HomeMy WebLinkAbout983 DENVER DR - Building Permits(7�a) 75a-5273 • Fax (71a) 75a-4856 • www.ci.costa-mesa��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Jobnddress: 983 DENVERDR
Suite:
Viciniry: THROUGH OUT HOUSE
PrimaryOct: R3
Parce� Number: 41808126
Applicant: NGUYEN, DIEN VAN
Address: 983 DENVER DR
COSTA MESA, CA
Owner: NGUYEN, DIEN VAN
Address 983 DENVER DR
COSTA MESA, CA
contractor: OW N ER-BU I LDE R
Address:
Zip:
Arch :
Address:
Phone:
Zip:
License:
Type of Construction: V-N
Zoning:
Phone: 714-641-1102
Zip: 92626
Phone:
Zip: 92626
Phone:
License: 000000
Eng:
Address:
Status: ISSUED
Applied: 03/30/2006
Issued: 03/30/2006
ISSUED BY: 1
Phone:
License:
SCOPE OF PERMIT
CHANGE OUT 7 WINDOWS LIKE FOR LIKE THROUGH OUT HOUSE, 1 WINDOW IN BEDROOM TO TO BE CHANGED FROM B'X2' TO 6'X3'.
WINDOWS SHALL MEET 1997 UBC EGRESS REQUIREMENTS.
FEE SUMMARY
Plan Check: $0.00
Permit: $83.25
SMIP Res: $0.50
SMIP Com: $0.00
Other: $0.00
Inspection: $0.00
Total: $83.75
PLANNING & ZONING
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0-0
PARKING Ezistin : 0
Calc Valuation: Sz,soo.00
Claim Valuation: Sz,Soo.00
Rear 0- 0 Left 0- 0 Right 0- 0
Rear 0- 0 LeR 0- 0 Right 0- 0
Re uired: 0 Proposed: 0
NOTICE: The work authorized by Ihis permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § t, 1241-92)
EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 780 days, or if work is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required inspectlons and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARAnON:
I hereby aHirm under penalty ot perjury one of the following declarations:
❑ I have end will maintain a certificate ol wnsent to self�lnsure for workers' compensation, as provided for by section 3700 of ihe Labor Code, for Ihe peAormance of the
work tor which this permit is issuo0. �
❑ I have and will maintain workers' compensation insurance, as requiretl by sectlon 3700 of Ihe�bor Code, for ihe peAortnance of ihe work for which this pertnit is issued.
My workers' compensation Insurance carrier end policy numbar are:
Carrier. Policy Number:
(This seclion need not be compleled il tne permif is valued ef one hundred tlollars ($700) or Iess.J
��I'ceNty that in the peAormance of the work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to ihe workers'
/compensation laws of Califomia, antl eg e that if I should become subject to the workers' compensation provisions of Section 3700 of ihe Labor Code, I shall forihwith
comply with these pr is ns. �
�- /{
�AppliceM�Sign'�: � �2L., ' n('�uy�i��^ , Date: _� � �(/ �
WARNING: FAILURE TO SECURE WORKERS' �MPENSATIHN CAVER4GE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AN� GVIL FINES UP TOONE HUNDRED
THOUSAND DOILARE ($t0U,00D), IN ADORION TOiHE WST OF CAMPENSATON, DAMAGE$ AS PqOVIDED FOR IN SECTION 3)O60F THE LABOR CAOE, IMEREST, AND ATfORNEV'$ FEES.
LICENSED CONTRACTORS DECLARAnON:
I hereDy aNirm that I am licensed under provisions of Chapter 9(commencing with Section 7000) ot Division 3 of the Business and Pmfessions Code, antl my license is in full
force and eflacL Lic. N Class a
Contracrors Signa�ure: Dete:
CONSTRUCTION LENDING AGENCY:
❑ I hereby affirm Ihat Nera is a consimction lending agency br ihe pedormance of the work tor which this permit is issued. (Sec. 3097, Civil Code). ,
Lendefs Name: _ _ _ _ Lentler's Adtlress: '
Signature: Oate: �
OWNER-BUILDER DECLARATIONS:
I hereby ettirtn that undar penalry of perjury that I am EXEMPT FROM THE CON7RAC70R5 LICENSE LAW for the following reason (Sec. 7031.5, Business and Professions
Cotle: Any ciry or county which requires e permit to construcC alter, improve, tlemolish, or repair any stmcture, prior to its issuance, also requires lhe applicant for such parmit
b tile a signed statement ihat he or she �s licensed pursuant to the pmvisions of ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 oi the
Business and Professions Code) or that he or she is exempt Iheretrom and the besis for ihe alleged ezemption. Any violetion of Section 7031.5 by any applicant for a permit
subjecffi�the aDP�icam to a civil penalry ot not more Ihan live hundred tlollars (5500)J:
�/I, as owner ot Ihe properry, or my employees wit� wages as �heir sole compensation, WILL DO T}IE WORK, and ihe sirucWre is not intentletl or ottered br sala (Sec.
7044, Business and Professions Code: Tha Coniractors License Law does not apply to an owner of property who builds or improves ihereon, and who does such work
himself or herself or thmugh his or her own employees, provided Ihat such improvaments are not imended or oftered tor sale. If, however, the building or impmvement is
sold within one year of completion, the owner-builder will have �he burden ot proving ihat he or she did not builtl or impmve tor purpose ol sale.�.
❑ I, es owner of Ihe Oroperty, am E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS b construct ihe prolec� (Sec. 7044, Business and Professions
Code: The contractors License Lew does nol apply to an owner of propetly who builds or Impmves thereon, antl who con�racts tor such project with a coniractor(s)
license pursuant to the Contrector8 License Laws.).
❑ lam
dnvers
❑ No
Business and Professions Code tor this reason:
Verificetion of Ownership by (type of tlocument, i.e. � property tax hiil or daed):
DIVISION OF INDUSTRIAL SAFETY PEAMIT CERTIFICATION:
❑ I hereby cenily thet no ezcavetion tive (5) or more feet in tlep�h into which a person is required to descend, will be made in connection with work authonzed by this
permit, and that no building stmcture, scaHoltling, lalsework, or tlemolition or dismamling thereof, will be more than thirry-six (36) feet hign. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Califomia Adminisirative Code).
❑ As owner-builder, I will not employ enyone lo do work which woultl require e permit trom ihe Division of Industrial Safety, as noted above, unless such person hes a
permit lo tlo such work irom Ihe tlivision.
Signature: Date:
Division ol Industrial Safety Permit Number:
CERTIFlCATE OF COMPUANCE AND AIJTHORVATION OF ENTRY: I certity under penalry ot perjury �ha� I have read this application antl state that the information given is
coaect. I e ree to comply wit� all state laws and ciry ordinances relating m builaing construction, and authonze representatives of the Ciry of Costa Mesa ro enter upon the
above-de nb property for in ection purposes. I agree not lo acupy or allow occupancy of any builtling authonzed by this permi� until final inspection.
— _.rp..,,. D�,,.�e 3-3� —(2ti
� Nre' Legel"Owner(s�_ � „�. _ Dat�—�
AnNOr Authonzed Applicant Date
COOE I, MSPECTONTYPE
1616 Fixetl System Final Fire Preven�ion
1266 Pool Spe Final
200 Final Ra-Raol
201 Finel BIocWRetaining Wall
202 Finel Factory Fire Place
203 Final Sign
204 Finel Demolition
Q� IMRIALS
COpEI INSPECTONTYPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Finel Fire Prevantion
22� Final Planning Approval
222 Final Site
250 Finel Builtling/Occupancy
o�re IL+��4$
0.1EG�RODHE55: 9B3 D.FSNVER DR
OWNEfl'SNnME: BANG Nr,�yEN.
RDONESS: BANG NGUYEN
983 DENVER DR
COSTA MESA CA
(714)641-1�02
FNCHIENGINEEB:
AODflESS:
UNIT:
9�626
flEG.NO.:
UNIT:
veeminEE: MANCAESTER BGILDERS ( 714 ) 760-7880
aooness: 14631 SAIL ST
GARDEN GROVE CA 92642
LILENSED LONTpRLTOB OECIAflAT10N: 1 hereby allirm thai 1 am licensea unOe� D�ovisions al Clupter 9(tOmmenpng wit� Seciion
7000� oi Div;sion 3 of t�e Business ane Professions Cotle, ana my lic m full me and, e\Bect.
ciTvuc.:05505 sTnTeuc.:U95459
— Oate: � Signature: �'
WOBKEPS' OMPENSITIONOECUMiION: Ihere0yallirminatlnaveacertificateattonsenitoself-insureoracertifiWteolworkers'
'qmpensa�ion Insurance, o� a ceridie0 tapy thereol (5¢clion 3800, LaU. CI.
iIICY NO.: E%P. OATE:
COMPpNC
❑ Cenitiea copy Is nerebY tiumishee. ❑ CertitieG wpy i51i1e0 vntA ine pty BuilOing Divrsion.
Oate: AODlicanC
EIIEMVfION FqOM WOflREBS' COMPENSII110N OECLAMTION: (T�is secuon neetl no� Ge completeA �� the perrttit is �a one h nOreU (5700) or less�.
I ceN�y lhai in Ihe pe orm3n ol Ihe vrork for w�ich Inis permi� ¢ R . I stull not e any perw�n`m ¢r 5o az �0 6eCame
su�ie�� to ihe wor� rs' CO ensation LavS of Cdlilamia:
Date: � � Z Signatura- �
NO710E il. atte making this declaration, you shoul0 bewm ubject to t�e Workers' Campensation pmvisions oi tAe Labor
COOe. yrou must lortnW�lh comoN ��n sUcn provL5ion5 or iNs ce�mit Shall Oe deeme0 rewketl.
CONSTqUCTION LENOING pGENLV: I �ereby allum that lhere is a construclion lending agency lor ihe Dedormance ai t�e work for
whit� IN5 permii i5 i55uetl (SettiOn 3097, Civ. C). �_
LENOEfl: �
i
PDDHE55:
OWNEfl BUILDEfl OECLAMt�ON: I hereby aifirm �Aat I am exem0� �mm the Comractors' Siate License Law br Ihe followinp reason
(Section 703t.5 Busineu a�d Professional fAtle: Any cily ol counly wnich requires a permil to constmct, alter, im0�ove, demolish, or
repair any struclure. prior W its issuance. also repuires the applicant for sucn vermit to tile a sipne0 siatement Iha1 nelshe is Iicense0
pursuanl to ihe D�ovisians d�he Coniraclors' Slate License Law �ChaD�e� 9(commencing wiih Section 7000) of Division 3 of Ihe Business
and Pmtesvon5 COGe) or IPat he/she is exempl t�e2imm anG Ihe Dasis �ar t�e a0eqetl ¢xemption. My n0lation ol Section 7031.5 Oy
any apD�icanifor a permii subj¢ct5 t�e applicani Io a civil penally of noi more l�an Lve hunGreE Eollars (55001.
I, as owner ol iPe pmDeny or my employees wit� wages as their sole compensation, will Eo the work, antl the
i strucwre s noi imenaea ar oihrea for sale (Sectron 70ad. Business anE Pmtessional Cotle: The Contractors' State License Law
/ tloes nol apD�Y to an owner af a pm0eny wllo GuilGs or impmves ther¢On, anG who Eoes suth wOM1 Nmself/hersell or t�rouBh
' �is or �er own employees. Omvitletl Ihat suc� impmvemen�s are not in�entleC or oilere0 lor sale. II, howeve� Ihe �uilding or
impmvemenl is SoIU wil�in ane year ol comple�ion. �he owner vrill have Ihe bUrtlen ol pmvinA hpJSh¢ tliA n0t huild or impmve
lor Ihe Durpose ol saie�.
I. as owner oi t�e p�openy, am e.clusiveN wntractinA ��h IicenseA caniracrors m constmct the project (Section 7041. Business
❑ ane Professims Code: 7he Contractors' $tale Licente Law Gces not appty Io an Ovmer ot properry xia Wtltls ar improves Ihereon
ana w�o tonVacts �or SucA pmlecl5 with a cantrador(5�license pursuanito ihe Coniractors' S�att 4cense Law�. I am awaa
Ihal Dmol o� ��eir Worker'S Compensalian insurance s�au10 be pmvidetl �o me.
� I am eRemp� un0e� ���on'. B. d P. G.
for this reason:
Date: Ownec
I do h¢reby cenily Ihat I am aware ol antl untlers�and t�e requiremenis o� Calilomia Healih anA Salery Code Sections 255�5. 25533. an0
2553E anG ihat I or any IUWre builtlmq occupant wilVvnll not (cirde one) ne¢tl �o wmply vnth saitl state co0es anA l�e requiremenis �or a
permii lor tm9mttian or ��dHica�ian imm Ihe Ai( Oualiry Managemeni OiSlriti. Ne5i0eniialcons�ructi0n aODlicafion5 are exempl trom
Ihese provisian5.
Oa�¢: ApPlicanL
� �er¢Uy [etlify tha� I �ave featl ihis applitation an0 51aie �hal lhe a0ave ini0rma�ion is Corr cL 1 apree t0 Cam01y wih ail ciry anG wuniy
or0iiun[es antl siate Wx5 re�' Io UuiWing cros�mpian ana IureEy orrze repreun oi Itls tiry �o enle upan Ihe above�men�onea
pmperiy loi- m/s0q,�� �ion pu oses.
Date: // I� Z SignaWre: _�
OriveYs L�¢nse or Social Securiry N:
__ t6at�a6 Wnne—BuilOing: Greon—CoOe Eniorcamem: Canary—Applicant: Pink—Revenua: GOltlenroE—Assessor
CITY OF COSTA MESA — BUILDING PERMZT
PERMIT NO: B 056046 FLAN CHECK NO: 00395-92 S
CONSTRUCTI()N TYPE; 5—N PERMIT TYPE: STR
JOH DESCRIPTION ; 60 LIN FT OF RCMU WALL @ 6' HIGH
CLAIM VALUE:
h N N. 7 9C
�u t: u i:
PURPOSE: OTH
SQ FT; 60
CALC—VALUE: 1,200,00 GRODP OCC: R-3 /
COMMENTS• SMOKE DETECTOR(S) RE�UIRED IN HOME.
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDINI; ---------- --------- ACCESSORY HUILDZNG ---------
FRNT; FT ZN REAR; FT IN FRNT: FT IN REAR; FT IN
LEFT; FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PLANNING��(7'fES> 60 LFR�6t HIGH BLOCKCWA�,L4ALONGZSIDEEpRUPERTYRLINE��
i
�1F 3F 3f- 1E 3E �1F �1F iF if if iE iF iF 3F If �k lF K� iE if i(• iE IF �lE i(� iE it iE ]h iE IE if iE 3f if ih iF 3E #k 3F 3f It if lE if iF iE if it a(� itif iE iF if iE �F if �E # 1e 3e 3(- ii * iE iF iE 3f �FiFiE iF iF 3F 3(� 1(� iF i4
D E V E L O P M E N T,/ S E R V I C E S R E Q U I R E M E N T S
20NZNG APPROVED bY �i`� — � DATE: � / '�
BUILDING APPROVED BY ; DATE: �
APPLICATION ISSUED HY; DATE;
�lkiliE�lhitlE�lE�EiE�lE�kiEjEitiklf�ifiEiFi! . x iE�Flcii�iEiEiEiFii•if � 1Fif
jE3ffflfiE�1E�E*ihiEiFiE3FiFikjEiEi'riFiF � � iFiEiF3Eif�fkiEiF iEiEif3Eififai�itiEifiEkifjEiEiElE3EifX-�1fff3E�FiFiEiFiE7f��1EiEiFiFii��EiF34iEiE
L£GALI7.ATION:t3 F E E � iJ M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING EI.
PERMIT 29,00
ISSUE FEE 18,85
BUILDING—DIV—> PERMI't ISSUE
TOTALS----> 29,50 0,00
IC MECHANIC
�PLAN—CHECK
18.85
rIRE SMIP/RSS� GRADING
SMIF/NON—RES
TOTAL PASD DUE
_ 98.35 98.35 .00
REVENUE DIVISION TOTALS--> COLLECTED; 4R,35 OVER/SHORT: ,00
BLDG PMT PLUMBING ELECIRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
29,00 %' ,50 18,8.�i
iE 1E 3E �l(� iF 3F lf if ik iE 3F iE iE ik 1f 3F iF iE iE IE 1E ie it iF i! it 1E If iE if� if iE iE iE iE iE if iE iE IE iF iE 3E iE iE iE iP if 1f 1Flf if 3E if iE if if iF iE iF 3E if 1k iE iE iE iE If iE if ic Y 1E fE af if 1E fe if
I N D I V I D U A;Y; r E F. B R E A K D O W N
l �
TYPE QTY D E S C R I P T I O N JNIT COST TOTAL COST
SFR 60 RES—CONCRETE BLOCK.WAiL / FT, 20.00 1,200,00
fiND OF FEES
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4 L & SPA
ICONSTRUCTION AND PLANNIN.. .
,�
APPROVALS Permit# Date Inspector p�PpROVAIS Permit# Date Inspector
�
t. Temporary EleCtrical Servicebfpole ' 52. Pool & Equipment Location �
2. Soil Pipe�Undrgrnd. � ' 53. Steel Reinforcement '
3. Electrical Conduit Utilitv-Und�grnd. 54. Forms
4. Electrical Condu�t�Undrgrnd. 55. Electrical Bonding .
�;. Steel Reinforcement 56. Rough Plumbing & Pressure Teet
6. Electrical UPER Gmd. ;�// 57. APPROVAL TO COVER-GUNITE
i. footings ?�7/9 /�Ai�%� 58. Electricat Conduit-Undr9rnd. '
G
8. Fo�ndation � 59. Gas Pipe, O Undrgrnd., Test ��
9. 4Va[er Pipe-Undrgrnd. �� • 60. Backwash Lines, P•Trap, O Undrgrnd. �
� !.
10. Structural Floor SYstem •� 61. APPROVAL TO DECK
11. Property Sewer Line & HOuse Connection , � 62. Backwesh & Receptor�Final f �
12. Sewer Cap � . � 63. Hea[er & Vent-Pina�
13. Roof Orains 64. Plumbing System • Final
14. Rough Plumbing . 65. Electricai-FinaV
75. Rough Electrical-Conduis �• 66. Solar Sysiem-Final
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVEO FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOI/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Dutts, Ventilating 71. Product Piping � Gas � Oil
23. Gas Pipe•Rough & Test 72, Underground Fiush
24. Roof Framing 73. Undergrnd. Stora9e Tank O Gas ❑ Oii
25. Roof Sheathinq 74. Overhead Hydro
26. T-Bar Ceiling (Svuctural) & 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 �
37. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriwl Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric Notes: � /�y' ,��ry �
l�r� �' � v� Sa G_r_c� � /-yr�v�,
34. Final Heating & Air Conditioning `
35. Final Gas Pipe-Tes[ ���
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 Irripation System .
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING �. •
48. FINAL PIANNING
49. Electric Release to Edison
50. Gas Release to Southern Califo�nia Gas Co
51. CERTIFICATE OF OCCUPANCY
Ne. Date
-'""'_
3� ay �,
pegffilt � MUS7 ACCOMPANY
THIS NUMBER REQ�ESTS
p,�� INSPECTION _���„�.
��������� I
City of Costa Mesa Buildin� G�P-�
DATE /�3/ 19/ �—
BY _ �n„ q�i -F.'•A„€
TNESE f'LANS tdrJST BEYOM�� /a���y'1.;^' '�' r;=p�.
NO CN:;�W'�=5 1N:T�CJ
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X^' .'w''J"� �� � C� ..:: t9`V�Y4.,i`n : � r TrilS'
�. '�+ic � p�'1 T aSF�i. M�. r tr(�.,a,�J�E
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i�V:�h( h it'!F �`C�iit ' t� M1arnl . �1 J�^iD
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.,..Y� �._,, nNCLLh\+ll'hn Ji�Y' "1#x ki.u�ia.�ar .-air�Jri�,!H
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?FIC- clTf
lhiPU :i""�.uTi %�tt;Aiia`fi l::i, .
__,. m. .. : n,a�u�
SURVEY OF LOT LINE
MAY BE REQUIRED
�j 83
�� V �IL.
ADDITI!��dS. �E[E6iGCJ;i �2:.neaFrrin �c c�.e,
B� ��°���� �k il;E �LF„diJING DEPARiMENI
'" � dTY OF �A MESA � ��
PLANN D�L �
aw� m ew�s. ca�r. e�. �
, ri `u,�bA,� �/�z
oneaa� a n,w►�o
�
�f!/IOKE DETECTOR
REQUIRED
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�OR I��PECTia�S
CALL
754-5626
754-5627
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r
Cement Coping Ootional --
Channel Blotk With 7-3/8Qi
Horizontal Top of all
Fences
For Fences 5' or Less
Vert. Bars 3/8"$S at 4' -0" O.C.
Fo� Fences High�r Than 5'
Vert. Bars 3/S"� at 32" O.C.
Fill Cells Salid With Grout
Where Steel Occure
Reinforcing Steei Shall
Conform to Sec.A-15-39
A.S.T.M.
AII Steel to be Lapped
24" or to Code
NATURALGRADE
TWO J/6"S56ARS
CONTINUOUSTOP
& BO7TOM
HOR7iSTEEL MUSY BE TIED IN
P.LACE AT TIME OF TRENCH
INSPECTION.
TYPICAL 6�� CONCRETE BLOCK FENCE
r
� o
d 'p N
pn
. F�-W'IDTN
p SEE CHl
+ BE�OW
D' I Q.
FOOTING REQUIREII�ENTS CHART
GENERAL•= NOTES .
MORTAR; p�e Part Plasfic Cement, and�
Three Parts Sand '
GROUT; One Part Cement Three and
One Hatf Parts S�and '
COPiNG: One Part Cement; Three
Parts Sand ' � �
CONCRETE: Wel I Mized (:2- I%2: 3- I/2 �
Max, of 7- I/2 Gallcns of
YVater Per Sack of Cement
'GROUT MAV BE POURED FROM THE TOP
OF 7HE FENCE IN CELLS WHERE STEEL
OCCURS.
CELLSAND AREASOF HOR120NTAL REIN-
FORCEMENT SHALL BE CLEAR, CLEAN &
FREE OF ALL MORTAR DEBRIS, ETC.
H OF �4RTHTCOTH
�/3 iHE HE�GTH Of FENCE
�BEIOW BOTTOM OF FOGTiNG.
SCALE: I/2" = I'
, WIDTH . 14'� . . . . . . . . . . 14�� . 12��.,. 12��
7HICKNESS .. 10��. ... 10�� 8". 8„
DEPTH OF EARTHTOOTH . . . 24�� . . . 20�� . . 16". . . �2��
SPACING OF EARTHTOOTH. . 12� . . . . . . . . 14� . . _ . . 16�. . . . . 16�
City of Costa Mesa, California
Building C?epartment
. . . , . _, . !cEv1SEP NOV. &2
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this �s�
�l//+�G1 , by and between �'V � � q.�� rQ.✓�
/
hereinafter referred to as "LANDOWNER;' and —�y��✓ �- �`�
/
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between 9���V� �^^'� 3�1y Tifr��3 ST
. . (Address af Adjoining Properties)
day of
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
�-r" 5 4g z
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach Nd �0� ��
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
1i/w..�.f —
(Signature)
ADJACENT PROPERTY OWNER
( i�ure �' �����`����� .
r
I� � n ��'t � S�'g ✓� ��dn/ G_. dlGt�G��/
Name (Typed or Printed) Name yped or Printed) �
_� �� sr._� � Mesa , cq 3� Bft� ,S_r, co s��.�A , c�-.
(A dress) (Address)
NOTARIZATION REQUIRED
1906 a6
GENERAL ACKNOWLEDGMENT
State oi
County of
o�riwi s�u
• L.HOMSANY
` NOT�RY PUBLIGUILIFOPNU
s PRINCIPAI OffICE Itl
ORINCE COUNfY
MY �mmissiaa E�pins Sepl. B. 1995
} SS.
)
On this the " day oi
�- - 7��0�
19 " , before me,
the undersigned Notary Public, personally appeared
��,v T�-i 7',�� Qna Sy,eo,� �� EDE��-/
�proved to me on the basis of satisfacnto� evidence
fo be the person(s) whose name(s) K� subscribed to ihe
within instrument, and acknowledged that � executed it.
WITNESS my F}and and ofticial seal.
ATTENTION NOTARY: AltMugh lhe intormation requestad below is OPTIONAL, it cowr/q prevent 'tre/utlulen/t ,a� achment of t✓N'a� �certificate to arwt�er document.
THIS CERTIFICATE Title or Type of Document S�7Y "" �G` �"/r����
i�Z
MUST BE ATTACHED Number of Pages � Date of, Documen[ �—��yZ�
TO THE DOCUMENT �,'9
DESCRIBED AT RIGHT: Signer(s) Other Than Named Above �/��
CF 1499 (&89) . 1120 122
.
PARTY WALL AGREEMENT
THIS AGREEMENT, made and entered into this �s� " day of
��/���Z�j , by and between �LYIi� �� � T�l4n
�
hereinafter referred to as "LANDOWNER;' and —%�fUH�+S �. Wi�i[/�Na
hereinafter referred to as "ADJACENT PROPERTY OWNER"
It is hereby agreed that a party wall will be constructed on the property line
between �j7!�E�✓1/�`�L �`�"� o o �P,g ST•
( dress ot Adjaining Properties) '-
in the City of Costa Mesa, County of Orange, State of California, as per map recorded
�1nzr s44z
in Book , Page of Miscellaneous Maps, in the office of the County Recorder
of said County. The party wall shall be permitted to encroach
IN WITNESS WHEREOF, the parties have entered into this Agreement the day and
year first above written.
LANDOWNER
ADJACENT PROPERTY OWNER
��. ���� ����� %�'�u-----'
(Signawre) (Signature)
�G(Ih i V!; T✓G n %f%Mi!$ L �y/Lc-/�-MS
Name (Typed or Printed) Name (fyped or Printed)
`�Bj? DEN!/�� , Ca51A.r�e3A CH 3U�0 B�/ir 5�%/c�'�Go3%I"�/Gtt3/} �,
(Addre55) '��-� (Address) �
1906Lfi
NOTARIZATION REQUIRED
.. �. . -
GENERAL AC
State ot _
County of
OFFICUL SFAL
"" ' L. HOMSANY
NOTARY PUBtICGIIIFORNUI
. PRINCIPAL OfFlCE IN
� ^ ORANGE COUNTY
M� Commisim Eao�ros SeD�� 8. 1995
SS.
On ihis the � day of ��� 19 � before me,
the undersigned Notary Public, personally appeared _ ,
7T�/.�l Tff/ 7��9-�U R-ru0 7�oM� .L - uJi//Ia..nS
proved to me on the basis of satisfactory evidence
o be the person(s) whose name(s) �E subscribed to the
within instrument, and acknowledged that �'�� executed it.
WITNESS my h�nd and official seal.
Al'fENTION NOTARY: Although the intormetion requesled below is OP710NAL, i� uld prevent Ireud'u�le?t atlachmenl of Ihis certificete'�t,o�,eanot��_e�r dacument.
THIS CERTIFICATE Title or Type of Documenl "��T� W�L �%Gti!', /C�U
MUST BE ATTACHED Number of Pages � Date of Document a' ��/�
TO THE DOCUMENT
DESCRIBED AT RIGHT: Signer(s) Other Than Named Above
CF ]69g (6�69) )izo ITz
J,
..
�
�� I
6�tTnooeEss: 983 DENVER DR
pJNEN'S NAME: NGUYEN, HANG VAN
aooaess: g83 DENVER DR
COSTA MESA,CA 92626
uxir:
I BHCH/ENGMEEP: AEG.NO.:
aooRess: uNiT:
PEFMITTEE: VILLA CONSTRUCTION ( 714 ) 554-4950
aooeess: 14351 EUCLID AV 10
GARDEN GROVE CA 92643
LICENSEU CONTHACTOB OECLAHATION: I here0y allirm Ihal I am licensetl unAer pmvisions of Chapter 9(commencing wi�� Section
7000� ol Orisian 3 of the Business and Pmfessians Cotle. antl rtry license is in lulliorce antl e I.
cirr uc.: 5 6 7 5 srare uc.: 616 8 6 9 cuss: H
Da�e:_'��.3— Si9namre: _ _ . _
WOFNENS' COMPENSRTION OECIAMTION: I Aere�y a��irm 1�ai I twve a teri te o consen� lo sell-insure or a ce � te of Warkers'
Compensalion Insurance, or a ceriilied copy ��ereo� (Seclion 3800. Lab. C�.
POLICY NO.: E%P. DRTE:
COMPRNY:
� Ceriitietl coOY is Aereby Nrnis�etl. ❑ Ce�i�ie0 copy i5 file0 wi�� Ihe ci(y BUiltling Oivision.
oate: Aoo��canC
E%EMFiION FHOM WOflNEflS' COMPENSATION �ECLAPATION: (ihis section neetl na� b¢ camplete0 il lhe p mil i!
I ce�ily Ihai in Ihe pedarman[e ol 1�¢ work br whiCh t�is permil i5 i55uetl. I Shall n01 employ any pe in
sublect la t�e 1NorkerY Comp n5aimn laws ol Califomia.
J
�ate: �_� SignaWre:
NOTICE: II, af�er making Ihis Oeclaralion. you shoultl become Subleci � W k rs' Compensaiior
CoOe. you mustfo��vnih compty wit� 5uc� O�oNsions or this permit 5 ee a e ea avakeA.
CONSTPOCTION LENOING pGENCY: I �ereby allirm Iha� I�ere is a constmction lentli g agency lor IAe
wnich this oermitis i<sueu (Section 3097. Civ. C�.
LENOEN:
AUOflE55:
for one �untlretl
any maynerso
pmvisions at
wark lor
OWNEP BUILOEX OECLABATION: I here0y allirm I�al I am exemp� �mm IAe Conlraciors' Siate License Law br I�e �ollovnng reason
(Seclion 703L5 6usiness antl Pmtessional Cotle: Nny ciry oi counry w�ich requires a Oermit �o con5imct, al�er. improve, demolis�, ar
repaii any stmciure. D�ior lo i�s issuance. also repuires ��e apPlican� lor such permil Io lile a signetl statement t�ai he/5Ae is Iicen5e0
pur5uamiolhe provisions otlhe Contrac�ais' Slale License Law�Chap�er9lcommencing with Seclion 7000) of0ivision 3 o�lhe Business
antl Pmlessions CoOe) or Ihat �e/she is exempi Iherefmm antl Ihe basis for Ihe alleged e�emptian. Any viola�ion ol Sec�ian 7031.5 by
any apDlican� for a permil sublecis t�e applicant �o a civil penaliy of not more �han �ive hunUreO Oollars (5500).
I. as owner ol Ihe D�operiy oi my employees wilh waqes as their 5ole campensa�ion, will tlo the work, anA Ihe
❑ simcmre is noi intenaetl or ollerea mr sale (Seclion 7044, Business and Pmlessional Code: The ConVactors' S�a�e License Law
does no� apply �o an owner ol a O�oOerty who builds or impmves Nereon, antl who does such work �imsell/Aersel� or �hrough
�is ot �er own em0�oyees. D�m'i0etl ��at suc� impmvemenis are not inlentle0 or oflered for 5aie. II, however Ihe 6uildinp or
lmpwvement is sola vnlhin one year of completion. �he awner will have I�e bur0en o� pmving he/she did no� builtl or impmve
for Ihe purpose al sale).
I, as owner ol Ihe O�openy, am eKclusively comracting wi�h licensetl coniracmrs �o wnsimct lhe pmjec� (Section 704a, Business
❑ a� Pmfessims CaOe: 7�e Coniractors' State Lkense Law tices rw� appy to an owner oi Dmperty who Ouil0.s or imD�wes t�ereon
and w�o caniraqs lor suc� O�oletls wit� a conirac�ar�s) license pursuant to t�e Caniraclori Slaie License Law�. I am aware
that proo� o� Iheir Worker'S Compensation insurance 5hou10 b¢ pwvitleC la me.
� I am ezempl untler Senion', B. 8 P. C.
for t�is reason:
Date: Ownec
I ao �ereby cenify t�ai I am awarr, ol and unaersland 1he requiremenls of Cali�omia Heallh and Sa�eiy Code Seclions 25505, 25533, antl
2553d antl Iha� I ar any WWre builtling occupant will/will nol (circle one) neetl �o comply wilh saitl s�ate cotles antl Ihe requirements lor a
permil lar con9mction or mo0ificalion hom Ihe Frt Oualily Management DisVict. Resideniial conslruclion apPlications are e�empl �mm
Inese O�ovisions.
�ate: ApPlicanl'.
I �ere0y cenity ��al I �ave reaU I�is aD0liea�ion antl slale thal Ihe a0ove inbrma�ion is correci. aA�¢e Io compty vnN all cii tl county
oi4inancesanOsiaielav�srelaiinglobui�tlmgcansimclionantl�erehyaWhorizerepresemaliveso� scityloenle ponihe ve-mentioneA
O�oDet�Y �oii m5peciion purposes.
Dale: 1 � ` (`?,_��_ Signamre:
Driv¢r'S License or Social SeNrity x: �. .� .�
i641�a6 Whne—Builping: Grean—Cotla Enlorcemem; Canary—Appl¢anl: Pink—Revenuo: 6oldenroa—Assessar
CZTY OF COSTA MESA — HUILDING PERMIT PERM NO: B 06442
PERMIT NO: B 064423 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE; 5—N PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : T/O,RESHT & REROOF W/LITE WEIHT TILE SQ FT: 7,000
CLAIM VALUE: 7,000.00 CALC—VALUE: 7,000.00 GROUP OCC: R-3 /M-1
COMMENTS: REROOF W/LITE WEIGHT TILE "5.85PSF", ICHOlt 2093
*+r+�*+c******�*+r*******�r******+�+�**�*�+r********���+r***�****�c***+�***�*+�***���+�*�c�c+�*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT IN RGFIT; FT IN
PARKING REQ: PROV: PARCEL: 41808126 ZNE: REF NO:
PLANNING NOTES> �
�
� �r*�r*�e�fr�r�r�r�r*x*�tx�r�r**�rrt�t�t***�r***�r+t�r+r+t�t**x�**+�i��t**x��r�r�x*+t�w*�r+�*�r�r�r**�*f�x��r*�+t**�
D E V E,L O P M E N T S E R V I C E S R E Q U I R E M E N„T S
ZONING APPROVED BY DATE: "
BUILDING APPROVED BY : DATE: '�
APPLICATION ISSUED BY: DATE: � ��J
iEilikitititMitiEitiEititifMkiElfiElEifk MifiEiFififlEiEif* iEiE
ititltilMff�ffElEfliEifkk�E1l1l1f1f1fffik1E1t1Eif1h4k4iEiEiE1l4il1fltiFitkklEfffFMiEitiEifllkff7filk%41f1EifMiEifiRiEifiEifKiEiEfflEi:ifMlflF
LEGALIZATION:N F E E S U M M A R Y STRUCTORAL'SEGMENT:Y
BLDG PMT PL BING ELECTRIC MECHANIC FIRE SMIP/RES/ GRADING
PERMIT 90,00 �p
SMIP/NON=RES
PLAN
ISSUE FEE '
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID �'` DUE
TOTALS----> 90.70 0.00 0.00 90.70 90,70 �; ,00
REVENUE DIVISION TOTALS--> COLLECTED: 90.70 OC'ER/SHORT; ,00
HLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING,PLAN—CHECK
90.00 .70 .t
it i! 1t i! if iE fE fE fE iE iE if 1E if it %k ff 1t 1E 1! jf ff if !f 1E iE �f iE �E if 1E iE 1E 1E i! i! it 1f if it k if if iE 1! if 1E if iE k!E if k%if iF if if iE M if iE iE 1f iE 1E 7E 1f iE iF iE 1E if M �E fE ff if
I N D I V I D U A L F E E JB 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
SFR 7000
REROOF BY VALUE RESIDENTIAL NOZONE
END OF FEES
���OVCE DETECTOR
�EQui� .. --
9
/.
1.00 ; 7,000.00
�
i
i'.
oi aoi�s�s4-�ei4e�ss T+3T vo.7o
GATE: ?Oi1319s 7i�1E: 11:07
i � •
CONSTRUC710N AN� PLANNING POG SPA
APPROVALS Permit # Date Inspector APpROVALS Permit � Date Inspector
1. Temporary Electrical $ervice or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Feiniorcement
3. El�ctrical Conduit Util�tv-Undrgmd. 54. Forms
4. Electrical Conduit•Undrgrnd. 55. Electrical Bonding
5: Stee� Reinforcement 56. Rough Plumbing & Pressure Test
6. Electricai UPER Grnd. 57. APPROVAL TO COVER�GUN�TE
7.-Footings 58. Electrical Conduit�Undrgrnd.
$. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Li�e & House Connection 62. Backwash & Receutor�Final
12. Sewer Cap 63. Heater & Vent-Final
73. Roof Drains 64. Plumhing System - Fina�
14. Rough Plumbing ' � 65. Electrical�Final
15. Rough Electrical-Conduit 66. Solar SVstem-Pinal I
16. Rough Electric Wiring ' 67. fencing & Access AnProval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTEftING .
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Ro�gh FBcmry Fireplace APPROVALS Permit #
21. Ducts, in Structure � 70. Undergroand Hydro
22. Ducts, Ventitating 71, productPiPingOGas �Oil
23. Gas Pipe�Rough & 7est 72, Underground Flush
24. Roof Framing� 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing N��fg /��� 74. Overhead Hydro
��s7
26. T�Bar Ceiling (Structural) & Monocoat � 75.-Dry Chemical
' 27. Prame and Flashing ]6. Dry Standpipe � �
28. latfiing &$iding . -• 77. FIXED SYSTEM'FVfVAL
�29. Insula[ion � 78, FIRE PREV. FINAL ' �
30. Drywall Nailin9 HEALTH�DEPT. REQUtREMENT -
� � 31. Plaster Brown Coat J9. FINAL INSPECTIQN
32. Electrical ?ower MeterFinal �80. f00D CERTIfiCATE ISSUED
33. Final Electric � � � Notes: ;�J ^'
34. Final Heating & Air Conditioning � �?'} yt�,
35. Fi�al Gas Pipe-Test � - ,' � �-r�
36. Hood or Canopy � ��
_ i � i
37. Finai Factory Fireplace � ' �
38. Final Plumbing �
39. Water Service-Finaf ' � �
40. Gas Service-Finai . �
41. Solar pomestic-Finaf
42. Backflow Preventer �
43. Backflow �rrigation' - �
44. Landscape Irrigation SYstem
45. Sound Attenuation ��"
46. Handicap Regulations �
47. FMALSTRUCTURE&BUIIDWG !(_1,,,.Ct7 �'G�/� � �j_,� �-/% �`�
( J ! ' - �CJ DG�"'- C.
48. FINAL PLANNING � � .
49. Electric Release to Edison
� 'S0. Gas Release to Southem Caiifornia Gas Co
5L CERTIFICATE OF OCCUPANCV
No. Date
P.Dclicant to till in all spaces excevt those witnin heavy EorCer Ilnas anG si9n all avvropriate tleclantions.
OF COSTA E CON�T�I � pE I RPERMITi� N'O. TRACT NO. LOT'fNO. UNIT NO. A P�y ,,.
roject Address � � ✓��+ �� 544 `�� S Main Bl ilding:
TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E�
Applicant"s Mailin Address ' Front
❑ CONVERSION ❑ DEMOLISH ❑ THER T
Qwner's Name � ione 1 DESCRIPTION OF b(ORK/USEAF BLDG, B Rear
Address �! ��� •
) � .. . r.
'Arch/Eng. License No.
�Address
Convactor's Nam Phone
Address (mailing)
City License No. �
LICENSED CONTRACTOR DECLARATION
1 hereby affi�m tha[ I am licensetl untler provi5ion5 ot C�a�ter 9(comm¢nGinq
WIIh SCCIIOII �OQ�) O1 ��V�S�OfI J Of Ih8 BlI5I0055 dllC PlOiC55�0I15 COdC� dfld
my license is in full torce ana eifect.
License Class License No.
Date Si9na[ure
WORKE0.5' COMPENSATION DECLARATION
I M1ereby a/firm thal I have a certlfiw[< Of consent to self-Inzure or a CertlfiGate
� Workers' Compensation Insuranca, or a certifietl copy tnereoi (Settlon
300,�Lab. C.)
Policy No. Company
BCertifietl copy is hereby turnishetl.
Certitietl copy is tiletl witn [he City Builtling DiviSion.
Date APPlicant
E%EMPTION FROM WORKERS' COMPENSATION DECLARATION
(Tnis section neetl not be completetl if lhe permit is for one huntlretl (5300) or
less).
I certify that in the performance ot Ihe wm e for which this petm�t is issuetl, I
shall nat ,mp�on In anY mann;r s as to become subiect to the
Worker 'omp nsati ws of Callt 'a
Da[ Si9na[ur
NO ICE:II,after making this tleclarati y u 5 e Subject [o [he
Workers' Compensation provisions of t lab Cotle, you must fortnwith
comply witn such provisions or tnls permlt snall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV
I hereby a(9rm that there is a constructlon lentling a9ency tor the performance
oi the work for which [his perml[ is Issuetl (Sectlon 3097 Civ. CJ
Lentler's Name
Lentler's Atltlress -
OWNER BUIIDEN DECLARATION
I hereby altirm�ihal I am exempt trom the Contractor'S License Law tor the
tollowing reason (Sectlon 7031.5 Businass antl Professional Cotle: AnY city or
county which requires a p¢rmlt [o con5truct, alter, improve, tlemolisb or r¢pair
any 5[ructure, prlo� to its issuance, al5o requlre5 [he applicant to� such pe�mit
[o file a signetl statement tnat h¢/She Is IicenSetl pu�suant to the provlsions of
the Con[ractor's License Law (Chapter 9(commenang wilh Section 7000) of
Division 3 of the Business antl Professions COUe) or that ne/she is exempl
'�erefrom antl the basis (or Ihe allegetl exemplion. Any violation of Secllon
J31.5 by any applicant 10r a permit su�jects Ihe applicdnt to a Civil
,e ry of not more tnan iwe nunCretl tlollars (E500).
1, az owner of tne oroperty or my employees with wages as Iheir sole
c 0¢nsation, will tlo the wo�k, antl the StruCtu/e I5 not in[entletl O� offe�etl
b sale (Section 7044, Business ana Professional Cotle: The Contractor's
l.icense Law tloes not apply to an owner of a property who builtls or improves
thereon, antl who aoes such work hlmselt/herself or throu9h nis or her own
employees, provi�etl that such improvements are not In[en0etl or offeretl for
sale. If, however, the bulltlin9 or Improvement is so10 within one year of com-
pletion, [he owner will hav¢ the burden oi prOvinq Ite/she tlitl nol builtl or IT-
�rove (or tne purpose oi sale).
I, a5 owner of tite prope�[y, am extlusivaly contractin9 with Iicenzetl con-
vactors m construct the projec[ (Section �044, Business antl Professions Cotle:
The Contractor's License Law doe5 not apply to an owner of properry who
�bui105 or imOroves thereon. antl who contracts br such oroiec[5 witlt�a ron-
tractor(51 Imense pursuan[ [O tne-Con[rac[o�'s License Lawj. I am awa�e [ha[
proof of their Worke�'s Compensatlon Ins rance shoultl be provitletl to m¢.
❑ I am exempt under Section� B. & P: C. to� tbis rea5on
i �d
Date `�Re.(��g._ Owner
1 h¢reby certity tM1at I have reaE thi pplica u
iniormalion is correcL I agree to comp y witn al
antl state laws relati�B �o builtling construttlon,
senlalives ot t is ty �to ente� `pOn Ihe ab�
InSpeGtiOn Du�p�s
Signature �
Drivers' licens r 55 �
OB65-46, rev. 5/BB White - Builtling; Canary
TVPE OF PERMIT LI GRADING �FOVNDATION STRI
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ ME HANI
❑ OTHER
PROJECT DESCRIPTION S�.F7. oCCUP�
CONSTRVCTION TYPE •VALUATION $
ZONE GRAOINGCU.VDS. AC
Remarks:
Ber Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers
Dishvrasher
Drinking FOuntains
Floor Drains
Floor Sinks
Gas Serviee Outlets
Kitchen Sink
Lavatories
P—Trap
Roof Drains �
Reinspection Fee $15
Boiler
Duct-UnderGround
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
Firepl/Fact. Blt. iCBO dk
Heating System & Ducting
❑0.100,000 BTU 0100,000
Reinspection Fee � $15
Pink - Accountln9; GOItlBnrOtl - A55¢SSOI
PLUMBING
Showers
Service Sink
Sewer Cap
Sewer Cannection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Auto�Wash'
Issue Fee
Haodor Typel ❑
Canopy Typell ❑
Retrigeretion Sys[em
❑0100,OOOBTU ❑100,000
System Repair/Alteration
Fire Dampers
Registers
laue Fee
A
C Right
SLeft r
Ping. Re(. #
Planning Notes: �
ennw'1C _
FEES Automatic Washer�
Construction Pole Su
Cooking Unit
Dishwasher
Dryers OGas ❑Eli
Fan
F.A.U.
Fizture5
D2VIC8 BO%25
OuHetS
$wiLChCS
Garba9e Disposal
Generator �a5 KW
Fea
Accessory Building:
//
Zone
ELECTRICAL
Transformer ❑ 15-50KW
❑ 50+KW
Merer LJup to 100 amps
Meter �over100amps
Sub Panel
Motors 061 HP � 1'h - B
Inc.Soiar �9-15 HP �16-15+
Microwave
Pole Light
Range
FEES
Standing Sections
5 KW Trash Compac[or !' '-
i '
$15 luue Fee _ $ 3
N
I
N
G
R
E
�
M
T
S.
DEVELOPMENTSERVICESREQUIREMENTS: ' � p�
$ 3 Zoning APProved BY ��1 'na{B� • •� v
FEES Buildine APProved By Daten.�}ri
APPliption laued eY �am� V � `�p
$ 3
SUMMARV OF FEES �
BUILDING PERMIT $ �� - °a SMIP ' $ •�
PLANCHECK $ q�.Ra PERMIT
PLUMBING $ ISSUANCE, $
PLAN CHECK 25% $ ENERGV P.C. $
ELECTRICAL $ GRAD�NG $,
PLAN CHECK 50% $ MICROFILM $ /�
MECHANICAL $ TOTALFEE' $ "1•�Sa
PLAN CHECK 25% $
01 00016386-AQD2638E 'TC7T li.9.�C
DATE: 10/Ob/EE TI19E: 09:4:
CONSSRUCTION ANDPLANNING
APPROVALS Permit #
i. Temporary Electrical Service or Pole
2. Soil Pipe-Undrgrnd.
.3., Electrical Conduit Utility-Undrgrnd.
'4. Electrical Conduit-Undrgrnd.
5. S[eel Rei�forcement .
:
6. Electrical UFER Grnd.
•-7•. Footings • -�
"-8. - Fountlation
9. 'Waten Pipe-Undrgrnd.
10. Structurel Floor System
� 1'. Property Sewer Line & House Connection
• 12. � Sewei Ca p
13. Roof Drains
14. Rougli Plumbing
15. Rough- Electrical-Conduit
�16. Rough Electric Wiring
,iJ. Rough Wiring Sign
J8. Rough Electriral-T Bar Ceiling
�19. Rough�Heating & Air Conditioning
20. Rough.Factory Fireplace
27. Ducts, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough &�Test
24., Roof F�aming �
25.�Roof Sheathing ••
26. T-Bar Ceiling (StFuctural) & Monocoat
27. Frame;and Flashing
28. Lathir�g &�Siding
29. Insulation
30. Drywall Nailing
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 Fectory 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. FINAL STRUCTURE & BUILDING
48. Soe.r.ial Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
Date
Date
..i-
POO. SP,A
� �.
Inspector p�ppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE
58. Electrical Conduit-Undrgrnd.
'. 59. Gas Pipe, O Undrgrnd., Test
'� 60. Backwash Lines, P-Trap, O Undrgrnd.
_ ��j 61. APPROVAL TO DECK
� 62. Backwash & Receptor-Final
63. Heater & Vent-Final
64. Plumbing System � Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPA�SYSTEMS FINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
70. Underground Hydro
71. ProductPipingOGas ❑Oil
72. Underground Flush
73. Undergrnd.StorageTank OGas ❑Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
_i
Date Inspector
!
, �.
, .� ,
Ltl9c.e. ti.k� $v-�a_o
z..�n p�,�-sQ-e. ��Q s��
a� � �ry.�
. �
'v
�
Caller's Name
Ad�ress
CITV OF COSTA MESA
SERVICE REQUEST & PUBLIC ASSISTANCE FORD1
Date—�� f� !� �
( — Time � !�
Phone ��/ —U �
// ,/� ��
N.i�ure of Request (loca[ion, type. severity) ��r4r���f�'i/_ �/�"'�-�✓ �/✓"
� i
Referred to — /
Person Receivi ig C� 11
�
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Information On
t +� C'��_
.� � ,. �c:;:, ..: . ..
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COSTA MESA BUILDING-SAFEIY DEPARTMENT
P. O. BOl[ 91] GOSTA MHHA, CALIFORNIA
For App�icani ►o Fill In Completely
TYPE OR PRINT
eui�oma ��3 FN iv"
A�DRE58
COS7A MESA. GALIFORNIA
OWNER �� i / . S o, �f'p 0
MAIL —
ADDRfiLB �S '{V . �J S I �= F-
c�rr n S n= � no �/hA 4-8:
ARCHITECT .- ,. . i TeL.
FEE RECEIVED
JAN 2 7 1965
fINANCE DEPT.
CITY OF COSTA MESA
�LICATION FOR PERMR
BUILDING
or Offlce Usa Only
R[C[II� NO. � EH T J10.
y 4 I
��2�Ie/O�i �/i�LB:fo�q�
G�L�'2 17E�
TVPB � GROUP I
OATE
O�+'.�¢ I6L. 90-TptlWC HCA Y.L.
LIC. NO. %' No. r_,�
EAVEH
SIZE � j � No. o� eLOOII. ALLOWH� �U. B. C. REQUIREMfiNi)
OF LOT � D rvOW ON LAT O
YAROH MPROVED YARDSAPPROVHD
USE OF MAIN BUILDINO ACCESSORY BUILOIN6
EXISTING BLO6.
(PROM C/'6TREET)
6ETB�CK LINE PHOM � PRONT PT.
CENTEH OP BTHHHT D RHAR YARD �
SID6YARD L6F'�' 6'� I RIGHT b'� R.SID F7. PT.
DESCRIPTION OF WORK L.61D Fr. Fr.
NEW � ALTERATION —I AOCITION RHAR PT. FT.
OI6TANCE BLT. BET. MAIN 8
REPAIR MOVIN6 DEMOLIBH MAIN BLD S. ACGESS. BLD69.
VAR.# DATE
BUILDINO NO.OP '
SIZE ROOM9 STOR164 �� C� U. P. APPROVED
EXTERIOR WALL I ROOF / / B1'PR�V DATE I��_ ��1
GOVERING 3'T e, p COVERfN6 / p!
USE OF BUILDItiG AND WORK TO BE PfiRFORMHD
s� e L M �,� r,�,� �r o /(/
l✓ � � �"..i✓ ��� so.Fr. ��/ev "o
I HEREBY I.CRNOW48O08 THAT I NAV6 R�D TN�B APPL�GTION TH8 �MOUNT SHO N UNDBH VALUATION IB FOp TXe �
AND BTATB TXAT TN6 ABOV6 IH COpqHCT ANO AOqH[ TO COM� PURP098 O!� [9T/�BLI9HIN0 A PHqMIT FEH ONLY. �
PLY WITH �LL CITY pRDINANCHB AND YTAT{ UW8 RZODUTINO ypLUATION p
BUILUINO CON9TPUCTION, / ry
PERMIT FEB
PERMnIITE E OF 9�� S �� �� � m
� 1
¢
/ 4
AUTHORIZfiD AGF,NT
TOTALPEE