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Home My WebLink About968 DENVER DR - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Jab Adtlress: 968 DENVER DR Suite: Vicinity: ROOF Primary Occ: R-3 Dwellings/ Cong Res <10 Type of Construction: V-N Parcel Number: 41808119 Zoning: Applicant: JOHN ALAJOKI Address: 25672 TALADRO CIR � SUIITE E MISSION VIEJO, CA , Owner: MIYAMOTO, MUTSUKO Address 968 DENVER DR . . COSTA MESA, CA- Convactor. JA ROOFING Address: 25672 TALADRO CIR SUIITE E MISSION VIEJO, CA Zip: 92691 Arch : Address: Phone: 949-481-8917 Zip: 92691 Phone: Zip: 92626 Phone: 949-081-8917 ��License: 735404 - Eng: Address: ISSUED BY: Status: ISSUED Applied: 03/30/2005 Issued: 03/30/2005 . Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16" OSB PLYWOOD, 30# FELT, GAF TIMBERLINE, 40 YEAR COMPOSITION SHINGLES. 1,200 S.F. INCLUDES ATTACHED GARAGE. � ' - - �- WILL NOT WORK ON FLAT ROOF AREA. � ` FEE SUMMARY Plan Check: $0.00 Calc Valuation: S2,�oo.00 Permit: $83.25 Claim Valuation: Sz,ioo.00 SMIP Res: $0.50 - SMIP Com: $0.00 Other. $0.00 � Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0, PARKING Existina: o Rear 0- 0 Rear 0-0 Required: 0 PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: ,0 Right 0- 0. Right 0- 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 72-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. ' INSPEC710NS: In order for the work authorized under this permit to be considered leqal, such work must comply with all applicable codes, and all requlred Inspeetions and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration o( this permit. FOR INSPECTIONS CALL: (774) 7545626 ��Ww� WORKERS'COMPENSAnON DECLARAnON: � I hereby effirtn under penelty of perjury one of the following declaratlons: ❑ I heve end will meintein e cerliFlcete ot consent to self-Insure lor workers' compensetioq as provided for by sedion 3700 oi the Labor Code, for the pertortnance of ihe work for which this pertnit is issued. �have antl will maintain workere' crompensation Insurance, es requiretl by section 3700 oi the Labor Code, �or ihe pertortnance ot the work for whic� this pertnit is issued. �' }My workers' compensatlon� urence carner and policy number ere: �.� � wY, l/ amL �.r -S1. ��— { U �-G, t_ , t" � �SJ/�7y�'�S 3�� {� �-Policy Number: '-' T� nis section need nof be completed il the permif is veluatl et one hundred dollers ($100) or less.) ❑ I certiy ihat in the pertormance oi the work which this permit is issued, I shall nol employ eny person in eny manner so as to become subject to the workars' compensation laws of Calito i, end gre at If I should become sub�ect to the workers' compensation provisions of Section 3700 of the Lebor Cotle, 1 shell forthwith comply with Ihese provisio . �plic6ril'Sig�nature,: .� �.. Date: .��3��Q� wSF: � WARNING: FAILURE TO SECURE ERS' COM NSATION CAVERpOE IS UNLAWFUL AND SHFLL SU&IECT AN EM LOYF�[7ifOCRIMINAL PENALTIES RNO CIVIL FWES UP TOONE HUNDPED TIKK15ANpDOLURE(5100.000),INA DITIONTO ECOSTOFCAMPENSATIIXJ,OAMAGESASPqOVIDEDFOFINSECT10rT3lO60FTHElABORWDE.INiEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: of Chapter 9(commencing wi�h Sac�lon 7000) of Dlvision 3 ot Ihe Bu�esS and Professions Code, and my license is in full CONSTRUCTION LENDING AGENCV: � ❑ I here6y aftirtn that there is a consiruction lending egency for ihe pedormance of ihe work for which ihis permit is issued. (Sec. 3097, Civil Cotle). Lender's Name: Lender's Address: Signature: OWNER-BUILDER DECLARATONS: Date: I hereby ettirtn that under penalry of perjury Ihat I am EXEMP7 FROM 7HE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business antl Professlons Code: Any dty or county which requires a pertnit to construct, aller, impmve, demolish, or repair any stmcture, prior to its issuance, also requires the applicant for such pertnit to file e 5igned 5tatement thet he ar she is Ilcensetl Oursuen� to Ihe provislons ol lhe Conirec�ors Llcense Lew (Chepter 9(wmmencing with Section 7000) of DlWsion 3 oi Ihe Business and Professions Code) or that he or she is anempt therefmm and Ihe basis for the allaged e:amption. Any violation of Saction 7031.5 by any applicant for a permit sublocls the appliCant ta e civil penalry ol not more �hen five huntlred tlollers ($500).): ❑ I, as owner ol the properry, or my employees wilh wages es their sola compensation, WILL DO TME WORK, and the stmcture is not intentle0 or otlered tor sale (Sec. 7044, Business antl Professions Cotle: The Con�rectors License Law does nol apply lo an owner oi pmperry who builds or improves ihereon, and who tices such work himself or herself or ihrough his or her own employaes, provided ihat such improvemenis are not intended or oReretl for sale. If, however, the huilding or improvement is sold within one yeer of completion, the owner-builder wiil have ihe burtlen of proving that he or she ditl not build or improve for puryo9e of sale.). ❑ I, es owner ol the property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to cons(mct the project (Sec. 7044, Business and Profession9 Cotla: Ttie contraciors License Law does not apply to an owner of pmpeny who builtls or improves thereon, antl who contracts tor such project with a contractor(s) license pursuent lo ihe Conlractors Licensa Laws.). ❑ I em eaempt untler sec. SignaNre: Owner ID venfied by dnvers license. ❑ Yes ❑ No Business and Professions Cotle for this reason: Venficetion of Ownership by (type ot document, i.e. - property tax bill or deatl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Driver's License No. Date: Ezpires: ❑ I here6y certify that no excavation five (5) or more feet in depth into which e person Is raquiretl to tlescend, will be made in connec�ion with work authonzad 6y this pertnit, antl Ihe� no bUilding SWdure, SCaHolding, talsework, or demolition of dismantling ihere0f, will be more ihan ihirty-siz (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 341, Title 8, Celifomia Atlministrative Cotle). ❑ As owneo-builtler, I will not employ enyone to tlo work whic� wou10 require a permit from the Division ol Indusinal Safery, as noted above, unless such person has e pertnit to do such work from the division. SignaWre: Dale: Division of Intlustrial Safery Pertnit Number: CERTIFlCATE OF COMVLIANCE AND AUTHORIZATION OF ENTAY: I cetliy under penelty of perjury ihat I have reed this epplication ene state ihat the information given is correci. I agree to comply wlth ell state lews entl city ordinances releting to bullding constmction, and euthorize represantallves of Ihe City of Costa Mesa to enter upon the above�described D�aPerty for inspectior�uryoses. I egree not to wcupy or ellow occupancy ol eny building authorized by this permil until final inspection. GOUE I, INSPECTIONTYPE � 1616 Fizetl System Final Fire Prevemion 1266 Pool Spe Final 200 Final Re-Roof 201 Final8lock/Retaining Wall 202 203 Final Factory Fire Place Final Sign 204 Final Demolition D�TE 400EN INSPECTIONTYPE 206 Flnal Mechanical 208 Final Plumbing 210 Final Elecirical 212 Flnal Flre Preven�ion 220 Final Planning Approval 222 Flnal Si�a 250 Final BuiltlinyOccupency QAIE INTITULg (714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 JobAddress: 968 DENVERDR Suite No Vicinity: 1ST FLOOR CLOSET Parcel Number: 41808119 Applicant: KOWERTZ, BILL Address: 20592 EGRET LN 0 HUNTINGTON BEACH, CA owner: MIYAMOTO, MUTSUKO Address: 968 DENVER DR � COSTA MESA, CA MECHANICAL PERMIT Phone: 714-969-8212 Zip: 92646 Phone: Zip: 92626 Contractor: SOUTHERN CALIFORNIA ENERGY SERVICDES INC Address: 20592 EGRET LN HUNTINGTON BEACH, CA Phone: 714-969-8212 Zip: � 92646 License:612389 SCOPE OF PERMIT CHANGE-OUT OF A FAU IN A FIRST FLOOR CLOSET IN AN EXISTING SFD. 1 INST FAU < 100K BTU NO OTHER WORK AUTHORIZED.WITH THIS PERMIT. FEE SUMMARY ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/All Cooling/Heat Inst / Rep. Recess Wall HV Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping . Factory Fireplace Hood w/Mech�Exhaust VAV Box � Vent Fan / Single Duct Appliance Fire Dampers , Smoke Dampers � Inst or Relocate Appl Vent Air Handlers < 70000cfm Air Handlers > 10000c(m Floor Furnace Floor or Suspend Heater $23.50. $14.80 50.00 50.00 $0.00 $0.00 $0.00 50.00 50.00 so.00 $0.00 50.00 ' 50.00 50.00 50.00 "$0.00 50.00 50.00 50.00 $0.00 Quantity � • __ 0 � 0 0 0 0 0 0 0 0 • 0 " 0 0 � � . . . 0 0 , 0 � 0 0 , �i m ISSUED BY: Repair / Alt Absorbtion Unit Repair / Alt Refrigeration Unit Ventillatlon System Evaporative Cooler Commercial I ncinera tor Domestic Incinerator Compressors / Absorption Svstems Upto3hp/100kBTU 3To15hpI500kBTU 15 To 30 hp"/ 1,000 k BTU - 30 To 50 hp (1,750 k BTU ' Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15to30hp� , � 30 to 50 hp Over 50 hp Olher Mechanical Fee Investigation Fee .Plan Check Fee Reinspection Fee Status: ISSUED Applied: 01/18/2005 Issued: 01/18/2005 Quantity $0.00 0, $0.00 0 $0.00 0 50.00 0 $0.00 0 � 50.00 0 $0.00 0 50.00 0 30.00 0 $0.00 0 50.00 0 50,00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 $0.00 50.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or If work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorizetl under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectlone and ffnal epproval must be obtained. Failure to obtain inspections and final epproval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5826 zaaaae �aroo� WORKERS'COMPENSAnON DECLARAnON: - , ., . � I hereby eXirtn under penelty o1 perjury one of the following declarations: ' � �� ❑ I have entl will meintain 0 certificate of consent b self-Insure for workers' compensatlon, es proviaetl for by sec�ion 3700 of the Lebar Code, for the�peAartnence at ihe work for which this permit is issuetl. ,1'�a I have antl vrill maintain workers' compensation insurance, as requiretl by section 3700 0l the Lebor Code, for the pertortnance of ihe work for which Ihis pertnii Is Issuetl. workers' compensatbn Insurence carrier antl policy number ere: `, (', ` 1 ` er: �T�Z�� f�� Policy�Tluihber. V O�vS "1� –".��fO (This secfion need not be com��eted il fhe permit is valued et one hundred dollars ($100) ar less.) . . ❑ I certity Ihat in Ihe pertormance ot the work for which this permit is issueq I shall not employ eny person in any manner so as to become wbject to the workers' compensation laws ol Ce�ifomia, and agree that if I shoultl become sublect to the workers' compensation provisions of Section 3700 of Ihe Lebor Cotle, I shall lorthwith comply with these proai ions. • Applican�t Sjp9plare: - �QQts: 1- � ln - O S WARNINQ'FAILURE TO SECURE W�RKERS' COMPENSA ION COVERAGE IS UNUWFUL PND SHALL SUBIECT AN EMPLOVEF i0 CiiIMINAI PENALTIES AND GVIL FlNES UP TOONE NUNDFED THOUSAN� DOLLARE (5100,000�, IN ADDITION TO THE WST OF COMPENSATION, UAMAGES AS PROVIDED FOR IN SECTIIXJ 3'1O60F THE LABOP �DE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I herehy eflirm Ihet I em li ens tl under ro ' ic forca antl eHecl. Lio:1t Z � Contradors SianaWre: \ � Chapter 9(commencing with Section 7000) of Division 3 oi the Busines�s-�ntl Pro�fe5,sion ode, end my license Is in full ^� CIeSe"A� l — / / �,v °�e"T��=—�-� CONSTRUCTION LENDING AGENCV: ❑ I hereby eMirm ihat chere is a consimction lending agency for the pedormance of ihe work tor which this pertnit is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lentlefs Adtlrass: SignaWre: Date: OWNER-BUILDER DECLARA'�ONS: I herehy eHirtn Ihat un0er penelry o� perjury �hat I am EXEMP7 FROM THE CONTRACTORS LICENSE LAW for the followinq reason (Sec. 7031.5, Business entl Proteuions Code: Any city or counry which �equires a pertnit to construct, alter, improve, demolish, or repair eny structure, pnor to its issuance, elso requires the epplicant tor such pertnit to file a signed statement thet He or she Is licensed pursuant b the pmvisions of ihe Contractors License Law (Chapter 9(commencing wi�h Sectlon 7000) ol Division 3 of Ihe Business end Professions Cotle) or ihat he or she is exempt Iherefrom entl ihe besis tor the alleged exemption. Any violation of Saction 7031.5 by eny applicent for a permlt subjects the epplicant to a civil penalry of not more than tive hundred dollars (5500)J: ❑ I, es owner of ihe properry, or my employees wiih wages as iheir sole compensation, WILL DO THE WORK, and ihe structure is not intentled or oMeretl for sale (Sec. 7044, Business and Professions Cotle: The Coniractors License Lew does not apply to an owner of property who builds or improves ihereon, and who tloes such work himself or herself or through his or her own employees, provided thet such improvements ere not intended or oHered for sale. If, however, ihe 6uiltling or Improvement is soltl within one year of completion, the owner-builder will have ihe burden o� proving ihat he or she tlitl not build or improve tor purpose of sale.�. � ❑ I, as owner of lhe property. am E%CLUSIVELY CONTRACTING WITM LICENSED CONTRACTORS to construct the prolect (Sec. 7044, Business antl Professions Code: The contrectors LlGense Law tloes not apply �o an owner of property who 6uilds or Impmves thereon, antl w�o contracts tor such pra�ect wlth e contractor(s) license pursuant to the COniractors License Laws.). ❑ I am exempt under sec. - Signature: Owner ID verified by driver's licanse. ❑ Ves ❑ No Business entl Professions Code for �his reason: Venfication of Ownership by (type oi tlaument, i.e. - property t� bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Driver's License No. Date: Expires: ❑ I hereby cenity thet no excavation five (5) or more feet in tlep�h into which e person is required to descentl, will be made in connection wit� work euthorized by Ihis permil, and ihat no building s�rucNre, scaflolding, lalsework, or tlemolition or dismantling thereof, will be more than thirry-six (36) leet high. (Chap. 32, Gry 2, An 2, Sec. 341, iitle 8, Califomia Administrative Cotle). ❑ As owner�builtler, I will nat employ anyone to tlo work which woultl require e permit irom Ihe Division ot Industrial Safery, as notatl above, unless 5uch person has a parmit to do such wark trom ihe division. Signature: Date: Division of Intlusinal Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF ENTRV: I certity untler penelry of perjury ihat I have read this applicetion and state lhat ihe infortnation given is correct. I egree to comply with ail state laws and ciry ordinances relating ro builtling consiruction, anC authonze representatives of the Ciry of Gosta Mesa to enter upon the ebove-doscribed propeny tor in5pec�ion purposes. I agrae not to occupy or ellow occupancy of any building authorized by this permit until finel inspec�ion. COUE �. INSPECTONTYFE , 1616 Pixetl SyStem Final Fire Prevention �266 Pool Spa Final 200 Finel Re-Rool 201 Final Block/Reteining Wall 202 Finel Factory Fire Place 203 Final Sign 204 Final Demolitlon Pfl7F ^�� ItRIDALS �—�� . COOEA INSPECTIONTYPE 206 Final Mechanical 208 Final Plumbing 210 Final Elecirical 212 Finel Fire Prevention 220 Final Planning P.pproval 222 FinalSite 250 FinalBuildincyOccupancy .i ADo��ant to filt in all soaces except those within neavr border CiTY oF COS7A MESA CONS/T(�j� UC{'T �IO�N�� ^PERMI Project Address � � CI V I OG��/ V�L�- � V� ApplicanYs Mailing Address c Owner� Name �� `�uK��phone AddrQ�a � Z� -�wi WI L.i6/� ST �jn�i1� /LI�� ArchlE'ng.• - License No. Address n ConVactor' N ,n-�� 0'�1 L('Y�H/1� 6 Pho �=t;�� Address Im�'�'nnl � n,oG ry� !'}L!4 �}iLG Qj �! f'/j City License No. / ��' � LICENSED CONTRACTOk OECLARATION � I hereby a(firm that 1 am licensetl untler provi5lon5 of Charter 9(commEncing with section ]000) of Division 3 of the Business antl Profeszions Cotle, antl my license is in i fo�e nd effect �� ;�� Licens I 55 ense No. �%�� Date Si9naWre WOHKER C MPENSATION OECLARATIO I hereby aifirm that I have a certiticate of consent seH,-insure or a certiflcate � Workers' Compen5ation Insurance, or a certifi tl copy thereof ($ection oo. �b. c.� ' �r�� '�+Al� rollcy No. Company eCertifietl copy is hareby furnishetl. CertyfiqU cqp,g isit�ley witn the cit Itling ivi 'on. Date! !/ GTS- 1� � APplicant EXEMPTION FROM WORKERS' COMPENSATION D CLA0.ATION (Thissection neetl not�be completetl if the permit is for one huntlretl ($100) or less). I certify that in the performance of the work for which this perm�t is i55uetl, I shall not employ any oerson In any manner so as to betome subject to the Worke�s' Compensation�,Laws of CalifOrnia. Date Signature NOTICE: If, atter makin9 this tleciaration, you shoultl.become subject to the Workers' CompenSatlon provisions of Ihe Labor Cotle, you must forthwith mmpty with such provisions or tM1is permlt shall be tleeme❑ revokeE. CONSTRUCTION LEPIDING AGENCV 1 hereby af9rm Ihat [h¢re is a mnst�uctlon lentling agency fo� the pertormance of the work for wM1ich thi5 permit is issuetl (SeCtion• 3097 Civ. CJ Lentler's Name Lentler's Adtlress OWNER BUILpEH �ECLARATION I her¢by affi�m that I'am exempt irom the Cont�acto�'s LicenSe Law tor the following reason (Section 7031.5 Business and Professional Cotle: Any city or counly which requires a permit to const�uct, alt¢r, improve, tlemolish or repai� any stracture, prioi t0 its issuance, also reqvires tne applicant tor such permit to file a signetl staternent that he/she Is licensetl pur5uant to the provision5 of the Contractor's License�Law (Ghapter 9�(wmmencing with Section ]000) of Olvision 3- of'the Business antl Protessions Cotle) or that he/she-is exempt "+erefrom antl the basis fot the alle9etl ezemOtion. Any violation of Section 31.5 by any appiican[ for a permit subjects the applicant to a civil nalty o! not more than five M1untlretl tlollarz ($500). • J I, as owne� oi the properry or my employees with wa9e5 as their sole compensation, will tlo the work, antl the sVucture is not intentled or Offeretl for sale (Section 7044, Business antl Professional Cotle: The Contractor's License Law tloes not appty to an owne� of a prope�ry who build5 or improves thereon, antl who tloes such work himself/herselt or through hiz or her own employees, provitletl tM1at such Improvements are not in[entl¢tl or otteretl for sale. If, however, Ihe builtlin9 ot improvement IS soltl wlthin one year of com- pletion, the owner wili have tha burtlen of proving'he/she ditl no[ builtl or im- prOve for the pu�pose of sale). ❑ I, as owner of the property, am ezclusivery mntractinq with Iicensetl con- tractoreto construct the�project (Section �044, Business antl Professions Cotle: TM1e Contrattor's License Law tloes nOt apply to an owner ot property who builtls or improves thereon, antl who contracts fo� such pwjet[s with a con- tractor(s) I�cense pursuant to Ihe Con[racto�'s License Law). I am aware [hat ' Oroof of their Worker'S Compensation insurance shoultl be provitletl�to me. ❑ I am exempt untler Section B. & P. C. for Ihis reason Date Owner I bereby certify that I have reatl this application and state that the above Cinformation i5 rr ct. I agree lo comply with all <ity and <ounty o�tlinances 'antl state law rela ing to buLL ing const�uction, antl hereby authorize �ep�e- sentatives of t is ity t upon the above-mentionetl pr pert for inspection pur ses ' �6i9nature Date Z �river5' License or SS � an0 si9n all apDroO�iate Ceclarations. _ _. . _ . O. UNIT NO. r33�4(�B ; , , TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR '❑ CONVERSION ❑ DEMOLISH ❑ OTH�jR� ,� q p # DESCRIPTION OF WORK/USE OF BLDG. ,�--�L� � ' S Main Buildi E TYPEOF.PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELEGTRICAL ❑ PLUMBING ❑ MECHANICAL 8 Reaf ❑ OTHER �1 .a� A PROJECT DESCRIPTION 5q. eL �<Z�l./ OCCUPAN Y C Right CONSTRUCTIONTYPE VALUATION8�6�_— g Le(t ZONE - GRA�INGCU.YpS. ACRES Pln Ref.# � � _ 9� Remarkz:�� ' PlanningNotes: Bar Sink Backflow Preventer Backflow Irrigation Bathtu6s Claritiers D ish washer . Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors ' Kitchen Sink � Lavarories � P—Trap Roof Drains � � ReinspeMion Fee $15 Boiler Duct - Under Ground Ouct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact Blt. ICBO # Heating System & Ducting ❑ o-i oo,000 sru � i oo,000 Reinspectian Fee �, $15 CMF 0865-46, rev. 10/84 White � Builtling; Canary - AppliGant: Pink - Accounting; Goltlenrotl - Assezsor Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Pipin9 � • Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater � Water Service Auto-Wash Laundry Trays Issue Fee Hood or Type I ❑ Canopy Type I I ❑ Refrigeration Sys[em ❑0-100,OOOBTU ❑100,000 System Repair/AI[eration Fire Dampers Registers , laue Fee ; $ 3 FEES � $ 3 Automatic Washer Canstruction Pale Sub. Cooking Unit � Dryers ❑Gas ❑Electric Fan F.Fi. U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0-5 KW �5-' Fee 2238 f2/28/G7 . Zone Accessory Building: .) Parking Req./Provided ELECTRICAI . Transtormer ❑ 15-50 KW ❑ 50+KW Meter ❑up m 100 amps Meter ❑over 700 amps Sub Panel Motors OO-1 HP �i'/:-8' Inc.Solar �9-15 HP �16-15+ Microwave Pole Light Range c"�o�0 '71 FEES ` Standing Sections - KW Trash Compactor T. . � i $15 � � luue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By � Aaolication luued Bv $ 3 Z O N I N G R E Q M T $ �7.�SU MAR F FEES � BUILDING PERMIT y+�— SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ' ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50°,6 � $ MICROFILM $ MECHANICAL $ TOTALFEE $ � PLAN CHECK 25% $ � .-� .� � ��CONSTRUCTION AND PLANNING POOL & SPA� . , APPROVALS Permit # Date Inspector pppROVALS Permit # Date Inspector ir.Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Gmd. � 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. . $. Foundation� - 59. Gas Pipe, � Undrgrnd., Test �. i 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 67. APPROVAL TO DECK 11 . Property Sewer Line & House Connection 62. Backwash & Receptor-Final 72. Sewer Cap � 63. Heater & Vent-final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing � -� 65. Electrical-Final ' 15. Rough Electrical-Conduit , 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign .. . 68. APPROVED FOR PLASTERING �78. Rough Electrica6T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping � 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 (StructuraQ & Monocoat 75. Dry Chemical ' 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL �� 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: --� � �Q < 34. Final Heating & Air Conditioning �j(L - � a, w � 35. Final Gas Pipe-Test 36. Hood or Canopy , 37. Final Factory Fireplace ' 38. Final Plumbing � ' 39.,Water Service-Final � 40. Gas Service-Final . 41. Solar pomestic-Final � 42. Backflow Preventer ' - ' 43. Backflow Irrigation ' � � 44. Landscape Irrigation System � 45. Sound Attenuation � 46. Handicap Regulations " 47. FINALSTRUCTURE&BUILDING 9� 8 � � �o �K, S'�` �p3 � 'b�'U�C ��, . 48: Special Requirements Completed - �49. Electric Releaseto Edison " - 50. Gas Release to Southern California Gas Co � _ r 57. CERTIFICATE OF OCCUPANCY No�� Date _ _ Applieant to fill in a11 spaces within heavy borOer lines anC sign all appro riate tleplantion CITY OF COSTA MESA PEj1��IT Nj}.��/ TRACT NO. LOT NO. �BLDG. NO. CONSTRUCTION PERMIT �� S 'V Addrea � Arch/Eng. � 1 Address Q Contrac[o Address / TYPE OF CONSTRUCTION Phone�J' -,%a U ❑ NEW ❑ ADD ❑ ALTERATION ❑REPAIR ❑CONVERSION ❑DEMOLISH License No. ❑ OTHER DESCRIPTION OF WORK I hereby atflrm that I am licensetl untler provisions of Charter 9(com- mencing wlth section �7000) of Division 3 of the Business antl Rofessions Cotle, a tl my. Iicense is in full force antl effect. � ucense Class - � n License No. �-/�ba � Datef--�'��'-��' Signature� � `-/ WORKERS'COMPENSATION�OECLARATION I herBby d�firm that I have a cer[Iflcate of Consent to self-insure or a certltiwt¢ ot Workers' Compen5ation InSurance, or a certlfletl copy Ihereot (SecN n 0 Lab. CJ. T�� P�IicyNo. � �� Company�CA✓Prc �� ?e�tifietl Copy is her¢by turnishetl. �ertifletl COpy is filetl with the City Builtlinq Divislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectlan neetl not be completetl if the permit is for ane huntlretl (E300� or less). ' I C2�t fy that In [he performanC¢ Of [he wo�k fo� which thlz permit is issuetl, I shall not employ any person in any manner so as to become subjeGt [o th¢ WO�kers' Comp¢nsa[ion Laws ot Calito�nia. Date Signature NOTICE: It af[er makinq this tleclaration, you shoultl become subject to the Workers' Compensation provl5iOn5 Of the Labor Cotle, you must forthwith COmply with such prOviSions or this permit shall be deemetl revaked. � - _ CONSTRUCTION LENDING AGENCV 1 her¢by atflrm that there is a const�uc[ion lentling agency fo� the per- formance of the work for.which this permit is issued (Settion 309] Clv. C.). '�,� ~ : :i L.entler's Name � "� } - Lentler's Atltlress � � OWNER BVILDER DECLARATION ' I hereby atfirm tnat I am exempt trom th¢ Cantrattar'S License �aw for [he following reason (Section 7031.5 Busines5 antl Professions Cotle: Any city or county which requir¢5 a permit to tonstruc[, alter, imp�ov¢, tl¢molish Or rEpair any structu�e,-prior to its i55uanc¢, dl5o re- quire5 th¢ applicant for suclt pe�mit to file d signetl Stat¢ment that he is IiCensetl Pursuant to the provi5io05 of [he Contrac[or'S License L.aw (Chapter 9(commencing with Seciion 7000) of Division 3 of the Bu51ne55 antl Prd¢ssions'Cotle)"o� that M1e is exempt the�efrom aptl th¢ basis for the allegetl exemption. Any violati0n of SeGtion 7031.5 by - appllUnt for a permit subjects the applicaM to a clvil penalty �t more than five M1undretl tlollars (5500). , as owne� ot tne property, or my employee5 with waqes 55�thei� sole compensation, will tlo the wOrk, antl the SVucture is not Inlentletl Con[rdC[or's License Law tloes noI dpply to an owner ot a propetry who builtls or improves tnereon, antl who tloes such work himself or th�ough his own employees, provitleC that such imp�ovement5 a�e not Mtentletl or offeretl (or sale. If, howev¢q Ih¢ builtling or imprOvement is.soltl wilhin one year of mmpletion, the owner will M1ave [he hurtlen of proving h¢ tlitl not builtl or irnProve (or the purpose of sale). ❑ I, as owner �of the property, am exclusivery- conVacting with licensed contractors to consiruct the project (Section �044, Business and Professions Code: The Contractor's Lic¢nSe�Law tloes not apply�to an owner of property wno builds or improves thereon, and who con- tracts from such projecis with a<ontractor(s)� licesnetl pursuant to IM12 COOIfdCIOI'S LIC2IISE LdW). ❑ I 5m exemp[ untler Section B. & P. C. for this �eazon ' �a[e - Owner I h¢r¢by certifythat Ipave reatl this appliW[ion antl state that the above information is correct. 1 agree to comply witn all city antl county ortlinances antl state laws relatin9 LO conSVuction, antl hereby au[hOriie repr¢sentatlyyye of this city to ter upon the above mentionetl p�ope�ty f r nspec ion p rpos Signature�� oate�d' �� -f7' TYPE OF PERMIT - ❑ GRADING ❑ FOUNDATION ❑ STRUCTVRAL ❑ TENANT ❑�ELECTRICAL �4j_VMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCV_CONSTRVCTIONTVPE VALUATION ZONE GRADING CU. YDS. ACRES PLUM8ING BATHTUBS TOILETS LAVATORIES KIT.SINKS ' SERVICE $INKS FLOOR SINKS -. PLAN CHECK SHOWEftS URINALS DOUBLE L'AV 5 DISHWASHERS SUMPS FLOOR DRAINS INTERCEPTORS CLARIFIERS SWIMMINGPOOL "PTRAP' WATE0. $ERVICE ALTERATION � GASSERVICE OUTlETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS� SOLAR PIPING SVS. '� ' ISSUE FEE MECHANICAL PLAN CHECK HEATING SVSTEM 0-100,000 BTU_ AND DUCTING 100,000 + gTU _ REFRIGERATION 0-300,000 BTU_ SVSTEM 100,000+gTU_ BOILERS BTV SYSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE ISSUE FEF orivers' License or 55 ��- � CMF 0865-46 White-Builtling; Canary-Applicanp Pink-Accountin9: Goltlenrotl-Assessor � . , 2581 I/05/B3 ZONING REGULATION A.P. � ZONE PLNG.REF.� REAR VARD (TO P/L) PKG.SPACE REq. $TREET WIDTH ZONING APPROVED B\ SPEGIAL CONDITIONS: .ELECTRICAL PROVIDED PARK FEE $ PLAN CHECK GENERATOR p-1 KW_ 1-lO KW _ TRANSFORMER APPLIANCE " '10-SOKW_SO+KW_ MOTORS 0-1'FIP_Id0 HP" '_ (INC. SOLAR) 30-50 HP 50 t HP _ FI%TVRES OUTLETS � SWITCHES" GHS TUBE SIGNS - ' POLE LIGHTS ' - -' PANELS ' MAIN SUB ' SERVICE ' ' AMP ISSUE FEE ' " - ' APPLICATION APPROVED BV � BUILDING PERMIT $ PLANCHECK $ PLUMBING $� PLAN CHECK 5 EIECTRICAL S � �PLANCHECK $ MECHHNICAL $ PLANCHECK $� - 5.OU TL SMIP, ^ $ PERMIT� -ISSUANCE $� GRADING $ . $ . MICROFILM $ TOTAL FEE y � LE55 AD- VANCEPC�$_ FINAL FEE $ � 6� CONSTRUCTION AND PLANNIN��C,�'� POOL & SPA � � � � - ' APPROVALS Permit #�_sL! �-I.- Date Inspector - qpPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole ' 43. Pool & Equipment Location Soil Pipe-Un rgrn 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_Gm 48. APPROVALTO COVER-GUNITE • - 7. Footings � 49. Electrical Conduit-Undr rn . 8. Foundation � 50. . Gas Pipe, ❑ Undr in; Test 9. _.Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn � � 10. Structural Floor System 52. APPROVALTO DECK . 7 t. _ Property Sewer Line & House Connection 53. _Backwash & Rece tor-Final � 12. Street Sewec Connection � ' 54. Heater & Vent-Final � 73. Rough Plumbing � � � - - 14. Rough ElectricConduit - - - �56. Electrical-Final � 15. Rough Electric-Wiring �� ' - - 57. Solar SYstem-Final ' - i 6. Rough Heating & Air-Conditioning - � • Fencing & Access Approval � 17. Ducts; in Structure -. � � 9• APPROVED FOR PLASTERING � -18. Ducts, Ventilating - ' _ . 19. Gas Pipe-Rough &Test � - . 60.. POOUSPA SYSTEMS�FINAL _ 20. - Roof- Framing - � -� - . ' - - ' � 21. Roof.Sheathin - -- ' � ' - . - • • 22. Fremeand 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 Complete� ' 40. =�Electric Release to Edison � � 41. Gas Release to Southern California Gas Co. 42. CERTIFICATEOFOCCUPANCY No Date OWNER S��y+ JO� JOB ADDRESS tXj$ ]�npC! jk'1 �GENERAL CONTRACTOR p��% AP No. 11F1-121-2�i LOT ECTIONS �l 5`_' i GAS � WRTER Y ROUGH PLUM0ING \PROP. SWR. LINE � HOUSE CON. SPRINNLING SYSTEM MISCELlANE0U5 ROUGH MEr1TING !N� RIR CONOITIONING TEMPORnRY SERVICE OR POLE UNOERGROUND � POwER � FOUGH WIRING TftENCNES � FORMS STEEL REINF FLOOfi SVSTEM BONU BEAM n STEEL REINFORCE ❑ SHEr1THING FqAME RNO FLASHING LATHING — IN � I OUT [� PLnSTER, BROWN COnT ST^'�CTURAL, FINr1L 1 JG, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINA� AND GAS TEST [� ELECTRIC, FINAL BUILDING. FINAL DATE SUBCONTRACTOR 4031 COSTA MESA BUILDING•SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant ro Fill in Complete/y O�^1N E R MAI l t BUILDING ADDRESS W W ........ )., v� TEL.� � d U CITV �F'JS � Q NO. TRACT za CpNSTRUCTION O N LENDER am � � BP/+NCH ' J �� OWNE i ApORESS ( APCHITECT TEL. � ` J a OP ENGINEER �% a FIRE w � AODRE55 ZONE a w APGROVED W Z CONTRACTOR ��/ BV J Q m Z J � ApDRESS P n_L �Uf 23-75�MSrO02389'+ **¢*1�.5C FOR BUILDING PERMIT 'T C D E ISSUED � � �Y-� PEFMIT NO. � EN ✓6�, � Y LOT �S BLOCK P �% VALUE $ 7VPE GRO/U�P �/ ! DATE /�Z��/.T W w TEL. �ONE NO.OF USE OF � Z� CITY NO. � P�� BUILDING w � SY�+TE CITV �'ARDS APPROVED VARD', y� LIC. NO. LIC. NO. MA�N BUII�ING � O (FROM C/LSTREET) 512E � � NO.OF BLDGS. pF LOT � � NOW ON LOT RONT USE OF � . EXISTING BLDG. f' SIZE OF � � 1 , NO. OF � ZQ N6WBLDG. X�'I ROOMS STORIES L.SIDE FT. U EXTERIOR WALL ROOF COVERING COVERING REAR FT. USE I DI G AND OR TO BE PERFORMED DISTANCE BET. L MAIN BLDGS. Q I -- VAR.� O � F�' I C.U.P. vW F APPROVEp�w P�'� � � � Z O VI M1araby acknowladpe that I heva reatl this eppllcat�on antl state � thet Mo above informatlon is correct entl aprea to comply wiM � all Iews repuletinq builtlinp eonstruction, entl 1 shall not amploy F any perwn In violatian of the wo�kman'� compenmtion laws of BET. MAIN ��a y-7 pTE y the Smte af Celifornle. `�� mW zI heroby carHfy thnt I em prpperly Iicansatl af e contracror under SQ. FT. d Ne Stete of CeliforMe Business end Protessions Cotla, OWlsicn 3, THE AMOVNT SHOWN UNDER VALUATION IS FOR ^ ChaPter 9, antl tha[ �uch Iicenms a�e in full force and efiect, or I TNE PURPOSE OF ESTA ISHING A PERMR FEE ONLV: � em exempt fro tha provisiona of t Srote of California B�alness Q and Professio C n 3, C ao VALUATION �% / � � P Mfr FEE $ ] $�pnatara of � m Pormittaa $ PLAN CHECK $ E • o Au<horlL tllA ent LL TOTAL FEE $ i/ ;; . a��.R� COSTA MESA BUILDING•SAFEfY DEPARTMENT ' P.O. BO%]77 COHTA M68A, CALIFORfiIA For ApplicaN fo Fill In Completely TYPE OR PRINT AODREb9 G // //L�/V✓%R iVE COSTA MESA. CALIFORNIA OWNERS�% � _S V/N�� '� O J AD RE98 �_S- VV S S ?-�— TEL. CITY O S -S NO. ARGHITECT J /� ' TEL. ' OR FNGINE6R FRA N�5 �[�N l�AL GSNO.I.A S=S � ,.. —_. V _ i � , � ., i FtE RECEIVED JAN 2 7 1965 FINANCE DEPT. CIiY Of COSTA MESA APPLICATION FOR PERMR BUILDING for Offite Usa Only P6C6�p�N0. ��({�Iy1\�1p. . �jµii� �D 0Y A[ HEC81 ED OAT@ 188UH� /r� � . ; �6 8' �E'ni U � E�— �/� R— TYPE (/ GROUP �X �A" D DATE ZONING � .� , �- NOTE: NOEAVEOVERHAN08HALLBELE59THAIJ STATH p TEL. 90' TO SIDfi 8 REAR P. L. ' LIC. NO. � p 3 NO. . — � EAVES SIZE 3S S'G No.oRa�ooa. �( ALLOWED tU.B.G.REqU1REMENT) OF LOT S> I Now ON LAT C/ YARDBAPPROVED YARDSAPPROVED USEOF MAIN BUILDIN� AGGESSORY BUILDING EXISTING BLDO. ( FROM C/L STREH BETBACK LINH FROM ' L RRONT . SFT. FT. CENTER OF sTRekT . S REAR YAR� ' 6 D '� 61D8 YARD I LEFf . I RIGHT �� R. BIDE S�, . �, DESCRIPTION OF WORK �.sioe F-r.� �� F-r. ) e, ��/// RHAR SFLf tT. NE• _IL\ AlT6RATION _ ADDITION REPAIR I DISTANCE BET. BET. MAIN Q MOVINO DEMOL BH MAIN BLDGS. ACCESS. BLOG9. BUILOIN6 NO.OP i VAR. i� OATE SIZE ROOMB � STORIES �� C,U.P. APPROVED COVER NGWALL � � � I COV�ERIN6 � J BYPRO DATE /' 0-�—�� US6 OF BUILDINC AND WORK TO BE P6RFORMED � ��G, F�'� - ,., . // /J �'"� - % r_/''i�tt o ld Uso. Fr. 7 �'� o 1 HEREBY ACKNOWLEDOE THAT 1 X�Ve REAO TH�B APPLICATION THE �MOUM 8H0 N UNUER V�LU�TION IB FOq TH! £ AND BTATE THAT TN6 AOOVB IB CORPHGT AND AaHEB TO COM. PUPPOSE OP iBTABLI6HING ♦ PEflMIT FEE ONLY. 0 PLY WITX ALL CITY OROINANC98 AND 8TAT8 LAWG H[OULATINO yALUATION n BUILOINO CON6THUCiION. . �j-�Y_o4 � �A / PERMIT FEE � j SIGNATURE OP ^ PERMITTE ��r /// �J // /�O� m %� f.7� 7� �� A CHEC ��ryI O �/'� � AUTHORIZ6D AG6NT TOTALFEE