HomeMy WebLinkAbout2114 ELDEN AVE - Building PermitsCITY OF COSTA MESA � � �
o ""'Fs �lIILDING DIVIS/ON
F�� 77 FAIR DRIVE, COSTA MESA. CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us
� ` FOR INSPECTIONS CALL: (714) 754-5626
4'"°"°"°fi PERMIT NUMBER: P10-00070
PERMIT TYPE PLUM
APN: 42613103
JOB ADDRESS: 2fr i1��LDEN AV;,CM
Vicinity: REAR YARD
STATUS:
DATEISSUED:
ISSUED BY:
Suite/Unit:
ISSUED
06/0112010
RMD
SCOPE OF WORK: PLUMBING PERMIT FOR GAS LINE AT BBQ AREA LOCATED AT REAR YARD. REF#: E10-00099
OWNER: OROZCO CONNIE
PHONE: 760•689-0504
APPLICANT: OROZCO CONNIE
PHONE: 760-889-0504
CONTRACTOR: OWNER-BUILDER
Address:
CirylState:
ARCHITECT:
ENGINEER:
ZipCode:
Address:
City/State/Zip:
Add2ss:
City/Stale/zZip:
License No.
License No.
2114 ELDEN AVE
COSTA MESA, CA
2114 ELDEN AVE
COSTA MESA, CA
License No. 000000
PHONE:
CE�L:
PLUMBING PERMIT FEE SUMMARY
PLAN CHECK FEE:
PERMIT FEE:
TOTAL FEES:
$0.00
$29.65
$29.65
PHONE:
PHONE:
NOTICE: The work authonzed by this permit shall wmply with all applicable handicap access requirements under California statutes and related
regulalions. (Ord. No. 92-28, § 1, 72-21-92)
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.
LOpE t, INSGEL710NTYPE URTE INIIIIRLS LOOEO INSPEGTIONTYPE ORTE IN1111RL5
1616 Fized System Final Fire Prevention 208 Final Mechanical
1286 Pool Spa Final 208 Final Plumbing � �� �-- � � (�'1P Q9"'
200 Final Re-Roof 2ID Final EleCtriwl
201 Final Block/ReWining 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' COMPERSAYIONSECLARATION:
I hereby a(frm untler penalry of perjury one of the follovnng declarations:
❑ I have and will maintain a certilwte of consent to sel4lnsure tor workers'
compensation, as provi0etl for Dy section 3700 of the Labor Code, for the
pertormance o( Ihe work for which this permit is issuetl.
❑ I have and will maintain workers' compensation insurance, as requiretl by
section 3700 of the Labor Code, for the peAortnance of the work for which this
pertnit is issuetl. My workers' compensalion Insurance carrier and policy
number are:
Carrier.
ee cvmpered ame pe.mrt is vaWee at one n✓�.ed ddiars (Stoo) w�ess )
Poliy Number:
�certi(y Ihal in the peAormance of the vrork for which this pertnit is
issued, i shall not employ any person in any manner so as to become subject
ro[he vrorkers' compensation laws of Cali(ornia, antl agree tha[ i( I should
become subject to Ihe orker5' o pensation provisions of Section 3700 of
the Lab — e, I shall hwit co ply with [hese provisions. ��
APPUCd�'e'319naty� C��
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIViI 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 affrtn Ihat I am licensed under provisions of Chapter 9(commencing
with Seclion 7000) of Division 3 of the Business and Professions Code, and
my license is in full force and eHecl.
Lic. # Class #
Contmcmr's SignaWre Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby aKrtn ihat there is a consWctbn lending agency tw the
pedormance of the work for wfiich Ihis pertnit is issuetl. (Sec. 3097, Civil Code�.
Lender's Name:
Lender's Address:
Da�e
OWNER-BUILDER DECLARATIONS:
I hereby aKrm Ihal under penalty of perjury that I am EXEMPT FROM 7HE
CON7RACTORS LICENSE LAW lor the following reason (Sec. 7031.5,
Business and Pmfessions Code: Any city or county which requires a permit to
construct, alter, improve, demolish, or repair any strucWre, prior ro its
issuance, also requires Ihe applicant lor such permit to fle a signed statement
Ihat he or she is licensed pursuant to the provisions of [he Con[ractors
License Law (Chapter 9(commencing with Section 7000) of Division 3 of the
Business and Pro(essions Code) or that he or she is exempt Iherefrom and
the basis !or lhe alleged exemption. Any violation of Section 7031.5 by any
applicant for a permit subjecls the applicant to a civil penalry of not more than
fve hundre0 dollars ($500).):
❑ I, as owner ol the property, or my employees with wages as iheir sole
compensation, WILL DO THE WORK, antl the strucWre is nol intended or
offered for sale (Sec. 7044, Business and Professions Cotle: The Contractors
License Law does not appty to an owner of propeAy who builds or improves
thereon, and who does such work himself or hersel( or lhrough his or her own
employees. provided that such improvements are not intended or oKeretl for
sale. If, however, lhe building or impmvement is sold within one year of
completion, the owner-builder will have the burden of proving that he or she
did ot huiltl or improve for purpose of sale.).
��, as owner of Ihe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS ro construcl the project (Sec. 7044, Business antl
Professbns Cotle: The contractors License Law dces not apply to an ovmer of
propetly who builds or improves Ihereon, an0 who contracls (or such prqect with
a contracta(s) license pursuant to the Conlractors License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
� � � 6 -D/�/D
$� �,.� Date
]OSl-ab(3/0]�
�.
�O er ID venfied by �ver's license. Yes ❑ No O
"ver.57icense No. M 'res� � �
Verifcation of Ovmership by (type of document, i.e. - propeny taa bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMI7 CERTIFICATION:
❑ I hereby certAy that no excavation frve (5) or more feet in tlepth inro which a
person is required to descend, will be made in cmnection with Hork authorized
by ihis pertnit, and that no building structure, scaffdding, talsework, a demolition
or dismantling thereof, will be more than thirty-six (36) teet high. (Chap. 32. Gry
2, Fvt 2, Sec. 347, Title B. Califomia Administrative Cotle).
❑ As owner-builder, I will not employ anyone to tlo work which woultl
require a permit fmm the Division of Industrial Safery, as noted above, unless
such person has a permit lo do such work from the division.
Applicanl's Signalure Da�e
Division of IndusMal Safery Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
7. Will the applicant or preseN or future builtling occupant need to file and
certi(y a Business Plan for emergency response to release or threatenetl
release o/ a hazardous matenal? ❑ Yes ❑ No
(Section 25505 0( the Calilornia Health and Safety Cotle requires, with some
exceptions, thal a Business Plan be fled wilh the Costa Mesa Fire
Department by every business which has at any one lime tlunng a reported
year a quantity of hazartlous materials equal [o or grea[er than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standard temperature and pressure).
2. Does or will the applicaM or present or fWure building occupant need to fle
a registration form for awtely hazardous materials? ❑ Yes ❑ No
(Section 25533 ot Ihe Califomia Health and Safety Code, with some
exceptions, requires registralion vrilh the Cosla Mesa Fire Department by
each business which al any one time has on hand a quantity of acutely
hazardous materials equal to or greater Ihan a weighl of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at standartl
temperaWre and pressure).
3. Does or will the applicant or present or fuWre building cecupant need to
prepare an RMPP (Risk Management antl Prevention Program tor awtely
hazardous materials)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safery Code provides that [he
Costa Mesa Fire Department may require Ihe preparalion, certi(calion and
filing with the Fire Department ot an RMPP by Dusinesses which are required
to register awtely hazardous materials with the Fire Department.
4. It an RMPP is presently required, has Section 25534 of the Califomia
Health and Safely Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future builtling occupant require for
ihe work which is the subjecl ol this application a pertnit for suc� construction
or modi5wtion from the South Coasl Air Quality Management District or from
any other air pollution control tlislrict or agency? ❑ Yes ❑ No
(Sectbn 658502 of the Cali(omia Govemment Code requires that the reques[ed
in(ormalion be fumished on applications tor non-residential building permits).
6. Will any part of the facility to be construc[etl untler this permit be within
1000 feet from the outer bountlaries of a school? ❑ Yes ❑ No
(If "yes", the tacility must meet the requirement of Sections 25534 and 42303
of the Califomia Health and Safery CoOe).
7. It a permit from the South Coast Air Dualiry Management DisMct or other
air pollution control district or agency is required for the work which is the
subject of this application, have all of the tlisclosures prescribed by Califomia
Health and Safety Cotle Section 42303 been made? ❑ Yes ❑ No
8. pf'yes", attach certifcate of compliance from the appropriate air polWtion
control offcer).
CERTIFICATE OF COMPLIANCE: I ceAify that under penalty of perjury the
informalion given above is correcL I agree to comply with all state laws and
city ordinances regarding Hazardous Materials and Emissions.
Signature oa�e
CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I
certi(y under penalry of perjury that I have reatl this application and state that
Ihe information given is wrrecL I agree to comply vrith all slate laws and city
ortlinances relating to building conslruction, and authorize representatives of
Ihe City of Costa Mesa to nter �� n the above-tlescribed property tor
inspection purpose . a9ree� t t occ y or allow occupanc o� any bu' ding
aulhorized b ��s e iit u{i ina insp cli 0/ �
� .ecm u � e�er
AnE/or Aut�orizetl Applipnt
/% p ��
�•.
—i—`..�
Costa Mesa
City of Costa �l�[esa BuiCding �ivision
77 Fair Drive, Costa Mesa, CA 92626
714-754-5273 / Fax 714-754-4856
OWNER BUILDER VERIFICATION
�10 -OD��jci
Permit # ��)�n
Disclosures & Forms for Owner- Builders Applying for Construction Permits
IMPORTANT! NOTICE TO PROPERTY OWNER
Dear Property Owner:
An application for a building permit has been submitted in yo r,! name listing yourself as the builder of the
property improvements specified at �' � �( �� �I I 61v1 Gt iJ{
We are providing you with an Owner-Builder Ackn wledgmen�'and Information erification Form to make you
aware of your responsibilities and possible risk you may incur by having this permit issued in your name as the
Owner-Builder. We will not issue a building permit until you have read, initialed your understanding of
each provision, signed, and returned this form to us at our official address indicated. An agent of the
owner cannot execute this notice unless you, the property owner, obtain the prior approval of the permitting
authority.
and initial each statement below to signify you understand or verify this information.
l�':��understand a frequent practice of unlicensed persons is to have the property owner obtain an "Owner-
Builder" building permit that erroneously implies that the property owner is providing his or her own labor and
material personally. I, as an Owner-Builder, may be held liable and subject to serious financial risk for any
injuries sustained by an unlicensed person and his or her employees while working on my property. My
homeowner's insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder
and am aware of the limits of my insurance coverage for injuries to workers on my property.
� 2 I understand building permits are not required to be signed by property owners unless they are
es"po ible for the construction and are not hiring a licensed Contractor to assume this responsibility.
q(.�3. I understand as an "Owner-Builder' I am the responsible party of record on the permit. I understand that
T�may protect myself from potential financial risk by hiring a licensed Contractor and having the permit filed in his
or her name instead of my own.
4. I understand Contractors are required by law to be licensed and bonded in California and to list their
li nse numbers on permits and contracts.
5. I understand if I employ or otherwise engage any persons, other than California licensed Contractors,
ahd:the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may
be nsidered an "employer" under state and federal law.
I understand if I am considered an "employer" under state and federal law, I must register with the state
ahd ederal government, withhold payroll taxes, provide workers' compensation disability insurance, and
cOntribute to unemployment compensation for each "employee." I also understand my failure to abide by these
}ay,�s �nay subject me to serious financial risk.
/�i\/
�yr7.—I,understand under California Contracfors' Stafe License Law, an Owner-Builder who builds single-family
resi8ent a structures cannot legally build them with the intent to offer them for sale, unless all work is performed
by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of
the work is pertormed under contract with a licensed general building Contractor.
3148-30 CALBO Jan 1, 2009 OB Packet template 1 of 2
�I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable
r any financial or personal injuries sustained by any subsequent owner(s) that result from any latent
co truction defects in the workmanship or materials.
I understand I may obtain more information regarding my obligations as an "employer" from the Internal
� ven'ue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information
a� ut licensed contractors.
(("/`N,1�0. I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand
$�at I am the party legally and financially responsible for proposed construction activity at the following address:
I agree that, as the party legally and financially responsible for this proposed construction activity, I will
all applicable laws and requirements that govern Owner-Builders as well as employers.
2. I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the
i a on I have provided on this form. Licensed contractors are regulated by laws designed to protect the
public. If you contract with someone who does not have a license, the Contractors' State License Board may be
unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against
unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed
Contractor or employee of that individual or firm is injured while working on your property, you may be held
liable for damages. If you obtain a permit as Owner-Builder and wish to hire Contractors, you will be responsible
for verifying whether or not those Contractors are properly licensed and the status of their workers'
compensation insurance coverage.
Before a building permit can be issued, this form must be completed and signed by the property owner
and returned to the agency responsible for issuing the permit. Note: A copy of the property owner's
driver's license, form notarizationJ-,or other verifi ation acceptable to the agency is required to be
presented when the permit Ji'/��/ sj��]�� to ver y ihe r perty owner's signature. %
Sirtnahrre-nf'nrnnactv-nwner-\..V2R�'��.ILW l !\ �I�a2e__ �.1�10// -lv
Note: The following Authorization Form is required to be completed by the property owne� only when
designating an agent of the property owner to apply for a construction permit for the Owner-Builder.
AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER'S BEHALF
Excluding the Notice to Property Owner, the execution of which I understand is my personal responsibility, I
hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents
necessary to obtain an Owner-Builder Permit for my project.
Scope of Construction Project (or Description of Work):
Project Location or Address:
Name of Authorized Agent:
Address of Authorized Agent:
Tel No
I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled
out the above information and certify its accuracy. Note: A copy of the owner's driver's license, form
notarization, or other verification acceptable to the agency is required to be presented when the permit is issued
to verify the property owner's signature.
Property Owner's Signature:
Date:
3148-30 CALBO Jan 1, 2009 OB Packet template 2 Of 2
a
� ' CITY OF COSTA MESA � /� '
B!/ILDING D/VISION
77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • ewHv.ci.costa-mesa.ca.us
FOR INSPECTIONS CALL: (714) 754•5626
PERMIT TYpE B_ROOF2
APN: 42613103
JOB ADDRESS: 2114 ELDEN AV CM
Vicinity: HOUSE 8 ATTACHED GARAGE
Squares: 0 •
PERMIT NUMBER: BOS-00307
STATUS:
DATE ISSUED:
ISSUED BY:
Suite/Unit:
Valuation:
ISSUED
10/30/2008
YH
$4,850.00
SCOPE OF WORK: REROOF HOUSE & ATTACHED GARAGE: TEAR OFF EXISTING GR.4VEL ROOF, REPAIR SHTG. AS NEEDED,
INSTALL 2 LAYERS OF 15# FELT, & APPROX. '17 SQR'S OF ASPHALT SHINGLES ON LESS THAN 4:'12 PI7CH
ROOF.
OWNER: SEVERINO,JOHN
PHONE: 949 697�330
APPLICANT: SEVERINO, JOHN .� �
PHONE: 949 697-4330
CONTRAC74R:
Address: Unit:
City/State2ip:
ARCHITECT: �- . -. '
ENGINEER: �
FEE SUMMARY
Reroof Plan Check: $0.00
Reroof Permit Fee: $11125
Reinspection Fee: $0.00
TOTALFEES
$111.25
Address: 2114 EIDEN AVE
City/State/Zip: COSTA MESA, CA
Address: 2114 ELDEN AVE ' '
City/State/Zip: COSTA MESA, CA
License No.
License No.
PHONE:
Unit:
UniC ';45�� I
License No.
CELL:
PHONE:
PHONE:
. ,:=e.
NOTICE: The work authonzed by this permit shall comply with all applfcable handicap access requirements under California slatutes and related
regulalions. (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 (or the work authorized under this permit to be considered le9al, 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 resull in the expiration of this permit.
4pDEt. INSPECTONTYPE � RL UEt INSPEC710NTYPE � � QLi�F � IN7I71�L
1816 Fixed System Final Fire Prevention 206 Final Mechanical �
1288 Pool Spa Final � �� /j \ 208 Final Plumbing
20o Final Re.Roof i 1"5-0l; �rr (vtam ! o�J 270 Final Electrical
201 Final Block/Retaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Approval
203 FinalSign 222 FinalSite
204 Final D¢mplition 250 Final Building/Occupancy �
WORKERS' COMPEWSATICy DECLARATION� � .
I hereby affirm under penalty of perjury one of ihe following declaretions: ,
❑ I have and will maintain a certificate of consent to self-Insure for vrorkers'
compensation, as provided for by section 3700 ot the Labor Code, for the
peAortnance of the work for which this permit is issued.
❑ I have and will maintain v.orkers compensation insurance, as required 6y
section 3700 of the Labor Cotle, for the peAortnance of ttre v.ork for which this
permit is issued. My vrorkers' compensation Insurance wrtier and policy
number are:
Carrier:
(This seqion need ipl �e cpnple(etl alhe p�vm4 is valuM at are hiaM�M �Yars (f 1 W) a IessJ
Policy Numbec
❑ I certify that in lhe peAormance of Ihe work for which this permit is
issued, I shall not employ any person in any manner so as to become subjecl
to the workers' compensation laws of California, and agree that if I should
become subjecl to the vrorkers' compensalion provisions of Seclion 3700 0/
the Labor CoOe, I shall forthwith comply with these provisions.
AOW����'s Signalure Dale
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 DOILP,RS
($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 aPorm that I am Iicense0 under provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Code, and
my license is in tull force antl effect.
Lic. # Class #
Conlratlors Signalure Dale
CONSTRUCTION LENDING AGENCY:
❑ I hereby affum that there is a constmctbn lentling agency fa the
peAortnance o( ihe v.ork ta wfiich this pertnit is issued. (Sea 3097, Civil Code).
Lender's Name:
Lender's Address:
Date
OWNER-BUILDER DECLARATIONS:
I hereby aKrm that under penalty of perjury t�at I am EXEMPT FROM 7HE
CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business and Professions Code: Any city or county which requires a permit ro
construct, alter, improve, demolish, or repair any slrutNre, pnor lo its
i55uance, also requires the applicant for such permit to fle a signed statement
that he or she is licensetl pursuant to the provisions ot the Contrectors
License Law (Chapter 9(commencing wilh Section 7000) o( Division 3 of the
Business and Pro(e55ions Code) or that he or she is exempt lhereGom and
the Dasis for lhe alleged exemption. My violalion o( Section 7037.5 by any
applicant for a permit subjects ihe applicant to a civil penalty ol not more �han
fve hundred tlollars ($500).):
� I, as owner of the property, or my employees vrith wages as their sole
compensation, WILL DO THE WORK, antl Ihe structure is not intended or
offeretl for sale (Sec. 7044, Business and Professions Code: The CoNractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such wnrk himself or herself or through his or her own
employees, provided that such improvements are not intended or offered for
sale. If, however, the builtling or improvement is sold,within one year of
completion, the owner-huiltler vnll have the burden ofpmving that he or she
did not build or improve for purpose of sale.). .
❑ I, as owner of the property. am EXCLUSIVELY CONTRACTING WI7H
LICENSED CONTRAC70RS to consWct the project (Sec. 7044, Business and
Pmfessbns Code: The contraclors License Law dces no[ apply to an owrier of
property vfio builds or improves ihereon, and who contracts (or such pmject with
a cont2ctor(s) license pursuant to Ihe Contractws License Laws.).
❑ I am exempt under sec.
Business and Professions Code for this reason:
���� ` lD/3v�o�
Signature Date
30 J6 0])
Ovmer ID verified by tlri�! ..cense. f� Yes ❑ No�
Oriver'sLicenseNo. � % Expires: YZ'�'IO
Verifcation of Ownership by (type of document, i.e. - property tax bill or tleetl�:
DIVISION OF INDUSTRIAL SAFEIY PERMIT CERTIFICATION:
❑ I hereby certify that no excavation frve (5) or more feet in dept� into wfiich a
person is required to descend, will be matle in connection with work authorized
by this permit, and that no building sWcture, scaHdtling, falsework, v demdition
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 32, Grp
2, Art 2, Sea 341, Title 8, Cali(omia Administrative Code�.
❑ As owner-6uilder, I will not employ anyone to tlo work whic� would
require a permit from �he Division o! Industrial Sa(ety, as noled above, unless
5uch person has a permit to tlo such work from ihe division.
Applicanl's Signatore Date
Division of Induslrial Safety Permit Number.
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
1. Will Ihe applicant or present or fuNre building occupant nee0 to fle and
certify a Business Plan for emergency response to release or threatened
release of a hazardous material? ❑ Yes ❑ No
(Section 25505 of the Calitornia Health and Safery Code requires, with some
exceplions, that a Business Plan be filed with the Costa Mesa Fire
Department by every business which has at any one lime during a reportetl
year a quantiry of hazardous matenals equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas
at standartl temperature and pressure).
2. Does or will the applicant or presenl or fuWre building occupant need to file
a registration form for acu[ely hazartlous materials? ❑ Yes ❑ No
(Seclion 25533 of the California Healih and Safety Code, with some
exceptions, requires registration with the Costa Mesa Fire Department by
each business which at any one lime has on hand a quantity of acu�ely
hazardous mafenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stan0ard
temperature and pressure).
3. Does or vnll the appliwnt or present or (uture building occupant need to
prepare an RMPP (Risk Managemenl and Prevention Program for awtely
hazardous matenals)? ❑ Yes ❑ No
(Seclion 25534 of the Califomia Health antl Safety Code provides that the
Costa Mesa Fire Department may require Ihe preparation, certification and
filing with the Fire Department of an RMPP by businesses whic� are requiretl
to regis�er acutely hazardous matenals with the Fire Department.
4. If an RMPP is presently requireQ has Section 25534 of the Califomia
Health antl Safety Code been fully complietl vrith? ❑ Yes ❑ No
5. Does or will the applicant or present or fuWre building occuDam require for
Ihe vrork which is lhe subjec[ o( Ihis applica�ion a pefmi� (or Such conStmCiion
or modification from the Soum Coast Air Oualiry Management DisMci or from
any other air pollution control disMcl or agency? ❑ Yes ❑ No
(Section 65850.2 of Ihe Califomia Govemment Code requires that the requested
in(ormation be fumishetl on applications for non-resitlential building permits).
6. Will any part of the facility to be constructed under lhis permit be within
1000 leel from the outer boundaries o( a school? � Yes ❑ No
(If "yes", the facility must meel the requiremenl of Sections 25534 and 42303
of the Califomia Health and Safery Code).
7. If a permit from the South Coast Air Quality Management District or other
air polNtion contml district or agency is required for Ihe vrork which is the
subject of Ihis application, have all of the disclosures prescribed by Califomia
Health and Safely Code Section 42303 been made? ❑ Yes ❑ No
8. Qf'yes", attach certifcate of compliance from the appropriate air polWtion
control oKcer). ° � � '
CERTIFICATE OF� COMPLIANCE: 1"certify that under penalty of perjury the
information given above is correcL I agree lo wmply wit� all state laws and
ciry.ortlinances regarding Hazardous Materials and Emissions. ,�
Signalure
CERTIFICATE OF COMPLIANCE AND'AUTHORIZATION OF ENTRY: I
certify under penalty of perjury that I have read lhis application and stale thal
the infortnation given is correcl I agree to comply vn[h all state laws and ciry
ordinances relaling to building construction, and authonze representatives of
the Ciry of Costa Mesa to enter upon Ihe above-descriDed pmperty tor
inspection purposes. I agree not to occupy or allow occupancy of any building
authorized b th�s permit until fnal inspec[ion.
� ' (D�SD�oB
g a ofle9ai0vmeqs) Date
AnOlorAut�arizeEApplicant Dale
. �
: ;
CITY OF COSTA MESA
B!/ILDING DNISION
� � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • w.wv.ci.costa-mesa.ca.us
��n. FOR INSPEC7IONS CAtL; (714) 754-5626
`+�c�m�
PERMIT NUMBER. E08-00354
PERMIT TYPE ELEC
ApN: 42613103
JOB ADDRESS: 2114 ELDEN AV CM."
Viciniry:
SCOPE OF WORK: REINSTALL 200�AMP. METER �- SAME LOCATION.
STATUS:
DATE ISSUED:
ISSUED BY:
SuitelUnif: �
ISSUED
09I05/2008
YH
O NER: SEVERINO, JOHN �- .. �Address: 21.14 ELDEN AVE Unit: -
PHONE: 949697-4330'� :. � ,City/State/Zip: � COSTAMESA...CA "
APPLICANT: SEVERINO, JOHN " � � � - � � - Address: � 2114 ELDEN AVE :Unit: -- � � �
PHONE: 949 697-4330 � �� � City/State/zZip: COSTA MESA, CA . �
CONTRACTOR: _ , License No.
Aqdress: UniC �"� ' ` � ' - PHONE: � � �� � - � - � .
City/Stale: - � _ � ZipCode: � - - - - . CELL: ` _ -�
ELECTRICAL PERMIT FEES -
Electricai Plan Check Fee'
Electrical Permit Fee:
Reinspection Fee
TOTAL FEES
$0.00
$54.00
$0.00 -
' $54.00 '
NOTICE: The work authonzed by lhis permit shall wmply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1. 12-21-92) �
EXPIRATION: PERMIT EXPIRES 780 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 lo oblain inspections and Tinaf approval will result in the expiration of this permit.
ER INSVEC110NTYPE � INIITIRL cooef INSPECTIONTYPE UATE INTITIpLS
1616 Fixed System Final Fire Prevention 206 Final Mechanical
1266 Pool Spa Final 208 Final Plumbing
200 Final Re-Roof 270 Final Electncal P/R- 9/�� 1'FQ��
Z01 Final BIocWRetaining Wall 212 Final Fire Prevention
202 Final Factory Fire Place 220 Final Planning Appmval
203 Final Sign 222 Final Site
204 Final Demolition 250 Final Building/Occupancy
WORKERS' COMPEN5ATION OECLARAT10Nr
I hereby affirm under penalty of perjury one of the followin9 deGarations:
❑ I have antl will maintain a certifcate of consent to self-Insure for vrorkers'
compensation, as providetl for by section 3700 of the Labor Cotle, for Ihe
peAormance of the vroiN for which this permit is issued. �
❑ I have and will maintain v.orkers' compensation insurance; as requiretl by
section 3700 0( Ihe LabOr Cotle, (or the peRormance of [he wnrk (or which this
permit is issued. My workers' compensation Insurance carrier and policy
number are:
Carrier
(This secTion need no( 6e wmplefed A(be peimrt 8 valuetl al are huntlretl dollars (Sf00J or less )
Policy Number:
❑ I certify Ihat in the paAortnance ot the vrork for which this pertnit is
issued, I shall not employ any person in any manner so as to become subject
to the workers' compensation laws of Calitomia, and a9ree that if I should
become subject to Ihe workers' compensation provisions of Section 3700 of
the Labor Code, I shall forthwith comply with [hese provisions.
Appliwnfs 90�aWre Date
WARNING: FAILURE TO SECURE WORKER5 COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED iHOUSAND DOLLARS
($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SEGTION 3706 OF THE IABOR CODE, IMEREST, AND
ATTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby affrm Ihat I am licensed under provisions of Chapter 9(commencing
wilh Section 7000) of Division 3 of Ihe Business and Professions Code, antl
my license is in full force an0 e%ect.
Lic. # Class #
Contrsctor's Signalure Date
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirtn that there is a constructbn lending agency for the
per(ormance o( Ihe v.ork (a wfiich lhis permil's issued. (Sec. 3097, Civil Code).
Lender's Nama:
Lenders Adtlress:
Signal4re Dale
OWNER-BUILDER DECLARATIONS:
I hereby affirtn Ihat unde� penalty of peryury that I am EXEMPT FROM THE
CONTRACTORS LICENSE LAW for Ihe follovnng reason (Sec. 7037.5.
Business and Professions Code: Any city or wunty which requires a permil to
construct, altai, improve, demolish, or repair any slrucWre, prior to iis
issuance, also requires the applicant for such pertnit ro file a signetl statement
that he or she is licensed pursuant to the provisions of Ihe Contractors
License Law (Chapter 9(commencing wiN Section 7000) ot DiviSion 3 0( Ihe
Business and Professioqs Code) or that he or she is exempt �here(rom and
the basis tor the alleged exemplion. Any violation of Section 7031.5 by any
applicant f�a permit subjects the applicaM [o a civil penalry of not more ihan
five h red dollars �$500).):
I, as owner ot lhe propeAy, or my empbyees with wages as iheir sole
ompensation, WILL DO THE WORK, antl the structure is not intended or
oHered for sale (Sec. 70b4, Business antl Professions Code: The Contractors
License Law does not apply to an owner of property who builds or improves
thereon, and who does such work himself or hersel( or through his or her ovm
employees, provided that such improvements are not inlended or oKered for
sale. If, however, ihe builCing or impmvement is sold within one year of
completion, the ovmerbuilder will have the burtlen of proving [hat he or she
did not build or improve for purpose of sale.�. .
❑ I, as owner of lhe property, am EXCLUSIVELY CONTRACTING WITH
LICENSED CONTRACTORS lo construct the project (Sec. 7044. Business antl
Professions Code: The co�[ractors License Law dces not appty to an ovmer of
property who.builds or improves thereon, and who contracts (or such projecl with
a co�tractor(s) license pursuani to the Contraciors l icense Laws.).
❑ I am exempt under sec.
Business and Professions Code for Ihis reason:
� � 9/�/�8
Signa u�e � Date
JOS 6 (10 )
/
Owner ID verified by tlme. ...ense. ❑ Ves ❑ No
Driver'sLicenseNo. � % Expires: �Z'Z(o-10
Veri(calion o! Ownership by (type of document, i.e. - property taz bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certdy Ihat no eacavation frve (5) or more (eet in tlepth into wfiich a
person is required to descend, will be made in connection with vrork authonzetl
by this permd, and 1ha1 no building structure, scaffdding, iatse�wrk, a demolifwn
or dismantling thereof, will be more than thirty-six (36) feet high. (Chap. 3.2, Gry
2, !vt 2. Sec. 341, Title B, Califomia Administralive Code�.
❑ As owner-builder, I will not employ anyone to do work which would
require a pertnit lrom the Division of Industnal Safety, as noted above. unless
such person has a permit to tlo such work /rom the division.
Appli W nfs SignaW�e
Division of Industrial Safety Permit Numbec _
HAZARDOUS MATERIAIS AND EMISSIONS CERTIFICATION:
1. Will the applicant or present or future building occupant need to file and
certify a Business Plan for emergency response to release or threalened
release of a hazardous matenal? ❑ Yes ❑ No
(Seclion 25505 0( the California Health and SafeTy Code requires, wilh some
exceptions, Ihat a Business Plan be (led with the Cosla Mesa Fire
Departmenl by every business which has at any one time tlunng a reported
year a quantity of hazaraous materials equal lo or greater than a weight o(
500 pounds, or a volume of 55 gallons, or 200 cubic Feet of compressed gas
at stantlartl temperature and pressure).
2. Does or will Ihe applicant or present or fuWre building occupant neetl to fle
a registration lorm for aculely hazardous materials? ❑ Yes ❑ No
(Seclion 25533 of the Califomia Health antl Safety Cotle. with some
exceptions, requires registration with the Cosla Mesa Fire �epartmem by
each business which al any one time has on hand a quan(ity ot acutely
hazardous matenals equal to or greater than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet o! compressed gas at standartl
temperature and pressure).
3. Does or will Ihe applicaN or present or future building occupanl neetl to
prepare an RMPP (Risk Management and Prevention Program for acutely
hazardous materials�? ❑ Yes ❑ No
(Section 25534 of the Califomia Health and Safety Code provitles that the
Costa Mesa Fire Depariment may require lhe preparation, certifcalion and
(ling with the Fire Department o( an RMPP by businesses which are required
to register acutely hazardous materials with the Fire Department.
4. If an RMPP is presently requireQ has Section 25534 of the Califomia
Heal[h and Safety Code been fully complied with? ❑ Yes ❑ No
5. Does or will the applicant or present or future building occupam require for
Ihe vrork which is ihe subject Of thi5 application a permit fof SUGh conSWGliOn
or modification fmm Ihe South Coast Air �ualiry Managemenl DisMct or from
any other air pollulion control distnct or agency? ❑ Yes ❑ No
(Section 65850.2 of the Califomia Govemment Code requires that the requesled
infortnalion be (umished on applications fa rwn-residential building permits).
6. Will any part of the faciliry to be construcled untler this permit be within
1000 feel from the outer boundanes of a school? ❑ Yes ❑ No
(If'yes", lhe facility must meet Ihe requirement of Sections 25534 antl 42303
of the Cali(omia Health antl Safery Code).
7. If a permit from the South Coast Air Qualily Management District or other
air pollution control distnct or agency is required for the vrork which is the
subjecl ot this application, have all of the disclosures prescnbed by California
Health and Safety Code Section 42303 been made? ❑ Yes � No
8. Q('yes", attach certificate ot compliance from the appropriale air pollution
control oKcer�. ' � � �
CERTIFICATE OF COMPLIANCE: I certifythat underpenalty�of peryury the
infortnalion given above is correcL 1 agree to comply wit� all state laws and
. city ordinances regaNinq Hazardous Materials and Emissions. �;_ �
Signamre
CERTIFICATE OF COMPLIANCE AND 'AUTHORIZATION OF ENTRY: I
cenify under penalry of perjury that I have read this application and state that
ihe inlormation given is correct. I agree ro comply with all stale laws and city
oreinances relating to building construction, and authorize representatives of
the City of Costa Mesa to enter upon the above-tlescribed pmperty for
inspection purposes. I agree not to occupy or allow occupancy of any builtling
authoriz th's pertnil until Mal inspection. -.- ��5/�
5 aWreol egalOwneqs) Dale
AnC/orAul�onzeC AppliWnl Dale
�
(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa€��TRICAL PERMIT T/ FAIR DFIVE, COSTA MESA, CA 92626
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
Applicant:
Address:
2114 ELDEN AV
42613103
SILLAPA, SELENE
2114 EDEN AVE
COSTA MESA, CA
Ownec SILLAPA, SELENE ,
Address 2114 ELDEN AVE �
Contractor:
Address:
ISSUE FEE
Temp service tesl
Res. alc package
New Res (1-2 units)
New Res (3+units)
Pool / Spa
Lighting Fi#s
Recept Outlets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors to 1 hp
Motors to 10hp
Motors to �SOhp
Motors to 100hp
Motors over 100hp
Communication drop
Sub panel to 200a� �
Pole Light Pkg
Sign Circuits
Temp Pwr Pole
Intermed Pole
�COSTA ME&A, CA .
OWNER-BUILDER
Phone: 714-454-6707
Zip 92627
Phone: 714-454-6707 �
Zip: 92627
Phone:
Zip:
License: 000000
SCOPE OF PERMIT
UPGRADE SERVICE PANEL TO 200A FOR A SFD.
s
�
\
$23.50
$0.00
50.00
$0.00
so.00
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$30.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00.
$0.00.`
$0.00
$0.00
$0.00
80.00
$0.00�
$0.00
Quantity
0
0
0
0
.0
0
0
0
1
0
0
0
0
o.
0
0
`0
',0
0
0
�': p ,
0
FEE SUMMARY
Temp Dist Syslem I Lighting
Busway I100 N
Standing Section
Misc Electriwl Equipment
Transformers up to 1 kva/kw
................up to 10 kva/kw
.................up to 50 kva/kw
.................up to 100 kva/kw
.................:over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misa Conduil
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Chrislmas Tree Stand
Fireworks Stand '
Other Eledrical Fee
Invesligation Fee
Plan Check Fee
Reinspection Fee
Stams: ISSUED
Applied: 10/04/2006
Issued: 10/OS/2006
ISSUED B .
Quanlity
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0
$O.QO 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
50.00
$0.00
$0.00
TOTAL CALCULATED FEES §54.00
'� �\ COMMENTS FSPECIAL CONDITIONS
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if woAc is suspended or abandoned
for a period of 1 BO days.
INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inspeetlons end final approval must be obtained. Failure to obtaln inspections and final approval will result in the expiration of this permit.
FOA INSPECTIONS CALL: (714) 7545626
ri..y.:.(�j:L'
WORKERS' COMPENSATION DECLARATION: .,
I hereDy eNlrm untler penelry ot per�ury one of Ihe tollowing tlecleretions:
❑ I have and wlll'maintein e certiflcete of consent ta selt-Insure for warkers' compensetlon, es proNAetl for by sectlan 3700 of the Lebor Cotle, for ihe peAormence af ihe
work for w�ic� Ihls pertnit is Issuetl.
❑ I �ave entl wlll maintain workers' campensallon insurence, es required by secUon 3700 af the Lelwr Code, tor Ne pertortnence of Ne wwk for which Mis partnit is issued.
My warkers' compansation Insurance carrier end poliq number ere:
Certi�r� Policy Number:
vslued et one
orless.)
� I.cerliy that in th e rtnance ork lor which t�is permit is issue4 I shall not employ any person in eny manner so as to become su6ject to Ihe workars'
compensetlon la s litorn' ,`an gree Ihet il I shoultl become sub�ect to Ihe wolkere' compansatlon provisions of SecNon 3700 of the labor Cotla, I shall forthwlth
camplywith thes s � r/�� ��
Applicant Signeture:— " . Date:
WARINN(3� fAILURE TO S R WOiiK ' COMPENSAT1dJ CpVERAGE IS UNLAWFUL AND SHALL SUBJECi AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO IXJE HUNDRED
THOUSAND OOLURE (5100,000). IN ADDITION TO TME COST OF COMPENSATION, DAMAGES AS PROVIDED WR IN SEGTION 31O60F THE UBOR ODOE. INTEREST, AND ATTORNE`fS FEES.
LICENSED CONTRACTORS DECLARATION:
I heraby eMirtn Ihet I em licensed under provisions oi Chapter 9(commencing with Section 7000) of �Ivision 3 ot the Business end Professions Cade, and my license is in full
foice antl elfect. Lic. # Class x
Contrectors SigneWre: Date:
CONSTRUCTION LENDING AGENCY:
� I �ereby aNirtn that there is a cons�ructlon lending egency for the performance of !he work tor which this permit is issued. (Sec. 3097, Civil Code).
Lender's Name: Lender's AAdress:
Signature: Date:
OWNER-BUILDER DECLAflAT10NS:
I hereby ettirm thet untler penalry oi perjury Ihat I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which requires e permit to construct, alter, improve, demolish, or repair any structure, prior to its issuenca, elso requires the applicant tor such permit
to lile e siqned stetement thet he or she is Iicensed pursuent ro the provislons ot the Conirectors License Law (Chapter 9(wmmendng with Seclion 7000) of DiWsion 3 of the
Business end Proleuions Code) or that he or she is e:empt Iherefrom and the basis for Ihe alleged exemption. Any violetion oi Section 7031.5 by any appliwnt for a pertnit
subJects the epplicant to a civil penalry c� not more then five hundred dollars ($500).):
❑ I, es owner oi Ihe property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, and the structure Is not Intended or aHeretl tor sele (Sec.
7044, Business and Professions Cotle: Tha Contractors License Law does not epply to an owner of property who bullds or Improves thereon, and who does such work
himself or harself or through his or her own employees, pmvided Ihat such improvements ere not intended or oHeretl for sele. If, howaver, the 6uilding or improvement is
s Id within one year of compietion, ihe owner-builde� wi�l have ihe 6urtlen of proving Ihat he or she ditl not build or improve for purpose of sale.).
/I, a9 owner of the properry, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construcl the prolecl (Sec. 7044, Business and Professions
� Cotle: The comractors License Lew tloes not epply ro en owner ot property who builtls or Improves thereon, end who contrecis lor such projec� wi�h e contractor(s)
license pursuent to �he Conirac�ors License Lews.).
❑ I am exempt under sea Business antl Professions Coda for this reason:
antietl Dy tlrivers license. �Ves ❑ No
of Ownership by (rype of tlocument i.e. - property taz bill
DIVISION OF INDUSTRIAL SAFETV PEHMIT CERTIFICATION:
� I he�eby certity ihat no azcavetion tive (5) or more feet in depth into which e person is required ro tlescend, will be meda in connection wlth work amhorizetl by this
permit, and Ihat no builtling siructure, swflolding, lalsework, or demolilion or dismantling t�ereol, will be more than thiny-six (38) faet high. (C�ap. 32, Grp 2, Ari 2, Sec.
341, Title e, Celifamia Administrative Cotle).
0 As owner-builder, I will nol emplay enyone to do work w�ich woultl require e permit irom ihe Division of Intlustrlel Sefety, es noted ebove, unless such person hes e
permit �o tlo such work irom the division.
Signeture: Date:
Division of Industrial Safery Permit Num�er:
CEHTIFlCATE OF COMPLIANCE AND AllTHORPJITON OF EHiAY: I certity under penalry of perjury that I have reatl t�is appliw�ion anA siate that ihe intortnaiion given is
cor���eeeqqq��� I egree co p wilh all state laws end ciry ordlnences relating to building consiruction, and suthonza representelives of t�e Ciry ot Casta Mesa lo enter upon Ihe
eb�pfffnqe r� for inspection purposes. I agree not to occupy or allow occupancy of eny building authorized �� i�i�ntil final inspection.
�1 �161 U �.�
�Sign_NreOl.Legal�Owner(s)� Date--�-'�• �,
And/OrAuthodzed Applicant Date
COOE /, �HsrecnoNnre
1616 Fixed System Final Fire Prevention
1266 PoolSpe Final
200 Final Re-Roof
201 Final BIocWRetaining wall
202 Final Factory Fire Place
203 Flnel Sign
206 Final Demalition
o�re f�j$ �1 INSVECTIONTYPE
206 Final Mechanical
20B Final Plumbing
210 Final Elactricel
212 Final Pire PrevenUon
220 � Final Planning Approval
222 Final Site
250 Final BuildingiOccupancy
P�IE 1t�L@
�op�����p� 211q ELDEN AV
axr+exsruMeic�+: WILLIAM ADAM
�ooxrss 2114 ELDEN AV
UNT:
COSTA MESA, CA 92626
�rri.. Yuw�c �ooxFss:
�xcxrtEcr on �an�x: uc. ra.:
W1CN.OX FNO.'S /�DDAESS: UNf:
caim�crars� BEACH ELECTRIC ( 714 ) 722-1906
caxm�croxs wu�wc 1 51 21 S T S T
�ooxEss COSTA MESA CA ucr+o: 512277
92627 urar: 0009
LICENSED COMNACTOHS OECUF�TION: I Mreby ert'vm uMx panWy W pe�jury thm I em licaneed uMer povuiwis d CMqer e
(ewnmeriviq �mA Section ]000) d Gvision J d the &iaress eM Grdeseunv Coda, eM�� n in full�«� eM Ww.
cpfiTa.no.:043056 uacuss: C 10 uc.No;q�„1:/1�� F�YY; 1�/97
NE BUILOfR DECUPATION: I he�aby elF�m u�Mm peneXy aTparjury the� I em aeempt Irom Ihe Conirepon Lieensa lew la the
I o' reeaon (Safion )0.'11.5 &xiiwss eM Prda�me Code: RM clY a munry wfiiN re9uiree e P�� lo mrotrun. eller. "unMare.
h, « repei eny sVuciure, pv lo ib oweMe, ebo requi�ea Ihe epplicent ta euch permn to fib e sipned ebtemaM tldt M a aM
licenaed purauent lo iM proviaiana d IM Comredas Liceme Lew �Cheqer 9(comme�ip wnh Seaon 10W) d DNebn 3 0l lha
,usinea eM Prdmaiore Code� a ihet he a Me ia e.�emq Ihaehom eM �he beeie lor Ne elbged uemqion. My videlon d Seaion
1031.5 Ey eny epplirent la e pemfi eubpUa �M ePd�� �o e mnl paralry W nd mare ihen iva huMrtd ddlen �5500�).
� I, m owrer d tM propeMy or my ampiqaee wh wepea ae �he'r sole mmpemetion, will Eo tln vrork, end Ne am�cture o iat imeMeE
or ollered M ub (Section ]00<. Busneav eM PMessiansCoda: Tha Conlredae licema Lew dma �at eppyto en ovmxol proparry
wno wu. «:nra� in«eo�..�,d wno aom a�n �x nmeen «ne�ser «wouon ne «ne, e�„ amWow�, w� �nm vucn
impwameme ere nol iMended a dle'ed f« eab. X. however. �M Wikiip a inpiv.emem is edd wuhm ww Y� d oompblion. Ne
owner-buiMm xi0 heve Ihe buMen N provi�p M or nha diE nm build or impeow fw tM purywe d eala�.
❑ I. m axrar d IM pWaM. em mtluvwN mmrean9 wilh IioenseJ wntreclas b cmmutl Me pM� (Setlion ]OU. Bua'vaes aM
Pmlasuone Gode: The Contreuae lieeeue law does iwl epqy lo en ow*wr d popeny Mw Wika or vnpwm Ihereon ud x1w
<onvecta /a wch prol�s � e oonireclor�e) licenaed punuen� lo IM Comredors Licenee Lew�.
� I em mamq uMar SxM'wn: , B. 8 P.G., la thu reawn:
�elti
Dete: d+.*e�:
I Eo haeby eenily thet I em eware d eed uMe�aia�d Ne rWuiremure d Celianalbellh end Selay Cade Seaims?5505.255�3. enE
255J0. eM Mel I a enY �ure WiIEinO �Pa^t will / wil irol (d�cb me) � to cwnply w�h eek pete mdea vd iM iepuimnenb 1«
epami0lwmruvuctionamadifiWionhomlheA'r e�y enepamenlDistnd.RaeiEanlielcaneVutlonappiratiomeraexemqlmm�haae
povitiona.
Deta: AVO����
WOFKEH'S COMPENSATION DKLARATION: I hereby dfim� uMx psW�y d perjivy aw d Na blbwiip Eeclarelbm:
� IheveeMwilmeinteneeeniliutedmmemloeell-inwml«xpken'wmpenWion.mpewideEtorbySeCim9100aI1heLeba
COEe, lw the pa�lormerce o/1M xark lor wlJch Ihia perm� ie ivued.
❑ � nev. d,a w� meiin.n w�Mu.• oon,omemon Irourerce. e� ma�'u.e M'seaion mo a ma l.m, cad.. ro, ine ro�ormenm d �he
wpk Iw xhiM ihis peimn ie mued. MY wa�n' �^Ge^�a^ imurenea faeebr enJ pdiry numCar are:
Ce�nx:
vd:.y N�mna:
;s s.crion neee mr ne romdu.e r Me v�•;, ro. are Mmered ea�em (S�ool w bss.l
I cMty iha in Na pMormerwe d the wak fa which ihia permn ia ivued. I ahdl no � lay eny pa�aon in en enner ao m
become eubjed la IM xorkere' compenvetion lexs d CaNanie. eM ee Ne� d I e N bacame w �j lo IM '
� compenemwn 0 eans d on 3100 W tha lebor Cada. I slWl lonl m 1� piovcioru. �
Applranl:
minp: F� n werten'rnmp�n�atlen rov�rp� l� I, anG�hsll �ub/eee en employw ro eNMml pmuMu siM
clvl/ flM� up ro aw hurOretl fMuuM ANbr� (S10q000A In elCltlon ro Ms cwf ol rompmnfbR tlemspu u povMW br In
S�ctlan J](I6 0/ fh� la6or CaM, /nfxuf, inJ attom�y'� Iwi.
CONSTNIlC710N LENDINO RGENCY: I Mraby eifiim unAer penelry d par'ryry thel �Mre u e oonst�udan IeMiiq eganry Iw the
paAarmenca W Ihe woA ip wfiidi �M1a peimL ie asued (�� �). CN. CI.
LENDER'S N�IIE:
LENDEWS ��DNESS:
I caniy ihet I heve reaE Nu eVdicatan ud meie Ihet Ne ebwe iMametian e conea. l�rae to comPN wkh all �Y aM oouM' adinencea
eM slab lewa nimiq to buildip mnstrudion vd haraEy eu1Mr¢e repraeeniativea d Ihis dly io antar upon �M ebove�mantioneE popxry
�°`�°'P°"�o°v°`D°�s S'fEVE DOMPROWSKT _
oda:
Whne-Buikiq 8 Sdey: G�eemFb: Cenery-RppFent: Pink-Revenue; Cbkenro�Mavsmr
CITY OF COSTA MESA - BUILDING PERMIT
PERMIT NO: E 082913 PLAN CHECK N0: N
CONSTRUCTION TYPE: I PERMIT TYPE: ELE
JOB DESCRIPTION ; 56 LIN FT BLOCK PILASTERS/WROUGHT IRON
CLAIM VALUE:
CALC-VALUE:
PERM NO: E 08291
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT;
GROUP OCC; R-3 /
COMMENTS: FOE ELECTRIC GATE REF:B-82849
**iE****at*�*****+�+�**�atetit****x*�it*it**+��*at�itit*iFjt*ff**xit***itat��**�*it*it�r�if�r+�at�tit*�e+�it�r�
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: 42613103 ZNE: REF NO:
PLANNING NdTES>
% �
If k 1E 1E iE IE 1E 1E iF 1E ff �E 3E ff if iE if iE iE 1E iE iE iElE 1E jE IE �E 1E 3E iE iE 1E iElE IE IE fElE 1E fF IE fE 1E 1E �E 1E iE IE k!E 1E iE 1E iE iE iE 1ElE 1E IE iE 1E if 1E 1Elf 1E 1E 1E iE iE iE �E 1F If IE iElE
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:
BUILDING APPROVED BY : `� DATE:
APPLICATION ISSUED BY: � DATE: � �l, S�
fElklkiflElF�FiEiEfFiF1EiE1EiE1E1E�F3E�Efk1E iEiFiEiEikiFif1E1E1F iliE
LEGALIZATION:N F�E E� S U M.M. R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTR'IC, MECHANIC FIRE SMIP/RES GRADING
PERMIT 20:50-, -
S,OR� . � SMIP/NON-RES
PLAN i' � . C'-� , _ t'
ISSUE FEE 22,00-� '
BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK :, TOTAL PAID/ DUE
TOTALS----> 20.50 22.00 0-,00 = 42.50 42.50 ,00
REVENUE DIVISION TOTALS--> COI;LECTED:-, � 42.50 OVER/SHORT / .00
BLDG PMT PLUMBING ELECTRIC MECAANIC FIRE SMIP/TOT GRADING PLAN-CHECK
42.50 .. ...i -
iblf iE iE iE 1E fE iE 1F �E iE iE iE k iE iE 3E 3E if fE 3E if ik iE iE aE iE iE iE if 1E iE iE IE 1E jE iE:iE if iE 1E iE IE iE 1E iE 1E iE k 9E iF 1E iE �E iF it ik jt iE IE iE iE it 1E iE IE aE 3E iE iE IE iE iE iE if iE iF iE IE
I N D I V I D U A li�� F�E E�: B R E A K D O W N
n ; .
TYPE QTY D E S C R I P T I O�N'�� =" UNIT COST TOTAL COST
r,
ELE 1 MOTOR/POWR APPARATpS� �0,'0•- 9.0 HP 4.25 4,25
EL�E 1 MISC CONDUIT NOT%!LIST,ED REQ PERMIT 16.25 16.25
'.END ; OF� FEES;
1 V
�, ~ � / .. / 1� ...e-C '�".. n� .
� ' :,J. i
� - " ,� -, f�1AY 141997 �
,. �'
�ITY Qi eioaa:N �a�
CONSTRUCTION AND PLANNING . PQ01 'PA
APPRQVALS Permit # � Date laspec2or APPROVALS Permit # Date inspector
i. 7emporary Electfical Service or Pdle 52. Pool & Equipmen[ Location �
2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement .,
3. Electrical Conduit Utility-Undrgrnd. �J 54. Forms � :
4. Electricai Conduit-Undrgrnd. �`���y��55. Electrical Bonding
V - .
� 5: Steel Feinforcement � � 56. Rough Plum4ing & Pressure Test
.6. Electrical UFER Gmd. . , 57. APPROVAL TO COVER-GUNITE " I
7. footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � 59. Gas Pipe, O Undrqrnd., TQst
r.
9. Water Pipe-Undrgrnd. ' 60. Backwash Linzs, P-Trap, � Undrgrnd. j
70. Struciural Ficor System �� � 61. APPROVAL TO DECK ; '
11. Property Sewer line & House Connection 62. Backwash & Receptor�Final !
12. Sewer Cap �' � 63. Heater & VenrFina! ��-
7 3. Roof Drains Y - 64. Plumbing System -.Final -'
74. Rough Plumb�ng � - 65. Electricai-Fina�
� 15. Rough Electrica��Conduit - 66. Solar SVstem-Final � � �
16. Rough Electric Wiring �� 67. Fencing & Access APP�oval �.
17. Rough Wiring Sign 6$, qPpROVED FOR PLAST�RdNG
18. Ro�gh Electrical-T Bar Celling � 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditloning PIRE DEPT. REQUIREMENT �
20.� Rough Fac:oYy Fireplace � - APPROVAIS Permit #
21. Ducts, in Struciure ' 70. Underground Hydro
22. Ducts, Ventilati�g � 71. Producc Piping O Gas L Oil
23. Gas Pipe-Raugh & Test '. � 72. Underground �Iush .
24. Roof Framing � 73. Undergrnd. Storage Tank `J Gas O Gii
25. Roof Sheathing . � 74. Overhead Hydro �
26. T-Bar Ceiling (Structuraq & Monocoat � 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding . 77. PIXED SYSTEM PINAL
29. Ins�lation 78, F�RE PREV. FINA�
30. Drywall Nailing � HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat 79, PWAL INSPECTIQN
32. Eiectrical Power MeterPinal ���; FQOD CERTIfICATE ISSUED
33. Final Electric `� Notes _���4 7 �, _ • ` �nc,-,_ �
� l 1�w
34. Final HeSting & Air Conditioning ���[/ �]
�=.-_"^'� --- � - � - - -
35. �Finai Gas Pip¢-Test ' /'_��� E�.� �L /� �.
h l=�'/ �
36. Hood or CanoPY n/ �
�Llo� l3 A.7 Lm,r- - ��,a-s - - -
37. Final Factory Fireplace - �
�'= - - - -- d^n • �(�jy1�1° - - ��
38. Finai Plumbing �
39. Water Service-Final _ _ �
40. Gas Service-Final , � .
41. Solar OomestioFinal �
- i
42. Backfiow Preventer ' , , y", -
43. Backflow Irrigation � � �- - -'
44. Landscape Irrigation System � � , �:`' - � �l (
45. Sound Attenuation - - � - � � `-,� ` ..
�:
46. Handicap Reguiations � - �
�'
47. fINAL STRUCTURE & BU(LDING ' ' .
48. FINALPLANNING '�r-Y �,; �
49. Eleciric Release to Edison � ', � �
50. Gas Release to Southern California Gas Co _
51. CERTIFICA7EOFOGGUPANCY
No Oate
�' I
�
�ooxFssavem�wxo: 2 1 1 4 ELD EN AV '
e
avaexe�Eiva+vxx: WILLIAM ADAM
monesx 2114 ELDEN AV
COSTA MESA, CA 92626
1VPl. WJIMO �O�NESA
UNT:
urcNrt� on u�m�vn: uc xo:
acx on uio.•s �oonEss: urrt:
cwm,�crarsru�, JIM CATON MASONRY ( 714 ) 638-2315
CWiPAGfOH4YNldl012561 AGNES STANLEY
�ooxES1GARDEN GROVE CA ��, 305339
9 2 6 41 ,,,,,,
ucwseo cor+rn�cTons oeeurunoN: i w.w .e'.m �.w p.,wy a oriw w� i.m r�m.a �.w� ao�e a cn,qa s
(canmeno�u .an seram l000) a oivuun 9 a ms eva"vm w vm�miam coee. ene my foaus e u nm bcs ene diae.
cmuc.xo.: uc.cuss:C-29 uc./No.): 305339 //,/EXP:
Dme: �— �� / / Conrmm/!/SrIA �b�
OWNEP BUILDEF DECIAR�TON: I Iw�b/ dfiim �aMx prWy psej�y tAp I mn �umq hom iM Caq�tlan liume law ta Ne
Idbx+q rsum (Sstlian JW t 5&miiaa eM Admawu CaEa: MY cF/ a aoumY wlvN �Nwa s V�u io mnhucY. etler. imPv+e.
'-;:;�nd"eh, a rpv ury �bucros. Pio� m m u�uuKe, ebo npiqy Ne eppbuN ta aN pen�0 �o fla a upneC sfelmwY tlul he a sha
ra.; i�.w w� �o me w�• a m. cw,.ao,. uows i.w Icnaq« e(��ro wun smo�, �aaol a u.so� a a m.
�6uamem md Prdwiom Codel a Nel M a da u evnq tlrahan eM tM bem ta Ne ebOb memqian. Mrv vcW'vi d Sedion
)031.5 by eiry eppliceN In a pemN abpni tM eppfica�u b e aN pmeb/ d nol maro IMn (ne h�mdied doYen �S.AOU.
❑ i.e.ovnwam.awa+v«mr«Mw«s�wn�.a�..m.:.deoomw��u+.�eome�k..mmem�wnomoa«mea
a dt«ed lu We ISaction lou. B�eneM Pmla=tlnuCoEs: TMCaareeon limme lerAoea ndxoaM toen owes tl p�apairy
Y/�p �II�B M TP�wV 1�1l1lJII. Yld 1Y�p dCGt tUf�l MV�'. iY111G� IX�IBIfl� Of bllOY�h �10 R �1M OMI MI�l�=. pw�� I�IBI M�1
impovemmN re mi imaWeE a dlred la ub. tl. howwer. Na dtitlm0 a inpwsinaa u wtl wuhm uw Yev d comWmm. Me
owrorbinlder vA Mw IM Mvden d pw'vq M a Ns Nd nq ddd a impwa la Re pvpwe d vb).
� I. n owner W IM PWMY. am urio"N/ awtlmfn0 MfN 4tautl caWedw� b omunwY Ne P9sd (SW ian )041. &n'vias end
PMeeeione Gob: The COMreem Lkan+a lew Aom MI nDqY b en wnw N G�W�Y wM bultla a mVA+o tlwaan eM who
wnvecu la aN popea wh e�vunevl�) licwved pN�yy io IM Canretla� l'smes lnw).
� I em evemq wder Seclion: • B. 8 P.C., br Yus reemn:
� do ne.eW ceniN �w � om ewms d em wdeeww ine i.a�imm«va d celianu Neenn ene smmr cuda seaions uws. 2ss?�, end
25SW. enC ilw I a ury Mun buildinp omipuv vnA� � w� (aeb aa) iwd �o mnp�y xih �eiE tlele mEe� and �M epu4amanb br
e permn Iwmnevuctian «moEifira�ian hwn�M Ai-6ZiyFAe�� pq�wy, qeW�iy Wnaruqion eppirmbm ere eumq Imm �haw
qwieiane.
Deie: MW4im:
WOFREH'9 COYPp14ATI0N DECLAFATION: I Mreby elrym ��yr peropy d pxpvy ons d tM IoOov.'vq Aadvtliom:
❑ I heve enE x1A meinten e<mNicW al m�venl ta �etlinan lu warkeri compsmelbn. u Pa'� la by Setlbn �]00 d �ha LeEa
Cods. ta �M pMamvics d Ms �ak la wAi^Ji Ne pemu u buW.
�] i na..�d.0 �wm� �.o�w�.� �v«+m� �w..ro... �.wnw w s.a:� s�oo a m. �n« coe.. m. ine wda� a ma
.�on��«�.eKninav�uam�.a.Mv..dk«+S�l�����wwr.v�w,...: EXPZRES
c�«:
PdiyNumber: , — � 1� � 1� 9 8
,ma ,«+;m,�..e nor e. mnwlM.e r w v�+�� � a. m. Mna.a me.n �f�ool o. iw.l
❑ I oenN ��� D�um^Ka d �M wh br whN � pymp b'warod. 1 dW mi anpb� erry pa�on n vy memer n n lo
Eeeomw wEjea to �M xahx�' mmpamuim Nw� d Callorw, eM pna tlW / I 4vdd eeo � M'ea b IM xarYeei
cpnpampion pwuiom tl Saeian T00 tl �M lebor ��.14W hrmA mmpl� reh IMM a'
Otls:���9' CJ� MMMsN: V
W�mlrp: F�Nun b utun wort�ri compw�tlon rowrp� I� M. �ml4Wl �W/�el �n �nployr ro ulminl pM�ltlu uW
e�w n�.. w ro w�. n�.n�.e rm�,w eww. lnatoanA a.miew� ro m. �o,r o� �o�wwuon �.. c�.a*e ro, r�
S�ctlm J106 0l IM Ltlor COE�. IntwL uM �rtom�%� /wa
CONSTflUC110H IENDINO AOENCT: I hwaby elfi�m ueM�i yenepy d par'�ey ihel IMn u s mrutwion MNnp q�r y M Na
perlamena d tM wM lor WJd� tA"s pwm� u uaatl (�ion ]OSI. CM. C).
LENpEP'S N�11E
LENDEH'S �DOFESS:
I<enEy tAm I hen �aeE thb e00�s� end tltls �M tlr elas edwmtlian o wnotl.I qyee to oomW wVh e0 Uy ad owvaY ud"viencm
end etals 4xs rdei�q b h+Jdiq m�u4umm a�tl 1wW' msharc� rta�+ewu d Ihuidyro em« upon tAe eEwe-menlia�ed popeery
�°`°'pBtl10""°D°�°'JIM CATON
o�a: s -9� �7
(5151JB.WP) NTGe-Bui�d�q85dMy.Orasr�FJb:Cenery-Appimn�:Pink-M.anue:OdEavoe-Avdan
PERMIT NO: B
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO; B 081849
082849 PLAN CHECK NO: 01898-97 L GOVT; N SUPP: N
CONSTRUCTION TYPE: I PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : 56 LIN FT HLOCK PILASTERS/WROUGHT IRON SQ FT; 8,200
CLAIM VALUE: CALC—VALUE: 8,200.00 GROUP OCC: R-3 /
COMMENTS: "RESIDENTIAL BLOCK 6WROUGHT IRON FENCE
**���*�*�*�it*�+tr ***�**��+t+t**�*x�**r�*����*���+t*+t+��+�it��***�r**�*���r*�r**�e�**��*�**�e
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 --------- -------- ACCESSOAY BOILDING ---------
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: 42613103 ZNE: R2MD REF NO:
PLANNZNG NOTES> CONSTRUCT 56 LINEAL FEET OF PILASTERS AND WROUGHT IRON ALONG
> RT AND FRONT PROPERTY LINES.
if �F if iE iE 1E if IE IE �E jE �k If i! iE k 1E 1E 1f k iP if iE 1E 3E 1E 1E �IE M iE 1E iE 1E iE fFlF IE iElf iE fE iE iF 1E fE iE iP 1E if iE �E if iF if df if 1E �t 3k iF iF �! 1f k k if iE * IE ik iE �E if 1f IE iElf if 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 y
ZONING APPROVED BY KA� DATE: •S ���/
BUTLD'ING APPROVED BY : DATE; �'�7'�
APPLICATION ISSUED BY: � DATE; �`�
�IFiF�E1l�E1E1kIF1E1FkiFiFlEiFikkikiElEifif 1kif�fifiE�kiEifiklf 1EiE
LEGALIZATION;N F E E S U M M A R X STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE''' SMIP/RES GRADING
PERMIT 149.75 82
PLAN 97,34 � SMIP/NON—RES
ISSUE FEE ��
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 150.57 0,00 97.34 247,91 247.91 ,00
REVENUE DIVISION TOTALS--> COLLECTED: 247,91 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT., GRADING PLAN—CHECK
149.75 .82 97,34
/,
ifiEkiElEifiEiElfiElElEk1E1E1E1E1E1fiE1E1h1lIEiEiElfiElEiEiflfiElElEiEiE1EiF1kk1ElElFififlklEklfklkk7FiflEklkikiflEkllkifkkkiFlEikklElkklklFiE7F
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C A I P T I O N UNIT CO5T TOTAL COST
SFR 8200 ALTER HY VALUE RESIDENTIAL NOZONE 1.00
END OF FEES
8,200.00
05-89-1997/81:17 P(i/f247.51
2CPT5:a1-25�51dS
F�ERMIT:082849
CONSTRUCTION AND PLANNING P�� 'PA �
.
APPROVALS Permit # Date Inspector APpROVALS Permit # - Date Inspector .
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location '
2. Soil Pipe•Undrgrnd. � 53. Steel Reinforcement
3. Electrical Conduit Utility•Undrgrrtd. 54. Forms
4. Electrical ConduibUndrgmd. 55. Electrical Bonding
. 5. Steel Reinforcement �/Z�7 ��r�-' 56. Rough Plumbing & Pressure Test I
!
6. Etecu�cal 11FER Grnd. 57. APPROVA�TO COVER•GUNITE .
7. Footings '�-�,L-(� �u.�' 58. Electrical Conduit�Undrgrnd. .
8. Foundation _ 59. Gas Pipe, � Undrgrnd., Test -
9. Water PiOe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
�
10. Structurol Floor Svscem � 67. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final �
12. Sewer CaP � 63. Heater & Vent�Final
13. Roof Dra�ns . 64. Plumbin9 SYstem - Final '
14. Rough Plumbing 65. Electrical-Fi�al
15. Rough Electrica6Conduit _ 66. Sola{ SYstem�Fina1 •
76. Rough Electric Wiring 67. Fencing & Access Approval
17. flough Wiring Sign 66. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling _ 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPAOVALS Permit #
21. Ducts, in Structure - 70.-Underground HYdro
22. Duct;, Ventilating 71. Product Piping OGas OOiI
23. Gas Pipe-Rough & Tesc 72. Underground Plush -
24. Root Framing 73. Undergrnd.StorageTank C1Gas d0i1
25. Roof Sh¢athing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
2�. Frame and Flashing 76. Dry Standpipe "
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 7$. FIRE PFEV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIFEMENT
31. Plaster 8rown Coat 79. FINAL 6NSPEC710N -
32. Electrica� Power MecerFinal 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heeting & Air Conditipning .
35. Finai Gas Pipe•Test
36. Hood or Canopy .
37. Final FaCtory Fireplace � - -
38. Final Plumbing `
39. Wa2er Service-Final
40. Gas Service�Final � -
. 47. Solar pomesticFinal -
42. BackFlow prevenrer -
43. Backflow Irrigation } _ `%�l� 6r/G �
i � � i� `
44. Landscape Irriqation System .
45. Sound Attenuation
4fi. Handicap Regulations
47. FINAL 5TRUCTURE & BUILDING �/�.��je ji/,(L �
6 'ii ""W
48. FINALPLANNING
49. Electne Reiease to Edison T
50. Gas Release to Southern California Gas Cu
51. CERTIFICATE OF OCCUPANCY
No. Date
� � ������
�V ���3 CITY OF COSTA MESA
PLANViNG DIV.
SUBJECT TO BLDG. DEPT. REG.
(�jYpn,t�lt�t- iro.--
NOTE
ADDITIONS, DELETIONS, OR CORRtCTI0N5 SNALL
g( pP°ROVED [iY THE PLA�lPIIPiG DIVISION
1� � DATE__� }/ I /
� Q;o��?-e�s ���:[�`a ltioT �2QPG'
�$" j�. W i r��-l� Lu i�G� A'�x.i �tii n,,�v�--
��� � ���,
NG SAFETY
MESA
p:'Y
gy�_ � S� 9- 97
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and Se�', dq ot Cos� I�Se.
TheefappigofRdsplan speafi�6ons TbeheNmpemd b an
of ihe vidxtion of any D visions of am/ C ot osta Mese J�ma andf Sta law.
TfMsa r,�aix and partnAb e�iro by . become rc,� ud d il ing cr
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IDLNCE 11[61D[NC[
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�LD�'T.1 AVF STREET A
TYPICAL
Cement Coping Opt�onal —'
Channel Block With 1-3/8�
Horizontal Top of all
Fences
For Fences 5' or Leu
Vert. Bars 3/8"y5 at 4' -0" O.C.
For Fences Higher Than 5'
Vert. Bars 3/8"� at 32" O.C. �
Fill Cells Solid With Grout
Where Steel Occurs
Reinforcing Steel Shall � _ � �
Conform to Sec.A-15-39`'' " `
A.S:T:M.^�, � . :.: � , � i
All Steel to,be Lapped� � � � �
24" or to Code �' •
_ NATURAL GRADE��;
TWO 3/8"Q BARS '�
CONTINUOUS�70Pet
& BOT.TOM' , '•�, � � ��' :
HOR7ZSTEEI MUST BE 71ED IN
PLACE AT TIME OF TRENCH
INSPECTION.
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p SEE CH<
1 BELOW
�.I e
6�� CONCRETE BLOCK FENCE
FOOTING REQUIREMENTS CHART
GENERAL- NOTES
MORTAR: p�e part Plostic Cement, and
Three Parts Sond
GROUT; One Part Cemenf Three and
One Half Poris S�and
COPING: One Part Cement, Three
Parts Sond
CONCRETE: Well M+xed C2-I/2:3-I/2
Max. of 7- I/2 Gallons of
YYater Per Sack of Cement
GROU7 MAV eE POURED FROM THE TOP
OF 7HE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLS AND AREAS Of HORIZONTAL REIN�
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, E7C.
�H GF E4RTHTCOTH
V3 THE HEiGTH OF FENCE
��IOW BOTTOM OF FOGTiNG
WIDTH . . . 14�� . . . . . . . . . . .14" . . . 12".
.._ . .
THICKNESS . . . . . . 10�� . 10�� . . . . . . . . . 8��.
DEPTH OF EARTHTOOTH . . . 24" . . . . 20" . . 16" .
SPACING OF EARTHTOOTH. . 12' . . . . . . . . . . .14� . . . 16�.
City of Costa Mesa, California
, Building Department
•�_ _�_ . . ti.=_�7sED Nov. am
SCALE: I/2��= I'
—�
12��
8„
12,�
16'
�' �
. j �.����
COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 COBTA MEBA. G1-�7GRN�A
For Applicanf fo Fill In Complefely
COSTA MESA.
1 ARGHITEG�'
��
1 STATE
PROM
NO. O� 9LD68.
� I LEFT �:+ �r� I RIGHT �
DESCRIPTION OF WORK
0
� EXTERIOR
ROOF
COVE
I$ TO
FEE� RECEIVED
)� r �.5 1�Ji �
AP����R�IT �
BUILDING
For Offlee Use Only
R6CCIPT NO. PHRMIT NO
9Y
BUILDING
ADDREBS
COSTA MESA. CALIFORNIA
PIRE
ZONE
APPROVEC
BY
20 ' L
� LlOAL
OE9CP1'TIOI
A'.P.NO.
YARDS
APPROVEC
�� fC6NT6R LI
_ 'PRONT
�r .
ZONING
� NO. OP I U88 OP l.
��PLAN9 �L BUILDINO
)O I�I '-�.� �
^�
ALLOWEC
BTJ ' _
1 N6qEBY �GKNOWLEDGH TMAT I HAVE RG� iM�B ANLJGTION THg AMOl1NT BHOWN UNDHR VALUATION IG POR TXB
AND BTATE THAT TH6 ABOV¢ IB COPqCGT AND AGR[C TO COM- pURPO6E OP EBTABLI8HIN6 /� PlRMIT F!E ONLY.
PLV WITN ALL CITY INwNCE ND HTATB lAW6 R[OULATNO
auILDINo CONe cTl VALUATION /�
81GNATURB O /� �/D — PERMIT FEE $'f �/"' m
PERMITTE
S � PLAN�CNECK $ �J^ �
AUTHORIZED ACEN7 —' o
TOTAL FEE LL