The URL can be used to link to this page

Home My WebLink About2757 DESOTO AVE - Building Permits(714) 754-5273 • FaX (714) 754-4856 • www.Ci.COSfa-meSa.Ce.US 77 FAIR DRNE, C051A MtSA, cA 926z6 Job Address: 2757 DESOTO AV Suite No Vicinity: GARAGE Parcel Nunm6er: 14164204 Applicant: GLOVER, LORIE Address: 2737 S CRODDY SANTA ANA, CA Owner: SARLAT, IRWIN M TR PLUMBING PERMIT Phone: (714)241•1414 ZIp: 92704 Address 77 ROCK WREN Phone: IRVINE, CA Zip: 92604 Contractor: COAST ROOTER PLUMING HEATING 8 AIR CONDITIONING Address: 2737 S CRODDY Arch / EnH : Address: SANTA ANA, CA Phone: (714) 241-1414 Zip: 92704 License: 529127 Phone: Zip: License: SCOPE OF PERMIT 1 WATER HEATER CHANGE-OUT. ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifer System Connect pce,Soda,ety Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (1-4 ouUets) Gas (Over 4 outl8ts) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) AMT $23.50 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 $0.00 50.00 $0.00 50.00 50.00 50.00 50.00 Qn FEE SUMMARY AMT Laundry Tub I Washer $0.00 Landswpe Irrigation $0.00 P-Trap $0.00 Pressure Regulator 50.00 Process Piping (per 10 fl) 50.00 Receptors $0.0� Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect 50.00 Sewer Private Line 50.00 Shower $0.00 Sink, bar j0.00 Sink, commercial $0.00 Sink, Floor 50.00 Sink, kitchen 50.00 Sink, 5ervice/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS Status: ISSUED Applied: 10/02/2000 Issued: 10/02I2000 ISSUED BY: � SumpPump Swimming Pool Trap Pnmer Unnal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toileq Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION AMT 30.00 50.00 50.00 50.00 50.00 50.00 30.00 50.00 50.00 50.00 512.30 50.00 50.00 50.00 50.00 50.00 50.00 50.00 50.00 TOTAL CALCULATED FEES: 535.80 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 NOTICE: The work authorized by this permil shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRA710N: This permit shall automatically axpire and become void ii work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order tor ihe work authorized under this permil to be considered legal, such work must comply with all applicable codes, and all requlred Inepeeti0na end final approvel must be obtained. Failure to obtain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 2me�ae {emo� WORKERS'COMPENSAnON DECLARAnON: � I hereby eHirm untler penalty ol perjury one ot Ihe following declarations: ❑ I have end will malniain a ceNlicate oi consent to selt-Insure for workers' compensatlon, as provitletl for �y section 3700 of the LeDor Code, br t�e pertormance ol the work for which this pertnit Is issued. � I have entl will melntain workers' compensatbn insurance, as require0 by section 3700 of Ihe Labor Code, for Iha peAormance of the work lor w�ich t�is pertnit is issued. My work s' com ennsatlon InsLur�ance cartier and pdiry number ere: �q Cernec �i [�- l 'l V V�.. Policy Number: �J OI 0 X � R U� (This secNon need not be crompletetl il fhe ermif is valued et one huntlre0 tlallers ($f 00) or /ess.J ❑ I certiy Ihet in l�e peAormance ol the work br which this permit is issuetl, I shall not omploy eny person in any manner so as to bacome subiect to tho workere' campensation laws ot Calilomia, entl egree that If I should become subJect to the workers' compensation prwislons of Sectlon 3700 0l Ihe LeEor Code, I shall forthwith comply wlth Ihese provislons. Appliceni Signeture: �/�- Dele: �� ' � � WARNING: FAILURE TO SECURE wOHKERS' COMPENSAiION OpVEMOE IS UNIAWFUL AND SHALL SUBIEGT AN EMPLOVEP TO CRIMIWU. PENALTIES M1D GVIL FlNES UP TO ONE MUNDRED THOUSAND DOl1APE �5100,000), IN ADDRION TO THE 00.ST OF COMPENSaTION, DAMAGES AS PROVIDEO FOR IN SECTION 3106 OF THE LABOH CODE, INfEREST, PND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby eflirm Ihat I em Ilcensed under pmvisions ot Ghapter 9(cammendnp with Sectlon 7000) of Di�nsion 3 ot Ihe Business entl Pmfesslons Cotle, end my license is in full force end eHect. Llc. a Clau M ComractoYs Signawre� �3 �ate: � i CONSTRUCTION LENDING AGENCY: ❑ I hereby eMirm Ihat Ihere is e canstruction lentling agenty lor ihe peAormance at t�e work tor which lhis permit is Issuetl. (Sec. 3097, Civil Catle). Lentlela Name: Signature: _ OWNER-BUILDER DECLARATONS: Lendefs Atldress: Date: I hereby aflirtn that untler penalry ol perjury that I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business entl Professions Code: Any city or county which requires e permii to consWct, aller, improve, tlamolish, or repair any stmcwre, prior to its issuance, elso requires ihe a001icem tor such pertnit to file e signed statement thet he or she is Ilcensetl pursuani to the pmvisions at the Contrectors License Law (Chepter 9(commencing wlth Sectlon 7000) of Division 3 01 the Business end Professions Gode) or thet he or 5he is axempi Iherefrom end Ihe basis lor the elleged exemption. Any violation ot Section 7031.5 by eny epplicant for e pertnit sublecis the epPlicant to e civil panalty of not more than five hunAretl Aollars (5500).): ❑ I, es owner ol the property, or my employees with waqes es thelr wle compense6on, WILL DO TME WORK, antl �he structura is not intentleC or oMeretl for sale (Sec. 7044, Business and Protessions Cotle: The Contractors License Lew Coes not epply to an owner of property who builds or improves t�ereon, and who tloes such work himself or hersell or through his a her own employees, pmvided Ihat such improvements are not Intended or oflered for sale. If, however, the building or improvemeni is soltl within one year ot completion, the owner-builder will have lhe burden of proving Ihat he or she tlid not build or improve tor purpose of sela.). ❑ I, es owner of the property, am E%CLUSIVELY COMRACTING WITM LICENSED CONTRACTOBS lo construct the project (Sec. 7044, Business antl Pmfessims Code: The contrecmrs LJcense Law does not appty to an owner of pmperty who bullQs or Improves ihereon, and who contracts lor such project with a contractor(s) license pursuant to the Contractors License Lews.). ❑ I em axempt under sec. Business anA Professions Co�e tor this reason: Signawre: Date: Owner ID venfietl 6y tlriver'Slicense. ❑ Yes ❑ No Dnvers Licen50 No. i. \ Vadllcetion of Ownership by (rype ol daument, i.e. - property tu blll or tleed): DIVISION OF INDUS\ IAL SAFETY.PERMII ❑ I hereby tertity thet no Bxcavalion fSe (5 permit, entl thet no 6uilding sirucWre,'sc 341, Tltle B, Califomia Administrative Ca ❑ A5 owner-Dulltler, I wlll not employ anyc permit to do such work trom t�e tlivision. SignaNre: Division of Intlusirlal Safety Permit Number: Expires: CERTIFICATION: or more teet in tlepth into which e person is required to descend, will be made in connection with work eulhonzetl by this ittolding, telsework, or demolition or tlismantling ��ereof, will be more ihan thirty-six (38) leet high. (ChaD� 32, Grp 2, An 2, Sec. to do work which would reqWre a permil Irom the Divislon ot Indusiriel Sefery, es notetl ebove, unless such person hes e Data: CERTIFlCATE OF COMPLIANCE ANO AUTHORPJITION OF ENTAY: I cenily under penalry oi perjury Ihat I have read this flpplication and state that ihe infortnation given is correct. I egree to wmply with ell state laws end ciry ortlinances relating Io Dullding construction, and authonze representetives ol ihe Clry of CosW Mesa to enter upon Ne ebove-tlescribed properry for inspection purposes. I agree not 10 occupy or ellow occupanry ol eny buil0ing authorized by this pertnil until tinel inspectbn. � _�Slgrreture Of Legal Owner(s) Date l�� /D-d-oo GG—� AnNOr Aut�onzetl Appliwnt Date CODE 1. INSPECTIONTYPE 1616 Fixod System Finel Fire Prevenilon 1266 Pool SDa Final 200 Final Re•Roof 201 Finel BIocWRetaining Wall 202 Finel Fattory Fire Place 203 Final Sign 204 Finel Demolition uerE Ii�eL$ �OOE I INSPECTION TYPE 206 Finel Mechanical 20B Finel Plumbing 210 Final Eleciricel 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final BuiltlingiOccupency PdIE Iti�LS FY'�a��!-•1� 5� PflOJECi AOOBESS: L•� ,-� D ESOTO AV OY7NEP'S NFME: SARLAT IRWI13 M TR aooness: 17 ROC�t WREN IRVINE,CA 92714 AflCHIENGINEEX: '�Si-0724 aooaEss: HFG.NO.: uNiT: uNiT: PEPMI7TEE: �ETRONELLA P.00FING ( 714 ) 54A-1645 AOOflE55: 2626 NEWPORT �� rr� M�S�. CA.92C��27 UCENSE� LONTNACTO OE��BA OIL Yhere y allirm t�a� I am licensea un0er O�ohsions oi aD er 9(commencing wilh $eciian 7000� ol �ivision 3 0l ihe Business ana Pmlessions Code. ane my license is in fu0 �orce antl ellec�. QTY LIC.: STATE LIC.: ClASS: � 032605 00460707 C'�9 �]a�e�. S '- � 3 ' "I I Si9nature: — _ . WONREBS' COMPENSATION OECIABATION: I �ereby a�hr nat I a cenilica�e ol consent io self-insure or a ceniticare of Workers' Compensation Inmrance, or a cenifie0 copY �hereof (Sect . La6. C�- roucrxo.: 1079987-91 EXP.DFTE: O%IOLI9Z comraev: STATE : UNI�, � Certified copy is hereby Wmis�etl. L}Y Certilie0 copy is IileU wn� the tity Builaing Oivision. .,ate: fi' l 3-`� 1 APDIicaN: � ESEMPTION FBOM WOPKEflS'fAMPENSATION DELlAf1AT10 : �7 ' eclion need notbe wmDleteOit�he perRut¢foronehuntlreU�510�)arless). �. I cetlify Ihal in t�e pedormance ai the work for w�ich this p r ii is issuetl. I shall noi employ any Oerson in any manner so as to become suble�� o Ihe Warkers' Compensalion laws o� Caiifomla. Oate'. Signature: NOTICE: Ii. a��er making t�is aeclaration, you s�oultl Eecome suDlec� lo �he Workers' Compensation pmvisions oi Ihe Labor Cotle. you musl lotl�with comply wit� such provisions or Ihis Oermi� shali Ce deeme0 revoke�. CONSTflUtTION LENOING RGENCY: I hereGy allirm t�a� there i5 a constmclion lending agency for ��e Oertormance of Ihe work �or whictl ihis permil is issue0 (Section 3W7, Gv. G�. LENDEN: AOOflESS: OwNEfl BUILOEN OECUPP710N: 1 hereby affirm Ina11 am erempt tmm Ihe CAniractors' Stale License Law lai the following reason (Semion 7031.5 Business ana Pmlessional CoOe: Fny ciiy ai caunty which requires a Oe�mil to ronstmn, alter, improve, Oemolis�, or ren�� any simclure, prior lo ils issuance. also requires ihe applicant lor sucn permit lo lile a signed statemeni Ihat ne/she is licensetl pursuam m t�e pmvisions ol t�e Comractors' State License Law (Ctupter 9(commencing vnt� Senion 7000) al Division 3 0l t�e Business ana Pm1eS5ion5 Coae) or Inai he/She i5 ehempl Iherelrom anG I�e hash lOr Ihe allegeG exemplion. Any violali0n ol SeClion 70.31.5 by eny aDPlicanl lor a permil subjects t�e aDO�icanl lo a civil Denalty of not more t�an live huntlretl Uollars (E500�. I, as owner ol iAe O�operty or rtry emVloyees vrith waAes as t�eir wle com0ensalion, will Co ihe work, an0 the O s�mcture is nol intended or afleree br sale (Seclion 704a, Business an0 Pmlessional CoOe: T�e Canlractars' State License Law tloes nol ap01y to an owne� ol a propeny wM UuiiAs or imD�aves t�ereon, an0 w�o tloes such wark himsell/�ersell or t�mugh his or her own ¢mployees. pmviOeC tha� Suth impmvemenls are n01 inlentle0 or ot�¢reE lOr sal¢. II. how¢ver �he builtlinp or im0�ovemen� is soltl wi��in one year al compleiion, tlle owner will hdve Ihe hur0en ol pmving he/s�e did noi builtl or impwve lor Ine purpose ol Salel. I, as owner ol I�e propetly. am exclusivety conVacting wit� licensetl coniranors Io consimc� Ihe pwjecl (Sec�ion 704d, Business ❑ ana Pmlessions COUe: T�e Contracmrs' State License Law tices nol apON �o an mmer ol property who Omlas or impmves thereon an0 who conlracis lor such proletls vnl� a coniractor�s) li[ense Dursuani to I�¢ Conlrac�ors' Sta�e License Law). I am aware I�di p�00� 01 Itl¢it WalkeYs COmpCn5a�i0n ip5ufdnW SfIOUIG G¢ pfONO¢tl t0 rtle. � I am e�emD� under Section: B. 8 P. C. lor Uis reason: oaie: Oanec i tlo hereby cenify tha� i am aware ol ana undersian0lhe repuiremenis ol Calilomia Healih antl Salery Code Seclions 25505, 25533, antl 25534 antllhail oranylulure builtling occupaniwill/willnol (circle one) neeCto [omply wilh saitl sta�e cotles an4lherequiremenisfor a permi� lor can5lmciion or motlihcatmn Imm the Fir Oualiry Managemeni Oistric�. flesi0eniial cons�mction applications are eKempl Imm mese pmvisions. �ate: ApPlicanL I n¢ieby ceruly I�al I Aave rea0lhis apP�ica�ion an0 sla�e ��ai Ne a�ove intormation is correci. I aBree Io compty wiih all city and counly ortlinances ana sia�elavrsrelatingto �uilUing constmction and hereby au1Mr¢e representatives oft�is ciryto enteruponthe a6ove�mentioned pmoerty lor msoeclion Ourposes. �-�3 q ` -Oale'. ( Signawre' Driver's License or Social Secun�y p: 16aba6 W�na—Bwldmg: Gieen—Cotle EnlorcemenC Canary—Applican�; Pink—Revenue', Goldenratl—Assessor CITY OF COSTA MESA - 9UILDING PnRMIT PERM iVO: 3 053356 PERMIT NO; B 053356 PLAN CHECK NO: N GOVT; N SliPP; N CO�STRUCTION TYPE: V—h PERMIT TYPE; STk PURPOSE; AL"P �JOB i7ESCRIPTION : T/OFF REROOF W/SHAKE SQ rT: 8,91U CLAL`9 VALliE: f1,910.00 CAI.C—VALUE: 8,910.OU GRUUP OCC: R-3 / COMMENTS; SMOKE DETECTOR R��UIRED IN THE HOME kii�3lieif�iE�IFiF3(�ji�iEiF#ii�3'ri%kieiE3Eie#iEii�if3i� ieifiFlE�FifIFif1'rlEifiEiEN�kiEN�ifif3l�iFlFii�ii�Y�ii�N-ii�k3EiEi!�#iEiEihlEiFi(�iEieiEii�iE3ej'ri(�kifi'tif 'L O N I N GS Ek1E�QAUCIKe� JE N, E N T S ------------ MAZN BU�LDING ---------- --------- ACCEs'.s'iORY BUILDING --------- FRNT; FT ZI� R..AR; FT IN �RNT; =T IN REAR: FT IN LEFT; FT IN RGHT: rT IN LEFT: FT IN RGHT: rT ITv PARKING RE • PROV; PARCEL: 1-0169204 ZNE: REF NO; PLANNING N TES> i �'�("� if±(' il' * K"'�t' i�' i(- jC'K' �' *�t �"K' j{' * i� if' if iF' iY J�"�if �t' �' i�' i�' �t � it' *'� �t'� i(-.'�(' �(' i'E it"x' y' i4"%f'�' l�' �(' *{F �f � jt' it'%�' �' }f iE x' �' i�' i�' �1"%F �f {�' j! i�' i�' �' i(' �t ***�'K' U E V n 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 7.�NING APPROVED BY DATE; ' UILDING APPrZOVED BY : Dr�.TE; PPLICATION ISSUED BY: ' DATE• � �3— `j/ icafi4ifM�3Ei(•3EiFiFiEiFiEaE#ieiEi(�ifri�3fiETriF�e'i�x��r.�'i��r3f�'i �7irR��iF3�- tT�£3Fii'�ilTc'ifiFTF'iFi(�ie3(•1E16%•aE%i4if��'�F�iFi'r YF �If %� iE 3F �k iE iE iF ii� jf iE 32 iF M� �E k if iE i% IE if iE iE IE # 3f� i(� iF iE if ih iE �Jf ih iE ib if if �lE i(� ii� �1F i'r lE iE iE �f� N� i iE�'r• iE� 3f !4 �3'r ie %� f4 3F � if-w� j(- 3(� �74 iE #)f N� le i4 fF # K• iE 3E?4 3F LEGALI`I.ATION:N : E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC NECHANIC F1RE SMIP/R�S GRADING YERMIT 108.00 SMIP/NON—R�S PLAN ISSUE FEE HLILDING—DIV—> PERMIT ISSUE PLAN—CH�CR TOTAL PAID DUE TOTALS----> 108,89 O.OU 0.00 lOB.89 108,89 ,OU REVENUE DIVISION TOTALS--> COLLECTED: 108.89 OVER/SHORT: 00 BLD��PM� PLUMbING ELECTRIC MECHANIC ;IRE SMIP/T89 GRADING PLAN—CHBCK if iF�1E if �f 1E N� �7E �)f if iF lf if Ir 1(- lf iE �7'r aF ih 36 iE 3E k iF 3f iE N� iF If 3E3E iF it iE iF 1? �If fE �; 3: iE 1f dk �N� it� aF jF M� k� 3: 3�.� i+� iF:4 i!� lE�)e i!� �N� 1'r M: aF ih r. i!� lF �(� ik 3F k*# 3f��E 1e %� aE�E I N D I V I D U A L F 8 c & R E A K D O W N TYPE QTY D E S C R I P T Z O N iJNIT COST TOTAL COST SFR 8910 REROOF BY VALU� RESIDENTIAL NOZONE END OF iEES (��.-�P�oL 9�,��9/ . St� �-��,�¢ . , � 1.00 8,910.U0 V o�. ocasa�ai-oar�sa��a � _; - ;-;.: , �ATE: d'o11;/91 TIE;.s 1=:�� CONSTRUCTION AND PLANNING P00 'A ° APPROVALS Permit# Date Inspector AppROVALS Permi*# Date Inspector 1. Temporary Electrical Service or Pole 52. Poo-i & Equipment Location 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. . 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electricai Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. 70. Structural Floor System 61. APPROVAI TO DECK � 1 i. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical�Final 75. Rough Elect�ical�Conduit 66. Solar System�Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Reugh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electriwl-T Bar Ceiling 69. POOL/SPA 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 OOiI ^ r 23. Gas Pipe-Rou9h & Tes[ 72. Underground Flush ;� 24. Roof Framing 73. Undergrnd. Stora9e Tank O Gas ❑ Oil - •; 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structurall & Monocoat 75. Dry Chemical " 27. Frameand Flashing 76. Dry Standpipe 2- F%' 28. Lathing & Siding 77. FIXED SYSTEM FINAL •- = 29. Insulation 76. 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: ` 34. Final Heating & Air Conditioning � "' . 35. Final Gas Pipe-Test �;+ '� 36. Hood or Canopy � 37. Final Faaory Fireplacc ' '� � 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 r 48. FINAL PI.ANNING � 49. Electric Release to Edison ,n 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY No. Date PflOJECTAU0qE5S: 27j� D�:SOTO AV owxeASNnme: IRWIh 5ARLAT � noon[ss: 17 ROCKWEN IRViNF ABCHIENGINEEfl: S 5 1- 0 7 z 4 POONE55: PEC.NO.: UNIT: I1NIT: 'Epmi"EE' AERO—THEAM CONSTRi7CT;ON (714)696-3953 AOOPESS C z.{8y LILAC I.N CA 92(� 27 UCENSEU CONTflFCTOB OFC �IAhPTION: I here0y allirm Ihal I am Iicense0 unUer pmvisions ol.ChaO�er 9(commencing with $ection 7000� of �ivision 3 ot Ihe Business antl Pmfessions Cotle. ana my license is in lull �orte an0 e�feci. , / ciTv uc.: Q n 9 0 l; srnTe uc.: 9 3 3 21l / cuss: ,/./,h ��/� ��-_26 /Y Daie: � " U SignaWre: —f/��'�''"u"��'(.�� a '`� � wONxEBS'CO PENSATIONOECIAPRTION: IhereOyaifirm��atl�aveaceniliwteotconsenttoselbinsureoracertilicateotWorkers' Com0en5aiion Insurance, or a cetltlietl copy �nereol (Secuon 3800, laD. C). POLICYNO.: '73t•,j('�078(3-OQ�i EXP.OFTE: O4�L4�9L COMPPNY: T?ATIONTv1ID� 7 Cenilietl copy is Aereby Nmis�ea nitietl copy is fileA vrith I�e ciry Builltling Uivisian. � �/� �ate: �Z `�' ` AOGlicant: �cL��! . %�/� �-LYGf�y �—��L' E%EMPTION FBOM WOAKEflS' COMPENSA➢ON DECIAMTION: (TNs seppn n¢ed rrot Oe mmpleied if Ihe permi is lar one tunaretl �S1lq) or kss�. I cetlily tha� in Ihe pedormance a� the work tor which ��is permii is issued, I stull no� employ any Oe�son in any manner so as �o Oecome SublCti Io the Workers' Comp¢nsation LawS al Cali�ornia. Date: SignaNre: NOTICE:I�. alter making (his declaration, you shoula be[ome subled �o �he Worke�s' Compen5aiion O�ovisions of the Labor COAe. you mus�loM1hvni� tomply wil� Suth provisions or INS permi� S�all 6¢ deeme0 revoketl. CONSTflUCTIUN LENUING RGENCY: 1 hereGy atiirm Iha� there iS a constmc�ion IenEing agency �o� Ihe pedormanc2 o� Ihe work lor which Ihis permit is i5sued �Sec�ion 3097. Civ. C�. LFNDEP: aooeess: OWNEfl BUILDEN OECIAMTION: I �ereGy a�lirm ��al I am exempi Imm lhe Coniractors' Siale License Law �or �he �ollowing reason �Seclion 703t.5 9usiness and Pmlessional CoOe: Any city ol counry w�ic� repuires a Oe�mit to constmct, alier, imDrove, DemolisR or repair any s�mcmre. prior to its iuuance, aiso rt0uires the apvliant for sucn oermil Io lile a signeA statement tnat he/sne is licensetl pursuani la the Drovisions ol Ihe Coniractars' S�a�e Litense Law (C�aO�er 9(commencinp wilh Sec�ion 7000) o� Oivision 3 0� I�e Business dna Prolessions Cotle) or inal he/sne is ehempt IAerelwm ane tne Uask lor Ine allegetl exemptian. any violation ol Section 7Q37.5 by any app6cant for a permil sublects I�e aDa��ant to a tivil penalry ol nal moro than live hundre0 Aollars (5500). I, as owner al Ihe propeny or my empl0yees witn wapes as ineir sole compensation. will tlo ihe work, anA the ❑ stmcture is nat imen0etl ar ollere0 br sale (Section 70aa, Busineu an0 Pmleuional Code: The Coniractors' State License Law aoes not apply to an owner ol a D�ooeny who euilds orimproves thereon, ana who Ooes sutn work nimse0lnerself orinrouAh nis or ner own employees. pmviJetl Inal such impmvemenis are not inten4Ctl ar ollere0 for Sale. 11, Aowever the buileing or impmvemeni is SOIE wilhin one year ol com01eti0n, ihe awner vrill have I�e bur�en ol Omvinp helshe OiJ na� bui10 or impmve lor Itle OurOose ol sale�. I, as owner ol Ihe Dmperly, am exclusively conVacling wi�h licensetl conVaciors lo conslmc� ihe O�oleci �Seclion 7044, Business ❑ and Prolessions Cotle: The Contracmrs' S�ate Lkense Law does nai apPN �o an owner ol O�oDenywt�o Duilas or improves thereon an0 w�o canVacis lar suc� Owl��s wit� a contratloqs�license Oursuan�io Ihe CONrac�orY Staie LiC¢nse Law�.l am aware Ihai pmol ol I�eii Worker's Compensation msurance s�uula Oe pmviOeC ta me. � � I am exemp� un0er Section: B. 8 P. C. IOrIhiS ieason: Dale: Pxner. I ao �ereUy ceNly ��ai I am aware o� an0 un0erslantl Ihe reQuiremenis of Cabiomia Healih and Salety CoUe S¢tlions 25505, 25533, antl 25534 and Ihat I or any IUW�e �uil0ing ouupan� wilV�Wll noi (cirUe one) need lo comply wiih ui0 s�a�e roAes and �he ieQuiremen�s �ar a permi� lor conslruclion or modilication Irom�he AirOualily Managemen� Oislrici. FeSideniial cons�mction apD�icalions ale exempl Irom IIICSC plOv1510115. Dai¢ ApD�icani: I hereby cerlily t�at I have reatl t�is ap0licati and slale Ilai I�e above inlormation is correcL I agree �o comply wiih all city and county, oreinances zntl slaielaw5 relatinglo bwl�ing on9mction antl �¢reUy aulMrizerepresentativ¢5 oflhis nryto enteruponthe above�meniion O�opetly lorins eclion purposes. // // �,/�- 1 �l, ',�'// �/�/�� %� �- Z �, �a�e�. � SignaWre:�v N. � ��,�(�'i"�i" - � orive(s license or Social Security k: 1641-46 Whne-Bmlping: Green-CaOe Enlorcemen[ Canary-ApplicanL Pink-Revenue: Goltlenrotl-Auessor CITY OF CUSTA N,ESA — BUILDING 1�ERM. � T PERN. NO: B 053579 PERMIT NO: 3 053579 PLAN CHECK NO: N GOV?; N SUFP: N CONS'"RiiCTION 'fYPE: PER,yIT TYPE; STR PiiRPOSE: ADD JOB DESCRIPTION : REROOF 3200SF RESID G GARAGE W COMP SHIN SQ FT; 6,60U CLA3M VAi.,iJE: 6,600.00 CALC—VALUE; 6,600,OU GR06P OCC; R-3 /H-1 r.oM;�sN•rs• x �MOKE ��ECTC�.R' ififieiciE�ii�iE'lElkaEifi'r#1'riFiF#iFiFii-1f1E#iFiEiEiE1F1f-iFiE)f##ieis�Rlfii�iFif�if#it�ifiFfejEiFlPitifiFiFiE�#ifiEi:leiFiF1f3e1Eif#1'r+v� r.z #Y.�.. Z O N I N G R E Q U I R E M E N T 5 ��u'�ED S E T H A C K S �'..—... -- N,AIN HUILDING ---------- -------- ACCESSORY BUILDING --------- FRNT: FT ZN REAR; rT IN FRNT: FT IN REAA: FT IN 1,F.FT; F't IN RGiiT: FT IN LEFT: FT IN RG3T: FT IN PARKING REQ• PROV; PARCEL; 1395'1305 ZNE: REF NO: Pi,ANNING N6TES> .. 1 if ii �t aF if if iE 1t it 1e )f 1E 3E iF if i iE # i(',4 if # iF # iE i! 3E 7t i% 3f k iE � iC if ?f iEif ae ie it x ii' it �f+l'te iE if if iF,% if 3E 1e i< it iejt } if ?aiF � i4 jf #�b3r if iE iF s if If 1t� 1e #% D�. V E L O P M E 1v T S E R V S C E S rZ E Q U i R E N, c N T S ZONING APPROV6'D 8Y DATE: BUILDING AFPROUED BY : DAT�; APPLSCATION ISSUED EtY: �� DATE: �� i��iF3F�Fi!�ifiE341fi:�iEiFiFjf'1fiF3f?i�3EkiFiE xxx ieiF�3EV.�iE1(�#ii1E�iFr . r i!�V� iF # iE �1e iF iF # iE IF 3E tk #?E !!� if 3i iF 3f- �! * iF i( iE If if +i lE 1e #'� 1E 1f if� # IE �(- lE %- i'r # iE 1E if ie �IE 1F iE i(� iE iF iE � ic ii� if ik if # jE+:� 3e?e ii� 3e iE 3F #}:� If # k!f +: 3c i!� �e Y: if iC� �!� LEGALIZATION;N F E E S U k M A R Y ST�UCTURAT_. SECMaNT;Y BLDG PMT PLUN.3ING ELECTRIC MECHANIC Fir2E SMIP/RES GRADING pERN.IT 90.00 • ,66 , SMIP/NON—RES Pi.AN IS5TJE FEE � BUILDING—DtV—> PERMIT ISSuE PLAI�—CfiECK TOTAL PA=D L�U�: TOTALS-----> 90.66 0,00 O.UO 90.66 ; 90.66 ,UO REVENUE UIVISION TOTALS--> COLLECTED; 90.66 OVER/SiiORT: ,00 HLDG pMT PLUMBING ELECTRIC MECHANiC FIRE SMIP/.�'pT GRADSNG PLAN—CHECK 90.00 .Y66 ��**�*�txxtt�rx��*x*�r��t��#*��ex+*!�#�r*s�c�*�t��r�e��*��r*�r�*��r#r��*��*�*��*i��Ku�sx _ N D i V T D U A L F E B B R E A K D O W N 1YPE [iTY D E S C R I P T I O N UNiT COST . SFR 6600 REROO:" BY VALUE RESIDENIIAL N07.ONE '.�,..00 E,ID OF FEnS r TOTAL COS" 6,600,00 �., l�� i.�y'.�.%�-�'J: i'?014 �.." L�GTc� u3i2Gr'4;. T:CE: 1�:4_. -, GONSTRUCTION ANOPLANNING P00, .SPA APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector 1. Temporary Electrical Service`or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement , 3. Electrical Conduit Utility�Undrgrnd. - 54. Forms 4. Electrical Conduit-Und�grnd. • 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVA� TO COVER�GUNITE 7. Footings � 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgmd., Test 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final • 52. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System � Final 14. Rough Plumbing 65. Electrical-Final 75. Rough Electriral-Conduit, 66. Solar System-Final i6. Rough Electric Wiring 67. Fencing & Access ApP�o�al 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Ba� Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE OEPT. REQUIREMENT 20. Rough Factory Fi�eplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing ]�-Gf � 6(ti-�i 74, Overhead HYdro 26. T-8ar Ceiling (Structu�al) & Monocoat 75. Dry Chemical 27. Freme and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation ' 76. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power MeterFinal S0. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & O.ir Conditioning . 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory FireplaGe 38. Final Plumbing 39. Water Service-Final � 40. Gas Service-Final 41. Sofar pomestic-Final 42. Backflow Preventer $ Z �Il.. � �� , �-1 43. Backflow Irrigation - ��..� 44. landscape Irrigation SYsiem 45. Sound Attenuatien � 46. Handicap Regulations �� 47. fINAL STRUCTURE &-BUILDING 9 SGj �j(N � 48. FINAIPLANNING ,.,, 49. Electric Release to Edispn • 50. Gas Release to Southem California Gas Co �•• 51. CERTIFICATE OF OCCUPANCY No. ' Date OWNER �RLAT� IRWIN M. k_ FEB BUILDING PERMIT NO. 21529 -- VALUE $ 4g5,00 � FIRE ZONE '3 DESCRIPTION OF WORK Add P8t10 t0 SUBCONTRACTOR ?15?4 ...,. 2..'Z . ,. . COSTA MESA BUILDINGSAFETY DEPARTMENT P• O. BOX 9f] COBTA M88A, CALIFOPNIA For Applicanf to Fill In Completely TYPE OR PRINT BUILDIN6 `(�� ADDRES9 COSTA MESA. GALIFORNIA ._, TEL. � �C.TNO. � J/ / 7 O NO. �% � 8128 (� 1� J /J' -7 � � No. ■ U6E FNOM DESCRIPTION OF WORK 'BUILDINQ NO.OP S1ZE ROOMB EXTERIOR WALL ROOF o r � asFo . 1 XEqEBY ACKNOWLEDOB TN�T I NAVB RB�� TXIB �PCLIGTION /�ND 6TATg TX�T iXe ABOV6 18 CORHBCT �ND AOpHH 70 COM- PLY WITH ALL CITY OPDINANC88 AND BTATH LI1W9 qeOYLATINO 9UtLOINO CONBTRUCTION. 61GNATURB OP � PERMITT@ h AUTMOfti=gD AQENT FEE RECEIVED FEB 3 1964 FINANCE DEPT. n�i��nQ�or�� r BUILDING for ONice Use On1y BUILDINO ZONING �/ ZON NO. OF UeE OP NQW .,. �[, ' .— f �LANB YI pUILO1N0 �/�/Iv °"` � /-0� �.�- 7-�2 �/3d �' oaecrt�mon A. P. NO. / I/��(f C I��— O�{- _I NOTE: NO EAVE OV ERHANO BHALL BG LESB THAN 90" TO 81DH B REAR P. L, PJ1VE8 ALLOWED (U.B.C.REQUIREMENT. YARDBAPPROVED YAROSAPPROVED MAIN BUILDIN6 ACCESSORY BUILDING (FROMGLSTRE _ �{� y. REAR V FT. —I F D19TANGH BET. BET. MAIN ! MAIN BLDG9. ACCE65. BL VAR.;C DATE C.U.P. APPROVEU APPROVED / fiY I � .DAiE �� THB �MOUNT BHOWN UNDlq V�LUATION IB PON TH8 PUHPO86 OP Eei/�BLIBHINO • PeHMIT FE8 ONLY. VALURT70N PERMIT FEE i rn s�� '� TOTAL FEE $ Y � �' '� � ' 18874 , _� ' - ;;;,�COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BOX 917 C08TA MBBA. CALIRO�IA For Applieanf to Fill In Complefely TYPE OR PRINT BUILDING De Soto Ave. ADDRE88 COSTA MESA CALIFORNIA �. V TEL. Del 1`iar OF LOT 6GYV S_F. I NOW oN Lo USE OF ISTING BLDG None 68T9ACK LINB FROM CBNTER OP BTPH6T �2, REAR YARDL SIDE YARO I LEFT ri � I RIGHT ri � DESCRIPTION OF WORK siie "ol' PXTERIOH �h COVERINO USE OP BUII � WORK TO �E PERFORMED ++�q _h �_C�co�sTn,72s Q*,a*94.QQ APPLICATION FOR PERMIT BUILDING For Offiee Use Only. R8C8�Pf NO. P8P �rL.� BUILDING ADDRE63 1ZP0 COSTA MESA. CALIFORNIA FIRE ZONE TYPE GROUP� APPROVED BY DATE ZONING ZON INO. OP I U88 OP N PI.ANB BUItD� LBOAL Lot 12 Tract 480E DHBCPIPTION � A. P. NO. � YARD3 EVES APPROVED ALLOWED � _ln ceerrran uns or.� �-r ) Area: -S 1 1 XEREBY ACKNOWLEDOH TH�i 1 MAVH RBAD TMIB APPLIGTION TX8 AMOUNT 6HOWN UNOER VALUATION IB FOR iH¢ ; AND BTATH THAT TH8 �BOV6 IS GORfiBR AND AGH88 TO LON- pURP086 OP E6TABL18HIN6 A PeRMIT F86 ONLY. � PLY WITN ALL CITY OFDINANCHB �ND BTATE tAWB HBDULATINO 3 BUILDINO CONBTRUCTON. VALUATION / /__ s,�NAruee oF�esa Del I4ar DeveloDment �o. PERMIT FEE s 6�� PERMITTE p �j dBy' � $ 2O�2V8.00 PLAN CHECK 5 ,-7 �� AUTHORIZED AGENT �, �(.�,�y,�h ^ ^^ 9C�