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HomeMy WebLinkAbout1863 ELBA CIR - Building Permits S CITY OF COSTA MESA BUILDING DIVISION F; All 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. Nigh FOR INSPECTIONS CALL: (714)754-5626 } PERMIT NUMBER. M07-00531 PERMIT TYPE MECH .T•TUS: ISSUED DA.F{ Q; ED: 11109/2007 I :X1 SOK • #'• ;.. JOB ADDRESS: 1863 ELBA CI CM Suite/Un'? vicinity: SO. FT: 0 SCOPE OF WORK: REPLACE FURNACE. • OWNER: GANOUNG,JOHN K TR Address: 1863 ELBA CIR Unit: PHONE: - City/State/Zip: COSTA MESA,CA APPLICANT: LAURA YENULONIS Address: 422 JENKS CI Unit: PHONE: 714-998-4300 City/State/zZip: CORONA,CA CONTRACTOR: ALLIED PLUMBING-HEATING-AIR CONDITIONING License No. 610780 Address: 422 JENKS ClUnit: PHONE: 714-998-4300 City/State: CORONA,CA ZipCode: 92880 • - CELL: • • MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.30 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: - $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: 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 final approval will result in the expiration of this permit. CODE I, INSPECTION TYPE DATE INTmALS CODES INSPECTION TYPE DATE N ALS 1- 1616 1616 Fixed System Final Fire Prevention 206 Final Mechanical v1 p-t,on 15 01 .4 1266 Pool Spa Final 208 Final Plumbing I' _ 200 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 l -' WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's In,- -a. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I.have and will maintain workers'compensation insurance,as required by ection 3700 of the Labor Code.for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy ❑ I hereby certify that no excavation five(5)or more feet in depth into which a umber-are; person is required to descend,will be made in connection with work authorized arrier-ter V \ ` C by this permit,and that no building structure,scafidding,falsework,or demolition -Re1d1f �� or dismantling thereof,will be more than thirty-sic(36)feet high.(Chap.3.2.Grp (This section need not be templet the pend k valued at one ketone°swears(SI00)or less) �„ 2,Ari 2,Sec.341,Title 8,California Administrative Code). ,,Pp icy N"f u�mbar: COQ - ' 03\ ]ve,c0�,0�1 .- 0 As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued,I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers'compensation provisions of Section 3700 of Applicant's Signature Date 1 Labor Code,I shall to with comply with these provisions. �(# . -1 1\_(�]\ c � Division of Industrial Safety Permit Number: ' • > „Ap$ant's Signature moi^'t)fie-- L�---1/{ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: ILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license isJp.full force and effect. a registration form for acutely hazardous materials? 0 Yes 0 No �" F. ICi _#—��Z d \C,ass#+�."'—� (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by ^e^� Ith _ \\- 0-1 . ._ each business which at any one time has on hand a quantity of acutely �-___ •ContregtCa -.a.: Date 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 CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affum that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,CMI Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes 0 No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes 0 No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65650.2 of the California Government Code that he or she is licensed pursuant to the provisions of the Contractors ( requiresbuildingnt the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential permits). Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If'yes",the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If'yes attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and IDI, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code: The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractors)license pursuant to the Contractors License Laws.). certify under penally of perjury that I have read this application and state that ❑ I am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature ort�,aga\i Owner(s) Date Signature • Date UDM�_r_-V ��Q=01 30946(3/O]) t/ p ` `J _. Ano/or AUNodzed A IKON �y�' Data • S . • • 11-14-2007 Inspection Request Reporting Page 101 4'05 pm Costa Mes CA - Ci&0f Requested Inspect Date: Thursday November 15, 2007 Site Address: 1863 ELBA CI CM AIP/D Information Activity M07-00531 Type: MECH Sub Type: Status: ISSUED Const Type Occupancy: Use: Insp Area: Owner GANOUNG, JOHN K TR Contractor ALLIED PLUMBING-HEATING -AIR Phone: 714-998-4300 CONDITIONING Applicant: LAURA YENULONIS Phone: 714-998-4300 Description: REPLACE FURNACE. Requested Inspection(s1 Item 64 ROUGH MECHANICAL Requested Time 08:00 AM Requestor Phone Assigned To Entered By KELLY_N K Action Time Exp: Inspection History tern 150 MISCELLANEOUS INSPECTION tern 63 PREWRAP tern 64 ROUGH MECHANICAL tem 66 ROUGH-FACTORY FIREPLACE tern 68 SEWER SYSTEM tern 70 DUCTS VENTILATING 1\I tern 72 GAS PIPE- ROUGH tern 86 HOOD OR CANOPY tern 90 GAS PIPE TEST-FINAL tem 108 GAS PIPE/UNDERGROUND TEST tern 114 POOL HEATER& VENT tern 202 tern 206 FINAL MECHANICAL • REPT131 Run Id: 7259 PROJECT ADDRESS: 1863 ELBA CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; P 058281 OWNER'S NAME: GANOUNG, JOHN K _ k ADDRESS: 1863 ELA CIR PERMIT NO: P 058280 PLAN CHECK NO: N GOVT: N SUPP; N • COSTA MESA,CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: OTH 545-2509 R SQ FT:C JOB DESCRIPTION : REPLACE WATER HEATER ARCH/ENGINEER: REG.NO.: ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 / PERMITTEE: GEORGE BRAZIL PLUMBING ( 714)535-7905 ADDRESS: 3022 N, HESPERIAN WY 101 COMMENTS: NO OTHER WORK PERMITTED SANTA ANA CA 92706 *****************JLl ***1ENdE****761eVIf1E%itdE****)Elf*lE***** E*****l **IFN1EiEifibitdE9FiF***klfiEl *** LICENSED CONTRACTOR DECLARATION: I hereby affirm tha tam licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code. d y license is in full force and effect. SETBACKS CITY LIC.: 055316 STATE LIC.:6222 4 cuss: C-36 7 a3 c� (/ ' /, MAIN BUILDING ACCESSORY BUILDING Date: Signature .� �� FRNT; FT IN REAR; FT IN FRNT: FT IN REAR : FT IN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN Compensation IAsj{af��ry Q4�yce a copxt ereol(Section 3600.Lab. POLICY NO.: `e'rt `4 kW Po I EXP.DATE: 1 /O I /9 3 COMPANY: }}ZZELIANCE PARKING REQ- PROV; PARCEL; 13942109 ZNE: REF NO: y5fea rilnuecirow >� PLANNING N IES> 0 Certified copy is herebyfurnished. it Certified c city dap Dir" /�� > 1 .ale: —7—,,-,?5-902_ Applicant: U (y " **3E****lf**********db***********3E***************%3i**********MTF*14*************M1h** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT $ E R V ( ES-- REQUIREMENTS I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. ZONING APPROVED BY — DATE; • Date: Signature: BUILDING APPROVED BY ode.NOTICE:If.alter making this declaration,wiyou should become i spermit the deemedrevoked.Compensation provisions of the Labor DATE; Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. �. h, � CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y; ].U.\ P. DATE• 7/2..//q1 which this permit is issued(Section 3097.Civ.C). ************1E*****************,c******** ****,iF********.************3e***it*if***** LENDER: ******************************************************************************-* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason — -- J BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2 00 repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed 5't '., r• SMSHIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ..1, and Professions Code)or trial he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE 3. 00 I, as owner of the property or my employees with as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS 2 , 00 3 , 0 0 0 . 00 5, 00 5. 00 , 0 0 • does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.It,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 5 . 00 OVER/SHORT: 00 Mrtheepurp is soldfS le)hin one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Mr Inc purpose 01 Saler. I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 5 . 00 KS ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon .4 and who contracts for such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware **'************'********************'TN•******************************-************** that proof of their Worker's Compensation insurance should be provided to me. I N D I V I D U A .L FEE BREAKDOWN ❑ I am exempt under Section: B.&P.C. ry fermis reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 WATER HEATER AND/OR VENT 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. la I' Date: Applicant' r1 I hereby certify that I have read this application and slate . .above information is correct.I agree to comply with all city and county '_ ordinances and state laws relating to building conslructio .ndhere.,authorize representatives of this city to enter upon the above-mentioned '2 properly for ins ecbon p e es �-023--(i it • ac�l ; Date. Signature: ` _ - -. Driver's License on Social Security x: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING POOL A APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 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 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 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation • 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes:7.2q.9 No OMEStant. L CA4a-(AO 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace / 38. Final Plumbing 7/,?7/= '4-PROJEC�i ADDRESS: 1863 ELBA CI UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: R 0791 /2 OWNER'S NAME: GANOUNG JOHN K ADDREss: 1863 ELBA CIR PERMIT NO; 8 059172 PLAN CHECK NO: N GOVT: N SUYP: N COSTA MESA, CA 92626 CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT 545-2509 ARCHIENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF W/CAPSHEET SQ FT: 1 , 749 ADDRESS: UNIT: CLAIM VALUE: 1 , 749 . 00 CALC—VALUE: 1, 749 . 00 GROUP OCC; R-3 / PERMmEE: CRANK BROTHERS ( 714 ) 548-5569 ADDRESS: 126 -COMMERCIAL WAY COMMENTS: SMOKE DETECTOR REQUIRED IN THE HOME 060E COSTA MESA CA 92627 *TESE**yE>EaPst* *****sESESEx*OE***O OEOE**********kE+E+PSE***sr*SLOE****OE*** OEOE****Or*s6**s6**ELSE*** LICENSED CONTRACTOR DECLARATION: I hereby atfir hat I am licensed under provisions of Chapter 9(commencing with Section ZONING R EQU IR EMEN TS 7000)of Division 3 0l the Business and Professions Code.nd my license is in lull force an. rr0) SETBACK S CITY 00599�i STATE MC.:40867 ' CLASS: C3) / ZI. ! 1 ' — _ — ` MAIN BUILDING ACCESSORY BUILDING 6ae: Signature: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: I hereby. r•hat l have a certificate of consent to self-insur' • a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN Compensation LisWWane,ppLL aal,cer4pplied cagy 1IRMO n 3800,Lab.Cl.1 /O 1 /9 3 POLICY NO.: L07-7LUN.L LVUL EXP.DATE: COMPANY: STATE FUND PARKING REQ• PROV PARCEL : 13942109 ZNE: REF NO: `7 Certified cop hereby flied copy with the t�ue Building Division. PLANNING NUTES> Applicant: Y,, _ ....�t *********************************************************************1(********* EXEMOTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one h dred($100)or less). D EVELOPMEN T SERVICES R E Q U I R E M E N' $' S I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: '= Date: Signature: BUILDING APPROVED BYIA NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. c CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y• .1 — •� DATE- �.�e— / which this permit is issued(Section 3097.Civ.Cf. *********'*'***********O6 ************r********** LENDER: ****-**************.***************************************************j6********* ADDRESS: LEGALIZATION :N F E E SUMMARY STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/RES ,' GRADING (Section 7031,5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 4 1 •0 0 . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed SHIP/NON'—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500). ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the TOTALS----> 41 . 50 0 . 00 0 . 00 41 . 50 41 . 50 ',A. . 00 - ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law dyes not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or offered for sale.It,however the building or REVENUE DIVISION TOTALS--> COLLECTED; 41 , 50 OVER/SHORT: 00 improvement is solde)hin one year of tampletion,the owner will have the burden of proving he/she did not build or improve foror the purpose offsale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/TOT GRADING PLAN—CHECK S I.as owner of the property,am exclusivelycontracting with licensed contractors to construct the project(Section 7044.Business 41 0 0 50 it ❑ and ProEcntra sdfo The Cprojects rs'wiSlate coitenseLawiensprsuly atuonhe owner of SLicense Lmp.ol as thereon ware *_*.*_*,***_*_**.*.***,*,*.*.*,*.**.**_*_*.*_*_*.*.**-*_*.**.*.**.*.*,***.**.**.*.*********************.********** and who contractsnCo for he Contract with a contractor(s)Lawidoese not apcanttatoe erContractors'Statewh builds er improves em aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ./.! ❑ I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST a;OtAL COST Date: Owner: SFR 1749 REROOF BY VALUE RESIDENTIAL NOZONE 1 . 00 •I), 749 , 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES ' 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt tram these provisions. Date: Applicant: I hereby certify that I have read this application and state Ih t tie above information is Lorre agree to comply with all city and county ordinances and state laws relating to building construction an h eby authorize represents( Ihistily to enter upon the above-mentioned proper;r inspection purpos• _Date: — Signature: < ��.� c _ - - •.4.`li Driver's License on Social Se unity a.- r641.46 white—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor I' CONSTRUCTION AND PLANNING POO. SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 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 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 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing . .74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation i 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Electric i Notes: 34. Final Heating& Air Conditioning 1, I i 35. Final Gas Pipe-Test i 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap-Regulations 47. FINAL STRUCTURE & BUILDING 1...2.4:42,. 6 �- 5 � oee_ 48. FINAL PLANNING �t/Y d-C-dg" 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 1863 ELBA CI UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 058650 OWNER'S NAME: GANOUNG JOHN K ADDRESS: 1863 ELhA CIR PERMIT NO: B 058650 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA,CA 92626 • CONSTRUCTION TYPE: V-N PERMIT TYPE: STR PURPOSE: ALT 545-2509 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : T/OFF REROOF PART OF ROOF W/HOT MOP ROOF SQ FT; 2, 000 )ADDRESS: UNIT: CLAIM VALUE: 2,000 , 00 CALL-VALUE: 2, 000. 00 GROUP OCC: R-3 / PERMITTEE: ALUMINUM ROOF SPECIALISTS ( 714 ) 558-0678 ADDRESS: 1529 MCFADDEN AV COMMENTS: REROOF 900SF FLAT ROOF SANTA ANA CA 92705 ****************************+E******* x********** ******** ij �+E g� �9 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENT (4 C 7000)of Division 3 of the Business and Professions Code,and my license is in full farce and effect. SETBACKS CITYuc.: 033723 STATELIC.:523043 cus C-39 /� n ������/� Signature- °� 1 �P �AXAn MAIN BUILDING ACCESSORY B Q1� CA--- Date: FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT TN WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN Compensation swapce,Q� tf{�,1 a (Section 3800.Lab POLICY NO,: V4D—J "• �� EXP.DATE: $ /01 /93 COMPANY: STATE FUND PARKING REQ• PROV; PARCEL: 13942109 ZNE: REF NO: —1 Certified copy is hereby furnished. X Certified copy is filed with the city Building Division. PLANNING NOTES> / L.-ft-In ^ > • Date: � [ /�Iy2 Applicant: 1 - 1 (9. . (1.12.-0_,-- ******************************************************************************* e) EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE Date: soushould APPROVED BY : DATE; NOTICE:If,atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. I /', CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: yy��V 1 1 8 j -1 l- whichthispermitisissued(Section 3097,Civ.C). ********************************************** ********************* ** *iE*** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE+,' SMIP/RES" :GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 45 .00 , 50 repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE - I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL • PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 45 . 50 0, 00 0 .00 45, 50 ,4 5 , 50 ' 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through r his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 4 5. 50 OVER/SHORT• 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 45,00 . 50 I,asrf owner of s the epeTh,am exclusively contracting withw licensed not contractors to constructo the project hb ills or ov, thereon , ❑ and who contra Code: The Contractors'wState License Law does not apply ua to an owner of property alic kens a improvesLl thereon n X anti who contracts for such protects with a Comratior(5)litense pursuant to the StateConhaCtors' License Law),I am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D O'W -N ❑ I am exempt under Section: B.8 P.C. x for this reason: TYPE QTY DESCRIPTIO N UNIT COST .1 TOTAL COST Date: Owner SFR 2000 REROOF BY VALUE RESIDENTIAL NOZONE 1% 00 - 2, 000 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES . !! a 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from 1.. j these provisions. F Date: Applicant: /� !jl ' I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county I(� j -♦ ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned l ,A"tAbM_ . property for inspection purposes. ` ', Date'. �( I 0 /9Z Signature: ----1\--k. `�L'_ LQ-f,,4/l .•wxM'\,L\N - - •- ea Driver's License or social Security x: _1_'; - . - ._ _ 1641-46 Wmte-Building:Green-Code Enforcement:Canarv-Aoolicant;Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POO .SPA APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector 1. Ter4orary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. - 53. Steel Reinforcement ,:3._Electrical Conduit Utility-Undrgrnd; T. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • '5, feel'einforcent$I?r 56. Rough Plumbing & Pressure Test t 6. EYectrical UFER•Grnd. , 57. APPROVAL TO COVER-GUNITE 7: Footings - _ 58. Electrical Conduit-Undrgrnd. '1/4:8. Foundation - 59. Gas Pipe, 0 Undrgrnd., Test s. 1 9. Water Pipe-Ungrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Float System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final • 12. ae-wer Cap c ry a, 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 jgn 68. APPROVED FOR PLASTERING 18. Rough Electrica6T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT:REQUIREMENT 20._Ro�h Factory Fireplace ' 'c C '^= - 'APPROVA-I:S%OPerfnit # ` -° ..G S r S CT x *t _ - - .. c L. i 21.Duds, In,Stryictutee �4 s - r . `_70. lrinde ground Hydro - r 22. Ducts, Ventilating -3.S rt S 1 • '71- Produ a in �� r -� S r c+(.. . g Gds Oil t. 23.;GasPip:Rough &'Test r ."' t - n I I _s .� � � r � Vii; t .�72. Underground Flu"s(T,�. o v r - 241tRoot Framing r::' - •• - • C =. '< �' i•73.11 Undergrnd.StolageTdnk 0 Gas O Oil 25. Roq-f Sheathing z s' ?J ' c J. ' ;t . x ' ,, " •- .� �• I]x 'J \ :, p .0 F K 74:?Qverhead Hydro_ r a ., 26. T-Bar Ceiling (Structural) & Monocoat ,c 7.r I *,`" r• 757Dry Chemical -I c - , - • •_c K T , 27.cFraSne and Flashing p lc _ x '- -_ - . AT 76:^y Stantfppe - ',28TLathing_& Siding- r.: ., _ i r ••I .• '•.: "K 774'" FIXED SYSTEM-- FINAL 29. Insulation 74;;C _ • - ' "' K 78.:=FIRE PREV. FINAL " ' 7'30. DrywallNaiUng •- ',: IC r r -HEALTHDEPT<. R-EQUIREMENT y ;'31- Plaster Brown ron CAC , r r• f I_ r.79c. FINAL INSP,-ECTION ; 32c-Electrical Power Metey-Final - .-:1 �,. x .-80.:FOOD CERTIFICATE ISSUED 33`Findl Elctric ` < Notes: y ='r r- q r, t. ,r;34.,Firia`I Heating& Air Conditioning• . . I , .r R -; , 35."Final Gas Pipe-Testy - - c < ' S " ' S0 r36. Hood or?:-Canopy _ ' r �� .. 5. z -'c t" t r. `37=Final Factory Fireplace` . - ` r x ' . 1 (, I .-i - .... - 38. Final Plumbing < _4 = Z. 39. Water Service<Final< w J 1 I •-.:.' ‘-• •t '1 ' D X40. Gas Service--`final ' ; � L ,< ;, - :41. Solar Domestic-Finals - •• s I I I, . S : - •42.'-Backflow Prevente4 - I I{ _ k r x J t _ _ .- I L. - 43. Backflow Irrigatiolt.. c -, t• e " • ;--'45- ,,(/ = :X44. Landscape IrrigatiotSystem. - - r -, t, / L •�_: �L�6 •45-_Sound Attenuation' l .1 . t[ •. - .� • `46.-Handicap Regulations - •_ . - -- - r 5 , r/�'1o� '•.- J 4T:.F1f3AL STRUCTURE & BUILDING x �, I F. ' �(�9=3:/ • /r j /cat; • 48:iFINALPLANNINGt. . W I I II. . ` - r _49;;ElectricRelease to•Edison - • •< I I - i , c ,.,�. • u - L • - t 50.i.GasLRelease to Sou'Lhefn California Gas Co tc. I j: ' _ - -.51. CERTIFICATE OF.OCCUPANCY No. ;.Date • a Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA M(� ON • CTION 'E• IT A.P.# I Zane Projeci,Address Lit _-- 13 3 8392—' I - ' S Main Building: Accessory Building: Applicant's Mail A dress .�29 • L � TYPE OF CONSTRUCTION J, Y EW U ADD U ALTERATION U REPAIR E Z L / D ❑ CONVERSION ❑ D MOLISH ❑ .`I ER T Front O DWnP 's Name 8KQ/ PhOn� i 'n ESC' .. WOR Ee' BUe .4 ��;✓ r� a� • N (, eiMPT���� Rear Address '``/ttl�g�l . �l • Id j, art er - Right N �.F. g Arch/Eng. License No. YPE OF PERMIT il GRADING le FOUNDATION gill` RUCTURAL 1. K — G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ M $ • Left R 41/As +'� • 7 'y}a ❑ !OTHER /� Ping. Ref.# Parking_ Re /Provided E Contractor's Nam " •r' �7 / Req ./Provided G '-w4 r� PROJE ESCRWTION SQ. FT. '(r�J '�' OCCUPA� O /5 / . /77 /� Planning Notes: Address(mailing) C da.., M /� CO STRUCTION TYPE�� VALUATION $ T City License No. ' ��'•� ZONE GRADING CU.YDS. ACR S S LICENSED CONTRACTOR DECLARATION . i hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ,� • /yam_ f 7 ' with section 7000) o • isl.n of the Business and Profes Ions Code, and 'Y f C. ftere) R•eaf/• I h //01N tt my license is in full f• ce a 0' At. 'y/a I \/ Q 1 ' ELECTRICAL FEES Lice• 5 •-J a iceneNo, ( 5,•�V I,TS v` Ic • f1 Ser . IZIO oat:�� fl._ ��ature �iz.�.•. PLUMBING FEES Automatic Washer Transformer 0 15-50 KW Q ❑ 50+KW WOR • •S CO PENSATION have certificate DECLARAT ON Construction Pole Sub. 41 ' hereby affirm that I have a of consent to se • . e or . certificate Bar Sink Showers `� Workers' Compen ati I r Ce, or a ce 'fie•/.• th- e•f (Section Cooking Unit Meter Dup to 100 amps lo, L Backflow Preventer Service Sink y �I� Dishwasher Meter ❑over 100 amps Policy r�{(d(J� Comp `� Backflow Irrigation Sewer Cap p Certifie copy is hereby furnished. `y�•. Dryers ❑Gas ❑Electric Sub Panel — 4..—�Cer p d with the city = f1CR^, / Bathtubs Sewer Connection ". Date Applicant X17 Fan Motors 00-1 HP ❑1 h-8 EXEMPT N F OM WORKERS'COMPENSATION D., • -ATION Clarifiers Solar Collectors (Thisleshsection need not be completed if the permit is fore hundred ($100)or Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP-016-15+ I certify that in the performance of the work for which his permit is issued, I Fixtur¢s shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave )i . Workers' Compensation Laws of California. Boxes 0x¢5 Date Signature Floor Drains Swimming Pool w/Spa DevicePole Light .td NOTICE: If,after making this declaration, you should become subject to the ts Outle Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYSwitches Si n ' Gas Service Outlets Water Closet 9 I hereby affirm that there Is a construction agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater • Garbage Disposal; Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION ...-- I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash . following reason (Section 7031.5 Business and Professional Code: Any city or - county which requires a permit to Construct,alter,Improve,demolish or repair P—Trap Laundry Trays ' any structure, prior to its issuance, also requires the applicant for such permit - - _ - to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - -. • the Contractor's License Law (Chapter 9(commencing with Section 7000)of "'vision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee. $15 Issue Fee efrom and the basis for the alleged exemption. Any violation of Section $ 3 1.5 by. any applicant for a permit subjects the applicant to a civil .ialty of-not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: LII, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or-offeretlti Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By License Law does not apply to an owner of a property who builds or improves . Date thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type ❑ Applitation•,Issued By Dat employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ .' SU&MARY OF FE pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground • - prove for the purpose of sale). BUILDING PERMIT $ 3• On_ SMIP $ . L5•0 ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - PLAN CHECK $ PER tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- ENERGY P.C. $ _ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration I , PLAN CHECK•; 25% $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICA Li $ GRADING $ ❑ I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $ HeatingSystem&DuctingRegisters PLAN CHECK- 50% $ / 7 Date O ter y • . MECHANICAL $ _ TOTAL FEE $ 4J ' -s0 I hereby certify that I h. e r this application and state that the above 00-100,000 BTU 0100,000 BTL information is correct. I a.re• • omply ith all city and county ordinances • PLAN CHECK) 25%. $ and state laws rel. ing t. buil: c•• Iction, and hereby authorize repre- sentatives of this ity o -I ••� " - above-mentionedSr} er y,j? Inspection purposes. • //✓��/ f\1/Y Signature .Da Drivers' License or S5# Pink -Accounting; Goldenrod - Assessor DATE: 05/03/29 TTtlE: 15:51 CONSTRUCTION AND PLANNING ! POO' SPA • , APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole _ . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. I 53. Steel Reinforcement 3. •Electrical Conduit Utility-Undrgrnd. . ' 54. Forms `4. Electrical Conduit-Undrgrnd.- • - y 55. Electrical Bonding • 5. Steel Reinforcement. 56. Rough Plumbing & Pressure Test - _.1 • 6., Electrical UF ER Grrid. 57. APPROVAL TO COVER-GUNITE �! 7. Footings - r , - I 58. Electrical Conduit-Undrgrnd. 8. Foundation ` 1 - 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10'1Structural Floor System - 61. APPROVAL TO DECK• • 11 Property Sewer Line,& House Connection `- 62. Backwash & Receptor-Final 12'-Sewer1 Cap r • 63. Heater & Vent-Final ? I • 13. Roof brains 64. Plumbing System - Final .. ' 14. Rough Plumbing • • 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 163 Rough Electric Wiring 67. Fencing & Access Approval 17:) Rough Wiring Sign 68. APPROVED FOR PLASTERING 1'8: Rough Electrical-Tar Ceili g 69. POOL/SPA SYSTEMS FINAL 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace r APPROVALS Permit# 21•. Ducts,in Structure -^ 70. Underground Hydro 22. Ducts; Los R Fsy L TY OF COSTA. MESh O' WA CALIFORNIA 92626 P.O. BOX 1200 J. - FROM THE OFFICE OF THE DIRECTOR OF BUILDING SAFETY • A 41cOqp A Project Address /56 3 FL/34 a„c zF permit # �� Project Name Pcor 4001 : . Type _fr/ Owners Name � �A i1 1,4/C Owners Address / 9 G 'ELS ,i rL s City Use Only Owners Telephone Sy/S •s , p I )j jt 1 Lef,. .c ry��j as-9eaer, Contractor, Agent (strike out all except one) do hereby attest/that employment of any person, or persons, is not anticipated at the time of seeking the above-referenced permit. In the event that any person, or persons, are employed under the provisions of this permit, I shall immediately cause a valid Certificate of Workmen Compensation to be filed with the Costa Mesa Building Division. I agree to defend at my own cost, and to indemnify and hold harmless, the City, its officers, agents and/or employees, from and against, any and all liability, damage, costs, losses, claims and expenses, howsoever caused, resulting directly or indirectly frau, or connected with the improvement under this permit. I further state that I have read and fully understand the implications and re- sponsibilities of the above statements, and will comply with all provisions of the Contractors State License Law found under the Business and Professions Code, Division 3, Chapter 9, of the State of California. Print Name 77 ac' 4/ X 3/-8/ Signature Date CMF 0777-46 APPLICATION FOR A BUILDING PE' 'IT yyy''' / BUILDING PERMIT NO. Electrical CO Tract y-3 4 I Block Lot /Y Permit No. E. BUIItlin ` /� !� Plumbing 5' Address 86 3 iC<B.4 ! (//,ec L� S7' 7(I Permit No. m '/ \ V v Mechanical 0- Cross Area M ESA Vet Street S/,e OM ff OL( Permit No. co owner SA C e )l , a dl tf 0/U6 T e of Project: 0 New ❑ Alter ❑ Addition Address 6 �L 6A C:(B c-L�- Repair ❑ Convert ❑Demo ❑ Occupancy Pmt. City ZIP Phonevjt(s d's0 -P- Insp.Area �04Tp /1�een % 6u Y Architect/ n Zone SPI.Pmt.No. Designer diu:co License No. tbacks P/L Front C/L St. Street Width Address Yards Left Right Rear City Zip Phone Eave Prof. Left Right 1-.P. Engineer License No. C Parking Space Required Provide Covered �a4 Address m City Zip Phone Struct No.of No.of Height Stories Family U LICENSED CONTRACTOR'S DECLARATION Park Fees 1..11 Yes Fee as Required U No C.T. Receipt m I hereby affirm that I am licensed under provisions of Chapter 9 s (commencing with Section 7000 of Division 3 of the Business and Zoning A'proved By: Date .. Professions Code,end my license is in full force and effect). License Class 5-/ L/i(fc+e�nse Number1r/?O 9 6 1'gsit T Date ,?^ 3/'RI Contractor /'/�P(eay[,v. 5.Tii/.eet)40 Misc. E Address 3/4 c S,'rjt .4-c Proposed U /� of Structure e jy City and Zip ^(5-4 EC,q Phone_419 A7/O ' « CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the 1 performance of the work for which this permit is issued (Sec. 3097, CCop' Code Civ.C). Class Co -t. Year ai Lender's Name . USE/OCC PANCY SIZE SQ.FT. C• Lender's Address J OWNER-BUILDER DECLARATION • r 1 hereby affirm that I am exempt from the Contractor's License Law 1. 8for the following reason: . 0 I, as owner of the property, or my employees with wages as their 2. C sole compensation, will do the work, and the structure is not ..C.— intended or offered for sale. !., 3. 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. • as 0 I am exempt under Sec. _, B&PC for this reason 4' d a Dote Owner E WORKERS'COMPENSATION DECLARATION Total Valuation 8' I hereby affirm that I have a certificate of consent to self-insure, Encroachment Permit Required la Yes ❑ No or a certificate of Workers' Compensation Insurance, or a certified C copy thereof. Grading Pmt. ,--, Grading S Policy No Company Required Yes ❑No Pmt.No. .a 0 Certified copy is hereby furnished, Rough Grading V Q ❑ Certified copy is filed with Orange County, EMA. Approved by: Date lb Date Applicant 3 • CERTIFICATE OP EXEMPTION r' FROM WORKERS'COMPENSATION INSURANCE Z c (This section need not be completed if permit is for $100 or less). 3 I certify that in the performance of the work for which this permit is e issued, I shall not employ any person in any manner so as to become to subject to the Workers'Compensa+• n Laws of California , PERMIT FEES Date 3'9i/—Pi Applicant // ' P 4S �. , /i NOTICE TO APPLICANT: If, alter making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such Special provisions or this permit shall be deemed revoked. Electrical E Invest. $ I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE Plumbing E THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE MENTIONED PROPERTY FOR INSPECTION PVR- Pre-Grade POSE $ ion ' 1� s g 81 Pre-Gradee-Gra Sign of Applicant r Agent Date Rec. $ Permit $ ��w Rec.No. Issue 442CUS U✓. 6.'TO0 CMA/._1 Print Applicant's/Agent's Name All spaces within this box must be completed to process Plan pprove A Check By: pprovetl: CMF 0335-46(BU-28)rev.6/80 18255 ,rte n-FrPfl W�02E m3 *** 35 COSTA MESA BUILDING-SAFETY DEPARTMENT P. 0. BOX 917 COSTA MEGA. CALIFORNIA For Applicant to Fill In Completely APPLICATION FOR PERMIT TYPE ORJJJPRINT ///]]] BUILDING BUILDING I `i / "� 7:1-4- / ' woDREas [�/1 COSTASMESA. CALIFORNIA For Office Use Only y�_ � /y ��-� I RECEIPT NO. I '8255 OWNER �F//{/// J t/-.' I 1VSLnV1SF/,� ADDRESS /%S3 ,% 4' Rc9 .//J y/MAIL RE ED BY I DwT4R/QJV t NovELB3uHis62 CITY dgY]-j¢ �f-,/S/S1• LD NEON//�O7r( ADDRESS // ARC'-TECF L� /,� �/ TEL COSTA MESA. CALIFORNIA OR INE EEyRL 4P R/7A/✓69'C.�NE0197Y-jam/ ///� J ADDRESS//TL rt//J;irLG.¢- f/fY✓A'/f�/�7 FIRE ZONE TYPE I/ GROUPII / CONTRACTOR R71M.--n ClCT/451; Lf.' s APPROVEDBY DATE ADDRESS '( j .�✓/im/o:1'8,- G ZONING AV,'�j /411 //��//''JJpp ///,/�_ Z`_'{(`, NO.OF UBE OF N—s -, j CITY `- -079 ////.'!5 p C. 11� •-- ( I PLAN°1//I BUILDING �/� 1({/d�'� LIC.TNO.////J,l 3,r TEL. (� NO. /C 7N' L EDESSCLEGCRIPTIONN f��/ /�s' re // SIZE OF LOT /(/ X/ �J I NOWGF ON LOTS A.P.NO. --((\ USE OFYARDS EVES EXISTING BLDG. ( _ APPROVED ALLOWED SETBACK tS-� / REAR YARD/7 Li % (CENTER LINE ST.) ��J 2./- FRONT LS OFT. IN. / SIDE YARD I LEFT � I RIGHT O / R.SIDE g FT. IN. DESCRIPTION OF WORK L.SIDE 7FT. IN. NEV IA- II ALTERATION I II ADDITION 1 REAR ) 7 F///T\. GIN. I II MOVING I II DEMOLISH I APPROVED / n/7! 1 DATE //r// 4 REPAIR 7 ....1-".-- .-. '/ 1Y IY/ BUILDING �3 .. NO. OF ROOMS / STORIES /- �Y/ SIZE lam/ C F COVERING EXTERIOR WA<-J�(C9j I COVVERING< }/lj1.T�. USE OF BUILDING AND WORK TO BE PERFORMED ( -Zer c . I c. /�%el 'Z/64 aHEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN'MI VALUATION IS FOR THE AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH AU. CITY ORDINANCES AND STATE-LAWS REGULATING BUILDING CONSTRUCTION( ) VALUATIONSIGN _ ` / A 5 0 P RMpITTEF TURE O e/11'I-//N // ��G�`e%(•1 FCII`fin I {., PERMIT FEE $ (/ D 7 / (r(�v� / !,f 211e� $a, /�J� PLAN CHECK $ �D��j�/�y�a AUTHORIZED AGENT ,I/. TOTAL FEE $ /770s e? 23054 FEERECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT F P.O.BOX 317 COSTA MESA,CALIFORNIA ®CT 7 196 For Applicant to Fill In Completely AIWIWi eii EERTP,ERMIT TYPE OR PRINT CITY 0831PJ ws v1ESA BUILDING / p' / - For Office Use Only ADDRESS / o 6 3 L/ b n eI a c /t. RECEIPT NO. P[pl(ITO. / COSTA MESA, CALIFORNIA OO��// 57 '}/ / �c[), n� RHC D BY DA�t/ T Ti ED DATE I%SU D. OWNER J o A m 4n # N 4u /v 77 ETV (/ /-b/ ry/ C n (/✓� c BUILDING i�/ ^��,^ CaI ADDRESS /I{(p 3 ` l 12* 2 1 %v C,/' ADDRESS C 3 a /-1 CITYC//�� ,{.. ��/ _A� - FIRE `' O $ J /� /r/Q 5 n Tg.`� /�'JSO9 ZONE . TYPE � GRGROU,�PI f/� ARCHI INFER T L APPROVED i/(j/4Y{/DATE/v ,NING ADDRESS - . ZON}� I I NO.OF I USE OF NE6) , �JAve �'7 r Afi PLANS BUILDING ^ - -y� CONTRACTOR i; /✓ p/ F_ C 9 N S N /1/ Y , �i ( y/--y(I/! LEGAL ,- Y ,' 1 �T"P-, 43 fit /� (7 D86CRIFTIO rrr��� 'V l ADDRE-SyS/(�^2 /4j�/'/n?C,/1�C�� J7 • CITY J �'/�� /9/V/9• A.P.NO. ' 3 q - 7 --1--- , ATE G TEL NOTE:OTO SOIDE V REAR P.LE NG SHALL BE LESS THAN ST LIC.NO. 13,5— Rs- NO.• f<397V0 y A0 EAVES SIZE OF LOT / 1 3 S I NO.OF BLOCS. , ALLOWED (U.B.C.REQUIREMENT) NOW ON LOT USE OF `2 YARDS APPROVED YARDS APPROVED EXISTING BLDG. 1 `a S MAIN BUILDING ACCESSORY BUILDING (FROM C/L STRE T SETBACK LINE FROM / • FRONT ., -‘2"--la Pr. CENTER OF STREET REAR YARDDc[�0 SIDE YARD LEFT 7'I - I RIGHT f R.SIDE FT. FT. DESCRIPTION OF WORK L.SIDE 7 Fr. T Fr. NI _ ALTERATION _ ADDITION REAR FT. FT. DISTANCE BET. BET.MAIN 9 REPAIR MOVING DEMOLISH MAIN SLOGS. ACCESS.BLDGS. • BUILDING �I NO.OF VAR.•$ DATE SIZEROOMS //// STORIES/ C.U.P. # APPROVED �T EOTERIOR WALL I COVEFRING/447W A I3I BYp/ !/-E/©/_ DATE ' —7 -�0y COVERING l l/ ��fjpJ USE OF BUIL INC AND RK TO BE PERFORMED l A im ,ret , • N SQ.FT. I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE E AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COM- PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. O PLY WITH ALL CITY ORDINANCES AND STATE LAWS MATING BUILDING CONSTRUCT}�ry /VALUATION / � PERMIT FEE $ (O �"0 B SIGNATURE OF PERMITTEF if I , ///,{�yg� G $ /�j A� �� PLAN CHECK $ 0 AUTHORIZED AGENT i���/// /1 0,� n te TOTAL FEE $ (O - • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI ATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 I n^'n •- • a 50 TL' REC. a� PERMIT n . - . For Applicant to Fill in Completely — Use Ink Only N° 515 3 8 BUILDING ) •a A.P. NO. 3 -- _ ' ' ADDRESS I Q , ' , - f - , BUILDING / 7 Det OWNER OR �� //r- v �/�) ADDRESS L egv 'V� TENANT ....7--k., CaA-ZV f/R/ !r UNIT OR MAILING ,/, SPACE NO. ADDRESS , p3 rElLBA _ ecce Te/3q// LOT /6 BLK. /�/J TEL. CITY �/j 7,4 "/fps{.'{ NO. -31/ Y 5'')49y NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION / LENDER I/ BRANCH ‘7. //• tistA U ARCHITECT TEL. _ _go ADDRESSUSE a.Yf'6 i d i*. fits--1 $ 70 ITE OR ENGINEER NO. '1 r ADDRESS ZONEAr, TYPE GROUP /✓ I / APPROVED{{{' - `)/3//45/ L' CONTRACTOR P94 a Ut \V- St Tdiantil•i-TA BY DATE J L/ ADDRESS ;/4/r �S/G(( y 4ae /n / TEL !4 CITY , c •r4 /n 5^4, NO.,/T9-611/6 F STATE CITY APPROVED SETB•_ S �//// ,g LIC. NO. Bog 4 1 I LIC. NO. i '....4a I s iA/ // . (.LI SIZE rX 7L s NO.OF BLDGS. (FROM C/LST' �7 C. OF LOT 70 ,07 / ,7 7 NOW ON LOT 1 FRONT ` r ci 4 USE OF EXISTING BLOC. 2�5' n g,uSd R,s117E/? / ./- / F Separate permits are required for L.SIDE 7 F1/2 er electric,plumbing and heating work.CT REAR6I�' FT. (_ F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION 5 TO e a�c e avc,¢,L' __LidP DATE Q APPROVED .rl CPl�=?� DA- / �j oG W CL I hereby acknowledge that I have read this application and state m that the above information is correct and agree to comply with C Is all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of m the State of California. T PP/ SQ. FT. is I hereby certify that I am properly licensed as a contractor under N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ /6„ p Q n and Professions Code,Division 3,Chapter 9. 7 riO D Signature of PLAN CHECK $ c ^ 00 ^ Permittee *T/_L/e/N 1$ $ "" ffr TAX $or - S f U Authorized Agent Date 2 --.y' BI ` TOTAL PAID2y$ Zor-D