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Home My WebLink About950 DOGWOOD ST - Building PermitsApplicant to fill in all soaeas ezceo< <�ose within heavy eortler Ilnas antl sign all aoo�ooriate Ceclantions. . . . _. . . . __. ... .. _ ._ . . .. ...._ ' _ ... CITV OF COSTA MESA � PERMI N ' TRACT NO. � LOT NO. • BLD . . . � CONSTRUCTION PERMIT ' • yYj ��' ' " � AppIICBnYS Mefling A/d�dre�55 A ' � .'-�'lA� TVPE OF CONSTRUCTION NEW .4DD ALTERATION � REVAI R , PfojEct AddlCSS r`6-��i'J� U��` I�v�r'f/T� ry� O CONVERSION ❑ DEMOLISH ❑ OTHER � . ��\\�', � (j�kr's Name —L[K/��3a.4�'^' ' DESCRIPTION OF WORK � ' PhOne �;> � Atldreu: `S��d - _ TYpE OF PERMIT GRADING � EOUNDATION STRUCTV RAL " �A. P. � � ' UJ AlCh/Eng. LiC¢n58 NO. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑�MECHANICAL' , PLNG. REF.qW � � Add�eu '. � , , ' �.0 �OTHER � ' ' ' ' TO BUILDING . �' Contracmr,'s Nam �'L�FQP LR_(6�3 T%�6� one 9S�I - ^s�� _ PROJECT DESCRIPTION Sq. FT. � �oCCUPANCv , P � I E J Aildresslmeilingl�s�O �-S' �� 5��'T CONSTRUCT.IONTVPE VA�UATION$ ' LEFTSIDE VARD \- .--� ' - . ' , . ' ' ZON� GRADINGCU.YDS. ACRES PKG.SFACEREQ. Licenu Na: LICENSED CONTRAGTOfi DECLARATION � Remarks: �. . ' STREET WIDTH , I YiereGy af/irin that 1 am Ilcensea untler provislons o! Charter 9(commencing . , wlth sectlon 7000) of Division 3� of the Business antl �rofe551on5 Cotle, antl . '- . , i ; . SPECIAL CONDITIONS: � . mv II<ense is In full forte ana�effect. ' ^ • , ' ' ' ' ' ' ' � Date �� Si9nature � `JRKERS'COMVENSATION DECLARATION � ereby aftirm t�at I nava a certifiwte of.consent to settinsure or a certlfiwte _ . Workers' Compensation Insurance, or a certifie0 copY Ihe�e,�o�/�(�Sect�ion 3000. I�b. � p� �Z � �VJ� �• lif' f��l � Pollcy No. �L/ Company _ �I�yIr Certifietl copy is hereby furnlsneE. ' R4 Cor if tl cop is llletl with the city Builtlin D' "on. Oate��— ApO��ant _ EXEMPTION FROM WORKERS' COMPENSATION DECLA ATION (This section neetl not be com0�etetl it the permit 15 (o� one huntlretl (5300) or less). ' I<ertify tnat In the performance of the work 1or which this Derm�t Is ISsueG I snall not employ any person in any manner so'as [o become subject to t{�e Workers' Compansatlon Laws of Calitomla.. Date ' Si9nature � ' ' ' NOTICE: If,efter makin9 this tleclaration, you shouldbecome-subjocfto�the- Wo�kers' Compansa[lon provisions of the Labor COCe, you must lorthwith. , comply wit� such provizions.or.this permit shall be tleamatl revoketl. CONSTRVCTION LENDING AGENCV'� � • I hereby aHlrm that tnere is a construttion.lentling a9en<y fm the periormance � af the work foY whith [his permit ' is issue0 (SecHon 3087, Civ, C�� Lentler's Name l.enanr�s nmress � � • - � _ � OWNER BUILOER OECLARATION ' ' 1 hereby�afflrm that 1 am exempt irom the Contractor'S'Llcense CSw for the� any sV� io tile a `""31.5 by any appliwnt for a,parmit subJects tha applicant to a civil � �enalty of not more than fiva huntlretl tlollars ($500). I, as owner of the property on my employees with wagas as thelr sole , compensatlon will tlo the work, antl� the structure I5 not IntantleA or offered for wle (Sec�lon 7044; Business� antl I Protessional Cotle: Tha: Contractor'S Ucense Law tloes not apply to,an owner o( a property who bulltls or Improves thcroon, antl who Coes.such work M1imself/�erself or through his or h¢r own employ ees, provltleC lhat such Improvements ara not Intentletl or ofteretl Tor • sale. If, howavar, t�e bulltling or Improvament is soltl within one year:o! com- � pletlon, the ownor,wlll have [he burCen of proving he/she tlltl not builtl or im- ' �rove for the purposo oLsale). �.' l^ - I, as owner of the property, am exclusively confracting with�licensotl <on- tractorsto mnstruct the�project (Sectlon 7044, Business antl Professions CoCe: + Th0 Contractor's LicanSa Law d0¢5 nOt dpply t0 an Owner o( property Wh0 � builtls or .improves [hereon, antl who contracts for such projects with a con- tractor(5) Ilc¢n5a purSuant to [he Contractor's�LlCense Law). , ❑ I am ezemD� untler Sectlon- 8. & P. Q Tor [nis�reason � � Date � Owner. � � , d �ereby certi/y-thaL I have reatl this application-antl state that the-above Inenrmatlnn h enr.oct I aaree to comolv with a11 cltv antl countv ortllnanees � Drivers' License or 55"$ CMF 0865-46 /ev. 12/82 ' White - Builtling; Canary - Applitant; Sink kflow Preven2er ktlow Irrigation Dishwasher Drinking Fountains � Floor Dreins ' Floor-Sinks . � . Gas Se�rvice ' Ou� Interceptors � ' Kitchen Sink '• � Lavatories • ' � Roof Drains � sno�ve.: . �. Service Sink � i N61NG . SewerCap : • Sewer Connectioo- � - - � - Soiar CollectOrs � Solar PiPing . . Sotar Tank � Urinal , Water Closat � - . Water Heater • lets Water Service. . � UnderGround wci-�uucw�a� � Duct-Ventilating ' � � Exhaust System ❑ Multiple ❑ Firepl/Faet.8lt.ICBO;W� a •� Heating System & Ducting ! ' ❑6100,000 BTU 0100,0008T' � Hoad oi Type I ❑ �� Ceno T e I I ❑ : s Re9isters AccounUng;GOlCenroC-Azsessor � �� - 4620 8125/d3 ZONING REGULATIONS ZONE . � - � BUILDING coTB�LK.J'n cr . ' REAR VARD (TO P/U ; ' RIGHTSIDE VARD �, Washer, _ _ ' Dryers 'UGas Fan . , F.A.U. .�. ` � Fixtures Device Boxes � Reinspection Fee $75 Iaue Fae � � � $ 3 OatOopooB7u ❑to0,000 System Fiepair/Alteiation � { � . , Reinspection Fee laue Fee . 0 315 $ 3 PARK FEE.$ ' ' -Meter Uover 100 � Sub Pole Morors OO-1 HP ❑1'6-8 ' � �Inc.Solai��9-15HP �16-15+ � MitrowavB � Pole Light • � 15.�� T;. vuciees Standing Sections Switches � � � Trash Compactor • � Gar6age Disposal � � ' Generator �0-5 KW 05-15 KW Transformer �75-SOKW ' . , �5U+ KW �Raincpectian Fee Meter ❑up to 100ampi Issue Fee ' Zoning Approved By ; �Date Appliption Approved By p' � �Date � Applirrtion Issued By � 1� � Date � � � SUMMARV OF FEES � �' � � s,51 1' :BUILDINGPERMIT $� � 'SMIP ; � $' � � : � i �PLAN CHECK. $� , � . PERMIT , PLUMBING � � $ � � ISSUANCE , $ 'PLAN CHECK $� � � GRADING � ' $ ' , EIECTRICAL ' $ $ . . PLAN CHECK � $�. MICROFILM •$ �MECHANICAL' � $ � TOTAL'FEE $ �PLAN CHECK . $ � � ' LESS ! , ADVANCED PC � $ ' � �� ' � i , FINAL FEE ' �, $ �� i . CONST�ICTION AND PLANNING � POO ;PA � APPRO LS Permit# Date Inspector qppROVALS Permit# Date Inspector. :� 1. Temporary Electrical Service or Pole'�; .'! 52. Pool & Equipment Location � ;-f� 2. Soil Pipe-llndrgrnd. %'� - 53. Steel Reinforcement .� 3. Electri;cal_GonduitUtilitv-Undrgrnd� � � 54. Forms ;� �i .� 4. Electrical Conduit-,�ndrgrnd. 55. Electricai Bonding n - 5. Stee1- Reinforcemeqt� � '�� 56. Rough Plumbing & Pressure Test , �•'%� 6• Elecfrical UFER Gmd. ,y 57. APPROVAL TO COVER-GUNITE ,�� t ,:; � � ,� ;. 7. Footings , , =� 58. ElectricalConduit-Undromd. , :;7, 8. Foundaiion ��' '•i'{` .� ' 59. Gas Pipe, O Undrgrnd., Test .�� J � i: 9. �Water Pi e-Undr rh'tl. � � �' �' ^� P 9 .� �1 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � j, 67. APPROVAL TO DECK "' 11. Property Sewer Line & House Connection ,�,; ;. 62. Backwash & Receptor-Final ''% 12. Sew€r CaP "• r. ' . ! i' : �� ' ' ; ,: 63. Heater & Vent-Final ; .; 13. Roof Drains ' �� + � .r 64. Plumbin S stem - Final . ... t • 19 �:� 9 Y 14. �Rough Plumbing �j � j ;;}`' ;�� 65. Electrical-Final '� 15. Rough Electrical-Conduit �� • ' 66. Solar System-Final 4� 16. Rough Electric Wiring 67. Fencing & Access Approval � - 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1�8: Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19'. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace Q f�/61 APPROVALS Permit # 21. Ducts, in Structure 70. Undergrouod Hydro �,,. 22. Ducts, Ventilating �" 71. Product Piping O Gas ❑ Oil "'_. 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structural�,& Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. fnsulation 78, FIRE PREV. FINAL 30. Drywall Nailing Notes: 31. Plaster Brown Coat 32. Electrical Power Meter-Final -. 33. Final Electric 34. Final Heating & Air Conditioning . 35. Final Gas Pipe-Test ' 36. Hood or Canopy - � 37. Final Factory Fireplace 38. Final Plumbing . 39. WaterService-Final 40. Gas Service-Final i � 41. Solar pomesticFinal �• - 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed � 49. Elearic Release to Edison - 50. Gas Release to Southern California Gas Co " � � 51. CERTIFICATE OF OCCUPANCY No Date Applicanl to fill in all SDaces except thosa within CITY OF COSTA MESA � • � CONSTRl1STION PERMIT ApplicenYi Mailing Address C ' Project Addrea � � Owner'sName -�r Phone � Addreu ��n s7CY ��LTJ �j+.C}T.?i./!R_eL� Arch/Eng. � License No. Addreu Contrector'sNam �« hone.�riV�$n�b Address (mailing) ��7 y �-�AN ta� i1,/i.YA , Licrose No. �2 ��'-' 9S LICENSED CONTRACTOR DECLARATION � I hereby affi�m that I am Ilcansetl untler Drovislons of C�arter 9(commencing with sectlon 7000) of Divizlon 3 of the Business antl Protessions CoEe, antl my Iitense Is in full (ofr an0 eftect. LJcensaC u V- � Lcense o. DdtB � Sl9ndtufG WORK RS COMVENSATION DECLARATION � 1 hereby afflrm that I �ave a wrtiflw[e oi consent to 5eH-ins e or a certlficate- ot Workars' Compen5ation Insuranca,�or a certifletl copy tha�eof (Sectlon 3800, LaE. C.) � � , ' �, . Pollcy No. Company ' 8CertlfleA copy Is heraby fumishetl. Cartifletl copy is tllatl with the city Builtling Division. Data AOP��wnt . EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (T�issactlon n¢<tl mt Ce cOmD�et¢0 it the pa�mlt is fo�,one huntlreC ( ) or less). ' ' � ' � 1 cerHfy that in the performance of the work for which this permR suetl I' shall not em oy any penon In any manner a be e 5 cGto t�e Workers• o il n Laws of California � � Date Signature ' NOTICE: ,'after making this Oeclaration, you shoultl beco sub�ect to tne Workerz' Compensation. Orovislons of the Labor Cotle,�you must forinwith ' comply with, such O�ovisions or this permlt sh511 be tleemeC ravokeC�.. CONSTRUCTION.LENDIfJG AGENCV • ' � I hBreCy a�tirm that there IS d con5truction IenOing agency:for tha'OBrfOrmance ot tha work tor which this Dermit is Issuetl (Section 3097 Civ. C.; Lentler's Name � Lentler'S' AaGress OWNER BUILDER DECIARATION � ' I hereby'affirm that I am exempt from the a ihe • therefrom anE tne basis for the allegetl axempuon: any vtoiauon or tiecuon 7031.5 by any aoo�i<ant for. a permtt sub�acts the.applicant to a civil �enalty of not more than flve huntlretl tlollars (5500): , - - I, as,owner of� the �property or`my employaes with wages,as their sole comoensation wilbtlo tne work, antl the,structure-Is not intentletl or offerea tor sale (Sec�ion 7044, Business antl ProfeSsional Cotle: The Contrattor'S � License Law tloes not apply to an owner ot a property who builtls or Improves , thereon, anU wno tloes�sucn�work himzeli/harself or [hrough M1is or her own amployees, Orovitletl that such �ImO/ovements are noi IntentleA or offeretl for sale. If, however, the bulltlin9 or improvement Is soltl within o�e year of com- pletlon, the owner will nave tne burtlen ot provin9 he/she tl10 not builtl or im- ��ova fo/ the pu�0ose of Sale). I, as owner ot tha D�Operty, am ¢xclusively COntrac[ing wi[h IIc0n5¢tl con- tractorsto constructthe project (Section 7044, Business antl Profezsions Cotle:�. The Contractor'S LI<ense law does not apPly to an owner of property who EuiltlS or improves thereon, antl who contracts tor such projects wlth a con- ' tractor(5) Iicense pursuant to the Contractor'S Lkenze Law): . ❑ I am exempt untler Section B. & P. C. for tnis reason � f Date � � Owner� ' I"hereby certity 'that I,have reatl this application antl state that the above IntO/mdtiOn is correct. 1 agre¢ to comply wlt� all city antl countY ortllndnces antl state laws relating t bu" in9 constr c�n, antl hereby authorize repre- ' sentatives o( thls Nty��o�ykeryPpn above-mentionetl property for , TVPE OF CONSTRUCTION LJ NE ❑ CONVERSION ❑ �EMOLISH DESCRIPTION OF WORK vy Oortler Iines anE sign all aDC�oDriato Coclarotions. LOTNO. BLD . . ADD ALTERATION REPAIR OTHER TYPE OF PERMIT� � U GRADING LJ FOUN�ATION LJ STRUCTURAL ❑ TENANT u�ELECTRICAL ❑ �LUMBING ❑ MECHANICAL O �OTHER PR0.IECT DESCRIPTION 5q. FT, oCCUPANCv_ CONSTRVCTION TVPE VALUATION $� ZONE GRADING CU. VDS. ACRES_ Remarks: Sink D�inking Fountains Floor Drains � Floor Sinks - Gas Service Outlets Interceptors KitchemSink Cavatories � P-Trap ^ fioot Drains Showers Service Sink - Duct - Under Ground Duct-Structural ' Duct - Ventilating � Exhaust System ❑ Multiple ❑ Fiiepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 6100,000 BTU � 100,000 BT Hood or Tvpe I ❑ - ""'"""` � �'—� Registers Drivers' Licensa or:55 $ CMF 0865-46 rev. 12/82 White `Builtling; Canary - Appliwnt; Pink - Accounting; Goltlenrotl - Assessor % X�%`b � L� / \ PLNG.REF.�k TO BVILDING PROPER V INE LEFTSIDE VARD PKG.SPACE REQ. STREET WIDTH �� SPECIAL CONUITIO .�1 . . Automatic Washer S018f Collectors Solar Piping � � So1ar Tank Swimmin9 Pool w/Spa Ufinel WaterCloset• ' �Water Heater, � - Water Service . Reinspectiod�Fee $15 laue Fee a 3 iANICAL Refrigeretion System . ❑0-100p00BTU ❑100,OOOBTU System Repair%Alteration � � � pei�upection Fee $75 Issue Fee . $ 3 Dishwasher Dryers ❑Ge Fan F.A.U. Fixtures Device Boxes I flEAR VARD (TO P/L) RIGHTSIDE VARD PROVIOED PARK FEE $ �M¢t¢f LJOV¢l1WdRIpS' Sub Panel ' . • ' Sub Pole Motors �0-1 HP ❑1X$ � Inc.Solar 09-15 HP 016-15+ �Microwave ' Pole Light . Sign • Standing Sections Tresh Compactor ��I 0-5 KW 0545 KW � • � ' • ❑15�50KW • � ❑5U+KW ReinspectionFee � i � � Meter j]fyp to 100 amps.,._J � � Issue Fee � I�� S 3 I 2oning Approvad By . Date Appliotion Approved By � ' ' Date q _ Applifation Issued By Date ' ` `� � �3 ' � � SUMMARV OF FEES , . � BUILDING PERMIT $ � SMIP $ � PLAN CHECK � $ ' ' PERMIT � ' PLUMBING $ ' �SSUANCE. $ PLAN CHECK $ � GRADING � . $ � ELECTRICAL $ PLANCHECK x$ MECHANICAL $ PLAN CHECK $ $ ', . MICROFILM � $ TOTAL;FEE $ LESS � ADVANCED PC $ � FINAL FEE' $� � _ 7n TL :i -- - -- -- --- - - - ---�---- --- -- , '.? �'CONSTRUCTION�AND`PLANNING. � -�" 5 j ' - -�q�, "' �" -POOL&SPA _- - � � J- �-pppROVALS �, Permit # ' � - �� a.Date � , '- ;Inspector , M �APPROVALS ' Permi4 # - `Date Inspeeto� .� • � �_ � - - .. _ - . _ . . ' 1_- Tem orar Electrical Service or Pole- � • - .:c o� �- `' ' � - _ , - � , P Y ,_c.� .52.,,Pool & Equipment Location , , .. . - . , .. - . . . _ . _, . . � � 2! Soil Pipe-Undrgrnd.c _ '-r � � � E � '' ' � ' ' _' 53.'Steel Reinforcement� � � � ' ' � ,- i � I - . .' � 3„? Elecirical Conduit Utilitv-Undrgrn�i.� ,� � = - � s�54�� Forms� � ' - � �' � � - _� � � �� , �� 4.� Electrical Conduit, Undrgrnd' _ � ` - . . 55.- Eiectrical Bonding' } I , � � 5; Steel Reinforcement , r ` � � � ` ' ' _ � - 56.+Rough Plurimbing�& Pressure Test E �� , i _ _ 6: Electrical UFER Grnd.: . � ' � � � r � � '. - �- ' . � 57:. APPROVAL-TO COVER-GUNITE - - � � 6� ' 7. Footings� � I ; � ��, " ' x .= ,; _. ��'� ` ,.'.�58. Electrical-Conduit-Undror��1F - ' ''" � 8. Foun'datioo ' ' * - : `,� � �� i ' 59. Gas �Pipe,t0 Undrgrnd.-, Test " ' - � - c r - , 9. Water Pipe-Undrgrnd. � - ' • - , ' '. �_ 60. Backwash Lines, P-Trap, O Undrgrnd..- - 10. Str,uctur,al Floor $ystem . `�` ' _ , ^�. E 61. APPROVAL-T,O�DECK �- - � . 11. Property Sewe� �Lin y:& House Connection '.- ' � ,� 62. Backwash& Receptor-Final '- �- ' � , a. 12. Sewec Cap � ! � , � ,. : ; �'; ': . � , . . � :'63. Heater,& Vent-Final i 13. Roof Drains , ' � , � ` � � t � � ' � " � � � � � = . >'64. Flumbing:System = Final . . , 14. Rough Plumbing ' • �il � � - • � � ' 65. Electrical-Final= � ' ' � 0 '` �� i'5: Rough'Electrical=Conduit-'�' , -;--T'T � � 66.; Solar System-Final- �� " "- � ' ' � . i. �� , � ;�i6. Rough�ElecEric Wiring-, � . c � ,� I';"' `� ' -� I�c � '�� 67.i Fencing &=Access Approyal. -� �' ' _ - � 3 , CC._ � . . . , � ' I c �`7,�Rou"gh'VJiring Sign,' ` ,� ; ; ' � � � � � i . _ � ' 68.�APPROVED FOR:PLASTERING ' �- � ' � - 18. .Rough�Electrical�T Bar Ceilingl '� � :, �- � . � � ` � � 69.� POOUSPA SYSTEMS FINAL ' � � . . . . _ . .� 9 . i ' : � , � ;, 1�9; Rough�Heating & Air Conditioning: � � �.- I � � { � � � i � FIRE DEPT. REQUIREMENT� • � �0. Rough'Factory Fireplace, � j ; � � � I ; i ' . � ' APPROVALS � � Peimit # . . � . n _� r 1 � i i' . � ' 21. Duct's,.in Sir.ucture: T ! , � ' ' I � � � ' � ' . � . ' � . _ , ,� � I 70.� Underground Hydro � i '' '��22. �Ducts, Ventitafing � , � , � ' + � ' � � 71 J product Piping O Gas ❑ Oil � I ) , - : �'23. Gas Pipe-Rough & Test � � � � �'�_ ti � '� ' I I � 72,� Underground Flush • i ��•24.'�Roof F�aming_ ' � � - ` ��'= „' � �� I �, � , � �, - 73.; Undeigrnd. Storage Tank 0 Gas .❑ Oib , ' 'r - �' 25. Roof Slieath'irig ; �. ` �� ' - � ; � � �� :74.; OJerNead Hydro � ' � � � ' _ _��26. T-Ba� Ceiling (Structural).& Monocoat' � � = ; �.! ' .' � � 75.! Dry Chemical . . - . � � , 27. Frame and Flashing ' � ' �; ! ' I 1 , ' 76. Dry Standpipe - � ' � � ` 28. .Lathing & Siding � � � �� j � � � � �77.t FIXED SYSTEM-FINAC ; ' ti _ i, 29. �Insulation � � i ., ` -. � ` �j � i j � I � � i78.; FI'RE PREV. FINAL �. ' ' �. ' -30. Drywall Nailing � � � '� � � F . � � � , ' ;Notes:� � � • •- • . � � - : ' . . � � . . � - -- - _ . _ . - . . . . . . _ .. _ . . _ .. -- - '31. P�aster 8rown Coat ! � . • ' � � i , { ' � � . � �, ��32. �Electrical Power Meter-Fina ' �� ' ' . � .� � , � . � i � i �' 33. Pinal ElecVic t � _,� I, i �' 3. .�„�,' I 1 1 � ' � . ' � � � 34. Final FJeating &�Air Conditiouing ! ,` � ' � i �'„ � ', , ,. . 35._Final Gas�Pipe=TesL' ' � +, -_ . ; q . � � ' ' ' , -� ' i - 36.sHood. or Canopyc:�' � � ' �',i = ( - ' � � " .' • ' ' . , ` - . ;� .� � � �' o� r, ' 37' F,inat'Factory Fireplace�. ' " ; ! ' � -- - Y i " I � � i , ; ' � � - �� ' . � r � _:�� T i i � 38. Final Plumbi,ng . , . ' _� , . � � � i � � ' . � . � � . . t � 39!�ater Service-Final' . � - � � ��' � i ; � � � , . �` , ' � ' t� 40:.Cias Servlce-Final ' � � � � � . � ' � �. � � . i � � t �`� . i 41. Solar pomestioFinal ; � � � � � __ �_� _ �_;, __ . I i_ � _ , , � � ' ' � . 42�Backflow'Prever{ter'_� ' ; ' G-� ' � � � � � ' ' �� • '- � y -,� � -- - �- - �-�-� '-- - - --- -. . . . ;i 43. Backflow lirigation� � � ' � '�� ` � � � ' � - � � �� ' � '� , ,, � � : I " I ; " - r 44: ,Landscape Irtigation SYstem � � ' i� - . � -� I � � , ' � , � _ - - 4��Sound+ Attenuation ' ; �. ; `, i I ' i �,'_ ' - , ' i . . , ; , � - � . . • . 46. Handicap�Regulations � � �� . '` ! ! .� � "'. , � ' � � - j . I ' . . - , � � ' .� , � , i i ; � . 4�.�'FIJ�1�C STRUCTURE & BUILDING . � � . , :-r. , i i � 1 � . , i �'48. �pecial Requirernenis Completed ., � i ' � � � i � � � � � � ' � � 49.� EleCtric Release�to Edisoni ; ' . y.- , -;.- i ' ' '"�'_. !' i"_. _ 'i"�... ' " ; 50. ;Gas Release io Soufher,n California Gas Co ; j ' �, � � ' , � � � 51. CERTIFICATEOFOCCUPANCY ' ' ' � � '•`� �"� � _9 � � - u � .E-'. No ' i' � � � Date ' � . � ; � �i s'i !;: " �,o , ' � i �N� Qv�CJ �� Applicant to fill in all spaces withln neavy bortler lines antl sign all aOG�oprlata tleclarations. � �CITY OF COSTA MESA PERMIT NO. TRACT NO. LpT NO. � BLDG. NO. �c;�iSTFikJCTIONPERMIT M—�'�O¢ Address ySQ (��[��Bm,� Arch/Eng'. License No. Address Contractor �/ n/Jf.q�� Phone I hereby aftlrm that I am Iicansatl untler provisions of Charter 9(<om- Rlencing wlt� secflan ]000) of Dlvlslon 3 of the Business antl Protessions Cotle/, ]antl my Ilcense is in full forc �p f Llcenj� � /�^Z'� LltenseNo 0 � oateal�� •Bs�T�<i,,.,,� � e D C.o�/ c.�_�� WORKE0.5' COMPENSATION DE ARATI N I heleby afflrfll Ihat I have a celtlflCata Of Consent t0 selt-in5ur8 or d �^•tiflrzt¢ 01 WOrkers' Compen5ation InSurance, or a certi(ietl Copy 'eof (Section 3800, Lab. C.). :y No. � Company LJ Certifietl COpy is h¢r¢by turnishetl. ❑ Ceriifietl copy is tiletl wlth the city Builtling Divislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl nat be completetl if the permit I5 for one huntlretl �5300) or lessl. C¢rLfy that in fhe performance of the work for which this permit is ISSuetl, I shall not empl0y any p¢r50n in any mannar so as to become SUDjlC t th O/kers' CAmpensatl y5 of Iltorn . oate L siy�ature NOTI : H aiter making LhiS tleclaratlon, you ShOultl become zubject to the Worker5' Compen5dtlon prOvisiOns Of the Labor COtle, you must fOrthwith COTpIy with sUch provi5ion5 or this permit Shall be deem¢tl revoketl. CONSTRUGTION LENDING AGENCV I her¢by aftirT tM1at thete I5 a const�uctlon lentling agency tor the per- formance ot the work for whic� this permit is iszuetl (Section 309] Civ. CJ. �0�� - . Lentler's Name Lentler's Atlaress a Is liGensetl pursuant to [he provi5ions O( the Gontractor's LicenSe Law "'hapter 9(commencing with Sectlon 7000) ot Division 3 of the 'ness antl Prdessions Cotle) or (hat he Is exemp( theretrom antl the ; for the allegetl exemplion. Any violation ot Sec[ion 7031.5 by .: appliwnt for a permit suDjects the applicant to a civil penaliy of�not more than five huntlretl dollars (5500). ❑ 1, as owne� of the Oroperty, or my ¢mploy¢es with wa9e5 as thei� SOIC compen5atlon, will tlo the wo�k, antl the st�ucture is not int¢ntletl Or off¢retl fOr Sal¢. (52clion ]044, Bu5ine55 antl R'0f¢Szions Cotle: The Coniractor's License Law tloes not appty to an owner of a property wno builtls o� Imp�oves thereon, and who tloes sucn wo�k himsllt or thtough his Own ¢mployees, provitletl thal Such improvemenis are nOt Intentletl or oifer2tl fo� sale. If, bowever, lhe builtling or improvement I5 zoltl witM1in one year of COmpletion, tb¢ owne� will have the burtl¢n ot provin9 he tlitl not builtl or improve for the purpose of sale). ❑ I, as owh¢r of the p�opetty, aT exclusively contracting with IicenSetl coni�acto�s to conslruct the p�oject (SeCtiOn ]044, Buslne55 ana Professions Cotle: The Contractor's Llc¢nze faw tloes not apply to an owner ot prOperty wIW builtls ar ImprOves thereon, antl who con- ttaCK from such projects with a contracto�(s) lic¢Sn¢tl pu�suanf [o the Contraclo�'s LicenSe Law). ❑ I am exempt untler Section � B. & P. G�or tM1is reason Date Owner 1 hEreby certify that I,have r¢atl this appli W[ion ana siai¢ tba[ [he above intormation is correct. I agree to comply with all city antl county o�tllnant¢s antl Slate IawS relaNng to con5t�uction, antl hereby au[hOriie r¢pr¢sentatives ( this tity ta ent¢r upon the above mentionetl property for a�tion urpo Slgnature ��/^� Date Lc%rr3 � TVPE OF CO_ NSIRUCTION ❑ NEW � ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DE C IPTION OF WORK .�h�i < �.,... —� TVPE OF PEHMIT " -;� ❑ GRADING ❑ FOVNDATION ❑ STRU,�C,�TURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING CSMECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCV_CONSTRVCTION TYPE VALUATION ZONE GRA�ING CU. YDS. ACRES LUMBING TOILETS LAVATORIES KIT. SINKS SERVICE SINKS FLOOR SINKS ORINKING FOUNTAINS INTERCEPTOR$ SWIMMING POOL WATER SERVICE GAS SERV ICE WATER HEATERS SEWER CONNECTIONS SOIARTANK PLAN CHECK' SHOWERS URINALS OOUBLE LAVS DISHWASHERS SUMPS FLOOR DRAINS CLARIFIERS P TRAP ALTERATION OUTLETS BTV OVTPVT COLLECTORS ISSUE FEE MECHANICAL PLAN CHEGK HEATING SVSTEM 0- 00,0G00 BTV� _/ AND DUCTING 700,000 i BTU S REFRIGERATION 0-300,000 BTU_ SVSTEM 100,000 + BTU _ BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAVSTSV$y�Vl / MVLTIPLE FEF �� C Drlvers' License or SS � � """� CMF 0865-46 White-Bulltling; Gnary-Appliwnt: Pink-Accountin9: Goltlenrotl-Assessor 4578 8/25/83 A.P. � ZONE REAR VARD (TO P/L) PKG.SPACE RE�. STREET WIDTH SPECIAL CONDITIONS: ELECTRICAL PLNG. REF. � PROVIDED PARK FEE S PLAN CHECK GENERATOR 0-1 KW_1-30 KW _ TRANSFORMER APPLIANCE 10�50KW_SO+KW_ MOTORS 0�1 HP_1-30 HP _ (INC. SOLAR) 30-50 HP 50 * HP _ FIXTURES Ol1TLET5 SWITCHES GAS TUBE SIGNS ' POLE LIGHT$ PANElS- MAIN SUB ISSUE FEE ' I 'LICATION APPROVED BY DAT SUMMARV OF FEES BUILDING S PERMIT S SMIP S_ PLAN CHECK § PERMIT ISSUANCE E_ PLVMBING E GRADING S_ PLAN CHECK E ELECTRICAL §G�_ §- PLANCHECK E� MICROFII.ME_ MECHANICAL S '00 TOTALFEES_ o� LE55 AD- �� PLAN CHECK E� VANCE PC b_ 27.00 TL 00 FINAL FEE S �� CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Insp 1. Temporary Electricyl Service or Pole 43. Pool & Equipment Location � � 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms � 4.. Electrical Conduit-Undrgrn � � 46.' Electrical Bonding . tee ein orce 47. Rough Plumbin &�Pressure Test �� ' � 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE '- ' 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test - 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ridr rn 10. Structural Floor System 52. APPROVAL TO DECK �� 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � 12. Street Sewer Connection 54. Heater & Vent-Final � � 13. Rough Plumbing ' 14. Rough Electric-Conduit �56. Electrical-Final 15. Rough Electric-Wiring � 57. So�ar System-Final 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts, in Structure ' 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating . . 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing � 21. Roof Sheathin 22. Frameand Flashin NOTES: . 23. Insulation � - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final ' 28. Final Electric 29. Final Heating & Air Conditioning �' 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final - 33. Gas Service-Final - ' 34. Solar pomestic-Final - 35. Landsca e S rinklin S stem � 36. Sound Attenuation � ' 37. Handicap Regulations � 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric flelease to Edison 41. Gas Release to Southern California Gas Co. \ 42. CERTIFICATE OF OCCUPANCY No Date CITt' OF COSTA MESA CONSTRUCTION PERMIT � -- � 1 � � Applieant tp fill in all sD��as exeeD< <�ow wlthln �aarY ApplicanYz MeilinyLpy dd eg �� nc� v ic. a �. Project Addreu I� V C C�U) O C Owner'f Neme �c e� ` r�C hone Address �-^� � Arch/Eng. Lkense No. Address Contractor's Nem �V��S �" ' ^5 Phone��b-1 I �f'S Add�esslmeiling) S 3 1 Myn�'✓� yZ iU License No. ZZ' '�9 _ IICENSED CONTitACTOR DECLARATION ' 1 hareEy affl�m that 1 am Ilcensetl untler provizlo�s o1 Charter 9(commenting with sactlon 7000) ot Divislon 3 oi t�e Businass anC Prolesslons CoCe, antl my IlCense Is In fu fo �0 affect. � �� -`��. ��,'�/.9,N0.5'�.Zs � Dat B�� i i i^.� `� i G<""�— . ' �•-. WORKERS'LOMPENSATION DECLARATION � ' 1 heraby a714rm that I nave a ceHifiwte of consont to salt�nsUro or e ceftlt{cata of Worke�z' Compensatian Iniurance, ar a urt�� opY �� eoT (50 on 3800, Lnb. �- f� Policy No. q�b'�a� Company 11etl�coDY Is �ereby furnis�e0Y.8W �j �C�pyYnfilBC wi�tOP icant//l Itll �/ ' ' Date � � L EXEMVTION FqOM WORKERS' COMPENSATIPN UECLARATION (This settian neatl not Ee completetl it the permit I5 for ona huntlretl (5300) or less) I tartify that In the performence o1 t�e work tor which t�is perm�l Is lisuatl 1 z�all not empioy'any perzon In any manner so as to Decome zuDJett to t�e � Workers', Compensatlon Laws of Californla. . Date q9�ature � NOTICE: If, after makin9 thlz tleclaration, you s„oultl become sub�ect to the ' Workers' Compen5alion provisions ot tne labor Cotle, you must tort�wilh com0ly with such provisions or thi5 cermit shall be tleemetl revoketl. CONSTRVCTION LENDING AGENCV � � I �ereby afTirm tnat t�ere Is a construction IenEing a9ency for t�e performance ot the work tor which this permit is Issuetl (Section 3087 Civ. C.) , Lantler•5 Name LPnCer'S AtltlreSs OWNER BUILDER DECLARATION I har¢by afllrm that I am exempt from the Cont�actor's License L.aw for the following reason (Section 7031.5 Bu5ine55 an0 Professional CoOe: Any city or <ounty which reqWres a permit to construct, alte4 �mprove, Eemol(sh or repalr any stru<lure, prlor to Its Issuance, also requires the a0��icant for such Oarmit to /ile a signetl statament that he/she is Ilcense0 pursuant to t�e Drovisions of tne Contrattor'S License Lnw (Chapter 9(commeq�ing with Saction 7000) of Olvislon 3 01 lhe 8usiness antl Professions CotlC) or that ha/5he is exempt therefrom antl l�e basis for the allegetl exemption. Any vlolation of Sectlon 7031.5 by any apPlicant for a permit subjects t�e apPlicant [o a tivil �enalty of not more than tive huntlretl tlollars (E500I. 1,' as owner of the property or my emo�oYees with wages as their sole CompensatlOn will CO the work, an0 the Structure is nOt intentletl Or of(eretl for zale �Secl�on 7044, Business antl Professio�al Cotle: The Coniractor's License Law tloes not aOP�Y [o'an owner of a prope�b �o builtls or improvez ther¢on, antl who tloez sucM1 work Nmself/�ersel� or through �is or her own employees, provitletl that zuch improvements are not intentleC or ofleretl tor sale. Ii, �owever, tne Duiltlln9 or improvement is soltl witnin one year of com- pletion, the owner wlll have tne burtlen of provin9 he/s�e tliE not builtl or Im- �rova (or the purposa oT sale). � I, as owner of [he properly, am exclusively cOntracting with IlcenSeE con- tractors to construct the prqect (Section 7044, BUsiness antl Aofessions Cotle: The Contractor's License Law tloes not apply to an owner of DroOerty who bulltls or ImOroves t�ereon, antl who contracts for suc� proJects with a con- tractor(s)Iicenze pursuant to the Con[ractor•5 License Law). ' ❑ I am exempl untler Section B. 8 P. C. for this reason Date Owner 1 nereby certify that I haae reatl thiz aoPlicatio� antl siate that the above informatlon is wrretL I agree to complY with ail city antl county orainanws and state laws relatlng to builtling construction. antl �ereby authorize repre- sentatives oi this city � �� uo ihe abo�e-mentionatl prop�e^rty�j �for InSpeGtiOn D }_`.'%'�% y[�/ �. 7L �Q % Signature �/ � � � Ilnei anE slgn ill aOD�ooriate Eeclantionf. TVPE OFCONSTRUCTION LI NEW C��ADD LI ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TVPE OF VERMIT GRAOINGp/ FD UNDATION STFVCTURAL ❑ TENANT ❑ ELECTRICAL U PLUMBING ❑ MECHANICAL ❑ �OTHER PR0.IECT DESCRIPTION 50. FT. OCCUPANCV CONSTRUCTION TVVE VALUATION $ ZON� GRADING CU. VOS. ACRE� Remark�: /2 �! � Sink Preventer Irrigation Drinking Fountains FlOor Dreins � Floor Sinks � GasService .Outlets Int2rC2ptOrs Kitchen Sink � Lavatories P-Trap Roof Drains � IShowers Service Sink Boiler Duct-UnderGround Duct-Svuctural � Dutt - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑0.100,000 BTU �100,000 Hood or Tvoe I ❑ Registers . CMF 0865-46 rev. 12/82 White - Builtling; Canary - ADaliwnt; Pink - Accounting; Goldenrotl - Assessor Sevuer Cap . $BNRf CpnnEC[iOn Solar CollectOrs � Solar Piping � Solar Tank w�ce� ao�t Water Heater Water Service — Reinspection Fee � $15 laue Fee � S 3 IANICAL Refrigeration System ' ❑0-IOO,OOOBTU ❑100,OOOBTU � System Reinspection Fee lave Fee A. P. qlE PLNG.REF.ik IEFTSIDE VARD PKG.SPACE RE�. STREET WIDTH SPECIAL CONDITIONS: utomat�c W asher onstruction Pole ooking Unit ishwasher ryers ❑Gas ❑Electric an A.U. ixtures evice Boxes Garbage Disposal Generator DO-5 KW �5-15 KW TransFormer 075-501:W �� ❑ 5U + KIV Meter Oup to 700 amps � 2onin8 Approvad BY .. Appliption Appro`ed By—1,� Applimtion laued By 1 1 / _ r .. REAR VARD �TO P/U RIGHTSIDE VARD • � PROVIDED PARK FEE E Mete� uovef 1 W amps Sub Panel Sub Pole Motors O04 HP OIY.$ - Inc.Solar �9-15HP �16-15+ Microwave Pale Light " Range Sign Standing Sections Trash Compactor Reinspection Fee �• ' SUMMARV OF FEES BUILDINGPERMI��`-5,;��. SMIP ' PLANCHECK �"�$� PERMIT PLUMBING $ !j �' ISSUANCE PLAN CH � $ � � GRADING ECK ELECTRICAL 3 PLAN CHECK $ MECHANICAL $ PLAN CHECK $ MICROFILM TOTALFEE LESS ADVANCEDPC FINAL FEE E15 '1 . '� �CONSTRUCTIOfy AND�P�ANNING ' . �L- d` SPA APPROVALS Permit # � •Date .� Inspector� ' AppROVALS Permit �`- Date Inspector � �' ,1. Tempurary Elucvical Service or Pole . . ,' 52. Pool & Equipment Location � '- 2.' Soil Pipe�Undrgmd: . � -� . � '� 53,� S[eel Fefnforcement � � 3i �lectrical CPnduit Utilitv-Undrgrnd. � � � . _ 54. Forms - °�: 4: �lectrica,l Condui4-Undrgrnd. �� ` d � _ � 55. Electrical Bonding � � 5: Steel Reinforcement � ,, � . �_ 56. Rough Rlumbing & Pressure Test � 6� ElectricalUF�RGrnd. ` �� ' � .- . �� _ 57. APPROVALTOCOVER-GUNITE 7. Fuotings � , ; - ,• � ' . � , 58. EleGtrical Conduit-Undrorr,rl. � 8. Founda[ion i ,., -� - ..; �. �• . 59. Gas Pipe, � Undrgrnd., Test ' 9. Water Pipe-Undr9rnd. - �' ,� � .� � 60. Backwash Lines, P•Trap, O Undrgrnd. 10. Strur.�ural Ropr $ystem . �� .� � ' 61 � APPROVAL TO DECK rr i l. Prop�n S�wer Line & House Connectfon � s. , . . . Y � , 62. B�ckwash'R Receptor-Finel �� 12. Sewer Cap ' , � ' � ' �' , 63. Heater & Vent-Final 13. Roof �Drains � � � � . - 64. Plumbing SYstem - Final 14. Rouyh Plumbin�' � -� • ' . � � 65. Electrical-Final � ' i'15: Rouc h'Electrical-Conduit ' �- ""^- • � ' �' � ' . J �.. ...... � ...:.. . .:.....�..` 66. �Solar.SYstem-Final ' - 46:� Rouyh Elect,ric Wiriny, , � ,�, ; �� : � � � � � � � � 67. Fencing & Access Approval . ';. - U.,Rouyh Wiriny Siyn,: ' 68. APF'ROVED FOR PLASTERING �: ` 16. Rough�Electrical=T Bar Ceiling ' I! ', i j ' 69. POOUSPA SYSTEMS FINAL ' ' 19.,� Rough�Hcatiny & Air Conditioning ; ! . FIRE DEPT. REQUIREMENT � ' 20. ,Rouyh.Factory, Fireplace ; ' � ' � � . ' APPROVALS Permit # � 21. �pucts,�in $cructure,; ' � � , � ' 70. Underground Hydro �� '22. �Ducts, V�ntila[ing ' � ' � . � 7�. Product Piping OGas ❑Oil 23. Ga,'Pip�:�Nough & Test . ! ' 72.' Unde�ground Flush .' 2M1. 'Rouf Praminy �' ' ' ... �73. Undergrnd. Storage Tank � Gas � Oil • ?.5. Rpof Shcathiny � '. �� 74. Oyerhead Hydro ' 26. T-Ba? Ceiling (Structuraq & Monqsoat'� . � i `�' � `. ' 75.� Dry Chemical � .�27. �Frame and Flashing: . � � � ( ! I 76. Dry Standpipe , . ' 28. �Lathing & Siding j �"� . �� ,. � ' ,77.� FIXED SYSTEM FINAL . , 29. `Insulation �� '. ' , � � i �78. FIRE PREV. FINAL '-30. Diywau Naiiiny : ;i , Noces: 37. Plaster t3rown Coat ' " , � „ ' i � '-32..Electricul Power Me[er-Final ` � � � - ` � ,I . � 33.'Final Electric ' '�'� ' ; � � � : : . , r' � . . ._...,.. ._.... ...� ... ....... . ... .... ..:..:.... .. . ._.....,__ _.. . . _. . . 34. Fin�i Heatin�j &,Air Conditioning � � � � j ' ' , ' � 35. Final Gas.Pipe-Test� : � : - I . � � . i ` ! � . � : + i� . . , � � � 36. Hood O� CanupY�''� ' � ' • . ; - � � . f . -j. � - y„ 37. Final Fac[ory F��eplac��. �� : � - � � - � � � � � ' ' � .�/� � � 38. Final Plurhhiny � , � I ' i.i ? . - I.. I I � � ! � i I . ' ' . 39. Water6ecvice-FinaG � � � � .��i ' p i � � I I � .. . .�'y °�J .� . ' - �.40. Ges Soi�vicc-Final ' , i � �I 'i 41. Solar Qoii�esticFinal : : : i ' � ' '� � � .� ' �' ..'.. i � � ' . _,.�. _ .. __ � � 42. 8�ckflnw:PrQventer , � ,��' � ..� . I � '� � . , - � i� ,..�i. �� , , � , 43. Buckflow Irriyafion , ' _ . . � , � � y,. .: � � ' � � � . . 44. Landscape Irrigdtion Syst�m � i • _ . , ' � 45. Sound; Attenu3tipn �'.; ��_ i - is. '� � - �� i � I � ' 46. Handica{i Reyulations '� � �I � ' - I I � � � � � I � . ' ' 47. FINA�$7RUCTURE&BUILDINGi' , �� , 48. Specinl Requirements Completed . �' ' - ', � � � � � 49. Electric Release�to Edisoni ! ` � ' _' . . ' . � � ' � ' ` , . . . .i :-. ..'. . ..---�... .. _ . 50. Gas Release to Southern California G�s Co � i � � � � , � 57. CERTIFICATEOFOGCUPANCY `, _ .,_ _ :_ ;.__.' . . . ' ` No � � Date � �� .� .'..` � �-= TflOSECTA�BESS: jSO DOGWO011 S�r � F� OWNEX'S NAME: GREEI`I, HARRY S nooaess: gATTN REO DEPT REO� 96° F O BOX i'B31 -' « GLENDALE,CA 91209 ANCHIENGMEEN: A�OHESS: flEG.NO.: UNIT: UNIT: PEflmiT'EE: WESTFALL 6 CO NATIOD7AL ( 714 ) 472-112C RODRESS: Z� z 3O CP.BOT ROAD LAGUNA HILLS CA 92553 LICENSEO CONTNPLTOfl OECLAflATION: I here�y affirm Nat I am licensed un0er pmvisions of Chapter 9(commencing wi�� Seciion 7000) ol Drvismn 9 ul ilie Business anJ Pmiessiuns Code. and my license is in full force an� effect. cirv uc.: sTnT¢ uc.: cuss: FKp ; Oate'. Siqna�ure: WOPNEFS' COMPENSATION OECLABRTION: I �ereby aifirm �hai I have a cehificaie ol consen� to seli-insure or a cetli�ica�e of Workers' Compensaiion Insurance. or a cenifietl coDY Ihereof (Section 3800, Lab. q. POLICY NO.: E%P. UpTE: COMPPNY: ❑ CetlilieU copy is hereby �umished. ❑ Certitied copy is �iletl wi�h ��e ciry Builtling Division. �ate'. Applicani: E%EMPTION FAOM WOflHEBS' COMPENSRTION OECLAPRTION: Qhi55etiion n¢¢tl not be cample�eA il�he permi� is forone huntlr¢tl ($100) Or less�. I ceritly ihal in Ihe periormance of I�e work for which t�is permi� is issued, I shall no� employ any person in any manner so as to become subleci lo ihe Workers' Compen5aiion'Laws o� California. ��j �7 n• � ,, HatE: l l'/P' 9�-/ SignaNre'. � Moc� �- p��Y+.�L..�-cS NOTICE: II, a�ter making �his tleclaralion, you shoultl �ecome suhlect �o the Workers ComDensation prow6ion5 of Ihe Labor Code, you musi forihwilh comply wi�h such provisions ar Ihis D¢rmii shall be deeme0 �evoketl. CONSTflUCTION LENDING FGENCY: I hereby a��irm lha� Ihere is a cons�mC�ion lentling agenCy for the pedarmanCe Oi the wOrk far whic� Ihis permil is issue0 (SecUon 3097. Civ. C). lENOEfl: aooness: OWNEB BWLUEB OECIAflPTION: I �ereDy a��irm �hai I am eeempt Imm ihe ConVacmrs' Sla�e License Law �or the following reason (Section 7031.5 Business antl Proles5ional CoOe: Nny city ol couniy which requires a De�mit to con5tmc�, alter, impmve, Oemolish, or reDair any SlmcWre. prior �o ils issuance, also requires t�e applicant �or such permit to file a signed statement Iha� he/she is licensea pursuanuo Ihe pmvisions o� ��e Comraclors' Sta�e License Law (Chapter 9(commencing with Seclion 7000) ot �ivision 3 of �he Business an0 Pmlessions Catle) or Ihai he/s�e is eMemD� Iherelrom antl ��e hasis br the alleged exemp�ion. Any vinlatian ol Section 7031.5 by any applican� �ar a permii 5u0jed5 ihe applicanl �o a civil penaliy of no� more than �ive �unAretl aollars ($500). I. as owner ol t�e propeny or my employees with wages as their sole compensation, will do ihe work. anA the ❑ stmcture is nat intenAetl or oileretl for sale (Section 704a, Business antl Professional Code: The Contracmrs' State License Law does no� apply lo an owner ol a pmpeny who builtls or improves Ihereon, antl who does such work himsel�/heRelf or ��roug� his or �er own employees. pmvi0etl I�at such imD�ovements are noi in�en0e0 or ottered �or sale. I�, however the huiltling ar impmvemeni is soltl wi�hin ane year of compleiian. �he owner will have ihe �ur0en o� pmving he/she Oitl not hui10 or impwve lor Ine purpose ol sale�. I, as owner ol Ihe Ompetly, am exclusively caniracting w�th licensetl conVacioa m consimct t�e pmlec� (Sec�ion 7044, Business ❑ and Proleuions COAe: T�e Comractars' Slale License Law Uoes no� apON �o an owner o� pmperry who Umlds or impmves Ihereon an0 who coniratls lor such pmleds wiih a comracmqs) license Dursuam m the Coniractors S�aie Laense Law�. I am aware Ihai D�oof ol Iheir Worker's Compensaiion insurance s�aul� be pwvitled �o me. � i am ehempt unaer Seamn: B p-� � q q B. 8 P. C. tormisreason: REACT. EXP PERMIT " �p-� � 1 � 1y -94 Owner (i+..e�o .i � ��c. I ao �ereby cenily Iha� I am aware ol antl underslanA lhe reQuirements o� Cali�omia Health and Sa�ery COAe Sec�ions 25505, 5533, an0 2553a an0 tnal I or any luture builtling ocapant willlwill nol (cirde one) neetl to tomply wilh said state cotles antl t�e requiremen(s lor a permi� tor conslmciion or motlilicalion imm Ihe Air �ualiiy Managemen� Oi5[nc�. Fesitlential constmciion ap0licalions are e�em0� ��om ihe5e provi5ion5. Date: ApplicanL I hereby cetlify Ihai I have reatl ihis applicalion antl state tha� ihe above infarmation is correc�. I agree to comDly wi�� all ciiy antl counry ordinances nntl 5�a�elawsrelaiingto builAing conslmciion antl herebV aNhoriterepresen�atives o�this ci�y�o en�erupon��e above�men�ionetl mm�env inr insnection oumoses. �river's License or Social Securiiy q� Sgnaiure: C � /V • tJ `-o`^-'..-.r�"„- i64ba6 White—Bwltlmg�, Green—Cotle EnbrcemenL Canary—ApplicanC Pink—Revenue'. Goltlenmtl—Assessor CITY OF COSTA MESA — BUILDIPJG PERMIT PEP.MIT P10: IP 069981 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: UTH PLU JOB DESCRZPTION : FINAL EXPIRED PERMIT CLAIM �'ALUE; CALC—VALUE; PEP.M NO; IP 069981 GOVT: N SUPP: Y PURPOSE: OTH SQ FT; GROUF OCC; R-3 : c:c�MMENTS; VERIFY WITH THE PLAN�—LEGALIZE EXFIRED PERMIT F7832 *.+rit+t+�*�k+r«*.e�t�*a�r�t+t+tx�f�ritirit�r�ft�tit�t+t*it*�t.��e,t*�r+r«+r�+***�r*+r***�tx�r+t*�r�r*r**�t+riF*.*u*+!�+t Z O N I N G R E Q U I R E M E N T S s s T� A c x s ------------ MAIN BUILDIP7G ---------- --------- ACCESSORY BUILDING --------- £RNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING RE�• PROV: PARCEL: 42252129 ZP]E; REF NO: FLANNING N TES> � . if if iF �f iF jf i(� iE if iF if if 1E iF if 41t iE ii #� iF �Y iF if if if if iE iE iF af iG iE aE-1E iE iE�if aF j43c ac ff 1f iE if �R M if if iF iE #'- iE iF iE s iF if if if 3f iF iF if iF af it iF �E iR i� aE jf iF af 3f aE #F D E �' 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 A1 T S ZOAIING APPROVED BY ' DATE; 5UILDING AFPROVEU HY � ,:fl ��,�� DATE: APPLICATION ISSUED bY; � � �""J ` !/ DATE; �l� O �/ �tf�)f aE�Ifif Y-ik if�k M��lf�lf if if�iF �f iFiEiFiE#i i(� x - +G iE�M-�lf M�f ii k% af . iR if jf iF i(�K if if�lE if�E�E if if�lE if�iF 1fiFi1-iE�4iE aE if !t if-iE iF if kiE�)f iE iEif-If af iFx iF ±f if 3f 3E if�tE K if iE JFi(�iFif s+E 3f if#� 1E iG !F �f-±E-t! if 4 a! if i4 i4 # it af N�N-x�% LEGALIZATION;N F E E S U, P4 A1 A R Y STP.UCTURAL SEGPIENT;t•7 BLDG PMT PLUMHIAIG ELECTP,T_C' TIECHANIC FIRE SMIP/RES GRADING PERMIT 30.00 � •' 25R � " SMIF;NON—RES PLAN ISSUE FEE EUILDING—DIV—> TOTALS----> PEkMIT ISSUE PI,AN—CHECIi TOTAL PAID DUE 30.00 0.00 _ o.oe 30.0o so.00 .eo REVENUE DIVISION TOTALS--> COLLECTED; 30.Q0 OL'EA/SHORT; ,00 bLDG PMT PLUMBING ELECTRIC MECHAPdIC FIAE SMIF/TOT GRADIP7G PLAP1—�HECK 30.00 � �f?F if il� k ih if it if it iE if iE r k+F af if iR it {I� if it ac+t i4 iF if +f if iF iE+E jE?E iE?� #?E it,iF it iF+t it �Y if i! iF if iF?E iE iE if it 1f if �If� iF ic {c �c+f iE ac iF if iF i4 it it if i� if+f- �1t+E if 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 �" FLU 1 PLUMBIAdG kE—INSPECTIO� FEc 30.OQ 30.00 Eran' nr: �EEs ni aoi7i956-Co1719S� T��'T 30.t70 LRTE: 1i/iS/'�4 TIhfE: 2D:OF ; , ; , � ; � �'� CONSTRUCTION AND PLANNING POOL & SPA ` � I AppROVALS Permit # Date Inspector APPflOVALS Permit # �ate lnspettor � }� 1. Temporary Electrical Service or Poie 52. Pool & Equipment �ocation � 2. $pii Pipe�Undrgmd. 53. Steel Reinforcement 3. Elecirical Conduit Utliity-Undrgrnd. 54. Forms 4. Electricai Conduit�Undrgmd. 55. Eiectrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. E�ectrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE i 7. Footings 58. Electricai Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O UndryrnU., Tesc 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, C7 Undrymd. � 10. Structural Floor Svstem 67. APPROVAL TO DECK 17. PraPertY Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Se�ver Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electricai�Final 15. Rough Electricaf-Conduit 66. Solar SYstem-Final 16. Rough E{ectric Wiring 67. Fencinq & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrica6T Bar Celiing 69. POOLJSPA SYSTEMS fINAL 79. Rough Heatin9 & Air Conditioning FlRE DEPT, REQUIREMENT 20. Rough Factory Firepiace APPROVALS Permit # I 21. Ducts, in Structure 70. Underground HYdro 22. Ducts, Ventilatin4 71. Product Pipiny O Gus ❑ Oil 23. Ga4 Pipe�Rough & Test 72. Underground Flush � 24. Foof Framing 73. Underyrnd. 5toraye'(ank O Gas ❑ Oil 25. Roof Sheathin9 � 74. pverhead Hydro i 26. T�6ar Ceiling (Structurai) & Monocoat 75. pry Chemical I 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding � 1 77. FIXED SYSTEM FINAL 29. Insulation �� f 78. FIRE PREV. FIPJAI 30. Dry�vall Nailing ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! 79. FINAL INSPECTION 32. Electrical Power Meter�Finai '� �. SQ, FOOD CERTIFICATE ISSUED � 33. Final Electric `+'�- Notes: �I 34. Finai Heating & Air Conditioning ��'�'� /� � 1 � _ _ ��^_a� -� - 35. Final Gas PiOe-Test pi'_2.� /J2.� '�� - - 36. Hood or Canopy i a 37. Final Factory Fireplace ± � 38. Final Plum6ing � � 39. Wazer Service-Final 40. Gas Service�Final �' 4t. So1ar pomesdcFinal 42. BaCkfiow Preventer � i 43. BaGkflow Irrigation � 44. landscape Irrigation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STtiUCTURE & BUILDING . 48. FINAL PLANNING ' 49. Electric Felease to Edison 50. Gas Release [o Southern Caiifornia Gas Cv . 51. CERTIFICATE OF OCCUPANCY No. Date A MESA 'ION PERMIT i" � -- ��7/ �r�u..cov�a iz .. .. _ APPIicBnYsMailin�e�� o,a � Rolect Address /^� ' , - MOwner's Neme 1:7 �� e� ` p K� Phone � Address ��""��•- � Arch/Eng. , License No. C� Addreu. � • � \ Cuntractor's Nema �V%'� V' ' � Phone�� S � ' Addresslmeiling) �S`3�1 -Mfl��✓`� 1Z � �icense No. �%L � - L�CENSED CONTRACTOR OECIARATION � I.hereby aftirm that 1' am Ilcensetl untler provlilons of Charter 9(commencing witn sectlon 7000� of Dlvlsion 3 of the Buslnass antl Profeislons Cotle, antl my Iicensa is In fugtotg �a ettect. �L� � Uce � �- `3 � ur�se,Nu. `7� 9 Date� �y �� G�-- ' WORKERS'COMPENSATION DECLARATION- � ' ' I heraDy Efflfm that I have a cartlflWte of consent to seltdnsure or a Ceftlflcate � of Workers• Compenutlon Insuranca,� o� a certif ° coDY th� eof (Se on � 3800, Lab. CT�- Qrj b I�4'J� ComPanY . PoIy�I�Ity �No. 7J� -� lH�Ce'91fle�R�S�Iletlbwithrthet[� Iltliqqr�y(�p n�o . �� Y//!�/L!� �f • Y� Date / - 1 qpplicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ,(Thiszectlon neatl�not ba completed if the permit I5 for one huntlretl (5100) or less). ' , ' . 1 certNy that in the partormance of t�e work tor which [his perm�t Is Issuatl I shalt not amD�oy'any perion In any manner so as to become subjecLto t�e � - Workars`Compensatlon laws af Calltomla.' Date � Signatura NOTICE: If, after making this Oeclaratlon, you shoultl become subject to'the ' Workers' ComDensa[ton provisions oi the Labor Cotle. You must forihwith comply withi such provisions ,or this permit shall be Oeemetl revoketl: ' CONSTRUCTION LENDING AGENCV � � , 1 hereEy affirm that there is a'mnstrucHon lentlin9 agency for the performan<e . o/ the work for whlch.this.parmit is�issuetl (Section 30B7 Civ. C.) , LenAer's Name � 12nOer's Atltlleis t � � OWNERBUILDER DECIARATION , - I herebv aifirm that I am examot from the�Contractor'S.License Law tor the by any applicant for,a p� ot not more than five nuntlre ',lowner of,the property or satlon will'tlo the work, an< � (Sac{lon 7044'. Businessl a Law Coes not apply to'an ov ,`antl who tloes,such�work 1 aes, provitletl Ihat such'impr� �owever, the builtlin9 ar Iml the owner wlll have tha bur rt [he purpose of sale). owner ot the orooertv. am to flll In all spaces e:eept t�ou wlthin heary Cortlar Ilnes anC sign all aDDroD��ata Oeelarotions. TVPE OF CONSTRUCTION LJ NEW I�` ADD LI ALTERATION LI REPAIR ' ❑ CONVERSION ❑ DEMOLISH ❑ OTNER DESCRIPTION OF WORK ' . TYPEOFPERMIT GRADING— �DUNDATION� STRUCTURAL A.P.1W . ❑TENANT ❑ELECTRIGAL C�'PLUMBIN6' ❑�MECHANICAL . PLNG.REF.gW �O �OTNEH . ' TO BUILDING PROJECT DESCRIPTION SQ.FT. ' OCCUPANCV P PE V I E CONSTRUCTIONTVPE VALUATIONS� ' LEFTSIDEVAqD ZON€ � GRADINGCU.VDS. ACHE� � PKG.SPACEREQ. Remarks: �/2 % �F � ' STREET WIDTH Sink kflow Preventer kflow Irrigation Drinking Fountains Floor Drains Floor Sinks Sink Iicant to a clvil ServiceSink i9e5'as tnelr sole � . , enGetl or otferetl ' ' ih0 COntfactOf'S ' uiltls or improves '� gpiler � ' h his or her own � ea or o((erea for � Duct- Under.Grc one year oi com- 1 not bulitl or Im- � Duct - StrUciUfal wv . '- - � SewerConnection "- Soler Cqllector5 ' � Solar PiPing �' � i � SolarTank . ' Swimming Pool w/Spa � Urinal � WatBr�Clout � Water Heater . � Outlets -� Water Service • � � ' 4s [laciofsio cons[ruc[ ine Prolec[. xcOon /v uaue» anu �� maon bo : _ ��.. ...��........ � " , '" " '" The Contractor's Licenze Law oes not a001y to an owner of property who � . . builtls or improves thereon, antl who <ontracts for such projects wlth a con- Exhaust Sys[em ❑ Multiple ❑ tractor(s) Iicense pursuant to the Contractor'S Li<ense L.awJ: , � � fam eaempt untler Se<Sion , B. & P. C. for this reason Firepl/FaCt. Blt. ICBO # Data Owner � ' � Heating System & Ducting -I-hereby� certity that I have�reatl�thlz'application an0•state that the above . ❑4100,OOO.BTU �100,OOOBT Informatlon is correct. I agree to comO�Y �+�th all city antl <ounty ortllnances antl state laws relating to builtling constructlon, antl hereby authorize repre- Hood o� TypO I ❑ � sentatives oi [his �city; r up ihe above-mentionetl properry tor � . Insvactlon p s. p 7� Ci2 . Cano T e II ❑ - Signature � Data o � , ` ' Drivers' License or�55 3� � Re9isters , CMF 0865-46 rev. 12/82 White - Bulitling; Canary - Appliwnt; Plnk - Accounting; Goltlenrotl - Assessor Reinspection Fee . - Issue Fee ' ' � HeTngeranon system i � ' ❑aioo,000sru ❑ioo,000er �.pair/Alteration � ;', -.... . ! .r� s++°' . ReinspeMion Fee � � Issue Fee . Washer Cooking Unit 0 Dryers ❑Gas ❑Electric Fan , F.A.U. Fixtures Device Boxes Switches Garbaqe D 1698. 7105/a3 BUILDINr S°TB�1r rn er REAR YARD (TO P/U ' RIGHTSIDE VARD ' � PROVIDED � ' PARK FEE $ - 'Meter Llover100amps Sub Panel ' Sub Pole ' Mators OO-1 HP ❑1:5$ • ,InaSolar 09-15HP �76- � Pole Light , 1 flenge.. . Sign Standing Sections Trash Compattor Generator DO-5 KW 05-15KW Transformer �15-50KW^�`�,_, •� �.. ❑5U+KWh.. ,:rv '$154 '., -,... Meter ❑up to 100'am i. "'� �a 3 Zonin9 APProvad By I ` MPliwtion APProved BY`_��:.� � . ' Aaaliption laued Bv �"'''Z:� ': '. : $15 � $ 3 t 'BUILDING PEF PLAN CHECK �P�UMBING � ,PLAN CHECK tELECTRICAL PLAN CHECK� MECHANICAL PLAN CHECK 21.OU 7l. � . � Reinspection Fee f7i laue Fee � � $ : � DatB :"'�k � SUMMARV OF FEES � � . � $>�. ' SMIP � . . $ . $ � ' PERMIT , $; � �. ISSUANCE i ' $ � $ � � : � GRADING i ; $ ' $: . $ $ � MICROFILM � $ ' � $ ' TOTALFEE, � $ � � � , $ � LESS �� i , ADVANCEDPC $ � . fINAL FEE $ � - ADDllont to fill In all spaqs a raesa�•" "grc:/�CTION PERMIT ' �pplicant's MailingAddrea y � Praject Addrea < <� � CrQ' � Owner's Nar,.: i� C hone Addrua � �' , Arch/Eng. � � ' u Licenm No. ' �� Addren �� ,]✓�i^L-�1�.1f � - aJP��(31�.Z,�/ /��l� Cqntrector's Nama �a+,�.7.. ��-�y./ C: N�1'T � PFoue s�t1��/,� Address (meiling) �� r � I �y}�L D(_ . Licensa No. � � �`�% y -� T LICENSEO CONTRACTOR DECIARATION 1 M1ereby af/irm Ihat 1 am IlcenSeO unGer proviSlons ot Cnartat 9(commendng wlth uttlon 7000) of Dlylsion 3 01 tha Buslnass anG Profezslons COEe, anG my Iicensa Is In f fores ana'effact. � ,7� 3 � �.ense�/ j � —�..ti Bn _/ r. �� .RKERS'COMPENSATION•OECLARATION ' I nereCy aHirm Mat I have a certlflwte ol consent to salMnsure or a certiflcate . of Workars' Compensatlan Insuranca, ar a certlfia0 copy t�ereof (SecUon 3800, LaD. C.j Pollcy Na. � Company BCerti71e0 CODY �s herBEy turnlShaC. ' � GrtlfiaU copy is f11eC W�� e [ity Builtlin9 Dlvislon. Date � AOPliwnt . EXEMFTION FROM WOqKERS' COMPENSATION DECIARATION (Thlf settlon neeE not be �ompletaO if t�e permlt is for One �untlroE (SI00) or . lessl. . - . . I certify l�at In the performanCe o1 Iha work for wM1ich t�li Oarm�t IS ISSueE I� sM1all not ploy, any Oeryp� �� any mar)psi so� j bacpme sub7ec- t t� Warkari'�C t Laws of CallfarN�. C'/ , Date 19�ature � - ��'�� ' NOTICE: 11, aftar makin9 (pis Geclaratlan, you ihoulC becoma subject to tha -: Workers' CompenSatlon pravislons of the Lnbor Code, you must for[hwlth comply with suth provislons'or'this D<rmit shall ba Ceame6 revoka0:� • CONSTRUCTION LENOING AGENCV . � ' 1 �ereEy af/irm that thera Is a constructlon IenGin9 agency for the Derformance; � o/ the wark for whlcA this permit is issued (Section 3097 Civ. C; LanGer's Name lsntler's Atlaress' � OWNENBUILDER DECtqRAT10t�1 � � I hera�v atflrm that I am eYemot from [he Contractor's ticense Law for the Dlvislon 3 ot ttfe Business antl Professlons Cotle)' or Mat he/she is exempi tnerotiom an0 the bazi3 }or tha allegeC exemp[ion. My violation ot Section 7031.5 Ey any aOPllcan� }ar a permit suDjects tna applican[ to a civil �enalty of not more than ��e huntlreE Collars (E500�. I, as owner a/ the Oroparty o� my em0loyees with wages as thelr wle compansatlon will'tlo t�0 work, anC tha structure is not intentletl or otferetl . for salo (Soc4lon 7044, Businoss anC Profeuional Cotla: The Conttattor'i U<enm Law Coes not apply to an owner ot a properiy wh0 Ouilds or tmprovas tnereon, anC who Coes such work himself/herself or tnrou9n h6 or her own employ ees, provitlatl that such improvements are not Intentletl or offerea for vle. I/, �owever, Ihe Eulltling or imvrovement Is soltl wit�in ena year ot com- O�etlon, tne ownar.will hdva the burCen of proving he/s�e ditl not bwltl or Im- �rove lor tne Durpose ot sale). I, af owne� of the Droperty, am excluslvely contracting w��h licen5etl can- lrattors to conztruct Ne pro)ect (Sectlon 7044, Busineu antl Professions Cotle: T�e Contractor's License ��y doe5 not appry fo an owner ot property who ' builtls or Improvas thareOn, antl who contracts for 5uch projecti with a ton- Vattor(s� Iicense Durivant (a phe Conlractor's license Law), ❑ I am axempt untler Se[tion B. 3 P. C. tor [his reason Data � Owner' tbat 1 4arn reatl lhis ap0��ation anC ztate that the above �rett. t dgree to comply wit� all city antl countY ortlinancas latina [n bWltlina mnsbuction. and �¢renv autha�ile reo�e- Signature � Orlvers' License ar 55 � � I�ose wit�in �eary DorUer Iinas anG f19� +��+��roorlala tlaclantloni. �I�RACTNO. ' �OTNO. BLD . -' � TYVE OF CONSTRUCTION LI NEW �ADD LJ ALTERATION LJ REPAI R ❑ CONVERSION ❑ DEMO'.pLISH ❑ OTHER DESCRIPTION OF WORK y �n��r�rtLZ ��^'+ ��'X� _ TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ EIECTRICAL ❑ �LUMB�NG ❑ MECHANICAL ❑ OTHER PRQIECT DESCRIPTION� Sa. FT. OccuPa CONSTftUCTIONTVPF - VALVATION§� ZON$ � GRADING GU. �'O5. � 4� 3S0 � Ramarks: .. � �7 Q' i n ii- � i.F Bar Sink Backflow Preventer BeckfloW Irrigation Drinking Fountains . � Floor Orains ' Floor Sinks � ' . GasService ' Outlets � Interceptors . ' � Kitchen Sink L.avatories � - P—Trap � Roof Drajlv� t►a� .� y, � Boiler Duct- UnderGround Ouct-Structurel � Duct-Ventilating ' . Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO �W Heating System & Ducting , ❑P700,000 BTU Q100,OOOBT Hood or Type I ❑ Registers SewN CaP Sewer Cnnnection Solar'CollectOrS Solar Pi0��9 � Soler.Tenk . _'. , . Swimming Pool wlSpa � Utinel^ : _> " - Water posel ' Water Heater - -- � - Watu Service � , ,- �� Reinspection Fea � laue Fee fANICAL � � . Retrigeration System : ❑4100,OOOBTU �100,OOOgTU System Repair/Alteration Reinspeetion Fee Iswa Fee S15 $' 3 515 S3 PLNG.REF.3W LEFTSIDEVARD ��,v� PKG.SPACE REQ. � � � STREET WIDTH �� SPECIAL CONDITIONS: il.<�.�.0 Automatic Wazher Construction Pole CAoking Unit Dizhwasher � Drvers ❑Gas ❑Electric Boxef ' -� Garbage Dispasal _ - - Generamr �0-5KW 0545KW � Transformer �15-50KW � ❑SU+KW - Meter ❑up to 100 amp? Zonirq APPraved By �� " �e ApPliption ApOroved BY �--,/L��t�4 APPIi1atian laued Bv ---L�Y IG REGULATIONS ZONE � � B ILDiNG G'� vroeCr rn cr _.J RBAR VARD (T0 P/L) �r�� RIGHTSIDE VARD 5 � .�V�ROVIDEO / ` � �v---L-�� ,L�LiL pARK FEE S �— _ -F�, !e l i�. Meter LJover100amps Sub Panel Suh Pole � ' Motors �0-1 HP ❑1X-8 Inc.Solar �9-75HP d16-15+ Microwave � Pole Light . • � Standing Sections Trash Compactor . ' ' SUMMARV OF FEES BUILDINGPERMIT $� Z� •"'� . SMIP PLAN CHECK � $ PERMIT �PLUMBING � �� $ ISSUANCE . PLAN CHECK $ GRADING EIECTRICAL $- � PLAN CHECK $ � MICROFILM '- MECHANICAL " $ ' TOTAL FEE PLAN CHECK $ LESS � ADVANCED PC . . FINAL FEE Fee �NS7RUCTION AND PLANNING . -..,4.'PROVAI�S . Permit�k � . . � Date � ��-ary Electrical Service or Pole � .�C Soil Pipe-Undrgrrid. , - � . 3. Electrical Conduit Utilitv-Undrgrnd: � 4. Electrical Conduit-Undrgrnd. � ' • 5. Steel Reinforcement � � %-�f�-$� 6•� Electrical UFER Grnd. 7 t1'&.� 7. Footings ., .' ' . � 7-Ff'Sij 8. FOu�da4ion . ' %4i"p,j 9. Water Pipe-Undrgrnd. � � • POL _. & SPA Inspector APPROVALS P # ermit 52. Pool & Equipment Location � 53. Steel Reinforcement : �.54o- Forms . �55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57: APPROVALTOCOVER-GUNITE , �58. Electrical ConduifUndrorn�l. _;�. 59. Gas Pipe,. � Undrgrnd„ Test 10. Structural Flooi Systerh :5�� ,� '1•,13-8� �'D i l, Property Sewer Line & House Connection 12, Sewer Cap � � � 73. Roof Drains - ' -� 14. Rough Plumbing !�7 : 15', Rough Electrical-ConAuit , - � ; ' 16, Rough Electric Wiring • 17. �Rough Wiring�Sign ' , � 18.� �Rough Electrical-T�Bar Ceiling � ' 19: Rough Heating & Air Conditioning �, 20. Rough Factory Fireplace � � 21. Ducts, in Structure ; � � � �22. Ducts, Ventilating , � • 23. Gas Pipe-Rough &.iest , . 24. Roof Framing ' . ' � 25, �Roof Sheathing '• � C• no'i �y $� 1 b�i �-6�•�? 26. T-Bar Ceiling (Structural6 & Monocoat 27. Frame and Flashing '"�� ^0 n N-3a_83 , 'fc''�� . 26. I„athing & $iding � ' . �I�'g-3 � 29: ;Insulation � ' ' � ' �-�� 30. Drywall Nailing , �� $'3 � 31. Plaster Brown Coat `;' • . �, !�_Z �-�� 32. Electrical Power Meter-Final ' 33, Final Electric � � . � �• 34. Final Neating & Air Conditioning . � � ;; 35. Final Gas Pipe-Test ` . � � � i � � 36 Hood or Cano ' 60. Backwash Lines, P-Trap, O Undrgrnd. 5.,, 61. APPROVAL TO DECK � 62. �Backwash & Receptor-Final 83. Heater & Vent-Final , , 64. Plumbing System - Finai� � 65. E�ectrical-Final � � 66.• Solar System-Final � 67.� Fencing & Access Approval 68. APPROVED FOR PLASTERING • � 69.�POOL/SPASY$T�M5FINAL ' FIRE DEPY.,'REQUIREMENT APPROVALS ' PeYmit # i 70. Undergrourtd'Flyilro 71�. Product PipiQ�,tlGas ❑ Oil ' �72. Underground��Flush 73.� Undergrnd. Storage Tank O Gas ❑ Oil 74: Overhead Hydro � 75. Dry Chemical � 76., Dcy Standpipe � i 77. FIXED SYSTEM FINAL i '78. FIRE PREV. FINAL � , �Notes: p�t/,s- Tti.�.o.'��.. .� . PY 'i i :� 37. Final Pactory FireplAce :', � I.' , 0 3$. Final Plumbing � ,�,: � � � � ! 39. Water Service-Final � ' , � 40. Gas Service-Final ' , � � � i 41. So�ar pomestic-Final ' � ! � ' � . � ,.. : .. -'--,-..., 42. Backflow Preventec . ' , � � I � � � I ! � ,, � . ; . , ��_ � . ... :.. . .: ..._.,.:-� -- 43. Backflow Irrigation � � ' � ' I�� j , ' � � ;; 44. Landscape Irrigation�5ystem �' I ,; �._i �� I :� � �, � �.. i 45. Sound Attenuatio� i �� • 46. Handicap Regulations � .. �� ' - �� 47. FINAC STRUCTURE & BUILDING •. � ze 48. Special Requirements Completed �i , , 49, Electric Release�to EdiSon�� . , ,i �. , _ 50. Gas Release to Sou4hern California Gas Co � ; � 51, CERTIFICATEOFOCCUPANCY , ,. . , No pate D >u�b3 F .! b-31 �8�3 � P►-t i''�'g� j� V✓ �how�r tu - O �_ .. . _.___i:._i _ . =i i , , ! .. i I 'A`�� ;I "� '�; iF x ✓d r� 4. w A'...... i i i --� . �__... . , I � 1 Date � Inspector � �b (.�n y�L i n Sf9%�r d. �1, srjur �G��l.d- 41r n � �s f card 6 �d PflOJECT p00PES5: ) S O DOGWOOD ST OWNEfl'SNPME: CREEI`�, HARRY S nooeEss: gATTN REO DEPT REO# 969 , P O HOX 1631 •'" GLENDALE,CA 91209 NflCHIENGINEEH: aooncss: PEG.NO.: uxir: ��;,! � CITY OF COSTA MESA — BUZLDING PERl4IT PERM NO; IB 06998 iFERMIT NO; IB 069980 PLAN CHECK NO: 1J GOVT: PJ SUFE'; Y .. CONSTRUCTION TYPE: V—N PERMIT TYPE: OTH STR PURPOSE: OTH uxir: PEwmiTTEE: WESTFALL & CO NATIONAL ( 714 ) 472-11 ZO noonEss: 2 S 2 30 CABOT ROAD LAGUNA HILLS CA 92653 LICENSEo CONTflACTOH oEClABA7lON: I nereby allirm inat I am IicenseA untler orovisions of Chapter 9(commencinA wi�h Section 70001 0l Orvisiun 3 0l Ihe Business antl Pmfessions Cotle. ana my license is in lull force an0 effect. cirr uc.: srnre uc.: cuss: EXP : �ate: SignaNre: WOflNEflS' COMPENSATION OECIANATION: I here6y aifirm Ihal I have a certi�icate ol consenl �o sel4insure or a certifica�e of Workers' Compensation Inm�ance. or a cerlilie0 copY �hereof (Seaion 3800, Lab. C�. POLICY NO.: E%P. OATE: COMPANY: ❑ Cerii�ied tOpy i5 her¢�y lurnishetl. ❑ Certilietl coDY is �ileG wi�h Ihe ciry Building Uivision. Daie: Applicam: E%EMPTIONFflOMWONNEflS'COMPENSRTIONOECIAflATION: Qhi55ec�ionnee0no�becomple�eEil��epermiti5loroneAunGre4�5100�orles5�. I cetlily I�ai in Ihe OeAormance o� the wark �or which tM1is permil is issuetl. I s�all not emDloy any person in any manne� so as �o become subject lo Ihe Workers' CompeIns'a�ion Laws of Calilomia.% _,)� � ) Q �J �� , � 8eee. ��' �tY —�l '1 Signalure: `�1�'C� /L/ • l.l �^a NOTICE: I�. a�ler making IhiS detlaraii0n, y0U Shou10 betome SuUleC1 �a Ihe Workers' Compen5alion D�ovi5i0n5 me Labor Coae. you mu5t latl�wilh comDly wi�� such provisions or t�is permi� shall be tleemed revokeA. CONSTflUCTION LENOING PGENCY: I here�y alfirm �nal lhere is a constmction IenUing agenCy for ine pertormance ol ihe wark for w�ich ihis permit is issuetl (Seciion 3W7, Civ. C). LENDEfl: aooxess: OWNEB BUILOEH UECLAflRTION: I Ilerehy allirm Iha� I am exempi Imm IAe COnVatlOrs' Sia�e License Law Por �he following reason �S¢ction 7031.5 Business and Pmlessional Code: Any city ol couniy whic� requires a permil b cons�mct. aller, impmve, demolish. or re0air any s�mclure, prior to its issuance. also requires Ihe apPlicanl for such Oarmi� to lile a signeA slatemen� Iha� he/she is licensed s am io �he mvisions ol the Comracmrs' Stale License law �Chapter 9(commencing vnth Section 7000) ol Division 3 0l tAe Business JOB DESCRIFTIOhd ; FINAL EXPIRED PERMIT SQ FT: 6LAIM VALUE: CALC—C�ALUE: GROUP OCC: R-3 / COMMEA7TS: VERIPY ldITH THE PLANS—LEGALIZE EY,FIRED PF�RMIT B7945 v*-w�*a�r****�t�*ac��rr�rxri+.;cit*+t�aac*�it-*+�*u+�*+r�-*�r�cr#****�*.v.+�***it;F*��r�*�c*ir**+r+Fifrac�r*ac****?� Z O N I N G R E Q U I R E M E N T S S E T B A C R S ----------- MAIN BUILDING ---------- -- -----= ACCESSOP,Y BUILDZNG --------- FRNT; FT IP] REAA; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IP] RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING P.Et—�: PROC*; PARCEL; 42252124 ZNE; REF PdO; I'LANNZNG NOTES> i **�****.�*u*+�*�.,�+��+r��***x�***x�+��r***+�+�*�+�**�+��r:«x+r**�**.,�,.*,c*+�*+r*+�+�+r»******+�+r�-*�r�* U E[? E L 6 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 APPROL'EU BY DATE; BUILDING P,PPRU'tTEL� BY ; DATE; G APPLICATION ISSUE� BY: • O DATE; U�/ 0 9� ?:x-*?ri!itit�f�lt��t�r�*!e+.?r��-#r��r�rtft. ?r+��.r�.rxittr�ir . ir. �ra�..,sx+��tif+rx�i,r*�*,r+t+�ic�cirx�r-+r.t+rw�aF+F+r*ara-a-ar�rYvit ic'k'V.�'IE iF i! M'N' i(�'tf �F iF'1f 1!! #%4 if'k ir V")t'IF 1E it if tF'lE+f if !f+f 1!�'1k iE i!� if �. M if 1f M i! fE iE iF M M if'IE M iF it M�?f� if'k 1E if if iF iF'41f �t if'lE aF ik 9f �F 1f iE'lf i!-if k if LEGALIZATION:2�I F E E S U M M A R Y STRUCTURAL SEGMEr]T;Y ftLPG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/RES GP,ADID7G PERMIT 3Q.00 P�,� o SMIP/NON—RES anA Pm�essi0n5 Code) Or Ihai he/SM1e is exempi there�mm anA fhe basis lor ��e allegetl eMempiion. Any vi0lalion o� SectiOn 7031.5 6y PLAN any applicam lor a D¢�mii subjecls t�e applicant Io a civil penal�y ol nol more t�an �ive �unUreU tlollars (5500�. 1 SSUE FEE i. as owner of Ihe proDerty or my em ioyees with wages as ineir soie compensatian, wio ao ine wone, and me BUILUID]G—DILr—> PERMIT IS'SUE FLAN—CHECK TOTAL PAID DUE `'--- .OQ ❑ simcture is noi in�entletl ar ollered lor sale ( ection 70aa. eusiness antl Professional Code: The Comractors' S�ate License Law TOTAL.� ? 3 0, 0 0 0, � 0 0, 0 0 3 �, 0 � 3 Q. 0 0 tl0e5 nol apPly Io an owner ol a D�oDe�Y wh0 builtls or impmve5 iherean, and who tlaes such work himseli/heroelf or �hroUgh his or Aer own employees. pmviUeO ��at such im0�ovemen�s are nol inlentle0 ar atleretl br sale. If, tlowever �he builtling or impmvemem is saltl wilbin one year oi completion. the owner will Aave ��e hur0en of proving he/she diA not huila or improve R E V ENUE D I�.T I S I ON TUTALS -- > COI,L ECTED ; 3 0. 0 0 OV ER / SHORT : , 0 0 iorineourooseoisaiel. BLL�G PMT PLUDIHING ELECTRIC MECHADIIC FIRE SMIP/T�T GRADING PLAN—CAECK i, as owner oi ine pmpeny, am eKcrosively contracting wit� licensea comracmrs to conslmct t�e O�alect (Section 7044, Business 3 Q. 0 0 ❑ antl Pmlessions CoOe: The ConVacmrs' S�ate License �aw does not aDPly Io an owner oi OraDe�Y who builOs or impmves Ihereon and who coniracls lor such O�oie��s wi�h a con�ractor�s) license pursuan� ta ihe Contractor5' Sla�e License Law�. I am aware Ihat 0�001 0l ��eir Workei 5 COmpenSa�ion insufante 5h0ultl be pmvitled lo me. � i am exempi unoer Senion�. B P�% � 4 4 e� g P� �� mrtnisreason: REACT. EXP PERMIT/ // '''� '- �1 9ete' �� ' � 8'Yy Ownec l nwOC:� �� '�nJ1�L.�t� \ I tlo hereby cenify tnat I am aware of ana untlerstanU Ihe requirements of Califomia Health antl Safery Cotle Sections 25505, 2553 , an0 25594 antl �hat I or any fuNre building occupan� will/will no� (circle one) neetl �o comply wi�� said slate co0e5 an0 ihe requirements for a permii lor conslmclion or motldicalion imm ��e Air �uality Management �isVicL Resitlential consimtlion applica�ions are exemp� imm these provisians. �a�e: Np0licant: I hereby ceriify I�al I have reatl Ihis applicaiion antl 51aie thai Ihe above iNorma�ion is correcL I agree �o comply wi�� all ciry and counly ortlinances and s�atelawsrelatingio 6uiltling consimction antl hereby au�horize reD�esentalives o�this ci�y�o en�eruponlhe above-mentioned properly lor inspeclion purposes. (/ p q%� (� �, �� ' Oaie: � �' � b�' �� SignaWre'. ` Gi�(Yl [./�� . P 1�-x-�'-�`^`Cs Driver's �icense ar Sociai Securiiy x: 16aL46 Whne—Builtling�. Green—C000 Enlorcemenl', Canary—Applicant; Pmk—Revenue', GOltlenroC—Assessor if if iE iF if iF jE iE j(-if �f if 3F if jE �Y aF if �f iF �F if iE if iF i� iE iE tif 3f if �f if aE M iE af it 3t if it if iF iE iM iE iE �f 1E if iF �F �f 1t 1f iF iF if iE if if 1! i4 iF it iG if iF iE �� aF+F jf if Y� iF 3F aE-K I N U I V I D U A L F E E B R E A K D O W N TYPE QTY U E S C R I P T I O N UNIT COST TOTAL COST IP7S i BUILDING P.E—INSPECTION FEE 30.00 30,OQ END OF FEES V U1 0017i951�—Q017Z451 T�]T' 30.0� DA?E: It/13/?; TItiE: 10:09 CONSTftUCT10N AND PLANNING � POOI. & SPA l ' , APPfiOVALS Permit # Date • Inspector AppROVALS Permit # Date � inspector � t. Temporary Electrical Service or Pole 52. Pool & Equipmeai Location 2. Soil Pipe-Undrgmd. 53. Sieei ReinForcement 3. ElectriCal Conduit Utiliry�Uodrgmd. 54. Forms i 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Stee! Reiniorcement 56. flough P4umhing & Pressuse Test j 6. Eiectrical UFER Gmd. 57, APPflOVAL TO COVER�GUNIT"t I i -l----� 7. Footings 58. Electrical Conduit-Undre�md. � 8. Foundation 59. Gas PiPe, O Undrgrnd., Test 9. Niater 7ipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgmd. � 10. Strucm�ai Floor Syetam 67. APPROVAL TQ DECK i l. PropertY Sewer li�e & House Connection � 62. Backwash & Recep[cr-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roo( D{a+ns 64. Plumbing System - Final 74. Rouqh Plumbing 65. Electricai�Fi�al 15. Rough Electrica!-Condua 66. Solar SYstem-Final 76. Rough Electric Wiring 67. Pencing & Recess Approvat � t7. Raugh Wiring Siyn 68. APPROVED FOR PIASTER4NG I 78. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTE?�iS FINAI � � 19. Rough Heating & Air Condi±ioning FIRE DEPT. REQUIREI47ENT ( 20. Rough Factory Fireplace APPRQVALS Permit;� � 21. 4uc.s,i� Structure 70. Underground Hydro I 22. Ducts, Ventilating 71. Product Pipin9 C7 Gas ❑ Oii i 23. Gas Pipe�Rou9h & Test 72. Under9round Fiush 24. Roof "rraming 73. Underyrnd. Staraye Tank Ci Gas ❑ Oi� � 25. Roo; Sheathing 74. Overhead t�tydro i 26. T�Bar Gei(ing (Structurai) & Monocoat 75. Dry Chemical I 27. Frame and Flashing 76. Dry Standpipe � 28. Lathin9 & Siding 77. FIXED SYSTEM FIPJAL 29. Insuiation ' 78. FIRE PREV. FINAI 30. Dry�vali Nailing .�/� HEALTH DEPT. REQUIRE141ENT !� 31. Plaster Brown Coat ' 79. FINAL INSPECTION � 32. Electrical Powzr Meter�Final .�� 80. FOOD CERTIFICATE ISSUED � 33. Finai Efecuic '� Notes: 34. Final Heat(ng & Air Conditioning " I 35. Pinai Gas Pipe-Test �., • 36. Hood or CanopY � 37. Finat Factory Fireplace 38. Final Plumbing J 39. Water 5ervice�Final 40. Gas Service-Finai 41. SoVar pomestic-final 42. Backfiow Preventer 43. Backflow Irrigation 44. �andscaPe Irrigation System 45. Sound Attenuatlon 46. Handicap Regulations 47. FINAL STAUCTURE & BUILDING �Z j_�u �� [ 46. PINAL PIANNING j 49. Electric Retease to Edlson 50. Gas Release to Southem California Gas Co 51. CERTIPICATE OF OCCUPANCY /+' No. Dace COVERING CERTIFICATION � -7`-�'�-( � , . Property address Owner Contrac State Contractor License Number 3�� '� � Classification �'/ I hereby certify that I have installed, or caused to be installed, a minimum Class C roof covering at the above address in conformance with Chapter 32, and Section 1704 of the 1979 Uniform Building Code, as amended in Section 5-17 Title 5 Costa Mesa Municipal Code, and the installation instructions of the manufacturer. _ [�' I further certify that I am the owner of the property. (Owner-Builder permittee only�. C�• 1 further certify that I am: �7 Owner of sole proprietorship company �7 Full partner of the company ❑ Limited partner of the company ❑ Officer of the corporation I certify that as an authorized officer or agent of the company or corporation, I am empowered to make this certification, which shall be binding on all successors or assigns of the company or corporation. I shall deliver a copy of this Certification to the above listed owner, after submittal of form to the Building Division for acceptance. Received by Building Division by: �y, }� % -Z � -��' Initlal Date Spaca for Notarial Statement for authoNzeE offieer ar agant SUhm1t0-P/v�.S C/h,�ST �,D Gompany or Corporata Name Si9nature Data � �-PivBi a�/�Vh1�..(ntiS Prin[etl or TYPetl Name CMF 0990-46 Whlte - Bulltling Div.: Canary - Contractor; Pink - Owner � � '£, ,� � � � INSULATlON CERTIFICATION �- �� wrro� ,_ e'.c�� r�sa o�� . NumOer�n 51.eet CIIY , CovntY /` SuDOivl>lon Lol N�mDer DESCRIPTION bF INSTALLATION RDOF y— Msierid � 1%t� 11 � Tnickneu I�nchesl / �/ EX7ERIOR WA:.L Malerisl _ � �1 Tbitwnesi Iinches) � ` a- BranAName ��I�W �� `�( i Thermal Revstance IF1 Vaiue) �� B�antl Name ��L� s �f � �-�� 7hermsl Rrsisience IR Yalue) � �! CEILING /� �y� ,./�� C 1 fiatcorBlantetType �.1� Bra�dName YVI��1..JuUll�--� 7 Thickrxu I�nches) /'� �� Tnermal Resisiance IR Vaiuel ,� � Loose Fill Type �--�T Brand Name Minimum Thickness (:nches) �� Number ot bags WeigM Oer Cag IC Area Co�ered Ih�) �" Thermal R<sistance (R Vaiud � FLOOR,ELEVATED ��/1L/�� . Material Brantl Aame � `� � "'V a Tnicknns pncnes) i 7Arrma! Res"isiance IR Va�ue) FLOOR,SLAB Abterial T�ic4ness (inc'�esl _ W�dth (inthesl __ FOUNDATION WALL Material TAickneu (in[�esl � 'Brand Namt /� TArrmal Res�stance 19 Value) �--f'T Br�nC Name _ Tnermai prs�staoct !A Vatue) _ DECLARATION 1 �erebp certity iha[ t0e a�ove' insuiation was installeC m �he �uiid��9 ac [+.e aCovr loca�io� im m��ormancr w�th rhe curreni requlatiom utting Energy Consrrvatnn Standa�ds 1or new res�tlential build��9s (IocateC in Tnle ?4 ot t�e Calilornia 4dmiriscnt�ve Cotlet. n ,-•�,. »i �$ �i �%-3 Gene.�i � iac r �Bei�oe.) licm e N�muer _ � �� . ' S�9�ature nne Tiu< Dit F�gu�e 4-1 Eum01e o1 a rompLance ceR�liule 4-9 / RiESA= � )N PER� ADG��Gnt ta fill In all spacas � Vroject Addr�ss � � W`�'J�V � . . Owner'e Na�r �L� � hone Addresa � � " � Arch/Enq. C u� licenmNo. 'Cc�� Address (�� C,OfItfBCtOf'S NBT@ � l'^ r^^'2� f^^ �s�' Phone �.f'd, Address'Imailingl-i� C��T�S—� �^ � License No. � � �'�% � � . . LICENSED CONTRACTOR DECLARATION � I.heraby-affirm that 1 am Iicensetl untlar O�ovislons of C�arter 9(commencing wl[h sectlon 7000) of Dlvlslon 3� o/ t�a Buslneu anG Pro}asslons Cotla, an0 my IICBnu IS In fy�l fOrce antl'effeet. �en� rq.��T 1.lcanse pF�I ' SJ � � Date_L 99 t r��h� W00.KER5' COMPENSATION DECLARATION - ' ' ' .1 haraGy aHirm that.l have a certlflwte o/ consent to 5elMnsura or a certlfirate . of Workars' Compensation Insuranca,�or a<ertitietl copy t�areof (Sectlon 3800, Lab. CJ , , - � Policy No. ' ' � ComDany Certitletl coPY IS hereDy fUrnishaU. CartHieO copy Ii tileE wi[h the city Bulltling DlviSion. , ' Date ApPlicant � _ E%EMPTION'FROM WORKERS' COMPENSATION DECLApATION � (Thissactlon neetl not Ee completetl if the permit is for one hundretl (5300) or lass). ' � ' � � � ' I certiiv �that In the oerlormanGe Of ihe wOrk.fOr wM1ich Mis permk is �ISsuatl, I Date - � � � � '" � 5lgnature i�-T �- �"' -�� . NOTICE: If, after making t�is tleclaratlon, you shoultl Decome sub)act to the - Workars' Compensation D�ovisions of lhe LaDor Cotle, ytiu must torthwith comply with such provlsions',or;this'Dermit shall be Geemetl revoketl: CONSTRUCTION�,LENDING AGENCV • ' I hereby affirm t�at t�ara I5 alconstructlon lantling agency lor [�e pertormance, � of tha �work for which� this De�mit I5'issuetl (Sectlon 30B� Civ. C.)- ' Lentler's� Name . Lentlar's AtlGrass' OWNERBUILDER DECLARATION . ' - ' ' ' I hereby�aftirm t�at I am azempt from tha Contractor's Ucense Law for tha . tollowing reason (Sectlon.7031.5 Business antl Protesslonal Cotle: Any city or county which requlres a permit to construct, alter� improve, tlemolis� orrepair � therefrom antl tbe ba5i5 for the allegatl axemptlon. My violatlon oPSecUon 7031.5 by any aDP��ant for a permit subjects the apP��cant [o a civll � �enalty of not more than fiva hunAretl tlollars (E500). 1, as ownar ot lhe proDerty or my eniployees with wagas as their sole ', ^ompensatlon will�tlo the work, antl the structura is not IntenOetl or offeretl lor sale.(Sec�lon 7044, Business'antl Protessional,Cotle: Tha Contractor'S ' LI<an56 Law Goes not apply to an owner of a property.wno builtls or improvas ' t�e�eon,'antl who tlocs zuth work himsolf/herself or through hls or her own ' employ ees, piovi0etl Ihat sucn improvements are'not Intantletl or o(feretl for sale. If, however, the builtling or improvement is soltl within one�year ot com- � platlon, t�e owner;wlll have the burtlen ot proving he/she tlitl not bulltl or Im- � �rovaforthe purpose oisale). I, a5 Own¢r ot the prop¢rty, am azclu5lv¢ly contracting with IlcenSGtl COn- t�actors to con5trutt the project, (Section 7044, Business antl Pro(e55ionz COUe: . Tha Contractor's LJcenSa Law does not apply to"an owner of property who i EUIIEs or Improvez thereon, antl who mntracts for such pro�acls with a con- , Iractor(5) IICenSe pursuant to [he ContractOt's LiG¢nse Law). ❑ 1 am ezempt untler Settion B. & P. C. lor this reason Date � � � Owner � ' ' I hereby�certify that-I have�roatl thls�application antl s[ate that the abova - informatlon is <orract. I a9ree to comDly with all city.antl county ortllnances tl � b i t�� t..��oyyw witnin neary Eoreer Ilnes anE slgn all aoarouriata Aeclantlo�, � �RACT NO. LOT NO. BL . . � + I>7/.� _--il TYPE OF CONS7RUCTION I.J NEW I�MDD LJ ALTERATION LJ REPAIR � ' ' ❑ CONVERSION�❑ DEMOLISH ❑ OTHER ,. DESGRIPTION OF WORK ��4�L /�^� � ��"'�,�e^ - TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL A.P.� � ❑ TENANT ❑ ELEGTRIGAL ❑ PLVMBINC. ❑ MEGHANICAL PLNG.REF.#�- � ❑ 9THER TO BUILDING PRQIECT DESCRIPTION 5�. FT. OCCUPA�� PERTY INE CONSTRUCTIONTVPF VAIUATION$ �� LEFTSIDEVAqD �, ZON� ' � GRADINGGU.YDS.��% 3SO � PKG.SPACE RE�. Ramarks: �8' �.r _C STREETWIDTH � , ' � ' � . SPECIALCONDITIONS: Ber Sink Backflow Preventer � - Backflow Irrigetion Bathtubs Clarifiers • ' Dishwasher � Drinking Fountains �. Floor Drains ' Floor Sinks Gas Service ' Outlets Interceptars , . � i . Lavatories , � ' P—Trnn . . Boiler � . � r.. , � Duct - Under Giound � Duct-Structural ' Duct: Ventilating _ ' � Exheust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting , ❑a�oo,000'sTu Qioo,000 antl state laws relating to builtling constructlon, an ere y author ze repre- HOOd ot 7ypg � ❑ � cnnear�vns o/�this cltv.to enfer pon the ove-mantlonetl roperty for , ' Signature �_\/L' Drivers' Liunse or S5 CMF 0865-46 rev. 12/8 �� Cano T e Date�� Reguters - Bulldln9: Canary - AGPliwnt: Pink - Accounting; GOIEenroE - Assessor �neinc � � � , . Sewer Cap $BNRf CAnnfttiOn' � ' ' ' ' Solar�Collectors ,•�' Sola�.PiPin9 • ,�- Solar,Tank • . `�.. . Urinai ' - Water Closet' = Water Heater Water Service � � � � t' : i r ' Reinspection.Fee '. Y ~ 9 . laue Fee � ? 4NICAL • ; :� '.efrigeration Systein ; � ,� , �0-100,OOOBTU ❑100,OOOBTU�^ � ystem Repair/Alteration _ � _ . � Washer Unit • ` �\\ ` . -` ' 0116 r,/f�/;!:,, . � /. �;i � �':/� �' REAR VARD ITO P/L) - � �p �� RIGHTSIDE VARD �,�� _�a�ROVIDED � � ) � Cjr--�'"��' PARK FEE S ❑Gas ❑Electric 3oxes- ��.�- -� �'r s; ' . . � Disposal_ � _ . t- :or �0-5 KW �5-15 KW rmer 0�5�50KW �" �. � . ❑5U� KW , .C." i -{v .!�! �a��_ ECTRICAL � ' �Meter over 100amps . ' . Sub VanBl . .�� ' � Sub Pole ' � ' /. '. Motors OO-i HP ❑tb;8 � Inc.Solar �9-15HP �16-15+ ' Microweve � 'Pole Light . �, ` . Ranga Sign � �StandingSections � �Trash Compactor � 1 3 Zonin9 APProvad BY ' . Date 1� ' +.• • Applintion Appro'ved BV ate �� 3 . Application laued BYY�. S� Date � i , �� ` .'� � �J . SUMMARV OF FEES ' � �' .�BUILDING PEFiM1T $' y� •"'� � SMIV . $ 3' � � _ J PCAN CHECK� y �� $, � � PERMIT � `� ' ISSUANCE ' $ � ' PLUMBING � -- $ � -i PL:AN CHECK $� _ , GRADING � $ ' ELECTRICAL $� � � ' $ • � IPLAN CHECK $ . . MICROFILM � $ •�h .MECHANICAL '" , $, ' TOTAL�FEE , $ � � - Reinspaction�Fee�� -' �$15 •p�p,NCHECK � $ LESS � � � , �� J ADVANCED PC ' $ �t Issue Fee . $ 3 � ' . . ' � f % : J „ FINAL FEE • � $ _2 I . t, NSTRUCTION AND-PL'ANNING; _ ., � �'s � ' �'.. -� - � ' ' � �e :: p ��L.& SPA r � •. : - ' � ' �� c � ; `Date . ` >Inspector �, �� - ` � - � � � �Date � InspecMr - . PROVAI:S �„ Permit�#' �' � � ' - _ . � ' � APP.ROVALS Permit # - . - �rw, . ., . _.. - . . _ �,��Tempc°ary•Electrical Servic� or,Pole:? � = .' '• ` � -- �� ' �52.' Pool &�Equipment Location . - ' - � 2. �Soil Pipe1Undrgcnd:- :� ' .� .. � � ' � � '53. Steel Reinforcement ` ' • - ' . � t / � : 3; �Ele'ctircal�Conduit-UtilitwUntlrgrod s. ` "_ �- T. �i54:��Porms; ' � -. - _ .' ' _ � � /�`' 4' Electrical Conduit-Undr nd' ° "� ` '"' - • � � - � . � r; �9r _� , � ~ � �� ,.� �55 � �Electrical Bonding' ' _ ' 5'. Steel!Reinforcement ' -•- ', ` - �= ' � . . � ` � ~ , ; � . , . . %^�f $3;; ;'�= 56. Rough �Pluinbing & Pressure Test _.. . � � �. „ � �' ' - . . 6:;rElecfrical'UFER�Grnd:- ' y:� �ij•�� 57'APPROVALTOCOVER-GUNITE • `�� - % $ _ �. 7. Foofi.ngs � ,'�^, � .°. �� Q .: ? :_, ' �? �f-�S3i "; � � � ��.58: Electrical Conduit=Undromd. " _ ' � - ' �, 8. 'Foundatiori r, � .� -' � � �=- i! � � , :? ti'�� . ;.. �,: � 59. Gas Pipe,�:O..Undrgmd�., Test • � � . 9. Water Pipe-Undrgr'nd. � � ' ' � � " ' �� -60. Backwasli Lines, P-Trap, O Undrgrnd. _ � � 10. Structural Flooi System ;5� ,`;' , �,13•8� 'D 5,,, . �.61. APPROVAL'TO DECK . , ;, 11. Property Sewer Line &"�House��nnection`,� ; ; � • . ' 62. -Backwash,&-:Receptor-Final • �� 12. Sewer Ca • ` � ' - . ' � � � ' - ' . . " . , P . � - i ? � �'�i � - � �r, 63. Heater &' Vent-Final � � 13. Roof•Drains' � �� , � , � � � = � � r ° � o �- i � 64. Plumbing SysYem,- Final�= � . 14..RoughPlumbingj�(Y � . ��d ��i ' � i •` �� t65. Electrical=Final �- - - �� - ' 15: Rough'Electriral-Conduit'�-, '-:-'T-'i '�"'� "('-"''' -�--r 68. SolanSystem-Final , � � � � ' � --16. Rough Elecfric Wiring. ,,, � ' ' �� -. { , V,� c '. = �-_ ' �67.� Fencing &�Access A�pproval � - �- - � 17'�Rough Wiring Sign • .;� ,-, I � � �' � `-_ � � �'� , � � � � �; ,68. APPROVED FOR`P,LASTERING � ' � ' 18: �Rough Electrical-T'Ba� Ceiling' j� � � � � ; � , ' 4 . '69: POOL/SPA SY,�T�MS FINAL � � 19: �Rough�Heating & Air.Conditioning � ' � ' ; � FIRE DEP1P' £QUIREMENT, � ., - I . � 'vn� 20. �RoughfFactory Fireplace ;• j �� `! f ? � j APPROVALS '�Peimit# - ;,�'2L Aucts; in Stiucture� '" r � i ' ' I � � � � � i 70. Unde�grountl'Hyd�o � _ ' � `i��22. �Ducf;, Veniilating � j ; ;: � � ' � ' 1 j � ,71�, Product Pip}� 'fdGas ❑Oil � t a'%�,., . .4 ; . . � . I',-_� _'�_. r_' _ ''_ .� . _ .. -�,�P3. Gas'Pipe-Rough ffi�Tesf �� '�,' �, � i, � � �' � �72y Undergrou d Flush . �`24..Roof F�aming� �_.� ' �+ � i ��;�'�..,1� ��i �j � ,� �- �� 73.� Undergrnd.StorageTank OGas ❑OiF f �� 25. �Roof Sheathing'•�5�ea -ho'��y S'�I � �3 ' �q-�.��? � � ' �7q,� Overhead Hydro . � � ` ` ; 26. �T-Bai Ceiling (Structuraq� & Monocoat' � � � , �• � �. � � - 75. Dry Chemical � . . . - - , . �� a 27.' Frame:and'Flashing p�'�� ' ��I j=: I j � � - , . . �(-3p_83 �� , , -�.j �� ,76. Dr�y Standpipe � , 28. Lathing &�Siding �''{'� !' i; t ��-�; S� ;,�� i 77.� FIXED SYSTEM FINAL I •29.+,Insulation'- ` ' '�,i ' �, ' �� j �-�-� � ��78. FIREPREV.FINAL �� , 30. •Drywall Nailing .(..r 1��. $�3 '� ° � ! i I i � � NotesC rlt�sJ� L , ...,. - - - p � . . . _ 31. Plaster`Brown Coat.��c��.l' �� ' ji �� f-2 �'fi� � o!� !� - -- � + ,$Z'�l - . �ii. � '� ; � � � � �'t 32. ��Electrical Power Meter-Final � y h � , , . - � i � �� s - ' . /� y-�,33.•FinalElectric ,i�l� � 1i�h.._+ � � � �j.-.. �0� .��IP �� - 34. Final Heating��&�Air�Conditioniog �' ' I � i . �a • s �pr I .� 6 � � 35. Final Gas Pipe-Test �� ' �� ' _^ � �'; � ! ' ,`� �'? - � J .�4 f4! '3 P -� � . i 36. Hood or Canopy "" � i: � � ' � - � � �� ,. _ ��-� ;� , �x�� 4 o..r�f � 37. Final F.actory Fireplacer ! i � ;; � , ' � �. � „ , ;. , I' � '8- 0-�r O � �'� �'�r t , 38. Finai Plumbing : ' � � � ol � f t : � �� ' � . i � - - 3 �.1'� �-f-,"� � � St , 39. Water Senrice-Final. � � � . ` fi � � '� � I ' � �,✓{ �Q! 40. Gas Service-Final" � , ; ' �� '� ' � � �*y- � ,�� , r �;� i� i � il $�' p V✓ al bH'f:. 'rePn beard b�hlnd 41. Solar� DomesticFinal � � I ' � � ; _L ' � ' � howtr '1'N - O • . ' • ' _ ' --l�- --t-. j': 42. Backflow.Preventer � � � � :i . I k`;��- - �- ��- -- - -�-+--• - - � . 43. Backflow Irrigation. F 1 � �?; d I ,- � �_ ( � � , � 3 � • � � �y; . ' . ' ' � ; . ,r, . .� . .I•.� e• � � �1...�� r, o�. . -t . . � - � . 44. Landscape I�rigation;System ' � ��,f�_ �� 5 � _ -�, ;; _ , , � � � � .._ - '_�a . ;��i:i�, �-��m.i � �. � - 45. Sound Attenuation �" " �' I` � � �, �. �: I�;� � 6�' - � 46. Handicap Regulations ; i ,� � 1� �, , ' . , _ � ' � ' ' .., � - Ili 47. FINAL STRUCTURE & BUILDING �! �' � �z� � � � i � i , , , • . 48. Special Requirements Completed ° ' j ( � �� i " a � � . � 49. Electric Release�to Edison� � i � � r' "t - i " "- -- ' " - ' �� ' " ' 50. Gas ReJease to Southern California Gas Co � j � � � � � � � � � � . . ' � � 51. CERTIFICATE�OFOCCUPqNCY °' _ � ' ' - - •"' , {- - - � - No. � Date ' � � ' � i .a �� I . ... . . . . .. .. . . � . � � � ,N0�-15-g4 TUE 23�09 � � � • . r , WEST L RND COMPANY FAX NO 30� 0292 wesffall & Company Naflonal Marketing and Managemeni Group 9i91 Sheridan Blvd. #203 Westminster, Colorado 80030 OfAce (30.3) 4308000 Fox (303)43(�7885 November 7, I994 City of Cosia Mesa Permit bept. Re; 950 Dogwood St. Costa Mesa, Ca. 'X'o Whom Tt May Concern, . � P 03 Please be advised that Iyis. Carol 5ihiliing of Barker & Assoc. Real Estate Inc. is our authorized agent in your area and has been assigned the above referenced property. There is currentiy a purchase contract on tl�e property a�.d it is our infendon to transfer the property with all the necessary permits. Westfall and Co., as representative of the owner, EIv1C 4fortgage Corp., authorize Ms. Sihilling to oUtain the necessary infotmation ,.garding said permits and act in the owners behalf in fulfilling the reGuirements n�cessary to have them issued. '1'hank you fot your cooperation and if you should have any questinons please call (303) 430-2765. � �.�� Geocge � . Rasmussen � REO Specialist Westfall and Company ,. � ��- J :. � , . , � . � /' . / A . . .. .. .. , , . NOV-15-94 TUE 23�09 WES" _L AND COMPANY ,' , ., ,i' No_ 1:�' ; 94 23 � 49 0020 SRtiFFiX515Hs e r t e s ^^ 1 � �AL9FALRNIA ALL•PUFtpOSE ACKNOWIEDGMENT State ot ��lY(.trl.Gr- �t v County oi � .� On / � �� before � �us a . FAX NO 3G�J0292 ' ' P 02 P. 2 personatly appeared -- • �� Wr�til OF W WlRISJ �ersonally known to me - OR - � proved to me on the basis of satisfactory evidence to be the person(s} whose name(s) Is/arA subscribed to the within tnstrument and ac- knowledged to me that he/she/they executed the same in his/her/their 6uthorized - eapacity(fes), and that by his/her/their signature(s) on the instrument the person{s), or the entity upon behaH of whictt the ` person(s) acted, executed the instrument. WITN� my hand and official seal, m� �,.x.��. .,�.��.�- i I�rcATV�EOPN�TAR�' rl � � ao- ys_ OPTIONAL Though lhe databelow is not reqvired hy law, It may prave �aluabie lo persons relying on ths documant and could prevent hautlulenlreattachmenlofthicform. CAPACITY CLAIMFD BY SIGNER n �No��o�� - ❑ CORPORaTE OFFlCER miFtS� ❑ PARTNEIilS) � LIMI'CEG � GENEiUL ❑ ATtL .cY-1N-FqCT ❑ TAUSTEE(S) ❑ GUARDIAWCONS@RV!ITOR ❑ OTH�R: 51GNER 1� .cSENriNG; r�,¢ cr �r�c.. 7 •.x� e+rtn'oFs1 OESCRIPTION OF ATTACNED DOCUMENT TITLE OA TYPE OF DOCUMEN7 NUMBEA OF PAQES DATE OF POCUMENT. SIGNER(S) OTHER THAN NAMED q80YE Westfall & Company National Marketing and Management Group 9191 Sheridan Blvd. #203 Westminster, Colorado 80030 Office (303) 430-8000 Fax (303)430-7885 November 7, 1994 City of Costa Mesa Permit Dept. Re: 950 Dogwood St. Costa Mesa, Ca. To Whom It May Concern: Please be advised that Ms. Carol Sihilling of Barker & Assoc. Real Estate Inc. is our authorized agent in your area and has been assigned the above referenced properry. There is currently a purchase contract on the property and it is our intectioi: to transfer the property with all the necessary permits. Westfall and Co., as representative of the owner, EMC Mortgage Corp., authorize Ms. Sihilling to obtain the necessary information regarding said permits and act in the owners behalf in fulfilling the requirements necessary to have them issued. Thank you for your cooperation and if you stiould have any questinons piease call (303) 430-2765. W ' �C'=�'`'�'"'`iA'^'` George . Rasmussen REO Specialist Westfall and Company PNOIECT AOOflE55: ] S O DOGidOOD ST OWNEfl'SNTiME: GREEN, HARRY S � noonEss: gATTN REO DEPT REOR 969 P O BOX 1631 GLENDALE,CA 91209 AflCHIENGINEEN: pDOflFSS: XEC.NO.: UNIT: UNIT: "EpMmEE:WESTFALL 6 CO NATIONAL (714)472-1120 aooaEss: 25230 CABOT ROAD LAGUNA HILLS CA 92653 I LICENSEU CONTflRCTOfl DECLAPATION: I here0y allirm t�at I am licensetl unAer D�ovisian5 oi ChaO�er 9(commencinp wi�� $e[tion 700�1 0l Oivision 3 oi t�e Business antl Prolessions Cotle. ana my license is in tutl lorce and effect. cirr uc.: srnTe uc.: cuss: EXP : Da�e: Signaiure: wOPNEBS' COMPENSPTION oECLAflATION: I hereby aflirm tnat I have a cenificate of tonsent to selFinsurt or a cenificate ol workers' Compensa�ion Insurance. ar a certilietl cooY ��ereal (Section 3800. Lao. C). POIICY NO.: EXP. DRTE: COMPANY: ❑ Ce�ilied copy is here�y lumis�ed. ❑ Certiliea copy is �iled wilh Ihe ciiy Builtling Division. Dale: ApplicanL El1EMPilON FAOM WONRENS' COMPENSpTION OECLABATION: (This section neetl nat be completeA il lhe permil is lar one hunaretl ($100� or less�. certity @al in ine oeAormance ol ihe wark for whicn Ihis permit is issued. I shall not emDloy any person in any manner so as lo become eebjex o ihe Workers' Compensation Laws ol Cali�omia ' j �a�e: � � Z � q y Signaiure: �� —'v ' �� • �---N ICF: II. al�er making I�is Ueclara�ion, you shoWa hecome suDlec� b t�e Workers' Compensalion O�ovisia �s f t�e LaDor CoDe, you musl lonnwilh comply wit� suc� pmvisions or t�is Oe�mit s�all Oe deemetl revoked. CONSTHUCTION LENOING PGENCY: I hereby a��irm �Aat there is a con5imc�ion lentling agenry lor lhe pedormanm a� lhe work br wnich Ihis uermit is issuea (Seclion 3097, Civ. C�. lENOEN: aoosess: OWNEP BUILOEB UECIAflRTION: I here�y ailirm �ha� I am exempl lmm lhe Conirac�ors' S�ale License Law br Ihe lollowing reason (Seclion 7031.5 Business anU Professional Code: Any ci�y of counry whicA rtquires a Dermi� to consimct, aller, im0�ove, tlemolish, or repair any simclure. orior to its issuance. also reQuires ihe aoDlicant for sucn permit to file a signetl statemeni inat hC/sne is licensea pursuanl 10 tne pmvisions ol lhe Coniraclors' State License Law �Chapler 9(commencinq vni� Seclion 70W) ol Divivon 3 of lhe Business ana Pmiessions Coael or �hai he/she is e.empt inerefmm ana ihe bazis lor ine alleAea exemption. Any violation of Section 7031.5 Ey any ap0litanl fo� a permii SuOjeCIS ihe applicani l0 a tivil penalty ot nol mor¢ IAan five hundretl Oollars (5500�. I. as Owner of I�e D�oDeriy or my emplayees vnth wdqes as tAeir Sole compensa�on, will Oa t�e work, anU the ❑ svucmre is nat imenCeG or offereG lor ule (Section 704a. Business anG Professianal COAe: The Coniractors' State Lirense Law Uoes nol aDD�Y �a an ownet ol a pmpeny who Guilas or impmves l�ereon, antl w�o Eces such wOrk him5elf/hersell or i�rouq� �i5 ar Oer mvn empi0yee5, O�a�0e0 Itu� Such impmvemeni5 are noi int¢ntl¢tl or oflereG �or 5aie. 11, hOwevef l�e Ouiltlinq or impmv¢menl is 5014 wilhin one year ol campietioq the owner will have Ihe EurEen ol pmving Ae/ihe OiU no� �uiltl ar improve lor Ihe Durpose of salel. I, as owner of t�e properiy. am e�clusively contracting with licensed coniracbrs to constNtt the prolect (Sectlon 7(W4, Business ❑ an0 PmleSsionS COOe: The Camratmr5' Slaie Lit¢nse law doe5 not aDPly lo an owner oi prop¢rty w�0 bwlEs or impmveSlAereon an0 wA0 Cantratl5 �or 5uth projetis wil� a contraCfor�s) lit¢nse pur5uanl �o ��e Contrat�Ors' State LiCense Law). I am axare t�a� pmol ol their Worker'S Compensalion insurance shoultl be O�ovidetl lo me. ,� i am e+emot uneer Seciion: B P 7 0 4 4 B. a P. G ionnisreason: REACT. EXP PERMZT/ � I1 (� �� ❑a^`� � I—d 1— 9 y Owner ( Gt.� D�QY iV -��Y�lL_SC.U-c� ere0y renily ihat I am aware of anA understan0 the requirements of Califomia Healih ana Salery Coae Sections 25505, 25533. 0 25534 antl I�ai I or any lulure builtlmg occupant will/will not (circle one) neetl lo comply wil� 5ai0 s�a�e cotles antl ��e requirements lor a peimil lor conslmclion or modilicatian �mm Ihe Air Oualiry Managemeni �isVict. flesideniial con9mction apDlicalions are eeemp� irom Ihese pmvisiuns. Oale', ApPlicanC I hereby reridy I�al I �ave reatl ��is applicalion and Stale thaUhe a0ave informalion i5 tarretl. I agre¢ t0 tompty wilA all Cily ana COuniy ortlinances and slatelax5relatingio Ouilainp consimction antl �ere�y aW�orizerepresenta�ives oi�his ci�y�o enteruponihe above�mentioned pra brins0eclion purpOses. � ♦ 0 : 'I'��'�� Signamre�� • � • �iiver's L¢ense or Saciai Secu�iiy r: � 16<ba6 wnne—Builaing: Green—CoOe Enforcemem; Canary—Applitant; Pmk—Revenue; GOICenroE—Assossor CITY OF COSTA P1ESA - BUILDIhIG FERMIT PERMIT NO: B 070022 PLAN CHECK NO: 04654-94 L CONSTRUCTION TYPE; PERMIT TYPE: STR PERM NO; B 07002: GOVT; N SUPP; N FORPOSE: CO[J JOB DESCRIPTION ; LEGALIZE 189SF. OPEN TRELLIS PATZO SQ FT; 184 CLAIM VALUE: 1,000.00 CALC-C�ALUE: 2,723,20 GROUP OCC: R-3 / COMMENTS: LEGALIZE OPEN TRELLIS PATIO iE 1E iE if if if-iE it �1F-tr-}--1f ir M� M� ik ih iF %1E # iE iF if iF iR r at if i�- if iE if-i4-M� it K�)t af if iF 14 ir-iE i! i!� iF iE-1F i� �r�+F it M if iR M i� af aE 1:1t iF it it �N� iR> }. if i� i/� if af x r it i'- it Z O N I N G R E Q U I P, E M E N T S S E T B A C K S ------------ NAIN BUILDING ---------- --------- ACCESSOP.Y BUILDING --------- FRNT; £T ZN REAR; FT IN FRNT; 25 FT IN REAR; FT IN LEFT: FT IN RGHT: FT ZN LEFT; FT IN P.GHT; FT IN PARKING REC�; PROV; FARCEL; 42252129 2NE; RI REF NO; PLANNING PJOTE5> LEGALIZATZC?N OF 196.7 SF FAEESTAFIDING TRELLIS FATIO COVEP. > CONSTRUCTED BETWEEN 2 WINGS 6 IA] FRONT OF EX. SF RESIDEPJCE �r*+t�*�tr***�t+��rar*+�*itr**+F***it�*.tiFx+t****ir+r**+�rr.r+c**x+rkrr�r-w-+racr�***�-*.ir�-r+. wi.*r***r**a�_ D E V E L O P P9 E N T S E R V I C E S R E Q U I R E M E N T S% 2013ING APPROVED BY �',� DATE: ��/ ? ! / BUILDING APPROVED BY : DATE: R`I APPLICATION ISSUED HY: �'�'iti DATE: I/ / � 1 i��) *****�t**�**�+�-x+r*�;�+t�t�ir+t��*�**a�**r�t�r***�****�t*��k,��rr��u+cr**-�aa**�c***r*u*t/�**�+�*�c*� 'If !l' if 1f 1F �f 4 iE 9F sf 3f ##�h+t 1!Y #f iF'k 1E'lI-Y a!?f 1E il' i% 1f'If 4'/f iF iE'IR af'If �f ih # Y�'Y tf i! il� iE sf }E ie')f iE+F 4?� w iF tt if 9E if �k aF 1F'1f'IE iF tF iE 1F Y'M�+f� i� M� �R iF �L Y{F af LEGALIZATION;Y F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG FMT PLUMBZNG ELECTRIC MECHANIC FZRE SMIP/RES GRADING PERMIT 108,00 ,5p SMIP/NON-RES PLAN 70.20 ISSUE FEE BUILDING-UIC�-> PERMZT ISSUE PLAN-CHECK TOTALS----> 108,50 0,00 35.10 REVENUE DIVISION TOTALS--> COLLECTED; BLDG PMT PLUMBING cLECTRIC MECHANIC 108,00 TOTAL PAID DUE 143,60 193,-60 .00 193.60 OCTER/SHORT; ,00 r^IRE SMIP/TOT GRADING PLAN-CHECK .50 35.10 if af af iE if if iF if af iE jE #-* iE if if �! iE it it if if jf iE �F iF if iF k iF %if iF iF iF iF iF jE iE M M ik iE K if ��+f iE aR if iM iM iR if if �f � iF iR jE If 1f if iF iF i: af 1F iRY� K+E K ic iF i� af ic I A7 D I C� I D U A L F c E B r^, E A K D O S•I N TYPE QTY D E S C R I P T I O PJ UNIT COST TOTAL COST SFR 189 RES-PATIO COVER-P05T d TRELLIS 14.80 2,723.20 END OF FEES U1 00172247-00172249 T�? T 143.60 nAiEs il/22/94 TInE: 11:17 CONSTRUCTION AND PLANNING POOL & SPA � .�PPROVALS Permit �F Date Inspector p,ppROVALS Permit # Date Inspector `i. Tempofary Etectrical Servlce or Pa4e 52. Pool & Eq�ipment Location 2. Soil Pipe-Undrgmd. 53. Sceel Reinforcement 3. Electrical Conduit Utility•Undrgrnd. 54. Forms ' 4. Electricai Conduii-Undrgrnd. 55. Electrical Bonding 5. Steel Ralnforcement 56. ftough Plumbing & Pressure Test 6. Electrita� UPER Gmd. 57. APPROVAL TO COVER�GUNITE 7. Footinas 58. Etectricaf Conduit�Undrgrod. 8. Foundation 59. Gas Pipe, i� Undrymd., Test 9. Water Pipe-Undrgmd. 60. Backm�ash Lines, P�Trap, C1 Undryrnd. 70, Structurai Fioar System 61. APPROVAL TO DECK 11�. Pr`operiy Sewer �ine & House Connection � , _. g2. Sackwash & Receptor-Final � 72. Sewer Cap , 63. Heater & Vent-Final . 13. Roof D�ains 64. Plumb'�ng System � Ffnat 74. Rough Plumbing 65. Electrica�-Finat 15. "Rough Elect�icai-Conduit 66. Solar SYstem-Finai 16. Rou9h Electric N�iring 67. Fencing & Rccess ApProvai 17. Rou9h Wirinq S�gn 68. APPROVED FOR PLASTERiNG 78. Rough Electrical�T Bar Ceiiing 69. POOLlSPA SYSTEPAS FINAL ' 79. Rou9h Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factary Fireplace APPROVALS Permit # 27. Duccs, in Structu*e �0. Underground Hvdro 22. Ducts, Venrlating 71. Product Piping O Gas OOii 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil 25. Aoof Sheathing � 74. Overhead Hydro 26. T�Bar Ce�ling tStructural) & Ivionocoat 75. Dry Chemicai - 27. Frame and fiashing 76. Dry Standpipe . 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insuiation � 78. FIRE PREV. FINAL 30. Drywall Nailing HEAITH DEPT. REQUIREINENT 31. Plaster Brow�n Coat 79. FINAL INSPECTION 32. Electricai Powzr MeterFinal 80. FOOD CERTIFICATE ISSUED 33. Finai Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test ' 36. Hood or Canopy i 37, Final Fattory Firepiaw 38. Final Plumb+ng J 39. Water Service�Finai 40. Gas Service-Final . 47. Solar pomesticFinaf 42. 8ackflow Preventer 43. BackfloW ��9ation 44. LandscaPe irrigation System 45. Sound Attenuation 46. Handicap Ragulazions . 47. FINAL STRUCTURE & BUILQING G�z9�.. �[ 48. FINAL P�ANNING 49. Electric Releese zo Edison ' 50. Gas Release to Southern California Gas Co 5L CERTIFICATE OF OCCUPANCY - No. Date � NOTE� SHOW AND DIMENSION PROPOSED PATIO COV�R ANO YARD AREAS � � 1��878 � _ .a ' �� IE$.�� 7 C17Y O FCOSTA�SAh � PLAt�iJllv CEf'T. etua�Ecr ta ei.o.;. �err. u[o. ro� � DarF (1 �,2-9�i �50 0.�w°� a OF BUILDING ( OF COSTA ME; APPROVEID � This set oi plans am specd�catior�s MUST be kepl on fhi pb ffi all9mas and it is unlavdul ,,, , a,.� o ��.y2 _:.-...: '�� permisston irom the uio�ision of Building and Safery, City 1 Cosla MesB. 7he stamping o� ��h�s ��an an�d� s,/pecificept,i�o,ns SH��A+�LLT NOT �be rh�eald�to pemt6 or to be an aPP�►/-�� •'`^`�1Y�Y P�Vt��i��rel�1Y"I.a�� Mesa Ordinance andlo� Stale law. 7hese p!��s antl permit shall expire by limitation arnl become nuli and w(d B .. . - '�"'�..'_ ....a..t..��n.itRf:R3M jaj w�i�,�� iE� ._ �=�a��e. �1—Li?� RI—a I�I ► I � 6 L � SEE DETAILS ON REVERSE SI�EI ROOF SHEATMING �� OVERNANfs _X_RAFTERS AT_ O.C. _x_ eenM T-STRAP EA. SIDE FOR POST- BEAM CONNECTION. ( m Q J N U f Z � O J V OROP PATIO W li = F1.00R 2' Q � f � `a SLOPE� IN 6I . 1 WOOD F I I�f� CONSTRUC' 1 V �..I' N ITIONS, DLLETIC ;S, DR CORRECTIO^1S SHALL APPRUVcJ [3Y I't E PLAidNlfu6 DEPARTMENT TION a� a = � w f- t- N 4 _ a _� ¢ O � � N = X � � -o cin- o � cc Piar �;�� OU6JECT S GLC � D.' 016CCT0@ OP . w � Z Q Q j � Z O � _� W O m a o . ;;i i' .uq - i N � 1 —LL _ _ J PIERS 12�� SOJ� o. a z u i � CONSTRUCTION DETAILS L•t� �,�D �Qa6 �va� 17 C� �A ✓I"l�S �- ��q�, � s.�F� � ,��;gi� ^„ grn -� To� " aF.3m,� �'� . � �, x I 5 �- -�vee - s-I-u� � -f ve.l I i s'h��e ��..k� v� v� �� `n �o o ' � � ' �CrJ{ O '` � y T Z � � y N j G � � D �d z � m b � � _. O � � ti �' y za �� Westtall & Company National Marketing and Management Group 9191 Sheridan Blvd. #203 Wesiminster, Colorado 800.30 Office (303) 43o-8000 Fax (303)430-7885 November 7, 1994 City of Costa Mesa Permit Dept. Re: 950 Dogwood St. Costa Mesa, Ca. To Whom It May Concern: ; Please be advised that Ms. Carol Sihilling of Barker & Assoc. Real Estate Inc. is our authorizcd agent in your area and has been assigned the above referenced property. There is currently a purchase contract on tlie property and it is our intention to transfer the property with all the necessary permits. Westfall and Co., as representative of the owner, EMC Mortgage Corp., authorize Ms. Sihilling to obtain the necessary information regarding said permits and act in the owners behalf in fulfilling the requirements necessary to have them issued. Thank you for your cooperation and if you should have any questinons please call (303) 430-2755. ,1 �„� • �t+1Mn�.w�..�... George . Rasmussen REO Specialist Westfall and Company . -No�. 13 '94 23�49 0000 ` �RXS15Hseries CALIFORNIA AtL.PURi►OSE ACKNOWLEDGMENT P. 2 State of Li11"I�fYIG� �f �' County of .+� Qn ��/ r// ��- / � , � 7`1 before n�y�19"=�„� � f�n�i/r /��/ ii,G�i�i 0.VE /� E.TIREOfOFFlCEq.EO.'u+EDOE,NOTA W6UC personally appeaLed �.PB2R-N_ �iT/ �f,C�-��%�%�� N�MEB) OF SI WJER�s) �personally known to me - OR - O proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the witRin insirumsnt and ac- knowledged to me that he/she/they executed the same in his/her/thel� authorized - capacity(les), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalt of which the person(s) acted, executed the instrument. ��x �U ��T� WITN� my hand and official seai. `�, � P�t/ I�f1ANRE OF NOTARY OPTIONAL Though the databelow Is not required by law, it may prove valuable to persons relying on the document end could prevent frautlulent reatlachment of this form. CAPACITY CLAIMED BY SIGNER � INDIVIDUAL ❑ CORPOAA7E OFFICER *mEtei ❑ PARTNER(S) � LIMffED C� GENERAL ❑ ATTORNEY-IN-FACT ❑ TAUSTEE(S) ❑ GUARD�AWCONSERVATOR 0 OTHER: SICiNER IS REPRESENTING: w� or c��soncb7 a+�roFsl swap DESCHIPTION Of ATTACHED DOCUMENT TITLE OR TYPE OF �OCUMENT NUMBER OF PACiES DATE OF DOCUMENT SIGNER(S) OTHER THAN NAMED ABOVE ORANGE COUNTY BUILDING DEPARTMENT •' ' 636 NoAh Broadway SANTA ANA, CALIFORNIA FOR APPLICANT TO FILL IN ui�oiNc _._ _ . Ci06ii8 M868 NEAREST �Ross ST. Renublio Ave. OWNER CNINOOK HOMES INC. MAIL 93 3 W��sH�Re BLVD. ADDRESS CITY BEVERLY HILl3 No� CR. 51I ENG N'EERT �AIN S� MCKERRACMEq�p' SY. 6�{ nooness ZiIO E. WAINUT ST., PASADENA coNrRacror%�EMPORT VISTA CO. Np' CF. 5�i ADDRE559 6 WILSHIRE BLVD.� BEV.H�I.I$ LEGAL / DESGRIPTION LOT NO. Q7p BLOCK � u fATTACH METES Q BOUND51 TRACT SIZE OF LOT �M M NO. OF BLDGS. �p x� W NOW ON LOT Q USE OF NO. OF NO. OF E%ISTING BLOG. I F�vaiee I ROOMS DESCRIPTION OF WORK BUIIDING 1. NO. OF SIZE �n�µ SO.FT ROOMS � STORIES WALL I ROOF COMPO COVERING STUCCO COVERING USE OF NEW BUILDING RESiDENCE_ALL.C&2`D02`L FOU I HEREBY ACKNOWLE'JGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ANO AGREE TO COMPLY WITH ALL COUNTY ORDINANCES FRA AND STATE LAWS REGULATING BUILDING CONSTRUCTION. IATI SIGNATURE OF PERMITfE EMPORT VISTA CO. LATI � I PLA' AUTHORI2ED AGT. _ $ 4830.00 " P. �. : VALUATION �� APPLICATION FOR PERMIT B� 1 `�� FOR OFFICE USE ONLY RECEIPT NO. PERI �.s��8 S/� BV DATE OF APPL. DATE QE /a "/-r").3 /o' , �. �0 � a�vuroz � NE RACING. BOLTS IIJT. PIASTER, E%T. MASONRV REIN BOND BEAM FINAL APPROVALS ION � IPJpPE¢. � U � J- � y 0 a � z s r STIiEET i . ._ _.. ��...�„.: .' - �'� :+i .^�- J . .^V�: p11Cf�J' 0�: . � : I . =1I. I •� ..1 I ., - . _. � ...�III�. I�� ' ' i . .i. ' .._1�� "._ �I �__ .r. __.._�,..._ ... ---� � - ._. ..' _. �.T . . � II 7 �r .'i, � ' .l✓ ..C.I�, ' 1'.-'17.. , . � � . ! 1...4'_' Jy.' . _ ; I I.: I . ' . �. _.�� . - � � ... . . . I � )�I X " '� ' � � , . .. . . � � r � � X . , _ ' .. �-�.^7 f ' .�1:.� '_ '� . . 7^J'. � . — ---v:: I.H' _ __ _ . .'ni^. _.;�.'.��_..�..'ll'.. _ f �... - . . . . . � �—_' , /. ..,:1�� '�V3�, • . _ ' . � --�.-. • _ ,