �76-15+
Microwave
Pole Light
Sign
Standing Sections
Trash Compactor
,}. � Rainspeition Fee , $15 Issue Fee
3 �' DEVELOPMENTSERVICESREnUIREMENTS:
laue Fee $ — Zoning Approved By
FEES L ��Build'ing Approved By _ --
Hood or Typel ❑
Canopy Type I I ❑
Refrigeratlon System �
❑0-100,000 BTU ❑100,000 BTU
System Repair/Alteretion
Fire Dampers
Registers
�i
N
1
N
G
R
E
Q
M
T
5.
FEES
$ 3
i •l �'; � SUMMARY OF FEES
�Y � BUILDING PERMIT $ SMIP $,
� = PLAN CHECK $ � PERMIT
hPLUMBING $ ISSUANCE $ �
• ',PLAN CHECK 25% $ ENERGV P.C. $
r - GRADING $
-� ��ELECTRICA� $
� �PLAN CHECK 50% $ RA�CROFILM $
� MECHANICAL $ ��e . . �TOTAL FEE $ Z�F.00
� ,�"FLAN CHECK 25% $ �
G1 �a0Q21�?�-0�:1:?=78 T,�'S ?4.G�
G+ST:: i2/��vr"n8 TI�E: ?Se34
5 .
�\ � �
\ � t `
CONSTRUCTION AND PLANNING J� • POOI PA-- � _ ,
Date - +Inspector � Date Inspector
'� AP�ROVALS Permit# - APPROVALS Permit# -.
� 1.�Temporary Electrical Service or Pole � 52. Pool & Equipment Location � �
2.� Soil Pipe� Undrgrnd. '' 53. Steel Reinforcement � " _.-, �
3. Electrical Conduit Utility-Undrgirid. ' . 54. Forms � � . . . . �
4. �Electrical ConduiT-Undrgrnd.. _. _ � 55. Electrical Bonding � - �
�
5. Steel ReinforcemenT ' � � -56. Rough Plumbing & Pressure Test �' � � .
6I:ElectricalUFERGrnd. ,.i ' - 57. APPROVALTOCOVER-GUNITE ' i ;
• �7..Footings � � 58. ElectricalConduit-Undrgmd. , -
8. Foundation :� l' _. � - , 59. Gas Pipe; �'Undrgrnd., Test ,
9. Water Pipe-Ondrgrnd. � � '� ' _, j : ' � 60. -Backwash Lines, P-Trap, � Undigrnd. � � .
�
10. Structural Floor.System � • I -�•� � 61. APPROVAL TO DECK .' ' ,
11. Property Sewer Line & House Connection � � 62. Backwasti & Receptor-Final
12. Sewer Cap !-•'•• �� � 63..Heater & Vent-Final •
;
13. Roof'Drains -� ` , " 64. Plumbing System - Final - � �- � �
14. Rough Plumbing� - 65. Electrical-Final � '
15. Rough Electrical=Conduit ._ 66. Solar System-Final
i 6. Rough Electric Wiring � 67. Fencing & Access ApproJal .
.�
9�7-Jiough 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 O Gas ❑ Oil
23. Gas Pipe-Rough & Test � " - 72. Underground�Flush � ' �', '
24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI �
25. Roof Sheathing 74. Overhead Hydro �
26. T-Bar.Ceiling (Structural) & Monocoat 75. Dry Chemical �
27. Frame�and Flashing 76. Dry Standpipe , �
28. Lathing & Siding 77. FIXED SYSTEM FINAL i
29. Insulation � �78. FIRE PREV. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT �
31. Plaster,Brown Coat 79: FINYaL INSPECTION
„
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED `
33. Final Electric Notes:(2•i3��j� �p (�.n��_(��(�p: L,�;Q
34. Final Heating & Air Conditioning /L^2li'��' L�-�42d • L��%
35. Final Gas Pipe-Test �-/'���T �p�` � �ytir e�-
36. Hood or Canopy � Q `o j,e
37. Final Factory Fireplace . .
38. Final Plumbing , �
' 39: Water Se�vice-Final � - ' .
40. Gas Service-Final �'`
i�
41. Solar pomestic-Final t � _
42. Backflow PrevenTer ::y v�'
43. Backflow Irrigation ' � ��
l
..J ' . . - ��..
44�.Landscape Irrigation SYstem^ • ,.: � -�:'
45. Sound Attenuation �' �:�
�
46. Handicap Regulations -,� ,
47. FINAL STRUCTURE & BU�I'LDING �
4S. Special Requirements Completed -
49: Electric Release to Edison . � p y�
' 50. Gas Release to Southem California Gas Co � � /� "� ' �
r
51. CERTIFICATE OF OCCUPANCY . � i� `��' ' �
No. Date � �/�
�I
�I
�
?7JELi3'lOflE55: 27ztj DRAKE AC'
OWNEN'S NAME: TI'IOMAS KATHLEEN M
. p00NES5: 2729 DitAKE AVE
COSTA MESA,CA 92626
RflLM/ENCINEEP:
aoosess:
NEG.NO.:
uxiT:
uxiT:
PEFMITTEE: S & S HEATING 6 AIR COND ( 714 ) 837-2000
nooness: g q 3 DARRELL
COSTA MESA CA 92627
LICENSEU CONTNACTOB OECtAflFTION: I �ereby alfirm tha� I am Iicense0 under pmvisions o� C�apter 9(commencinp wilh Sec�ion
7000) a� Oivision 3 of �he Business antl Pm�essions Cotle, antl my license is in fu0 �orze and eflect.
arruc.: 027758 sraTeuc.:393818 cuss: z0 EXP; 12/94
Da�e T ' L L `�1 � Si9naNre: _ —��.... �". _.�
WOFREB$' COMPENSATION OECLAflATION: I hereby affirm I�a� I have a cetlitica�e oi consent �o sel4insure or a certilica�e of Workers'
Compensation Insurante. or a cenilietl copy thereoi (Section 3800, Lab. C).
POLICY NO.: E%P. OATE:
COMPANV:
❑ Cenifietl copy is here6y tumishe0. ❑ Cenified copy is tiletl with the ciry Building Division.
�ate: ADPlicanC
E%EMPTIONfPOMWOPREBS'COMPENSATIONOECIAflATIUN: QhisseclianneednotbewmpleteOil�hepermi�isforone�untlretl�3100)orless).
I wriity �hai in �he pedormance al ��e work lor which �his permi� is i55ued. I shall no� employ any Oerson in any manner so as to become
Sublet� ID Ihe WOrkers' Compen5aiion LawS of Calilomia. `
�a�e- ` 'w `1 Signaiure: 1 r'
NOTI : II, all¢r making Ihis tleclaraii0n, y0u Shou10 6ew e 5� Workers' CO�mpensaiion D�ovisions o� Ihe labor
Cotle. you musl lorihwil� compty wiih such D�ovisions or �his permit shail be Aeemed �evoke0.
CONSTNUCTION LENOING AGENCY: I hereby a��irm that �here is a conSVuctmn lending agency lor IAe De�o�mance o� �he work �or
which Ihis permi� is issuetl (Section 3097. Civ. C�.
LENOEfl:
AUOPESS:
OwNEX BUILOEB oEClABA7lON: I hereby affirm ihat I am exempt irom ine ConVactoK State license Law tor ihe following reason
(Sec�ion 7031.5 Business and Pmfessional Cotle: Fny ci�y ol cowry which requires a permit Io conslmc�, al�e�, improve, demolis�, or
repair any stmclure. prior lo its issuance. also repuires ihe aDD�ican� tor such permi� �o file a signetl sta�emenl Ihat he/she is licensed
pursuam ta ��e pmvisions oi Ihe Con�ractors' Sla�e License Law (Chapter 9(commencing wiih Section 7000) ot �ivision 3 of �Ae Business
an� Professons Cotle) or ihat helshe is exempt Iherefmm and �he 6asis tor Ihe alleBed exemp�ion. Fny violaiion o� Section 7031.5 hy
any applican�for a permi� sublec�s Ihe apPlicant �o a civil penatly of not mo�e �han live hundretl dollars ($500�.
I. as owner of ihe pmpeny or my emyloyees with waBes as iheir sole compensation, will do ihe work, and ihe
❑ stmcNre is no� intendetl or oflered �or sale (Sec�ion 7044, Business and Professional Cotle: TAe Contractors' Stale License Law
tloes nol apply lo an owner ol a pmperiy who �uilds or impmves Ihereon, and w�o Ooes suc� work himseli/�ersel� or IAmugh
his ar her awn employees. provitletl �hai 5uch impmvemenis are no� in�ende0 or ollered for Sale. I�, however Ihe building or
impmvemeni is soltl wi�hin ane year o� compleiion, Ihe owner will have Ue bu�0en oi proving he/she Citl not huilA or impmve
tor Ihe purpase o� sale�.
L as owner oi t�e proDerty. am eKclusivelp contracting wit� licensetl contractors Io constmci Ihe Dmlec� (Sec�ion 7044. 9usiness
❑ and Pmleuions Cotle� The Coniractors' State License Law tloes not appry to an owner oi pmper1y w�o DutlAs or improves t�ereon
and who coniracis lor such pmlecis wiih a coniractor(5� license Dursuantlo the ConVac�ors' Siate License Law�.l am aware
��at pmo� oi Iheir Worker'S Compensalion insurance 5houlA he pmvi0e0 �o me.
� I am exem0� un0ei Seclion: B. 8 P. C.
br �his reason:
�ate: Owner.
I tla hereby certify ��at I am aware o� ana unders1an01he requiremems ot Califomia Health antl Sa�ery Cotle Seciions 25505, 25533, antl
25534 antl ��ai I or any IUWre Ouiltlmg occupan� willlwill nol (circle one) need to compty wi�h saitl sta�e coGes and Ihe requirement5 for a
permil br conslmqion or mo0ilicaiion imm I�e Air �uah�y Management DistricL Resiaential cons�mction apDlications are exemp� �mm
mese pmvisions.
�ate'. Applicant: '
I hereby certity�hai I have reatl t�is applicalian and s�ate thai the abovein�ormation is correcL I agree lo comply with all ciry and county
ortlinances ana staielawsrelalingto building cons�mc�ion anU hereby authorizereDresen�atives oflhis ciryto enleruDonthe a6ove�mentionetl
pmperiy lor inspettion purpa5e5.
Oate: _ q� 2 Z—h "� Signa�ure'. � ��
Oriver's License or Social Securiiy x� �
1ficLa6 Wpue—Builtling; Green—Co�e Enlorcemem; Canary—Applicant; Pink—Rev¢nue; Goltlenrotl—Assessor
CITY OF CO5TA ME5A — BUILDIPdG PERMIT PERM NO; E 069979
PERMIT NO; E 068974 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: ADD
JOB DESCRIPTZON ; INSTALL NEW A/C UNIT
SQ FT;
CLAIM VALUE; CALC—VALUE: GROUP OCC; R-3 /
COMMENTS: ELECTRICAL WORK INCIDENTAL TO MECH WORK, RE:#M68973
**�r�r�r�rx�x��r�r�rx�*�r*ir*�t**+�*�r*�r*x�+r+t�t*i���r****+��*�rx��**�r*�r��r+�*�--u�x�,r*�r�ex-x�i��t*�r*�r**��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 BUILDING ---------- --------- ACCESS`ORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT; FT IN AEAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN
PARKING RE • PROV: PARCEL; 14130212 ZNE: REF NO;
PLANNING N�TES>
>
iE ir iE iE %� IE iE iE iF iE iE iE �ElE if iE if iE �E if if fE jf iE iE iE il� i! iE iE iE jE �! ib iE if iE iF iE if if iE iE iE iE iF �E k iE iF iE iE 1E iE iE # iE iE jf if !P iE iE ik k jt �K iE �E if iE �f jE iF iE iF iE iE 1E
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:
BUZLDING APPROC�ED BY ; DATE:
APPLICATZON ISSUED BY: �'i'� DATE• �I rLt-�rl�
iEiEiEjElEfEifiFlklE!likiEltiEiElE�F�f*lflf i! aEfEiE�EiEiFiliFi(-iE��.:yt�{�*,:
3F iE jE iF iE it ik ik iE iE if iE 3E iE �E iE iE if if iF iE it iE iE iE i! if iE iE iE iE if iE ie iE iE iF iF iE if iE if iE �f iE K iE iE iE iE i' if iE 3E iE iE iE iE iE jE iE iE iE jf it iE iE 1E iE �f #' iF �)f iE 3f iE �E iE iF
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLDMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 7,50
SO& SMIP/NON—RRR
PLAN
ISSUE FEE 15.00
BUILDING—DZV—> PERMIT ISSUE PLAN—CHECIC
TOTALS----> 7,50 15.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
22.50
TOTAL PAID DUE
22,50 / "12.50 ,00
zz,so IOVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
iE if 1E iE iE if !E if it if if 1F iF iE iE 7E fE!! i! it ie iE k if it iF 3F i! iE 1E 1E 1f �E iE iE iF if iF iE f! �f 1E fE iE if iE k if iE jt iE if if iE iE iE it if iF iE it iE iE iF it k iE it±f # �f iE 1f if if iE iE %� iE
I N D I V I P U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL CpST
ELE 1 MOTOR/POWR APFAkATUS 1.1 — 10,0 HP 7,50 7,50
END OF EEES
EXPIRED �
DATE� f�,.�
�
�i u0i6822c�—OGSfi3235 TCe ;` �L,�p
t DAi�: Oi/22.'74 iT!``c� 1[i:d9
, CONSTRUCTION AND PLANNING POOL & SPA �
i• APPROVALS Permit# ' �ate Inspector APpqpVALS Permit?k Date Inspector
�
L Temvorary Etectricai Service,or Pote 52. Poot & Equipmenc Location ,
2. Soil Pipe�Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical Conduit-Undrgrnd. 55. Electrical 8onding
5. Sceel Reinforcement 56. Rough Plum6ing & Pressure Test ,
6. Eiectrical UFEfl Grnd. 57. APPROVAL TO COVER�GUNITE
7. Foocings 58. Eiectrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe. O Undrgrnd., Test
9. Water Pipe•Undrgrnd. . . 60. Backwash Lines�. P�Trap, � Undrgrnd. '
10. Strucfural Ploor SYsiem � 61. APPROVAL TO DECK -
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
72. Sewer Cap �� 63. Heater & VenFPinal
73. Roof Drains � 64. Plumbiny System - Final �
74. Rough Piumbing 65. Electrical�Finai
15. Rough Electrical-Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Siyn 68. APPROVED FOR PLASTERING
78. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEf:;S FINAL �
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Firepiace � APPROVALS Permit #
21. Outts, �n Structure . 70. Under9round Hydro
22. Ducts, Ventilating 77. Product Piping G Gas � Oil
23. Gas Pioe�Rough & Ter. 72. Underground Flush
24. Roof Framing 73. Undergrnd.Stora9eTank OGas ❑Oil �.� �
25. Roof Sheathing , : 74. Overhead Hydro 4 " (
I
26. T-8ar Ceiling (Structural; &(tlonocoat 75. Dry Chemical �`� +-=��
�raK�
2Z Frama and flashing ' .. 76. Dry Standpipe ' �` �
w .. .s.
28. Lathin & Sidin � � _3
9 9 � 77. FIXED SYSTEM FINAL e. ..i
29. Insulation � . � 78. FIRE PREV. PINAL �,i�
30. Drywa�l Nailirg HEALTH OEPT. REQUIREMENT �
31. Plasier Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric . ' Notes: �
34. Final Heating & Air Conditioning .
35. Final Gas Pipe-Test � `
36. Hood or Canopy ,
37. Final Factory Fireplace �
38. FinabPlumbing , �
39. Water Service�Finai ' � �
40. Gas Service-Final � .
41. Solar pomestic•Final ' .
42. Backflow Preventer �
43. 8ackflow Irrigation
44. Landscaoe Irrigation System .
45. Sound Attenuation
46. Handicap Regulations
47. FtiVAL STRUCTUflE & SUILDIlJG
48. PINAL PIANNING - .
49. Electric Release to Edison
50. Gas Release to Southem California Gas Co ,_
51. CER7IFICATE OF OCCUPANCY - �
No. Date
�
�
AD,WlE550FBUILdtq: z%ZJ DRAKE AV
ox'"Easr�wEiFa,w�r+: THOMAS, KATHLEEN M
� wo�u 2729 DRAKE A��E
COSTA MESA,CA 92626
,wv�. x�iuxc woxess:
ARCXRECT Ofl FNtlNEEq:
urcx. on ¢++a.•s �oonea:
ux,: CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: P 074309 PLAN CHECK NO: N
CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU
uc.rw.: I JOB dESCRIPTION : R E R WATER HEATER
uNr:
CLAIM VALUE: CALC-6'ALUE:
cam+�cta+'Sx�: THE EARLS PLUMBING ( 719 ) 524-4300
CQRRALTOW8YYf1N0 501 N. PLACENTIA
�oonesa: FULLERTON CA uaao.: 217657
92631 uNr:
UCENSED CONfFACTOfl3 DECLAflATION: I henby ellFm uMer peneAy of prjury tlW I em liceneed urWv poWtlom ot Cheqar B
(cwnmandiq Milh Saction ]000) d Division 3 d IM Butlnw W Profpslom Cada, uM my Ikenw le In lull brcs uk sMaa.
cmuc.No.:0l059�3p8r uc.cuss: C-36 ���No 2176 7 EXP: 06/96
Oms�. ��/. � ' /l Cmireaa. '
OWNER BUILOEP UECLANATION: I henEy e/firm uMer paneAy d perNrY � em ammq Imm tM COMradon Lkeme l�w la tln
Idbwirp raewn (Setlion 1031.5 Bus'vwe� eM Pmtaeaione Code: �ny cYy a coun�y xfiidi �eyuim e permN to mmVun, eller, improva,
vnd'nh, w repalr eny sirucWre, qia io na oeuenn, eho reQuirea ihe epplirant br euch permn to fib e eipned etebment Ihet M a sM
licensad W��t lo iM Orovivone d iM ConVaqon License law IChepx 9(cwnmenaiq xilh Sedian ]000) d Divbion 3 M iM
.�nese uM Prdembns Cadaj or �hel M or ahe ie a�amq ihxehom aM Ihe beeie lor ihe elbpad exampibn. My violelon d Sedion
%03�.$ b`/ 011Y AG��IfBfl� �O! 0�10IT11911q0d81�1B 9��IC811� �O B CIVI� %�0M O� 1101 IIIqG I�1M �NB �111114lBQ ���Blt �t.�iY���.
❑ I. ea ovrtnr ol �he PropenY a mY empbyeee wYh wapm u thev ede eompenaeiion. xill do ihe work. eed Iha sVuelure e iwt inleMed
IX O�BfBj iM 9B�B ($BC�1OII 1014, BUSIM39 BIIQ PIO�B95MI19 ri01�0: T�1B �iO111f0d018 �1MI19B �AW f�DB9 MI0�1�'�0011 ONTM O� plO�1BI!/
w�o builds or vnDroves �hareon, end w1w doea auch wwk Mmaell or hanaX or through he a her ovm employeee, prwkeA Ihel auch
improvemeMs are not inleMed w Werad la eab. H. howawr. iM buitli'q a'vnpwemeni is sold within oroY� a�mOblion. tM
owererbuilder will heva ihe buNen d 0�'i'p �a or sAe did nrn build ar improve br t�e W�a IN aele).
� I. aa owner ol iM D�DeM. � exduarvay mnlreain9 �Ih licanaed conirecwra to wnnrud ihe P�I� l�� ]Ou. Businms eM
apre�.�e�a com: rna com,m� �a,s� ie. d� �w eoMi �� a� ow�r a v�w�y wno w�aa «�mww� �ne.ao� ene ..m
wntrects for wd� Drqeds with e mnlredoKe) IicansaE W9uanl lo Ihe Contredors Liceme Lew).
❑ i�..amm ��aa, sen�o��. e. a a c. ia m�s ,�oo:
Dale: Owner:
i do naeer �anM �nm i� e.�.e d�d ��sie�e me rea���a��s d ce��wnie Haenn ene smay cado smm�s sssos, zss�a, ene
zssaa. �a m� i«d,y mm.� emim�o oo�o�� �ii i wai �a �a«� o�l ��e m ��dr w�n,�a ,w. ooe� �e ma reaw�«,u'«
epertnnlorwnsirunnnamodifrationhwniM�i ue�.iy arupement0istriq.Resken�ieloonsvunioneppiratvuereeaemqfmmthesa
a�Ao�s.
Daie: Rpplcenl:
WOFKEF'S COMPEHSATION OECLAF�TION: I MreEy affifm urdx perelly d peijury ona d tM Idlowi�q dedeiatiom:
❑ I heve aM v.il meinian e ceMicele d mueni ta eeMinwre I« wwken' companemion, u pwkad Iw by Sedion 3>00 d the Lebor
coaa, m, ma ronam��a o� ma .w� m,.m�n in�s ae�a �a ���a.
❑ i ne� �a �;o me�m� wonare mmoa�*a�o�, ms��a�ce, a, �aa��rea M seu�� a�ao d me ianm coae. �« ine ron«mence a ine
work la v.Aich Ihis qimil e isaueE. MY �kers mmpenulion inwreMa farriar eM pdiq numbar ma:
c�m: CALI COMP EXPIRES
Pa�Kv ��mc��: t 0 3/ 01 / 9 6
� Ihis section need nm 6e com0lered J t�e pemid'u /a one hvndred ddlers (SIDp/ w bsa.)
❑ I cenM ��a� in Ina parlormence o/ iM work br whkh ihia pertnn ia iasued, I aMll M empby any permn in eny menner eo ea io
e«oma s�Nw �o �na .on�,: ca�ro���on �.w a c��t��a. ena aoree inm a i ano�w mca� �nim �o ine �n,en
compa/ns�afwn Opvisiona I Seqpn 0]00 0l IM1e Lebor GaEe. I shall /on c' mmPN. � h t Pmvin/ions�.
Dele: `% ��Z ' �� ADDlcenl: � �y! i'I�/�'
Weming: fellun ro axuro woAeri rompxuaHon covsraps la unkw/ul, ntl sMll �ubj�cf an smployer fo cNmlrie/ pene/Hu en0
elvll flme up ro one M1undrM pwuaaM dolbn (5100,OW), ln etltllHon ro Ms ewl ol eompxu�tbrt tlamrps u povMW br In
Sxtlon 3lW oI fh� L�or Cotls, /ntuuf, an0 ertomsy i bu.
CONSTqUC110N LENDING FGENCY: I hereW elfirm uMer penaXy oi perNrY �� �� n e mnativaion bMi�p eparcy Iw �M
peAamar�oe a �ha waM i« whiN �hv paimY is esueE (Seapn 309]. Crv. Cl.
lENOEP'S NAME:
LEN�EP'S ��ORESS:
I ceniry Ihet I heve reed iM1is epplicmion eM seie thel �he abova inlame�ian ia correa, l epree to comply wnh ell ciry eM couMy orEine�vxa
aM sieta lexs eeblv�g Io Wikvp eonmunion eM Mreby eWwr¢a reprasenialives d this aly lo enlar upon the ebore�mentoned properry
����H'����°��°��� OMAR AL FAROUK
�� aema
��r.-C oa�a: 9•,Z1's�
s� ure a o�,nnaa�vapv��om,an«
(5151de WP) Whne-Buikmp 8 Selery; Greer�-Fle; Cariary-Appirani; Pink-Rerenue: GdCenroE-Aaxuw
PERM NO: P 074309
GUVT: N SUPP: N
PCTRPOSE; OTH
SQ FT:
GROUP OCC: R-3 /
COMMENTS: X
***xx***r�*+�a��*«�**�*�*****�*��********�**�t��x�*�*�****�**��*+�***�*******x***�*�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
- — — ------- MAIN BUILDING ---------- --------- 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: 14130212 ZNE: REF NO:
PLANNING NOTES>
�
�'� * * �-*'x"�'�'�'�'� * * iE ie *+�'�'� �-±� *'�'iE *'� *'iE+t-* * �t'� �t'it * * �c-* ie * * * * * * * x"� * � * * �' x' � *'�'x� *'x' * *+�'�'� ie i� * *'iE iE �- �-* * * *
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
BUILDING APPROVED 8Y
APPLICATION ISSUED BY:��j'J� � (�
*****�**��**�*�*****�� �i�iF�7� iF�F�#,�' ��FiFiFiFiFiF�FiF�F
LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMBING ELECTRIC MECHANIC
PERMIT 7.00
25�
PLAN
ISSUE FEE 20.00
BUILDING-DIV-> PEAMIT ISSUE PLAN-CHECK
TOTALS----> 7.00 20.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHING ELECTRIC MECHANIC
2%.�Q
DATE:
DATE:
DATE
STRUCTURAL SEGMENT:N
FIRE SMIP/RES GRADING
SMIP/NON-RES
TOTAL PAID DUE
27.00 27_00 _00
27.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN-CHECK
iE dE iE iE iE 9F iE aF jk iE 1E 1f if 1E iE it if 3E iE iE jE iE if iE iE 1E iF ik iE if if 1E iE iE iE 3f iE iE dE 3E iE 9E iElE 3E iE 3E dE iE iF iE if iE 9E 1E iE iE iF jE 3E iE �E iE iE 9f 1E iE iE 9E IE iE iE 1E iE iE �E iE if ic
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 R I P T I O N UNIT COST TOTAL COST
PLU 1 WATER HEATER AND/OR VENT 7,00 7.00
END OF FEES
EXPI ED � � �
DATESc'�--
� A�t 0�7.4n7:4-Q0190724 3't_ti- 2?.4J
DATE: G9/22/9r 7ifi�c 11:OG
1; ''', �
' CONSTRUCTION AND PLANNING " ��� 'Pp'
`� APPqpVALS Permit # Date Inspector AppROVAIS Permit # � Date Inspector
1. TemOorary Electrical Service or Pole 52. Pool & Equ�pment Location - %
'2. Soil Pipe•Undrgrnd. - 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgmd. 54. Forms - ��
4. Electrical ConduibUndrqrnd. ' 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test .
. 6. Electrical UFER Gmd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undigrnd.
8. Foundation • . 59. Gas Pipe, O Undrgrnd., Test
9. Watef Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, C� Uridrgmd.
10. Structural Floor Svstem - - 61. APPROVAL TO DECK , '
11. Property Sewer �ine & House Connection 62. Backwash & Receptor-Finai �
12. Sewer Cap � - 63. Heater & Vent-Final
13. Roof Drains • 64. Plumbing System � Final '
14. Rough Plumbing 65. Electrical-Final
� 15. Rough Electrical�Conduit , 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign - 66.'APPROVED FOR PIASTERING
78. Rough Electrica6T Bar Ceiling � 69. POOL;SPA SYSTEMS FINAL �
19. Rough Heating-& Air Conditionin9 FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' - APPROVALS Permit #
21. DuctS, �n $tructure • 70. Undeiground Hydro
22. Dutts, Ventilating 71. Product Pipin9 O Gas ❑ Oil
23. Gas F�Pe-Rough & Test � 72. Underground Flush
24. Roof Framing �� � 73. Undergmd.SrorageTank OGas ❑Oil �.
25. Roof Sheathtng � 74. Overhead HYdro :��({ �`
�
26. T-6ar Ceiling (Structurall & Monocoat 75. Dry Chemical `^+� '�
. S-' i
27. FrameandFlashing � 76.•DryStandpipe - - �"`"� . � .
- .�
28. Lathing & Siding - 77. FIXED SYSTEM FINAL � a�� �
29. Insulation . V 78. fIRE PREV. FINAL �'�.
30. Drywall Nailing ,� ' HEALTH DEPT. REQUIREMENT '
31. Plaster Brown Coat � 79. FINAL ItVSPECT10N
32. Elecirical Power MeterFinal .' 80.` FO00 CERTIFICATE ISSUED
33. Finai Electric Notes: •
34. Final Heating & Air Conditioning .�'� � � ' .
35. Pinal Gas Pipe�Test . � j." � -
t
36. Hood or Canopy � ' ' ' �
37. Final�Factory Fireplace
38. Final Plumbing ,
39. tiVater Service�Finai �
40. Gas Service-Final • -
41. Solar OomesticFinal , - , �
42. Backtlow Preventer � �' - � -�
43. Backflow Irrigation �
44. �andscape lrripation System ' " ' .
45. Sound Attenuation .
46. Hand�cap Regulations • -
47. fiNAL STRUCTURE & BU�LDING ��-, "
48. fINAI PLANNING � �
49. Elect�ic Release to Edison � � 4 .
50. Gas Felease to Southern California Gas Co � '
51. CER7IFICATE OF OCCUPANCY
No Date
' 12230
COSTA MESA BUILDING-SAFETY DEPARTMENT
' �P. O. BOX 917 CO9TA MEBA. CALIFORNIA
For Applieanf fo Fill In Complefely
- TYPE OR PRINT
BUILDING _ • i�!� '
COSTA MESA. CALIFORNIA
FEE RECEfVED
`;Q�,� JUN 1 � 1960
FINANCE DEPT.
CITY OF COSTA MESA
APPLICATION FOR PERMIT
� 44 BUILDING
� 4D
For Office Use Only
$S Suite -1, 3800 -E• Ci�$$t [iYgLLS1�8Y RECEIVED BY I UA'!e RECEIVEDO I DA� �et
b J�
Corona del 1`1ar No`Or 34229 qDDRE55 2729 Columbo Avenue
,ECf^^ p�_���a T e ��eQ 7E�. � Z�nl COSTA MESA. CALIFORNIA
3432 Via Oporto, New
,,, Macco Corporation
■ STATE _ _ _ _ _ TEL.
NO. OF
■ 86TBACK LINH FROM
DESCRIPTIOId OF WORK
NO. OF " '
R�OMS 7 ST[]RIES 1
EXTERIOR WALLSC11CC0 ROOF
COVERING�${`j{�o COVERING idOOd Shinale
USE OF BUILDING AN W�RK TO BE PERFORMED
Conatruct.Si le Family Residence
with attached garage
1 XEREBY AGKNOWL2DGH TX 1 NAVE qEAO THIB AP IWTION
AND 9'lATE TXAT TH6 A90V6 IB CORHECT AND AGH TO COM-
PLV WITM ALL CIiY ORDI� EB D eTATB LAWB GULATINO
eU1LDIN0 CON9TRUGTION•
61GNATURE OF //A i
Project Manager
AUTHORIZED AGENT
' ZONING
>NE NO, OF U3E OF NEW
� �/ I PLANS I au�Lo1NG
'�"��� Lot 44 Tract �k 3749
LINE BTJ
�
�
TXE AMOUNT 6HOWN UNDER VALUNTION 16 FOP TME
PUPPOBE OF EBTABLI9HING A PERMIT FEE- ONLY.
VALUATION
PERMIT FEE $ 34.0�
$ 14,563.00 pLAN CHECK $ 17•00
___.. ___ a 51.0�