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Home My WebLink About904 DOGWOOD ST - Building PermitsEP (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 904 DOGWOODST Suite: Viciniry: KITCHEN Parcel Number: 42252120 Applicant: FARTHING, SCOTT M Address: 904 DOGWOOD ST COSTA MESA, CA Owner: FARTHING, SCOTT M Addr�ss 904 DOGWOOD ST COSTA MESA, CA Con tra ctor: O W N E R-B U I L D E R Address: Zip: Arch : Address: Phone: Zoning: Phone: 949-645-9325 Zip: 92627 Phone: Zip: 92627 Phone: License: 000000 Eng: Address: ISSUED BY: Slatus: ISSUED Applied: 09/19/2002 Issued: 09/19/2002 Phone: Zip: License: License: SCOPE OF PERMIT RENEWAL OF EXPIRED PERMIT FOR A KITCHEN EXPANSION AND REMODEL IN AN EXISTING SFD. (ORIGINAL PERMIT ATTACHED) REF:B058345 � Plan Check: $0.00 Permit: $0.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $0.50 SETBACKS MAIN STRUC7URE Front 0- 0 ACCESSORY Fiont 0- 0 Rear 0- 0 Rear 0- 0 FEE SUMMARY Calc Valuation: So.00 Claim Valuation: 50.00 PLANNING & ZONING left 0- 0 Right Left 0- 0 Right PARKING Existinq: 0 Required: o Pr000sed: o NO7ES: KUBOT BJ 09/19I2002 OK TO RENEW FOR FINAL INSPECTION PER NOTICE: The work authonzed by Ihis permit shall comply with ail appticable handicap access requirements under Californta statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work aulhorized under ihis permit to ba considered legal, such work must comply with all applicable codes, and all required Inspections and final approvel mus� be obtained. Failure to obtain inspections and final approval will result in the ezpiration o( this pertnit. FOR INSPECTIONS CALL: (714) 754-5626 zae�ae �aw7 WORKERS' COMPENSATION DECLARATON: • I hereby aHirm under penalry oi perjury one ot the tollowinq deUaretions: ❑ I have antl wlll melntain e cenificate of consent to self-Insure br workers' compensatlon, es providetl for by section 3700 of the Labor Code, for the peAortnence o1 the work tor which thispertni� ISlssued. ❑ I have and will mainlain workers' componsation insurence, as requiretl �y sectlon 3700 ot the Labor Code, tor Iha pertortnance of the work tor which this pertnit Is Issued. My workers' compen�etlon Insuranre carrier and policy number are: t. Carrier: � Policy Number. (Tiiis sectian need not be comp/efed i! fheOermi! is velued at one hundre0 tlollars ($100) or less.) � I certify Ihet in the peAormence af the wark for which Ihis permit is issued, I shall not employ eny person in eny manner so as to becoma subject to the workers' campensatlon laws oi Cellfomla, end egrae ihet If I shoultl become suD�ect to the workers' mmpensatlon provisions oi Sectlon 3700 0l Iha Lebor Code, I s�ell iorthwlih comply with Ihese provislons. Applicent Signature: Data: WAFNINQ: FAILURE TO SECURE WORKERS' COMPENSATION COVEPAGE IS UNLAWFUL AND SIIALL SUBIECT AN EMPLOVEF TO CRIMINAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOLLAFE (51 W,000), IN ADDITION TO THE COST OF COMPENSATION, OAMAGES AS PqOVIDED FOR IN SECTIqJ 3]OB OF THE LABOR WDE, IMEREST, AND ATTORNEV'S fEES. LICENSED CONTRACTORS DECLARATION: I hereby aNirm thet I em licensed under provlsions ot Chapter 9(commencing with Section 7000) of Divlslon 3 ot Ihe Business end Professions Cotle, end my license Is In full torce end ettect. Lic. q Clau N Contractols Slgnature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby attirm that there is e consWction lending agency br ihe DeAormence of Ihe work tor which t�is permit is issued. (Sec. 3097, Civil Code). Lenders Name: Lenders Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby eHirtn thac under penelry ot perjury t�et I am E7(EMPT FROM THE CONTRACTORS LICENSE LAW for the following reeson (Sec. 7031.5, Buslness end Professions Code: Any ciry ar counry which requires a permit to construct, alter, improve, demolish, or reDeir any siructure, prior to its issuance, also requires the a0011can� for such pertnit to tile e signed statement Ihat he or sha is Ilcensetl pursuant to ihe provisions of the Contractars LJcense Lew (Chepter 9(commendng wlth Section 7000) ot DlNslon 3 of the Buslneu end Professlons Code) or that he or she is axempt thereirom and ihe besis for Ihe elleged ezemption. Any violation ol Seciion 7031.5 6y eny epplicant for a pertnit subjecta the appllcent to e civll penalry of not more ihan live hundred dollers ($500).): � I, es owner ot the property, or my employees with wages es their sole compensatlon, WILL 00 THE WORK, entl the structure is not iNended or oHered for sele (Sec. 7044, Business entl Pmtessions Cotle: The Conirectors License Lew does not apply to en owner ot pmperry who builtls or improves iheraon, end who tloes such work himsetl o� hersell or through hls or her own employees, providetl Ihat such improvemenls ere not Intended or oHeretl for sale. If, however, Ihe builtling or Impmvement Is sold within ono year of completion, the owner-builder will heve Ihe burden ot proving ihat he or she did not build or improve for purpose ot sale.). ❑ I, es ownet of the property, Bm E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the pro�ect (Sac. 7044, Business entl Professions Cotle: The contrectors License Lew tloes nm epply to an owner ol property who bullds or Improves Ihereon, end who coniracts for such project wlih e comrector(s) licen5e pur5uen� �o �he Conirec�ors Licensa Laws.). ❑ 1 em exemp(,ym�Ysea �,' ) Business antl Professions Code for Ihis reason: Owner ID vedfied by ❑ Ves ❑ No Driver's License No. Venfication at Ownership by (type oi tlacumem, i.e. - property tez bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: �'Gti��,� _ // � ❑ I hereby canity that no excevetion frve (5) or more feet in tlepih into w�ich e person Is required to descend, will be made in connection with work euthonzed by this pertniL end that no 6uilding strucWre, scaHolding, talsework, or demolition or tlismentling ihereof, will be more than ihiry-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Title 8, Celitomia Administrative Cade). ❑ As owner-builtler, I will not employ enyone to tlo work which would require e permit tmm t�e DiNsion of Industrial Satery, as noted ebove, unless such person hes e pertnit to do such work Irom the division. Signature: Date: Division ot Industnel Satery Permit Number: CERTIFICATE OF COMPLIANCE AND AUiHORVA710N OF ENTRY: 1 certify under penalty of perjury Ihet I have reatl �his application and state that the informetion given is wrrect. I agree to comply wlth ell state lews end city ortlinances releting to hullding construction, end euthorize representatives ot ihe Ciry of Costa Mesa to enter upon Ihe ebove-described pro� or inspec' R oses. I agree not to occupy or ellow xcupency of eny building authorized by this permit until fine inspectlon. 9//q O � SigneN egalOwner(s) Date ° AnNOr Authorized Applicam Date •� . • ' qIJ� �' 1616 Fl:ed System Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 Flnel Black/Retaining Well 202 Finel Factory Fire Place 203 Finel Sign 20d Final Demolitlon PAIE 1t�L$ COOE� INSPECTIONTYPE 206 Final Mechenicel 208 210 212 220 Finel Plumbing Final Eleciricel Final Fire Preveniion Final Planning Approval �g � 222 Final Site p�, 250 Final Building/Occupency � 7�- � PN0.IECTADOflESS: yOA DOGWOUD ST uxir: owNEn�sNnme: FARTHING,. SCO'iT M �,noosess: rARTHiNG KIM 904 DUGW60D ST COSTA MESA,CA 92627 � �flCN/ENCINEEN: SCOTT FARTHTNG nec.xo.: NONE c noosess: 909 DOGWOOD ST UNIT: • COSTA MESA CA 92627 eenrninee: FARTHING DcVELOPMENT,ZNC. (714)F73-121? nooeess:• 904 DOGWOOD COSTA MESA CA 9262'7 ULENSE� CONTPPCTOB OECLANATION: I �ereby aliirm Ihal 1 am Iicense0 wUei pmvisions oi ChaD�er 9(commencinp with Section 7000) ol Division 3 0l t�e Business ana Prolessions COGe. antl my licensa is in Iuli b¢e and eifecl. cirr uc.: 0 4 8�1i1 1 STRTE LIC.: S� O�% S cuss: Date: �/�_, �± Signawry; � WOpKERS' COMPENSATION OEClANA710N: I trereDy attirm that I nave a certrticate oi consent to sell-inswe a a ce��iwte ot WaBers ComDensation I�s;a�ezog{#e��repju�y inereai lSection ssoo. �ah. ��3 / O 1/ 9 3 roucr xo.: 5'tATE FUND E%P. oere: COMPANY: ,.3/ C¢rtilieG [ODY �5 here�y �Umish¢E. L'1 CertAieG �oDY �5 �ile0 vn�� IAe tiiy ilOpA Drvision. �.�'��i� Ua�e: � � � Applican�: � E%EMPTIONFROMWONKEflS'fAMPENSlITIONDEtLRN,ITION: Q�is5ttlionnee0notbecomDleleOilUepermitisforonehwMrM�5100�orless�. I[erlily Iha� in the peAormance ol Ihe work lor w�ich I�iS Oe�mil is issuetl, I s�all noi em0�oy any person in any manner w as �o become subjetl to t�e Worker5' Compen5alion Laws ol Calilorpia. Date: � SiAnatur¢: NOTILE:It. atter making IhiS A¢ttaration. you Shou10 C¢wm¢ SuUjeti�a Ihe WOrkefs' CAmp¢nsalion proviY0n5 01 Ihe LabOr CoOe. }rou must fonAwiln campty witn sucn D�ovi�ons or iNs cermit slull Ee aeemetl revokea. CONSTflUt710N LENUING AGENCY: I hereGy allirm �pai t�ere is a consiNction IenGinp aAenLy lar ��e p¢tlarrtWnte of the woM1 br wpic� ihis p¢rmil is issuCd (SMlion 3097. Civ. C�. �noee: ADD'POP—OUT'(BAY) WINDOW. nooeess: REMODEI, EXISTING KITCHEN. OWNEB BUILOEN OECLAflPTION: I her¢Gy allirm iha� I am e�empi �rom the COniradors' State License Law lor the lollowing reason (Seclion 7031.5 Business antl Pro�essional Cotle: Any �iiy o� counry which reQuires a DQ�mii to constmc�, aller, impmve, tlemoiish, or repair any strocture. Onor ro ifs issuanre, also repaire; tAe aPO��ant Por SUCn permit ta Ide a sipned statement that helshe is licenu� pursuam Io I�e pmvisions o� IAe Conlraclors' Staie License Law (ChaO�er 9(commenting wi�A Sec�ion 7000) ot Division 3 0� lhe Business anC Pm�esvan5 CoOe� or Ihal he/5�e i5 exempt �hertlrom antl ��e OaSiS �or IAe alle0etl e�¢mD��On. My vi01ali0n ol S¢tlian 7031.5 by any applicanl lor a De�mit subjecis I�e appliWnt lo a civil penalty of not more lhan live hunEreO dotlars (5500�. 1, as owner af ine pmpeny or my employees wilh wages as tAeir sole compensation, will Oo Ine work, an0 �he `� simcWre is no� inlen0e0 or o��ere0 br sale �SeClion 70C4, Busness anE Pmlessional CoEe: The Cantraclors' S[ale License Law ■ tlaes not apply Io an owner ol a OmDerty who Gui�As or impmves I�ereon, antl wha tloes such work himseli/�ersell or �hmugh � his or her own employees. pmvi0etl lhat 5uth impmvem¢nls are nol inlen0e0 Of off¢retl �or 5ale. II, Aowever Ihe Euilaing or impmvemeni is solA wilhin one year ol complC�ion, �he owner will have �he 6urUen o� pwving he/she tlitl nol builtl or impmve for tne purvose ol sale�. I. as owner of Ihe proDehY. am exclusively con��acting with IicenseA conVac�ors �o cons�Ncl the pmlecl (Seclion 7p44, Business ❑ antl Pmlessions CoOe: T�e Contraciars' Slale �iten5¢ Law Ooes nol ap01y lo an owner o� DmOeny wha budJs m improues �hereon ana who contracis far suc� O�olecls with a coniractor�s) license pursuanl to tlle Contmclors' State License Law�. 1 am aware Ihat pmal ol t�eir Worker'S ComOensation insurance should be D�oviOed to me. � 1 am exemp� untler Sec�ion: 0. 8 P. C. for this reason: Oate: Ownec I Ao hereby cenity that 1 am aware ol antl unGersianU �he requiremen�s al Calilomia Heal�� an0 Safety Cotle Seclions 25505, 25533, an0 25534 antl IAaI I ar any fu�ure builtling occupan� will/will nol (circle one) neetl Io comply wi�� saitl state codes and Ihe r¢quiremenfs for a permil br consimction or madilication Irom I�e Air Opaliry Management OisVicL Re5i0en�ial constmc�ion apDlica�ians are exemp� imm Ihese pmvisions. ��Oate: ApDlican�; I �er¢Ey tertiry��all haver¢atl��is a001itaiion anG S�a�¢��aithe aUaveiniormali0ni5 Correti. Iagreeio tOmply vnih all tiry an0 COUnty orCinances and sta�e laws rela�ing to OuilEing cons�mclion anE hereEy au��orize represematiues af �Ns city to enter upon �he ahove�mentioneA property lor in pection purpases. • �% Oate: " � � SignaWra,��_� Oriver's License or Social Secmily x: %] 1641-L6 Wbue—Bmldmo: Green—CoOe Enlorcemenl: Canarv—Aoolicanl: Pink—Revenue: Goltlenroe—Assessar CITY OF COSTA MESA — BUILDING PERMST PtxM �U; b v7�j�i: PERMIT NO: B 058345 PLAN CHECK NO: 02813-92 S �v �; rv Sui�r; rv CUNSTRUCTION TYPE: 5—N PrRMIT' TYPE; STR PURPOSE: W�D JOB DESCF.IPTION : EXTEND KITCHcN 35SQ FT & REMODEL KITCHEN SQ rT: 2,035 CLAIM VALUE; 2,000.00 CALC—VALUE: 4,�90,00 GROUP OCC; R-3 / COMN,ENTS: SMOKE DETECTOR(S) RE�UIRED IN HOME. *�*x*+�**�x*�uxx***��*x*****�** #�*�*��****��*�u•+�x#�*x*�crt��*��***k*�r:�**�*�� 2 O N I N G R E Q 0 I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- --------- ACC..SSORY BLILDING r T _ FRNT: 21 FT IN REAR: FT ZN FRNT: FT IN REAR: FT IN LEFT: 12 FT 6 IN RGHT: FT IN LE:T: FT IN RGHT: Fi IN PARKING REp • PROV• FARCEL: 42252120 ZNE: R1 REF NO• PLANNING NCST'cS> ADD A BA1C WSNI)OW (WITH FOUNDATION) TO T:iE FRONT OF AN LX, SF > DWnLLING AND REMODEL KITCHEN. if if iF if iE if iE iE iF iF iE �F fE kif is iE iF if X� iE #E 1F iEiM il� iE 9k � iE iE it iF �f iE # IF if if it f! 1F �1F if� * iF±F i'� if� k� le aF iE 1F iF �(� i(� 1e )F�f #� �E � jF IF ic it 3f ?E iF }�. �Ii Y iEje #(� .Y� 3(��1l� D E V& 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 201�ING APPROVED BY I.t�� DATE; 7�2$ YZ BUILDING APPROVED BY : __ DATE; 7 l'L-g'l%'� APPLICATION ISSUED BY: DATE: %l'�-d'�/�� iEii�if±EiFiFiEiEfF;c3elE�lflF:Eie3E�3Ei(-ifiE�r'£�.. �.',f�3Fn .. . . �iel'ri:�kifiF3i�'r��k"�itt?`�7i'it�£'i3c'iriiit iEi61E�1EiEitifiElfielEiEiEii�YiEi'riE?E�1F#ii�iEiFif�t#iE?6ltihikM��K�3cifiEjf IERiFlEikiFdF�1(�ii�k1FN�1F#iF?FjfiEiEli�ii�3F�(-i(�jF�IE}#ki�i£3F>##}3f## LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SnGMENT;Y BLDG PMT PLUN,HING ELECTRIC MECHANIC FTRE SMIP/RES GkAD'iNG PERMIT 72.00 .� SMIF'/IVON—RES PLAN 46.R0 ISS[JE FEE Bi7ILDING—DIV—> PERMIT ISSUE PLAN—CHECH TOTAL PAID DUE TOTALS----> 77..50 O,DO 46,80 119,30 3.19.30 .0� REVENUE DTVISiON TOTALS--> COLLECTEL�; 17.9.30 OVER/SHORT• 00 BLDG PMT PLUMBING ELEC7'kIC MECHANIC FIRE SMIP/TOT GRADING FiAN—CHECK 7?,OU � ,50 46,R0 if it fk ie ie s 3e Y.• iF-1f �E �)f K if ik ie � fF V.� �t� iE �IK 1E �Y ii� fk iE �k iF Y.� jt k� 7'r iF iE 1E if� dE M� ik 1E V M� iE 1!� #� iC�±h lF K� N� IE 3f 1(� V�1(� 1f ih �lE 1!�if iF i'r K� #� 3F k�: ir if 3ei k� 3i� iE iE ii� �k iP T N D I V I D U A L F E E H R E A K D O W V TYPE (ZTY A � S C R I P T Z O�N UNIT COST TOTAL COsT SFR 35 DWE—TYPE V—WOOD FRAMF. —GOOA 74,00 2,5=0,Q0 SFR 20U0 ALTER BY VALUE RESIDENTZAL NOZONE 1,00 2,000,00 END OF FEES � EXPIRED -' � � Inc;,mplete InspeGt�16 II� � o � ' `�* �I�3 �i0 .�( � � �� • �, � � j l� a � I :. �p _� � �-, ♦ JU� 2.$ 1992 O ��Ty, OF COSTA MESA , ,�� CO' 7�JCTION AND PLANNiNG P��'PA � A� /ROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector i t. Tsmporary Electriwl Serviceor Pole 52. Pool & Equipment Location 2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement 3. Electrical Conduit Ut�lity•Undrgrnd. 54. _forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reintorcement � 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, O Undrgrnd., Test 9. Water Pipe-Und�grnd. 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 1 t. Prpperty Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap � 63. Heater & Vent-Final � 73. Roof Drains ` 64. Plumbing System • Final 14. Rough Plumbing 65. Electrical�Final 15. Rough Electrical-Condu�t 66. Solar System-Fina� 76. ROugh Electric Wiring 67. Fencing & Access APP�oval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough E�ectrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DUtts, in Struct�re • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Pipin9 O Gas O Oit 23. Gae Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oii 25. Roof Sheathing C�'L D v 74. Overhead Hydro 26. T•Bar Ceiling (Seructural) & Monocoat 75. Ory Chemical 27. Frame and Flashing ,0 � � 76. Dry Standpipe ' -; 28. L3thing & Siding `C�'L.. 77. FIXED SYSTEM FINAL •�- 29. Insulation % ( �y., _Qf� 78. FIRE PREV. FINAL " 30. Drvwall Nailing � l� �- HEALTH pEPT. REQUIREMENT � 31. Plaster Brown Coat Q� � 79. FINAL INSPECTION 32. EVactriwl Powar Meter�Final ' 80. FOOD CEATIFICATE ISSUED 33. Final Electric Notes: �0 /C!Z O� �� -i 34. Fi�al Heating & Air Conditioninq �O/,� �4y 6�J � 35. Final Gas Pipe�Test � � / � 36. Hood or CanopY 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic•Final 42. Backflow Preventer 43. Backflow Irrigation � . 44. Landscape Irrigation SYstem /fi�.,- �,j a 45, Sound Attenuation � � � 46. Handicap Regulations � � ' -. � 47. FINAL STRUCTURE & BUILDING - ��' �� ' 48. FINAL P�ANNING � - � � � ' .� 49. EI¢ctric Release to Edison � • �'" ;� 50. Gas Release to Southem Califomia Gas Co ' "� � - 51. CERTIFICATE OF OCCUPANCY � ' • No. Date � CITY OF COSTA MESA d1LIFORNIA Y26t8�1200 ►.O.BO%12W DEVELOPMEfiT SERVICES DE►ANTMtENT � . • , � r _ .\ t Janusry 1.1990 TO COMPAI�IIES & CONTRACfORS WHO RENOVATE OR DEMOLISH BUILDINGS THAT MAY CONTAIN ASBESTOS .� . . . ��_ �� • ��. ��i• �� . ., :, Recently the South Coast Air Qualiry Management District adopted Rufe 1403 - Asbestos Emissions from Demolition/Renovat(on Activities. It became effective January 1,1990. This nile speci5es work practia requiremenu for demolition and renovation activities and the associated dist�ubana of a5bcstos-containing waste material. Demolition or renovadon operators must meet the following requiremenu: o notificatinn o removal techniques for asbestos-containing material o clean-up procedures, and o waste storage and disposal requiremeat Failure to compl with the provisions otthis rule may result in a penalty of up to �25,000 per day. Encloxd are copies of a fact sheet, which desrn'bes the major features of Rule 1403, the NotiScation form, and tLe Norifiration form instrucUon sbeei. Should you have a:ry questions, please call AQIvID staff at (818) 572-6283. I hereby acknowledge I have read the above. �� DATE � t`O M�sq o, � , � J A`�+oemm `F (714) 754-5273 • Fax (714) 754-4856 . CITY OF COSTA MESA BUILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT JobAddress: 904 DOGWOOD ST Suite: Vicinity: . Parcel Nunmber: 42252120 Applicant EVE, DARYL Address: Owner: FARTHING, SCOTT M Address FARTHING, KIM ' COSTA MESA,CA , 904 DOGWOOD ST Contractor. SUNDANCE ROOFING CO Address: 1752 MIRAMAR DR BALBOA,CA Zip: 92661 Arch : Address: Zip: Phone: License: BUILDING PERMIT Zoning: Phone: Zip: Phone: 949-645-9325 Zip: 92627 Phone: 673-6063 License: 718369 Eng: Address: SCOPE OF PERMIT TEAR OFF INSTALL 30LBS FELT 8 30 YEAR COMP. SHINGLES. FEE SUMMARY Plan Check: $0.00 - Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $74.75 $0.50 $0.00 $0.00 $0.00 $75.25 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0. 0 Re uiretl: 0 PLANNING & ZONING LeR 0- 0 Left 0. 0 Pr000sed: 0 �� PE U BER 898-02248 ✓ 77 FAIR DRIVE, COSTA MESA, CA 92626 Calc Valuation: Claim Valuation: Righl 0- 0 Right 0. 0 Status: ISSUED Applied: 12/17/1998 Issued: 12/17/1998 Phone: License: $3,000.00 $3,000.00 EXPIRA710N: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order tor Ihe work authorized untler this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and iinal approval must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION UECLARATION: I hereby effirtn under penalry of perjury one of the following declaretions: ❑ 1 �eve antl will maintein a certiticete of consent to selt-Insure tor workers' compensation, es provitletl for by section 3700 of the Lebor Code, for I�e peAormence ot the work for whiCh ihi5 permit is issued. ❑ I heve end will maintain workers' compensation insurance, es requiretl by section 3700 ot the Lebor Gode, for Ne peAortnance oi the work tor which this permit is issued. My workers' compensation Insurence carrier end policy number are: Carrier: Policy Number. (This�ection neetl nof be comp/efed i! the Oermif is valued ef one hundred dollars ($100) or less.) / � I cetlily that i ie performance o 1�¢-y�q�y�pi this er is ssued, I shall not employ any person in eny manner so es lo become su6ject to ihe workers' t comp e w�S�efEallo[ i, entl eg�e thet if I shou ec ro s jea m the warkers' compensation provisions oi Section 3700 oi lhe Lebor Cotla, I shell forthwith YT'+RRthe Yisi0L5 /� /� A licant dgneNr . -" Dale'� ��_ W . URE TO SECURE WORKERS' COMpENSATION COV GE IS UNUWFlIL M1D SHALL SUBJECT AN E OYER TO MINAL PENALTIES AND GVIL FINES UP TOONE HUNDRED THOUSAN�OOLLARE�5100,000),INADDITIONTOTHEWSTOF ENSATION,DAMAGESASPiiOVIDEDFORINSE�THEIPBOR((XbE,IMEREST,ANDATTORNEY'$FEES. LICENSED CONTRACTORS DECLARATION: I �e�ebyptl' _ eLl em Ilcanse tler prov�jons ot with Section 7000) ot Division 3 at Ihe Business entl Protessiuns Cotle, antl my license is in full CONSTRUC710N LENDING AGENCV: �� ❑ I hereby eHirm that ihere is e constmctibn lending agency tor the peAortnance of Ihe work for which ihis permit is issuetl. (Sec. 3097, Clvll Cotle). Lendefs Name: Lentlers Atltlress: Signature: OWNER•BUILDER DECLARATIONS: Date: I hereby aHirtn �het under penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business end Professions Code: Any ciry or counry which requlras e permit ro construct, alter, improve, demolish, or repalr any structure, prior to Its Issuance, elso requlres the applicant far such permit m file e signed statemant Ihet he or she is licensed pursuant to ihe provisions of the Cantrectore Licensa Lew (Chepter 9(commencing wlth Sectlon 7000) of Division 3 of Ihe Business antl Professions Code) or Ihet he or she is e:empt iherefrom antl the basis tor the allegad exemption. Any violation of Section 7031.5 by any applicant for a permit sub�ects Ne applicant to e civd penalry ol not more Nan fve hundred dollars ($500) J: ❑ I, es owner oi Ihe propeny, or my employees with wages es Iheir sole compensation, WILL DO TME WORK, and the structura is not intentletl or oHered for sale (Sec. 7044, Business end Protessions Code: Tha Contrectors License Law does not appty to an owner oi property w�o builtls or Improves thereon, end who does such work himself or hersetl or through his or her Own employees, provitled that such Improvements ere not intentletl or offered tor sala. If, however, the bulltlinq or Improvement is soltl within one year ot completion, Ihe owner�builtler will have the burden of proving ihat he or she did not builtl or improve for purpose ot sala.�. ❑ I, as owner of Ihe property, am EXCLUSIVELY CON7RALTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business entl Professions Code: Tha coniractors License Lew dqes not apply to en owner of property who builds or improves thereon, end who contracts tor such project wiih a coniraqor(s) licanse pursuant to ihe Coniractors Lic�nse Laws.). ❑ I am ezempt under sec. Business antl Prolessions Code for this reason: Signature: Daie: Owner ID venlietl by tlnveYs license. ❑ Yes ❑ No Dnver's License No. Ventication of Ownership by (rype of daument, i.e. - property tax bill or deed�: DIVISION OF INDUSTRIAL SAFE7Y PERMIT CERTIFICATION: Expires: ❑ 1 hereby certily thel no excavation five (5) or more feet in depih into which e person Is requlred to tlescentl, wlll be maae In connectlon with work euthorized by this permit, end thet no 6uiltling siructure, scaffolding, telsewark, or demolition or dismantling thereof, will �e more then t�irry-six (3fi) feet high. (Chep. 32, Gry 2. Art 2, Sec. 341, Tflle 8, Celifomia Atlminisiretive Code). ❑ As owner�builtler, I will not employ eny6ne to tlo work which would requlre a permi� irom Ihe Division ot Indusirial Sefery, as noted ebove, unless such person has a pertnit to do such work fmm i�e tlivision. SignaNre: Date: Division of InOusirial Sefery Permit Number: CER7IFlCATE OF COMPLIANCE AND AIJTFIORIZ.ATION OF ENTRV: I certify under penalty ot perjury iha� I have read this application and stete that ihe infortnation given is correct. I egree to compty with ell sta�e laws and ciry ortlinences relating �o buil0ing consWction, and authonze representetives of the Ciry of Costa Mesa to enter upon Ihe above-descnbed proDeny for insDec�ion pur�ses. I agree not to occupy or allow occupancy ot any building authonzetl Dy this pertnit until finel inspection. COOEI' IHSPECTIONTYPE\ — 1616 Fixed System Finel Fire Prevention 1266 Pool Spe Finel 200 201 202 203 204 2aa8-dfi Finel Re-Root Finel BIaWRetaining Wall Finel Factory Fire Place Final Sign Final Demolition U1SIDE65 (Z �� (�-� GooE� INSPECTIONTYPE 206 Final Mechanicel 208 Final Plumbing 210 final Eleciricel 212 Final Fire Prevention 220 Final Plenning Approvel 222 Final Site 250 Final Builtling/Occupency QA7F It�lS � �� I � PpOJECTR00flE55t •yP9 L�OGir70nD S�: OWNEP'SNAME: FARTHIN�i� SL:O;'i M aooness: FARTFiING KIM 904 DOGWc.ip*J ST COSTA ��ir.SA,CA 92627 uxrt: AflLHIENGINEEB: SCQTT 1'�Tijli�.ri flEG.NO.: ��G RDOBESS: BO4 DUGWOOD ST ux�r: COSTA thESA CA 52627 rexminee: FARTHING DEVELOPMENT, INC. ( 719 ) 67's-1217, aooeess: 904 DOGWOOD COSTA MESA CA 97.627 LICENSEO CONTNALTOfl OECLANATION: I hereby aflirm tha�l am licensed unEer D�ovi5ion5 oi C�apt¢r 9(cammencing wi�h $ection ]000� oi �ivisinn 9 al Ne Business ana Pm�Cssions Catle. antl my license is in Wlitorce and eftec�. ciTruc.: 048/.2�11 sraTeuc.:560$75 euss: Oate: �/�2 X Signaiure'. _ WOflKEPS' COMPENSRTION OECIAflATION: I hereby a�tirm Iha� I have a ceni�icaie oi c6a�ew sell�insure or a cenifica�e o� Workers' Campensalion I j la�e�o�y�e�ttlietl�c`py �hereo� ISectian 3800, La�. GV1.3 / O 1/!3 3 POLICY NO.: STATE FC.I�`ID EXP. OATE: COMPANY: ❑ Ceni�ietl� y is here� umished. � Ceni�ied coDY is liletl w' h �Ae ciry Build' g Di ision. Dale: � � � FpPlican ' -n � � � E%EMPTION FBOM WOflNEPS' COMPENSRTION pEClAMT10 : Qhis seciion neetl not Ue cample if Ihe permil is lar one huntlretl (511p) o� less�. I ceNfy I�at in ��e pEAormance ol Ihe work lor which Ihis De�mit is issued. I s�all nol employ any De�son in any manner 5o as to become suble�� o the Workers' Compensa�ion Laws ai Califomia. �ale: Signamre: in �i 4 claration m - t m the Wa�kers' Com ensation � wvisions oi the Lahor NOTILE:II. aliermak A� s e , you should heco e suClec P 0 CoOe. you mus� larl�with compry with such provisions or Ihis permit shall be tleemeE revoked. ;�� CONSTflUtTION LENDING FGENCY: I here6y affirm that I�ere is a constmction lending agenry �or Ihe Oedormance o� the work for which Ihis permit is issuetl �Setlian 3097. Civ. C). LENDEB: ADD'POP--OUT' (BAY? WINDOTA, aooeess: REMODEL EXISTING KITCHEN, OWNEB BUILOEP OECLRflRTION: I here6y aifirm Iha� I am exempt Imm t�e Coniractors' Sia�e License Law br the following reason (Sec�ion 7031.5 Business anE Pmiessional Code' Any city o� counry which requires a permil �o constmc�, aller, improve, tlemolish, ar re0air any stmclure, prior Io its issuance, alyo requires �he applicant �or such permii to lile a signetl Statement �hat helshe is licensetl pursuant m Ue piovisions al ihe ConVacmrs' Siate License Law (Chapter 9(commencinp with Seclion 7000) oi Divisbn 3 0� the Business antl Pmlessions Cotle) or �ha� he/she is exempi thereimm antl �he basi5 for Ihe alleged exemplion. Any viola�ion ol Sec�ion 7031.5 by any applicani Por a permit sublecis ��e appliranl �o a civil penalry a� not more ihan �ive huntlretl Oollars ($500). I, as owner oi the D�operty or rny emDloyees wi�h wages as their sole compensation, will do the work, antl the ❑ simctureis notinlenaea orollered torsale�5ection 7044, Business antl ProfessionalCoOe: The Contractors' State'License Caw Ooes not apDly to an owner of a D�oPerty who huilds or impmves Ihereon, antl who tloes such work hlmsetl/hersel� or Nrough his or her own em0loyees, pmvide0 �hat such impmvemenls are noi in�enUetl or oftereA �or sale. I�, however �he 6uilUing or improvemeni is sold within one year of comple�ion, the owner will �ave ihe burtlen ol pmving he/sAe Oitl no� huild or impmve for ine purpose ol salel. I. as owne� ol Ihe pmperty, am ¢ecluSively coniracting with Iicen5e0 contraciors lo cons�mc� [h¢ pmjecl (Seclian 70.14, Business ❑ antl Pm�essions CoAe: The Coniratlp� S�a�e License Law Ooes nol appty Io an owne� of Drop¢rry who huilOs or imprwes thereon antl w�o conVacts lor such D�ojects wilA a coniractoqs)license Dursuan� to IAe Con�rac�ors' S�ate License Law�.l am aware ��al pmol ol �heir Worker'S Compensa�ion insurance s�ould De provitletl to me. � I am exempt unGer Section�. B. 8 P. C. lor inis reason: Date: Owner. I Oo here�y cerlily I�at I am aware ol and untlerstana the requiremen(5 0l Cah�omia Healih antl Sa�ery CoAe Sec�ions 25505, 25533, antl 25534 and Ihat I or any �ulure building occupant will/will not (circle one) need Io comply wiih said stale cotles an0 �he requiremenis for a permit for conslmc�ion or motli�ication imm t�e Air Ouality Managemen� DiSiric�. Resitlential consimc�ion apPlica�ions are exempt �mm Ihese pmvisions. �ale'. Npplicant: I hereby certily Ihal I have reatl Ihis appl¢aiipn and Sla�e Ua� �he above informa�ion is correcL I agree �o comply with all ciry and coun�y ortlinances antl stalelawsrelalingto �uilding cons�mc�ion and hereby authorize represenlativ li 'S citylo en�er uDonthe above-mentioned pmpetly lar inspetlion purpo5e5. iy Oate'. �� Signalure- ��— Oriver's License or Social Securily M: 16<t�C6 W�ite—Builtlinp; Green—Code p��osemenl'. Canary—Aoolicanl: Pink—Revenue: GolEenraC—Assessor DN7 �+ CITY OF COSTA f�fESA � BL7SLllING PERMIT r�n Nv: i� u�c��ti � PERMI'f NO: P� OSf3347 PLAN CHECK h0: N �,vvt: rv�urr; rv CONSTRUCTION TYPE; 5-h � PERMIT TYPE: PLU PGRPOSH: OTii SOB DESCRIP'fION : EHYEND FCITCHEN 35S'Q FT e REMODEL KITCHEN S� FT: CLAIM VALUE; CALC-VALUE: GROUP OCC: R-3 / COMM�NT5: RE• B58345 PRZ,+?ARY HLDG. PERN,IT. *�*�i��x*x�x��c*�x�c*�*x±��x�*�c**��r��+�*�*�* �***�r�x�t�*�*��c�*��+�x�r�x**��r��*+x�n**�ttr�- 7, O N I N G R E Q li.i R E M E N T 5 S E T B A C R S ------------ MAiN BUILDING ---------- -------- A(:CESSORY 3UII,DING ---------- =RNT: FT ZN REAR: FT IN rRN�': FT SN REAR: FT IN LEFT: F't ZN RGHT; FT IN I,Er?; FT IN RGHT; FT I'N FARKING Rcc� • PROV; PARCEL; 92252120 ZNE; REF NO; PLANNING Ni�7'ES> 7 iP it # iF If iE 1(� iE K'� if 1f %# iE if- 3F if iF J(��( iF # iF if 3E?F if # 1F R- N� 14 iFlc iF if iF i'F %� ib If �7i- ##-i63j 3E # N� IF a'� if� i!� iF ih?F ih i(� 1E I(� if iE i?� IF } i'r iE 3E li- iE iE ��!e V i�� # ie 3f 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 AF,PROVED BY � DATE; EOILDING APPROVED HY ; _ _ _ APPLICAT�'ON ISSU�D BY; - #3hIEd@3I'iFif9EiF'kiE$#tiEiEiFiFiE3i�iEiE'N'�iF�w'�FiFkfflF%'iF3i�'R' ; � ,c. ±r ' �P ' , � #k �lE if ik if # ii iE 3e i!� ae iF iE iE iF ic # if f: 3E �)E ff• #E iE 3E !E x 1E ii� i( iF af-!f if if R if� 3f� !E if �}��{ 34� LEGALIZATIOt4;N � r�' E S U M M A R BLDG PMT NLUMBT_iJG EL�EC'TR�C MECHANI PERMIT' 5,�0$' � w Y DAT : • DATE- 7��8"�9'Z_ K� iF IE i!� �Y.K 1F>c i 4}: '�� .' �� !( i!� if �h i(�+r.?e *� i'r �Y.�3'r ie if k?c 1F } ti�?F?F ?E!E iE STRT.ICTURAL S:GMENT:N C FIRE SMIP/RES GRADING PLAN -I . SM.FP /NOt�-R£S I5SUE PF.E 3,00 � ." BtiIt,DING-DIV-> PERMIT ISSUE AZ.AN.�CHECK TOTAL PAID DliE TOTALS----> B.UQ 3.UQ ••,f R U.UO 11.00 11.U0 .00 RcVENUE llIVTSION TOTAI,S--> COLL''�CTE�; 11.00 OVER/SHORT: ,00 BI�DG PMT PLUMBIhTG :.LECTRIC MECii7��NiC FIRE SMiP/TOT GRADING PLAt3-CHECR 1 1 , Q � / 3FlF ih ib!( 1F ik iE %� fE 3F iF IE±F 1E-?E 1E �%iE iF 3F �lE # I(• iF 1E iF ! if if i(� �lk i!� ie �)c �L:�;f iF if k�?f �lc iF }. iF?i iF �(� �lf iE ii� iF li�?c if 1E iF iFie i41f �t If ?F f ic ?i 4)F 3'r ii� ?4 if iF }..x. �i.x. , I N D I V I D U A�•��F E c B R a A K D O W A! TYFE (�TY 3? E S C R Z P T I�O N'� UNIT COST TOiAL CO�T . � ' FLU 1 DZS3WASHER !. 2 UO Z p0 PL❑ 1 SINK, KIT'CHEN � 2.00 2,00 PLiJ 1 WATER HEATER AND/Ok VENT 2.00 2.00 ��Lli 1 GAS RH-PZPE . -; ' ��, �� ,, 00 E1�llV,OF FcES �� -^ li Y5, '� n,,I � } .lUL � 8 �992 CITY OF COS7A MESA CONSTRUCTION AND PLANNING POOL .PA . APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 7. Temporary Electrical Service�or Pole 52. Pool & Equipment Location � ' 2, Soit Pipe-Undr9rnd. , ��j�� (�� 53. Steel Reinforcement j 3. Electrical Conduit Uiflity-Undrgmd. 54. Forms � 4. Electrical Conduit�Undrqmd. 55. Electrical Bond�ng 5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVA� TO COVER-GUNITE �7. FOotings 58. Electrical Conduit-Undrgrnd. .%.8. FOundation " 59. Gas Pipe, O Undrgrnd., Test :, � 9. Water Pipe-Undrgrnd. , � 60. Backwash Li�es, P�Trap, O Undrgmd. 10. Structural floor System 61. APPROVAL TO DECK 7 7. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing �/7y�'/_ G� 65. ElecVica6Final Z ,.� 75. Rough Electrical�Conduit � 66. Solar SYstem-Final 76. ROugh Electric Wiring 67. Fencing & Access AqP�oval 17. Rough Wiring Si9n 68. APPROVED FOR P�ASTERING 18.�Rough Electriral�T Bar CeiHng 69. POOLlSPA SYSTEMS FINA� 79. ROugh Hea[ing & Air Conditioning FIRE DEPT. REQUIREMEN7 20. Rough Factory Fireplace APPROVAIS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. DUcts, Venti6aRing 77. Product Pipin9 OGas OOiI 23. G25 Pipe-Rough & Test el/�e��(�E1� �2. Underground Plush / 24. Roof Praming 73. Undergmd. Stnrage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Svuctural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. L2thing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. DrYwa�l Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Bfown Coat � 79. FINAL INSPECTION 32. Efecvical Power MeterFinai S0. FOOD CEATtFICATE ISSUED • 33. Final Electric .' Notes: ��/i�� S��n/f/�,�Q./�� /�/, , l o� t< d sP �' 34. Final Heating & Air Conditioning ' + / �-_, ''[ [�M %T. F��'Aw-Y��47��i_/JP�-f � �TJP Il/I � 35. Final Gas Pipe-7est � l� � 36. Hood or Canopy � � 37. Final FactorY F��eplace � i � . 38. Final Plumbing rz-',jrC(Z ' � �• 39. Waier Service•Final - 40. Gas Service-Final ' 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation '� _ 44�. Landscape Irrigation System i � .. 45. Sound Attenuation , � 46. Handicap Regulations � , .� �� r` 47. FINAL STRUCTURE & BUILDING . � �" 46. FINAL PLANNING ' � - !1-. ,t 49. Electric Release to Edison � �� - . ,. 50. Gas Release to Southem California Gas Co '. �� '�.. . 51. CERTIFICATE OF OCCUPANCY No. __ Date � PP0.IECT AOOflE$S: 5 O 4�� vrI00D S7' � uxiT: owxen�sxame: FARTHI,��, SCOTT.M aooxEss: FARTHZNG KIM 909 DOCWbOD ST COSTA MESA,CA 92627 RflCH/ENGINEEfl: SCOTT FARTHING eec.so.: NONE RDOflESS: 9O�i DOGWOOD ST uxir: COSTA MESA CA 92627 PEflMITTEE: FARTHING DEVELOPMENT, INC, -(�719 )��73-1212 ADDXE55: yO�i DOGWOOD COSTA MESA CA 9267.7 UCENSEO CONTRALTOB OECUBATION: I hereGy aHirm f�ail am Iicense0 untler provisions of C�apier 9(commencing with Section 70001 of Division 3 ot Ihe Busineu antl Prolession5 Code. ana my licensr. is in full �orce and ellect. arruc.: 04fli1] STFTEUC.:SOOS-IS cuss— Dale:�� Signalure:� . WONREPS' COMPENSpTION DECNPIITION: I here6 flirm Iha� I �ave a cetlilicale of conse elbinsure or a certi�icate o� Workers' Compensa�ion Ipsura{�g� tifie ceDY I�ereo� (Se 'on 3800, La� POLICY NO.: ! 1 0`� �� . oaTe: ��3 / O 1/ 9 3 comrnxr: STATE FUND O cen�nea coov �s nereoy mrm:nea. C�S Cenilietl copy is lilee i n tne city Buimin � ision. Oate: �/� � ApPiicam: - E%EMPTION FNOM WOflKEflS' fAMPEN5ATI0N �ECLANRTION: Qhis se[Iion necd nol Ge comDlelN ii t�e or one hwAreA (8100) or less�. I ceriify ��al in Ihe OehOrmance ol ��e work lor wliich this Dermi� is i55ueQ I 5�all nnl em0loy any per5on in any manner 50 as to become 5u01e�� o ��e Workeri Campensation Laws oi Calilornia. �� Date: SignaWre: NO710E:11. after makinp iNs aeGaration. yrou slwulE Oerome suhhct lo I�e Workeri Compensa�bn provisions ol�ihe Lahor CoEe. you mu51 �onMnln comply with suc� pmvisions or 1Ns Oermi� shall Ee EeemeE revake0. .� ' . I �ereby allirm Ihat ihere is a conslmciion lending aqenty lor Ille Dedarmance ol t�e work �or which mis permit is issuetl (Section 3097. Civ. CI. �xeen: ADD'PUP—OUT' (BAY) WINDOW, i`' """'_<` REMODEL EXISTING KITCHEN. OWNEP BUILOEB UECIABRTION: I �ereby atiirm thatl am exempiimm tAe Caniractors' Staie License Lawlorihe lollovnng reason �Seclion 7031.5 Business an0 Pm�essional Cqtle: Pny ciry o� couniy w�ic� reQuires a pefmil lo conSlmci, alter, impmve. tlemolish, or repair any SImCNr¢, prior to i�5 issUance. also reQuireS Ihe applicani IOr SUCh Dermil lo lile a signe0 Slaiemen� �ha� �elshe is IiCen5e0 pursuam b I�e pmvisions oi Ihe ConVacmrs' Slale License Law (ChaD�er 9(commencing with Sec�ion 7000) of Division 3 oi Ihe Business antl Pmfessions Code) or t�at he/s�e is e.rempt iherelmm an0 Ihe �asis lor Ihe allepeU exemption. Any violalion al Section 7037.5 6y any apDlicant lor a p¢rmi� su�iects ine applicantlo a civil penalry ol not more than hve huntlred tlollars ($500). I. as owner oi me o�ooenv or my employees vnlh wages as Iheir sole wmpensation, vrill Oo Ihe work, and ihe ❑ 9mcWre is nol inteneed or olleretl for Sale (secbon 7ME. BUSine55 and Pmie55ianal CoOe: The fAntractors' State License Law Eces noi apON to an owner oi a D�operty wtn Euilds or impmves thereon, and who tloes suc� work himseli/herself or t�raugh �is or �et Own emDloyees, pmviAed t�at suc� impmvements are not intenaeA ar afleretl for Sale. If, Mwever tAe OuilAing or impmvemenl is 5oltl vnthin ane year ol com0le�ion. the awner vnll �ave t�2 GurUen of proving he/she tlitl noi EuilA or imDmve for Ihe vurpose of sale). I. as owner ol I�e pm0erty, am eMclusively coniracling wil� licensed conlrac�ors �o consimct lhe O�ojec� (Seclion 7044, Business ❑ an0 Proleuims CoCe: ihe Coniractors Slaie Licenu Law Ooes no1 aDPN �o an owner al pmperry wlro hml0s or improves Iherean and wha cantracts lor Suc� Omle��s with a tontrador�s�lic¢nse pur5uant to I�e Cantraclors' State License Law�.l am aware �AE� DraOl ol their Worker's fAmpensdtion insurance stroulA be O��a¢E to me. � I am exemp� un0er Section: B. 8 P. C. br Illis reaSOn: Date: Ownec I do �ereby cetlily Ihat I am aware o� antl untler5tan0 �he requiremems ol Calilornia Heal�� antl Sa�ery Code Sections 25505, 25533, antl 25534 antl ihat I or any IUWre builtling occuDanl willlwill not (circle one� neetl to comply wilh sai0 slale cotles antl the requiremenis for a permii lor cansimclion or rtwtlilication tmm Ihe Fir �uabry Management �isVicl. qesi4eniial conslmc�ion applica�ions are exempt �mm mese piovisions �ate: ApplicanL I hereby ceriilythal I Aave read Ihis apPlica�ion an0 Slaiethat�he above in�ormation is correct. I aBree to comply wi�� allci�y an0 counry ortlinances antl slate laws rela�ing lo bwleing consimc�ion antl hereby aulhori[e repres Ie6 es ol ihis ci�y �o en�er upon Ihe a0ove-mentioned pmpeny lor insq0eclion purpases. Oa�e'. �d� � Signa�ure: Driver's License or so��,i seo�mY r: 169L46 WM1i�e—BuilOing: Green—Cade EnforcemenC Canary—AOO�icam; Pmk—Ravenuo: GOIEenroC—Assessor CITY OF COS'I'A MESA — 3UILllING PERMIT YtKM tuu: r: U�tlS4G PERMIT NU: E 05l3396 PL.AN CHECK NO: N GUV;: N SUYY; N CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE: OTH ,70H DESCRIPTIOh : EXT�ND KITCHEN 35SQ FT S RcMODEL KITCHEN S(J FT; CLAIM VALUE: CALC—VALUE; GROUP OCC: R-3 / COMMENTS: RE; B58395 PRIMARY BLDG. PERMIT. iE iF #�%� �)f if �1F iE iE if R iE i(� if iE 3F iF �1F iE if N� aF 3E ie iE iP IF iE �F 3t iE 9k ic� i(� IE aF iE iF �I(� IFif i't i(� iF fE * df �F iE # 3(� #� 1F 1G�lE j(� if if #� )f ?(� i!� �?k if �743e 3E 3F #E if iF � iF 1f V.� iF IE # 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 BUILDING -------- FRNT; FT IN REAR: FT IN FRNT; FT SN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING RE • PROV; PARCEL; 92252120 ZNE; RE? ?30: PLANNING N 'PES> > 1E iF iE itif #� i(�?E iE aE ic 3F iE # 3t # iF iEi6 ieiF #�1F iF iE iF #* N• 1f�?f if fi�1F 1c iF jF if �F ti-# ih iE iF ##�i� ii� iF iFlf id 1f� %� 1e #� if i4 3F 3f� * iE ii *?i�+E �1F ie } 3F �)c+f i'r if t ic iE 1E iF D E V E L O P N E N T S£ R V T C E S R E Q U I R E M E N T S ZONING APPkOVEU BY DATE; HUILDING APPRO�TED BY : DATE: APPLICATION ZSyUED BY: " � DATE: 7�2 $' %�%Z if?EiF3fifif-iEiFiEiEiEiEiEi(�:.iEtFiEiFieiEi'r ... < r ri. � �'Y."'�'t e�� ii�. r£�£�`.��EiF3tiFN�iFIF#EiEYTr".��Z"rr�£3FiEff ihiFiEiEiF%iEiEiE�IEN�iFificifiFiF�lEiFifiFif#aEM!(�1EiEkiElf�1FK-liif�lf-1E�1f1FiFi(•if#-iFiFiEiFi(KIf1F� �(�ifiEififiFiPil�fiE3E#iEiEiFiffF3fi�iF#fE�1FiE�1k1F LEGALIZATION:N F E E S U M M A R Y STRUCTiiRAL SEGMENT;N BLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/RES CRAPING r FERMIT 17�Ot S,MIP/NON—RES PL'AN ISSUE FEfi 15,00 BUZLDING—DIV—> PERMIT ISST7E PLAN—CH€CK TUTAL PA3D DUE TOTALS----> 17.25 15.00 0,00 32,25 32.25 ,00 REVENUE DIVISION TOTALS--> COLI.ECTED: 32,25 OVER/SHORT; .00 HLDG PDST PLUMBI�'G ELECTRIC MECHANIC ?IRE SMIP/TOT GRADING PLAN—CHECK 32.25 iE ie if ?t M� 1c i(� �3E k 1E af 3'r if +F �k ie i(� 3E if if i` iE �lE iE if ?F iF � if iF if ?e if iE 3( � 1E if?i� �IE 3E iF 3E aE if iE iE dk iE iF �f� if iF 1.IF if� if �k ih iFii 3F R iF f>� � u k 1F 3f� �e s If 1k jE 1E'.E )` I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 8 cIXTURES LSGHTING 1 ST 20 EA, F.LE ]0 RECEPT/OUTLET 1 ST 20 EA. ELE 1 RECEPT/SWITCH 1 ST 20 EA. ELE 1 RES APPLIANCE NOT OVER 1,0 HP END Or FEES .75 7;50 � �� j�° D .�s � �-- 3.00 JU 2 8 1992 � L CITY OF COSTA MESA CONSTRUCTION ANDPLANNING POOL PA APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector 1. Temporary Electrical Service or Pole � f}52. Pool & Equipmen[ Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. ElectriCal Conduit Utility-Undrgrnd. 54. Forms '�Q4. Electrical Conduit-Undrgrnd. � 55. Electrital Bondmg � Steet Reinforcement 56. Rough Plumbing & Pressure Test J � ��'Electrical UFER Grnd. 57. APPROVAI TO COVER�GUNITE 7. Footings 58. Etectrical Cdnduit•Undrgrnd. 8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pipe-Undrgrnd. 60. Backwash Lirtes, P�Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Propertv Sewer Line & House Connection ' 62. Backwash & Receptor-Final �' 12. Sewer Cap 63. Heater & Vent•Final 73. Roof Drains � . 64. PlumUing System - Final 74. Rough Plumbing , 65. Electrical�Final 15. Rough Electriwl�Conduit 66. Solar SYstem-Final 1G. Rough Electric Wiring �O/(rllQZ � 67. Fencing & Access ApProval ! I! 17. Rough Wiring Sign 68. APPROVED FOR P�ASTERING 18. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof framing 73. Undergrnd.StorageTank OGas OOiI 25. Roof Sheathing 74. Overhead Hyclro � 26. T-Bar Geiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Sidin9 77. FIXED SYSTEM FINAL 29. �nsulation 78. FIRE P(iEV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 37. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric (Q/�'3 Q� Notes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test 36. Hood or Canopy - � 37. Final Factory fireplace 38. Final Plumbing � 39. Water Service-Final -f . ' 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer . ,, 43. Backflvw Irrigation � " ' -- 1.r 44. Landscape Irriqation System c 45. Sound Attenuation �'- �~: 46. HandicaP Regulations • _ `��;�''. ; : � 47. FINALSTRUCTURE&BUILDING ' �,y. � �-- � � . 48. FINALPLANNING '�' i- - - _ , �-- 49. Electrit Release to Edison �`..tA �� 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No. Date •PflOJHCTA00PESS: 9O�I DOGWOOD ST awyessr+nmc: FARTHING, SCOTT M nooness: FARTHING KIM 909 �1�GW�D ST COSTr� MESA, CA APCMIENGINEEH: noosess: uxir: 92627 XEG.NO.: uxiT: PEHMITTEE: SCOTT FARTHING ( 714 ) 645-9325 ADOflESS: )O�i DOGWOOD ST ' COSTA MESA CA 92627 LICENSED CONTHACTON UECNBATION: I hereby attirm Ipai I am licensetl untler pmvisions of Chapter 9(commencing with Sec�ian 7000) ol Oivision 3 0l Ihe Business and Pmfessions Code. qnd my license is in full Porce and eilect. CITY LIC.: STFTE UC.: CIASS: Date: SignaWre: wOBKEflS' COMPEN54TION �ECLPBa7lON: I hereby affirm ihat I have a cenilicate of consent to self-insure or a cetlilicate o1 workers' Compensalion Insurance. or a certified copY Ihereol (Seclion 3800. La�. C�. POLICY NO.: ESP. OAiE: COMPFNY: ❑ CerlifieJ coOY is hereby �umishetl. ❑ Ceni�ietl coDY is liletl wiih I�e ciry Builtling Division. Dale: ApplicanC EXEMPTION FROM WOflNEflS' COMPENSRTION DECLANpTION: (ihis SeClion n¢e0 nol b¢ tOmpletetl if the permi� is forone Aunar¢U ($11q) ar 1e55). I ceriity Ihai in Ihe pedormance oi Ihe work for which �his permii is issuetl, I s�all not employ any person in any manne� so as �o become subjecl to the Workers' Compensa�ion Laws ot Califomia. Oale'. Signature'. NOTICE: Ii, a�ter making Ihis Oeclaration, you shoultl bo�ame subjecl �o ihe Workers' Compensa�ion provisions o� �he Labor CoOe. you musi fotlhwith comply with such provisions a� (his permit shall �e deemeA revoke0. CONSTNUCTION LENUING FGENCY: I hereby aftirm Iha� �here is a conslmc�ion lenaing agency for �he petlormance al Ihe work fOr which I�¢ permitis issued (Secnan 30W, Civ. q. LENOEP: aoonEss: OWNEH BUILOEfl OECIABATION: I �ere�y affirm Nat I am exempi iwm ihe ConVaciors' S�ate License Law lor Ihe �ollowing reason �Seciion 703L5 Business antl Pmiessional Cotle: Any cily 01 county whic� requires a permi� to con5tmc�. alier, improve, GemaliSA, Or repair any slmclwe. prioi to its issuance. also requires I�e aDVlicant br Su[h permil �o lile a signetl s�a�emeni Ihal he/she is licensed pursuanl lo �Ae pmvisions of Ihe Contrac�ors' Slaie License Law �Chapter 9(commencing wiih Sec�ion 7000) ol 0ivision 3 0l I�e Business antl Pmlessions Cotle� or iha� he/she is exemp� ��eretmm and Ihe basi5lor I�e alleged exemption. Any viola�ion of SectiOn 7031.5 6y any aDPlicanilor a permil sublecis the applican� to a civil penally ol nol more than �ive hundreA dollars (5500). I, as owner of Ihe propeny or my employees with wages as iheir sole compensation, will tlo �he work, and tAe ❑ slmciure is not inten0ed or offerea for sale (Section 7044, Business and Pmfessional Code: The Conimclors' Slale License Law - does not apPly to an awner of a properly who builds or improves iHereon, and who tloes such work himself/herself or ihmugh his or her own emplayees, pmvi0e0 ihat such improvements are not intentle0 or offeretl br sale. Ii, however Ihe builtling or impmvement is soltl wiihin ane year of compleiion.'�he owner will have �he 6ur0en of proving he/she tlid no� 6ui10 or impmve br Ihe purpose of sale). I, as owner of I�e pmperry, am exclusively conirac�ing wilh licensed coniractors to consimct Ihe Dmject (Section 7044, Busine5s ❑ an0 Professions Code: The Contracmrs' S[a�e Licen9e Law tloes not aDPly b an owner of pmperty who 6uilds or improves there0n and who conVacls �ar such projec�s with a conUac�or(s) license pursuanl to the Contrac�ors' S�aie License Law),I am aware Ihat prool of �heir WoBer'S Compensa�ion insuranc¢ s�oula be providea lo me. � � am exemot under Section: H P 7 Q Q Q B. g P. C. mr tnis reason: ApLL WORK BY OWNER Date: � � �� L / Owner � I tlo here�y cerlify Ihal I am aware o� an0 untlers�and Ihe requiremen�s ol Calilomia Health id Sa ry C ae 5 c�ions 2550.5, 25533, antl 2553a and Ihal I or any luWre building occupan� will/will not (�ircle one) neeC to comply wi�h '�ale c anE ihe requiremems lor a permil lor conSlmciion or moDilicalion imm t�e Air Ouabty Managemeni Distric�. flesi0en�ial cons�mc�ion applicalions are exemD� �mm Ihese provi5ian5. Daie: ApplicanC I hereby ceriify ihat I have reatl Ihls applicaiion and sla�a ihal Ih a�ove Inlormatlon is wrrect. I oNlnances antl stata laws relaiing �o bulltling cons�mction an0 here y aN�onze repr Senlative5 of II pmpetly Idi inspeCtion purpases. ozie. c� — � 3=L-i slgnawre�. _ onver's I.icense or Socia� Securi�y p: tfiataB W�ew—Rulltlinn' f.rean—GAa FnlnrcemenP. Camrv-4nnlicam� PinN—Ravani to comply with all city antl counly �o enter upon the a6ove�meniioned BnitlnnrrM—Assnsm� CITY OF COSTA MESA — BUZLDING PERMIT PERMIT NO: E 052092 PLAN CHECK NO; N CONSTRUCTION TYPE: S—N PERMIT TYPE: ELE JOH DESCRIPTION : UPGRADE EXISTING ELECT'RICAL SEAVICE CLAIM VALUE; CALC—VALUE: PERM NO: E 05204 GOVT: N SUPP: N PURPOSE: OTH SQ FT; GROUP OCC: R-3 / COMMENTS: * �t�+tx�*x***�r***�**��t**�t**�*x*�r��r�*x*��x�***+��r�r+�***+�**�**x�t*x**�*�****�r�*********** 'L O N I N GS ERTEB�AUCIKRSE M E N T S ------------ MAIN BUILDING ---------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• PROV; PARCEL; 42252120 ZNE: REF NO: PLANNING N(7TES> � if 9f iE iE �IE IE iF ib If i6 iE it if 1f If aF K jF iE if if iE 3k iE if iF iF if i61F iF i4 �IF iF 3E IE if �f �ElE iE aE 3F IE iF IE !F iE IF !E IE �f iF if ## iE iF If iE # iF iE aE iE �E iF 1E if iE IE iE iF IE iE #f iE iE iE D E V E L O P M E N T S E R V I C E S A E Q U I R E M E N T S ZONING APPROVED BY DATE; BUILDZNG P.PPROVED BY : DATE: / APPLICATION ISSUED BY:' � ` DATE: /�3` / iEiFfk*iF�lf�fifiEiFiflFiEaFiFifiEiPiEiF3fiE ifM�lEifiF*iElf#E3f �EiF3EiF 3E3f9E�lEiEitiElEkiflEfElEifiE�EiF9E3E1EiEjF3EiF�ElEiEiFiEiF3EfEjEiElFaEiEiPlEiEif�lEiEiEiF3EjE1f F �ifiElE3FiEkjEiEifihiE3FiE1E1F*jlIFlflEiEiEi(�rtiE�k3FiEi! LEGALIZATION:N F E�E ' S U M M A R Y STRUCTiJRAL SEGMENT:N n HLDG PMT PLUMBING ELECTR�IC MECHANIC FIRE SMIP/RES GRADING PERMIT 18508 SMIP/NON—RES PLAN , . ISSUE FEE 1'S,00 BUZLDING—DIV—> PERMIT ISSUE PLAI!—CHECK TOTAL PAID DUE TOTALS----> 18.50 15.00 ., - 0.00 33.50 33.50 ,QO REVENUE DIVISION TOTALS--> COLLECTED: �33.50 UVER/SHURT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33,50 , �E 1E i4 lE #P iE �E If 1E if iE iF 3E if iF 1F IE iE iE k IP �f �E 1F iE 3P 3f iE �f ff iF IE iF if aE iF iE iF �k �k �F i4 3E jk iE iF iF k IF iE if )f if ik # 3F If lE 1E IF 3E af if iE iF?E fE jF )E lf 1f !E 1f iF IE 1f iF iE 1F I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V& BELOW 201 AMP 18.50 18,50 END OF FEES V '� i ' l'0;;-1�` - ,`�ti'^;; � �y' ' ��,�-�: cs; c,�: �:�.r" :�,-. � _ . e� �• CONSTRUCTION AND.PLANNING POOL & SPA •APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector � 1. Temporary Electriral Service or Pole 52. Pool & Equipment Location �� 2. Soil.Pipe�Undrgrnd. 53. Steel Reinforcement ' 3. ;Electrical Conduit Utility-Undrgrnd. 54. Forms �, ' 4. E� ric21 Conduit-Undrgrnd. 55. Electrical Bonding - � 5. Steel RB��forcemenf 56. Rough Plumbing & Pressure Test' �' 6. E ectrical UFER Grrid. 57. APPROVAL TO COVER�GUNITE = 7. Footinqs - 58. Electrical ConduibUndrgrnd. ' ��8. Foundation � 59. Gas Pipe, � Undrgrnd., Test - -" 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgmd. -- 10. Structural Floor System 67. APPROVAL TO DECK _ � 11. Prope�ty Sewer Line & House Connection 62. Backwash & Receptor�Final - � 12. Sewer Cap ; 63. Heater & Vent-Final - " 13..floof Drains � 64. Plumbing SYstem � Final -"t,=-- _. "- 14. Rough Plumbing " 65. Electrical-Final -, ' 75. 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 - i� - . 20. �Rough Factory FiFeplace - � ' = -� � • APPROVALS�� Permit # 21. Ducts, in-Structure�. � . ' � ; � .70. Underground Hydro .. � 22. DucYs, Ventilating_ � _ _ f� � 71. ProducYPlping O Gas ❑ Oil � 23. Gas Pip¢�Rough & T.est � �, - �- 72. Underground Flush� � - 24.•Roof.Framing . • �� - : ' •73.-Undergmd:StorageTankOGas OOiI 25. Roof SNeathing ; �" ' � ,_ �� ., 74 =0verhead Hydro- , 26. T�Bar Geiling (Strueturall & M000coat �'� 75.-Dry Chemical - � ' � 27.-Framea�d Flashing�", J,u. , ' '� 76:'DryStandpipe ' � . ' � : � ' 28. Lathing & Siding .��' . .� �� '�: � � � ��• : 77.- FIXED SYSTEM.FINAL` r� �29. Insulation � � ' : � � i.; � . 78: FIRE PREV. FINAL _ i 30. Drywall Nailing �� ';� : HEALTH�DEPT. REQUIREMENT � '�31. Plaster 6iown Coat' ' � � , �. , 79. FINAL INSRECTION, ' � , � �32. Electrical Power MeterFinal .' � '� �. - :80. •FOOD CERTIFICATE ISSUED ., 33. Fina,l Electric � , - � � � ' Notes:�2 �o� � �34.,�Finel HBating & Air.Conditioning-, ,� � � ,�'; � � � � - � S-. ,.� 7r 35. _Final Ga's Pipe-Test ' ' � �' � � "' ' ` ' �,. - - i_. .36: Hood or,Canopy . t . . .- _ , s � � � 37.-Final Factory Fireplace . ' `� ; " I � � � � ' , , 38. Final Plumbing � � - -� �� t�� . � + .. �� .�39. Water Sarvice-Pinal• � � 'r ' ' • - - . � 1 „40. Gas SeNice-Final . , �� . , � � ' , ' , . � .' t •41. Solar pomesticFinal " � : � j j � • � � 42.�BackflowPreventer� ' - � � �• � ' � . � 43. Backflow Irrigation ` � � ; '44. LandscaPe Irrigation System, , , . � - �45..Sound Attenuation • - �" ' - . '� - 46. Handicap Regulations � � � � � � - - . �. 47. FINAL STRUCTURE & BUICDING � i . � h � �� - 48. PINAL PLANNING ` � i �/, • - � � . -49. -Elecfric Release to Edison . � � j�� ;: � i ' • �- � 50. Gas Release to Southem California Gas Co �` � I��!, .- _; . � 51. CERTIFICATEOF;OCCUPANCY : , .. ,� �y,. , , ,., No. Date `�'OWNER Mr rT.U$KF.Y- �JOB ADDRESS 90 14 � GENERAL CONTRACTOR py � A 115-491-19 LOT j IN�rECTIONS SOIL � GAS � WATER ROUGM PWMBING PROP. $WR. LINE Q HOI15E CON. SPRINKLING SVSTEM MISCELLAN ROUGH HEA' ANO AIR CON�ITIONING UNDEFGROUNO U POWER U ROl1GH WIRING TRENCHES � FORMS � STEEL REINF. F100R SVSTEM BON� BEAM ❑ STEEL REINFORCE � SNEATMING FRAME AN� FLASHING LATHING — IN ❑ OUT P' 'TER,BROWN COAT :TURAL, FINPL lG, VENT., REYnic. ING, FINAL ANO GA RIC FINFL ulf. FINGI DATE 4-14-75 BUILDING PERMIT N0. 39861 CRIPTION of WORK Leealize Patio C E ZONE VALUE $400.00 YPE GROUP J ZONE R SUBCONTRACTOR PERMITS ISSI ti : 39861 � COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COS7A MESA, CALIFOFN�A 92626 P For Applicant to Fill in Completely RE BVILDING � �, ADDRESS ' O g� ) OWNER A.P. NO. MAf L BUILDING ADDRESS AODRE55 O� O ".�R 14-7.P°'�OO 4�2'� ��:*=�e �}c � ON FOR BUILDING PERMIT aU CITYCC�IH" �eS%'N NOL/YnIiP. TFACT � Z Q CANSTRUCTION W AD f O N LENOER am J � BFANCN � N OWNER � m J ADDRESS m ARCHITECT TEL. S '� a OR ENGINEEF N V N FIRE Q W K AOORE55 ZON d w APPROV W Z CONTRACTOR � /"� BV J � m Z J � ADDRESS i VALUE W w TEL. ZO NO.OF �J USE OF NEW 'r � �= CITY NO. P�� (,� BUILOING t Z � WO STATE CITV �'AR�SAPPROVED VARDSAPPROVED y� LIC. NO. LIC. NO. MAIN BUILDING ACCESSOFV BVILDII � O (FROM C/ S EES�_ Ii . 512E NO.OF BLOC'aS. OF LOT NOW ON LOT FRONT FT3 VSE OF EXISiING BLDG. T, H SIZE OF NO. OF Z NEVJBLDG O � ROOMS STORIES L.SIDE �FT. EXTERIOR WAIL ROOF f �% COVERING COVERING REAR � FT.' J USE OF BUILOING AND WORK TO BE PERFOAM£D DI5TANCE BET. a MAIN BlDGS. a o�e� �'ze_ -' / CURP glE F APPROVED N Z I O UI hereby acknowledge that I have reatl ihis applicaxion end state � that the ebove informetion is correct end apree to comply wlth � all laws reBulating buildinB construction, entl I shall not employ � eny person in vlalaHon oi t�e workman'S compensntian laws ot y the Stete of California. zI �ereby certify that I em properly licensetl as a eontractor untler SQ. FT. the State ot Calitornia Businesa antl Professions Code, Dlvisicn 3, THE AMOUNT SI Chapter 9, antl that such licenses are In tull forca and effect, or I THE PURPOSE OF am exempt trom-the provisions of the State of California Business / 1 VALUATION antl Protessiqns Cotle, Division 3, Chapter 9. Sipnamre ot ✓ ��/ �!/� / / Perminee ( � � � ""<� % $ LL//-�% � j � (/ Au[horizetl'ABBnt BET. MAIN & ACCF�. BLD DATE APPFOVEO r-.�� m � 0 VAI.UATION IS FOR � A PERMIT FEE ONLY: Q `o LL .... ,". MAIZKWaEtDT L. JOB ADDRE55 904 Do �oo S GENERAL CONTRACTOR Air—xn Q" 'o. 115-491-19 L T� IA. ECTIONS 501 L GAS WRTER ROUGH PLUMBING 'PROP. SWR. LIHE Q MOUSE CON. � �SPRINRLINf, SVSTEM MISCELLANEOU$ ROUGN HEATING ANO RIR CONOITIONING TEMPORARY SERVICE OA POLE UNDERGROUND � POWER � ROUGH WIRING TRENCHES FORMS STEEL REINF FLOOR SYSTEM BOND BEAM n SiEEL HEINFORCE n SXEATMING FRAME RND FLASHING LATHING - IN n OUT n PLASTER,BROWN CORT :TURqL, FINRL .ING, VENT., REFRIG. �ND �.C., FIN/.L PLUMBING. FIN4L NND GAS TEST n ELECTRIC. FIN�L vni� �' BUILDING P E VALUE SUBCONTRACTOR � F � {al a Q = � 's F G � F Q C J Q 7 %' � C � o. Q C a Z � s 3 ` 42131 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING /'j..� �._ _ . .,, � _-r OWNEF �, /I,j4� MAIL (1AM� ADDiiESS d CITV �OS'TA / BRANCH ADDRESS ARCHIYECT /. . ./ .i.•/�� TEL. ADDRESS �(' Ge/(/T TEL. CITV �q/Q(/f%��I N0.9(�� LIC. NO�Z'3� �OCG� LICVNO. SIZE NO.OF BLDGS. J OF LOT I NOW ON LOT / EX�4NG 8��. c,9.�.�r ,p•�E� .a�,—.—. Separate permits are required for elecVic, plumbing and hea[ing work. USE OF BUILDIfJ.(i ANO WORK TO BE PERFORMED .,. ; 0-7��=y00 6,�5 � �-. � ::21.5C APPLICATION FOR STRUCTURAL PERMIT E I D@� DATE `REC�EJI/�(ED ATE SSSU£f '� �`�/CJ /1.�� / BVILDING ADDRE55 ROVED'//�/ DFT9/1 ��_ � � tl! � NO.OF USE OF m � PLANS BUILDING , �ARDSAPPROVED VARC� APPROVED MAIN BUIIDING _ ACCESSORV BUILDII VAR. 3i-` C. V.P. qy� APPROVED r FT I haraby acknowletlpa that I havo reatl t�is opplieatlon entl state '^ n that tho abova Intormallon le correct nntl apree to comply with m all iawa �epuletlnB bulltlln0 �onRruction, anC I shall not employ any perse� �� oloilon of tha workmnn'a <omponwtion laws oi u tha State of Celifornle. I hereby certify that I am proparly Ilcensatl az a conlrector untler SQ. FT. N the Stet6 of Callfornia Businea antl Profauiona Cotle, Dlvizion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl ihat sueh Iicenws era In full forca ond effeci, or 1 7HE PVRPpSE OF ESTABLISHING A PERMIT FEE ONIV: am exeenPt from the prov(slons of the Stete ot Callfornia Business 'D VALUATION PERMIT FEE E � e antl Professions Code, Divislon 3, Cheptar 9. •�d ui m PLAN CHECK E ^� Sipnatureot /'/ !� ' � o PermltteB 8 L� �� TAX S � Q � U Authorizatl t TOTALPAI� 5 � p�RANGE COUNTY BUILDING DEPARTMENT • APPLICATION FOR PERMIT � I� � ^ 636 Nor1h B.oadway A . • SANTA ANA, CALIFORNIA � U I`D I N� _ . ... . - , w . .�` i1�J' �1" �=n � " • `• .�. ��:' . . ...=7 +�rl .•�;` ..G .C.1� .:l':-i ; •';�I'; , _ _ '..1::".'I ' � � � . . '_:1:� ... _V� i ' ' :I!J'.:�'„ � :'I 1_, . , .� ,. �.T. :�: _, . rr . f. � . . . •r. . i `.' . . - �. • r. . -�.i:.•.� :�� [.t:. �i: � � .; r __ -' , i � - . - � . � � . ;. . ��'� � ' _ -S:f-., - �^^ . 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