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Home My WebLink About3011 DONNYBROOK LN - Building PermitsCITY OF COSTA MESA � o , BUILDING DIVISION t � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us F �. ` FOR INSPECTIONS CALL: (714) 754-5626 �� fi PERMIT NUMBER: BX09-00145 PERMIT TYPE B MISC STATUS: ISSUED APN: 14116514 DATE ISSUED: 08/03/2009 Zoning: R1, ISSUED BY: RMD JOB ADDRESS: 3011 DONNYBROOK LN CM Suite/Unit: Vicinity: REAR OF HOUSE Primary Occ: 32 Const Type :?? SQ. FT: 396 Valuation: 56,383.52 SCOPE OF WORK: CONSTURCTION OF A 396 SF SOLID ATTACHED ALUMINUM PATIO COVER WITH 2 LIGHT FIXTS AND 1 LIGHT SWITCH FOR A SFD. OWNER: LE, ANNE Address:: 3011 DONNYBROOK LN City/State: COSTA MESA, CA Zip Code: 92626 Phone: APPLICANT: GOLKS, DAVID Address: - City/State: Zip Code: Phone: 951-243-5876 CONTRACTOR: CALIFORNIA CONSTRUCTION CONSULTANT License No. 552305 Address: 25567 CAMINO CASTILLO City/State: MORENO VALLEY, CA Zip Code: 92551 Phone 951-243-5876 Cell: ARCHITECT: Phone ENGINEER: TOM CAMPBELL AND ASSOCIATES INC Phone 951-741-2107 FEE SUMMARY Building Plan Check: Building Permit: Electrical Permit SMIP Residential SMIP Commercial Bidg Std Admin Fund TOTALFEES $90.51 $139.25 $26.80 $0.64 $0.00 $1.00 $258.20 License No. License No. 37948 Unit Unih Unit: NOTICE: The work authonzed by this permil shall wmply with all applicable handicap access requiremenLs under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) ' EXPIRATION: PERMIT EXPIRES iB0 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 inspections and final approval must be obtained. Failure to obtain inspections and final approval will resull in the expiration of this permit. CO�Et INSPECTIONTYPE ORTE INTRIRlS CODE! INSPECTIONTYPE OpTE INTITIRLS 1616 Fixed Syslem Final Fire Prevention 206 Final Mechanical 7266 Pool Spa Final 208 Final Plumbing 2r � 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site �� 204 Final Demoli�ion 250 Final Building/OccupanCy � WORKERS' COMPENSATION DECLARATION: � I hereby affrm under penalry of perjury one of Ihe follovnng tleclarations: ❑ I have and will maintain a cehifcate of consent to selGlnsure for workers' compensation, as provitletl for by section 3700 0( the Labor Code, for Ihe performance of the work (or which this permit is issued. ❑ I have and will maintain workers' compensation insurdnce, as required by section 3700 of the Labor Cotle, /or the pertortnance of the work tor which this permit is issued. My wo kers' compensation Insurance carrier antl policy numberare: �� / �v� Cartier:_3 �'� (This 5ectbn need rrot De mmplefed �Ihe peimrt is valued af one hundretl tlollars ($100J or less.) Policy.Number: I � 1- L�� ❑ I certify that in the peAormance of the work for which this permi� is issued, I shail not employ any person in any manner so as to become subject to lhe workers' compensation laws of California, and agree that if I shoultl become subject to the workers' compensation provisions of Section 3700 of the Labor(Co�J�j a�ll forthwith compty with these pmv�+ \ �1.....�._l.y j,. �� - �canfSSignaivre rDat �� ,`, �• � WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affrm Ihal I am licensed under provisions of Chapter 9(commencing with Sec�ion 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. r"� l"ic::#` %—�' � � /— Class.#. ' � � mrec�or'e�Signaure^" Daie CONSTRUCTION LENDING AGENCY: ��"' ❑ I hereby aHirtn that there is a cons[Nction lentling agency for the performance o( the wurk fa which this pertnit is issuetl. (Sec. 3097, Civil Code). Lender's Name: lender's Address: Signature Oate OWNER-BUILDER DECLARATIONS: I hereby affrm that under penalty of perjury ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for lhe following reason (Sec. 7031.5, eusiness antl Professions Code: Any city or county which requires a permit lo conslrucC alter, impmve, demolish, or repair any stmcture, prior to i�s issuance, also requires [he applicant for such permit to fle a signed statement Ihat he or she is licensed pursuant to the provisions o( Ihe Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business antl Professions Code) or that he or she is exempt therefrom and the basis for the allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjecls the applicant [o a civil penalty o( not more than five hundred dollars ($500).): ❑ I, as owner ot Ihe property, or my employees with vrages as their sole compensation, WILL DO THE WORK, and the struc[ure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The CoMractors License Law does not apply to an owner of propeAy who builds or improves ihereon, and who does such work himself or herself or Nrough his or her own employees, provided Ihat such improvements are not intended or offered for sale.�lf, however, the building or improvement is sotd within one year of completion, the owner-builder will have the burden of pmving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRAC7ING WITH LICENSED CONTRAC70RS to cons[ruct Ihe project (Sec. 7044, Business and Professions Code: The contractors License Law dces not apply to an ovmer of property who builds or improves lhereon, and wfio cont2cts for such project vrith a conlractor(s) license pursuaN to the CoNractws License Lavrs.). ❑ I am exempt under sec. Business and Professions Cotle (or this reason: SignaWre 305�-66�3/01 Owner ID verified by driver's license. ❑ Yes ❑ No Driver's License No. Expires: Verifcation o( Ownership by (rype of tlocument, i.e. - property tax bill or deetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereDy certAy that no excavation five (5) or more feet in deplh into which a person is required to descend, will be made in connection wi[h work authonzed by Ihis permit, and ihat no building strucWre, scaffdding, falsewvrk, or demolition or dismantling thereof, will be more than thiny-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, rtle 8, Califomia Atlministrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Intlustrial Safery, as noted above, unless such person has a permit to tlo such work fmm the division. ApplicanCs SignaWre Division of Industrial Safery Permit Number HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or (uture building occupant need to (le and certify a Business Plan for emergency response �o release or threatenetl release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the Califomia Health and Safety Code requires, with some exceptions, that a Business Plan be fled with fhe Costa Mesa Fire Department hy every business which has at any one time during a reported year a quantity o( hazardous materials equal to or greater [han a weight o( 500 pounds, or a volume of 55 gallons, or 200 cubic (eet o( compressetl gas a� standard temperature and pressure). 2. Does or will ihe applicant or preseM or future building occupant need to fle a registration form for aculely hazardous materials? ❑ Yes ❑ No (Section 25533 of �he Cali(omia Health and Safe�y Code, with some exceptions, requires regis[ration with ihe Costa Mesa Fire Department by each business which a� any one time has on hand a quantity of acutely hazardous materials equal to or grea[er Ihan a weighl of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperawre and pressure). 3. Does or will �he applicant or present or Wture building occupant need to prepare an RMPP (Risk Management and Prevention Program (or acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 0( the Califomia Heaiih and Satery Code provides that the Costa Mesa Fire Department may require the preparation, cehification antl flinq with lhe Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 of the Califomia Health and Salety Cotle been (ully complied with? ❑ Yes ❑ No 5. Does or will Ne applicant or present or fuNre building occupan� require (or the work which is [he subject of this application a permit for such conshuction or modifcation fmm ihe South Coast Air Quality Management Dis�rict or trom any other air polWtion contml district or agency? ❑ Yes ❑ No (Section 658502 of [he Califomia Govemment Code requires that the requestetl in(ormation be fumished on applications fa nomresidential building permits). 6. Will any part of Ihe facility to he conslructed under this permit be within 1000 feet from Ihe outer boundaries of a school? ❑ Yes ❑ No Qf'yes", the facility must meet the requirement of Sections 25534 and 42303 of the Cali(ornia Health and Safery Code). 7. If a permit from the South Coast Air Quality Management District or other air pollution control dishict or agency is required for the work which is the subject of lhis application, have all of [he disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", atlach certificate ot compliance fmm the appropriate air pollution control offcer). CERTIFICATE OF COMPUANCE: I certify that under penalty of perjury [he in(ormation given above is covecL I agree to comply with all state laws and city ordinances regarding Hazartlous Materials and Emissions. SignaWre Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and state that the information given is correct. I agree to comply vrith all state laws and city ordinances relating to building construction, and authonze representatives of the Ciry of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by Ihis permit un[il fnal inspection. S, d= e IOwner(s) Da�e �� _�� {Mtl(or.AWhOrfzeC'AOP,��nityg�,.n.-..�.a� 'Dat¢�--�—� ❑ (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��.sCTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: Ownec Address CoNractor. Address: 3017 DONNYBROOKLN 14116514 TRAN,ANDY 13392 SORRELL DR GARDEN GROVE, CA Phone: 714-292-9608 Zip 92843 ISSUED BY: Status: ISSUED Applied: 17/29I2006 Issued: 11Y292006 LE, ANNE- :�.. 3011 DONNYBROOK LN �i�' , � � � Phone: � ' � � COSTA MESA, CA � Zip: 92626 OWNER-BUILDER Phone: Zip: License: 000000 SCOPE OF PERMIT � CHANGE-OUT AND POSSIBLE RELOCATION OF AN ELECTRICAL SERVICE FOR AN EXISTING SFD. ISSUE FEE Temp service test � Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fixts Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to t000a Service over 1000a Motors l0 1 hp Motors to 70hp Motors to SOhp Molors to 100hp Motors over 100hp Communicalion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole 1 SERVICE TO 200A NO OTHER WORK AUTHORIZED WITH THIS PERMIT. 823.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 530.50 $0.00 $0.00 � 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ' ..- , $0.00 , FEE SUMMARY . Quantity puantiry 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 Temp Dist System / Lighting Busway I100 fl ' Standing Section . Misc Eledrical Equipment Transfortners up to 1 kva/kw ................up to 10 kva/kw .................up to 50 kvalkw .......:.........up to 100 kva/kw . . ..................over 100 kvalkw .� � Low Voltage Equipment Low Volt Wiring System I Ckt Misa Conduit Misa Conductor � , � . � Cirws ( gen or ride) Circus (mech ride or lighis) Christmas Tree Stand Fireworks Stand Other Electrical Fee � Investigation Fee Plan Check Fee Reinspection Fee 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 � $0.00 0 $0.00 0 $0.00� ��0 � ' $0.00" 0 $0.00 0 $0.00 0 $0.00 0 50.00 , 0 $0.00 0 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES �E54.00 nr�uue��rn � c�nvr� w NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1. 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is no� commenced within 1 BO days, or if work is suspended or abandoned for 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 requlred Inspections end final approval must be obtained. Fallure to ob�ain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zua-ae la'oo� WORKERS'COMPENSAnON DECLARArON: � I hereby eRlrm untler penelty oi per�ury one a� ihe following declareilons: � " ❑ I heve end will melnteln e certlticate oi consent to self�lnsure for workers' compensetlon, es proNded for by section 3700 of t�e Labor Code, for the pertormence of the work ror wnlch tnis pertnit is Issuetl. " • ❑ I have eM vnL melnteln workers' compeM1Setlon insurance. as requiretl by seclion 3700 oi Me Lebor Cotle, for the peAormarke of the work for which this permit Cs LSsuetl. My workers' compensatlon Insurenca cerrier and policy number ere: Cartier: Poliry Numbec (—Th/is sectlon neea nof be complefed It (he pe��t is valued e( one huntlred dollars ($700) or less.) [(�' I certity thet in tha paAortnance ol tha work for whic� this pertnit is issued, I shell not employ any person in any menner so as to become subject to the workers' � compensailon lews ol Celifomia, erM eBr e thet Il l should become subjact to the workers' compensatlon proNsions of Secti n 370 of the LeDor Code, 1 s�all forthwith comply with these prov�isi �/ /P Applicant Signature: l �/17AU �L�' Date: � �/%.�� (o WARNING: FNLURE TO SECURE WORKE ' COMPENSATIIXJ CWERAGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOVER TO CRIAUNAL PENqLT1E5 AND CML FlNES UP TOONE HUN�RED T!%HISAND DOLLARE (5100,000), IN ADDIT1dJ TO TME WST OF COMPENSATION, DAA41GE5 A$ PROVIDED f-0R IN SECTION 31O60F TiE LABOR CODE, IMEREST, AND AiTORNEI"S FEES. LICENSED CONTRACTORS DECLARA710N: I hareby eHirtn that I am licensad untler provl5lons of Chapter 9(commencing with Section 7000) of Division 3 oi t�e Business antl Proteuions Cotle, and my license is in full farce and eMect Lic. q Class a Comremors Signature: De�e: CONS7RUCTION LENDING AGENCV: ❑ I hereby ettirtn that Ihere is a construction lending egency for the Derformance ol the work br which this permit is issued. (Sec. 3097, Civil Code�. Lentlefs Name: Lander's Atltlress: Signeture: OWNER-BUILDER DECLARATONS: Date: I hereDy elfirm that under penelry oi perjury Iqet I am E%EMP7 FROM THE CONTRACTORS LICENSE LAW for Iha tollowing reason (Sec. 7037.5, Business antl Pmtessions Code: Any city or couny which requires a parmit to conSWct, alter, improve, tlemolish, or repair any strucWre, pnor to its issuence, elso requires the applicant tor such permit lo file e signed stetement thet he or she is Ilcensetl pursuant to the provislons of t�e Contrectors License Lew (C�epter 9(commencing with Sectlon 7000) of Dlvision 3 of the Business end Professions Code) or thet he 0� she is exempt therefrom antl t�e besis for Ihe alleged exemption. Any violatian o1 Section 7031.5 by any applicent for a pertnil sut�jects the eppliwnt to e clvll penalry c� not more than five hundred dWlars ($500).): � I, es owner oi ihe property, or my employees with wages as their sole compensation, WILL DO THE WORK, entl the structure is not intenCed or otteretl for sale (Sec. 7044, Business antl Professions Code: The Contractors License Law tices not epply to an owner oi property who builds or Improves thereon, antl who does such work �imselt or herself or ihrough his or her own amployaes, provided Ihat such improvements are not Intended or oNeretl for sale. Il, however, the building or improvemem is soltl within one year ot completion, the ow�er-builder will have tha burden ol proving that he or she tlid not build or improve for purpose of sale.). � I, as owner of Ihe pro0erty, am EXCLUSIVELY CONTRAC7ING W17H LICENSED CONTRACTORS to conslruct Ihe projecl (Sec. 7044, Business and Protessions Cotle: Tha wntractoro License Lew does not appy to an owner of properry who builds or impmves t�ereon, end who contracis lor such project with a comracmr(s) license pursuanl ta Ihe Contractor5 LicenSe LewsJ. ❑ I em exempt Signature: _E Owner ID veritietl 1 ❑ Ves ❑ No Business antl Professions Code for Ihis reason: Varifcation ot Ownership Dy (type ol document, i.e. - pmperty tau bill or tleetl�: DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATON: oate: / O 6 , Oriver's License No. � Expires: ❑ I hereby certify thet no excavation five (5) or more faet in tlepih into w�ich e person is required to tlescend, wlll be mede in connection with work authorized by Ihis permit, entl that no DuilGing sirucWre, sCaflolding, talsework, or demolition or tlismantling Ihereol, will be more ihan ihirty-six (36) teet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Title B, Calitomle Atlministrative Code). ❑ As owner-builder, I wlll not amploy enyone to tlo work which would require e permit irom the Division ol Indusiriel Sataty, es noted ebove, uniess such person has a permit to tl0 SUCh work from ihe tlivision. Signature: Date: Division ot Industnal Sefery Pertnit Number: CEH7IFlCATE OF COMPLIANCE AND AIJTHORVATON OF ENTAY: I certity under penalry ot perjury thet I have read this application and state that the informetion given is cortect. I egree to comply with all stete lews end ciry ordinances relating to huiltling construction, entl euthorize rapresematives of the Ciry of Gwsta Mesa to enter upon Ihe ebove-described property for inspection purptlses. I egree no� �o xcupy or allow occupency of any building euthonzed by ihis permil until final inspection. i t e O Legal Owner(s) D e �rc�. l/ ,�4%OC n 'Or%u[i�otlzetlAppllcanl ate CppE �. IMSPECTIONTYPE ' 1616 Fixed Sysiem Final Fire Prevention 1266 Pool Spa Final 200 Finel Re-Root 201 Finel BIocWRetaining Well 202 203 204 Final Fectory Fire Place Final Sign Final'DemoliUan Qyj� IMlil� 5 COOE I INSPECTION TYPE 206 Final Mec�aniwl 208 Finel Plumbing 210 Finel Electrical 212 Finel Fire Preventlon 220 Final Planning Approval 222 Final Site ' ' 250 Final BulldingiOccupancy � �� P�L 1t�45 DECLARATION OF AUTHORITY FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS Bldg. Permit # This Permil # StreetAddress: �O�I �oWN7 gRoot� �., cAaT�-- nE sp APNumber. �► `�Lci� 1(we), A�1 NE �...E , declare that I am the Owner of Title of the above referenced real property, and that I(we) hereby authorize: Name: rl N��/ TRA-rJ Telephone Number�� Y ��-�2 '� 6 6� Street Address: I J 3 l�- s O�2 '�L (_ �Q City: l] n Q- ��IJ �o V Fi state: �n4- zip: q.i, r� �3 to obtain pertnits in my behalf, as owner/builder, for at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I(we) shall immediately provide Workers CompensaUon Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact, I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or o�cers harmless from any claim resulting in damage or personal injury to myself or any other paRies as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the pe,n.palty of perjury that the foregoing is true and correct. . Executed this 2 �o l� day of � d vG- n g E2 20 �� , at � Ip A/J ia 6 Go U N 7 y California. `,Prin_ _ t Name� iCN � � 1..6 � Sign� �Jl�"� � o ��I�� D� Note: This authorization does not grant authorization to perfortn the work as owner, it solely provides for IimRed power of attomey to secure this permR in any behaH. 07]9-46 (rev.11/00) � �� (714) 754-5273 • Fax (714) 754-4856 • wviw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 �ob address: 3011 DONNYBROOK LN Suite No Vicinity: WATER HEATER Parcel Nunmber: 14116514 Applicant: STARK, CHRIS Address: 7229 VARNA�AVE � NORTH HOLLYWOOD, CA ! � , ' �' Owner: LE, ANNE Address 3011 DONNYBROOK LN Contractor: Address: Arch / Eng : Address: COSTA MESA, CA ALAP ASSOCIATES GP 7229 VARNA AVE - NORTH HOLLYWOOD, CA PLUMBING PERMIT Phone: (800)444-8865 Zip: 91605 Phone: Zip: , 92626 Phone: (800)444-8865 Zip: 91605 License: 771905 Phone: - - - Zip: License: SCOPE OF PERMIT � ; � WATER HEATER CHANGEOUT. FEE SUMMARY �, �� AMT • QTK . - " AMT ISSUEFEE, ,� �$23.50 . � - ' �'LaundryTublWasher", ' $0.00 Backflow irrigation;� $0.00 �� 0��' � Landscape Irrigation � $0.00 BackflowPreventer�� ,$000 � 0`� ,�`� P,-Trap - �;� $0.00 Bathtub �, � A $0 00� , 0 -; Pressure Regulator $0.00 Clarifier System �, - �� $0.00 � ; 0 � �� Process Piping (per 10 ft) � $0.00 Connect(Ice,Soda,etc)� "$0.00 �., 0�,'� � Receptors � $0.00 Dental Units ��$0.00, �" 0-. - Seplic Tank $0.00 Dishwasher $0.00,: _ 0� ,'� Sewer Cap for Demo. .-$0.00 Drain,Floor $0.00� �r0�� . SewerConned ' ' �$0.00 Drein, Rainwater $0.00 -��-0� ,�-, Sewer Private Line, � $0.00 Drain, Roo( $0.00 0 , Shower ' � $0.00 Drinking Fountain $0.00 0 � Sink; bar $0;00 Expansion Tank $0.00 0 Sink, wmmercial " �$0.00 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 Gas (1-4 outlets) $0.00 0 Sink, kitchen $0.00 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 Gas Service $0.00 0 Spa (public) $0.00 Interceptors (Grease, Oip $0.00 0 ' Interceptors (Sand Auto ) $0.00 0 nTv 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: O7/25/2001 Issued: 01I25I2001 ISSUED BY: / / � �� i. � , � � /; � i ` l � � . � . �..� / ,. �- ' „ AMT , � � Sump�Pump � � !� / a0.00 - Swimming Pool �' $0.00 , =. Trap Primer� ��$0.00 - / " Urinat % � � % �,' $0.00 � Vacuum Brkr Bkflow(1-4) $0.00 ��,VacuumBrkrBkFlovS(5+) $0.00 . Wash Basin - ; $0.00 � Wash Basin Set $0.00 . Waste"and Vent System $0.00 . - ,Water Closet (Toilet) $0.00 � � Water Heater / vent $12.30 Water Piping (Inst or Rep.) $0.00 Water Re-pipe $0.00 Water Service $0.00 Water Softener $0.00 OTHER $0.00 VIOLATION $0.00 PLAN CHECK $0.00 REINSPECTION $0.00 TOTAL CALCULATED FEES: E35.80 nrv 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access raquirements under California statutes and related regulations. (Ord. No. 92-28, § t, 72-27-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or it.work is suspended or abandoned for 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 requlred Inepections and tinal approval mus� be obtained. Failure to obtain inspections and final approval vnll result in the expiration.of this permit. FOR INSPECTIONS CALL: (714) 7545626 2M6d8 (fl/00) L�.aJ WORKERS' COMPENSATION DECLARATION: � I hereby eHirm under penaliy oi perjury one ol ihe following declarations: ❑ I have end will maintein a certllicate of wnsent to self- sure for workers' compensation, as provided for by section 3700 ot the Lebor Code, for the pertortnance of the tor whiCh this pertnil is issuetl. —I have fvill mainWin worker ensation ins ran , as required by section 3700 of the Labor Code, for the DeAortnance ol tha work for which this pertnit is issuetl. �My rker� compens tt aCCBTri rentl oll numberere: �Q Carner.— • � Policy Number. ��C�� "�� (Tlds section need nof be comp/eted i! pe v I d et one hundie0 dollars ($100) or Iess.J �—� -�— ._• ❑ I cenity Ihel in the p Ih fo ich Ihis pertnit is issueq I shall not employ eny person in any menner so es to become subject to ihe workers' compensetion laws e e t if I should become subject to the workers' compensation provislons of Sectlon 3700 of ihe Labor Code, I she0 forthwith comply with these vis . 7 P Applicant Signeture: � - — Date:_ - � —L�' WARNINp:.FAILURE TO SECU ERS' COMPENSATION CAVERAGE IS UNLAWFUL PN� SHALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVII FINES UP TO IXJE HUNORED iFiOUSPND DOILARE (5100.000�, IN AOOITION TO THE COST OF COMPENSATIIXJ, DPM4GE5 AS PROVIDED F-0R IN SECTIIXJ 31060F THE LABOR CODE, IMEPESi, AND ATiORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirm that 1 am Ilcensed under is' f Ch pter 9(commencing with Section 7000) of Division 3 of the Busine �s a�ofessions Code, and my license is in full torce and eflett'Cic. x � rClass k j� Con,rectors�Si�ure:- j ate:-- �� '� CONSTRUCTION LENDING AGE Y: ❑ 1 hereby ettirtn Ihat Ihera is a construction lentling agency for ihe peAormance of Ihe work tor which ihis pertni� is issued. (Sec. 3097, Civil Code). Lentlefs Neme: Lenders Address: SignaWre: Date: OWNEq-BUILDER DECLARATIONS: I herehy eNirm thet under penalry ot perjury Ihei I am E%EMPT FFOM THE CONTRAC70RS LICENSE LAW tor Ihe following reeson (Sec. 7031.5, Busineu entl Pratessions Code: Any ciry or counry which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuence, elso requires ihe appliwnt for such permit to tile e signed stetement Ihat he or sha is Ilcensetl pursuant m the pmvisions of the Comrecrors License Lew (Chepter 9(commencing wllh Sectlon 7000) of Division 3 of the Business antl Profeulons Code) or that ha or she is exempt therefrom and the basis for the alleged azemption. Any violetion oi Sectlon 7031.5 by eny appliwnt lor a permit subjects ihe epplicant to a civil penalry of not more ihen Ilve hundred dollars (5500).): ❑ I, as owner ot ihe properry, or my employees with weges as their sole compensation, WILL DO THE WORK, antl ihe siructura is not intended or oHeretl for sele (Sec. 7044, Business end'Professions Code: The Contrectors License Law dces no� apply to an owner ot propeny who builds or improves theraon, and who tloes such work himself or herselt bi.l6rough hIs or her own employees, providetl that such improvemenis are not Intentletl or offered for sale. tl, however, tha builtling or improvement is sold within ona year ot completion, the owner-6uilder will have ihe 6urden of proving ihat he or she did not 6uiltl or Improve for purpose of sale.). \�/v,- ❑ I, as owner of the property; am EXCLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS ro construct tha prolect (SecJ044, Business ana Pmtessions Code: The coniractors License C"aw tloes not epply to an owner of properry who builds or improves thereon, and who conlracts for such project wit� a contractor(s) license pursuenl Io Ihe Conirectors License Lews.). ❑ I am exempt under sea �� Business and Professions Code for this reason: Signature: �C� Date: Owner ID verifietl Dy tlnver's licen5e. ��VeS ❑ No Drivers License No. Expires: Venfication of Ownership by pype oi daument, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hareby certity that no excevatlon flve (5) or more feet in depth into which a person is requiretl to descend, will be made in connaction with work eu�horizad by ihis pertnit, end that no building siructure, scaHolding, lelsework, or demolition or dismantling ihereot, will be more than ihirty-siz (36) feet high. (Chap. 32, Grp 2, An 2, Sec. 34i, Title B, Celllornie Administretiva Code). ❑ As awner-builder, I will not employ anyone to do work which would require e permit from the Division of Industrial Sefety, es nated above, unless such person has a permit to do such work from the division. Signature: Division ol Intlus�rial Salery Permit Number: Date: Will tha epplicant or present or future bulltling occupant neetl to file antl cenify a Business Plen for emergency rasponse to release or threatened release of a hazardous materiel? ❑ Ves ❑ No (Saction 25505 of I�e Celitomia Health antl Safery Cotle requires, with some exceptions, ihat a Business Plen be filed wilh ihe Costa Mesa Fire Depanment by every business which has et any one time dunng a reported year a quantity of hazardous matenals equel to or greater ihan a weight ot 500 pountls, or a voluma of 55 gallons, Does or wm tne appiicant or presem a� tmure ouaamg occupam neea �o me a regis�reuon tortn tor ecutery na�mous matenais7 LI Yes LJ No (Secllon 25533 0l the Calitomia Heelth and Safery Code, with some exceptions, requires regisiretion with the Costa Mesa Fira Depanment by each business which at any one time hes on hentl e quantiy of acutety hezertlous matenels equal to or greeter then e weight of 500 pountls, or e volume ot 55 gellons, or 200 cubic feet of compressed gas at standerd tempereture and pressure). . ........................................................................................................................................... ..................................................................................................................................................................................................... Does or will ihe eppllrent or present or luture builtling occupant nead to prepare an RMPP (Risk Managemen� entl PreveNion Program for acutely hazartlous matenals)7 (Section 25534 0l the Celifomia Heelth end Safery Code provides that the Costa Mesa Fire DepanmeN may require Ihe preparation, certification and filing with the Fire Depertment ol en RMPP by businesses which ere required to register acutely �ezertlous materials wit� the Fire Department. ........................................................................................................................................................................................................................................................................................................................................................................................ 4 If an RMPP is prasently required, �es Saction 25534 of ihe California Healih and Sefery Code been lully complietl withl ❑ Ves ❑ No ...................................................._................................................................................ .....................................................................................................,.........._........................................._.... 5 Does or will ihe eppllcan� or present or future huildlnq occupan� require tor iha work whic� is ihe su0ject of Ihis e plication n germit for such constmction or modification fmm Ihe South Coast Alr Ouelity Menagement Dlsidct or irom any olher air polWtion control tlisMct or egency7 � Yes u No (Section 658502 0l tho Celilornia Govemment Code requires tha� �he requestetl inlormation be turnishetl on epplicetions lor nornresitleNiel Oullding permits). ....................................................................................................................................................................................................................................................................................................................................................................................... 6 W ill eny part of lhe feciliry to he constructed under this permit be within 1000 feat irom the outer boundanes ol e school7 ❑ Ves ❑ No (If "yes", the lecility must meet ihe requirement ot Sections 25534 and 42303 of the Califomia Heelth and Sefety Code). .................. .. .... .... ..........................................................................._..................................................................................................................................................................................._... ........... .... ... . .. .................................... .. .. 7 If e perml� �rom the South Coest Alr Quelity Menagement Dishict or other eir pollution control district or egency is requlred br Ihe work which is the subject oi this aoolicailon, have all oi Ihe tlisclosures orescribetl by Celifornia Health and Safery Cotle Section 42303 baen mede9 ❑ Ves ❑ No COMPLIANCE: I certify Ihat under penalry of perjury Ihe informa�ion given ebove is wrrect. I egree to comply with all state laws and ciry ortlinances is Meterials antl Emissions. � Signature: Date: CER71FlCAiE OF COMPLIANCE AND AUTHOR O.OF ENTAV: I certify under penalry of perjury ihat I have reaa this appliwtion and state that the information given is correa. I egree to compy witn all s end ry dinances relating to building consiruction, antl authonze representatives ol the City of Costa Mesa to enter upon Ihe above-descnbed property for inspec ion pury ses. I ee not to occupy or allow occupancy of any builtling au�honzed by Ihis permil until finel inspection. COpE �, INSPECTIONTYFE `/ 161fi Fixed System Flnal Fire Prevention 726fi Pool Spa Finel 200 Finel Re-Roof 201 Finel BIocWRetelning Wall 202 Finel Factary Fire Place 203 Flnel Sign PAI&" I�ALS COpE1 INSPECfIONTYiE 206 Final Mechanical 20B Finel Plumhing 210 Finel Electdcal 272 Final Fira Prevention 220 Flnal Planning Approval 222 Flnal Site 204 Finel Demolition ' '- 250 Final Building/Occupancy Da�9 /- 2.� � / � �� / I _� Pfl0.1ECTR00XE$S: 3UI1 DONNYBROOFt 1.t�1 OWNEfl'S NRME: SGROSSO, S'fEPHEN F � noosess:3U11 DONNYHROOK COSTA MESA,CA 92626 AflCHIENCINEEfl: AOOflE55: sec.xo.: uxiT: uwT: PEflMITTEE:B �, J ROOFING ( 714 ) 637-5609 aoonEss: 7040 N SACRANENTO ORANGE CA 92667 LICENSEO LONTNACTON OELLAfll1TI0N: I here�y allirm �ha� I am �icenseU untler pmvision ap�er cam encing wii� Seciion 7000� ol Diwsion 3 0l t�e Business an� Pmlessions de. antl my license is in full larce a 0 elle ciTvuc.:�3a321 STATELIL.:3E+ 956� 'ss:� Daie: ._� ^Q�� Signaiu WONREBS' COMPENSRTION �ECLAflATION: I hereby a��irm thal ave a cenific ConSe o 5ell�in ure or a cetliliw�e ol Worker5' Campensation Insurance. or a certtlietl coDY ��ereot�Section 3800. LaD. C1. POIICY NO.: E%P. ORTE: COMPRNY: � Cenifietl capy is �ere�y WcMshed. ❑ Ce0.ilie6 wpY �s hletl wit� the city Builtling Oivisian. Date: � ADDlicam: E%EMPTIONFBOMWOBRfNS'COMPENSATION BATION: (Thisseh neednolbecomplete'H per �isforon hunUrea($11p�orle55). I ceriity �ha� in t�e perlormance ot the work whiCh Ihis permi� i5 i55u , all n0 any r5 n in any anner 5o a5 to heCome SUGIe�� e VJo�kers' CamDenCs�atian Laws o alilornia. Oaie: � � � — / SignaWre. ��" NOTICE: If, afier making Ihis Declaration. y0u S�oultl Gecame SUGjett lo orke ' mpen ian pmvi5ion5 0l the Labor Co�e. yrou must bn�vnt� comply vn1A sutn pmvisions or I�is M�mil s �e deemed revokea. CONSTflUCTION LENDING AGENCY' I Aere�y all rm Iha� ihere s a conSlmcti0n lentlin r the pedormance ol lhe work lor which ihis permit is issueQf$q�l � LENDEN: AOUflESS: OWNEB BUILOEN OECIANPTION: I hereDy aifirm t�a� I am exempl �mm the Conlraciors' Slate License Law for I�¢ I011ovring reason (Seciion 7031.5 Business an0 Professfonal CoOe: Any city ol couniy w�ich re0uire5 a permii �a wns�mct, al�¢r, impmv¢, Oemolish, or r¢paii any stmcture. prior to its issuance, atso repuires tne aD0licanl �or such permil 10 lile a signeA statemenl that he/s�e is IicenseJ pursuan�tol�e pwvisions olthe Contractars' $lale License Law�C�ap�e�9l�ammencing with Seclion 7000)0l Division 3 olihe Business antl Pmlessions Cotle) or iha� helshe is exem0� ��erelrom an0 Ihe basis lor I�e allegea exemp�ian. Any violation ol Seclion 7031.5 by any applicanl lor a permil su01e��5 ihe applican� to a civil penalty U� nol more than live huntlreC dallars (5500�. I, as awner oi me o�oPeny or my employees wilh waAes as Iheir sole comDensa�ion, will Ao t�e work, antl the ❑ 9mclure is nat intenEed or aflerea �or sale (SetliOn 70C4. Bu5mei5 anA Pmle55ional COJe: ihe ConVatior5' Sla�e LiC¢nse Law Ooes noi ap01y lo an owner o� a prOperiy wM builGs ar impmve5 ihere0n, antl w�o Eoes suc� xrork himsel�/hersel� o� through his ar her own emDloyees. proviEeG Ihal suc� impmvemenls are nol intentleE or otlere0 lor sale. I1, however Ihe building or im0�ovementi5 soltl within one year ol com0telion. t�e owtler will �ave Ihe Ourden of D�oving �e/she tliU nol build o�impruve for �ne ourpose ol salel. I, as owner ol IOe pmpetly, am eeclusively conVacting wiih licensed coNractors to conslmct t�e pmlect (Seclion 7044, Business ❑ ana Pr0fes5ions Code: The ConVacmrs' State License Law UOes nol apply lo an owner o� prapetly who builtls or im0��'es �hereon antl w�o contratls br such pmletls wit� a caniractm�s�license pursuan�lo ihe Cantra[lors' Slate License Law�.l am aware Ihat O�oo� o� Ueir Wo�ker'S Campensation insurance should �e pmvitle0 �o me. � I am exemp� untler Seciion: B. 8 P. G lor Inis reason: Da�e: Ownec I Oo hereby cetlily thal I am aware ol antl unGerStanG ihe reqwremen�s ol Catilomia Healih antl Safe�y Catle Sections 25505, 25533, ane 25534 antl tnal I or any lulure �uil0ing acuoam wilVvnll no� Icircle one) neea to campry witn uia slale fA0e5 anA Ihe reQuiremenis for a permii lo� tOn5lmtiion or mOtli�itatian Irom �he Aii Oualiiy Manag¢Rienl USIri[I. Ne9Gen�ial canSlmtiion aDPlitdtions aR exempUrom mese v��ons. �ate'. ADplicant: I hereby cetlify lhai I have reatl this applicalion ana ' inlormation is carrecL I agree t om ly wiih all cily and counry ordinances an� slaielawsrelatingto building cons�i �clion an0 hereby aulho .represenlative is ciiy a enier panihe abaue-mentioned 0�aperry �arinspection purposes/. � Oate: CI � 2 —7 � Signa�we: � o�iver's License or Social Seariiy +: i64i-a6 W�ne—BwlGing: Green—Cotle Enbrcemenl: Canary—qpplicanL Pink—Revenue; Goltlenroe—Assassar CITY OF COSTA MESA - BUILDING PEkM.IT PEkM NO; � 063288 PEkMIT NO; B 063288 PLAN CHECK NO; N GOVT; N SOPP; N CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION ; T/OFF, REROOF W/CLASS "A" CONP SHINGLES SQ FT: 1.,600 CLAIM VALUE: 2,600,00 CALC-VALUE; 2,600,00 GROUP OCC; R-3 /M-i COMMENTS• SMOKE DET'EC7'ORS RE�UIRED PER 1991 UHC REROOF 2400SF RESID 6 GARA �tx��r*�txx*��e**�x�x�x��rx�*��xnx �r*�r�r*x��rn�*#*��#x-3�xx��r��rx*x�r�*xux�rt # u�.• �n /� p 2 O N I N G R E Q U t R E M E N T S �� EV�v�? ------------ MAI,U HUILDING _____S-E-T B A-C_K_S-_- ACCESSORY ��JTLD.Y7F.Q�� FRNT; FT IN REAR; FT IN FRNT; FT IN Rn�; FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARRING REp • PROV; PARCEL; 14116514 ZNE; REF NO; PI;AN[3ZNG Nf3TES> `' k# IE-1f� 3f IE IE iE �1E if fE ik iE if iE i(� N� # 3E 7f # it fE # i(� k ik if it # 3E-%- 3E ### iE X� fE !t �lE �K� IE iE Ik iF # i(� N-iF 3f fE!(� IE # if IE iE �IE # i!� fE ## iE # if'1F fE #iE iE iE ih �%� iF iE # fE D E V E" L O P M E N T S E R V T C E S R E Q IJ I R E M E N�"P S ZONING APPROVEb�BY DATE; BUILDING APPROVED BY ; DATE; �` APPLICATION IS§[JED BY: � DATE: R.L 2� itlfNiFiE%%iEiEit�lE%7tieifi63tiEiE%%�iFiF7fiFSFiF3F�FiGiFiFtF3F7FiF3F3CR'-R�it 3'f �FZF�Ffirit�TF'iFitiFiF£ifit%�)FiEit�lk�N��iEiE�e�rp�• x trir ��16N� 3h IE fE IE If �lE rt it iE )f �E ik iE fk'iF1E %!f iE iP iE fE %if iE N� k ik �1EiF 3E-lE %!f k if� iE if if� # fF i(� iE 1f� )f # 1! iF M� # k iE il-iE 3E �1f IF �1- fE iF iF i! lf I(� if� it fE �161%i(� if If �f ik if�iE IF )f if LEGALIZATION:N F� B S � M M A R Y STRUCTURALiSEGMENT:Y BLDG PMT PLUMHING ELECTAIC MECHANIC FIRE SMIP/RES. GRADING PERMIT 59,00 50 PLAN SMIP/NON:RES ISSUE 3.�E:E BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID � DUE TOTALS----> 54,50 0,00 0,00 59.50 54,50 ' .UO REVENUE DIVISION TUTALS--> COLLECTED; 54,50 UVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 59.00 ,50 if f! k# iFlE if �lE M lE %� ft fE i! %� M� k k 3f -1E iE il� ik iE it iE i!� ff i! it iF if 3E # 1E k iE f! if� iE # ft iE �)f 1(� k 1! iE iE iE fE iE it if 3ElE iF iE k k%� iF i! ik i(-iE it iE i�` fh ff iE iF 3E iE if ik !E if I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C K I P T I O N UNIT COST �?OT'AL COST SFH 2600 REROOfi BY VALUB RESIDENTIAL NOZONE 1.00 '� 2,6�0,00 END OF' FEES OI �0144012-00144Dt3 T C�T 54.50 �ATE� 08/D:/93 TI17E: 13:?E , -- ---- CONS7RUCTION AND PLANfdING APPROVALS Permic;;- 1. Temporary Electrical Serv�ce;or Pole 2. Sod Pipe-Undrgmd. ' 3. Eiectncal Co�duit Uti��tV•Und,rgrnd. 4. Electrical Condwt�Undrgmr!. 5. Stael Reinforcemen• � Eir.cVical UFEFl GrnA 7. Footings 8. Foundation 9. :",ate� P�p2�Ur.c�y�rd. 10. St ucturat Floor SVs!e�^ ! , 17. Property Seever Line & Hau52 �;qnnection 12. Se:ve� Cap • 13 Aaof Dra ns ___ '` 14. ROu�h P{umh�n� _ - _ ' 15. Rough Elcctncal�ConOu.t ' - 16. Roug� EI^c!nc!7lrino 77. Rough !'J rrg Sign 16. Rough ElectricabT Bar G �i�nq �19. flo��h Ncsting & A�r Car6�t�on�ng 0. Ro�gh Facta�y F�rep'ac 7.7. Ducts, in Structure 22. Ducts, Vuntilating 23. Gas ?��ac-Fouqh fa ?est �4. Raaf Faming - 25 Roof Sheatnmg 26. T�Bar Ce�ling ISt�u�tu*��' � ��o:�ocoat � 27. Frame and Fla;hin� __ _ � 28. Lathing & Sdiny 7.9. Insulation 30. Dryc✓a!� Na�ling �_ _ 37. Plaeter 6�o�m Coat _ __ 3?. Electrical Power Mete�_F_�,el _ � 33. Final Elect� c 34 Final He�Lnu $:.1 � C�"- tiun,:.� -- 35. Final Gas Pipc�Te;t 36. Hood or Canopy � I 37. Firal Facto�v F�r:�p�acz � -- - - ---- - 38. Final Plumb�ng _ 39. \4'ater Sen'ice�Firal 40. GasSery.ce�F.n>! 41. S�;a• Oomt::icfir.c'----- 42. Backflov� Preventer � 43. Backflovi Irr;n,aTo� �� ti4. �ar.d5c:.p:Irr�q�:�c�SYst�rt, � 45. Sound Attenuat�nr 46. Handicap Regulat;o�i 47, FUJAL STRUCTUHE n ��LDING 48. F;yALPLA\iIP!G a9� Electric Relcase to Ed�sorr - 50. Gas Release to Soujbem C�hfo�nia Gas ( 51. CERTIFICATEOFOCCUPARCY Date PO(. . SPA Date lospector qpPROVALS Permic #f 52. Pooi & Equipmen[ �ocalio�� l 53. Ste21 Reintorcemrnt 54. Fo.ms 55. Electrical Bnr�d�ng • 56. ^o�gh't�mbing & P�essure Test G!/ 0 5i. F�PPFlO'JFL TO CO�:EP�GI��'�' 'e �� 58. E�ectnca! Cordu��t�Undre�ne. 59. Ga, P�pe, � U�u. pr^d . Test Date I inspector c;l. E'c'cr::sn t..rc,, v...s:r.:_: �ro�..r �,�. � I - - --� - '-r..--' - - 61. AFPftOVAL TO L'ECK � ' _ i -� 62. �acinv&sh & Rernptcr Finai � I --- ---t--- � 63. Hcater 8 Veni-F�ra' F 64 P:��nu�^9 Syc:cm F�^at �--�- -� � 65. E:ectrical�F.�al �,� _ ti 66. Salar Svster�-F�.r;,� ��- - ---�---- - --i-- - . . 67 Frcc.ng & Acuc�, Ao.^�u.�� ' � fi8. APPRUVEDF07'LASTERi�tiG � � __ � ___ 69. POOUSP�I SYSTEl�15 f1NAL _� FIREDEPT.REQllIREP.�iE�d� i APPpOVALS Pcr.-n�.! .�-- '� 70. Undxrground Hti�:,o --- -� 71. Pruduct P'n;n9 '; Gas � O�' 72. Undvrg,ac�,,� Fius'- --- %3. Underg;nd.Sturt�i i.:^.!«.Gae .-'GI � 74. Overhead HycJro __ _ ' _ 75. D�Y Chem�cal - 76. D.y Stam,ip��F-- --- _ . 77. FIXED SYSTEA.A FiNAL , 7B. FIRE PREV. PIfJL,L _ __ _- HEALTH DEPT. REQUIRE':4E�l�i _ 72 FIiVAL I�iS"ECTION � 90. FOOD C"tRTIFIC�"�E �SSUCD _ _�__ � _ R oT_>: �e Final or )N OF WORK ] VALUE; TYPE SUBCONTR,ACTOR � Date :. . ' _-.' ' COSTA MESA BUILDING-SAfETY DEPARTMENT P.O. BOX 1T00 COSTA MESA, CALIFORNIA 92626 Far Appficant fo Fill In Completaly TYPE OR PRINT wooResa O\\ c cok COSTA ME3A. CALIFORNIA � .�,e �u��:.0 :. '.� .T,C.,�' — n.\'l1= NL-7-66 00 258A3*T�***3.00 ��] �J APPLICATION FOR PERMR BUILDINf3 for OffJce Uae Only 11[C[IPT HO. �CPMIT NO. 1 . ZONIN(i ( � � � xo. or •�/ uaa o� Hcw ' �Q G � rux� ew�oino , � . L a � 9 / 1�0� �-3 � / . � , ,, �°�:..�� CITY c� � r � � � � �� fffATfi T64 ,�_ LIC. NO. NO. 81ZE j J f � xo.o� OFLOT L�� I� b� �' noWOI F� USEOF \\ .._ DESCRIPTION OF WORK >.Or 1 YTORI[Y ' �MH ROO� _ , . 1 HCREBY ACKNOWL6D0[ TMAT I XAV[ RlAD TN19 APPLIGTION AND 9TAT8 THAT TN6 ABOV6 It CORR6CT�AND AO0.H[ TO COM• PLY WITX ALL CITY OpDINANCO AND BTAT[ LAWY R[OULATINY CUILDINOCONOiRY O BIGNATUREOP �� PERMITf6� AUTNORIZ¢D AO[MT YARDB MPROV HD MAIN BUILDINO IOM C/L IITR[LT ) vwn. 4C -/la.5 ^ NQ BHALL BH YARUS MPROV BG ACCEi80RYBUILDINO DATH 3 er ----- / re '10 " ! a W � � BQ.FT. g TX6 wXOUM GNOWN UNOBR VALWTIOn te �Oa TH¢ j �llpPOOt OP [BTABLIBX�NO w P6RMIT PHe oNlr. :y VALUATION � � �Q � PERMIT FEH p G s�6 w OWNER Q, T. Clark �p'k 2 195�. DATE 6-30-5� JOB AI?DRESS 3011 Donnvbrook Lane BUILDING PERMIT NO. %0%4 � GENERALCONTRACTOR �eT' VALUE$ 620�00 - J INSPECTIONS 1 Final LOT 91 TRACT 23141 FIRE ZONE DESCRIPTION OF WORK Slab poured -roo£ over labe TYPE 5 ZONE PLAN NO. t� I DATE I I PERMITSISSUED "\ SUBCONTfiAGTOR DATE I NUMBER � � coat sTE v.i , �� o�� COSTA MESA BUILDING DEPARTMENT P. O. BOX 31� COSTA MESA, CALIFORNIA FOR MAI� AODRE55 cirv � 3 ARCHITECT OR ENGINEER AO�RE55 LEGAL L� OESCRIPTION �.f( A.P. NO. / � SIZE OF LOT USE OF E%ISTING BLDG TO FILL IN COSTA MESA. CALIFORNIA TEL. NO • LIC. NO. QTY LIC. NO. � INO.OF BLOGS. �:�� C'r��lED �. ;i�c.� c� � 6�3a�� FINRNCE DEPT. CIiY OF COSTA MESA APPLICATION FOR PERMIT BUILDING F�OR OFFICE USE ONLY � acc[i r rvo. nMMtiwn.. ar o.l [/ / / � l�J O I COSTA MESA. CALI I_� DATE ION SETBnCN LiNE :'wOM � � � c/ �� '%' / � c[Nien oF srn[Er REAR YARD J //� `� i i SIDE YAftD RIGHT LEFT DESCRIPTION OF WORK j. " NEW ALTERATION AODITION " REPAIR MOVING DEMOLISH PLANNING DEPT. ' BUILDWG No.oF � � SUBJECT BLDG. DEPT. RE6. i SIZE I� � � ROOMS STORIES COVERIINGWALL/�/n��•L COVOERING �C� � use oF New pLAN TiCH. BUII. ING � C� /� � C�Ki / � • O G � I XEREBY nCl(NOWIEOGE THAT I MAVE RE4O THIS >PPLIC ION PNp STf�TE THPT THE 1BOVE IS CORnECT RNO AGFEE TO COMP WITH r1LL CITY ORDINervCES nND STATE LMNS REG L4T G BVRD� G CONSTPUG norv. VALUATION SIGNATURE OF O� PERMiT FEE S � � A PERMITTEE � � � $ ^ �� f ry AUTN01t¢e� nGENT TOTAL FEE S�'�� °'�� OW NER College Mesa Co. DATE 9/21/55 JOBADDRESS 3011 Donnybrook Lane BUILDINGPERMITNO. i1j(� �=�NERALCONTRACTOR {jp�p (�� VAWE $ R /1nn�� LOT '� 91 BLOCK TRACT 2�µ1 GROUP I INSPECTIONS Footing Trench Foundation Forms and Grade to Rough Framing _ Plumbing, Rough to Slab Plumbing, Rough Complete 1 Temporary Pole Wirinp, Rough Heating, Fi Sewer, Hou � cTanl L__.�ina. In Plumbing, Final, Flxtures Plumbing, Final Gas Test W iring, Final Occupancy b'orm 210 G-H 15001-5f St. '/ ZONE �`4 DATE I SUBCONTRACTOR -oe ¢I _ , FIREDISTRICT 12370 PERMITS ISSUED DATE I NUMBI �Costa Mesa Building Department 1yn APPLICATION FOR P1:liMl� �� 171 EAST 20th STREET �_S /�/ g U I L D L N G COSTA MESA, CALIFORNIA � FOR OF�ICE US� ONLY FOR APPLICANT TO Y'ILL IN � e.,.e�.,. N„ � e..�.�. ti. Cross St Owner Mail Address Costa Mesa, California Haker BUIIfllflg - � �`�JJ � Address Costa Mesa, California ;g Nearest Tel. Cross St. No. Le.9-2158 zone n.1 . I No. ot I 7vae � Fiesa Grove adaress43 llalaRa Cove P1aza�Palos Verdes City Lia contraccor The Hale Comnanv rvo. 3422 Address 8002 Central Ave.� Gardea Grove , Legal Lot I Description No. 91 Block I Tract 2.i47 Size of Use oT SideYard 8� Adtlition Rooms R SWries Date CORRECTIONS Covering Stucco I Covering Eock ApPROVALS Use ot New Building Foundation Locatian Inspecto Farms, Materlale, attached 3I'a Q Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby acimowledge that I have read this Application and state that the above is correct and agree to cromply Lath. Int. with all City Ordinances and State Iaws regulating building construction. �ath. Ext. Signature of � Permittee THE f1A � Plaster, Int. Authorfzed Agt. �1 ' �i G OJt_. Plaster, ExL SILVIA LARDNER Valuation 0/ Pe�mit Fee $ .� •� Masonry ReinToroed � 6 Plan Check $ � • � $ � Total ^ Bond Beam Fee $ -F..�./ FINAL FORM 2M S-BP �S 8-SS Data �. u c J C a` IStreet PLOT Pi.AN • Show Iowtion and distancea irom property line and between buildinga cnsra SEP 21 -SSPUuesn 564i �`'�:��t:?3.(14 � 0 _.